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This article presents methods and results of surgery and radiotherapy of brain metastases from non-small cell lung cancer (BMF-NSCLC). Patients with single BMF-NSCLC, with Karnofsky score 70 and controlled extracranial disease are the best candidates for surgery. Stereotactic radiosurgery (SRS) is recommended in patients with 1-3 BMF-NSCLC below 3-3.5 cm, with minor neurological symptoms, located in parts of the brain not accessible to surgery, with controlled extracranial disease. Whole brain radiotherapy (WBRT) following SRS reduces the risk of local relapse; in selected patients median survival reaches more than 10 months. Whole brain radiotherapy alone is a treatment in patients with multiple metastases, poor performance status, uncontrolled extracranial disease, disqualified from surgery or SRS with median survival 3 to 6 months. There is no doubt that there are patients with BMF-NSCLC who should receive only the best supportive care. There is a debate in the literature on how to select these patients. [ABSTRACT FROM AUTHOR]

Summary Objective The evaluation of efficacy of palliative thoracic radiotherapy (PTR) in patients with advanced non-small cell lung cancer (NSCLC) and to compare it with efficacy of supportive care (SC) alone. Materials and methods Between 2000 and 2012, 235 patients with advanced NSCLC (IIIB and IV) and Karnofsky Performance Status accounted 40–30, were qualified to PTR. In fact, 125 (53.2%) out of them were treated with PTR, and 110 (46.8%)—with SC alone, in accordance with patients expectations. There were no differences between PTR and SC group with respect to patient and tumor characteristics as well as with respect to the type and incidence of symptoms related to the local growth of NSCLC. In all 125 PTR patients the delivered tumor dose was 20 Gy given in five daily fractions over five treatment days. All 110 patients who refused PTR were treated with SC in another hospital (28.2%), in a hospice (21.8%) or by general practitioners at home (50.0%). Results The 90-day overall survival rate in the group of PTR patients was 20.0%, and in the group of SC patients it was 18.2%. Median survival amounted 58 and 59 days, respectively. The efficacy of PTR and SC, relative to the symptoms associated with the local growth of NSCLC, was comparable. Tolerance of PTR was poor and early toxicity—significant. Moreover 41.6% of irradiated patients received PTR within the last 30 days of their lives and 16.0% of these patients—within the last 15 days prior to death. Conclusion The life expectancy of patients with advanced NSCLC and poor performance status (Karnofsky 40–30), who presenting moderate or severe symptoms related to the local growth of cancer, is measured in days or weeks. The effective method of treatment for these patients is modern supportive care rather than PTR. [ABSTRACT FROM AUTHOR]

The continuum material has been modeled employing a 2D discrete lattice containing 200x200 elements. Four different nucleation models, i.e. site saturation, continuous, increasing and decreasing nucleation rate were compared. The sigmoidal time dependence of recrystallized volume fraction observed in the simulation is often emphasized in the literature and finds its justification in the experiment. The Avrami exponent n = 2 is properly reproduced by the simulations. It has been shown that the model correctly responds to the change in the degree of stored energy H/J. [ABSTRACT FROM AUTHOR]

This article emphasizes the significance of understanding the actual thermal properties of thermal insulation materials, which are crucial for avoiding errors in building design and estimating heat losses within the energy balance. The aim of this study was to analyse the thermal parameters of selected thermal insulation materials, particularly in the context of their stability after a period of storage under specific conditions. The materials chosen for this study include commonly used construction insulations such as polystyrene and mineral wool, as well as modern options like rigid foam composites. Experimental studies were conducted, including the determination of the thermal conductivity coefficient λ, as well as numerical analyses and analytical calculations of heat flow through a double-layer external wall with a window. The numerical analyses were performed using the TRISCO software version 12.0w, based on the finite element method (FEM). A macrostructural analysis of the investigated materials was also performed. The findings indicated that improper storage conditions adversely affect the thermal properties of insulation materials. Specifically, storing materials outdoors led to a deterioration in insulating properties, with an average reduction of about 4% for the standard materials and as much as 19% for the tested composite material. Insufficient understanding of the true thermal properties of insulation materials can result in incorrect insulation layer thickness, degrading the fundamental thermal parameters of external walls. This, in turn, increases heat loss through major building surfaces, raises heating costs, and indirectly contributes to greenhouse gas emissions. [ABSTRACT FROM AUTHOR]

This article presents methods and results of surgical treatment and radiation therapy of brain metastases in breast cancer patients (brain metastases from breast cancer BMFBC). Based on the literature data, it was shown that patients with single BMF-BC, aged less than 65 years, with Karnofsky score (KPS) of 70 or more and with cured or controlled extracranial disease are the best candidates to surgical treatment. Irrespective of the extracranial disease control status, there are indications for surgery in patients with symptomatic mass effect (tumour diameter larger than 3 cm) and patients with obstructive hydrocephalus from their BMF-BC. Stereotactic radiosurgery (SRS) has some advantages over surgery, with similar effectiveness: it may be used in the treatment of lesions inaccessible to surgery, the number of lesion is not a limiting factor if each lesion is small (< 3) and adequate doses can be delivered, it is not contraindicated in patients with active extracranial disease, it does not interfere with ongoing systemic treatment, and it does not require general anaesthesia or hospitalisation. A disadvantage of SRS, as compared to whole brain radiotherapy (WBRT), in patients with BMF-BC is the possibility of subsequent development of new lesion in the non-irradiated field. Thus the majority of the BMF-BC patients are not good candidates to surgery or SRS; WBRT alone or combined with a systemic treatment still plays a major role in the treatment of these patients. [ABSTRACT FROM AUTHOR]

In the systemic treatment of brain metastases from non-small cell lung cancer (BMF-NSCLC) chemo- and targeted therapy are used. Response rates after platinum-based chemotherapy, range from 23% to 45%. Development of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) gefitinib or erlotinib, was an improvement in treatment of advanced NSCLC patients. EGFR mutations are present in 10-25% of NSCLC (mostly adenocarcinoma), and up to 55% in never-smoking women of East Asian descent. In the non-selected group of patients with BMF-NSCLC, the overall response rates after gefitinib or erlotinib treatment range from 10% to 38%, and the duration of response ranges from 9 to 13.5 months. In the case of present activating EGFR mutation, the response rate after EGRF-TKIs is greater than 50%, and in selected groups (adenocarcinoma, patients of Asian descent, never-smokers, asymptomatic BMF-NSCLC) even 70%. Gefitinib or erlotinib treatment improves survival of BMF-NSCLC patients with EGFR mutation in comparison to cases without the presence of this mutation. There is no data on the activity of the anti-EML4-ALK agent crizotinib. Bevacizumab, recombinant humanised monoclonal antibody anti-VEGF, in the treatment of advanced non-squamous NSCLC patients is a subject of intense research. Data from a clinical trial enrolling patients with pretreated or occult BMF-NSCLC proved that the addition of bevacizumab to various chemotherapy agents or erlotinib is a safe and efficient treatment, associated with a low incidence of CSN haemorrhages. However, the efficacy and safety of bevacizumab used for therapeutic intent, regarding active brain metastases is unknown. [ABSTRACT FROM AUTHOR]

Purpose We report a single-institution retrospective analysis of the outcomes, disease control, and toxicity of high-dose-rate (HDR) brachytherapy used as the only treatment modality (monotherapy) for localized prostate cancer. Methods Between 2006 and 2012, 77 patients with diagnosed prostate cancer were treated with HDR brachytherapy as a monotherapy. The prescribed dose was 45 Gy in three separate implants 21 days apart, with single fraction per implant. Of the 77 patients, 67 (87%) received hormonal therapy. Prostate-specific antigen failure was defined according to Phoenix consensus, as nadir + 2 ng/mL. Toxicity was scored according to Common Terminology Criteria for Adverse Events, version 4.03. Results The median followup time was 57 months (4.75 years). The 5-year actuarial overall survival was 98.7%, biochemical control 96.7%, local control 96.9%, and metastasis-free survival 98.4%. Younger age at the beginning of brachytherapy predicted the onset of bounce phenomenon. There were no Grade 3 or higher acute toxicities detected, and Grade 2 genitourinary acute toxicity developed in 19 patients (24.6%). There were no Grade 2 gastrointestinal complications. No Grade 4 or 5 late toxicity was detected. There were also no Grade 3 gastrointestinal toxicities detected. One patient (1.3%) underwent transurethral resection of the prostate because of Grade 3 urethral stenosis and urinary retention. A total of 26 patients (33.8%) developed Grade 2 late toxicity. Conclusions HDR brachytherapy as monotherapy for localized prostate cancer was feasible, effective, and had acceptable toxicity profile. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To present our experience with short-time, split-course palliative thoracic radiotherapy (PTR) in patients with advanced non-small cell lung cancer (NSCLC) with special regard to palliation of symptoms, tolerance and toxicity of PTR treatment. Patients and methods: Between 1980 and 2005, a group of 1250 patients with locally advanced or metastatic NSCLC was treated with PTR in our Center. All patients presented with moderate or severe symptoms related to local cancer growth. Results: The response rate defined as palliation of NSCLC symptoms after PTR was 54.1% for cough, 68% for haemoptysis, 51.1% for thoracic pain, 38.3% for dyspnoea, 12% for hoarseness, and 8% for dysphagia. Tolerance of PTR, expressed in terms of patient compliance to the treatment, was good in 92% of patients (i.e., 2 series of radiotherapy were given at the planned dose and time). Early treatment toxicity was observed in 4.6% of patients and included pneumonitis in 2.3%, intense nausea and vomiting in 0.6%, lung hemorrhage in 0.6%, and severe oesophagitis in 0.5% of patients. Lhermitte''s syndrome and broncho-oesophageal fistula were observed in 0.4% and 0.2%, respectively. Six out of 70 patients who survived longer than 2 years developed chronic pulmonary fibrosis with respiratory insufficiency and one patient presented symptoms of radiation-induced myelopathy. Conclusions: The analysis of our results and data from the literature show that short-time, split-course PTR is a safe and effective method of palliative treatment in patients with advanced NSCLC. [Copyright &y& Elsevier]

Typical medullary breast carcinoma (T-MBC) accounts for less than 1% of all malignant breast neoplasms, and immunohistochemically is characteristic of “triple-negative” breast carcinoma. The purpose of this study was to describe the clinical characteristics and treatment results for patients with T-MBC treated at a single institution, and discuss the controversial aspects of this very rare form of breast cancer. Analyses was performed in 120 patients with T-MBC who were treated between 1970 and 2005. These cases represent 1.1% of all (11 270) patients treated for breast cancer during this period. According to TNM classification, 26 patients (21.6%) were in stage I, 80 patients (66.7%) in stage II and 14 (11.7%) in stage III of clinically advanced breast cancer. Involved axillary lymph nodes occurred in just 10 (8.3%) of the patients, and in all cases metastases were observed in 1-3 lymph nodes. All the patients underwent primary surgery. Radical mastectomies were performed on 98 (81.6%) patients, while the other 22 (18.4%) underwent breast-conserving surgery (BCS). Radiotherapy was performed in 36 patients (22 after BCS and 14 after mastectomy). Patients with nodal involvement (10 patients) received adjuvant chemotherapy, and 8 patients with hormone receptor expression received hormonotherapy with tamoxifen. The 10-year DFS rate was 90%. Out of 120 patients with T-MBC, only 4 (3.3%) died from this cancer. We showed that none of the population, neither clinical nor microscopic, had a statistically significant influence on the 10-year disease-free survival rate. Our results are similar to others presented in literature. [ABSTRACT FROM AUTHOR]

Mucinous breast carcinoma ( MBC) carcinoma represents approximately 1-6% of all malignant breast carcinoma and is divided into pure ( PMBC) and mixed ( MMBC) subtypes. This study presents the comparison of clinical characteristics and treatment results in 70 patients with PMBC and 40 patients with MMBC, treated at a single institution during 25 years. Performed analyses showed that only nodal status was different in both subtypes. Patients with MMBC showed a significantly higher incidence of axillary nodal metastases in comparison to PMBC (25% versus 10%, respectively). Instead, the 10-year disease-free survival rate was significant higher in PMBC than MMBC (85.7% versus 65%, p < 0.02, test log rank). Authors own observations and data from literature proved that MMBC should be considered as subtypes of mucinous breast cancer. [ABSTRACT FROM AUTHOR]

Optimal treatment for patients with only local prostate cancer recurrence after external beam radiation therapy (EBRT) failure remains unclear. Possible curative treatments are radical prostatectomy, cryosurgery, and brachytherapy. Several single institution series proved that high-dose-rate brachytherapy (HDRBT) and pulsed-dose-rate brachytherapy (PDRBT) are reasonable options for this group of patients with acceptable levels of genitourinary and gastrointestinal toxicity. A standard dose prescription and scheme have not been established yet, and the literature presents a wide range of fractionation protocols. Furthermore, hyperthermia has shown the potential to enhance the efficacy of re-irradiation. Consequently, a prospective trial is urgently needed to attain clear structured prospective data regarding the effi- cacy of salvage brachytherapy with adjuvant hyperthermia for locally recurrent prostate cancer. The purpose of this report is to introduce a new prospective phase II trial that would meet this need. The primary aim of this prospective phase II study combining Iridium-192 brachytherapy with interstitial hyperthermia (IHT) is to analyze toxicity of the combined treatment; a secondary aim is to define the efficacy (bNED, DFS, OS) of salvage brachytherapy. The dose prescribed to PTV will be 30 Gy in 3 fractions for HDRBT, and 60 Gy in 2 fractions for PDRBT. During IHT, the prostate will be heated to the range of 40-47°C for 60 minutes prior to brachytherapy dose delivery. The protocol plans for treatment of 77 patients. [ABSTRACT FROM AUTHOR]

Aim of the study is to evaluate the results of postoperative radiotherapy of paragangliomas, prognostic factors and causes of treatment failure. Material and methods: Forty-four patients (39 females and 5 males) aged 20 to 74 years were treated for paraganglioma between 1970 and 2010 at the Centre of Oncology in Kraków. Patient survival probability was estimated with the Kaplan-Meier method. Log-rank tests and Cox proportional hazard model were used in univariate and multivariate analysis, respectively. Results: The most common locations of paragangliomas were the following: the ear, carotid body and internal jugular vein bulb. Forty (91%) out of them were benign and 4 - malignant. All patients underwent surgery followed by adjuvant radiotherapy. The delivered dose ranged from 50 to 72 Gy, the mean dose was 60 Gy. Five-year overall survival was 84%. Five-year relapse-free survival was 84%, either. The multivariate analysis has shown that the dose in an independent prognostic factor for the overall survival. The univariate analysis has shown significantly higher 5-year overall survival in patients who received a dose of 60 Gy or higher - 92% vs. 70% in patients who received a dose lower than 60 Gy. Conclusions: Postoperative radiotherapy with doses higher than 60 Gy in patients with paragangliomas is associated with longer overall survival. [ABSTRACT FROM AUTHOR]