Lukas Knybel

Evaluation Application for Tracking and Statistical Analysis of Patient Data from Hospital Real Time Location System

In the recent time, an importance of the Real-time Locating systems (RTLS) in the hospital environment is increasingly important. Such systems are essentially utilized for the localization of either unmovable objects, or patients in the hospital environment. It is supposed that patients who underwent some trauma and surgery may have influenced their cognitive functions in a sense of lost concentration, and orientation is space. Such disorders may endanger the patient’s health. In cooperation with the Trauma Center of University Hospital we have designed a localization system constituting the patients IR tags which are detected by the IR anchors placed in every hospital room. Data from such system represents the patient’s movement and localization completed by sophisticated system of alarms. In this context we have developed the SW application which is connected with the RTLS database where the patient’s localization data are stored. This application is fully integrated into the RTLS system. The SW application evaluates time data represents spent time in every room. The patient’s data are consecutively refreshed and updated in the SW application to receive current information.

Stereotactic Body Radiotherapy of Prostate Cancer – Effectiveness and Toxicity

BACKGROUND Prostate cancer is the most prevalent cancer in males and its incidence is steadily increasing. Most cases of prostate cancer are diagnosed during the early asymptomatic period, in which case the prognosis is very good. Therapies differ widely in their efficacies and toxicities, and this is an important consideration when it comes to deciding which treatment is optimal for a particular patient. One treatment method for early stage prostate cancer is stereotactic body radiotherapy (SBRT). We present the first results obtained using this modality at our institution. PATIENTS AND METHODS A total of 261 patients with low or intermediate risk prostate cancer were treated with SBRT between August 2010 and July 2012. Patients received a total dose of 36.25 Gy in five fractions of 7.25 Gy every other day. The toxicity of the treatment was evaluated according to RTOG criteria. For assessment of quality of life, patients filled out a modified EPIC questionnaire (Expanded Prostate Composite index). RESULTS Overall survival (OS) in this study was 93.1%. Biochemical relapse free survival (bRFS) was 97.7%. As expected, OS and bRFS were worse in the group of patients with an intermediate risk of recurrence. Acute and chronic urinary and gastrointestinal RTOG toxicity was very low. Quality of life after treatment, as determined using the EPIC questionnaire, was slightly reduced immediately after treatment but returned to baseline or even improved during long term follow-up. CONCLUSION SBRT is an effective therapeutic modality for early prostate cancer and has acceptable rates of acute and low late toxicity.Key words: prostate cancer - stereotactic body radiotherapy - quality of life The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 5. 1. 2017Accepted: 1. 2. 2017.

Intensity Modulated Hyperfractionated Accelerated Radiotherapy to Treat Advanced Head and Neck Cancer – Predictive Factors of Overall Survival

AIM The aim of this study was to evaluate overall survival (OS) and prognostic factors in patients ineligible for chemotherapy who were treated with a hyperfractionated accelerated schedule with simultaneous integrated boost. MATERIAL AND METHODS From May, 2008, to April, 2013, 122 patients with locally advanced nonmetastatic squamous laryngeal (14%), hypopharyngeal (30%), oropharyngeal (30%), and oral cavity (27%) cancer were treated at our institution. The median age, Karnofsky Performance Status (KPS), and gross tumor volume (GTV) of the patients were 63 years (range, 46-87 years), 80% (range, 50-100%), and 46 ml (range, 5-250 ml), resp. The median total dose of radiotherapy was 72.6 Gy (range, 62-77 Gy) at 1.4-1.5 Gy per fraction, and 55 Gy at 1.1 Gy per fraction was delivered for GTV (primary and lymphadenopathy) with a margin of 0.7 cm and regional lymphatic areas with a margin of 0.3 cm. The dose was delivered 2× a day, with a 6-8 hour interval between doses, via a 6 MeV linear accelerator. OS was estimated using the Kaplan-Meier method, and predictors of OS were analyzed using Cox proportional hazards regression. RESULTS The median duration of the radiotherapy series was 37 days (range, 32-45 days). The incidence of grade 3 acute toxicity was 62% for mucosa (oral cavity and/or pharynx) and 0% for skin. Confluent mucositis cleared in all cases within 21 days. No grade 4 or 5 toxicities were recorded. PEG was introduced before treatment in 55 patients (45%). The 1-and 2-year OS was 65% and 32%, resp. KPS less than 80% (RR 2.4, 95% CI 1.3-4.2; p = 0.004), cancers other than oropharyngeal or laryngeal cancer (RR 2.0, 95% CI 1.1-3.5; p = 0.016), and capacity of high GTV (RR 1.006, 95% CI 1.001-1.011; p = 0.017) were found to be negative prognostic factors for OS. CONCLUSION More than 30% of patients with poor prognosis survived for longer than 2 years. KPS before treatment was the strongest prognostic factor for better OS.Key words: head and neck cancer - radiotherapy dose fractionation - survival analysis - acceleration - hyperfractionation This work was supported by RVO-FNOs/2016 (HPV status as predictive and prognostic factor for primary and secondary head and neck cancer). The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 9. 3. 2017Accepted: 19. 4. 2017.

Design and Implementation of an Algorithm for System of Exposure Limit in Radiology

This thesis describes the implementation of application for effective planning process of CyberKnife system by processing CT images. CyberKnife system, which focuses therapeutic target using two X-ray tubes and takes images of the patient at an angle of 45°, allows localization of lung irradiated tumor bearing based on the difference in density between the bearing and the surrounding tissue. Some tumor bearings are difficult to localize due to summation and overlay of monitoring area with other high densities structures. The application is designed as a client created in C#, connected to the COM server of computing system MATLAB, which provides most of the calculations. The application was tested on a single core chip system and speed of acquisition and processing is in average around 1 s. The application was developed, implemented and now successfully tested on the Oncology Clinic at FN Ostrava.