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Michael G Haddock
Although there have been significant advances in the adjuvant therapy of colorectal cancer, results for patients have historically been poor when complete resection is unlikely or not possible. Similarly, locally recurrent colorectal cancer patients often experience significant tumor related morbidity and disease control and long term survival have historically been poor with standard therapies. Intraoperative radiation therapy (IORT) has been proposed as a possible tool for dose escalation in patients with locally advanced colorectal cancer...
January 11, 2017: Radiation Oncology
Tracy S A Underwood, Justin C Voog, Maryam Moteabbed, Shikui Tang, Edward Soffen, Oren Cahlon, Hsiao-Ming Lu, Anthony L Zietman, Jason A Efstathiou, Harald Paganetti
AIM: Anterior-oblique (AO) proton beams can form an attractive option for prostate patients receiving external beam radiotherapy (EBRT) as they avoid the femoral heads. For a cohort with hydrogel prostate-rectum spacers, we asked whether it was possible to generate AO proton plans robust to end-of-range elevations in linear energy transfer (LET) and modeled relative biological effectiveness (RBE). Additionally we considered how rectal spacers influenced planned dose distributions for AO and standard bilateral (SB) proton beams versus intensity-modulated radiotherapy (IMRT)...
January 11, 2017: Acta Oncologica
Liz B Wang, David McAneny, Gerard Doherty, Teviah Sachs
BACKGROUND: Current National Comprehensive Cancer Network guidelines for the treatment of retroperitoneal sarcomas (RPS) endorse surgical resection, but the role of radiotherapy (RT) is less clear. We investigate the utilization and benefits of intraoperative RT (IORT) in the treatment of RPS. METHODS: We queried the Surveillance, Epidemiology and End Results (SEER) database (1988-2013) for the utilization of IORT and perioperative external beam RT (EBRT) in patients who underwent surgical resection of RPS...
January 10, 2017: International Journal of Clinical Oncology
Robert Krempien, Falk Roeder
Despite the important improvements made in the fields of surgery, chemotherapy and radiation therapy, pancreatic cancer remains one of the most lethal malignancies. Improved outcomes with novel chemotherapy regimes led again to increased attention on the role of localized radiotherapy, since local tumor progression causes significant morbidity and mortality in patients. Even after resection local failure rates are as high as 50-80%. The immediate proximity to critical structures (bone marrow, spinal cord, kidneys, liver, and intestine) limits the dose of radiation that can be administered to the tumor bed with conventional external beam radiation therapy (EBRT)...
January 10, 2017: Radiation Oncology
Sarika N Rao, Mark Zafereo, Ramona Dadu, Naifa Busaidy, Kenneth Hess, Gilbert J Cote, Michelle D Williams, William Nassib William, Vlad C Sandulache, Neil D Gross, Brandon Gunn, Charles Lu, Renata Ferrarotto, Stephen Y Lai, Maria Cabanillas
BACKGROUND: Anaplastic thyroid cancer (ATC) is one of the most lethal forms of cancer with a high mortality rate. Current guidelines support surgery for resectable ATC followed by external beam radiation therapy (EBRT) with or without chemotherapy. Treatment for those who are unresectable is palliative. Our goal was to examine first-line therapies as well as the role of genomic profiling in an effort better understand how to approach ATC. METHODS: This is a retrospective study of ATC patients who were seen at our institution from 1/2013 to 10/2015...
January 9, 2017: Thyroid: Official Journal of the American Thyroid Association
Sebastien Crouzet, Andreas Blana, Francois J Murat, Gilles Pasticier, Stephen C W Brown, Giario N Conti, Roman Ganzer, Olivier Chapet, Albert Gelet, Christian G Chaussy, Cary N Robertson, Stefan Thuroff, John F Ward
OBJECTIVE: To report the oncological outcome of Salvage high-intensity focused ultrasound (S-HIFU) for locally recurrent prostate cancer (PCa) following External Beam Radiotherapy (EBRT) from a multicenter database. MATERIALS AND METHODS: This retrospective study comprises patients from 9 centers with local recurrent disease following EBRT treated with S-HIFU from 1995 to 2009. Biochemical free survival rates (BFSR) was based on the "Phoenix" definition (nadir+2)...
January 7, 2017: BJU International
Vladimir Feygelman, Frank Lohr, Colin G Orton
The use of MRI in radiotherapy planning and simulation is increasing rapidly and is beginning to be integrated into the external beam radiation therapy (EBRT) treatment process. Some have suggested that integrated MRI-linac systems, not the standalone MRI-Sim, represents the future of MRI in radiotherapy, and this is the claim debated in this month's Point/Counterpoint. This article is protected by copyright. All rights reserved.
January 7, 2017: Medical Physics
Abbas Alinejad, Seyed Morteza Zamir, Seyed Abbas Shojaosadati
Biotrickling filters (BTFs) are often subjected to transient-state operation due to different variations in the operation of industrial-scale sources of pollution. In this research, performance of a laboratory-scale BTF packed with pall ring and pumice (1:1 v/v) and inoculated with Ralstonia eutropha was evaluated for the treatment of toluene vapor under various transient conditions. The experiments were performed at empty bed residence times (EBRTs) of 45 and 90 s and toluene inlet concentration in the range of 0...
January 6, 2017: Applied Microbiology and Biotechnology
Prahlad H Yathiraj, Anshul Singh, Sudha Vidyasagar, Muralidhar Varma, Vidyasagar Mamidipudi
Spinal cord compression (SCC) is an unusual sequale of extra-medullary hematopoiesis (EMH). We report a patient diagnosed with β-thalassemia intermedia at the age of 7 years presenting as a 24-year-old with symptoms suggestive of paraparesis. MR imaging revealed long masses of EMH opposite T5-T11 and L5-S2 vertebrae with cord compression at T6 vertebrae. Patient was treated with external beam radiotherapy (EBRT) to a low dose of 20 Gy in 10 fractions over 2 weeks. The patient had symptomatic relief of paraparesis by the 5th fraction and nearly regained full power in bilateral lower limbs by EBRT conclusion...
December 9, 2016: Annals of Palliative Medicine
M J Rivard, J G Emrich, J Poli
PURPOSE: Preceding surgical implantation following external-beam radiotherapy (EBRT) delivery, a radiobiological evaluation was performed for a new LDR Pd-103 directional brachytherapy device (CivaSheet). As this was the first case with the device used in combination with EBRT, there was concern to determine the appropriate prescription dose. METHODS: The radiobiological model of Dale (1985, 1989) was used for a permanent LDR implant including radioactive decay...
June 2016: Medical Physics
S Liu, Y Wu, X Chang, H Li, D Yang
PURPOSE: A novel computer software system, namely APDV (Automatic Pre-Delivery Verification), has been developed for verifying patient treatment plan parameters right prior to treatment deliveries in order to automatically detect and prevent catastrophic errors. METHODS: APDV is designed to continuously monitor new DICOM plan files on the TMS computer at the treatment console. When new plans to be delivered are detected, APDV checks the consistencies of plan parameters and high-level plan statistics using underlying rules and statistical properties based on given treatment site, technique and modality...
June 2016: Medical Physics
Z Ouyang, B Liu, S Yasmin-Karim, E Sajo, W Ngwa
PURPOSE: This study investigates the feasibility of exploiting the Cerenkov radiation (CR) present during external beam radiotherapy (EBRT) for significant therapeutic gain, using titanium dioxide nanoparticles (titania) delivered via a new design of radiotherapy biomaterials. METHODS: Recently published work has shown that CR generated by radionuclides during PET imaging could substantially enhance damage to cancer cells in the presence of 0.625 µg/g titania. We hypothesize that equal or greater damage can be achieved during EBRT...
June 2016: Medical Physics
H Xu, S Lee, T Diwanji, P Amin, K Krudys, M Guerrero
PURPOSE: In our clinic, the planning CT is used for definitive and boost low-dose-rate (LDR) brachytherapy treatments to determine the ultrasound volume in the operating room (OR) at the time of the implant. While the CT overestimation of OR volume is known, a larger estimation discrepancy has been observed for boost treatments. A possible reason is the prostate size reduction during EBRT for boost patients. Since cone-beam CT (CBCT) is often used as routine imaging guidance of EBRT, this prostate volume change may be captured...
June 2016: Medical Physics
D Fiedler, H Kuo, W Bodner, W Tome
PURPOSE: To introduce a non-standard method of patient setup, using BellyBoard immobilization, to better utilize the localization and tracking potential of an RF-beacon system with EBRT for prostate cancer. METHODS: An RF-beacon phantom was imaged using a wide bore CT scanner, both in a standard level position and with a known rotation (4° pitch and 7.5° yaw). A commercial treatment planning system (TPS) was used to determine positional coordinates of each beacon, and the centroid of the three beacons for both setups...
June 2016: Medical Physics
Y Miyasaka, N Kadoya, Y Kuroda, K Ito, M Chiba, Y Nakajima, K Sato, S Dobashi, K Takeda, K Jingu
PURPOSE: Accurate deformable image registration (DIR) between external beam radiotherapy (EBRT) and HDR brachytherapy (BT) CT images in cervical cancer is challenging. DSC has been evaluated only on the basis of the consistency of the structure, and its use does not guarantee an anatomically reasonable deformation. We evaluate the DIR accuracy for cervical cancer with DSC and anatomical landmarks using a 3D-printed pelvis phantom. METHODS: A 3D-printed, deformable female pelvis phantom was created on the basis of the patient's CT image...
June 2016: Medical Physics
U Mwidu, S Devic, M Shehadeh, M AlKafi, R Mahmood, B Moftah
PURPOSE: A retrospective comparison of dose distributions achievable by High dose rate brachytherapy (HDRBT), Helical TomoTherapy (TOMO), CyberKnife (CK) and RapidArc (RA) in locally advanced inoperable cervical cancer patients is presented. METHODS: Five patients with advanced stage cervical carcinoma were selected for this study after a full course of external beam radiotherapy (EBRT), chemotherapy and HDR Brachytherapy. To highlight any significant similarities/differences in dose distributions, high-risk clinical target volume (HRCTV) coverage, organs at risk (OAR) sparing, and machine specific delivery limitations, we used D90 (dose received by 90% of the volume) as the parameter for HRCTV coverage as recommended by the GEC-ESTRO Working Group...
June 2016: Medical Physics
M Rilling, M Goulet, L Beaulieu, S Thibault, L Archambault
PURPOSE: To characterize the performance of a real-time three-dimensional scintillation dosimeter in terms of signal-to-noise ratio (SNR) and temporal resolution of 3D dose measurements. This study quantifies its efficiency in measuring low dose levels characteristic of EBRT dynamic treatments, and in reproducing field profiles for varying multileaf collimator (MLC) speeds. METHODS: The dosimeter prototype uses a plenoptic camera to acquire continuous images of the light field emitted by a 10×10×10 cm(3) plastic scintillator...
June 2016: Medical Physics
H Zhang
PURPOSE: To evaluate the dosimetric metrics of HDR Ring and Tandem applicator Brachytherapy for primary cervical cancers. METHODS: The dosimetric metrics of high-risk clinical target volumes (HDR-CTV) of 12 patients (in total 60 fractions/plans) treated with the HDR ring and tandem applicators were retrospectively analyzed. Ring diameter is from 2.6 to 3.4 cm, tandem length is from 4 to 6 cm, and the angle is either 45 or 60 degrees. The first fraction plan was MR guided, the MR images were then used as a reference for contouring the HR-CTV in CT images of following 4 fractions...
June 2016: Medical Physics
I Buzurovic, R Cormack
PURPOSE: We proposed a method for collision avoidance (CA) in external beam radiation therapy (EBRT). The method encompasses the analysis of all positions of the moving components of the beam delivery system such as the treatment table and gantry, including patient specific information obtained from the CT images. This method eliminates the need for time-consuming dry-runs prior to the actual treatments. METHODS: The QA procedure for EBRT requires that the collision should be checked prior to treatment...
June 2016: Medical Physics
R Meerschaert, A Paul, W Chen, S Miller, L Zhuang
PURPOSE: To identify indicators for recurrence in cervical cancer patients treated with high-dose-rate brachytherapy (HDR-BT). METHODS: A total of 37 biopsy proven uterine cervical cancer patients of stage IB-IVA treated between 2011 and 2015 were included in this study. All patients were treated with 37.8-52.2Gy of external beam radiotherapy (EBRT) plus 5 × 5.0-6.5Gy of HDR-BT. Patient age, standard deviation of high-risk clinical tumor volume (HR-CTVSD) collected throughout HDR-BT, and D90 (EQD2, α/β=10Gy) of the HR-CTV were investigated as potential indicators for local/distant recurrence using ROC analysis...
June 2016: Medical Physics
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