148 research outputs found
Evaluation of the surgical learning curve for I-125 episcleral plaque placement for the treatment of posterior uveal melanoma: a two decade review
Mucosal Melanomas of the Head and Neck: The Role of Postoperative Radiation Therapy
Objectives. Mucosal melanomas are rarer than their cutaneous counterparts and are associated with a poorer prognosis. We report the clinical outcomes of patients with mucosal melanomas of the head and neck region generally treated with definitive surgery followed by postoperative radiation therapy (RT). Methods. We reviewed the records of 17 patients treated at the University of Miami in 1990–2007. Patients generally received conventionally fractionated RT regimens to the postoperative bed. Elective nodal RT was not routinely delivered. Eight patients received adjuvant chemotherapy or immunotherapy. Results. Median followup was 35.2 months (range 5–225). As the first site of failure: 3 patients recurred locally, 2 regionally and 2 distantly. All 3 patients who recurred locally had not received RT. Of the 5 locoregional recurrences, 4 were salvaged successfully with multimodality therapy with no evidence of disease at last followup. Overall survival was 64.7% at 2 years and 51.5% at 5 years. Conclusions. Patients with mucosal melanoma of the head and neck are best treated with surgery to achieve negative margins, followed by postoperative RT to optimize local control. Elective nodal irradiation may not be indicated in all cases, as regional failures were not predominant. Distant metastases were fewer when compared to historical data, potentially due to advancements in adjuvant therapies as well as aggressive multi-modality salvage at time of failure
Long-Term Followup Comparing Two Treatment Dosing Strategies of 125
Objective. To investigate the efficacy of two different dosing strategies of radioactive iodine-125 (125I) in the management of small- and medium-sized posterior uveal melanoma. Patients and Methods. The medical records of consecutive patients with choroidal melanomas between 1.5 and 5.0 mm in apical height treated initially with 125I plaque radiotherapy were reviewed. Patients were treated with one of the following two treatment dosing strategies: (1) 85 Gy to the apical height of the tumor (group 1) or (2) 85 Gy to a prescription point of 5.0 mm (group 2). Results. Of 95 patients, 55 patients were treated to the apical height of the tumor, and 40 were treated to a prescription point of 5.0 mm. Comparative analysis of the incidence rates of specific complications between the two groups demonstrates that group 2 had a significantly higher incidence of radiation retinopathy, radiation optic neuropathy, and/or visually significant cataract formation than group 1 (). Conclusion. Treatment of choroidal melanomas less than 5 mm in apical height with 125I brachytherapy to the true apical height is equally effective when compared to treatment with 85 Gy to 5.0 mm. Treatment to the apical height of the tumor may result in lower incidence of radiation-related complications
Clinical Study Long-Term Followup Comparing Two Treatment Dosing Strategies of 125 I Plaque Radiotherapy in the Management of Small/Medium Posterior Uveal Melanoma
Objective. To investigate the efficacy of two different dosing strategies of radioactive iodine-125 ( 125 I) in the management of smalland medium-sized posterior uveal melanoma. Patients and Methods. The medical records of consecutive patients with choroidal melanomas between 1.5 and 5.0 mm in apical height treated initially with 125 I plaque radiotherapy were reviewed. Patients were treated with one of the following two treatment dosing strategies: (1) 85 Gy to the apical height of the tumor (group 1) or (2) 85 Gy to a prescription point of 5.0 mm (group 2). Results. Of 95 patients, 55 patients were treated to the apical height of the tumor, and 40 were treated to a prescription point of 5.0 mm. Comparative analysis of the incidence rates of specific complications between the two groups demonstrates that group 2 had a significantly higher incidence of radiation retinopathy, radiation optic neuropathy, and/or visually significant cataract formation than group 1 ( = 0.028). Conclusion. Treatment of choroidal melanomas less than 5 mm in apical height with 125 I brachytherapy to the true apical height is equally effective when compared to treatment with 85 Gy to 5.0 mm. Treatment to the apical height of the tumor may result in lower incidence of radiation-related complications
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Time-dose relationships and brachytherapy in radiation oncology of head and neck cancer
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Clinical summary: The challenge of local tumor control and its impact on survival
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Radiation Therapy for Adjunctive Treatment of Adrenal Cortical Carcinoma
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The effect of sublethal X-irradiation on erythropoiesis in the mouse
BALC/c female mice were exposed to 300 R of total body X-irradiation following which erythropoiesis was studied for the next 8 weeks. The data indicate that the initial effects of radiation injury on erythropoiesis is marked depression of both splenic and marrow erynthropoiesis and the development of ineffective release of maturing RBCs from these organs, as demonstrated by marked decreases in organ radioiron uptake and in radioiron reappearance in RBCs, respectively. The data suggest a complex interrelationship between splenic and marrow erythropoiesis following erythropoietic perturbation. We conclude that the mouse spleen may function in a booster capacity to marrow erythropoiesis in the attainment and maintenance of a new steady-state condition
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Increased Splenic Transplantable Colony-Forming Units Related to Increased Radioresistance After Rauscher Leukemia Virus Infection of the SJL/J Mouse
Using the exogenous colony-forming unit (CFU) assay of Till and McCulloch, we studied changes in splenic CFU content as a function of time after Rauscher leukemia virus (RLV) infection of the SJL/J mouse, and we related splenic CFU content to previously reported changes in radiosensitivity after infection. Total splenic CFU content [colony-forming potential (CFP)/spleen] first increased after the 6th day of infection, correlating with the appearance of splenomegaly and of radioresistance. CFP/spleen continued to increase until day 22 after infection, reaching 16 times normal levels. This increase was positively correlated with greater radioresistance. Beyond the 22d day of infection, CFP/spleen fell somewhat but was never <9 times normal values. However, calculations based on existing information regarding spleen cell radiation survival and turnover indicated that this level of splenic CFU was sufficient to provide radioprotection at the level of X-ray exposure used. We conclude, from these studies, that RLV infection increased the number of splenic hematopoietic stem cells of the SJL/J mouse and this increase resulted in the greater radio-resistance
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