This study sought to investigate the clinical outcome and the role of postoperative radiotherapy for patients with salivary duct carcinoma (SDC) who had undergone surgery and postoperative radiotherapy. We performed a retrospective analysis of 25 SDC patients treated between 1998 and 2011 with surgery and postoperative radiotherapy. The median prescribed dose was 60 Gy (range, 49.5–61.4 Gy). The clinical target volume (CTV) was defined as the tumor bed in four patients, the tumor bed and ipsilateral neck in 14 patients, and the tumor bed and bilateral neck in six patients. Local control (LC), disease-free survival (DFS) and overall survival (OS) were estimated using the Kaplan-Meier method, and prognostic variables were analyzed with the log-rank test. The 5-year LC, DFS and OS were 67%, 45% and 47%, respectively. Disease recurrence was found in 12 patients: seven as local, four as regional and eight as distant failure. Perineural and lymphovascular invasion was a significant prognostic factor for LC (P = 0.03). Local failure was common, and the presence of local recurrence significantly affected the OS (P < 0.05). We conclude that surgery and postoperative radiotherapy is expected to decrease the risk of local failure and contribute to good prognoses for patients with SDC. It might be advisable to have the CTV include the cranial nerves involved and the corresponding parts of the skull base in cases of pathologically positive perineural invasion.

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retrospectively. They were treated with thoracic radiation therapy with median dose of 54 Gy (range, 45-64 Gy) in combination with chemotherapy regimen of etoposide/carboplatin (nZ15) or etoposide/cisplatin (nZ33). We proposed early treatment volume reduction rate (ETVRR) as a parameter for early treatment response that appeared percentage changes in gross tumor volume (GTV) between diagnostic chest CT or FDG-PET/ CT at pretreatment and adaptive CT performed at median dose of 36 Gy (range, 30-43 Gy) during CRT. Adaptive CT was performed in 30 patients (62.5%). Results: With median follow-up time of 27.4 months (range, 6.2-66.4 months), 2 year loco-regional progression free survival (LRPFS), and overall survival (OS) rates were 72.5% and 58.2%, respectively. Median initial GTV, median adaptive GTV, median ETVRR were 88.8 cc (range, 5.9-447 cc), 26 cc (range, 2.5-391 cc), and 71.4% (range, 31-97.6%). The ETVRR was correlated significantly with LRPFS (p Z 0.008) and OS (p < 0.001). The median LRPFS and OS were 47.8 and 31.8 months for patients with more than 45% of ETVRR, compared with 6.8 and 8.2 months for those with below 45%. Other factors such as age, sex, ECOG performance status, TNM stage, initial GTV, and overall treatment response did not show statistically difference in LRPFS and OS (All p > 0.05). Conclusion: The ETVRR as a parameter for early treatment response may be useful in prognostic factor of treatment outcomes in LS-SCLC patients treated with CRT.

Results: With the1 min. irradiation, the neutron yield from brass is about a factor of 3 lower than that of W, and the decay of activities is about 10 times faster. For the second simulation, the neutron activity builds up slowly in brass, from about 7x10 3 Bq/cm 3 at the end of week one to a maximum of 10 4 Bq/cm 3 at the end of week 7. For W, the neutron activity builds up slowly from about 5.5x10 6 Bq/cm 3 at the end of week one, to about 9x10 6 Bq/cm 3 (0.24 mCi) at the end of week 5. The neutron activities at the beginning of the week (during irradiation) are due to nuclides with atomic numbers in the range Z = 8 -78. At the end of the week, the neutron activities are mostly due to nuclides in the range Z = 60-78, and a smaller contribution from nuclides in the range Z = 20-60. Conclusions: Our simulation showed that brass results in much lower neutron production than W. Although neutron activity slowly builds up in W, the activity is only about 0.24 mCi after 5 weeks at the surface of the metal. At the patient level, the activity will be smaller due to inverse square law. Our next step is to simulate a realistic treatment schedule with a commercial MLC to more accurately predict the neutron activities.Purpose/Objective(s): The purpose of this study is to clarify the incidence, the risk factors, and the dose-volume relationship of radiation induced rib fracture after hypofractionated stereotactic body radiation therapy (SBRT). consecutive patients treated with hypofractionated SBRT for primary or metastatic lung cancer were reviewed. The inclusion criteria were at least 3 months of follow-up by CT scan and no previous overlapped radiation exposure. Radiation induced rib fractures were defined as rib fractures located in the radiation field, detected by CT scan after treatment. The risk factors considered; age, gender, GTV diameter, chest wall -tumor distance were reviewed and each parameter was divided into two groups. Dose-volume histogram analysis was conducted on ribs received over 20 Gy at maximal point dose. The max dose and absolute volume received; $10 Gy, $20 Gy, $30 Gy and $40 Gy were determined for each ribs as the dosimetric parameters. The 3-and 5-year Kaplan-Meier (KM) estimates of rib fracture were calculated. Each risk factor was assessed by a log-rank test. The optimal cut off value for each dosimetric parameter was analyzed through the use of receiver-operating characteristic (ROC) curves. The area under the curve (AUC) values were also calculated. To estimate the cumulative risk of fracture, the ribs were divided into two groups according to the cutoff value and compared by log-rank test. S136 I. J. Radiation Oncology d Biology d Physics Volume 78, Number 3, Supplement, 2010 Results: From 129 patients, 409 ribs met the inclusion criteria. Median follow-up period was 19 months. Among the 129 patients, 26 patients (44 ribs) experienced radiation induced rib fractures. The KM estimates of rib fracture at 3 years and 5 years were 35.3%, 53.7%, respectively. As a risk factor, chest wall -tumor d...

The purpose of this study was to evaluate the treatment outcomes of stereotactic body radiotherapy (SBRT) for Stage I small-cell lung cancer (SCLC). From April 2003 to September 2009, a total of eight patients with Stage I SCLC were treated with SBRT in our institution. In all patients, the lung tumors were proven as SCLC pathologically. The patients' ages were 58–84 years (median: 74). The T-stage of the primary tumor was T1a in two, T1b in two and T2a in four patients. Six of the patients were inoperable because of poor cardiac and/or pulmonary function, and two patients refused surgery. SBRT was given using 7–8 non-coplanar beams with 48 Gy in four fractions. Six of the eight patients received 3–4 cycles of chemotherapy using carboplatin (CBDCA) + etoposide (VP-16) or cisplatin (CDDP) + irinotecan (CPT-11). The follow-up period for all patients was 6–60 months (median: 32). Six patients were still alive without any recurrence. One patient died from this disease and one died from another disease. The overall and disease-specific survival rate at three years was 72% and 86%, respectively. There were no patients with local progression of the lesion targeted by SBRT. Only one patient had nodal recurrence in the mediastinum at 12 months after treatment. The progression-free survival rate was 71%. No Grade 2 or higher SBRT-related toxicities were observed. SBRT plus chemotherapy could be an alternative to surgery with chemotherapy for inoperable patients with Stage I small-cell lung cancer. However, further investigation is needed using a large series of patients.