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A 2011 updated systematic review and clinical practice guideline for the management of malignant extradural spinal cord compression.

https://arctichealth.org/en/permalink/ahliterature126132
Source
Int J Radiat Oncol Biol Phys. 2012 Oct 1;84(2):312-7
Publication Type
Article
Date
Oct-1-2012
Author
D Andrew Loblaw
Gunita Mitera
Michael Ford
Normand J Laperriere
Author Affiliation
Department of Radiation Oncology, Sunnybrook Health Science Centre, University of Toronto, Toronto, Canada. andrew.loblaw@sunnybrook.ca
Source
Int J Radiat Oncol Biol Phys. 2012 Oct 1;84(2):312-7
Date
Oct-1-2012
Language
English
Publication Type
Article
Keywords
Adult
Decompression, Surgical - methods
Dose Fractionation
Humans
Meta-Analysis as Topic
Multicenter Studies as Topic
Neoplasm Recurrence, Local - radiotherapy
Ontario
Randomized Controlled Trials as Topic
Retrospective Studies
Spinal Cord Compression - diagnosis - therapy
Spinal Cord Neoplasms - secondary - therapy
Steroids - therapeutic use
Walking
Abstract
To update the 2005 Cancer Care Ontario practice guidelines for the diagnosis and treatment of adult patients with a suspected or confirmed diagnosis of extradural malignant spinal cord compression (MESCC).
A review and analysis of data published from January 2004 to May 2011. The systematic literature review included published randomized control trials (RCTs), systematic reviews, meta-analyses, and prospective/retrospective studies.
An RCT of radiation therapy (RT) with or without decompressive surgery showed improvements in pain, ambulatory ability, urinary continence, duration of continence, functional status, and overall survival. Two RCTs of RT (30 Gy in eight fractions vs. 16 Gy in two fractions; 16 Gy in two fractions vs. 8 Gy in one fraction) in patients with a poor prognosis showed no difference in ambulation, duration of ambulation, bladder function, pain response, in-field failure, and overall survival. Retrospective multicenter studies reported that protracted RT schedules in nonsurgical patients with a good prognosis improved local control but had no effect on functional or survival outcomes.
If not medically contraindicated, steroids are recommended for any patient with neurologic deficits suspected or confirmed to have MESCC. Surgery should be considered for patients with a good prognosis who are medically and surgically operable. RT should be given to nonsurgical patients. For those with a poor prognosis, a single fraction of 8 Gy should be given; for those with a good prognosis, 30 Gy in 10 fractions could be considered. Patients should be followed up clinically and/or radiographically to determine whether a local relapse develops. Salvage therapies should be introduced before significant neurologic deficits occur.
PubMed ID
22420969 View in PubMed
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Boron neutron capture therapy of brain tumors: clinical trials at the finnish facility using boronophenylalanine.

https://arctichealth.org/en/permalink/ahliterature185360
Source
J Neurooncol. 2003 Mar-Apr;62(1-2):123-34
Publication Type
Article
Author
Heikki Joensuu
Leena Kankaanranta
Tiina Seppälä
Iiro Auterinen
Merja Kallio
Martti Kulvik
Juha Laakso
Jyrki Vähätalo
Mika Kortesniemi
Petri Kotiluoto
Tom Serén
Johanna Karila
Antti Brander
Eija Järviluoma
Päiivi Ryynänen
Anders Paetau
Inkeri Ruokonen
Heikki Minn
Mikko Tenhunen
Juha Jääskeläinen
Markus Färkkilä
Sauli Savolainen
Author Affiliation
Department of Oncology, University of Helsinki, Finland. heikki.joensuu@hus.fi
Source
J Neurooncol. 2003 Mar-Apr;62(1-2):123-34
Language
English
Publication Type
Article
Keywords
Adult
Aged
Boron - blood
Boron Compounds - therapeutic use
Boron Neutron Capture Therapy - adverse effects - instrumentation - mortality
Brain Neoplasms - mortality - radiotherapy
Dose-Response Relationship, Radiation
Female
Finland
Glioblastoma - mortality - radiotherapy
Humans
Male
Middle Aged
Neoplasm Recurrence, Local - radiotherapy
Prospective Studies
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted
Survival Rate
Abstract
Two clinical trials are currently running at the Finnish dedicated boron neutron capture therapy (BNCT) facility. Between May 1999 and December 2001, 18 patients with supratentorial glioblastoma were treated with boronophenylalanine (BPA)-based BNCT within a context of a prospective clinical trial (protocol P-01). All patients underwent prior surgery, but none had received conventional radiotherapy or cancer chemotherapy before BNCT. BPA-fructose was given as 2-h infusion at BPA-dosages ranging from 290 to 400 mg/kg prior to neutron beam irradiation, which was given as a single fraction from two fields. The average planning target volume dose ranged from 30 to 61 Gy (W), and the average normal brain dose from 3 to 6 Gy (W). The treatment was generally well tolerated, and none of the patients have died during the first months following BNCT. The estimated 1-year overall survival is 61%. In another trial (protocol P-03), three patients with recurring or progressing glioblastoma following surgery and conventional cranial radiotherapy to 50-60 Gy, were treated with BPA-based BNCT using the BPA dosage of 290 mg/kg. The average planning target dose in these patients was 25-29 Gy (W), and the average whole brain dose 2-3 Gy (W). All three patients tolerated brain reirradiation with BNCT, and none died during the first three months following BNCT. We conclude that BPA-based BNCT has been relatively well tolerated both in previously irradiated and unirradiated glioblastoma patients. Efficacy comparisons with conventional photon radiation are difficult due to patient selection and confounding factors such as other treatments given, but the results support continuation of clinical research on BPA-based BNCT.
PubMed ID
12749708 View in PubMed
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The potential of proton beam radiation for palliation and reirradiation.

https://arctichealth.org/en/permalink/ahliterature76162
Source
Acta Oncol. 2005;44(8):918-20
Publication Type
Article
Date
2005
Author
Thomas Björk-Eriksson
Anders Ask
Bengt Glimelius
Author Affiliation
Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden. Thomas.bjork-eriksson@oncology.gu.se
Source
Acta Oncol. 2005;44(8):918-20
Date
2005
Language
English
Publication Type
Article
Keywords
Humans
Models, Biological
Neoplasm Recurrence, Local - radiotherapy
Neoplasm, Residual - radiotherapy
Palliative Care
Protons - therapeutic use
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted - methods
Sweden
Abstract
A group of Swedish oncologists and hospital physicists have estimated the number of patients in Sweden suitable for proton beam therapy. The estimations have been based on current statistics of tumour incidence, number of patients potentially eligible for radiation treatment, scientific support from clinical trials and model dose planning studies and knowledge of the dose-response relations of different tumours and normal tissues. If an estimated 1% of the palliative treatments can be administered by protons with substantial benefits to the patient, almost 100 patients per year in Sweden would be eligible. It is further estimated that around 150 patients per year in need of reirradiation would benefit from radiation with protons compared to photons.
PubMed ID
16332602 View in PubMed
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Primary transoral robotic surgery with concurrent neck dissection for early stage oropharyngeal squamous cell carcinoma implemented at a Danish head and neck cancer center: a phase II trial on feasibility and tumour margin status.

https://arctichealth.org/en/permalink/ahliterature282954
Source
Eur Arch Otorhinolaryngol. 2017 May;274(5):2229-2237
Publication Type
Article
Date
May-2017
Author
Niclas Rubek
Hani Ibrahim Channir
Birgitte Wittenborg Charabi
Christel Bræmer Lajer
Katalin Kiss
Hans Ulrik Nielsen
Jens Bentzen
Jeppe Friborg
Christian von Buchwald
Source
Eur Arch Otorhinolaryngol. 2017 May;274(5):2229-2237
Date
May-2017
Language
English
Publication Type
Article
Keywords
Aged
Antineoplastic Agents - therapeutic use
Carcinoma, Squamous Cell - drug therapy - pathology - radiotherapy - surgery
Cisplatin - therapeutic use
Combined Modality Therapy
Denmark
Feasibility Studies
Female
Humans
Male
Middle Aged
Neck Dissection - methods
Neoplasm Recurrence, Local - radiotherapy - surgery
Neoplasm Staging
Oropharyngeal Neoplasms - drug therapy - pathology - radiotherapy - surgery
Robotic Surgical Procedures
Abstract
There is an increasing incidence of oropharyngeal squamous cell carcinoma (OPSCC) in the western world due to human papillomavirus (HPV). According to the Danish Head and Neck Cancer Group guidelines, the current recommended treatment of patients with OPSCC in Denmark is primary radiation therapy (RT) with or without concomitant chemotherapy. This is the first study in Scandinavia from a head and neck cancer centre that aims to demonstrate the feasibility of performing primary transoral robotic surgery (TORS) and concurrent neck dissection for patients with early stage OPSCC. Between September 2014 and January 2016, 30 consecutive patients with clinical T1-T2, N0-N1 OPSCC underwent primary TORS and concurrent neck dissection. The patients were offered postoperative adjuvant therapy according to pathological risk parameters: pT >2, T-site margin 1 or extracapsular extension (ECE). Concomitant chemotherapy was offered to patients with the presence of ECE or involved margins. Twenty-nine patients had negative margins on T-site after primary resection. Only one patient had a close margin of 1 mm. Unilateral neck dissection was performed in 21 patients while nine patients underwent bilateral neck dissection. Due to an upstaging following surgery, 13 patients were referred to adjuvant therapy. Four of these patients received RT and two patients received concomitant chemo-radiation (CCR) therapy. Seven patients declined the recommended adjuvant therapy one of whom later developed an N-site recurrence and received salvage surgery with postoperative RT. In summary, 43% of the patients were referred to adjuvant therapy following primary surgery which was mainly due to N-site stage migration and ECE. Primary TORS and concurrent neck dissection is a safe and feasible procedure that may be an alternative to primary RT and CCR in a selected group of patients with early stage OPSCC.
PubMed ID
28050651 View in PubMed
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Time trends in the results of breast conservation in 4694 women.

https://arctichealth.org/en/permalink/ahliterature19607
Source
Eur J Cancer. 2001 Aug;37(12):1537-44
Publication Type
Article
Date
Aug-2001
Author
I. Fredriksson
G. Liljegren
L G Arnesson
S O Emdin
M. Palm-Sjövall
T. Fornander
J. Frisell
L. Holmberg
Author Affiliation
The Karolinska Institute, Department of Surgery, Stockholm Söder Hospital, Stockholm, Sweden. irma.fredriksson@kirurg.sos.sll.se
Source
Eur J Cancer. 2001 Aug;37(12):1537-44
Date
Aug-2001
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Aged, 80 and over
Breast Neoplasms - radiotherapy - surgery
Chemotherapy, Adjuvant
Cohort Studies
Combined Modality Therapy
Female
Humans
Mastectomy, Segmental - methods
Middle Aged
Neoplasm Recurrence, Local - radiotherapy - surgery
Physician's Practice Patterns
Radiotherapy, Adjuvant
Research Support, Non-U.S. Gov't
Survival Rate
Sweden
Abstract
In a population-based cohort of 4694 women with invasive breast cancer, operated upon with breast conserving surgery (BCS) in 1981--1990 and followed through to 1997, we studied how this technique had been adopted into clinical practice, especially with reference to the use of radiotherapy (RT). Our main aim was to see whether there was a drift in the risk of local recurrence and breast cancer death over time. During the 30,151 person-years of observation in the cohort, there were 582 local recurrences, 456 breast cancer deaths and 438 deaths due to other causes. Postoperative RT was given to 70.2%, but usage increased over the period. The women not receiving RT were mostly elderly, but also in women
PubMed ID
11506963 View in PubMed
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