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The time factor in radical radiotherapy of head and neck tumours
Lohynská, Radka ; Stankušová, Hana (advisor) ; Klozar, Jan (referee) ; Feltl, David (referee) ; Odrážka, Karel (referee)
The impact of waiting time and overall treatment time on locoregional control and survival in normofractionated radical radiotherapy for squamous cell head and neck cancer was evaluated. There is evidence for decreased locoregional control of missed radiotherapy treatment days (one week prolongation amounts for 7-10% loss of local control). There are three main compensation methods for treatment gaps (1. weekend treatment days and two fractions per day to catch up; 2. retain overall treatment time and increase dose per fraction; 3. accept protraction and give extra fraction to compensate for gap). Powered by TCPDF (www.tcpdf.org)
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The impact of PET/CT scanning in the radioteraphy planning of non-small cell lung cancer
Vojtíšek, Radovan ; Petera, Jiří (advisor) ; Feltl, David (referee) ; Zemanová, Milada (referee)
The impact of PET/CT scanning in the radiotherapy planning of non-small cell lung cancer Background: In the current practice of radiotherapy planning and target volume determination in patients suffering from the non-small cell lung cancer (NSCLC), a contrast-enhanced CT is standard procedure. Contemporary studies have proven that PET/CT examination attains higher sensitivity and specificity in the diagnosis of lung cancer and also leads to higher accuracy in the process of target-volume delineation in NSCLC. Aim: To compare radiotherapy plans made according to CT and PET/CT examinations in the same patient and to investigate the impact of changes in target volume sizes on tumor control probability (TCP) and normal tissue complication probability (NTCP) and the impact of combined PET/CT examination on the staging of the disease and treatment strategy. Materials and Methods: Between October 2008 and November 2013, 42 patients suffering from pathologically proven inoperable locally advanced NSCLC that were referred to radical radiotherapy were involved in our study. They all underwent planning PET/CT examination. I carried out two separate delineations of target volumes and two radiotherapy plans, both with their own dose-volume histograms (DVH). I compared the following parameters of radiotherapy...
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Postoperative brachytherapy in the treatment of the early oral cancer
Tuček, Luboš ; Šimůnek, Antonín (advisor) ; Feltl, David (referee) ; Soumarová, Renata (referee)
2 Summary Purpose: Evaluation of the postoperative high-dose-rate brachytherapy (HDR BT) in the treatment of early oral cancer and factors influencing tumour control. Material and methods: Thirty patients with T1-T3N0 tongue and floor of mouth cancer were treated with tumour excision elective neck dissection and HDR BT 18 x 3 Gy bid. The Kaplan- Meier model was used for survival analyses and the log-rank test and Cox regression analyses were used to evaluate the influence of T-stage, histological grade, resection margin, depth of invasion, and vascular endothelial growth factor (VEGF) intensity on local control (LC), nodal control (NC), disease-free survival (DFS) and overall survival (OS). Median follow up was 40 months (6 - 145). Results: Actuarial 5 year LC, NC, DFS, DFS after salvage treatment and OS were 85.4%, 69.2%, 65.4%, 75.6% and 73.0%, respectively. The log-rank test and univariate Cox regression analysis revealed the following correlations: tumour grade correlated with LC, DFS and OS; T- stage with NC and DFS; depth of invasion and VEGF intensity with NC, DFS and OS. Associations detected on the multivariate analysis were as follows: tumour grade with LC; depth of invasion with NC; depth of invasion and tumour grade with DFS; and VEGF intensity with DFS after salvage treatment. Only one case of...
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Postoperative brachytherapy in the treatment of the early oral cancer
Tuček, Luboš ; Šimůnek, Antonín (advisor) ; Feltl, David (referee) ; Soumarová, Renata (referee)
2 Summary Purpose: Evaluation of the postoperative high-dose-rate brachytherapy (HDR BT) in the treatment of early oral cancer and factors influencing tumour control. Material and methods: Thirty patients with T1-T3N0 tongue and floor of mouth cancer were treated with tumour excision elective neck dissection and HDR BT 18 x 3 Gy bid. The Kaplan- Meier model was used for survival analyses and the log-rank test and Cox regression analyses were used to evaluate the influence of T-stage, histological grade, resection margin, depth of invasion, and vascular endothelial growth factor (VEGF) intensity on local control (LC), nodal control (NC), disease-free survival (DFS) and overall survival (OS). Median follow up was 40 months (6 - 145). Results: Actuarial 5 year LC, NC, DFS, DFS after salvage treatment and OS were 85.4%, 69.2%, 65.4%, 75.6% and 73.0%, respectively. The log-rank test and univariate Cox regression analysis revealed the following correlations: tumour grade correlated with LC, DFS and OS; T- stage with NC and DFS; depth of invasion and VEGF intensity with NC, DFS and OS. Associations detected on the multivariate analysis were as follows: tumour grade with LC; depth of invasion with NC; depth of invasion and tumour grade with DFS; and VEGF intensity with DFS after salvage treatment. Only one case of...
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Baseline Hematologic Parameters Influencing Outcomes in Patients with Locally Advanced Rectal Cancer
Hodek, Miroslav ; Petera, Jiří (advisor) ; Feltl, David (referee) ; Soumarová, Renata (referee)
Baseline Hematologic Parameters Influencing Outcomes in Patients with Locally Advanced Rectal Cancer Aim of the study: The link between the blood count and a systemic inflammatory response (SIR) is indisputable and well described. Pretreatment hematological parameters may predict the overall clinical outcomes in many types of cancer. Thus, this study aims to systematically evaluate the relationship between baseline blood count levels and treatment response in rectal cancer patients treated with neoadjuvant chemoradiotherapy. Patients and methods: From 2009-2015, 173 patients with locally advanced rectal cancer were retrospectively enrolled in the study and analyzed. The baseline blood count was recorded in all patients 1 week before chemoradiation. Tumor response was evaluated through pathologic findings. Blood count levels which included RBC (red blood cells), Hb (hemoglobin), PLT (platelet count), neutrophil count, WBC (white blood cells), NLR (neutrophil-to-lymphocyte ratio), and PLR (platelet-to-lymphocyte ratio) were analyzed in relation to tumor downstaging, pCR (pathologic complete response), OS (overall survival), and DFS (disease-free survival). Results: Hb levels were associated with a response in logistic regression analysis: pCR (p = 0.05; OR 1.04, 95% CI 1.00-1.07); T downstaging (p =...
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The impact of PET/CT scanning in the radioteraphy planning of non-small cell lung cancer
Vojtíšek, Radovan ; Petera, Jiří (advisor) ; Feltl, David (referee) ; Zemanová, Milada (referee)
The impact of PET/CT scanning in the radiotherapy planning of non-small cell lung cancer Background: In the current practice of radiotherapy planning and target volume determination in patients suffering from the non-small cell lung cancer (NSCLC), a contrast-enhanced CT is standard procedure. Contemporary studies have proven that PET/CT examination attains higher sensitivity and specificity in the diagnosis of lung cancer and also leads to higher accuracy in the process of target-volume delineation in NSCLC. Aim: To compare radiotherapy plans made according to CT and PET/CT examinations in the same patient and to investigate the impact of changes in target volume sizes on tumor control probability (TCP) and normal tissue complication probability (NTCP) and the impact of combined PET/CT examination on the staging of the disease and treatment strategy. Materials and Methods: Between October 2008 and November 2013, 42 patients suffering from pathologically proven inoperable locally advanced NSCLC that were referred to radical radiotherapy were involved in our study. They all underwent planning PET/CT examination. I carried out two separate delineations of target volumes and two radiotherapy plans, both with their own dose-volume histograms (DVH). I compared the following parameters of radiotherapy...
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The time factor in radical radiotherapy of head and neck tumours
Lohynská, Radka ; Stankušová, Hana (advisor) ; Klozar, Jan (referee) ; Feltl, David (referee) ; Odrážka, Karel (referee)
The impact of waiting time and overall treatment time on locoregional control and survival in normofractionated radical radiotherapy for squamous cell head and neck cancer was evaluated. There is evidence for decreased locoregional control of missed radiotherapy treatment days (one week prolongation amounts for 7-10% loss of local control). There are three main compensation methods for treatment gaps (1. weekend treatment days and two fractions per day to catch up; 2. retain overall treatment time and increase dose per fraction; 3. accept protraction and give extra fraction to compensate for gap). Powered by TCPDF (www.tcpdf.org)
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