JOURNAL DESCRIPTION
The Medical Radiology and Radiation Safety journal ISSN 1024-6177 was founded in January 1956 (before December 30, 1993 it was entitled Medical Radiology, ISSN 0025-8334). In 2018, the journal received Online ISSN: 2618-9615 and was registered as an electronic online publication in Roskomnadzor on March 29, 2018. It publishes original research articles which cover questions of radiobiology, radiation medicine, radiation safety, radiation therapy, nuclear medicine and scientific reviews. In general the journal has more than 30 headings and it is of interest for specialists working in thefields of medicine¸ radiation biology, epidemiology, medical physics and technology. Since July 01, 2008 the journal has been published by State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency. The founder from 1956 to the present time is the Ministry of Health of the Russian Federation, and from 2008 to the present time is the Federal Medical Biological Agency.
Members of the editorial board are scientists specializing in the field of radiation biology and medicine, radiation protection, radiation epidemiology, radiation oncology, radiation diagnostics and therapy, nuclear medicine and medical physics. The editorial board consists of academicians (members of the Russian Academy of Science (RAS)), the full member of Academy of Medical Sciences of the Republic of Armenia, corresponding members of the RAS, Doctors of Medicine, professor, candidates and doctors of biological, physical mathematics and engineering sciences. The editorial board is constantly replenished by experts who work in the CIS and foreign countries.
Six issues of the journal are published per year, the volume is 13.5 conventional printed sheets, 88 printer’s sheets, 1.000 copies. The journal has an identical full-text electronic version, which, simultaneously with the printed version and color drawings, is posted on the sites of the Scientific Electronic Library (SEL) and the journal's website. The journal is distributed through the Rospechat Agency under the contract № 7407 of June 16, 2006, through individual buyers and commercial structures. The publication of articles is free.
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Medical Radiology and Radiation Safety. 2024. Vol. 69. № 5
DOI:10.33266/1024-6177-2024-69-5-104-108
P.A. Lushnikova1, 2, Ya.N. Sutygina1, 2, E.S. Sukhikh2, 3, Zh.A. Startseva3,
A.A. Polyakov1
Possibilities of Modern Radiation Therapy for Locally Advanced Endometrial Cancer
1 Tomsk Regional Oncology Center, Tomsk, Russia
2 National Research Tomsk Polytechnic University, Tomsk, Russia
3 Tomsk National Research Medical Center, Tomsk, Russia
Contact person: P.A. Lushnikova, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
ABSTRACT
Purpose: Analysis of radical radiotherapy efficacy (combination of remote irradiation with simultaneous dose escalation to the tumor focus and subsequent intracavitary component) in a patient diagnosed with stage III endometrial cancer when surgical treatment is impossible. Assessment of the dynamics of the underlying disease and adverse events. The purpose of the study is to analyze the effectiveness of radical radiation therapy in a patient diagnosed with stage III endometrial cancer when surgical treatment is impossible.
Material and methods: We present a clinical case of a patient with inoperable stage III endometrial cancer (histologic variant-highly differentiated adenocarcinoma) with metastasis to the lower third of the vagina. The first stage was a course of remote radiotherapy on a linear gas pedal VarianTrueBeamSTx on the uterus, vagina, paravaginal tissues, pelvic lymph nodes up to a total dose of 50 Gy and simultaneous dose intensification on the area of tumor focus in the lower third of the vagina up to a total dose of 62.5 Gy. The method of dose administration was rotational radiotherapy with intensity modulation of photon radiation (Volume-modulated arc therapy ‒ VMAT).
The second stage was a course of intracavitary (contact, brachytherapy) radiotherapy on MultiSource HDR device with 60Co ionizing radiation source. A gynecological two-channel applicator was used during treatment. The plan of each treatment session was developed based on CT images on the SagiPlan planning station. Intracavitary radiation therapy mode – single dose of 6 Gy, 4 fractions were performed.
The effect of radiation therapy was assessed by MRI of pelvic organs with intravenous contrasting immediately after treatment and further at intervals of every 3 months.We present a clinical case of a 71 year old female patient diagnosed with stage III endometrial cancer (well-differentiated adenocarcinoma), with adenocarcinoma metastasis to the lower 1/3 of the vagina. Planning of radiotherapy and radiation therapy in a patient with inoperable endometrial cancer with simultaneous escalation of the dose of ionizing radiation to the area of metastasis in the vagina during the remote component and subsequent intracavitary boost to the uterine area. Study of the results of radiation therapy.
Results: After treatment, MRI data showed complete regression of the tumor nidus in the vagina and reduction of the nidus in the uterine body (more 50 %). Long-term control of the tumor process in the patient, confirmed by clinical and radiological studies (MRI of the pelvic organs), was also achieved.The capabilities of modern radiation therapy make it possible to carry out radical treatment of patients with endometrial cancer in clinical cases when it is necessary to increase the dose of ionizing radiation to a separate tumor focus, without exceeding the tolerable levels of radiation exposure to risk organs. This approach makes it possible to achieve remission in real clinical practice.
Conclusion: The capabilities of modern radiation therapy allow radical treatment of patients with inoperable endometrial cancer in clinical cases when it is necessary to increase the dose of ionizing radiation to a separate tumor focus without exceeding tolerance levels of radiation loads on risk organs. This approach makes it possible to achieve remission in real clinical practice.
Keywords: endometrial cancer, radiation therapy, dose escalation, intensity modulated radiation therapy, dosimetric planning, linear accelerator
For citation: Lushnikova PA, Sutygina YaN, Sukhikh ES, Startseva ZhA, Polyakov AA. Possibilities of Modern Radiation Therapy for Locally Advanced Endometrial Cancer. Medical Radiology and Radiation Safety. 2024;69(5):104–108. (In Russian). DOI:10.33266/1024-6177-2024-69-5-104-108
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PDF (RUS) Full-text article (in Russian)
Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship.
Contribution. Article was prepared with equal participation of the authors.
Article received: 20.05.2024. Accepted for publication: 25.06.2024.