Acta oncologica
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The MammoSite radiotherapy system is an alternative treatment option for patients with early-stage breast cancer to overcome the longer schedules associated with external beam radiation therapy. The device is placed inside the breast surgical cavity and inflated with a combination of saline and radiographic contrast to completely fill the cavity. The treatment schedule for the MammoSite monotherapy is 34 Gy delivered in 10 fractions at 1.0 cm from the balloon surface with a minimum of 6 hours between fractions on the same day. ⋯ Initial clinical results have shown that the MammoSite device could be used as a sole radiation treatment for selected patients with early stage breast cancer providing good local control, minimal complication rate and excellent cosmesis.
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Estrogen receptor-alpha (ERalpha) is an important prognostic and predictive marker in breast cancer. ERalpha signaling normally down-regulates expression of Apolipoprotein D (ApoD), a lipocalin that binds, transports or chelates lipophilic ligands, including tamoxifen (TAM). Hence, the co-expression of ApoD may therefore identify clinical relevant subgroups of ERalpha positive breast cancer patients. ⋯ ERalpha and ApoD(CN) co-expression seems to be of prognostic importance in node positive elderly patients with operable breast cancer. In addition, we hypothesize that ApoD(CN) expression may be a novel marker and/or mechanism of TAM resistance in postmenopausal node positive patients. Thus, when targeting the ERalpha pathway in these patients, the ApoD status of the tumor may be of clinical relevance.
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Recently, Varian Medical Systems have announced the introduction of a new treatment technique, in which dose is delivered over a single gantry rotation with variable MLC positions, dose rate and gantry speed. In February 2008, a preclinical installation of the RapidArc beam delivery approach was carried out on a Varian Clinac at Rigshospitalet in Copenhagen. The purpose of the installation was to perform measurements to verify the correctness of doses delivered with the RapidArc technique. In May 2008, the clinical release of the RapidArc application was installed at Rigshospitalet. ⋯ The delivery of RapidArc beam delivery has been verified to correspond well with calculated dose distributions for a number of different cases. The delivery was very reproducible, and was carried out with high stability of the accelerator performance.
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Comparative Study
Variation in radiation sensitivity and repair kinetics in different parts of the spinal cord.
The spinal cord, known for its strongly serial character and high sensitivity to radiation even when a small segment is irradiated, is one of the most critical organs at risk to be spared during radiation therapy. To compare the sensitivity of different parts of the spinal cord, data for radiation myelopathy have been used. ⋯ Large differences in radiation response between the cervical and thoracic region of spinal cord are thus observed: cervical myelopathy seems to be characterized by medium seriality, while thoracic spinal cord is characterized by a highly serial dose-response. The much steeper dose-response curve for cervical spinal cord myelopathy can be interpreted as a higher number of functional subunits consistent with a higher amount of white matter close to the brain.