International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2001
Randomized Controlled Trial Multicenter Study Clinical TrialRandomized phase III trial of radiation treatment +/- amifostine in patients with advanced-stage lung cancer.
This multicenter trial investigated whether daily pretreatment with amifostine (A) could reduce the incidence of acute and late lung toxicity and esophagitis without affecting antitumor efficacy of radiation in advanced lung cancer. ⋯ Amifostine reduces the incidence of pneumonitis, lung fibrosis, and esophagitis in radiotherapy patients with lung cancer without compromising antitumor efficacy.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2001
ReviewIntensity-modulated radiotherapy: current status and issues of interest.
To develop and disseminate a report aimed primarily at practicing radiation oncology physicians and medical physicists that describes the current state-of-the-art of intensity-modulated radiotherapy (IMRT). Those areas needing further research and development are identified by category and recommendations are given, which should also be of interest to IMRT equipment manufacturers and research funding agencies. ⋯ Recommendations in the areas pertinent to IMRT, including dose-calculation algorithms, acceptance testing, commissioning and quality assurance, facility planning and radiation safety, and target volume and dose specification, are presented. Several of the areas in which future research and development are needed are also indicated. These broad recommendations are intended to be both technical and advisory in nature, but the ultimate responsibility for clinical decisions pertaining to the implementation and use of IMRT rests with the radiation oncologist and radiation oncology physicist. This is an evolving field, and modifications of these recommendations are expected as new technology and data become available.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2001
Long-term follow-up of RTOG 92-10: cervical cancer with positive para-aortic lymph nodes.
The purpose of this study was to evaluate the late toxicity and efficacy of twice-daily external irradiation to the pelvis and lumbar para-aortic region with brachytherapy and concurrent chemotherapy for carcinoma of the cervix with positive para-aortic lymph nodes. ⋯ The results suggest that twice-daily external irradiation to the pelvis and lumbar para-aortic region with brachytherapy and concurrent chemotherapy resulted in an unacceptably high rate (17%, 5 of 29) of Grade 4 late toxicity. One patient died of acute complications of therapy. The survival estimates seem no better than standard fractionation irradiation without chemotherapy.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2001
Implant volume as a prognostic variable in brachytherapy decision-making for malignant gliomas stratified by the RTOG recursive partitioning analysis.
When an initial retrospective review of malignant glioma patients (MG) undergoing brachytherapy was carried out using the Radiation Therapy Oncology Group (RTOG) recursive partitioning analysis (RPA) criteria, it revealed that glioblastoma multiforme (GBM) cases benefit the most from implant. In the present study, we focused exclusively on these GBM patients stratified by RPA survival class and looked at the relationship between survival and implanted target volume, to distinguish the prognostic value of volume in general and for a given GBM class. ⋯ For all GBM patients, an inverse relationship between implanted TV size and median survival is suggested by this study. However, when GBM patients are stratified using the RTOG's RPA criteria, the prognostic effect of implant volume disappears within each RPA survival class. At the critical volume of 25 cc, which approximates an implant of 5-cm diameter (upper implantation limit of many CNS brachytherapy protocols), the "poorest" prognosis GBM patients stratified by RPA still demonstrate a survival benefit with implant. We suggest that any GBM patient meeting brachytherapy recognized size criteria be considered for I-125 implant.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2001
Observer variation in contouring gross tumor volume in patients with poorly defined non-small-cell lung tumors on CT: the impact of 18FDG-hybrid PET fusion.
To quantify interobserver variation in gross tumor volume (GTV) localization using CT images for patients with non-small-cell lung carcinoma and poorly defined tumors on CT and to determine whether variability would be reduced if coregistered 2-[18F]fluoro-2-deoxy-d-glucose (FDG)-hybrid positron emission tomography (PET) with CT images were used. ⋯ High observer variability in CT-based definition of the GTV can occur. A more consistent definition of the GTV can often be obtained if coregistered FDG-hybrid PET images are used.