International journal of radiation oncology, biology, physics
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To report contemporary outcomes for inflammatory breast cancer (IBC) patients treated in the modern era of trastuzumab and taxane-based chemotherapy. ⋯ For IBC patients, the rate of distant metastases is still high despite excellent local control, particularly for patients who received >60.4 Gy to the chest wall. Despite the use of taxanes and trastuzumab, outcomes remain modest, particularly for those with ER/PR-negative disease and those without a pathologic complete response.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2012
Factors associated with external and internal lymphedema in patients with head-and-neck cancer.
The purpose of this study was to examine factors associated with the presence of secondary external and internal lymphedema in patients with head-and-neck cancer (HNC). ⋯ Select tumor and treatment parameters are associated with increased occurrence of lymphedema in patients with HNC. Larger and longitudinal studies are needed to identify adjusted effects and causative risk factors contributing to the development of lymphedema in patients with HNC.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2012
Comparative StudyIntensity modulated proton and photon therapy for early prostate cancer with or without transperineal injection of a polyethylen glycol spacer: a treatment planning comparison study.
Rectal toxicity is a serious adverse effect in early-stage prostate cancer patients treated with curative radiation therapy (RT). Injecting a spacer between Denonvilliers' fascia increases the distance between the prostate and the anterior rectal wall and may thus decrease the rectal radiation-induced toxicity. We assessed the dosimetric impact of this spacer with advanced delivery RT techniques, including intensity modulated RT (IMRT), volumetric modulated arc therapy (VMAT), and intensity modulated proton beam RT (IMPT). ⋯ Regardless of the radiation technique, a substantial decrease of rectal dose was observed after spacer injection for curative RT to the prostate.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2012
What is the optimal treatment of large brain metastases? An argument for a multidisciplinary approach.
Single-modality treatment of large brain metastases (>2 cm) with whole-brain irradiation, stereotactic radiosurgery (SRS) alone, or surgery alone is not effective, with local failure (LF) rates of 50% to 90%. Our goal was to improve local control (LC) by using multimodality therapy of surgery and adjuvant SRS targeting the resection cavity. ⋯ Surgery and adjuvant resection cavity SRS yields excellent LC of large brain metastases. Compared with other multimodality treatment options, this approach allows patients to avoid or delay whole-brain irradiation without compromising LC.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2012
A three-isocenter jagged-junction IMRT approach for craniospinal irradiation without beam edge matching for field junctions.
Traditionally craniospinal irradiation treats the central nervous system using two or three adjacent field sets. We propose a technique using a three-isocenter intensity-modulated radiotherapy (IMRT) plan (jagged-junction IMRT) which overcomes problems associated with field junctions and beam edge matching and improves planning and treatment setup efficiencies with homogenous target dose distribution. ⋯ Jagged-junction IMRT planning provided good dose homogeneity and conformity to the target while maintaining a low dose to organs at risk. Results from jagged-junction IMRT plans were better than or equivalent to those from the conventional technique. Jagged-junction IMRT optimization smoothly distributed dose in the junction between field sets. Because there was no beam matching, this treatment technique is less likely to produce hot or cold spots at the junction, in contrast to conventional techniques. The planning process is also simplified as only one IMRT plan is required for the entire target volume.