PubMed · 12166190
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Atsushi Sone, Kengo Ohta, Yoshimasa Tsune, Masaaki Morioka, Hiroyoshi Tanaka. 2002. [Brachytherapy].. https://pubmed.ncbi.nlm.nih.gov/12166190/
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We report the long-term outcome of 225 patients who failed gamma-brachytherapy for in-stent restenosis. Total adverse events, target vessel revascularization, and myocardial infarction were higher after repeat percutaneous coronary intervention versus coronary artery bypass grafting. Therefore, coronary artery bypass grafting may be the preferable first-line therapy in these patients until other therapies (i.e., drug-eluting stents) are available. Shorter time from brachytherapy to radiation failure and late thrombosis after brachytherapy were independent predictors of adverse events.
PURPOSE: To outline the process for developing a data management system for patients with prostate cancer. METHODS AND MATERIALS: Between 1997 and 2002, several generations of a working database using a Microsoft Access platform were developed for the tracking of patients with prostate cancer. The database evolved to include both the management of clinical practice and outcomes research. A chronological data system lists events by their date and value. Algorithms for data exporting can access these lists in defined ways to mine for specific parameters. RESULTS: The most recent working model of our database was implemented with over 2000 patients entered and over 250,000 rows of data. It is utilized by the entire staff and is central for processing prostate cancer data within the department. Outcome studies have been performed using the system, and data export algorithm development remains ongoing. CONCLUSIONS: This work demonstrates that functional database systems are possible for large clinics treating patients with prostate cancer. The ability to maintain up-to-the-minute data variables is vital not only for unbiased outcomes analysis, but for patient flow and care. Future systems will migrate to web platforms.
PURPOSE: To report our experience in treating medium-size ocular melanomas with custom-made "Nag" eye plaques. METHODS: Seventy-eight patients with medium-size ocular melanomas were treated with plaques of 0.6-mm-thick, 18k gold with a radius of curvature of 12 mm to conform to the curvature of the eyeball. These plaques were custom-made in various sizes and shapes to encompass the base of the tumor and a 1-mm margin on all sides. Apertures in three wings of these plaques allowed sutures to be easily placed to hold the plaques onto the sclera. A dose of 100 Gy (before TG-43) or 85 Gy (after TG-43) was delivered with (125)I in 4 days. The dose was prescribed to the periphery of tumor at the level of tumor apex to ensure that the entire tumor volume received at least this dose. RESULTS: The median follow-up was 49 months (range 8-112 months). The progression-free survival (Kaplan-Meier method), overall survival, and disease-specific survival at 5 years were 93%, 86%, and 97%, respectively. Fifty of 78 (64%) patients retained useful visual acuity (20/200 or better). Thirty-one of 78 (40%) patients developed retinopathy or papillopathy. In the subgroup of 22 patients with tumor distance < or =2 mm from optic disc or macula, 12 patients (54%) developed retinopathy or papillopathy. Only 7 of these patients (32%) had useful vision (20/200 or better). Short distance to optic disc or macula was associated with significantly poor visual acuity and moderate to severe retinopathy or papillopathy (ANOVA, p = 0.004 and p = 0.002, respectively). CONCLUSION: Our experience suggests that custom-made Nag plaque brachytherapy can control medium-size choroidal melanoma and that a 1-mm, rather than the standard 2-mm, minimum margin is sufficient when this plaque and prescription methods are used. Patients with tumors close (< or =2 mm) to optic disc or macula have a significantly poorer visual outcome.