International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Jul 2004
Factors predictive of having four or more positive axillary lymph nodes in patients with positive sentinel lymph nodes: implications for selection of radiation fields.
The optimal design of radiation fields for patients with positive sentinel lymph nodes (SLNs) who do not undergo axillary dissection is unknown. We have previously shown that modified breast tangent fields can include most axillary Level I-II lymph nodes. We have also reported that irradiation of the axillary apex/supraclavicular fossa is indicated for patients with four or more positive axillary lymph nodes. To determine the optimal arrangement for patients with positive SLNs, we studied what factors predicted for having four or more positive lymph nodes. ⋯ It is reasonable to treat with modified tangents fields that include most axillary Level I-II nodes for patients with one positive SLN who do not undergo axillary dissection if drainage is seen on lymphoscintigraphy and no LVSI is present. This approach is also reasonable for patients treated with neoadjuvant chemotherapy who have Stage II disease, no LVSI, and only one positive SLN. The remaining patients have a greater risk of having four or more positive lymph nodes, and, therefore, the high axilla/supraclavicular fossa should also be included in the radiation fields.
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Int. J. Radiat. Oncol. Biol. Phys. · Jul 2004
Randomized Controlled Trial Clinical TrialPerirectal seeds as a risk factor for prostate brachytherapy-related rectal bleeding.
To correlate rectal wall doses and perirectal seed numbers with late rectal bleeding after prostate brachytherapy. ⋯ A limited number of errant perirectal sources in itself does not appear to place patients at increased risk of rectal bleeding, providing that the overall rectal wall doses are within acceptable values.
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Int. J. Radiat. Oncol. Biol. Phys. · Jul 2004
Low complication rates are achievable after postmastectomy breast reconstruction and radiation therapy.
To report our institution's experience of complications and cosmetic results among patients who underwent modified radical mastectomy followed by reconstruction and radiation therapy (RT). ⋯ Patients treated with breast reconstruction and RT can experience a very low rate of major complications. We demonstrate no significant difference in the overall rate of major complications between TRAM and TE/I patients. Bolus can be safely used during postmastectomy RT with reconstruction, and we advocate the use of a custom wax bolus in the treatment of these patients. Postmastectomy RT should be considered in all eligible patients, even in the setting of reconstruction.
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Int. J. Radiat. Oncol. Biol. Phys. · Jul 2004
Stereotactic conformal radiotherapy in patients with growth hormone-secreting pituitary adenoma.
To evaluate the reduction of hormonal overproduction and side effects as well as survival rates after fractionated stereotactic conformal radiotherapy (FSRT) and radiosurgery in patients with growth hormone (GH)-secreting pituitary adenoma. ⋯ Stereotactic conformal radiotherapy is effective and safe in the treatment of GH-secreting pituitary adenoma to reduce hormonal overproduction and to improve local control. It is an alternative option to surgery especially for patients at high risk of surgical complications due to comorbidity.
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Int. J. Radiat. Oncol. Biol. Phys. · Jul 2004
Stereotactic radiosurgical treatment in 103 patients for 153 cerebral melanoma metastases.
To report on the outcome of patients with melanoma brain metastases treated with stereotactic radiosurgery (SRS). ⋯ Initial SRS alone was an effective treatment modality for smaller cerebral melanoma metastases, achieving a 75% incidence of 1-year LC for < or =2 cm(3) single brain metastases and should be considered in patients with SIR >6. The role of WBRT in melanoma brain metastases cannot be addressed, owing to retrospective bias toward administering this treatment to patients with more aggressive disease. A prospective study is needed to assess the role of WBRT in patients with melanoma brain metastasis.