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1:
Related Articles, Links
Chamberlain MC, Glantz MJ.
Predictors of Acute Esophagitis in Lung Cancer Patients Treated With Concurrent Three-
Dimensional Conformal Radiotherapy and Chemotherapy.
Int J Radiat Oncol Biol Phys. 2008 Aug 26. [Epub ahead of print]
PMID: 18755556 [PubMed - as supplied by publisher]
7:
Related Articles, Links
King CR, Brooks JD, Gill H, Pawlicki T, Cotrutz C, Presti JC Jr.
Stereotactic Body Radiotherapy for Localized Prostate Cancer: Interim Results of a Prospective
Phase II Clinical Trial.
Int J Radiat Oncol Biol Phys. 2008 Aug 26. [Epub ahead of print]
PMID: 18755555 [PubMed - as supplied by publisher]
8:
Related Articles, Links
Aaronson DS, Elliott SP, McAninch JW.
Transcorporal Artificial Urinary Sphincter Placement for Incontinence in High-risk Patients After
Treatment of Prostate Cancer.
Urology. 2008 Aug 25. [Epub ahead of print]
PMID: 18752838 [PubMed - as supplied by publisher]
9:
Related Articles, Links
Bjerggaard Jensen J, Johansen JK, Graversen PH.
Laparoscopic pelvic lymph-node dissection in prostate cancer before external beam radiotherapy:
Risk factors of nodal involvement and relapse following intended curative treatment.
Scand J Urol Nephrol. 2008 Aug 27:1-6. [Epub ahead of print]
PMID: 18752151 [PubMed - as supplied by publisher]
10:
Related Articles, Links
Maemura K, Shinchi H, Noma H, Mataki Y, Kurahara H, Maeda S, Hiraki Y, Nakajo M,
Natsugoe S, Takao S.
Ras pathway activation in gliomas: a strategic target for intranasal administration of perillyl
alcohol.
Arch Immunol Ther Exp (Warsz). 2008 Jul-Aug;56(4):267-76. Epub 2008 Jul 29.
PMID: 18726148 [PubMed - in process]
13:
Related Articles, Links
Smith GL, Smith BD, Buchholz TA, Giordano SH, Garden AS, Woodward WA, Krumholz HM,
Weber RS, Ang KK, Rosenthal DI.
Cerebrovascular Disease Risk in Older Head and Neck Cancer Patients After Radiotherapy.
J Clin Oncol. 2008 Aug 25. [Epub ahead of print]
PMID: 18725647 [PubMed - as supplied by publisher]
14:
Related Articles, Links
Fuwa N, Kodaira T, Tachibana H, Nakamura T, Tomita N, Daimon T.
Selective Axillary Node Sampling and Radiotherapy to the Axilla in the Management of Breast
Cancer.
Clin Oncol (R Coll Radiol). 2008 Aug 21. [Epub ahead of print]
PMID: 18722758 [PubMed - as supplied by publisher]
16:
Related Articles, Links
Chen Y, Guo W, Lu Y, Zou B.
Dose-individualized stereotactic body radiotherapy for T1-3N0 non-small cell lung cancer:
Long-term results and efficacy of adjuvant chemotherapy.
Radiother Oncol. 2008 Aug 21. [Epub ahead of print]
PMID: 18722684 [PubMed - as supplied by publisher]
17:
Related Articles, Links
Lian J, Dundas G, Carlone M, Ghosh S, Pearcey R.
[Article in French]
The << Standards, Options : Recommendations >> (SOR) project has been undertaken by
the French National Federation of Cancer Centers (FNCLCC) is now part of the French
National Cancer Institute. The project involves the development and updating of
evidence-based Clinical Practice Guidelines (CPG) in oncology. This paper is a summary
version of the full clinical practice guideline presenting the updated recommendations for
management of patients with salivary gland malignant tumours. Recommendations on
radiotherapy have been updated to underline new Options on more and more accessible
emerging techniques including intensity-modulated radiotherapy, 3D conformational
radiotherapy, Cyberknife, tomotherapy, protontherapy and particle accelerators producing
carbon ions (e.g. last generation hadrontherapy).
Publication Types:
• English Abstract
PURPOSE: To quantify the interfraction position variability of the excision cavity (EC)
and to compare the rib and breast surface as surrogates for the cavity. Additionally, we
sought to determine the required margin for on-line, off-line and no correction protocols
in external beam radiotherapy. METHODS AND MATERIALS: A total of 20 patients
were studied who had been treated in the supine position for 28 daily fractions. Cone-
beam computed tomography scans were regularly acquired according to a shrinking
action level setup correction protocol based on bony anatomy registration of the ribs and
sternum. The position of the excision area was retrospectively analyzed by gray value
cone-beam computed tomography-to-computed tomography registration. Subsequently,
three setup correction strategies (on-line, off-line, and no corrections) were applied,
according to the rib and breast surface registrations, to estimate the residual setup errors
(systematic [Sigma] and random [sigma]) of the excision area. The required margins were
calculated using a margin recipe. RESULTS: The image quality of the cone-beam
computed tomography scans was sufficient for localization of the EC. The margins
required for the investigated setup correction protocols and the setup errors for the left-
right, craniocaudal and anteroposterior directions were 8.3 mm (Sigma = 3.0, sigma =
2.6), 10.6 mm (Sigma = 3.8, sigma = 3.2), and 7.7 mm (Sigma = 2.7, sigma = 2.9) for the
no correction strategy; 5.6 mm (Sigma = 2.0, Sigma = 1.8), 6.5 mm (Sigma = 2.3, sigma
= 2.3), and 4.5 mm (Sigma = 1.5, sigma = 1.9) for the on-line rib strategy; and 5.1 mm
(Sigma = 1.8, sigma = 1.7), 4.8 mm (Sigma = 1.7, sigma = 1.6), and 3.3 mm (Sigma =
1.1, sigma = 1.6) for the on-line surface strategy, respectively. CONCLUSION:
Considerable geometric uncertainties in the position of the EC relative to the bony
anatomy and breast surface have been observed. By using registration of the breast
surface, instead of the rib, the uncertainties in the position of the EC area were reduced.
PURPOSE: To evaluate the risk factors for acute esophagitis (AET) in lung cancer
patients treated with concurrent 3D-CRT and chemotherapy. METHODS AND
MATERIALS: Data from 100 patients treated with concurrent chemoradiotherapy with a
mean dose of 62.05 +/- 4.64 Gy were prospectively evaluated. Esophageal toxicity was
graded according to criteria of the Radiation Therapy Oncology Group. The following
dosimetric parameters were analyzed: length and volume of esophagus in treatment field,
percentage of esophagus volume treated to >/=10, >/=20, >/=30, >/=35, >/=40, >/=45,
>/=50, >/=55, and >/=60 Gy, and the maximum (D(max)) and mean doses (D(mean))
delivered to the esophagus. Also, we developed an esophagitis index (EI) to account the
esophagitis grades over treatment time. RESULTS: A total of 59 patients developed AET
(Grade 1, 26 patients; Grade 2, 29 patients; and Grade 3, 4 patients). V50 was associated
with AET duration (p = 0.017), AET Grade 1 duration (p = 0.016), maximum analgesia (p
= 0.019), esophagitis index score (p = 0.024), and AET Grade >/=1 (p = 0.058). If V50 is
<30% there is a 47.3% risk of AET Grade >/=1, which increases to 73.3% if V50 is
>/=30% (p = 0.008). The predictive abilities of models (sensitivity and specificity) were
calculated by receiver operating characeristic curves. CONCLUSIONS: According to the
receiver operating characeristic curve analysis, the 30% of esophageal volume receiving
>/=50 Gy was the most statistically significant factor associated with AET Grade >/=1
and maximum analgesia (A(max)). There was an association with AET Grade >/=2 but it
did not achieve statistical significance (p = 0.076).
INTRODUCTION: Tumors of any histological origin can give rise to cutaneous and
subcutaneous metastases during follow-up. This study aims to evaluate the costs and
benefits of electrochemotherapy (ECT) with the Cliniporatortrade mark vs other currently
used methods in the control and treatment of cutaneous and subcutaneous advanced
neoplasms. MATERIALS AND METHODS: A cost-effectiveness analysis was carried
out on ECT using the Cliniporator vs other techniques (radiotherapy, hyperthermia
associated with radiotherapy and chemotherapy, interferon-alpha, and isolated limb
perfusion) for the control and treatment of cutaneous and subcutaneous neoplasms. The
direct health costs were attributed a value according to the Italian National Healthcare
System. Resource consumption and clinical outcomes were derived from cost survey data
collection and literature review. RESULTS: ECT is cost-effective with an incremental
cost effectiveness ratio (ICER) of euro1,571.53 to achieve a further additional response.
Radiotherapy and interferon-alpha are the least effective strategies. A combination of
hyperthermia, chemotherapy, radiotherapy, and interferon-alpha treatment are dominated
by ECT (more costly and less effective). Isolated limb perfusion is the most effective
treatment, but is very costly (euro18,530.47) because of the use of antiblastic drugs
(TNFalpha), with an ICER of euro92,717.29. CONCLUSIONS: After sensitivity analysis,
the study results confirm the favorable cost-effectiveness ratio of ECT with the
Cliniporator and justify its wider use.
Smith GL, Smith BD, Buchholz TA, Giordano SH, Garden AS, Woodward WA,
Krumholz HM, Weber RS, Ang KK, Rosenthal DI.
Departments of Radiation Oncology, Breast Medical Oncology, and Head and Neck
Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, TX; and the
Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University
School of Medicine, New Haven, CT.
PURPOSE: Cerebrovascular disease is common in head and neck cancer patients, but it is
unknown whether radiotherapy increases the cerebrovascular disease risk in this
population. PATIENTS AND METHODS: We identified 6,862 patients (age > 65 years)
from the Surveillance, Epidemiology, and End Results (SEER) -Medicare cohort
diagnosed with nonmetastatic head and neck cancer between 1992 and 2002. Using
proportional hazards regression, we compared risk of cerebrovascular events (stroke,
carotid revascularization, or stroke death) after treatment with radiotherapy alone, surgery
plus radiotherapy, or surgery alone. To further validate whether treatment groups had
equivalent baseline risk of vascular disease, we compared the risks of developing a
control diagnosis, cardiac events (myocardial infarction, percutaneous coronary
intervention, coronary artery bypass graft, or cardiac death). Unlike cerebrovascular risk,
no difference in cardiac risk was hypothesized. RESULTS: Mean age was 76 +/- 7 years.
Ten-year incidence of cerebrovascular events was 34% in patients treated with
radiotherapy alone compared with 25% in patients treated with surgery plus radiotherapy
and 26% in patients treated with surgery alone (P < .001). After adjusting for covariates,
patients treated with radiotherapy alone had increased cerebrovascular risk compared
with surgery plus radiotherapy (hazard ratio [HR] = 1.42; 95% CI, 1.14 to 1.77) and
surgery alone (HR = 1.50; 95% CI, 1.18 to 1.90). However, no difference was found for
surgery plus radiotherapy versus surgery alone (P = .60). As expected, patients treated
with radiotherapy alone had no increased cardiac risk compared with the other treatment
groups (P = .63 and P = .81). CONCLUSION: Definitive radiotherapy for head and neck
cancer, but not postoperative radiotherapy, was associated with excess cerebrovascular
disease risk in older patients.
PMID: 18725647 [PubMed - as supplied by publisher]
14: Jpn J Clin Oncol. 2008 Aug 22. [Epub ahead of print]
Related Articles, Links
Tanguay JS, Ford DR, Sadler G, Buckley L, Uppal H, Cross J, Holmes N, Fortes
Mayer K, Fernando I.
AIMS: Axillary treatment for patients with early-stage breast cancer can be associated
with considerable morbidity. Techniques, such as axillary node sampling (ANS) and,
more recently, sentinel node biopsy, in combination with radiotherapy have the potential
to reduce toxicity. A retrospective review of axillary treatment in patients with early-stage
breast cancer treated at our institution between 1997 and 2003 was carried out to assess
the outcome and morbidity of ANS in combination with radiotherapy. MATERIALS
AND METHODS: The treatment policy was to carry out four-node, Edinburgh-style
ANS except in those cases with either palpably enlarged nodes or cytological
confirmation of involvement or with clinically obvious node involvement at surgery
when level 2 axillary node clearance (ANC) was carried out. Patients with involved
nodes after ANS received postoperative axillary radiotherapy. RESULTS: In total, 381
patients were included, 331 received ANS and 50 received ANC. The median follow-up
was 6.5 years and overall survival at 5 years was 84%. Pathologically involved nodes
were found in 152/331 (50%) ANS patients and 43/50 (86%) ANC patients. The rate of
local recurrence (breast or chest wall) at 5 years was 4% (95% confidence interval 1-
17%) in the ANC group and 2% (95% confidence interval 1-4%) in the ANS group. The
nodal recurrence rate of those undergoing ANS was 3% (11/331) compared with 6%
(3/50) for those treated by ANC. The rate of clinically significant lymphoedema at 5
years was significantly higher (P=0.01) in the ANC arm: 18% (95% confidence interval
9-32%) compared with 5% (95% confidence interval 3-8%) in those treated by ANS.
Thirty-one cases received additional supraclavicular fossa irradiation because of the
involvement of more than four nodes on ANS, which may not have been available with
sentinel node biopsy and has implications for current practice. CONCLUSIONS:
Selective ANS with the removal of a minimum of four nodes guides optimal locoregional
treatment with good local control rates, low overall morbidity and may obviate the need
for a second surgical procedure.
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