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Radiation, proton therapy

Justin M Famoso, Brady Laughlin, Ali McBride, Victor J Gonzalez
Purpose: Breast fibrosis is a common late effect after therapeutic irradiation that can result in pain, poor cosmesis, and functional impairment. Randomized trials have demonstrated that radiation fibrosis may be preventable with a medication regimen of pentoxifylline and vitamin E. This study investigates patient compliance with pentoxifylline therapy while examining possible correlations to compliance. Methods and materials: We identified 90 patients who were prescribed pentoxifylline (400 mg 3 times daily) and vitamin E (400 IU once daily) after adjuvant breast radiation...
January 2018: Advances in Radiation Oncology
Chenbin Liu, Steven E Schild, Joe Y Chang, Zhongxing Liao, Shawn Korte, Jiajian Shen, Xiaoning Ding, Yanle Hu, Yixiu Kang, Sameer R Keole, Terence T Sio, William W Wong, Narayan Sahoo, Martin Bues, Wei Liu
PURPOSE: To investigate how spot size and spacing affect plan quality, robustness, and interplay effects of robustly optimized intensity modulated proton therapy (IMPT) for lung cancer. METHODS AND MATERIALS: Two robustly optimized IMPT plans were created for 10 lung cancer patients: first by a large-spot machine with in-air energy-dependent large spot size at isocenter (σ: 6-15 mm) and spacing (1.3 σ), and second by a small-spot machine with in-air energy-dependent small spot size (σ: 2-6 mm) and spacing (5 mm)...
February 14, 2018: International Journal of Radiation Oncology, Biology, Physics
Sweet Ping Ng, Joseph M Herman
Pancreatic cancer is a devastating disease with poor survival outcomes. Recent studies have shown that the addition of radiotherapy to chemotherapy in the setting of locally advanced pancreatic cancer did not improve overall survival outcome. These studies commonly utilize conventional radiotherapy treatment fractionation and technique (typically 3-D conformal radiotherapy or intensity modulated radiotherapy). Although no clear benefit in overall survival was demonstrated in those studies, those who received radiotherapy did have a clear benefit in terms of local control...
March 16, 2018: Cancers
Krista C J Wink, Erik Roelofs, Charles B Simone, David Dechambre, Alina Santiago, Judith van der Stoep, Wim Dries, Julia Smits, Stephen Avery, Filippo Ammazzalorso, Nicolas Jansen, Urszula Jelen, Timothy Solberg, Dirk de Ruysscher, Esther G C Troost
PURPOSE: To compare dose to organs at risk (OARs) and dose-escalation possibility for 24 stage I non-small cell lung cancer (NSCLC) patients in a ROCOCO (Radiation Oncology Collaborative Comparison) trial. METHODS: For each patient, 3 photon plans [Intensity-modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT) and CyberKnife], a double scattered proton (DSP) and an intensity-modulated carbon-ion (IMIT) therapy plan were created. Dose prescription was 60 Gy (equivalent) in 8 fractions...
March 12, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Atallah Baydoun, Neha Vapiwala, Lee E Ponsky, Musaddiq Awan, Ali Kassaee, David Sutton, Tarun K Podder, Yuxia Zhang, Donald Dobbins, Raymond F Muzic, Bryan Traughber, Mitchell Machtay, Rodney Ellis
PURPOSE: We conducted this dosimetric analysis to evaluate the feasibility of a multi-center stereotactic body radiation therapy (SBRT) trial for renal cell carcinoma (RCC) using different SBRT platforms. MATERIALS/METHODS: The computed tomography (CT) simulation images of 10 patients with unilateral RCC previously treated on a Phase 1 trial at Institution 1 were anonymized and shared with Institution 2 after IRB approval. Treatment planning was generated through five different platforms aiming a total dose of 48 Gy in three fractions...
March 14, 2018: Journal of Applied Clinical Medical Physics
Keiji Kobashi, Anussara Prayongrat, Takuya Kimoto, Chie Toramatsu, Yasuhiro Dekura, Norio Katoh, Shinichi Shimizu, Yoichi M Ito, Hiroki Shirato
Modern radiotherapy technologies such as proton beam therapy (PBT) permit dose escalation to the tumour and minimize unnecessary doses to normal tissues. To achieve appropriate patient selection for PBT, a normal tissue complication probability (NTCP) model can be applied to estimate the risk of treatment-related toxicity relative to X-ray therapy (XRT). A methodology for estimating the difference in NTCP (∆NTCP), including its uncertainty as a function of dose to normal tissue, is described in this study using the Delta method, a statistical method for evaluating the variance of functions, considering the variance-covariance matrix...
March 12, 2018: Journal of Radiation Research
Sahaja Acharya, Clifford G Robinson, Jeff M Michalski, Dan Mullen, Todd A DeWees, Jian L Campian, Anupama Chundury, Beth Bottani, Dennis E Hallahan, Jeffrey D Bradley, Jiayi Huang
PURPOSE: To analyze the incidence of and risk factors for clinically significant radiation necrosis (cRN) in adult cranial oligodendrogliomas and astrocytomas treated with proton or photon therapy. METHODS AND MATERIALS: Between 2007 and 2015, 160 patients with grade 2 or 3 oligodendrogliomas (with 1p/19q codeletion, n = 53) or astrocytomas (without 1p/19q codeletion, n = 107) were treated with proton (n = 37) or photon (n = 123) therapy. Clinically significant radiation necrosis (RN) was defined as symptomatic RN or asymptomatic RN that resulted in surgery or bevacizumab administration...
February 9, 2018: International Journal of Radiation Oncology, Biology, Physics
Angelo Castello, Laura Olivari, Egesta Lopci
Surgery, radiation therapy and chemotherapy are the oldest modalities for cancer treatment. However, as part of a continuous research in medicine, in order to improve therapeutic precision and biological effectiveness, there is an increasing interest into the use of heavy particle (e.g. protons or heavy ions) in the treatment of solid tumors. However, the restricted availability of the technology has concentrated the expertise in highly specialized centers that take care and treat extreme cases and rare pathologies...
2018: American Journal of Nuclear Medicine and Molecular Imaging
Olivier van Wulfften Palthe, Kyung-Wook Jee, Jos A M Bramer, Francis J Hornicek, Yen-Lin E Chen, Joseph H Schwab
BACKGROUND: Effects of high-dose radiation using protons and photons on bone are relatively unexplored, but high rates of insufficiency fractures are reported, and the causes of this are incompletely understood. Imaging studies with pre- and postradiation scans can help one understand the effect of radiation on bone. QUESTIONS/PURPOSES: The purpose of this study was to assess the effects of high-dose radiation on the trabecular density of bone in the sacrum using CT-derived Hounsfield units (HU)...
March 2018: Clinical Orthopaedics and related Research
Agata Tobola-Galus, Jan Swakon, Pawel Olko
The aim of these studies was to investigate depth dose distribution of a 60 MeV proton beam formed by a set of dedicated mesh-formed collimators. The set of mini-beams formed by the mesh is scattered in the tissue and lead to uniform energy deposition in the target volume. The rationale is to protect the eyelid skin from complications after hypofractionated radiation therapy. The experimental verification of the depth dose distribution for collimators of 1-3 mm mesh size was performed in solid state and water phantoms on 60 MeV proton beam from the AIC-144 cyclotron...
February 24, 2018: Radiation Protection Dosimetry
Saumya S Gurbani, Eduard Schreibmann, Andrew A Maudsley, James Scott Cordova, Brian J Soher, Harish Poptani, Gaurav Verma, Peter B Barker, Hyunsuk Shim, Lee A D Cooper
PURPOSE: Proton MRSI is a noninvasive modality capable of generating volumetric maps of in vivo tissue metabolism without the need for ionizing radiation or injected contrast agent. Magnetic resonance spectroscopic imaging has been shown to be a viable imaging modality for studying several neuropathologies. However, a key hurdle in the routine clinical adoption of MRSI is the presence of spectral artifacts that can arise from a number of sources, possibly leading to false information...
March 9, 2018: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Beat Bojaxhiu, Frank Ahlhelm, Marc Walser, Lorenzo Placidi, Ulrike Kliebsch, Lorentzos Mikroutsikos, Petra Morach, Alessandra Bolsi, Tony Lomax, Alessia Pica, Damien C Weber
PURPOSE: To assess the rate of radiation necrosis (RN) and white matter lesions (WMLs) in pediatric patients with primary brain tumors treated with pencil beam scanning (PBS) proton therapy (PT) with or without concomitant chemotherapy at the PSI. METHODS AND MATERIALS: Between 1999 and 2015, 171 pediatric patients (age <18 years) were treated with PT. Median age at diagnosis was 3.3 years (range, 0.3-17.0 years), and the median delivered dose was 54 Gy (relative biological effectiveness) (range, 40...
March 15, 2018: International Journal of Radiation Oncology, Biology, Physics
Radhe Mohan, Kathryn D Held, Michael D Story, David Grosshans, Jacek Capala
In April 2016, the National Cancer Institute hosted a multidisciplinary workshop to discuss the current knowledge of the radiobiological aspects of charged particles used in cancer therapy to identify gaps in that knowledge that might hinder the effective clinical use of charged particles and to propose research that could help fill those gaps. The workshop was organized into 10 topics ranging from biophysical models to clinical trials and included treatment optimization, relative biological effectiveness of tumors and normal tissues, hypofractionation with particles, combination with immunotherapy, "omics," hypoxia, and particle-induced second malignancies...
March 15, 2018: International Journal of Radiation Oncology, Biology, Physics
Koji Kase, Ryo Okada, Makoto Muto, Junichiro Watanabe, Naoya Sato, Yasuhide Kofunato, Teruhide Ishigame, Takashi Kimura, Akira Kenjo, Tatsuo Shimura, Shigeru Marubashi
We hereby report a case of long-term survival of the pancreatic tail cancer with a synchronous small liver metastasis. A 62- year-old male with pancreatic tail cancer was incidentally diagnosed with single tiny metastasis in the left medial section of the liver duringthe distal pancreatectomy. The lesion was also resected together with primary lesion. Since then, systemic chemotherapies such as gemcitabine(GEM)plus S-1 combination therapy, GEM alone therapy and S-1 alone therapy had been given to escape from recurrence...
February 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Reshma Munbodh, Jonathan P S Knisely, David A Jaffray, Douglas J Moseley
PURPOSE: We present and evaluate a fully automated 2D-3D intensity-based registration framework using a single limited field-of-view (FOV) 2D kV radiograph and a 3D kV CBCT for 3D estimation of patient setup errors during brain radiotherapy. METHODS: We evaluated two similarity measures, the Pearson correlation coefficient on image intensity values (ICC) and maximum likelihood measure with Gaussian noise (MLG), derived from the statistics of transmission images...
February 22, 2018: Medical Physics
Amanda F Saltzman, Nicholas G Cost
PURPOSE OF REVIEW: Rhabdomyosarcoma (RMS) is the most common sarcoma diagnosed in the first 20 years of life; bladder/prostate (BP) RMS accounts for 5% of all cases. Through efforts from multiple cooperative study groups, survival has improved significantly. This article aims to review the complex RMS classification system and treatment of BP RMS, with a focus on developing aspects of treatment. RECENT FINDINGS: Recent advancements in technology are responsible for most of the progress in RMS treatment...
February 22, 2018: Current Urology Reports
Aline I Riechardt, Julian P Klein, Dino Cordini, Jens Heufelder, Matus Rehak, Ira Seibel, Antonia M Joussen
PURPOSE: This study aims to analyze the effect of salvage proton beam therapy for the treatment of recurrent iris melanoma. METHOD: In this clinical case series, we retrospectively analyzed the data of eight patients who underwent proton beam therapy of the whole anterior segment as salvage therapy between 2000 and 2016 for recurrent iris melanoma after resection, ruthenium brachytherapy, or sector proton beam therapy. Two patients received salvage proton beam therapy for repeated tumor relapse...
February 20, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
Seán Walsh, Erik Roelofs, Peter Kuess, Yvonka van Wijk, Ben Vanneste, Andre Dekker, Philippe Lambin, Bleddyn Jones, Dietmar Georg, Frank Verhaegen
We present a methodology which can be utilized to select proton or photon radiotherapy in prostate cancer patients. Four state-of-the-art competing treatment modalities were compared (by way of an in silico trial) for a cohort of 25 prostate cancer patients, with and without correction strategies for prostate displacements. Metrics measured from clinical image guidance systems were used. Three correction strategies were investigated; no-correction, extended-no-action-limit, and online-correction. Clinical efficacy was estimated via radiobiological models incorporating robustness (how probable a given treatment plan was delivered) and stability (the consistency between the probable best and worst delivered treatments at the 95% confidence limit)...
February 18, 2018: Cancers
Clarissa Gillmann, Antony J Lomax, Damien C Weber, Oliver Jäkel, Christian P Karger
PURPOSE: To derive the dose-response curve for temporal lobe reactions (TLRs) after proton therapy and to compare the resulting relative biological effectiveness (RBE)-weighted tolerance doses based on an RBE of 1.1 with published values for carbon ions, which were calculated by the two versions of the local effect model (LEM I or IV). METHODS AND MATERIALS: 62 patients treated with protons for skull base tumors were analyzed for TLRs using magnetic resonance imaging...
February 16, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Florian Wiesinger, Mikael Bylund, Jaewon Yang, Sandeep Kaushik, Dattesh Shanbhag, Sangtae Ahn, Joakim H Jonsson, Josef A Lundman, Thomas Hope, Tufve Nyholm, Peder Larson, Cristina Cozzini
PURPOSE: To describe a method for converting Zero TE (ZTE) MR images into X-ray attenuation information in the form of pseudo-CT images and demonstrate its performance for (1) attenuation correction (AC) in PET/MR and (2) dose planning in MR-guided radiation therapy planning (RTP). METHODS: Proton density-weighted ZTE images were acquired as input for MR-based pseudo-CT conversion, providing (1) efficient capture of short-lived bone signals, (2) flat soft-tissue contrast, and (3) fast and robust 3D MR imaging...
February 18, 2018: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
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