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Evalution of the results of 3D conformal radiotherapy inT1/T2 of larynx cancer, Experience radiotherapy´department of tishreen university hospital

تقييم نتائج المعالجة الشعاعية ثلاثية الأبعاد لسرطان الحنجرة T1/T2، خبرة شعبة المعالجة الشعاعية في مستشفى تشرين الجامعي في اللاذقية

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 Publication date 2018
  fields Medicine
and research's language is العربية
 Created by Shamra Editor




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Larynx cancer is the most common cancer of the head and neck with the exception of the skin and it accounts for 2% of all cancer diagnoses, its genesis is directly associated with alcohol drinking and smoking, squamous cell carcinoma (SCC) is the most common histological type (95%) of larynx cancer. Aim: The purpose of this study was to evaluate 3D conformal radiotherapy of accelerated system for early larynx cancer and to estimate acute and late toxicity which appear because of irradiated normal tissues around the tumor (thyroid gland, spine cord, ….) and also to evaluate the rate of recurrence and survival. Materials and methods: The study was performed of 44 patients of scc larengeal cancer stage T1/T2, that underwent RT (2015 – 2017), 84% with glottic cancer, the median age was 63 years, all patients were treated 3D conformal RT, Total dose between (60-66) Gy, 2Gy/fraction (5 fractions in week).Our analysis was to evaluate the acute and late toxicity dure and after radiotherapy, and also the rate of recurrence and survival. Results: The most toxicity was dysphagia (42 PTs) 96%, radiodermitis (30 PTs) 70%, the least toxicity was tooth damage. No evidence of late toxicity, the rate of recurrence (11 PTs) 25%, metastases occur in (1 PT). (6/ 41 PTs) 16.4% were dead. Conclusion: Radiotherapy is the important role to control early larynx cancer, and 3DRadiotherapy is giving a large dose to treat the tumor and save the normal tissues around the tumor from effect of radiation, therefor absence the late toxicity.


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Research summary
تتناول هذه الدراسة تقييم نتائج المعالجة الشعاعية ثلاثية الأبعاد لسرطان الحنجرة في مراحله المبكرة (T1/T2) باستخدام جهاز المسرع الخطي في مستشفى تشرين الجامعي في اللاذقية. سرطان الحنجرة هو أحد أكثر سرطانات الرأس والعنق شيوعاً، حيث يشكل 2% من جميع السرطانات المشخصة، ويرتبط بشكل كبير بتناول الكحول والتدخين. الهدف من الدراسة هو تقييم فعالية العلاج الشعاعي ثلاثي الأبعاد في السيطرة على سرطان الحنجرة وتحديد الاختلاطات الشعاعية الحادة والمتأخرة، بالإضافة إلى تقييم نسبة النكس والوفاة. شملت الدراسة 44 مريضاً بسرطان الحنجرة من النوع شائك الخلايا في المرحلتين T1/T2، حيث تلقوا علاجاً شعاعياً بجرعة كلية تتراوح بين 60-66 غري موزعة على جرعات جزئية قدرها 2 غري يومياً (خمس جلسات في الأسبوع). أظهرت النتائج أن الاختلاطات الأكثر حدوثاً كانت جفاف الفم وصعوبة البلع بنسبة 96%، تليها الاختلاطات الجلدية بنسبة 70%. لم يتم ملاحظة أي اختلاطات متأخرة. نسبة النكس كانت 25% ونسبة الوفاة 16.4%. خلصت الدراسة إلى أن العلاج الشعاعي ثلاثي الأبعاد يلعب دوراً هاماً في السيطرة على سرطان الحنجرة في مراحله المبكرة مع تقليل تعرض الأنسجة السليمة للأشعة، مما يقلل من حدوث الاختلاطات المتأخرة.
Critical review
دراسة نقدية: تعتبر هذه الدراسة خطوة هامة في مجال علاج سرطان الحنجرة باستخدام العلاج الشعاعي ثلاثي الأبعاد، حيث تقدم بيانات مفصلة حول فعالية العلاج والاختلاطات المرتبطة به. ومع ذلك، هناك بعض النقاط التي يمكن تحسينها. أولاً، حجم العينة صغير نسبياً (44 مريضاً)، مما قد يؤثر على تعميم النتائج. ثانياً، لم يتم تقديم معلومات كافية حول المتغيرات الديموغرافية الأخرى مثل الحالة الاجتماعية والاقتصادية التي قد تؤثر على النتائج. ثالثاً، كان من المفيد تقديم مقارنة مع تقنيات علاجية أخرى مثل العلاج الكيميائي أو الجراحي لتقديم صورة شاملة عن فعالية العلاج الشعاعي ثلاثي الأبعاد. أخيراً، يفضل إجراء دراسات مستقبلية تشمل فترة متابعة أطول لتقييم الاختلاطات المتأخرة بشكل أكثر دقة.
Questions related to the research
  1. ما هو الهدف الرئيسي من الدراسة؟

    الهدف الرئيسي من الدراسة هو تقييم فعالية العلاج الشعاعي ثلاثي الأبعاد في السيطرة على سرطان الحنجرة في مراحله المبكرة وتحديد الاختلاطات الشعاعية الحادة والمتأخرة، بالإضافة إلى تقييم نسبة النكس والوفاة.

  2. ما هي الاختلاطات الأكثر شيوعاً التي تم ملاحظتها خلال الدراسة؟

    الاختلاطات الأكثر شيوعاً التي تم ملاحظتها خلال الدراسة هي جفاف الفم وصعوبة البلع بنسبة 96%، تليها الاختلاطات الجلدية بنسبة 70%.

  3. هل تم ملاحظة أي اختلاطات متأخرة خلال فترة المتابعة؟

    لم يتم ملاحظة أي اختلاطات متأخرة خلال فترة المتابعة.

  4. ما هي نسبة النكس والوفاة التي تم تسجيلها في الدراسة؟

    نسبة النكس التي تم تسجيلها في الدراسة هي 25%، ونسبة الوفاة هي 16.4%.


References used
BRUCHON,Y; BONNETAIN,F; BARILLOT,I; TRUC,G; Conservative treatment of early glottic carcinomas with exclusive radiotherapy Cancer/Radiothérapie, Volume 8, Issue 5, October 2004, Pages 288-296
AMADOA,A.C; BUJOR,A.L;GRILLO,M.G ,3D conformal hypofractionated radical radiotherapy in early glottic cancer a Radiotherapy Department, Hospital de Santa Maria – Centro Hospitalar Lisboa Norte, Lisbon, Portugal , Medical Faculty of Lisbon, Lisbon University,September–October 2013.Pages 261-264
EITAN MEDINI, M.D ; ALLEN MEDINI, B.A. ; MARKUS GAPANY, M .D ;et al, Radiation therapy in early carcinoma of the glottic larynx T1NOMO, , Volume 36, Issue 5, 1 December 1996, Pages 1211-1213
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