Early clinical outcomes for 3 radiation techniques for brain metastases: focal versus whole-brain.

Purpose: To present our novel technique for brain metastases (low-dose whole brain radiation therapy [WBRT] with simultaneous integrated boost (SIB) and focal, frameless stereotactic intensity modulated radiotherapy [IMRT]) in the context of patterns of failure, dosimetry, acute toxicity, and overall survival for 3 different radiation techniques.

Methods And Materials: We retrospectively reviewed 92 patients undergoing radiation for brain metastases via the following: (1) "prophylactic" WBRT to a low dose (median 30 Gy) with an SIB to the gross tumor volume plus 2-3 mm margin (median dose 45 Gy) in 10-15 fractions; (2) focal, frameless image-guided stereotactic IMRT (S-IMRT) in 5 fractions to tumor only (median 30 Gy); or (3) conventional (c)WBRT using 2 lateral opposed beams in 10-15 fractions (30-37.5 Gy).

Superiority of equivalent uniform dose (EUD)-based optimization for breast and chest wall.

We investigate whether IMRT optimization based on generalized equivalent uniform dose (gEUD) objectives for organs at risk (OAR) results in superior dosimetric outcomes when compared with multiple dose-volume (DV)-based objectives plans for patients with intact breast and postmastectomy chest wall (CW) cancer. Four separate IMRT plans were prepared for each of the breast and CW cases (10 patients). The first three plans used our standard in-house, physician-selected, DV objectives (phys-plan); gEUD-based objectives for the OARs (gEUD-plan); and multiple, "very stringent," DV objectives for each OAR and PTV (DV-plan), respectively.

Multidisciplinary treatment of synchronous primary rectal and prostate cancers.

Background: A 58-year-old Caucasian man with a history of irritable bowel syndrome and occasional rectal bleeding presented with a 4-week history of progressive, bright red blood per rectum. A digital rectal examination revealed a 3 cm distal, midrectal mass. Laboratory tests showed an elevated serum prostate-specific antigen of 32 ng/ml but other physical and medical examinations were unremarkable.