The Prognostic Significance of Facial Nerve Involvement in Carcinomas of the Parotid Gland.

Importance And Background: Facial nerve (FN) palsy and perineural invasion (PNI) are adverse features in carcinomas of the parotid gland. FN sacrifice at the time of surgery is associated with significant morbidity. The role of adjuvant radiotherapy in patients with high-risk features, including FN involvement, remains unclear.

Gynecologic Cancer InterGroup (GCIG) consensus review: uterine and ovarian leiomyosarcomas.

Objectives: The Gynecologic Cancer InterGroup aimed to provide an overview of uterine and ovarian leiomyosarcoma management.

Methods: Published articles and author experience were used to draft management overview. The draft manuscript was circulated to international members of the Gynecologic Cancer InterGroup for review and comment, and appropriate revisions were made.

Factors associated with improved survival after resection of pancreatic adenocarcinoma: a multivariable model.

Background: Several retrospective studies suggest that perioperative care and anesthetic management for cancer resection may influence cancer recurrence or patient survival. Various intraoperative techniques such as paravertebral blocks, decreased opioid use, immunomodulation, and perioperative antiinflammatory administration, have previously been assessed for improved patient survival. The aim of this study was to assess associations between perioperative management and survival in patients undergoing resection of pancreatic adenocarcinoma.

Comparison and consensus guidelines for delineation of clinical target volume for CT- and MR-based brachytherapy in locally advanced cervical cancer.

Objective: To create and compare consensus clinical target volume (CTV) contours for computed tomography (CT) and 3-Tesla (3-T) magnetic resonance (MR) image-based cervical-cancer brachytherapy.

Methods And Materials: Twenty-three experts in gynecologic radiation oncology contoured the same 3 cervical cancer brachytherapy cases: 1 stage IIB near-complete response (CR) case with a tandem and ovoid, 1 stage IIB partial response (PR) case with tandem and ovoid with needles, and 1 stage IB2 CR case with a tandem and ring applicator. The CT contours were completed before the MRI contours.

Patterns of care with brachytherapy for cervical cancer.

Objective: Concurrent chemotherapy with external beam radiotherapy (EBRT) and brachytherapy (BT) is critical to the curative treatment of locally advanced cervical cancer. Patterns of care and the use of EBRT and BT for locally advanced cervical cancer in the United States were analyzed with an emphasis on regional variation across the United States.

Methods/materials: A retrospective analysis was performed using the Surveillance, Epidemiology, and End Results Program database from 1988 to 2010 to identify women with locally advanced cervical carcinoma treated with definitive radiotherapy.

Cardiac, skeletal, and smooth muscle mitochondrial respiration: are all mitochondria created equal?

Unlike cardiac and skeletal muscle, little is known about vascular smooth muscle mitochondrial respiration. Therefore, the present study examined mitochondrial respiratory rates in smooth muscle of healthy human feed arteries and compared with that of healthy cardiac and skeletal muscles. Cardiac, skeletal, and smooth muscles were harvested from a total of 22 subjects (53 ± 6 yr), and mitochondrial respiration was assessed in permeabilized fibers.

Radiation therapy oncology group gynecologic oncology working group: comprehensive results.

The purpose of this report was to comprehensively describe the activities of the Gynecologic Oncology Working Group within the Radiation Therapy Oncology Group (RTOG). Clinical trials will be reviewed as well as translational science and ancillary activities. During the past 40 years, a myriad of clinical trials have been performed within the RTOG with the aim of improving overall survival (OS) and decreasing morbidity in women with cervical or endometrial cancer.

Survival analysis of endometrial cancer patients with cervical stromal involvement.

Objective: Stage II endometrial cancer is relatively uncommon. There is no consensus for appropriate adjuvant therapy in endometrial cancer patients with cervical stromal involvement (International Federation of Gynecology and Obstetrics [FIGO] stage II). This study investigates how adjuvant treatments and tumor characteristics influence overall survival (OS) and disease-free survival (DFS) in stage II patients in order to establish better treatment guidelines.

The KRAS-variant and miRNA expression in RTOG endometrial cancer clinical trials 9708 and 9905.

Objective: To explore the association of a functional germline variant in the 3'-UTR of KRAS with endometrial cancer risk, as well as the association of microRNA (miRNA) signatures and the KRAS-variant with clinical characteristics and survival outcomes in two prospective RTOG endometrial cancer trials.

Methods/materials: The association of the KRAS-variant with endometrial cancer risk was evaluated by case-control analysis of 467 women with type 1 or 2 endometrial cancer and 582 age-matched controls. miRNA and DNA were isolated for expression profiling and genotyping from tumor specimens of 46 women with type 1 endometrial cancer enrolled in RTOG trials 9708 and 9905.

Effect of brachytherapy technique and patient characteristics on cervical cancer implant dosimetry.

Our purpose was to evaluate the relationship between brachytherapy technique and patient characteristics on dose to organs-at-risk (OARs) in patients undergoing high dose rate (HDR) brachytherapy for cervical cancer. From 1998 to 2008, 31 patients with cervical cancer with full dosimetric data were identified who received definitive external-beam radiation and HDR brachytherapy with tandem and ovoid applicators. Doses were recorded at point A, the International Commission on Radiation Units and Measurements (ICRU)-38 rectal point, the ICRU-38 bladder point, the vaginal surface, and the pelvic sidewall.

Self-expanding stent effects on radiation dosimetry in esophageal cancer.

It is the purpose of this study to evaluate how self-expanding stents (SESs) affect esophageal cancer radiation planning target volumes (PTVs) and dose delivered to surrounding organs at risk (OARs). Ten patients were evaluated, for whom a SES was placed before radiation. A computed tomography (CT) scan obtained before stent placement was fused to the post-stent CT simulation scan.

Survival Analysis of Cancer Patients With FIGO Stage IIIA Endometrial Cancer.

Objective: Endometrial cancer patients with positive serosa and/or adnexae (FIGO stage IIIA) have a variable prognosis and are at a significant risk for recurrence. We investigated how tumor characteristics and adjuvant treatments influence the overall survival (OS) and recurrence patterns in these patients and patients with positive cytology alone (previously classified as stage IIIA before 2009).

Materials And Methods: This multi-institution retrospective study reviewed 55 patients with positive serosa and/or adnexae and 18 patients with positive cytology only, surgically staged from 1990 to 2010.

Collaborative learning using nursing student dyads in the clinical setting.

Formal pairing of student nurses to work collaboratively on one patient assignment is a strategy for improving the quality and efficiency of clinical instruction while better utilizing the limited resources at clinical agencies. The aim of this qualitative study was to explore the student nurse and patient experiences of collaborative learning when peer dyads are used in clinical nursing education. Interviews were conducted with 11 students and 9 patients.

Impact of comorbid conditions on survival in endometrial cancer.

Objectives: To evaluate the contribution of multiple medical comorbidities on the overall survival of endometrial cancer patients.

Methods: The study evaluated 490 endometrial cancer patients stages I to IV who were treated between 1992 and 2008 with a hysterectomy with or without radiation therapy (RT). Hazard ratios (HR) were calculated for multiple variables including: diabetes mellitus (DM), hypertension (HTN), body mass index, smoking, RT, and years of estrogen exposure and then recalculated with an adjustment for age and grade as potential confounders.

Tissue characterization using a phantom to validate four-dimensional tissue deformation.

Purpose: This project proposes using a real tissue phantom for 4D tissue deformation reconstruction (4DTDR) and 4D deformable image registration (DIR) validation, which allows for the complete verification of the motion path rather than limited end-point to end-point of motion.

Methods: Three electro-magnetic-tracking (EMT) fiducials were implanted into fresh porcine liver that was subsequently animated in a clinically realistic phantom. The animation was previously shown to be similar to organ motion, including hysteresis, when driven using a real patient's breathing pattern.

Atypical intradermal smooth muscle neoplasms (formerly cutaneous leiomyosarcomas): case series, immunohistochemical profile and review of the literature.

Atypical intradermal smooth muscle neoplasms (AISMN, formerly known as cutaneous leiomyosarcomas) are uncommon neoplasms, which seem to be remarkable for their excellent prognosis in contrast to their deeper counterparts. The rarity of AISMN has posed a challenge for characterizing the morphologic spectrum, immunohistochemical staining pattern, and behavior. In this study we evaluated the histologic and immunohistochemical features of 20 cases of AISMN.

Advances in clinical research in gynecologic radiation oncology: an RTOG symposium.

There have been inexorable improvements in gynecologic radiation oncology through technologically advances, 3-dimensional imaging, and clinical research. Investment in these 3 critical areas has improved, and will continue to improve, the lives of patients with gynecologic cancer. Advanced technology delivery in gynecologic radiation oncology is challenging owing to the following: (1) setup difficulties, (2) managing considerable internal organ motion, and (3) responding to tumor volume reduction during treatment.

Does the FIGO 2009 endometrial cancer staging system more accurately correlate with clinical outcome in different histologies? Revised staging, endometrial cancer, histology.

Objective: In 2009, the International Federation of Gynecology and Obstetrics (FIGO) staging system was revised for endometrial cancers. Different histologies were examined in a large population database. The FIGO 1988 and 2009 staging systems were compared for stage at presentation, differences in patient populations, and disease-specific survival (DSS).

Stereotactic radiosurgery and radiotherapy for meningiomas: biomarker predictors of patient outcome and response to therapy.

Although surgery has traditionally been the primary treatment of meningiomas, stereotactic radiosurgery (SRS) and radiotherapy (SRT) techniques have become a standard part of the treatment approach to intracranial meningiomas. For incompletely resected or inoperable benign meningiomas, SRT and SRS can provide excellent 5-year tumor control rates in 90% to 95% of benign meningioma cases. The current data on prognostic factors in meningioma SRT and SRS treatment outcomes are sparse.