Radiographic and Histopathologic Observations After Combined EGFR Inhibition and Hypofractionated Stereotactic Radiosurgery in Patients With Recurrent Malignant GliomasPage 1352
A. L. Schwer, B. D. Kavanagh, R. McCammon, L. E. Gaspar, B. K. Kleinschmidt-De Masters, K. Stuhr, and C. Chen
The article is on the magnetic resonance imaging (MRI) volume changes in T1 enhancement and the T2 abnormality seen in patients with a recurrent malignant glioma after stereotactic radiosurgery and epidermal growth factor receptor inhibition with gefitinib. The majority of patients had a dramatic volume increase in T1 enhancement and the T2 abnormality after treatment, and the patients who showed the most dramatic changes survived longer.
Does Incidental Irradiation With Doses Below 50 Gy Effectively Reduce Isolated Nodal Failures in Non–Small-Cell Lung Cancer: Dose–Response RelationshipPage 1391
L. Kepka, B. Maciejewski, and H. R. Withers
This is the first radiobiological investigation based on a large amount of clinical data of the dose–response relationship with regard to the incidence of isolated nodal recurrences in non–small-cell lung cancer. In the range of doses of incidental irradiation examined, the authors observed a progressive reduction in the risk of isolated nodal recurrences with increasing doses of between 5 and 50 Gy. Therefore, incidental irradiation beyond the defined PTV should not be disregarded when overall tumor control is considered.
Microscopic and Macroscopic Tumor and Parenchymal Effects of Liver Stereotactic Body RadiotherapyPage 1414
C. C. Olsen, J. Welsh, B. D. Kavanagh, W. Franklin, M. McCarter, H. R. Cardenes, L. E. Gaspar, and T. E. Schefter
Partial liver radiation therapy, specifically stereotactic body radiotherapy (SBRT), is commonly used to treat liver tumors. This paper describes the radiographic and pathologic changes in the liver (both focally and globally) following SBRT. Histologically, the authors consistently observed four well-demarcated zones of tissue injury as a result of focal high-dose radiotherapy. They also observed transient global whole-organ atrophy on computed tomography (CT) scans that was most pronounced 3 months following SBRT, and this effect was most strongly correlated with the volume of normal liver receiving 30 Gy or more. While this volume reduction was not clinically relevant in the study cohort, it may be for patients with small liver volumes.
Setup Uncertainties of Anatomical Sub-Regions in Head-and-Neck Cancer Patients After Offline CBCT GuidancePage 1566
S. van Kranen, S. van Beek, C. Rasch, M. van Herk, and J.-J. Sonke
This article quantifies anatomical deformations that occur during radiotherapy in patients with head and neck cancer. For accurate dose delivery, reproducible positioning of the patient is required, for which fixation masks are used. Rigid misalignments are corrected with couch shifts. Residual anatomical misalignments during treatment, due to deformations, were studied in detail by analyzing anatomic sub-regions (e.g., vertebrae, mandible, jugular notch) in cone-beam CT scans. In spite of the applied fixation, substantial deformations were observed that often exceeded the commonly applied 5-mm safety margin. We conclude that deformations during the radiotherapy of head and neck cancer cannot be ignored.
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