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https://www.readbyqxmd.com/read/28102933/what-if-a-tumor-is-significantly-enlarged-just-before-stereotactic-body-radiation-therapy-a-case-report-and-review-of-the-literature
#1
Hung-Jen Chen, Ji-An Liang, Chih-Yi Chen, Yang-Hao Yu, Chun-Ru Chien
Stereotactic body radiation therapy (SBRT) plays an important role in early stage non-small cell lung cancer. Tumor growth before radiotherapy planning (RTP) or during SBRT has been reported in lung cancer patients; however, little is known of growth during the period in-between (i.e. after RTP but before SBRT). An 83-year-old man referred to our hospital and diagnosed with medically inoperable non-small cell lung cancer was noted to have significant tumor progression on day 1 of cone beam computed tomography just before the planned SBRT delivery...
November 18, 2016: Thoracic Cancer
https://www.readbyqxmd.com/read/28089158/cardiac-dose-and-survival-after-stereotactic-body-radiotherapy-for-early-stage-non-small-cell-lung-cancer
#2
Amode R Tembhekar, Cari L Wright, Megan E Daly
INTRODUCTION: Recent analyses have identified cardiac dose as an important predictor of overall survival (OS) after chemoradiation for locally advanced non-small-cell lung cancer (NSCLC). However, the survival influence of the cardiac dose after stereotactic body radiotherapy (SBRT) is unknown. We performed a dose-volume histogram (DVH) analysis of patients treated with SBRT for early stage NSCLC to examine survival and cardiac toxicity. MATERIALS AND METHODS: We reviewed the medical records of patients who had undergone SBRT for early-stage NSCLC from June 2007 to June 2015 and documented the cardiac DVH parameters, including the maximum and mean dose and percentage of volume receiving >5, >10, >20, and >30 Gy (V5, V10, V20, and V30, respectively)...
December 22, 2016: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28073946/a-randomized-phase-iii-trial-of-comparing-two-dose-fractionations-stereotactic-body-radiotherapy-sbrt-for-medically-inoperable-stage-ia-non-small-cell-lung-cancer-or-small-lung-lesions-clinically-diagnosed-as-primary-lung-cancer-japan-clinical-oncology-group
#3
EDITORIAL
Tomoki Kimura, Yasushi Nagata, Junko Eba, Shuichi Ozawa, Satoshi Ishikura, Taro Shibata, Yoshinori Ito, Masahiro Hiraoka, Yasumasa Nishimura
A randomized Phase III trial commenced in Japan in February 2016. Currently, 42 Gy in four fractions of stereotactic body radiotherapy prescribed at the D95% of the planning target volume, which is considered equal to the commonly used 48 Gy in four fractions at the isocenter using an old dose calculation algorithm, is the standard treatment in Japan for medically inoperable Stage IA non-small cell lung cancer and small lung lesions clinically diagnosed as primary lung cancer. This study aims to examine the superiority of 55 Gy in four fractions over 42 Gy in four fractions...
January 9, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28070470/assessing-the-need-for-adjuvant-chemotherapy-after-stereotactic-body-radiation-therapy-in-early-stage-non-small-cell-lung-carcinoma
#4
Raphaël Jumeau, Houda Bahig, Édith Filion, Marie-Pierre Campeau, Louise Lambert, David Roberge, Andrei-Bogdan Gorgos, Toni Vu
PURPOSE: Surgery remains the standard treatment for medically operable patients with early-stage non-small cell lung carcinoma (NSCLC). Following surgical resection, adjuvant chemotherapy is recommended for large tumors >4 cm. For unfit patients, stereotactic body radiation therapy (SBRT) has emerged as an excellent alternative to surgery. This study aims to assess patterns of recurrence and discuss the role of chemotherapy after SBRT for NSCLC. METHODS: We reviewed patients treated with SBRT for primary early-stage NSCLC between 2009 and 2015...
November 29, 2016: Curēus
https://www.readbyqxmd.com/read/28057036/clinical-outcomes-of-stage-i-and-iia-non-small-cell-lung-cancer-patients-treated-with-stereotactic-body-radiotherapy-using-a-real-time-tumor-tracking-radiotherapy-system
#5
Norio Katoh, Itaru Soda, Hiroyasu Tamamura, Shotaro Takahashi, Yusuke Uchinami, Hiromichi Ishiyama, Kiyotaka Ota, Tetsuya Inoue, Rikiya Onimaru, Keiko Shibuya, Kazushige Hayakawa, Hiroki Shirato
PURPOSE: To investigate the clinical outcomes of stage I and IIA non-small cell lung cancer (NSCLC) patients treated with stereotactic body radiotherapy (SBRT) using a real-time tumor-tracking radiotherapy (RTRT) system. MATERIALS AND METHODS: Patterns-of-care in SBRT using RTRT for histologically proven, peripherally located, stage I and IIA NSCLC was retrospectively investigated in four institutions by an identical clinical report format. Patterns-of-outcomes was also investigated in the same manner...
January 5, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28054139/-local-ablative-radiotherapy-of-oligometastatic-colorectal-cancer
#6
C Petersen, T Gauer
BACKGROUND: Colorectal cancer (CRC) often presents as oligometastatic disease. Currently available intensive systemic treatment regimens, including combination chemotherapy and molecular targeted agents, result in tumor response and transient to long-term disease control in a high percentage of patients, thus raising the question of further management. Secondary resection and ablation, e.g. by surgery or radiofrequency may contribute to long-term survival and even be curative or at least allow a relevant chemotherapy-free interval...
January 4, 2017: Der Radiologe
https://www.readbyqxmd.com/read/28054137/-local-treatment-of-solitary-intrapulmonary-malignant-nodules
#7
J Op den Winkel, F Eichhorn, S Rieken, H Dienemann
DEFINITION: Intrapulmonary nodules generally represent an incidental finding in the roentgenogram or computed tomography (CT) scan of the chest. They are defined as single, well-circumscribed, radiographic opaque lesions that measures up to 3 cm in diameter and are surrounded completely by aerated lung. The probability of malignancy directly correlates with increasing diameter. Lesions that have a diameter of 1 cm or larger require direct evaluation. THERAPY: Surgery is the first option for patients with a malignant lesion, given an acceptable perioperative risk; for high-risk patients either radiofrequency ablation (RFA) or stereotactic body radiation therapy (SBRT) should be offered...
January 4, 2017: Der Radiologe
https://www.readbyqxmd.com/read/28048907/su-f-r-46-predicting-distant-failure-in-lung-sbrt-using-multi-objective-radiomics-model
#8
Z Zhou, M Folkert, P Iyengar, Y Zhang, J Wang
PURPOSE: To predict distant failure in lung stereotactic body radiation therapy (SBRT) in early stage non-small cell lung cancer (NSCLC) by using a new multi-objective radiomics model. METHODS: Currently, most available radiomics models use the overall accuracy as the objective function. However, due to data imbalance, a single object may not reflect the performance of a predictive model. Therefore, we developed a multi-objective radiomics model which considers both sensitivity and specificity as the objective functions simultaneously...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048901/su-f-t-627-a-conformity-index-study-of-sbrt-plans-for-lung-cancer-patient
#9
Dengsong Zhu, Guoqing Fan, Chong Peng, Carlos Austerlitz
PURPOSE: To evaluate the conformity index for SBRT lung plan in Eclipse (version 11) treatment planning system. METHODS: In the Eclipse treatment planning system the conformity index was defined as VRI/TV, where VRI is prescription isodose surface, and TV is the target volume. In 1997, Van't Riet et al introduced TVRI/TV × TVRI/VRI as a conformal index, where TVRI is the target volume closed by the prescription isodose surface. We chose a lung cancer patient who was assigned to be treated with SBRT...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048859/su-g-jep4-12-real-time-organ-motion-monitoring-using-ultrasound-and-kv-fluoroscopy-during-lung-sbrt-delivery
#10
E Omari, A Tai, D Cooper, M Lachaine, X Li
PURPOSE: Real-time ultrasound monitoring during SBRT is advantageous in understanding and identifying motion irregularities which may cause geometric misses. In this work, we propose to utilize real-time ultrasound to track the diaphragm in conjunction with periodical kV fluoroscopy to monitor motion of tumor or landmarks during SBRT delivery. METHODS: Transabdominal Ultrasound (TAUS) b-mode images were collected from 10 healthy volunteers using the Clarity Autoscan System (Elekta)...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048836/su-f-j-30-application-of-intra-fractional-imaging-for-pretreatment-cbct-of-breath-hold-lung-sbrt
#11
D Cao, M Jermoumi, V Mehta, D Shepard
PURPOSE: Clinical implementation of gated lung SBRT requires tools to verify the accuracy of the target positioning on a daily basis. This is a particular challenge on Elekta linacs where the XVI imaging system does not interface directly to any commercial gating solution. In this study, we used the Elekta's intra-fractional imaging functionality to perform the pretreatment CBCT verifications and evaluated both the image quality and gating accuracy. METHODS: To use intrafraction imaging tools for pretreatment verifications, we planned a 360-degree arc with 1mmx5mm MLC opening...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048830/su-f-r-53-ct-based-radiomics-analysis-of-non-small-cell-lung-cancer-patients-treated-with-stereotactic-body-radiation-therapy
#12
E Huynh, T Coroller, V Narayan, V Agrawal, Y Hou, J Romano, I Franco, R Mak, H Aerts
PURPOSE: Stereotactic body radiation therapy (SBRT) is the standard of care for medically inoperable non-small cell lung cancer (NSCLC) patients and has demonstrated excellent local control and survival. However, some patients still develop distant metastases and local recurrence, and therefore, there is a clinical need to identify patients at high-risk of disease recurrence. The aim of the current study is to use a radiomics approach to identify imaging biomarkers, based on tumor phenotype, for clinical outcomes in SBRT patients...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048800/su-f-t-112-long-term-follow-up-of-nsclc-patients-treated-with-lung-sbrt-using-the-modified-conformal-arc-mdca-planning-technique
#13
E Ku, A Desai, D Fang, C Lawrence, C Iannuzzi, C Shi
PURPOSE: To assess long-term toxicity and primary tumor changes for Stage I/II non-small cell lung carcinoma (NSCLC) patients after treatment with lung SBRT using the modified dynamic conformal arc (MDCA) planning technique. METHODS: Clinical and radiograph data from electronic health records of 15 NSCLC patients treated with lung SBRT utilizing the MDCA technique between October 2011 and July 2014 were retrospectively reviewed. MDCA uses a coplanar beam arrangement, patient body center for the beam isocenter, and six partial rotation conformal arcs to target the tumor...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048777/mo-e-brb-00-panel-discussion-sbrt-srs-case-studies-lung
#14
Stanley Benedict
: In this interactive session, lung SBRT patient cases will be presented to highlight real-world considerations for ensuring safe and accurate treatment delivery. An expert panel of speakers will discuss challenges specific to lung SBRT including patient selection, patient immobilization techniques, 4D CT simulation and respiratory motion management, target delineation for treatment planning, online treatment alignment, and established prescription regimens and OAR dose limits. Practical examples of cases, including the patient flow thought the clinical process are presented and audience participation will be encouraged...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048757/mo-e-brb-01-panel-member
#15
S Benedict
: In this interactive session, lung SBRT patient cases will be presented to highlight real-world considerations for ensuring safe and accurate treatment delivery. An expert panel of speakers will discuss challenges specific to lung SBRT including patient selection, patient immobilization techniques, 4D CT simulation and respiratory motion management, target delineation for treatment planning, online treatment alignment, and established prescription regimens and OAR dose limits. Practical examples of cases, including the patient flow thought the clinical process are presented and audience participation will be encouraged...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048728/tu-a-201-01-introduction-to-in-room-imaging-system-characteristics
#16
J Chang
: Recent years have seen a widespread proliferation of available in-room image guidance systems for radiation therapy target localization with many centers having multiple in-room options. In this session, available imaging systems for in-room IGRT will be reviewed highlighting the main differences in workflow efficiency, targeting accuracy and image quality as it relates to target visualization. Decision-making strategies for integrating these tools into clinical image guidance protocols that are tailored to specific disease sites like H&N, lung, pelvis, and spine SBRT will be discussed...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048666/su-f-t-312-identifying-distinct-radiation-therapy-plan-classes-through-multi-dimensional-analysis-of-plan-complexity-metrics
#17
V Desai, Z Labby, W Culberson
PURPOSE: To determine whether body site-specific treatment plans form unique "plan class" clusters in a multi-dimensional analysis of plan complexity metrics such that a single beam quality correction determined for a representative plan could be universally applied within the "plan class", thereby increasing the dosimetric accuracy of a detector's response within a subset of similarly modulated nonstandard deliveries. METHODS: We collected 95 clinical volumetric modulated arc therapy (VMAT) plans from four body sites (brain, lung, prostate, and spine)...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048661/su-f-t-277-using-dose-weighted-mean-effective-depth-to-improve-accuracy-of-secondary-mu-calculation-for-vmat-plans
#18
H Qu, N Yu, P Qi, A Godley, P Xia
PURPOSE: In commercial secondary dose calculation system, an average effective depth is used to calculate the Monitor Units for an arc beam from the volumetric modulated arc (VMAT) plans. Typically, an arithmetic mean of the effective depths (AMED) of a VMAT arc beam is used, which may result in large MU discrepancy from that of the primary treatment planning system. This study is to demonstrate the use of a dose weighted mean effective depth (DWED) can improve accuracy of MU calculation for the secondary MU verification...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048567/su-c-bra-07-variability-of-patient-specific-motion-models-derived-using-different-deformable-image-registration-algorithms-for-lung-cancer-stereotactic-body-radiotherapy-sbrt-patients
#19
S Dhou, D Ionascu, J Lewis, C Williams
PURPOSE: To study the variability of patient-specific motion models derived from 4-dimensional CT (4DCT) images using different deformable image registration (DIR) algorithms for lung cancer stereotactic body radiotherapy (SBRT) patients. METHODS: Motion models are derived by 1) applying DIR between each 4DCT image and a reference image, resulting in a set of displacement vector fields (DVFs), and 2) performing principal component analysis (PCA) on the DVFs, resulting in a motion model (a set of eigenvectors capturing the variations in the DVFs)...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048563/we-ab-207b-05-correlation-of-normal-lung-density-changes-with-dose-after-stereotactic-body-radiotherapy-sbrt-for-early-stage-lung-cancer
#20
Q Wu, S Devpura, K Feghali, C Liu, M Ajlouni, B Movsas, I Chetty
PURPOSE: To investigate correlation of normal lung CT density changes with dose accuracy and outcome after SBRT for patients with early stage lung cancer. METHODS: Dose distributions for patients originally planned and treated using a 1-D pencil beam-based (PB-1D) dose algorithm were retrospectively recomputed using algorithms: 3-D pencil beam (PB-3D), and model-based METHODS: AAA, Acuros XB (AXB), and Monte Carlo (MC). Prescription dose was 12 Gy × 4 fractions...
June 2016: Medical Physics
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