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Breast Intensity-Modulated Radiation Therapy Reduces Time Spent With Acute Dermatitis for Women of All Breast Sizes During Radiation
Page 689
G. M. Freedman, T. Li, N. Nicolaou, Y. Chen, C. C.-M. Ma, and P. R. Anderson
Further evidence is needed showing that intensity-modulated radiation therapy (IMRT) for breast cancer improves clinical outcomes so that the added cost and complexity of treatment compared with conventional radiation can be justified. This study was unique in assessing the degree of skin toxicity during each week of a typical 6- to 7-week course of radiation. The authors observed that patients treated with IMRT had a reduced incidence of grade ≥ 2 dermatitis and spent the majority of the time with grade 0-1 toxicity. IMRT delayed the onset of grade 2 toxicity by 1 to 2 weeks compared with conventional radiation.
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Elective Clinical Target Volumes for Conformal Therapy in Anorectal Cancer: A Radiation Therapy Oncology Group Consensus Panel Contouring AtlasPage 824
R. J. Myerson, M. C. Garofalo, I. El Naqa, R. A. Abrams, A. Apte, W. R. Bosch, P. Das, L. L. Gunderson, T. S. Hong, J. J. J. Kim, C. G. Willett, and L. A. Kachnic
Highly conformable radiotherapy requires a detailed understanding of appropriate clinical target volumes. However, the elective nodal target volumes for anorectal cancer include regions, e.g., perirectal, that are not routinely contoured for other disease sites. In addition, patient positioning and organ motion considerations can be quite different. Therefore, the Gastrointestinal Committee of the RTOG established a nine-physician task group to develop a contouring atlas. They responded to a questionnaire concerning three elective CTVs and outlined these areas on computed tomography images from a representative case. The group reviewed and modified a computer-generated 95% consensus contour to provide a final consensus atlas.
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Frequency Distribution of Second Solid Cancer Locations in Relation to the Irradiated Volume Among 115 Patients Treated for Childhood CancerPage 876
I. Diallo, N. Haddy, E. Adjadj, A. Samand, E. Quiniou, J. Chavaudra, I. Alziar, N. Perret, S. Guérin, D. Lefkopoulos, and F. de Vathaire
The contribution radiotherapy has made to the increasing curability of cancer is well established. However, of the potential harmful consequences of radiotherapy, the risk of second malignant neoplasms (SMNs) is not a negligible one. The purpose of this study was to show that the majority of SMNs that develop after radiotherapy develop in the area surrounding the planning target volume. Among 115 young patients, 66% of SMNs that developed after radiotherapy arose in this area. The corresponding dose levels have also been evaluated and found to range from almost zero to more than 75 Gy. About 30% of the 115 SMNs developed in sites that received less than 2.5 Gy.
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Radiation-Induced Astrogliosis and Blood-Brain Barrier Damage Can Be Abrogated Using Anti-TNF TreatmentPage 934
C. M. Wilson, M. W. Gaber, O. M. Sabek, J. A. Zawaski, and T. E. Merchant
Irradiated normal brain responds by inducing inflammatory molecules that target circulating cells, cellular barriers to noxious substances, and normal parenchyma. The goal of this research was to demonstrate the critical effect of tumor necrosis factor (TNF) on cellular adhesion, blood-brain barrier (BBB) permeability, and gliosis in an established system used to study irradiated murine cranial microvasculature. The authors showed that anti-TNF therapy lowered leukocyte adhesion, decreased BBB permeability, and reduced astrocyte activation, suggesting a target for the reduction of the early and late effects of radiation therapy.
