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These data suggest that a model that considers performance status, extent of disease, serum albumin, mental status, and primary tumor site represents a clinically relevant tool in radiation oncology to predict survival for patients with stage IV cancer.
All patients in this review developed ORN in the posterior aspect of the mandible. Neither the specific systemic agent (Erbitux or chemotherapy) nor the manner in which the agent was delivered (induction vs concurrent) appeared to increase the risk of ORN. It is hoped that having a better understanding as to the location, etiology, and treatment of ORN will help to minimize this potentially devastating complication for future generations of head and neck cancer patients.
This is the largest analysis to date examining the effects of RT in a broad population of solid tumor patients. Although we were unable to control for chemotherapy use in this cohort, RT was associated with superior oncologic outcome compared with surgery alone among patients with multiple solid malignancies. This positive effect was most pronounced in older patients with breast and rectal cancer, suggesting age-dependent effects of RT.
Our study shows that rectal spacer placement in patients who have had a prostatectomy is feasible. Despite the high dose of salvage RT, GI toxicity rate was low, and no patient developed grade ≥ 2 GI toxicity with the rectal spacer.
In this large, retrospective series, we report very good long-term oncologic outcomes and minimal toxicity in patients with GS 9/10 prostate cancer treated with combination EBRT, LDRBT, and ADT. Trimodality therapy is a well-tolerated and effective treatment for these very-high-risk patients.
In this large population-based cohort of 1,794 men with low-risk, low-volume prostate cancer, AA race was not associated with more aggressive pathology compared with Caucasians.
HIMRT is more cost-efficient than CIMRT for treating prostate cancer, taking into account additional costs owing to late radiation toxicities.
There has been a decrease in the use of radiotherapy for patients with localized RCC, although patients with more aggressive disease were more likely to receive radiation. Modern trials are needed to better identify the role of radiation in the management of these patients.
This study did not find any significant differences in treatment tolerance or any outcome endpoints between men with and without psychiatric disorders undergoing definitive radiation treatment for prostate cancer. This finding suggests that early diagnosis and reduced barriers to definitive treatment will alleviate the decreased cancer-specific mortality in this patient population.
In our population of predominantly minority men with HR disease, the use of anticoagulation is associated with improved bFS and DMFS on multivariate analysis. However, AA race was not associated with any differences in outcome.
This study suggests that certain patients with high-risk prostate cancer may be effectively treated with a shorter course of hormone ablation therapy. Longer follow-up and more patients will be needed to verify the efficacy of a shorter course of hormone ablation therapy in this patient population.
At a comprehensive cancer center, men who are referred for adjuvant RT often have margin involvement and/or ECE. Patients did well overall, with high 5- and 10-year freedom from failure. Only Gleason 8/9 disease was associated with increased failure after adjuvant RT.
Our analysis of this large, population-based database demonstrates that after accounting for other demographics and clinical factors at diagnosis, race does not predict for pathologic upgrading or pathologic upstaging at the time of prostatectomy among patients with low-risk prostate cancer. As such, race by itself should not be used to select potential candidates for active surveillance or treatment.
Single-isocenter, frameless VMAR for multiple intracranial metastases can produce clinical outcomes comparable with those of conventional radiosurgery techniques.
IMRT plans that were adapted to perfused but not ventilated lung on 4D-V/Q PET/CT allowed for reduced dose to the functional lung while maintaining consistent plan quality.
There were slightly smaller declines in bowel QoL after SBRT and slightly larger declines in urinary QoL after brachytherapy. While QoL after SBRT, IMRT, or brachytherapy is largely similar and supports SBRT as a reasonable radiotherapy option for localized prostate cancer, a randomized comparison is needed for the strongest evidence.
When treated with SRS to the spine, metastatic HCC has worse pain and radiographic control than other highly radioresistant histologies, suggesting that HCC should be included in the category of highly radioresistant tumors. Whether these lesions may benefit from further dose escalation and/or alternate treatment strategies will be the subject of future studies.
Proton therapy for prostate cancer typically generates treatment plans that are below dose constraints defined in the photon literature, with the exception of a small subset of patients. In order to promote the best possible proton treatment plans, lower dose constraints for OARs should be considered.
Posttreatment offline PET-CT imaging has the potential to evaluate the particle beam range and beam stop for prostate cancer patients treated with heavy ion therapy, which might overcome the pitfalls of simple bone structure fusions with two-dimensional imaging, and provides another approach to monitor the treatment accuracy of prostate cancer treated with carbon ion therapy. Further investigation needs to be performed.
nPSA has been related to biochemical progression–free survival, freedom from metastasis, and death from prostate cancer. BT with either EBRT or HT achieves a lower PSA nadir. There was no difference in disease failure. Longer follow-up may be necessary to see differences in disease failure in this population.
Pelvic radiotherapy followed by HDR brachytherapy boost is an effective treatment for high-risk prostate cancer. It provides excellent long-term disease control and very low rates of severe (grade ≥ 3) toxicity when delivered in two or three fractions.
In this cohort, VMAT plans without a specific constraint for BM were not found to be superior to ssIMRT in terms of BM reserve irradiation, while VMAT could be encouraged for patients with higher rectum doses, such as V80.
In this urban, academic center cohort, PCa patients of lower SES were significantly less likely to undergo staging MRI, particularly in the low-risk group. No differences were found in dominant IPL presence, area, ECE, or SVI, except in the low-risk group. Further investigation is required to better understand trends in pretreatment MRI utilization and dominant IPL characteristics differing by SES.
Three-dimensional composite dose distribution analysis plays a significant role in the correct understanding of the dose distribution of the combination of EBRT and ICBT for cervical cancer. The use of CS in radiotherapy for cervical cancer provided tumor doses higher than those referred by the Point-A dose in previous reports, with no irregularly “cold” regions around the central target.
Epidural analgesia provides safe and effective pain control in patients undergoing ISBT. Epidural delivery of narcotics with ropivacaine improves pain control and lowers oral and intravenous narcotic requirements without increased risk of adverse effects.
SBRT boost appears to be an effective and well-tolerated alternative treatment method for patients with gynecologic malignancies who cannot undergo brachytherapy. Target coverage and dose to organs at risk with SBRT appear to be comparable with those of brachytherapy. Acute toxicity is minimal. These initial clinical results substantiate the need for further evaluation of this treatment approach and its long-term efficacy and safety.
Long-term survival can be achieved following salvage radiation for nodal recurrence of endometrial cancer. However, central and distant recurrences remain a challenge. Chemotherapy prior to radiation was associated with an increased rate of central recurrences and reduced survival, while the use of concurrent chemotherapy was associated with higher rates of survival.
BT is the most common AT modality recommended by SGO members in the postoperative management of stage I EC. CT was recommended in a substantial number of scenarios and even exceeded the use of EBRT in G3 disease. Although there was generally agreement about the management of low-risk EC, there was much more variability in high-intermediate–risk patients. Further studies are needed to compare these SGO members’ recommendations with those of radiation oncologists and to determine optimal management.
This SEER study demonstrates the pronounced increase in the utilization of VB over WPRT alone in the adjuvant setting for endometrial cancer. This observation may spark critical evaluation of US practice patterns seen from 2000 to 2011 and its potential impact on cost, new policies, and the patient’s quality of life.
This treatment schema provided excellent tolerance with sustained local control. All patients obtained cCR and were able to avoid pelvic exenteration surgery and maintain preservation of bladder and rectal function.
