International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Apr 2005
Randomized Controlled Trial Clinical TrialAndrogen suppression adjuvant to definitive radiotherapy in prostate carcinoma--long-term results of phase III RTOG 85-31.
Radiation Therapy Oncology Group protocol 85-31 was designed to evaluate the effectiveness of adjuvant androgen suppression, using goserelin, in unfavorable prognosis carcinoma of the prostate treated with definitive radiotherapy (RT). ⋯ In a population of patients with unfavorable prognosis carcinoma of the prostate, androgen suppression applied as an adjuvant after definitive RT was associated not only with a reduction in disease progression but in a statistically significant improvement in absolute survival. The improvement in survival appeared preferentially in patients with a Gleason score of 7-10.
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Int. J. Radiat. Oncol. Biol. Phys. · Apr 2005
Clinical TrialReirradiation alternating with docetaxel and cisplatin in inoperable recurrence of head-and-neck cancer: a prospective phase I/II trial.
Inoperable locoregional recurrences of head-and-neck cancer in a previously irradiated volume represent a therapeutic dilemma. Chemotherapy alone has no curative potential, whereas reirradiation and concurrent chemoradiation can salvage a small fraction of patients. Mucosal toxicity of concurrent chemoradiation requires substantial dose reduction of chemotherapy. Alternating chemoradiation offers the chance to give both full-dose chemotherapy and radiotherapy. The latter may provide a particular advantage for recurrent, potentially radiation resistant tumors. The feasibility and efficacy of a full-dose docetaxel containing alternating chemoradiation schedule was tested. ⋯ Alternating chemoreirradiation in recurrences of head-and-neck cancer resulted in 80% overall response with acceptable toxicity. A significant minority of patients had durable tumor control with a chance of long-term survival.
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Int. J. Radiat. Oncol. Biol. Phys. · Apr 2005
The effect of finite patient dimensions and tissue inhomogeneities on dosimetry planning of 192Ir HDR breast brachytherapy: a Monte Carlo dose verification study.
To evaluate the accuracy of clinical dosimetry planning using commercially available treatment planning systems in (192)Ir high-dose-rate (HDR) breast brachytherapy, with emphasis on skin dose, in view of potential uncertainties owing to the patient finite dimensions and the presence of the lung. ⋯ Dose-volume histogram and all other relevant planning quality indices for the planning target volume calculated by the treatment planning system are credible. Skin and lung dose calculations by the treatment planning system can be thought of as a conservative approach in view of the reported dose overestimation.
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Int. J. Radiat. Oncol. Biol. Phys. · Apr 2005
Error in the delivery of radiation therapy: results of a quality assurance review.
To examine error rates in the delivery of radiation therapy (RT), technical factors associated with RT errors, and the influence of a quality improvement intervention on the RT error rate. ⋯ Errors in the delivery of RT are uncommon and usually of little clinical significance. Patient subgroups and technical factors associated with errors can be identified. The introduction of new technology can produce new ways for errors to occur, necessitating ongoing evaluation of RT errors for quality assurance. Modifications to processes of care can produce important reductions in error rates.
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Int. J. Radiat. Oncol. Biol. Phys. · Apr 2005
Initial clinical experience with frameless radiosurgery for patients with intracranial metastases.
To review the initial clinical experience with frameless stereotactic radiosurgery (SRS) for treating intracranial metastatic disease. ⋯ Frameless optically guided radiosurgery is less invasive, can be performed as a standard radiotherapy-based simulation procedure, and maintains submillimetric accuracy. Our initial results with frameless SRS for metastatic disease suggest survival times and local control (88%) eqiuvalent to frame-based methodologies. Practical noninvasive delivery makes treatment and potential retreatment to avoid WBRT more feasible.