International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 1995
Multicenter StudyRadiotherapy and chemotherapy for invasive thymomas: a multicentric retrospective review of 90 cases. The FNCLCC trialists. Fédération Nationale des Centres de Lutte Contre le Cancer.
Thymoma is a rare disease. The treatment of patients with invasive thymoma remains controversial. The prognosis of such patients is poor, even with the use of postoperative radiation therapy and chemotherapy. We retrospectively reviewed the outcome and prognostic factors in a series of 90 patients presenting with an invasive thymoma treated by partial resection or biopsy and radiation therapy. ⋯ In this large multicentric retrospective study of invasive thymomas (Stage III-IVA) treated by surgery and radiation, results show the importance of loco-regional treatments, such as surgery and radiation therapy. There is also a great impact of radiation on local control. However, the rate of local recurrence (34%) justifies recommending a higher dose of radiation (> 50 Gy) than doses used in this study, for incompletely resected patients. The role of chemotherapy needs to be further assessed.
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 1995
Cataracts after bone marrow transplantation: long-term follow-up of adults treated with fractionated total body irradiation.
To determine the risk of, and risk factors for, developing cataracts after bone marrow transplantation. ⋯ TBI is the major risk factor for developing cataracts after BMT. Single-dose TBI results in the highest risk of cataracts. However, the risk of cataracts in recipients of fractionated-TBI is significantly higher than in patients who receive no TBI. In addition to TBI, steroid therapy is an independent risk factor for cataracts after BMT.
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 1995
Split-course accelerated therapy in head and neck cancer: an analysis of toxicity.
To retrospectively assess a protocol of split-course accelerated radiation therapy (SCAT) for selected head and neck cancers. ⋯ Given the encouraging complete response rate and local control for such advanced tumors, SCAT for locoregionally advanced tumors merits further investigation. However, because of the significant late toxicity observed, the total dose, interfraction interval, and fractionation technique used should be reconsidered.
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 1995
The influence of positive margins and nerve invasion in adenoid cystic carcinoma of the head and neck treated with surgery and radiation.
Surgery is the primary treatment for adenoid cystic carcinomas arising from major and minor salivary glands of the head and neck. However, local recurrence is frequent because of the infiltrative growth pattern and perineural spread associated with these tumors. At UTMDACC, we have had a longstanding policy of using postoperative radiotherapy to reduce the risk of local recurrence and to avoid the need for radical surgery; this 30-year retrospective study analyzes the results of this combined modality approach. ⋯ Excellent local control rates were obtained in this population using surgery and postoperative radiotherapy and we recommend this combined approach for most patients with adenoid cystic carcinomas of the head and neck. Perineural invasion was an adverse prognostic factor only when a major (named) nerve was involved. Microscopic positive margins was also an adverse prognostic factor, but even when present, local control was achieved in over 80% of our patients. We recommend a dose of 60 Gy to the tumor bed, supplemented to 66 Gy for patients with positive margins. Despite effective local therapy, one-third of patients fail systemically, and good treatment to address this problem is lacking.
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 1995
A method for delivering accurate and uniform radiation dosages to the head and neck with asymmetric collimators and a single isocenter.
To investigate the use of asymmetric collimators and a single isocenter for delivering a uniform, accurate dose of radiation to the head, neck, and supraclavicular lymph nodes. ⋯ The asymmetric collimators lead to easy and accurate patient setup. The absence of the trapezoid effect resulted in the complete coverage of the submandibular and cervical nodes without any hot spots.