Assuntos
Compostos Radiofarmacêuticos/uso terapêutico , Anticorpos Monoclonais/uso terapêutico , Ascite/radioterapia , Neoplasias Ósseas/radioterapia , Neoplasias Ósseas/secundário , Compostos de Cromo/uso terapêutico , Humanos , Hipertireoidismo/radioterapia , Radioisótopos do Iodo/uso terapêutico , Linfoma não Hodgkin/radioterapia , Compostos Organometálicos/uso terapêutico , Compostos Organofosforados/uso terapêutico , Dor/etiologia , Dor/radioterapia , Isolamento de Pacientes/normas , Fosfatos/uso terapêutico , Derrame Pleural Maligno/radioterapia , Policitemia Vera/radioterapia , Proteção Radiológica/normas , Compostos Radiofarmacêuticos/efeitos adversos , Iodeto de Sódio/uso terapêutico , Radioisótopos de Estrôncio/uso terapêutico , Trombocitopenia/radioterapia , Neoplasias da Glândula Tireoide/radioterapia , Radioisótopos de Ítrio/uso terapêuticoRESUMO
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.
Assuntos
Carcinoma/radioterapia , Recidiva Local de Neoplasia , Neoplasias da Próstata/radioterapia , Radioterapia Conformacional , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Antígeno Prostático Específico , Neoplasias da Próstata/patologia , Estudos Retrospectivos , Fatores de Risco , Resultado do TratamentoRESUMO
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.
