Nasopharyngeal non-intestinal-type adenocarcinoma: a case report and updated review of the literature.

Background: Non-intestinal-type adenocarcinoma is a malignancy traditionally found in the sinonasal cavity. To our knowledge, this case is the first reported of this rare condition originating in the nasopharynx.

Case Presentation: A 67-year-old woman with nasopharyngeal non-intestinal-type adenocarcinoma, with an accompanying parapharyngeal mass received primary radiation treatment for both lesions.

IMRT sparing of normal tissues in locoregional treatment of breast cancer.

Purpose: This clinical study was designed to prospectively evaluate the acute and moderately-late cardiac and lung toxicities of intensity modulated radiation therapy delivered by helical tomotherapy (IMRT-HT) for locoregional breast radiation treatment including the internal mammary nodes (IMN).

Material/methods: 30 patients with stage III breast cancers have been accrued in this study. All patients received adjuvant chemotherapy.

[Acceptance of a telemonitoring device in patients with chronic obstructive pulmonary disease].

Objective: The aim of this trial was to assess the acceptance of a telemonitoring device (Health Buddy®) by patients with chronic obstructive pulmonary disease (COPD). The device makes it possible to monitor vital parameters and to ask questions about symptoms, behavior and disease-specific knowledge.

Method: A single-arm non-randomized clinical study was performed for three months in 43 patients with severe/very severe COPD.

Interstitial brachytherapy in the management of persistent head and neck disease after definitive external beam radiation therapy.

Purpose: Persistent disease after definitive external beam radiation therapy for head and neck (H&N) malignancies negatively impacts survival. In this series, the effectiveness of low-dose-rate brachytherapy in the management of persistent H&N disease is explored.

Methods: All patients who received brachytherapy for persistent H&N disease between 1987 and 2002 were identified.

Simultaneous treatment of multiple basal cell carcinoma lesions.

We present a rare case of advanced basal cell carcinoma where multiple large lesions, located on the anterior chest wall and back, were treated simultaneously using tomotherapy (TomoTherapy HiArt; TomoTherapy Inc, Madison, WI). A 74-year-old man presented with seven to eight separate extensive lesions on his body, some with a duration of 7 years or more. The image-guidance component of tomotherapy allowed daily verification of the position of the target and critical structures, enabling accurate targeting in the vicinity of sensitive critical structures.

[The respiratory therapist].

Because of the expected significant growth in the elderly population and respiratory diseases, the topic of "delegation of physician's duties" is of increasing importance to the German health-care system. In 2004 the German Respiratory Society (Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin e. V.

Brachytherapy in the retreatment of patients with new primary head and neck cancer.

Objective: Re-treatment for cure of the Head and Neck (H&N) region is therapeutically challenging. In this review we explore the long-term results of Ir(192) low-dose-rate (LDR) brachytherapy in the select subgroup of patients treated for a new H&N malignancy.

Methods & Material: Thirteen patients received brachytherapy between 1987-2004 for a new primary H&N cancer, six of whom had been retreated previously.

Interstitial low-dose-rate brachytherapy in the treatment of recurrent head and neck malignancies.

Background: Recurrent head and neck malignancies are therapeutically challenging. Brachytherapy is a retreatment alternative to external-beam radiation therapy (EBRT).

Methods: Patients receiving brachytherapy during 1987-2004 for recurrent head and neck cancer were identified.

Penile brachytherapy: results for 49 patients.

Purpose: To report results for 49 men with squamous cell carcinoma (SCC) of the penis treated with primary penile interstitial brachytherapy at one of two institutions: the Ottawa Regional Cancer Center, Ottawa, and the Princess Margaret Hospital, Toronto, Ontario, Canada.

Methods And Materials: From September 1989 to September 2003, 49 men (mean age, 58 years; range, 22-93 years) had brachytherapy for penile SCC. Fifty-one percent of tumors were T1, 33% T2, and 8% T3; 4% were in situ and 4% Tx.

Clinical use of a commercial Monte Carlo treatment planning system for electron beams.

In 2002 we fully implemented clinically a commercial Monte Carlo based treatment planning system for electron beams. The software, developed by MDS Nordion (presently Nucletron), is based on Kawrakow's VMC++ algorithm. The Monte Carlo module is integrated with our Theraplan Plustrade mark treatment planning system.

Prognostic factors derived from recursive partition analysis (RPA) of Radiation Therapy Oncology Group (RTOG) brain metastases trials applied to surgically resected and irradiated brain metastatic cases.

Purpose: (a) To identify the prognostic factors that determine survival after surgical resection and irradiation of tumors metastatic to brain. (b) To determine if the prognostic factors used in the recursive partition analysis (RPA) of brain metastases cases from Radiation Therapy Oncology Group (RTOG) studies into three distinct survival classes is applicable to surgically resected and irradiated patients.

Method: The medical records of 125 patients who had surgical resection and radiotherapy for brain metastases from 1985 to 1997 were reviewed.

Serum prostate-specific antigen profile following radiotherapy for prostate cancer: implications for patterns of failure and definition of cure.

Objectives: A reference range of prostate-specific antigen (PSA) values compatible with cure following radiotherapy (RT) for prostate cancer (PCa) has yet to be established. Various thresholds, as low as 0.5 ng/mL, have been used to define biochemical disease-free status.

Radiotherapy for localized prostate carcinoma. The correlation of pretreatment prostate specific antigen and nadir prostate specific antigen with outcome as assessed by systematic biopsy and serum prostate specific antigen.

Background: The objective of this study was to correlate the failure pattern of localized prostate carcinoma after radiotherapy (RT) with pretreatment (preTx) PSA and post-RT nadir PSA, using systematic biopsies and serum PSA in the assessment of outcome.

Methods: From January 1990 to February 1994, 207 patients treated with external beam RT were followed prospectively with systematic transrectal ultrasound-guided biopsies and measurements of serum PSA levels. Three hundred forty-three biopsies were performed, with 4-7 samples taken per session.

Evaluation of radiation effect, tumor differentiation, and prostate specific antigen staining in sequential prostate biopsies after external beam radiotherapy for patients with prostate carcinoma.

Background: Sequential systematic biopsies after radiotherapy (RT) for prostate carcinoma were evaluated with respect to radiation effect, tumor differentiation, and prostate specific antigen (PSA) staining, and these histopathologic parameters were correlated with local outcome.

Methods: Since 1990, transrectal ultrasound-guided biopsies have been used to follow patients with localized prostate carcinoma after radical external RT at the General Hospital division of the Ottawa Regional Cancer Centre. Eighty-nine patients with residual tumor in 1 or more biopsies at 10-78 months of follow-up were selected for review.

Radiotherapy for localized prostate cancer: assessment of results by systematic biopsy and PSA.

This study attempted to determine the failure pattern after radiotherapy for localized prostate cancer using systematic biopsies and serum PSA in assessment of outcome. Between July 1987 and February 1993, 226 patients treated with radical external beam radiotherapy were followed prospectively with systematic transrectal ultrasound-guided biopsies and serum PSA. Four hundred and ten transrectal ultrasound-guided biopsies were performed with 4-7 samples (usually six) per session.

Effect of pelvic radiotherapy for prostate cancer on bowel, bladder, and sexual function: the patient's perspective.

Objectives: To document the effects of pelvic radiotherapy on bowel, bladder, and sexual function, as reported by the patient.

Methods: A confidential questionnaire was distributed to 202 prostate cancer patients. Mean age was 70 years (range, 49 to 87) and mean follow-up was 33 months (range, 12 to 72).

Prostate motion during standard radiotherapy as assessed by fiducial markers.

From November 1993 to August 1994, 55 patients with localized prostate carcinoma had three gold seeds placed in the prostate under transrectal ultrasound guidance prior to the start of radiotherapy in order to track prostate motion. Patients had a planning CT scan before initial simulation and again at about 40 Gy, just prior to simulation of a field reduction. Seed position relative to fixed bony landmarks (pubic symphysis and both ischial tuberosities) was digitized from each pair of orthogonal films from the initial and boost simulation using the Nucletron brachytherapy planning system.

Interstitial brachytherapy for penile carcinoma: an alternative to amputation.

From 1987 to 1994, 15 patients with penile saquamous cell carcinoma were referred to the Ottawa Regional Cancer Centre. Seven had already been managed surgically. The other eight were treated with interstitial implantation.

Routine prostate biopsies following radiotherapy for prostate cancer: results for 226 patients.

Objectives: To determine the time course of histologic resolution of prostate cancer following radiotherapy (RT) and to correlate biopsy results with clinical outcome.

Methods: Since July 1990, all patients treated with radical external beam RT for prostate cancer at the General Division of the Ottawa Regional Cancer Centre have had systematic transrectal ultrasound (TRUS) and TRUS-guided biopsies beginning 12 months after RT and then every 6 months until negative or until clinical failure. Thus, 226 patients have had 375 TRUS with four to seven specimens per examination.

Proliferative cell nuclear antigen in postradiotherapy prostate biopsies.

Purpose: To determine if staining for proliferative cell nuclear antigen (PCNA) can distinguish between biologically active and inactive "residual tumor" in postradiotherapy prostate biopsies by correlating PCNA staining with clinical outcome.

Methods And Materials: Since July 1990 all patients treated at the General Division of the Ottawa Regional Cancer Center with radical external beam radiotherapy for prostate cancer have had systematic transrectal ultrasound and transrectal ultrasound-guided biopsies beginning 12 months postradiotherapy. One hundred sixty-two patients have had 278 transrectal ultrasounds with four to seven biopsy specimens per examination.

Clinical relevance of trans-rectal ultrasound, biopsy, and serum prostate-specific antigen following external beam radiotherapy for carcinoma of the prostate.

Purpose: To correlate the results of routine transrectal ultrasound-guided prostate biopsies with the usual clinical parameters of digital rectal examination, prostate specific antigen and ultrasound in the follow-up of one hundred patients treated with radical radiotherapy for prostate cancer.

Methods And Materials: Stage distribution of the 100 patients was T1b; 19, T2a: 24, T2b: 36, T3: 20, T4: 1. Median follow-up is 26 months (range 15-48).

Brachytherapy of neck metastases.

Brachytherapy with iridium 192 was used in 20 patients with recurrent or persistent neck metastases from a primary head and neck carcinoma. Nine patients had intra-operative brachytherapy in combination with a neck dissection. Three patients had an implant as a boost following external beam radiotherapy.

A prospective study of ultrasound localization for renal shielding.

Accurate and reproducible shielding of sensitive tissues is essential in clinical radiotherapy. Renal localization is necessary when the kidneys are to be shielded during upper or whole abdominal radiotherapy. Despite extensive clinical experience with intravenous contrast media for renal localization, ultrasound has been proposed as a safer, more cost-effective alternative.