Patient Research Beta

Contact Us | Terms & Conditions | Privacy Policy | About

Elsevier is the world's leading publisher of Medical Information. We are proud to make available our Patient Research option as a Beta program for patients, or friends/family of patients, who have a medical need for information regarding a medical situation for them or someone they know. This Beta program provides the article you request for free, with a small handling fee, $4.95. After ordering the article and confirmation of payment, we will e-mail the document to you typically within 2 hours, but no longer than 24 hours. Feasibility of dose escalation using intensity-modulated radiotherapy in posthysterectomy cervical carcinoma International Journal of Radiation Oncology*Biology*Physics, Volume 61, Issue 4, 15 March 2005, Pages 1062-1070 Abstract: PurposeTo evaluate retrospectively the utility of intensity-modulated radiotherapy (IMRT) in reducing the volume of normal tissues receiving radiation at varying dose levels when the female pelvis after hysterectomy is treated to doses of 50.4 Gy and 54 Gy.Methods and materialsComputed tomography scans from 10 patients who had previously undergone conventional postoperative RT were selected. The clinical tumor volume (vaginal apex and iliac nodes) and organs at risk were contoured. Margins were added to generate the planning tumor volume. The Pinnacle and Corvus planning systems were used to develop conventional and IMRT plans, respectively. Conventional four-field plans were prescribed to deliver 45 Gy (4F45 Gy) or 50.4 Gy; eight-field IMRT plans were prescribed to deliver 50.4 Gy (IMRT50.4 Gy) or 54 Gy (IMRT54 Gy) to the planning tumor volume. All plans were normalized so that ≥97% of the planning tumor volume received the prescribed dose. Student's t test was used to compare the volumes of organs at risk receiving the same doses with different plans.ResultsThe mean volume of bowel receiving ≥45 Gy was lower with the IMRT50.4 Gy (33% lower) and IMRT54 Gy (18% lower) plans than with the 4F45 Gy plan. The mean volume of rectum receiving ≥45 Gy or ≥50 Gy was also significantly reduced with the IMRT plans despite an escalation of the prescribed dose from 45 Gy with the conventional plans to 54 Gy with IMRT. The mean volume of bladder treated to 45 Gy was the same or slightly lower with the IMRT50.4 Gy and IMRT54 Gy plans compared with the 4F45 Gy plan. Compared with the 4F45 Gy plan, the IMRT50.4 Gy plan resulted in a smaller volume of bowel receiving 35–45 Gy and a larger volume of bowel receiving 50–55 Gy. Compared with the 4F45 Gy plan, the IMRT54 Gy plan resulted in smaller volumes of bowel receiving 45–50 Gy; however, small volumes of bowel received 55–60 Gy with the IMRT plan.ConclusionIntensity-modulated RT may permit an increase in the radiation dose that can safely be delivered to the central pelvis and pelvic lymph nodes after hysterectomy. However, dose–volume calculations using individual CT scans do not account for internal organ motion. Detailed data concerning the relationships among radiation dose, treatment volume, and treatment effects are lacking, and prospective studies of pelvic IMRT are needed to determine the safety and efficacy of this treatment. This Beta program is not intended for use by Medical Professionals. To obtain this document through the Patient Research option you must have a medical need, only use the document for personal use, and agree to all the terms and conditions below. Also, these articles can be obtained for free at your local public or university hospital library. We encourage you to use this as a means of obtaining articles of interest to you. Patient Research Terms and Conditions The terms and conditions set out below govern your use of the content made available through this web-site (the "Site"), including the article or articles that you have selected in connection with your personal medical research (the "Content") for delivery to the e-mail address you will be asked to provide in connection with this service (collectively, the "Service"). In order to provide this Service you understand and agree to provide the personal information you will be asked to provide after you accept these terms and conditions, although our use of such information will be limited to this purpose and otherwise governed by our privacy policy (see Privacy Policy). The Content, the Site and the Service are provided by Elsevier Inc. and its affiliates and licensors (collectively "Elsevier"). For further information about Elsevier or to contact us, see Contact Us. Permitted Uses You may access in a given twenty-four hour period a reasonable number of Content items, and you may download and print such Content after it has been delivered to your e-mail address. Such access and use is for your own personal use, although you may also share and discuss such Content with family members and medical professionals involved in your medical care or the care of a family member. You can make further copies for such family members and medical professionals. Prohibited Uses Personal use does not include the use by researchers, instructors or students for research purposes or educational use. You may not copy, display, distribute, modify, publish, reproduce, store, transmit, create derivative works from, or sell or license all or any part of the Content, or any other information obtained from or accessed through this Service in any medium to anyone. You may not modify in any way the text of the Content. You may not use any robots, spiders, crawlers or other automated downloading programs or devices to: (i) continuously and automatically search or index the Site or the Content, unless authorized by us; (ii) harvest personal information from this web site for purposes of sending unsolicited or unauthorized material; or (iii) cause disruption to the working of the Service or this Site. You may not use the Service or this Site to publish or distribute any advertising, promotional material, or solicitation to other users to use any goods or services. Copyright Notice All Content provided through this Service, and the Site layout, design, images, programs, text and other information displayed, are the property of Elsevier and is protected by copyright and other intellectual property laws. Warranty We will use reasonable efforts to respond to your requests for Content items and to maintain the indexes and other services involved in providing this Service and Site. Disclaimer of Warranties and Liability We make no other warranty whatsoever, including without limitation, that the operation of the Service or this Site will be uninterrupted or error-free; that defects will be corrected; that this Site, including the server that makes it available, is free of viruses or other harmful components; as to the results that may be obtained from use of the Content or other materials on the Site; or as to the accuracy, completeness, reliability, availability, suitability, quality, non-infringement or operation of any Content, product or service provided on or accessible from the Site. THIS SERVICE, SITE AND ALL CONTENT, PRODUCTS AND SERVICES INCLUDED IN OR ACCESSIBLE FROM THIS SITE ARE PROVIDED "AS IS" AND WITHOUT WARRANTIES OR REPRESENTATIONS OF ANY KIND (EXPRESS, IMPLIED AND STATUTORY, INCLUDING BUT NOT LIMITED TO THE WARRANTIES OF TITLE AND NONINFRINGEMENT AND THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE), ALL OF WHICH NAME DISCLAIMS TO THE FULLEST EXTENT PERMITTED BY LAW. YOUR USE OF THE SITE IS AT YOUR SOLE RISK. To the extent permissible under applicable laws, no responsibility is assumed for any injury and/or damage to persons, animals or property as a matter of products liability, negligence or otherwise, or from any use or operation of any ideas, instructions, methods, products or procedures contained in the Content or on this Site. If the Content items provided through the Service provide information about medical diagnoses and treatment, it is intended for professional use within the medical field. No suggested test or procedure should be carried out unless, in the judgment of a medical professional, its risk is justified. Because of rapid advances in the medical sciences, we recommend that the independent verification of diagnoses and drug dosages should be made. Discussions, views, and recommendations as to medical procedures, products, choice of drugs, and drug dosages are the responsibility of the authors. WE SHALL NOT BE LIABLE TO YOU OR ANYONE ELSE FOR ANY LOSS OR INJURY, CAUSED IN WHOLE OR PART BY ITS NEGLIGENCE OR CONTINGENCIES BEYOND ITS CONTROL IN PROCURING, COMPILING, INTERPRETING, REPORTING OR DELIVERING INFORMATION THROUGH THE SITE. IN NO EVENT WILL WE BE LIABLE TO YOU OR ANYONE ELSE FOR ANY DECISION MADE OR ACTION TAKEN BY YOU IN RELIANCE ON SUCH INFORMATION. WE SHALL NOT BE LIABLE TO YOU OR ANYONE ELSE FOR ANY DAMAGES (INCLUDING, WITHOUT LIMITATION, CONSEQUENTIAL, SPECIAL, INCIDENTAL, INDIRECT, OR SIMILAR DAMAGES) EVEN IF ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. Governing Law and Venue These terms and conditions shall be governed by and construed in accordance with the laws of the State of New York, without regard to its conflicts of law principles. You hereby submit to and agree that the sole jurisdiction and venue for any actions that may arise under or in relation to the subject matter hereof shall be the courts located in the State of New York. Last revised: 10/2006 I have read and agree to the terms and conditions above