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Seminars in Radiation Oncology

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https://www.readbyqxmd.com/read/29933885/relative-biological-effectiveness-uncertainties-and-implications-for-beam-arrangements-and-dose-constraints-in-proton-therapy
#1
REVIEW
Harald Paganetti, Drosoula Giantsoudi
Current clinical implementation of proton radiation therapy assumes a constant relative biological effectiveness (RBE) value of 1.1 throughout the treatment field, for both the target and organs at risks. Although few in vivo clinical data suggest that this approximation is clinically significant, in vitro studies demonstrate the dependency of RBE on dose, fractionation, proton energy, and linear energy transfer, as well as patient radiosensitivity and definition of endpoint. This article provides a brief review on the principles and individual factors contributing to RBE uncertainties, with emphasis on clinical practice...
June 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29933884/concepts-of-ptv-and-robustness-in-passively-scattered-and-pencil-beam-scanning-proton-therapy
#2
REVIEW
Katja Langen, Mingyao Zhu
Concepts of planning target volume and plan robustness in proton therapy are described. Implementation of these concepts into treatment planning is described. Proton plan sensitivity and interfractional and intrafractional anatomical variation are also discussed.
June 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29933883/current-state-of-image-guidance-in-radiation-oncology-implications-for-ptv-margin-expansion-and-adaptive-therapy
#3
REVIEW
Wei Zou, Lei Dong, Boon-Keng Kevin Teo
Image guidance technology has evolved and seen widespread application in the past several decades. Advancements in the diagnostic imaging field have found new applications in radiation oncology and promoted the development of therapeutic devices with advanced imaging capabilities. A recent example is the development of linear accelerators that offer magnetic resonance imaging for real-time imaging and online adaptive planning. Volumetric imaging, in particular, offers more precise localization of soft tissue targets and critical organs which reduces setup uncertainty and permit the use of smaller setup margins...
June 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29933882/how-histopathologic-tumor-extent-and-patterns-of-recurrence-data-inform-the-development-of-radiation-therapy-treatment-volumes-in-solid-malignancies
#4
Arpit Chhabra, Craig Schneider, Mudit Chowdhary, Tejan P Diwanji, Pranshu Mohindra, Mark V Mishra
The ability to deliver highly conformal radiation therapy using intensity-modulated radiation therapy and particle therapy provides for new opportunities to improve patient outcomes by reducing treatment-related morbidities following radiation therapy. By reducing the volume of normal tissue exposed to radiation therapy (RT), while also allowing for the opportunity to escalate the dose of RT delivered to the tumor, use of conformal RT delivery should also provide the possibility of expanding the therapeutic index of radiotherapy...
June 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29933881/stereotactic-ablative-radiotherapy-uncertainties-delineation-setup-and-motion
#5
REVIEW
Ming Yang, Robert Timmerman
Stereotactic ablative radiotherapy (SAbR), also known as stereotactic body radiation therapy, is biologically distinct from conventionally fractionated radiotherapy in that it is ablative, causing functional incapacitation of targeted tissue including margins added to avoid errors. In striking contrast, small 1.8-2Gy daily doses associated with historical fractionated radiotherapy cause more modest injury more likely to be repaired by normal tissue than tumor. Strategic plans to deal with uncertainties in tumor location, motion during treatment, dose deposition and heterogeneity effects, and tolerance require a novel approach for SAbR very different from what has been dogma for conventionally fractionated treatments...
June 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29933880/the-practicality-of-icru-and-considerations-for-future-icru-definitions
#6
REVIEW
Annemarie Shepherd, Sara St James, Ramesh Rengan
The International Commission on Radiation Units and Measurements (ICRU) volumes are standardized volume definitions used in radiation oncology practice that have evolved over time to account for advancements in technology and radiation planning. The current definitions have strengths but also practical limitations. The main limitation is related to the process of accounting for tumor motion during treatment. As radiotherapeutic techniques become more precise, motion interplay effects and anatomical changes during treatment must be taken into account to ensure accurate and safe delivery of treatment...
June 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29933879/accounting-for-mitigating-and-choice-of-margins-for-moving-tumors
#7
REVIEW
Heng Li, Joe Y Chang
Tumor motion can lead to uncertainties in delivered dose to patients and undesirable outcomes. Motion management has become an integrated component of the standard of care for moving tumors in external beam radiotherapy with the development of novel imaging and treatment techniques in the past 2 decades. This article reviews the use of advanced and functional imaging to guide target delineation, considerations for margin selections, technique for accounting for and mitigation of tumor motion in treatment planning and delivery, and motion management in radiation therapy...
June 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29933878/the-role-of-optical-surface-imaging-systems-in-radiation-therapy
#8
REVIEW
Jeremy D P Hoisak, Todd Pawlicki
Optical surface imaging is a nonradiographic, noninvasive technology for continuous localization of patients during radiation therapy. Surface-guided radiation therapy (SGRT) has been applied to many treatment sites including breast, intracranial, head and neck, and extremities. SGRT enables a reduction of initial setup variability, provides verification of immobilization continuously during treatment including at noncoplanar linac gantry angles, and provides dynamic surface information for use in gated and breath-hold treatment techniques, all of which can permit reductions in the margins required to account for target localization uncertainty...
June 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29933877/magnetic-resonance-imaging-for-target-delineation-and-daily-treatment-modification
#9
REVIEW
Rojano Kashani, Jeffrey R Olsen
Magnetic resonance (MR) imaging has become a prevalent modality in radiation oncology owing to its excellent soft-tissue contrast and ability to provide functional information. Recent technological developments have combined MR imaging with treatment delivery systems, to provide in-room MR guidance for patient setup and treatment delivery. Availability of in-room MR imaging enables direct visualization of soft-tissue targets and nearby organs at risk, thus providing a platform for fast and accurate target and organs at risk delineation for plan adaptation and target tracking during treatment...
June 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29933876/use-of-pet-and-other-functional-imaging-to-guide-target-delineation-in-radiation-oncology
#10
REVIEW
Vivek Verma, J Isabelle Choi, Amit Sawant, Rao P Gullapalli, Wengen Chen, Abass Alavi, Charles B Simone
Molecular and functional imaging is increasingly being used to guide radiotherapy (RT) management and target delineation. This review summarizes existing data in several disease sites of various functional imaging modalities, chiefly positron emission tomography/computed tomography (PET/CT), with respect to RT target definition and management. For gliomas, differentiation between postoperative changes and viable tumor is discussed, as well as focal dose escalation and reirradiation. Head and neck neoplasms may also benefit from precise PET/CT-based target delineation, especially for cancers of unknown primary; focal dose escalation is also described...
June 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29933875/margins-and-uncertainties-in-radiation-oncology
#11
EDITORIAL
Charles B Simone, Amit Sawant
No abstract text is available yet for this article.
June 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29735196/protons-vs-photons-for-brain-and-skull-base-tumors
#12
REVIEW
Safia K Ahmed, Paul D Brown, Robert L Foote
The physical characteristics of proton therapy result in steeper dose gradients and superior dose conformality compared to photon therapy. These properties render proton therapy ideal for skull base tumors requiring dose escalation for optimal tumor control, and may also be beneficial for brain tumors as a means of mitigating radiation-related adverse effects. This review summarizes the literature regarding the role of proton therapy compared to photon therapy in the treatment of adult brain and skull base tumors...
April 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29735195/robust-proton-treatment-planning-physical-and-biological-optimization
#13
REVIEW
Jan Unkelbach, Harald Paganetti
Accurate prediction of tumor control and toxicities in radiation therapy faces many uncertainties. Besides interpatient variability in the response to radiation, there are also dosimetric uncertainties, that is, differences between the dose displayed in a treatment planning system and the dose actually delivered to the patient. These uncertainties originate from several sources including imperfect knowledge of the patient geometry, approximation in the physics of radiation interaction with tissues, and uncertainties in the biological effectiveness of radiation...
April 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29735194/clinical-trial-strategies-to-compare-protons-with-photons
#14
REVIEW
Johannes A Langendijk, Liesbeth J Boersma, Coen R N Rasch, Marco van Vulpen, Johannes B Reitsma, Arjen van der Schaaf, Ewoud Schuit
The favorable beam properties of protons can be translated into clinical benefits by target dose escalation to improve local control without enhancing unacceptable radiation toxicity or to spare normal tissues to prevent radiation-induced side effects without jeopardizing local tumor control. For the clinical validation of the added value of protons to improve local control, randomized controlled trials are required. For the clinical validation of the added value of protons to prevent side effects, both model-based validation or randomized controlled trials can be used...
April 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29735193/charged-issues-particle-radiation-therapy
#15
EDITORIAL
Thomas F DeLaney
No abstract text is available yet for this article.
April 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29735192/heavy-charged-particles-does-improved-precision-and-higher-biological-effectiveness-translate-to-better-outcome-in-patients
#16
REVIEW
Marco Durante, J├╝rgen Debus
Protons are the most common charged particles used in oncology. Acceleration of heavier ions requires larger accelerators and is more expensive, yet heavy nuclei share the same advantageous dose-depth profile characteristics of protons and have potential additional advantages. These advantages are related to the physical characteristics of the beam, owing to reduced lateral scattering and sharper lateral penumbra. In addition, heavy ions produce an increased biological response. In fact, in the target region heavy ions behave as densely ionizing radiation, which produce distinct biological effects compared to sparsely ionizing x-rays and protons...
April 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29735191/can-technological-improvements-reduce-the-cost-of-proton-radiation-therapy
#17
REVIEW
Jacobus Maarten Schippers, Anthony Lomax, Adriano Garonna, Katia Parodi
In recent years there has been increasing interest in the more extensive application of proton therapy in a clinical and preferably hospital-based environment. However, broader adoption of proton therapy has been hindered by the costs of treatment, which are still much higher than those in advanced photon therapy. This article presents an overview of on-going technical developments, which have a reduction of the capital investment or operational costs either as a major goal or as a potential outcome. Developments in instrumentation for proton therapy, such as gantries and accelerators, as well as facility layout and efficiency in treatment logistics will be discussed in this context...
April 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29735190/potential-morbidity-reduction-with-proton-radiation-therapy-for-breast-cancer
#18
REVIEW
Lior Z Braunstein, Oren Cahlon
Proton radiotherapy confers significant dosimetric advantages in the treatment of malignancies that arise adjacent to critical radiosensitive structures. To date, these advantages have been most prominent in the treatment of pediatric and central nervous system malignancies, although emerging data support the use of protons among other anatomical sites in which radiotherapy plays an important role. With advances in the overall treatment paradigm for breast cancer, most patients with localized disease now exhibit long-term disease control and, consequently, may manifest the late toxicities of aggressive treatment...
April 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29735189/finding-value-for-protons-the-case-of-prostate-cancer
#19
REVIEW
Eric Ojerholm, Justin E Bekelman
The standard radiotherapy treatment for prostate cancer is intensity-modulated radiotherapy (IMRT). An alternative option is proton beam therapy (PBT). PBT is a safe and effective treatment, but does it add value over IMRT? We explore this controversial question by examining the available dosimetric and clinical evidence.
April 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29735188/will-there-be-a-clinically-significant-role-for-protons-in-patients-with-gastrointestinal-malignancies
#20
REVIEW
Ann C Raldow, Theodore S Hong
Gastrointestinal malignancies inherently arise amidst visceral organs that are very radiation sensitive. While radiation therapy is an integral part of cancer treatment, its use has historically been limited by normal tissue toxicity. Proton therapy is a form of external-beam radiation associated with several dosimetric advantages as compared to photon therapy. Proton radiation may allow for the delivery of tumoricidal doses while minimizing side effects by decreasing the dose to adjacent organs at risk. We discuss the rationale for and challenges of using protons in the treatment of gastrointestinal cancers...
April 2018: Seminars in Radiation Oncology
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