International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Jan 2005
Repeat radiosurgery for idiopathic trigeminal neuralgia.
Although frequently performed, the efficacy and safety of repeat trigeminal neuralgia radiosurgery is not well described. ⋯ Repeat trigeminal neuralgia radiosurgery at the dosage described has better facial pain outcomes than primary radiosurgery. However, because the procedure is nonselective and the rate of bothersome numbness was relatively high (16%), dose reduction is recommended to reduce the morbidity of repeat trigeminal neuralgia radiosurgery.
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Int. J. Radiat. Oncol. Biol. Phys. · Jan 2005
Clinical TrialCisplatin/etoposide chemotherapy combined with twice daily thoracic radiotherapy for limited small-cell lung cancer: a clinical phase II trial.
To fit the situation of developing countries, where supportive care is not sufficient, a modified combined therapy of cisplatin/etoposide (EP) and hyperfractionated accelerated radiation therapy (HART) was conducted as a Phase II trial for limited-stage small-cell lung cancer (LSCLC) to evaluate the feasibility, toxicity, and tolerance of the combined therapy and to observe its efficacy and patterns of failure. ⋯ The study led to the following conclusions: (1) LSCLC patients tolerate HART at 56 Gy in 40 fractions over 4 weeks combined with 6 cycles of EP chemotherapy. (2) Both control of the tumor in the thorax and survival appear superior to conventional fractionated radiation but not as good as that in a study by Turrisi and colleagues. (3) This modified chemoradiation schedule could be recommended to LSCLC patients in developing countries. (4) The lessons learned from our study are (a) higher radiation doses may be needed for better locoregional control, and (b) prophylactic cranial irradiation is necessary for LSCLC patients who show complete response.
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Int. J. Radiat. Oncol. Biol. Phys. · Jan 2005
Comparative StudyThe effect of an endorectal balloon and off-line correction on the interfraction systematic and random prostate position variations: a comparative study.
To investigate the effect of an endorectal balloon (ERB) and an off-line correction protocol on the day-to-day, interfraction prostate gland motion, in patients receiving external beam radiotherapy for prostate cancer. ⋯ The off-line corrections on the fiducial markers are effective in reducing the systematic prostate displacements. The investigated ERB does not reduce the interfraction prostate motion. Although the overall mean displacement is low, the day-to-day interfraction motion, especially in anterior-posterior direction, remains high compared with the systematic displacements.
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Int. J. Radiat. Oncol. Biol. Phys. · Jan 2005
Acute complications of MammoSite brachytherapy: a single institution's initial clinical experience.
To report the acute complications incurred by the initial 37 patients who underwent accelerated partial breast irradiation with the MammoSite balloon breast brachytherapy applicator at the Medical University of South Carolina. ⋯ The types of complications in this experience were similar to those in the Phase I trial of the MammoSite brachytherapy applicator. However, catheter failure due to leak occurred in our experience and was not described in the Phase I trial. The incidence of complications was greater in our series than in the Phase I trial; however, differences in toxicity scoring and the length of follow-up between the two series impeded direct comparisons. The incidences of complications over time reflect the steep learning curve for accelerated partial breast irradiation using the MammoSite brachytherapy applicator. Finally, radiation recall dermatitis developed in 1 patient treated after this review was completed.
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Int. J. Radiat. Oncol. Biol. Phys. · Jan 2005
Impact of tumor repopulation on radiotherapy planning.
Biologic/functional imaging (e.g., fluorodeoxyglucose/3'-deoxy-3'-fluorothymidine-positron emission tomography) is promising to provide information on tumor cell repopulation. Such information is important in the design of biologically conformal radiotherapy for cancer. The questions remaining unclear are whether it is necessary to escalate the dose to the regions with rapid cell repopulation in the tumor target and, if so, by how much. The purpose of this work was to address these questions using radiobiologic modeling. ⋯ Dose escalation is necessary to offset the accelerated tumor cell repopulation during prolonged treatment courses. This study provides a preliminary estimate of the dose escalation for prostate cancer based on the in situ measurements of potential doubling time and radiobiologic models. The proposed dose prescriptions are technically feasible for clinical trials.