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adaptive radiotherapy

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https://www.readbyqxmd.com/read/27913497/response-adapted-frontline-therapy-for-hodgkin-lymphoma-are-we-there-yet
#1
Peter W M Johnson
Treating Hodgkin lymphoma by using chemotherapy with or without radiotherapy is highly successful, with substantially fewer deaths from lymphoma than from other causes in recent studies of both early-stage and advanced-stage disease. Long-term toxicity is a major consideration in this context, and recent trials have used functional imaging with [(18)F]fluorodeoxyglucose (FDG) positron emission tomography early in the course of treatment (interim PET) to assess response and modulate subsequent therapy. In early-stage disease, this has allowed omission of consolidation radiotherapy after a good response to doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) chemotherapy, and trials have shown that this can be done without detriment to overall survival, despite a small increase in rates of recurrence of ∼5%...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913106/innovations-in-radiotherapy-technology
#2
I J Feain, L Court, J R Palta, S Beddar, P Keall
Many low- and middle-income countries, together with remote and low socioeconomic populations within high-income countries, lack the resources and services to deal with cancer. The challenges in upgrading or introducing the necessary services are enormous, from screening and diagnosis to radiotherapy planning/treatment and quality assurance. There are severe shortages not only in equipment, but also in the capacity to train, recruit and retain staff as well as in their ongoing professional development via effective international peer-review and collaboration...
November 29, 2016: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/27903114/a-quantitative-analysis-of-craniopharyngioma-cyst-expansion-during-and-after-radiation-therapy-and-surgical-implications
#3
Kelly Lamiman, Kenneth K Wong, Benita Tamrazi, Jason D Nosrati, Arthur Olch, Eric L Chang, Erin N Kiehna
OBJECTIVE When complete resection of craniopharyngioma is not achievable or the sequelae are prohibitive, limited surgery and radiation therapy have demonstrated excellent local disease control while minimizing treatment-related sequelae. When residual tissue exists, there is a propensity for further cyst development and expansion during and after radiation therapy. This can result in obstructive hydrocephalus, visual changes, and/or clinical decline. The authors present a quantitative analysis of cyst expansion during and after radiotherapy and examine how it affected subsequent management...
December 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27898991/nipple-and-areola-sparing-mastectomy-for-the-treatment-of-breast-cancer
#4
REVIEW
Bruna S Mota, Rachel Riera, Marcos Desidério Ricci, Jessica Barrett, Tiago B de Castria, Álvaro N Atallah, Jose Luiz B Bevilacqua
BACKGROUND: The efficacy and safety of nipple-sparing mastectomy and areola-sparing mastectomy for the treatment of breast cancer are still questionable. It is estimated that the local recurrence rates following nipple-sparing mastectomy are very similar to breast-conserving surgery followed by radiotherapy. OBJECTIVES: To assess the efficacy and safety of nipple-sparing mastectomy and areola-sparing mastectomy for the treatment of ductal carcinoma in situ and invasive breast cancer in women...
November 29, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27897274/modelling-tumour-volume-variations-in-head-and-neck-cancer-magnetic-resonance-imaging-contribution-for-patients-undergoing-induction-chemotherapy
#5
N Dinapoli, T Tartaglione, F Bussu, R Autorino, F Miccichè, M Sciandra, E Visconti, C Colosimo, G Paludetti, V Valentini
Primary tumour volume evaluation has predictive value for estimating survival outcomes. Using volumetric data acquired by MRI in patients undergoing induction chemotherapy (IC) these outcomes were estimated before the radiotherapy course in head and neck cancer (HNC) patients. MRI performed before and after IC in 36 locally advanced HNC patients were analysed to measure primary tumour volume. The two volumes were correlated using the linear-log ratio (LLR) between the volume in the first MRI and the volume in the second...
November 29, 2016: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/27897060/potential-for-adaptive-dose-escalation-in-radiotherapy-for-patients-with-locally-advanced-non-small-cell-lung-cancer-in-a-low-mid-income-setting
#6
Sushma Agrawal, Sunil Kumar, Anil Kumar Maurya
OBJECTIVE: To evaluate the effect of tumour volume regression on adaptive treatment planning, reduction in doses to organs at risk (OAR) and dose escalation. METHODS: 20 patients undergoing radical chemoradiotherapy were imaged in fifth week of radiotherapy (CT_45) to evaluate differences in tumour volume regression between concurrent (CONC) and sequential chemoradiotherapy (SEQ). Replanning was done on CT_45 in those with >20% regression (n=10) and evaluated for change in target coverage indices (coverage index [CI], external volume index [EI]) and doses to OAR [mean lung dose, V20 and V5 of whole and ipsilateral lung (MLDWL, V20WL, V5WL, MLDIL, V20IL, V5IL), mean esophagus dose, V50 esophagus and maximum spinal cord doses]...
November 29, 2016: British Journal of Radiology
https://www.readbyqxmd.com/read/27895686/successful-treatment-of-a-67-year-old-woman-with-urethral-adenocarcinoma-with-the-use-of-external-beam-radiotherapy-and-image-guided-adaptive-interstitial-brachytherapy
#7
Jasmin Mujkanovic, Kari Tanderup, Mads Agerbæk, Ulla Bisgaard, Søren Høyer, Jacob Christian Lindegaard, Lars Fokdal
Primary urethral cancer (PUC) is a very rare disease. This case report illustrates a successful treatment approach of a 67-year-old woman with a urethral adenocarcinoma selected for an organ preserving treatment with external beam radiotherapy (EBRT) and interstitial brachytherapy (BT) boost, using the GEC-ESTRO target concept originally designed for locally advanced cervical cancer (LACC). Treatment included EBRT with 45 Gy in 25 fractions followed by image guided adaptive interstitial BT (IGABT) with a pulsed-dose-rate (PDR) BT boost with 30 Gy in 50 hourly pulses...
October 2016: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/27880733/an-automated-workflow-for-patient-specific-quality-control-of-contour-propagation
#8
William J Beasley, Alan McWilliam, Nicholas J Slevin, Ranald I Mackay, Marcel van Herk
Contour propagation is an essential component of adaptive radiotherapy, but current contour propagation algorithms are not yet sufficiently accurate to be used without manual supervision. Manual review of propagated contours is time-consuming, making routine implementation of real-time adaptive radiotherapy unrealistic. Automated methods of monitoring the performance of contour propagation algorithms are therefore required. We have developed an automated workflow for patient-specific quality control of contour propagation and validated it on a cohort of head and neck patients, on which parotids were outlined by two observers...
December 21, 2016: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/27870387/primary-myelofibrosis-2017-update-on-diagnosis-risk-stratification-and-management
#9
Ayalew Tefferi
: Disease overview: Primary myelofibrosis (PMF) is a myeloproliferative neoplasm (MPN) characterized by stem cell-derived clonal myeloproliferation that is often but not always accompanied by JAK2, CALR or MPL mutation, abnormal cytokine expression, bone marrow fibrosis, anemia, splenomegaly, extramedullary hematopoiesis (EMH), constitutional symptoms, cachexia, leukemic progression and shortened survival. DIAGNOSIS: Diagnosis is based on bone marrow morphology...
December 2016: American Journal of Hematology
https://www.readbyqxmd.com/read/27866848/analysis-of-gtv-reduction-during-radiotherapy-for-oropharyngeal-cancer-implications-for-adaptive-radiotherapy
#10
Olga Hamming-Vrieze, Simon R van Kranen, Wilma D Heemsbergen, Charlotte A H Lange, Michiel W M van den Brekel, Marcel Verheij, Coen R N Rasch, Jan Jakob Sonke
BACKGROUND AND PURPOSE: Adaptive field size reduction based on gross tumor volume (GTV) shrinkage imposes risk on coverage. Fiducial markers were used as surrogate for behavior of tissue surrounding the GTV edge to assess this risk by evaluating if GTVs during treatment are dissolving or actually shrinking. MATERIALS AND METHODS: Eight patients with oropharyngeal tumors treated with chemo-radiation were included. Before treatment, fiducial markers (0.035×0.2cm(2), n=40) were implanted at the edge of the primary tumor...
November 18, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/27860454/geographical-miss-of-the-prostate-during-image-guided-radiotherapy-with-a-6-mm-posterior-expansion-margin
#11
Richard Oates, Daryl Jones, Farshad Foroudi, Suki Gill, Prabhakar Ramachandran, Michal Schneider, Michael LimJoon, Tomas Kron
INTRODUCTION: Our department commonly uses a planning target volume (PTV) expansion of 6 mm posterior and 1 cm in all other directions when treating prostate cancer patients with image-guided radiotherapy (IGRT). This study aimed to test the adequacy of this PTV expansion by assessing geographical miss of the prostate on post-treatment cone-beam CT (CBCT) and identify those at risk of geographical miss. METHODS: Twenty-two prostate cancer patients receiving IGRT with implanted fiducial markers underwent daily pre-treatment orthogonal kV imaging followed by a post-treatment CBCT for a total of 432 fractions...
November 8, 2016: Journal of Medical Radiation Sciences
https://www.readbyqxmd.com/read/27846929/-ccafu-french-national-guidelines-2016-2018-on-testicular-germ-cell-tumors
#12
X Durand, A Fléchon, T Murez, L Rocher, P Camparo, N Morel-Journel, P-H Savoie, L Ferretti, P Sèbe, A Méjean
INTRODUCTION: The purpose of the oncologic comitee of the french association of urology was to establish guidelines proposed by the external genital organ group, for the diagnosis, treatment and follow-up of the germ cell tumours of the testis. MATERIAL AND METHODS: The multidisciplinary working group studied 2013 guidelines, exhaustively reviewed the literature, and evaluated references and their level of proof in order to attribute grades of recommandation. RESULTS: The initial workup of testicular cancer is based on clinical, laboratory (AFP, total hCG, LDH) and imaging assessment (scrotal ultrasound and chest, abdomen and pelvis computed tomography)...
November 2016: Progrès en Urologie
https://www.readbyqxmd.com/read/27834643/visualization-of-deformable-image-registration-quality-using-local-image-dissimilarity
#13
Matthias Schlachter, Tobias Fechter, Miro Jurisic, Tanja Schimek-Jasch, Oliver Oehlke, Sonja Adebahr, Wolfgang Birkfellner, Ursula Nestle, Katja Bu Hler
Deformable image registration (DIR) has the potential to improve modern radiotherapy in many aspects, including volume definition, treatment planning and image-guided adaptive radiotherapy. Studies have shown its possible clinical benefits. However, measuring DIR accuracy is difficult without known ground truth, but necessary before integration in the radiotherapy workflow. Visual assessment is an important step towards clinical acceptance. We propose a visualization framework which supports the exploration and the assessment of DIR accuracy...
October 2016: IEEE Transactions on Medical Imaging
https://www.readbyqxmd.com/read/27833352/adaptive-radiotherapy-for-head-neck-cancer
#14
Shrikant Balasaheb Mali
Changes in patient anatomy may occur either from a tumour volume, position or function of a specific organ at risk, or target volume, weight loss or a reduction in postoperative oedema, and may vary between patients. Adaptive radiotherapy aims to correct morphological variations by realizing one or more plans during the treatment course. Imaging is used to detect these variations, thereby deciding on a potential replanning. At present, adaptive radiotherapy for head neck cancer (HNC) mainly deals with treatment response, such as weight loss or tumor shrinkage...
December 2016: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/27826466/buttock-reconstruction-in-sarcoma-surgery-an-esthetic-sigmoidplasty-closure-for-large-circular-defects-using-double-opposing-skin-flaps
#15
Corné P G Nel, Mahendra Daya
BACKGROUND: Large defects arising from extirpation surgery of buttock sarcomas requiring adjuvant radiotherapy are best closed with flap surgery. The traditional solutions are derived from an approach to pressure sores, which were designed for the ischial, sacral, or trochanteric areas, and have now been adapted for true buttock defects. This invariably destroys the esthetics of the buttock. We describe a novel technique of sigmoidplasty, which preserves most of the esthetic features...
October 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27806848/a-comparison-of-cancer-stem-cell-markers-and-nonclassical-major-histocompatibility-complex-antigens-in-colorectal-tumor-and-noncancerous-tissues
#16
Rabia Bilge Özgül Özdemir, Alper Tunga Özdemir, Fatih Oltulu, Kamile Kurt, Gürkan Yiğittürk, Cengiz Kırmaz
Colorectal carcinoma (CRC) is one of the most fatal types of cancer in both women and men, and, unfortunately, patients are often diagnosed at an advanced stage. Cancer stem cells (CSCs) are associated with poor prognosis, metastasis, and recurrence, as well as chemotherapy and radiotherapy resistance. Therefore, different treatment alternatives are needed to facilitate the elimination of CSCs. One such approach is immunotherapy; however, tumor cells can evade immune cells by alteration of the expression patterns of human leukocyte antigens (HLA)...
December 2016: Annals of Diagnostic Pathology
https://www.readbyqxmd.com/read/27785933/a-kernel-based-dose-calculation-algorithm-for-kv-photon-beams-with-explicit-handling-of-energy-and-material-dependencies
#17
Anna Merle Reinhart, Martin F Fast, Peter Ziegenhein, Simeon Nill, Uwe Oelfke
OBJECTIVES: Mimicking state-of-the-art patient radiotherapy with high precision irradiators for small animals is expected to advance the understanding of dose-effect relationships and radiobiology in general. We work on the implementation of intensity modulated radiotherapy-like irradiation schemes for small animals. As a first step we present a fast analytical dose calculation algorithm for keV photon beams. METHODS: We follow a superposition-convolution approach adapted to kV x-rays, based on previous work for microbeam therapy...
October 27, 2016: British Journal of Radiology
https://www.readbyqxmd.com/read/27782723/automatic-multiorgan-segmentation-in-ct-images-of-the-male-pelvis-using-region-specific-hierarchical-appearance-cluster-models
#18
Dengwang Li, Pengxiao Zang, Xiangfei Chai, Yi Cui, Ruijiang Li, Lei Xing
PURPOSE: Accurate segmentation of pelvic organs in CT images is of great importance in external beam radiotherapy for prostate cancer. The aim of this studying is to develop a novel method for automatic, multiorgan segmentation of the male pelvis. METHODS: The authors' segmentation method consists of several stages. First, a pretreatment includes parameterization, principal component analysis (PCA), and an established process of region-specific hierarchical appearance cluster (RSHAC) model which was executed on the training dataset...
October 2016: Medical Physics
https://www.readbyqxmd.com/read/27782712/use-of-regularized-principal-component-analysis-to-model-anatomical-changes-during-head-and-neck-radiation-therapy-for-treatment-adaptation-and-response-assessment
#19
Mikhail A Chetvertkov, Farzan Siddiqui, Jinkoo Kim, Indrin Chetty, Akila Kumarasiri, Chang Liu, J James Gordon
PURPOSE: To develop standard (SPCA) and regularized (RPCA) principal component analysis models of anatomical changes from daily cone beam CTs (CBCTs) of head and neck (H&N) patients and assess their potential use in adaptive radiation therapy, and for extracting quantitative information for treatment response assessment. METHODS: Planning CT images of ten H&N patients were artificially deformed to create "digital phantom" images, which modeled systematic anatomical changes during radiation therapy...
October 2016: Medical Physics
https://www.readbyqxmd.com/read/27782691/technical-note-scuda-a-software-platform-for-cumulative-dose-assessment
#20
Seyoun Park, Todd McNutt, William Plishker, Harry Quon, John Wong, Raj Shekhar, Junghoon Lee
PURPOSE: Accurate tracking of anatomical changes and computation of actually delivered dose to the patient are critical for successful adaptive radiation therapy (ART). Additionally, efficient data management and fast processing are practically important for the adoption in clinic as ART involves a large amount of image and treatment data. The purpose of this study was to develop an accurate and efficient Software platform for CUmulative Dose Assessment (scuda) that can be seamlessly integrated into the clinical workflow...
October 2016: Medical Physics
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