International journal of radiation oncology, biology, physics
-
Int. J. Radiat. Oncol. Biol. Phys. · Jun 1998
A close or positive margin after mastectomy is not an indication for chest wall irradiation except in women aged fifty or younger.
Indications for postmastectomy radiation include primary tumor size > or = 5 cm and/or > or = 4 positive axillary nodes. In clinical practice, patients with a close or positive margin after mastectomy are also often treated with postmastectomy radiation. However, there is little data regarding the risk of a chest wall recurrence in patients with close or positive margins who otherwise would be considered low risk (tumor size <5 cm and/or 0-3 positive nodes). To address this issue, we assessed the risk of a chest wall recurrence in women with Stage I-II breast cancer who underwent mastectomy and were found to have primary tumor size <5 cm and 0-3 positive nodes with a close or positive deep margin. ⋯ A close or positive margin is uncommon (< or = 5%) after mastectomy in patients with tumor size <5 cm and 0-3 positive axillary nodes but, when present, it appears to be in a younger patient population. The subgroup of patients aged 50 or younger with clinical T1-T2 tumor size and 0-3 positive nodes who have a close (< or = 5 mm) or positive mastectomy margin are at high risk (28% at 8 years) for chest wall recurrence regardless of adjuvant systemic therapy and, therefore, should be considered for postmastectomy radiation.
-
Int. J. Radiat. Oncol. Biol. Phys. · Jun 1998
Clinical TrialDose escalation with three-dimensional conformal radiation therapy affects the outcome in prostate cancer.
Three-dimensional conformal radiation therapy (3D-CRT) is a technique designed to deliver prescribed radiation doses to localized tumors with high precision, while effectively excluding the surrounding normal tissues. It facilitates tumor dose escalation which should overcome the relative resistance of tumor clonogens to conventional radiation dose levels. The present study was undertaken to test this hypothesis in patients with clinically localized prostate cancer. ⋯ The data provide evidence for a significant effect of dose escalation on the response of human prostate cancer to irradiation and defines new standards for curative radiotherapy in this disease.
-
Int. J. Radiat. Oncol. Biol. Phys. · Jun 1998
The treatment of nonpalpable PSA-detected adenocarcinoma of the prostate with 3-dimensional conformal radiation therapy.
We reviewed our institution's experience treating patients with nonpalpable PSA-detected prostate cancer with three-dimensional conformal radiation therapy (3DCRT) to determine prognostic factors that predict for biochemical-free survival (bNED) control and present the bNED control rates. ⋯ Patients with nonpalpable PSA-detected prostate cancer can be effectively treated with 3DCRT with minimal morbidity and high rates of bNED control at 5 years. Pretreatment PSA level is an independent predictor of bNED control.
-
Int. J. Radiat. Oncol. Biol. Phys. · Jun 1998
The use of adaptive radiation therapy to reduce setup error: a prospective clinical study.
Adaptive Radiation Therapy (ART) is a feedback treatment process that optimizes a patient's treatment according to the patient specific information measured during the course of treatment. Utilizing an electronic portal imaging device (EPID) and a computer-controlled multileaf collimator (MLC), the ART process is currently being implemented in our clinic to improve the treatment accuracy by compensating for the treatment setup error. A prospective study was conducted to evaluate the feasibility and efficacy of the ART process for clinical use. ⋯ The prospective study demonstrates that the ART process can be effectively implemented in routine clinical practice to improve treatment accuracy. This process is also ready to be further extended to reoptimize the treatment plan by incorporating the predicted patient specific setup variation.
-
Int. J. Radiat. Oncol. Biol. Phys. · Jun 1998
Cataracts after total body irradiation and bone marrow transplantation in patients with acute leukemia in complete remission: a study of the European Group for Blood and Marrow Transplantation.
Advances in bone marrow transplantation (BMT) have consistently improved long-term survival. Therefore, evaluation of late complications such as cataracts is of paramount importance. ⋯ High dose rate and STBI are the main risk factors for cataract development and the need for surgery, and the administration of heparin has a protective role in cataractogenesis.