Interstitial HDR brachytherapy for advanced recurrent squamous cell carcinoma of the head and neck.

Background: Surgical treatment remains the mainstay therapy for recurrence of head and neck cancer after previous radiotherapy. In inoperable cases, interstitial high-dose rate brachytherapy is a treatment option for local dose escalation.

Patients And Methods: A retrospective analysis of all patients who were treated solely with brachytherapy for advanced non-resectable recurrences of squamous cell carcinomas of the head and neck and who previously received radiotherapy was performed.

Advantage of robotic needle placement on a prostate model in HDR brachytherapy.

Purpose: To compare the accuracy of the robot-assisted needle positioning with that of the conventional template-guided method with the help of a prostate model in high dose rate (HDR) brachytherapy.

Materials And Methods: A prostate model of fresh porcine abdomen and special polyvinylchloride (PVC) sheets was developed. To verify the model, deviations from 311 needle placements of real prostate implants were analyzed.

Preoxygenated hyperventilated hypocapnic apnea-induced radiation (PHAIR) in breast cancer patients.

Introduction: The study was performed to quantify the benefit of preoxygenated hyperventilated hypocapnic apnea-induced radiation (PHAIR) for breath hold (BH) time in patients with breast cancer.

Methods And Materials: We compared in a single blind study 6 healthy volunteers and 10 breast cancer patients using PHAIR. Both groups were subdivided into two arms, each including 4min eupnea and hyperventilation with 20 breaths/min to 19-20mmHG FeCO2 before apnea without (hBH) and with 100% oxygen (ohBH).

Atlas-based semiautomatic target volume definition (CTV) for head-and-neck tumors.

Purpose: To develop a new semiautomatic method to improve target delineation in head-and-neck cancer.

Methods And Materials: We implemented an atlas-based software program using fourteen anatomic landmarks as well as the most superior and inferior computerd tomography slices for automatic target delineation, using an advanced laryngeal carcinoma as an example. Registration was made by an affine transformation.

Fractionated stereotactic radiotherapy of glomus jugulare tumors. Local control, toxicity, symptomatology, and quality of life.

Background And Purpose: For glomus jugulare tumors, the goal of treatment is microsurgical excision. To minimize postoperative neurologic deficits, stereotactic radiosurgery (SRS) was performed as an alternative treatment option. Stereotactic fractionated radiotherapy (SRT) could be a further alternative.

Significant tumor volume reduction of meningiomas after stereotactic radiotherapy: results of a prospective multicenter study.

Objective: Stereotactic radiosurgery (SRS) is well established in the treatment of cranial base meningiomas. Fractionated stereotactic radiotherapy (SRT) offers an additional treatment option. Data for radiological regression differ, ranging from 13 to 61%.

Accuracy of single-session extracranial radiotherapy for simple shaped lung tumor or metastasis using fast 3-D CT treatment planning.

Background: This study is situated in the area of measuring set-up accuracy and time periods of single-session extracranial radiotherapy (SSRT) for simple-shaped targets (e.g., spherical or rotational symmetrical) definitively located in the peripheral lung.

Stereotactic radiotherapy of meningiomas: symptomatology, acute and late toxicity.

Background And Purpose: Stereotactic radiosurgery (SRS) is well established in the treatment of skull base meningiomas, but this therapy approach is limited to small tumors only. The fractionated stereotactic radiotherapy (SRT) offers an alternative treatment option. This study aims at local control, symptomatology, and toxicity.

Local irradiation prior to stem cell harvest has no influence on CD34+ yield: a quantitative analysis.

In patients with multiple myeloma, irradiation of bone marrow prior to mobilization of autologous peripheral blood progenitor cells (PBPCs) may lead to a reduced yield of CD34+ cells. Quantitative effects have not been sufficiently assessed. We retrospectively performed a multivariate analysis in 114 patients (67 men, 47 women) with multiple myeloma, of whom 53 (47%) patients had been irradiated prior to mobilization chemotherapy.

Evaluation of a laser system for CT software simulation (EXOMIO) in patients with breast cancer.

Purpose: To develop a manually movable laser system connected to the CT table for alignment of the isocenter cross of irradiation fields on the patient's skin directly after CT software simulation.

Material And Methods: The specially designed laser system was constructed in the authors' department, and the mean focusing accuracy of isocenter translations was analyzed using Alderson phantom measurements. The mean overall accuracy from setup to treatment of the whole procedure of CT software simulation was measured by the comparison of bone structures and mamma contour of the digitally reconstructed radiograph (DRR) with the verification film.

Methodology of continuous extracranial radiosurgery for lung cancer using EXOMIO 3-D CT simulation.

Background: It is well known that precision can be achieved using radiosurgery for brain tumors. This method can be extended to treat localized lung tumors and lung metastases.

Material And Methods: The conventional procedure of extracranial radiosurgery is contained in the following steps: adaptation of the vacuum mattress, planning CT, three-dimensional (3-D) treatment planning, CT repositioning, and irradiation.

Palliative interstitial HDR brachytherapy for recurrent rectal cancer. Implantation techniques and results.

Purpose: To report the methods and clinical results of CT-based interstitial high-dose-rate (HDR) brachytherapy procedures for the palliative treatment of recurrent rectal cancer.

Patients And Methods: A total of 44 brachytherapy implants were performed in 38 patients. CT-guided catheter implants were performed in 34 patients under local anesthesia and sedation, and four patients were implanted intraoperatively.

Radiotherapy for Graves' orbitopathy: results of a national survey.

Background: Graves' orbitopathy (GO) is a widely accepted indication for radiation therapy (RT). In conjunction with the German Cooperative Group on Radiotherapy for Benign Diseases (GCG-BD), a national survey was conducted in order to assess whether or not there is a consensus on the indication for RT and various treatment factors which were studied.

Material And Methods: A questionnaire was circulated to 190 RT institutions to obtain relevant data concerning the patients' workload, stage-dependent indication, and diagnostic procedures, which were considered to be necessary.

Accuracy of 3-d needle navigation in interstitial brachytherapy in various body regions.

Background: Precise immobilisation of a patient during extracranial stereotactic 3-D navigation is essential in order to minimize the patient's movement during CT data recording and needle application. In this paper we report the first results of needle positioning accuracy in various body regions, using a 3-D navigation system for brachytherapy and a new patient immobilisation system.

Patients And Methods: Six patients with different manifestations of neoplastic diseases were immobilized by a special vacuum system and treated with stereotactic 3-D navigational interstitial brachytherapy.

Hypofractionated radiotherapy for Graves' orbitopathy.

Background: Radiotherapy (RT) has been proven effective in the management of Graves' orbitopathy in numerous studies. Most commonly is the use of conventional fractionated RT and the value of hypofractionated irradiation has not been investigated.

Materials And Methods: The results in 33 euthyroid cases who underwent RT with a total dose of 21.

CT-based navigation systems for intraoperative radiotherapy using the afterloading-flab technique.

Introduction: The fact that conventional intraoperative radiotherapy does not give the opportunity to exactly document the radiation volume applied and the dose distribution has been criticized in many ways. We would like to introduce a system for surgical navigation and documentation of flap positioning in intraoperative brachytherapy using the afterloading flap technique.

Methods: Our system consists of an electromagnetic 3D-digitizer and a PC workstation.

[Intraoperative radiotherapy--progress with a CT-assisted navigation system].

Introduction: The fact that conventional intraoperative radiotherapy (IORT) does not give the opportunity for exact documentation of the applied radiation volume and dose distribution has been criticised. We would like to introduce a system for surgical navigation and documentation of the flab positioning for intraoperative brachytherapy in afterloading flab technique.

Methods: Our system consists of an electromagnetic 3D digitizer and a PC workstation.

Radiation therapy for the prevention of heterotopic ossification at the elbow.

We present nine patients (five men and four women) who underwent surgical excision of clinically significant heterotopic ossification at the elbow. They also received perioperative radiation therapy using total doses between 600 and 1000 cGy. Five received fractionated radiotherapy, with two fractions of 500 cGy applied on the first two postoperative days, and the remaining four were irradiated with single doses of 600 and 700 cGy.

[Radiotherapy in vertebral hemangioma].

Vertebral hemangiomas are the most common benign spinal tumors with an incidence range of 10-12%. Approximately 1-2% of the cases develop clinically significant symptoms causing the necessity for treatment. Based on our own results and a review of the literature we discuss the role of radiotherapy in the management of symptomatic vertebral hemangiomas.

[Radiotherapy in Langerhans-cell histiocytosis. 2 case reports and review of the literature].

The use of radiotherapy in the treatment of Langerhans' cell histiocytosis was first reported in the literature in 1930 and has been proven as effective in numerous studies. We present the results of two female adults with eosinophilic granuloma of bone who underwent conventionally fractionated radiation therapy with total doses of 7 x 1.8 Gy and 7 x 2.

3D interstitial HDR brachytherapy combined with 3D external beam radiotherapy and androgen deprivation for prostate cancer. Preliminary results.

Background: Evaluation of feasibility, tolerance and efficiency for a new 3D interstitial HDR brachytherapy technique combined with 3D external beam radiotherapy and androgen deprivation for prostate cancer.

Patients And Methods: Between January 1997 and August 1998 we treated 35 patients with stage cT1-3 N0 M0 prostate cancer. Thirty-two patients with a follow-up of 12 to 28 months (median: 18 months) were evaluated.

Reconstruction and navigation system for intraoperative brachytherapy using the flab technique for colorectal tumor bed irradiation.

Purpose: To present the development of a new navigation and reconstruction system based on an electromagnetic free-hand tracker and on CT imaging for treatment planning of intraoperative high-dose-rate brachytherapy (IORT-HDRB) in the sacral region. Our aim is to improve accuracy and to enable individualized treatment planning and dose documentation to be performed for IORT-HDRB using a flab technique.

Methods And Materials: The material consists of an electromagnetic 3D tracker system, a PC workstation with Microsoft Windows NT 4.

Navigation system for interstitial brachytherapy.

Purpose: To develop a computed tomography (CT) based electromagnetic navigation system for interstitial brachytherapy. This is especially designed for situations when needles have to be positioned adjacent to or within critical anatomical structures. In such instances interactive 3D visualisation of the needle positions is essential.

Neutrophils augment the release of TNFalpha from LPS-stimulated macrophages via hydrogen peroxide.

We examined the effect of polymorphonuclear cells on the release of tumor necrosis factor (TNFalpha) in endotoxin-treated macrophages. Human peripheral blood neutrophils were co-cultured with mouse peritoneal macrophages stimulated with lipopolysaccharide (LPS). In a dose-dependent manner, FMLP (n-formyl-methionyl-leucyl-phenylalanine) augmented the release of TNFalpha by LPS-stimulated macrophages in the presence, but not in the absence, of neutrophils.

Clinical relevance of tumor ploidy and micronucleus formation for oral cavity cancer.

Aims And Background: To study the clinical relevance of tumor ploidy and micronucleus formation as prognostic factors.

Methods And Study Design: Twenty-eight patients with squamous cell carcinoma of the oral cavity were treated with primary radiochemotherapy consisting of irradiation up to 70 Gy in combination with cisplatin. Cell cycle distribution, micronucleus formation and ploidy were evaluated by flow cytometry of biopsies taken before treatment and after irradiation to 10 Gy (5x2 Gy).