International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Jul 2002
Multicenter Study Comparative StudyA multi-institutional review of radiosurgery alone vs. radiosurgery with whole brain radiotherapy as the initial management of brain metastases.
Data collected from 10 institutions were reviewed to compare survival probabilities of patients with newly diagnosed brain metastases managed initially with radiosurgery (RS) alone vs. RS + whole brain radiotherapy (WBRT). ⋯ Omission of up-front WBRT does not seem to compromise length of survival in patients treated with RS for newly diagnosed brain metastases.
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Int. J. Radiat. Oncol. Biol. Phys. · Jul 2002
Craniopharyngioma: the St. Jude Children's Research Hospital experience 1984-2001.
To review our institution's experience in the treatment of craniopharyngioma and assess the merits of initial therapy with limited surgery and irradiation. ⋯ The acute neurologic, cognitive, and endocrine effects of surgery often affect long-term function and quality of life. Our experience suggests that limited surgery and radiotherapy cause lesser or comparable sequelae. Diabetes insipidus was the only endocrine deficiency that differed substantially in frequency between the two groups. Newer radiation planning and delivery techniques may make a combined-modality approach a good initial option for most patients.
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Int. J. Radiat. Oncol. Biol. Phys. · Jul 2002
Impact of postimplant edema on V(100) and D(90) in prostate brachytherapy: can implant quality be predicted on day 0?
To determine the effect of edema on the dosimetric parameters V(100) (percentage of prostate volume that received a dose equal to or greater than the prescribed dose) and D(90) (minimal dose delivered to 90% of prostate volume) in 125I prostate brachytherapy and to determine whether the edema can be used to predict implant quality on the day of the implant (Day 0). ⋯ V(100) and D(90) increased by 5% +/- 6% and 15% +/- 17%, respectively, during the first 30-60 days after implant. The results of a multivariate linear regression analysis showed that the increases in V(100) and D(90) were proportional to both the magnitude of the edema and the values of these parameters on Day 0. The relationships derived by linear regression analysis predict V(100) and D(90) at 30-60 days after implant to within +/-4% and +/-24 Gy, respectively. However, predicting the 30-60-day V(100) and D(90) on Day 0 is a poor substitute for obtaining a 30-60-day CT scan, because the uncertainty in the predicted values is greater by a factor of > or =2. Nevertheless, on average, the predicted values should provide a more reliable estimate of the actual V(100) and D(90) than the Day 0 values that ignore the effect of edema altogether. The increase in V(100) was also found to depend on the width of the preplan dose margin; therefore, our results for V(100) are only valid for implants planned with a 3-5-mm margin.
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Int. J. Radiat. Oncol. Biol. Phys. · Jul 2002
MRI simulation: effect of gradient distortions on three-dimensional prostate cancer plans.
To quantify the dosimetric consequences of external patient contour distortions produced on low-field and high-field MRIs for external beam radiation of prostate cancer. ⋯ For patients with lateral separations <40 cm, a homogeneous calculation simulated using a 1.5 T MRI or a 0.23 T MRI with a gradient distortion correction will yield a monitor unit calculation indistinguishable from that generated using CT simulation.
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Int. J. Radiat. Oncol. Biol. Phys. · Jul 2002
Intravaginal high-dose-rate brachytherapy for Stage IB (FIGO Grade 1, 2) endometrial cancer.
To evaluate the outcome of patients with Stage IB Grades 1 and 2 endometrial cancer treated with adjuvant high-dose-rate intravaginal brachytherapy. ⋯ On the basis of this retrospective study, adjuvant postoperative high-dose-rate intravaginal brachytherapy provides excellent outcomes and acceptable morbidity. These results compare very favorably with those reported in the literature using surgery alone or with pelvic radiation.