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Radiation Therapy as an Effective Tool to fight cancer in Women PowerPoint Presentation

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Description : Check out this medical presentation on Cervical Cancer, which is titled "Radiation Therapy as an Effective Tool to fight cancer in Women", to know about radiation therapy as an effective tool to fight cancer in Women.

Tags : Cervical Cancer, Radiation Therapy, cancer in Women, human papillomavirus, HPV

Published on : May 13, 2021 | Views : 2142 | Downloads : 0

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Slide 1-

Radiation Therapy as an Effective Tool to fight cancer in Women: Future Trends R. Sankaranarayanan MD Screening Group International Agency for Research on Cancer, World Health Organization Lyon, France
Slide 2-

CANCER TREATMENT IN DEVELOPING COUNTRIES Vast range in health service infrastructure Wide range in health care resources Problems in Availability Accessibility Affordability
Slide 3-

CANCER IN WOMEN: BASIC TREATMENT MODALITIES
Slide 4-

WORLD-WIDE BURDEN OF WOMEN CANCER: AROUND 2002 AD 1 849 000 new cases 809 000 deaths 6 354 000 prevalent cases
Slide 5-

WORLD-WIDE BURDEN OF WOMEN CANCER: AROUND 2015 and 2030 AD 2015 2030 Cases 2 446 000 3 169 000 Deaths 1 081 000 1 442 000 GLOBOCAN 2002
Slide 6-

WORLD-WIDE BURDEN OF CERVICAL CANCER: AROUND 2002 AD 493,000 new cases annually 274,000 deaths annually 1.4 million prevalent cases More than 80% in developing countries
Slide 7-

WORLD-WIDE BURDEN OF CERVICAL CANCER: AROUND 2015 and 2030 AD 2015 2030 Cases 645 000 810 000 Deaths 365 000 475 500 GLOBOCAN 2002
Slide 8-

5-Year Age Standardised Relative Survival (0-74 yrs) Cervix Cancer (ICD-10:C53) Highest in Seoul, South Korea Least in Kampala, Uganda Intra country variation Pronounced in China (urban  vs rural ) & India No difference in South Korea & Thailand Data from developed countries US-SEER: 70% Eurocare: 62%
Slide 9-

CERVICAL CANCER CONTROL Prevention – HPV Vaccines Early detection by screening Clinical early detection Treatment
Slide 10-

1920 1940 1960 1980 0 10 20 30 40 50 Stage I Stage II Stage III Stage IV Percent Year 60 Data on stage distribution at time of diagnosis at the Radiumhemmet (Heyman, 1937-1952; Heyman, 1953-1955; Kottmeier, 1958-1961; Kottmeier, 1964-1967; Kottmeier, 1973-1976; Kottmeier, 1979-1982; Pettersson, 1988-1991). Ponten et al., Int J Cancer, 1995; 60: 1-26
Slide 11-

Crude stage-specific 5-year survival compiled from the material followed at the Radiumhemmet (Heyman, 1937-1952; Heyman, 1953-1955; Kottmeier, 1958-1961; Kottmeier, 1964-1967; Kottmeier, 1973-1976; Kottmeier, 1979-1982; Pettersson, 1988-1991) 1920 1940 1960 1980 0 20 40 60 80 100 Stage I Stage II Stage III Stage IV Percent Year Ponten et al., Int J Cancer. 1995; 60: 1-26
Slide 12-

CANCER OF THE UTERINE CERVIX: RADIOTHERAPY Radical radiotherapy: Delivered with a curative intention; for stages I-IIIB; selected cases of IVA Concurrent Chemoradiotherapy is an option for stage II and III disease Dose delivery reference points: Points A & B Post OP RT in high risk early stage disease after surgery Palliative radiotherapy
Slide 13-

CANCER OF THE UTERINE CERVIX: RADICAL RADIOTHERAPY A combination of external-beam pelvic irradiation covering the uterus, parametria and the lymphnodes and intracavitary irradiation for the central disease is used The aim is to deliver a total dose of around 80 Gy to point A
Slide 14-

CANCER OF THE UTERINE CERVIX: EXTERNAL RADIOTHERAPY Parallel pair of portals Four-field beam arrangement Special midline shields (after 20 Gy in stages I & II; after 40 Gy in stage III) 40-50 Gy in 20-25 F over 4-5 weeks
Slide 15-

CANCER OF THE UTERINE CERVIX: INTRACAVITARY RADIOTHERAPY LDR: 1 (for stage III) or 2 (for stages I & II if midline shield is used) applications of 30 Gy to point A HDR: 5 weekly applications of 7 Gy to point A (for stages I and II if midline shield is used) or 3 applications of 7 Gy to point A (for stage III) 1 – Tandem 2 – Rectal marker 3 – Marker seeds 4 – Flange 5 – Right ovoid 6 – Urinary catheter balloon 1 – Rectal marker 2 – Tandem 3 – Ovoids
Slide 16-

CANCER OF THE UTERINE CERVIX: PALLIATIVE RADIOTHERAPY In most cases of IVA and IVB 30 Gy in 10 F over 2 weeks
Slide 17-

BREAST CANCER IN THE WORLD 1.15 million new cases Incidence increasing in most countries 470 000 deaths Half of the global burden in low- and medium-resourced countries
Slide 18-

WORLD-WIDE BURDEN OF BREAST CANCER: AROUND 2015 and 2030 AD 2015 2030 Cases 1 531 000 2 004 000 Deaths 549 000 737 500 GLOBOCAN 2002
Slide 19-

ROLE OF RADIOTHERAPY IN BREAST CANCER Breast conservation Adjuvant radiotherapy Palliative radiotherapy
Slide 20-

Breast cancer incidence rates (age 35-74) in selected developed countries
Slide 21-

Breast cancer incidence rates (age 35-74) in selected developing countries
Slide 22-

Breast cancer mortality rates (age 35-74) in selected developed countries
Slide 23-

Breast cancer mortality rates (age 35-74) in selected Asian countries
Slide 24-

BREAST CONSERVING SURGERY Breast cancer screening programs Increase mass awareness Patients with earlier stages presenting to clinic Better psycho-social Adjustment BREAST CONSERVING THERAPY (BCT) Better Quality of life
Slide 25-

MRM Vs BCT Randomized trials Meta-analysis Comparable local control, Overall survival Better cosmetic outcome
Slide 26-

BCT: EFFECT OF RADIOTHERAPY ON LOCAL RECURRENCE EBCTCG meta-analysis. Lancet 2005; 366: 2087–2106 5 year gain 16.1% 5 year gain 30.1% Node Negative Women Node Positive Women
Slide 27-

BCT: BREAST CANCER AND OVERALL MORTALITY EBCTCG meta-analysis. Lancet 2005; 366: 2087–2106 15 year gain 5.4% 15 year gain 5.3% Breast Cancer Mortality Overall Mortality
Slide 28-

ADJUVANT RADIOTHERAPY Indications of Radiation therapy Patients with 4 or more positive lymph nodes Presence of extracapsular extension, positive or close margins T3 tumors with positive lymph nodes, medial quadrant tumors Any T4 tumors and pectoral fascia involvement
Slide 29-

MASTECTOMY: EFFECT OF RADIOTHERAPY ON LOCAL RECURRENCE Node negative disease (1428 women ) Node positive disease (8505 women ) EBCTCG meta-analysis. Lancet 2005; 366: 2087–2106
Slide 30-

MASTECTOMY: EFFECT OF RADIOTHERAPY ON BREAST CANCER MORTALITY Node negative disease (1428 women) Node positive disease (8505 women) EBCTCG meta-analysis. Lancet 2005; 366: 2087–2106 15 year loss 3.6% 15 year gain 5.4%
Slide 31-

EBCTCG meta-analysis. Lancet 2005; 366: 2087–2106 MASTECTOMY: BREAST CANCER AND OVERALL MORTALITY NODE POSITIVE WOMEN 15 year gain 5.4% 15 year gain 4.4% Breast Cancer Mortality Overall Mortality
Slide 32-

Dose: 45Gy/25#/5 wks with 6/10MV LA or telecobalt
Slide 33-

RECENT ADVANCES IN RADIOTHERAPY CT simulators and Portal imaging 3DCRT IMRT IGRT Portable LA for IORT Only 20% of population has access to RT in Africa; 40 % in Asia and 50 % in Latin America
Slide 34-

EARLY DETECTION APPROACHES Screening: mass application of screening test in asymptomatic populations at regular intervals Early clinical diagnosis: detection of early clinical stages of disease in symptomatic or high-risk subjects
Slide 35-

HOW TO DEVELOP CANCER TREATMENT SERVICES IN DEVELOPING COUNTRIES National policy - NCCP Resource allocation/ Phased development Human resource development Investments in diagnosis/ treatment Comprehensive basic services Team approach National guidelines of Rx