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Jacob Y Shin, Ja Kyoung Yoon, Gaurav Marwaha
PURPOSE: The purpose of this study is to assess temporal trends in population-based treatment and survival rates in patients with early-stage non-small cell lung cancer (NSCLC). METHODS: Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Chi-square test, Kaplan-Meier method, and Cox regression models were employed in SPSS 23.0. RESULTS: Fifty-seven thousand and eighty-eight NSCLC patients with early-stage disease from 1988 to 2014 were identified...
March 17, 2018: Lung
Hesham Mostafa Zakaria, Lara Massie, Azam Basheer, David Boyce-Fappiano, Erinma Elibe, Lonni Schultz, Ian Lee, Brent Griffith, Farzan Siddiqui, Victor Chang
BACKGROUND CONTEXT: The current standard of care for prediction of survival of cancer staging is based on TNM staging. However, for patients with spinal metastasis, who all have identical stage IV disease, identifying accurate prognostic markers of survival would allow better treatment stratification between more aggressive treatment strategies or palliation. Analytic morphometrics enables physicians to quantify patient frailty by measuring lean muscle mass. Morphometrics also predicts survival in patients with lung cancer metastases to the spine...
March 14, 2018: Spine Journal: Official Journal of the North American Spine Society
Mazen Soufi, Hidetaka Arimura, Takahiro Nakamoto, Taka-Aki Hirose, Saiji Ohga, Yoshiyuki Umezu, Hiroshi Honda, Tomonari Sasaki
PURPOSE: We aimed to explore the temporal stability of radiomic features in the presence of tumor motion and the prognostic powers of temporally stable features. METHODS: We selected single fraction dynamic electronic portal imaging device (EPID) (n = 275 frames) and static digitally reconstructed radiographs (DRRs) of 11 lung cancer patients, who received stereotactic body radiation therapy (SBRT) under free breathing. Forty-seven statistical radiomic features, which consisted of 14 histogram-based features and 33 texture features derived from the graylevel co-occurrence and graylevel run-length matrices, were computed...
February 2018: Physica Medica: PM
Anastasia Oikonomou, Farzad Khalvati, Pascal N Tyrrell, Masoom A Haider, Usman Tarique, Laura Jimenez-Juan, Michael C Tjong, Ian Poon, Armin Eilaghi, Lisa Ehrlich, Patrick Cheung
We sought to quantify contribution of radiomics and SUVmax at PET/CT to predict clinical outcome in lung cancer patients treated with stereotactic body radiotherapy (SBRT). 150 patients with 172 lung cancers, who underwent SBRT were retrospectively included. Radiomics were applied on PET/CT. Principal components (PC) for 42 CT and PET-derived features were examined to determine which ones accounted for most of variability. Survival analysis quantified ability of radiomics and SUVmax to predict outcome. PCs including homogeneity, size, maximum intensity, mean and median gray level, standard deviation, entropy, kurtosis, skewness, morphology and asymmetry were included in prediction models for regional control (RC) [PC4-HR:0...
March 5, 2018: Scientific Reports
Natalie A Lockney, T Jonathan Yang, David Barron, Emily Gelb, Daphna Y Gelblum, Ellen Yorke, Weiji Shi, Zhigang Zhang, Andreas Rimner, Abraham J Wu
Objectives: Hyperactivation of the phosphatidylinositol-3-kinase (PI3K) pathway has been associated with radioresistance. It is unclear whether such mutations confer suboptimal local control for patients who receive lung stereotactic body radiation therapy (SBRT). Our objective was to examine whether mutations in the EGFR/AKT/PIK3CA signaling pathway are associated with local failure (LF) after lung SBRT. Methods: We retrospectively reviewed 166 patients who underwent SBRT to primary or metastatic lung lesions from 2007-2015 for whom genetic testing data was available for EGFR, AKT, and PIK3CA genes...
December 2017: Clinical and translational radiation oncology
Masahide Saito, Naoki Sano, Yuki Shibata, Kengo Kuriyama, Takafumi Komiyama, Kan Marino, Shinichi Aoki, Kazunari Ashizawa, Kazuya Yoshizawa, Hiroshi Onishi
The purpose of this study was to compare the MLC error sensitivity of various measurement devices for VMAT pre-treatment quality assurance (QA). This study used four QA devices (Scandidos Delta4, PTW 2D-array, iRT systems IQM, and PTW Farmer chamber). Nine retrospective VMAT plans were used and nine MLC error plans were generated for all nine original VMAT plans. The IQM and Farmer chamber were evaluated using the cumulative signal difference between the baseline and error-induced measurements. In addition, to investigate the sensitivity of the Delta4 device and the 2D-array, global gamma analysis (1%/1, 2%/2, and 3%/3 mm), dose difference (1%, 2%, and 3%) were used between the baseline and error-induced measurements...
March 3, 2018: Journal of Applied Clinical Medical Physics
Cory Pierson, Taras Grinchak, Casey Sokolovic, Brandi Holland, Teresa Parent, Mark Bowling, Hyder Arastu, Paul Walker, Andrew Ju
BACKGROUND: The purpose of this study was to evaluate the prognostic impact of Positron Emission Tomography Response Criteria in Solid Tumors (PERCIST) and Response Evaluation Criteria in Solid Tumors (RECIST) and of pre- and post-treatment maximum Standard Uptake Value (SUVmax ) in regards to survival and tumor control for patients treated for early-stage non-small cell lung cancer (ES-NSCLC) with stereotactic body radiotherapy (SBRT). METHODS: This is a retrospective review of patients with ES-NSCLC treated at our institution using SBRT...
February 27, 2018: Radiation Oncology
Ganesh Narayanasamy, Dharmin Desai, Steven Morrill, Xin Zhang, Edvaldo Galhardo, Sanjay Maraboyina, Jose Penagaricano
PURPOSE: Intermediate and low dose falloff in stereotactic body radiotherapy (SBRT) of lung tumor is known to relate to normal tissue toxicity. The purpose is two-fold: to analyze the relation between RTOG parameters (namely, R50%, D2cm) in lung SBRT plans and to explore planning methods that correlate with higher than acceptable dose to normal tissue. METHODS: RTOG recommended target dose coverage, conformity index, homogeneity index, R50% and D2cm were evaluated retrospectively in 105 lung tumor SBRT plans...
February 26, 2018: Medical Physics
Takehiro Shiinoki, Ryota Onizuka, Daisuke Kawahara, Tatsuhiko Suzuki, Yuki Yuasa, Koya Fujimoto, Takuya Uehara, Hideki Hanazawa, Keiko Shibuya
<u>Purpose: </u>To quantify the patient-specific imaging dose for real-time tumor monitoring in the lung during respiratory-gated stereotactic body radiotherapy (SBRT) in clinical cases using SyncTraX.
 <u>Methods and Materials:</u> Ten patients who underwent respiratory-gated SBRT with SyncTraX were enrolled in this study. The imaging procedure for real-time tumor monitoring using SyncTraX was simulated using Monte Carlo. We evaluated the dosimetric effect of a real-time tumor monitoring in a critical organ at risk (OAR) and the planning target volume (PTV) over the course of treatment...
February 26, 2018: Physics in Medicine and Biology
D Dechambre, L Z Janvary, N Jansen, P Berkovic, C Mievis, V Baart, S Cucchiaro, A P Coucke, A Gulyban
BACKGROUND AND PURPOSE: The use of Monte Carlo (MC) dose calculation algorithm for lung patients treated with stereotactic body radiotherapy (SBRT) can be challenging. Prescription in low density media and time-consuming optimization conducted CyberKnife centers to propose an equivalent path length (EPL)-to-MC re-prescription method based on GTV median dose. Unknown at the time of planning, GTV D50% practical application remains difficult. The current study aims at creating a re-prescription predictive model in order to limit conflicting dose value during EPL optimization...
January 2018: Physica Medica: PM
Vanessa Figlia, Rosario Mazzola, Francesco Cuccia, Filippo Alongi, Gianluca Mortellaro, Daniela Cespuglio, Teresa Cucchiara, Giuseppina Iacoviello, Vito Valenti, Massimo Molino, Francesco Verderame, Domenica Matranga, Antonio Lo Casto, Giuseppe Ferrera
BACKGROUND: Several experiences in the literature report SBRT as an effective treatment option for medically inoperable early stage non-small cell lung cancer (NSCLC) and oligometastatic disease. The optimal fractionation schedules and total dose remain controversial. In this study, we evaluated the safety in terms of toxicity and efficacy of using of 8-10 fractions schedules with Helical Tomotherapy (HT) for primary and metastatic lung lesions. METHODS: Between March 2014 and May 2016, a total of 39 patients (median age 72 years, range 26-91) were treated with HT-SBRT for malignant lung lesions: 22 patients with early stage NSCLC, 17 with oligometastases...
February 17, 2018: La Radiologia Medica
Yair Hillman, Josh Kim, Indrin Chetty, Ning Wen
PURPOSE: Mobius 3D (M3D) provides a volumetric dose verification of the treatment planning system's calculated dose using an independent beam model and a collapsed cone convolution superposition algorithm. However, there is a lack of investigation into M3D's accuracy and effectiveness for stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT) quality assurance (QA). Here, we collaborated with the vendor to develop a revised M3D beam model for SRS/SBRT cases treated with a 6X Flattening Filter Free (FFF) beam and high definition multiple leaf collimator (HDMLC) on an Edge linear accelerator...
February 12, 2018: Medical Physics
Mark Chan, Matthew Wong, Ronnie Leung, Steven Cheung, Oliver Blanck
BACKGROUND: To derive and exploit the optimal prescription isodose level (PIL) in inverse optimization of volumetric modulated arc radiotherapy (VMAT) as a potential approach to dose de-escalation in stereotactic body radiotherapy for non-small cell lung carcinomas (NSCLC). METHODS: For ten patients, inverse Monte Carlo dose optimization was performed to cover 95% PTV by varying prescription isodose lines (PIL) at 60 to 80% and reference 85%. Subsequently, these were re-normalized to the median gross tumor volume dose (GTV-based prescription) to assess the impacts of PTV and normal tissue dose reduction...
February 9, 2018: Radiation Oncology
Tingliang Zhuang, Neil M Woody, Han Liu, Sheen Cherian, Chandana A Reddy, Peng Qi, Anthony Magnelli, Toufik Djemil, Kevin L Stephans, Ping Xia, Gregory Mm Videtic
INTRODUCTION: Concerns were raised about the accuracy of pencil beam (PB) calculation and potential underdosing of medically inoperable non-small cell lung cancer (NSCLC) treated with stereotactic body radiation therapy (SBRT). From our institutional series, we designed a matched-pair study where each local failure and controlled patient was matched based upon several clinical factors, to investigate the dose difference between the matched-pair. METHODS: Eighteen pairs of NSCLC patients, treated with 50 Gy in five fractions, were selected...
February 5, 2018: Journal of Medical Imaging and Radiation Oncology
Mikiko Yamashita, Ryo Takahashi, Masaki Kokubo, Kenji Takayama, Hiroaki Tanabe, Masaki Sueoka, Masao Ishii, Hidenobu Tachibana
Dose verification for a gimbal-mounted image-guided radiotherapy system, Vero4DRT (Mitsubishi Heavy Industries Ltd., Tokyo, Japan) is usually carried out by pretreatment measurement. Independent verification calculations using Monte Carlo methods for Vero4DRT have been published. As the Clarkson method is faster and easier to use than measurement and Monte Carlo methods, we evaluated the accuracy of an independent calculation verification program and its feasibility as a secondary check for Vero4DRT. Computed tomography (CT)-based dose calculation was performed using a modified Clarkson-based algorithm...
January 25, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Henri B Wolff, Leonie Alberts, Elisabeth A Kastelijn, Birgit I Lissenberg-Witte, Jos W Twisk, Frank J Lagerwaard, Suresh Senan, Sherif Y El Sharouni, Franz M N H Schramel, Veerle M H Coupé
INTRODUCTION: There is an ongoing debate on the optimal treatment for stage I non-small cell lung cancer (NSCLC), with increasing evidence for comparable health outcomes after surgery or stereotactic body radiation therapy (SBRT). For clinical decision making, the experienced quality of life, summarized as health utility, is of importance to choose between treatments. In this study, we evaluated differences in longitudinal health utility in stage I NSCLC in the first year after surgical resection versus SBRT, before any recurrence of disease...
January 29, 2018: Journal of Thoracic Oncology
Dandan Zheng, Vivek Verma, Shuo Wang, Xiaoying Liang, Sumin Zhou
PURPOSE: Conventional dose algorithms (Type A and Type B) for lung SBRT can display considerable target dose errors compared to Type-C algorithms. Intensity-modulated techniques (IMRT/VMAT) are increasingly being utilized for lung SBRT. Therefore, our study aimed to assess whether intensity modulation increased target dose calculation errors by conventional algorithms over conformal techniques. METHODS: Twenty lung SBRT patients were parallely planned with both IMRT and dynamic conformal arc (DCA) techniques using a Type-A algorithm, and another 20 patients were parallely planned with IMRT, VMAT, and DCA using a Type-B algorithm...
February 1, 2018: Journal of Applied Clinical Medical Physics
Mitsuhiro Nakamura, Yoshitomo Ishihara, Yukinori Matsuo, Yusuke Iizuka, Nami Ueki, Hiraku Iramina, Hideaki Hirashima, Takashi Mizowaki
Knowledge of the imaging doses delivered to patients and accurate dosimetry of the radiation to organs from various imaging procedures is becoming increasingly important for clinicians. The purposes of this study were to calculate imaging doses delivered to the organs of lung cancer patients during real-time tumor tracking (RTTT) with three-dimensional (3D), and four-dimensional (4D) cone-beam computed tomography (CBCT), using Monte Carlo techniques to simulate kV X-ray dose distributions delivered using the Vero4DRT...
January 27, 2018: Journal of Radiation Research
Kazuki Kubo, Hajime Monzen, Mikoto Tamura, Makoto Hirata, Kentaro Ishii, Wataru Okada, Ryuta Nakahara, Shun Kishimoto, Ryu Kawamorita, Yasumasa Nishimura
It is important to improve the magnitude of dose variation that is caused by the interplay effect. The aim of this study was to investigate the impact of the number of breaths (NBs) to the dose variation for VMAT-SBRT to lung cancer. Data on respiratory motion and multileaf collimator (MLC) sequence were collected from the cases of 30 patients who underwent radiotherapy with VMAT-SBRT for lung cancer. The NBs in the total irradiation time with VMAT and the maximum craniocaudal amplitude of the target were calculated...
January 25, 2018: Journal of Applied Clinical Medical Physics
Hyun Ju Kim, Sangjoon Park, Kyoung-Jin Kim, Jinsil Seong
PURPOSE: To investigate the clinical implications of the soluble programmed cell death-ligand 1 (sPD-L1) level in hepatocellular carcinoma (HCC) patients treated with radiotherapy (RT). MATERIALS/METHODS: HCC patients treated with RT between June 2011 and March 2015 were prospectively recruited and sPD-L1 levels were measured using an enzyme-linked immunosorbent assay. Blood samples were obtained at the RT start, RT end, and 1-month follow-up. The associations of the sPD-L1 level with the clinical features and outcomes were analyzed...
January 20, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
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