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ANALYTICAL ANALYSIS OF THE CONDITION OF PATIENTS WITH
BRAIN TUMORS AFTER RADIATION THERAPY
Shagazatova Barno Khabibullayevna
doctor of medical sciences, professor, Tashkent Medical University
Artikova Dilfuza Maxamatovna
Doctor of Philosophy (PhD) of medical sciences,
associate professor Tashkent Medical University
+998901746491 Artikova73@mail.ru
Alimov Jamshid Maxmudjonovich
Republican specialized scientific-practical
medical center of oncology and radiology
https://doi.org/10.5281/zenodo.16910830
Relevance.
The number of oncological diseases is growing from year to
year. This is due to the widespread use of computer-based visualized research
methods in the modern world. Brain tumors occupy a special place among
oncopathology. The treatment of brain tumors is an urgent problem of modern
neuro-oncology, since the survival rate of patients remained low until recently,
and the disease itself led to an increase in cases of disability and a decrease in
quality of life. Along with surgical and drug treatment methods, radiation
therapy is currently widely used, which allows for long-term remission, even
complete recovery, in some diseases.
Modern innovative methods of radiation
therapy in combination with other types of therapy undeniably increase the
survival of patients, especially with primary brain tumors.
The main goal of
radiation therapy is to increase the effectiveness of targeted impact on the
tumor with minimal radiation exposure to healthy organs and tissues.
Radiation
therapy for brain tumors can be performed using whole brain radiation therapy
(WBRT), classical conformal radiation therapy, stereotactic radiation surgery
(SRS), stereotactic radiation therapy (SRT).
The effectiveness of radiation therapy against tumor cells is achieved by
high doses of ionizing radiation, which in turn increases the risk of developing
radiation necrosis (RN) of brain tissue in the irradiated area.
The risk of ROP
also increases with the volume of brain parenchyma and the radiation dose.
Keywords:
brain, radiation therapy, single focal dose, total focal dose, IMRI,
3D-CRT, VMAT, SRS, DGT
Objective
: to conduct an analytical structured analysis of the data of
patients who received radiation for primary brain tumors.
Materials and methods:
333 patients underwent a retrospective and
prospective analysis of their medical records from 2018 to 2024 with an
assessment of the results of radiation therapy. All patients were treated with
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Elekta infinity linear accelerator and Terabalt 100 cobalt system using various
radiation techniques such as 3D conformal radiation therapy (3D-CRT), intensity
modulated radiation therapy (IMRT), volumetric dose modification with
rotational therapy (VMAT), stereotactic radiosurgery (SRS), external gamma
therapy (EGT).
Radiation therapy was planned by a radiation oncologist and a
medical physicist. Patients received a single focal dose (SFD) of 2.09±0.05 Gy
(1.8-14 Gy) on average once a day for 5 days and a total focal dose (TFD) of
52.56±0.57 Gy (18-69.9).
Pre-radiation preparation was carried out using CT
simulators (Siemens - Somatom difinished AC) with mandatory immobilization
of the patient using an individually designed thermoplastic mask (Orfit).
The
volume of irradiation and the choice of the type of irradiation were determined
individually after a thorough collection of the anamnesis, tumor localization, the
volume of the operation performed, and MRI and CT data.
Results
: Out of 333 patients who received radiation therapy, 178 patients
(53.4%) were alive. The number of deceased patients was 155, which
corresponds to 46.6% of cases. Of these, 93 are men and 62 are women. 53
people (34.1%) died in the first year after radiation therapy.
The results showed
that in men, the majority of deaths were observed in those who received IMRT
(70% of patients). In addition, 14% (13 cases) of deceased patients were treated
with VMAT, 12% (11 people) with 3D, 3% (3 people) with DHT, and 1% (1
patient) with SRS.
Among women, the number of deaths was 49 (79%) after
IMRT, 8 cases (13%) after VMAT, 4 cases (6%) after 3D, and 1 case (2%) after
DHT. The high mortality rates after IMRT can be explained by the highest
number of patients using this method in cancer patients.
In continuation of the
analysis of fatal cases, we studied the most common localization of brain tumors.
In deceased men, in an equal percentage of cases (24% each), the tumor was
localized in the frontal and temporal regions, 5 men (5%) had a cerebellar
tumor. In 18 women (29%), the tumor was in the frontal lobe of the brain, in 7
(11%) - in the temporal region, in 6 (10%) - a cerebellar tumor.
Conclusions
:
More men died (58.4%) after radiation therapy compared to women
(41.6%). The highest number of deaths in both men and women occurred in the
first year after radiation therapy. The most common tumor localization in men is
the frontal and temporal lobes, and in women, the frontal lobe.
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