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Hypofractionation

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https://www.readbyqxmd.com/read/29664796/long-term-outcomes-with-ifosfamide-based-hypofractionated-preoperative-chemoradiotherapy-for-extremity-soft-tissue-sarcomas
#1
Joseph Daniel Pennington, Fritz C Eilber, Frederick R Eilber, Arun S Singh, Jarred P Reed, Bartosz Chmielowski, Jeffrey J Eckardt, Susan V Bukata, Nicholas M Bernthal, Noah Federman, Scott D Nelson, Sarah M Dry, Pin-Chieh Wang, Michael Luu, Michael T Selch, Michael L Steinberg, Anusha Kalbasi, Mitchell Kamrava
OBJECTIVES: The objective of this study was to analyze outcomes for patients with soft tissue sarcoma of the extremities using neoadjuvant ifosfamide-based chemotherapy and hypofractionated reduced dose radiotherapy, followed by limb-sparing surgery. MATERIALS AND METHODS: An Institutional Review Board (IRB)-approved retrospective review of patients treated at a single institution between 1990 and 2013 was performed. In total, 116 patients were identified who received neoadjuvant ifosfamide-based chemotherapy and 28 Gy in 8 fractions of preoperative radiation (equivalent dose in 2 Gray fractions, 31...
April 16, 2018: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29662532/cosmesis-after-early-stage-breast-cancer-treatment-with-surgery-and-radiation-therapy-experience-of-patients-treated-in-a-chilean-radiotherapy-centre
#2
Lorena Vargas, Sebastián Solé, Claudio Vicente Solé
Aim: To analyse the overall cosmetic outcome according to patient self-assessment in relation to the fractionation received. Materials and methods: A questionnaire, drawn up on the basis of subjective rating scales of cosmesis and of acute and late toxicity RTOG/EORTC, EORTC QLQ-C30 (v3) and LENT SOMA, was applied to patients with early-stage breast cancer who received radiotherapy with tangential fields between June 2014 and July 2015. Self-perception of cosmesis, changes in the treated breast, pain and fractionation used (hypofractionation (HF) 42...
2018: Ecancermedicalscience
https://www.readbyqxmd.com/read/29649281/classification-for-long-term-survival-in-oligometastatic-patients-treated-with-ablative-radiotherapy-a-multi-institutional-pooled-analysis
#3
Julian C Hong, Diandra N Ayala-Peacock, Jason Lee, A William Blackstock, Paul Okunieff, Max W Sung, Ralph R Weichselbaum, Johnny Kao, James J Urbanic, Michael T Milano, Steven J Chmura, Joseph K Salama
BACKGROUND: Radiotherapy is increasingly used to treat oligometastatic patients. We sought to identify prognostic criteria in oligometastatic patients undergoing definitive hypofractionated image-guided radiotherapy (HIGRT). METHODS: Exclusively extracranial oligometastatic patients treated with HIGRT were pooled. Characteristics including age, sex, primary tumor type, interval to metastatic diagnosis, number of treated metastases and organs, metastatic site, prior systemic therapy for primary tumor treatment, prior definitive metastasis-directed therapy, and systemic therapy for metastasis associated with overall survival (OS), progression-free survival (PFS), and treated metastasis control (TMC) were assessed by the Cox proportional hazards method...
2018: PloS One
https://www.readbyqxmd.com/read/29648580/bevacizumab-plus-hypofractionated-radiotherapy-versus-radiotherapy-alone-in-elderly-patients-with-glioblastoma-the-randomized-open-label-phase-ii-arte-trial
#4
H-G Wirsching, G Tabatabai, U Roelcke, A F Hottinger, F Jörger, A Schmid, L Plasswilm, D Schrimpf, C Mancao, D Capper, K Conen, T Hundsberger, F Caparrotti, R von Moos, C Riklin, J Felsberg, P Roth, D T W Jones, S Pfister, E J Rushing, L Abrey, G Reifenberger, L Held, A von Deimling, A Ochsenbein, M Weller
Background: The addition of bevacizumab to temozolomide-based chemoradiotherapy (TMZ/RT→TMZ) did not prolong overall survival (OS) in patients with newly diagnosed glioblastoma in phase III trials. Elderly and frail patients are underrepresented in clinical trials, but early reports suggested preferential benefit in this population. Patients and Methods: ARTE was a 2:1 randomized, multi-center, open-label, non-comparative phase II trial of hypofractionated RT (40 Gy in 15 fractions) with bevacizumab (10 mg/kg x 14 days) (arm A, N = 50) or without bevacizumab (arm B, N = 25) in patients with newly diagnosed glioblastoma aged ≥65 years...
April 10, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/29645076/the-role-of-external-beam-radiotherapy-in-the-treatment-of-hepatocellular-cancer
#5
REVIEW
Fumiko Chino, Sarah Jo Stephens, Steve S Choi, Daniele Marin, Charles Y Kim, Michael A Morse, Devon J Godfrey, Brian G Czito, Christopher G Willett, Manisha Palta
Hepatocellular carcinoma (HCC) is increasing in incidence and mortality. Although the prognosis remains poor, long-term survival has improved from 3% in 1970 to an 18% 5-year survival rate today. This is likely because of the introduction of well tolerated, oral antiviral therapies for hepatitis C. Curative options for patients with HCC are often limited by underlying liver dysfunction/cirrhosis and medical comorbidities. Less than one-third of patients are candidates for surgery, which is the current gold standard for cure...
April 12, 2018: Cancer
https://www.readbyqxmd.com/read/29628205/dose-constraints-for-moderate-hypofractionated-radiotherapy-for-prostate-cancer-the-french-genito-urinary-group-getug-recommendations
#6
J Langrand-Escure, R de Crevoisier, C Llagostera, G Créhange, G Delaroche, C Lafond, C Bonin, F Bideault, P Sargos, S Belhomme, D Pasquier, I Latorzeff, S Supiot, C Hennequin
Considering recent phase III trials results, moderate hypofractionated radiotherapy can be considered as a standard treatment for low and intermediate risk prostate cancer management. This assessment call for a framework allowing homogeneous and reproducible practices in the different centers using this radiotherapy schedule. The French Genito-Urinary Group (GETUG) provides here recommendations for daily practice of moderate hypofractionated radiotherapy for prostate cancer, with indications, dose, fractionation, pre-treatment planning, volume of interest delineation (target volume and organs at risk) and margins, dose constraints and radiotherapy techniques...
April 5, 2018: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/29625898/palliative-thoracic-radiation-therapy-for-non-small-cell-lung-cancer-2018-update-of-an-american-society-for-radiation-oncology-astro-evidence-based-guideline
#7
Benjamin Moeller, Ehsan H Balagamwala, Aileen Chen, Kimberly M Creach, Giuseppe Giaccone, Matthew Koshy, Sandra Zaky, George Rodrigues
PURPOSE: To revise the recommendation on the use of concurrent chemotherapy (CC) with palliative thoracic external beam radiation therapy (EBRT) made in the original 2011 American Society for Radiation Oncology guideline on palliative thoracic radiation for lung cancer. METHODS AND MATERIALS: Based on a systematic PubMed search showing new evidence for this key question, the task force felt an update was merited. Guideline recommendations were created using a predefined consensus-building methodology supported by American Society for Radiation Oncology-approved tools for grading evidence quality and recommendation strength...
April 3, 2018: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29621319/dosimetric-impact-of-intra-fraction-prostate-motion-under-a-tumour-tracking-system-in-hypofractionated-robotic-radiosurgery
#8
Yuhei Koike, Iori Sumida, Hirokazu Mizuno, Hiroya Shiomi, Keita Kurosu, Seiichi Ota, Yasuo Yoshioka, Osamu Suzuki, Keisuke Tamari, Kazuhiko Ogawa
For CyberKnife-mediated prostate cancer treatment, a tumour-tracking approach is applied to correct the target location by acquiring X-ray images of implanted fiducial markers intermittently. This study investigated the dosimetric impact of intra-fraction prostate motion during CyberKnife treatment. We retrospectively analyzed 16 patients treated using the CyberKnife (35 Gy delivered in five fractions). Using log files of recorded prostate motion, the intra-fraction prostate motion was simulated. We defined the worst-case intra-fraction prostate motion as the difference between pre- and post-deviation on log files and shifted structure sets according to the corresponding offsets for each beam...
2018: PloS One
https://www.readbyqxmd.com/read/29619980/targeting-myeloid-derived-suppressor-cells-and-programmed-death-ligand-1-confers-therapeutic-advantage-of-ablative-hypofractionated-radiation-therapy-compared-with-conventional-fractionated-radiation-therapy
#9
Jie Lan, Rui Li, Li-Mei Yin, Lei Deng, Jun Gui, Bao-Qing Chen, Lin Zhou, Mao-Bin Meng, Qiao-Rong Huang, Xian-Ming Mo, Yu-Quan Wei, Bo Lu, Adam Dicker, Jian-Xin Xue, You Lu
PURPOSE: Ablative hypofractionated radiation therapy (AHFRT) presents a therapeutic advantage compared with conventional fractionated radiation therapy (CFRT) for primary and oligometastatic cancers. However, the underlying mechanisms remain largely unknown. In the present study, we compared the immune alterations in response to AHFRT versus CFRT and examined the significance of immune regulations contributing to the efficacy of AHFRT. METHODS AND MATERIALS: We established subcutaneous tumors using syngeneic lung cancer and melanoma cells in both immunocompetent and immunocompromised mice and treated them with AHFRT and CFRT under the same biologically equivalent dose...
May 1, 2018: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29619976/ablative-hypofractionated-radiation-therapy-enhances-non-small-cell-lung-cancer-cell-killing-via-preferential-stimulation-of-necroptosis-in-vitro-and-in-vivo
#10
Huan-Huan Wang, Zhi-Qiang Wu, Dong Qian, Nicholas G Zaorsky, Ming-Han Qiu, Jing-Jing Cheng, Chao Jiang, Juan Wang, Xian-Liang Zeng, Chun-Lei Liu, Li-Jun Tian, Guo-Guang Ying, Mao-Bin Meng, Xi-Shan Hao, Zhi-Yong Yuan
PURPOSE: To investigate how necroptosis (ie, programmed necrosis) is involved in killing of non-small cell lung cancer (NSCLC) after ablative hypofractionated radiation therapy (HFRT). METHODS AND MATERIALS: Deoxyribonucleic acid damage, DNA repair, and the death form of NSCLC cells were assessed after radiation therapy. The overexpression and silencing of receptor-interacting protein kinases 3 (RIP3, a key protein involved activation of necroptosis)-stable NSCLC cell lines were successfully constructed...
May 1, 2018: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29616366/de-escalation-of-breast-radiotherapy-after-conserving-surgery-in-low-risk-early-breast-cancer-patients
#11
REVIEW
Pierfrancesco Franco, Giuseppe Carlo Iorio, Sara Bartoncini, Mario Airoldi, Corrado De Sanctis, Isabella Castellano, Umberto Ricardi
The reduction in the burden related to treatment is becoming more and more important in modern oncology. Radiation therapy is a mainstay option in the postoperative setting for early breast cancer patients after breast-conserving surgery. Nowadays, different options are available to de-escalate radiotherapy in this scenario such as the use of hypofractionated whole-breast radiation, the selective delivery of the boost dose to the lumpectomy cavity, the introduction of accelerated partial breast irradiation and the omission of treatment in appropriately selected patients with low-risk features...
April 3, 2018: Medical Oncology
https://www.readbyqxmd.com/read/29615363/trends-in-medicare-reimbursement-and-work-relative-value-unit-production-in-radiation-oncology
#12
Charles C Vu, Thomas B Lanni, Sirisha R Nandalur
PURPOSE: Medicare payments to individual physicians are released annually by the CMS. The purpose of this study is to analyze trends in Medicare reimbursement and work relative value unit (wRVU) production to radiation oncologists. MATERIALS AND METHODS: The Medicare Physician Supplier and Other Provider Public Use File and the CMS Physician Fee Schedule Relative Value Files (to calculate wRVUs) for the calendar years 2012 to 2015 were used in this analysis. Medicare reimbursement was aggregated for each calendar year...
March 31, 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29613803/treatment-of-canine-oral-melanoma-with-nanotechnology-based-immunotherapy-and-radiation
#13
P Jack Hoopes, Robert J Wagner, Kayla Duval, Kevin Kang, David J Gladstone, Karen L Moodie, Margaret Crary-Burney, Hugo Ariaspulido, Frank A Veliz, Nicole F Steinmetz, Steven Fiering
The presence and benefit of a radiation therapy-associated immune reaction is of great interest as the overall interest in cancer immunotherapy expands. Radiation therapy (RT) pathology studies have rarely demonstrated a consistent immune or inflammatory response following conventional RT. More recent information, primarily associated with the "abscopal effect", suggests a subtle radiation-based systemic immune response may be more common and have more therapeutic potential than previously believed...
April 3, 2018: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/29607827/vaginal-metastasis-of-renal-clear-cell-cancer
#14
Rehailia-Blanchard Amel, Morel Adeline, Rancoul Chloé, He Ming Yuan, Magné Nicolas, Falkowski Sabrina
BACKGROUND: Vaginal metastases originating from renal cancer remain a rare event, with less than 100 cases reported in the literature. The spreading mechanism is still under scrutiny. The tumoral bleeding often is a symptom revealing vaginal metastases. CASE: The present work reports patient case having vaginal metastasis of renal clear-cell cancer. The vaginal metastasis was treated by a 3-D conformational radiotherapy. Our experience is discussed with respect to an updated literature review concerning the medical management of vaginal metastasis related to kidney cancer...
January 2018: Gulf Journal of Oncology
https://www.readbyqxmd.com/read/29606150/stereotactic-ablative-radiotherapy-for-ultra-central-lung-tumors-prioritize-target-coverage-or-organs-at-risk
#15
Donna H Murrell, Joanna M Laba, Abigail Erickson, Barbara Millman, David A Palma, Alexander V Louie
BACKGROUND: Lung stereotactic ablative radiotherapy (SABR) is associated with low morbidity, however there is an increased risk of treatment-related toxicity in tumors directly abutting or invading the proximal bronchial tree, termed 'ultra-central' tumors. As there is no consensus regarding the optimal radiotherapy treatment regimen for these tumors, we performed a modeling study to evaluate the trade-offs between predicted toxicity and local control for commonly used high-precision dose-fractionation regimens...
April 2, 2018: Radiation Oncology
https://www.readbyqxmd.com/read/29594220/role-of-radiotherapy-in-extracranial-metastatic-malignant-melanoma-in-the-modern-era
#16
Ryan S Youland, Miran L Blanchard, Roxanna Dronca, Lisa Kottschade, Svetomir N Markovic, Kenneth R Olivier, Sean S Park
Background: To assess the role of radiotherapy in metastatic malignant melanoma (MM) patients in modern era. Materials and methods: This is a retrospective study of MM patients treated with radiotherapy at Mayo Clinic from 1999 to 2014. Patients with pre- and post-treatment imaging studies (CT, MRI, and/or PET/CT) were assessed for metastasis failure (MF), regional/distant failure, and overall survival (OS). Results: In 75 MM patients, 56 and 68 lesions were treated with conventional/hypofractionated radiotherapy (CHRT) and stereotactic body radiotherapy (SBRT), respectively...
October 2017: Clinical and Translational Radiation Oncology
https://www.readbyqxmd.com/read/29594215/age-not-charlson-co-morbidity-index-predicts-for-mortality-after-stereotactic-ablative-radiotherapy-for-medically-inoperable-stage-i-non-small-cell-lung-cancer
#17
Oliver Edwin Holmes, Robert MacRae, Graham Cook, Peter Cross, Vimoj Nair, Horia Marginean, Jason R Pantarotto
Purpose: In this single institution retrospective study of patients with stage I medically inoperable non-small cell lung cancer (NSCLC) treated with stereotactic ablative radiotherapy (SABR) we attempt to model overall survival (OS) using initial prognostic variables with specific attention on the Charlson co-morbidity index (CCI). Methods: Between 2008 and 2013, 335 patients with medically inoperable stage I NSCLC were treated with SABR or hypofractionated radiotherapy (50-60 Gy in at least 5 Gy or 4 Gy fractions respectively) at our institution...
August 2017: Clinical and Translational Radiation Oncology
https://www.readbyqxmd.com/read/29578185/hypofractionated-postoperative-irradiation-in-localized-renal-cell-cancer-a-case-report-and-pertinent-literature-review
#18
Xiang-Rong Zhao, Guang-Lian Shan, Yong Zhang, Yong-Hua Yu
For localized the incidence of renal cell carcinoma (RCC), nephrectomy is the standard treatment. As RCC is generally regarded as a radiation-resistant tumor, the value of postoperative adjuvant radiotherapy is controversial. However, with new advance in radiotherapy (i.e., three-dimensional conformal radiation therapy [3DCRT] and intensity-modulated radiation therapy [IMRT]), target volume delineation, intensity modulation in treatment planning, and treatment delivery are more accurate with fewer adverse effect...
2018: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/29576443/modifiable-risk-factors-for-acute-skin-toxicity-in-adjuvant-breast-radiotherapy-dosimetric-analysis-and-review-of-the-literature
#19
Lorna G Keenan, Naomi Lavan, Mary Dunne, Orla McArdle
Acute skin toxicity in adjuvant breast radiation can be reduced with modern radiotherapy (RT) techniques. However, having reviewed the literature, we found no dosimetric constraint for acute skin toxicity that would be applicable to modern RT planning. This study aimed to identify dosimetric factors that are associated with higher rates of acute skin toxicity. A retrospective review was carried out including women who received adjuvant forward-planned intensity-modulated radiotherapy (IMRT) after breast-conserving surgery...
March 23, 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/29571936/early-results-of-extreme-hypofractionation-using-stereotactic-body-radiation-therapy-for-high-risk-very-high-risk-and-node-positive-prostate-cancer
#20
V Murthy, M Gupta, G Mulye, S Maulik, M Munshi, R Krishnatry, R Phurailatpam, R Mhatre, G Prakash, G Bakshi
AIMS: Stereotactic body radiotherapy (SBRT) in low- and intermediate-risk prostate cancer has shown encouraging results. However, its use in high-risk patients is limited due to lack of data regarding adequate radiotherapy dose, need for pelvic nodal treatment and androgen deprivation therapy. Herein we report our experience of SBRT in this subgroup. MATERIALS AND METHODS: Analysis of a prospectively maintained database of 68 consecutive patients of the National Comprehensive Cancer Network (NCCN) high-risk, very high-risk and node-positive adenocarcinoma prostate treated with SBRT was undertaken...
March 20, 2018: Clinical Oncology: a Journal of the Royal College of Radiologists
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