International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Feb 1997
Biochemical disease-free survival following 125I prostate implantation.
To assess the 5-year clinical and biochemical results of ultrasound-guided permanent 125I brachytherapy in early adenocarcinoma of the prostate. Biochemical disease-free survival (BDFS) is reported, using PSA follow-up and is compared to the surgical and radiation therapy literature. ⋯ While biochemical disease-free survival reports in the literature are immature and have short follow-up, our data compares favorably with studies following radical prostatectomy or radiation therapy. Further follow-up of this cohort is required. The complication rate is low and patient acceptance excellent. Permanent implantation of 125I as the sole treatment for early prostate adenocarcinoma is a viable alternative for patients with early-stage and low- to moderate-grade cancers. The PSA provides significant prognostic information and aids in case selection. Better management options are needed for high grade and bilateral tumors.
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Int. J. Radiat. Oncol. Biol. Phys. · Feb 1997
Locally advanced primary colorectal cancer: intraoperative electron and external beam irradiation +/- 5-FU.
For locally advanced primary colorectal cancer, our institution has combined intraoperative electron irradiation (IOERT) with external beam irradiation (EBRT) +/- 5-fluorouracil (5-FU) and surgical resection. Disease control and survival were compared with the current IOERT and prior non-IOERT regimens. ⋯ Both overall survival and disease control appear to be improved with the addition of IOERT to standard treatment. More routine use of systemic therapy is indicated as a component of IOERT containing treatment regimens because the incidence of distant metastases was 50% of patients at risk.
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Int. J. Radiat. Oncol. Biol. Phys. · Feb 1997
Pediatric medulloblastoma: radiation treatment technique and patterns of failure.
In this study factors are analyzed that may potentially influence the site of failure in pediatric medulloblastoma. Patient-related, disease-related, and treatment-related variables are analyzed with a special focus on radiotherapy time-dose and technical factors. ⋯ A correlation between WBI field correctness and supratentorial failure-free survival was observed. Treatment protocols should be considered that limit supratentorial irradiation mainly to subsites at highest risk of relapse. Optimized conformal therapy or proton beam therapy may help to reach this goal. Treating the spine with electron beams was not deletereous. A significant correlation between local control and other technical factors was not observed, including those relating to posterior fossa treatment. The use of small conformal tumor bed boost fields may be prefered to the larger posterior fossa fields usually considered as the standard treatment approach.
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Int. J. Radiat. Oncol. Biol. Phys. · Feb 1997
Comparative Study"Sandwich" preoperative and postoperative combined chemotherapy and radiation in tethered and fixed rectal cancer: impact of treatment intensity on local control and survival.
The present "sandwich" preoperative and postoperative chemotherapy and radiation study was undertaken to evaluate the impact of treatment intensity on the local control and survival in tethered or fixed rectal adenocarcinoma (T3, 4 NX M0). ⋯ More intensive radiation and chemotherapy appeared to improve the resectability, local control, and survival in tethered and fixed rectal cancers. There was a moderate but acceptable increase in the bowel morbidity.
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Int. J. Radiat. Oncol. Biol. Phys. · Feb 1997
Optimization of conformal radiation treatment of prostate cancer: report of a dose escalation study.
The development of conformal radiation technique including improved patient immobilization has allowed us to test the value of dose escalation in optimizing the radiation treatment of prostate cancer. ⋯ Patients with pretreatment PSA < 10 ngm/ml do not benefit from dose escalation, and the serious late morbidity of conformal radiation at 70 Gy is < 3%. Patients with PSA values 10-19.9 ngm/ml and 20+ ngm/ml benefit from dose escalation beyond 70 Gy. Treatment beyond 75 Gy results in > 10% serious morbidity unless special precautions are taken to protect the rectal mucosa. All levels of severity of radiation morbidity show a dose response and combined with the dose response for bNED survival these data allow the optimization of treatment.