International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · May 2003
Comparative StudyIntensity-modulated radiotherapy in nasopharyngeal carcinoma: dosimetric advantage over conventional plans and feasibility of dose escalation.
To compare intensity-modulated radiotherapy (IMRT) with two-dimensional RT (2D-RT) and three-dimensional conformal radiotherapy (3D-CRT) treatment plans in different stages of nasopharyngeal carcinoma and to explore the feasibility of dose escalation in locally advanced disease. ⋯ IMRT is useful in treating all stages of nonmetastatic nasopharyngeal carcinoma because of its dosimetric advantages. In early-stage disease, it provides better parotid gland sparing. In locally advanced disease, IMRT offers better tumor coverage and normal organ sparing and allows room for dose escalation.
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Int. J. Radiat. Oncol. Biol. Phys. · May 2003
Linear accelerator-based stereotactic radiosurgery for limited, locally persistent, and recurrent nasopharyngeal carcinoma: efficacy and complications.
To evaluate the efficacy and complication of linear accelerator-based stereotactic radiosurgery (SRS) when used as salvage treatment for early-stage persistent and recurrent nasopharyngeal carcinoma (NPC) after primary radiotherapy (RT). ⋯ Our preliminary results indicate that SRS is an effective treatment modality for persistent and recurrent early-stage NPC, with early control rates comparable to other salvage treatments such as brachytherapy and nasopharyngectomy. A modest SRS dose at 12.5 Gy also appears to be effective and is associated with minimal morbidities. More clinical experience and longer follow-up are needed to validate our results and to address fully the role of SRS in salvaging local failures of NPC.
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Int. J. Radiat. Oncol. Biol. Phys. · May 2003
Clinical TrialTolerance of organs at risk in small-volume, hypofractionated, image-guided radiotherapy for primary and metastatic lung cancers.
To determine the organ at risk and the maximum tolerated dose (MTD) of radiation that could be delivered to lung cancer using small-volume, image-guided radiotherapy (IGRT) using hypofractionated, coplanar, and noncoplanar multiple fields. ⋯ Small-volume IGRT using 60 Gy in eight fractions is highly effective for the local control of lung tumors, but MTD has not been determined in this study. The organs at risk are extrapleural organs such as the esophagus and internal chest wall/visceral pleura rather than the pulmonary parenchyma in the present protocol setting. Consideration of the uncertainty in the contouring of normal structures is critically important, as is uncertainty in setup of patients and internal organ in the high-dose hypofractionated IGRT.
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Int. J. Radiat. Oncol. Biol. Phys. · May 2003
Comparative StudySequencing radiotherapy for soft tissue sarcoma when re-resection is planned.
To evaluate whether disease outcome for localized soft-tissue sarcoma (STS) excised before referral to a specialist center and there re-resected was influenced by the timing of radiation therapy (XRT)-before or after re-resection. ⋯ Patients who present after total but oncologically inadequate excision of STS can receive approximately 50 Gy before re-resection or approximately 60 Gy after re-resection, with approximately equivalent, satisfactory local control and overall disease outcome. Decisions as to the most appropriate treatment sequence for any individual patient can be made regardless of considerations as to the effectiveness of one sequence compared with the other.
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Int. J. Radiat. Oncol. Biol. Phys. · May 2003
Prediction of the benefits from dose-escalated hypofractionated intensity-modulated radiotherapy for prostate cancer.
To estimate the benefits of dose escalation in hypofractionated intensity-modulated radiotherapy (IMRT) for prostate cancer, using radiobiologic modeling and incorporating positional uncertainties of organs. ⋯ Dose escalation to the prostate using IMRT to deliver daily doses of 3 Gy was predicted to significantly increase tumor control without increasing late rectal complications, and currently this prediction is being tested in a clinical trial.