Clinical versus pathologic staging for prostate adenocarcinoma: how do they correlate?

Objectives: We assessed the ability of 3 clinical factors-stage, D'Amico risk stratification, and Roach formula-estimated nodal risk-to predict the pathologic outcomes in a modern cohort of prostate cancer patients.

Methods: Data were obtained from the Surveillance, Epidemiology, and End Results Program for 2004 and 2005. Men with adenocarcinoma of the prostate who had complete staging information were included.

Does the revised International Federation of Gynecology and Obstetrics staging system for endometrial cancer lead to increased discrimination in patient outcomes?

Background: Recent changes were made to the International Federation of Gynecology and Obstetrics (FIGO) staging system for endometrial cancer. The objective of this study was to compare survival outcomes for patients who were staged according to the 1988 FIGO staging system versus the 2009 FIGO staging system.

Methods: Data were obtained from the Surveillance, Epidemiology, and End Results Program for the years 1998 to 2006.

Radiation Dose Escalation in Stage III Non-Small-Cell Lung Cancer.

For patients with stage III non-small-cell lung cancer with unresectable or inoperable tumors, definitive chemoradiotherapy is often utilized. Historically, local control and overall survival rates have been poor. In an effort to improve local control, new chemotherapeutic agents in combination with higher doses of radiotherapy have been investigated.

IMRT with simultaneous integrated boost and concurrent chemotherapy for locoregionally advanced squamous cell carcinoma of the head and neck.

Purpose: To evaluate the efficacy and toxicity of accelerated radiotherapy with concurrent chemotherapy in advanced head-and-neck squamous cell carcinoma.

Methods And Materials: Between April 2003 and May 2008, 43 consecutive patients with advanced head-and-neck squamous cell carcinoma received accelerated chemoradiation with concurrent cisplatin or cetuximab. The doses for intensity-modulated radiotherapy with simultaneous integrated boost were 67.

DART, a platform for the creation and registration of cone beam digital tomosynthesis datasets.

Digital tomosynthesis is an imaging modality that allows for tomographic reconstructions using only a fraction of the images needed for CT reconstruction. Since it offers the advantages of tomographic images with a smaller imaging dose delivered to the patient, the technique offers much promise for use in patient positioning prior to radiation delivery. This paper describes a software environment developed to help in the creation of digital tomosynthesis image sets from digital portal images using three different reconstruction algorithms.

A comparison of helical intensity-modulated radiotherapy, intensity-modulated radiotherapy, and 3D-conformal radiation therapy for pancreatic cancer.

We assessed dosimetric differences in pancreatic cancer radiotherapy via helical intensity-modulated radiotherapy (HIMRT), linac-based IMRT, and 3D-conformal radiation therapy (3D-CRT) with regard to successful plan acceptance and dose to critical organs. Dosimetric analysis was performed in 16 pancreatic cases that were planned to 54 Gy; both post-pancreaticoduodenectomy (n = 8) and unresected (n = 8) cases were compared. Without volume modification, plans met constraints 75% of the time with HIMRT and IMRT and 13% with 3D-CRT.

Preoperative versus postoperative radiotherapy in soft-tissue sarcoma: multi-institutional analysis of 821 patients.

Purpose: To assess the impact of radiotherapy (RT) sequencing with surgery on overall survival (OS), cause-specific survival (CSS), local failure, and distant failure in soft-tissue sarcoma (STS).

Methods And Materials: A retrospective analysis was conducted using the National Oncology Database, a proprietary database of aggregated tumor registries owned by IMPAC Medical Systems (Sunnyvale, CA). Patients with STS of all major anatomic sites who received definitive surgery and either preoperative (preop) or postoperative (postop) RT were included.

Specimen labeling errors in surgical pathology: an 18-month experience.

Elimination of medical errors is important for pathologists. Errors occurring in surgical pathology involve specimen defects, specimen labeling, processing, diagnosis, and reporting defects. Errors occur during prelaboratory, laboratory, and postlaboratory phases.

Evaluation of fluence-smoothing feature for three IMRT planning systems.

Commercially available intensity-modulated radiation therapy (IMRT) inverse treatment planning systems (ITPS) typically include a smoothing function which allows the user to vary the complexity of delivered beam fluence patterns. This study evaluated the behavior of three ITPSs when varying smoothing parameters. We evaluated four cases treated with IMRT in our clinic: sinonasal carcinoma (SNC), glioblastoma multiforme (GBM), base of tongue carcinoma (BOT), and prostate carcinoma (PST).

Stereotactic radiosurgery eligibility and selection bias in the treatment of glioblastoma multiforme.

Several single institution studies have shown a survival advantage when a stereotactic radiosurgery (SRS) boost followed fractionated external beam radiation (FracRT) in the treatment of glioblastoma (GBM). RTOG 93-05 employed SRS before FracRT and demonstrated no survival benefit. We examined the effect of SRS eligibility before and after FracRT on patient outcome in a group of patients treated with conventional therapy without SRS.

Curative radiation therapy for pancreatic malignancies.

Surgery is generally considered as the only curative therapy for pancreatic cancer; however, even with optimal surgery, long-term cure is achieved in very few patients, thus highlighting the need for adjuvant therapies. Radiation therapy, usually in combination with chemotherapy, plays a role in the setting of unresectable, nonmetastatic pancreatic cancer. Its role in the adjuvant setting remains controversial and as yet undefined.

Radiotherapy and extent of surgical resection in retroperitoneal soft-tissue sarcoma: multi-institutional analysis of 261 patients.

Background And Objective: To examine the impact of adjuvant radiotherapy (RT) and surgical technique on survival in retroperitoneal soft-tissue sarcoma.

Methods: A retrospective analysis was conducted using the National Oncology Database, a proprietary database of aggregated tumor registries owned by IMPAC(R) Medical Systems (Sunnyvale, CA). Patients who received definitive surgery with negative or microscopic-positive margins were included.

Comparing eccentric resistance exercise in prostate cancer survivors on and off hormone therapy: a pilot study.

Objectives: To determine the feasibility of an eccentric resistance exercise training protocol in men with prostate cancer and to assess whether men with prostate cancer who are receiving androgen deprivation therapy (ADT) have a blunted effect from the training as compared with prostate cancer survivors not receiving ADT.

Design: Prospective pilot study.

Setting: Academic medical center.

Does radiotherapy or lymphadenectomy improve survival in endometrial stromal sarcoma?

Introduction: Endometrial stromal sarcoma (ESS) is a rare uterine malignancy characterized by cells resembling proliferative-phase endometrial stroma. Standard treatment is total hysterectomy and bilateral salpingo-oophorectomy (TAH-BSO). The roles of radiation therapy (RT) and lymphadenectomy (LAD) remain unclear.

Basic principles of radiobiology applied to radiosurgery and radiotherapy of benign skull base tumors.

Various types of ionizing radiation may be used therapeutically for benign skull base tumors. Treatment may involve single-dose radiosurgery, or may be fractionated into multiple doses. Designing and implementing a radiotherapy plan that maximizes the therapeutic ratio requires knowledge of the biophysical and radiobiological principles involved in these treatments.

Autoimmune acrosyringitis with ductal cysts: reclassification of case of eruptive syringoma.

Syringomas are architecturally complex tumors composed of small, cystically dilated segments of dermal eccrine duct. Syringomas typically form isolated flesh-colored periorbital papules, however, in a peculiar condition termed eruptive syringoma; scores develop simultaneously in near confluence over a large surface area. While traditionally regarded as a neoplasm, more recent observations indicate eruptive syringoma is a reactive proliferation secondary to autoimmune disruption of the acrosyringium.

Does the entire uterus need to be treated in cancer of the cervix? Role of adaptive brachytherapy.

Purpose: To evaluate local control and toxicity by use of a method of adaptive cervical brachytherapy (ACB).

Methods And Materials: From 1998 to 2008, we identified 65 cervical cancer patients with FIGO (International Federation of Gynecology and Obstetrics) Stage IB1-IVA disease who received definitive external beam radiation therapy and high-dose rate brachytherapy with tandem and ovoid applicators. As tumors regressed, 45 of 65 patients had the tandem source retracted from the uterine fundus at successive brachytherapy insertions, thus decreasing the number of (192)Ir dwell positions.

Current challenges in clinical management of endometrial cancer.

Endometrial cancer remains a management challenge. Improved understanding of the mechanisms of carcinogenesis may enable better understanding of biologic behavior and guide therapy. Improvements in diagnostic imaging, radiation delivery systems, and systemic therapies potentially can improve outcomes while minimizing morbidity.

The role of radiation therapy in pancreas cancer.

The role of radiation therapy in pancreatic cancer continues to be investigated. Its use in the adjuvant setting remains controversial. Its use is more generally accepted in borderline resectable disease, but prospective data are sparse.

Patterns of care for radiotherapy in vulvar cancer: a Gynecologic Cancer Intergroup study.

Background: This study aimed to describe radiotherapeutic practice in the treatment of vulvar cancer in member study groups of the Gynecologic Cancer Intergroup (GCIG).

Methods: A survey was developed and distributed to representatives of the member study groups of the GCIG, targeting the use of radiotherapy (RT) in vulvar cancer.

Results: Thirty-two surveys were returned from 12 different cooperative groups.

Principles and techniques of radiation therapy for esophageal and gastroesophageal junction cancers.

Radiation therapy serves an integral role in the primary and adjuvant treatment of esophagus cancer. Radiation techniques continue to improve, providing more accurate localization of the tumor while limiting dose to normal structures. This article reviews current practices and recommendations for radiation therapy technique for esophageal and gastroesophageal malignancies.

Relative contributions of radiation and cisplatin-based chemotherapy to sensorineural hearing loss in head-and-neck cancer patients.

Purpose: To investigate the risk of sensorineural hearing loss (SNHL) in patients with head-and-neck cancer and treated with radiation therapy (RT) or concomitant cisplatin-based chemoradiation, the relationship among SNHL and radiation dose to the cochlea, the use of two common cisplatin dose regimens.

Methods And Materials: A total of 62 head-and-neck cancer patients treated with curative intent were included in this prospective study. Of the patients, 21 received RT alone, 27 received 40 mg/m(2) weekly cisplatin, 13 received 100 mg/m(2) every 3 weeks during RT, and 1 received RT with weekly epidermal growth factor receptor inhibitor antibody.

Conformity of LINAC-based stereotactic radiosurgery using dynamic conformal arcs and micro-multileaf collimator.

Purpose: To assess the conformity of dynamic conformal arc linear accelerator-based stereotactic radiosurgery and to describe a standardized method of isodose surface (IDS) selection.

Methods And Materials: In 174 targets, the conformity index (CI) at the prescription IDS used for treatment was calculated as CI = (PIV/PVTV)/(PVTV/TV), where TV is the target volume, PIV (prescription isodose volume) is the total volume encompassed by the prescription IDS, and PVTV is the TV encompassed by the IDS. In addition, a "standardized" prescription IDS (sIDS) was chosen according to the following criteria: 95% of the TV was encompassed by the PIV and 99% of TV was covered by 95% of the prescription dose.