Dosimetric Factors Associated With Long-Term Dysphagia After Definitive Radiotherapy for Squamous Cell Carcinoma of the Head and NeckPage 403
J. J. Caudell, P. E. Schaner, R. A. Desmond, R. F. Meredith, S. A. Spencer, and J. A. Bonner
Emerging data suggests that certain anatomical structures may be related to swallowing dysfunction following radiotherapy for head and neck cancers. This report retrospectively examined patients definitively treated for head and neck cancer with intensity modulated radiotherapy and correlated doses received to seven swallowing related structures with three swallowing dysfunction endpoints. Doses to the larynx and inferior pharyngeal constrictor were associated with gastrostomy dependence and aspiration. Doses to the superior and middle pharyngeal constrictor were associated with pharyngoesophageal stricture requiring a dilation procedure. These data may help physicians spare these structures in appropriate patients, possibly resulting in less swallowing toxicity.
Factors Associated With Neurological Recovery of Brainstem Function Following Postoperative Conformal Radiation Therapy for Infratentorial EpendymomaPage 496
T. E. Merchant, R. M. Chitti, C. Li, X. Xiong, R. A. Sanford, and R. B. Khan
The most common site of brain tumor in children is the posterior fossa. When radiation therapy is administered, the targeted volume often encompasses the brainstem and the required doses may exceed historic limits. To further the understanding of the effects of brainstem irradiation, investigators prospectively assessed recovery of cranial nerve function in children with ependymoma after aggressive surgery and post-operative radiation therapy. They found that recovery of function was not impeded by radiation therapy even when substantial volumes of the brainstem received doses in excess of 54 Gy. Recovery was influence by tumor and treatment-related factors that implicated pre-existing neurological morbidity, more extensive disease and surgery.
Quantifying Local Radiation-Induced Lung Damage from Computed TomographyPage 548
G. Ghobadi, L. E. Hogeweg, H. Faber, W. G. J. Tukker, J. M. Schippers, S. Brandenburg, J. A. Langendijk, R. P. Coppes, and P. van Luijk
“In this article, an objective measure to quantify local damage to the lung tissue from Computed Tomography (CT) imaging was developed. The current method uses local mean and local standard deviation of the CT density (HU) in 1-mm3 sub-volumes of the lung to quantify local radiation induced lung toxicity. Thus observed changes correlate well to alterations in lung histology and function loss. Our method enables objective and reproducible measurement of local pulmonary damage necessary for the development of more accurate predictive models.”
Biological in situ Dose Painting for Image-Guided Radiation Therapy Using Drug-Loaded Implantable DevicesPage 615
R. A. Cormack, S. Sridhar, W. W. Suh, A. V. D'Amico, and G. M. Makrigiorgos
This article proposes that implantable devices routinely used for increasing spatial accuracy in modern image-guided radiation treatments, such as fiducials or brachytherapy spacers, can be coated with slow-releasing tumoricidal or radio-sensitizing drugs prior to implantation. The approach would select drug to match the specific tumor biology and deliver an extra ‘punch’ to the tumor during radiation therapy, without changing the established radiation procedures. The theoretical feasibility of this new approach, termed BIS-IGRT, is modeled for two types of treatment, lung SBRT and prostate brachytherapy.
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