Clinical oncology : a journal of the Royal College of Radiologists
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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.
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Clin Oncol (R Coll Radiol) · Dec 2007
ReviewGastrointestinal problems after pelvic radiotherapy: the past, the present and the future.
Up to 300,000 patients per year undergo pelvic radiotherapy worldwide. Nine out of 10 will develop a permanent change in their bowel habit as a result. Five out of 10 of all patients will say that this change in their bowel habit affects quality of life and two to three out of 10 will say that this effect on quality of life is moderate or severe. ⋯ Although research carried out into the basic molecular, cytokine and physiological changes underlying radiation-induced bowel symptoms and the optimal treatment that should be provided to symptomatic patients is scant, it does seem probable that a significant proportion of these patients can be cured or improved by specialist gastroenterological intervention. However, most patients never get referred to a specialist gastroenterologist and research into late radiation bowel damage has not been considered a priority. With the advent of more effective cancer therapies leading to greater numbers of affected long-term survivors, much more emphasis is urgently required to provide better information to patients at the start and after treatment, developing techniques that might reduce the frequency of significant bowel toxicity and researching better ways of measuring and treating late-onset side-effects.
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Clin Oncol (R Coll Radiol) · Sep 2007
Worst, average or current pain in the Brief Pain Inventory: which should be used to calculate the response to palliative radiotherapy in patients with bone metastases?
To determine which pain intensity scale in the Brief Pain Inventory correlates best with functional interference and should be used to calculate the response to palliative radiotherapy. To determine the differences in functional interference scores for patients classified as responders and non-responders to palliative radiotherapy. ⋯ Worst pain intensity had higher correlations with all functional interference scores except relationships with others. Therefore, we recommend an 11-point scale measuring worst pain to evaluate response rates in future radiotherapy trials. The mean difference from baseline to follow-up in functional interference scores was significantly larger in patients who responded to radiotherapy treatment.
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Clin Oncol (R Coll Radiol) · Sep 2007
Detection of occult spinal cord compression with magnetic resonance imaging of the spine.
Spinal cord compression (SCC) is the most significant complication due to skeletal metastasis from prostate cancer. The early detection of SCC is essential as the neurological status before treatment is the major determinant influencing outcome. The aim of this investigation was to determine the role of magnetic resonance imaging of the spine in detecting SCC or occult SCC in patients with metastatic prostate cancer with no functional neurological deficit (FND). ⋯ A significant proportion (27.3%) of patients with metastatic prostate cancer may harbour overt or occult SCC in the absence of FND. MRI of the spine for the early diagnosis of SCC may be considered useful in patients with extensive skeletal metastasis and back pain.