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Abstract: Introduction: The role of elective nodal irradiation of non-small-cell lung cancer (NSCLC) patients treated with radiotherapy remains unclear. We investigated the significance of treating clinically uninvolved lymph nodes by retrospectively analyzing the relationship between loco-regional failure and the irradiated volume. Methods: Between 1998 and 2003, patients with IA–IIIB NSCLC were treated with radiotherapy. The eligibility criteria for this study were an irradiation dose of 60Gy or more and a clinical response better than stable disease. Typical radiotherapy consisted of 40Gy/20fr to the tumor volumes (clinical target volume of the primary tumor [CTVp], of the metastatic lymph nodes [CTVn], and of the subclinical nodal region [CTVs]), followed by off-cord boost to CTVp+n to a total dose 60–68Gy/30–34fr. The relationship between the sites of recurrence and irradiated volumes was analyzed. Results: A total of 127 patients fulfilled the eligibility criteria. Their median overall and progression-free survival times were 23.5 (range, 4.2–109.7) and 9.0 months (2.2–109.7), respectively. At a median follow-up time of 50.5 months (range, 14.2–83.0) for the surviving patients, the first treatment failure was observed in 95 patients (loco-regional; 41, distant; 42, both; 12). Among the patients with loco-regional failure, in-field recurrence occurred in 38 patients, and four CTVs recurrences associated with CTVp+n failure were observed. No isolated recurrence in CTVs was observed. Conclusions: In-field loco-regional failure, as well as distant metastasis, was a major type of failure, and there was no isolated elective nodal failure. Radiation volume adequacy did not seem to affect elective nodal failure. [Copyright &y& Elsevier]

Purpose: To evaluate the effectiveness of small-field radiotherapy in combination with concomitant 5-fluorouracil (5FU) or cisplatin for locally advanced pancreatic carcinoma.Materials and methods: From November 1993 to January 1999, 53 patients underwent continuous 5FU infusion at 200 mg/m2 (27 patients) or a 30-min cisplatin infusion at 5 mg/m2/day (26 patients) just prior to each irradiation. The radiation field was limited to cover the primary and the paraaortic regions at celiac and supramesenteric axis levels. A total dose of 50.4 Gy in 28 sessions was given in 5.6 weeks.Results: Median and 1-year survival rates were 10.2 months and 35.2%, respectively. Local failure occurred in 19 patients (36%) and liver metastases in 16 patients (30%). All local recurrences occurred only within the radiation field.Conclusions: Median survival rates were comparable to other studies. Because local failure occurred only within the radiation field, the use of relatively small-field radiotherapy may be justified in the treatment of locally advanced pancreatic carcinoma in addition to concurrent administration of either 5FU or cisplatin. [Copyright &y& Elsevier]