The dose is prescribed to the encompassing isodose, incorporating all tumor-related dose points, that is, the so-called “BOS” (base of skull) point, “R” (Rouviere) point, “Pal” right/left points, and the
two newly defined patient points, that is, the “Pt” points (pterygoid plates) and “St” (styloid process) points. (4) To reach high doses in the TT points, small volumes (0.02 cm3) are assigned to the dose points. Thus, when using the inverse planning simulated annealing (automated learn more inverse planning), this could further increase the dose in the TT points. (5). Three-dimensional dose summation of intensity-modulated radiation therapy and BT is still experimental and currently not routinely available in our clinic as yet ( Fig. 2), but it has great potential in future cases of head and neck cancer, associated with (extreme) high doses being applied in TTs (and normal tissues). “
“High-dose intensity-modulated radiotherapy (IMRT) has proven to be an effective treatment for localized prostate cancer , , , ,  and . In the case of local recurrence, salvage options are limited for these patients. These patients are often not considered optimal candidates for salvage prostatectomy because of their age or medical comorbidities even if the disease presentation at the time Pifithrin-�� mw of recurrence demonstrates localized disease only. Prior Selleck C59 definitive dose levels of radiation
to the bladder,
rectal wall, and urethra place these patients at higher risk for severe complications with additional salvage therapy. High-dose-rate brachytherapy (HDR) has dosimetric and radiobiologic advantages as a salvage treatment paradigm. One recent study (7) reported 50% biochemical tumor control outcomes with salvage HDR brachytherapy when used as monotherapy. We report on the long-term results of a prospective Phase II trial where HDR brachytherapy was used as salvage therapy for localized recurrent disease after external beam radiotherapy (EBRT). Forty-two patients with biopsy-proven recurrence were enrolled on an institutional review board–approved Phase II study of salvage HDR monotherapy using iridium-192. The primary end points of the trial were toxicity, assessed with the Common Toxicity Criteria for Adverse Events version 3, as well as the International Prostate Symptom Score (IPSS), and the International Index of Erectile Function. Biochemical control was evaluated using the Phoenix definition (nadir +2). Patient accrual spanned from 2007 to 2011, and patients were followed for at least 1 year after treatment on protocol and then in routine followup thereafter. Patients were seen in followup 1 month after treatment and then at 4-month intervals. To be eligible for the trial, patients were required to have biopsy-proven recurrence after definitive EBRT.