Radiation Oncology

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Browsing Radiation Oncology by browse.metadata.advisor "Akudugu, John M."

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    A retrospective analysis of toxicity and outcomes following chemotherapy for the older population at a single institution
    (Stellenbosch : Stellenbosch University, 2018-03) Pupwe, George; Fourie, Anna Elizabeth; Akudugu, John M.; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Medical Imaging and Clinical Oncology. Radiation Oncology.
    ENGLISH SUMMARY: Introduction: Surgical treatment of colorectal cancer (CRC) in elderly patients has improved, but data on adjuvant and palliative chemotherapy tolerability and benefits in this growing population remains scarce. The elderly population is mostly underrepresented in clinical trials and results for this group of patients are seldom reported separately. Patients and method: Using a retrospective study, we analyzed demographics, compared toxicities in the age groups < 70 years and ≥ 70 years in colorectal cancer patients at Tygerberg Hospital (South Africa). We assessed tumor related mortality, progression free survival (PFS) and overall survival (OS) including predictive factors of OS. Results: A total of 50 patients received either adjuvant or palliative chemotherapy. Different chemotherapy regimens were used. There was no difference in overall or severe (Common Toxicity Criteria Grades 3-4) toxicity in both age groups. Out of the 50 patients, 8 (16%) had Grade 3-4 toxicity. Of these 4 (15%) were < 70years, 4 (17%) were ≥ 70 years. The progression free survival (PFS) and overall survival (OS) were measured using Kaplan-Meier curves. The mean follow-up time was 47.5 months (range: 14.4-80.8 months, 95% CI 41.5-53.5 months). The 5-year overall survival rate for Stage II&III patients <70 years and ≥70 years were 80.9% and69.5%, respectively, and not significantly different; P=0.5156; HR=0.65 (95% CI: 0.17-2.41). Also, no statistically significant difference emerged between the 5-year progression free survival rates of 70.7% and 58.8%; P=0.4920; HR=0.68 (95% CI: 0.23-2.04). For Stage IV patients, there were no significant differences in survival in both groups. There were no survivors beyond 40 months. Median survival rates were similar at 16.3 months (for < 70 years) and 15.9 months (for ≥ 70 years); P=0.8105; HR=1.14(95% CI: 0.35-3.81). There were also no progression free survivors beyond 23 months. Median PF survival rates were 11.1 months (for < 70 years) and 13.5 months (for ≥ 70 years), and were not significantly different; P=0.1743; HR=1.99 (95% CI: 0.66-9.67). Weight loss and performance status (PS) were evaluated as potential predictive factors of OS. For Stage II&III patients of <70 and ≥70 years of age, 68 and 84% of patients presented with a weight loss of <5%, respectively. The corresponding proportions of Stage IV patients were 75 and 100%. Also, 84 and 100% of Stage II&III patients <70 and ≥70 years, respectively, had a PS of 1. All Stage IV patients had a PS of 1. Conclusion: “Fit” elderly patients benefit, at least to the same extent, from adjuvant and palliative chemotherapy as younger patients in this cohort. Therefore, standardized adjuvant and palliative chemotherapy could be offered to elderly patients and they should not be excluded from clinical trials.
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    Treatment of advanced salivary gland tumours with neutron radiotherapy
    (Stellenbosch : Stellenbosch University, 2016-12) Lombe, Dorothy Chilambe; Simonds, Hannah; Akudugu, John M.; Stellenbosch University. Faculty of Medicine and Health Science. Dept. of Medical Imaging and Clinical Oncology. Radiation Oncology.
    ENGLISH SUMMARY : Background: Success rates in the treatment of salivary gland malignancies are associated with completeness of surgical resection with or without postoperative radiotherapy. For patients with unresectable tumours, radiotherapy is an option to attempt to gain local control and improve survival. Different modalities of radiotherapy are available and fast neutrons represent a form of radiotherapy effective in controlling locally advanced salivary gland malignancies. We report on 22 patients treated for locally advanced parotid gland malignancies at iThemba Laboratory for Accelerator Based Sciences via a tertiary institution in Cape Town, South Africa. Methods: Records of patients with unresectable parotid gland malignancies treated with neutron radiotherapy at a tertiary institution between January 1991 and December 2012 were reviewed retrospectively. Twenty-two patients were eligible for statistical analysis. Results: Complete, partial and no response rates were 64%, 14% and 22%, respectively. Of the 14 patients with a complete response, 3 recurred with the earliest recurrence being at 18 months. Locoregional control was 80% and 69% at 2 and 5 years respectively. Twelve out of the 22 patients died post treatment. Overall survival at 2 years was 40% and at 5 years 35%. Seven cases of CTCAE grade 3 and above late toxicities were observed. These included bone necrosis, eardrum perforation and skin ulceration. Conclusions: Treatment modality of this group of patients depends on availability. Response rates of parotid gland malignancy to neutron radiotherapy in this small cohort are comparable to historical controls.