INTRODUCTION: Glomus jugulare tumours (GJT) are benign tumours that arise locally and destructively in the base of the skull and can be successfully treated with radiotherapy. Patients have a long-life expectancy and the late effects of radiotherapy can be serious. Proton radiotherapy reduces doses to critical organs and can reduce late side effects of radiotherapy. The aim of this study was to report feasibility and early clinical results of 12 patients treated using proton therapy. METHODS: Between December 2013 and June 2019, 12 patients (pts) with GJT (median volume 20.4 cm3 ; range 8.5-41 cm3 ) were treated with intensity modulated proton therapy (IMPT). Median dose was 54 GyE (Gray Equivalents) (50-60 GyE) with daily fractions of 2 GyE. Twelve patients were analysed with a median follow-up time of 42.2 months (11.3-86.7). Feasibility, dosimetric parameters, acute and late toxicity and local effect on tumour were evaluated in this retrospective study. RESULTS: All patients finished treatment without interruption, with excellent dosimetric parameters and mild acute toxicity. Stabilisation of tumour size was detected on MRI in all patients. No changes in symptoms were observed in comparison with pre-treatment conditions. No late effects of radiotherapy were observed. CONCLUSION: Pencil-beam scanning proton radiotherapy is highly feasible in the treatment of large GJT with mild acute toxicity and promising short-term results. Longer follow-up and larger patient cohorts are required to further identify the role of pencil-beam scanning (PBS) for this indication.

• MeSH
• celková dávka radioterapie MeSH
• lidé MeSH
• plánování radioterapie pomocí počítače metody   MeSH
• protonová terapie * škodlivé účinky   metody   MeSH
• protony MeSH
• radioterapie s modulovanou intenzitou * škodlivé účinky   metody   MeSH
• retrospektivní studie MeSH
• tumor glomus jugulare * etiologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Background: A favourable dose distribution has been described for proton beam therapy (PBT) of anal cancer in dosimetric studies. The relationship between dosimetric parameters in bone marrow and haematologic toxicity, treatment interruptions, and treatment efficacy has also been documented. There are only few references on clinical results of PBT for anal cancer. The primary objective of the retrospective study was to assess the efficacy of pencil beam scanning intensity-modulated proton therapy (PBS IMPT) in the definitive chemoradiotherapy of anal cancer. Secondary objectives were established to identify the risks of acute chronic toxicity risks and to assess colostomy rates. Materials and methods: Patients were treated for biopsy-proven squamous cell cancer (SCC) of the anus at initial or advanced stages. Eligible patients received PBS IMPT at a single institution. Treatment was administered in two volumes: 1-tumour with margins plus involved lymph nodes; 2-regional lymph node groups: perirectal (mesorectal), obturatory, inguinal, internal, external, and common iliac. The total doses of 57.5 GyE and 45 GyE, respectively, were administered in volumes 1 and 2 in 25 fractions, 5 fractions per week, respectively (a simultaneous integrated boost). Concomitant chemotherapy cisplatinum (CDDP) plus 5-FU or CDDP plus capecitabine was administered as per protocol. The treatment effect was assessed using DRE (digital rectal examination) and MRI (magnetic resonance imaging) within the follow-up period. Toxicity was scaled using CTCAE version 4.0 criteria. Results: 39 of 41 patients treated during the period of February 2014-August 2021 were eligible for analysis. All patients completed treatment, 76.9% without interruption. The median treatment time was 35 days (32-35). The median follow-up period was 30 months, 34 patients are alive to-date, 5 patients died prior to the date of analysis, and 2 deaths were unrelated to the primary disease. The 2-year overall survival, relapse-free survival, and colostomy-free survival were 94.2%, 93.8%, and 91.0%, respectively. Complete regression was achieved in 36 patients (92.3%), partial regression was achieved in 2 (5.1%), and immediate progression at end of treatment occurred in 1 patient (2.6%). Salvage resection was indicated for two patients in partial regression and due to severe chronic dermatologic toxicity. The grade 3 and 4 haematological toxicity rates were 7.7% and 5.1%, respectively. The most frequent non-haematological acute toxicities of grade 3-4 observed were dermatitis (23.1%), diarrhoea (7.7%), and dehydration (7.7%). Chronic toxicity emerged predominantly as skin atrophy/ulceration grade 2 (26.5%) and grade 3-4 (5.8%), and radiation proctitis grade 2 (38.2%) and grade 3 (2.9%). Discussion, conclusions: This single-institution study showed the high efficacy of PBS IMPT, achieving a high rate of complete regression. The haematological acute toxicity of grade 3-4 remained low; however, the impact of altered chemotherapy (CDDP instead of mitomycin C) remains unclear. The incidence of other acute toxicities shares similarity with photon therapy investigated in large studies. The acute toxicity completely resolved in all patients, had no lethal outcomes, and never resulted in the necessity for colostomy. By contrast, it was chronic toxicity, skin ulceration, perirectal fistulation, and fibrosis that resulted in salvage surgery and/or the need for a colostomy. A challenging question remains: to what extent can PBT prevent chronic toxicity? Longer follow-up remains necessary.

• Publikační typ
• časopisecké články MeSH

OBJECTIVES: Patients with nasopharyngeal cancer are candidates for proton radiotherapy due to large and comprehensive target volumes, and the necessity for sparing of healthy tissues. The aim of this work is to evaluate treatment outcome and toxicity profile of patients treated with proton pencil-beam scanning radiotherapy. MATERIALS AND METHODS: Between Jan 2013 and June 2018, 40 patients were treated for nasopharyngeal cancer (NPC) with IMPT (proton radiotherapy with modulated intensity). Median age was 47 years and the majority of patients had locally advanced tumors (stage 2-8 patients. (20%); stage 3-18 patients (45%); stage 4A-10 patients. (25%); stage 4B-4 patients. (10%). Median of total dose was 74 GyE (70-76 GyE) in 37 fractions (35-38). Bilateral neck irradiation was used in all cases. Concomitant chemotherapy was applied in 34 cases. (85%). Median follow-up time was 24 (1.5-62) months. RESULTS: Two-year overall survival (OS), disease-free survival (DFS), and local control (LC) were 80%, 75%, and 84%, respectively. Acute toxicity was generally mild despite large target volumes and concurrent application of chemotherapy with skin toxicity and dysphagia reported as the most frequent acute side effects. The insertion of a percutaneous endoscopic gastrectomy (PEG) was necessary in four cases (10%). Serious late toxicity (G > 3. RTOG) was observed in two patients (5%) (dysphagia and brain necrosis). CONCLUSION: IMPT for nasopharyngeal cancer patients is feasible with mild acute toxicity. Treatment outcomes are promising despite the high percentage of advanced disease in this group.

• MeSH
• celková dávka radioterapie MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory nosohltanu * radioterapie   MeSH
• následné studie MeSH
• nasofaryngeální karcinom radioterapie   MeSH
• protonová terapie * škodlivé účinky   MeSH
• protony MeSH
• radioterapie s modulovanou intenzitou škodlivé účinky   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE: To analyze the 5-year biochemical disease-free survival (bDFS) and late toxicity profile in patients with prostate cancer treated with pencil beam scanning (PBS) proton radiation therapy. METHODS AND MATERIALS: Between January 2013 and March 2016, 284 patients with prostate cancer were treated using intensity modulated proton therapy (IMPT), with an ultrahypofractionated schedule (36.25 GyE in 5 fractions). Five patients were immediately lost from follow-up and thus were excluded from analysis. Data for 279 patients were prospectively collected and analyzed with a median follow-up time of 56.5 (range, 3.4-87.5) months. The mean age at time of treatment was 64.5 (40.1-85.7) years, and the median prostate-specific antigen (PSA) value was 6.35 μg/L (0.67-17.3 μg/L). A total of 121 (43.4%) patients had low-risk, 125 patients (44.8%) had favorable, and 33 (11.8%) unfavorable intermediate-risk cancer. In addition, 49 (17.6%) patients underwent neoadjuvant hormonal therapy, and no patients had adjuvant hormonal therapy. bDFS and late toxicity profiles were evaluated. RESULTS: The median treatment time was 9 days (range, 7-18 days). The 5-year bDFS was 96.9%, 91.7%, and 83.5% for the low-, favorable, and unfavorable intermediate-risk group, respectively. Late toxicity (Common Terminology Criteria for Adverse Events v.4) was as follows: gastrointestinal: grade 1, 62 patients (22%), grade 2, 20 patients (7.2%), and grade 3, 1 patient (0.36%); genitourinary: grade 1, 80 patients (28.7%), grade 2, 14 patients (5%), and grade 3, 0 patients. PSA relapse was observed in 17 patients (6.1%), and lymph node or bone recurrence was detected in 11 patients. Four (1.4%) local recurrences were detected. Nine patients (3.2%) died of causes unrelated to prostate cancer. No deaths related to prostate cancer were reported. CONCLUSION: Ultrahypofractionated proton beam radiation therapy for prostate cancer is effective with long-term bDFS comparable with other fractionation schedules and with minimal serious long-term GI and GU toxicity.

• MeSH
• hypofrakcionace při ozařování * MeSH
• lidé středního věku MeSH
• lidé MeSH
• membránové proteiny MeSH
• nádorové supresorové proteiny MeSH
• nádory prostaty radioterapie   MeSH
• přežití bez známek nemoci MeSH
• protonová terapie * MeSH
• senioři MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Twenty (10 intensity-modulated proton therapy (IMPT) and 10 intensity-modulated x-ray therapy (IMXT) treatment plans for patients with advanced prostate carcinoma were compared in this study. All chosen patients were indicated for prostate and pelvic lymph nodes irradiation using simultaneous integrated boost technique. These patients represent typical specimen for this diagnose. IMPT irradiates just half of the tissue volume with a low dose (up to 10 cobalt gray equivalent) compared to IMXT without compromise in target volumes coverage and in this way reduces the risk of secondary cancer development or other possible complications.

• MeSH
• celková dávka radioterapie MeSH
• kritické orgány účinky záření   MeSH
• lidé MeSH
• lymfatické uzliny účinky záření   MeSH
• nádory prostaty radioterapie   MeSH
• pánev účinky záření   MeSH
• plánování radioterapie pomocí počítače metody   MeSH
• protonová terapie metody   MeSH
• radioterapie s modulovanou intenzitou metody   MeSH
• rentgenová terapie metody   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

INTRODUCTION: Extreme hypofractionated radiotherapy for prostate cancer is a common modality in photon therapy. Pencil beam scanning (PBS) in similar fractionation allows better dose distribution and makes proton therapy more available for such patients. The purpose of this study is the feasibility of extreme proton hypofractionated radiotherapy and publication of early clinical results. METHODS: Two hundred patients with early-stage prostate cancer were treated with IMPT (intensity-modulated proton therapy), extreme hypofractionated schedule (36.25 GyE in five fractions) between February 2013 and December 2015. Mean age of the patients was 64.3 years, and the mean value of prostate-specific antigen (PSA) before treatment was 6.83 μg/L (0.6-17.3 μg/L). Ninety-three patients (46.5%) were in the low-risk group. One hundred and seven patients (53.5%) were in the intermediate-risk group. Twenty-nine patients (14.5%) had neoadjuvant hormonal therapy, and no patients had adjuvant hormonal therapy. Acute toxicity, late toxicity and short-term results were evaluated. RESULTS: All patients finished radiotherapy without interruptions. The median follow-up time was 36 months. The mean treatment time was 9.5 days (median 9 days). Acute toxicity according to Common Terminology Criteria for Adverse Events (CTCAE) v 4.0 was (gastrointestinal toxicity) GI (grade) G1-17%, G2-3.5%; (genitourinary toxicity) GU G1-40%, G2-19%; and no G3 toxicity was observed. Late toxicity was GI G1-19%, G2-5.5%; GU G1-17%, G2-4%; and no G3 toxicity was observed. PSA relapse was observed in one patient (1.08%) in the low-risk group (pelvic lymph node involvement was detected) and in seven patients (6.5%) in the intermediate-risk group (three lymph node metastases, two lymph node and bone metastases, two PSA relapses). No patient died of prostate cancer, and three patients died from other reasons. No local recurrence of cancer in the prostate was observed. CONCLUSIONS: Proton beam radiotherapy for prostate cancer is feasible with a low rate of acute toxicity and promising late toxicity and effectivity.

• MeSH
• celková dávka radioterapie MeSH
• hypofrakcionace při ozařování * MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory prostaty radioterapie   MeSH
• prostata účinky záření   MeSH
• protonová terapie škodlivé účinky   metody   MeSH
• radiační poranění prevence a kontrola   MeSH
• studie proveditelnosti MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Tato studie byla zaměřena na experimentální hodnocení účinnosti heparinu jako radioprotektivní látky ve stavu akutního celotělového ozáření zářením gama. Účinnost přípravku byla založena na třicetidenním přežívání a průměrné době života uhynulých ozářených zvířat. Pro zjištění možných mechanismů radioprotektivních účinků heparinu byla studována hmotnost thymu, počet leukocytů a jednotek tvořících kolonie v periferní krvi a kostní dřeni. Bylo zjištěno, že radioprotektivní účinek heparinu podaného intraperitoneálně v dávce 250 jednotek na kilogram se dostavil během jednoho dne po podání a udržoval se po dobu do 30 dnů. Heparin zvyšoval přežívání pouze u radiosenzitivních myší BALB/c a inbredních myší. Přípravek vykazoval stimulační účinky na migraci krvetvorných buněk: injekce heparinu zvyšovala počet jednotek tvořících kolonie na dvojnásobek v periferní krvi myší BALB/c a spolehlivě snižovala tento počet v kostní dřeni.

The study was aimed at the experimental assessment of the efficacy of heparin as radioprotector in condition of acute whole body γ-ray irradiation. The efficacy of the product was based on the 30-day survival rate and average life expectancy of dead irradiated animals. To reveal possible mechanisms of radioprotective effects of heparin the thymus mass, the number of leukocytes and colony formation units (CFU) in the peripheral blood and bone marrow were studied. It was shown that radioprotective effect of heparin administered intraperitoneally in a dose of 250 unit/kg was developed within one day after the administration and maintained for periods up to 30 days. Heparin increased the survival rate only in radiosensitive BALB/c and inbred mice. The product exerted stimulating effects on the migration of haemopoietic cells: injection of heparin doubled the number of CFU in the peripheral blood of BALB/c mice and reliably reduced it in the bone marrow.

• Klíčová slova
• radioprotektivní látka, ozáření, přežívání, krvetvorba,
• MeSH
• heparin aplikace a dávkování   terapeutické užití   účinky záření   MeSH
• myši inbrední BALB C MeSH
• myši MeSH
• počet leukocytů využití   MeSH
• přežití bez známek nemoci MeSH
• radiační poranění krev   terapie   MeSH
• radiační účinky MeSH
• zvířata MeSH
• Check Tag
• myši MeSH
• zvířata MeSH

The study was aimed at the experimental assessment of the efficacy of recombinant interleukin-1ß in the early therapy of haemopoiesis disorders caused by X-ray irradiation. The efficacy of the product was based on the 30-day survival rate and average life expectancy of dead animals. Endogenous and exogenous colony-formations were studied to reveal possible mechanisms of therapeutic effects of interleukin-1ß on the bone marrow. The early administration (10–15 min after exposure to radiation) of recombinant interleukin-1ß in a dose of 50 µg/kg increased the survival rate and prevented the post-irradiation decrease in the number of endogenous and exogenous CFU-S9 in irradiated mice.

• MeSH
• experimentální radiační poranění farmakoterapie   mortalita   MeSH
• hematopoéza účinky léků   účinky záření   MeSH
• interleukin-1beta aplikace a dávkování   MeSH
• krevní nemoci etiologie   farmakoterapie   krev   mortalita   MeSH
• míra přežití MeSH
• myši inbrední C57BL MeSH
• myši inbrední CBA MeSH
• myši MeSH
• radioprotektivní látky terapeutické užití   MeSH
• rekombinantní proteiny aplikace a dávkování   MeSH
• zvířata MeSH
• Check Tag
• mužské pohlaví MeSH
• myši MeSH
• zvířata MeSH