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Clinical Outcomes of Patients Receiving Integrated PET/CT-Guided Radiotherapy for Head and Neck Carcinoma
Page 678
M. R. Vernon, M. Maheshwari, C. J. Schultz, M. A. Michel, S. J. Wong, B. H. Campbell, B. L. Massey, J. F. Wilson, and D. Wang
The study reported in this article examined the survival outcomes in patients with head and neck cancer who undergo PET/CT as part of tumor staging and treatment planning for radiotherapy. A high level of disease control combined with favorable toxicity profiles was achieved in the patients receiving PET/CT fusion-guided intensity-modulated radiation treatment.
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Effect of Radiotherapy Volume and Dose on Secondary Cancer Risk in Stage I Testicular SeminomaPage 853
D. R. Zwahlen, J. M. Martin, J. L. Millar, and U. Schneider
This article describes a model that can be used to estimate secondary cancer risk in patients treated with postoperative radiotherapy for stage I testicular seminoma. The idea behind this work is that field size and radiation dose have a significant impact on radiation-induced cancers. The model (organ equivalent dose concept) suggests that the risk of secondary cancer induction is less by a factor of 2 for radiotherapy to the para-aortic lymph nodes (PA-RT) compared with the para-aortic and ipsilateral iliac lymph nodes (dogleg field). Fewer new second primary cancers could be detected when a lower dose (20 Gy versus 30 Gy) and PA-RT were used.
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Local Anatomic Changes in Parotid and Submandibular Glands During Radiotherapy for Oropharynx Cancer and Correlation With Dose, Studied in Detail With Nonrigid RegistrationPage 875
E. M. Vásquez Osorio, M. S. Hoogeman, A. Al-Mamgani, D. N. Teguh, P. C. Levendag, and B. J. M. Heijmen
In patients with head and neck cancer undergoing fractionated radiotherapy, local anatomy often changes as a result of the ionizing radiation or weight loss. These changes may jeopardize the precision of the treatment. In this article, the authors describe their introduction of a non-rigid registration method to precisely measure tissue deformations in 3D. They applied this method using CT scans of oropharynx cancer patients, acquired before and after treatment, and found substantial anatomical changes that were consistent among patients. Submandibular and parotid glands in treated necks deformed more than those in non-treated necks. Parotid gland volume reduction was proportional to the planned mean dose.
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Fiducial-Based Translational Localization Accuracy of Electromagnetic Tracking System and On-Board Kilovoltage Imaging SystemPage 892
L. Santanam, K. Malinowski, J. Hubenshmidt, S. Dimmer, M. L. Mayse, J. Bradley, A. Chaudhari, K. Lechleiter, S. K. M. Goddu, J. Esthappan, S. Mutic, D. A. Low, and P. Parikh
The Calypso Medical 4D Localization System utilizes AC electromagnetics, which does not require ionizing radiation, for accurate, real-time tumor tracking. This investigation compared the static and dynamic tracking accuracy of this system to that of an on-board imaging (OBI) kilovoltage x-ray system for concurrent use of the two systems. The results showed that both localization systems provided submillimeter accuracy. The Calypso and OBI tracking systems offer distinct sets of advantages, and given their compatibility, patients could benefit from the complementary nature of the two systems when used concurrently.
