PubMed Journal Database | Clinical oncology (Royal College of Radiologists (Great Britain)) 
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Showing PubMed Articles 1–25 of 33 from Clinical oncology (Royal College of Radiologists (Great Britain))
AIMS: To compare average computed tomography (CT(AVE)) datasets with free breathing helical computed tomography (CT(HEL)) for contouring organs at risk (OARs) and radiation treatment planning in patients receiving stereotactic body radiation therapy (SBRT) in the lung. MATERIALS AND METHODS: Ten SBRT patients with peripheral stage I non-small cell lung cancer underwent a CT(HEL) and a four-dimensional computed tomography scan in the treatment position. CT(AVE) datasets were generated from the four-dimension...
AIMS: Hypofractionated accelerated radiotherapy with concurrent carboplatin utilises both advantages of altered fractionation and synchronous chemotherapy to maximise local control in locally advanced head and neck cancer. Such fractionation schedules are increasingly used in the intensity-modulated radiotherapy era and the aim of this study was to determine the outcome of hypofractionated accelerated radiotherapy with carboplatin. MATERIALS AND METHODS: One hundred and fifty consecutive patients with squam...
Endovascular Techniques in Palliative Care.
Most palliative care patients will require multidisciplinary management to optimise symptom control. This overview will show that endovascular procedures are an important consideration in many cases. These procedures can be used primarily, or more commonly, as an adjunct to other therapy modalities. Catheter, wire and modern imaging technology allow interventional radiologists to treat a wide, and growing, spectrum of conditions. Percutaneous endovascular procedures allow for minimal discomfort and rapid re...
AIMS: We conducted a population-based study of practice patterns and outcome across the regional cancer centres providing care to patients with laryngeal cancer in the Province of Ontario, Canada. MATERIALS AND METHODS: : This was a retrospective cohort study of 1547 patients with cancers of the glottic or supraglottic larynx diagnosed between 1982 and 1995. Data were collected via chart review, including: patient and disease characteristics, treatment, waiting times and treatment volumes. Vital status was...
Radiofrequency Ablation in the Treatment of Breast Cancer Liver Metastases.
Minimally invasive, image-guided thermal ablation is gaining acceptance for the treatment of solid tumour deposits and its use is increasing. This overview discusses one method of thermal ablation in one palliative setting; the local control of breast cancer liver metastases (BCLM) using radiofrequency ablation. Breast cancer is common and over half of all women diagnosed with metastatic disease develop BCLM. The mainstay of therapy remains chemotherapy and supportive care, which may prolong survival to a m...
The Surgical Palliation of Advanced Head and Neck Cancer using Photodynamic Therapy.
End-stage head and neck cancer is a difficult disease to manage. The only curative treatment option remains surgery, but this is frequently not feasible. Often, however, significant palliation can be achieved with minimally invasive surgically directed treatments, such as photodynamic therapy. To avoid the morbidity of treating non-cancer areas, photodynamic therapy can now be very accurately directed by radiological imaging along pre-planned grids to document and optimise laser-guided photo-activation of t...
AIMS: There has been a resurgence in interest in radiobiological modelling in head and neck cancer. The aim of this study was to determine if currently used parameters accurately predict both tumour and toxicity outcomes. MATERIALS AND METHODS: Trials were identified from a recent meta-analysis of altered fractionation. The tumour biologically effective dose (tBED; α/β=10Gy, t(k) [onset time of accelerated repopulation]=22 days, t(p) [average doubling time during accelerated repopulation]=3 days, α=0.3Gy...
Management of Oncological and Iatrogenic Urinary Incontinence in Malignant Disease.
Urinary incontinence can have a major effect on quality of life, and may contribute to overall disability in patients with abdominal and pelvic malignancy. It can lead to isolation and depression, and delay rehabilitation and integration within family and society. With prompt assessment and correct management, urinary leakage can be controlled and many of the problems associated with urinary incontinence can be prevented to the patient's satisfaction. In oncological patients, this is best achieved in a mult...
Malignant diseases of the upper gastrointestinal tract are common and often diagnosed at a point when the opportunity for curative surgical resection has passed. Symptoms of luminal obstruction include nausea, vomiting, weight loss, pain, pruritis and jaundice. The median survival of patients who cannot be cured surgically is extremely short, with a duration of only a few months. Effective palliative techniques with a low morbidity and associated mortality are required. The length of hospital stay, rapid re...
Palliation of Male Genital Cancers.
Advanced genital tumours are rare. Traditionally, surgical intervention in these patients has had a limited role due to the associated co-morbidities, poor performance status and overall poor prognosis. Because the potential benefit of surgical intervention in advanced cases is not evidence based, a large proportion of these patients are treated palliatively with chemoradiation therapy, which may have a limited role in advanced disease together with no significant improvement in quality of life for the pati...
AIMS: Determining the appropriate rate of radiotherapy is important for ensuring optimal radiotherapy utilisation and accessibility. A criterion-based benchmark (CBB) approach was developed as an alternative to evidence-based methods of determining the need for radiotherapy in prostate cancer. Our primary objective was to determine the initial/lifetime CBB radiotherapy rates in prostate cancer and to compare results with evidence-based estimates. Secondary objectives were to compare observed radiotherapy ra...
Supra-vesical Urinary Diversion and Ureteric Re-implantation for Malignant Disease.
Supra-vesical diversion or ureteric reconstruction is indicated for fistulae from the bladder or ureter, urinary incontinence, painful frequency and for end-stage renal failure due to obstructive uropathy. In a palliative setting, conservative measures, such as an indwelling catheter or ureteric stents, should be tried first. Open or laparoscopic surgery should be considered if these measures fail. For a patient who is leaking urine or has a very painful bladder, such surgery may well be justified, even ver...
Surgical Palliation in Malignant Disease.
The Role of Surgery in the Palliation of Malignancy.
Surgery has always had an important role to play in the palliation of advanced malignancy and the advent of new techniques and procedures means that this role will continue to evolve. The field is not built on a strong evidence base, however, and the lack of consensus regarding definitions of palliative surgery and few validated outcome measures mean good prospective trials are difficult to carry out. In this review we propose a definition of palliative surgery from the literature and review the current rol...
Percutaneous Urinary Drainage and Ureteric Stenting in Malignant Disease.
Patients with malignant ureteric obstruction often have a poor life expectancy, even if relief of urinary obstruction is achieved. Careful discussion between the patient, their family and all health care professionals involved in the case must be undertaken before any intervention. The goal of treatment in the palliative setting may be to offer symptom relief, avoid complications from renal insufficiency or allow further oncological systemic therapy. The obstruction can be relieved by placement of a percuta...
Treatment Options in Obstructed Left-sided Colonic Cancer.
Colorectal cancer presents as an emergency with large bowel obstruction in up to 29% of cases. These patients are often elderly with multiple co-morbidities and deranged physiological function. Traditionally, the mainstay of treatment was with staged surgical procedures, but recent trends have moved towards a primary resection and anastomosis. The use of self-expanding metallic stents has been described to alleviate obstruction and act as a bridge to surgery or as a definitive palliative procedure. Although...
Pelvic Exenterative Surgery for Palliation of Malignant Disease in the Robotic Era.
A Medline-based literature review was carried out of the surgical management of advanced pelvic cancers and the effect of minimally invasive technology in this setting to review the current status of exenterative surgery for advanced pelvic malignancies. Palliation and/or resection of advanced pelvic cancer affecting one or more pelvic compartments offers benefit and improved quality of life in carefully selected patients. This complex surgery is best carried out by experienced multidisciplinary teams after...
Palliative Radiotherapy for Non-melanoma Skin Cancer.
AIMS: The primary objective of this study was to assess the rate of tumour response to the palliative radiotherapy regimen used at our centre (8Gy/fraction on days 0, 7, 21) for non-melanoma skin cancer. The secondary objective was to evaluate symptom palliation. MATERIALS AND METHODS: A retrospective chart review identified patients treated with this palliative radiotherapy regimen from August 2003 to December 2008. Patient age, gender, tumour histology, location, size, presenting symptoms and radiation tr...
HER2 Testing, Adjuvant Trastuzumab Use and Results. Our Experience in South Wales.
Spinal Surgery for Palliation in Malignant Spinal Cord Compression.
Malignant spinal cord compression is an important neuro-oncological emergency, the management of which has been changing throughout the last 30 years. We hereby attempt to present an overview of this pathological entity with general management concepts, paying special attention to the palliative surgical treatments available, the decision-making process and the new emerging treatment modalities.
Brachytherapy for Cervix Cancer: Time for Change.
Clinical Application of Image-guided Radiotherapy in Bladder and Prostate Cancer.
Advances in radiotherapy planning reduced the volumes of irradiated normal tissue and allowed safe dose escalation in prostate cancer. Image-guided radiotherapy solutions to prostate and bladder cancer offer further improvements. The initial process is understanding the causes and extent of internal organ motion, followed by development of equipment and protocols to minimise geographical miss. Further refinements may allow margin reduction and further dose escalation. This paper reviews these issues for bla...
A Review of the Clinical Evidence for Intensity-modulated Radiotherapy.
AIMS: Intensity-modulated radiotherapy (IMRT) is a development of three-dimensional conformal radiotherapy that offers improvements in dosimetry in many clinical scenarios. Here we review the clinical evidence for IMRT and present ongoing or unpublished randomised controlled trials (RCTs). METHODS: We identified randomised and non-randomised comparative studies of IMRT and conventional radiotherapy using MEDLINE, hand-searching Radiotherapy and Oncology and the International Journal of Radiation Oncology, B...
UK Guidelines for the Safe Delivery of Intensity-modulated Radiotherapy.
This paper outlines the guidelines for the development of intensity-modulated radiotherapy (IMRT) in the UK. The guidelines are designed to cover the complete implementation of IMRT, with guidelines in the following categories: commissioning, quality, clinical, audit, and training and education. These guidelines have been compiled by the Radiotherapy Development Board of the Royal College of Radiologists and will support the safe application of IMRT in the UK.
