BACKGROUNDFew studies were reported on the comparison of clinical outcomes between intensity-modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3D-CRT) in the treatment of glioblastoma multiforme (GBM). This study aimed to determine whether IMRT improves clinical outcomes compared with 3D-CRT in patients with GBM.

METHODSThe records of 54 patients with newly-diagnosed GBM from July 2009 to December 2010 were reviewed. The patients underwent postoperative IMRT or 3D-CRT with concurrent and adjuvant temozolomide. Kaplan-Meier method and log rank test were used to estimate differences of patients' survival.

RESULTSThe median follow-up was 13 months. Of the 54 patients, fifty (92.6%) completed the combined modality treatment. The 1-year overall survival rate (OS) was 79.6%. The pattern of failure was predominantly local. A comparative analysis revealed that no statistical difference was observed between the IMRT group (n = 21) and the 3D-CRT group (n = 33) for 1-year OS (89.6% vs. 75.8%, P = 0.795), or 1-year progression-free survival (PFS) (61.0% vs. 45.5%, P = 0.867). In dosimetric comparison, IMRT seemed to allow better sparing of organs at risk than 3D-CRT did (P = 0.050, P = 0.055). However, there was no significant difference for toxicities of irradiation between the IMRT group and the 3D-CRT group.

CONCLUSIONSOur preliminary results suggested that delivering standard radiation doses by IMRT is unlikely to improve local control or overall survival for GBM compared with 3D-CRT. Given this lack of survival benefit and increased costs of IMRT, the utilization of IMRT treatment for GBM needs to be carefully rationalized.

Adult ; Aged ; Brain Neoplasms ; mortality ; radiotherapy ; Female ; Glioblastoma ; mortality ; radiotherapy ; Humans ; Male ; Middle Aged ; Radiotherapy, Conformal ; adverse effects ; Radiotherapy, Intensity-Modulated ; adverse effects ; Treatment Outcome

The influence of the position and radiation technique on the organs at risk (OARs) in radiotherapy of rectal cancer was evaluated. The relationship between the volume of irradiated small bowel (VSB) and acute bowel toxicity was determined. A total of 97 cases of rectal cancer were retrospectively randomized to receive radiotherapy with the designated treatment positions and radiation plans. Among 64 patients in the supine position, 32 patients were given three-dimensional conformal radiotherapy (3DCR) and 32 patients were subjected to intensity-modulated radiation therapy (IMRT) respectively. The rest 33 patients were treated with 3DCRT in the prone position with a belly board. The VSB was calculated for doses from 5 to 45 Gy at an interval of 5 Gy. With prescription dose in planned target volume (PTV) of 50 Gy, the dose distribution, conformal index for PTV (CI), dose-volume histogram (DVH) of OARs, the correlation of VSB and the acute toxicity were compared. The results were shown as follows: (1) Among the 3 methods, there were no differences in PTV's converge including V95 and D95; (2) For IMRT under a supine position, CIwas closest to 1, the mean dose of small bowel decreased (P<0.05), and the mean VSB from V30 to V45 significantly decreased (P<0.05). (3) For 3DCRT with a belly board under a prone position, the mean dose and the mean VSB from 40 to 45 Gy were less than those for 3DCRT under a supine position (P<0.05); (4) Mean proportion of VSB was significantly greater in the patients experiencing diarrhea grade 2-4 than in those with diarrhea grade 0-1 at dose levels from V30 to V45 (P<0.05). It was concluded that for the radiotherapy of rectal cancer, IMRT technique might decrease the high-dose VSB to reduce the risk of acute injury. 3DCRT with a belly board under a prone position is superior to 3DCRT under a supine position, which could be a second choice for radiation of rectal cancer.
Female ; Humans ; Intestine, Small ; pathology ; radiation effects ; Male ; Organs at Risk ; pathology ; radiation effects ; Prone Position ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Conformal ; adverse effects ; Radiotherapy, Intensity-Modulated ; adverse effects ; Rectal Neoplasms ; pathology ; radiotherapy ; Urinary Bladder ; pathology ; radiation effects

Ionizing radiation (IR) is a potential carcinogen. Evidence for the carcinogenic effect of IR radiation has been shown after long-term animal investigations and observations on survivors of the atom bombs in Hiroshima and Nagasaki. However, IR has been widely used in a controlled manner in the medical imaging for diagnosis and monitoring of various diseases and also in cancer therapy. The collective radiation dose from medical imagings has increased six times in the last two decades, and grow continuously day to day. A large number of evidence has revealed the increased cancer risk in the people who had frequently exposed to x-rays, especially in childhood. It has also been shown that secondary malignancy may develop within the five years in cancer survivors who have received radiotherapy, because of IR-mediated damage to healthy cells. In this article, we review the current knowledge about the role of medical x-ray exposure in cancer development in humans, and recently recognized epigenetic mechanisms in IR-induced carcinogenesis.
Carcinogenesis ; Epigenesis, Genetic ; Humans ; Neoplasms ; etiology ; Radiography ; adverse effects ; Radiotherapy ; adverse effects

Antineoplastic Agents/adverse effects* ; Head and Neck Neoplasms ; Humans ; Radiotherapy/adverse effects* ; Stomatitis/prevention & control*

The purpose of this pictorial essay is to illustrate the multimodality imaging findings of a wide spectrum of radiation-induced complications of breast cancer in the sequence of occurrence. We have classified radiation-induced complications into three groups based on the time sequence of occurrence. Knowledge of these findings will allow for the early detection of complications as well as the ability to differentiate tumor recurrence.
Breast Neoplasms/*radiotherapy ; *Diagnostic Imaging ; Female ; Humans ; Radiation Injuries/*diagnosis ; Radiotherapy/*adverse effects

Acupuncture Therapy ; Aged ; Female ; Humans ; Radiotherapy ; adverse effects ; Tonsillar Neoplasms ; radiotherapy ; Xerostomia ; etiology ; therapy

We have established a computer model of calculating the normal tissue complication probability (NTCP) in line with the current primary methods and have designed the relevant software. Consequently, the complex calculation becomes easy, thus facilitating the clinical use of NTCP and improving the model step by step.
Algorithms ; Humans ; Probability ; Radiation Injuries ; epidemiology ; Radiotherapy ; adverse effects ; Radiotherapy Planning, Computer-Assisted ; Software Design

To identify the effect of post-operative irradiation to the thyroid gland in patients with breast carcinoma. Seventy seven patients with partial or total mastectomized breast carcinoma who received routine irradiation therapy (Hockey stick method: supraclavicular, internal mammary lymph nodes, and chest wall irradiation with 5, 040 rads, divided into 30 treatments) were reviewed in terms of their ipsilateral thyroid gland response. All patients had the bilateral thyroid sizes measured annually by ultrasonography before and after radiation therapy. In the one-year follow-up group (n=77), 32 patients (41.5%) demonstrated decreased ipsilateral thyroid gland size after Hockey Stick irradiation therapy (p=0.428), in the two-year follow-up group (n=37), 26 patients (70.3%) demonstrated decreased gland size after Hockey Stick irradiation (p=0.001), and in the three-year follow-up group (n=21), 15 patients (71.4%) showed a decreased thyroid gland size (p=0.005). Most the patients with breast carcinoma (32/77 at the one-year follow-up, 26/37 at the two-year follow-up, and 15/21 at the three-year follow-up) after post-operative Hockey Stick irradiation therapy showed reduced ipsilateral thyroid gland size. Routine en face treatment of the supraclavicular lymph nodes, using the Hockey Stick method, should be reconsidered.
Breast Neoplasms/*radiotherapy ; Female ; Follow-Up Studies ; Human ; Lymph Nodes/*radiation effects ; Radiotherapy/adverse effects ; Thyroid Gland/pathology/*radiation effects

OBJECTIVE: To compare the side effects of intensity modulated radiotherapy(IMRT) and conventional radiotherapy in nasopharyngeal carcinoma. METHOD: Sixty nine cases of nasopharyngeal carcinoma were random selected by stages,with 32 cases in IMRT group and 37 cases in conventional radiotherapy group. The target areas in IMRT group were nasopharyngeal carcinoma, parapharyngeal space and neck lymphatic area with the fractional dose of 2.00-2.12 Gy per time, for 33-35 times. The cases in conventional radiotherapy group were given facio-cervical field radiation, DT 40-60 Gy per time, for 20-30 times. The reinforcing dosage in lateral facial field increased to DT 70 Gy in the nasopharyngeal area. The prophylactic irradiation dose of the neck was DT 50-55 Gy. RESULT: The incidence of dry mouth one year after radiotherapy in the IMRT and conventional radiotherapy groups were 9.38% (3/32) and 94.59% (35/37) respectively, with a significant difference between the two groups (P < 0.01). The incidence of difficulty in opening mouth in the IMRT and conventional radiotherapy groups were 6.25% (2/32) and 72.97% (27/37) respectively, with a significant difference between the two groups(P < 0.01). CONCLUSION Compared with the conventional radiotherapy, IMRT may improve the control rate and obviously de creases the side effects. It could be recommended for the radiotherapy of nasopharyngeal carcinoma.
Adult ; Carcinoma ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; radiotherapy ; Radiotherapy ; adverse effects ; methods ; Radiotherapy, Intensity-Modulated ; adverse effects

Malnutrition occurs frequently in patients with cancer. Indeed, a variety of nutritional and tumor-related factors must be taken into account in these patients. Recognizing this relationship, we aimed to prospectively evaluate the risk factors that influence weight loss in patients undergoing radiotherapy with oral nutritional supplementation and dietetic counseling. Weight loss of 74 patients during radiotherapy and 1 month after treatment was analyzed. Parameters such as age, gender, tumor location, tumor stage, Eastern Cooperative Oncology Group performance status (ECOG PS) score, and the use of chemotherapy were analyzed to evaluate their influence on weight loss. All patients underwent oral nutritional supplementation and dietetic counseling. Forty-six (65.7%) patients lost weight, with a mean weight loss of (4.73 ± 3.91) kg, during radiotherapy. At 1 month after treatment, 45 (66.2%) patients lost weight, presenting a mean weight loss of (4.96 ± 4.04) kg, corresponding to a (6.84 ± 5.24)% net reduction from their baseline weight. Head and neck cancer patients had a mean weight loss of (3.25 ± 5.30) kg, whereas the remaining patients had a mean weight loss of (0.64 ± 2.39) kg (P = 0.028) during radiotherapy. In the multivariate analysis, the head and neck tumor location (P = 0.005), use of chemotherapy (P = 0.011), and ECOG PS score of 2-3 (P = 0.026) were considered independent risk factors. Nutritional status and parameters, such as tumor location (especially the head and neck), the use of chemotherapy, and the ECOG PS score, should be evaluated before radiotherapy because these factors can influence weight loss during radiotherapy and 1 month after treatment.
Body Weight ; Head and Neck Neoplasms ; radiotherapy ; Humans ; Neoplasms ; radiotherapy ; Prospective Studies ; Radiotherapy ; adverse effects ; Risk Factors ; Weight Loss