International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Feb 2009
Multicenter StudyMulticenter analysis of effect of high biologic effective dose on biochemical failure and survival outcomes in patients with Gleason score 7-10 prostate cancer treated with permanent prostate brachytherapy.
To investigate the biochemical control rates and survival for Gleason score 7-10 prostate cancer patients undergoing permanent prostate brachytherapy as a function of the biologic effective dose (BED). ⋯ These data suggest that permanent prostate brachytherapy combined with EBRT and hormonal therapy yields excellent bFFF and survival results in Gleason score 7-10 patients when the delivered BEDs are >220 Gy. These doses can be achieved by a combination of 45-Gy EBRT with a minimal dose received by 90% of the target volume of 120 Gy of (103)Pd or 130 Gy of (125)I.
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Int. J. Radiat. Oncol. Biol. Phys. · Feb 2009
Comparative StudyRefinement of treatment setup and target localization accuracy using three-dimensional cone-beam computed tomography for stereotactic body radiotherapy.
To quantitatively compare two-dimensional (2D) orthogonal kV with three-dimensional (3D) cone-beam CT (CBCT) for target localization; and to assess intrafraction motion with kV images in patients undergoing stereotactic body radiotherapy (SBRT). ⋯ After localization based on superficial markings in patients undergoing SBRT, orthogonal kV imaging detects setup variations of approximately 3 to 4 mm in each direction. Cone-beam CT detects residual setup variations of approximately 2 to 3 mm.
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Int. J. Radiat. Oncol. Biol. Phys. · Feb 2009
Patients with t1 to t2 breast cancer with one to three positive nodes have higher local and regional recurrence risks compared with node-negative patients after breast-conserving surgery and whole-breast radiotherapy.
To evaluate locoregional recurrence according to nodal status in women with T1 to T2 breast cancer and zero to three positive nodes (0-3N+) treated with breast-conserving surgery (BCS). ⋯ Patients with 1-3N+ and young age, Grade III, or ER-negative disease have high LRR risks approximating 15% to 20% despite BCS, whole-breast RT and systemic therapy. These patients may benefit with more comprehensive RT volume encompassing the regional nodes.
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Int. J. Radiat. Oncol. Biol. Phys. · Feb 2009
IMRT reirradiation of head and neck cancer-disease control and morbidity outcomes.
Institutional and cooperative group experience has demonstrated the feasibility of reirradiation for head and neck cancer. Limited data are available regarding the use of intensity-modulated radiotherapy (IMRT) for this indication. We reviewed our initial experience using IMRT for previously irradiated head and neck cancer patients. ⋯ The use of IMRT for reirradiation of recurrent or second primary head and neck cancers resulted in encouraging local control and survival. Reirradiation-related morbidity was significant, but may be less severe than previously published reports using conventional techniques.
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Int. J. Radiat. Oncol. Biol. Phys. · Feb 2009
Commissioning of volumetric modulated arc therapy (VMAT).
Volumetric modulated arc therapy (VMAT) involves the simultaneous use of dynamic multileaf collimator (DMLC) techniques and gantry arcing; appropriate quality assurance is therefore required. This article describes the development and implementation of procedures for commissioning VMAT on a commercial linear accelerator (Elekta PreciseBeam VMAT with MLCi and Beam Modulator heads). ⋯ VMAT has been successfully commissioned and has been introduced into clinical use. The Elekta DMLC has also been shown to be suitable for sliding window delivery.