Patrick Kupelian

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..Accounting for these changes would facilitate the retrospective comparison of outcomes for patients treated in different periods...

..To test this assumption, the intermarker distances (IMD) of implanted markers was monitored during the full course of radiation therapy to determine marker stability within the prostate gland...

..To study the radiation dose-response as determined by Kaplan-Meier prostate-specific antigen (PSA) disease-free survival (PSA-DFS) estimates in patients with stage T1-T2 prostate cancer treated within a 2-year period (1994-1995)...

..The purpose of the present study was to study a similar phenomenon with definitive radiotherapy (RT)...

..To review the biochemical recurrence-free survival (bRFS) rates of treatment with either external beam radiotherapy or radical prostatectomy in patients with biopsy Gleason score 8 or above in the prostate specific antigen (PSA) era...

..To compare long-term outcome using alternative failure definitions after external beam radiation for localized prostate cancer...

..These observations suggest that younger men with a lower PSA are more likely to have organ-confined and curable disease at diagnosis. This information has important implications for counseling and screening...

..To report the long-term outcome for patients with Stage T1-T2 adenocarcinoma of the prostate definitively irradiated in the prostate-specific antigen (PSA) era...

..This assay has no clinical utility in this patient population...

..The profile and gamma analysis results validate the accuracy of this method for incorporating intra-fraction motion into the dose calculation engine for assessment of dosimetric effects on helical tomotherapy dose deliveries...

..To study the impact of biochemical failure on overall survival rates during the first 10 years after definitive radiotherapy for localized prostate cancer...

..To review biochemical relapse-free survival (bRFS) rates after either external-beam radiotherapy (RT) or radical prostatectomy (RP) for localized prostate cancer...

..The purpose of this study was to analyze predictors of late rectal bleeding after external-beam radiotherapy for localized prostate cancer, with a focus on the volume of rectum irradiated...

..The real-time capability enables the framework to be coupled with real-time tumor monitoring systems such as implanted fiducials for computing the dose delivered in real time during the treatment...

..To determine whether nadir prostate-specific antigen (PSA) levels within 12 months (nadir PSA12) after completion of radiotherapy (RT) can be used as an early marker of recurrence risk...

..Our hypothesis was that the gap in biochemical relapse-free survival between these groups would lessen in the later prostate specific antigen era due to catch-up awareness/availability of screening and treatment in the black population...

..To assess the impact of intrafraction intervention on margins for prostate radiotherapy...

..The goal of this study was to develop and test a model for predicting lung tumor response during IGRT treatment using serial megavoltage CT (MVCT)...

..Most of the present data regarding the PG of GS7 CaP refer to surgical specimens. Our goal was to determine whether the biopsy GS used at the time of medical decision making predicted for the biochemical outcome...

..Dosimetric impact of the two alignment techniques on target coverage is presented...

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..To report the clinical experience with an electromagnetic treatment target positioning and continuous monitoring system in patients with localized prostate cancer receiving external beam radiotherapy...

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..A radiation treatment plan for the lung tumor is developed using one of the 4D CT phases. During the simulation of radiation delivery, the dose on the lung tumor is computed for each beam independently...

..To report and describe implantation techniques and stability of metallic fiducials in lung lesions to be treated with external beam radiotherapy...

..To study the outcomes in patients treated for localized prostate cancer with 70 Gy delivered at 2.5-Gy/fraction within 5 weeks...

..Ideally, the distances between transponders remains constant over the course of treatment. In this work, we evaluate the accuracy of these conditions...

..Applications of radiotherapy optical tracking technology to respiratory gating and the monitoring of implanted fiducial markers are also discussed...

..To determine the rate and magnitude of late genitourinary (GU) and gastrointestinal (GI) toxicities after salvage or adjuvant radiotherapy (RT) for prostate cancer, and to determine predictive factors for these toxicities...

..Using data from patients who were treated with daily IG, the residual setup errors for several different protocols are retrospectively calculated...

..1 cm(3) and 2.0 cm(3), respectively. Our initial experience in using MVCT imaging for clinical LDR gynecological brachytherapy indicates that the MVCT images are of sufficient quality for use in 3D, MVCT-based dose planning...

..To verify whether rectal distention at the time of planning impacts outcomes in patients with localized prostate cancer treated with daily image guidance...

..To study the effect of radiation dose on local failure (LF) and distant metastasis (DM) in prostate cancer patients treated with external beam radiotherapy...

..To assess the dosimetric consequence of intrafraction prostate motion on helical tomotherapy plans...

..However, when motion management techniques are evaluated, it should be kept in mind that the dosimetric impact of observed prostate motion is small for the majority of fractions...

..To assess and evaluate geometrical changes in parotid glands using deformable image registration and megavoltage CT (MVCT) images...

..To analyze changes in parotid gland dose resulting from anatomic changes throughout a course of radiotherapy in a cohort of head-and-neck cancer patients...

..To quantify and describe the real-time movement of the prostate gland in a large data set of patients treated with radiotherapy...

..The results suggest similar short-term survival but domain-specific effects on QOL after treatment with radical prostatectomy, brachytherapy, or external beam radiotherapy...

..The purpose of this investigation was to show that the MVCT dose can be computed in phantoms, and further, that the dose can be reported for actual patients from MVCT on a helical tomotherapy unit...

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..Understanding and managing the consequences of anatomic variations within the lower pelvis should be a priority in designing and implementing future clinical trials...

..Using data from patients treated using daily image guidance, the remaining setup errors for several different strategies were retrospectively calculated...

..Based on this study, we show that EBT film has several favorable features that allow for its use in routine IMRT patient-specific QA...

..The aim of this work was to study the variations in delivered doses to the prostate, rectum, and bladder during a full course of image-guided external beam radiotherapy...

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..In conjunction with the ability to recalculate radiotherapy doses on these images, this enables dose guidance as well as image guidance of radiotherapy treatments...

..To analyze the long-term relapse-free survival and toxicity rates in patients treated with hypofractionated intensity-modulated radiotherapy...

..Three manual techniques of registering the MVCT images with the planning kilovoltage (kV) CT images were evaluated. The techniques are based on visual alignment of (1) fiducial prostate markers, (2) CT anatomy, and (3) kVCT contours...

..Lastly, optical tracking has been integrated with ultrasound or stereoscopic x-ray imaging to determine the position of internal anatomy targets relative to isocenter...

..To report on the aggressiveness of sporadic versus familial prostate cancer...

..To report on the initial clinical use of a commercially available system to deliver gated treatment using implanted fiducials, in-room kV X-rays, and an infrared camera tracking system...

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..The aim of this study was to evaluate the extent of the variation in the position of the prostate bed with respect to the bony anatomy...

..To report biochemical relapse-free survival (bRFS) after radiotherapy (RT) for localized prostate cancer with two separate failure definitions and compare the results with those after radical prostatectomy (RP)...

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..The presence of DM at the time of treatment was significantly associated with worse late GI and GU toxicity. RT was significantly associated with worse late GI toxicity compared to PI and RP...

..D'Ambrosio et al. demonstrated that prolonging treatment duration has an adverse effect in low-risk patients with prostate cancer. Thus, limiting or modifying the overall elapsed time between treatments is necessary...

..The workflow and capabilities of each imaging system need to be evaluated and investigated individually...

..On-line adaptive radiotherapy requires robust deformable registration and replanning programs. These are beginning to emerge in useful clinic applications...

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..1% for 1987 to 1994 and 82.6% for 1995 to 2001 (P-value = 0.0022). PSA screening has resulted in a downward pathological stage migration. These observations demonstrate improved biochemical failure rates in more recently treated patients...

..Our study finds that there are systematic differences between Calypso and ultrasound for prostate localization...

..In this report we determined the sensitivity and specificity of several BF definitions using distant failure (DF) alone or clinical failure (CF), defined as local failure (LF) and/or DF...

..We examined patients treated by radical prostatectomy between 1987 and 2005 to establish temporal trends in pathologic stage migration as assessed by the proportion of patients with nonorgan-confined disease (NOCD)...

..Clinical evaluation of this novel 4D nonionizing electromagnetic localization system with transponders indicates a comparable localization accuracy to isocenter, (within 2 mm) compared with X-ray localization...

..At the same time, routine clinical use of MVCT imaging has provided a wealth of clinical experience. Both technical and clinical experiences with the MVCT system will be reviewed in this chapter...

..The available data suggest that these two modalities provide similar rates of cancer control at 10 years, and that except for the youngest patients, choice of therapy should be based on toxicity and QOL issues...

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..If the time-and-PSA threshold model is shown to be predictive of prostate carcinoma mortality as well, then it may allow the scientific community to evaluate promising treatment concepts and technologies at a highly accelerated pace...

..More research is needed to incorporate other biomarkers such as proliferative and hypoxia biomarkers in PET as well as integrating metabolic information in adaptive, patient-centered, tailored radiation therapy...

..However, daily CBCT is time intensive and increases the overall radiation dose. We assessed the feasibility of using the average couch shifts from the first several CBCTs to estimate and correct for the presumed systematic setup error...

..In conclusion, a method for estimation of the 3D target position from 2D projections has been developed and its use has been demonstrated in a simulation study of monoscopic prostate tracking...

..Results show depth images of the alveolar tissue construct for a bilayer construct, as well as predictions of the gas exchange process in a simple model of a bio-reactor hosting the construct...

..Therefore, when possible, we advocate more effective treatment by combining radiation therapy with other treatment modalities, as recommended in ongoing clinical trials...

..For whole-breast treatments, topotherapy is an efficient technique that achieves adequate target uniformity while maintaining low doses to sensitive structures...

..The applications of deformable registration in ART, including 'deformable dose accumulation', 'automatic re-contouring' and 'tumour growth/regression evaluation' throughout the course of radiotherapy are also studied...

..CONCLUSION: The postoperative Baylor nomogram was accurate when applied at international treatment institutions. Our results suggest that accurate predictions may be expected when using this nomogram across different patient populations...

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..To analyze two methods of image-guided radiotherapy (IGRT) for external beam radiotherapy of prostate cancer...

..Selected patients with high-grade disease and/or a rapid PSADT who were previously thought to be destined to develop progressive metastatic disease may achieve a durable response to salvage radiotherapy...

..The goal of this study was to create and to externally validate a nomogram for predicting the probability that a patient will develop metastasis within 5 years after three-dimensional conformal radiation therapy (CRT)...

..The objective of this survey was to identify factors associated with good sexual outcomes in a large group of survivors of localized prostate carcinoma...

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