Localization of the prostatic apex for radiation treatment planning.

Purpose: To determine whether retrograde urethrogram, or the combination of computed tomography (CT) scan/retrograde urethrogram is more accurate for locating the magnetic resonance imaging (MRI) designated prostatic apex, and to determine whether patients treated in our department with CT/urethrogram are receiving the prescribed minimal dose to the MRI identified prostatic apex.

Methods And Materials: Seventeen patients with early stage prostate cancer were enrolled in a prospective study to determine the location of the prostatic apex. All of the patients agreed to undergo MRI in addition to retrograde urethrogram, and CT of the pelvis for three dimensional (3D) treatment planning.

Pretreatment prostate-specific antigen values in patients with prostate cancer: 1989 patterns of care study process survey.

Purpose: A Patterns of Care Study (PCS) national survey was conducted to show the national averages for processes of radiation therapy care for prostate cancer patients in 1989. In the current study we report an analysis of pretreatment prostate-specific antigen (PSA) by stage, grade, and ethnic origin.

Methods And Materials: Process data were collected from 672 patients treated in 1989 at 71 separate institutions.

Patterns of care survey results: treatment planning for carcinoma of the prostate.

Purpose: Treatment planning has been defined differently at various institutions to encompass tasks ranging from the initial evaluation of the patient to the delivery of the treatment as well as a more narrow view, focused primarily on isodose computation. To evaluate the impact of much of the new treatment-planning technology that has become available, it is necessary to define and develop recommended guidelines for the treatment-planning process.

Methods And Materials: The 1989 Patterns of Care Study (PCS) included questionnaires to access treatment planning practices currently in use for the entire census of oncology facilities in the United States.

Treatment planning for Hodgkin's disease: a patterns of care study.

Purpose: To conduct a survey of the process of treatment planning for the radiation treatment of Hodgkin's Disease in the United States, and to compare survey results with consensus guidelines as determined by recognized experts.

Methods And Materials: A consensus committee developed guidelines for the radiotherapeutic management of Hodgkin's Disease. A series of survey forms were designed to evaluate the standards of practice and compare these with the consensus guidelines.

Polarographic needle electrode measurements of oxygen in rat prostate carcinomas: accuracy and reproducibility.

Purpose: The oxygenation status of tumors may be important for predicting tumor response to therapy. Previous studies with the anaplastic (R3327-AT) and well-differentiated (R3327-H) Dunning rat prostate tumors using indirect assays of tumor oxygenation indicated the relative hypoxic and radioresistant nature of the anaplastic tumor. We now report direct measurements of oxygen in these tumors made with the pO2 histograph to determine: (a) whether a significant difference in oxygenation status could be detected between them: (b) whether sequential measurements on the same tumor gave similar values; and (c) whether tumor oxygenation correlated with tumor volume.

Clinical and biochemical evidence of control of prostate cancer at 5 years after external beam radiation.

Purpose: We demonstrate the 5-year survival rate for patients with prostate cancer treated by irradiation, the value of the conformal technique and prostate specific antigen (PSA) doubling times after irradiation.

Materials And Methods: The outcome of 502 consecutive patients with stages T1 to T3 prostate cancer treated by irradiation alone is reported. PSA doubling times before and after failure are reported for 13 patients and posttreatment PSA doubling times are reported for 93 consecutive patients in whom radiation failed.

Carcinoma of the cervix: patterns of care studies: review of 1978, 1983, and 1988-1989 surveys.

Purpose: A review of the Patterns of Care Studies Process Survey data on carcinoma of the cervix conducted on patients in 1978, 1983, and 1988-89 was carried out to identify changes or trends in the demographics, evaluation, and treatment that might have occurred over this time period.

Methods And Materials: Patterns of Care Studies conducted surveys on patients treated by radiation therapy for cervical carcinoma in 1978, 1983, and 1988-89. These surveys have compiled demographic and treatment data on a total of 993 patients.

Treatment of adenocarcinoma of the stomach with resection, intraoperative radiotherapy, and adjuvant external beam radiation: a phase II study from Radiation Therapy Oncology Group 85-04.

Background: Fewer than 10% of patients presenting with adenocarcinoma of the stomach in the United States can expect to be cured. These discouraging results have led to trials of various adjuvant therapies. Some studies suggest a role for radiation in improving regional control.

Management of adenocarcinoma of the esophagus with chemoradiation alone or chemoradiation followed by esophagectomy: results of sequential nonrandomized phase II studies.

Purpose: The incidence of adenocarcinoma of the esophagus is increasing, but the optimal treatment for this disease is unknown. We evaluated the efficacy of chemoradiation and chemoradiation followed by esophagectomy as treatment for adenocarcinoma of the esophagus in sequential prospective nonrandomized phase II studies.

Methods And Materials: Between May 1981 and June 1992, all previously untreated patients (N = 35) with potentially resectable adenocarcinoma of the esophagus (clinical Stage I or II) were treated with curative intent in sequential prospective Phase II studies.

Incidence of and factors related to late complications in conformal and conventional radiation treatment of cancer of the prostate.

Purpose: The fundament hypothesis of conformal radiation therapy is that tumor control can be increased by using conformal treatment techniques that allow a higher tumor dose while maintaining an acceptable level of complications. To test this hypothesis, it is necessary first to estimate the incidence of morbidity for both standard and conformal fields. In this study, we examine factors that influence the incidence of late Grade 3 and 4 morbidity in patients treated with conformal and standard radiation treatment for prostate cancer.

Prostate specific antigen density is not an independent predictor of response for prostate cancer treated by conformal radiotherapy.

Although prostate specific antigen (PSA) density appears to be an important discriminator between benign and malignant prostatic disease, conflicting data exist concerning its prognostic value. The present study was undertaken to confirm whether PSA density represents a new prognostic indicator of disease-free survival for prostate cancer treated with conformal radio-therapy. Between April 1989 and December 1992, 186 patients with organ confined prostate cancer were treated with definitive irradiation according to previously published conformal guidelines.

Conformal treatment of prostate cancer with improved targeting: superior prostate-specific antigen response compared to standard treatment.

Purpose: Conformal radiation therapy (CRT) decreases the morbidity of prostate cancer treatment, but no published data attest to the improved ability of CRT to control disease. Therefore, we compared Prostate-Specific Antigen (PSA) response at 1 year among similarly staged patients treated by conformal techniques to those treated with conventional approaches, looking for an early indicator of tumor response.

Method And Materials: Patients with locally advanced disease were treated by pelvic field followed by prostate field conedowns; those with early stage/low grade disease received only prostate field irradiation.

Treatment planning structure and process in the United States: a "Patterns of Care" study.

Purpose: To conduct a study of the structure and process of treatment planning in the United States.

Methods And Materials: A Patterns of Care treatment planning consensus committee developed a survey form that was used to gather data for 106 items relating to the structure and process of treatment planning. These questions were general in nature and not specific to any particular disease site.

An evaluation of setup uncertainties for patients treated to pelvic sites.

Purpose: Successful delivery of conformal fields requires stringent immobilization and treatment verification, as well as knowledge of the setup reproducibility. The purpose of this study was to compare the three-dimensional distribution of setup variations for patients treated to pelvic sites with electronic portal imaging devices (EPID) and portal film.

Methods And Materials: Nine patients with genitourinary and gynecological cancers immobilized with custom casts and treated with a four-field whole-pelvis technique were imaged daily using an EPID and filmed once every five to seven treatments.

Cancer pain and the importance of its control.

In 1985 there were almost 5 million deaths from cancer, and it is estimated that in 2015 there will be over 9 million, of which almost three-quarters will be in developing countries. Seventy to eighty per cent of these patients will experience moderate or severe pain at some stage of their illness and at present most of these will die in pain. This is true in spite of the fact that there is substantial evidence which shows that in as many as 80% of patients with cancer pain it is possible to obtain complete relief with orally administered analgesics, either alone or supplemented with co-analgesic (adjuvant) drugs.

Use of a truss to maintain inguinal hernia reduction in a very low birth weight infant.

Trusses are not usually used in management of inguinal hernia of the very low birth weight infant. A potential benefit of this therapy is maintenance of hernia reduction, thus delaying operative repair until the infant is larger and healthier. We designed a safe and effective truss with supplies found in most neonatal intensive care units.

Do the current subclassifications of stage T3 adenocarcinoma of the prostate have clinical relevance?

Objectives: To compare the outcome of patients with T3a and T3c adenocarcinoma of the prostate and determine the utility of these substages as defined in the current American Joint Committee on Cancer and the International Union Against Cancer (AJCC/UICC) staging system.

Methods: An analysis was performed of patients with T3 (clinical) prostate cancer treated with definitive irradiation at the Fox Chase Cancer Center between 1986 and 1993. The series was composed of 66 patients with T3a tumors and 44 patients with T3c tumors.

Long-term results of treatment of cervical carcinoma in the United States in 1973, 1978, and 1983: Patterns of Care Study (PCS).

Purpose: To extend the observations of patients with carcinoma of the cervix treated in 1973 for over 15 years, in 1978 for over 10 years, and in 1983 for over 5 years for survival and local control to compare treatment times and outcome.

Methods And Materials: A nationwide survey of the patterns of practice in radiation therapy for patients with squamous carcinoma of the cervix collected pretreatment and treatment data using external surveyors who reviewed patients' records. Outcome information was updated for the three separate databases by mail survey.