The impact of tumor volume and radiotherapy dose on outcome in previously irradiated recurrent squamous cell carcinoma of the head and neck treated with stereotactic body radiation therapy.

Purpose: To assess the effect of stereotactic body radiotherapy (SBRT) dose and tumor volume on outcomes in patients with recurrent, previously irradiated squamous cell carcinoma of the head and neck.

Materials And Methods: A total of 96 patients with recurrent, previously irradiated squamous cell carcinoma of the head and neck were treated with SBRT using Cyberknife and Trilogy-intensity-modulated radiosurgery. Kaplan-Meier survival analyses were used to estimate locoregional control (LRC) and overall survival rates.

A simple and effective daily pain management method for patients receiving radiation therapy for painful bone metastases.

Purpose: The incidence of painful bone metastases increases with longer survival times. Although external beam radiation therapy (EBRT) is an effective palliative treatment, it often requires several days from the start of treatment to produce a measurable reduction in pain scores and a qualitative amelioration of patient pain levels. Meanwhile, the use of analgesics remains the best approach early on in the treatment course.

Stereotactic body radiotherapy for recurrent squamous cell carcinoma of the head and neck: results of a phase I dose-escalation trial.

Purpose: To evaluate the safety and efficacy of stereotactic body radiotherapy (SBRT) in previously irradiated patients with squamous cell carcinoma of the head and neck (SCCHN).

Patients And Methods: In this Phase I dose-escalation clinical trial, 25 patients were treated in five dose tiers up to 44 Gy, administered in 5 fractions over a 2-week course. Response was assessed according to the Response Evaluation Criteria in Solid Tumors and [(18)F]-fluorodeoxyglucose standardized uptake value change on positron emission tomography-computed tomography (PET-CT).

PET-CT in radiation oncology: the impact on diagnosis, treatment planning, and assessment of treatment response.

Objective: To review the role of hybrid positron emission tomography (PET)-computed tomography (CT) systems in the design and management of cancer patients in the modern radiation oncology practice. PET is co-registered with CT and incorporated into a systematic approach to the staging, management, and assessment of response and surveillance of a variety of oncologic diagnoses.

Methods: A review of the literature of functional imaging such as PET-CT in staging, treatment plan design, assessment of response and detection of recurrence for tumors involving the head and neck, lung, esophagus, rectum amongst others.

Four-dimensional computed tomography-based interfractional reproducibility study of lung tumor intrafractional motion.

Purpose: To evaluate the interfractional reproducibility of respiration-induced lung tumors motion, defined by their centroids and the intrafractional target motion range.

Methods And Materials: Twentythree pairs of four-dimensional/computed tomography scans were acquired for 22 patients. Gross tumor volumes were contoured, Clinical target volumes (CTVs) were generated.

Assessment of "best practice" treatment patterns for a "radiation oncology community outreach group" engaged in cancer disparities outcomes.

Objective: Minority patients with cancer have higher recurrence rates than the general population and are more likely to be treated at community centers where the standard of care has been reported to be inferior to that at academic centers. These issues are being explored by Radiation Oncology Community Outreach Group (ROCOG), a consortium of 5 Community Radiation Oncology centers participating in a National Cancer Institute-funded Disparities Grant. As a quality assurance/quality improvement initiative, this study was undertaken to ensure that treatment was at a "best practice" level.

Deferring planned neck dissection following chemoradiation for stage IV head and neck cancer: the utility of PET-CT.

Objective: To determine whether combined positron emission tomography and computed tomography (PET-CT) may be of value in deferring planned neck dissections for patients with advanced head and neck squamous cell carcinoma (HNSCC).

Study Design: Observational study of patients with de novo cervical > or =N2 regional spread of HNSCC in a tertiary care academic medical center.

Methods: Forty-three patients were identified who underwent post-treatment PET-CT within 6 months of completing neoadjuvant chemotherapy combined with radiation therapy (CRT).

Radiation Treatment Planning for Head and Neck Malignancies.

Innovative approaches have been incorporated to radiation therapy over the last decades. The technologic advances, such as intensity modulated radiation therapy and image guided radiation have resulted in a modern era for this oncologic modality. The mix of imaging approach using computed tomography (CT), magnetic resonance, and positron emission tomography (PET) have been of great value to ascertain the accuracy of tumor target delineation.

Dosimetric and toxicity comparison between prone and supine position IMRT for endometrial cancer.

Purpose: To determine the dosimetric and toxicity differences between prone and supine position intensity-modulate radiotherapy in endometrial cancer patients treated with adjuvant radiotherapy.

Methods: Forty-seven consecutive endometrial cancer patients treated with adjuvant RT were analyzed. Of these, 21 were treated in prone position and 26 in the supine position.

Posttreatment assessment of response using FDG-PET/CT for patients treated with definitive radiation therapy for head and neck cancers.

Purpose: The goal of this study was to evaluate coregistered [18F] fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) for the detection of persistent disease after definitive radiation therapy in head and neck cancer.

Methods And Materials: Posttreatment FDG-PET/CT was performed in 28 patients on average 8 weeks (range, 4 to 15.7 weeks) after completing definitive radiation therapy.

Advances in image-guided radiation therapy--the role of PET-CT.

In the era of image-guided radiation therapy (IGRT), the greatest challenge remains target delineation, as the opportunity to maximize cures while simultaneously decreasing radiation dose to the surrounding normal tissues is to be realized. Over the last 2 decades, technological advances in radiographic imaging, biochemistry, and molecular biology have played an increasing role in radiation treatment planning, delivery, and evaluation of response. Previously, fluoroscopy formed the basis of radiation treatment planning.

Hybrid PET-CT simulation for radiation treatment planning in head-and-neck cancers: a brief technical report.

Purpose: To prospectively study the impact on tumor and normal tissue delineation for RT planning by use of hybrid PET-CT simulation for patients with head-and-neck cancer.

Methods And Materials: Twenty-one patients were simulated in treatment position on a hybrid PET-CT scanner. Images were transferred to the Varian Eclipse planning system.