1
|
Kišonas J, Venius J, Sevriukova O, Grybauskas M, Dabkevičienė D, Burneckis A, Rotomskis R. Individual Radiosensitivity as a Risk Factor for the Radiation-Induced Acute Radiodermatitis. Life (Basel) 2021; 12:life12010020. [PMID: 35054413 PMCID: PMC8781761 DOI: 10.3390/life12010020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/20/2021] [Accepted: 12/20/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Up to 95% of irradiated patients suffer from ionizing radiation (IR) induced early skin reaction, acute radiation dermatitis (ARD). Some experts think that additional skin hydration can reduce acute skin reactions. Individual radiosensitivity (IRS) determined from lymphocytes may help to predict acute radiation toxicity. The purpose of this study is to evaluate the clinical manifestation of ARD in different skincare groups during whole breast radiotherapy depending on IRS and other risk factors. Methods: A total of 108 early-stage breast cancer patients were randomized into best supportive care (BSC) and additional skincare (ASC) groups. IRS was evaluated using a G2 assay modified with caffeine-induced G2 checkpoint arrest. All patients received a 50 Gy dose to the breast planning target volume (PTV). Clinical assessment of ARD symptoms according to the CTCAE grading scale was performed once a week. Results: IRS was successfully determined for 91 out of 108 patients. A total of 10 patients (11%) had normal IRS, 47 patients (52%) were categorized as radiosensitive, and 34 (37%) as highly radiosensitive. There was no significant difference in the manifestation of ARD between patient groups by skincare or IRS. According to logistic regression, patients with bigger breasts were prone to more severe ARD (p = 0.002). Conclusions: The additional skincare did not improve skin condition during RT. A total of 89% of patients had increased radiosensitivity. IRS determined before RT did not show the predictive value for the manifestation of ARD. Logistic regression revealed that breast volume was the most significant risk factor for the manifestation of ARD.
Collapse
Affiliation(s)
- Juras Kišonas
- Department of Radiation Oncology, National Cancer Institute, LT-08660 Vilnius, Lithuania; (M.G.); (A.B.)
- Department of Neurobiology and Biophysics, Vilnius University, LT-10257 Vilnius, Lithuania
- Correspondence: ; Tel.: +370-612-376-96
| | - Jonas Venius
- Medical Physics Department, National Cancer Institute, LT-08660 Vilnius, Lithuania;
- Biomedical Physics Laboratory, National Cancer Institute, LT-08660 Vilnius, Lithuania;
| | | | - Mindaugas Grybauskas
- Department of Radiation Oncology, National Cancer Institute, LT-08660 Vilnius, Lithuania; (M.G.); (A.B.)
| | | | - Arvydas Burneckis
- Department of Radiation Oncology, National Cancer Institute, LT-08660 Vilnius, Lithuania; (M.G.); (A.B.)
| | - Ričardas Rotomskis
- Biomedical Physics Laboratory, National Cancer Institute, LT-08660 Vilnius, Lithuania;
| |
Collapse
|
2
|
Fitzal F, Bolliger M, Dunkler D, Geroldinger A, Gambone L, Heil J, Riedel F, de Boniface J, Andre C, Matrai Z, Pukancsik D, Paulinelli RR, Ostapenko V, Burneckis A, Ostapenko A, Ostapenko E, Meani F, Harder Y, Bonollo M, Alberti ASM, Tausch C, Papassotiropoulos B, Helfgott R, Heck D, Fehrer HJ, Acko M, Schrenk P, Trapp E, Gunda P, Clara P, Montagna G, Ritter M, Blohmer JU, Steffen S, Romics L, Morrow E, Lorenz K, Fehr M, Weber WP. ASO Visual Abstract: Retrospective Multicenter Analysis Comparing Conventional with Oncoplastic Breast-Conserving Surgery: Oncological and Surgical Outcomes in Women with High-Risk Breast Cancer from the OPBC-01/iTOP2 Study. Ann Surg Oncol 2021. [PMID: 34676460 DOI: 10.1245/s10434-021-10898-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Florian Fitzal
- Department of General Surgery and Breast Health Center, Medical University Vienna, Vienna, Austria.
| | - Michael Bolliger
- Department of General Surgery and Breast Health Center, Medical University Vienna, Vienna, Austria
| | - Daniela Dunkler
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Angelika Geroldinger
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Luca Gambone
- Department of General Surgery and Breast Health Center, Medical University Vienna, Vienna, Austria
| | - Jörg Heil
- Departement of Obstetrics and Gynecology, Breast Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Fabian Riedel
- Departement of Obstetrics and Gynecology, Breast Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Jana de Boniface
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Departemt of Surgery, Capio S:t Göran's Hospital, Stockholm, Sweden
| | - Camilla Andre
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Surgery, Uppsala University Hospital, Uppsala, Sweden
| | - Zoltan Matrai
- Department of Breast and Sarcoma Surgery, National Institute of Oncology, Budapest, Hungary
| | - Dávid Pukancsik
- Department of Breast and Sarcoma Surgery, National Institute of Oncology, Budapest, Hungary
| | - Regis R Paulinelli
- Araújo Jorge Hospital, Federal University of Goiás, Goiás Anti-Cancer Association, Goiás, Brazil
| | - Valerijus Ostapenko
- National Cancer Institute Vilnius Lithuania, Vilnius, Lithuania.,Faculty of Medicine, University of Vilnius, Vilnius, Lithuania
| | - Arvydas Burneckis
- National Cancer Institute Vilnius Lithuania, Vilnius, Lithuania.,Faculty of Medicine, University of Vilnius, Vilnius, Lithuania
| | - Andrej Ostapenko
- National Cancer Institute Vilnius Lithuania, Vilnius, Lithuania.,Faculty of Medicine, University of Vilnius, Vilnius, Lithuania
| | - Edvin Ostapenko
- National Cancer Institute Vilnius Lithuania, Vilnius, Lithuania.,Faculty of Medicine, University of Vilnius, Vilnius, Lithuania
| | - Francesco Meani
- Centro di Senologia della Svizzera Italiana (CSSI), Lugano, Switzerland.,Department of Obstetrics and Gynecology, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
| | - Yves Harder
- Centro di Senologia della Svizzera Italiana (CSSI), Lugano, Switzerland.,Department of Plastic, Reconstructive and Aesthetic Surgery, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
| | - Marta Bonollo
- Centro di Senologia della Svizzera Italiana (CSSI), Lugano, Switzerland.,Department of Obstetrics and Gynecology, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
| | - Andrea S M Alberti
- Centro di Senologia della Svizzera Italiana (CSSI), Lugano, Switzerland.,Department of Plastic, Reconstructive and Aesthetic Surgery, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
| | | | | | - Ruth Helfgott
- Department of Surgery, Ordensklinikum Linz - Sisters of Charity, Linz, Austria
| | - Dietmar Heck
- Department of Surgery, Ordensklinikum Linz - Sisters of Charity, Linz, Austria
| | - Hans-Jörg Fehrer
- Department of Surgery, Ordensklinikum Linz - Sisters of Charity, Linz, Austria
| | - Markus Acko
- Department of Surgery, Ordensklinikum Linz - Sisters of Charity, Linz, Austria
| | - Peter Schrenk
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Elisabeth Trapp
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Pristauz Gunda
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Paliczek Clara
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Giacomo Montagna
- Breast Center, University Hospital of Basel, Basel, Switzerland.,Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mathilde Ritter
- Breast Center, University Hospital of Basel, Basel, Switzerland
| | - Jens-Uwe Blohmer
- Department of Gynecology and Breast Center, Charité University Hospital Campus Charité-Mitte, Berlin, Germany
| | - Sander Steffen
- Clinical Cancer Registry, Charité Comprehensive Cancer Center (CCCC), University Medical Center Berlin, Campus Charité Mitte, Berlin, Germany
| | - Laszlo Romics
- New Victoria Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Elizabeth Morrow
- Department of Academic Surgery, University of Glasgow, Glasgow, UK
| | - Katharina Lorenz
- Department of Gynecology and Obstetrics, Cantonal Hospital, Frauenfeld, Frauenfeld, Switzerland
| | - Mathias Fehr
- Department of Gynecology and Obstetrics, Cantonal Hospital, Frauenfeld, Frauenfeld, Switzerland
| | - Walter Paul Weber
- Breast Center, University Hospital of Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
| |
Collapse
|
3
|
Fitzal F, Bolliger M, Dunkler D, Geroldinger A, Gambone L, Heil J, Riedel F, de Boniface J, Andre C, Matrai Z, Pukancsik D, Paulinelli RR, Ostapenko V, Burneckis A, Ostapenko A, Ostapenko E, Meani F, Harder Y, Bonollo M, Alberti ASM, Tausch C, Papassotiropoulos B, Helfgott R, Heck D, Fehrer HJ, Acko M, Schrenk P, Trapp EK, Gunda PT, Clara P, Montagna G, Ritter M, Blohmer JU, Steffen S, Romics L, Morrow E, Lorenz K, Fehr M, Weber WP. Retrospective, Multicenter Analysis Comparing Conventional with Oncoplastic Breast Conserving Surgery: Oncological and Surgical Outcomes in Women with High-Risk Breast Cancer from the OPBC-01/iTOP2 Study. Ann Surg Oncol 2021; 29:1061-1070. [PMID: 34647202 PMCID: PMC8724061 DOI: 10.1245/s10434-021-10809-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/03/2021] [Indexed: 11/18/2022]
Abstract
Introduction Recent data suggest that margins ≥2 mm after breast-conserving surgery may improve local control in invasive breast cancer (BC). By allowing large resection volumes, oncoplastic breast-conserving surgery (OBCII; Clough level II/Tübingen 5-6) may achieve better local control than conventional breast conserving surgery (BCS; Tübingen 1-2) or oncoplastic breast conservation with low resection volumes (OBCI; Clough level I/Tübingen 3-4). Methods Data from consecutive high-risk BC patients treated in 15 centers from the Oncoplastic Breast Consortium (OPBC) network, between January 2010 and December 2013, were retrospectively reviewed. Results A total of 3,177 women were included, 30% of whom were treated with OBC (OBCI n = 663; OBCII n = 297). The BCS/OBCI group had significantly smaller tumors and smaller resection margins compared with OBCII (pT1: 50% vs. 37%, p = 0.002; proportion with margin <1 mm: 17% vs. 6%, p < 0.001). There were significantly more re-excisions due to R1 (“ink on tumor”) in the BCS/OBCI compared with the OBCII group (11% vs. 7%, p = 0.049). Univariate and multivariable regression analysis adjusted for tumor biology, tumor size, radiotherapy, and systemic treatment demonstrated no differences in local, regional, or distant recurrence-free or overall survival between the two groups. Conclusions Large resection volumes in oncoplastic surgery increases the distance from cancer cells to the margin of the specimen and reduces reexcision rates significantly. With OBCII larger tumors are resected with similar local, regional and distant recurrence-free as well as overall survival rates as BCS/OBCI. Supplementary information The online version contains supplementary material available at 10.1245/s10434-021-10809-1.
Collapse
Affiliation(s)
- Florian Fitzal
- Department of General Surgery and Breast Health Center, Medical University Vienna, Vienna, Austria.
| | - Michael Bolliger
- Department of General Surgery and Breast Health Center, Medical University Vienna, Vienna, Austria
| | - Daniela Dunkler
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Angelika Geroldinger
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Luca Gambone
- Department of General Surgery and Breast Health Center, Medical University Vienna, Vienna, Austria
| | - Jörg Heil
- Departement of Obstetrics and Gynecology, Breast Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Fabian Riedel
- Departement of Obstetrics and Gynecology, Breast Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Jana de Boniface
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Departemt of Surgery, Capio St Göran's Hospital, Stockholm, Sweden
| | - Camilla Andre
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Surgery, Uppsala University Hospital, Uppsala, Sweden
| | - Zoltan Matrai
- Department of Breast and Sarcoma Surgery, National Institute of Oncology, Budapest, Hungary
| | - Dávid Pukancsik
- Department of Breast and Sarcoma Surgery, National Institute of Oncology, Budapest, Hungary
| | - Regis R Paulinelli
- Federal University of Goiás, Araújo Jorge Hospital, Goiás Anti-Cancer Association, Goiás, Brazil
| | - Valerijus Ostapenko
- National Cancer Institute Vilnius Lithuania, Vilnius, Lithuania.,Faculty of Medicine, University of Vilnius, Vilnius, Lithuania
| | - Arvydas Burneckis
- National Cancer Institute Vilnius Lithuania, Vilnius, Lithuania.,Faculty of Medicine, University of Vilnius, Vilnius, Lithuania
| | - Andrej Ostapenko
- National Cancer Institute Vilnius Lithuania, Vilnius, Lithuania.,Faculty of Medicine, University of Vilnius, Vilnius, Lithuania
| | - Edvin Ostapenko
- National Cancer Institute Vilnius Lithuania, Vilnius, Lithuania.,Faculty of Medicine, University of Vilnius, Vilnius, Lithuania
| | - Francesco Meani
- Centro di Senologia della Svizzera Italiana (CSSI), Lugano, Switzerland.,Department of Obstetrics and Gynecology, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
| | - Yves Harder
- Centro di Senologia della Svizzera Italiana (CSSI), Lugano, Switzerland.,Department of Plastic, Reconstructive and Aesthetic Surgery, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
| | - Marta Bonollo
- Centro di Senologia della Svizzera Italiana (CSSI), Lugano, Switzerland.,Department of Obstetrics and Gynecology, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
| | - Andrea S M Alberti
- Centro di Senologia della Svizzera Italiana (CSSI), Lugano, Switzerland.,Department of Plastic, Reconstructive and Aesthetic Surgery, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
| | | | | | - Ruth Helfgott
- Department of Surgery, Ordensklinikum Linz - Sisters of Charity, Linz, Austria
| | - Dietmar Heck
- Department of Surgery, Ordensklinikum Linz - Sisters of Charity, Linz, Austria
| | - Hans-Jörg Fehrer
- Department of Surgery, Ordensklinikum Linz - Sisters of Charity, Linz, Austria
| | - Markus Acko
- Department of Surgery, Ordensklinikum Linz - Sisters of Charity, Linz, Austria
| | - Peter Schrenk
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Elisabeth K Trapp
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | | | - Paliczek Clara
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Giacomo Montagna
- Breast Center, University Hospital of Basel, Basel, Switzerland.,Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mathilde Ritter
- Breast Center, University Hospital of Basel, Basel, Switzerland
| | - Jens-Uwe Blohmer
- Department of Gynecology and Breast Center, Charité University Hospital Campus Charité-Mitte, Berlin, Germany
| | - Sander Steffen
- Clinical Cancer Registry, Charité Comprehensive Cancer Center (CCCC), University Medical Center Berlin, Campus Charité Mitte, Berlin, Germany
| | - Laszlo Romics
- New Victoria Hospital, NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - Elizabeth Morrow
- Department of Academic Surgery, University of Glasgow, Glasgow, United Kingdom
| | - Katharina Lorenz
- Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland
| | - Mathias Fehr
- Department of Gynecology and Obstetrics, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland
| | - Walter Paul Weber
- Breast Center, University Hospital of Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
| |
Collapse
|
4
|
Kišonas J, Venius J, Grybauskas M, Dabkevičienė D, Burneckis A, Rotomskis R. Acute Radiation Dermatitis Evaluation with Reflectance Confocal Microscopy: A Prospective Study. Diagnostics (Basel) 2021; 11:diagnostics11091670. [PMID: 34574012 PMCID: PMC8471711 DOI: 10.3390/diagnostics11091670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/17/2021] [Accepted: 09/07/2021] [Indexed: 11/24/2022] Open
Abstract
Background: During radiotherapy (RT), most breast cancer patients experience ionizing radiation (IR)-induced skin injury—acute radiation dermatitis (ARD). The severity of ARD is determined by a physician according to CTCAE or RTOG scales, which are subjective. Reflectance confocal microscopy (RCM) is a noninvasive skin imaging technique offering cellular resolution. Digital dermoscopy (DD) performed in conjugation with RCM can provide more information regarding skin toxicity. The purpose of this study is to create an RCM and DD features-based ARD assessment scale, to assess the association with CTCAE scale and possible predictive value. Methods: One hundred and three breast cancer patients during RT were recruited; every week, clinical symptoms of ARD (CTCAE scale) were evaluated and RCM, together with digital dermoscopy (DD), was performed. Results: According to RCM; after 2 RT weeks, exocytosis and/or spongiosis were present in 94% of patients; after 3 weeks, mild contrast cells (MMCs) were detected in 45%; disarrayed epidermis (DE) was present in 66% of patients after 4 weeks and in 93% after 5 weeks; abnormal dermal papillae (ADP) were present in 68% of patients after 5 weeks. The coefficients of RCM features (RCMcoef) alone and together with dermoscopically determined erythema (RCM-ERYcoef) were significantly associated with ARD severity grade. RCMcoef is a significant predictive factor for the clinical manifestation of ARD. Conclusions: RCM features of irradiated skin appear earlier than clinical symptoms, have a characteristic course, and allow the severity of ARD to be predicted.
Collapse
Affiliation(s)
- Juras Kišonas
- Department of Radiation Oncology, National Cancer Institute, LT-08660 Vilnius, Lithuania; (M.G.); (A.B.)
- Department of Neurobiology and Biophysics, Vilnius University, LT-01513 Vilnius, Lithuania
- Correspondence: ; Tel.: +370-61237696
| | - Jonas Venius
- Medical Physics Department, National Cancer Institute, LT-08660 Vilnius, Lithuania;
- Biomedical Physics Laboratory, National Cancer Institute, LT-08660 Vilnius, Lithuania;
| | - Mindaugas Grybauskas
- Department of Radiation Oncology, National Cancer Institute, LT-08660 Vilnius, Lithuania; (M.G.); (A.B.)
| | | | - Arvydas Burneckis
- Department of Radiation Oncology, National Cancer Institute, LT-08660 Vilnius, Lithuania; (M.G.); (A.B.)
| | - Ričardas Rotomskis
- Biomedical Physics Laboratory, National Cancer Institute, LT-08660 Vilnius, Lithuania;
| |
Collapse
|
5
|
Fitzal F, Bolliger M, Dunkler D, Gambone L, Heil J, Riedel F, de Boniface J, André C, Matrai Z, Pukancsik D, Paulinelli R, Ostapenko V, Burneckis A, Ostapenko A, Ostapenko E, Meani F, Harder Y, Bonollo M, Alberti A, Tausch C, Papassotiropoulos B, Helfgott R, Heck D, Fehrer H, Acko M, Schrenk P, Montagna G, Trapp E, Pristauz G, Paliczek C, Blohmer J, Steffen S, Romics L, Morrow E, Lorenz K, Fehr M, Ritter M, Weber W. Retrospective multicenter analysis comparing conventional with oncoplastic breast conservation: oncologic and surgical outcome in women with high risk breast cancer from the OPBC-01/iTOP2 study. Breast 2021. [DOI: 10.1016/s0960-9776(21)00222-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
6
|
Kišonas J, Venius J, Sevriukova O, Grybauskas M, Guogyte K, Burneckis A, Rotomskis R. APPLICATION OF REFLECTANCE CONFOCAL MICROSCOPY FOR EARLY DIAGNOSIS OF RADIATION-INDUCED ACUTE DERMATITIS IN RADIOSENSITIVE PATIENT: CASE STUDY. Radiat Prot Dosimetry 2018; 182:93-97. [PMID: 30137559 DOI: 10.1093/rpd/ncy135] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Indexed: 05/16/2023]
Abstract
According to the guidelines on cancer treatment up to 52% of newly diagnosed cancer patients should be treated with external beam radiotherapy. Ionizing radiation (IR)-induced skin injury (radiation dermatitis) occurs in up to 95% of radiotherapy patients and can manifest from mild erythema till necrosis and ulceration. Individual radiosensitivity was proposed to be an important factor for the development of adverse reactions to IR. Therefore, assessment of radiosensitivity could be useful in predicting and dealing with radiation injuries caused by both radiotherapy and accidental overexposure. Here, we present a case of early diagnosis of IR-induced skin lesions performed by reflectance confocal microscopy in comparison to clinical evaluation in a highly radiosensitive patient.
Collapse
Affiliation(s)
- J Kišonas
- Department of Radiation oncology, National Cancer Institute, Vilnius, Lithuania
- Department of Neurobiology and Biophysics, Vilnius University, Vilnius, Lithuania
| | - J Venius
- Medical Physics Department, National Cancer Institute, Vilnius, Lithuania
- Biomedical Physics Laboratory, National Cancer Institute, Vilnius, Lithuania
| | | | - M Grybauskas
- Department of Radiation oncology, National Cancer Institute, Vilnius, Lithuania
| | - K Guogyte
- Radiation Protection Centre, Vilnius, Lithuania
| | - A Burneckis
- Department of Radiation oncology, National Cancer Institute, Vilnius, Lithuania
| | - R Rotomskis
- Biomedical Physics Laboratory, National Cancer Institute, Vilnius, Lithuania
| |
Collapse
|
7
|
Kišonas J, Burneckis A, Ivanauskas A, Mickevičius R, Vėželis A. First experience of salvage HDR brachytherapy after prostate cancer radiotherapy. Acta Med Litu 2015. [DOI: 10.6001/actamedica.v21i4.3049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Introduction. Prostate cancer (PC) is the most common oncologic disease among men. The number of patients with recurrent PC after primary radiotherapy is increasing, unfortunately, criteria for the choice among different treatment methods for these patients have not been defined yet. Salvage treatment options include prostatectomy, brachytherapy (BT), cryotherapy, thermoablation, and high frequency ultrasound. The lack of long-term evaluation of the toxicity and influence on the survival of patients after salvage high-dose-rate (HDR) BT is an important problem when considering this treatment option. In this study we have analyzed the treatment results of twelve patients who were diagnosed with local recurrent prostate cancer after primary radiotherapy and then treated with HDR BT.
Materials and methods. Patients were treated with salvage HDR BT between January 2013 and February 2014 at the Institute of Oncology, Vilnius University
Results. Average age of the patients at the time of salvage treatment was 67.5 years (min 54 years, max 76 years). The PSA value at the salvage treatment was from 2.06 ng/ml to 9.20 ng/ml. The time from the initial diagnosis till the salvage treatment was from 33 months to 134 months. All 24 procedures were successful and without any early complications.
Conclusions. HDR BT is a presumable and safe treatment option for local prostate cancer recurrence after primary radiotherapy. Prospective clinical trial is initiated to evaluate survival, long-term toxicity and predictive value of different biomarkers.
Collapse
|
8
|
Samalavicius NE, Dulskas A, Kilius A, Petrulis K, Norkus D, Burneckis A, Valuckas KP. Treatment of hemorrhagic radiation-induced proctopathy with a 4% formalin application under perianal anesthetic infiltration. World J Gastroenterol 2013; 19:4944-4949. [PMID: 23946599 PMCID: PMC3740424 DOI: 10.3748/wjg.v19.i30.4944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2012] [Revised: 04/05/2013] [Accepted: 05/08/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the results of hemorrhagic radiation proctopathy treatment with a 4% formalin application.
METHODS: A prospective study was performed. Over a three-year period, 38 patients underwent 4% formalin application under perianal anesthetic infiltration for hemorrhagic radiation proctopathy. All patients included in the study were irradiated for prostate cancer. The patients ranged in age from 56-77 years (average 70 ± 5 years). All of the patients were referred for formalin therapy after noninvasive management had failed. Twenty-four (63.2%) patients underwent a single application, 10 (26.3%) patients underwent 2 applications, and 4 (10.5%) patients underwent 3 applications.
RESULTS: Two to 36 mo (average 12 ± 3 mo) following treatment, 34 patients were interviewed (four were lost to follow-up). Twenty (58.8%) subjects reported complete cure, 8 (23.5%) subjects reported significant improvement, and 6 (17.7%) subjects reported no change. One patient (who underwent a colostomy at a regional hospital with no specialized services available for previous bleeding episodes from radiation proctopathy) was cured, and the colostomy was closed. One patient (2.6%) developed rectal mucosal damage after the second application.
CONCLUSION: A 4-min application of 4% formalin for hemorrhagic radiation-induced proctopathy under perianal anesthetic infiltration in patients who have received external radial radiation therapy for prostate cancer is simple, reasonably safe, inexpensive, generally well tolerated, and effective.
Collapse
|
9
|
Stratilatovas E, Sangaila E, Burneckis A, Strupas K, Poskus E. 173. A randomized multicenter trial to compare functional outcome and complications of surgical procedures for low rectal cancers. Eur J Surg Oncol 2012. [DOI: 10.1016/j.ejso.2012.06.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
10
|
Ivanauskas A, Aleknavicius E, Burneckis A, Vezelis A, Kasulaityte L. UP-02.161 Low Dose Rate (LDR) Prostate Brachytherapy: Review of Our Experience. Urology 2011. [DOI: 10.1016/j.urology.2011.07.979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
11
|
Aleknavicius E, Burneckis A, Ivanauskas A. 1017 poster GENITOURINARY TOXICITY IN PROSTATE HDR BRACHYTHERAPY. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)71139-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
12
|
Aleknavicius E, Burneckis A, Ivanauskas A. 720 poster OUR FIRST EXPERIENCE IN LDR PROSTATE BRACHYTHERAPY. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70842-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
13
|
Mickevicius R, Burneckis A, Aleknavicius E. 819 poster BRAIN TUMORS BRACHYTHERAPY BY USING IR 192. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70941-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
14
|
Ridgway D, Sopata M, Burneckis A, Jespersen L, Andersen C. Clinical efficacy and safety of once-daily dosing of a novel, prolonged-release oral morphine tablet compared with twice-daily dosing of a standard controlled-release morphine tablet in patients with cancer pain: a randomized, double-blind, exploratory crossover study. J Pain Symptom Manage 2010; 39:712-20. [PMID: 20413058 DOI: 10.1016/j.jpainsymman.2009.08.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2009] [Revised: 08/04/2009] [Accepted: 08/11/2009] [Indexed: 11/23/2022]
Abstract
CONTEXT Recently, a new oral prolonged-release formulation of morphine sulfate for once-daily dosing has been developed based on an injection-molded matrix (abuse-deterrent, prolonged-release erodible matrix [ADPREM]). OBJECTIVES The objective of this double-blind, randomized, exploratory crossover study was to assess the efficacy and safety of once-daily ADPREM compared with twice-daily controlled-release morphine (CRM; MST ContinusNapp Pharmaceuticals, Cambridge, UK). METHODS Thirty-eight adult cancer pain patients participated in the study, which consisted of a run-in period for stabilization and two consecutive fixed-dose treatment periods of two weeks' duration each. Rescue medication, immediate-release morphine sulfate, was available during the entire study for treatment of breakthrough pain (BTP). RESULTS There was no difference between the treatments in use of rescue medication. The medians of the average number of rescue doses per day were 1.0 and 0.7 during the ADPREM and CRM treatment periods, respectively, with an estimated median difference of 0.07 dose/day (95% confidence interval: -0.21, 0.29). Likewise, no differences between treatments were found for the number of BTP episodes per day or morning and evening ratings of pain intensity (current, average, minimum, and maximum). Median assessment of the drugs was "good" for both treatments, and neither of the treatments was preferred. Steady-state trough concentrations of morphine and its metabolites in plasma before morning dosing were similar after either treatment period. The adverse events were as expected in an opioid-treated cancer population and showed no differences between ADPREM and CRM. CONCLUSION In this study, dosing with ADPREM at intervals of 24 hours was therapeutically equivalent to CRM dosed at intervals of 12 hours.
Collapse
|
15
|
Baranauskas Z, Valuckas K, Aleknavicius E, Jankevicius F, Burneckis A, Paviloniene I. [Use of strontium-89 in the analgesic treatment of cancer patients with bone metastases]. Medicina (Kaunas) 2006; 42:11-4. [PMID: 16467608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
The aim of this article was to review the available literature regarding to the use of strontium-89 in the palliation of osteoblastic bone pain. The data of many researchers showed that approximately 80% of patients with pain from osteoblastic lesions resulting from prostate or breast cancer experience significant pain relief by administration of strontium-89, with only mild levels of hematotoxicity. The duration of pain relief in some cases exceeded 3-6 months. Indications for administration of strontium-89, effectiveness and duration of the treatment, side effects are reviewed in this article.
Collapse
Affiliation(s)
- Zenonas Baranauskas
- Institute of Oncology, Vilnius University, Santariskiu 1, 08660 Vilnius, Lithuania.
| | | | | | | | | | | |
Collapse
|
16
|
Kazbariene B, Prasmickiene G, Krikstaponiene A, Sukeliene D, Burneckis A, Didziapetriene J. [Changes in the parameters of immune and antioxidant systems in patients with cervical cancer]. Medicina (Kaunas) 2004; 40:1158-64. [PMID: 15630341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Taking into account the possibility of interaction of immune and antioxidant systems, the aim of this study was to investigate the changes in the parameters of immune and antioxidant systems in patients with cervical cancer and to compare them with the corresponding data obtained from healthy women. Ninety-four women with cervical cancer at II and III stage comprised the patient group and 69 healthy women were taken as the control group. The investigation results showed that the cellular immunity functions of patients with cervical cancer were suppressed in comparison with the same of healthy women. Though with respect to age, in 35-49-year-old women group with cervical cancer, some immune system indices were suppressed (quantity of T-, B-lymphocytes, NK); however in order to maintain the immune homeostasis of the organism other immune system functions were compensatorily stimulated (neutrophils and its phagocytic activity, CD8(+), IgG and IgA concentration were higher). The activity of the antioxidant system in patients with cervical cancer was impaired: the concentration of lipid peroxidation products was increased, the level of the endogenous antioxidant vitamin E and the activity of the antioxidant enzyme superoxide dismutase were decreased in comparison with the control group.
Collapse
|
17
|
Cicenas S, Pipiriene-Zelviene T, Burneckis A, Ciceniene A. Induction chemoterapy gemcitabine(G)-cisplatin(C) versus etoposide(E)-cisplatin(C) in IIIA/IIIB stages non — small cell lung cancer (NSCLC) patients with intermittent radiotherapy. Lung Cancer 2003. [DOI: 10.1016/s0169-5002(03)92520-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
18
|
Atkočius V, Burneckis A, Atkočiené E. Clinical radiobiology of HDR Cf-252 brachytherapy for rectal cancer. Radiother Oncol 1995. [DOI: 10.1016/0167-8140(96)80478-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
19
|
Atkocius V, Burneckis A, Janulionis E. 76 Combined external gamma and intracavitary 252Cf neutron radiation therapy in the management of rectal cancer. Radiother Oncol 1994. [DOI: 10.1016/0167-8140(94)91174-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
20
|
Atkoćius V, Burneckis A, Sinkevičiûs Z. Intracavitary Cf-252 neutron therapy in the rectal cancer treatment. Eur J Cancer 1993. [DOI: 10.1016/0959-8049(93)91887-q] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|