Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
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Evaluation of loco-regional failure patterns and survival after parotid-sparing three-dimensional conformal and intensity modulated radiotherapy (IMRT) for head and neck cancer. ⋯ The selection of patients treated with parotid-sparing radiotherapy, by omitting irradiation to the junctional nodes contralateral to the tumour, proved to be safe in our hands, since no recurrences developed in the spared area. As this parotid-sparing technique reduces significantly the dose to the contralateral parotid and is easy to perform, it should be considered for all selected patients.
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Comparative Study
Potential outcomes of modalities and techniques in radiotherapy for patients with hypopharyngeal carcinoma.
To determine potential improvements in treatment outcome for patients with hypopharyngeal carcinoma, T4N0M0, using proton and intensity modulated photon radiotherapy (IMRT) compared to a standard 3D conformal radiotherapy treatment (3D-CRT) in terms of local tumour control probability, TCP, and normal tissue complication probability (NTCP) for the spinal cord and the parotid glands using. ⋯ Protons and IMRT gave a significant TCP increase compared to 3D-CRT while no significant difference between protons and IMRT was found. Protons generally show lower non-target tissue doses, which indicates a possibility for further dose escalation. Large individual dose differences between protons and IMRT for parotid glands indicate that some patients may benefit more from protons and others from IMRT.
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Postoperative radiotherapy in endometrial cancer reduces the risk of local relapse but is also associated with substantial acute and late reactions. The aim of our study was to evaluate time without tumor symptoms and toxicity (TWIST) in a consecutive series of 317 endometrial cancer patients administered postoperative irradiation. ⋯ Endometrial cancer patients treated with postoperative irradiation have a long time interval without relapse and severe late toxicity. However, when any late normal tissue injury is considered, the median time without relapse and late toxicity is significantly shorter. The impact of mild late radiotherapy complications on the quality of life should be further investigated. TWIST calculation should be attempted in future prospective studies evaluating the role of postoperative radiotherapy.
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Randomized Controlled Trial Multicenter Study Clinical Trial
The influence of the boost technique on local control in breast conserving treatment in the EORTC 'boost versus no boost' randomised trial.
The EORTC Trial 22881/10882 investigating the role of a boost dose in breast conserving therapy demonstrated a significantly better local control rate with the higher radiotherapy dose, especially in women younger than 50 years of age. This paper investigates the potential impact of the different boost techniques on local control and on fibrosis after breast conserving therapy. ⋯ Although the three groups are of a rather unequal size, the results of the interstitial boost seem similar in terms of fibrosis and at least as good in terms of local control, despite a lower treatment volume and a longer overall treatment time.
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Clinical Trial
Breathing adapted radiotherapy of breast cancer: reduction of cardiac and pulmonary doses using voluntary inspiration breath-hold.
Adjuvant radiotherapy of breast cancer using wide tangential photon fields implies a risk of late cardiac and pulmonary toxicity. This CT-study evaluates the detailed potential dosimetric consequences of applying breathing adapted radiotherapy (BART), and the feasibility of a monitored voluntary breath-hold technique for right-sided as well as for left-sided tumours. ⋯ Irradiated cardiac volumes can consistently be reduced for left-sided breast cancers using DIBH for wide tangential treatment fields. Additionally, substantial dose reductions in the lung are observed for both right- and left-sided tumours.