International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Oct 1995
Long-term visual changes following pituitary irradiation.
To analyze possible long-term effects of pituitary irradiation on visual fields and acuity. ⋯ Postoperative radiation for partially resected or recurrent pituitary adenomas using megavoltage radiation, as well as modern field arrangements and fractionation, is extremely effective and safe. Ninety-five percent of patients are free of recurrence with not deterioration in the visual fields or acuities. Some patients experienced neurovascular symptoms (mostly vascular headaches) following surgery and radiation. There is a trend (p2 = 0.064) toward increased symptoms following higher radiation doses.
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Int. J. Radiat. Oncol. Biol. Phys. · Oct 1995
Long-term follow-up of efficacy and safety of megavoltage radiotherapy in high-risk giant cell tumors of bone.
Giant cell tumors of the bone are rare and have variable presentations and natural history. There may be significant functional sequelae as a result of their locally aggressive nature or as a result of treatment. We reviewed the long-term results of radiotherapy for high risk giant cell tumors to assess: the efficacy of radiotherapy and the potential late toxicity of treatment, and to determine indications for radiation treatment. ⋯ Long-term results in this series indicate that radiotherapy in modest doses (35 Gy in 15 fractions or equivalent) is a safe and effective option for primary and recurrent giant cell tumors of the bone. Radiotherapy should be used if surgery would result in significant functional morbidity and should be considered in select sites where the probability of recurrence is high and there is potential for significant morbidity from tumor relapse or subsequent surgery.
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Int. J. Radiat. Oncol. Biol. Phys. · Oct 1995
Analysis of weekly complete blood counts in patients receiving standard fractionated partial body radiation therapy.
Hematopoiesis is among the most sensitive systems in the body to radiation. Routine complete blood counts (CBCs) are common in clinical radiotherapy practice. Only a few studies have attempted to characterize the behavior of peripheral blood levels during partial body radiation therapy with field sizes smaller than those used in hemibody or total nodal irradiation. Such information is needed to identify which patients are at risk for cytopenia and require close monitoring. ⋯ Low CBC levels during radiation therapy are likely to be the result of other medical problems that cancer patients face. Regional irradiation with small field sizes (< 40% of total body marrow) typically used in clinical radiotherapy is unlikely to be the cause of marrow depression significant enough to warrant medical intervention. Blood levels taken during the first week of treatment (Week 1) can be used to determine risks of developing critical nadirs. Localized breast and prostate cancer patients are unlikely to require routine CBCs if initial levels are normal. Routine CBC levels on all radiation oncology patients without other reasons for hematopoietic depression requires reevaluation, as millions of dollars are spent on unnecessary testing. If weekly CBC blood levels are avoided in localized breast and prostate cancer patients, this alone could potentially result in a savings of as much as $40 million a year nationally.