RADIATION THERAPY WITH ONCE-WEEKLY GEMCITABINE IN PANCREATIC CANCER: CURRENT STATUS OF CLINICAL TRIALS
|
|
- Ross Harris
- 5 years ago
- Views:
Transcription
1 doi: /s (03) Int. J. Radiation Oncology Biol. Phys., Vol. 56, No. 4, Supplement, pp , 2003 Copyright 2003 Elsevier Inc. Printed in the USA. All rights reserved /03/$ see front matter NEW PARADIGMS IN THE TREATMENT OF PANCREAS CANCER RADIATION THERAPY WITH ONCE-WEEKLY GEMCITABINE IN PANCREATIC CANCER: CURRENT STATUS OF CLINICAL TRIALS CORNELIUS J. MCGINN, M.D.,* AND MARK M. ZALUPSKI, M.D. *Department of Radiation Oncology and Division of Hematology and Oncology, Department of Internal Medicine, University of Michigan Health Systems, Ann Arbor, MI Clinical trials investigating a variety of gemcitabine-based chemoradiation therapy regimens were initiated several years ago and remain under active investigation for the treatment of patients with pancreatic cancer. These trials are based, in part, on the activity of gemcitabine as a single agent in pancreatic cancer, preclinical studies that demonstrated radiosensitization, and the need for approaches with greater efficacy than that provided by 5-fluorouracil (5-FU) based chemoradiation therapy. In this review, we describe and compare several Phase I clinical trials investigating dose escalation of once-weekly gemcitabine with concurrent radiation therapy. We also describe a relatively novel approach successfully investigating radiation dose escalation with a standard weekly dose of gemcitabine. Toxicity data from this trial, and the prior trials of gemcitabine dose escalation with more conventional radiation therapy, suggest that the volume of normal tissue radiated in gemcitabine-based chemotherapy regimens may be the most critical consideration for future trial designs. Finally, we highlight the need to fully consider the design of future trials in the context of both local and distant disease control, given the radiosensitizing potential and systemic activity of gemcitabine Elsevier Inc. Pancreatic cancer, Gemcitabine, Radiotherapy, Clinical trials. INTRODUCTION Reprint requests to: Cornelius J. McGinn, M.D., Department of Radiation Oncology, Maine Medical Center, 22 Bramhall Street, Portland, ME Tel: (207) ; Fax: (207) ; mcginn9@spectrummg.com Drugs that affect nucleoside and nucleotide metabolism are among the most effective and widely used agents to sensitize tumor cells to radiation treatment (i.e., radiosensitizers). 5-Fluorouracil (5-FU) remains the predominant agent in clinical use today. The deoxycytidine analog, gemcitabine (2,2 -difluoro-2 -deoxycytidine or dfdcyd; (Gemzar, Eli Lilly, Indianapolis, IN), has recently been shown to be a potent radiosensitizer in preclinical studies using human tumor cell lines, including pancreatic cancer cell lines (1 5). Gemcitabine has been approved for clinical use as a single agent and in combination chemotherapy regimens. The integration of gemcitabine in chemoradiation therapy regimens is based on this information, as well as the generally accepted role of chemotherapy with concurrent radiation therapy (RT) in the management of pancreatic cancer. The treatment strategy of combined-modality therapy in pancreatic cancer is based in large part on data from serial Gastrointestinal Tumor Study Group trials that investigated 5-FU based chemoradiation therapy. A benefit of combined-modality therapy was observed compared with RT alone in patients with unresectable disease and compared with observation in patients who had undergone surgical resection (6, 7). However, the annual mortality from pancreatic cancer continues to nearly equal the incidence, and few significant advances have been made in the nonoperative treatment of these patients (8). A renewed interest in alternative chemoradiation therapy regimens for patients with pancreatic cancer has been stimulated by advances in the technical delivery of RT. The integration of new systemic agents such as gemcitabine with advanced RT techniques in combined modality regimens is promising and requires additional investigation. CLINICAL TRIALS OF GEMCITABINE DOSE ESCALATION Considering the preclinical data indicating substantial radiosensitization and clinical data indicating advantages of gemcitabine relative to 5-FU, the use of gemcitabine with concurrent RT may improve the outcome of pancreatic cancer patients (6, 7). A variety of Phase I studies have now been conducted in patients with pancreatic cancer in an effort to define a tolerable regimen using RT with weekly gemcitabine. RT with twice-weekly gemcitabine has also been investigated in an attempt to maximize radiosensitization and is discussed elsewhere in this Supplement. In 1996, two multicenter Phase I trials were initiated in Received Nov 5, 2002, and in revised form Dec 27, Accepted for publication Jan 24,
2 RT and gemcitabine in pancreas cancer C. J. MCGINN AND M. M. ZALUPSKI 11 Fig. 1. Gemcitabine (G) dose-escalation schema investigated in patients with unresectable and potentially resectable pancreatic cancer. Abbreviation: XRT RT. patients with locally advanced, unresectable disease and potentially resectable disease (9, 10). Both trials attempted to determine the maximal tolerated dose of gemcitabine when delivered once weekly, concurrent with 50.4 Gy in 1.8-Gy fractions (Fig. 1). A margin of 3 cm around the gross target volume was required for the initial field (39.6 Gy). This margin was reduced to 2 cm for the final boost (10.8 Gy). The starting dose of weekly gemcitabine was 300 mg/m 2. Hematologic and GI toxicity were found to be dose limiting at 700 mg/m 2. Late toxicity remains a concern; 2 of 6 patients with unresectable disease treated at 600 mg/m 2 on the trial developed duodenal strictures 3 months after treatment completion, with one requiring a duodenal stent. Objective partial responses were not observed at doses 500 mg/m 2 ; however, 3 of 6 patients treated with 600 mg/m 2 experienced an objective partial response. The final reports of these trials have not yet been published. Significant GI toxicity was encountered with gemcitabine delivered at weekly doses of 400 mg/m 2 with concurrent rapid fractionation (30 Gy in 3-Gy fractions) (11). Seven of 12 patients treated with 400 mg/m 2 required hospitalization for management of nausea/vomiting and dehydration. In that study, gemcitabine was given on the Friday before initiation of RT and was continued weekly during and after the course of RT (Fig. 2). This schedule was based on in vivo data indicating more selective tumor radiosensitization with gemcitabine exposure at least 24 h before radiation (12). The treatment volumes covered the primary tumor with a 3 5-cm margin, as well as the porta hepatis and celiac axis lymph nodes. Field sizes ranged from 10 cm 10 cm to 15 cm 15 cm, and certainly may be implicated in the toxicity encountered. It is unclear whether the schedule of gemcitabine administration influenced toxicity. In a recent Eastern Cooperative Oncology Group Phase I trial, the use of gemcitabine with concurrent protracted venous infusion of 5-FU and RT was investigated. Weekly gemcitabine with doses beginning at 50 mg/m 2 with dose escalation as determined by tolerance was intended (13) (Fig. 3). The RT volume included nodes at risk for occult metastases. Three of 7 patients on the trial experienced GI dose-limiting toxicity at low weekly doses of gemcitabine (50 and 100 mg/m 2 ). In 2 patients, this occurred after RT completion (59.4 Gy in 1.8-Gy fractions). In that trial, the delivery of concurrent protracted venous infusion 5-FU, a relatively high dose of RT, and treatment volumes that included lymph nodes at risk may have contributed to the toxicity observed, despite the low doses of gemcitabine. CLINICAL TRIALS OF RADIATION DOSE ESCALATION In each of the trials discussed above, emphasis was placed on the delivery of RT with gemcitabine dose escalation. An alternative strategy has been investigated at the University of Michigan (Ann Arbor, MI), using standard doses of gemcitabine, considering the clinical benefit associated with its use as a systemic agent (14). The goal of this effort is to maximize the systemic drug effect while providing local control through sensitization of a modest radiation dose. The use of a standard dose of gemcitabine (1000 mg/m 2 /wk) is also consistent with our laboratory data Fig. 2. Gemcitabine (G) dose-escalation schema with concurrent rapid fractionation. Abbreviation: XRT RT.
3 12 I. J. Radiation Oncology Biology Physics Volume 56, Number 4, Supplement, 2003 Fig. 3. Gemcitabine (G) dose-escalation schema investigated in the Eastern Cooperative Oncology Group trial, with concurrent protracted venous infusion (PVI) 5-FU and RT (XRT). that demonstrate maximal radiosensitization when cytotoxic concentrations of drug are used (3). Considering prior clinical experience, it is clear that use of full-dose gemcitabine requires reduction and investigation of the radiation dose and modification of the treatment volumes. Radiation dose escalation, in our initial Phase I trial, was achieved by increasing the fraction size, keeping the duration of RT at 3 weeks (15). The radiation fields were planned with threedimensional RT (3D-CRT) planning, and covered only the gross target volume with a 1-cm margin (i.e., no elective nodal RT). Doses in the range of Gy ( Gy fractions) were investigated. A second cycle of gemcitabine alone was delivered after a 1-week rest (Fig. 4). Thirty-seven patients with unresectable (n 34) or incompletely resected (n 3) pancreatic cancer were treated using this approach (15). Suspected or confirmed metastatic disease was identified at the time of enrollment in 14 patients. Three patients experienced dose-limiting toxicity, two with Grade 4 vomiting (one at the 30-Gy and one at the 42-Gy dose level) and one with gastric/duodenal ulceration at the 42-Gy-dose level. Thus, at the final planned dose level of the trial (42 Gy in 2.8-Gy fractions), dose-limiting toxicity was noted in 2 of 6 assessable patients. Additional escalation could have been considered on the basis of the dose escalation criteria had the trial specified a high dose level. However, the occurrence of dose-limiting GI toxicity in 2 patients at this final dose level suggests that additional dose escalation may result in intolerable toxicity. Two additional patients at this dose level experienced late GI toxicity that required surgical repair. We have elected not to investigate a higher dose on the basis of this observation and the potential for late toxicity. The concern for late toxicity is based on radiobiologic data that indicate an increasing risk of late toxicity as the fraction size increases. Application of the linear quadratic model indicates that 42 Gy in 2.8-Gy fractions is biologically equivalent (with regard to late effects) to 50.4 Gy in 1.8-Gy fractions, a relatively standard dose and fractionation schedule used in the treatment of patients with unresectable pancreatic cancer. With a median potential follow-up of 22 months, local progression was noted in 7, regional progression in 3, and distant progression in 25 of 37 patients. These data represent failure at any site, rather than the first site of failure. Only 1 patient developed local or regional progression in the absence of distant progression. These patterns of failure suggest that the reduction in the radiation dose and field size did not result in excess locoregional failure. The median survival was 11.6 months (95% confidence interval ). The presence of metastatic disease at study entry did not have a significant impact on survival (p 0.69). The relative lack of GI toxicity, in our experience, using a more conformal approach and excluding prophylactic nodal RT, suggests that the RT volume is the most critical variable influencing GI toxicity in gemcitabine-based chemoradiation therapy regimens. This approach of weekly standard-dose gemcitabine combined with conformal RT to Fig. 4. Radiation (XRT) dose-escalation schema with concurrent full-dose gemcitabine (G) investigated at the University of Michigan (Ann Arbor, MI).
4 RT and gemcitabine in pancreas cancer C. J. MCGINN AND M. M. ZALUPSKI 13 Fig. 5. Digitally reconstructed radiographs of (a) anterior and (b) lateral beams for a sample case with radiation field sizes used for target coverage of gross target volume (GTV), which included primary tumor with a 3-cm expansion and additional expansion to cover porta hepatis (PH), celiac axis (CA), and periaortic lymph nodes vs. (c, d) beams that would include the GTV with a 1-cm expansion, without nodal coverage. the gross target volume within 3 weeks is currently being studied in a multi-institutional Phase II trial for patients with resectable or unresectable pancreatic cancer. RT CONSIDERATIONS Traditional RT volumes have included the primary tumor, as defined by CT and/or surgical clips placed at surgery, as well as pancreaticoduodenal, porta hepatis, and celiac nodes that may be at risk (16). A margin of normal tissue around these structures is included as well, given the uncertainties of target definition and variation in daily patient setup. As a result, a substantial volume of small bowel is included within the treatment fields. The use of 3D-CRT planning is now becoming more common and may reduce the toxicity associated with RT (17, 18). This technology
5 14 I. J. Radiation Oncology Biology Physics Volume 56, Number 4, Supplement, 2003 allows more accurate definition of target volumes, as identified on a dedicated RT planning CT scan, thus limiting the amount of adjacent normal tissue irradiated. In addition, nonaxial beam arrangements can be used, which may permit additional reduction in the radiation dose to normal tissue (19). The impact of this technology has not been fully assessed at present. Yet, 3D-CRT planning may become critically important as more effective systemic therapies are developed. In this setting, prophylactic RT of regional nodes may not be required, and accurate targeting of the gross tumor volume, with a minimal margin of normal tissue, may be essential to optimize local control. The issue of RT volume needs to be critically addressed in all chemoradiation studies using gemcitabine, secondary to the potent radiosensitization of normal tissues. A comparison of local toxicity (both acute and late) between trials of gemcitabine dose escalation and full-dose gemcitabine with radiation dose escalation may be informative, because the volumes of normal tissue irradiated (as indicated by the margins of expansion) are dramatically different (Fig. 5). FUTURE CONSIDERATIONS In considering the therapeutic options for patients with pancreatic cancer, both locoregional control and systemic failure must be addressed, particularly in situations in which the radiosensitizer being used also has systemic activity as a cytotoxic agent. This is certainly the case in pancreatic cancer, for which additional improvements in local control are not likely to result in a survival advantage. However, the benefit of local control is obvious and may certainly be augmented by the use of gemcitabine concurrent with RT. The radiation dose-escalation trial described above, in which full-dose gemcitabine was delivered, is an example of such consideration. The approach was also based on preclinical data and may serve as a new paradigm for regimens using gemcitabine with concurrent RT. It is apparent that RT volumes will need to be critically assessed and controlled in subsequent Phase II or Phase III trials. As these trials are designed, the role of gemcitabine-based chemoradiation therapy regimens in the adjuvant setting will need to be considered as well. The sequencing of multimodality therapy in pancreatic cancer also deserves further study. Treatment algorithms generally begin with determination of resectability followed by surgery for patients who appear to have operable disease. Surgical treatment alone uncommonly cures patients with this disease. A substantial fraction of patients are unable to receive postoperative adjuvant therapy or have treatment delayed because of postoperative recovery (after resection or exploration without resection). Preoperative chemoradiation therapy may shorten the course of treatment and increase the fraction of patients receiving all modalities of therapy. Because distant disease is a component of failure in most cases, earlier application of systemic treatment may be a better strategy for control of micrometastasis. This potential would be maximized with the use of chemoradiation therapy regimens that emphasize the systemic component of therapy. Preoperative RT may also be associated with less toxicity as a result of RT volume considerations, because the target remains in situ. Issues of sequencing must also be considered in patients with unresectable disease as determined by imaging, particularly when combined-modality therapy is designed to optimize local control. In this setting, delivery of systemic therapy preceding the measures for local control should be emphasized. The considerations discussed above may, if appropriately applied, provide some incremental benefit to patients with pancreatic cancer. The development of novel agents may improve results as well. As newer agents are integrated into more conventional combined-modality regimens, these considerations become even more critical, such that the novel agents can be incorporated to maximize their therapeutic potential. REFERENCES 1. Shewach DS, Hahn TM, Chang E, et al. Metabolism of 2,2 -difluoro-2 -deoxycytidine and radiation sensitization of human colon carcinoma cells. Cancer Res 1994;54: Lawrence TS, Chang EY, Hahn TM, et al. Delayed radiosensitization of human colon carcinoma cells after a brief exposure to 2,2 -difluoro-2 -deoxycytidine (gemcitabine). Clin Cancer Res 1997;3: Lawrence TS, Chang EY, Hahn TM, et al. Radiosensitization of pancreatic cancer cells by 2,2 -difluoro-2 -deoxycytidine. Int J Radiat Oncol Biol Phys 1996;34: Rosier JF, Beauduin M, Bruniaux M, et al. The effect of 2-2 difluorodeoxycytidine (dfdc, gemcitabine) on radiation-induced cell lethality in two human head and neck squamous carcinoma cell lines differing in intrinsic radiosensitivity. Int J Radiat Biol 1999;75: McGinn CJ, Shewach DS, Lawrence TS. Radiosensitizing nucleosides. J Natl Cancer Inst 1996;88: Moertel CG, Frytak S, Hahn RG, et al., for the Gastrointestinal Tumor Study Group. Therapy of locally unresectable pancreatic carcinoma: A randomized comparison of high dose (6000 rads) radiation alone, moderate dose radiation (4000 rads 5-fluorouracil), and high dose radiation 5-fluorouracil. Cancer 1981;48: Gastrointestinal Tumor Study Group. Further evidence of effective adjuvant combined radiation and chemotherapy following curative resection of pancreatic cancer. Cancer 1987; 59: Landis SH, Murray T, Bolden S, et al. Cancer statistics, CA Cancer J Clin 1999;49: McGinn C, Smith D, Szarka C, et al. A phase I study of gemcitabine in combination with radiation therapy in patients with localized, unresectable pancreatic cancer [Abstract]. Proc Am Soc Clin Oncol 1998;17:264a. 10. Hoffman J, McGinn CJ, Szarka C, et al. A phase I study of preoperative gemcitabine with radiation therapy followed by postoperative gemcitabine in patients with localized, resectable pancreatic adenocarcinoma [Abstract]. Proc Am Soc Clin Oncol 1998;17:283a. 11. Wolff RA, Evans DB, Gravel DM, et al. Phase I trial of
6 RT and gemcitabine in pancreas cancer C. J. MCGINN AND M. M. ZALUPSKI 15 gemcitabine combined with radiation for the treatment of locally advanced pancreatic adenocarcinoma. Clin Cancer Res 2001;7: Mason KA, Milas L, Hunter NR, et al. Maximizing therapeutic gain with gemcitabine and fractionated radiation. Int J Radiat Oncol Biol Phys 1995;44: Talamonti MS, Catalano PJ, Vaughn DJ, et al. Eastern Cooperative Oncology Group phase I trial of protracted venous infusion fluorouracil plus weekly gemcitabine with concurrent radiation therapy in patients with locally advanced pancreas cancer: A regimen with unexpected early toxicity. J Clin Oncol 2000;18: Burris HA, III, Moore MJ, Andersen J, et al. Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: A randomized trial. J Clin Oncol 1997;15: McGinn CJ, Zalupski MM, Shureiqi I, et al. A phase I trial of radiation dose escalation with concurrent weekly full-dose gemcitabine in patients with advanced pancreatic cancer. J Clin Oncol 2001;19: Gunderson LL, Martin JK, Kvols LK, et al. Intraoperative and external beam irradiation /- 5-FU for locally advanced pancreatic cancer. Int J Radiat Oncol Biol Phys 1987;13: Robertson JM, Marsh L, TenHaken RK, et al. The clinical application of a non-axial treatment plan for pancreatic and biliary malignancies. Radiother Oncol 1992;24: Higgins PD, Sohn JW, Fine RM, et al. Three-dimensional conformal pancreas treatment: Comparison of four- to sixfield techniques. Int J Radiat Oncol Biol Phys 1995;31: Lichter AS, Lawrence TS. Recent advances in radiation oncology. N Engl J Med 1995;332:
Drugs that affect nucleoside and nucleotide metabolism are among
Gemcitabine and Pancreatic Cancer Supplement to Cancer 933 On the Development of Gemcitabine-Based Chemoradiotherapy Regimens in Pancreatic Cancer Cornelius J. McGinn, M.D. 1 Theodore S. Lawrence, M.D.,
More informationChicago, Illinois Illinois Chicago, Illinois Ann Arbor, Michigan 48109
Annals of Surgical Oncology, 13(2): 150)158 DOI: 10.1245/ASO.2006.03.039 A Multi-Institutional Phase II Trial of Preoperative Full-Dose emcitabine and Concurrent Radiation for Patients With Potentially
More informationThe 2010 Gastrointestinal Cancers Symposium Oral Abstract Session: Cancers of the Pancreas, Small Bowel and Hepatobilliary Tract
The 2010 Gastrointestinal Cancers Symposium : Cancers of the Pancreas, Small Bowel and Hepatobilliary Tract Abstract #131: Phase I study of MK 0646 (dalotuzumab), a humanized monoclonal antibody against
More informationNCCN Guidelines for Hepatobiliary Cancers V Web teleconference on 10/24/17
Guideline Page and Request HCC-4 the American Society of Radiation Oncology (ASTRO): We recommend further clarification of the eligibility criteria for surgical resection and liver transplantation, respectively.
More informationAlliance A Alliance SWOG ECOG/ACRIN - NRG
Preoperative chemotherapy and chemotherapy plus hypofractionated radiation therapy for borderline resectable adenocarcinoma of the head of the pancreas Alliance A021501 Alliance SWOG ECOG/ACRIN - NRG Clinical
More informationPRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES
PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES GASTROINTESTINAL RECTAL CANCER GI Site Group Rectal Cancer Authors: Dr. Jennifer Knox, Dr. Mairead McNamara 1. INTRODUCTION 3 2. SCREENING AND
More informationNeoadjuvant radiotherapy for pancreatic cancer: rationale and outcomes
Review Article Neoadjuvant radiotherapy for pancreatic cancer: rationale and outcomes Rohan Deraniyagala, Emily D. Tanzler The University of Florida College of Medicine Department of Radiation Oncology,
More informationAdjuvant Treatment of Pancreatic Cancer in 2009: Where Are We? Highlights from the 45 th ASCO Annual Meeting. Orlando, FL, USA. May 29 - June 2, 2009
HIGHLIGHT ARTICLE - Slide Show Adjuvant Treatment of Pancreatic Cancer in 2009: Where Are We? Highlights from the 45 th ASCO Annual Meeting. Orlando, FL, USA. May 29 - June 2, 2009 Muhammad Wasif Saif
More informationWhere are we with radiotherapy for biliary tract cancers?
Where are we with radiotherapy for biliary tract cancers? Professor Maria A. Hawkins Associate Professor in Clinical Oncology MRC Group Leader/Honorary Consultant Clinical Oncologist CRUK MRC Oxford Institute
More informationdoi: /s (03)
doi:10.1016/s0360-3016(03)00446-2 Int. J. Radiation Oncology Biol. Phys., Vol. 56, No. 4, Supplement, pp. 31 37, 2003 Copyright 2003 Elsevier Inc. Printed in the USA. All rights reserved 0360-3016/03/$
More informationIntended for use by Clinicians and Health Care Providers involved in the Management or Referral of adult patients with pancreatic
Intended for use by Clinicians and Health Care Providers involved in the Management or Referral of adult patients with pancreatic cancer Section AA Cancer Centre Referrals In the absence of metastatic
More informationPancreatic Cancer Where are we?
Pancreatic Cancer Treatment Approaches & Options Pancreatic Cancer Action Network OUMC 9/22/2016 Russell G. Postier, MD Pancreatic Cancer Where are we? Estimated 2016 data 3% of cancer cases 7% of cancer
More informationSurgical Management of Pancreatic Cancer
I Congresso de Oncologia D Or July 5-6, 2013 Surgical Management of Pancreatic Cancer Michael A. Choti, MD, MBA, FACS Department of Surgery Johns Hopkins University School of Medicine, Baltimore, MD Estimated
More informationSeptember 10, Dear Dr. Clark,
September 10, 2015 Peter E. Clark, MD Chair, NCCN Bladder Cancer Guidelines (Version 2.2015) Associate Professor of Urologic Surgery Vanderbilt Ingram Cancer Center Nashville, TN 37232 Dear Dr. Clark,
More informationProtocol of Radiotherapy for Small Cell Lung Cancer
107 年 12 月修訂 Protocol of Radiotherapy for Small Cell Lung Cancer Indication of radiotherapy Limited stage: AJCC (8th edition) stage I-III (T any, N any, M0) that can be safely treated with definitive RT
More informationProtocol of Radiotherapy for Head and Neck Cancer
106 年 12 月修訂 Protocol of Radiotherapy for Head and Neck Cancer Indication of radiotherapy Indication of definitive radiotherapy with or without chemotherapy (1) Resectable, but medically unfit, or high
More informationNEOADJUVANT THERAPY IN CARCINOMA STOMACH. Dr Jyotirup Goswami Consultant Radiation Oncologist Narayana Superspeciality Hospital, Howrah
NEOADJUVANT THERAPY IN CARCINOMA STOMACH Dr Jyotirup Goswami Consultant Radiation Oncologist Narayana Superspeciality Hospital, Howrah NEOADJUVANT THERAPY?! Few believers Limited evidence Many surgeons
More informationIndex. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Abdominal drainage, after hepatic resection, 159 160 Ablation, radiofrequency, for hepatocellular carcinoma, 160 161 Adenocarcinoma, pancreatic.
More informationCitation Key for more information see:
Citation Key for more information see: http://open.umich.edu/wiki/citationpolicy Use + Share + Adapt { Content the copyright holder, author, or law permits you to use, share and adapt. } Public Domain
More informationPrognostic factors in squamous cell anal cancers
Prognostic factors in squamous cell anal cancers Zainul Abedin Kapacee Year 4-5 Intercalating Medical Student, University of Manchester Dr. Shabbir Susnerwala, Mr. Nigel Scott Dr. Falalu Danwata, Dr. Marcus
More informationPHASE I STUDY OF CONFORMAL RADIOTHERAPY AND CONCURRENT FULL-DOSE GEMCITABINE WITH ERLOTINIB FOR UNRESECTED PANCREATIC CANCER
doi:10.1016/j.ijrobp.2010.08.050 Int. J. Radiation Oncology Biol. Phys., Vol. 82, No. 2, pp. e187 e192, 2012 Copyright Ó 2012 Elsevier Inc. Printed in the USA. All rights reserved 0360-3016/$ - see front
More informationBCCA Protocol Summary for Combined Modality Adjuvant Therapy for High Risk Rectal Carcinoma using Capecitabine and Radiation Therapy
BCCA Protocol Summary for Combined Modality Adjuvant Therapy for High Risk Rectal Carcinoma using Capecitabine and Radiation Therapy Protocol Code: Tumour Group: Contact Physician: GIRCRT Gastrointestinal
More informationHypofractionated radiation therapy for glioblastoma
Hypofractionated radiation therapy for glioblastoma Luis Souhami, MD, FASTRO Professor McGill University Department of Oncology, Division of Radiation Oncology Montreal Canada McGill University Health
More informationA phase II study of weekly paclitaxel and cisplatin followed by radical hysterectomy in stages IB2 and IIA2 cervical cancer AGOG14-001/TGOG1008
A phase II study of weekly paclitaxel and cisplatin followed by radical hysterectomy in stages IB2 and IIA2 cervical cancer AGOG14-001/TGOG1008 NCT02432365 Chyong-Huey Lai, MD On behalf of Principal investigator
More informationLaryngeal Preservation Using Radiation Therapy. Chemotherapy and Organ Preservation
1 Laryngeal Preservation Using Radiation Therapy 1903: Schepegrell was the first to perform radiation therapy for the treatment of laryngeal cancer Conventional external beam radiation produced disappointing
More informationARROCase: Borderline Resectable Pancreatic Cancer
ARROCase: Borderline Resectable Pancreatic Cancer Resident: Jordan Kharofa, MD Staff: Beth Erickson, MD 8/2012 Medical College of Wisconsin Department of Radiation Oncology Case Presentation: 60 year old
More informationSurvival impact of cervical metastasis in squamous cell carcinoma of hard palate
Vol. 116 No. 1 July 2013 Survival impact of cervical metastasis in squamous cell carcinoma of hard palate Quan Li, MD, a Di Wu, MD, b,c Wei-Wei Liu, MD, PhD, b,c Hao Li, MD, PhD, b,c Wei-Guo Liao, MD,
More information肺癌放射治療新進展 Recent Advance in Radiation Oncology in Lung Cancer 許峰銘成佳憲國立台灣大學醫學院附設醫院腫瘤醫學部
肺癌放射治療新進展 Recent Advance in Radiation Oncology in Lung Cancer 許峰銘成佳憲國立台灣大學醫學院附設醫院腫瘤醫學部 Outline Current status of radiation oncology in lung cancer Focused on stage III non-small cell lung cancer Radiation
More informationAdjuvant Chemotherapy for Rectal Cancer: Are we making progress?
Adjuvant Chemotherapy for Rectal Cancer: Are we making progress? Hagen Kennecke, MD, MHA, FRCPC Division Of Medical Oncology British Columbia Cancer Agency October 25, 2008 Objectives Review milestones
More informationPancreas Quizzes c. Both A and B a. Directly into the blood stream (not using ducts)
Pancreas Quizzes Quiz 1 1. The pancreas produces hormones. Which type of hormone producing organ is the pancreas? a. Endocrine b. Exocrine c. Both A and B d. Neither A or B 2. Endocrine indicates hormones
More informationRadiation Oncology MOC Study Guide
Radiation Oncology MOC Study Guide The following study guide is intended to give a general overview of the type of material that will be covered on the Radiation Oncology Maintenance of Certification (MOC)
More informationTreatment outcomes and prognostic factors of gallbladder cancer patients after postoperative radiation therapy
Korean J Hepatobiliary Pancreat Surg 2011;15:152-156 Original Article Treatment outcomes and prognostic factors of gallbladder cancer patients after postoperative radiation therapy Suzy Kim 1,#, Kyubo
More informationDe-Escalate Trial for the Head and neck NSSG. Dr Eleanor Aynsley Consultant Clinical Oncologist
De-Escalate Trial for the Head and neck NSSG Dr Eleanor Aynsley Consultant Clinical Oncologist 3 HPV+ H&N A distinct disease entity Leemans et al., Nature Reviews, 2011 4 Good news Improved response to
More informationAdvances in gastric cancer: How to approach localised disease?
Advances in gastric cancer: How to approach localised disease? Andrés Cervantes Professor of Medicine Classical approach to localised gastric cancer Surgical resection Pathology assessment and estimation
More informationThe Evolution of SBRT and Hypofractionation in Thoracic Radiation Oncology
The Evolution of SBRT and Hypofractionation in Thoracic Radiation Oncology (specifically, lung cancer) 2/10/18 Jeffrey Kittel, MD Radiation Oncology, Aurora St. Luke s Medical Center Outline The history
More informationUse of chemotherapy and radiotherapy in patients with pancreatic cancer in Victoria ( ): a retrospective cohort study
Use of chemotherapy and radiotherapy in patients with pancreatic cancer in Victoria (2002 2003): a retrospective cohort study Michael Jefford, Vicky Thursfield, Yvonne Torn-Broers, Trevor Leong, Mario
More informationReference No: Author(s) 12/05/16. Approval date: committee. June Operational Date: Review:
Reference No: Title: Author(s) Systemic Anti-Cancer Therapy (SACT) Guidelines for Pancreatic Adenocarcinoma Dr Colin Purcell, Consultant Medical Oncologist & on behalf of the GI Oncologists Group, Cancer
More informationChemoradiotherapy after gemcitabine plus erlotinib in patients with locally advanced pancreatic cancer
JBUON 2017; 22(4): 1046-1052 ISSN: 1107-0625, online ISSN: 2241-6293 www.jbuon.com E-mail: editorial_office@jbuon.com ORIGINAL ARTICLE Chemoradiotherapy after gemcitabine plus erlotinib in patients with
More informationReport. biology physics. Received Jul 21, 2011, and in revised form Jan 4, Accepted for publication Jan 5, 2012
International Journal of Radiation Oncology biology physics www.redjournal.org Report Radiation Therapy Oncology Group Consensus Panel Guidelines for the Delineation of the Clinical Target Volume in the
More informationMight Adaptive Radiotherapy in NSCLC be feasible in clinical practice?
Might Adaptive Radiotherapy in NSCLC be feasible in clinical practice? E.Molfese, P.Matteucci, A.Iurato, L.E.Trodella, A.Sicilia, B.Floreno, S.Ramella, L.Trodella Radioterapia Oncologica, Università Campus
More informationOral cavity cancer Post-operative treatment
Oral cavity cancer Post-operative treatment Dr. Christos CHRISTOPOULOS Radiation Oncologist Centre Hospitalier Universitaire (C.H.U.) de Limoges, France Important issues RT -techniques Patient selection
More informationPancreatic cancer remains one of the most formidable
ORIGINAL ARTICLES Long-term Results of Intraoperative Electron Beam Irradiation () for Patients With Unresectable Pancreatic Cancer Christopher G. Willett, MD,* Carlos Fernandez Del Castillo, MD, Helen
More informationChemoradiation (CRT) Safety Analysis of ACOSOG Z6041: A Phase II Trial of Neoadjuvant CRT followed by Local Excision in ut2 Rectal Cancer
Chemoradiation (CRT) Safety Analysis of ACOSOG Z6041: A Phase II Trial of Neoadjuvant CRT followed by Local Excision in ut2 Rectal Cancer Emily Chan, Qian Shi, Julio Garcia-Aguilar, Peter Cataldo, Jorge
More informationPancreatic Cancer and Radiation Therapy
Pancreatic Cancer and Radiation Therapy Why? Is there a role for local therapy with radiation in a disease with such a high rate of distant metastases? When? Resectable Disease Is there a role for post-op
More informationLocally advanced disease & challenges in management
Gynecologic Cancer InterGroup Cervix Cancer Research Network Cervix Cancer Education Symposium, February 2018 Locally advanced disease & challenges in management Carien Creutzberg Radiation Oncology, Leiden
More informationIndex. Surg Oncol Clin N Am 16 (2007) Note: Page numbers of article titles are in boldface type.
Surg Oncol Clin N Am 16 (2007) 465 469 Index Note: Page numbers of article titles are in boldface type. A Adjuvant therapy, preoperative for gastric cancer, staging and, 339 B Breast cancer, metabolic
More informationDepartment of Radiotherapy, Pt. BDS PGIMS, Rohtak, Haryana, India
Bharti et al., IJPSR, 2010; Vol. 1 (11): 169-173 ISSN: 0975-8232 IJPSR (2010), Vol. 1, Issue 11 (Research Article) Received on 29 September, 2010; received in revised form 21 October, 2010; accepted 26
More informationAdjuvant Therapy in Locally Advanced Head and Neck Cancer. Ezra EW Cohen University of Chicago. Financial Support
Adjuvant Therapy in Locally Advanced Head and Neck Cancer Ezra EW Cohen University of Chicago Financial Support This program is made possible by an educational grant from Eli Lilly Oncology, who had no
More informationPreoperative Gemcitabine and Cisplatin Followed by Gemcitabine-Based Chemoradiation for Resectable Adenocarcinoma of the Pancreatic Head
VOLUME 26 NUMBER 21 JULY 20 2008 JOURNAL OF CLINICAL ONCOLOGY O R I G I N A L R E P O R T Preoperative Gemcitabine and Cisplatin Followed by Gemcitabine-Based Chemoradiation for Resectable Adenocarcinoma
More informationMedicinae Doctoris. One university. Many futures.
Medicinae Doctoris The Before and The After: Can chemotherapy revise the trajectory of gastric and esophageal cancers? Dr. David Dawe MD, FRCPC Medical Oncologist Assistant Professor Disclosures None All
More informationPatterns of Care in Patients with Cervical Cancer:
Patterns of Care in Patients with Cervical Cancer: Power and Pitfalls of Claims-Based Analysis Grace Smith, MD, PhD, MPH Resident, PGY-5 Department of Radiation Oncology, MD Anderson Cancer Center Acknowledgments
More informationCapecitabine and Concurrent Radiation in Patients with Locally Advanced Irresectable Pancreatic Cancer
Journal of the Egyptian Nat. Cancer Inst., Vol. 13,. 4, December: 51-57, 001 Capecitabine and Concurrent Radiation in Patients with Locally Advanced Irresectable Pancreatic Cancer TAREK HASHEM, M.D.*;
More informationRetrospective Analysis of Capecitabine and Radiation Therapy in the Treatment of Pancreatic Cancer
Retrospective Analysis of Capecitabine and Radiation Therapy in the Treatment of Pancreatic Cancer M. Wasif Saif, MD M. Joseph, MD S. Tang, PhD Selwyn Vickers, MD B. Plants, MD S. Russo, MD University
More informationRadiation Therapy for the Oncologist in Breast Cancer
REVIEW ARTICLE Chonnam National University Medical School Sung-Ja Ahn, M.D. Adjuvant Tamoxifen with or without in Patients 70 Years of Age with Stage I ER-Positive Breast Cancer: Efficacy Outcomes (10
More informationA dosimetric comparison of proton and photon therapy in unresectable cancers of the head of pancreas
A dosimetric comparison of proton and photon therapy in unresectable cancers of the head of pancreas Reid F. Thompson University of Pennsylvania, Philadelphia, Pennsylvania 1914 Sonal U. Mayekar Thomas
More informationEVIDENCE BASED MANAGEMENT OF STAGE III NSCLC MILIND BALDI
EVIDENCE BASED MANAGEMENT OF STAGE III NSCLC MILIND BALDI Overview Introduction Diagnostic work up Treatment Group 1 Group 2 Group 3 Stage III lung cancer Historically was defined as locoregionally advanced
More informationEpidemiology, aetiology and the patient pathway in oesophageal and pancreatic cancers
Epidemiology, aetiology and the patient pathway in oesophageal and pancreatic cancers Dr Ian Chau Consultant Medical Oncologist Women's cancers Breast cancer introduction 3 What profession are you in?
More informationSequential Dose-Dense Adjuvant Therapy With Doxorubicin, Paclitaxel, and Cyclophosphamide
Sequential Dose-Dense Adjuvant Therapy With Doxorubicin, Paclitaxel, and Cyclophosphamide Review Article [1] April 01, 1997 By Clifford A. Hudis, MD [2] The recognition of paclitaxel's (Taxol's) activity
More informationCarcinoma del retto: Highlights
Carcinoma del retto: Highlights Stefano Cordio Struttura Complessa di Oncologia Medica ARNAS Garibaldi Catania Roma 17 Febbraio 2018 Disclosures Advisory Committee, research funding and speakers bureau
More informationGAP (Gemcitabine Abraxane Pancreas) Trial. Codice Eudract Sponsor non profit: Rossana Berardi, MD Alessandro Bittoni, MD
A Phase II randomized trial comparing a combination of Abraxane and Gemcitabine versus Gemcitabine alone as first line treatment in locally advanced unresectable pancreatic cancer. GAP (Gemcitabine Abraxane
More informationHPV INDUCED OROPHARYNGEAL CARCINOMA radiation-oncologist point of view. Prof. dr. Sandra Nuyts Dep. Radiation-Oncology UH Leuven Belgium
HPV INDUCED OROPHARYNGEAL CARCINOMA radiation-oncologist point of view Prof. dr. Sandra Nuyts Dep. Radiation-Oncology UH Leuven Belgium DISCLOSURE OF INTEREST Nothing to declare HEAD AND NECK CANCER -HPV
More informationClinically Proven Metabolically-Guided TomoTherapy SM Treatments Advancing Cancer Care
Clinically Proven Metabolically-Guided TomoTherapy SM Treatments Advancing Cancer Care Institution: San Raffaele Hospital Milan, Italy By Nadia Di Muzio, M.D., Radiotherapy Department (collaborators: Berardi
More informationTratamiento Multidisciplinar de Estadios Localmente Avanzados en Cáncer de Pulmón
Tratamiento Multidisciplinar de Estadios Localmente Avanzados en Cáncer de Pulmón Santiago Ponce Aix Servicio Oncología Médica Hospital Universitario 12 de Octubre Madrid Stage III: heterogenous disease
More informationORIGINAL ARTICLE CHEMOTHERAPY ALONE FOR ORGAN PRESERVATION IN ADVANCED LARYNGEAL CANCER
ORIGINAL ARTICLE CHEMOTHERAPY ALONE FOR ORGAN PRESERVATION IN ADVANCED LARYNGEAL CANCER Vasu Divi, MD, 1 * Francis P. Worden, MD, 1,2 * Mark E. Prince, MD, 1 Avraham Eisbruch, MD, 3 Julia S. Lee, MD, 4
More informationOverview. What s New in the Treatment of Pancreatic Cancer? Lots! Steven J. Cohen, M.D. Fox Chase Cancer Center September 17, 2013
What s New in the Treatment of Pancreatic Cancer? Lots! Steven J. Cohen, M.D. Fox Chase Cancer Center September 17, 2013 Overview Staging and Workup Resectable Disease Surgery Adjuvant therapy Locally
More informationCurrent Status of Adjuvant Therapy for Colorectal Cancer
Review Article [1] May 01, 2004 By Michael J. O connell, MD [2] Adjuvant therapy with chemotherapy and/or radiation therapy in addition to surgery improves outcome for patients with high-risk carcinomas
More informationGallbladder Cancer. GI Practice Guideline. Michael Sanatani, MD, FRCPC (Medical Oncologist) Barbara Fisher, MD, FRCPC (Radiation Oncologist)
Gallbladder Cancer GI Practice Guideline Michael Sanatani, MD, FRCPC (Medical Oncologist) Barbara Fisher, MD, FRCPC (Radiation Oncologist) Approval Date: September 2006 This guideline is a statement of
More informationAccepted 20 April 2009 Published online 25 June 2009 in Wiley InterScience (www.interscience.wiley.com). DOI: /hed.21179
ORIGINAL ARTICLE DOCETAXEL, CISPLATIN, AND FLUOROURACIL INDUCTION CHEMOTHERAPY FOLLOWED BY ACCELERATED FRACTIONATION/CONCOMITANT BOOST RADIATION AND CONCURRENT CISPLATIN IN PATIENTS WITH ADVANCED SQUAMOUS
More informationChemoradiation - an overview and examples (adapted from issues of JOC Bulletin, Joint Oncology Conference)
Chemoradiation - an overview and examples (adapted from issues of JOC Bulletin, Joint Oncology Conference) Chemoradiation for Carcinoma of the Cervix Dr. William Foo Chemoradiation became the standard
More informationHead and Neck Reirradiation: Perils and Practice
Head and Neck Reirradiation: Perils and Practice David J. Sher, MD, MPH Department of Radiation Oncology Dana-Farber Cancer Institute/ Brigham and Women s Hospital Conflicts of Interest No conflicts of
More informationTHE ROLE OF RADIATION THERAPY IN MANAGEMENT OF PANCREATIC ADENOCARCINOMA. TIMUR MITIN, MD, PhD
THE ROLE OF RADIATION THERAPY IN MANAGEMENT OF PANCREATIC ADENOCARCINOMA TIMUR MITIN, MD, PhD RESECTABLE DISEASE MANAGEMENT: RESECTABLE DISEASE Resection offers the only possibility of long term survival
More informationIMRT - the physician s eye-view. Cinzia Iotti Department of Radiation Oncology S.Maria Nuova Hospital Reggio Emilia
IMRT - the physician s eye-view Cinzia Iotti Department of Radiation Oncology S.Maria Nuova Hospital Reggio Emilia The goals of cancer therapy Local control Survival Functional status Quality of life Causes
More informationRTOG Lung Cancer Committee 2012 Clinical Trial Update. Wally Curran RTOG Group Chairman
RTOG Lung Cancer Committee 2012 Clinical Trial Update Wally Curran RTOG Group Chairman 1 RTOG Lung Committee: Active Trials Small Cell Lung Cancer Limited Stage (Intergroup Trial) Extensive Stage (RTOG
More informationAdjuvant chemoradiotherapy for high -
43 Original Article Adjuvant chemoradiotherapy for high - risk pancreatic cancer Wang M L C, Foo K F ABSTRACT Introduction: The role of adjuvant chemoradiotherapy for resected pancreatic cancer remains
More informationtrial update clinical
trial update clinical by John W. Mucenski, BS, PharmD, Director of Pharmacy Operations, UPMC Cancer Centers The treatment outcome for patients with relapsed or refractory cervical carcinoma remains dismal.
More informationCholangiocarcinoma. GI Practice Guideline. Michael Sanatani, MD, FRCPC (Medical Oncologist) Barbara Fisher, MD, FRCPC (Radiation Oncologist)
Cholangiocarcinoma GI Practice Guideline Michael Sanatani, MD, FRCPC (Medical Oncologist) Barbara Fisher, MD, FRCPC (Radiation Oncologist) Approval Date: October 2006 This guideline is a statement of consensus
More informationErbitux. Erbitux (cetuximab) Description
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.21.84 Subject: Erbitux Page: 1 of 6 Last Review Date: December 2, 2016 Erbitux Description Erbitux (cetuximab)
More informationConcurrent chemoradiotherapy for N2 or N3 squamous cell carcinoma of the head and neck from an occult primary
Original article Annals of Oncology 14: 1306 1311, 2003 DOI: 10.1093/annonc/mdg330 Concurrent chemoradiotherapy for N2 or N3 squamous cell carcinoma of the head and neck from an occult primary A. Argiris
More informationAre we making progress? Marked reduction in operative morbidity and mortality
Are we making progress? Surgical Progress Marked reduction in operative morbidity and mortality Introduction of Minimal-Access approaches for complex esophageal cancer resections Significantly better functional
More information17. Oesophagus. Upper gastrointestinal cancer
110 17. Upper gastrointestinal cancer Oesophagus Radical treatment For patients with localised disease, the standard curative approach to treatment is either surgery + perioperative chemotherapy, surgery
More informationSan Antonio Breast Cancer Symposium 2010 Highlights Radiotherapy
San Antonio Breast Cancer Symposium 2010 Highlights Radiotherapy Kathleen C. Horst, M.D. Assistant Professor Department of Radiation Oncology Stanford University The Optimal SEquencing of Adjuvant Chemotherapy
More informationThe role of chemoradiotherapy in GE junction and gastric cancer. Karin Haustermans
The role of chemoradiotherapy in GE junction and gastric cancer Karin Haustermans Overview Postoperative chemoradiotherapy Preoperative chemoradiotherapy Palliative radiation Technical aspects Overview
More informationCase Conference. Craig Morgenthal Department of Surgery Long Island College Hospital
Case Conference Craig Morgenthal Department of Surgery Long Island College Hospital Neoadjuvant versus Adjuvant Radiation Therapy in Rectal Carcinoma Epidemiology American Cancer Society statistics for
More information3/8/2014. Case Presentation. Primary Treatment of Anal Cancer. Anatomy. Overview. March 6, 2014
Case Presentation Primary Treatment of Anal Cancer 65 year old female presents with perianal pain, lower GI bleeding, and anemia with Hb of 7. On exam 6 cm mass protruding through the anus with bulky R
More informationis time consuming and expensive. An intra-operative assessment is not going to be helpful if there is no more tissue that can be taken to improve the
My name is Barry Feig. I am a Professor of Surgical Oncology at The University of Texas MD Anderson Cancer Center in Houston, Texas. I am going to talk to you today about the role for surgery in the treatment
More informationAdjuvant Therapy for Adenocarcinoma of the Pancreas: Analysis of Reported Trials and Recommendations for Future Progress
Annals of Surgical Oncology DOI: 10.1245/s10434-008-0002-3 Adjuvant Therapy for Adenocarcinoma of the Pancreas: Analysis of Reported Trials and Recommendations for Future Progress Robert A. Wolff, MD,
More informationCURRENT STANDARD OF CARE IN NASOPHARYNGEAL CANCER
CURRENT STANDARD OF CARE IN NASOPHARYNGEAL CANCER Jean-Pascal Machiels Department of medical oncology Institut I Roi Albert II Cliniques universitaires Saint-Luc Université catholique de Louvain, Brussels,
More informationConcurrent Chemoradiation of Patients with Inoperable
Med. J. Cairo Univ., VoL 81, No. 2, March: 29-34, 2013 www.medicaljournalofcairouniversity.com Concurrent Chemoradiation of Patients with Inoperable Non-Metastatic Pancreatic Cancer MOHAMED S. ELZAHI,
More informationHeterogeneity of N2 disease
Locally Advanced NSCLC Surgery? No. Ramaswamy Govindan M.D Co-Director, Section of Medical Oncology Alvin J Siteman Cancer Center at Washington University School of Medicine St. Louis, Missouri Heterogeneity
More informationJOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS, VOLUME 6, NUMBER 2, SPRING 2005
JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS, VOLUME 6, NUMBER 2, SPRING 2005 Advantages of inflatable multichannel endorectal applicator in the neo-adjuvant treatment of patients with locally advanced
More informationNordic Society for Gynecological Oncology Advisory Board of Radiotherapy
Nordic Society for Gynecological Oncology Advisory Board of Radiotherapy Guidelines for postoperative irradiation of cervical cancer Contents: 1. Treatment planning for EBRT. 2 2. Target definition for
More informationJ Clin Oncol 26: by American Society of Clinical Oncology INTRODUCTION
VOLUME 26 NUMBER 21 JULY 20 2008 JOURNAL OF CLINICAL ONCOLOGY O R I G I N A L R E P O R T Preoperative Gemcitabine-Based Chemoradiation for Patients With Resectable Adenocarcinoma of the Pancreatic Head
More informationParticle therapy for pancreatic cancer
Review Article Particle therapy for pancreatic cancer R. Charles Nichols Jr The University of Florida Health Proton Therapy Institute, Jacksonville, FL, USA Correspondence to: R. Charles Nichols Jr, MD.
More informationRe-irradiation in recurrent rectal cancer: single institution experience
Original Article Re-irradiation in recurrent rectal cancer: single institution experience Rasha Mohammad Abdel Latif, Ghada E. El-Adawei, Wael El-Sada Clinical Oncology & Nuclear Medicine Department, Mansoura
More informationSpecification of Tumor Dose. Prescription dose. Purpose
Specification of Tumor Dose George Starkschall, Ph.D. Department of Radiation Physics U.T. M.D. Anderson Cancer Center Prescription dose What do we mean by a dose prescription of 63 Gy? Isocenter dose
More informationIntensity Modulated Radiotherapy (IMRT) of the Abdomen and Pelvis
Medical Policy Manual Medicine, Policy No. 139 Intensity Modulated Radiotherapy (IMRT) of the Abdomen and Pelvis Next Review: August 2018 Last Review: November 2017 Effective: December 1, 2017 IMPORTANT
More informationAytul OZGEN 1, *, Mutlu HAYRAN 2 and Fatih KAHRAMAN 3 INTRODUCTION
Journal of Radiation Research, 2012, 53, 916 922 doi: 10.1093/jrr/rrs056 Advance Access Publication 21 August 2012 Mean esophageal radiation dose is predictive of the grade of acute esophagitis in lung
More informationIndex. Note: Page numbers of article titles are in boldface type.
Note: Page numbers of article titles are in boldface type. A Ablative therapy, nonsurgical, for pulmonary metastases of soft tissue sarcoma, 279 280 Adipocytic tumors, atypical lipomatous tumor vs. well-differentiated
More informationNew Technologies for the Radiotherapy of Prostate Cancer
Prostate Cancer Meyer JL (ed): IMRT, IGRT, SBRT Advances in the Treatment Planning and Delivery of Radiotherapy. Front Radiat Ther Oncol. Basel, Karger, 27, vol. 4, pp 315 337 New Technologies for the
More informationSingle Technology Appraisal (STA)
Single Technology Appraisal (STA) Durvalumab for maintenance treatment of locally advanced unresectable non-small cell lung cancer that has not progressed after platinum-based chemoradiation therapy Response
More information