miércoles, 9 de septiembre de 2015

Stereotactic body radiation therapy versus no treatment for early stage non-small cell lung cancer in medically inoperable elderly patients: A National Cancer Data Base analysis.

Abstract

BACKGROUND:
Stereotactic body radiation therapy (SBRT) has demonstrated high rates of local control with low morbidity and has now emerged as the standard of care for medically inoperable, early stage non-small cell lung cancer (NSCLC). However, the impact of lung SBRT on survival in the elderly population is less clear given competing comorbid conditions. An analysis of the National Cancer Data Base (NCDB) was undertaken to determine whether definitive SBRT improves survival relative to observation alone patients ages 70 years and older.

METHODS:
The NCDB, a retrospective national database that captures approximately 70% of all patients treated for cancer, was queried for patients aged 70 years or older with early stage (T1-T3N0M0) NSCLC from 2003 to 2006. Overall survival was compared between patients who received stereotactic body radiotherapy alone and those who received no treatment. An extended Cox proportional hazards model was applied to estimate the treatment effect of SBRT.

RESULTS:
In total, 3147 patients met the selection criteria for this analysis. SBRT was elivered to 258 patients (8.2%), and 2889 patients (91.8%) received no treatment. There was no significant difference in the distribution of Charlson/Deyo comorbidity index scores between the 2 groups (P = .076). Multivariable analysis revealed improved overall survival with SBRT compared with observation for the entire cohort (hazard ratio, 0.64; P < .001).

CONCLUSIONS:
SBRT is associated with improved survival in elderly patients with early stage NSCLC who have concurrent comorbid conditions compared with observation alone. The current data support the use of SBRT for the treatment of elderly patients with early stage NSCLC who have limiting comorbid conditions.
Source:  2015 Sep 8. doi: 10.1002/cncr.29640. 

martes, 8 de septiembre de 2015

OPTIMIZATION OF CT/MRI FUSION AS A QUALITY STRATEGY IN RADIOTHERAPY


Planification of soft tissue lesions in radiation therapy is conditioned by the difficulties in contouring these structures in CT images, especially after surgical manipulation. It associates higher prescription volumes and more toxicity. We developed a planification strategy for superior extremity soft tissue lesions based on an immobilization system which allows reliable CT/MRI fusions in soft tissue lesions treatments.

Moldcare® ‐Alcare Co., Ltd.‐ and eXaFrame are a greate solution to allow perfect immobilization and get reliable CT/MRI fusions

http://media.wix.com/ugd/864ff5_e3b9c5c40fa74d52a3bafffb52b90d39.pdf 

domingo, 6 de septiembre de 2015

Stereotactic body radiation therapy for liver tumours: A review of the literature and recommendations


Abstract


Stereotactic body radiation therapy is a modern approach for delivering ablative high doses of irradiation in small volumes. This technique is being developed for the treatment of liver tumors, such as hepatocellular carcinoma, cholangiocarcinoma, or liver metastases. It represents a real alternative to surgical resection or liver transplantation when patients are inoperable or when tumours are unresectable. It is mandatory to standardize and simplify the current methods of evaluation and monitoring in order to benefit from a better understanding of the effectiveness and of the tolerance of this new treatment modality. Several scientific societies have recently proposed recommendations for the implementation of stereotactic radiotherapy for liver tumors. We conducted a literature review to provide recommendations for follow-up after completion of a stereotactic body radiation therapy for liver tumours.