Clinical oncology : a journal of the Royal College of Radiologists
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To explore the presence of symptom clusters in patients with brain metastases. ⋯ Symptom clusters seemed to exist in patients with brain metastases before and after whole brain radiotherapy. However, different symptoms clustered at various time points. The effectiveness of whole brain radiotherapy in providing palliative relief to patients with brain metastases needs to be explored with regards to symptom clusters.
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Clin Oncol (R Coll Radiol) · Feb 2008
When should we define the response rates in the treatment of bone metastases by palliative radiotherapy?
It is well established that palliative radiotherapy provides effective pain relief for symptomatic bone metastases, but controversy remains regarding the optimal dose fractionation. Several meta-analyses and systematic reviews of trials comparing the efficacy of single vs multiple fractionated radiotherapy schedules noted that it is difficult to reach a consensus when inconsistent response end point definitions are used. The purpose of this study was to determine when the most appropriate time to evaluate a response is. ⋯ We conclude that 2 months after radiotherapy is the most appropriate time point to measure response rates for two reasons: (i) the maximum pain relief for some patients may take more than 4 weeks to achieve and (ii) attrition poses a major problem when response rates are measured at a later date. Future trials should use standardised criteria for end points to facilitate comparison and analysis across clinical trials. Given the limitations of this study, however, further investigations are needed to confirm the response time points for palliative cancer patients.
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Clin Oncol (R Coll Radiol) · Feb 2008
Randomized Controlled Trial Multicenter Study Comparative StudyA comparison of treatment planning techniques used in two randomised UK external beam radiotherapy trials for localised prostate cancer.
To compare the radiotherapy planning techniques from two multicentre randomised external beam radiotherapy trials in the UK of conformal radiotherapy vs intensity-modulated radiotherapy (IMRT). ⋯ The forward planned CHHiP IMRT planning solution gives more favourable rectal sparing than the RT-01 plan. This is important to limit any potential increase in late rectal toxicity for prostate cancer patients treated with high-dose conventional or hypofractionated schedules.
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Clin Oncol (R Coll Radiol) · Feb 2008
Comparative StudyDosimetric comparison of conventional radiograph- and three-dimensional computed tomography-based planning using dose volume indices for partial breast intraoperative implants.
The dosimetric outcomes of radiograph- and computed tomography-based plans generated with various optimisation strategies were compared using dose volume indices for partial breast intraoperative implants. ⋯ Objective dosimetric evaluation on three-dimensional computed tomography confirms its superiority over conventional two-dimensional radiograph-based planning in terms of a reduction in normal breast irradiated with the prescription dose and improvement in conformity. Interactive graphical optimisation based on the target volume in computed tomography further improves conformity with a reduction in dose homogeneity. The use of dose volume indices allows the comparison of different plans and can be used as a tool to correlate dosimetric with clinical outcome.