International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Jan 2000
Nodal basin recurrence following lymph node dissection for melanoma: implications for adjuvant radiotherapy.
To analyze patterns of failure in malignant melanoma patients with lymph node involvement who underwent complete lymph node dissection (LND) of the nodal basin. To determine prognostic factors predictive of local recurrence in the lymph node basin in order to select patients who may benefit from adjuvant radiotherapy. ⋯ Malignant melanoma patients with nodal involvement have a significant risk of nodal basin failure after LND if they have cervical involvement, ECE, >3 positive lymph nodes, clinically involved nodes, or any node larger than 3 cm. Patients with these risk factors should be considered for adjuvant radiotherapy to the lymph node basin to reduce the incidence of nodal basin recurrence. Patients with nodal basin failure are at higher risk of developing distant metastases.
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Int. J. Radiat. Oncol. Biol. Phys. · Jan 2000
Randomized Controlled Trial Multicenter Study Clinical TrialPostoperative neoadjuvant chemotherapy before radiotherapy as compared to immediate radiotherapy followed by maintenance chemotherapy in the treatment of medulloblastoma in childhood: results of the German prospective randomized trial HIT '91.
The German Society of Pediatric Hematology and Oncology (GPOH) conducted a randomized, prospective, multicenter trial (HIT '91) in order to improve the survival of children with medulloblastoma by using postoperative neoadjuvant chemotherapy before radiation therapy as opposed to maintenance chemotherapy after immediate postoperative radiotherapy. ⋯ Maintenance chemotherapy would seem to be more effective in low-risk medulloblastoma, especially in patients older than 6 years of age. Neoadjuvant chemotherapy was accompanied by increased myelotoxicity of the subsequent radiotherapy, causing a higher rate of interruptions and an extended overall treatment time. Delayed and/or protracted radiotherapy may therefore have a negative impact on outcome. M2/3 disease was associated with a poor survival in both arms, suggesting the need for a more intensive treatment. Young age and M2/3 stage were negative prognostic factors in medulloblastoma, but residual or M1 disease was not, suggesting a new stratification system for risk subgroups. High quality of radiotherapy may be a major contributing factor for the overall outcome.
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Int. J. Radiat. Oncol. Biol. Phys. · Jan 2000
Neurobehavioral toxicity of total body irradiation: a follow-up in long-term survivors.
Total body irradiation (TBI) in preparation for bone marrow transplantation (BMT) is a routine treatment of hematological malignancy. A retrospective and a prospective group study of long-term cerebral side effects was performed, with a special emphasis on neurobehavioral toxicity effects. ⋯ The incidence of long-term neurobehavioral toxicity was very low for the present TBI/BMT regimen.
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Int. J. Radiat. Oncol. Biol. Phys. · Jan 2000
The situation of radiation oncology practice training programs and their graduates in 1998.
To keep the profession apprised of current trends in the job market, the American College of Radiology (ACR) studied the employment situation of 1998 radiation oncology graduates and the status and plans of radiation oncology training programs in the United States. ⋯ Unemployment continues to be low, and another, "softer" indicator, the job market perceptions of residency program directors, continues to improve. Possibly as a result, plans for program reductions are evaporating.
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Int. J. Radiat. Oncol. Biol. Phys. · Jan 2000
Clinical TrialPostimplant analysis of transperineal interstitial permanent prostate brachytherapy: evidence for a learning curve in the first year at a single institution.
The utilization of transperineal interstitial permanent prostate brachytherapy (TIPPB) is increasing in the United States. Quality assessment of TIPPB is in its infancy, and to date, dosimetric analyses have only been reported from centers with a large experience in prostate brachytherapy. The purpose of this report is to critically analyze the dosimetric coverage achieved following TIPPB in the first 63 cases performed by a multidisciplinary group of investigators with no prior experience with TIPPB. ⋯ In this single institution experience with the first 63 men receiving TIPPB by a multidisciplinary group of investigators, there is evidence for a learning curve. All quantifiers of implant adequacy improved as clinicians gained experience. In the most recent group of patients, quantifiers of implant adequacy are similar to those reported from other groups with significantly more experience with TIPPB.