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Megavoltage cone-beam computed tomography
Published in Ross I. Berbeco, Beam’s Eye View Imaging in Radiation Oncology, 2017
One of the great advantages of volumetric information obtained from CBCT imaging is the ability to not only correct for mispositioning but also to monitor changes in anatomy over the course of treatment. For example, patients treated for head-and-neck cancer tend to lose a lot of weight as a result of dysphagia and odynophagia caused by treatment-induced irritation. In some cases, weight loss can be so severe that the planning CT no longer represents proper patient geometry and the dose distribution does not conform to the actual disease. Daily volumetric imaging is a great tool for monitoring such changes. Figure 5.5 shows the planning CT with initial contours of target and OAR for an oropharyngeal cancer patient, along with a MV-CBCT image taken after 4 weeks of treatment. The MV-CBCT image shows an approximately 3 cm reduction in neck diameter, leading the planning target volume to lie outside the patient contour. Subsequently, a second planning CT was acquired for that patient, and a new plan was created and used for the remainder of the treatment. In this case, the daily use of MV-CBCT imaging directly led to this simple form of adaptive therapy.
Developing Taxanes for Oral Intake Employing Apt Nanocarriers
Published in Bhupinder Singh, Om Prakash Katare, Eliana B. Souto, NanoAgroceuticals & NanoPhytoChemicals, 2018
Rajneet Kaur Khurana, Teenu Sharma, Harpreet Kaur, Anchal, Kaisar Raza, Bhupinder Singh
Despite the potential promises, the challenges associated with the oral taxane delivery vouch significant attention. The oral absorption of these agents is hampered by the co-administered of drugs, food items, nutritional supplements, and herbal medications, which may unpredictably influence bioavailability (Khurana et al., 2016). On the other hand, side effects—such as dysphagia, nausea, odynophagia, gastrectomy, vomiting, and diarrhea—generally associated with oral administration are the other major concern. Therefore, the regimen needs to be supplemented with antiulcer and antiemetic drugs prior to oral chemotherapy.
Radiation-induced lung disease
Published in Philippe Camus, Edward C Rosenow, Drug-induced and Iatrogenic Respiratory Disease, 2010
Max M Weder, M Patricia Rivera
Radiation-induced oesophagitis remains the main dose-limiting acute toxicity in radiotherapeutic management of thoracic neoplasms. The oesophageal mucosa is subject to constant regeneration and high cell turnover, which renders it very susceptible to radiation injury. The basal epithelial layer is usually affected in acute oesophageal radiation injury, resulting in mucosal thinning that may progress to denudation. Symptoms usually occur within 2–3 weeks after initiation of radiotherapy and consist of dysphagia, odynophagia and sub-sternal chest discomfort. In severe cases, decreased food and fluid intake may result in dehydration and weight loss and warrant discontinuation or interruption of radiation therapy.
Single-session high-intensity focused ultrasound (HIFU) ablation for benign thyroid nodules: a systematic review
Published in Expert Review of Medical Devices, 2020
Eleftherios Spartalis, Sotirios P. Karagiannis, Nikolaos Plakopitis, Maria Anna Theodori, Dimosthenis Chrysikos, Stavroula A. Paschou, Georgios Boutzios, Dimitrios Schizas, Michael Spartalis, Theodore Troupis, Nikolaos Nikiteas
Thyroid nodules are palpable in about 5% of iodine-sufficient populations, depending on age and sex. Other thyroid nodules can be diagnosed in up to 68% of individuals through different imaging modalities [1,2]. The reported prevalence is about 65% with ultrasonography (US), 15% with computed tomography (CT) or magnetic resonance imaging (MRI), and 1–2% with 18-fluoro-deoxy-glucose positron emission tomography (PET) [1,2]. Approximately 90-95% of thyroid nodules are benign and asymptomatic, generally small in size that either grow slowly or do not grow at all (85%), contrary to malignant thyroid nodules [2,3]. A minority of patients develop thyroid dysfunction. The presence of local symptoms depends on nodule size and position. Patients may develop globus sensation when they have nodules larger than 3 cm; dysphagia or swallowing complaints, such as stasis, choking and odynophagia, dyspnea, dysphonia or hoarseness, and pain, due to acute nodule enlargement or intranodular bleeding [2].