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کاربرد نوع شرط:
- جایگاه : پژوهشی
- مجله: Asian Pacific Journal of Cancer Prevention
- نوع مقاله: Journal Article
- کلمات کلیدی: Cisplatin,IMRT,weekly,every 3 weeks
- چکیده:
- چکیده انگلیسی: Purpose: The aim of this prospective randomized study is to compare cisplatin at 2 dose levels given concurrently with intensity modulated radiation therapy (IMRT) in the treatment of locally advanced HNSCC. The main objectives were to evaluate treatment toxicities, loco-regional control, tumor response and patients compliance. Methods: Patients were randomized into two groups that either received 30 mg/m2 cisplatin weekly (arm A) or 100 mg/m2 once every 3 weeks (arm B). Radiotherapy prescribed dose was 70Gy in 33 fractions. Treatment adverse events were documented. Results: Sixty patients with locally advanced HNSCC were included in this study. Recruitment started at the beginning of July 2016 and ended in July 2019. The Median follow-up was 24 months. Acute non-hematological toxicities of grade 3 or higher during the treatment course were significantly more observed in Arm B patients (76.6%) compared to Arm A patients (56.6%) with a P-value of 0.007. Hematological toxicities in the form of anemia, leucopenia and neutropenia were also significantly higher in Arm B patients with a p-value of 0.435, 0.002 & 0,002, respectively. The median 2 year loco-regional control rate in Arm B was 72.8% versus 57.6% in Arm A with a p-value of 0.015. Complete responses were similar between both groups (77%). Compliance to treatment was better in Arm A with 70% of the patients received at least 6 weekly doses where as 60% of the patients in Arm B completed the three cycles of treatment and 40 % received only 2 cycles. Conclusion: Once weekly low dose cisplatin treatment showed lower acute toxicity and a better compliance compared to once every 3 weeks high dose cisplatin treatment at the expense of a lower loco-regional control.
- انتشار مقاله: 02-10-1398
- نویسندگان: Karim Mashhour,Wedad Hashem
- مشاهده
- جایگاه : پژوهشی
- مجله: Asian Pacific Journal of Cancer Prevention
- نوع مقاله: Journal Article
- کلمات کلیدی: Quality of Life,Dysphagia,Exercises
- چکیده:
- چکیده انگلیسی: Purpose: The work was a comparative study, the aim of which is to evaluate the impact of swallowing exercises on
swallowing problems among head and neck cancer patients (HNCPs) after CRT. Methods: The sample of 60 HNCPs
was equally divided into control and study groups. The investigators met all patients 3 times (before, during and after
CRT); swallowing ability was assessed using the Sydney Swallowing Questionnaire (SSQ). The University of Texas,
MD Anderson Cancer Center Swallowing Exercise Protocol was explained and demonstrated by the investigators to
the study group. All tools used were translated into Arabic. Data analyses were carried out using the statistical package
for social sciences (SPSS), program version 20. Results: Most of the patients from both groups experienced mild
dysphagia during the 1st visit. By the 3rd visit, severe dysphagia (to thin and thick liquids, and soft and hard food)
was higher in the control group (73.3%) compared to the study group (26.7%). By the third visit there was statistically
significant difference between both groups in swallowing thin liquids (p = 0.01), as well as thick liquids (p = 0.01).
At the 1st visit, there was no significant difference regarding swallowing soft food (p = 0.24), hard food (p = 0.17),
dry food (p = 0.89) and swallowing Saliva (p = 0.28). While by the 3rd visit, there was significant difference between
control and study groups in all parameters. Conclusions: Adequate prevention and treatment of dysphagia, with use
of swallowing programs, is essential to plan a complete therapeutic programme.- انتشار مقاله: 18-07-1396
- نویسندگان: Karim Mashhour,Rehab Abdelkader,Labiba Abdelkader,Shaimaa El Hadary,Wedad Hashem
- مشاهده
- جایگاه : پژوهشی
- مجله: Asian Pacific Journal of Cancer Prevention
- نوع مقاله: Journal Article
- کلمات کلیدی: dosimetric,double arc,IMRT,MUs
- چکیده:
- چکیده انگلیسی:
Purpose: The aim of this study was to dosimetrically evaluate and compare double arc RapidArc (RA) with conventional IMRT (7 fields) plans for irradiation of locally advanced head and neck cancers (LAHNC), focusing on target coverage and doses received by organs at risk (OAR). Methods: Computed tomography scans of 20 patients with LAHNC were obtained. Contouring of the target volumes and OAR was done. Two plans were made for each patient, one using IMRT and the other double arc RA, and calculated doses to planning target volume (PTV) and OAR were compared. Monitor units for each technique were also calculated. Results: PTV coverage was similar with both techniques. The homogeneity index (HI) was higher for the IMRT plans with a value of 0.108 ± 0.021 compared to 0.0975 ± 0.017 for double arc RA plans (p-value of 0.540). The double arc RA plans achieved a better conformity with a CI95%= 1.01 ± 0.021 compared to 1.05 ± 0.057 achieved with the IMRT plans (p-value of 0.036). The average monitor units (MU) ±SD were 930.5 ± 142.42 for the IMRT plans as opposed to 484.25 ± 69.47 for the double arc RA plans (P-value of 0.002). Double arc plans provided better OAR sparing with a significant p-value of 0.002 and 0.004 for the right and left parotid glands, respectively. Conclusions: RA is a rapid and accurate technique that uses lower MUs than conventional IMRT. Double arc plans provide better dose conformity, OAR sparing and a more homogeneous target coverage compared to IMRT.- انتشار مقاله: 13-07-1396
- نویسندگان: Karim Mashhour,Maha Kamaleldin,Wedad Hashem
- مشاهده