Accelerated Hyperfractionation of Radiotherapy for Rapidly Growing Inoperable Breast Cancer Unresponsive to Chemotherapy

1992 ◽  
Vol 78 (5) ◽  
pp. 326-329 ◽  
Author(s):  
Dimitrios Giannakakis ◽  
Michael Koukourakis ◽  
Anastasia Sotiropoulou ◽  
Haralambos Zambatis ◽  
John Scarlatos
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Breast Carcinoma ◽  
Acute Toxicity ◽  
Late Complications ◽  
Low Grade ◽  
Radiation Fields ◽  
Multidrug Chemotherapy

Eleven patients with rapidly growing inoperable breast carcinoma were treated with a thrice-a-day fractionation of 1.2 Gy per fraction (5-h intervals, 15 fractions per week). Nine of them had been considered as non-responders to previous aggressive multidrug chemotherapy. A split of 2 weeks was inserted after 54 Gy, and radiation fields were then restricted to the clinical positive area up to a total tumor dose of 90 Gy. Nine of 11 patients completed their treatment, and 7 of them were considered as complete responders. Acute toxicity was surprisingly low (grade I-II). Four patients surviving 12-18 months after radiotherapy did not relapse and did not present any late complications. A favorably improved quality of life was obtained for all 9 patients.

scholarly journals Changing goals in the management of breast carcinoma patients towards preservation of feminity and quality of life

2018 ◽  
Vol 4 (2) ◽  
pp. 96-98
Author(s):  
Soumi Pathak ◽  
Ajay Kumar Bhargava
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Health Care ◽  
Developing Countries ◽  
Breast Carcinoma ◽  
Cancer Patients ◽  
Breast Cancer Survivors ◽  
Breast Cancer Patients ◽  
Health Care Burden

Breast cancer is the commonest cancer in women worldwide. In the developing countries of Asia, the health care burden on account of breast cancer has been steadily mounting. Over 100,000 new breast cancer patients are estimated to be diagnosed annually in India.1 As per the ICMR-PBCR data, breast cancer is the commonest cancer among women in urban registries of Delhi, Mumbai, Ahmedabad, Calcutta, and Trivandrum where it constitutes > 30% of all cancers in females. Previous literature on mastectomy indicates that the operation may be perceived by the patient as a threat to her feminity. Breast cancer survivors have dissatisfaction with appearance, perceived loss of femininity and body integrity, self-consciousness about appearance, and dissatisfaction with surgical scars… Journal of Society of Anesthesiologists of NepalVol. 4, No. 2, 2017, Page: 96-98 

B-TREUH: A single-arm phase II pilot study of euthyroid hypothyroxinemia in metastatic breast carcinoma.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. TPS1115-TPS1115
Author(s):  
Shruti Trehan ◽  
Suzan S. Cheng ◽  
Aleck Hercbergs
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Breast Carcinoma ◽  
Radiation Effects ◽  
Metastatic Breast ◽  
Progression Free Survival ◽  
Free T4 ◽  
Metastatic Breast Carcinoma ◽  
The Us

TPS1115 Background: It is estimated that there are approximately 155,000 people living with metastatic breast cancer in the US. Studies exploring the connection between hypothyroidism or hyperthyroidism and breast cancer have yielded varying results with up to 33% prevalence of thyroid disease in these patients. L-thyroxine (T4) is the most commonly prescribed agent in the US to manage hypothyroidism. However, there are data suggesting that T4 is a pro-oncogenic agent with proposed mechanisms such as stimulation of mitogenesis, angiogenesis, resistance to apoptosis. In addition, T4 May counter anti-PDL-1 and radiation effects. Triiodothyronine (T3), which is deiodinated form of T4 and also commercially available, is felt to be less oncogenic and less mitogenic. Therefore, exogenous supplementation of T3 would decrease the T4 levels creating the desired state of EUTHYROID HYPOTHYROXINEMIA. The study hypothesizes that replacing L-thyroxine (T4) with Triiodothyronine (T3) in hypothyroid patients with metastatic breast carcinoma, while they simultaneously continue to receive standard systemic therapy, with titrating T3 dose to achieve a state of Euthyroid Hypothyroxinemia would result in improved disease outcomes. Methods: Eligible participants are adults with metastatic breast carcinoma with estimated life expectancy of > 3months, hypothyroidism, and with normal TSH on L-thyroxine (T4). Following consent, participants will discontinue L-thyroixne (T4) and initiate Triiodothyronine (T3) dose based on current T4 dose after an appropriate washout period. Drug titration will be in accordance with thyroid function testing to maintain levels of free T4 at < 50% normal range. The treatment period will continue for 9 months with periodic assessment of disease status, quality of life (FACT-B) and laboratory measures. The primary endpoint is the progression free survival at 12 months while the secondary endpoints are prevalence of hypothyroidism in the cohort, overall survival, quality of life, and duration of time to achieve the Euthyroid Hypothyroxinemia state. Given many uncertainties to calculate power precisely, the sample size is estimated to be approximately 30 patients. Clinical trial information: NCT03787303 .

Acute toxicity and quality of life in breast cancer patients treated by radiotherapy – results from the REQUITE multi-centre cohort study

2018 ◽  
Vol 92 ◽  
pp. S60
Author(s):  
T. Rattay ◽  
K. Johnson ◽  
D. Azria ◽  
J. Chang-Claude ◽  
S. Davidson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cohort Study ◽  
Acute Toxicity ◽  
Cancer Patients ◽  
Breast Cancer Patients

scholarly journals Association Between the Use of a Mobile Health Strategy App and Biological Changes in Breast Cancer Survivors: Prospective Pre-Post Study

10.2196/15062 ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. e15062 ◽  
Author(s):  
Mario Lozano-Lozano ◽  
Lucia Melguizo-Rodríguez ◽  
Carolina Fernández-Lao ◽  
Noelia Galiano-Castillo ◽  
Irene Cantarero-Villanueva ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Energy Balance ◽  
Breast Cancer Survivors ◽  
Low Grade ◽  
Tumor Removal ◽  
Risk Of Cancer ◽  
Low Grade Inflammation ◽  
Predictors Of Change

Background There is a bidirectional relationship between chronic low-grade inflammation and cancer. Inflammatory markers, such as interleukin-6 (IL-6), have been associated with both the malignant transformation of epithelial cells and tumor progression, thus linking low-grade inflammation with a higher risk of cancer and recurrence in the survival phase. Therefore, they are considered valuable prognostic biomarkers. Knowing and finding appropriate primary prevention strategies to modify these parameters is a major challenge in reducing the risk of cancer recurrence and increasing survival. Different therapeutic strategies have shown efficacy in the modification of these and other biological parameters, but with contradictory results. There are apparently no strategies in which telemedicine, and specifically mobile health (mHealth), are used as a means to potentially cause biological changes. Objective The objectives of this study were to: (1) check whether it is feasible to find changes in inflammation biomarkers through an mHealth strategy app as a delivery mechanism of an intervention to monitor energy balance; and (2) discover potential predictors of change of these markers in breast cancer survivors (BCSs). Methods A prospective quasi-experimental pre-post study was conducted through an mHealth energy balance monitoring app with 73 BCSs, defined as stage I-IIIA of breast cancer and at least six months from the completion of the adjuvant therapy. Measurements included were biological salivary markers (IL-6 and C-reactive protein [CRP]), self-completed questionnaires (the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, the user version of the Mobile Application Rating Scale [uMARS] and an ad hoc clinical and sociodemographic questionnaire) and physical objective measures (accelerometry, weight and height). In addition, using the logging data of the mHealth app, the rate of use (in days) was recorded during the entire experimental phase of the study. Using Stata software, a paired two-tailed t test, Pearson and Spearman correlations, and a stepwise multiple regression analysis were used to interpret the data. Results Analyzing changes in inflammatory biomarker concentrations after using the mHealth app, differences between preassessment CRP (4899.04 pg/ml; SD 1085.25) and IL-6 (87.15 pg/ml; SD 33.59) and postassessment CRP (4221.24 pg/ml; SD 911.55) and IL-6 (60.53 pg/ml; SD 36.31) showed a significant decrease in both markers, with a mean difference of –635.25 pg/ml (95% CI –935.65 to –334.85; P<.001) in CRP and –26.61 pg/ml (95% CI –42.51 to –10.71; P=.002) in IL-6. Stepwise regression analyses revealed that changes in global quality of life, as well as uMARS score and hormonal therapy, were possible predictors of change in CRP concentration after using the mHealth app. In the same way, the type of tumor removal surgery conducted, as well as changes in weight and pain score, were possible predictors of change in IL-6 concentration after using the app. Conclusions In conclusion, through the results of this study, we hypothesize that there is a possible association between an mHealth energy balance monitoring strategy and biological changes in BCSs. These changes could be explained by different biopsychosocial parameters, such as the use of the application itself, quality of life, pain, type of tumor removal surgery, hormonal treatment or obesity.

scholarly journals Late complications of the treatment of patients with germ cell tumors

2020 ◽  
Vol 16 (2) ◽  
pp. 152-161
Author(s):  
D. G. Danielyan ◽  
A. A. Salimova ◽  
A. A. Bulanov ◽  
M. Yu. Fedyanin ◽  
A. A. Tryakin
Keyword(s):  
Quality Of Life ◽  
Acute Toxicity ◽  
Germ Cell ◽  
Germ Cell Tumors ◽  
Late Complications ◽  
Highly Sensitive ◽  
Life Threatening

Germ cell tumors are one of the highly sensitive to chemotherapy, and about 80 % of patients can be cured even having metastases. Apartfrom acute toxicity, chemotherapy is characterized by late complications that occur many years later and not only negatively affect the quality of life, but in some cases are life-threatening. The review summarizes the results of studies on the late complications’ occurrence and prevention when treating patients with germ cell tumors.

Acute Toxicity and Quality of Life of Hypofractionated Radiation Therapy for Breast Cancer

2020 ◽  
Vol 107 (5) ◽  
pp. 943-948 ◽  
Author(s):  
Julie Arsenault ◽  
Sameer Parpia ◽  
Mira Goldberg ◽  
Eileen Rakovitch ◽  
Harold Reiter ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Radiation Therapy ◽  
Acute Toxicity ◽  
Hypofractionated Radiation Therapy ◽  
Hypofractionated Radiation

scholarly journals Acute and late toxicity in radical radiotherapy of prostate cancer

2009 ◽  
Vol 137 (1-2) ◽  
pp. 38-42 ◽  
Author(s):  
Tatjana Josifovski ◽  
Cane Tulic ◽  
Aleksandar Milosevic ◽  
Ljiljana Radosevic-Jelic
Keyword(s):  
Prostate Cancer ◽  
Acute Toxicity ◽  
Adverse Events ◽  
Late Toxicity ◽  
Late Complications ◽  
Radiation Dermatitis ◽  
Low Grade ◽  
Radical Radiotherapy ◽  
Treatment Tolerance

Introduction. Although radical radiotherapy has proved to be a successful method in prostate cancer treatment, the conventional (box) technique can result in significant adverse events. Objective. The objective of our study was to estimate the frequency, type and severity of acute and late toxicity in radical radiotherapy of prostate cancer. Methods. In a clinical retrospective study, we included 283 patients with histologically confirmed prostate cancer. All our patients received radical, conventional radiotherapy using the four-field technique. The study was performed at the Radiotherapy Department of the Institute for Oncology and Radiology of Serbia between January 1991 and December 2005. During regular follow-up, we analyzed the frequency, type and severity of acute and late toxicity. Results. Two thirds (71%) of our patients had acute toxicity of at least one organ within the radiation field. Most frequent complication was radiation dermatitis (10.5%), and enteritis (9%), cystitis (6%) and proctitis (2.5%). Acute adverse events were mostly low grade (I and II, 28-61%). Late complications were registered in 20.5% of patients. Skin fibrosis was most frequent (12%). Chronic proctitis was detected in 4% and urethral stricture in 4.5% of our patients. All late complications were low grade. Conclusion. Treatment tolerance of radical radiotherapy is relatively good. Although most patients develop acute toxicity, it is commonly low grade and requires the interruption of radiotherapy treatment in 20% of patients only. Late toxicity is rarer than acute and, in most cases, it does not affect the quality of life.

Hypofractionated volumetric modulated arc therapy with SIB adjuvant to breast preservation surgery: retrospective experience from a Regional Cancer Centre in Eastern India

2019 ◽  
Vol 18 (4) ◽  
pp. 369-374 ◽  
Author(s):  
Ashwin Mohandas Pallath ◽  
Debarshi Lahiri ◽  
Biplab Misra ◽  
Sanjoy Roy ◽  
Tapas Maji ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Acute Toxicity ◽  
Treatment Time ◽  
Volumetric Modulated Arc Therapy ◽  
Overall Treatment Time ◽  
Arc Therapy ◽  
Regional Cancer Centre ◽  
Good Cosmesis

AbstractBackground:The incidence of breast cancer has surpassed cervical cancer in India and it has now become the most common cancer in women. Multiple randomised studies have reported low α/β value in the range of 3–4 for breast cancer, which predict a potential radiobiological advantage for hypofractionated radiotherapy resulting in such schedules becoming standard in many centers with reduction in overall treatment time. Volumetric modulated arc therapy (VMAT) is a novel technique of delivering radiotherapy that reduces treatment delivery time, requires less monitor units (MU) and offers good conformity. The mean dose to normal tissue may be minimised using this technique although there will be inferior sparing if we consider the low-dose volume such as V5, the effect of which is not quantifiable yet.Aim:Reporting acute toxicity, cosmetic effects, and quality of life in patients of early breast cancer treated with adjuvant hypofractionated VMAT with SIB.Material and Methods:The records of 44 patients registered at the hospital between August 2014 and December 2015 were included in this analysis. Acute toxicities were analysed using CTCAE v4.03. Cosmetic outcomes were assessed using Harvard scale, while quality of life outcomes were assessed using EORTC scales and Health Related quality of life (HRQOL) questionnaires (QLQ-C30 and QLQ-BR23).Results:No grade ≥2 skin toxicities were recorded. Breast pain was recorded as Grade 1 in 13·8% patients and Grade 1 fatigue in 18·2%. The maximum haematological abnormality grade recorded was Grade 1. Cosmesis was assessed at the baseline, 6 months, 1 year and 2 years. A total of 88·6% of the patients had an Excellent or good cosmesis at the baseline, which was similar even at 6 months, at 88·7%, improved further at 1 year to 90·9%. At 6 months post radiotherapy, high functional scale QOL scores were noted.Conclusion:The technique is associated with minimum acute toxicity, good to excellent cosmesis and acceptable quality of life.

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