International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Jan 2000
Clinical TrialImproving the dosimetric coverage of interstitial high-dose-rate breast implants.
We performed a retrospective computed tomography (CT)-based three-dimensional (3D) dose-volume analysis of high-dose-rate (HDR) interstitial breast implants to evaluate the adequacy of lumpectomy cavity coverage, and then designed a simple, reproducible algorithm for dwell-time adjustment to correct for underdosage of the lumpectomy cavity. ⋯ Lumpectomy cavity coverage sometimes appears suboptimal with interstitial HDR breast brachytherapy using our current technique. A simple dwell-time increase at only 1-3 dwell positions can compensate for some underdosage without creating significant regions of overdosage. Using simple methodology, a single reference point representing the underdosed region can be utilized for initial selection of the dwell positions to be increased.
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Int. J. Radiat. Oncol. Biol. Phys. · Jan 2000
Optimal radiotherapy for prostate cancer: predictions for conventional external beam, IMRT, and brachytherapy from radiobiologic models.
To determine, on the basis of radiobiological models, optimal modalities of radiotherapy for localized prostate cancer, and to provide a rational basis for therapeutic decisions. ⋯ The radiobiological models presented suggest a rational basis for choosing among several radiotherapeutic modalities based on biologic risk factors. In addition, they suggest that IMRT may potentially be superior to 3D-CRT in allowing dose escalation without increased morbidity, and that brachytherapy, as monotherapy or as boost, may achieve superior tumor control compared with dose escalation 3D-CRT. The latter conclusion is supported by clinical data.
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Int. J. Radiat. Oncol. Biol. Phys. · Jan 2000
Comparative StudyThe significance of extracapsular extension of axillary lymph node metastases in early-stage breast cancer.
To investigate if extracapsular extension (ECE) of axillary lymph node metastases predicts for a decreased rate of disease-free survival or an increased rate of regional recurrence of breast carcinoma. ⋯ In this population of patients with nodal involvement, the presence of ECE correlates with the number of involved LN but does not appear to add predictive power to models of local, regional, or distant recurrence when the number of positive LN is included.
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Int. J. Radiat. Oncol. Biol. Phys. · Jan 2000
Seed fixity in the prostate/periprostatic region following brachytherapy.
Although postoperative dosimetric analyses of prostate brachytherapy are commonly reported, the long-term persistence, or fixity, of seeds implanted in the prostate gland and periprostatic region remains unclear, with only a few reports regarding the loss or migration of the seeds in the implanted region and none which correlate lung embolization to pelvic seed loss. ⋯ With a median follow-up of 9 months, 125I seeds embedded in a vicryl suture or 103Pd seeds can be safely implanted in the prostate and periprostatic tissue with a high probability of prostate bed seed fixity and a low incidence of radioactive seed embolization to the lungs.