International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 2003
Elective nodal failures are uncommon in medically inoperable patients with Stage I non-small-cell lung carcinoma treated with limited radiotherapy fields.
To review the outcome for 56 Stage I non-small-cell lung cancer treated definitively with three-dimensional conformal radiotherapy (3D-CRT) and to investigate the value of elective nodal irradiation in this patient population. ⋯ Many patients with medically inoperable Stage I lung cancer die of intercurrent causes. The omission of the elective nodal regions from the RT portals did not compromise either the cause-specific or overall survival rate. Elective nodal failures were uncommon in the group treated with limited RT fields. A radiation dose 70 Gy was predictive of better survival in our population. We await the results of prospective trials evaluating high-dose RT in patients treated with RT alone for Stage I lung cancer.
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 2003
Long-term urinary quality of life after permanent prostate brachytherapy.
To evaluate late urinary function after permanent prostate brachytherapy using a validated, patient-administered quality-of-life instrument. ⋯ No significant difference was noted in the overall long-term urinary quality of life when brachytherapy patients were compared with a group of newly diagnosed prostate cancer patients of comparable demographics. Of all parameters evaluated, tobacco consumption was the single strongest predictor of late urinary function.
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 2003
Experience of ultrasound-based daily prostate localization.
The NOMOS (Sewickley, PA) B-mode Acquisition and Targeting System (BAT) ultrasound system provides a rapid means of correcting for interfraction prostate positional variation. In this investigation, we report our experience on the clinical issues relevant to the daily use of the BAT system and the analysis of combined setup error and organ motion for 3509 BAT alignment procedures in 147 consecutive patients treated with IMRT for prostate cancer. ⋯ The quality of the daily ultrasound images was deemed acceptable in 95%. Major alignment errors by therapists were only 3%. The BAT system is clinically effective and feasible in a matter of 5 min. Although the accuracy of the BAT was not addressed in this investigation, we found a significant percentage of large shifts being made from the initial alignment position.
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 2003
Is intraoperative nomogram-based overplanning of prostate implants necessary?
Several investigators have described intraoperative planning of prostate implants based on a nomogram. The aim of this work was to investigate the adequacy of the nomogram in predicting the total activity necessary for optimal dosimetry. ⋯ The doses evaluated at CT1 represent an underestimate, whereas those obtained at CT2 represent an overestimate of the actual delivered protracted permanent implant dose. Based on these results and consideration of the dynamic nature of the dose distribution, target coverage obtained with intraoperative planning using the nomogram predicted activity is consistent with published guidelines for a quality implant and critical structure doses are within tolerance.
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 2003
Significance of dose in postoperative radiotherapy for soft tissue sarcoma.
For soft tissue sarcoma, adjuvant postoperative radiotherapy improves the local control rate over surgery alone. However, the issue of a dose-control relationship is controversial and was addressed in this study. ⋯ After gross total resection, soft tissue sarcoma with features predictive of a higher than average local recurrence rate benefited from doses of 64-68 Gy compared with 60 Gy.