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Preoperative evaluation and risk factors of lung cancer. 肺癌术前评价及危险因素分析。
Rays Pub Date : 2004-10-01
Annarita Gaballo, Giuseppe M Corbo, Salvatore Valente, Giuliano Ciappi
{"title":"Preoperative evaluation and risk factors of lung cancer.","authors":"Annarita Gaballo,&nbsp;Giuseppe M Corbo,&nbsp;Salvatore Valente,&nbsp;Giuliano Ciappi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Based on a review of the literature on resectable lung cancer, pulmonary risk factors before, during and after surgery are discussed. The role of preoperative evaluation in order to determine the patient ability to withstand radical resection is considered. Spirometric indexes as forced expired volume (FEV1) and diffusing lung carbon monoxide capacity (DLCO) should be measured first. If FEV1 and DLCO are > 60% of predicted, patients are at low risk for complications and can undergo pulmonary resection. However, if FEV1 and DLCO are <60% of predicted, further evaluation with a quantitative lung scan is required. If predicted postoperative values for FEV1 and DLCO are >40%, patients can undergo lung resection, otherwise exercise testing is necessary. If the latter shows maximal oxygen uptake (VO2max) of > 15ml/Kg, surgery can be performed; if VO2max is <15 ml/Kg, patients are inoperable.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"29 4","pages":"391-400"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25252684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The PRE.DI.CA. project for radiographic lung cancer screening in cigarette smokers. PRE.DI.CA。吸烟人群肺癌放射筛查项目。
Rays Pub Date : 2004-10-01
Fabio Vassallo, Andrea Imperatori, Francesca Rovera, Andrea Pericelli, Cinzia Antonini, Lorenzo Dominioni
{"title":"The PRE.DI.CA. project for radiographic lung cancer screening in cigarette smokers.","authors":"Fabio Vassallo,&nbsp;Andrea Imperatori,&nbsp;Francesca Rovera,&nbsp;Andrea Pericelli,&nbsp;Cinzia Antonini,&nbsp;Lorenzo Dominioni","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In heavy cigarette smokers and former smokers who have accumulated a high risk of lung carcinoma, a primary objective is early detection. Annual chest x-ray screening is a readily available, low cost method to detect asymptomatic lung carcinoma at an early stage (stage I) and, after radical resection, to improve the 5-year survival rate. A project of annual chest x-ray screening, named PRE.DI.CA. was started, for the early diagnosis of asymptomatic lung cancer in the high risk population of heavy cigarette smokers and former smokers, males and females, aged 45-75 years, in the province of Varese. Over a 7-year period, 4.598 heavy smokers enrolled in the PRE.DI.CA. lung project underwent 14.461 chest x-ray examinations. 45 asymptomatic lung cancers were detected and defined histologically. In the province of Varese it was possible to establish early diagnosis of lung carcinoma with annual chest x-ray screening of asymptomatic high risk smokers. 52% stage I diagnosis was achieved at the incidence screening.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"29 4","pages":"383-5"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25076354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Noninvasive staging of lung cancer. 肺癌的无创分期。
Rays Pub Date : 2004-10-01
Teresa Misciasci
{"title":"Noninvasive staging of lung cancer.","authors":"Teresa Misciasci","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Accurate evaluation of disease extent is mandatory when the diagnosis of resectable lung cancer is established. Staging has a significant impact on subsequent therapeutic options and prognosis. Radiologists can now rely on numerous instruments, each with different advantages and limitations. The procedure of choice is still chest X-ray whose intrinsic limitations require better tumor characterization with chest CT. CT difficulties in the differential diagnosis between the tumor and secondary changes occurring in adjacent structures can be overcome by 18F-FDG-PET or MRI. Functional information is acquired with the former and multiparametric information with the latter. According to the case, further extension to adjacent structures can be evaluated based on CT or MRI. For lymph node and distant metastasis PET is increasingly used, except for brain parenchyma where MRI is definitely more accurate in the detection of brain metastasis.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"29 4","pages":"363-71"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25076912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intraoperative complications in lung cancer surgery. 肺癌手术的术中并发症。
Rays Pub Date : 2004-10-01
Francesco Carleo
{"title":"Intraoperative complications in lung cancer surgery.","authors":"Francesco Carleo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Lung cancer surgery is burdened by complications often related to the performed procedure. An accidental damage to thoracic structures may be caused by the surgeon's incorrect operative management. Elective thoracic surgery for lung cancer includes technically well-known operations. However, thoracic anatomy is characterized by a number of variants which a thoracic surgeon should know to be able to tackle serious situations. In this review the major variants and hazards which may be the cause of operative problems are presented. An approach to control hiatrogenic damages while performing lung resection for neoplastic lesions is suggested. It is stressed that surgical injuries, especially in thoracic surgery, should be prevented rather than repaired.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"29 4","pages":"457-60"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25077410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Biological optimization of the dose in pancreatic cancer. 胰腺癌剂量的生物学优化。
Rays Pub Date : 2004-07-01
Gian Carlo Mattiucci, Giuseppe D'Agostino, Berardino De Bari, Maria Grazia Mangiacotti, Daniela Smaniotto, Lucio Trodella
{"title":"Biological optimization of the dose in pancreatic cancer.","authors":"Gian Carlo Mattiucci,&nbsp;Giuseppe D'Agostino,&nbsp;Berardino De Bari,&nbsp;Maria Grazia Mangiacotti,&nbsp;Daniela Smaniotto,&nbsp;Lucio Trodella","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In the last decades, many attempts were made to optimize the biological effect of RT in the treatment of pancreatic carcinoma. The use of combined radiotherapy and chemotherapy was certainly successful, with the most promising results achieved with the combination of several drugs with RT or with innovative modalities of administration of concomitant chemotherapy. A dose effect in resected tumors seems suggested by some studies; while the use of high doses in inoperable tumors did not result in significant advantages in terms of response and outcome, a significant correlation between dose and toxicity was observed. Altered fractionations were not studied systematically, though an accelerated-hypofractionated (30 Gy in 10 fractions) treatment is indicated as feasible in combination with concomitant chemotherapy with results similar to those achieved with conventional fractionations and a markedly shorter duration. Based on the small improvements recorded in the treatment of these tumors, the evaluation of newer treatment modalities seems justified.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"29 3","pages":"301-8"},"PeriodicalIF":0.0,"publicationDate":"2004-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24864995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dose fractionation and biological optimization in carcinoma of the prostate. 前列腺癌的剂量分级和生物学优化。
Rays Pub Date : 2004-07-01
Carlos A Perez
{"title":"Dose fractionation and biological optimization in carcinoma of the prostate.","authors":"Carlos A Perez","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Three-dimensional conformal radiation therapy (3-D CRT) or intensity-modulated radiation therapy (IMRT) have been increasingly used as an alternative to radical prostatectomy in patients with localized carcinoma of the prostate and in patients at high risk, in combination with hormonal therapy. To better understand the implications of dose-time and fractionation in prostate cancer, it is important to be familiar with some laboratory investigations dealing with the cell kinetics characteristics of this tumor. Biological and clinical considerations of dose fractionation, total dose of irradiation and local tumor control, elapsed overall treatment time and sequelae of irradiation are illustrated, based on an exhaustive review of the literature.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"29 3","pages":"237-52"},"PeriodicalIF":0.0,"publicationDate":"2004-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24864492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Implementation of intensity-modulated radiation therapy in head and neck tumors: what are the important data for biological optimization? 头颈部肿瘤调强放疗的实施:生物学优化的重要数据是什么?
Rays Pub Date : 2004-07-01
Vincent Grégoire
{"title":"Implementation of intensity-modulated radiation therapy in head and neck tumors: what are the important data for biological optimization?","authors":"Vincent Grégoire","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Intensity-modulated radiation therapy (IMRT) for head and neck (HN) tumors refers to a new approach to the whole treatment procedure from patient immobilization to beam delivery. Implementation of IMRT thus requires knowledge of setup uncertainties, adequate selection and delineation of target volumes based on optimal imaging modalities, appropriate specification and dose prescription regarding dose-volume constraints, and ad hoc quality control of both the clinical and physical aspects of the whole procedure. A large number of issues still need to be resolved and/or further refined. In particular, data need to be accumulated in a better integration of improved dose distribution into the fractionation strategy, and in-depth knowledge of dose-volume constraints for normal tissues at risk. In this article, these issues will be reviewed and put into the prospective of IMRT treatment.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"29 3","pages":"271-4"},"PeriodicalIF":0.0,"publicationDate":"2004-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24864494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dose fractionation and biological optimization in breast cancer. 乳腺癌的剂量分割和生物学优化。
Rays Pub Date : 2004-07-01
Giovanni Palazzoni, Luigia Nardone, Michele Cianciulli, Marzia Ciresa, Giampiero Ausili-Cefaro
{"title":"Dose fractionation and biological optimization in breast cancer.","authors":"Giovanni Palazzoni,&nbsp;Luigia Nardone,&nbsp;Michele Cianciulli,&nbsp;Marzia Ciresa,&nbsp;Giampiero Ausili-Cefaro","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Standard radiotherapy in breast cancer is performed at the dose of 1.8-2 Gy daily 5 fractions a week for a total dose between 45 and 60 Gy. However research is addressed to different fractionations. For total time reduction, the interest was focused on conventional brachytherapy which radiobiologically represents \"continuous\" accelerated hyperfractionation, as well as on conventional external beam radiotherapy with accelerated hyperfractionation. A phase I study was conducted to define and validate a radiotherapy schedule with non conventional fractionation. Nine patients with metastatic breast cancer were enrolled in the study. None of them had undergone breast surgery or lymph node dissection. They were sequentially divided into three different, progressively increasing dose levels administered with double daily fractionation. Each schedule of accelerated fractionation (AF) included the administration of 1.8 Gy in two daily fractions, at least six hours apart for 10, 11 and 12 days and a total dose of 36, 39.6 and 43.2 Gy, respectively. Results of dose escalation, acute toxicity and mathematical calculation of radiobiological equivalence led to consider the dose of 36 Gy in 20 fractions during 10 days the most suitable for cost/benefit ratio within a non conventional fractionation.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"29 3","pages":"333-8"},"PeriodicalIF":0.0,"publicationDate":"2004-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24864384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Biological optimization of the dose in stereotactic radiotherapy of brain tumors. 脑肿瘤立体定向放疗剂量的生物学优化。
Rays Pub Date : 2004-07-01
Mario De Santis, Mario Balducci, Andrea Simili, Vincenzo Frascino, Daniela Giammarino
{"title":"Biological optimization of the dose in stereotactic radiotherapy of brain tumors.","authors":"Mario De Santis,&nbsp;Mario Balducci,&nbsp;Andrea Simili,&nbsp;Vincenzo Frascino,&nbsp;Daniela Giammarino","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The techniques of radiotherapy with a high dose gradient require several demanding choices but represent a major innovation in the radiation therapy of brain tumors. To optimize the expected outcomes in terms of effectiveness and efficacy some recent acquisitions of biological parameters of integration of the linear-quadratic model are illustrated, aimed at the progressive understanding of the role of histology, dose fractionation, timing, toxicity and combined modality therapy.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"29 3","pages":"339-42"},"PeriodicalIF":0.0,"publicationDate":"2004-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24864387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Is one Gy always one Gy? The integration between conventional radiotherapy and special techniques. 1gy总是1gy吗?传统放射治疗与特殊技术的结合。
Rays Pub Date : 2004-07-01
Pietro Gabriele, Cristina Bona, Angelo Piermattei, Barbara Baiotto
{"title":"Is one Gy always one Gy? The integration between conventional radiotherapy and special techniques.","authors":"Pietro Gabriele,&nbsp;Cristina Bona,&nbsp;Angelo Piermattei,&nbsp;Barbara Baiotto","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The new radiotherapy techniques as HDR and LDR brachytherapy, stereotactic radiotherapy, 3D-CRT, and IMRT require an accurate knowledge of the biological characteristics of the tumor with correct definition of target volumes. As demonstrated by the two reported cases, the formulae equivalent to 2 Gy in the special techniques are useful for the increase in the total dose to GTV while sparing the organs at risk.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"29 3","pages":"283-5"},"PeriodicalIF":0.0,"publicationDate":"2004-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24864993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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