International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2009
Predicting likelihood of having four or more positive nodes in patient with sentinel lymph node-positive breast cancer: a nomogram validation study.
Katz suggested a nomogram for predicting having four or more positive nodes in sentinel lymph node (SLN)-positive breast cancer patients. The findings from this formula might influence adjuvant radiotherapy decisions. Our goal was to validate the accuracy of the Katz nomogram. ⋯ The probability of four or more involved nodes is significantly greater in patients who have an increased number of positive SLNs, increased overall metastasis size, increased tumor size, and extracapsular extension. The Katz nomogram was validated in our patients. This nomogram will be helpful to clinicians making adjuvant treatment recommendations to their patients.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2009
Dosimetric study of pelvic proton radiotherapy for high-risk prostate cancer.
To compare dose distributions in targeted tissues (prostate, seminal vesicles, pelvic regional nodes) and nontargeted tissues in the pelvis with intensity-modulated radiotherapy (IMRT) and forward-planned, double-scattered, three-dimensional proton radiotherapy (3D-PRT). ⋯ Use of 3D-PRT significantly reduced the dose to normal tissues in the pelvis while maintaining adequate target coverage compared with IMRT or IMRT/3D-PRT. When treating the prostate, seminal vesicles, and pelvic lymph nodes in prostate cancer, proton therapy may improve the therapeutic ratio beyond what is possible with IMRT.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2009
Quantifying interfraction and intrafraction tumor motion in lung stereotactic body radiotherapy using respiration-correlated cone beam computed tomography.
Stereotactic body radiation therapy (SBRT) is an effective treatment for medically inoperable Stage I non-small-cell lung cancer. However, changes in the patient's breathing patterns during the course of SBRT may result in a geographic miss or an overexposure of healthy tissues to radiation. However, the precise extent of these changes in breathing pattern is not well known. We evaluated the inter- and intrafractional changes in tumor motion amplitude (DeltaM) over an SBRT course. ⋯ The inter- and intrafractional DeltaM that occur during a course of lung SBRT are small. However, abdominal compression causes larger variations in the time spent on the treatment couch and in the inter- and intrafractional DeltaM values.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2009
Stereotactic body radiation therapy for early-stage non-small-cell lung carcinoma: four-year results of a prospective phase II study.
The 50-month results of a prospective Phase II trial of stereotactic body radiation therapy (SBRT) in medically inoperable patients are reported. ⋯ Based on our study results, use of SBRT results in high rates of local control in medically inoperable patients with Stage I NSCLC.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2009
Practice GuidelineClinical practice guidance for radiotherapy planning after induction chemotherapy in locoregionally advanced head-and-neck cancer.
The use of induction chemotherapy (IC) for locoregionally advanced head-and-neck cancer is increasing. The response to IC often causes significant alterations in tumor volume and location and shifts in normal anatomy. Proper determination of the radiotherapy (RT) targets after IC becomes challenging, especially with the use of conformal and precision RT techniques. Therefore, a consensus conference was convened to discuss issues related to RT planning and coordination of care for patients receiving IC. ⋯ A multidisciplinary approach is strongly encouraged. Although these recommendations were provided primarily for patients treated with IC, many of these same principles apply to concurrent chemoradiotherapy without IC. A rapid response during RT is quite common, requiring the development of two or more plans in a sizeable fraction of patients, and suggesting the need for similar guidance in the rapidly evolving area of adaptive RT.