Radiation therapy, risk factor

Patients with at least one adverse risk factor should receive six to eight cycles of R-CHOP followed by locoregional radiation therapy. 

In untreated women, the main risk factors for endometrial carcinoma are age, obesity, nulliparity, late menopause (and possibly early menarche), the Stein-Leventhal syndrome, exposure to exogenous estrogens, radiation, and certain systemic diseases, including diabetes mellitus, hypertension, hypothyroidism, and arthritis (SED-14, 1451) (88). Certain of these risk factors indicate that an altered endocrine state with increased estrogen stimulation is a predisposing cause, and one might thus in theory expect estrogen treatment (and notably hormonal replacement therapy) to increase the risk (SEDA-22, 466). 

The strongest risk factors for breast cancer are female gender and increasing age. Additional risk factors include endocrine factors (e.g., early menarche, nulliparity, late age at first birth, hormone replacement therapy), genetic factors (e.g., personal and family history, mutations of tumor suppresser genes [BRCAl and BRCA2]), and environmental and lifestyle factors (e.g., radiation exposure). 

Nausea and vomiting associated with radiation therapy is not well understood. It is neither as predictable nor as severe as CINV, and many patients receiving radiation therapy will not experience nausea or vomiting. Risk factors associated with the development of RINV include the site of radiation, the dose, dose rate, and field size. Patients receiving single-exposure, high-dose radiation therapy... 

Candidates for teriparatide treatment include women who have a history of osteoporotic fracture, who have multiple risk factors for fracture, or who failed or are intolerant of previous osteoporosis therapy. Teriparatide should not be used in patients who are at increased baseline risk for osteosarcoma (including those with Paget s disease of bone, unexplained elevations of alkaline phosphatase, open epiphyses, or prior radiation therapy involving the skeleton). Full-length PTH(l-84), which is in clinical trials, has not been associated with osteosarcomas. Other adverse effects have included exacerbation of nephrolithiasis and elevation of serum uric acid levels. 

Technological advances such as robots and simulators enhance precision in surgical practice and are increasingly employed by otorhinolaryngology specialists. Advances in surgical techniques, radiation therapy, and chemotherapy have improved the survival and quality of life for patients with head and neck cancer. The outcomes of these treatments have allowed physicians to focus less on tumor removal and more on functional preservation and restoration. Preventative efforts, coupled with the study of tobacco use and occupational exposure as risk factors for carcinogenesis, have also become a priority. 

ScHEELE et al. 1995). Therefore, surgical resection is still considered to be the gold standard in Hver metasta-ses, while chemotherapy and radiation therapy are seen as palliative treatment options. However, due to risk factors only 10 to 25% of aU patients suffering from Uver metastases are suitable candidates for Uver surgery. This has a major impact on the demand for minimally invasive treatments achieving an effective and reproducible percutaneous tumor ablation while simultaneously lowering both morbidity and costs. 

Hiraki T, Tajiri N, Mimura H, Yasui K, Gobara H, Mukai T et al (2006b) Pneumothorax, pleural effusion, and chest tube placement after radiofrequency ablation of lung tumors incidence and risk factors. Radiology 241(l) 275-283 Holt RW, Nauta RJ, Lee TC, Heres EK, Dritschilo A, Harter KW et al (1988) Intraoperative interstitial radiation therapy for hepatic metastases from colorectal carcinomas. Am Surg 54(4) 231-233... 

To diminish these risk factors and to facilitate the surgical resection, preoperative intra-arterial embolization, radiation therapy and exogenous estrogens has been largely used. 

Importantly, the toxicity of bleomycin is cumulative. Total doses in excess of 450 units are associated with a significantly increased incidence of adverse lung reactions and death. The incidence of bleomycin-induced lung toxicity has been reported between 0% and 46% with a mortality rate of 3% (5,7). As mentioned above, high cumulative dose, extreme of age, uremia, the use of supplemental oxygen, and radiation therapy are well-documented risk factors for bleomycin toxicity. Other chemotherapeutic agents (cyclophosphamide and vincristine) may also have a synergistic effect with bleomycin. Finally, bleomycin may occasionally reactivate a prior radiation-induced pneumonitis, a phenomenon known as radiation-recall. ... 

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