Hepatic transcriptomic assessment of Sprague Dawley rats in response to dietary perfluorobutane sulfonate (PFBS) ingestion.

Perfluorobutane sulfonate is a short-chain PFAS that is a less toxic replacement for the rather more toxic long-chain perfluorooctane sulfonate. PFBS is widespread in the environment and has raised environmental and health concerns. The study goal was to investigate whether dietary ingestion of PFBS would induce hepatic damage.

Enhancing patient-provider communication with the electronic self-report assessment for cancer: a randomized trial.

Purpose: Although patient-reported cancer symptoms and quality-of-life issues (SQLIs) have been promoted as essential to a comprehensive assessment, efficient and efficacious methods have not been widely tested in clinical settings. The purpose of this trial was to determine the effect of the Electronic Self-Report Assessment-Cancer (ESRA-C) on the likelihood of SQLIs discussed between clinicians and patients with cancer in ambulatory clinic visits. Secondary objectives included comparison of visit duration between groups and usefulness of the ESRA-C as reported by clinicians.

Acceptability of an Electronic Self-Report Assessment Program for patients with cancer.

Eliciting symptom and quality of life information from patients is an important component of medical and nursing care processes. Traditionally, this information has been collected with paper and pencil. However, this approach presents several barriers, including delays in receiving information, difficulty in integrating responses with electronic records, and the time required to manually score questionnaires for measurement purposes.

Depression screening using the Patient Health Questionnaire-9 administered on a touch screen computer.

Objective: To (1) evaluate the feasibility of touch screen depression screening in cancer patients using the Patient Health Questionnaire-9 (PHQ-9), (2) evaluate the construct validity of the PHQ-9 using the touch screen modality, and (3) examine the prevalence and severity of depression using this screening modality.

Methods: The PHQ-9 was placed in a web-based survey within a study of the clinical impact of computerized symptom and quality of life screening. Patients in medical oncology, radiation oncology, and hematopoietic stem cell transplantation (HSCT) clinics used the program on a touch screen computer in waiting rooms prior to therapy (T1) and during therapy (T2).

Automatic selection of non-coplanar beam directions for three-dimensional conformal radiotherapy.

An algorithm is described, based on ray-tracing and the beam's-eye-view, that exhaustively searches all permitted beam directions. The evaluation of the search is based on a general cost function that can be adapted to the clinical objectives by means of parameters and weighting factors. The approach takes into account the constraints of the linear accelerator by discarding beam directions that are not permitted.

Axillary lymph node dose with tangential breast irradiation.

Purpose: The advent of sentinel lymph node mapping and biopsy in the staging of breast cancer has resulted in a significant decrease in the extent of axillary nodal surgery. As the extent of axillary surgery decreases, the radiation dose and distribution within the axilla becomes increasingly important for current therapy planning and future analysis of results. This analysis examined the radiation dose distribution delivered to the anatomically defined axillary level I and II lymph node volume and surgically placed axillary clips with conventional tangential breast fields and CT-based three-dimensional (3D) planning.

Radiation therapy does not impact local complication rates after free flap reconstruction for head and neck cancer.

Objective: To determine whether external beam radiation therapy (XRT), administered either before or after surgery, increases the rate and/or severity of local postoperative complications in patients with head and neck cancer who undergo microvascular free flap reconstruction.

Design: Retrospective cohort study.

Setting: University of Washington Medical Center, Seattle, a tertiary care hospital.

Computerized symptom and quality-of-life assessment for patients with cancer part I: development and pilot testing.

Purpose/objectives: To develop and test an innovative computerized symptom and quality-of-life (QOL) assessment for patients with cancer who are evaluated for and treated with radiation therapy.

Design: Descriptive, longitudinal prototype development and cross-sectional clinical data.

Setting: Department of radiation oncology in an urban, academic medical center.

Impact of FDG PET on defining the extent of disease and on the treatment of patients with recurrent or metastatic breast cancer.

Objective: Our aim was to evaluate the impact of FDG PET on defining the extent of disease and on the treatment of patients with advanced breast cancer.

Materials And Methods: The medical records of 125 consecutive patients with recurrent or metastatic breast cancer referred for FDG PET from January 1998 through May 2002 were retrospectively reviewed. The rationale for FDG PET referral and the impact of FDG PET on subsequent treatment decisions for patients were determined by chart review.

Postradiotherapy surveillance practice for head and neck squamous cell carcinoma--too much for too little?

Introduction: Limited information is available regarding surveillance patterns after head and neck cancer radiotherapy. We cataloged follow-up for a specified patient cohort treated at three neighboring university, community, and Veterans Administration institutions.

Methods: One hundred fifteen patients were treated with curative intent between 1994-1998 with definitive or postoperative radiotherapy for newly diagnosed squamous cell carcinoma of the oral cavity, oropharynx, larynx, or hypopharynx.

Treatment of salivary gland neoplasms with fast neutron radiotherapy.

Objective: To evaluate the efficacy of fast neutron radiotherapy for the treatment of salivary gland neoplasms.

Design: Retrospective analysis.

Setting: University of Washington Cancer Center, Neutron Facility, Seattle.

Head and neck lymph node region delineation with 3-D CT image registration.

The success of radiation therapy depends critically on accurately delineating the target volume, which is the region of known or suspected disease in a patient. Methods that can compute a contour set defining a target volume on a set of patient images will contribute greatly to the success of radiation therapy and dramatically reduce the workload of radiation oncologists, who currently draw the target by hand on the images using simple computer drawing tools. The most challenging part of this process is to estimate where there is microscopic spread of disease.

A rule-based model for local and regional tumor spread.

Prediction of microscopic spread of tumor cells is becoming critically important in the decision making process in planning radiation therapy for cancer. Until recently, radiation treatment of head and neck cancer has been conservative, treating large regions to insure eradication of disease. However, if it is known that regional spread is confined, a more focused treatment can be considered, with the payoff of reducing or eliminating morbidity due to irradiating healthy tissue in the vicinity of node groups.

Detection of locoregional and distant recurrences in breast cancer patients by using FDG PET.

Cases of recurrence of breast cancer can pose considerable diagnostic and therapeutic challenges for the oncologic team. The prognosis and management decisions are based on knowledge of the true extent of disease. Conventional staging methods, including physical examination, assessment of levels of tumor markers, cross-sectional imaging, and bone scintigraphy, may not reliably demonstrate the extent of disease in all cases.

Neutron radiotherapy for recurrent pleomorphic adenomas of major salivary glands.

Introduction: Pleomorphic adenoma is the most common neoplasm arising in the salivary glands. Surgical management is the primary therapeutic modality. With the use of modern surgical techniques, recurrence is infrequent, and facial nerve sparing is the norm.

18fluorodeoxyglucose positron emission tomography to detect mediastinal or internal mammary metastases in breast cancer.

Purpose: To determine the prevalence of suspected disease in the mediastinum and internal mammary (IM) node chain by 18fluorodeoxyglucose (FDG) positron emission tomography (PET), compared with conventional staging by computed tomography (CT) in patients with recurrent or metastatic breast cancer.

Patients And Methods: We retrospectively evaluated intrathoracic lymph nodes using FDG PET and CT data in 73 consecutive patients with recurrent or metastatic breast cancer who had both CT and FDG PET within 30 days of each other. In reviews of CT scans, mediastinal nodes measuring 1 cm or greater in the short axis were considered positive.

Concurrent radiation therapy and paclitaxel or docetaxel chemotherapy in high-risk breast cancer.

Purpose: Evidence supports the inclusion of the taxanes in the treatment of breast cancer. A recent randomized trial has shown a survival advantage to the addition of paclitaxel in the adjuvant treatment of node-positive patients. Several studies have suggested diminished local control if adjuvant radiation is delayed, while in vitro and in vivo studies have demonstrated a benefit of concurrent administration of taxanes with radiation.

A Multidisciplinary Approach to Locoregional Management of the Axilla for Primary Operable Breast Cancer.

BACKGROUND: Lymph node metastasis is the single most important factor in assessing breast cancer prognosis and planning systemic therapy. However, lymph node dissection portends significant morbidity, with little or no therapeutic benefit if the nodes prove to be negative for cancer. METHODS: The authors review indications for avoiding axillary dissection, and they analyze the results from lower-level axillary lymphadenectomy together with the morbidity from full axillary dissection.

Treatment of locally advanced adenoid cystic carcinoma of the head and neck with neutron radiotherapy.

Purpose: To examine the efficacy of fast neutron radiotherapy for the treatment of locally advanced and/or recurrent adenoid cystic carcinoma of the head and neck and to identify prognostic variables associated with local-regional control and survival.

Methods And Materials: One hundred fifty-nine patients with nonmetastatic, previously unirradiated, locally advanced, and/or recurrent adenoid cystic carcinoma (ACC) of the head and neck region were treated with fast neutron radiotherapy during the years 1985-1997. One hundred fifty-one patients had either unresectable disease, or gross residual disease (GRD) after an attempted surgical extirpation.

Anatomical information in radiation treatment planning.

We report on experience and insights gained from prototyping, for clinical radiation oncologists, a new access tool for the University of Washington Digital Anatomist information resources. This access tool is designed to integrate with a radiation therapy planning (RTP) system in use in a clinical setting. We hypothesize that the needs of practitioners in a clinical setting are different from the needs of students, the original targeted users of the Digital Anatomist system, but that a common knowledge resource can serve both.

Non-physician practitioners in radiation oncology: advanced practice nurses and physician assistants.

Purpose: With changes in reimbursement and a decrease in the number of residents, there is a need to explore new ways of achieving high quality patient care in radiation oncology. One mechanism is the implementation of non-physician practitioner roles, such as the advanced practice nurse (APN) and physician assistant (PA). This paper provides information for radiation oncologists and nurses making decisions about: (1) whether or not APNs or PAs are appropriate for their practice, (2) which type of provider would be most effective, and (3) how best to implement this role.

Neutron radiotherapy for the treatment of locally advanced major salivary gland tumors.

Background: Malignant salivary gland tumors are rare tumors of the head and neck region. The treatment of these tumors has generally consisted of surgical extirpation, with postoperative radiotherapy improving locoregional control and survival in patients with high risk tumors. Neutron radiotherapy has been found to be more efficacious than conventional radiotherapy in the setting of inoperable or subtotally resected salivary gland tumors.

Value of combined FDG PET and MR imaging in the evaluation of suspected recurrent local-regional breast cancer: preliminary experience.

Purpose: To assess the performance and potential clinical effects of combined 2-[fluorine 18]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) and magnetic resonance (MR) imaging of the axilla and brachial plexus in patients suspected of having local-regional breast cancer metastases.

Materials And Methods: Upper-body FDG PET and axillary and supraclavicular MR imaging were performed in 10 patients (age range, 45-71 years) with clinical findings suggestive of breast cancer metastases. Medical records were reviewed retrospectively.

Fast neutrons in prostatic adenocarcinomas: worldwide clinical experience.

Primary tumor control remains a major problem in the treatment of locally advanced prostate carcinoma. Clinical local failure rates approach 30-40% and may be significantly higher when results of prostatic biopsy or prostate-specific antigen (PSA) levels are considered. The low growth rate and cycling fraction of prostate adenocarcinoma suggest potential therapeutic advantage for the high linear energy transfer (LET) of neutrons.

The use of medical images in planning and delivery of radiation therapy.

The authors provide a survey of how images are used in radiation therapy to improve the precision of radiation therapy plans, and delivery of radiation treatment. In contrast to diagnostic radiology, where the focus is on interpretation of the images to decide if disease is present, radiation therapy quantifies the extent of the region to be treated, and relates it to the proposed treatment using a quantitative modeling system called a radiation treatment planning (RTP) system. This necessitates several requirements of image display and manipulation in radiation therapy that are not usually important in diagnosis.