Due to improved life spans, cancer incidence has increased with more aged patients presenting with cancer. Elderly cancer patients could have compromised organ function and/or comorbidities. Due to poor social support or lack of early diagnosis, treatment outcomes for elderly cancer patients are poor in general. However, with aggressive support during cancer management as well as careful selection, most elderly cancer patients can tolerate standard radiation therapy with good results based on published articles. Here, we reviewed existing articles regarding compliance and treatment results in elderly cancer patients based on tumor site.
Aged ; Comorbidity ; Compliance ; Early Diagnosis ; Humans ; Incidence

Majority of cancer patients used CAM modalities during and even after cancer treatment. Main reasons for CAM use are to improve immunity, with expectation of fewer recurrences, and to have better quality of life. Still many patients did not reveal precise detailed information of CAM use to their physicians. Due to possible interaction between herbs and cancer drugs, it is essential for physicians to know whether their patients use CAM modalities or not and to have interest in existing evidence. This article will provide the lists of evidence and references on supplements and life styles including diet and exercise. Mind body medicine is not commonly used in Korea but there is increasing evidence on meditation and usefulness with relaxation even in supportive care.
Diet ; Humans ; Integrative Medicine ; Korea ; Life Style ; Meditation ; Mind-Body Therapies ; Quality of Life ; Recurrence ; Relaxation

No abstract available.
Humans ; Uterine Cervical Neoplasms

A clear consensus has not been established regarding the best treatment for solitary bone metastasis. Here, we reviewed the medical records of patients with a controlled primary malignancy who had only solitary spine metastasis without metastasis to the extraspinal bone or viscera and underwent treatment between April 2007 and December 2012 with stereotactic body radiosurgery using CyberKnife, with a total dose of 24 Gy in three to four fractions. During that time, there were only four cases. This was effective in each case, and all the four patients had no local failure and remained alive at a median follow-up of 68 months (range, 64 to 80 months). Although our experience is limited, this study suggests that stereotactic body radiotherapy could be a feasible, safe, effective, and noninvasive alternative treatment for solitary spine metastasis in patients who are medically inoperable or unsuitable for surgery.
Consensus ; Follow-Up Studies ; Humans ; Medical Records ; Neoplasm Metastasis* ; Radiosurgery* ; Spine* ; Viscera

This article reviewed new trends and controversial issues, including the intensification of chemotherapy and recent brachytherapy (BT) advances, and also reviewed recent consensuses from different societies on the management of locally advanced cervical cancer (LACC). Intensive chemotherapy during and after radiation therapy (RT) was not recommended as a standard treatment due to severe toxicities reported by several studies. The use of positron emission tomography-computed tomography (PET-CT) and magnetic resonance imaging (MRI) for pelvic RT planning has increased the clinical utilization of intensity-modulated radiation therapy (IMRT) for the evaluation of pelvic lymph node metastasis and pelvic bone marrow. Recent RT techniques for LACC patients mainly aim to minimize toxicities by sparing the normal bladder and rectum tissues and shortening the overall treatment time by administering a simultaneous integrated boost for metastatic pelvic lymph node in pelvic IMRT followed by MRI-based image guided adaptive BT.
Bone Marrow ; Brachytherapy ; Consensus ; Drug Therapy ; Electrons ; Humans ; Lymph Nodes ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Pelvic Bones ; Radiotherapy, Intensity-Modulated ; Rectum ; Urinary Bladder ; Uterine Cervical Neoplasms

Radiation therapy is an effective modality to alleviate cancer-related symptoms. To deliver radiation accurately, it is essential to secure stability of the treatment position in patients during each treatment time. However, some patients could be less cooperative due to their psychoemotional issues. We present two cases of terminal-stage cancer patients who were initially unable to lie still on the treatment table before simulation. A relaxation technique was taught to them on the bed, and they could relax and undergo radiation therapy with effective symptom relief.
Humans ; Integrative Medicine ; Posture ; Radiotherapy ; Relaxation*

PURPOSE: The degree of radiation-induced lung fibrosis (RILF) can be measured quantitatively by fibrosis volume (VF) on chest computed tomography (CT) scan. The purpose of this study was to investigate the interobserver and intraobserver variability in CT-based measurement of VF. MATERIALS AND METHODS: We selected 10 non-small cell lung cancer patients developed with RILF after postoperative radiation therapy (PORT) and delineated VF on the follow-up chest CT scanned at more than 6 months after radiotherapy. Three radiation oncologists independently delineated VF to investigate the interobserver variability. Three times of delineation of VF was performed by two radiation oncologists for the analysis of intraobserver variability. We analysed the concordance index (CI) and inter/intraclass correlation coefficient (ICC). RESULTS: The median CI was 0.61 (range, 0.44 to 0.68) for interobserver variability and the median CIs for intraobserver variability were 0.69 (range, 0.65 to 0.79) and 0.61(range, 0.55 to 0.65) by two observers. The ICC for interobserver variability was 0.974 (p < 0.001) and ICCs for intraobserver variability were 0.996 (p < 0.001) and 0.991 (p < 0.001), respectively. CONCLUSION: CT-based measurement of VF with patients who received PORT was a highly consistent and reproducible quantitative method between and within observers.
Carcinoma, Non-Small-Cell Lung ; Evaluation Studies as Topic* ; Fibrosis* ; Follow-Up Studies ; Humans ; Lung* ; Observer Variation* ; Radiotherapy ; Thorax ; Tomography, X-Ray Computed

No abstract available.
Ependymoma*

PURPOSE: To discuss the technical aspect of interstitial brachytherapy including method of implant, insertion time of radioactive source, total radiation dose, and complication, we reviewed patients who had diagnoses of soft tissue sarcoma and were treated by conservative surgery, interstitial implant and external beam radiation therapy. MATERIALS AND METHODS: Between May 1995 and Dec. 1997, ten patients with primary or recurrent soft tissue sarcoma underwent surgical resection (wide margin excision) and received radiotherapy including interstitial brachytherapy. Catheters were placed with regular intervals of 1~1.5 cm immediately after tumor removal and covering the critical structures, such as neurovascular bundle or bone, with gelform, muscle, or tissue expander in the cases where the tumors were close to those structures. Brachytherapy consisted of high dose rate, iridium-192 implant which delivered 12~15 Gy to 1 cm distance from the center of source axis with 2~2.5 Gy/fraction, twice a day, starting on 6th day after the surgery. Within one month after the surgery, total dose of 50~55 Gy was delivered to the tumor bed with wide margin by the external beam radiotherapy. RESULTS: All patients completed planned interstitial brachytherapy without acute side effects directly related with catheter implantation such as infection or bleeding. With median follow up duration of 25 months (range 12~41 months), no local recurrences were observed. And there was no severe form of chronic complication (RTOG/EORTC grade 3 or 4). CONCLUSION: The high dose rate interstitial brachytherapy is easy and safe way to minimize the radiation dose delivered to the adjacent normal tissue and to decrease radiation induced chronic morbidity such as fibrosis by reducing the total dose of external radiotherapy in the management of soft tissue sarcoma with conservative surgery.
Axis, Cervical Vertebra ; Brachytherapy* ; Catheters ; Diagnosis ; Fibrosis ; Follow-Up Studies ; Hemorrhage ; Humans ; Radiotherapy ; Recurrence ; Sarcoma* ; Tissue Expansion Devices

PURPOSE: Many studies for unresectable stage III non-small cell lung carcinomas (NSCLC) have focused on patients with good prognostic factors. However, there have been few reports on patients with poor prognostic factors. Herein, those patients with poor prognostic factors were treated with conservative split course radiation therapy (RT) alone, and the feasibility and survivals evaluated. Methods and Materials: Between Jan 1997 and Dec 2001, 73 patients started conservative split course RT. They were confirmed to have unresectable stage III NSCLC with poor prognostic factors; performance scale> or = ECOG 2 or weight loss> or =5% during the last 6 months. They initially received 30 Gy of radiation in 2.5 or 3 Gy per fractions to the gross tumor volume (GTV). The tumor response was evaluated 2~3 weeks later. A second course of RT was also recommended for good responders: > or =50% tumor diameter reduction or improved distal atelectasis. The treatment related toxicity was also evaluated. RESULTS: Nine patients failed to finish the initial course of RT (3~27 Gy) due to disease progression or personal reasons. Thirty-four (53.1%) of the 64 patients who completed the first course of RT showed a good tumor response. Twenty-seven good responders received the second course of RT, with a total of 51 to 60 Gy. Seven of these did not receive the second course of RT due to distant metastasis or poor performance. The two-year survival rate and median survival in all patients and in the 27 good responders who completed the second course of RT were 19.7% and 12 months and 30.3 and 20 months, respectively. Five (12.8%) of the 39 evaluable patients had grade III radiation esophagitis (N=1) or pneumonitis (N=4). Conclusions: Conservative split course RT was a tolerable and effective modality for unresectable stage III NSCLC with poor prognostic factors. In addition, it was able to produce relatively good survival results in patients showing a good response after the first course and who completed the second course of RT
Disease Progression ; Esophagitis ; Humans ; Lung* ; Neoplasm Metastasis ; Pneumonia ; Pulmonary Atelectasis ; Survival Rate ; Tumor Burden