International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Jun 1984
Quality assurance in radiation therapy: multidisciplinary considerations--European experience.
The organization of a multidisciplinary cancer treatment center is very heterogeneous in Europe. In Eastern Europe, there are written concepts of cancer treatment with advanced plans and an acceptable position for radiotherapy. In the future, there will be no principal differences between Eastern and Western Europe. ⋯ In the Scandanavian countries, radiotherapy has always had a strong position and has been able to develop further by integration with medical oncology. Cooperation between radiotherapists, radiophysicists, surgeons, pathologists, cytologists, etc., has given the cancer patient an opportunity for better overall treatment. The quality assurance in cancer therapy is the teamwork between different specialists before the treatment plan for the patient is decided.
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A shortage of radiation therapy technologists has existed in the United States for many years. This report analyzes the data from the third manpower survey of ACR/ASTR carried out in 1981 to 1982, using the Patterns of Care master facility list. Of 1106 questionnaires mailed, 77% were returned. ⋯ A trend toward a changing standard of 3 RTT/megavoltage unit, reflecting the increased complexity of modern radiation therapy techniques, especially in Patterns of Care Strata A1, A2, C1 institutions was identified. While great progress has been made, there is a continuing need for recruitment into the 113 existing educational programs to try to stabilize the supply of technologists. Attention should also be given to measures for upgrading the skills and knowledge of the non RTT personnel in the field and retention of the RTT personnel.
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Int. J. Radiat. Oncol. Biol. Phys. · Dec 1983
Intensive combined modality therapy including low-dose TBI in high-risk Ewing's Sarcoma Patients.
Twenty-four high-risk Ewing's sarcoma patients were treatedf on an intensive combined modality protocol including low-dose fractionated total body irradiation (TBI) and autologous bone marrow infusion (ABMI). Twenty patients (83%) achieved a complete clinical response to the primary and/or metastatic sites following induction therapy. The median disease-free interval was 18 months, and nine patients remain disease-free with a follow-up of 22 to 72 months. ⋯ We conclude that these high-risk Ewing's sarcoma patients remain a poor-prognosis group in spite of intensive combined modality therapy include low-dose TBI. The control of microscopic systemic disease remains the major challenge to improving the cure rate. A new combined modality protocol with high-dose 'therapeutic' TBI (800 rad/2 fractions) is being used and the protocol design is outlined.
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Int. J. Radiat. Oncol. Biol. Phys. · Aug 1983
Randomized Controlled Trial Clinical TrialA randomized comparison of misonidazole sensitized radiotherapy plus BCNU and radiotherapy plus BCNU for treatment of malignant glioma after surgery; preliminary results of an RTOG study.
A randomized prospective study was performed to evaluate misonidazole radiosensitized radiation therapy in the treatment of malignant glioma. The control arm, Group A, consisted of conventional radiation therapy (6000 cGy/6-7 weeks) to the whole brain plus BCNU (80 mg/m2 on day 3, 4, 5, and then repeated q 8 weeks for 2 years). The BCNU schedule was identical in both arms. ⋯ The median survival for Group A was 12.6, and for Group B, 10.7 months. Misonidazole toxicity included an 11% peripheral neuropathy and a 3% central nervous system toxicity. BCNU toxicity included severe hematologic toxicity in 25%, including one death, and significant pulmonary toxicity in 6 out of 55 patients who received a minimum total dose of 960 mg/m2 of BCNU.