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Intensity-Modulated Radiotherapy in the Treatment of Oropharyngeal Cancer: An Update of the Memorial Sloan-Kettering Cancer Center Experience
Setton J; Caria N; Romanyshyn J; Koutcher L; Wolden SL; Zelefsky MJ; Rowan N; Sherman EJ; Fury MG; Pfister DG; Wong RJ; Shah JP; Kraus DH; Shi W; Zhang Z; Schupak KD; Gelblum DY; Rao SD; Lee NY
PURPOSE: To update the Memorial Sloan-Kettering Cancer Center's experience with intensity-modulated radiotherapy (IMRT) in the treatment of oropharyngeal cancer (OPC). METHODS AND MATERIALS: Between September 1998 and April 2009, 442 patients with histologically confirmed OPC underwent IMRT at our center. There were 379 men and 63 women with a median age of 57 years (range, 27-91). The disease was Stage I in 2%, Stage II in 4%, Stage III in 21%, and Stage IV in 73% of patients. The primary tumor subsite was tonsil in 50%, base of tongue in 46%, pharyngeal wall in 3%, and soft palate in 2%. The median prescription dose to the planning target volume of the gross tumor was 70 Gy for definitive (n = 412) cases and 66 Gy for postoperative cases (n = 30). A total 404 patients (91%) received chemotherapy, including 389 (88%) who received concurrent chemotherapy, the majority of which was platinum-based. RESULTS: Median follow-up among surviving patients was 36.8 months (range, 3-135). The 3-year cumulative incidence of local failure, regional failure, and distant metastasis was 5.4%, 5.6%, and 12.5%, respectively. The 3-year OS rate was 84.9%. The incidence of late dysphagia and late xerostomia >/=Grade 2 was 11% and 29%, respectively. CONCLUSIONS: Our results confirm the feasibility of IMRT in achieving excellent locoregional control and low rates of xerostomia. According to our knowledge, this study is the largest report of patients treated with IMRT for OPC
PMID: 21167652
ISSN: 1879-355x
CID: 138136
Does Low PSA Predict for Worse Outcome in Patients With Gleason 8-10 Localized Prostate Cancer Treated With Radiation Therapy? [Meeting Abstract]
Gewanter, R. M.; Fidaleo, A.; Pei, X.; Zelefsky, M. J.
ISI:000310542901139
ISSN: 0360-3016
CID: 5530752
Metformin Improves Prostate Cancer-specific Survival and Inhibits the Development of Castrate Resistant Metastasis [Meeting Abstract]
Spratt, D.; Zhang, C.; Zumsteg, Z. S.; Pei, X.; Zhang, Z.; Yamada, J.; Kollmeier, M.; Cox, B.; Zelefsky, M. J.
ISI:000310542900230
ISSN: 0360-3016
CID: 5530742
Predicting biochemical tumor control after brachytherapy for clinically localized prostate cancer: The Memorial Sloan-Kettering Cancer Center experience
Zelefsky, Michael J; Chou, Joanne F; Pei, Xin; Yamada, Yoshiya; Kollmeier, Marisa; Cox, Brett; Zhang, Zhigang; Schechter, Michael; Cohen, Gil'ad N; Zaider, Marco
PURPOSE/OBJECTIVE:To identify predictors of biochemical tumor control and present an updated prognostic nomogram for patients with clinically localized prostate cancer treated with brachytherapy. METHODS AND MATERIALS/METHODS:One thousand four hundred sixty-six patients with clinically localized prostate cancer were treated with brachytherapy alone or along with supplemental conformal radiotherapy. Nine hundred one patients (61%) were treated with Iodine-125 ((125)I) monotherapy to a prescribed dose of 144Gy, and 41 (4.5%) were treated with Palladium-103 ((103)Pd) monotherapy to a prescribed dose of 125Gy. In patients with higher risk features (n=715), a combined modality approach was used, which comprised (125)I or (103)Pd seed implantation or Iridium-192 high-dose rate brachytherapy followed 1-2 months later by supplemental intensity-modulated image-guided radiotherapy to the prostate. RESULTS:The 5-year prostate-specific antigen relapse-free survival (PSA-RFS) outcomes for favorable-, intermediate-, and high-risk patients were 98%, 95%, and 80%, respectively (p<0.001). Multivariate Cox regression analysis identified Gleason score (p<0.001) and pretreatment PSA (p=0.04) as predictors for PSA tumor control. In this cohort of patients, the use of neoadjuvant and concurrent androgen deprivation therapy did not influence biochemical tumor control outcomes. In the subset of patients treated with (125)I monotherapy, D(90)>140Gy compared with lower doses was associated with improved PSA-RFS. A nomogram predicting PSA-RFS was developed based on these predictors and had a concordance index of 0.70. CONCLUSIONS:Results with brachytherapy for all treatment groups were excellent. D(90) higher than 140Gy was associated with improved biochemical tumor control compared with lower doses. Androgen deprivation therapy use did not impact on tumor control outcomes in these patients.
PMID: 21925957
ISSN: 1873-1449
CID: 5528392
Short-term Androgen Deprivation Decreases Distant Metastasis and Prostate Cancer-specific Mortality in Intermediate-risk Prostate Cancer Patients Undergoing Dose Escalated External Beam Radiation Therapy [Meeting Abstract]
Zumsteg, Z. S.; Spratt, D. E.; Pei, X.; Yamada, Y.; Kalikstein, A.; Kuk, D.; Zhang, Z.; Zelefsky, M. J.
ISI:000310542900226
ISSN: 0360-3016
CID: 5530732
Long-term Survival and Toxicity of Patients Treated With Ultra-high-dose IMRT for Localized Prostate Cancer [Meeting Abstract]
Spratt, D.; Pei, X.; Yamada, J.; Kollmeier, M. A.; Cox, B.; Zhang, Z.; Zelefsky, M. J.
ISI:000310542900036
ISSN: 0360-3016
CID: 5530722
Results of a Prospective Randomized Double-blind, Placebo-controlled Trial Evaluating the Use of Prophylactic Sildenafil Citrate During Radiation Therapy in the Treatment of Prostate Cancer [Meeting Abstract]
Zelefsky, M. J.; Shasha, D.; Kollmeier, M.; Baser, R. E.; Cox, B.; Stock, R.; Ennis, R. D.; Bar-Chama, N.; Pei, X.; Mulhall, J.
ISI:000310542900008
ISSN: 0360-3016
CID: 5530712
LONG TERM URINARY AND RECTAL TOLERANCE IN PROSTATE CANCER SURVIVORS TREATED WITH DEFINITIVE CONFORMAL RADIOTHERAPY [Meeting Abstract]
Knoll, Miriam A.; Pei, Xin; Sperling, Dahlia; Zelefsky, Michael J.
ISI:000302912501108
ISSN: 0022-5347
CID: 5530702
COMPARISON OF THE INCIDENCE OF SECONDARY CANCERS AFTER IMRT, BRACHYTHERAPY AND SURGERY FOR THE TREATMENT OF PROSTATE CANCER [Meeting Abstract]
Teslova, Tatiana; Pei, Xin; Kuk, Deborah; Eastham, James; Magsanoc, Juan Martin; Kollmeier, Marisa; Cox, Brett; Zhang, Zhigang; Zelefsky, Michael J.
ISI:000302912500342
ISSN: 0022-5347
CID: 5530692
Perspectives for 2012 from the editor-in-chief [Editorial]
Zelefsky, Michael J
PMID: 22265432
ISSN: 1873-1449
CID: 5528462