International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Mar 2013
Impact of quality assurance rounds in a Canadian radiation therapy department.
Quality assurance (QA) programs aim to identify inconsistencies that may compromise patient care. Radiation treatment planning is a well-documented source of variation in radiation oncology, leading many organizations to recommend the implementation of QA rounds in which radiation therapy plans are peer reviewed. This study evaluates the outcome of QA rounds that have been conducted by a radiation therapy department since 2004. ⋯ This study demonstrated that QA rounds are feasible and an important element of a radiation therapy department's QA program. Through peer review, plans that deviate from a department's expected standard can be identified and corrected. Additional benefits include identifying patterns of practice that may contribute to inconsistencies in treatment planning and the continuing education of staff members who attend.
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Int. J. Radiat. Oncol. Biol. Phys. · Feb 2013
A phase I study of the combination of sorafenib with temozolomide and radiation therapy for the treatment of primary and recurrent high-grade gliomas.
Despite recent advances in the management of high-grade and recurrent gliomas, survival remains poor. Antiangiogenic therapy has been shown to be efficacious in the treatment of high-grade gliomas both in preclinical models and in clinical trials. We sought to determine the safety and maximum tolerated dose of sorafenib when combined with both radiation and temozolomide in the primary setting or radiation alone in the recurrent setting. ⋯ Sorafenib can be safely combined with radiation and temozolomide in patients with high-grade glioma and with radiation alone in patients with recurrent glioma. The recommended phase II dose of sorafenib is 200 mg twice daily when combined with temozolomide and radiation and 400 mg with radiation alone. To our knowledge, this is the first publication of concurrent sorafenib with radiation monotherapy or combined with radiation and temozolomide.
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Int. J. Radiat. Oncol. Biol. Phys. · Feb 2013
Megavoltage computed tomography image guidance with helical tomotherapy in patients with vertebral tumors: analysis of factors influencing interobserver variability.
To evaluate megavoltage computed tomography (MVCT)-based image guidance with helical tomotherapy in patients with vertebral tumors by analyzing factors influencing interobserver variability, considered as quality criterion of image guidance. ⋯ Tomotherapy image guidance precision is affected by image resolution and residual deviations after setup correction. Eliminating the effect of residual deviations yields small interobserver variabilities with submillimeter precision in the axial plane. In contrast, interobserver variability in the craniocaudal direction is dominated by the poorer longitudinal MVCT image resolution. Residual deviations after image guidance exist and need to be considered when dose gradients ultimately achievable with image guided radiation therapy techniques are analyzed.
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Int. J. Radiat. Oncol. Biol. Phys. · Feb 2013
Multicenter StudyA multi-institutional study of factors influencing the use of stereotactic radiosurgery for brain metastases.
Stereotactic radiosurgery (SRS) for brain metastases is a relatively well-studied technology with established guidelines regarding patient selection, although its implementation is technically complex. We evaluated the extent to which local availability of SRS affected the treatment of patients with brain metastases. ⋯ The availability of on-site SRS is the factor most strongly associated with the provision of this treatment to patients with brain metastases and appears to be more influential than accepted clinical eligibility factors.
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Int. J. Radiat. Oncol. Biol. Phys. · Feb 2013
Multicenter StudyQuality Research in Radiation Oncology analysis of clinical performance measures in the management of gastric cancer.
The specific aim was to determine national patterns of radiation therapy (RT) practice in patients treated for stage IB-IV (nonmetastatic) gastric cancer (GC). ⋯ This analysis of radiation practice patterns for treating nonmetastatic GC indicates widespread adoption of CT-based planning with use of DVH to evaluate normal tissue doses. Most patients completed adjuvant RT in the prescribed time frame. IMRT and IGRT were not routinely incorporated into clinical practice during the 2005-2007 period. These data will be a benchmark for future Quality Research in Radiation Oncology GC surveys.