Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
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To evaluate the influence of uterus and bladder size on large and small bowel sparing with intensity modulated whole pelvic radiotherapy (IM-WPRT) in gynecologic patients. ⋯ IMRT significantly reduced the absolute volume of rectal wall, bladder and bowel irradiated at the prescribed dose level in gynaecologic patients. Main differences between POST and DEF patients receiving IM-WPRT were absolute volumes of LB irradiated to doses between 35 and 50Gy, suggesting an impact of intact uterus on LB volume in the pelvis. POST patients seem to benefit most from elective nodal IMRT. Bladder filling is an important co-factor influencing the benefit of IMRT with respect to OAR sparing.
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To evaluate the early side effects of a short course hypofractionated radiotherapy regimen in prostate cancer. ⋯ Though no grade 3-4 side effects were observed, the investigated schedule results in a marked increase of grade 1-2 early side effects as compared to a conventional regimen. Side effects resolved within two months post-treatment.
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Multicenter Study
Clinical experience with the MammoSite radiation therapy system for brachytherapy of breast cancer: results from an international phase II trial.
In a prospective multi-center phase II trial, we investigated the MammoSite Radiation Therapy System, a new device for delivering intracavitary brachytherapy following breast conserving surgery. The MammoSite is a dual lumen, closed ended catheter with a small, spherical inflatable balloon and a port for connecting a remote afterloader to the central lumen. We analyzed the surgical procedure and placement of the MammoSite, treatment planning and radiation delivery complications and cosmesis, as well the comfort for the patients. ⋯ The MammoSite Radiation Therapy System is a feasible treatment modality for intracavitary brachytherapy of breast cancer after breast conserving surgery. The advantage of the system is only one applicator is necessary for the delivery of a fractionated radiotherapy. In addition, patient tolerance of the procedure is high. Critical issues concern possible overdosages at the skin reflected by a high rate of late skin damage after only 20 months of follow-up time. The method could serve as an alternative to conventional multi-catheter brachytherapy for a selected group of patients.
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Comparative Study
Dosimetric comparisons between high dose rate interstitial and MammoSite balloon brachytherapy for breast cancer.
To make a quantitative dosimetric comparison between treatment plans of multicatheter-based interstitial brachytherapy (IB) and MammoSite brachytherapy (MSB) for breast cancer. ⋯ Target volume coverage was better for MSB than conventional IB, and it was comparable to conformal IB. The suboptimal coverage for IB patients is due to radiography based planning, which is unable to provide 3D information of the target. Dose homogeneity was somewhat better for MSB than IB(CONV), but the dose to skin and lung was higher for MSB. The MSB provides dosimetrically acceptable dose plans. The quality of interstitial implants can be improved with image-guided catheter insertions regarding both homogeneity and conformality.
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To investigate the feasibility and potential benefits of combining electron and photon intensity modulated radiotherapy (IMRT) for patients with malignant pleural mesothelioma (MPM). ⋯ This study showed that IMRT or IMRT+e is a viable treatment modality for MPM patients. Both plans can provide excellent target coverage and normal tissue sparing, but with the addition of electron beams, the critical structures can be further spared. Additional refining of the electron contribution is expected to further reduce radiation-induced morbidity.