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Radiotherapy and heart

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https://www.readbyqxmd.com/read/28100239/elective-breast-radiotherapy-including-level-i-and-ii-lymph-nodes-a-planning-study-with-the-humeral-head-as-planning-risk-volume
#1
Kathrin Surmann, Jorien van der Leer, Tammy Branje, Maurice van der Sangen, Maarten van Lieshout, Coen W Hurkmans
BACKGROUND: The aim of this study was to assess the dose to the humeral head planning risk volume with the currently used high tangential fields (HTF) and compare different planning techniques for breast radiotherapy including axillary level I and II lymph nodes (PTVn) while sparing the humeral head. METHODS: Ten patients with left-sided breast cancer were enrolled in a planning study with 16 fractions of 2.66 Gy. Four planning techniques were compared: HTF, HTF with sparing of the humeral head, 6-field IMRT with sparing of the humeral head and VMAT with sparing of the humeral head...
January 18, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28095159/validation-and-modification-of-a-prediction-model-for-acute-cardiac-events-in-patients-with-breast-cancer-treated-with-radiotherapy-based-on-three-dimensional-dose-distributions-to-cardiac-substructures
#2
Veerle A B van den Bogaard, Bastiaan D P Ta, Arjen van der Schaaf, Angelique B Bouma, Astrid M H Middag, Enja J Bantema-Joppe, Lisanne V van Dijk, Femke B J van Dijk-Peters, Laurens A W Marteijn, Gertruida H de Bock, Johannes G M Burgerhof, Jourik A Gietema, Johannes A Langendijk, John H Maduro, Anne P G Crijns
Purpose A relationship between mean heart dose (MHD) and acute coronary event (ACE) rate was reported in a study of patients with breast cancer (BC). The main objective of our cohort study was to validate this relationship and investigate if other dose-distribution parameters are better predictors for ACEs than MHD. Patients and Methods The cohort consisted of 910 consecutive female patients with BC treated with radiotherapy (RT) after breast-conserving surgery. The primary end point was cumulative incidence of ACEs within 9 years of follow-up...
January 17, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28094211/likelihood-of-unacceptable-normal-tissue-doses-in-breast-cancer-patients-undergoing-regional-nodal-irradiation-in-routine-clinical-practice
#3
Jose Bazan, Dominic DiCostanzo, Karla Kuhn, Lonika Majithia, Allison Quick, Nilendu Gupta, Julia White
PURPOSE: As indications for regional nodal irradiation (RNI) for breast cancer have expanded, so too has scrutiny over potential late toxicity from radiotherapy. This emphasizes the need for careful radiation treatment planning to maximize the therapeutic ratio. We sought to evaluate how often unacceptable doses (UDs) to organs at risk (OARs) occur and the associated factors for patients receiving RNI in daily practice. METHODS AND MATERIALS: Treatment records of patients who received RNI from February 2012 to May 2015 were studied...
October 19, 2016: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28089762/long-terms-results-of-a-trial-of-concurrent-chemotherapy-and-escalating-doses-of-radiation-for-unresectable-non-small-cell-lung-cancer-ncctg-n0028-alliance
#4
Steven E Schild, Shauna L Hillman, Angelina D Tan, Helen J Ross, William L McGinnis, Yolanda A Garces, David L Graham, Alex A Adjei, James R Jett
INTRODUCTION OR HYPOTHESIS: This phase I/II trial was originally designed to determine the maximally tolerated dose(MTD) of thoracic radiotherapy(TRT) as part of a combined modality approach. This report includes the long-term outcome of patients treated on this study. The phase II portion was never completed as RTOG-0617 opened before it was concluded. METHODS: The MTD was defined as 74Gy in 37 fractions in this study. Twenty-five patients with unresectable non-small cell lung cancer(NSCLC) were treated with 2Gy daily fractions and concurrent weekly carboplatin and paclitaxel...
January 12, 2017: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/28089158/cardiac-dose-and-survival-after-stereotactic-body-radiotherapy-for-early-stage-non-small-cell-lung-cancer
#5
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/28048860/su-f-p-54-guidelines-to-check-image-registration-qa-of-a-clinical-deformation-registration-software-a-single-institution-preliminary-study
#6
G Gill, S Souri, A Rea, Y Chen, J Antone, X Qian, A Riegel, P Taylor, M Marrero, F Diaz, Y Cao, A Jamshidi, S Barley, V Sorell, G Karangelis, T Button, E Klein
PURPOSE: The objective of this study is to verify and analyze the accuracy of a clinical deformable image registration (DIR) software. METHODS: To test clinical DIR software qualitatively and quantitatively, we focused on lung radiotherapy and analyzed a single (Lung) patient CT scan. Artificial anatomical changes were applied to account for daily variations during the course of treatment including the planning target volume (PTV) and organs at risk (OAR). The primary CT (pCT) and the structure set (pST) was deformed with commercial tool (ImSimQA-Oncology Systems Limited) and after artificial deformation (dCT and dST) sent to another commercial tool (VelocityAI-Varian Medical Systems)...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048853/su-f-p-14-oxygen-inhalation-should-be-the-conventional-approach-in-the-treatment-of-thoracic-and-abdominal-cancer-by-radiotherapy-with-active-breathing-control-abc
#7
G Gong, Y Guo, Y Yin
PURPOSE: To investigate the feasibility and potential benefit of oxygen inhalation (OI) during radiotherapy applying an active breathing control (ABC) device, by analyzing the blood oxygen saturation (SpO2) and the instantaneous heart rate (IHR) variation in breath holding with OI and oxygen non-inhalation (ONI). METHODS: The 27 healthy volunteers (16 males, 11 females) who were involved in this trial were all required to hold their breath for 10 times, non-inhaling and inhaling oxygen successively...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048831/su-g-jep4-01-an-assessment-of-a-microsoft-kinect-v2-sensor-for-voluntary-breath-hold-monitoring-in-radiotherapy
#8
D Edmunds, E Donovan
PURPOSE: To determine whether the Microsoft Kinect Version 2 (Kinect v2), a commercial off-the-shelf (COTS) depth sensors designed for entertainment purposes, were robust to the radiotherapy treatment environment and could be suitable for monitoring of voluntary breath-hold compliance. This could complement current visual monitoring techniques, and be useful for heart sparing left breast radiotherapy. METHODS: In-house software to control Kinect v2 sensors, and capture output information, was developed using the free Microsoft software development kit, and the Cinder creative coding C++ library...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048814/su-f-j-123-ct-based-determination-of-dibh-variability-and-its-dosimetric-impact-on-post-mastectomy-plus-regional-nodal-radiation-therapy
#9
M Malin, H Kang, K Tatebe, Y Hasan, S Chmura, H Al-Hallaq
PURPOSE: Breast cancer radiotherapy delivered using voluntary deep inspiration breath-hold (DIBH) requires reproducible breath holds, particularly when matching supraclavicular fields to tangential fields. We studied the impact of variation in DIBHs on CTV and OAR dose metrics by comparing the dose distribution computed on two DIBH CT scans taken at the time of simulation. METHODS: Ten patients receiving 50Gy in 25 fractions to the left chestwall and regional lymph nodes were studied...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048744/su-f-t-119-development-of-heart-prediction-model-to-increase-accuracy-of-dose-reconstruction-for-radiotherapy-patients
#10
E Mosher, M Choi, E Jones, C Lee
PURPOSE: To assess individual variation in heart volume and location in order to develop a prediction model of the heart. This heart prediction model will be used to calculate individualized heart doses for radiotherapy patients in epidemiological studies. METHODS: Chest CT images for 30 adult male and 30 adult female patients were obtained from NIH Clinical Center. Image-analysis computer programs were used to segment the whole heart and 8 sub-regions and to measure the volume of each sub- region and the dimension of the whole heart...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048690/su-f-j-22-lung-volumevariability-assessed-by-bh-cbct-in-3d-surface-image-guided-deep-inspirationbreath-hold-dibh-radiotherapy-for-left-sided-breast-cancer
#11
A Gutierrez, D Stanley, N Papanikolaou, R Crownover
PURPOSE: With the increasing use of DIBH techniques for left-sided breast cancer, 3D surface-image guided DIBH techniques have improved patient setup and facilitated DIBH radiation delivery. However, quantification of the daily separation between the heart and left breast still presents a challenge. One method of assuring separation is to ensure consistent left lung filling. With this in mind, the aim of this study is to retrospectively quantify left lung volume from weekly breath hold-CBCTs (bh-CBCT) of left-sided breast patients treated using a 3D surface imaging system...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048510/su-f-t-499-anatomic-features-for-selection-of-electronic-tissue-compensation-radiotherapy-in-early-stage-breast-cancer-patients-after-breast-conserving-surgery
#12
Y Song, M Zhang, N Yue, L Gan, X Chen, T Zhang, G Ren
PURPOSE: To explore the correlations between anatomic features and dose-volumetric parameters in 3DCRT and eComp whole breast irradiation and identify the feasibility of anatomic parameters to predict the planning method selection. METHODS: We compared the effectiveness between conventional three-dimensional conformal radiotherapy (3DCRT) and electronic tissue compensation (eComp) for whole breast irradiation. 3DCRT and eComp planning techniques were used to generate treatment plans for 60 whole breast patients, respectively...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048472/tu-h-campus-jep3-04-factors-predicting-a-need-for-treatment-replanning-with-proton-radiotherapy-for-lung-cancer
#13
C Teng, G Janssens, C Ainsley, B Teo, G Valdes, B Burgdorf, A Berman, W Levin, Y Xiao, L Lin, P Gabriel, C Simone, T Solberg
PURPOSE: Proton dose distribution is sensitive to tumor regression and tissue and normal anatomy changes. Replanning is sometimes necessary during treatment to ensure continue tumor coverage or avoid overtreatment of organs at risk (OARs). We investigated action thresholds for replanning and identified both dosimetric and non-dosimetric metrics that would predict a need for replan. METHODS: All consecutive lung cancer patients (n = 188) who received definitive proton radiotherapy and had more than two evaluation CT scans at the Roberts Proton Therapy Center (Philadelphia, USA) from 2011 to 2015 were included in this study...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048455/we-ab-209-02-a-new-inverse-planning-framework-with-principle-based-modeling-of-inter-structural-dosimetric-tradeoffs
#14
H Liu, P Dong, L Xing
PURPOSE: Traditional radiotherapy inverse planning relies on the weighting factors to phenomenologically balance the conflicting criteria for different structures. The resulting manual trial-and-error determination of the weights has long been recognized as the most time-consuming part of treatment planning. The purpose of this work is to develop an inverse planning framework that parameterizes the inter-structural dosimetric tradeoff among with physically more meaningful quantities to simplify the search for a clinically sensible plan...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048390/su-f-t-415-differences-in-lung-sparing-in-deep-inspiration-breath-hold-and-free-breathing-breast-plans-calculated-in-pinnacle-and-monaco
#15
D Saenz, S Stathakis
PURPOSE: Deep inspiration breath-hold (DIBH) is used for left-sided breast radiotherapy to spare the heart and lung. The magnitude of sparing has been shown to be significant. Monte Carlo, furthermore, has the potential to calculate most accurately the dose in the heterogeneous lung medium at the interface with the lung wall. The lung dose was investigated in Monaco to determine the level of sparing relative to that calculated in Pinnacle(3) . METHODS: Five patients undergoing DIBH radiotherapy on an Elekta Versa HD linear accelerator in conjunction with the Catalyst C-RAD surface imaging system were planned using Phillips Pinnacle(3) ...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048366/su-f-t-632-on-the-use-of-intensity-modulated-arc-therapy-for-thoracic-vertebral-metastases-sbrt-treatment
#16
D Pokhrel, M Mallory, R Badkul, H Jiang, H Saleh, F Wang, C Lominska
PURPOSE: To retrospectively evaluate quality, efficiency and delivery accuracy of intensity modulated arc therapy (IMAT) plans for thoracic-vertebral metastases using stereotactic body radiotherapy (SBRT). METHODS: After obtaining approval of RPC-benchmark plan, seven previously treated thoracic-vertebral metastases patients with non-coplanar hybrid arcs(NC-HA)using 1-2 3D-dynamic conformal partial-arcs plus 7-9 IMRT-beams were re-optimized with IMAT using 3 full co-planar arcs...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048133/su-f-j-113-multi-atlas-based-automatic-organ-segmentation-for-lung-radiotherapy-planning
#17
J Kim, J Han, S Ailawadi, J Baker, A Hsia, Z Xu, S Ryu
PURPOSE: Normal organ segmentation is one time-consuming and labor-intensive step for lung radiotherapy treatment planning. The aim of this study is to evaluate the performance of a multi-atlas based segmentation approach for automatic organs at risk (OAR) delineation. METHODS: Fifteen Lung stereotactic body radiation therapy patients were randomly selected. Planning CT images and OAR contours of the heart - HT, aorta - AO, vena cava - VC, pulmonary trunk - PT, and esophagus - ES were exported and used as reference and atlas sets...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048098/su-f-j-67-dosimetric-changes-during-radiotherapy-in-lung-cancer-patients-with-atelectasis
#18
C Guy, E Weiss, N Jan, L Reshko, G Christensen, G Hugo
PURPOSE: Large geometric changes which occur during thoracic radiotherapy alter normal anatomy and target position and may induce clinically important dose changes. This study investigates variation of organ-at-risk (OAR) dose caused by atelectasis resolution during radiotherapy. METHODS: 3D IMRT treatment plans were obtained for 14 non-small-cell lung cancer patients. Dose of the clinical plan was recalculated on a baseline scan in which lung was collapsed and on a midtreatment scan in which lung re-aeration had occurred...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048033/su-f-t-87-comparison-of-advanced-radiotherapy-techniques-for-post-mastectomy-breast-cancer-patients
#19
D Heins, R Zhang, K Hogstrom, M Sanders
PURPOSE: To determine if bolus electron conformal therapy (Bolus-ECT) combined with intensity modulated x-ray therapy (IMXT) and flattening filter free volumetric modulated arc therapy (FFF-VMAT (6x and 10x)) can maintain equal or better dose coverage than standard volumetric modulated arc therapy (Std-VMAT) while reducing doses to organs at risk (OARs). METHODS: Bolus-ECT with IMXT, FFF-VMAT, and Std-VMAT treatment plans were produced for ten post-mastectomy radiotherapy (PMRT) patients previously treated at our clinic...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047965/tu-h-campus-jep2-05-can-automatic-delineation-of-cardiac-substructures-on-noncontrast-ct-be-used-for-cardiac-toxicity-analysis
#20
Y Luo, Z Liao, W Jiang, D Gomez, R Williamson, L Court, J Yang
PURPOSE: To evaluate the feasibility of using an automatic segmentation tool to delineate cardiac substructures from computed tomography (CT) images for cardiac toxicity analysis for non-small cell lung cancer (NSCLC) patients after radiotherapy. METHODS: A multi-atlas segmentation tool developed in-house was used to delineate eleven cardiac substructures including the whole heart, four heart chambers, and six greater vessels automatically from the averaged 4DCT planning images for 49 NSCLC patients...
June 2016: Medical Physics
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