International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2004
Four-dimensional CT scans for treatment planning in stereotactic radiotherapy for stage I lung cancer.
Hypofractionated stereotactic radiotherapy (SRT) for Stage I non-small-cell lung cancer requires that meticulous attention be paid toward ensuring optimal target definition. Two computed tomography (CT) scan techniques for defining internal target volumes (ITV) were evaluated. ⋯ Individualized ITVs can improve target definition for SRT of Stage I non-small-cell lung cancer, and use of only a single CT scan with a 10-mm margin is inappropriate. A single 4D scan generates comparable or larger ITVs than are generated using six unmonitored rapid CT scans, a finding related to the ability to account for all respiration-correlated mobility.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2004
Reproducibility of organ position using voluntary breath-hold method with spirometer for extracranial stereotactic radiotherapy.
To evaluate in healthy volunteers the reproducibility of organ position using a voluntary breath-hold method with a spirometer and the feasibility of this method for extracranial stereotactic radiotherapy in a clinical setting. ⋯ The voluntary breath-hold method with a spirometer is feasible, with relatively good reproducibility. We are encouraged about the use of this technique clinically for extracranial stereotactic radiotherapy.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2004
Practice Guideline GuidelineProposed guidelines for image-based intracavitary brachytherapy for cervical carcinoma: report from Image-Guided Brachytherapy Working Group.
To present issues to be considered in, and make proposals for, image-based brachytherapy for cervical cancer. ⋯ Although current institutional brachytherapy prescription for cervical cancer should continue, image-based data collection and analysis are needed to optimize cervical cancer brachytherapy. Proposals are made for research in image-based brachytherapy for cervical cancer.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2004
Do differences in target volume definition in prostate cancer lead to clinically relevant differences in normal tissue toxicity?
Many studies have described the quantitated differences between clinicians in target volume definition in prostate cancer. However, few studies have looked at the clinical effects of this. We aimed to assess the relevance and sequelae of such differences. ⋯ The statistically significant difference in outlined volumes of the CTV1, CTV2, and PTV1 among the 5 clinicians is in keeping with the findings of previous studies. However, the interclinician variability did not result in clinically relevant outcomes with respect to the irradiated volume of rectum and bladder or NTCP. This may have been because the outlined areas in which interclinician differences were smallest (the rectal-prostate and prostate-bladder interfaces) are the areas that have the greatest effect on normal tissue toxicity. For the areas in which the interclinician correlation was lowest (the prostatic apex and distal seminal vesicles), the effects on normal tissue toxicity are smallest. The results of this study suggest that interclinician outlining differences in prostate cancer may have less clinical relevance than was previously thought.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2004
Multicenter Study Comparative StudyPatterns of radiotherapy practice for patients with carcinoma of the uterine cervix: a patterns of care study.
To determine the influence of research findings and evolving technology on the practice of radiotherapy in patients with carcinoma of the cervix. ⋯ The sharp increase in the use of chemotherapy in 1999 suggested rapid application of the results from randomized trials. However, considerable heterogeneity in practice patterns remains, particularly in the use of brachytherapy. The practice at small facilities appears to differ significantly from that at larger facilities in several respects, with a statistically significantly larger proportion of treatments at small facilities failing to meet current guidelines for optimal treatment.