International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 2004
Primary non-Hodgkin's lymphoma of the CNS treated with CHOD/BVAM or BVAM chemotherapy before radiotherapy: long-term survival and prognostic factors.
To assess the long-term survival and prognostic factors associated with the cyclophosphamide, doxorubicin, vincristine, and dexamethasone (CHOD)/carmustine, vincristine, methotrexate, and cytarabine (BVAM) and BVAM chemotherapy regimens followed by cranial radiotherapy in the treatment of primary central nervous system (CNS) non-Hodgkin lymphoma. ⋯ The Nottingham/Barcelona prediction score, which is similar to the International Prognostic Index, may be useful in comparing survival with different regimens studied in Phase II trials. Patients with primary CNS non-Hodgkin's lymphoma aged <60 years treated with CHOD/BVAM or BVAM followed by radiotherapy have a similar long-term survival to that of patients with large B cell non-Hodgkin's lymphoma at other extranodal sites.
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 2004
Evaluation of a contour-alignment technique for CT-guided prostate radiotherapy: an intra- and interobserver study.
The recent introduction of integrated CT/linear accelerator systems may mean that daily CT localization can become a reality in the clinic, possibly allowing further dose escalation to the prostate while limiting unwanted doses to the rectum and bladder. However, the implementation of CT localization is currently impeded by the lack of precise and robust techniques to align the treatment plan with the daily CT images. The purpose of this study was to evaluate a manual alignment technique, in which the gross target volume contours are overlaid on the daily CT images and then shifted to match the structures visible in the images. ⋯ The interobserver uncertainties associated with aligning the gross target volume contours with daily CT images were sufficiently small that this method may be used for daily CT localization of the prostate. The use of a reference image is important to improve the consistency among different users in this technique.
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 2004
A preliminary study of the role of modulated electron beams in intensity modulated radiotherapy, using automated beam orientation and modality selection.
To develop an algorithm for optimal beam arrangement selection in intensity-modulated radiotherapy (IMRT) of mixed photon and electron beams. To apply this algorithm to study the utility of modulated electron beams in the context of IMRT planning. ⋯ In the two cases analyzed using the selection algorithm, the primary role of modulated electrons differs based on treatment site-normal tissue dose reduction in breast and target homogeneity improvement in head and neck. Although this preliminary study with two cases appears to suggest that the role of intensity-modulated electrons differs based on treatment site, further investigation of large numbers of cases and varied treatment sites are required to establish a definitive conclusion.
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 2004
Clinical TrialIntensity-modulated radiotherapy in treatment of pancreatic and bile duct malignancies: toxicity and clinical outcome.
To assess the efficacy and toxicity of intensity-modulated radiotherapy (IMRT) in pancreatic and bile duct (cholangiocarcinoma) malignancies. ⋯ In this hypothesis-generating analysis, the acute and chronic toxicity profile with IMRT in the treatment of pancreatic and bile duct cancer was encouraging. Local control was not compromised, despite efforts to increase conformality and avoid doses to normal structures. Distant failure remains a major obstacle in pancreatic cancer.
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 2004
A forward-planned treatment technique using multisegments in the treatment of head-and-neck cancer.
To describe in detail a forward-planned multisegment technique (FPMS) as an alternative treatment method for patients who are not suitable for inverse-planned intensity-modulated radiation therapy (IP-IMRT), or for situations where IP-IMRT is not available in a medical clinic. ⋯ FPMS achieved plans comparable to those for IP-IMRT and is an ideal alternative treatment technique for a center without the capabilities of IP-IMRT or for a patient who is not a suitable candidate, because of prolonged treatment time. The treatment outcomes from our clinical experience indicate that FPMS can achieve excellent local freedom from progression rates without causing excessive toxicity. Lastly, IP-IMRT plans should be comparable to, if not better than, FPMS plans in the treatment of head-and-neck cancer.