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https://www.readbyqxmd.com/read/28094211/likelihood-of-unacceptable-normal-tissue-doses-in-breast-cancer-patients-undergoing-regional-nodal-irradiation-in-routine-clinical-practice
#1
Jose Bazan, Dominic DiCostanzo, Karla Kuhn, Lonika Majithia, Allison Quick, Nilendu Gupta, Julia White
PURPOSE: As indications for regional nodal irradiation (RNI) for breast cancer have expanded, so too has scrutiny over potential late toxicity from radiotherapy. This emphasizes the need for careful radiation treatment planning to maximize the therapeutic ratio. We sought to evaluate how often unacceptable doses (UDs) to organs at risk (OARs) occur and the associated factors for patients receiving RNI in daily practice. METHODS AND MATERIALS: Treatment records of patients who received RNI from February 2012 to May 2015 were studied...
October 19, 2016: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28093714/neuroplasticity-based-technologies-and-interventions-for-restoring-motor-functions-in-multiple-sclerosis
#2
Sofia Straudi, Nino Basaglia
Motor impairments are very common in multiple sclerosis (MS), leading to a reduced Quality of Life and active participation. In the past decades, new insights into the functional reorganization processes that occur after a brain injury have been introduced. Specifically, the motor practice seems to be determinant to induce neuroplastic changes and motor recovery. More recently, these findings have been extended to multiple sclerosis, in particular, it has been hypothesized that disease progression, functional reorganization and disability are mutually related...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28068238/hematologic-nadirs-during-chemoradiation-for-anal-cancer-temporal-characterization-and-dosimetric-predictors
#3
Andrew Y Lee, Daniel W Golden, Jose G Bazan, Malgorzata Kopec, Charles A Pelizzari, Sonya Aggarwal, Daniel T Chang, Stanley L Liauw
PURPOSE: Pelvic bone marrow (BM) constraints may offer a means to reduce the toxicity commonly associated with chemoradiation for anal cancer. We conducted a bi-institutional analysis of dose-volume metrics in a time-sensitive fashion to devise practical metrics to minimize hematologic toxicity. METHODS AND MATERIALS: Fifty-six anal cancer patients from 2 institutions received definitive radiation therapy (median primary dose of 54 Gy) using intensity modulated radiation therapy (IMRT, n=49) or 3-dimensional (3D) conformal therapy (n=7) with concurrent 5-fluorouracil (5-FU) and mitomycin C...
February 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28068234/radiation-dose-dependent-hippocampal-atrophy-detected-with-longitudinal-volumetric-magnetic-resonance-imaging
#4
Tyler M Seibert, Roshan Karunamuni, Hauke Bartsch, Samar Kaifi, Anitha Priya Krishnan, Yoseph Dalia, Jeffrey Burkeen, Vyacheslav Murzin, Vitali Moiseenko, Joshua Kuperman, Nathan S White, James B Brewer, Nikdokht Farid, Carrie R McDonald, Jona A Hattangadi-Gluth
PURPOSE: After radiation therapy (RT) to the brain, patients often experience memory impairment, which may be partially mediated by damage to the hippocampus. Hippocampal sparing in RT planning is the subject of recent and ongoing clinical trials. Calculating appropriate hippocampal dose constraints would be improved by efficient in vivo measurements of hippocampal damage. In this study we sought to determine whether brain RT was associated with dose-dependent hippocampal atrophy. METHODS AND MATERIALS: Hippocampal volume was measured with magnetic resonance imaging (MRI) in 52 patients who underwent fractionated, partial brain RT for primary brain tumors...
February 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28060412/optimizing-dual-energy-x-ray-parameters-for-the-exactrac-clinical-stereoscopic-imaging-system-to-enhance-soft-tissue-imaging
#5
Wesley A Bowman, James L Robar, Mike Sattarivand
PURPOSE: Stereoscopic x-ray image guided radiotherapy for lung tumors is often hindered by bone overlap and limited soft tissue contrast. This study aims to evaluate the feasibility of dual-energy imaging techniques and to optimize parameters of the ExacTrac stereoscopic imaging system to enhance soft tissue imaging for application to lung stereotactic body radiation therapy. METHODS: Simulated spectra and a physical lung phantom were used to optimize filter material, thickness, tube potentials, and weighting factors to obtain bone subtracted dual-energy images...
January 6, 2017: Medical Physics
https://www.readbyqxmd.com/read/28059905/functional-tricuspid-regurgitation-model-in-a-beating-heart-platform
#6
Michal Jaworek, Marco Piola, Federico Lucherini, Guido Gelpi, Marco Castagna, Giuliana Lentini, Carlo Antona, Gianfranco B Fiore, Riccardo Vismara
Currently, clinicians are seeking new, minimally invasive treatment options for functional tricuspid regurgitation (FTR). Challenging tricuspid complexity requires the evaluation of the treatment techniques in adequate and realistic preclinical scenario. The purpose of this paper is to describe the design and functional assessment of a novel passive beating heart model of the pulmonary circulation with the possibility to tightly control FTR.The model housed porcine hearts actuated by a volumetric pump that cyclically pressurized the right ventricle...
January 3, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28051283/incremental-cost-effectiveness-pharmacoeconomic-assessment-of-hepatitis-c-virus-therapy-an-approach-for-less-wealthy-members-of-the-common-market
#7
Diana Mance, Davor Mance, Dinko Vitezić
AIM: To develop a new method of health-economic analysis based on a marginal approach. METHODS: We tested the research hypothesis that a detailed comparative a priori incremental cost-effectiveness analysis provides the necessary input for budget impact analysis about the proper order of introduction of new therapies, and thus maximizes the cost-effectiveness bounded by the total budget constraint. For the analysis we chose a combination therapy for the treatment of hepatitis C virus (HCV) genotype 1 (GT1) infection, which was approved by the European Medicine Agency in 2015...
December 31, 2016: Croatian Medical Journal
https://www.readbyqxmd.com/read/28050492/efficacy-of-modified-constraint-induced-movement-therapy-in-the-treatment-of-hemiparetic-upper-limb-in-stroke-patients-a-randomized-controlled-trial
#8
Raj Kumar Yadav, Rajendra Sharma, Diganta Borah, S Y Kothari
INTRODUCTION: Paretic upper limb in stroke patients has a significant impact on the quality of life. Modified Constraint Induced Movement Therapy (mCIMT) is one of the treatment options used for the improvement of the function of the paretic limb. AIM: To investigate the efficacy of four week duration mCIMT in the management of upper extremity weakness in hemiparetic patients due to stroke. MATERIALS AND METHODS: Prospective single blind, parallel randomized controlled trial in which 30 patients received conventional rehabilitation programme (control group) and 30 patients participated in a mCIMT programme in addition to the conventional rehabilitation programme (study group)...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28048914/su-g-brc-02-a-novel-multi-criteria-optimization-approach-to-generate-deliverable-intensity-modulated-radiation-therapy-imrt-treatment-plans
#9
G Kirlik, W D'Souza, H Zhang
PURPOSE: To present a novel multi-criteria optimization (MCO) solution approach that generates treatment plans with deliverable apertures using column generation. METHODS: We demonstrate our method with 10 locally advanced head-and-neck cancer cases retrospectively. In our MCO formulation, we defined an objective function for each structure in the treatment volume. This resulted in 9 objective functions, including 3 distinct objectives for primary target volume, high-risk and low-risk target volumes, 5 objectives for each of the organs-at-risk (OARs) (two parotid glands, spinal cord, brain stem and oral cavity), and one for the non-target non-OAR normal tissue...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048898/mo-fg-brc-03-design-and-construction-of-a-dielectiric-wall-accelerator
#10
D Westerly
Experimental research in medical physics has expanded the limits of our knowledge and provided novel imaging and therapy technologies for patients around the world. However, experimental efforts are challenging due to constraints in funding, space, time and other forms of institutional support. In this joint ESTRO-AAPM symposium, four exciting experimental projects from four different countries are highlighted. Each project is focused on a different aspect of radiation therapy. From the USA, we will hear about a new linear accelerator concept for more compact and efficient therapy devices...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048850/su-g-brc-14-multi-lesion-multi-rx-brain-radiosurgery-with-novel-single-isocenter-technique
#11
N Honig, S Alani, A Schlocker, N Shtraus, A Kanner
PURPOSE: There is a strong trend to treat multiple brain metastases with radiosurgery rather than whole brain irradiation. This feasibility study investigates a novel planning technique for radio-surgical treatment of multiple brain lesions with differing dose prescriptions, a single isocenter, and dynamic conformal arcs. The novel technique will be compared to the well-established single-isocenter volumetric modulated arc therapy (VMAT) technique commonly used for treating brain lesions...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048809/mo-d-brc-01-memorial-lecture
#12
B Fraass
Treatment planning is a central part of radiation therapy, including delineation in tumor volumes and critical organs, setting treatment goals of prescription doses to the tumor targets and tolerance doses to the critical organs, and finally generation of treatment plans to meet the treatment goals. National groups like RTOG have led the effort to standardize treatment goals of the prescription doses to the tumor targets and tolerance doses to the critical organs based on accumulated knowledge from decades of abundant clinical trial experience...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048786/mo-d-brc-04-multiple-criteria-optimization-planning
#13
J Donaghue
Treatment planning is a central part of radiation therapy, including delineation in tumor volumes and critical organs, setting treatment goals of prescription doses to the tumor targets and tolerance doses to the critical organs, and finally generation of treatment plans to meet the treatment goals. National groups like RTOG have led the effort to standardize treatment goals of the prescription doses to the tumor targets and tolerance doses to the critical organs based on accumulated knowledge from decades of abundant clinical trial experience...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048752/tu-a-brb-02-panel-member
#14
L Ma
: Brain stereotactic radiosurgery (SRS) and spine stereotactic body radiation therapy (SBRT) are commonly treated by a multidisciplinary team of neurosurgeons, radiation oncologists, and medical physicists. However the treatment objectives, constraints, and technical considerations involved can be quite different between the two techniques. In this interactive session an expert panel of speakers will present clinical brain SRS and spine SBRT cases in order to demonstrate real-world considerations for ensuring safe and accurate treatment delivery and to highlight the significant differences in approach for each treatment site...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048671/su-f-t-104-determining-the-ntcp-parameters-of-pharyngeal-constrictors-and-proximal-esophagus-for-radiation-induced-swallowing-problems-recorded-six-months-after-radiation-therapy-for-head-and-neck-tumors
#15
P Mavroidis, A Price, M Kostich, R Amdur, W Mendenhall, N Sheets, R Green, S Das, L Marks, B Chera
PURPOSE: To estimate the radiobiological parameters of four NTCP models that describe the dose-response relations of pharyngeal constrictors and proximal esophagus regarding the severity of patient reported swallowing problems 6 months post chemo-radiotherapy. To identify the section/structure that best correlates with the manifestation of the clinical endpoints. Finally, to compare the goodness-of-fit of those models. METHODS: Forty-three patients were treated on a prospective multi-institutional phase II study for oropharyngeal squamous cell carcinoma...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048650/su-f-t-195-systematic-constraining-of-contralateral-parotid-gland-led-to-improved-dosimetric-outcomes-for-multi-field-optimization-with-scanning-beam-proton-therapy-promising-results-from-a-pilot-study-in-patients-with-base-of-tongue-carcinoma
#16
R Wu, C Crowford, R Georges, A Liu, M Amin, T Sio, B Gunn, F Poenisch, M Palmer, M Gillin, S Frank, X Zhu
PURPOSE: Treatment planning for Intensity Modulated Proton Therapy (IMPT) for head and neck cancer is time-consuming due to the large number of organs-at-risk (OAR) to be considered. As there are many competing objectives and also wide range of acceptable OAR constraints, the final approved plan may not be most optimal for the given structures. We evaluated the dose reduction to the contralateral parotid by implementing standardized constraints during optimization for scanning beam proton therapy planning...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048503/su-d-204-04-correlations-between-dosimetric-indices-and-follow-up-data-for-salivary-glands-six-months-after-radiation-therapy-for-head-and-neck-cancer
#17
B Chera, A Price, M Kostich, R Amdur, W Mendenhall, N Sheets, R Green, L Marks, S Das, P Mavroidis
PURPOSE: To investigate the correlation between different dosimetric indices of salivary glands (as separate or combined structures) to patient-reported dry mouth 6 months post radiotherapy using the novel patient reported outcome version of the CTCAE (PRO-CTCAE). METHODS: Forty-three patients with oropharyngeal squamous cell carcinoma were treated on a prospective multi-institutional study. All patients received de-intensified 60 Gy intensity modulated radiotherapy...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048474/we-ab-202-01-evaluating-the-toxicity-reduction-with-ct-ventilation-functional-avoidance-radiation-therapy
#18
Y Vinogradskiy, Y Miyasaka, N Kadoya, R Castillo, E Castillo, T Guerrero, T Yamamoto
PURPOSE: CT-ventilation is an exciting new imaging modality that uses 4DCTs to calculate lung ventilation. Studies have proposed to use 4DCT-ventilation imaging for functional avoidance radiotherapy which implies designing treatment plans to spare functional portions of the lung. Although retrospective studies have been performed to evaluate the dosimetric gains to functional lung; no work has been done to translate the dosimetric gains to an improvement in pulmonary toxicity. The purpose of our work was to evaluate the potential reduction in toxicity for 4DCT-ventilation based functional avoidance...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048458/we-h-207b-02-mr-driven-rt-planning
#19
M Cao
: In recent years, steady progress has been made towards the implementation of MRI in external beam radiation therapy for processes ranging from treatment simulation to in-room guidance. Novel procedures relying mostly on MR data are currently implemented in the clinic. This session will cover topics such as (a) commissioning and quality control of the MR in-room imagers and simulators specific to RT, (b) treatment planning requirements, constraints and challenges when dealing with various MR data, (c) quantification of organ motion with an emphasis on treatment delivery guidance, and (d) MR-driven strategies for adaptive RT workflows...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048265/su-g-brc-03-a-novel-multi-criteria-optimization-method-for-volumetric-modulated-arc-therapy-vmat-treatment-planning
#20
G Kirlik, W D'Souza, H Zhang
PURPOSE: To present a novel multi-criteria optimization (MCO) solution approach that generates treatment plans for VMAT. METHODS: We demonstrate our method with generating double-arc VMAT plans for 10 locally advanced head-and-neck cancer cases retrospectively. In our MCO formulation, we defined an objective function for each structure in the treatment volume. This resulted in 9 objective functions, including 3 distinct objectives for primary, high-risk and low-risk target volumes, 5 objectives for each of the organs-at-risk (OARs) (two parotid glands, spinal cord, brain stem and oral cavity), and one for the non-target non-OAR normal tissue...
June 2016: Medical Physics
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