Validation of a web-based predictive nomogram for ipsilateral breast tumor recurrence after breast conserving therapy.

PURPOSE IBTR! version 1.0 is a web-based tool that uses literature-derived relative risk ratios for seven clinicopathologic variables to predict ipsilateral breast tumor recurrence (IBTR) after breast-conserving therapy (BCT). Preliminary testing demonstrated over-estimation in high-risk subgroups.

Impact of axillary lymph node dissection on breast cancer outcome in clinically node negative patients: a systematic review and meta-analysis.

Background: The regional lymph node control and survival impact of axillary dissection in breast cancer has been the subject of multiple randomized trials, with various results. This study reviews and conducts a meta-analysis of contemporary trials of axillary dissection in patients with early stage breast cancer.

Methods: A systematic MEDLINE review identified 3 randomized trials published between January 2000 and January 2007 of axillary dissection versus no dissection in clinically lymph node negative early stage breast cancer patients.

Predicting the risk of local recurrence in patients with breast cancer: an approach to a new computer-based predictive tool.

Objective: To develop a new web-based tool, designated IBTR!, which integrates prognostic factors for local recurrence (LR) into a model to predict the 10-year risk of LR after breast conserving surgery (BCS) with or without radiation therapy (RT) with the goal of assisting with patient counseling and medical decision-making.

Methods: All available randomized trials of BCS alone versus BCS plus RT, meta-analyses, and institutional reports were reviewed to identify the principal prognostic factors for LR after breast-conserving therapy. Patient age, margin status, lymphovascular invasion (LVI), tumor size, tumor grade, use of chemotherapy, and use of hormonal therapy were found to consistently and significantly impact LR across multiple studies.

Intensity modulated radiation therapy: a review of current practice and future directions.

The use of intensity modulated radiation therapy (IMRT) has been rapidly growing in the United States. This technology is now being used in a multitude of academic and community centers throughout the country and is being incorporated into the treatment of cancers in almost every anatomical site, most commonly head and neck cancer, central nervous system tumors, and prostate cancer. In addition, current protocols are investigating the use of IMRT for the treatment of breast cancer, lung cancer, abdominal/retroperitoneal malignancies, and gynecological diseases.

Impact on rectal dose from the use of a prostate immobilization and rectal localization device for patients receiving dose escalated 3D conformal radiation therapy.

Purpose: When >25% of the rectum is irradiated to > or = 70 Gy, the risk of developing Grade 2 or higher rectal complications is significantly increased. This study evaluates the impact on dose to the rectum from the use of an intrarectal (IR) balloon device, previously shown to immobilize the prostate gland and localize the rectum, in patients receiving dose escalated 3-dimentional (3D) conformal radiation therapy.

Materials And Methods: From July 2001 through February 2003, 28 consecutive patients with prostate cancer underwent computerized tomography-based simulation with and without the IR balloon in place.