Interferon-alpha For Recurrent World Health Organization Grade 1 Intracranial Meningiomas.

Items 1 - 20 of 56202 Page of 2811Next 1: Related Articles, Links Chamberlain MC, Glantz MJ. Interferon-alpha for recurrent World Health Organization grade 1 intracranial meningiomas. Cancer. 2008 Aug 28. [Epub ahead of print] PMID: 18756531 [PubMed - as supplied by publisher] 2: Related Articles, Links Perry JR, Rizek P, Cashman R, Morrison M, Morrison T. Temozolomide rechallenge in recurrent malignant glioma by using a continuous temozolomide schedule: the "rescue" approach. Cancer. 2008 Aug 28. [Epub ahead of print] PMID: 18756530 [PubMed - as supplied by publisher] 3: Related Articles, Links Bensadoun RJ, Dassonville O, Rousmans S. [2008 Update of Standards, Options: Recommendations for management of patients with salivary gland malignant tumours (excluding lymphoma, sarcoma and melanoma), summary report.] Bull Cancer. 2008 Aug;95(7):735-49. French. PMID: 18755651 [PubMed - in process] 4: Related Articles, Links Katayama N, Sato S, Katsui K, Takemoto M, Tsuda T, Yoshida A, Morito T, Nakagawa T, Mizuta A, Waki T, Niiya H, Kanazawa S. Analysis of Factors Associated with Radiation-Induced Bronchiolitis Obliterans Organizing Pneumonia Syndrome After Breast-Conserving Therapy. Int J Radiat Oncol Biol Phys. 2008 Aug 26. [Epub ahead of print] PMID: 18755559 [PubMed - as supplied by publisher] 5: Related Articles, Links Topolnjak R, van Vliet-Vroegindeweij C, Sonke JJ, Minkema D, Remeijer P, Nijkamp J, Elkhuizen P, Rasch C. Breast-Conserving Therapy: Radiotherapy Margins for Breast Tumor Bed Boost. Int J Radiat Oncol Biol Phys. 2008 Aug 26. [Epub ahead of print] PMID: 18755557 [PubMed - as supplied by publisher]

6: Related Articles, Links Rodríguez N, Algara M, Foro P, Lacruz M, Reig A, Membrive I, Lozano J, López JL, Quera J, Fernández-Velilla E, Sanz X. Predictors of Acute Esophagitis in Lung Cancer Patients Treated With Concurrent ThreeDimensional Conformal Radiotherapy and Chemotherapy. Int J Radiat Oncol Biol Phys. 2008 Aug 26. [Epub ahead of print] PMID: 18755556 [PubMed - as supplied by publisher] 7: Related Articles, Links King CR, Brooks JD, Gill H, Pawlicki T, Cotrutz C, Presti JC Jr. Stereotactic Body Radiotherapy for Localized Prostate Cancer: Interim Results of a Prospective Phase II Clinical Trial. Int J Radiat Oncol Biol Phys. 2008 Aug 26. [Epub ahead of print] PMID: 18755555 [PubMed - as supplied by publisher] 8: Related Articles, Links Aaronson DS, Elliott SP, McAninch JW. Transcorporal Artificial Urinary Sphincter Placement for Incontinence in High-risk Patients After Treatment of Prostate Cancer. Urology. 2008 Aug 25. [Epub ahead of print] PMID: 18752838 [PubMed - as supplied by publisher] 9: Related Articles, Links Bjerggaard Jensen J, Johansen JK, Graversen PH. Laparoscopic pelvic lymph-node dissection in prostate cancer before external beam radiotherapy: Risk factors of nodal involvement and relapse following intended curative treatment. Scand J Urol Nephrol. 2008 Aug 27:1-6. [Epub ahead of print] PMID: 18752151 [PubMed - as supplied by publisher] 10: Related Articles, Links Maemura K, Shinchi H, Noma H, Mataki Y, Kurahara H, Maeda S, Hiraki Y, Nakajo M, Natsugoe S, Takao S. Comparison of hyper-fractionated accelerated and standard fractionated radiotherapy with concomitant low-dose gemcitabine for unresectable pancreatic cancer. Anticancer Res. 2008 Jul-Aug;28(4C):2369-72. PMID: 18751420 [PubMed - in process] 11:

Related Articles, Links Colombo GL, Matteo SD, Mir LM. Cost-effectiveness analysis of electrochemotherapy with the Cliniporatortrade mark vs other methods for the control and treatment of cutaneous and subcutaneous tumors. Ther Clin Risk Manag. 2008 Apr;4(2):541-8. PMID: 18728828 [PubMed - in process] 12: Related Articles, Links Fonseca CO, Linden R, Futuro D, Gattass CR, Quirico-Santos T. Ras pathway activation in gliomas: a strategic target for intranasal administration of perillyl alcohol. Arch Immunol Ther Exp (Warsz). 2008 Jul-Aug;56(4):267-76. Epub 2008 Jul 29. PMID: 18726148 [PubMed - in process] 13: Related Articles, Links Smith GL, Smith BD, Buchholz TA, Giordano SH, Garden AS, Woodward WA, Krumholz HM, Weber RS, Ang KK, Rosenthal DI. Cerebrovascular Disease Risk in Older Head and Neck Cancer Patients After Radiotherapy. J Clin Oncol. 2008 Aug 25. [Epub ahead of print] PMID: 18725647 [PubMed - as supplied by publisher] 14: Related Articles, Links Fuwa N, Kodaira T, Tachibana H, Nakamura T, Tomita N, Daimon T. Long-term Observation of 64 Patients with Roentgenographically Occult Lung Cancer Treated with External Irradiation and Intraluminal Irradiation Using Low-dose-rate Iridium. Jpn J Clin Oncol. 2008 Aug 22. [Epub ahead of print] PMID: 18723609 [PubMed - as supplied by publisher] 15: Related Articles, Links Tanguay JS, Ford DR, Sadler G, Buckley L, Uppal H, Cross J, Holmes N, Fortes Mayer K, Fernando I. Selective Axillary Node Sampling and Radiotherapy to the Axilla in the Management of Breast Cancer. Clin Oncol (R Coll Radiol). 2008 Aug 21. [Epub ahead of print] PMID: 18722758 [PubMed - as supplied by publisher] 16: Related Articles, Links Chen Y, Guo W, Lu Y, Zou B.

Dose-individualized stereotactic body radiotherapy for T1-3N0 non-small cell lung cancer: Long-term results and efficacy of adjuvant chemotherapy. Radiother Oncol. 2008 Aug 21. [Epub ahead of print] PMID: 18722684 [PubMed - as supplied by publisher] 17: Related Articles, Links Lian J, Dundas G, Carlone M, Ghosh S, Pearcey R. Twenty-year review of radiotherapy for vaginal cancer: An institutional experience. Gynecol Oncol. 2008 Aug 21. [Epub ahead of print] PMID: 18722657 [PubMed - as supplied by publisher] 18: Related Articles, Links Soto DE, Daignault S, Sandler HM, Ray ME. No Effect of Statins on Biochemical Outcomes After Radiotherapy for Localized Prostate Cancer. Urology. 2008 Aug 21. [Epub ahead of print] PMID: 18722651 [PubMed - as supplied by publisher] 19: Related Articles, Links Rosen B, Starkschall G, Britton K, Mohan R, Cox JD. Utility of four-dimensional computed tomography for analysis of intrafractional and interfractional variation in lung volumes. Int J Radiat Oncol Biol Phys. 2008 Sep 1;72(1):288-94. PMID: 18722279 [PubMed - in process] 20: Related Articles, Links Xie Y, Djajaputra D, King CR, Hossain S, Ma L, Xing L. Intrafractional motion of the prostate during hypofractionated radiotherapy. Int J Radiat Oncol Biol Phys. 2008 Sep 1;72(1):236-46. PMID: 18722274 [PubMed - in process]

Cancer. 2008 Aug 28. [Epub ahead of print] Related Articles, Links

Interferon-alpha for recurrent World Health Organization grade 1

intracranial meningiomas. Chamberlain MC, Glantz MJ. Department of Neurology, University of Washington/Fred Hutchinson Cancer Research Center, Seattle, Washington. BACKGROUND.: Intracranial meningiomas are common, they frequently recur after surgery or radiotherapy, and there are limited data regarding the treatment of intracranial meningiomas with chemotherapy. A phase 2 study was designed to estimate the 6-month progression-free survival of patients with recurrent, treatment-refractory, World Health Organization grade 1 meningiomas who were treated with interferon-alpha. METHODS.: Thirty-five patients with recurrent meningiomas ranging in age from 36 years to 88 years (median age, 61 years) were treated according to a prospective phase 2 study. All patients had received prior surgery, radiotherapy, (involved-field radiotherapy in 35 patients andstereotactic radiotherapy in 22 patients), and chemotherapy (hydroxyurea in 19 patients and other in 17 patients). On radiographic documentation of progressive disease, interferon-alpha (at a dose of 10 million U/m(2) administered subcutaneously every other day) was initiated. A complete blood count and chemistry panel was obtained before every cycle, and cranial magnetic resonance images were obtained every 3 months. RESULTS.: The most common grade 3 and 4 toxicities were fatigue (6 patients; 17%), anemia (3 patients; 8.6%), and leukopenia (3 patients; 8.6%) (toxicities were graded according to the National Cancer Institute's Common Toxicity Criteria [version 3.0]). Three patients went off study because of toxicity, and 7 patients required a dose reduction. There were no treatment-related deaths or delays in therapy reported. All patients were assessable for response. No patient demonstrated a neuroradiographic complete or partial response. Twenty-six patients demonstrated stable disease after the first 3 cycles of interferon-alpha, and 9 patients had progressive disease. The progressionfree survival rate was 54% at 6 months and 31% at 12 months. The median time to tumor progression was 7 months (range, 2-24 months). The median survival was 8 months (range, 3-28 months). CONCLUSIONS.: Treatment with interferon-alpha for recurrent meningiomas was found to be tolerated moderately well and was modestly effective. Cancer 2008. (c) 2008 American Cancer Society. PMID: 18756531 [PubMed - as supplied by publisher] 2: Cancer. 2008 Aug 28. [Epub ahead of print] Related Articles, Links

Temozolomide rechallenge in recurrent malignant glioma by using a continuous temozolomide schedule: the "rescue" approach. Perry JR, Rizek P, Cashman R, Morrison M, Morrison T. Crolla Family Brain Tumour Research Unit, Department of Medicine, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada.

BACKGROUND.: Despite advances in first-line therapy, there are few data on treatment of glioblastoma multiforme (GBM) at recurrence. Temozolomide (TMZ) is well tolerated and may have activity despite prior TMZ exposure if novel dose schedules are used. METHODS.: The authors reviewed their experience with a continuous TMZ schedule (50 mg/m(2) daily), given at progression after conventional 5-day TMZ. Patients were reported in 3 groups: 1) GBM after progression on conventional TMZ; 2) GBM at first recurrence after completion of standard concomitant and adjuvant TMZ; and 3) patients with other anaplastic gliomas at second relapse on conventional TMZ. RESULTS.: In Group 1, 21 patients with a median age of 54 years (range, 33 years-68 years) received a median of 3 cycles (range, 2-12 cycles) of continuous TMZ at 50 mg/m(2). Overall clinical benefit (complete response, partial response, and stable disease) was 47%, with 6-month progression-free survival (PFS) of 17%. In Group 2, 14 patients with GBM, median age 52 years (range, 38 years-62 years) received continuous TMZ at progression after initial TMZ/radiotherapy (RT) and adjuvant TMZ. The median interval after adjuvant TMZ was 3 months (range, 2 months-10 months). A median of 5 cycles of TMZ was given, and 6-month PFS was 57%. In Group 3, 14 patients with a median age of 49 years (range, 34 years-56 years) received continuous TMZ; 2 partial responses and 6 with stable disease were seen, with a 6-month PFS of 42%. Toxicities were mild and well tolerated; lymphopenia was common but no serious opportunistic infections were identified. CONCLUSIONS.: Although retrospective, our results demonstrate that continuous daily administration of TMZ is an active regimen despite prior TMZ therapy. The excellent tolerability of this regimen may allow future combination with other alkylating agents or with novel therapies. Cancer 2008. (c) 2008 American Cancer Society. PMID: 18756530 [PubMed - as supplied by publisher] 3: Bull Cancer. 2008 Aug;95(7):735-49. Related Articles, Links

[2008 Update of Standards, Options: Recommendations for management of patients with salivary gland malignant tumours (excluding lymphoma, sarcoma and melanoma), summary report.] [Article in French] Bensadoun RJ, Dassonville O, Rousmans S. Oncologue radiothérapeute, Centre Antoine-Lacassagne, Nice (coordonnateur), Chirurgien ORL cervico-facial et maxillofacial, Centre Antoine-Lacassagne, Nice, Méthodologiste SOR-chef de projet, Institut National du Cancer, Boulogne-Billancourt. The << Standards, Options : Recommendations >> (SOR) project has been undertaken by the French National Federation of Cancer Centers (FNCLCC) is now part of the French National Cancer Institute. The project involves the development and updating of evidence-based Clinical Practice Guidelines (CPG) in oncology. This paper is a summary

version of the full clinical practice guideline presenting the updated recommendations for management of patients with salivary gland malignant tumours. Recommendations on radiotherapy have been updated to underline new Options on more and more accessible emerging techniques including intensity-modulated radiotherapy, 3D conformational radiotherapy, Cyberknife, tomotherapy, protontherapy and particle accelerators producing carbon ions (e.g. last generation hadrontherapy). Publication Types: •

English Abstract

PMID: 18755651 [PubMed - in process] 4: Int J Radiat Oncol Biol Phys. 2008 Aug 26. [Epub ahead of print] Related Articles, Links

Analysis of Factors Associated with Radiation-Induced Bronchiolitis Obliterans Organizing Pneumonia Syndrome After Breast-Conserving Therapy. Katayama N, Sato S, Katsui K, Takemoto M, Tsuda T, Yoshida A, Morito T, Nakagawa T, Mizuta A, Waki T, Niiya H, Kanazawa S. Department of Radiology, Okayama University Hospital, Okayama, Japan. PURPOSE: To evaluate factors associated with radiation-induced bronchiolitis obliterans organizing pneumonia (BOOP) syndrome after breast-conserving therapy. METHODS AND MATERIALS: A total of 702 women with breast cancer who received radiotherapy after breast-conserving surgery at seven institutions between July 1995 and December 2006 were analyzed. In all patients, the whole breast was irradiated with two tangential photon beams. The criteria used for the diagnosis of radiation-induced BOOP syndrome were as follows: (1) radiotherapy to the breast within 12 months, (2) general and/or respiratory symptoms lasting for >/=2 weeks, (3) radiographs showing lung infiltration outside the radiation port, and (4) no evidence of a specific cause. RESULTS: Radiationinduced BOOP syndrome was seen in 16 patients (2.3%). Eleven patients (68.8%) were administered steroids. The duration of steroid administration ranged from 1 week to 3.7 years (median, 1.1 years). Multivariate analysis revealed that age (>/=50 years; odds ratio [OR] 8.88; 95% confidence interval [CI] 1.16-67.76; p = 0.04) and concurrent endocrine therapy (OR 3.05; 95% CI 1.09-8.54; p = 0.03) were significantly associated with BOOP syndrome. Of the 161 patients whose age was >/=50 years and who received concurrent endocrine therapy, 10 (6.2%) developed BOOP syndrome. CONCLUSIONS: Age (>/=50 years) and concurrent endocrine therapy can promote the development of radiationinduced BOOP syndrome after breast-conserving therapy. Physicians should carefully follow patients who received breast-conserving therapy, especially those who are older than 50 years and received concurrent endocrine therapy during radiotherapy.

PMID: 18755559 [PubMed - as supplied by publisher] 5: Int J Radiat Oncol Biol Phys. 2008 Aug 26. [Epub ahead of print] Related Articles, Links

Breast-Conserving Therapy: Radiotherapy Margins for Breast Tumor Bed Boost. Topolnjak R, van Vliet-Vroegindeweij C, Sonke JJ, Minkema D, Remeijer P, Nijkamp J, Elkhuizen P, Rasch C. Department of Radiotherapy, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Huis, Amsterdam, The Netherlands. PURPOSE: To quantify the interfraction position variability of the excision cavity (EC) and to compare the rib and breast surface as surrogates for the cavity. Additionally, we sought to determine the required margin for on-line, off-line and no correction protocols in external beam radiotherapy. METHODS AND MATERIALS: A total of 20 patients were studied who had been treated in the supine position for 28 daily fractions. Conebeam computed tomography scans were regularly acquired according to a shrinking action level setup correction protocol based on bony anatomy registration of the ribs and sternum. The position of the excision area was retrospectively analyzed by gray value cone-beam computed tomography-to-computed tomography registration. Subsequently, three setup correction strategies (on-line, off-line, and no corrections) were applied, according to the rib and breast surface registrations, to estimate the residual setup errors (systematic [Sigma] and random [sigma]) of the excision area. The required margins were calculated using a margin recipe. RESULTS: The image quality of the cone-beam computed tomography scans was sufficient for localization of the EC. The margins required for the investigated setup correction protocols and the setup errors for the leftright, craniocaudal and anteroposterior directions were 8.3 mm (Sigma = 3.0, sigma = 2.6), 10.6 mm (Sigma = 3.8, sigma = 3.2), and 7.7 mm (Sigma = 2.7, sigma = 2.9) for the no correction strategy; 5.6 mm (Sigma = 2.0, Sigma = 1.8), 6.5 mm (Sigma = 2.3, sigma = 2.3), and 4.5 mm (Sigma = 1.5, sigma = 1.9) for the on-line rib strategy; and 5.1 mm (Sigma = 1.8, sigma = 1.7), 4.8 mm (Sigma = 1.7, sigma = 1.6), and 3.3 mm (Sigma = 1.1, sigma = 1.6) for the on-line surface strategy, respectively. CONCLUSION: Considerable geometric uncertainties in the position of the EC relative to the bony anatomy and breast surface have been observed. By using registration of the breast surface, instead of the rib, the uncertainties in the position of the EC area were reduced. PMID: 18755557 [PubMed - as supplied by publisher] 6: Int J Radiat Oncol Biol Phys. 2008 Aug 26. [Epub ahead of print] Related Articles, Links

Predictors of Acute Esophagitis in Lung Cancer Patients Treated With Concurrent Three-Dimensional Conformal Radiotherapy and

Chemotherapy. Rodríguez N, Algara M, Foro P, Lacruz M, Reig A, Membrive I, Lozano J, López JL, Quera J, Fernández-Velilla E, Sanz X. Department of Radiation Oncology, Hospital de la Esperanza, IMAS, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain. PURPOSE: To evaluate the risk factors for acute esophagitis (AET) in lung cancer patients treated with concurrent 3D-CRT and chemotherapy. METHODS AND MATERIALS: Data from 100 patients treated with concurrent chemoradiotherapy with a mean dose of 62.05 +/- 4.64 Gy were prospectively evaluated. Esophageal toxicity was graded according to criteria of the Radiation Therapy Oncology Group. The following dosimetric parameters were analyzed: length and volume of esophagus in treatment field, percentage of esophagus volume treated to >/=10, >/=20, >/=30, >/=35, >/=40, >/=45, >/=50, >/=55, and >/=60 Gy, and the maximum (D(max)) and mean doses (D(mean)) delivered to the esophagus. Also, we developed an esophagitis index (EI) to account the esophagitis grades over treatment time. RESULTS: A total of 59 patients developed AET (Grade 1, 26 patients; Grade 2, 29 patients; and Grade 3, 4 patients). V50 was associated with AET duration (p = 0.017), AET Grade 1 duration (p = 0.016), maximum analgesia (p = 0.019), esophagitis index score (p = 0.024), and AET Grade >/=1 (p = 0.058). If V50 is <30% there is a 47.3% risk of AET Grade >/=1, which increases to 73.3% if V50 is >/=30% (p = 0.008). The predictive abilities of models (sensitivity and specificity) were calculated by receiver operating characeristic curves. CONCLUSIONS: According to the receiver operating characeristic curve analysis, the 30% of esophageal volume receiving >/=50 Gy was the most statistically significant factor associated with AET Grade >/=1 and maximum analgesia (A(max)). There was an association with AET Grade >/=2 but it did not achieve statistical significance (p = 0.076). PMID: 18755556 [PubMed - as supplied by publisher] 7: Int J Radiat Oncol Biol Phys. 2008 Aug 26. [Epub ahead of print] Related Articles, Links

Stereotactic Body Radiotherapy for Localized Prostate Cancer: Interim Results of a Prospective Phase II Clinical Trial. King CR, Brooks JD, Gill H, Pawlicki T, Cotrutz C, Presti JC Jr. Department of Radiation Oncology, Division of Urologic Oncology, Stanford University School of Medicine, Stanford, CA. PURPOSE: The radiobiology of prostate cancer favors a hypofractionated dose regimen. We report results of a prospective Phase II clinical trial of stereotactic body radiotherapy (SBRT) for localized prostate cancer. METHODS AND MATERIALS: Forty-one lowrisk prostate cancer patients with 6 months' minimum follow-up received 36.25 Gy in five fractions of 7.25 Gy with image-guided SBRT alone using the CyberKnife. The early

(<3 months) and late (>6 months) urinary and rectal toxicities were assessed using validated quality of life questionnaires (International Prostate Symptom Score, Expanded Prostate Cancer Index Composite) and the Radiation Therapy Oncology Group (RTOG) toxicity criteria. Patterns of prostate-specific antigen (PSA) response are analyzed. RESULTS: The median follow-up was 33 months. There were no RTOG Grade 4 acute or late rectal/urinary complications. There were 2 patients with RTOG Grade 3 late urinary toxicity and none with RTOG Grade 3 rectal complications. A reduced rate of severe rectal toxicities was observed with every-other-day vs. 5 consecutive days treatment regimen (0% vs. 38%, p = 0.0035). A benign PSA bounce (median, 0.4 ng/mL) was observed in 12 patients (29%) occurring at 18 months (median) after treatment. At last follow-up, no patient has had a PSA failure regardless of biochemical failure definition. Of 32 patients with 12 months minimum follow-up, 25 patients (78%) achieved a PSA nadir
Transcorporal Artificial Urinary Sphincter Placement for Incontinence in High-risk Patients After Treatment of Prostate Cancer. Aaronson DS, Elliott SP, McAninch JW. University of California, San Francisco, School of Medicine, San Francisco, California. OBJECTIVES: To investigate the transcorporal (TC) vs standard (ST) approach of artificial urinary sphincter (AUS) placement for incontinence after treatment of prostate adenocarcinoma (PCa) with radiotherapy or surgery, or both. METHODS: A database was created to include the data from all patients who had undergone AUS placement from January 2000 to August 2005 at the University of California, San Francisco, Medical Center. We noted the demographic features, comorbidities, PCa therapy, technique for AUS placement, and postoperative outcome. The continence and failure rates were recorded for TC AUS placement in patients previously treated for PCa. RESULTS: A total of 30 patients underwent aus surgery during the study period: 26 for incontinence after PCa treatment. Of the 26 patients, 18 had undergone ST (ST group) and 8 had undergone TC (TC group) AUS placement, with a minimal follow-up of 12 months and a mean follow-up of 31 and 28 months, respectively. The 2 groups did not differ widely in age or comorbidities. Of the patients in the ST and TC groups, 44% and 50% had undergone external beam radiotherapy or brachytherapy and 78% and 100% had undergone radical prostatectomy, respectively. Of the patients in the ST and TC groups, 22% and 89% had undergone >/=2 types of urethral surgery before AUS placement, respectively. A total of 50% of TC group underwent TC placement without having undergone a previous sling or ST AUS procedure. The AUS removal rates were

equivalent between the 2 groups at 2 years. Finally, the success rate for social continence was 69% and 81% for ST and TC group, respectively. CONCLUSIONS: The results of our study, with 2 years of follow-up, have shown that TC AUS placement is an effective salvage or primary incontinence treatment for high-risk patients after PCa therapy. PMID: 18752838 [PubMed - as supplied by publisher] 9: Scand J Urol Nephrol. 2008 Aug 27:1-6. [Epub ahead of print] Related Articles, Links

Laparoscopic pelvic lymph-node dissection in prostate cancer before external beam radiotherapy: Risk factors of nodal involvement and relapse following intended curative treatment. Bjerggaard Jensen J, Johansen JK, Graversen PH. Department of Urology, Regionshospitalet Holstebro, Denmark. Objective. To report experience with laparoscopic pelvic lymph-node dissection (LPLND) in patients with prostate cancer before radiotherapy. Selection of risk factors for nodal involvement (N1) and recurrence following radiotherapy was made. Material and methods. From November 1999 to June 2007, 177 patients with prostate cancer underwent LPLND at this department. The lymphadenectomy was limited to the obturator fossa bilaterally. Patients without nodal involvement were offered external beam radiotherapy with adjuvant hormone treatment. Results. Complications occurred in 17 patients (9%). The majority of these were minor and were managed by conservative methods. Twenty-six patients (15%) were diagnosed with N1. High Gleason score and a high percentage of positive needle core biopsies were both risk factors of N1 as well as recurrent disease following radiotherapy (p<0.01 and 0.01, respectively). Clinically, T3 disease was associated with a risk of recurrence but not N1. High prostate-specific antigen (PSA) nadir was also a significant predictor of recurrence. Neither pretreatment PSA nor prostate volume was associated with N1 or recurrence. Conclusions. LPLND is a safe, well-established staging modality in clinically localized prostate cancer before radiotherapy. Risk factors upon diagnosis may be useful in the estimation of N1 and risk of recurrence. PMID: 18752151 [PubMed - as supplied by publisher] 10: Anticancer Res. 2008 Jul-Aug;28(4C):2369-72. Related Articles, Links

Comparison of hyper-fractionated accelerated and standard fractionated radiotherapy with concomitant low-dose gemcitabine for unresectable pancreatic cancer. Maemura K, Shinchi H, Noma H, Mataki Y, Kurahara H, Maeda S, Hiraki Y, Nakajo M, Natsugoe S, Takao S.

Surgical Oncology and Digestive Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan. [email protected] BACKGROUND: Concurrent chemoradiotherapy with gemcitabine improves median survival for patients with unresectable pancreatic cancer. Recently, hyperfractionated accelerated radiotherapy (HART) has been used to treat these patients; however, the safety and efficacy are not well defined. PATIENTS AND METHODS: The standardfractionated radiotherapy (SFRT) group (n=17) received 50.4 Gy in 28 fractions of 1.8 Gy/day. The HART group (n=18) received 50 Gy in 40 fractions of 1.25 Gy twice/day. Concurrent gemcitabine was administered to both groups. RESULTS: Median survival times were 11.3 months (SFRT) and 12.9 months (HART). One- and two-year survival rates were 37.5% and 18.8% (SFRT) and 47.1% and 17.6% (HART), respectively. The response rates did not differ significantly. The HART regimen required significantly fewer treatment days (35.5) than did the SFRT regimen (41.3). The toxicity profiles were similar. CONCLUSION: The HART/gemcitabine regimen has equivalent efficacy and a shorter treatment time as compared with the SFRT/gemcitabine regimen for patients with unresectable pancreatic cancer. PMID: 18751420 [PubMed - in process] 11: Ther Clin Risk Manag. 2008 Apr;4(2):541-8. Related Articles, Links

Cost-effectiveness analysis of electrochemotherapy with the Cliniporatortrade mark vs other methods for the control and treatment of cutaneous and subcutaneous tumors. Colombo GL, Matteo SD, Mir LM. S.A.V.E. Studi Analisi Valutazioni Economiche Milan, Italy. INTRODUCTION: Tumors of any histological origin can give rise to cutaneous and subcutaneous metastases during follow-up. This study aims to evaluate the costs and benefits of electrochemotherapy (ECT) with the Cliniporatortrade mark vs other currently used methods in the control and treatment of cutaneous and subcutaneous advanced neoplasms. MATERIALS AND METHODS: A cost-effectiveness analysis was carried out on ECT using the Cliniporator vs other techniques (radiotherapy, hyperthermia associated with radiotherapy and chemotherapy, interferon-alpha, and isolated limb perfusion) for the control and treatment of cutaneous and subcutaneous neoplasms. The direct health costs were attributed a value according to the Italian National Healthcare System. Resource consumption and clinical outcomes were derived from cost survey data collection and literature review. RESULTS: ECT is cost-effective with an incremental cost effectiveness ratio (ICER) of euro1,571.53 to achieve a further additional response. Radiotherapy and interferon-alpha are the least effective strategies. A combination of hyperthermia, chemotherapy, radiotherapy, and interferon-alpha treatment are dominated by ECT (more costly and less effective). Isolated limb perfusion is the most effective

treatment, but is very costly (euro18,530.47) because of the use of antiblastic drugs (TNFalpha), with an ICER of euro92,717.29. CONCLUSIONS: After sensitivity analysis, the study results confirm the favorable cost-effectiveness ratio of ECT with the Cliniporator and justify its wider use. PMID: 18728828 [PubMed - in process] 12: Arch Immunol Ther Exp (Warsz). 2008 Jul-Aug;56(4):267-76. Epub 2008 Jul 29. Related Articles, Links

Ras pathway activation in gliomas: a strategic target for intranasal administration of perillyl alcohol. Fonseca CO, Linden R, Futuro D, Gattass CR, Quirico-Santos T. Serviço de Neurocirurgia, Hospital Universitário Antônio Pedro, Departamento de Cirurgia Geral e Especializada, Centro de Ciências Médicas, CEP 24030-210, Niterói, RJ, Brazil, [email protected]. INTRODUCTION: Targeted therapy directed at specific molecular alterations is already creating a shift in the treatment of cancer patients. Malignant gliomas commonly overexpress the oncogenes EGFR and PDGFR and contain mutations and deletions of the tumor suppressor genes PTEN and TP53. Some of these alterations lead to activation of the P13K/Akt and Ras/MAPK pathways, which provide targets for therapy. Perillyl alcohol (POH), the isoprenoid of greatest clinical interest, was initially considered to inhibit farnesyl protein transferase. Follow-up studies revealed that POH suppresses the synthesis of small G proteins, including Ras. Intranasal delivery allows drugs that do not cross the blood-brain barrier to enter the central nervous system. Moreover, it eliminates the need for systemic delivery, thereby reducing unwanted systemic side effects. MATERIALS AND METHODS: Applying this method, a phase I/II clinical trial of POH was performed in patients with relapsed malignant gliomas after standard treatment: surgery, radiotherapy, and chemotherapy. POH was administrated in a concentration of 0.3% volume/volume (55 mg) four times daily in an interrupted administration schedule. The objective was to evaluate toxicity and progression-free survival (PFS) after six months of treatment. The cohort consisted of 37 patients, including 29 with glioblastoma multiforme (GBM), 5 with grade III astrocytoma (AA), and 3 with anaplastic oligodendroglioma (AO). Neurological examination and suitable image analysis (computed tomography (CT), magnetic resonance imaging (MRI)) established disease progression. Complete response was defined as neurological stability or improvement of conditions, disappearance of CT/MRI tumor image, and corticosteroid withdraw; partial response (PR) as >/=50 reduction of CT/MRI tumor image, neurological stability, or improvement of conditions and corticosteroid requirement; progressive course (PC) as >/=25 increase in CT/MRI tumor image or the appearance of a new lesion; and stable disease as a lack of any changes in the CT/MR tumor image or neurological status. RESULTS: After six months of treatment, PR was observed in 3.4% (n=1) of the patients with GBM and 33.3% (n=1) with AO; stable disease in 44.8% (n=13) with GBM, 60% (n=3) with AA, and 33.3% (n=1) with AO; and PC in 51.7% (n=15) with GBM, 40%

(n=2), with AA and 33.3% (n=1) AO. PFS (sum of PRs and stable disease) was 48.2% for GBM, 60% for AA, and 66.6% for AO patients. CONCLUSIONS: The preliminary results indicate that intranasal administration of the signal transduction inhibitor POH is a safe, noninvasive, and low-cost method. There were no toxicity events and the regression of tumor size in some patients is suggestive of antitumor activity. PMID: 18726148 [PubMed - in process] 13: J Clin Oncol. 2008 Aug 25. [Epub ahead of print] Related Articles, Links

Cerebrovascular Disease Risk in Older Head and Neck Cancer Patients After Radiotherapy. Smith GL, Smith BD, Buchholz TA, Giordano SH, Garden AS, Woodward WA, Krumholz HM, Weber RS, Ang KK, Rosenthal DI. Departments of Radiation Oncology, Breast Medical Oncology, and Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, TX; and the Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT. PURPOSE: Cerebrovascular disease is common in head and neck cancer patients, but it is unknown whether radiotherapy increases the cerebrovascular disease risk in this population. PATIENTS AND METHODS: We identified 6,862 patients (age > 65 years) from the Surveillance, Epidemiology, and End Results (SEER) -Medicare cohort diagnosed with nonmetastatic head and neck cancer between 1992 and 2002. Using proportional hazards regression, we compared risk of cerebrovascular events (stroke, carotid revascularization, or stroke death) after treatment with radiotherapy alone, surgery plus radiotherapy, or surgery alone. To further validate whether treatment groups had equivalent baseline risk of vascular disease, we compared the risks of developing a control diagnosis, cardiac events (myocardial infarction, percutaneous coronary intervention, coronary artery bypass graft, or cardiac death). Unlike cerebrovascular risk, no difference in cardiac risk was hypothesized. RESULTS: Mean age was 76 +/- 7 years. Ten-year incidence of cerebrovascular events was 34% in patients treated with radiotherapy alone compared with 25% in patients treated with surgery plus radiotherapy and 26% in patients treated with surgery alone (P < .001). After adjusting for covariates, patients treated with radiotherapy alone had increased cerebrovascular risk compared with surgery plus radiotherapy (hazard ratio [HR] = 1.42; 95% CI, 1.14 to 1.77) and surgery alone (HR = 1.50; 95% CI, 1.18 to 1.90). However, no difference was found for surgery plus radiotherapy versus surgery alone (P = .60). As expected, patients treated with radiotherapy alone had no increased cardiac risk compared with the other treatment groups (P = .63 and P = .81). CONCLUSION: Definitive radiotherapy for head and neck cancer, but not postoperative radiotherapy, was associated with excess cerebrovascular disease risk in older patients.

PMID: 18725647 [PubMed - as supplied by publisher] 14: Jpn J Clin Oncol. 2008 Aug 22. [Epub ahead of print] Related Articles, Links

Long-term Observation of 64 Patients with Roentgenographically Occult Lung Cancer Treated with External Irradiation and Intraluminal Irradiation Using Low-dose-rate Iridium. Fuwa N, Kodaira T, Tachibana H, Nakamura T, Tomita N, Daimon T. 1Department of Radiation Oncology, Southern Tohoku Proton Center, Fukushima. OBJECTIVE: Therapeutic results of intraluminal irradiation were analyzed in 64 patients with roentgenographically occult lung cancer (ROLC). METHODS: The subjects were 64 patients who underwent intraluminal irradiation between 1987 and 2003. Radiotherapy was performed by combining external irradiation with intraluminal irradiation using lowdose-rate iridium (four 370-MBq wires) through a catheter with a spacer. The doses of radiation were 0-70 Gy (median value 46 Gy) by external irradiation and 10-60 Gy (median value 29.3 Gy) by intraluminal irradiation. RESULTS: The therapeutic effect was CR in 63 patients and PR in 1 patient, and local recurrence was observed in a PR case and in seven of the 63 patients who showed CR. The 5-year overall and relapse-free survival rates were 56 (95% CI, 43-69%) and 55% (95% CI, 43-68%), respectively. Fatal pulmonary hemorrhage was observed in one case. CONCLUSIONS: Considering the facts that ROLC often occurs as multiple cancers and that many patients with ROLC have reduced lung function, radiation therapy by a combination of intraluminal and external irradiation may replace surgery as the first choice for the treatment of this disease. PMID: 18723609 [PubMed - as supplied by publisher] 15: Clin Oncol (R Coll Radiol). 2008 Aug 21. [Epub ahead of print] Related Articles, Links

Selective Axillary Node Sampling and Radiotherapy to the Axilla in the Management of Breast Cancer. Tanguay JS, Ford DR, Sadler G, Buckley L, Uppal H, Cross J, Holmes N, Fortes Mayer K, Fernando I. University Hospital Birmingham, Birmingham, UK; Walsall Manor Hospital, Walsall, West Midlands, UK. AIMS: Axillary treatment for patients with early-stage breast cancer can be associated with considerable morbidity. Techniques, such as axillary node sampling (ANS) and, more recently, sentinel node biopsy, in combination with radiotherapy have the potential

to reduce toxicity. A retrospective review of axillary treatment in patients with early-stage breast cancer treated at our institution between 1997 and 2003 was carried out to assess the outcome and morbidity of ANS in combination with radiotherapy. MATERIALS AND METHODS: The treatment policy was to carry out four-node, Edinburgh-style ANS except in those cases with either palpably enlarged nodes or cytological confirmation of involvement or with clinically obvious node involvement at surgery when level 2 axillary node clearance (ANC) was carried out. Patients with involved nodes after ANS received postoperative axillary radiotherapy. RESULTS: In total, 381 patients were included, 331 received ANS and 50 received ANC. The median follow-up was 6.5 years and overall survival at 5 years was 84%. Pathologically involved nodes were found in 152/331 (50%) ANS patients and 43/50 (86%) ANC patients. The rate of local recurrence (breast or chest wall) at 5 years was 4% (95% confidence interval 117%) in the ANC group and 2% (95% confidence interval 1-4%) in the ANS group. The nodal recurrence rate of those undergoing ANS was 3% (11/331) compared with 6% (3/50) for those treated by ANC. The rate of clinically significant lymphoedema at 5 years was significantly higher (P=0.01) in the ANC arm: 18% (95% confidence interval 9-32%) compared with 5% (95% confidence interval 3-8%) in those treated by ANS. Thirty-one cases received additional supraclavicular fossa irradiation because of the involvement of more than four nodes on ANS, which may not have been available with sentinel node biopsy and has implications for current practice. CONCLUSIONS: Selective ANS with the removal of a minimum of four nodes guides optimal locoregional treatment with good local control rates, low overall morbidity and may obviate the need for a second surgical procedure. PMID: 18722758 [PubMed - as supplied by publisher] 16: Radiother Oncol. 2008 Aug 21. [Epub ahead of print] Related Articles, Links

Dose-individualized stereotactic body radiotherapy for T1-3N0 non-small cell lung cancer: Long-term results and efficacy of adjuvant chemotherapy. Chen Y, Guo W, Lu Y, Zou B. Division of Thoracic Cancer, Huaxi Hospital, Sichuan University Chengdu, China. PURPOSE: To evaluate the efficacy of dose-individualized stereotactic body radiotherapy (SBRT) and adjuvant chemotherapy in stage T1-3N0M0 non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Sixty-five patients with T1-3N0M0 NSCLC treated by SBRT between April 2001 and August 2005 were included. Twenty patients were CT-staged at stage T1, 34 at stage T2, and 11 at stage T3. All patients underwent no elective nodal irradiation. SBRT total doses ranged from 71.8 to 115.2Gy of biological equivalent dose (BED) in 3.6 to 8.0Gy daily fractions. Seventeen patients were offered cisplatin-containing adjuvant chemotherapy. RESULTS: The overall response rate was 90.6% at six months. The 3- and 5-year overall survival rates for all patients were 57.3% and 35.1%, respectively, and for stage T1-2 patients these were 60.2,

36.5%, respectively. Of all patients, the 3- and 5-year overall survival rates of adjuvant chemotherapy group were 80.5% and 46.0%, respectively, and those of patients with SBRT alone were 49.6% and 31.5%, respectively. Patients who accepted adjuvant chemotherapy had a lower relapse rate and better overall survival. Acute toxicities were mild, and no long-term toxicity was observed. CONCLUSIONS: Patients treated with the dose-individualization strategy of SBRT showed excellent local control and improved survival. Adjuvant chemotherapy may reduce the frequency of relapse and increase overall survival in stage at T1-3N0M0 NSCLC patients. PMID: 18722684 [PubMed - as supplied by publisher] 17: Gynecol Oncol. 2008 Aug 21. [Epub ahead of print] Related Articles, Links

Twenty-year review of radiotherapy for vaginal cancer: An institutional experience. Lian J, Dundas G, Carlone M, Ghosh S, Pearcey R. Department of Radiation Oncology, Cross Cancer Institute and University of Alberta, Edmonton, Canada. OBJECTIVE: To evaluate clinical outcome, prognostic factors and chronic morbidity with radiotherapy for vaginal cancer treatment. MATERIALS AND METHODS: 68 patients with vaginal cancer treated by radical or adjuvant radiotherapy (RT) were selected. Five with rare subtypes of histopathology and 8 with adenocarcinoma were excluded from this study. 76.4% of the remainder had early-stage diseases (stage I: 14, II: 28, III: 9, and IV: 4). The patients in the years from which they were treated were almost evenly distributed (1st 5 years: 13, 2nd: 14, 3rd: 16, and 4th: 12). There were four treatment groups: external beam radiotherapy (EBRT) alone (n=18), brachytherapy (BT) alone (n=4), EBRT and BT (n=30), and surgery plus RT (n=3). RESULTS: Median follow-up was 50.3 months ranging from 3 to 213 months. 5-year overall survival (OS) was 55.6%, disease-specific survival (DSS) was 77.3%, disease-free survival was 74.2%, and local control was 87.7%. Independent prognostic factors for DSS and OS were tumor stage, site and size (p<0.05). Late radiation toxicity was minimal in the bladder (4.6%) and bowel (4.6%). Vaginal morbidity was observed in 35 patients (63.6%). It was lowest in the BT alone (0%), and highest in the EBRT and BT group (82.1%), especially for those received more than 70 Gy (p=0.05, Odds ratio=4.64, 95% confidence interval: 1.01-21.65). CONCLUSION: This retrospective review suggested that tumor stage, site, and size were important prognostic factors in patients with vaginal cancer. Higher radiation dose was associated with more frequent vaginal toxicity. PMID: 18722657 [PubMed - as supplied by publisher] 18: Urology. 2008 Aug 21. [Epub ahead of print] Related Articles, Links

No Effect of Statins on Biochemical Outcomes After Radiotherapy for Localized Prostate Cancer. Soto DE, Daignault S, Sandler HM, Ray ME. Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA. OBJECTIVES: To examine the effect of concurrent statin use during definitive radiotherapy (RT) on the biochemical outcomes for localized prostate cancer. METHODS: A total of 968 patients treated with RT had information about medication use available. Of these, 23% had been taking using statins during RT. Progression-free survival (PFS) was determined by a biochemical failure definition of prostate-specific antigen nadir plus 2 ng/mL, clinical failure, start of androgen deprivation therapy, or death. RESULTS: The mean patient age was 68 years. The median radiation dose was 76 Gy. Of the patients, 29% underwent androgen deprivation therapy. The 5-year overall survival rate was 83%. The median PFS time was 7.8 years versus 6.4 years, and the 5year PFS rate was 70% versus 59% in favor of the statin users (P = 0.03). The analysis by risk group demonstrated no significant statin effect in any of the three risk strata. Stratification by hydrophilic versus hydrophobic statin agents revealed similar results. Multivariate analysis revealed that T stage (P <0.0001), pretreatment prostate-specific antigen level (P <0.0001), and Gleason score (P = 0.0026) were significant predictors of PFS; however, statin use (P = 0.48), androgen deprivation therapy (P = 0.95), pelvic RT (P = 0.96), radiation dose (P = 0.13), age (P = 0.19), and year of treatment (P = 0.07) were not. CONCLUSIONS: Statin use did not affect PFS after adjusting for differences in treatment year and multiple prognostic factors. However, T stage, baseline prostatespecific antigen level, and Gleason score were critical determinants of prostate-specific antigen failure. These results did not differ when hydrophilic pravastatin was excluded. PMID: 18722651 [PubMed - as supplied by publisher] 19: Int J Radiat Oncol Biol Phys. 2008 Sep 1;72(1):288-94. Related Articles, Links

Utility of four-dimensional computed tomography for analysis of intrafractional and interfractional variation in lung volumes. Rosen B, Starkschall G, Britton K, Mohan R, Cox JD. Department of Radiation Physics, The University of Texas M. D. Anderson Cancer Center, Houston, TX. PURPOSE: To assess the viability of four-dimensional (4D) computed tomography (CT) in describing intrafractional and interfractional changes in lung volumes and to determine which breathing phase, if any, produces the most highly reproducible lung volumes among fractions. METHODS AND MATERIALS: Weekly 4D CT scans were acquired

for 13 patients with non-small-cell lung cancer during a course of radiotherapy. Contours delineating the right lung, left lung, and total lung were obtained by adapting library models of the anatomic structures to the CT images and propagating them to all 10 respiratory phases represented in the 4D CT image data set. Lung volumes were calculated using software tools in a commercial radiation treatment-planning system and analyzed for interfractional volume reproducibility using t tests and for phase reproducibility using a phase-dependent uncertainty curve across all patients. Probability (p) values of <0.05 were considered to indicate significant differences in all comparisons. RESULTS: The average mean coefficient of variation of tidal volume across all patients was 25.0%. The average standard deviation of tidal volumes was 5.7% relative to the lung volume at end-expiration. Total volumes measured at the 30% phase were 15% more consistent than those measured at end-inspiration (p = 0.03). CONCLUSIONS: Fourdimensional CT assesses lung volume with acceptable precision; but the technique was unable to accurately predict interfractional changes in lung volume because wide variations in intra- and interfractional breathing cause high uncertainties in 4D CT data acquisition. The most reproducible breathing phase seems to be at the 30-40% phase (just before end-expiration). PMID: 18722279 [PubMed - in process] 20: Int J Radiat Oncol Biol Phys. 2008 Sep 1;72(1):236-46. Related Articles, Links

Intrafractional motion of the prostate during hypofractionated radiotherapy. Xie Y, Djajaputra D, King CR, Hossain S, Ma L, Xing L. Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA. PURPOSE: To report the characteristics of prostate motion as tracked by the stereoscopic X-ray images of the implanted fiducials during hypofractionated radiotherapy with CyberKnife. METHODS AND MATERIALS: Twenty-one patients with prostate cancer who were treated with CyberKnife between January 2005 and September 2007 were selected for this retrospective study. The CyberKnife uses a stereoscopic X-ray system to obtain the position of the prostate target through the monitoring of implanted gold fiducial markers. If there is a significant deviation, the treatment is paused while the patient is repositioned by moving the couch. The deviations calculated from X-ray images acquired within the time interval between two consecutive couch motions constitute a data set. RESULTS: Included in the analysis were 427 data sets and 4,439 time stamps of X-ray images. The mean duration for each data set was 697 sec. At 30 sec, a motion >2 mm exists in about 5% of data sets. The percentage is increased to 8%, 11%, and 14% at 60 sec, 90 sec, and 120 sec, respectively. A similar trend exists for other values of prostate motion. CONCLUSIONS: With proper monitoring and intervention during treatment, the prostate shifts observed among patients can be kept within the tracking range of the CyberKnife. On average, a sampling rate of approximately 40 sec

between consecutive X-rays is acceptable to ensure submillimeter tracking. However, there is significant movement variation among patients, and a higher sampling rate may be necessary in some patients. PMID: 18722274 [PubMed - in process] Items 1 - 20 of 56202 Page of 2811Next Display Show • •

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