Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
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Randomized Controlled Trial Multicenter Study Comparative Study
The impact of dose heterogeneity on late normal tissue complication risk after hypofractionated whole breast radiotherapy.
Linear quadratic models predict that hypofractionation increases the biological effect of physical dose inhomogeneity. The clinical significance of this effect was tested retrospectively in a trial of adjuvant breast hypofractionation. ⋯ Dose inhomogeneity had no greater impact on the risk of 2-year change in photographic breast appearance after hypofractionated breast radiotherapy than after standard fractionation.
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Randomized Controlled Trial Comparative Study
Predictors of severe late radiotherapy-related toxicity after hyperfractionated radiotherapy with or without concomitant cisplatin in locally advanced head and neck cancer. Secondary retrospective analysis of a randomized phase III trial (SAKK 10/94).
This secondary analysis was performed to identify predictive factors for severe late radiotherapy (RT)-related toxicity after treatment with hyperfractionated RT +/- concomitant cisplatin in locally advanced head and neck cancer. ⋯ Chemotherapy did not appear to affect severe late RT-related toxicity, but advanced N-classification, technically unresectable disease, weight loss ratio, and severe acute dysphagia were independent predictive factors for severe late RT-related toxicity.
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Comparative Study
Correlation between prostate brachytherapy-related urethral stricture and peri-apical urethral dosimetry: a matched case-control study.
Radiation dose to the bulbomembranous urethra has been shown to correlate with urethral stricture formation. This retrospective case-control study was designed to explore the relationship between dose to the apical/peri-apical regions of the urethra and development of brachytherapy (BXT)-related urethral stricture. ⋯ There was evidence to suggest that the development of BXT-related stricture was associated with radiation dose at the apical and peri-apical urethra. Attention to the dose delivered to those areas may minimise the risk of developing such morbidity.
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We reviewed our seven year single institution experience with pulsed dose rate brachytherapy dose escalation study in patients with intermediate and high risk prostate cancer. ⋯ Image-guided conformal PDR-brachytherapy using up to 35 Gy as boost dose after 50 Gy of external beam radiation therapy (total dose up to 85 Gy) is a very effective treatment option with very low morbidity in patients with intermediate or high risk prostate cancer. Further dose escalation seems possible.
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Reliable post-implant evaluation of prostate seed implants requires optimal seed identification and accurate delineation of anatomical structures. In this study the GEC-ESTRO groups BRAPHYQS and PROBATE investigated the interobserver variability in post-implant prostate contouring, seed reconstruction and image fusion and its impact on the dose-volume parameters. ⋯ The dosimetric parameters for prostate post-implant evaluation showed large technique-dependent interobserver variabilities. Contouring and image fusion are the 'weak links' in the procedure. Guidelines and training in contouring together with incorporation of automated fusion software need to be implemented.