International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Apr 2010
ReviewThe negative impact of stark law exemptions on graduate medical education and health care costs: the example of radiation oncology.
To survey radiation oncology training programs to determine the impact of ownership of radiation oncology facilities by non-radiation oncologists on these training programs and to place these findings in a health policy context based on data from the literature. ⋯ Ownership of radiation oncology facilities by non-radiation oncologists appears to have a negative impact on residency training by shifting patients away from training programs and into community practices. In addition, the literature supports the conclusion that self-referral results in overutilization of expensive services without benefit to patients. As a result of these findings, recommendations are made to study further how physician ownership of radiation oncology facilities influence graduate medical education, treatment patterns and utilization, and health care costs. Patients also need to be aware of financial arrangements that may influence their physician's treatment recommendations.
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Int. J. Radiat. Oncol. Biol. Phys. · Apr 2010
Multicenter StudyTotal androgen blockade versus a luteinizing hormone-releasing hormone agonist alone in men with high-risk prostate cancer treated with radiotherapy.
To assess whether short-course total androgen blockade vs. a luteinizing hormone-releasing hormone (LHRH) agonist alone affects the risk of prostate cancer-specific mortality (PCSM) in men with localized but high-risk disease treated with radiotherapy. ⋯ In men with localized but high-risk prostate cancer treated with external beam radiotherapy and brachytherapy, short-course AST with an LHRH agonist plus an antiandrogen is associated with a decreased risk of PCSM when compared with monotherapy with an LHRH agonist.
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Int. J. Radiat. Oncol. Biol. Phys. · Apr 2010
Elderly patients with painful bone metastases should be offered palliative radiotherapy.
To investigate the efficacy of palliative radiotherapy (RT) in relieving metastatic bone pain in elderly patients. ⋯ Age alone did not affect the response to palliative RT for bone metastases. Elderly patients should be referred for palliative RT for their painful bone metastases, regardless of age, because they receive equal benefit from the treatment.
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Int. J. Radiat. Oncol. Biol. Phys. · Apr 2010
Comparative StudyPreoperative capecitabine and pelvic radiation in locally advanced rectal cancer--is it equivalent to 5-FU infusion plus leucovorin and radiotherapy?
The aim of this retrospective case-matching study was to compare the treatment outcomes and acute toxicity of preoperative radiotherapy (RT) with capecitabine vs. preoperative RT with intermittent 5-fluorouracil (5-FU) infusion, leucovorin, and mitomycin C in rectal cancer. ⋯ When administered with concurrent preoperative RT, both capecitabine and intermittent 5-FU infusion with leucovorin modulation provided comparable pathologic tumor response, local control, relapse-free survival, and disease-specific survival rates in rectal cancer.
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Int. J. Radiat. Oncol. Biol. Phys. · Apr 2010
Stereotactic radiosurgery in the management of brain metastases: an institutional retrospective analysis of survival.
The objective of this study was to report our experience with stereotactic radiosurgery performed with the Gamma Knife (GK) in the treatment of patients with brain metastases and to compare survival for those treated with radiosurgery alone with survival for those treated with radiosurgery and whole-brain radiotherapy. ⋯ Radiosurgery with the GK is an efficacious treatment modality for brain metastases. A KPS greater than 70, histology of breast cancer, smaller tumor volume, and age less than 65 years were associated with a longer median survival in our study.