International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · May 2004
Pilot study of postoperative reirradiation, chemotherapy, and amifostine after surgical salvage for recurrent head-and-neck cancer.
Salvage surgery alone after radiotherapy (RT) failure for locally advanced head-and-neck cancer is frequently unsuccessful because of subsequent recurrence. We designed a prospective protocol to determine the feasibility, toxicity, and preliminary efficacy of a regimen of postoperative reirradiation, chemotherapy and the radioprotector amifostine after salvage head-and-neck surgery. ⋯ This regimen of postoperative reirradiation/chemotherapy plus amifostine is feasible and was well tolerated acutely, with encouraging oncologic efficacy. However, the incidence and severity of late effects was significant and suggests that modifications are necessary for future studies in this patient population.
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Int. J. Radiat. Oncol. Biol. Phys. · May 2004
T3 disease at presentation or pathologic involvement of four or more lymph nodes predict for locoregional recurrence in stage II breast cancer treated with neoadjuvant chemotherapy and mastectomy without radiotherapy.
To help define the clinical and pathologic predictors of locoregional recurrence (LRR) in breast cancer patients treated with neoadjuvant chemotherapy and mastectomy without radiotherapy for early-stage disease. ⋯ For patients with clinical Stage II breast cancer, T3 primary disease, four or more positive lymph nodes after chemotherapy, and age < or =40 years old predicted for LRR. For most patients with clinical T1 or T2 disease and one to three positive lymph nodes, the 5-year risk for LRR was low, and the routine inclusion of postmastectomy radiotherapy does not appear to be justified.
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Int. J. Radiat. Oncol. Biol. Phys. · May 2004
Clinical TrialPhase I study of involved-field radiotherapy preceding autologous stem cell transplantation for patients with high-risk lymphoma or Hodgkin's disease.
This Phase I study was designed to evaluate the tolerability of involved-field radiotherapy (IFRT) to areas of persistent disease in patients with high-risk Hodgkin's disease and non-Hodgkin's lymphomas before autologous stem cell transplantation (ASCT). ⋯ The maximal tolerated dose of IFRT was not reached when Grade 3-4 Bearman toxicity was dose limiting. Increased pulmonary toxicity and mucositis severity was seen after mediastinal IFRT compared with nonmediastinal IFRT. Because local control was excellent, higher doses of IFRT are not recommended. The absolute benefit of IFRT in this patient population needs investigation in future studies.
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Int. J. Radiat. Oncol. Biol. Phys. · May 2004
Intensity-modulated radiation therapy for oropharyngeal carcinoma: impact of tumor volume.
To assess the therapeutic outcomes in oropharyngeal cancer patients treated with intensity-modulated radiotherapy (IMRT) and analyze the impact of primary gross tumor volume (GTV) and nodal GTV (nGTV) on survival and locoregional control rates. ⋯ IMRT is an effective treatment modality for locally advanced oropharyngeal carcinoma. The GTV and nGTV are the most important factors predictive of therapeutic outcome.
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Int. J. Radiat. Oncol. Biol. Phys. · May 2004
Stereotactic radiotherapy for treatment of cavernous sinus meningiomas.
To assess the safety and efficacy of stereotactic radiotherapy (SRT) using a linear accelerator equipped with a micromultileaf collimator for cavernous sinus meningiomas. ⋯ Stereotactic radiotherapy is both safe and effective for patients with cavernous sinus meningiomas. Field shaping using a micromultileaf collimator allows conformal and homogeneous radiation of cavernous sinus meningiomas that may not be amenable to single-fraction stereotactic radiosurgery because of tumor size or location. Additional clinical experience is necessary to determine the position of SRT among the available innovative fractionated RT options for challenging skull base meningiomas.