International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Jan 2004
Effect of transurethral resection on urinary quality of life after permanent prostate brachytherapy.
To determine the effect of transurethral resection on urinary function after permanent prostate brachytherapy using a validated, patient-administered, quality-of-life (QOL) instrument. ⋯ TURP results in diminished urinary QOL after brachytherapy. However, patients who underwent preimplant TURP had urinary QOL approaching that of non-TURP brachytherapy patients. Significant urinary dysfunction was noted in approximately one-half of patients who underwent postimplant TURP (especially pre- and postimplant TURP). Because most patients with brachytherapy-related urinary obstruction will eventually spontaneously void, TURP should be approached with extreme caution and only after substantial time has transpired.
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Int. J. Radiat. Oncol. Biol. Phys. · Jan 2004
Level II lymph nodes and radiation-induced xerostomia.
To investigate the influence of the cranial border of electively irradiated Level II lymph nodes on xerostomia in patients with oropharyngeal cancer using three-dimensional conformal and intensity-modulated radiotherapy (3D-CRT and IMRT). ⋯ Lowering the cranial border of the Level II lymph nodes from C1 to C2, in the case of bilateral elective neck irradiation, could be considered on the contralateral side when the risk of metastasis on that side is very low. This is especially true when IMRT is used, because the relative reduction of NTCP for xerostomia 1 year after RT could be up to 68% compared with conventional conformal RT up to C1.
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Int. J. Radiat. Oncol. Biol. Phys. · Jan 2004
The use of hypofractionated intensity-modulated irradiation in the treatment of glioblastoma multiforme: preliminary results of a prospective trial.
Despite major advances in treatment modalities, the prognosis of patients with glioblastoma multiforme (GBM) remains poor. Exploring hypofractionated regimens to replace the standard 6-week radiotherapy schedule is an attractive strategy as an attempt to prevent accelerated tumor cell repopulation. There is equally interest in dose escalation to the gross tumor volume where the majority of failures occur. We report our preliminary results using hypofractionated intensity-modulated accelerated radiotherapy regimen in the treatment of patients with GBM. ⋯ This hypofractionated accelerated irradiation schedule using forward planning (step-and-shoot) hypofractionated, intensity-modulated accelerated radiotherapy is feasible and seems to be a safe treatment for patients with GBM. A 2-week reduction in the treatment time may be of valuable benefit for this group of patients. However, despite this accelerated regimen, no survival advantage has been observed.
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Int. J. Radiat. Oncol. Biol. Phys. · Jan 2004
ReviewEpidermal growth factor receptor-targeted therapy with ZD1839: symptom improvement in non-small-cell lung cancer.
Non-small-cell lung cancer (NSCLC) is a common and frequently incurable disease. Patients with advanced Stage IIIB and Stage IV disease, although not candidates for curative resection, can benefit from receiving treatment (chemotherapy and radiation therapy) that prolongs survival, alleviates symptoms, and/or reduces complications. However, these therapies are often associated with significant adverse events. ⋯ ZD1839 is one of a new class of targeted anticancer agents known as tyrosine kinase inhibitors that has demonstrated activity in the treatment of NSCLC. In clinical trials, ZD1839 produced responses in patients with relapsed or refractory NSCLC, reduced disease-related symptoms, and was associated with an improvement in quality of life. Results from pivotal trials with single-agent ZD1839 are reviewed in this article, with an emphasis on its effects on quality of life and symptom improvement.
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Int. J. Radiat. Oncol. Biol. Phys. · Jan 2004
Is there a favorable subset of patients with prostate cancer who develop oligometastases?
To analyze, retrospectively, the patterns and behavior of metastatic lesions in prostate cancer patients treated with external beam radiotherapy and to investigate whether patients with < or =5 lesions had an improved outcome relative to patients with >5 lesions. ⋯ Patients with < or =5 metastatic sites had significantly better survival rates than patients with >5 lesions. Because existing sites of metastatic disease may be the primary sites of origin for additional metastases, our findings suggest that early detection and aggressive treatment of patients with a small number of metastatic lesions is worth testing as an approach to improving long-term survival.