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Philip Sutera, Ronny Kalash, John Flickinger, Johnathan Engh, Dwight E Heron
INTRODUCTION: Despite multimodal treatment for high-grade gliomas, prognosis remains grim. Prior Radiation Therapy Oncology Group-Recursive Partitioning Analysis (RTOG-RPA) reports indicate based on pretreatment and treatment-related factors, a subset of patients experience a significantly improved survival. Since the development of the RTOG-RPA, high-grade gliomas have seen the widespread introduction of temozolomide and tumor oncogenetics. Here we aimed to determine whether the RTOG-RPA retained prognostic significance in the context of modern treatment, as well as generate an updated RPA incorporating both clinical and genetic variables...
June 14, 2018: American Journal of Clinical Oncology
Dario Pasalic, Ryan K Funk, Joaquín J García, Daniel L Price, Katharine A Price, William S Harmsen, Samir H Patel, Geoffrey D Young, Robert L Foote, Eric J Moore, Daniel J Ma
OBJECTIVE: To determine the outcomes and toxicities of minimally-invasive surgery with adjuvant intensity-modulated radiotherapy +/- chemotherapy (AT) compared to definitive surgical therapy (ST) in a contemporary cohort of HPV-positive oropharyngeal squamous cell carcinoma (OPSCC). METHODS: From 2005 to 2013, a consecutive cohort of 190 HPV-positive OPSCC patients was retrospectively reviewed from multi-institutional databases maintained by the Departments of Otorhinolaryngology and Radiation Oncology...
July 2018: Oral Oncology
Ying-Lin Peng, Li Chen, Guan-Zhu Shen, Ya-Ning Li, Ji-Jin Yao, Wei-Wei Xiao, Lin Yang, Shu Zhou, Jia-Xin Li, Wan-Qin Cheng, Ying Guan, Hai-Qun Xia, Shuai Liu, Chong Zhao, Xiao-Wu Deng
OBJECTIVE: This study aimed to (a) assess the differences in the delineation of target volumes and organs-at-risk (OARs) by different physicians designing an intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC) and (b) analyze the impact of these differences on the treatment plan optimization. MATERIALS AND METHODS: The planning target volumes (PTVs) and OARs for radiotherapy were manually delineated from computed tomography images of a patient with NPC, and a standard delineation was determined using the STAPLE algorithm of ABAS software...
July 2018: Oral Oncology
Lone Hoffmann, Markus Alber, Matthias Söhn, Ulrik Vindelev Elstrøm
PURPOSE: The two distinct dose computation paradigms of Boltzmann Equation Solvers and Monte Carlo simulation both promise in principle maximum accuracy. In practice, clinically acceptable calculation times demand approximations and numerical short-cuts on one hand, and modelling the beam characteristics of a real linear accelerator to the required accuracy on the other. A thorough benchmark of both algorithm types therefore needs to start with beam modelling, and needs to include a number of clinically challenging treatment plans...
June 16, 2018: Medical Physics
Dandan Zhang, Bin Wang, Guangshun Zhang, Charlie Ma, Xiaowu Deng
This study compared three-dimensional (3D) and two-dimensional (2D) percentage gamma passing rates (%GPs) for detection sensitivity to IMRT delivery errors and investigated the correlation between two kinds of %GP. Eleven prostate IMRT cases were selected, and errors in multileaf collimator (MLC) bank sag, MLC leaf traveling, and machine output were simulated by recalculating the dose distributions in patients. 2D doses were extracted from the 3D doses at the isocenter position. The 3D and 2D %GPs with different gamma criteria were then obtained by comparing the recalculated and original doses in specific regions of interest (ROI), such as the whole body, the planning target volume (PTV), the bladder, and the rectum...
June 15, 2018: Journal of Applied Clinical Medical Physics
Allen M Chen, Taeko Yoshizaki, Pin-Chieh Wang, Darlene Veruttipong, Phillip J Beron, Robert Chin, Argin G Mikaeilian, Minsong Cao
Purpose: The practice of deliberately sparing the ipsilateral parotid gland with intensity modulated radiation therapy (IMRT) in patients with node-positive head and neck cancer is controversial. We sought to compare the clinical outcomes among consecutive cohorts of patients with head and neck cancer who were treated with differing strategies to spare the parotid gland that is ipsilateral to the involved neck using IMRT. Methods and materials: A total of 305 patients were treated with IMRT for node-positive squamous cell carcinoma of the head and neck...
April 2018: Advances in Radiation Oncology
Kaley Woods, Percy Lee, Tania Kaprealian, Isaac Yang, Ke Sheng
Purpose: This study investigates whether 4π noncoplanar radiation therapy can spare the cochleae and consequently potentially improve hearing preservation in patients with acoustic neuroma who are treated with radiation therapy. Methods and materials: Clinical radiation therapy plans for 30 patients with acoustic neuroma were included (14 stereotactic radiation surgery [SRS], 6 stereotactic radiation therapy [SRT], and 10 intensity modulated radiation therapy [IMRT])...
April 2018: Advances in Radiation Oncology
Dong-Su Kim, Siyong Kim, Seong-Hee Kang, Tae-Ho Kim, So-Hyun Park, Kyeong-Hyeon Kim, Min-Seok Cho, Dong-Seok Shin, Yu-Yun Noh, Jin-Beom Chung, Tae Suk Suh
BACKGROUND: In intensity modulated radiation therapy (IMRT) quality assurance (QA), evaluation of QA result using a pass/non-pass strategy under an acceptance criterion often suffers from lack of information on how good the plan is in absolute manner. In this study, we suggested adding an index system, previously developed for dose painting technique, to current IMRT QA process for better understanding of QA result. METHODS: The index system consists of three indices, index of achievement (IOA), index of hotness (IOH) and index of coldness (IOC)...
June 15, 2018: Radiation Oncology
Barbara Zollner, Ute Ganswindt, Cornelius Maihöfer, Stefanie Corradini, Nathalie Lisa Albert, Christian Schichor, Claus Belka, Maximilian Niyazi
BACKGROUND: The aim of the present study was to evaluate the influence of the applied safety margins of modern intensity-modulated radiotherapy (IMRT) in patients with high-grade meningiomas on local control and recurrence patterns. METHODS: Twenty patients with a neuropathological diagnosis of a high-grade meningioma (WHO°II or °III) treated with adjuvant or definitive radiotherapy between 2010 and 2015 were included in the present retrospective analysis. All patients were planned PET-based...
June 14, 2018: Radiation Oncology
Ophelie Piron, Nicolas Varfalvy, Louis Archambault
PURPOSE: To present a new adaptive radiotherapy (ART) method based on relative gamma analysis and patient classification for the identification of anatomical changes that induce a sufficient dosimetric impact to affect the treatment delivery and require complete replanning. METHODS: This retrospective study includes 55 patients treated for a head and neck cancer with IMRT, VMAT or 3D conformal RT. EPID images for all treatment fields were acquired daily at every fraction...
June 13, 2018: Medical Physics
Lilie Wang, George X Ding
Therapeutic radiation to cancer patients is accompanied by unintended radiation to organs outside the treatment field. It is known that the model-based dose algorithm has limitation in calculating the out-of-field doses. This study evaluated the out-of-field dose calculated by the Varian Eclipse treatment planning system (v.11 with AAA algorithm) in realistic treatment plans with the goal of estimating the uncertainties of calculated organ doses. Photon beam phase-space files for TrueBeam linear accelerator were provided by Varian...
June 12, 2018: Journal of Applied Clinical Medical Physics
Wang Fangzheng, Jiang Chuner, Sun Quanquan, Ye Zhimin, Liu Tongxin, Liu Jiping, Masoto Sakamoto, Wu Peng, Shi Kaiyuan, Qin Weifeng, Fu Zhenfu, Jiang Yangming
In this study, we examined whether combining neoadjuvant chemotherapy (NAC) and/or concurrent chemotherapy (CC) with intensity-modulated radiotherapy (IMRT) improved survival in patients with stage II nasopharyngeal carcinoma (NPC). Two hundred forty-two stage II NPC patients were enrolled between May 2008 and April 2014 and received radical IMRT with simultaneous integrated boost technique using 6 MV photons; some patient groups also received chemotherapy every 3 weeks for 2-3 cycles. The median follow-up duration was 69 months for all patients...
2018: Journal of Cancer
Michael P Grams, Luis E Fong de Los Santos
PURPOSE: To describe the design and clinical use of a rotational phantom for dosimetric verification of IMRT/VMAT treatment plans using radiochromic film. METHODS: A solid water cylindrical phantom was designed with separable upper and lower halves and rests on plastic bearings allowing for 360° rotation about its central axis. The phantom accommodates a half sheet of radiochromic film, and by rotating the cylinder, the film can be placed in any plane between coronal and sagittal...
June 2018: Physica Medica: PM
Xiaobo Li, Benhua Xu, Yu Lei, Jianping Zhang, Zhixing Lin, Sicong Li
BACKGROUND: Differences often exist in the dose calculation accuracy caused by using different dose calculation algorithms in non-uniform tissues. OBJECTIVE: To evaluate the accuracy of dose calculation with inhomogeneity correction in intensity-modulated radiation therapy (IMRT) by comparing dose calculated in Monaco with measurements in lung-chest phantom for esophagus cancer treatments. METHODS: Finite size pencil beam (FSPB) and X-ray voxel Monte Carlo (XVMC) were used respectively for IMRT dose recalculations...
June 5, 2018: Journal of X-ray Science and Technology
Shaoqiang Liang, Ning Zhang, Lusi Chen, Yang Zhang, Zhenhe Zheng, Weijun Luo, Tao Xu, Zhiqian Lü, Shao'en Li
To study the potential effects of intensity modulated radiation therapy (IMRT) on clinical efficacy, oral mucosa reaction and immunological foundation; and to explore the effect of immunological changes on clinical efficacy and oral mucosa reaction in patients with nasopharyngeal carcinoma.
 Methods: A total of 200 patients with nasopharyngeal carcinoma, who came from First Department of Nasopharyngeal Radiotherapy, the First People's Hospital of Foshan from October 2008 to November 2011, were selected. The patients were treated with nasopharyngeal radiotherapy, and divided into an observation group and a control group (n=100 in each group)...
May 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Qiuyuan Yue, Mingwei Zhang, Yunbin Chen, Dechun Zheng, Ying Chen, Meimei Feng
Local recurrence remains a major cause of therapeutic failure in patients with nasopharyngeal carcinoma (NPC) and the effective treatment of recurrent NPC (r-NPC) is still a challenge. Intensity-modulated radiotherapy (IMRT) is considered as a favorable technique in the management of r-NPC, especially for extensive lesions. However, local r-NPC is a highly heterogeneous disease and the survival outcome following salvage IMRT varies. Furthermore, due to varied samples and therapeutic protocols, no consensus has been reached in the establishment of prognostic values...
June 2018: Oral Oncology
Frank E Mott, Renatta Ferrarotto, Theresa Nguyen, Jack Phan
Treatment of Nasopharyngeal Carcinoma (NPC) has been based on the Intergroup 0999 trial with chemoradiation (CRT) and consolidation chemotherapy (CT). While effective, toxicities are significant. As a result, many oncologists use induction chemotherapy (IC) followed by CRT, citing better tolerance with anecdotally no worse outcome. We reviewed 95 NPC patients treated between 2005 and 2015 at MDACC with IC followed by CRT. Median age was 49 years. Fifty-seven were T3/T4 and 62 were N2-3. The most common IC regimen was a platinum-taxane doublet (N = 72)...
June 2018: Oral Oncology
Renáta Kószó, Linda Varga, Emese Fodor, Zsuzsanna Kahán, Adrienne Cserháti, Katalin Hideghéty, Zsófia Együd, Csilla Szabó, Emőke Borzási, Dorottya Szabó, Kitti Müllner, Zoltán Varga, Anikó Maráz
The presence of normal tissues in the irradiated volume limits dose escalation during pelvic radiotherapy (RT) for prostate cancer. Supine and prone positions on a belly board were compared by analyzing the exposure of organs at risk (OARs) using intensity modulated RT (IMRT). The prospective trial included 55 high risk, localized or locally advanced prostate cancer patients, receiving definitive image-guided RT. Computed tomography scanning for irradiation planning was carried out in both positions. Gross tumor volume, clinical and planning target volumes (PTV) and OARs were delineated, defining subprostatic and periprostatic rectal subsegments...
June 7, 2018: Pathology Oncology Research: POR
Wade P Smith, Patrick J Richard, Jing Zeng, Smith Apisarnthanarax, Ramesh Rengan, Mark H Phillips
Background: Although proton radiation treatments are more costly than photon/X-ray therapy, they may lower overall treatment costs through reducing rates of severe toxicities and the costly management of those toxicities. To study this issue, we created a decision-model comparing proton vs. X-ray radiotherapy for locally advanced non-small cell lung cancer patients. Methods: An influence diagram was created to model for radiation delivery, associated 6-month pneumonitis/esophagitis rates, and overall costs (radiation plus toxicity costs)...
April 2018: Translational Lung Cancer Research
He J Zhu, Bradford S Hoppe, Stella Flampouri, Debbie Louis, John Pirris, R Charles Nichols, Randal H Henderson, Catherine E Mercado
Background: Radiotherapy for thymic malignancies is technically challenging due to their close proximity to the heart, lungs, esophagus, and breasts, raising concerns about significant acute and late toxicities from conventional photon radiotherapy. Proton therapy (PT) may reduce the radiation dose to these vital organs, leading to less toxicity. We reviewed the dosimetry and outcomes among patients treated with PT for thymic malignancies at our institution. Methods: From January 2008 to March 2017, six patients with de novo Masaoka stages II-III thymic malignancies were treated with PT on an IRB-approved outcomes tracking protocol...
April 2018: Translational Lung Cancer Research
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