MedWorm: External Beam Therapy

Metastasis After Radical Prostatectomy or External Beam Radiotherapy for Patients With Clinically Localized Prostate Cancer: A Comparison of Clinical Cohorts Adjusted for Case Mix [Genitourinary Cancer]

Journal of Clinical Oncology — Thu, 18 Mar 2010 22:01:36 +0100

Conclusion Metastatic progression is infrequent in men with low-risk prostate cancer treated with either RP or EBRT. RP patients with higher-risk disease treated had a lower risk of metastatic progression and prostate cancer–specific death than EBRT patients. These results may be confounded by differences in the use and timing of salvage therapy. (Source: Journal of Clinical Oncology)

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A qualitative analysis of acute skin toxicity among breast cancer radiotherapy patients

Psycho-Oncology — Wed, 17 Mar 2010 00:00:00 +0100

Conclusions: Implications of results are as follows: (1) skin toxicity affects numerous dimensions of QOL, and assessment approaches and psychosocial interventions should address this; (2) individual differences may affect the experience of skin toxicity and should be considered in treatment and education approaches; and (3) participants' own creativity and problem-solving should be used to improve the treatment experience. Copyright © 2010 John Wiley & Sons, Ltd. (Source: Psycho-Oncology)

Development of an Irradiated Rodent Model to Study Flap Revascularization [Original Article]

Archives of Facial Plastic Surgery — Mon, 15 Mar 2010 19:51:35 +0100

Conclusions This animal model establishes that external beam irradiation at a total dose of 40 Gy leads to significantly delayed flap revascularization over time compared with 23-Gy irradiation. This model will allow future investigators to study novel therapies to improve healing and flap revascularization. (Source: Archives of Facial Plastic Surgery)

Prostate-specific antigen kinetics following external-beam radiotherapy and temporary (Ir-192) or permanent (I-125) brachytherapy for prostate cancer.

Sat, 13 Mar 2010 00:00:00 +0100

CONCLUSIONS: PSA kinetics differ significantly following different radiotherapy methods. A lower nadir and a higher biochemical control rate suggest a higher radiobiological efficiency of brachytherapy in comparison to EBRT (with a dose of 70.2Gy). PMID: 20231039 [PubMed - as supplied by publisher] (Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology)

Medullary Thyroid Cancer: Are Practice Patterns in the United States Discordant From American Thyroid Association Guidelines?

Annals of Surgical Oncology — Fri, 12 Mar 2010 06:48:08 +0100

Conclusions Variation in practice patterns exist in the United States with regard to extent of surgery and lymphadenectomy for MTC. Dissemination of standardized guidelines is important to ensure optimal treatment with less variation in quality of care. Content Type Journal ArticleCategory Healthcare Policy and OutcomesDOI 10.1245/s10434-010-1017-0Authors Babita Panigrahi, Yale University School of Medicine Department of Surgery New Haven CT USASanziana A. Roman, Yale University School of Medicine Department of Surgery New Haven CT USAJulie Ann Sosa, Yale University School of Medicine Department of Surgery New Haven CT USA Journal Annals of Surgical OncologyOnline ISSN 1534-4681Print ISSN 1068-9265 (Source: Annals of Surgical Oncology)

Partial breast irradiation: a review of techniques and indications.

The British Journal of Radiology — Thu, 11 Mar 2010 00:00:00 +0100

Authors: Stewart AJ, Khan AJ, Devlin PM The addition of whole-breast external beam radiotherapy (EBRT) to breast-conserving surgery results in a significant reduction in the risk of death due to breast cancer, but this may be offset by an increase in deaths from other causes and toxicity to surrounding organs. Because of this, and with a view to patterns of local recurrence, irradiation of the tumour bed has been explored in selected patients with early breast cancer using a variety of radiotherapeutic modalities. This review article explores the treatment options for partial breast irradiation and examines their role within the field of breast cancer treatment. PMID: 20223911 [PubMed - as supplied by publisher] (Source: The British Journal of Radiology)

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Association between utility and treatment among patients with prostate cancer

Quality of Life Research — Wed, 10 Mar 2010 16:08:03 +0100

Conclusions Treatment appears to have significant association with post-treatment utility. Thus, utility assessment provides an important quantitative tool to support patient and physician clinical treatment decision-making process in prostate cancer care. Content Type Journal ArticleDOI 10.1007/s11136-010-9622-8Authors Ravishankar Jayadevappa, University of Pennsylvania Department of Medicine 224, 3615 Chestnut Street Philadelphia PA 19104-2676 USAJ Sanford Schwartz, University of Pennsylvania Department of Medicine Philadelphia PA 19104-2676 USASumedha Chhatre, University of Pennsylvania Department of Psychiatry Philadelphia PA USAAlan J. Wein, University of Pennsylvania Division of Urology, Department of Surgery Philadelphia PA USAS. Bruce Malkowicz, University of...

Tracking technology reduces side effects from radiation

Modern Medicine — Tue, 09 Mar 2010 00:00:00 +0100

The Calypso System (Calypso Medical Technologies, Inc., Seattle) offers a significant reduction in rectal and urinary treatment-related side effects during high-dose external beam radiation for prostate cancer, according to recent findings. (Source: Modern Medicine)

Accuracy of multiparametric magnetic resonance imaging in detecting recurrent prostate cancer after radiotherapy

BJU International — Tue, 09 Mar 2010 00:00:00 +0100

To assess the role of multiparametric magnetic resonance imaging (mp-MRI) of the prostate in evaluating local recurrence of prostate cancer, using transperineal template-guided 5 mm-spaced biopsies as a reference standard, in men treated with external beam radiotherapy (EBRT) for prostate cancer. The study included 13 patients with evidence of biochemical recurrence after EBRT who had undergone mp-MRI and prostate mapping. Each MRI scan (consisting of T1/T2 weighting, dynamic contrast enhancement and diffusion weighting) was reported by two expert uro-radiologists. Each prostate was divided into four regions of interest (ROI), generating 52 paired datasets for analysis. The mean (range) age of the men was 65.5 (55[ndash]70) years, the mean prostate-specific antigen (PSA) level before EBRT ...

Vaginal Brachytherapy Instead of EBRT for Endometrial Cancer

Medscape Today Headlines — Mon, 08 Mar 2010 19:07:50 +0100

For women with endometrial cancer of high-intermediate risk, adjuvant therapy should be vaginal brachytherapy instead of external beam radiation therapy. Medscape Medical News (Source: Medscape Today Headlines)

Hypothyroidism after 131I-monoclonal antibody treatment of neuroblastoma

Pediatric Blood and Cancer — Mon, 08 Mar 2010 00:00:00 +0100

To determine the prevalence of and risk factors for primary hypothyroidism following treatment with a radiolabeled monoclonal antibody (131I-3F8) in children with neuroblastoma.In the current study, we assessed thyroid function in 51 neuroblastoma patients who survived for [ge]3 months after treatment with 131I-3F8 (a murine IgG3 monoclonal antibody that reacts with the ganglioside GD2) at 4 mCi/kg/day × 5 days (total 20 mCi/kg). Prior therapy in all subjects included dose-intensive chemotherapy; 13 subjects also received external beam radiation to the neck. Oral iodide and liothyronine sodium (T3) were administered for protection of the thyroid gland.Thirty-two of 51 subjects (63%) developed hormonal evidence of primary hypothyroidism. The median time to hypothyroidism after treatment wi...

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Brachytherapy Called New Standard for Endometrial CA (CME/CE)

MedPage Today Hematology/Oncology — Fri, 05 Mar 2010 14:40:59 +0100

Endometrial cancer patients with intermediate recurrence risk may be better off with adjuvant internal radiotherapy than with external beam radiation, Dutch researchers said. (Source: MedPage Today Hematology/Oncology)

[Comment] Radiotherapy for endometrial cancer: a key piece in the jigsaw

LANCET — Fri, 05 Mar 2010 00:00:00 +0100

With a rising yearly incidence of more than 20 women per 100 000, endometrial cancer is now the most common gynaecological cancer in developed countries. More than 75% of patients present with disease confined to the uterus. After hysterectomy and bilateral salpingo-oophorectomy, histopathological variables are used to assign risk of recurrence. Endometrial cancer of high-intermediate risk accounts for around 30% of women with early disease, of whom about 15% either have occult metastases or will develop metastatic disease. Adjuvant treatment to reduce the risk of recurrence has traditionally been external beam radiotherapy (EBRT), which is presently offered to about a third of women with endometrial cancer, with or without vaginal brachytherapy (VBT). However, although EBRT reduces the r...

[Articles] Vaginal brachytherapy versus pelvic external beam radiotherapy for patients with endometrial cancer of high-intermediate risk (PORTEC-2): an open-label, non-inferiority, randomised trial

LANCET — Fri, 05 Mar 2010 00:00:00 +0100

This study established whether vaginal brachytherapy (VBT) is as effective as pelvic external beam radiotherapy (EBRT) in prevention of vaginal recurrence, with fewer adverse effects and improved quality of life. (Source: LANCET)

Vaginal Brachytherapy May Be Best for Endometrial Cancer

Modern Medicine — Fri, 05 Mar 2010 00:00:00 +0100

In patients with high-intermediate-risk endometrial cancer, vaginal brachytherapy is just as effective as pelvic external beam radiotherapy for prevention of vaginal recurrence, has fewer toxic effects and leads to improved quality of life, according to a study in the March 6 issue of The Lancet. (Source: Modern Medicine)

Association between utility and treatment among patients with prostate cancer.

Pain Physician — Fri, 05 Mar 2010 00:00:00 +0100

CONCLUSIONS: Treatment appears to have significant association with post-treatment utility. Thus, utility assessment provides an important quantitative tool to support patient and physician clinical treatment decision-making process in prostate cancer care. PMID: 20204704 [PubMed - as supplied by publisher] (Source: Pain Physician)

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Accumulation of CD133-positive glioma cells after high-dose irradiation by Gamma Knife surgery plus external beam radiation.

Journal of Neurosurgery — Fri, 05 Mar 2010 00:00:00 +0100

Conclusions The results indicate that CD133-positive glioma stemlike cells can survive high-dose irradiation, leading to recurrence, despite prolonged damage to tumor blood vessels. This could be an essential factor limiting the effectiveness of GKS plus EBRT for malignant gliomas. PMID: 20205512 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery)

The Effect of External Beam Irradiation Timing on Skin Graft Survival

European Surgical Research — Thu, 04 Mar 2010 23:00:00 +0100

Eur Surg Res 2010;44:142151 (DOI:10.1159/000276985) (Source: European Surgical Research)

Response to “Predictors of Prostate Cancer–Specific Mortality in Elderly Men With Intermediate-Risk Prostate Cancer Treated With Brachytherapy With or Without External Beam Radiation Therapy” (Int J Radiat Oncol Biol Phys 2009, in press)

International Journal of Radiation Oncology * Biology * Physics — Wed, 03 Mar 2010 15:35:20 +0100

To the Editor: We read with great interest the article by Nanda et al. suggesting a decreased prostate cancer–specific mortality in elderly men with cardiovascular disease treated by brachytherapy with or without external beam radiation therapy for intermediate-risk prostate cancer. Attracted by this surprising finding, we performed an exploratory analysis of our sample of 2,205 consecutive patients who underwent radical prostatectomy in the years 1992–2005 (median follow-up, 5.4 years; median age, 65 years) stratified by several possible definitions of cardiovascular disease (the way of comorbidity assessment has previously been described in detail ). In all stratifications, cardiovascular disease was associated with increased overall mortality, and there was no detectable protective...

Adaptive Management of Cervical Cancer Radiotherapy

Seminars in Radiation Oncology — Wed, 03 Mar 2010 13:43:51 +0100

Since the breakthrough 10 years ago with concomitant radio-chemotherapy, substantial progress in the treatment of locally advanced cervical cancer has been lacking. Radiotherapy continues to be the cornerstone in the treatment of this disease and now shows much potential for progress, as image guidance of both external beam radiation therapy and brachytherapy, linked with strong tools for treatment planning and dose delivery, is becoming available. With these new techniques, it again seems possible to improve the therapeutic ratio as we begin to understand how the treatment for each patient can be individualized, not only in terms of volume (3-dimensional), but also during treatment (4-dimensional), as the tumor regresses and the topography of the target and organs at risk change significa...

Relationship between prostate cancer mortality and number of unfavourable risk factors in men treated with definitive brachytherapy

BJU International — Mon, 01 Mar 2010 00:00:00 +0100

Study Type [ndash] Therapy (case series)Level of Evidence 4 To explore whether the number of unfavourable pretreatment risk factors predicts cause-specific mortality in men treated with prostate brachytherapy. Between April 1995 and March 2006, 739 patients were treated who had at least one of the following adverse risk factors: pretreatment prostate-specific antigen (PSA) level of >10 ng/mL, a Gleason score of [ge]7, clinical stage [ge]T2b, or a PSA velocity (PSAV) of >2 ng/mL/year. Supplemental external beam radiotherapy (EBRT) was delivered to 464 (62.8%) men and 301 (40.7%) received androgen deprivation therapy (ADT). Of men with more than two risk factors, 87% received EBRT and 62% received ADT. The biochemical progression-free survival (bPFS), cause-specific survival (CSS) and overal...

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Approach to the thyroid cancer patient with extracervical metastases.

The Journal of Clinical Endocrinology and Metabolism — Mon, 01 Mar 2010 00:00:00 +0100

Authors: Haugen BR, Kane MA Patients with distant, or extracervical, metastases from differentiated thyroid cancer require multimodality diagnostic, therapeutic, and monitoring approaches. Whereas cure is the initial goal, especially in those with small, radioiodine-avid pulmonary metastases, improved survival and management of symptoms become the primary objective in many patients with persistent disease, especially those with bone metastases. Levothyroxine therapy with suppression of serum TSH is a primary therapy in all patients with advanced differentiated thyroid cancer, and this therapy has been shown to improve overall survival and slow disease progression. Radioiodine is also an important systemic therapy for those patients with radioiodine-avid disease who respond to this targ...

Prospective comparison of PSA kinetics following two different prostate cancer brachytherapy planning methods: Preoperative and real-time intraoperative dosimetry planning.

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

CONCLUSIONS: Our initial finding of highly superior postimplant CT dosimetry calculations of the IoP method are now substantiated by the biochemical favorable results (PSA kinetics) of this method. PMID: 20189847 [PubMed - as supplied by publisher] (Source: Urologic Oncology)

Time Trends and Local Variation in Primary Treatment of Localized Prostate Cancer [Genitourinary Cancer]

Journal of Clinical Oncology — Wed, 24 Feb 2010 23:01:02 +0100

Conclusion Substantial variation exists in management of localized prostate cancer that is not explained by measurable factors. A critical need exists for high-quality comparative effectiveness research in localized prostate cancer to help guide treatment decision making. (Source: Journal of Clinical Oncology)

Primary osteosarcoma of the urinary bladder treated with external radiotherapy in a patient with a history of transitional cell carcinoma: a case report

BioMed Central — Wed, 24 Feb 2010 00:00:00 +0100

Conclusion: Osteosarcoma of the bladder has a dismal prognosis. External beam radiation therapy as an adjunct to transurethral resection of bladder tumor not only provides no benefit to patients with primary osteosarcoma of urinary bladder, but also may be associated with poor quality of life. (Source: BioMed Central)

Metastasis after treatment for prostate cancer depends on disease risk

MedWire News - Oncology — Tue, 23 Feb 2010 00:00:00 +0100

Men with high-risk prostate cancer are less likely to experience metastatic disease progression if they are treated with radical prostatectomy compared with external beam radiotherapy, report researchers. (Source: MedWire News - Oncology)

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Metastasis after treatment for prostate cancer depends on disease risk

MedWire News - Prostate Cancer — Tue, 23 Feb 2010 00:00:00 +0100

A Randomized Trial Of External Beam Radiotherapy Versus Cryoablation In Patients With Localized Prostate Cancer

Health News from Medical News Today — Sun, 21 Feb 2010 17:00:00 +0100

UroToday.com - This type of trial is very difficult to conduct, resulting in slow accrual, and ultimately, early closure. Thus the study is underpowered. Other shortcomings are pointed out in our discussion. As an equivalence study, it meets the 4 criteria for such an undertaking: margin clearly stated initially sample size indicated reported on an intention to treat (ITT) basis, and confidence intervals reported The results are presented very clearly and openly, and the data is clean... (Source: Health News from Medical News Today)

A Randomized Trial Of External Beam Radiotherapy Versus Cryoablation In Patients With Localized Prostate Cancer

Cancer / Oncology News From Medical News Today — Sun, 21 Feb 2010 17:00:00 +0100

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)...

Thyroid Cancer Outcomes in Filipino Patients [Original Article]

Archives of Otolaryngology — Mon, 15 Feb 2010 20:50:39 +0100

Conclusions Filipino patients have a significantly higher risk of thyroid cancer recurrence compared with non-Filipino patients. However, no significant difference was noted in the time to recurrence or the rate of death from disease. These findings justify a more aggressive initial management and follow-up regimen for Filipino patients with thyroid cancer. (Source: Archives of Otolaryngology)

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MammoSite Brachytherapy

About.com Breast Cancer — Mon, 15 Feb 2010 00:00:00 +0100

MammoSite breast brachytherapy is an alternative radiation treatment to external beam radiation of the breast. MammoSite breast brachytherapy takes 5 days to completely treat early stage breast cancer with radiation after a lumpectomy. Learn more about MammoSite breast brachytherapy here. (Source: About.com Breast Cancer)

Beyond the Abstract - A randomized trial of external beam radiotherapy versus cryoablation in ...

UroToday — Sun, 14 Feb 2010 23:05:00 +0100

BERKELEY, CA (UroToday.com) - This type of trial is very... (Source: UroToday)

Treatment of Thyroid Eye Disease

Current Treatment Options in Neurology — Fri, 12 Feb 2010 07:32:58 +0100

Opinion statement Thyroid eye disease (TED) is an autoimmune disease characterized by varying degrees of proptosis, congestion and inflammation of the extraocular tissues, and eyelid retraction. It is usually seen in the setting of Graves’ disease, but the severity of TED does not necessarily correlate with the level of systemic disease in a given patient. It is very important, nonetheless, to try to achieve a euthyroid state to minimize the chances of exacerbation of TED. Treatment of TED is based on the signs and symptoms displayed by the patient; there is no “one size fits all” approach. Generally, it is advisable to start with conservative measures, such as ocular lubrication with artificial tears, to manage symptoms of chronic irritation and redness. It is also ...

Mismatch repair status and outcomes after adjuvant therapy in patients with surgically staged endometrial cancer.

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

CONCLUSIONS: Subgroups of patients with non-endometrioid endometrial cancer and defective MMR may have improved survival after adjuvant radiotherapy. Patients with advanced stage endometrial cancer and defects in mismatch repair may receive less benefit from adjuvant chemotherapy. PMID: 20153885 [PubMed - as supplied by publisher] (Source: Gynecologic Oncology)

The use of anticoagulants improves biochemical control of localized prostate cancer treated with radiotherapy

Cancer — Mon, 08 Feb 2010 00:00:00 +0100

Substantial experimental evidence suggests that anticoagulants (ACs) may inhibit cancer growth and metastasis, although the limited data from clinical trials have been inconsistent. The potential antineoplastic effect of ACs was investigated in patients who received radiotherapy for localized prostate cancer.The study cohort consisted of 662 patients with adenocarcinoma of the prostate who received radiotherapy (RT) with curative intent. Among those 622 men, 243 (37%) were receiving ACs (warfarin, clopidogrel, and/or aspirin). All patients received external-beam RT, permanent seed implantation, or a combination of both. Prostate-specific antigen (PSA) values were monitored for biochemical control of disease.At a median follow-up of 49 months, the biochemical control rate at 4-years was sig...

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Standard and Emerging Therapies for Metastatic Differentiated Thyroid Cancer.

The Oncologist — Mon, 08 Feb 2010 00:00:00 +0100

Authors: O'Neill CJ, Oucharek J, Learoyd D, Sidhu SB Differentiated thyroid cancer accounts for >90% of cases of thyroid cancer, with most patients having an excellent prognosis. Distant metastases occur in 10%-15% of patients, decreasing the overall 10-year survival rate in this group to 40%. Radioactive iodine has been the mainstay of treatment for distant metastases, with good results when lesions retain the ability to take up iodine. For patients with metastatic disease resistant to radioactive iodine, treatment options are few and survival is poor. Chemotherapy and external beam radiotherapy have been used in these patients, but with disappointing results. In recent years, our understanding of the molecular pathways involved in thyroid cancer has increased and a number of molec...

Benefit of radiotherapy for 90 patients with resected intrahepatic cholangiocarcinoma and concurrent lymph node metastases

Journal of Cancer Research and Clinical Oncology — Thu, 04 Feb 2010 06:44:59 +0100

Conclusions External beam radiotherapy seems to improve the prognosis of patients with resected intrahepatic cholangiocarcinoma and concurrent macroscopic lymph node metastases. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s00432-010-0783-1Authors Wei Jiang, Fudan University Department of Radiation Oncology, Zhongshan Hospital 136 Yi Xue Yuan Road Shanghai 200032 ChinaZhao-Chong Zeng, Fudan University Department of Radiation Oncology, Zhongshan Hospital 136 Yi Xue Yuan Road Shanghai 200032 ChinaZhao-You Tang, Fudan University Liver Cancer Institute, Zhongshan Hospital Shanghai 200032 ChinaJia Fan, Fudan University Liver Cancer Institute, Zhongshan Hospital Shanghai 200032 ChinaJian Zhou, Fudan University Liver Cancer Institute, Zhongshan Hospital Shan...

Is There a Role for Adjuvant Hysterectomy after Suboptimal Concurrent Chemoradiation in Cervical Carcinoma?

Clinical Oncology — Wed, 03 Feb 2010 15:36:34 +0100

Conclusions: Adjuvant hysterectomy after unsuccessful ICBT does not seem to increase late toxicity and reduces the risk of pelvic recurrence and may improve survival. The role of adjuvant hysterectomy after suboptimal chemoradiation merits further investigation in clinical trials. (Source: Clinical Oncology)

Breast Radiation: Fewer Treatments, Larger Dosage Works Well

About.com Breast Cancer — Mon, 01 Feb 2010 00:00:00 +0100

Breast Cancer Patients Report Better Quality of Life, Less Side Effects Would you rather have five weeks or three weeks of radiation treatments? How about less total radiation to your breast? Throw in better quality of life, better satisfaction with your body image, and effective prevention of a breast cancer recurrence. That's what researchers found at the START (Standardisation of Breast Radiotherapy) Trials. This new schedule of radiation for breast cancer is called hypofractionated radiation. Each dose of radiation was higher than the standard now used for external beam radiation. Patients were given fewer radiation treatments, saving them time, travel, disruption of schedule, and cost. When researchers surveyed the patients in the START Trials, they asked the women about their person...

Helping patients with localized prostate cancer reach treatment decisions.

Canadian Family Physician Medecin de Famille Canadien — Mon, 01 Feb 2010 00:00:00 +0100

CONCLUSION: Family physicians can help minimize the decisional regret experienced by patients after treatment by encouraging patients to consider their values and social supports, as well as the accuracy and appropriateness of the information used in the decision-making process. PMID: 20154243 [PubMed - in process] (Source: Canadian Family Physician Medecin de Famille Canadien)

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Targeted molecular therapies in thyroid carcinoma

Arquivos Brasileiros de Endocrinologia e Metabologia — Sat, 30 Jan 2010 14:14:11 +0100

Thyroid cancer incidence has significantly increased in the last three decades and many patients seek medical attention for its treatment every year. Among follicular cell-derived tumors, the majority are differentiated thyroid carcinomas (DTC), whose prognosis is very good with only 15% of the cases presenting disease persistence or recurrence after initial treatment. Medullary thyroid carcinoma has a worse prognosis, especially in patients with diffused cancers at the time of initial surgery. Traditional treatment options for persistent or recurrent disease include additional surgery, radioiodine treatment and TSH-suppression in DTC patients; external beam radiotherapy, and cytotoxic chemotherapy, often have low efficacy and many patients with advanced disease ultimately die. In the last...

In Prostate CA, Sexual Decline After Radiation Has Limit (CME/CE)

MedPage Today Hematology/Oncology — Sat, 30 Jan 2010 13:13:05 +0100

Sexual function declines in the first two years after external beam radiation therapy for prostate cancer but stabilizes thereafter, according to data from a prospective cohort study. (Source: MedPage Today Hematology/Oncology)

Radioimmunotherapy of Lymphoma: Bexxar and Zevalin

Seminars in Nuclear Medicine — Fri, 29 Jan 2010 15:14:19 +0100

This article reviews the basis for dose selection, the nuclear medicine procedures involved, the results obtained to date, and issues related to patient and staff safety. (Source: Seminars in Nuclear Medicine)

Systemic Metabolic Radiopharmaceutical Therapy in the Treatment of Metastatic Bone Pain

Seminars in Nuclear Medicine — Fri, 29 Jan 2010 15:14:18 +0100

Bone pain due to skeletal metastases constitutes the most common type of chronic pain among patients with cancer. It significantly decreases the patient's quality of life and is associated with comorbidities, such as hypercalcemia, pathologic fractures and spinal cord compression. Approximately 65% of patients with prostate or breast cancer and 35% of those with advanced lung, thyroid, and kidney cancers will have symptomatic skeletal metastases. The management of bone pain is extremely difficult and involves a multidisciplinary approach, which usually includes analgesics, hormone therapies, bisphosphonates, external beam radiation, and systemic radiopharmaceuticals. In patients with extensive osseous metastases, systemic radiopharmaceuticals should be the preferred adjunctive therapy for ...

Inferior Vena Cava Leiomyosarcoma: Is Reconstruction Necessary after Resection?

Journal of the American College of Surgeons — Wed, 27 Jan 2010 15:29:17 +0100

Conclusions: Leiomyosarcoma of the IVC is a treatable malignancy. Preoperative external-beam radiation facilitates marginally negative resection, although our study is too small to demonstrate a survival benefit. Reconstruction of the IVC is not necessary for resection of tumors below the level of the hepatic veins in most if not all cases. Lower-extremity edema after ligation of the IVC is well tolerated. Acute renal failure can be a common, albeit transient, early postoperative complication. Extensive periaortic dissection can be associated with chylous leak, which can be managed with internal or external drainage. (Source: Journal of the American College of Surgeons)

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Cyberknife Radiotherapy Extends Survival for Patients with Margin-Positive, Resected Pancreatic Cancer

Journal of Surgical Research — Mon, 25 Jan 2010 16:42:25 +0100

Conclusion: In this contemporary single institution, non-randomized, prospective study of 86 pancreatic cancer resections, survival for R1 patients treated with adjuvant Chemo/RT did not differ significantly from R0 patients, suggesting adjuvant therapy can “salvage” a positive microscopic margin. Targeted CK radiotherapy boost to R1 margins appears to extend survival further for these patients beyond historical controls. This survival benefit may be driven by improved local control. (Source: Journal of Surgical Research)

The Efficacy of Transarterial Radioembolization and Transarterial Chemoembolization in Hepatocellular Carcinoma: Effect on Total Tumor Volume and Patient Survival at a Single Center

Journal of Surgical Research — Mon, 25 Jan 2010 16:42:16 +0100

Conclusion: Thus far, these data demonstrate that TARE is an effective treatment for unresectable HCC. A profound reduction in TTV and partial response was observed in >50% of patients (WHO and RECIST). Our preliminary results suggest a survival benefit and an acceptable safety profile, particularly in patients who may not be good candidates for TACE because tumor size or pre-existing portal vein thrombosis. Ongoing analysis should indicate optimal pre-treatment parameters, especially in relation to TTV, to decide when TACE or TARE should be utilized in patients with unresectable HCC. (Source: Journal of Surgical Research)

Medullary Thyroid Cancer: Are Practice Patterns in the U.S. Discordant from ATA Guidelines?

Journal of Surgical Research — Mon, 25 Jan 2010 16:40:52 +0100

Objective: To benchmark national practice patterns against 2009 American Thyroid Association (ATA) guidelines for medullary thyroid cancer (MTC) regarding use of thyroidectomy, lymphadenectomy, radioactive iodine (RAI), and external beam radiation (EBRT). Background: Surgery is the mainstay of treatment for MTC, with long-term patient outcomes associated with adequacy of resection. Guidelines for the clinical management of MTC have been published by several professional societies. The most comprehensive guidelines were put forth by the ATA in 2009, bringing together evidence-based recommendations and expert opinion. Methods: This is a cross-sectional, retrospective cohort study of MTC patients in the Surveillance, Epidemiology and End Results (SEER) database, 1973-2006. ATA Recommendations...

Inferior Vena Cava Leiomyosarcoma: Is Reconstruction Necessary after Resection?

Journal of Surgical Research — Mon, 25 Jan 2010 16:40:47 +0100

Conclusion: Leiomyosarcomas of the inferior vena cava is a treatable malignancy. Preoperative external beam radiation facilitates marginal resection, though our study is too small to demonstrate a survival benefit. Reconstruction of the inferior vena cava is not necessary for resection of tumors below the level of the hepatic veins. Lower extremity edema following ligation of the inferior vena cava is well tolerated. Acute renal failure may be a common, albeit transient, early postoperative complication. Extensive periaortic dissection may be associated with Chylous leak which can be managed with internal or external drainage. (Source: Journal of Surgical Research)

How costly is particle therapy? Cost analysis of external beam radiotherapy with carbon-ions, protons and photons.

Mon, 25 Jan 2010 00:00:00 +0100

CONCLUSION: Investment costs are highest for the combined carbon-ion/proton facility and lowest for the photon facility. Cost differences become smaller when total costs per year and specific treatment costs are compared. Lower fractionation schedule of particle therapy might further reduce its costs. PMID: 20106540 [PubMed - as supplied by publisher] (Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology)

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Editorial - A randomized trial of external beam radiotherapy versus cryoablation in patients ...

UroToday — Thu, 21 Jan 2010 23:05:00 +0100

BERKELEY, CA (UroToday.com) - Radiotherapy (EBRT) and cryotherapy (cryo) are two treatment modalities for localized prostate cancer (CaP). (Source: UroToday)

EBRT for prostate cancer linked to increased rates of secondary malignancies

MedWire News - Oncology — Mon, 18 Jan 2010 00:00:00 +0100

Men treated with external beam radiotherapy for prostate cancer may have a higher risk for developing secondary bladder cancer, lung cancer, and renal cancer than their surgically treated counterparts, researchers report. (Source: MedWire News - Oncology)

EBRT for prostate cancer linked to increased rates of secondary malignancies

MedWire News - Prostate Cancer — Mon, 18 Jan 2010 00:00:00 +0100

Determining DVH parameters for combined external beam and brachytherapy treatment: 3D biological dose adding for patients with cervical cancer

Radiotherapy and Oncology — Mon, 18 Jan 2010 00:00:00 +0100

Conclusion: Without an EBRT boost ‘parameter adding’, as proposed by the GEC-ESTRO, yielded accurate results for the values for DVH parameters. If an EBRT boost is given ‘distributions adding’ should be considered. (Source: Radiotherapy and Oncology)

Target volume definition for external beam partial breast radiotherapy: Clinical, pathological and technical studies informing current approaches

Radiotherapy and Oncology — Mon, 18 Jan 2010 00:00:00 +0100

Abstract: Partial breast irradiation (PBI) is currently under investigation in several phase III trials and, following a recent consensus statement, its use off-study may increase despite ongoing uncertainty regarding optimal target volume definition. We review the clinical, pathological and technical evidence for target volume definition in external beam partial breast irradiation (EB-PBI). The optimal method of tumour bed (TB) delineation requires X-ray CT imaging of implanted excision cavity wall markers. The definition of clinical target volume (CTV) as TB plus concentric 15mm margins is based on the anatomical distribution of multifocal and multicentric disease around the primary tumour in mastectomy specimens, and the clinical locations of local tumour relapse (LR) after breast conse...

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Treatment of small-cell lung cancer in elderly patients

Cancer — Fri, 15 Jan 2010 00:00:00 +0100

Small-cell lung cancer (SCLC) represents 15% to 20% of all lung carcinomas. Approximately 30% to 40% of these cases are diagnosed in patients older than 70 years of age. Staging of SCLC classifies patients as having either limited or extensive-stage disease. The standard treatment for limited-stage disease is platinum-based chemotherapy, combined with external-beam thoracic radiotherapy, whereas platinum-based regimens alone represent the standard of care for extensive-stage disease. In the elderly population, treatment of SCLC is more challenging given the decline in physiological organ reserve and the presence of comorbidities. The majority of data are drawn from retrospective studies, which are likely to suffer from selection bias. However, limited prospective data are available to guid...

Target volume definition for external beam partial breast radiotherapy: Clinical, pathological and technical studies informing current approaches.

Fri, 15 Jan 2010 00:00:00 +0100

Authors: Kirby AM, Coles CE, Yarnold JR Partial breast irradiation (PBI) is currently under investigation in several phase III trials and, following a recent consensus statement, its use off-study may increase despite ongoing uncertainty regarding optimal target volume definition. We review the clinical, pathological and technical evidence for target volume definition in external beam partial breast irradiation (EB-PBI). The optimal method of tumour bed (TB) delineation requires X-ray CT imaging of implanted excision cavity wall markers. The definition of clinical target volume (CTV) as TB plus concentric 15mm margins is based on the anatomical distribution of multifocal and multicentric disease around the primary tumour in mastectomy specimens, and the clinical locations of local tumo...

Determining DVH parameters for combined external beam and brachytherapy treatment: 3D biological dose adding for patients with cervical cancer.

Fri, 15 Jan 2010 00:00:00 +0100

CONCLUSION: Without an EBRT boost 'parameter adding', as proposed by the GEC-ESTRO, yielded accurate results for the values for DVH parameters. If an EBRT boost is given 'distributions adding' should be considered. PMID: 20080309 [PubMed - as supplied by publisher] (Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology)

Radiotherapy for hepatocellular carcinoma: Systematic review of radiobiology and modeling projections indicate reconsideration of its use

Journal of Gastroenterology and Hepatology — Thu, 14 Jan 2010 00:00:00 +0100

Conclusion: New radiobiological data, modeling, emerging clinical data and the advantages offered by standard external beam radiotherapy techniques suggest the need for reconsidering the use of radiotherapy and for new trials. (Source: Journal of Gastroenterology and Hepatology)

The Rate of Secondary Malignancies After Radical Prostatectomy Versus External Beam Radiation Therapy for Localized Prostate Cancer: A Population-Based Study on 17,845 Patients

International Journal of Radiation Oncology * Biology * Physics — Wed, 13 Jan 2010 15:20:30 +0100

Purpose: External-beam radiation therapy (EBRT) may predispose to secondary malignancies that include bladder cancer (BCa), rectal cancer (RCa), and lung cancer (LCa). We tested this hypothesis in a large French Canadian population-based cohort of prostate cancer patients.Methods and Materials: Overall, 8,455 radical prostatectomy (RP) and 9,390 EBRT patients treated between 1983 and 2003 were assessed with Kaplan-Meier and Cox regression analyses. Three endpoints were examined: (1) diagnosis of secondary BCa, (2) LCa, or (3) RCa. Covariates included age, Charlson comorbidity index, and year of treatment.Results: In multivariable analyses that relied on incident cases diagnosed 60 months or later after RP or EBRT, the rates of BCa (hazard ratio [HR], 1.4; p = 0.02), LCa (HR, 2.0; p = 0.004...

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A theoretical dose-escalation study based on biological effective dose in radioimmunotherapy with 90Y-ibritumomab tiuxetan (Zevalin)

European Journal of Nuclear Medicine and Molecular Imaging — Wed, 13 Jan 2010 06:51:08 +0100

Conclusion At standard activities, absorbed doses to lesions appear to be effective, even though lower than prescribed by EBRT. At myeloablative dosages, the uncertainty associated with the absorbed doses and radiobiological parameters considerably affect BED evaluation and may account for possible “second-organ” toxicities. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00259-009-1333-4Authors Massimiliano Pacilio, Azienda Ospedaliera S. Camillo Forlanini Department of Medical Physics Rome ItalyMargherita Betti, “Sapienza” University of Rome Health Physics Postgraduate School Rome ItalyFrancesco Cicone, “Sapienza” University of Rome Department of Nuclear Medicine, Second Faculty of Medicine Rome ItalyCarolina Del Mastro, “Sapienza” ...

EBRT versus CRYO for prostate cancer: short- and long-term effects differ

MedWire News - Oncology — Mon, 11 Jan 2010 00:00:00 +0100

Rates of disease progression after treatment with external beam radiotherapy and cryoablation for prostate cancer do not differ in the short term, whereas long-term rates favor CRYO, report researchers. (Source: MedWire News - Oncology)

EBRT versus CRYO for prostate cancer: short- and long-term effects differ

MedWire News - Prostate Cancer — Mon, 11 Jan 2010 00:00:00 +0100

Phase II trial of intratumoral BCNU injection and radiotherapy on untreated adult malignant glioma

Journal of Neuro-Oncology — Sun, 10 Jan 2010 06:44:38 +0100

Abstract DTI-015 (BCNU dissolved in ethanol) utilizes solvent facilitated perfusion (SFP) for intratumoral drug delivery. A phase II clinical trial of DTI-015 and fractionated external beam radiotherapy on newly diagnosed, malignant gliomas investigated early changes in tumour physiology and metabolism, clinical outcome and safety. Pre- and post DTI-015 injection neuro-imaging included computed tomography (CT) cerebral blood flow and volume, glucose and thallium single photon emission computed tomography (SPECT) and magnetic resonance imaging (MRI). Clinical status was determined before and after DTI-015, prior to radiotherapy and 3 monthly thereafter until progression (defined by Macdonald criteria). Primary endpoint was radiographic response. Secondary endpoints wer...

External beam APBI may cause unacceptable cosmesis

MedWire News - Breast Cancer — Sat, 09 Jan 2010 13:48:14 +0100

Accelerated partial-breast irradiation, using an external beam technique of beamlet intensity-modulated radiotherapy with active breathing control leads to unacceptable changes in breast appearance in patients with breast cancer, study findings indicate. (Source: MedWire News - Breast Cancer)

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External beam APBI may cause unacceptable cosmesis

MedWire News - Oncology — Sat, 09 Jan 2010 13:48:14 +0100

Sexual function does not continuously decline after RT for PCa

Modern Medicine — Sat, 09 Jan 2010 00:00:00 +0100

Sexual function in prostate cancer patients receiving external beam radiation therapy (EBRT) decreases within the first 2 years after treatment but then stabilizes and does not continuously decline as was previously thought, according to a recently published study. (Source: Modern Medicine)

New Cervical Cancer Research From Brigham And Women's Hospital Outlined

Cancercompass News: Gynecological Cancer — Fri, 08 Jan 2010 00:00:00 +0100

In this recent report, researchers in the United States conducted a study To evaluate factors affecting survival and toxicity in patients with stage IIIB cervical cancer treated with external- beam radiotherapy and low-dose-rate brachytherapy. Seventy patients with stage IIIB cervical cancer treated between 1980 and 2000 were identified. (Source: Cancercompass News: Gynecological Cancer)

Prostate-specific antigen relapse-free survival and side-effects in 734 patients with up to 10 years of follow-up with localized prostate cancer treated by permanent 125iodine implants

BJU International — Fri, 08 Jan 2010 00:00:00 +0100

Study Type [ndash] Therapy (case series)Level of Evidence 4 To report our analysis of the oncological outcome, side-effects and complications after 125I-brachytherapy, based on 10 years of experience, as low dose-rate (LDR) prostate brachytherapy is an accepted, effective and safe therapy for localized prostate cancer. Between April 1999 and December 2006, 734 consecutive patients were treated with clinically localized prostate cancer with a follow-up of [ge]30 months. No patients received external beam radiotherapy and 43% received hormonal therapy before brachytherapy; this therapy was given for 3[ndash]4 months. All patients had LDR prostate brachytherapy administered by one radiation oncologist. Biochemical failure was defined according to the 'Phoenix consensus'. The median follow-up ...

Sexual Function Does Not Continuously Decline After Radiation Therapy Treatments For Prostate Cancer

Health News from Medical News Today — Thu, 07 Jan 2010 08:00:00 +0100

Sexual function in prostate cancer patients receiving external beam radiation therapy (EBRT) decreases within the first two years after treatment but then stabilizes and does not continuously decline as was previously thought, according to a study in the January 1 issue of the International Journal of Radiation Oncology*Biology*Physics, the official journal of the American Society for Radiation Oncology (ASTRO). Prostate cancer is the most common male cancer other than skin cancer... (Source: Health News from Medical News Today)

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Sexual Function Does Not Continuously Decline After Radiation Therapy Treatments For Prostate Cancer

Radiology / Nuclear Medicine News From Medical News Today — Thu, 07 Jan 2010 08:00:00 +0100

Sexual function in prostate cancer patients receiving external beam radiation therapy (EBRT) decreases within the first two years after treatment but then stabilizes and does not continuously decline as was previously thought, according to a study in the January 1 issue of the International Journal of Radiation Oncology*Biology*Physics, the official journal of the American So... (Source: Radiology / Nuclear Medicine News From Medical News Today)

Concurrent Weekly Nedaplatin, External Beam Radiotherapy and High-Dose-Rate Brachytherapy in Patients with FIGO Stage IIIb Cervical Cancer: A Comparison with a Cohort Treated by Radiotherapy Alone

Karger Publishers — Wed, 06 Jan 2010 23:00:00 +0100

Gynecol Obstet Invest 2010;69:224232 (DOI:10.1159/000273207) (Source: Karger Publishers)

Sexual Dysfunction After Radiation Shown to Level Off

About.com Prostate Cancer — Wed, 06 Jan 2010 19:08:36 +0100

Sexual dysfunction was shown to level off roughly two years after radiation therapy for prostate cancer, a new study has shown. In men treated with external beam radiation therapy for prostate cancer who went on to develop sexual dysfunction, the degree of their sexual problems progressively worsened for roughly two years and then plateaued. This new study, which has recently been published in the official journal of the American Society for Therapeutic Radiation Oncology (ASTRO), is the first to show that sexual dysfunction does not indefinitely worsen follow radiation treatment. Sexual Dysfunction After Radiation Shown to Level Off originally appeared on About.com Prostate Cancer on Wednesday, January 6th, 2010 at 19:08:36.Permalink | Comment | Email this (Source: About.com Prostate Canc...

Sexual function does not continuously decline after radiation therapy treatments for prostate cancer, study finds

ScienceDaily Headlines — Wed, 06 Jan 2010 15:49:54 +0100

Sexual function in prostate cancer patients receiving external beam radiation therapy decreases within the first two years after treatment but then stabilizes and does not continuously decline as was previously thought, according to a new study. (Source: ScienceDaily Headlines)

Sexual Dysfunction After Radiation Shown to Level Off

About.com Prostate Cancer — Wed, 06 Jan 2010 00:00:00 +0100

Sexual dysfunction was shown to level off roughly two years after radiation therapy for prostate cancer, a new study has shown. In men treated with external beam radiation therapy for prostate cancer who went on to develop sexual dysfunction, the degree of their sexual problems progressively worsened for roughly two years and then plateaued. This new study, which has recently been published in the official journal of the American Society for Therapeutic Radiation Oncology (ASTRO), is the first to show that sexual dysfunction does not indefinitely worsen follow radiation treatment. Sexual Dysfunction After Radiation Shown to Level Off originally appeared on About.com Prostate Cancer on Saturday, January 9th, 2010 at 03:08:36.Permalink | Comment | Email this (Source: About.com Prostate Cance...

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Sexual function does not continuously decline after radiation therapy treatments for prostate cancer

EurekAlert! - Social and Behavioral Science — Tue, 05 Jan 2010 05:00:00 +0100

(American Society for Radiation Oncology) Sexual function in prostate cancer patients receiving external beam radiation therapy decreases within the first two years after treatment but then stabilizes and does not continuously decline as was previously thought, according to a study in the Jan. 1 issue of the International Journal of Radiation Oncology*Biology*Physics, the official journal of the American Society for Radiation Oncology. (Source: EurekAlert! - Social and Behavioral Science)

Mortality in men with localized prostate cancer treated with brachytherapy with or without neoadjuvant hormone therapy

Cancer — Tue, 05 Jan 2010 00:00:00 +0100

Discrepancies exist regarding the impact of neoadjuvant hormone therapy (NHT) on the risk of all-cause mortality (ACM) in men who receive brachytherapy for localized prostate cancer. Therefore, the objective of the current study was to examine the effect of NHT on the risk of ACM in men with prostate cancer who receive with brachytherapy.The study cohort included 2474 men with localized prostate cancer who either received NHT (N = 1083) or did not receive NHT (N = 1391) and brachytherapy without supplemental external beam radiation between 1991 and 2005 at centers within the 21st Century Oncology Consortium. All men had at least 2 years of follow-up. Low-risk, intermediate-risk, and high-risk disease was present in 65%, 23%, and 12% of men, respectively. A Cox regression multivariate analy...

PSA value at 2 years post-treatment can predict long-term survival in prostate cancer patients

ScienceDaily Headlines — Mon, 04 Jan 2010 22:00:00 +0100

Prostate cancer patients who have a prostate-specific antigen value of less than or equal to 1.5 at two years after external beam radiation therapy are less likely to have a cancer recurrence and cancer-related death, according to a new study. (Source: ScienceDaily Headlines)

Combined external and intracavitary irradiation in treatment of advanced cervical carcinomas: predictive factors for local tumor control and early recurrences.

International Journal of Oncology — Sat, 02 Jan 2010 08:48:50 +0100

Authors: Sorbe B, Bohr L, Karlsson L, Bermark B In a series of 131 primary cervical carcinomas in FIGO stages I-IV suitable for combined external pelvic and intraluminal cervical-vaginal brachytherapy predictive and prognostic factors were analyzed with regard to locoregional tumor control, recurrences and survival data. Patients with prior surgery or patients treated with external beam therapy alone were excluded from this series. Concomitant chemotherapy was given to 47 patients (36%). The external beam therapy was given with a four-field technique (50-60 Gy) and brachytherapy with high dose-rate (Ir-192) using a ring applicator set. The dose (18-30 Gy) was specified according to the rules in ICRU 38 (a minimum dose to the surface of the target volume). Three or five fractions were g...

Radiation therapy in the treatment of desmoid tumours reduces surgical indications

European Journal of Surgical Oncology — Fri, 01 Jan 2010 00:00:00 +0100

Conclusion: Low recurrence rates can be achieved with the use of radiation therapy alone in selected cases. Patients with a metabolic response (decrease) to radiotherapy may be treated with a non-surgical approach. Surgery might be considered in patients with a poor metabolic response to radiotherapy. (Source: European Journal of Surgical Oncology)

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The second decade of prostate brachytherapy: Evidence and cost based outcomes

Urologic Oncology: Seminars and Original Investigations — Wed, 30 Dec 2009 15:27:04 +0100

Abstract: Permanent prostate brachytherapy (PPB) is an established and successful treatment option for localized prostate cancer. Under ultrasound guidance, the procedure can be performed in the ambulatory setting and represents a conformal, ablative technique. For low-risk patients, PSA control is expected in over 90% with outcomes now reported past 12 years. High-risk patients can benefit from PPB as part of a program that may include external beam therapy and androgen ablation. Morbidity tends to center on urinary function, but with modern adaptive techniques, this can be minimized. Sexual functioning is likely disturbed less with PPB than with surgery or external beam radiation therapy. Finally, cost benefit analysis confirms PPB as the most attractive radiation option. With the incide...

Anti-Androgen Therapy Adds No Benefit in Mid-Risk Radiation-Treated Prostate Cancers

Medscape Today Headlines — Tue, 29 Dec 2009 16:20:26 +0100

Androgen suppression therapy - and its attendant side effects -- may not be necessary for patients with intermediate-risk prostate cancer treated with combination brachytherapy and external beam irradiation, New York-based investigators report. Reuters Health Information (Source: Medscape Today Headlines)

Medullary Thyroid Carcinoma: Targeted Therapies and Future Directions

Journal of Oncology — Thu, 24 Dec 2009 13:47:02 +0100

Medullary thyroid cancer (MTC) is a rare neuroendocrine neoplasm that accounts for approximately 5% of all thyroid malignancies. The natural history of MTC is characterized by early lymph node and distant metastases, making complete surgical cure often impossible. Conventional chemotherapy and external beam radiation have been largely ineffective in altering the natural history of MTC. Therefore, there is a great need to develop novel therapeutic strategies to affect symptom control and reduce tumor burden in patients with widely disseminated disease. Here, we review several pathways which have been shown to be vital in MTC tumorigenesis and focus on the pathways of interest for which targeted drug therapies are currently being developed. (Source: Journal of Oncology)

Complete response to radiation therapy of orbital metastasis from hepatocellular carcinoma.

World Journal of Gastroenterology : WJG — Fri, 18 Dec 2009 19:22:13 +0100

We report the case of a 52-year-old male with known metastatic HCC, who presented with severe proptosis and diplopia. An orbital mass was identified on magnetic resonance imaging (MRI) and confirmed to have hypermetabolic activity on positron emission tomography/computed tomography. He received a palliative course of external beam radiation therapy to the right orbit. Intensity modulated radiation therapy (IMRT) was used to allow sparing of critical normal tissues in close proximity to the tumor. One month after completion of IMRT to 58 Gray in 30 fractions delivered over 6 wk, the patient had a complete clinical, radiologic (MRI) and symptomatic response. The patient continues to have local control in the orbit 1.7 years after therapy completion. All critical normal structures were kept b...

The effect of aerobic exercise on treatment-related acute toxicity in men receiving radical external beam radiotherapy for localised prostate cancer

European Journal of Cancer Care — Thu, 17 Dec 2009 00:00:00 +0100

KAPUR G., WINDSOR P.M. & Mc COWAN C. (2009) European Journal of Cancer CareThe effect of aerobic exercise on treatment-related acute toxicity in men receiving radical external beam radiotherapy for localised prostate cancer We retrospectively analysed acute radiation toxicity data for patients who had participated in a randomised controlled study in our centre in order to assess the impact of aerobic exercise on acute rectal and bladder morbidity during treatment. Data from 65 of 66 patients were analysed: 33 allocated into a control group (standard advice) and 33 into an exercise group (aerobic walking for 30 min at least three times per week) during 4 weeks of external beam radiotherapy; one patient in the exercise group withdrew after randomisation before starting radiotherapy. There wa...

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Bladder Preservation in Octogenarians With Invasive Bladder Cancer

Urology — Thu, 17 Dec 2009 00:00:00 +0100

Conclusions: OS in TCC is dependent on tumor stage, age, mobility, and comorbidities, and a risk-stratified management is necessary. Patients with pT1G3 tumor and low ASA score have satisfying OS with bladder preservation, but in patients with ≥pT2 and ASA 3-4 the prognosis is very bad. It remains questionable whether patients with tumor stages ≥pT2 and ASA 1-2 despite high age would benefit from radical cystectomy. (Source: Urology)

Brachytherapy offers superior cancer control for prostate patients

MedWire News - Oncology — Wed, 16 Dec 2009 00:00:00 +0100

Brachytherapy (BT) achieves superior cancer control in prostate cancer patients with low- or intermediate-risk disease compared with external beam radiotherapy (EBRT), but at the cost of higher rates of urinary toxicity, report researchers. (Source: MedWire News - Oncology)

Brachytherapy offers superior cancer control for prostate patients

MedWire News - Prostate Cancer — Wed, 16 Dec 2009 00:00:00 +0100

Editorial Comment

The Journal of Urology — Wed, 16 Dec 2009 00:00:00 +0100

These authors evaluated an important subject in a large number of patients with long followup. NHT is still commonly used in clinical practice to downsize PV, although prior studies show a detrimental effect of NHT on the urinary retention rate and quality of life. Oncological outcomes cannot be improved, as supported by the current results. In a smaller subgroup of patients with I-PSS greater than 15 a benefit of NHT was noted only in the urinary retention rate and in relative but not absolute posttreatment I-PSS changes. Apart from considering NHT in patients at increased risk for long-term morbidity (not limited to urinary retention) before brachytherapy, alternative prostate cancer treatments must be offered to our patients. External beam radiotherapy is associated with more favorable ...

Reply by Authors

The Journal of Urology — Wed, 16 Dec 2009 00:00:00 +0100

We wish to reiterate that neoadjuvant hormonal therapy does not increase morbidity in patients with large prostates treated with brachytherapy. In addition, there may be an advantage to NHT in men with a prostate gland larger than 50 cc and an initial I-PSS of 15 or greater. We disagree that external beam radiotherapy is associated with more favorable outcomes than brachytherapy (reference 3 in comment). Pinkawa et al compared 52 patients receiving 125I or external beam radiotherapy who were followed a median of 16 months. Gastrointestinal complaints were worse in the external radiation group while genitourinary complaints were more bothersome in the brachytherapy group. However, the dose of external radiation delivered to these patients was low by current standards (70 to 72 Gy). In addit...

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Sexual function stops declining after 2 years in prostate EBRT patients

MedWire News - Oncology — Tue, 15 Dec 2009 13:50:30 +0100

Contrary to conventional wisdom, men treated with external beam radiotherapy for prostate cancer experience a decline in sexual function for 2 years after treatment at which point it stabilizes, report researchers. (Source: MedWire News - Oncology)

Combined Cetuximab and Reirradiation for Locoregional Recurrent and Inoperable Squamous Cell Carcinoma of the Head and Neck

Strahlentherapie und Onkologie — Tue, 15 Dec 2009 07:04:57 +0100

Conclusion: A second course of RT combined with cetuximab in patients with inoperable, recurrent HNSCC proved to be feasible with mild or moderate toxicity and encouraging response to treatment. Content Type Journal ArticleCategory Current DiscussionDOI 10.1007/s00066-009-2092-7Authors Panagiotis Balermpas, Goethe University Department of Radiation Therapy and Oncology Frankfurt/Main GermanyMarkus Hambek, Goethe University Department of Otorhinolaryngology Frankfurt/Main GermanyOliver Seitz, Goethe University Department of Oral Maxillofacial and Plastic Facial Surgery Frankfurt/Main GermanyClaus Rödel, Goethe University Department of Radiation Therapy and Oncology Frankfurt/Main GermanyChristian Weiss, Goethe University Department of Radiation Therapy and Oncology F...

Sexual function stops declining after 2 years in prostate EBRT patients

MedWire News - Prostate Cancer — Mon, 14 Dec 2009 00:00:00 +0100

Impact of Hormonal Therapy on Intermediate Risk Prostate Cancer Treated With Combination Brachytherapy and External Beam Irradiation

The Journal of Urology — Mon, 14 Dec 2009 00:00:00 +0100

Conclusions: We addressed the relative importance of radiation dose vs hormonal therapy for intermediate risk prostate cancer. With high biologically effective dose combination treatment androgen suppressive therapy did not have a significant impact on the 8-year biochemical failure-free rate. We question its routine use in this setting. (Source: The Journal of Urology)

Response to “Role of External Beam Radiotherapy in Patients With Advanced or Recurrent Nonanaplastic Thyroid Cancer: Memorial Sloan-Kettering Cancer Center Experience” (Int J Radiat Oncol Biol Phys 2009;73:795–801)

International Journal of Radiation Oncology * Biology * Physics — Thu, 10 Dec 2009 15:06:02 +0100

To the Editor: We read with interest the article by Terezakis et al. . The exact role of external beam radiotherapy (EBRT) in the management of differentiated thyroid cancer (DTC) has not been well defined. External beam radiotherapy has usually been administered in DTC patients having gross residual disease, unresectable tumors, or recurrent tumors and for palliation of symptomatic metastatic lesions . The current study highlights the beneficial effect of EBRT in achieving locoregional control (LRC), both in cases of complete tumor removal and in patients with residual microscopic disease. However, we have a few queries. (Source: International Journal of Radiation Oncology * Biology * Physics)

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In Reply to Drs. Mehrotra and Mishra

International Journal of Radiation Oncology * Biology * Physics — Thu, 10 Dec 2009 15:06:02 +0100

To the Editor: We thank Drs. Mehrotra and Mishra for their great interest in our recent publication . As noted, locoregional control is difficult to assess in a patient with gross residual disease after external beam radiation (EBRT). Therefore, for patients who had gross disease, we defined locoregional control as a patient with no evidence of progression on imaging after EBRT. Patients who underwent upfront EBRT without radioactive iodine ablation were typically unresectable patients or those patients with histologies not requiring radioactive iodine ablation (i.e., medullary carcinomas). Chemotherapy was administered as a radioenhancer to improve locoregional control and was not typically administered as a systemic palliative measure. The overall 2-year locoregional control rate in our ...

Clinical Experience With Image-Guided Radiotherapy in an Accelerated Partial Breast Intensity-Modulated Radiotherapy Protocol: In Regard to Leonard CE et al. (Int J Radiat Oncol Biol Phys Epub May 19, 2009)

International Journal of Radiation Oncology * Biology * Physics — Thu, 10 Dec 2009 15:06:02 +0100

To the Editor: We read with great interest the recent paper by Leonard et al. where they described their experience with image-guided external beam accelerated partial breast irradiation (APBI). Leonard et al. describe a protocol that used implanted markers as fiducials for megavoltage image localization. We take issue with several statements from their paper, namely that there has been little to no reported experience in image guidance for APBI and that their paper is the first publication concerning the use of implanted fiducials for APBI. Rather, we submit that several publications describing a wide range of image-guidance techniques for APBI, including reports of implanted fiducial markers, have previously been published. Weed et al. studied the validity of clips as a surrogate for ...

Outcomes Following Iodine-125 Monotherapy for Localized Prostate Cancer: The Results of Leeds 10-Year Single-Center Brachytherapy Experience

International Journal of Radiation Oncology * Biology * Physics — Thu, 10 Dec 2009 15:05:48 +0100

This study reports the 10-year experience of permanent brachytherapy monotherapy at a single UK center.Methods and Materials: Between March 1995 and September 2004, 1,298 patients underwent trans-rectal ultrasound (TRUS) planned transperineal brachytherapy delivering 145 Gy using I-125. No patient received supplemental external beam; 44.2% received neoadjuvant hormones. In 688, CT postimplant dosimetry was available. Outcome data were analyzed in terms of overall survival (OS), disease specific survival (DSS), and PSA relapse-free survival (PSA-RFS).Results: The mean age was 62.9 (range, 34–83) years. Median follow-up was 4.9 years (range, 2.03–11.7 years). OS and DSS were 85% and 95%, respectively, at 10 years. Twenty-one patients died from prostate cancer (1.6%) and 34 (2.5%) from un...

How does knowledge of three-dimensional excision margins following breast conservation surgery impact upon clinical target volume definition for partial-breast radiotherapy?

Radiotherapy and Oncology — Mon, 07 Dec 2009 00:00:00 +0100

Conclusions: CTVs based on 3D excision margin data are discordant with those defined using a standard uniform 15mm TB–CTV margin. In women with narrow excision margins, the standard TB–CTV margin could result in a geographical miss. Therefore, wider TB–CTV margins should be considered where re-excision does not occur. (Source: Radiotherapy and Oncology)

For High-Grade Prostate CA, Combined Therapies Are Better Than Any One Alone

Medscape Today Headlines — Fri, 04 Dec 2009 23:09:03 +0100

High-grade prostate cancer patients treated with a triple protocol of brachytherapy, external beam radiotherapy and hormonal therapy fare better than the published success rates for any one of those treatments, alone or with radical prostatectomy. Reuters Health Information (Source: Medscape Today Headlines)

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Prediction of PSA bounce after permanent prostate brachytherapy for localized prostate cancer

International Journal of Clinical Oncology — Fri, 04 Dec 2009 22:14:50 +0100

Conclusion PSA bounce is not a rare phenomenon after prostate brachytherapy. It is more common in younger patients and patients receiving higher doses of radiation. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s10147-009-0909-0Authors Kunimitsu Kanai, Keio University School of Medicine Department of Urology 35 Shinanomachi, Shinjuku-ku Tokyo 160-8582 JapanJun Nakashima, Keio University School of Medicine Department of Urology 35 Shinanomachi, Shinjuku-ku Tokyo 160-8582 JapanAkitomo Sugawara, Keio University School of Medicine Department of Radiology Tokyo JapanNaoyuki Shigematsu, Keio University School of Medicine Department of Radiology Tokyo JapanHirohiko Nagata, Keio University School of Medicine Department of Urology 35 Shinanomachi, Shinjuku-ku...

How does knowledge of three-dimensional excision margins following breast conservation surgery impact upon clinical target volume definition for partial-breast radiotherapy?

Fri, 04 Dec 2009 00:00:00 +0100

CONCLUSIONS: CTVs based on 3D excision margin data are discordant with those defined using a standard uniform 15mm TB-CTV margin. In women with narrow excision margins, the standard TB-CTV margin could result in a geographical miss. Therefore, wider TB-CTV margins should be considered where re-excision does not occur. PMID: 19963294 [PubMed - as supplied by publisher] (Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology)

Long-Term Survival In Prostate Cancer Patients Can Be Predicted By PSA Value At 2 Years Post-Treatment

Health News from Medical News Today — Thu, 03 Dec 2009 13:00:00 +0100

Prostate cancer patients who have a prostate-specific antigen (PSA) value of less than or equal to 1.5 at two years after external beam radiation therapy (EBRT) are less likely to have a cancer recurrence and cancer-related death, according to a study in the December 1 issue of the International Journal of Radiation Oncology*Biology*Physics, the official journal of the American Society for Radiation Oncology (ASTRO)... (Source: Health News from Medical News Today)

A multidisciplinary approach to fertility-sparing therapy for a rare vulvar tumor

Fertility and Sterility — Thu, 03 Dec 2009 00:00:00 +0100

Conclusion(s): By using several disciplines and subspecialists, this patient received personalized treatment for a rare cancer, focused at curing her cancer and optimizing her future fertility. (Source: Fertility and Sterility)

PSA value at 2 years post-treatment can predict long-term survival in prostate cancer patients

EurekAlert! - Medicine and Health — Wed, 02 Dec 2009 05:00:00 +0100

(American Society for Radiation Oncology) Prostate cancer patients who have a prostate-specific antigen value of less than or equal to 1.5 at two years after external beam radiation therapy are less likely to have a cancer recurrence and cancer-related death, according to a study in the December 1 issue of the International Journal of Radiation Oncology, Biology, Physics, the official journal of the American Society for Radiation Oncology. (Source: EurekAlert! - Medicine and Health)

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Fatal central venous air embolism: A rare complication of esophageal dilation by rendezvous

Head and Neck — Tue, 01 Dec 2009 00:00:00 +0100

We present a case of a 74-year-old man with chronic dysphagia caused by a complete cervical esophageal stricture that developed after external beam radiotherapy for treatment of papillary thyroid carcinoma. During attempted dilation using the rendezvous technique, the patient suffered a fatal pulmonary air embolism. The technique of esophageal dilation by rendezvous, complications, and risk factors for development of venous air embolism are discussed.To the best of our knowledge, this is the first report in the literature of fatal venous air embolism after dilation by rendezvous. © 2009 Wiley Periodicals, Inc. Head Neck, 2010 (Source: Head and Neck)

Role of stereotactic radiosurgery and fractionated stereotactic radiotherapy for the treatment of recurrent glioblastoma multiforme.

Neurosurgical Focus — Tue, 01 Dec 2009 00:00:00 +0100

Authors: Romanelli P, Conti A, Pontoriero A, Ricciardi GK, Tomasello F, De Renzis C, Innocenzi G, Esposito V, Cantore G Glioblastoma multiforme (GBM) is a devastating malignant brain tumor characterized by resistance to available therapeutic approaches and relentless malignant progression that includes widespread intracranial invasion, destruction of normal brain tissue, progressive disability, and death. Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (fSRT) are increasingly used in patients with recurrent GBM to complement traditional treatments such as resection, conventional external beam radiotherapy, and chemotherapy. Both SRS and fSRT are powerful noninvasive therapeutic modalities well suited to treat focal neoplastic lesions through the delivery of p...

Emerging applications of stereotactic radiotherapy in head and neck cancer.

Neurosurgical Focus — Tue, 01 Dec 2009 00:00:00 +0100

This article focuses on the emerging evidence for the use of stereotactic body radiotherapy for treatment of HNC as a boost after conventional external-beam radiotherapy, and also as reirradiation in recurrent or second primary HNC. PMID: 19951054 [PubMed - in process] (Source: Neurosurgical Focus)

Quality of life three years after diagnosis of localised prostate cancer: population based cohort study

BMJ Online First — Fri, 27 Nov 2009 12:25:04 +0100

Conclusions The various treatments for localised prostate cancer each have persistent effects on quality of life. Sexual dysfunction three years after diagnosis was common in all treatment groups, whereas poor urinary function was less common. Bowel function was most compromised in those who had external beam radiotherapy. Men with prostate cancer and the clinicians who treat them should be aware of the effects of treatment on quality of life, and weigh them up against the patient’s age and the risk of progression of prostate cancer if untreated to make informed decisions about treatment. (Source: BMJ Online First)

Quality Assurance in the Prospective Multi-institutional Trial on Definitive Radiotherapy Using High-dose-rate Intracavitary Brachytherapy for Uterine Cervical Cancer: The Individual Case Review

Japanese Journal of Clinical Oncology — Thu, 26 Nov 2009 16:16:47 +0100

Conclusions The present ICR demonstrated the favorable radiotherapy compliance with the JAROG0401/JROSG04-2 protocol. The QA process using ICRs can potentially be used to improve the quality of radiotherapy, including HDR-ICBT in the multi-institutional prospective studies for cervical cancer. (Source: Japanese Journal of Clinical Oncology)

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A randomized trial of external beam radiotherapy versus cryoablation in patients with localized prostate cancer

Cancer — Tue, 24 Nov 2009 00:00:00 +0100

Localized prostate cancer can be treated several different ways, but head-to-head comparisons of treatments are infrequent. The authors of this report conducted a randomized, unblinded, noninferiority trial to compare cryoablation with external beam radiotherapy in these patients.From December 1997 through February 2003, 244 men with newly diagnosed localized prostate cancer were assigned randomly to receive either cryoablation or radiotherapy (122 men in each arm). All received neoadjuvant antiandrogen therapy. The primary endpoint was disease progression at 36 months based on a trifecta definition: 1) radiologic evidence of metastatic disease, or 2) initiation of further antineoplastic therapy, or 3) biochemical failure. Two definitions of biochemical failure were used: 1) 2 consecutive ...

Effects of Prostate-Rectum Separation on Rectal Dose From External Beam Radiotherapy

International Journal of Radiation Oncology * Biology * Physics — Tue, 24 Nov 2009 00:00:00 +0100

Purpose: In radiotherapy for prostate cancer, the rectum is the major dose-limiting structure. Physically separating the rectum from the prostate (e.g., by injecting a spacer) can reduce the rectal radiation dose. Despite pilot clinical studies, no careful analysis has been done of the risks, benefits, and dosimetric effects of this practice.Methods and Materials: Using cadaveric specimens, 20 mL of a hydrogel was injected between the prostate and rectum using a transperineal approach. Imaging was performed before and after spacer placement, and the cadavers were subsequently dissected. Ten intensity-modulated radiotherapy plans were generated (five before and five after separation), allowing for characterization of the rectal dose reduction. To quantify the amount of prostate-rectum separ...

EBRT plus HDR brachytherapy offers good prostate cancer control and survival rates

MedWire News - Oncology — Mon, 23 Nov 2009 00:00:00 +0100

Prostate cancer patients experience longer biochemical disease free and overall survival if they receive external beam radiotherapy combined with high-dose rate brachytherapy, according to a systematic review. (Source: MedWire News - Oncology)

EBRT plus HDR brachytherapy offers good prostate cancer control and survival rates

MedWire News - Prostate Cancer — Mon, 23 Nov 2009 00:00:00 +0100

We need better randomized comparison trials of prostate cancer

Cancer — Wed, 18 Nov 2009 00:00:00 +0100

More than 50 years after the first randomized oncology trial, the number of randomized trials comparing differing primary treatments for prostate cancer is disappointing. One of these rare, randomized primary treatment comparisons appears in this edition of Cancer, and the investigators are to be congratulated for their efforts comparing cryotherapy with external beam radiotherapy. (Source: Cancer)

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Salvage high-intensity focused ultrasound for biopsy-confirmed local recurrence of prostate cancer after radical prostatectomy

BJU International — Tue, 17 Nov 2009 00:00:00 +0100

To present experience in high-intensity focused ultrasound (HIFU) used as a salvage therapy for biopsy-confirmed local recurrence at the vesico-urethral anastomosis after radical prostatectomy (RP). From July 2006, four patients diagnosed with prostate cancer recurrence after RP were treated with HIFU, with or without salvage radiotherapy, using the Sonablate® 500 (Focus Surgery, IN, USA). Biochemical failure was defined as in increase in prostate-specific antigen (PSA) level of >0.2 ng/mL. No patients received any adjuvant therapy after HIFU therapy before reporting failure. The mean age and initial PSA level before RP was 74 years and 10.0 ng/mL, respectively. After RP, one patient was stage T2aN0M0, two were stage T3N0M0 and the last had an unknown pathological stage. Three patients re...

This Month in Adult Urology

The Journal of Urology — Mon, 16 Nov 2009 00:00:00 +0100

Salvage prostatectomy is associated with the highest biochemical cure rate following radiation failure for prostate cancer. However, this approach is technically difficult and associated with tremendous potential morbidity including massive blood loss, urinary incontinence, erectile dysfunction and bowel injury. It is unclear whether a laparoscopic approach provides a less morbid treatment. Eandi et al (page 133) from Duarte, California report the results of salvage robotic assisted laparoscopic prostatectomy in 18 patients with a mean followup of 18 months. Previous treatment included brachytherapy in 8, external beam radiation in 8 and proton beam therapy in 2 patients. Mean time to surgery following primary treatment with radiation was 79 months. Median parameters for operative blood lo...

Initial Experience of Diffusion-weighted Magnetic Resonance Imaging to Assess Therapeutic Response to Induction Chemoradiotherapy Against Muscle-invasive Bladder Cancer

Urology — Mon, 16 Nov 2009 00:00:00 +0100

Conclusions: This is the first study to show the feasibility of DWI over T2W and DCE for assessing therapeutic response to induction chemoradiotherapy against MIBC. The high specificity of DWI indicates that DWI is useful to accurately predict pathologic complete response, allowing more optimal patient selection in bladder-sparing protocols. (Source: Urology)

Robotic Assisted Laparoscopic Salvage Prostatectomy for Radiation Resistant Prostate Cancer

The Journal of Urology — Thu, 12 Nov 2009 00:00:00 +0100

Conclusions: Robotic assisted laparoscopic radical prostatectomy can be performed safely as salvage local therapy after failed radiation therapy. Outcomes are comparable to those of large series of open salvage prostatectomy. (Source: The Journal of Urology)

Survival and relapse pattern after trimodality therapy for malignant pleural mesothelioma

General Thoracic and Cardiovascular Surgery — Wed, 11 Nov 2009 19:27:04 +0100

Conclusion Trimodality therapy showed a survival benefit in patients with stage III or lower malignant pleural mesothelioma. Most of the recurrences were local. Therefore, better local control is required to improve the prognosis of the disease. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11748-009-0440-2Authors Kenichi Okubo, Kyoto University Hospital Department of Thoracic Surgery 54 Kawahara-cho, Shogoin, Sakyo-ku Kyoto 606-8507 JapanMakoto Sonobe, Kyoto University Hospital Department of Thoracic Surgery 54 Kawahara-cho, Shogoin, Sakyo-ku Kyoto 606-8507 JapanTakuji Fujinaga, Kyoto University Hospital Department of Thoracic Surgery 54 Kawahara-cho, Shogoin, Sakyo-ku Kyoto 606-8507 JapanTsuyoshi Shoji, Kyoto University Hospital Department of Thor...

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Trilateral retinoblastoma: Potentially curable with intensive chemotherapy

Pediatric Blood and Cancer — Wed, 11 Nov 2009 00:00:00 +0100

We describe a series of 13 patients treated with intensive chemotherapy, defined as the intention to include high-dose chemotherapy with autologous hematopoietic stem cell rescue.Induction chemotherapy generally included vincristine, cisplatin or carboplatin, cyclophosphamide, and etoposide. Hematopoietic stem cells typically were harvested after the first or second cycle of induction chemotherapy, usually from peripheral blood. High-dose chemotherapy regimens were thiotepa-based (n = 7) or melphalan and cyclophosphamide (n = 3).Trilateral sites were pineal (n = 11) and suprasellar (n = 2); 7 patients had localized (M-0) disease and six had leptomeningeal dissemination (M-1+). Five patients had trilateral retinoblastoma at original diagnosis of intra-ocular retinoblastoma; eight later deve...

Acute Toxicity after Single Fraction High Dose Rate Brachytherapy with External Beam Radiotherapy in Intermediate and High Risk Prostate Cancer

Clinical Oncology — Mon, 09 Nov 2009 15:31:43 +0100

We report our experience of a single HDR fraction. (Source: Clinical Oncology)

Dose Escalated Radiotherapy in the Treatment of Locally Advanced Prostate Cancer using High Dose Rate Brachytherapy in Combination with Whole Pelvic Radiotherapy: a Single Centre Experience

Clinical Oncology — Mon, 09 Nov 2009 15:31:43 +0100

We present the outcome of dose escalation treatment using high dose rate brachytherapy in combination with whole pelvic external beam radiotherapy in the treatment of locally advanced prostate cancer, in our centre. (Source: Clinical Oncology)

Long Term Follow-up of Patients Receiving High Dose Rate (HDR) Brachytherapy Boost in Combination with External Beam Radiotherapy Treatment (EBRT) for High Risk Prostate Cancer: Relapse Rate and Toxicity

Clinical Oncology — Mon, 09 Nov 2009 15:31:43 +0100

Aim/introduction: Prostate cancer is the most commonly diagnosed male cancer in the UK; one third of all new cases present with locally advanced disease. At UCLH, high risk patients deemed to benefit from dose escalation have been treated with combined EBRT and HDR brachytherapy boost since 2000. We revisited 32 of these patients to assess late bowel and bladder toxicity, survival, biochemical relapse and metastatic disease rates. (Source: Clinical Oncology)

Pattern of Relapse after Fractionated External Beam Radiotherapy for Meningioma: Experience from Addenbrooke's Hospital

Clinical Oncology — Mon, 09 Nov 2009 15:31:41 +0100

Conclusions: Our cohort of patients had an overall local control and survival similar to those documented from other departments. Grade was an important prognostic factor. Patients treated with >50Gy had worse local control outcomes, probably due to selection bias. Dose escalation may still be appropriate for high-risk disease, and may be more effective with more conformal techniques, such as intensity-modulated radiotherapy. (Source: Clinical Oncology)

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Impact of the Target Volume (Prostate Alone vs. Prostate with Seminal Vesicles) and Fraction Dose (1.8 Gy vs. 2.0 Gy) on Quality of Life Changes After External-Beam Radiotherapy for Prostate Cancer

Strahlentherapie und Onkologie — Mon, 09 Nov 2009 06:59:55 +0100

Conclusion: The risk of adverse QoL changes after EBRT for prostate cancer cannot be derived from the dose-volume histogram alone. Seminal vesicles can be included in the CTV up to a moderate total dose without adverse effects on QoL. Apart from a longer recovery period, higher fraction doses were not associated with higher toxicity. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00066-009-2008-6Authors Michael Pinkawa, RWTH Aachen Department of Radiotherapy Aachen GermanyMarc D Piroth, RWTH Aachen Department of Radiotherapy Aachen GermanyKarin Fischedick, RWTH Aachen Department of Radiotherapy Aachen GermanyRichard Holy, RWTH Aachen Department of Radiotherapy Aachen GermanyJens Klotz, RWTH Aachen Department of Radiotherapy Aachen GermanySandra Nu...

A Dosimetric Selectivity Intercomparison of HDR Brachytherapy, IMRT and Helical Tomotherapy in Prostate Cancer Radiotherapy

Strahlentherapie und Onkologie — Mon, 09 Nov 2009 06:59:53 +0100

Conclusion: HDR-BT offers better conformality in comparison with HT and IMRT and reduces the volume of healthy tissue receiving a low dose. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00066-009-2009-5Authors Johanne Hermesse, Liège University Hospital Department of Radiation Oncology Liège BelgiumSylvie Biver, Liège University Hospital Department of Radiation Oncology Liège BelgiumNicolas Jansen, Liège University Hospital Department of Radiation Oncology Liège BelgiumEric Lenaerts, Liège University Hospital Department of Medical Physics Liège BelgiumNathalie De Patoul, St Luc University Hospital Department of Medical Physics Brussels BelgiumStefaan Vynckier, St Luc University Hospital Department of Medical Physics Brussels BelgiumPhilipp...

A Randomized Trial Comparing Hypofractionated and Conventionally Fractionated Three-Dimensional External-Beam Radiotherapy for Localized Prostate Adenocarcinoma

Strahlentherapie und Onkologie — Mon, 09 Nov 2009 06:59:51 +0100

Conclusion: In this first evaluation, the HFRT schedule is feasible and induces acceptable or even lower acute toxicity compared with the toxicities in the CFRT schedule. Extended follow-up is needed to justify this fractionation schedule’s safety in the long term. Content Type Journal ArticleCategory Current DiscussionDOI 10.1007/s00066-009-1982-zAuthors Darius Norkus, Institute of Oncology, Vilnius University Department of Radiotherapy Vilnius LithuaniaAlbert Miller, Institute of Oncology, Vilnius University Department of Radiotherapy Vilnius LithuaniaJuozas Kurtinaitis, Institute of Oncology, Vilnius University Department of Radiotherapy Vilnius LithuaniaUwe Haverkamp, Clemenshospital Department of Radiology Münster GermanySergey Popov, Riga Eastern Hospital, ...

Comment by J. Schäfer, G. Welzel, F. Wenz on D. Norkus et al. A Randomized Trial Comparing Hypofractionated and Conventionally Fractionated Three-Dimensional External-Beam Radiotherapy for Localized Prostate Adenocarcinoma. A Report on Acute Toxicity

Strahlentherapie und Onkologie — Mon, 09 Nov 2009 06:59:50 +0100

Content Type Journal ArticleCategory CommentDOI 10.1007/s00066-009-9982-6Authors Frederik Wenz, Universitätsmedizin Mannheim, Universität Heidelberg Theodor Klinik für Strahlentherapie und Radioonkologie Kutzer Ufer 1–3 68167 Mannheim Germany Journal Strahlentherapie und OnkologieOnline ISSN 1439-099XPrint ISSN 0179-7158 Journal Volume Volume 185 Journal Issue Volume 185, Number 11 / November, 2009 (Source: Strahlentherapie und Onkologie)

Mesothelioma Trimodality Therapy Benefits Patients

Asbestos and Mesothelioma News — Thu, 05 Nov 2009 14:53:07 +0100

In a study recently published in The Annals of Thoracic Surgery, mesothelioma researchers found a trimodality therapeutic approach of chemotherapy, surgery and radiation to be effective in treating malignant pleural mesothelioma. Mesothelioma is a cancer caused almost exclusively by asbestos exposure. A long latency period of 20 to 50 years complicates the diagnostic process and usually leads to a diagnosis at a late stage of cancer development. Because most cases of malignant mesothelioma are diagnosed in a late stage of development, treatment options are often limited to palliative measures intended to improve quality of life. Researchers are avidly searching for a cure for this rare cancer, as current treatment therapies typically fail to fully combat the cancer. According to the study�...

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Fractionated radiosurgical management of intramedullary spinal cord metastasis: A case report and review of the literature

Clinical Neurology and Neurosurgery — Wed, 04 Nov 2009 16:46:55 +0100

Conclusion: Fractionated stereotactic radiosurgery is a feasible, safe, and effective modality for the treatment of ICSM and should be carefully considered in the management of this difficult to treat condition. (Source: Clinical Neurology and Neurosurgery)

Association of age and response to androgen-deprivation therapy with or without radiotherapy for prostate cancer: data from CaPSURE

BJU International — Wed, 04 Nov 2009 00:00:00 +0100

To assess whether the response to primary androgen-deprivation therapy (PADT) and radiotherapy (RT) plus adjuvant ADT would be muted in older men, as their tumours might already be relatively androgen insensitive, because serum testosterone levels decline with increasing age. Using the Cancer of the Prostate Strategic Urologic Research Endeavor database, we conducted an observational study evaluating two groups of men treated for prostate cancer from 1995 to 2006. One group of 1748 men was treated with PADT and the second group of 612 men was treated with RT (external beam RT or brachytherapy) with neoadjuvant and/or adjuvant ADT. We tested whether age was a predictor of disease progression in the PADT group and prostate-specific antigen (PSA) recurrence in the RT + ADT group (Phoenix defi...

Duodenal complications in radiotherapy for bile duct cancer: A dose–volume histogram analysis

Brachytherapy — Mon, 02 Nov 2009 00:00:00 +0100

Conclusions: Measuring the duodenal volume exposed to determine doses that exceed the prescription in BRTx may be useful for predicting intractable complications in the combined radiotherapy. (Source: Brachytherapy)

Primary therapy for early-stage cervical cancer: radical hysterectomy vs radiation

American Journal of Obstetrics and Gynecology — Sat, 31 Oct 2009 14:41:43 +0100

Conclusion: Our data indicate that, in women with cervical cancer lesions of (Source: American Journal of Obstetrics and Gynecology)

EBRT has better biochemical outcomes than RP in high-risk prostate cancer

MedWire News - Prostate Cancer — Sat, 31 Oct 2009 13:47:11 +0100

Patients treated with external beam radiotherapy for high-risk prostate cancer have significantly better outcomes than those treated with radical prostatectomy, according to Italian research. (Source: MedWire News - Prostate Cancer)

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Commentary on Salvage robotic-assisted radical prostatectomy: Initial results and early report of outcomes: Boris RS, Bhandari A, Krane LS, Eun D, Kaul S, Peabody JO, Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI

Urologic Oncology: Seminars and Original Investigations — Fri, 30 Oct 2009 15:30:10 +0100

To evaluate the initial results of salvage robotic-assisted radical prostatectomy (SRARP) after recurrence following primary radiotherapy (RT) for localized prostate cancer.Between December 2002 and January 2008, 11 patients had SRARP with pelvic lymph node dissection by 1 surgeon from 1 institution. Six patients had brachytherapy, 3 had external beam RT (EBRT), 1 intensity-modulated RT, and 1 received brachytherapy with an EBRT boost. All patients had prostate cancer on biopsy after RT, with negative computed tomography and bone scan. The mean (range) follow-up was 20.5 (1–77) months.The mean interval from RT to SRARP was 53.2 months; the mean preoperative prostate-specific antigen (PSA) level was 5.2 ng/ml, the operative duration 183 minutes, and the estimated blood loss 113 ml. One pa...

EBRT has better biochemical outcomes than RP in high-risk prostate cancer

MedWire News - Oncology — Fri, 30 Oct 2009 00:00:00 +0100

Evaluation of a Protocol to Reduce Rectal Volume and Prostate Motion for External Beam Radiation Therapy of the Prostate

Journal of Medical Imaging and Radiation Sciences — Fri, 30 Oct 2009 00:00:00 +0100

Conclusion: Prostate displacement evaluated in this study is similar to that found by others. The empty rectum protocol used in this study has some impact on prostate displacement in some dimensions, but overall does not reduce the variability of prostate position or have an influence on patients' bowel habits.Résumé: Objet: Évaluer la répercussion d'un protocole avec rectum vide sur le mouvement de la prostate au moment de la séance d'irradiation et 1'effet de ce protocole sur les habitudes intestinales.Méthodes et matériaux: On a implanté à trente-deux patients trois marqueurs intraprostatiques avant la planification de la radiothérapie. On a demandé à quinze patients d'observer un protocole avec rectum vide pour la planification et la réalisation du traitement, tandis que d...

Differentiation of Recurrent Glioblastoma Multiforme from Radiation Necrosis after External Beam Radiation Therapy with Dynamic Susceptibility-weighted Contrast-enhanced Perfusion MR Imaging [Neuroradiology]

Radiology — Wed, 28 Oct 2009 16:04:58 +0100

In this study, we showed that quantitative measurement of hemodynamic values derived from T2*-weighted dynamic susceptibility-weighted contrast material–enhanced MR imaging results can be used to distinguish recurrent glioblastoma multiforme from external beam radiation therapy–induced necrosis. (Source: Radiology)

The Importance of Serum Prostate-specific Antigen Testing Frequency in Assessing Biochemical and Clinical Failure After Prostate Cancer Treatment

Urology — Wed, 28 Oct 2009 00:00:00 +0100

Conclusions: The frequency of PSA testing is strongly associated with the detection of bF and cF. Because it is a variable that can be controlled, PSA testing frequency should be standardized to minimize spurious conclusions from studies with bF and cF endpoints. The sensitivity and specificity can be optimized by obtaining 2 PSA tests per year. (Source: Urology)

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Research Reporting Standards for Image-guided Ablation of Bone and Soft Tissue Tumors

Journal of Vascular and Interventional Radiology : JVIR — Tue, 27 Oct 2009 00:00:00 +0100

IMAGE-guided percutaneous methods of tumor destruction have proven effective for treatment of benign bone tumors as well as for palliation of metastases involving bone and soft tissue sites beyond the liver and lung. Treatment of primary bone tumors is largely restricted to benign tumors, most notably osteoid osteomas, as a single-modality treatment or as an adjunct to surgical resection (). More recently, image-guided ablation techniques have proven helpful for palliation of painful metastatic disease involving bone and soft tissue beyond the liver and lung for those patients im whom conventional therapies have failed, including external-beam radiation and narcotic analgesic agents. The purpose of this document from the Society of Interventional Radiology (SIR) is to provide a guideline f...

Randomized Trial Of External Beam Radiotherapy Versus Cryoablation In Patients With Localized Prostate Cancer: Quality Of Life Outcomes

Health News from Medical News Today — Mon, 26 Oct 2009 10:00:00 +0100

UroToday.com - In the online edition of Cancer, Dr. John Robinson and associates present QoL outcomes from a single institution randomized trial comparing external beam radiotherapy (EBRT) with cryotherapy for localized prostate cancer (CaP). They previously reported a non-inferiority oncologic outcome for cryotherapy in this study. (Source: Health News from Medical News Today)

Use of force plate analysis to evaluate the efficacy of external beam radiation to alleviate osteosarcoma pain

Veterinary Radiology & Ultrasound — Mon, 26 Oct 2009 00:00:00 +0100

A standard of therapy for osteosarcoma includes amputation with or without adjuvant chemotherapy. There is a subset of dogs with osteosarcoma that are unsuitable for amputation. We evaluated kinetic variables in dogs with appendicular osteosarcoma treated with a single 8 Gy dose of radiation. Eighteen pet dogs with appendicular osteosarcoma received one 8 Gy fraction of palliative radiation on day 0. Force plate measurements and clinical assessments were made on days 0, 7, 14, and 21. Peak vertical forces (Fz) were recorded for each limb and a symmetric index (SI) was calculated. There were no significant changes in kinetic parameters after one 8 Gy dose of radiation therapy. Nine of these 18 dogs exhibited increased limb function at day 21 based on force plate analysis. Significant factor...

IPF 2009 - Approach to local failure after radiation therapy - Session Highlights

UroToday — Sun, 25 Oct 2009 23:05:00 +0100

IZMIR, TURKEY (UroToday.com) - The PSA level after external beam radiation therapy should be low (< 1ng/ml), but there is... (Source: UroToday)

3D CT-based volumetric dose assessment of 2D plans using GEC-ESTRO guidelines for cervical cancer brachytherapy

Brachytherapy — Fri, 23 Oct 2009 00:00:00 +0100

Conclusions: The DVH analysis of 2D plans revealed a suboptimal coverage of CT-based cervix and a negative correlation between coverage and cervical size. Rectum dose to 2cc weakly correlated with ICRU point dose. Currently published constraint for bladder in 3D planning is tighter than ABS guidelines in past 2D planning. (Source: Brachytherapy)

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[Definitive treatment of anal canal carcinoma with radiotherapy: Adverse impact of a pre-radiation resection. A retrospective study of 57 patients treated with curative intent.]

Cancer Radiotherapie — Thu, 22 Oct 2009 00:00:00 +0100

CONCLUSION: Radiotherapy and chemoradiation with cisplatine-based chemotherapy cure a vast majority of patients with epidermoid carcinoma of the anal canal. Therapeutic factors that may interfere with the definition of the target volume and the patients' repositioning may decrease the efficacy of radiotherapy. Pre-radiotherapy surgical resection should be avoided. PMID: 19854092 [PubMed - as supplied by publisher] (Source: Cancer Radiotherapie)

High-dose-rate brachytherapy in combination with conformal external beam radiotherapy in the treatment of prostate cancer

Brachytherapy — Wed, 21 Oct 2009 00:00:00 +0100

Conclusions: HDR brachytherapy combined with 3DCRT was associated with improved BC and minimal toxicity in patients with unfavorable prostate cancer compared with conventional 3DCRT. (Source: Brachytherapy)

Single dose radiotherapy during surgery for breast cancer patients where external beam radiation was not feasible - results after 3 years of follow-up

European Journal of Surgical Oncology — Fri, 16 Oct 2009 12:47:10 +0100

Introduction: Intra-operative radiotherapy (IORT) with Intrabeam® (Carl Zeiss, Germany) has been used since 2000 in the international randomised TARGIT Trial to determine if there is equivalence between the novel IORT technique and conventional external beam radiotherapy (EBRT) in women with early breast cancer. Some patients were unsuitable for inclusion in our trial for a number of reasons and were given IORT as a single treatment off-trial. (Source: European Journal of Surgical Oncology)

Treatment outcome with low-dose-rate interstitial brachytherapy in early-stage oral tongue cancers

Journal of Cancer Research and Therapeutics — Fri, 16 Oct 2009 12:45:52 +0100

Conclusion</b> : BT, as an integral part of radical radiation therapy in early-stage tongue cancers, appears to be an effective alternative treatment modality with preservation of the organ and function without jeopardizing the outcome. (Source: Journal of Cancer Research and Therapeutics)