Comparative Survival in Patients with Postresection Recurrent Versus Newly Diagnosed Non–Small-Cell Lung Cancer Treated with RadiotherapyPage 1100
X.-W. Cai, L.-Y. Xu, L. Wang, J. A. Hayman, A. C. Chang, A. Pickens, K. B. Cease, M. B. Orringer, and F.-M. Kong
This study, through survival analysis of 661 consecutive patients treated in 2 medical centers, demonstrates that patients with post-resection recurrent non-small cell lung cancer (54 patients) achieved comparable survival to those with the newly diagnosed disease (607 patients) when they both were treated with radiotherapy or chemoradiotherapy. Chemotherapy was also a significant factor in predicting 5-year progression free survival for patients with recurrent disease. These findings suggest that patients with post-resection recurrent non-small cell lung cancer should be treated as aggressively as those with newly diagnosed disease.
Primary Tumor Necrosis Predicts Distant Control in Locally Advanced Soft-Tissue Sarcomas After Preoperative Concurrent ChemoradiotherapyPage 1147
D. M. MacDermed, L. L. Miller, T. D. Peabody, M. A. Simon, H. H. Luu, R. C. Haydon, A. G. Montag, S. D. Undevia, and P. P. Connell
This article focuses on a neoadjuvant approach for locally advanced soft tissue extremity sarcomas, whereby patients receive concurrent chemotherapy together with hypofractionated radiation (28 Gy in 3.5 Gy daily fractions) prior to resection. A retrospective review demonstrated that this well tolerated regimen yields excellent rates of tumor necrosis, limb preservation, and local control. A key finding was that freedom from distant metastasis rates could be predicted by the degree of treatment-induced tumor necrosis observed in surgical specimens. This information may provide a new opportunity to guide decisions regarding subsequent postoperative systemic therapies.
Accumulation of DNA Double-Strand Breaks in Normal Tissues After Fractionated IrradiationPage 1206
C. E. Rübe, A. Fricke, J. Wendorf, A. Stützel, M. Kühne, M. F. Ong, P. Lipp, and C. Rübe
Genetic factors regulating the recognition and/or repair of DNA double-strand breaks (DSBs) are responsible for differences in radiosensitivity, and thus determine patients' individual susceptibility to develop adverse normal-tissue reactions after radiotherapy. By visualizing γH2AX-foci in irradiated mice, we show that radiation-induced DSBs accumulate similarly in acute- and late-responding tissues during fractionated irradiation, whereas the whole extent of residual DNA damage depends decisively on the underlying genetically-defined DSB repair capacity. Moreover, we show that even minor impairments in DSB repair lead to exceeding DNA damage accumulation during fractionated irradiation, and thus may have significant impact on normal-tissue responses in clinical radiotherapy.
Quantification of Artifact Reduction with Real-Time Cine Four-Dimensional Computed Tomography Acquisition MethodsPage 1242
U. W. Langner and P. J. Keall
“4D CT can be used to accurately delineate and decrease the treatment margins for tumor volumes affected by respiratory motion. The aim of this work was to simulate 4D CT image acquisition with current retrospective phase sorting and proposed real-time sorting methods. The magnitude and frequency of artifacts in these 4D CT images that resulted from each method were then compared, as were the relative CT dose and image-acquisition time. It was found that the real-time sorting methods can reduce the frequency and magnitude of artifacts, as well as the imaging dose to the patient, but they increase the image acquisition time. ”
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