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High-dose-rate brachytherapy is a relatively new radiotherapeutic intervention that is used as a curative treatment for patients with many types of cancer. Advances in mechanical systems and computer applications result [...]

The frequency and effect of adjuvant Radiation Therapy (RT) on overall and relative survival within the large US population was evaluated on 21,249 women's. Of 21,249 women's, 4080 received adjuvant RT and 17,169 did not receive adjuvant RT while the study also revealed a statistically significant association between improved overall and relative survival and adjuvant RT in stage IC disease.

The article discusses the study which aims to evaluate the effects of prophylactic cranial irradiation (PCI) on overall survival and cause-specific survival. The study includes 7995 patients with limited stage small cell lung cancer from the National Cancer Institute's Surveillance, Epidemiology and End Result (SEER) Program from 1988 and 1997. The study needs to consider prophylactic cranial irradiation for patients with restricted stage small cell lung cancer.

The article reports on results of a study comparing the incidence, mortality and presentation of small cell carcinoma of the cervix with other histologies. A description of the study design and methods is presented. The study concluded that small cell carcinoma is a rare histology of cervical cancer associated with a worse prognosis and a predilection for nodal and distant metastasis.

The article discusses a study on descriptive nomograms of adjuvant radiotherapy (RT) use and patterns of care analysis for stage I and II of endometrial adenocarcinoma. It found that higher tumor grade and stage led to greater use of RT. It notes that geographic location had a significant effect on overall RT use and therapy choice. It also mentions the absence of a national consensus on adjuvant treatment for early-stage disease.

Abstract: Objective. : The role of post-operative radiotherapy (RT) in women with early-stage, low to intermediate risk cancer of the uterine corpus remains controversial. The primary objective of this analysis was to evaluate the survival outcomes of women with early-stage endometrial cancer treated with surgery alone or surgery followed by RT. Methods. : Data from two institutions were collected from 1990 to 2003. The 608 eligible women had FIGO stage IA to IIA endometrial cancer and underwent primary surgery±RT. Univariate and multivariate analyses of pertinent variables were performed for the end points of disease-free survival (DFS) and overall survival (OS). Results. : The median age for all women was 64 years. RT was delivered to 133 women (22%). Unfavorable histologic grade (P < 0.0001) and stage (P < 0.0001) were significantly more prevalent in the adjuvant RT group. At a median follow-up of 5.2 years, 26 pelvic (11 vaginal) and 16 distant failures occurred along with 110 deaths (with no significant differences between women undergoing surgery alone or followed by RT). Adjuvant RT, younger age, and lower stage predicted for improved DFS and OS on multivariate analysis. Stratified analysis revealed that adjuvant RT conferred a survival benefit in women with stage IC or IIA disease. Conclusions. : Adjuvant RT was associated with improved disease-free and overall survival in women with higher risk disease. Despite significantly worse disease characteristics among women in the adjuvant RT group, the analyzed end points were equivalent among the two groups. These findings suggest that adjuvant radiotherapy has a significant benefit in reducing mortality and disease progression in early-stage carcinoma of the uterine corpus. [Copyright &y& Elsevier]

Abstract: Objective.: To evaluate treatment outcomes in women with early-stage endometrial cancer (FIGO IA, IB, IC, or IIA) surgically managed by a general gynecologist (GYN) or a gynecologic oncologist (GYO). Methods and results.: 349 women treated from 1990–2003 were studied. Median follow-up was 3.7 years. Ninety-five were classified as high-intermediate risk (HIR: stages IB grade III, IC grade II or III, any stage IIA). 110 women received adjuvant radiotherapy. The GYO group had more unfavorable tumor characteristics based on stage and grade (P < 0.0001), shorter follow-up (median 3.1 vs. 5.1 years, P = 0.0002), and an absolute 12% less likelihood of receiving adjuvant radiotherapy (P = 0.04). Local and distant failures were not significantly different. Overall survival favored GYN patients (P = 0.02) with no difference in disease-specific survival (P = 0.38). Multivariate analysis for disease-free survival revealed HIR disease (P = 0.04) and GYO treatment (P = 0.049) to be significant, with a trend for age ≤64 (P = 0.05). Multivariate analysis for overall survival found age ≤64 (P = 0.0001), HIR disease (P = 0.01), and adjuvant radiotherapy (P = 0.0055) to be significant. Conclusions.: Women primarily managed by a GYO for early-stage disease were significantly less likely to receive adjuvant radiotherapy. Despite significantly more unfavorable disease characteristics among GYO-managed women, disease-free and cause-specific survival were equivalent between the two groups. Favorable disease characteristics and adjuvant radiotherapy correlated with improved survival on multivariate analysis. [Copyright &y& Elsevier]

: PurposeA retrospective study to evaluate the outcome of salvage radiotherapy (RT) for clinically apparent, palpable prostate cancer recurrence after radical prostatectomy (RP).: Methods and materialsForty-two patients underwent RT for clinically apparent recurrent prostate cancer after RP between 1993 and 1999. The end points and treatment variables of biochemical disease-free survival were evaluated statistically.: ResultsThe median follow-up was 4.3 years. All 42 patients experienced resolution of clinically detectable recurrence within 1 year after RT. The 5-year biochemical disease-free survival, local control, freedom from distant metastases, and overall survival rate was 27%, 94%, 82%, and 78%, respectively. The initial pathologic stage (T3 or T4; p = 0.04) and interval (<2 years from RP to RT; p = 0.01) were independent predictors of biochemical failure, and RT simulation without contrast (p = 0.05) was nearly significant on multivariate analysis. Three patients (7%) experienced chronic Grade 3 or 4 RT-related toxicity.: ConclusionSalvage prostate bed RT for clinically apparent locally recurrent prostate cancer after RP provides effective local tumor control with modest durable biochemical control. Patients irradiated with a better simulation technique were found to have a more favorable outcome. A consensus on a definition of biochemical disease-free survival after salvage RT is critical for meaningful comparison of the available data and to future progress in treating this disease process. [Copyright &y& Elsevier]