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No abstract

In accordance with literature data the hitherto course of this case corroborates that radiation therapy (RT) modalities can play an important role in the treatment of PC.

The primary objective of the present randomized phase III trial was to compare the 3-yr survival rate of patients treated with standard fractionated radiotherapy (RT) alone or with the same RT concomitantly with cisplatin (DDP) or carboplatin (Cb). From January 1995 until July 1999, 124 patients with histologically proven locally advanced non-nasopharyngeal head and neck cancer (HNC) were randomized to receive either RT monotherapy (70 Gy, Group A) or the same RT concomitantly with DDP (100 mg/m2 on d 2, 22, 42, Group B) or Cb (7 AUC on d 2, 22, 42, Group C). There were no significant differences in complete response rates between patients treated with RT alone or combined chemoradiotherapy. However, median time to progression (TTP) and overall survival (OS) were significantly longer in patients treated with concomitant chemoradiotherapy. Thus, median TTP was 6.3, 45.2, and 17.7 mo in groups A, B, and C respectively (p = 0.0002). Similarly, median OS was 12.2, 48.6, and 24.5 mo, respectively (p = 0.0003). At 3 yr follow-up, 17.5% of patients in group A were alive compared to 52% in group B and 42% in group C (p < 0.001). Patients treated with concomitant chemoradiotherapy experienced more frequently severe hematological toxicity. Also, severe nausea/vomiting was more pronounced in group B, as expected. The present study clearly demonstrated that concomitant chemoradiotherapy with platinum analogs significantly prolongs 3-yr survival and median OS in patients with locally advanced HNC compared to conventional RT alone.

No abstract

3-D conformal HDR brachytherapy as monotherapy using intraoperative real-time planning is a feasible and highly conformal treatment for localized prostate cancer associated with minimal acute toxicity. Longer follow-up is needed to evaluate late toxicity and biochemical control.

In high dose rate (HDR) brachytherapy, conventional dose optimization algorithms consider multiple objectives in the form of an aggregate function that transforms the multiobjective problem into a single-objective problem. As a result, there is a loss of information on the available alternative possible solutions. This method assumes that the treatment planner exactly understands the correlation between competing objectives and knows the physical constraints. This knowledge is provided by the Pareto trade-off set obtained by single-objective optimization algorithms with a repeated optimization with different importance vectors. A mapping technique avoids non-feasible solutions with negative dwell weights and allows the use of constraint free gradient-based deterministic algorithms. We compare various such algorithms and methods which could improve their performance. This finally allows us to generate a large number of solutions in a few minutes. We use objectives expressed in terms of dose variances obtained from a few hundred sampling points in the planning target volume (PTV) and in organs at risk (OAR). We compare two- to four-dimensional Pareto fronts obtained with the deterministic algorithms and with a fast-simulated annealing algorithm. For PTV-based objectives, due to the convex objective functions, the obtained solutions are global optimal. If OARs are included, then the solutions found are also global optimal, although local minima may be present as suggested.