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Three-dimensional conformal radiotherapy versus intensity modulated radiotherapy in the treatment of head and neck carcinoma
Jirkovská, Michaela ; Lohynská, Radka (advisor) ; Pála, Miloslav (referee) ; Mrzena, Lubor (referee)
The treatment of locally advanced head and neck cancer (LAHNC) requires a multimodality approach. Radiotherapy with combination of chemotherapy has demonstrated to be effective, however, the treatment intensification leads to increased toxicity at the same time. The implementation of "three-dimensional conformal radiotherapy" (3D-CRT) allowed to irradiate the treatment volume more precisely with better surrounding healthy tissue sparing. Intensity modulated radiotherapy (IMRT) facilitated higher conformity in dose shaping to target volume. IMRT with simultaneous integrated boost (IMRT-SIB) offered the possibility to deliver individualized dose levels within one fraction and enabled escalation of the dose per fraction and radiotherapy acceleration. The aim of our study was to compare the technique of 3D-CRT and IMRT-SIB in the treatment of LAHNC and evaluate the treatment outcome and the treatment-related toxicity. 262 patients in 3D-CRT group and 263 patients in IMRT-SIB group underwent the radical treatment for LAHNC between 1/1998 and 12/2016. No statistically significant differences in locoregional control (LCR) and overall survival (OS) were found between the two groups. Acute toxicity and xerostomia were significantly reduced in patients treated with IMRT-SIB. IMRT-SIB is a safe radiotherapy...
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Quality of Life in Patients with Head and Neck Tumors
Doležalová, Helena ; Šimůnek, Antonín (advisor) ; Kubecová, Martina (referee) ; Pála, Miloslav (referee)
2. Summary Quality of life in patients with head and neck tumors The prevalence of head and neck tumours constantly increasing in the last decades represents the serious medical and social problem. The retrospective assessment of the quality deals with the quality of life in patients with early stages of oral cavity tumours after the high dose rate brachytherapy treatment (HDR BRT). The quality of life has been evaluated in 14 patients treated at the Department of Oncology and Radiotherapy, University Hospital Hradec Kralove for early onset of oral cavity tumour using the high dose rate brachytherapy treatment. The standardized EORTC QLQ- C30 and EORTC QLQ-H&N35 questionnaires have been used in this study. The evaluation of the questionnaires was performed 12 months after the treatment. General health status using the EORTC QLQ-C30 was scored with 70 points. The most severe reported symptoms were fatigue, insomnia, loss of appetite, dyspnoea and financial problems. The main problems being identified by EORTC QLQ-H&N35 were weight gain, cough, pain, sticky saliva and social eating. On the contrary weight loss, speech impairments, difficulties in mouth opening, swallowing and sensory problems were not considered as significant ones. The quality of life in individuals treated with the high dose rate...
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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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