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Radiation therapy planning

C Grassberger, H Paganetti
The variety of treatment options for cancer patients has increased significantly in recent years. Not only do we combine radiation with surgery and chemotherapy, new therapeutic approaches such as immunotherapy and targeted therapies are starting to play a bigger role. Physics has made significant contributions to radiation therapy treatment planning and delivery. In particular, treatment plan optimization using inverse planning techniques has improved dose conformity considerably. Furthermore, medical physics is often the driving force behind tumor control and normal tissue complication modeling...
October 19, 2016: Physics in Medicine and Biology
Thomas B Brunner, Ursula Nestle, Sonja Adebahr, Eleni Gkika, Rolf Wiehle, Dimos Baltas, Anca-Ligia Grosu
OBJECTIVE: Stereotactic radiotherapy near serial organs at risk (OAR) requires special caution. A novel intensity-modulated radiotherapy (IMRT) prescription concept termed simultaneous integrated protection (SIP) for quantifiable and comparable dose prescription to targets very close to OAR is described. MATERIALS AND METHODS: An intersection volume of a planning risk volume (PRV) with the total planning target volume (PTV) defined the protection volume (PTVSIP)...
October 18, 2016: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Laure Vieillevigne, Sandra Bessieres, Monia Ouali, Christel Lanaspeze
PURPOSE: Flattening filter free (FFF) beams are frequently used for stereotactic body radiation therapy with various treatment modalities: conventional static fields, dynamic conformal arc (DCA) or Rapid Arc (RA). The goal of this study was to obtain some criteria to enable a conscious choice of the employment of FFF beams and of the DCA or RA technique, depending on the PTV size. METHODS AND MATERIALS: 24 PTVs from 1.52cm(3) to 445.24cm(3) were studied in various sites: virtual phantom, lung and liver...
October 15, 2016: Physica Medica: PM
Wei Yu, Wei Hu, Yongjie Shui, Xiaoyang Zhu, Chao Li, Xiaoqiu Ren, Xueli Bai, Risheng Yu, Li Shen, Tingbo Liang, Lei Zheng, Qichun Wei
OBJECTIVES: To explore the areas at highest risk for postoperative pancreatic cancer local recurrence according to the spatial location of local failures, with the aim to provide a precise target volume for pancreatic cancer adjuvant radiotherapy. METHODS: Patients with pancreatic cancer who had undergone surgery for the primary tumor in pancreas at our institution from January 2010 to August 2015 were retrospectively analyzed. All local recurrences were plotted on the computed tomography (CT) image of a representative patient according to their relative coordinates to superior mesenteric artery (SMA) or celiac axis (CA)...
October 19, 2016: Radiation Oncology
Tamir Ailon, Radmehr Torabi, Charles G Fisher, Laurence D Rhines, Michelle J Clarke, Chetan Bettegowda, Stefano Boriani, Yoshiya J Yamada, Norio Kawahara, Peter P Varga, John H Shin, Arjun Saghal, Ziya L Gokaslan
STUDY DESIGN: Systematic review. OBJECTIVE: To determine evidence-based guidelines for the management of locally recurrent spinal chordoma. SUMMARY OF BACKGROUND DATA: Chordoma of the spine is a low-grade malignant tumor with a strong propensity for local recurrence. Salvage therapy is challenging due to its relentless nature and refractoriness to adjuvant therapies. There are currently no guidelines regarding the best management of recurrent chordoma...
October 15, 2016: Spine
Jun-Feng Wang, Hui Li, Hua Xiong, He Huang, Yan-Mei Zou
The influence of the position and radiation technique on the organs at risk (OARs) in radiotherapy of rectal cancer was evaluated. The relationship between the volume of irradiated small bowel (VSB) and acute bowel toxicity was determined. A total of 97 cases of rectal cancer were retrospectively randomized to receive radiotherapy with the designated treatment positions and radiation plans. Among 64 patients in the supine position, 32 patients were given three-dimensional conformal radiotherapy (3DCR) and 32 patients were subjected to intensity-modulated radiation therapy (IMRT) respectively...
October 2016: Journal of Huazhong University of Science and Technology. Medical Sciences
Katia Pasciuti, Shrinivas Kuthpady, Anne Anderson, Bronagh Best, Saleem Waqar, Subhra Chowdhury
To examine tumor׳s and organ׳s response when different radiotherapy plan techniques are used. Ten patients with confirmed bladder tumors were first treated using 3-dimensional conformal radiotherapy (3DCRT) and subsequently the original plans were re-optimized using the intensity-modulated radiation treatment (IMRT) and volumetric-modulated arc therapy (VMAT)-techniques. Targets coverage in terms of conformity and homogeneity index, TCP, and organs׳ dose limits, including integral dose analysis were evaluated...
October 14, 2016: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Marcus Sonier, William Chu, Nafisha Lalani, Darby Erler, Patrick Cheung, Renee Korol
To develop a volumetric modulated arc therapy (VMAT) treatment planning solution in the treatment of primary renal cell carcinoma and oligometastatic adrenal lesions with stereotactic body radiation therapy. Single-arc VMAT plans (n = 5) were compared with clinically delivered step-and-shoot intensity-modulated radiotherapy (IMRT) with planning target volume coverage normalized between techniques. Target volume conformity, organ-at-risk (OAR) dose, treatment time, and monitor units were compared. A VMAT planning solution, created from a combination of arc settings and optimization constraints, auto-generated treatment plans in a single optimization...
October 13, 2016: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Jaroslaw T Hepel, Kara Lynne Leonard, Howard Safran, Thomas Ng, Angela Taber, Humera Khurshid, Ariel Birnbaum, David E Wazer, Thomas DiPetrillo
PURPOSE: Stereotactic body radiation therapy (SBRT) boost to primary and nodal disease after chemoradiation has potential to improve outcomes for advanced non-small cell lung cancer (NSCLC). A dose escalation study was initiated to evaluate the maximum tolerated dose (MTD). METHODS AND MATERIALS: Eligible patients received chemoradiation to a dose of 50.4 Gy in 28 fractions and had primary and nodal volumes appropriate for SBRT boost (<120 cc and <60 cc, respectively)...
August 31, 2016: International Journal of Radiation Oncology, Biology, Physics
Thomas M Pisansky, Shree Agrawal, Daniel A Hamstra, Bridget F Koontz, Stanley L Liauw, Jason A Efstathiou, Jeff M Michalski, Felix Y Feng, Matthew C Abramowitz, Alan Pollack, Mitchell S Anscher, Drew Moghanaki, Robert B Den, Kevin L Stephans, Anthony L Zietman, W Robert Lee, Michael W Kattan, Andrew J Stephenson, Rahul D Tendulkar
PURPOSE: To determine whether a dose-response relationship exists for salvage radiation therapy (RT) of biochemical failure after prostatectomy for prostate cancer. METHODS AND MATERIALS: Individual data from 1108 patients who underwent salvage RT at 10 academic centers were pooled. The cohort was enriched for selection criteria more likely associated with tumor recurrence in the prostate bed (margin positive and pre-RT prostate-specific antigen [PSA] level of ≤2...
September 3, 2016: International Journal of Radiation Oncology, Biology, Physics
Christina K Speirs, Todd A DeWees, Sana Rehman, Alerson Molotievschi, Maria A Velez, Daniel Mullen, Sandra Fergus, Marco Trovo, Jeffrey D Bradley, Cliff G Robinson
INTRODUCTION: In the randomized trial of standard vs high dose chemoradiotherapy (CRT) for locally advanced non-small cell lung cancer (LA-NSCLC) (RTOG 0617), overall survival (OS) was worse in the high dose arm. While heart dose was suggested as a contributing factor, actionable parameters have not been established. We present an analysis of clinical and dosimetric parameters impacting OS in this patient population, focusing on heart dose. METHODS: Clinical data was collected on 416 patients with LA-NSLC treated at a single institution, with a subset of 333 available treatment plans re-contoured using RTOG normal tissue guidelines...
October 12, 2016: Journal of Thoracic Oncology
Feng Liu, An Tai, Ergun Ahunbay, Elizabeth Gore, Candice Johnstone, X Allen Li
PURPOSE: To quantify interfractional independent motions between multiple primary targets in radiation therapy (RT) of lung cancer and to study the dosimetric benefits of an online adaptive replanning method to account for these variations. METHODS AND MATERIALS: Ninety-five on-treatment diagnostic-quality computed tomography (CT) scans acquired for 9 lung cancer patients treated with image-guided RT (IGRT) using a CT-on-rails (CTVision, Siemens) were analyzed. On each on-treatment CT set, contours of the targets (gross tumor volume, clinical target volume, or involved nodes), and organs at risk were generated by populating the planning contours using an autosegmentation tool (ABAS, Elekta) with manual editing...
September 2, 2016: Practical Radiation Oncology
Apoorva Trivedi, Takamura Ashikaga, Daphne Hard, Jessica Archambault, Martin Lachaine, David T Cooper, Harold James Wallace
PURPOSE: Transperineal ultrasound (TPUS) allows for continuous imaging of the prostate gland, but the accuracy of TPUS has not been rigorously studied. We determined the feasibility of prostate imaging with TPUS and subsequently compared prostate localization with TPUS and computed tomography (CT). METHODS AND MATERIALS: We completed 2 sequential evaluations of TPUS. The feasibility study included 15 men with localized prostate cancer and tested if TPUS adequately imaged the prostate...
September 2, 2016: Practical Radiation Oncology
Lauren Henke, Rojano Kashani, Deshan Yang, Tianyu Zhao, Olga Green, Lindsey Olsen, Vivian Rodriguez, H Omar Wooten, H Harold Li, Yanle Hu, Jeffrey Bradley, Clifford Robinson, Parag Parikh, Jeff Michalski, Sasa Mutic, Jeffrey R Olsen
PURPOSE: To characterize potential advantages of online-adaptive magnetic resonance (MR)-guided stereotactic body radiation therapy (SBRT) to treat oligometastatic disease of the non-liver abdomen and central thorax. METHODS AND MATERIALS: Ten patients treated with RT for unresectable primary or oligometastatic disease of the non-liver abdomen (n=5) or central thorax (n=5) underwent imaging throughout treatment on a clinical MR image guided RT system. The SBRT plans were created on the basis of tumor/organ at risk (OAR) anatomy at initial computed tomography simulation (PI), and simulated adaptive plans were created on the basis of observed MR image set tumor/OAR "anatomy of the day" (PA)...
August 31, 2016: International Journal of Radiation Oncology, Biology, Physics
Georgia Halkett, Moira O'Connor, Sanchia Aranda, Michael Jefford, Susan Merchant, Debra York, Lisa Miller, Penelope Schofield
INTRODUCTION: Patients sometimes present for radiation therapy with high levels of anxiety. Communication skills training may assist radiation therapists to conduct more effective consultations with patients prior to treatment planning and treatment commencement. The overall aim of our research is to examine the effectiveness of a preparatory programme 'RT Prepare' delivered by radiation therapists to reduce patient psychological distress. The purpose of this manuscript was to describe the communication skills workshops developed for radiation therapists and evaluate participants' feedback...
April 21, 2016: Journal of Medical Radiation Sciences
Jenna Dean, Carmen J Hansen, Justin Westhuyzen, Brett Waller, Kirsty Turnbull, Maree Wood, Andrew Last
INTRODUCTION: Inverse-planned intensity modulated radiation therapy (IP-IMRT) has potential benefits over other techniques for tangential intact breast radiotherapy. Possible benefits include increased homogeneity, faster planning time, less inter-planner variability and lower doses to organs at risk (OAR). We therefore conducted a pilot study of previously treated intact breast patients to compare the current forward-planned 'field-in-field' technique (FP-IMRT) with an IP-IMRT alternative...
July 18, 2016: Journal of Medical Radiation Sciences
Gregory P Kalemkerian
Small cell lung cancer (SCLC) is a high-grade neuroendocrine tumor characterized by rapid growth, early metastatic spread, and initial responsiveness to therapy. Although the incidence of SCLC is declining, it remains one of the common causes of cancer-related mortality. Initial evaluation of patients with SCLC should focus on determining the extent of disease and the ability of the patient to tolerate specific therapy. Positron emission tomography (PET) can improve the accuracy of staging and treatment planning in many patients...
October 2016: Seminars in Respiratory and Critical Care Medicine
Amar U Kishan, Percy Lee
Non-small cell lung cancer (NSCLC) is the second most common solid malignancy in the United States of America, and the leading cause of cancer-related mortality. Nearly 15% of patients present with early-stage disease, for which the standard of care is lobectomy. However, the median age at diagnosis ranges from 65 to 74 years, and many patients have significant comorbidities that preclude surgical treatment. Previously, the standard of care for these patients was definitive radiotherapy (RT) with conventional fractionation (i...
October 2016: Seminars in Respiratory and Critical Care Medicine
Hyeon Woo Lim, Tae Hyun Kim, Il Ju Choi, Chan Gyoo Kim, Jong Yeul Lee, Soo Jeong Cho, Hyeon Seok Eom, Sung Ho Moon, Dae Yong Kim
PURPOSE: To assess the clinical outcomes of radiotherapy (RT) using two-dimensional (2D) and three-dimensional conformal RT (3D-CRT) for patients with gastric mucosa-associated lymphoid tissue (MALT) lymphoma to evaluate the effectiveness of involved field RT with moderate-dose and to evaluate the benefit of 3D-CRT comparing with 2D-RT. MATERIALS AND METHODS: Between July 2003 and March 2015, 33 patients with stage IE and IIE gastric MALT lymphoma received RT were analyzed...
September 2016: Radiation Oncology Journal
R Orecchia, A Surgo, M Muto, A Ferrari, G Piperno, M A Gerardi, S Comi, C Garibaldi, D Ciardo, A Bazani, F Golino, F Pansini, C Fodor, P Romanelli, D Maestri, V Scroffi, S Mazza, B A Jereczek-Fossa
PURPOSE: The aim of this retrospective study is to evaluate patient profile, feasibility, and acute toxicity of RadioTherapy (RT) delivered by VERO® in the first 20 months of clinical activity. METHODS: Inclusion criteria: 1) adult patients; 2) limited volume cancer (M0 or oligometastatic); 3) small extracranial lesions; 4) treatment between April 2012 and December 2013 and 5) written informed consent. Two techniques were employed: intensity modulated radiotherapy (IMRT) and stereotactic body radiotherapy (SBRT)...
2016: Ecancermedicalscience
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