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Advances in Radiation Oncology

Hunter C Gits, Scott C Lester, Laura A McGrath, James A Martenson
No abstract text is available yet for this article.
July 2018: Advances in Radiation Oncology
Leah M Katz, Carmen A Perez, Naamit K Gerber, Juhi Purswani, Allison McCarthy, Indra J Das
No abstract text is available yet for this article.
July 2018: Advances in Radiation Oncology
Jonathan W Lischalk, Hao Chen, Michael C Repka, Lloyd D Campbell, Olusola Obayomi-Davies, Shaan Kataria, Thomas P Kole, Sonali Rudra, Brian T Collins
Purpose: Few definitive treatment options exist for elderly patients diagnosed with early stage breast cancer who are medically inoperable or refuse surgery. Historical data suggest very poor local control with hormone therapy alone. We examined the dosimetric feasibility of hypofractionated radiation therapy using stereotactic ablative radiotherapy (SABR) and proton beam therapy (PBT) as a means of definitive treatment for early stage breast cancer. Methods and Materials: Fifteen patients with biopsy-proven early stage breast cancer with a clinically visible tumor on preoperative computed tomography scans were identified...
July 2018: Advances in Radiation Oncology
Jens Hemmingsson, Jonas Högberg, Johan Mölne, Johanna Svensson, Peter Gjertsson, Magnus Rizell, Olof Henrikson, Peter Bernhardt
Purpose: Radioembolization is an alternative palliative treatment for hepatocellular carcinoma. Here, we examine the uptake differences between tumor tissue phenotypes and present a cross-section of the absorbed dose throughout a liver tissue specimen. Methods and materials: A patient with hepatocellular carcinoma was treated with 90 Y radioembolization followed by liver tissue resection. Gamma camera images and autoradiographs were collected and biopsy tissue samples were analyzed using a gamma well counter and light microscopy...
July 2018: Advances in Radiation Oncology
Joseph T Rakowski
Purpose: This is an investigation of a lung motion digital tomosynthesis (DTS) model using combined stationary detector and stationary cold cathode x-ray sources at projection acquisition rates that exceed the present norms. The intent is to reduce anatomical uncertainties from artifacts inherent in thoracic 4-dimensional computed tomography (CT). Methods and materials: Parameters necessary to perform rapid lung 4-dimensional DTS were studied using a conventional radiographic system with linear motion of the x-ray source and a simple hypothetical hardware performance model...
July 2018: Advances in Radiation Oncology
Canhua Xiao, Jennifer Moughan, Benjamin Movsas, Andre A Konski, Gerald E Hanks, James D Cox, Mack Roach, Kenneth L Zeitzer, Colleen A Lawton, Christopher A Peters, Seth A Rosenthal, I-Chow Joe Hsu, Eric M Horwitz, Mark V Mishra, Jeff M Michalski, Matthew B Parliament, David P D'Souza, Stephanie L Pugh, Deborah W Bruner
Purpose: A meta-analysis of sociodemographic variables and their association with late (>180 days from start of radiation therapy[RT]) bowel, bladder, and clustered bowel and bladder toxicities was conducted in patients with high-risk (clinical stages T2c-T4b or Gleason score 8-10 or prostate-specific antigen level >20) prostate cancer. Methods and materials: Three NRG trials (RTOG 9202, RTOG 9413, and RTOG 9406) that accrued from 1992 to 2000 were used. Late toxicities were measured with the Radiation Therapy Oncology Group Late Radiation Morbidity Scale...
July 2018: Advances in Radiation Oncology
Neha P Amin, Maliha Zainib, Sean M Parker, Manuj Agarwal, Malcolm D Mattes
Purpose: Radiation therapy (RT) and nivolumab are standard therapies for a wide range of advanced and metastatic cancers, yet little is known about the toxicity profile of their combined treatment. The rate of grade ≥3 toxicities from nivolumab monotherapy and radiation-only palliative treatments has been reported at 10% to 18% and 0% to 26%, respectively. We reviewed our experience to assess the acute toxicity profile of concurrent RT-nivolumab. Methods and materials: A retrospective review of all consecutive patients from January 2015 to May 2017 who received concurrent RT-nivolumab was conducted at 4 separate centers...
July 2018: Advances in Radiation Oncology
Donata von Reibnitz, Jamie E Chaft, Abraham J Wu, Robert Samstein, Matthew D Hellmann, Andrew J Plodkowski, Zhigang Zhang, Weiji Shi, Rosalind Dick-Godfrey, Kelly H Panchoo, Christopher A Barker, Andreas Rimner
Purpose: The objective of this study was to evaluate adverse events (AEs) in patients who received both immune checkpoint inhibitors and thoracic radiation therapy (RT). In particular, we compared the rate of toxicities of concurrent versus sequential delivery of thoracic RT and checkpoint inhibitors. Methods and Materials: Patient and treatment characteristics were collected on all patients at our institution who were treated with programmed cell death protein 1 (PD-1), programmed death-ligand 1 (PD-L1), and/or cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) inhibitors and underwent thoracic RT (n = 79)...
July 2018: Advances in Radiation Oncology
Miranda B Lam, Ling Li, Angel Cronin, Deborah Schrag, Aileen B Chen
Purpose: Palliative radiation therapy (RT) can improve quality of life but also incurs time and financial costs. The aim of this study was to evaluate factors associated with use and intensity of palliative RT for incurable non-small cell lung cancer (NSCLC). Methods and materials: This was a retrospective analysis of Medicare's Surveillance, Epidemiology and End Results data. We identified patients who were diagnosed with incurable (American Joint Committee on Cancer 6th edition stage IIIB with malignant effusion or stage IV) NSCLC between 2004 and 2011...
July 2018: Advances in Radiation Oncology
Chelsea C Pinnix, Jinhai Huo, Sarah A Milgrom, Zeinab Abou Yehia, Michelle Fanale, Yasuhiro Oki, Bouthaina S Dabaja, Grace L Smith
Purpose: We identified lung dosimetric constraints to assist in predicting the radiation pneumonitis (RP) risk in patients with mediastinal lymphoma and then identified the clinical prognostic factors that were associated with the achievement of key dosimetric constraints. Methods and Materials: In 190 patients who received mediastinal intensity modulated radiation therapy, we used univariate χ2 and multivariate logistic models to identify the predictors of RP and achievement of lung dose-volume histogram (DVH) constraints and build a predictive nomogram for RP...
July 2018: Advances in Radiation Oncology
Kaleigh N Doke, Laine Bowman, Yelizaveta Shnayder, Xinglei Shen, Mindi TenNapel, Sufi Mary Thomas, Prakash Neupane, Hung-Wen Yeh, Chris E Lominska
Purpose: Head and neck surgery and radiation cause tissue fibrosis that leads to functional limitations and lymphedema. The objective of this study was to determine whether lymphedema therapy after surgery and radiation for head and neck cancer decreases neck circumference, increases cervical range of motion, and improves pain scores. Methods and materials: A retrospective review of all patients with squamous cell carcinoma of the oral cavity, oropharynx, or larynx who were treated with high-dose radiation therapy at a single center between 2011 and 2012 was performed...
July 2018: Advances in Radiation Oncology
Adil S Akthar, Anthony C Wong, Akash D Parekh, Greg Hubert, Christina H Son, Charles A Pelizzari, Stanley L Liauw
Purpose: Dose-volume histogram (DVH) toxicity relationships are poorly defined in men who receive radiation after radical prostatectomy (RP). We evaluated Radiation Therapy Oncology Group (RTOG) study 0534 and institutional intact normal-tissue sparing guidelines, as well as dose to bladder trigone, for ability to minimize late toxicity. Methods and materials: 164 men received intensity modulated radiation therapy (RT) to a median prostate bed dose of 66.6 Gy at a median of 22 months after RP...
July 2018: Advances in Radiation Oncology
Yubing Tong, Jayaram K Udupa, Chuang Wang, Jerry Chen, Sriram Venigalla, Thomas J Guzzo, Ronac Mamtani, Brian C Baumann, John P Christodouleas, Drew A Torigian
Background: Current clinical staging methods are unable to accurately define the extent of invasion of localized bladder cancer, which affects the proper use of systemic therapy, surgery, and radiation. Our purpose was to test a novel radiomics approach to identify optimal imaging biomarkers from T2-weighted magnetic resonance imaging (MRI) scans that accurately classify localized bladder cancer into 2 tumor stage groups (≤T2 vs >T2) at both the patient level and within bladder subsectors...
July 2018: Advances in Radiation Oncology
Carlos E Vargas, Matthew Q Schmidt, Joshua R Niska, William F Hartsell, Sameer R Keole, Lucius Doh, John Han-Chih Chang, Christopher Sinesi, Rossio Rodriquez, Mark Pankuch, Gary L Larson
Purpose: Randomized evidence for extreme hypofractionation in prostate cancer is lacking. We aimed to identify differences in toxicity and quality-of-life outcomes between standard fractionation and extreme hypofractionated radiation in a phase 3 randomized trial. Methods and materials: We analyzed the results of the first 75 patients in our phase 3 trial, comparing 38 Gy relative biologic effectiveness (RBE) in 5 fractions (n = 46) versus 79.2 Gy RBE in 44 fractions (n = 29)...
July 2018: Advances in Radiation Oncology
Krishan R Jethwa, Erik J Tryggestad, Thomas J Whitaker, Broc T Giffey, Bret D Kazemba, Michelle A Neben-Wittich, Kenneth W Merrell, Michael G Haddock, Christopher L Hallemeier
Purpose: Pencil-beam scanning intensity modulated proton therapy (IMPT) may allow for an improvement in the therapeutic ratio compared with conventional techniques of radiation therapy delivery for pancreatic cancer. The purpose of this study was to describe the clinical implementation of IMPT for intact and clinically localized pancreatic cancer, perform a matched dosimetric comparison with volumetric modulated arc therapy (VMAT), and report acute adverse event (AE) rates and patient-reported outcomes (PROs) of health-related quality of life...
July 2018: Advances in Radiation Oncology
Alexander L Chin, Sonya Aggarwal, Pooja Pradhan, Karl Bush, Rie von Eyben, Albert C Koong, Daniel T Chang
Purpose: The purpose of this study was to determine the impact of splenic and thoracic bone marrow irradiation on hematologic toxicity in the setting of chemoradiation therapy for esophageal cancer. Methods and materials: We analyzed 60 patients with carcinoma of the distal esophagus or gastroesophageal junction who received concurrent chemoradiation in the preoperative or definitive setting. Dosimetric and volumetric parameters were calculated for the spleen, thoracic spine, and posterior ribs...
July 2018: Advances in Radiation Oncology
Ankur Sharma, David Sasaki, Daniel W Rickey, Ahmet Leylek, Chad Harris, Kate Johnson, Jorge E Alpuche Aviles, Boyd McCurdy, Andy Egtberts, Rashmi Koul, Arbind Dubey
Purpose: Three-dimensional printing has been implemented at our institution to create customized treatment accessories, including lead shields used during radiation therapy for facial skin cancer. To effectively use 3-dimensional printing, the topography of the patient must first be acquired. We evaluated a low-cost, structured-light, 3-dimensional, optical scanner to assess the clinical viability of this technology. Methods and materials: For ease of use, the scanner was mounted to a simple gantry that guided its motion and maintained an optimum distance between the scanner and the object...
July 2018: Advances in Radiation Oncology
Ashley Albert, Anna Lee, Srinivasan Vijayakumar, Madhava Kanakamedala, Robert Allbright, David Schreiber
Objectives: Stereotactic radiation surgery (SRS) and hypofractionated stereotactic radiation surgery (HF-SRS) have become an alternative to external beam radiation therapy (EBRT) in the adjuvant treatment of meningiomas. The purpose of this study was to identify national treatment patterns and survival outcomes for meningiomas on the basis of radiation treatment modality in the adjuvant setting. Methods and materials: The National Cancer Database was queried for patients with meningioma diagnosed between 2010 and 2012...
July 2018: Advances in Radiation Oncology
Naomi Nakajima, Masahiko Oguchi, Yasuko Kumai, Masahiro Yoshida, Hirotaka Inoda, Yasuo Yoshioka, Takuji Iwase, Yoshinori Ito, Futoshi Akiyama, Shinji Ohno
Purpose: There are no randomized studies on the indication for postmastectomy radiation therapy (PMRT) in patients who receive neoadjuvant chemotherapy (NAC) followed by a mastectomy. The aim of this study was to determine clinical outcomes and identify reliable prognostic factors in patients with locally advanced breast cancer treated with NAC followed by a mastectomy and PMRT. Methods and materials: We retrospectively evaluated the relationship between clinicopathological factors and outcomes in 351 patients with stage II or III breast cancer who underwent NAC followed by radical mastectomy and PMRT between March 2005 and December 2013...
July 2018: Advances in Radiation Oncology
Philip Gilbo, Louis Potters, Lucille Lee
Purpose: Hypofractionation (HF) of whole breast irradiation has become a standard treatment regimen because randomized trials continue to demonstrate equivalence in survival and local control compared with conventional fractionation. In 2011, the American Society for Radiation Oncology (ASTRO) adopted clinical guidelines on the proper selection of HF. Nevertheless, utilization remains lower than predicted. We evaluate the effects of clinical directives that serve as default treatment decisions and prospective contouring rounds on the implementation of HF in a large, multicenter radiation oncology department...
July 2018: Advances in Radiation Oncology
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