Gamma knife surgery for brain metastases from ovarian cancer.

Gamma knife surgery for brain metastases from ovarian cancer.


numerous tables including:

Table 1 Patient characteristics of 16 patients with 119 brain metastases

Conclusions

Brain metastases from ovarian cancer are rare, but their incidence is increasing as patient survival has been extended by successful platinum-based chemotherapy and improved imaging techniques have enabled the identification of smaller lesions. In our study, the median survival from brain metastases was 12.5 months, and the local control rate was 86.4 %. The KPS and total volume of brain metastases were important factors predictive of survival. Our results suggest that GKS is an acceptable therapy for brain metastases from ovarian cancer. 

Conflicts of interest  

None.

Open Access  

open access: Cone-beam computed tomography in hypofractionated stereotactic radiotherapy for brain metastases

Cone-beam computed tomography in hypofractionatedstereotactic radiotherapy for brain metastases

Conclusions
Hypofractionated stereotactic radiotherapy have the significant limitation of uncertainty in interfraction repeatability of the patient setup; image-guided radiotherapy using cone-beam computed tomography improves the accuracy of the treatment delivery reducing set-up uncertainty, giving the possibility of 3-dimensional anatomic informations in the treatment
position.

abstract: A hypofractionated radiotherapy regimen (0-7-21) for advanced gynaecological cancer patients.

Abstract

AIMS:

To evaluate the efficacy of a palliative three fraction radiation regimen delivered on days 0, 7 and 21 (0-7-21 regimen) for advanced stage gynaecological cancer patients.

MATERIALS AND METHODS:

Fifty-one patients with advanced gynaecological cancer who were treated with the 0-7-21 regimen between 1998 and 2008 were identified. The median follow-up period was 1.4 months (range 0.2-33.4). Treatment completion data, symptomatic response, toxicity and survival were retrospectively analysed.

RESULTS:

Forty-eight patients received at least two of the three planned fractions. Complete and partial responses of vaginal bleeding were seen in 92% of 26 evaluable patients. Complete and partial responses of pain were seen in 76% of 25 evaluable patients. Eighteen of the 33 evaluable patients experienced grade 1/2 acute toxicity. No patients experienced grade 3/4 toxicity. Grade 1/2 and grade 3 late toxicity occurred in four and one of 12 evaluable patients, respectively. Grade 5 toxicity was assigned in two patients. It was uncertain whether these deaths were radiation related or due to tumour progression. Eleven patients survived longer than 12 months.

CONCLUSIONS:

The 0-7-21 regimen provided effective and rapid symptomatic relief with acceptable toxicity, and offered the advantage of convenience for most patients. It offers an alternate treatment option for carefully selected patients with incurable gynaecological malignancies.

abstract: (breast cancer) Timing of Radiotherapy and Outcome in Patients Receiving Adjuvant Endocrine Therapy

full free access: Proportion of second cancers attributable to radiotherapy treatment in adults: a cohort study in the US SEER cancer registries : The Lancet Oncology

Note: there is also chemotherapy-induced secondary cancers (not part of this study) but putting all treatment-related therapies (adverse events) in perspective
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Interpretation
A relatively small proportion of second cancers are related to radiotherapy in adults, suggesting that most are due to other factors, such as lifestyle or genetics.

full free access: Effect of tamoxifen and radiotherapy in women with locally excised ductal carcinoma in situ: long-term results from the UK/ANZ DCIS trial

full free access The Lancet: Effect of tamoxifen and radiotherapy in women with locally excised ductal carcinoma in situ: long-term results from the UK/ANZ DCIS trial : The Lancet Oncology

abstract: (Aug 6, 2010) Histotype predicts the curative potential of radiotherapy: the example of ovarian cancers

Blogger's Note: 

1) assumption - WAR (whole abdominal radiation - low dose/dosage; 2) ratio of cell types/RT; 3) study time period; 'apparent' stage 1/11; 4) surgical intervention by ?; 5) primary and/or secondary surgical debulking; 6) 'enhanced' as a %..... many questions in the absence of the full paper

 

Background: To explore the influence of ovarian cancer histotype on the effectiveness of adjuvant radiotherapy (RT).

Methods: A review of a population-based experience included all referred women with no reported macroscopic residuum following primary surgery who underwent adjuvant platin-based chemotherapy (CT), with or without sequential RT, and for whom it was possible to assign histotype according to the contemporary criteria.

Results: Seven hundred and three subjects were eligible, of these 351 received RT. For those with apparent stage I and II tumors, the cohort with clear cell (C), endometrioid (E), and mucinous (M) disease who additionally received RT exhibited a 40% reduction in disease-specific mortality and a 43% reduction in overall mortality.

Conclusions: The curability of those with stage I and II C-, E-, and M-type ovarian carcinomas was enhanced by RT-containing adjuvant therapy. This benefit did not extend to those with stage III or serous tumors. These findings necessitate reassessments of the role of RT and of the nonselective surgical and CT approaches that have characterized ovarian cancer care.

Emerging role of radiotherapy in the management of liver metastases