Prostate cancer review article 2019
Article Introduction Several previous prospective randomized trials and their meta-analysis proved that in the treatment of breast tumours, radiation therapy is an important part of breast conserving therapy. Breast conserving surgery and the subsequent irradiation of the remaining breast tissue ensure the same survival rate as radical breast surgery.
In our previous paper the dosimetrical differences of the external beam and interstitial brachytherapy for APBI were evaluated. In a phase II sequential trial was launched at our institution.
Patients prostate cancer review article 2019 methods Patients For this study 40 patients were selected, who were previously treated with early-stage invasive breast cancer at our institution between and in a phase II APBI trial.
The trial was registered at ClinicalTrials.
Bevezetés: Az utóbbi években az oligometastaticus prosztatadaganatok kezelése során a szisztémás kezelés mellett egyre gyakrabban végzik a primer tumor lokális kezelését is. Célkitűzés: A szerzők a tanulmányban a cytoreductiv radikális prostatectomia szerepét vizsgálták az oligometastaticus prosztatadaganatok kezelése során. Módszer:
During breast-conserving surgery titanium surgical térdízületek ízületi gyulladása az okok kezelés were placed in each patient to mark the boundaries of the excision cavity, which increased the accuracy of defining the resection cavity and consequently the planning target volume PTV.
Around both breasts and on the surgical scar metal wires were placed to increase the precision of contouring. CT scans started from the mandible and included the complete volume of the lungs and the volumes of both breasts.
The most crucial part of partial breast irradiation is the exact localization of the excision cavity. Using titanium clips and the 3 mm thickness of coxarthrosis slideshare planning CT slices, the borders of surgical cavity could be defined in accepTable precision.
Results During the 4-year period of —, mean weekly all-cause mortality varied between 3, and 2, in Hungary Figure 1with higher numbers in the early weeks of the year and in the fourth quarter Q4, highest ízületi kezelés mildronát 3, deaths in week 5,and lower mid-year numbers lowest number: 2, deaths, week 28, In the first 11 weeks ofweekly mortality was lower compared to the — average of the same period difference was not significant Supplementary Table S1while there were no relevant differences from week 12 to week On the other hand, the number of weekly deaths exceeded the average of the preceding 4 years starting from week Between weeks 42 and 52, significantly higher weekly mortality was recorded in Hungary than in the reference period of — Cumulative all-cause excess mortality was lower until week 44 inthan the mean cumulative excess mortality of the — period Figure 2corresponding to fewer Hungarian deaths from week 1 to 44 in than in the previous 4 years.
In the first step of target volume definition, the tumour bed was contoured by the radiation oncologist based on the seroma and the surrounding clips. In the second step, on the basis of the intact surgical margins and pathological results, it was expanded in 6 directions with margins of different size to define CTV. The minimal and maximal value of the extension between the tumour bed and the CTV was 5 and 18 mm, respectively. As the skin is an organ at risk during partial breast irradiation, a 5 mm thick volume of the skin was cropped from PTV to create PTVeval.
Heart, ipsilateral and contralateral breasts and lungs, non-target breast were contoured as organs at risk.
Non-target breast was created with the extraction of PTV from ipsilateral breast. Planning purposes To make the techniques comparable, the same target coverage was achieved for all plans.
These requirements were fulfilled in all of the plans. Planning The 3D-CRT plans were created with 4 or 5 wedged conformal non-coplanar fields from tangential directions Figure 1.
Avoidance sectors were not applied, only strict constrains were given for ipsilateral lung, heart and spine. All plans were created for linear accelerator equipped with 5 mm wide MLC and 6 MV photon energy was used.