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Radiation Oncology

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https://www.readbyqxmd.com/read/28148287/intraoperative-irradiation-precision-medicine-for-quality-cancer-control-promotion
#1
EDITORIAL
Felipe A Calvo
Intraoperative irradiation was implemented 4 decades ago, pioneering the efforts to improve precision in local cancer therapy by combining real-time surgical exploration/resection with high single dose radiotherapy (Gunderson et al., Intraoperative irradiation: techniques and results, 2011). Clinical and technical developments have led to very precise radiation dose deposit. The ability to deliver a very precise dose of radiation is an essential element of contemporary multidisciplinary individualized oncology...
February 2, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28143558/lung-metastases-treated-with-stereotactic-body-radiotherapy-the-rssearch%C3%A2-patient-registry-s-experience
#2
Anthony Ricco, Joanne Davis, William Rate, Jun Yang, David Perry, John Pablo, David D'Ambrosio, Sanjeev Sharma, Srinath Sundararaman, James Kolker, Kimberly M Creach, Rachelle Lanciano
OBJECTIVES: To report overall survival and local control for patients identified in the RSSearch® Patient Registry with metastatic cancer to the lung treated with SBRT. METHODS: Seven hundred two patients were identified with lung metastases in the RSSearch® Registry. Of these patients, 577 patients had SBRT dose and fractionation information available. Patients were excluded if they received prior surgery, radiation, or radiofrequency ablation to the SBRT treated area...
February 1, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28143532/is-pulmonary-artery-a-dose-limiting-organ-at-risk-in-non-small-cell-lung-cancer-patients-treated-with-definitive-radiotherapy
#3
Jie-Tao Ma, Li Sun, Xin Sun, Zhi-Cheng Xiong, Yang Liu, Shu-Ling Zhang, Le-Tian Huang, Cheng-Bo Han
PURPOSE: Our previous study suggested that some pulmonary artery (PA) dosimetric parameters were associated with mortality in unresectable non-small cell lung cancer (NSCLC) treated with definitive radiotherapy. The present study aims to analyze the impact of both PA and heart dosimetric parameters on survival of patients with NSCLC treated with definitive conventional fractionated radiotherapy (CFRT) in another independent research center and further determine whether the PA should be considered a dose-limiting organ at risk (OAR) for patients receiving thoracic CFRT...
February 1, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28143623/fully-automated-treatment-planning-of-spinal-metastases-a-comparison-to-manual-planning-of-volumetric-modulated-arc-therapy-for-conventionally-fractionated-irradiation
#4
Daniel Buergy, Abdul Wahab M Sharfo, Ben J M Heijmen, Peter W J Voet, Sebastiaan Breedveld, Frederik Wenz, Frank Lohr, Florian Stieler
BACKGROUND: Planning for Volumetric Modulated Arc Therapy (VMAT) may be time consuming and its use is limited by available staff resources. Automated multicriterial treatment planning can eliminate this bottleneck. We compared automatically created (auto) VMAT plans generated by Erasmus-iCycle to manually created VMAT plans for treatment of spinal metastases. METHODS: Forty-two targets in 32 patients were analyzed. Lungs and kidneys were defined as organs at risk (OARs)...
January 31, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28143487/helical-tomotherapy-of-spinal-chordomas-french-multicentric-retrospective-study-of-a-cohort-of-30-cases
#5
Maxime Bobin, Christina Zacharatou, Paul Sargos, Véronique Brouste, Albert Lisbona, Marc-André Mahé, Georges Noël, Amandine Halley, Loïc Feuvret, Louis Gras, Stéphanie Hoppe, Bénédicte Henriques de Figueiredo, Guy Kantor
PURPOSE: To evaluate the efficacy and toxicity of helical tomotherapy (HT) in the management of spine chordomas when proton therapy is unavailable or non-feasible. METHODS AND MATERIALS: Between 2007 and 2013, 30 patients with biopsy-proven chordomas were treated by HT in five French institutions. Information regarding local control (LC), overall survival (OS), progression-free survival (PFS) and metastasis-free survival (MFS) was collected. Clinical efficacy, toxicity and treatment quality were evaluated...
January 31, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28129767/helical-tomotherapy-for-locally-advanced-or-recurrent-breast-cancer
#6
M N Duma, C Heinrich, C Schönknecht, B Chizzali, M Mayinger, M Devecka, S Kampfer, S E Combs
PURPOSE: We report our experience of using helical tomotherapy (HT) to treat large and irregular shaped loco-regional advanced breast cancer target volumes embracing various organs at risk. PATIENTS AND METHODS: We retrospectively analyzed 26 patients treated for very large, irregular shaped breast cancers. Patients were treated either with the intent to achieve local control in a primary setting (n = 14) or in a reirradiation setting (n = 12). The recurrence group was heavily pretreated with systemic therapy...
January 28, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28193241/present-state-and-issues-in-iort-physics
#7
REVIEW
Frank W Hensley
Literature was reviewed to assess the physical aspects governing the present and emerging technologies used in intraoperative radiation therapy (IORT). Three major technologies were identified: treatment with electrons, treatment with external generators of kV X-rays and electronic brachytherapy. Although also used in IORT, literature on brachytherapy with radioactive sources is not systematically reviewed since an extensive own body of specialized literature and reviews exists in this field. A comparison with radioactive sources is made in the use of balloon catheters for partial breast irradiation where these are applied in almost an identical applicator technique as used with kV X-ray sources...
January 27, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28129789/short-report-interim-safety-results-for-a-phase-ii-trial-measuring-the-integration-of-stereotactic-ablative-radiotherapy-sabr-plus-surgery-for-early-stage-non-small-cell-lung-cancer-missile-nsclc
#8
David A Palma, Timothy K Nguyen, Keith Kwan, Stewart Gaede, Mark Landis, Richard Malthaner, Dalilah Fortin, Alexander V Louie, Eric Frechette, George B Rodrigues, Brian Yaremko, Edward Yu, A Rashid Dar, Ting-Yim Lee, Al Gratton, Andrew Warner, Aaron Ward, Richard Inculet
: A phase II trial was launched to evaluate if neoadjuvant stereotactic ablative radiotherapy (SABR) before surgery improves oncologic outcomes in patients with stage I non-small cell lung cancer (NSCLC). We report a mandated interim safety analysis for the first 10 patients who completed protocol treatment. Operable patients with biopsy-proven T1-2 N0 NSCLC were eligible. SABR was delivered using a risk-adapted fractionation (54Gy/3 fractions, 55/5 or 60/8). Surgical resection was planned 10 weeks later at a high-volume center (>200 lung cancer resections annually)...
January 27, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28126030/a-review-of-substitute-ct-generation-for-mri-only-radiation-therapy
#9
REVIEW
Jens M Edmund, Tufve Nyholm
Radiotherapy based on magnetic resonance imaging as the sole modality (MRI-only RT) is an area of growing scientific interest due to the increasing use of MRI for both target and normal tissue delineation and the development of MR based delivery systems. One major issue in MRI-only RT is the assignment of electron densities (ED) to MRI scans for dose calculation and a similar need for attenuation correction can be found for hybrid PET/MR systems. The ED assigned MRI scan is here named a substitute CT (sCT)...
January 26, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28126006/significant-benefits-in-survival-by-the-use-of-surgery-combined-with-radiotherapy-for-retroperitoneal-soft-tissue-sarcoma
#10
Sven Hager, Frank Makowiec, Karl Henne, Ulrich T Hopt, Uwe A Wittel
BACKGROUND: To report the effect of intraoperative electron beam radiotherapy (IOERT) and external beam radiotherapy (EBRT) in addition to surgery as well as to evaluate the role of resectable local recurrence for long-term prognosis. METHODS: In 53 patients who underwent surgery for retroperitoneal soft tissue sarcoma (RSTS) from 2001 to 2014 prognostic and epidemiologic factors were reviewed retrospectively to analyze their impact on survival and recurrence. RESULTS: Twenty three patients (50%) had surgery plus radiotherapy, 23 (50%) had surgery only...
January 26, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28122566/intentional-avoidance-of-the-esophagus-using-intensity-modulated-radiation-therapy-to-reduce-dysphagia-after-palliative-thoracic-radiation
#11
Patrick V Granton, David A Palma, Alexander V Louie
BACKGROUND: Palliative thoracic radiotherapy is an effective technique to alleviate symptoms of disease burden in advanced-stage lung cancer patients. Previous randomized controlled studies demonstrated a survival benefit in patients with good performance status at radiation doses of 35Gy10 or greater but with an increased incidence of esophagitis. The objective of this planning study was to assess the potential impact of esophageal-sparing IMRT (ES-IMRT) compared to the current standard of care using parallel-opposed pair beams (POP)...
January 26, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28114948/current-controversies-in-radiotherapy-for-breast-cancer
#12
REVIEW
David Krug, René Baumann, Wilfried Budach, Jürgen Dunst, Petra Feyer, Rainer Fietkau, Wulf Haase, Wolfgang Harms, Marc D Piroth, Marie-Luise Sautter-Bihl, Felix Sedlmayer, Rainer Souchon, Frederik Wenz, Rolf Sauer
Multimodal treatment approaches have substantially improved the outcome of breast cancer patients in the last decades. Radiotherapy is an integral component of multimodal treatment concepts used in curative and palliative intention in numerous clinical situations from precursor lesions such as ductal carcinoma in situ (DCIS) to advanced breast cancer. This review addresses current controversial topics in radiotherapy with special consideration of DCIS, accelerated partial breast irradiation (APBI) and regional nodal irradiation (RNI) and provides an update on the clinical practice guidelines of the Breast Cancer Expert Panel of the German Society of Radiation Oncology (DEGRO)...
January 23, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28114947/evaluation-of-a-novel-sodium-borocaptate-containing-unnatural-amino-acid-as-a-boron-delivery-agent-for-neutron-capture-therapy-of-the-f98-rat-glioma
#13
Gen Futamura, Shinji Kawabata, Naosuke Nonoguchi, Ryo Hiramatsu, Taichiro Toho, Hiroki Tanaka, Shin-Ichiro Masunaga, Yoshihide Hattori, Mitsunori Kirihata, Koji Ono, Toshihiko Kuroiwa, Shin-Ichi Miyatake
BACKGROUND: Boron neutron capture therapy (BNCT) is a unique particle radiation therapy based on the nuclear capture reactions in boron-10. We developed a novel boron-10 containing sodium borocaptate (BSH) derivative, 1-amino-3-fluorocyclobutane-1-carboxylic acid (ACBC)-BSH. ACBC is a tumor selective synthetic amino acid. The purpose of this study was to assess the biodistribution of ACBC-BSH and its therapeutic efficacy following Boron Neutron Capture Therapy (BNCT) of the F98 rat glioma...
January 23, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28107823/biology-of-high-single-doses-of-iort-rbe-5-r-s-and-other-biological-aspects
#14
REVIEW
Carsten Herskind, Lin Ma, Qi Liu, Bo Zhang, Frank Schneider, Marlon R Veldwijk, Frederik Wenz
Intraoperative radiotherapy differs from conventional, fractionated radiotherapy in several aspects that may influence its biological effect. The radiation quality influences the relative biologic effectiveness (RBE), and the role of the five R's of radiotherapy (reassortment, repair, reoxygenation, repopulation, radiosensitivity) is different. Furthermore, putative special biological effects and the small volume receiving a high single dose may be important. The present review focuses on RBE, repair, and repopulation, and gives an overview of the other factors that potentially contribute to the efficacy...
January 19, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28103903/intraoperative-radiotherapy-iort-as-boost-in-breast-cancer
#15
REVIEW
Felix Sedlmayer, Roland Reitsamer, Frederik Wenz, Elena Sperk, Christoph Fussl, Julia Kaiser, Ingrid Ziegler, Franz Zehentmayr, Heinz Deutschmann, Peter Kopp, Gerd Fastner
The term IORT (intraoperative radiotherapy) is currently used for various techniques that show huge differences in dose delivery and coverage of the tissue at risk. The largest evidence for boost IORT preceding whole breast irradiation (WBI) originates from intraoperative electron treatments (IOERT) with single doses around 10 Gy. At median follow-up periods at 6 years, outstandingly low local recurrence rates of less than 1% are observed. Higher local relapse rates were described for G3 tumors and triple negative breast cancers as well as for IORT following primary systemic treatment for locally advanced tumors...
January 19, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28100249/intraoperative-radiation-therapy-iort-in-soft-tissue-sarcoma
#16
REVIEW
Falk Roeder, Robert Krempien
Soft-tissue sarcoma (STS) represent a rare tumor entity, accounting for less than 1% of adult malignancies. The cornerstone of curative intent treatment is surgery with free margins, although the extent of the surgical approach has been subject to change in the last decades. Multimodal approaches usually including radiation therapy have replaced extensive surgical procedures in order to preserve functionality while maintaining adequate local control. However, the possibility to apply adequate radiation doses by external beam radiation therapy (EBRT) can be limited in some situation especially in case of directly adjacent organs at risk with low radiation tolerance...
January 19, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28100242/intraoperative-radiotherapy-in-gynaecological-and-genito-urinary-malignancies-focus-on-endometrial-cervical-renal-bladder-and-prostate-cancers
#17
REVIEW
Marco Krengli, Carla Pisani, Letizia Deantonio, Daniela Surico, Alessandro Volpe, Nicola Surico, Carlo Terrone
Intraoperative radiotherapy (IORT) refers to the delivery of a single radiation dose to a limited volume of tissue during a surgical procedure. A literature review was performed to analyze the role of IORT in gynaecological and genito-urinary cancer including endometrial, cervical, renal, bladder and prostate cancers.Literature search was performed by Pubmed and Scopus, using the words "intraoperative radiotherapy/IORT", "gynaecological cancer", "uterine/endometrial cancer", "cervical/cervix cancer", "renal/kidney cancer", "bladder cancer" and "prostate cancer"...
January 19, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28100275/cell-in-cell-structures-are-more-potent-predictors-of-outcome-than-senescence-or-apoptosis-in-head-and-neck-squamous-cell-carcinomas
#18
Hannah Schenker, Maike Büttner-Herold, Rainer Fietkau, Luitpold V Distel
BACKGROUND: This study sheds light on cell inactivating processes with focus on the phenomenon of cell-in-cell (CIC). Cell-in-cell describes a cell process where one cell is being engulfed by another non-professional phagocyte. We determined frequency and prognostic impact of CIC structures (CICs) as well as of senescent and apoptotic cells in head and neck squamous cell carcinomas (HNSCC). METHODS: These different forms of cell inactivation as well as the proportion of proliferating and tumor cells were assessed in 169 pre-radiochemotherapy biopsies and 32 post-therapy tumor resections by immunohistochemistry of tissue microarrays...
January 18, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28100239/elective-breast-radiotherapy-including-level-i-and-ii-lymph-nodes-a-planning-study-with-the-humeral-head-as-planning-risk-volume
#19
Kathrin Surmann, Jorien van der Leer, Tammy Branje, Maurice van der Sangen, Maarten van Lieshout, Coen W Hurkmans
BACKGROUND: The aim of this study was to assess the dose to the humeral head planning risk volume with the currently used high tangential fields (HTF) and compare different planning techniques for breast radiotherapy including axillary level I and II lymph nodes (PTVn) while sparing the humeral head. METHODS: Ten patients with left-sided breast cancer were enrolled in a planning study with 16 fractions of 2.66 Gy. Four planning techniques were compared: HTF, HTF with sparing of the humeral head, 6-field IMRT with sparing of the humeral head and VMAT with sparing of the humeral head...
January 18, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28095882/the-use-of-dose-escalated-radiation-for-locally-advanced-non-small-cell-lung-cancer-in-the-u-s-2004-2013
#20
John P Christodouleas, Matthew D Hall, Marjorie A van der Pas, Wensheng Guo, Timothy E Schultheiss, Peter Gabriel
PURPOSE/OBJECTIVES: The clinical effects of radiation dose-intensification in locally advanced non-small cell lung (NSCLCa) and other cancers are challenging to predict and are ideally studied in randomized trials. The purpose of this study was to assess the use of dose-escalated radiation for locally advanced NSCLCa in the U.S., 2004-2013, a period in which there were no published level 1 studies on dose-escalation. MATERIALS/METHODS: We performed analyses on two cancer registry databases with complementary strengths and weaknesses: the National Oncology Data Alliance (NODA) 2004-2013 and the National Cancer Database (NCDB) 2004-2012...
January 17, 2017: Radiation Oncology
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