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RISS 인기검색어
- 검색키워드
- 저자 : Srinivas Kondalsamy-Chennakesavan (검색결과 4 건)
- 무료
- 기관 내 무료
- 유료
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Ming Yin Lin,Srinivas Kondalsamy-Chennakesavan,David Bernshaw,Pearly Khaw,Kailash Narayan 대한부인종양학회 2016 Journal of Gynecologic Oncology Vol.27 No.6
Objective: The aim of this analysis was to examine the management of cervix cancer inelderly patients referred for radiotherapy and the results of treatment in terms of overallsurvival (OS), relapse-free survival (RFS), and treatment-related toxicities. Methods: Patients were eligible if they were aged ≥75 years, newly diagnosed with cervixcancer and referred for radiotherapy as part of their treatment. Patient details were retrievedfrom the gynaecology service database where clinical, histopathological treatment andfollow-up data were prospectively collected. Results: From 1998 to 2010, 126 patients aged ≥75 years, met selection criteria. Medianage was 81.5 years. Eighty-one patients had definitive radiotherapy, 10 received adjuvantradiotherapy and 35 had palliative radiotherapy. Seventy-one percent of patients had theInternational Federation of Gynecology and Obstetrics stage 1b–2b disease. Median followupwas 37 months. OS and RFS at 3 years among those treated with curative intent were66.6% and 75.9% respectively with majority of patients dying without any evidence of cervixcancer. Grade 2 or more late toxicities were: bladder 5%, bowel 11%, and vagina 27%. EasternCooperative Oncology Group (ECOG) status was a significant predictor of OS and RFS witheach unit increment in ECOG score increased the risk of death by 1.69 times (p<0.001). Conclusion: Following appropriate patient selection, elderly patients treated curativelywith radiotherapy for cervix cancer have good disease control. Palliative hypofractionatedregimens are well tolerated in patients unsuitable for radical treatment.
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Chrishanthi Rajasooriyar,David Bernshaw,Srinivas Kondalsamy-Chennakesavan,Linda Mileshkin,Kailash Narayan 대한부인종양학회 2014 Journal of Gynecologic Oncology Vol.25 No.4
Objective: The purpose of this study was to evaluate the patterns of failure, overall survival (OS), disease-free survival (DFS) and factors influencing outcome in endometrial cancer patients who presented with metastatic lymph nodes and were treated with curative intent. Methods: One hundred and twenty-six patients treated between January 1996 to December 2008 with surgery and adjuvant radiotherapy were identified from our service’s prospective database. Radiotherapy consisted of 45 Gy in 1.8 Gy fractions to the whole pelvis. The involved nodal sites were boosted to a total dose of 50.4 to 54 Gy. Results: The 5-year OS rate was 61% and the 5-year DFS rate was 59%. Grade 3 endometrioid, serous, and clear cell histologies and involvement of upper para-aortic nodes had lower OS and DFS. The number of positive nodes did not influence survival. Among the histological groups, serous histology had the worst survival. Among the 54 patients relapsed, only three (6%) failed exclusively in the pelvis and the rest of the 94% failed in extrapelvic nodal or distant sites. Patients with grade 3 endometrioid, serous and clear cell histologies did not influence pelvic failure but had significant extrapelvic failures (p<0.001). Conclusion: Majority of node positive endometrial cancer patients fail at extrapelvic sites. The most important factors influencing survival and extrapelvic failure are grade 3 endometrioid, clear cell and serous histologies and involvement of upper para-aortic nodes.
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Kailash Narayan,Sylvia van Dyk,David Bernshaw,Pearly Khaw,Linda Mileshkin,Srinivas Kondalsamy-Chennakesavan 대한부인종양학회 2014 Journal of Gynecologic Oncology Vol.25 No.3
Objective: The aim of this study was to report on the long-term results of transabdominal ultrasound guided conformal brachytherapy in patients with cervical cancer with respect to patterns of failures, treatment related toxicities and survival. Methods: Three hundred and nine patients with cervical cancer who presented to Institute between January 1999 and December 2008 were staged with magnetic resonance imaging and positron emission tomography and treated with external beam radiotherapy and high dose rate conformal image guided brachytherapy with curative intent. Follow-up data relating to sites of failure and toxicity was recorded prospectively. Results: Two hundred and ninety-two patients were available for analyses. The median (interquantile range) follow-up time was 4.1 years (range, 2.4 to 6.1 years). Five-year failure free survival and overall survival (OS) were 66% and 65%, respectively. Primary, pelvic, para-aortic, and distant failure were observed in 12.5%, 16.4%, 22%, and 23% of patients, respectively. In multivariate analysis, tumor volume and nodal disease related to survival, whereas local disease control and point A dose did not. Conclusion: Ultrasound guided conformal brachytherapy of cervix cancer has led to optimal local control and OS. The Melbourne protocol compares favorably to the more technically elaborate and expensive GEC-ESTRO recommendations. The Melbourne protocol’s technical simplicity with real-time imaging and treatment planning makes this a method of choice for treating patients with cervical cancer.
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