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Hypofractionation

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https://www.readbyqxmd.com/read/28428017/outcomes-and-toxicity-following-high-dose-radiation-therapy-in-15-fractions-for-non-small-cell-lung-cancer
#1
Penny Fang, Cameron W Swanick, Todd A Pezzi, Zhongxing Liao, James Welsh, Steven H Lin, Daniel R Gomez
PURPOSE: Accelerated hypofractionated radiation therapy (AHRT) is increasingly used for select lung cancer patients. We evaluated clinical outcomes and predictors of pulmonary/esophageal toxicity in patients treated with ≥52.5 Gy in 15 fractions. METHODS AND MATERIALS: We evaluated 229 patients treated with radiation therapy doses ≥52.5 Gy in 15 fractions for non-small cell lung cancer from January 2009 through January 2016. Toxicity was scored using Common Terminology Criteria for Adverse Events, v4...
March 9, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28427756/human-tissue-kallikreins-blood-levels-and-response-to-radiotherapy-in-intermediate-risk-prostate-cancer
#2
Nicola J Nasser, John Thoms, Antoninus Soosaipillai, Melania Pintilie, Ri Wang, Eleftherios P Diamandis, Robert G Bristow
OBJECTIVES: Kallikreins are serine proteases over expressed in many malignancies. In this study, we measure changes in serum kallikrein (KLKs) levels during intensity-modulated radiotherapy (IMRT) in prostate cancer patients, and find potential correlations between serum kallikrein level and normal tissues toxicity during radiation. METHODS: Forty-nine patients with prostate cancer were recruited as follows: group 1, definitive standard fractionation IMRT (78Gy in 39 fractions, n=15); group 2, definitive hypofractionated IMRT (60Gy in 20 fractions, n=15); and group 3, IMRT postprostatectomy (66Gy in 33 fractions, n=19)...
April 17, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28421162/r-ideal-a-framework-for-systematic-clinical-evaluation-of-technical-innovations-in-radiation-oncology
#3
Helena M Verkooijen, Linda G W Kerkmeijer, Clifton D Fuller, Robbert Huddart, Corinne Faivre-Finn, Marcel Verheij, Stella Mook, Arjun Sahgal, Emma Hall, Chris Schultz
The pace of innovation in radiation oncology is high and the window of opportunity for evaluation narrow. Financial incentives, industry pressure, and patients' demand for high-tech treatments have led to widespread implementation of innovations before, or even without, robust evidence of improved outcomes has been generated. The standard phase I-IV framework for drug evaluation is not the most efficient and desirable framework for assessment of technological innovations. In order to provide a standard assessment methodology for clinical evaluation of innovations in radiotherapy, we adapted the surgical IDEAL framework to fit the radiation oncology setting...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28415581/tumor-physiological-changes-during-hypofractionated-stereotactic-body-radiation-therapy-assessed-using-multi-parametric-magnetic-resonance-imaging
#4
Heling Zhou, Zhang Zhang, Rebecca Denney, Jessica S Williams, Jeni Gerberich, Strahinja Stojadinovic, Debabrata Saha, John M Shelton, Ralph P Mason
Radiation therapy is a primary treatment for non-resectable lung cancer and hypoxia is thought to influence tumor response. Hypoxia is expected to be particularly relevant to the evolving new radiation treatment scheme of hypofractionated stereotactic body radiation therapy (SBRT). As such, we sought to develop non-invasive tools to assess tumor pathophysiology and response to irradiation. We applied blood oxygen level dependent (BOLD) and tissue oxygen level dependent (TOLD) MRI, together with dynamic contrast enhanced (DCE) MRI to explore the longitudinal effects of SBRT on tumor oxygenation and vascular perfusion using A549 human lung cancer xenografts in a subcutaneous rat model...
March 21, 2017: Oncotarget
https://www.readbyqxmd.com/read/28412775/defining-value-in-radiation-oncology-approaches-to-weighing-benefits-vs-costs
#5
REVIEW
Andre A Konski
The passage of the Affordable Care Act in 2010 initiated discussion regarding transitioning from a fee-for-service arrangement of care reimbursement to value-based care. Cost-effectiveness analysis (CEA) has been used in the past to quantify value as it relates to the provision of healthcare. New treatments or techniques being compared with other new or existing therapies or approaches to care were determined to be cost-effective if the incremental cost-effectiveness ratio was less than $50,000/life-year or quality-adjusted life-year...
April 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/28410691/quantification-of-the-uncertainties-of-a-biological-model-and-their-impact-on-variable-rbe-proton-treatment-plan-optimization
#6
A F Resch, G Landry, F Kamp, G Cabal, C Belka, J J Wilkens, K Parodi, G Dedes
PURPOSE: In proton radiation therapy, a relative biological effectiveness (RBE) equal to 1.1 is currently assumed, although biological experiments show that it is not constant. The purpose of this study was to quantify the uncertainties of a published biological model and explore their impact on variable RBE treatment plan (TP) optimization. METHODS: Two patient cases with a high and a low (α/β)x tumor were investigated. Firstly, intensity modulated proton therapy TPs assuming constant RBE were derived, and subsequently the variable RBE weighted dose (RWD), including the uncertainty originating in the fit to the experimental data and the uncertainty of the (α/β)x, were calculated...
April 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28407345/dosimetric-impacts-of-endorectal-balloon-in-cyberknife-stereotactic-body-radiation-therapy-sbrt-for-early-stage-prostate-cancer
#7
Hong F Xiang, Hsiao-Ming Lu, Jason A Efstathiou, Anthony L Zietman, Ricardo De Armas, Kathryn Harris, B Nicolas Bloch, Muhammad Mustafa Qureshi, Sean Keohan, Ariel E Hirsch
PURPOSE: In SBRT for prostate cancer, higher fractional dose to the rectum is a major toxicity concern due to using smaller PTV margin and hypofractionation. We investigate the dosimetric impact on rectum using endorectal balloon (ERB) in prostate SBRT. MATERIALS AND METHODS: Twenty prostate cancer patients were included in a retrospective study, ten with ERB and 10 without ERB. Optimized SBRT plans were generated on CyberKnife MultiPlan for 5 × 7.25 Gy to PTV under RTOG-0938 protocol for early-stage prostate cancer...
April 13, 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28392704/predictive-parameters-in-hypofractionated-whole-breast-3d-conformal-radiotherapy-according-to-the-ontario-canadian-trial
#8
Grazia Lazzari, Angela Terlizzi, Giuseppina Della Vittoria Scarpati, Francesco Perri, Vincenzo De Chiara, Barbara Turi, Giovanni Silvano
AIM: To evaluate the possible role of dosimetric parameters according Normal Tissue Complication Probability (NTCP) model as predictive of late toxicity and cosmesis in hypofractionated whole-breast three-dimensional conformal radiotherapy. PATIENTS AND METHODS: A retrospective analysis on 215 consecutive early breast cancer patients treated with breast conserving surgery and adjuvant hypofractionated whole-breast radiotherapy (according the Ontario Canadian trial), with a 6 years median follow-up was conducted...
2017: OncoTargets and Therapy
https://www.readbyqxmd.com/read/28390657/clinical-outcomes-of-patients-with-limited-brain-metastases-treated-with-hypofractionated-5%C3%A3-6gy-conformal-radiotherapy
#9
Natalie A Lockney, Diana G Wang, Philip H Gutin, Cameron Brennan, Viviane Tabar, Ase Ballangrud, Xin Pei, Timothy A Chan, Yoshiya Yamada, T Jonathan Yang, Kathryn Beal
BACKGROUND AND PURPOSE: Hypofractionated conformal radiotherapy (hfCRT) is used for larger brain metastases or metastases near critical structures. We investigated hfCRT outcomes for newly diagnosed brain metastases. MATERIALS AND METHODS: We identified 195 patients with 1-3 brain metastases who underwent 5×6Gy hfCRT for 231 lesions from 2007 to 2013. Associations among clinical factors, local control (LC), distant brain control (DC) and overall survival (OS) were tested using univariate and multivariate (MVA) Cox regression analysis and Kaplan-Meier method...
April 5, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28380634/the-radiosurgery-fractionation-quandary-single-fraction-or-hypofractionation
#10
John P Kirkpatrick, Scott G Soltys, Simon S Lo, Kathryn Beal, Dennis C Shrieve, Paul D Brown
Stereotactic radiosurgery (SRS), typically administered in a single session, is widely employed to safely, efficiently, and effectively treat small intracranial lesions. However, for large lesions or those in close proximity to critical structures, it can be difficult to obtain an acceptable balance of tumor control while avoiding damage to normal tissue when single-fraction SRS is utilized. Treating a lesion in 2 to 5 fractions of SRS (termed "hypofractionated SRS" [HF-SRS]) potentially provides the ability to treat a lesion with a total dose of radiation that provides both adequate tumor control and acceptable toxicity...
April 1, 2017: Neuro-oncology
https://www.readbyqxmd.com/read/28378194/management-of-gbm-a-problem-of-local-recurrence
#11
REVIEW
John P Kirkpatrick, Nadia N Laack, Helen A Shih, Vinai Gondi
Forty years ago, adjuvant treatment of patients with GBM using fractionated radiotherapy following surgery was shown to substantially improve survival compared to surgery alone. However, even with the addition of temozolomide to radiotherapy, overall survival is quite limited and local failure remains a fundamental problem, despite multiple attempts to increase dose to the tumor target. This review presents the historical background and clinical rationale leading to the current standard of care consisting of 60 Gy total dose in 2 Gy fractions to the MRI-defined targets in younger, high performance status patients and more hypofractionated regimens in elderly and/or debilitated patients...
April 4, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28377213/risk-factors-and-state-of-the-art-indications-for-boost-irradiation-in-invasive-breast-carcinoma
#12
REVIEW
Alfredo Polo, Csaba Polgár, Jean-Michel Hannoun-Levi, Jose-Luis Guinot, Cristina Gutierrez, Razvan Galalae, Erik van Limbergen, Vratislav Strnad
PURPOSE: The aim of the study was to give recommendations on patient selection criteria for the administration of boost doses after whole-breast irradiation (WBI) in invasive breast cancer based on available clinical evidence complemented by expert opinion. METHODS AND MATERIALS: A systematic search of the PubMed database was conducted to identify factors associated with increased risk for local failure that can define risk groups, and to provide evidence for an adequate guidance to the use of the boost as a function of the risk of local recurrence in breast-conserving therapy...
April 1, 2017: Brachytherapy
https://www.readbyqxmd.com/read/28376918/retrospective-clinical-study-on-outcome-in-cats-with-nasal-planum-squamous-cell-carcinoma-treated-with-an-accelerated-radiation-protocol
#13
Evgeniya Gasymova, Valeria Meier, Franco Guscetti, Simona Cancedda, Malgorzata Roos, Carla Rohrer Bley
BACKGROUND: Cutaneous squamous cell carcinoma of the nasal planum in cats is a common indication for antitumor treatment such as external beam radiation therapy. Curative-intent radiation therapy has been described as a valuable treatment option, resulting in long and stable tumor control in these patients. The aim of the current study was to evaluate outcome and toxicity, as well as possible prognostic factors using an accelerated hypofractionated radiation therapy protocol. Cats with squamous cell carcinoma of the nasal planum treated with an accelerated radiation protocol (10 × 4...
April 4, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/28376214/prospective-validation-of-diagnostic-tumor-biomarkers-in-men-treated-with-radiotherapy-for-prostate-cancer
#14
Alan Pollack, Deukwoo Kwon, Gail Walker, Li Yan Khor, Eric M Horwitz, Mark K Buyyounouski, Radka Stoyanova
Background: In prior retrospective studies, we assessed a number of prostate tumor tissue biomarkers that were associated independently with the clinical outcome of men treated with radiotherapy (RT) ± androgen deprivation therapy (ADT). In this report, the associations of selected biomarkers with biochemical or clinical disease failure (BCDF) were prospectively evaluated in men with T1-T3 prostate cancer on a randomized hypofractionation trial. Methods: Biomarkers were analyzed in 263 of 303 men randomly assigned to standard vs moderate hypofractionation...
February 1, 2017: Journal of the National Cancer Institute
https://www.readbyqxmd.com/read/28367393/thymic-carcinoma-treated-by-cyberknife-stereotactic-body-radiotherapy
#15
Yuko Harada, Shinichiro Miyazaki
The standard treatment for advanced thymic carcinoma has not yet been established. Most patients have no symptoms until the advanced stage. Radiation therapy has been used for advanced stage cancer, usually in combination with surgery or chemotherapy; however, the survival rates are 30%-50%. We performed hypofractionated stereotactic radiotherapy with CyberKnife (Accuray, Sunnyvale, CA, USA) for 10 cases of advanced thymic cancer. All cases reached at least partial remission (PR) in two months with progression-free irradiated lesions and minimal radiation-related toxicity...
February 26, 2017: Curēus
https://www.readbyqxmd.com/read/28366580/influence-of-age-on-guideline-concordant-cancer-care-for-elderly-patients-in-the-united-states
#16
Penny Fang, Weiguo He, Daniel R Gomez, Karen E Hoffman, Benjamin D Smith, Sharon H Giordano, Reshma Jagsi, Grace L Smith
PURPOSE: To examine the frequency of guideline-concordant cancer care in elderly patients, including "older" elderly (age ≥80 years). METHODS AND MATERIALS: Using the Surveillance, Epidemiology and End Results-Medicare dataset in patients aged ≥66 years diagnosed with nonmetastatic breast cancer (n=55,094), non-small cell lung (NSCLC) (n=36,203), or prostate cancer (n=86,544) from 2006 to 2011, chemotherapy, surgery, and radiation (RT) treatments were identified using claims...
February 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28355114/hypofractionated-radiotherapy-for-prostate-cancer-further-evidence-to-tip-the-scales
#17
James B Yu
No abstract text is available yet for this article.
March 29, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28355113/moderate-hypofractionation-in-high-risk-organ-confined-prostate-cancer-final-results-of-a-phase-iii-randomized-trial
#18
Giorgio Arcangeli, Biancamaria Saracino, Stefano Arcangeli, Sara Gomellini, Maria Grazia Petrongari, Giuseppe Sanguineti, Lidia Strigari
Purpose To report the final results on treatment outcomes of a randomized trial comparing conventional and hypofractionated radiotherapy in high-risk, organ-confined prostate cancer (PCa). Patients and Methods This single-institution, randomized clinical trial, conducted from January 2003 to December 2007, enrolled 168 patients with high-risk PCa who were randomly assigned in a 1:1 ratio to conventional (80 Gy in 40 fractions in 8 weeks) or hypofractionated radiotherapy (62 Gy in 20 fractions in 5 weeks) to prostate and seminal vesicles...
March 29, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28351523/quality-assessment-of-delineation-and-dose-planning-of-early-breast-cancer-patients-included-in-the-randomized-skagen-trial-1
#19
Giulio Francolini, Mette S Thomsen, Esben S Yates, Carine Kirkove, Ingelise Jensen, Egil S Blix, Claus Kamby, Mette H Nielsen, Mechthild Krause, Martin Berg, Ingvil Mjaaland, Andreas Schreiber, Unn-Miriam Kasti, Kristian Boye, Birgitte V Offersen
BACKGROUND AND PURPOSE: To report on a Quality assessment (QA) of Skagen Trial 1, exploring hypofractionation for breast cancer patients with indication for regional nodal radiotherapy. MATERIAL AND METHODS: Deviations from protocol regarding target volume delineations and dose parameters (Dmin, Dmax, D98%, D95% and D2%) from randomly selected dose plans were assessed. Target volume delineation according to ESTRO guidelines was obtained through atlas based automated segmentation and centrally approved as gold standard (GS)...
March 25, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28343538/accelerated-hypofractionated-adjuvant-whole-breast-radiation-with-simultaneous-integrated-boost-using-volumetric-modulated-arc-therapy-for-early-breast-cancer-a-phase-i-ii-dosimetric-and-clinical-feasibility-study-from-a-tertiary-cancer-care-centre-of-india
#20
Dodul Mondal, Pramod Kumar Julka, Daya Nand Sharma, Manisha Jana, Macharla Anjaneyelu Laviraj, Suryanarayan Vs Deo, Soumyajit Roy, Randeep Guleria, Goura K Rath
BACKGROUND: Hypofractionation has become standard of care after Breast Conserving Therapy (BCT) in many European and few others western countries. Though still debatable, tumor cavity boost is routinely practised in our centre. Hypofractionation is not yet the current standard of practice in Asian countries. Employing hypofractionation and simultaneous integrated boost to lumpectomy cavity with conformal technique is not the current practice in this region. Hence the study was performed to see whether accelerated hypofractionation and simultaneous boost can be combined using volumetric modulated arc therapy (VMAT) in treating early breast cancer (EBC) patients...
March 2017: Journal of the Egyptian National Cancer Institute
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