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International Journal of Radiation Oncology, Biology, Physics

Luke R G Pike, Andrew Bang, Brandon A Mahal, Allison Taylor, Monica Krishnan, Alexander Spektor, Daniel N Cagney, Ayal A Aizer, Brian M Alexander, Osama Rahma, Tracy Balboni, Patrick A Ott, F Stephen Hodi, Jonathan D Schoenfeld
PURPOSE: Therapeutic radiation has conflicting immune effects: radiation (RT)-induced immunogenic cell death can contribute to immune response, but lymphocytes are also sensitive to RT. It is unknown whether palliative RT leads to lymphopenia in patients treated with immune checkpoint inhibitors (ICI) and whether this impacts outcomes. As such, we sought to assess the impact of palliative RT on circulating lymphocyte count and neutrophil-lymphocyte-ratio (NTL) in patients being treated with PD-1 directed ICI and associations with survival...
September 15, 2018: International Journal of Radiation Oncology, Biology, Physics
Catarina Veiga, David Landau, Anand Devaraj, Tom Doel, Jared White, Yenting Ngai, David J Hawkes, Jamie R McClelland
PURPOSE: Recent improvements in lung cancer survival have spurred an interest in understanding and minimizing long-term radiation-induced lung damage (RILD). However, there are still no objective criteria to quantify RILD, leading to variable reporting across centers and trials. We propose a set of objective imaging biomarkers for quantifying common radiologic findings observed 12 months after lung cancer radiation therapy. METHODS AND MATERIALS: Baseline and 12-month computed tomography (CT) scans of 27 patients from a phase 1/2 clinical trial of isotoxic chemoradiation were included in this study...
September 11, 2018: International Journal of Radiation Oncology, Biology, Physics
Avani D Rao, Qinyu Chen, Lynn Million, Sheri L Spunt, Thomas J Fitzgerald, Chen Hu, Sandesh S Rao, Fran Laurie, Sandy Kessel, Karen Morano, Matthew M Ladra, Stephanie A Terezakis
BACKGROUND/OBJECTIVES: For pediatric patients with large, high-grade extremity non-rhabdomyosarcoma soft tissue sarcomas (NRSTS), preoperative radiation therapy (RT) provides the opportunity for smaller radiation fields and tumor shrinkage resulting in less extensive surgery. The potential disadvantage is an increased risk of wound complications after surgery compared to rates following postoperative chemoradiation. We assessed the impact of preoperative RT technique on target coverage in relationship to dose to skin and adjacent joints to determine if acute wound complications and late musculoskeletal injury might be influenced by treatment technique...
September 10, 2018: International Journal of Radiation Oncology, Biology, Physics
Mishal Mendiratta-Lala, William Masch, Prasad R Shankar, Holly E Hartman, Matthew S Davenport, Matthew J Schipper, Chris Maurino, Kyle C Cuneo, Theodore S Lawrence, Dawn Owen
PURPOSE: To determine the natural history of imaging findings seen by MRI of hepatocellular carcinoma (HCC) treated with stereotactic body radiation therapy (SBRT). Although arterial hyperenhancement is a key feature of untreated HCC, our clinical experience suggested that tumors which never progressed could still show hyperenhancement. Therefore, we carried out a systematic study to test the hypothesis that persistent arterial phase hyperenhancement (APHE) following SBRT is an expected finding that does not suggest failure of treatment...
September 10, 2018: International Journal of Radiation Oncology, Biology, Physics
Supriya Chopra, Kedar Deodhar, Venkatesh Pai, Sidharth Pant, Nidul Rathod, Jayant S Goda, Niyati Sudhakar, Puloma Pandey, Sanjeev Waghmare, Reena Engineer, Umesh Mahantshetty, Jaya Ghosh, Sudeep Gupta, Shyam Shrivastava
PURPOSE: While cancer stem cells (CSCs) have been reported across solid tumors, there is dearth of data regarding CSC and its impact on outcomes of cervical cancer. METHODS: From October, 2013-December 2015, patients with squamous cancer of cervix (Stage IB2-IVA) were included. Pretreatment and post-treatment biopsy was obtained and immunohistochemistry (IHC) was performed for SOX-2, OCT-4, Nanog, CD44 and Podoplanin. All patients received concurrent radiation and brachytherapy to an equivalent dose of 80-84 Gy to point A with concurrent weekly cisplatin...
September 10, 2018: International Journal of Radiation Oncology, Biology, Physics
Jaden D Evans, Lindsay K Morris, Henan Zhang, Siyu Cao, Xin Liu, Kristin C Mara, Bradley J Stish, Brian J Davis, Aaron S Mansfield, Roxana S Dronca, Matthew J Iott Cnp, Eugene D Kwon, Robert L Foote, Kenneth R Olivier, Haidong Dong, Sean S Park
PURPOSE: To study the effects of metastasis-directed stereotactic body radiation therapy (mdSBRT) on CD8+ T-cell subpopulations and to correlate post-mdSBRT immunophenotypic responses with clinical outcomes in patients with oligometastatic prostate cancer (OPCa). METHODS AND MATERIALS: Peripheral blood mononuclear cells (PBMCs) were prospectively isolated from 37 patients with OPCa (≤3 metastases) treated with mdSBRT. Immunophenotyping identified circulating CD8+ T-cell subpopulations including: Tumor-Reactive (TTR ), Effector Memory (TEM ), Central Memory (TCM ), Effector (TEF ), and Naïve (TN ) T-cells from samples collected before and after mdSBRT...
September 8, 2018: International Journal of Radiation Oncology, Biology, Physics
Robert W Gao, Daniel J Weisdorf, Todd E DeFor, Eric Ehler, Kathryn E Dusenbery
PURPOSE/OBJECTIVES: To determine the relationship between dose rate and other factors with the development of idiopathic pneumonia syndrome (IPS) in acute lymphoblastic (ALL) and acute myeloid (AML) leukemia patients undergoing total body irradiation (TBI)-based myeloablative conditioning for allogeneic hematopoietic cell transplantation (HCT). MATERIALS/METHODS: From 2006 to 2016, 202 acute leukemia patients (111 ALL, 91 AML) ranging in age from 1 to 57 years (median: 25) underwent allogeneic HCT at XXX...
September 8, 2018: International Journal of Radiation Oncology, Biology, Physics
Alexander Soldatov, Christoph A J von Klot, Daniel Walacides, Thorsten Derlin, Frank M Bengel, Tobias L Ross, Hans-Jürgen Wester, Katja Derlin, Markus A Kuczyk, Hans Christiansen, Christoph Henkenberens
We demonstrated in 108 patients with increased prostate-specific antigen levels, who received 68 Ga-PSMA-ligand PET/CT-guided radiotherapy (RT) for recurrent oligometastatic disease after primary therapy for prostate cancer (PCa) that PSMA-ligand PET/CT-guided RT for relapsed PCa with limited tumor burden allowed individualized treatment approaches, provided effective local control and considerably prolonged biochemical progression-free survival. The PSMA-ligand PET/CT patterns of progression revealed a shift in the pattern of metastases towards skeletal involvement and distant lymph node metastases...
September 7, 2018: International Journal of Radiation Oncology, Biology, Physics
Le Zhang, Milana Bochkur Dratver, Taha Yazal, Kevin Dong, Andrea Nguyen, Garrett Yu, Amy Dao, Michael Bochkur Dratver, Sara Duhachek-Muggy, Kruttika Bhat, Claudia Alli, Frank Pajonk, Erina Vlashi
PURPOSE: The lack of a molecular target in triple negative breast cancer (TNBC) makes it one of the most challenging breast cancers to treat. Radiation therapy (RT) is an important treatment modality for managing breast cancer, however we previously showed that RT can also reprogram a fraction of the surviving BC cells into BC initiating cells (BCICs), that are thought to contribute to disease recurrence. In this study we characterize mebendazole as a drug with potential for preventing radiation-induced reprogramming from occurring and improve the effect of RT in TNBC patients...
September 6, 2018: International Journal of Radiation Oncology, Biology, Physics
Barbara Stam, Margriet Kwint, Matthias Guckenberger, Frederick Mantel, Andrew Hope, Meredith Giuliani, Maria Werner-Wasik, Inga Grills, Jan-Jakob Sonke, José Belderbos
PURPOSE: Stereotactic body radiation therapy (SBRT) has been associated with increased toxicity when delivered to early stage non-small cell lung cancer (NSCLC) patients with a tumor within 2cm of the proximal bronchial tree (PBT). We investigated non-cancer death for these patients as it relates to GTV-proximity to the PBT compared to peripheral tumors. METHODS AND MATERIALS: We included 765 early stage NSCLC patients treated with SBRT to a median of 3x18Gy. Patients with central tumors were treated with a risk-adapted (less intense) schedule (mostly 8 fractions) in 55% of the patients in the first cm group, and 27% of the patients in the second cm group...
August 31, 2018: International Journal of Radiation Oncology, Biology, Physics
Chong Duan, Ruimeng Yang, Liya Yuan, John A Engelbach, Christina I Tsien, Keith M Rich, Sonika M Dahiya, Tanner M Johanns, Joseph J H Ackerman, Joel R Garbow
PURPOSE: Glioblastoma (GBM) remains incurable, despite state-of-the-art treatment involving surgical resection, chemotherapy, and radiation. GBM invariably recurs as a highly invasive and aggressive phenotype, with the majority of recurrences within the radiotherapy treatment field. While a large body of literature reporting on primary GBM exists, comprehensive studies of how prior irradiation alters recurrent tumor growth are lacking. An animal model that replicates the delayed effects of radiotherapy on the brain microenvironment and its impact on the development of recurrent GBM would be a significant advance...
August 29, 2018: International Journal of Radiation Oncology, Biology, Physics
Zhongjie Chen, Yinshan Fang, Si Zhang, Lian Li, Li Wang, Aixu Zhang, Zhiyong Yuan, Ping Wang, Honggang Zhou, Wanchang Cui, Thomas J MacVittie, Wen Ning
PURPOSE: Radiation-induced pulmonary fibrosis (RIPF) is a severe and life-threatening complication of radiotherapy in thoracic cancer patients; however, the exact molecular mechanisms remain unknown, and there is no effective treatment method in clinic. Here, we assessed the role of follistatin-like 1 (Fstl1) in RIPF. EXPERIMENTAL DESIGN: Protein and mRNA levels of Fstl1 in lung tissues from symptomatic RIPF patients, Rhesus macaques and mice were assessed. Then, fibrotic and inflammatory responses to radiation-induced lung injury as well as accumulation of myofibroblasts in Fstl1 haplodeficient (Fstl1+/- ) mice were determined...
August 29, 2018: International Journal of Radiation Oncology, Biology, Physics
John A Kalapurakal, Mahesh Gopalakrishnan, David O Walterhouse, Cynthia K Rigsby, Alfred Rademaker, Irene Helenowski, Sandy Kessel, Karen Morano, Fran Laurie, Ken Ulin, Natia Esiashvili, Howard Katzenstein, Karen Marcus, David Followill, Suzanne L Wolden, Anita Mahajan, Thomas J Fitzgerald
PURPOSE: A prospective clinical trial was conducted for patients undergoing cardiac sparing (CS) whole lung irradiation (WLI) using IMRT. The 3 trial aims were: 1) To demonstrate the feasibility of CS IMRT with real time central quality control; 2) To determine the dosimetric advantages of WLI using IMRT compared to standard antero-posterior (AP) techniques; and 3) To determine acute tolerance and short-term efficacy after a protocol mandated minimum 2 year follow up for all patients...
August 28, 2018: International Journal of Radiation Oncology, Biology, Physics
Olivier Morin, Martin Vallières, Arthur Jochems, Henry C Woodruff, Gilmer Valdes, Steve E Braunstein, Joachim E Wildberger, Javier E Villanueva-Meyer, Vasant Kearney, Sue S Yom, Timothy D Solberg, Philippe Lambin
The adoption of enterprise digital imaging, along with the development of quantitative imaging methods and the re-emergence of statistical learning, has opened the opportunity for transformative data science research for more personalized cancer treatments. In the last 5 years, accumulating evidence has indicated that non-invasive advanced imaging analytics, i.e. radiomics, can reveal key components of tumor phenotype for multiple lesions at multiple time points over the course of treatment. Many groups using home-grown software have extracted engineered and deep quantitative features on three-dimensional medical images for better spatial and longitudinal understanding of tumor biology and for the prediction of diverse outcomes...
August 28, 2018: International Journal of Radiation Oncology, Biology, Physics
Stephanie K Schaub, Smith Apisarnthanarax, Ryan G Price, Matthew J Nyflot, Tobias R Chapman, Manuela Matesan, Hubert J Vesselle, Stephen R Bowen
PURPOSE/OBJECTIVE: Mitigating radiation-induced liver disease (RILD) is an ongoing need in hepatocellular carcinoma (HCC) patients. We hypothesize that [99m Tc]-sulfur colloid (SC) SPECT/CT scans can provide global functional liver metrics and functional liver dosimetric parameters that are predictive of hepatotoxicity risk in primary liver cancer patients with cirrhosis. MATERIALS/METHODS: We retrospectively reviewed 47 patients (n=26 proton, n=21 SBRT) with Child-Pugh (CP)-A (62%) or CP-B (38%) cirrhosis who underwent SC SPECT/CT scans for radiation therapy (RT) planning...
August 28, 2018: International Journal of Radiation Oncology, Biology, Physics
Alejandro Berlin, Jure Murgic, Ali Hosni, Melania Pintilie, Adriana Salcedo, Michael Fraser, Suzanne Kamel-Reid, Jingbin Zhang, Qiqi Wang, Carolyn Ch'ng, Samineh Deheshi, Elai Davicioni, Theodorus van der Kwast, Paul C Boutros, Robert G Bristow, Melvin L K Chua
BACKGROUND: The NCCN has recently endorsed the stratification of intermediate-risk prostate cancer (IR-PCa) into favorable and unfavourable subgourps, and recommend the addition of androgen deprivation therapy (ADT) to radiotherapy (RT) for unfavorable IR-PCa. Recently, more accurate prognostication was demonstrated by integrating a 22-feature genomic classifier (GC) to the NCCN stratification system. Here, we test the utility of the GC to better identify IR-PCa patients who are sufficiently treated by RT alone...
August 28, 2018: International Journal of Radiation Oncology, Biology, Physics
Pei Yang, Ting Xu, Daniel R Gomez, Weiye Deng, Xiong Wei, Hesham Elhalawani, Hekun Jin, Fada Guan, Dragan Mirkovic, Yujin Xu, Radhe Mohan, Zhongxing Liao
PURPOSE: We compared differences in patterns of local-regional failure, and the influence of adaptive planning on those patterns, in patients given passive scattering proton therapy (PSPT) vs. intensity-modulated photon therapy (IMRT) for non-small cell lung cancer. METHODS: Treatment simulation CT scans and dose distributions were registered with images depicting the recurrence. Local failure (LF) was failure within the internal target volume (ITV); marginal failure (MF), as failure between the ITV and PTV plus a 10-mm margin (PTV+10mm ); and regional failure (RF) as those outside the PTV+10mm ...
August 27, 2018: International Journal of Radiation Oncology, Biology, Physics
Nina N Sanford, Ruoyu Miao, Haotong Wang, Saveli Goldberg, Alex Jacobson, Andrew M Brunner, Gregory M Cote, Torunn I Yock, David H Ebb, Yi-Bin Chen, Kyung-Wook Jee, Francis Hornicek, Thomas F DeLaney, Edwin Choy, Yen-Lin Chen
BACKGROUND: Long-term survivors of Ewing sarcoma (ES) and osteosarcoma may be at risk for therapy-related acute leukemia or myelodysplastic syndrome (t-AL/MDS). PATIENTS AND METHODS: We retrospectively reviewed the clinicopathologic characteristics of 1,071 patients with osteosarcoma (n=757) and ES (n=314) treated between 1985 and 2014. Multivariable competing risk analysis was used to analyze predictors of t-AL/MDS including a radiation dose (>55.8 Gy vs. <55...
August 27, 2018: International Journal of Radiation Oncology, Biology, Physics
Susan G R McDuff, Amir I Mina, Cheryl L Brunelle, Laura Salama, Laura E G Warren, Mohamed Abouegylah, Meyha Swaroop, Melissa N Skolny, Maria Asdourian, Tessa Gillespie, Kayla Daniell, Hoda E Sayegh, George Naoum, Hui Zheng, Alphonse G Taghian
PURPOSE: To determine when the risk of lymphedema is highest following treatment for breast cancer and which factors influence the time-course of lymphedema development. PATIENTS AND METHODS: Between 2005-2017, 2,171 women (with 2,266 at-risk arms) who received surgery for unilateral or bilateral breast cancer at our institution were enrolled. Perometry was used to objectively assess limb volume preoperatively, and lymphedema was defined as ≥10% relative arm volume increase arising >3 months postoperatively...
August 27, 2018: International Journal of Radiation Oncology, Biology, Physics
Philip Sutera, David A Clump, Ronny Kalash, David D'Ambrosio, Alina Mihai, Hong Wang, Daniel P Petro, Steven A Burton, Dwight E Heron
BACKGROUND: Oligometastatic disease has emerged as a potentially curable state in the spectrum of cancer progression. Aggressive local therapy such as stereotactic ablative radiation therapy (SABR) may improve oncologic outcomes. Herein, we report the initial oncologic outcomes and patient-reported quality of life (PR-QoL) from a phase II multi-center trial for patients with oliogmetastatic disease. METHODS: Patients with oligometastatic disease (1-5 metastases) were prospectively recruited between 2011-2017...
August 24, 2018: International Journal of Radiation Oncology, Biology, Physics
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