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https://www.readbyqxmd.com/read/29453893/cbct-guided-evolutive-library-for-cervical-adaptive-imrt
#1
Bastien Rigaud, Antoine Simon, Maxime Gobeli, Caroline Lafond, Julie Leseur, Anais Barateau, Nicolas Jaksic, Joël Castelli, Danièle Williaume, Pascal Haigron, Renaud De Crevoisier
PURPOSE: In the context of adaptive radiation therapy (ART) for locally advanced cervical carcinoma (LACC), this study proposed an original cone-beam computed tomography (CBCT)-guided "Evolutive library" and evaluated it against four other known radiotherapy (RT) strategies. MATERIAL AND METHODS: For 20 patients who underwent intensity-modulated radiation therapy (IMRT) for LACC, three planning CTs (with empty [EB], intermediate [IB], and full [FB] bladder volumes), a CT scan at 20 Gy and bi-weekly CBCTs for 5 weeks were performed...
February 17, 2018: Medical Physics
https://www.readbyqxmd.com/read/29452869/three-dimensional-printer-aided-casting-of-soft-custom-silicone-boluses-scsbs-for-head-and-neck-radiation-therapy
#2
Tsuicheng Chiu, Jun Tan, Mathew Brenner, Xuejun Gu, Ming Yang, Kenneth Westover, Tobin Strom, David Sher, Steve Jiang, Bo Zhao
PURPOSE: Custom tissue compensators provide dosimetric advantages for treating superficial or complex anatomy, but currently available fabrication technology is expensive or impractical for most clinical operations and yields compensators that are difficult for patients to tolerate. We aimed to develop an inexpensive, clinically feasible workflow for generating patient-specific, soft, custom silicone boluses (SCSBs) for head-and-neck (HN) radiation therapy. METHODS AND MATERIALS: We developed a method using 3-dimensional printed parts for generating SCSBs for the treatment of HN cancers...
November 11, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29452868/chest-wall-dose-reduction-using-noncoplanar-volumetric-modulated-arc-radiation-therapy-for-lung-stereotactic-ablative-radiation-therapy
#3
Amy S Yu, Peter G Maxim, Billy W Loo, Michael F Gensheimer
PURPOSE: Stereotactic ablative radiation therapy (SABR) to lung tumors close to the chest wall can cause rib fractures or chest wall pain. We evaluated and propose a clinically practical solution of using noncoplanar volumetric modulated arc radiation therapy (VMAT) to reduce chest wall dose from lung SABR. METHODS AND MATERIALS: Twenty lung SABR VMAT plans in which the chest wall volume receiving 30 Gy or higher (V30) exceeded 30 mL were replanned by noncoplanar VMAT with opposite 15° couch kicks...
December 19, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29452866/intrapatient-study-comparing-3d-printed-bolus-versus-standard-vinyl-gel-sheet-bolus-for-postmastectomy-chest-wall-radiation-therapy
#4
James L Robar, Kathryn Moran, James Allan, James Clancey, Tami Joseph, Krista Chytyk-Praznik, R Lee MacDonald, John Lincoln, Parisa Sadeghi, Robert Rutledge
PURPOSE: This patient study evaluated the use of 3-dimensional (3D) printed bolus for chest wall radiation therapy compared with standard sheet bolus with regard to accuracy of fit, surface dose measured in vivo, and efficiency of patient setup. By alternating bolus type over the course of therapy, each patient served as her own control. METHODS AND MATERIALS: For 16 patients undergoing chest wall radiation therapy, a custom 5.0 mm thick bolus was designed based on the treatment planning computed tomography scan and 3D printed using polylactic acid...
December 24, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29452770/single-arm-phase-2-trial-of-elective-nodal-dose-reduction-for-patients-with-locoregionally-advanced-squamous-cell-carcinoma-of-the-head-and-neck
#5
Patrick D Maguire, Charles R Neal, Stuart M Hardy, Andrew M Schreiber
PURPOSE: To evaluate a novel chemoradiation therapy (CRT) regimen for patients with squamous cell carcinoma of the head and neck (SCCHN) incorporating a lower intensity modulated radiation therapy dose to electively treated neck lymph nodes than is currently standard. METHODS AND MATERIALS: Eligible patients had locally advanced SCCHN of the oral cavity, oropharynx, larynx, or hypopharynx. The 7-week CRT course consisted of weekly cisplatin at 35 mg/m 2 concurrently with sequential-boost intensity modulated radiation therapy: 36 Gy to high- and low-risk planning target volumes followed by a sequential boost to the high-risk planning target volume to 70 Gy...
December 28, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29450811/debulking-surgery-of-pituitary-adenoma-as-a-strategy-to-facilitate-definitive-stereotactic-radiosurgery
#6
Neil Forster, Ronald Warnick, Vinita Takiar, Luke Pater, John Breneman
In patients with pituitary adenomas (PA) who are unable to undergo complete surgical resection, radiation therapy (RT), specifically stereotactic radiosurgery (SRS), results in excellent local control. However, the utility of radiosurgery may be limited by the proximity of the lesion to the optic chiasm (OC). We evaluate the efficacy of debulking surgery in increasing the PA-OC separation to convert patients into SRS candidates. From 2007 to 2015, 31 patients with PA < 2 mm from the OC underwent debulking surgery followed by RT within 2 years of resection...
February 15, 2018: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29447260/optimal-dose-reduction-algorithm-using-an-attenuation-based-tube-current-modulation-method-for-cone-beam-ct-imaging
#7
Kihong Son, Jieun Chang, Hoyeon Lee, Changhwan Kim, Taewon Lee, Seungryong Cho, Sohyun Park, Jin Sung Kim
To reduce the radiation dose given to patients, a tube current modulation (TCM) method has been widely used in diagnostic CT systems. However, the TCM method has not yet been applied to a kV-CBCT system on a LINAC machine. The purpose of this study is to investigate if a TCM method would be desirable in a kV-CBCT system for image-guided radiation therapy (IGRT) or not. We have developed an attenuation-based TCM method using prior knowledge from planning CT images of patients. The TCM method can provide optimized dose reductions without degrading image quality for kV-CBCT imaging...
2018: PloS One
https://www.readbyqxmd.com/read/29445728/radiation-induced-cardiovascular-disease-mechanisms-and-importance-of-linear-energy-transfer
#8
REVIEW
Christopher B Sylvester, Jun-Ichi Abe, Zarana S Patel, K Jane Grande-Allen
Radiation therapy (RT) in the form of photons and protons is a well-established treatment for cancer. More recently, heavy charged particles have been used to treat radioresistant and high-risk cancers. Radiation treatment is known to cause cardiovascular disease (CVD) which can occur acutely during treatment or years afterward in the form of accelerated atherosclerosis. Radiation-induced cardiovascular disease (RICVD) can be a limiting factor in treatment as well as a cause of morbidity and mortality in successfully treated patients...
2018: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29444693/monitoring-of-mechanical-errors-and-their-dosimetric-impact-throughout-the-course-of-non-coplanar-continuous-volumetric-modulated-arc-therapy
#9
Hideaki Hirashima, Mitsuhiro Nakamura, Yuki Miyabe, Megumi Uto, Kiyonao Nakamura, Takashi Mizowaki
BACKGROUND: Volumetric-modulated Dynamic WaveArc therapy (VMDWAT) is a non-coplanar continuous volumetric modulated radiation therapy (VMAT) delivery technique. Here, we monitored mechanical errors and their impact on dose distributions in VMDWAT using logfiles throughout the course of treatment. METHODS: Fifteen patients were enrolled (2 skull base tumor patients and 13 prostate cancer patients). VMDWAT plans were created for the enrolled patients. The prescribed dose for the skull base tumor was set as 54 Gy at 1...
February 14, 2018: Radiation Oncology
https://www.readbyqxmd.com/read/29441104/current-status-of-brachytherapy-in-cancer-treatment-short-overview
#10
REVIEW
Janusz Skowronek
Cancer incidence and mortality depend on a number of factors, including age, socio-economic status and geographical location, and its prevalence is growing around the world. Most of cancer treatments include external beam radiotherapy or brachytherapy. Brachytherapy, a type of radiotherapy with energy from radionuclides inserted directly into the tumor, is increasingly used in cancer treatment. For cervical and skin cancers, it has become a standard therapy for more than 100 years as well as an important part of the treatment guidelines for other malignancies, including head and neck, skin, breast, and prostate cancers...
December 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/29439305/strategic-application-of-radiotherapy-for-hepatocellular-carcinoma
#11
Seo Hee Choi, Jinsil Seong
With increasing clinical use, radiotherapy (RT) has been considered reliable and effective method for hepatocellular carcinoma (HCC) treatment, depending on extent of disease and patient characteristics. RT for HCC can improve therapeutic outcomes through excellent local control, downstaging, conversion from unresectable to resectable status, and treatments of unresectable HCCs with vessel invasion or multiple intrahepatic metastases. In addition, further development of modern RT technologies, including image-guided radiotherapy (IGRT), intensity-modulated radiotherapy (IMRT), and stereotactic body radiotherapy, has expanded the indication of RT...
February 14, 2018: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/29436163/using-geud-based-plan-analysis-method-to-evaluate-proton-vs-photon-plans-for-lung-cancer-radiation-therapy
#12
Zhiyan Xiao, Wei J Zou, Ting Chen, Ning J Yue, Salma K Jabbour, Rahul Parikh, Miao Zhang
The goal of this study was to exam the efficacy of current DVH based clinical guidelines draw from photon experience for lung cancer radiation therapy on proton therapy. Comparison proton plans and IMRT plans were generated for 10 lung patients treated in our proton facility. A gEUD based plan evaluation method was developed for plan evaluation. This evaluation method used normal lung gEUD(a) curve in which the model parameter "a" was sampled from the literature reported value. For all patients, the proton plans delivered lower normal lung V5 Gy with similar V20 Gy and similar target coverage...
February 13, 2018: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/29432550/strategies-for-prediction-and-mitigation-of-radiation-induced-liver-toxicity
#13
Diego A S Toesca, Bulat Ibragimov, Amanda J Koong, Lei Xing, Albert C Koong, Daniel T Chang
Although well described in the 1960s, liver toxicity secondary to radiation therapy, commonly known as radiation-induced liver disease (RILD), remains a major challenge. RILD encompasses two distinct clinical entities, a 'classic' form, composed of anicteric hepatomegaly, ascites and elevated alkaline phosphatase; and a 'non-classic' form, with liver transaminases elevated to more than five times the reference value, or worsening of liver metabolic function represented as an increase of 2 or more points in the Child-Pugh score classification...
February 8, 2018: Journal of Radiation Research
https://www.readbyqxmd.com/read/29432473/setup-in-a-clinical-workflow-and-impact-on-radiotherapy-routine-of-an-in-vivo-dosimetry-procedure-with-an-electronic-portal-imaging-device
#14
Jie Li, Angelo Piermattei, Pei Wang, Shengwei Kang, Mingyong Xiao, Bin Tang, Xiongfei Liao, Xin Xin, Mattia Grusio, Lucia Clara Orlandini
High conformal techniques such as intensity-modulated radiation therapy and volumetric-modulated arc therapy are widely used in overloaded radiotherapy departments. In vivo dosimetric screening is essential in this environment to avoid important dosimetric errors. This work examines the feasibility of introducing in vivo dosimetry (IVD) checks in a radiotherapy routine. The causes of dosimetric disagreements between delivered and planned treatments were identified and corrected during the course of treatment...
2018: PloS One
https://www.readbyqxmd.com/read/29431867/spatially-fractionated-grid-radiation-therapy-using-proton-pencil-beam-scanning-pbs-feasibility-study-and-clinical-implementation
#15
M Gao, M M Mohiuddin, W F Hartsell, M Pankuch
PURPOSE: GRID therapy is an effective treatment for bulky tumors. Linear accelerator (Linac)-produced photon beams collimated through blocks or multi-leaf collimators (MLCs) are the most common methods used to deliver this therapy. Utilizing the newest proton delivery method of pencil beam scanning (PBS) can further improve the efficacy of GRID therapy. In this study, we developed a method of delivering GRID therapy using proton PBS, evaluated the dosimetry of this novel technique and applied this method in two clinical cases...
February 12, 2018: Medical Physics
https://www.readbyqxmd.com/read/29431573/palliative-care-specialist-series-top-10-tips-palliative-care-clinicians-should-know-about-radiation-oncology
#16
Kavita V Dharmarajan, Shayna E Rich, Candice A Johnstone, Lauren M Hertan, Randy Wei, Lauren E Colbert, Joshua A Jones, Arif H Kamal, Christopher A Jones
As palliative care (PC) moves upstream in the course of advanced illness, it is critical that PC providers have a broad understanding of curative and palliative treatments for serious diseases. Possessing a working knowledge of radiation therapy (RT), one of the three pillars of cancer care, is crucial to PC providers given RT's role in both the curative and palliative settings. This article provides PC providers with a primer on the vocabulary of RT; the team of people involved in the planning of RT; and common indications, benefits, and side effects of treatment...
February 12, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29431250/esophagitis-associated-with-multimodality-management-of-pediatric-ewing-sarcoma-of-thorax
#17
Vibhuti Agarwal, Natalie Logie, Christopher G Morris, Julie A Bradley, Ronny L Rotondo, Scott M Bradfield, Daniel J Indelicato
BACKGROUND: Ewing sarcoma of the thoracic spine and chest wall is frequently treated with concurrent chemotherapy and radiation therapy (RT). Treatment-related acute esophagitis can lead to hospitalization and treatment delays. The aim of this study was to analyze the incidence, risk factors, and management of esophagitis in pediatric patients with Ewing sarcoma of the thoracic region. METHODS: We conducted a single-institution retrospective review of patients treated over a 10-year period...
February 12, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29429922/five-years-experience-with-a-customized-electronic-checklist-for-radiation-therapy-planning-quality-assurance-in-a-multicampus-institution
#18
Sean L Berry, Kevin P Tierney, Sharif Elguindi, James G Mechalakos
INTRODUCTION: An electronic checklist has been designed with the intention of reducing errors while minimizing user effort in completing the checklist. We analyze the clinical use and evolution of the checklist over the past 5 years and review data in an incident learning system (ILS) to investigate whether it has contributed to an improvement in patient safety. METHODS AND MATERIALS: The checklist is written as a standalone HTML application using VBScript. User selection of pertinent demographic details limits the display of checklist items only to those necessary for the particular clinical scenario...
December 24, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29428258/the-first-clinical-implementation-of-real-time-image-guided-adaptive-radiotherapy-using-a-standard-linear-accelerator
#19
Paul J Keall, Doan Trang Nguyen, Ricky O'Brien, Vincent Caillet, Emily Hewson, Per Rugaard Poulsen, Regina Bromley, Linda Bell, Thomas Eade, Andrew Kneebone, Jarad Martin, Jeremy T Booth
PURPOSE: Until now, real-time image guided adaptive radiation therapy (IGART) has been the domain of dedicated cancer radiotherapy systems. The purpose of this study was to clinically implement and investigate real-time IGART using a standard linear accelerator. MATERIALS/METHODS: We developed and implemented two real-time technologies for standard linear accelerators: (1) Kilovoltage Intrafraction Monitoring (KIM) that finds the target and (2) multileaf collimator (MLC) tracking that aligns the radiation beam to the target...
February 7, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/29427312/evaluation-of-surface-and-shallow-depth-dose-reductions-using-a-superflab-bolus-during-conventional-and-advanced-external-beam-radiotherapy
#20
Jihyung Yoon, Yibo Xie, Rui Zhang
The purpose of this study was to evaluate a methodology to reduce scatter and leakage radiations to patients' surface and shallow depths during conventional and advanced external beam radiotherapy. Superflab boluses of different thicknesses were placed on top of a stack of solid water phantoms, and the bolus effect on surface and shallow depth doses for both open and intensity-modulated radiotherapy (IMRT) beams was evaluated using thermoluminescent dosimeters and ion chamber measurements. Contralateral breast dose reduction caused by the bolus was evaluated by delivering clinical postmastectomy radiotherapy (PMRT) plans to an anthropomorphic phantom...
February 10, 2018: Journal of Applied Clinical Medical Physics
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