Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
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Multicenter Study Comparative Study
Observer variation in target volume delineation of lung cancer related to radiation oncologist-computer interaction: a 'Big Brother' evaluation.
To evaluate the process of target volume delineation in lung cancer for optimization of imaging, delineation protocol and delineation software. ⋯ With the 'Big Brother' tool a method was developed to trace the delineation process. The differences between observers concerning the delineation style were large. This study led to recommendations on how to improve delineation accuracy by adapting the delineation protocol (guidelines for L/W use) and delineation software (double window with lung and mediastinum L/W settings at the same time, enforced use of coronal and sagittal views) and including FDG-PET information (lymph nodes and atelectasis).
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To investigate the feasibility and the advantages of using Intensity-Modulated Radiotherapy (IMRT) for the treatment of head-and-neck cancer. Comparing different methods to deliver IMRT in this clinical setting. ⋯ With the Varian planning and delivery system, Step-and-shoot approximations of inversely optimised fluences in head-neck IMRT compare well with SW delivery, even with only five intensity levels. With a number of intensity level of 10 or more, no differences can be appreciated in PTV coverage/OAR sparing with respect to SW.
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To investigate the association between the mean salivary gland and oral cavity dose, with patient-rated moderate and severe xerostomia and sticky saliva. ⋯ Both MD(par) and MD(subm) influence the risk of xerostomia in irradiated patients at 6 months. This probability as a function of the mean parotid dose significantly depended on the mean dose in the submandibular glands. Sticky saliva mainly depends on MD(subm).
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To investigate the effect of radiotherapy planning with a dedicated combined PET-CT simulator of patients with locally advanced non-small cell lung cancer. ⋯ The use of a combined dedicated PET-CT-simulator reduced radiation exposure of the oesophagus and the lung, and thus allowed significant radiation dose escalation whilst respecting all relevant normal tissue constraints.
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Randomized Controlled Trial
Randomized clinical trial on continuous 7-days-a-week postoperative radiotherapy for high-risk squamous cell head-and-neck cancer: a report on acute normal tissue reactions.
To analyse acute mucosal reactions in patients treated with continuous accelerated postoperative irradiation (p-CAIR) compared to conventionally fractionated postoperative radiotherapy (p-CF). ⋯ While the incidence, intensity and duration of mucosal reactions was higher in p-CAIR than in p-CF the accelerated treatment can be considered tolerable with respect to acute toxicity. In both arms of the trial slight or moderate mucosal erythema was the most frequent acute side effect, which did not completely subside within 8 weeks after irradiation.