International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2012
What is the optimal treatment of large brain metastases? An argument for a multidisciplinary approach.
Single-modality treatment of large brain metastases (>2 cm) with whole-brain irradiation, stereotactic radiosurgery (SRS) alone, or surgery alone is not effective, with local failure (LF) rates of 50% to 90%. Our goal was to improve local control (LC) by using multimodality therapy of surgery and adjuvant SRS targeting the resection cavity. ⋯ Surgery and adjuvant resection cavity SRS yields excellent LC of large brain metastases. Compared with other multimodality treatment options, this approach allows patients to avoid or delay whole-brain irradiation without compromising LC.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2012
Conformal postoperative radiotherapy in patients with positive resection margins and/or pT3-4 prostate adenocarcinoma.
To evaluate outcome and toxicity of high-dose conformal radiotherapy (RT) after radical prostatectomy. ⋯ Postoperative high-dose conformal RT in patients with high-risk features was associated with a low risk of biochemical relapse as well as minimal morbidity.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2012
Multicenter StudyQuality of life after palliative radiation therapy for patients with painful bone metastases: results of an international study validating the EORTC QLQ-BM22.
Radiation therapy (RT) is an effective method of palliating painful bone metastases and can improve function and reduce analgesic requirements. In advanced cancer patients, quality of life (QOL) is the primary outcome of interest over traditional endpoints such as survival. The purpose of our study was to compare bone metastasis-specific QOL scores among patients who responded differently to palliative RT. ⋯ Patients who report pain relief after palliative RT also have better QOL with respect to bone metastasis-specific issues. The QLQ-BM22 and QLQ-C30 are able to discriminate among patients with varying responses and are recommended for use in future bone metastasis clinical trials.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2012
A three-isocenter jagged-junction IMRT approach for craniospinal irradiation without beam edge matching for field junctions.
Traditionally craniospinal irradiation treats the central nervous system using two or three adjacent field sets. We propose a technique using a three-isocenter intensity-modulated radiotherapy (IMRT) plan (jagged-junction IMRT) which overcomes problems associated with field junctions and beam edge matching and improves planning and treatment setup efficiencies with homogenous target dose distribution. ⋯ Jagged-junction IMRT planning provided good dose homogeneity and conformity to the target while maintaining a low dose to organs at risk. Results from jagged-junction IMRT plans were better than or equivalent to those from the conventional technique. Jagged-junction IMRT optimization smoothly distributed dose in the junction between field sets. Because there was no beam matching, this treatment technique is less likely to produce hot or cold spots at the junction, in contrast to conventional techniques. The planning process is also simplified as only one IMRT plan is required for the entire target volume.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2012
A mathematical study to select fractionation regimen based on physical dose distribution and the linear-quadratic model.
Hypofractionated irradiation is often used in precise radiotherapy instead of conventional multifractionated irradiation. We propose a novel mathematical method for selecting a hypofractionated or multifractionated irradiation regimen based on physical dose distribution adding to biologic consideration. ⋯ Our mathematical method shows that multifractionated irradiation with a constant dose is better if the ratio of α/β for the OAR and tumor is less than the ratio of the dose for the OAR and tumor, whereas hypofractionated irradiation is better otherwise.