International journal of radiation oncology, biology, physics
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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.
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Int. J. Radiat. Oncol. Biol. Phys. · Jul 2001
ReviewCervical lymph node metastases from occult squamous cell carcinoma: cut down a tree to get an apple?
To review the value of extended diagnostic work-up procedures and to compare the results of comprehensive or volume-restricted radiotherapy in patients presenting with cervical lymph node metastases from clinically undetectable squamous cell carcinoma. ⋯ Physical examination, CT or MRI, and panendoscopy with biopsies remain the standard work-up for these patients. Routine use of PET or laser-induced fluorescence imaging cannot be firmly advocated based on presently available data. Although combination of nodal dissection with comprehensive radiotherapy yielded most favorable results, its impact on the quality of life should be recognized, and the confounding effects of patient selection for various treatment modalities on therapeutic outcome cannot be ruled out. A randomized trial comparing the therapeutic value of comprehensive vs. volume-limited radiotherapy is being considered.
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Int. J. Radiat. Oncol. Biol. Phys. · Jul 2001
ReviewCervical lymph node metastases from occult squamous cell carcinoma: cut down a tree to get an apple?
To review the value of extended diagnostic work-up procedures and to compare the results of comprehensive or volume-restricted radiotherapy in patients presenting with cervical lymph node metastases from clinically undetectable squamous cell carcinoma. ⋯ Physical examination, CT or MRI, and panendoscopy with biopsies remain the standard work-up for these patients. Routine use of PET or laser-induced fluorescence imaging cannot be firmly advocated based on presently available data. Although combination of nodal dissection with comprehensive radiotherapy yielded most favorable results, its impact on the quality of life should be recognized, and the confounding effects of patient selection for various treatment modalities on therapeutic outcome cannot be ruled out. A randomized trial comparing the therapeutic value of comprehensive vs. volume-limited radiotherapy is being considered.
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Int. J. Radiat. Oncol. Biol. Phys. · Jan 2001
Review Comparative StudyQuality of life study in prostate cancer patients treated with three-dimensional conformal radiation therapy: comparing late bowel and bladder quality of life symptoms to that of the normal population.
The goals of this study were twofold. First, differences were quantified for symptoms that impact bowel and bladder quality of life (QOL) in prostate cancer patients treated with three-dimensional conformal radiotherapy (3DCRT) alone to the prostate vs. whole pelvis with prostate boost. Second, bowel and bladder QOL measures for these patients were compared to those of the normal population of men with a similar age distribution. ⋯ This is the first long-term study of QOL in men treated with high-dose 3DCRT for prostate cancer. It demonstrates that these men enjoy QOL related to bladder function similar to that of the normal population. Few patients report bother from bowel symptoms as a big problem but tend to have more very small to moderate bother than the normal population. Treatment of prostate cancer patients to the whole pelvis may result in decreased QOL as defined by rectal urgency, the use of pads for bowel incontinence, and satisfaction with bowel functioning. However, regardless of field size, men are generally satisfied with their bowel and bladder functioning three to six years post treatment.
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Int. J. Radiat. Oncol. Biol. Phys. · Jul 2000
ReviewThe influence of the radicality of resection and dose of postoperative radiation therapy on local control and survival in carcinomas of the upper aerodigestive tract.
To evaluate dose concepts in postoperative irradiation of carcinomas of the upper aerodigestive tract according to the radicality of resection. ⋯ In postoperative radiotherapy of head and neck carcinomas, doses adapted to the risk of locoregional recurrent disease should be applied. Patients with R1 and R2 resections should be treated with doses of more than 68 Gy (2 Gy/fraction, 5 fractions/week) (with close margins [< 3 mm] more than 66 Gy) to achieve an improvement in locoregional control and survival.