International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Feb 2009
Randomized Controlled Trial Multicenter StudyFinal report of multicenter Canadian Phase III randomized trial of 3 versus 8 months of neoadjuvant androgen deprivation therapy before conventional-dose radiotherapy for clinically localized prostate cancer.
To evaluate the effect of 3 vs. 8 months of neoadjuvant hormonal therapy before conventional-dose radiotherapy (RT) on disease-free survival for localized prostate cancer. ⋯ A longer period of NHT before standard-dose RT did not alter the patterns of failure when combined with 66-Gy RT. High-risk patients in the 8-month arm had significant improvement in the 5-year disease-free survival rate.
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Int. J. Radiat. Oncol. Biol. Phys. · Feb 2009
Multicenter StudyMulticenter analysis of effect of high biologic effective dose on biochemical failure and survival outcomes in patients with Gleason score 7-10 prostate cancer treated with permanent prostate brachytherapy.
To investigate the biochemical control rates and survival for Gleason score 7-10 prostate cancer patients undergoing permanent prostate brachytherapy as a function of the biologic effective dose (BED). ⋯ These data suggest that permanent prostate brachytherapy combined with EBRT and hormonal therapy yields excellent bFFF and survival results in Gleason score 7-10 patients when the delivered BEDs are >220 Gy. These doses can be achieved by a combination of 45-Gy EBRT with a minimal dose received by 90% of the target volume of 120 Gy of (103)Pd or 130 Gy of (125)I.
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Int. J. Radiat. Oncol. Biol. Phys. · Feb 2009
IMRT reirradiation of head and neck cancer-disease control and morbidity outcomes.
Institutional and cooperative group experience has demonstrated the feasibility of reirradiation for head and neck cancer. Limited data are available regarding the use of intensity-modulated radiotherapy (IMRT) for this indication. We reviewed our initial experience using IMRT for previously irradiated head and neck cancer patients. ⋯ The use of IMRT for reirradiation of recurrent or second primary head and neck cancers resulted in encouraging local control and survival. Reirradiation-related morbidity was significant, but may be less severe than previously published reports using conventional techniques.
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Int. J. Radiat. Oncol. Biol. Phys. · Feb 2009
Comparative StudyRefinement of treatment setup and target localization accuracy using three-dimensional cone-beam computed tomography for stereotactic body radiotherapy.
To quantitatively compare two-dimensional (2D) orthogonal kV with three-dimensional (3D) cone-beam CT (CBCT) for target localization; and to assess intrafraction motion with kV images in patients undergoing stereotactic body radiotherapy (SBRT). ⋯ After localization based on superficial markings in patients undergoing SBRT, orthogonal kV imaging detects setup variations of approximately 3 to 4 mm in each direction. Cone-beam CT detects residual setup variations of approximately 2 to 3 mm.
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Int. J. Radiat. Oncol. Biol. Phys. · Feb 2009
Factors associated with long-term dysphagia after definitive radiotherapy for locally advanced head-and-neck cancer.
The use of altered fractionation radiotherapy (RT) regimens, as well as concomitant chemotherapy and RT, to intensify therapy for locally advanced head-and-neck cancer can lead to increased rates of long-term dysphagia. ⋯ The addition of concurrent chemotherapy to RT for locally advanced head-and-neck cancer resulted in increased long-term dysphagia. Early intervention using swallowing exercises, avoidance of nothing-by-mouth periods, and the use of intensity-modulated RT to reduce the dose to the uninvolved swallowing structures should be explored further in populations at greater risk of long-term dysphagia.