Introduction: The aim of this paper is to study the distribution of the therapy dosage applied by a modified conventional “field in field” technique and compare it to the distribution of the dosage applied by the standard conventional technique.Methods: The study included ten patients with right side breast cancer, after they were exposed to radical mastectomy and chemotherapy. Radiotherapy dosage of TD 50 Gy in 25 fractions was applied to the anterolateral side of the right thoracic wall, with two opposite conventional tangential fields by the linear accelerator Elekta Synergy and the energy of 6 megavolts (MV). A delineation of the target volume (CTV – Clinical Target Volume) was done within conventional fields. At the XiO system for planning we included additional fields within the existing conventional fields, which was the so called “field in field” technique. On the basis of CTV the Dose Volume Histogram (DVH) was calculated for conventional and “field in field” plans. VD90%, VD95%, VD107%, VD115%, CI and HI were calculated for both techniques. Means were pared with the paired Student's t-test. The results were considered significantly different if p<0.05.Results: VD90% and VD 95% were significantly higher for the “field in field” technique. Therefore, CI also favored the “field in field” technique (p=0.02). There was no difference in VD107% and VD115% between the compared groups. Consequently, there was no statistically significant difference in HI (1.13±0.03 vs.1.13±0.03, p=0.06).Conclusion: Conventional postoperative radiotherapy of localized right side breast cancer by “field in field” technique provides excellent coverage of the target volume by radiotherapy isodose.
The opinion regarding sexual and vaginal function of patients with advanced cervical cancer treated primarily by chemoradiotherapy has still not been formed, mainly due to inappropriate methodology as the control group was comprised of healthy women. The aim of this study is to, by means of interview, evaluate vaginal and sexual function of patients with advanced cervical cancer before and after chemoradiotherapy and compare the results. A number of 35 patients were irradiated by teleradiotherapy dose of 45 Gy in 25 fractions over 5 weeks to the pelvis and additional 20-24 Gy in 4-6 fractions were given by intracavitary HDR brachytherapy. Patients received 40 mg/m(2) of cisplatin once a week, which is a total of 4-6 cycles of cisplatin. Patients answered the questions in a form of a questionnaire specifically created for cervical cancer (EORTC-QLQ-Cx 24), for the period immediately before diagnosed cervical cancer (thus being a control group). They also answered the same questions for the period starting 12 months after the completion of concomitant chemoradiotherapy, and were an experimental group at the time. For the testing of statistical significance of differences among the examined groups parameter and non-parameter tests were used (the Wilcoxon signed ranks test and Student's t-test). The difference p<0.05 was considered statistically significant. Vaginal problems of patients after chemoradiotherapy were statistically reduced (44 versus 0; p<0.0001). There is no statistical significance in the vaginal function among the analyzed groups but weaker pain during intercourse was registered after chemoradiotherapy (p=0.009). After chemoradiotherapy, patients' vaginal function is extremely improved whereas there is no difference in the sexual function. Pain during intercourse is statistically reduced after chemoradiotherapy.
Quality of life in patients with cervical cancer FIGO IIb stage after concomitant chemoradiotherapy Background. The literature reports are unclear regarding the quality of life in patients after the concomitant chemoradiotherapy. Our aim was to define and compare the quality of life of patients with cervical cancer FIGO IIb stage before and after the concomitant chemoradiotherapy. Methods. Nineteen patients were irradiated to 45 Gy in 25 fractions over 5 weeks to the pelvis and additional 20-24 Gy in 4-6 fractions were given by intracavitary high dosage rate (HDR) brachytherapy. Patients received 40 mg/m2 of cisplatin once a week, starting from the first day of the intracavitary brachytherapy treatment, which is a total of 4-6 cycles of cisplatin. Patients were surveyed with two questionnaires for the assessment of the quality of life. They were developed by the European Organisation for Research and Treatment of Cancer (EORTC): one was cancer specific (EORTC QLQ-C30) and one was site specific (EORTC QLQ-Cx24). Patients answered the questions for the period immediately before diagnosed cervical cancer (thus being a control group) and for the period starting 12 months after the completion of the concomitant chemoradiotherapy (thus being an experimental group). Results. A statistically significant difference between the median scores of these two groups has been found in the quality of life, role function, emotional function, social function, pain, fatigue and vaginal problems. Conclusions. The quality of life of patients with cervical cancer FIGO IIb stage was better after concomitant chemoradiotherapy than before it.
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