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Biomedical subjects

F García-Vicente

Publications and source records attributed to F García-Vicente.

4 recordsLinked to original sources

Dose escalation with three-dimensional conformal radiotherapy for prostate cancer. Is more dose really better in high-risk patients treated with androgen deprivation?

AIMS: To determine the effect of radiation dose on biochemical control in prostate cancer patients treated in a single institution with three-dimensional conformal radiotherapy (3DCRT) and the additional effect of androgen deprivation in prostate cancer patients. MATERIALS AND METHODS: In total, 363 men with T1-T3b prostate cancer treated in a sequential radiation dose-escalation trial from 66.0 to 84.1 Gy (International Commission Radiation Units and Measurement [ICRU] reference point) between 1995 and 2003, and with a minimum follow-up of 24 months, were included in the analysis. One hundred and forty-eight (41%) men were treated with 3DCRT alone; 74 (20%) men received neoadjuvant androgen deprivation (NAD) 4-6 months before and during 3DCRT; and 141 (39%) men received NAD and adjuvant androgen deprivation (AAD) 2 years after 3DCRT. Univariate, stratified and multivariate analyses were carried out separately for defined risk groups (low, intermediate and high) to determine the effect of radiation dose on biochemical control and its interaction with hormonal manipulation and clinical prognostic variables. RESULTS: The median follow-up was 59 months (range 24-147 months). The actuarial biochemical disease-free survival (bDFS) at 5 years for all patients was 75% (standard error 3%). For low-risk patients, the bDFS was 82% (standard error 5%), for intermediate-risk patients it was 64% (standard error 6%) and for high-risk patients it was 77% (standard error 3%) (P = 0.031). In stratified and multivariate analyses, high-dose 3DCRT for all risk groups, and for high-risk patients, the use of long-term AAD vs NAD, contributed independently and significantly to improve the outcome of prostate cancer patients. CONCLUSION: The present study indicates an independent benefit on biochemical outcome of high-dose 3DCRT for low-, intermediate- and high-risk patients and of long-term AAD in high-risk prostate cancer patients.

Aged↗

[Dose escalation with three dimensional conformal radiotherapy for prostate cancer: more is better?].

PURPOSE: The present study was undertaken to determine the effect of radiation dose on biochemical control and morbidity in prostate cancer patients. MATERIALS AND METHODS: Between 1995 and 2003, 360 patients with T1-T3b prostate cancer were treated in a sequential radiation dose escalation trial from 66.0 to 82.6 Gy. These patients were prospectively assigned to 1 of 3 prognostic groups according to risk factors: a) low risk patients were treated with 3DCRT alone; b) intermediate risk patients were allocated to receive neoadjuvant AD (NAD) 4-6 months prior and during 3DCRT; and c) high-risk received NAD and adjuvant AD (AAD) 2 years after 3DCRT. RTOG/EORTC toxicity score was used to analyze late complications RESULTS: Median follow-up was 48 months (12-138). The actuarial biochemical disease free survival (bDFS) at 4 years for low risk, intermediate risk and high risk patients was 88%, 68% and 79% respectively. Stratified and multivariate analysis showed that higher radiation dose (>76 Gy) (p=0.0053) and the use of AAD for high risk patients (p=0.0046) correlated significantly with an improvement of bDFS for all patients. The incidence of late grade 2 rectal and urinary bleeding were 7% and 11% respectively. CONCLUSION: The present study confirms an independent benefit of high-dose (> 76 Gy) radiation therapy and long-term AAD in high-risk prostate cancerpatients.

Aged↗

Exact analytical solution of the convolution integral equation for a general profile fitting function and Gaussian detector kernel.

One of the most important aspects in the metrology of radiation fields is the problem of the measurement of dose profiles in regions where the dose gradient is large. In such zones, the 'detector size effect' may produce experimental measurements that do not correspond to reality. Mathematically it can be proved, under some general assumptions of spatial linearity, that the disturbance induced in the measurement by the effect of the finite size of the detector is equal to the convolution of the real profile with a representative kernel of the detector. In this work the exact relation between the measured profile and the real profile is shown, through the analytical resolution of the integral equation for a general type of profile fitting function using Gaussian convolution kernels.

Densitometry↗

Experimental determination of the convolution kernel for the study of the spatial response of a detector.

One of the most important parameters in the characterization of a detector is its spatial convolution kernel. This kernel contains all of the information about the influence that the detector size has on the measured beam profile. In this paper we present an experimental method for the determination of the spatial convolution kernel for commonly used detectors that are employed in the x-ray profile measurement: film + densitometer, diode, and ionization minichamber. Our work is based on first assuming a step function pattern on a photographic film is known and is a perfect step function. The kernel of the densitometer system was then derived from the deconvolution of the scanned profile to the step function. Next a film was exposed to a penumbra area of an x-ray beam from a linac. The film was scanned using the same densitometer. The "real profile" that emerges from a linear accelerator was derived by the deconvolution of the scanned profile using the now known kernel of the film densitometer. Under the same irradiation condition the x-ray profile was measured with other detectors and with this information we obtained the convolution kernels for these detectors by solving numerically their basic convolution integrals. The results show that the Gaussian convolution kernel is the most consistent with the measurements. The best numerical values for the FWHM of the kernels are 1.1 mm, 2.2 mm, and 5.4 mm for densitometer, diode, and minichamber, respectively.

Biophysical Phenomena↗