Biomedical subjects

Peiman Haddad

Publications and source records attributed to Peiman Haddad.

5 recordsLinked to original sources

PubMed2006

Computerized tomographic simulation compared with clinical mark-up in palliative radiotherapy: a prospective study.

PURPOSE: To evaluate the impact of computed tomographic (CT) planning in comparison to clinical mark-up (CM) for palliative radiation of chest wall metastases. METHODS AND MATERIALS: In patients treated with CM for chest wall bone metastases (without conventional simulation/fluoroscopy), two consecutive planning CT scans were acquired with and without an external marker to delineate the CM treatment field. The two sets of scans were fused for evaluation of clinical tumor volume (CTV) coverage by the CM technique. Under-coverage was defined as the proportion of CTV not covered by the CM 80% isodose. RESULTS: Twenty-one treatments (ribs 17, sternum 2, and scapula 2) formed the basis of our study. Due to technical reasons, comparable data between CM and CT plans were available for 19 treatments only. CM resulted in a mean CTV under-coverage of 36%. Eleven sites (58%) had an under-coverage of >20%. Mean volume of normal tissues receiving >/=80% of the dose was 5.4% in CM and 9.3% in CT plans (p = 0.017). Based on dose-volume histogram comparisons, CT planning resulted in a change of treatment technique from direct apposition to a tangential pair in 7 of 19 cases. CONCLUSIONS: CT planning demonstrated a 36% under-coverage of CTV with CM of ribs and chest wall metastases.

Bone Neoplasms↗

PubMed2005

Pentoxifylline and vitamin E combination for superficial radiation-induced fibrosis: a phase II clinical trial.

We treated 34 radiation-induced superficial fibrotic lesions with pentoxifylline and vitamin E for 3 months. Mean surface area of the lesions decreased from 112 to 65 cm(2) after treatment (P<0.001). A subgroup of 21 fibrotic lesions received the medications for 6 months, in which surface area decreased from 80 to 27 cm(2) (P<0.001). Pentoxifylline-vitamin E combination improved radiation-induced fibrosis.

Administration, Oral↗

PubMed2005

Assessing perfusion changes during whole brain irradiation for patients with cerebral metastases.

PURPOSE: To assess perfusion changes within brain and correlate these with clinical symptoms during whole brain radiotherapy (WBRT) for cerebral metastases. MATERIALS AND METHODS: Fourteen patients with cerebral metastases underwent dynamic CT perfusion scans during palliative whole brain irradiation. Perfusion scans were performed on Day 1 prior to initial radiotherapy treatment, then on Day 2, and on Day 5 immediately after completion of radiotherapy. Measurements of cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT) and capillary surface area permeability product (PS) were performed for each perfusion scan, and daily symptom assessment was taken prior to initial perfusion scan and thereafter prior to each daily radiation treatment. RESULTS: Utilizing Day 1 as baseline, a 19% increase (P = 0.033) was noted in PS at Day 2, (median 1.47 ml/100 g/min), which returned to Day 1 range at Day 5 (median 1.31 ml/100 g/min). When symptoms were correlated with perfusion parameters, a statistically significant association between change in MTT with change in headache scores was observed, baseline to Day 2 (P = 0.019), and a trend between change in nausea scores with change in CBV (P = 0.059) as well as change in MTT (P = 0.098), baseline to Day 5. CONCLUSION: This study has demonstrated the feasibility of a non-invasive technique to assess changes occurring within the human brain during a course of radiation treatment. Dynamic perfusion tomography provides insight into the pathophysiological processes taking place and allows correlation with patient symptomatology.

Adult↗

PubMed2003

The success of data collection in the palliative setting--telephone or clinic follow-up?

Assessment of outcomes is essential in order to improve available palliative treatments. Collecting follow-up information can be a challenging task in the palliative setting. We compared the effectiveness of data collection by telephone contact and clinic visit in 112 patients with brain metastases treated with whole-brain radiotherapy. The first 56 patients (group A) were followed by telephone only. The second 56 patients (group B) were asked to attend an outpatient clinic appointment 4 weeks after radiotherapy. Successful contact was defined as obtaining data at week 4. Patients in the two groups did not differ significantly with regard to age, sex, performance status, primary site, number of brain metastases, or the treatment given. The proportions of patients with successful follow-up contact at week 4 were 45% and 61% in groups A and B, respectively ( P = 0.09). The quality of the collected data did not differ significantly between the two groups. The side effects and responses to therapy were similar. However, there were significantly more patients with a reduced dose of dexamethasone among the successful contacts in group B, which probably reflected the better condition of the patients coming back to clinic at week 4. In conclusion, there was a trend towards more successful data collection in our clinic follow-up. Some of the observed outcome data suggest that the two methods of follow-up might be reaching different populations of patients; considering this and the high attrition rate, a combined follow-up strategy of clinic and telephone contacts might be the best strategy.

Ambulatory Care↗

PubMed2002

A randomized, double-blind, placebo-controlled trial of concomitant pilocarpine with head and neck irradiation for prevention of radiation-induced xerostomia.

BACKGROUND: Xerostomia is one of the disturbing side-effects of radiotherapy to the head and neck region. Pilocarpine has been approved for the treatment of this condition in the chronic phase, but its use concurrent with radiation could also be beneficial for prevention or reduction of the subsequent radiation-induced xerostomia. We undertook to test this hypothesis in a clinical trial. METHODS: At the start of radiotherapy, randomization was performed to either pilocarpine 5 mg three times daily or placebo in a double-blind setting. The drug was started with irradiation and continued until 3 months after the end of radiotherapy. Xerostomia was evaluated 6 months after the end of radiation by a subjective visual analog scale questionnaire. Also the objective grade of xerostomia was recorded by two separate observers. RESULTS: A total number of 60 patients were randomized into the trial, but unfortunately only 39 patients were finally evaluated for xerostomia, 18 in the pilocarpine and 21 in the placebo group. Mean age was 42 years, and mean parotid dose was 58 Gy. Mean subjective xerostomia was 40.3 mm in the pilocarpine group and 57 mm in the placebo group (P = 0.02). Also mean objective xerostomia grade was 2.2 in the pilocarpine group and 2.6 in the placebo group (P = 0.01). Subjective and objective xerostomia results were positively correlated (P = 0.01). Age and the parotid dose did not have a significant effect on xerostomia. CONCLUSIONS: Compared to placebo, pilocarpine used with radiotherapy could lead to a significant diminishment of subsequent radiation-induced xerostomia.

Administration, Oral↗