Letteratura scientifica selezionata sul tema "306.76/6"

<b><i>Purpose:</i></b> The aim of this study was to report the efficacy of combined intravitreal chemotherapy (IVC) and ruthenium-106 brachytherapy in retinoblastoma, either as first-line or second-line treatment, following systemic chemoreduction or intra-arterial chemotherapy. <b><i>Methods:</i></b> Retrospective data of 18 eyes from 18 patients treated with IVC and brachytherapy from August 2014 to December 2019 were collected. <b><i>Results:</i></b> The method described was our first-line therapy in 6 patients, whereas it was used as second-line treatment after chemoreduction in the remaining 12 patients. The eyes showed the following classification at initial presentation: 2 group B eyes, 3 group C eyes, and 13 group D eyes. The mean follow-up was 19.5 months (range 2–53 months). The mean patient age at brachytherapy was 34.0 months (range 15–83 months). The median prescribed dose at the tumour base and apex was 574.5 ± 306.7 Gy and 88.5 ± 12.2 Gy, respectively. The ocular retention rate was 66.7%. Six eyes had to be enucleated due to uncontrollable subretinal and recurrent vitreous seeding, tumour relapse, recurrence of a solid tumour elsewhere in the eye, and persistent vitreous bleeding with loss of tumour control. The mean number of intravitreal injections of melphalan was 5.0. Two patients received a simultaneous injection of topotecan for insufficient therapeutic response. With regard to radiogenic complications, we could observe temporary retinal and vitreous bleeding (27.8%), serous retinal detachment (44.4%), and radiogenic maculopathy and retinopathy (11.1%). None of the children showed metastatic disease during follow-up. <b><i>Conclusion:</i></b> Ruthenium-106 plaque therapy in combination with IVC is an effective local therapy with good tumour control rates even in advanced eyes. Overall, the analysed therapeutic approach shows an acceptable side-effect profile, especially when considering that external-beam radiation therapy and systemic polychemotherapy or at least the number of cycles needed, with their increased incidence of adverse events, can thus be avoided.

Abstract Introduction: The prognosis of metastatic breast cancer patients is improving due to advances in systemic therapy, which led to better control of the disease. Brain metastasis that requires whole-brain radiotherapy (WBRT) is mandatory for some patients.Acute alopecia is a common side effect, and total hair loss occurs in 100% of patients receiving parallel opposed direct laterals fields.Because of the recognized reduction in quality of life associated with clinically apparent and clinically undetectable hair loss, efforts are made to minimize hair loss resulting from WBRT.It is theorized that intensity-modulated radiotherapy (IMRT) may reduce hair loss. It will be less patchy because IMRT enables dose modulation, minimizing the radiation dose received by the hair follicles in the scalp.This dosimetric study assessed the dose received to the whole scalp and its subvolumes by three radiotherapy techniques. Methods: A total of 30 treatment plans for ten patients receiving WBRT were evaluated retrospectively. All patients were simulated in a supine position with a thermoplastic mask. The scalp was contoured as 5 mm between the skin and the outer table of the skull. Then we subdivided the scalp volume into superior, anterior, lateral, and posterior subvolumes. The dose prescribed was 30 Gy in 10 fractions. We compared three different radiotherapy techniques using the standard WBRT procedure that involves applying two lateral opposing fields (OF-WBRT) with a margin surrounding the brain, which includes the hair follicles situated about 5 mm. below the scalp, the field in field (FiF), and IMRT techniques without introducing the scalp in the optimization process using 6 MV photon energy. Results: All techniques showed comparable PTV coverage. The homogeneity index with opposed lateral was 0.057±.09, 0.057±.0111 for FiF, and 058±.0114 for IMRT with no statistically significant difference (p = 0.407).IMRT resulted in a marked decrease in all scalp parameters with a statistically significant difference, with a little difference in the dose delivered to lateral subvolumes. (table 1) Conclusion: Scalp sparing IMRT for WBRT reduces the scalp dose compared to conventional WBRT, especially in the superior, anterior and posterior axis. Further randomized prospective trials are needed to confirm this benefit. 2 Table. PTV coverage and dose to the scalp and its subvolumes.characteristicsOPPOSED LATERALFIFIMRTP-ValueMean ± SDMean ± SDMean ± SDAll groupsOpposes lateral/FIFOpposes lateral/IMRTIMRT/FIFPTV D 98%96.9±0.796.9±0.797.1±0.71.000Scalp mean dose (cGy)2165.7±270.52120.5±242.81385.9±306.7&lt;0.0010.076&lt;0.0010.076Scalp V 20 (%)68.4±12.567.1±11.237.6±11.2&lt;0.0010.221&lt;0.0010.042Superior mean dose (cGy)2396.8±138.92326.1±1211419.0± 372.4&lt;0.0010.076&lt;0.0010.076Anterior mean dose (cGy)2180.9±237.82209.7±205.01267.4±462.2&lt;0.0010.221&lt;0.0010.042Lateral mean dose (cGy)2127.7±252.62136.9±249.12071.4±257.10.0020.2210.2210.001Posterior meanDose (cGy)2317.8±205.62273.3±207.81467.2±209.7&lt;0.0010.0760.076&lt;0.001 Citation Format: Mohsen Samy Barsoum, Emad Mohsen Barsoum, Maha Kamaleldin, Niven Mahmoud, Shaimaa Abdelgeleel, May Gamal Ashour. Scalp sparing whole-brain radiotherapy using IMRT technique. Do we need it? [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P1-21-02.

ABSTRACT Background: Previous studies have shown that better glycemic control in type 2 diabetes mellitus (DM) is associated with fewer physical symptoms and better well being. The purpose of this study was to determine factors affecting the quality of life in patients with type 2 diabetes mellitus in Surakarta, Central Java. Subjects and Method: A cross-sectional study was conducted at Dr. Moewardi hospital, Surakarta, Central Java, from February to March 2020. A sample of 200 patients with type 2 DM aged ≥18 years was selected by simple random sampling. The dependent variable was quality of life. The independent variables were self-care, family support, peer support, length of disease, body mass index (BMI), and education. The data were collected by questionnaire and analyzed by a multiple logistic regression run on Stata 13. Results: Quality of life in type 2 DM patients increased with good self care (OR= 14.34; 95% CI= 1.47 to 140.06; p= 0.022), strong family support (OR= 21.52; 95% CI= 2.98 to 155.44; p=0.002), strong peer support (OR= 31.03; 95% CI= 3.14 to 306.78; p=0.003), length of disease <6 years (OR= 0.05; 95% CI= 0.01 to 0.45; p= 0.007), normal BMI (OR= 0.08; 95%= 0.01 to 0.60; p= 0.014), and education ≥Senior high school (OR= 11.76; 95% CI= 2.05 to 67.41; p= 0.006). Conclusion: Quality of life in type 2 DM patients increases with good self care, strong family support, strong peer support, length of disease <6 years, normal BMI, and education ≥Senior high school. Keywords: quality of life, type 2 diabetes mellitus Correspondence: Devi Marlina. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta, Central Java. Email: devimarlinaaa94@gmail.com. Mobile:+6281340983044 DOI: https://doi.org/10.26911/the7thicph.05.39