Clinical oncology : a journal of the Royal College of Radiologists
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Clin Oncol (R Coll Radiol) · May 2008
Improved quality of life with hyperbaric oxygen therapy in patients with persistent pelvic radiation-induced toxicity.
We report the results of hyperbaric oxygen therapy (HBOT) used in the treatment of radiation-induced persistent side-effects after the irradiation of pelvic tumours. ⋯ HBOT is apparently safe and effective in managing radiation-induced late side-effects, such as soft tissue necrosis (skin and vagina), cystitis, proctitis and fistulas.
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Clin Oncol (R Coll Radiol) · May 2008
A comparison of internal target volume definition by limited four-dimensional computed tomography, the addition of patient-specific margins, or the addition of generic margins when planning radical radiotherapy for lymph node-positive non-small cell lung cancer.
Radical radiotherapy for stage II/III non-small cell lung cancer (NSCLC) includes the primary tumour and positive mediastinal lymph nodes in the clinical target volume (CTV). These move independently of each other in magnitude and direction during respiration. To prevent a geographical miss, a generic margin is usually added to the CTV to create an internal target volume (ITV). Previous studies have investigated the use of additional breath-hold computed tomography to generate patient-specific ITVs for primary tumours alone. We used a similar technique to investigate the generation of patient-specific and generic ITVs for CTVs that include mediastinal lymph nodes. ⋯ Further work is required to determine whether end-tidal breath-hold scans are representative of the anatomy at the limits of tidal respiration. Planning strategies are also needed to account for breathing cycle variation during a course of radiotherapy.
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Clin Oncol (R Coll Radiol) · Apr 2008
Randomized Controlled TrialConcomitant boost radiotherapy compared with conventional radiotherapy in squamous cell carcinoma of the head and neck--a phase III trial from a single institution in India.
To test the efficacy of an accelerated fractionation schedule (concomitant boost) against standard conventional fractionation in squamous cell carcinomas of the head and neck region in our patient population. ⋯ Concomitant boost is a therapeutically superior and logistically feasible accelerated radiotherapy regimen in advanced head and neck cancers, especially in the setting of a developing country.
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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.