Soehartati A. Gondhowiardjo
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Radiation Therapy Strategies in Geriatric Patients: A Literature Review Steven Octavianus; Soehartati A. Gondhowiardjo
Radioterapi & Onkologi Indonesia Vol 12, No 1 (2021): VOLUME 12 NO.1 JANUARY 2021
Publisher : Perhimpunan Dokter Spesialis Onkologi Radiasi Indonesia (PORI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32532/jori.v12i1.133

Abstract

For humans, aging is defined as a universal biological process that manifests itself as a decrease in functional capacity and an increase in the risk of morbidity and mortality over time. Age is considered the single most significant risk factor for many chronic conditions including malignancies. Breast, lungs, prostate, colorectal, stomach, thyroid, pancreas, and ovarian cancers, as well as several types of leukemia, increase exponentially with age. Oncologists are often faced with difficulties when treat this population. Even though elderly and younger individuals seem to be able to get the same benefits result from a treatment, elderly are at greater risk of experiencing toxicity, serious side effects and death. A comprehensive multidisciplinary evaluation in elderly individuals with cancer can identify the risks and benefits of toxicity due to treatment plans including morbidity and mortality. Radiotherapy can be the solution in elderly with cancer, especially in patients at high risk for systemic therapy or surgery. Radiotherapy with modern techniques and fractionation adjustments (hypofractionation) can minimize the toxicity due to therapy and can be well tolerated by elderly individuals with cancer.
Dosimetric Parameter Analysis of Stereotactic Radiosurgery on Vestibular Schwannoma with Intensity-Modulated Radiotherapy Step-and-Shoot, Volumetric-Modulated Arc Therapy and Helical Tomotherapy Soehartati A. Gondhowiardjo; Aurika Sinambela; Handoko Handoko; Arie Munandar; Wahyu Edy Wibowo; Sri Mutya Sekarutami; Angela Giselvania
Radioterapi & Onkologi Indonesia Vol 12, No 2 (2021): VOLUME 12 NO.2 JULY 2021
Publisher : Perhimpunan Dokter Spesialis Onkologi Radiasi Indonesia (PORI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32532/jori.v12i2.140

Abstract

Introduction: SRS is a non-invasive modality in management of vestibular schwannoma. There is limited study comparing dosimetric parameters between three techniques SRS in vestibular schwannoma cases, thus IMRT Step and Shoot (IMRT-SS), VMAT, and Helical Tomotherapy (HT). Aim: To compare the dosimetry parameters on SRS among IMRT-SS, VMAT, and HT techniques on Vestibular ScwhanomaMethod: Treatment planning with IMRT-SS, VMAT, and HT on eleven CT plan data for schwannoma vestibular cases. The marginal dose is 12 Gy with single fraction. Results: Mean tumor size was 8.23 cm + 5.08 cm3. No significant difference were found in the mean CI, GI, V100%, and V50% among three techniques. There was no significant difference in maximal dose to brainstem, ipsilateral cochlea, chiasma opticum, ipsilateral and contralateral optic nerve between the three techniques. There was significant difference of maximum dose on contralateral cochlea between IMRT-SS and VMAT techniques. The longest beam-on time was obtained with HT technique (1209,18 +390,20 second), followed by IMRT-SS technique (665,05 + 73,40 second), and the shortest was with VMAT technique (362,87 + 24,55 second). There was significant difference in mean MU and beam on time between three techniques. Conclusion: VMAT technique could be an option for SRS for vestibular schwannoma cases to provide conformity and gradient index as well as IMRT-SS and HT techniques, with better sparing to contralateral cochlea compared with IMRT-SS technique, and provides shorter beam-on time rather than IMRT-SS and HT.
The effect of bone radiation on hematopoiesis: A literature review Rendhy Tito Apreza; Soehartati A. Gondhowiardjo
Radioterapi & Onkologi Indonesia Vol 12, No 2 (2021): VOLUME 12 NO.2 JULY 2021
Publisher : Perhimpunan Dokter Spesialis Onkologi Radiasi Indonesia (PORI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32532/jori.v12i2.135

Abstract

Over time, external radiation techniques have continued to evolve so that they can be used totreat bone malignancies for curative, postoperative adjunct, and metastases purposes. However,in the bone, there is the bone marrow that is sensitive to radiation. Even sublethal doses cancause bone marrow microenvironment deficits, including a decrease in hematopoietic cells.There is a complex relationship between radiotherapy (RT) and the hematopoietic system.Acute radiation injury usually manifests as cytopenia: anemia, neutropenia, andthrombocytopenia. Several potential mechanisms regarding the effects of radiotherapy on bonemarrow, including direct damage to the hematopoietic stem cells (HSC), lead to decreasednumber and function. This literature review will discuss hematopoiesis, the effect of boneradiation on hematopoiesis, and its mechanisms.