Stuff to add:

  • Chamberlain prodedure
  • ACOSOG Z0050 (PET for Lung ca)
  • cyrotherapy - Jewel THompson effect, Argon
  • ICRU publications 38/50/62
  • Prostate MRI: T2 best for visualizing prostate gland, T1 for showing post-bx hemorrhage, can use T1 or T2 for LN
  • American Urologic Association (AUA) stage for prostate
  • [training.seer.cancer.gov/ss]
  • MRI: Choline/Creatinine ratio versus Citrate. In cancer, citrate is lowered, and choline/creat is increased
  • MRI: diffusion coefficient decreased in tumor
  • Prostate: T3, include all SV in PTV
  • Prostate: RTOG P-0126, 79.2 Gy vs 70.2, Int Risk
  • Prostate: ext/int iliac LN. common iliac uncommon. presarcal uncommon.
  • Look up: Radiol 211: 815-828, 1991 - cross sectional nodal anatomy
  • ASTRO 2004: LN relationship to vessels (prostate)
  • Prostate "standard" pelvic field: up to L4/L5
  • Treatment planning: EUD (equivalent uniform dose), TCP/NTCP (biological cost function), Lyman - sigmoid curve
  • Treatment planning: score, uncomplicated tumor control S=T(1-P1)*(1-P2)
  • Langer et al, Kallman et al.
  • EUD: Niemierco and Mohan
  • EUD=[volume*dose^a]^(1/a)... where a=exponent. if a>>0, EUD trends toward max dose. if a<<0 trends toward min dose
  • inverse planning algorithms:
    • exhausive search, 1960s
    • simulated annealing (Kirkpatrick 1983, Gemen 1984, Aarts 1985, Webb 1989)
    • filtered backprojection - based on inverse CT technique, Fourier transform. but often gives negative doses which aren't possible
    • L.Xing, Med PHys 25, 1845-49 - iterative method
    • genetic algorithms
  • GIST - KIT tyrosine kinase receptor, binds growth factor
  • SARCOMA:
    • Rosenberg 1982, NCI - amp vs surg/xrt
    • Pisters, MSKCC, JCO 1996 - surg vs surg/xrt
    • Yang, NCI, 1998
    • O'Sullivan NCIC, Lancet 2002 - pre-op vs post-op
    • LR/OS/Regional/Distant control - same for pre/post-op (already metastatic?). post-op has worse grade 3/4 fibrosis (36% vs 23% for preop)
    • fractures 10% at 60-66 Gy (postop) vs 2% for preop 50 Gy
    • preop more wound complications
    • tumor cells >1cm from tumor in 1/3 of cases -- need for large margins
  • HODGKIN LYMPHOMA (correct name)
    • Rye 1966, WHO 2001 (added lymphocyte rich classical HL)
    • use ABVD chemo + IF-XRT 30-36 Gy
    • early stage: extended field + ABVD - high risk of 2nd malignancy, but good cause-specific survival (overall survival is less)
      Milan 1990-1996, EFRT v IFRT (30-36 Gy) x 4 cycles chemo
      EORTC H8F
      Engent JCo 21: 3601, 2003
      new std of care is short course chemo + IF-RT
  • MALT LYMPHOMA (stomach) - treated like low grade
    • stomach 18 Gy AP/PA, boost obliques to 36 Gy off kidneys
    • new disease - described in 1980s
    • 1/3 have diffuse disease (Stage III-IV)
    • if treat H.pylori may regress. response can take 6 months. assay C-14 urea breath test to follow response, not antibodies
    • Tsang, PMH, JCO 2003, 21:4157
    • 100% control w XRT
  • BURKITT'S LYMHOMA
    • "starry sky"
    • BCL-2 negative usually
  • CNS: RTOG 95-08
  • defn of "conformity index" (by Paddick)
  • GK: trigeminal neuralgia, 75 Gy
  • RPA classification for GBM, Curran 1993 - I to VI
  • RPA for mets
  • RTOG 93-05 - GBM... RT+BCNU vs GK then RT+BCNU
  • RTOG 80-07: neutrons for GBM

NEED TO FIX:

  • At RTOG page, 78-03 and 76-15 have same PMID. Which is correct? RTOG 76-15 need ref.

Miscellaneous info edit

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