Jiri Kubes

Accelerated radiotherapy with concomitant boost technique (69.5 Gy/5 weeks) : an alternative in the treatment of locally advanced head and neck cancer.

Background and PurposeTo present the feasibility and results of accelerated radiotherapy with concomitant boost technique (69.5 Gy/5 weeks) in the treatment of locally advanced head and neck cancer.Patients and MethodsA total of 65 patients were treated between June 2006 and August 2009. The distribution of clinical stages was as follows: II 11%, III 23%, IV 61%, and not defined 5%.ResultsThe median follow-up was 30.5 months. The treatment plan was completed in 94% of patients. Patients were treated using the conformal or intensity-modulated radiotherapy (IMRT) technique. The median overall treatment time was 37 days (13–45 days). The mean radiotherapy dose was 68.4 Gy (16–74 Gy). Overall survival was 69% after 2 years. Disease-free survival was 62% after 2 years. Acute toxicity ≥ grade 3(RTOG scale) included mucositis (grade 3: 42.6%), pharynx (grade 3: 42.3%), skin (grade 3: 9.5%), larynx (grade 3: 4%), while late toxicity affected skin (grade 3: 6.25%) and salivary glands (grade 3: 3.7%).ConclusionAccelerated radiotherapy with concomitant boost technique is feasible in patients with locally advanced head and neck cancer, has an acceptable toxicity profile, and yields promising treatment results.Hintergrund und ZielPräsentation von Durchführbarkeit und Ergebnissen der Strahlentherapie mit Concomitant-Boost-Technik (69,5 Gy/5 Wochen) bei der Behandlung von lokal fortgeschrittenen Kopf-Hals-Tumoren.Patienten und MethodikIm Zeitraum 6/06 bis 8/09 wurden 65 Patienten behandelt. Stadienverteilung: II in 11%, III in 23%, IV in 61% und undefinierbar in 5% der Fälle.ErgebnisseMediane Beoachtungszeit: 30,5 Monate. Die geplante Therapie ließ sich bei 94% der Patienten durchführen. Die Patienten wurden mit 3D-konformaler oder IMRT-Technik bestrahlt. Der Median der Bestrahlungsdauer betrug 37 Tage (13–45 Tage). Die applizierte durchschnittliche Dosis betrug 68,4 Gy (16–74 Gy). Das gesamte 2-Jahres-Überleben betrug 69%, Das krankheitsfreie 2-Jahres-Überleben 62%. Akuttoxizitäten von mindestens Grad 3 (RTOG Skala) betrafen Mukositis (Grad 3: 42%), Pharynx (Grad 3: 42,3%) Haut (Grad 3: 9,5%) und Kehlkopf (Grad 3: 4%). Die Spättoxizitäten betrafen Haut (Grad 3: 9,5%) und Speicheldrüsen (Grad 3: 3,7%).SchlussfolgerungDie akzelerierte Strahlentherapie mit der Concomitant-Boost-Technik ist bei Patienten mit Kopf- und Halstumoren durchführbar. Diese Technik hat ein akzeptables Toxizitätsprofil und gute Heilungsergebnisse.

Accelerated radiotherapy with concomitant boost technique (69.5 Gy/5 weeks)

Background and PurposeTo present the feasibility and results of accelerated radiotherapy with concomitant boost technique (69.5 Gy/5 weeks) in the treatment of locally advanced head and neck cancer.Patients and MethodsA total of 65 patients were treated between June 2006 and August 2009. The distribution of clinical stages was as follows: II 11%, III 23%, IV 61%, and not defined 5%.ResultsThe median follow-up was 30.5 months. The treatment plan was completed in 94% of patients. Patients were treated using the conformal or intensity-modulated radiotherapy (IMRT) technique. The median overall treatment time was 37 days (13–45 days). The mean radiotherapy dose was 68.4 Gy (16–74 Gy). Overall survival was 69% after 2 years. Disease-free survival was 62% after 2 years. Acute toxicity ≥ grade 3(RTOG scale) included mucositis (grade 3: 42.6%), pharynx (grade 3: 42.3%), skin (grade 3: 9.5%), larynx (grade 3: 4%), while late toxicity affected skin (grade 3: 6.25%) and salivary glands (grade 3: 3.7%).ConclusionAccelerated radiotherapy with concomitant boost technique is feasible in patients with locally advanced head and neck cancer, has an acceptable toxicity profile, and yields promising treatment results.Hintergrund und ZielPräsentation von Durchführbarkeit und Ergebnissen der Strahlentherapie mit Concomitant-Boost-Technik (69,5 Gy/5 Wochen) bei der Behandlung von lokal fortgeschrittenen Kopf-Hals-Tumoren.Patienten und MethodikIm Zeitraum 6/06 bis 8/09 wurden 65 Patienten behandelt. Stadienverteilung: II in 11%, III in 23%, IV in 61% und undefinierbar in 5% der Fälle.ErgebnisseMediane Beoachtungszeit: 30,5 Monate. Die geplante Therapie ließ sich bei 94% der Patienten durchführen. Die Patienten wurden mit 3D-konformaler oder IMRT-Technik bestrahlt. Der Median der Bestrahlungsdauer betrug 37 Tage (13–45 Tage). Die applizierte durchschnittliche Dosis betrug 68,4 Gy (16–74 Gy). Das gesamte 2-Jahres-Überleben betrug 69%, Das krankheitsfreie 2-Jahres-Überleben 62%. Akuttoxizitäten von mindestens Grad 3 (RTOG Skala) betrafen Mukositis (Grad 3: 42%), Pharynx (Grad 3: 42,3%) Haut (Grad 3: 9,5%) und Kehlkopf (Grad 3: 4%). Die Spättoxizitäten betrafen Haut (Grad 3: 9,5%) und Speicheldrüsen (Grad 3: 3,7%).SchlussfolgerungDie akzelerierte Strahlentherapie mit der Concomitant-Boost-Technik ist bei Patienten mit Kopf- und Halstumoren durchführbar. Diese Technik hat ein akzeptables Toxizitätsprofil und gute Heilungsergebnisse.

Plasma levels of vascular endothelial growth factor during and after radiotherapy in combination with celecoxib in patients with advanced head and neck cancer

Celebrex and radiotherapy in advanced head and neck cancer. This phase I dose-escalation study seeks to determine the phase II recommended dose of cyclooxygenase type 2 (COX-2) inhibitor in patients with locally advanced squamous cell head and neck (H&N) cancer, treated with accelerated radiotherapy. Anti-vasculogenic effect of this treatment on serum vascular endothelial growth factor (VEGF) is examined. Patients were irradiated with curative intent (72Gy in 6weeks). Celecoxib was administered throughout the radiotherapy course. Serum VEGF level were tested during radiotherapy and in follow-up. Tumor specimens were stained to quantify the COX-2 expression. Thirty-two patients completed the treatment. The dose of celecoxib was escalated (200, 400 and 800mg bid, then de-escalated to 600mg bid). The acute toxicity related to the treatment in the first and second cohort did not reach grade III; in the third cohort three patients had grade III radiation toxicity and one had celecoxib-related toxicity. In the last fourth cohort the toxicity was acceptable. Significant VEGF level drop (p=0.011) was found between radiation day 1 and post-treatment visit. Significant decrease (p=0.022) of the VEGF level was shown in patients with high COX-2 expression in the tumor. Phase II recommended dose of celecoxib combined with accelerated radiotherapy in advanced H&N cancer was 600mg bid. A significant decrease of the post-treatment serum VEGF level compared to the initial level was noticed only in patients with high COX-2 expression in tumors.

Accelerated radiotherapy with concomitant boost technique (69.5 Gy/5 weeks)Akzelerierte Strahlentherapie in Concomitant-Boost-Technik (69,5 Gy/5 Wochen) als Therapiealternative für lokal fortgeschrittene Kopf-Hals-Tumoren

Background and PurposeTo present the feasibility and results of accelerated radiotherapy with concomitant boost technique (69.5 Gy/5 weeks) in the treatment of locally advanced head and neck cancer.Patients and MethodsA total of 65 patients were treated between June 2006 and August 2009. The distribution of clinical stages was as follows: II 11%, III 23%, IV 61%, and not defined 5%.ResultsThe median follow-up was 30.5 months. The treatment plan was completed in 94% of patients. Patients were treated using the conformal or intensity-modulated radiotherapy (IMRT) technique. The median overall treatment time was 37 days (13–45 days). The mean radiotherapy dose was 68.4 Gy (16–74 Gy). Overall survival was 69% after 2 years. Disease-free survival was 62% after 2 years. Acute toxicity ≥ grade 3(RTOG scale) included mucositis (grade 3: 42.6%), pharynx (grade 3: 42.3%), skin (grade 3: 9.5%), larynx (grade 3: 4%), while late toxicity affected skin (grade 3: 6.25%) and salivary glands (grade 3: 3.7%).ConclusionAccelerated radiotherapy with concomitant boost technique is feasible in patients with locally advanced head and neck cancer, has an acceptable toxicity profile, and yields promising treatment results.Hintergrund und ZielPräsentation von Durchführbarkeit und Ergebnissen der Strahlentherapie mit Concomitant-Boost-Technik (69,5 Gy/5 Wochen) bei der Behandlung von lokal fortgeschrittenen Kopf-Hals-Tumoren.Patienten und MethodikIm Zeitraum 6/06 bis 8/09 wurden 65 Patienten behandelt. Stadienverteilung: II in 11%, III in 23%, IV in 61% und undefinierbar in 5% der Fälle.ErgebnisseMediane Beoachtungszeit: 30,5 Monate. Die geplante Therapie ließ sich bei 94% der Patienten durchführen. Die Patienten wurden mit 3D-konformaler oder IMRT-Technik bestrahlt. Der Median der Bestrahlungsdauer betrug 37 Tage (13–45 Tage). Die applizierte durchschnittliche Dosis betrug 68,4 Gy (16–74 Gy). Das gesamte 2-Jahres-Überleben betrug 69%, Das krankheitsfreie 2-Jahres-Überleben 62%. Akuttoxizitäten von mindestens Grad 3 (RTOG Skala) betrafen Mukositis (Grad 3: 42%), Pharynx (Grad 3: 42,3%) Haut (Grad 3: 9,5%) und Kehlkopf (Grad 3: 4%). Die Spättoxizitäten betrafen Haut (Grad 3: 9,5%) und Speicheldrüsen (Grad 3: 3,7%).SchlussfolgerungDie akzelerierte Strahlentherapie mit der Concomitant-Boost-Technik ist bei Patienten mit Kopf- und Halstumoren durchführbar. Diese Technik hat ein akzeptables Toxizitätsprofil und gute Heilungsergebnisse.

Accelerated radiotherapy with concomitant boost technique (69.5 Gy/5 weeks)@@@Akzelerierte Strahlentherapie in Concomitant-Boost-Technik (69,5 Gy/5 Wochen) als Therapiealternative für lokal fortgeschrittene Kopf-Hals-Tumoren: An alternative in the treatment of locally advanced head and neck cancer

Background and PurposeTo present the feasibility and results of accelerated radiotherapy with concomitant boost technique (69.5 Gy/5 weeks) in the treatment of locally advanced head and neck cancer.Patients and MethodsA total of 65 patients were treated between June 2006 and August 2009. The distribution of clinical stages was as follows: II 11%, III 23%, IV 61%, and not defined 5%.ResultsThe median follow-up was 30.5 months. The treatment plan was completed in 94% of patients. Patients were treated using the conformal or intensity-modulated radiotherapy (IMRT) technique. The median overall treatment time was 37 days (13–45 days). The mean radiotherapy dose was 68.4 Gy (16–74 Gy). Overall survival was 69% after 2 years. Disease-free survival was 62% after 2 years. Acute toxicity ≥ grade 3(RTOG scale) included mucositis (grade 3: 42.6%), pharynx (grade 3: 42.3%), skin (grade 3: 9.5%), larynx (grade 3: 4%), while late toxicity affected skin (grade 3: 6.25%) and salivary glands (grade 3: 3.7%).ConclusionAccelerated radiotherapy with concomitant boost technique is feasible in patients with locally advanced head and neck cancer, has an acceptable toxicity profile, and yields promising treatment results.Hintergrund und ZielPräsentation von Durchführbarkeit und Ergebnissen der Strahlentherapie mit Concomitant-Boost-Technik (69,5 Gy/5 Wochen) bei der Behandlung von lokal fortgeschrittenen Kopf-Hals-Tumoren.Patienten und MethodikIm Zeitraum 6/06 bis 8/09 wurden 65 Patienten behandelt. Stadienverteilung: II in 11%, III in 23%, IV in 61% und undefinierbar in 5% der Fälle.ErgebnisseMediane Beoachtungszeit: 30,5 Monate. Die geplante Therapie ließ sich bei 94% der Patienten durchführen. Die Patienten wurden mit 3D-konformaler oder IMRT-Technik bestrahlt. Der Median der Bestrahlungsdauer betrug 37 Tage (13–45 Tage). Die applizierte durchschnittliche Dosis betrug 68,4 Gy (16–74 Gy). Das gesamte 2-Jahres-Überleben betrug 69%, Das krankheitsfreie 2-Jahres-Überleben 62%. Akuttoxizitäten von mindestens Grad 3 (RTOG Skala) betrafen Mukositis (Grad 3: 42%), Pharynx (Grad 3: 42,3%) Haut (Grad 3: 9,5%) und Kehlkopf (Grad 3: 4%). Die Spättoxizitäten betrafen Haut (Grad 3: 9,5%) und Speicheldrüsen (Grad 3: 3,7%).SchlussfolgerungDie akzelerierte Strahlentherapie mit der Concomitant-Boost-Technik ist bei Patienten mit Kopf- und Halstumoren durchführbar. Diese Technik hat ein akzeptables Toxizitätsprofil und gute Heilungsergebnisse.

Experiences with Superficial Hyperthermia in the Treatment of Patients with Head and Neck Cancers

In this paper is presented our longstanding experience with combination of teleradiotherapy and superficial hyperthermia in the treatment of patients with head and neck cancers, especially in cases with superficial tumors or lymph node metastases, in the Institute of Radiation Oncology in Prague. Microwave thermotherapy - hyperthermia in combination with other treatment methods (mainly with teleradiotherapy) is currently very effective and important method for cancer treatment. Technical equipment for before-mentioned therapeutic method in this clinical working place is described as well. The treatment results were evaluated after 1-2 month after end of treatment series by various examination methods. They are part of this paper as well.