Browsing by Author "Stanic, Dragana (56941616400)"

Purpose: To analyze the dose distribution achieved during 2D radiography-based brachytherapy (BRT) planning, by using a 3D MRI-based BRT replanning evaluation, in patients with advanced cervical carcinoma, treated with definitive concomitant chemoradiation (CCRT). Methods: The curative CCRT was applied to 30 patients with advanced cervical carcinoma. For each patient, 2D radiography-based planning and a 3D MRI-based BRT replanning were performed. Applying the same source positions and dwell times in both planning methods, it was possible to use the MRI replanning to evaluate the dose distribution, maximum organs at risk (OAR) doses and target volume coverage, that was obtained during 2D BRT planning. Results: A statistically significant difference for bladder and rectum maximum doses, between 2D planning (Bmax, Rmax) and 3D replanning (D0.1ccm, D1ccm, D2ccm) was found, except between Bmax and bladder D2ccm dose (p=0.07), and Rmax and rectal D2ccm dose in the group of patients with symmetrical rectum position regarding the applicator system (p=0.47). MRI evaluation of the HR-CTV volume, according to the 2D planning achieved dose distribution, revealed total EQD2 HR-CTV doses: D90 (107.15±22.06 Gy) and D100 (80.66±14.58 Gy). Conclusion: 2D radiography-based BRT planning can provide a good estimation for the bladder and rectum 3D D2ccm dose with a significant statistical difference for the doses in the smaller OAR volumes (D0.1ccm, D1ccm). Inability to visualize tumor tissue during 2D BRT planning provides no option in tailoring the dose distribution to the tumor volume and patient anatomy, leading to potential under/over-treatment in some patients. © This work by JBUON is licensed under a Creative Commons Attribution 4.0 International License.

Purpose: To analyze the dose distribution achieved during 2D radiography-based brachytherapy (BRT) planning, by using a 3D MRI-based BRT replanning evaluation, in patients with advanced cervical carcinoma, treated with definitive concomitant chemoradiation (CCRT). Methods: The curative CCRT was applied to 30 patients with advanced cervical carcinoma. For each patient, 2D radiography-based planning and a 3D MRI-based BRT replanning were performed. Applying the same source positions and dwell times in both planning methods, it was possible to use the MRI replanning to evaluate the dose distribution, maximum organs at risk (OAR) doses and target volume coverage, that was obtained during 2D BRT planning. Results: A statistically significant difference for bladder and rectum maximum doses, between 2D planning (Bmax, Rmax) and 3D replanning (D0.1ccm, D1ccm, D2ccm) was found, except between Bmax and bladder D2ccm dose (p=0.07), and Rmax and rectal D2ccm dose in the group of patients with symmetrical rectum position regarding the applicator system (p=0.47). MRI evaluation of the HR-CTV volume, according to the 2D planning achieved dose distribution, revealed total EQD2 HR-CTV doses: D90 (107.15±22.06 Gy) and D100 (80.66±14.58 Gy). Conclusion: 2D radiography-based BRT planning can provide a good estimation for the bladder and rectum 3D D2ccm dose with a significant statistical difference for the doses in the smaller OAR volumes (D0.1ccm, D1ccm). Inability to visualize tumor tissue during 2D BRT planning provides no option in tailoring the dose distribution to the tumor volume and patient anatomy, leading to potential under/over-treatment in some patients. © This work by JBUON is licensed under a Creative Commons Attribution 4.0 International License.

Purpose: The aim of the study was to assess health-related quality of life (HRQoL) and contributing factors among parents of children with solid tumors in Serbia. Methods: The cross-sectional study included 51 parents of children treated for different solid tumors at the Institute of Oncology and Radiology of Serbia. Parents filled out validated Serbian version of SF-36 questionnaire. Hierarchical multiple regression analysis was conducted to identify predictors of total score of SF-36. Results: Almost all parents (94.1%) were mothers and average age was 38.6 ± 6.7 years. Majority of children had brain tumors (43.1%), followed by bone tumors (37.3%). The hierarchical regression analysis showed that socio-demographic characteristics explained 26% of the variance (p > 0.05) of the total score of SF-36. Addition of quality of life of children assessed by parents in the second model caused an increase of 21% in the variance explained (p < 0.05). After adding the Beck Depression Inventory score in the third block, an additional 18% of the variance in total score was explained (p < 0.05). Conclusions: This study showed that HRQoL measured by SF-36 in parents of children with cancer is strongly influenced by depression and quality of life of children assessed by parents. © 2020, Springer-Verlag GmbH Germany, part of Springer Nature.

Purpose: The aim of this study was to present the management and treatment of children with medulloblastoma in Serbia, a middle-income country (MIC). Methods: The data of 87 children diagnosed with medulloblastoma and treated at the Institute for Oncology and Radiology of Serbia from 2000 to 2013 were analyzed. Results: The children’s median age was 8.3 years (range 2.5-17.3). Eighty-two (94.2%) were 3 years or older. Sixty-two (71.3%) patients had stage M0 medulloblastoma, 12 (13.8%) had stage M1 and 13 (14.9%) had stage M2 or M3. As of October 2015, 51 (58.6%) patients were alive and 31 (35.6%) had died. Five patients (5.7%) were lost to followup. Twenty-six patients relapsed. The median follow-up time was 58 months (range 4–187). Mean overall survival (OS) was 76.4% at 3 years, 66.2% at 5 years and 59.2% at 10 years. Mean disease-free survival (DFS) was 75.8% at 3 years, 62.8% at 5 years and 56.6% at 10 years. Mean OS of stage M0 patients was 86.4% at 3 years, 74% at 5 years and 63.1% at 10 years. The OS of stage M1, M2 and M3 patients combined was 48.9% at 3 years, 44.0% at 5 years and 37.7% at 10 years. Conclusion: In Serbia, a MIC, it is possible to achieve good treatment results in children with medulloblastoma using international treatment guidelines and recommendations, available resources and an experienced team of professionals dedicated to pediatric neurooncology. © 2018 Zerbinis Publications. All Rights Reserved.

Purpose: The aim of this study was to present the management and treatment of children with medulloblastoma in Serbia, a middle-income country (MIC). Methods: The data of 87 children diagnosed with medulloblastoma and treated at the Institute for Oncology and Radiology of Serbia from 2000 to 2013 were analyzed. Results: The children’s median age was 8.3 years (range 2.5-17.3). Eighty-two (94.2%) were 3 years or older. Sixty-two (71.3%) patients had stage M0 medulloblastoma, 12 (13.8%) had stage M1 and 13 (14.9%) had stage M2 or M3. As of October 2015, 51 (58.6%) patients were alive and 31 (35.6%) had died. Five patients (5.7%) were lost to followup. Twenty-six patients relapsed. The median follow-up time was 58 months (range 4–187). Mean overall survival (OS) was 76.4% at 3 years, 66.2% at 5 years and 59.2% at 10 years. Mean disease-free survival (DFS) was 75.8% at 3 years, 62.8% at 5 years and 56.6% at 10 years. Mean OS of stage M0 patients was 86.4% at 3 years, 74% at 5 years and 63.1% at 10 years. The OS of stage M1, M2 and M3 patients combined was 48.9% at 3 years, 44.0% at 5 years and 37.7% at 10 years. Conclusion: In Serbia, a MIC, it is possible to achieve good treatment results in children with medulloblastoma using international treatment guidelines and recommendations, available resources and an experienced team of professionals dedicated to pediatric neurooncology. © 2018 Zerbinis Publications. All Rights Reserved.

Objectives: Nasopharyngeal carcinoma is a rare malignancy in children. The aim of this study was to provide analysis of children with nasopharyngeal carcinoma treated in a single institution. Methods and materials: Between 1999 and 2016, fourteen pediatric patients with a diagnosis of undifferentiated nasopharyngeal carcinoma were treated in our institution, and the patients’ clinical characteristics, treatment modality, outcome, and toxicity were analyzed. Results: The median age at diagnosis was 15,5 years. The gender ratio was 1:1. The majority of patients had regionally and/or locally advanced tumors and one had bone metastases at the time of diagnosis. All patients received chemotherapy before radiotherapy, with partial response in thirteen patients and complete response in one. Radiation dose to the primary tumor and involved cervical lymph nodes was 55–60 Gy, uninvolved cervical and supraclavicular regions received prophylactic radiation with dose of 45–50 Gy. Ten patients received adjuvant chemotherapy. Three-year progression-free rate and three-year overall survival (OS) rates were 75% and 73% respectively. Five-year progression-free rate was 65% and OS 63% respectively, and after ten years progression-free rate and OS remained the same. At the end of follow-up period, ten patients were alive, and four died. All of the patients that had distant metastases died. Most common late complications were skin fibrosis and xerostomia. Conclusions: Multimodal therapy of children with nasopharyngeal carcinoma is associated with long-term survival. It is expected that further advances in the management of these patients, with improved radiotherapy and chemotherapy, will reduce acute and late toxicity and improve quality of life of treated children. © 2018