Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
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Practice Guideline Guideline
Quality assurance in radiotherapy. European Society for Therapeutic Radiology and Oncology Advisory Report to the Commission of the European Union for the 'Europe Against Cancer Programme'.
This document is now in the process of being endorsed by all National Scientific Societies of Radiotherapy and Medical Physics of the European countries. It can therefore not be formally considered as the definitive version and is still susceptible to benefit from further alterations or improvements.
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The European radiotherapy society has for many years had a great interest in quality assurance. The EORTC radiotherapy group has put enormous effort into its quality assurance programmes. ⋯ In 1992, in the radiotherapy department in Leiden, a project was started to develop a quality assurance system based on the so-called ISO 9001 quality standards. This paper describes how these standards can be applied to create a quality assurance system in a hospital department.
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Comparative Study
Early breast cancer: influence of type of boost (electrons vs iridium-192 implant) on local control and cosmesis after conservative surgery and radiation therapy.
Between December 1981 and December 1988, 329 consecutive patients with stage I and II breast cancers who underwent wide excision (n = 261) or quadrantectomy (n = 68) with (n = 303) or without (n = 26) axillary dissection were referred to radiotherapy. Final margins of resection were microscopically free from tumor involvement in all cases. Radiotherapy consisted in 40-45 Gy over 4-4.5 weeks to the breast, with (n = 168) or without (n = 161) regional nodal irradiation of 45-50 Gy over 4.5-5 weeks. ⋯ For all patients the 5- and 10-year local breast relapse rates were 6.7% and 11%, respectively. No difference was observed regarding local control either by the electron or the iridium-192 implant boosts. Axillary dissection and age had an impact on the breast cosmetic outcome.(ABSTRACT TRUNCATED AT 250 WORDS)
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Review Multicenter Study
Thymoma: results of a multicentric retrospective series of 149 non-metastatic irradiated patients and review of the literature. FNCLCC trialists. Fédération Nationale des Centres de Lutte Contre le Cancer.
Between 1979 and 1990, 149 patients with non-metastatic thymomas were treated in ten French cancer centers. Patients were staged according to the 'GETT' classification, derived from that of Masaoka. There were 13 stage I patients, 46 stage II, 58 stage III and 32 stage IVA. ⋯ Four factors could predict a worse overall survival in the multivariate analysis: mediastinal compression on presentation (p < 0.001), absence of chemotherapy (p < 0.001), biopsy alone (p = 0.003), and young age (p = 0.013). A worse DFS was predicted by mediastinal compression on presentation (p < 0.001), absence of chemotherapy (p < 0.001), young age (p = 0.006), and stages III-IVA (p = 0.04). Future therapeutic strategies are discussed and the literature is reviewed.
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This retrospective review of 85 patients presents the prognostic factors and disease outcome for localized synovial sarcoma treated with conservation surgery and radiotherapy. Tumors were located in the lower extremity (48), upper extremity (20), trunk (11), and head and neck (6). All patients were treated with limited excision and radiotherapy. ⋯ Ten-year metastatic rates according to tumor size, s, were s < or = 2 cm, 0%; 2 < s < or = 5 cm, 35%; 5 < s < or = 10 cm, 59%; 10 cm < s, 100%. Our retrospective data failed to reveal benefits for adjuvant chemotherapy either in univariate or multivariate analysis. Eight patients (9%) had local recurrence as the initial failure and 4 others had local failure after disease appeared elsewhere, yielding a 5-year actuarial local recurrence rate of 14%.(ABSTRACT TRUNCATED AT 250 WORDS)