The overall results did not demonstrate significant differences by treatment arm for survival and ERC time to neurologic progression. Investigator neurologic assessments demonstrated an MGd treatment benefit in all patients. In lung cancer patients, ERC- and investigator-determined time to neurologic progression demonstrated an MGd treatment benefit. MGd may improve time to neurologic and neurocognitive progression in lung cancer.

This is a retrospective study of 362 patients with a T1N0M0 glottic laryngeal carcinoma treated by radiotherapy. Waiting time was defined as time from the day of histopathological diagnosis to the first day of radiotherapy. The Cox regression model was used to analyse the influence of waiting time for radiotherapy on the incidence of recurrence. The median follow-up time was 4.4 years. The median waiting time for radiotherapy was 43 days. Local recurrences were found in 58 patients. There was no significant correlation (P= 0.88) between waiting time and the outcome of early glottic cancer as analysed by Cox regression. This retrospective study did not demonstrate an effect of waiting time for radiotherapy on the outcome of early glottic laryngeal cancer.

Background: Validation of magnetic resonance imaging (MRI) and development of guidelines for the delineation of the gross tumor volume (GTV) is of utmost importance to benefit from the visibility of anatomical details on MR images and to achieve an accurate GTV delineation. In the ideal situation, the GTV delineation corresponds to the histopathologically determined 'true tumor volume'. Consequently, we developed guidelines for GTV delineation of laryngeal and hypopharyngeal tumors on MRI and determined the accuracy of the resulting delineation of the tumor outline on histopathology as gold standard. Material and methods: Twenty-seven patients with T3 or T4 laryngeal/hypopharyngeal cancer underwent a MRI scan before laryngectomy. Hematoxylin and eosin sections were obtained from surgical specimens and tumor was delineated by one pathologist. GTV was delineated on MR images by three independent observers in two sessions. The first session (del1) was performed according to clinical practice. In the second session (del2) guidelines were used. The reconstructed specimen was registered to the MR images for comparison of the delineated GTVs to the tumor on histopathology. Volumes and overlap parameters were analyzed. A target margin needed to assure tumor coverage was determined. Results: The median GTVs (del1: 19.4 cm 3 , del2: 15.8 cm 3 ) were larger than the tumor volume on pathology (10.5 cm 3 ). Comparable target margins were needed for both delineation sessions to assure tumor coverage. By adding these margins to the GTVs, the target volumes for del1 (median: 81.3 cm 3 ) were significantly larger than for del2 (median: 64.2 cm 3 ) (p 0.0001) with similar tumor coverage. Conclusions: In clinical radiotherapy practice, the delineated GTV on MRI is twice as large as the tumor volume. Validated delineation guidelines lead to a significant decrease in the overestimation of the tumor volume.