1. Increased late urinary toxicity with whole pelvic radiotherapy after prostatectomyBorut Kragelj, 2009, original scientific article Abstract: Background. Radiotherapy aimed at prostatic bed (PBRT) can prevent recurrence or reestablish remission in prostate cancer patients primarily treated with prostatectomy. In selected patients results may be improved with the additional irradiation of pelvic nodes (WPRT). Patients and methods. The objective of the study was to evaluate late toxicity of postoperative radiotherapy in 43 patients - 21/43 treated with WPRT. Dysuria, haematuria, nocturia, continence and obstructive urination problems as well as urgency, continence, frequency, pain and bleeding of defecations were prospectively registered and converted to a modified Radiation Therapy Oncology Group (RTOG)- late effects normal tissue (LENT) scoring system. Median tumour dose (TD) for PBRT was 64.8 (59.4-70.0) Gy and for WPRT 50.4 (48.0-56.0) Gy. Results. More important than the deterioration of intestinal function (worsening for 1 grade in 54% and >= 2 grades in 5% of patients) was the deterioration of urinary function (worsening for 1 grade in 33% and >= 2 grades in 26% of patients). This appeared to be more frequent in patients withWPRT than PBRT (67% vs. 50% of patients) especially in conjunction with WPRT TD > 52 Gy (deterioration in 71% of patients). Conclusions. Although several factors may influence increased urinary toxicity after WPRT, it seems reasonable to lower the urinary bladder dose as it possible with novel radiation techniques.
Published in DiRROS: 08.03.2024; Views: 105; Downloads: 23
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4. Setup and its effect on safety margin in conformal radiotherapy of the prostateBorut Kragelj, 2005, original scientific article Abstract: Background. In radiotherapy, setup errors in positioning the patients influence the size of safety margin and thereby also the size of irradiation field and toxicity of radiotherapy. Methods. The setup errors were calculated by evaluating the deviations from the measured distance between the irradiation field margin and the bony pelvis. Results. The research was performed on 23 patients. With respect to lateral, craniocaudal and anteroposterior axis, the observed systemic error ranged from -5 to + 9 mm, -4to +5 mm, and from -4 to +4 mm, respectively, whereas the observed random error ranged from 0 to 7.5 mm, 0 to 3.6 mm, and from 0 to 4.2 mm, respectively. The safety margin, with the 90% probability to cover clinical target volume (CTV) and allowing for the prostate position variability, measured 9 mm, 9.5 mm, 7 mm, and 10 mm in the respective lateral, craniocaudal, anterior and dorsal direction. Conclusions. Irradiation of the prostate with a 7 mm dorsal safety margin, allowing for 90% coverage probability of CTV, was feasible in 22/23 patients on condition that the grosssystemic error (>3mm) was eliminated.
Published in DiRROS: 14.02.2024; Views: 134; Downloads: 30
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5. Radical irradiation of the prostate. Combination of percutaneous irradiation and irradiation with LDR Ir-192 implantsBorut Kragelj, Franc Guna, Janez Burger, 2001, original scientific article Abstract: Background. The irradiation of the carcinomas of the prostate with the doses above the tolerable ones of standard radiotherapy improves the local control of the disease. The aim of this study is to determine the acute toxicity and tolerability of the high-dose prostate irradiation combining external beam radiotherapy (EBRT) and interstitial low dose rate (LDR) brachyradiotherapy (BRT) Ir-192 of the prostate. Material and methods. We examined medical records of 8 patients with localized carcinoma of the prostate (T2-T3 No-x Mo)treated from August 1999 until February 2000. The initial PSA was 2.7-37.5 ng/ml (median 13.7) and Gleason score 4-9 (median 7). Radiotherapy consisted of 48.6-50.4 Gy of EBRT to the prostate and seminal vesicles (4 patients) or the whole pelvis (4 patients) and 20.0-28.0 Gy of interstital LDR Ir-192 BRT given as a single fraction, fluoroscopic guided transperineal Implantation of the prostate. The cumulative doses of percutaneous and interstitial irraditations to the prostate were 68.6 - 79.1 Gy. Results. Acute toxic effects of irradiation though observed in all patients were of only mild intensity. According to the RTOG criteria, 20/30 toxicities were assessed as grade 1, 9/30 as grade 2, and 1/30 as grade 3. In none of the patients, toxic effects required any specific modification of the treatment regimen. Conclusions. The very first experiences indicate moderate toxicity and optimaltolerance of the treatment by patients. An improvement of implantation techniques may be expected with regular CT controls of the implants and extra attentive care of the implants in the urethra region.
Published in DiRROS: 25.01.2024; Views: 146; Downloads: 34
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10. Zdravljenje raka prostate : kdaj obsevati po operacijiBorut Kragelj, 2019, dictionary, encyclopaedia, lexicon, manual, atlas, map Keywords: rak prostate, kirurško zdravljenje, radioterapija, obsevanje
Published in DiRROS: 11.03.2022; Views: 653; Downloads: 330
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