Subject(s)
Radiopharmaceuticals/therapeutic use , Antibodies, Monoclonal/therapeutic use , Ascites/radiotherapy , Bone Neoplasms/radiotherapy , Bone Neoplasms/secondary , Chromium Compounds/therapeutic use , Humans , Hyperthyroidism/radiotherapy , Iodine Radioisotopes/therapeutic use , Lymphoma, Non-Hodgkin/radiotherapy , Organometallic Compounds/therapeutic use , Organophosphorus Compounds/therapeutic use , Pain/etiology , Pain/radiotherapy , Patient Isolation/standards , Phosphates/therapeutic use , Pleural Effusion, Malignant/radiotherapy , Polycythemia Vera/radiotherapy , Radiation Protection/standards , Radiopharmaceuticals/adverse effects , Sodium Iodide/therapeutic use , Strontium Radioisotopes/therapeutic use , Thrombocytopenia/radiotherapy , Thyroid Neoplasms/radiotherapy , Yttrium Radioisotopes/therapeutic useABSTRACT
Since 1996, seven patients from six radiotherapy facilities that treat more than 2,000 patients per year were treated with radiotherapy for symptomatic metastases to the mandible from primary carcinoma of the prostate (3 patients), carcinoma of the breast (2 patients), adenocarcinoma of the ethmoid sinuses (1 patient), and multiple myeloma (1 patient). All patients presented with pain of several weeks' duration and had radiographic confirmation of a destructive lesion in the mandible. Administered radiotherapy doses ranged from 400 cGy/1 fraction to 4,000 cGy/20 fractions. All patients experienced excellent palliation with complete or almost complete resolution of all symptoms within 1 month. The authors suggest short courses of radiotherapy for symptomatic metastases to the mandible.
Subject(s)
Mandibular Neoplasms/radiotherapy , Mandibular Neoplasms/secondary , Palliative Care , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Radiotherapy DosageABSTRACT
BACKGROUND: The current study documented the implementation of three-dimensional conformal radiotherapy and assessed the tumor control and toxicity of such treatment in a large, multisite community practice. METHODS: The authors retrospectively reviewed their first 222 consecutive patients with clinically localized (N0) prostate carcinoma treated with a 6-field conformal technique from October 1993 through March 2000. Standardized target definitions, dose planning constraints, and gantry angles were utilized to develop the treatment plan. Patients were categorized by low, intermediate, and high risk. Low risk was defined as T1a-T2a disease, a Gleason score < 7, and prostate-specific antigen (PSA) level 6, or PSA level > 10.01 ng/mL (n = 60 [27%]). High risk was defined as 2 of the above risk factors or as T3 disease, a Gleason score > 7, or a PSA level > 20 (n = 115 [52%]). Biochemical disease recurrence was defined in accordance with the American Society for Therapeutic Radiology and Oncology definition. Urinary and bowel toxicity were graded using the Radiation Therapy Oncology Group morbidity scoring system. RESULTS: The median follow-up after radiotherapy for surviving patients was 47 months (range, 0-99 months). The 2 and 5-year actuarial biochemical control rates for all patients were 84% and 78%, respectively. Using logistic regression analysis, lower dose (< 75.6 gray [Gy] vs. 75.6 Gy; P = 0.006), higher risk group (P = 0.033), higher stage (P = 0.045), and higher PSA level (P = 0.001) were significantly associated with biochemical disease recurrence. Toxicity was not significantly correlated with a higher radiotherapy dose. CONCLUSIONS: Dose escalation to 75.6 Gy using a 6-field conformal technique was feasible in the authors' community practice and resulted in acceptable toxicity and early biochemical outcomes.