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Vízkeleti J, Fröhlich G, Horváth K, Nguyen Anhhong N, Polgár C, Major T. PO-0188 Are active dwells always necessary in the applicator ring in the brachytherapy of cervical cancer? Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06347-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Fröhlich G, Vízkeleti J, Nguyen NA, Major T, Polgár C. EP-2130 Dose integration of intensity-modulated arc therapy and interstitial brachytherapy of cervix cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32550-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Fröhlich G, Vízkeleti J, Nhung NA, Horváth K, Major T, Polgár C. [Dosimetric evaluation of intracavitary-interstitial image-guided adaptive brachytherapy of cervical cancer and comparison with conventional treatment techniques]. Magy Onkol 2018; 62:242-248. [PMID: 30540867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Accepted: 08/31/2018] [Indexed: 06/09/2023]
Abstract
Our aim was the dosimetric evaluation of intracavitary-interstitial high-dose-rate image-guided adaptive cervix brachytherapy, implemented in Hungary. Between 2016 and 2018, 21 patients with cervical cancer were treated with overall 72 fractions. Graphical optimized treatment plans were compared to inverse optimized plans, 3D optimized plans (without needles) and conventional intracavitary 2D plans. Significant difference was found in almost all dose-volume parameters. The most advantageous values came from interstitial plans, inverse optimized plans did not differ dosimetrically from the treatment plans, while intracavitary optimized plans disposed of less appropriate dose-volume parameters, the least of all were intracavitary 2D plans. Needle number showed correlation with conformality, but inverse correlation with Dose Nonuniformity Ratio and D2cm3 of rectum. Volume of High Risk CTV correlated with D2cm3 of bladder, rectum and sigmoid. Although 3D optimization improved the quality of conventional 2D plans, interstitial plans resulted in even more homogeneous dose distribution and significantly lower doses to organs at risks.
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Affiliation(s)
- Georgina Fröhlich
- Sugárterápiás Központ, Országos Onkológiai Intézet, Budapest, Hungary.
| | - Júlia Vízkeleti
- Sugárterápiás Központ, Országos Onkológiai Intézet, Budapest, Hungary.
| | | | - Katalin Horváth
- Onkológiai Képalkotó és Invazív Diagnosztikai Központ, Országos Onkológiai Intézet, Budapest, Hungary
| | - Tibor Major
- Sugárterápiás Központ, Országos Onkológiai Intézet, Budapest, Hungary.
| | - Csaba Polgár
- Onkológiai Tanszék, Semmelweis Egyetem, Általános Orvostudományi Kar, Budapest, Hungary
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Geiszl Z, Kiss J, Szendrõi M, Vízkeleti J, Arató G, Sápi Z, Kriván G, Mohás A, Rényi I, Garami M, Hauser P. [Survival of pediatric patients with Ewing sarcoma treated at Semmelweis University]. Magy Onkol 2018; 62:230-236. [PMID: 30540865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 10/19/2018] [Indexed: 06/09/2023]
Abstract
The survival of children treated with Ewing sarcoma at Semmelweis University were investigated. Pediatric patients with Ewing sarcoma treated at Semmelweis University from 2001 through 2013 were analyzed in terms of overall survival and clinical factors (age, primary localization and extent of the tumor, time interval from primary complaints to diagnosis). For statistical analysis Kaplan-Meier estimated survival and log rank test were applied. Mean age and follow-up time of the 78 patients were 11.16 and 6.29 years, respectively. In 57% of patients time interval from primary symptoms to diagnosis was less than half year. In 53.8% of the patients the disease was metastatic at primary diagnosis (pulmonary only: 29.5%, any other: 24.3%). 5- and 10-year overall survival of patients were 68.1% and 60.4%, respectively. Among the analyzed factors, the presence of metastasis impaired 5-year overall survival significantly (88.5% for localized disease, 63.5% for pulmonary only and 40.9% for any other metastasis). The survival rate of pediatric patients with Ewing sarcoma treated at Semmelweis University is similar to the result in Western European countries.
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Affiliation(s)
- Zsófia Geiszl
- II. Sz. Gyermekgyógyászati Klinika, Semmelweis Egyetem, Budapest, Hungary.
| | - János Kiss
- Ortopédiai Klinika, Semmelweis Egyetem, Budapest, Hungary
| | | | | | - Gabriella Arató
- I. Sz. Patológiai és Kísérleti Rákkutató Intézet, Semmelweis Egyetem, Budapest, Hungary
| | - Zoltán Sápi
- I. Sz. Patológiai és Kísérleti Rákkutató Intézet, Semmelweis Egyetem, Budapest, Hungary
| | | | - Anna Mohás
- II. Sz. Gyermekgyógyászati Klinika, Semmelweis Egyetem, Budapest, Hungary.
| | - Imre Rényi
- II. Sz. Gyermekgyógyászati Klinika, Semmelweis Egyetem, Budapest, Hungary.
| | - Miklós Garami
- II. Sz. Gyermekgyógyászati Klinika, Semmelweis Egyetem, Budapest, Hungary.
| | - Péter Hauser
- II. Sz. Gyermekgyógyászati Klinika, Semmelweis Egyetem, Budapest, Hungary.
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Vízkeleti J, Fröhlich G, Nhung NA, Horváth K, Major T, Polgár C. [Clinical results of combined intracavitary-interstitial image-guided adaptive brachytherapy in locally advanced cervical cancer]. Magy Onkol 2018; 62:249-257. [PMID: 30540868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 08/10/2018] [Indexed: 06/09/2023]
Abstract
We present the early clinical results achieved with image-guided adaptive brachytherapy (IGABT) with combined intracavitary-interstitial (IC-IS) technique recently implemented in Hungary in the treatment of locally advanced cervical cancer (LACC). Twenty-one patients were treated with radio-chemotherapy (RCT) followed by combined IC-IS BT. At the end of the RCT we assessed the residual tumour with pelvic MRI. On CT images registered with the applicator in place we contoured the organs at risk and the high-risk clinical target volume, which included the whole cervix and the eventual residual tumour in the parametria. No grade 4 toxicity was noticed. At 11 months follow-up the local control rate was 92.3%, the pelvic control rate 86.5%, the distant metastasis free survival and the disease-free survival were 74%. The combined IC-IS treatment was well tolerated. Our clinical results are similar to those reported in the literature.
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Affiliation(s)
- Júlia Vízkeleti
- Sugárterápiás Központ, Országos Onkológiai Intézet, Budapest, Hungary.
| | - Georgina Fröhlich
- Sugárterápiás Központ, Országos Onkológiai Intézet, Budapest, Hungary.
| | | | - Katalin Horváth
- Onkológiai Képalkotó és Invazív Diagnosztikai Központ, Országos Onkológiai Intézet, Budapest, Hungary
| | - Tibor Major
- Sugárterápiás Központ, Országos Onkológiai Intézet, Budapest, Hungary.
| | - Csaba Polgár
- Onkológiai Tanszék, Semmelweis Egyetem, Általános Orvostudományi Kar, Budapest, Hungary
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Fröhlich G, Vízkeleti J, Anhhong N, Mészáros N, Major T, Polgár C. EP-1778: Combined intracavitary-interstitial IGABT of cervical cancer -First dosimetric experience in Hungary. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)32140-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Vízkeleti J, Pete I, Vereczkey I, Fröhlich G, Horváth K, Varga S, Pulay T, Kásler M, Polgár C. [Complete pathologic remission after preoperative high-dose brachytherapy in patients with operable cervical cancer: preliminary results of a prospective randomized study]. Magy Onkol 2012; 56:171-177. [PMID: 23008825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2012] [Accepted: 04/15/2012] [Indexed: 06/01/2023]
Abstract
The purpose of the study was a preliminary evaluation of the efficacy of preoperative intracavitary high-dose-rate brachytherapy (HDR BT) in sterilization of the specimen of operable cervical cancer patients enrolled into a prospective, randomized study. Between 2005 and 2010, 100 operable cervical cancer patients of FIGO stage I/A2 (n=4), I/B1 (n=51), I/B2 (n=19), IIA (n=17), and proximal II/B (n=9) were randomized in two arms: in arm "A" (n=50) allocated treatment was 2x8 Gy preoperative intracavitary HDR BT followed by radical surgery, in arm "B" (n= 50) no preoperative treatment was given before the planned radical Wertheim hysterectomy. The rates of pathologic complete remission (pCR) were compared using the Fisher-exact test. In arm "A" 41 patients (82%), in arm "B" 42 patients (84%) underwent radical hysterectomy. The rate of pCR after preoperative BT was 26.8% (11/41), while in the control group the specimen was free of tumor in 7.1% (3/42; p=0.0204). Preoperative HDR BT for cervical cancer patients significantly increases the rate of pathologically tumor-free specimens. Longer follow-up is needed to evaluate the impact of pCR on local tumor control and survival. Our preliminary results support further enrollment of patients into our randomized clinical trial.
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Affiliation(s)
- Júlia Vízkeleti
- Sugárterápiás Központ, Országos Onkológiai Intézet, Budapest, Hungary.
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Vízkeleti J, PETE I, Vereczkey I, Fröhlich G, Varga S, Pulay T, Kásler M, Polgár C. 658 poster PATHOLOGIC COMPLETE REMISSION AFTER PREOPERATIVE HDR BRACHYTHERAPY IN PATIENTS WITH OPERABLE CERVIX CARCINOMA. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70780-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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