Radiation Therapy. A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

ADIATION HERAPY A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R EFERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright Ó2004 by ICON Group International, Inc. Copyright Ó2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Radiation Therapy: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84599-9 1. Radiation Therapy-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on radiation therapy. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications.

Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON RADIATION THERAPY ............................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Radiation Therapy....................................................................... 11 E-Journals: PubMed Central ....................................................................................................... 66 The National Library of Medicine: PubMed ................................................................................ 67 CHAPTER 2. NUTRITION AND RADIATION THERAPY ................................................................... 117 Overview.................................................................................................................................... 117 Finding Nutrition Studies on Radiation Therapy ..................................................................... 117 Federal Resources on Nutrition ................................................................................................. 121 Additional Web Resources ......................................................................................................... 121 CHAPTER 3. DISSERTATIONS ON RADIATION THERAPY ............................................................... 123 Overview.................................................................................................................................... 123 Dissertations on Radiation Therapy .......................................................................................... 123 Keeping Current ........................................................................................................................ 124 CHAPTER 4. CLINICAL TRIALS AND RADIATION THERAPY.......................................................... 125 Overview.................................................................................................................................... 125 Recent Trials on Radiation Therapy .......................................................................................... 125 Keeping Current on Clinical Trials ........................................................................................... 145 CHAPTER 5. PATENTS ON RADIATION THERAPY.......................................................................... 147 Overview.................................................................................................................................... 147 Patents on Radiation Therapy.................................................................................................... 147 Patent Applications on Radiation Therapy................................................................................ 180 Keeping Current ........................................................................................................................ 213 CHAPTER 6. BOOKS ON RADIATION THERAPY ............................................................................. 215 Overview.................................................................................................................................... 215 Book Summaries: Federal Agencies............................................................................................ 215 Book Summaries: Online Booksellers......................................................................................... 217 Chapters on Radiation Therapy ................................................................................................. 224 CHAPTER 7. MULTIMEDIA ON RADIATION THERAPY................................................................... 229 Overview.................................................................................................................................... 229 Video Recordings ....................................................................................................................... 229 CHAPTER 8. PERIODICALS AND NEWS ON RADIATION THERAPY................................................ 233 Overview.................................................................................................................................... 233 News Services and Press Releases.............................................................................................. 233 Newsletter Articles .................................................................................................................... 236 Academic Periodicals covering Radiation Therapy.................................................................... 238 CHAPTER 9. RESEARCHING MEDICATIONS ................................................................................... 239 Overview.................................................................................................................................... 239 U.S. Pharmacopeia..................................................................................................................... 239 Commercial Databases ............................................................................................................... 240 Researching Orphan Drugs ....................................................................................................... 241 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 245 Overview.................................................................................................................................... 245 NIH Guidelines.......................................................................................................................... 245 NIH Databases........................................................................................................................... 247 Other Commercial Databases..................................................................................................... 249 APPENDIX B. PATIENT RESOURCES ............................................................................................... 251 Overview.................................................................................................................................... 251 Patient Guideline Sources.......................................................................................................... 251

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Finding Associations.................................................................................................................. 278 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 281 Overview.................................................................................................................................... 281 Preparation................................................................................................................................. 281 Finding a Local Medical Library................................................................................................ 281 Medical Libraries in the U.S. and Canada ................................................................................. 281 ONLINE GLOSSARIES ................................................................................................................ 287 Online Dictionary Directories ................................................................................................... 288 RADIATION THERAPY DICTIONARY .................................................................................. 289 INDEX .............................................................................................................................................. 371

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading." 1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with radiation therapy is indexed in search engines, such as http://www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about radiation therapy, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to radiation therapy, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on radiation therapy. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to radiation therapy, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on radiation therapy. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON RADIATION THERAPY Overview In this chapter, we will show you how to locate peer-reviewed references and studies on radiation therapy.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and radiation therapy, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “radiation therapy” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: ·

Dental Considerations and Treatment of the Oncology Patient Receiving Radiation Therapy Source: JADA. Journal of American Dental Association. 129(2): 201-205. February 1998. Summary: As many as 400,000 out of 1 million patients newly diagnosed with cancer may develop oral complications. The effects of radiation therapy to the head and neck include reduced salivary capacity, hypovascularity (less blood flow), the possibility of osteoradionecrosis, mucositis, trismus, and radiation caries, as well as developmental dental and maxillofacial abnormalities in pediatric patients. The authors note that the trend toward people maintaining their teeth longer coupled with the rising age of the population suggest that dentists frequently may be treating patients with cancer, and should be informed about aspects of their oncologic care that will affect their oral health.

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The authors highlight some of the important clinical considerations and offers guidelines for treating patients receiving radiation therapy. Patients planning to undergo radiation therapy should receive dental treatment before the radiation treatment begins, in order to reduce postradiation complications. Preventive measures may be the approach which best minimizes the need for extensive treatment. An understanding of the potential sequelae, such as a reduction in the healing potential of irradiated areas and the development of radiation caries, will help the dentist provide well-informed treatment recommendations as well as appropriate management. 2 figures. 29 references. (AA-M). ·

Cancer of Retromolar Tigone: Long-Term Radiation Therapy Outcome Source: Head and Neck. 23(9): 758-763. September 2001. Contact: Available from John Wiley and Sons, Inc. 605 Third Avenue, New York, NY 10158. (212) 850-6645. Summary: Cancer of the retromolar trigone (a cusp of the upper molar) is an uncommon head and neck cancer. In this retrospective study, the authors identified the prognostic factors and evaluated the therapeutic outcomes of patients treated with preoperative radiation therapy (RT), postoperative RT, and RT alone. Between 1971 and 1994, 65 patients with histologically proven epidermoid carcinoma of the retromolar trigone were treated at the Mallinckrodt Institute of Radiology (St. Louis, Missouri). Ten patients received preoperative RT, 39 received postoperative RT, and 15 were treated with RT alone. Surgery included 44 composite resections and 7 wide excisions. The minimum follow up was 5 years. The 5 year disease free survival rates were 90 percent with preoperative RT, 63 percent with postoperative RT, and 31 percent with RT alone. The 5 year disease free survival rates were 76 percent for patients with (tumor stage) T1 disease, 50 percent for T2, 72 percent for T3, and 54 percent for T4. The locoregional recurrence rates were 10 percent (1 of 10 patients) for preoperative RT, 23 percent (9 of 39 patients) for postoperative RT, and 44 percent (7 of 16 patients) for RT alone. On multivariate analysis, the significant factors for disease free survival were treatment modality and N stage (a measure of nodal involvement); for locoregional control it was treatment modality; for distant metastasis (spread of the cancer) it was N stage. The incidence of bone necrosis (tissue death), soft tissue necrosis, and severe trismus (restricted ability to open the mouth) was 12 percent with postoperative RT, 11 percent with RT alone, and none with preoperative RT. The authors conclude that combination surgery with postoperative or preoperative RT offers better locoregional control and disease free survival than RT alone for epidermoid carcinoma of the retromolar trigone. Lymph node status significantly influences the disease free survival and distant metastasis rates. 2 figures. 3 tables. 16 references.

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Phase II Trial of Concurrent Paclitaxel, Carboplatin and Radiotherapy in State III/IV Resectable Cancer of the Oral Cavity and Oropharynx Source: International Poster Journal. 4(1), Poster 112. 2002. Contact: Available from Quintessence Publishing Co, Inc. 551 Kimberly Drive, Carol Stream, IL 60188-9981. (800) 621-0387 or (630) 682-3223. Fax (630) 682-3288. E-mail: [email protected]. Website: www.quintpub.com. Summary: In the treatment of head and neck cancer, chemotherapy used to be limited to metastatic or recurrent settings. During the last twenty years, the addition of chemotherapy to aggressive local treatment has been investigated to overcome high local relapse rates. This article reports on a phase II trial of the use of concurrent

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Paclitaxel, Carboplatin and radiotherapy in patients with stage III (n = 6) or IV (n = 22) resectable cancer of the oral cavity and oropharynx. One early death was reported due to septic neutropenia. Clinical response was as follows: Carboplatin and radiotherapy (CR), 14 of 27 patients (52 percent); Paclitaxel and radiotherapy (PR), 13 of 27 patients (48 percent). Mucositis occurred in all patients. The follow up of this ongoing study shows that 88 percent of the patients were alive at the 1 year mark. 3 figures. 5 tables. 8 references. ·

Quality of Life and Oral Function Following Radiotherapy for Head and Neck Cancer Source: Head and Neck. 21(1): 1-11. January 1999. Contact: Available from John Wiley and Sons, Inc. 605 Third Avenue, New York, NY 10158. (212) 850-6645. Summary: Multiple oral complaints occur following radiation therapy for oral or pharyngeal cancer, but the frequency and severity of symptoms of dysfunction and discomfort are not well understood. This article reports on a study undertaken to assess the quality of life, oral function, and oral symptoms following radiation therapy. A general quality of life survey, with an added oral symptom and function scale was mailed to 100 patients more than 6 months following radiation therapy. Sixty-five patients responded. Difficulty chewing or eating was reported by 43 percent of respondents. Dry mouth was reported by 91.8 percent, change in taste by 75.4 percent, dysphagia by 63.1 percent, altered speech by 50.8 percent, difficulty with dentures by 48.5 percent, and increased tooth decay by 38.5 percent of dentate patients. Pain was common (58.4 percent) and interfered with daily activities in 30.8 percent. Mood complaints were reported by approximately half the patients and interference with social activities was reported by 60 percent. The frequency of oral side effects correlated with radiation treatment fields and dose. The authors conclude that oral complications following radiation therapy for head and neck cancer are common and negatively affect quality of life. 6 tables. 34 references. (AA-M).

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Necrotizing Stomatitis After Radiotherapy in a Patient with AIDS: Case Report Source: Journal of Oral and Maxillofacial Surgery. 60(1): 100-101. January 2002. Contact: Available from W.B. Saunders Company. Periodicals Department, P.O. Box 629239, Orlando, FL 32862-8239. (800) 654-2452. Website: www.harcourthealth.com. Summary: Necrotizing stomatitis (NS) is recognized as an opportunistic disease associated with AIDS. NS is often described as beginning as an aggressive necrotizing ulcerative gingivitis (inflammation of the gums with ulcering) that then invades the surrounding tissues and ultimately exposes the underlying bone. This article reports a case of NS that developed in a patient with full blown AIDS after craniofacial radiotherapy for treatment of a pharyngeal nonHodgkins lymphoma (NHL). The authors present the case report, then discuss NS in the HIV infected patient. In this case, no significant periodontal disease was detected. The initial signs of the disease were related to irradiation of the head and neck; the side effects of radiation therapy provoked colonization of the orofacial tissues and the consequent necrotizing infection. However, radiation therapy is reported to be the only curative treatment for pharyngeal NHL in immunosuppressed HIV patients. The authors caution that the management of NS in the full blown AIDS patient has a poor prognosis because it is impossible to achieve a disease free state and NS is just one of the multiple disorders associated with immunosuppression. A conservative attitude must prevail, with sensibly adapted antibiotic therapy, local debridement, improved oral hygiene, lavage with antiseptic

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agents, and analgesic (painkillers) medication. Periodontal curettage, dental extraction, and aggressive surgical procedures are to be avoided. Even severely immunosuppressed patients are sometimes able to arrest the destructive process; however, the final outcome in the majority of cases is death after a short period because of the compromised clinical situation. 2 figures. 9 references. ·

Influence of Pre-Radiation Salivary Flow Rates and Radiation Dose on Parotid Salivary Gland Dysfunction in Patients Receiving Radiotherapy for Head and Neck Cancers Source: SCD. Special Care in Dentistry. 18(3): 102-108. May-June 1998. Contact: Available from Special Care Dentistry. 211 East Chicago Avenue, Chicago, IL 60611. (312) 440-2660. Fax (312) 440-2824. Summary: Radiotherapy used for head and neck cancers causes permanent salivary gland dysfunction (SGD). Previous short-term studies have demonstrated that preradiotherapy salivary flow rates and the amount of radiation exposure to parotid glands influence the amount of radiotherapy-induced SGD. This article reports on a study undertaken to determine which variables are related to the development of long-term post-radiotherapy SGD. Parotid flow rates (PFR) were assessed prior to and 1 year after completion of radiotherapy in spared parotid glands from 24 patients from 2 parotidsparing protocols. The results reveal that spared PFR were not significantly higher 1 year post-radiotherapy in patients who had high pre-radiotherapy PFR, when compared with patients with low pre-radiotherapy PFR. However, patients who received higher doses of radiotherapy to spared parotid glands had lower PFR 1 year post-radiotherapy, compared with patients who had received lower doses of radiotherapy. These one-year findings suggest that high pre-radiotherapy PFR do not provide protection against radiotherapy-induced salivary gland dysfunction. Conversely, reduced radiotherapy dosages to contralateral parotid glands are protective of PFR after completion of radiotherapy. 2 figures. 4 tables. 21 references. (AA).

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Aggressive Ameloblastoma Treated With Radiotherapy, Surgical Ablation, and Reconstruction Source: JADA. Journal of the American Dental Association. 129(1): 84-87. January 1998. Summary: The ameloblastoma is a benign, slow growing, rare, odontogenic (arising from the dentition, or teeth) neoplasm. The solid or multicystic ameloblastoma has a tendency to be locally invasive and has a high incidence of recurrence if not adequately removed. This article presents a case report of an aggressive ameloblastoma treated with radiotherapy, surgical ablation, and reconstruction. Surgical resection of aggressive solid or multicystic ameloblastoma is a well documented and accepted treatment modality. Controversies exist, however, with regard to the extent of operative intervention. Unresectable lesions have been treated with radiation or combined radiation and chemotherapy. The authors present a case report of a patient with recurrent ameloblastoma who underwent simultaneous hard and soft tissue reconstruction. The patient had been treated with external beam radiation for a recurrent ameloblastoma with direct extension to the cranial base. Significant hard and soft tissue defects developed. Twenty two years after the initial treatment, the 40 year old patient developed an infection of the right mandible with a draining extraoral fistula. This led to a nontraumatic pathological fracture of the posterior mandible (lower jaw). In addition, pronounced soft tissue atrophy was present on the irradiated side of the face. The patient's postoperative course was uneventful and intermaxillary fixation

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was released at six weeks. Bony union was evident and no motor nerve deficit was observed. Fourteen months after surgery, the patient remained free of tumor and symptoms. 5 figures. 15 references. ·

Complicating Mucosal Reactions in Patients Receiving Radiation Therapy for Head and Neck Cancer Source: SCD. Special Care in Dentistry. 17(8): 88-93. May-June 1997. Summary: The oral sequelae resulting from head and neck radiotherapy may include mucositis, hyposalivation, taste loss, radiation caries, osteonecrosis, and trismus. Radiation mucositis is characterized by erythema, pseudomembranes, and ulceration of mucosa in the irradiated field. In this article, the authors present two cases of oral mucosal changes in patients treated with radiotherapy in the head and neck region, which included mucosal erythema and ulceration outside of the radiated fields. One case was confirmed as herpes virus infection, and the other was diagnosed as Sweet's syndrome. The authors discuss both case histories as well as the possible contribution of Herpes simplex virus (HSV) infection in oral mucositis associated with radiation treatment. The authors stress that, when mucositis extends beyond the radiation fields, the clinician should consider other causes of mucosal inflammation and erythema in order to begin appropriate management. 8 figures. 19 references. (AA-M).

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Manifestations and Treatment of Xerostomia and Associated Oral Effects Secondary to Head and Neck Radiation Therapy Source: JADA. Journal of American Dental Association. 128(7): 1128-1133. August 1997. Summary: This article discusses the manifestations and treatment of xerostomia and associated oral effects resulting from head and neck radiation therapy. Xerostomia (dry mouth) is one of the most common side effects of head and neck radiation therapy; other oral effects are mucositis and radiation caries. Because xerostomia resulting from radiation therapy may be of a more permanent nature than xerostomia resulting from other causes, treatment is typically more extensive. Numerous regimens treat symptoms of xerostomia and associated caries and mucositis. Among them is the daily application of a fluoride gel, recommended to prevent or minimize dental caries. For patients with severe, chronic xerostomia who have some residual salivary tissue, the use of a sialagogue can promote an increased flow of saliva and treat the symptoms. 4 figures. 40 references. (AA-M).

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Late Effects of Radiation Therapy in the Head and Neck Region Source: International Journal of Radiation Oncology, Biology, Physics. 31(5): 1141-1164. March 30, 1995. Contact: Available from Elsevier Science. Customer Support Department, P.O. Box 945, New York, NY 10010. (888) 4ES-INFO or (212) 633-3730. Fax (212) 633-3680. E-mail: [email protected]. Summary: This article discusses the pathophysiology, clinical syndromes, and potential treatment of the late (chronic) effects of radiation therapy in the head and neck region. The head and neck region is composed on numerous structures, each with an inherent response to radiation that is largely governed by the presence or absence of mucosa, salivary glands, or specialized organs within that site. Irradiated mucocutaneous tissues demonstrate increased vascular permeability that leads to fibrin deposition, subsequent collagen formation, and eventual fibrosis. Irradiated salivary tissue degenerates after

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relatively small doses, leading to markedly diminished salivary output. This, in turn, affects the teeth by promoting dental decay which, in turn, affects the integrity of the mandible. 13 figures. 4 table. 110 references. (AA-M). ·

Radiotherapy for Metastases to the Mandible in Children Source: Journal of Oral and Maxillofacial Surgery. 60(3): 269-271. March 2002. Contact: Available from W.B. Saunders Company. Periodicals Department, P.O. Box 629239, Orlando, FL 32862-8239. (800) 654-2452. Website: www.harcourthealth.com. Summary: This article presents a retrospective review of all children treated since 1979 at the authors' institution with radiation therapy for symptomatic metastases (spread of cancer) that involved the mandible (lower jaw). Nine children were treated with 1 or more courses of radiotherapy for symptomatic metastases that involve the mandible. Six children had a neuroblastoma, 1 had angiosarcoma of the liver, 1 had adenocarcinoma of the rectum, and 1 had peripheral primitive neuroectodermal tumor (Ewing's sarcoma) of the spine. In 3 children, the mandible was the first bone involved by metastases. Seven children were treated with short intensive courses of radiotherapy consisting of 1 to 3 fractions to a total dose of 400 to 1,200 cGy. One child received 2,400 cGy in 6 fractions, and another child received 3,000 cGy in 10 fractions. Three children were treated with second courses of radiotherapy at 1, 2, and 5 months, respectively, from the initial course of radiotherapy. All children had received chemotherapy. All children died of disseminated disease at 5 to 59 months from their initial diagnosis, 5 to 29 months from the detection of metastases to bone, and only 6 days to 17 months (median, 20 months) from the first treatment of metastases to the mandible. The authors conclude that the outlook for children with metastases that involve the mandible is very poor, and the authors recommend short intensive courses of radiotherapy consisting of 1 to 3 treatments to total doses of 400 to 1,200 cGy for palliation of pain. 1 table. 7 references.

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Radiotherapy and Oral Sequelae: Preventive and Management Protocols Source: Journal of Dental Hygiene. 71(1): 23-29. January-February 1997. Summary: This article provides background information on radiotherapy and presents dental hygiene protocols for the treatment of head and neck radiation patients. These patients experience specific oral complications or sequelae that require specialized care. To assist dental hygienists in understanding the genesis of these complications, the authors include a brief history of the use of radiotherapy and its effects on mammalian tissue. Complications may include mucositis, candidiasis, xerostomia, loss of taste, trismus, severe caries, nutritional deficit, and osteoradionecrosis. The authors present management protocols for the prevention and treatment of these complications. They caution that maximum protocol effectiveness and long-term success may only be attained by educating and communicating with the patient. The authors conclude that, as the number of head and neck radiation patients increases, a thorough understanding of the disease and treatment process is becoming more necessary for all oral health care providers. 5 figures. 1 table. 25 references. (AA-M).

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Oral Capsaicin Provides Temporary Relief for Oral Mucositis Pain Secondary to Chemotherapy-Radiation Therapy Source: Journal of Pain and Symptom Management. 10(3): 243-248. April 1995. Summary: This article reports on a pilot study that examined the ability of oral capsaicin to provide temporary relief of oral mucositis pain. Capsaicin, the active ingredient in

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chili peppers, desensitizes some neurons and has provided moderate pain relief when applied to the skin surface. Oral capsaicin in a candy (taffy) vehicle produced substantial pain reduction in 11 patients with oral mucositis pain from cancer therapy. However, this pain relief was not complete for most patients and was only temporary. The authors note that oral mucositis affects up to 40 percent of patients receiving chemotherapy or radiation therapy. The authors call for additional research in the area of the properties of capsaicin desensitization in order to optimize analgesia. 2 figures. 2 tables. 36 references. (AA-M). ·

Late Effects of Head and Neck Radiation Therapy and Patient-Dentist Compliance with Recommended Dental Care Source: SCD. Special Care in Dentistry. 13(4): 159-162. July-August 1993. Summary: This article reports on a study assessing the late effects of radiation therapy and compliance with long-term care recommendations in 75 patients at the Oncology Dental Support Clinic, University of Missouri-Kansas City School of Dentistry, 1981 to 1989. Telephone interviews of patients and their dentists were conducted, and a written questionnaire to the dentists provided further data. The authors remind readers that head and neck radiation therapy patients have permanent damage to their salivary glands, tissue, and bone. This damage may result in late effects such as xerostomia, rampant dental caries, demineralization, trismus, and osteoradionecrosis. Late effects noted in the study were consistent with those reported in the literature. A compliance rate of approximately 50 percent was reported. The authors briefly report on several measures implemented in an attempt to increase compliance. The study emphasizes the importance of a pre-radiation therapy dental evaluation and documents the late effects of radiation therapy, including xerostomia, jaw pain, and rampant dental caries. 23 references. (AA-M).

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Cariogenic Microflora in Patients with Hodgkin's Disease Before and After Mantle Field Radiotherapy Source: Oral Surgery, Oral Medicine, Oral Pathology. 78(5): 577-582. November 1994. Summary: This article reports on a study of cariogenic microflora in patients with Hodgkin's disease before and after mantle field radiotherapy. The authors obtained samples of oral saline rinse from 40 patients with Hodgkin's disease before radiotherapy and from 31 patients with Hodgkin's disease who had survived 1 to 24 years after radiotherapy. They also evaluated the caries experience and history of fluoride gel use for caries prevention. Mutans streptococci and lactobacilli levels were significantly higher in the postradiotherapy patients with carious teeth, particularly in those with limited home use of fluoride gels. In the postradiotherapy group, caries parameters were significantly higher than in the preradiotherapy group. Within the postradiotherapy group, both caries and microbial parameters tended to be higher in patients who were less compliant about using the recommended 0.4 percent stannous fluoride 'brush in' technique than in those who used the gel regularly at home. The authors conclude that for patients with Hodgkin's disease who receive mantle field irradiation during the management of their disease, a sustained brush-in program with stannous fluoride gel can be of benefit for caries prevention and for limitation of oral levels of cariogenic mutans streptococci. 5 tables. 33 references. (AA).

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Artificial Urinary Sphincter for Post-Prostatectomy Incontinence in Men who had Prior Radiotherapy: A Risk and Outcome Analysis Source: Journal of Urology. 167(2 Part 1): 591-596. February 2002. Contact: Available from Lippincott Williams and Wilkins. 12107 Insurance Way, Hagerstown, MD 21740. (800) 638-3030 or (301) 714-2334. Fax (301) 824-7290. Summary: This article reports on a study that retrospectively reviewed the authors' experience with the artificial urinary sphincter for postprostatectomy incontinence (involuntary loss of urine following removal of the prostate), comparing the outcome of those patients who did and did not receive previous radiation therapy. A total of 86 patients with postprostatectomy incontinence treated with implantation of artificial urinary sphincter includes 58 who did not (group 1) and 28 who did (group 2) receive prior radiation therapy during treatment of prostate carcinoma. In group 2, radiation was the primary treatment, followed by salvage prostatectomy in 5 patients, adjuvant after radical retropubic prostatectomy in 20 patients, and after transurethral prostatic resection (TURP) in 3 patients. Mean patient age plus or minus standard deviation was 68.3 plus or minus 6.6 years (group 1) and 69.7 plus or minus 6.6 years (group 2). Reoperation was required in 13 patients (22.4 percent) in group 1 and in 7 patients (25 percent) in group 2. Urethral atrophy or inadequate compression was seen in 8 patients (14 percent) and 4 patients (14 percent), and urethral erosion was observed in 1 patient (2 percent) and 2 patients (7 percent) in groups 1 and 2, respectively. Infection of the device was observed in 4 patients (7 percent) in group 1 but none in group 2. Continence status was similar in both groups (around 60 percent). Urgency with or without urge incontinence was reported after implantation of artificial urinary sphincter in 47 percent and 44 percent of patients in groups 1 and 2, respectively. The authors conclude that the artificial urinary sphincter has a similar outcome in patients with postprostatectomy incontinence whether or not they have received previous radiation therapy. 5 tables. 12 references.

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Overview of the Oral Complications of Adult Patients with Malignant Haematological Conditions Who Have Undergone Radiotherapy or Chemotherapy Source: Journal of Advanced Nursing. 22(6): 1085-1091. December 1995. Summary: This review article covers mouth care in adult patients with malignant hematological (blood) conditions and, in particular, those with disturbed immunity or bone marrow depression due to radiotherapy (radiation) or chemotherapy. The oral assessment tools available are discussed. The author describes different products used and the research that supports their use, as well as staging systems used to introduce such products to the patient's schedule. The author focuses on the nursing care involved in this provision of care. The author notes that patient education has been found to be the most important aspect of mouth care in these patients. Topics include chemotherapy agents, maintaining hydration (avoiding xerostomia), infections, mouth washes, and toothbrushes. Chlorhexidine mouthwashes, professional scaling (if the patient's white cell count allows it), elimination of possible sources of oral infection and irritation, and relief of pain form the basis of care for these patients. 47 references. (AA-M).

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Large Vascular Malformation of the Tongue Treated With Radiation Therapy Source: Journal of Oral and Maxillofacial Surgery. 55(5): 509-514. May 1997. Summary: Vascular malformations are common lesions, accounting for approximately 7 percent of all benign tumors. Intracranial vascular malformations are not uncommon

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and can result in devastating complications should rupture occur. However, extracranial vascular malformations that enlarge to life-threatening proportions are rare. This article describes the case presentation and management of a patient who required emergent care for a large extracranial vascular malformation involving the tongue, oral pharynx, and labial (lips) region. The authors describe the symptoms, emergency care, use of tracheostomy, gastric and jejunostomy tubes, decision for use of radiation therapy, treatment, and follow up care. A brief discussion focuses on the choice of treatment modality for this type of vascular malformation. 8 figures. 24 references. (AA-M).

Federally Funded Research on Radiation Therapy The U.S. Government supports a variety of research studies relating to radiation therapy. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to radiation therapy. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore radiation therapy. The following is typical of the type of information found when searching the CRISP database for radiation therapy: ·

Project Title: ACCURATE, HIGH RESOLUTION 3D DOSIMETRY. Principal Investigator & Institution: Oldham, Mark; William Beaumont Hospital Research Inst Suite 501 Royal Oak, Mi 48073 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2007 Summary: (provided by applicant): Dose distributions associated with advanced radiation treatments (e.g. intensity modulated radiation therapy, IMRT) typically exhibit complicated steep dose gradients that conform to irregular anatomical surfaces in three-dimensions (3D). Comprehensive verification is difficult to achieve with conventional dosimeters presenting an immediate and substantial problem. In short, rapid advances in the technology to deliver radiation treatments have not been paralleled by corresponding advances in the ability to verify these treatments. A potential solution has emerged in the form of 3D gel-dosimetry utilizing opticalcomputed-tomography (optical-CT). It is the long-term objective of this proposal to investigate, optimize and develop gel-dosimetry to a level where accuracy is comparable to that of other standard relative clinical dosimeters (e.g. ion-chambers at 3%) while maintaining the unique feature of high spatial resolution in 3D (Imm3 or better). Should this be possible, it would represent a key goal for radiation dosimetry, and could significantly improve and influence clinical practice. The proposal includes the development and use of a model to study the fundamentals of light transport

2 Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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through the gel and scanning system and the transfer of signal and noise to dose reconstruction. The model will also enable optimization of the system and provide a platform of knowledge to guide in the refinement of future gel dosimeters. Geldosimeters (polymer and radiochromic gels) will be characterized according to the physical factors affecting accuracy. Finally, an optical-CT gel-dosimetry system is constructed that is capable of high-resolution 3D dose measurement with accuracy consistent with other standard dosimeters. The utility, accuracy and feasibility of the finalized system will be demonstrated by application to dosimetric verification of advanced IMRT, radiosurgery and brachytherapy treatments in the clinic. Completion will result in a 3D dosimetry system capable of unprecedented comprehensive dosimetric verification, and applicability to the spectrum of modern radiation treatments, including IMRT, brachytherapy, radiosurgery and orthovoltage teletherapy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen ·

Project Title: ACTIVATION OF THE IMMUNE SYSTEM BY TNFERADE Principal Investigator & Institution: King, Charles R.; Genvec, Inc. 65 W Watkins Mill Rd Gaithersburg, Md 20878 Timing: Fiscal Year 2004; Project Start 01-APR-2004; Project End 31-JAN-2005 Summary: (provided by applicant): This proposal will investigate the mechanism of action of TNFerade, a promising cancer treatment now in clinical testing. In TNFerade, the TNF coding sequence is controlled by a radiation responsive promoter, egr-1, is contained within an adenovirus vector. Direct injection of TNFerade into a tumor restricts the expression of TNFerade to the region of radiation therapy. Early but encouraging data suggests that TNFerade causes complete tumor responses in multiple tumor types and in very large lesions. These results indicate that TNFerade acts by mechanisms in addition to the direct TNF induced cytolysis of cancer cells. In the phase I portion of the SBIR grant, the hypothesis that the host immune system contributes to the anti-tumor activity of TNFerade will be tested in animal models. To date, all published reports of TNFerade in animal models involve compromised immune systems and limited TNF signal transduction. In the first specific aim, a vector will be constructed that is equivalent to TNFerade but containing a murine TNF coding sequence to allow for the full induction of host TNF receptors. The anti-tumor activity of this vector in immuno-competent (syngeneic) animals will be compared with immunocompromised animals. In a second specific aim, induced immune responses will be measured at distant, noninjected, tumors. This feasibility study will allow more detailed analysis of the TNFerade mechanism in the phase II portion of the grant leading to improvements in the clinical testing of TNFerade and the design of follow up products with improved efficacy for treatment of cancers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: ADULT HODGKIN'S DISEASE AND EPSTEIN BARR VIRUS Principal Investigator & Institution: Ambinder, Richard F.; Professor and Director; Oncology; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002; Project Start 05-APR-2002; Project End 31-MAR-2007 Summary: (PROVIDED BY APPLICANT): Successes in the treatment of Hodgkin's disease (HD) highlight the long-term consequences of chemotherapy and radiation therapy in the management of this disease. The current inter-group trial reflects the improvement in failure free survival as it pays increasing attention to reducing the late effects of therapy in survivors. The presence of Epstein-Barr virus (EBV) in a significant

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proportion of HD tumors offers the opportunity to develop the use of virus-specific tumor markers and virus-specific immune therapy. The Eastern Cooperative Oncology Group (ECOG) and Southwestern Oncology Group (SWOG) trial E2496 offers an unparalleled opportunity to address these questions. Through evaluation of this large group of patients, the determination of whether EBV detection in biopsy specimens identifies a poor risk group (particularly in patients over the age of 45 years) should be possible. In addition, the validation of the utility of tissue arrays in the detection of EBV in HD will allow the development of this important and cost-efficient resource. A careful analysis will be performed to determine whether EBV detection studies in tissue arrays or in plasma by real-time PCR yield results parallel to those achieved with detection studies applied to conventional tissue sections. In parallel, the determination of the rate of viral DNA clearance in plasma and the effect of different treatment regimens on this clearance will be performed using real-time PCR. The rate of clearance as well as the persistence of viral DNA in plasma will analyzed to determine if they predict resistant disease or relapse. The relationship between plasma IL-10 levels, IL-10 promoter polymorphisms, and the EBV status of the tumor will be evaluated. Finally, we seek to characterize the cytotoxic T-cell response to EBV antigens expressed in HD (in the context of response to other EBV antigens and antigens from other viruses) and to assess the impact of chemotherapy/radiotherapy on these responses. This work should lay the groundwork for future viral antigen targeted therapies. Website: Error! Hyperlink reference not valid. ·

Project Title: AMORPHOUS SELENIUM IMAGING FOR TOMOTHERAPY Principal Investigator & Institution: Fang, Guang M.; Tomotherapy 2228 Evergreen Rd Middleton, Wi 53562 Timing: Fiscal Year 2003; Project Start 05-SEP-1998; Project End 31-JUL-2005 Summary: (provided by applicant): TomoTherapy Incorporated was founded in 1997 to develop and commercialize a new type of radiation therapy device for improving cancer treatment. TomoTherapy's first FDA cleared product, the HiArt System, combines, for the first time, the means to accurately plan, deliver, verify and review treatments for cancer therapy, and as a result, to greatly improve treatment results and lifestyles of cancer patients because of the better targeting of irradiation to the tumor and the sparing of normal tissue. This "entire radiotherapy department in a machine" integration and automation greatly reduces the need for human intervention, thus reducing staff needs for cancer treatment. The HiArt System employs image-guided radiation delivery, enabling tumors to be irradiated more effectively while saving the critical organs surrounding the tumor. Central to the capability of image-guided radiotherapy is a detector system that efficiently detects high energy x-rays employed in cancer therapy. The objective of the proposed project is to develop a new type of megavoltage detector system that meets all the requirements of tomotherapy imaging applications. The proposed design combines i) amorphous selenium (a-Se) material which has seen extensive research and development in applications ranging from imaging and display, to radiology and astronomy, with ii) TomoTherapy's patented technology for improving detection efficiency for high energy x-rays. This new detector system will improve the detection efficiency, a key requirement for an imaging detector, over the existent technology by an order of magnitude, thus offering great improvement in resolving power on the images. When employed, the multi-row approach and the improved detection efficiency and readout speed of the new detector will improve the tomotherapy imaging quality and throughput significantly, and offers great potential for imaging the patient in real-time during treatment, a key element for further

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improving cancer treatment where organ motion is a significant obstacle to improved precision. It is expected that the proposed detector will also save $10 to $20 million in tomotherapy manufacturing cost yearly. This technology also has potential applications in other areas as well, including security inspections at ports, forest inspections and orthopedic imaging where there are implanted metal devices or joints. Website: Error! Hyperlink reference not valid. ·

Project Title: AN IMAGE GUIDED SMALL ANIMAL RADIATION RESEARCH PLATFORM Principal Investigator & Institution: Wong, John W.; Director, Clinical Physics; William Beaumont Hospital Research Inst Suite 501 Royal Oak, Mi 48073 Timing: Fiscal Year 2004; Project Start 01-APR-2004; Project End 31-MAR-2008 Summary: (provided by applicant): Significant advances have been made in medical anatomical imaging over the past 25 years. More recently, there has been increased interest in small animal biological imaging research based on the increasing understanding of various molecular and genetic signals in tumor cells in vitro and in vivo. These initiatives have focused primarily on therapeutic research with drugs and other systemic agents, somewhat ironically, overlooking radiation therapy. The addition of biological imaging information to radiation therapy will have a major impact on the management and evaluation of treatment. Unfortunately, despite the interest in biological imaging research, animal radiation research methodology lags far behind clinical practices. Advanced techniques such as conformal, intensity modulated radiation therapy (IMRT) is increasingly becoming routine in human clinics, and has led to a shift in the clinical paradigm of the uniform dose delivery towards non-uniform dose delivery, particularly to the critical organs. The advent of new image guidance methods for short course radiation treatment will yet lead to the delivery of dose distributions of even greater nonuniformity. Regrettably, present laboratory research equipment prohibits testing of these paradigms in animal models. As a consequence, the advanced treatment technologies are applied clinically without any guidance from small animal radiation experimentation to evaluate efficacy in a preclinical setting. In this proposal we request funding for the de novo construction, testing and evaluation of an image guided small animal radiation research platform (SARRP) that will accurately deliver complex ionizing radiation dose distributions in small animal tumor model systems, mice, rats and rabbits. Specifically we propose 1) the construction of a gantry system containing three kilovoltage (kV) radiation sources that will have energy deposition resolution of about 1mm and on-board cone beam CT imaging resolution of about 0.5 mm; 2) the development of dosimetric and treatment planning methodologies that parallel that for human treatment. Finally (3) the third specific aim is to develop methods of precise animal setups and to validate the imaging and irradiation capabilities of the system for accurate delivery of localized dose distributions in small animals. The research requires integration of expertise in mechanical engineering, x-ray optics and radiation dosimetry physics. The collaborative efforts are best coordinated in a Bioengineering Research Partnership (BRP). An Oversight Group is formed to evaluate the progress of the BRP, and to help identify opportunities and hypotheses for future research. Website: Error! Hyperlink reference not valid.

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Project Title: AN INTRAVASCULAR X-RAY SOURCE FOR RESTENOSIS TREATMENT Principal Investigator & Institution: Shefer, Ruth E.; President; Newton Scientific, Inc. 245 Bent St Cambridge, Ma 02141 Timing: Fiscal Year 2002; Project Start 01-MAY-1999; Project End 31-JAN-2004 Summary: (Applicant's abstract verbatim): The goal of this project is to develop a miniature, catheter-based X-ray source for radiation therapy to prevent restenosis after percutaneous transluminal angioplasty. Restenosis affects 30 percent to 50 percent of angioplasty patients within six months of the procedure. Intravascular radiation therapy has been shown to be effective in preventing or significantly delaying restenosis in both coronary and peripheral vessels. Ongoing clinical trials of intravascular brachytherapy for restenosis use gamma or beta-emitting radioisotopes delivered to the angioplasty site via a guide catheter and withdrawn when sufficient dose has been delivered to the arterial segment. These radioactive devices have significant drawbacks, including limited dose rates and fixed dose-depth profiles, safety hazards to patient and medical personnel, and restrictions on transportation, storage and disposal. In Phase I, we evaluated the feasibility of developing a disposable, electrically-powered X-ray source small enough to reach the angioplasty site through a standard guide catheter. Advantages of the proposed source include on-off capability, high radiation dose rate, user-controlled dose-depth profile, and elimination of the regulatory and safety issues that accompany the use of radioactive materials. The Phase I results demonstrate the feasibility of constructing an ultra-miniature X-ray source with the required radiation dose rate and dose-depth characteristics. A fully operational X-ray source and delivery catheter will be developed in Phase II and tested in phantoms. PROPOSED COMMERCIAL APPLICATION: Approximately 1,000,000 coronary angioplasty procedures are performed worldwide each year. If radiation therapy for restenosis is proven effective in clinical trials, this represents a large market for catheter-based radiation devices. A flexible, catheter-based X-ray source also has many potential applications in radiation oncology. Website: Error! Hyperlink reference not valid.

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Project Title: ANGIOGENIC PROFILE OF RECTAL CANCER Principal Investigator & Institution: Willett, Christopher G.; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2003; Project Start 15-AUG-2003; Project End 31-JUL-2005 Summary: (provided by applicant): This investigation has two broad and long range objectives. Our first goal is to establish the clinical feasibility of integrating a novel antiangiogenesis agent, bevacizumab, into a contemporary treatment program of chemotherapy, radiation therapy, and surgery for patients with primary and nonmetastatic rectal carcinoma. Our second objective is to clarify through correlative studies the mechanisms by which bevacizumab inhibits angiogenesis in concert with other therapeutic modalities in the treatment of this malignancy. Bevacizumab is a recombinant, humanized antibody to vascular endothelial growth factor (VEGF), which is overexpressed in rectal cancer and is associated with disease progression and inferior survival. Importantly, this data may aid further development of this novel agent in the treatment of rectal cancer. The central hypothesis of this proposal is that inhibition of VEGF will result in clinical benefit through enhancement of radiation and chemotherapy response for patients with rectal cancer. We will address this hypothesis using two specific aims: AIM 1: A phase I clinical trial will be undertaken to establish the

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maximum tolerable dose (MTD) of bevacizumab when combined with chemotherapy, radiation therapy, and surgery. Following this determination, an additional cohort of 20 patients will be treated to further assess tolerance and efficacy of this treatment program. AIM 2: To evaluate the mechanisms of effect of this therapy on rectal cancer, angiogenesis assays will be carried out using rectal cancer biopsy samples, blood, urinary samples, interstitial tumor pressure measurements, and radiological imaging (perfusion CT scans and PET scans). These assays will be performed before, during, and after treatment. Website: Error! Hyperlink reference not valid. ·

Project Title: ANTIPROLIFERATIVE HYPERPLASIA

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Principal Investigator & Institution: Roy-Chaudhury, Prabir; Internal Medicine; University of Cincinnati 2624 Clifton Ave Cincinnati, Oh 45221 Timing: Fiscal Year 2002; Project Start 05-AUG-2002; Project End 31-JUL-2006 Summary: (provided by applicant): Hemodialysis vascular access dysfunction is the single most important cause of hospitalization in hemodialysis patients and is responsible for a very significant morbidity within this patient population. Thrombosis of PTFE dialysis grafts due to venous stenosis as a result of venous neointimal hyperplasia (VNH), is the most common cause of vascular access dysfunction. Surprisingly, there are currently no effective therapeutic interventions for VNH despite its clinical importance. Analysis of cell types and cytokines in dialysis patients with venous stenosis due to VNH and data from a validated pig model of venous neointimal hyperplasia, that is very similar to the human lesion have been described. These studies clearly demonstrate that smooth muscle cell (SMC) proliferation and the formation of microvessels (endothelial cell proliferation), within the neointima and adventitia are critical features of VNH. In addition, it is likely that PTFE dialysis grafts are the ideal clinical model to test out novel local interventions, in view of their superficial location and easy accessibility. It is therefore proposed to test out novel locally delivered antiproliferative therapies in a validated pig model of VNH, in the hope of being able to rapidly translate positive findings into a clinical setting of great need. Three local interventions will be evaluated in this proposal for their anti-proliferative effects. (a) External radiation therapy: Initial studies in the pig model, have demonstrated a reduction in VNH (albeit less than in models of coronary angioplasty), with a single dose of l6Gy. We now plan to optimize a radiation schedule for VNH by testing out 3 different radiation regimens (b) Local polymeric delivery of paclitaxel and TNP-470: A local polymeric delivery system comprising ethylene-vinyl-acetate matrices loaded with paclitaxel and TNP-470 (both are potent anti-proliferative agents) will be developed and tested in vitro against SMC and endothelial cells. Polymeric matrices will then be wrapped around the graft vein anastomosis in a perivascular configuration in an attempt to reduce luminal stenosis and VNH. (c) Combination radiation therapy and local anti-proliferative therapy: The most effective radiation and anti-proliferative regimens from (a) and (b) will be combined in this final analysis, in the hope of achieving a synergistic effect. We believe that the results from this study could transform the clinical care of hemodialysis patients and at the same time result in the successful clinical application of local therapy for the treatment of neointimal hyperplasia. Website: Error! Hyperlink reference not valid.

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Project Title: ASSESSMENT AND OPTIMIZATION OF RADIATION THERAPY Principal Investigator & Institution: Niemierko, Andrzej; Associate Professor; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2002; Project Start 01-SEP-1989; Project End 31-MAY-2004 Summary: This abstract is not available. Website: Error! Hyperlink reference not valid.

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Project Title: ASSESSMENT OF HYPOXIA IN MALIGNANT GLIOMAS USING EF5 Principal Investigator & Institution: Evans, Sydney M.; Associate Professor; Radiation Oncology; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2002; Project Start 04-JUN-2001; Project End 31-MAY-2004 Summary: (Provided by applicant) It has been known since the 1950s that hypoxic tumor cells require up to 3 times the radiation dose compared to aerobic cells for equal toxicity. Because the total radiation dose administered is limited by the tolerance of normal adjacent tissues, the search for approaches to overcome the "hypoxia problem" has dominated radiation biology research for the last half century. One of the major limitations to attacking this problem has been the inability to identify and quantitate the presence of hypoxic cells in individual patients. In the last decade, the availability of the Eppendorf needle electrode technology has allowed data to be obtained on tumor tissue oxygenation in patients. Such studies have demonstrated hypoxia to negatively influence outcome in cervix, sarcomas and head and neck cancers. There is also substantial evidence that hypoxia exists and is biologically relevant in malignant brain tumors. The overall goal of our clinical hypoxia program is to determine whether the presence, levels and patterns of EF5 binding are important in the prognosis and therapy response of cancer patients. Our interests include patients with sarcomas, head and neck squamous cancer, cervix cancer and now, patients with brain tumors. In the studies proposed herein, we will study EF5 binding in patients with de novo supratentorial malignant gliomas (SMG). Concurrent studies in the same patient group using the Eppendorf needle electrode will serve as a bridge to previously published work. We will determine the relationship between EF5 binding and clinical outcome in patients with glioblastoma multiforme (GBM) versus non-GBM histologies. To better understand the pathophysiology of MG, we will study the presence and levels of various additional biomarkers. These studies are the necessary preliminary studies towards non-invasive studies of hypoxia in brain tumors. These non-invasive studies will be based on Positron Emission Tomographic (PET) imaging of 18F-EF5 followed by hypoxia-specific treatment interventions. 18F-EF5 has been synthesized and studied in animal tumors by our group. The necessary additional pre-clinical studies and applications for permits for these PET studies are ongoing at the University of Pennsylvania (PENN). We project that we will be able to institute clinical EF5 PET studies at PENN in patients with brain tumors in approximately 2 years, corresponding to the time that much of the data from the studies proposed herein will mature. Website: Error! Hyperlink reference not valid.

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Project Title: AUTOMATIC RADIOTHERAPY

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Principal Investigator & Institution: Duncan, James S.; Professor; Diagnostic Radiology; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2002; Project Start 03-FEB-2000; Project End 31-JAN-2004

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Summary: The effectiveness of externam beam radiation treatment for prostate cancer is decreased due to a variety of uncertainties in the treatment setup, including the physical characteristics of the treatment beam, patient positioning issues, patient organ motion and operator non-reproducibility. The development and administration of a treatment plan using image- guided techniques to account for some of these uncertainties can positively impact its effectiveness. However, the use of these techniques to date has been limited by i.) a lack of accuracy, robustness and reproducibility in the registration of the high resolution 3D computed tomographic (3DCT) or simulator images acquired in a reference )or planning) frame to the highly noisy and blurry portal images, acquired in the treatment environment and ii.) the difficulty in measuring organ motion and relating it to these data. Thus, we first propose to develop a new automated, accurate, and robust system for performing bony anatomy- based 3DCT- to- multiple- (2D) portal image registration by simultaneously incorporating portal image segmentation. The system will rely on a combination of dense field (region-based) and sparse field (gradient/boundary features) information and will use information- theoretic metrics in an optimization framework to solve for the mapping parameters. This approach will be validated using a gold standard developed from serial CT acquisitions taken each week during the treatment. Next, we will study the relationship between setup variation due to bony structure movement and that due to organ motion in preparation for the design of a future complete system that can acquire treatment- environment images of the prostate using an ultrasound probe attached to an articulated arm in an external- skinmarker-based frame, and the 3DCT-to-multiple portal registration algorithm described above. The feasibility of using external markers to relate portal and ultrasound information will be a key part of this study as well. Finally, we will evaluate the utility of the 3DCT-to-multiple portal registration approach by applying it to the problem of quantitatively studying the sensitivity of errors in the delivery of an optimal dose distribution for a particular patient on a particular day to variations in patientpositioning-related setup for treatment plans of different complexity. These studies will help us understand the utility of more complex treatment plans and planning systems in today's health care environment. Website: Error! Hyperlink reference not valid. ·

Project Title: BREAST CANCER PREVENTION IN HODGKINS DISEASE Principal Investigator & Institution: Garber, Judy E.; Assistant Professor of Medicine; Dana-Farber Cancer Institute 44 Binney St Boston, Ma 02115 Timing: Fiscal Year 2002; Project Start 29-JUN-2001; Project End 31-MAY-2004 Summary: (Applicant's Description) Hodgkin's Disease carries an excellent prognosis, with the majority of patients cured of their primary tumor. However, late complications of therapy in these patients are of increasing concern, especially new primary cancers of particular importance in this group is the increased risk of breast cancer among female Hodgkin's disease survivors who received mantle or chest radiation (RR approximate 20 by 15 yrs after treatment). Tamoxifen has been shown to reduce the risk of breast cancer by nearly 50percents in women at increased risk on the basis factors considered in the Gail model, DCIS or prior breast cancer II. It has not yet been evaluated in radiogenic breast cancer. HD survivors may also experience early menopause if their HD treatment included chemotherapy 12, and early atherosclerotic heart disease l3,14 and other second cancer risk from radiation or combined modalities I. These concerns may affect the risk/benefit considerations of tamoxifen in this high risk population whose risk becomes manifest at young ages. Because of these issues, it seems important to prove, rather than assume, that tamoxifen ireduces breast cancer risk in this population.

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However, since there are a limited number of women available for a study of sufficient size to address the question with sufficient power, demonstration of feasibility seems critical. In the proposed study, we will address aspects of feasibility , including recruitment/acceptance, adherence, toxicities and quality of life, and reproductive hormone status. We propose to recruit 50 female Hodgkin's Disease survivors whose treatment included radiation therapy (mantle or other chest), diagnosed before age 30, current age greater than 30 years, greater than 8 years from radiation to participate in a pilot study in which they will receive tamoxifen for 2 years on study, and 5 years in total. We will estimate recruitment rates, evaluate adherence, and assess quality of life and toxicities using measures employed in the BCPT, as well as questions developed for this population. Our advisory board will consider the one year data and assist us in deciding whether or not to proceed to attempt the larger study. A definitive randomized trial would be feasible with available HD survivors if adherence were 90 percents, based upon an estimated absolute risk of 8 percents over a 5 year period in women without tamoxifen. This is a risk much greater than the average risk in the BCPT cohort, permitting the smaller sample size. We will also evaluate mammographic density as a potential intermediate endpoint that might permit more rapid completion of a randomized study. Website: Error! Hyperlink reference not valid. ·

Project Title: CANCER AND LEUKEMIA GROUP B Principal Investigator & Institution: Crawford, Jeffrey; Medicine; Duke University Durham, Nc 27706 Timing: Fiscal Year 2002; Project Start 01-APR-1988; Project End 31-MAR-2003 Summary: (adapted from the applicant's abstract): Duke Medical Center is currently completing its second five year grant cycle as a member of Cancer and Leukemia Group B (CALGB). Throughout Duke's involvement with CALGB, this institution has consistently been one of the top institutions in overall patient accrual and specifically has been one of the leading institutions in patient accrual from a main member institution. Over the period of the last grant cycle, Duke has developed an affiliate program through the Duke Oncology Consortia (DOC) which involves cancer centers and hospitals throughout the Southeast United States. This affiliate membership is still growing in number of sites and level of participation in clinical trials. In addition, the Duke Oncology OutReach Services (DOORS) network provides onsite cancer care at small hospitals and clinics in neighboring counties. Both intramural and extramural clinical trial participation are coordinated through centralized clinical trials offices at Duke. This includes personnel support for core administrative functions, clinical trial coordination provided by disease and modality specific clinical research nurses, and data management and follow-up by dedicated CALGB data managers. This organizational structure is further strengthened by close interaction with the CALGB biostatistics and data management center under the direction of Dr. Stephen George who is also director of biostatistics for the Duke Cancer Center, Scientifically, Duke has active cadre members in all the disease and modality related CALGB committees. Duke investigators serve as study chairs on Phase III trials in AML, stage IV breast cancer, the national high priority trial of bone marrow transplant in the adjuvant treatment of breast cancer patients (9082), as well as numerous Phase II studies. Duke is also a center for Phase I studies for pharmacology/experimental therapeutics. This has been further strengthened by the recruitment of Dr. Michael Colvin to become Director of the Cancer Center. Furthermore, Dr. Harvey J. Cohen, Director of the Aging Center has become an active member of CALGB and was instrumental in the formation and leadership of a

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working group evaluating cancer and aging. The recruitment of Dr. David Harpole in Thoracic Surgery, led to Duke becoming a major site for participation in CALGB surgical trials. Multimodality support has also been provided by active participation from other members of surgical oncology as well as radiation oncology, pathology, and correlative sciences. Areas of expansion by Duke investigators within CALGB over the next grant cycle will be particularly targeted to multimodality trials, Phase I studies, bone marrow transplant trials, and the continued participation in ongoing phase II and III trials. In addition, our participation in community trials addressing minority issues, gero-oncology, and cancer control will expand with the participation of Dr. Barbara Rimer and Dr. Colleen McBride. As a leading institution in CALGB activities over the last decade, Duke is looking forward to funding support appropriate to our current and anticipated level of patient accrual and scientific involvement in CALGB trials during the next grant cycle. Website: Error! Hyperlink reference not valid. ·

Project Title: CANCER AND LEUKEMIA GROUP B (CALGB) Principal Investigator & Institution: Ernstoff, Marc S.; Medicine; Dartmouth College 11 Rope Ferry Rd. #6210 Hanover, Nh 03755 Timing: Fiscal Year 2002; Project Start 01-APR-1979; Project End 31-MAR-2004 Summary: (adapted from the applicant's abstract): Patients with breast cancer, lung cancer, gastrointestinal malignancies, prostate carcinoma, leukemia and lymphoma and other malignancies will be entered into therapeutic, cancer control and correlative science trials developed by the Cancer and Leukemia Group B (CALGB). A broader base for recruitment of patients to CALGB has been established in much of New Hampshire, eastern Vermont and northern Massachusetts through the eight member Cooperative Group Oncology Program, and with this network it is planned to increase the numbers of patients accrued to CALGB studies. Dartmouth will continue to make significant contributions to the scientific and administrative activities of CALGB. Within the Norris Cotton Cancer Center (NCCC) strategies to refocus the scientific directions will allow more translational programs to be piloted for future testing in the CALGB setting. The six areas of development are immunotherapy, retinoid development, clinical pharmacology, genetics and gene modulation, drug development and interactions with radiation, tumor markers, pain and psychosocial initiatives. It is anticipated that phase I, II and pilot clinical trials currently underway at the Norris Cotton Cancer Center will soon be ready for expanded trials in CALGB. Website: Error! Hyperlink reference not valid.

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Project Title: CANCER RADIOTHERAPY: SENSITIZATION BY INHIBITORS OF PAR* Principal Investigator & Institution: Southan, Garry J.; Inotek Pharmaceuticals Corporation 100 Cummings Ctr, Ste 419E Beverly, Ma 01915 Timing: Fiscal Year 2002; Project Start 18-JUL-2001; Project End 31-JAN-2004 Summary: (provided by applicant): Activation of the nuclear enzyme poly (ADP-ribose) synthetase (PARP) has been implicated in the process of recovery from radiation induced cell injury. Consequently, inhibitors of PARP or cells deficient from PARP exhibit enhancements in their radiation sensitivity. The principle of this radiosensitizing effect of PARP inhibition can be exploited for the development of novel radiosensitizing agents for cancer therapy. The applicants are developing a series of novel, proprietary PARP inhibitors, with a high potency, good water-solubility and optimal cell

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penetration characteristics. The goal of the present application, supported by preliminary data, is to confirm that the applicants' proprietary, novel PARP inhibitors act as potent radiosensitizers in vivo, and to select a lead candidate for further preclinical development (i.e. toxicity and safety studies). The results of the present application will permit application for Phase 2 funding to support: completion of preclinical pharmaceutical testing (additional advanced toxicity determinations, pathology, stability, pharmacokinetics), preparation of investigational drug application to the FDA, and a Phase I and II clinical trials. PROPOSED COMMERCIAL APPLICATION: The annual anticipated revenues for an effective therapeutic to safely enhance radiation therapy is over $100 million in the US alone. Website: Error! Hyperlink reference not valid. ·

Project Title: CERVICAL CANCER--PREDICTIVE ASSAY BY MR IMAGING Principal Investigator & Institution: Mayr, Nina A.; Radiological Sciences; University of Oklahoma Hlth Sciences Ctr Health Sciences Center Oklahoma City, Ok 73126 Timing: Fiscal Year 2003; Project Start 21-SEP-1998; Project End 31-JUL-2004 Summary: Radiotherapy is the principal treatment modality for advanced cervical cancer, but local control is frequently not achieved. The failure rate may be reduced by treating high-risk patients with more intense therapies including higher doses of radiation, chemotherapy, and/or surgery. However, there is no well-established predictor to identify patients whose high risk for failure justified the increased morbidity of more aggressive therapy. The investigators seek to identify those at high risk early, such that more aggressive treatment can be rendered that may improve outcome. Quantitative tumor volume and enhancement pattern analysis based on sequential MRI examination were shown to provide very early signals of failure in plot studies. Tumor size and dynamic enhancement pattern judged by the MRI prior to radiation therapy and temporal changes during the early course of radiation therapy appear to be sensitive predictors of tumor response; consistent with the notion that tumor blood supply and or oxygenation status strongly influence radiation response. The overall goal of this project is to test the hypothesis that MR-based measurements predict the likelihood of tumor control in patients with advanced cervical cancer treated by conventional radiation therapy. This will be achieved by three specific aims: (1) further develop, test, and refine predictive metrics of advanced cervical cancer radioresponsiveness based on contrast enhanced MRI and MR-based tumor volumetry, (2) apply MRI in a clinical population through their course of therapy and correlate tumor response with image-based metrics, and (3) determine predictive value (positive and negative) of MRI-based metrics. On completion, this project will provide a clinically validated MR protocol for prediction of tumor radio-responsiveness in advanced cervical carcinoma treated with radio-therapy. A prognostic index using MRI in a clinical setting to identify the high-risk patients who require more aggressive multimodality therapy will be developed. The pixel signal distribution within the entire tumor between the radiosensitive and resistant groups will be further defined using multi-spectral and multi- temporal analysis, and characterized to discern subgroups contributing to treatment failure within the heterogeneous tumor. Website: Error! Hyperlink reference not valid.

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Project Title: CHILDRENS NATIONAL MEDICAL CENTER Principal Investigator & Institution: Packer, Roger J.; Children's Research Institute Washington, D.C., Dc 20010

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Timing: Fiscal Year 2002; Project Start 01-APR-1999; Project End 31-MAR-2004 Summary: As a member of the Pediatric Brain Tumor Clinical Trials Consortium, the CNMC Neuro-Oncology Program proposes to develop, facilitate, and participate in innovative hypothesis-driven, technically challenging, clinical research designed to improve the survival and quality of life of children with primary central nervous system tumors. It is anticipated that these investigations will include, but will not be limited to: the use of novel chemotherapeutic agents; means to overcome the blood-brain barrier, immunotherapeutic approaches; modifications of radiation therapy; and new neurobiologic approaches, such as gene therapy, maturation agents, and antiangiogenesis agents. The CNMC Neuro-Oncology Program plans on participating in research investigations which will improve the means to diagnose and characterize childhood brain tumors and to develop and participate in carefully monitored innovative diagnostic and therapeutic studies which will lead to future Phase III studies for children with such tumors. Over the past five years, the CNMC Neuro-Oncology Program has evaluated and managed 442 children (new to the institution) with primary central nervous system tumors and has entered over 189 children on Phase I, Phase II, and Phase III clinical investigations. Investigations have been done over this period of time, in concert with private industry and working groups, evaluating novel approaches such as gene therapy, immunotherapy, and approaches to overcome the blood-brain barrier; as well as evaluations of new chemotherapeutic agents, intensification of chemotherapy, and means to increase the efficacy of radiotherapy. The CNMC NeuroOncology Program has a well-developed multidisciplinary clinical core which includes a weekly neuro-oncology clinic, a quarterly groupwide neuro- oncology planning meeting, and a regional referral system. The program has a well-designed data management system, and an established system for specimen accrual. State-of-the-art neuroradiologic, neuropathologic, neurosurgical and radiation-oncologic facilities are available. In addition, innovative neurobiologic investigations in childhood brain tumors have been successfully completed and are underway at CNMC. The welldeveloped program structure, expertise of the CNMC Neuro-Oncology Program, proven commitment to performance of clinical trials, and available facilities should ensure the ability of the CNMC Neuro-Oncology Program to effectively participate in the proposed Pediatric Brain Tumor Clinical Consortium. Website: Error! Hyperlink reference not valid. ·

Project Title: CLINICAL APPLICATION OF IMAGE GUIDED LIVER SURGERY Principal Investigator & Institution: Chapman, William C.; Surgery; Vanderbilt University 3319 West End Ave. Nashville, Tn 372036917 Timing: Fiscal Year 2002; Project Start 01-MAR-2002; Project End 31-MAY-2002 Summary: The surgical treatment of hepatic tumors is performed by removal or ablation of the involved tissue based on direct palpation and visual assessment sometimes aided with intraoperative ultrasound (IOUS). A new technology, interactive image-guided surgery (IIGS) displays current surgical positions on tomographic images (CT,MR,PET, etc) and permits the identification of precise working position with respect to previously identified anatomic and/or pathologic landmarks. Thus, the exact location in 3-D space can be shared and correlated throughout an operative procedure and significantly enhance surgical navigation. Engineering concepts and mathematical principles will be used in the development of an innovative IIGS system for hepatic surgery, including image processing for effective segmentation of the liver from abdominal CT scans, image registration to map physical space into image space, and integrated hardware and software development to create a system that can be used in th operating room. The

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specific aims of the R21 phase of this grant are: 1) Develop an automatic method for 3-D liver segmentation for accurate registration under image-guided hepatic surgery; 2) Develop techniques for track ultrasounds for specific use in image-guided hepatic surgery; 3) Adequately control hepatic motion and develop accurate registration algorithms incorporating liver surface data obtained in real-time with a laser scanner. The focus in the R33 phase of this grant will be on the clinical use of the system, with the eventual goal being image-guided ablation and resection of tumors. The specific aims proposed for years 2-4 of this project are: 1) Strengthen automatic methods for robust liver segmentation and surface registration during image-guided hepatic surgery; 2) Confirm system accuracy in tumor targeting using image-guidance in patients undergoing standard liver resection; 3) Determine th effectiveness of image-guided ablation in patients undergoing liver resection procedures; 4) Use image-guided ablation to accurately target and destroy primary and metastatic hepatic tumors and provide surgical navigation during hepatic resection. We believe that IIGS will significantly enhance currently performed clinical procedures and will permit accurate tumor localization for ablation and resection procedures. This technology also may permit minimally invasive treatment of liver tumors now performed in very limited circumstances. This work will also be carried out as a collaborative project between William Chapman, M.D. in the Department of Hepatobilliary Surgery and Liver Transplantation and Robert Galloway Ph.D., in the Department of Biomedical Engineering and other members within the center for Technology-Guided Therapy at Vanderbilt. Website: Error! Hyperlink reference not valid. ·

Project Title: CLINICAL INVESTIGATION IN HODGKIN'S DISEASE Principal Investigator & Institution: Horning, Sandra J.; Professor of Medicine; Medicine; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2002; Project Start 07-FEB-1992; Project End 31-MAR-2006 Summary: (Provided by applicant): The long-term objectives of this application are to maintain or improve the efficacy ofHodgkin's disease (HD) therapy while reducing late effects through a series of clinical trials in which novel, abbreviated chemotherapy is combined with reduced volumes and doses of radiation therapy. The specific aims in this proposal represent the evolution of prospective clinical trials conducted at Stanford University Medical Center continuously since 1962. During that period of time, the influence of advances in diagnostics, staging, multi-modality therapeutics and appreciation of the late effects of treatment has extended from HD management to that of other neoplasms. Although the cure rate of HD is high relative to other cancers, morbidity and mortality in excess of that expected on the basis of age and gender, primarily due to second cancers and ischemic heart disease provides a strong rationale for continued clinical investigations. In Aim 1, a risk-adapted Phase II trial is proposed for favorable, early stage disease in which patients will receive 12 weeks of chemotherapy alone or 8 weeks of chemotherapy and low dose radiotherapy. Following the success of Stanford V chemotherapy with or without radiotherapy and international consensus in prognostic factors in advanced HD, a Phase III Intergroup trial comparing this approach with ABVD is proposed in patients with 0-2 risk factors in Aim 2. For higher risk patients, those with 3 or more adverse factors, a Phase II trial of a novel chemotherapy regimen based upon Stanford V and introducing the new active agents, gemcitabine and vinorelbine, is planned in Aim 3. Aim 4 relates to the continued followup of patients enrolled in HD clinical trials at Stanford since 1962 and the provision of information management and statistical support to analyze efficacy and long-term

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morbidity and mortality. The ability to chronicle the late effects of treatment at Stanford has been made possible by a dedicated group of investigators, use of standardized diagnostics and treatments, and maintenance of a database now containing information on more than 3000 HD patients. Identification and notification of patients at risk is important for follow-up care and screening, where appropriate. Continued follow-up of HD patients and maintenance of the Stanford HD database, which can be considered a national resource, has never been more important as the time period after treatment of patients receiving lower doses and volumes of radiotherapy as well as novel combinations of chemotherapy approaches 10-15 years, a critical latency for second cancers. Website: Error! Hyperlink reference not valid. ·

Project Title: COLLABORATIVE OCULAR MELANOMA STUDY Principal Investigator & Institution: Capone, Antionio; William Beaumont Hospital 3601 W Thirteen Mile Rd Royal Oak, Mi 480736769 Timing: Fiscal Year 2002; Project Start 30-SEP-1985; Project End 31-JAN-2004 Summary: The proposed study is a multicenter, randomized, controlled clinical trial designed to compare enucleation of eyes with choroidal melanomas with irradiation on the basis of survival after diagnosis and treatment. Candidates for the study will be newly diagnosed cases with choroidal melanoma in one eye greater than 3 mm in height and up to 18 mm by 8 mm in size and with no evidence of metastatic disease who are 21 years of age or older. Informed consent will be obtained from all patients prior to randomization. All patients will be followed for a minimum of ten years or until death. The outcome of primary interest is death from all causes. Secondary outcomes will include death from cancer, whether metastatic or not, and diagnosis of other tumors. Complications of irradiation and changes in visual acuity will be documented and monitored carefully throughout follow-up. The study will be conducted in clinical centers located throughout the United States which draw patients from the major population centers; a Coordinating Center; a Fundus Photograph Reading Center; a Pathology Center; and a Sonography Center. Each clinical center will be expected to enroll at least 12 eligible patients each year. The study will be directed by a Executive Committee consisting of 12 to 15 study investigators and a Steering Committee to deal with day-to-day operational decisions. An independent Data and Safety Monitoring Committee will be responsible for assuring the ethical conduct of the study and for reviewing the accumulating data on a regular basis for evidence of adverse or beneficial effects of therapy. The intention of the investigators is to collect and analyze data of high quality which will provide a conclusive answer to the question of therapeutic preference in the management of patients with choroidal melanomas. Standardized clinical and data collection procedures will be employed, and standardized forms will be used in all centers. Central training and certification of all study staff will be required. Website: Error! Hyperlink reference not valid.

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Project Title: COMBINATION OF GM-CSF WITH TKR GENE THERAPY Principal Investigator & Institution: Chhikara, Madhu; Advantagene, Inc. 160 Paulson Rd Waban, Ma 02468 Timing: Fiscal Year 2003; Project Start 04-APR-2003; Project End 31-MAR-2005 Summary: (provided by applicant): Combined gene therapy (Herpes Simplex Virus Thymidine Kinase + Anti-herpetic Prodrug) and radiation therapy (TKR therapy) is a novel approach in the armamentarium against cancer. This radio-gene therapy

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combination creates a new spatial co-operation whereby two local treatment modalities have demonstrated enhanced local and metastatic tumor control and prolongation of survival. We have taken TKR therapy into clinical studies and currently have more than 60 patients in a Phase II trial in prostate cancer. Our corporate strategy is to add novel therapies (gene therapy) with distinct, non-additive toxicity profiles to the standard-ofcare (surgery, chemo- or radio-therapy) to enhance cancer cure or decrease treatment morbidity. TKR shows a potent systemic anti-metastatic effect, however, we believe this effect could be significantly enhanced by the addition of a cytokine that could further stimulate antigen presentation to the immune system. This Phase I application proposes to develop the reagents and single gene animal data to adequately evaluate the use of GM-CSF in combination with TKR. Website: Error! Hyperlink reference not valid. ·

Project Title: COMBINED RADIOIMMUNOTHERAPY WITH RADIOTHERAPY Principal Investigator & Institution: Humm, John L.; Associate Member; Sloan-Kettering Institute for Cancer Res New York, Ny 10021 Timing: Fiscal Year 2002; Project Start 01-APR-1999; Project End 31-JAN-2004 Summary: This grant application examines the hypothesis that radiolabeled antibody heterogeneity is the principal source of failure of radioimmunotherapy (RIT). It proposes that this limitation can be overcome by the combination of RIT with external beam radiotherapy (XRT). This study will investigate the interaction between XRT with RIT, and determine the optimum combination of these two modalities for maximum tumor efficacy. The hypothesis will be tested with the murine SW1222 colorectal xenograft model system using intact A33 IgG monoclonal antibody as the targeting agent and its single chain hypervariable sFv fragment. There are four specific aims: (1) To determine the 3D microdistribution of radiolabeled A33 IgG within the SW1222 tumor xenograft system using phosphor plate autoradiography. The dependence of the distribution will be investigated with respect of the antibody/antigen molar ratio, the effect of molecular weight, by concomitant administration of the single chain hypervariable fragment sFv A33 with the parent A33 IgG, and following pre-external beam irradiation. (2) To determine how radiation tissue damage facilitates/impedes the penetration of antibody into the tumor. This will be achieved by conventional histological and immunohistochemical stains designed to ascertain the effects of radiation damage on tumor blood supply, tumor cell density, as well as antigen density and inflammatory response. These changes will be used to provide a scientific rationale for the measured radiolabeled antibody distribution from specific aim 1. In addition, this aim will attempt to quantitate changes in tumor cell response by determining the fraction of cells undergoing apoptotic cell death, (by the tunel assay), as well as changes in the fraction of cycling cells, (determined by IUdR incorporation and Ki67 and PCNA immunohistochemistry), as a surrogate of mitotic cell death. (3) To determine the therapeutic efficacy by tumor growth delay and cure after treatment with XRT and RIT alone and then in combination. Experiments will be performed in which tumors are treated with XRT followed by RIT, XRT and RIT simultaneously, and RIT prior to XRT, in order to determine the optimum combination therapy. Variations in the tumor response will be correlated with the results from aim 1 and 2. (4) To develop a radiobiological model, which determines the therapeutic effectiveness from a heterogeneous activity distribution. The model will be tested using information from the source distribution from autoradiographic data (aim 1) to predict overall tumor response measured by specific aim 3. Website: Error! Hyperlink reference not valid.

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Project Title: COMBINED TREATMENT OF HEAD/NECK CANCER-EGFR/TK INHIBITOR Principal Investigator & Institution: Forastiere, Arlene; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002; Project Start 12-SEP-2002; Project End 31-MAY-2007 Summary: (provided by applicant): The epidermal growth factor receptor (EGFR) is overexpressed in the majority (approximately 90%) of head and neck squamous cell cancers (HNSC). EGFR inhibitors are attractive novel therapeutics to incorporate into current therapies as a strategy to achieve substantial improvement in the survival rates of patients with locally advanced HNSC. Binding the ligands to the EGFR activates a series of downstream signaling pathways, including the Ras/Erk/MAPK pathway and the P13K/Akt pathway. We have shown that the tyrosine kinase inhibitor 0SI-774 blocks EGFR signaling through the Ras/ErK/MAPK pathway but fails to inhibit the P13/Akt signaling pathway in selected patients with HNSC. We have shown that rapamycin and analog compunds, inhibitors in the P13/Akt downstream signaling pathway, reverse resistance to chemotherapy conferred by Akt hyperactivation in breast cancer cell lines. Clinical studies with 0SI-774 and other EGFR inhibitors show that not all patients respond to treatment. Thus, our central hypothesis is that EGFR blockade with 0SI-774 will inhibit the Ras/Erk/MAPK signaling pathway in the majority of HNSCs but that inhibition of the P13K/Akt pathway will require additional therapeutics. We will test this hypothesis by determining the molecular response of 0SI-774 in newly diagnosed patients with locally advanced HNSC enrolled in Phase I dose-finding trial of 0SI-774 combined with radiation therapy and cisplatin. Along with the tumor specimens, HNSC cell lines will be used in preclinical in vivo and in vitro experiments. The molecular findings from the patient tumor specimens will be used to validate our model system. Confirmation of the in vitro/in vivo model will allow us to explore the effects of adding other inhibitors of the P13K/Akt pathway in the model system. The Specific Aims are: (1) To determine the molecular response of 0SI-774 in newly diagnosed patients with locally advanced HNSC enrolled in a phase I trial. (2). To determine the biological effects of 0SI-774 on the EGFR signaling pathways in vitro and in vivo HNSC models. (3). To determine the molecular effects of combining 0SI-774 with inhibitors of the P13K/Akt signaling pathway in preclinical HNSC models. (4) To conduct a phase I clinical trial that incorporates inhibitors of P13k/Akt downstream targets to our backbone regimen of OSI-774/cisplatin/radiation treatment of patients with locally advanced head and neck cancer. Website: Error! Hyperlink reference not valid.

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Project Title: COST-EFFECTIVENESS--TREATMENTS--DUCTAL CARCINOMA IN SITU Principal Investigator & Institution: Dick, Andrew W.; Assistant Professor; Community and Prev Medicine; University of Rochester Orpa - Rc Box 270140 Rochester, Ny 14627 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2005 Summary: (provided by applicant): The incidence of ductal carcinoma in situ (DCIS) of the breast, a non-invasive form of breast cancer, has increased dramatically in the last 15 years. Its burden both on patients and on society has grown correspondingly. The optimal management of DCIS remains controversial because of the heterogeneity of the disease, the lack of randomized clinical trials comparing treatment strategies for women diagnosed with DCIS, the importance of patient preferences for possible outcomes and the uncertainty surrounding its natural history. Variations in the treatment of DCIS

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highlight the gaps in knowledge about the optimal management of the disease, gaps that have become increasingly important as the incidence of DCIS has increased. The cost implications of treatment variations also become substantial as DCIS is diagnosed more frequently. Ultimately, the variations in treatment result in differences in outcomes, including life expectancy, quality of life, and cost-effectiveness. We will examine the effects of various treatment strategies, including mastectomy with and without tamoxifen, and breast-conserving surgery with and without radiation and tamoxifen, on the following patient outcomes: DCIS recurrence rates, survival, costs, and quality of life. Decision analytic models will be used to estimate the costeffectiveness and cost-utility of the various treatment strategies. Models will include patient preferences for DCIS and associated treatments obtained from primary data collection. Transition probabilities for the decision analytic models wilt be estimated from primary data using duration models and supplemented from the literature as necessary. Potential endogeneity in treatment selection will be corrected using instrumental variable techniques. The linked Medicare-SEER data will be used to examine the generalizability of our estimated transition probabilities. DCIS treatment costs will be estimated using Medicare data. Sensitivity analyses will be used to test the robustness of our models. The ultimate goal of our project is to identify the most costeffective approaches to manage DCIS, taking into account a variety of clinical presentations and patient preferences, thus improving patient care and reducing the burden of the illness on society. Website: Error! Hyperlink reference not valid. ·

Project Title: DEVELOPMENT OF POLY-L-GLUTAMIC ACID PACLITAXEL CONJUGATE Principal Investigator & Institution: Wallace, Sidney; Fem Cadet 3324 Pittsburgh St Houston, Tx 77005 Timing: Fiscal Year 2002; Project Start 15-APR-1999; Project End 31-MAY-2006 Summary: Chemoradiation improves survival for patients with locally advanced nonsmall cell lung cancer (NSCLC) over radiotherapy (R) alone. Les than 20% of patients have complete pathologic response to combination therapy. Paclitaxel (TXL) is effective as an anti-tumor agent and a radiosensitizer. Peripheral neurotoxicity and granulocytopenia limit its dosage; acute effects from TXL's infusion include nausea, hypotension, and cardiac arrhythmias related to Cremophor and ethanol. Conjugating TXL with poly-L-glutamate (PG-TXL/CT-2103) makes it water-soluble, allowing infusion of twice the amount of free TXL and higher intratumoral drug concentrations, which was confirmed by preclinical testing. Combining PG-TXL with radiation demonstrated synergistic radiation enhancement higher than that seen with other taxane or nucleoside analog. A phase I clinical trial of CT-2103 as single agent salvage therapy for patients with advanced solid tumors demonstrated safety and tolerability in dose up to 266 mg equivalent paclitaxel/m2 without significant alopecia. This Phase II STTR proposes a Phase I/II clinical trial of CT-213 given concurrently with chest RT in patients with unresectable Stage III or medically inoperable Stage II NSCLC. This study will determine MTD, DLT, pharmacokinetics, assess toxicity, and document patient costs. We expect this combination RT and CT-2103 to improve patient survival and response to treatment. PROPOSED COMMERCIAL APPLICATIONS: At M.D. Anderson Cancer Center, the combination of Taxol and cisplatin given concurrently with radiation therapy is the treatment of choice for lung cancer patients. In animal studies, CT-2103 is water soluble, infectable intravenously in 10 minutes without pre-

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medication, more effective (2-3X) and less toxic than Taxol. CT-2103 could possibly replace Taxol. Website: Error! Hyperlink reference not valid. ·

Project Title: DOSE ESCALATION Principal Investigator & Institution: Shipley, William U.; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2002; Project Start 11-APR-2002; Project End 31-MAR-2007 Summary: (Applicant?s Description) The major goal of this project is to determine the extent of the clinical gains that can be achieved by radiation dose escalation with proton beams. The superior dose distributions of proton beams make it possible to deliver higher tumor doses than are possible with photon beams while respecting the tolerance of critical normal tissues and organs. The proposed clinical trials will be carried out for a variety of solid tumors where conventional photon treatments have provided unsatisfactory treatment outcomes. This work will be accomplished through the mechanism of phase I/II/III clinical trials. We will assess clinical gains in terms of local control, treatment-related morbidity, distant metastasis-free survival, overall survival and quality of life. Our clinical studies in skull base and cervical spine chordomas and chondrosarcomas, paranasal sinus tumors, and choroidal melanomas, show a significant increase in local control using protons when compared to historical results with photon beams. These results were achieved with less than optimal treatment facilities at the Harvard Cyclotron Laboratory. The higher proton beam energy, isocentric gantries, and increased treatment capacity at the Northeast Proton Treatment Center make it possible to: treat disease sites throughout the body; deliver advanced proton therapy including intensity modulation; deliver treatments entirely with protons rather than giving primarily proton boost treatments; and treat patients in sufficient numbers to carry out several new clinical trials. The proposed clinical trials are based on the rationale that proton beam treatments decrease the volume of normal tissues/organs receiving high doses of radiation, thereby increasing the tolerance to radiation treatment. This makes it possible to deliver higher doses of radiation to the target/tumor volume with the expectation that higher rates of tumor control probabililty will be possible without increases in treatment morbidity. We will conduct clinical trials in lung, nasopharynx, paranasal sinus, prostate and hepatocellular cancers. In non-small-cell lung cancer we will investigate whether the reduced treatment volumes of proton beams result in decreased toxicity to chemotherapy, and hence decreased co-morbidity of radiation and concurrent chemotherapy, resulting in higher tolerated doses of both cytoxic treatments. In addition to addressing a broader spectrum of diseases in this application, we have included chemotherapy in those sites where it has become standard treatment, and have proposed quality-of-life studies to assess the total range of benefits resulting from improved dose distributions. Website: Error! Hyperlink reference not valid.

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Project Title: ENDING HETEROTOPIC OSSIFICATION IN SPINAL CORD INJURY Principal Investigator & Institution: Fleckenstein, James L.; Professor; Medicine; University of Oklahoma Hlth Sciences Ctr Health Sciences Center Oklahoma City, Ok 73126 Timing: Fiscal Year 2002; Project Start 01-JUN-1999; Project End 31-MAY-2005 Summary: This abstract is not available. Website: Error! Hyperlink reference not valid.

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Project Title: ENHANCING RADIATION THERAPY: VASCULAR TARGETING AGENTS Principal Investigator & Institution: Siemann, Dietmar W.; Professor and Associate Chair for Resear; Radiation Oncology; University of Florida Gainesville, Fl 32611 Timing: Fiscal Year 2004; Project Start 01-APR-2004; Project End 31-MAR-2008 Summary: (provided by applicant): The aberrant vascular morphology, spatial heterogeneity in vessels, and metabolic microenvironments associated with solid tumors, are major factors contributing to treatment failures in radiotherapy. Since all of these may be affected by treatment with vascular targeting agents (VTAs), the combination of such agents with radiotherapy is likely to improve treatment outcomes. Indeed, we previously have shown that combining a VTA with radiotherapy would allow the two treatments to act in a complimentary fashion in tumors at the microregional level resulting in an overall amplification of the antitumor effects of radiation. Though clearly promising, many questions regarding the successful application of this new approach to cancer treatment remain. The central goal of the present application is to develop new insights into the underlying mechanisms of vascular targeting therapy and to explore new avenues to maximize its therapeutic potential. One of the issues to be addressed in this research program is whether at lower doses than have typically be used pre-clinically, but closer to those attainable in the clinic, enhancement of radiation response by VTAs is still feasible. Secondly, we propose to examine whether post VTA treatment conditions provide a favorable setting for the application of antiangiogenic therapies. This strategy is based on the observation that cells surviving VTA treatment at the tumor periphery aggressively promote neovascularization in order to achieve the rapid regrowth that occurs from the viable rim. A third component of the program is focused on the evaluation of new emerging second generation compounds as current VTAs progress through early clinical trial evaluations. Specifically the antitumor potency and potential superiority of a recently identified lead candidate analog of combretastatin will be examined. Finally, based on the hypothesis that targeting the tumor neovasculature should offer the possibility of inducing responses in all tumors with an established vessel network, we will examine whether in addition to their activity in primary tumors, VTAs can impact the management of metastatic disease. Website: Error! Hyperlink reference not valid.

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Project Title: GENE MODIFIED CELL LINES AS VACCINE FOR PANCREAS CANCER Principal Investigator & Institution: Laheru, Daniel A.; Oncology; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002; Project Start 14-SEP-2002; Project End 31-JUL-2007 Summary: (provided by applicant): Pancreatic cancer is the fourth leading cause of cancer related deaths in the US. Although surgical resection is the only curative option, the median survival is only 15-19 months for resectable stage 1,2 and 3 disease. For patients who present with metastatic disease, the median survival is 3-6 months. The addition of chemotherapy and/or radiation therapy in select settings have resulted in only modest clinical benefits. Therefore, more effective therapies are urgently needed. The central theme of this grant proposal is to optimize immunotherapy for pancreatic cancer by designing and conducting clinical trials using genetically modified pancreatic tumor cell lines as vaccine that would improve on the outcome of: (1) patients with pancreatic adenocarcinoma following surgical resection when given in combination

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with chemoradiation (Specific Aim #1); and (2) patients with primary metastatic or relapsed disease when given in sequence with immune modulating doses of Paclitaxel or with cytoreductive doses of Gemcitabine (Specific Aim #2). We hypothesize that: (1) Biologic endpoints that include the measurement of post vaccination delayed type hypersensitivity (DTH) responses to autologous tumor (adjuvant study) or to mutated k-ras peptides (metastatic study) and the measurement of the immune infiltration at the vaccine site can correlate with clinical endpoints such as overall and disease-free survival. (2) Measurement of serum GM-CSF levels as a measure of longevity of the vaccine cells following each vaccination can provide an improved understanding of the in vivo kinetics of the allogeneic cells at the vaccine site and will allow for the optimization of the vaccine boosting schedule. (3) The vaccine is associated with minimal toxicities and can be safely integrated with chemotherapy and radiation therapy. The design of Specific Aim #1 is a single institution Phase II study of vaccine in combination with adjuvant chemoradiotherapy for the treatment of pancreatic adenocarcinoma following surgical resection. The study will enroll 60 patients over 2 years. The design of Specific Aim #2 is a single institution randomized study of vaccine in sequence with Gemcitabine or with Paclitaxel in patients with primary metastatic or relapsed pancreatic adenocarcinoma. This study will enroll 120 patients over 2 years. If these studies demonstrate anti-tumor immunity that is associated with prolongation of disease free survival, they will lead to the design and conduction of multi-center phase III studies. Ultimately, these studies could lead to the approval of a new therapeutic option for pancreatic cancer, which is currently fatal in most patients. In addition, data from these studies could contribute to a better understanding of how to schedule multiple vaccine boosts. Finally, these data will provide valuable information on how to best integrate the vaccine with other therapeutic modalities including surgery, radiotherapy and chemotherapy. Website: Error! Hyperlink reference not valid. ·

Project Title: GENE THERAPY TARGETING HYPOXIC GLIOMA CELLS Principal Investigator & Institution: Deen, Dennis F.; Berthold and Belle N. Guggenhime Profess; Neurological Surgery; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 941222747 Timing: Fiscal Year 2002; Project Start 01-FEB-2001; Project End 31-JAN-2006 Summary: Radiation is a primary treatment modality for patients with malignant gliomas, and in most patients radiation therapy is clearly beneficial. However, the overall outcome of therapy for these patients is dismal, and most patients with glioblastoma multiforme (GBM) die within a year of diagnosis. The presence of hypoxic cells in brain tumors is a major obstacle for radiation therapy, because these cells are notoriously resistant to radiation-induced damage. Therefore, we propose to devise a gene therapy approach for killing hypoxic brain tumor cells during the course of radiation therapy. The DNA construct to be delivered to the tumor cells contains hypoxia-responsive elements (HREs) in the enhancer region of the promoter and a suicide gene. Under hypoxic conditions, the transcriptional complex hypoxia inducible factor-1 (HIF- 1) builds up in cells and binds to HREs. This, in turn, activates the adjacent promoter and causes expression of the downstream suicide gene that kills the cell. This project has 2 goals. The first is to investigate how several cellular or intratumoral characteristics impact on this gene therapy strategy. The second is to investigate whether the gene therapy enhances the radiation response of the tumor cells. We propose 4 specific aims to accomplish these goals. 1) investigate the relationship between HIF-1 and oxygenation status in brain tumor and normal brain; 2) evaluate

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suicide genes under low pH and in noncycling brain tumor cells; 3) reveal and investigate any bystander effect (BE) produced by specific suicide genes under hypoxic conditions; 4) determine whether expression of suicide genes in hypoxic and oxic cells enhances their response to radiation. Website: Error! Hyperlink reference not valid. ·

Project Title: HARVARD PEDIATRIC BRAIN TUMOR CENTER Principal Investigator & Institution: Kieran, Mark W.; Dana-Farber Cancer Institute 44 Binney St Boston, Ma 02115 Timing: Fiscal Year 2002; Project Start 01-APR-1999; Project End 31-MAR-2004 Summary: The Harvard Pediatric Brain Tumor Center will join the Pediatric Brain Tumor Clinical Trials Consortium, endorse its Constitution, participate in committee activities, give absolute priority to Consortium protocols, and collaborate with other Consortium members. Our multi-disciplinary group is committed to: 1) Ensuring that, each year, more than 15 patients with newly diagnosed or recurrent brain tumors are available for Consortium studies; 2) Acting as a resource for the Consortium in those areas where our expertise will assist the Consortium in ensuring its success; our commitment to being a resource will include members from all areas, including our departments of Neurosurgery, Radiation Oncology, Oncology, Neurology, Pathology, Radiology, Gene Therapy and Angiogenesis. 3) Proposing novel studies that meet the Consortium's goals. In that regard, we have already developed three proposals: i) Phase I study of endostatin, an angiogenic inhibitor, in pediatric patients with poor prognosis malignancies; ii) Phase I study of GM3, a novel ganglioside in pediatric patients with malignant brain tumors; iii) a Phase I study of oxaliplatin as a radiation sensitizer in pediatric brain stem gliomas. 4) Developing and expanding a pediatric brain tumor tissue bank. We will cooperate with Consortium partners to develop a new central tissue bank or a virtual tissue bank. On request, we will also make material from the Harvard Brain Tumor Tissue Bank, which currently has over 1500 adult and 200 pediatric samples, available to Consortium members. 5) Continuing to develop our current expertise in several areas, including: anti-angiogenic molecules (Dr. Judah Folkman); biodegradable wafers containing endostatin (Dr. Peter Black); novel gene therapy vectors (Dr. Richard Mulligan); proton beam and stereotactic radiation therapy (Dr. Nancy Tarbell); small molecule signal transduction inhibitors (Dr. Chuck Stiles); Multivoxal high resolution magnetic resonance spectroscopy (Dr. Aria Tzika); and molecular characterization of brain tumors (Dr. David Louis). In summary, we will bring the full thrust of a Comprehensive Cancer Center and the full services of a pediatric center to enhance the Consortium and our mutual missions. Website: Error! Hyperlink reference not valid.

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Project Title: KIDNEY RESPONSE TO RADIATION AND CHEMOTHERAPY Principal Investigator & Institution: Moulder, John E.; Professor; Radiation Oncology; Medical College of Wisconsin Po Box26509 Milwaukee, Wi 532260509 Timing: Fiscal Year 2003; Project Start 01-JAN-1979; Project End 31-JAN-2007 Summary: (provided by applicant): This project is based on the hypothesis that late radiation-induced normal tissue injuries can be prevented and/or treated with postirradiation pharmacologic intervention. The rat radiation nephropathy model is used to study the pathophysiological mechanism(s) of late radiation-induced normal tissue injuries, and these mechanistic understandings are used in the development of methods for prophylaxis and treatment of these injuries. The discovery that radiation

32 Radiation Therapy

nephropathy is a major complication of bone marrow transplantation (BMT) conditioning, and that the rat was an excellent model for this nephropathy, added a preclinical component to the project. The discovery that angiotensin converting enzyme (ACE) inhibitors and an angiotensin II (AII) blockers could be used for the prophylaxis and treatment of BMT nephropathy led directly to clinical studies. The studies are strongly influenced by the finding that blocking the renin-angiotensin system can permanently interfere with the development of radiation nephropathy even when treatment is started weeks after irradiation and/or is not continued indefinitely. These latter findings cast considerable doubt on the standard mechanistic explanations for late radiation injuries, and suggest that injuries caused by radiation therapy, radiation accidents or nuclear terrorism could be treated or prevented with post-irradiation pharmacological interventions. The specific aims of this proposal fall into four related groups: 1) Refute the hypothesis that radiation-induced activation of the reninangiotensin system is the proximal mechanistic cause of radiation nephropathy. 2) Confirm the hypothesis that prophylaxis and treatment of radiation nephropathy with ACE inhibitors and AII blockers operate by different mechanisms. 3) Determine the mechanistic basis for the efficacy of ACE inhibitors and AII receptor blockers in the prophylaxis of radiation nephropathy. 4) Complete the randomized, prospective, trial of the use of ACE inhibitors to prevent the development of radiation nephropathy in BMT patients. Website: Error! Hyperlink reference not valid. ·

Project Title: LATE TRANSPLANTATION

EFFECTS

IN

SURVIVORS

OF

STEM

CELL

Principal Investigator & Institution: Baker, Kevin S.; Pediatrics; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2002; Project Start 01-AUG-2001; Project End 31-JUL-2006 Summary: (Applicant's Description) K. Scott Baker, M.D. is a pediatric oncologist in the Blood and Marrow Transplant Program at the University of Minnesota, and holds an appointment as an Assistant Professor in the Department of Pediatrics. The candidates career goals are: 1) to develop clinical research expertise which has a solid foundation in clinical research methodology, epidemiology, and biostatistics, 2) to focus these activities on patient oriented research in the field of hematopoietic stem cell transplantation (SCT), specifically transplant related complications and late effects, 3) to utilize these newly acquired skills in order to achieve the status as an independent clinical investigator. The proposed career development plan will provide a comprehensive, multidisciplinary, closely mentored, patient oriented research experience. This will be accomplished in conjunction with formal didactic training in Clinical Research obtained by the candidate enrolling in the master's degree program in clinical research in the Division of Epidemiology. Under the mentorship of Dr. Leslie Robison and Dr. Norma Ramsay, the candidate will initiate investigations into the late effects seen in long-term survivors after SCT. The proposed research will establish prospective and retrospective, long-term follow-up studies of SCT survivors at the University of Minnesota for the systematic, protocol driven, evaluation of the incidence, risk factors, and characteristics of cardiopulmonary, renal, endocrine and reproductive late effects, quality of life outcomes, and second malignant neoplasms. Hypothesis driven investigations will also be undertaken in the current population of 1226 longterm survivors. These will include studies of the impact of different transplant conditioning regimens (total body irradiation, total lymphoid irradiation, and chemotherapy only) on subsequent late effects in children, an analysis of the spectrum

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and severity of treatment related sequelae which develop in the second decade of longterm follow-up, and an analysis of the impact that chronic graft-versus-host disease has on late effects and quality of life in SCT survivors. The candidate will also utilize data frorn the ongoing, multi-institutional, Childhood Cancer Survivor Study (Dr. Robison is Principal Investigator) for a comparative analysis of patients in that cohort receiving standard chemotherapy versus those who have undergone SCT as part of their therapy. Website: Error! Hyperlink reference not valid. ·

Project Title: LOCAL TOMOGRAPHY FOR RADIATION THERAPY TUMOR IMAGING Principal Investigator & Institution: Anastasio, Mark A.; Biomedical Engineering; Illinois Institute of Technology Main Building, Room 301 Chicago, Il 606163793 Timing: Fiscal Year 2004; Project Start 01-APR-2004; Project End 31-MAR-2006 Summary: (provided by applicant): Radiation therapy remains to be one of the most important procedures for treating cancer. The goal of conformal radiation therapy is to deliver a high radiation dose to the target volume that contains the cancerous tissue, while minimizing the radiation exposure of healthy tissues that surround this volume. When delivering the treatment, it is critically important that the position and orientation of the patient (or more specifically, the tumor volume and radiation sensitive structures that surround it) are consistent with those assumed when designing the treatment plan. if there are errors in the positioning of the patient, the effectiveness of the treatment may be degraded and a large radiation dose may be delivered to healthy tissues surrounding the target volume. The broad objective of this proposal is to develop and investigate dose-efficient tomographic image guided treatment methods that will provide a clinically-viable solution for detecting patient positioning errors in conformal radiation therapy treatments. Unlike previously proposed tomographic approaches, our methods will be based on the theory of local tomography, and consequently will only utilize megavoltage X-ray radiation that passes through or very near the tumor volume to form the reconstructed image of the tumor volume. The specific aims of the proposed research are: (1) To develop and investigate local tomography algorithms for reconstructing two-dimensional 2D) images of a tumor volume, (2) To develop and investigate local tomography algorithms for reconstructing three-dimensional(3D) images of a tumor volume, (3) To investigate the feasibility of reconstructing 2D and 3D images of a tumor volume using truncated projections that correspond to treatment beam orientations, and (4) To quantitatively and objectively evaluate the ability of the algorithms to reconstruct accurate and clinically useful tumor volume images. The successful completion of our proposed work could provide a clinically viable solution to the patient positioning problem and could improve the accuracy of the delivery of radiation therapy treatment procedures. By increasing the conformality of the radiation therapy treatment procedure, the chances of survival for cancer patients could be improved while simultaneously minimizing the risk of radiation-induced complications. Website: Error! Hyperlink reference not valid.

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Project Title: LONG-TERM COMPLICATIONS OF CHILDREN/ADOLESCENTS & CANCER Principal Investigator & Institution: Green, Daniel M.; Associate Chief; Roswell Park Cancer Institute Corp Buffalo, Ny 14263 Timing: Fiscal Year 2002; Project Start 01-JUN-2002; Project End 31-MAY-2007

34 Radiation Therapy

Summary: (provided by applicant): We propose to hold a two-day conference on June 28-29, 2002 at Queen's Landing Inn (Niagara-on-the-Lake, Ontario, Canada). The program will be of interest to pediatric hematologists/oncologists, pediatric nurse practitioners, pediatric psychologists, pediatric oncology social workers, medical oncologists, fellows, residents, interns, clinical research associates and other primary care providers. The topic of bone complications following treatment of children and adolescents for cancer will be addressed. The goals of the 7th International Conference on Long-Term Complications of Treatment of Children and Adolescents for Cancer will be to: 1) Review the biology of the basic multicellular unit; 2) review the role of the kidney in the regulation of calcium metabolism; 3) review the effect of cis-platinum on renal function and calcium metabolism; 4) review the late effects of ifosfamide on the kidney; 5) review the issues involved in the measurement of bone density; 6) review the effects of radiation therapy effects on bone density; 7) review the effects of glucocorticoid hormones on bone density; 8) review the roles of androgen and estrogen in skeletal physiology; 9) review the issues involved in the management of osteoporosis due to ovarian failure; 10) review the role of growth hormone in the regulation of bone density; and 11) review the issues involved in the duration of treatment with growth hormone replacement therapy. The conference will include presentations by nationally and internationally recognized experts in these areas. The conference will facilitate subsequent discussions among the investigators of the Childhood Cancer Survivor Study, most of whom attend this conference, regarding future research on bone complications among participants in the Childhood Cancer Survivor Study. Website: Error! Hyperlink reference not valid. ·

Project Title: LOW-COST DIGITAL X-RAY DETECTORS USING LIQUID CRYSTALS Principal Investigator & Institution: Rowlands, John A.; Senior Scientist/Professor; Sunnybrook & Women's Coll Hlth Scis Ctr Health Sciences Centre Toronto, Timing: Fiscal Year 2003; Project Start 19-SEP-2003; Project End 31-JUL-2008 Summary: (provided by applicant): The broad, long-term objective of this proposal is to develop low cost direct digital x-ray imaging systems for general application in radiology and radiation therapy. The Specific Aims are (1) to measure the imaging properties of an XLV (x-ray sensitive light valve) based on the use of a-Se (amorphousselenium) and a TN (twisted nematic) and ECB (electrically controlled birefringence) liquid crystal cells and develop a theoretical model that can predict the behavior precisely, (2) to design and construct XLV optimized for specific imaging tasks, (3) to challenge the XLV technology to perform in a quantum limited manner for the three radiographic procedures (chest radiography, mammography, and portal imaging) by independent evaluation of XLV/scanner imaging prototypes. The health relatedness of the project is that it will provide a low cost system for any application in radiology and radiation therapy that will maintain or surpass currently available image quality, produce images quickly while doing so at greatly reduced cost, particularly the capital cost. The system has the potential to be manufactured locally in every country with sufficient infrastructure making this an empowering technology for developing countries as well as a cost effective solution for clinics in North America. The research design is that we will combine three well-established technologies, using a-Se as an xray to image charge transducer, liquid crystal display technology, and digital optical readout to achieve our goal. The concept is that the latent charge image created on the aSe layer by interaction with x-rays is made into visible image by physically coupling it to a liquid crystal display. This visible image is then readout optically by a digital camera.

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The Methods to be used are linear systems analysis, Monte Carlo simulation, detective quantum efficiency (DQE) measurement, phantom tests, as well as comparison of performance with state of the art flat panel imagers. Website: Error! Hyperlink reference not valid. ·

Project Title: LUNG RADIATION PROTECTION BY MNSOD TRANSGENE THERAPY Principal Investigator & Institution: Greenberger, Joel S.; Professor and Chairman; Radiation Oncology; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2002; Project Start 01-DEC-1998; Project End 31-JAN-2006 Summary: (provided by applicant): Thoracic radiotherapy (RT) is often limited by lung toxicity (pulmonary fibrosis). Pulmonary fibrosis ensues after an unexplained latent period which follows the acute reaction and is characterized by reduction in pulmonary vital capacity and exertional dyspnea. Elevation of fibrogenic cytokines, most notably, TGF-B1 and B2 (TGF-B1-B2), and fibroblast proliferation that extends from irradiated to adjacent lung, are features at the molecular and cellular levels. The principal investigator recently demonstrated that intratracheal (IT) injection of manganese superoxide dismutase-plasmid/liposomes (MnSOD-PL) protects the murine lung from irradiation-induced organizing alveolitis/fibrosis induced by single dose or fractionated irradiation. The proposed research will use validated, genetically modified animal models along with quantitative molecular methods to elucidate the cellular mechanism of irradiation lung fibrosis and the level(s) at which epitope-hemagglutinin (HA)-tagged MnSOD transgene therapy protects. The first specific aim tests the hypothesis that organizing alveolitis/fibrosis is initiated by accumulation of macrophage attractant, VCAM-1 in endothelial cells at 80-100 days after irradiation. The second specific aim tests the hypothesis that TGF-B1-B2 production by bone marrow-derived bronchoalveolar macrophages (BAMs) mediates fibroblast recruitment and proliferation. The third specific aim tests the hypothesis that circulating fibroblast progenitor cells, also of bone marrow origin, home to, and proliferate in irradiated lung to produce organizing alveolitis/fibrosis. Methods include BrdU in situ labelling, histopathology, green fluorescent protein-positive (GFP+) male hematopoietic stem cell (macrophage progenitor) engraftment to GFP- female mice and transplantation of GFP+ purified bone marrow stromal cells (BMSCs), continuous anti-TGF-B antibody or soluble TGF-B receptor (TGF-B-R) delivery, injection of HA-MnSOD-PL, fractionated irradiation, and in situ assays of DNA damage. These experiments will provide substantial, new insight into the basic pathogenesis of the pulmonary irradiation response. A comprehensive understanding of the underlying mechanisms is critical for identifying novel targets for intervention. This project may facilitate development of specific strategies to minimize pulmonary irradiation toxicity, thereby making RT safer and more effective. Website: Error! Hyperlink reference not valid.

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Project Title: MAINLINE HEALTH CCOP Principal Investigator & Institution: Gilman, Paul B.; Lankenau Hospital 100 Lancaster Ave W Wynnewood, Pa 190963411 Timing: Fiscal Year 2002; Project Start 05-AUG-1994; Project End 31-MAY-2007 Summary: (provided by applicant): In this reapplication of the CCOP grant, we propose to maintain the Main Line Health CCOP as a consortium of oncology research programs

36 Radiation Therapy

between The Lankenau Hospital, Bryn Mawr Hospital, and Paoli Memorial Hospital. These three acute care hospitals are part of the Main Line Health System, whose service area includes the western and northwestern portions of Philadelphia County, into suburban Montgomery, Delaware and Chester Counties of Pennsylvania. This service area represents a population of over 1.2 million individuals of whom 15% are aged 65 or older. Main Line Health has blended the three hospitals oncology programs into a joint coordinated program, of which the CCOP is a part. Additionally, the three IRBs have merged and with the CCOP, this consortium continues to bring the communities stateof-the-art cancer care. The CCOP has developed affiliations with NSABP, ECOG, M.D. Anderson and RTOG to bring clinical trials to the area. These affiliations will continue, with a look to increasing accruals to these and other research based studies. Main Line Health has twelve medical oncologists, three gynecologic oncologists, eight surgical oncologists and ten radiation oncologists who see over 2000 patients annually, or 31 percent of the newly diagnosed cancer patients in our catchment area. We plan to continue to expand our available programs, increase ties to primary care physicians, and further develop involvement with minority and underserved populations for cancer prevention, control and treatment protocols. The ongoing commitment to cutting edge cancer prevention, diagnosis and treatment available through the research bases will allow the Main Line Health CCOP to continue to offer our communities state-of-the-art care for cancer. Website: Error! Hyperlink reference not valid. ·

Project Title: MDM2 ONCOGENE AS A TARGET FOR MODULATING CANCER THERAPY Principal Investigator & Institution: Zhang, Ruiwen; Associate Professor; Pharmacology and Toxicology; University of Alabama at Birmingham Uab Station Birmingham, Al 35294 Timing: Fiscal Year 2002; Project Start 07-APR-1999; Project End 31-MAR-2004 Summary: The mdm2 oncogene has been shown to be amplified or overexpressed in human cancers, about 50 percent of breast cancers, 40-60 percent of osteosarcomas, 30 percent of soft tissue sarcomas, and 60 percent of gliomas. It also has been suggested that mdm2 levels are associated with poor prognosis of several human cancers. The mdm2 oncoprotein binds to the p53 tumor suppressor protein and serves as a negative regulator of p53. The p53 tumor suppressor also has an important role in cancer therapy, with p53-mediated apoptosis being a major mechanism of action for many clinically used cancer chemotherapeutic agents and radiation therapy. Therefore, the negative regulation of p53 by mdm2 may limit the magnitude of p53 activation by DNA damaging agents, thereby limiting their therapeutic effectiveness. The investigators hypothesize that, by inhibiting mdm2 expression, the mdm2 oncoprotein level will be reduced and the mdm2 negative feed-back inhibition of p53 will be diminished, resulting in a significant increase of functional p53 levels that will modulate p53mediated therapeutic effects. The overall objective of this grant application is to investigate the functions of mdm2 oncogene in tumor growth and the potential value of mdm2 as a drug target for cancer therapy. The following Specific Aims will be examined: 1). To determine the role of mdm2 in tumor growth by inhibiting mdm2 expression in in vivo models of human cancers; 2). To determine whether mdm2 inhibition activates p53 and induces apoptosis and whether these effects result in tumor growth inhibition in vivo; 3). To determine whether there are in vivo synergistically therapeutic effects between mdm2 inhibition and DNA damaging agents; and 4). To determine whether mdm2 inhibition has specific effects on key host tissues that are

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often sites of toxicity induced by cancer chemotherapy. When these specific aims have been accomplished, it will be possible in future studies to investigate the role of mdm2 in tumor development in humans and, ultimately, determine the usefulness of mdm2 as a target for new drug design for human cancer therapy. Website: Error! Hyperlink reference not valid. ·

Project Title: MECHANISM OF HYPOXIA MEDIATED RADIATION LUNG INJURY Principal Investigator & Institution: Vujaskovic, Zeljko; Radiation Oncology; Duke University Durham, Nc 27706 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2007 Summary: (provided by applicant): The risk of unacceptable radiation (RT)-induced lung injury remains a significant limiting factor in the current treatment of the tumors involving the thoracic region. Despite advances in normal tissue radiobiology demonstrating that ionizing radiation triggers a cascade of genetic and molecular events, which lead to pulmonary injury, it is still unclear how a prolonged response to injury can be sustained for months to years after irradiation has ended. This deficiency in understanding of the mechanisms of RT-induced lung injury has hindered the development of appropriate interventional approaches to prevent this serious problem. The current proposal is based on our recent finding implicating hypoxia as an important contributing factor in the development of RT-induced pulmonary injury. We believe that hypoxia results from two factors: 1) increased oxygen consumption by activated macrophages with associated production of reactive oxygen species (ROS) and cytokines, and 2) decreased oxygen delivery to tissue due to vascular damage causing reduced perfusion. We hypothesize that hypoxia mediates a cycle of continuous, macrophage-associated production of ROS and expression/activation of profibroqenic and proanqioqenic cytokines. This process leads to l disre.qulation of angiogenesis, endothelial cell death, and collagen deposition which result in sustained hypoxia that I_erpetuates further pulmonary tissue damage and fibrosis, The goal of this study is to determine the I temporal onset of hypoxia after lung irradiation, and to define how hypoxia relates to macrophage activity (the production of ROS and cytokines) and vascular damage at different time points after irradiation. Lung hypoxia will be determined using the EF5 hypoxia marker. Macrophage activation will be assessed by immunohistochemistry. ROS will be detected using electron spin resonance (ESR) spectroscopy and spin trapping. A radionuclide perfusion assay will be used to assess pulmonary perfusion. After characterizing the relationship between hypoxia, macrophage activation and vascular damage following RT we will attempt to disrupt this injury cycle in two ways. First, ROS will be targeted directly with superoxide dismutase (SOD) mimetics. Second, ROS mediated injury will be targeted indirectly by inhibiting macrophage activity with gadolinium chloride (GdCI3). If successful, this project may lead directly to the development of clinically applicable strategies to reduce the risk of RT-induced lung injury in an attempt to permit delivery of higher doses of radiation to thoracic tumors without increasing the risk of pulmonary complications. Website: Error! Hyperlink reference not valid.

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Project Title: MECHANISM OF NICOTINE INHIBITION OF APOPTOSIS Principal Investigator & Institution: Wright, Susan C.; Senior Scientist; Palo Alto Institute/Molecular Medicine Molecular Medicine Mountain View, Ca 94043 Timing: Fiscal Year 2002; Project Start 01-APR-2000; Project End 31-MAR-2004

38 Radiation Therapy

Summary: Apoptosis is a form of physiological cell death that is thought to be an important mechanism for the elimination of abnormal or transformed cells. It is also the form of death induced in cancer cells by chemotherapeutic drugs and gammairradiation. An agent which interferes with the process of apoptosis could potentially promote tumor formation as well as interfere with cancer therapies. Our previous studies demonstrated that nicotine inhibits cytokine and chemotherapeutic druginduced apoptosis of a ability of nicotine to inhibit apoptosis may promote tobaccorelated carcinogenesis as well as decrease the efficacy of cancer therapies. Our previous studies demonstrated that nicotine inhibits cytokine and chemotherapeutic druginduced apoptosis of a variety of tumor cell lines, including those types related to tobacco use. We hypothesize that the ability of nicotine to inhibit to inhibit apoptosis may promote tobacco-related carcinogenesis as well as decrease the efficacy of cancer therapies. The aims of this proposal are: 1) to further define the conditions under which nicotine inhibits apoptosis in tumor cell lines and in normal epithelial cells; 2) investigate the molecular mechanism in which nicotine obstructs the apoptotic pathway; 3) determine if nicotine will decrease the efficacy of chemotherapy in a mouse model. We will examine the effects of acuter high dose, chronic low dose exposure, and the reversibility of nicotine's ability to inhibit apoptosis in tumor cell lines and normal lung epithelial cells. We will test the effects of nicotine on different inducers of apoptosis in tumor cell lines and normal lung epithelial cells. We will test the effects of nicotine on different inducers of apoptosis including ionizing radiation, chemotherapeutic drugs, and anoikis (enforced cell detachment). We will analyze the mechanism of inhibition with special focus on signal transduction pathways that have been implicated as negative modulators of apoptosis. Studies will analyze the effects of nicotine on expression of Bcl-2, protein kinase C activity, the mitogen activated protein kinase pathway, and the PI3-kinase/Akt kinase pathway. Mice bearing transplantable tumors will be treated with different chemotherapeutic drugs with and without coadministration of nicotine to determine if there is a reduction in the therapeutic effect. The results of these studies should increase our understanding of the mechanisms underlying development of cancer in cigarette smokers and in smokeless tobacco users. This investigation will also provide insight into the potential hazards of continued tobacco use in patients undergoing cancer therapy. Website: Error! Hyperlink reference not valid. ·

Project Title: MELANOMA THERAPY VIA PEPTIDE TARGETED ALPHARADIATION Principal Investigator & Institution: Quinn, Thomas P.; Assistant Professor; Alphamed, Inc. 20 Juniper Ridge Rd Acton, Ma 01720 Timing: Fiscal Year 2002; Project Start 01-FEB-2000; Project End 31-JAN-2005 Summary: (provided by applicant): The long-term objectives of this proposal are to develop and commercialize an effective therapeutic agent for malignant melanoma. The incidence of melanoma is on the increase. The current cumulative life-time risk for melanoma is 1:75 in the US, with approximately 20% developing metastatic disease. Metastatic malignant melanoma is resistant to current chemo- and immuno- therapy regimens. Median survival for patients with disseminated disease ranges 4-15 months. Clearly there is a need for a new and efficacious melanoma treatments. A novel rhenium (Re) cyclized alpha-melanocyte stimulating hormone analog that targets melanoma has been developed in our laboratory. The peptide [DOTA]- ReCCMSH was designed to be radiolabeled with Alpha-particle emitting radionuclides. Alpha-particle radiation is highly focused and very potent. Only a few Alpha-particle emitting radionulcides are

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necessary to cause cell death. Radiolabeled [DOTA] ReCCMSH has low nanomolar affinity for the melanocortin-1 receptor present on melanoma tumor cells and is rapidly internalized upon binding. In vivo biodistrubution studies have shown that radiolabeled [DOTA]- ReCCMSH displays high tumor uptake and extended tumor retention properties coupled with rapid clearance kinetics. It is hypothesized that melanoma specific deposition of Alpha-particle emitting radionuclides by [DOTA]ReCCMSH will result in tumor cell death. The specific aims of this Phase-ll STTR proposal are to scale up production of high specific activity [DOTA]-ReCCMSH and determine its maximum tolerated dose and therapeutic efficacy in human and mouse melanom animal modes. In addition, acute toxicity studies will be performed in mouse and swine with the non-radiolabeled [DOTA]-ReCCMSH to demonstrate that the peptide-targeting vehicle is non-toxic. The results of these studies will be used to support an investigational new drug application to the Food and Drug Administration for phase-l clinical trials. [DOTA]-ReCCMSH targeting of Alpha-particle emitting radiation to melanoma tumors in patients with metastatic disease. Website: Error! Hyperlink reference not valid. ·

Project Title: PROGRAM

MINORITY

BASED

COMMUNITY

CLINICAL

ONCOLOGY

Principal Investigator & Institution: Conrad, Marcel E.; Professor of Medicine; Mobile Infirmary Medical Center 3 Mobile Infirmary Circle, Ste 3 Mobile, Al 36607 Timing: Fiscal Year 2002; Project Start 14-SEP-1990; Project End 31-MAY-2002 Summary: The University of South Alabama (USA) has been a designated MBCCOP since the inception of the program. The grant supports the administration and data management of cancer treatment protocols, cancer control programs and cancer prevention trials at USA. In addition, it supports limited travel of faculty to national research base meetings and the cost of transporting specimens to designated laboratories as required by protocols. USA is currently involved and has membership in the Southwest Oncology Group (SWOG), the National Surgical Adjuvant Breast and Bowel Program (NSABP), the Radiation Therapy Oncology Group (RTOG), the Pediatric Oncology Group (POG), the MD Anderson program (MSKCC) and The University of Rochester. We are participants in the P1-Breast Cancer Prevention Trial (BCPT) and the Study of Tamoxifen and Roloxafine (STAR) program and the Prostate Cancer Prevention Trial (PCPT). We plan to participate in the Prostate Prevention Trial utilizing vitamin E and selenium. Currently, over 450 living cancer patients are in active follow up. USA keeps about 185 active Investigative Review Board (IRB) approved protocols for eligible patients at any given time. Approximately ten percent of newly diagnosed cancer patients become participants of cancer treatment protocols at USA. We do not engage in any studies sponsored by pharmaceutical firms. Approximately one half of patients placed on cancer treatment protocols are minority individuals with the majority being African American. We have no difficulty in recruiting minority patients for cancer treatment protocols. However, it is difficult to recruit minority patients to cancer prevention trials and cancer control programs which involve either a procedure or a medication with potential side effects. Most minority subjects recruited to cancer prevention studies are from upper socioeconomic and educated groups. Recruitment occurs through appropriate radio, newspaper, health fairs, churches and social organizations. Population surveys at USA suggest that 'fatalism' plays an important role in delayed diagnosis and failure to use cancer preventative means. USA is the only University hospital with a 150 mile radius of Mobile Alabama in the Gulf Coast. It serves the urban population of a Gulf Coast Port City and a surrounding rural southern

40 Radiation Therapy

population of patients from South Alabama, Southern Mississippi and the panhandle of Florida. The University hospital has 840 beds with 32 beds in a designated adult oncology unit. Approximately 475 new cancer patients are seen yearly at this facility with half of them from minority populations. With increasing numbers of oncologists in the region and development of radiation treatment facilities in the community hospitals, cancer patient accrual has not increased at USA in recent years. To solve this problem it is planned to construct a USA Cancer Hospital and treatment facility largely using existent buildings, and assume responsibility for oncologic care at a community hospital. Further, we are involving former fellows and associates in Biloxi and Mobile for participation in the STAR trial. Website: Error! Hyperlink reference not valid. ·

Project Title: MODIFICATION OF EFFERENT IMMUNOLOGICAL RESPONSES Principal Investigator & Institution: Glorioso, Joseph C.; Professor and Chairman; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 31-MAY-2007 Summary: Survival of patients with malignant glioma remains poor despite the availability of surgical debulking, radiation therapy, and chemotherapeutic regimens. Progress in applying gene therapy to the treatment of cancer provides an additional strategy which may prove effective in combination with more standard therapies. NUREL-C2 is a completely inactivated herpes simplex virus (HSV)- based gene transfer vehicle that expresses the four novel therapeutic proteins ICP0, thymidine kinase, connexin-43 and TNFalpha which work in concert to kill tumor cells when used in combination with intravenous administration of the anti-cancer drug ganciclovir (GCV) and radiosurgery. Animal experiments using this combination of gene and conventional therapies to treat intracerebral implants of radiosensitive human glioblastoma cells have resulted in excellent tumor control and improved survival. To establish the maximum the maximum potential of this approach, additional preclinical studies are proposed to optimize the contributions of each component to the combined treatment and to evaluate efficacy in models of radioresistant human glioblastoma (Aim 1). The vector and combined therapy will be systematically tested for safety and dose-limiting toxicity in normal mice and rhesus monkeys to expand our current results (Aim 2). A Phase I clinical trial is proposed with two consecutive components involving a) pre- and postsurgical intracranial NUREL-C2 inoculation followed by GCT treatment, and b) stereotactic NUREL-C2 delivery into the tumor with maintenance on GCV and gamma knife radiosurgery two days later. Using a battery of molecular, serological, imaging and clinical tests, patients will be evaluated for adverse effects of viral vector implantation, vector toxicity prior to, during, and after GCV treatment, short-term vector distribution and transgene expression in the tumor, metabolic activity of the tumor, and imaging responses to therapy. Safe vector dose will be determined in the first aim of the trial by dose escalation between consecutive groups of 3 patients. In the second arm, potential changes in toxicity profile and safe dose due to the combination with radiosurgery will be identified. Concurrent manifestations of efficacy will be recorded (Aim 3). In the final Aim, the therapeutic potential of HSV vectors expressing radiosensitizing genes or novel genes from Projects 1 and 2 will be tested for effectiveness in glioma models. Effective genes will be incorporated into NUREL-C2 and the new derivatives tested for improved cytocidal qualities in vitro and efficacy in vivo to arrive at an optimally effective gene transfer agent for the treatment of malignant glioma (Aim 4). Website: Error! Hyperlink reference not valid.

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Project Title: ESOPHAGEAL CA

MOLECULAR

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CORRELATES--OXALIPLATIN/5FU/XRT,

Principal Investigator & Institution: Pendyala, Lakshmi; Roswell Park Cancer Institute Corp Buffalo, Ny 14263 Timing: Fiscal Year 2002; Project Start 01-APR-2001; Project End 31-MAR-2004 Summary: (Provided by applicant): There is a pressing need for new agents in the treatment of esophageal cancer and to identify intratumoral molecular markers predictive for tumor response to chemotherapy. Although cisplatin/5-fluorouracil (5FU) plus radiation (XRT) is considered standard therapy for patients with locally advanced esophageal cancer, distant tumor recurrence, representing chemotherapy failure, is the rule. Moreover, the toxicity profile for cisplatin may be disabling. Oxaliplatin (OXP) a diaminocyclohexane platinum complex has a more manageable toxicity profile. Clinical/pre-clinical data suggest OXP-5FU synergy; mechanisms behind the synergy are not understood. Prior studies have shown that response and survival after therapy with 5FU (colon cancer) or 5FU/cisplatin (gastric cancer) are inversely associated with thymidylate synthase (TS), dihydropyrmidine dehydrogenase (DPD) and the excision repair cross-complementing-1 (ERCC-1) gene expressions. Studies of OXP resistant cell lines indicate that resistance is multifactorial, as evidenced by lowered drug accumulation, increased glutathione and decreased DNA-Pt adducts. Resistant cells also had elevated expression of gamma-glutamyltranspeptidase (gamma-GT) and ERCC- 1 genes. Thus, the underlying hypotheses in this application are: A) molecular markers within a primary esophageal tumor will predict sensitivity or resistance to chemotherapy, B) oxaliplatin affects 5FU by lowering TS gene expression and C) pharmacokinetics (PK) of OXP will influence the changes in gene expression. The specific aims of this study are to determine: 1) the intra-tumoral mRNA expression of TS, DPD, gamma-glutamylcysteine synthetase (gamma-GCS), gamma-GT, multidrug resistance associated protein-2 (MRP-2), ERCC-1 and xeroderma pigmentosum A (XPA) at pretreatment, 1 week after OXP alone, and after 1 cycle (with 5FU/radiation), exploring the relationship between these expression levels and response/resistance to treatment; 2) the PK of ultrafilterable platinum on day 1 when OXP is given alone and again on day 15 a week after combination with 5FU + XRT and 3) the relation between PK and changes in intratumoral gene expression and 4) maximum tolerated dose (MTD), dose limiting toxicity (DLT), and the potential therapeutic responses to OXP when given with continuous infusion 5FU + XRT. The gene expression studies will be carried out using real time quantitative RT-PCR (Taqman( r )) assays in endoscopic biopsies. Preliminary results indicate that the regimen is tolerable, the proposed gene expression measurements can be carried out using endoscopic biopsies and changes in gene expression are being detected for some genes during therapy. The long term objectives are to identify a drug combination for better clinical outcome and to identify molecular parameters predictive for response or resistance. Website: Error! Hyperlink reference not valid. ·

Project Title: MONITORING RADIATION THERAPY OF PROSTATE CANCER BY MRSI Principal Investigator & Institution: Kurhanewicz, John; Associate Professor; Radiology; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 941222747 Timing: Fiscal Year 2002; Project Start 05-FEB-1999; Project End 31-JAN-2004 Summary: Prostate cancer is an extremely prevalent disease, resulting in the deaths of over 41,800 men annually in the United States. When prostate cancer is confined to the

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gland, or is minimally invasive into the seminal vesicles and capsule, it has been conventionally treated by surgical removal. An increasing number of patients are now selecting focal radiation therapies (conformal radiation therapy and Brachytherapy) which have demonstrated lower complication rates without survival disadvantage, and are much less intrusive. Selection of appropriate patients, therapeutic planning, and assessment of therapeutic efficacy of focal radiation therapies requires an accurate knowledge of the location, spatial extent and aggressiveness of the cancer prior to and after therapy. Currently available clinical measures (PSA, histology of biopsies) and non-invasive radiologic techniques (transrectal ultrasound, CT, MRI) often cannot reliably provide this information. The goal of the current proposal is to determine whether the metabolic information provided by 3-dimensional 1H spectroscopic imaging (MRSI) can accurately assess the spatial extent and grade of prostate cancer prior to and after conformal radiation therapy and radioactive seed implantation (Brachytherapy). The feasibility of accomplishing this goal is supported by our experience in performing over 800 MRI/MRSI examinations of prostate cancer patients, the large patient population at UCSF, the direct involvement of radiation oncologists and urologists in the project, and the large amount of preliminary MRSI/MRI data which support the biochemical hypotheses which form the basis of this proposal. Specifically, in a 3-D MRSI study of 85 prostate cancer patients prior to radical resection, we demonstrated that choline and citrate levels could assess the presence and spatial extent of prostate cancer prior to therapy with high specificity. In a recently completed study of 62 pre-radical prostatectomy patients with step section histopathology, we demonstrated for the first time that the addition of MRSI to MRI can significantly improve both cancer staging and localization of cancer within the prostate prior to therapy. There is also preliminary evidence that the magnitude of the changes in choline and citrate are correlated with cancer grade, and that MRSI can discriminate cancer from necrosis and other viable tissues after therapy. However, there has not been to date, a serial prospective MRSI study on a clinically significant number of prostate cancer patients receiving radiotherapy. The data acquired in this proposal should allow us to determine if combined MRI/MRSI can: 1) improve our understanding of the metabolic effects of radiation therapy on normal and malignant prostatic tissues, 2) improve the selection of patients for radiation therapy, 3) aid in therapeutic planning, and 4) allow a early, more quantitative assessment of therapeutic efficacy. Website: Error! Hyperlink reference not valid. ·

Project Title: MONTANA CANCER CONSORTIUM Principal Investigator & Institution: Cobb, Patrick W.; Md, Facp; Montana Cancer Consortium 1236 N 28Th St, Ste 204 Billings, Mt 59101 Timing: Fiscal Year 2003; Project Start 18-SEP-1995; Project End 31-MAY-2008 Summary: (provided by applicant): The Montana Cancer Consortium (MCC) consists of two components (the central data management office in Billings and one component from Great Falls) with eight affiliates [Missoula (2), Helena (1), Kalispell (2), Butte (1), Bozeman (1) and Great Falls (1).] MCC is composed of 44 physicians, which includes all medical and radiation oncologists within the state. The Consortium encompasses a catchment area which includes the entire state of Montana with extension into Wyoming, Idaho, and the Dakotas (some 150,000 sq. miles/population of 903,000). This area is uniquely rural, as well as home to Native Americans from eight reservations. Objective l: Accrual. MCC has named the Southwest Oncology Group (SWOG), the National Surgical Breast and Bowel Project (NSABP), and the Radiation Therapy Oncology Group (RTOG) as primary research bases. MCC estimates a 5% increase per

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year in accrual to treatment clinical trials. Cancer control accrual for the SELECT trial is estimated at 50 participants per year; and the STAR trial has an estimate of 20 new participants per year. Objective 2: Quality. MCC has centralized data management for this large geographic area to one office in Billings. Centralization facilitates registrations and data management. A quality assurance program has been implemented to facilitate registrations and submission of quality data in a timely manner. The consortium has consolidated into two Institutional Review Boards and two pharmacies. Objective 3: Access. The cooperative effort of the MCC with hospital and health care providers from Montana and surrounding states improves access to state-of-the-art cancer treatment and prevention for an extensive, largely rural population. The network of MCC physicians provides a higher profile for clinical trials, which will create a stimulus to increased accrual. By promoting protocol participation in this geographically unique area and its inclusion of the minority component, MCC provides an excellent site for diffusion of knowledge and improved cancer care in a consortium, which is essential to achieve the NCI's CCOP intent. Website: Error! Hyperlink reference not valid. ·

Project Title: MRSI OPTIMIZATION OF PROSTATE BRACHYTHERAPY Principal Investigator & Institution: Dibiase, Steven J.; Cooper Health System, Inc. Medical Center Camden, Nj 08103 Timing: Fiscal Year 2003; Project Start 22-SEP-2003; Project End 31-MAR-2007 Summary: (provided by applicant): This is an interactive proposal from radiation oncologists, urologists, radiologists and medical physicists at the University of Maryland investigating the use of Magnetic Resonance Spectroscopic Imaging (MRSI) to guide the delivery of radiation during prostate brachytherapy (PB). MRSI provides biochemical information on the levels of citrate and choline in the prostate to localize the cancer within the gland. Previous work at University of Maryland established relationship of citrate metabolism in prostate cancer and the molecular events that are characteristic in the malignant transformation. The ability to image the chemical makeup of the prostate with MRSI has become feasible during the last few years, but whether this information can be used effectively to treat prostate cancer patients with radiation is unknown. In order to explore the hypothesis that MRSI can be used to improve PB treatment, the following 3 specific aims will be explored: Specific aim 1 will test the hypothesis that MRSI information can be effectively incorporated into the treatment planning of prostate brachytherapy. Specific aim 2 will test the hypothesis that a pilot study and a Phase II trial utilizing MRSI-Guided prostate brachytherapy can be performed safely and effectively. Specific aim 3 will test the hypothesis that MRSI can provide a unique assessment of treatment response after radiation therapy to the prostate gland. We have conducted preliminary pilot work using MRSI in PB, which is encouraging. Our basic scientists in our physics division have strong backgrounds in this area and have worked closely with clinicians in translating the MRSI information into the therapy of our patients with prostate cancer. Website: Error! Hyperlink reference not valid.

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Project Title: NORTHWEST COMMUNITY CLINICAL ONCOLOGY PROGRAM Principal Investigator & Institution: Colman, Lauren K.; Medical Director; Multicare Health System 315 Sw Ml King Way Tacoma, Wa 98405 Timing: Fiscal Year 2002; Project Start 15-SEP-1983; Project End 31-MAY-2003

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Summary: (Applicant's Description) The Northwest Community Clinical Oncology Program has been in existence sine 1983, and is now applying for competitive renewal. The Northwest CCOP consists of 42 participating physicians, including medical and radiation oncologists, and 11 hospital facilities located in Southwestern Washington and Norther Oregon. The Northwest CCOP utilizes five research bases, to include the Southwest Oncology Group, M.D. Anderson Cancer Center, University of Rochester Cancer Center, the National Surgical Adjuvant Breast and Bowel Project and the Radiation Therapy Oncology Group. The objective of the Northwest CCOP is to provide community physicians the opportunity of continued participation in a wide variety of clinical trials sponsored by these research bases, to include not only treatment but cancer prevention and control trials. Through this mechanism, the latest and most up-to-date cancer treatment regimens can be provided to patients. It is anticipated that further increase in accrual to clinical trials will be possible throughout the next five years. The funds obtained through a successful application will be used to support the administration of these activities. Website: Error! Hyperlink reference not valid. ·

Project Title: OCULAR MELANOMA Principal Investigator & Institution: Fine, Stuart L.; Professor & Chairman; Ophthalmology; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2002; Project Start 01-AUG-1991; Project End 31-JUL-2005 Summary: The proposed study is a multicenter, randomized, controlled clinical trial designed to compare enucleation of eyes with choroidal melanomas with irradiation on the basis of survival after diagnosis and treatment. Candidates for the study will be newly diagnosed cases with choroidal melanomal in one eye greater than 3 mm in height and up to 18 mm by 8 mm in size and with no evidence of metastatic disease who are 21 years of age or older. Informed consent will be obtained from all patients prior to randomizatic. All patients will be followed for a minimum of ten years or until death. The outcome of primary interest is death from all causes. Secondary outcome will include death from cancer, whether metastatic or not, and diagnosis of other tumors. Complications of irradiation and changes in visual acuity will be documented and monitored carefully throughout follow-up. The study will be conducted in clinical centers loated throughout the United States which draw patients from the major population centers; a Coordinating Center; a Fundus Photograph Reading Center; a Pathology Center; and a Sonography Center. Each clinical center will be expected to enroll at least 12 eligible patients each year. The study will be directed by an executive committee consisting of 12 to 15 study investigators and a Steering Committe to deal with day-to-day operational decisions. An independent data and Safety Monitoring Committee will be responsible for assuring the ethical conduct of the study and for reviewing the accumulating data on a regular basis for evidence of adverse or beneficial effects of therapy. The intention of the investigators is to collect and analyze data of high quality which will provide a conclusive answer to the question of therapeutic preference in the management of patients with choroidal melanoma. Standardized clinical and data collection procedures will be employed, and standardized forms will be used in all centers. Central training and certification of all study staff will be required. Website: Error! Hyperlink reference not valid.

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Project Title: OPTIMIZATION OF HIGH DOSE CONFORMAL THERAPY Principal Investigator & Institution: Fraass, Benedick A.; Professor and Director of Radiation Phys; Radiation Oncology; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2002; Project Start 09-APR-1993; Project End 31-JUL-2005 Summary: (Applicant's Description) The overall objective of this program project is to continue the study and improvement of high dose conformal radiation therapy treatments for cancer. The previous program project studied plan optimization, conformal dose delivery techniques, patient related geometrical uncertainties, and helped define the dose/volume tolerance boundaries of treatment limiting normal tissues while showing that conformal therapy allowed significantly higher tumor doses to be delivered without increasing complications. Currently, increasingly sophisticated tools (automated optimization software, intensity modulated radiation therapy (IMRT), improved methods for patient and target volume localization and models to begin to more fully characterize the response of tissues to irradiation) are available to leverage the progress of the previous grant toward further optimization of individual patient treatments. Thus, this program project will work to optimize the entire treatment planning and delivery process. Project 1 will examine and evaluate enhanced automated optimization capabilities which begin to include all relevant parts of the planning/delivery process. Project 2 will investigate and evaluate the dosimetric impact and limitations of different optimization strategies and IMRT delivery capabilities. Project 3 will research and evaluate the benefits of inclusion of patient-related geometric uncertainties into the calculation, compilation and treatment of conformal dose distributions. Project 4 will treat patients to unprecedented high dose levels as it completes normal tissue tolerance dose escalation trials in the brain, liver, and lung, finishes normal tissue dose reduction studies in the head/neck and prostate, and moves on to Phase II (lung, liver, brain) and head/neck and prostate escalation trials. The projects are supported by Core A (administrative and statistical support), Core B (automated treatment delivery process), Core C (quality assurance for an optimized treatment planning/delivery process), and Core D (computer software support). The investigators possess a unique combination of capabilities to successfully perform this work, based on more than 14 years experience in clinical 3-D treatment planning, conformal therapy, dose escalation, and computer-controlled treatment delivery. Website: Error! Hyperlink reference not valid.

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Project Title: PATTERNS OF CARE STUDY IN RADIATION ONCOLOGY Principal Investigator & Institution: Wilson, Jesse F.; American College of Radiology 1101 Market St, 14Th Fl Philadelphia, Pa 19107 Timing: Fiscal Year 2002; Project Start 30-SEP-1994; Project End 31-JAN-2004 Summary: The Patterns of Care Study (PCS) in radiation oncology has the overall goal of improving the care received by cancer patients throughout the USA. To achieve this goal, national surveys will determine structure, process, and outcome of care, emphasizing practice setting, new technologies, and other factors likely to influence outcome. The proposed studies will include cancer of the breast prostate, and lung, which have the highest incidence and death rates in both men and women. This first PCS survey of lung cancer is timely, because positive clinical trials have created the foundation for improvement in treatment and outcome. Cancer of the cervix and esophagus, where radiation therapy is critical and further improvement in care is still needed, will also be studied. Additional outcome data will be collected for other existing

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studies. A special study will focus on patients treated with implants for prostate cancer. Another special study will focus on the care received by implants in minority-rich facilities. A continuing important collaboration between the American College of Radiology (ACR) and the American College of Surgeons (ACoS) will compare the patterns of treatment for breast cancer patients with locally advanced disease to treatment used in recently reported positive clinical trials. The ongoing close collaboration with national clinical trial groups, especially the Radiation Therapy Oncology Group, enables the PCS to measure the penetration of positive phase III clinical trials into the national practice. Similarly, collaboration with professional organizations provides a foundation for measuring the penetration of evidence-based practice standards and guidelines. An international collaboration will lead to comparison of the processes and outcomes of care for patients with cancer of the breast, cervix, esophagus, and lung between the USA and Japan. For cervix cancer comparisons will also be made with Canada. The PCS findings will direct the development of specific educational programs targeted at correcting identified deficits in care. The research time is experienced and have over twenty-five years of successful Patterns of Care Studies with stable leadership by the Principal Investigator, Director, and sponsoring organization. Ready access to patient records has resulted from the enthusiastic cooperation of the specialty of radiation oncology. Website: Error! Hyperlink reference not valid. ·

Project Title: PEDIATRIC BRAIN TUMOR CLINICAL TRIALS CONSORTIUM Principal Investigator & Institution: Geyer, J R.; Children's Hospital and Reg Medical Ctr Box 5371, 4800 Sand Point Way Ne, Ms 6D-1 Seattle, Wa 98105 Timing: Fiscal Year 2002; Project Start 01-APR-1999; Project End 31-MAR-2004 Summary: Therapeutic advances in pediatric neurooncology over the last two decades have been limited. New clinical research opportunities exist including novel approaches in the areas of cytotoxic drugs, radiation therapy and immunotherapy which require evaluation. No single institution accrues sufficient numbers of children with brain tumors to conduct trials of such new approaches in a timely fashion, and only a limited number of institutions have the sophisticated equipment and skills required to implement and evaluate such therapies. Therefore, to expeditiously evaluate innovative therapies, a Pediatric Brain Tumor Clinical Trials Consortium (PBTCTC) is required. The University of Washington Pediatric Neuro-Oncology Program brings the requisite personnel, resources and research expertise, discussed in this application, to contribute substantially to the goals of the PBTCTC. The Pediatric Neuro-Oncology Program was established in 1980 and was thus one of the initial programs recognizing the need for multidisciplinary care of children with brain tumors. The program includes a broad range of clinical and laboratory investigators. The goal of this application is to describe the efforts of this broad multidisciplinary group on issues relevant to improving the outcome of children with brain tumors in concert with PBTCC. In particular, our extensive experience with leadership in national cooperative clinical trials in pediatric brain tumor therapy, together with leading programs in radiation therapy, neuroimaging, neurosurgery, and neuropathology provides the critical mass and expertise required to effectively contribute to clinical evaluation of innovative brain tumor treatments. Our laboratory-based investigations of the molecular aspects of pediatric and adult brain tumors as well as a unique institutional program aimed at developing targeted therapy for malignancies also have the potential to contribute to the development of novel approaches to brain tumor therapy, in concert with the PBTCTC. Specifically we propose to: 1) effectively contribute to the clinical trials program of the

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PBTCTC; 2) provide laboratory-based analysis of molecular aspects of brain tumors required for the development of novel prognostic and therapeutic approaches; 3) develop novel methods of imaging brain tumors, including methods for rapid assessment of response to therapy; 4) develop novel targeted therapies for brain tumors. Website: Error! Hyperlink reference not valid. ·

Project Title: PEDIATRIC BRAIN TUMOR RESEARCH CENTER Principal Investigator & Institution: Blaney, Susan; Assistant Professor; Pediatrics; Baylor College of Medicine 1 Baylor Plaza Houston, Tx 77030 Timing: Fiscal Year 2002; Project Start 01-APR-1999; Project End 31-MAR-2004 Summary: The Texas Children s Cancer Center(TCCC) Brain Tumor Program (BTP) is a multidisciplinary, highly integrated program of clinical and laboratory research dedicated to improving survival rates of children with central nervous system(CNS) tumors. The Program is one of the largest of its kind in the United States, each year evaluating more than 50 children. The BTP is composed of clinical and laboratory investigators whose research encompasses the entire spectrum of pediatric neurooncology. They are exceptionally qualified to design, conduct, and monitor clinical trials for children with brain tumors. In national cooperative group clinical research and in numerous studies sponsored by the National Cancer Institute and private industry, the BTP has led new approaches to the treatment of infants with brain tumors, introduced new agents against brain tumors through Phase I and Phase II clinical trials, and pioneered the use of highly conformal radiation therapy (RT) to decrease toxicity to normal structures surrounding brain tumors. The BTP works closely with the Gene Therapy Program, Molecular Neuro-Oncology Program, and Clinical Pharmacology Group, all within TCCC, to translate advances in laboratory and pre-clinical science to treatment of children with brain tumors. Examples of ongoing clinical trials include those seeking to determine the impact of intrathecal chemotherapy and highly conformal radiation therapy on the survival of infants with brain tumors, the activity of various new agents against leptomeningeal disease, the activity of various agents against malignant glioma, the use of bone marrow transplant for recurrent medulloblastoma, and the efficacy of gene therapy for children with refractory brain tumors. The BTP utilizes the most modern diagnostic neuroimaging modalities and innovative technologies such as functional MR, MR spectroscopy, and 18F imaging. Its neurosurgeons utilize state- of-the-art operating microscopes and guidance systems. RT is delivered through the most technically advanced conformal system. The BTP neuropathologists have complete diagnostic capabilities to classify tumors according to WHO criteria. The BTP maintains a storage bank of tumor specimens for institutional and cooperative group correlative studies. The BTP has an innovative molecular neurooncology program that uses high-throughput technologies to study differential gene expression in pediatric brain tumors. BTP investigators are committed to utilizing their resources for the Pediatric Brain Tumor Clinical Trial Consortium (PBTCTC) studies. The TCCC BTP serves a culturally and ethnically diverse population. It receives considerable research support from Texas Children s Hospital, the largest children s hospital in the United States and from Baylor College of Medicine, one of the top ten medical schools in the country. The unique expertise of the TCCC BTP make it ideally suited to be a Participating Member of the PBTCTC. It offers leadership in the development of new agents, in new uses of sophisticated radiotherapy, and in the application of new approaches to brain tumor therapy. Website: Error! Hyperlink reference not valid.

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Project Title: PET IN MULTIMODALITY THERAPY FOR ESOPHAGEAL CANCER Principal Investigator & Institution: Levine, Edward A.; Surgical Sciences; Wake Forest University Health Sciences Winston-Salem, Nc 27157 Timing: Fiscal Year 2002; Project Start 05-FEB-2001; Project End 31-JAN-2004 Summary: Historically, localized cancer of the esophagus was managed by either surgery or radiation therapy alone. Recently, studies have found a substantial improvement in survival when chemotherapy is combined with radiation therapy either alone or as an induction regimen prior to surgery. It has been demonstrated in several clinical trials of chemo- radiation followed by surgery that approximately 30% of patients will have no tumor found in the esophageal resection specimen at the time of resection. Clearly, local control after chemo-radiation is improved with the addition of surgery when residual disease is present. However, there is little data (none of which is randomized) demonstrating an outcome advantage with the addition of surgery when patients have achieved a complete pathologic response to preoperative therapy. Further, resection of the esophagus with a pathologic complete response has no clear therapeutic benefit and is associated with considerable morbidity. Consequently, rather than subjecting all patients to a resection, a more logical approach is to further refine current prognostic and diagnostic techniques to allow for a more rational selection of patients at risk of having residual disease after induction chemo-radiation. In a correlative study, we plan to evaluate the utility of [18F]-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) imaging, both before and at the completion of the induction chemo-radiation to assess changes in the tumor uptake FDG. Recent improvements in PET imaging suggest that this tool is sensitive for identifying subclinical disease; either at the time of initial staging or to determine recurrent/persistent disease during and following therapy. Further, although PET holds great promise, it is currently an expensive modality. Consequently, defining the optimal time for its use in a patient's course is clinically important. We plan to correlate the PET findings with endoscopic ultrasound (EUS), and spiral CT imaging to pathologic findings from resected specimens. Website: Error! Hyperlink reference not valid.

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Project Title: PHYSICS Principal Investigator & Institution: Smith, Afred R.; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2002; Project Start 11-APR-2002; Project End 31-MAR-2007 Summary: (Applicant's Description) The research in the physics program is driven by two goals: 1) to make proton beam therapy as good as the physics of protons will allow; and 2) to make the planning, delivery and verification of proton beam therapy as efficient and therefore as cost-effective as possible. To these ends, we propose initiatives in the following areas: Improved Proton Dose Distributions: We propose to develop and implement: highly accurate isocentric treatment techniques featuring multi-segment treatments; technology for the delivery of intensity-modulated proton beam therapy through the use of pencil beam scanning; multi-leaf collimators; optimization algorithms which feature full 3D intensity-modulation using scanned beams; beam gating techniques to overcome problems of organ/target motion; and improved immobilization, treatment set-up and verification techniques. More Efficient Planning and Delivery: We propose to develop and implement: faster patient set-ups through the implementation of digital imaging technology; faster planning algorithms, automated documentation, electronic charting, patient scheduling, faster hardware, improved

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human interface, and beam optimization tools; and use a control system which minimizes interactions to those absolutely necessary for the execution of complex, multisegment treatments. Improved Dosimetry & QA: We propose to develop and implement: a Monte Carlo calculation capability both for the most accurate possible computation of the dose delivered during patient treatments and for basic dosimetry; investigations of dosimetry systems; a dose-prediction algorithm which obviates the need to calibrate each field; instrumentation to efficiently and accurately test the performance of the beam delivery systems; procedures for QA and QC in order to ensure the quality and safety of treatments; a 3D dose-collection capability; and a capability within the treatment planning programs to compute detector-response distributions for non-linear detectors so that observations can be compared with prediction. Website: Error! Hyperlink reference not valid. ·

Project Title: PRE-CLINICAL STUDIES OF SPINAL-CORD INJURY REPAIR Principal Investigator & Institution: Kalderon, Nurit; Sloan-Kettering Institute for Cancer Res New York, Ny 10021 Timing: Fiscal Year 2002; Project Start 22-AUG-2000; Project End 31-JUL-2005 Summary: Adapted from the Investigator's Abstract): Repair mechanisms are activated in response to injury in the adult spinal cord; these begin wound healing and reconstructing the cord tissue including the regrowth of severed axons. However, at about the 4th week after the injury, the natural inherent repair is aborted and decay processes take over yielding a permanent wound gap. The severed nerve fibers fail to cross the wound gap, leaving the cord beyond the site of injury permanently disconnected from the brain and the related muscles become and remain paralyzed. The long-term goal of our research is to identify the mechanisms by which the intrinsic repair is aborted. Identifying the ~who" and understanding the ~how~ will enable us to develop therapeutic clinical strategies for facilitating the intrinsic repair thereby preventing paralysis. Thus far, by using x-irradiation in an analytical setting as used to eradicate proliferating cells-it has been possible to identify one cell, the reactive astrocyte, that plays an important role in discontinuing the wound healing processes. Further, it was possible to demonstrate that the destructive outcome of injury can be averted and the natural inherent repair of structure and motor function can be attained provided that reactive glia at the damage site are destroyed by x-ray therapy targeted at the right time after transection injury in adult rat spinal cord. The objective of this proposal is to establish the methods to transform a strategy which is effective in the experimental setting into a strategy effective in a clinical setting in facilitating structural and functional repair in injured spinal cord. The parameters of radiation therapy protocols that are clinically safe for the human spinal cord are very well defined and in routine use to eradicate tumor cells. These clinical radiation parameters will be used by themselves and in conjunction with the clinical procedures currently used in human spinal cord injury, such as drugs to prevent secondary damage and protect the spared fibers tracts. The efficacy of these in facilitating intrinsic repair will be examined in transection and contusion injuries in the rat spinal cord. Studies in each of the specific aims are focused on identifying the parameters (e.g., window of opportunity for the therapy) and defining the conditions (e.g., dose protocol) at which repair is facilitated. Analysis of repair is conducted using magnetic resonance imaging of the lesion site at the cord, quantitative histologic and electrophysiologic methods and behavioral methods. Website: Error! Hyperlink reference not valid.

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Project Title: PRODUCTION OF Y-90 MICROSPHERES FOR RADIATION THERAPY Principal Investigator & Institution: Peng, Yongren B.; Vice President; Xl Sci-Tech, Inc. 3100 George Washington Way, Ste 135 Richland, Wa 99352 Timing: Fiscal Year 2002; Project Start 01-JUN-1998; Project End 31-JUL-2004 Summary: (Provided by Applicant): The feasibility of continuous and economical microfabrication of timed-bioresorbable glass microspheres containing yttrium-90 (Y-90) at therapeutic concentrations has been successfully demonstrated using Y-89 surrogate in the Phase I research. The microspheres are uniform in size and chemistry, and the timed-bioresorption characteristics can be predetermined according to the isotope halflife and the dosimetry requirements. A dependable commercial supply of Y-90 glass microspheres will have a positive impact on localized radiation therapy worldwide. This Phase II research has the objective of making such a supply a commercial reality. The proposed microfabrication process can be streamlined and fully automated from Y90 isotope extraction to packaged Y-90 microspheres ready for delivery and treatment injection. The microsphere production process will be optimized with regard to minimized personnel radiation exposure, maximized use of source radioisotopes, much shortened overall process time to preserve radioactivity, and above all, much reduced cost. Microspheres containing therapeutic concentrations of radioisotopes will be evaluated in vitro for radioactivity retention, biocompatibility, and completeness of bioresorption; and in vivo to demonstrate the efficacy of the Y-90 microspheres in treating tumor-bearing rodents. PROPOSED COMMERCIAL APPLICATIONS: Timedbioresorbable glass microspheres containing Y-90 are ideal for direct intratumoral injection in the treatment of cancers such as the liver, pancreas, or the synovectomy of rheumatoid arthritis. Microspheres containing other radioactive isotopes such as P-32 can also be readily produced by the methods described. Website: Error! Hyperlink reference not valid.

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Project Title: PROGNOSTIC MARKERS IN TRIALS FOR HEAD AND NECK CANCER Principal Investigator & Institution: Cullen, Kevin J.; Director, University of Maryland Greeneb; V T Lombardi Cancer Res Center; Georgetown University Washington, Dc 20057 Timing: Fiscal Year 2003; Project Start 01-JUN-2003; Project End 31-MAY-2006 Summary: (provided by applicant): Our fundamental hypothesis is that readily identifiable biomarkers, including p53, thymidylate synthase and enzymes in the glutathione pathway are critical determinants of response and long term outcome for patients receiving chemotherapy and/or radiation for head and neck cancer. These biomarkers may be developed both as prognostic indicators to guide therapy and as targets for strategies which will enhance the efficacy of cisplatin based chemotherapy in this set of diseases. We present preliminary data which strongly suggest that overexpression of p53, thymidylate synthase and glutathione s-transferase (pi) are associated with poor outcome in patients receiving chemotherapy for head and neck cancer. We believe they can be developed as clinically important markers for patients with head and neck cancer. On the basis of our preliminary data, we propose the following aims: 1. To confirm the prognostic significance of p53, glutathione stransferase and thymidylate synthase in patients participating in clinical trials for head and neck cancer. 2. To confirm the prognostic significance of p53, glutathione stransferase and thymidylate synthase in a control group of patients receiving standard

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surgery and/or radiation therapy. 3. To develop tissue microarrays based on the samples in specific aims 1 and 2 for focused screening and validation of additional cellular factors as determinants of clinical response and outcome. Website: Error! Hyperlink reference not valid. ·

Project Title: PROTON RADIATION THERAPY RESEARCH Principal Investigator & Institution: Loeffler, Jay S.; Professor; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2002; Project Start 31-AUG-1995; Project End 31-MAR-2007 Summary: (Applicant's Description) It is estimated that between 20-80 percent of patients treated for locally advanced epithelial or mesenchymal tumors will die secondary to the failure of photon therapy and/or surgery to achieve local control. Furthermore, these aggressive local therapies are themselves often associated with significant acute and late morbidity. There are other tumors, particularly pediatric tumors, for which local control is often satisfactory but treatment-related late effects are high. It is the primary aim of this Program Project to exploit the superior dose distributions of proton beams to improve clinical outcomes for patients with a variety of solid tumors both in terms of cancer control and treatment-related morbidity. We have treated over 5,000 cancer patients with proton therapy at the Harvard Cyclotron Laboratory since 1974. We have achieved significant gains in clinical outcomes for a number of disease sites including chondrosarcomas and chordomas of the skull base and cervical spine (95 percent and 50 percent local control, respectively), paranasal sinus tumors (87 percent local control), and ocular melanomas (97 percent local control). We propose to carry out clinical trials using proton beams in additional tumor sites where photon therapy has provided suboptimal treatment outcomes. The two basic hypotheses for this Program Project are that, using the superior dose distributions of proton beams, we can (in subproject 5) escalate tumor dose and improve local control without increasing damage to non-target normal tissues and (in subproject 6) maintain high rates of local control while decreasing treatment related morbidity. We will assess clinical gains in terms of five endpoints: 1) local control, 2) distant metastasis-free survival, 3) overall survival, 4) treatment-related morbidity, and 5) quality-of-life (QOL) We also hypothesize that proton irradiation will decrease the comorbidity between radiation therapy and chemotherapy thus improving compliance and intensity of treatment. We will use well-designed prospective phase I/II/III trials to test these hypotheses. The proposed research program consists of three closely related projects. In subproject 5 we will carry out phase I/II/III dose escalation studies for prostate, lung, paranasal sinus, nasopharynx and hepatocellular cancers. The goals of these trials are to improve local control and survival. In subproject 6 we will carry out phase II/III studies designed to reduce treatment-related morbidity for pediatric cancers including medulloblastoma, retinoblastoma, and soft tissue sarcomas, and adult tumors including rectal carcinoma and choroidal melanoma. In the prostate clinical trial we will collaborate with the Loma Linda University Medical Center in protocol design and patient accrual. In subproject 4 we will develop treatment delivery and planning systems, and design and carry out dosimetry and quality assurance programs to support the proposed clinical trials. The Northeast Proton Therapy Center (NPTC), jointly funded by the NCI and the MGH, has been built on the MGH campus. The NPTC will provide the increased capacity and new technologies needed to conduct the clinical trials proposed in this application. With our experience in conducting proton clinical trials, and the resources offered by the NPTC, we have unique capabilities to carry out the proposed research. It is our expectation that

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these clinical trials will show improved cancer control rates, reduced treatment morbidity and improved QOL. Website: Error! Hyperlink reference not valid. ·

Project Title: PROTON THERAPY CTR: PEDIATRIC Principal Investigator & Institution: Cameron, John M.; None; Indiana University Bloomington P.O. Box 1847 Bloomington, in 47402 Timing: Fiscal Year 2002; Project Start 01-JUN-2002; Project End 31-MAY-2003 Summary: (provided by applicant): The IU Cyclotron Facility is converting 50,000 sq. ft. of physics research space into a regional proton therapy center, the Midwest Proton Radiation Institute (MPRI). Clinical trials and research for development and optimization of new treatments will be conducted at MPRI. The medical director, Allan Thornton, M.D., and the technical director, John Cameron, Ph.D. are directing the conversion. The renovation will include three patient treatment rooms, a research room for radiation biology research and development of new equipment to enhance patient treatments, and a patient clinic. The first treatment room will contain a large-field fixed horizontal treatment line and an eye line. The second treatment room will be equipped with the subject of this application a 360x isocentric rotating gantry. The gantry makes it possible to rotate the beam around the patient and thus treat tumors from any angle. A gantry provides maximum efficacy in avoiding critical organs, and efficiency in patient set-up and beam delivery. This application is a request for funding to provide the gantry mechanical structure and controls, the gantry beam transport system, and the dose monitoring system for the second treatment room. The cost of the project including the first treatment room, the clinic and one gantry is estimated to be $15 million and $13 million has already been raised by Indiana University. With the addition of the $2 million being requested in this application, the gantry can be completed. If funded, the gantry installation and commissioning could be completed by June 2004. Website: Error! Hyperlink reference not valid.

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Project Title: RACE, TREATMENT AND ENDOMETRIAL CANCER SURVIVAL Principal Investigator & Institution: Armstrong, Katrina; Medicine; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2003; Project Start 11-APR-2003; Project End 31-MAR-2006 Summary: (provided by investigator): Survival after the diagnosis of endometrial cancer varies significantly between African-American and Caucasian women. Between 1992 and 1998, five-year survival for African-American women after endometrial cancer diagnosis was 58.9%, compared to 85.8% for Caucasian women. The disparity in survival is greatest among older women, with an absolute difference in five year survival of 10% for women under 50 compared to 30% for women 50 years of age and older. Prior studies have identified several factors that contribute to the observed racial disparity in endometrial cancer survival, including stage at diagnosis and tumor grade. However, significant differences in survival between Caucasian and African-American women persist even after adjusting for these factors. There are several reasons to believe that differences in the prevalence and characteristics of treatment may contribute to this residual survival disparity. African- Americans have been shown to be less likely to undergo definitive treatment for many different medical and surgical conditions. Characteristics of treatment (including provider characteristics, hospital characteristics and intensity of therapy) are associated with outcome for other surgical conditions, including surgery for lung, pancreatic and breast cancer. Understanding the prevalence

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and outcomes of differences in treatment characteristics between African-American and Caucasian women offers a potentially promising new approach to improving endometrial cancer survival among African-American women. In this application we propose to use SEER-Medicare linked data to examine the outcomes of AfricanAmerican and Caucasian women diagnosed with endometrial cancer between 1991 and 1999. The primary outcome will be overall and disease-specific survival times (which may be censored) as assessed by Medicare vital statistics and SEER linkage to the National Death Index respectively. Analyses will adjust for comorbidity, socioeconomic status and tumor characteristics using information provided in the SEER-Medicare database. Provider and hospital characteristics will be determined by linkage to the AMA practitioner database and AHA annual survey respectively. Our three specific aims explore the contribution of differences in treatment to the higher mortality among African-American women diagnosed with endometrial cancer. We group differences in treatment into three categories: (1) differences in the rates of treatment; (2) differences in the extent/intensity of treatment; and (3) differences in the providers and hospitals/facilities who deliver the treatment. For each category, we will explore differences between African-American and Caucasian women, their association with outcome, and to what extent variations in treatment explain the excess mortality among African-American women. In addition, within each category, we will investigate differences related to primary surgery and adjuvant radiation therapy. Website: Error! Hyperlink reference not valid. ·

Project Title: RADIATION AFFECTS TUMOR ANTIGEN PRESENTATION Principal Investigator & Institution: Mcbride, William H.; Professor of Radiation Oncology; Radiation Oncology; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2003; Project Start 06-AUG-2003; Project End 31-JUL-2008 Summary: (provided by applicant): Radiation delivered to the whole body or locally is immunomodulatory. Multiple arms of the immune system can be affected. A better mechanistic understanding of the subtleties of the interactions is a prerequisite if cancer immunotherapy is to be effectively combined with radiation therapy. This proposal focuses on radiation effects on dendritic cells (DC) functioning to process and present the human melanoma antigen MART-1 to cytotoxic T lymphocytes (CTL). Two pathways of antigen processing by DC have been identified. The endogenous pathway involves proteasome degradation, which is compromised by radiation. Irradiated DC is less able to generate protective immunity utilizing this pathway. In contrast, under similar conditions, presentation of an exogenous MART peptide antigen by DC is enhanced by radiation and by proteasome inhibition. It is hypothesized that this is due to alterations in stability of peptide or of MHC-peptide complexes on the surface of the DC. This proposal aims to study the effects of radiation on the endogenous and exogenous pathways of antigen presentation and the impact maturation status and proteasome composition of the DC will have on the responses. These basic mechanistic studies will give insight as to how to devise novel strategies to convert tumor death during radiation therapy into the generation of immunity that would assist in gaining local tumor control and inhibit the development of micrometastatic disease. Website: Error! Hyperlink reference not valid.

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Project Title: RADIATION PROTECTION CANCER THERAPY WITH AN SOD MIMETIC Principal Investigator & Institution: Gammans, Richard E.; Incara Pharmaceuticals Corporation Box 14287, 79 Tw Alexander Dr Research Triangle Park, Nc 27709 Timing: Fiscal Year 2003; Project Start 14-AUG-2003; Project End 31-JAN-2004 Summary: (provided by applicant): Phase I. In the treatment of cancer, radiation therapy has been limited by the tolerance of the surrounding normal tissues, such as lung or mucosa. Until now, there have been no compounds available that protect the normal tissues without reducing the tumor response to radiation therapy. The overall goal of this project is to develop a new approach to radiation therapy for cancer, based on the recently discovered radioprotective effects of novel synthetic catalytic SOD mimetic compounds. These compounds may also independently inhibit tumor growth under certain conditions. In Phase 1 of this SBIR application specific SOD mimetics will have demonstrated effectiveness in animal models of radiation therapy of human cancers. The proposed study will specifically research a selected compound in preparation for human studies directed at enhancing the efficacy of radiation therapy. The goal is to both increase tolerance of normal tissues to radiation therapy and retain or increase the net anti-tumor effects. Well-established functional, radiographic and histopathologic end-points will be used to assess possible mechanisms behind this compound's radioprotective effect in rat and hamster models of radiation-induced injury. Models of both radiation-induced mucositis and radiation-induced lung fibrosis will be studied. The antitumor effect of the selected SOD mimetic given alone or in combination with radiation therapy will be evaluated by using standard tumor growth delay assays. This new strategy of utilizing a single compound with both anti-tumor and radioprotective properties in combination with radiotherapy could result in an improvement in patient survival with a concomitant reduction in the risk of complications. The potential of independent tumor growth inhibition by the SOD mimetics would be an additional benefit. Website: Error! Hyperlink reference not valid.

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Project Title: RDNA METHYLATION AND PROGNOSIS IN ENDOMETRIAL CANCERS Principal Investigator & Institution: Goodfellow, Paul J.; Professor; Surgery; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2004 Summary: (provided by applicant) Endometrial cancer is the most common primary gynecologic malignancy in the United States, with over 39,000 new cases diagnosed each year. Most women in the US present with endometrioid endometrial carcinoma. This histologic subtype carries a favorable prognosis, with an overall 5-year survival that approaches 90%. Despite the fact that most patients are cured with surgery, recurrent endometrioid adenocarcinoma is a significant cause of mortality. Adjuvant radiation therapy, given in an attempt to eliminate any remaining tumor cells, is often a part of the treatment plan for women who are at increased risk for recurrent disease. In women with early stage (I and II) endometrial carcinoma, the use and benefits of adjuvant therapy are controversial. Radiation therapy carries a significant risk for complications. Furthermore, the costs for radiation therapy are considerable. In a large multicenter randomized trial of adjuvant therapy for intermediate risk endometrioid adenocarcinoma, it was demonstrated that pelvic radiation significantly decreased recurrences but brought about only a small, non-statistically significant improvement in

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overall survival. There is a need to find a balance between the increased cost and morbidity that comes with adjuvant radiation therapy, and the reduction in the recurrences for women with intermediate risk disease. A molecular marker to identify those patients who are at very low-risk for recurrence could help avoid unnecessary adjuvant therapy and by doing so, lessen the morbidity and expense associated with treating endometrial cancer. Conversely, a marker for high-risk disease could help target the use of adjuvant therapy. Furthermore, the ability to recognize those women at higher risk for aggressive or deadly disease prior to hysterectomy could have a positive effect on how this group of women is cared for. The long-term goal for the marker studies proposed here is to combine molecular stratification and conventional risk assessment in prospective randomized trials. In this application we propose to develop a new method to analyze methylation of rDNA sequences in clinical tumor specimens. We previously demonstrated that rDNA methylation was an independent prognostic marker in patients with endometrioid endometrial adenocarcinoma. We will develop 1) Pyrosequencing TM methods to assess rDNA methylation in tumor DNAs, 2) apply the rDNA Pyrosequencing TM methylation analyses to clinical specimens (paraffinembedded, formalin-fixed hysterectomy and pre-hysterectomy, biopsies) and 3) in the R33 phase of the application, we will use these methods to assess the prognostic and diagnostic significance of Pyrosequencing TM rDNA methylation in a consecutive series of women with endometrioid adenocarcinoma. These studies are designed to determine whether tumor rDNA methylation could serve as a prognostic and diagnostic marker in both pre-hysterectomy and hysterectomy specimens from women with endometrial cancer, rDNA methylation analyses could ultimately be used to help guide the treatment of endometrial cancer patients Website: Error! Hyperlink reference not valid. ·

Project Title: REDUCTION OF TREATMENT MORBIDITY Principal Investigator & Institution: Tarbell, Nancy; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2002; Project Start 11-APR-2002; Project End 31-MAR-2007 Summary: (Applicant's Description) The major goal of this project is to determine the extent to which proton beams can decrease the damage to normal tissues that is often seen with standard photon treatments. It is our expectation that treatment morbidity will be decreased without a decrease in local control. The proposed clinical trials will be carried out for a variety of solid tumors where conventional photon treatments have provided suboptimal treatment outcomes. This work will be accomplished through the mechanism of Phase II/III clinical trials. We will assess clinical gains in terms of the incidence and severity of treatment-related acute and late effects of proton therapy compared to those for photon therapy. In addition, we will assess quality-of-life (QOL) in selected clinical trials. The higher proton beam energy, isocentric gantries, and increased treatment capacity at the Northeast Proton Therapy Center make it possible to safely deliver treatments to pediatric patients and to treat large numbers of patients in order to carry out expanded clinical trials. The proposed clinical trials are based on the rationale that proton beam treatments decrease the volume of normal tissues/organs receiving high doses of radiation, thereby decreasing the rate of treatment-related morbidity seen in photon therapy. This is particularity important in pediatric patients where the irradiated tissues and organs are immature and more sensitive to radiation damage. We will conduct clinical trials in pediatric cancers including medulloblastoma, retinoblastoma and pediatric sarcomas and in rectal cancer and choroidal melanoma. We hypothesize that proton therapy will produce fewer acute and late effects in

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developing children, e.g., growth defects, cognitive changes, organ damage and secondary tumors, than those resulting from photon beam treatment. In medulloblastoma and rectal cancer, we will investigate whether the reduced treatment volumes resulting from proton beams will decrease co-morbidity in multi-modality treatments and whether patient-reported QOL is improved. We will investigate whether altered fractionation decreases the loss of visual acuity in patients treated for choroidal melanoma compared to that found in standard proton treatments. New areas of focus in this application are inclusion of chemotherapy in those sites where it has become standard treatment, and QOL studies to assess the total range of benefits resulting from improved dose distributions. We expect that the highly conformal dose distributions achievable with proton therapy will result in a reduction in treatment-related morbidity and improved QOL. A reduction in acute morbidity in combined modality treatment may improve treatment intensity and compliance which could ultimately impact on cancer control. Website: Error! Hyperlink reference not valid. ·

Project Title: RESEARCH TRAINING IN BIOMEDICAL PHYSICS Principal Investigator & Institution: Hoffman, Edward J.; Professor; Radiology; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2002; Project Start 19-AUG-1997; Project End 31-MAY-2007 Summary: (provided by applicant): The long term goals and specific aims of this proposal are to train young scientists and engineers to apply their knowledge of physics and engineering to the problems in diagnosis and therapy that are encountered in radiology, nuclear medicine and radiation oncology. Most people who have recently had a serious health problem realize the complexity and power of the devices employed in radiology and nuclear medicine. As patients it is likely that they would have had an x-ray CT, an MRI, ultrasound, a PET or SPECT scan, and if they were unlucky enough to have cancer, most likely there would have been radiation therapy from a electron accelerator. All of this hardware did not exist 30 years ago. With their complexities optimum application of these devices requires support from individuals who are trained in physics and engineering, who understand the hardware and its role in diagnosis and therapy. The focus of this proposal is the Biomedical Physics Interdepartmental Graduate Program at UCLA. This program provides all trainees with general didactic and practical training on all the types of diagnostic and therapeutic hardware common to diagnostic radiology and therapeutic radiation oncology. During the research for the Ph.D. thesis, each trainee will become an expert on one or more of these systems. The typical research projects may involve developing new or improving current diagnostic systems or using the current systems in a novel way to extract new or more precise diagnostic information from the system under study. The projects in radiation oncology generally involve new methods of radiation therapy and improvement in the accuracy of delivery of the radiation close to the tumor while minimizing the dose to healthy tissue. The UCLA Biomedical Physics Interdepartmental Graduate Program has had an exemplary record in training individuals for these roles at the predoctoral and postdoctoral level. It has the programmatic infrastructure in place for the program, it has a rich and varied research environment, but most important, it has a dedicated and outstanding faculty. Website: Error! Hyperlink reference not valid.

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Project Title: RESPONSE TO FRACTIONATED RADIATION THERAPY BY MRSI Principal Investigator & Institution: Nelson, Sarah J.; Professor; Radiology; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 941222747 Timing: Fiscal Year 2003; Project Start 15-MAY-1993; Project End 31-JUL-2008 Summary: (provided by applicant): Magnetic Resonance Spectroscopic Imaging (MRSI) is an in vivo molecular imaging technique that has been proposed for defining tumor burden for patients with gliomas. The current funding cycle has demonstrated that MRSI is superior to conventional MR imaging for predicting outcome and following response to Gamma Knife Radiosurgery (GK-RS) in recurrent gliomas. The objective in the next funding cycle is to make this technology more generally applicable by investigating the application of MRSI to the evaluation of fractionated radiation therapy. This treatment is used as a follow-up to surgical resection for almost all newly diagnosed malignant gliomas. New approaches such as Intensity Modulated Radiation Therapy (IMRT) have made it possible to treat irregular 3-D volumes accurately and reproducibly in a highly conformal manner. Critical factors for realizing the potential of IMRT and for understanding its limitations are the ability to determine whether treatment failure is due to inadequate targeting or to an intrinsic lack of sensitivity to radiation. This represents a complex problem in gliomas because of the heterogeneity of the lesion and the spatial variations in radiation dose to the tumor and surrounding brain tissue. Specific Aim 1 will address the optimization of data acquisition and reconstruction parameters. This will include the investigation of the use of a 3T MR scanner rather the standard 1.5T clinical system for obtaining the anatomic and metabolic data. Specific Aim 2 will involve the development of algorithms for quantitative analysis of the MRSI data and correlation with serial MR images. The final Specific Aim will apply the new technology to the serial evaluation of 60 patients with malignant gliomas who are being treated at UCSF with fractionated radiation therapy. Using the MRSI data to guide and evaluate such focal therapy is expected to have a major impact upon treatment effectiveness and ultimately upon patient outcome. Website: Error! Hyperlink reference not valid.

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Project Title: RHENIUM-188 THERAPY OF NIS-EXPRESSING BREAST TUMORS Principal Investigator & Institution: Dadachova, Ekaterina; Nuclear Medicine; Yeshiva University 500 W 185Th St New York, Ny 10033 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2004 Summary: (provided by applicant): Breast cancer remains the major cause of cancer death in women in the developed world. Novel therapeutic modalities are needed for those patients in whom chemotherapy, hormonal treatment and external radiation therapy are not effective. Recently a new molecular target has been identified in 80% of mammary cancers in humans but not in normal/healthy breast tissue - mammary gland sodium/iodide symporter (mgNIS) which may open a new avenue in treatment of breast cancer with radioactive iodine 131-I. However, in the absence of prolonged biological retention of 131-I in NIS-expressing mammary tumors an isotope with shorter physical half-life and superior to 131-I decay properties, which can be transported by NIS may provide a better therapeutic option. We have recently showed that the powerful beta-emitter 188-Rhenium (188-Re) which has therapeutically useful emissions superior to those of 131-I, is also transported by NIS and will deliver several times higher radiation dose to the tumor in comparison with 131-I. We hypothesize that 188Re will be more efficient than 131-I in elimination of NIS-expressing breast tumors in mice. We also hypothesize that the combination of dose fractionation/normal organ

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protection will increase 188-Re tumodcidal effect while decreasing the radiation dose to normal organs. To test these hypotheses we will start with evaluation of 188-Re and 131I cell-killing impact on NIS-expressing cells of thyroid in normal mice under the conditions of suppressed organification. We will perform comparative 188-Re and 131-I therapy of xenografted breast tumors in nude mice including dose escalation and maximum tolerated dose determination. We will employ the combination of dose fractionation/stomach protection to protect the stomach from radiation. We wilt also perform comprehensive dosimetry calculations for future therapy of NIS-expressing breast cancers in humans. The Specific Aims of the project are: Aim 1 To compare cellkilling potential of 188-Rhenium versus 131-Iodine in NIS-expressing tissue in vivo using thyroid in healthy mice as a target organ. Aim 2 To evaluate the feasibility of using 188-REO4- as a tumoricidal agent in NtS-expressing breast cancer tumors in mice. The proposed research will provide data on interaction of a novel molecular cancer target - mgNiS with non-iodine therapeutic radioisotope and on its potential to eradicate breast tumors. The long-term goal of this research is to contribute to the development of a novel cost-effective radionuclide therapy for treatment of breast cancer and, possibly, for other NIS-expressing cancers such as thyroid cancer. Website: Error! Hyperlink reference not valid. ·

Project Title: ROLE OF KSR IN TUMORIGENESIS AND THE RADIATION RESPONSE Principal Investigator & Institution: Xing, H. R.; Sloan-Kettering Institute for Cancer Res New York, Ny 10021 Timing: Fiscal Year 2003; Project Start 01-FEB-2003; Project End 31-JAN-2007 Summary: (provided by applicant): The long-term goal of this project is to explore the molecular mechanisms underlying cellular sensitivity to ionizing radiation (IR) and to devise strategies to regulate radiosensitivity by manipulating signal transduction events. Signal transduction events, especially those mediated by the oncogenic Ras and epidermal growth factor receptor (EGFR), can significantly alter the radiosensitivity of tumor cells and cause them to become more resistant to ionizing radiation-induced cell killing. However, the precise mechanisms underlying the actions of EGFR and Ras are not well understood. This application proposes to adopt a multidisciplinary (biochemical, genetic and pharmacologic) approach to define the role of Kinase Suppressor of Ras (KSR), a newly identified component of the EGFRIRaslRaflMAPK signaling pathway, in EGFR/Ras-mediated tumorigenesis and radio-response to IR. The hypotheses to be explored in this project are 1) oncogenic gf Ras, and hyper-activated wild-type (wt) Ras as a result of constitutively activated EGFR, signal oncogenesis via KSR; and 2) KSR is required for Ras-mediated radioresistance to IR. Specific aims to address these hypotheses are: 1) to investigate the role of KSR in EGFR/Ras tumorigenesis using transplanted human tumors, 2) to evaluate the role of KSR in EGFR/Ras-mediated responses to IR, and 3) to explore the potential of KSR as a molecular target for radiation therapy in various human tumors, specifically, the feasibility of using antisense oligodeoxynucleotide (AS-ODN) as a radiosensitizer. Results from these studies may offer new insights into the biological functions of KSR, which at this moment are largely unknown. Concomitantly, these investigations will help to identify new elements of Ras signaling which may have implications not only for the utility of KSR AS-ODNs in tumors with oncogenic ras mutations, but also in tumors with a highly activated wt Ras pathway as a result of overexpression of growth factors and/or their receptors. In summary, elucidation of KSR as an essential component of the EGFR/Ras-mediated tumorigenesis and cellular response to IR will potentially offer a

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highly tumor-specific molecular target for the development of diagnostic and therapeutic tools to treat a variety of human malignancies dependent on EGFR/Ras signaling. Website: Error! Hyperlink reference not valid. ·

Project Title: SEED BRACHYTHERAPY

LOCALIZER

FOR

IMAGE

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PROSTATE

Principal Investigator & Institution: Cho, Paul S.; Associate Professor; Radiation Oncology; University of Washington Grant & Contract Services Seattle, Wa 98105 Timing: Fiscal Year 2002; Project Start 01-FEB-2001; Project End 31-JAN-2004 Summary: Permanent implantation of radioactive seeds is a viable and effective therapeutic option widely used today for early-stage prostate cancer. Compared to external radiation therapy in which radiation must penetrate healthy tissues in order to reach cancer cells, implantation of low-energy radionuclides permits highly localized delivery of radiation. Although the implant procedure has improved in recent years with the help of computerized treatment planning and image guidance techniques, significant enhancement of clinical outcome is expected from implementation of realtime intraoperative dosimetry and optimization. Intraoperative evaluation of dose delivery would permit identification of underdosed regions and remedial seed placement, thus ensuring that the entire prostate volume receive the prescribed dose. However, before the concept can be realized, the problem of real-time seed localization must be solved. This is the focus of this investigation. The specific aims of the project include development of (1) a fully automated method to segment seed images from the fluoroscopic data and (2) a fully automated method to identify individual seed positions including those that are superposed. The image segmentation will be accomplished by a region based adaptive thresholding technique. Subsequent localization of the seeds will be performed by a hierarchical decision process aided by an artificial intelligence controlled seed classifier. Website: Error! Hyperlink reference not valid. ·

Project Title: TARGETED RADIOTHERAPY FOR EWING'S SARCOMA Principal Investigator & Institution: Hawkins, Douglas S.; Children's Hospital and Reg Medical Ctr Box 5371, 4800 Sand Point Way Ne, Ms 6D-1 Seattle, Wa 98105 Timing: Fiscal Year 2002; Project Start 04-AUG-2000; Project End 31-JUL-2005 Summary: (Applicant's Description) Dr. Douglas Hawkins seeks to become a patientoriented clinical investigator committed to improving the prognosis for pediatric sarcomas by developing a bone-seeking radiopharmaceutical. The prognosis for patients with recurrent or refractory Ewing's sarcoma family of tumors (ESFT) is quite poor, particularly for those with bone metastases. Although ESFT are radiosensitive, effective treatment with radiation therapy is limited by the toxicity of standard external beam radiation therapy to normal tissues, especially when bone metastases are widespread. A strategy that targets radiation to bone while sparing non-osseous tissue could allow the delivery of radiation to bone metastases with acceptable toxicity to normal organs. Holmium-166 (Ho)-DOTMP is a beta-particle emitting radiopharmaceutical that localizes to trabecular bone, with enhanced uptake in areas of active bone turnover. Studies in animals and in patients with multiple myeloma demonstrate that Ho-166DOTMP delivers high doses of radiation to bone and bone marrow, with minimal nonhematopoietic toxicity. Dr. Hawkins will conduct a Phase I/II study of Ho-166-DOTMP in the treatment of recurrent or refractory ESFT with bone disease. The first specific aim

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of the project is to define the MTD and the range of toxicity for Ho-166-DOTMP using peripheral blood progenitor calls (PBPC) to support hematopoietic recovery. The second specific aim of the project is to determine the biodistribution and pharmacokinetics of Ho-166-DOTMP in ESFT, including estimation of the radiation dose to bone lesions. Because all patients will be required to have evaluable disease, the third specific aim of this project is to evaluate response to Ho-166-DOTMP. Once the MTD of Ho-166DOTMP is defined, the fourth specific aim is to initiate a phase II study to estimate the response rate for recurrent or refractory ESFT with bone disease and to initiate a trial incorporating Ho-166-DOTMP into myeloablative therapy for poor risk ESFT. The clinical research environment at Children's Hospital and Regional Medical Center, the University of Washington, and the Fred Hutchinson Cancer Research Center are particularly well suited to the development of his clinical investigation. Dr. Irwin Bernstein, who has extensive clinical research and training experience, will serve as Dr. Hawkins' mentor. Dr. Hawkins also proposes to take courses in radiation biology, radiation pharmacology, biostatistics, and medical ethics at the University of Washington and Children's Hospital and Regional Medical Center. Upon completion of the five-year K23 award, he anticipates having acquired a strong foundation biostatistics and radiation biology, as well as considerable experience planning and conducting clinical trials enabling him to emerge as an independent clinical investigator. Website: Error! Hyperlink reference not valid. ·

Project Title: TARGETING THERAPY OF HUMAN BREAST CANCER Principal Investigator & Institution: Fisher, Paul B.; Professor/ Chernow Research Scientist; Urology; Columbia University Health Sciences New York, Ny 10032 Timing: Fiscal Year 2002; Project Start 01-JUN-2001; Project End 31-MAY-2003 Summary: (Applicant's Description) Abnormalities in differentiation and growth control are common occurrences in human cancers. Treatment of human melanoma cells with the combination of recombinant human fibroblast interferon and the protein kinase Cactivating, antileukemic compound mezerein results in a loss of tumorigenic potential that correlates with an irreversible suppression in proliferative ability and induction of terminal differentiation. It is hypothesized that this process is associated with differential expression of genes that may directly regulate cancer cell growth and differentiation. Through the use of subtraction hybridization, we have identified a gene associated with induction of irreversible growth arrest, cancer reversion and terminal differentiation in human melanoma cells, melanoma differentiation associated gene-7 (mda-7). Ectopic expression of mda-7 using a recombinant adenovirus, Ad.mda-7 S, results in growth suppression and apoptosis in diverse cancer cell types, including tumor cells with wild-type p53 or mutant for p53, Rb or p53 + Rb. Additionally, Ad.mda-7 S inhibits the growth and progression of human breast and cervical cancer cells in vivo in nude mice. In contrast to its effect on cancer cells, mda-7 displays no apparent negative effect on growth or survival in normal human skin fibroblast or mammary epithelial cells. In this context, mda-7 may prove useful for selectively targeting human breast cancer cells for eradication. Studies will be conducted to determine the effect of Ad.mda-7 S alone, and in combination with chemotherapy or radiation, on the in vitro and in vivo growth in nude mice of human breast cancers. Subtraction hybridization has also been used to clone a gene directly associated with cancer progression, progression elevated gene-3 (PEG-3). Genomic walking permitted the isolation of the promoter region of the PEG-3 gene, PEG-Prom. PEG-Prom-luciferase reporter constructs display high-levels of activity in human cancer cells, including breast cancer cells, and low or no activity in normal human cells. We propose to construct

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cancer inhibitory recombinant adenoviruses (CIRAs) utilizing the PEG-Prom to control expression of indicator genes [luciferase and green fluorescence protein (GFP)] and genes that induce growth suppression, apoptosis or toxicity [mda-7, wild-type p53 or the herpes simplex virus thymidine kinase gene (HSV-TK)]. These viruses will be used to determine if the PEG-Prom can specifically target the expression of genes to human breast carcinoma cells. If successful, this approach, termed CURE (cancer utilized reporter execution), could provide a novel means of therapy for human breast cancer without inducing nonspecific damage to normal tissues. Website: Error! Hyperlink reference not valid. ·

Project Title: THE LATE EFFECTS OF NORMAL TISSUE (LENT) IV CONFERENCE Principal Investigator & Institution: Trotti, Andrea; Associate Professor; Interdisciplinary Oncology Prg; University of South Florida 4202 E Fowler Ave Tampa, Fl 33620 Timing: Fiscal Year 2002; Project Start 10-APR-2002; Project End 31-MAR-2003 Summary: (Provided by applicant): The Late Effects of Normal Tissue (LENT) conferences are a succession of meetings held over the past two decades with the ultimate goal of developing a systematic and reproducibly effective scoring systems and approaches to the management of the chronic adverse consequences of cancer therapy. The LENT conferences have had, and continue to have, international cooperation and major impact on protocol design in the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). The importance of accurately assessing chronic toxicity is even more obvious with the introduction of new therapeutic techniques with delivery of very high, intensely concentrated doses in very short times (e.g. conformal radiation therapy, radiosurgery, radionuclide therapy, high-dose rate brachytherapy, intensity-modulated radiation therapy), and the aggressive integration of chemotherapy, radiation therapy, and biologic response modifiers. The era of molecular biology, which is permitting the exploration of cytokine and gene therapy, further stresses the critical need to accurately determine therapeutic ratios. Thus there is a pressing need to refine protocols which will complete validation of the LENT scales. With respect to the pediatric and young adult (20 years) population, chronic normal tissue damage is clearly a critical consequence of successful cancer therapy. Such late effects impact on the quality of life, and in part determine the aggressiveness of therapy. Pediatric late effects assume increased importance due to the potential life span of survivors, and the sensitivity of developing normal tissues to cytotoxic therapy. The goals of LENT Consensus Conference IV will be multiple and focus on (i) validating the effectiveness of scales defined in previous LENT conferences, (ii) extending LENT Scales to include molecular biomarkers of normal tissue damage, and (iii) modifying LENT scales for application to the PEDIATRIC population. In addition, it is now possible to discuss the (iv) development of predictive assays and interventions for normal tissue damage with precise assessments of their efficacy. These are achieved with the aid of the accurate grading of therapy-induced toxicities that grew out of the previous LENT conferences and the subsequently completed clinical and laboratory studies with (v) proper statistical analysis. The proposed date of the conference is 10/29/2001 to 11/1/2001. Website: Error! Hyperlink reference not valid.

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·

Project Title: THERMALLY BIOPOLYMERS

TARGETED

DRUG

DELIVERY

BY

ELASTIN

Principal Investigator & Institution: Chilkoti, Ashutosh; Associate Professor; Biomedical Engineering; Duke University Durham, Nc 27706 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2006 Summary: The objective of the proposed research is to selectively deliver systemically injected radionuclides to solid tumors by a thermal targeting strategy. This objective will be achieved by conjugating radionuclides (131I and 211 At) to thermally sensitive polypeptide carriers, which will be targeted to solid tumors by focused hyperthermia of the tumor. The thermally responsive macromolecular carriers used for thermal targeting are polypeptides derived from mammalian elastin, composed of Val-Pro- Gly-Xaa-Gly (VPGXG) repeats, which undergo an inverse phase transition; below their inverse transition temperature (Tt), ELPs are highly soluble, but when the temperature is raised above their Tt, they undergo a phase transition within a 2-3 degrees Celsius range, leading to desolvation and aggregation of the polypeptide. The underlying hypothesis of the proposed research is that intravenously injected radionuclides, conjugated to a temperature-responsive ELP, can be designed such that they will selectively accumulate in the tumor, maintained at 42 degrees Celsius by local hyperthermia due to aggregation of the ELP in response to its phase transition. In preliminary research, we have demonstrated that thermal targeting provides a 2-3 fold increase in tumor localization versus non-heated controls and a approximately 2 fold enhancement with respect to a thermally insensitive control ELP in heated human tumor xenografts implanted in athymic mice. We propose the following specific aims to achieve the objectives of this proposal: (1) to synthesize ELPs with a Tt of 40 degrees Celsius by recombinant DNA methods; (2) to conjugate radionuclides to the ELPs; (3) to optimize the thermally targeted delivery of ELPs to human tumor xenografts implanted in athymic mice; (4) to carry out systemic radionuclide therapy with 211 At-labeled ELPs using the optimized protocols and external hyperthermia of solid tumors. The development of thermally responsive radionuclide-ELP conjugates that can be targeted to solid tumors by externally-induced local hyperthermia is a new paradigm for targeted delivery which directly targets the tumor microvasculature and circumvents the barriers associated with the interstitium and antibody-tumor cell surface antigen/receptor binding that are intrinsic to affinity targeting approaches for radionuclide therapy. Website: Error! Hyperlink reference not valid. ·

Project Title: TUMOR RADIORESPONSE

OXYGENATION,

VASCULARIZATION,

AND

Principal Investigator & Institution: Fenton, Bruce M.; Associate Professor; Radiation Oncology; University of Rochester Orpa - Rc Box 270140 Rochester, Ny 14627 Timing: Fiscal Year 2002; Project Start 01-APR-1992; Project End 31-JUL-2004 Summary: Inhibition of tumor angiogenesis has emerged as a promising strategy to treat both primary and metastatic tumors. Although effective at shrinking tumors, antiangiogenic agents are not tumoricidal, and tumor regrowth frequently occurs after termination of treatment with the angiogenesis inhibitor. One strategy to overcome this limitation is to combine antiangiogenic agents with conventional therapies such as radiotherapy, although the underlying physiological rationale for such combinations remains unexplored. The primary focus of this proposal is to explore both physiological and molecular changes following both antiangiogenic and angiogenic stimuli. Although established, transplantable murine tumor models have long been the standard for

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radiobiological investigations, the dependence of physiological function on tumor derivation remains uncertain. Differences in vascular development, specifically in regards to relative proportions of host versus tumor vessels, could be vital in the evaluation of antiangiogenic and combined modality, preclinical strategies. The current application proposes to examine tumor microregional changes in vascular structure and hypoxia, in conjunction with alterations in angiogenic and antiangiogenic growth factor expression, among a panel of carefully chosen murine tumor models. First, spontaneous mammary carcinomas will be contrasted with slow and fast growing 1st generation transplants of these tumors. Second, nonmetastatic MCa-IV versus aggressive, metastatic MCa-35 established mammary carcinoma models will be studied. Our methods include: a) cryospectrophotometry to define intravascular oxygen levels, b) immunohistochemical staining to quantify total and perfused vessels, tumor cell proliferation, apoptosis, and percent necrosis, c) immunohistochemistry, in situ hybridization, and RNA protection assays to quantify growth factor and receptor levels, d) hypoxic marker uptake (EF5) to delineate regional changes in oxygenation, and e) growth delay assays to evaluate response to single and multi-fraction radiotherapy, as well as antiangiogenic agents. In view of an increasing interest in the use of multimodality therapies that incorporate potentially angiogenic and antiangiogenic agents, this proposal will quantitate the effects of both angiogenic growth factors (VEGF and FGF2) and antiangiogenic agents (endostatin). Endostatin will also be combined with radiotherapy to determine whether the radiation is potentiated by the antiangiogenic agent. In summary, our primary goals are to determine the fundamental relationships between molecular and pathophysiological changes in disparate tumor models and whether observed differences can be therapeutically exploited. Website: Error! Hyperlink reference not valid. ·

Project Title: ULTRASOUND IMAGE GUIDED STEREOTACTIC NAVIGATIONAL SYSTEM Principal Investigator & Institution: Lattanzi, Joseph P.; Community Medical Center 99 Highway 37 W Toms River, Nj 08755 Timing: Fiscal Year 2003; Project Start 14-JUN-2001; Project End 31-MAY-2004 Summary: (Applicant's Description) A major advance in the delivery of external beam therapy for prostate cancer has been the development of three-dimensional conformal therapy (3DCRT). Reducing the irradiated normal tissue volume with 3DCRT translates into fewer treatment-related complications. Furthermore, dose escalation studies from multiple institutions have demonstrated that higher doses of external beam radiation achievable with current 3DCRT techniques improve the biochemical cure rate by 20 percent-40 percent in selected prostate cancer patients. The data also suggest that a dose plateau has not yet been reached. Innovative refinements in the conformal technique which can enhance the therapeutic ratio by improving target identification and reducing treatment margins will reduce morbidity at current dose levels and ultimately facilitate further improvement in the cancer control rate in the high risk population. One factor, which limits our ability to take full advantage of closely tailored field arrangements, is the problem of target localization and tracking during treatment. Real time correction of patient positioning and internal organ motion errors by ultrasound image guidance and infrared navigational tracking is a novel approach to achieve treatment margin reduction. An infrared sensor driven navigational system utilized in conjunction with a rigid extracranial body frame immobilizer is under development to link the initial CT simulation image to a real time ultrasound prostate image. Automated image registration of the baseline CT and ultrasound will detect any isocenter misalignment

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and this information may then be electronically transferred to the treatment couch for automated correction. The purpose of this project is twofold: 1/Perform precision validation studies using a CI standard. 2/Complete a phase III randomized trial to assess the expected reduction in complications achievable with ultrasound-guided precision 3D conformal external beam radiation therapy. Website: Error! Hyperlink reference not valid. ·

Project Title: USE OF RADIATION IN STAGE IV NON-SMALL CELL LUNG CANCER Principal Investigator & Institution: Hayman, James A.; Assistant Professor; Radiation Oncology; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 31-MAR-2004 Summary: (provided by applicant): The primary objective of this project is to examine factors associated with the utilization of radiation therapy in a sample of patients with Stage IV (i.e., metastatic) non-small cell lung cancer diagnosed in selected regions of the U.S. during a period ranging from 1991 to 1996. Anecdotal reports suggest that the use of radiation therapy to palliate symptoms associated with metastatic cancer is common and that there may be substantial variation in the intensity of treatment (i.e., number of treatments). This has important cost and quality implications because studies published over the last decade suggest that shorter courses of radiation treatment may be as effective as longer courses. Although this remains controversial in the U.S., as early as 1994 clinical guidelines in the U.S. began to endorse shorter courses of therapy. We propose to use the population-based linked SEER-Medicare data set to examine patterns and determinants of the utilization of palliative radiation therapy in patients age 65 or greater diagnosed with metastatic non-small cell lung cancer between 1991 and 1996. Created by researchers at the National Cancer Institute, this data set contains clinical data on almost all patients aged 65 and older diagnosed with cancer in the eleven SEER regions that have been linked to their respective Medicare claims data. Specifically, we plan to use SEER data to identify incident cases of metastatic non-small cell lung cancer and then use the Medicare claims data to identify those patients who received radiation therapy and quantify the intensity with which they were treated. We then propose to use this information to identify factors associated with the use and intensity of treatment with radiation including patient predisposing/enabling factors, clinical factors, organizational factors and physician factors. Lastly, we plan to examine whether the frequency and intensity of the administration of treatment with palliative radiation in this patient population has changed over time. Website: Error! Hyperlink reference not valid.

·

Project Title: VIRAL AND MOLECULAR CHEMOTHERAPY OF MALIGNANT CNS TUMORS Principal Investigator & Institution: Buchsbaum, Donald J.; Professor; University of Alabama at Birmingham Uab Station Birmingham, Al 35294 Timing: Fiscal Year 2002; Project Start 05-SEP-2002; Project End 31-MAY-2007 Summary: This multi-disciplinary group of investigators has several years' experience working together designing and characterizing viral vector approaches to gene therapy of malignant brain tumors. A major focus has been producing and testing both nonreplicative and replicative adenovirus (Ad) and conditionally replicative herpes simplex virus (HSV) vectors that express foreign gene products within infected tumor cells.

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These studies have been conducted at both the in vitro and in vivo levels to demonstrate proof-of-principle, safety and efficacy in experimental mouse models of intracranial gliomas. We have conducted Phase I and III clinical trials using retrovirus, Ad and HSV administered intratumorally in patients with malignant gliomas. In keeping with the translational theme of this SPORE application, this project seeks to design and deploy effective viral vector therapies of malignant glioma by utilizing rational combinations of foreign gene-viral vectors, oncolytic virus and irradiation., defined by additive, synergistic or antagonistic interactions determined for these various modalities. Aim 1 seeks to optimize the timing and dose of irradiation to achieve greater viral replication and spread and/or enhanced foreign gene expression in glioma cells and in intracranial experimental gliomas. In athymic nude mice. Aim 2 will develop and characterize both replicative HSV and replicative Ad that expression the pro-drug converting enzyme cytosine deaminase and optimize its use in intracranial preclinical models of malignant gliomas in combination with systemic 5-fluorocytosine. Other genetic constructs (uracil phosphoribosyl transferase) and drugs (dihydropyrimidine inhibitors) that facilitate appropriate 5-FU incorporation into host cell DNA synthesis pathways will also be tested to improve the therapeutic effect. Further, the radiation sensitization properties of certain pro-drugs products (5-FU) will be characterized to achieve a greater anti-glioma effect. Aim 3 will combine findings in Aims 1 and 2 to design and test strategies that rationally combine intratumoral viral vector injection, systemic pro-drug administration and low dose external beam irradiation to achieve the most effective and safe antiglioma therapy (ies). Aim 4 will translate our findings in preclinical models for brain tumor therapy into pilot, Phase I and Phase II clinical trials in patients with malignant gliomas. Website: Error! Hyperlink reference not valid. ·

Project Title: WUMC-CANCER AND LEUKEMIA GROUP B Principal Investigator & Institution: Bartlett, Nancy L.; Internal Medicine; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2003; Project Start 08-MAY-1998; Project End 31-MAR-2009 Summary: (adapted from the applicant's abstract): Washington University has been a CALGB main member institution since 1986. Over the last five years, the cancer research program at the Washington University Medical Center (WUMC) has experienced tremendous growth. Barnes-Jewish Hospital, the largest hospital in St. Louis, diagnoses more than 5,400 patients a year with cancer and remains the major referral center for southeast Missouri and southern Illinois. The Siteman Cancer Center (SCC) at WUMC received NCI-designated Cancer Center status in August 2001. The infrastructure developed by the SCC to compete successfully for the NCI Cancer Center Support Grant has significantly enhanced our ability to carry out all aspects of clinical cancer research, including cooperative group trials. Our recent efforts to expand institutional research studies will significantly enhance our ability to contribute concepts to CALGB during the next grant cycle, specifically in the areas of Hematologic malignancies, thoracic oncology, and pharmacogenomics. Between 1998 and 2002, 16 Washington University physicians and research assistants served on 36 different CALGB scientific and administrative committees. WUMC investigators chaired 12 CALGB studies, including Phase II studies in non-Hodgkin's lymphoma, Hodgkin's lymphoma, prostate cancer, mesothelioma, and several pharmacokinetic and pharmacogenomic correlative science studies. Six additional studies are in the final stages of development. Accrual to CALGB trials has continued to increase during this grant period, with an average of 183 patients per year registered to therapeutic and non-therapeutic trials from 1998 to 2001. Accrual

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to therapeutic trials increased from 61 patients in 1998 to 105 in 2001. Based on registrations to date, projected accrual to CALGB trials for 2002 is estimated to be 312, with 136 to therapeutic studies. Plans for the next grant cycle include 1) continued involvement by all current WUMC investigators, 2) increased participation by our Phase I investigators to facilitate development of Phase II studies within CALGB, 3) involvement of at least five additional WUMC investigators in CALGB activities including faculty interested in GU oncology, quality of life, stem cell transplant and leukemia, leukemia correlative sciences, and radiation oncology, and 5) continued efforts to increase accruals, particularly minority accruals, to CALGB trials. Website: Error! Hyperlink reference not valid.

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “radiation therapy” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for radiation therapy in the PubMed Central database: ·

Bad reporting does not mean bad methods for randomised trials: observational study of randomised controlled trials performed by the Radiation Therapy Oncology Group. by Soares HP, Daniels S, Kumar A, Clarke M, Scott C, Swann S, Djulbegovic B.; 2004 Jan 3; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=313900

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Biological-effective versus conventional dose volume histograms correlated with late genitourinary and gastrointestinal toxicity after external beam radiotherapy for prostate cancer: a matched pair analysis. by Jani AB, Hand CM, Pelizzari CA, Roeske JC, Krauz L, Vijayakumar S.; 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=156635

·

Clinical practice guidelines for the care and treatment of breast cancer: breast radiotherapy after breast-conserving surgery (summary of the 2003 update). by Whelan T, Olivotto I, Levine M.; 2003 Feb 18; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=143551

·

Combined effects of radiotherapy and angiostatin gene therapy in glioma tumor model. by Griscelli F, Li H, Cheong C, Opolon P, Bennaceur-Griscelli A, Vassal G, Soria J, Soria C, Lu H, Perricaudet M, Yeh P.; 2000 Jun 6; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=18707

3 4

Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.

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Copper-64-diacetyl-bis(N 4-methylthiosemicarbazone): An agent for radiotherapy. by Lewis JS, Laforest R, Buettner TL, Song SK, Fujibayashi Y, Connett JM, Welch MJ.; 2001 Jan 30; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=14733

·

Immediate versus delayed palliative thoracic radiotherapy in patients with unresectable locally advanced non-small cell lung cancer and minimal thoracic symptoms: randomised controlled trial. by Falk SJ, Girling DJ, White RJ, Hopwood P, Harvey A, Qian W, Stephens RJ.; 2002 Aug 31; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=119441

·

Influence of local radiotherapy on penetration of fluconazole into human saliva. by Oliary J, Tod M, Louchahi K, Petitjean O, Frachet B, Le Gros V, Brion N.; 1993 Dec; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=192775

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Intraoperative radiation therapy (IORT) for previously untreated malignant gliomas. by Nemoto K, Ogawa Y, Matsushita H, Takeda K, Takai Y, Yamada S, Kumabe T.; 2002; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=65041

·

Mortality from cardiovascular disease more than 10 years after radiotherapy for breast cancer: nationwide cohort study of 90 000 Swedish women. by Darby S, McGale P, Peto R, Granath F, Hall P, Ekbom A.; 2003 Feb 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=140764

·

Pretarget radiotherapy with an anti-CD25 antibody-streptavidin fusion protein was effective in therapy of leukemia /lymphoma xenografts. by Zhang M, Zhang Z, Garmestani K, Schultz J, Axworthy DB, Goldman CK, Brechbiel MW, Carrasquillo JA, Waldmann TA.; 2003 Feb 18; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=149929

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The Use of Medical Images in Planning and Delivery of Radiation Therapy. by Kalet IJ, Austin-Seymour MM.; 1997 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=61250

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The use of preoperative radiotherapy in the management of patients with clinically resectable rectal cancer: a practice guideline. by Figueredo A, Zuraw L, Wong RK, Agboola O, Rumble RB, Tandan V.; 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=281590

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Theoretic Considerations regarding Low-Dose Radiation Therapy for Prevention of Restenosis after Angioplasty. by Dawson JT Jr.; 1991; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=324954

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Waiting Lists for Radiation Therapy: A Case Study. by D'Souza DP, Martin DK, Purdy L, Bezjak A, Singer PA.; 2001; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=32176

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction

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The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with radiation therapy, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “radiation therapy” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for radiation therapy (hyperlinks lead to article summaries): ·

A clinical trial of breast radiation therapy versus breast plus regional radiation therapy in early-stage breast cancer: the MA20 trial. Author(s): Olivotto IA, Chua B, Elliott EA, Parda DS, Pierce LJ, Shepherd L, Vallow LA, White JR, Whelan TJ. Source: Clinical Breast Cancer. 2003 December; 4(5): 361-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14715112

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A prospective longitudinal study comparing the impact of external radiation therapy with radical prostatectomy on health related quality of life (HRQOL) in prostate cancer patients. Author(s): van Andel G, Visser AP, Zwinderman AH, Hulshof MC, Horenblas S, Kurth KH. Source: The Prostate. 2004 March 1; 58(4): 354-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14968436

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A systematic overview of radiation therapy effects in brain tumours. Author(s): Berg G, Blomquist E, Cavallin-Stahl E. Source: Acta Oncologica (Stockholm, Sweden). 2003; 42(5-6): 582-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14596516

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A systematic overview of radiation therapy effects in breast cancer. Author(s): Rutqvist LE, Rose C, Cavallin-Stahl E. Source: Acta Oncologica (Stockholm, Sweden). 2003; 42(5-6): 532-45. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14596511

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A systematic overview of radiation therapy effects in cervical cancer (cervix uteri). Author(s): Einhorn N, Trope C, Ridderheim M, Boman K, Sorbe B, Cavallin-Stahl E. Source: Acta Oncologica (Stockholm, Sweden). 2003; 42(5-6): 546-56. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14596512

with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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A systematic overview of radiation therapy effects in Hodgkin's lymphoma. Author(s): Gustavsson A, Osterman B, Cavallin-Stahl E. Source: Acta Oncologica (Stockholm, Sweden). 2003; 42(5-6): 589-604. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14596517

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A systematic overview of radiation therapy effects in non-Hodgkin's lymphoma. Author(s): Gustavsson A, Osterman B, Cavallin-Stahl E. Source: Acta Oncologica (Stockholm, Sweden). 2003; 42(5-6): 605-19. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14596518

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A systematic overview of radiation therapy effects in non-small cell lung cancer. Author(s): Sirzen F, Kjellen E, Sorenson S, Cavallin-Stahl E. Source: Acta Oncologica (Stockholm, Sweden). 2003; 42(5-6): 493-515. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14596509

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A systematic overview of radiation therapy effects in oesophageal cancer. Author(s): Ask A, Albertsson M, Jarhult J, Cavallin-Stahl E. Source: Acta Oncologica (Stockholm, Sweden). 2003; 42(5-6): 462-75. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14596507

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A systematic overview of radiation therapy effects in ovarian cancer. Author(s): Einhorn N, Trope C, Ridderheim M, Boman K, Sorbe B, Cavallin-Stahl E. Source: Acta Oncologica (Stockholm, Sweden). 2003; 42(5-6): 562-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14596514

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A systematic overview of radiation therapy effects in rectal cancer. Author(s): Glimelius B, Gronberg H, Jarhult J, Wallgren A, Cavallin-Stahl E. Source: Acta Oncologica (Stockholm, Sweden). 2003; 42(5-6): 476-92. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14596508

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A systematic overview of radiation therapy effects in skeletal metastases. Author(s): Falkmer U, Jarhult J, Wersall P, Cavallin-Stahl E. Source: Acta Oncologica (Stockholm, Sweden). 2003; 42(5-6): 620-33. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14596519

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A systematic overview of radiation therapy effects in soft tissue sarcomas. Author(s): Strander H, Turesson I, Cavallin-Stahl E. Source: Acta Oncologica (Stockholm, Sweden). 2003; 42(5-6): 516-31. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14596510

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A systematic overview of radiation therapy effects in urinary bladder cancer. Author(s): Widmark A, Flodgren P, Damber JE, Hellsten S, Cavallin-Stahl E. Source: Acta Oncologica (Stockholm, Sweden). 2003; 42(5-6): 567-81. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14596515

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A systematic overview of radiation therapy effects in uterine cancer (corpus uteri). Author(s): Einhorn N, Trope C, Ridderheim M, Boman K, Sorbe B, Cavallin-Stahl E. Source: Acta Oncologica (Stockholm, Sweden). 2003; 42(5-6): 557-61. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14596513

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Amifostine and external beam radiation therapy and/or high-dose rate brachytherapy in the treatment of localized prostate carcinoma: preliminary results of a phase II trial. Author(s): Linares LA, Echols D. Source: Seminars in Oncology. 2003 December; 30(6 Suppl 18): 58-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14727241

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An application framework for computer-aided patient positioning in radiation therapy. Author(s): Liebler T, Hub M, Sanner C, Schlegel W. Source: Medical Informatics and the Internet in Medicine. 2003 September; 28(3): 161-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14612305

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An integrated two-level hierarchical system for decision making in radiation therapy based on fuzzy cognitive maps. Author(s): Papageorgiou EI, Stylios CD, Groumpos PP. Source: Ieee Transactions on Bio-Medical Engineering. 2003 December; 50(12): 1326-39. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14656062

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Assessment of geometrical accuracy of magnetic resonance images for radiation therapy of lung cancers. Author(s): Koch N, Liu HH, Olsson LE, Jackson EF. Source: Journal of Applied Clinical Medical Physics [electronic Resource] / American College of Medical Physics. 2003 Autumn; 4(4): 352-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14604425

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Australian prostate-specific antigen outcome and toxicity following radiation therapy for localized prostate cancer. Author(s): Kneebone A, Turner S, Berry M, Cakir B, Gebski V. Source: Australasian Radiology. 2003 December; 47(4): 422-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14641196

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Bad reporting does not mean bad methods for randomised trials: observational study of randomised controlled trials performed by the Radiation Therapy Oncology Group. Author(s): Soares HP, Daniels S, Kumar A, Clarke M, Scott C, Swann S, Djulbegovic B; Radiation Therapy Oncology Group. Source: Bmj (Clinical Research Ed.). 2004 January 3; 328(7430): 22-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14703540

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Balloon-based radiation therapy for treatment of in-stent restenosis in human coronary arteries: results from the BRITE I study. Author(s): Waksman R, Buchbinder M, Reisman M, Lansky AJ, Trauthen B, Whiting J, Li A. Source: Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions. 2002 November; 57(3): 286-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12410499

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Beam configurations for 3D tomographic intensity modulated radiation therapy. Author(s): Levine RY, Braunstein M. Source: Physics in Medicine and Biology. 2002 March 7; 47(5): 765-87. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11931470

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Beam orientation selection for intensity-modulated radiation therapy based on target equivalent uniform dose maximization. Author(s): Das S, Cullip T, Tracton G, Chang S, Marks L, Anscher M, Rosenman J. Source: International Journal of Radiation Oncology, Biology, Physics. 2003 January 1; 55(1): 215-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12504056

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Beta-radiation therapy for long lesions in native coronary vessels: a matched comparison between de novo and in-stent restenotic lesions. Author(s): Stankovic G, Orlic D, Di Mario C, Corvaja N, Airoldi F, Chieffo A, Amato A, Orecchia R, Colombo A. Source: Cardiovascular Radiation Medicine. 2003 January-March; 4(1): 18-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12892768

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Beyond bixels: generalizing the optimization parameters for intensity modulated radiation therapy. Author(s): Markman J, Low DA, Beavis AW, Deasy JO. Source: Medical Physics. 2002 October; 29(10): 2298-304. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12408304

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Biliary stricture as a possible late complication of radiation therapy. Author(s): Nakakubo Y, Kondo S, Katoh H, Shimizu M. Source: Hepatogastroenterology. 2000 November-December; 47(36): 1531-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11148994

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Biochemical failure rates in prostate cancer patients predicted to have biologically insignificant tumors treated with three-dimensional conformal radiation therapy. Author(s): Kramer NM, Hanlon AL, Horwitz EM, Pinover WH, Hanks GH. Source: International Journal of Radiation Oncology, Biology, Physics. 2002 June 1; 53(2): 277-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12023130

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Biochemical outcome after radical prostatectomy or external beam radiation therapy for patients with clinically localized prostate carcinoma in the prostate specific antigen era. Author(s): D'Amico AV, Whittington R, Malkowicz SB, Cote K, Loffredo M, Schultz D, Chen MH, Tomaszewski JE, Renshaw AA, Wein A, Richie JP. Source: Cancer. 2002 July 15; 95(2): 281-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12124827

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Biologic premises of combined radiation therapy and chemotherapy in lung cancer. Author(s): Shibamoto Y, Jeremic B. Source: Hematology/Oncology Clinics of North America. 2004 February; 18(1): 29-40. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15005279

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Biological response to radiation therapy. Author(s): Turesson I, Carlsson J, Brahme A, Glimelius B, Zackrisson B, Stenerlow B; Swedish Cancer Society Investigation Group. Source: Acta Oncologica (Stockholm, Sweden). 2003; 42(2): 92-106. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12801128

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Biological weighting of absorbed dose in radiation therapy. Author(s): Wambersie A, Menzel HG, Gahbauer RA, Jones DT, Michael BD, Paretzke H. Source: Radiat Prot Dosimetry. 2002; 99(1-4): 445-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12194351

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Biologically optimized 3-dimensional in vivo predictive assay-based radiation therapy using positron emission tomography-computerized tomography imaging. Author(s): Brahme A. Source: Acta Oncologica (Stockholm, Sweden). 2003; 42(2): 123-36. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12801131

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Bisphosphonates and radiation therapy for palliation of metastatic bone disease. Author(s): Hoskin PJ. Source: Cancer Treatment Reviews. 2003 August; 29(4): 321-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12927572

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Brachytherapy for recurrent prostate cancer after radiation therapy. Author(s): Beyer DC. Source: Seminars in Radiation Oncology. 2003 April; 13(2): 158-65. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12728445

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Breast MR imaging during or soon after radiation therapy. Author(s): Morakkabati N, Leutner CC, Schmiedel A, Schild HH, Kuhl CK. Source: Radiology. 2003 December; 229(3): 893-901. Epub 2003 October 30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14593189

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Breast-conserving surgery following radiation therapy of 50 Gy in stages I and II carcinoma of the breast: the experience at one institute in Japan. Author(s): Horiguchi J, Koibuchi Y, Takei H, Yokoe T, Yamakawa M, Nakajima T, Oyama T, Iino Y, Morishita Y. Source: Oncol Rep. 2002 September-October; 9(5): 1053-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12168072

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Breast-conserving therapy for ductal carcinoma in situ: a 20-year experience with excision plus radiation therapy. Author(s): Nakamura S, Woo C, Silberman H, Streeter OE, Lewinsky BS, Silverstein MJ. Source: American Journal of Surgery. 2002 November; 184(5): 403-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12433602

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Breast-conserving therapy with adjuvant paclitaxel and radiation therapy: feasibility of concurrent treatment. Author(s): Ellerbroek N, Martino S, Mautner B, Tao ML, Rose C, Botnick L. Source: The Breast Journal. 2003 March-April; 9(2): 74-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12603378

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Bronchoalveolar lavage in bronchiolitis obliterans organizing pneumonia primed by radiation therapy to the breast. Author(s): Majori M, Poletti V, Curti A, Corradi M, Falcone F, Pesci A. Source: The Journal of Allergy and Clinical Immunology. 2000 February; 105(2 Pt 1): 239-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10669842

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Can post-RT neck dissection be omitted for patients with head-and-neck cancer who have a negative PET scan after definitive radiation therapy? Author(s): Rogers JW, Greven KM, McGuirt WF, Keyes JW Jr, Williams DW 3rd, Watson NE, Geisinger K, Cappellari JO. Source: International Journal of Radiation Oncology, Biology, Physics. 2004 March 1; 58(3): 694-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14967422

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Cataract surgery and intraocular lens implantation in a retinoblastoma case treated by external-beam radiation therapy. Author(s): Bhattacharjee H, Bhattacharjee K, Chakraborty D, Talukdar M, Das D. Source: Journal of Cataract and Refractive Surgery. 2003 September; 29(9): 1837-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14522312

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Children undergoing repeated exposures for radiation therapy do not develop tolerance to propofol: clinical and bispectral index data. Author(s): Keidan I, Perel A, Shabtai EL, Pfeffer RM. Source: Anesthesiology. 2004 February; 100(2): 251-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14739796

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Clinical investigation: Reliability and validity of the Japanese version of quality of life radiation therapy instrument (QOL-RTI) for Japanese patients with head and neck malignancies. Author(s): Karasawa K, Sasaki T, Okawa T, Takahashi T, Hayakawa K, Ohizumi Y, Tamaki Y, Makino M, Kobyashi M, Shibayama C, Saitou T, Johnson DJ. Source: J Oncol Manag. 2003 March-April; 12(2): 18-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12699112

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Clinical outcome and cosmesis in African-American patients treated with conservative surgery and radiation therapy. Author(s): Tuamokumo NL, Haffty BG. Source: Cancer Journal (Sudbury, Mass.). 2003 July-August; 9(4): 313-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12967142

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Clinical physics, applicator choice, technique, and equipment for electron intraoperative radiation therapy. Author(s): Biggs PJ, Noyes RD, Willett CG. Source: Surg Oncol Clin N Am. 2003 October; 12(4): 899-924. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14989123

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Clinical research in pancreatic cancer: the Radiation Therapy Oncology Group trials. Author(s): Willett CG, Safran H, Abrams RA, Regine WF, Rich TA; Gastrointestinal Committee of the Radiation Therapy Oncology Group. Source: International Journal of Radiation Oncology, Biology, Physics. 2003; 56(4 Suppl): 31-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12826249

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Clinical utility of percent-positive prostate biopsies in predicting biochemical outcome after radical prostatectomy or external-beam radiation therapy for patients with clinically localized prostate cancer. Author(s): D'Amico AV, Whittington R, Malkowicz SB, Schultz D, Silver B, Henry L, Hurwitz M, Kaplan I, Beard CJ, Tomaszewski JE, Renshaw AA, Wein A, Richie JP. Source: Molecular Urology. 2000 Fall; 4(3): 171-5; Discussion 177. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11062371

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Comparable outcomes of radiation therapy without high-dose methotrexate for patients with primary central nervous system lymphoma. Author(s): Ishikawa H, Hasegawa M, Tamaki Y, Hayakawa K, Akimoto T, Sakurai H, Mitsuhashi N, Niibe H, Tamura M, Nakano T. Source: Japanese Journal of Clinical Oncology. 2003 September; 33(9): 443-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14594937

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Comparison of conformal radiation therapy techniques within the dynamic radiotherapy project 'Dynarad'. Author(s): Mavroidis P, Lind BK, Van Dijk J, Koedooder K, De Neve W, De Wagter C, Planskoy B, Rosenwald JC, Proimos B, Kappas C, Claudia D, Benassi M, Chierego G, Brahme A. Source: Physics in Medicine and Biology. 2000 September; 45(9): 2459-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11008949

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Complications associated with selective high-dose intraarterial cisplatin and concomitant radiation therapy for advanced head and neck cancer. Author(s): Gemmete JJ. Source: Journal of Vascular and Interventional Radiology : Jvir. 2003 June; 14(6): 743-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12817041

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Computer verification of fluence map for intensity modulated radiation therapy. Author(s): Xing L, Li JG. Source: Medical Physics. 2000 September; 27(9): 2084-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11011737

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Concurrent carboplatin with pelvic radiation therapy in the primary treatment of cervix cancer. Author(s): Higgins RV, Naumann WR, Hall JB, Haake M. Source: Gynecologic Oncology. 2003 June; 89(3): 499-503. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12798718

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Concurrent radiation therapy and irinotecan in stage IIIB cervical cancer. Author(s): Suntornpong N, Pattaranutaporn P, Chanslip Y, Thephamongkhol K. Source: J Med Assoc Thai. 2003 May; 86(5): 430-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12859099

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Conformal radiation therapy for liver metastasis of esophageal carcinoma. Author(s): Ikeda Y, Niimi M, Kan S, Shatari T, Takami H, Kodaira S. Source: Hepatogastroenterology. 2003 March-April; 50(50): 532-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12749266

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Conservative surgery and radiation therapy for early stage breast cancer after previous mantle radiation for Hodgkin's disease. Author(s): Aref I, Cross P. Source: The British Journal of Radiology. 2000 August; 73(872): 905-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11026871

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COX-2 inhibitors and cancer therapeutics: potential roles for inhibitors of COX-2 in combination with cytotoxic therapy: reports from a symposium held in conjunction with the Radiation Therapy Oncology Group June 2001 Meeting. Author(s): Dicker AP. Source: American Journal of Clinical Oncology : the Official Publication of the American Radium Society. 2003 August; 26(4): S46-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12902855

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Current and future strategies in radiotherapy of childhood low-grade glioma of the brain. Part I: Treatment modalities of radiation therapy. Author(s): Kortmann RD, Timmermann B, Taylor RE, Scarzello G, Plasswilm L, Paulsen F, Jeremic B, Gnekow AK, Dieckmann K, Kay S, Bamberg M. Source: Strahlentherapie Und Onkologie : Organ Der Deutschen Rontgengesellschaft. [et Al]. 2003 August; 179(8): 509-20. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14509949

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Cutaneous angiosarcoma as a delayed complication of radiation therapy for carcinoma of the breast. Author(s): Rao J, Dekoven JG, Beatty JD, Jones G. Source: Journal of the American Academy of Dermatology. 2003 September; 49(3): 532-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12963926

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Cytoprotection/radioprotection with amifostine: potential role in cervical cancer and early findings in the Radiation Therapy Oncology Group C-0116 trial. Author(s): Small W Jr; Radiation Therapy Oncology Group C-0116 trial. Source: Seminars in Oncology. 2003 December; 30(6 Suppl 18): 68-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14727243

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Debulking does not benefit patients undergoing intracoronary beta-radiation therapy for in-stent restenosis: insights from the START trial. Author(s): Bass TA, Gilmore P, Zenni M, Sasseen B, Savage M, Bonan R, Laskey W, Popma JJ, Costa MA. Source: Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions. 2003 March; 58(3): 331-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12594697

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Decision-analytic model and cost-effectiveness evaluation of postmastectomy radiation therapy in high-risk premenopausal breast cancer patients. Author(s): Lee JH, Glick HA, Hayman JA, Solin LJ. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2002 June 1; 20(11): 2713-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12039934

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Decreased local control following radiation therapy alone in early-stage glottic carcinoma with anterior commissure extension. Author(s): Zouhair A, Azria D, Coucke P, Matzinger O, Bron L, Moeckli R, Do HP, Mirimanoff RO, Ozsahin M. Source: Strahlentherapie Und Onkologie : Organ Der Deutschen Rontgengesellschaft. [et Al]. 2004 February; 180(2): 84-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14762660

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Defining the optimal radiation dose with three-dimensional conformal radiation therapy for patients with nonmetastatic prostate carcinoma by using recursive partitioning techniques. Author(s): Horwitz EM, Hanlon AL, Pinover WH, Anderson PR, Hanks GE. Source: Cancer. 2001 September 1; 92(5): 1281-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11571744

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Desmoid tumour of the neck: complete regression following radiation therapy. Author(s): Amin R. Source: The Journal of Laryngology and Otology. 2002 June; 116(6): 477-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12385367

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Desmoplastic neurotropic melanoma of the head and neck: the role of radiation therapy. Author(s): Anderson TD, Weber RS, Guerry D, Elder D, Schuchter L, Loevner LA, Rosenthal DI. Source: Head & Neck. 2002 December; 24(12): 1068-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12454945

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Determinants of prostate cancer specific survival following radiation therapy during the prostate specific antigen era. Author(s): D'Amico AV, Cote K, Loffredo M, Renshaw AA, Schultz D. Source: The Journal of Urology. 2003 December; 170(6 Pt 2): S42-6; Discussion S46-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14610409

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Determinants of prostate cancer-specific survival after radiation therapy for patients with clinically localized prostate cancer. Author(s): D'Amico AV, Cote K, Loffredo M, Renshaw AA, Schultz D. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2002 December 1; 20(23): 4567-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12454114

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Development and clinical application of a fast superposition algorithm in radiation therapy. Author(s): Scholz C, Schulze C, Oelfke U, Bortfeld T. Source: Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology. 2003 October; 69(1): 79-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14597360

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Development of carcinoma of esophagus in a treated case of breast carcinoma: possibly related to radiation therapy. Author(s): Sharma DN, Shukla NK, Rath GK. Source: J Assoc Physicians India. 2002 August; 50: 1082-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12421040

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Difference in prognostic factors between stage IB and II uterine cervical carcinoma patients treated with radical hysterectomy and postoperative radiation therapy. Author(s): Niibe Y, Karasawa K, Kaizu T, Mizutani K, Ozaki Y, Nagano H, Ueda K, Murakami A, Tanaka Y. Source: Radiat Med. 2002 July-August; 20(4): 161-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12296431

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Differentiation between recurrent tumor and radiation necrosis in a child with anaplastic ependymoma after chemotherapy and radiation therapy. Author(s): Beuthien-Baumann B, Hahn G, Winkler C, Heubner G. Source: Strahlentherapie Und Onkologie : Organ Der Deutschen Rontgengesellschaft. [et Al]. 2003 December; 179(12): 819-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14652670

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Does adjuvant radiation therapy increase loco-regional control after optimal resection of soft-tissue sarcoma of the extremities? Author(s): Khanfir K, Alzieu L, Terrier P, Le Pechoux C, Bonvalot S, Vanel D, Le Cesne A. Source: European Journal of Cancer (Oxford, England : 1990). 2003 September; 39(13): 1872-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12932665

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Dose escalation in non-small-cell lung cancer using three-dimensional conformal radiation therapy: update of a phase I trial. Author(s): Hayman JA, Martel MK, Ten Haken RK, Normolle DP, Todd RF 3rd, Littles JF, Sullivan MA, Possert PW, Turrisi AT, Lichter AS. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2001 January 1; 19(1): 127-36. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11134205

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Dose-escalating conformal thoracic radiation therapy with induction and concurrent carboplatin/paclitaxel in unresectable stage IIIA/B nonsmall cell lung carcinoma: a modified phase I/II trial. Author(s): Socinski MA, Rosenman JG, Halle J, Schell MJ, Lin Y, Russo S, Rivera MP, Clark J, Limentani S, Fraser R, Mitchell W, Detterbeck FC. Source: Cancer. 2001 September 1; 92(5): 1213-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11571735

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Dosimetric analysis and comparison of three-dimensional conformal radiotherapy and intensity-modulated radiation therapy for patients with hepatocellular carcinoma and radiation-induced liver disease. Author(s): Cheng JC, Wu JK, Huang CM, Liu HS, Huang DY, Tsai SY, Cheng SH, Jian JJ, Huang AT. Source: International Journal of Radiation Oncology, Biology, Physics. 2003 May 1; 56(1): 229-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12694843

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Dosimetric considerations for patients with HIP prostheses undergoing pelvic irradiation. Report of the AAPM Radiation Therapy Committee Task Group 63. Author(s): Reft C, Alecu R, Das IJ, Gerbi BJ, Keall P, Lief E, Mijnheer BJ, Papanikolaou N, Sibata C, Van Dyk J; AAPM Radiation Therapy Committee Task Group 63. Source: Medical Physics. 2003 June; 30(6): 1162-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12852541

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Dosimetric predictors of xerostomia for head-and-neck cancer patients treated with the smart (simultaneous modulated accelerated radiation therapy) boost technique. Author(s): Amosson CM, Teh BS, Van TJ, Uy N, Huang E, Mai WY, Frolov A, Woo SY, Chiu JK, Carpenter LS, Lu HH, Grant WH 3rd, Butler EB. Source: International Journal of Radiation Oncology, Biology, Physics. 2003 May 1; 56(1): 136-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12694832

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Double blind clinical trial of a remineralizing dentifrice in the prevention of caries in a radiation therapy population. Author(s): Papas A, Russell D, Singh M, Stack K, Kent R, Triol C, Winston A. Source: Gerodontology. 1999 July; 16(1): 2-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10687503

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Dysphagia in patients with nasopharyngeal cancer after radiation therapy: a videofluoroscopic swallowing study. Author(s): Chang YC, Chen SY, Lui LT, Wang TG, Wang TC, Hsiao TY, Li YW, Lien IN. Source: Dysphagia. 2003 Spring; 18(2): 135-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12825907

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Early detection of response to radiation therapy in patients with brain malignancies using conventional and high b-value diffusion-weighted magnetic resonance imaging. Author(s): Mardor Y, Pfeffer R, Spiegelmann R, Roth Y, Maier SE, Nissim O, Berger R, Glicksman A, Baram J, Orenstein A, Cohen JS, Tichler T. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2003 March 15; 21(6): 1094-100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12637476

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Eastern Cooperative Oncology Group Phase I trial of protracted venous infusion fluorouracil plus weekly gemcitabine with concurrent radiation therapy in patients with locally advanced pancreas cancer: a regimen with unexpected early toxicity. Author(s): Talamonti MS, Catalano PJ, Vaughn DJ, Whittington R, Beauchamp RD, Berlin J, Benson AB 3rd. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2000 October 1; 18(19): 3384-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11013279

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Effect of concurrent radiation therapy and chemotherapy on pulmonary function in patients with esophageal cancer: dose-volume histogram analysis. Author(s): Gergel TJ, Leichman L, Nava HR, Blumenson LE, Loewen GM, Gibbs JE, Khushalani NI, Leichman CG, Bodnar LM, Douglass HO, Smith JL, Kuettel MR, Proulx GM. Source: Cancer Journal (Sudbury, Mass.). 2002 November-December; 8(6): 451-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12500854

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Effect of education level on outcome of patients treated on Radiation Therapy Oncology Group Protocol 90-03. Author(s): Konski A, Berkey BA, Kian Ang K, Fu KK. Source: Cancer. 2003 October 1; 98(7): 1497-503. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14508838

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Effect of race on biochemical disease-free outcome in patients with prostate cancer treated with definitive radiation therapy in an equal-access health care system: radiation oncology report of the Department of Defense Center for Prostate Disease Research. Author(s): Johnstone PA, Kane CJ, Sun L, Wu H, Moul JW, McLeod DG, Martin DD, Kusuda L, Lance R, Douglas R, Donahue T, Beat MG, Foley J, Baldwin D, Soderdahl D, Do J, Amling CL. Source: Radiology. 2002 November; 225(2): 420-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12409575

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Efficacy of preoperative radiation therapy for resectable rectal adenocarcinoma when combined with oral tegafur-uracil modulated with leucovorin: results from a phase II study. Author(s): Uzcudun AE, Batlle JF, Velasco JC, Sanchez Santos ME, Carpeno Jde C, Grande AG, Juberias AM, Pineiro EH, Olivar LM, Garcia AG. Source: Diseases of the Colon and Rectum. 2002 October; 45(10): 1349-58. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12394434

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Efficacy of radiation therapy in the local control of desmoplastic malignant melanoma. Author(s): Vongtama R, Safa A, Gallardo D, Calcaterra T, Juillard G. Source: Head & Neck. 2003 June; 25(6): 423-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12784232

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Endocavitary radiation therapy for rectal adenocarcinoma: 10-year results. Author(s): Lavertu S, Schild SE, Gunderson LL, Haddock MG, Martenson JA. Source: American Journal of Clinical Oncology : the Official Publication of the American Radium Society. 2003 October; 26(5): 508-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14528081

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Enhancement of radiation therapy by tumor necrosis factor alpha in human colon cancer using a bispecific antibody. Author(s): Azria D, Dorvillius M, Gourgou S, Martineau P, Robert B, Pugniere M, Delard R, Ychou M, Dubois JB, Pelegrin A. Source: International Journal of Radiation Oncology, Biology, Physics. 2003 April 1; 55(5): 1363-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12654449

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Enhancement of radiation therapy by vascular targeting agents. Author(s): Siemann DW, Horsman MR. Source: Curr Opin Investig Drugs. 2002 November; 3(11): 1660-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12476970

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Evaluating radiation therapy in prostate cancer. Author(s): Lawrence G, Crawford J. Source: International Journal of Radiation Oncology, Biology, Physics. 2003 June 1; 56(2): 599. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12738338

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Evaluation of a segmentation procedure to delineate organs for use in construction of a radiation therapy planning atlas. Author(s): Qatarneh SM, Noz ME, Hyodynmaa S, Maguire GQ Jr, Kramer EL, Crafoord J. Source: International Journal of Medical Informatics. 2003 January; 69(1): 39-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12485703

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Evaluation of lung injury after three-dimensional conformal stereotactic radiation therapy for solitary lung tumors: CT appearance. Author(s): Aoki T, Nagata Y, Negoro Y, Takayama K, Mizowaki T, Kokubo M, Oya N, Mitsumori M, Hiraoka M. Source: Radiology. 2004 January; 230(1): 101-8. Epub 2003 November 26. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14645881

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Evaluation of methods for opto-electronic body surface sensing applied to patient position control in breast radiation therapy. Author(s): Baroni G, Troia A, Riboldi M, Orecchia R, Ferrigno G, Pedotti A. Source: Medical & Biological Engineering & Computing. 2003 November; 41(6): 679-88. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14686594

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Evaluation of three-dimensional conformal radiation therapy for small primary hepatocellular carcinoma. Author(s): Chen LH, Guan J. Source: Di Yi June Yi Da Xue Xue Bao. 2003 March; 23(3): 260-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12651247

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Evolution of treatment for Hodgkin's disease: a population-based study of radiation therapy use and outcome. Author(s): Hodgson DC, Zhang-Salomons J, Rothwell D, Paszat LF, Tsang RW, Crump M, Mackillop WJ. Source: Clin Oncol (R Coll Radiol). 2003 August; 15(5): 255-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12924456

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Ewing sarcoma/primitive neuroectodermal tumor of the chest wall: impact of initial versus delayed resection on tumor margins, survival, and use of radiation therapy. Author(s): Shamberger RC, LaQuaglia MP, Gebhardt MC, Neff JR, Tarbell NJ, Marcus KC, Sailer SL, Womer RB, Miser JS, Dickman PS, Perlman EJ, Devidas M, Linda SB, Krailo MD, Grier HE, Granowetter L. Source: Annals of Surgery. 2003 October; 238(4): 563-7; Discussion 567-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14530727

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External auditory canal stenosis after radiation therapy. Author(s): Carls JL, Mendenhall WM, Morris CG, Antonelli PJ. Source: The Laryngoscope. 2002 November; 112(11): 1975-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12439165

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External beam radiation therapy to prevent anastomotic intimal hyperplasia in prosthetic arteriovenous fistulas: results of a randomized trial. Author(s): van Tongeren RB, Levendag PC, Coen VL, Schmitz PI, Gescher FM, Vernhout RM, Wittens CH, Bruijninckx CM. Source: Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology. 2003 October; 69(1): 73-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14597359

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External beam radiation therapy: role of androgen deprivation. Author(s): Kupelian P. Source: World Journal of Urology. 2003 September; 21(4): 190-9. Epub 2003 August 09. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12910363

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Failure of radiation therapy for brain involvement in Erdheim Chester disease. Author(s): Mascalchi M, Nencini P, Nistri M, Sarti C, Santoni R. Source: Journal of Neuro-Oncology. 2002 September; 59(2): 169-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12241111

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Family history of prostate cancer and relapse after definitive external beam radiation therapy. Author(s): Ray ME, Dunn RL, Cooney KA, Sandler HM. Source: International Journal of Radiation Oncology, Biology, Physics. 2003 October 1; 57(2): 371-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12957247

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Fatigue in the radiation therapy patient: current management and investigations. Author(s): Jacobsen PB, Thors CL. Source: Seminars in Radiation Oncology. 2003 July; 13(3): 372-80. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12903024

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Favre-Racouchot-like disease after radiation therapy. Author(s): Breit S, Flaig MJ, Wolff H, Plewig G. Source: Journal of the American Academy of Dermatology. 2003 July; 49(1): 117-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12833021

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Feasibility of intensity-modulated radiation therapy in the treatment of advanced cervical chordoma. Author(s): Gabriele P, Macias V, Stasi M, Chauvie S, Munoz F, Delmastro E, Scielzo G. Source: Tumori. 2003 May-June; 89(3): 298-304. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12908787

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Film dosimetry for intensity modulated radiation therapy: dosimetric evaluation. Author(s): Ju SG, Ahn YC, Huh SJ, Yeo IJ. Source: Medical Physics. 2002 March; 29(3): 351-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11929018

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Final results of phase III trial in regionally advanced unresectable non-small cell lung cancer: Radiation Therapy Oncology Group, Eastern Cooperative Oncology Group, and Southwest Oncology Group. Author(s): Sause W, Kolesar P, Taylor S IV, Johnson D, Livingston R, Komaki R, Emami B, Curran W Jr, Byhardt R, Dar AR, Turrisi A 3rd. Source: Chest. 2000 February; 117(2): 358-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10669675

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Five-year clinical and angiographic follow-up after intracoronary iridium-192 radiation therapy. Author(s): Condado JA, Waksman R, Saucedo JF, Bhargava B, Lansky AJ, Calderas C, Gurdiel O, Gonzalez J, Fadoul M, Parra B, Iturria I, Amezaga B. Source: Cardiovascular Radiation Medicine. 2002 April-June; 3(2): 74-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12699836

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Five-year follow-up after intracoronary gamma radiation therapy for in-stent restenosis. Author(s): Waksman R, Ajani AE, White RL, Chan R, Bass B, Pichard AD, Satler LF, Kent KM, Torguson R, Deible R, Pinnow E, Lindsay J. Source: Circulation. 2004 January 27; 109(3): 340-4. Epub 2004 Jan 19. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14732756

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Flat-panel cone-beam computed tomography for image-guided radiation therapy. Author(s): Jaffray DA, Siewerdsen JH, Wong JW, Martinez AA. Source: International Journal of Radiation Oncology, Biology, Physics. 2002 August 1; 53(5): 1337-49. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12128137

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Flow cytometric and Ki-67 immunohistochemical analysis of cell cycle distribution of cervical cancer during radiation therapy. Author(s): Higuchi KH, Nakano T, Tsuboi A, Suzuki Y, Ohno T, Oka K. Source: Anticancer Res. 2001 July-August; 21(4A): 2511-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11724315

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Focal lesion in the splenium of the corpus callosum on FLAIR MR images: a common finding with aging and after brain radiation therapy. Author(s): Pekala JS, Mamourian AC, Wishart HA, Hickey WF, Raque JD. Source: Ajnr. American Journal of Neuroradiology. 2003 May; 24(5): 855-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12748085

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Follicular non-Hodgkin's lymphoma: the role of radiation therapy. Author(s): Mauch P. Source: Annals of Hematology. 2001; 80 Suppl 3: B63-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11757711

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Fractionated stereotactic conformal radiation therapy of brain stem gliomas: outcome and prognostic factors. Author(s): Schulz-Ertner D, Debus J, Lohr F, Frank C, Hoss A, Wannenmacher M. Source: Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology. 2000 November; 57(2): 215-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11054526

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Fractionation and outcomes with palliative radiation therapy. Author(s): Anderson PR, Coia LR. Source: Seminars in Radiation Oncology. 2000 July; 10(3): 191-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11034630

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Freedom from castration: an alternative end point for men with localized prostate cancer treated by external beam radiation therapy. Author(s): Zietman A, Thakral H, Skowronski U, Shipley W. Source: International Journal of Radiation Oncology, Biology, Physics. 2002 August 1; 53(5): 1152-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12128115

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Frequency of coexistent disease at CT in patients with prostate carcinoma selected for definitive radiation therapy: is limited treatment-planning CT adequate? Author(s): Miller JS, Puckett ML, Johnstone PA. Source: Radiology. 2000 April; 215(1): 41-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10751465

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Fulminant radiation-induced necrosis after stereotactic radiation therapy to the posterior fossa. Case report and review of the literature. Author(s): Tandon N, Vollmer DG, New PZ, Hevezi JM, Herman T, Kagan-Hallet K, West GA. Source: Journal of Neurosurgery. 2001 September; 95(3): 507-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11565876

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Functional imaging in treatment planning in radiation therapy: a review. Author(s): Perez CA, Bradley J, Chao CK, Grigsby PW, Mutic S, Malyapa R. Source: Rays. 2002 July-September; 27(3): 157-73. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12696245

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Future directions in intraoperative radiation therapy. Author(s): Merrick HW 3rd, Gunderson LL, Calvo FA. Source: Surg Oncol Clin N Am. 2003 October; 12(4): 1099-105. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14989135

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Gamma knife treatment for multiple metastatic brain tumors compared with wholebrain radiation therapy. Author(s): Serizawa T, Iuchi T, Ono J, Saeki N, Osato K, Odaki M, Ushikubo O, Hirai S, Sato M, Matsuda S. Source: Journal of Neurosurgery. 2000 December; 93 Suppl 3: 32-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11143259

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Gastric adenocarcinoma treated with R0-R1 surgical resection and intraoperative radiotherapy (IORT) plus external beam radiation therapy (EBRT). Author(s): Glehen O, Beaujard AC, Romestaing P, Sentenac I, Francois Y, Peyrat P, Braillon G, Vignal J, Gerard JP, Gilly FN. Source: Suppl Tumori. 2003 September-October; 2(5): S51-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12914392

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Gemcitabine-induced radiation recall dermatitis following whole pelvic radiation therapy. Author(s): Schwartz BM, Khuntia D, Kennedy AW, Markman M. Source: Gynecologic Oncology. 2003 November; 91(2): 421-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14599876

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General principles of external beam radiation therapy for skeletal metastases. Author(s): Frassica DA. Source: Clinical Orthopaedics and Related Research. 2003 October; (415 Suppl): S158-64. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14600606

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Geographic miss: a cause of treatment failure in radio-oncology applied to intracoronary radiation therapy. Author(s): Parikh S, Nori D, Tripuraneni P. Source: Circulation. 2001 March 27; 103(12): E65-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11274005

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Geographic miss: a cause of treatment failure in radio-oncology applied to intracoronary radiation therapy. Author(s): Sabate M, Costa MA, Kozuma K, Kay IP, van der Giessen WJ, Coen VL, Ligthart JM, Serrano P, Levendag PC, Serruys PW. Source: Circulation. 2000 May 30; 101(21): 2467-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10831519

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Glutathione level and its relation to radiation therapy in patients with cancer of uterine cervix. Author(s): Mukundan H, Bahadur AK, Kumar A, Sardana S, Naik SL, Ray A, Sharma BK. Source: Indian J Exp Biol. 1999 September; 37(9): 859-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10687279

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Gross tumor volume, critical prognostic factor in patients treated with threedimensional conformal radiation therapy for non-small-cell lung carcinoma. Author(s): Bradley JD, Ieumwananonthachai N, Purdy JA, Wasserman TH, Lockett MA, Graham MV, Perez CA. Source: International Journal of Radiation Oncology, Biology, Physics. 2002 January 1; 52(1): 49-57. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11777621

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Guidelines for dosimetry and calibration in ultraviolet radiation therapy: a report of a British Photodermatology Group workshop. Author(s): Taylor DK, Anstey AV, Coleman AJ, Diffey BL, Farr PM, Ferguson J, Ibbotson S, Langmack K, Lloyd JJ, McCann P, Martin CJ, Menage Hdu P, Moseley H, Murphy G, Pye SD, Rhodes LE, Rogers S; British Photodermatology Group. Source: The British Journal of Dermatology. 2002 May; 146(5): 755-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12000370

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Head and neck nodal station images: guidance for three-dimensional radiation therapy treatment planning. Author(s): Yen SH, Chao LS, Liou SC, Hsiao CH, Lee YL, Chao MM. Source: Journal of Digital Imaging : the Official Journal of the Society for Computer Applications in Radiology. 2002 December; 15(4): 240-6. Epub 2003 January 21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12532256

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Health outcomes after external-beam radiation therapy for clinically localized prostate cancer: results from the Prostate Cancer Outcomes Study. Author(s): Hamilton AS, Stanford JL, Gilliland FD, Albertsen PC, Stephenson RA, Hoffman RM, Eley JW, Harlan LC, Potosky AL. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2001 May 1; 19(9): 2517-26. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11331331

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Health-related quality of life and psychosocial factors in patients with prostate cancer scheduled for radical prostatectomy or external radiation therapy. Author(s): Van Andel G, Visser AP, Hulshof MC, Horenblas S, Kurth KH. Source: Bju International. 2003 August; 92(3): 217-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12887470

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Helical tomotherapy: an innovative technology and approach to radiation therapy. Author(s): Welsh JS, Patel RR, Ritter MA, Harari PM, Mackie TR, Mehta MP. Source: Technology in Cancer Research & Treatment. 2002 August; 1(4): 311-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12625791

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Hematologic toxic reaction to radiation therapy adjuvant to autologous peripheral blood stem cell transplantation for recurrent or refractory Hodgkin disease. Author(s): Bogart JA, Ungureanu C, Ryu S, Chung CT, Zamkoff KW. Source: Radiology. 2000 February; 214(2): 421-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10671589

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High rate of detection of unsuspected distant metastases by pet in apparent stage III non-small-cell lung cancer: implications for radical radiation therapy. Author(s): MacManus MP, Hicks RJ, Matthews JP, Hogg A, McKenzie AF, Wirth A, Ware RE, Ball DL. Source: International Journal of Radiation Oncology, Biology, Physics. 2001 June 1; 50(2): 287-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11380213

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High-dose intensity modulated radiation therapy for prostate cancer: early toxicity and biochemical outcome in 772 patients. Author(s): Zelefsky MJ, Fuks Z, Hunt M, Yamada Y, Marion C, Ling CC, Amols H, Venkatraman ES, Leibel SA. Source: International Journal of Radiation Oncology, Biology, Physics. 2002 August 1; 53(5): 1111-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12128109

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High-dose intra-arterial cisplatin boost with hyperfractionated radiation therapy for advanced squamous cell carcinoma of the head and neck. Author(s): Regine WF, Valentino J, Arnold SM, Haydon RC, Sloan D, Kenady D, Strottmann J, Pulmano C, Mohiuddin M. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2001 July 15; 19(14): 3333-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11454880

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High-dose intra-arterial cisplatin therapy followed by radiation therapy for advanced squamous cell carcinoma of the head and neck. Author(s): Wilson WR, Siegel RS, Harisiadis LA, Davis DO, Nguyen HH, Bank WO. Source: Archives of Otolaryngology--Head & Neck Surgery. 2001 July; 127(7): 809-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11448355

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High-dose radiation therapy and neoadjuvant plus concomitant chemotherapy with 5fluorouracil and cisplatin in patients with locally advanced squamous-cell anal canal cancer: final results of a phase II study. Author(s): Peiffert D, Giovannini M, Ducreux M, Michel P, Francois E, Lemanski C, Mirabel X, Cvitkovic F, Luporsi E, Conroy T, Gerard JP; Digestive Tumours Group of the French 'Federation Nationale des Centres de Lutte Contre le Cancer'. Source: Annals of Oncology : Official Journal of the European Society for Medical Oncology / Esmo. 2001 March; 12(3): 397-404. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11332154

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High-dose radiation therapy for elderly patients with inoperable or unresectable nonsmall cell lung cancer. Author(s): Hayakawa K, Mitsuhashi N, Katano S, Saito Y, Nakayama Y, Sakurai H, Akimoto T, Hasegawa M, Yamakawa M, Niibe H. Source: Lung Cancer (Amsterdam, Netherlands). 2001 April; 32(1): 81-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11282432

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Hormones and radiation therapy in locally advanced adenocarcinoma of the prostate. Author(s): Lawton CA. Source: Seminars in Radiation Oncology. 2003 April; 13(2): 141-51. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12728443

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How iliopelvic lymphoscintigraphy can affect the definition of planning target volume in radiation therapy of pelvic and testicular tumors. Author(s): Campostrini F, Gregianin M, Rampin L, Lonardi F, De Lucchi A, Coeli M, Gioga G, Prina M, Ferretti G, Povolato M. Source: International Journal of Radiation Oncology, Biology, Physics. 2002 August 1; 53(5): 1303-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12128133

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How one defines intensity-modulated radiation therapy. Author(s): Potters L, Steinberg M, Wallner P, Hevezi J. Source: International Journal of Radiation Oncology, Biology, Physics. 2003 July 1; 56(3): 609-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12788164

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Hyperfractionated radiation therapy and concurrent low-dose, daily carboplatin/etoposide with or without weekend carboplatin/etoposide chemotherapy in stage III non-small-cell lung cancer: a randomized trial. Author(s): Jeremic B, Shibamoto Y, Acimovic L, Milicic B, Milisavljevic S, Nikolic N, Dagovic A, Aleksandrovic J, Radosavljevic-Asic G. Source: International Journal of Radiation Oncology, Biology, Physics. 2001 May 1; 50(1): 19-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11316542

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Hyperfractionated radiation therapy for hypopharyngeal carcinoma compared with conventional radiation therapy: local control, laryngeal preservation and overall survival. Author(s): Niibe Y, Karasawa K, Mitsuhashi T, Tanaka Y. Source: Japanese Journal of Clinical Oncology. 2003 September; 33(9): 450-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14594938

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Hyperfractionated radiation therapy for incompletely resected supratentorial lowgrade glioma: a 10-year update of a phase II study. Author(s): Jeremic B, Milicic B, Grujicic D, Samardzic M, Antunovic V, Dagovic A, Aleksandrovic J, Stojanovic M. Source: International Journal of Radiation Oncology, Biology, Physics. 2003 October 1; 57(2): 465-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12957258

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Hyperthermia in combination with radiation therapy for treatment of advanced inoperable breast cancer. Author(s): Iemwananonthachai N, Pattaranutaporn P, Chansilpa Y, Sukkasem M. Source: J Med Assoc Thai. 2003 August; 86(8): 715-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12948269

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Hypogonadism following prostate-bed radiation therapy for prostate carcinoma. Author(s): Daniell HW, Clark JC, Pereira SE, Niazi ZA, Ferguson DW, Dunn SR, Figueroa ML, Stratte PT. Source: Cancer. 2001 May 15; 91(10): 1889-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11346871

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Hypopharyngeal cancer: results of treatment based on radiation therapy and salvage surgery. Author(s): Godballe C, Jorgensen K, Hansen O, Bastholt L. Source: The Laryngoscope. 2002 May; 112(5): 834-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12150614

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Identification of factors predicting response to adjuvant radiation therapy in patients with positive margins after radical prostatectomy. Author(s): Kamat AM, Babaian K, Cheung MR, Naya Y, Huang SH, Kuban D, Babaian RJ. Source: The Journal of Urology. 2003 November; 170(5): 1860-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14532793

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Image-guided conformal radiation therapy planning and delivery for non-small-cell lung cancer. Author(s): Wagner H. Source: Cancer Control : Journal of the Moffitt Cancer Center. 2003 July-August; 10(4): 277-88. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12915806

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Impact of prolonged fraction delivery times on tumor control: a note of caution for intensity-modulated radiation therapy (IMRT). Author(s): Wang JZ, Li XA, D'Souza WD, Stewart RD. Source: International Journal of Radiation Oncology, Biology, Physics. 2003 October 1; 57(2): 543-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12957268

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Impact of treatment interruptions due to toxicity on outcome of patients with early stage (I/II) non-small-cell lung cancer (NSCLC) treated with hyperfractionated radiation therapy alone. Author(s): Jeremic B, Shibamoto Y, Milicic B, Dagovic A, Nikolic N, Aleksandrovic J, Acimovic L, Milisavljevic S. Source: Lung Cancer (Amsterdam, Netherlands). 2003 June; 40(3): 317-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12781431

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Impact of volume weighted mean nuclear volume on outcomes following salvage radiation therapy after radical prostatectomy. Author(s): Matsui Y, Ichioka K, Terada N, Yoshimura K, Terai A, Dodo Y, Arai Y. Source: The Journal of Urology. 2004 February; 171(2 Pt 1): 687-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14713787

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Influence of radiation therapy delay on abdominal tumor recurrence in patients with favorable histology Wilms' tumor treated on NWTS-3 and NWTS-4: a report from the National Wilms' Tumor Study Group. Author(s): Kalapurakal JA, Li SM, Breslow NE, Beckwith JB, Macklis R, Thomas PR, D'Angio GJ, Kim T, de Lorimier A, Kelalis P, Shochat S, Ritchey M, Haase G, Hrabovsky E, Otherson HB, Grundy P, Green DM; National Wilms' Tumor Study Group. Source: International Journal of Radiation Oncology, Biology, Physics. 2003 October 1; 57(2): 495-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12957262

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Initial clinical experience with moderate deep-inspiration breath hold using an active breathing control device in the treatment of patients with left-sided breast cancer using external beam radiation therapy. Author(s): Remouchamps VM, Letts N, Vicini FA, Sharpe MB, Kestin LL, Chen PY, Martinez AA, Wong JW. Source: International Journal of Radiation Oncology, Biology, Physics. 2003 July 1; 56(3): 704-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12788176

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Integration of systemic therapy and radiation therapy for patients with early-stage breast cancer treated with conservative surgery. Author(s): Recht A. Source: Clinical Breast Cancer. 2003 June; 4(2): 104-13. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12864938

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Intensity modulated radiation therapy and chemotherapy for locally advanced pancreatic cancer: results of feasibility study. Author(s): Bai YR, Wu GH, Guo WJ, Wu XD, Yao Y, Chen Y, Zhou RH, Lu DQ. Source: World Journal of Gastroenterology : Wjg. 2003 November; 9(11): 2561-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14606097

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Intensity-modulated radiation therapy for head and neck cancer. Author(s): Ozyigit G, Yang T, Chao KS. Source: Curr Treat Options Oncol. 2004 February; 5(1): 3-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14697152

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Intensity-modulated radiation therapy for head-and-neck cancer: the UCSF experience focusing on target volume delineation. Author(s): Lee N, Xia P, Fischbein NJ, Akazawa P, Akazawa C, Quivey JM. Source: International Journal of Radiation Oncology, Biology, Physics. 2003 September 1; 57(1): 49-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12909215

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Intra- and postoperative radiation therapy for an alpha-fetoprotein-producing pancreatic carcinoma. Author(s): Hirai I, Kimura W, Kamiga M, Shibasaki H, Kawaguchi K, Fuse A. Source: Journal of Hepato-Biliary-Pancreatic Surgery. 2003; 10(3): 239-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14605982

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Intraoperative radiation therapy (IORT) in primary locally advanced and recurrent carcinoma of the rectum at a “non-dedicated” facility. Author(s): Hesselmann S, Micke O, Bruewer M, Ochman S, Senninger N, Willich N, Schaefer U. Source: Anticancer Res. 2003 March-April; 23(2C): 1875-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12820472

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Intraoperative radiation therapy in surgical oncology. Author(s): Merrick HW 3rd, Dobelbower RR Jr. Source: Surg Oncol Clin N Am. 2003 October; 12(4): 883-97, Vii. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14989122

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Intraoperative radiation therapy in the management of gynecologic and genitourinary malignancies. Author(s): del Carmen MG, Eisner B, Willet CG, Fuller AF. Source: Surg Oncol Clin N Am. 2003 October; 12(4): 1031-42. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14989131

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Intraoperative radiation therapy in the multimodality approach to hepatobiliary tract cancer. Author(s): Thomas CR Jr, Merrick HW 3rd. Source: Surg Oncol Clin N Am. 2003 October; 12(4): 979-92. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14989128

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Intraoperative radiation therapy in the multimodality approach to upper aerodigestive tract cancer. Author(s): Carter YM, Jablons DM, DuBois JB, Thomas CR Jr. Source: Surg Oncol Clin N Am. 2003 October; 12(4): 1043-63. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14989132

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Intraopertive radiation therapy for breast cancer. Author(s): Merrick HW 3rd, Hager E, Dobelbower RR Jr. Source: Surg Oncol Clin N Am. 2003 October; 12(4): 1065-78. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14989133

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Is bicalutamide equivalent to goserelin for prostate volume reduction before radiation therapy? A prospective, observational study. Author(s): Henderson A, Langley SE, Laing RW. Source: Clin Oncol (R Coll Radiol). 2003 September; 15(6): 318-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14524484

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Is there a role for radiation therapy in the management of Hurthle cell carcinoma? Author(s): Foote RL, Brown PD, Garces YI, McIver B, Kasperbauer JL. Source: International Journal of Radiation Oncology, Biology, Physics. 2003 July 15; 56(4): 1067-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12829143

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Kindler syndrome complicated by squamous cell carcinoma of the hard palate: successful treatment with high-dose radiation therapy and granulocyte-macrophage colony-stimulating factor. Author(s): Lotem M, Raben M, Zeltser R, Landau M, Sela M, Wygoda M, Tochner ZA. Source: The British Journal of Dermatology. 2001 June; 144(6): 1284-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11422071

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Kinetics of plasma Epstein-Barr virus DNA during radiation therapy for nasopharyngeal carcinoma. Author(s): Lo YM, Leung SF, Chan LY, Chan AT, Lo KW, Johnson PJ, Huang DP. Source: Cancer Research. 2000 May 1; 60(9): 2351-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10811107

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Laryngeal long-term morbidity after supraglottic laryngectomy and postoperative radiation therapy. Author(s): Spriano G, Antognoni P, Sanguineti G, Sormani M, Richetti A, Ameli F, Piantanida R, Luraghi R, Magli A, Corvo R, Tordiglione M, Vitale V. Source: American Journal of Otolaryngology. 2000 January-February; 21(1): 14-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10668672

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Late genitourinary and gastrointestinal toxicity after magnetic resonance imageguided prostate brachytherapy with or without neoadjuvant external beam radiation therapy. Author(s): Albert M, Tempany CM, Schultz D, Chen MH, Cormack RA, Kumar S, Hurwitz MD, Beard C, Tuncali K, O'Leary M, Topulos GP, Valentine K, Lopes L, Kanan A, Kacher D, Rosato J, Kooy H, Jolesz F, Carr-Locke DL, Richie JP, D'Amico AV. Source: Cancer. 2003 September 1; 98(5): 949-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12942561

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Late urinary morbidity with high dose prostate brachytherapy as a boost to conventional external beam radiation therapy for local and locally advanced prostate cancer. Author(s): Pellizzon AC, Salvajoli JV, Maia MA, Ferrigno R, Novaes PE, Fogarolli RC, Pellizzon RJ. Source: The Journal of Urology. 2004 March; 171(3): 1105-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14767280

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L-dopa-resistant parkinsonism syndrome following cerebral radiation therapy for neoplasm. Author(s): Wick W, Hochberg F, O'Sullivan J, Goessling A, Hughes A, Cher L. Source: Oncol Rep. 2000 November-December; 7(6): 1367-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11032946

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Limitation of conventional two dimensional radiation therapy planning in nasopharyngeal carcinoma. Author(s): Waldron J, Tin MM, Keller A, Lum C, Japp B, Sellmann S, van Prooijen M, Gitterman L, Blend R, Payne D, Liu FF, Warde P, Cummings B, Pintilie M, O'Sullivan B. Source: Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology. 2003 August; 68(2): 153-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12972310

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Limited-field radiation therapy in the management of early-stage breast cancer. Author(s): Vicini FA, Kestin L, Chen P, Benitez P, Goldstein NS, Martinez A. Source: Journal of the National Cancer Institute. 2003 August 20; 95(16): 1205-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12928345

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Local radiation therapy for localized relapsed or refractory ovarian cancer patients with or without symptoms after chemotherapy. Author(s): Fujiwara K, Suzuki S, Yoden E, Ishikawa H, Imajo Y, Kohno I. Source: International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society. 2002 May-June; 12(3): 250-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12060445

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Localized bullous pemphigoid as an unusual complication of radiation therapy. Author(s): Calikoglu E, Anadolu R, Erdem C, Calikoglu T. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 2002 November; 16(6): 646-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12482060

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Localized mucosa-associated lymphoid tissue lymphoma treated with radiation therapy has excellent clinical outcome. Author(s): Tsang RW, Gospodarowicz MK, Pintilie M, Wells W, Hodgson DC, Sun A, Crump M, Patterson BJ. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2003 November 15; 21(22): 4157-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14615444

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Longitudinal comparison of sexual function after 3-dimensional conformal radiation therapy or prostate brachytherapy. Author(s): Valicenti RK, Bissonette EA, Chen C, Theodorescu D. Source: The Journal of Urology. 2002 December; 168(6): 2499-504; Discussion 2504. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12441949

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Long-term outcome after radiation therapy for subfoveal choroidal neovascularization associated with age-related macular degeneration. Author(s): Mandai M, Takahashi M, Miyamoto H, Hiroshiba N, Kimura H, Ogura Y, Honda Y, Sasai K. Source: Japanese Journal of Ophthalmology. 2000 September-October; 44(5): 530-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11033133

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Long-term outcome in patients with central neurocytoma following stereotactic biopsy and radiation therapy. Author(s): Kulkarni V, Rajshekhar V, Haran RP, Chandi SM. Source: British Journal of Neurosurgery. 2002 April; 16(2): 126-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12046730

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Long-term outcomes after treatment with external beam radiation therapy and palladium 103 for patients with higher risk prostate carcinoma: influence of prostatic acid phosphatase. Author(s): Dattoli M, Wallner K, True L, Cash J, Sorace R. Source: Cancer. 2003 February 15; 97(4): 979-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12569596

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Long-term results after external beam radiation therapy for T1-T2 localized prostate cancer. Author(s): Lagerveld BW, Laguna MP, de la Rosette JJ. Source: Curr Urol Rep. 2003 June; 4(3): 240-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12756089

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Long-term results of three-dimensional conformal radiation therapy for patients with rhabdomyosarcoma. Author(s): Wolden SL, La TH, LaQuaglia MP, Meyers PA, Kraus DH, Wexler LH. Source: Cancer. 2003 January 1; 97(1): 179-85. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12491519

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Long-term symptoms after external beam radiation therapy for prostate cancer with three or four fields. Author(s): al-Abany M, Helgason AR, Cronqvist AK, Svensson C, Wersall P, Steineck G. Source: Acta Oncologica (Stockholm, Sweden). 2002; 41(6): 532-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12546526

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Loss of p16 expression is of prognostic significance in locally advanced prostate cancer: an analysis from the Radiation Therapy Oncology Group protocol 86-10. Author(s): Chakravarti A, Heydon K, Wu CL, Hammond E, Pollack A, Roach M, Wolkov H, Okunieff P, Cox J, Fontanesi J, Abrams R, Pilepich M, Shipley W; Radiation Therapy Oncology Group. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2003 September 1; 21(17): 3328-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12947069

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Lung carcinoma after radiation therapy in women treated with lumpectomy or mastectomy for primary breast carcinoma. Author(s): Zablotska LB, Neugut AI. Source: Cancer. 2003 March 15; 97(6): 1404-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12627503

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Lymph nodes of patients with regional metastases from head and neck squamous cell carcinoma as a predictor of pathologic outcome: size changes at CT before and after radiation therapy. Author(s): Ojiri H, Mancuso AA, Mendenhall WM, Stringer SP. Source: Ajnr. American Journal of Neuroradiology. 2002 November-December; 23(10): 1627-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12427611

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MAGIC-type polymer gel for three-dimensional dosimetry: intensity-modulated radiation therapy verification. Author(s): Gustavsson H, Karlsson A, Back SA, Olsson LE, Haraldsson P, Engstrom P, Nystrom H. Source: Medical Physics. 2003 June; 30(6): 1264-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12852552

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Making the right choices for radiation therapy. Author(s): DeWeese TL. Source: Johns Hopkins Med Lett Health after 50. 2004 March; 16(1): 6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15029868

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Massive epistaxis related to petrous carotid artery pseudoaneurysm after radiation therapy: emergency treatment with covered stent in two cases. Author(s): Auyeung KM, Lui WM, Chow LC, Chan FL. Source: Ajnr. American Journal of Neuroradiology. 2003 August; 24(7): 1449-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12917144

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Mechanisms behind intracoronary radiation therapy failure. Author(s): Almeda FQ, Schaer GL. Source: Journal of the American College of Cardiology. 2003 July 16; 42(2): 395-6; Author Reply 396. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12875790

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Medical and legal hazards of the use of radiation therapy. Author(s): Tobias JS. Source: Med Leg J. 2003; 71(Pt 3): 96-105. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14619620

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Membrane oxidative damage and apoptosis in cervical carcinoma cells of patients after radiation therapy. Author(s): Bhosle SM, Pandey BN, Huilgol NG, Mishra KP. Source: Methods in Cell Science : an Official Journal of the Society for in Vitro Biology. 2002; 24(1-3): 65-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12815293

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Modifying the American Society for Therapeutic Radiology and Oncology definition of biochemical failure to minimize the influence of backdating in patients with prostate cancer treated with 3-dimensional conformal radiation therapy alone. Author(s): Horwitz EM, Uzzo RG, Hanlon AL, Greenberg RE, Hanks GE, Pollack A. Source: The Journal of Urology. 2003 June; 169(6): 2153-7; Discussion 2157-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12771738

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Monitoring of response to radiation therapy for human tumor xenografts using 99mTc-HL91 (4,9-diaza-3,3,10,10-tetramethyldodecan-2,11-dione dioxime). Author(s): Suzuki T, Nakamura K, Kawase T, Kubo A. Source: Ann Nucl Med. 2003 April; 17(2): 131-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12790362

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MOSFET dosimetry for microbeam radiation therapy at the European Synchrotron Radiation Facility. Author(s): Brauer-Krisch E, Bravin A, Lerch M, Rosenfeld A, Stepanek J, Di Michiel M, Laissue JA. Source: Medical Physics. 2003 April; 30(4): 583-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12722810

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Mycosis fungoides with follicular mucinosis displaying aggressive tumor-stage transformation : successful treatment using radiation therapy plus oral bexarotene combination therapy. Author(s): Apisarnthanarax N, Ha CS, Duvic M. Source: American Journal of Clinical Dermatology. 2003; 4(6): 429-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12762834

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Narrowband ultraviolet B radiation therapy for recalcitrant vitiligo in Asians. Author(s): Natta R, Somsak T, Wisuttida T, Laor L. Source: Journal of the American Academy of Dermatology. 2003 September; 49(3): 473-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12963911

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Neck level-specific nodal metastases in oropharyngeal cancer: is there a role for selective neck dissection after definitive radiation therapy? Author(s): Doweck I, Robbins KT, Mendenhall WM, Hinerman RW, Morris C, Amdur R. Source: Head & Neck. 2003 November; 25(11): 960-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14603457

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Needle displacement during high-dose-rate afterloading brachytherapy boost and conventional external beam radiation therapy for initial and local advanced prostate cancer. Author(s): Pellizzon AC, Salvajoli JV, Novaes PE, Maia MA, Ferigno R, Fogaroli RC. Source: Urologia Internationalis. 2003; 70(3): 200-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12660457

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Neoadjuvant chemotherapy, radical resection with intraoperative radiation therapy (IORT): improved treatment for gastric adenocarcinoma. Author(s): Weese JL, Harbison SP, Stiller GD, Henry DH, Fisher SA. Source: Surgery. 2000 October; 128(4): 564-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11015089

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Neurologic complications of radiation therapy. Author(s): Cross NE, Glantz MJ. Source: Neurologic Clinics. 2003 February; 21(1): 249-77. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12690652

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Neurological changes following radiation therapy for head and neck tumours. Author(s): Chong VF, Khoo JB, Chan LL, Rumpel H. Source: European Journal of Radiology. 2002 November; 44(2): 120-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12413680

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Neutron production associated with radiotherapy linear accelerators using intensity modulated radiation therapy mode. Author(s): Waller EJ. Source: Health Physics. 2003 November; 85(5 Suppl): S75-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14570257

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Normal-tissue toxicities of thoracic radiation therapy: esophagus, lung, and spinal cord as organs at risk. Author(s): Werner-Wasik M, Yu X, Marks LB, Schultheiss TE. Source: Hematology/Oncology Clinics of North America. 2004 February; 18(1): 131-60, X-Xi. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15005286

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Novel approaches to postoperative radiation therapy as part of breast-conserving therapy for early-stage breast cancer. Author(s): Troung MT, Hirsch AE, Formenti SC. Source: Clinical Breast Cancer. 2003 October; 4(4): 253-63. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14651770

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Novel therapeutic strategies in prostate cancer management using gene therapy in combination with radiation therapy. Author(s): Collis SJ, Khater K, DeWeese TL. Source: World Journal of Urology. 2003 September; 21(4): 275-89. Epub 2003 August 13. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12920560

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Once-weekly dosing of epoetin-alpha increases hemoglobin and improves quality of life in anemic cancer patients receiving radiation therapy either concomitantly or sequentially with chemotherapy. Author(s): Shasha D, George MJ, Harrison LB. Source: Cancer. 2003 September 1; 98(5): 1072-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12942577

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Optimisation of conformal radiation therapy by intensity modulation: cancer of the larynx and salivary gland function. Author(s): Braaksma MM, Wijers OB, van Sornsen de Koste JR, van der Est H, Schmitz PI, Nowak PJ, Levendag PC. Source: Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology. 2003 March; 66(3): 291-302. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12742269

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Optimization of radiation therapy for locally advanced adenoid cystic carcinomas with infiltration of the skull base using photon intensity-modulated radiation therapy (IMRT) and a carbon ion boost. Author(s): Schulz-Ertner D, Didinger B, Nikoghosyan A, Jakel O, Zuna I, Wannenmacher M, Debus J. Source: Strahlentherapie Und Onkologie : Organ Der Deutschen Rontgengesellschaft. [et Al]. 2003 May; 179(5): 345-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12740662

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Oral and dental management related to radiation therapy for head and neck cancer. Author(s): Hancock PJ, Epstein JB, Sadler GR. Source: Journal (Canadian Dental Association). 2003 October; 69(9): 585-90. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14653934

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Oral pseudotumor: benign polypoid masses following radiation therapy. Author(s): Oota S, Shibuya H, Hamagaki M, Yoshimura R, Iwaki H, Kojima M, Takagi M. Source: Cancer. 2003 March 1; 97(5): 1353-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12599245

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Outcome and pattern of failure in pathologic stage I-II papillary serous carcinoma of the endometrium: implications for adjuvant radiation therapy. Author(s): Mehta N, Yamada SD, Rotmensch J, Mundt AJ. Source: International Journal of Radiation Oncology, Biology, Physics. 2003 November 15; 57(4): 1004-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14575831

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Outcome of salvage total laryngectomy following organ preservation therapy: the Radiation Therapy Oncology Group trial 91-11. Author(s): Weber RS, Berkey BA, Forastiere A, Cooper J, Maor M, Goepfert H, Morrison W, Glisson B, Trotti A, Ridge JA, Chao KS, Peters G, Lee DJ, Leaf A, Ensley J. Source: Archives of Otolaryngology--Head & Neck Surgery. 2003 January; 129(1): 44-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12525193

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Outcome of treatment for breast cancer patients with chest wall recurrence according to initial stage: implications for post-mastectomy radiation therapy. Author(s): Chagpar A, Kuerer HM, Hunt KK, Strom EA, Buchholz TA. Source: International Journal of Radiation Oncology, Biology, Physics. 2003 September 1; 57(1): 128-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12909225

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Overall survival after prostate-specific-antigen-detected recurrence following conformal radiation therapy. Author(s): Sandler HM, Dunn RL, McLaughlin PW, Hayman JA, Sullivan MA, Taylor JM. Source: International Journal of Radiation Oncology, Biology, Physics. 2000 October 1; 48(3): 629-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11020557

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Overcoming the hypoxic barrier to radiation therapy with anaerobic bacteria. Author(s): Bettegowda C, Dang LH, Abrams R, Huso DL, Dillehay L, Cheong I, Agrawal N, Borzillary S, McCaffery JM, Watson EL, Lin KS, Bunz F, Baidoo K, Pomper MG, Kinzler KW, Vogelstein B, Zhou S. Source: Proceedings of the National Academy of Sciences of the United States of America. 2003 December 9; 100(25): 15083-8. Epub 2003 Dec 01. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14657371

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Palladium-103 plaque radiation therapy for macular degeneration: results of a 7 year study. Author(s): Finger PT, Gelman YP, Berson AM, Szechter A. Source: The British Journal of Ophthalmology. 2003 December; 87(12): 1497-503. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14660461

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Parathyroid carcinoma: is there a role for adjuvant radiation therapy? Author(s): Munson ND, Foote RL, Northcutt RC, Tiegs RD, Fitzpatrick LA, Grant CS, van Heerden JA, Thompson GB, Lloyd RV. Source: Cancer. 2003 December 1; 98(11): 2378-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14635072

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Pelvic irradiation with concurrent chemotherapy versus pelvic and para-aortic irradiation for high-risk cervical cancer: an update of radiation therapy oncology group trial (RTOG) 90-01. Author(s): Eifel PJ, Winter K, Morris M, Levenback C, Grigsby PW, Cooper J, Rotman M, Gershenson D, Mutch DG. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2004 March 1; 22(5): 872-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14990643

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Permanent iodine-125 interstitial radiation therapy in the treatment of nonglioblastoma multiforme high-grade gliomas. Author(s): Zamorano L, Li Q, Tekyi-Mensah S, Gaspar L, Fontanesi J, Levin K. Source: Stereotactic and Functional Neurosurgery. 2003; 81(1-4): 10-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14742958

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Phase I trial of combined-modality therapy for localized esophageal cancer: escalating doses of continuous-infusion paclitaxel with cisplatin and concurrent radiation therapy. Author(s): Brenner B, Ilson DH, Minsky BD, Bains MS, Tong W, Gonen M, Kelsen DP. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2004 January 1; 22(1): 45-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14701767

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Phase I trial using a time-to-event continual reassessment strategy for dose escalation of cisplatin combined with gemcitabine and radiation therapy in pancreatic cancer. Author(s): Muler JH, McGinn CJ, Normolle D, Lawrence T, Brown D, Hejna G, Zalupski MM. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2004 January 15; 22(2): 238-43. Epub 2003 December 09. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14665608

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Pilot study of subcutaneous amifostine in patients undergoing postoperative intensity modulated radiation therapy for head and neck cancer: preliminary data. Author(s): Thorstad WL, Haughey B, Chao KS. Source: Seminars in Oncology. 2003 December; 30(6 Suppl 18): 96-100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14727249

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Presurgical cytoreduction of oral cancer using intra-arterial cisplatin and limited concomitant radiation therapy (Neo-RADPLAT). Author(s): Robbins KT, Samant S, Vieira F, Kumar P. Source: Archives of Otolaryngology--Head & Neck Surgery. 2004 January; 130(1): 28-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14732764

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Pretreatment nomogram that predicts 5-year probability of metastasis following three-dimensional conformal radiation therapy for localized prostate cancer. Author(s): Kattan MW, Zelefsky MJ, Kupelian PA, Cho D, Scardino PT, Fuks Z, Leibel SA. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2003 December 15; 21(24): 4568-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14673043

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Prognostic significance of c-erbB-2/HER2 expression in advanced uterine cervical carcinoma with para-aortic lymph node metastasis treated with radiation therapy. Author(s): Niibe Y, Nakano T, Ohno T, Suzuki Y, Oka K, Tsujii H. Source: International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society. 2003 November-December; 13(6): 849-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14675323

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Quality of life and oral function in patients treated with radiation therapy for head and neck cancer. Author(s): Epstein JB, Robertson M, Emerton S, Phillips N, Stevenson-Moore P. Source: Head & Neck. 2001 May; 23(5): 389-98. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11295813

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Quality of life in patients receiving radiation therapy for non-small cell lung cancer. Author(s): John LD. Source: Oncology Nursing Forum. 2001 June; 28(5): 807-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11421140

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Quality of life study in prostate cancer patients treated with three-dimensional conformal radiation therapy: comparing late bowel and bladder quality of life symptoms to that of the normal population. Author(s): Hanlon AL, Watkins Bruner D, Peter R, Hanks GE. Source: International Journal of Radiation Oncology, Biology, Physics. 2001 January 1; 49(1): 51-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11163497

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Quality of life, survivorship, and psychosocial adjustment of young women with breast cancer after breast-conserving surgery and radiation therapy. Author(s): Dow KH, Lafferty P. Source: Oncology Nursing Forum. 2000 November-December; 27(10): 1555-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11103374

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Quality of virtual colonoscopy in patients who have undergone radiation therapy or surgery: how successful are we? Author(s): Gollub MJ, Ginsberg MS, Cooper C, Thaler HT. Source: Ajr. American Journal of Roentgenology. 2002 May; 178(5): 1109-16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11959711

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Quality-adjusted survival after tumor resection and/or radiation therapy for elderly patients with glioblastoma multiforme. Author(s): Muacevic A, Kreth FW. Source: Journal of Neurology. 2003 May; 250(5): 561-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12736735

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Quantification of late complications after radiation therapy. Author(s): Jung H, Beck-Bornholdt HP, Svoboda V, Alberti W, Herrmann T. Source: Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology. 2001 December; 61(3): 233-46. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11730992

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Quantifying radiation therapy-induced brain injury with whole-brain proton MR spectroscopy: initial observations. Author(s): Movsas B, Li BS, Babb JS, Fowble BL, Nicolaou N, Gonen O. Source: Radiology. 2001 November; 221(2): 327-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11687671

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Quantitative status of resources for radiation therapy in Asia and Pacific region. Author(s): Tatsuzaki H, Levin CV. Source: Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology. 2001 July; 60(1): 81-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11410308

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Quantitative tissue perfusion measurements in head and neck carcinoma patients before and during radiation therapy with a non-invasive MR imaging spin-labeling technique. Author(s): Schmitt P, Kotas M, Tobermann A, Haase A, Flentje M. Source: Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology. 2003 April; 67(1): 27-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12758237

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Radiation therapy for brain metastases from breast cancer. Author(s): Ogura M, Mitsumori M, Okumura S, Yamauchi C, Kawamura S, Oya N, Nagata Y, Hiraoka M. Source: Breast Cancer. 2003; 10(4): 349-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14634514

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Radiation therapy for metastatic brain tumors from lung cancer--a review to devise individualized treatment plans. Author(s): Itoh Y, Fuwa N, Morita K. Source: Nagoya J Med Sci. 2003 November; 66(3-4): 119-28. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14727688

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Radiation therapy through activation of stable nuclides. Author(s): Carlsson J, Forssell-Aronsson E, Glimelius B; Swedish Cancer Society Investigation Group. Source: Acta Oncologica (Stockholm, Sweden). 2002; 41(7-8): 629-34. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14651206

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Radiation therapy. Author(s): Jeremic B. Source: Hematology/Oncology Clinics of North America. 2004 February; 18(1): 1-12. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15005277

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Rationale and clinical basis for combining gefitinib (IRESSA, ZD1839) with radiation therapy for solid tumors. Author(s): Ochs JS. Source: International Journal of Radiation Oncology, Biology, Physics. 2004 March 1; 58(3): 941-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14967454

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Re: Radiation therapy in the treatment of Hodgkin's disease--do you see what I see? Author(s): Aleman BM, Russell NS, Bartelink H, van Leeuwen FE. Source: Journal of the National Cancer Institute. 2004 February 4; 96(3): 235-6; Author Reply 236-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14759992

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Reassessment of growth hormone status is required at final height in children treated with growth hormone replacement after radiation therapy. Author(s): Gleeson HK, Gattamaneni HR, Smethurst L, Brennan BM, Shalet SM. Source: The Journal of Clinical Endocrinology and Metabolism. 2004 February; 89(2): 662-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14764778

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Recent advances in light ion radiation therapy. Author(s): Brahme A. Source: International Journal of Radiation Oncology, Biology, Physics. 2004 February 1; 58(2): 603-16. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14751534

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Recombinant mutant human tumor necrosis factor-alpha (TNF-SAM2) immunotherapy with ranimustine chemotherapy and concurrent radiation therapy for malignant astrocytomas. Author(s): Fukushima T, Yamamoto M, Oshiro S, Tsugu H, Hirakawa K, Soma G. Source: Anticancer Res. 2003 November-December; 23(6A): 4473-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14666736

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Repeat spontaneous bladder rupture following radiation therapy. Author(s): Baseman AG, Snodgrass WT. Source: The Journal of Urology. 2003 December; 170(6 Pt 1): 2417. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14634441

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Sensitizing and protective substances in radiation therapy and predictive assays. Author(s): Zackrisson B, Kjellen E, Glimelius B, Carlsson J, Littbrand B, Turesson I; Swedish Cancer Society Investigation Group. Source: Acta Oncologica (Stockholm, Sweden). 2002; 41(7-8): 615-22. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14651204

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Short-term androgen deprivation and PSA doubling time: their association and relationship to disease progression after radiation therapy for prostate cancer. Author(s): Hanlon AL, Horwitz EM, Hanks GE, Pollack A. Source: International Journal of Radiation Oncology, Biology, Physics. 2004 January 1; 58(1): 43-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14697419

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Sparing critical organs from the effects of radiation therapy. Author(s): Hogle WP, Pourarian RJ. Source: Clinical Journal of Oncology Nursing. 2003 September-October; 7(5): 587-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14603557

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Sparing of the penile bulb and proximal penile structures with intensity-modulated radiation therapy for prostate cancer. Author(s): Kao J, Turian J, Meyers A, Hamilton RJ, Smith B, Vijayakumar S, Jani AB. Source: The British Journal of Radiology. 2004 February; 77(914): 129-36. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15010385

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Stereotactic intensity-modulated radiation therapy (IMRT) and inverse treatment planning for advanced pleural mesothelioma. Feasibility and initial results. Author(s): Munter MW, Nill S, Thilmann C, Hof H, Hoss A, Haring P, Partridge M, Manegold C, Wannenmacher M, Debus J. Source: Strahlentherapie Und Onkologie : Organ Der Deutschen Rontgengesellschaft. [et Al]. 2003 August; 179(8): 535-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14509952

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Surgery with or without radiation therapy in the management of craniopharyngiomas in children and young adults. Author(s): Stripp DC, Maity A, Janss AJ, Belasco JB, Tochner ZA, Goldwein JW, Moshang T, Rorke LB, Phillips PC, Sutton LN, Shu HK. Source: International Journal of Radiation Oncology, Biology, Physics. 2004 March 1; 58(3): 714-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14967425

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Surrogate end point for prostate cancer-specific mortality after radical prostatectomy or radiation therapy. Author(s): D'Amico AV, Moul JW, Carroll PR, Sun L, Lubeck D, Chen MH. Source: Journal of the National Cancer Institute. 2003 September 17; 95(18): 1376-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=13130113

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Swedish Cancer Society radiation therapy research investigation. Author(s): Mattsson S, Brahme A, Carlsson J, Denekamp J, Forssell-Aronsson E, Hellstrom M, Johansson KA, Kjellen E, Littbrand B, Nordenskjold B, Stenerlow B, Turesson I, Zackrisson B, Glimelius B; Swedish Cancer Society. Source: Acta Oncologica (Stockholm, Sweden). 2002; 41(7-8): 596-603. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14651202

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Symptomatic cardiac events following radiation therapy for left-sided breast cancer: possible association with radiation therapy-induced changes in regional perfusion. Author(s): Yu X, Prosnitz RR, Zhou S, Hardenberg PH, Tisch A, Blazing MA, BorgesNeto S, Hollis D, Wong T, Marks LB. Source: Clinical Breast Cancer. 2003 August; 4(3): 193-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14499012

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Systemic benefit of local radiation therapy. Author(s): Lawrence G, Crawford J. Source: International Journal of Radiation Oncology, Biology, Physics. 2003 December 1; 57(5): 1510-1; Author Reply 1511. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14630294

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The effect of leukocyte interleukin injection (Multikine) treatment on the peritumoral and intratumoral subpopulation of mononuclear cells and on tumor epithelia: a possible new approach to augmenting sensitivity to radiation therapy and chemotherapy in oral cancer--a multicenter phase I/II clinical Trial. Author(s): Timar J, Forster-Horvath C, Lukits J, Dome B, Ladanyi A, Remenar E, Kasler M, Bencsik M, Repassy G, Szabo G, Velich N, Suba Z, Elo J, Balatoni Z, Bajtai A, Chretien P, Talor E. Source: The Laryngoscope. 2003 December; 113(12): 2206-17. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14660929

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The efficacy and sequencing of a short course of androgen suppression on freedom from biochemical failure when administered with radiation therapy for T2-T3 prostate cancer. Author(s): Laverdiere J, Nabid A, De Bedoya LD, Ebacher A, Fortin A, Wang CS, Harel F. Source: The Journal of Urology. 2004 March; 171(3): 1137-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14767287

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The efficacy of pilocarpine and bethanechol upon saliva production in cancer patients with hyposalivation following radiation therapy. Author(s): Gorsky M, Epstein JB, Parry J, Epstein MS, Le ND, Silverman S Jr. Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics. 2004 February; 97(2): 190-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14970777

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The sequencing of radiation therapy and chemotherapy after mastectomy in premenopausal women with breast cancer. Author(s): Cakir S, Gursel B, Meydan D, Yildiz L. Source: Japanese Journal of Clinical Oncology. 2003 November; 33(11): 563-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14711980

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Three-dimensional conformal radiation therapy for non-small-cell lung cancer: a phase I/II dose escalation clinical trial. Author(s): Wu KL, Jiang GL, Liao Y, Qian H, Wang LJ, Fu XL, Zhao S. Source: International Journal of Radiation Oncology, Biology, Physics. 2003 December 1; 57(5): 1336-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14630271

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Thrombospondin-1 treatment prevents growth of dormant lung micrometastases after surgical resection and curative radiation therapy of the primary tumor in human melanoma xenografts. Author(s): Rofstad EK, Galappathi K, Mathiesen B. Source: International Journal of Radiation Oncology, Biology, Physics. 2004 February 1; 58(2): 493-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14751520

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Toxicity profile of intensity-modulated radiation therapy for head and neck carcinoma and potential role of amifostine. Author(s): Chao KS, Ozyigit G, Thorsdad WL. Source: Seminars in Oncology. 2003 December; 30(6 Suppl 18): 101-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14727250

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Tracheobronchial amyloidosis: a case report of successful treatment with external beam radiation therapy. Author(s): Monroe AT, Walia R, Zlotecki RA, Jantz MA. Source: Chest. 2004 February; 125(2): 784-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14769766

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Transforming the patient experience in radiation therapy. Author(s): Jarvis JA. Source: Radiol Manage. 2003 November-December; 25(6): 34-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14699925

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Treatment of solitary brain metastasis. Resection followed by whole brain radiation therapy (WBRT) and a radiation boost to the metastatic site. Author(s): Rades D, Raabe A, Bajrovic A, Alberti W. Source: Strahlentherapie Und Onkologie : Organ Der Deutschen Rontgengesellschaft. [et Al]. 2004 March; 180(3): 144-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14991201

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Ultimate results of radiation therapy for T1-T2 mycosis fungoides (including reirradiation). Author(s): Ysebaert L, Truc G, Dalac S, Lambert D, Petrella T, Barillot I, Naudy S, Horiot JC, Maingon P. Source: International Journal of Radiation Oncology, Biology, Physics. 2004 March 15; 58(4): 1128-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15001254

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Ultrasound-based stereotactic guidance in prostate cancer--quantification of organ motion and set-up errors in external beam radiation therapy. Author(s): Lattanzi J, McNeeley S, Donnelly S, Palacio E, Hanlon A, Schultheiss TE, Hanks GE. Source: Computer Aided Surgery : Official Journal of the International Society for Computer Aided Surgery. 2000; 5(4): 289-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11029161

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Urinary VEGF and MMP levels as predictive markers of 1-year progression-free survival in cancer patients treated with radiation therapy: a longitudinal study of protein kinetics throughout tumor progression and therapy. Author(s): Chan LW, Moses MA, Goley E, Sproull M, Muanza T, Coleman CN, Figg WD, Albert PS, Menard C, Camphausen K. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2004 February 1; 22(3): 499-506. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14752073

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Use of adjuvant chemotherapy and radiation therapy for colorectal cancer in a population-based cohort. Author(s): Ayanian JZ, Zaslavsky AM, Fuchs CS, Guadagnoli E, Creech CM, Cress RD, O'Connor LC, West DW, Allen ME, Wolf RE, Wright WE. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2003 April 1; 21(7): 1293-300. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12663717

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Use of restenting should be minimized with intracoronary radiation therapy for instent restenosis. Author(s): Cha DH, Malik IA, Cheneau E, Ajani AE, Leborgne L, Wolfram R, Porrazzo M, Satler LF, Kent KM, Pichard AD, Pinnow E, Lindsay J, Waksman R. Source: Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions. 2003 May; 59(1): 1-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12720231

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Usefulness of periprocedural creatinine phosphokinase-MB release to predict adverse outcomes after intracoronary radiation therapy for in-stent restenosis. Author(s): Ajani AE, Waksman R, Sharma AK, Lew R, Pinnow E, Canos DA, Cheneau E, Castagna M, Cha DH, Leborgne L, Satler LF, Pichard AD, Kent KM, Lindsay J. Source: The American Journal of Cardiology. 2004 February 1; 93(3): 313-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14759380

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Using intraoperative radiation therapy--a case study. Author(s): Domanovic MA, Ouzidane M, Ellis RJ, Kinsella TJ, Beddar AS. Source: Aorn Journal. 2003 February; 77(2): 412-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12619854

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Using technology to decrease xerostomia for head and neck cancer patients treated with radiation therapy. Author(s): Amosson CM, Teh BS, Mai WY, Woo SY, Chiu JK, Donovan DT, Parke R, Carpenter LS, Lu HH, Grant WH 3rd, Butler EB. Source: Seminars in Oncology. 2002 December; 29(6 Suppl 19): 71-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12577249

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Uterine papillary serous carcinoma after pelvic radiation therapy for cancer of the cervix. Author(s): Behtash N, Tehranian A, Ardalan FA, Hanjani P. Source: Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology. 2002 January; 22(1): 96-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12521747

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Utility of surgical resection with or without radiation therapy in patients with lowgrade gastric mucosa-associated lymphoid tissue lymphoma. Author(s): Zinzani PL, Tani M, Barbieri E, Stefoni V, Alinari L, Baccarani M. Source: Haematologica. 2003 July; 88(7): 830-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12857565

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Validation of a treatment policy for patients with prostate specific antigen failure after three-dimensional conformal prostate radiation therapy. Author(s): Pinover WH, Horwitz EM, Hanlon AL, Uzzo RG, Hanks GE. Source: Cancer. 2003 February 15; 97(4): 1127-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12569615

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Valvular dysfunction and carotid, subclavian, and coronary artery disease in survivors of hodgkin lymphoma treated with radiation therapy. Author(s): Hull MC, Morris CG, Pepine CJ, Mendenhall NP. Source: Jama : the Journal of the American Medical Association. 2003 December 3; 290(21): 2831-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14657067

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Valvular heart operation in patients with previous mediastinal radiation therapy. Author(s): Handa N, McGregor CG, Danielson GK, Daly RC, Dearani JA, Mullany CJ, Orszulak TA, Schaff HV, Zehr KJ, Anderson BJ, Schomberg PJ, Puga FJ. Source: The Annals of Thoracic Surgery. 2001 June; 71(6): 1880-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11426762

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Vascular in situ activation radiation therapy insitustent dosimetry. Author(s): Adnani N. Source: Cardiovascular Radiation Medicine. 2002 July-December; 3(3-4): 193-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12974373

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Verification techniques and dose distribution for computed tomographic planned supine craniospinal radiation therapy. Author(s): Chang EL, Wong PF, Forster KM, Petru MD, Kowalski AV, Maor MH. Source: Medical Dosimetry : Official Journal of the American Association of Medical Dosimetrists. 2003 Summer; 28(2): 127-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12804712

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Very high energy electrons (50-250 MeV) and radiation therapy. Author(s): Papiez L, DesRosiers C, Moskvin V. Source: Technology in Cancer Research & Treatment. 2002 April; 1(2): 105-10. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12622516

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Virtual micro-intensity modulated radiation therapy. Author(s): Alfredo R, Siochi C. Source: Medical Physics. 2000 November; 27(11): 2480-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11128299

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Visual acuity and contrast sensitivity in patients with neovascular age-related macular degeneration. Results from the Radiation Therapy for Age-Related Macular Degeneration (RAD-) Study. Author(s): Bellmann C, Unnebrink K, Rubin GS, Miller D, Holz FG. Source: Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie. 2003 December; 241(12): 968-74. Epub 2003 September 06. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=13680248

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Vitamin D and UVB radiation therapy. Author(s): Kragballe K. Source: Cutis; Cutaneous Medicine for the Practitioner. 2002 November; 70(5 Suppl): 912. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12467333

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Voice rehabilitation after total laryngectomy and postoperative radiation therapy. Author(s): Mendenhall WM, Morris CG, Stringer SP, Amdur RJ, Hinerman RW, Villaret DB, Robbins KT. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2002 May 15; 20(10): 2500-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12011128

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Waiting for radiation therapy: does it matter? Author(s): Seel M, Foroudi F. Source: Australasian Radiology. 2002 September; 46(3): 275-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12196236

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Waiting lists for radiation therapy: a case study. Author(s): D'Souza DP, Martin DK, Purdy L, Bezjak A, Singer PA. Source: Bmc Health Services Research [electronic Resource]. 2001; 1(1): 3. Epub 2001 April 17. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11319944

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Weekly irinotecan and concurrent radiation therapy for stage III unresectable NSCLC. Author(s): Choy H, Chakravarthy A, Devore RF 3rd, Jagasia M, Hande KR, Roberts JR, Johnson DH, Yunus F. Source: Oncology (Huntingt). 2000 July; 14(7 Suppl 5): 43-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10981290

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Weighing the benefits and risks of radiation therapy for low-grade glioma. Author(s): Peterson K, DeAngelis LM. Source: Neurology. 2001 May 22; 56(10): 1255-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11376168

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What is the current role of radiation therapy in the treatment of skin carcinomas? Author(s): Finizio L, Vidali C, Calacione R, Beorchia A, Trevisan G. Source: Tumori. 2002 January-February; 88(1): 48-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12004850

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When not to give radiation therapy after breast conservation surgery for breast cancer. Author(s): de Csepel J, Tartter PI, Gajdos C. Source: Journal of Surgical Oncology. 2000 August; 74(4): 273-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10962459

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Where next with preoperative radiation therapy for rectal cancer? Author(s): Withers HR, Haustermans K. Source: International Journal of Radiation Oncology, Biology, Physics. 2004 February 1; 58(2): 597-602. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14751533

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Whole-brain radiation therapy is not beneficial as an adjuvant therapy for brain metastases compared with localized irradiation. Author(s): Iwadate Y, Namba H, Yamaura A. Source: Anticancer Res. 2002 January-February; 22(1A): 325-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12017311

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Whole-pulmonary low-dose radiation therapy in agnogenic myeloid metaplasia with diffuse lung involvement. Author(s): Weinschenker P, Kutner JM, Salvajoli JV, Hanriot RM, Ribeiro AF, Capelozzi VL, Del Giglio A. Source: American Journal of Hematology. 2002 April; 69(4): 277-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11921022

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Wound care after radiation therapy. Author(s): Mendelsohn FA, Divino CM, Reis ED, Kerstein MD. Source: Advances in Skin & Wound Care. 2002 September-October; 15(5): 216-24. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12368711

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CHAPTER 2. NUTRITION AND RADIATION THERAPY Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and radiation therapy.

Finding Nutrition Studies on Radiation Therapy The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “radiation therapy” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

7 Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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The following information is typical of that found when using the “Full IBIDS Database” to search for “radiation therapy” (or a synonym): ·

A phase I study of cranial radiation therapy with concomitant continuous infusion paclitaxel in children with brain tumors. Author(s): Department of Radiation Oncology, University of Pennsylvania Medical Center, 3400 Spruce Street, Philadelphia, PA 19104-4283, USA. Source: Liu, L Vapiwala, N Munoz, L K Winick, N J Weitman, S Strauss, L C Frankel, L S Rosenthal, D I Med-Pediatr-Oncol. 2001 October; 37(4): 390-2 0098-1532

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A survey of researches on synergy and toxicity abatement of traditional Chinese medicine in radiotherapy of nasopharyngeal carcinoma. Author(s): Municipal Hospital of Traditional Chinese Medicine, Zhaoqing, Guangdong 526020. Source: Liu, C Liu, L Li, P J-Tradit-Chin-Med. 2001 December; 21(4): 303-11 0254-6272

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Acute and subacute toxicity associated with concurrent adjuvant radiation therapy and paclitaxel in primary breast cancer therapy. Author(s): Department of Internal Medicine, William Beaumont Hospital, Royal Oak, Michigan 48073, USA. Source: Hanna, Youseff M Baglan, Kathleen L Stromberg, Jannifer S Vicini, Frank A A Decker, David Breast-J. 2002 May-June; 8(3): 149-53 1075-122X

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Changing role and decreasing size: current trends in radiotherapy for Hodgkin's disease. Author(s): Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, Weill Medical College of Cornell University, 1275 York Avenue, New York, NY 10021, USA. [email protected] Source: Yahalom, J Curr-Oncol-Repage 2002 September; 4(5): 415-23 1523-3790

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Combination chemotherapy and radiotherapy for primary central nervous system lymphoma: Radiation Therapy Oncology Group Study 93-10. Author(s): Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. [email protected] Source: DeAngelis, L M Seiferheld, W Schold, S C Fisher, B Schultz, C J J-Clin-Oncol. 2002 December 15; 20(24): 4643-8 0732-183X

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Concurrent administration of Docetaxel and Stealth liposomal doxorubicin with radiotherapy in non-small cell lung cancer : excellent tolerance using subcutaneous amifostine for cytoprotection. Author(s): Tumour and Angiogenesis Research Group, PO Box 12, Democritus University of Thrace, Alexandroupolis 68100, Greece. [email protected] Source: Koukourakis, M I Romanidis, K Froudarakis, M Kyrgias, G Koukourakis, G V Retalis, G Bahlitzanakis, N Br-J-Cancer. 2002 August 12; 87(4): 385-92 0007-0920

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Dose-escalation study of weekly irinotecan and daily carboplatin with concurrent thoracic radiotherapy for unresectable stage III non-small cell lung cancer. Author(s): First Department of Internal Medicine, Osaka City University Medical School, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan. [email protected] Source: Yamada, M Kudoh, S Fukuda, H Nakagawa, K Yamamoto, N Nishimura, Y Negoro, S Takeda, K Tanaka, M Fukuoka, M Br-J-Cancer. 2002 July 29; 87(3): 258-63 0007-0920

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Efficacy of an early intensification treatment integrating chemotherapy, autologous stem cell transplantation and radiotherapy for poor risk primary mediastinal large B cell lymphoma with sclerosis. Author(s): Department of Hematology, Niguarda Ca' Granda Hospital, Piazza Ospedale Maggiore, 20162 Milan, Italy. Source: Cairoli, R Grillo, G Tedeschi, A Gargantini, L Marenco, P Tresoldi, E Barbarano, L Nosari, A M Morra, E Bone-Marrow-Transplant. 2002 Mar; 29(6): 473-7 0268-3369

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Evaluation of the immunomodulatory activity of Aronia in combination with apple pectin in patients with breast cancer undergoing postoperative radiation therapy. Author(s): Clinic of Radiology, St. George University Hospital, Plovdiv, Bulgaria. Source: Yaneva, M P Botushanova, A D Grigorov, L A Kokov, J L Todorova, E P Krachanova, M G Folia-Med-(Plovdiv). 2002; 44(1-2): 22-5 0204-8043

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Induction chemotherapy followed by concomitant chemoradiation therapy in advanced head and neck cancer: a phase II study for organ-sparing purposes evaluating feasibility, effectiveness and toxicity. Author(s): Department of Medical Oncology, Policlinico Universitario, University of Cagliari, Cagliari 09042, Italy. [email protected] Source: Mantovani, Giovanni Proto, Ernesto Massa, Elena Mulas, Carlo Madeddu, Clelia Mura, Loredana Mudu, M Caterina Astara, Giorgio Murgia, Viviana Gramignano, Giulia Ferreli, Luca Camboni, Paolo Lusso, Maria Rita Mocci, Miria Tore, Giorgio Mura, Manfredi Amichetti, Maurizio Maccio, Antonio Int-J-Oncol. 2002 February; 20(2): 419-27 1019-6439

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Induction paclitaxel, carboplatin, and infusional 5-FU followed by concurrent radiation therapy and weekly paclitaxel/carboplatin in the treatment of locally advanced head and neck cancer: a phase II trial of the Minnie Pearl Cancer Research Network. Author(s): Sarah Cannon Cancer Center, Nashville, TN 37203, USA. Source: Hainsworth, J D Meluch, A A McClurkan, S Gray, J R Stroup, S L Burris, H A 3rd Yardley, D A Bradof, J E Yost, K Ellis, J K Greco, F A Cancer-J. 2002 Jul-August; 8(4): 311-21 1528-9117

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Inverse treatment planning and stereotactic intensity-modulated radiation therapy (IMRT) of the tumor and lymph node levels for nasopharyngeal carcinomas. Description of treatment technique, plan comparison, and case study. Author(s): Department of Medical Physics, German Cancer Research Center (DKFZ), Heidelberg, Germany. [email protected] Source: Munter, M W Debus, J Hof, H Nill, S Haring, P Bortfeld, T Wannenmacher, M Strahlenther-Onkol. 2002 September; 178(9): 517-23 0179-7158

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Irinotecan in combination with radiation therapy for small-cell and non-small-cell lung cancer. Author(s): Center for Radiation Oncology, Vanderbilt University Medical Center, Nashville, Tennessee 37232-5671, USA. Source: Wu, H G Choy, H Oncology-(Huntingt). 2002 September; 16(9 Suppl 9): 13-8 0890-9091

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Is postoperative radiotherapy useful for the rectal carcinoma in the era of total mesorectal excision? Author(s): Department of Surgery, Ajou University School of Medicine, San-5 Paldal ku, Wonchon dong, Suwon 442-749, Korea. [email protected] Source: Suh, K W Kim, B W Chun, M Lim, H Y Hepatogastroenterology. 2002 MarApril; 49(44): 399-403 0172-6390

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MACOP-B regimen followed by involved-field radiation therapy in early-stage aggressive non-Hodgkin's lymphoma patients: 14-year update results. Author(s): Institute of Hematology and Medical Oncology Seragnoli, University of Bologna, Italy. [email protected] Source: Zinzani, P L Stefoni, V Tani, M Barbieri, E Albertini, P Vigna, E Gherlinzoni, F Alinari, L Galuppi, A Pileri, S Babini, L Tura, S Leuk-Lymphoma. 2001 Sep-October; 42(5): 989-95 1042-8194

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Monte Carlo dose simulation for intracoronary radiation therapy with a rhenium 188 solution-filled balloon with contrast medium. Author(s): Laboratory of Cyclotron Application, Korea Cancer Center Hospital, 215-4 Gongneung-dong Nowon-gu, Seoul 139-706, Korea. [email protected] Source: Kim, Eun Hee Moon, Dae Hyuk Oh, Seung June Choi, Chang Woon Lim, Sang Moo Hong, Myeong Ki Park, Seong Wook J-Nucl-Cardiol. 2002 May-Jun; 9(3): 312-8 1071-3581

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Non surgical interventions for late radiation proctitis in patients who have received radical radiotherapy to the pelvis. Author(s): Centre for Cancer Treatment, Mount Vernon Hospital, Rickmansworth Rd, Northwood, Middlesex, UK, HA6 2RN. [email protected] Source: Denton, A Forbes, A Andreyev, J Maher, E J Cochrane-Database-Syst-Revolume 2002; (1): CD003455 1469-493X

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Oral etoposide following combination chemotherapy and radiation therapy in a patient with advanced adult neuroblastoma led to long survival. Author(s): Department of Urology, Yamaguchi University School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan. Source: Yamaguchi, S Wada, T Oba, K Yoshihiro, S Naito, K Int-J-Clin-Oncol. 2001 October; 6(5): 259-61 1341-9625

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Phase II: trial of twice weekly amifostine in patients with non-small cell lung cancer treated with chemoradiotherapy. Author(s): Kimmel Cancer Center of Jefferson Medical College, Philadelphia, PA, USA. Source: Werner Wasik, Maria Axelrod, Rita S Friedland, David P Hauck, Walter Rose, Lewis J Chapman, Andrew E Grubbs, S Deshields, M Curran, Walter J Semin-RadiatOncol. 2002 January; 12(1 Suppl 1): 34-9 1053-4296

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Preoperative twice-weekly paclitaxel with concurrent radiation therapy followed by surgery and postoperative doxorubicin-based chemotherapy in locally advanced breast cancer: a phase I/II trial. Author(s): Kaplan Comprehensive Cancer Center, New York University School of Medicine, New York, NY, USA. [email protected] Source: Formenti, S C Volm, M Skinner, K A Spicer, D Cohen, D Perez, E Bettini, A C Groshen, S Gee, C Florentine, B Press, M Danenberg, P Muggia, F J-Clin-Oncol. 2003 March 1; 21(5): 864-70 0732-183X

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Prevention and treatment of chemo- and radiotherapy-induced oral mucositis. Author(s): Dipartimento di Medicina Chirurgia e Odontoiatria, Unita di Patologia e Medicina Orale, Universita degli Studi, Milan, Italy. [email protected] Source: Demarosi, F Bez, C Carrassi, A Minerva-Stomatol. 2002 May; 51(5): 173-86 00264970

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Primary breast lymphoma successfully treated with combination therapy including local radiation therapy: a report of two cases. Author(s): Department of Radiology, Maebashi Red Cross Hospital, Japan.

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Source: Suzuki, Y Ito, J Hasegawa, M Katano, S Saito, J Ito, H Radiat-Med. 2002 JanFebruary; 20(1): 37-9 0288-2043 ·

Pros and cons of antioxidant use during radiation therapy. Author(s): Center for Vitamin and Cancer Research, Department of Radiology, Health Sciences Center, University of Colorado, Denver, CO 80262, USA. [email protected] Source: Prasad, K N Cole, W C KuMarch, B Che Prasad, K Cancer-Treat-Revolume 2002 April; 28(2): 79-91 0305-7372

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Survival of patients with newly diagnosed glioblastoma multiforme treated with RSR13 and radiotherapy: results of a phase II new approaches to brain tumor therapy CNS consortium safety and efficacy study. Author(s): Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231-2410, USA. [email protected] Source: Kleinberg, L Grossman, S A Carson, K Lesser, G O'Neill, A Pearlman, J Phillips, P Herman, T Gerber, M J-Clin-Oncol. 2002 July 15; 20(14): 3149-55 0732-183X

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: ·

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: ·

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

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Google: http://directory.google.com/Top/Health/Nutrition/

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Healthnotes: http://www.healthnotes.com/

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Open Directory Project: http://dmoz.org/Health/Nutrition/

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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

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WebMDÒHealth: http://my.webmd.com/nutrition

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

The following is a specific Web list relating to radiation therapy; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: ·

Minerals Cisplatin Source: Healthnotes, Inc.; www.healthnotes.com Sulfur Source: Integrative Medicine Communications; www.drkoop.com

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CHAPTER 3. DISSERTATIONS ON RADIATION THERAPY Overview In this chapter, we will give you a bibliography on recent dissertations relating to radiation therapy. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “radiation therapy” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on radiation therapy, we have not necessarily excluded non-medical dissertations in this bibliography.

Dissertations on Radiation Therapy ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to radiation therapy. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: ·

A Comparison of TLD Dosimeters: Lithium Fluoride:magnesium, Titanium and Lithium Fluoride: Magnesium, Copper, Phosphate, for Measurement of Radiation Therapy Doses by Glennie, Gilbert Douglas; PhD from University of Virginia, 2003, 272 pages http://wwwlib.umi.com/dissertations/fullcit/3083065

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A Study of the Dosimetry of Small Field Photon Beams Used in Intensity-Modulated Radiation Therapy in Inhomogeneous Media: Monte Carlo Simulations and Algorithm Comparisons and Corrections by Jones, Andrew Osler; PhD from Drexel University College of Medicine, 2003, 142 pages http://wwwlib.umi.com/dissertations/fullcit/3100224

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Absorbed Dose Determination and Characteristics of Degraded Electron Beams: Application to Intraoperative Radiation Therapy by Bjork, Peter; PhD from Lunds Universitet (Sweden), 2003, 53 pages http://wwwlib.umi.com/dissertations/fullcit/f439361

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An Analysis of Radiation Therapy Program Directors' Attitudes toward Specialized Accreditation by Adams, Laurie Ann, EdD from Georgia Southern University, 1998, 137 pages http://wwwlib.umi.com/dissertations/fullcit/9906225

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An Analysis of the Role of the Program Director in Radiation Therapy Technology by Uschold, George Michael, EdD from The University of Rochester, 1990, 153 pages http://wwwlib.umi.com/dissertations/fullcit/9025839

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Experimental Investigation of Organ Motion Effect in Intensity-Modulated Radiation Therapy by Pope, Cynthia Jean; MS from University of Massachusetts Lowell, 2003, 84 pages http://wwwlib.umi.com/dissertations/fullcit/1414976

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Factors Associated with Health-Promoting Lifestyle Behaviors among Radiation Therapy Patients by Tighe, Mary Beth; PhD from The Ohio State University, 1999, 230 pages http://wwwlib.umi.com/dissertations/fullcit/9951738

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Hippocampal Volume and Verbal Memory Performance in Pediatric Medulloblastoma Patients Treated with Risk-Adapted Radiation Therapy by Nagel, Bonnie Jean; PhD from The University of Memphis, 2003, 58 pages http://wwwlib.umi.com/dissertations/fullcit/3095678

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Impact of Viewing an Educational Videotape Program on the Significant Others of Radiation Therapy Oncology Patients by Beattie, Helen Morgan, EdD from University of Massachusetts, 1989, 247 pages http://wwwlib.umi.com/dissertations/fullcit/9001483

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Intensity-Modulated Radiation Therapy Inverse Planning Algorithm: Minimize the Negative Beams from Iterating the Dose Voxels by Luo, Chunsong; PhD from University of Miami, 2003, 79 pages http://wwwlib.umi.com/dissertations/fullcit/3081300

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Magnetic Field in Radiation Therapy: Improving Dose Coverage in Tumors of the Head and Neck by Reducing Lateral Electronic Disequilibrium by Wadi-Ramahi, Shada Jamal; PhD from Rush University, 2003, 132 pages http://wwwlib.umi.com/dissertations/fullcit/3104040

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Quality Assurance and Treatment Verification for Intensity-Modulated Radiation Therapy by Richardson, Susan Lynn; PhD from The University of Wisconsin - Madison, 2003, 143 pages http://wwwlib.umi.com/dissertations/fullcit/3089699

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The Effect of a Peer to Peer Strategy Within Radiation Therapy and Nursing Clinical Settings on the Development of Critical Thinking Skills by Belinsky, Susan Beth; EdD from University of Massachusetts Lowell, 2000, 146 pages http://wwwlib.umi.com/dissertations/fullcit/9961539

Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.

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CHAPTER 4. CLINICAL TRIALS AND RADIATION THERAPY Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning radiation therapy.

Recent Trials on Radiation Therapy The following is a list of recent trials dedicated to radiation therapy.8 Further information on a trial is available at the Web site indicated. ·

Adjuvant Radiation Therapy in Treating Patients With Brain Metastases Condition(s): brain metastases Study Status: This study is currently recruiting patients. Sponsor(s): EORTC Cooperative Group

Radiotherapy

Cooperative

Group;

EORTC

Brain

Tumor

Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Adjuvant radiation therapy may kill any remaining tumor cells following surgery or radiosurgery for brain metastases. PURPOSE: Randomizedphase III trial to study the effectiveness of whole-brain radiation therapy after surgery or radiosurgery in treating patients with brain metastases from solid tumors. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002899 ·

Celecoxib and Radiation Therapy in Treating Patients With Locally Advanced NonSmall Cell Lung Cancer Condition(s): stage II non-small cell lung cancer; stage IIIA non-small cell lung cancer; stage IIIB non-small cell lung cancer

8

These are listed at www.ClinicalTrials.gov.

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Study Status: This study is currently recruiting patients. Sponsor(s): Radiation Therapy Oncology Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Celecoxib may stop the growth of tumor cells by stopping blood flow to the tumor and may make the tumor cells more sensitive to radiation therapy. PURPOSE: Phase I/II trial to study the effectiveness of combining celecoxib with radiation therapy in treating patients who have locally advancednon-small cell lung cancer. Phase(s): Phase I; Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00046839 ·

Chemotherapy Plus Radiation Therapy in Treating Patients With Stage II or Stage III Anal Cancer Condition(s): stage II anal cancer; stage III anal cancer; squamous cell carcinoma of the anus; cloacogenic carcinoma of the anus; basaloid carcinoma of the anus Study Status: This study is currently recruiting patients. Sponsor(s): Radiation Therapy Oncology Group; National Cancer Institute (NCI); Eastern Cooperative Oncology Group; Cancer and Leukemia Group B; Southwest Oncology Group; North Central Cancer Treatment Group Purpose - Excerpt: RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining more than one drug or combining radiation therapy with chemotherapy may kill more tumor cells. It is not yet known whether fluorouracil and mitomycin plus radiation therapy is more effective than fluorouracil and cisplatin plus radiation therapy for anal cancer. PURPOSE: Randomizedphase III trial to compare the effectiveness of fluorouracil and mitomycin plus radiation therapy with that of fluorouracil and cisplatin plus radiation therapy in treating patients who have stage II or stage III anal cancer. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00003596

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Combination Chemotherapy and Radiation Therapy With or Without Surgery In Treating Patients With Stage II or Stage III Bladder Cancer Condition(s): stage II bladder cancer; stage III bladder cancer Study Status: This study is currently recruiting patients. Sponsor(s): Radiation Therapy Oncology Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells. It is not yet known which regimen of combination chemotherapy plus radiation therapy with or without surgery is more effective in treating bladder cancer. PURPOSE: Randomizedphase II trial to compare the effectiveness of two combination chemotherapy regimens and radiation therapy with or

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without radical cystectomy in treating patients who have stage II or stage III bladder cancer. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00055601 ·

Combination Chemotherapy, Monoclonal Antibody, and Radiation Therapy in Treating Patients With Primary Central Nervous System Lymphoma Condition(s): primary central nervous system lymphoma Study Status: This study is currently recruiting patients. Sponsor(s): Radiation Therapy Oncology Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Drugs used in chemotherapy such as methotrexate and temozolomide use different ways to stop cancer cells from dividing so they stop growing or die. Monoclonal antibodies such as rituximab can locate cancer cells and either kill them or deliver cancer-killing substances to them without harming normal cells. Radiation therapy uses high-energy x-rays to damage cancer cells. Combining methotrexate, temozolomide, and rituximab with radiation therapy may kill more cancer cells. PURPOSE: Phase I/II trial to study the effectiveness of combining methotrexate, rituximab, and temozolomide with radiation therapy in treating patients who have primary central nervous system lymphoma. Phase(s): Phase I; Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00068250

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Hormone Therapy and Radiation Therapy in Treating Patients With Prostate Cancer Condition(s): adenocarcinoma of the prostate; stage II prostate cancer; stage III prostate cancer Study Status: This study is currently recruiting patients. Sponsor(s): Radiation Therapy Oncology Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Hormones can stimulate the growth of prostate cancer cells. Hormone therapy may fight prostate cancer by reducing the production of androgens. Radiation therapy uses high-energy x-rays to damage tumor cells. It is not yet known which regimen of hormone therapy and radiation therapy is more effective for prostate cancer. PURPOSE: Randomizedphase III trial to compare the effectiveness of two different regimens of hormone therapy and radiation therapy in treating patients who have prostate cancer. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005044

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Radiation Therapy Alone Compared to Radiation Therapy Plus Chemotherapy in Treating Patients With Previously Untreated Cancer of the Nasopharynx Condition(s): stage III lymphoepithelioma of the nasopharynx; stage IV squamous cell carcinoma of the nasopharynx; stage III squamous cell carcinoma of the nasopharynx; stage IV lymphoepithelioma of the nasopharynx Study Status: This study is currently recruiting patients. Sponsor(s): NMRC Nasopharyngeal Cancer Work Group Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. It is not yet known whether radiation therapy alone is more effective than radiation therapy plus chemotherapy in treating cancer of the nasopharynx. PURPOSE: Randomizedphase III trial to compare the effectiveness of radiation therapy alone with radiation therapy plus chemotherapy in treating patients with previously untreated cancer of the nasopharynx. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00003637

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Radiation Therapy Following Surgery in Treating Women With Early-Stage Invasive Breast Cancer Condition(s): stage I breast cancer; stage II breast cancer Study Status: This study is currently recruiting patients. Sponsor(s): National Cancer Institute of Canada; National Cancer Institute (NCI); National Surgical Adjuvant Breast and Bowel Project (NSABP); Radiation Therapy Oncology Group; Southwest Oncology Group; Trans-Tasman Radiation Oncological Group; North Central Cancer Treatment Group Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Radiation to the tumor site and surrounding area may kill more tumor cells. It is not yet known if radiation therapy to the breast alone following surgery is more effective than radiation therapy to the breast plus surrounding tissue in treating invasive breast cancer. PURPOSE: Randomizedphase III trial to compare the effectiveness of radiation therapy to the breast alone following surgery with that of radiation therapy to the breast plus surrounding tissue in treating women who have early-stage invasive breast cancer. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005957

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Radiation Therapy in Patients With Limited-Stage Small Cell Lung Cancer in Complete Remission Condition(s): limited stage small cell lung cancer Study Status: This study is currently recruiting patients.

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Sponsor(s): Institut Gustave Roussy; EORTC Radiotherapy Cooperative Group; EORTC Lung Cancer Cooperative Group Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells and prevent the spread of cancer to the brain. It is not yet known if standard-dose radiation therapy is more effective than high-dose radiation therapy in preventing the spread of limited-stage small cell lung cancer cells to the brain. PURPOSE: Randomizedphase III trial to compare the effectiveness of two regimens of radiation therapy in treating patients who have limited-stage small cell lung cancer in complete remission. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005062 ·

Radiation Therapy in Preventing CNS Metastases in Patients With Non-Small Cell Lung Cancer Condition(s): brain metastases; stage IIIA non-small cell lung cancer; stage IIIB nonsmall cell lung cancer Study Status: This study is currently recruiting patients. Sponsor(s): Radiation Therapy Oncology Group; National Cancer Institute (NCI); Eastern Cooperative Oncology Group Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. It is not yet known if giving radiation therapy to the head is effective in preventing CNS metastases in patients who have stage III non-small cell lung cancer. PURPOSE: Randomizedphase III trial to study the effectiveness of radiation therapy to the head in preventing CNS metastases in patients who have been previously treated for stage III non-small cell lung cancer. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00048997

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Radiation Therapy in Treating Patients With Metastases to the Lymph Nodes in the Neck From an Unknown Primary Tumor Condition(s): newly diagnosed carcinoma of unknown primary; squamous cell carcinoma of unknown primary Study Status: This study is currently recruiting patients. Sponsor(s): European Organization for Research and Treatment of Cancer; Radiation Therapy Oncology Group; National Cancer Institute of Canada; EORTC Radiotherapy Cooperative Group; Danish Head and Neck Cancer Group Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Giving radiation therapy in different ways may kill more tumor cells. It is not yet known which regimen of radiation therapy is more effective in treating patients who have metastases to the lymph nodes in the neck. PURPOSE: Randomizedphase III

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trial to compare different radiation therapy regimens in treating patients who have metastases to the lymph nodes in the neck from an unknown primary tumor. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00047125 ·

Radiation Therapy in Treating Patients With Stage I or Stage II Non-Hodgkin's Lymphoma Condition(s): adult non-Hodgkin's lymphoma; grade 1 follicular lymphoma; grade 2 follicular lymphoma; grade 3 follicular lymphoma Study Status: This study is currently recruiting patients. Sponsor(s): EORTC Lymphoma Cooperative Group; EORTC Radiotherapy Cooperative Group Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Giving radiation therapy in different ways may kill more tumor cells. It is not yet known which regimen of radiation therapy is more effective for non-Hodgkin's lymphoma. PURPOSE: Randomizedphase III trial to compare the effectiveness of radiation therapy to the involved area with or without total-body irradiation in treating patients who have stage I or stage II non-Hodgkin's lymphoma that has not previously been treated. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00014326

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Radiation Therapy in Treating Patients With Stage I, Stage II, or Stage III Prostate Cancer Condition(s): adenocarcinoma of the prostate; stage I prostate cancer; stage II prostate cancer; stage III prostate cancer Study Status: This study is currently recruiting patients. Sponsor(s): Federation Nationale des Centres de Lutte Contre le Cancer Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. It is not yet known whether radiation therapy to the prostate and pelvis is more effective than radiation therapy to the prostate alone in treating prostate cancer. PURPOSE: Randomizedphase III trial to compare the effectiveness of radiation therapy to the prostate with or without radiation to the pelvis in treating patients with stage I, stage II, or stage III prostate cancer. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00003607

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Radiation Therapy Plus Hormone Therapy Compared With Radiation Therapy Alone in Treating Patients With Stage II or Stage III Prostate Cancer Condition(s): stage III prostate cancer; stage II prostate cancer Study Status: This study is currently recruiting patients. Sponsor(s): Radiation Therapy Oncology Group; National Cancer Institute (NCI); National Cancer Institute of Canada Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Androgens can stimulate the growth of prostate cancer cells. Drugs such as goserelin, leuprolide, flutamide, or bicalutamide may stop the adrenal glands from producing androgens. Combining radiation therapy with hormone therapy may be an effective treatment for stage II or stage III prostate cancer. It is not yet known if radiation therapy combined with hormone therapy is more effective than either radiation therapy alone or hormone therapy alone in treating stage II or stage III prostate cancer. (Hormone therapy alone group closed as of 12/9/2002.) PURPOSE: Randomizedphase III trial to compare the effectiveness of radiation therapy plus hormone therapy to that of radiation therapy alone or hormone therapy alone in treating patients who have stage II or stage III prostate cancer. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00023829

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Radiation Therapy With or Without Chemotherapy in Reducing Mouth Dryness in Patients With Nasopharyngeal Cancer Condition(s): oral complications of chemotherapy and head/neck radiation; radiation toxicity; stage I squamous cell carcinoma of the nasopharynx; stage II squamous cell carcinoma of the nasopharynx; stage III squamous cell carcinoma of the nasopharynx; stage IV squamous cell carcinoma of the nasopharynx Study Status: This study is currently recruiting patients. Sponsor(s): Radiation Therapy Oncology Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Giving radiation therapy in different ways may cause less damage to normal tissue, prevent or lessen mouth dryness, and may help patients live more comfortably. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining chemotherapy with radiation therapy may kill more tumor cells. PURPOSE: Phase II trial to study the effectiveness of specialized radiation therapy techniques with or without chemotherapy in reducing mouth dryness in patients who have nasopharyngeal cancer. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00057785

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Radiation Therapy With or Without Chemotherapy in Treating Patients With Stage II or Stage III Bladder Cancer Condition(s): stage II bladder cancer; stage III bladder cancer; transitional cell carcinoma of the bladder; squamous cell carcinoma of the bladder; adenocarcinoma of the bladder Study Status: This study is currently recruiting patients. Sponsor(s): Cancer Research Campaign Clinical Trials Centre Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Drugs used in chemotherapy such as fluorouracil and mitomycin use different ways to stop tumor cells from dividing so they stop growing or die. Fluorouracil and mitomycin may make the tumor cells more sensitive to radiation therapy. It is not yet known if radiation therapy is more effective with or without chemotherapy in treating bladder cancer. PURPOSE: Randomizedphase III trial to compare the effectiveness of radiation therapy to all or part of the bladder with or without chemotherapy in treating patients who have stage II or stage III bladder cancer. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00024349

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Radiation Therapy With or Without Optional Tamoxifen in Treating Women With Ductal Carcinoma in Situ Condition(s): breast cancer in situ; intraductal breast carcinoma Study Status: This study is currently recruiting patients. Sponsor(s): Radiation Therapy Oncology Group; National Cancer Institute (NCI); Cancer and Leukemia Group B; National Cancer Institute of Canada Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Estrogen can stimulate the growth of breast cancer cells. Hormone therapy using tamoxifen may fight breast cancer by blocking the uptake of estrogen by the tumor cells. It is not yet known if radiation therapy is more effective than observation, with or without tamoxifen, in treating ductal carcinoma in situ. PURPOSE: Randomizedphase III trial to compare the effectiveness of radiation therapy with that of observation, with or without tamoxifen, in treating women who have ductal carcinoma in situ. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00003857

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Radiation Therapy With or Without Thalidomide in Treating Patients With Brain Metastases Condition(s): brain metastases Study Status: This study is currently recruiting patients. Sponsor(s): Radiation Therapy Oncology Group; National Cancer Institute (NCI)

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Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Drugs such as thalidomide may stop the growth of brain metastases by stopping blood flow to the tumor. It is not yet known whether radiation therapy is more effective with or without thalidomide in treating brain metastases. PURPOSE: Randomizedphase III trial to compare the effectiveness of radiation therapy with or without thalidomide in treating patients who have brain metastases. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00033254 ·

Salivary Gland Surgery Before Radiation Therapy in Preventing Radiation-Caused Xerostomia in Patients With Head and Neck Cancer Condition(s): Hypopharyngeal Cancer; Laryngeal Cancer; metastatic squamous neck cancer with occult primary; oral complications of cancer and cancer therapy; Oropharyngeal Cancer Study Status: This study is currently recruiting patients. Sponsor(s): Radiation Therapy Oncology Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Moving a salivary gland out of the area that will undergo radiation therapy may protect the gland from side effects of radiation therapy and may prevent xerostomia (dry mouth). PURPOSE: Phase II trial to study the effectiveness of salivary gland surgery in preventing xerostomia in patients who are undergoing radiation therapy for head and neck cancer. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00068237

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Surgery and Radiation Therapy Compared With Chemotherapy and Radiation Therapy in Treating Patients With Stage III or Stage IV Head and Neck Cancer That Can Be Removed During Surgery Condition(s): Hypopharyngeal Cancer; Laryngeal Cancer; lip and oral cavity cancer; Oropharyngeal Cancer; paranasal sinus and nasal cavity cancer Study Status: This study is currently recruiting patients. Sponsor(s): NMRC Head and Neck Cancer Group Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. It is not yet known whether surgery plus radiation therapy is more effective than chemotherapy plus radiation therapy for head and neck cancer. PURPOSE: Randomizedphase III trial to compare the effectiveness of surgery plus radiation therapy to chemotherapy plus radiation therapy in treating patients with stage III or stage IV head and neck cancer that can be removed during surgery. Phase(s): Phase III Study Type: Interventional

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Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00003576 ·

Biafine Cream to Reduce Side Effects of Radiation Therapy in Patients Receiving Treatment for Head and Neck Cancer Condition(s): stage IV squamous cell carcinoma of the lip and oral cavity; stage III squamous cell carcinoma of the hypopharynx; skin reactions secondary to radiation therapy; stage III squamous cell carcinoma of the larynx; stage IV squamous cell carcinoma of the larynx; stage III squamous cell carcinoma of the lip and oral cavity; stage III squamous cell carcinoma of the oropharynx; stage IV squamous cell carcinoma of the oropharynx; stage IV squamous cell carcinoma of the hypopharynx; Quality of Life Study Status: This study is no longer recruiting patients. Sponsor(s): National Cancer Institute (NCI); Radiation Therapy Oncology Group Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells, but may cause skin irritation and inflammation. Biafine cream may be effective in lessening side effects caused by radiation therapy. PURPOSE: Randomized phase III trial to determine the effectiveness of Biafine cream in reducing side effects of radiation therapy in patients receiving treatment for head and neck cancer. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006481

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Chemotherapy and Radiation Therapy Following Surgery in Treating Patients With Head and Neck Cancer Condition(s): stage III squamous cell carcinoma of the lip and oral cavity; stage IV squamous cell carcinoma of the lip and oral cavity; stage III squamous cell carcinoma of the oropharynx; stage IV squamous cell carcinoma of the oropharynx; stage III squamous cell carcinoma of the hypopharynx; stage IV squamous cell carcinoma of the hypopharynx; stage III squamous cell carcinoma of the larynx; stage IV squamous cell carcinoma of the larynx Study Status: This study is no longer recruiting patients. Sponsor(s): Radiation Therapy Oncology Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells. Combining chemotherapy with radiation therapy following surgery may kill more tumor cells. PURPOSE: Phase II trial to study the effectiveness of chemotherapy plus radiation therapy in treating patients who have undergone surgery for stage III or stage IV head and neck cancer. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00011999

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Computer Planned Radiation Therapy Plus Chemotherapy in Treating Patients With Glioblastoma Multiforme Condition(s): adult glioblastoma multiforme Study Status: This study is no longer recruiting patients. Sponsor(s): Radiation Therapy Oncology Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Computer systems that allow doctors to create a 3-dimensional picture of the tumor in order to plan treatment may result in more effective radiation therapy. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining radiation therapy with chemotherapy may kill more tumor cells. PURPOSE: Phase I/II trial to study the effectiveness of radiation therapy that has been planned with a computer plus chemotherapy in treating patients who have glioblastoma multiforme. Phase(s): Phase I; Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00003417

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Evaluation of Memory Skills in Patients Receiving Radiation Therapy for Brain Metastases Condition(s): cognitive/functional effects; radiation toxicity; brain metastases; Quality of Life Study Status: This study is no longer recruiting patients. Sponsor(s): National Cancer Institute (NCI); Radiation Therapy Oncology Group Purpose - Excerpt: RATIONALE: Assessment of patients undergoing radiation therapy may help to determine the effects of the treatment and may help improve cancer treatment. PURPOSE: Clinical trial to evaluate the memory skills in patients receiving radiation therapy for brain metastases. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00007007

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External-Beam Radiation Therapy Plus Implanted Radiation Therapy in Treating Patients With Prostate Cancer Condition(s): stage II prostate cancer; stage I prostate cancer; adenocarcinoma of the prostate Study Status: This study is no longer recruiting patients. Sponsor(s): National Cancer Institute (NCI); Radiation Therapy Oncology Group Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays and other sources to damage tumor cells. Giving radiation therapy in different ways may kill more tumor cells. PURPOSE: Phase II trial to study the effectiveness of external-beam radiation therapy followed by implanted radiation therapy in treating patients who have prostate cancer. Phase(s): Phase II

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Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006365 ·

Melatonin and Radiation Therapy in Treating Patients With Brain Metastases Condition(s): unspecified adult solid tumor, protocol specific; brain metastases; radiation toxicity Study Status: This study is no longer recruiting patients. Sponsor(s): Radiation Therapy Oncology Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Drugs such as melatonin may make tumor cells more sensitive to radiation therapy and may protect normal cells from the side effects of radiation therapy. PURPOSE: Randomized phase II trial to determine the effectiveness of combining melatonin with radiation therapy in treating patients who have brain metastases. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00031967

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Paclitaxel, Cisplatin, and Filgrastim Combined With Radiation Therapy in Treating Patients With Locally Recurrent Head and Neck Cancer Condition(s): Hypopharyngeal Cancer; Laryngeal Cancer; lip and oral cavity cancer; metastatic squamous neck cancer with occult primary; Oropharyngeal Cancer; paranasal sinus and nasal cavity cancer Study Status: This study is no longer recruiting patients. Sponsor(s): Radiation Therapy Oncology Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Colony-stimulating factors such as filgrastim may increase the number of immune cells found in bone marrow or peripheral blood and may help a person's immune system recover from the side effects of chemotherapy. Radiation therapy uses high-energy x-rays to damage tumor cells. PURPOSE: Phase II trial to study the effectiveness of paclitaxel, cisplatin, and filgrastim combined with radiation therapy in treating patients who have locally recurrent head and neck cancer and have received previous treatment with radiation therapy. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005087

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Radiation Therapy After Lumpectomy in Treating Women With Ductal Carcinoma in Situ or Invasive Breast Cancer Condition(s): stage I breast cancer; stage II breast cancer; stage IIIA breast cancer; intraductal breast carcinoma; breast cancer in situ Study Status: This study is no longer recruiting patients.

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Sponsor(s): Ireland Cancer Center; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Giving radiation during surgery followed by external-beam radiation to the entire breast may kill more tumor cells. PURPOSE: Phase II trial to study the effectiveness of radiation therapy during surgery followed by whole-breast radiation therapy in treating women who have undergone lumpectomy for ductal carcinoma in situ or invasive breast cancer Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00054301 ·

Radiation Therapy and Combination Chemotherapy in Treating Patients With Stage II or Stage III Bladder Cancer Condition(s): stage III bladder cancer; stage II bladder cancer Study Status: This study is no longer recruiting patients. Sponsor(s): National Cancer Institute (NCI); Radiation Therapy Oncology Group Purpose - Excerpt: RATIONALE: Radiation therapy uses x-rays to damage tumor cells. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining radiation therapy with chemotherapy and surgery may kill more tumor cells. PURPOSE: Phase I/II trial to study the effectiveness of radiation therapy plus combination chemotherapy in treating patients who have stage II or stage III bladder cancer that can be removed by surgery. Phase(s): Phase I; Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00003930

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Radiation Therapy and Tamoxifen in Treating Adults With Newly Diagnosed Supratentorial Glioblastoma Multiforme Condition(s): adult glioblastoma multiforme Study Status: This study is no longer recruiting patients. Sponsor(s): National Cancer Institute (NCI); Radiation Therapy Oncology Group Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Drugs such as tamoxifen may make the tumor cells more sensitive to radiation therapy. PURPOSE: Phase II trial to study the effectiveness of radiation therapy and tamoxifen in treating adults who have newly diagnosed supratentorial glioblastoma multiforme. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006388

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Radiation Therapy Followed by Carmustine in Treating Patients Who Have Supratentorial Glioblastoma Multiforme Condition(s): adult glioblastoma multiforme Study Status: This study is no longer recruiting patients. Sponsor(s): Radiation Therapy Oncology Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. PURPOSE: Phase II trial to study the effectiveness of radiation therapy followed by carmustine in treating patients who have supratentorial glioblastoma multiforme. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006386

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Radiation Therapy in Treating Patients With Bone Metastases From Breast or Prostate Cancer Condition(s): Pain; stage IV prostate cancer; stage IV breast cancer; recurrent breast cancer; bone metastases; recurrent prostate cancer Study Status: This study is no longer recruiting patients. Sponsor(s): National Cancer Institute (NCI); North Central Cancer Treatment Group; Radiation Therapy Oncology Group Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. It is not yet known which radiation therapy regimen is more effective for bone metastases. PURPOSE: Randomized phase III trial to compare different radiation therapy regimens in treating patients who have bone metastases from breast or prostate cancer. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00003162

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Radiation Therapy in Treating Patients With Non-small Cell Lung Cancer Condition(s): stage IIIB non-small cell lung cancer; recurrent non-small cell lung cancer; stage IIIA non-small cell lung cancer; stage II non-small cell lung cancer; squamous cell lung cancer; adenocarcinoma of the lung; large cell lung cancer; stage I non-small cell lung cancer Study Status: This study is no longer recruiting patients. Sponsor(s): National Cancer Institute (NCI); Radiation Therapy Oncology Group Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. PURPOSE: Phase I/II trial to study the effectiveness of radiation therapy in treating patients with non-small cell lung cancer that cannot be surgically removed. Phase(s): Phase I; Phase II

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Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002577 ·

Radiation Therapy in Treating Patients With Stage II Cancer of the Vocal Cord Condition(s): stage II squamous cell carcinoma of the larynx Study Status: This study is no longer recruiting patients. Sponsor(s): Radiation Therapy Oncology Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. It is not yet known which radiation therapy regimen is more effective in treating patients with stage II cancer of the vocal cord. PURPOSE: Randomized phase III trial to compare two regimens of radiation therapy in treating patients who have stage II cancer of the vocal cord. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002727

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Radiation Therapy Plus Chemotherapy Followed by Surgery in Treating Patients With Locally Advanced Cancer of the Rectum Condition(s): stage II rectal cancer; stage III rectal cancer; adenocarcinoma of the rectum Study Status: This study is no longer recruiting patients. Sponsor(s): Radiation Therapy Oncology Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. It is not yet known which regimen of radiation therapy plus chemotherapy is more effective for rectal cancer. PURPOSE: Randomized phase II trial to compare two regimens of radiation therapy plus chemotherapy followed by surgery in treating patients who have locally advanced cancer of the rectum. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006366

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Radiation Therapy Plus Combination Chemotherapy in Treating Patients With Small Cell Lung Cancer Condition(s): limited stage small cell lung cancer Study Status: This study is no longer recruiting patients. Sponsor(s): National Cancer Institute (NCI); Radiation Therapy Oncology Group Purpose - Excerpt: RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells. Combining more than one chemotherapy

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drug with radiation therapy may kill more tumor cells. PURPOSE: Phase I trial to study the effectiveness of radiation therapy plus combination chemotherapy in treating patients with limited-stage small cell lung cancer. Phase(s): Phase I Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005022 ·

Radiation Therapy With or Without Antiandrogen Therapy in Treating Patients With Stage I or Stage II Prostate Cancer Condition(s): stage II prostate cancer; stage I prostate cancer; adenocarcinoma of the prostate Study Status: This study is no longer recruiting patients. Sponsor(s): National Cancer Institute (NCI); Radiation Therapy Oncology Group Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Androgens can stimulate the growth of prostate cancer cells. Hormone therapy using flutamide, goserelin, and leuprolide may fight prostate cancer by reducing the production of androgens. It is not yet known which regimen of antiandrogen therapy is most effective for prostate cancer. PURPOSE: Randomized phase III trial to study the effectiveness of radiation therapy with or without antiandrogen therapy in treating patients who have stage I or stage II prostate cancer. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002597

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Radiation Therapy With or Without Temozolomide in Treating Patients With Newly Diagnosed Glioblastoma Multiforme Condition(s): adult glioblastoma multiforme Study Status: This study is no longer recruiting patients. Sponsor(s): EORTC Brain Tumor Cooperative Group; Cooperative Group; National Cancer Institute of Canada

EORTC

Radiotherapy

Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. It is not yet known if radiation therapy is more effective with or without temozolomide for glioblastoma multiforme. PURPOSE: Randomized phase III trial to compare the effectiveness of radiation therapy with or without temozolomide in treating patients who have newly diagnosed glioblastoma multiforme. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006353

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Sargramostim in Decreasing Mucositis in Patients Receiving Radiation Therapy for Head and Neck Cancer Condition(s): lip and oral cavity cancer; Head and Neck Cancer; Oropharyngeal Cancer Study Status: This study is no longer recruiting patients. Sponsor(s): National Cancer Institute (NCI); Radiation Therapy Oncology Group Purpose - Excerpt: RATIONALE: Sargramostim may lessen symptoms of mucositis in patients receiving radiation therapy for head and neck cancer. It is not yet known if sargramostim is more effective than no treatment in reducing mucositis caused by radiation therapy. PURPOSE: Randomized phase III trial to determine the effectiveness of sargramostim in decreasing mucositis in patients who are receiving radiation therapy for head and neck cancer. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00008398

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Standard Radiation Therapy With or Without Stereotactic Radiation Therapy in Treating Patients With Glioma Condition(s): adult glioblastoma multiforme; adult anaplastic astrocytoma Study Status: This study is no longer recruiting patients. Sponsor(s): EORTC Radiotherapy Cooperative Group Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells and may be an effective treatment for patients with glioma. Stereotactic radiation therapy may be able to deliver x-rays directly to the tumor and cause less damage to normal tissue. It is not yet known if standard radiation therapy is more effective when followed by stereotactic radiation therapy. PURPOSE: Randomized phase III trial to compare the effectiveness of standard radiation therapy with or without stereotactic radiation therapy in treating patients who have glioma. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00003916

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Vaccine Therapy Plus Radiation Therapy in Treating Patients With Non-small Cell Lung Cancer That Has Been Completely Removed in Surgery Condition(s): stage II non-small cell lung cancer; stage IIIA non-small cell lung cancer Study Status: This study is no longer recruiting patients. Sponsor(s): Radiation Therapy Oncology Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Vaccines may make the body build an immune response to kill tumor cells. Radiation therapy uses high-energy x-rays to damage tumor cells. Combining these two treatments may kill more tumor cells. PURPOSE: Phase II trial to study the effectiveness of combining vaccine therapy with radiation therapy in treating patients who have stage II or stage IIIA non-small cell lung cancer that has been completely removed in surgery.

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Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006470 ·

Chemotherapy Plus Radiation Therapy With or Without Surgery in Treating Patients With Stage IIIA Non-small Cell Lung Cancer Condition(s): squamous cell lung cancer; adenocarcinoma of the lung; bronchoalveolar cell lung cancer; stage IIIA non-small cell lung cancer; large cell lung cancer Study Status: This study is completed. Sponsor(s): National Cancer Institute (NCI); Southwest Oncology Group; Eastern Cooperative Oncology Group; Cancer and Leukemia Group B; North Central Cancer Treatment Group; National Cancer Institute of Canada; Radiation Therapy Oncology Group Purpose - Excerpt: RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining radiation therapy with chemotherapy may kill more tumor cells. It is not yet known if chemotherapy plus radiation therapy is more effective with or without surgery for lung cancer. PURPOSE: Randomized phase III trial to compare the effectiveness of cisplatin and etoposide plus radiation therapy with or without surgery in treating patients with stage IIIA non-small cell lung cancer. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002550

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Chemotherapy, SU5416, Radiation Therapy, and Surgery in Treating Patients With Soft Tissue Sarcoma Condition(s): stage IIC adult soft tissue sarcoma; recurrent adult soft tissue sarcoma; stage III adult soft tissue sarcoma Study Status: This study is completed. Sponsor(s): National Cancer Institute (NCI); Radiation Therapy Oncology Group Purpose - Excerpt: RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Drugs such as SU5416 may stop the growth of cancer by stopping blood flow to the tumor. Radiation therapy uses high-energy x-rays to damage tumor cells. Giving chemotherapy, SU5416, and radiation therapy before and after surgery may kill more tumor cells. PURPOSE: Phase I/II trial to study the effectiveness of chemotherapy, SU5416, radiation therapy, and surgery in treating patients who have stage IIC or stage III soft tissue sarcoma. Phase(s): Phase I; Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00023738

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Combination Chemotherapy, Radiation Therapy, and Surgery in Treating Patients With Primary or Recurrent Sarcoma Condition(s): stage III adult soft tissue sarcoma; recurrent adult soft tissue sarcoma; stage IVA adult soft tissue sarcoma; stage IIB adult soft tissue sarcoma; stage IIC adult soft tissue sarcoma Study Status: This study is suspended. Sponsor(s): Radiation Therapy Oncology Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells. Combining chemotherapy, radiation therapy, and surgery may kill more tumor cells. PURPOSE: Phase II trial to study the effectiveness of combination chemotherapy, radiation therapy, and surgery in treating patients who have primary or recurrent sarcoma. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00017160

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Glutamine in Treating Mucositis Caused by Radiation Therapy in Patients With Newly Diagnosed Cancer of the Mouth or Throat Condition(s): lip and oral cavity cancer; oral complications of cancer and cancer therapy; Oropharyngeal Cancer; Pain; radiation toxicity Study Status: This study is suspended. Sponsor(s): Southwest Oncology Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Glutamine may be effective in decreasing side effects, such as inflammation of the mouth and throat, caused by radiation therapy. The effectiveness of glutamine for mucositis is not yet known. PURPOSE: Randomized phase III trial to determine the effectiveness of glutamine in treating patients who develop mucositis following radiation therapy for newly diagnosed cancer of the mouth or throat. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006994

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Radiation Therapy and Cisplatin With or Without Amifostine in Treating Patients With Stage IIIB or Stage IVA Cancer of the Cervix Condition(s): radiation toxicity; stage III cervical cancer; stage IVA cervical cancer; cervical squamous cell carcinoma; cervical adenocarcinoma; cervical adenosquamous cell carcinoma Study Status: This study is suspended. Sponsor(s): Radiation Therapy Oncology Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Drugs used in chemotherapy, such as cisplatin, use different ways to stop tumor cells from dividing so they stop growing or die. Radiation

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therapy uses high-energy x-rays to damage tumor cells. Combining radiation therapy with chemotherapy may kill more tumor cells. Drugs such as amifostine may protect normal cells from the side effects of radiation therapy. PURPOSE: Phase I/II trial to study the effectiveness of combining cisplatin and radiation therapy with or without amifostine in treating patients who have stage IIIB or stage IVA cancer of the cervix. Phase(s): Phase I; Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00012012 ·

Radiation Therapy With or Without Bicalutamide in Treating Patients With Stage II, Stage III, or Recurrent Prostate Cancer Condition(s): stage II prostate cancer; stage III prostate cancer; recurrent prostate cancer Study Status: This study is completed. Sponsor(s): Radiation Therapy Oncology Group; National Cancer Institute (NCI); Southwest Oncology Group Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Androgens can stimulate the growth of prostate cancer cells. Hormone therapy using bicalutamide may fight prostate cancer by reducing the production of androgens. It is not yet known if radiation therapy is more effective with or without bicalutamide for prostate cancer. PURPOSE: Randomized phase III trial to compare the effectiveness of radiation therapy with or without bicalutamide in treating patients who have stage II, stage III, or recurrent prostate cancer and elevated PSA levels following radical prostatectomy. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002874

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Radiation Therapy With or Without Epoetin alfa in Anemic Patients With Head and Neck Cancer Condition(s): Anemia; Hypopharyngeal Cancer; Laryngeal Cancer; lip and oral cavity cancer; Oropharyngeal Cancer Study Status: This study is suspended. Sponsor(s): Radiation Therapy Oncology Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Epoetin alfa may stimulate red blood cell production and treat anemia in patients with head and neck cancer. It is not yet known whether receiving radiation therapy with epoetin alfa is more effective than radiation therapy alone for anemic patients with head and neck cancer. PURPOSE: Randomized phase III trial to compare the effectiveness of radiation therapy with or without epoetin alfa in treating anemic patients who have head and neck cancer. Phase(s): Phase III Study Type: Interventional

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Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004917 ·

Radiation Therapy With or Without SU5416 in Treating Patients With Soft Tissue Sarcoma Condition(s): stage IB adult soft tissue sarcoma; stage IIA adult soft tissue sarcoma Study Status: This study is completed. Sponsor(s): National Cancer Institute (NCI); Radiation Therapy Oncology Group Purpose - Excerpt: RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Drugs such as SU5416 may stop the growth of cancer by stopping blood flow to the tumor. It is not yet known if radiation therapy is more effective with or without SU5416 in treating soft tissue sarcoma. PURPOSE: Phase I/II trial to compare the effectiveness of radiation therapy with or without SU5416 in treating patients who have stage IB or stage IIA soft tissue sarcoma. Phase(s): Phase I; Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00023725

Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “radiation therapy” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: ·

For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/

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For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html

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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/

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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm

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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm

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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm

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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp

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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm

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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/

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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm

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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm

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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm

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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm

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For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm

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For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials

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CHAPTER 5. PATENTS ON RADIATION THERAPY Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.9 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “radiation therapy” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on radiation therapy, we have not necessarily excluded nonmedical patents in this bibliography.

Patents on Radiation Therapy By performing a patent search focusing on radiation therapy, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. 9Adapted from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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The following is an example of the type of information that you can expect to obtain from a patent search on radiation therapy: ·

Cancer treatment with Go6976 and its related compounds Inventor(s): Lu; Zhimin (8452 New Salem St., #20, San Diego, CA 92126), Wang; Keming (79 East Ximei Street, Apt. 303, Suzhou, CN 215002) Assignee(s): None Reported Patent Number: 6,696,478 Date filed: July 24, 2001 Abstract: A chemotheraputic cancer treatment in which Go6976 or a compound chemically similar to Go6976 is administered to a mammal for the treatment of the cancer. The chemical compound is targeted to PKC.alpha. activity. Experiments have shown Go6976 and similar compounds to be effective for the treatment of breast cancer, leukemia, lung cancer, bone cancer, skin cancer, prostate cancer, liver cancer, brain tumor, cervical cancer, and cancers located in the digestive tract including gastric cancer and colorectal cancers. These treatments may be accomplished utilizing Go6976 and compounds similar to it alone or in combination with prior art chemotherapy agents or with radiation therapy. In a preferred embodiment Go6976 is used for the treatment of cancer as a preventative drug by preventing cancer cell formation. Excerpt(s): Researchers have recognized that a family of enzymes known as protein kinase C enzymes is associated with a large number of cancers. This family includes at least eleven isoenzymes. A particular member of this family is identified as the protein kinase C alpha enzyme, abbreviated: PKC.alpha. Researches have reported increases in PKC.alpha. activity in human breast tumors (NG et al., Science. 283:2085-2089) and significant increases in PKC.alpha.: expression in prostate cancers (Cornford et al., Am. J. Pathol. 154: 137-144). Researchers have reported that PKC.alpha. is required for the metastasis of human melanoma (Dennis et al., Cancer Lett. 128:65-70) and that PKC.alpha. is related to the progression of brain tumors (Shen et al., Mol. Pharmacol. 55:396-402). Recently, Muller et al were granted a patent, U.S. Pat. No. 5,744,460, which discloses a cancer treatment utilizing an antisense oligonuclotide targeted to PKC.alpha. combined with a chemotherapeutic agent. U.S. Pat. Nos. 5,882,927 and 5,885,970 issued to Bennett et al also disclose antisense oligonuclotides targeted to PKC. where A, B, C, D, B, F and G are each a modifying chemical or chemical compound. Web site: http://www.delphion.com/details?pn=US06696478__

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Caspase inhibitors for the treatment and prevention of chemotherapy and radiation therapy induced cell death Inventor(s): Green; Douglas R. (San Diego, CA), Mills; Gordon B. (Houston, TX), Weber; Eckard (San Diego, CA) Assignee(s): Cytovia, Inc. (san Diego, Ca) Patent Number: 6,566,338 Date filed: October 11, 2000 Abstract: The use of caspase inhibitors for treating, ameliorating, and preventing noncancer cell death during chemotherapy and radiation therapy and for treating and

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ameliorating the side effects of chemotherapy and radiation therapy of cancer is disclosed. Excerpt(s): This invention is in the field of medicinal chemistry. In particular, the invention relates to the use of caspase inhibitors to treat or prevent non-cancer cell death during chemotherapy and radiation therapy of cancer. Organisms eliminate unwanted cells by a process variously known as regulated cell death, programmed cell death or apoptosis. Such cell death occurs as a normal aspect of animal development as well as in tissue homeostasis and aging (Glucksmann, A., Biol. Rev. Cambridge Philos. Soc. 26:5986 (1951); Glucksmann, A., Archives de Biologie 76:419-437 (1965); Ellis et al., Dev. 112:591-603 (1991); Vaux et al., Cell 76:777-779 (1994)). Apoptosis regulates cell number, facilitates morphogenesis, removes harmful or otherwise abnormal cells and eliminates cells that have already performed their function. Additionally, apoptosis occurs in response to various physiological stresses, such as hypoxia or ischemia (PCT published application WO6/20721). There are a number of morphological changes shared by cells experiencing regulated cell death, including plasma and nuclear membrane blebbing, cell shrinkage (condensation of nucleoplasm and cytoplasm), organelle relocalization and compaction, chromatin condensation and production of apoptotic bodies (membrane enclosed particles containing intracellular material) (Orrenius, S., J. Internal Medicine 237:529-536 (1995)). Web site: http://www.delphion.com/details?pn=US06566338__ ·

Compositions and methods for delivery of a molecule into a cell Inventor(s): de Noronha; Carlos M.C. (San Francisco, CA), Greene; Warner C. (San Francisco, CA), Henklein; Peter (Berlin, GB), Schubert; Ulrich (Bethesda, MA), Sherman; Michael P. (San Francisco, CA) Assignee(s): The Regents of the University of California (oakland, Ca) Patent Number: 6,664,040 Date filed: April 20, 2001 Abstract: Provided is a composition comprising a Vpr polypeptide conjugated to a therapeutic molecule. Preferably, the Vpr comprises synthetic Vpr. The therapeutic molecule can comprise any molecule capable of being conjugated to Vpr or a fragment thereof, including a polypeptide, a polynucleotide, and/or a toxin. The invention additionally provides a method for delivering a molecule into a cell. The method comprises contacting the cell with a conjugate comprising a Vpr polypeptide conjugated to the molecule. The invention further provides a method for modulating the expression of a transgene in a cell, a method for killing a target cell population in a subject, a method for increasing the sensitivity of cells to radiation therapy, and a method for inhibiting cell proliferation. Excerpt(s): Throughout this application various publications are referenced. In some instances, the references are indicated by numerals in parentheses, which numerals refer to a list of citations for the corresponding references that appears at the end of the specification. The disclosures of these publications in their entireties are hereby incorporated by reference into this application in order to describe more fully the state of the art to which this invention pertains. This application is related to German patent applications 199 08 752.0 and 199 08 766.0, filed on Feb. 19, 1999 and Feb. 17, 2000, respectively, as well as to the corresponding PCT international patent application filed on Feb. 17, 2000. The disclosures of each of these related patent applications is

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incorporated herein by reference. The invention relates to compositions and methods for delivery of a molecule into a cell. More particularly, the invention relates to a Vpr polypeptide or fragment thereof conjugated to a molecule, which conjugate is capable of entering the plasma membrane of a cell. The compositions include pharmaceutical and vaccine compositions, and can be used in a variety of methods, including methods to modulate the sensitivity of cells to radiation therapy and to modulate cell proliferation and apoptosis. Human immunodeficiency virus type 1 (HIV-1) is a lentivirus that encodes the canonical retroviral Gag, Pol, and Env proteins, as well as six regulatory or auxiliary proteins including Tat, Rev, Vpu, Vif, Nef, and Vpr. Although not essential for viral replication in tissue culture, the latter four proteins are highly conserved and likely exert important but less well understood functions in vivo that contribute to viral pathogenesis. Vpr, a.about.14-kDa, 96-amino acid protein is conserved among the primate lentiviruses HIV-1, HIV-2, and the simian immunodeficiency virus (SIV), supporting the notion that it serves an important function in the viral life cycle in vivo. Web site: http://www.delphion.com/details?pn=US06664040__ ·

Computer assisted radiotherapy dosimeter system and a method therefor Inventor(s): Ding; Wei (Kanata, CA) Assignee(s): Thomson & Nielsen Electronics Ltd. (nepean, Ca) Patent Number: 6,650,930 Date filed: October 18, 2001 Abstract: In order to facilitate the display and evaluation of data acquired while irradiating a body, e.g. a patient undergoing radiation therapy, a dosimetry system has a plurality of sensors for disposition on, in or near the body to be irradiated and connected to a sensor reading instrument which is interfaced with a display system, for example a personal computer, which is arranged to display, in use, one or more representations, for example drawings or photographs, of the body to be irradiated, along with the positions and the dose data for those specific locations where the dosimeter sensors were placed. Excerpt(s): The invention relates to radiotherapy dosimeter systems, especially of the kind which use a plurality of dosimeter sensors distributed in a region to be irradiated and means for monitoring radiation levels detected by the sensors. Radiotherapy treatment of cancer patients involves the use of machines which produce high energy Xrays or high energy electrons. It is common practice to verify the radiation dose delivered to the patient with a dosimetry system such as the Thomson & Nielsen Patient Dose Verification System. There are three different types of dosimetry system used in radiotherapy. These are based on (a) film or thermal luminescent dosimeters (TLD), (b) diodes and (c) MOSFETs. Diode and MOSFET systems use electronic dosimeter sensors together with electronic reading systems, whereas film or TLD use chemical or thermal methods of reading the detectors into an electronic reading system. Web site: http://www.delphion.com/details?pn=US06650930__

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Contour collimator for use in radiotherapy Inventor(s): Echner; Gernot (Wiesenbach, DE), Hover; Karl-Heinz (Sinsheim, DE), Pastyr; Otto (Leimen, DE), Richter; Jurgen (Wurzburg, DE), Schlegel; Wolfgang (Heidelberg, DE) Assignee(s): Deutsches Krebsforschungszentrum Stiftung Des Offentlichen Rechts (heidelberg, De) Patent Number: 6,711,237 Date filed: January 16, 2002 Abstract: A contour collimator for radiation therapy has a plurality of diaphragm elements that are movable with respect to each other by means of drive units. The diaphragm elements of the invention are supported only on the side near the drive units for ease of movement. This allows larger contour collimators to be constructed having relatively heavy diaphragm elements while retaining relatively small motors. Excerpt(s): The invention relates to a contour collimator for radiation therapy having a plurality of diaphragm elements arranged movably with respect to each other, such movement being powered by a drive unit. A contour collimator of this kind is known for example from DE 195 36 804.5 A1. In the contour collimator described therein, a drive unit is provided for each of the plurality of diaphragm elements, and the drive units move the diaphragm elements in two directions along a guide rail. By means of the control for each individual diaphragm element, a radiation field is set up with which it is possible to create a special contour for radiation on the body part that is being radiated. This contour collimator is especially suitable for small radiation fields. It is impossible to increase the size of this known contour collimator in order to create larger radiation fields because the motors such an increase in size would necessitate are too big and they can scarcely be arranged about the radiation field. The task of the present invention was therefore to adapt a known contour collimator in such a way that it is also suited for use with larger radiation fields. Web site: http://www.delphion.com/details?pn=US06711237__

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Edge extension of intensity map for radiation therapy with a modulating multi-leaf collimator Inventor(s): Siochi; Ramon Alfredo Carvalho (Apex, NC) Assignee(s): Siemens Medical Solutions Usa, Inc. (malvern, Pa) Patent Number: 6,577,707 Date filed: October 30, 2001 Abstract: A method for defining an extended field area of an intensity map for use in delivering radiation from a radiation source to an object with a multi-leaf collimator is disclosed. The multi-leaf collimator includes a plurality of leaves operable to travel in a first direction and rotatable such that the leaves are operable to travel in a second direction extending generally orthogonal to the first direction. The method includes defining a central square area having dimensions approximately equal to two times an over travel margin of the multi-leaf collimator and defining four edge margins each extending from a side of the central square and having dimensions approximately equal to two times an over travel margin of the multi-leaf collimator along an edge adjacent to the central square and half the number of leaves within the multi-leaf collimator times

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leaf width minus half the central square dimension. The central square and four edge margins define a field area for an intensity map deliverable with the multi-leaf collimator positioned such that leaves travel in the first and second directions. Excerpt(s): The present invention relates generally to radiation therapy, and more particularly, to a method and system for extending the field area of an intensity map used in radiation therapy with a modulating multi-leaf collimator. Radiation emitting devices are generally known and used, for instance, as radiation therapy devices for the treatment of patients. A radiation therapy device generally includes a gantry which can be swiveled around a horizontal axis of rotation in the course of a therapeutic treatment. A linear accelerator is located within the gantry for generating a high energy radiation beam for therapy. This high energy radiation beam may be an electron beam or photon (x-ray) beam, for example. During treatment, the radiation beam is trained on a zone of a patient lying in the isocenter of the gantry rotation. In order to control the radiation emitted toward the patient, a beam shielding device, such as a plate arrangement or collimator, is typically provided in the trajectory of the radiation beam between the radiation source and the patient. An example of a plate arrangement is a set of four plates which can be used to define an opening for the radiation beam. The collimator is a beam shielding device which may include multiple leaves (e.g., relatively thin plates or rods) typically arranged as opposing leaf pairs. The plates are formed of a relatively dense and radiation impervious material and are generally independently positionable to delimit the radiation beam. Web site: http://www.delphion.com/details?pn=US06577707__ ·

Electron gun heating control to reduce the effect of back heating in medical linear accelerators Inventor(s): Hernandez-Guerra; Francisco M. (Concord, CA), Marziale; Michael John (Point Richmond, CA) Assignee(s): Siemens Medical Solutions, Usa, Inc. (malvern, Pa) Patent Number: 6,639,967 Date filed: September 27, 2001 Abstract: A radiation therapy device (2) includes a programmable power source (300) and controller (302) that monitor an injected current level and controls heater voltage in response thereto. The heater voltage is reduced in predetermined increments without affecting the beam profile. Excerpt(s): The present invention relates to medical linear accelerators and, more particularly, to a system and method for reducing the effects of backheating on the electron gun in a medical linear accelerator. Radiation emitting devices are generally known and used, for instance, as radiation therapy devices for the treatment of patients. A radiation therapy device generally includes a gantry which can be swiveled around a horizontal axis of rotation in the course of a therapeutic treatment. A linear accelerator including an electron gun and a waveguide is located in the gantry for generating a high energy radiation beam for therapy. This high energy radiation beam can be an electron beam or photon (X-ray) beam. During treatment, this radiation beam is trained on one zone of a patient lying in the isocenter of the gantry rotation. An important consideration in delivering radiation treatment is control of the radiation beam. The electron gun is subject to a phenomenon known as "back heating." Backheating causes an increase in the temperature of the electron gun resulting in an increase in the barium

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evaporation rate (Barium is impregnated into the gun cathode tungsten matrix to enhance electron emission.). This causes a deposition of barium in cavities of the linear accelerator adjacent the electron gun. This, in turn, results in an increase in dark current, which has a deleterious effect on the control of the radiation beam. The net result is that the linear accelerator's useful life is decreased, and therefore must be replaced sooner than would necessarily be desired. Web site: http://www.delphion.com/details?pn=US06639967__ ·

Endocurietherapy Inventor(s): Good; Roger (Omaha, NE) Assignee(s): Endotech, Inc. (spokane, Wa) Patent Number: 6,666,811 Date filed: August 7, 2000 Abstract: To provide versatile radioactive implants and methods of radiation therapy, plating methods such sputtering, as are used to coat single elements such as microspheres, wires and ribbons with radioactive metals, protective layers and identification layers. The resulting solid, radioactive, multilayered seamless elements are implanted individually or combined in intercavity applicators, with fabrics and in ribbons. Because they have selected half-lives and intensities, they provide flexibility in treatment, permitting low intensity or high intensity treatment using temporary or permanent implants and implants with high intensity or low intensity or contoured intensity to permit different therapies. Excerpt(s): This invention relates to radioactive implants, methods of making them and methods of using them. It is known to use external beam supervoltage or megavoltage conventional fractionated radiation therapy to treat subclinical microscopic metastases in surgically undisturbed lymph node chains and to sterilize the postoperative tumor bed after the tumor is grossly excised. The uses of external beam radiation techniques have a disadvantage that they are not able to safely treat solid tumors because the solid tumors require an intensity of radiation that is harmful to the surrounding normal tissue. It is also known to implant radioactive sources directly into solid tumors for the destruction of the tumors in a therapy referred to as brachytherapy (short-range therapy). This therapy permits the application of larger doses of radiation. Web site: http://www.delphion.com/details?pn=US06666811__

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Fluence adjustment for improving delivery to voxels without reoptimization Inventor(s): Kapatoes; Jeffrey M. (Madison, WI), Mackie; Thomas R. (Verona, WI), Olivera; Gustavo H. (Verona, WI), Reckwerdt; Paul J. (Madison, WI), Ruchala; Kenneth J. (Madison, WI) Assignee(s): Tomotherapy Incorporated (madison, Wi) Patent Number: 6,661,870 Date filed: March 9, 2001 Abstract: A method of compensating for unexpected changes in the size, shape, and/or position of a patient in the delivery of radiation therapy. An image of a patient is used to prepare a treatment plan for the irradiation of a tumor or the like, shown in the

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image. A second image of a patient includes a visual representation of the tumor and sensitive structures wherein any combination of the size, shape, or position of the tumor or sensitive structures is different from any combination of the size, shape, or position of the visual representation of the tumor or sensitive structures in said first image. The radiation treatment is adjusted to more closely conform the treatment plan to the new size, shape, or position of the tumor as shown in said second image. This adjustment can occur before, during, or after the radiation delivery and can be used to define trade-offs that exist for the delivery. The trade-offs can be assessed and decisions made regarding which fluence adjustment strategy will be acceptable for treatment delivery. Excerpt(s): This invention relates generally to the use of radiation therapy equipment for the treatment of tumors, or the like, and specifically to a method for modifying a prepared radiation treatment plan in response to a detected change in a tumor, or the like. Medical equipment for radiation therapy treats tumorous tissue with high energy radiation. The amount of radiation and its placement must be accurately controlled to ensure both that the tumor receives sufficient radiation to be destroyed, and that the damage to the surrounding and adjacent non-tumorous tissue is minimized. In external beam radiation therapy, a radiation source external to the patient treats internal tumors. The external source is normally collimated to direct a beam only to the tumorous site. The source of high energy radiation may be x-rays, or electrons from linear accelerators in the range of 2-25 MeV, or gamma rays from highly focused radioisotopes such as a Co.sup.60 source having an energy of 1.25 MeV. Web site: http://www.delphion.com/details?pn=US06661870__ ·

Integral lens for high energy particle flow, method for producing such lenses use thereof in analysis devices and devices for radiation therapy and lithography Inventor(s): Kumakhov; Muradin Abubekirovich (Russia, 123298, Moscow,ul. Narodnogo Opolcheniya, d. 35, kv. 55, Moscow, RU) Assignee(s): None Reported Patent Number: 6,678,348 Date filed: June 15, 2001 Abstract: The invention makes possible to increase the degree of radiation focusing by the lens, to use particles of higher energies, and to increase the coefficients, depending on these factors, of the devices, the lens is used in. Thus the sublens 18 of the least degree of integration represents a package of the channels 5, which is growing out of joint drawing and forming the capillaries, which are laid in a bundle. The sublens of each higher degree of integration represents a package of sublenses of the previous degree of integration, which is growing out of their joint drawing and forming. The sublenses are growing out of performing the said operations at the pressure of the gaseous medium inside the channels being higher than the pressure in the space between the sublenses of the previous degree of integration and at the temperature of their material softening and splicing the walls. To produce the lenses a bundle of stocks (capillaries) in a tubular envelope is fed to the furnace (at the first stage) or stocks, produced on the previous degree, and the bundle is drawing from the furnace at the speed, exceeding the speed of feeding. The product is cut off on stocks for the next stage, and at the final stage the product is formed by varying the drawing speed, after what the parts with formed barrel-shaped thickenings are cut of.

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Excerpt(s): The present invention generally relates to radiation lenses and, more particularly, to x-ray lenses comprising a plurality of sub-lenses drawn together which is useful in flaw detection and diagnostics in engineering and medicine. The usage of different types of radiation (X-rays, gamma ray, neutral or charged particle radiation) in different fields, such as instrument making, medicine, microelectronics, etc., considerably broadened for the last 20-30 years. More powerful X-ray and safe neutron sources are made. These sources help to solve important fundamental and applied tasks of science and industry. Unfortunately, x-ray sources are very expensive. To build such sources, as does the European Center for Synchrotron Radiation (Grenoble, France), several states must cooperate. Therefore it is very important to create optical devices, which can significantly increase effective luminance of cheap and available sources. Web site: http://www.delphion.com/details?pn=US06678348__ ·

Integrated control of portal imaging device Inventor(s): Collins; William F. (Clayton, CA) Assignee(s): Siemens Medical Solutions Usa, Inc. (malvern, Pa) Patent Number: 6,519,316 Date filed: November 2, 2001 Abstract: A system, method, apparatus, and means for controlling a portal imager includes operating a radiation therapy device to identify segment data defining a radiation therapy segment, identifying (from the segment data) portal position information, and positioning a portal imaging device based on the portal position information. The radiation therapy device may be further operated to identify field information identifying a radiation field to be delivered, position elements of the radiation therapy device to deliver the field, deliver the field, and capture a portal image on the portal imaging device. Excerpt(s): The present invention relates generally to radiation therapy devices, and more particularly, to the automated delivery and monitoring of radiation therapy. Conventional radiation therapy typically involves directing a radiation beam at a tumor in a patient to deliver a predetermined dose of therapeutic radiation to the tumor according to an established treatment plan. This is typically accomplished using a radiation therapy device such as the device described in U.S. Pat. No. 5,668,847 issued Sep. 16, 1997 to Hernandez, the contents of which are incorporated herein for all purposes. The radiotherapy treatment of tumors involves three-dimensional treatment volumes which typically include segments of normal, healthy tissue and organs. Healthy tissue and organs are often in the treatment path of the radiation beam. This complicates treatment, because the healthy tissue and organs must be taken into account when delivering a dose of radiation to the tumor. While there is a need to minimize damage to healthy tissue and organs, there is an equally important need to ensure that the tumor receives an adequately high dose of radiation. Cure rates for many tumors are a sensitive function of the dose they receive. Therefore, it is important to closely match the radiation beam's shape and effects with the shape and volume of the tumor being treated. It is also important to properly position the patient on the treatment table to avoid damaging tissue and critical organs. Web site: http://www.delphion.com/details?pn=US06519316__

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Intensity modulated radiation therapy planning system Inventor(s): Bova; Frank J. (Gainesville, FL) Assignee(s): University of Florida (gainesville, Fl) Patent Number: 6,661,872 Date filed: December 17, 2001 Abstract: A method for planning an intensity modulated radiation therapy system comprising outlining a 3D target volume, providing relative radiation intensities of the 3D, a) selecting specific beam directions for the system to use and b) optimizing the system using an arcing paradigm; back-projecting the given intensities to the selected beam entry portals; sub-dividing each entry portal into discrete dose elements; applying thereto a cost function that scores the goodness of the plan by positively rewarding doses in selected regions and negatively rewarding doses in protected regions, and adjusting the weights of each of the dose elements to increase the overall score. Excerpt(s): The present invention relates to a system for optimally planning an Intensity Modulated Radiation Therapy system. So-called Intensity Modulated Radiation Therapy (IMRT) systems are well known in the art [see U.S. Pat. Nos. 5,663,999; 6,142,925; 6,076,005; 6052,435; 6,038,283; 5,764,723; 5,701,897; 5,673,700; 5,669,387; 5,622,174, and "Intensity Modulated Radiation Therapy--Complications," Advance for Administrators in Radiology, Radiology Technology Profile, July, 1996]. IMRT systems using Dynamic Multileaf Collimators (DMLC) entail rotation of the linear accelerator gantry in coordination with the opening and closing of the DMLC jaws. When delivering IMRT, at any desired combination of gentry angle and DMLC jaw position, it is necessary that the linear accelerator beams be properly gated to insure that radiation is only applied at the proper time and in the proper doses. The field of radiation delivery has long relied upon dose delivery using either uniform fields or fields that are have a dose gradient in only one direction. These latter fields are commonly known as "wedged fields". Intensity Modulated Radiation Therapy systems demand that treatment planners be provided with a tool that allows optimization dose distributions. Up until the present time such planning has been either extremely difficult to design when using routine planning techniques or else simply impossible. While one of the initial proposals of IMRT planning advocated a simple method of involving the packing of the planned target volume with spheres of dose, each having a unique intensity, this technique was never fully developed. Other techniques based upon back projections and iterative optimization techniques have been advanced and commercialized. Although these techniques have been applied to routine radiation therapy targets and even to some radiosurgery targets they have yet to produce the highly conformal dose distributions with high dose gradients that are the hallmark of a good radiosurgery treatment plan. Web site: http://www.delphion.com/details?pn=US06661872__

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Internal marker device for identification of biological substances Inventor(s): Fisher; Susan J. (Ann Arbor, MI), Thomas; Cherry T. (Ann Arbor, MI), Wahl; Richard L. (Ann Arbor, MI) Assignee(s): The Regents of the University of Michigan (ann Arbor, Mi) Patent Number: 6,628,982 Date filed: March 30, 2000

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Abstract: The present invention is directed to a device for visualizing structure located on the interior of a biological substance. The device of the present invention includes a marker member which may be a solid cylinder or lumen having an interior volume. The marker member has a proximal end, and a distal end. The distal end of the device is removably insertable in the biological substance relative to the interior structure to be visualized and is composed of a biologically stable substrate material. An imageenhancing material is contained relative to the marker member in a manner such that the imaging material does not directly contact the biological substance; such imaging material will remain self-contained without causing significant tissue absorption, toxicity or undesired image distortion. The imaging material of choice is one which is capable of producing an emission or signal detectable external to the biological substance by suitable imaging instrumentation. Also disclosed is a method for visualizing critical structures or radiation therapy targets employing the device of the present invention, particularly in imaging processes such as positron emission tomography and/or single photon emission computerized tomography, MRI or ultrasound either used alone or in combination with anatomical imaging processes such as computerized tomography or mammography. Excerpt(s): The present invention is related to identifying landmarks which assist in visualizing internal structures during diagnostic and/or therapeutic procedures, including medical procedures. Targeting aids or landmarking devices have been employed in diagnostic imaging techniques such as computed tomography (CT), magnetic resonance imaging (MRI)and ultrasound. These devices, commonly referred to as fiducial markers, generally occur as two types: internally occurring markers which are inherent in the subject's anatomy; and externally positionable imaging aids which can be permanently or temporarily affixed to the body under analysis. External fiducial markers have also been proposed for use and used in other imaging techniques such as positron emission tomography (PET) and single photon emission computed tomography (SPECT)as well as in imaging techniques such as MRI and CT. No effective internally positionable devices have been developed. Imaging techniques such as PET and SPECT rely upon cellular uptake of suitable imaging solutions such as 2-(.sup.18 F)fluoro-2-deoxy-D-glucose (FDG) to provide accurate images of metabolically active tissue, including cancerous or abnormal tissue material. Malignant cells such as those found in cancerous tumor tissue, generally exhibit elevated energy requirements resulting in elevated levels of glucose consumption. By comparison, surrounding tissue is less metabolically active. Imaging techniques such as PET make use of this differential in cellular glucose uptake by employing radiopharmaceutically tagged uptake solutions to demonstrate areas of interest for imaging and analysis. Other PET techniques such as image amino acid transport, DNA synthesis, etc., as well as SPECT can, for example, image overexpression of receptors on tumors. While both methods allow distinction of tumor from normal tissues, there are instances in which PET and SPECT are difficult to use as a single scanning modality. Web site: http://www.delphion.com/details?pn=US06628982__

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Intravascular catheter device and method for simultaneous local delivery of radiation and a therapeutic substance Inventor(s): Bhat; Vinayak D. (Sunnyvale, CA) Assignee(s): Advanced Cardiovascular Systems, Inc. (santa Clara, Ca) Patent Number: 6,645,135 Date filed: March 30, 2001 Abstract: Methods and devices for providing intravascular local radiation therapy and simultaneous local delivery of a solution of a therapeutic substance are disclosed. The therapeutic substance may be an antiplatelet substance, an antithrombotic substance, a thrombolytic substance, or a mixture thereof, among other possibilities. An exemplary balloon catheter assembly for delivery of the simultaneous radiation and therapeutic substance treatments includes an elongate body with lumen for delivering the solution of the therapeutic substance to a permeable inflation region at a distal end of the body, and a centerable delivery lumen for transporting a radiation source to the treatment site. Excerpt(s): The present invention involves medical devices that are capable of providing intravascular radiation therapy. Percutaneous transluminal coronary angioplasty (PTCA) is a medical procedure used to open arteries that have been partially closed ("stenosed") by the buildup of atherosclerotic plaque or other materials, and accordingly pass a reduced amount of blood. In a typical PTCA procedure, a guiding catheter having a preformed distal tip is percutaneously introduced into the cardiovascular system of a patient through the brachial or femoral arteries. The guiding catheter is advanced therein until the distal tip is in the ostium of the desired coronary artery. A guide wire and dilation catheter having an inflatable balloon on the distal end thereof are introduced through the guiding catheter with the guide wire slidably disposed within an inner lumen of the dilation catheter. The guide wire is first advanced out of the distal end of the guiding catheter and is then maneuvered into the patient's coronary vasculature containing the lesion to be dilated, and is then advanced beyond the lesion. Thereafter, the dilation catheter is advanced over the guide wire until the dilation balloon is located across the lesion. Once in position across the lesion, the balloon is inflated to a predetermined size to radially compress against the atherosclerotic plaque of the lesion for remodeling the vessel. The balloon is then deflated so that the dilation catheter can be removed and blood flow resumed through the dilated artery. After an angioplasty procedure, restenosis at or near the site of the original stenosis in the artery occasionally occurs. The smooth muscle cells of the artery may proliferate at the site of angioplasty treatment. Restenosis may result in a reformation of the lesion and a narrowing of the artery at the site. Web site: http://www.delphion.com/details?pn=US06645135__

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Manual ribbon delivery system for intravascular radiation therapy Inventor(s): Castelo; Astor S. (Miami, FL), Janowski; James L. (Dania Beach, FL), Singer; Martin H. (Lauderhill, FL), Wilkinson; Jeffrey L. (Silver Springs, FL) Assignee(s): Cordis Corporation (miami Lakes, Fl) Patent Number: 6,575,891 Date filed: July 20, 2001

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Abstract: An afterloader for safely and rapidly advancing a flexible ribbon with a radioactive source (42) through a lumen of a catheter within a patient includes a containment vessel (12), a ribbon extension stop, a ribbon retraction stop, emergency ribbon retraction, ribbon drive mechanism, slip clutch (18), ribbon position indicator (30), security lock mechanism (32), ribbon brake (22), and other novel features. Excerpt(s): The present invention relates to medical devices generally, and to storing, delivering and positioning radioactive ribbons or wires into the body of a patient, which are commonly used in radiation oncology and intravascular radiotherapy. In particular, the present invention relates to such devices, often referred to as "pigs" or "afterloaders." Such devices advance a ribbon having a radioactive source at its distal end along a catheter previously positioned within the body of a patient for a predetermined period of time, and which later withdraw the ribbon from the patient. Restenosis after arterial intervention in general, and after percutaneous transluminal coronary angioplasty ("PTCA") in particular, is a concern of physicians practicing PTCA today. Conventional PTCA is performed using a standard balloon catheter such as the type described in U.S. Pat. No. 5,304,197 entitled "Balloons For Medical Devices And Fabrication Thereof," issued to Pinchuk et al. on Apr. 19, 1994, which is incorporated into this disclosure by reference. Balloon catheters are typically used with a guidewire which is inserted into the patient's artery until its distal end is advanced past the diseased or stenotic area of the vessel, where there is a buildup of material. Balloon catheters typically have a guidewire lumen so that the proximal end of the guidewire can be inserted into the distal end of the balloon catheter. Thereafter, the balloon catheter is advanced over the guidewire until the balloon is adjacent the buildup of material, and the balloon is then inflated to compress the buildup. Finally, the balloon is deflated and the catheter is pulled back through the guidewire and removed from the patient's vasculature. Restenosis of the artery may occur after this procedure, such that the same area of the vessel collapses or becomes clogged again. Recent technology has discovered that treating the diseased area of the vessel with radiation after balloon angioplasty may help prevent restenosis. Web site: http://www.delphion.com/details?pn=US06575891__ ·

Megavoltage computed tomography during radiotherapy Inventor(s): Mackie; Thomas R. (Madison, WI), Olivera; Gustavo H. (Madison, WI), Ruchala; Kenneth J. (Madison, WI) Assignee(s): Wisconsin Alumni Research Foundation (madison, Wi) Patent Number: 6,618,467 Date filed: August 9, 2001 Abstract: Reduced dose megavoltage CT images are obtained using low flux data resulting from leakage through modulating shutters and/or collected by other means and augmented by incomplete high flux data collected during radiation therapy. The ability to construct tomographic projection sets from significantly varying flux rate data is provided by the use of air scans windowed to account for variations in mechanical leaf movement. These methods are also provide a means of imaging the patient entirely during radiation therapy treatments without any additional scan time. Excerpt(s): In external radiation therapy, converging beams of radiation are used to irradiate cancerous tissue within a patient. Tomotherapy is a form of external radiation therapy in which the radiation source is placed on a gantry rotating in a single plane

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about an axis through the patient. The patient may be translated across the plane during the rotation to impart a relative helical motion between the patient and a point on the gantry. During this rotation, the radiation beam is modulated by a multi-leaf collimator (MLC) or other modulating device which divides the radiation beam into independently controllable rays. By controlling the intensity of each ray as a function of gantry angle, radiation dose may be precisely placed in arbitrary cross-sectional regions within the body. Methods of constructing and of operating such tomotherapy equipment are described in U.S. Pat. No. 5,317,616 issued May 31, 1994 entitled Method and Apparatus for Radiation Therapy, and U.S. Pat. No. 5,548,627 issued Aug. 20, 1996 entitled Radiation Therapy System With Constrained Rotational Freedom as assigned to the assignees of the present application and hereby incorporated by reference. Tomotherapy's ability to precisely place a radiation dose makes it important to be able to accurately image the treatment region and precisely locate the patient during treatment. U.S. Pat. No. 5,724,400 issued Mar. 3, 1998 entitled Radiation Therapy System With Constrained Rotational Freedom also assigned to the assignees of the present invention and hereby incorporated by reference describes a combination computed tomography (CT) machine and radiation tomotherapy machine that can provide both imaging and accurate registration of the patient. Web site: http://www.delphion.com/details?pn=US06618467__ ·

Method and apparatus for calibration of radiation therapy equipment and verification of radiation treatment Inventor(s): Mackie; Thomas R. (Madison, WI), McNutt; Todd R. (Madison, WI), Reckwerdt; Paul J. (Madison, WI) Assignee(s): Wisconsin Alumni Research Foundation (madison, Wi) Patent Number: 6,636,622 Date filed: January 4, 2002 Abstract: A method of calibration and verification of radiotherapy systems deduced radiation beam fluence profiles from the radiation source from a complete model of an extended radiation phantom together with dose information from a portal imaging device. The improved beam fluence profile characterization made with an iterative modeling which includes scatter effects may be used to compute dose profiles in the extended phantom or a patient who has been previously characterized with a CT scan. Deviations from the expected beam fluence profile can be used to detect patient misregistration. Excerpt(s): This invention relates to radiation therapy equipment for the treatment of tumors or the like and specifically to an improved method of characterizing the radiation beam of such systems and confirming the dose received by the patient using a portal image of radiation exiting the patient. Medical equipment for radiation therapy treats tumorous tissue with high energy radiation. The dose and the placement of the dose must be accurately controlled to insure both that the tumor receives sufficient radiation to be destroyed, and that damage to the surrounding and adjacent nontumorous tissue is minimized. Internal-source radiation therapy places capsules of radioactive material inside the patient in proximity to the tumorous tissue. Dose and placement are accurately controlled by the physical positioning of the isotope. However, internal-source radiation therapy has the disadvantages of any surgically invasive procedure, including discomfort to the patient and risk of infection.

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Web site: http://www.delphion.com/details?pn=US06636622__ ·

Method and system for predictive physiological gating of radiation therapy Inventor(s): Mostafavi; Hassan (Los Altos, CA) Assignee(s): Varian Medical Systems, Inc. (palo Alto, Ca) Patent Number: 6,621,889 Date filed: October 23, 1998 Abstract: A method and system for physiological gating for radiation therapy is disclosed. A method and system for detecting and predictably estimating regular cycles of physiological activity or movements is disclosed. Another disclosed aspect of the invention is directed to predictive actuation of gating system components. Yet another disclosed aspect of the invention is directed to physiological gating of radiation treatment based upon the phase of the physiological activity. Excerpt(s): The present invention relates to medical methods and systems. More particularly, the invention relates to a method and system for physiological gating of radiation therapy. Radiation therapy involves medical procedures that selectively expose certain areas of a human body, such as cancerous tumors, to high doses of radiation. The intent of the radiation therapy is to irradiate the targeted biological tissue such that the harmful tissue is destroyed. In certain types of radiotherapy, the irradiation volume can be restricted to the size and shape of the tumor or targeted tissue region to avoid inflicting unnecessary radiation damage to healthy tissue. For example, conformal therapy is a radiotherapy technique that is often employed to optimize dose distribution by conforming the treatment volume more closely to the targeted tumor. Normal physiological movement represents a limitation in the clinical planning and delivery of conventional radiotherapy and conformal therapy. Normal physiological movement, such as respiration or heart movement, can cause a positional movement of the tumor or tissue region undergoing irradiation. If the radiation beam has been shaped to conform the treatment volume to the exact dimensions of a tumor, then movement of that tumor during treatment could result in the radiation beam not being sufficiently sized or shaped to fully cover the targeted tumoral tissue. Web site: http://www.delphion.com/details?pn=US06621889__

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Method and system for secondary lock for securing accessories in a radiation therapy system Inventor(s): Ma; Edmund Leung (Alameda, CA) Assignee(s): Siemens Medical Solutions Usa, Inc. (malvern, Pa) Patent Number: 6,695,363 Date filed: January 21, 2000 Abstract: The present invention provides a method and system for a secondary lock for securing accessories in a radiation therapy system. The latching mechanism provided in accordance with the present invention includes a primary lock, a secondary lock, and a retainer shaft. The primary lock includes a head at a first end of the primary lock, and a protrusion at a first side of the primary lock. The secondary lock includes a main body, an engagement tang at a first end and a first side of the main body, and a locking tang at

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the first end and a second side of the main body. The retainer shaft is coupled to the primary lock and the main body of the secondary lock, where the secondary lock is fixedly positioned when the protrusion engages the accessory and the head resides between the engagement tang and the locking tang. The secondary lock creates a failsafe locking system, such that the secondary lock causes the primary lock to continue to engage an accessory tray even if failure occurs elsewhere in the latching mechanism. This lowers the probability of failure of the latching mechanism significantly, resulting in a safer radiation therapy system. The secondary lock of the latching mechanism also remains in a disengaged position when no tray in inserted, allowing trays to be inserted without the need to press the release button first to set the secondary lock into the disengaged position. Excerpt(s): The present invention relates to latching mechanisms, and more particularly to latching mechanisms for securing accessories in a radiation therapy system. The latching mechanisms 112 and 114 are coupled to the frame 102 by a retainer assembly 132 which includes a retainer shaft 134. When the tray 110 is inserted into the slot 104, the protrusion 122 of the lock 118 engages a notch 136 on the tray 110, preventing the tray 110 from sliding out of the slot 104. An opening 154 in the frame 102 allows the lock 118 to freely engage the notch 136. When the release button 128 is pressed, the release assembly 126 pivots the lock 118 counterclockwise about the retainer shaft 134, releasing the tray 110. This is facilitated by the wedging action between an elongated hole 152 of the release assembly 126 and the roll pin 124. The release button 128 is spring loaded. This button spring 130 keeps the lock 118 engaged when a tray is inserted. A crescent washer 138 is used to constrain the latching mechanisms 112 and 114 in the direction of the retainer shaft 134 axis. The compliance of the crescent washer 138 limits the friction in the latching mechanisms 112, 114 while maintaining precision. The spacer 140 maintains the proper height alignment between the latching mechanisms 112 and 114 and their respective slots 104 and 106. The latching mechanism 116 for slot 108 uses a retainer ring 142 to loosely constrain the parts. The release assembly 144, the roll pin 146, the lock 148, and the spacer 150 for latching mechanism 116 perform the same functions as those for latching mechanisms 112 and 114. However, the dislodgment of the roll pin 124 and/or the loss of release button spring 130 force due to breakage of the spring 130 or loosening of the release button 128 have been known to occur. If one of these failures occur, then the tray 110 is in danger of sliding out of the accessory holder 100 and falling onto a patient on the platform 20, possibly causing serious injuries. Web site: http://www.delphion.com/details?pn=US06695363__ ·

Method for preventing and reducing radiation cystitis using hyaluronic acid Inventor(s): Pommerville; Peter J. (614 Inglewood Terrace, Victoria, British Columbia, CA) Assignee(s): None Reported Patent Number: 6,667,296 Date filed: July 30, 2001 Abstract: A method for preventing, reducing or treating radiation cystitis caused by external beam radiation therapy, which impinges on the urinary bladder and associated structures, comprising administering into the urinary bladder and associated structures a composition comprising hyaluronic acid (HA) having an average molecular weight of not less than 2.times.10.sup.5 Daltons and a pharmaceutically acceptable carrier.

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Excerpt(s): The present invention relates to a method for preventing, reducing and treating radiation cystitis caused by external beam radiation therapy, which impinges on the urinary bladder and associated structures, comprising administering into the urinary bladder and associated structures a composition comprising hyaluronic acid (HA) having an average molecular weight of not less than 2.times.10.sup.5 Daltons and a pharmaceutically acceptable carrier. Carcinoma of the prostate is among the most common forms of cancer and of cancer mortality in males. External beam radiation therapy (hereinafter, radiotherapy) is widely used for patients with clinically localized carcinoma of the prostate and is standard therapy for patients diagnosed with extensive local disease (American Joint Committee on Cancer). Radiotherapy also is used for patients with clinically localized carcinoma of the bladder, rectum, uterus and cervix. Acute effects of radiotherapy on normal tissue are observed during and immediately following a course of radiotherapy. The major complication of radiotherapy, which impinges on the bladder area, is its effect on urinary bladder function resulting in radiation cystitis. Radiation cystitis is defined in terms of bladder pain, increased urinary urgency, increased voiding frequency and increased nocturia. Its duration is usually 3 to 6 months, but can be 24 months or longer. Moreover, serious delayed urinary complications involving lifestyle altering symptoms or requiring hospitalization are observed in 2-7% of patients undergoing radiotherapy for prostate cancer. Web site: http://www.delphion.com/details?pn=US06667296__ ·

Method for reducing the severity of side effects of chemotherapy and/or radiation therapy Inventor(s): Davis; Stephen Thomas (Durham, NC) Assignee(s): Smithkline Beecham Corporation (philadelphia, Pa) Patent Number: 6,620,818 Date filed: August 28, 2001 Abstract: A composition and method for preventing/reducing the severity of epithelial cytoxicity side effects such as alopecia, plantar-palmar syndrome, mucositis) induced by chemoptherapy and/or radiation therapy in a patient receiving such therapy wherein a cyclin-dependent kinase II inhibitor is contemporaneously administered to the patient. Excerpt(s): The present invention relates generally to cyclin-dependent kinase II inhibitor compounds having utility as pharmacological agents for preventing/reducing the severity of epithelial cytotoxicity side effects of chemotherapy and/or radiation therapy, including alopecia plantar-palmar syndrome and/or mucositis. The invention also relates to a corresponding method of preventing/reducing the severity of such side effects, by administration of such a pharmalogical agent to a patient subjected to chemotherapy and/or radiation therapy treatment. Protein kinases play a critical role in the control of cell growth and differentiation and are key mediators of cellular signals leading to the production of growth factors and cytokines. See, for example, Schiessinger and Ulirich, Neuron 1992, 9, 383. A partial non-limiting list of such kinases includes abl, ARaf, ATK, ATM, bcr-abl, Blk, BRaf, Brk, Btk, CDK1, CDK2, CDK3, CDK4, CDK5, CDK6, CDK7, CDK8, CDK9, cfms, c-fms, c-kit, c-met, cRaf1, CSF1R, CSK, c-src, EGFR, ErbB2, ErbB3, ErbB4, ERK, ERK1, ERK2, Fak, fes, FGFR1, FGFR2, FGFR3, FGFR4, FGFR5, Fgr, FLK-4, Fps, Frk, Fyn, GSK, gsk3a, gsk3b, Hck, IGF-1R, IKK, IKK1, IKK2, JKK3, INS-R, Integrin-linkedkinase, Jak, JAK1, JAK2, JAK3, JNK, JNK, Lck, Lyn, MEK, MEK1, MEK2, p38, PDGFR, PIK, PKB1, PKB2, PKB3, PKC, PKC.alpha., PKC.beta., PKC.delta., PKC.epsilon., PKC.gamma., PKC.lambda., PKC.mu., PKC.zeta., PLK1, Polo-

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like kinase, PYK2, tie1, tie2, TrkA, TrkB, TrkC, UL13, UL97, VEGF-R1, VEGF-R2, Yes and Zap70. Protein kineses have been implicated as targets in central nervous system disorders such as Alzheimer's (Mandelkow, E. M. et al. FEBS Lett. 1992, 314, 315. Sengupta, A. et al. Mol. Cell. Biochem. 1997, 167,99), pain sensation (Yashpal, K. J. Neurosci. 1995, 15, 3263-72), inflammatory disorders such as arthritis (Badger, J. Pharm. Exp. Ther. 1996, 279, 1453), psoriasis (Dvir, et al. J. Cell Biol. 1991, 113, 857), and chronic obstructive pulmononary disease, bone diseases such as osteoporosis (Tanaka et al, Nature, 1996, 383, 528), cancer (Hunter and Pines, Cell 1994, 79, 573), atherosclerosis (Hajjar and Pomerantz, FASEB J. 1992, 6, 2933), thrombosis (Salari, FEBS 1990, 263, 104), metabolic disorders such as diabetes (Borthwick, A. C. et al. Biochem. Biophys. Res. Commun. 1995, 210, 738), blood vessel proliferative disorders such as angiogenesis (Strawn et al Cancer Res. 1996, 56, 3540; Jackson et al J. Pharm. Exp. Ther. 1998, 284, 687), restenosis (Buchdunger et al, Proc, Nat. Acad. Sci USA 1991, 92, 2258), autoimmune diseases and transplant rejection (Bolen and Brugge, Ann. Rev. Immunol. 1997, 15, 371) and infectious diseases such as viral (Littler, E. Nature 1992, 358, 160), and fungal infections (Lum, R. T. PCT Int. Appl., WO 9805335 A1 980212). Chemotherapeutic techniques and radiation therapy techniques are well-established in the treatment of neoplastic conditions of various types. As concomitant side-effects to the administration of chemotherapy and/or radiation therapy, patients commonly experience severe host epithelial cell toxicity. The consequences of damage to the proliferating epithelium induced by chemotherapy frequently include hair loss (alopecia), plantar-palmar syndrome and mucositis; such side effects, especially mucositis, are also known to occur as a result of radiation therapy. These side-effects may be of varying severity, depending on the type, dosages and dosing schedule of the respective chemotherapy and/or radiation therapy involved. Web site: http://www.delphion.com/details?pn=US06620818__ ·

Method of using caffeic acid phenethyl ester and analogs thereof as radiation sensitizers Inventor(s): Koumenis; Constantinos (Winston-Salem, NC), Naczki; Christine (WinstonSalem, NC) Assignee(s): Wake Forest University (winston-salem, Nc) Patent Number: 6,689,811 Date filed: April 19, 2002 Abstract: A method of potentiating radiation therapy in a subject in need thereof comprises administering a potentiating agent such as caffeic acid phenethyl ester (CAPE) or an analog thereof to the subject in an amount effective to potentiate radiation therapy in the subject. Excerpt(s): present invention concerns the use of caffeic acid phenethyl esters as radiation sensitizers in the treatment of tumors in subjects in need thereof. Adenocarcinoma of the prostate is the most commonly diagnosed non-skin cancer and the second leading cause of cancer deaths in the United States (F. Keely and L. Gomella, Epidemiology of Prostate Cancer, in Prostate Cancer, M. Ernstoff, J. Heany, and R. Peschel, Eds., 1998, p.2-14). Currently, the only therapies that have shown significant promise for curability of localized disease are radical prostatectomy and radiation therapy (RT). Selection of each type of treatment depends mainly upon tumor stage, with the majority of patients with A2 and B1 tumors receiving surgery, while those with stages B2, or C and higher-grade tumors are treated with radiation (R. Peschel, External

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Beam Radiation Therapy for Local Prostate Cancer, in Prostate Cancer, p. 117-136). Studies have suggested that adjuvant radiotherapy following prostatectomy provides superior results in terms of biochemical relapse (Prostate Specific Antigen levels) than surgery alone (R. Peschel, supra). Radiation therapy can consist of Conventional External Beam Radiotherapy, Three-Dimensional Conformal Radiation Therapy, or Radioactive Implant therapy. The latter modality, which was first developed in the early 1970's and is currently experiencing a resurgence, offers the advantage of delivery of relatively high-dose radiation therapy in a localized area. Despite the effectiveness of these different RT modalities in achieving local control of the disease and reducing the mortality rate of prostate cancer patients, approximately 20-40% of patients with local disease receiving irradiation will relapse at the site of irradiation (P. Scardino and T. Wheeler, NCI Monogr, 7, 95-103 (1988); J. Crook et al., Urology 45, 624-31 (1995); J. Crook et al., Cancer 79, 81-9 (1997)). Web site: http://www.delphion.com/details?pn=US06689811__ ·

Methods for the administration of amifostine and related compounds Inventor(s): Stogniew; Martin (Blue Bell, PA) Assignee(s): Medimmune Oncology Inc. (west Conshohocken, Pa) Patent Number: 6,573,253 Date filed: February 5, 2001 Abstract: The present invention provides methods of administering aminoalkyl phosphorothioate and/or aminoalkyl thiol compounds to patients receiving radiation therapy in a manner that significantly reduces or decreases the adverse or undesirable side-effects of the compounds as compared with conventional intravenous administration. Excerpt(s): The present invention relates to methods of administering aminoalkyl phosphorothioate and/or aminoalkyl thiol compounds to a subject in a manner that reduces or decreases the undesirable side effects of the compounds. One aspect of the invention relates to the subcutaneous administration of amifostine and/or its active metabolite to a patient, which reduces adverse side effects. Another aspect of the invention relates to methods of administering amifostine and/or its active metabolite to a patient in a manner such that a characteristic pharmacokinetic profile is obtained. When administered according to the characteristic pharmacokinetic profile, fewer adverse side effects are experienced by patients. Amifostine (also known as WR-2721) has been shown to be useful as a radiation protectant in cancer patients receiving radiation therapy (Constine et al., 1986, "Protection by WR-2721 of Human Bone Marrow Function Following Irradiation" Int. J. Radia. Oncol. Biol. Phys. 12:1505-8; Liu et al., 1992, "Use of Radiation with or Without WR-2721 in Advanced Rectal Cancer" Cancer 69(11):2820-5; Wadler et al., 1993, "Pilot Trial of Cisplatin, Radiation and WR2721 in Carcinoma of the Uterine Cervix: A New York Gynecologic Oncology Group Study" J. Clin. Oncol. 11(8):1511-6; Buntzel et al., 1996, "Selective Cytoprotection with Amifostine in Simultaneous Radiochemotherapy of Head Neck Cancer" Ann. Oncol. 7(Suppl.5):81(381P)). Amifostine is a pro-drug that is dephosphorylated at the tissue site by alkaline phosphatase to the free thiol, which is the active metabolite (also known as WR-1065). Once inside the cell, the active free thiol can protect against the toxicities associated with radiation by acting as a scavenger for oxygen free-radicals that are produced by ionizing radiation (Yuhas, 1977, "On the Potential Application of Radioprotective Drugs in Solid Tumor Radiotherapy," In: Radiation-Drug Interactions

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in Cancer Management pp. 303-52; Yuhas, 1973, "Radiotherapy of Experimental Lung Tumors in the Presence and Absence of a Radioprotective Drug S-2-(3Aminopropylamino) thylphosphorothioc Acid (WR-2721)" J. Natl. Cancer Inst. 50:69-78; Philips et al., 1984, "Promise of Radiosensitizers and Radioprotectors in the Treatment of Human Cancer" Cancer Treat. Rep. 68:291-302). Amifostine's ability to selectively protect normal tissues is based on the differential metabolism and uptake of amifostine into normal tissue versus tumor tissue. Amifostine is rapidly taken up and retained in normal tissues. Differences in capillary and membrane-bound alkaline phosphatase concentration and pH between normal and tumor tissues have been shown to favor the conversion of the pro-drug and uptake of the active form of amifostine, the free thiol, into normal tissues. Coupled with the fact that normal cells concentrate the free thiol at a faster rate than tumors and retain it for longer periods of time, amifostine is able to selectively protect normal tissues against the toxicities associated with radiation without negatively affecting the antitumor response. The marked differences in tissue uptake and retention between normal and tumor tissues produces a temporary state of acquired drug resistance in normal tissues, analogous to that produced by an excess of endogenous glutathione. Web site: http://www.delphion.com/details?pn=US06573253__ ·

MR-based real-time radiation therapy oncology simulator Inventor(s): Shukla; Himanshu P. (Gates Mills, OH), Steckner; Michael C. (Richmond Heights, OH) Assignee(s): Koninklijke Philips Electronics, N.v. (eindhoven, Nl) Patent Number: 6,708,054 Date filed: April 12, 2001 Abstract: In radiation oncology, a magnetic resonance apparatus is used to plan a treatment regimen. The oncologist uses the features of slice width selection, and depth selection to better ascertain where a medical malignancy is within a patient. In order to facilitate a user-friendly atmosphere for the oncologist, a new user control interface (50) is added to an MRI apparatus that includes controls normally found on a typical oncology linear accelerator. A conversion algorithm (52) translates the linac input into an imaging region for a magnetic resonance sequence that images the malignancy. Along each planned treatment trajectory radiation and MR projection images are superimposed to delineate the malignancy clearly for beam aiming and collimation adjustments. Excerpt(s): The present invention relates to the diagnostic imaging arts. It finds particular application in conjunction with diagnostic imaging in MRI scanners for oncology treatment applications and will be described with particular reference thereto. It will be appreciated, however, that the invention is also applicable to other types of diagnostic oncological imaging and for other diagnostic imaging for other purposes. In oncological planning, the oncologist typically generates a plurality of x-ray, projection images of a region to be treated. The images show bone and other internal structures, but do not necessarily differentiate the tumor from non-cancerous tissue. However, from an apriori knowledge of anatomy and the nature of the carcinoma, the oncologist estimates the center of the tumor and its size (diameter). One of the priorities in oncological procedures is accurately aligning a high power tumor killing x-ray beam with the internal tumor. If the selected trajectory is even slightly off, the x-ray beam will

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treat most of the tumor, but leave a small segment un-irradiated and damage healthy tissue. Un-irradiated tumor tissue can survive the treatment. Web site: http://www.delphion.com/details?pn=US06708054__ ·

Multiple layer multileaf collimator design to improve resolution and reduce leakage Inventor(s): Hughes; John H. (Martinez, CA) Assignee(s): Siemens Medical Solutions Usa, Inc. (malvern, Pa) Patent Number: 6,600,810 Date filed: August 10, 1998 Abstract: Aspects of a multiple layer multileaf collimator capable of improving resolution for coverage of a target during radiation therapy are described. A multiple layer multileaf collimator includes a first layer of multiple elongated radiation blocking leaves supported by a first frame for individual leaf positioning in a first direction. The multiple layer multileaf collimator further includes a to second layer of multiple elongated radiation blocking leaves supported by a second frame for individual leaf positioning in a second direction, the second direction offset at a desired angle relative to the first direction, wherein the individual leaves of the first and second layers conform more closely with a target shape to improve resolution. Further, the second layer is positioned above the first layer and provides leakage coverage for the multiple elongated radiation blocking leaves of the first layer. The multiple layer multileaf collimator is not limited to a single type of multileaf collimator and thus is suitable for use in a variety of multileaf collimator designs, including single focus and double focus multileaf collimators. Excerpt(s): The present invention relates to collimators in radiation therapy devices, and more particularly to multiple layer multileaf collimator design to improve resolution and reduce leakage. During conventional radiation therapy treatment, a beam of radiation, varying in angles and intensities, is directed at an area of a patient, e.g., at a tumor. Typical treatment field shapes, square, rectangular, or a modification thereof, result in a three-dimensional treatment volume that, unfortunately, may include healthy tissue and organs. For obvious safety reasons, the dose capable of being delivered to the tumor is limited by the healthy tissue and organs in the path of the radiation beam. Since cure rates for many tumors are a sensitive function of the dose they receive, reducing the amount of exposed healthy tissue and organs is highly desirable in order to be able to increase the dose delivered to the tumor. Methods of making the treatment volume correspond more closely with a tumor include moving solid-jaw blocks during treatment, scanning the radiation beam over the volume to be treated, and using a multileaf collimator to create an irregularly shaped field related to the shape of the tumor. An example of a multileaf collimator arrangement positioned about the central axis of a radiation-emitting head for shaping an irradiated beam is disclosed in U.S. Pat. No. 5,166,531, issued to Hunzinger on Nov. 24, 1992. Two opposing arrays of side-byside elongated radiation blocking collimator leaves act in place of opposing solid jaw blocks. Each leaf in each opposing array can be moved longitudinally towards or away from the central axis of the beam, thus defining a desired shape through which the radiation beam will pass. Web site: http://www.delphion.com/details?pn=US06600810__

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Muon radiation therapy Inventor(s): Angha; Nader (Franksville, WI) Assignee(s): Maktab Tarighe Oveyssi Shah Maghsoudi (burbank, Ca) Patent Number: 6,705,984 Date filed: February 15, 2001 Abstract: This invention relates to a novel idea for irradiating a patient with a beam of Muon (.mu.) particles, which in the proton (H.sup.+) rich environment of the blood and the cells catalyzes more fusions of the Hydrogen-Deuterium, Deuterium-Deuterium, and Deuterium-Tritium nuclei. Through local radiation of the related body part(s), the already existing fusion energy is accelerated within the particular body part(s), thus facilitating the treatment of diseases. Muon bombardment of the cells can be applied for the treatment of all kinds of conditions and injuries, including AIDS and other infectious diseases, all cancers, all varieties of internal and external injuries and internal disorders, weight loss, repairment and rejuvenation of all body organs, treatment of enzyme inhibition, all neurological disorders, including paralysis, all psychological disorders, all genetic disorders, all endocrine system disorders, and all musculoskeletal disorders. Excerpt(s): Muon radiation therapy is a novel means for the treatment of AIDS and other infectious diseases, for treatment of cancers, for all varieties of internal and external injuries and internal disorders, for weight loss, for repairment and rejuvenation of all body organs, for treatment of enzyme inhibition, all neurological disorders including paralysis, all psychological disorders, all genetic disorders, all endocrine system disorders, and all musculosketetal disorders. Muons are unstable nuclear particles, sometimes called Mu mesons. Muons may be generated as a by-product in a cyclotron. Muons have a mass which is close to 200 times the mass of an electron. One type of Muon, namely an elementary particle, has an electric charge equal to that of an electron, but is about 207 times more massive than the electron. These short-lived elementary particles are produced when primary cosmic rays, primarily containing very fast protons, collide with the Earth's atmospheric particles. The average Muon's' lifetime in its rest frame is 2.2.times.10.sup.-6 seconds. Web site: http://www.delphion.com/details?pn=US06705984__

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Non-myeloablative/lymphoablative conditioning regimen to induce patient antidonor unresponsiveness in stem cell transplantation Inventor(s): Slavin; Shimon (Jerusalem, IL) Assignee(s): Baxter International Inc. (deerfield, Il), Hadash Medical Research Services and Development Ltd. (jerusalem, Il) Patent Number: 6,544,787 Date filed: November 14, 1997 Abstract: Serious hematologic malignancies are treated through high dose or lethal chemotherapy and/or radiation therapy conditioning regimens followed by rescue with allogeneic stem cell transplantation (allo-SCT) or autologous stem cell transplantation (ASCT). These myeloablative/lymphoablative (M/L) treatment regimens involve the elimination of both the patient's hematopoietic stem cells and T-lymphocytes, often leading to serious complications including graft versus host disease (GVHD). The claimed invention addresses some of these problems by providing a conditioning

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regimen that is designed to eliminate the patient's T-lymphocytes while retaining a functional population of hematopoietic stem cells (HSC). This nonmyeloablative/lymphoablative (-/L) conditioning regimen involves the administration of one or more agents such as purine analogs (e.g., fludarabine), alkylating agents (e.g., bisulfan, cyclophosphamide), or anti-leukocyte globulins (e.g., anti-T lymphocyte globulin). After this, a donor-derived allogeneic stem cell preparation is administered to the patient. Patients treated according to the claimed invention develop donor-specific unresponsiveness and relatively fewer complications as compared to standard M/L conditioning regimens. The claimed methodologies should prove useful in the treatment of a number of hematologic malignancies such as chronic myelogenous leukemia, acute myelogenous leukemia, acute lymphoblastic leukemia, and non-Hodgkin's lymphoma. Excerpt(s): High dose or lethal conditioning regimens using chemotherapy and/or radiation therapy followed by rescue with allogeneic stem cell transplantation (alloSCT) or autologous stem cell transplantation (ASCT) have been the treatments of choice for patients with a variety of hematologic malignancies and chemosensitive solid tumors resistant to conventional doses of chemotherapy. A common source of stem cells for such procedures has been the bone marrow. Recently, peripheral blood stem cells (PBSC) have also been used. As such, the terms "allogeneic bone marrow transplantation" (allo-BMT) and "autologous bone marrow transplantation" (ABMT) are widely used in the literature to refer to particular types of allo-SCT and ASCT, respectively, whether the rescue is with bone marrow or PBSC. Current procedures typically employ allo-SCT or ASCT after myeloablative/lymphoablative (M/L) conditioning. As the name implies, M/L conditioning involves elimination, through cell killing, blocking, and/or down-regulation, of substantially all the hematopoietic stem cells and lymphocytes of the patient. Patients treated by allo-SCT or ASCT can develop major complications due to the M/L conditioning. In addition, patients receiving alloSCT are susceptible to graft versus host disease (GVHD), as well as to graft rejection. Moreover, relapse is still a frequent problem in these patients. Several attempts to improve disease-free survival by increasing the intensity of the M/L conditioning have failed due to unacceptable toxicity. Furthermore, increasing the intensity of the M/L conditioning does not appear to improve the outcome by decreasing the rate of relapse. A wide variety of protocols of varying intensities have been used among greater than 30,000 transplants worldwide reported to the International Bone Marrow Transplant Registry. Despite these numerous attempts to vary the intensity of the conditioning regimens, there have not been any documented significant differences in the over-all patient outcomes. Web site: http://www.delphion.com/details?pn=US06544787__ ·

Portal acquisition tool Inventor(s): Vaughan; Thomas F. (122 Central Rd. #201, Indian Harbour Beach, FL 32937) Assignee(s): None Reported Patent Number: 6,540,756 Date filed: April 19, 2000 Abstract: A tool is provided for use in acquiring a treatment portal on the skin surface of a patient undergoing radiation therapy or the like. The portal acquisition tool includes a template portion having a cut-out pattern for marking the treatment portal on the skin and a handle portion which both facilitates use of the template and includes ruled

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markings for taking measurements. Additionally, the handle portion is provided with transverse lines for assisting the therapist in altering the source-to-skin distance during the administration of electron energy and an opaque backing which serves as a screen for reflecting the optical distance indicator projected by the linear accelerator. Excerpt(s): The present invention relates generally to the medical art and, more particularly, to a tool for assisting in accurately establishing and marking a treatment portal on the skin surface of a patient undergoing radiation therapy or the like. The administration of radiation energy is in widespread use as an effective means of treating malignant and benign conditions. Such radiation therapy is generally administered by large, complex machines called linear accelerators. Although the linear accelerators administer specific dosages of radiation to precise locations inside the human body, it must be realized that operation of these machines is highly dependent on human interaction to ensure that the treatment regimen is successful. One important area where human interaction is necessary is in identifying the precise location on the skin surface of the patient where radiation must be administered to produce an effective treatment outcome. This area is commonly referred to as the treatment "portal." Prior to administering the actual radiation energy doses, it is first necessary for a team of scientists, including a treating oncologist and medical physicist, to view the internal anatomy of the patient and determine the precise locations where treatment is necessary. This is done when the patient is first brought in for radiation therapy by using a simulator, which is basically a scale model of the actual linear accelerator used during treatment without the radiation administering capabilities. To perform the simulation, the subject patient is laid on the treatment couch of the simulator below a gantry and raised vertically to the optimal imaging range. The oncologist and treating staff view the internal anatomy of the patient and locate the treatment site using fluoroscopy and reviewing pictures taken during internal imaging procedures, such as computerized axial tomography (CAT) scanning, magnetic-resonance imaging (MRI), or the like. The couch and gantry are movable to provide the oncologist with the best view of the anatomy he or she has determined needs treatment. Based on the positioning of the patient, who is normally laying down in a supine position, a sagittal laser is projected down the length of the patient's torso, a transverse laser is projected across the sagittal laser, and laterally extending lasers are projected running up and down the left and right sides of the body that intersect with the transverse laser. As any radiation therapist skilled in the art recognizes, the three areas where the lasers cross represent the triangulation points, which are marked. For some procedures, these triangulation points identify the treatment portals (i.e., the locations where radiation must be precisely administered to effectively eradicate a centralized diseased tissue mass), but it is also known to mark the triangulation points to ensure that the patient setup is the same for every treatment. For example, while a four field pelvic treatment will use triangulation points for both a setup point and a treatment portal, a two-field lung treatment would not but the lung still needs to be triangulated for accuracy and reproducibility. Web site: http://www.delphion.com/details?pn=US06540756__ ·

Radiation therapy and real time imaging of a patient treatment region Inventor(s): Burdette; Everette C. (Champaign, IL), Komandina; Bruce M. (Urbana, IL) Assignee(s): Computerized Medical Systems, Inc. (st. Louis, Mo) Patent Number: 6,512,942 Date filed: May 18, 2000

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Abstract: A method and apparatus for three-dimensional imaging and treatment of a patient's body. The method and apparatus utilize a system for developing a therapy plan for treatment of an organ of the patient, a device for generating ultrasound image data from a treatment region and a device for providing a translucent volume image of a portion of a patient's body and a separate translucent image of the patient organ and a three dimensional viewing device to superimpose a translucent article image to enable viewing of the article image simultaneously with the patient organ and a portion of the patient's body. Excerpt(s): The present invention is directed in general to an improved method and apparatus for carrying out minimally invasive treatments of the human body by virtual reality visualization of the treatment area. More particularly the invention is concerned with use of an apparatus and method for providing real time images of a human anatomy undergoing treatment along with rapid radiation seed therapy planning and rapid performance of therapy including an automatic seed loading methodology which enhances therapeutic treatment with greatly improved efficiency both in terms of time and resources. New minimally invasive surgical procedures are most often optically guided, but such optical guidance methods do not permit visualization and guidance of instruments or probes within (inside) the target tissue or organ. Incorporation of realtime three-dimensional visualization inside diseased tissues would provide accurate guidance of therapy. Open-magnet MRI is used to visualize some procedures such as thermal therapy and brain biopsies. However, the method is expensive, not truly realtime, and is limited in application. Numerous conventional treatment methods involve attempts to provide a targeted dosage of radiation or chemicals to the organ, and such treatments are often based on general anatomical assumptions of size and location. These methods suffer from inaccuracy of localizing the target for any one particular individual and potential real time changes of relative orientation and position of target tissue, normal tissue, and radiation therapy devices. Web site: http://www.delphion.com/details?pn=US06512942__ ·

Radiation therapy treatment method Inventor(s): Caflisch; Russel (Manhattan Beach, CA), Goldenfeld; Nigel (Champaign, IL), Gorlachev; Gennady (Moscow, RU), Kalugin; Pavel (Les Ulis, FR), Mechkov; Serguei (Montpellier, FR) Assignee(s): Numerix, Llc (new York, Ny) Patent Number: 6,714,620 Date filed: September 20, 2001 Abstract: Radiation therapy planning uses a beam commissioning tool and a Monte Carlo dose calculation tool. In the beam commissioning, measured dose data are input into a data processor. The measured dose data are derived from exposing a phantom to radiation from a source; and measuring the radiation dose to obtain a measured dose in the phantom resulting from the exposing step. The dose is measured at a plurality of points within the phantom, at least some of said points being axial points located at positions along a substantially central axis of the radiation source and others of said points being transverse points located at positions along an axis transverse to the central axis. The method further performs a Monte Carlo simulation of the radiation source to determine a simulated dose at the plurality of points; and further models the radiation source using the simulated dose and the measured dose.

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Excerpt(s): This invention relates to radiation therapy. Embodiments of the invention are implemented as a software system, called NXEGS, that uses Monte Carlo simulation of radiation transport for radiotherapy treatment planning (RTP) and includes the following capabilities: commissioning of a linear accelerator to construct an equivalent source model, simulation of radiation transport through beam modifiers, and simulation of radiation transport in a patient or phantom to obtain the resulting dose distribution. Embodiments of the invention are implemented using a digital computer programmed to execute the NXEGS software and algorithms described herein. The following background citations will be referred to by the references indicated in brackets. The entirety of all of these citations are incorporated herein by reference. [1] W. R. Nelson and D. W. O. Rogers, "Structure and Operation of the EGS4 Code System" in Monte Carlo Transport of Electrons and Photons, T. M. Jenkins, W. R. Nelson and A. Rindi, eds., Plenum, 287-305, (1989). Web site: http://www.delphion.com/details?pn=US06714620__ ·

Radiation therapy using a radioactive implantable device and a radiosensitizer agent Inventor(s): Hu; Ty T. (Mountain View, CA) Assignee(s): Advanced Cardiovascular Systems, Inc. (santa Clara, Ca) Patent Number: 6,547,812 Date filed: December 29, 2000 Abstract: A method and apparatus for inhibiting vascular restenosis using a radioactive implantable medical device and a radiosensitizer agent. In one embodiment, the method of the invention includes implanting a medical device at a blood vessel site that has undergone a procedure to open a stenosed region within a blood vessel. The medical device contains a radioisotope to emit a radioactivity to a tissue mass at the blood vessel site. The method further includes delivering a radiosensitizer agent to the tissue mass at the blood vessel site. The radiosensitizer agent increases a therapeutic response of the tissue mass to the radioactivity emitted by the radioisotope. Excerpt(s): The present invention relates generally to intravascular radiation therapy. More specifically, the present invention relates to radiation therapy for inhibition of vascular restenosis using an intravascular radioactive implantable device and a radiosensitizer agent. In a typical balloon PTCA procedure, a catheter is inserted into the cardiovascular system via a femoral artery under local anesthesia. A pre-shaped guiding catheter is positioned in the coronary artery, and a dilatation catheter having a distensible balloon portion is advanced through the guiding catheter into the branches of the coronary artery until the balloon portion traverses or crosses a stenotic lesion. The balloon portion is then inflated with an inflation medium to compress the stenotic lesion in a direction generally perpendicular to the wall of the artery, thus dilating the lumen of the artery. Patients treated by PTCA procedures, however, suffer from an incidence of restenosis i.e., at or near the original site of the stenosis in which the coronary vessel collapses or becomes obstructed by extensive tissue growth intimal hyperplasia. When restenosis occurs, a second angioplasty procedure or even bypass surgery may be required, depending upon the degree of restenosis. Web site: http://www.delphion.com/details?pn=US06547812__

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Radioactive medical device for radiation therapy Inventor(s): Bensimon; Corinne (Kanata, CA), Chan; Albert (Ottawa, CA) Assignee(s): Mds (canada) Inc. (ottawa, Ca) Patent Number: 6,638,205 Date filed: November 17, 2000 Abstract: The present invention discloses a radioactive medical device comprising a radioactive, electroplated substrate coated with at least one layer of polymer and sealed in a jacket layer. The at least one layer of polymer and jacket layer reduce leaching of a radioactive element from the electroplated substrate. The radioactive medical device is useful for radiation therapy of diseased tissue such as cancers and especially malignant tumors. Excerpt(s): The invention relates to radioactive medical devices. More specifically, the invention relates to radioactive medical devices which may be used in radiation therapy of diseased tissue. Radiation therapy is used extensively to treat diseased tissue such as cancers and especially malignant tumors. The goal of radiation therapy is to destroy the diseased or malignant tissue without causing excessive damage to nearby healthy tissue. One form of radiation therapy involves directing one or more beams of radiation from a point external to a subject's body into the area in which the tumor, malignant cells or diseased tissue, is located. Unfortunately, the beam of radiation must pass through healthy tissue to reach the diseased target tissue. Another type of radiation therapy involves the delivery of a radioactive source directly to the site of diseased tissue. These methods include, for example, the use of a catheter, the surgical implantation of one or more radioactive seeds, or the injection of one or more seeds into the patient in close proximity to the diseased tissue. Web site: http://www.delphion.com/details?pn=US06638205__

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Substituted aza-oxindole derivatives Inventor(s): Harris; Philip Anthony (Durham, NC), Kuyper; Lee Frederick (Durham, NC), Lackey; Karen Elizabeth (Durham, NC), Veal; James Marvin (Durham, NC) Assignee(s): Smithkline Beecham Corporation (philadelphia, Pa) Patent Number: 6,624,171 Date filed: August 28, 2001 Abstract: Substituted aza-oxindole derivatives useful as cyclin dependent kinase 11 inhibitors, for preventing/reducing the severity of epithelial cytotoxicity side-effects (e.g., alopecia, plantar-palmar syndrome, mucositis) induced by chemoptherapy and/or radiation therapy in a patient receiving such therapy. Excerpt(s): The present invention provides novel compounds, novel compositions and methods for their use and manufacture. The compounds and compositions of the present invention are generally useful pharmacologically as therapeutic agents in disease states alleviated by the inhibition or antagonism of protein kinase activated signalling pathways in general, and in particular in the pathological processes which involve aberrant cellular proliferation, such disease states including tumor growth, restenosis, atherosclerosis, and thrombosis. In particular, the present invention relates to a series of substituted aza-oxindole compounds, which exhibit protein tyrosine kinase and protein serine/threonine kinase inhibition, and which are useful for the prevention

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of chemotherapy-induced alopecia. Protein kinases play a critical role in the control of cell growth and differentiation and are key mediators of cellular signals leading to the production of growth factors and cytokines. See, for example, Schlessinger and Ullrich, Neuron 1992, 9, 383. A partial, non-limiting, list of such kinases includes abl, ARaf, ATK, ATM, bcr-abl, BIk, BRaf, Brk, Btk, CDK1, CDK2, CDK3, CDK4, CDK5, CDK6, CDK7, CDK8, CDK9, cfms, c-fms, c-kit, c-met, cRaf1, CSF1R, CSK, c-src, EGFR, ErbB2, ErbB3, ErbB4, ERK, ERK1, ERK2, Fak, fes, FGFR1, FGFR2, FGFR3, FGFR4, FGFR5, Fgr, FLK-4, Fps, Frk, Fyn, GSK, gsk3a, gsk3b, Hck, IGF-1R, IKK, IKK1, IKK2, IKK3, INS-R, Integrinlinkedkinase, Jak, JAK1, JAK2, JAK3, JNK, JNK, Lck, Lyn, MEK, MEK1, MEK2, p38, PDGFR, PIK, PKB1, PKB2, PKB3, PKC, PKC.alpha., PKC.beta., PKC.delta., PKC.epsilon., PKC.gamma., PKC.lambda., PKC.mu., PKC.zeta., PLK1, Polo-like kinase, PYK2, tie.sub.1, tie.sub.2, TrkA, TrkB, TrkC, UL13, UL97, VEGF-R1, VEGF-R2, Yes and Zap70. Protein kinases have been implicated as targets in central nervous system disorders such as Alzheimer's (Mandelkow, E. M. et al. FEBS Lett. 1992, 314, 315; Sengupta, A. et al. Mol. Cell. Biochem. 1997, 167,99), pain sensation (Yashpal, K. J. Neurosci. 1995, 15, 326372), inflammatory disorders such as arthritis (Badger, J. Pharm. Exp. Ther. 1996, 279, 1453), psoriasis (Dvir, et al, J. Cell Biol. 1991, 113, 857), bone diseases such as osteoporosis (Tanaka et al, Nature, 1996, 383, 528), cancer (Hunter and Pines, Cell 1994, 79, 573), atherosclerosis (Hajjar and Pomerantz, FASEB J. 1992, 6, 2933), thrombosis (Salari, FEBS 1990, 263, 104), metabolic disorders such as diabetes (Borthwick, A. C. et al. Biochem. Biophys. Res. Commun. 1995, 210, 738), blood vessel proliferative disorders such as angiogenesis (Strawn et al Cancer Res. 1996, 56, 3540; Jackson et al J. Pharm. Exp. Ther. 1998, 284, 687), restenosis (Buchdunger et al, Proc, Nat. Acad. Sci USA 1991, 92, 2258), autoimmune diseases and transplant rejection (Bolen and Brugge, Ann. Rev. Immunol. 1997, 15, 371) and infectious diseases such as viral (Littler, E. Nature 1992, 358, 160), and fungal infections (Lum, R. T. PCT Int. Appl., WO 9805335 A1 980212). The signals mediated by kinases have also been shown to control growth, death and differentiation in the cell by regulating the processes of the cell cycle (Massague and Roberts, Current Opinion in Cell Biology 1995, 7, 769-72). Progression through the eukaryotic cell cycle is controlled by a family of kinases called cyclin dependent kinases (CDKs) (Myerson, et al., EMBO Journal 1992, 11, 2909). The coordinate activation and inactivation of different cyclin/CDK complexes is necessary for normal progression through the cell cycle (Pines, Trends in Biochemical Sciences 1993, 18, 195; Sherr, Cell 1993, 73, 1059). Both the critical G1-S and G2-M transitions are controlled by the activation of different cyclin/CDK activities. In G1, both cyclin D/CDK4 and cyclin E/CDK2 are thought to mediate the onset of S-phase (Matsushime, et al., Molecular & Cellular Biology 1994, 14, 2066; Ohtsubo and Roberts, Science 1993, 259, 1908; Quelle, et al., Genes & Development 1993, 7, 1559; Resnitzky, et al., Molecular & Cellular Biology 1994, 14, 1669). Progression through S-phase requires the activity of cyclin A/CDK2 (Girard, et al., Cell 1991, 67, 1169; Pagano, et al., EMBO Journal 1992, 11, 961; Rosenblatt, et al., Proceedings of the National Academy of Science USA 1992, 89, 2824; Walker and Maller, Nature 1991, 354, 314; Zindy, et al., Biochemical & Biophysical Research Communications 1992, 182, 1144) whereas the activation of cyclin A/cdc2 (CDK1) and cyclin B/cdc2 are required for the onset of metaphase (Draetta, Trends in Cell Biology 1993, 3, 287; Murray and Kirschner, Nature 1989, 339, 275; Solomon, et al., Molecular Biology of the Cell. 1992, 3, 13; Girard, et al., Cell 1991, 67, 1169; Pagano, et al., EMBO Joumal 1992, 11, 961; Rosenblatt, et al., Proceedings of the National Academy of Science USA 1992, 89, 2824; Walker and Maller, Nature 1991, 354, 314; Zindy, et al., Biochemical & Biophysical Research Communications 1992, 182, 1144). It is not surprising, therefore, that the loss of control of CDK regulation is a frequent event in hyperproliferative diseases and cancer (Pines, Current Opinion in Cell Biology 1992, 4, 144; Lees, Current

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Opinion in Cell Biology 1995, 7, 773; Hunter and Pines, Cell 1994, 79, 573). The selective inhibition of CDKs is therefore an object of the present invention. Web site: http://www.delphion.com/details?pn=US06624171__ ·

Synchronized moving shield for a radiation therapy apparatus Inventor(s): Ueda; Hiroshi (Tokyo, JP), Uematsu; Minoru (651 Yamanouchi, Kamakurashi, Kanagawa-ken, JP) Assignee(s): Euro Meditech Co., Ltd. (tokyo, Jp), Hitk Enterprise Corp. (tokyo, Jp), Uematsu; Minoru (kanagawa-ken, Jp) Patent Number: 6,530,874 Date filed: December 19, 2000 Abstract: A synchronized moving radiation shield apparatus includes at least one shielding block disposed under a radiation pathway of a radiation therapy unit in such a manner that a radiation field is formed with the shielding block, wherein an affected portion of a person is exposed to radiation through the radiation field while radiation therapy of a portion, other than the affected portion, of the person, is shielded by the shielding block. The apparatus further includes a movable portion for movably holding the shielding block while not blocking the passing of radiation through the radiation field; drive means, connected to the movable portion, for moving the radiation field to a specific position; and control means for controlling the drive means in such a manner that the radiation field is movable in matching to a variation in position of the affected portion. With this configuration, since the radiation field is moved in accordance with the motion of the affected portion during radiation therapy for carcinoma, it is possible to prevent radiation therapy of adjacent normal portions, and hence to improve the treatment results by increasing the radiation doses for the affected portion. Excerpt(s): The above radiation therapy unit, however, has a problem. For example, for a patient having an affected portion in the lung, since the position of the affected portion is shifted by respiratory motion, adjacent normal portions of the affected portion should be exposed to radiation during radiation therapy of the affected portion. Accordingly, in consideration of radiation injury to adjacent normal portions of the patient, total radiation doses or daily fraction sizes must be limited, so that the affected portion may not be irradiated with sufficient doses. An object of the present invention is to provide a synchronized moving radiation shield apparatus for shielding radiation therapy of a portion other than a moving affected portion of a patient to be exposed to radiation by moving a radiation field in accordance with the motion of the affected portion due to respiratory motion. To achieve the above object, according to the present invention, there is provided a synchronized moving radiation shield apparatus including at least one shielding block disposed under a radiation pathway of a radiation therapy unit in such a manner that a radiation field is formed with the shielding block, wherein an affected portion of a person is exposed to radiation through the radiation field while radiation therapy of a portion, other than the affected portion, of the person, is shielded by the shielding block, the radiation shielding apparatus including: a movable portion for movably holding the shielding block while not blocking the passing of radiation through the radiation field; drive means, connected to the movable portion, for moving the radiation field to a specific position; and control means for controlling the drive means in such a manner that the radiation field is moving in matching to a variation in position of the affected portion.

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Web site: http://www.delphion.com/details?pn=US06530874__ ·

System and method for intensity modulated radiation therapy Inventor(s): Hernandez-Guerra; Francisco M. (Concord, CA) Assignee(s): Siemens Medical Solutions Usa, Inc. (malvern, Pa) Patent Number: 6,687,330 Date filed: July 31, 2001 Abstract: A dynamic IMRT scheme. A RAD ON/RAD OFF cycle is an IMRT segment. Every set of opposing leaves in the collimator produces an IMRT profile or track. According to such an embodiment, at least one of the opposing leaves moves toward the other to produce the given track. When a track is complete, the opposing leaves remain together until the end of the segment. The dose rate remains constant during the segment. Excerpt(s): The present invention relates to radiation therapy, and more particularly, to a system and method for efficiently delivering radiation treatment. Radiation emitting devices are generally known and used, for instance, as radiation therapy devices for the treatment of patients. A radiation therapy device generally includes a gantry which can be swiveled around a horizontal axis of rotation in the course of a therapeutic treatment. A linear accelerator is located in the gantry for generating a high energy radiation beam for therapy. This high energy radiation beam can be an electron beam or photon (X-ray) beam. During treatment, this radiation beam is trained on one zone of a patient lying in the isocenter of the gantry rotation. To control the radiation emitted toward an object, a beam shielding device, such as a plate arrangement or a collimator, is typically provided in the trajectory of the radiation beam between the radiation source and the object. An example of a plate arrangement is a set of four plates that can be used to define an opening for the radiation beam. A collimator is a beam shielding device which could include multiple leaves, for example, a plurality of relatively thin plates or rods, typically arranged as opposing leaf pairs. The plates themselves are formed of a relatively dense and radiation impervious material and are generally independently positionable to delimit the radiation beam. Web site: http://www.delphion.com/details?pn=US06687330__

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Tissue positioning apparatus and method for protecting tissue from radiotherapy Inventor(s): Winkler; Rance A. (Atlanta, GA) Assignee(s): Proxima Therapeutics, Inc. (alpharetta, Ga) Patent Number: 6,673,006 Date filed: June 15, 2001 Abstract: A spacing apparatus for use with radiation therapy devices, and in particular, for use with a brachytherapy device. The spacing apparatus is useful in that the instrument is effective to limit the amount of radiation that comes into contact with the sensitive tissue proximate to the extraction site, and thereby protect sensitive tissue from overheating or hotspots, and/or protect against radiation exposure outside of the patient's body which may affect healthcare providers or others who might come close to the patient. In particular, the spacing apparatus is effective to control the proximity of a

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brachytherapy device to the outer surface of the sensitive tissue proximate to a surgical extraction site. Excerpt(s): The present invention relates to methods and apparatuses for use in treating proliferative tissue disorders, and more particularly to methods and apparatus for controlling the positioning of a radiation therapy apparatus with respect to the sensitive tissue. Malignant tumors are often treated by surgical resection of the tumor to remove as much of the tumor as possible. Infiltration of the tumor cells into normal tissue surrounding the tumor, however, can limit the therapeutic value of surgical resection because the infiltration can be difficult or impossible to treat surgically. Radiation therapy can be used to supplement surgical resection by targeting the residual tumor margin after resection, with the goal of reducing its size or stabilizing it. Radiation therapy can be administered through one of several methods, or a combination of methods, including external-beam radiation, stereotactic radiosurgery, and permanent or temporary interstitial brachytherapy. The term "brachytherapy," as used herein, refers to radiation therapy delivered by a spatially confined radioactive material inserted into the body at or near a tumor or other proliferative tissue disease site. Owing to the proximity of the radiation source, brachytherapy offers the advantage of delivering a more localized dose to the target tissue region. Brachytherapy can be performed by implanting radiation sources directly into the tissue to be treated. Interstitial brachytherapy is traditionally carried out using radioactive seeds such as.sup.125 I seeds. These seeds, however, produce inhomogeneous dose distributions. In order to achieve a minimum prescribed dosage throughout a target region of tissue, high activity seeds must be used, resulting in very high doses being delivered in some regions in proximity to the seed or seeds which can cause radionecrosis in healthy tissue. Interstitial brachytherapy is useful for treating malignant brain and breast tumors, among others. Web site: http://www.delphion.com/details?pn=US06673006__ ·

Use of angiotensin II inhibitors to prevent malignancies associated with immunosuppression Inventor(s): Maluccio; Mary (New York, NY), Suthanthiran; Manikkam (Scarsdale, NY) Assignee(s): Cornell Research Foundation, Inc. (ithaca, Ny) Patent Number: 6,641,811 Date filed: February 9, 2001 Abstract: The invention provides a method for reducing formation or progression of neoplasms associated with immunosuppressive therapy in a mammal, the method comprising treating the mammal with an effective amount of an angiotensin II inhibitor. In addition the invention provides a method of preventing or treating a neoplasm in a mammal, the method includes treating the mammal with an effective amount of an angiotensin II inhibitor where the treatment is not associated with chemotherapy or radiation therapy. Also provided are compositions comprising an angiotensin II inhibitor and an immunosuppressive agent such as cyclosporin or FK506. The angiotensin II inhibitor of the invention includes proteins and polypeptides that bind angiotensin II receptors, anti-angiotensin II antibodies, angiotensin II receptors and fragments thereof. In another aspect the invention provides methods for identifying compounds capable of inhibiting the formation or proliferation of tumors in a mammal undergoing immunosuppressive therapy.

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Excerpt(s): Malignancy is a common and dreaded complication following organ transplantation (References 1-4). The high incidence of neoplasms and its aggressive progression, which are associated with immunosuppressive therapy, has been thought to be due to the resulting impairment of the organ graft recipient's immune surveillance system. Cyclosporine, a cyclic peptide (also known as cyclosporin A or CsA) and the macrolide FK506 (tacrolimus) are well known and widely used immunosuppressants for transplant recipients and autoimmune patients. Cyclosporine has had major impact on improving patient outcome following organ transplantation (References 4 and 5). Drugs typically employed as immunosuppressive agents include cyclosporine, azathioprine, leflunomide, rapamycin and other FKBP targeted compounds including dexamethasone; also included in this group are steroids (including corticosteroids), antilymphocyte globulins, and monoclonal anti-T cell antibodies. A surprising mechanism for the heightened malignancy that is independent of host immunity has been discovered. In a co-filed application entitled "Use of TGF-.beta. antagonists to inhibit tumor cell formation or progression" the present inventors, et al., have disclosed that TGF-.beta. antagonists are effective in reducing or eliminating the incidence of neoplasms mentioned above. Herein yet further methods and compositions comprising angiotensin II inhibitors useful for preventing or overcoming these complications are provided. Web site: http://www.delphion.com/details?pn=US06641811__ ·

UVC radiation therapy for chronic lymphocytic leukemia Inventor(s): Larcom; Lyndon L. (Clemson, SC), Smith; Samuel (Greenville, SC), Tuck; Amy (Piedmont, SC) Assignee(s): Clemson University (clemson, Sc) Patent Number: 6,585,676 Date filed: June 12, 2001 Abstract: Lymphocytes from chronic lymphocytic leukemia (CLL) patients have been found to be readily killed by ultra-violet light-C (UVC) radiation. Cells from healthy donors were minimally affected by doses of UVC 10 times higher than those which caused dramatic drops in the metabolism of CLL cells and eventual death.Irradiated cells from CLL patients and from healthy individuals all demonstrated a number of single strand DNA breaks and alkali-labile sites compared to unirradiated control cells. The extent of DNA damage to both healthy and CLL cells is dose dependent. However, the CLL cells demonstrated more extensive DNA fragmentation and an inability to undergo self-repair. The heightened sensitivity to UVC radiation of lymphocytes from CLL patients is used to provide an excorporeal treatment of CLL lymphocytes followed by the re-introduction of the treated lymphocytes to the patient. Excerpt(s): This invention is directed towards a therapeutic treatment for chronic lymphocytic leukemia. The lymphocytes from CLL patients have been found to be sensitive to ultraviolet radiation in the UVC range. It has been found possible to provide a UVC radiation exposure which will kill CLL cells without any measurable adverse effects on healthy lymphocytes taken from non-leukemia control patients. A treatment therapy in which a CLL patient's blood is treated extracorporeally with UVC radiation is provided which takes advantage of the CLL lymphocyte's sensitivity to UVC radiation. Chronic lymphocytic leukemia (CLL) is a hematological malignancy characterized by the clonal expansion of naive B-lymphocytes mainly in GO phase of the cell cycle. CLL results in the accumulation of mature immunologically defective lymphocytes in the GO

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phase. The disease is further characterized by the accumulation of B-lymphocytes in bone marrow, lymph nodes, spleen, and liver. In CLL patients, both the B and T cells are ineffective in their response to antigens and are associated with hypogammaglobulinemia and susceptibility to infectious diseases. The end stages of the disease results in the failure of production of myeloid and erythroid marrow elements as well as the presence of lymphoid masses. It is currently believed that the defective lymphocytes in CLL patients are produced at a normal rate as in healthy individuals, but fail to undergo appropriate apoptosis. Currently, existing therapies and treatment protocols for advanced clinical stages have met with only partial success. Traditional drug treatments have involved combinations of chlorambucil (an alkylating agent) and prednisone (corticoid steroid). More recently, the purine analog fludarabine has been shown to have positive effects on new and pre-treated CLL patients. However, such drug treatments pose undesirable side effect for some patients. Further, some patients develop resistance to a particular drug. Web site: http://www.delphion.com/details?pn=US06585676__ ·

Verification method of monitor units and fluence map in intensity modulated radiation therapy Inventor(s): Xing; Lei (Stanford, CA) Assignee(s): The Board of Trustees of the Leland Stanford Junior University (stanford, Ca) Patent Number: 6,697,452 Date filed: February 15, 2002 Abstract: A general computer-implemented method and computer program for an independent MU or dose and fluence calculation of an intensity modulated photon field in intensity modulated radiation therapy (IMRT) is provided. The present invention provides for the verification MU or dose calculation in high dose regions or low dose regions. In general, the dose at an arbitrary spatial point is expressed as a summation of the contributions from all the beamlets in a treatment field, each modulated by a dynamic modulation factor. The verification of a low dose region is based on using the inverted field of the low dose region. The advantage of the present invention that it is an independent method and therefore generally applicable and useful irrespective of the type of leaf sequence algorithm and delivery machines. It provides an automated computer-implemented method or program that generalizes and simplifies dose verification in IMRT. Excerpt(s): The present invention relates generally to intensity modulated radiation therapy. More particularly, the present invention relates to a method for verification of monitor units and fluence map in intensity modulated radiation therapy. Intensity modulated radiation therapy (IMRT) is a new modality of radiation therapy that shows promise for significantly improving dose conformation to the target and dose avoidance to the sensitive structures. IMRT has emerged from the developments of inverse planning and computer-controlled delivery using collimators (MiMiC) or multileaf collimators (MLC). An important problem in IMRT planning verification is how to efficiently verify the monitor unit (MU) calculation of an inverse planning system. An intensity modulated beam consists of a set of beamlets and is designed on a patientspecific basis. The beam can literally have any fluence profile and it is no longer possible to follow the manual MU check procedure of conventional conformal radiation therapy to validate an IMRT plan. Currently, the MU verification of IMRT is labor intensive,

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time consuming, costly and an institution dependent method. One way to verify the MU or dose calculation of an IMRT treatment planning system is to sum the fractional MUs corresponding to the segmented fields. The MU calculation for a multileaf collimated static field has been described in the literature (Georg D and Dutreix A 1997. A formalism to calculate the output ratio in a mini-phantom for a GE multileaf collimator, Phys. Med. Biol. 42, 521-536). Boyer et al. (1999) have illustrated how MU settings are derived from the prescribed dose in CORVUS inverse planning system (NOMOS Corporation, Sewickley, Pa.) and experimentally verified the system using ionization chamber in a water phantom (Boyer A L, Xing L, Ma C, Curran B, Hill R, Kinia A and Bleier A 1999. Theoretical considerations of monitor unit calculations for intensity modulated beam treatment planning. Med. Phys. 26, 187-195). However, they did not touch the issue of how to use a computer to independently verify the MU settings provided by an inverse planning system. Geis and Boyer (Geis P and Boyer A L, Use of a multileaf collimator as a dynamic missing-tissue compensator, Med. Phys. 23, 1199-1205, 1996) investigated the feasibility of replacing conventional physical missing-tissue compensators by using dynamic multileaf collimators. Geis and Boyer (1996) introduced a method to calculate MU for dynamic compensated fields that is analogous to and expands upon methods used for conventional compensating filter MU calculation. The formula ignored the MLC leaf transmission and the MLC movements were designed to mimic a physical compensator. To obtain the MU of a dynamic compensator, it requires to know the MU setting of the corresponding physical compensator, which is generally not available and rendered the approach invalid for MU verification of an intensity modulated field. Kung and Chen (1999) have applied the Clarkson method to directly calculate the dose of an intensity modulated field at central axis and then compared the result with the result from the treatment planning system. (Kung J and Chen G 1999. A modified Clarkson integration (MCI) for IMRT. Med. Phys. 26: 1135; Kung J, Chen G Kuchnir F 2000, A monitor unit verification calculation in intensity modulated radiotherapy as a dosimetry quality assurance, Med. Phys. 27, 2226-2230). Their method has two major deficiencies. First, it did not separate the dosimetric effect of the dynamic modulation from the beamlet kernels and was thus applicable only when the Clarkson method was used for dose evaluation. It is practically impossible to generalize their approach for dose calculation based on other more advanced methods. The validity of the Clarkson-based approach becomes questionable as the spatial resolution of intensity modulation increases. The approach is also problematic for accelerators with variable jaw settings during IMRT delivery. Second, their approach fails to yield useful information when the verification point is located in a low dose region. Web site: http://www.delphion.com/details?pn=US06697452__

Patent Applications on Radiation Therapy As of December 2000, U.S. patent applications are open to public viewing.10 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to radiation therapy:

10

This has been a common practice outside the United States prior to December 2000.

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Apparatus and method for predicting treatment response of cancer Inventor(s): Buen, James; (Little Rock, AR), Hanna, Ehah Y.N.; (Little Rock, AR), Li, Shulin; (Troy, MI) Correspondence: J.M. (mark) Gilbreth; Gilbreth & Associates, P.C.; P.O. Box 2428; Bellaire; TX; 77402-2428; US Patent Application Number: 20030175717 Date filed: March 14, 2002 Abstract: The present invention is directed to the identification of prognostic molecular markers of cancer and methods of predicting treatment response of a cancer. The invention further discloses molecular chips useful in predicting whether a cancer will respond to treatment. Preferably, the treatment is radiation therapy. Methods of using and methods of making the molecular chips of the invention are also disclosed. Excerpt(s): The present invention relates to cancer and the treatment of cancer. In another aspect, the present invention relates to apparatus and methods for predicting treatment response of a cancer. In even another aspect, the present invention relates to molecular chips and methods of using such chips for predicting whether a cancer will be radiation-sensitive or radiation-resistant. In still another aspect, the present invention relates to molecular chips and methods of using said chips for predicting whether a cancer will respond to chemotherapy. In yet another aspect, the present invention relates to molecular chips and methods of using said chips for predicting whether a cancer will respond to concomitant chemoradiotherapy. In even still another aspect, the present invention relates to molecular chips and methods of using such chips for predicting whether a squamous cell carcinoma of the head and neck will respond to radiation therapy. If detected in early stages, many types of cancer can be effectively treated using treatments comprising surgery, radiation therapy, chemotherapy, and/or any combination thereof. For example, if diagnosed in its early stages, squamous cell carcinoma (SCC) of the upper aerodigestive tract has excellent control rates with either surgery or radiation. However, when detected in an advanced stage, SCC of the head and neck (SCCHN) has a significantly high death rate with reported 5-year survival rates of 38-60%, despite the development of aggressive and multi-modal treatments (Kramer, S., Gelber, R. D., Snow, J. B., Marcial, V. A., Lowry, L. D., Davis, L. W., and Chandler, R. Combined radiation therapy and surgery in the management of advanced head and neck cancer: final report of study 73-03 of the Radiation Therapy Oncology Group. Head Neck Surg., 10: 19-30, 1987.; Lavertu, P., Adelstein, D. J., Saxton, J. P., Secic, M., Eliachar, I., Strome, M., Larto, M, A., and Wood, B. G. Aggressive concurrent chemoradiotherapy for squamous cell head and neck cancer: an 8-year single-institution experience. Arch Otolaryngol Head Neck Surg., 125: 142-148, 1999; Wanebo, H. J., Glicksman, A. S., Landman, C., Slotman, G., Doolittle, C., Clark, J., and Koness, R. J. Preoperative cisplatin and accelerated hyperfractionated radiation induces high tumor response and control rates in patients with advanced head and neck cancer. Am J Surg., 170: 512-516, 1995; Dragovic, J., Doyle, T. J., Tilchen, E. J., Nichols, R. D., Benninger, M. S., Carlson, E. R., Boyd, S. B., and Jacobsen, G. R. Accelerated fractionation radiotherapy and concomitant chemotherapy in patients with stage 1V inoperable head and neck cancer. Cancer, 76: 1655-1661, 1995.). Recently, alternative therapy protocols utilizing concomitant chemoradiotherapy have appeared in the art in hope that the morbidity associated with advanced stage SCCHN can be avoided or decreased. Although the success rate of chemoradiotherapy is generally high, there are patients whose cancers fail to respond to this treatment. Thus, after having gone through treatment for which their cancer is relatively resistant, these patients must usually then undergo a difficult

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surgery. Clearly, the ability to accurately predict treatment response of a cancer would be a valuable, time-saving tool for both the patient and the physician, and would minimize patient suffering and optimize time and treatment strategy. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·

Apparatus and method for registration, guidance and targeting of external beam radiation therapy Inventor(s): Burdette, Everette C.; (Champaign, IL), Deardorff, Dana L.; (Oakland, CA) Correspondence: Foley & Lardner; 330 North Wabash Avenue; Suite 3300; Chicago; IL; 60611-3608; US Patent Application Number: 20030112922 Date filed: November 1, 2002 Abstract: An improved system and method for optimizing the planning, registration, targeting, and delivery of conformal, external beam radiation therapy of prostate cancer and other soft-tissue diseases. Real-time ultrasound imaging during planning and treatment is used for localization of soft tissue treatment targets and fused with radiographic or CT data for conformal treatment optimization. The fusion technique provides accurate localization of the prostate volume in real time. For treatment of prostate cancer, visualization of the prostate gland is achieved using transrectal ultrasonography and the fusion of that image in the precise location of the prostate within the pelvic region, accurately determining the location of the prostate target by transformation of the ultrasound image data on both the ultrasound and X-ray/CT images. The radiation field may be optimized to significantly reduce the volume of irradiated normal tissue, minimizing the exposure of the surrounding healthy tissues and increasing dosage delivered to the prostate treatment target. Excerpt(s): The present invention relates generally to systems for radiation therapy. More particularly, the present invention relates to a system for targeting soft tissue for external beam radiation therapy. Prostate adenocarcinoma is the most commonly diagnosed cancer in the U.S. male population (excluding skin cancer). Over 20% of these cases are locally-advanced non-metastatic cancers. Treatment for this stage is problematic with significantly low control rates using traditional doses of radiation, which is the main-line therapy. Treatment of prostate cancer is difficult because of the extreme proximal position of tissues that are sensitive to radiation, such as the bladder and rectum. Radiation treatment, which is typically delivered in daily fractionated doses over the course of several weeks, is further complicated by prostate motion relative to the radiation field on a daily basis. More aggressive radiation treatment techniques utilizing conformal fields and higher doses have been used with improved therapeutic results. However, these dose-escalated treatments have met with problems due to increased dose delivered to normal tissues that are in the radiation field, producing many unacceptable complications such as rectal fistulas and bladder perforation and/or sloughing. Therefore, dose-escalated, conformal treatments cannot be delivered without significantly increased morbidity unless the exact position of the prostate can be visualized and registered, and this field localization maintained during the course of the treatment. The following sections describe in more detail the current treatment model for external beam radiation therapy, including the equipment involved, the procedural methods or phases involved, and the existing problems and limitations. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Catheter for radiation therapy Inventor(s): Ishibashi, Takuya; (Ikoma-shi, Nara, JP), Nakano, Ryoji; (Settsu-shi, Osaka, JP) Correspondence: Hogan & Hartson L.L.P.; 500 S. Grand Avenue; Suite 1900; Los Angeles; CA; 90071-2611; US Patent Application Number: 20030176758 Date filed: January 14, 2003 Abstract: In an expandable part positioned on the tip end side of the catheter, protruding parts are produced in specific regions when the expandable part is expanded through the difference in elasticity between two materials having a different elasticity to one another. The structure is made to be such that low-elasticity regions and highelasticity regions are disposed in the expandable part, and when pressure is applied the high-elasticity regions expand more than the low-elasticity regions, thus becoming the protruding parts. Alternatively, the structure is made to be such that two materials having a different elasticity to one another are made into a two-layer structure of an inner layer and an outer layer, and voids are provided in the layer formed from the lowelasticity material, so that when pressure is applied, parts of the layer formed from the high-elasticity material corresponding to the void parts become the protruding parts. Excerpt(s): The present invention relates to a catheter for radiation therapy for treating part of a body vessel with ionizing radiation. A widely carried out therapy for stenosis of blood vessels, in particular stenosis of the coronary artery, which is a cause of myocardial infarction, angina pectoris and so on, is to expand the stenosed part using a catheter having a balloon disposed on the tip thereof, which is known as a PTCA (percutaneous transluminal coronary angioplasty) balloon catheter. Describing this technique in more detail, first a hollow.phi.2 mm to.phi.3 mm catheter called a guiding catheter for leading in the PTCA balloon catheter is led into the aorta, and the tip thereof is disposed at the entrance of the coronary artery. Next, a wire of outside diameter.phi.0.010" (0.254 mm) to 0.018" (0.457 mm) which is called a guide wire and fulfills a role of guiding the PTCA balloon catheter is led into the guiding catheter, and is passed through the stenosed part of the coronary artery. Then, the PTCA balloon catheter having the balloon disposed on the tip thereof is led in along the guide wire as far as the coronary artery, is similarly passed through the stenosed part, and the balloon part of the PTCA balloon catheter is disposed in the stenosed part. The balloon is then expanded using high-pressure physiological saline, contrast medium or the like, thus forcibly opening up the stenosed part. However, there is a large problem with this PTCA therapy in that after the therapy, restenosis, i.e. repeated stenosis, occurs with a probability of approximately 40% within a short time period of 3 to 6 months. It has been shown that restenosis is caused by the blood vessel walls being damaged through the forcible expansion of the blood vessel by the balloon, and then smooth muscle cells proliferating excessively during the subsequent healing process. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Combination therapy using receptor tyrosine kinase inhibitors and angiogenesis inhibitors Inventor(s): Goodman, Simon; (Griesheim, DE), Kreysch, Hans-Georg; (Mainz, DE) Correspondence: Millen, White, Zelano & Branigan, P.C.; 2200 Clarendon BLVD.; Suite 1400; Arlington; VA; 22201; US Patent Application Number: 20040052785 Date filed: July 9, 2003 Excerpt(s): The invention relates to a combination therapy for the treatment of tumors and tumor metastases comprising administration of receptor tyrosine kinase antagonists/inhibitors, especially ErbB receptor antagonists, more preferably EGF receptor (Her 1) antagonists and anti-angiogenic agents, preferably integrin antagonists, optionally together with agents or therapy forms that have additive or synergistic efficacy when administered together with said combination of antagonists/inhibitors, such as chemotherapeutic agents and or radiation therapy. The therapy can result in a synergistic potential increase of the inhibition effect of each individual therapeutic on tumor cell proliferation, yielding more effective treatment than found by administering an individual component alone. The epidermal growth factor receptor (EGF receptor or EGFR), also known as c-erbB1/Her 1, and the product of the neu oncogene (also known as c-erbB2/Her 2) are the members of the EFG receptor super family, which belongs to the large family of receptor tyrosine kinases. They interact at the cell surface with specific growth factors or natural ligands, such as EGF or TGF alpha, thus, activating the receptor tyrosine kinase. A cascade of downstream signaling proteins are activated in general leading to altered gene expression and increased growth rates. C-erbB2 (Her 2) is a transmembrane tyrosine kinase having a molecular weight of about 185.000, with considerable homology to the EGF receptor (Her 1), although a specific ligand for Her 2 has not yet been clearly identified so far. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Composite system for radiation therapy Inventor(s): Uematsu, Minoru; (Kamakura-shi, JP) Correspondence: Birch Stewart Kolasch & Birch; PO Box 747; Falls Church; VA; 220400747; US Patent Application Number: 20040034438 Date filed: July 8, 2003 Abstract: A composite system for radiation therapy includes a CT scanner for checking the position of an affected portion of a patient to be irradiated, an irradiation apparatus for disposing, on the basis of positional information of the affected portion checked by the CT scanner, the patient at a specific position at which the affected portion is aligned to an irradiation position, and performing irradiation to the affected portion, a common bed used for the CT scanner and the irradiation apparatus, in a state that the patient lies on the common bed and moving means for moving the patient from the CT scanner to the specific position of the irradiation apparatus. The moving means moves the patient on the common bed to the specific position by causing either of linear movement of the CT scanner and the irradiation apparatus, linear movement of the CT scanner and curved movement of the irradiation apparatus, curved movement of the CT scanner and the irradiation apparatus and linear movement of the CT scanner, linear movement of

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the CT scanner and the common bed, and linear movement of the CT scanner and curved movement of the common bed. With this composite system, at the time of radiation therapy for tumor or the like, the affected portion can be irradiated in a state that the position of the affected portion aligned by a CT scanner is accurately kept. As a result, it is possible to significantly enhance the control of the positional accuracy of the affected portion in radiation therapy and hence to significantly increase the effect of the radiation therapy. Excerpt(s): The present invention relates to a composite system for radiation therapy (equipment for radiation therapy) capable of carrying out a series of radiation therapy operations for tumor or the like, specifically, an operation of accurately performing alignment of an affected portion (equivalent to target area) to be irradiated of a patient by a CT scanner, an operation of moving the patient to an irradiation apparatus such that the affected portion is matched to an irradiation position of the irradiation apparatus (equivalent to radiation therapy apparatus), and an operation of performing irradiation to the affected portion. In particular, the present invention relates to a composite system for radiation therapy, which includes a common bed that is used for a CT (Computer tomography) scanner and an irradiation apparatus, and also X-ray simulator (optionally used), in state that the patient lies on the common bed, at the time of moving a patient to an irradiation apparatus (e.g. linear accelerator, proton machine) such that an affected portion of the patient is matched to an irradiation position of the radiation therapy, and means for moving the patient on the common bed to a specific position of each of the CT scanner and the irradiation apparatus, and also X-ray simulator (optionally used), without any rotational movement of the common bed, thereby suppressing occurrence of a positional error caused between alignment of an affected portion and irradiation thereof, and greatly improving the control of accuracy in therapy position at the time of radiation therapy. The present invention further relates to a composite system for radiation therapy including the common bed having an isocentric rotation function or an isocentric rotation mechanism allowing the common bed to be rotated around an isocenter position (equivalent to an irradiation center upon irradiation of a target site of a patient to irradiated at different angles), thereby allowing the effective use of the isocentric rotation mechanism not only at the time of radiation therapy but also at the time of inspection by a CT scanner, an X-ray simulator (optionally used), and the like. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·

Concentrated irradiation type radiotherapy apparatus Inventor(s): Ozaki, Masahiro; (Otawara-shi, JP) Correspondence: Oblon, Spivak, Mcclelland, Maier & Neustadt, P.C.; 1940 Duke Street; Alexandria; VA; 22314; US Patent Application Number: 20040034269 Date filed: August 14, 2003 Abstract: A concentrated irradiation type radiotherapy apparatus comprises a radiation source, a multi-channeled radiation detector, a rotating mechanism, an image reconstruction unit, a multi-leaf collimator disposed between the radiation source and the subject to trim the radioactive rays in arbitrary shapes and including a plurality of first leaves and a plurality of second leaves each disposed to be individually movable forwards/backwards and each having a strip shape and in which types of the first leaves are different from those of the second leaves.

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Excerpt(s): This application is based upon and claims the benefit of priority from the prior Japanese Patent Applications No. 2002-236504, filed Aug. 14, 2002; No. 2002236505, filed Aug. 14, 2002; and No. 2002-236506, filed Aug. 14, 2002, the entire contents of all of which are incorporated herein by reference. The present invention relates to a concentrated irradiation type radiotherapy apparatus including an X-ray computer tomography function. An X-ray computer tomography apparatus reconstructs image data based on data transmitted through a subject. Diversion of the X-ray computer tomography apparatus to a concentrated irradiation type radiotherapy apparatus has been studied. For this, an X-ray tube is replaced with that having high-dose specifications. A multi-leaf collimator is added before the X-ray tube. The multi-leaf collimator includes a plurality of leaves which can individually move forwards/backwards. By forward/backward control of the leaves, it is possible to trim an X-ray in a shape in accordance with a shape of a treatment object. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·

Conjugates of macrocyclic metal complexes with biomolecules and their use for the production of agents for NMR diagnosis and radiodiagnosis as well as radiotherapy Inventor(s): Bauer, Hans; (Berlin, DE), Frenzel, Thomas; (Berlin, DE), Michl, Gunther; (Rudersdorf, DE), Platzek, Johannes; (Berlin, DE), Raduchel, Bernd; (Berlin, DE), Schirmer, Henko; (Berlin, DE), Schmitt-Willich, Heribert; (Berlin, DE), Sulzle, Detlev; (Berlin, DE), Weinmann, Hans-Joachim; (Berlin, DE) Correspondence: Millen, White, Zelano & Branigan, P.C.; 2200 Clarendon BLVD.; Suite 1400; Arlington; VA; 22201; US Patent Application Number: 20030206865 Date filed: July 19, 2002 Abstract: The invention relates to conjugates that consist of macrocyclic metal complexes with biomolecules and their production. The conjugates are suitable as contrast media in NMR diagnosis and radiodiagnosis as well as as agents for radiotherapy. High relaxivity is achieved by a special liganding of macrocyclic compounds, and a finetuning of the relaxivity is made possible. Excerpt(s): The invention relates to the subjects that are characterized in the claims, i.e., conjugates of macrocyclic metal complexes. The conjugates are suitable for the production of agents, especially contrast media for NMR diagnosis and radiodiagnosis as well as agents for radiotherapy. A prerequisite for a specific and successful therapy is an exact diagnosis. Specifically in the diagnostic field, the possibilities have very greatly increased in recent years, whereby, for example, NMR diagnosis and x-ray diagnosis are able to visualize virtually any anatomical detail selectively and with great accuracy. In many cases, the corresponding structures are visible only by the application of contrast media, however. Moreover, the possibility exists of configuring the contrast media in such a way that they selectively accumulate in the desired target structures. To this end, the accuracy of the imaging can be increased with simultaneous reduction of the required amount of contrast medium. As contrast media for NMR diagnosis, chelate complexes of paramagnetic metals are suitable. The theory and application of gadolinium(III) chelates as NMR contrast media are explained in detail in a survey article by P. Caravan et al. in Chem. Rev. 1999, 99, 2293-2352. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Delivery system and method for interstitial radiation therapy Inventor(s): Lamoureux, Gary A.; (Woodbury, CT), Terwilliger, Richard A.; (Southbury, CT) Correspondence: Sheldon R. Meyer; Fliesler Dubb Meyer & Lovejoy Llp; Four Embarcadero Center, Fourth Floor; San Francisco; CA; 94111-4156; US Patent Application Number: 20030171637 Date filed: March 26, 2003 Abstract: A delivery system and method for interstitial radiation therapy comprising a substantially axially stiff and longitudinally flexible elongated member made of material, which is bio-absorbable in living tissue and a plurality of radioactive seeds dispersed in a predetermined array within the member. The delivery system and method further customize the member based on a prescription. Excerpt(s): This application is a continuation of U.S. patent application Ser. No. 10/035,083, filed Dec. 28, 2001, which claims priority to U.S. Provisional Patent Application No. 60/336,329, filed Nov. 2, 2001, both of which are incorporated herein in their entirety. The present invention relates to systems and methods for delivering a plurality of radioactive sources to a treatment site. In interstitial radiation therapy, one method for treating tumors is to permanently place small, radioactive seeds into the tumor site. This method is currently accomplished by one of the following two procedures: (a) loose seeds are implanted in the target tissue, and/or (b) seeds are contained within a woven or braided absorbable carrier such as braided suture material and implanted in the target tissue. The loose seeds, however, are dependent on the tissue itself to hold each individual seed in place during treatment, and the woven or braided sutures do not assist in the placement of the seeds relative to the target tissue. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Determining the position of an axis of rotation (patient positioning table, radiation therapy) on the basis of an angle of rotation and a chord through a movable mark Inventor(s): Hartmann, Gunther; (Heidelberg, DE), Jackel, Oliver; (Dossenheim, DE), Karger, Christian; (Dossenheim, DE) Correspondence: William Collard; Collard & Roe, P.C.; 1077 Northern Boulevard; Roslyn; NY; 11576; US Patent Application Number: 20040013414 Date filed: June 11, 2003 Abstract: For precision radiation therapy it is essential that the patient be positioned as accurately as possible with reference to the irradiation center (IC). To this end, an axis of rotation (TA) of a patient positioning table (7) is first determined in terms of its position and is then aligned correspondingly. For determining the position, a mark (5) is introduced into the isocenter (IC) of the irradiation device and rotates with the patient positioning table (7). The distance between the axis of rotation (TA) and the isocenter (IC) is determined on the basis of the distance (P, IC) traveled and the angle of rotation (.phi.), and the axis of rotation is then aligned correspondingly. Excerpt(s): The invention relates to a method and a measuring arrangement for determining the position of an axis of rotation of a body with reference to a spatial point and a method for aligning a patient's table which can be rotated about an axis of

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rotation. The invention on this occasion especially relates to the field of radiation therapy. As a rule, suitable irradiation devices have linear accelerators which are directed towards an irradiation centre, wherein the present invention can also be applied to other radiation sources. With such devices an isocentre can be defined as the point of intersection of several axes, for example, an axis of rotation of a radiation source holder or a retaining clip, an axis of a collimator head, a beam axis or an axis of rotation of a patient's table. In practice, this isocentre is found to be the irradiation centre, i.e. the position at which the radiation is focussed during the treatment. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·

Device for a non-contact measurement of distance at a radiotherapy of the human body Inventor(s): Roeckseisen, Armin; (Adendorf, DE) Correspondence: M.R. Forrester; Intoximeters, INC.; 1901 Locust Street; ST. Louis; MO; 63103 Patent Application Number: 20030185349 Date filed: March 26, 2003 Abstract: Device for non-contact measurement of a distance to a human body at radiotherapy, comprising a moveable radiation head which directs a treatment beam to the tissue area to be treated, a support provided at the radiation head in a defined distance to the beam, the support is provided for distance measuring means directed to a piercing point, in a measuring position the distance measuring means direct a laser beam to a piercing point of the treatment beam on the skin and measures the distance to the piercing point, and evaluation means computing from the measured distance value the distance of the focus of the treatment beam to the piercing point. Excerpt(s): Not Applicable. The invention relates to a device for a non-contact measurement of distance at a radiotherapy of the human body, in particular the distance between the focus of the treatment beam to the skin of the patient. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Device for effecting radiation therapy in an animal body Inventor(s): Kindlein, Johann; (Oberhausen, DE), Schaart, Dennis Robert; (Delf, NL) Correspondence: Birch Stewart Kolasch & Birch; PO Box 747; Falls Church; VA; 220400747; US Patent Application Number: 20030128808 Date filed: November 22, 2002 Excerpt(s): The invention relates to a device for effecting radiation therapy in an animal body comprising a housing provided with at least one outlet channel, a guide tube connected at one end with said outlet channel and wherein the other end of said guide tube is positionable in said animal body near the site of the intended radiation therapy, one electro-magnetic radiation emitting source connected to a first end of a transport wire, and transport means for moving said transport wire and said radiation emitting source via said outlet channel through said guide tube to and from said site of the intended radiation therapy in said body. It is known in the medical field to use

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afterloader devices in the treatment of cancerous tumours using radioactive sources having intensity greater than that which can safely be handled. Remote afterloaders are devices generally used in the cancer treatment field to accurately advance and retract a flexible wire containing an electro-magnetic radiation emitting source over a specified distance for a specific time period. A remote afterloader comprises a flexible simulation wire for testing purposes and a flexible wire with the electro-magnetic radiation emitting source, controllers and transport mechanisms to operate both types of wires, as well as a radiation shielded housing for the radiation emitting source. Typically one or more catheters, needles, or other closed pathways (hereafter "guide tubes") to the treatment site are positioned in the patient. The guide tubes are then attached to the afterloader, which advances the radioactive source at the end of the transport wire, sometimes called a source-wire, along the guide tubes according to a predetermined sequence calculated to deliver a therapeutic dose of radiation to the tumour. Many of these prior art devices advance the source-wire by means of a friction drive belt trained about a wheel with the wire sandwiched between the belt and wheel. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·

Device for radiation therapy Inventor(s): Kumakhov, Muradin Abubekirovich; (Moscow, RU) Correspondence: William H Holt; Law Offices OF William H Holt; Unit 2 First Floor; 1423 Powhatan Street; Alexandria; VA; 22314; US Patent Application Number: 20040013230 Date filed: November 13, 2002 Abstract: Device, related to the means for radiation therapy of malignant and benign neoplasms and certain other diseases, comprise hollow probe 5, source 1 of neutral particle radiation in the form of X-ray or gamma quanta or neutrons, and means of shaping the particle beam of said radiation oriented by the longitudinal axis of the probe. Means of shaping the particle beam is executed in the form of collimator or lens 18 comprising aggregate of curved channels for radiation transmission with a total internal reflection. Said means may be located inside of the probe 5.On using the device, probe 5 is introduced into the body of patient 11, with its distal end 7 approaching pathological locus 13 or inserted directly into it.For exposure of pathological locus, use is made of radiation of the neutral particles source directly or secondary radiation excited in the target placed in the distal end of the probe or radiation dissipated with this target.Design of the device requires no evacuation of the probe and use of high voltage in the latter, is easily transformed by the probe replacement, in particular, to change its size, to change energy and directional pattern of radiation affecting the pathological locus. Making of the probe removable simplifies its sterilization.1 independent claim and 42 dependent claims, 10 figures of drawings. Excerpt(s): The present invention relates to means for radiation therapy of malignant and benign neoplasms and certain other diseases. At present, treatment with ionizing radiation is widely used not only in the therapy of malignant neoplasms, but benign tumors and a series of inflammatory and other diseases of nonneoplastic nature as well (Aspects of Clinical Dosimetry, Ed. R. V.Stavitskij, Moscow, "MNPI", 2000 [1] (in Russian)). Devices are known for radiation therapy which comprise X-ray source, oriented for the purpose of directing radiation created with it to the pathological locus area. In order to minimize irradiation of healthy tissues surrounding pathological locus, such devices may comprise several X-ray sources. The irradiation created with them is

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directed to the pathological locus area from different directions (Radiation Therapy of Malignant Tumors. Guide for Physicians. Ed. Prof. E. S.Kiseleva, Moscow, "Meditsina" Publishing House, 1996 [2] (in Russian)). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·

Enhanced radiation therapy Inventor(s): Bacon, Edward R.; (Audubon, PA), McIntire, Gregory L.; (West Chester, PA), Wolf, Gerald L.; (Westboro, MA) Correspondence: Fish & Richardson PC; 225 Franklin ST; Boston; MA; 02110; US Patent Application Number: 20040047804 Date filed: August 12, 2003 Abstract: The invention features new methods of enhanced radiation therapy based on the discovery that by using controlled combinations of (i) specific radiodense compositions, (ii) specific modes of administration of these radiodense compositions, and (iii) specific energy bands and sources of radiation, that the effect of radiation on tumors and other diseased tissues can be effectively and safely enhanced to provide significantly improved radiation therapy. Excerpt(s): This application is a continuation of, and claims priority from, U.S. patent application Ser. No. 09/585,938, filed on Jun. 2, 2000, which is a continuation of U.S. patent application Ser. No. 09/183,166, filed on Oct. 29, 1998. The contents of both applications are incorporated herein by reference in their entirety. The invention relates to new methods of enhancing radiation therapy, e.g., for tumor therapy. Radiation therapy has been used with some success in treating tumors and other diseases. However, the dose of effective radiation must be sufficiently limited to the tumor or other target tissue to avoid injuring the surrounding tissues and the overall health of the patient. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Erbb-2 selective small molecule kinase inhibitors Inventor(s): Enyedy, Istvan; (Hamden, CT), Wang, Shaomeng; (Saline, MI), Yang, Dajun; (Rockville, MD) Correspondence: Medlen & Carroll; 101 Howard Street, Suite 350; San Francisco; CA; 94105; US Patent Application Number: 20040023957 Date filed: August 4, 2003 Abstract: A novel method for erbB-2 kinase inhibition by compounds identifies through computational modeling and data processing and/or rational and de novo drug design is provided the compounds bind erbB-2 kinase molecules and which can be used as erbB-2 kinase agonists or antagonists. These compounds are useful especially in the treatment of cancer, particularly breast cancer, and can be used alone or in combination with other chemotherapeutic agents, particularly with hercetin, a humanized anti-HER2 antibody, or with radiation therapy. A specific compound which is exemplified is "compound B17"=methyl-(posa-notrophenyl)-2-propynoate.

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Excerpt(s): This application claims priority from U.S. Provisional Patent Application Serial No. 60/221,515, filed Jul. 30, 2000, the entirety of which is incorporated herein by reference. The present invention relates to a novel method of prevention or treatment of diseases where signal transduction pathways mediated by erbB-2 tyrosine kinase play a significant role. Examples thereof include abnormal cell proliferation, including cancer, particularly, breast cancer. For mammalian cells to survive, they must be able to respond rapidly to changes in their environment. Furthermore, for cells to reproduce and carry out other cooperative functions, they must be able to communicate efficiently with each other. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·

Fiduciary tray for an IMRT collimator Inventor(s): Manske, Maria A.; (Missouri City, TX) Correspondence: Fullbright & Jaworski L.L.P.; 600 Congress AVE.; Suite 2400; Austin; TX; 78701; US Patent Application Number: 20030123609 Date filed: December 5, 2002 Abstract: A fiduciary tray for use in Intensity Modulated Radiation Therapy (IMRT). In an exemplary embodiment the tray includes a first horizontal surface, a second horizontal surface, vertical walls, and a plurality of openings. The second horizontal surface is located above the first horizontal surface and is configured to enter an opening of a collimator. The vertical walls couple the first and second horizontal surfaces and engage a rim within the opening of the collimator. The plurality of openings in the second horizontal surface accept radiopaque materials. Excerpt(s): The present invention relates generally to radiation therapy. More particularly, the invention relates to a fiduciary tray that can be used with Intensity Modulated Radiation Therapy (IMRT). IMRT is an approach to conformal therapy that not only conforms dose to the target volume, but also conforms dose away from sensitive structures. Conformal therapy typically shapes a treatment beam so that its contour corresponds to a beam's eye view of a target plus margin. IMRT allows specific modifications to be made to dose distribution by controlling the movement of shutters or leaves in a collimator. Even more control is gained when the beam is allowed to move in an arc or other pattern around a patient. Through the use of collimators and movement, IMRT is able to deliver nonuniform radiation exposure to the patient to create a uniform dose distribution at a target site. Effectively, the target site is exposed to a certain extent while sensitive structures of the patient are exposed to a lesser extent. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Flavin N-oxides: new anti-cancer agents and pathogen eradication agents Inventor(s): Platz, Matthew S.; (Columbus, OH) Correspondence: Calfee Halter & Griswold, Llp; 800 Superior Avenue; Suite 1400; Cleveland; OH; 44114; US Patent Application Number: 20040006028 Date filed: May 12, 2003

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Abstract: Compounds comprising flavin N-oxides for treatments of solid tumors, nonsolid tumor masses, leukemias, and non-small cell lung cancers and for eradicating contaminants in blood products. Methods of treating patients having solid type cancers comprising administering a therapeutically effective amount of a flavin N-oxide to a subject in need of treatment and exposing the flavin N-oxide to an activator such that activation of the flavin N-oxide results in damage to the DNA in the cancer cells without substantial damage to the DNA of normal cells are also provided. Methods of using a flavin N-oxide as part of a combination therapy with chemotherapy, radiation therapy, or both are also provided. Methods of reducing pathogenic bacterial or viral contamination in a composition comprising a) mixing the composition with an efficacious amount of a flavin N-oxide and b) exposing the mixture of the composition and the flavin N-oxide to an activator for a period of time sufficient to activate the flavin N-oxide such that the flavin N-oxide reduces the contamination in the composition are also provided. Preferably, the composition is a blood product selected from plasma, platelets, and red blood cells and the activator is an enzyme. Excerpt(s): This application claims priority to U.S. Provisional Application Serial No. 60/379,321 filed May 10, 2002, the entirety of which is incorporated herein by reference. Solid tumors account for more than 90% of all human cancers. As the tumor grows, in order to sustain itself, it must develop its own blood supply. This blood supply, however, is much different from the blood supply to normal tissues. The blood vessels formed in tumors are typically highly irregular and tortuous. They may have arteriovenous shunts and blind ends, and lack smooth muscle or nerves and have incomplete endothelial linings and basement membranes. This leads to low overall levels of oxygen in most tumors. Many tumors have areas of extreme hypoxia. (Brown, J. M. "Exploiting the hypoxic cancer cell: mechanisms and therapeutic strategies." Molecular Medicine Today April 2000 (Vol. 6)). Unfortunately, there is considerable evidence that hypoxic tumors are refractory towards many of the currently available treatments for solid tumor cancers, including radiation therapy and chemotherapy. Accordingly, there exists a need for a method of treating solid tumor cancers having hypoxic regions. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·

Integral lens for high energy particle flow, method for producing such lenses and use thereof in analysis devices and devices for radiation therapy and lithography Inventor(s): Kumakhov, Muradin Abubekirovich; (Moscow, RU) Correspondence: Kevin A. Reif; Mcguire Woods Llp; Suite 1800; 1750 Tysons Boulevard; Mclean; VA; 22102; US Patent Application Number: 20030209677 Date filed: June 11, 2003 Abstract: The invention makes possible to increase the degree of radiation focusing by the lens, to use particles of higher energies, and to increase the coefficients, depending on these factors, of the devices, the lens is used in. Thus the sublens 18 of the least degree of integration represents a package of the channels 5, which is growing out of joint drawing and forming the capillaries, which are laid in a bundle. The sublens of each higher degree of integration represents a package of sublenses of the previous degree of integration, which is growing out of their joint drawing and forming. The sublenses are growing out of performing the said operations at the pressure of the gaseous medium inside the channels being higher than the pressure in the space between the sublenses of the previous degree of integration and at the temperature of

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their material softening and splicing the walls. To produce the lenses a bundle of stocks (capillaries) in a tubular envelope is fed to the furnace (at the first stage) or stocks, produced on the previous degree, and the bundle is drawing from the furnace at the speed, exceeding the speed of feeding. The product is cut off on stocks for the next stage, and at the final stage the product is formed by varying the drawing speed, after what the parts with formed barrel-shaped thickenings are cut of. Excerpt(s): The present invention generally relates to radiation lenses and, more particularly, to x-ray lenses comprising a plurality of sub-lenses drawn together which is useful in flaw detection and diagnostics in engineering and medicine. The usage of different types of radiation (X-rays, gamma ray, neutral or charged particle radiation) in different fields, such as instrument making, medicine, microelectronics, etc., considerably broadened for the last 20-30 years. More powerful X-ray and safe neutron sources are made. These sources help to solve important fundamental and applied tasks of science and industry. Unfortunately, x-ray sources are very expensive. To build such sources, as does the European Center for Synchrotron Radiation (Grenoble, France), several states must cooperate. Therefore it is very important to create optical devices, which can significantly increase effective luminance of cheap and available sources. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·

Intensity modulated radiotherapy inverse planning algorithm Inventor(s): Luo, Chunsong; (Miami, FL) Correspondence: Venable, Baetjer, Howard And Civiletti, Llp; P.O. Box 34385; Washington; DC; 20043-9998; US Patent Application Number: 20040001569 Date filed: April 29, 2003 Abstract: A method in a computer for optimizing a dosage of intensity modulated radiotherapy (IMRT) comprises the steps of: dividing a three dimensional (3D) volume into a grid of dose voxels, wherein each dose voxel receives a dose of radiation from at least one pencil beam having a pencil beam weight and a gantry angle; selecting a first set of dose voxels from the 3D volume positioned within at least one of a planning target volume (PTV), organs at risk (OAR), and normal tissue in a neighborhood of the PTV; choosing a dose matrix from the first set of dose voxels; constructing a beam weight vector of individual beam weights for each pencil beam at each gantry angle; calculating a transfer matrix representing a dose deposition to the dose voxels from each pencil beam with unit beam weight; inverting the transfer matrix; performing a matrix multiplication of the inverted transfer matrix and the dose matrix and populating the beam weight vector with the results of the matrix multiplication; and iteratively modifying a plurality of doses in the dose matrix within a given range, wherein the range has a specific probability distribution function of acceptable dose values, and repeating the matrix multiplication until the negative weights in the beam weight vector are substantially eliminated, resulting in an optimized set of doses. Excerpt(s): This application claims the benefit of U.S. Provisional Patent Application No. 60/375,828, Confirmation No. 3165, filed Apr. 29, 2002, of common inventorship and assignee, the contents of which are incorporated by reference in their entirety. The present invention relates generally to optimizing a dosage of intensity modulated radiotherapy (IMRT), and more particularly to minimizing the negative beam in IMRT. Intensity modulated radiotherapy (IMRT) is a method of treating cancer that is

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particularly useful when the cancer is entangled with critical organs, such as the spinal cord. IMRT allows for a balanced dose to the target, i.e. the cancerous area, while sparing the surrounding critical organs. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·

Method for determining a dose distribution in radiation therapy Inventor(s): Cotrutz, Cristian; (Redwood City, CA), Xing, Lei; (Stanford, CA) Correspondence: Lumen Intellectual Property Services, INC.; 2345 Yale Street, 2nd Floor; Palo Alto; CA; 94306; US Patent Application Number: 20030212325 Date filed: March 12, 2003 Abstract: A method is provided for interactive treatment planning of IMRT or other radiation modalities that employs non-uniform tuning or optimization. One aspect provides a voxel-dependent penalty scheme by varying the importance factor associated with a voxel, the prescription at the voxel, or the form of the penalty function at the voxel in a non-uniform manner. Another aspect provides the dose shape at a specified sub-volume tuned by varying the local importance factor(s) or the local prescription or the form/value of penalty function. Yet another aspect provides the use of a nonuniform penalty scheme (non-uniform importance factors, non-uniform prescription in one or more structures, or non-uniform form of the objective function). Still another aspect provides the method of pre-estimating the values of the voxel-specific importance factors using prior dosimetric knowledge of a given system. Excerpt(s): This application is cross-referenced to and claims priority from U.S. Provisional application 60/363,913 filed Mar. 12, 2002, which is hereby incorporated by reference. The present invention relates generally to radiation therapy. More particularly, the present invention relates to a method for determining a dose distribution in intensity modulated radiation therapy with non-uniform parameters that affect local dosimetric behavior. Inverse modulated radiation therapy (IMRT) represents one of the most important advancements in radiation therapy. IMRT aims at delivering high radiation doses to target volumes while minimizing radiation exposure of adjacent critical structures. IMRT inverse planning is usually performed by pre-selecting parameters like beam modality, beam configuration and importance factors and then optimizing the fluence profiles or beamlet weights. The beam profiles of an IMRT treatment are usually obtained using inverse planning. Examples of such approaches can be found in, for instance, Webb (1989) in a paper entitled "Optimisation of conformal radiotherapy dose distributions by simulated annealing" and published in "Phys. Med. Biol. 34(10):1349-70"; Bortfeld et al. (1990) in a paper entitled "Methods of image reconstruction from projections applied to conformation radiotherapy" and published in "Phys. Med. Biol. 35(10):1423-34"; Xing et al. (1996) in a paper entitled "Iterative algorithms for Inverse treatment planning" and published in "Phys. Med. Biol. 41(2):2107-23"; Olivera et al. (1998) in a paper entitled "Maximum likelihood as a common computational framework in tomotherapy" and published in "Phys. Med. Biol. 43(11):3277-94"; Spirou et al. (1998) in a paper entitled "A gradient inverse planning algorithm with dose-volume constraints" and published in "Med. Phys. 25(3):321-33"; in Wu et al. (2000) in a paper entitled "Algorithms and functionality of an intensity modulated radiotherapy optimization system" and published in "Med. Phys. 27(4):70111"; and Cotrutz et al (2001) in a paper entitled "A multiobjective gradient-based dose

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optimization algorithm for external beam conformal radiotherapy" and published in "Phys. Med. Biol. 46(8) 2161-2175". Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·

Method for the enumeration of mammalian micronucleated erythrocyte populations with a single-laser flow cytometer Inventor(s): Dertinger, Stephen D.; (Webster, NY), Tometsko, Carol R.; (Rochester, NY), Torous, Dorothea K.; (Rochester, NY) Correspondence: Edwin V. Merkel; Nixon Peabody Llp; Clinton Square; P.O. Box 31051; Rochester; NY; 14603-1051; US Patent Application Number: 20030134305 Date filed: August 16, 2002 Abstract: A single-laser flow cytometric method for the enumeration of micronucleated erythrocyte populations is disclosed which affords superior fluorescent resolution of young reticulocytes from normochromatic erythrocytes, particularly in mammals that exhibit efficient splenic sequestering. The method can also be used for assessing the DNA damaging potential of pharmaceuticals undergoing clinical trials; evaluating patient-specific responses to chemotherapy or radiation therapy; evaluating compounds, diets, or other factors that may protect against DNA damage resulting from endogenous or exogenous agents; evaluating compounds, diets, or other factors that may potentiate DNA damage resulting from endogenous or exogenous agents; determining the level of DNA damage in a population following a major accident; and monitoring workers who may be occupationally exposed to DNA damaging agents Excerpt(s): This application claims the benefit of U.S. Provisional Patent Application Serial No. 60/312,709 filed Aug. 16, 2001, which is hereby incorporated by reference in its entirety. The present invention is directed to medical applications, and to the field of toxicology, in which a need exists for a rapid, sensitive and economical method for evaluating chromosome damage. Specifically, the present invention relates to a process for analyzing the frequency of micronuclei in mammalian erythrocyte populations by a rapid and sensitive single-laser flow cytometric method. Micronuclei ("MN") are extranuclear chromatin resulting from double-strand DNA breaks or from mitotic spindle apparatus dysfunction. Since MN are the result of clastogenic or aneugenic activity, researchers in academia, industry and government have utilized in vivo rodent micronucleus assays to screen chemical and physical agents for clastogenic and aneugenic activity (Hayashi et al., "In vivo Rodent Erythrocyte Micronucleus Assay," Mutat. Res. 312:293-304 (1994)). When these studies are performed with mice, micronuclei are often scored in peripheral blood erythrocyte populations, as these cells persist in peripheral circulation. Whereas micronucleated erythrocytes persist in mice, they are actively sequestered and eliminated from circulation by the spleen of most other mammalian species, including the rat and human. For this reason, micronucleus studies that involve mammalian species other than the mouse have tended to measure the incidence of MN in newly formed erythrocytes obtained from the bone marrow compartment (that is, before spleen sequestering). Aside from bone marrow aspirates, MN induction in human erythrocytes has also been studied in peripheral blood, but a focus has been on splenectomized subjects. Given the removal of MN-containing erythrocytes from the peripheral blood of humans and most other mammals, it had been assumed that the peripheral blood compartment of eusplenic individuals would not ordinarily provide a sensitive indication of clastogenic or aneugenic exposure (Schlegel

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et al., "Assessment of Cytogenetic Damage by Quantitation of Micronuclei in Human Peripheral Blood Erythrocytes," Cancer Res. 46:3717-3721 (1986)). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·

Method of using geranium oil and sophora root extracts as a supporting composition in cancer treatments Inventor(s): Fong, Andy A.T.; (Taipei, TW), Shane, Guang-Tzuu; (Taipei, TW) Correspondence: Ya-chiao Chang; C/o Baker & Mckenzie; 29th Floor; 805 Third Avenue; New York; NY; 10022; US Patent Application Number: 20030134003 Date filed: October 9, 2002 Abstract: The present invention relates to a method of use involving the administration of the herbal composition, comprising geranium oil and extracts from roots of the plants of the genus Sophora, to mammalian animals undergoing cancer treatments that would induce the bone marrow suppression side effect, such as chemotherapy and radiation therapy. The composition can take on the form of an oil capsule, tablets, pills, and pastes etc. to be administered orally at specific dosages. The composition can also take on the form of an injection to be administered intravenously and intraperitoneally at specific dosages. The administration can be made before and or after the cancer treatment. Excerpt(s): This invention relates generally to the use of a supporting composition in cancer treatments and more particularly to administering an herbal composition together with chemotherapy or radiation therapy (or both) in the treatment of cancer. Normal cells grow and divide in an orderly and controlled manner. Cancer is a disease where cells become abnormal (cancerous cells) and begin to multiply without control to develop into an extra mass of tissue called a tumor. These cancerous cells can invade nearby tissues and spread through the blood stream and lymphatic system to other parts of the body. Currently, the four primary types of cancer treatments are immunotherapy, surgery, radiation therapy, and chemotherapy. These cancer treatments may be applied alone or in conjunction with one another. Thus a cancer patient may undergo one or more treatments at a time. A single treatment would span a period of time with therapies delivered at various timed intervals. Immunotherapy, also known as biological therapy or biological response modifier (BRM) therapy, tries to stimulate or restore the ability of the immune system to fight the disease. It is also used to lessen immune system related side effects that may be caused by some cancer treatments. Surgery seeks to directly remove the tumor from the body. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Methods and compositions using immunomodulatory compounds for treatment and management of cancers and other diseases Inventor(s): Zeldis, Jerome B.; (Princeton, NJ) Correspondence: Pennie And Edmonds; 1155 Avenue OF The Americas; New York; NY; 100362711 Patent Application Number: 20040029832 Date filed: May 15, 2003

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Abstract: Methods of treating, preventing and/or managing cancer as well as and diseases and disorders associated with, or characterized by, undesired angiogenesis are disclosed. Specific methods encompass the administration of an immunomodulatory compound alone or in combination with a second active ingredient. The invention further relates to methods of reducing or avoiding adverse side effects associated with chemotherapy, radiation therapy, hormonal therapy, biological therapy or immunotherapy which comprise the administration of an immunomodulatory compound. Pharmaceutical compositions, single unit dosage forms, and kits suitable for use in methods of the invention are also disclosed. Excerpt(s): This application claims the benefit of U.S. provisional application No. 60/380,842, filed May 17, 2002, and No. 60/424,600, filed Nov. 6, 2002, the entireties of which are incorporated herein by reference. This invention relates to methods of treating, preventing and/or managing specific cancers, and other diseases including, but not limited to, those associated with, or characterized by, undesired angiogenesis, by the administration of one or more immunomodulatory compounds alone or in combination with other therapeutics. In particular, the invention encompasses the use of specific combinations, or "cocktails," of drugs and other therapy, e.g., radiation to treat these specific cancers, including those refractory to conventional therapy. The invention also relates to pharmaceutical compositions and dosing regimens. Cancer is characterized primarily by an increase in the number of abnormal cells derived from a given normal tissue, invasion of adjacent tissues by these abnormal cells, or lymphatic or blood-borne spread of malignant cells to regional lymph nodes and to distant sites (metastasis). Clinical data and molecular biologic studies indicate that cancer is a multistep process that begins with minor preneoplastic changes, which may under certain conditions progress to neoplasia. The neoplastic lesion may evolve clonally and develop an increasing capacity for invasion, growth, metastasis, and heterogeneity, especially under conditions in which the neoplastic cells escape the host's immune surveillance. Roitt, I., Brostoff, J and Kale, D., Immunology, 17.1-17.12 (3rd ed., Mosby, St. Louis, Mo., 1993). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·

Methods for preventing reovirus recognition for the treatment of cellular proliferative disorders Inventor(s): Coffey, Matthew C.; (Calgary, CA), Thompson, Bradley G.; (Calgary, CA) Correspondence: Burns Doane Swecker & Mathis L L P; Post Office Box 1404; Alexandria; VA; 22313-1404; US Patent Application Number: 20030215443 Date filed: March 28, 2003 Abstract: The present invention pertains to methods for preventing reovirus recognition in the treatment of cellular proliferative disorders, and particularly ras-mediated cellular proliferative disorders, in mammals. The mammal may be selected from dogs, cats, sheep, goats, cattle, horses, pigs, mice, humans and non-human primates. The method comprises suppressing or otherwise inhibiting the immune system of the mammal and, concurrently or subsequently, administering to the proliferating cells an effective amount of one or more reoviruses under conditions which result in substantial lysis of the proliferating cells. In particular, the methods provide for reovirus treatment of immunosuppressed or immuno-deficient mammals to treat the proliferative disorders. Immunosuppression, immunoinhibition or otherwise inducing an immunodeficient

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state in a mammal renders the reovirus more effective. The methods may include the selective removal of immune constituents that may interfere with the systemic delivery of the virus; preventing reovirus recognition by the host immune system; and removal of the virus from an immune suppressed or immune incompetent host following treatment with reovirus. Alternatively, reovirus may be administered to a mammal with a diminished immune response system under conditions which result in substantial lysis of the proliferating cells. Immune systems may be compromised by one or more of the following: an HIV infection; as a side effect of chemotherapy or radiation therapy; by selective removal of B and/or T cell populations; by removal of antibodies (antiantireovirus antibodies or all antibodies), and the like. Excerpt(s): The present invention pertains to methods for preventing reovirus recognition in the treatment of cellular proliferative disorders, and particularly rasmediated cellular proliferative disorders, in mammals. In particular, the methods provide for reovirus treatment of immunosuppressed or immunodeficient mammals to treat the proliferative disorders. Immunosuppression, immunoinhibition or otherwise inducing an immunodeficient state in a mammal renders the reovirus more effective. The methods may include the selective removal of immune constituents that may interfere with the systemic delivery of the virus; preventing reovirus recognition by the host immune system; and removal of the virus from an immune suppressed or immune incompetent host following treatment with reovirus. All of the above publications, patent applications and patents are herein incorporated by reference in their entirety to the same extent as if each individual publication, patent application or patent was specifically and individually indicated to be incorporated by reference in its entirety. Normal cell proliferation is regulated by a balance between growth-promoting protooncogenes and growth-constraining tumor-suppressor genes. Tumorigenesis can be caused by genetic alterations to the genome that result in the mutation of those cellular elements that govern the interpretation of cellular signals, such as potentiation of protooncogene activity or inactivation of tumor suppression. It is believed that the interpretation of these signals ultimately influences the growth and differentiation of a cell, and that misinterpretation of these signals can result in neoplastic growth (neoplasia). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·

Molecular chemotherapy enhancement of radiotherapy Inventor(s): Buchsbaum, Donald J.; (South Birmingham, AL), Garver, Robert J. JR.; (Hoover, AL), Gillespie, G. Yancey; (Birmingham, AL), Miller, C. Ryan; (Homewood, AL) Correspondence: DR. Benjamin Adler; Adler & Associates; 8011 Candle Lane; Houston; TX; 77071; US Patent Application Number: 20030148984 Date filed: November 26, 2002 Abstract: The present invention provides a new approach for cancer treatment by utilizing gene therapy combined with radiation therapy to enhance cytotoxicity in malignant cells. Specifically, the present invention demonstrates that molecular chemotherapy with the cytosine deaminase gene and 5-fluorocytosine is an effective radiosensitizing strategy which may lead to substantial improvement in tumor control, with less normal tissue toxicity than conventional systemic administration of 5fluorouracil, that would translate into improved cure rates and better survival. A

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noninvasive method is described for continuous in vivo monitoring of 5-fluorouracil production via magnetic resonance spectroscopy An adenovirus encoding cytosine deaminase gene which selectively replicates in tumor cells with a defective p53 pathway was constructed. Also provided is an adenovirus which encodes a fusion protein of cytosine deaminase and uracil phosphoribosyltransferase. Excerpt(s): This application is a divisional of U.S. Ser. No. 09/706,190, filed Nov. 3, 2000, which is a continuation-in-part of U.S. Ser. No. 09/408,055, filed Sep. 29, 1999, which claims benefit of provisional patent application U.S. Serial No. 60/102,391, filed Sep. 29, 1998, now abandoned. The present invention relates generally to the fields of molecular biology, radiation oncology and cancer therapy. More specifically, the present invention relates to the finding that a combination of molecular chemotherapy and radiation therapy enhances therapeutic effects against cancer. Clinical applications of cancer gene therapy have had limited success due to a variety of factors, including ineffective therapeutic gene delivery in situ. The physiologic milieu of the target tumor may have deleterious effects on the delivery of therapeutic genes. This limitation may be disease specific, and variable depending on the specific tumor type and tumor location. Most clinical gene therapy trials thus far have utilized compartmental models of malignant disease (1, 2). In this regard, thoracic malignancies and intra-abdominal carcinomatosis represent common body compartmentalized diseases that have been explored in an experimental therapeutic context. Attempts to address the issue of achieving viral vector delivery to cancer cells in the face of a physiologic infection medium of pleural fluid or abdominal ascites have been examined (3, 4). Yang et al. demonstrated retroviral transduction of pancreatic cancer cells in the presence of human ascites, similar to the results obtained in culture medium (3). Batra et al. reported significant inhibition of retroviral transduction of mesothelioma cells in the presence of malignant pleural fluid, specifically the chondroitin sulfate proteoglycan fraction (4). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·

Patient representation in medical machines Inventor(s): Skatt, Bjorn; (Saltsjobaden, SE), Brahme, Anders; (Danderyd, SE), Coblentz, Pedro; (Solna, SE), Jansson, Allan; (Taby, SE), Lof, Johan; (Danderyd, SE), Sjogren, Bo; (Taby, SE) Correspondence: Young & Thompson; 745 South 23rd Street 2nd Floor; Arlington; VA; 22202 Patent Application Number: 20040002641 Date filed: June 24, 2002 Abstract: Methods and systems for relating anatomical patient information between different medical machines in a radiation therapy or diagnostic process are disclosed. In connection with each machine a respective 2- or 3-dimensional representation of at least a portion of the patient is determined in relation to an overall common coordinate system associated with the patient. The anatomical patient information between the different medical machines are then related based on the 2- or 3-dimensional representations as common reference between the machines. This makes it possible to integrate and depict anatomical information obtained with different imaging techniques into the common coordinate system. Also methods and systems for accurate patient positioning are disclosed, whereby the 2- or 3-dimensional representation is compared to a reference representation. The patient is then positioned to minimize the deviation between the representations.

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Excerpt(s): The present invention generally relates to the management of anatomical patient information in therapeutic and/or diagnostic processes, and in particular to methods and systems for accurate patient positioning and for coordinating anatomical patient information in such processes. During the past decades there have been considerable developments within the fields of radiation therapy and medical diagnosis. The performance of external beam radiation therapy accelerators, brachytherapy and other specialized radiation therapy equipment has improved rapidly. Developments taking place in the quality and adaptability of radiation beams have included new targets and filters, improved accelerators, increased flexibility in beam-shaping through new applicators, collimator and scanning systems and beam compensation techniques, and improved dosimetric and geometric treatment verification methods have been introduced. Furthermore, a number of powerful 3dimensional techniques have been developed, ranging from computed tomography (CT), positron and single photon emission computed tomography (PET and SPECT) to ultrasound and magnetic resonance imaging and spectroscopy (MRI and MRS). Equally important is the increased knowledge of the biological effect of fractionated uniform and non-uniform dose delivery to tumors and normal tissues and new assay techniques, including the determination of effective cell doubling times and individual tissue sensitivities, allowing optimization of the dose delivery to tumors of complex shape and advanced stages. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·

Patient support device for radiation therapy Inventor(s): Amann, Karl; (Gebenbach, DE), Plannerer, Jurgen; (Kemnath, DE), Seufert, Matthias; (Oberreichenbach, DE) Correspondence: Brinks Hofer Gilson & Lione; P.O. Box 10395; Chicago; IL; 60610; US Patent Application Number: 20040028188 Date filed: May 9, 2003 Abstract: A patient support device for a radiation therapy system has a load-bearing element, which is set up so as to be supported rotatably on a stationary structure about a vertical iso-axis extending through a treatment iso-center. The load-bearing element, with a patient tabletop mounted on it, can be leveled by a continuously adjustable leveling device. The leveling device is embodied in particular as a leveling shoe, which includes a bottom plate, a top plate, and an adjustable wedge disposed between them. Excerpt(s): The invention relates to a patient support device for a radiation therapy system, having a load-bearing element, which is set up so as to be supported rotatably on a stationary structure about a vertical iso-axis extending through a treatment isocenter, and having a patient tabletop mounted on the load-bearing element. German Patent Disclosure DE 38 03 567 A1 discloses a levelable patient support table that is not location-dependent or is moveable from place-to-place. The invention is in the field of radiation therapy systems with which diseased tumor tissue, for instance, is treated by means of hard X-radiation, electrons, or gamma rays. Because of the high energy of the radiation employed for the purpose, which is lethal to the diseased tissue, the necessity exists of protecting body cells surrounding the diseased region. This is done by distributing the total dose over a plurality of irradiation angles. First, various irradiation angles are created by providing that the radiator head, during the irradiation, rotates about a horizontal axis (horizontal iso-axis), and the irradiation occurs either at discrete irradiation angles or continuously during the rotation. Second, various angles of

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incidence are created by rotating the patient tabletop about a vertical axis (vertical isoaxis). The two iso-axes intersect at a so-called treatment iso-center. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·

Peptides and compounds that bind to a receptor Inventor(s): Barrett, Ronald W.; (Saratoga, CA), Cwirla, Steven E.; (Menlo Park, CA), Dower, William J.; (Menlo Park, CA), Duffin, David J.; (East Palo Alto, CA), Gates, Christian M.; (Santa Cruz, CA), Haselden, Sherril S.; (Santa Cruz, CA), Mattheakis, Larry C.; (Cupertino, CA), Schatz, Peter J.; (Mountain View, CA), Wagstrom, Christopher R.; (Los Altos, CA), Wrighton, Nicholas C.; (Palo Alto, CA) Correspondence: David J Levy, Corporate Intellectual Property; Glaxosmithkline; Five Moore DR.; PO Box 13398; Durham; NC; 27709-3398; US Patent Application Number: 20030158116 Date filed: February 27, 2002 Abstract: Described are peptides and peptide mimetics that bind to and activate the thrombopoietin receptor. Such peptides and peptide mimetics are useful in methods for treating hematological disorders and particularly, thrombocytopenia resulting from chemotherapy, radiation therapy, or bone marrow transfusions as well as in diagnostic methods employing labeled peptides and peptide mimetics. Excerpt(s): This application is a continuation of U.S. patent application Ser. No. 09/549,090, filed Apr. 13, 2000, which is a continuation of U.S. application Ser. No. 08/973,225, now U.S. Pat. No. 6,083,913, filed Dec. 4, 1997 pursuant to 35 U.S.C. 371 as a United States National Phase Application of International Application No. PCT/US96/09623, filed Jun. 7, 1996, which claims priority from U.S. patent application Ser. No. 08/485,301, filed Jun. 7, 1995, and U.S. patent application Ser. No. 08/478,128, filed Jun. 7, 1995. The present invention provides peptides and compounds that bind to and activate the thrombopoietin receptor (c-mpl or TPO-R) or otherwise act as a TPO agonist. The invention has application in the fields of biochemistry and medicinal chemistry and particularly provides TPO agonists for use in the treatment of human disease. Megakaryocytes are bone marrow-derived cells, which are responsible for producing circulating blood platelets. Although comprising <0.25% of the bone marrow cells in most species, they have >10 times the volume of typical marrow cells. See Kuter et. al. Proc. Natl. Acad. Sci. USA 91:11104-11108 (1994). Megakaryocytes undergo a process known as endomitosis whereby they replicate their nuclei but fail to undergo cell division and thereby give rise to polyploid cells. In response to a decreased platelet count, the endomitotic rate increases, higher ploidy megakaryocytes are formed, and the number of megakaryocytes may increase up to 3-fold. See Harker J. Clin. Invest. 47:458465 (1968). In contrast, in response to an elevated platelet count, the endomitotic rate decreases, lower ploidy megakaryocytes are formed, and the number of megakaryocytes may decrease by 50%. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Polyamine compounds and compositions for use in conjunction with cancer therapy Inventor(s): Copp, Richard R. JR.; (Oregon, WI), Fahl, Kathleen L.; (Madison, WI), Fahl, William E.; (Madison, WI), Ochsner, Cynthia E.; (Madison, WI), Peebles, Daniel D.; (Fond du Lac, WI) Correspondence: Woodcock Washburn Llp; One Liberty Place, 46th Floor; 1650 Market Street; Philadelphia; PA; 19103; US Patent Application Number: 20030185778 Date filed: February 7, 2003 Abstract: The invention provides novel polyamine compounds and pharmaceutical compositions for administration in conjunction with cancer chemotherapy or radiation therapy. The compounds are administered locally to provide protection against the adverse side-effects of chemotherapy or radiation therapy, such as alopecia, mucositis and dermatitis. Pharmaceutical preparations comprising one or more chemoprotective polyamines formulated for topical or local delivery to epithelial or mucosal cells are disclosed. Methods of administering the pharmaceutical preparations are also disclosed. Excerpt(s): This application claims benefit of U.S. Provisional Application No.60/355,356, filed Feb. 7, 2002, the entirety of which is incorporated by reference herein. The present invention relates to the field of cancer therapy. In particular, the invention provides novel polyamine compounds and pharmaceutical compositions for reducing or preventing toxic side effects of radiotherapy and cancer chemotherapeutic agents. Various patents and other publications are referenced in this application in order to more fully describe the state of the art to which this invention pertains. The disclosure of each of these publications is incorporated by reference herein, in its entirety. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Prediction method of the effect of radiotherapy for cancer patients Inventor(s): Inoue, Hiroshi; (Ooita-shi, JP), Matsuyama, Ayumi; (Beppu-shi, JP), Mori, Masaki; (Beppu-shi, JP), Shibuta, Kenji; (Beppu-shi, JP), Sugimachi, Keizo; (Fukuoka-shi, JP), Tanaka, Yoichi; (Tokyo, JP) Correspondence: Armstrong,westerman & Hattori, Llp; 1725 K Street, NW; Suite 1000; Washington; DC; 20006; US Patent Application Number: 20030120428 Date filed: July 31, 2002 Abstract: A method of predicting the effectiveness of radiotherapy for cancer patients. A method of predicting the effectiveness of radiotherapy for cancer patients, which includes the steps of: (a) performing a biopsy to collect cancer cells or cancer tissues from a cancer patient, (b) determining the expression level of hepatoma derived growth factor (HDGF) in the cancer cells or cancer tissues obtained in step (a), and (c) on the basis of the results obtained by the determination in step (b), predicting whether or not a significant treatment effect can be obtained when radiotherapy is carried out on the cancer patient. Excerpt(s): The present invention relates to a prediction method of the effect of radiotherapy for cancer patients (especially esophageal cancer patients). Radiotherapy for cancer is a treatment that applies high energy X-rays in order to cause damage to cancer cells and control growth and proliferation thereof. Radiotherapy is a useful

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method of treating many kinds of cancers located on almost all sites in the body, and about half of all cancer patients undergo radiotherapy. However, where radiotherapy is carried out on a cancer patient, it does not only cause damage to cancer cells so as to produce a life-prolonging effect, but exerts damage even on normal cells. As a result, the patient suffers from side effects such as nausea, anorexia, cardiopathy, alopecia, myelopathy, encephalopathy, bleeding tendency and immunodeficiency. There exist many patients who have experienced only a low treatment effect of treatment with radiotherapy, while they greatly suffer from side effects. For such patients, it is extremely important that the effect of radiotherapy is predicted before treatment and when a significant effect cannot be expected, treatments other than radiotherapy are applied, so as to enhance the quality of life (QOL) of patients. However, presently, an effective method of predicting the effect of radiotherapy before treatment is still unknown. It is the object of the present invention to provide a method of predicting before treatment whether or not a significant treatment effect can be obtained when radiotherapy is carried out on a cancer patient (especially an esophageal cancer patient), or the like. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·

Prostatic hormonal implants treatment of prostate cancer Inventor(s): Sahadevan, Velayudhan; (Beckley, WV) Correspondence: DR. V. Sahadevan; Dag Hammarskjold Cancer Treatment Center; 155 Dry Hill Road; Beckley; WV; 25801; US Patent Application Number: 20030147936 Date filed: February 7, 2002 Abstract: An improved method and products for the primary hormonal treatment of early stage, low and intermediate risk prostate cancers by prostatic implants of androgen suppressive drugs formulated as fused with a lipoid carrier or encapsulated in microcapsules or in Silastic capsules is provided. Such prostatic implants renders a constant slow-release of their contents to the prostate for extended periods by biodegradation and diffusion. It facilitates higher prostatic and lower systemic concentrations of androgen suppressive hormones. Because of their high prostatic and lower systemic concentrations, tumor control is much improved and the their systemic toxicity is minimized. Tumor control after such primary hormonal implant treatment is followed by clinical examinations and the biochemical tumor control is followed by periodic estimations of serum levels of PSA and acid phosphatase. More complex and expensive surgery or radiation therapy for this group of good prognostic early stage prostate cancer is reserved for those patients failing to this primary hormonal treatment. It will preserve potency more than by surgery or radiation therapy. Furthermore, it would reduce the cost of treatment for early stage prostate cancer significantly. Androgen suppressive hormonal implants to the prostate before, during or after lower dose conventional radiation therapy would also facilitate equal or better cure rates of localized prostate cancer as compared to the more complex and toxic higher dose radiation therapy. Excerpt(s): This invention relates to natural and synthetic chemical hormonal compositions for the treatment of prostate cancer, especially to improved androgen suppressive hormonal treatments by prostatic implants of slow-release androgen suppressive formulations by diffusion and biodegradation, maintaining high concentrations of said formulations in the prostate and maintaining low but sufficient

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blood levels to effect the hypothalamic-pituitary LHRH, FSH and LH mediated androgen synthesis with minimal systemic toxicity. Heretofore, hormone treatment of prostate is given by per oral, subcutaneous, intramuscular or intravenous injections. Because of the systemic distribution of such administrated hormones, only a very small amount of hormone reaches the target cancer cells in the prostate. A great percentage of the systemically administered hormone is rapidly metabolized and eliminated from the body and hence it is wasted. Therefore patients have to take larger quantities of these hormones daily. It increases the undesirable side effects of hormone treatment making it unsafe for some patients. Daily systemic administration of the hormones also adds to the cost of these medications and hence unaffordable to some patients. Because of the very low concentration of the systemically administrated hormone reaching the cancer cells, it may not even be adequately effective in some patients. The treatment of prostate cancer and its relative prognosis is better defined and discussed in terms of its stage at the time of diagnosis. In the following descriptions on the diagnosis and treatment of prostate cancer, the American Joint Committee on Cancer, AJCC cancer staging system of before 1998 is elected. The present commonly used staging system is the 1998 modified AJC cancer staging system. However since the literature that are to be referred here in the discussions relates to 10, 15 and to 20 year post treatment survival, the older AJC staging system is the more relevant one for the discussions here. The newer methods of interstitial radioactive seed implant treatment of T0-T2 prostate cancer have no 10 to 15-year survival data. For the available 3 and 5 year results for interstitial radioactive seed implants and that are referred here, no efforts to correct the small differences in stages T0-T2 between before 1998 and since 1988 AJC staging system is made. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·

Radiation therapy methods Inventor(s): DiZerega, Gere; (Pasadena, CA), Rodgers, Kathleen E.; (Long Beach, CA) Correspondence: Mcdonnell Boehnen Hulbert & Berghoff; 300 South Wacker Drive; Suite 3200; Chicago; IL; 60606; US Patent Application Number: 20030130196 Date filed: January 13, 2003 Abstract: The present invention provides methods and kits for mitigating radiation induced tissue damage, improving the effectiveness of radiation therapy, to support bone marrow transplantation, and promoting megakaryocyte production and mobilization and platelet production, each method comprising the administration of an effective amount of angiotensinogen, angiotensin I (AI), AI analogues, AI fragments and analogues thereof, angiotensin II (AII), AII analogues, AII fragments or analogues thereof or AII AT.sub.2 type 2 receptor agonists. Excerpt(s): This application is a Continuation-In-Part of U.S. Provisional Application Nos. 60/077,382 filed Mar. 10, 1998; 60/083670 filed Apr. 29, 1998; 60/081,262 filed Apr. 9, 1998; 60/090216 filed Jun. 22, 1998; 60/090,096 filed Jun. 19, 1998; and 60/099,957 filed Sep. 11, 1998. Radiation therapy is currently one of the most useful methods of treating cancerous tumors. However, radiation therapy damages normal tissue surrounding the tumor (U.S. Pat. No. 5,599,712, incorporated by reference herein in its entirety). This damage can include fibrosis, remodeling of the extracellular matrix, vascular damage, aberrant angiogenesis, pneumonitis, atherogenesis, osteonecrosis, mucositis, immunosuppression and functional impairment (U.S. Pat. No. 5,616,561, incorporated

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by reference herein in its entirety). As a result of these radiation-induced side effects, techniques have been developed to minimize radiation-induced damage to surrounding normal tissues by limiting radiation to the lowest level effective for cancer treatment. Since there is a direct relationship between the amount of radiation and the effectiveness of the treatment, this method compromises the overall effectiveness of the treatment. For some cancer patients, hematopoietic toxicity frequently limits the opportunity for radiation dose escalation (Watanabe et al., British J. Haematol. 94:619-627 (1996)). Repeated or high dose cycles of radiation therapy may be responsible for severe stem cell depletion leading to important long-term hematopoictic sequelea and marrow exhaustion (Masse et al., Blood 91:441-449 (1998). Such stem cell depletion leads to depletion of the full range of hematopoietic lineage specific cells, including megakaryocytes, platelets, monocytes, neutrophils, and lymphocytes, and the resulting complications of such depletion. For example, in patients suffering from depressed levels of platelets (thrombocytopenia) the inability to form clots is the most immediate and serious consequence, a potentially fatal complication of many therapies for cancer. Such cancer patients are generally treated for this problem with platelet transfusions. Other patients frequently requiring platelet transfusions are those undergoing bone marrow transplantation or patients with aplastic anemia. Platelets for such procedures are obtained by plateletpheresis from normal donors. Like most human blood products, platelets for transfusion have a relatively short shelf-life and also expose the patients to considerable risk of exposure to dangerous viruses, such as the human immunodeficiency virus (HIV). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·

RADIATION THERAPY VOLUME PHANTOM USING FILM Inventor(s): Paliwal, Bhudatt R.; (Madison, WI), Tome, Wolfgang; (Madison, WI) Correspondence: Quarles & Brady Llp; 411 E. Wisconsin Avenue, Suite 2040; Milwaukee; WI; 53202-4497; US Patent Application Number: 20030231740 Date filed: June 12, 2002 Abstract: A volume phantom for radiation therapy verification employs film held in a spiral configuration within a equalizing ring of attenuating material. The ring provides improved uniformity in radiation measurement and may be extended, for example, to a hemisphere to provide improved modeling and simulation of treatments in the region of the head. Excerpt(s): This invention relates to the evaluation of radiation therapy phantoms in particular to a phantom using film and providing radiation measurement throughout a volume. External beam radiation therapy treats cancerous tissue by exposing the tissue to a high-energy radiation from an external source. Normally, a number of different external beams are employed, each approaching the tissue at a different angle, simultaneously or in sequence. The use of multiple beams and angles minimizes the radiation exposure of any given area of the skin and of nearby, possibly radiationsensitive organs. The selection of the angles and the exposure times for each beam comprises a radiation treatment plan. Whereas some treatment plans may have a relatively low number of beams and exposure times, the latest generation of radiation therapy equipment allows for extremely complex radiation treatment plans employing many independently controllable beams throughout a range of angles. Multiple beams

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of varying average intensity may be formed by a multileaf collimator or similar mechanism. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·

Radiotherapy apparatus and collimator set therefor Inventor(s): Brown, Kevin John; (West Sussex, GB), Streamer, Ralph Peter; (West Sussex, GB) Correspondence: Bromberg & Sunstein Llp; 125 Summer Street; Boston; MA; 02110-1618; US Patent Application Number: 20040013237 Date filed: April 10, 2003 Abstract: A collimator set for a radiotherapy apparatus comprises, in sequence, an aperture collimator, a multi-leaf collimator with a pair of opposing arrays of elongate leaves each moveable longitudinally in a Y direction, and a leaf edge collimator, the aperture collimator being adapted to collimate the beam in the X and Y direction to a first extent, and the leaf edge collimator being adapted to further collimate the extent of the beam in the Y direction to a second and therefore lesser extend. This means that to close a pair of opposing leaves, they are moved to their minimum separation, with the gap being convered by the leaf edge collimator. The MLC is after the aperture collimator, so in combination with thin leaves, the MLC leaves will project a much reduced leaf width at the isocentre of the radiotherapy apparatus and collimation of the radiation field by fractional leaf widths becomes unnecessary. A radiotherapy apparatus comprising a collimator set as defined above is also disclosed. Excerpt(s): The present invention relates to a radiotherapy apparatus, in particular to the arrangement of collimators within the radiation head. In a conventional multi-leaf collimator (MLC), the radiation beam is collimated by an array of thin leaves lying alongside each other which can each be extended longitudinally to define a unique edge. The leaves move in a given direction (Y) and generally there are two sets of additional backup diaphragms orthogonal to this (X). These are solid and move in and out in the X and Y directions. They perform two functions. The X diaphragm allows the field edge to be adjusted in a continuous manner, whereas the leaves alone would only allow discrete adjustments a leaf width at a time. The Y diaphragm reduces the effect of leakage through the leaves. The X diaphragm also shields the gap between leaves that are out of the treatment field and are effectively `closed`. Subsequent to the MLC 22 is a Y collimator. This consists of a pair of jaws 32, 34 which each extend across the width of the multi-leaf array 22 and can be moved in and out in the same Y direction as the leaves 24, 26 of the MLC array 22. These leaves therefore lie behind the leaves of the MLC 22 and limit leakage of radiation between the individual leaves. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Radiotherapy device Inventor(s): Hara, Kenji; (Hiroshima, JP), Kamino, Yuichiro; (Aichi, JP), Mihara, Kazumasa; (Hiroshima, JP), Wakamoto, Ikuo; (Hiroshima, JP), Yamashita, Ichiro; (Hiroshima, JP) Correspondence: Armstrong, Kratz, Quintos, Hanson & Brooks, Llp; 1725 K Street, NW; Suite 1000; Washington; DC; 20006; US Patent Application Number: 20040037390 Date filed: May 9, 2003 Abstract: The radiotherapy apparatus in the present invention includes a bed, a radiation irradiating head, head swing mechanisms, a precise inspection unit and a control unit. The bed carries a subject. The radiation irradiating head irradiates a treatment radiation to a treatment field of the subject. The head swing mechanisms, which are coupled to the radiation irradiating head, swings the head of the radiation irradiating head so that the treatment radiation emitted from the radiation irradiating head pursues the motion of the treatment field. The precise inspection unit obtains a diagnosis image containing the treatment field. The control unit controls the positions of the head swing mechanisms so that an irradiation field of the radiation irradiating head pursues the treatment field, based on the diagnosis image, the position of the radiation irradiating head and the state of the swung head. Then, the control unit controls the radiation irradiating head so that the treatment radiation is irradiated from the radiation irradiating head, after the positional control of the head swing mechanisms. Excerpt(s): The present invention relates to a radiotherapy apparatus, and more particularly to a radiotherapy apparatus used for a stereotactic radiotherapy. A radiotherapy apparatus for treating a cancer and a tumor by using radiation has been well known. As a three-dimensional irradiation radiotherapy apparatus for carrying out an irradiation at a stereotactic multiple arc, there are a radiosurgery treating apparatus, a linac (medical linear accelerator) treating apparatus and the like. Here, the stereotactic multiple arc irradiation designates the radiotherapy method that intensively irradiates the radiation to a small focus from many directions and thereby improves the treatment effect, and further minimizes the exposure amount of ambient tissues. Its power is exerted on the treatment for a primary benign brain tumor, a single metastatic brain tumor whose size is 3 cm or less, a small lesion inside a brain such as a cranial base metastasis whose operation is difficult, an artery malformation, a vein malformation or the like. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Real time radiation treament planning system Inventor(s): Baltas, Dimos; (Darmstadt, DE), Kindlein, Johann; (Oberhausen, DE), Kuipers, Frans; (Veenendaal, NL), Sakas, Georgios; (Darmstadt, DE), Schot, Hans Martin; (Veenendaal, NL) Correspondence: Birch Stewart Kolasch & Birch; PO Box 747; Falls Church; VA; 220400747; US Patent Application Number: 20030233123 Date filed: May 30, 2003

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Abstract: The invention relates to a real time radiation treatment planning system for use in effecting radiation therapy of a pre-selected anatomical portion of an animal body according to the preamble of claim 1.According to the invention said processing means are provided with a three-dimensional imaging algorithm and a threedimensional image segmentation algorithm for at least the specific organs within said anatomical portion and the needles for converting the image data obtained with said imaging means into a three-dimensional image of the anatomical portion, whereby by using at least one single or multi-objective anatomy based genetic optimization algorithmfor pre-planning or virtual simulation purposes said processing means are arranged to determine in real time the optimal number and position of at least one of said hollow needles, the position of said energy emitting source within each hollow needle as well as the dwell times of said energy emitting source at each position; whereasfor post planning purposes said processing means are arranged to determine based on three-dimensional image information in real time the real needle positions and the dwell times of said energy emitting source for each position. Excerpt(s): the amount of radiation dose to be emitted. The last decade has seen major changes in the way radiation treatments are delivered. The century-old objective of radiation therapy, i.e. to deliver a curative dose to the target, e.g. a tumour, while preserving normal tissues of the animal body can now be aimed at with a high degree of sophistication. However, despite of major improvements achieved with threedimensional imaging techniques, that allow the anatomy to be properly defined, brachytherapy treatments have not yet fully benefited from these important new pieces of information. For brachytherapy using high dose rate (HDR) energy emitting sources, catheters or hollow needles are placed in a target volume within an animal body and it is assumed that if the dose distribution covers the catheters, it should also cover the anatomy. Imaging is commonly used to set the treatment margins, but optimized dose distributions are based on considerations, such as the catheter positions and desired dose and limited to a few defined points. This necessarily results in an approximation of the shape of the anatomical portion to be treated. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·

Removable electron multileaf collimator Inventor(s): Collins, William F.; (Clayton, CA), Svatos, Michelle Marie; (Oakland, CA) Correspondence: Siemens Corporation; Attn: Elsa Keller, Legal Administrator; Intellectual Property Department; 186 Wood Avenue South; Iselin; NJ; 08830; US Patent Application Number: 20030202632 Date filed: July 20, 2001 Abstract: A removable electron collimator for use in collimating an electron beam in a radiation therapy device is provided, where the collimator includes drive electronics, removably mounted on an exterior of an accessory tray of the radiation therapy device. The electron collimator also includes a plurality of leaves positionable by the drive electronics to move across a path of the electron beam, the plurality of leaves removably mounted on the accessory tray of the radiation therapy device. Excerpt(s): This application is related to commonly owned U.S. patent application Ser. No. ______, filed Jul. 20, 2001 (on even date herewith), Attorney Docket No. 2001P13116US for "AUTOMATED DELIVERY OF TREATMENT FIELDS", and U.S. patent application Ser. No. ______, filed Jul. 20, 2001 (on even date herewith), Attorney

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Docket No. 2001P13113US for "VERIFICATION OF ELECTRON TREATMENT FIELDS", the contents of each of which are incorporated by reference in their entirety for all purposes. The present invention relates generally to radiation therapy devices, and more particularly, to a removable electron multileaf collimator for use in a radiation therapy device. Conventional radiation therapy typically involves directing a radiation beam at a tumor in a patient to deliver a predetermined dose of therapeutic radiation to the tumor according to an established treatment plan. This is typically accomplished using a radiation therapy device such as the device described in U.S. Pat. No. 5,668,847 issued Sep. 16, 1997 to Hernandez, the contents of which are incorporated herein for all purposes. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·

Substituted benzimidazoles and imidazo-[4,5]-pyridines Inventor(s): Arienti, Kristen L.; (La Mesa, CA), Axe, Frank U.; (Escondido, CA), Breitenbucher, J. Guy; (Escondido, CA), Huang, Liming; (San Diego, CA), Lee, Alice; (San Diego, CA), McClure, Kelly J.; (San Diego, CA) Correspondence: Audley A. Ciamporcero JR.; Johnson & Johnson; One Johnson & Johnson Plaza; New Brunswick; NJ; 08933-7003; US Patent Application Number: 20030176438 Date filed: October 18, 2002 Abstract: 2-Aryl substituted benzimidazoles and imidazo[4,5]pyridines are disclosed as inhibitors of Cds1 and useful as adjuvants to chemotherapy or radiation therapy in the treatment of cancer. Excerpt(s): The present invention relates to substituted benzimidazole and imidazo[4,5]-pyridine compounds, compositions containing them, and methods of using them. The maintenance of an intact genome is of crucial importance to every organism. The individual cell in a multicellular eukaryotic organism possesses sophisticated and intricate mechanisms to properly respond to DNA damage. Such mechanisms repair damaged DNA or trigger programmed cell death (apoptosis). In response to DNA damage, checkpoint kinases are thought to be intimately involved in these processes. These kinases are activated by upstream proteins, such as ATM (ataxia-telangiectasia mutated) and ATR (ataxia-telangiectasia mutated and rad3-related), and in turn trigger cell cycle arrest by inhibition of proteins such as Cdc25A or Cdc25C. The checkpoint kinases may also modulate the activity of other proteins that are thought to be involved in DNA repair and programmed cell death. Examples of such proteins are BRCA1 and p53. The checkpoint kinase Cds1 (in man also known as Chk2) is conserved from yeast to man. A human homolog of the Schizosaccharomyces pombe Cds1 gene has been described (Tominaga, K. et al. J. Biol. Chem. 1999, 274(44):31463-31467; Matsouka, S. et al. Science 1998, 282:1893-1897; Blasina, A. et al. Curr. Biol. 1999, 9(1):1-10). Human Cds1 was rapidly activated by phosphorylation in response to DNA damage in both normal cells and in p53-deficient cancer cells. High levels of hCds1 were observed in p53deficient cells. In human cells Cds1 has been implicated in the regulation by phosphorylation of proteins such as p53, BRCA1, Cdc25A, and Cdc25C (See: Lee, J.-S. et al. Nature 2000, 404:201-204; Falck, J. et al. Nature 2001, 410:842-847; and Buscemi, G. et al. Mol. Cell. Biol. 2001, 21(15):5214-5222). As described below, inhibition of Cds1 offers two strategies for improving the effectiveness of DNA-damaging cancer treatments. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Systems and methods for global optimization of treatment planning for external beam radiation therapy Inventor(s): Lee, Eva K.; (Atlanta, GA) Correspondence: Thomas, Kayden, Horstemeyer & Risley, Llp; 100 Galleria Parkway, NW; Ste 1750; Atlanta; GA; 30339-5948; US Patent Application Number: 20030138077 Date filed: January 13, 2003 Abstract: Systems and methods for providing an optimal treatment plan for delivering a prescribed radiation dose to a predefined target volume within a patient using an external beam radiation delivery unit are provided. The systems have an interface which is adapted to receive information related to a prescribed radiation dose, a predefined target volume within a patient, and parameters associated with an external beam delivery unit. The systems also have a treatment plan modeling processor which is adapted to receive all of the input data and develop a dose calculation optimization model defining a global system. The systems also have an optimization processor which is adapted to determine an optimal treatment plan based on the dose calculation optimization model and all the input data. The methods involve (1) receiving information related to the prescribed radiation dose, the predefined target volume, and parameters associated with the external beam delivery unit, (2) developing a dose calculation optimization model based on a plurality of variables corresponding to the information which define a global system, and (3) outputting an optimal treatment plan based on the dose calculation optimization model and the information. Excerpt(s): This application claims the benefit of U.S. Provisional Application No. 60/164,029, filed Nov. 5, 1999, which is also incorporated herein by reference. The present invention relates generally to treatment planning for external beam radiation therapy, and more particularly, to systems and methods for global optimization of treatment planning for external beam radiation therapy. External beam radiation therapy is a well-known treatment option available to the radiation oncology and neurosurgery communities for treating and controlling certain central nervous systems lesions, such as arteriovenous malformations, metastatic lesions, acoustic neuromas, pituitary tumors, malignant gliomas, and other intracranial tumors. As the name implies, the procedure involves the use of external beams of radiation directed into the patient at the lesion using either a gamma unit (referred to as a Gamma Knife), a linear accelerator, or similar beam delivery apparatus. Although treating the lesions with the radiation provides the potential for curing the related disorder, the proximity of critical normal structures and surrounding normal tissue to the lesions makes external beam radiation therapy an inherently high risk procedure that can cause severe complications. Hence, the primary objective of external beam radiation therapy is the precise delivery of the desired radiation dose to the target area defining the lesion, while minimizing the radiation dose to surrounding normal tissue and critical structures. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Treatment of B cell malignancies using anti-CD40L antibodies in combination with anti-CD20 antibodies and/or chemotherapeutics and radiotherapy Inventor(s): Hanna, Nabil; (Rancho Santa Fe, CA), Hariharan, Kandasamy; (San Diego, CA) Correspondence: Pillsbury Winthrop, Llp; P.O. Box 10500; Mclean; VA; 22102; US Patent Application Number: 20030180292 Date filed: March 14, 2002 Abstract: The invention discloses compositions, combination therapies and methods of treating B-cell lymphomas and leukemias, as well as other CD40.sup.+ malignancies. The primary active agent of the composition is an anti-CD40L antibody or other CD40L antagonist that inhibits CD40-CD40L interaction. Compositions may additionally contain or utilize any one or more of the following in combination for the treatment of said disease: anti-CD20 antibodies, chemotherapeutic agents, chemotherapy cocktails, and radiotherapy. Excerpt(s): The invention describes a method and combination therapy for treating Bcell lymphomas and leukemias, as well as other CD40.sup.+ malignancies, by regulating the interaction between CD40 and its ligand, CD40L or regulating CD40 signaling. Specifically, the interaction can be inhibited using anti-CD40L antibodies to prevent CD40L from binding to CD40. These antibodies or other agents which can inhibit CD40/CD40L interaction further can be combined with chemotherapeutics, radiation and/or anti-CD20 antibodies and anti-CD40 antibodies. Lymphomas are tumors of the lymphocytes. Ninety percent of lymphomas are of B-cell origin, with the remaining ten percent of T-cell origin. Most patients are diagnosed with either Hodgkin's Disease (HD) or non-Hodgkin's type lymphoma (NHL). Depending on the lymphoma diagnosed, treatment options include radiotherapy, chemotherapy, and use of monoclonal antibodies. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Tungsten composite x-ray target assembly for radiation therapy Inventor(s): Egley, Bert D.; (Walnut Creek, CA), Steinberg, Todd Howard; (Antioch, CA) Correspondence: Siemens Corporation; Attn: Elsa Keller, Legal Administrator; Intellectual Property Department; 186 Wood Avenue South; Iselin; NJ; 08830; US Patent Application Number: 20040057555 Date filed: September 24, 2002 Abstract: An x-ray target assembly including a housing having a recess, a cooling fluid contained within the recess and an x-ray target attached to the housing, wherein the xray target does not directly contact the cooling fluid. Excerpt(s): The present invention relates to an x-ray target assembly. The x-ray target assembly preferably is used with a charged particle accelerator in a radiation therapy machine. It is known to produce x-rays by bombarding an x-ray target assembly with electrons emitted from a charged particle accelerator. FIGS. 1 and 2 show an embodiment of a known x-ray target assembly used within radiation therapy machines manufactured and sold by Siemens Medical Solutions of Concord, Calif. under the trade names of Mevatron and Primus. The x-ray target assembly 100 includes a stainless steel cylindrical housing 102 that is supported by a pair of tubes 103. Within the interior of the housing 102, a graphite cylindrical electron absorber 104 is centrally located within

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the housing 102 and is supported upon an annular bottom piece 106 of the housing 102. The annular bottom piece 106 is attached to bottom side edges of the housing 102 via mechanical fasteners, such as screws, inserted into openings 108 of the piece 106 and openings of the housing 102. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html ·

Use of novel metalloporphyrins as imageable tumor-targeting agents for radiation therapy Inventor(s): Miura, Michiko; (Hampton Bays, NY), Slatkin, Daniel N.; (Southold, NY) Correspondence: Margaret C. Bogosian; Brookhaven National Laboratory; BLDG. 475d; P.O. Box 5000; Upton; NY; 11973-5000; US Patent Application Number: 20030165426 Date filed: February 27, 2003 Abstract: The present invention covers halogenated derivatives of boronated phorphyrins containing multiple carborane cages having the formula 1which selectively accumulate in neoplastic tissue within the irradiation volume and thus can be used in cancer therapies including, but not limited to, boron neutron-capture therapy and photodynamic therapy. The present invention also covers methods for using these halogenated derivatives of boronated porphyrins in tumor imaging and cancer treatment. Excerpt(s): The present application is a continuation-in-part of U.S. patent application Ser. No. 09/874,203 filed on Jun. 6, 2001 incorporated herein by reference. The present invention relates to compounds and methods for treating malignant tumors, in particular brain tumors and tumors of the head and neck, using such compounds. Porphyrins in general belong to a class of colored, aromatic tetrapyrrole compounds, some of which are found naturally in plants and animals, e.g., chlorophyll and heme, respectively. Porphyrins are known to have a high affinity to neoplastic tissues of mammals, including man. Because of their affinity for neoplastic tissues, in general, porphyrins with boron-containing substituents could prove useful in the treatment of primary and metastatic tumors of the central nervous system by boron neutron capture therapy (BNCT). Porphyrins and other tetrapyrroles with relatively long singlet lifetimes have already been used to treat malignant tumors with photodynamic therapy (PDT), but this application has limited clinical applicability because of the poor penetration of the visible light required to activate the administered enhancer so as to render it toxic to living tissues, i.e., to the targeted tumor. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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X-ray apparatus with field emission current stabilization and method of providing xray radiation therapy Inventor(s): Jaafar, Ali; (Eden Prairie, MN) Correspondence: Ali Jaafar; 11600 Landing Road; Eden Prairie; MN; 55347; US Patent Application Number: 20030179854 Date filed: March 19, 2003

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Abstract: The present invention provides apparatus and method for providing a stabilized x-ray output from a field emission x-ray apparatus by monitoring the operating current and adjusting the gap between the anode and cathode to stabilize the output. Excerpt(s): The present application claims priority from U.S. Provisional Patent Application Serial No. 60/365,712, entitled "X-ray apparatus for radiation therapy" and filed on Mar. 20, 2002. The present invention relates generally to apparatus and method for providing x-ray radiation therapy and specifically to apparatus and method for providing x-ray radiation therapy with real-time stabilization of the operating current, and thus the dosage rate. The use of x-ray radiation for medical and non-medical applications is well known. In the medical arena, x-ray radiation therapy is a commonly used and accepted practice in the treatment of disease, including but not limited to, for example, tumors, certain skin diseases, and/or benign conditions. Historically, treatment first utilized external x-ray sources that supplied x-ray radiation to the target site. Where the target site was internal, such as a tumor, the applied x-ray radiation had to traverse the skin and other soft tissue and perhaps bone on its way to the target site, resulting in damage and burn to those tissues. Among other reasons, this disadvantage of x-ray therapy using external x-ray sources caused innovators to seek devices and methods to generate x-rays internally. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with radiation therapy, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “radiation therapy” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on radiation therapy. You can also use this procedure to view pending patent applications concerning radiation therapy. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 6. BOOKS ON RADIATION THERAPY Overview This chapter provides bibliographic book references relating to radiation therapy. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on radiation therapy include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “radiation therapy” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on radiation therapy: ·

Managing the Side Effects of Chemotherapy and Radiation Therapy Source: San Francisco, CA: UCSF Nursing Press, University of California, San Francisco. 2001. 324 p. Contact: Available from UCSF Nursing Press. University of California, San Francisco, Room N535C, 521 Parnassus Avenue, Box 0608, San Francisco, CA 94143-0608. (415) 4764992. Fax (415) 476-6042. Website: nurseweb.ucsf.edu/www/books.htm. PRICE: $20.00 plus shipping and handling. ISBN: 0943671205. Summary: This book helps people who are undergoing cancer therapy to cope with the side effects of chemotherapy and radiation. The author lists over 70 chemotherapy agents and potential side effects, signs, and symptoms for each; describes side effects associated with radiation therapy; offers specific strategies for coping with each symptom; and advises when to contact a physician or nurse about a particular

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symptoms. The section on each side effect includes a description of the effect, its likely duration, self-care measures, when to consult a health care provider, and what other side effects may be cumulative. The book includes nutritional advice for cancer patients and various self-care worksheets for recordkeeping and help in talking with physicians and nurses. References are provided for the reader who desires more detailed information. A chart of drugs helps readers locate each medication; a subject index concludes the volume. ·

Managing the Side Effects of Chemotherapy and Radiation Therapy: A Guide for Patients and Their Families. 3rd ed Source: San Francisco, CA: UCSF Nursing Press. 1996. 198 p. Contact: Available from UCSF Nursing Press. 521 Parnassus Avenue, Room N-535C, San Francisco, CA 94143-0608. (415) 476-4992 or (415) 476-2626. Fax (415) 476-6042. PRICE: $20.00 plus $6.00 shipping and handling. ISBN: 0943671120. Summary: This book is designed to help patients and their families learn to cope with the many side effects of cancer chemotherapy and radiation therapy. The chemotherapy section lists every frequently used cancer drug and common side effects of each. This information is first presented in chart format, then discussed in some detail. Suggestions for managing each side effect are included. The section on side effects includes a description of the problem, its likely duration, recommended self-care measures, and when to consult with a health care provider. The remainder of the book discusses the common side effects of radiation therapy, with the same type of information and in the same format. Side effects particularly relevant to the digestive system include abdominal pain, constipation, diarrhea, liver damage, sore mouth or difficulty swallowing, nausea and vomiting, and stomach irritation and ulcers. A subject index concludes the book.

·

Oral Management of the Cancer Patient: A Professional Guide for the Management of Patients Undergoing Chemotherapy and Head and Neck Radiation Therapy. 6th ed Source: Kansas City, MO: University of Missouri-Kansas City School of Dentistry. 2000. 28 p. Contact: Available from University of Missouri-Kansas City School of Dentistry. Instructional Resources Librarian, 650 East 25th Street, Kansas City, MO 64108-2795. (816) 235-2064. PRICE: Single copy free to referring healthcare professionals. Summary: This manual provides a general outline for the oral management of the cancer patient undergoing chemotherapy, bone marrow transplantation, or radiation therapy to the oral cavity or salivary glands. Radiation therapy to the head and neck, which includes the salivary glands or the oral and pharyngeal tissues, may result in acute side effects that include taste loss, mucositis, infection, and decreased salivary flow. Long term, permanent side effects may include salivary gland dysfunction, dental demineralization, radiation caries, trismus, soft tissue breakdown and failure to heal, and osteoradionecrosis (ORN). In patients receiving chemotherapy for any malignancy, approximately 40 percent will experience oral complications. The objectives of an oral and dental program for the cancer patient are to: improve oral function and quality of life; improve and maintain oral hygiene in order to reduce the risk and severity of oral complications; eliminate oral infection and prevent potentially fatal systemic infections of dental origin; to prevent, eliminate or control oropharyngeal pain; to prevent or control salivary gland dysfunction and the destruction of the dentition; to assist with maintaining adequate nutrition; and to prevent or reduce the incidence of bone necrosis

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(death). The document outlines the complications that can arise from each type of cancer therapy, then discusses palliative measures for xerostomia (dry mouth) and pain, oral care products and resources for the cancer patient, and the issue of medically necessary oral health care and reimbursement. The manual concludes with a reference for professional education materials and a list of additional information sources. 4 figures.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in PrintÒ). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “radiation therapy” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “radiation therapy” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “radiation therapy” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): ·

A concise textbook of radiotherapy by Priscilla Barnes; ISBN: 0397580827; http://www.amazon.com/exec/obidos/ASIN/0397580827/icongroupinterna

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A Primer on Theory and Operation of Linear Accelerators in Radiation Therapy by C. J. Karzmark, Robert J. Morton; ISBN: 0944838669; http://www.amazon.com/exec/obidos/ASIN/0944838669/icongroupinterna

·

Acute and Long-Term Side-Effects of Radiotherapy: Biological Basis and Clinical Relevance (Recent Results in Cancer Research, Vol 130) by W. Hinkelbein, et al; ISBN: 0387564071; http://www.amazon.com/exec/obidos/ASIN/0387564071/icongroupinterna

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Advances in Radiation Therapy by Bharat B. Mittal (Editor), et al; ISBN: 0792399811; http://www.amazon.com/exec/obidos/ASIN/0792399811/icongroupinterna

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Advances in Radiation Therapy Treatment Planning by Ann E. Wright (Editor), Arthur L. Boyer (Editor); ISBN: 0883184230; http://www.amazon.com/exec/obidos/ASIN/0883184230/icongroupinterna

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Adverse Effects of Radiotherapy: Medical Subject Analysis With Reference Bibliography by Judy Jacobs Hallcrest; ISBN: 0881644773; http://www.amazon.com/exec/obidos/ASIN/0881644773/icongroupinterna

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Blackburn's Introduction to Clinical Radiation Therapy Physics by Siamak Shahabi (Editor), Ben Blackburn; ISBN: 0944838065; http://www.amazon.com/exec/obidos/ASIN/0944838065/icongroupinterna

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Californium-252: Isotope for 21st Century Radiotherapy: Proceedings of the NATO Advanced Research Workshop On: Californium-252, Isotope for 21st Century Radiotherapy (NATO Asi Series. Partnership Sub-Series 3, High Technology, V. 29) by Jcek G. Wierzbicki (Editor), et al; ISBN: 0792345436; http://www.amazon.com/exec/obidos/ASIN/0792345436/icongroupinterna

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Cancer and Radiotherapy: A Short Guide for Nurses and Medical Students by J. Walter; ISBN: 0443015333; http://www.amazon.com/exec/obidos/ASIN/0443015333/icongroupinterna

218 Radiation Therapy

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Cancer Nursing: Radiotherapy by R Tiffany; ISBN: 0571113621; http://www.amazon.com/exec/obidos/ASIN/0571113621/icongroupinterna

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Cancers of the Head and Neck: Advances in Surgical Therapy, Radiation Therapy and Chemotherapy (Cancer Treatment and Research) by Charlotte Jacobs (Editor); ISBN: 0898388252; http://www.amazon.com/exec/obidos/ASIN/0898388252/icongroupinterna

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Chemotherapy and Radiotherapy of Gastrointestinal Tumors by H. O. Klein; ISBN: 0387109382; http://www.amazon.com/exec/obidos/ASIN/0387109382/icongroupinterna

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Clinical Applications of Continuous Infusion Chemotherapy and Concomitant Radiation Therapy by Conference on Continuous Infusion Chemotherapy and Its Interactions Wi, et al; ISBN: 0306422603; http://www.amazon.com/exec/obidos/ASIN/0306422603/icongroupinterna

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Clinical Oncology for Students of Radiation Therapy Technology by John A. Stryker; ISBN: 0875274889; http://www.amazon.com/exec/obidos/ASIN/0875274889/icongroupinterna

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Clinical Radiotherapy Physics: Treatment Planning and Radiation Safety by Subramania Jayaraman (Editor), Lawrence H.Nia Lanzl (Editor); ISBN: 0849340179; http://www.amazon.com/exec/obidos/ASIN/0849340179/icongroupinterna

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Clinical Target Volumes in Conformal and Intensity Modulated Radiation Therapy by V. Gregorie (Editor), et al; ISBN: 3540413804; http://www.amazon.com/exec/obidos/ASIN/3540413804/icongroupinterna

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Combined Radiotherapy and Chemotherapy in Clinical Oncology by Horwich; ISBN: 0340551593; http://www.amazon.com/exec/obidos/ASIN/0340551593/icongroupinterna

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Computed Tomography in Radiation Therapy by C. Clifton Ling (Editor); ISBN: 0890048312; http://www.amazon.com/exec/obidos/ASIN/0890048312/icongroupinterna

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Controversies in Neuro-Oncology: 3rd International Symposium on Special Aspects of Radiotherapy, Berlin, Germany, April 30-May 2, 1998 (Frontiers of Radiation Therapy and Oncology, Vol. 33) by International Symposium on Special Aspects of Radiotherapy 1998 Berli, et al; ISBN: 3805568347; http://www.amazon.com/exec/obidos/ASIN/3805568347/icongroupinterna

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Controversies in Uro-Oncology: 5th International Symposium on Special Aspects of Radiotherapy, Berlin, May 11-13, 2000 (Frontiers of Radiation Therapy and Oncology, Vol 36) by T. Wiegel (Editor), et al; ISBN: 3805572174; http://www.amazon.com/exec/obidos/ASIN/3805572174/icongroupinterna

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Coping with Radiation Therapy by Daniel, Md. Cukier, et al; ISBN: 0737304154; http://www.amazon.com/exec/obidos/ASIN/0737304154/icongroupinterna

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Diagnostic roentgenology of radiotherapy change; ISBN: 0683049798; http://www.amazon.com/exec/obidos/ASIN/0683049798/icongroupinterna

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Elementary clinical radiotherapy by Matthew L. Fenner; ISBN: 0407534008; http://www.amazon.com/exec/obidos/ASIN/0407534008/icongroupinterna

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Evolving Approaches to Improve Outcomes and Minimize Toxicities in Radiation Therapy: San Francisco, California, November 2001 by G. M. Thomas (Editor); ISBN:

Books 219

3805575289; http://www.amazon.com/exec/obidos/ASIN/3805575289/icongroupinterna ·

Fraction size in radiobiology and radiotherapy : [mit] 57 tables; ISBN: 3541064013; http://www.amazon.com/exec/obidos/ASIN/3541064013/icongroupinterna

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Fundamentals of Radiation Therapy and Cancer Chemotherapy by Sidney Lowry; ISBN: 0668034629; http://www.amazon.com/exec/obidos/ASIN/0668034629/icongroupinterna

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Gastrointestinal Cancer: Radiation Therapy (Medical Radiology) by Ralph R. Dobelbower (Editor); ISBN: 0387505059; http://www.amazon.com/exec/obidos/ASIN/0387505059/icongroupinterna

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Healing Photons: The Science & Art of Blood Irradiation Therapy by Kenneth J. Dillon (Introduction); ISBN: 0964297655; http://www.amazon.com/exec/obidos/ASIN/0964297655/icongroupinterna

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Healing: A Women's Guide to Lumpectomy & Radiation Therapy by Rosalind Benedet; ISBN: 0963791710; http://www.amazon.com/exec/obidos/ASIN/0963791710/icongroupinterna

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High Energy in Radiation Therapy by A. Zuppinger; ISBN: 0387101888; http://www.amazon.com/exec/obidos/ASIN/0387101888/icongroupinterna

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Hyperthermia and Radiation Therapy/Chemotherapy in the Treatment of Cancer: Frontiers of Radiation Therapy and Oncology Series by John Meyer (Editor), J. M. Vaeth (Editor); ISBN: 3805537255; http://www.amazon.com/exec/obidos/ASIN/3805537255/icongroupinterna

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ICRP Publication 44: Protection of the Patient in Radiation Therapy by F. D. Sowby (Editor), International Commission On Radiological; ISBN: 0080323367; http://www.amazon.com/exec/obidos/ASIN/0080323367/icongroupinterna

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ICRP Publication 86: Prevention of Accidents to Patients Undergoing Radiation Therapy by Icrp (Editor); ISBN: 0080440827; http://www.amazon.com/exec/obidos/ASIN/0080440827/icongroupinterna

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Imaging in Radiation Therapy by John Downton Hazlett, et al; ISBN: 1888340126; http://www.amazon.com/exec/obidos/ASIN/1888340126/icongroupinterna

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Immunopharmacologic Effects of Radiation Therapy by Dubois; ISBN: 0890045313; http://www.amazon.com/exec/obidos/ASIN/0890045313/icongroupinterna

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Intensity-Modulated Radiation Therapy by Steve Webb; ISBN: 0750306998; http://www.amazon.com/exec/obidos/ASIN/0750306998/icongroupinterna

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Interactive Volume Visualization in the Context of Virtual Radiotherapy Treatment Planning (European University Studies: Series, Informatic, 41) by Wenli Cai; ISBN: 082045351X; http://www.amazon.com/exec/obidos/ASIN/082045351X/icongroupinterna

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Interstitial and Intracavitary Thermoradiotherapy (Medical Radiology: Diagnostic Imaging and Radiation Oncology) by M.H. Seegenschmiedt, et al; ISBN: 0387556702; http://www.amazon.com/exec/obidos/ASIN/0387556702/icongroupinterna

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Intraoperative Radiation Therapy by Ralph R. Dobelbower, et al; ISBN: 0849368464; http://www.amazon.com/exec/obidos/ASIN/0849368464/icongroupinterna

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Intraoperative Radiation Therapy in the Treatment of Cancer (Frontiers of Radiation Therapy and Oncology, Vol. 31) by Jerome M. Vaeth, San Francisco Cancer Symposium

220 Radiation Therapy

1996); ISBN: 3805564562; http://www.amazon.com/exec/obidos/ASIN/3805564562/icongroupinterna ·

Intraoperative Radiation Therapy: Proceedings of the Third International Symposium on Intraoperative Radiation Therapy, November 12-15, 1990, Kyoto by Mitsuyuki Abe (Editor), Masaji Takahashi (Editor); ISBN: 0080407021; http://www.amazon.com/exec/obidos/ASIN/0080407021/icongroupinterna

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Introduction to Radiation Therapy by Charles M. Washington (Editor), Dennis T. Leaver (Editor); ISBN: 0815191456; http://www.amazon.com/exec/obidos/ASIN/0815191456/icongroupinterna

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Levitt and Tapley's Technological Basis of Radiation Therapy; ISBN: 0812108981; http://www.amazon.com/exec/obidos/ASIN/0812108981/icongroupinterna

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Levitt and Tapley's Technological Basis of Radiation Therapy: Clinical Applications by Seymour H. Levitt (Editor), et al; ISBN: 0683301233; http://www.amazon.com/exec/obidos/ASIN/0683301233/icongroupinterna

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Linear Accelerators for Radiation Therapy (Medical Science Series) by D. Greene, P. C. Williams; ISBN: 0750304766; http://www.amazon.com/exec/obidos/ASIN/0750304766/icongroupinterna

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Managing the Side Effects of Chemotherapy and Radiation Therapy by Marylin J. Dodd, Marylin J. Dodd; ISBN: 0943671205; http://www.amazon.com/exec/obidos/ASIN/0943671205/icongroupinterna

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Megavoltage Radiotherapy, 1837-1987 (British Journal of Radiology, Supplement 22) by P.N. Plowman, A.N. Harnett (Editor); ISBN: 0905749162; http://www.amazon.com/exec/obidos/ASIN/0905749162/icongroupinterna

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Normal Tissue Reactions in Radiotherapy and Oncology: International Symposium, Marburg, Germany, April 14-16, 2000 (Frontiers of Radiation Therapy and Oncology, Vol 37) by Wolfgang Dorr (Editor), et al; ISBN: 3805572840; http://www.amazon.com/exec/obidos/ASIN/3805572840/icongroupinterna

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Outcomes in Radiation Therapy: Multidisciplinary Management by Deborah Watkins Bruner, et al; ISBN: 0763714798; http://www.amazon.com/exec/obidos/ASIN/0763714798/icongroupinterna

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Poly-radiomodification in the Radiotherapy of Tumors/Thermoradio-therapy in the USSR/Oxybaro- and Hypoxyradiotherapy (Soviet Medical Reviews Series, Section F) by Blokhin, et al; ISBN: 3718652285; http://www.amazon.com/exec/obidos/ASIN/3718652285/icongroupinterna

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Portal Design in Radiation Therapy by Byron G. Dasher; ISBN: 0964271508; http://www.amazon.com/exec/obidos/ASIN/0964271508/icongroupinterna

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Prediction of Response in Radiation Therapy by Donald Ph. D. Herbert; ISBN: 1563962713; http://www.amazon.com/exec/obidos/ASIN/1563962713/icongroupinterna

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Present and Future Role of Monoclonal Antibodies in the Management of Cancer (Frontiers of Radiation Therapy and Oncology, Vol 24) by J.M. Vaeth, J.L. Meyer (Editor); ISBN: 3805550294; http://www.amazon.com/exec/obidos/ASIN/3805550294/icongroupinterna

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Principles of Successful Radiation Therapy by Stanley E. Order; ISBN: 0816121508; http://www.amazon.com/exec/obidos/ASIN/0816121508/icongroupinterna

Books 221

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Proceedings: Radiation Therapy, 8th International Conference (84Ch20487); ISBN: 0818605596; http://www.amazon.com/exec/obidos/ASIN/0818605596/icongroupinterna

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Proton Radiotherapy Accelerators by Wioletta Wieszczycka, Waldemar Henryk Schaf; ISBN: 9810245289; http://www.amazon.com/exec/obidos/ASIN/9810245289/icongroupinterna

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Psychosocial Aspects of Radiation Therapy : The Patient, the Family and the Staff by Patricia Tretter; ISBN: 0405130961; http://www.amazon.com/exec/obidos/ASIN/0405130961/icongroupinterna

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Radiation Therapy and Thanatology by Richard J. Torpie; ISBN: 0398048851; http://www.amazon.com/exec/obidos/ASIN/0398048851/icongroupinterna

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Radiation therapy and you : a guide to self-help during cancer treatment (SuDoc HE 20.3158:R 11/2001) by U.S. Dept of Health and Human Services; ISBN: B000115CVA; http://www.amazon.com/exec/obidos/ASIN/B000115CVA/icongroupinterna

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Radiation Therapy and You: A Guide to Self-Help During Treatment by Barry Leonard (Editor); ISBN: 0756705177; http://www.amazon.com/exec/obidos/ASIN/0756705177/icongroupinterna

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Radiation Therapy for Head and Neck Neoplasms, 3rd Edition by C. C. Wang (Author); ISBN: 0471149713; http://www.amazon.com/exec/obidos/ASIN/0471149713/icongroupinterna

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Radiation therapy in cancer management by Franz Buschke; ISBN: 0808907255; http://www.amazon.com/exec/obidos/ASIN/0808907255/icongroupinterna

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Radiation Therapy in Pediatric Oncology (Medical Radiology: Diagnostic Imaging and Radiation Oncology) by J.R. Cassady (Editor), et al; ISBN: 3540541055; http://www.amazon.com/exec/obidos/ASIN/3540541055/icongroupinterna

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Radiation Therapy of Benign Disease: Current Indications and Techniques: 33rd San Francisco Cancer Symposium, San Francisco, Calif., April 3-4, 1999 (Frontiers of Radiation Therapy and Oncology, Vol 35) by J. L. Meyer (Editor); ISBN: 3805570635; http://www.amazon.com/exec/obidos/ASIN/3805570635/icongroupinterna

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Radiation Therapy of Benign Diseases: A Clinical Guide (Medical Radiology) by Stanley E. Order, et al; ISBN: 3540005757; http://www.amazon.com/exec/obidos/ASIN/3540005757/icongroupinterna

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Radiation Therapy of Head and Neck Cancer; ISBN: 354019360X; http://www.amazon.com/exec/obidos/ASIN/354019360X/icongroupinterna

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Radiation Therapy Physics by William R. Hendee, Geoffrey S. Ibbott; ISBN: 0801680999; http://www.amazon.com/exec/obidos/ASIN/0801680999/icongroupinterna

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Radiation Therapy Physics (Medical Radiology: Diagnostic Imaging and Radiation Oncology) by A.R. Smith (Editor), et al; ISBN: 3540554300; http://www.amazon.com/exec/obidos/ASIN/3540554300/icongroupinterna

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Radiation Therapy Planning by Norman M. Bleehen (Editor); ISBN: 0824718305; http://www.amazon.com/exec/obidos/ASIN/0824718305/icongroupinterna

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Radiation Therapy Planning by Gunilla C. Bentel (Author); ISBN: 0070051151; http://www.amazon.com/exec/obidos/ASIN/0070051151/icongroupinterna

222 Radiation Therapy

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Radiation Therapy With Heavy Particles and Fast Electrons (Radiology Review, No 2) by R. Silverman (Editor); ISBN: 0815507909; http://www.amazon.com/exec/obidos/ASIN/0815507909/icongroupinterna

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Radiobiology in Radiotherapy by Norman M. Bleehen (Editor); ISBN: 0387195033; http://www.amazon.com/exec/obidos/ASIN/0387195033/icongroupinterna

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Radiobiology of Human Cancer Radiotherapy. 2d Ed by John Robert Andrews; ISBN: 0839111614; http://www.amazon.com/exec/obidos/ASIN/0839111614/icongroupinterna

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Radiotherapy and Cancer Immunology (CRC Series in High Level Radiation and Immunology) by Naresh Prasad; ISBN: 0849359015; http://www.amazon.com/exec/obidos/ASIN/0849359015/icongroupinterna

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Radiotherapy in Cancer Management: A Practical Manual by J. Stjernsward (Editor), G. P. Hanson (Editor); ISBN: 0412635801; http://www.amazon.com/exec/obidos/ASIN/0412635801/icongroupinterna

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Radiotherapy Principles and Practices by Griffiths; ISBN: 0443047839; http://www.amazon.com/exec/obidos/ASIN/0443047839/icongroupinterna

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Radiotherapy Safety: Proceedings of a Short Course Held at the University of Wisconsin, Madison, Wisconsin, March 25-26, 1982 by Bruce Thomadsen (Editor); ISBN: 0883184435; http://www.amazon.com/exec/obidos/ASIN/0883184435/icongroupinterna

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Radiotherapy Treatment Planning (Medical Physics Handbook 14) by Richard F. Mould; ISBN: 0852747888; http://www.amazon.com/exec/obidos/ASIN/0852747888/icongroupinterna

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Radiotherapy/Chemotherapy Interactions in Cancer Therapy: Potential Benefits and Hazards in the Clinic/26th Annual San Francisco Cancer Symposium, S (Frontiers of Radiation Therapy and Oncology, Vol. 26) by Jerome San Francisco Cancer Symposium 1991)/ Vaeth (Editor); ISBN: 3805554931; http://www.amazon.com/exec/obidos/ASIN/3805554931/icongroupinterna

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Radiotherapy-Pediatric Oncology-Neurooncology (International Cancer Congress, Lectures and Symposia, Vol 8) by K. Lapis, S. Eckhardt (Editor); ISBN: 3805544243; http://www.amazon.com/exec/obidos/ASIN/3805544243/icongroupinterna

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Scientific Basis of Modern Radiotherapy (British Institute Radiology Report Ser.: No. 19) by N.J. McNally (Editor); ISBN: 0905749200; http://www.amazon.com/exec/obidos/ASIN/0905749200/icongroupinterna

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Secondary Neoplasias Following Chemotherapy, Radiotherapy and Immunosuppression: Secondary Neoplasias After Organ Transplants and Radiotherapy by W. Queisser (Editor), et al; ISBN: 380557116X; http://www.amazon.com/exec/obidos/ASIN/380557116X/icongroupinterna

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Short Textbook of Radiotherapy: Radiation Physics, Therapy, Oncology by Joseph Walter; ISBN: 0443013896; http://www.amazon.com/exec/obidos/ASIN/0443013896/icongroupinterna

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Simplified Radiotherapy for Technicians by Barbara Howl; ISBN: 0398023182; http://www.amazon.com/exec/obidos/ASIN/0398023182/icongroupinterna

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Sing-Radiotherapy Riffany, Fa by Ber and; ISBN: 057111363X; http://www.amazon.com/exec/obidos/ASIN/057111363X/icongroupinterna

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The Basic Physics of Radiation Therapy by Joseph Selman; ISBN: 0398056854; http://www.amazon.com/exec/obidos/ASIN/0398056854/icongroupinterna

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The Lymphatic System and Cancer: Mechanisms and Clinical Management (Frontiers of Radiation Therapy and Oncology, Vol 28) by John L. Meyer, Jerome M. Vaeth (Editor); ISBN: 3805558899; http://www.amazon.com/exec/obidos/ASIN/3805558899/icongroupinterna

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The Nurse and Radiotherapy: A Manual for Daily Care by Irene M. Leahy; ISBN: 0801628962; http://www.amazon.com/exec/obidos/ASIN/0801628962/icongroupinterna

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The Physics of Radiotherapy X-Rays from Linear Accelerators by Peter Metcalfe, et al; ISBN: 0944838766; http://www.amazon.com/exec/obidos/ASIN/0944838766/icongroupinterna

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The Physics of Three-Dimensional Radiation Therapy: Conformal Radiotherapy, Radiosurgery, and Treatment Planning (Medical Science) by Steve Webb; ISBN: 0750302542; http://www.amazon.com/exec/obidos/ASIN/0750302542/icongroupinterna

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The Q Book: The Physics of Radiotherapy X-Rays Problems & Solutions by Peter Metcalfe, et al; ISBN: 0944838863; http://www.amazon.com/exec/obidos/ASIN/0944838863/icongroupinterna

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The Radiation Therapy Workbook by Julius B. Armstrong, Thomas Morgan III; ISBN: 0943589223; http://www.amazon.com/exec/obidos/ASIN/0943589223/icongroupinterna

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The Radiotherapy of Malignant Disease by Eric C. Easson; ISBN: 0387131043; http://www.amazon.com/exec/obidos/ASIN/0387131043/icongroupinterna

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The Role of High Energy Electrons in the Treatment of Cancer (Frontiers of Radiation Therapy and Oncology, Vol 25) by Jerome M. Vaeth, John L. Meyer (Editor); ISBN: 3805552351; http://www.amazon.com/exec/obidos/ASIN/3805552351/icongroupinterna

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The Use of Computers in Radiation Therapy by P.H. van der Giessen, et al; ISBN: 0444702636; http://www.amazon.com/exec/obidos/ASIN/0444702636/icongroupinterna

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Three-Dimensional Radiation Treatment: Technological Innovations and Clinical Results Symposium on 3-D Radiation Treatment: Technological Innovations and Clinical Results, Munich, 03/1999 (Frontiers of Radiation Therapy and Oncology, Vol 34) by Symposium on 3-D Radiation Treatment: Technological Innovations and Cl, et al; ISBN: 3805569475; http://www.amazon.com/exec/obidos/ASIN/3805569475/icongroupinterna

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Treatment Planning in the Radiation Therapy of Cancer (Frontiers of Radiation Therapy and Oncology, Vol 21) by J. Meyer (Editor), Jerome M. Vaeth; ISBN: 3805543778; http://www.amazon.com/exec/obidos/ASIN/3805543778/icongroupinterna

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Urological Complications of Pelvic Surgery and Radiotherapy by Michael A. S. Jewett (Editor); ISBN: 1899066144; http://www.amazon.com/exec/obidos/ASIN/1899066144/icongroupinterna

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Veterinary Cancer Therapy Handbook: Chemotherapy, Radiation Therapy, and Surgical Oncology for the Practicing Veterinarian by Barbara Kitchell, et al; ISBN:

224 Radiation Therapy

1583260080; http://www.amazon.com/exec/obidos/ASIN/1583260080/icongroupinterna ·

Walter and Miller's Textbook of Radiotherapy: Radiation Physics, Therapy and Oncology by C. K. Bomford, et al; ISBN: 0443028737; http://www.amazon.com/exec/obidos/ASIN/0443028737/icongroupinterna

Chapters on Radiation Therapy In order to find chapters that specifically relate to radiation therapy, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and radiation therapy using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “radiation therapy” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on radiation therapy: ·

Radiation Therapy Source: in Lydiatt, W.M. and Johnson, P.J. Cancers of the Mouth and Throat: A Patient's Guide to Treatment. Omaha, NE: Addicus Books, Inc. 2001. p. 64-75. Contact: Available from Addicus Books, Inc. P.O. Box 45327, Omaha, NE 68145. (402) 330-7493. Fax (402) 330-1707. E-mail: [email protected]. Website: www.AddicusBooks.com. PRICE: $14.95 plus shipping and handling. ISBN: 1886039445. Summary: Almost two-thirds of people with mouth or throat cancer will receive radiation therapy, which kills fast growing cells directly or keeps them from reproducing. Normal cells, too, are damaged by radiation, but they can better repair the damage, whereas cancer cells typically cannot. This chapter on radiation therapy to treat cancer is from a book that is designed to help patients and their families better understand cancers of the head and neck, including cancers of the mouth, throat, voice box (larynx), sinuses, thyroid, and salivary glands. This book supports the idea that the better informed the patient is, the better questions they can ask and the more they can be involved in their own treatment. The authors explain in nontechnical terms how the decision to use radiation involves a careful weighing of the potential risks and side effects against the benefits. Topics include the steps involved in radiation therapy, including consultation, simulation, shields, and delivery of treatment; the short term side effects of radiation, including dry mouth (xerostomia), mucositis (inflammation of the lining of the mouth) and mouth sores, difficulty swallowing (dysphagia) and loss of taste, dental problems, middle ear fluid and hearing loss, eye problems, skin changes, and fatigue; and long term side effects, including bone and tissue injury, chronic skin changes, chronic swelling, decreased jaw opening, and secondary cancer formation.

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Principles and Complications of Radiation Therapy Source: in Ord, R.A. and Blanchaert, R.H., eds. Oral Cancer: The Dentist's Role in Diagnosis, Management, Rehabilitation, and Prevention. Chicago, IL: Quintessence Publishing Co, Inc. 1999. p. 111-122. Contact: Available from Quintessence Publishing Co, Inc. 551 Kimberly Drive, Carol Stream, IL 60188-9981. (800) 621-0387. Fax (630) 682-3288. E-mail: [email protected].

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Website: www.quintpub.com. PRICE: $79.00 plus shipping and handling. ISBN: 0867153571. Summary: Radiation therapy has a well established role in the treatment of patients with carcinoma of the oral cavity. This chapter on the principles and complications of radiation therapy for oral cancer is from a book written specifically for dental health care providers, including dental students, general dentists, dental specialists, and hygienists. The author discusses external beam therapy, altered fractionation, brachytherapy (the use of localized doses of radiation that can spare surrounding normal tissues), intraoral cone irradiation, treatment philosophies (for carcinoma of the lip, for the anterior two thirds of the tongue, for the floor of the mouth, for the buccal mucosa, and for the retromolar trigone), and normal tissue toxicities, including those affecting the mucous membranes, sense of taste, salivary tissue, bone (osteoradionecrosis), and skin. The author concludes that radiation therapy will continue to have a major role in the management of the early stage of the disease, as technologic advances have improved the ability to maximize doses to well defined targets while simultaneously limiting radiation doses to the surrounding normal tissue. 21 references. ·

Management of Patients Receiving Antineoplastic Agents and Radiation Therapy Source: in Bottomley, W.K. and Rosenberg, S.W., eds. Clinician's Guide to Treatment of Common Oral Conditions. 4th ed. Baltimore, MD: American Academy of Oral Medicine (AAOM). 1997. p. 14-16. Contact: Available from American Academy of Oral Medicine (AAOM). 2910 Lightfoot Drive, Baltimore, MD 21209-1452. (410) 602-8585. Website: www.aaom.com. PRICE: $21.00 plus shipping and handling. Summary: This brief chapter is from a quick reference guide to the management of some common oral conditions. It discusses the management of patients receiving antineoplastic agents and radiation therapy. The authors provide a summary of the problems triggered by cancer chemotherapy and radiation to the head and neck, describe the clinical presentation, and outline the rationale for treatment. Recommended prescription agents, including mouth rinses, drugs for gingivitis and caries control, topical anesthetics, and antifungals are noted. The chapter includes a patient information sheet, designed to be distributed to patients, that discusses guidelines for rinses, care of the teeth and gums, nutrition, maintenance, and supportive care.

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Radiation Therapy Patient: Treatment Planning and Posttreatment Care Source: in Taylor, T.D., ed. Clinical Maxillofacial Prosthetics. Chicago, IL: Quintessence Publishing Co, Inc. 2000. p. 37-52. Contact: Available from Quintessence Publishing Co, Inc. 551 Kimberly Drive, Carol Stream, IL 60188-9981. (800) 621-0387 or (630) 682-3223. Fax (630) 682-3288. E-mail: [email protected]. Website: www.quintpub.com. PRICE: $138.00 plus shipping and handling. ISBN: 0867153911. Summary: This chapter is from a textbook that offers an indepth review of prosthodontic (the construction of artificial appliances that replace missing teeth or restore parts of the face) procedures as they are applied in the maxillofacial (jaw) situation. This chapter covers treatment planning and posttreatment care for patients undergoing radiation therapy. The author stresses that early dental intervention is the most important factor in preventing the possibility of infection during active phases of

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chemotherapy and in reducing the potential for both short and long term problems in the patient undergoing radiation. The author discusses the dental examination and treatment plan, including restorative procedures and dental extractions, and preradiation prosthodontic care; dental management during radiation therapy, to manage mucositis, loss of taste, xerostomia (dry mouth), dental caries, the use of saliva substitutes, trismus (lack of ability to open the mouth) and fibrosis; the use of shielding and positioning stents; and dental management following radiation, including how to manage mucositis and loss of taste, xerostomia and dental caries, candidiasis (thrush, a fungal infection), trismus and fibrosis, dental extractions, osteoradionecrosis (bone death), and postradiation prosthodontic care. The author stresses that dentists assuming the responsibility for treating this group of patients must be willing to make a long term commitment to each individual patient's care. The chapter is illustrated with full color and black and white photographs and radiographs. 14 figures. 11 references. ·

Cytotoxic Chemotherapy and Radiotherapy Source: in Scully, C. and Cawson, R.A. Medical Problems in Dentistry. 4th ed. Woburn, MA: Butterworth-Heinemann. 1998. p. 145-153. Contact: Available from Butterworth-Heinemann. 225 Wildwood Avenue, Woburn, MA 01801-2041. (800) 366-2665 or (781) 904-2500. Fax (800) 446-6520 or (781) 933-6333. E-mail: [email protected]. Website: www.bh.com. PRICE: $110.00. ISBN: 0723610568. Summary: This chapter on cytotoxic chemotherapy and radiotherapy (radiation therapy) is from a text that covers the general medical and surgical conditions relevant to the oral health care sciences. Topics include the complications of cytotoxic chemotherapy, including infections, ulcers and mucositis, lip cracking, bleeding, xerostomia (dry mouth), and delayed and abnormal development of the teeth and jaws; the dental management of patients on cytotoxic chemotherapy; the complications of radiation therapy involving the oral cavity or salivary glands, including mucositis, xerostomia and infections, radiation caries and dental hypersensitivity, loss of taste, trismus (reduction of mouth opening), osteoradionecrosis (bone death) and osteomyelitis (bone marrow infection), and craniofacial defects; and the dental management of patients receiving radiotherapy to the head and neck. Extensive tables summarize the various chemotherapeutic agents and their main uses. The chapter includes a lengthy summary of the points covered. 1 figure. 4 tables. 37 references.

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Management of the Patient Undergoing Radiotherapy or Chemotherapy Source: in Peterson, L.J., et al., eds. Contemporary Oral and Maxillofacial Surgery. 3rd ed. St. Louis, MO: Mosby-Year Book, Inc. 1998. p. 456-468. Contact: Available from Mosby-Year Book, Inc. 11830 Westline Industrial Drive, St. Louis, MO 63146. PRICE: $69.00. ISBN: 0815166990. Summary: This chapter on management of the patient undergoing radiotherapy (radiation therapy) or chemotherapy is from a textbook that provides a comprehensive description of the basic oral surgery procedures that the general practitioner performs in his or her office. The basic techniques of evaluation, diagnosis, and medical management are described in sufficient detail to allow immediate clinical application. The first section covers radiation effects on oral mucosa, radiation effects on salivary glands, the treatment of xerostomia (dry mouth), radiation effects on bone, other effects of radiation, evaluation of the dentition before radiation therapy, preparation of the dentition for radiation therapy, maintenance after irradiation, a method of performing preirradiation extractions, the interval between preirradiation extractions and the

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beginning of radiotherapy, impacted third molar removal before radiotherapy, a method of dealing with carious teeth (those with cavities) after radiation therapy, tooth extraction after radiation therapy, denture considerations, the use of dental implants in patients who have been irradiated, and the management of patients who develop osteoradionecrosis. The second section focuses on the dental management of patients on systemic chemotherapy for malignant disease (cancer). Topics include the effects on the oral mucosa, on the hematopoietic system, on the oral microbiology, general dental management, and the treatment of oral candidiasis. The chapter is illustrated with black and white photographs and radiographs. 14 figures. 32 references. ·

Mouth Problems: Dry Mouth, Xerostomia (Radiation Therapy) Source: in Dodd, M.J. Managing the Side Effects of Chemotherapy and Radiation Therapy: A Guide for Patients and Their Families. 3rd ed. San Francisco, CA: School of Nursing, University of California, San Francisco. 1996. p. 161-162. Contact: Available from UCSF Nursing Press. School of Nursing, University of California, San Francisco, 521 Parnassus Avenue, San Francisco, CA 94143-0608. (415) 476-2626. PRICE: $26.00 per copy. ISBN: 0943671120. Summary: This chapter on mouth problems resulting from radiation therapy is from a handbook designed to help patients and their families get through cancer treatment and on the road to recovery. This chapter discusses xerostomia (dry mouth). The author describes what can happen, notes the anticipated duration of the complication, and then lists recommended self-care measures. Self-care measures focus on oral hygiene and proper nutrition. Recommendations for when to consult a health care provider are given.

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Oral Care of the Patient Receiving Radiation Therapy Source: in Ord, R.A. and Blanchaert, R.H., eds. Oral Cancer: The Dentist's Role in Diagnosis, Management, Rehabilitation, and Prevention. Chicago, IL: Quintessence Publishing Co, Inc. 1999. p. 149-164. Contact: Available from Quintessence Publishing Co, Inc. 551 Kimberly Drive, Carol Stream, IL 60188-9981. (800) 621-0387. Fax (630) 682-3288. E-mail: [email protected]. Website: www.quintpub.com. PRICE: $79.00 plus shipping and handling. ISBN: 0867153571. Summary: This chapter on the oral care of the patient receiving radiation therapy for oral cancer is from a book written specifically for dental health care providers, including dental students, general dentists, dental specialists, and hygienists. The author notes that the reaction of the tissues of the head and neck, both perioral and oral, varies with the type of radiation used, area of exposure, dose given per fraction, time between fractions, duration of treatment, and total dose received. Radiation causes both acute and chronic tissue changes that have a profound effect on oral health during and after radiation therapy. Unlike chemotherapy, the transient effects of radiation therapy are chronic, irreversible, and progressive due to permanent damage to the proliferative cells of the head and neck. The author discusses the acute complications of radiation therapy, including mucositis, taste alterations (hypogeusia), infectious stomatitis, dermatitis, and dysphagia (swallowing disorder). The author then discusses the chronic, permanent changes associated with radiation therapy, including xerostomia (dry mouth), radiation caries (tooth cavities), trismus (limited mouth opening), periodontal deterioration, decreased resiliency in perioral tissue, intrinsic bone changes, and osteoradionecrosis. The author emphasizes that effective oral care requires appropriate preventive and

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interceptive therapy, patient and family education, and close observation. The maintenance of oral health during and after radiation therapy requires an investment of time and effort beyond that needed for normal oral care on the part of the patient and the practitioner. The chapter is illustrated with full color photographs of the complications discussed. 14 figures. 56 references. ·

Iatrogenic Causes of Taste Disturbances: Radiation Therapy, Surgery, and Medication Source: in Doty, R.L., ed. Handbook of Olfaction and Gustation. New York, NY: Marcel Dekker, Inc. 1995. p. 785-791. Contact: Available from Marcel Dekker, Inc. 270 Madison Avenue, New York, NY 10016. (800) 228-1160 or (212) 696-9000; Fax (212) 685-4540. PRICE: $225.00 plus shipping and handling. ISBN: 0824792521. Summary: This chapter, from a medical text on olfaction and gustation, discusses the iatrogenic causes of taste disturbances, including those attributable to radiation therapy, surgery, and medication. The authors note that recent findings concerning the physiology of taste cells, taste transduction mechanisms, and central nervous system (CNS) processing of gustatory information are beginning to provide some basis for understanding mechanisms for these iatrogenically-caused taste disturbances. Topics covered include surgical procedures of the head or neck that damage cranial nerves innervating the taste structures, or any of the central neural pathways involved in gustation; surgical risk; tonsillectomy; radiation-induced taste dysfunction, including that due to damage of the salivary glands; taste dysfunction as a side effect of drug therapy; and some of the medications associated with alterations in taste function. 57 references. (AA-M).

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CHAPTER 7. MULTIMEDIA ON RADIATION THERAPY Overview In this chapter, we show you how to keep current on multimedia sources of information on radiation therapy. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

Video Recordings An excellent source of multimedia information on radiation therapy is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “radiation therapy” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “radiation therapy” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on radiation therapy: ·

Health Care Professionals' Guide to Oral Cancer Source: Fairburn, GA: Oral Health Education Foundation. 1996. (videocassette). Contact: Available from American Dental Hygienists' Association (ADHA). 444 North Michigan Avenue, Suite 3400, Chicago, IL 60611. (800) 243-2342 (press 2) or (312) 4408900. Fax (312) 467-1806. Website: www.adha.org. PRICE: $15.00 each. Item Number 3673 DEV. Summary: The diagnosis, treatment, rehabilitation, and maintenance of oral cancer patients are explored in this multi-disciplinary educational video for health care professionals. Throughout the video, the importance of early detection and diagnosis is emphasized. The program discusses risk factors, including age and lifestyle factors such as alcohol and tobacco use. The video reviews epidemiology, including the most common types of oral cancer. The program describes typical symptoms, appearance, and classification of oral cancers and precancerous conditions including leukoplakia and

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erythroplakia. The potential role of diet in reducing risk for oral cancer is discussed. The program addresses diagnostic issues, including step-by-step guidelines for performing an oral cancer examination, the common presenting signs of oral cancer, the role of histologic confirmation of suspected lesions, and the use of imaging. Treatment considerations discussed include radiation therapy, surgery, chemotherapy, indications for surgery, the benefits and disadvantages of surgery, the importance of speech and swallowing assessments prior to surgery, and the need for dental evaluation and possible treatment before surgery. Rehabilitation and maintenance issues described includes prostheses, cosmetic surgery, speech and swallowing rehabilitation, audiologic monitoring, physical therapy, psychological testing and counseling, and ongoing oral health and dental care. The program briefly mentions the SPOHNC (Support for People with Oral and Head and Neck Cancer) organization and its newsletter. Each segment provides recommendations for referral services and the program concludes by reiterating the importance of coordination among health care providers involved in the care of patients with oral cancer. ·

What You Should Know About Xerostomia (Dry Mouth) Source: Fairburn, GA: National Oral Cancer Awareness (NOCAP). 199x. (videocassette). Contact: Available from American Dental Hygienists' Association (ADHA). 444 North Michigan Avenue, Suite 3400, Chicago, IL 60611. (800) 243-2342 (press 2) or (312) 4408900. Fax (312) 467-1806. Website: www.adha.org. PRICE: $18.00. Item Number 3917 COM. Summary: This videocassette program describes the problem of xerostomia (dry mouth). The introduction stresses that the health impact of saliva goes far beyond the mouth and includes eating, talking, tooth maintenance, and tasting. The program then features a person with xerostomia describing how it feels to have problems with dry mouth. A brief description of the chemical makeup of salivary and the anatomy of the salivary glands follow. The next section discusses the potential causes of xerostomia, including radiation therapy, especially for cancer of the head and neck; drug effects, particularly from antihistamines, tranquilizers, and some blood pressure medications; anxiety or depression, even without drug therapy; dehydration; and systemic diseases, including Sjogren's syndrome, lupus, cystic fibrosis, rheumatoid arthritis, and scleroderma. The narrator stresses that aging itself is not necessarily the cause of xerostomia. Complications of xerostomia include dry lips, burning mouth or tongue, constant thirst, difficulty talking or swallowing, impaired taste, dental caries (cavities), candidiasis (a fungal infection), and problems related to dehydration. Viewers are encouraged to work closely with health care providers to obtain an accurate diagnosis and employ strategies to cope with xerostomia. Treatment encompasses three options: eliminating the cause of the xerostomia, if possible; stimulating the salivary glands with sugar-free chewing gum, oral moisturizers, or the prescription drug pilocarpine; and using other measures to get relief, including saliva substitutes, frequent sips of water, room humidifiers (especially during winter), and lip balm. The program concludes with a reminder that xerostomia results in the need for increased attention to dental hygiene, including increased dental visits, limiting sugar intake, the use of fluoride, and the prevention of candidiasis. The program encourages viewers to learn about xerostomia, seek help, and improve the quality of their lives.

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Health Care Professionals' Guide to Xerostomia Source: Bethesda, MD: Sjogren's Syndrome Foundation, Inc. 1997. (videocassette).

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Contact: Available from Sjogren's Syndrome Foundation, Inc. 8120 Woodmont Avenue, Suite 530, Bethesda MD 20814-1437. (301) 718-0300 or (800) 475-6473. Fax (301) 718-0322. Website: www.sjogrens.org. PRICE: $29.00. Summary: This videotape program reviews xerostomia (dry mouth). The program begins with an overview of the anatomy and physiology of the salivary glands, followed by a discussion of the three functional roles of saliva: digestion (and taste facilitation), lubrication, and protection (including antimicrobial and pH mechanisms). The narrator notes that saliva is also being used more and more as a diagnostic tool to measure systemic health. The program begins with a physician narrating, then includes interviews with two middle age women who have xerostomia; the interviews focus on the impact xerostomia has on quality of life and on the difficulties of obtaining an accurate diagnosis. The program then details the three causes of xerostomia: medical therapies (including drug side effects, radiation therapy, and surgery or trauma of the salivary glands), systemic disorders (including Sjogren's syndrome, HIV, rheumatoid arthritis, systemic lupus erythematosus, scleroderma, graft versus host disease, sarcoidosis, amyloidosis, cystic fibrosis, and neural disease affecting the salivary glands), and dehydration. The program emphasizes that xerostomia is not a natural consequence of the aging process. The program then reviews the clinical signs and oral complications of xerostomia; each is illustrated with a color photograph. Other topics include problems associated with xerostomia, the need for a multidisciplinary team approach to patients with salivary gland dysfunction, diagnostic tests used, treatment options (including chewing activity, oral moisturizing agents, and oral pilocarpine hydrochloride), determining residual salivary gland function, and the behavioral and lifestyle changes that can help patients cope with xerostomia.

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CHAPTER 8. PERIODICALS AND NEWS ON RADIATION THERAPY Overview In this chapter, we suggest a number of news sources and present various periodicals that cover radiation therapy.

News Services and Press Releases One of the simplest ways of tracking press releases on radiation therapy is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing.

PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “radiation therapy” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance.

Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to radiation therapy. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “radiation therapy” (or synonyms). The following was recently listed in this archive for radiation therapy: ·

Early salvage radiotherapy treats "incurable" recurrent prostate cancer Source: Reuters Industry Breifing Date: March 16, 2004

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Utilization of radiotherapy for breast cancer suboptimal Source: Reuters Medical News Date: November 12, 2003

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Targeted high-dose radiotherapy benefits inoperable lung cancer patients Source: Reuters Medical News Date: November 12, 2003

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Radiation therapy underused for breast cancer Source: Reuters Health eLine Date: November 12, 2003

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Single-fraction radiotherapy effectively treats painful bone metastases Source: Reuters Medical News Date: October 20, 2003

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Limited-field radiotherapy provides adequate local control for early breast cancer Source: Reuters Medical News Date: August 19, 2003

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Radiotherapy reduces risk of invasive cancer after surgery for DCIS Source: Reuters Medical News Date: July 10, 2003

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Radiotherapy access must be improved in developing world: UN Source: Reuters Medical News Date: June 26, 2003

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Endothelial cell apoptosis influences tumor response to radiotherapy Source: Reuters Industry Breifing Date: May 16, 2003

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FDA seeks injunction against radiation therapy devices firm Source: Reuters Industry Breifing Date: May 07, 2003

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Predictors of PSA relapse after radiotherapy for prostate cancer identified Source: Reuters Medical News Date: March 14, 2003

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Phototherapy may enhance tumor sensitivity to radiation therapy Source: Reuters Industry Breifing Date: February 28, 2003

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Radiation therapy controls local disease in patients with osteosarcoma of the extremities Source: Reuters Industry Breifing Date: February 17, 2003

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Salvage radiotherapy shows promise for PSA recurrence after prostatectomy Source: Reuters Industry Breifing Date: January 03, 2003

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Carbon ion radiotherapy helpful in unresectable sarcomas Source: Reuters Medical News Date: December 04, 2002

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Radiation therapy turns patient into terror suspect Source: Reuters Health eLine Date: December 03, 2002

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Adjuvant radiotherapy after lumpectomy reduces recurrence of very small tumors Source: Reuters Industry Breifing Date: October 22, 2002

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Once-daily granisetron most effective for nausea in abdominal radiation therapy Source: Reuters Industry Breifing Date: October 09, 2002

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Temozolomide improves response of brain metastases to radiation therapy Source: Reuters Medical News Date: October 08, 2002

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Guidant wins US nod for updated radiotherapy system Source: Reuters Industry Breifing Date: September 24, 2002

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Intra-operative radiotherapy good alternative after breast-conserving surgery Source: Reuters Medical News Date: September 18, 2002

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Surgery, radiotherapy equivalent for localized prostate cancer Source: Reuters Medical News Date: August 29, 2002

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Younger prostate cancer patients at risk for treatment failure with radiotherapy Source: Reuters Medical News Date: August 07, 2002

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Joint venture to develop biodegradable silicon for radiation therapy Source: Reuters Industry Breifing Date: August 01, 2002

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Intracoronary radiation therapy effective in diabetics with in-stent restenosis Source: Reuters Industry Breifing Date: July 01, 2002

The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine.

Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name.

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Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “radiation therapy” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests.

Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “radiation therapy” (or synonyms). If you know the name of a company that is relevant to radiation therapy, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/.

BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “radiation therapy” (or synonyms).

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “radiation therapy” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on radiation therapy: ·

Early and Late Side Effects of Radiation Therapy for Head and Neck Cancers Source: News from SPOHNC. News from Support for People with Oral and Head and Neck Cancer, Inc. 10(4): 1-3. Winter 2000. Contact: Available from Support for People with Oral and Head and Neck Cancer, Inc. (SPOHNC). P.O. Box 53, Locust Valley, NY 11560-0053. (516) 759-5333. E-mail: [email protected]. Website: www.spohnc.org. Summary: Radiation therapy plays an important role in the treatment of head and neck cancers. With the new imaging modalities and sophisticated treatment planning and

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delivery systems, it is possible today to deliver radiation more precisely, but still not without some side effects to the normal tissues in the vicinity of the tumor bearing area. This article briefly discusses the early and late side effects of curative irradiation for head and neck cancers. Early side effects discussed include fatigue, radiation dermatitis (skin changes in the area under treatment, something like sunburn), mucositis (inflammation of the mucous membranes lining the mouth and throat), loss of taste and smell, and impaired hearing. Late side effects (more than 3 months after radiation therapy) discussed include xerostomia (dry mouth), osteoradionecrosis (bone disease, notably necrosis or death of the jawbone), dry eyes, hair loss, laryngeal edema (swelling of the voice box), hypothyroidism, delayed wound healing, stiffness in the muscles that open and close the mouth, and risk of secondary cancers. The authors briefly describe each of these problems, how they may be treated, and what the patient can expect in terms of recovery. ·

Effects of Hyperbaric Oxygen on Cancer Patients Who Have Received Radiation Therapy Source: News from SPOHNC. News from Support for People with Oral and Head and Neck Cancer, Inc. 11(9): 1-3. Summer 2002. Contact: Available from Support for People with Oral and Head and Neck Cancer, Inc. (SPOHNC). P.O. Box 53, Locust Valley, NY 11560-0053. (516) 759-5333. E-mail: [email protected]. Website: www.spohnc.org. Summary: This newsletter article explores the effects of hyperbaric oxygen therapy for cancer patients who have received radiation therapy for head and neck or oral cancer. Radiation therapy can result in loss of blood flow to the irradiated areas, making healing difficult and sometimes progressing to osteoradionecrosis (bone tissue death due to radiation therapy). Hyperbaric oxygen is currently the most effective treatment to improve radiated tissues. In most cases, it can prevent osteoradionecrosis if used before dental surgeries, mouth surgeries, or other surgeries in the radiated area. Hyperbaric oxygen also remains the mainstay of treating osteoradionecrosis if it has already developed. The author discusses the indications for hyperbaric oxygen therapy, who would be most likely to benefit, the treatment itself and the time required to complete it, safety considerations, and insurance coverage. 5 references.

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Radiation Therapy of Head and Neck Tumors Source: News from SPOHNC. News from Support for People with Oral and Head and Neck Cancer, Inc. 9(6): 1-3. March 2000. Contact: Available from Support for People with Oral and Head and Neck Cancer, Inc. (SPOHNC). P.O. Box 53, Locust Valley, NY 11560-0053. (516) 759-5333. E-mail: [email protected]. Website: www.spohnc.org. Summary: This newsletter article reviews the radiation therapy of head and neck tumors. After a brief review of the historical use of radiation, the author explains how radiation therapy is used and why it works. The author also discusses the factors that determine the number of treatments that will be used, how normal structures are protected from the effects of radiation, the side effects of radiation to the head and neck area, the importance of pretreatment dental management bringing the oral cavity and dentition to a state of optimal health, care of the skin during and after radiation treatment, fatigue as a side effect of radiation treatment, and the need to consider nutrition during treatment. The author emphasizes the importance of informing patients of the need for proper oral health care before the treatments begin. 2 tables.

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·

Acupuncture to Treat Xerostomia (Dry Mouth) in Head and Neck Cancer Patients Following Radiation Therapy Source: News from SPOHNC. News from Support for People with Oral and Head and Neck Cancer, Inc. 11(5): 6. February 2002. Contact: Available from Support for People with Oral and Head and Neck Cancer, Inc. (SPOHNC). P.O. Box 53, Locust Valley, NY 11560-0053. (516) 759-5333. E-mail: [email protected]. Website: www.spohnc.org. Summary: Xerostomia (dry mouth) is experienced by approximately 70 percent of patients after receiving radiation therapy for treatment of oral and head and neck cancer. This brief newsletter article explores the use of acupuncture to treat xerostomia following radiation therapy. The author first reviews the anatomy and the physiology of the salivary glands and then explains what happens to the salivary glands during radiation. The author then describes the acupuncture technique that was developed to help overcome dry mouth in patients who have been irradiated for oral and head and neck cancer. More than 70 patients have been treated since 1999 with this acupuncture technique, with various degrees of saliva restoration without complications. The treatment consists of three small needles placed in each ear and one needle placed near the tip of both index fingers. The patient produces saliva in approximately 20 to 30 minutes. Several follow up treatments are required and in the majority of cases, the saliva flow may be permanently reestablished. For the most part, those patients treated with acupuncture have found that it is superior to costly drug therapy. Although the resulting production and quality of saliva may not be completely normal, it has permitted many patients to enjoy a better quality of life: gum can be chewed, candy dissolves, food can be swallowed with less difficulty, and talking is not constantly interrupted by frequent sips of water. The contact information for the author (who developed the acupuncture treatment) is available for readers wishing to obtain additional information. 2 references.

Academic Periodicals covering Radiation Therapy Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to radiation therapy. In addition to these sources, you can search for articles covering radiation therapy that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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CHAPTER 9. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for radiation therapy. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a non-profit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DIÒ Advice for the PatientÒ can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with radiation therapy. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.).

240 Radiation Therapy

The following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to radiation therapy: Amifostine ·

Systemic - U.S. Brands: Ethyol http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203557.html

Corticosteroids ·

Rectal - U.S. Brands: Anucort-HC; Anu-Med HC; Anuprep HC; Anusol-HC; Anutone-HC; Anuzone-HC; Cort-Dome; Cortenema; Cortifoam; Hemorrhoidal HC; Hemril-HC Uniserts; Proctocort; Proctosol-HC; Rectosol-HC http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203366.html

Granisetron ·

Systemic - U.S. Brands: Kytril http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202724.html

Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.

Mosby’s Drug ConsultÔ Mosby’s Drug ConsultÔ database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/.

PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html.

Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee.

Researching Medications 241

Researching Orphan Drugs Although the list of orphan drugs is revised on a daily basis, you can quickly research orphan drugs that might be applicable to radiation therapy by using the database managed by the National Organization for Rare Disorders, Inc. (NORD), at http://www.rarediseases.org/. Scroll down the page, and on the left toolbar, click on “Orphan Drug Designation Database.” On this page (http://www.rarediseases.org/search/noddsearch.html), type “radiation therapy” (or synonyms) into the search box, and click “Submit Query.” When you receive your results, note that not all of the drugs may be relevant, as some may have been withdrawn from orphan status. Write down or print out the name of each drug and the relevant contact information. From there, visit the Pharmacopeia Web site and type the name of each orphan drug into the search box at http://www.nlm.nih.gov/medlineplus/druginformation.html. You may need to contact the sponsor or NORD for further information. NORD conducts “early access programs for investigational new drugs (IND) under the Food and Drug Administration’s (FDA’s) approval ‘Treatment INDs’ programs which allow for a limited number of individuals to receive investigational drugs before FDA marketing approval.” If the orphan product about which you are seeking information is approved for marketing, information on side effects can be found on the product’s label. If the product is not approved, you may need to contact the sponsor. The following is a list of orphan drugs currently listed in the NORD Orphan Drug Designation Database for radiation therapy: ·

Temoporfin (trade name: Foscan) http://www.rarediseases.org/nord/search/nodd_full?code=1000

·

Sucralfate http://www.rarediseases.org/nord/search/nodd_full?code=176

·

Pilocarpine (trade name: Salagen) http://www.rarediseases.org/nord/search/nodd_full?code=376

·

Sodium phenylbutyrate http://www.rarediseases.org/nord/search/nodd_full?code=913

·

Benzydamine hydrochloride (trade name: Tantum) http://www.rarediseases.org/nord/search/nodd_full?code=919

If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

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APPENDICES

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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute11: ·

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

·

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

·

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

·

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

·

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

·

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

·

National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

·

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

11

These publications are typically written by one or more of the various NIH Institutes.

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·

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

·

National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

·

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

·

National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

·

National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

·

National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

·

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

·

National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

·

National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

·

National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

·

National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

·

National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

·

National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

·

Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

·

National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

·

National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

·

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

·

Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

Physician Resources 247

NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.12 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:13 ·

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

·

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

·

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

·

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

·

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

·

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

·

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

·

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

·

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

·

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

·

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

12 Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 13 See http://www.nlm.nih.gov/databases/databases.html.

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·

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

·

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM Gateway14 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.15 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “radiation therapy” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 23329 2283 1987 122 123 27844

HSTAT16 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.17 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.18 Simply search by “radiation therapy” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

14

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

15

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 16 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 17 18

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

Physician Resources 249

Coffee Break: Tutorials for Biologists19 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.20 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.21 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: ·

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

·

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

19 Adapted from 20

http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 21 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on radiation therapy can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to radiation therapy. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly.

The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below.

Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to radiation therapy. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “radiation therapy”:

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Brain Cancer http://www.nlm.nih.gov/medlineplus/braincancer.html Cancer http://www.nlm.nih.gov/medlineplus/cancer.html Prostate Cancer http://www.nlm.nih.gov/medlineplus/prostatecancer.html Soft Tissue Sarcoma http://www.nlm.nih.gov/medlineplus/softtissuesarcoma.html

Within the health topic page dedicated to radiation therapy, the following was listed: ·

General/Overviews Interventional Radiology Is 21st Century Medicine Source: Society of Interventional Radiology http://www.sirweb.org/patPub/whatIsAnIR.shtml Radiation Therapy - Introduction http://www.nlm.nih.gov/medlineplus/tutorials/radiationtherapyintroductionloa der.html Radiation Therapy Principles Source: American Cancer Society http://www.cancer.org/docroot/ETO/eto_1_3_Radiation_Therapy.asp Radiosurgery Frequently Asked Questions Source: International Radiosurgery Support Association http://www.irsa.org/qa.html Understanding Radiation Therapy: A Guide for Patients and Families Source: American Cancer Society http://www.cancer.org/docroot/ETO/ETO_1_5x_radiation_therapy_guide_for_pa tients_and_families.asp

·

Treatment Epoetin Treatment Source: American Society of Clinical Oncology http://www.asco.org/ac/1%2C1003%2C_12-002214-00_18-0024517-00_19-002451800_20-001%2C00.asp

·

Coping Radiation Therapy Effects Source: American Cancer Society http://www.cancer.org/docroot/MBC/MBC_2x_RadiationEffects.asp?sitearea=M BC

Patient Resources 253

·

Specific Conditions/Aspects Arteriovenous Malformations (AVM): Treatment Source: International Radiosurgery Support Association http://www.irsa.org/avms.html External Beam Therapy (EBT) Source: American College of Radiology, Radiological Society of North America http://www.radiologyinfo.org/content/therapy/external_beam.htm Gamma Knife Source: American College of Radiology, Radiological Society of North America http://www.radiologyinfo.org/content/therapy/gamma_knife.htm How Are Cancers Diagnosed and Treated (Radiation Therapy)? Source: Society of Interventional Radiology http://www.sirweb.org/patPub/cancer.shtml Intensity Modulated Radiation Therapy (IMRT) Source: International Radiosurgery Support Association http://www.irsa.org/imrt.html Interventional Treatments for Liver Disease Source: Society of Interventional Radiology http://www.sirweb.org/patPub/liverDisease.shtml Linear Accelerator (LINAC) Source: American College of Radiology, Radiological Society of North America http://www.radiologyinfo.org/content/therapy/linear_accelerator.htm Nasopharyngeal Radium Irradiation (NRI) Source: National Cancer Institute http://www.cancer.gov/newscenter/pressreleases/NRI Radiation Enteritis (PDQ) Source: National Cancer Institute http://www.cancer.gov/cancerinfo/pdq/supportivecare/radiationenteritis/patien t/ Radiation Therapy for Prostate Cancer http://www.nlm.nih.gov/medlineplus/tutorials/radiationtherapyforprostatecance rloader.html Radioactive Seed Implants: An Effective Cancer Treatment? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00178 Radiofrequency Catheter Ablation (RFA) Source: Society of Interventional Radiology http://www.sirweb.org/patPub/radiofrequencyAblation.shtml Stroke Prevention & Treatments Source: Society of Interventional Radiology http://www.sirweb.org/patPub/strokeTreatments.shtml Treatments: Chemoembolization, Tumor Ablation, and More Source: Society of Interventional Radiology http://www.sirweb.org/patPub/cancerTreatments.shtml

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Typical Treatment Day: Stereotactic Radiosurgery Source: International Radiosurgery Support Association http://www.irsa.org/treatment.html Vascular Access Procedures Source: American College of Radiology, Radiological Society of North America http://www.radiologyinfo.org/content/interventional/vascular-access.htm ·

Children Childhood Tumors Source: International Radiosurgery Support Association http://www.irsa.org/childhood_tumors.html Interventional Radiology for Children Source: Society of Interventional Radiology http://www.sirweb.org/patPub/forChildren.shtml

·

From the National Institutes of Health Radiation Therapy and You: A Guide to Self-Help during Cancer Treatment Source: National Cancer Institute http://www.cancer.gov/cancerinfo/radiation-therapy-and-you/

·

Latest News Breast Radiotherapy Linked to Heart Disease Deaths Source: 03/18/2004, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_16650 .html Correction: Heat Treatment Can Kill Off Some Breast Cancers Source: 03/31/2004, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_16882 .html Microwaves Can Kill Off Some Breast Cancers Source: 03/30/2004, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_16849 .html More News on Radiation Therapy http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/alphanews_r.html#Ra diationTherapy

·

Organizations International Radiosurgery Support Association http://www.irsa.org/ Radiation Therapy Oncology Group http://www.rtog.org/index.html Radiology Info Source: American College of Radiology, Radiological Society of North America http://www.radiologyinfo.org/default.htm

Patient Resources 255

Society of Interventional Radiology http://www.sirweb.org/ ·

Research Radiation for Childhood Cancer May Affect Future Pregnancies Source: American Cancer Society http://www.cancer.org/docroot/NWS/content/NWS_2_1x_Radiation_For_Childh ood_Cancer_May_Affect_Future_Pregnancies.asp Single-Dose Radiation Cost Effective for Cancer Bone Pain Source: American Cancer Society http://www.cancer.org/docroot/NWS/content/NWS_2_1x_SingleDose_Radiation_Cost_Effective_For_Cancer_Bone_Pain.asp

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on radiation therapy. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: ·

We Have Walked in Your Shoes: Radiation Therapy and Chemotherapy for the Oral and Head and Neck Cancer Patient: Part II Source: Locust Valley, New York: SPOHNC (Support for People with Oral and Head and Neck Cancer, Inc.). 2002. 20 p. Contact: Available from SPOHNC (Support for People with Oral and Head and Neck Cancer, Inc.). P. O. Box 53, Locust Valley, New York, 11560-0053. (800) 377-0928. Fax: (516) 671-8794. Website: www.spohnc.org. Email: [email protected]. PRICE: Full-text available online at no charge; Single copy free; $5.00 for shipping and handling. Summary: Cancer patients and their families face many challenges in learning to live with their disease. Having access to helpful information and support services may help people to cope with their individual circumstances. This booklet is the second component of the SPOHNC (Support for People with Oral and Head and Neck Cancer) Patient Information Folder. The booklet contains basic information about two treatments for oral and head and neck cancer: radiation therapy and chemotherapy. Written in a question and answer format, the booklet covers standard radiation therapy, hyperfractionated radiation therapy, brachytherapy (radiation implant therapy), three dimensional conformal radiation therapy, intensity modulated radiation therapy

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Radiation Therapy

(IMRT), 3D stereotactic radiation therapy, chemotherapy, the use of radiation therapy and chemotherapy at the same time, fast neutron radiotherapy, proton therapy, how to maintain a healthy mouth, pretreatment considerations, and the oral complications of radiation therapy and chemotherapy, including dry mouth (xerostomia), loss or change of taste, mucositis, bleeding in the mouth, trismus (loss of elasticity in the muscles that open and close the mouth), infections of the tongue, osteoradionecrosis (bone death, usually in the jaw bones), difficulties in swallowing and eating, difficulties in maintaining proper nutrition, and fatigue. The booklet also includes a list of oral and head and neck cancer resources and web site addresses, as well as related publications. A glossary of acronyms and medical terms concludes the booklet. Readers are encouraged to contact the organization (www.spohnc.org or 800-377-0928) for more information. ·

Patient Information Sheet: Oral Regimen for Patients Receiving Chemotherapy and Radiation Therapy Source: in Rosenberg, S.W., ed., et al. Clinician's Guide to Treatment of Common Oral Conditions. 4th ed. Baltimore, MD: American Academy of Oral Medicine (AAOM). Spring 1997. p. 16. Contact: Available from American Academy of Oral Medicine (AAOM). 2910 Lightfoot Drive, Baltimore, MD 21209-1452. (410) 602-8585. Website: www.aaom.com. PRICE: $21.00 plus shipping and handling. Summary: This fact sheet outlines an oral regimen for patients receiving chemotherapy and radiation therapy. The fact sheet addresses five areas: rinses, care of teeth and gums, nutrition, maintenance, and supportive measures. Each section provides specific suggestions for daily activities to help prevent oral problems associated with cancer therapies. Rinsing with a warm, dilute solution of sodium bicarbonate (baking soda) every two hours is recommended to bathe the tissues and control oral acidity. Other suggestions for managing xerostomia (dry mouth) and preventing yeast infections are provided. The fact sheet emphasizes that adequate nutrition and fluid intake are very important for oral and general health. This fact sheet is designed to be reproduced by health care providers and distributed to patients.

The National Guideline Clearinghouse™ The National Guideline Clearinghouse™ offers hundreds of evidence-based clinical practice guidelines published in the United States and other countries. You can search this site located at http://www.guideline.gov/ by using the keyword “radiation therapy” (or synonyms). The following was recently posted: ·

2002 update of recommendations for the use of chemotherapy and radiotherapy protectants: clinical practice guidelines of the American Society of Clinical Oncology Source: American Society of Clinical Oncology - Medical Specialty Society; 1999 October (revised 2002 Jun); 9 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3348&nbr=2574&a mp;string=radiation+AND+therapy

Patient Resources 257

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A clinician's guide to surgical fires: how they occur, how to prevent them, how to put them out Source: ECRI - Private Nonprofit Research Organization; 2003 January; 20 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3688&nbr=2914&a mp;string=radiation+AND+therapy

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AACE/AAES medical/surgical guidelines for clinical practice: management of thyroid carcinoma Source: American Association of Clinical Endocrinologists - Medical Specialty Society; 1997 (updated 2001 May-Jun); 19 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2848&nbr=2074&a mp;string=radiotherapy

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Accelerated radiotherapy for locally advanced squamous cell carcinoma of the head and neck Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 2000 November 27 (updated online 2002 Oct); 19 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3764&nbr=2990&a mp;string=radiation+AND+therapy

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Acne Source: Finnish Medical Society Duodecim - Professional Association; 2001 April 30; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3389&nbr=2615&a mp;string=radiation+AND+therapy

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ACR Appropriateness Criteriatm for osteoporosis and bone mineral density Source: American College of Radiology - Medical Specialty Society; 1998 (revised 2001); 17 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3263&nbr=2489&a mp;string=radiation+AND+therapy

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ACR Appropriateness Criteriatm for anal cancer Source: American College of Radiology - Medical Specialty Society; 1998 (revised 2002); 11 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3553&nbr=2779&a mp;string=radiation+AND+therapy

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ACR Appropriateness Criteriatm for blunt abdominal or pelvic trauma--suspected vascular injury Source: American College of Radiology - Medical Specialty Society; 1995 (revised 1999); 7 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2385&nbr=1611&a mp;string=radiation+AND+therapy

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ACR Appropriateness Criteriatm for blunt chest trauma--suspected aortic injury Source: American College of Radiology - Medical Specialty Society; 1995 (revised 1999); 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2384&nbr=1610&a mp;string=radiotherapy

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ACR Appropriateness Criteriatm for bone metastases Source: American College of Radiology - Medical Specialty Society; 1996 September (revised 2000); 27 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2569&nbr=1795&a mp;string=radiation+AND+therapy

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ACR Appropriateness Criteriatm for bone tumors Source: American College of Radiology - Medical Specialty Society; 1995 (revised 1999); 4 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2418&nbr=1644&a mp;string=radiotherapy

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ACR Appropriateness Criteriatm for cerebrovascular disease Source: American College of Radiology - Medical Specialty Society; 1996 (revised 2000); 21 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2437&nbr=1663&a mp;string=radiotherapy

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ACR Appropriateness Criteriatm for chronic wrist pain Source: American College of Radiology - Medical Specialty Society; 1998; 6 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2427&nbr=1653&a mp;string=radiation+AND+therapy

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ACR Appropriateness Criteriatm for diagnostic imaging in patients with claudication Source: American College of Radiology - Medical Specialty Society; 1995 (revised 1999); 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2388&nbr=1614&a mp;string=radiotherapy

Patient Resources 259

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ACR Appropriateness Criteriatm for diagnostic imaging of avascular necrosis of the hip Source: American College of Radiology - Medical Specialty Society; 1995 (revised 1999); 8 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2416&nbr=1642&a mp;string=radiation+AND+therapy

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ACR Appropriateness Criteriatm for endometrial cancer of the uterus Source: American College of Radiology - Medical Specialty Society; 1999; 7 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2494&nbr=1720&a mp;string=radiation+AND+therapy

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ACR Appropriateness Criteriatm for epilepsy Source: American College of Radiology - Medical Specialty Society; 1996 (revised 1999); 12 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2439&nbr=1665&a mp;string=radiotherapy

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ACR Appropriateness Criteriatm for evaluation of left lower quadrant pain Source: American College of Radiology - Medical Specialty Society; 1996 (revised 1999); 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2404&nbr=1630&a mp;string=radiotherapy

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ACR Appropriateness Criteriatm for follow-up and retreatment of brain metastases Source: American College of Radiology - Medical Specialty Society; 1999; 7 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2505&nbr=1731&a mp;string=radiation+AND+therapy

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ACR Appropriateness Criteriatm for head trauma Source: American College of Radiology - Medical Specialty Society; 1996 (revised 1999); 18 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2444&nbr=1670&a mp;string=radiation+AND+therapy

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ACR Appropriateness Criteriatm for iliac angioplasty Source: American College of Radiology - Medical Specialty Society; 1996 (revised 1999); 15 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2497&nbr=1723&a mp;string=radiotherapy

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ACR Appropriateness Criteriatm for imaging evaluation of suspected ankle fractures Source: American College of Radiology - Medical Specialty Society; 1995 (revised 1999); 3 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2414&nbr=1640&a mp;string=radiation+AND+therapy

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ACR Appropriateness Criteriatm for imaging of blunt abdominal trauma Source: American College of Radiology - Medical Specialty Society; 1996 (revised 1999); 9 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2401&nbr=1627&a mp;string=radiation+AND+therapy

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ACR Appropriateness Criteriatm for imaging of intracranial infections Source: American College of Radiology - Medical Specialty Society; 1996 (revised 1999); 11 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2446&nbr=1672&a mp;string=radiotherapy

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ACR Appropriateness Criteriatm for imaging of the multiply injured patient Source: American College of Radiology - Medical Specialty Society; 1995 (revised 1999); 10 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2420&nbr=1646&a mp;string=radiation+AND+therapy

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ACR Appropriateness Criteriatm for locally unresectable rectal cancer Source: American College of Radiology - Medical Specialty Society; 1998 (revised 2002); 10 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3559&nbr=2785&a mp;string=radiation+AND+therapy

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ACR Appropriateness Criteriatm for multiple brain metastases Source: American College of Radiology - Medical Specialty Society; 1999; 8 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2504&nbr=1730&a mp;string=radiation+AND+therapy

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ACR Appropriateness Criteriatm for myelopathy Source: American College of Radiology - Medical Specialty Society; 1996 (revised 1999); 11 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2443&nbr=1669&a mp;string=radiation+AND+therapy

Patient Resources 261

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ACR Appropriateness Criteriatm for neurodegenerative disorders Source: American College of Radiology - Medical Specialty Society; 1999; 9 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2452&nbr=1678&a mp;string=radiation+AND+therapy

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ACR Appropriateness Criteriatm for neuroendocrine imaging Source: American College of Radiology - Medical Specialty Society; 1999; 9 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2448&nbr=1674&a mp;string=radiation+AND+therapy

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ACR Appropriateness Criteriatm for non traumatic knee pain Source: American College of Radiology - Medical Specialty Society; 1995 (revised 1999); 10 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2425&nbr=1651&a mp;string=radiotherapy

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ACR Appropriateness Criteriatm for orbits, vision and visual loss Source: American College of Radiology - Medical Specialty Society; 1999; 9 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2450&nbr=1676&a mp;string=radiotherapy

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ACR Appropriateness Criteriatm for patient with suspected small bowel obstruction: imaging strategies Source: American College of Radiology - Medical Specialty Society; 1996 (revised 1999); 4 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2398&nbr=1624&a mp;string=radiation+AND+therapy

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ACR Appropriateness Criteriatm for percutaneous biliary drainage in malignant biliary obstruction Source: American College of Radiology - Medical Specialty Society; 1996 (revised 1999); 12 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2500&nbr=1726&a mp;string=radiotherapy

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ACR Appropriateness Criteriatm for percutaneous catheter drainage of infected intraabdominal fluid collections Source: American College of Radiology - Medical Specialty Society; 1996 (revised 1999); 9 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2501&nbr=1727&a mp;string=radiation+AND+therapy

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ACR Appropriateness Criteriatm for pre-treatment staging of colorectal cancer Source: American College of Radiology - Medical Specialty Society; 1996 (revised 1999); 8 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2400&nbr=1626&a mp;string=radiotherapy

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ACR Appropriateness Criteriatm for progressive neurologic deficit Source: American College of Radiology - Medical Specialty Society; 1996 (revised 1999); 21 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2438&nbr=1664&a mp;string=radiotherapy

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ACR Appropriateness Criteriatm for pulsatile abdominal mass Source: American College of Radiology - Medical Specialty Society; 1995 (revised 1999); 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2387&nbr=1613&a mp;string=radiation+AND+therapy

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ACR Appropriateness Criteriatm for screening for colorectal cancer Source: American College of Radiology - Medical Specialty Society; 1998; 7 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2413&nbr=1639&a mp;string=radiotherapy

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ACR Appropriateness Criteriatm for shortness of breath--suspected cardiac origin Source: American College of Radiology - Medical Specialty Society; 1995 (revised 1999); 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2382&nbr=1608&a mp;string=radiation+AND+therapy

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ACR Appropriateness Criteriatm for soft tissue masses Source: American College of Radiology - Medical Specialty Society; 1995 (revised 1999); 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2417&nbr=1643&a mp;string=radiation+AND+therapy

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ACR Appropriateness Criteriatm for solitary brain metastasis Source: American College of Radiology - Medical Specialty Society; 1999; 10 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2503&nbr=1729&a mp;string=radiation+AND+therapy

Patient Resources 263

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ACR Appropriateness Criteriatm for spine trauma Source: American College of Radiology - Medical Specialty Society; 1999; 7 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2451&nbr=1677&a mp;string=radiation+AND+therapy

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ACR Appropriateness vertebral)

Criteriatm

for

stress/insufficiency

fractures

(excluding

Source: American College of Radiology - Medical Specialty Society; 1995 (revised 1999); 8 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2419&nbr=1645&a mp;string=radiotherapy ·

ACR Appropriateness Criteriatm for sudden onset of cold, painful leg Source: American College of Radiology - Medical Specialty Society; 1998; 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2395&nbr=1621&a mp;string=radiotherapy

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ACR Appropriateness Criteriatm for suspected abdominal abscess Source: American College of Radiology - Medical Specialty Society; 1996 (revised 1999); 7 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2405&nbr=1631&a mp;string=radiotherapy

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ACR Appropriateness Criteriatm for suspected bacterial endocarditis Source: American College of Radiology - Medical Specialty Society; 1998; 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2390&nbr=1616&a mp;string=radiotherapy

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ACR Appropriateness Criteriatm for suspected liver metastases Source: American College of Radiology - Medical Specialty Society; 1998; 12 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2411&nbr=1637&a mp;string=radiotherapy

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ACR Appropriateness Criteriatm for suspected lower extremity deep vein thrombosis Source: American College of Radiology - Medical Specialty Society; 1995 (revised 1999); 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2386&nbr=1612&a mp;string=radiotherapy

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ACR Appropriateness Criteriatm for thrombolysis for lower extremity arterial and graft occlusions Source: American College of Radiology - Medical Specialty Society; 1996 (revised 1999); 14 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2499&nbr=1725&a mp;string=radiation+AND+therapy

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ACR Appropriateness Criteriatm for unilateral upper extremity swelling and pain Source: American College of Radiology - Medical Specialty Society; 1998; 6 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2396&nbr=1622&a mp;string=radiation+AND+therapy

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ACR Appropriateness Criteriatm for work-up of the solitary pulmonary nodule (SPN) Source: American College of Radiology - Medical Specialty Society; 1995 September (revised 2000); 7 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2570&nbr=1796&a mp;string=radiotherapy

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Adjuvant therapy for breast cancer Source: National Cancer Institute - Federal Government Agency [U.S.]; 2000 November 3; 24 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2715&nbr=1941&a mp;string=radiotherapy

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Adult low back pain Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1994 June (revised 2002 Sep); 61 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3498&nbr=2724&a mp;string=radiation+AND+therapy

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Altered fractionation of radical radiation therapy in the management of unresectable non-small cell lung cancer Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 1999 October 8 (revised online 2002 Sep); 25 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3599&nbr=2825&a mp;string=radiation+AND+therapy

Patient Resources 265

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American Gastroenterological Association medical position statement: epidemiology, diagnosis, and treatment of pancreatic ductal adenocarcinoma Source: American Gastroenterological Association - Medical Specialty Society; 1999 May (reviewed 2001); 2 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3063&nbr=2289&a mp;string=radiation+AND+therapy

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American Gastroenterological Association medical position statement: parenteral nutrition Source: American Gastroenterological Association - Medical Specialty Society; 2001 May 18; 4 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3056&nbr=2282&a mp;string=radiation+AND+therapy

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American Society of Clinical Oncology treatment of unresectable non-small-cell lung cancer guideline: update 2003 Source: American Society of Clinical Oncology - Medical Specialty Society; 1997 May (revised 2004 January 15); 24 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4547&nbr=3361&a mp;string=radiotherapy

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ASHP therapeutic guidelines on the pharmacologic management of nausea and vomiting in adult and pediatric patients receiving chemotherapy or radiation therapy or undergoing surgery Source: American Society of Health-System Pharmacists - Professional Association; 1999; 36 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1875&nbr=1101&a mp;string=radiation+AND+therapy

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Assessment and management of stage I to IV pressure ulcers Source: Registered Nurses Association of Ontario - Professional Association; 2002 August; 104 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3719&nbr=2945&a mp;string=radiation+AND+therapy

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Body plethysmography: 2001 revision and update Source: American Association for Respiratory Care - Professional Association; 2001 May; 8 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2843&nbr=2069&a mp;string=radiotherapy

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Breast cancer treatment Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1996 September (revised 2003 Jan); 45 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3670&nbr=2896&a mp;string=radiation+AND+therapy

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Breast irradiation in women with early stage invasive breast cancer following breast conserving surgery Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 1997 March 11 (new information released online January 2002); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3200&nbr=2426&a mp;string=radiation+AND+therapy

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Cancer pain Source: Singapore Ministry of Health - National Government Agency [Non-U.S.]; 2003 March; 88 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3748&nbr=2974&a mp;string=radiation+AND+therapy

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Cervical cancer Source: Singapore Ministry of Health - National Government Agency [Non-U.S.]; 2003 February; 45 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3747&nbr=2973&a mp;string=radiation+AND+therapy

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Clinical policy for the management and risk stratification of community-acquired pneumonia in adults in the emergency department Source: American College of Emergency Physicians - Medical Specialty Society; 2001; 7 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3301&nbr=2527&a mp;string=radiotherapy

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Clinical policy: critical issues for the initial evaluation and management of patients presenting with a chief complaint of nontraumatic acute abdominal pain Source: American College of Emergency Physicians - Medical Specialty Society; 2000; 10 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3300&nbr=2526&a mp;string=radiotherapy

Patient Resources 267

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Combined modality radiotherapy and chemotherapy in the non-surgical management of localized carcinoma of the esophagus Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 2003 August 18; 22 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4264&nbr=3264&a mp;string=radiation+AND+therapy

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Common gynecologic problems: a guide to diagnosis and treatment Source: Brigham and Women's Hospital (Boston) - Hospital/Medical Center; 2002; 11 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3486&nbr=2712&a mp;string=radiation+AND+therapy

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Concomitant chemotherapy and radiotherapy in squamous cell head and neck cancer (excluding nasopharynx) Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 2000 February 23 (updated online 2000 Mar); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=2989&nbr=2215&a mp;string=radiotherapy

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Discharge guidelines for the technology dependent infant Source: National Association of Neonatal Nurses - Professional Association; 1999; 26 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2145&nbr=1371&a mp;string=radiation+AND+therapy

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General recommendations on immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Family Physicians (AAFP) Source: American Academy of Family Physicians - Medical Specialty Society; 2002 February 8; 36 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3180&nbr=2406&a mp;string=radiation+AND+therapy

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Guidelines for the diagnosis and management of blunt aortic injury Source: Eastern Association for the Surgery of Trauma - Professional Association; 2000; 20 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2676&nbr=1902&a mp;string=radiotherapy

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Guidelines on treatment of stage IIIB non-small cell lung cancer Source: American College of Chest Physicians - Medical Specialty Society; 2003 January; 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3648&nbr=2874&a mp;string=radiation+AND+therapy

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Gynaecologic ultrasound examination Source: Finnish Medical Society Duodecim - Professional Association; 2001 January 5 (revised 2001 March 21); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3817&nbr=3043&a mp;string=radiotherapy

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Hyperfractionated radiotherapy for locally advanced squamous cell carcinoma of the head and neck Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 2000 November 27 (revised online 2003 Jan); 13 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3601&nbr=2827&a mp;string=radiotherapy

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Identifying and treating eating disorders Source: American Academy of Pediatrics - Medical Specialty Society; 2003 January; 8 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3589&nbr=2815&a mp;string=radiation+AND+therapy

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Lung cancer. Palliative care Source: American College of Chest Physicians - Medical Specialty Society; 2003 January; 28 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3653&nbr=2879&a mp;string=radiation+AND+therapy

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Major depression in adults for mental health care providers Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1996 February (revised 2002 May); 43 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3354&nbr=2580&a mp;string=radiation+AND+therapy

Patient Resources 269

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Management of ductal carcinoma in situ of the breast Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 1998 January 20 (updated online 2003 Jan); 18 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3701&nbr=2927&a mp;string=radiotherapy

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Neoadjuvant or adjuvant therapy for resectable gastric cancer Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 2000 December 6 (updated online 2003 May); 21 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3884&nbr=3089&a mp;string=radiotherapy

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Optimal therapy for patients diagnosed with multiple myeloma and the role of highdose chemotherapy and stem cell support Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 2000 December 22 (revised online 2002 Apr); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3212&nbr=2438&a mp;string=radiation+AND+therapy

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Ottawa Ankle Rules for ankle injury radiography Source: Ottawa Health Research Institute - Hospital/Medical Center; 1999; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=2807&nbr=2033&a mp;string=radiation+AND+therapy

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Ottawa Knee Rule for knee injury radiography Source: Ottawa Health Research Institute - Hospital/Medical Center; 1999; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=2808&nbr=2034&a mp;string=radiotherapy

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Postmastectomy radiotherapy: clinical practice guidelines of the American Society of Clinical Oncology Source: American Society of Clinical Oncology - Medical Specialty Society; 2000 November 3; 31 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2760&nbr=1986&a mp;string=radiotherapy

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Postoperative adjuvant radiation therapy in stage II or IIIA completely resected nonsmall cell lung cancer Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 1997 September 15 (revised online 2003 Aug); 15 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4262&nbr=3262&a mp;string=radiation+AND+therapy

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Postoperative adjuvant radiotherapy and/or chemotherapy for resected stage II or III rectal cancer Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 1998 September 5 (updated online 2001 Dec); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3282&nbr=2508&a mp;string=radiation+AND+therapy

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Practice guideline for the treatment of patients with bipolar disorder (revision) Source: American Psychiatric Association - Medical Specialty Society; 1994 December (revised 2002 Apr); 50 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3302&nbr=2528&a mp;string=radiation+AND+therapy

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Practice parameters for the use of laser-assisted uvulopalatoplasty: an update for 2000. Source: American Academy of Sleep Medicine - Professional Association; 1994 (updated 2001 Aug); 17 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2932&nbr=2158&a mp;string=radiation+AND+therapy

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Practice parameters for the use of light therapy in the treatment of sleep disorders Source: American Academy of Sleep Medicine - Professional Association; 1999; 20 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2273&nbr=1499&a mp;string=radiation+AND+therapy

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Presentations of lung cancer with special treatment considerations Source: American College of Chest Physicians - Medical Specialty Society; 2003 January; 15 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3650&nbr=2876&a mp;string=radiation+AND+therapy

Patient Resources 271

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Preventive health care, 1999 update. Follow-up after breast cancer Source: Canadian Task Force on Preventive Health Care - National Government Agency [Non-U.S.]; 1999; 8 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2704&nbr=1930&a mp;string=radiotherapy

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Primary treatment for locally advanced cervical cancer: concurrent platinum-based chemotherapy and radiation Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 2002 August 26 (updated online 2003 Jun); 25 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3879&nbr=3088&a mp;string=radiation+AND+therapy

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Procedure guideline for bone pain treatment Source: Society of Nuclear Medicine, Inc - Medical Specialty Society; 1999 February; 15 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1362&nbr=620&am p;string=radiation+AND+therapy

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Procedure guideline for gallium scintigraphy in the evaluation of malignant disease Source: Society of Nuclear Medicine, Inc - Medical Specialty Society; 1999 February (updated 2001 June 23); 9 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2949&nbr=2175&a mp;string=radiation+AND+therapy

·

Procedure guideline for gastric emptying and motility Source: Society of Nuclear Medicine, Inc - Medical Specialty Society; 1999 July; 16 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1746&nbr=972&am p;string=radiation+AND+therapy

·

Procedure guideline for gastrointestinal bleeding and Meckel's diverticulum scintigraphy Source: Society of Nuclear Medicine, Inc - Medical Specialty Society; 1999 July; 31 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1747&nbr=973&am p;string=radiation+AND+therapy

·

Procedure guideline for general imaging Source: Society of Nuclear Medicine, Inc - Medical Specialty Society; 1999 February; 36 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1338&nbr=606&am p;string=radiotherapy

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Procedure guideline for hepatobiliary scintigraphy Source: Society of Nuclear Medicine, Inc - Medical Specialty Society; 1999 February (updated 2001 June 23); 16 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2948&nbr=2174&a mp;string=radiation+AND+therapy

·

Procedure guideline for pediatric sedation in nuclear medicine Source: Society of Nuclear Medicine, Inc - Medical Specialty Society; 1999 February http://www.guideline.gov/summary/summary.aspx?doc_id=1358&nbr=616&am p;string=radiotherapy

·

Procedure guideline for the use of radiopharmaceuticals Source: Society of Nuclear Medicine, Inc - Medical Specialty Society; 1998 June (updated 2001 Jun 23); 6 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2946&nbr=2172&a mp;string=radiotherapy

·

Procedure guideline for thyroid uptake measurement Source: Society of Nuclear Medicine, Inc - Medical Specialty Society; 1999 February; 15 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1342&nbr=623&am p;string=radiation+AND+therapy

·

Procedure guideline for tumor imaging using F-18 FDG Source: Society of Nuclear Medicine, Inc - Medical Specialty Society; 1999 February; 20 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1335&nbr=603&am p;string=radiation+AND+therapy

·

Prophylactic cranial irradiation in small cell lung cancer Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 2000 March 22 (updated online 2002 Jul); 14 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3459&nbr=2685&a mp;string=radiotherapy

·

Prostate cancer Source: National Committee on Cancer Care (Singapore) - National Government Agency [Non-U.S.]; 2000 May; 49 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2836&nbr=2062&a mp;string=radiotherapy

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Psoriasis Source: Finnish Medical Society Duodecim - Professional Association; 2002 May 7; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3388&nbr=2614&a mp;string=radiation+AND+therapy

·

Radiotherapy fractionation for the palliation of uncomplicated painful bone metastases Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 2003 March 14; 22 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3766&nbr=2992&a mp;string=radiation+AND+therapy

·

Recommendations for the use of antiemetics: evidence-based, clinical practice guidelines Source: American Society of Clinical Oncology - Medical Specialty Society; 1999 September; 37 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2149&nbr=1375&a mp;string=radiation+AND+therapy

·

Seborrhoeic dermatitis Source: Finnish Medical Society Duodecim - Professional Association; 2001 April 21; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3392&nbr=2618&a mp;string=radiation+AND+therapy

·

Small cell lung cancer Source: American College of Chest Physicians - Medical Specialty Society; 2003 January; 13 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3651&nbr=2877&a mp;string=radiation+AND+therapy

·

Society of Nuclear Medicine procedure guideline for therapy of thyroid disease with iodine-131 (sodium iodide) Source: Society of Nuclear Medicine, Inc - Medical Specialty Society; 2002 February 10; 11 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3191&nbr=2417&a mp;string=radiation+AND+therapy

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Standards for breast conservation therapy in the management of invasive breast carcinoma. Source: American College of Radiology - Medical Specialty Society; 1992 (revised 2001); 24 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3291&nbr=2517&a mp;string=radiation+AND+therapy

·

Standards for the management of ductal carcinoma in situ of the breast (DCIS) Source: American College of Radiology - Medical Specialty Society; 1997 (revised 2001); 21 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3292&nbr=2518&a mp;string=radiation+AND+therapy

·

Surgical management of early stage invasive breast cancer Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 1996 February 14 (revised January 2003); 20 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3706&nbr=2932&a mp;string=radiation+AND+therapy

·

Surgical management of hemorrhoids Source: Society for Surgery of the Alimentary Tract, Inc - Medical Specialty Society; 1996 (revised 2000); 3 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2171&nbr=1397&a mp;string=radiation+AND+therapy

·

Symptomatic treatment of radiation-induced xerostomia in head and neck cancer patients Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 1998 October 15 (updated online 2002 Oct); 15 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3534&nbr=2760&a mp;string=radiotherapy

·

The role of neoadjuvant chemotherapy in locally advanced squamous cell carcinoma of the head and neck (SCCHN) (excluding nasopharynx) Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 1996 February 15 (updated online 2003 Feb); 10 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3699&nbr=2925&a mp;string=radiation+AND+therapy

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The role of thoracic radiotherapy as an adjunct to standard chemotherapy in limitedstage small cell lung cancer Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 1999 October 8 (updated online 2003 Jan); 20 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3765&nbr=2991&a mp;string=radiation+AND+therapy

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The treatment of locally advanced pancreatic cancer Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 2002 June 10 (updated online 2003 May 21); 15 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3869&nbr=3079&a mp;string=radiation+AND+therapy

·

The use of conformal radiotherapy and the selection of radiation dose in T1 or T2 prostate cancer Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 2002 October; 23 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3461&nbr=2687&a mp;string=radiation+AND+therapy

·

The use of preoperative radiotherapy in the management of patients with clinically resectable rectal cancer Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 2002 December; 23 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3709&nbr=2935&a mp;string=radiation+AND+therapy

·

Treatment of early stage non-small cell lung cancer Source: American College of Chest Physicians - Medical Specialty Society; 2003 January; 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3644&nbr=2870&a mp;string=radiation+AND+therapy

·

Treatment of pressure ulcers Source: Agency for Healthcare Research and Quality - Federal Government Agency [U.S.]; 1994 December (reviewed 2000); 154 pages http://www.guideline.gov/summary/summary.aspx?doc_id=810&nbr=8&st ring=radiation+AND+therapy

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Treatment of stage I non-small cell lung carcinoma Source: American College of Chest Physicians - Medical Specialty Society; 2003 January; 7 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3645&nbr=2871&a mp;string=radiation+AND+therapy

·

Treatment of stage II non-small cell lung cancer Source: American College of Chest Physicians - Medical Specialty Society; 2003 January; 14 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3646&nbr=2872&a mp;string=radiation+AND+therapy

·

Treatment of stage IIIA non-small cell lung cancer Source: American College of Chest Physicians - Medical Specialty Society; 2003 January; 19 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3647&nbr=2873&a mp;string=radiation+AND+therapy

·

Unresected stage III non-small cell lung cancer Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 1997 March 14 (updated online 2003 Jan); 22 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3702&nbr=2928&a mp;string=radiation+AND+therapy

·

Use of preoperative chemotherapy with or without postoperative radiotherapy in technically resectable stage IIIA non-small cell lung cancer Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 1997 September 15 (updated online 2002 Apr); 14 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3281&nbr=2507&a mp;string=radiotherapy

·

Use of strontium Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 1997 November 23 (updated online 2001 Oct); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3012&nbr=2238&a mp;string=radiation+AND+therapy

Healthfinder™ Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is

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located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database: ·

Oral Care Provider's Reference Guide to Oncology Patients Summary: A pocket guide for oral health professionals that provides guidelines for the prevention and management of oral complications in patients receiving radiation therapy to the head and neck , Source: National Institute of Dental and Craniofacial Research, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5197

·

Radiation Therapy Summary: This document describes what happens before, during, and after radiation therapy. Source: American Society of Radiologic Technologists http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7941

·

Radiation Therapy and You: A Guide to Self-Help During Treatment Summary: What to expect and how to care for yourself if you are receiving radiation therapy for cancer. Source: National Cancer Institute, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3741

·

What To Expect from Your Next Imaging Exam Summary: This page links to information on numerous imaging exams, including radiography (x-rays), magnetic resonance imaging (MRI), nuclear medicine, computed tomography (CT), mammography, radiation therapy, Source: American Society of Radiologic Technologists http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7934 The NIH Search Utility

The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to radiation therapy. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html.

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Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: ·

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

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Family Village: http://www.familyvillage.wisc.edu/specific.htm

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Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

·

Med Help International: http://www.medhelp.org/HealthTopics/A.html

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Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

·

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

·

WebMDÒHealth: http://my.webmd.com/health_topics

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to radiation therapy. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with radiation therapy.

The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about radiation therapy. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797.

Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “radiation therapy” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received

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your search results, click on the name of the organization for its description and contact information.

The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “radiation therapy”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “radiation therapy” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “radiation therapy” (or a synonym) into the search box, and click “Submit Query.”

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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.22

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

22

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)23: ·

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

·

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

·

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

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California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

·

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

·

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

·

California: Gateway Health Library (Sutter Gould Medical Foundation)

·

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

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California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

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California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

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California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

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California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

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California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

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California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

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California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

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Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

·

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

·

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

23

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

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·

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

·

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

·

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

·

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

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Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

·

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

·

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

·

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

·

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

·

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

·

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

·

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

·

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

·

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

·

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

·

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

·

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

·

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

·

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

·

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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·

Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

·

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

·

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

·

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

·

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

·

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

·

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

·

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

·

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

·

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

·

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

·

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

·

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

·

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

·

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

·

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

·

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

·

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

·

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

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·

Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

·

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

·

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

·

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

·

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

·

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

·

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

·

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

·

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

·

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

·

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

·

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

·

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

·

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

·

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

·

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

·

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

·

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

·

Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

·

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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·

South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

·

Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

·

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

·

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: ·

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

·

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

·

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

·

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

·

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

·

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

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Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on radiation therapy: ·

Basic Guidelines for Radiation Therapy Radiation therapy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001918.htm

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Signs & Symptoms for Radiation Therapy Anorexia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003121.htm Edema Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm Erythema Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003220.htm Hair loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003246.htm

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Hyperpigmentation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003242.htm Itching Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003217.htm Malaise Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003089.htm Nausea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Skin lesions Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003220.htm Vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm ·

Background Topics for Radiation Therapy Cobalt Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002495.htm Skin pigment Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002256.htm

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: ·

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

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MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

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Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

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Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

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RADIATION THERAPY DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 3-dimensional: 3-D. A graphic display of depth, width, and height. Three-dimensional radiation therapy uses computers to create a 3-dimensional picture of the tumor. This allows doctors to give the highest possible dose of radiation to the tumor, while sparing the normal tissue as much as possible. [NIH] Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] Ablation: The removal of an organ by surgery. [NIH] Abscess: A localized, circumscribed collection of pus. [NIH] Absolute risk: The observed or calculated probability of an event in a population under study, as contrasted with the relative risk. [NIH] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acid Phosphatase: An enzyme that catalyzes the conversion of an orthophosphoric monoester and water to an alcohol and orthophosphate. EC 3.1.3.2. [NIH] Acidity: The quality of being acid or sour; containing acid (hydrogen ions). [EU] Acoustic: Having to do with sound or hearing. [NIH] Acuity: Clarity or clearness, especially of the vision. [EU] Acute lymphoblastic leukemia: ALL. A quickly progressing disease in which too many immature white blood cells called lymphoblasts are found in the blood and bone marrow. Also called acute lymphocytic leukemia. [NIH] Acute lymphocytic leukemia: ALL. A quickly progressing disease in which too many immature white blood cells called lymphoblasts are found in the blood and bone marrow. Also called acute lymphoblastic leukemia. [NIH] Acute myelogenous leukemia: AML. A quickly progressing disease in which too many immature blood-forming cells are found in the blood and bone marrow. Also called acute myeloid leukemia or acute nonlymphocytic leukemia. [NIH] Acute myeloid leukemia: AML. A quickly progressing disease in which too many immature blood-forming cells are found in the blood and bone marrow. Also called acute myelogenous leukemia or acute nonlymphocytic leukemia. [NIH]

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Acute nonlymphocytic leukemia: A quickly progressing disease in which too many immature blood-forming cells are found in the blood and bone marrow. Also called acute myeloid leukemia or acute myelogenous leukemia. [NIH] Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH] Adenovirus: A group of viruses that cause respiratory tract and eye infections. Adenoviruses used in gene therapy are altered to carry a specific tumor-fighting gene. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adjuvant Therapy: Treatment given after the primary treatment to increase the chances of a cure. Adjuvant therapy may include chemotherapy, radiation therapy, or hormone therapy. [NIH]

Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]

Aggressiveness: The quality of being aggressive (= characterized by aggression; militant; enterprising; spreading with vigour; chemically active; variable and adaptable). [EU] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU]

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Alkaline: Having the reactions of an alkali. [EU] Alkaline Phosphatase: An enzyme that catalyzes the conversion of an orthophosphoric monoester and water to an alcohol and orthophosphate. EC 3.1.3.1. [NIH] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alkylating Agents: Highly reactive chemicals that introduce alkyl radicals into biologically active molecules and thereby prevent their proper functioning. Many are used as antineoplastic agents, but most are very toxic, with carcinogenic, mutagenic, teratogenic, and immunosuppressant actions. They have also been used as components in poison gases. [NIH]

Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Allo: A female hormone. [NIH] Allogeneic: Taken from different individuals of the same species. [NIH] Allogeneic bone marrow transplantation: A procedure in which a person receives stem cells, the cells from which all blood cells develop, from a compatible, though not genetically identical, donor. [NIH] Alloys: A mixture of metallic elements or compounds with other metallic or metalloid elements in varying proportions. [NIH] Alopecia: Absence of hair from areas where it is normally present. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alpha-fetoprotein: AFP. A protein normally produced by a developing fetus. AFP levels are usually undetectable in the blood of healthy nonpregnant adults. An elevated level of AFP suggests the presence of either a primary liver cancer or germ cell tumor. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Aluminum: A metallic element that has the atomic number 13, atomic symbol Al, and atomic weight 26.98. [NIH] Alveoli: Tiny air sacs at the end of the bronchioles in the lungs. [NIH] Alveolitis: Inflammation of an alveolus. Called also odontobothritis. [EU] Ameliorating: A changeable condition which prevents the consequence of a failure or accident from becoming as bad as it otherwise would. [NIH] Ameloblastoma: An epithelial tumor of the jaw originating from the epithelial rests of Malassez or from other epithelial remnants of the developing period of the enamel. [NIH] Amifostine: A phosphorothioate proposed as a radiation-protective agent. It causes splenic vasodilation and may block autonomic ganglia. [NIH] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by

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posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amplification: The production of additional copies of a chromosomal DNA sequence, found as either intrachromosomal or extrachromosomal DNA. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Amyloidosis: A group of diseases in which protein is deposited in specific organs (localized amyloidosis) or throughout the body (systemic amyloidosis). Amyloidosis may be either primary (with no known cause) or secondary (caused by another disease, including some types of cancer). Generally, primary amyloidosis affects the nerves, skin, tongue, joints, heart, and liver; secondary amyloidosis often affects the spleen, kidneys, liver, and adrenal glands. [NIH] Anaerobic: 1. Lacking molecular oxygen. 2. Growing, living, or occurring in the absence of molecular oxygen; pertaining to an anaerobe. [EU] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Anaplastic: A term used to describe cancer cells that divide rapidly and bear little or no resemblance to normal cells. [NIH] Anastomosis: A procedure to connect healthy sections of tubular structures in the body after the diseased portion has been surgically removed. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgen suppression: Treatment to suppress or block the production of male hormones. Androgen suppression is achieved by surgical removal of the testicles, by taking female sex hormones, or by taking other drugs. Also called androgen ablation. [NIH] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anemic: Hypoxia due to reduction of the oxygen-carrying capacity of the blood as a result of a decrease in the total hemoglobin or an alteration of the hemoglobin constituents. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH]

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Anesthetics: Agents that are capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general anesthesia, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. [NIH] Angina: Chest pain that originates in the heart. [NIH] Angina Pectoris: The symptom of paroxysmal pain consequent to myocardial ischemia usually of distinctive character, location and radiation, and provoked by a transient stressful situation during which the oxygen requirements of the myocardium exceed the capacity of the coronary circulation to supply it. [NIH] Angiogenesis: Blood vessel formation. Tumor angiogenesis is the growth of blood vessels from surrounding tissue to a solid tumor. This is caused by the release of chemicals by the tumor. [NIH] Angiogenesis inhibitor: A substance that may prevent the formation of blood vessels. In anticancer therapy, an angiogenesis inhibitor prevents the growth of blood vessels from surrounding tissue to a solid tumor. [NIH] Angioplasty: Endovascular reconstruction of an artery, which may include the removal of atheromatous plaque and/or the endothelial lining as well as simple dilatation. These are procedures performed by catheterization. When reconstruction of an artery is performed surgically, it is called endarterectomy. [NIH] Angiosarcoma: A type of cancer that begins in the lining of blood vessels. [NIH] Angiotensinogen: An alpha-globulin of which a fragment of 14 amino acids is converted by renin to angiotensin I, the inactive precursor of angiotensin II. It is a member of the serpin superfamily. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Ankle: That part of the lower limb directly above the foot. [NIH] Annealing: The spontaneous alignment of two single DNA strands to form a double helix. [NIH]

Anode: Electrode held at a positive potential with respect to a cathode. [NIH] Anoikis: Apoptosis triggered by loss of contact with the extracellular matrix. [NIH] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Antiandrogen therapy: Treatment with drugs used to block production or interfere with the action of male sex hormones. [NIH] Antiandrogens: Drugs used to block the production or interfere with the action of male sex hormones. [NIH] Antiangiogenic: Having to do with reducing the growth of new blood vessels. [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or

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reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antidote: A remedy for counteracting a poison. [EU] Antiemetic: An agent that prevents or alleviates nausea and vomiting. Also antinauseant. [EU]

Antifungal: Destructive to fungi, or suppressing their reproduction or growth; effective against fungal infections. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-presenting cell: APC. A cell that shows antigen on its surface to other cells of the immune system. This is an important part of an immune response. [NIH] Anti-infective: An agent that so acts. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antineoplastic Agents: Substances that inhibit or prevent the proliferation of neoplasms. [NIH]

Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antiseptic: A substance that inhibits the growth and development of microorganisms without necessarily killing them. [EU] Antithrombotic: Preventing or interfering with the formation of thrombi; an agent that so acts. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Aorta: The main trunk of the systemic arteries. [NIH]

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Aperture: A natural hole of perforation, especially one in a bone. [NIH] Aplastic anemia: A condition in which the bone marrow is unable to produce blood cells. [NIH]

Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Applicability: A list of the commodities to which the candidate method can be applied as presented or with minor modifications. [NIH] Approximate: Approximal [EU] Aqueous: Having to do with water. [NIH] Archaea: One of the three domains of life (the others being bacteria and Eucarya), formerly called Archaebacteria under the taxon Bacteria, but now considered separate and distinct. They are characterized by: 1) the presence of characteristic tRNAs and ribosomal RNAs; 2) the absence of peptidoglycan cell walls; 3) the presence of ether-linked lipids built from branched-chain subunits; and 4) their occurrence in unusual habitats. While archaea resemble bacteria in morphology and genomic organization, they resemble eukarya in their method of genomic replication. The domain contains at least three kingdoms: crenarchaeota, euryarchaeota, and korarchaeota. [NIH] Aromatic: Having a spicy odour. [EU] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arteriolar: Pertaining to or resembling arterioles. [EU] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteriosclerosis: Thickening and loss of elasticity of arterial walls. Atherosclerosis is the most common form of arteriosclerosis and involves lipid deposition and thickening of the intimal cell layers within arteries. Additional forms of arteriosclerosis involve calcification of the media of muscular arteries (Monkeberg medial calcific sclerosis) and thickening of the walls of small arteries or arterioles due to cell proliferation or hyaline deposition (arteriolosclerosis). [NIH] Arteriovenous: Both arterial and venous; pertaining to or affecting an artery and a vein. [EU] Arteriovenous Fistula: An abnormal communication between an artery and a vein. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Artificial Intelligence: The study and implementation of techniques and methods for designing computer systems to perform functions normally associated with human intelligence, such as understanding language, learning, reasoning, problem solving, etc. [NIH]

Asbestos: Fibrous incombustible mineral composed of magnesium and calcium silicates with or without other elements. It is relatively inert chemically and used in thermal insulation and fireproofing. Inhalation of dust causes asbestosis and later lung and gastrointestinal neoplasms. [NIH]

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Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Astrocytes: The largest and most numerous neuroglial cells in the brain and spinal cord. Astrocytes (from "star" cells) are irregularly shaped with many long processes, including those with "end feet" which form the glial (limiting) membrane and directly and indirectly contribute to the blood brain barrier. They regulate the extracellular ionic and chemical environment, and "reactive astrocytes" (along with microglia) respond to injury. Astrocytes have high- affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitter, but their role in signaling (as in many other functions) is not well understood. [NIH] Astrocytoma: A tumor that begins in the brain or spinal cord in small, star-shaped cells called astrocytes. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atmospheric Pressure: The pressure at any point in an atmosphere due solely to the weight of the atmospheric gases above the point concerned. [NIH] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Auditory: Pertaining to the sense of hearing. [EU] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autologous: Taken from an individual's own tissues, cells, or DNA. [NIH] Autologous bone marrow transplantation: A procedure in which bone marrow is removed from a person, stored, and then given back to the person after intensive treatment. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Autoradiography: A process in which radioactive material within an object produces an image when it is in close proximity to a radiation sensitive emulsion. [NIH] Axillary: Pertaining to the armpit area, including the lymph nodes that are located there. [NIH]

Axillary Vein: The venous trunk of the upper limb; a continuation of the basilar and brachial veins running from the lower border of the teres major muscle to the outer border of the first rib where it becomes the subclavian vein. [NIH] Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most

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important. [NIH] Barbiturate: A drug with sedative and hypnotic effects. Barbiturates have been used as sedatives and anesthetics, and they have been used to treat the convulsions associated with epilepsy. [NIH] Barium: An element of the alkaline earth group of metals. It has an atomic symbol Ba, atomic number 56, and atomic weight 138. All of its acid-soluble salts are poisonous. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Basement Membrane: Ubiquitous supportive tissue adjacent to epithelium and around smooth and striated muscle cells. This tissue contains intrinsic macromolecular components such as collagen, laminin, and sulfated proteoglycans. As seen by light microscopy one of its subdivisions is the basal (basement) lamina. [NIH] Basophils: Granular leukocytes characterized by a relatively pale-staining, lobate nucleus and cytoplasm containing coarse dark-staining granules of variable size and stainable by basic dyes. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Bethanechol: A slowly hydrolyzed muscarinic agonist with no nicotinic effects. Bethanechol is generally used to increase smooth muscle tone, as in the GI tract following abdominal surgery or in urinary retention in the absence of obstruction. It may cause hypotension, cardiac rate changes, and bronchial spasms. [NIH] Bevacizumab: A monoclonal antibody that may prevent the growth of blood vessels from surrounding tissue to a solid tumor. [NIH] Bexarotene: An anticancer drug used to decrease the growth of some types of cancer cells. Also called LGD1069. [NIH] Bicalutamide: An anticancer drug that belongs to the family of drugs called antiandrogens. [NIH]

Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile duct: A tube through which bile passes in and out of the liver. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Binding Sites: The reactive parts of a macromolecule that directly participate in its specific combination with another molecule. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biodegradation: The series of processes by which living organisms degrade pollutant

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chemicals, organic wastes, pesticides, and implantable materials. [NIH] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biomarkers: Substances sometimes found in an increased amount in the blood, other body fluids, or tissues and that may suggest the presence of some types of cancer. Biomarkers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and GI tract cancers), and PSA (prostate cancer). Also called tumor markers. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biopsy specimen: Tissue removed from the body and examined under a microscope to determine whether disease is present. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Biotin: Hexahydro-2-oxo-1H-thieno(3,4-d)imidazole-4-pentanoic acid. Growth factor present in minute amounts in every living cell. It occurs mainly bound to proteins or polypeptides and is abundant in liver, kidney, pancreas, yeast, and milk.The biotin content of cancerous tissue is higher than that of normal tissue. [NIH] Bipolar Disorder: A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence. [NIH] Bladder: The organ that stores urine. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood-Brain Barrier: Specialized non-fenestrated tightly-joined endothelial cells (tight junctions) that form a transport barrier for certain substances between the cerebral capillaries and the brain tissue. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bone Density: The amount of mineral per square centimeter of bone. This is the definition used in clinical practice. Actual bone density would be expressed in grams per milliliter. It is most frequently measured by photon absorptiometry or x-ray computed tomography. [NIH]

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Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone Marrow Cells: Cells contained in the bone marrow including fat cells, stromal cells, megakaryocytes, and the immediate precursors of most blood cells. [NIH] Bone Marrow Transplantation: The transference of bone marrow from one human or animal to another. [NIH] Bone metastases: Cancer that has spread from the original (primary) tumor to the bone. [NIH]

Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] Boron: A trace element with the atomic symbol B, atomic number 5, and atomic weight 10.81. Boron-10, an isotope of boron, is used as a neutron absorber in boron neutron capture therapy. [NIH] Boron Neutron Capture Therapy: A technique for the treatment of neoplasms, especially gliomas and melanomas in which boron-10, an isotope, is introduced into the target cells followed by irradiation with thermal neutrons. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brachial: All the nerves from the arm are ripped from the spinal cord. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] Brain metastases: Cancer that has spread from the original (primary) tumor to the brain. [NIH]

Brain Stem: The part of the brain that connects the cerebral hemispheres with the spinal cord. It consists of the mesencephalon, pons, and medulla oblongata. [NIH] Brain stem glioma: A tumor located in the part of the brain that connects to the spinal cord (the brain stem). It may grow rapidly or slowly, depending on the grade of the tumor. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Breast Neoplasms: Tumors or cancer of the breast. [NIH] Breast-conserving surgery: An operation to remove the breast cancer but not the breast itself. Types of breast-conserving surgery include lumpectomy (removal of the lump), quadrantectomy (removal of one quarter of the breast), and segmental mastectomy (removal of the cancer as well as some of the breast tissue around the tumor and the lining over the chest muscles below the tumor). [NIH] Bronchial: Pertaining to one or more bronchi. [EU] Bronchial Spasm: Spasmodic contraction of the smooth muscle of the bronchi. [NIH] Bronchioles: The tiny branches of air tubes in the lungs. [NIH]

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Bronchiolitis: Inflammation of the bronchioles. [NIH] Bronchiolitis Obliterans: Inflammation of the bronchioles with obstruction by fibrous granulation tissue or bronchial exudate. It may follow inhalation of irritating gases or foreign bodies and it complicates pneumonia. [NIH] Bronchiolitis Obliterans Organizing Pneumonia: Inflammation of the bronchioles. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Buccal mucosa: The inner lining of the cheeks and lips. [NIH] Bullous: Pertaining to or characterized by bullae. [EU] Bypass: A surgical procedure in which the doctor creates a new pathway for the flow of body fluids. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calibration: Determination, by measurement or comparison with a standard, of the correct value of each scale reading on a meter or other measuring instrument; or determination of the settings of a control device that correspond to particular values of voltage, current, frequency, or other output. [NIH] Camptothecin: An alkaloid isolated from the stem wood of the Chinese tree, Camptotheca acuminata. This compound selectively inhibits the nuclear enzyme DNA topoisomerase. Several semisynthetic analogs of camptothecin have demonstrated antitumor activity. [NIH] Candidiasis: Infection with a fungus of the genus Candida. It is usually a superficial infection of the moist cutaneous areas of the body, and is generally caused by C. albicans; it most commonly involves the skin (dermatocandidiasis), oral mucous membranes (thrush, def. 1), respiratory tract (bronchocandidiasis), and vagina (vaginitis). Rarely there is a systemic infection or endocarditis. Called also moniliasis, candidosis, oidiomycosis, and formerly blastodendriosis. [EU] Candidosis: An infection caused by an opportunistic yeasts that tends to proliferate and become pathologic when the environment is favorable and the host resistance is weakened. [NIH]

Canonical: A particular nucleotide sequence in which each position represents the base more often found when many actual sequences of a given class of genetic elements are compared. [NIH] Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Capsaicin: Cytotoxic alkaloid from various species of Capsicum (pepper, paprika), of the Solanaceae. [NIH] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, poly-

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and heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carboplatin: An organoplatinum compound that possesses antineoplastic activity. [NIH] Carcinogenesis: The process by which normal cells are transformed into cancer cells. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Carcinoma in Situ: A malignant tumor that has not yet invaded the basement membrane of the epithelial cell of origin and has not spread to other tissues. [NIH] Cardiac: Having to do with the heart. [NIH] Cardiopathy: Any disorder or disease of the heart. In addition to heart disease of inflammatory origin, there are arteriosclerotic cardiopathy, due to arteriosclerosis; fatty cardiopathy, due to growth of fatty tissue; hypertensive cardiopathy, due to high blood pressure; nephropathic cardiopathy, due to kidney disease, thyrotoxic cardiopathy, due to thyroid intoxication; toxic cardiopathy, due to the effect of some toxin; and valvular cardiopathy, due to faulty valve action. [EU] Cardiopulmonary: Having to do with the heart and lungs. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Cardiovascular System: The heart and the blood vessels by which blood is pumped and circulated through the body. [NIH] Carmustine: An anticancer drug that belongs to the family of drugs called alkylating agents. [NIH]

Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Caspase: Enzyme released by the cell at a crucial stage in apoptosis in order to shred all cellular proteins. [NIH] Castration: Surgical removal or artificial destruction of gonads. [NIH] Catheter: A flexible tube used to deliver fluids into or withdraw fluids from the body. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [NIH] Cathode: An electrode, usually an incandescent filament of tungsten, which emits electrons in an X-ray tube. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU]

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CDC2: It is crucial for entry into mitosis of eukaryotic cells. [NIH] Celecoxib: A drug that reduces pain. Celecoxib belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is being studied for cancer prevention. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Count: A count of the number of cells of a specific kind, usually measured per unit volume of sample. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Cell Transplantation: Transference of cells within an individual, between individuals of the same species, or between individuals of different species. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Centrosome: The cell center, consisting of a pair of centrioles surrounded by a cloud of amorphous material called the pericentriolar region. During interphase, the centrosome nucleates microtubule outgrowth. The centrosome duplicates and, during mitosis, separates to form the two poles of the mitotic spindle (mitotic spindle apparatus). [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Cortex: The thin layer of gray matter on the surface of the cerebral hemisphere that develops from the telencephalon and folds into gyri. It reaches its highest development in man and is responsible for intellectual faculties and higher mental functions. [NIH] Cerebral hemispheres: The two halves of the cerebrum, the part of the brain that controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. The right hemisphere controls muscle movement on the left side of the body, and the left hemisphere controls muscle movement on the right side of the body. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH]

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Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chemoprotective: A quality of some drugs used in cancer treatment. Chemoprotective agents protect healthy tissue from the toxic effects of anticancer drugs. [NIH] Chemotherapeutic agent: A drug used to treat cancer. [NIH] Chemotherapeutics: Noun plural but singular or plural in constructions : chemotherapy. [EU]

Chemotherapy: Treatment with anticancer drugs. [NIH] Chest wall: The ribs and muscles, bones, and joints that make up the area of the body between the neck and the abdomen. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Chlorambucil: An anticancer drug that belongs to the family of drugs called alkylating agents. [NIH] Chlorophyll: Porphyrin derivatives containing magnesium that act to convert light energy in photosynthetic organisms. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Choline: A basic constituent of lecithin that is found in many plants and animal organs. It is important as a precursor of acetylcholine, as a methyl donor in various metabolic processes, and in lipid metabolism. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chondroitin sulfate: The major glycosaminoglycan (a type of sugar molecule) in cartilage. [NIH]

Chordoma: A type of bone cancer that usually starts in the lower spinal column. [NIH] Choroid: The thin, highly vascular membrane covering most of the posterior of the eye between the retina and sclera. [NIH] Choroidal Neovascularization: A pathological process consisting of the formation of new blood vessels in the choroid. [NIH] Chromaffin System: The cells of the body which stain with chromium salts. They occur along the sympathetic nerves, in the adrenal gland, and in various other organs. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH]

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Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic granulocytic leukemia: A slowly progressing disease in which too many white blood cells are made in the bone marrow. Also called chronic myelogenous leukemia or chronic myeloid leukemia. [NIH] Chronic lymphocytic leukemia: A slowly progressing disease in which too many white blood cells (called lymphocytes) are found in the body. [NIH] Chronic myelogenous leukemia: CML. A slowly progressing disease in which too many white blood cells are made in the bone marrow. Also called chronic myeloid leukemia or chronic granulocytic leukemia. [NIH] Circulatory system: The system that contains the heart and the blood vessels and moves blood throughout the body. This system helps tissues get enough oxygen and nutrients, and it helps them get rid of waste products. The lymph system, which connects with the blood system, is often considered part of the circulatory system. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Claudication: Limping or lameness. [EU] Clear cell carcinoma: A rare type of tumor of the female genital tract in which the inside of the cells looks clear when viewed under a microscope. [NIH] Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Clone: The term "clone" has acquired a new meaning. It is applied specifically to the bits of inserted foreign DNA in the hybrid molecules of the population. Each inserted segment originally resided in the DNA of a complex genome amid millions of other DNA segment. [NIH]

Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2.

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Abnormal falling in of the walls of any part of organ. [EU] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Colonoscopy: Endoscopic examination, therapy or surgery of the luminal surface of the colon. [NIH] Colorectal: Having to do with the colon or the rectum. [NIH] Colorectal Cancer: Cancer that occurs in the colon (large intestine) or the rectum (the end of the large intestine). A number of digestive diseases may increase a person's risk of colorectal cancer, including polyposis and Zollinger-Ellison Syndrome. [NIH] Combination chemotherapy: Treatment using more than one anticancer drug. [NIH] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [NIH] Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complete remission: The disappearance of all signs of cancer. Also called a complete response. [NIH] Complete response: The disappearance of all signs of cancer in response to treatment. This does not always mean the cancer has been cured. [NIH] Compliance: Distensibility measure of a chamber such as the lungs (lung compliance) or bladder. Compliance is expressed as a change in volume per unit change in pressure. [NIH] Compress: A plug used to occludate an orifice in the control of bleeding, or to mop up secretions; an absorbent pad. [NIH]

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Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computer Systems: Systems composed of a computer or computers, peripheral equipment, such as disks, printers, and terminals, and telecommunications capabilities. [NIH] Computerized tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized axial tomography (CAT) scan and computed tomography (CT scan). [NIH] Concomitant: Accompanying; accessory; joined with another. [EU] Conduction: The transfer of sound waves, heat, nervous impulses, or electricity. [EU] Cone: One of the special retinal receptor elements which are presumed to be primarily concerned with perception of light and color stimuli when the eye is adapted to light. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Conjugated: Acting or operating as if joined; simultaneous. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constriction: The act of constricting. [NIH] Consultation: A deliberation between two or more physicians concerning the diagnosis and the proper method of treatment in a case. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Continuous infusion: The administration of a fluid into a blood vessel, usually over a prolonged period of time. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Contralateral: Having to do with the opposite side of the body. [NIH] Contrast Media: Substances used in radiography that allow visualization of certain tissues. [NIH]

Contrast medium: A substance that is introduced into or around a structure and, because of the difference in absorption of x-rays by the contrast medium and the surrounding tissues, allows radiographic visualization of the structure. [EU] Contrast Sensitivity: The ability to detect sharp boundaries (stimuli) and to detect slight changes in luminance at regions without distinct contours. Psychophysical measurements of

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this visual function are used to evaluate visual acuity and to detect eye disease. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Contusion: A bruise; an injury of a part without a break in the skin. [EU] Conventional therapy: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional treatment. [NIH] Conventional treatment: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional therapy. [NIH] Cooperative group: A group of physicians, hospitals, or both formed to treat a large number of persons in the same way so that new treatment can be evaluated quickly. Clinical trials of new cancer treatments often require many more people than a single physician or hospital can care for. [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Circulation: The circulation of blood through the coronary vessels of the heart. [NIH]

Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Coronary Vessels: The veins and arteries of the heart. [NIH] Corpus: The body of the uterus. [NIH] Corpus Callosum: Broad plate of dense myelinated fibers that reciprocally interconnect regions of the cortex in all lobes with corresponding regions of the opposite hemisphere. The corpus callosum is located deep in the longitudinal fissure. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Corticosteroids: Hormones that have antitumor activity in lymphomas and lymphoid leukemias; in addition, corticosteroids (steroids) may be used for hormone replacement and for the management of some of the complications of cancer and its treatment. [NIH] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Cosmic Radiation: High-energy radiation or particles from extraterrestrial space that strike the earth, its atmosphere, or spacecraft and may create secondary radiation as a result of collisions with the atmosphere or spacecraft. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU]

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Cranial Irradiation: The exposure of the head to roentgen rays or other forms of radioactivity for therapeutic or preventive purposes. [NIH] Cranial Nerves: Twelve pairs of nerves that carry general afferent, visceral afferent, special afferent, somatic efferent, and autonomic efferent fibers. [NIH] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Crowns: A prosthetic restoration that reproduces the entire surface anatomy of the visible natural crown of a tooth. It may be partial (covering three or more surfaces of a tooth) or complete (covering all surfaces). It is made of gold or other metal, porcelain, or resin. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Curettage: Removal of tissue with a curette, a spoon-shaped instrument with a sharp edge. [NIH]

Curette: A spoon-shaped instrument with a sharp edge. [NIH] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyclin: Molecule that regulates the cell cycle. [NIH] Cyclophosphamide: Precursor of an alkylating nitrogen mustard antineoplastic and immunosuppressive agent that must be activated in the liver to form the active aldophosphamide. It is used in the treatment of lymphomas, leukemias, etc. Its side effect, alopecia, has been made use of in defleecing sheep. Cyclophosphamide may also cause sterility, birth defects, mutations, and cancer. [NIH] Cyclosporine: A drug used to help reduce the risk of rejection of organ and bone marrow transplants by the body. It is also used in clinical trials to make cancer cells more sensitive to anticancer drugs. [NIH] Cyproterone: An anti-androgen that, in the form of its acetate, also has progestational properties. It is used in the treatment of hypersexuality in males, as a palliative in prostatic carcinoma, and, in combination with estrogen, for the therapy of severe acne and hirsutism in females. [NIH] Cystectomy: Used for excision of the urinary bladder. [NIH] Cystitis: Inflammation of the urinary bladder. [EU] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytomegalovirus: A genus of the family Herpesviridae, subfamily Betaherpesvirinae, infecting the salivary glands, liver, spleen, lungs, eyes, and other organs, in which they produce characteristically enlarged cells with intranuclear inclusions. Infection with Cytomegalovirus is also seen as an opportunistic infection in AIDS. [NIH] Cytomegalovirus Infections: Infection with Cytomegalovirus, characterized by enlarged cells bearing intranuclear inclusions. Infection may be in almost any organ, but the salivary glands are the most common site in children, as are the lungs in adults. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytoprotection: The process by which chemical compounds provide protection to cells against harmful agents. [NIH]

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Cytosine: A pyrimidine base that is a fundamental unit of nucleic acids. [NIH] Cytotoxic: Cell-killing. [NIH] Cytotoxic chemotherapy: Anticancer drugs that kill cells, especially cancer cells. [NIH] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of special organs. [NIH] Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. [NIH] Daunorubicin: Very toxic anthracycline aminoglycoside antibiotic isolated from Streptomyces peucetius and others, used in treatment of leukemias and other neoplasms. [NIH]

De novo: In cancer, the first occurrence of cancer in the body. [NIH] Decision Making: The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea. [NIH] Dehydration: The condition that results from excessive loss of body water. [NIH] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Dendritic: 1. Branched like a tree. 2. Pertaining to or possessing dendrites. [EU] Dendritic cell: A special type of antigen-presenting cell (APC) that activates T lymphocytes. [NIH]

Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dental Abutments: Natural teeth or teeth roots used as anchorage for a fixed or removable denture or other prosthesis (such as an implant) serving the same purpose. [NIH] Dental Care: The total of dental diagnostic, preventive, and restorative services provided to meet the needs of a patient (from Illustrated Dictionary of Dentistry, 1982). [NIH] Dental Caries: Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. The three most prominent theories used to explain the etiology of the disase are that acids produced by bacteria lead to decalcification; that micro-organisms destroy the enamel protein; or that keratolytic micro-organisms produce chelates that lead to decalcification. [NIH]

Dental Hygienists: Persons trained in an accredited school or dental college and licensed by the state in which they reside to provide dental prophylaxis under the direction of a licensed dentist. [NIH] Dental implant: A small metal pin placed inside the jawbone to mimic the root of a tooth. Dental implants can be used to help anchor a false tooth or teeth, or a crown or bridge. [NIH] Dentists: Individuals licensed to practice dentistry. [NIH] Dentition: The teeth in the dental arch; ordinarily used to designate the natural teeth in position in their alveoli. [EU] Dentures: An appliance used as an artificial or prosthetic replacement for missing teeth and adjacent tissues. It does not include crowns, dental abutments, nor artificial teeth. [NIH]

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Depigmentation: Removal or loss of pigment, especially melanin. [EU] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Deprivation: Loss or absence of parts, organs, powers, or things that are needed. [EU] Dermatitis: Any inflammation of the skin. [NIH] DES: Diethylstilbestrol. A synthetic hormone that was prescribed from the early 1940s until 1971 to help women with complications of pregnancy. DES has been linked to an increased risk of clear cell carcinoma of the vagina in daughters of women who used DES. DES may also increase the risk of breast cancer in women who used DES. [NIH] Desensitization: The prevention or reduction of immediate hypersensitivity reactions by administration of graded doses of allergen; called also hyposensitization and immunotherapy. [EU] Developing Countries: Countries in the process of change directed toward economic growth, that is, an increase in production, per capita consumption, and income. The process of economic growth involves better utilization of natural and human resources, which results in a change in the social, political, and economic structures. [NIH] Dexamethasone: (11 beta,16 alpha)-9-Fluoro-11,17,21-trihydroxy-16-methylpregna-1,4diene-3,20-dione. An anti-inflammatory glucocorticoid used either in the free alcohol or esterified form in treatment of conditions that respond generally to cortisone. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diacetyl: Carrier of aroma of butter, vinegar, coffee, and other foods. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Dialysate: A cleansing liquid used in the two major forms of dialysis--hemodialysis and peritoneal dialysis. [NIH] Dialyzer: A part of the hemodialysis machine. (See hemodialysis under dialysis.) The dialyzer has two sections separated by a membrane. One section holds dialysate. The other holds the patient's blood. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dilatation: The act of dilating. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Diploid: Having two sets of chromosomes. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention

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of subsidiary means. [EU] Discrete: Made up of separate parts or characterized by lesions which do not become blended; not running together; separate. [NIH] Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. [NIH] Disease-Free Survival: Period after successful treatment in which there is no appearance of the symptoms or effects of the disease. [NIH] Disease-specific survival: The percentage of subjects in a study who have survived a particular disease for a defined period of time. Usually reported as time since diagnosis or treatment. In calculating this percentage, only deaths from the disease being studied are counted. Subjects who died from some other cause are not included in the calculation. [NIH] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Disparity: Failure of the two retinal images of an object to fall on corresponding retinal points. [NIH] Disposition: A tendency either physical or mental toward certain diseases. [EU] Dissection: Cutting up of an organism for study. [NIH] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Diverticulum: A pathological condition manifested as a pouch or sac opening from a tubular or sacular organ. [NIH] Dopa: The racemic or DL form of DOPA, an amino acid found in various legumes. The dextro form has little physiologic activity but the levo form (levodopa) is a very important physiologic mediator and precursor and pharmacological agent. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Dosage Forms: Completed forms of the pharmaceutical preparation in which prescribed doses of medication are included. They are designed to resist action by gastric fluids, prevent vomiting and nausea, reduce or alleviate the undesirable taste and smells associated with oral administration, achieve a high concentration of drug at target site, or produce a delayed or long-acting drug effect. They include capsules, liniments, ointments, pharmaceutical solutions, powders, tablets, etc. [NIH] Dose Fractionation: Adminstration of the total dose of radiation in parts, at timed intervals. [NIH]

Dose-limiting: Describes side effects of a drug or other treatment that are serious enough to prevent an increase in dose or level of that treatment. [NIH]

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Dose-rate: The strength of a treatment given over a period of time. [NIH] Dosimeter: In nuclear science and radiotherapy, a device used for the detection and measurement of radiation absorbed dose or any dose-related ionizing radiation received by the individual; a radiation meter intended to measure absorbed dose. [NIH] Dosimetry: All the methods either of measuring directly, or of measuring indirectly and computing, absorbed dose, absorbed dose rate, exposure, exposure rate, dose equivalent, and the science associated with these methods. [NIH] Doxorubicin: Antineoplastic antibiotic obtained from Streptomyces peucetics. It is a hydroxy derivative of daunorubicin and is used in treatment of both leukemia and solid tumors. [NIH] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] Drug Design: The molecular designing of drugs for specific purposes (such as DNAbinding, enzyme inhibition, anti-cancer efficacy, etc.) based on knowledge of molecular properties such as activity of functional groups, molecular geometry, and electronic structure, and also on information cataloged on analogous molecules. Drug design is generally computer-assisted molecular modeling and does not include pharmacokinetics, dosage analysis, or drug administration analysis. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Resistance: Diminished or failed response of an organism, disease or tissue to the intended effectiveness of a chemical or drug. It should be differentiated from drug tolerance which is the progressive diminution of the susceptibility of a human or animal to the effects of a drug, as a result of continued administration. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Ductal carcinoma in situ: DCIS. Abnormal cells that involve only the lining of a duct. The cells have not spread outside the duct to other tissues in the breast. Also called intraductal carcinoma. [NIH] Duodenum: The first part of the small intestine. [NIH] Dwell time: In peritoneal dialysis, the amount of time a bag of dialysate remains in the patient's abdominal cavity during an exchange. [NIH] Dyes: Chemical substances that are used to stain and color other materials. The coloring may or may not be permanent. Dyes can also be used as therapeutic agents and test reagents in medicine and scientific research. [NIH] Dysphagia: Difficulty in swallowing. [EU] Dyspnea: Difficult or labored breathing. [NIH] Eating Disorders: A group of disorders characterized by physiological and psychological disturbances in appetite or food intake. [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH]

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Efferent: Nerve fibers which conduct impulses from the central nervous system to muscles and glands. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Elasticity: Resistance and recovery from distortion of shape. [NIH] Elastin: The protein that gives flexibility to tissues. [NIH] Electrode: Component of the pacing system which is at the distal end of the lead. It is the interface with living cardiac tissue across which the stimulus is transmitted. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Elementary Particles: Individual components of atoms, usually subatomic; subnuclear particles are usually detected only when the atomic nucleus decays and then only transiently, as most of them are unstable, often yielding pure energy without substance, i.e., radiation. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emergency Treatment: First aid or other immediate intervention for accidents or medical conditions requiring immediate care and treatment before definitive medical and surgical management can be procured. [NIH] Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Enamel: A very hard whitish substance which covers the dentine of the anatomical crown of a tooth. [NIH] Encapsulated: Confined to a specific, localized area and surrounded by a thin layer of tissue. [NIH]

Encephalopathy: A disorder of the brain that can be caused by disease, injury, drugs, or chemicals. [NIH] Endarterectomy: Surgical excision, performed under general anesthesia, of the atheromatous tunica intima of an artery. When reconstruction of an artery is performed as an endovascular procedure through a catheter, it is called atherectomy. [NIH] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] Endocardium: The innermost layer of the heart, comprised of endothelial cells. [NIH] Endocrine Glands: Ductless glands that secrete substances which are released directly into the circulation and which influence metabolism and other body functions. [NIH] Endocrine System: The system of glands that release their secretions (hormones) directly

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into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endometrial: Having to do with the endometrium (the layer of tissue that lines the uterus). [NIH]

Endometrium: The layer of tissue that lines the uterus. [NIH] Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endostatin: A drug that is being studied for its ability to prevent the growth of new blood vessels into a solid tumor. Endostatin belongs to the family of drugs called angiogenesis inhibitors. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endotoxin: Toxin from cell walls of bacteria. [NIH] Enhancer: Transcriptional element in the virus genome. [NIH] Enucleation: Removal of the nucleus from an eucaryiotic cell. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Eosinophil: A polymorphonuclear leucocyte with large eosinophilic granules in its cytoplasm, which plays a role in hypersensitivity reactions. [NIH] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epidermal Growth Factor: A 6 kD polypeptide growth factor initially discovered in mouse submaxillary glands. Human epidermal growth factor was originally isolated from urine based on its ability to inhibit gastric secretion and called urogastrone. epidermal growth factor exerts a wide variety of biological effects including the promotion of proliferation and differentiation of mesenchymal and epithelial cells. [NIH] Epidermal growth factor receptor: EGFR. The protein found on the surface of some cells and to which epidermal growth factor binds, causing the cells to divide. It is found at abnormally high levels on the surface of many types of cancer cells, so these cells may divide excessively in the presence of epidermal growth factor. Also known as ErbB1 or HER1. [NIH] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epidermoid carcinoma: A type of cancer in which the cells are flat and look like fish scales. Also called squamous cell carcinoma. [NIH] Epigastric: Having to do with the upper middle area of the abdomen. [NIH]

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Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epistaxis: Bleeding from the nose. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Epitope: A molecule or portion of a molecule capable of binding to the combining site of an antibody. For every given antigenic determinant, the body can construct a variety of antibody-combining sites, some of which fit almost perfectly, and others which barely fit. [NIH]

Epoetin alfa: A colony-stimulating factor that is made in the laboratory. It increases the production of red blood cells. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Erythroplakia: A reddened patch with a velvety surface found in the mouth. [NIH] Escalation: Progressive use of more harmful drugs. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Estrogen: One of the two female sex hormones. [NIH] Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Etoposide: A semisynthetic derivative of podophyllotoxin that exhibits antitumor activity. Etoposide inhibits DNA synthesis by forming a complex with topoisomerase II and DNA. This complex induces breaks in double stranded DNA and prevents repair by topoisomerase II binding. Accumulated breaks in DNA prevent entry into the mitotic phase of cell division, and lead to cell death. Etoposide acts primarily in the G2 and S phases of the cell cycle. [NIH] Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Evacuation: An emptying, as of the bowels. [EU] Evaluable disease: Disease that cannot be measured directly by the size of the tumor but can be evaluated by other methods specific to a particular clinical trial. [NIH] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Excisional: The surgical procedure of removing a tumor by cutting it out. The biopsy is then examined under a microscope. [NIH]

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Exhaustion: The feeling of weariness of mind and body. [NIH] Exocrine: Secreting outwardly, via a duct. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Expectorant: 1. Promoting the ejection, by spitting, of mucus or other fluids from the lungs and trachea. 2. An agent that promotes the ejection of mucus or exudate from the lungs, bronchi, and trachea; sometimes extended to all remedies that quiet cough (antitussives). [EU]

Expiration: The act of breathing out, or expelling air from the lungs. [EU] Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [NIH]

External radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external-beam radiation. [NIH] External-beam radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external radiation. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extraction: The process or act of pulling or drawing out. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Exudate: Material, such as fluid, cells, or cellular debris, which has escaped from blood vessels and has been deposited in tissues or on tissue surfaces, usually as a result of inflammation. An exudate, in contrast to a transudate, is characterized by a high content of protein, cells, or solid materials derived from cells. [EU] Eye Infections: Infection, moderate to severe, caused by bacteria, fungi, or viruses, which occurs either on the external surface of the eye or intraocularly with probable inflammation, visual impairment, or blindness. [NIH] Facial: Of or pertaining to the face. [EU] Facial Nerve: The 7th cranial nerve. The facial nerve has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root. Together they provide efferent innervation to the muscles of facial expression and to the lacrimal and salivary glands, and convey afferent information for taste from the anterior two-thirds of the tongue and for touch from the external ear. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fast Neutrons: Neutrons, the energy of which exceeds some arbitrary level, usually around one million electron volts. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

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Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Femoral: Pertaining to the femur, or to the thigh. [EU] Femoral Artery: The main artery of the thigh, a continuation of the external iliac artery. [NIH] Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Fetoprotein: Transabdominal aspiration of fluid from the amniotic sac with a view to detecting increases of alpha-fetoprotein in maternal blood during pregnancy, as this is an important indicator of open neural tube defects in the fetus. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Filgrastim: A colony-stimulating factor that stimulates the production of neutrophils (a type of white blood cell). It is a cytokine that belongs to the family of drugs called hematopoietic (blood-forming) agents. Also called granulocyte colony-stimulating factor (G-CSF). [NIH] Fissure: Any cleft or groove, normal or otherwise; especially a deep fold in the cerebral cortex which involves the entire thickness of the brain wall. [EU] Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body. [NIH] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Fluconazole: Triazole antifungal agent that is used to treat oropharyngeal candidiasis and cryptococcal meningitis in AIDS. [NIH] Fludarabine: An anticancer drug that belongs to the family of drugs called antimetabolites. [NIH]

Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can

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be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH] Fluoroscopy: Production of an image when X-rays strike a fluorescent screen. [NIH] Fluorouracil: A pyrimidine analog that acts as an antineoplastic antimetabolite and also has immunosuppressant. It interferes with DNA synthesis by blocking the thymidylate synthetase conversion of deoxyuridylic acid to thymidylic acid. [NIH] Flutamide: An antiandrogen with about the same potency as cyproterone in rodent and canine species. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. [NIH]

Forearm: The part between the elbow and the wrist. [NIH] Fossa: A cavity, depression, or pit. [NIH] Fovea: The central part of the macula that provides the sharpest vision. [NIH] Fractionation: Dividing the total dose of radiation therapy into several smaller, equal doses delivered over a period of several days. [NIH] Free Radicals: Highly reactive molecules with an unsatisfied electron valence pair. Free radicals are produced in both normal and pathological processes. They are proven or suspected agents of tissue damage in a wide variety of circumstances including radiation, damage from environment chemicals, and aging. Natural and pharmacological prevention of free radical damage is being actively investigated. [NIH] Friction: Surface resistance to the relative motion of one body against the rubbing, sliding, rolling, or flowing of another with which it is in contact. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] Gadolinium: An element of the rare earth family of metals. It has the atomic symbol Gd, atomic number 64, and atomic weight 157.25. Its oxide is used in the control rods of some nuclear reactors. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gallium: A rare, metallic element designated by the symbol, Ga, atomic number 31, and

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atomic weight 69.72. [NIH] Gamma knife: Radiation therapy in which high-energy rays are aimed at a tumor from many angles in a single treatment session. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Ganciclovir: Acyclovir analog that is a potent inhibitor of the Herpesvirus family including cytomegalovirus. Ganciclovir is used to treat complications from AIDS-associated cytomegalovirus infections. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Ganglioside: Protein kinase C's inhibitor which reduces ischemia-related brain damage. [NIH]

Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Emptying: The evacuation of food from the stomach into the duodenum. [NIH] Gastric Mucosa: Surface epithelium in the stomach that invaginates into the lamina propria, forming gastric pits. Tubular glands, characteristic of each region of the stomach (cardiac, gastric, and pyloric), empty into the gastric pits. The gastric mucosa is made up of several different kinds of cells. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH] Gels: Colloids with a solid continuous phase and liquid as the dispersed phase; gels may be unstable when, due to temperature or other cause, the solid phase liquifies; the resulting colloid is called a sol. [NIH] Gemcitabine: An anticancer drug that belongs to the family of drugs called antimetabolites. [NIH]

Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Gene Therapy: The introduction of new genes into cells for the purpose of treating disease by restoring or adding gene expression. Techniques include insertion of retroviral vectors, transfection, homologous recombination, and injection of new genes into the nuclei of single cell embryos. The entire gene therapy process may consist of multiple steps. The new genes may be introduced into proliferating cells in vivo (e.g., bone marrow) or in vitro (e.g., fibroblast cultures) and the modified cells transferred to the site where the gene expression is required. Gene therapy may be particularly useful for treating enzyme deficiency diseases, hemoglobinopathies, and leukemias and may also prove useful in restoring drug sensitivity, particularly for leukemia. [NIH]

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General practitioner: A medical practitioner who does not specialize in a particular branch of medicine or limit his practice to a specific class of diseases. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genital: Pertaining to the genitalia. [EU] Genitourinary: Pertaining to the genital and urinary organs; urogenital; urinosexual. [EU] Giant Cells: Multinucleated masses produced by the fusion of many cells; often associated with viral infections. In AIDS, they are induced when the envelope glycoprotein of the HIV virus binds to the CD4 antigen of uninfected neighboring T4 cells. The resulting syncytium leads to cell death and thus may account for the cytopathic effect of the virus. [NIH] Gingivitis: Inflammation of the gingivae. Gingivitis associated with bony changes is referred to as periodontitis. Called also oulitis and ulitis. [EU] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glioblastoma: A malignant form of astrocytoma histologically characterized by pleomorphism of cells, nuclear atypia, microhemorrhage, and necrosis. They may arise in any region of the central nervous system, with a predilection for the cerebral hemispheres, basal ganglia, and commissural pathways. Clinical presentation most frequently occurs in the fifth or sixth decade of life with focal neurologic signs or seizures. [NIH] Glioblastoma multiforme: A type of brain tumor that forms from glial (supportive) tissue of the brain. It grows very quickly and has cells that look very different from normal cells. Also called grade IV astrocytoma. [NIH] Glioma: A cancer of the brain that comes from glial, or supportive, cells. [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]

Glutamine: A non-essential amino acid present abundantly throught the body and is involved in many metabolic processes. It is synthesized from glutamic acid and ammonia. It is the principal carrier of nitrogen in the body and is an important energy source for many cells. [NIH] Glutathione Peroxidase: An enzyme catalyzing the oxidation of 2 moles of glutathione in the presence of hydrogen peroxide to yield oxidized glutathione and water. EC 1.11.1.9. [NIH]

Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Glycosaminoglycan:

A

type

of

long,

unbranched

polysaccharide

molecule.

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Glycosaminoglycans are major structural components of cartilage and are also found in the cornea of the eye. [NIH] Goats: Any of numerous agile, hollow-horned ruminants of the genus Capra, closely related to the sheep. [NIH] Gonadal: Pertaining to a gonad. [EU] Gonadorelin: A decapeptide hormone released by the hypothalamus. It stimulates the synthesis and secretion of both follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the pituitary gland. [NIH] Gonadotropin: The water-soluble follicle stimulating substance, by some believed to originate in chorionic tissue, obtained from the serum of pregnant mares. It is used to supplement the action of estrogens. [NIH] Gonads: The gamete-producing glands, ovary or testis. [NIH] Goserelin: 6-(O-(1,1-Dimethylethyl)-D-serine)-10-deglycinamideluteinizing hormonereleasing factor (pig) 2-(aminocarbonyl)hydrazide. A long-acting gonadorelin agonist. It is used in the treatment of malignant neoplasms of the prostate, uterine fibromas, and metastatic breast cancer. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Grading: A system for classifying cancer cells in terms of how abnormal they appear when examined under a microscope. The objective of a grading system is to provide information about the probable growth rate of the tumor and its tendency to spread. The systems used to grade tumors vary with each type of cancer. Grading plays a role in treatment decisions. [NIH]

Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Graft Rejection: An immune response with both cellular and humoral components, directed against an allogeneic transplant, whose tissue antigens are not compatible with those of the recipient. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Graft-versus-host disease: GVHD. A reaction of donated bone marrow or peripheral stem cells against a person's tissue. [NIH] Granisetron: A serotonin receptor (5HT-3 selective) antagonist that has been used as an antiemetic for cancer chemotherapy patients. [NIH] Granulation Tissue: A vascular connective tissue formed on the surface of a healing wound, ulcer, or inflamed tissue. It consists of new capillaries and an infiltrate containing lymphoid cells, macrophages, and plasma cells. [NIH] Granulocyte: A type of white blood cell that fights bacterial infection. Neutrophils, eosinophils, and basophils are granulocytes. [NIH] Granulocyte-Macrophage Colony-Stimulating Factor: An acidic glycoprotein of MW 23 kDa with internal disulfide bonds. The protein is produced in response to a number of inflammatory mediators by mesenchymal cells present in the hemopoietic environment and at peripheral sites of inflammation. GM-CSF is able to stimulate the production of neutrophilic granulocytes, macrophages, and mixed granulocyte-macrophage colonies from

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bone marrow cells and can stimulate the formation of eosinophil colonies from fetal liver progenitor cells. GM-CSF can also stimulate some functional activities in mature granulocytes and macrophages. [NIH] Granulocytopenia: A deficiency in the number of granulocytes, a type of white blood cell. [NIH]

Graphite: An allotropic form of carbon that is used in pencils, as a lubricant, and in matches and explosives. It is obtained by mining and its dust can cause lung irritation. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Gynecologic oncologist: A doctor who specializes in treating cancers of the female reproductive organs. [NIH] Half-Life: The time it takes for a substance (drug, radioactive nuclide, or other) to lose half of its pharmacologic, physiologic, or radiologic activity. [NIH] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Health Education: Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis. [NIH] Health Fairs: Community health education events focused on prevention of disease and promotion of health through audiovisual exhibits. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Hematologic malignancies: Cancers of the blood or bone marrow, including leukemia and lymphoma. Also called hematologic cancers. [NIH] Hematopoietic Stem Cell Transplantation: The transference of stem cells from one animal or human to another (allogeneic), or within the same individual (autologous). The source for the stem cells may be the bone marrow or peripheral blood. Stem cell transplantation has been used as an alternative to autologous bone marrow transplantation in the treatment of a variety of neoplasms. [NIH] Hematopoietic Stem Cells: Progenitor cells from which all blood cells derive. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma

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glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobin A: Normal adult human hemoglobin. The globin moiety consists of two alpha and two beta chains. [NIH] Hemoglobinopathies: A group of inherited disorders characterized by structural alterations within the hemoglobin molecule. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemorrhoids: Varicosities of the hemorrhoidal venous plexuses. [NIH] Hepatic: Refers to the liver. [NIH] Hepatocellular: Pertaining to or affecting liver cells. [EU] Hepatocellular carcinoma: A type of adenocarcinoma, the most common type of liver tumor. [NIH] Hepatoma: A liver tumor. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Herpes: Any inflammatory skin disease caused by a herpesvirus and characterized by the formation of clusters of small vesicles. When used alone, the term may refer to herpes simplex or to herpes zoster. [EU] Herpes virus: A member of the herpes family of viruses. [NIH] Herpes Zoster: Acute vesicular inflammation. [NIH] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]

Histology: The study of tissues and cells under a microscope. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormonal therapy: Treatment of cancer by removing, blocking, or adding hormones. Also called hormone therapy or endocrine therapy. [NIH] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hormone Replacement Therapy: Therapeutic use of hormones to alleviate the effects of hormone deficiency. [NIH] Hormone therapy: Treatment of cancer by removing, blocking, or adding hormones. Also called endocrine therapy. [NIH] Host: Any animal that receives a transplanted graft. [NIH]

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Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hybridization: The genetic process of crossbreeding to produce a hybrid. Hybrid nucleic acids can be formed by nucleic acid hybridization of DNA and RNA molecules. Protein hybridization allows for hybrid proteins to be formed from polypeptide chains. [NIH] Hydration: Combining with water. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent, bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hyperbaric: Characterized by greater than normal pressure or weight; applied to gases under greater than atmospheric pressure, as hyperbaric oxygen, or to a solution of greater specific gravity than another taken as a standard of reference. [EU] Hyperbaric oxygen: Oxygen that is at an atmospheric pressure higher than the pressure at sea level. Breathing hyperbaric oxygen to enhance the effectiveness of radiation therapy is being studied. [NIH] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthermia: A type of treatment in which body tissue is exposed to high temperatures to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation and certain anticancer drugs. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Hypogammaglobulinemia: The most common primary immunodeficiency in which antibody production is deficient. [NIH] Hypokinesia: Slow or diminished movement of body musculature. It may be associated with basal ganglia diseases; mental disorders; prolonged inactivity due to illness; experimental protocols used to evaluate the physiologic effects of immobility; and other

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conditions. [NIH] Hypopharynx: The portion of the pharynx between the inferior portion of the oropharynx and the larynx. [NIH] Hypotension: Abnormally low blood pressure. [NIH] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Hypothyroidism: Deficiency of thyroid activity. In adults, it is most common in women and is characterized by decrease in basal metabolic rate, tiredness and lethargy, sensitivity to cold, and menstrual disturbances. If untreated, it progresses to full-blown myxoedema. In infants, severe hypothyroidism leads to cretinism. In juveniles, the manifestations are intermediate, with less severe mental and developmental retardation and only mild symptoms of the adult form. When due to pituitary deficiency of thyrotropin secretion it is called secondary hypothyroidism. [EU] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] Hypoxic: Having too little oxygen. [NIH] Hysterectomy: Excision of the uterus. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Iliac Artery: Either of two large arteries originating from the abdominal aorta; they supply blood to the pelvis, abdominal wall and legs. [NIH] Immune function: Production and action of cells that fight disease or infection. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune Sera: Serum that contains antibodies. It is obtained from an animal that has been immunized either by antigen injection or infection with microorganisms containing the antigen. [NIH] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]

effects

of

foreign

Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large

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amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Immunosuppressant: An agent capable of suppressing immune responses. [EU] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Immunosuppressive Agents: Agents that suppress immune function by one of several mechanisms of action. Classical cytotoxic immunosuppressants act by inhibiting DNA synthesis. Others may act through activation of suppressor T-cell populations or by inhibiting the activation of helper cells. While immunosuppression has been brought about in the past primarily to prevent rejection of transplanted organs, new applications involving mediation of the effects of interleukins and other cytokines are emerging. [NIH] Immunosuppressive therapy: Therapy used to decrease the body's immune response, such as drugs given to prevent transplant rejection. [NIH] Immunotherapy: Manipulation of the host's immune system in treatment of disease. It includes both active and passive immunization as well as immunosuppressive therapy to prevent graft rejection. [NIH] Immunotoxins: Semisynthetic conjugates of various toxic molecules, including radioactive isotopes and bacterial or plant toxins, with specific immune substances such as immunoglobulins, monoclonal antibodies, and antigens. The antitumor or antiviral immune substance carries the toxin to the tumor or infected cell where the toxin exerts its poisonous effect. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In Situ Hybridization: A technique that localizes specific nucleic acid sequences within intact chromosomes, eukaryotic cells, or bacterial cells through the use of specific nucleic acid-labeled probes. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Incubation: The development of an infectious disease from the entrance of the pathogen to the appearance of clinical symptoms. [EU] Incubation period: The period of time likely to elapse between exposure to the agent of the disease and the onset of clinical symptoms. [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU]

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Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infiltrating cancer: Cancer that has spread beyond the layer of tissue in which it developed and is growing into surrounding, healthy tissues. Also called invasive cancer. [NIH] Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Inlay: In dentistry, a filling first made to correspond with the form of a dental cavity and then cemented into the cavity. [NIH] Inoperable: Not suitable to be operated upon. [EU] Inorganic: Pertaining to substances not of organic origin. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] Interleukins: Soluble factors which stimulate growth-related activities of leukocytes as well as other cell types. They enhance cell proliferation and differentiation, DNA synthesis, secretion of other biologically active molecules and responses to immune and inflammatory stimuli. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] International Cooperation: The interaction of persons or groups of persons representing various nations in the pursuit of a common goal or interest. [NIH]

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Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intervertebral: Situated between two contiguous vertebrae. [EU] Intervertebral Disk Displacement: An intervertebral disk in which the nucleus pulposus has protruded through surrounding fibrocartilage. This occurs most frequently in the lower lumbar region. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intracranial tumors: Tumors that occur in the brain. [NIH] Intraductal carcinoma: Abnormal cells that involve only the lining of a duct. The cells have not spread outside the duct to other tissues in the breast. Also called ductal carcinoma in situ. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intraocular: Within the eye. [EU] Intraoperative radiation therapy: IORT. Radiation treatment aimed directly at a tumor during surgery. [NIH] Intrathecal chemotherapy: Anticancer drugs that are injected into the fluid-filled space between the thin layers of tissue that cover the brain and spinal cord. [NIH] Intravascular: Within a vessel or vessels. [EU] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Invasive cancer: Cancer that has spread beyond the layer of tissue in which it developed and is growing into surrounding, healthy tissues. Also called infiltrating cancer. [NIH] Involuntary: Reaction occurring without intention or volition. [NIH] Iodine: A nonmetallic element of the halogen group that is represented by the atomic symbol I, atomic number 53, and atomic weight of 126.90. It is a nutritionally essential element, especially important in thyroid hormone synthesis. In solution, it has anti-infective properties and is used topically. [NIH] Iodine-131: Radioactive isotope of iodine. [NIH] Ionization: 1. Any process by which a neutral atom gains or loses electrons, thus acquiring a net charge, as the dissociation of a substance in solution into ions or ion production by the passage of radioactive particles. 2. Iontophoresis. [EU] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Iridium: A metallic element with the atomic symbol Ir, atomic number 77, and atomic weight 192.22. [NIH] Irinotecan: An anticancer drug that belongs to a family of anticancer drugs called

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topoisomerase inhibitors. It is a camptothecin analogue. Also called CPT 11. [NIH] Irradiation: The use of high-energy radiation from x-rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Irradiation is also called radiation therapy, radiotherapy, and x-ray therapy. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Isoelectric: Separation of amphoteric substances, dissolved in water, based on their isoelectric behavior. The amphoteric substances are a mixture of proteins to be separated and of auxiliary "carrier ampholytes". [NIH] Isoelectric Point: The pH in solutions of proteins and related compounds at which the dipolar ions are at a maximum. [NIH] Isoenzymes: One of various structurally related forms of an enzyme, each having the same mechanism but with differing chemical, physical, or immunological characteristics. [NIH] Jejunostomy: Surgical formation of an opening through the abdominal wall into the jejunum, usually for enteral hyperalimentation. [NIH] Jejunum: That portion of the small intestine which extends from the duodenum to the ileum; called also intestinum jejunum. [EU] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keratolytic: An agent that promotes keratolysis. [EU] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kinetic: Pertaining to or producing motion. [EU] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Laminin: Large, noncollagenous glycoprotein with antigenic properties. It is localized in the basement membrane lamina lucida and functions to bind epithelial cells to the basement membrane. Evidence suggests that the protein plays a role in tumor invasion. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Laryngeal: Having to do with the larynx. [NIH] Laryngectomy: Total or partial excision of the larynx. [NIH] Larynx: An irregularly shaped, musculocartilaginous tubular structure, lined with mucous membrane, located at the top of the trachea and below the root of the tongue and the hyoid bone. It is the essential sphincter guarding the entrance into the trachea and functioning secondarily as the organ of voice. [NIH]

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Latency: The period of apparent inactivity between the time when a stimulus is presented and the moment a response occurs. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Latent period: A seemingly inactive period, as that between exposure of tissue to an injurious agent and the manifestation of response, or that between the instant of stimulation and the beginning of response. [EU] Lavage: A cleaning of the stomach and colon. Uses a special drink and enemas. [NIH] Leflunomide: An anticancer drug that works by inhibiting a cancer cell growth factor. Also called SU101. [NIH] Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Lentivirus: A genus of the family Retroviridae consisting of non-oncogenic retroviruses that produce multi-organ diseases characterized by long incubation periods and persistent infection. Lentiviruses are unique in that they contain open reading frames (ORFs) between the pol and env genes and in the 3' env region. Five serogroups are recognized, reflecting the mammalian hosts with which they are associated. HIV-1 is the type species. [NIH] Lethal: Deadly, fatal. [EU] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Leucovorin: The active metabolite of folic acid. Leucovorin is used principally as its calcium salt as an antidote to folic acid antagonists which block the conversion of folic acid to folinic acid. [NIH] Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Leukoplakia: A white patch that may develop on mucous membranes such as the cheek, gums, or tongue and may become cancerous. [NIH] Leuprolide: A potent and long acting analog of naturally occurring gonadotropin-releasing hormone (gonadorelin). Its action is similar to gonadorelin, which regulates the synthesis and release of pituitary gonadotropins. [NIH] Levodopa: The naturally occurring form of dopa and the immediate precursor of dopamine. Unlike dopamine itself, it can be taken orally and crosses the blood-brain barrier. It is rapidly taken up by dopaminergic neurons and converted to dopamine. It is used for the treatment of parkinsonism and is usually given with agents that inhibit its conversion to dopamine outside of the central nervous system. [NIH] Libido: The psychic drive or energy associated with sexual instinct in the broad sense (pleasure and love-object seeking). It may also connote the psychic energy associated with instincts in general that motivate behavior. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Life cycle: The successive stages through which an organism passes from fertilized ovum or spore to the fertilized ovum or spore of the next generation. [NIH] Life Expectancy: A figure representing the number of years, based on known statistics, to which any person of a given age may reasonably expect to live. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU]

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Ligands: A RNA simulation method developed by the MIT. [NIH] Limited-stage small cell lung cancer: Cancer found in one lung and in nearby lymph nodes. [NIH]

Linear accelerator: An accelerator in which charged particles are accelerated along a straight path either by means of a traveling electromagnetic field or through a series of small gaps between electrodes that are so connected to an alternating voltage supply of high frequency. [NIH]

Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lip: Either of the two fleshy, full-blooded margins of the mouth. [NIH] Lipid: Fat. [NIH] Liposomal: A drug preparation that contains the active drug in very tiny fat particles. This fat-encapsulated drug is absorbed better, and its distribution to the tumor site is improved. [NIH]

Liposomes: Artificial, single or multilaminar vesicles (made from lecithins or other lipids) that are used for the delivery of a variety of biological molecules or molecular complexes to cells, for example, drug delivery and gene transfer. They are also used to study membranes and membrane proteins. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver cancer: A disease in which malignant (cancer) cells are found in the tissues of the liver. [NIH]

Liver metastases: Cancer that has spread from the original (primary) tumor to the liver. [NIH]

Liver scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in the liver, especially in abnormal areas, and can be detected by the scanner. [NIH] Local therapy: Treatment that affects cells in the tumor and the area close to it. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locally advanced cancer: Cancer that has spread only to nearby tissues or lymph nodes. [NIH]

Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Locoregional: The characteristic of a disease-producing organism to transfer itself, but typically to the same region of the body (a leg, the lungs, .) [EU] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH] Long-Term Care: Care over an extended period, usually for a chronic condition or disability,

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requiring periodic, intermittent, or continuous care. [NIH] Low Back Pain: Acute or chronic pain in the lumbar or sacral regions, which may be associated with musculo-ligamentous sprains and strains; intervertebral disk displacement; and other conditions. [NIH] Lubricants: Oily or slippery substances. [NIH] Lubrication: The application of a substance to diminish friction between two surfaces. It may refer to oils, greases, and similar substances for the lubrication of medical equipment but it can be used for the application of substances to tissue to reduce friction, such as lotions for skin and vaginal lubricants. [NIH] Luciferase: Any one of several enzymes that catalyze the bioluminescent reaction in certain marine crustaceans, fish, bacteria, and insects. The enzyme is a flavoprotein; it oxidizes luciferins to an electronically excited compound that emits energy in the form of light. The color of light emitted varies with the organism. The firefly enzyme is a valuable reagent for measurement of ATP concentration. (Dorland, 27th ed) EC 1.13.12.-. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lumen: The cavity or channel within a tube or tubular organ. [EU] Lumpectomy: Surgery to remove the tumor and a small amount of normal tissue around it. [NIH]

Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphoblastic: One of the most aggressive types of non-Hodgkin lymphoma. [NIH] Lymphoblasts: Interferon produced predominantly by leucocyte cells. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphocytic: Referring to lymphocytes, a type of white blood cell. [NIH] Lymphoepithelioma: A type of cancer that begins in the tissues covering the nasopharynx (the upper part of the throat behind the nose). [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphokines: Soluble protein factors generated by activated lymphocytes that affect other cells, primarily those involved in cellular immunity. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH]

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Lymphoscintigraphy: A method used to identify the sentinel node (the first draining lymph node near a tumor). A radioactive substance that can be taken up by lymph nodes is injected at the site of the tumor, and a doctor follows the movement of this substance on a computer screen. Once the lymph nodes that have taken up the substance are identified, they can be removed and examined to see if they contain tumor cells. [NIH] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Macrophage Activation: The process of altering the morphology and functional activity of macrophages so that they become avidly phagocytic. It is initiated by lymphokines, such as the macrophage activation factor (MAF) and the macrophage migration-inhibitory factor (MMIF), immune complexes, C3b, and various peptides, polysaccharides, and immunologic adjuvants. [NIH] Macula: A stain, spot, or thickening. Often used alone to refer to the macula retinae. [EU] Macula Lutea: An oval area in the retina, 3 to 5 mm in diameter, usually located temporal to the superior pole of the eye and slightly below the level of the optic disk. [NIH] Macular Degeneration: Degenerative changes in the macula lutea of the retina. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Magnetic Resonance Spectroscopy: Spectroscopic method of measuring the magnetic moment of elementary particles such as atomic nuclei, protons or electrons. It is employed in clinical applications such as NMR Tomography (magnetic resonance imaging). [NIH] Malformation: A morphologic developmental process. [EU]

defect

resulting

from

an

intrinsically

abnormal

Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant mesothelioma: A rare type of cancer in which malignant cells are found in the sac lining the chest or abdomen. Exposure to airborne asbestos particles increases one's risk of developing malignant mesothelioma. [NIH] Malignant tumor: A tumor capable of metastasizing. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mammary: Pertaining to the mamma, or breast. [EU] Mammography: Radiographic examination of the breast. [NIH] Mandible: The largest and strongest bone of the face constituting the lower jaw. It supports the lower teeth. [NIH] Manic: Affected with mania. [EU] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Mantle field: The area of the neck, chest, and lymph nodes in the armpit that are exposed to radiation. [NIH] Masseter Muscle: A masticatory muscle whose action is closing the jaws. [NIH]

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Mastectomy: Surgery to remove the breast (or as much of the breast tissue as possible). [NIH] Maxillofacial Abnormalities: Congenital structural deformities, malformations, or other abnormalities of the maxilla and face or facial bones. [NIH] Maximum Tolerated Dose: The highest dose level eliciting signs of toxicity without having major effects on survival relative to the test in which it is used. [NIH] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical oncologist: A doctor who specializes in diagnosing and treating cancer using chemotherapy, hormonal therapy, and biological therapy. A medical oncologist often serves as the main caretaker of someone who has cancer and coordinates treatment provided by other specialists. [NIH] Medical Oncology: A subspecialty of internal medicine concerned with the study of neoplasms. [NIH] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medullary: Pertaining to the marrow or to any medulla; resembling marrow. [EU] Medulloblastoma: A malignant brain tumor that begins in the lower part of the brain and can spread to the spine or to other parts of the body. Medulloblastomas are sometimes called primitive neuroectodermal tumors (PNET). [NIH] Megakaryocytes: Very large bone marrow cells which release mature blood platelets. [NIH] Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Melanin: The substance that gives the skin its color. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Proteins: Proteins which are found in membranes including cellular and intracellular membranes. They consist of two types, peripheral and integral proteins. They include most membrane-associated enzymes, antigenic proteins, transport proteins, and drug, hormone, and lectin receptors. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH]

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Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU] Menopause: Permanent cessation of menstruation. [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Mesenchymal: Refers to cells that develop into connective tissue, blood vessels, and lymphatic tissue. [NIH] Mesons: Short-lived elementary particles found in cosmic radiation or produced from nuclear disintegration. Their mass is between that of protons and electrons and they can be negative, positive, or neutral. pi-Mesons (pions) are heavier than mu-mesons (muons) and are proposed for cancer radiotherapy because their capture and disintegration by matter produces powerful, but short-lived, secondary radiation. [NIH] Mesothelioma: A benign (noncancerous) or malignant (cancerous) tumor affecting the lining of the chest or abdomen. Exposure to asbestos particles in the air increases the risk of developing malignant mesothelioma. [NIH] Metabolic disorder: A condition in which normal metabolic processes are disrupted, usually because of a missing enzyme. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Metalloporphyrins: Porphyrins which are combined with a metal ion. The metal is bound equally to all four nitrogen atoms of the pyrrole rings. They possess characteristic absorption spectra which can be utilized for identification or quantitative estimation of porphyrins and porphyrin-bound compounds. [NIH] Metaphase: The second phase of cell division, in which the chromosomes line up across the equatorial plane of the spindle prior to separation. [NIH] Metaplasia: A condition in which there is a change of one adult cell type to another similar adult cell type. [NIH] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Metastasize: To spread from one part of the body to another. When cancer cells metastasize and form secondary tumors, the cells in the metastatic tumor are like those in the original (primary) tumor. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] Metastatic cancer: Cancer that has spread from the place in which it started to other parts of the body. [NIH] Methotrexate: An antineoplastic antimetabolite with immunosuppressant properties. It is an inhibitor of dihydrofolate reductase and prevents the formation of tetrahydrofolate, necessary for synthesis of thymidylate, an essential component of DNA. [NIH]

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MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Micronuclei: Nuclei, separate from and additional to the main nucleus of a cell, produced during the telophase of mitosis or meiosis by lagging chromosomes or chromosome fragments derived from spontaneous or experimentally induced chromosomal structural changes. This concept also includes the smaller, reproductive nuclei found in multinucleate protozoans. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Micro-organism: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Microspheres: Small uniformly-sized spherical particles frequently radioisotopes or various reagents acting as tags or markers. [NIH]

labeled

with

Microtubules: Slender, cylindrical filaments found in the cytoskeleton of plant and animal cells. They are composed of the protein tubulin. [NIH] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Milliliter: A measure of volume for a liquid. A milliliter is approximately 950-times smaller than a quart and 30-times smaller than a fluid ounce. A milliliter of liquid and a cubic centimeter (cc) of liquid are the same. [NIH] Miotic: 1. Pertaining to, characterized by, or producing miosis : contraction of the pupil. 2. An agent that causes the pupil to contract. 3. Meiotic: characterized by cell division. [EU] Mitomycin: An antineoplastic antibiotic produced by Streptomyces caespitosus. It acts as a bi- or trifunctional alkylating agent causing cross-linking of DNA and inhibition of DNA synthesis. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Mitotic: Cell resulting from mitosis. [NIH] Mitotic Spindle Apparatus: An organelle consisting of three components: (1) the astral microtubules, which form around each centrosome and extend to the periphery; (2) the polar microtubules which extend from one spindle pole to the equator; and (3) the kinetochore microtubules, which connect the centromeres of the various chromosomes to either centrosome. [NIH] Mobilization: The process of making a fixed part or stored substance mobile, as by separating a part from surrounding structures to make it accessible for an operative procedure or by causing release into the circulation for body use of a substance stored in the body. [EU]

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Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monoclonal antibodies: Laboratory-produced substances that can locate and bind to cancer cells wherever they are in the body. Many monoclonal antibodies are used in cancer detection or therapy; each one recognizes a different protein on certain cancer cells. Monoclonal antibodies can be used alone, or they can be used to deliver drugs, toxins, or radioactive material directly to a tumor. [NIH] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Mononuclear: A cell with one nucleus. [NIH] Morphogenesis: The development of the form of an organ, part of the body, or organism. [NIH]

Morphological: Relating to the configuration or the structure of live organs. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Motor nerve: An efferent nerve conveying an impulse that excites muscular contraction. [NIH]

Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Mucocutaneous: Pertaining to or affecting the mucous membrane and the skin. [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucositis: A complication of some cancer therapies in which the lining of the digestive system becomes inflamed. Often seen as sores in the mouth. [NIH] Multidrug resistance: Adaptation of tumor cells to anticancer drugs in ways that make the drugs less effective. [NIH] Multiple Myeloma: A malignant tumor of plasma cells usually arising in the bone marrow; characterized by diffuse involvement of the skeletal system, hyperglobulinemia, Bence-Jones proteinuria, and anemia. [NIH] Multivariate Analysis: A set of techniques used when variation in several variables has to

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be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables. [NIH] Mutagenic: Inducing genetic mutation. [EU] Mycosis: Any disease caused by a fungus. [EU] Mycosis Fungoides: A chronic malignant T-cell lymphoma of the skin. In the late stages the lymph nodes and viscera are affected. [NIH] Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Myelogenous: Produced by, or originating in, the bone marrow. [NIH] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardial Ischemia: A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (coronary arteriosclerosis), to obstruction by a thrombus (coronary thrombosis), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (myocardial infarction). [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myoglobin: A conjugated protein which is the oxygen-transporting pigment of muscle. It is made up of one globin polypeptide chain and one heme group. [NIH] Naive: Used to describe an individual who has never taken a certain drug or class of drugs (e. g., AZT-naive, antiretroviral-naive), or to refer to an undifferentiated immune system cell. [NIH] Nasal Cavity: The proximal portion of the respiratory passages on either side of the nasal septum, lined with ciliated mucosa, extending from the nares to the pharynx. [NIH] Nasal Septum: The partition separating the two nasal cavities in the midplane, composed of cartilaginous, membranous and bony parts. [NIH] Nasopharynx: The nasal part of the pharynx, lying above the level of the soft palate. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Neck dissection: Surgery to remove lymph nodes and other tissues in the neck. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephropathy: Disease of the kidneys. [EU]

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Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nerve Fibers: Slender processes of neurons, especially the prolonged axons that conduct nerve impulses. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neural Pathways: Neural tracts connecting one part of the nervous system with another. [NIH]

Neuroblastoma: Cancer that arises in immature nerve cells and affects mostly infants and children. [NIH] Neuroectodermal tumor: A tumor of the central or peripheral nervous system. [NIH] Neuroendocrine: Having to do with the interactions between the nervous system and the endocrine system. Describes certain cells that release hormones into the blood in response to stimulation of the nervous system. [NIH] Neurologic: Having to do with nerves or the nervous system. [NIH] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neurosecretory Systems: A system of neurons that has the specialized function to produce and secrete hormones, and that constitutes, in whole or in part, an endocrine organ or system. [NIH] Neurosurgery: A surgical specialty concerned with the treatment of diseases and disorders of the brain, spinal cord, and peripheral and sympathetic nervous system. [NIH] Neurotoxicity: The tendency of some treatments to cause damage to the nervous system. [NIH]

Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Neutrophils: Granular leukocytes having a nucleus with three to five lobes connected by slender threads of chromatin, and cytoplasm containing fine inconspicuous granules and stainable by neutral dyes. [NIH] Nicotine: Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by

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volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nocturia: Excessive urination at night. [EU] Nonmetastatic: Cancer that has not spread from the primary (original) site to other sites in the body. [NIH] Non-small cell lung cancer: A group of lung cancers that includes squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclear Medicine: A specialty field of radiology concerned with diagnostic, therapeutic, and investigative use of radioactive compounds in a pharmaceutical form. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleic Acid Hybridization: The process whereby two single-stranded polynucleotides form a double-stranded molecule, with hydrogen bonding between the complementary bases in the two strains. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nurse Practitioners: Nurses who are specially trained to assume an expanded role in providing medical care under the supervision of a physician. [NIH] Nursing Care: Care given to patients by nursing service personnel. [NIH] Observational study: An epidemiologic study that does not involve any intervention, experimental or otherwise. Such a study may be one in which nature is allowed to take its course, with changes in one characteristic being studied in relation to changes in other characteristics. Analytical epidemiologic methods, such as case-control and cohort study designs, are properly called observational epidemiology because the investigator is observing without intervention other than to record, classify, count, and statistically analyze results. [NIH] Occult: Obscure; concealed from observation, difficult to understand. [EU] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Odour: A volatile emanation that is perceived by the sense of smell. [EU] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Olfaction: Function of the olfactory apparatus to perceive and discriminate between the molecules that reach it, in gas form from an external environment, directly or indirectly via the nose. [NIH] Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH] Oncogenic: Chemical, viral, radioactive or other agent that causes cancer; carcinogenic. [NIH]

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Oncologist: A doctor who specializes in treating cancer. Some oncologists specialize in a particular type of cancer treatment. For example, a radiation oncologist specializes in treating cancer with radiation. [NIH] Oncology: The study of cancer. [NIH] Oncolysis: The destruction of or disposal by absorption of any neoplastic cells. [NIH] Oncolytic: Pertaining to, characterized by, or causing oncolysis (= the lysis or destruction of tumour cells). [EU] Opacity: Degree of density (area most dense taken for reading). [NIH] Open Reading Frames: Reading frames where successive nucleotide triplets can be read as codons specifying amino acids and where the sequence of these triplets is not interrupted by stop codons. [NIH] Ophthalmology: A surgical specialty concerned with the structure and function of the eye and the medical and surgical treatment of its defects and diseases. [NIH] Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease. [NIH] Oral Hygiene: The practice of personal hygiene of the mouth. It includes the maintenance of oral cleanliness, tissue tone, and general preservation of oral health. [NIH] Orderly: A male hospital attendant. [NIH] Organ Culture: The growth in aseptic culture of plant organs such as roots or shoots, beginning with organ primordia or segments and maintaining the characteristics of the organ. [NIH] Organ Preservation: The process by which organs are kept viable outside of the organism from which they were removed (i.e., kept from decay by means of a chemical agent, cooling, or a fluid substitute that mimics the natural state within the organism). [NIH] Organ Transplantation: Transference of an organ between individuals of the same species or between individuals of different species. [NIH] Organelles: Specific particles of membrane-bound organized living substances present in eukaryotic cells, such as the mitochondria; the golgi apparatus; endoplasmic reticulum; lysomomes; plastids; and vacuoles. [NIH] Orofacial: Of or relating to the mouth and face. [EU] Oropharynx: Oral part of the pharynx. [NIH] Osteogenic sarcoma: A malignant tumor of the bone. Also called osteosarcoma. [NIH] Osteomyelitis: Inflammation of bone caused by a pyogenic organism. It may remain localized or may spread through the bone to involve the marrow, cortex, cancellous tissue, and periosteum. [EU] Osteonecrosis: Death of a bone or part of a bone, either atraumatic or posttraumatic. [NIH] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Osteoradionecrosis: Necrosis of bone following radiation injury. [NIH] Osteosarcoma: A cancer of the bone that affects primarily children and adolescents. Also called osteogenic sarcoma. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH]

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Overall survival: The percentage of subjects in a study who have survived for a defined period of time. Usually reported as time since diagnosis or treatment. Often called the survival rate. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxaliplatin: An anticancer drug that belongs to the family of drugs called platinum compounds. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxides: Binary compounds of oxygen containing the anion O(2-). The anion combines with metals to form alkaline oxides and non-metals to form acidic oxides. [NIH] Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Oxygenation: The process of supplying, treating, or mixing with oxygen. No:1245 oxygenation the process of supplying, treating, or mixing with oxygen. [EU] Paclitaxel: Antineoplastic agent isolated from the bark of the Pacific yew tree, Taxus brevifolia. Paclitaxel stabilizes microtubules in their polymerized form and thus mimics the action of the proto-oncogene proteins c-mos. [NIH] Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH] Palladium: A chemical element having an atomic weight of 106.4, atomic number of 46, and the symbol Pd. It is a white, ductile metal resembling platinum, and following it in abundance and importance of applications. It is used in dentistry in the form of gold, silver, and copper alloys. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Palpation: Application of fingers with light pressure to the surface of the body to determine consistence of parts beneath in physical diagnosis; includes palpation for determining the outlines of organs. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Papilla: A small nipple-shaped elevation. [NIH] Papillary: Pertaining to or resembling papilla, or nipple. [EU] Paraffin: A mixture of solid hydrocarbons obtained from petroleum. It has a wide range of uses including as a stiffening agent in ointments, as a lubricant, and as a topical antiinflammatory. It is also commonly used as an embedding material in histology. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU]

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Parenteral Nutrition: The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously). [NIH] Parietal: 1. Of or pertaining to the walls of a cavity. 2. Pertaining to or located near the parietal bone, as the parietal lobe. [EU] Parkinsonism: A group of neurological disorders characterized by hypokinesia, tremor, and muscular rigidity. [EU] Parotid: The space that contains the parotid gland, the facial nerve, the external carotid artery, and the retromandibular vein. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathogen: Any disease-producing microorganism. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

PDQ: Physician Data Query. PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information is available on the CancerNet Web site, and more specific information about PDQ can be found at http://cancernet.nci.nih.gov/pdq.html. [NIH] Pelvic: Pertaining to the pelvis. [EU] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Penicillin: An antibiotic drug used to treat infection. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Percutaneous: Performed through the skin, as injection of radiopacque material in radiological examination, or the removal of tissue for biopsy accomplished by a needle. [EU] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood

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vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [NIH]

Perineal: Pertaining to the perineum. [EU] Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Periodontitis: Inflammation of the periodontal membrane; also called periodontitis simplex. [NIH]

Perioral: Situated or occurring around the mouth. [EU] Peripheral blood: Blood circulating throughout the body. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peripheral stem cell transplantation: A method of replacing blood-forming cells destroyed by cancer treatment. Immature blood cells (stem cells) in the circulating blood that are similar to those in the bone marrow are given after treatment to help the bone marrow recover and continue producing healthy blood cells. Transplantation may be autologous (an individual's own blood cells saved earlier), allogeneic (blood cells donated by someone else), or syngeneic (blood cells donated by an identical twin). Also called peripheral stem cell support. [NIH] Peripheral stem cells: Immature cells found circulating in the bloodstream. New blood cells develop from peripheral stem cells. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Dialysis: Dialysis fluid being introduced into and removed from the peritoneal cavity as either a continuous or an intermittent procedure. [NIH] Perivascular: Situated around a vessel. [EU] Pesticides: Chemicals used to destroy pests of any sort. The concept includes fungicides (industrial fungicides), insecticides, rodenticides, etc. [NIH] Petroleum: Naturally occurring complex liquid hydrocarbons which, after distillation, yield combustible fuels, petrochemicals, and lubricants. [NIH] PH: The symbol relating the hydrogen ion (H+) concentration or activity of a solution to that of a given standard solution. Numerically the pH is approximately equal to the negative logarithm of H+ concentration expressed in molarity. pH 7 is neutral; above it alkalinity increases and below it acidity increases. [EU] Phallic: Pertaining to the phallus, or penis. [EU] Phantom: Used to absorb and/or scatter radiation equivalently to a patient, and hence to estimate radiation doses and test imaging systems without actually exposing a patient. It may be an anthropomorphic or a physical test object. [NIH] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH]

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Pharmaceutical Solutions: Homogeneous liquid preparations that contain one or more chemical substances dissolved, i.e., molecularly dispersed, in a suitable solvent or mixture of mutually miscible solvents. For reasons of their ingredients, method of preparation, or use, they do not fall into another group of products. [NIH] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH] Phenylbutyrate: An anticancer drug that belongs to the family of drugs called differentiating agents. [NIH] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Phosphorylation: The introduction of a phosphoryl group into a compound through the formation of an ester bond between the compound and a phosphorus moiety. [NIH] Photodynamic therapy: Treatment with drugs that become active when exposed to light. These drugs kill cancer cells. [NIH] Photosensitivity: An abnormal cutaneous response involving the interaction between photosensitizing substances and sunlight or filtered or artificial light at wavelengths of 280400 mm. There are two main types : photoallergy and photoxicity. [EU] Physical Therapy: The restoration of function and the prevention of disability following disease or injury with the use of light, heat, cold, water, electricity, ultrasound, and exercise. [NIH]

Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pilocarpine: A slowly hydrolyzed muscarinic agonist with no nicotinic effects. Pilocarpine is used as a miotic and in the treatment of glaucoma. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Planning Techniques: Procedures, strategies, and theories of planning. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins

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that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Platelet Count: A count of the number of platelets per unit volume in a sample of venous blood. [NIH] Platelet Transfusion: The transfer of blood platelets from a donor to a recipient or reinfusion to the donor. [NIH] Plateletpheresis: The preparation of platelet concentrates with the return of red cells and platelet-poor plasma to the donor. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]

Platinum Compounds: Inorganic compounds which contain platinum as the central atom. [NIH]

Plethysmography: Recording of change in the size of a part as modified by the circulation in it. [NIH] Pleura: The thin serous membrane enveloping the lungs and lining the thoracic cavity. [NIH] Pleural: A circumscribed area of hyaline whorled fibrous tissue which appears on the surface of the parietal pleura, on the fibrous part of the diaphragm or on the pleura in the interlobar fissures. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Pneumonitis: A disease caused by inhaling a wide variety of substances such as dusts and molds. Also called "farmer's disease". [NIH] Podophyllotoxin: The main active constituent of the resin from the roots of may apple or mandrake (Podophyllum peltatum and P. emodi). It is a potent spindle poison, toxic if taken internally, and has been used as a cathartic. It is very irritating to skin and mucous membranes, has keratolytic actions, has been used to treat warts and keratoses, and may have antineoplastic properties, as do some of its congeners and derivatives. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polyploid: An organism with more than two chromosome sets in its vegetative cells. [NIH] Polyposis: The development of numerous polyps (growths that protrude from a mucous membrane). [NIH] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Pons: The part of the central nervous system lying between the medulla oblongata and the mesencephalon, ventral to the cerebellum, and consisting of a pars dorsalis and a pars ventralis. [NIH] Porphyrins: A group of compounds containing the porphin structure, four pyrrole rings

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connected by methine bridges in a cyclic configuration to which a variety of side chains are attached. The nature of the side chain is indicated by a prefix, as uroporphyrin, hematoporphyrin, etc. The porphyrins, in combination with iron, form the heme component in biologically significant compounds such as hemoglobin and myoglobin. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postnatal: Occurring after birth, with reference to the newborn. [EU] Postoperative: After surgery. [NIH] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Potentiate: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Potentiating: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practicability: A non-standard characteristic of an analytical procedure. It is dependent on the scope of the method and is determined by requirements such as sample throughout and costs. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precancerous: A term used to describe a condition that may (or is likely to) become cancer. Also called premalignant. [NIH] Preclinical: Before a disease becomes clinically recognizable. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Prednisolone: A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states. [NIH] Prednisone: A synthetic anti-inflammatory glucocorticoid derived from cortisone. It is biologically inert and converted to prednisolone in the liver. [NIH] Premalignant: A term used to describe a condition that may (or is likely to) become cancer. Also called precancerous. [NIH] Premenopausal: Refers to the time before menopause. Menopause is the time of life when a women's menstrual periods stop permanently; also called "change of life." [NIH] Preoperative: Preceding an operation. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH]

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Primary tumor: The original tumor. [NIH] Primitive neuroectodermal tumors: PNET. A type of bone cancer that forms in the middle (shaft) of large bones. Also called Ewing's sarcoma/primitive neuroectodermal tumor. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Problem Solving: A learning situation involving more than one alternative from which a selection is made in order to attain a specific goal. [NIH] Proctitis: Inflammation of the rectum. [EU] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Prognostic factor: A situation or condition, or a characteristic of a patient, that can be used to estimate the chance of recovery from a disease, or the chance of the disease recurring (coming back). [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Propofol: A widely used anesthetic. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Prostate gland: A gland in the male reproductive system just below the bladder. It surrounds part of the urethra, the canal that empties the bladder, and produces a fluid that forms part of semen. [NIH] Prostatectomy: Complete or partial surgical removal of the prostate. Three primary approaches are commonly employed: suprapubic - removal through an incision above the pubis and through the urinary bladder; retropubic - as for suprapubic but without entering the urinary bladder; and transurethral (transurethral resection of prostate). [NIH] Prostate-Specific Antigen: Kallikrein-like serine proteinase produced by epithelial cells of both benign and malignant prostate tissue. It is an important marker for the diagnosis of prostate cancer. EC 3.4.21.77. [NIH] Prostatic acid phosphatase: PAP. An enzyme produced by the prostate. It may be found in increased amounts in men who have prostate cancer. [NIH]

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Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Proteoglycan: A molecule that contains both protein and glycosaminoglycans, which are a type of polysaccharide. Proteoglycans are found in cartilage and other connective tissues. [NIH]

Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Proto-Oncogene Proteins: Products of proto-oncogenes. Normally they do not have oncogenic or transforming properties, but are involved in the regulation or differentiation of cell growth. They often have protein kinase activity. [NIH] Proto-Oncogene Proteins c-mos: Cellular proteins encoded by the c-mos genes. They function in the cell cycle to maintain maturation promoting factor in the active state and have protein-serine/threonine kinase activity. Oncogenic transformation can take place when c-mos proteins are expressed at the wrong time. [NIH] Proto-Oncogenes: Normal cellular genes homologous to viral oncogenes. The products of proto-oncogenes are important regulators of biological processes and appear to be involved in the events that serve to maintain the ordered procession through the cell cycle. Protooncogenes have names of the form c-onc. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Psoriasis: A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. [NIH] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Fibrosis: Chronic inflammation and progressive fibrosis of the pulmonary alveolar walls, with steadily progressive dyspnea, resulting finally in death from oxygen lack or right heart failure. [NIH]

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Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Pupil: The aperture in the iris through which light passes. [NIH] Pyogenic: Producing pus; pyopoietic (= liquid inflammation product made up of cells and a thin fluid called liquor puris). [EU] Quadrantectomy: Surgical removal of the region of the breast (approximately one quarter) containing cancer. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Quiescent: Marked by a state of inactivity or repose. [EU] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Racemic: Optically inactive but resolvable in the way of all racemic compounds. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation Injuries: Harmful effects of non-experimental exposure to ionizing or nonionizing radiation in chordates. [NIH] Radiation oncologist: A doctor who specializes in using radiation to treat cancer. [NIH] Radiation Oncology: A subspecialty of medical oncology and radiology concerned with the radiotherapy of cancer. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radical cystectomy: Surgery to remove the bladder as well as nearby tissues and organs. [NIH]

Radical prostatectomy: Surgery to remove the entire prostate. The two types of radical prostatectomy are retropubic prostatectomy and perineal prostatectomy. [NIH] Radioactive: Giving off radiation. [NIH] Radioactive iodine: A radioactive form of the chemical element iodine, often used for imaging tests or as a treatment for cancer. [NIH] Radioactivity: The quality of emitting or the emission of corpuscular or electromagnetic radiations consequent to nuclear disintegration, a natural property of all chemical elements of atomic number above 83, and possible of induction in all other known elements. [EU] Radiobiology: That part of biology which deals with the effects of radiation on living organisms. [NIH] Radiography: Examination of any part of the body for diagnostic purposes by means of roentgen rays, recording the image on a sensitized surface (such as photographic film). [NIH] Radioimmunotherapy: Radiotherapy where cytotoxic radionuclides are linked to antibodies in order to deliver toxins directly to tumor targets. Therapy with targeted radiation rather

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than antibody-targeted toxins (immunotoxins) has the advantage that adjacent tumor cells, which lack the appropriate antigenic determinants, can be destroyed by radiation cross-fire. Radioimmunotherapy is sometimes called targeted radiotherapy, but this latter term can also refer to radionuclides linked to non-immune molecules (radiotherapy). [NIH] Radioisotope: An unstable element that releases radiation as it breaks down. Radioisotopes can be used in imaging tests or as a treatment for cancer. [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [NIH] Radiopharmaceutical: Any medicinal product which, when ready for use, contains one or more radionuclides (radioactive isotopes) included for a medicinal purpose. [NIH] Radiosensitizers: Drugs that make tumor cells more sensitive to radiation. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Radiotherapy Dosage: The total amount of radiation absorbed by tissues as a result of radiotherapy. [NIH] Radius: The lateral bone of the forearm. [NIH] Random Allocation: A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects. [NIH] Randomization: Also called random allocation. Is allocation of individuals to groups, e.g., for experimental and control regimens, by chance. Within the limits of chance variation, random allocation should make the control and experimental groups similar at the start of an investigation and ensure that personal judgment and prejudices of the investigator do not influence allocation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Reactive Oxygen Species: Reactive intermediate oxygen species including both radicals and non-radicals. These substances are constantly formed in the human body and have been shown to kill bacteria and inactivate proteins, and have been implicated in a number of diseases. Scientific data exist that link the reactive oxygen species produced by inflammatory phagocytes to cancer development. [NIH] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU]

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Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectal Fistula: Abnormal passage communicating with the rectum. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractory: Not readily yielding to treatment. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regional lymph node: In oncology, a lymph node that drains lymph from the region around a tumor. [NIH] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Relative risk: The ratio of the incidence rate of a disease among individuals exposed to a specific risk factor to the incidence rate among unexposed individuals; synonymous with risk ratio. Alternatively, the ratio of the cumulative incidence rate in the exposed to the cumulative incidence rate in the unexposed (cumulative incidence ratio). The term relative risk has also been used synonymously with odds ratio. This is because the odds ratio and relative risk approach each other if the disease is rare ( 5 percent of population) and the number of subjects is large. [NIH] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renal pelvis: The area at the center of the kidney. Urine collects here and is funneled into the ureter, the tube that connects the kidney to the bladder. [NIH] Renin: An enzyme which is secreted by the kidney and is formed from prorenin in plasma and kidney. The enzyme cleaves the Leu-Leu bond in angiotensinogen to generate angiotensin I. EC 3.4.23.15. (Formerly EC 3.4.99.19). [NIH] Renin-Angiotensin System: A system consisting of renin, angiotensin-converting enzyme,

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and angiotensin II. Renin, an enzyme produced in the kidney, acts on angiotensinogen, an alpha-2 globulin produced by the liver, forming angiotensin I. The converting enzyme contained in the lung acts on angiotensin I in the plasma converting it to angiotensin II, the most powerful directly pressor substance known. It causes contraction of the arteriolar smooth muscle and has other indirect actions mediated through the adrenal cortex. [NIH] Reproductive system: In women, this system includes the ovaries, the fallopian tubes, the uterus (womb), the cervix, and the vagina (birth canal). The reproductive system in men includes the prostate, the testes, and the penis. [NIH] Research Design: A plan for collecting and utilizing data so that desired information can be obtained with sufficient precision or so that an hypothesis can be tested properly. [NIH] Research Support: Financial support of research activities. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Residual disease: Cancer cells that remain after attempts have been made to remove the cancer. [NIH] Resolving: The ability of the eye or of a lens to make small objects that are close together, separately visible; thus revealing the structure of an object. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Response rate: The percentage of patients whose cancer shrinks or disappears after treatment. [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Reticulocytes: Immature erythrocytes. In humans, these are erythroid cells that have just undergone extrusion of their cell nucleus. They still contain some organelles that gradually decrease in number as the cells mature. ribosomes are last to disappear. Certain staining techniques cause components of the ribosomes to precipitate into characteristic "reticulum" (not the same as the endoplasmic reticulum), hence the name reticulocytes. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Retinoid: Vitamin A or a vitamin A-like compound. [NIH] Retreatment: The therapy of the same disease in a patient, with the same agent or procedure repeated after initial treatment, or with an additional or alternate measure or follow-up. It

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does not include therapy which requires more than one administration of a therapeutic agent or regimen. Retreatment is often used with reference to a different modality when the original one was inadequate, harmful, or unsuccessful. [NIH] Retroperitoneal: Having to do with the area outside or behind the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Retropubic: A potential space between the urinary bladder and the symphisis and body of the pubis. [NIH] Retropubic prostatectomy: Surgery to remove the prostate through an incision made in the abdominal wall. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Retrospective study: A study that looks backward in time, usually using medical records and interviews with patients who already have or had a disease. [NIH] Retroviral vector: RNA from a virus that is used to insert genetic material into cells. [NIH] Retrovirus: A member of a group of RNA viruses, the RNA of which is copied during viral replication into DNA by reverse transcriptase. The viral DNA is then able to be integrated into the host chromosomal DNA. [NIH] Reversion: A return to the original condition, e. g. the reappearance of the normal or wild type in previously mutated cells, tissues, or organisms. [NIH] Rhabdomyosarcoma: A malignant tumor of muscle tissue. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Risk patient: Patient who is at risk, because of his/her behaviour or because of the type of person he/she is. [EU] Rituximab: A type of monoclonal antibody used in cancer detection or therapy. Monoclonal antibodies are laboratory-produced substances that can locate and bind to cancer cells. [NIH] Ruminants: A suborder of the order Artiodactyla whose members have the distinguishing feature of a four-chambered stomach. Horns or antlers are usually present, at least in males. [NIH]

Rural Population: The inhabitants of rural areas or of small towns classified as rural. [NIH] Sagittal: The line of direction passing through the body from back to front, or any vertical plane parallel to the medial plane of the body and inclusive of that plane; often restricted to the medial plane, the plane of the sagittal suture. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH]

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Salvage Therapy: A therapeutic approach, involving chemotherapy, radiation therapy, or surgery, after initial regimens have failed to lead to improvement in a patient's condition. Salvage therapy is most often used for neoplastic diseases. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Sarcoidosis: An idiopathic systemic inflammatory granulomatous disorder comprised of epithelioid and multinucleated giant cells with little necrosis. It usually invades the lungs with fibrosis and may also involve lymph nodes, skin, liver, spleen, eyes, phalangeal bones, and parotid glands. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH] Sargramostim: A colony-stimulating factor that stimulates the production of blood cells, especially platelets, during chemotherapy. It is a cytokine that belongs to the family of drugs called hematopoietic (blood-forming) agents. Also called GM-CSF. [NIH] Scans: Pictures of structures inside the body. Scans often used in diagnosing, staging, and monitoring disease include liver scans, bone scans, and computed tomography (CT) or computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body. [NIH] Scatter: The extent to which relative success and failure are divergently manifested in qualitatively different tests. [NIH] Scleroderma: A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized or it can affect the entire body (systemic). [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Second cancer: Refers to a new primary cancer that is caused by previous cancer treatment, or a new primary cancer in a person with a history of cancer. [NIH] Secondary tumor: Cancer that has spread from the organ in which it first appeared to another organ. For example, breast cancer cells may spread (metastasize) to the lungs and cause the growth of a new tumor. When this happens, the disease is called metastatic breast cancer, and the tumor in the lungs is called a secondary tumor. Also called secondary cancer. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Segmental: Describing or pertaining to a structure which is repeated in similar form in successive segments of an organism, or which is undergoing segmentation. [NIH] Segmental mastectomy: The removal of the cancer as well as some of the breast tissue around the tumor and the lining over the chest muscles below the tumor. Usually some of

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the lymph nodes under the arm are also taken out. Sometimes called partial mastectomy. [NIH]

Segmentation: The process by which muscles in the intestines move food and wastes through the body. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Selective estrogen receptor modulator: SERM. A drug that acts like estrogen on some tissues, but blocks the effect of estrogen on other tissues. Tamoxifen and raloxifene are SERMs. [NIH] Selenium: An element with the atomic symbol Se, atomic number 34, and atomic weight 78.96. It is an essential micronutrient for mammals and other animals but is toxic in large amounts. Selenium protects intracellular structures against oxidative damage. It is an essential component of glutathione peroxidase. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Seminal vesicles: Glands that help produce semen. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sensitization: 1. Administration of antigen to induce a primary immune response; priming; immunization. 2. Exposure to allergen that results in the development of hypersensitivity. 3. The coating of erythrocytes with antibody so that they are subject to lysis by complement in the presence of homologous antigen, the first stage of a complement fixation test. [EU] Sensor: A device designed to respond to physical stimuli such as temperature, light, magnetism or movement and transmit resulting impulses for interpretation, recording, movement, or operating control. [NIH] Septic: Produced by or due to decomposition by microorganisms; putrefactive. [EU] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serine: A non-essential amino acid occurring in natural form as the L-isomer. It is synthesized from glycine or threonine. It is involved in the biosynthesis of purines, pyrimidines, and other amino acids. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serous: Having to do with serum, the clear liquid part of blood. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to

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reproduction. [NIH] Sharpness: The apparent blurring of the border between two adjacent areas of a radiograph having different optical densities. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Silicon: A trace element that constitutes about 27.6% of the earth's crust in the form of silicon dioxide. It does not occur free in nature. Silicon has the atomic symbol Si, atomic number 14, and atomic weight 28.09. [NIH] Silicon Dioxide: Silica. Transparent, tasteless crystals found in nature as agate, amethyst, chalcedony, cristobalite, flint, sand, quartz, and tridymite. The compound is insoluble in water or acids except hydrofluoric acid. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Skull Base: The inferior region of the skull consisting of an internal (cerebral), and an external (basilar) surface. [NIH] Small cell lung cancer: A type of lung cancer in which the cells appear small and round when viewed under the microscope. Also called oat cell lung cancer. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH]

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Social Work: The use of community resources, individual case work, or group work to promote the adaptive capacities of individuals in relation to their social and economic environments. It includes social service agencies. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Sodium Bicarbonate: A white, crystalline powder that is commonly used as a pH buffering agent, an electrolyte replenisher, systemic alkalizer and in topical cleansing solutions. [NIH] Sodium Iodide: Sodium iodide (NaI). A compound forming white, odorless deliquescent crystals and used as iodine supplement, expectorant or in its radioactive (I-131) form as an diagnostic aid, particularly for thyroid function determinants. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Soft tissue sarcoma: A sarcoma that begins in the muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Sonogram: A computer picture of areas inside the body created by bouncing sound waves off organs and other tissues. Also called ultrasonogram or ultrasound. [NIH] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectroscopic: The recognition of elements through their emission spectra. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU]

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Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Sprains and Strains: A collective term for muscle and ligament injuries without dislocation or fracture. A sprain is a joint injury in which some of the fibers of a supporting ligament are ruptured but the continuity of the ligament remains intact. A strain is an overstretching or overexertion of some part of the musculature. [NIH] Squamous: Scaly, or platelike. [EU] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Squamous cells: Flat cells that look like fish scales under a microscope. These cells cover internal and external surfaces of the body. [NIH] Stabilization: The creation of a stable state. [EU] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]

Standard therapy: A currently accepted and widely used treatment for a certain type of cancer, based on the results of past research. [NIH] Statistically significant: Describes a mathematical measure of difference between groups. The difference is said to be statistically significant if it is greater than what might be expected to happen by chance alone. [NIH] Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Stem cell transplantation: A method of replacing immature blood-forming cells that were destroyed by cancer treatment. The stem cells are given to the person after treatment to help the bone marrow recover and continue producing healthy blood cells. [NIH] Stem Cells: Relatively undifferentiated cells of the same lineage (family type) that retain the ability to divide and cycle throughout postnatal life to provide cells that can become specialized and take the place of those that die or are lost. [NIH] Stenosis: Narrowing or stricture of a duct or canal. [EU] Stent: A device placed in a body structure (such as a blood vessel or the gastrointestinal tract) to provide support and keep the structure open. [NIH] Stereotactic: Radiotherapy that treats brain tumors by using a special frame affixed directly to the patient's cranium. By aiming the X-ray source with respect to the rigid frame, technicians can position the beam extremely precisely during each treatment. [NIH]

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Stereotactic biopsy: A biopsy procedure that uses a computer and a three-dimensional scanning device to find a tumor site and guide the removal of tissue for examination under a microscope. [NIH] Stereotactic radiosurgery: A radiation therapy technique involving a rigid head frame that is attached to the skull; high-dose radiation is administered through openings in the head frame to the tumor while decreasing the amount of radiation given to normal brain tissue. This procedure does not involve surgery. Also called stereotaxic radiosurgery and stereotactic radiation therapy. [NIH] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Sterilization: The destroying of all forms of life, especially microorganisms, by heat, chemical, or other means. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stomatitis: Inflammation of the oral mucosa, due to local or systemic factors which may involve the buccal and labial mucosa, palate, tongue, floor of the mouth, and the gingivae. [EU]

Stool: The waste matter discharged in a bowel movement; feces. [NIH] Strand: DNA normally exists in the bacterial nucleus in a helix, in which two strands are coiled together. [NIH] Streptavidin: A 60kD extracellular protein of Streptomyces avidinii with four high-affinity biotin binding sites. Unlike AVIDIN, streptavidin has a near neutral isoelectric point and is free of carbohydrate side chains. [NIH] Streptococci: A genus of spherical Gram-positive bacteria occurring in chains or pairs. They are widely distributed in nature, being important pathogens but often found as normal commensals in the mouth, skin, and intestine of humans and other animals. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stricture: The abnormal narrowing of a body opening. Also called stenosis. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Stromal: Large, veil-like cell in the bone marrow. [NIH] Stromal Cells: Connective tissue cells of an organ found in the loose connective tissue. These are most often associated with the uterine mucosa and the ovary as well as the hematopoietic system and elsewhere. [NIH] Strontium: An element of the alkaline earth family of metals. It has the atomic symbol Sr, atomic number 38, and atomic weight 87.62. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclavian: The direct continuation of the axillary vein at the lateral border of the first rib. It

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passes medially to join the internal jugular vein and form the brachiocephalic vein on each side. [NIH] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Submaxillary: Four to six lymph glands, located between the lower jaw and the submandibular salivary gland. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Substrate: A substance upon which an enzyme acts. [EU] Sunburn: An injury to the skin causing erythema, tenderness, and sometimes blistering and resulting from excessive exposure to the sun. The reaction is produced by the ultraviolet radiation in sunlight. [NIH] Superoxide: Derivative of molecular oxygen that can damage cells. [NIH] Superoxide Dismutase: An oxidoreductase that catalyzes the reaction between superoxide anions and hydrogen to yield molecular oxygen and hydrogen peroxide. The enzyme protects the cell against dangerous levels of superoxide. EC 1.15.1.1. [NIH] Supine: Having the front portion of the body upwards. [NIH] Supine Position: The posture of an individual lying face up. [NIH] Supportive care: Treatment given to prevent, control, or relieve complications and side effects and to improve the comfort and quality of life of people who have cancer. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Suppressive: Tending to suppress : effecting suppression; specifically : serving to suppress activity, function, symptoms. [EU] Supratentorial: Located in the upper part of the brain. [NIH] Survival Rate: The proportion of survivors in a group, e.g., of patients, studied and followed over a period, or the proportion of persons in a specified group alive at the beginning of a time interval who survive to the end of the interval. It is often studied using life table methods. [NIH] Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. [NIH] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH]

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Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Transmission: The communication from a neuron to a target (neuron, muscle, or secretory cell) across a synapse. In chemical synaptic transmission, the presynaptic neuron releases a neurotransmitter that diffuses across the synaptic cleft and binds to specific synaptic receptors. These activated receptors modulate ion channels and/or secondmessenger systems to influence the postsynaptic cell. Electrical transmission is less common in the nervous system, and, as in other tissues, is mediated by gap junctions. [NIH] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systemic: Affecting the entire body. [NIH] Systemic disease: Disease that affects the whole body. [NIH] Systemic lupus erythematosus: SLE. A chronic inflammatory connective tissue disease marked by skin rashes, joint pain and swelling, inflammation of the kidneys, inflammation of the fibrous tissue surrounding the heart (i.e., the pericardium), as well as other problems. Not all affected individuals display all of these problems. May be referred to as lupus. [NIH] Systemic therapy: Treatment that uses substances that travel through the bloodstream, reaching and affecting cells all over the body. [NIH] Systems Analysis: The analysis of an activity, procedure, method, technique, or business to determine what must be accomplished and how the necessary operations may best be accomplished. [NIH] Tacrolimus: A macrolide isolated from the culture broth of a strain of Streptomyces tsukubaensis that has strong immunosuppressive activity in vivo and prevents the activation of T-lymphocytes in response to antigenic or mitogenic stimulation in vitro. [NIH] Tamoxifen: A first generation selective estrogen receptor modulator (SERM). It acts as an agonist for bone tissue and cholesterol metabolism but is an estrogen antagonist in mammary and uterine. [NIH] Tegafur: 5-Fluoro-1-(tetrahydro-2-furanyl)-2,4-(1H,3H)-pyrimidinedione. Congener of fluorouracil with comparable antineoplastic action. It has been suggested especially for the treatment of breast neoplasms. [NIH] Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes. [NIH] Teletherapy: Radiotherapy with a souce-skin distance that is large compared to the dimensions of the irradiated tissue being treated. [NIH] Telophase: The final phase of cell division, in which two daughter nuclei are formed, the cytoplasm divides, and the chromosomes lose their distinctness and are transformed into chromatin networks. [NIH] Temozolomide: An anticancer drug that belongs to the family of drugs called alkylating agents. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Teratogenic: Tending to produce anomalies of formation, or teratism (= anomaly of formation or development : condition of a monster). [EU] Testicles: The two egg-shaped glands found inside the scrotum. They produce sperm and

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male hormones. Also called testes. [NIH] Testicular: Pertaining to a testis. [EU] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Tetanus: A disease caused by tetanospasmin, a powerful protein toxin produced by Clostridium tetani. Tetanus usually occurs after an acute injury, such as a puncture wound or laceration. Generalized tetanus, the most common form, is characterized by tetanic muscular contractions and hyperreflexia. Localized tetanus presents itself as a mild condition with manifestations restricted to muscles near the wound. It may progress to the generalized form. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Thalidomide: A pharmaceutical agent originally introduced as a non-barbiturate hypnotic, but withdrawn from the market because of its known tetratogenic effects. It has been reintroduced and used for a number of immunological and inflammatory disorders. Thalidomide displays immunosuppresive and anti-angiogenic activity. It inhibits release of tumor necrosis factor alpha from monocytes, and modulates other cytokine action. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Thoracic: Having to do with the chest. [NIH] Threonine: An essential amino acid occurring naturally in the L-form, which is the active form. It is found in eggs, milk, gelatin, and other proteins. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombocytes: Blood cells that help prevent bleeding by causing blood clots to form. Also called platelets. [NIH] Thrombocytopenia: A decrease in the number of blood platelets. [NIH] Thrombolytic: 1. Dissolving or splitting up a thrombus. 2. A thrombolytic agent. [EU] Thrombopoietin: A humoral factor that controls blood platelet production through stimulation of megakaryocyte populations. Bone marrow megakaryocytes increase in both size and number in response to exposure to thrombopoietin. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Thrush: A disease due to infection with species of fungi of the genus Candida. [NIH]

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Thymidine: A chemical compound found in DNA. Also used as treatment for mucositis. [NIH]

Thymidine Kinase: An enzyme that catalyzes the conversion of ATP and thymidine to ADP and thymidine 5'-phosphate. Deoxyuridine can also act as an acceptor and dGTP as a donor. (From Enzyme Nomenclature, 1992) EC 2.7.1.21. [NIH] Thymidylate Synthase: An enzyme of the transferase class that catalyzes the reaction 5,10methylenetetrahydrofolate and dUMP to dihydrofolate and dTMP in the synthesis of thymidine triphosphate. (From Dorland, 27th ed) EC 2.1.1.45. [NIH] Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyrotropin: A peptide hormone secreted by the anterior pituitary. It promotes the growth of the thyroid gland and stimulates the synthesis of thyroid hormones and the release of thyroxine by the thyroid gland. [NIH] Tin: A trace element that is required in bone formation. It has the atomic symbol Sn, atomic number 50, and atomic weight 118.71. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Culture: Maintaining or growing of tissue, organ primordia, or the whole or part of an organ in vitro so as to preserve its architecture and/or function (Dorland, 28th ed). Tissue culture includes both organ culture and cell culture. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU] Topical: On the surface of the body. [NIH] Topoisomerase inhibitors: A family of anticancer drugs. The topoisomerase enzymes are responsible for the arrangement and rearrangement of DNA in the cell and for cell growth and replication. Inhibiting these enzymes may kill cancer cells or stop their growth. [NIH] Total-body irradiation: Radiation therapy to the entire body. Usually followed by bone marrow or peripheral stem cell transplantation. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living

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organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Tracheostomy: Surgical formation of an opening into the trachea through the neck, or the opening so created. [NIH] Transcriptase: An enzyme which catalyses the synthesis of a complementary mRNA molecule from a DNA template in the presence of a mixture of the four ribonucleotides (ATP, UTP, GTP and CTP). [NIH] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfer Factor: Factor derived from leukocyte lysates of immune donors which can transfer both local and systemic cellular immunity to nonimmune recipients. [NIH] Transfusion: The infusion of components of blood or whole blood into the bloodstream. The blood may be donated from another person, or it may have been taken from the person earlier and stored until needed. [NIH] Transitional cell carcinoma: A type of cancer that develops in the lining of the bladder, ureter, or renal pelvis. [NIH] Translating: Conversion from one language to another language. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Transrectal ultrasound: A procedure used to examine the prostate. An instrument is inserted into the rectum, and sound waves bounce off the prostate. These sound waves create echoes, which a computer uses to create a picture called a sonogram. [NIH] Transurethral: Performed through the urethra. [EU] Transurethral resection: Surgery performed with a special instrument inserted through the urethra. Also called TUR. [NIH] Transurethral Resection of Prostate: Resection of the prostate using a cystoscope passed through the urethra. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Treatment Failure: A measure of the quality of health care by assessment of unsuccessful results of management and procedures used in combating disease, in individual cases or series. [NIH] Treatment Outcome: Evaluation undertaken to assess the results or consequences of

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management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, practicability, etc., of these interventions in individual cases or series. [NIH]

Tremor: Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of cerebellar diseases, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of Parkinson disease. [NIH] Trigger zone: Dolorogenic zone (= producing or causing pain). [EU] Trismus: Spasmodic contraction of the masseter muscle resulting in forceful jaw closure. This may be seen with a variety of diseases, including tetanus, as a complication of radiation therapy, trauma, or in association with neoplastic conditions. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tumor marker: A substance sometimes found in an increased amount in the blood, other body fluids, or tissues and which may mean that a certain type of cancer is in the body. Examples of tumor markers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and gastrointestinal tract cancers), and PSA (prostate cancer). Also called biomarker. [NIH] Tumor model: A type of animal model which can be used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] Tumorigenic: Chemical, viral, radioactive or other agent that causes cancer; carcinogenic. [NIH]

Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU] Tungsten: A metallic element with the atomic symbol W, atomic number 74, and atomic weight 183.85. It is used in many manufacturing applications, including increasing the hardness, toughness, and tensile strength of steel; manufacture of filaments for incandescent light bulbs; and in contact points for automotive and electrical apparatus. [NIH] Tunica: A rather vague term to denote the lining coat of hollow organs, tubes, or cavities. [NIH]

Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulceration: 1. The formation or development of an ulcer. 2. An ulcer. [EU] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Ultraviolet radiation: Invisible rays that are part of the energy that comes from the sun. UV radiation can damage the skin and cause melanoma and other types of skin cancer. UV

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radiation that reaches the earth's surface is made up of two types of rays, called UVA and UVB rays. UVB rays are more likely than UVA rays to cause sunburn, but UVA rays pass deeper into the skin. Scientists have long thought that UVB radiation can cause melanoma and other types of skin cancer. They now think that UVA radiation also may add to skin damage that can lead to skin cancer and cause premature aging. For this reason, skin specialists recommend that people use sunscreens that reflect, absorb, or scatter both kinds of UV radiation. [NIH] Ultraviolet radiation therapy: A form of radiation used in the treatment of cancer. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Unresectable: Unable to be surgically removed. [NIH] Uracil: An anticancer drug that belongs to the family of drugs called alkylating agents. [NIH] Urban Population: The inhabitants of a city or town, including metropolitan areas and suburban areas. [NIH] Ureter: One of a pair of thick-walled tubes that transports urine from the kidney pelvis to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary Retention: Inability to urinate. The etiology of this disorder includes obstructive, neurogenic, pharmacologic, and psychogenic causes. [NIH] Urinate: To release urine from the bladder to the outside. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccination: Administration of vaccines to stimulate the host's immune response. This includes any preparation intended for active immunological prophylaxis. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vaginitis: Inflammation of the vagina characterized by pain and a purulent discharge. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular endothelial growth factor: VEGF. A substance made by cells that stimulates new blood vessel formation. [NIH] Vasodilation: Physiological dilation of the blood vessels without anatomic change. For dilation with anatomic change, dilatation, pathologic or aneurysm (or specific aneurysm) is used. [NIH] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH]

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Vegetative: 1. Concerned with growth and with nutrition. 2. Functioning involuntarily or unconsciously, as the vegetative nervous system. 3. Resting; denoting the portion of a cell cycle during which the cell is not involved in replication. 4. Of, pertaining to, or characteristic of plants. [EU] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Venous blood: Blood that has given up its oxygen to the tissues and carries carbon dioxide back for gas exchange. [NIH] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vertebral: Of or pertaining to a vertebra. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Vinca Alkaloids: A class of alkaloids from the genus of apocyanaceous woody herbs including periwinkles. They are some of the most useful antineoplastic agents. [NIH] Vinorelbine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Viral vector: A type of virus used in cancer therapy. The virus is changed in the laboratory and cannot cause disease. Viral vectors produce tumor antigens (proteins found on a tumor cell) and can stimulate an antitumor immune response in the body. Viral vectors may also be used to carry genes that can change cancer cells back to normal cells. [NIH] Virtual colonoscopy: A method under study to examine the colon by taking a series of xrays (called a CT scan) and then using a high-powered computer to reconstruct 2-D and 3-D pictures of the interior surfaces of the colon from these x-rays. The pictures can be saved, manipulated to better viewing angles, and reviewed after the procedure, even years later. Also called computed tomography colography. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visual Acuity: Acuteness or clearness of vision, especially of form vision, which is dependent mainly on the sharpness of the retinal focus. [NIH] Vital Capacity: The volume of air that is exhaled by a maximal expiration following a maximal inspiration. [NIH] Vital Statistics: Used for general articles concerning statistics of births, deaths, marriages, etc. [NIH] Vitiligo: A disorder consisting of areas of macular depigmentation, commonly on extensor aspects of extremities, on the face or neck, and in skin folds. Age of onset is often in young adulthood and the condition tends to progress gradually with lesions enlarging and extending until a quiescent state is reached. [NIH]

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Vitreous: Glasslike or hyaline; often used alone to designate the vitreous body of the eye (corpus vitreum). [EU] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Vocal cord: The vocal folds of the larynx. [NIH] Void: To urinate, empty the bladder. [NIH] Volition: Voluntary activity without external compulsion. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Womb: A hollow, thick-walled, muscular organ in which the impregnated ovum is developed into a child. [NIH] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] Xeroderma Pigmentosum: A rare, pigmentary, and atrophic autosomal recessive disease affecting all races. It is manifested as an extreme photosensitivity to ultraviolet light as the result of a deficiency in the enzyme that permits excisional repair of ultraviolet-damaged DNA. [NIH] Xerostomia: Decreased salivary flow. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] X-ray therapy: The use of high-energy radiation from x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. X-ray therapy is also called radiation therapy, radiotherapy, and irradiation. [NIH] Yttrium: An element of the rare earth family of metals. It has the atomic symbol Y, atomic number 39, and atomic weight 88.91. In conjunction with other rare earths, yttrium is used as a phosphor in television receivers and is a component of the yttrium-aluminum garnet (YAG) lasers. [NIH]

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INDEX 3 3-dimensional, 42, 72, 97, 99, 135, 199, 200, 289 A Abdomen, 289, 299, 303, 314, 328, 331, 333, 335, 342, 343, 344, 354, 359, 360 Abdominal Pain, 216, 266, 289 Aberrant, 29, 173, 204, 289 Ablation, 6, 22, 253, 289, 292 Abscess, 263, 289 Absolute risk, 19, 289 Acceptor, 289, 342, 364 Acetylcholine, 289, 303, 339 Acid Phosphatase, 203, 289 Acidity, 256, 289, 344 Acoustic, 210, 289 Acuity, 114, 289 Acute lymphoblastic leukemia, 169, 289 Acute lymphocytic leukemia, 289 Acute myelogenous leukemia, 169, 289, 290 Acute myeloid leukemia, 289, 290 Acute nonlymphocytic leukemia, 289, 290 Adaptability, 200, 290, 302 Adenovirus, 12, 60, 64, 199, 290 Adjustment, 105, 153, 154, 290 Adjuvant Therapy, 54, 115, 269, 290 Adrenal Glands, 131, 290, 292 Adverse Effect, 40, 178, 217, 290, 357 Aerobic, 17, 290 Afferent, 290, 308, 316 Affinity, 39, 62, 212, 290, 296, 358, 360 Agar, 290, 345 Aggressiveness, 42, 61, 290 Agonist, 201, 290, 297, 321, 339, 345, 362 Algorithms, 23, 33, 48, 57, 172, 194, 290, 298 Alimentary, 274, 290, 342, 343 Alkaline, 165, 291, 292, 297, 300, 342, 360 Alkaline Phosphatase, 165, 291 Alkaloid, 291, 300, 339 Alkylating Agents, 169, 291, 301, 303, 362, 367 Allergen, 291, 310, 356 Allo, 168, 169, 291, 322 Allogeneic, 30, 168, 169, 291, 321, 322, 344 Allogeneic bone marrow transplantation, 169, 291

Alloys, 291, 342 Alopecia, 27, 163, 173, 174, 202, 203, 291, 308 Alpha Particles, 291, 350 Alpha-fetoprotein, 93, 291, 317 Alternative medicine, 236, 291 Aluminum, 291, 369 Alveoli, 291, 309 Alveolitis, 35, 291 Ameliorating, 148, 291 Ameloblastoma, 6, 291 Amifostine, 70, 77, 104, 110, 118, 120, 143, 144, 165, 240, 291 Amino acid, 150, 157, 291, 292, 293, 294, 311, 320, 324, 341, 343, 345, 348, 349, 356, 361, 363, 365, 366 Amino Acid Sequence, 292, 294 Ammonia, 292, 320 Amplification, 29, 292 Ampulla, 292, 314 Amyloidosis, 110, 231, 292 Anaerobic, 103, 292 Anaesthesia, 292, 326 Anal, 27, 77, 90, 126, 257, 292, 317, 331, 338 Analgesic, 6, 292 Analog, 26, 27, 29, 38, 164, 179, 292, 318, 319, 330 Analogous, 166, 180, 292, 312, 365 Anaplastic, 79, 141, 292 Anastomosis, 16, 292 Anatomical, 11, 14, 157, 171, 186, 199, 200, 208, 292, 303, 313, 326, 355 Androgen suppression, 109, 292 Androgens, 127, 131, 140, 144, 292 Anemia, 144, 292, 318, 337 Anemic, 101, 144, 292 Anesthesia, 172, 292, 293, 313 Anesthetics, 225, 293, 297, 315 Angina, 183, 293 Angina Pectoris, 183, 293 Angiogenesis, 15, 22, 31, 37, 62, 118, 164, 174, 184, 197, 204, 293, 314 Angiogenesis inhibitor, 62, 184, 293, 314 Angioplasty, 15, 16, 67, 158, 159, 172, 183, 259, 293 Angiosarcoma, 8, 77, 293 Angiotensinogen, 204, 293, 352, 353 Animal model, 12, 14, 35, 54, 293, 366

Radiation therapy

Anions, 293, 328, 361 Ankle, 260, 269, 293 Annealing, 194, 293 Anode, 213, 293 Anoikis, 38, 293 Anorexia, 203, 287, 293 Antagonism, 173, 293 Antiandrogen therapy, 140, 293 Antiandrogens, 293, 297 Antiangiogenic, 29, 62, 293 Antibacterial, 293, 358 Antibiotic, 5, 293, 294, 309, 312, 336, 343, 358 Antibodies, 177, 178, 198, 211, 220, 294, 322, 325, 332, 337, 346, 350 Antidote, 294, 330 Antiemetic, 294, 321 Antifungal, 294, 317 Antigen-presenting cell, 294, 309 Anti-infective, 294, 324, 328 Anti-inflammatory, 294, 302, 310, 320, 342, 347 Anti-Inflammatory Agents, 294, 302 Antimetabolite, 294, 318, 335 Antimicrobial, 231, 294 Antineoplastic, 225, 291, 294, 301, 308, 312, 318, 335, 336, 342, 346, 362, 368 Antineoplastic Agents, 225, 291, 294, 368 Antioxidant, 121, 294 Antiseptic, 5, 294 Antithrombotic, 158, 294 Anus, 126, 292, 294, 299, 305, 352 Anxiety, 230, 294 Aorta, 183, 294, 325 Aperture, 206, 295, 350 Aplastic anemia, 205, 295 Apoptosis, 36, 38, 60, 63, 99, 149, 150, 179, 209, 234, 293, 295, 301 Applicability, 12, 212, 295 Approximate, 18, 295 Aqueous, 295, 297, 308, 313, 324, 330 Archaea, 295, 336 Aromatic, 212, 295, 345 Arterial, 15, 89, 90, 104, 159, 264, 295, 324, 349 Arteries, 71, 158, 294, 295, 298, 307, 325, 336, 338 Arteriolar, 295, 353 Arterioles, 295, 298, 300, 338 Arteriosclerosis, 295, 301, 338 Arteriovenous, 84, 210, 253, 295 Arteriovenous Fistula, 84, 295

372

Artery, 98, 113, 158, 159, 172, 183, 207, 293, 295, 307, 313, 317, 343, 350 Artificial Intelligence, 59, 295 Asbestos, 295, 333, 335 Assay, 25, 37, 72, 195, 200, 296 Astrocytes, 296 Astrocytoma, 141, 296, 320 Ataxia, 209, 296, 363 Atmospheric Pressure, 296, 324 Atrophy, 6, 10, 296 Auditory, 83, 296 Autoimmune disease, 164, 174, 296 Autologous, 30, 89, 119, 168, 169, 296, 322, 344 Autologous bone marrow transplantation, 169, 296, 322 Autonomic, 289, 291, 296, 308, 344, 361 Autoradiography, 25, 296 Axillary, 296, 360 Axillary Vein, 296, 360 Axons, 49, 296, 339 B Bacteria, 103, 293, 294, 295, 296, 309, 314, 316, 317, 332, 336, 351, 358, 360, 364, 365, 367 Bactericidal, 296, 315 Bacteriophage, 296, 345, 365 Barbiturate, 297, 363 Barium, 152, 297 Basal Ganglia, 296, 297, 320, 324 Basal Ganglia Diseases, 296, 297, 324 Base, 6, 20, 39, 207, 297, 300, 309, 329, 362 Basement Membrane, 192, 297, 301, 316, 329 Basophils, 297, 321, 330 Benign, 6, 10, 102, 170, 189, 207, 213, 221, 297, 335, 338, 348, 351 Bethanechol, 110, 297 Bevacizumab, 15, 297 Bexarotene, 100, 297 Bicalutamide, 94, 131, 144, 297 Bile, 297, 318, 331, 360 Bile duct, 297 Biliary, 72, 93, 261, 297 Binding Sites, 297, 360 Biochemical, 42, 43, 58, 63, 72, 75, 81, 89, 99, 109, 165, 174, 203, 294, 297, 356 Biodegradation, 203, 297 Biological response modifier, 196, 298, 327 Biological therapy, 196, 197, 298, 322, 334 Biomarkers, 17, 50, 61, 298 Biopsy, 13, 16, 202, 298, 315, 343, 360

373

Biopsy specimen, 13, 298 Biotechnology, 66, 67, 236, 247, 298 Biotin, 298, 360 Bipolar Disorder, 270, 298 Blood Coagulation, 298, 300 Blood Glucose, 298, 322 Blood Platelets, 201, 298, 334, 346, 356, 363 Blood pressure, 230, 298, 301, 324, 325, 337, 358 Blood-Brain Barrier, 22, 298, 330 Body Fluids, 298, 300, 312, 358, 366 Bone Density, 34, 298 Bone Marrow Cells, 201, 299, 322, 334 Bone Marrow Transplantation, 32, 204, 205, 216, 299 Bone metastases, 59, 138, 234, 258, 273, 299 Bone scan, 299, 355 Boron, 212, 299 Boron Neutron Capture Therapy, 212, 299 Bowel, 39, 42, 44, 105, 128, 261, 292, 299, 310, 328, 360 Bowel Movement, 299, 310, 360 Brachial, 158, 296, 299 Brain metastases, 106, 115, 125, 129, 132, 133, 135, 136, 235, 259, 260, 299 Brain Stem, 31, 86, 299 Brain stem glioma, 31, 86, 299 Branch, 285, 299, 320, 332, 343, 358, 363 Breakdown, 216, 299, 310, 319 Breast Neoplasms, 299, 362 Breast-conserving surgery, 27, 66, 73, 105, 235, 299 Bronchial, 297, 299, 300 Bronchial Spasm, 297, 299 Bronchioles, 291, 299, 300 Bronchiolitis, 73, 300 Bronchiolitis Obliterans, 73, 300 Bronchiolitis Obliterans Organizing Pneumonia, 73, 300 Buccal, 225, 300, 332, 360 Buccal mucosa, 225, 300 Bullous, 96, 300 Bypass, 172, 300 C Calcium, 34, 295, 300, 305, 330, 357 Calibration, 88, 160, 300 Camptothecin, 300, 329 Candidiasis, 8, 226, 227, 230, 300, 317 Candidosis, 300 Canonical, 150, 300 Capillary, 166, 300, 368

Capsaicin, 8, 300 Capsules, 160, 203, 300, 311, 319 Carbohydrate, 300, 346, 360 Carbon Dioxide, 301, 317, 353, 368 Carboplatin, 4, 5, 76, 79, 91, 118, 119, 301 Carcinogenesis, 38, 301 Carcinogenic, 291, 301, 340, 348, 360, 366 Carcinogens, 301, 340 Carcinoma in Situ, 132, 136, 301 Cardiac, 27, 71, 77, 109, 112, 262, 297, 301, 313, 315, 319, 338, 360 Cardiopathy, 203, 301 Cardiopulmonary, 32, 301 Cardiovascular, 67, 71, 77, 85, 112, 113, 158, 172, 301, 356 Cardiovascular disease, 67, 301 Cardiovascular System, 158, 172, 301 Carmustine, 138, 301 Case report, 5, 6, 86, 110, 301, 304 Caspase, 148, 149, 301 Castration, 86, 301 Catheter, 15, 158, 159, 172, 173, 183, 208, 253, 261, 301, 313 Catheterization, 71, 77, 112, 293, 301 Cathode, 153, 213, 293, 301 Caudal, 301, 325, 347 CDC2, 174, 302 Celecoxib, 125, 126, 302 Cell Count, 10, 302 Cell Death, 25, 38, 39, 148, 149, 209, 295, 302, 315, 320 Cell Differentiation, 302, 357 Cell Division, 201, 296, 302, 315, 322, 334, 335, 336, 345, 362 Cell proliferation, 63, 149, 150, 184, 191, 198, 295, 302, 327, 357 Cell Respiration, 302, 353 Cell Survival, 302, 322 Cell Transplantation, 168, 169, 302 Cellulose, 302, 318, 345 Centrosome, 302, 336 Cerebellar, 296, 302, 352, 366 Cerebral, 96, 296, 297, 298, 299, 302, 315, 317, 320, 357 Cerebral Cortex, 296, 302, 315, 317 Cerebral hemispheres, 297, 299, 302, 320 Cerebrovascular, 258, 297, 301, 302, 363 Cerebrum, 302 Cervical, 21, 28, 51, 60, 68, 76, 77, 79, 84, 85, 99, 103, 104, 143, 148, 266, 271, 303 Cervix, 17, 45, 68, 76, 88, 112, 143, 144, 163, 165, 303, 353

Radiation therapy

Character, 293, 303 Chemoprotective, 202, 303 Chemotherapeutic agent, 22, 36, 148, 184, 190, 202, 211, 226, 303 Chemotherapeutics, 211, 303 Chest wall, 83, 102, 303 Chin, 118, 303, 335 Chlorambucil, 179, 303 Chlorophyll, 212, 303, 318 Cholesterol, 297, 303, 307, 360, 362 Choline, 42, 43, 303 Cholinergic, 303, 339 Chondroitin sulfate, 199, 303 Chordoma, 84, 303 Choroid, 303, 353 Choroidal Neovascularization, 97, 303 Chromaffin System, 303, 314 Chromatin, 149, 195, 295, 303, 339, 362 Chromosomal, 292, 303, 336, 354 Chromosome, 195, 303, 322, 331, 336, 346 Chronic granulocytic leukemia, 304 Chronic lymphocytic leukemia, 178, 304 Chronic myelogenous leukemia, 169, 304 Circulatory system, 304, 314 CIS, 26, 34, 304, 353 Cisplatin, 26, 27, 41, 50, 75, 89, 90, 104, 122, 126, 136, 142, 143, 165, 181, 304 Claudication, 258, 304 Clear cell carcinoma, 304, 310 Clinical study, 304, 307 Clinical trial, 11, 15, 19, 20, 21, 22, 23, 26, 27, 28, 29, 36, 39, 40, 43, 44, 45, 46, 47, 48, 50, 51, 52, 55, 60, 65, 68, 80, 110, 125, 135, 145, 195, 247, 304, 307, 308, 315, 343, 349, 351 Clone, 60, 304 Cloning, 298, 304 Cofactor, 304, 349 Collagen, 7, 37, 291, 297, 304, 319, 348 Collapse, 299, 304 Colon, 41, 81, 82, 305, 329, 330, 368 Colonoscopy, 305 Colorectal, 25, 111, 148, 262, 305 Colorectal Cancer, 111, 148, 262, 305 Combination chemotherapy, 118, 120, 126, 137, 140, 143, 305 Combination Therapy, 25, 27, 100, 120, 184, 192, 211, 305 Comorbidity, 51, 53, 305 Complement, 305, 356 Complete remission, 129, 305, 352 Complete response, 48, 305

374

Compliance, 9, 51, 56, 162, 305 Compress, 158, 159, 172, 305 Computational Biology, 247, 306 Computed tomography, 85, 157, 159, 160, 200, 277, 298, 306, 355, 368 Computer Systems, 295, 306 Computerized tomography, 72, 157, 306 Concomitant, 25, 54, 75, 90, 104, 118, 119, 164, 181, 218, 267, 306 Conduction, 30, 306 Cone, 14, 85, 225, 306 Congestion, 306, 315 Conjugated, 62, 149, 150, 306, 338 Connective Tissue, 299, 304, 306, 317, 319, 321, 332, 335, 349, 354, 355, 360, 362 Consciousness, 292, 306, 311 Constipation, 216, 306 Constriction, 306, 329 Consultation, 224, 306 Consumption, 157, 306, 310, 342 Contamination, 192, 306 Continuous infusion, 41, 118, 306 Contraindications, ii, 306 Contralateral, 6, 306, 352 Contrast Media, 186, 306 Contrast medium, 120, 183, 186, 306 Contrast Sensitivity, 114, 306 Control group, 50, 307, 351 Controlled clinical trial, 24, 44, 307 Contusion, 49, 307 Conventional therapy, 197, 307 Conventional treatment, 171, 307 Cooperative group, 47, 65, 307 Coordination, 19, 156, 230, 307 Coronary, 15, 16, 71, 113, 158, 159, 172, 183, 293, 301, 307, 336, 338 Coronary Circulation, 293, 307 Coronary heart disease, 301, 307 Coronary Thrombosis, 307, 336, 338 Coronary Vessels, 71, 307 Corpus, 70, 86, 307, 348, 369 Corpus Callosum, 86, 307 Cortex, 307, 341, 348, 352, 353 Corticosteroids, 178, 240, 307, 320, 347 Cortisone, 307, 310, 347 Cosmic Radiation, 307, 335 Cranial, 6, 118, 207, 228, 272, 307, 308, 316, 344 Cranial Irradiation, 272, 308 Cranial Nerves, 228, 308 Creatinine, 112, 308 Crowns, 308, 309

375

Curative, 5, 29, 110, 208, 237, 308, 363 Curettage, 6, 308 Curette, 308 Cutaneous, 77, 114, 300, 308, 332, 345 Cyclic, 178, 308, 347 Cyclin, 163, 173, 174, 308 Cyclophosphamide, 169, 308 Cyclosporine, 178, 308 Cyproterone, 308, 318 Cystectomy, 308 Cystitis, 162, 163, 308 Cytokine, 25, 38, 61, 308, 317, 355, 363 Cytomegalovirus, 308, 319 Cytomegalovirus Infections, 308, 319 Cytoplasm, 149, 295, 297, 308, 314, 337, 339, 362 Cytoprotection, 77, 118, 165, 308 Cytosine, 65, 198, 309 Cytotoxic, 13, 46, 53, 61, 76, 226, 300, 309, 326, 350, 351, 357 Cytotoxic chemotherapy, 226, 309 Cytotoxicity, 163, 173, 198, 304, 309 D Data Collection, 24, 27, 44, 309 Daunorubicin, 309, 312 De novo, 14, 17, 71, 190, 309 Decision Making, 70, 309 Dehydration, 230, 231, 309 Deletion, 295, 309 Dendrites, 309, 339 Dendritic, 53, 309, 334 Dendritic cell, 53, 309 Density, 19, 25, 34, 257, 298, 309, 341, 358 Dental Abutments, 309 Dental Care, 9, 230, 309 Dental Caries, 7, 9, 226, 230, 309 Dental Hygienists, 8, 229, 230, 309 Dental implant, 227, 309 Dentists, 3, 9, 225, 226, 227, 309 Dentition, 6, 216, 226, 237, 309 Dentures, 5, 309 Depigmentation, 310, 368 Depolarization, 310, 357 Deprivation, 84, 108, 310 Dermatitis, 87, 202, 227, 237, 273, 310 DES, 90, 130, 310 Desensitization, 9, 310 Developing Countries, 34, 310 Dexamethasone, 178, 310 Diabetes Mellitus, 310, 323 Diacetyl, 67, 310 Diagnostic procedure, 147, 236, 310

Dialysate, 310, 312 Dialyzer, 310, 322 Diaphragm, 151, 206, 310, 346 Diarrhea, 216, 310 Digestion, 231, 290, 297, 299, 310, 328, 331, 360 Digestive system, 146, 216, 310, 337 Digestive tract, 148, 310, 357, 359 Dilatation, 172, 293, 310, 348, 367 Dilation, 158, 310, 367 Diploid, 310, 345 Direct, iii, 6, 12, 22, 34, 42, 46, 50, 154, 188, 205, 239, 310, 352, 360 Discrete, 156, 200, 206, 311 Disease Progression, 15, 108, 311 Disease-Free Survival, 30, 169, 311 Disease-specific survival, 53, 311 Disinfectant, 311, 315 Disparity, 52, 311 Disposition, 150, 311 Dissection, 311 Dissociation, 290, 311, 328 Distal, 157, 158, 159, 189, 311, 313, 349 Diverticulum, 271, 311 Dopa, 96, 311, 330 Dorsal, 311, 347 Dosage Forms, 197, 311 Dose Fractionation, 57, 311 Dose-limiting, 40, 311 Dose-rate, 100, 312 Dosimeter, 11, 123, 150, 312 Dosimetry, 11, 14, 49, 50, 51, 58, 59, 72, 85, 88, 98, 99, 113, 123, 150, 180, 189, 312 Doxorubicin, 118, 120, 312 Drive, ii, vi, 4, 117, 151, 159, 175, 189, 208, 224, 225, 226, 227, 256, 312, 330 Drug Design, 37, 190, 241, 312 Drug Interactions, 165, 240, 312 Drug Resistance, 166, 312 Drug Tolerance, 312, 364 Duct, 292, 301, 312, 316, 328, 342, 354, 359 Ductal carcinoma in situ, 26, 73, 132, 137, 269, 274, 312, 328 Duodenum, 297, 312, 314, 319, 329, 360 Dwell time, 208, 312 Dyes, 297, 312, 339 Dysphagia, 5, 80, 224, 227, 312 Dyspnea, 35, 312, 349 E Eating Disorders, 268, 312 Edema, 237, 287, 312 Efferent, 308, 313, 316, 337

Radiation therapy

Elasticity, 183, 256, 295, 313 Elastin, 62, 304, 313 Electrode, 17, 293, 301, 313 Electrolyte, 313, 358 Elementary Particles, 168, 313, 333, 335, 339, 349 Embryo, 302, 313, 326 Emergency Treatment, 98, 313 Emulsion, 296, 313, 317 Enamel, 291, 309, 313 Encapsulated, 203, 313, 331 Encephalopathy, 203, 313 Endarterectomy, 293, 313 Endocarditis, 263, 300, 313 Endocardium, 313 Endocrine Glands, 313, 314 Endocrine System, 168, 313, 339 Endogenous, 53, 166, 195, 314 Endometrial, 52, 54, 259, 314 Endometrium, 102, 314 Endoscope, 314 Endoscopic, 41, 48, 305, 314 Endostatin, 31, 63, 314 Endothelial cell, 16, 35, 37, 234, 298, 313, 314 Endotoxin, 314, 366 Enhancer, 30, 212, 314 Enucleation, 24, 44, 314 Environmental Exposure, 314, 340 Environmental Health, 246, 248, 314 Enzymatic, 292, 300, 305, 309, 314, 353 Enzyme, 20, 32, 65, 148, 168, 192, 289, 291, 300, 301, 312, 314, 319, 320, 329, 332, 335, 348, 349, 352, 357, 361, 363, 364, 365, 369 Eosinophil, 314, 322 Epidermal, 26, 58, 184, 314, 334 Epidermal Growth Factor, 26, 58, 184, 314 Epidermal growth factor receptor, 26, 58, 184, 314 Epidermis, 314 Epidermoid carcinoma, 4, 314, 359 Epigastric, 314, 342 Epinephrine, 315, 339, 366 Epistaxis, 98, 315 Epithelial, 38, 51, 60, 163, 173, 202, 290, 291, 301, 314, 315, 329, 348 Epithelial Cells, 38, 60, 314, 315, 329, 348 Epithelium, 164, 297, 315, 319 Epitope, 35, 315 Epoetin alfa, 144, 315 Erythema, 7, 287, 315, 361

376

Erythrocytes, 195, 292, 299, 315, 352, 353, 356 Erythroplakia, 230, 315 Escalation, 28, 40, 45, 51, 58, 63, 79, 104, 110, 118, 205, 315 Esophageal, 41, 48, 76, 81, 104, 202, 315 Esophagus, 45, 48, 78, 101, 267, 310, 315, 345, 360 Estrogen, 34, 132, 308, 315, 356, 362 Ethanol, 27, 315 Etoposide, 91, 120, 142, 315 Eukaryotic Cells, 302, 315, 326, 341 Evacuation, 189, 306, 315, 319 Evaluable disease, 60, 315 Evoke, 315, 360 Excisional, 315, 369 Exhaustion, 205, 293, 316 Exocrine, 316, 342 Exogenous, 53, 195, 314, 316 Expectorant, 316, 358 Expiration, 316, 353, 368 Extensor, 316, 349, 368 External radiation, 16, 57, 59, 68, 89, 159, 316 External-beam radiation, 74, 75, 88, 135, 137, 177, 316, 329, 350, 369 Extracellular, 204, 293, 296, 306, 316, 358, 360 Extracellular Matrix, 204, 293, 306, 316 Extracellular Space, 316 Extraction, 6, 50, 176, 227, 316 Extremity, 263, 264, 316 Exudate, 300, 316 Eye Infections, 290, 316 F Facial, 316, 334, 343 Facial Nerve, 316, 343 Family Planning, 247, 316 Fast Neutrons, 316, 339 Fat, 299, 307, 316, 331, 354, 358 Fatigue, 84, 224, 237, 256, 316, 322 Feces, 306, 317, 360 Femoral, 158, 172, 317 Femoral Artery, 172, 317 Femur, 317 Fetoprotein, 317 Fetus, 291, 317, 367 Fibrin, 7, 298, 317, 363 Fibrinogen, 317, 363 Fibrosis, 7, 35, 37, 54, 204, 226, 230, 231, 317, 349, 355 Filgrastim, 136, 317

377

Fissure, 307, 317 Fistula, 6, 317 Fixation, 6, 317, 356 Fluconazole, 67, 317 Fludarabine, 169, 179, 317 Fluorescence, 61, 317 Fluoroscopy, 170, 318 Fluorouracil, 41, 81, 90, 126, 132, 198, 318, 362 Flutamide, 131, 140, 318 Fold, 62, 201, 317, 318 Folic Acid, 318, 330 Follow-Up Studies, 32, 318 Forearm, 298, 318, 351 Fossa, 86, 318 Fovea, 317, 318 Fractionation, 56, 58, 86, 181, 225, 264, 273, 318 Free Radicals, 294, 311, 318 Friction, 162, 189, 318, 332 Fungi, 294, 316, 318, 336, 363 Fungus, 300, 318, 338 G Gadolinium, 37, 186, 318 Gallbladder, 289, 297, 310, 318 Gallium, 271, 318 Gamma knife, 40, 87, 319 Gamma Rays, 154, 200, 319, 350, 351 Ganciclovir, 40, 319 Ganglia, 289, 291, 297, 319, 339, 344, 361 Ganglioside, 31, 319 Gas, 292, 301, 319, 324, 339, 340, 368 Gastric, 11, 41, 87, 100, 112, 148, 269, 271, 311, 314, 319 Gastric Emptying, 271, 319 Gastric Mucosa, 112, 319 Gastrin, 319, 323 Gastrointestinal, 20, 66, 75, 95, 218, 219, 271, 295, 315, 319, 356, 359, 361, 366 Gastrointestinal tract, 315, 319, 356, 359, 366 Gelatin, 319, 320, 363 Gels, 9, 12, 319 Gemcitabine, 23, 30, 81, 87, 104, 319 Gene, 20, 22, 24, 30, 31, 40, 41, 47, 60, 61, 64, 66, 101, 184, 198, 199, 209, 290, 298, 319, 331, 340 Gene Expression, 41, 47, 65, 184, 319 Gene Therapy, 22, 24, 30, 31, 40, 47, 61, 64, 66, 101, 198, 199, 290, 319 General practitioner, 226, 320 Genetics, 20, 320, 343

Genital, 304, 320, 367 Genitourinary, 66, 94, 95, 320, 367 Giant Cells, 320, 355 Gingivitis, 5, 225, 320 Glioblastoma, 17, 30, 40, 103, 105, 121, 135, 137, 138, 140, 141, 320 Glioblastoma multiforme, 17, 30, 103, 105, 121, 135, 137, 138, 140, 141, 320 Glioma, 40, 47, 65, 66, 76, 91, 115, 141, 320 Glucocorticoid, 34, 310, 320, 347 Glucose, 48, 157, 298, 302, 310, 320, 322, 355 Glutamate, 27, 320 Glutamic Acid, 318, 320, 339, 348 Glutamine, 143, 320 Glutathione Peroxidase, 320, 356 Glycine, 291, 320, 339, 356 Glycoprotein, 317, 320, 321, 329, 366 Glycosaminoglycan, 303, 320 Goats, 197, 321 Gonadal, 321, 360 Gonadorelin, 321, 330 Gonadotropin, 321, 330 Gonads, 301, 321 Goserelin, 94, 131, 140, 321 Governing Board, 321, 347 Grade, 42, 52, 76, 91, 103, 112, 115, 130, 164, 299, 320, 321 Grading, 61, 321 Graft, 16, 33, 168, 169, 178, 231, 264, 321, 323, 326 Graft Rejection, 169, 321, 326 Grafting, 321, 326 Graft-versus-host disease, 33, 321 Granisetron, 235, 240, 321 Granulation Tissue, 300, 321 Granulocyte, 95, 317, 321 Granulocyte-Macrophage ColonyStimulating Factor, 95, 321 Granulocytopenia, 27, 322 Graphite, 211, 322 Growth factors, 58, 63, 163, 174, 184, 322 Gynecologic oncologist, 36, 322 H Half-Life, 50, 57, 322 Haploid, 322, 345 Haptens, 290, 322 Health Education, 322 Health Fairs, 39, 322 Heart attack, 301, 322 Heart failure, 322, 349

Radiation therapy

Hematologic malignancies, 65, 168, 169, 322 Hematopoietic Stem Cell Transplantation, 32, 322 Hematopoietic Stem Cells, 168, 169, 322 Heme, 212, 322, 338, 347 Hemodialysis, 16, 310, 322 Hemoglobin, 101, 292, 315, 322, 323, 347 Hemoglobin A, 101, 323, 347 Hemoglobinopathies, 319, 323 Hemorrhage, 323, 360 Hemorrhoids, 274, 323 Hepatic, 22, 323 Hepatocellular, 28, 51, 80, 83, 323 Hepatocellular carcinoma, 80, 83, 323 Hepatoma, 202, 323 Hereditary, 323, 353 Heredity, 319, 320, 323 Herpes, 7, 24, 40, 61, 64, 323 Herpes virus, 7, 323 Herpes Zoster, 323 Heterogeneity, 25, 26, 29, 57, 197, 290, 323 Histology, 42, 92, 323, 342 Homeostasis, 149, 323 Homologous, 319, 323, 349, 356, 362 Hormonal, 57, 197, 203, 296, 323, 334 Hormonal therapy, 197, 323, 334 Hormone Replacement Therapy, 34, 323 Hormone therapy, 127, 131, 132, 140, 144, 290, 323 Host, 12, 36, 63, 65, 164, 168, 169, 178, 197, 198, 231, 296, 300, 323, 325, 326, 354, 367, 368 Humoral, 321, 324, 363 Hybrid, 304, 324 Hybridization, 60, 324 Hydration, 10, 324 Hydrogen, 168, 289, 297, 300, 320, 324, 337, 339, 340, 342, 344, 349, 361 Hydrogen Peroxide, 320, 324, 361 Hydrolysis, 304, 324, 345 Hydroxylysine, 304, 324 Hydroxyproline, 291, 304, 324 Hyperbaric, 237, 324 Hyperbaric oxygen, 237, 324 Hyperplasia, 16, 84, 172, 324 Hypersensitivity, 30, 226, 291, 310, 314, 324, 354, 356 Hypertension, 301, 324 Hyperthermia, 62, 91, 219, 324 Hypertrophy, 324 Hypnotic, 297, 324, 363

378

Hypogammaglobulinemia, 179, 324 Hypokinesia, 324, 343 Hypopharynx, 134, 325 Hypotension, 27, 297, 325 Hypothalamic, 204, 325 Hypothalamus, 321, 325 Hypothyroidism, 237, 325 Hypoxia, 17, 30, 37, 63, 149, 192, 292, 325, 363 Hypoxic, 17, 30, 63, 103, 192, 325 Hysterectomy, 55, 79, 325 I Idiopathic, 325, 355 Iliac Artery, 317, 325 Immune function, 325, 326 Immune response, 12, 141, 198, 290, 294, 296, 307, 321, 322, 325, 326, 356, 361, 367, 368 Immune Sera, 325 Immune system, 12, 25, 53, 136, 196, 197, 198, 294, 298, 325, 326, 332, 333, 338, 367, 369 Immunity, 10, 30, 53, 178, 325, 332, 365 Immunization, 267, 325, 326, 356 Immunodeficiency, 150, 203, 205, 324, 325 Immunoglobulin, 294, 325, 337 Immunohistochemistry, 25, 37, 63, 325 Immunologic, 325, 333, 351 Immunology, 73, 197, 222, 290, 326 Immunosuppressant, 291, 318, 326, 335 Immunosuppressive, 177, 178, 308, 320, 326, 362 Immunosuppressive Agents, 178, 326 Immunosuppressive therapy, 177, 178, 326 Immunotherapy, 20, 22, 29, 46, 53, 107, 196, 197, 298, 310, 326 Immunotoxins, 326, 351 Impairment, 178, 204, 296, 316, 326, 335 Implant radiation, 326, 327, 329, 350, 369 Implantation, 10, 40, 42, 59, 74, 173, 326 In situ, 35, 63, 113, 132, 136, 199, 326 In Situ Hybridization, 63, 326 In vitro, 14, 16, 26, 40, 50, 60, 65, 319, 326, 362, 364 In vivo, 14, 21, 26, 30, 36, 39, 40, 50, 57, 58, 60, 65, 72, 150, 195, 199, 319, 326, 362 Incision, 326, 328, 348, 354 Incontinence, 10, 326 Incubation, 326, 330 Incubation period, 326, 330 Indicative, 217, 326, 343, 367

379

Induction, 12, 48, 60, 79, 119, 195, 292, 326, 350 Infarction, 327 Infiltrating cancer, 327, 328 Infiltration, 30, 102, 177, 327 Infusion, 27, 81, 104, 218, 327, 365 Inhalation, 295, 300, 327, 346 Inlay, 327, 353 Inoperable, 27, 90, 91, 181, 234, 327 Inorganic, 304, 327, 346 Insight, 35, 38, 53, 327 Interferon, 60, 327, 332 Interferon-alpha, 327 Interleukins, 326, 327 Intermittent, 327, 332, 344 Internal radiation, 327, 329, 350, 369 International Cooperation, 61, 327 Interstitial, 16, 103, 177, 187, 204, 219, 299, 316, 327, 328, 329, 369 Intervertebral, 328, 332 Intervertebral Disk Displacement, 328, 332 Intestine, 299, 305, 328, 329, 360 Intoxication, 301, 328 Intracellular, 149, 327, 328, 334, 356, 357 Intracranial tumors, 210, 328 Intraductal carcinoma, 312, 328 Intramuscular, 204, 328, 342 Intraocular, 74, 328 Intraoperative radiation therapy, 67, 74, 87, 94, 100, 112, 328 Intrathecal chemotherapy, 47, 328 Intravascular, 15, 63, 158, 159, 172, 328 Intravenous, 40, 165, 204, 327, 328, 342 Intrinsic, 49, 57, 62, 227, 290, 297, 328 Invasive, 6, 17, 23, 26, 42, 106, 128, 136, 137, 160, 171, 234, 266, 274, 325, 327, 328, 333 Invasive cancer, 234, 327, 328 Involuntary, 10, 297, 328, 338 Iodine, 58, 103, 273, 328, 350, 358 Iodine-131, 273, 328 Ionization, 180, 328 Ionizing, 14, 37, 38, 58, 165, 183, 189, 291, 312, 314, 328, 350, 351 Ions, 289, 297, 311, 313, 324, 328, 329 Iridium, 85, 328 Irinotecan, 76, 114, 118, 119, 328 Ischemia, 149, 296, 319, 329 Isoelectric, 329, 360 Isoelectric Point, 329, 360 Isoenzymes, 148, 329

J Jejunostomy, 11, 329 Jejunum, 329 Joint, 36, 154, 163, 192, 204, 235, 329, 359, 361, 362 K Kb, 246, 329 Keratolytic, 309, 329, 346 Kidney Disease, 146, 246, 301, 329 Kinetic, 328, 329 L Labile, 178, 305, 329 Laminin, 297, 329 Large Intestine, 305, 310, 328, 329, 352, 357 Laryngeal, 91, 95, 133, 136, 144, 237, 329 Laryngectomy, 95, 102, 114, 329 Larynx, 101, 134, 139, 224, 325, 329, 365, 369 Latency, 24, 330 Latent, 34, 35, 330 Latent period, 35, 330 Lavage, 5, 73, 330 Leflunomide, 178, 330 Lens, 74, 154, 189, 192, 330, 353 Lentivirus, 150, 330 Lethal, 168, 169, 200, 296, 330 Lethargy, 325, 330 Leucovorin, 81, 330 Leukemia, 19, 20, 66, 67, 126, 132, 142, 148, 178, 304, 312, 319, 322, 330 Leukocytes, 297, 299, 327, 330, 337, 339, 366 Leukoplakia, 229, 330 Leuprolide, 131, 140, 330 Levodopa, 311, 330 Libido, 292, 330 Library Services, 284, 330 Life cycle, 150, 318, 330 Life Expectancy, 27, 330 Ligament, 330, 348, 359 Ligands, 26, 184, 331 Limited-stage small cell lung cancer, 129, 140, 275, 331 Linear accelerator, 101, 152, 154, 156, 166, 170, 172, 176, 185, 188, 207, 210, 331 Linkage, 53, 331 Lip, 133, 134, 136, 141, 143, 144, 225, 226, 230, 331 Lipid, 295, 303, 331 Liposomal, 118, 331 Liposomes, 35, 331 Liver cancer, 148, 291, 331

Radiation therapy

Liver metastases, 263, 331 Liver scan, 331, 355 Local therapy, 16, 331 Localization, 23, 42, 45, 59, 62, 63, 182, 325, 331 Locally advanced cancer, 139, 331 Locomotion, 331, 345 Locoregional, 4, 331 Longitudinal study, 68, 111, 331 Long-Term Care, 9, 331 Low Back Pain, 264, 332 Lubricants, 332, 344 Lubrication, 231, 332 Luciferase, 60, 332 Lumbar, 328, 332 Lumen, 157, 158, 159, 172, 332 Lumpectomy, 98, 136, 137, 219, 235, 299, 332 Lupus, 230, 332, 362 Lymph node, 4, 98, 104, 119, 129, 153, 179, 296, 303, 331, 332, 333, 338, 352, 355, 356 Lymphatic, 196, 197, 223, 327, 332, 335, 358, 359, 364 Lymphatic system, 196, 332, 358, 359, 364 Lymphoblastic, 332 Lymphoblasts, 289, 332 Lymphocyte, 169, 178, 294, 332, 334 Lymphocytic, 178, 332 Lymphoepithelioma, 128, 332 Lymphoid, 32, 96, 112, 179, 294, 307, 321, 332 Lymphokines, 332, 333 Lymphoscintigraphy, 90, 333 M Macrophage, 35, 37, 321, 333 Macrophage Activation, 37, 333 Macula, 318, 333 Macula Lutea, 333 Macular Degeneration, 97, 103, 114, 333 Magnetic Resonance Imaging, 49, 80, 157, 200, 277, 333, 355 Magnetic Resonance Spectroscopy, 31, 199, 333 Malformation, 10, 11, 207, 333 Malignancy, 15, 54, 166, 178, 216, 333 Malignant mesothelioma, 333, 335 Malignant tumor, 173, 177, 212, 301, 333, 337, 341, 354 Malnutrition, 296, 333 Mammary, 57, 60, 63, 333, 362 Mammography, 34, 157, 277, 333 Mandible, 6, 8, 303, 333

380

Manic, 298, 333 Manifest, 18, 333 Mantle field, 9, 333 Masseter Muscle, 333, 366 Mastectomy, 27, 98, 102, 110, 334, 356 Maxillofacial Abnormalities, 3, 334 Maximum Tolerated Dose, 39, 41, 58, 312, 334 Medial, 295, 334, 354 Mediate, 174, 334 Mediator, 311, 334, 356 Medical oncologist, 34, 36, 334 Medical Oncology, 90, 119, 120, 334, 350 Medical Records, 334, 354 MEDLINE, 247, 334 Medullary, 334 Medulloblastoma, 47, 51, 55, 124, 334 Megakaryocytes, 201, 205, 299, 334, 363 Meiosis, 334, 336, 362 Melanin, 310, 334, 345, 366 Melanocytes, 334 Melanoma, 24, 28, 38, 44, 51, 53, 55, 60, 78, 82, 110, 148, 299, 334, 366 Membrane, 99, 149, 150, 166, 296, 303, 305, 310, 315, 329, 331, 334, 337, 341, 344, 346, 353, 357, 365 Membrane Proteins, 331, 334 Memory, 124, 135, 293, 334 Meninges, 302, 335 Meningitis, 317, 335 Menopause, 18, 335, 347 Menstruation, 335 Mental, iv, 11, 146, 246, 248, 268, 302, 303, 311, 316, 324, 325, 334, 335, 349 Mental Disorders, 146, 324, 335, 349 Mental Health, iv, 11, 146, 246, 248, 268, 335 Mesenchymal, 51, 314, 321, 335 Mesons, 168, 335 Mesothelioma, 65, 108, 199, 333, 335 Metabolic disorder, 164, 174, 335 Metabolite, 165, 330, 335 Metalloporphyrins, 212, 335 Metaphase, 174, 335 Metaplasia, 115, 335 Metastasis, 4, 28, 51, 76, 104, 111, 148, 197, 207, 262, 335 Metastasize, 335, 355 Metastatic cancer, 64, 182, 335 Methotrexate, 75, 127, 335 MI, 156, 181, 190, 288, 336 Microbe, 336, 364

381

Microbiology, 227, 336 Micronuclei, 195, 336 Microorganism, 304, 336, 343, 369 Micro-organism, 309, 336 Microscopy, 297, 336 Microspheres, 50, 153, 336 Microtubules, 336, 342 Migration, 333, 336 Milliliter, 298, 336 Miotic, 336, 345 Mitomycin, 126, 132, 336 Mitosis, 295, 302, 336 Mitotic, 25, 195, 302, 315, 336 Mitotic Spindle Apparatus, 195, 302, 336 Mobilization, 204, 336 Modeling, 160, 190, 205, 210, 312, 337 Modification, 167, 292, 337, 350 Monitor, 47, 152, 179, 308, 337, 340 Monoclonal, 25, 127, 178, 211, 220, 297, 326, 329, 337, 350, 354, 369 Monoclonal antibodies, 127, 211, 326, 337, 354 Monocytes, 205, 330, 337, 363 Mononuclear, 109, 337, 366 Morphogenesis, 149, 337 Morphological, 149, 313, 318, 334, 337 Morphology, 29, 295, 333, 337 Motility, 271, 337, 356 Motion Sickness, 337, 338 Motor nerve, 7, 337 Mucins, 337, 354 Mucocutaneous, 7, 337 Mucosa, 7, 54, 96, 226, 319, 332, 337, 338, 360 Multidrug resistance, 41, 337 Multiple Myeloma, 59, 269, 337 Multivariate Analysis, 4, 337 Mutagenic, 291, 338 Mycosis, 100, 111, 338 Mycosis Fungoides, 111, 338 Mydriatic, 310, 338 Myelogenous, 338 Myocardial infarction, 183, 307, 336, 338 Myocardial Ischemia, 293, 338 Myocardium, 293, 336, 338 Myoglobin, 338, 347 N Naive, 178, 338 Nasal Cavity, 133, 136, 338 Nasal Septum, 338 Nasopharynx, 28, 51, 128, 131, 267, 274, 332, 338

Nausea, 27, 203, 216, 235, 265, 288, 294, 311, 338 Neck dissection, 74, 100, 338 Neoplasia, 197, 198, 338 Neoplasm, 6, 96, 177, 338, 355, 366 Neoplastic, 164, 197, 198, 212, 332, 338, 341, 355, 366 Nephropathy, 31, 329, 338 Nerve, 49, 292, 296, 303, 309, 313, 316, 334, 337, 339, 347, 353, 355, 360 Nerve Fibers, 49, 339 Nervous System, 22, 47, 75, 118, 127, 164, 174, 210, 212, 228, 289, 290, 302, 313, 319, 320, 330, 334, 339, 344, 346, 356, 361, 362, 368 Neural, 228, 231, 290, 317, 324, 339 Neural Pathways, 228, 339 Neuroblastoma, 8, 120, 339 Neuroectodermal tumor, 8, 83, 339, 348 Neuroendocrine, 261, 339 Neurologic, 100, 262, 320, 339 Neurons, 9, 309, 319, 330, 339, 361, 362 Neurosecretory Systems, 314, 339 Neurosurgery, 31, 46, 86, 87, 97, 103, 210, 339 Neurotoxicity, 27, 339 Neurotransmitter, 289, 292, 320, 339, 357, 361, 362 Neutrons, 189, 291, 299, 316, 329, 339, 350 Neutrophils, 205, 317, 321, 330, 339 Nicotine, 38, 339 Nitrogen, 291, 292, 308, 317, 320, 335, 339, 366 Nocturia, 163, 340 Nonmetastatic, 63, 77, 340 Nuclear Medicine, 56, 57, 271, 272, 273, 277, 340 Nuclei, 168, 201, 291, 319, 333, 336, 339, 340, 349, 362 Nucleic acid, 309, 324, 326, 340 Nucleic Acid Hybridization, 324, 340 Nurse Practitioners, 34, 340 Nursing Care, 10, 340 O Observational study, 66, 71, 94, 340 Occult, 133, 136, 340 Ocular, 51, 340 Odour, 295, 340 Ointments, 311, 340, 342 Olfaction, 228, 340 Oncogene, 36, 184, 198, 340 Oncogenic, 58, 330, 340, 349

Radiation therapy

Oncologist, 32, 166, 170, 334, 341 Oncolysis, 341 Oncolytic, 65, 341 Opacity, 309, 341 Open Reading Frames, 330, 341 Ophthalmology, 44, 97, 103, 114, 317, 341 Oral Health, 3, 8, 217, 226, 227, 229, 230, 237, 277, 341 Oral Hygiene, 5, 216, 227, 341 Orderly, 196, 341 Organ Culture, 341, 364 Organ Preservation, 102, 341 Organ Transplantation, 178, 341 Organelles, 308, 334, 337, 341, 353 Orofacial, 5, 341 Oropharynx, 4, 5, 134, 325, 341 Osteogenic sarcoma, 341 Osteomyelitis, 226, 341 Osteonecrosis, 7, 204, 341 Osteoporosis, 34, 164, 174, 341 Osteoradionecrosis, 3, 8, 9, 216, 225, 226, 227, 237, 256, 341 Osteosarcoma, 234, 341 Ovary, 321, 341, 342, 360 Overall survival, 28, 51, 55, 91, 103, 342 Ovum, 330, 342, 348, 369 Oxaliplatin, 31, 41, 342 Oxidation, 289, 294, 320, 342 Oxides, 191, 192, 342 Oxygen Consumption, 37, 342, 353 Oxygenation, 17, 21, 30, 63, 342 P Paclitaxel, 4, 5, 16, 27, 30, 73, 79, 104, 118, 119, 120, 136, 342 Palate, 95, 338, 342, 360 Palladium, 97, 103, 342 Palliative, 64, 67, 86, 217, 268, 308, 342, 363 Palpation, 22, 342 Pancreas, 50, 81, 289, 298, 310, 342, 366 Pancreatic, 29, 52, 75, 93, 104, 199, 265, 275, 342 Pancreatic cancer, 29, 75, 93, 104, 199, 275, 342 Papilla, 342 Papillary, 102, 112, 342 Paraffin, 55, 342 Paralysis, 49, 168, 342 Parenteral, 265, 342, 343 Parenteral Nutrition, 265, 343 Parietal, 343, 346 Parkinsonism, 96, 330, 343 Parotid, 6, 343, 355

382

Paroxysmal, 293, 343 Patch, 315, 330, 343 Pathogen, 191, 326, 343 Pathogenesis, 35, 150, 343 Pathologic, 22, 27, 48, 98, 102, 295, 298, 300, 307, 324, 343, 349, 367 Pathologic Processes, 295, 343 Pathophysiology, 7, 17, 343 Patient Education, 10, 255, 282, 284, 288, 343 PDQ, 253, 343 Pelvic, 54, 76, 80, 87, 90, 103, 112, 170, 182, 223, 258, 343, 348 Pelvis, 120, 130, 289, 325, 332, 343, 367 Penicillin, 293, 343 Peptide, 38, 53, 178, 201, 291, 343, 349, 364 Perception, 306, 343 Percutaneous, 15, 158, 159, 183, 261, 343 Perforation, 182, 295, 343 Perfusion, 16, 37, 106, 109, 325, 343 Pericardium, 344, 362 Perineal, 344, 350 Periodontal disease, 5, 344 Periodontitis, 320, 344 Perioral, 227, 344 Peripheral blood, 60, 89, 136, 169, 195, 322, 327, 344 Peripheral Nervous System, 339, 344, 361 Peripheral stem cell transplantation, 344, 364 Peripheral stem cells, 321, 344 Peritoneal, 310, 312, 344 Peritoneal Dialysis, 310, 312, 344 Perivascular, 16, 344 Pesticides, 298, 344 Petroleum, 342, 344 PH, 28, 51, 55, 102, 109, 152, 157, 176, 179, 200, 298, 344 Phallic, 317, 344 Phantom, 35, 160, 171, 172, 180, 205, 344 Pharmaceutical Preparations, 202, 302, 315, 319, 344 Pharmaceutical Solutions, 311, 345 Pharmacokinetic, 65, 165, 345 Pharmacologic, 31, 58, 265, 292, 322, 345, 364, 367 Pharynx, 11, 325, 338, 341, 345 Phenylalanine, 345, 366 Phenylbutyrate, 241, 345 Phospholipases, 345, 357 Phosphorus, 300, 345 Phosphorylation, 209, 345

383

Photodynamic therapy, 212, 345 Photosensitivity, 345, 369 Physical Therapy, 230, 345 Physiologic, 199, 290, 311, 322, 324, 335, 345, 352, 366 Physiology, 34, 228, 231, 238, 345 Pilocarpine, 110, 230, 231, 241, 345 Pilot study, 8, 19, 43, 104, 345 Planning Techniques, 156, 345 Plants, 196, 212, 291, 301, 303, 320, 337, 345, 355, 364, 368 Plaque, 103, 158, 293, 345 Plasma, 13, 95, 149, 150, 192, 294, 317, 319, 321, 322, 337, 345, 346, 352, 353, 356 Plasma cells, 294, 321, 337, 346 Platelet Activation, 346, 357 Platelet Count, 201, 346 Platelet Transfusion, 205, 346 Plateletpheresis, 205, 346 Platelets, 192, 205, 346, 355, 363 Platinum, 34, 41, 271, 304, 342, 346 Platinum Compounds, 342, 346 Plethysmography, 265, 346 Pleura, 346 Pleural, 108, 199, 346 Pneumonia, 266, 300, 306, 346 Pneumonitis, 204, 346 Podophyllotoxin, 315, 346 Poisoning, 328, 338, 346 Polyploid, 201, 346 Polyposis, 305, 346 Polysaccharide, 294, 302, 320, 346, 349 Pons, 299, 346 Porphyrins, 212, 335, 346 Posterior, 6, 86, 292, 296, 303, 311, 342, 347 Postmenopausal, 341, 347 Postnatal, 347, 359 Postoperative, 4, 6, 79, 93, 95, 101, 104, 114, 119, 120, 153, 270, 276, 347 Postsynaptic, 347, 357, 362 Potentiate, 164, 195, 347 Potentiating, 164, 347 Potentiation, 198, 347, 357 Practicability, 347, 366 Practice Guidelines, 66, 248, 256, 257, 264, 266, 267, 268, 269, 270, 271, 272, 273, 274, 275, 276, 347 Precancerous, 229, 347 Preclinical, 14, 21, 26, 27, 32, 40, 63, 65, 347 Precursor, 293, 303, 308, 311, 314, 330, 345, 347, 366 Prednisolone, 347

Prednisone, 179, 347 Premalignant, 347 Premenopausal, 77, 110, 347 Preoperative, 4, 48, 67, 81, 115, 120, 181, 275, 276, 347 Prevalence, 52, 347 Primary tumor, 18, 29, 110, 130, 348 Primitive neuroectodermal tumors, 334, 348 Probe, 18, 189, 348 Problem Solving, 295, 348 Proctitis, 120, 348 Progesterone, 348, 360 Prognostic factor, 4, 23, 79, 86, 88, 348 Progression, 60, 111, 148, 174, 177, 178, 293, 348, 366 Progressive, 227, 262, 302, 312, 315, 322, 346, 348, 349, 366 Projection, 159, 166, 348, 352 Proline, 304, 324, 348 Promoter, 12, 13, 30, 60, 348 Prophylaxis, 31, 309, 348, 367 Propofol, 74, 348 Prospective study, 331, 348 Prostate gland, 43, 182, 348 Prostatectomy, 10, 165, 234, 348, 350 Prostate-Specific Antigen, 70, 348 Prostatic acid phosphatase, 97, 348 Protease, 305, 349 Protein S, 173, 298, 349 Proteinuria, 337, 349 Proteoglycan, 199, 349 Protocol, 8, 21, 32, 43, 49, 51, 61, 81, 98, 136, 349 Protons, 28, 48, 168, 291, 324, 328, 333, 335, 349, 350 Proto-Oncogene Proteins, 342, 349 Proto-Oncogene Proteins c-mos, 342, 349 Proto-Oncogenes, 198, 349 Proximal, 32, 108, 157, 159, 182, 311, 338, 349 Psoriasis, 164, 174, 273, 349 Psychiatry, 317, 349 Psychic, 330, 335, 349, 356 Public Policy, 247, 349 Pulmonary, 35, 37, 81, 115, 264, 298, 306, 349 Pulmonary Artery, 298, 349 Pulmonary Fibrosis, 35, 349 Pulse, 337, 350 Pupil, 310, 336, 338, 350 Pyogenic, 341, 350

Radiation therapy

Q Quadrantectomy, 299, 350 Quiescent, 350, 368 R Race, 81, 311, 336, 350 Racemic, 311, 350 Radiation Injuries, 32, 350 Radiation oncologist, 36, 42, 43, 44, 341, 350 Radical cystectomy, 127, 350 Radical prostatectomy, 42, 68, 72, 75, 89, 92, 109, 144, 164, 350 Radioactive, 15, 42, 50, 57, 59, 153, 159, 160, 165, 172, 173, 177, 185, 187, 189, 204, 253, 296, 299, 322, 324, 326, 327, 328, 329, 331, 333, 337, 340, 350, 351, 355, 358, 366, 369 Radioactive iodine, 57, 350 Radioactivity, 50, 172, 308, 350 Radiobiology, 37, 219, 222, 350 Radiography, 34, 269, 277, 306, 350 Radioimmunotherapy, 25, 350, 351 Radioisotope, 58, 172, 351 Radiolabeled, 25, 38, 329, 350, 351, 369 Radiological, 16, 21, 219, 253, 254, 343, 351 Radiopharmaceutical, 59, 351 Radiosensitizers, 21, 166, 351 Radiotherapy Dosage, 6, 351 Radius, 39, 351 Random Allocation, 351 Randomization, 24, 351 Randomized clinical trial, 26, 351 Reactive Oxygen Species, 37, 351 Reagent, 332, 351 Receptor, 32, 35, 39, 62, 63, 184, 201, 204, 294, 306, 321, 352, 356, 357 Recombinant, 15, 60, 62, 107, 352, 367 Recombination, 319, 352 Rectal, 15, 51, 55, 67, 69, 81, 82, 115, 119, 139, 165, 182, 240, 260, 270, 275, 352 Rectal Fistula, 182, 352 Rectum, 8, 81, 94, 139, 163, 182, 294, 299, 305, 310, 319, 326, 329, 348, 352, 365 Recurrence, 4, 6, 27, 41, 55, 92, 102, 103, 234, 235, 298, 352 Red blood cells, 192, 315, 352, 355 Red Nucleus, 296, 352 Reductase, 335, 352 Refer, 1, 149, 169, 300, 305, 317, 318, 323, 331, 332, 333, 338, 339, 351, 352, 364 Refraction, 352, 358 Refractory, 47, 59, 89, 96, 192, 197, 352

384

Regional lymph node, 197, 352 Relapse, 4, 13, 84, 165, 169, 234, 352 Relative risk, 289, 352 Remission, 128, 298, 352 Renal pelvis, 352, 365 Renin, 32, 293, 352 Renin-Angiotensin System, 32, 352 Reproductive system, 348, 353 Research Design, 22, 34, 353 Research Support, 47, 353 Resection, 6, 10, 23, 29, 42, 48, 57, 79, 83, 87, 100, 105, 110, 111, 112, 177, 353, 365 Residual disease, 48, 353 Resolving, 13, 353 Respiration, 161, 301, 337, 353 Response rate, 60, 353 Restoration, 238, 308, 345, 353, 369 Reticulocytes, 195, 353 Retina, 303, 330, 333, 353 Retinal, 306, 311, 353, 368 Retinoblastoma, 51, 55, 74, 353 Retinoid, 20, 353 Retreatment, 104, 259, 353 Retroperitoneal, 290, 354 Retropubic, 10, 348, 350, 354 Retropubic prostatectomy, 10, 350, 354 Retrospective, 4, 8, 32, 354 Retrospective study, 4, 354 Retroviral vector, 319, 354 Retrovirus, 65, 354 Reversion, 60, 354 Rhabdomyosarcoma, 97, 354 Rheumatism, 354 Rheumatoid, 50, 230, 231, 354 Rheumatoid arthritis, 50, 230, 231, 354 Ribose, 20, 354 Rigidity, 343, 345, 354 Risk factor, 23, 32, 229, 348, 352, 354 Risk patient, 21, 23, 354 Rituximab, 127, 354 Ruminants, 321, 354 Rural Population, 43, 354 S Sagittal, 170, 354 Saliva, 7, 67, 110, 226, 230, 231, 238, 354 Salivary glands, 7, 9, 216, 224, 226, 228, 230, 231, 238, 308, 310, 316, 354 Salvage Therapy, 27, 355 Saponins, 355, 360 Sarcoidosis, 231, 355 Sarcoma, 8, 59, 79, 83, 142, 143, 145, 252, 348, 355, 358

385

Sargramostim, 141, 355 Scans, 16, 22, 159, 355 Scatter, 160, 344, 355, 367 Scleroderma, 230, 231, 355 Sclerosis, 119, 295, 355 Screening, 24, 51, 262, 304, 343, 355 Second cancer, 18, 23, 355 Secondary tumor, 56, 335, 355 Secretion, 314, 321, 325, 327, 337, 355, 356 Segmental, 299, 355 Segmental mastectomy, 299, 355 Segmentation, 18, 22, 59, 82, 208, 355, 356 Seizures, 320, 343, 356 Selective estrogen receptor modulator, 356, 362 Selenium, 13, 34, 39, 356 Semen, 348, 356 Seminal vesicles, 42, 356 Semisynthetic, 300, 315, 326, 356 Senile, 341, 356 Sensitization, 65, 356 Sensor, 63, 150, 356 Septic, 5, 356 Sequencing, 109, 110, 356 Serine, 321, 348, 349, 356 Serotonin, 321, 339, 356, 366 Serous, 102, 112, 346, 356 Serum, 30, 203, 305, 321, 325, 356, 366 Sex Characteristics, 292, 356 Sharpness, 357, 368 Shock, 357, 365 Signal Transduction, 12, 31, 38, 58, 191, 357 Signs and Symptoms, 352, 357 Silicon, 235, 357 Silicon Dioxide, 357 Skeletal, 34, 69, 87, 292, 337, 357 Skeleton, 317, 329, 357 Skull, 28, 51, 102, 357, 360, 362 Skull Base, 28, 51, 102, 357 Small cell lung cancer, 27, 64, 67, 69, 85, 90, 105, 118, 120, 125, 126, 128, 129, 138, 139, 141, 142, 192, 264, 268, 270, 272, 273, 275, 276, 340, 357 Small intestine, 312, 323, 328, 329, 357 Smooth muscle, 16, 158, 183, 192, 297, 299, 353, 357, 361 Social Environment, 350, 357 Social Work, 34, 358 Sodium, 57, 241, 256, 273, 358 Sodium Bicarbonate, 256, 358 Sodium Iodide, 273, 358

Soft tissue, 4, 6, 36, 51, 69, 142, 143, 145, 182, 213, 216, 262, 299, 357, 358 Soft tissue sarcoma, 36, 51, 69, 142, 143, 145, 358 Solid tumor, 27, 28, 29, 51, 55, 62, 107, 125, 136, 153, 169, 192, 293, 297, 312, 314, 358 Solvent, 315, 345, 358 Somatic, 308, 324, 334, 336, 344, 358 Sonogram, 358, 365 Sound wave, 306, 358, 365 Specialist, 278, 310, 358 Specificity, 42, 290, 358 Spectroscopic, 42, 43, 57, 333, 358 Spectrum, 12, 28, 32, 47, 358 Sperm, 292, 303, 358, 362 Sphincter, 10, 329, 358 Spinal cord, 49, 101, 194, 296, 299, 302, 303, 328, 335, 339, 344, 359, 361 Spleen, 179, 195, 292, 308, 332, 355, 359 Sporadic, 353, 359 Sprains and Strains, 332, 359 Squamous cells, 359 Stabilization, 212, 213, 359 Staging, 10, 23, 42, 48, 204, 262, 355, 359 Standard therapy, 41, 163, 359 Statistically significant, 54, 359 Steel, 211, 359, 366 Stem cell transplantation, 89, 119, 168, 169, 322, 359 Stem Cells, 169, 291, 322, 344, 359 Stenosis, 16, 83, 158, 172, 183, 359, 360 Stent, 71, 77, 85, 98, 112, 235, 359 Stereotactic, 31, 40, 83, 86, 97, 103, 108, 111, 119, 141, 177, 207, 254, 256, 359, 360 Stereotactic biopsy, 97, 360 Stereotactic radiosurgery, 177, 360 Sterility, 308, 360 Sterilization, 189, 360 Steroid, 179, 307, 355, 360 Stimulus, 43, 312, 313, 330, 360 Stomach, 58, 216, 289, 310, 315, 319, 323, 330, 338, 345, 354, 357, 359, 360 Stomatitis, 5, 227, 360 Stool, 305, 326, 329, 360 Strand, 178, 195, 360 Streptavidin, 67, 360 Streptococci, 9, 360 Stress, 7, 263, 338, 354, 360 Stricture, 72, 359, 360 Stroke, 146, 246, 253, 301, 360 Stromal, 35, 299, 360 Stromal Cells, 35, 299, 360

Radiation therapy

Strontium, 276, 360 Subacute, 118, 327, 360 Subclavian, 113, 296, 360 Subclinical, 48, 153, 327, 356, 361 Subcutaneous, 104, 118, 165, 204, 312, 342, 361 Submaxillary, 314, 361 Subspecies, 358, 361 Substance P, 335, 355, 361 Substrate, 157, 173, 361 Sunburn, 237, 361, 367 Superoxide, 35, 37, 361 Superoxide Dismutase, 35, 37, 361 Supine, 113, 170, 361 Supine Position, 170, 361 Supportive care, 225, 343, 361 Suppression, 60, 196, 198, 292, 361 Suppressive, 203, 361 Supratentorial, 17, 91, 137, 138, 361 Survival Rate, 4, 26, 47, 181, 342, 361 Sympathetic Nervous System, 339, 361 Symphysis, 303, 348, 361 Symptomatic, 8, 109, 274, 361 Synaptic, 339, 357, 362 Synaptic Transmission, 339, 362 Synergistic, 16, 27, 65, 184, 362 Systemic disease, 230, 362 Systemic lupus erythematosus, 231, 362 Systemic therapy, 93, 362 Systems Analysis, 35, 362 T Tacrolimus, 178, 362 Tamoxifen, 18, 27, 39, 132, 137, 356, 362 Tegafur, 81, 362 Telangiectasia, 209, 362 Teletherapy, 12, 362 Telophase, 336, 362 Temozolomide, 127, 140, 235, 362 Temporal, 21, 37, 333, 362 Teratogenic, 291, 362 Testicles, 292, 362 Testicular, 90, 363 Testis, 321, 363 Tetanus, 363, 366 Thalamic, 296, 363 Thalamic Diseases, 296, 363 Thalidomide, 132, 133, 363 Therapeutics, 19, 23, 26, 76, 176, 197, 240, 363 Thermal, 62, 150, 171, 295, 299, 311, 339, 363 Thigh, 317, 363

386

Thoracic, 20, 35, 37, 65, 67, 79, 101, 113, 118, 199, 275, 310, 346, 363, 369 Threonine, 173, 349, 356, 363 Thrombin, 317, 363 Thrombocytes, 346, 363 Thrombocytopenia, 201, 205, 363 Thrombolytic, 158, 363 Thrombopoietin, 201, 363 Thrombosis, 16, 164, 173, 263, 349, 360, 363 Thrombus, 307, 327, 338, 363 Thrush, 226, 300, 363 Thymidine, 24, 40, 61, 364 Thymidine Kinase, 24, 40, 61, 364 Thymidylate Synthase, 41, 50, 364 Thymus, 325, 332, 364 Thyroid, 58, 224, 257, 272, 273, 301, 325, 328, 358, 364, 366 Thyrotropin, 325, 364 Tin, 96, 346, 364 Tissue Culture, 150, 364 Tolerance, 16, 17, 28, 45, 54, 74, 118, 290, 364 Tomography, 11, 33, 48, 72, 157, 170, 185, 186, 200, 218, 306, 333, 355, 364 Tone, 297, 341, 364 Topical, 202, 225, 315, 324, 342, 358, 364 Topoisomerase inhibitors, 329, 364 Total-body irradiation, 130, 364 Toxic, iv, 28, 39, 89, 202, 203, 212, 291, 301, 303, 309, 314, 325, 326, 339, 346, 356, 364 Toxicology, 36, 195, 248, 364 Toxin, 149, 301, 314, 326, 363, 364 Trace element, 299, 357, 364, 365 Trachea, 316, 329, 345, 364, 365 Tracheostomy, 11, 365 Transcriptase, 354, 365 Transduction, 58, 199, 228, 357, 365 Transfection, 298, 319, 365 Transfer Factor, 325, 365 Transfusion, 205, 365 Transitional cell carcinoma, 132, 365 Translating, 43, 365 Translation, 291, 365 Translational, 20, 65, 365 Transplantation, 23, 35, 178, 325, 344, 365 Transrectal ultrasound, 42, 365 Transurethral, 10, 348, 365 Transurethral resection, 348, 365 Transurethral Resection of Prostate, 348, 365

387

Trauma, 231, 258, 259, 260, 263, 267, 297, 363, 365, 366 Treatment Failure, 21, 29, 57, 87, 88, 235, 365 Treatment Outcome, 28, 29, 51, 55, 170, 365 Tremor, 343, 366 Trigger zone, 366 Trismus, 3, 4, 7, 8, 9, 216, 226, 227, 256, 366 Tryptophan, 304, 356, 366 Tumor marker, 13, 20, 298, 366 Tumor model, 14, 62, 66, 366 Tumor Necrosis Factor, 82, 107, 363, 366 Tumorigenic, 60, 366 Tumour, 78, 118, 189, 208, 341, 366 Tungsten, 153, 211, 301, 366 Tunica, 313, 337, 366 Tyrosine, 26, 173, 184, 191, 366 U Ulcer, 321, 366 Ulceration, 7, 366 Ultrasonography, 182, 366 Ultraviolet radiation, 88, 178, 361, 366, 367 Ultraviolet radiation therapy, 88, 367 Unconscious, 293, 325, 367 Unresectable, 6, 27, 67, 79, 85, 90, 114, 118, 234, 260, 264, 265, 367 Uracil, 65, 81, 199, 367 Urban Population, 39, 367 Ureter, 352, 365, 367 Urethra, 348, 365, 367 Urinary, 10, 16, 70, 95, 111, 162, 163, 297, 308, 320, 326, 348, 354, 367 Urinary Retention, 297, 367 Urinate, 367, 369 Urine, 10, 298, 308, 314, 326, 349, 352, 367 Urogenital, 320, 367 Uterus, 163, 259, 303, 307, 314, 325, 335, 348, 353, 367 V Vaccination, 30, 367 Vaccine, 29, 141, 150, 290, 349, 367 Vagina, 300, 303, 310, 335, 353, 367 Vaginal, 332, 367 Vaginitis, 300, 367 Vascular, 7, 10, 15, 16, 29, 37, 63, 75, 82, 113, 172, 204, 254, 258, 303, 321, 327, 363, 367

Vascular endothelial growth factor, 15, 367 Vasodilation, 291, 367 Vector, 12, 40, 65, 193, 365, 367 Vegetative, 346, 368 Vein, 16, 207, 263, 295, 296, 328, 340, 343, 361, 368 Venous, 16, 81, 192, 295, 296, 323, 346, 349, 368 Venous blood, 346, 368 Venules, 298, 300, 368 Vertebrae, 328, 359, 368 Vertebral, 263, 368 Veterinary Medicine, 247, 368 Vinca Alkaloids, 368 Vinorelbine, 23, 368 Viral, 13, 40, 64, 150, 164, 174, 192, 199, 320, 340, 349, 354, 365, 366, 368 Viral vector, 40, 64, 199, 368 Virtual colonoscopy, 105, 368 Virulence, 364, 368 Virus, 7, 12, 24, 40, 61, 64, 95, 150, 198, 205, 296, 314, 320, 327, 345, 354, 365, 368 Visceral, 308, 368 Visual Acuity, 24, 44, 56, 307, 368 Vital Capacity, 35, 368 Vital Statistics, 53, 368 Vitiligo, 100, 368 Vitreous, 330, 353, 369 Vitro, 26, 99, 369 Vivo, 26, 36, 60, 150, 195, 369 Vocal cord, 139, 369 Void, 183, 369 Volition, 328, 369 W White blood cell, 289, 294, 304, 317, 321, 322, 330, 332, 333, 346, 369 Windpipe, 345, 364, 369 Womb, 353, 367, 369 Wound Healing, 49, 237, 369 X Xenograft, 25, 293, 366, 369 Xeroderma Pigmentosum, 41, 369 Xerostomia, 7, 8, 9, 10, 80, 112, 133, 217, 224, 226, 227, 230, 231, 237, 238, 256, 274, 369 X-ray therapy, 49, 213, 329, 369 Y Yttrium, 50, 369

Radiation therapy

388