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Biomedical subjects

A Nahum

Publications and source records attributed to A Nahum.

At least 19 recordsLinked to original sources
PubMed2003

Neuronal-binding antibodies from patients with antiphospholipid syndrome induce cognitive deficits following intrathecal passive transfer.

Antiphospholipid antibodies (aPL) have been suggested to play a role in causing cognitive and behavioral impairments. In the present study we investigated the pathogenic potential of aPL by intracerebro-ventricular (ICV) administration of immunoglobulins (IgG) from patients with antiphospholipid syndrome (APS). IgG, purified from the sera of four APS patients, was tested for binding to normal mouse brain by immunohistological staining. These IgG (7.5 microg) were injected ICV unilaterally to male C3H mice. Mice injected with IgG purified from pooled sera derived from healthy subjects served as controls. The mice were examined neurologically for motor function and coordination, and cognitively in a Morris water maze. The cognitive tests were performed with the experimenter blinded to the treatment. The performance of the mice in four separate experiments was compared by analysis of variance with repeated measures. IgG from one APS patient was found to bind best to neuronal structures in the hippocampus and cerebral cortex. Mice (n = 43) injected with this IgG performed worse in the water maze compared to the controls (n = 45) with significant effects of the aPL IgG on the overall performance of the mice (treatment, P < 0.03), on learning throughout the experiment (treatment x day, P < 0.02) and on short term memory (treatment x day xtrial, P < 0.002). IgG injected from two of the three other patients also bound specifically to mouse brain neurons and produced an impairment in performance of the water maze. These results support the hypothesis that aPL that gain access to the central nervous system may play a direct role in the pathogenesis of neurological manifestations of APS.

Adult↗
PubMed2002

Changes in astigmatism after congenital cataract surgery and intraocular lens implantation using scleral tunnel incision.

PURPOSE: To evaluate the post-operative changes in astigmatism in pseudophakic eyes in children. Only eyes with astigmatism of 3.0 D or more were included in the study. METHODS: The charts of children who had undergone surgery for non-traumatic cataract, using a scleral tunnel method were retrospectively reviewed. In 11 eyes with astigmatism of 3.0 D or more, the refraction was tested and recorded at 1 week, 3 months and 5 months post-operatively. The paired t-test was used to compare between the variables. RESULTS: Mean astigmatism 1 week post-operatively was 5.8 +/- 3.6 D (range 3.0-14.0 D). Thereafter, the astigmatic component of the refractive error underwent a spontaneous steady decline, reaching a mean value of 2.1 +/- 1.3 D (range 1-4.0 D) 5 months after surgery. The change in the difference between the mean values at 1 week and at 5 months was statistically significant (P < 0.005). CONCLUSION: Children who underwent congenital cataract surgery and intraocular lens implantation showed a significant spontaneous reduction in astigmatism post-operatively.

Astigmatism↗
PubMed2002

Lung recruitment in unilateral lung disease.

The treatment of unilateral lung injury is supportive. Gas exchange can be improves by positioning the patient with the "good lung down" and applying differential ventilation with selective PEEP in some patients. However, both strategies have serious limitations in clinical practice. Basic research have shown that the application of selective TGI and the combination of selective TGI and PLV permitted a reduction in tidal volume with resultant decrease in airway pressures and improvement in lung compliance, without any adverse effects on CO2 elimination. Experimental models have shown that the use of selective TGI and PLV at low tidal volume is a simple method to provide regional recruitment, enhancing gas exchange while reducing cyclic lung stretch and shear stresses associated with mechanical ventilation. These experimental studies cannot be extrapolated to clinical practice because further studies are needed to determine human applications of these therapies.

Humans↗
PubMed2001

Application of tracheal gas insufflation to acute unilateral lung injury in an experimental model.

In unilateral lung injury, application of global positive end-expiratory pressure (PEEP) may cause overdistension of normal alveoli and redistribution of blood flow to diseased lung areas, thereby worsening oxygenation. We hypothesized that selective application of tracheal gas insufflation (TGI) will recruit the injured lung without causing overdistension of the normal lung. In eight anesthetized dogs, left lung saline lavage was performed until Pa(O(2))/FI(O(2)) fell below 100 mm Hg. Then, the dogs were reintubated with a Univent single lumen endotracheal tube that incorporates an internal catheter to provide TGI. After injury, increasing PEEP from 3 to 10 cm H(2)O did not change gas exchange, hemodynamics, or lung compliance. Selective TGI, while keeping end-expiratory lung volume (EELV) constant, improved Pa(O(2))/FI(O(2)) from 212 +/- 43 to 301 +/- 38 mm Hg (p < 0.01) while Pa(CO(2)) and airway pressures decreased (p < 0.01). During selective TGI, reducing tidal volume to 5.2 ml/kg while keeping EELV constant, normalized Pa(CO(2)), did not affect Pa(O(2))/FI(O(2)), and decreased end-inspiratory plateau pressure from 16.6 +/- 1.0 to 11.9 +/- 0.5 cm H(2)O (p < 0.01). In unilateral lung injury, we conclude that selective TGI (1) improves oxygenation at a lower pressure cost as compared with conventional mechanical ventilation, (2) allows reduction in tidal volume without a change in alveolar ventilation, and (3) may be a useful adjunct to limit ventilator-associated lung injury.

Animals↗
PubMed2001

Effects of acyclo-retinoic acid and lycopene on activation of the retinoic acid receptor and proliferation of mammary cancer cells.

The biochemical mechanisms underlying the inhibitory effects of lycopene, the main tomato carotenoid, on the growth of cancer cells are largely unknown. It has been hypothesized that lycopene derivatives may act as ligands for a nuclear receptor in analogy to retinoic acid, the hormone derived from beta-carotene. The inhibition of human mammary cancer (MCF-7) cell growth and the transactivation of the retinoic acid receptor (RAR) reporter gene by synthetic acyclo-retinoic acid, the open chain analog of retinoic acid, was compared to the effects of lycopene and retinoic acid in the same systems. Acyclo-retinoic acid activated the DR-5 retinoic acid response element with a approximately 100-fold lower potency than retinoic acid. This effect was independent of cotransfection with the RARalpha receptor. Lycopene exhibited only very modest activity in this system. In contrast to the results from the transactivation studies, acyclo-retinoic acid, retinoic acid, and lycopene inhibited cell growth with a similar potency. Preincubation with each of the three compounds slowed down cell cycle progression from G1 to S phase. In summary, acyclo-retinoic acid inhibited cancer cell growth and interacted with RAR. However, it exhibited low affinity for RAR and a correspondingly low efficacy in activating this receptor, indicating that RAR does not mediate the growth inhibitory effect of the compound. In addition, the concentrations of acyclo-retinoic acid and of lycopene required for inducing inhibition of cell growth were similar, suggesting that acyclo-retinoic acid is unlikely to be the active metabolite of lycopene.

Antineoplastic Agents↗
PubMed2001

Lycopene inhibition of cell cycle progression in breast and endometrial cancer cells is associated with reduction in cyclin D levels and retention of p27(Kip1) in the cyclin E-cdk2 complexes.

Numerous studies have demonstrated the anticancer activity of the tomato carotenoid, lycopene. However, the molecular mechanism of this action remains unknown. Lycopene inhibition of human breast and endometrial cancer cell growth is associated with inhibition of cell cycle progression at the G(1) phase. In this study we determined the lycopene-mediated changes in the cell cycle machinery. Cells synchronized in the G(1) phase by serum deprivation were treated with lycopene or vehicle and restimulated with 5% serum. Lycopene treatment decreased serum-induced phosphorylation of the retinoblastoma protein and related pocket proteins. This effect was associated with reduced cyclin-dependent kinase (cdk4 and cdk2) activities with no alterations in CDK protein levels. Lycopene caused a decrease in cyclin D1 and D3 levels whereas cyclin E levels did not change. The CDK inhibitor p21(Cip1/Waf1) abundance was reduced while p27(Kip1) levels were unaltered in comparison to control cells. Serum stimulation of control cells resulted in reduction in the p27 content in the cyclin E--cdk2 complex and its accumulation in the cyclin D1--cdk4 complex. This change in distribution was largely prevented by lycopene treatment. These results suggest that lycopene inhibits cell cycle progression via reduction of the cyclin D level and retention of p27 in cyclin E--cdk2, thus leading to inhibition of G(1) CDK activities.

Adenocarcinoma↗
PubMed2001

Time required for partial pressure of arterial oxygen equilibration during mechanical ventilation after a step change in fractional inspired oxygen concentration.

OBJECTIVE: To determine the time required for the partial pressure of arterial oxygen (PaO2) to reach equilibrium after a 0.20 increment or decrement in fractional inspired oxygen concentration (FIO2) during mechanical ventilation. SETTING: A multi-disciplinary ICU in a university hospital. PATIENTS AND METHODS: Twenty-five adult, non-COPD patients with stable blood gas values (PaO2/FIO2 > or = 180 on the day of the study) on pressure-controlled ventilation (PCV). Following a baseline PaO2 (PaO2b) measurement at FIO2 = 0.35, the FIO2 was increased to 0.55 for 30 min and then decreased to 0.35 without any other change in ventilatory parameters. Sequential blood gas measurements were performed at 3, 5, 7, 9, 11, 15, 20, 25 and 30 min in both periods. The PaO2 values measured at the 30th min after a step change in FIO2 (FIO2 = 0.55, PaO2[55] and FIO2 = 0.35, PaO2[35]) were accepted as representative of the equilibrium values for PaO2. Each patient's rise and fall in PaO2 over time, PaO2(t), were fitted to the following respective exponential equations: PaO2b + (PaO2[55]-PaO2b)(1-e-kt) and PaO2[55] + (PaO2[35]-PaO2[55])(e-kt) where "t" refers to time, PaO2[55] and PaO2[35] are the final PaO2 values obtained at a new FIO2 of 0.55 and 0.35, after a 0.20 increment and decrement in FIO2, respectively. Time constant "k" was determined by a non-linear fitting curve and 90% oxygenation times were defined as the time required to reach 90% of the final equilibrated PaO2 calculated by using the non-linear fitting curves. RESULTS: Time constant values for the rise and fall periods were 1.01 +/- 0.71 min-1, 0.69 +/- 0.42 min-1, respectively, and 90% oxygenation times for rises and falls in PaO2 periods were 4.2 +/- 4.1 min-1 and 5.5 +/- 4.8 min-1, respectively. There was no significant difference between the rise and fall periods for the two parameters (p > 0.05). CONCLUSION: We conclude that in stable patients ventilated with PCV, after a step change in FIO2 of 0.20, 5-10 min will be adequate for obtaining a blood gas sample to measure a PaO2 that will be representative of the equilibrium PaO2 value.

Adult↗
PubMed2001

Selective tracheal gas insufflation during partial liquid ventilation improves lung function in an animal model of unilateral acute lung injury.

OBJECTIVE: During unilateral lung injury, we hypothesized that we can improve global lung function by applying selective tracheal gas insufflation (TGI) and partial liquid ventilation (PLV) to the injured lung. DESIGN: Prospective, interventional animal study. SETTING: Animal laboratory in a university hospital. SUBJECTS: Adult mixed-breed dogs. INTERVENTIONS: In six anesthetized dogs, left saline lung lavage was performed until PaO(2)/FiO(2) fell below 100 torr (13.3 kPa). The dogs were then reintubated with a Univent single-lumen endotracheal tube, which incorporates an internal catheter to provide TGI. In a consecutive manner, we studied 1) the application of 10 cm H(2)O of positive end-expiratory pressure (PEEP); 2) instillation of 10 mL/kg of perflubron (Liquivent) to the left lung at a PEEP level of 10 cm H(2)O (PLV+PEEP 10 initial); 3) application of selective TGI (PLV+TGI) while maintaining end-expiratory lung volume (EELV) constant; 4) PLV+TGI at reduced tidal volume (VT); and 5) PLV+PEEP 10 final. MEASUREMENTS AND MAIN RESULTS: Application of PLV+PEEP 10 initial did not change gas exchange, lung mechanics, or hemodynamics. PLV+TGI improved PaO(2)/FiO(2) from 189 +/- 13 torr (25.2 +/- 1.7 kPa) to 383 +/- 44 torr (51.1 +/- 5.9 kPa) (p <.01) and decreased PaCO(2) from 55 +/- 5 torr (7.3 +/- 0.7 kPa) to 30 +/- 2 torr (4.0 +/- 0.3 kPa) (p <.01). During ventilation with PLV+TGI, reducing VT from 15 mL/kg to 3.5 mL/kg while keeping EELV constant decreased PaO(2)/FiO(2) to 288 +/- 49 torr (38.4 +/- 6.5 kPa) (not significant) and normalized PaCO(2). At this stage, end-inspiratory plateau pressure decreased from 19.2 +/- 0.7 cm H(2)O to 13.6 +/- 0.7 cm H(2)O (p <.01). At PLV+PEEP 10 final, measurements returned to those observed at previous baseline stage (PLV+PEEP 10 initial). CONCLUSIONS: During unilateral lung injury, PLV with a moderate PEEP did not improve oxygenation, TGI superimposed on PLV improved gas exchange, and combination of TGI and PLV allowed a 77% reduction in VT without any adverse effect on PaCO(2).

Animals↗
PubMed2001

Animal and lung model studies of tracheal gas insufflation.

Tracheal gas insufflation (TGI) is the continuous or phasic insufflation of fresh gas into the central airways for the purpose of improving the efficiency of alveolar ventilation and/or minimizing the ventilatory pressure requirements. Fresh gas is insufflated near the main carina, usually at flow rates of 2-15 L/min. During expiration, TGI clears the anatomic and apparatus dead space proximal to the catheter tip, thus improving carbon dioxide (CO2) clearance. Moreover, at high catheter flow rates turbulence generated at the tip of the catheter may enhance distal gas mixing. CO2 elimination during TGI depends on catheter flow rate, as at higher flow rates a greater portion of the proximal dead space is flushed clear of CO2. Consequently, as TGI flow is increased, arterial carbon dioxide tension (PaCO2) decreases. Eventually, with increasing catheter flow rate, fresh gas completely flushes the available dead space during expiration and the PaCO2 reaches a plateau. At that point, increasing catheter flow rate decreases PaCO2 much less, probably because of turbulent mixing in the airways distal to the catheter tip. In clinical practice, TGI can be applied either to decrease PaCO2 while maintaining tidal volume constant or to decrease tidal volume while keeping PaCO2 constant. In the former strategy, TGI is used to protect pH, whereas in the latter it is used to minimize the stretch forces acting on the lung parenchyma, to minimize ventilator-associated lung injury.

Animals↗
PubMed2000

Improving detection of venous thromboembolism. New technology holds promise for early, precise diagnosis.

In recent years, a number of modalities have been evaluated for the diagnosis of venous thromboembolism. The role of these modalities is still evolving. While ventilation-perfusion scanning is important in the diagnosis of venous thromboembolism, spiral CT scanning, MRI, and D-dimer assays are now being used more often, either exclusively or in combination with ventilation-perfusion scanning. A number of diagnostic algorithms using these modalities are currently being evaluated. Regardless of which diagnostic approach is used, the clinician must be aware of some key limitations. Spiral CT scanning has gained popularity because it is noninvasive and can rapidly identify other cardiopulmonary diseases that mimic pulmonary embolism. Its use has been limited because of its inability to detect subsegmental pulmonary emboli. D-dimer assays offer promise as rapid, inexpensive screening tools. However, the wide variability in assay performance has limited its usefulness. We recommend that if D-dimer assays are to be used in a diagnostic algorithm, the clinician be aware of the details of the assay. At present, lack of data precludes use of MRI as a primary diagnostic tool for detection of venous thromboembolism.

Fibrin Fibrinogen Degradation Products↗
PubMed2000

Prone positioning attenuates and redistributes ventilator-induced lung injury in dogs.

BACKGROUND: We previously demonstrated a markedly dependent distribution of ventilator-induced lung injury in oleic acid-injured supine animals ventilated with large tidal volumes and positive end-expiratory pressure > or =10 cm H2O. Because pleural pressure distributes more uniformly in the prone position, we hypothesized that the extent of injury induced by purely mechanical forces applied to the lungs of normal animals might improve and that the distribution of injury might be altered with prone positioning. OBJECTIVE: To compare the extent and distribution of histologic changes and edema resulting from identical patterns of high end-inspiratory/low end-expiratory airway pressures in both supine and prone normal dogs. DESIGN/SETTING: We ventilated 10 normal dogs (5 prone, 5 supine) for 6 hrs with identical ventilatory patterns (a tidal volume that generated a peak transpulmonary pressure of 35 cm H2O when implemented in the supine position before randomization, positive end-expiratory pressure = 3 cm H2O). Ventilator-induced lung injury was assessed by gravimetric analysis and histologic grading. MEASUREMENTS AND MAIN RESULTS: Wet weight/dry weight ratios (WW/DW) and histologic scores were greater in the supine than the prone group (8.8+/-2.8 vs. 6.1+/-0.7; p = .01 and 1.4+/-0.3 vs. 1+/-0.3; p = .037, respectively). In the supine group, WW/DW and histologic scores were significantly greater in dependent than nondependent regions (9.4+/-1.9 vs. 6.7+/-0.9; p = .01 and 2.0+/-0.4 vs. 0.9+/-0.4; p = .043, respectively). In the prone group, WW/DW also was greater in dependent regions (6.7+/-1.1 vs. 5.8+/-0.5; p = .054), but no significant differences were found in histologic scores between dependent and nondependent regions (p = .42). CONCLUSION: In this model of lung injury induced solely by mechanical forces, the prone position resulted in a less severe and more homogeneous distribution of ventilator-induced lung injury. These results parallel those previously obtained in oleic acid-preinjured animals ventilated with higher positive end-expiratory pressure.

Airway Resistance↗
PubMed2000

Recruitment maneuvers in three experimental models of acute lung injury. Effect on lung volume and gas exchange.

Recruitment maneuvers (RM), consisting of sustained inflations at high airway pressures, have been advocated as an adjunct to mechanical ventilation in acute respiratory distress syndrome (ARDS). We studied the effect of baseline ventilatory strategy and RM on end-expiratory lung volume (EELV) and oxygenation in 18 dogs, using three models of acute lung injury (ALI; n = 6 in each group): saline lavage (LAV), oleic acid injury (OAI), and intratracheal instillation of Escherichia coli (pneumonia; PNM). All three models exhibited similar degrees of lung injury. The PNM model was less responsive to positive end-expiratory pressure (PEEP) than was the LAV or OAI model. Only the LAV model showed an oxygenation response to increasing tidal volume (VT). After RM, there were transient increases in Pa(O(2)) and EELV when ventilating with PEEP = 10 cm H(2)O. At PEEP = 20 cm H(2)O the lungs were probably fully recruited, since the plateau airway pressures were relatively high ( approximately 45 cm H(2)O) and the oxygenation was similar to preinjury values, thus making the system unresponsive to RM. Sustained improvement in oxygenation after RM was seen in the LAV model when ventilating with PEEP = 10 cm H(2)O and VT = 15 ml/kg. Changes in EELV correlated with changes in Pa(O(2)) only in the OAI model with PEEP = 10 cm H(2)O. We conclude that responses to PEEP, VT, and RM differ among these models of ALI. RM may have a role in some patients with ARDS who are ventilated with low PEEP and low VT.

Animals↗
PubMed2000

Oxygenation response to a recruitment maneuver during supine and prone positions in an oleic acid-induced lung injury model.

Prone position and recruitment maneuvers (RM) are proposed as adjuncts to mechanical ventilation to open up the lung and keep it open. We studied the oxygenation response to a RM (composed of a 30-s sustained inflation at 60 cm H(2)O airway pressure) performed in prone and supine positions in dogs after oleic acid- induced lung injury using an inspired O(2) fraction of 0.60. In one group (n = 6) first supine then prone positions were examined after a RM at 8 cm H(2)O and 15 cm H(2)O of positive end-expiratory pressure (PEEP). In the second group (n = 6) the sequence of positions was reversed. Prone positioning after supine position always improved oxygenation, whereas the decrement in Pa(O(2)) was relatively small when dogs were returned to the supine position. Oxygenation improved in both groups after a RM, and the improvement was sustained (after 15 min) in the prone position at 8 cm H(2)O of PEEP, but 15 cm H(2)O of PEEP was required in supine position. Our results suggest that a RM improves oxygenation more effectively with a decreased PEEP requirement for the preservation of the oxygenation response in prone compared with supine position.

Animals↗
PubMed2000

Lycopene interferes with cell cycle progression and insulin-like growth factor I signaling in mammary cancer cells.

Recent studies have shown that high insulin-like growth factor I (IGF-I) blood level is a risk factor in breast and prostate cancer. The aim of this study was to determine whether the mitogenic activity of IGF-I in mammary cancer cells can be reduced by the dietary carotenoid lycopene. The anticancer activity of lycopene, the major tomato carotenoid, has been suggested by in vitro, in vivo, and epidemiological studies. Growth stimulation of MCF7 mammary cancer cells by IGF-I was markedly reduced by physiological concentrations of lycopene. The inhibitory effects of lycopene on MCF7 cell growth were not accompanied by apoptotic or necrotic cell death, as determined by annexin V binding to plasma membrane and propidium iodide staining of nuclei in unfixed cells. Lycopene treatment markedly reduced the IGF-I stimulation of tyrosine phosphorylation of insulin receptor substrate 1 and binding capacity of the AP-1 transcription complex. These effects were not associated with changes in the number or affinity of IGF-I receptors, but with an increase in membrane-associated IGF-binding proteins, which were previously shown in different cancer cells to negatively regulate IGF-I receptor activation. The inhibitory effect of lycopene on IGF signaling was associated with suppression of IGF-stimulated cell cycle progression of serum-starved, synchronized cells. Moreover, in cells synchronized by mimosine treatment, lycopene delayed cell cycle progression after release from the mimosine block. Collectively, the above data suggest that the inhibitory effects of lycopene on MCF7 cell growth are not due to the toxicity of the carotenoid but, rather, to interference in IGF-I receptor signaling and cell cycle progression.

Anticarcinogenic Agents↗
PubMed2000

[Malaria and pregnancy: attitude of health care personnel during prenatal care in Cotonou, Benin].

The purpose of this study was to evaluate the state of knowledge and use of drug in pregnant women diagnosed with malaria at the first prenatal examination. Survey data were conducted of physicians and paramedical staff working the public and private sector in Cotonou, Benin from November 1996 to January 1997. A questionnaire including items on the type of antimalarials used, therapeutic regimens and compliance with the treatment posology and duration guidelines as defined by the WHO and recommended by the National Program against Malaria. A study of informational supports allowed validation of responses obtained during the interview on the day of survey. A random two-degree, stratified sample of 208 prescribers including 109 physicians, 51 midwives, and 48 nurses was interviewed. Data analysis showed that chemoprophylaxis was prescribed by all midwives, 87.5 p. 100 of nurses, and 8.2 p. 100 of physicians. Midwives prescribed this strategy in all pregnant women. For 5.5 p. 100 of physicians and 6.3 p. 100 of nurses, primigravid women were considered as a target group. Chloroquine was the most widely used antimalarial. It was sometimes used in association with proguanil. Of the other drugs used for prevention, quinine was prescribed by 2.4 p. 100 of nurses and 1.1 p. 100 of physicians. The therapeutic regimes and posologies used by the health care workers were not in compliance with the policies of the National Program for Control of Malaria. The findings warrant the creation of an organization to promote consultation and communication between health care authorities and workers.

Antimalarials↗
PubMed1999

Comparison of radiation side-effects of conformal and conventional radiotherapy in prostate cancer: a randomised trial.

BACKGROUND: Radical radiotherapy is commonly used to treat localised prostate cancer. Late chronic side-effects limit the dose that can be given, and may be linked to the volume of normal tissues irradiated. Conformal radiotherapy allows a smaller amount of rectum and bladder to be treated, by shaping the high-dose volume to the prostate. We assessed the ability of this new technology to lessen the risk of radiation-related effects in a randomised controlled trial of conformal versus conventional radiotherapy. METHODS: We recruited men with prostate cancer for treatment with a standard dose of 64 Gy in daily 2 Gy fractions. The men were randomly assigned conformal or conventional radiotherapy treatment. The primary endpoint was the development of late radiation complications (> 3 months after treatment) measured with the Radiation Therapy and Oncology Group (RTOG) score. Indicators of disease (cancer) control were also recorded. FINDINGS: In the 225 men treated, significantly fewer men developed radiation-induced proctitis and bleeding in the conformal group than in the conventional group (37 vs 56% > or = RTOG grade 1, p=0.004; 5 vs 15% > or = RTOG grade 2, p=0.01). There were no differences between groups in bladder function after treatment (53 vs 59% > or = grade 1, p=0.34; 20 vs 23% > or = grade 2, p=0.61). After median follow-up of 3.6 years there was no significant difference between groups in local tumour control (conformal 78% [95% CI 66-86], conventional 83% [69-90]). INTERPRETATION: Conformal techniques significantly lowered the risk of late radiation-induced proctitis after radiotherapy for prostate cancer. Widespread introduction of these radiotherapy treatment methods is appropriate. Our results are the basis for dose-escalation studies to improve local tumour control.

Follow-Up Studies↗