International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Jul 2005
Detailed urethral dosimetry in the evaluation of prostate brachytherapy-related urinary morbidity.
To evaluate the relationship between urinary morbidity after prostate brachytherapy and urethral doses calculated at the base, midprostate, apex, and urogenital diaphragm. ⋯ With the routine use of prophylactic alpha blockers and strict adherence to urethral-sparing techniques, detailed urethral dosimetry did not substantially improve the ability to predict urinary morbidity. Neither the average dose to the prostatic urethra nor urethral doses stratified into base, midprostate, apex, or urogenital diaphragm segments predicted for IPSS normalization. Radiation doses of 100%-140% minimum peripheral dose are well tolerated by all segments of the prostatic urethra with resultant tumoricidal doses to foci of periurethral cancer.
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Int. J. Radiat. Oncol. Biol. Phys. · Jul 2005
Locoregional recurrence rates and prognostic factors for failure in node-negative patients treated with mastectomy: implications for postmastectomy radiation.
Postmastectomy radiation therapy (PMRT) reduces locoregional recurrence (LRR) of breast cancer. Survival appears improved in patients at higher risk for LRR. This study addresses whether subsets of node-negative patients with sufficiently high risk of LRR might benefit from PMRT. ⋯ Postmastectomy radiation therapy has not been recommended for node-negative patients because the LRR rate is low in that population overall. This study suggests, however, that node-negative patients with multiple risk factors, including close margins, T2 or larger tumors, premenopausal status, and LVI, are at higher risk for LRR and might benefit from PMRT. Because the chest wall is the most common site of failure, treating the chest wall alone in these patients to minimize toxicity is reasonable.
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Int. J. Radiat. Oncol. Biol. Phys. · Jul 2005
Multicenter Study Clinical TrialHealth-related quality of life in men receiving prostate brachytherapy on RTOG 98-05.
To prospectively assess health-related quality of life (HRQOL) during the first year after treatment with prostate brachytherapy (PB) alone for T1c-2a prostate cancer. ⋯ This article represents the first prospective, multi-institutional study of HRQOL in men treated with PB and demonstrates that patients undergoing PB have a very high overall HRQOL. The rate of incontinence by 1 year after PB is low, but many patients continue to have obstructive symptoms at 1 year. Although 78% of 1-year respondents state that they can achieve an erection with or without assistance, almost 50% report a decrease in sexual function.
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Int. J. Radiat. Oncol. Biol. Phys. · Jul 2005
Dose-volume modeling of salivary function in patients with head-and-neck cancer receiving radiotherapy.
We investigated the factors that affect salivary function after head-and-neck radiotherapy (RT), including parotid gland dose-volume effects, potential compensation by less-irradiated gland tissue, and functional recovery over time. ⋯ Stimulated parotid salivary gland dose-volume models strongly correlated with both stimulated salivary function and quality-of-life scores at 6 months after RT. The mean stimulated saliva flow rates improved from 6 to 12 months after RT. Salivary function, in each gland, appeared to be lost exponentially at a rate of approximately 5%/1 Gy of mean dose. Additional research is necessary to distinguish among the models for use in treatment planning. The incidence of xerostomia was significantly decreased when the mean dose of at least one parotid gland was kept to < 25.8 Gy with conventional fractionation. However, even lower mean doses imply increased late salivary function.