International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Mar 2004
Multicenter StudyCentralized radiation oncologic review of cross-sectional imaging of Hodgkin's disease leads to significant changes in required involved field-results of a quality assurance program of the German Hodgkin Study Group.
To guarantee the treatment quality of involved-field radiotherapy (IF-RT) of patients in the Hodgkin's disease (HD)10 and HD11 trials of the German Hodgkin Study Group, with 460 participating study centers, a quality assurance program was conducted. It was based on a central prospective radiation oncologic review of all patients' entire diagnostic imaging and clinical findings. An individual RT prescription was provided for every study patient. The purpose of the present investigation was to assess the feasibility of such a procedure and its impact on the final definition of disease extension and patient treatment. ⋯ A central prospective review of patient data and consecutive prescription of individual RT treatment volume is feasible within large multicenter trials for HD. Such a procedure has a significant impact on the correctness of stage definition, allocation to treatment groups, and extent of the IF treatment volume.
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Int. J. Radiat. Oncol. Biol. Phys. · Mar 2004
GuidelineTreatment planning guidelines regarding the use of CT/PET-guided IMRT for cervical carcinoma with positive paraaortic lymph nodes.
Computed tomography (CT)/positron emission tomography (PET)-guided intensity-modulated radiotherapy of the paraaortic lymph nodes (PALNs) has been proposed for patients with cervical carcinoma and paraaortic metastasis. This investigation attempted to determine the guidelines regarding the selection of appropriate treatment parameters (e.g., number of beams, beam geometry) and organ-specific parameters (e.g., importance weighting and tolerance dose) for intensity-modulated radiotherapy planning for the PALNs. ⋯ We successfully developed treatment plans that deliver 59.4 Gy to the positive PALNs and 50.4 Gy to the paraaortic region using CT/PET-guided intensity-modulated radiotherapy.
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Int. J. Radiat. Oncol. Biol. Phys. · Mar 2004
Multicenter Study Clinical TrialLong-term outcome by risk factors using conformal high-dose-rate brachytherapy (HDR-BT) boost with or without neoadjuvant androgen suppression for localized prostate cancer.
The aim of this study is to analyze, during the prostate-specific antigen (PSA) era, the long-term outcome of patients treated with conformal high-dose-rate (HDR) brachytherapy boost to the prostate with or without androgen deprivation therapy (ADT) when patients are stratified by risk factors for failure. ⋯ EBRT with HDR-BT produced excellent long-term outcomes in terms of BC, DFS, and CSS in patients with prostate cancer even for those at highest risk. Conformal HDR-BT is both a precise dose delivery system and an effective treatment for both favorable and unfavorable prostate cancer. The addition of a short course of neoadjuvant/concurrent ADT failed to improve outcome. The results were similar at all three institutions, giving credence to the reproducibility of the brachytherapy treatment.
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Int. J. Radiat. Oncol. Biol. Phys. · Mar 2004
Partial breast irradiation with interstitial 60CO brachytherapy results in frequent grade 3 or 4 toxicity. Evidence based on a 12-year follow-up of 70 patients.
To investigate the radiation-induced toxicity and cosmesis of brachytherapy (BT) alone in early stage breast cancer. ⋯ Interstitial (60)Co BT of the breast tumor bed alone with a limited CTV (median, 72 cm(3)) and a total dose of 28 Gy is associated with a high rate (59%) of grade > or =3 radiation-induced toxicity and a high rate (50%) of poor cosmetic outcome at the end of a median follow-up of 12 years. A relatively high BT dose rate (1.3-2.8 Gy/h) applied during a short overall treatment time (10-22 h) and a possible geographic miss (close to skin implantation) might have contributed to the development of these sequelae.
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Int. J. Radiat. Oncol. Biol. Phys. · Mar 2004
Integration of functional brain information into stereotactic irradiation treatment planning using magnetoencephalography and magnetic resonance axonography.
To minimize the risk of neurologic deficit after stereotactic irradiation, functional brain information was integrated into treatment planning. ⋯ Integration of magnetoencephalography and magnetic resonance axonography in treatment planning has the potential to reduce the risk of radiation-induced functional dysfunction without deterioration of the dose distribution in the target volume.