Abstract:
OBJECTIVE:For several decades, radiotherapy has been widely used to treat metastatic vertebral tumors. This study was designed to assess the feasibility and early clinical outcomes of high-dose radiotherapy to treat such tumors, using helical tomotherapy. METHODS:Between June 2009 and December 2011, 51 sites in 36 patients were treated with high-dose radiotherapy using helical tomotherapy for vertebral metastasis. Treatment outcomes and dosimetric analyses of spinal cord were retrospectively evaluated. RESULTS:Median follow-up was 11.5 months (range, 6-34.6) for surviving patients. The median total dose and the number of fractions in the primary helical tomotherapy arm were 2700 cGy and 3 fractions, respectively. Actuarial 6-month local control rates were 85.7%, and symptomatic vertebral compression fractures developed in five patients after a median of 4.2 (range, 2.9-5.7) months. Among 13 patients with 19 metastatic sites who showed pre-treatment impairment in neurologic function, five patients (with seven sites) in whom symptoms were mild showed improvement in neuronal function. The median pre-treatment pain visual analog scale score of 7 decreased to a median of 3 after helical tomotherapy (P < 0.001) at a median of 1 month (range, 0.5-3.2) of follow-up. No significant morbidity developed during follow-up except for one grade 3 esophagitis. CONCLUSIONS:The use of helical tomotherapy to treat metastatic vertebral tumors appears to be both safe and reliable in terms of local tumor control and early pain relief. Local progression and the risk of compression fracture in patients with pre-existing spinal instability remain the principal factors of limiting improved clinical and functional outcomes. Optimal dose-fractionation schemes and appropriate patient selection are required to achieve better outcomes with high-dose radiotherapy using helical tomotherapy.
journal_name
Jpn J Clin Oncoljournal_title
Japanese journal of clinical oncologyauthors
Lee DS,Kwak YK,Jeong SM,Song JH,Kang YN,Lee SN,Jang HS,Kim YS,Yoon SC,Choi BOdoi
10.1093/jjco/hyt050subject
Has Abstractpub_date
2013-06-01 00:00:00pages
646-53issue
6eissn
0368-2811issn
1465-3621pii
hyt050journal_volume
43pub_type
临床试验,杂志文章abstract::The joint international symposium of the 22nd Hiroshima Cancer Seminar and the 4th Japanese Association for RNA Interference focused on a pivotal role of microRNAs in carcinogenesis, progression and therapy of human cancer. Mammalian immune regulator MCPIP1 (Zc3h12a) RNase acts as a novel suppressor of microRNA activi...
journal_title:Japanese journal of clinical oncology
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journal_title:Japanese journal of clinical oncology
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journal_title:Japanese journal of clinical oncology
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journal_title:Japanese journal of clinical oncology
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journal_title:Japanese journal of clinical oncology
pub_type: 杂志文章,随机对照试验
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abstract::Pure red cell aplasia (PRCA) rarely occurs in non-thymic lymphoproliferative disorders. The present article describes a patient with non-Hodgkin's lymphoma (follicular, mixed type), who concurrently developed PRCA and warm type autoimmune hemolytic anemia during the clinical course. The PRCA and hemolytic anemia were ...
journal_title:Japanese journal of clinical oncology
pub_type: 杂志文章
doi:
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journal_title:Japanese journal of clinical oncology
pub_type: 杂志文章
doi:
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journal_title:Japanese journal of clinical oncology
pub_type: 杂志文章,评审
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journal_title:Japanese journal of clinical oncology
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pub_type: 杂志文章,评审
doi:
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journal_title:Japanese journal of clinical oncology
pub_type: 杂志文章,评审
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journal_title:Japanese journal of clinical oncology
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journal_title:Japanese journal of clinical oncology
pub_type: 临床试验,杂志文章
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pub_type: 杂志文章
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journal_title:Japanese journal of clinical oncology
pub_type: 杂志文章
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journal_title:Japanese journal of clinical oncology
pub_type: 临床试验,杂志文章
doi:
更新日期:1993-10-01 00:00:00
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journal_title:Japanese journal of clinical oncology
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journal_title:Japanese journal of clinical oncology
pub_type: 临床试验,杂志文章,多中心研究
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journal_title:Japanese journal of clinical oncology
pub_type: 杂志文章
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