The Experts below are selected from a list of 219 Experts worldwide ranked by ideXlab platform

Juanita Crook - One of the best experts on this subject based on the ideXlab platform.

Patricia J. Eifel - One of the best experts on this subject based on the ideXlab platform.

  • definitive radiation therapy for squamous cell carcinoma of the vagina
    International Journal of Radiation Oncology Biology Physics, 2005
    Co-Authors: Steven J Frank, Anuja Jhingran, Charles F Levenback, Patricia J. Eifel
    Abstract:

    Purpose: To evaluate outcome and describe clinical treatment guidelines for patients with primary squamous cell carcinoma of the vagina treated with definitive radiation therapy. Methods and Materials: Between 1970 and 2000, a total of 193 patients were treated with definitive radiation therapy for squamous cell carcinoma of the vagina at The University of Texas M. D. Anderson Cancer Center. The patients' medical records were reviewed to obtain information about patient, tumor, and treatment characteristics, as well as outcome and patterns of recurrence. Surviving patients were followed for a median of 137 months. Survival rates were calculated using the Kaplan-Meier method, with differences assessed using log-rank tests. Results: Disease-specific survival (DSS) and Pelvic Disease control rates correlated with International Federation of Gynecology and Obstetrics (FIGO) stage and tumor size. At 5 years, DSS rates were 85% for the 50 patients with Stage I, 78% for the 97 patients with Stage II, and 58% for the 46 patients with Stage III–IVA Disease ( p = 0.0013). Five-year DSS rates were 82% and 60% for patients with tumors ≤4 cm or >4 cm, respectively ( p = 0.0001). At 5 years, Pelvic Disease control rates were 86% for Stage I, 84% for Stage II, and 71% for Stage III–IVA ( p = 0.027). The predominant mode of relapse after definitive radiation therapy was local-regional (68% and 83%, respectively, for patients with stages I–II or III–IVA Disease). The incidence of major complications was correlated with FIGO stage; at 5 years, the rates of major complications were 4% for Stage I, 9% for Stage II, and 21% for Stage III–IVA ( p Conclusions: Excellent outcomes can be achieved with definitive radiation therapy for invasive squamous cell carcinoma of the vagina. However, to achieve these results, treatment must be individualized according to the site and size of the tumor at presentation and the response to initial external-beam radiation therapy. Brachytherapy plays an important role in the treatment of many vaginal cancers but should be carefully selected and applied to obtain optimal coverage of the target volume.

  • Adjuvant surgery after radiotherapy.
    Journal of the National Cancer Institute. Monographs, 1996
    Co-Authors: Patricia J. Eifel
    Abstract:

    Investigators disagree about the role of adjuvant hysterectomy after irradiation of bulky stage IB cervical carcinomas, although the benefit of combined treatment has never been clearly demonstrated. Studies that have correlated outcome with initial tumor diameter suggest that central recurrences are rare after irradiation of tumors less than 5 cm in diameter, leaving little room for improvement with additional local treatment. Early studies suggested that adjuvant hysterectomy may improve Pelvic Disease control for patients with bulky endocervical tumors, but these results may have reflected the selection of tumors with relatively favorable characteristics for combined treatment. Several studies have suggested that central Pelvic Disease can be controlled in more than 90% of patients with bulky endocervical tumors if they are treated with adequate doses of irradiation. Although published studies are somewhat limited by their retrospective designs, the available data do not support the added cost and morbidity of adjuvant hysterectomy in the routine treatment of patients with bulky early stage cervical carcinomas.

  • THE RELATIONSHIP BETWEEN BRACHYTHERAPY DOSE AND OUTCOME IN PATIENTS WITH BULKY ENDOCERVICAL TUMORS TREATED WITH RADIATION ALONE
    International journal of radiation oncology biology physics, 1994
    Co-Authors: Patricia J. Eifel, William W. Thoms, Terry L. Smith, Mitchell Morris, Mary Jane Oswald
    Abstract:

    Abstract Purpose: To evaluate the relationship between brachytherapy dose and outcome in patients treated with external radiotherapy (40 Gy to the whole pelvis) and intracavitary radium therapy for bulky endocervical tumors. Methods and Materials: Between 1962 and 1985, 98 patients with Stage IB-IIB bulky endocervical carcinomas (≥ 6 cm in diameter) treated with radiotherapy alone received 40 Gy to the whole pelvis followed by 2 or more intracavitary treatments. Twenty-five patients received Results: Patients who received p p p = 0.03). Actuarial survival rates at 5 years were 44% and 60% for the low- and high-dose groups, respectively ( p = 0.14). Among those who received more than 6000 mg-hr, there was no significant relationship between brachytherapy dose and Pelvic Disease control. Calculated actuarially, the rate of major ≥ grade 3) complications at 5 years was 23% in the low-dose group and 10% in the high-dose group ( p = 0.1). Conclusions: The relatively high incidence of Pelvic Disease recurrence and complications in patients who receive less than 6000 mg-hr reflects the narrow therapeutic window for complication-free Pelvic Disease control in patients with bulky central Disease and unfavorable normal tissue anatomy. The results also demonstrate a high Pelvic control rate and acceptable morbidity in patients with favorable anatomy treated with high-dose radiotherapy alone.

Jim Rose - One of the best experts on this subject based on the ideXlab platform.

Matthew R Smith - One of the best experts on this subject based on the ideXlab platform.

  • prostate specific membrane antigen ligand positron emission tomography in men with nonmetastatic castration resistant prostate cancer
    Clinical Cancer Research, 2019
    Co-Authors: Wolfgang P Fendler, Manuel Weber, Amir Iravani, Michael S Hofman, Jeremie Calais, Johannes Czernin, Harun Ilhan, Fred Saad, Eric J Small, Matthew R Smith
    Abstract:

    Purpose: Systemic androgen-signaling inhibition added to ongoing androgen-deprivation therapy (ADT) improved clinical outcomes in patients with nonmetastatic castration-resistant prostate cancer without detectable metastases by conventional imaging (nmCRPC). Prostate-specific membrane antigen ligand positron-emission tomography (PSMA-PET) detects prostate cancer with superior sensitivity to conventional imaging, but its performance in nmCRPC remains largely unknown. We characterized cancer burden in high-risk nmCRPC patients using PSMA-PET. Experimental Design: We retrospectively included 200 patients with nmCRPC, prostate-specific antigen (PSA) >2 ng/mL, and high risk for metastatic Disease (PSA doubling time [PSADT] ≤10 months and/or Gleason score ≥8) from six high-volume PET centers. We centrally reviewed PSMA-PET detection rate for Pelvic Disease and distant metastases (M1). We further evaluated SPARTAN patients stratified by risk factors for PSMA-PET-detected M1 Disease. Results: PSMA-PET was positive in 196/200 patients. Overall, 44% had Pelvic Disease including 24% with local prostate bed recurrence, and 55% had M1 Disease despite negative conventional imaging. Interobserver agreement was very high (κ 0.81-0.91). PSA ≥5.5 ng/mL, loco-regional nodal involvement determined by pathology (pN1), prior primary radiation, and prior salvage radiation therapy independently predicted M1 Disease (all P < 0.05). Conclusions: PSMA-PET detected any Disease in nearly all patients and M1 Disease in 55% of patients previously diagnosed with nmCRPC, including subgroups with PSADT ≤10 months and Gleason score ≥8. The value of PSMA-PET imaging for treatment guidance should be tested in future studies.

Ralph S Freedman - One of the best experts on this subject based on the ideXlab platform.