International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Apr 2003
ReviewOutcome and patterns of failure in pathologic stages I-IV clear-cell carcinoma of the endometrium: implications for adjuvant radiation therapy.
To evaluate the outcome and patterns of failure in women with uterine clear-cell carcinoma and discuss implications for adjuvant radiation therapy (RT). ⋯ Clear-cell carcinoma comprises a small percentage of endometrial cancers, frequently presents as a mixed histology, and has a poor overall outcome. Unlike papillary serous tumors, clear-cell carcinoma does not seem to have a high propensity for abdominal failure. Our results thus do not support the routine use of whole-abdominal RT in these patients. Future protocols should focus instead on combinations of locoregional RT and chemotherapy to reduce the risk of local and systemic recurrence.
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Int. J. Radiat. Oncol. Biol. Phys. · Apr 2003
ReviewTen-year outcome after combined modality therapy for inflammatory breast cancer.
To evaluate the long-term outcome of combined modality therapy for inflammatory breast cancer. ⋯ The outcomes for patients completing multimodality therapy compare favorably with published data; however, the exclusion of patients with progression during induction chemotherapy may account in part for these results. The pathologic complete response rate was found to be an important prognostic factor. Selected patients with inflammatory breast cancer have the potential for long-term survival.
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Int. J. Radiat. Oncol. Biol. Phys. · Mar 2003
Review Meta AnalysisMeta-analysis of dose-fractionation radiotherapy trials for the palliation of painful bone metastases.
To compare pain relief among various dose-fractionation schedules of localized radiotherapy (RT) in the treatment of painful bone metastases. ⋯ Meta-analysis of reported randomized trials shows no significant difference in complete and overall pain relief between single and multifraction palliative RT for bone metastases. No dose-response relationship could be detected by including data from the multifraction vs. multifraction trials. Additional data are needed to evaluate the role of re-irradiation and the impact of RT on other treatment end points such as quality of life.
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To study and report 6 patients with radiation recall in unique sites, secondary to gemcitabine chemotherapy. ⋯ Radiation recall from gemcitabine chemotherapy is rare, but can potentially arise in any site that has been previously irradiated. Treating physicians must be aware of this potential toxicity from gemcitabine and radiation and discontinue the gemcitabine if radiation recall is observed.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2001
ReviewIntensity-modulated radiotherapy: current status and issues of interest.
To develop and disseminate a report aimed primarily at practicing radiation oncology physicians and medical physicists that describes the current state-of-the-art of intensity-modulated radiotherapy (IMRT). Those areas needing further research and development are identified by category and recommendations are given, which should also be of interest to IMRT equipment manufacturers and research funding agencies. ⋯ Recommendations in the areas pertinent to IMRT, including dose-calculation algorithms, acceptance testing, commissioning and quality assurance, facility planning and radiation safety, and target volume and dose specification, are presented. Several of the areas in which future research and development are needed are also indicated. These broad recommendations are intended to be both technical and advisory in nature, but the ultimate responsibility for clinical decisions pertaining to the implementation and use of IMRT rests with the radiation oncologist and radiation oncology physicist. This is an evolving field, and modifications of these recommendations are expected as new technology and data become available.