International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Jul 2005
Simultaneous integrated intensity-modulated radiotherapy boost for locally advanced gynecological cancer: radiobiological and dosimetric considerations.
Whole-pelvis irradiation (WPI) followed by a boost to the tumor site is the standard of practice for the radiotherapeutic management of locally advanced gynecologic cancers. The boost is frequently administered by use of brachytherapy or, occasionally, external-beam radiotherapy (EBRT) when brachytherapy does not provide sufficient coverage because of the size of the tumor or the geometry of the patient. In this work, we propose using an intensity-modulated radiotherapy (IMRT) simultaneous integrated boost (SIB), which is a single-phase process, to replace the conventional two-phase process involving WPI plus a boost. Radiobiological modeling is used to design appropriate regimens for the IMRT SIB. To demonstrate feasibility, a dosimetric study is carried out on an example patient. ⋯ An IMRT simultaneous integrated boost to replace the conventional two-phase treatments (whole pelvic irradiation followed by brachytherapy or EBRT boost) is radiobiologically and dosimetricaly feasible for locally advanced gynecological cancers that may not be amenable to brachytherapy for anatomic or medical reasons. In addition to its shorter treatment time, the proposed IMRT SIB can provide significant sparing to normal structures, which offers potential for dose escalation. Issues such as organ motion and changing anatomy as tumor responds still must be addressed.
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Int. J. Radiat. Oncol. Biol. Phys. · Jul 2005
Pulmonary function changes after radiotherapy in non-small-cell lung cancer patients with long-term disease-free survival.
To evaluate the changes in pulmonary function after high-dose radiotherapy (RT) for non-small-cell lung cancer in patients with a long-term disease-free survival. ⋯ A significant decrease in pulmonary function was observed 3 months after RT. No recovery in pulmonary function was seen at 18 and 36 months after RT. The decrease in pulmonary function was dependent on the mean lung dose, and patients with chronic obstructive pulmonary disease had larger reductions in the PFTs.