Long-Term Outcomes of Radiotherapy for Pituitary AdenomasPage 994
F. E. Snead, R. J. Amdur, C. G. Morris, and W. M. Mendenhall
The study reported in this article examined the treatment results and side effects in patients with pituitary adenomas seen over a 20-year period. The authors especially focused on the results and side effects of fractionated radiotherapy in the treatment of these benign tumors of the adenohypophysis that constitute 10% of all adult intracranial neoplasms. Nonetheless, these tumors cause visual loss and metabolic disturbances, which can be life threatening. Treatment usually consists of surgery, which is associated with a significant risk of recurrence. Fractionated radiotherapy with modern CAT scan-based treatment planning are the current standard of care. The tumor control rates associated with fractionated radiotherapy with or without surgery were found to be excellent at 10 years, and the toxicity rates were found to be acceptable.
Radiation Use and Long-Term Survival in Breast Cancer Patients With T1, T2 Primary Tumors and One to Three Positive Axillary Lymph NodesPage 1022
T. A. Buchholz, W. A. Woodward, Z. Duan, S. Fang, J. L. Oh, W. Tereffe, E. A. Strom, G. H. Perkins, T.-K. Yu, K. K. Hunt, F. Meric-Bernstam, G. N. Hortobagyi, and S. H. Giordano
Adjuvant radiation offers a significant survival benefit for selected breast cancer patients. To determine whether patients with stage II disease with one to three positive lymph nodes should be recommended to receive radiation, we analyzed SEER data and compared the breast cancer-specific survival of patients with stage II disease with one to three positive lymph nodes who were treated with breast conservation surgery and radiation versus those treated with a modified radical mastectomy without adjuvant radiation. The results of a Cox regression analysis that accounted for the identifiable confounding biases between the two populations indicated that treatment with mastectomy without radiation was associated with a higher breast cancer mortality rate (hazard ratio 1.19, p < 0.001). Moreover, radiation use was associated with an improved outcome in all subsets of patients when they were divided according to T stage categories and according to the number of positive lymph nodes.
Long-Term Results of Conformal Radiotherapy for Prostate Cancer: Impact of Dose Escalation on Biochemical Tumor Control and Distant Metastases-Free Survival OutcomesPage 1028
M. J. Zelefsky, Y. Yamada, Z. Fuks, Z. Zhang, M. Hunt, O. Cahlon, J. Park, and A. Shippy
In this article, the long-term results of 2,047 patients with clinically localized prostate cancer who received high radiation doses using conformal external beam radiation techniques are presented. The study demonstrated that, especially in the case of patients with intermediate and unfavorable risk prognostic features, higher doses delivered to the prostate not only improved the biochemical relapse-free survival outcomes, but also effectively reduced the risk of distant metastases. These data further support the notion that improved eradication of local prostatic cancer reduces the likelihood of distant dissemination of the disease.
Radiation Dose Prescription for Non–Small-Cell Lung Cancer According to Normal Tissue Dose Constraints: An In Silico Clinical TrialPage 1103
A. van Baardwijk, G. Bosmans, S. M. Bentzen, L. Boersma, A. Dekker, R. Wanders, B. G. Wouters, P. Lambin, and D. De Ruysscher
Local tumor recurrence remains a major problem in patients treated for non–small-cell lung cancer (NSCLC). This study explored the theoretical gain in estimated tumor control probability (TCP) using an individualized maximal tolerable dose (MTD) based on normal tissue constraints. Five treatment plans in 64 NSCLC patients were compared, and this comparison included classic fractionation schemes, a hypofractionated scheme, and an individualized MTD scheme. This planning study showed a large gain in estimated TCP using an MTD prescription scheme given in 1.8 Gy fractions twice daily to an individualized maximal tolerable dose.
FULL TEXT
Page 994