Cancer more aggressive after chemo.
For instance, hair loss, which is one of the major concerns for some patients, such as a young lady with BM of breast cancer, is a less frequently encountered problem with SRS than WBRT as a result of the smaller irradiated field size and focalized dose distribution Figure 2. All the aforementioned advantages of SRS are provided by utilization of multiple convergent narrow beams to deliver high dose focal irradiation in a single fraction by using multiple cobalt sources, linear accelerators or cyclotrons 37, Similar with neurosurgery, SRS alone or in combination with WBRT has been exhibited to cancer more aggressive after chemo with prolonged overall survival, local control and also better neurologic status in these patients compared to WBRT alone 33, Cancer more aggressive after chemo, SRS differs from neurosurgery by offering a chance of ablative treatment to those patients who are not appropriate candidates for neurosurgery due to various reasons.
Albeit such an approach may be beneficial in a select group of patients, prerequisites for close monitorization with monthly or bimonthly magnetic resonance imaging MRI and risk for unavoidable repeat SRS procedures for newly emerging BM, both increasing the total cost of overall treatment, should be carefully considered Moreover, contrasted with SRS and WBRT combination, the risk for a plausibility of inferior survival outcomes with SRS alone in patients with controlled primary cancer more aggressive after chemo no extracranial disease should be kept in mind, as it has been cancer more aggressive after chemo previously by various authors 41, Although local- and distant brain control rates were reported to be better with the addition of WBRT, this distinction did not translate into a notable survival advantage in any study.
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Furthermore, in the study by Chang et al. It is unfortunate to point out that the results of these RCTs ought to be interpreted with caution because of their insufficient design to explicitly concentrate on survival endpoints, such as significant imbalances between the study groups with regards to the prognostic factors and utilization of salvage WBRT in SRS alone cohorts 43, First meta-analysis was performed by Duan et al.
Как странно было бы, подумалось Олвину, если бы эти громоздящиеся стены стали вдруг прозрачными, будто стекло, и можно было бы наблюдать жизнь, протекающую там, внутри.
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In the second meta-analysis, Hasan et al. Thirdly, the meta-analysis by Soon et al. In the fourth and most recent meta-analysis, by Sahgal et al. Additionally omission of WBRT in this subgroup was not identified to relate with increased rates of distant brain relapses.
Он вызывал в памяти леса и прерии и удивительных животных, которые когда-то делили Землю с Человеком. Древних этих записей обнаружилось совсем. Было принято считать, хотя никто и не знал -- почему, что где-то в промежутке между появлением Пришельцев и основанием Диаспара все воспоминания о тех примитивных временах были утрачены.
In a recent systematic review of 14 studies incorporating BM patients, Gans et cancer more aggressive after chemo.
Therefore, although the concept of TC-SRS is relatively new, with its acceptable toxicity rates the results appear to be encouraging for irradiation of a limited area with ablative doses of radiotherapy. In a study by Pinkham et al.
Verbal memory and fine motor functions were cancer more aggressive after chemo commonest parameters to be impaired in this study Theoretically, restriction of the irradiated brain volume with local therapies like surgery and SRS may prove beneficial in preservation of neurocognitive functions without any scarification in tumor control rates.
Although results of some studies appear to support this idea 35others reported poorer neurocognitive outcomes with omission of WBRT.
Activity47 Laura Lala hasn't added a story. A few weeks ago, my father, Florin, was diagnosed with stage 3 pancreatic cancer at the head of the pancreas. I saw him first on the 13th of February after my last visit home in October, and I felt a knot in my throat. At the moment, the tumor they found is a huge 45 millimeters adenocarcinoma and is not operable.
In one such study, with the end goal of preserving neurocognitive functions with maximum BM control rates, Aoyoma et al. Because many of the traditionally argued WBRT toxicity data is derived from small-cell lung carcinoma patients treated with chemotherapy prior to prophylactic cranial irradiation, caution is advised when diagnosing WBRT toxicity.
Therefore, as cancer more aggressive after chemo side effects evoked by cranial irradiation are largely similar, it is not astounding that the impacts were preferably ascribed to the radiation than to chemotherapy.
This information is of foremost significance for radiation oncologists considering the way that almost all toxicities following therapeutic WBRT are almost constantly ascribed to cranial irradiation by the other oncologic disciplines. Deteriorations in neurocognitive functions may also be already present before the initiation of WBRT. This issue has been addressed in two key studies by Meyers et al. In the second study by Komaki et al. The authors pointed out that roughly half of all eligible patients had neurocognitive shortages before the onset of cranial prophylaxis, and observed a somewhat noteworthy decay in executive function and language after one year, cancer more aggressive after chemo turned inconsequential in later evaluations.
These two excellent studies strongly emphasize the paramount importance of implementation of neurocognitive function tests prior to WBRT in order to reflect the actual impact of therapeutic WBRT on neurocognitive domains.
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Moreover, the negative neurocognitive impact of progressive BM may further be ameliorated or even improved by WBRT in some patients groups with resultant enhancement in executive functions and fine cancer more aggressive after chemo co-ordination as neurologic deterioration is reported to directly relate with disease progression in the brain 51, Management of this regretful complication of cancer involves neurosurgery, WBRT, SRS, chemotherapy, and targeted agents individually or as any combination of them, regarding the prognostic factors.
Curr Probl Surg J Clin Oncol Cancer Oncologist Cancer Metastasis Rev J Cell Biochem Berk L: An overview of radiotherapy trials for the treatment of brain metastases.
Oncology Williston Park ; discussion, Radiother Oncol Sperduto PW, Kased N, Roberge D, et al: Summary report on the graded prognostic assessment: an accurate cancer more aggressive after chemo facile diagnosis-specific tool to estimate survival for patients with brain metastases. Abrahams JM, Torchia M, Putt M, et al: Risk factors affecting survival after brain metastases from non-small cell lung carcinoma: a follow-up study of 70 patients.
С помощью синтезаторов материи она изобретала переплетающиеся трехмерные структуры такой красоты и сложности, что это, в общем-то, были уже не просто стереометрические конструкции, а топологические теоремы высшего порядка. Ее работы можно было увидеть по всему Диаспару, и по мотивам некоторых из этих композиций были даже созданы мозаики полов в гигантских хореографических залах -- рисунок пола служил своего рода основой для создателей новых танцевальных вариаций.
Все эти занятия могли бы показаться бесплодными тому,кто не обладал достаточным интеллектом, чтобы оценить их тонкость.
Но в Диаспаре не нашлось бы ни единого человека, который не смог бы понять то, что пытались создать Эристон и Итания, и кем ж двигал бы такой же всепоглощающий интерес.
J Neurosurg Chin Clin Oncol BMC Cancer Strahlenther Onkol Rades D, Cancer more aggressive after chemo L, Haatanen T, et al: Scoring systems to estimate intracerebral control and survival rates of patients irradiated for brain metastases.
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Cancer Res Biomater Artif Cells Immobilization Biotechnol Mehta MP, Rodrigus P, Terhaard CH, et al: Survival and neurologic outcomes in a randomized trial of motexafin gadolinium and whole-brain radiation therapy in brain metastases.
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Lancet Oncol Shaw E, Scott C, Souhami L, et al: Single dose radiosurgical treatment of recurrent previously irradiated primary brain tumors and brain metastases: final report of RTOG protocol Aoyama H, Shirato H, Tago M, et al: Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases: a randomized controlled trial. JAMA Kocher M, Soffietti R, Abacioglu U, et al: Adjuvant whole-brain radiotherapy versus observation after radiosurgery or surgical cancer more aggressive after chemo of one to three cerebral metastases: results of the EORTC study.
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Duan L, Zeng R, Yang KH, et al: Whole brain radiotherapy combined with stereotactic radiotherapy versus stereotactic radiotherapy alone for brain metastases: a meta-analysis.
Asian Pac J Cancer Prev Pract Radiat Oncol Neurosurgery ; discussion Clin Oncol R Coll Radiol