RESUMO
We evaluate techniques for radiotherapy to low neck and inguinal lymph nodes. Partial transmission blocks (PTBs) simplify treatment planning, daily setup, and improve reproducibility and dose homogeneity. PTBs minimize the risk for dose misadministration to critical organs. Disadvantages include doses that are potentially lower to the medial cervical lymphatics and higher to the femur. PTBs can surmount common treatment planning problems.
Assuntos
Irradiação Linfática/métodos , Proteção Radiológica/métodos , Virilha , Humanos , Pescoço , Proteção Radiológica/instrumentação , Dosagem RadioterapêuticaRESUMO
Patients with locally advanced solid tumors of the lung, head and neck, and malignant astrocytomas usually succumb to their disease despite aggressive standard therapy. Laboratory data suggest that the addition of 1.0 to 10 nmol/L paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ), a microtubule stabilizing drug, to radiation therapy may result in significant radiation sensitization, perhaps due to accumulation of cells at G2/M. Relatively low concentrations (1.0 to 10 nmol/L) appear to be optimal for direct cytotoxicity and radiosensitization in vitro. Within this dose range, more prolonged exposure seems to result in higher response rates. The phase I trials reported here are designed to test the combination of paclitaxel, administered by continuous intravenous infusion (24 hours a day, 7 days a week), and standard, curative-intent radiation therapy. The ultimate goal of this study is to improve local and systemic control and survival for patients with these three tumor types. To date, 39 evaluable patients are enrolled in this study; there has been no dose-limiting toxicity up to 6.5 mg/m2/d. Observed toxicities include anemia, lymphopenia, mucositis, and cutaneous toxicities.
Assuntos
Antineoplásicos Fitogênicos/uso terapêutico , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Neoplasias Pulmonares/tratamento farmacológico , Paclitaxel/uso terapêutico , Radiossensibilizantes/uso terapêutico , Antineoplásicos Fitogênicos/administração & dosagem , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/radioterapia , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/radioterapia , Glioblastoma/tratamento farmacológico , Glioblastoma/radioterapia , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Infusões Intravenosas , Neoplasias Pulmonares/radioterapia , Paclitaxel/administração & dosagem , Radiossensibilizantes/administração & dosagem , Radioterapia Adjuvante , Análise de SobrevidaRESUMO
The use of a vertex field can be a practical technique for treatment of pituitary and brain tumors. This approach may be underutilized, primarily because of the difficulty in documenting noncoplanar treatment fields. This paper describes a method for documenting vertex treatment fields by inference using portal films. This method is relatively simple to implement, yet yields accurate results.
