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Biomedical subjects

T LoSasso

Publications and source records attributed to T LoSasso.

21 records · Page 2Linked to original sources

Three-dimensional treatment planning for postoperative treatment of rectal carcinoma.

The role of three-dimensional (3-D) treatment planning for postoperative radiation therapy was evaluated for rectal carcinoma as part of an NCI contract awarded to four institutions. It was found that the most important contribution of 3-D planning for this site was the ability to plan and localize target and normal tissues at all levels of the treatment volume, rather than using the traditional method of planning with only a single central transverse slice and simulation films. There was also a slight additional improvement when there were no constraints on the types of plans (i.e., when noncoplanar beams were used). Inhomogeneity considerations were not important at this site under the conditions of planning, i.e., with energies greater than 4 MV and multiple fields. Higher beam energies (15-25 MV) were preferred by a small margin over lower energies (down to 4 MV). The beam's eye view and dose-volume histograms were found quite useful as planning tools, but it was clear that work should continue on better 3-D displays and improved means of translating such plans to the treatment area.

Combined Modality Therapy↗

Radiation therapy for retinoblastoma: comparison of results with lens-sparing versus lateral beam techniques.

From 1979 through 1986, 170 children were seen at our institution diagnosed with retinoblastoma. Sixty-six of the children with involvement of 121 eyes, were referred for definitive external beam radiation to one or both eyes. During the study period, two distinct radiation techniques were used. From 1980 through mid-1984, a lens-sparing technique included an anterior electron beam with a contact lens mounted lead shield, combined with a lateral field, was used. Since mid-1984, a modified lateral beam technique has been used, mixing lateral electrons and superior and inferior lateral oblique split beam wedged photons. Doses prescribed were similar for both techniques, ranging from 3,850 to 5,000 cGy in 4 to 5 weeks. The lens-sparing and the modified lateral techniques are compared for local control. For eyes with Group I through III disease, the lens-sparing technique resulted in local control in 33% of the eyes treated, where the modified lateral technique controlled 83% of the eyes treated (p = .006). Mean time to relapse was identical in both groups, that is 24 and 26 months respectively. Most relapses were successfully treated with further local therapy, including laser or cryosurgery, or 60Co plaques. Five eyes required enucleation following initial treatment with the lens-sparing technique, but none thus far with the lateral beam technique. For eyes with Group IV and V disease, no significant differences were found between the two techniques in terms of local control or eventual need for enucleation. With a mean follow-up time of 33 months for the entire group, the 4-year survival is 93%. Two of the 4 deaths are due to second primary tumor, and all 4 have occurred in the lens-sparing group. Because follow-up time is more limited in the lateral beam group, this is not statistically significant and direct survival comparisons are premature.

Eye Neoplasms↗

Results of external beam radiation for children with retinoblastoma: a comparison of two techniques.

From 1979 through 1987, 82 children with retinoblastoma were treated with primary external beam therapy, to one or both eyes. A total of 120 eyes were irradiated, with doses from 3850-5000 cGy. We used a lens-sparing electron beam technique from 1979 to 1984 and a modified lateral beam technique from 1984 to 1987. Comparison of outcome for eyes with Group I-III (Reese-Ellsworth) disease revealed a significant advantage for freedom from relapse favoring the lateral technique (p = 0.0009). A similar trend was noted for final eye outcome (need for enucleation). No differences were noted for eyes with Group IV-V disease. Patient survival was 90% at 4 years, with a mean follow-up time of 36 months.

Child, Preschool↗