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Zagurovskaya M, Shareef MM, Das A, Reeves A, Gupta S, Sudol M, Bedford MT, Prichard J, Mohiuddin M, Ahmed MM. EGR-1 forms a complex with YAP-1 and upregulates Bax expression in irradiated prostate carcinoma cells. Oncogene 2009; 28:1121-31. [DOI: 10.1038/onc.2008.461] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Regine W, Hanna N, Wong R, Major P, Garofalo M, Alexander H, Pandya N, Kennedy N, Mohiuddin M. Radiation Therapy (RT) as a Chemopotentiator of Gemcitabine (G) in Patients with Advanced Pancreatic Cancer: A Multi-institutional Phase II Study. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Neuner G, Vander Walde N, Ha J, Yu C, Mohiuddin M, Regine W. High-dose Spatially-fractionated GRID Radiation Therapy (SFGRT): A Comparison of Outcomes of Treatment Delivered Through Cerrobend GRID versus MLC GRID. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.1435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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54
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Naqvi S, Mohiuddin M, Ha J, Regine W. SU-GG-T-510: Dose Smearing in GRID Therapy Due to Tumor Motion. Med Phys 2008. [DOI: 10.1118/1.2962259] [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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Yu C, Rhee J, Ha J, Vitantonio D, Mohiuddin M, Regine W. WE-C-AUD B-07: Comparison of Time-Fractionated and Space-Fractionated Radiotherapy. Med Phys 2008. [DOI: 10.1118/1.2962694] [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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Warren G, Arnold S, Valentino J, Brill Y, Regine W, Spring P, Given C, Mohiuddin M, Meigooni A, Kudrimoti M. Long Term Results of a Phase II Trial of Hyperfractionated Radiation and Intraarterial Cisplatin (HYPERRADPLAT) on Stage III-IV Head and Neck Cancer With Bulky Primary Tumors. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mohiuddin M, Garcia M, Mitchell E, Hanna N, Yuen A, Nichols C, Share R, Hayostek C, Willett C. 2092. Int J Radiat Oncol Biol Phys 2006. [DOI: 10.1016/j.ijrobp.2006.07.495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Arnold SM, Graham WW, Valentino J, Brill Y, Regine W, Spring P, Given C, Mohiuddin M, St Claire W, Kudrimoti M. Results of intraarterial cisplatin and hyperfractionated radiotherapy in locally advanced cancer of the oropharynx and oral cavity. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.5563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5563 Background: Intraarterial cisplatin and hyperfractionated radiation (HYPERADPLAT) is an accepted therapy for Stage III and IV head and neck cancer. We present long-term follow-up of patients with OP and OC cancer treated with HYPERADPLAT at a single institution. Methods: 44 patients with Stage III-IV squamous cell carcinomas of the OP or OC were treated with the HYPERRADPLAT regimen consisting of external beam radiotherapy (76.8–81.6 Gy) delivered in 1.2 Gy BID fractions with intraarterial cisplatin (150 mg/m2) administered when patients had reached 60 Gy. Tumor response, disease free survival (DFS), overall survival (OS), and toxicity were assessed for all patients according to NCI CCT criteria. Results: Of 44 patients, 21 had tumors of the base of tongue, 14-tonsil, 4-floor of mouth, and 5-other. Eighty eight percent of patients had T4 tumors and 7% had T3 tumors. Complete tumor response was observed in 86% of patients and 14% had a partial response. Lymph node metastases were present in 84% of patients with 78% of node positive patients having a complete nodal response and 19% with a partial response to treatment. Three-year DFS was 55% and OS was 45%. Locoregional recurrence was noted in 30% of patients and 16% had distant failure. Overall recurrence was noted in 47% of patients with a median time to recurrence of 8 months (range 4–55 months). Median weight loss during treatment was 9% of initial body weight and 28 patients required a feeding tube within 6 months of starting treatment. Grade 3 mucositis was noted in 68% of patients and 3 patients developed Grade 4 toxicity (2 mucosal, 1 hematologic). Conclusions: HYPERRADPLAT results in excellent tumor control that is well tolerated with minimal Grade 4 toxicity in patients with advanced poor prognosis cancers of the OP and OC. These results compare favorably with historically reported control rates and response for patients with a significantly high percentage of T4 tumors of the oropharynx and oral cavity. No significant financial relationships to disclose.
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Kudrimoti MR, Warren GW, Valentino J, Spring PM, Mohiuddin M, St. Clair WH, Brill Y, Given C, Regine WF, Arnold SM. Results of reduction of treatment intensity based on response to a novel induction therapy in stage III and IV head and neck cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.5561] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5561 Background: Concurrent cisplatinum based chemotherapy and qd radiotherapy (RT) to 70 Gy is standard therapy for stage III-IV head and neck (H/N) SCCA. Presented is a prospective IRB approved study tailoring the definitive therapy based on response to induction therapy. Methods: 25 patients with Stage III-IV H/N SCCA were treated with 2 cycles of induction therapy every 21 days comprised of carboplatin (AUC 6 day 1), paclitaxel (75 mg/m2 days 1, 8, and 15), and low dose RT (0.5 Gy BID days 1, 2, 8, and 15) for chemosensitization. The response rates of this mode of induction therapy have been presented previously (ASCO 2005 #3184). Patients with complete response (CR) to induction were treated with reduced dose RT at the primary site (reduced from 70 to 60–66 Gy) and 2 cycles of IV cisplatin (100 mg/m2) instead of 3. Those with partial response (PR) or stable disease (SD) were treated with surgery and adjuvant therapy or with altered fractionation regimens. The impact of dose reduction on survival (OS and DFS), failure patterns, compliance and toxicity (according to NCI CTCAE) were used as end points for the study. Results: Patients included 9 with tonsil, 5-L, 3-HP, 3-OC, and 5-BOT. There were 4-T1,9-T2,9-T3,and 3-T4 tumors. The nodal involvement was N0–5, N1–3, N2–13, N3–4. Patients presented with Stage III (28%), IVA (52%), and IVB (20%). Sixty percent had a CR, 32% had a PR, and 8% had SD after induction therapy. Two patients with CR were non-compliant after induction therapy and not further evaluated. With a median FU of 20.5 months (range 11–36 mo) the OS and DFS is 100% (13/13) in the dose reduced group (CR) and 60% (6/10) in the PR/SD treated with more aggressive regimens. The incidence of distant failure is 40% (4/10) in the PR vs 0% (0/13) in the CR. No patients in the dose reduced group required feeding tubes; however 30% (3/10) were required in patients with PR. Compliance with chemotherapy was 79% (10/13) in the CR vs 80% (8/10) in the PR. Conclusions: Our early results show that the patients showing a CR to induction chemotherapy are a favorable group of patients and they may be treated with reduced treatment intensity. This report provides strong evidence that RT dose deescalation for head and neck cancers may be feasible following assessment after induction therapy. [Table: see text]
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Warren GW, Arnold SM, Curtis G, Valentino J, Brill Y, Regine WF, Spring PM, Mohiuddin M, St. Clair WH, Kudrimoti MR. The effect of induction therapy with carboplatin-paclitaxel and low dose radiotherapy followed by hyperfractionated radiotherapy and intraarterial chemotherapy on advanced cancers of the head and neck. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.15517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
15517 Background: The purpose of this study is to evaluate the potential benefits of induction therapy followed by intraarterial cisplatin and hyperfractionated radiation (HYPERRADPLAT) on patients with advanced head and neck tumors. Methods: 20 patients with Stage III-IV squamous cell carcinoma of the head and neck were treated with induction therapy consisting of 2 cycles of carboplatin (AUC 6) and paclitaxel (225 mg/m2) and 0.8 Gy BID on the day of and the day following chemotherapy. Induction therapy was given over 2 cycles separated by 3 weeks (previously described in ASCO 2002 abstract # 921 and 2004 abstract # 5593). Patients were then treated with the HYPERRADPLAT regimen consisting of external beam radiotherapy (74.4–81.6 Gy) delivered in 1.2 Gy BID fractions with intraarterial cisplatin (150 mg/m2) administered when patients had reached 60 Gy. Tumor response, disease free survival, overall survival, and toxicity were assessed for all patients according to NCI CTCAE criteria. Results: Of 20 patients, 9 had tumors of the oropharynx, 9-supralaryngeal, and 2-hypopharyngeal. Fifty percent of patients had T4 tumors and 35% had T3 tumors. Complete tumor response was observed in 80% of patients and 20% had a partial response. Three-year disease free survival was 75% and overall survival was 75%. Locoregional recurrence was noted in 25% of patients and 15% had distant failure. Overall recurrence was noted in 40% of patients with a median time to recurrence of 12 months (range 6–55 months). Median weight loss during treatment was 10% of initial body weight and 13 patients required a feeding tube within 6 months of starting treatment. Grade 3 mucositis was noted in 65% of patients and no patients developed Grade 4 toxicity. Conclusions: Two cycles of carboplatin-paclitaxel induction therapy followed by intraarterial cisplatin and hyperfractionated radiotherapy produces excellent tumor response and reduces distant failure. These results compare favorably with historical controls and produce tolerable toxicity profiles. [Table: see text]
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Sharma V, Chetty DN, Donde B, Mohiuddin M, Giraud A, Nayler S. Aggressive fibromatosis--impact of prognostic variables on management. S AFR J SURG 2006; 44:6-8, 10-1. [PMID: 16619984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
OBJECTIVE To determine the impact of prognostic variables on local control in patients with aggressive fibromatosis treated with or without radiation. MATERIALS AND METHODS Forty-two patients presenting to the combined sarcoma clinic at Johannesburg Hospital with aggressive fibromatosis from 1990 to 2003 were analysed retrospectively. There were 14 males and 28 females. The lesions involved the head and neck in 6 cases (14%), the thorax in 6 (14%), the extremities in 19 (45%) and the abdomen in 11 (26%). Thirty-seven patients (88%) presented to the clinic for the first time, whereas 5 (12%) had recurrent disease at presentation. Fifteen patients (36%) underwent excision only, 15 (36%) had excision followed by postoperative radiation, 8 (19%) had biopsy only, and 4 (9%) had radiation only. The median dose of radiation was 60 Gy (range 9 - 70 Gy). RESULTS One patient had local failure following excision and postoperative radiation therapy. The local control was 100% for surgery alone and 86% for surgery followed by postoperative radiation at > or = 24 months. On univariate analysis, age, sex, positive margins, primary or recurrent presentation, site of involvement and initial treatment did not affect local control significantly. Eight of 19 patients (42%) receiving radiation developed severe moist desquamation following treatment, and all these patients had doses of 60 Gy or more. CONCLUSION Surgery with or without radiation therapy gave excellent local control. The addition of radiation therapy to surgery as well as other known prognostic parameters did not impact on local control. The morbidity of radiation treatment is considerable, as noted in this series, and adjuvant radiation therapy should therefore be considered only in situations where the risk of recurrence and the morbidity of re-excision are high.
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Regine W, Hanna N, Garofalo M, Doyle A, Arnold S, Kataria R, Simms J, Mohiuddin M. Radiation Therapy (RT) as a Chemosensitizer of Gemcitabine (G) in Patients with Metastatic/Unresectable Tumors of the Gastrointestinal (GI) Tract - a Phase I/II Study Exploring a New Treatment Paradigm. Int J Radiat Oncol Biol Phys 2005. [DOI: 10.1016/j.ijrobp.2005.07.029] [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]
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63
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Arnold SM, Kudrimoti M, Valentino J, Spring P, Ahmed M, Regine W, Kenady D, Given C, Mohiuddin M. Potentiating the effect of chemotherapy with low-dose fractionated radiation (LDFRT) in locally advanced squamous cell carcinoma of the head and neck (SCCHN). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.3184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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64
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Payne J, Yoneda J, Mohiuddin M, Meigooni A, Malik U. Radiation therapy in the treatment of advanced endometrial carcinoma. Int J Radiat Oncol Biol Phys 2004. [DOI: 10.1016/j.ijrobp.2004.07.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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65
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Arnold S, Kudrimoti M, Valentino J, Spring P, Ahmed M, Regine W, Given C, Kenady D, Mohiuddin M. Low-dose fractionated radiation (LDFRT) as a potentiator of neoadjuvant paclitaxel (P) and carboplatin (C) in locally advanced squamous cell carcinoma of the head and neck (SCCHN). Int J Radiat Oncol Biol Phys 2004. [DOI: 10.1016/j.ijrobp.2004.07.139] [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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66
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Shehata M, Regine W, St. Clair W, Sims J, Sanders M, Meigooni A, Mohiuddin M, Young A. Impact of SRS (stereotactic radiosurgery) dose on survival among 98 patients with 1–3 brain metastases ≤2 cm. Int J Radiat Oncol Biol Phys 2004. [DOI: 10.1016/j.ijrobp.2004.07.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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67
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Mohiuddin M, Winter K, Mitchell E, Hanna N, Yuen A, Nichols C, Shane R, Hayostek C, Willett C. Results of RTOG-0012 randomized phase II study of neoadjuvant combined modality chemoradiation for distal rectal cancer. Int J Radiat Oncol Biol Phys 2004. [DOI: 10.1016/j.ijrobp.2004.06.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Arnold SM, Kudrimoti M, Regine W, Valentino J, Spring P, Kenady D, Ahmed M, Mohiuddin M. Low-dose fractionated radiation (LDFRT) plus paclitaxel (P) and carboplatin (CBCDA) as induction therapy for locally advanced squamous cell carcinoma of the head and neck (SCCHN): Two-year follow-up. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.5593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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69
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Mitchell EP, Winter K, Mohiuddin M, Hanna N, Yuen A, Nichols C, Share R, Hayostek C, Willett C. Randomized phase II trial of preoperative combined modality chemoradiation for distal rectal cancer. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.3535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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70
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Sharma V, Majeed U, Joseph D, Lindikile S, Madhoo N, Copelyn H, Kotzen J, Mohiuddin M, Donde B, Van der Merwe D. Treatment optimisation using external beam radiation in gynaecological cancers. SA J Radiol 2004. [DOI: 10.4102/sajr.v8i3.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
The majority of patients with gynaecological cancers present with advanced stages in which external beam radiation forms a major component of the treatment. These patients undergo simulation for treatment planning prior to radiation. Currently the lower extent of the disease is evaluated by vaginal examination and marked using a lead wire on the anterior abdominal wall in the pelvic region. A 2 cm margin inferior to this level is used as the lower border of the treatment field. The suggested modified technique includes the placement of an indigenously designed perspex vaginal obturator with graduations at 1 cm distance from its tip. Following vaginal examination the obturator can be inserted into the vagina and fixed at the predefined length using a fixation device. The radio-opaque markers can be seen even in the lateral films. Twentyfive consecutive patients underwent the procedure and the differences between the two methods of marking the lower border were calculated. The external lead wire was inferior to the internal obturator in 19 patients (76%) ranging from 0.5 cm to 3 cm (median 1.5 cm, mean 1.37 cm). It was at the same level in 4 patients (16%) and 1 cm superior to the internal obturator in 2 (8%). With the modified technique using the internal obturator application for delineating the lower border of vaginal disease or vault, it was possible to decrease the length of field thereby reducing the chances of treatment-related toxicity, especially groin and vulval reactions, as well as avoiding treatment interruptions.
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Shamra V, Donde B, Mohiuddin M, Rabin B, Majeed U, Chetty D, Nyongensa C, Msemo A, Van der Merwe D, Glynn-Thomas R. Vertebral height as the measure of lesion length in carcinoma of the oesophagus - is it accurate? SA J Radiol 2004. [DOI: 10.4102/sajr.v8i1.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
No abstract available.
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Mohiuddin M, Ceilley E, Goldberg S, Grignon L, Powell S, Kachnic L, Taghian A. Current perception for negative and close margins in breast conserving therapy: results from the MGH international survey. Int J Radiat Oncol Biol Phys 2003. [DOI: 10.1016/s0360-3016(03)01070-8] [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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Mohiuddin M, Marks J, Marks G. The adequacy of distal surgical margin following high dose preoperative radiation and sphincter preservation surgery for rectal cancer. Int J Radiat Oncol Biol Phys 2003. [DOI: 10.1016/s0360-3016(03)01304-x] [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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Meigooni AS, Parker SA, Zheng J, Kalbaugh KJ, Regine WF, Mohiuddin M. Dosimetric characteristics with spatial fractionation using electron grid therapy. Med Dosim 2002; 27:37-42. [PMID: 12019964 DOI: 10.1016/s0958-3947(02)00086-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Recently, promising clinical results have been shown in the delivery of palliative treatments using megavoltage photon grid therapy. However, the use of megavoltage photon grid therapy is limited in the treatment of bulky superficial lesions where critical radiosensitive anatomical structures are present beyond tumor volumes. As a result, spatially fractionated electron grid therapy was investigated in this project. Dose distributions of 1.4-cm-thick cerrobend grid blocks were experimentally determined for electron beams ranging from 6 to 20 MeV. These blocks were designed and fabricated at out institution to fit into a 20 x 20-cm(2) electron cone of a commercially available linear accelerator. Beam profiles and percentage depth dose (PDD) curves were measured in Solid Water phantom material using radiographic film, LiF TLD, and ionometric techniques. Open-field PDD curves were compared with those of single holes grid with diameters of 1.5, 2.0, 2.5, 3.0, and 3.5 cm to find the optimum diameter. A 2.5-cm hole diameter was found to be the optimal size for all electron energies between 6 and 20 MeV. The results indicate peak-to-valley ratios decrease with depth and the largest ratio is found at Dmax. Also, the TLD measurements show that the dose under the blocked regions of the grid ranged from 9.7% to 39% of the dose beneath the grid holes, depending on the measurement location and beam energy.
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Mohiuddin M, Brandon J, Dey S, Sathishkumar S, Chendil D, Chatfield L, Ahmed M. Low dose fractionated radiation (LDFRT) inhibits estrogen response element (ERE) and progesterone response element (PRE) binding activity: a potential molecular mechanism of ldfrt mediated sensitization. Int J Radiat Oncol Biol Phys 2002. [DOI: 10.1016/s0360-3016(02)03445-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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