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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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Late Toxicity of Radiotherapy in Prostate Cancer - Clinical Aspects
Vlková, Jana ; Odrážka, Karel (advisor) ; Kubecová, Martina (referee) ; Šlampa, Pavel (referee)
Late Toxicity of Radiotherapy in Prostate Cancer - Clinical Aspects. (Influence of Hormonal Therapy on Chronic Gastrointestinal Toxicity in Prostate Cancer Patients Treated with Intensity Modulated Radiotherapy) Besides dose escalation, hormonal therapy is the second factor that can prolong survival in men with localized prostate cancer. The aim of our study was to investigate if hormonal ablation influence the incidence of chronic gastrointestinal (GI) and genitourinary (GU) toxicity in men treated with radiotherapy. Materials and methods: We evaluated data of chronic toxicity in 320 men irradiated by 3D-CRT technique with a dose of 70 or 74 Gy and 233 men irradiated by IMRT with a dose of 78 or 82 Gy. Toxicity was scored using RTOG and FC-LENT criteria. Results: There was no difference in chronic GI or GU toxicity if we evaluated all the patients together. Also no significant difference was observed in the 3D-CRT group, we have only noticed a tendency to higher incidence of GI and lower incidence of GU toxicity in men with hormonal therapy. In the IMRT group, there was no difference in GI toxicity, but GU toxicity G3-4 was significantly higher in men with hormonal therapy (p = 0.045). If we evaluated separately neoadjuvant and adjuvant hormonal treatment, there were lower GU toxicity in...
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Late Toxicity of Radiotherapy in Prostate Cancer - Clinical Aspects
Vlková, Jana ; Odrážka, Karel (advisor) ; Kubecová, Martina (referee) ; Šlampa, Pavel (referee)
Late Toxicity of Radiotherapy in Prostate Cancer - Clinical Aspects. (Influence of Hormonal Therapy on Chronic Gastrointestinal Toxicity in Prostate Cancer Patients Treated with Intensity Modulated Radiotherapy) Besides dose escalation, hormonal therapy is the second factor that can prolong survival in men with localized prostate cancer. The aim of our study was to investigate if hormonal ablation influence the incidence of chronic gastrointestinal (GI) and genitourinary (GU) toxicity in men treated with radiotherapy. Materials and methods: We evaluated data of chronic toxicity in 320 men irradiated by 3D-CRT technique with a dose of 70 or 74 Gy and 233 men irradiated by IMRT with a dose of 78 or 82 Gy. Toxicity was scored using RTOG and FC-LENT criteria. Results: There was no difference in chronic GI or GU toxicity if we evaluated all the patients together. Also no significant difference was observed in the 3D-CRT group, we have only noticed a tendency to higher incidence of GI and lower incidence of GU toxicity in men with hormonal therapy. In the IMRT group, there was no difference in GI toxicity, but GU toxicity G3-4 was significantly higher in men with hormonal therapy (p = 0.045). If we evaluated separately neoadjuvant and adjuvant hormonal treatment, there were lower GU toxicity in...
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Molekulářně biologické změny u karcinomu endometria
Dvořáková, Eva ; Špaček, Jiří (advisor) ; Odrážka, Karel (referee) ; Sláma, Jiří (referee)
Molecular biological changes in endometrial carcinoma Endometrial cancer is the most common cancer of the female reproductive tract. The incidence has increased with lifestyle and environmental changes. Similar to other cancers, endometrial cancer has been shown to be a complex disease driven by different factors, including genetic and epigenetic alterations. Understanding these changes underlaying cancer development or progression is important for finding of new standards for both diagnosis and therapy of individual patients. The aim of the study was to evaluate selected molecular biological changes in endometrial carcinoma comparing to non-neoplastic endometrium. The first specific aim was to compare presence of K- ras mutation in early stages of endometrioid type of endometrial carcinoma with normal endometrium, and to evaluate association to clinical-pathological characteristics (tumor stage and grade). We analyzed 79 samples of endometrium (59 samples of endometrioid endometrial carcinoma stage I, and 20 samples of normal, non-neoplastic endometrium). Detection of K-ras mutation was made by using of K-ras StripAssay™ (ViennaLab Diagnostics GmbH). The frequency of K-ras mutation in the carcinoma group did not differ from the group of control samples (24% vs. 15%). No association between K-ras...
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Thoracoscopic chemically induced pleurodesis in the treatment of malignant pleural effusion as a model of general and local inflammatory reaction
Habal, Petr ; Manďák, Jiří (advisor) ; Schützner, Jan (referee) ; Odrážka, Karel (referee)
Thoracoscopic chemically induced pleurodesis in the treatment of malignant pleural effusion as a model of general and local inflammatory reaction Petr Habal Summary Continuous formation of malignant pleural effusions causes metabolic and mineral disruption. Large effusions gradually compress the lung parenchyma. The result is an increasing shortness of breath. Prolonged compression of pulmonary parenchyma also causes atelaktasis which may then cause an inflammatory process of the lung parenchyma. An effective method of palliative treatment is a chemical pleurodesis, which is used in selected patients as a second line of palliative cancer treatment. The principle is to eliminate the space between the visceral and parietal sheets of pleura by inducing aseptic inflammation. The most effective way of application of chemicals is via videothoracoscopy. The advantage is the possibility of drainage of pleural cavity and application of talc powder. Pleurodesis has been used for many years, but there is a lack of objective assessment of the overall and local inflammatory reactions, by which the body responds to foreign substances. In a group of 47 patients who were treated at our department in the period between January 2009 and December 2010, 29 (61.7%) were men and 18 (38.3%) were women with a cytologically proven...
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Radiochemotherapy with weekly cisplatin in the treatment of head and neck cancer
Pála, Miloslav ; Odrážka, Karel (advisor) ; Soumarová, Renata (referee) ; Klozar, Jan (referee)
Radiochemotherapy with weekly cisplatin in the treatment of head and neck cancer. Purpose: The objective of this study was to evaluate the feasibility, toxicity and efficacy of postoperative and definitive radiochemotherapy with weekly cisplatin in locoregionally advanced or high risk head and neck cancer. Material and methods: Patients with head and neck cancer of stage III-IVb or patients with insufficient margins of resection after initial surgery were included in the study of postoperative radiotherapy. Radiotherapy consisted of 70 Gy/ 7 weeks/ 35 fraction after R1/2 resection and 60- 64 Gy/ 6-6,5 weeks/ 30-32 fraction after R0 resection, respectively. Patients with head and neck cancer of stage II-IVb without initial resection were included in the study of definitive radiochemotherapy. Radiotherapy consisted of 70 Gy / 7 weeks / 35 fraction. All patients received concurrent cisplatin 40 mg/m2 weekly. Results: Postoperative radiochemotherapy: Between 6/2002 and 12/2008, 100 consecutive patients WHO 2, male to female ratio 84/16, median age 54 years were treated. Tumours of the oropharynx were the most frequent (49%) and stage IV was predominant (86%). 96% patients received the full radiation treatment as planned. Median total tumor dose was 66 Gy. Omission of weekly cisplatin had been...
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Simultaneous integrated boost in the treatment of localized prostate cancer
Doležel, Martin ; Odrážka, Karel (advisor) ; Šlampa, Pavel (referee) ; Kovařík, Josef (referee)
The purpose of my doctoral thesis was to compare acute and late toxicity after three-dimensional conformal radiotherapy to the prostate to 74 Gy with intensity-modulated radioterapy (IMRT) to 78 Gy and IMRT using simultaneus integrated boost to 82 Gy. Ninety-four patients treated with conformal radiotherapy to the prostate and base of seminal vesicles to 74 Gy represented the first group. The second group consisted of 138 patients irradiated with IMRT covering the prostate and base of seminal vesicles to 78 Gy. The last group was treated with IMRT using simultaneus integrated boost. The prescribed doses were 82 Gy and 73. 8 Gy in 42 fractions to prostate and to seminal vesicles. Late toxicity was prospectively scored according to the RTOG/FC-LENT scale. Acute gastrointestinal toxicity Grade 2 or greater occured in 35.1% patients treated with 3D-CRT, 16% with IMRT 78 and 7.7% using IMRT/SIB 82. Acute urogenital toxicity Grade 2 or greater was presented in 26.6% (3D-CRT), 33% (IMRT 78) and 30.7% (IMRT/SIB 82). At 3 years, the estimated cumulative incidence of Grade 3 late gastrointestinal toxicity was 14% for 3D-CRT, 5% for IMRT 78 and 2% for IMRT/SIB 82. The difference became significant (log rank p=0.02). The estimated cumulative incidence of Grade 3 late urogenital toxicity was 9% (3D-CRT), 7%...
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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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