International journal of radiation oncology, biology, physics
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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.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2009
Long-term outcome of gamma knife radiosurgery for treatment of typical trigeminal neuralgia.
To analyze the long-term outcomes of patients with typical trigeminal neuralgia treated with gamma knife radiosurgery (GKRS). ⋯ GKRS seems to be an effective treatment modality for patients with typical trigeminal neuralgia considering the initial response rate; however, fewer than one-half of patients might continue to benefit from GKRS after long-term follow-up. Elderly patients might be good candidates for radiosurgery considering the long-term durability of efficacy.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2009
Urinary symptom flare in 712 125I prostate brachytherapy patients: long-term follow-up.
To describe the late transient worsening of urinary symptoms ("urinary symptom flare") in 712 consecutive prostate brachytherapy patients, associated predictive factors, association with rectal and urinary toxicity, and the development of erectile dysfunction. ⋯ Urinary symptom flare is a common, transient phenomenon after prostate brachytherapy. A greater baseline IPSS and maximal postimplant IPSS were the strongest predictive factors. Flare was associated with a greater incidence of late RTOG Grade 3 urinary toxicity and greater rate of late RTOG Grade 2 or greater rectal toxicity.
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Int. J. Radiat. Oncol. Biol. Phys. · Nov 2009
Study of robustness of IMPT and IMRT for prostate cancer against organ movement.
Intensity-modulated radiotherapy with photons (IMRT) and protons (IMPT) produces dose distributions that have high conformality to the planning target volume and sufficient sparing of the organs at risk if calculated on a single static computed tomography (CT) scan. For prostate cancer patients, organ movement with related changes to the density distribution in the irradiated volume occurs during the treatment course. We evaluated the sensitivity of IMPT and IMRT plans to organ movement. ⋯ The sensitivities of IMPT and IMRT to organ movement are of the same order if appropriate planning strategies are applied. The latter is especially crucial for IMPT.
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Int. J. Radiat. Oncol. Biol. Phys. · Oct 2009
ReviewReview of adjuvant radiochemotherapy for resected pancreatic cancer and results from Mayo Clinic for the 5th JUCTS symposium.
To present an overview of Phase III trials in adjuvant therapy for pancreatic cancer and review outcomes at the Mayo Clinic after adjuvant radiochemotherapy (RT/CT) for resected pancreatic cancer. ⋯ Results from recent clinical trials support the use of adjuvant chemotherapy in resected pancreatic cancer. The role of radiochemotherapy in adjuvant treatment of pancreatic cancer remains a topic of debate. Results from the Mayo Clinic suggest improved outcomes after the administration of adjuvant radiochemotherapy after a complete resection of invasive pancreatic malignancies.