Early pain relief and toxicity after image-guided VMAT for spinal cord compression Fog, L S1 , Iovane, V1 , Hemer, M1 , Pappot, H1 , Aznar, M C2 , Sjøgren,

Slides:



Advertisements
Similar presentations
Long-Term Data for 884 Patients Show Vertebroplasty for Osteoporotic Spinal Fractures Provides Dramatic Pain Relief, Greatly Decreases Disability Giovanni.
Advertisements

Radiotherapy for Brain Tumours What do I need to know? Dr Matthew Foote Radiation Oncologist Princess Alexandra Hospital Queensland.
Stereotactic Body Radiation Therapy (SBRT): The optimal indication for operable tumors in inoperable patients D.Katsochi 1, S.Kosmidis 1, A.Fotopoulou.
The Health Roundtable 1-1b_HRT1215-Session_HEGI_JOHNSON_WESTMEAD_NSW Volumetric Modulated Arc Therapy for Stereotactic Body Radiotherapy in Early Lung.
Radiotherapy for Kidney cancer
QUALITY AND ADOPTION TO FAMILY LIFE IN CERVICAL CANCER SURVIVORS AFTER RADIOTHERAPY Dr.Rishan.T.S, Cancer Institute(WIA), Adyar,Chennai.
A Phase II Study to Evaluate the Safety and Toxicity of Sparing Radiation to the Pathologic N0 Side of the Neck in Squamous Cell.
Ten Year Outcomes In Men Under 60 Treated With Iodine-125 Permanent Brachytherapy As Monotherapy GU - Prostate Cancer: Novel Imaging (MRI,PET) & Brachytherapy.
PATIENT CASE Module 4 Date of preparation: June 2015 HQ/EFF/15/0024h.
Optimization of Volumetric Modulated Arc Therapy (VMAT) Planning Strategy Using Ring-shaped ROI for Localized Prostate cancer Kentaro Ishii, Masako Hosono,
T. Hijal MD, A. Al Hamad MD, N. Khalaf, K. Sultanem MD, S. Faria MD and T. Muanza MD McGill University, Department of Radiation Oncology, Montréal, Québec,
Reducing excess imaging dose to cancer patients receiving radiotherapy Adam Schwertner, Justin Guan, Xiaofei Ying, Darrin Pelland, Ann Morris, Ryan Flynn.
Which Method Is More Effective In Treatment Of Calcific Tendinitis In The Shoulder? - Prospective Randomized Comparison Between US- Guided Needling and.
ISAAC iPEHOC Project Printout and Output Guide.
Accuracy and usefulness of a clinical prediction rule and D-dimer testing in excluding deep vein thrombosis in cancer patients Thrombosis Research (2008)
Date of download: 9/20/2016 From: Massage Therapy versus Simple Touch to Improve Pain and Mood in Patients with Advanced Cancer: A Randomized Trial Ann.
Date of download: 9/20/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Effects of a Palliative Care Intervention on Clinical.
Beckert,  Maria Witte,  Corinna Wicke, 
CANCER CAUSES, REMEDIES & PREVENTION
A Randomized Trial Comparing Immediate versus Delayed Treatment of Anemia with Once-Weekly Epoetin Alfa in Patients with Non-small Cell Lung Cancer Scheduled.
Hypothermia for Preventing Chemotherapy-Induced Peripheral Neuropathy
Sofija Zagarins1, PhD, Garry Welch1, PhD, Jane Garb2, MS
R1.이용석 / modulator pf.한재준.
Radiation therapy for Early Stage Prostate Cancer
Figure 1. Dose modification scheme for the second cycle of capecitabine treatment. From: Adjuvant capecitabine chemotherapy using a tailored-dose strategy.
Kasey Etreni BSc., MRT(T), RTT, CTIC
Long-Term Follow-Up of Patients Receiving Lung-Volume-Reduction Surgery Versus Medical Therapy for Severe Emphysema by the National Emphysema Treatment.
24 hour levodopa-carbidopa intestinal gel may reduce “unresponsive” freezing of gait and falls in Parkinson’s disease Florence CF Chang, David S Tsui,
Treatment allocation bias
Treatment With Continuous, Hyperfractionated, Accelerated Radiotherapy (CHART) For Non-Small Cell Lung Cancer (NSCLC): The Weston Park Hospital Experience.
Quality of Life after Total Laryngectomy Cyprus experience
Copyright © 2003 American Medical Association. All rights reserved.
Introduction and Objectives
IMRT delivery of preoperative, high dose radiotherapy to a large volume, with Simultaneous Integrated Boost (SIB) in retroperitoneal sarcomas: The Ottawa.
Unidade de Oncologia SPINAL CORD COMPRESSION ASSOCIATED TO METASTATIC PROSTATE CANCER Miguens, M. (1); Ferreira, F. (1); Malheiro, M. (1); Cardoso,
New Horizons for SMA.
Hospice Palliative Care – Tips for Primary care
SCORAD III: Randomised non-inferiority phase III trial of single-dose radiotherapy (RT) compared to multifraction RT in patients with metastatic spinal.
Clinical Trial Results with OROS® Hydromorphone
Insert tables Insert figure
Radiotherapy for Metastatic Spinal Cord Compression
Volumetric Modulated Arc Therapy (VMAT) versus Intensity Modulated Radiation Therapy (IMRT) for Anal Carcinoma Heather Ortega, BSRT(T), CMD, Kerry Hibbitts,
Dr T P E Wells 13 July 2018 Breast SSG Bath
Patient-Reported Outcomes Data From REVEAL at the Time of Enrollment (Baseline): A Prospective Observational Study of Patients With Polycythemia Vera.
Radiation Oncology Department, Bank of Cyprus Oncology Center.
Long-Term Follow-Up of Patients Receiving Lung-Volume-Reduction Surgery Versus Medical Therapy for Severe Emphysema by the National Emphysema Treatment.
L. A. den Otter. , R. M. Anakotta. , M. Dieters. , C. T. Muijs. , S
Volume 54, Issue 2, Pages (August 2008)
Pain, Fatigue, and Sleep Disturbances in Oncology Outpatients Receiving Radiation Therapy for Bone Metastasis  Christine Miaskowski, RN, PhD, FAAN, Kathryn.
A Randomized Trial Comparing Immediate versus Delayed Treatment of Anemia with Once-Weekly Epoetin Alfa in Patients with Non-small Cell Lung Cancer Scheduled.
Safety and Efficacy of Dacomitinib in Korean Patients with KRAS Wild-Type Advanced Non–Small-Cell Lung Cancer Refractory to Chemotherapy and Erlotinib.
Health-Related Quality of Life of Patients With Multiple Myeloma Treated in Routine Clinical Practice in France  Nicolas Despiégel, Chantal Touboul, Alain.
Predictors of acute throat or esophageal patient reported pain during radiation therapy for head and neck cancer  Hiram A. Gay, Jung Hun Oh, Aditya P.
Cough in Patients With Lung Cancer
Symptom and Quality of Life Improvement in LUX-Lung 6: An Open-Label Phase III Study of Afatinib Versus Cisplatin/Gemcitabine in Asian Patients With EGFR.
1 Verstovsek S et al. Proc ASH 2012;Abstract Cervantes F et al.
Subcutaneous injection of depot medroxyprogesterone acetate compared with leuprolide acetate in the treatment of endometriosis-associated pain  William.
Effect of Once- or Twice-Daily MMX Mesalamine (SPD476) for the Induction of Remission of Mild to Moderately Active Ulcerative Colitis  Gary R. Lichtenstein,
Mean difference between treatment groups in the change from baseline for all PRO scores at months 1, 2 and 3. *Evaluable patients. Mean difference between.
Early Impact of Pulmonary Fractionated Stereotactic Body Radiotherapy on Quality of Life:Benefit for Patients With Low Initial Scores (STRIPE Trial) 
Prolonged Treatment with Transdermal Fentanyl in Neuropathic Pain
Mean change from baseline in symptom scales and single-item assessments after 6 weeks of alectinib treatment according to (A) the QLQ-C30 and (B) the QLQ-LC13.
No evidence for sex differences in the severity and treatment of cancer pain  Janet M. Edrington, RN, MS, Steven Paul, PhD, Marylin Dodd, RN, PhD, Claudia.
ULTRASOUND NEWS
Mean change from baseline for perceived cognitive impairments (A), cognitive functioning (B), usual level of fatigue (C) and fatigue interference (D) at.
The efficacy and safety of omalizumab in pediatric allergic asthma
Health-Related Quality of Life in KEYNOTE-010: a Phase II/III Study of Pembrolizumab Versus Docetaxel in Patients With Previously Treated Advanced, Programmed.
Nathaniel P Katz, MD  Journal of Pain and Symptom Management 
Fig. 2. Change in IPSS scores as a measure of treatment effectiveness
Does the Medical Record Cover the Symptoms Experienced by Cancer Patients Receiving Palliative Care? A Comparison of the Record and Patient Self-Rating 
Presentation transcript:

Early pain relief and toxicity after image-guided VMAT for spinal cord compression Fog, L S1 , Iovane, V1 , Hemer, M1 , Pappot, H1 , Aznar, M C2 , Sjøgren, P1, Appelt, A1,3 1 Dept. of Oncology, Rigshospitalet, University of Copenhagen, Denmark , 2 Nuffield Dept. of Population Health, University of Oxford, UK , 3 Inst. of Cancer and Pathology, St James’s University Hospital, Leeds, UK Introduction We present preliminary data from a prospective study investigating early pain relief and toxicity in patients with malignant spinal cord compression (SCC). Results Worst pain was significantly reduced on days 9 and 13 (3.36, n=11, p=0.01; 3.18, n=17, p=0.007) (figure 2) compared to baseline (5.62) as well as average pain on days 7,9, 13 and 20 (2.52, n=22, p=0.03; 1.96, n=11, p=0.03; 1.72, n=18, p=0.01; 2.64, n=14, p=0.02) compared to baseline (3.55). Tiredness was significantly greater only on day 9 (3.07 vs 2.10, n=9, p= 0.03). Three patients had increased diarrhea in week 2 or 3; these had SCC at the level of Th9 or below (Th9 and L1; L1-3; Th5 and Th11). Six patients reported increased constipation in week 2 or 3. Patients reported an average of 1.8 “other symptoms”. These were oral or throat pain and difficulty in swallowing (11 pts, all of for whom the most cranially treated vertebrae were Th8 or above) (figure 3), others were bone pain (7), dizziness (2) and 12 symptoms experienced by only one patient. Materials and methods 30 consecutive SCC patients treated with 10x3 Gy at our clinic were included (figure 1). Radiotherapy (RT) was delivered as image-guided volumetric modulated arc therapy (VMAT), with sparing of intestines for patients treated at abdomen and pelvis. The patients answered the modified Brief Pain Inventory (mBPI) and Edmonton Symptom Assessment Scale (ESAS) daily on weekdays for three weeks and the EORTC-QLQ-C30 questionnaire weekly for 7 weeks, both from the start of RT. Daily data on worst pain, average pain, tiredness and “other symptoms” were compared to baseline scores using the Wilcoxon signed rank test. Change in diarrhea and constipation from week 1 was recorded. One patient was excluded from analysis due to a change in fractionation. Conclusion Reduction in pain is not observed until the second week of treatment for most patients treated with RT for SCC, and not necessarily maintained after end of treatment. Patients experience multiple early toxicities – particularly oral or throat pain, difficulty in swallowing, and diarrhea, which may all be treatment related. All patients for whom the most cranially treated vertebra was Th8 or above experienced oral or throat pain and difficulty in swallowing. Figure 1. Planning CT for patient no. 1 in this work. Figure 2. Changes relative to baseline of ”worst pain”. The error bars indicate the standard deviation. Figure 3. Treated vertebra versus patient number. A solid circle indicates that the patient experienced DOG (Dysphagia, Odynophagia and Globulus), a cross that the patient did not. The patients are listed in order of when they experienced DOG. Lotte.fog@regionh.dk