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Hypofractionation

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https://www.readbyqxmd.com/read/28527010/glioblastoma-multiforme-gbm-in-the-elderly-initial-treatment-strategy-and-overall-survival
#1
Scott M Glaser, Michael J Dohopolski, Goundappa K Balasubramani, John C Flickinger, Sushil Beriwal
The EORTC trial which solidified the role of external beam radiotherapy (EBRT) plus temozolomide (TMZ) in the management of GBM excluded patients over age 70. Randomized studies of elderly patients showed that hypofractionated EBRT (HFRT) alone or TMZ alone was at least equivalent to conventionally fractionated EBRT (CFRT) alone. We sought to investigate the practice patterns and survival in elderly patients with GBM. We identified patients age 65-90 in the National Cancer Data Base (NCDB) with histologically confirmed GBM from 1998 to 2012 and known chemotherapy and radiotherapy status...
May 19, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28526979/the-probabilities-of-one-and-multi-track-events-for-modeling-radiation-induced-cell-kill
#2
Uwe Schneider, Fabiano Vasi, Jürgen Besserer
In view of the clinical importance of hypofractionated radiotherapy, track models which are based on multi-hit events are currently reinvestigated. These models are often criticized, because it is believed that the probability of multi-track hits is negligible. In this work, the probabilities for one- and multi-track events are determined for different biological targets. The obtained probabilities can be used with nano-dosimetric cluster size distributions to obtain the parameters of track models. We quantitatively determined the probabilities for one- and multi-track events for 100, 500 and 1000 keV electrons, respectively...
May 19, 2017: Radiation and Environmental Biophysics
https://www.readbyqxmd.com/read/28526192/comparison-of-spinal-stereotactic-body-radiotherapy-sbrt-planning-techniques-intensity-modulated-radiation-therapy-modulated-arc-therapy-and-helical-tomotherapy
#3
Jina Kim, Hong Seok Jang, Yeon Sil Kim, Byung Ock Choi, Young-Nam Kang
Stereotactic body radiotherapy (SBRT) delivers a highly conformal, hypofractionated radiation dose to a small target with minimal radiation applied to the surrounding areas. Therefore, using the proper treatment planning techniques for SBRT is important. Intensity modulation techniques, such as static intensity-modulated radiation therapy (IMRT), modulated arc therapy (mARC), and helical tomotherapy (HT), are useful for spinal SBRT because of a rapid dose fall-off and spinal cord avoidance. This study compared the planning characteristics for hypofractionated spinal SBRT administered using 3 treatment techniques...
May 16, 2017: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/28521361/hypofractionated-radiotherapy-for-patients-with-early-stage-glottic-cancer-patterns-of-care-and-survival
#4
Trevor J Bledsoe, Henry S Park, John M Stahl, Wendell G Yarbrough, Barbara A Burtness, Roy H Decker, Zain A Husain
Background: Radiotherapy alone is often used to treat early-stage glottic cancer (ESGC); however, the optimal radiation treatment schedule remains unknown. The National Comprehensive Cancer Network (NCCN) guidelines recommend both hypofractionated radiotherapy (HFX) and conventionally fractionated radiotherapy (CFX). We compared overall survival (OS) and treatment patterns among patients treated with HFX vs CFX for ESGC using a large national database. Methods: We identified patients diagnosed with stage I-II (cT1-2N0M0) glottic cancer from 2004 to 2013 within the National Cancer Data Base who were treated with either HFX (2...
October 1, 2017: Journal of the National Cancer Institute
https://www.readbyqxmd.com/read/28516441/decision-making-in-the-surgical-management-of-invasive-breast-cancer-part-2-expanded-applications-for-breast-conserving-surgery
#5
REVIEW
Lisa A Newman
Treatment of early-stage invasive breast cancer with breast-conserving surgery plus radiation therapy (RT) yields overall survival outcomes equivalent to those achieved with mastectomy. Further, breast-conserving surgery is endorsed by the National Comprehensive Cancer Network as being supported by the highest-level, category 1 evidence. Advances in pathologic evaluation, management of multiple tumors, oncoplastic lumpectomy techniques, neoadjuvant chemotherapy, and hypofractionated RT can expand the pool of patients eligible for breast-conserving surgery...
May 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/28515243/nccn-guidelines-update-evolving-radiation-therapy-recommendations-for-breast-cancer
#6
Kilian E Salerno
In the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Breast Cancer, among adjuvant radiotherapy options for whole-breast irradiation after breast-conserving surgery, hypofractionation is preferred. For the use of accelerated partial-breast irradiation, the NCCN Guidelines have adopted the updated definition of "suitability" used by the American Society for Radiation Oncology. Regional nodal irradiation is indicated-either in the setting of breast-conserving surgery or after mastectomy-for women with ≥4 positive nodes and should be strongly considered for 1 to 3 positive lymph nodes and select patients with node-negative disease deemed at high risk for recurrence...
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28514930/hypofractionated-stereotactic-body-radiotherapy-for-localized-prostate-cancer-first-nordic-clinical-experience
#7
Kristiina Koskela, Jan-Erik Palmgren, Janne Heikkilä, Heli Virsunen, Liisa Sailas, Päivi Auvinen, Jan Seppälä, Vesa Kataja
BACKGROUND: The use of hypofractionated stereotactic body radiotherapy (SBRT) as primary treatment modality in clinically localized prostate cancer (PCa) is emerging, because the low α/β-ratio favors the use of high dose per fraction in PCa. There is a need for more data about SBRT, especially in high-risk PCa patients. The purpose of this retrospective study was to evaluate the safety and the short-term efficacy of robotic SBRT in a clinical patient cohort with localized PCa including also high-risk patients (D'Amico risk stratification)...
July 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28514929/five-year-outcomes-from-a-prospective-trial-of-image-guided-accelerated-hypofractionated-proton-therapy-for-prostate-cancer
#8
Randal H Henderson, Curtis Bryant, Bradford S Hoppe, R Charles Nichols, William M Mendenhall, Stella Flampouri, Zhong Su, Zuofeng Li, Christopher G Morris, Nancy P Mendenhall
PURPOSE: To report 5-year outcomes of a prospective trial of image-guided accelerated hypofractionated proton therapy (AHPT) for prostate cancer. PATIENTS AND METHODS: 215 prostate cancer patients accrued to a prospective institutional review board-approved trial of 70Gy(RBE) in 28 fractions for low-risk disease (n = 120) and 72.5Gy(RBE) in 29 fractions for intermediate-risk disease (n = 95). This trial excluded patients with prostate volumes of ≥60 cm(3) or International Prostate Symptom Scores (IPSS) of ≥15, patients on anticoagulants or alpha-blockers, and patients in whom dose-constraint goals for organs at risk (OAR) could not be met...
July 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28501507/peering-over-the-chasm-diffusion-of-prostate-radiation-therapy-hypofractionation
#9
EDITORIAL
Mark K Buyyounouski
No abstract text is available yet for this article.
April 8, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28501459/-cancer-radiotherapy-and-immune-system
#10
J P Nesseler, D Peiffert, G Vogin, P Nickers
Novel paradigms emerge in oncology today. Systemic treatments are more effective and diversified along with an increased life expectancy in oligometastatic patients. Stereotactic radiotherapy using hypofractionation opens new perspectives for local tumour control. The area of radiobiology has expanded with integration of tumour microenvironment in which radiation-induced inflammation mediators and immune system play a major role. Immunity checkpoints inhibitors experience a major development. This rapidly evolving field seems involved in the abscopal effects, especially when radiation is combined with checkpoints inhibitors, as demonstrated in numerous preclinical studies and several clinical trials...
May 10, 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/28497027/data-based-radiation-oncology-design-of-clinical-trials-in-the-toxicity-biomarkers-era
#11
REVIEW
David Azria, Ariane Lapierre, Sophie Gourgou, Dirk De Ruysscher, Jacques Colinge, Philippe Lambin, Muriel Brengues, Tim Ward, Søren M Bentzen, Hubert Thierens, Tiziana Rancati, Christopher J Talbot, Ana Vega, Sarah L Kerns, Christian Nicolaj Andreassen, Jenny Chang-Claude, Catharine M L West, Corey M Gill, Barry S Rosenstein
The ability to stratify patients using a set of biomarkers, which predict that toxicity risk would allow for radiotherapy (RT) modulation and serve as a valuable tool for precision medicine and personalized RT. For patients presenting with tumors with a low risk of recurrence, modifying RT schedules to avoid toxicity would be clinically advantageous. Indeed, for the patient at low risk of developing radiation-associated toxicity, use of a hypofractionated protocol could be proposed leading to treatment time reduction and a cost-utility advantage...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28491135/highlights-from-the-15th-st-gallen-international-breast-cancer-conference-15-18-march-2017-vienna-tailored-treatments-for-patients-with-early-breast-cancer
#12
Consuelo Morigi
The 15th St Gallen International Breast Cancer Conference was held in Vienna for the second time, from 15th-18th March 2017. 4000 people from 105 countries all over the world were invited to take part in the event. The real highlight of the conference was the last day with the International Consensus Session which was chaired by around 50 experts on breast cancer worldwide. With reference to data from scientific research, the consensus panel tried to offer guidelines for the management of breast cancer with the aim of providing patients with optimal treatment...
2017: Ecancermedicalscience
https://www.readbyqxmd.com/read/28490978/radiobiology-of-stereotactic-body-radiation-therapy-sbrt
#13
REVIEW
Miquel Macià I Garau
Recent advances in the technology of radiotherapy have enabled the development of new therapeutic modalities that deliver radiation with very high accuracy, reduced margins and high dose conformation, allowing the reduction of healthy tissue irradiated and therefore minimizing the risk of toxicity. The next step was to increase the total tumor dose using conventional fractionation (which remains the best way to relatively radioprotect healthy tissues when large volumes are treated) or to use new fractionation schemes with greater biological effectiveness...
March 2017: Reports of Practical Oncology and Radiotherapy
https://www.readbyqxmd.com/read/28490931/treatment-and-outcomes-for-glioblastoma-in-elderly-compared-with-non-elderly-patients-a-population-based-study
#14
E R Morgan, A Norman, K Laing, M D Seal
PURPOSE: Elderly patients make up a large percentage of the individuals newly diagnosed with glioblastoma (gbm), but they face particular challenges in tolerating standard therapy, and compared with younger patients, they experience significantly shorter survival. We set out to compare clinical characteristics, treatment patterns, and outcomes in a non-elderly group (<65 years) and an elderly group (≥65 years) of patients diagnosed with gbm. METHODS: This retrospective population-based study used a province-wide cancer registry to identify patients with a new diagnosis of gbm within a 6-year period (2006-2012)...
April 2017: Current Oncology
https://www.readbyqxmd.com/read/28480067/radiation-therapy-for-hepatobiliary-malignancies
#15
REVIEW
Jonathan W Lischalk, Michael C Repka, Keith Unger
Hepatobiliary malignancies represent a heterogeneous group of diseases, which often arise in a background of underlying hepatic dysfunction complicating their local management. Surgical resection continues to be the standard of care for hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC); unfortunately the majority of patients are inoperable at presentation. The aggressiveness of these lesions makes locoregional control of particular importance. Historical experience with less sophisticated radiotherapy resulted in underwhelming efficacy and oftentimes prohibitive liver toxicity...
April 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28459606/hypofractionated-postmastectomy-radiation-therapy-is-safe-and-effective-first-results-from-a-prospective-phase-ii-trial
#16
Atif J Khan, Matthew M Poppe, Sharad Goyal, Kristine E Kokeny, Thomas Kearney, Laurie Kirstein, Deborah Toppmeyer, Dirk F Moore, Chunxia Chen, David K Gaffney, Bruce G Haffty
Purpose Conventionally fractionated postmastectomy radiation therapy (PMRT) takes approximately 5 to 6 weeks. Data supporting hypofractionated PMRT is limited. We prospectively evaluated a short course of hypofractionated PMRT, in which therapy was completed in 15 treatment days. Patients and Methods We delivered PMRT at a dose of 36.63 Gy in 11 fractions of 3.33 Gy over 11 days to the chest wall and the draining regional lymph nodes, followed by an optional mastectomy scar boost of four fractions of 3.33 Gy...
May 1, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28449626/a-pilot-study-evaluating-the-use-of-dynamic-contrast-enhanced-perfusion-mri-to-predict-local-recurrence-after-radiosurgery-on-spinal-metastases
#17
Kiran A Kumar, Kyung K Peck, Sasan Karimi, Eric Lis, Andrei I Holodny, Mark H Bilsky, Yoshiya Yamada
PURPOSE: Dynamic contrast-enhanced magnetic resonance imaging offers noninvasive characterization of the vascular microenvironment and hemodynamics. Stereotactic radiosurgery, or stereotactic body radiation therapy, engages a vascular component of the tumor response which may be detectable using dynamic contrast-enhanced magnetic resonance imaging. The purpose of this study is to examine whether dynamic contrast-enhanced magnetic resonance imaging can be used to predict local tumor recurrence in patients with spinal bone metastases who undergo high-dose radiotherapy with stereotactic radiosurgery...
January 1, 2017: Technology in Cancer Research & Treatment
https://www.readbyqxmd.com/read/28443140/chemoradiotherapy-in-octogenarians-as-primary-treatment-for-muscle-invasive-bladder-cancer
#18
Victor A McPherson, George Rodrigues, Glenn Bauman, Eric Winquist, Joseph Chin, Jonathan Izawa, Kylea Potvin, Scott Ernst, Varagur Venkatesan, Tracy Sexton, Belal Ahmad, Nicholas Power
INTRODUCTION: While radical cystectomy is the gold standard for muscle-invasive bladder cancer (MIBC), in octogenarians cystectomy results in a higher perioperative mortality rate (6.8-11.1%) than in younger patients (2.2%). Trimodality therapy is a bladder-sparing regimen composed of transurethral resection of bladder tumour (TURBT) and chemoradiotherapy, with intent for salvage cystectomy, and has a 62.5-90% initial complete response rate. In this study, we evaluate TURBT and chemoradiotherapy without salvage cystectomy in medically inoperable octogenarian patients...
January 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28440040/hypofractionated-short-course-radiotherapy-in-elderly-patients-with-glioblastoma-multiforme-an-analysis-of-the-national-cancer-database
#19
Kimberley S Mak, Ankit Agarwal, Muhammad M Qureshi, Minh Tam Truong
For elderly patients with glioblastoma multiforme (GBM), randomized trials have shown similar survival with hypofractionated short-course radiotherapy (SCRT) compared to conventionally fractionated long-course radiotherapy (LCRT). We evaluated the adoption of SCRT along with associated factors and survival in a national patient registry. Using the National Cancer Data Base (NCDB), we identified patients aged ≥70 years with GBM, diagnosed between 1998 and 2011, who received SCRT (34-42 Gy in 2.5-3.4 Gy fractions), or LCRT (58-63 Gy in 1...
April 24, 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28438431/phantom-to-clinic-development-of-hypofractionated-stereotactic-body-radiotherapy-for-early-stage-glottic-laryngeal-cancer
#20
Chuxiong Ding, Stephen G Chun, Baran D Sumer, Lucien A Nedzi, Ramzi E Abdulrahman, John S Yordy, Pam Lee, Brian Hrycushko, Timothy D Solberg, Chul Ahn, Robert D Timmerman, David L Schwartz
The purpose of this study was to commission and clinically test a robotic stereotactic delivery system (CyberKnife, Sunnyvale, CA) to treat early-stage glottic laryngeal cancer. We enrolled 15 patients with cTis-T2N0M0 carcinoma of the glottic larynx onto an institutional review board (IRB)-approved clinical trial. Stereotactic body radiotherapy (SBRT) plans prescribed 45 Gy/10 fractions to the involved hemilarynx. SBRT dosimetry was compared with (1) standard carotid-sparing laryngeal intensity-modulated radiation therapy (IMRT) and (2) selective hemilaryngeal IMRT...
April 21, 2017: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
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