International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2001
ReviewThe rush to judgment: Does the evidence support the enthusiasm over three-dimensional conformal radiation therapy and dose escalation in the treatment of prostate cancer?.
To discuss the assumptions behind and current clinical evidence on three-dimensional conformal radiation therapy (3D-CRT) and dose escalation in the treatment of prostate cancer. ⋯ Although 3D-CRT is a promising technology that many radiation oncologists and clinics are quickly adopting to treat such tumors as prostate cancer, the long-term evidence on the benefits and limitations of this technology is still lacking. Until we have solid long-term evidence on the true clinical potential of this new technology, let us not rush to judgment, but exercise caution, diligence, and thoughtfulness in using this new technology to treat our patients.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2001
The influence of interpatient and intrapatient rectum variation on external beam treatment of prostate cancer.
The rectal dose/volume relationship and inherent variations thereof are fundamental parameters to guide dose escalation in prostate cancer treatment. This study evaluates the effect of rectal dose/volume variation on the risk of rectal complication for different planning target volume (PTV) constructions. ⋯ Shape and position variation of rectum has less influence on treatment planning in the conventional 2D treatment of prostate cancer. However, this influence is quickly growing with high treatment dose or small CTV-to-PTV margins. To reduce the variation and uncertainties in the treatment planning evaluation associated with the inter- and intrapatient rectal dose/volume variation, the iso-NTCP model and treatment image feedback technique can be applied in dose escalation trials of prostate cancer treatment.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2001
Randomized Controlled Trial Multicenter Study Clinical TrialThe effect of oral sucralfate on the acute proctitis associated with prostate radiotherapy: a double-blind, randomized trial.
Acute rectal complications occur in the majority of patients receiving external-beam radiotherapy for carcinoma of the prostate. Sucralfate has been proposed to reduce radiation-induced mucosal injury by forming a protective barrier on ulcer bases, binding local growth factors, and stimulating angiogenesis. However, there is conflicting clinical evidence as to whether sucralfate, taken prophylactically during radiotherapy, can ameliorate the symptoms of acute radiation proctitis. ⋯ This study suggests that oral sucralfate taken prophylactically during radiotherapy does not ameliorate the symptoms of acute radiation proctitis and may increase acute bleeding. The cause of the increased bleeding in the sucralfate group is unclear. As the pathogenesis of acute and late reactions are different, late follow-up, which includes sigmoidoscopic evaluation, is currently being performed on this cohort of patients.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2001
A prospective quality-of-life study in men with clinically localized prostate carcinoma treated with radical prostatectomy, external beam radiotherapy, or interstitial brachytherapy.
To prospectively assess the health-related quality of life (HRQOL) and changes in HRQOL during the first year after 3 different treatments for clinically localized prostate cancer. ⋯ The results of this analysis suggest that significant decreases in HRQOL, as measured by the FACT-P instrument, are evident in the first month after IB or RP, but not after EBRT. One year after treatment, however, the FACT-P scores were not statistically different from the baseline measures for any group. For all treatment groups, most of the HRQOL decreases were observed in the physical, functional, and prostate cancer-specific domains. These results suggest that the HRQOL changes are likely to be treatment-specific, further emphasizing the importance of a randomized trial comparing the different treatment options in this population of men.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2001
Fatigue, serum cytokine levels, and blood cell counts during radiotherapy of patients with breast cancer.
To assess the level of fatigue during the course of adjuvant radiotherapy (RT) of breast cancer patients and its relation to anxiety, depression, serum cytokines, and blood count levels. ⋯ We observed an increase in fatigue during adjuvant RT of patients with breast cancer. Fatigue returned to pretreatment levels 2 months after treatment. No evidence was found that anxiety, depression, serum levels of IL-1beta, IL-6, tumor necrosis factor-alpha, or declining hemoglobin levels were responsible for the treatment-induced fatigue.