International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Mar 2005
Dosimetric advantages of IMRT simultaneous integrated boost for high-risk prostate cancer.
A sequential two-phase process, initial and boost irradiation, is the common practice for the radiotherapy management of high-risk prostate cancer. In this work, we explore the feasibility of using intensity modulated radiation therapy (IMRT) simultaneous integrated boost (SIB), a single-phase process, to simultaneously deliver high dose to the prostate and lower dose to the pelvic nodes. In addition, we introduce the concept of voxel-equivalent dose for the comparison of treatment plans. ⋯ A new IMRT simultaneous integrated boost strategy that irradiates prostate via hypofractionation while irradiating pelvic nodes with the conventional fractionation is proposed for high-risk prostate cancer. Compared to the conventional two-phase treatment, the proposed SIB technique offers potential advantages, including better sparing of critical structures, more efficient delivery, shorter treatment duration, and better biologic effectiveness.
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Int. J. Radiat. Oncol. Biol. Phys. · Mar 2005
Randomized Controlled Trial Multicenter Study Clinical TrialAcute and late complications after radiotherapy for prostate cancer: results of a multicenter randomized trial comparing 68 Gy to 78 Gy.
To compare acute and late gastrointestinal (GI) and genitourinary (GU) side effects in prostate cancer patients randomized to receive 68 Gy or 78 Gy. ⋯ Raising the dose to the prostate from 68 Gy to 78 Gy resulted in higher incidences of acute and late GI and GU toxicity, but these differences were not significant, except for late rectal bleeding requiring treatment and late nocturia. Other factors than the studied dose levels appeared to be important in predicting toxicity after radiotherapy, especially previous surgical interventions (abdominal surgery or TURP), hormonal therapy, and the presence of pretreatment symptoms.
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Int. J. Radiat. Oncol. Biol. Phys. · Mar 2005
Randomized Controlled Trial Clinical TrialWhat pretreatment prostate-specific antigen level warrants long-term androgen deprivation?
Several large randomized prospective studies have demonstrated a survival benefit with the addition of long-term androgen deprivation to definitive radiotherapy for patients with Gleason score 8-10 or T3-T4 prostate cancer. However, these studies were performed before the routine use of prostate-specific antigen (PSA) measurement. The purpose of this study was to determine what pretreatment (initial) PSA (iPSA) level, if any, warrants the addition of long-term androgen deprivation in the PSA era. ⋯ Recursive partitioning techniques defined an iPSA cutpoint of 30 ng/mL for delineating intermediate vs. high risk. Patients with a PSA level >30 ng/mL in the absence of Gleason score >7 or T3 disease do poorly when treated with radiotherapy alone and should be considered for long-term androgen deprivation or other aggressive systemic therapy.
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Int. J. Radiat. Oncol. Biol. Phys. · Mar 2005
Clitoral therapy device for treatment of sexual dysfunction in irradiated cervical cancer patients.
The purpose of this pilot study was to evaluate the efficacy of the clitoral therapy device (Eros Therapy) in alleviating sexual dysfunction in irradiated cervical cancer patients. ⋯ Our results from this pilot study suggest that the clitoral therapy device may alleviate sexual dysfunction in irradiated cervical cancer patients. A randomized, controlled trial is warranted to assess the full benefits of this approach.