Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]
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Review Comparative Study
Positron emission tomography for radiation treatment planning.
To evaluate the impact of positron emission tomography (PET) on target volume delineation for radiation treatment planning. ⋯ Regarding treatment planning in radiotherapy, PET offers advantages in terms of tumor delineation and the description of biological processes. To define the real impact of this investigation in radiation treatment planning, subsequent experimental, clinical and cost-benefit analyses are required.
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Radiation treatment of head-and-neck tumors mostly leads to a damage to the salivary glands and a consequential permanent loss of saliva. The aim of this investigation was to establish a modern three-dimensional conformal radiotherapy (3D-CRT) to show a decrease in severe xerostomia in contrast to the proven conventional technique (K-RT) with photons and electrons. ⋯ Basically, 3D-CRT seems to be suitable as a standard for all patients with carcinomas of the oral cavity, oro- and hypopharynx. Especially in patients with tumors located in the larynx and hypopharynx, averaged D(mean) doses of both parotids during irradiation can be reached, to conserve salivary flow rates, which are similar to baseline flow rates.
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Comparative Study
Comparative treatment planning on localized prostate carcinoma conformal photon- versus proton-based radiotherapy.
To assess the potential benefit of proton-beam therapy in comparison to 3-D conformal photon therapy and photon- based intensity-modulated radiotherapy (IMRT) in prostate carcinoma for various stages of disease. ⋯ IMRT enabled dose reductions to OARs in the medium dose range compared to 3-D conformal radiotherapy. A rather simple two-field proton-based treatment technique further reduced doses to OARs compared to photon-beam radiotherapy. The advantageous dose distribution of proton-beam therapy for prostate cancer may result in reduced side effects, which needs to be confirmed in clinical studies.
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Randomized Controlled Trial
Hypoxic versus normoxic external-beam irradiation of cervical carcinoma combined with californium-252 neutron brachytherapy. Comparative treatment results of a 5-year randomized study.
The article focuses on the treatment and protective effects of hypoxyradiotherapy during external-beam irradiation of cervical carcinoma, including paraaortic lymph nodes, combining radiotherapy with californium-252 ((252)Cf) neutron brachytherapy. An analysis of treatment results, early and late side effects and complications is presented. ⋯ The importance of the protective effects of hypoxyradiotherapy for dose escalation in external-beam irradiation of cervical carcinoma, including paraaortic lymph nodes, with regard to an improvement of the cure rates of metastases in paraaortic lymph nodes has been confirmed.
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Intensity-modulated stereotactic radiotherapy (IMSRT) has shown the ability to conform the dose to concavities and to better avoid critical organs for large tumors. Given the availability of an electronically driven micro-multileaf collimator, both intensity-modulated stereotactic radiosurgery (IMSRS) and dynamic conformal arc (DCA) technique (DCA) can be performed at the Novalis Shaped Beam Surgery Center, University of Erlangen-Nuremberg, Germany, since 12/2002. This study evaluates both techniques in small skull-base tumors treated with radiosurgery. ⋯ RTOG radiosurgery guidelines were best met by the DCA rather than IMSRS approach for the treatment of small skull-base lesions. The IMSRS approach will increase the time for planning, dose delivery and integral dose to the brain. Thus, IMSRT techniques are recommended for fractionated stereotactic radiotherapy to larger volumes rather than for radiosurgery in small skull-base lesions.