International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 2012
Intensity-modulated radiation therapy with concurrent chemotherapy as preoperative treatment for localized gastric adenocarcinoma.
The goal of this study was to evaluate dosimetric parameters, acute toxicity, pathologic response, and local control in patients treated with preoperative intensity-modulated radiation therapy (IMRT) and concurrent chemotherapy for localized gastric adenocarcinoma. ⋯ Preoperative IMRT for gastric adenocarcinoma was well tolerated, accomplished excellent target coverage and normal structure sparing, and led to appropriate pathologic outcomes.
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 2012
Planned two-fraction proton beam stereotactic radiosurgery for high-risk inoperable cerebral arteriovenous malformations.
To evaluate patients with high-risk cerebral arteriovenous malformations (AVMs), based on eloquent brain location or large size, who underwent planned two-fraction proton stereotactic radiosurgery (PSRS). ⋯ High-risk AVMs can be safely treated with two-fraction PSRS, although total obliteration rate is low and patients remain at risk for future hemorrhage. Future studies should include higher doses or a multistaged PSRS approach for lesions more resistant to obliteration with radiation.
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 2012
Quality of life after hypofractionated concomitant intensity-modulated radiotherapy boost for high-risk prostate cancer.
To evaluate the change in health-related quality of life (QOL) of patients with high-risk prostate cancer treated using hypofractionated radiotherapy combined with long-term androgen deprivation therapy. ⋯ Hypofractionated radiotherapy combined with long-term androgen deprivation therapy was well tolerated. Although there were modest rates of clinically significant patient-reported urinary and bowel toxicity, most of this caused only mild distress, and moderate and severe effects on QOL were limited. Additional follow-up is ongoing to characterize long-term QOL.
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 2012
Distant metastases in head-and-neck squamous cell carcinoma treated with intensity-modulated radiotherapy.
To determine the pattern and risk factors for distant metastases in head-and-neck squamous cell carcinoma (HNSCC) after curative treatment with intensity-modulated radiotherapy (IMRT). ⋯ With advanced radiation techniques and concurrent chemotherapy, the failure pattern has changed with more patients failing distantly. The majority of patients with distant metastases had no local or regional failures, indicating that these patients might have microscopic distant disease before treatment. The clinical factors identified here should be incorporated in future clinical trials.
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 2012
Comparative StudyClinical application of a novel hybrid intensity-modulated radiotherapy technique for stage III lung cancer and dosimetric comparison with four other techniques.
In large stage III lung tumors, planning delivery of doses exceeding 60 Gy can be challenging and time consuming. Intensity modulated radiation therapy (IMRT) can improve target coverage but may increase volumes receiving low-dose irradiation. We clinically implemented a novel hybrid IMRT (h-IMRT) technique that allowed plans to be produced quickly, and compared these plans with 4 other techniques. ⋯ Both h-IMRT and h-RapidArc permitted delivery of 66 Gy to large stage III lung tumors, and both were superior to either full IMRT or RapidArc plans for reducing lung doses. The clinical significance of small increases in V(5) during chemo-radiation therapy delivery are unknown, but the present study suggests that h-IMRT and h-RapidArc are preferable for treatment of large tumors.