Local control in non-metastatic medulloblastoma.

Background: A single-institution review of long-term outcomes and factors affecting local control (LC) following radiotherapy for non-metastatic medulloblastoma.

Material And Methods: From 1963 to 2008, 50 children (median age, 7.3 years; range 1.

Late toxicity following craniospinal radiation for early-stage medulloblastoma.

Background: The purpose of this study is to review late toxicity following craniospinal radiation for early-stage medulloblastoma.

Material And Methods: Between 1963 and 2008, 53 children with stage M0 (n = 50) or M1 (n = 3) medulloblastoma were treated at our institution. The median age at diagnosis was 7.

Hypofractionated passively scattered proton radiotherapy for low- and intermediate-risk prostate cancer is not associated with post-treatment testosterone suppression.

Background: To investigate post-treatment changes in serum testosterone in low- and intermediate-risk prostate cancer patients treated with hypofractionated passively scattered proton radiotherapy.

Material And Methods: Between April 2008 and October 2011, 228 patients with low- and intermediate-risk prostate cancer were enrolled into an institutional review board-approved prospective protocol. Patients received doses ranging from 70 Cobalt Gray Equivalent (CGE) to 72.

Urinary functional outcomes and toxicity five years after proton therapy for low- and intermediate-risk prostate cancer: results of two prospective trials.

Background: To assess genitourinary (GU) function and toxicity in patients treated with image-guided proton therapy (PT) for early- and intermediate-risk prostate cancer and to analyze the impact of pretreatment urinary obstructive symptoms on urinary function after PT.

Material And Methods: Two prospective trials accrued 171 prostate cancer patients from August 2006 to September 2007. Low-risk patients received 78 cobalt gray equivalent (CGE) in 39 fractions and intermediate-risk patients received 78-82 CGE.

Radiation therapy target volume reduction in pediatric rhabdomyosarcoma: implications for patterns of disease recurrence and overall survival.

Background: The use of radiation therapy (RT) "cone-down" boost to reduce high-dose treatment volumes according to tumor response to induction chemotherapy in patients with pediatric rhabdomyosarcoma (RMS) may reduce treatment morbidity, yet the impact on tumor control is unknown.

Methods: Fifty-five children, including 18 (33%) with parameningeal (PM) RMS and 37 (67%) with non-PM RMS, who received definitive treatment with chemotherapy and RT from April 2000 through January 2010 were retrospectively reviewed.

Results: In total, 28 patients (51%) received a cone-down boost.

Radiation therapy for hemangioendothelioma: the university of Florida experience.

Objectives: The benefit of radiotherapy (RT) for unresectable hemangioendotheliomas or patients with a high risk of local recurrence is unclear. This single-institution report describes the long-term effectiveness of RT for hemangioendothelioma.

Methods: From 1976 to 2009, 14 patients with nonmetastatic hemangioendothelioma were treated with RT at our institution.

Long-term results following postoperative radiotherapy for soft tissue sarcomas of the extremity.

Purpose: To review long-term outcomes following postoperative radiotherapy (RT) for extremity soft tissue sarcoma (STS) and identify variables affecting the therapeutic ratio.

Methods And Materials: Between 1970 and 2008, 173 patients with localized extremity STS were treated with postoperative radiation. No patients received prior irradiation.

Erectile function, incontinence, and other quality of life outcomes following proton therapy for prostate cancer in men 60 years old and younger.

Background: This study sought to evaluate patient-reported health-related quality of life following proton therapy for prostate cancer in men ≤ 60 years old.

Methods: Between August 2006 and January 2010, 262 hormone-naive men ≤ 60 years old were treated with definitive proton therapy for prostate cancer. Before treatment and every 6 months after treatment, patients filled out the Expanded Prostate Index Composite (EPIC) and the International Index of Erectile Function (IIEF) questionnaires.

The significance of a marginal excision after preoperative radiation therapy for soft tissue sarcoma of the extremity.

Background: Marginal excision of soft tissue sarcoma (STS), defined as resection through the tumor pseudocapsule or surrounding reactive tissue, increases the likelihood of local recurrence and necessitates re-excision or postoperative radiation. However, its impact after preoperative radiation therapy (RT) remains unclear. This study therefore investigated the significance of marginal margins in patients treated with preoperative RT for extremity STS, reporting long-term local control and limb preservation endpoints.

Multimodality local therapy for retroperitoneal sarcoma.

Purpose: Soft-tissue sarcomas of the retroperitoneum are rare tumors comprising less than 1% of all malignancies. Although surgery continues as the mainstay of treatment, the large size of these tumors coupled with their proximity to critical structures make resection with wide margins difficult to achieve. The role and timing of radiotherapy are controversial.

Fractionated radiotherapy in the management of benign vascular tumors.

Purpose: To better characterize the long-term therapeutic ratio of fractionated radiotherapy for benign vascular and lymphatic tumors.

Methods: We retrospectively reviewed 19 medical records with 13 hemangiomas, 3 hemangioblastomas, and 3 benign lymphatic tumors treated with radiotherapy at the University of Florida from 1984 to 2007 to assess clinical presentation, treatment, and outcomes. The 10 men and 9 women had a median age of 43 years (range, 2 to 74 y).

Consolidative Proton Therapy Following High-dose Chemotherapy and Autologous Stem Cell Transplant in an Adolescent with Relapsed Hodgkin Lymphoma.

We present a case of an adolescent male with relapsed Hodgkin lymphoma involving the mediastinum two years following chemotherapy without radiotherapy. The patient was treated with second-line chemotherapy followed by high-dose chemotherapy and autologous stem cell transplant and then presented for evaluation of consolidative involved-field proton therapy (PT). Comparative treatment plans were developed with three-dimensional X-ray radiotherapy (3DXRT) and PT.

Dosimetric characterization of whole brain radiotherapy of pediatric patients using modulated proton beams.

This study was designed to investigate dosimetric variations between proton plans with (PPW) and without (PPWO), a compensator for whole brain radiotherapy (WBRT). The retrospective study on PPW and PPWO in Eclipse and XiO systems and photon plans (XP) using controlled segments in Pinnacle system was performed on nine pediatric patients for craniospinal irradiations. DVHs and derived metrics, such as the homogeneity index (HI), the doses to 2% (D(2%)) and 5% (D(5%)) volumes, and mean dose (D(mean)) of the whole brain (i.

Proton radiotherapy for prostate cancer is not associated with post-treatment testosterone suppression.

Purpose: Three independent studies of photon (x-ray) radiotherapy (RT) for prostate cancer have demonstrated evidence of testosterone suppression after treatment. The present study was undertaken to determine whether this would also be the case with conformal protons.

Methods And Materials: Between August 2006 and October 2007, 171 patients with low- and intermediate-risk prostate cancer were enrolled and underwent treatment according to the University of Florida Proton Therapy Institute institutional review board-approved PR01 and PR02 protocols.

Second tumors in pediatric patients treated with radiotherapy to the central nervous system.

Objective: To determine the rate of second tumors in pediatric patients treated with radiotherapy to the central nervous system (CNS) with long-term follow-up.

Methods: We retrospectively reviewed the charts of 370 consecutive pediatric patients with solid tumors and leukemia treated at the University of Florida from 1963 to 2006 with curative CNS radiotherapy. The median age was 8.

Early outcomes from three prospective trials of image-guided proton therapy for prostate cancer.

Purpose: To report early outcomes with image-guided proton therapy for prostate cancer.

Methods And Materials: We accrued 211 prostate cancer patients on prospective Institutional Review Board-approved trials of 78 cobalt gray equivalent (CGE) in 39 fractions for low-risk disease, dose escalation from 78 to 82 CGE for intermediate-risk disease, and 78 CGE with concomitant docetaxel followed by androgen deprivation for high-risk disease. Minimum follow-up was 2 years.

Titanium screws as fiducial markers for image-guided stereotactic proton irradiation in pediatric central nervous system tumors: a technical report.

Objectives: Fiducial markers (FM) have been used to enhance the accuracy of radiation therapy in central nervous system (CNS) tumors. Recently, image-guided radiotherapy utilizing FM has been used in proton therapy of CNS tumors. We describe our surgical technique of placement of titanium screws as cranial FM in children undergoing proton therapy for CNS tumors.

Chest wall Ewing sarcoma family of tumors: long-term outcomes.

Purpose: To review the 40-year University of Florida experience treating Ewing sarcoma family of tumors of the chest wall.

Methods And Materials: Thirty-nine patients were treated from 1966 to 2006. Of the patients, 22 were treated with radiotherapy (RT) alone, and 17 patients were treated with surgery with or without RT.

Intracranial ependymomas treated with radiotherapy: long-term results from a single institution.

The purpose of the study is to report long-term outcomes following surgery and radiotherapy for intracranial ependymoma. We retrospectively reviewed the medical records of patients treated with radiotherapy for localized intracranial ependymomas from 1964 to 2006. Patients with subependymomas and ependymoblastomas, and those undergoing re-irradiation, were excluded.

Ewing tumors of the head and neck.

Purpose: Retrospective review describing the 40-year University of Florida experience treating Ewing tumors of the head-and-neck region with a summary of the pertinent literature.

Patients And Methods: Nine patients were diagnosed and treated for Ewing sarcoma of the head and neck at our institution between 1965 and 2007. Primary sites included: mandible (3 patients), calvarium (2 patients), paranasal sinus (2 patients), oral cavity (1 patient), and the extraosseous soft tissue of the neck (1 patient).

Incidence, risks, and sequelae of posterior fossa syndrome in pediatric medulloblastoma.

Purpose: To investigate the incidence, risks, severity, and sequelae of posterior fossa syndrome (PFS) in children with medulloblastoma.

Methods And Materials: Between 1990 and 2007, 63 children with medulloblastoma at Emory University and Children's Healthcare of Atlanta were treated with craniectomy followed by radiation. Fifty-one patients were assigned to a standard-risk group, and 12 patients were assigned to a high-risk group.

Spinal and paraspinal Ewing tumors.

Purpose: To perform a review of the 40-year University of Florida experience treating spinal and paraspinal Ewing tumors.

Patients And Methods: A total of 27 patients were treated between 1965 and 2007. For local management, 21 patients were treated with radiotherapy (RT) alone and 6 with surgery plus RT.

Changes in incidence and survival of Ewing sarcoma patients over the past 3 decades: Surveillance Epidemiology and End Results data.

Purpose: The US population-based cancer registry Surveillance, Epidemiology, and End Results (SEER) database provides an opportunity to evaluate the incidence and survival rates of Ewing sarcoma (ES) for the past 3 decades. This analysis reflects trends for the diagnosis of localized versus metastatic disease and changes in ES survival in a setting of wide-ranging cancer care institutions across the United States, which is expected to be different from clinical trials published to date.

Materials/methods: Data from the SEER public-access database were reviewed for the diagnosis of ES of the bone among patients of 1 to 19 years of age between 1973 and 2004.