Interdisciplinary consensus statement on indication and application of a hydrogel spacer for prostate radiotherapy based on experience in more than 250 patients.

Background: The aim of the study was to reach a consensus on indication and application of a hydrogel spacer based on multicentre experience and give new users important information to shorten the learning curve for this innovative technique.

Methods: The interdisciplinary meeting was attended by radiation oncologists and urologists, each with experience of 23 - 138 hydrogel injections (SpaceOAR®) in prostate cancer patients before dose-escalated radiotherapy. User experience was discussed and questions were defined to comprise practical information relevant for successful hydrogel injection and treatment.

Neoadjuvant hormonal therapy and external-beam radiotherapy versus external-beam irradiation alone for prostate cancer. A quality-of-life analysis.

Purpose: To evaluate the impact of neoadjuvant hormonal therapy (NHT) on quality of life after external-beam radiotherapy (EBRT) for prostate cancer.

Patients And Methods: A group of 170 patients (85 with and 85 without NHT) has been surveyed prospectively before EBRT (70.2-72 Gy), at the last day of EBRT, a median time of 2 months and 15 months after EBRT using a validated questionnaire (Expanded Prostate Cancer Index Composite).

Image-guided radiotherapy for prostate cancer. Implementation of ultrasound-based prostate localization for the analysis of inter- and intrafraction organ motion.

Purpose: To evaluate inter- and intrafraction organ motion with an ultrasound-based prostate localization system (BAT) for patients treated with intensity-modulated radiotherapy for prostate cancer.

Patients And Methods: After set-up to external skin marks, 260/219 ultrasound-based alignments were performed before/after irradiation in 32 consecutive patients. Image quality was classified as good, satisfactory or poor.

Rectal dosimetry following prostate brachytherapy with stranded seeds--comparison of transrectal ultrasound intra-operative planning (day 0) and computed tomography-postplanning (day 1 vs. day 30) with special focus on sources placed close to the rectal wall.

Background And Purpose: The aim of the study was to compare intra-operative and postplanning at different intervals with special focus on sources placed close to the rectal wall.

Materials And Methods: In 61 consecutive patients, CT scans were performed on day 1 and day 30 after an I-125 implant with stranded seeds. The number of sources < or =7 mm to the rectal wall was determined, and displacements were analyzed.

Health-related quality of life after permanent I-125 brachytherapy and conformal external beam radiotherapy for prostate cancer--a matched-pair comparison.

Background And Purpose: The aim of the study was to compare quality of life after permanent I-125 brachytherapy (BT) and external beam radiotherapy (EBRT) for prostate cancer.

Materials And Methods: A group of 104 patients (52 in each group) have been surveyed prospectively before EBRT/BT (time A), at the last day of EBRT (70.2-72.

Seed displacements after permanent brachytherapy for prostate cancer in dependence on the prostate level.

Purpose: To evaluate seed displacements after permanent prostate brachytherapy considering different prostate levels.

Patients And Methods: In 61 patients, postimplant CT scans were performed 1 day and 1 month after an implant with stranded seeds. Seed and prostate surface displacements were determined relative to pelvic bones.

Sequencing chemotherapy and radiotherapy in locoregional advanced breast cancer patients after mastectomy - a retrospective analysis.

Background: Combined chemo- and radiotherapy are established in breast cancer treatment. Chemotherapy is recommended prior to radiotherapy but decisive data on the optimal sequence are rare. This retrospective analysis aimed to assess the role of sequencing in patients after mastectomy because of advanced locoregional disease.

Erectile dysfunction after external beam radiotherapy for prostate cancer.

Background: There is a lack of prospective studies focusing on the sexual quality of life of prostate cancer patients after conformal radiotherapy (RT).

Objective: To evaluate the incidence, progression, and predictive factors for erectile dysfunction (ED).

Design, Setting And Participants: Patients who responded to the sexual domain of the Expanded Prostate Cancer Index Composite (EPIC) questionnaire before and more than 1 yr after RT and never received an antiandrogen treatment were included (n=123).

Postoperative radiotherapy of glioblastoma multiforme: analysis and critical assessment of different treatment strategies and predictive factors.

Background And Purpose: Different factors influence glioblastoma patients' prognosis. The aim of this retrospective, explorative analysis was to define the role of recent treatment strategies and to examine the value of different prognostic factors.

Patients And Methods: A total of 110 patients was analyzed.

Health-related quality of life after adjuvant and salvage postoperative radiotherapy for prostate cancer - a prospective analysis.

Background And Purpose: The aim of the study was to analyze health-related quality of life changes after postoperative radiotherapy (RT) for prostate cancer.

Materials And Methods: A group of 101 patients has been surveyed prospectively before (time A), at the last day (B), two months after (C) and >1 year after (D) RT using a validated questionnaire (Expanded Prostate Cancer Index Composite) with urinary, bowel, sexual and hormonal domains. The prostatic fossa was treated with a four-field box technique up to a total dose of 66.

Toxicity profile with a large prostate volume after external beam radiotherapy for localized prostate cancer.

Purpose: To assess the impact of prostate volume on health-related quality of life (HRQOL) before and at different intervals after radiotherapy for prostate cancer.

Methods And Materials: A group of 204 patients was surveyed prospectively before (Time A), at the last day (Time B), 2 months after (Time C), and 16 months (median) after (Time D) radiotherapy, with a validated questionnaire (Expanded Prostate Cancer Index Composite). The group was divided into subgroups with a small (11-43 cm(3)) and a large (44-151 cm(3)) prostate volume.

Evaluation of source displacement and dose--volume changes after permanent prostate brachytherapy with stranded seeds.

Background And Purpose: The aim of the study was to analyze source displacements and dose-volume changes in the first month after a permanent implant.

Materials And Methods: In 51 consecutive patients, CT scans were performed at the postoperative day (day 1) and one month (day 30) after an (125)I implant with stranded seeds. Seed positions were determined relative to pelvic bones for five seeds at the base and five seeds at the apex for each patient (n=510) and compared.

pO polarography, contrast enhanced color duplex sonography (CDS), [18F] fluoromisonidazole and [18F] fluorodeoxyglucose positron emission tomography: validated methods for the evaluation of therapy-relevant tumor oxygenation or only bricks in the puzzle of tumor hypoxia?

Background: The present study was conducted to analyze the value of ([18F] fluoromisonidazole (FMISO) and [18F]-2-fluoro-2'-deoxyglucose (FDG) PET as well as color pixel density (CPD) and tumor perfusion (TP) assessed by color duplex sonography (CDS) for determination of therapeutic relevant hypoxia. As a standard for measuring tissue oxygenation in human tumors, the invasive, computerized polarographic needle electrode system (pO2 histography) was used for comparing the different non invasive measurements.

Methods: Until now a total of 38 Patients with malignancies of the head and neck were examined.

Sequential (gemcitabine/vinorelbine) and concurrent (gemcitabine) radiochemotherapy with FDG-PET-based target volume definition in locally advanced non-small cell lung cancer: first results of a phase I/II study.

Background: The aim of the study was to determine the maximal tolerated dose (MTD) of gemcitabine every two weeks concurrent to radiotherapy, administered during an aggressive program of sequential and simultaneous radiochemotherapy for locally advanced, unresectable non-small cell lung cancer (NSCLC) and to evaluate the efficacy of this regime in a phase II study.

Methods: 33 patients with histologically confirmed NSCLC were enrolled in a combined radiochemotherapy protocol. 29 patients were assessable for evaluation of toxicity and tumor response.

Bladder extension variability during pelvic external beam radiotherapy with a full or empty bladder.

Background And Purpose: Varying bladder fillings during radiotherapy lead to a changing dose-volume load to the bladder and adjacent structures. The aim of the study was to compare the extent of bladder wall movements during parallel series with full bladder (FB) and empty bladder (EB).

Materials And Methods: Three hundred and forty serial computed tomography (CT) scans were performed in 50 patients scheduled for primary and postoperative radiotherapy for prostate cancer.

Prostate-specific antigen kinetics after brachytherapy or external beam radiotherapy and neoadjuvant hormonal therapy.

Objectives: To characterize the kinetics of prostate-specific antigen (PSA) after radiotherapy (RT) and neoadjuvant hormonal therapy (NHT) for localized prostate cancer.

Methods: The PSA kinetics of 75 consecutive patients who had undergone RT and NHT (median time 4 months) were followed up for a minimum of 24 months after treatment. RT included a permanent iodine-125 implant (n = 29), a temporary iridium-192 implant as a boost to external beam RT (n = 21), and sole external beam RT (n = 25).

Postoperative radiotherapy for prostate cancer : evaluation of target motion and treatment techniques (intensity-modulated versus conformal radiotherapy).

Purpose: To determine the extent of target motion in postprostatectomy radiotherapy (RT) and the value of intensity-modulated radiotherapy (IMRT) compared to three-dimensional conformal radiotherapy (3D-CRT).

Patients And Methods: 20 patients underwent CT scans in supine position with both a full bladder (FB) and an empty bladder (EB) before RT and at three dates during the RT series. Displacements of the CTV (clinical target volume) center of mass and the posterior border were determined.

Active breathing control (ABC): determination and reduction of breathing-induced organ motion in the chest.

Purpose: Extensive radiotherapy volumes for tumors of the chest are partly caused by interfractional organ motion. We evaluated the feasibility of respiratory observation tools using the active breathing control (ABC) system and the effect on breathing cycle regularity and reproducibility.

Methods And Materials: Thirty-six patients with unresectable tumors of the chest were selected for evaluation of the ABC system.

Influence of the initial rectal distension on posterior margins in primary and postoperative radiotherapy for prostate cancer.

Background And Purpose: The aim of the study was to define the effect of different rectum fillings in the planning CT study on the posterior clinical target volume (CTV) displacements (PD) in primary and postoperative radiotherapy (RT) for prostate cancer.

Materials And Methods: Fifty patients underwent CT scans in supine position with a full bladder and an empty bladder before RT and at several points in time during the treatment. PD were determined depending on the initial rectum volume (RV), average cross-sectional rectal area (CSA), and the rectal diameter at the level of the bladder neck (RD).

Health-related quality of life after permanent interstitial brachytherapy for prostate cancer: correlation with postimplant CT scan parameters.

Purpose: To determine dosimetric risk factors for increased toxicity after permanent interstitial brachytherapy for prostate cancer.

Patients And Methods: Quality of life questionnaires (Expanded Prostate Cancer Index Composite) of 60 and 56 patients were analyzed after a median posttreatment time of 6 weeks (A-acute) and 16 months (L-late). The corresponding CT scans were performed 30 days after the implant.

Contrast-enhanced color duplex sonography (CDS): an alternative for the evaluation of therapy-relevant tumor oxygenation?

Purpose: To evaluate the predictive value of radiotherapeutically relevant tumor hypoxia by contrast-enhanced color duplex sonography (CDS). The objectification was based on pO(2) histography.

Material And Methods: 25 patients with metastatic neck lymph node from a primary squamous carcinoma of the head and neck were examined.

Changes of dose delivery distribution within the first month after permanent interstitial brachytherapy for prostate cancer.

Purpose: To evaluate changes of dose distribution for both the prostate and the surrounding tissues after permanent brachytherapy as monotherapy for prostate cancer.

Patients And Methods: In 35 patients, CT scans were performed before, 1 day after (day 1) and 1 month after the implantation (day 30). Changes of prostate volume, dosimetric parameters, and distances between posterior prostate contour and rectal wall as well as prostate contour and prescription isodose were analyzed.

FDG--a marker of tumour hypoxia? A comparison with [18F]fluoromisonidazole and pO2-polarography in metastatic head and neck cancer.

Purpose: Experimental data suggest that the accumulation of [(18)F]fluorodeoxyglucose (FDG) in malignant tumours is related to regional hypoxia. The aim of this study was to evaluate the clinical potential of FDG positron emission tomography (PET) to assess tumour hypoxia in comparison with [(18)F]fluoromisonidazole (FMISO) PET and pO(2)-polarography.

Methods: Twenty-four patients with head and neck malignancies underwent FDG PET, FMISO PET, and pO(2)-polarography within 1 week.

Association of neoadjuvant hormonal therapy with adverse health-related quality of life after permanent iodine-125 brachytherapy for localized prostate cancer.

Objectives: To characterize the influence of neoadjuvant hormonal therapy (NHT) on health-related quality of life after permanent iodine-125 brachytherapy (BT) for prostate cancer.

Methods: A cross-sectional survey using the Expanded Prostate Cancer Index Composite health-related quality-of-life instrument was administered to 134 consecutive patients a median of 29 months after BT. A separate group of 111 patients with comparable demographic characteristics without any prior treatment for prostate cancer rendered the baseline information (control group).