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Oral care practice in cancer nursingYip, Shuaih-yee, Bethia., 葉率意. January 2006 (has links)
published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice
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Surgery for post-radiotherapy cervical metastasis in nasopharyngeal carcinoma韋霖, Wei, William I. January 1991 (has links)
published_or_final_version / Surgery / Master / Master of Surgery
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The efficacy of a novel lubricating system in the management of radiotherapy related xerostomiaKam, Yuk-lun., 甘玉麟. January 2004 (has links)
published_or_final_version / Dentistry / Master / Master of Dental Surgery
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Patients receiving chemotherapy and radiation therapy and the perception of the quality of lifeNewberry, Rebecca Louise January 1980 (has links)
No description available.
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Radioactive iodine in the management of thyrotoxicosis.Narsai, Neil Yeshwant. January 2011 (has links)
Objective : An audit of the use and outcomes of Radioactive Iodine (RAI) therapy
in the definitive management of thyrotoxicosis at Inkosi Albert Luthuli Central
Hospital (IALCH), KwaZulu-Natal, South Africa.
Methods : The clinical records of all new patients with thyrotoxicosis, referred in a
4 year period between 01/01/2003 and 31/12/2006, were analysed. Response to
RAI was monitored using biochemical parameters (namely, Thyroid Stimulating
Hormone and Free T4 levels). Rates of euthyroidism (cure), hypothyroidism and
hyperthyroidism (treatment failure) were correlated to dose of RAI. Patients were
followed-up for at least 2 years or until the onset of hypothyroidism. The follow-up
period was until 31/12/2007.
Results : One hundred and fourteen patients (37.7%), of a cohort of 302 new
thyrotoxic patients treated with RAI, met the inclusion criteria. Ninety-six patients
(84.2%) had Graves Disease (GD) whilst 18 had Toxic Nodular Disease (TND).
At 2 year follow-up, 91 patients (79.8%) were hypothyroid, 10 (8.8%) were
euthyroid and 13 (11.4%) were hyperthyroid. The average dose of RAI to achieve
euthyroidism was 10mCi and hypothyroidism, 9.7mCi. The average time to achieve
euthyroidism was 5.9 months and 10.1 months to become hypothyroid. Thirty-one
patients (27.2%) remained persistently hyperthyroid after one dose of RAI.
Patients with GD (88.5%) were more likely to become hypothyroid (p < 0.001)
whilst 38.9% of TND patients remained hyperthyroid (p = .001). Baseline TFT values
were significant in terms of outcomes correlated with the prescribed RAI dose i.e
Low Dose (<8mCi) vs. Intermediate Dose (8-9mCi) vs. High Dose (>9mCi)(TSH p =
0.05; FT4 p = 0.003; FT3 p = 0.001).
Conclusion : The majority of patients became hypothyroid over time, in keeping
with reported data. In the public health sector, where early access to RAI (in terms
of waiting times for appointments for RAI) and follow-up are major problems, early
cure is essential to minimize the morbidity of thyrotoxicosis and this may be
achieved with an initial high dose of RAI. / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2011.
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Exploring racial differences in disease stage and risk profile at presentation, and its influence on outcome in men with prostate cancer in KwaZulu-Natal.Govender, Poovandren S. January 2009 (has links)
Introduction Prostate cancer (PCa) is the most commonly diagnosed male malignancy and the second leading cause of male cancer death in the Western world. In the United States of America (USA), African American men (AAM) have among the highest rates of PCa in the world. They develop the disease 1.5 times more frequently than European American men (EAM) of the same age .The mortality rate is approximately two to three times higher for AAM compared to EAM. There is a dearth of literature exploring the incidence and treatment outcomes of this disease based on racial profiling in a South African population. This study aims to evaluate racial disparities with a focus on patients with PCa managed in the public health care sector in the province of Kwazulu Natal (KZN). Patients and methods The study was a retrospective analysis of patients with PCa treated at Inkosi Albert Luthuli Central Hospital and Addington Hospital, which are both based in the Durban Metropolitan area in the province of KZN. Data extracted from the folders of patients with PCa who presented between March 2003 and December 2007 were collated onto a data capture form and analysed. Patient data were analysed according to the following categories: „h Patient demographics; „h Patient follow-up period; „h Disease risk profile; „h Response to treatment; „h Compliance on treatment. SPSS version 15.0 was used to analyse the data. Within each disease category, the response variables were analysed by race group using non-parametric Kruskal-Wallis tests. Multiple comparisons were made using pairwise Mann-Whitney tests and Bonferroni adjusted significance levels according to the number of multiple comparisons made. In order to control for other confounding factors such as age, serum PSA levels and compliance, Cox proportional hazards models were used. Hazard ratios and 95% confidence intervals were also reported. Results In KZN, the majority of the population is classified as blacks (82.9%). The Indian population group makes up 9.0% of the provincial population while white and coloured people make up 6.1% and 2.0% of the provincial population respectively. In this study population, Blacks made up 57.7% and whites made up 27.5%, followed by 11.4% of Indians and 3.4% of coloureds. The racial frequency distribution of the study population demonstrated that whites had a higher incidence of PCa when analysing their demographic profile in the province. Blacks had the highest median total serum prostate specific antigen (PSA) levels on presentation. When compared to that of the white study population, this was found to be statistically significant (p < 0.001). There was a significant association between stage of disease and race (p = 0.001). In the black group, a greater proportion had metastatic rather than localised or locally advanced disease, and in the white group the converse was seen, whereas in the Indian and coloured groups an almost equal proportion had localised or locally advanced disease versus metastatic disease. A crude analysis of progression free survival (PFS) data in patients with metastatic disease demonstrated that PFS was significantly (p = 0.003) longer for whites compared to blacks. Cox regression analysis did not confirm the influence of race on disease progression but this was confounded by incomplete data. Discussion The high incidence of whites in our study population relative to their racial distribution in the province may be explained by better educational and awareness levels of PCa and better access to healthcare facilities in this race group as compared to blacks. The data demonstrating a more advanced stage of disease presentation and higher median PSA levels in the black population may be reflective of an informational void on screening and awareness of PCa and/or a more aggressive disease course in this population group. The hypothesis that the black population may have a more aggressive disease course is given further credence by the crude analysis data suggesting a longer PFS for whites when compared to blacks. Conclusions This study invites further exploration of racial trends in PCa incidence, risk profile and outcomes amongst the diverse population groups of SA. / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2009.
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Retrospective Case Series of 15 Patients Treated with Chemoradiation Using 5-FU and Nedaplatin for Gynecological Malignancy: With Regard to HemotoxicityISHIGAKI, TAKEO, NAGANAWA, SHINJI, OKADA, TOHRU, KUBOTA, SEIJI, MURAO, TAKAYUKI, OKUDA, TAKAHITO, ISHIHARA, SHUNICHI, HIRASAWA, NAOKI, IKEDA, MITSURU, ITOH, YOSHIYUKI 02 1900 (has links)
No description available.
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Prostate cancer-specific suvival differences between radical prostatectomy and curative radiotherapyDEGROOT, JULIE 26 September 2009 (has links)
Background: The relative treatment effectiveness of surgery versus radiotherapy for early-stage prostate cancer is uncertain and randomized clinical trials are unlikely to be performed. This study describes the difference in cause-specific survival between patients treated with radiotherapy versus surgery, using a number of design and analytic steps to mitigate confounding by indication within an observational study.
Methods: We conducted a population-based case-cohort study, sampling patients from the Ontario Cancer Registry who were treated or were candidates for cure by radiotherapy or surgery. Cases were those who died of prostate cancer within 10 years. Cause-specific survival was analyzed using Cox-proportional hazard regression, with variance adjustment for the case-cohort sampling. Analysis using intent to treat was compared to that using treatment received. Propensity scores were also calculated and Cox-proportional hazard regression was conducted within each propensity score quintile. We formed instrumental variable groups based on radiotherapy rates in Cancer Care Ontario Regions (CCORs) using the study population sampling frame and checked the instrumental variable assumption of equal distribution of covariates by comparing those covariates across these groups using data from the subcohort.
Results: The adjusted hazard ratios for risk of prostate cancer death for radiotherapy compared to surgery were 1.44 (95% CI 0.86-2.40) and 1.84 (1.06-3.17) using intent to treat and treatment received respectively. Stratified hazard ratios comparing radiotherapy to surgery for death from prostate cancer from the lowest propensity quintile to the highest propensity quintile were 0.30 (0.04-2.28), 1.54 (0.35-6.77), 0.90 (0.29-2.82), 2.71 (1.01-7.31) and 1.08 (0.41-2.81). Differences among these hazard ratios were not statistically significant (p=0.13). The distributions of all prognostic indicators were statistically significantly different between instrumental variable groups.
Conclusion: Analysis by intent to treat produced a hazard ratio closer to the null than analysis by treatment received, indicating that uncontrolled confounding toward more serious cases getting radiotherapy was present in the analysis by treatment received. Future studies should focus on obtaining enough numbers for subgroup analysis such as the stratification by risk groups. Caution should be used when using the instrumental variable approach in this population, as prognostic indicators were not as equally distributed as expected. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2009-09-24 17:54:09.955
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The use of Palliatiave Radiotherapy for bone and brain metastases in OntarioSUTTON, DANIEL 26 September 2009 (has links)
Abstract
Background: Palliative radiotherapy (PRT) plays an important role in the management of patients with bone and brain metastases; however, little is known about the use of this treatment in Ontario.
Objectives: The objectives of this thesis were to a)identify health system-related and patient-related factors associated with the use of PRT for bone and brain metastases , and b) describe temporal trends in the use of PRT for bone and brain metastases.
Methods: The Ontario Cancer Registry was used to identify patients who died of cancer between the years 1984 and 2004. Temporal trends in the use of PRT were described by year and disease site, using the Cochran-Armitage test for trend. A multivariate logistic regression was conducted to describe the relationship between health system-related and patient-related factors, and the use of PRT, while controlling for disease-related factors.
Results: Overall, 10.0% and 4.1% of patients dying of cancer received at least one course of PRT within the last two years of life for bone metastases and brain metastases, respectively. The use of PRT for bone metastases significantly decreased from 10.4% to 9.5% (p<0.0001), while the use of PRT for brain metastases more than doubled from 2.2 to 5.1% during the same period (p<0.0001). In the multivariate analysis, age was negatively associated with the use of PRT in both cases. Patients residing in the richest communities were more likely to receive treatment. A farther distance to the nearest cancer was negatively associated with the use of PRT. The level of radiotherapy (RT) services at the diagnosing hospital was positively associated with the use of PRT for bone metastases. Prevailing waiting time did not significantly influence the use of PRT in either case.
Conclusions: Over the course of the study period, the use of PRT for bone metastases decreased, while the use of PRT for brain metastases increased. Access to PRT for both bone and brain metastases was influenced by factors unrelated to need. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2009-09-24 23:02:05.662
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Tomographic Imaging on a Cobalt Radiotherapy MachineMARSH, MATTHEW BRENDON 06 February 2012 (has links)
Cancer is a global problem, and many people in low-income countries do not have access to the treatment options, such as radiation therapy, that are available in wealthy countries. Where radiation therapy is available, it is often delivered using older Co-60 equipment that has not been updated to modern standards.
Previous research has indicated that an updated Co-60 radiation therapy machine could deliver treatments that are equivalent to those performed with modern linear accelerators. Among the key features of these modern treatments is a tightly conformal dose distribution-- the radiation dose is shaped in three dimensions to closely match the tumour, with minimal irradiation of surrounding normal tissues. Very accurate alignment of the patient in the beam is therefore necessary to avoid missing the tumour, so all modern radiotherapy machines include imaging systems to verify the patient's position before treatment.
Imaging with the treatment beam is relatively cost-effective, as it avoids the need for a second radiation source and the associated control systems. The dose rate from a Co-60 therapy source, though, is more than an order of magnitude too high to use for computed tomography (CT) imaging of a patient. Digital tomosynthesis (DT), a limited-arc imaging method that can be thought of as a hybrid of CT and conventional radiography, allows some of the three-dimensional selectivity of CT but with shorter imaging times and a five- to fifteen-fold reduction in dose.
In the present work, a prototype Co-60 DT imaging system was developed and characterized. A class of clinically useful Co-60 DT protocols has been identified, based on the filtered backprojection algorithm originally designed for CT, with images acquired over a relatively small arc. Parts of the reconstruction algorithm must be modified for the DT case, and a way to reduce the beam intensity will be necessary to reduce the imaging dose to acceptable levels. Some additional study is required to determine whether improvements made to the DT imaging protocol translate to improvements in the accuracy of the image guidance process, but it is clear that Co-60 DT is feasible and will probably be practical for clinical use. / Thesis (Master, Physics, Engineering Physics and Astronomy) -- Queen's University, 2012-01-30 12:56:56.075
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