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intensity-modulated radiation therapy

A S Talebi, M Maleki, P Hejazi, M Jadidi, R Ghorbani
Background: One of the most significant Intensity Modulated Radiation Therapy treatment benefits is a high target to normal tissue dose ratio. To improve this advantage, an additional accessory such as a compensator is used to deliver doses. Compensator-based IMRT treatment is usually operated with an energy higher than 10 MV. Photoneutrons, which have high linear energy transfer and radiobiological effectiveness, are produced by colliding high-energy photon beams with linear accelerator structures, then they deliver the unwanted doses to patients and staff...
September 2018: Journal of Biomedical Physics & Engineering
Montserrat Pazos, Stephan Schönecker, Daniel Reitz, Paul Rogowski, Maximilian Niyazi, Filippo Alongi, Christiane Matuschek, Michael Braun, Nadia Harbeck, Claus Belka, Stefanie Corradini
Radiation therapy (RT) for breast cancer has dramatically changed over the past years, leading to individualized risk-adapted treatment strategies. Historically, the choice of RT regimen was limited to conventional fractionation protocols using standard tangential fields. Nowadays, technological and technical improvements in modern RT have added a variety of other RT modalities, different fractionation schedules, and individualised treatment volumes to the portfolio of breast RT. This review aims to give a short overview on the main topics which have recently found their way into clinical practice: hypofractionated treatment protocols, accelerated partial breast irradiation (APBI) for low-risk patients, deep inspiration breath hold (DIBH) for maximal heart protection, extent of regional nodal irradiation for high-risk patients, and the implementation of new radiation techniques such as intensity modulated RT (IMRT) and volumetric modulated RT (VMAT)...
August 2018: Breast Care
Scott C Morgan, Karen Hoffman, D Andrew Loblaw, Mark K Buyyounouski, Caroline Patton, Daniel Barocas, Soren Bentzen, Michael Chang, Jason Efstathiou, Patrick Greany, Per Halvorsen, Bridget F Koontz, Colleen Lawton, C Marc Leyrer, Daniel Lin, Michael Ray, Howard Sandler
PURPOSE: The aim of this guideline is to present recommendations regarding moderately hypofractionated (240-340 cGy per fraction) and ultrahypofractionated (500 cGy or more per fraction) radiation therapy for localized prostate cancer. METHODS AND MATERIALS: The American Society for Radiation Oncology convened a task force to address 8 key questions on appropriate indications and dose-fractionation for moderately and ultrahypofractionated radiation therapy, as well as technical issues, including normal tissue dose constraints, treatment volumes, and use of image guided and intensity modulated radiation therapy...
October 9, 2018: Journal of Urology
Henri Azaïs, Charles-Henri Canova, Elie Vesale, Jean-Marc Simon, Geoffroy Canlorbe, Catherine Uzan
OBJECTIVE: To describe a surgical technique for laparoscopic uterine fixation (LUF) to decrease uterine radiation therapy side effects in case of rectal or anal cancer. DESIGN: This video article uses a surgical case to demonstrate the detailed technique. Institutional Review Board approval was not required for this video presentation. SETTING: University hospital. PATIENT(S): A 26-year-old nulliparous female patient diagnosed with rectal adenocarcinoma and liver metastases...
October 2018: Fertility and Sterility
F Böckelmann, M Hammon, S Lettmaier, R Fietkau, C Bert, F Putz
OBJECTIVE: This study aimed to assess the reduction in dose to the penile bulb (PB) achieved by MRI-based contouring following drinking and endorectal balloon (ERB) instructions. PATIENTS AND METHODS: A total of 17 prostate cancer patients were treated with intensity-modulated radiation therapy (IMRT) and interstitial brachytherapy (IBT). CT and MRI datasets were acquired back-to-back based on a 65 cm3 air-filled ERB and drinking instructions. After rigid co-registration of the imaging data, the CT-based planning target volume (PTV) used for treatment planning was retrospectively compared to an MRI-based adaptive PTV and the dose to the PB was determined in each case...
October 12, 2018: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Victor H Lee, Ka-On Lam, Amy T Chang, Tai-Chung Lam, Chi-Leung Chiang, Tsz-Him So, Cheuk-Wai Choi, Anne W Lee
Nasopharyngeal carcinoma of the undifferentiated histologic subtype is endemic and prevalent in southeast Asia. The dramatic improvement of treatment outcomes and overall prognosis during the past few decades has been attributed to advances in disease screening and diagnosis, diagnostic imaging, radiotherapy techniques, use of combination systemic therapy, and dedicated clinical and biomarker surveillance. The current practice of treating patients with advanced locoregional disease using cisplatin concurrent with conventional fractionated radiotherapy, followed by adjuvant cisplatin and fluorouracil, was established in 1998 when the landmark Intergroup-0099 Study demonstrated a survival benefit with the addition of systemic therapy...
October 2018: Journal of Oncology Practice
Ludovic De Marzi, Annalisa Patriarca, Catherine Nauraye, Eric Hierso, Rémi Dendale, Consuelo Guardiola, Yolanda Prezado
PURPOSE: Proton minibeam radiation therapy (pMBRT) is an innovative approach that combines the advantages of minibeam radiation therapy with the more precise ballistics of protons to further reduce the side effects of radiation. One of the main challenges of this approach is the generation of very narrow proton pencil beams with an adequate dose-rate to treat patients within a reasonable treatment time (several minutes) in existing clinical facilities. The aim of this study was to demonstrate the feasibility of implementing pMBRT by combining the pencil beam scanning (PBS) technique with the use of multislit collimators...
September 22, 2018: Medical Physics
Lu-Lu Zhang, Guo-Hong Li, Yi-Yang Li, Zhen-Yu Qi, Ai-Hua Lin, Ying Sun
Purpose: The incidence, risk factors and survival impact of secondary primary malignancies (SPMs) among survivors of nasopharyngeal carcinoma (NPC) treated with definitive intensity-modulated radiation therapy (IMRT) with or without chemotherapy are poorly characterized. Methods and Materials: Consecutive patients (n=6,377) from the big-data intelligence platform at Sun Yat-Sen University Cancer Center, China (in a high-incidence area) with newly diagnosed non-metastatic pathologically proven non-keratinizing undifferentiated NPC treated with IMRT±chemotherapy between January 2003 and June 2013 were retrospectively analyzed...
October 11, 2018: Cancer Research and Treatment: Official Journal of Korean Cancer Association
Jae Ho Kim, Kenneth A Jenrow, Stephen L Brown
Successful anticancer strategies require a differential response between tumor and normal tissue (i.e., a therapeutic ratio). In fact, improving the effectiveness of a cancer therapeutic is of no clinical value in the absence of a significant increase in the differential response between tumor and normal tissue. Although radiation dose escalation with the use of intensity modulated radiation therapy has permitted the maximum tolerable dose for most locally advanced cancers, improvements in tumor control without damaging normal adjacent tissues are needed...
September 2018: Radiation Oncology Journal
A Barateau, N Perichon, J Castelli, U Schick, O Henry, E Chajon, A Simon, C Lafond, R De Crevoisier
BACKGROUND AND PURPOSE: During head-and-neck (H&N) radiotherapy, the parotid glands (PGs) may be overdosed; thus, a tool is required to monitor the delivered dose. This study aimed to assess the dose accuracy of a patient-specific density assignment method (DAM) for dose calculation to monitor the dose to PGs during treatment. PATIENTS AND METHODS: Forty patients with H&N cancer received an intensity modulated radiation therapy (IMRT), among whom 15 had weekly CTs...
October 9, 2018: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Minoru Nakatsugawa, Zhi Cheng, Ana Kiess, Amanda Choflet, Michael Bowers, Kazuki Utsunomiya, Shinya Sugiyama, John Wong, Harry Quon, Todd McNutt
BACKGROUND: and Purpose: Clinical data collection and development of outcome prediction models by machine learning can form the foundation for a learning health system offering precision radiotherapy. However, changes in clinical practice over time can affect the measures and outcomes of patients and hence the collected data. We hypothesize that regular prediction model updates along with continuous prospective data collection is important to prevent the degradation of a model's predication accuracy...
October 6, 2018: International Journal of Radiation Oncology, Biology, Physics
Susan L Tucker, Ting Xu, Harald Paganetti, Timo Deist, Vivek Verma, Noah Choi, Radhe Mohan, Zhongxing Liao
PURPOSE: To confirm the superiority of effective dose (Deff ) over mean lung dose (MLD) for predicting risk of radiation pneumonitis (RP), using data from patients on a randomized trial of intensity-modulated radiotherapy (IMRT) versus passively scattered proton therapy (PSPT). METHODS: The prescribed target dose for the 203 evaluated patients was 66-74 Gy(RBE) in 33-37 fractions with concurrent carboplatin/paclitaxel. Time to grade >2 RP was computed from the start of radiotherapy, with disease recurrence or death considered censoring events...
October 3, 2018: International Journal of Radiation Oncology, Biology, Physics
Xiaofeng He, Pengfei Zhang, Zhiping Li, Feng Bi, Feng Xu, Xin Wang, Yali Shen, Qiu Li, Meng Qiu
The purpose of the present study was to investigate the efficacy and safety of radiotherapy for patients with oligometastases from colorectal cancer (CRC).This was a retrospective cross-sectional study. Patients with liver and/or lung oligometastatic lesions from CRC treated with curative-intent radiotherapy in West China Hospital, Sichuan University, between 2009 and 2013 were included. Radiotherapy modality included 3-dimensional conformal radiation therapy (3D-CRT), intensity-modulated radiation therapy (IMRT), and stereotactic body radiation therapy (SBRT); simultaneous chemotherapies along with radiotherapy of metastasis were allowed...
October 2018: Medicine (Baltimore)
Peng Jin, Koen F Crama, Jorrit Visser, Niek van Wieringen, Arjan Bel, Maarten C C M Hulshof, Tanja Alderliesten
PURPOSE: To investigate the dosimetric effect of variable gas volume in esophageal cancer radiation therapy (RT) and whether a density override (DO) in treatment planning can effectively mitigate this dosimetric effect. MATERIAL AND METHODS: Nine patients with gastrointestinal gas pockets in the planning computed tomography (pCT) were retrospectively included. Per patient, the intensity-modulated RT (IMRT) and volumetric-modulated arc therapy (VMAT) plans associated with no DO, DO = 0...
October 5, 2018: Acta Oncologica
Cheng-Yun Yao, Guo-Ren Zhou, Li-Jun Wang, Jian-Hua Xu, Jin-Jun Ye, Lan-Fang Zhang, Xia He, Zhen-Zhang Chen, Sheng-Fu Huang
BACKGROUND: Radiation therapy is the standard radical treatment for nasopharyngeal carcinoma (NPC) but also causes transient as well as long-term complications. Patients who develop severe radiation-induced brainstem injuries have a poor prognosis due to the lack of effective medical therapies. However, the relationship between brainstem injury and radiation volume dose is unknown. In this study, we found that radiation-induced brainstem injury was significantly associated with brainstem dose per unit volume...
October 3, 2018: Radiation Oncology
Xufeng Guo, Wentao Fang, Zhigang Li, Zhengtao Yu, Tiehua Rong, Jianhua Fu, Yongtao Han, Lijie Tan, Chun Chen, Shuoyan Liu, Yongde Liao, Gaoming Xiao, Yucheng Wei, Chengchu Zhu, Hecheng Li, Jinhua Luo, Wenqun Xing
Histologically node negative esophageal squamous cell carcinoma (pN0 ESCC) after radical resection still carries a significant risk of recurrence, especially in high-risk patients. Our previous study showed that the risk of recurrence was associated with tumor location and cell differentiation, as well as the presence of lymphovascular invasion. Most recurrence occurs within two years after surgery. There is still a lack of knowledge on the risks or potential benefits of postoperative adjuvant therapies for high-risk pN0 ESCC patients...
October 1, 2018: Thoracic Cancer
Weiping Wang, Fuquan Zhang, Ke Hu, Xiaorong Hou
OBJECTIVE: Image guidance should be used for patients with cervical cancer treated with definitive intensity-modulated radiation therapy (IMRT). In this study, we provided a pattern of image guidance and verified it in a large population. METHODS: We retrospectively analyzed patients with stages IB1-IVA cervical cancer treated with IMRT combined with high-dose brachytherapy and concurrent chemotherapy in our institute from January 2005 to December 2015. A dose of 50...
September 25, 2018: Gynecologic Oncology
Yi Bin Pan, Yasuko Maeda, Ana Wilson, Rob Glynne-Jones, Carolynne J Vaizey
INTRODUCTION: There is a paucity of data on incidence and mechanisms of long-term gastrointestinal consequences after chemoradiotherapy for anal cancer. Most of the adverse effects reported were based on traditional external beam radiotherapy whilst only short-term follow-ups have been available for intensity-modulated radiotherapy, and there is lack of knowledge about consequences of dose-escalation radiotherapy. METHOD: A systematic literature review. RESULTS: Two thousand nine hundred and eighty-five titles (excluding duplicates) were identified through the search; 130 articles were included in this review...
September 28, 2018: Acta Oncologica
Minsik Lee, Kai Ding, Byong Yong Yi
 Purpose: It has been proven that portal dosimetry can be derived from a mirror-based fluorescent EPID system by applying multiple kernels that are position dependent. The purpose of this study is to show that patient-specific IMRT/VMAT verification with a single kernel which is acquired from a series of output measurements of a few field sizes is feasible using a commercially available phosphor-screen-based geometric QA system. 
 Methods: The optical scatter component in the RavenQA<sup>TM</sup> (LAP GmbH Laser Applications; Lüneberg, Germany) is corrected by deconvolution with a two-dimenstional (2D) spatially invariant single optical scatter kernel (OSK)...
September 26, 2018: Physics in Medicine and Biology
Ravindra Yaparpalvi, Nitin Ohri, Wolfgang A Tomé, Shalom Kalnicki
INTRODUCTION: In this study, we catalogued physics contributions in the Red Journal over the past three decades and compared publication trends with global publication trends. METHODS: We used the website of the Red Journal (International Journal of Radiation Oncology, Biology, and Physics) to access physics contributions published between 1988 and 2017. The contributions were catalogued following taxonomy guidelines endorsed by the American Association of Physicists in Medicine...
July 20, 2018: Curēus
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