International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Apr 2005
Selecting breast cancer patients with T1-T2 tumors and one to three positive axillary nodes at high postmastectomy locoregional recurrence risk for adjuvant radiotherapy.
To define the individual factors and combinations of factors associated with increased risk of locoregional recurrence (LRR) that may justify postmastectomy radiotherapy (PMRT) in patients with T1-T2 breast cancer and one to three positive nodes. ⋯ Clinical and pathologic factors can identify women with T1-T2 breast cancer and one to three positive nodes at high LRR risk after mastectomy. Age <45 years, >25% of nodes positive, a medial tumor location, and ER-negative status were statistically significant independent factors associated with greater LRR, meriting consideration and discussion of PMRT. Combinations of these factors further augmented the LRR risk, warranting recommendation of PMRT to optimize locoregional control and potentially improve survival. The absence of high-risk factors identifies women who may reasonably be spared the morbidity of PMRT.
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Int. J. Radiat. Oncol. Biol. Phys. · Apr 2005
Impact of IMRT and leaf width on stereotactic body radiotherapy of liver and lung lesions.
The present study explored the impact of intensity-modulated radiotherapy (IMRT) on stereotactic body RT (SBRT) of liver and lung lesions. Additionally, because target dose conformity can be affected by the leaf width of a multileaf collimator (MLC), especially for small targets and stereotactic applications, the use of a micro-MLC on "uniform intensity" conformal and intensity-modulated SBRT was evaluated. ⋯ Standard conformal treatment techniques for SBRT could not be improved with inversely planned IMRT approaches. Dose calculation algorithms applied in optimization modules for IMRT applications in the thoracic region need to be based on the most accurate dose calculation algorithms, especially when using higher energy photon beams.
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Int. J. Radiat. Oncol. Biol. Phys. · Apr 2005
Hypofractionated conformal stereotactic radiotherapy alone or in combination with whole-brain radiotherapy in patients with cerebral metastases.
The aim was to evaluate treatment of cerebral metastases with hypofractionated conformal stereotactic radiotherapy (HCSRT) or whole-brain radiotherapy (WBRT) in combination with a stereotactic boost. ⋯ Although there may be a higher risk of distant new metastases, HCSRT as a treatment for brain metastases seems to be as effective as WBRT in combination with a stereotactic boost. Complications are in the range of what has been reported previously.
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Int. J. Radiat. Oncol. Biol. Phys. · Apr 2005
Biochemical failure and the temporal kinetics of prostate-specific antigen after radiation therapy with androgen deprivation.
The accuracy of the American Society of Therapeutic Radiation Oncology consensus definition of biochemical failure (BF) after radiation therapy (RT) and androgen deprivation (AD) has been questioned, because posttreatment prostate-specific antigen (PSA) levels typically rise after release from AD, and misclassification of BF may be made. The temporal kinetics of posttreatment PSA levels was examined to define the error in the classification of BF. ⋯ The temporal kinetics of posttreatment PSA after RT+AD and RT alone are different. The American Society of Therapeutic Radiation Oncology definition for biochemical failure overestimates BF in 20-30% after RT+AD compared to 5% after RT alone.
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Int. J. Radiat. Oncol. Biol. Phys. · Apr 2005
Intensity-modulated radiotherapy for head-and-neck rhabdomyosarcoma.
To determine the preliminary results of intensity-modulated radiotherapy (IMRT) for head-and-neck rhabdomyosarcoma. ⋯ IMRT with image fusion results in outstanding local control despite the use of a reduced margin. However, survival among patients with alveolar histologic findings or intracranial extension remains unacceptably low.