International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Jul 2004
Influence of radiation therapy parameters on outcome in children treated with radiation therapy for localized parameningeal rhabdomyosarcoma in Intergroup Rhabdomyosarcoma Study Group trials II through IV.
To evaluate the impact of radiation treatment parameters on cancer control outcomes for children with parameningeal rhabdomyosarcoma (PM-RMS) treated on Intergroup Rhabdomyosarcoma Study Group protocols II through IV (including IRS-IV pilot). ⋯ The availability of cross-sectional diagnostic images (CT or MRI) has improved detection of ICE. Starting radiation therapy within 2 weeks of diagnosis for patients with signs of meningeal impingement was associated with lower rates of local failure. When no signs of meningeal impingement were present, delay of radiation therapy for more than 10 weeks did not impact local failure rates. Whole brain radiation therapy is unnecessary in PM-RMS. A dose of at least 47.5 Gy seems to be associated with lower rates of local failure, especially when tumor diameter is > or =5 cm.
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Int. J. Radiat. Oncol. Biol. Phys. · Jul 2004
3D CT-based high-dose-rate breast brachytherapy implants: treatment planning and quality assurance.
Although accelerated partial breast irradiation (APBI) as the sole radiation modality after lumpectomy has shown promising results for select breast cancer patients, published experiences thus far have provided limited information on treatment planning methodology and quality assurance measures. A novel three-dimensional computed tomography (CT)-based treatment planning method for accurate delineation and geometric coverage of the target volume is presented. A correlation between treatment volume and irradiation time has also been studied for quality assurance purposes. ⋯ CT-based treatment planning allowed excellent visualization of the lumpectomy cavity and normal structures, thereby improving target volume delineation and optimal coverage, relative to conventional orthogonal film dosimetry. Using the Manchester volume implant table calculated irradiation time can be used as quality assurance for the HDR computed time. Thus dosimetric quality assurance and adequate target volume coverage can be concurrently confirmed, allowing prospective evaluation and optimization of implants.
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Int. J. Radiat. Oncol. Biol. Phys. · Jul 2004
Randomized Controlled Trial Multicenter Study Clinical TrialLong-term results of a phase III trial comparing once-daily radiotherapy with twice-daily radiotherapy in limited-stage small-cell lung cancer.
This Phase III study was performed to determine whether twice-daily (b.i.d.) radiotherapy (RT) resulted in better survival than once-daily (q.d.) RT for patients with limited-stage small-cell lung cancer (LD-SCLC). ⋯ Although this study did not demonstrate an advantage to split-course b.i.d. RT, the long-term survival was favorable, likely reflecting the positive influences of concurrent combined modality therapy and prophylactic cranial RT.
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Int. J. Radiat. Oncol. Biol. Phys. · Jul 2004
Daily ultrasound-based image-guided targeting for radiotherapy of upper abdominal malignancies.
Development and implementation of a strategy to use a stereotactic ultrasound (US)-based image-guided targeting device (BAT) to align intensity-modulated radiotherapy (IMRT) target volumes accurately in the upper abdomen. Because the outlines of such targets may be poorly visualized by US, we present a method that uses adjacent vascular guidance structures as surrogates for the target position. We assessed the potential for improvement of daily repositioning and the feasibility of daily application. ⋯ Daily US-guided BAT targeting for patients with upper abdominal tumors was feasible in the vast majority of attempted setups. This method of US-based image-guided tumor targeting has been successfully implemented in clinical routine. The observed improved daily repositioning accuracy might allow for individualized reduction of safety margins and optional dose escalation. Compared with the established application of the BAT device for prostate radiotherapy, in which the target can be directly visualized, the TV in the present study was predominantly positioned relative to guidance vascular structures in close anatomic relation. We perceived an enormous potential in improved and individualized patient positioning for fractionated radiotherapy and also for stereotactic extracranial radiotherapy and radiosurgery, especially for tumors of the liver and pancreas.
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Int. J. Radiat. Oncol. Biol. Phys. · Jul 2004
Impact on cytoprotective efficacy of intermediate interval between amifostine administration and radiotherapy: a retrospective analysis.
To evaluate the cytoprotective impact of the interval between amifostine administration and radiotherapy (RT). ⋯ A significantly better cytoprotective effect of amifostine against radiation-induced mucositis, dermatitis, and alopecia was noted if RT was administered no later than 15 min after i.v. amifostine infusion. The results presented here need additional investigation with randomized prospective trials.