Radiation Oncology via MedWorm.com

Choline PET based dose-painting in prostate cancer - Modelling of dose effects

Radiation Oncology — Thu, 18 Mar 2010 00:00:00 +0100

Conclusions: Based on the employed assumptions, specific dose escalation to choline PET positive areas within the prostate may increase the local control rates. Due to the lack of exact PET sensitivity and prostate alpha/beta parameter, no firm conclusions can be made. Small variations may completely abrogate the clinical benefit of a SIB based on choline PET imaging. (Source: Radiation Oncology)

Pro-inflammatory cytokines play a key role in the development of radiotherapy-induced gastrointestinal mucositis

Radiation Oncology — Tue, 16 Mar 2010 00:00:00 +0100

Conclusions: Pro-inflammatory cytokines play a key role in radiotherapy-induced gastrointestinal mucositis in the sub-acute onset setting. (Source: Radiation Oncology)

Decreased 3D observer variation with matched CT- MRI, for target delineation in Nasopharynx cancer

Radiation Oncology — Mon, 15 Mar 2010 00:00:00 +0100

DiscussionAttempts to decrease the variation need to be tailored to the specific causes of the variation. Use of delineation instructions multimodality imaging, the use of sagittal windows and an on-line atlas result in a higher agreement on the intended target. (Source: Radiation Oncology)

Clinical application of tumor volume in advanced nasopharyngeal carcinoma to predict outcome

Radiation Oncology — Thu, 11 Mar 2010 00:00:00 +0100

Conclusions: The incorporation of GTVprn can provide more information to adjust treatment strategy. (Source: Radiation Oncology)

Hypofractionated radiotherapy for lung tumors with online cone beam CT guidance and active breathe control

Radiation Oncology — Sat, 27 Feb 2010 00:00:00 +0100

Conclusion: The positioning errors for lung SBRT using ABC were significant. Online correction with CBCT image guidance should be applied to reduce setup errors and PTV margin, which may reduce radiotherapy toxicity of tissues when ABC was used. (Source: Radiation Oncology)

Intensity-modulated radiation therapy (IMRT) vs. 3D conformal radiotherapy (3DCRT) in locally advanced rectal cancer (LARC): dosimetric comparison and clinical implications

Radiation Oncology — Fri, 26 Feb 2010 00:00:00 +0100

Purpose: To compare target dose distribution, comformality, normal tissue avoidance, and irradiated body volume (IBV) in 3DCRT using classic anatomical landmarks (c3DCRT), 3DCRT fitting the PTV (f3DCRT), and intensity-modulated radiation therapy (IMRT) in patients with locally advanced rectal cancer (LARC).Methods and Materials: Fifteen patients with LARC underwent c3DCRT, f3DCRT, and IMRT planning. Target definition followed the recommendations of the ICRU reports No. 50 and 62. OAR (SB and bladder) constraints were D5 50 Gy and Dmax < 55 Gy. PTV dose prescription was defined as PTV95 [greater than or equal to]45 Gy and PTVmin [greater than or equal to] 35 Gy. Target coverage was evaluated with the D95, Dmin, and Dmax. Target dose distribution and comformality was evaluated with the homo...

Intensity modulated radiotherapy (IMRT) in benign giant cell tumors - a single institution case series and a short review of the literature

Radiation Oncology — Fri, 26 Feb 2010 00:00:00 +0100

Conclusion: IMRT is a feasible option in giant cells tumors not amendable to complete surgical removal. In our case series local control was achieved in four out of five patients with marked symptom relief in the majority of cases. No severe toxicity was observed. (Source: Radiation Oncology)

Cytokines levels, Severity of acute mucositis and the need of PEG tube installation during chemo-radiation for head and neck cancer - a prospective pilot study

Radiation Oncology — Thu, 25 Feb 2010 00:00:00 +0100

Conclusion: These preliminary results, indicating a correlation between IL-6 and IL-8 serum levels and severity of mucositis and a need for a PEG tube installation, justify a large scale study. (Source: Radiation Oncology)

Hemizygosity for Atm and Brca1 influence the balance between cell transformation and apoptosis

Radiation Oncology — Mon, 22 Feb 2010 00:00:00 +0100

Conclusions: Under stress, the efficiency and capacity for DNA repair mediated by the ATM/ BRCA1 cell signalling network depends on the expression levels of both proteins. (Source: Radiation Oncology)

Neo-adjuvant chemo-radiation of rectal cancer with Volumetric Modulated Arc Therapy: summary of technical and dosimetric features and early clinical experience

Radiation Oncology — Fri, 19 Feb 2010 00:00:00 +0100

Conclusion: RA proved to be a safe, qualitatively advantageous treatment modality for rectal cancer, showing some improved results in dosimetric aspects. (Source: Radiation Oncology)

Whole brain radiotherapy with a conformational external beam radiation boost for lung cancer patients with 1-3 brain metastasis: a multi institutional study

Radiation Oncology — Thu, 18 Feb 2010 00:00:00 +0100

Background: To determine the outcome of patients with brain metastasis (BM) from lung cancer treated with an external beam radiotherapy boost (RTB) after whole brain radiotherapy (WBRT). Methods: A total of 53 BM patients with lung cancer were treated sequentially with WBRT and RTB between 1996 and 2008 according to our institutional protocol. Mean age was 58.8 years. The median KPS was 90. Median recursive partitioning analysis (RPA) and graded prognostic assessment (GPA) grouping were 2 and 2.5, respectively. Surgery was performed on 38 (71%) patients. The median number of BM was 1 (range, 1-3). Median WBRT and RTB combined dose was 39 Gy (range, 37.5 - 54). Median follow-up was 12.0 months. Results: During the period of follow-up, 37 (70%) patients died. The median overall survival (OS)...

Maintenance of Sorafenib following combined therapy of three-dimensional conformal radiation therapy/intensity-modulated radiation therapy and transcatheter arterial chemoembolization in patients with locally advanced hepatocellular carcinoma: a phase I/II study

Radiation Oncology — Fri, 12 Feb 2010 00:00:00 +0100

In this study, local therapy for HCC is the combination of TACE and radiotherapy. Radiation exposure as a kind of stress might induce the compensatory activations of multiple intracellular signaling pathway mediators, such as PI3K, MAPK, JNK and NF-kB. Vascular endothelial growth factor (VEGF) was identified as one factor that was increased in a time- and dose-dependent manner after sublethal irradiation of HCC cells in vitro, translating to enhanced intratumor angiogenesis in vivo. Therefore, Sorafenib-mediated blockade of the Raf/MAPK and VEGFR pathways might enhance the efficacy of radiation, when Sorafenib is followed sequentially as a maintenance modality. (ClinicalTrials.gov number, NCT00999843.) (Source: Radiation Oncology)

Kypho-IORT - a novel approach of intraoperative radiotherapy during kyphoplasty for vertebral metastases

Radiation Oncology — Thu, 11 Feb 2010 00:00:00 +0100

Conclusion: In conclusion, this novel, minimally invasive procedure can be performed in standard operating rooms and may become a valuable option for patients with vertebral metastases providing immediate stability and local control. A phase I/II study is under way to establish the optimal dose prescription. (Source: Radiation Oncology)

FDG-PET/CT imaging for staging and target volume delineation in conformal radiotherapy of anal carcinoma

Radiation Oncology — Sat, 06 Feb 2010 00:00:00 +0100

Conclusions: FDG-PET/CT has a potential relevant impact in staging and target volume delineation of the carcinoma of the anal canal. Clinical stage variation occurred in 18.5% of cases with change of treatment intent in 3.7%. The GTV and the CTV changed in shape and in size based on PET/CT imaging. (Source: Radiation Oncology)

A case report of pseudoprogression followed by complete remission after proton-beam irradiation for a low-grade glioma in a teenager: the value of dynamic contrast-enhanced MRI.

Radiation Oncology — Thu, 04 Feb 2010 00:00:00 +0100

A fourteen years-old boy was treated post-operatively with proton therapy for a recurrent low-grade oligodendroglioma located in the tectal region. Six months after the end of irradiation (RT), a new enhancing lesion appeared within the radiation fields. To differentiate disease progression from radiation-induced changes, dynamic susceptibility contrast-enhanced (DSCE) MRI was used with a T2* sequence to study perfusion and permeability characteristics simultaneously. Typically, the lesion showed hypoperfusion and hyperpermeability compared to the controlateral normal brain. Without additional treatment but a short course of steroids, the image disappeared over a six months period allowing us to conclude for a pseudo-progression. The patient is alive in complete remission more than 2 years...

Loratadine dysregulates cell cycle progression and enhances the effect of radiation in human tumor cell lines

Radiation Oncology — Wed, 03 Feb 2010 00:00:00 +0100

Conclusions: Given this unique possible mechanism of action, loratadine has potential as a chemotherapeutic agent and as a modifier of radiation responsiveness in the treatment of cancer and, as such, may warrant further clinical evaluation. (Source: Radiation Oncology)

Neoadjuvant radiotherapy of primary irresectable unicentric Castleman's disease: a case report and review of the literature

Radiation Oncology — Tue, 02 Feb 2010 00:00:00 +0100

Conclusions: Neo-adjuvant radiotherapy should be considered in case of an irresectable unicentric CD. (Source: Radiation Oncology)

Ramipril mitigates radiation-induced impairment of neurogenesis in the rat dentate gyrus

Radiation Oncology — Mon, 01 Feb 2010 00:00:00 +0100

Conclusions: Our results indicate that chronic ACE inhibition with ramipril, initiated 24 hours post-irradiation, may reduce apoptosis among SGZ progenitors and/or inflammatory disruption of neurogenic signaling within SGZ microenvironment, and suggest that angiotensin II may participate in maintaining the basal rate of granule cell neurogenesis. (Source: Radiation Oncology)

Prediction of clinical toxicity in locally advanced head and neck cancer patients by radio-induced apoptosis in peripheral blood lymphocytes (PBLs)

Radiation Oncology — Thu, 28 Jan 2010 00:00:00 +0100

Head and neck cancer is treated mainly by surgery and radiotherapy. Normal tissue toxicity due to x-ray exposure is a limiting factor for treatment success. Many efforts have been employed to develop predictive tests applied to clinical practice. Determination of lymphocyte radiosensitivityby radio-induced apoptosis arises as a possible method to predict tissue toxicity due to radiotherapy. The aim of the present study was to analyze radio-induced apoptosis ofperipheral blood lymphocytes in head and neck cancer patients and to explore their role in predicting radiation induced toxicity. Seventy nine consecutive patients suffering from head and neck cancer, diagnosed and treated in our institution, were included in the study. Toxicity was evaluated using the Radiation Therapy Oncology Group...

Comparison of T2 and FLAIR imaging for target delineation in high grade gliomas

Radiation Oncology — Thu, 28 Jan 2010 00:00:00 +0100

Background: FLAIR and T2 weighted MRIs are used based on institutional preference to delineate high grade gliomas and surrounding edema for radiation treatment planning. Although these sequences have inherent physical differences there is limited data on the clinical and dosimetric impact of using either or both sequences. Methods: 40 patients with high grade gliomas consecutively treated between 2002 and 2008 of which 32 had pretreatment MRIs with T1, T2 and FLAIR available for review were selected for this study. These MRIs were fused with the treatment planning CT. Normal structures, clinical tumor volume (CTV) and planning tumor volume (PTV) were then defined on the T2 and FLAIR sequences. A Venn diagram analysis was performed for each pair of tumor volumes as well as a fractional comp...

Tailored total lymphoid irradiation in heart transplant patients: 10-years experience of one center

Radiation Oncology — Sat, 16 Jan 2010 00:00:00 +0100

Background: To assess safety and efficacy of tailored total lymphoid irradiation (tTLI) in cardiac transplant patients. Methods: A total of seven patients, of which five had recalcitrant cellular cardiac allograft rejection (RCCAR), confirmed by endomyocardial biopsies, and two had side effects of immunosuppressive drug therapy, were all treated with tTLI. tTLI was defined by the adjustment of both the fraction interval and the final irradiation dosage both being dependent on the patients general condition, irradiation-dependent response, and the white blood and platelet counts. A mean dose of 6.4 Gy (range, 1.6 - 8.8 Gy) was given. Median follow-up was 7 years (range, 1.8 - 12.2 years). Results: tTLI was well tolerated. Two patients experienced a severe infection during tTLI (pneumocystis...

Multidisciplinary approach of early breast cancer: The biology applied to radiation oncology

Radiation Oncology — Thu, 14 Jan 2010 00:00:00 +0100

(105 words)Early breast cancer treatment is based on a multimodality approach with the application of clinical and histological prognostic factors to determine locoregional and systemic treatments. The entire scientific community is strongly involved in the management of this disease: radiologists for screening and early diagnosis, gynecologists, surgical oncologists and radiation oncologists for locoregional treatment, pathologists and biologists for personalized characterization, genetic counsellors for BRCA mutation history and medical oncologists for systemic therapies.Recently, new biological tools have established various prognostic subsets of breast cancer and developed predictive markers for miscellaneous treatments.The aim of this article is to highlight the contribution of biolog...

Fractionated stereotactic radiotherapy for skull base tumors: analysis of treatment accuracy using a stereotactic mask fixation system

Radiation Oncology — Wed, 13 Jan 2010 00:00:00 +0100

Conclusions: The results indicate that the setup error of the presented mask system evaluated by CT verification scans and portal imaging are minimal. Reproducibility of the isocenter position is in the best range of positioning reproducibility reported for other stereotactic systems. (Source: Radiation Oncology)

Toxicity risk of non-target organs at risk receiving low-dose radiation: case report

Radiation Oncology — Thu, 31 Dec 2009 00:00:00 +0100

The spine is the most common site for bone metastases. Radiation therapy is a common treatment for palliation of pain and for prevention or treatment of spinal cord compression. Helical tomotherapy (HT), a new image-guided intensity modulated radiotherapy (IMRT), delivers highly conformal dose distributions and provides an impressive ability to spare adjacent organs at risk, thus increasing the local control of spinal column metastases and decreasing the potential risk of critical organs under treatment. However, there are a lot of non-target organs at risk (OARs) occupied by low dose with underestimate in this modern rotational IMRT treatment. Herein, we report a case of a pathologic compression fracture of the T9 vertebra in a 55-year-old patient with cholangiocarcinoma. The patient unde...

3D-conformal Accelerated Partial Breast Irradiation treatment planning: the value of surgical clips in the delineation of the lumpectomy cavity

Radiation Oncology — Thu, 31 Dec 2009 00:00:00 +0100

Conclusions: The placement of surgical clips improved the accuracy of lumpectomy cavity delineation in 3D-APBI. However, a learning curve is needed to improve the conformity index of the lumpectomy cavity. (Source: Radiation Oncology)

The c-Met receptor tyrosine kinase inhibitor MP470 radiosensitizes glioblastoma cells

Radiation Oncology — Tue, 22 Dec 2009 00:00:00 +0100

Conclusions: GBM is a disease site where radiation is often used to address both macroscopic and microscopic disease. Despite attempts at dose escalation outcomes remain poor. MP470, a potent small-molecule tyrosine kinase inhibitor of c-Met, radiosensitized several GBM cell lines both in vitro and in vivo, and may help to improve outcomes for patients with GBM. (Source: Radiation Oncology)

Evalution of surface-based deformable image registration for adaptive radiotherapy of non-small cell lung cancer (NSCLC)

Radiation Oncology — Mon, 21 Dec 2009 00:00:00 +0100

DiscussionThe surface-based DR performed accurately for the majority of the patients with locally advanced NSCLC. However, morphological response patterns were identified, where results of the surface-based DR are uncertain. (Source: Radiation Oncology)

Prospective phase II study of preoperative short course radiotherapy for rectal cancer with twice daily fractions of 2.9Gy to a total dose of 29Gy - long term results

Radiation Oncology — Mon, 21 Dec 2009 00:00:00 +0100

Conclusions: Preoperative short-course radiotherapy, total mesorectal excision and adjuvant chemotherapy for pathological stage UICC [greater than or equal to] II achieved excellent local control and favorable survival. (Source: Radiation Oncology)

Evaluation of surface-based deformable image registration for adaptive radiotherapy of non-small cell lung cancer (NSCLC)

Radiation Oncology — Mon, 21 Dec 2009 00:00:00 +0100

Late treatment with Imatinib mesylate ameliorates radiation-induced lung fibrosis in a mouse model

Radiation Oncology — Mon, 21 Dec 2009 00:00:00 +0100

Conclusions: Our findings show that Imatinib, even when administered after the acute inflammation has subsided, attenuates radiation-induced lung fibrosis in mice. Our data also indicate that the fibrotic fate is not only determined by the early inflammatory events but rather a complex process in which secondary events at later time points are important. Because of the clinical availability of Imatinib or similar compounds, a meaningful attenuation of radiation-induced lung fibrosis in patients seems possible. (Source: Radiation Oncology)

Correction:Image guided dose escalated prostate radiotherapy: still room to improve

Radiation Oncology — Wed, 16 Dec 2009 00:00:00 +0100

We regret to report that a proofreading error caused an incorrect legend and description of the contents of table 6 to appear in our original publication of this work. The correct description of table 6 is: Univariate analysis of prognostic factors for 5-year nadir + 2 biochemical outcome for men presenting with intermediate risk factors. (Source: Radiation Oncology)

Monte Carlo vs. Pencil Beam based optimization of stereotactic lung IMRT

Radiation Oncology — Sat, 12 Dec 2009 00:00:00 +0100

Background: The purpose of the present study is to compare 3D pencil beam (3DPB) and Monte Carlo (MC) based optimization of lung intensity-modulated stereotactic radiotherapy (lung IMSRT).Materials and methods: A 3DPB and a MC algorithm as implemented in a biological IMRT planning system were validated by film measurements in a static lung phantom. Then, they were applied for static lung IMSRT planning based on three different geometrical patient models (one phase static CT, density overwrite one phase static CT, average CT) of the same patient. Both 6 and 15 MV beam energies were used. The resulting treatment plans were compared by how well they fulfilled the prescribed optimization constraints both for the dose distributions calculated on the static patient models and for the accumulated...

Role of p53 mutation in the effect of boron neutron capture therapy on oral squamous cell carcinoma

Radiation Oncology — Fri, 11 Dec 2009 00:00:00 +0100

Conclusion: These results indicate that oral SCC cells with mutant-type are more resistant to BNCT than those with wild-type p53, and that the lack of G1 arrest and related apoptosis may contribute to the resistance. At a dose affecting the cell cycle, BNCT inhibits oral SCC cells in p53-dependent and -independent manners. (Source: Radiation Oncology)

Whole pelvic helical tomotherapy for locally advanced cervical cancer: technical implementation of IMRT with helical tomothearapy

Radiation Oncology — Thu, 10 Dec 2009 00:00:00 +0100

Conclusion: HT provides feasible clinical outcomes in locally advanced cervical cancer patients. Long-term follow-up and enroll more locally advanced cervical carcinoma patients by limiting bone marrow radiation dose with WPHT technique is warranted. (Source: Radiation Oncology)

The effect on the small bowel of 5-FU and oxaliplatin in combination with radiation using a microcolony survival assay

Radiation Oncology — Wed, 09 Dec 2009 00:00:00 +0100

Conclusions: Combining 5-FU or oxaliplatin with RT lead to an increase in mucosal damage as compared to RT alone in our experimental setting. No additional reduction of jejunal crypt counts was noted when both drugs were combined with single dose RT. The higher crypt survival with split dose radiation indicates a substantial recovery between radiation fractions. This mucosal-sparing effect achieved by fractionation was maintained also when chemotherapy was added. (Source: Radiation Oncology)

Radiation therapy in primary orbital lymphoma: a single institution retrospective analysis

Radiation Oncology — Mon, 07 Dec 2009 00:00:00 +0100

Conclusions: Radiotherapy is an effective and at the same time well tolerated treatment for primary orbital lymphoma. (Source: Radiation Oncology)

The TGF-beta1 dynamics during radiation therapy and its correlation to symptomatic radiation pneumonitis in lung cancer patients

Radiation Oncology — Fri, 27 Nov 2009 00:00:00 +0100

Conclusion: Our results show that the changes of TGF- beta1 could be correlated with RP and the incorporation of the biological parameters into the dosimetric data could be useful for predicting symptomatic RP. (Source: Radiation Oncology)

Integrated-boost IMRT or 3-D-CRT using FET-PET based auto-contoured target volume delineation for glioblastoma multiforme - a dosimetric comparison

Radiation Oncology — Mon, 23 Nov 2009 00:00:00 +0100

Background: Biological brain tumor imaging using O-(2-[18F]fluoroethyl)-L-tyrosine (FET)-PET combined with inverse treatment planning for locally restricted dose es-calation in patients with glioblastoma multiforme seems to be a promising approach.The aim of this study was to compare inverse with forward treatment planning for an integrated boost dose application in patients suffering from a glioblastoma multi-forme, while biological target volumes are based on FET-PET and MRI data sets. Methods: In 16 glioblastoma patients an intensity-modulated radiotherapy technique comprising an integrated boost (IB-IMRT) and a 3-dimensional conventional radio-therapy (3D-CRT) technique were generated for dosimetric comparison. FET-PET, MRI and treatment planning CT (P-CT) were co-registrated. The inte...

Reirradiation to the abdomen for gastrointestinal malignancies

Radiation Oncology — Wed, 18 Nov 2009 00:00:00 +0100

Conclusions: Hyperfractionated accelerated reirradiation to the abdomen was well-tolerated with low rates of acute and late toxicity. Reirradiation could play a role in providing a limited duration of local control in gastrointestinal cancer patients with a history of prior abdominal radiotherapy. (Source: Radiation Oncology)

[68Ga]-DOTATOC-PET/CT for meningioma IMRT treatment planning

Radiation Oncology — Wed, 18 Nov 2009 00:00:00 +0100

Conclusion: DOTATOC-PET/CT information may strongly complement patho-anatomical data from MRI and CT in cases with complex meningioma and is thus helpful for improved target volume delineation especially for skull base manifestations and recurrent disease after surgery. (Source: Radiation Oncology)

Systematisation of spatial uncertainties for comparison between a MR and a CT-based radiotherapy workflow for prostate treatments

Radiation Oncology — Tue, 17 Nov 2009 00:00:00 +0100

Conclusion: Treatment planning directly on MR images reduce the spatial uncertainty for prostate treatments. (Source: Radiation Oncology)

Audiological findings in patients treated with radio- and concomitant chemotherapy for head and neck tumors

Radiation Oncology — Sun, 15 Nov 2009 00:00:00 +0100

Conclusions: Patients with head and neck cancer submitted to the conventional radiotherapy treatment, combined with the chemotherapy with cisplatin, presented a high incidence of decreased hearing by the end of treatment. Strong evidence was observed linking auditory alteration to the amount of radiotherapy treatment. (Source: Radiation Oncology)

Clinical-Dosimetric Analysis of Measures of Dysphagia including Gastrostomy-tube Dependence among Head and Neck Cancer Patients Treated Definitively by Intensity-Modulated Radiotherapy with Concurrent Chemotherapy

Radiation Oncology — Thu, 12 Nov 2009 00:00:00 +0100

Conclusion: Our analysis suggests that adhering to the following parameters may decrease the risk of prolonged GT dependence and dysphagia: IPC V65 < 15%, IPC V60 < 40%, IPC Dmean < 55 Gy, and CPI Dmax < 60 Gy. (Source: Radiation Oncology)

The ATM and ATR inhibitors CGK733 and caffeine suppress cyclin D1 levels and inhibit cell proliferation

Radiation Oncology — Tue, 10 Nov 2009 00:00:00 +0100

The ataxia telangiectasia mutated (ATM) and the ATM- related (ATR) kinases play a central role in facilitating the resistance of cancer cells to genotoxic treatment regimens. The components of the ATM and ATR regulated signaling pathways thus provide attractive pharmacological targets, since their inhibition enhances cellular sensitivity to chemo- and radiotherapy. Caffeine as well as more specific inhibitors of ATM (KU55933) or ATM and ATR (CGK733) have recently been shown to induce cell death in drug-induced senescent tumor cells. Addition of these agents to cancer cells previously rendered senescent by exposure to genotoxins suppressed the ATM mediated p21 expression required for the survival of these cells. The precise molecular pharmacology of these agents however, is not well charact...

Image guided dose escalated prostate radiotherapy: still room to improve

Radiation Oncology — Tue, 03 Nov 2009 00:00:00 +0100

Conclusions: IGRT to 79.8 Gy results in favourable rates of late toxicity compared with published non-IGRT treated cohorts. Future avenues of investigation for toxicity reduction include IMRT, margin reduction, and dose modulation targeted to sites of disease burden. Further work is required to maximize efficacy beyond that achieved through radiation dose escalation alone. (Source: Radiation Oncology)

Combined treatment with lexatumumab and irradiation leads to strongly increased long term tumour control under normoxic and hypoxic conditions

Radiation Oncology — Tue, 27 Oct 2009 00:00:00 +0100

Conclusions: Our data show that a combination of the pro-apoptotic antibody lexatumumab with irradiation reduces tumour regrowth and leads to a highly increased local tumour control in a nude mouse model. This substantial effect was observed under ambient and more pronounced under hypoxic conditions. (Source: Radiation Oncology)

A fast radiotherapy paradigm for anal cancer with volumetric modulated arc therapy (VMAT)

Radiation Oncology — Sun, 25 Oct 2009 00:00:00 +0100

Conclusion: VMAT provides treatment plans with high conformity and homogeneity equivalent to step-and-shoot-IMRT for this mono-concave treatment volume. Short treatment delivery time and low primary MU are the most important advantages. (Source: Radiation Oncology)

AT-101, a small molecule inhibitor of anti-apoptotic Bcl-2 family members, activates the SAPK/JNK pathway and enhances radiation-induced apoptosis

Radiation Oncology — Thu, 22 Oct 2009 23:00:00 +0100

Conclusions: Our data show that AT-101 strongly enhances radiation-induced apoptosis in human leukemic cells and indicate a requirement for the SAPK/JNK pathway in this response. This type of apoptosis modulation may overcome treatment resistance and lead to the development of new effective combination therapies. (Source: Radiation Oncology)

Pharmacokinetics and biodistribution of Erufosine in nude mice - implications for combination with radiotherapy

Radiation Oncology — Thu, 22 Oct 2009 23:00:00 +0100

Background: Alkylphosphocholines represent promising antineoplastic drugs that induce cell death in tumor cells by primary interaction with the cell membrane. Recently we could show that a combination of radiotherapy with Erufosine, a paradigmatic intravenously applicable alkylphosphocholine, in vitro leads to a clear increase of irradiation-induced cell death. In view of a possible combination of Erufosine and radiotherapy in vivo we determined the pharmacokinetics and bioavailability as well as the compatibility of Erufosine in nude mice. Methods: NMRI (nu/nu) nude mice were treated by intraperitoneal or subcutaneous injections of 5 to 40 mg/kg body weight Erufosine every 48h for one to three weeks. Erufosine-concentrations were measured in brain, lungs, liver, small intestine, colon, sp...

Radiation-induced Akt activation modulates radioresistance in human glioblastoma cells

Radiation Oncology — Tue, 13 Oct 2009 23:00:00 +0100

Conclusions: These results suggest that Akt may be a central player in a feedback loop whereby activation of Akt induced by IR increases radioresistance of GBM cells. Targeting the Akt signaling pathway may have important therapeutic implications when used in combination with IR in the treatment of a subset of brain tumor patients. (Source: Radiation Oncology)

Remarks on reporting and recording consistent with the ICRU Reference Dose

Radiation Oncology — Tue, 13 Oct 2009 23:00:00 +0100

Conclusions: The authors advocate reporting the PTV median dose or preferably the mean dose of the central dose plateau PTVx as a potential replacement or successor of the ICRU Reference Dose - both usable for CRT and IMRT. (Source: Radiation Oncology)

Radiotherapy and radiosurgery for benign skull base meningiomas

Radiation Oncology — Tue, 13 Oct 2009 23:00:00 +0100

Meningiomas located in the region of the base of skull are difficult to access. Complex combined surgical approaches are more likely to achieve complete tumor removal, but frequently at a cost of treatment related high morbidity. Local control following subtotal excision of benign meningiomas can be improved with conventional fractionated external beam radiation therapy with a reported 5-year progression-free survival up to 95%. New radiation techniques, including stereotactic radiosurgery (SRS), fractionated stereotactic radiotherapy (FSRT), and intensity-modulated radiotherapy (IMRT) have been developed as a more accurate technique of irradiation with more precise tumor localization, and consequently a reduction in the volume of normal brain irradiated to high radiation doses. SRS achiev...

Differential protection by wildtype vs. organelle-specific Bcl-2 suggests a combined requirement of both the ER and mitochondria in ceramide-mediated caspase-independent programmed cell death

Radiation Oncology — Thu, 08 Oct 2009 23:00:00 +0100

Conclusions: Our data suggest a combined requirement for both mitochondria and the ER in the induction and the signaling pathways of ciPCD mediated by ceramide. (Source: Radiation Oncology)

Patient information in radiation oncology: a cross- sectional pilot study using the EORTC QLQ-INFO26 module

Radiation Oncology — Sun, 27 Sep 2009 23:00:00 +0100

Conclusions: In a single-center pilot study, radiotherapy patients indicated having received most information about medical tests and their disease. Patients very satisfied with their information had received the largest amount of information. Brochures, television and internet were the most important media. Individual patient needs should be considered in the development of novel information strategies. (Source: Radiation Oncology)

Development of a neuro-fuzzy technique for automated parameter optimization of inverse treatment planning

Radiation Oncology — Thu, 24 Sep 2009 23:00:00 +0100

Conclusions: The study demonstrated a feasible way to automatically perform parameter optimization of inverse treatment planning under guidance of prior knowledge without human intervention other than providing a set of constraints that have proven clinically useful in a given setting. (Source: Radiation Oncology)

The effect of on-line position correction on the dose distribution in focal radiotherapy for bladder cancer

Radiation Oncology — Wed, 23 Sep 2009 23:00:00 +0100

Conclusions: On-line position correction does result in an altered target coverage, due to changes in average path length after position correction. An extra margin can be added to prevent underdosage. (Source: Radiation Oncology)

Intensity Modulated Radiotherapy (IMRT) in the treatment of children and adolescents - a single institution's experience and a review of the literature

Radiation Oncology — Tue, 22 Sep 2009 23:00:00 +0100

Conclusions: IMRT in the treatment of children and adolescents is feasible and was applied safely within the last 9 years at our institution. Several reports in literature show the excellent possibilities of IMRT in selective sparing of organs at risk and achieving local control. In selected cases the quality of IMRT plans increases the therapeutic ratio and outweighs the risk of potentially increased rates of secondary malignancies by the augmented low dose exposure. (Source: Radiation Oncology)

Self-assessed bowel toxicity after external beam radiotherapy for prostate cancer - predictive factors on irritative symptoms, incontinence and rectal bleeding

Radiation Oncology — Sun, 20 Sep 2009 23:00:00 +0100

Background: The aim of the study was to evaluate self-assessed bowel toxicity after radiotherapy (RT) for prostate cancer. In contrast to rectal bleeding, information concerning irritative symptoms (rectal urgency, pain) and incontinence after RT has not been adequately documented and reported in the past. Methods: Patients (n=286) have been surveyed prospectively before (A), at the last day (70.2-72.0Gy; B), a median time of two (C) and 16 months after RT (D) using a validated questionnaire (Expanded Prostate Cancer Index Composite). Bowel domain score changes were analyzed and patient-/dose-volume-related factors tested for a predictive value on three separate factors (subscales): irritative symptoms, incontinence and rectal bleeding. Results: Irritative symptoms were most strongly affec...

Comparison of CT and integrated PET- based radiation therapy planning in patients with malignant pleural mesothelioma

Radiation Oncology — Tue, 15 Sep 2009 23:00:00 +0100

Conclusions: This study demonstrated the usefulness of PET-CT-based target volume delineation in patients with MPM. Co-registration of PET and CT information reduces the likelihood of geographic misses, and additionally, significant reductions observed in target volumes may potentially allow escalation of RT dose beyond conventional limits potential clinical benefits in tumor control rates, which needs to be tested in future studies. (Source: Radiation Oncology)

RapidArc, intensity modulated photon and proton techniques for recurrent prostate cancer in previously irradiated patients: a treatment planning comparison study

Radiation Oncology — Tue, 08 Sep 2009 23:00:00 +0100

Conclusions: RA and IMPT showed improvements in conformal avoidance relative to fixed beam IMRT for 7 patients with recurrent prostate cancer. IMPT showed further sparing of organs at risk. (Source: Radiation Oncology)

Ipsilateral irradiation for well lateralized carcinomas of the oral cavity and oropharynx: results on tumor control and xerostomia

Radiation Oncology — Mon, 31 Aug 2009 23:00:00 +0100

Conclusions: In selected patients with early and moderate stages, well lateralized oral and oropharyngeal carcinomas, ipsilateral irradiation treatment of the primary site and ipsilateral neck spares salivary gland function without compromising loco-regional control. (Source: Radiation Oncology)

Intraoperative radiotherapy (IORT) combined with external beam radiotherapy (EBRT) for soft-tissue sarcomas - a retrospective evaluation of the Homburg experience in the years 1995-2007

Radiation Oncology — Tue, 25 Aug 2009 23:00:00 +0100

Conclusion: The combination of surgery, IORT, and EBRT yields favourable local control and survival data which are well within the range of the results reported in the literature. The complication rates, however, are considerable although the complications are not severe, they should be taken into account when therapy decisions are made. (Source: Radiation Oncology)

High throughput evaluation of gamma-H2AX

Radiation Oncology — Sun, 23 Aug 2009 23:00:00 +0100

The DNA double-strand break (DSB) is the primary lethal lesion after therapeutic radiation. Thus, the development of assays to detect and to quantitate these lesions could have broad preclinical and clinical impact. Phosphorylation of histone H2AX to form gamma-H2AX is a known marker for irradiation-induced DNA DSBs. However, the first generation assay involves the use of immunofluorescent staining of gamma-H2AX foci. This assay is time consuming, operator dependent and is not scalable for high throughput assay development. Thus, we sought to develop a new assay using a high throughput electrochemiluminescent platform from Mesoscale Discovery Systems to quantify gamma-H2AX levels. The results show that our assay utilizes significantly less time and labor, has greater intra-assay reproducib...

Target splitting in radiation therapy for lung cancer: further developments and exemplary treatment plans

Radiation Oncology — Thu, 13 Aug 2009 23:00:00 +0100

Conclusions: Target splitting is a highly conformal and nontheless non-expensive method with regard to linac and staff time. It enables secure accelerated high-dose treatments of patients with NSCLC. (Source: Radiation Oncology)

Severe hypoxia induces chemoresistance in clinical cervical tumors through MVP overexpression

Radiation Oncology — Wed, 05 Aug 2009 23:00:00 +0100

The oxygen molecule modulates tumour response to radiotherapy. Higher radiation doses are required under hypoxic conditions to induce cell death. Hypoxia may inhibit the non-homologous end-joining DNA repair through down regulating Ku70/80 expression. Hypoxia induces drug resistance in clinical tumours, although the mechanism is not clearly elucidated. Vaults are ribonucleoprotein particles with a hollow barrel-like structure composed of three proteins: major vault protein (MVP), vault poly(ADP-ribose) polymerase, and telomerase associated protein-1 and small untranslated RNA. Overexpression of MVP has been associated with chemotherapy resistance. Also, it has been related to poor outcome in patients treated with radiotherapy alone. The aim of the present study was to assess the relation o...

Conformal radiotherapy for lung cancer: interobservers' variability in the definition of gross tumor volume between radiologists and radiotherapists

Radiation Oncology — Tue, 04 Aug 2009 23:00:00 +0100

Conclusions: There were no significant differences in the definition of gross tumor volume between radiologists and radiotherapists. (Source: Radiation Oncology)

Simultaneous integrated boost radiotherapy for bilateral breast: a treatment planning and dosimetric comparison for volumetric modulated arc and fixed field intensity modulated therapy

Radiation Oncology — Thu, 23 Jul 2009 23:00:00 +0100

Purpose: A study was performed comparing dosimetric characteristics of volumetric modulated arcs (RapidArc, RA) and fixed field intensity modulated therapy (IMRT) on patients with bilateral breast carcinoma.Methods and Materials: Plans for IMRT and RA, were optimised for 10 patients prescribing 50Gy to the breast (PTVII, 2.0Gy/fraction) and 60Gy to the tumour bed (PTVI, 2.4Gy/fraction). Objectives were: for PTVs V90%>95%, Dmax (Source: Radiation Oncology)

External beam radiation results in minimal changes in post void residual urine volumes during the treatment of clinically localized prostate cancer

Radiation Oncology — Tue, 21 Jul 2009 23:00:00 +0100

Background: To evaluate the impact of external beam radiation therapy (XRT) on weekly ultrasound determined post-void residual (PVR) urine volumes in patients with prostate cancer. Methods: 125 patients received XRT for clinically localized prostate cancer. XRT was delivered to the prostate only (n=66) or if the risk of lymph node involvement was greater than 10% to the whole pelvis followed by a prostate boost (n=59). All patients were irradiated in the prone position in a custom hip-fix mobilization device with an empty bladder and rectum. PVR was obtained at baseline and weekly. Multiple clinical and treatment parameters were evaluated as predictors for weekly PVR changes. Results: The mean patient age was 73.9 years with a mean pre-treatment prostate volume of 53.3 cc, a mean IPSS of 1...

The radiosensitizer 2-benzoyl-3-phenyl-6,7-dichloroquinoxaline 1,4-dioxide induces DNA damage in EMT-6 mammary carcinoma cells

Radiation Oncology — Mon, 13 Jul 2009 23:00:00 +0100

Conclusions: Collectively, our findings indicate that radiosensitization by DCQ is mediated by DNA damage and decreased repair and that ROS are at least partially responsible. (Source: Radiation Oncology)

Concurrent chemo-radiotherapy following neoadjuvant chemotherapy in locally advanced breast cancer

Radiation Oncology — Fri, 10 Jul 2009 23:00:00 +0100

Conclusions: This non-conventional multimodal treatment has good loco-regional control for LABC. Randomized clinical trials of preoperative CCRTh following chemotherapy, in patients with LABC are warranted. (Source: Radiation Oncology)

Implications of a high-definition multileaf collimator (HD-MLC) on treatment planning techniques for stereotactic body radiation therapy (SBRT): a planning study

Radiation Oncology — Thu, 09 Jul 2009 23:00:00 +0100

Conclusions: Data derived from the present comparative assessment suggest dosimetric merit of the high definition MLC system over the millennium MLC system. However, the clinical significance of these results warrants further investigation in order to determine whether the observed dosimetric advantages translate into outcome improvements. (Source: Radiation Oncology)

Negligible or weak expression of cyclooxygenase-2 is associated with poorer outcome in endemic nasopharyngeal carcinoma: analysis of data from randomized trial between radiation alone versus concurrent chemo-radiation (SQNP-01)

Radiation Oncology — Thu, 09 Jul 2009 23:00:00 +0100

Conclusions: Contrary to literature published on other malignancies, our findings seemed to indicate that over-expression of COX-2 confer a better prognosis in patients with endemic NPC. Larger studies are required to conclusively determine the significance of COX-2 expression in these patients. (Source: Radiation Oncology)

Radiation-induced cancer after radiotherapy for non-Hodgkin's lymphoma of the head and neck: a retrospective study

Radiation Oncology — Thu, 09 Jul 2009 23:00:00 +0100

In this study, we evaluated the incidence and clinical features of head and neck cancer (HNC) occurring after radiotherapy (RT) for NHL.Material and methodsWe investigated the clinical records of 322 patients who had received RT for early-stage NHL of the head and neck at our institute between 1952 and 2000. Results: There were 4 patients with a second HNC developing in the irradiated field, consisting of 2 patients with gum cancer, 1 case with tongue cancer and 1 case with maxillary sinus cancer. The pathological diagnosis in all the 4 patients was squamous cell carcinoma (SCC). Two of the patients (one with gum cancer and one with maxillary sinus cancer) died of the second HNC, while the remaining 2 patients are still living at the time of writing after therapy for the second HNC, with n...

Extraneural metastases from cranial meningioma: a case report

Radiation Oncology — Sun, 05 Jul 2009 23:00:00 +0100

We report here on a patient who was treated for an atypical brain meningioma with multiple surgeries and multiple sessions of stereotactic radiosurgery with good control of his brain disease. Thirteen years after diagnosis, he developed bilateral large sacroiliac and abdominal metastases. (Source: Radiation Oncology)

Clinical outcome of breast cancer occurring after treatment for Hodgkin's lymphoma: case-control analysis

Radiation Oncology — Mon, 29 Jun 2009 23:00:00 +0100

Conclusions: The previous history of HL does not appear to be a poor prognostic factor for BC occurring thereafter. (Source: Radiation Oncology)

Monte Carlo dose verification of prostate patients treated with simultaneous integrated boost intensity modulated radiation therapy

Radiation Oncology — Mon, 15 Jun 2009 04:00:00 +0100

Conclusion: MC agrees better with film measurements than SC. Although, on average, SC-calculated doses agreed with MC calculations within the targets within 2%, there were deviations up to 5% for some patient's treatment plans. For some patients, the magnitude of such deviations might decrease the intended target dose levels that are required for the treatment protocol, placing the patients in different dose levels that do not satisfy the protocol dose requirements. (Source: Radiation Oncology)

Constitutive gene expression profile segregates toxicity in locally advanced breast cancer patients treated with high-dose hyperfractionated radical radiotherapy

Radiation Oncology — Thu, 04 Jun 2009 04:00:00 +0100

In conclusion, we have found an association between the constitutive gene expression profile of peripheral blood lymphocytes and the development of acute and late toxicity in consecutive, unselected patients. These observations suggest the possibility of predicting normal tissue response to irradiation in high-dose non-conventional radiation therapy regimens. Prospective studies with higher number of patients are needed to validate these preliminary results. (Source: Radiation Oncology)

Constitutive gene expression profile segregates toxicity in locally advanced breast cancer patients treated with high-dose hyperfractionated radical radiotherapy

Radiation Oncology — Thu, 04 Jun 2009 04:00:00 +0100

Radiotherapy quality assurance review in a multi-center randomized trial of limited-disease small cell lung cancer: the Japan Clinical Oncology Group (JCOG) trial 0202

Radiation Oncology — Tue, 02 Jun 2009 04:00:00 +0100

Conclusions: The results of the RT QA assessment in JCOG 0202 seemed to be acceptable, providing reliable results. (Source: Radiation Oncology)

Stereotactic body radiotherapy for stage I lung cancer and small lung metastasis: evaluation of an immobilization system for suppression of respiratory tumor movement and preliminary results

Radiation Oncology — Thu, 28 May 2009 04:00:00 +0100

Conclusions: Respiratory tumor movement was modestly suppressed by the BodyFIX system, while the SpO2 level did not decrease. It was considered a simple and effective method for SBRT of lung tumors. Preliminary results were encouraging. (Source: Radiation Oncology)

Comparison of rectal volume definition techniques and their influence on rectal toxicity in patients with prostate cancer treated with 3D conformal radiotherapy: a dose-volume analysis

Radiation Oncology — Mon, 11 May 2009 04:00:00 +0100

Conclusions: Different techniques of rectal contouring significantly influence the calculation of radiation doses to the rectum and the prediction of rectal toxicity. Rectal volume receiving higher doses (>70 Gy) and mean rectal doses may significantly predict rectal bleeding for techniques contouring larger rectal volumes, as was in method 3. (Source: Radiation Oncology)

Potentials of on-line repositioning based on implanted fiducial markers and electronic portal imaging in prostate cancer radiotherapy

Radiation Oncology — Mon, 27 Apr 2009 04:00:00 +0100

Conclusions: Prostate movement relative to adjacent bony anatomy is significant and contributes substantially to the target position variability. Performing on-line setup correction using implanted radioopaque markers and megavoltage radiography results in reduced treatment margins depending on the online imaging protocol (once a week or more frequently). (Source: Radiation Oncology)

Concurrent chemoradiotherapy in adjuvant treatment of breast cancer

Radiation Oncology — Tue, 07 Apr 2009 04:00:00 +0100

Conclusions: From the 5 years retrospective investigation we showed similar disease free survival and overall survival in the two concurrent chemo-radiotherapy treatments based on anthracycline and CMF. However in the loco-regional breast cancer the treatment based on anthracycline was significantly better than that of the treatment based on CMF. There was more haematological and skin dermatitis toxicity in the anthracycline group. (Source: Radiation Oncology)

Stereotactic radiosurgery for glioblastoma: retrospective analysis

Radiation Oncology — Tue, 17 Mar 2009 04:00:00 +0100

Conclusions: SRS is well tolerated in the treatment of glioblastoma. As there was no difference in survival whether SRS is delivered upfront or at recurrence, the treatment for each patient should be individualized. Future studies are needed to identify patients most likely to respond to SRS. (Source: Radiation Oncology)

The script concordance test in radiation oncology: validation study of a new tool to assess clinical reasoning

Radiation Oncology — Mon, 09 Feb 2009 05:00:00 +0100

Conclusions: The SCT is reliable and useful to discriminate among participants according to their level of experience in radiation oncology. It appears as a useful tool to document the progression of reasoning during residency training. (Source: Radiation Oncology)

Job stress and job satisfaction of physicians, radiographers, nurses and physicists working in radiotherapy: a multicenter analysis by the DEGRO Quality of Life Work Group

Radiation Oncology — Fri, 06 Feb 2009 05:00:00 +0100

Background: Ongoing changes in cancer care cause an increase in the complexity of cases which is characterized by modern treatment techniques and a higher demand for patient information about the underlying disease and therapeutic options. At the same time, the restructuring of health services and reduced funding have led to the downsizing of hospital care services. These trends strongly influence the workplace environment and are a potential source of stress and burnout among professionals working in radiotherapy. Methods and patients: A postal survey was sent to members of the workgroup "Quality of Life" which is part of DEGRO (German Society for Radiooncology). Thus far, 11 departments have answered the survey. 406 (76.1%) out of 534 cancer care workers (23% physicians, 35% radiographe...

On the performances of Intensity Modulated Protons, RapidArc and Helical Tomotherapy for selected paediatric cases

Radiation Oncology — Wed, 14 Jan 2009 05:00:00 +0100

Conclusions: Five complex pediatric cases were selected as representative examples to compare three advanced radiation delivery techniques. While differences were noted in the metrics examined, all three techniques provided satisfactory conformal avoidance and conformation. (Source: Radiation Oncology)

Investigation of the usability of conebeam CT data sets for dose calculation

Radiation Oncology — Tue, 16 Dec 2008 05:00:00 +0100

Conclusion: The generation of three HU-D tables specific for the anatomical regions pelvis, thorax and head and specific for the corresponding CBCT image acquisition parameters resulted in accurate dose calculation in CBCT images. Once these HU-D tables are created, direct dose calculation on CBCT datasets is possible without the need of a reference CT images for pixel value calibration. (Source: Radiation Oncology)

Parotid gland sparing IMRT for head and neck cancer improves xerostomia related quality of life

Radiation Oncology — Tue, 09 Dec 2008 05:00:00 +0100

Conclusions: Parotid gland sparing IMRT for head and neck cancer patients improves xerostomia related quality of life compared to conventional radiation both in rest and during meals. Laryngeal cancer patients had fewer complaints but benefited equally compared to oropharyngeal cancer patients from IMRT. (Source: Radiation Oncology)

Radiation-induced skin injury in the animal model of scleroderma: implications for post-radiotherapy fibrosis

Radiation Oncology — Mon, 24 Nov 2008 05:00:00 +0100

Conclusion: TSK mice are not recommended as a model of scleroderma involving radiation injury. The genetic and molecular basis for reduced radiation injury observed in TSK mice warrants further investigation particularly to identify mechanisms capable of reducing tissue fibrosis after radiation injury. (Source: Radiation Oncology)

Dose volume histogram analysis of normal structures associated with accelerated intracavitary partial breast irradiation delivered by high dose rate brachytherapy and comparison with whole breast external beam radiotherapy fields

Radiation Oncology — Wed, 19 Nov 2008 05:00:00 +0100

Conclusion: This study gives low values for incidental radiation received by the heart and ipsilateral lung using the MammoSite applicator. The volume of heart and lung irradiated to clinically significant levels was significantly lower with the MammoSite applicator than using simulated WBRT fields of the same CT data sets. Trial Registration Dana Farber Trial Registry number 03-179 (Source: Radiation Oncology)

Pre-segmented 2-Step IMRT with subsequent direct machine parameter optimisation - a planning study

Radiation Oncology — Thu, 06 Nov 2008 05:00:00 +0100

Conclusions: 2-Step IMRT segmentation is suitable as starting point for further DMPO optimisation and, in general, results in less complex plans which are equal or superior to plans generated by DMPO alone. (Source: Radiation Oncology)

Intrafraction motion of the prostate during an IMRT session: a fiducial-based 3D measurement with Cone-beam CT

Radiation Oncology — Wed, 05 Nov 2008 05:00:00 +0100

Conclusions: a) Overall displacement vector length during an IMRT session is (Source: Radiation Oncology)

Motion compensation with a scanned ion beam: a technical feasibility study

Radiation Oncology — Tue, 14 Oct 2008 04:00:00 +0100

Conclusion: Motion compensation with scanned particle beams is technically feasible with high precision. (Source: Radiation Oncology)

Impact of different leaf velocities and dose rates on the number of monitor units and the dose-volume-histograms using intensity modulated radiotherapy with sliding-window technique

Radiation Oncology — Tue, 23 Sep 2008 04:00:00 +0100

Conclusions: For best protection of organs at risk, a low DR and high LV should be applied. But the consequence of a low DR is both a long treatment time and also that a LV of higher than 3.0cm/sec is mechanically not applicable. Our recommendation for an optimisation of the discussed parameters is a leaf velocity of 2.5cm/sec and a dose rate of 300-400MU/min (prostate cancer) and 100-200MU/min (SCCscalp) for best protection of organs at risk, short treatment time and number of monitor units. (Source: Radiation Oncology)

A phase I radiation dose-escalation study to determine the maximal dose of radiotherapy in combination with weekly gemcitabine in patients with locally advanced pancreatic adenocarcinoma

Radiation Oncology — Mon, 22 Sep 2008 04:00:00 +0100

Conclusions: Accelerated dose escalation to a total dose of 54Gy with 300mg/m^2/week gemcitabine was not feasible. GI toxicity was the DLT. Retrospectively, the dose escalation of 9 Gy by accelerated radiotherapy might have been to large. A dose of 45 Gy is recommended. Considering the good patient outcomes, there might be a role for the investigation of a fixed dose of gemcitabine and concurrent RT with small fractions (1.8 Gy/day) in borderline resectable or unresectable non-metastatic locally advanced pancreatic cancer. (Source: Radiation Oncology)

Reirradiation of recurrent breast cancer with and without concurrent chemotherapy

Radiation Oncology — Thu, 18 Sep 2008 04:00:00 +0100

Conclusions: In this heterogeneous group of patients reirradiation of locoregional recurrences of breast cancer showed low to moderate acute toxicity. In our experience, local control rates are high and palliation is good. (Source: Radiation Oncology)

FDG-PET/CT imaging for staging and radiotherapy treatment planning of head and neck carcinoma

Radiation Oncology — Thu, 18 Sep 2008 04:00:00 +0100

Background: Positron emission tomography (PET) has a potential improvement for staging and radiation treatment planning of various tumor sites. We analyzed the use of 18F-fluorodeoxyglucose (FDG)-PET/ computed tomography (CT) images for staging and target volume delineation of patients with head and neck carcinoma candidates for radiotherapy. Methods: Twenty-two patients candidates for primary radiotherapy, who did not receive any curative surgery, underwent both CT and PET/CT simulation. Gross Tumor Volume (GTV) was contoured on CT (CT-GTV), PET (PET-GTV), and PET/CT images (PET/CT-GTV). The resulting volumes were analyzed and compared. Results: Based on PET/CT, changes in TNM categories and clinical stage occurred in 5/22 cases (22%). The difference between CT-GTV and PET-GTV was not st...

Randomized multicenter trial on the effect of radiotherapy for plantar Fasciitis (painful heel spur) using very low doses - a study protocol

Radiation Oncology — Thu, 18 Sep 2008 04:00:00 +0100

Background: A lot of retrospective data concerning the effect of radiotherapy on the painful heel spur (plantar fasciitis) is available in the literature. Nevertheless, a randomized proof of this effect is still missing. Thus, the GCGBD (German cooperative group on radiotherapy for benign diseases) of the DEGRO (German Society for Radiation Oncology) decided to start a randomized multicenter trial in order to find out if the effect of a conventional total dose is superior compared to that of a very low dose. Methods: In a prospective, controlled and randomized phase III trial two radiotherapy schedules are to be compared: standard arm: total dose 6.0Gy in single fractions of 1.0Gy applied twice a week experimental arm: total dose 0.6Gy in single fractions of 0.1Gy applied twice a week (...

Neuropsychological testing and biomarkers in the management of brain metastases

Radiation Oncology — Wed, 17 Sep 2008 04:00:00 +0100

This article will review the current management of brain metastases, summarize the data on the CNS effects associated with brain metastases and whole brain radiation therapy in these patients, discuss the use of neuropsychological tests as outcome measures in clinical trials evaluating treatments for brain metastases, and give an overview of the potential of biomarker development in brain metastasis research. (Source: Radiation Oncology)

The impact of functional imaging on radiation medicine

Radiation Oncology — Mon, 15 Sep 2008 04:00:00 +0100

Radiation medicine has previously utilized planning methods based primarily on anatomic and volumetric imaging technologies such as CT (Computerized Tomography), ultrasound, and MRI (Magnetic Resonance Imaging). In recent years, it has become apparent that a new dimension of non-invasive imaging studies may hold great promise for expanding the utility and effectiveness of the treatment planning process. Functional imaging such as PET (Positron Emission Tomography) studies and other nuclear medicine based assays are beginning to occupy a larger place in the oncology imaging world. Unlike the previously mentioned anatomic imaging methodologies, functional imaging allows differentiation between metabolically dead and dying cells and those which are actively metabolizing. The ability of functi...

Developing and evaluating stereotactic lung RT trials: what we should know about the influence of inhomogeneity corrections on dose

Radiation Oncology — Mon, 28 Jul 2008 04:00:00 +0100

Conclusion: Inhomogeneity corrections have a large influence on the dose delivered to the PTV and OARs for SBRT of lung tumors. A simple rescaling of the dose to the PTV is not possible, implicating that accurate dose calculations are necessary for these treatment plans in order to prevent large discrepancies between planned and actually delivered doses to individual patients. (Source: Radiation Oncology)

Effect of prolonging radiation delivery time on retention of gammaH2AX

Radiation Oncology — Fri, 27 Jun 2008 04:00:00 +0100

Conclusion: These results support the concept that DNA repair underlies the increase in survival observed when dose delivery is prolonged. They also help to establish the limits of sensitivity of residual γH2AX, as measured using flow cytometry, for detecting differences in response to irradiation. (Source: Radiation Oncology)

Reproducibility and geometric accuracy of the Fixster system during hypofractionated stereotactic radiotherapy

Radiation Oncology — Wed, 28 May 2008 04:00:00 +0100

Conclusion: There is a high degree of reproducibility of the isocenter during successive treatment sessions with HCSRT using the Fixster frame for stereotactic targeting. The high reducibility enables a safe treatment using hypofractionated stereotactic radiotherapy. (Source: Radiation Oncology)

Highly proliferative neuroendocrine carcinoma – influence of radiotherapy fractionation on tumor response

Radiation Oncology — Mon, 19 May 2008 04:00:00 +0100

A 45-year-old white male presented to our department with postoperative recurrence of gastrointestinal poorly differentiated neuroendocrine carcinoma manifesting as lymph node dissemination and a solitary implantation metastasis in the rectovesical pouch. Following disease progression on chemotherapy, the patient was treated with radiotherapy using either a conventional daily treatment or an accelerated hyperfractionated protocol to separate sites of disease progression. Using serial CT scan assessment, changes in cross-sectional area of the separately treated metastatic lesions were evaluated for determination of therapy response. The accelerated hyperfractionated radiotherapy appeared to limit the rate of tumor growth to a greater degree than the conventional fractionation schedule. Of u...

The effect of radio-adaptive doses on HT29 and GM637 cells

Radiation Oncology — Wed, 23 Apr 2008 04:00:00 +0100

Conclusions: A pre-irradiation with 0.03 Gy can protect normal fibroblasts, but not colorectal cancer cells, from damage induced by an irradiation of 2.0 Gy and the application of 0.05 Gy prior to the 2.0 Gy fraction can enhance the cell killing of colorectal cancer cells while not additionally damaging normal fibroblasts. If these findings prove to be true in vivo as well this may optimize the balance between local tumour control and injury to normal tissue in modern radiotherapy. (Source: Radiation Oncology)

Study protocol of the German Registry for the Detection of Late Sequelae after Radiotherapy in Childhood and Adolescence (RiSK)

Radiation Oncology — Mon, 21 Apr 2008 04:00:00 +0100

DiscussionTo our knowledge, 'RiSK' is the only multi-centre study that evaluates radiation associated side effects prospectively with detailed information about organ dose levels. With ongoing recruitment and prolongation of follow-up powerful data will be obtained in a few years. A broad use and international cooperation are welcome. (Source: Radiation Oncology)

High-dose-rate brachytherapy for soft tissue sarcoma in children: a single institution experience

Radiation Oncology — Sat, 19 Apr 2008 04:00:00 +0100

Conclusion: Excellent local control with tolerable side effects have been observed in a small group of paediatric patients with STS treated by HBRT alone or in combination with EBRT . (Source: Radiation Oncology)

Expanded risk groups help determine which prostate radiotherapy sub-group may benefit from adjuvant androgen deprivation therapy

Radiation Oncology — Fri, 18 Apr 2008 04:00:00 +0100

Conclusions: There appears to be no advantage to ADT where the Gleason score is 6 or less and PSA is 15 or less. ADT is beneficial in patients treated to standard dose radiation with Gleason 6 disease and a PSA greater than 15 or where the Gleason score is 7 or higher. (Source: Radiation Oncology)

High-dose rate brachytherapy (HDRB) for primary or recurrent cancer in the vagina

Radiation Oncology — Wed, 13 Feb 2008 05:00:00 +0100

Conclusions: Our small series suggests that HDRB is efficacious for primary or recurrent vaginal cancer. Patients treated with primary disease and those with recurrent disease without prior irradiation have the greatest benefit from HDRB in this setting. The salvage rate for patients with prior radiation therapy is lower with a higher risk of significant complications. Additional patients and follow-up are ongoing to determine the long-term efficacy of this approach. (Source: Radiation Oncology)

Dosimetric consequences of the shift towards computed tomography guided target definition and planning for breast conserving radiotherapy

Radiation Oncology — Thu, 31 Jan 2008 05:00:00 +0100

Conclusions: The shift towards CT-guided target definition and planning as the golden standard for breast conserving radiotherapy has resulted in improved target coverage at the cost of larger irradiated volumes and an increased dose delivered to organs at risk. Tissue is now included into the breast and boost target volumes that was never explicitly defined or included with conventional treatment. Therefore, a coherent definition of the breast and boost target volumes is needed, based on clinical data confirming tumour control probability and normal tissue complication probability with the use of 3D-conformal radiotherapy. (Source: Radiation Oncology)

Severe skin reaction secondary to concomitant radiotherapy plus cetuximab

Radiation Oncology — Mon, 28 Jan 2008 05:00:00 +0100

The therapeutic use of monoclonal antibodies against the epidermal growth factor receptor (EGFR) is specifically associated with dermatologic reactions of variable severity. Recent evidence suggests superiority of the EGFR inhibitor (EGFRI) cetuximab plus radiotherapy compared to radiotherapy alone in patients with squamous cell carcinoma of the head and neck. Although not documented in a study population, several reports indicate a possible overlap between radiation dermatitis and the EGFRI-induced skin rash. We here present a case of severe skin reaction secondary to the addition of cetuximab to radiotherapy. (Source: Radiation Oncology)

Intensity-modulated radiotherapy of nasopharyngeal carcinoma: A comparative treatment planning study of photons and protons

Radiation Oncology — Thu, 24 Jan 2008 05:00:00 +0100

Conclusions: In radiotherapy of NPC patients, three-field IMPT has greater potential than nine-field IMRT with respect to tumor coverage and reduction of the integral dose to OARs and non-specific normal tissues. The practicality of IMPT in NPC deserves further exploration when this technique becomes available on wider clinical scale. (Source: Radiation Oncology)

Does Intensity Modulated Radiation Therapy (IMRT) prevent additional toxicity of treating the pelvic lymph nodes compared to treatment of the prostate only?

Radiation Oncology — Fri, 11 Jan 2008 05:00:00 +0100

Background: To evaluate the risk of rectal, bladder and small bowel toxicity in intensity modulated radiation therapy (IMRT) of the prostate only compared to additional irradiation of the pelvic lymphatic region. Methods: For ten patients with localized prostate cancer, IMRT plans with a simultaneous integrated boost (SIB) were generated for treatment of the prostate only (plan-PO) and for additional treatment of the pelvic lymph nodes (plan-WP). In plan-PO, doses of 60Gy and 74Gy (33 fractions) were prescribed to the seminal vesicles and to the prostate, respectively. Three plans-WP were generated with prescription doses of 46Gy, 50.4Gy and 54Gy to the pelvic target volume; doses to the prostate and seminal vesicles were identical to plan-PO. The risk of rectal, bladder and small bowel to...

Can prophylactic breast irradiation contribute to cardiac toxicity in patients with prostate cancer receiving androgen suppressing drugs?

Radiation Oncology — Thu, 10 Jan 2008 05:00:00 +0100

Conclusions: The present data provide preliminary evidence that PMRT might be a factor that contributes to cardiac side effects. Previous studies that established a relationship between AST and cardiac morbidity did not include information on delivery of PMRT. (Source: Radiation Oncology)

A phase III trial comparing an anionic phospholipid-based cream and aloe vera-based gel in the prevention of radiation dermatitis in pediatric patients

Radiation Oncology — Wed, 19 Dec 2007 05:00:00 +0100

Conclusion: APP cream is more effective than aloe vera-based gel for prevention and treatment of radiation dermatitis. (Source: Radiation Oncology)

Validity and reliability testing of two instruments to measure breast cancer patients' concerns and information needs relating to radiation therapy

Radiation Oncology — Sun, 25 Nov 2007 01:21:19 +0100

Conclusions: This paper provides preliminary data suggesting that the two tools presented are reliable and valid and would be suitable for use in trials or in the clinical setting. (Source: Radiation Oncology)

What is an acceptably smoothed fluence? Dosimetric and delivery considerations for dynamic sliding window IMRT

Radiation Oncology — Fri, 23 Nov 2007 05:00:00 +0100

Background: The study summarised in this report aimed to investigate the interplay between fluence complexity, dose calculation algorithms, dose calculation spatial resolution and delivery characteristics (monitor units, effective field width and dose delivery against dose prediction agreement) was investigated. A sample set of complex planning cases was selected and tested using a commercial treatment planning system capable of inverse optimisation and equipped with tools to tune fluence smoothness. Methods: A set of increasingly smoothed fluence patterns was investigated and correlated to a generalised expression of the Modulation Index (MI) concept, in nature independent from the specific planning system used that could therefore be recommended as a predictor to score fluence "quality"...

Optimal organ-sparing intensity-modulated radiation therapy (IMRT) regimen for the treatment of locally advanced anal canal carcinoma: a comparison of conventional and IMRT plans

Radiation Oncology — Thu, 15 Nov 2007 05:00:00 +0100

Conclusion: IMRT is superior to conformal treatment with respect to OAR sparing, including bone marrow sparing. (Source: Radiation Oncology)

Radical stereotactic radiosurgery with real-time tumor motion tracking in the treatment of small peripheral lung tumors

Radiation Oncology — Mon, 22 Oct 2007 04:00:00 +0100

Conclusion: Radical stereotactic radiosurgery with real-time tumor motion tracking is a promising well-tolerated treatment option for small peripheral lung tumors. (Source: Radiation Oncology)

Experimental iodine-125 seed irradiation of intracerebral brain tumors in nude mice

Radiation Oncology — Wed, 26 Sep 2007 04:00:00 +0100

Conclusions: The intracerebral implantation of an iodine-125 brachytherapy seed through a stereotactic guide-screw in the skull of mice with implanted brain tumors resulted in a significantly prolonged survival, caused by high-dose irradiation of the brain tumor that is biologically comparable to high-dose fractionated radiotherapy-- without fatal irradiation toxicity. This is an excellent mouse model for testing orthotopic brain tumor therapies in combination with radiation therapy. (Source: Radiation Oncology)

Simultaneous integrated boost of biopsy proven, MRI defined dominant intra-prostatic lesions to 95 Gray with IMRT: early results of a phase I NCI study

Radiation Oncology — Tue, 18 Sep 2007 04:00:00 +0100

Conclusion: These early results demonstrate the feasibility of using IMRT for simultaneous integrated boost to biopsy proven dominant intra-prostatic lesions visible on MRI. The treatment was well tolerated. (Source: Radiation Oncology)

Long-term results of radiotherapy for periarthritis of the shoulder: a retrospective evaluation

Radiation Oncology — Fri, 14 Sep 2007 04:00:00 +0100

Conclusions: Low-dose radiotherapy for periarthropathy of the shoulder was highly effective and yielded long-lasting improvement of pain and motility without side effects. (Source: Radiation Oncology)

Verifying 4D gated radiotherapy using time-integrated electronic portal imaging: a phantom and clinical study

Radiation Oncology — Thu, 30 Aug 2007 04:00:00 +0100

Conclusion: TI-EPI appears to be a promising method for verifying delivery of RGRT. The RPM system was a good indirect surrogate of internal anatomy, but use of TI-EPI allowed for a direct link between anatomy and breathing patterns. (Source: Radiation Oncology)

Hypofractionated intensity modulated irradiation for localized prostate cancer,results from a phase I/II feasibility study

Radiation Oncology — Wed, 08 Aug 2007 04:00:00 +0100

Conclusion: This hypofractionated IMRT schedule for prostate cancer using 25 fractions of 2.64 Gy did not result in severe acute side effects. Until now late urethral, rectal toxicities seemed acceptable as well as failure rates. Detailed analysis of quality of life questionnaires resulted in the same conclusion. (Source: Radiation Oncology)

Breast-conserving surgery with or without radiotherapy in women with ductal carcinoma in situ: a meta-analysis of randomized trials.

Radiation Oncology — Thu, 02 Aug 2007 04:00:00 +0100

Purpose To investigate whether Radiation therapy (RT) should follow breast conserving surgery in women with ductal carcinoma in situ from breast cancer (DCIS) with objective of decreased mortality, invasive or non invasive recurrence, distant metastases and contralateral breast cancer rates. We have done a meta-analysis of these results to give a more balanced view of the total evidence and to increase statistical precision. Materials and methods A meta-analysis of randomized controlled trials (RCT) was performed comparing RT treatment for DCIS of breast cancer to observation. The MEDLINE, EMBASE, CANCERLIT, Cochrane Library databases, Trial registers, bibliographic databases, and recent issues of relevant journals were searched . Relevant reports were reviewed by two reviewers independet...

Standard fractionation intensity modulated radiation therapy (IMRT) of primary and recurrent glioblastoma multiforme

Radiation Oncology — Sat, 14 Jul 2007 04:00:00 +0100

Conclusion: While technically feasible, preliminary results suggest delivering standard radiation doses by IMRT did not improve survival outcomes in this series compared to historical controls. In light of this lack of a survival benefit and the costs associated with use of IMRT, future prospective trials are needed to evaluate non-survival endpoints such as quality of life and functional preservation. Short of such evidence, the use of IMRT for treatment of GBM needs to be carefully rationalized. (Source: Radiation Oncology)

Experimental concepts for toxicity prevention and tissue restoration after central nervous system irradiation

Radiation Oncology — Sat, 30 Jun 2007 04:00:00 +0100

Several experimental strategies of radiation-induced central nervous system toxicity prevention have recently resulted in encouraging data. The present review summarizes the background for this research and the treatment results. It extends to the perspectives of tissue regeneration strategies, based for example on stem and progenitor cells. Preliminary data suggest a scenario with individually tailored strategies where patients with certain types of comorbidity, resulting in impaired regeneration reserve capacity, might be considered for toxicity prevention, while others might be salvaged by delayed interventions that circumvent the problem of normal tissue specificity. Given the complexity of radiation-induced changes, single target interventions might not suffice. Future interventions m...

PET/CT with Intensity-Modulated Radiotherapy (IMRT) Improves Treatment Outcome of Locally Advanced Pharyngeal Carcinoma: A Matched-Pair Analysis

Radiation Oncology — Sat, 09 Jun 2007 04:00:00 +0100

The role of 2-[18-F]-fluoro-2-deoxyglucose-positron emission tomography and integrated computer tomography (PET/CT) and intensity-modulated radiotherapy (IMRT) for advanced pharyngeal carcinoma was assessed. 45 consecutive patients with stage IVA pharyngeal carcinoma treated with definitive chemorasdiation with a PET/CT and IMRT from 2002 until 2005 were analysed. Patients with PET/CT and IMRT were matched with patients without PET/CT and 3D-conformal radiotherapy. Eighty six patients treated between 1991 and 2001 served as controls. The median follow-up time was eighteen months (range, 6-49) for the PET/CT-IMRT group and twenty eight months (range, 1-168) for the controls. The overall survival with PET/CT and IMRT was 97% and 91% at 1 and 2 years respectively, compared to 74% and 54% with...

Exceptionally high incidence of symptomatic grade 2-5 radiation pneumonitis after stereotactic radiation therapy for lung tumors

Radiation Oncology — Thu, 07 Jun 2007 04:00:00 +0100

Background: To determine the usefulness of dose volume histogram (DVH) factors for predicting the occurrence of radiation pneumonitis (RP) after application of stereotactic radiation therapy (SRT) for lung tumors, DVH factors were measured before irradiation. Methods: From May 2004 to April 2006, 25 patients were treated with SRT at the University of Tokyo Hospital. Eighteen patients had primary lung cancer and seven had metastatic lung cancer. SRT was given in 6-7 fields with an isocenter dose of 48 Gy in four fractions over 5-8 days by linear accelerator. Results: Seven of the 25 patients suffered from RP of symptomatic grade 2-5 according to the NCI-CTC version 3.0. The overall incidence rate of RP grade2 or more was 29% at 18 months after completing SRT and three patients died from RP....

Influence of different treatment techniques on radiation dose to the LAD coronary artery

Radiation Oncology — Tue, 05 Jun 2007 04:00:00 +0100

Conclusion: IMRT techniques are able to reduce the radiation dose to the heart. In addition to dose reduction to whole heart, individualised dose distributions can be created, which spare, e.g., one ventricle plus one of the coronary arteries. Certain patients with well-defined vessel pathology might profit from an approach of general heart sparing with further selective dose reduction, accounting for the individual aspects of pre-existing damage. (Source: Radiation Oncology)

Oral Pirfenidone in patients with chronic fibrosis resulting from radiotherapy: a pilot study

Radiation Oncology — Thu, 31 May 2007 04:00:00 +0100

Conclusion: Several patients experienced improved function of at least 25% and reported subjective improvement. Pirfenidone may benefit patients with radiation-induced fibrosis and is worthy of a larger well controlled trial. Trial Registration: ClinicalTrials.gov NCT00020631 (Source: Radiation Oncology)

Correlating metabolic and anatomic responses of primary lung cancers to radiotherapy by combined F-18 FDG PET-CT imaging

Radiation Oncology — Wed, 23 May 2007 04:00:00 +0100

Background: To correlate the metabolic changes with size changes for tumor response by concomitant PET-CT evaluation of lung cancers after radiotherapy. Methods: 36 patients were studied pre- and post-radiotherapy with 18FDG PET-CT scans at a median interval of 71 days. All of the patients were followed clinically and radiographically after a mean period of 342 days for assessment of local control or failure rates. Change in size (sum of maximum orthogonal diameters) was correlated with that of maximum standard uptake value (SUV) of the primary lung cancer before and after conventional radiotherapy. Results: There was a significant reduction in both SUV and size of the primary cancer after radiotherapy (p (Source: Radiation Oncology)

IMRT in oral cavity cancer

Radiation Oncology — Thu, 12 Apr 2007 04:00:00 +0100

Background: Except for early T1,2 N0 stages, the prognosis for patients with oral cavity cancer (OCC) is reported to be worse than for carcinoma in other sites of the head and neck (HNC). The aim of this work was to assess disease outcome in OCC following IMRT. Between January 2002 and January 2007, 346 HNC patients have been treated with curative intensity modulated radiation therapy (IMRT) at the Department of Radiation Oncology, University Hospital Zurich. Fifty eight of these (16%) were referred for postoperative (28) or definitive (30) radiation therapy of OCC. 40 of the 58 OCC patients (69%) presented with locally advanced T3/4 or recurred lesions. Doses between 60 and 70Gy were applied, combined with simultaneous cisplatin based chemotherapy in 78%. Outcome analyses were performed ...

Range accuracy in carbon ion treatment planning based on CT-calibration with real tissue samples

Radiation Oncology — Fri, 23 Mar 2007 04:00:00 +0100

Conclusions: Carbon ion ranges can be controlled within ~1 mm in soft tissue for typical depths of head and neck treatments. (Source: Radiation Oncology)

A comparison of mantle versus involved-field radiotherapy for Hodgkins lymphoma: reduction in normal tissue dose and second cancer risk

Radiation Oncology — Thu, 15 Mar 2007 04:00:00 +0100

Conclusions: The significant decreases estimated for radiation-induced SC risks associated with modern IFRT provide strong support for the use of IFRT to reduce the late effects of treatment. The approach employed here can provide new insight into the risks associated with contemporary IFRT for HL, and may facilitate the counseling of patients regarding the risks associated with this treatment. (Source: Radiation Oncology)

The impact of radiotherapy in the treatment of desmoid tumours. An international survey of 110 patients. A study of the Rare Cancer Network.

Radiation Oncology — Wed, 07 Mar 2007 05:00:00 +0100

Conclusions: Postoperative radiotherapy significantly improved the PFS compared to surgery alone. Therefore it should always be considered after a non-radical tumour resection and should be given preferably in an adjuvant setting. It is effective in limb preservation and for preserving the function of joints in situations where surgery alone would result in deficits, which is especially important in young patients. (Source: Radiation Oncology)

Functional intercomparison of intraoperative radiotherapy equipment – Photon Radiosurgery System

Radiation Oncology — Tue, 27 Feb 2007 05:00:00 +0100

Conclusion: The x-ray sources are stable over time. Most measurements were found to lie within the manufacturer's tolerances and an intercomparison of these checks suggests that the four x-ray sources have similar performance characteristics. (Source: Radiation Oncology)

Salvage radiotherapy for biochemical relapse after complete PSA response following radical prostatectomy: outcome and prognostic factors for patients who have never received hormonal therapy

Radiation Oncology — Thu, 22 Feb 2007 07:00:00 +0100

Background: To evaluate the results of salvage conformal radiation therapy (3DC-EBRT) for patients submitted to radical prostatectomy (RP) who have achieved complete PSA response and who have never been treated with hormonal therapy (HT). To present the results of biochemical control, a period free from hormonal therapy and factors related to its prognosis. Methods: From August 2002 to December 2004, 43 prostate cancer patients submitted to RP presented biochemical failure after achieving a PSA (Source: Radiation Oncology)

Preoperative external beam radiotherapy and reduced dose brachytherapy for carcinoma of the cervix: survival and pathological response

Radiation Oncology — Thu, 22 Feb 2007 07:00:00 +0100

Conclusions: Time allowed between RT and surgery correlated with pathlogical response. Pelvic pathological response was associated with improved outcome. Postoperative additional HDRB did not improve therapeutic results. Treatment was well tolerated. (Source: Radiation Oncology)

Comparison of different IMRT treatment planning systems for pediatric cases

Radiation Oncology — Thu, 15 Feb 2007 07:00:00 +0100

Conclusions: A set of complex paediatric cases presented a variety of individual treatment planning challenges. Despite the large spread of results, inverse planning systems offer promising results for IMRT delivery, hence widening the treatment strategies for this very sensitive class of patients. (Source: Radiation Oncology)

On the performances of different IMRT treatment planning systems for selected paediatric cases

Radiation Oncology — Thu, 15 Feb 2007 05:00:00 +0100

Conclusion: A set of complex paediatric cases presented a variety of individual treatment planning challenges. Despite the large spread of results, inverse planning systems offer promising results for IMRT delivery, hence widening the treatment strategies for this very sensitive class of patients. (Source: Radiation Oncology)

The role of PDGF in radiation oncology

Radiation Oncology — Thu, 11 Jan 2007 07:00:00 +0100

Platelet-derived growth factor (PDGF) was originally identified as a constituent of blood serum and subsequently purified from human platelets. PDGF ligand is a dimeric molecule consisting of two disulfide-bonded chains from A-, B-, C- and D-polypeptide chains, which combine to homo- and heterodimers. The PDGF isoforms exert their cellular effects by binding to and activating two structurally related protein tyrosine kinase receptors. PDGF is a potent mitogen and chemoattractant for mesenchymal cells and also a chemoattractant for neutrophils and monocytes. In radiation oncology, PDGF are important for several pathologic processes, including oncogenesis, angiogenesis and fibrogenesis. Autocrine activation of PDGF was observed and interpreted as an important mechanism involved in brain and ...

Radiosensitization by 2-benzoyl-3-phenyl-6,7-dichloroquinoxaline 1,4-dioxide under oxia and hypoxia in human colon cancer cells

Radiation Oncology — Wed, 03 Jan 2007 07:00:00 +0100

Conclusion: DCQ is a hypoxic cell radiosensitizer in DLD-1 human colon cancer cells. (Source: Radiation Oncology)

Bronchiolitis obliterans organizing pneumonia (BOOP) after thoracic radiotherapy for breast carcinoma

Radiation Oncology — Wed, 03 Jan 2007 07:00:00 +0100

This report provides guidelines for the evaluation and treatment of patients with pulmonary infiltrates after radiotherapy. (Source: Radiation Oncology)

On the visualization of universal degeneracy in the IMRT problem

Radiation Oncology — Mon, 18 Dec 2006 07:00:00 +0100

Conclusion: In an example case, it is demonstrated how the assessment of the curvature space can indicate the equivalence of rival beam configurations and their proximity to the global optimum. (Source: Radiation Oncology)

CyberKnife® radiosurgery in the treatment of complex skull base tumors: analysis of treatment planning parameters

Radiation Oncology — Sat, 16 Dec 2006 07:00:00 +0100

Conclusion: Our data indicate that CyberKnife® treatment plans with excellent homogeneity, conformity and percent target coverage can be obtained for complex skull base tumors. Longer follow-up will be required to determine the safety and efficacy of fractionated treatment of these lesions with this radiosurgical system. (Source: Radiation Oncology)