|
| |
|
| |
|
| |
|
| |
|
| |
|
| |
|
| |
|
| |
|
|
Toxicity of chemoradiotherapy in patients with head and neck tumors
TYLOVÁ, Pavla
Malignant ORL tumors represent about 5% of all malignant tumors. Especially smoking and alcohol consumption are major risk factors for tumor development. Among ORL tumors are usually classified those of oral cavity, tongue, nasal cavity, paranasal sinuses, pharynx and larynx. A standard therapy of locally advanced tumor stages of malignant head and neck tumors(T3, T4, N1-3, MO) consists in surgical treatment combined with radiotherapy alone or with radiotherapy with concomitant chemotherapy. A concomitant chemotherapy seems to be the perspective strategy in the treatment of advanced head and neck carcinoma stages. The primary tumor is recommended to be irradiated by a single dose of 2 Gy up to the total dose of 60{--}70 Gy. In case the tumor cannot be operated, the neoadjuvant chemotherapy (chemotherapy administered before irradiation) is indicated to prolong survival. Patients with a locally advanced tumor stage (stage III) show 5-year survival in 20-50 %. The aim of my work has been to evaluate the chemotherapy toxicity in head and neck tumor patients of the Department of Clinical and Radiation Oncology in České Budějovice and compare the toxicity data with those of the Hemato-Oncology Clinic of the University Hospital in Olomouc, the Department of Clinical and Radiation Oncology in Pardubice and the Department of Radiation and Oncology of the Faculty Hospital in Motol. I evaluated the changes in blood pictures at the beginning and the end of the treatment, mucositidis induction, infections of oral and nasal cavities, the necessity of treatment interruption or early termination, supportive treatment, antibiotic coverage and infusions. I studied head and neck tumor patients of stage III who underwent chemotherapy in years 2005-2008. Chemoradiotherapy toxicity which has been reported in professional literature does not differ from the toxicity I have found out within the group of 100 patients. The findings have been approximately comparable in tumor incidence between men and women, mucositis incidence and hematologic toxicity. There are some differences in antibiotic coverage and infusion administration among the departments.
|
|
|
Evolution of radiotherapeutic methods from 2D to 3D techniques in radiotherapy of the head and neck area
URBANOVÁ, Petra
Malign tumours of the ENT area rank fifth to sixth in the global occurrence of malignities. Two thirds of patients with head and neck tumours start their treatment with locally developed condition. In the Czech Republic, head and neck tumours represent 2 {--} 3 % of all malignant tumours. The most common head and neck tumours occur in the areas of larynx, hypopharynx, and oropharynx. In the everyday life, the face, head, and neck represent areas most exposed in external contact, perception, and control of oneself. The centres of mimics, communication, and speech are located there. Head, neck, and especially the face are the most visible parts of the human body. This also makes for the specific nature of oncological conditions of the head and neck. Currently, thanks to modern technologies, powerful computer systems, and a range of modern appliances, radiotherapy takes up prominent position in the treatment of head and neck carcinomas. Thanks to advanced imaging technologies, new techniques can be performed with linear accelerators, especially the IMRT and IGRT methods. These techniques allow for substantially lower radiation load on the surrounding healthy organs, which was not possible previously. Results of comparative studies based on average values speak clearly for the latest technologies and modern IMRT techniques. The resulting dosage load on the critical organs (the spinal cord) is much higher in patients planned with the older techniques than in the case of the IMRT. When using IMRT techniques, dose gradient is steeper, and so are the mean dose values (Dmean), than in the case of 3D techniques planning, which allows for the escalation of the dose in the target volume in the next phases of radiotherapy. The other studied parameter is also lower {--} the maximum dose in the PTV target volume, which is usually easy to keep below 107 % of the total prescribed dose (in accordance with international recommendations the dose in target volume should range between 95 % and 107 % of the total dose). The aim of the bachelor{\crq}s thesis was to compare the new and older radiotherapeutic methods applied to the head and neck area. Comparing these methods is very complicated as the planning itself is a sophisticated issue. The evaluation was carried out through statistic processing of 25 patients treated with the IMRT technique. In order to make the comparison as exact as possible the 3D plan was performed also on identically designed target volume.
|
guest ::
