Predicting Prostate Cancer Mortality Among Men With Intermediate to High-Risk Disease and Multiple Unfavorable Risk FactorsPage 659
P. L. Nguyen, M.-H. Chen, W. J. Catalona, J. W. Moul, L. Sun, and A. V. D'Amico
Among men with intermediate- to high-risk prostate cancer, the authors found that the risk of death from prostate cancer was significantly associated with the number of unfavorable features (PSA>10, Gleason >=7, Stage >=T2b, PSA velocity >2ng/ml/yr) present at diagnosis, regardless of the treatment given. Prostate cancer rarely caused death among those with a single risk factor but caused the majority of deaths in those with three or four risk factors. Consideration should be given to incorporating the number of unfavorable features into the risk assessment and patient selection process for clinical trials done in high-risk patients.
Phase I Three-Dimensional Conformal Radiation Dose Escalation Study in Newly Diagnosed Glioblastoma: Radiation Therapy Oncology Group Trial 98-03Page 699
C. Tsien, J. Moughan, J. M. Michalski, M. R. Gilbert, J. Purdy, J. Simpson, J. J. Kresel, W. J. Curran, A. Diaz, and M. P. Mehta
This article describes the results of the first multi-institutional Radiation Therapy Oncology Group (RTOG) study assessing radiation dose escalation using 3DCRT in patients with newly diagnosed glioblastoma multiforme (GBM). This study demonstrates the feasibility and tolerance of delivering higher-than-standard doses of radiation (60 Gy) with concurrent chemotherapy for primary supratentorial GBM with an acceptable risk of late CNS toxicity. There was a trend toward improved survival in the 84 Gy dose arm, but this may have been due to smaller tumor size and not necessarily the higher RT dose.
Assessment of Hypoxia in Human Cervical Carcinoma Xenografts by Dynamic Contrast-Enhanced Magnetic Resonance ImagingPage 838
C. Ellingsen, T. A. M. Egeland, K. Gulliksrud, J.-V. Gaustad, B. Mathiesen, and E. K. Rofstad
Tumor hypoxia has been identified as a major cause of treatment failure in locally advanced cervical carcinoma. This preclinical study examined the potential usefulness of gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA)–based dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in assessing tumor hypoxia using human cervical carcinoma xenografts as experimental models of human cancer. Tumor images of Ktrans and ve were produced by pharmacokinetic analysis of DCE-MRI data. A strong inverse relationship was found between Ktrans and the fraction of radiobiologically hypoxic cells, supporting the clinical development of DCE-MRI as a noninvasive method for assessing the extent of hypoxia in carcinoma of the cervix.
4D-Imaging of the Lung: Reproducibility of Lesion Size and Displacement on Helical CT, MRI, and Cone Beam CT in a Ventilated Ex Vivo SystemPage 919
J. Biederer, J. Dinkel, G. Remmert, S. Jetter, S. Nill, T. Moser, R. Bendl, C. Thierfelder, M. Fabel, U. Oelfke, M. Bock, C. Plathow, H. Bolte, T. Welzel, B. Hoffmann, G. Hartmann, W. Schlegel, J. Debus, M. Heller, and H.-U. Kauczor
The exact dimensions of a tumor (3D) and its displacement during respiration (4D) are essential information for motion-adapted radiotherapy. Three current techniques, X-ray-based (low pitch helical CT, linear-accelerator-integrated cone beam CT) and MR-based (time-resolved 3D MRI), were evaluated in an ex vivo system involving the use of artificial tumors inside ventilated porcine lung explants. From this, the performance and the principal limitations of 4D-imaging of lung tumors were estimated. Depending on temporal and spatial resolution, lesion sizes tended to be overestimated and lesion displacement was slightly underestimated. Currently, the best results are achieved with low-pitch helical CT.
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