International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Mar 2009
Randomized Controlled TrialMajor late toxicities after conformal radiotherapy for nasopharyngeal carcinoma-patient- and treatment-related risk factors.
To retrospectively analyze the factors affecting late toxicity for nasopharyngeal carcinoma. ⋯ The therapeutic margin for nasopharyngeal carcinoma is extremely narrow, and a significant increase in brain necrosis could result from dose escalation. The significant factors affecting the risk of deafness included age, concurrent chemoradiotherapy, and greater radiation dose to the cochlea.
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Int. J. Radiat. Oncol. Biol. Phys. · Mar 2009
Multicenter StudyPredictive factors for acute and late urinary toxicity after permanent prostate brachytherapy: long-term outcome in 712 consecutive patients.
To describe the frequency of acute and late Radiation Therapy Oncology Group (RTOG) urinary toxicity, associated predictive factors, and resolution of International Prostate Symptom Score (IPSS) in 712 consecutive prostate brachytherapy patients. ⋯ Most urinary symptoms resolved within 12 months after prostate brachytherapy, and significant long-term urinary toxicity was very low. Refined patient selection and greater technical experience in prostate brachytherapy were associated with less urinary toxicity.
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Int. J. Radiat. Oncol. Biol. Phys. · Mar 2009
Stereotactic body radiotherapy for localized prostate cancer: interim results of a prospective phase II clinical trial.
The radiobiology of prostate cancer favors a hypofractionated dose regimen. We report results of a prospective Phase II clinical trial of stereotactic body radiotherapy (SBRT) for localized prostate cancer. ⋯ The early and late toxicity profile and PSA response for prostate SBRT are highly encouraging. Continued accrual and follow-up will be necessary to confirm durable biochemical control rates and low toxicity profiles.
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Int. J. Radiat. Oncol. Biol. Phys. · Mar 2009
Comparative StudyA matched-pair analysis comparing whole-brain radiotherapy plus stereotactic radiosurgery versus surgery plus whole-brain radiotherapy and a boost to the metastatic site for one or two brain metastases.
To compare the results of whole-brain radiotherapy plus stereotactic radiosurgery (WBRT+SRS) with those of surgery plus whole-brain radiotherapy and a boost to the metastatic site (OP+WBRT+boost) for patients with one or two brain metastases. ⋯ Treatment outcomes were not significantly different after WBRT+SRS compared with OP+WBRT+boost. However, WBRT+SRS is less invasive than OP+WBRT+boost and may be preferable for patients with one or two brain metastases. The results should be confirmed by randomized trials.
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Int. J. Radiat. Oncol. Biol. Phys. · Mar 2009
Achieving an undetectable PSA after radiotherapy for biochemical progression after radical prostatectomy is an independent predictor of biochemical outcome--results of a retrospective study.
Salvage radiotherapy (SRT) is commonly used to treat patients with biochemical failure after radical prostatectomy (RP). Retrospective series have demonstrated biochemical response in approximately 60-75% of patients, but only a significantly lower rate of patients achieves a response with a decrease of the prostate-specific antigen (PSA) to a value below the limits of detectability. Therefore, long-term response at 10 years is only about 20-25% in all of these patients. The purpose of this study was to determine prognostic factors with impact on achieving the undetectable PSA range after SRT and to define the role of this end point. ⋯ The study represents one of the largest retrospective single-institution series of SRT for increasing PSA after RP in patients without any hormonal treatment before the initiation of SRT. Our findings suggest that achieving an undetectable PSA after RT is an important prognosticator for a high chance of cure and patients with a low PSA pre-SRT, positive surgical margins, and low tumor stage at the time of RP are best candidates for SRT.