Cancer of the vulva is undoubtedly a serious social problem. It, more and more often, affects young women and is associated with the spread of infection with cancer-causing HPV types. It is recommended that treatment of vulvar cancer dealt with an interdisciplinary team consisting of a gynecologist oncologist, radiotherapist oncologist, pathologist, radiologist, and psychologist. The current, modern treatment strategy is based on saving procedures. Patients with very advanced disease are often treated only by surgery. Adjuvant radiotherapy is reserved for cases with close or positive margins or with metastatic inguinal lymph nodes to ensure adequate local control and longer overall survival.
Total body irradiation aims at preparing the patient for a bone marrow transplant. Various schemes of fractionation doses have been developed. Each scheme is adjusted according to the diagnosis and technical capabilities of given entity. The main difficulty is small size of the irradiation field which limits the patient's positioning. It is possible to obtain the field dimension 50 × 200 cm thanks to significant averting the patient from the radiation source. Another important factor is to obtain regular distribution of dose and simultaneously its reduction in critical organs such as the lungs. When it comes to the lateral fields, the organic class plate is commonly used. This plate allows radiating more superficial layers of the body. During patient positioning in the position AP/PA, the best solution is to reduce the thickness of the field. The process of total body irradiation (TBI) should be comfortable for the patient. His/her position should be fully reproducible.The aim of the study is to present the whole body irradiation techniques, potential complications, side effects and patient positioning during the treatment.
In all countries of the world, an increase in expenditure on health care is recorded. Cancer has become the main health and social problem whose effective solution requires the development of a comprehensive cancer control program. The Law on the National Programme for Combating Cancer is an example of the comprehensive approach in Poland. Treatment of cancer in Poland is based on a network of public full-profiling dozen cancer centers and oncology units located at university hospitals and local government. An example of a systemic approach at the regional level is “Wielkopolski program rozwoju radioterapii i onkologii” adopted by the provincial government.
Different methods of treatment are dependent on the type of tumour. The dominant form of treatment is still surgery, which can be used as an independent method of treatment or it can be combined with other methods. Surgical treatment may be replaced by other possible alternatives such as chemotherapy or radiotherapy. Nowadays, the most commonly used radiotherapy is this with the usage of protons or electrons. However, proton beam therapy is becoming increasingly important. On the one hand it has many advantages; for example, it decreases rapidly the dose behind the Bragg peak, reduces significantly the time of treatment or reduces the appearance of secondary malignancies. On the other hand, there are also disadvantages. For instance, high cost of production the beam and the cost of therapy itself, problems with the dose's inhomogeneity during the air passing or appearance of nuclear reactions. Proton therapy is mainly used in the treatment of changes localized in the eye, brain and in paediatrics. The aim of this study is to present applications and limitations of proton beam therapy.
Different methods of treatment are dependent on the type of tumour. The dominant form of treatment is still surgery, which can be used as an independent method of treatment or it can be combined with other methods. Surgical treatment may be replaced by other possible alternatives such as chemotherapy or radiotherapy. Nowadays, the most commonly used radiotherapy is this with the usage of protons or electrons. However, proton beam therapy is becoming increasingly important. On the one hand it has many advantages; for example, it decreases rapidly the dose behind the Bragg peak, reduces significantly the time of treatment or reduces the appearance of secondary malignancies. On the other hand, there are also disadvantages. For instance, high cost of production the beam and the cost of therapy itself, problems with the dose's inhomogeneity during the air passing or appearance of nuclear reactions. Proton therapy is mainly used in the treatment of changes localized in the eye, brain and in paediatrics. The aim of this study is to present applications and limitations of proton beam therapy.
Breast cancer is the most common cancer among women and the most common cause of death. Treatment of breast cancer includes various methods such as surgery, chemotherapy, and radiotherapy. Oncological treatment may adversely impact on the organs’ operations and systems of the human body as well as the mental state of patients, their functional performance and social functioning. The adopted patients’ attitude towards the disease and emotions is of great importance for the quality of life and final treatment results. The objective of this work is to assess a possible impact of therapeutic agents on the women's life after breast cancer treatment. The study includes patients with breast cancer treated in the Lower Silesian Oncology Center in Wrocław in 2012, 12 mths. after surgery. To evaluate their quality of life, I used QLQ-C30 questionnaire and QLQ-BR23 breast cancer module. In the study group, I have found statistically significant correlations between the age of patients and the therapies (especially breast conserving surgery and radiation) with the quality of life responses.
The aim of this study was to review the scientific reports describing new technology and methods of treatment planning used in teleradiotherapy. The analysis was based on selected reports presented during ASTRO 56th Annual Meeting.
Efficient stem cell differentiation is considered to be the future of regenerative medicine. Pursuing the most productive method of directed differentiation has been the subject of numerous studies, resulting in the development of many effective protocols. However, the necessity for further improvement in differentiation efficiency remains. This review contains a description of molecular processes underlying the response of stem cells to ionizing radiation, indicating its potential application in differentiation procedures. In the first part, the radiation-induced damage response in various types of stem cells is described. Second, the role of the p53 protein in embryonic and adult stem cells is highlighted. Last, the hypothesis on the mitochondrial involvement in stem cell development including its response to ionizing radiation is presented. In summary, subjecting cells to the appropriate dosage of ionizing radiation may become a useful method for enhancing directed differentiation in certain stem cell types.
Total body irradiation aims at preparing the patient for a bone marrow transplant. Various schemes of fractionation doses have been developed. Each scheme is adjusted according to the diagnosis and technical capabilities of given entity. The main difficulty is small size of the irradiation field which limits the patient's positioning. It is possible to obtain the field dimension 50×200cm thanks to significant averting the patient from the radiation source. Another important factor is to obtain regular distribution of dose and simultaneously its reduction in critical organs such as the lungs. When it comes to the lateral fields, the organic class plate is commonly used. This plate allows radiating more superficial layers of the body. During patient positioning in the position AP/PA, the best solution is to reduce the thickness of the field. The process of total body irradiation (TBI) should be comfortable for the patient. His/her position should be fully reproducible.
Head and neck squamous cell carcinomas are one of the worst prognosis cancers with high mortality of patients. The main methods of treatment are surgery, radiotherapy and chemotherapy. The improvement of currently applied therapeutic methods is seen in the use of molecular features of tumour marker that describes the behavior of cells after treatment. miRNAs are supposed to be a good diagnostic and prognostic biomarkers. They are small, non-coding RNAs which are involved in regulatory function in the cell. It has been revealed that the biogenesis and function of miRNAs are disturbed in tumour cells which results in the acquisition of specific phenotypic characteristics by tumour cells. The tumour examination in the context of miRNAs expression may allow to describe potential tumour ability to its growth, progression, radio – and chemosensitivity. Creation of the miRNA panel for the personalization of treatment is still at the research stage. In this work, we collected data concerning two miRNAs: let-7d and miR-18a. We have characterized them for potential use as miRbiomarkers.
During the ASTRO 56 conference, which was held in San Francisco in 2014, majority of the scientific sessions on prostate cancer were devoted to the combined treatment (radiation and hormone therapy). Modern radiotherapy in the last decade contributed significantly to improved treatment results of prostate cancer. However, especially in the group of more advanced prostate cancer, we can expect further improvement in treatment results. This combined therapy should improve treatment results because of the reduction in the dose delivered to the rectum and the bladder, the most important organs at risk for radiotherapy of prostate cancer.Zapatero and coworkers from Spain presented the results of randomized phase III clinical trial (DART 01/05). In the study, they compared the results of treatment of high risk and intermediate risk of progression in prostate cancer patients with radiotherapy combined with hormonal therapy. Into the study were included 364 patients with prostate cancer who were randomized between 2005 and 2010 to the arm where the hormone therapy was used only for 4 months before the start of radiation therapy (neoadjuvant) and to the second arm where the hormone was continued for 24 months after the complition of radiotherapy. Results suggested that the biggest benefit from long-term use of hormone therapy was observed in the group of patients at high risk of progression (cT3 or PSA> 20 ng/mL or Gleason> 7) in prostate cancer.
During last year's conference, breast malignancies gained a lot of attention. The sessions were divided into three main parts: “The proceedings in the early stages of advancement”, “Irradiation after preoperative treatment system” and “regional irradiation areas”. Of particular note is the multidisciplinary nature of each session. Lectures were conducted by experts in the field of radiotherapy, as well as medical oncology, surgery and pathology. At the moment, the exchange of views by experts from various fields of medicine seems to be a key element in the healing process of patients.
The aim of this paper is to underline the most important physical aspects of stereotactic body radiation therapy (SBRT) techniques. The described trends and some research problems were presented during ASTRO 56 conference in San Francisco.
Evaluation of tests and guidelines provided by the regulation of the Minister of Health on 18 February 2011 relating to quality assurance in computed tomography. Catphan 600 phantom, 2-part PMMA CT-Phantom IBA phantom and Raysafe Xi modules were used to carry out quality assurance tests on Siemens Sensation Open tomograph. For evaluation of the results Microsoft Excel and Varian Eclipse software were used. The range of the assay with use of Catphan phantom was extended for better assessment of tests provided in regulations. Performed tests revealed that according to the regulations, CT is working properly. On the other hand, it is easily observed that results vary for different scan settings in tests performed on Catphan phantom. Performed tests showed that conditions given in regulations are easy to fulfil. Another conclusion is that there are no strict guidelines about scan settings in by the regulation of the Minister of Health on 18 February 2011. In order to maintain constant conditions of testing, the settings from standard workflow should be used.
The aim of this paper is to underline the most important aspects of advanced lung cancer therapy. The described trends and problems were presented during ASTRO 56 Conference in San Francisco.
In the large parts of Europe the impact of the economic situation on the availability of healthcare is noticeable. This effect is mostly visible in specialties such as radiotherapy, where much depends on investing in expensive equipment or qualification of specialists.
The aim of the study was to compare changes in the structure of performed radiotherapy techniques, and to examine whether there was an increase in more complex techniques – IMRT, additionally whether the decreased number of simpler techniques like 2D, 3D was seen. Details about the techniques of radiotherapy were obtained from radiotherapy cards of patients in Wielkopolska Cancer Center. The study covered the years 2012 and 2013. In group I analysis was done for 20 weeks of year 2012 – from 1 to 10 weeks and from 27 to 36 weeks of that year, and in group II 20 weeks of 2013 – from 1 to 10 weeks and from 27 to 36 week of that year. An increase in number of highly specialized techniques (IMRT, IGRT, Tomotherapy) was achieved by 2% in 2013 compared with 2012, and a reduction of standard techniques (2D, 3D, palliative) by 1% in 2013. The greater number of highly specialized techniques was found.
An idea of stereotactic body radiation therapy in early stage has been presented in this work. Implementation, outcomes and toxicity of the method are revealed. Some approaches to compare the technique with surgery have been presented. The author has outlined the trends and some research problems.
Several studies now indicate that dose escalation can increase the chances of freedom from biochemical recurrence for early stage prostate cancer treated with primary radiation. These data, and evidence suggesting a low a/b ratio for prostate cancer, have prompted some to use hypofractionated delivery (i.e., small number of high dose fractions) to treat localized prostate cancer. Stereotactic body radiation therapy (SBRT) delivers fewer high-dose fractions of radiation which could be more radiobiologically favorable than conventional radiotherapy doses. Early experiences using CK for localized low-risk and intermediate-risk prostate cancer showed that such treatment resulted in very high oncological efficacy with minimal toxicity risk.
The aim of this study was to analyze the influence of the size of the clinical target volume (CTV) on the displacement obtained from the patients irradiated because of the left breast cancer using the geometric verification with the megavoltage images. Examined group of 100 patients was treated with the three-dimensional conformal radiotherapy. The analysis was performed on the 396 megavoltage images. The examined group of patients was divided into two subgroups according to the breast's CTV volume. The first subgroup (I) was the patient with the CTV ≤ 700 cm3 and the second (II) one CTV > 700 cm3. The displacements were obtained in the three directions: anterior-posterior (AP), crania-caudal (CC) and left-right (LR). The systematic (Σ), random (σ) errors and safety margins (SM) were calculated. The range of the Σ error was 0,20–0,34 cm for the (I) and 0,26–0,42 cm for the (II). The maximum value of the σ error was 0,46–0,26 cm, respectively. The lowest value of the SM was in the AP and the largest one in the CC direction. The SM ranges were 0,65–1,00 cm for CTV ≤ 700 cm3 and 0,88–1,37 cm for CTV > 700 cm3. SM for the whole group of the breast patient was in the range 0,80–1,24 cm. The set-up of the breast patient with the smaller volume of the CTV ≤ 700 cm3 is much accurate and connected with smaller values of the geometric displacements. Safety margin used during the treatment planning should be selected individually depending on the size of the breast volume – CTV.
