International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2009
Predicting likelihood of having four or more positive nodes in patient with sentinel lymph node-positive breast cancer: a nomogram validation study.
Katz suggested a nomogram for predicting having four or more positive nodes in sentinel lymph node (SLN)-positive breast cancer patients. The findings from this formula might influence adjuvant radiotherapy decisions. Our goal was to validate the accuracy of the Katz nomogram. ⋯ The probability of four or more involved nodes is significantly greater in patients who have an increased number of positive SLNs, increased overall metastasis size, increased tumor size, and extracapsular extension. The Katz nomogram was validated in our patients. This nomogram will be helpful to clinicians making adjuvant treatment recommendations to their patients.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2009
Dosimetric study of pelvic proton radiotherapy for high-risk prostate cancer.
To compare dose distributions in targeted tissues (prostate, seminal vesicles, pelvic regional nodes) and nontargeted tissues in the pelvis with intensity-modulated radiotherapy (IMRT) and forward-planned, double-scattered, three-dimensional proton radiotherapy (3D-PRT). ⋯ Use of 3D-PRT significantly reduced the dose to normal tissues in the pelvis while maintaining adequate target coverage compared with IMRT or IMRT/3D-PRT. When treating the prostate, seminal vesicles, and pelvic lymph nodes in prostate cancer, proton therapy may improve the therapeutic ratio beyond what is possible with IMRT.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2009
Randomized Controlled Trial Comparative StudyRetrospective comparison of external beam radiotherapy and radical prostatectomy in high-risk, clinically localized prostate cancer.
Because of the lack of conclusive and well-conducted randomized studies, the optimal therapy for prostate tumors remains controversial. The aim of this study was to retrospectively compare the results of radical surgery vs. a conservative approach such as external beam radiotherapy (EBRT) plus androgen deprivation therapy using an intent-to-treat analysis on two pretreatment defined, concurrently treated, high-risk patient populations. ⋯ This retrospective intention-to-treat analysis showed a significantly better outcome after EBRT than after RP in patients with high-risk prostate cancer, although a well-conducted randomized comparison would be the best procedure to confirm these results.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2009
Visual outcome and tumor control after conformal radiotherapy for patients with optic nerve sheath meningioma.
Optic nerve sheath meningioma (ONSM) is a rare tumor that almost uniformly leads to visual dysfunction and even blindness without intervention. Because surgical extirpation carries a high risk of postoperative blindness, vision-sparing treatment strategies are desirable. ⋯ Highly conformal, fractionated radiation therapy for symptomatic primary ONSM provides tumor control and improvement in visual function in most cases, with minimal treatment-induced morbidity. Longer follow-up is needed to assess the durability of tumor control and treatment-related late effects.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2009
Quantifying interfraction and intrafraction tumor motion in lung stereotactic body radiotherapy using respiration-correlated cone beam computed tomography.
Stereotactic body radiation therapy (SBRT) is an effective treatment for medically inoperable Stage I non-small-cell lung cancer. However, changes in the patient's breathing patterns during the course of SBRT may result in a geographic miss or an overexposure of healthy tissues to radiation. However, the precise extent of these changes in breathing pattern is not well known. We evaluated the inter- and intrafractional changes in tumor motion amplitude (DeltaM) over an SBRT course. ⋯ The inter- and intrafractional DeltaM that occur during a course of lung SBRT are small. However, abdominal compression causes larger variations in the time spent on the treatment couch and in the inter- and intrafractional DeltaM values.