International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 2009
Comparative StudyUsefulness of diffusion-weighted imaging in the localization of prostate cancer.
Advances in high-precision radiation therapy techniques for patients with prostate cancer permit selective escalation of the radiation dose delivered to the dominant intraprostatic lesion and improve the therapeutic ratio. We evaluated the value of diffusion-weighted imaging (DWI) for dominant intraprostatic lesion assessment. ⋯ Because the addition of DWI to T2WI improves the detectability of prostate cancer, DWI may offer a promising new approach for radiation therapy planning.
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 2009
Randomized Controlled Trial Multicenter StudyRecognizing false biochemical failure calls after radiation with or without neo-adjuvant androgen deprivation for prostate cancer.
We studied prostate-specific antigen (PSA) changes after radiation with or without neoadjuvant androgen deprivation to determine posttreatment PSA scenarios in which false-positive biochemical failures (FPBF) are most likely to occur. ⋯ The Phoenix definition avoided 50% of FPBF calls that occurred with the ASTRO definition. Failures should be confirmed by further PSA rises before investigation and treatment is considered.
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 2009
Multicenter StudyToward submillimeter accuracy in the management of intrafraction motion: the integration of real-time internal position monitoring and multileaf collimator target tracking.
We report on an integrated system for real-time adaptive radiation delivery to moving tumors. The system combines two promising technologies-three-dimensional internal position monitoring using implanted electromagnetically excitable transponders and corresponding real-time beam adaptation using a dynamic multileaf collimator (DMLC). ⋯ We have developed and characterized a research version of a novel four-dimensional delivery system that integrates nonionizing radiation-based internal position monitoring and accurate real-time DMLC-based beam adaptation. This system represents a significant step toward achieving the eventual goal of geometrically ideal dose delivery to moving tumors.
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 2009
Salvage gamma knife stereotactic radiosurgery for surgically refractory trigeminal neuralgia.
To evaluate the clinical outcome of patients with surgically refractory trigeminal neuralgia (TN) treated with rescue gamma knife radiosurgery (GKRS). ⋯ GKRS salvage for refractory TN is well tolerated and results in long-term pain relief in approximately half the patients treated. Clinicians may reconsider using GKRS to salvage patients who have failed prior MVD.
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 2009
Frameless stereotactic body radiotherapy for lung cancer using four-dimensional cone beam CT guidance.
To quantify the localization accuracy and intrafraction stability of lung cancer patients treated with frameless, four-dimensional (4D) cone beam computed tomography (CBCT)-guided stereotactic body radiotherapy (SBRT) and to calculate and validate planning target volume (PTV) margins to account for the residual geometric uncertainties. ⋯ Frameless SBRT can be safely administered using 4D-CBCT guidance. Even with considerable breathing motion, the PTV margins can safely be kept small, allowing patients with larger tumors to benefit from the advantages of SBRT. In case bony anatomy would be used as a surrogate for tumor position, considerably larger PTV margins would be required.