Radiation Therapy

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Elissa M Ozanne - One of the best experts on this subject based on the ideXlab platform.

  • cost effectiveness analysis of intraoperative Radiation Therapy for early stage breast cancer
    Annals of Surgical Oncology, 2013
    Co-Authors: Michael Alvarado, A J Mohan, Laura J Esserman, Catherine C Park, Brittany Harrison, Rebecca Howe, Cristina M Thorsen, Elissa M Ozanne
    Abstract:

    Background Shortened courses of Radiation Therapy have been shown to be similarly effective to whole-breast external-beam Radiation Therapy (WB-EBRT) in terms of local control. We sought to analyze, from a societal perspective, the cost-effectiveness of two Radiation strategies for early-stage invasive breast cancer: single-dose intraoperative Radiation Therapy (IORT) and the standard 6-week course of WB-EBRT.

Peter F. Orio - One of the best experts on this subject based on the ideXlab platform.

Michael J Zelefsky - One of the best experts on this subject based on the ideXlab platform.

  • improved toxicity profile following high dose postprostatectomy salvage Radiation Therapy with intensity modulated Radiation Therapy
    European Urology, 2011
    Co-Authors: Anuj Goenka, Juan Martin Magsanoc, Xin Pei, Michael Schechter, Marisa A Kollmeier, Brett Cox, Peter T Scardino, James A Eastham, Michael J Zelefsky
    Abstract:

    Background: With salvage Radiation Therapy (SRT) in the postprostatectomy setting, the need to deliver sufficient Radiation doses to achieve a high probability of tumor control is balanced with the risk of increased toxicity. Intensity-modulated Radiation Therapy (IMRT) in the postprostatectomy salvage setting is gaining interest as a treatment strategy. Objective: Compare acute and late toxicities in patients treated with IMRT and threedimensional conformal Radiation Therapy (3D-CRT) in the postprostatectomy salvage setting. Design, setting, and participants: A total of 285 patients who were treated at our institution between 1988 and 2007 with SRT after radical prostatectomy for biochemical recurrence were identified. All medical records were reviewed and toxicity recorded. Median follow-up was 60 mo. Intervention: All patients were treated with SRT with either 3D-CRT (n = 109) or IMRT (n = 176). A total of 205 patients (72%) were treated with doses 70 Gy. Measurements: Late gastrointestinal (GI) and genitourinary (GU) toxicities were recorded using the Common Terminology Criteria for Adverse Events v. 3.0 definition. Results and limitations: The 5-yr actuarial rates of late grade2 GI and GU toxicity were 5.2% and 17.0%, respectively. IMRT was independently associated with a reduction in grade 2 GI toxicity compared with 3D-CRT (5-yr IMRT, 1.9%; 5-yr 3D-CRT, 10.2%; p = 0.02). IMRT was not associated with a reduction in risk of grade 2 GU toxicity (5-yr IMRT, 16.8%; 5-yr 3D-CRT, 15.8%; p = 0.86), urinary incontinence (5-yr IMRT, 13.6%; 5-yr 3D-CRT, 7.9%; p = 0.25), or grade 3 erectile dysfunction (5-yr IMRT, 26%; 5-yr 3D-CRT, 30%; p = 0.82). Of patients who developed late grade 2 GI or GU toxicity, 38% and 44%, respectively, experienced resolution of their symptoms prior to the last follow-up. Conclusions: Our experience with high-dose IMRT in the postprostatectomy salvage setting demonstrates that the treatment can be delivered safely with an associated reduction in late GI toxicity.

  • three dimensional conformal Radiation Therapy may improve the therapeutic ratio of high dose Radiation Therapy for lung cancer
    International Journal of Radiation Oncology Biology Physics, 1993
    Co-Authors: John G Armstrong, C Burman, Steve Leibel, Doracy P Fontenla, G J Kutcher, Michael J Zelefsky, Zvi Fuks
    Abstract:

    Abstract Purpose: The specific aim of 3-dimensional conformal Radiation Therapy is to improve the target dose distribution while concomitantly reducing normal tissue dose. Such an approach should permit dose escalation until the limits of acceptable normal tissue toxicity are reached. To evaluate the feasibility of tumor dose escalation for nine patients with lung cancer, we determined the dose distribution to the target and normal tissues with 3-dimensional conformal Radiation Therapy and conventional planning. Methods and Materials: Plans were compared to assess adequacy of dose delivery to target volumes, dose-volume histograms for normal tissue, and normal tissue complication probabilities (NTCP) for nine patients with lung tumors. Results: The mean percentage of gross disease which received ≤ 70.2 Gy with 3-dimensional conformal Radiation Therapy (31)CRT) was 40% of the mean percentage of gross disease which received ≤ 70.2 Gy with conventional treatment planning (CTP). The mean NTCP for lung parenchyma with 3DCRT was 36% of the mean NTCP with CTP. The mean esophageal NTCP with 3DCRT was 88% of the mean NTCP with CTP. Conclusion: This preliminary analysis suggests that three dimensional conformal Radiation Therapy may provide superior delivery of high dose Radiation with reduced risk to normal tissue, suggesting that this approach may have the potential to improve the therapeutic ratio of high dose Radiation Therapy for lung cancer.

Vinayak Muralidhar - One of the best experts on this subject based on the ideXlab platform.

Cary P Gross - One of the best experts on this subject based on the ideXlab platform.

  • stereotactic body Radiation Therapy versus intensity modulated Radiation Therapy for prostate cancer comparison of toxicity
    Journal of Clinical Oncology, 2014
    Co-Authors: Laura D Cramer, Jeph Herrin, Pamela R Soulos, Arnold L Potosky, Cary P Gross
    Abstract:

    Purpose Stereotactic body Radiation Therapy (SBRT) is a technically demanding prostate cancer treatment that may be less expensive than intensity-modulated Radiation Therapy (IMRT). Because SBRT may deliver a greater biologic dose of Radiation than IMRT, toxicity could be increased. Studies comparing treatment cost to the Medicare program and toxicity are needed. Methods We performed a retrospective study by using a national sample of Medicare beneficiaries age ≥ 66 years who received SBRT or IMRT as primary treatment for prostate cancer from 2008 to 2011. Each SBRT patient was matched to two IMRT patients with similar follow-up (6, 12, or 24 months). We calculated the cost of Radiation Therapy treatment to the Medicare program and toxicity as measured by Medicare claims; we used a random effects model to compare genitourinary (GU), GI, and other toxicity between matched patients. Results The study sample consisted of 1,335 SBRT patients matched to 2,670 IMRT patients. The mean treatment cost was $13,645 ...

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