American journal of clinical oncology
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Am. J. Clin. Oncol. · Feb 2013
Randomized Controlled Trial Multicenter Study Comparative StudyComparison of lymphedema in patients with axillary lymph node dissections to those with sentinel lymph node biopsy followed by immediate and delayed ALND.
The purpose of the study was to show that delayed axillary lymph node dissection (ALND) has higher rates of lymphedema compared with immediate ALND, using data from NSABP-B32 at Beaumont Hospital. ⋯ The rate of lymphedema was higher in delayed ALND but not statistically significant. Comparison, however, is difficult, given the limited sample size. We urge the other centers of NSABP-B32 to validate this, by contacting the node-positive patients for measurements. The lymphedema rate for SLNB alone was 0% and approached statistical significance when compared with node-negative ALND.
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Am. J. Clin. Oncol. · Aug 2012
Comparative StudyClinical versus pathologic staging for prostate adenocarcinoma: how do they correlate?
We assessed the ability of 3 clinical factors-stage, D'Amico risk stratification, and Roach formula-estimated nodal risk-to predict the pathologic outcomes in a modern cohort of prostate cancer patients. ⋯ Pathologic staging results in higher risk stratification than that predicted by clinical criteria in the majority of patients. Nodal positivity at diagnosis is uncommon in the current era, and the Roach formula overestimates the actual risk of node-positive disease.
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Am. J. Clin. Oncol. · Jun 2012
Is there a clinical benefit to adaptive planning during tomotherapy in patients with head and neck cancer at risk for xerostomia?
To evaluate the necessity of adaptive planning in helical tomotherapy (TOMO) for head and neck cancer in terms of dosimetric influence on the parotid gland. ⋯ For patients with significant anatomic contour change; neck diameter decrease (>10%) or weight loss (>5%), adaptive planning using mega-voltage computed tomography can identify dosimetric changes and reduce deleterious side effects such as xerostomia.
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Am. J. Clin. Oncol. · Jun 2012
ReviewACR Appropriateness Criteria® follow-up and retreatment of brain metastases.
Multiple options for retreatment are available, which include whole-brain radiation therapy, stereotactic radiosurgery, surgery, chemotherapy, and supportive care. Size, number, timing, location, histology, performance status, and extracranial disease status all need to be carefully considered when choosing a treatment modality. There are no randomized trials examining the retreatment of brain metastases. ⋯ The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of the current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
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Am. J. Clin. Oncol. · Jun 2012
Adjuvant radiation therapy increases overall survival in node-positive gastric cancer patients with aggressive surgical resection and lymph node dissection: a SEER database analysis.
To determine the outcomes of postoperative radiation therapy on survival in gastric cancer. ⋯ There is a correlation between survival and radiation therapy in node-positive gastric cancer patients and is independent of the extent of surgical resection and lymph node dissection.