1. The role of PET-CT in radiotherapy planning of solid tumoursStaša Jelerčič, Mirjana Rajer, 2015, pregledni znanstveni članek Povzetek: PET-CT is becoming more and more important in various aspects of oncology. Until recently it was used mainly as part of diagnostic procedures and for evaluation of treatment results. With development of personalized radiotherapy, volumetric and radiobiological characteristics of individual tumour have become integrated in the multistep radiotherapy (RT) planning process. Standard anatomical imaging used to select and delineate RT target volumes can be enriched by the information on tumour biology gained by PET-CT. In this review we explore the current and possible future role of PET-CT in radiotherapy treatment planning. After general explanation, we assess its role in radiotherapy of those solid tumours for which PET-CT is being used most. Conclusions. In the nearby future PET-CT will be an integral part of the most radiotherapy treatment planning procedures in an every-day clinical practice. Apart from a clear role in radiation planning of lung cancer, with forthcoming clinical trials, we will get more evidence of the optimal use of PET-CT in radiotherapy planning of other solid tumours.
Ključne besede: positron emission therapy, radiotherapy, radiotherapy planning, tumour biology
Objavljeno v DiRROS: 16.04.2024; Ogledov: 44; Prenosov: 6
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2. Glioblastoma patients in Slovenia from 1997 to 2008Uroš Smrdel, Viljem Kovač, Mara Popović, Matjaž Zwitter, 2014, izvirni znanstveni članek Povzetek: Glioblastoma is the most common primary brain tumour. It has a poor prognosis despite some advances in treatment that have been achieved over the last ten years. In Slovenia, 50 to 60 glioblastoma patients are diagnosed each year. In order to establish whether the current treatment options have any influence on the survival of the Slovenian glioblastoma patients, their data in the period from the beginning of the year 1997 to the end of the year 2008 have been analysed. Patients and methods. All patients treated at the Institute of Oncology Ljubljana from 1997 to 2008 were included in the retrospective study. Demographics, treatment details, and survival time after the diagnosis were collected and statistically analysed for the group as a whole and for subgroups. Results. From 1997 to 2008, 527 adult patients were diagnosed with glioblastoma and referred to the Institute of Oncology for further treatment. Their median age was 59 years (from 20 to 85) and all but one had the diagnosis confirmed by a pathologist. Gross total resection was reported by surgeons in 261 (49.5%) patients; good functional status (WHO 0 or 1) after surgery was observed in 336 (63.7%) patients, radiotherapy was performed in 422 (80.1%) patients, in 317 (75.1%) of them with radical intent, and 198 (62.5 %) of those received some form of systemic treatment (usually temozolomide). The median survival of all patients amounted to 9.7 months. There was no difference in median survival of all patients or of all treated patients before or after the chemo-radiotherapy era. However, the overall survival of patients treated with radical intent was significantly better (11.4 months; p < 0.05). A better survival was also noticed in radically treated patients who received additional temozolomide therapy (11.4 vs. 13.1 months; p = 0.014). The longer survival was associated with a younger age and a good performance status as well as with a more extensive tumour resection. In patients treated with radical intent, having a good performance status, and receiving radiotherapy and additional temozolomide therapy, the survival was significantly longer, based on multivariate analysis.
Ključne besede: glioblastoma, treatment, survival, surgery, radiotherapy, termozolomide
Objavljeno v DiRROS: 11.04.2024; Ogledov: 73; Prenosov: 37
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3. Cardiotoxicity of concomitant radiotherapy and trastuzumab for early breast cancerTanja Marinko, Jure Dolenc, Cvetka Bilban-Jakopin, 2014, izvirni znanstveni članek Povzetek: Background. Trastuzumab therapy given in combination with one of several chemotherapy regimens is currently considered the standard of care for the treatment of early-stage, human epidermal growth factor receptor-2 (HER2) -positive breast cancer. The treatment with trastuzumab is due to a significant impact on the survival part of the standard adjuvant treatment of patients with HER2-positive breast cancer. Patients treated with postoperative breast or chest wall irradiation receive trastuzumab concomitant with radiotherapy. In a small proportion of patients trastuzumab causes cardiotoxicity. Preclinical findings indicate a radiosensibilizing effect of trastuzumab in breast cancer cells, but it is not yet clear whether it radiosensibilizes cells of healthy tissues too.Conclusions. Special attention is required when left breast or left thoracic wall is irradiated in patient receiving trastuzumab, because long-term effects of the concurrent treatment with trastuzumab and radiotherapy are not yet known. In an era where more patients are surviving a diagnosis of breast cancer, better understanding and earlier detection of therapy-induced cardiac toxicity will be of paramount importance.
Ključne besede: radiotherapy, cardiotoxicity, trastuzumab, early breast cancer
Objavljeno v DiRROS: 11.04.2024; Ogledov: 57; Prenosov: 32
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5. A novel approach for the definition of small-field sizes using the concept of superellipseIgnasi Méndez Carot, Božidar Casar, 2021, izvirni znanstveni članek Povzetek: In radiotherapy, field sizes are defined in terms of the dimensions of the irradiation area. However, geometric square fields result in irradiation areas with rounded corners, which become almost elliptical for small fields. Superellipses are a family of curves encompassing shapes lying between ellipses and rectangles. The purpose of this work was to analyze the advantages and disadvantages of a novel approach that describes small-field sizes with superellipses. Square fields with nominal side lengths ranging from 0.5 to 10 cm were irradiated with two different linacs using 6 and 10 MV photon beams with and without flattening filters. Field size dimensions and output factors were measured by employing radiochromic films and the Radiochromic.com software. An alternative definition of equivalent square small-field size based on the superellipse (Sse) was introduced. The degree n of the superellipse for 10 cm nominal fields measured between 14.8 % 1.0 to 27.7 % 1.9. However, it decreased with the field size, down to between 2.26 % 0.10 and 2.64 % 0.15 for 0.5 cm nominal side lengths. A relation between the degree n and the equivalent square small-field size (Sclin) as defined by Cranmer-Sargison et al. [%A methodological approach to reporting corrected small field relative outputs,% Radiotherapy and Oncology 109, 350%355 (2013)] was found. For nominal side lengths of 10 cm, Sse was between 0.34 % 0.04% and 0.10 % 0.01% smaller than Sclin, while for 0.5 cm nominal side length Sse was between 9.5 % 0.6% and 7.4 % 0.7% smaller than Sclin. There was no significant difference in the goodness of the regression between using Sse or Sclin to fit field output factors with the function proposed by Sauer and Wilbert. Small fields were found to be more accurately characterized with superellipses. The advantages and disadvantages of describing field sizes with superellipses were examined. Field output factors can be derived with equivalent square small-field sizes based on the superellipse approach.
Ključne besede: superellipsa, small fields, dosimetry, radiotherapy
Objavljeno v DiRROS: 07.09.2022; Ogledov: 385; Prenosov: 240
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6. Idiopathic pulmonary fibrosis in patients with early-stage non-small-cell lung cancer after surgical resectionNežka Hribernik, Igor Požek, Izidor Kern, 2019, izvirni znanstveni članek Povzetek: Background. The outcomes of patients with both lung cancer and idiopathic pulmonary fibrosis (IPF) are unfavorable. Therapeutic interventions for lung cancer such as surgery can cause acute exacerbation of IPF (aeIPF). This study aimed to assess the frequency of IPF in a group of patients with early-stage non-small-cell lung cancer (NSCLC) and to report clinical characteristics and outcomes of this cohort of patients. Patients and methods. This observational cohort retrospective study analyzed 641 pathological records of patients after surgical resection of early-stage non-small-cell lung cancer (NSCLC) at University Clinic Golnik from May 2010 to April 2017. Pathological records of NSCLC with coexisting IPF were reviewed. CT scans and biopsy specimens for this group of patients were analyzed by a thoracic radiologist and pathologist, independently. We searched radiological and pathological features of usual interstitial pneumonia (UIP) pattern in this group of patients. We report the clinical characteristics and outcome of this cohort of patients. Results. Out of 641 patients with early-stage NSCLC, only 13 (2.0%) had histologically and radiologically proven coexisting UIP/IPF. Squamous cell carcinoma was the most common type of lung cancer (7/13 patients). The majority of tumors were small size (all being pT1 or pT2), stage I–II (11/13 patients), located in the lower lung lobes (11/13 patients). Almost all patients were current or ex-smokers (11/13 patients). There were two pathologically confirmed fatal cases (15.4%) due to aeIPF in the first two months after radical treatment, one after adjuvant radiotherapy and the other after surgery. Out of 13 patients, one patient had a lung cancer relapse. Conclusions. Frequency of UIP/IPF in surgically treated early stage NSCLC is rather low. Our observational study shows that radical treatment of lung cancer can cause aeIPF with dismal outcome in this group of patients. The standard of care in these mostly elderly patients still remains unresolved.
Ključne besede: non-small-cell lung cancer, early-stage cancer, idiopathic pulmonary fibrosis, surgery, radiotherapy
Objavljeno v DiRROS: 07.10.2020; Ogledov: 1905; Prenosov: 853
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