International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Apr 1999
Local-regional control of recurrent breast carcinoma after mastectomy: does hyperfractionated accelerated radiotherapy improve local control?
Hyperfractionated, accelerated radiotherapy (HART) has been advocated for patients with local-regionally recurrent breast cancer because it is believed to enhance treatment effects in rapidly proliferating or chemoresistant tumors. This report examines the value of HART in patients with local-regionally recurrent breast cancer treated with multimodality therapy. ⋯ Hyperfractionated accelerated radiotherapy, although well tolerated by patients with local-regionally recurrent breast cancer, did not result in superior local-regional control rates when compared to daily fractionated regimens. Alternative strategies, such as dose escalation or chemoradiation, may be required to improve control.
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Int. J. Radiat. Oncol. Biol. Phys. · Apr 1999
National survey on prophylactic cranial irradiation: differences in practice patterns between medical and radiation oncologists.
Prophylactic cranial irradiation (PCI) in the treatment of small cell lung cancer (SCLC) patients remains controversial in the oncology community because of its potential for long-term toxicity and unproven survival benefit in randomized trials. A national survey of 9176 oncologists was conducted to characterize the use of PCI with regard to physician demographics, patient characteristics, and oncologists' beliefs. ⋯ Results confirm that oncologic subspecialists have statistically significant differences in opinion regarding the use of PCI. However, these differences may not translate into large differences in clinical practice. Most oncologists continue to recommend PCI in limited-stage SCLC patients, despite many believing PCI may not provide a survival advantage nor improve quality of life.
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Int. J. Radiat. Oncol. Biol. Phys. · Mar 1999
The employment status of 1995 graduates from radiation oncology training programs in the United States.
To quantify the employment status of 1995 graduates of radiation oncology training programs in the United States. ⋯ This is the only employment survey for any specialty in which a 100% response rate was achieved. Upon graduation, a significant number of residents and fellows were either unemployed or involuntarily underemployed. The job market absorbed only a fraction of them at 6-8 months. Most graduates, including those employed full-time, were not satisfied with the practice opportunities available to them during their job search. Many private-sector jobs did not offer a partnership track, and those that did required an increased employment period. A higher rate of involuntary part-time employment was seen for female graduates. Geographic restrictions in job search alone could not account for graduates being unemployed or underemployed, and could not account for gender differences. An overwhelming majority of 1995 radiation oncology graduates believed that the job market had deteriorated and that there was an oversupply of radiation oncologists. As one of two major studies tracking the employment status of radiation oncology graduates, we believe this study to be superior in methodology. We also believe this study presents data in a manner useful to medical students, training program directors, and healthcare policymakers.
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Int. J. Radiat. Oncol. Biol. Phys. · Mar 1999
Radiation therapy in the treatment of giant cell tumor of bone.
To assess the local control rate and potential complications of radiotherapy, and the factors influencing response to radiotherapy for primary and locally recurrent giant cell tumor of bone. ⋯ Radiotherapy is effective in producing local control in primary as well as recurrent giant cell tumor of bone. There are no major complications and no significant risk of malignant transformation. Radiotherapy could be considered as the primary treatment modality in patients where surgery would produce functional deficits.
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Int. J. Radiat. Oncol. Biol. Phys. · Mar 1999
Rectal dosimetric analysis following prostate brachytherapy.
To retrospectively assess the rectal tolerance dose in transperineal ultrasound-guided prostate brachytherapy using easily measured point doses. ⋯ Our results indicate that in an implant program which maintains the anterior rectal mucosa point dose averages to about 85% of the prescribed dose (regardless of the choice of isotope or the treatment approach), the average maximum to 120% of mPD, and the length of the anterior rectal mucosa receiving 100% and 120% of the prescribed dose at approximately 10 mm and 5 mm, respectively, the incidence of mild self-limited proctitis will be in the range of approximately 9%, without incidence of rectal ulceration and/or fistula formation.