International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 1995
Split-course accelerated therapy in head and neck cancer: an analysis of toxicity.
To retrospectively assess a protocol of split-course accelerated radiation therapy (SCAT) for selected head and neck cancers. ⋯ Given the encouraging complete response rate and local control for such advanced tumors, SCAT for locoregionally advanced tumors merits further investigation. However, because of the significant late toxicity observed, the total dose, interfraction interval, and fractionation technique used should be reconsidered.
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 1995
The influence of positive margins and nerve invasion in adenoid cystic carcinoma of the head and neck treated with surgery and radiation.
Surgery is the primary treatment for adenoid cystic carcinomas arising from major and minor salivary glands of the head and neck. However, local recurrence is frequent because of the infiltrative growth pattern and perineural spread associated with these tumors. At UTMDACC, we have had a longstanding policy of using postoperative radiotherapy to reduce the risk of local recurrence and to avoid the need for radical surgery; this 30-year retrospective study analyzes the results of this combined modality approach. ⋯ Excellent local control rates were obtained in this population using surgery and postoperative radiotherapy and we recommend this combined approach for most patients with adenoid cystic carcinomas of the head and neck. Perineural invasion was an adverse prognostic factor only when a major (named) nerve was involved. Microscopic positive margins was also an adverse prognostic factor, but even when present, local control was achieved in over 80% of our patients. We recommend a dose of 60 Gy to the tumor bed, supplemented to 66 Gy for patients with positive margins. Despite effective local therapy, one-third of patients fail systemically, and good treatment to address this problem is lacking.
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 1995
A method for delivering accurate and uniform radiation dosages to the head and neck with asymmetric collimators and a single isocenter.
To investigate the use of asymmetric collimators and a single isocenter for delivering a uniform, accurate dose of radiation to the head, neck, and supraclavicular lymph nodes. ⋯ The asymmetric collimators lead to easy and accurate patient setup. The absence of the trapezoid effect resulted in the complete coverage of the submandibular and cervical nodes without any hot spots.