Bone metastasis consensus statement.
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Bone Neoplasms↗
Biomedical subjects
P Blitzer
Publications and source records attributed to P Blitzer.
Three-dimensional photon treatment planning in carcinoma of the larynx.
The role of three-dimensional (3-D) treatment planning in the definitive treatment of carcinoma of the larynx with radiation was evaluated at four institutions as part of an NCI contract. A total of 30 different treatment approaches were devised for two patients with larynx cancer. CT scans were obtained for both patients and various treatment planning tools were employed to optimize beam arrangements and to evaluate the resulting dose distribution. The effect on dose distribution of a number of factors was also examined: 1) the use of dose calculation algorithms which correct for tissue inhomogeneities, 2) the variation of the CT numbers used for inhomogeneity corrections to simulate inaccuracies in the knowledge of the CT numbers, and 3) the modification of beam energy. A multitude of data was used in plan evaluation and a numerical score was given to each plan to estimate the tumor control probability and the normal tissue complication probability. We found 3-D treatment planning to be of potential value in optimizing treatment plans in larynx cancer. Improved target coverage was achieved when complete information describing 3-D geometry of the anatomy was utilized. In some cases, the treatment planning tools employed, such as the beam's eye view, helped devise novel beam arrangements which were useful alternatives to standard techniques. We found little effect of change in CT number on dose distributions. A comparison between dose distributions calculated with tissue inhomogeneity corrections to those calculated without this correction showed little difference. We did find some improvement in the dose to the primary tumor volume at lower beam energies, but with an increased larynx volume potentially receiving doses above tolerance.
Adult↗
Current results of proton beam irradiation of uveal melanomas.
Proton beam irradiation has been used for the treatment of 241 uveal melanomas over the past 7 1/2 years. Twelve melanomas (5%) were small, 99 (41%) medium, 103 (43%) large and 27 (1%) extra-large melanomas. The mean length of follow-up was 21 months and the median 15 months. Ninety-four percent of the treated lesions with a follow-up more than two years and 65% of tumors with shorter follow-up showed regression. The most recent visual acuity was 20/40 or better in 47% and 20/100 or better in 66%. Ten eyes were enucleated because of complications (9) or continued tumor growth (1). Thirteen patients developed metastases from 4 to 50 months of treatment. Our data indicate that proton irradiation can be used to treat melanomas of various sizes and in a variety of locations, and preliminary results suggest that proton therapy has no deleterious effect on the likelihood of the development of metastases.
Adolescent↗