International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Feb 1999
Radiosurgery for brain metastases: is whole brain radiotherapy necessary?
Because whole brain radiotherapy (WBRT) may cause dementia in long-term survivors, selected patients with brain metastases may benefit from initial treatment with radiosurgery (RS) alone reserving WBRT for salvage as needed. We reviewed results of RS +/- WBRT in patients with newly diagnosed brain metastasis to provide background for a prospective trial. ⋯ The omission of WBRT in the initial management of patients treated with RS for up to 4 brain metastases does not appear to compromise survival or intracranial control allowing for salvage therapy as indicated. A randomized trial of RS vs. RS + WBRT is needed to assess survival, quality of life, and cost in good-prognosis patients with newly diagnosed brain metastases.
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Int. J. Radiat. Oncol. Biol. Phys. · Feb 1999
Review Clinical TrialUse of three-dimensional radiation therapy planning tools and intraoperative ultrasound to evaluate high dose rate prostate brachytherapy implants.
We performed a pilot study to evaluate the quality of high dose rate (HDR) prostate implants using a new technique combining intraoperative real-time ultrasound images with a commercially available 3-dimensional radiation therapy planning (3D RTP) system. ⋯ The feasibility of evaluating HDR prostate implants using ultrasound images (acquired immediately prior to treatment) with a commercially available 3D RTP system was established. The dosimetric characteristics of these HDR implants appear to be substantially different compared to permanent implants. These developments allow quantitative evaluation of the dosimetric quality of HDR prostate treatments. Future studies will examine any correlation between the dosimetric quality of the implant and clinical/biochemical outcomes.
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Int. J. Radiat. Oncol. Biol. Phys. · Feb 1999
Total body irradiation correlates with chronic graft versus host disease and affects prognosis of patients with acute lymphoblastic leukemia receiving an HLA identical allogeneic bone marrow transplant.
To investigate whether different procedure variables involved in the delivery of fractionated total body irradiation (TBI) impact on prognosis of patients affected by acute lymphoblastic leukemia (ALL) receiving allogeneic bone marrow transplant (BMT). ⋯ This retrospective analysis showed that different variables involved in TBI delivery may influence the occurrence of cGvHd and affect prognosis of patients with ALL receiving allogeneic BMT. The total dose of 12 Gy, administered in six fractions over 3 days, appears to be an effective and low toxic regimen for ALL patients transplanted in first remission.
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Int. J. Radiat. Oncol. Biol. Phys. · Jan 1999
Hodgkin's disease with lymphocyte predominance: long-term results based on current histopathologic criteria.
To define the disease course, therapeutic strategies, patterns and rates of relapse and causes of death for patients with Hodgkin's disease with lymphocyte predominance (LPHD) and to assess prognostic factors including nodular and diffuse histologic patterns. ⋯ Patients with LPHD usually present with localized and asymptomatic disease. Laparotomy is unnecessary if the lymphogram is negative. Nodular histology occurred in the majority of patients. Though all relapses from diffuse subtype occurred within 3 years in contrast to some late relapses observed for nodular subtype, there was no statistically significant difference in relapse free survival or survival between the subtypes. The extent of irradiation had no effect on relapse free survival or survival. We could not find any evidence that LPHD should be treated any different from the classical Hodgkin's disease at this point despite suggestions that it be classified as a non-Hodgkin's B-cell lymphoma.
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Int. J. Radiat. Oncol. Biol. Phys. · Jan 1999
Patterns of radiotherapy practice for patients with squamous carcinoma of the uterine cervix: patterns of care study.
To determine the impact of research findings and evolving technology on the patterns of radiotherapy practice for patients with carcinoma of the uterine cervix. ⋯ Greater participation in well-designed prospective trials might help clinicians address important clinical questions and reduce current inconsistencies in the use of adjuvant treatments. Radiation oncologists should take steps to avoid unnecessary treatment protraction and to improve patient compliance. Future studies will be needed to determine whether the small number of cases being treated in most nonacademic facilities will influence the outcome for patients with invasive cervical carcinoma.