Radiotherapy for liver cancers used to be palliative treatment.Currently, three-dimensional conformal radiotherapy, stereotactic body radiotherapy, and particle beam therapy using proton beams and carbon ion beams are used for the treatment of liver cancers.Radiotherapy for liver cancers has become to curative treatment due to the various technical progress.Radiotherapy can accomplish safe and effective treatment for liver cancers.
Optimal timing of the measurement of serum squamous cell carcinoma (SCC) antigen during radiation therapy (RT) and its significance for predicting the response of cervical carcinoma patients as early as possible remain unknown.Sixty-three patients with SCC of the uterine cervix who received RT only were studied. Patients were treated with a combination of external beam irradiation and high-dose rate intracavitary irradiation. The serum SCC antigen level was measured before, every 2 or 3 weeks during, and 1 or 2 months after RT. Clinical outcome was divided into complete response and incomplete response.Forty-seven patients (74.6%) had serum SCC antigen levels 1.5 ng/mL (the reference value) before RT. Normalization of serum SCC antigen levels at the end of RT were found to be significantly correlated with complete response in the SCC-positive patients. It was especially noted that in patients with serum SCC levels between 5-30 ng/mL before RT, a > 70% decrease in the serum SCC antigen level at 4 weeks was correlated significantly with complete response. In this group, a significant correlation also was found between a > 70% decrease in serum SCC level at 4 weeks and the normalization of SCC at the end of RT.The current study data suggest that the serum SCC antigen level not only before, but also during and at the end of RT can predict the response of patients with cervical carcinoma and help in identifying those patients who are at high risk of local recurrence and/or distant metastasis.
Purpose: A commercial 6D carbon fiber radiotherapy treatment couch (Imaging Couch Top, BrainLAB) has recently been reported to attenuate photon beams and increase skin dose. To prevent skin toxicity and ensure the target dose, it is important to correct the attenuation properties of the treatment couch with the treatment planning system (TPS). In this study, we evaluated the accuracy of dose attenuation correction by a virtual couch technique integrated into the TPS. Methods: A virtual couch was modeled in the TPS (Eclipse v10.0, Varian). The CT value of the virtual couch was assigned with the CT value of the kilovoltage‐CT images of the treatment couch. A phantom consisting of several plastic water slabs was created. We selected an evaluation point within the phantom on the couch structure at a 9 cm depth from the couch surface, which was placed at the isocenter. The doses at this point were calculated and measured at several gantry angles, from 120 degree to 240 degree at 10 degree steps, and each field size was 10 cm × 10 cm. The prescribed dose was 100 monitor units for 6/10 MV photon beams and 6 MV‐SRS mode (Trilogy Tx, Varian). Dose measurements were performed with an ion chamber. Results: The largest difference between measured and calculated doses was 3.3% for a gantry angle of 120 degree and 6 MV‐SRS mode. The average dose difference was within 1.6% for all gantry angles and photon beams. In the case without attenuation correction, the largest difference was 8.2% and the average difference was 5.2%. Conclusions: Use of the virtual couch technique in TPS accomplished sufficient accuracy for dose attenuation correction of the 6D carbon fiber treatment couch, and it is an effective method for clinical use.
Standard treatment for localized renal pelvis and ureter cancer is surgery. Previously, the primary role of radiation therapy (RT) in cancer treatment was to control pain and hemostasis as palliative or as adjuvant therapy following surgery. In this report, we describe 5 patients with the disease treated with proton beam therapy (PBT) as curative treatment. Between September 2009 and July 2013, 5 males with renal pelvis (n=3) or ureter (n=2) cancer were treated by PBT with hypofractionated [72.6 Gy relative biological effectiveness (RBE)/22 fractions] or conventional [64-66 Gy (RBE)/32-33 fractions] fractionation. The median patient age was 72 years (range, 59-85 years). Three patients were deemed unfit for surgery. Local hypofractionated PBT was performed in 2 patients with T1-2N0M0 diseases, while prophylactic lymph node irradiation using a patch irradiation technique was performed for the remaining 3 patients, who had T3-4 disease. Two patients with T3-4 disease received chemotherapy prior to definitive PBT. No serious acute or late toxicities were observed in any patient. Local tumor control was achieved in 3 patients (60%); however, distant metastases were observed in 2 patients. Four of the five patients (80%) evaluated in the present study survived for >3 years. The data is limited; however, PBT appears to be a potential option for patients with renal pelvis or ureter cancer, especially for those who are unsuitable for radical surgery.
Purpose: The aim of this study is to evaluate the outcome of the patients with stage II-III esophageal cancer treated with radiation therapy. Methods: Between 1999 and 2006, 87 patients with squamous cell esophageal carcinoma were treated with radiation therapy (RT) or concurrent chemoradiotherapy (CRT) at Gunma University Hospital. Seventy-four patients were men and 14 patients were women, and the median age was 71 years (range: 48–93 years). According to TNM staging system (UICC, 2002), 29 patients were stage II (IIA: 23, IIB: 6), and 58 patients were stage III. Radiation therapy consisted of 40–46 Gy with anteroposterior opposing field including the primary tumor and positive regional lymphnodes with optimal margins with conventional fraction followed by external beam boost up to 50–70 Gy (median: 64 Gy). Chemotherapy was administered concurrently with radiation therapy to 50 patients, and the 30 patients received the regimen contained cisplatin or nedaplatin (CRT-PT) and the 20 patients received the regimen consisting of docetaxel (CRT-DOC). Results: At the end of this study, there were 27 survivors with a median follow-up period of 20 months (range: 6–85 months). The 2- and 3-year disease specific survival rates (DSS) were 44% and 29% for all 87 patients, 71% and 44% for stage II, and 31% and 22% for stage III. The difference of DSS between the patients with stage II and stage III was statistically significant (P= 0.0016). The CR rate and the 2- and 3-year DSS for the CRT group were 34%, 44%, 29%, respectively, and these results were better than those for the RT group of 24%, 43%, 19%, respectively, however, these differences observed were not statistically significant. The outcomes of the patients with CRT-DOC regimen resulted in almost the same as those of CRT-PT regimen group. Conclusion: Our results revealed that definitive radiation therapy for squamous cell carcinoma of the esophagus is effective. Further investigations of the protocol of radiation therapy technique or chemotherapy are needed to clarify the impact of CRT on prognosis of the patients with this disease.
