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Andrews M, Abazeed M, Woody N, Stephans K, Videtic G, Xia P, Zhuang T. SU-F-R-20: Image Texture Features Correlate with Time to Local Failure in Lung SBRT Patients. Med Phys 2016. [DOI: 10.1118/1.4955792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Liu H, Zhuang T, Stephans K, Videtic G, Raithel S, Djemil T, Xia P. Dose differences in intensity-modulated radiotherapy plans calculated with pencil beam and Monte Carlo for lung SBRT. J Appl Clin Med Phys 2015; 16:91–99. [PMID: 26699560 PMCID: PMC5690987 DOI: 10.1120/jacmp.v16i6.5514] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 09/21/2015] [Accepted: 08/07/2015] [Indexed: 11/23/2022] Open
Abstract
For patients with medically inoperable early‐stage non‐small cell lung cancer (NSCLC) treated with stereotactic body radiation therapy, early treatment plans were based on a simpler dose calculation algorithm, the pencil beam (PB) calculation. Because these patients had the longest treatment follow‐up, identifying dose differences between the PB calculated dose and Monte Carlo calculated dose is clinically important for understanding of treatment outcomes. Previous studies found significant dose differences between the PB dose calculation and more accurate dose calculation algorithms, such as convolution‐based or Monte Carlo (MC), mostly for three‐dimensional conformal radiotherapy (3D CRT) plans. The aim of this study is to investigate whether these observed dose differences also exist for intensity‐modulated radiotherapy (IMRT) plans for both centrally and peripherally located tumors. Seventy patients (35 central and 35 peripheral) were retrospectively selected for this study. The clinical IMRT plans that were initially calculated with the PB algorithm were recalculated with the MC algorithm. Among these paired plans, dosimetric parameters were compared for the targets and critical organs. When compared to MC calculation, PB calculation overestimated doses to the planning target volumes (PTVs) of central and peripheral tumors with different magnitudes. The doses to 95% of the central and peripheral PTVs were overestimated by 9.7%±5.6% and 12.0%±7.3%, respectively. This dose overestimation did not affect doses to the critical organs, such as the spinal cord and lung. In conclusion, for NSCLC treated with IMRT, dose differences between the PB and MC calculations were different from that of 3D CRT. No significant dose differences in critical organs were observed between the two calculations. PACS number: 87.53.Ly
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Qi P, Zhuang T, Magnelli A, Djemil T, Shang Q, Balik S, Andrews M, Stephans K, Videtic G, Xia P. SU-E-T-513: Investigating Dose of Internal Target Volume After Correcting for Tissue Heterogeneity in SBRT Lung Plans with Homogeneity Calculation. Med Phys 2015. [DOI: 10.1118/1.4924875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Ha D, Choi H, Zell K, Raymond DP, Stephans K, Wang XF, Videtic G, McCarthy K, Minai OA, Mazzone PJ. Association of impaired heart rate recovery with cardiopulmonary complications after lung cancer resection surgery. J Thorac Cardiovasc Surg 2015; 149:1168-73.e3. [DOI: 10.1016/j.jtcvs.2014.11.037] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Revised: 10/30/2014] [Accepted: 11/14/2014] [Indexed: 12/25/2022]
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Ha D, Stephans K, Choi H, Zell K, Wang XF, Minai OA, Raymond DP, Videtic G, Mazzone PJ. Heart rate recovery and survival in patients undergoing stereotactic body radiotherapy for treatment of early-stage lung cancer. JOURNAL OF RADIOSURGERY AND SBRT 2015; 3:193-201. [PMID: 29296402 PMCID: PMC5746334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Accepted: 11/06/2014] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Up to 25% of patients with stage I non-small cell lung cancer (NSCLC) are considered high-risk for surgery, due to severe medical comorbidity and/or poor pulmonary reserve. Many of these patients are treated with stereotactic body radiotherapy (SBRT). Prognosis in this subgroup of patients is difficult to determine. We investigated the association of impaired heart rate recovery (HRR) with survival in patients who received SBRT for treatment of early-stage lung cancer. METHODS We collected data from consecutive patients who, between October 2009 and December 2012, received SBRT for treatment of lung cancer at the Cleveland Clinic, and had 6-minute walk test (6MWT) followed by HRR evaluation performed within six months of initiation of treatment. Impaired HRR was defined as a ≤ 12 beat decrease within the first minute following the 6MWT. Survival analyses were performed using Kaplan-Meier estimates and Cox proportional hazard ratios. RESULTS Forty nine patients who received SBRT for treatment of early-stage lung cancer had HRR data available. Thirty two (65%) patients had impaired HRR following the 6MWT. In univariable and multivariable Cox regression analyses, impaired HRR was associated with poorer survival (HR: 11.0, 95% CI: 1.42 - 84.4, p = 0.004, and HR: 15.8, 95% CI: 1.96 - 128.0, p = 0.010, respectively). The 2-year overall survival rates were 52.6% for those with impaired HRR, and 94.1% for those with normal HRR. CONCLUSION Impaired HRR was associated with poorer survival in patients who received SBRT for treatment of early-stage lung cancer. HRR following the 6MWT can be one of the factors considered in patient selection for treatment with SBRT, along with other medical comorbidities.
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Suntharalingam M, Winter K, Ilson D, Dicker A, Kachnic L, Konski A, Chakravarthy B, Anker C, Thakrar H, Horiba N, Kavadi V, Deutsch M, Raben A, Roof M, Videtic G, Pollack J, Safran H, Crane C. The Initial Report of Local Control on RTOG 0436: A Phase 3 Trial Evaluating the Addition of Cetuximab to Paclitaxel, Cisplatin, and Radiation for Patients With Esophageal Cancer Treated Without Surgery. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.06.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Liu H, Cherian S, Stephans K, Videtic G, Qi P, Xia P, Zhuang T. SU-F-BRD-16: Under Dose Regions Recalculated by Monte Carlo Cannot Predict the Local Failure for NSCLC Patients Treated with SBRT. Med Phys 2014. [DOI: 10.1118/1.4889837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Ilson D, Winter K, Suntharalingham M, Dicker A, Kachnic L, Konski A, Chakravarthy A, Anker C, Thakrar H, Horiba N, Kavadi V, Giguere J, Deutsch M, Raben A, Roof K, Videtic G, Pollock J, Safran H, Crane C. Rtog 0436: A Phase III Trial of Cisplatin, Paclitaxel and Radiation with or Without Cetuximab in the Nonoperative Treatment of Esophageal Cancer. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu193.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Liu H, Cherian S, Stephans K, Videtic G, Qi P, Xia P, Zhuang T. Analysis of Local Failure of Lung Cancer Patients Treated With Stereotactic Body Radiation Therapy. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Machtay M, Duan F, Siegel BA, Snyder BS, Gorelick JJ, Reddin JS, Munden R, Johnson DW, Wilf LH, DeNittis A, Sherwin N, Cho KH, Kim SK, Videtic G, Neumann DR, Komaki R, Macapinlac H, Bradley JD, Alavi A. Prediction of survival by [18F]fluorodeoxyglucose positron emission tomography in patients with locally advanced non-small-cell lung cancer undergoing definitive chemoradiation therapy: results of the ACRIN 6668/RTOG 0235 trial. J Clin Oncol 2013; 31:3823-30. [PMID: 24043740 DOI: 10.1200/jco.2012.47.5947] [Citation(s) in RCA: 128] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE In this prospective National Cancer Institute-funded American College of Radiology Imaging Network/Radiation Therapy Oncology Group cooperative group trial, we hypothesized that standardized uptake value (SUV) on post-treatment [(18)F]fluorodeoxyglucose positron emission tomography (FDG-PET) correlates with survival in stage III non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS Patients received conventional concurrent platinum-based chemoradiotherapy without surgery; postradiotherapy consolidation chemotherapy was allowed. Post-treatment FDG-PET was performed at approximately 14 weeks after radiotherapy. SUVs were analyzed both as peak SUV (SUVpeak) and maximum SUV (SUVmax; both institutional and central review readings), with institutional SUVpeak as the primary end point. Relationships between the continuous and categorical (cutoff) SUVs and survival were analyzed using Cox proportional hazards multivariate models. RESULTS Of 250 enrolled patients (226 were evaluable for pretreatment SUV), 173 patients were evaluable for post-treatment SUV analyses. The 2-year survival rate for the entire population was 42.5%. Pretreatment SUVpeak and SUVmax (mean, 10.3 and 13.1, respectively) were not associated with survival. Mean post-treatment SUVpeak and SUVmax were 3.2 and 4.0, respectively. Post-treatment SUVpeak was associated with survival in a continuous variable model (hazard ratio, 1.087; 95% CI, 1.014 to 1.166; P = .020). When analyzed as a prespecified binary value (≤ v > 3.5), there was no association with survival. However, in exploratory analyses, significant results for survival were found using an SUVpeak cutoff of 5.0 (P = .041) or 7.0 (P < .001). All results were similar when SUVmax was used in univariate and multivariate models in place of SUVpeak. CONCLUSION Higher post-treatment tumor SUV (SUVpeak or SUVmax) is associated with worse survival in stage III NSCLC, although a clear cutoff value for routine clinical use as a prognostic factor is uncertain at this time.
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Videtic G. Recurrent Non-Small Cell Lung Cancer After Resection of Early-Stage Disease. Radiat Oncol 2013. [DOI: 10.1891/9781617050725.0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Zhuang T, Djemil T, Qi P, Magnelli A, Stephans K, Videtic G, Xia P. Dose calculation differences between Monte Carlo and pencil beam depend on the tumor locations and volumes for lung stereotactic body radiation therapy. J Appl Clin Med Phys 2013; 14:4011. [PMID: 23470930 PMCID: PMC5714368 DOI: 10.1120/jacmp.v14i2.4011] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 12/05/2012] [Indexed: 12/25/2022] Open
Abstract
Stereotactic body radiation therapy (SBRT) has been increasingly used as an efficacious treatment modality for early-stage non-small cell lung cancer. The accuracy of dose calculations is compromised due to the presence of inhomogeneity. For the purpose of a consistent prescription, radiation doses were calculated without heterogeneity correction in several RTOG trials. For patients participating in these trials, recalculations of the planned doses with more accurate dose methods could provide better correlations between the treatment outcomes and the planned doses. Using a Monte Carlo (MC) dose calculation algorithm as a gold standard, we compared the recalculated doses with the MC algorithm to the original pencil beam (PB) calculations for our institutional clinical lung SBRT plans. The focus of this comparison is to investigate the volume and location dependence on the differences between the two dose calculations. Thirty-one clinical plans that followed RTOG and other protocol guidelines were retrospectively investigated in this study. Dosimetric parameters, such as D1, D95, and D99 for the PTV and D1 for organs at risk, were compared between two calculations. Correlations of mean lung dose and V20 of lungs between two calculations were investigated. Significant dependence on tumor size and location was observed from the comparisons between the two dose calculation methods. When comparing the PB calculations without heterogeneity correction to the MC calculations with heterogeneity correction, we found that in terms of D95 of PTV: (1) the two calculations resulted in similar D95 for edge tumors with volumes greater than 25.1 cc; (2) an average overestimation of 5% in PB calculations for edge tumors with volumes less than 25.1 cc; and (3) an average overestimation of 9% or underestimation of 3% in PB calculations for island tumors with volumes smaller or greater than 22.6 cc, respectively. With heterogeneity correction, the PB calculations resulted in an average reduction of 23.8% and 15.3% in the D95 for the PTV for island and edge lesions, respectively, when compared to the MC calculations. For organs at risks, very small differences were found among all the comparisons. Excellent correlations for mean dose and V20 of lungs were observed between the two calculations. This study demonstrated that using a single scaling factor may be overly simplified when accounting for the effects of heterogeneity correction. Accurate dose calculations, such as the Monte Carlo algorithms, are highly recommended to understand dose responses in lung SBRT.
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Diaconu C, Stephans K, Djemil T, Videtic G, Greskovich J, Xia P. Active Breathing Control Provides an Accurate Method for Stereotactic Body Radiation Therapy of Lung and Liver Tumors. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.2223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Chen W, Cui Y, Kong F, Machtay M, Videtic G, Loo B, Gore E, Galvin J, Yu Y, Xiao Y. Is Recontouring Organs-at-Risk (OAR) for Adaptive Radiation Therapy Plans for Locally Advanced Lung Cancer Necessary? A Preactivation Analysis From Radiation Therapy Oncology Group (RTOG) 1106. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.1605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chen W, Cui Y, Kong F, Machtay M, Videtic G, Loo B, Gore E, Galvin J, Yan Y, Xiao Y. Quantitative Evaluation of Impact Upon Tumor Control Probability (TCP) From Quality Assurance Criteria for Non-small Cell Lung Cancer From RTOG 1106 Study. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.1603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Gore E, Paulus R, Wong S, Sun A, Videtic G, Dutta S, Suntharalingam M, Chen Y, Gaspar L, Choy H. Phase III Comparison of Prophylactic Cranial Irradiation Versus Observation in Patients with Locally Advanced Non-small Cell Lung Cancer -- An Updated Analysis of RTOG 0214. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.169] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Rodrigues G, Louie A, Videtic G, Best L, Patil N, Hallock A, Gaede S, Kempe J, Battista J, de Haan P, Bauman G. Categorizing segmentation quality using a quantitative quality assurance algorithm. J Med Imaging Radiat Oncol 2012; 56:668-78. [DOI: 10.1111/j.1754-9485.2012.02442.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2011] [Accepted: 04/25/2012] [Indexed: 12/25/2022]
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Zhuang T, Djemil T, Qi P, Magnelli A, Stephans K, Videtic G, Xia P. SU-E-T-486: Volume and Location Dependence on the Difference Between Monte Carlo and Pencil Beam Dose Calculations for Lung Stereotactic Body Radiation Therapy. Med Phys 2012; 39:3817. [PMID: 28517485 DOI: 10.1118/1.4735575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Stereotactic body radiotherapy has been an efficacious treatment modality for early stage non-small cell lung cancer. The accuracy of dose calculations is in question due to the presence of inhomogeneity. It was required in several clinical trials to calculate dose without heterogeneity correction. However, to better correlate the outcomes with the planned dose, accurate dose calculation with heterogeneity correction is highly desirable. METHODS We compared the recalculated dose with Monte Carlo (MC) algorithm to the original Pencil Beam (PB) calculations for clinical lung SBRT plans. Thirty-one clinical plans that followed protocol guidelines were retrospectively investigated. Dosimetric parameters D1, D95 and D99 for the PTV and D1 for organs at risk were compared. Correlations of mean lung dose and V20 of lungs between two calculations were investigated. RESULTS Compared to the PB calculations without heterogeneity correction in clinical plans, we found that in terms of D95 of PTV, (1) the two calculations resulted in similar D95 for edge tumors with volumes greater than 25.1cc; (2) an average overestimation of 5% in PB calculations for edge tumors with volumes less than 25.1cc; and (3) an average overestimation of 9% or underestimation of 3% in PB calculations for island tumors with volumes smaller or greater than 22.6 cc, respectively. With heterogeneity correction, the PB calculation resulted in an average reduction of 23.8% and 15.3% in D95 for island and edge lesions respectively compared to the MC calculation. For organs at risks, no clinical meaningful differences were found among all the comparisons. Excellent correlations for mean dose and V20 of lungs were observed between the two calculations. CONCLUSIONS Using a single scaling factor to account for the differences in using heterogeneity correction may not be sufficient. To understand dose-response relation in Lung SBRT, accurate dose calculation such as the Monte Carlo algorithms is highly recommended.
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Zhuang T, Magnelli A, Liu H, Qi P, Djemil T, Stephans K, Videtic G, Xia P. SU-E-J-10: Accuracy of Image Guidance Using Cone-Beam CT with Multiple Breath Hold Using Active Breathing Coordination. Med Phys 2012; 39:3654. [DOI: 10.1118/1.4734843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Stephans K, Woody N, Djemil T, Tizora N, Xia P, Videtic G. Stereotactic Body Radiotherapy (SBRT) for Central Lung Lesions: Treating Beyond RTOG 0813 Parameters. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Haque W, Videtic G, Woody N, Srinivas S, Gupta A, Reddy C, Stephans K. Do Regional Nodal Pet SUVs Obtained At The Time Of Staging Predict For Treatment Outcomes In Patients Treated Receiving SBRT For Early-stage Medically Inoperable Lung Cancer? Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.1131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Zhuang T, Magnelli A, Djemil T, Videtic G, Xia P. SU-E-T-634: Dosimetric Impact of Temporal Variation of Electron Density within Planning Target Volume for Lung Cancer SBRT. Med Phys 2011. [DOI: 10.1118/1.3612597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Guo S, Reddy C, Chao S, Suh J, Videtic G. Impact of Non-small Cell Lung Cancer (NSCLC) Histology on Survival Predicted from the Graded Prognostic Assessment (GPA) for Patients with Brain Metastases. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Sheplan Olsen L, Adelstein D, Pennell N, Shapiro M, Mason D, Murthy S, Rice T, Srinivas S, Hunter G, Videtic G. The Value of Primary Tumor Maximum Standardized Uptake Value (SUV) from a Staging Positron Emission Tomography (PET) Scan as a Predictor of Clinical and Pathologic Outcomes in Patients Undergoing Trimodality Therapy for Locally Advanced Lung Cancer. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Sorenson L, Reddy C, Videtic G. Lessons Learned from a Prospective Study of Quality of Life in Lung Cancer Patients Undergoing Stereotactic Body Radiotherapy: The Earlier, the Better! Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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