PURPOSE: While anal cancer is a very rare oncological diagnosis representing less than 2% of lower gastrointestinal tract cancers, the incidence has doubled in the past 20 years. Radical radiochemotherapy with sequential or simultaneous boost is now the standard treatment modality. Interstitial HDR brachytherapy is one of the boost application options. Implementation of new radiotherapy techniques has resulted in improved therapeutic outcomes; however, it is still associated with acute and especially late toxicity. Gastrointestinal disorders and sexual dysfunction are the most frequent factors affecting the long-term quality of cured patients' lives. METHODS: A total of 96 patients consecutively treated between 2000 and 2022 with external beam radio-/chemotherapy and an interstitial brachytherapy boost for histologically verified nonmetastatic anal squamous cell carcinoma were evaluated. The median follow-up time was 15.4 years (range 13.4-17.3 years). The primary objective of the study was to assess local control (LC) and quality of life (QoL). The Czech versions of internationally validated EORTC questionnaires were used to evaluate life quality-the basic EORTC QOL-C30 v.3 and the specific QOL-ANL 27 questionnaire. RESULTS: Local control was 85.5% at 5 years, 83.4% at 10 years, 83.4% at 15 years, and 83.4% at 20 years, and there was no dependence on clinical stage. The most common forms of acute toxicity were cutaneous and hematological but were gastrointestinal for late toxicities. In the evaluation of quality of life, 80.5% of patients alive at the time participated. In the EORTC quality of life questionnaire C30 v.3, patients rated the functional scale score as 86.2 points (standard deviation [SD] = 12.6) and the symptom score as 15.5 points (SD = 12.5). The global health score achieved 68.4 points (SD = 23.6). The most common symptoms were fatigue with 25.6 points (SD = 20.2) and diarrhea with 19.0 points (SD = 27.8). In the QOL-ANL 27 questionnaire, symptom scales assessing bowel symptoms were scored 27.5 points (SD = 19) in non-stoma patients and 11.9 points (SD = 17.2) in stoma patients. In the single-item symptom scales, the highest scores were rated for frequency of urination with 26.4 points (SD = 30.8), need to be close to a toilet with 22.4 points (SD = 27.3), and self-cleaning more often with 25.3 points (SD = 31.8). In the functional scales assessing sex life and interest, men and women reported scores of 45.2 (SD = 23) and 45.5 points (SD = 19), respectively. CONCLUSION: Boost with interstitial HDR brachytherapy is an established safe method of anal cancer treatment, with excellent results and limited late toxicity. Functioning scales were rated relatively highly in QoL questionnaires, and the overall global health score was comparable to published data. Gastrointestinal difficulties, fatigue, and sexual dysfunction dominated the symptom scales in our cohort.
- MeSH
- brachyterapie * metody MeSH
- celková dávka radioterapie MeSH
- dospělí MeSH
- kvalita života * psychologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory anu * radioterapie psychologie patologie MeSH
- následné studie MeSH
- průzkumy a dotazníky MeSH
- radiační poranění * psychologie etiologie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- spinocelulární karcinom * radioterapie patologie MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
AIMS: Curative sphincter sparing radiotherapy is a treatment option for early rectal cancer. There are many methods developed for fertility preservation in young patients treated with pelvic radiotherapy. Pregnancy rates after radiotherapy are dependent on the radiation dose to ovaries and uterus. Data on outcomes of total body irradiation suggest a pregnancy is possible following 12-14 Gy TBI, despite elevated rates of preterm deliveries and other complications. METHODS: We report a case of full-term delivery of twins after curative chemoradiotherapy for anorectal adenocarcinoma T2 N0 M0 with the total dose 58.6 Gy. The patient underwent laparoscopic laterocranial ovarian transposition before radiotherapy. RESULTS: Long term complete remission was achieved after treatment. Although a spontaneous conception was not successful, the patient underwent an in vitro fertilisation procedure with donor eggs and conceived twins 10 years after the radiotherapy treatment. The mean dose to the uterus was 16 Gy and to the uterine cervix 35 Gy. She reached a full-term pregnancy and delivered two healthy babies by caesarean section at a gestational age of 38 weeks, weighing 2420 g and 2220 g. CONCLUSION: This is the first case report of the successful pregnancy following sphincter sparing curative pelvic radiotherapy for rectal cancer. Furthermore it allows us to propose an increased limit dose to the uterus enabling fertility sparing beyond the limits achieved from total body irradiation series with 12-14 Gy and accept 16 Gy as uterine body (35 Gy for uterine cervix) limit for IMRT treatment planning in young patients asking for maintaining fertility potential.
- MeSH
- adenokarcinom terapie MeSH
- celková dávka radioterapie MeSH
- chemoradioterapie * MeSH
- dospělí MeSH
- fertilizace in vitro MeSH
- léčba šetřící orgány metody MeSH
- lidé MeSH
- nádory rekta terapie MeSH
- těhotenství MeSH
- uterus MeSH
- výsledek těhotenství MeSH
- zachování plodnosti metody MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Germinální nádory CNS (centrální nervový systém) jsou vzácně se vyskytující malignity dětského věku, adolescentů a mladých dospělých. V úvodu je uvedena charakteristika těchto nádorů, jejich histologické typy, principy léčby a prognóza. Kazuistika popisuje klinický nález, diagnostický a léčebný postup, poléčebný průběh a terapii pozdní recidivy germinálního nádoru CNS. Kazuistika potvrdila vysokou radio i chemosenzitivitu této malignity.
Intracranial germ cell tumours are rare malignancies of childhood, adolescence and young adults. The tumour characteristics, histology types, principles of treatment and their prognosis are described in the introduction. The case describes clinical finding, diagnostic and therapeutic procedure, result of treatment and late recurrence of the malignancy and its treatment in a young woman. The case confirmed a high radio- and chemosensitivity of intracranial germ cell tumours.
- MeSH
- dávka záření MeSH
- dospělí MeSH
- fotony terapeutické užití MeSH
- germinální a embryonální nádory * chirurgie diagnostické zobrazování farmakoterapie radioterapie terapie MeSH
- karboplatina aplikace a dávkování MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mozek chirurgie diagnostické zobrazování MeSH
- nádory centrálního nervového systému * chirurgie diagnostické zobrazování farmakoterapie radioterapie terapie MeSH
- protonová terapie MeSH
- radioterapie metody MeSH
- recidiva MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Závěrečná zpráva o řešení grantu Interní grantové agentury MZ ČR
Nestr. : il. ; 32 cm + 3 volné přílohy
Podrobná metodika a pomůcky pro sjednocení postupů používaných na RT pracovištích v ČR ke kontrole fyzikálních parametrů RT zařízení. Metodika pro plošné kontroly uvedených parametrů nezávislým subjektem s návazností na evropská pravoviště.
- Konspekt
- Fyzioterapie. Psychoterapie. Alternativní lékařství
- NLK Obory
- radiologie, nukleární medicína a zobrazovací metody
- NLK Publikační typ
- závěrečné zprávy o řešení grantu IGA MZ ČR
Závěrečná zpráva o řešení grantu Interní grantové agentury MZ ČR
Přeruš. str. : il. ; 32 cm + 12 volných příloh
Zajištění kvality v radioterapii z fyzikálního hlediska. XXX XXX XXX
