RADICAL RADIOTHERAPY FOR CERVIX CARCINOMA AT MOUNT ELIZABETH HOSPITAL

Send This

Download

Comment

Favourite

more

Rating :

Rate It:

Embed :

Post a comment

Post Comment on Twitter Post Comment on SlideWorld

Comments:

Subscribe to follow-up comments

Notes

Hide Notes

Slide 1 :

RADICAL RADIOTHERAPY FOR CERVIX CARCINOMA AT MOUNT ELIZABETH HOSPITALLong-Term Results TH Khor, JKL Tuan, SW Hee and IWK Tham

Slide 2 :

INTRODUCTION Total 106 patients Jan 1990 – Dec 1993 Radical RT- Pelvic XRT & HDRBT Median age – 57 (range 32-80)

Slide 3 :

DISTRIBUTION BY FIGO STAGE Stage N= Percent Cumulative Percent IB1 14 13.2 13.2 IB2 3 2.8 16.0 IIA 11 10.4 26.4 IIB 36 34.0 60.4 IIIB 39 36.8 97.2 IV 3 2.8 100.0 All Stages 106 100.0

Slide 4 :

HISTOLOGY Squamous Cell Carcinoma 96 - 90.6% Adenocarcinoma 7 - 6.6% Adeno-squamous Carcinoma 3 - 2.8%

Slide 5 :

HISTOLOGY - GRADING Grade Frequency Percent Well 4 3.8 Mod 39 36.8 Poor 50 47.2 Unspecified 13 12.3 Total 106 100.0

Slide 6 :

INITIAL Hb Median Hb at start of RT 78 patients – 12.3 (range – 5.9-15.5) Hb unknown – 28 patients

Slide 7 :

EBRT Megavoltage 6MV Photons AP-PA up to 3rd quarter 1990 (16 pts) 4 field box later (90 pts) Median dose – 45Gy (range 40.6-64.8) Median No of # - 25 (range 17-36) Median duration of treatment – 40 days (range – 31-65 days)

Slide 8 :

Slide 9 :

Slide 10 :

Slide 11 :

Slide 12 :

HDR REMOTE AFTERLOADING Benefits Increased treatment accuracy Radiation protection of personnel Patient preference New applications (small source size, Ir192) Outpatient treatment Disadvantages High initial and maintenance cost Theoretical RBE problem of tumour/normal tissue response vs LDR

Slide 13 :

Slide 14 :

Slide 15 :

Slide 16 :

Slide 17 :

Slide 18 :

BRACHYTHERAPY NO. OF APPLICATIONS Frequency Percent 1 (ovoids only) 1 .9 2 36 34.0 3 69 65.1 Total 106 100

Slide 19 :

BRACHYTHERAPY DOSE TO POINT “A” Range – 5Gy to 7.5Gy for each application Mean total dose – 17.17Gy Median total dose – 18Gy DOSE TO BLADDER AND RECTUM (ICRU) Bladder (101 patients) Rectum (104 patients) Mean 14.08Gy 15.65Gy Median 13.78Gy 15.64Gy

Slide 20 :

Slide 21 :

Slide 22 :

Slide 23 :

Overall Survival 10 8 6 4 2 0 1.0 .9 .8 .7 .6 .5 .4 .3 .2 .1 0.0 Overall Survival Censored Cumulative Survival Years 70% 64%

Slide 24 :

Relapse Free Survival 10 8 6 4 2 0 Cum Survival 1.0 .9 .8 .7 .6 .5 .4 .3 .2 .1 0.0 Survival Function Censored 69% 63% Years

Slide 25 :

Relapse Free Survival by Stage

Slide 26 :

Relapse Free Survival - Stage 1B

Slide 27 :

COMPLICATIONS G1* G2* G4* TOTAL Rectum 7 (6.6%) - 1 (0.9%)† 8 (7.5%) Bladder 13 (12.3%) 2 (1.9%) - 15 (14.2%) Vagina 46 (43.4%) 2 (1.9%) - 48 (45.3%) * RTOG † With recurrent disease

Slide 28 :

RELAPSE RATES 31 patients - 29.2% Residual disease : 6 patients 5.7% Local relapse : 11 patients 10.4% Distant relapse : 11 patients 10.4% Local + distant relapse : 3 patients 2.8%

Slide 29 :

PROGNOSTIC FACTORS HR p-value Stage I/II 1.000 Stage III/IV 3.158 0.001 Hb > 11 1.000 Hb < 11 4.267 < 0.001 Overall Treatment 1.083 0.003 Time

Slide 30 :

THANK YOU

Strategic Management...

Infiltrating Basal c...

Building a hospital ...

Serial Murder in Hos...

The angiogenesis in ...

Suicide Prevention a...

Free Powerpoint Templates

	flintoff 5 Years ago.



2281 Views, 0 favourite
PowerPoint Presentation on RADICAL RADIOTHERAPY FOR CERVIX CARCINOMA AT MOUNT ELIZABETH HOSPITAL or more PowerPoint Presentation on RADICAL RADIOTHERAPY FOR CERVIX CARCINOMA AT MOUNT ELIZABETH HOSPITAL or PowerPoint Presentation on less
More By User Flag as inappropriate Select your reason for flagging this presentation as inappropriate. If needed, use the feedback form to let us know more details. Cancel