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International Journal of Radiation Oncology, Biology, Physics

Lars Fokdal, Kari Tanderup, Richard Pötter, Alina Sturdza, Kathrin Kirchheiner, Cyrus Chargari, Ina Maria Jürgenliemk-Schulz, Barbara Segedin, Li-Tee Tan, Peter Hoskin, Umesh Mahantshetty, Kjersti Bruheim, Bhavana Rai, Christian Kirisits, Jacob Christian Lindegaard
BACKGROUND: and purpose: Ureteral stricture is a rare but severe side effect, after radiotherapy for locally advanced cervical cancer (LACC). This report describes the incidence and predictive factors for ureteral stricture in a large patient cohort treated with 3D image guided adaptive brachytherapy (IGABT) and radiochemotherapy within the XXXXXXX studies. MATERIAL AND METHODS: A total of 1860 patients were included. Treatment consisted of external beam radiotherapy (45-50 Gy in 25-30 fx), concomitant Cisplatin and IGABT...
November 9, 2018: International Journal of Radiation Oncology, Biology, Physics
Daphna Y Spiegel, Julian C Hong, Taofik Oyekunle, Laura Waters, W Robert Lee, Joseph K Salama, Bridget F Koontz
PURPOSE: Testosterone recovery (TR) after androgen deprivation therapy (ADT) and radiation therapy (RT) is not well characterized. We studied TR in men who received RT and either short-term (ST) or long-term (LT) ADT and aimed to create a nomogram to predict TR. METHODS AND MATERIALS: We identified consecutive localized PC patients treated with ADT-RT at two academic medical centers from 1/2011-10/2016 with documented baseline testosterone (T). TR was time from last ADT injection to T normalization...
November 9, 2018: International Journal of Radiation Oncology, Biology, Physics
Chuanxu Luo, Xiaorong Zhong, Ling Deng, Yuxin Xie, Kejia Hu, Hong Zheng
PURPOSE: Postmastectomy radiotherapy (PMRT) showed heterogeneous effects on survival outcome of patients with T1-2N1 breast cancer. A reliable model to estimate individuals' risk of locoregional recurrence (LRR) and the potential benefit derived from PMRT is in need. METHODS AND MATERIALS: We retrospectively analyzed 1141 patients with T1-2N1 breast cancer who underwent mastectomy between January 2001 and December 2012. Based on the Fine and Gray competing risks regression in 623 unirradiated patients, a nomogram predicting LRR was conducted for risk quantification...
November 9, 2018: International Journal of Radiation Oncology, Biology, Physics
Irwin Tendler, Petr Brůža, Jacqueline Andreozzi, Michael Jermyn, Benjamin Williams, Lesley Jarvis, Brian Pogue, David Gladstone
PURPOSE: The goal of this work is to produce a surface dosimetry method capable of accurately and remotely measuring skin dose for patients undergoing total skin electron therapy (TSET) without the need for post-exposure dosimeter processing. A rapid and wireless surface dosimetry system was developed to improve clinical workflow. Scintillator surface dosimetry was conducted on patients undergoing TSET by imaging scintillator targets with an intensified camera during TSET delivery. METHODS: & Materials: Disc-shaped scintillator targets were attached to the skin surface of patients undergoing TSET and imaged with an intensified, time-gated, and linac-synchronized camera...
November 9, 2018: International Journal of Radiation Oncology, Biology, Physics
Joel M Cherlow, Dennis W Shaw, Linda R Margraf, Daniel C Bowers, Jie Huang, Maryam Fouladi, Arzu Onar-Thomas, Tianni Zhou, Ian F Pollack, Amar Gajjar, Sandy Kessel, Patricia L Cullen, Kevin McMullen, John C Wellons, Thomas E Merchant
PURPOSE: To determine the rate of marginal relapse, progression-free survival (PFS), and overall survival (OS) in patients with pediatric low-grade glioma (PLGG) treated with conformal radiation therapy (CRT) with a clinical target volume (CTV) margin of 5 mm in the Children's Oncology Group trial XXXX. METHODS AND MATERIALS: Children (age 3-21 years) with unresectable progressive, recurrent, or residual PLGG were eligible for this study. Patients younger than 10 years were required to have received at least 1 chemotherapy course...
November 9, 2018: International Journal of Radiation Oncology, Biology, Physics
Boris Epel, Matthew C Maggio, Eugene D Barth, Richard C Miller, Charles A Pelizzari, Martyna Krzykawska-Serda, Subramanian V Sundramoorthy, Bulent Aydogan, Ralph R Weichselbaum, Victor M Tormyshev, Howard J Halpern
BACKGROUND: It has been known for over a hundred years that tumor hypoxia, a near-universal characteristic of solid tumors, decreases the curative effectiveness of radiation therapy. However, to date, there are no reports that demonstrate an improvement in radiation effectiveness in a mammalian tumor based on tumor hypoxia localization and local hypoxia treatment. METHODS: For radiation targeting of hypoxic subregions in a mouse fibrosarcoma, we used oxygen images obtained using electron paramagnetic resonance (EPR) pO2 imaging combined with 3D-printed radiation blocks...
November 8, 2018: International Journal of Radiation Oncology, Biology, Physics
Avani D Rao, Matthew Ladra, Emily Dunn, Rahul Kumar, Sandesh S Rao, Shuchi Sehgal, Amir H Dorafshar, Carol D Morris, Stephanie A Terezakis
With the increasing use of advanced radiation techniques such as intensity modulated radiation therapy, stereotactic radiation therapy, and proton therapy, radiation oncologists now have the tools to mitigate radiation-associated toxicities. This is of utmost importance in the treatment of a pediatric patient. To best utilize these advanced techniques to mitigate radiation-induced growth abnormalities, the radiation oncologist should be equipped with a nuanced understanding of the anatomy of centers of growth...
November 7, 2018: International Journal of Radiation Oncology, Biology, Physics
Erik Traneus, Jakob Ödén
PURPOSE: We propose the use of proton track-end objectives in intensity modulated proton therapy (IMPT) optimization to reduce the linear energy transfer (LET) and the relative biological effectiveness (RBE) in critical structures. METHODS: IMPT plans were generated for three intracranial patient cases (1.8 Gy (RBE) in 30 fractions) and three head-and neck cases (2 Gy (RBE) in 35 fractions) assuming a constant RBE=1.1. Two plans were generated for each patient: (1) Physical dose objectives only (DOSEopt), (2) same dose objectives as DOSEopt, and with additional proton track-end objectives (TEopt)...
November 2, 2018: International Journal of Radiation Oncology, Biology, Physics
Masaaki Yamamoto, Hitoshi Aiyama, Takao Koiso, Shinya Watanabe, Takuya Kawabe, Yasunori Sato, Yoshinori Higuchi, Hidetoshi Kasuya, Bierta E Barfod
PURPOSE: This study, based on our brain metastasis (BM) patients undergoing multiple stereotactic radiosurgery (SRS) procedures, aimed to validate whether the recently-proposed prognostic grading system, brain metastasis velocity (BMV, scoring the cumulative number of new BMs that developed after the first SRS divided by time [years] since the initial SRS), is generally applicable. Patients are categorized into three classes by their BMV scores, i.e., ≤3, 4-13 and ≥14. METHODS AND MATERIALS: This was an institutional review board-approved, retrospective cohort study using our prospectively accumulated database including 833 patients (patients with whole brain radiotherapy were excluded) who underwent a second SRS procedure for newly-detected lesions using a gamma knife for BMs during the 19-year-period between July, 1998 and June, 2017...
November 2, 2018: International Journal of Radiation Oncology, Biology, Physics
Terence T Sio, Pamela J Atherton, Levi D Pederson, W Ken Zhen, Robert W Mutter, Yolanda I Garces, Daniel J Ma, James L Leenstra, Jean-Claude M Rwigema, Shaker Dakhil, James D Bearden, Sonja J van der Veen, Apar K Ganti, Steven E Schild, Robert C Miller
PURPOSE: Chemoradiation (CRT) is an integral treatment modality for patients with locally advanced lung cancer. It has been hypothesized that current use of an angiotensin-converting enzyme inhibitor during CRT may be protective for treatment-related lung damage and pneumonitis. METHODS AND MATERIALS: We conducted a pilot, double-blind, placebo-controlled randomized trial. Study-eligible patients receiving curative thoracic RT were randomly assigned to 20 mg of lisinopril or placebo once daily during and up to 3 months after RT...
November 2, 2018: International Journal of Radiation Oncology, Biology, Physics
Kevin A Pearlstein, Kyle Wang, Robert J Amdur, Colette J Shen, Roi Dagan, Jared Weiss, Juneko E Grilley-Olson, Adam Zanation, Trevor G Hackman, Brian Thorp, Jeffrey M Blumberg, Samip Patel, Nathan Sheets, Mark C Weissler, William M Mendenhall, Bhishamjit S Chera
BACKGROUND: Human Papillomavirus (HPV)-associated oropharynx cancers have a favorable prognosis, but current treatment approaches carry significant long-term morbidity. Strategies to de-intensify treatment in this population are under investigation, but the impact of these approaches on quality of life is not well-understood. We present patient-reported outcomes from two prospective studies examining de-intensified chemoradiotherapy METHODS: This study included patients enrolled on two prospective phase II trials of de-intensified chemoradiotherapy in HPV-associated oropharynx cancer patients who had at least one year of follow-up...
November 2, 2018: International Journal of Radiation Oncology, Biology, Physics
Eric J Lehrer, Jennifer L Peterson, Nicholas G Zaorsky, Paul D Brown, Arjun Sahgal, Veronica L Chiang, Samuel T Chao, Jason P Sheehan, Daniel M Trifiletti
PURPOSE: Multifraction stereotactic radiosurgery (MF-SRS) purportedly reduces radionecrosis risk over single fraction SRS (SF-SRS) in the treatment of large brain metastases. The purpose of the current work is to compare local control (LC) and radionecrosis rates of SF-SRS and MF-SRS in the definitive (SF-SRSD and MF-SRSD ) and postoperative (SF-SRSP and MF-SRSP ) settings. METHODS/MATERIALS: PICOS/PRISMA/MOOSE guidelines were used to select articles where patients: diagnosed with "large" brain metastases (Group A: 4-14 cm3 , or about 2-3 cm; Group B: >14 cm3 , or > 3 cm); 1-year LC and/or rates of radionecrosis were reported; radiosurgery was administered definitively or postoperatively...
November 2, 2018: International Journal of Radiation Oncology, Biology, Physics
Niloy R Datta, Emanuel Stutz, Silvia Gomez, Stephan Bodis
PURPOSE: Treatment options in locally advanced cervix cancer (LACC) have evolved around radiotherapy (RT) and/or chemotherapy (CT), hypoxic cell sensitizers (HypCS), immunotherapy (Imm) and loco-regional moderate hyperthermia (HT). A systematic review and network meta-analysis (NMA) was conducted to synthesize the evidence for efficacy and safety in terms of long-term loco-regional control (LRC), overall survival (OS), grade ≥3 acute (AM) and late morbidity (LM). METHODS AND MATERIALS: Five databases were searched and 6285 articles (1974-2018) were screened as per the PRISMA guidelines...
November 1, 2018: International Journal of Radiation Oncology, Biology, Physics
Zhe Ji, Yuliang Jiang, Suqing Tian, Fuxin Guo, Ran Peng, Fei Xu, Haitao Sun, Jinghong Fan, Junjie Wang
OBJECTIVE: To analyze the efficacy and safety of radioactive I-125 seeds implantation in the treatment of recurrent head and neck tumors after radiotherapy. METHODS: The data of 101 patients with recurrent head and neck cancer after radiotherapy who received CT-guided radioactive I-125 seeds implantation were analyzed. The median previous cumulative external irradiation dose was 66 Gy, the median verified D90 after operation was 117 Gy. The short-term efficacy was evaluated by RECIST v1...
November 1, 2018: International Journal of Radiation Oncology, Biology, Physics
Judy N Jacobse, Frances K Duane, Naomi B Boekel, Michael Schaapveld, Michael Hauptmann, Maartje J Hooning, Caroline M Seynaeve, Margreet H A Baaijens, Jourik A Gietema, Sarah C Darby, Flora E van Leeuwen, Berthe M P Aleman, Carolyn W Taylor
BACKGROUND: Previous reports suggest that radiotherapy for breast cancer (BC) can cause ischemic heart disease, with the radiation-related risk increasing linearly with mean whole heart dose (MWHD). This study aimed to validate these findings in younger BC patients and to investigate additional risk factors for radiation-related myocardial infarction (MI). METHODS: A nested case-control study was conducted within a cohort of BC survivors treated during 1970-2009...
October 29, 2018: International Journal of Radiation Oncology, Biology, Physics
Claire Y Fung, Erli Chen, Neha Vapiwala, Surjeet Pohar, Daniel Trifiletti, Minh-Tam Truong, George Uschold, Jessica Schuster, Akshar Patel, Ashesh Jani, Pranshu Mohindra, Tim Sanders, Liz Gardner, Anna Arnone, Trevor Royce
PURPOSE: To report the American Society for Radiation Oncology (ASTRO) 2017 radiation oncologist (RO) workforce survey results; identify demographic, technology utilization, and employment trends; and assess the profession's ability to meet patients' needs, offer job satisfaction and attract high-caliber trainees. METHODS: In spring 2017, ASTRO distributed an online survey to 3,856 US RO members. The questionnaire was patterned after the 2012 workforce survey for trend analysis...
October 24, 2018: International Journal of Radiation Oncology, Biology, Physics
Carl DeSelm, T Jonathan Yang, Oren Cahlon, Jamie Tisnado, Atif J Khan, Erin F Gillespie, Chun Ting Siu, Simon N Powell, Alice Y Ho
PURPOSE: The primary goal was to map the anatomic pattern of isolated nodal recurrences (NR) in the supraclavicular (SCV), axillary (Ax), and internal mammary nodes (IMN) in breast cancer patients treated with curative-intent surgery +/- radiation therapy (RT). Secondary objectives were to assess clinical and pathologic factors associated with patterns of NR and survival rates. MATERIALS AND METHODS: Breast cancer patients with NR post-treatment at a single cancer center between 1998-2013 were identified...
October 24, 2018: International Journal of Radiation Oncology, Biology, Physics
Abram Recht, Heather McArthur, Lawrence J Solin, Rahul Tendulkar, Alexander Whitley, Armando Giuliano
The American Society for Radiation Oncology (ASTRO) produced an evidence-based guideline on whole-breast radiation therapy for patients with early-stage invasive breast cancer and ductal carcinoma in situ. This commentary points out areas where we believe the data are too limited to make definitive recommendations and where alternative approaches are also supported by evidence.
October 23, 2018: International Journal of Radiation Oncology, Biology, Physics
Stephanie M C Smith, Brandon M Bianski, Brent A Orr, Gretchen Harknett, Arzu Onar-Thomas, Richard J Gilbertson, Thomas E Merchant, Martine F Roussel, Christopher L Tinkle
BACKGROUND: Craniospinal irradiation (CSI) is a crucial component of treatment for medulloblastoma (MB), a brain tumor clinically stratified into prognostically distinct molecular subgroups. Preclinical models of clinically-relevant CSI offer the potential to study radiation dose and volume effects in these subgroups and identify subgroup-specific combination adjuvant therapies, particularly for very-high-risk MB in which treatments are often unsuccessful. METHODS: The commercially available Small Animal Radiation Research Platform equipped with a motorized variable collimator was used for image-guided CSI...
October 23, 2018: International Journal of Radiation Oncology, Biology, Physics
Daphna Y Spiegel, Matthew J Boyer, Julian C Hong, Christina D Williams, Michael J Kelley, Harvey Moore, Joseph K Salama, Manisha Palta
PURPOSE: Standard therapy for locally advanced rectal cancer includes neoadjuvant chemoradiation and surgery. Complete response (CR) rates after chemoradiation can be as high as 29%, suggesting that nonoperative management (NOM) may be reasonable with appropriately selected patients. We sought to identify potential NOM candidates. METHODS AND MATERIALS: Using the VA Central Cancer Registry, stage II-III rectal cancer patients receiving chemoradiation +/- subsequent surgery were identified...
October 22, 2018: International Journal of Radiation Oncology, Biology, Physics
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