Journal of clinical oncology : official journal of the American Society of Clinical Oncology
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Improving the conformity of the radiation dose to targets in the head and neck promises reduced toxicity and, in some cases, potentially improved local-regional tumor control. Intensity-modulated radiotherapy (IMRT) is a method that allows highly conformal delivery of radiotherapy. ⋯ The use of IMRT has raised multiple issues related to target definition, optimal treatment delivery methods, and the need to account for anatomic changes occurring during therapy. Some of these issues are reviewed in this article.
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Randomized Controlled Trial Multicenter Study
Zoledronic acid inhibits adjuvant letrozole-induced bone loss in postmenopausal women with early breast cancer.
Treatment with aromatase inhibitors decreases bone mineral density (BMD) and may increase the risk of fractures in postmenopausal women with early-stage breast cancer. The addition of zoledronic acid to adjuvant letrozole therapy may protect against bone loss. ⋯ With 1 year of follow-up, results of the primary end point of the Zometa-Femara Adjuvant Synergy Trial (Z-FAST) indicate that upfront zoledronic acid therapy prevents bone loss in the LS in postmenopausal women receiving adjuvant letrozole for early-stage breast cancer.
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Randomized Controlled Trial
Zoledronic acid prevents cancer treatment-induced bone loss in premenopausal women receiving adjuvant endocrine therapy for hormone-responsive breast cancer: a report from the Austrian Breast and Colorectal Cancer Study Group.
Adjuvant therapy for breast cancer can be associated with decreased bone mineral density (BMD) that may lead to skeletal morbidity. This study examined whether zoledronic acid can prevent bone loss associated with adjuvant endocrine therapy in premenopausal patients. ⋯ Endocrine therapy caused significant bone loss that increased with treatment duration in premenopausal women with breast cancer. Zoledronic acid 4 mg every 6 months effectively inhibited bone loss. Regular BMD measurements and initiation of concomitant bisphosphonate therapy on evidence of bone loss should be considered for patients undergoing endocrine therapy.