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3-D Conformal Radiotherapy

Sweet Ping Ng, Joseph M Herman
Pancreatic cancer is a devastating disease with poor survival outcomes. Recent studies have shown that the addition of radiotherapy to chemotherapy in the setting of locally advanced pancreatic cancer did not improve overall survival outcome. These studies commonly utilize conventional radiotherapy treatment fractionation and technique (typically 3-D conformal radiotherapy or intensity modulated radiotherapy). Although no clear benefit in overall survival was demonstrated in those studies, those who received radiotherapy did have a clear benefit in terms of local control...
March 16, 2018: Cancers
A Ranger, A Dunlop, K Hutchinson, H Convery, M K Maclennan, H Chantler, N Twyman, C Rose, D McQuaid, R A Amos, C Griffin, N M deSouza, E Donovan, E Harris, C E Coles, A Kirby
AIMS: Radiotherapy target volumes in early breast cancer treatment increasingly include the internal mammary chain (IMC). In order to maximise survival benefits of IMC radiotherapy, doses to the heart and lung should be minimised. This dosimetry study compared the ability of three-dimensional conformal radiotherapy, arc therapy and proton beam therapy (PBT) techniques with and without breath-hold to achieve target volume constraints while minimising dose to organs at risk (OARs). MATERIALS AND METHODS: In 14 patients' datasets, seven IMC radiotherapy techniques were compared: wide tangent (WT) three-dimensional conformal radiotherapy, volumetric-modulated arc therapy (VMAT) and PBT, each in voluntary deep inspiratory breath-hold (vDIBH) and free breathing (FB), and tomotherapy in FB only...
February 23, 2018: Clinical Oncology: a Journal of the Royal College of Radiologists
Benjamin P T Loveday, Jennifer J Knox, Laura A Dawson, Ur Metser, Anthony Brade, Anne M Horgan, Steven Gallinger, Paul D Greig, Carol-Anne Moulton
BACKGROUND AND OBJECTIVES: Neoadjuvant chemoradiation and liver transplantation may be offered for unresectable perihilar cholangiocarcinoma (pCCA). This study aimed to determine the dropout rate and survival of patients who entered a national tri-modality protocol. METHOD: Patients enrolled Jan 2009-Aug 2015 were included. Enrolment criteria: ≤65 years, brush biopsy-proven unresectable pCCA <3.5 cm diameter. Conformal radiotherapy was given concurrently with Capecitabine...
February 2018: Journal of Surgical Oncology
Jeremy Michael Brownstein, Amy Jordan Wisdom, Katherine D Castle, Yvonne M Mowery, Peter M Guida, Chang-Lung Lee, Francesco Tommasino, Chiara La Tessa, Emanuele Scifoni, Junheng Gao, Lixia Luo, Lorraine Da Silva Campos, Yan Ma, Nerissa Williams, Sin-Ho Jung, Marco Durante, David G Kirsch
Carbon ion therapy (CIT) offers several potential advantages for treating cancers compared with X-ray and proton radiotherapy including increased biological efficacy and more conformal dosimetry. However, CIT potency has not been characterized in primary tumor animal models. Here, we calculate the relative biological effectiveness (RBE) of carbon ions compared to X-rays in an autochthonous mouse model of soft tissue sarcoma. We used Cre/loxP technology to generate primary sarcomas in KrasLSL-G12D/+; p53fl/fl mice...
February 7, 2018: Molecular Cancer Therapeutics
Saif Aljabab, Balamurugan Vellayappan, Eric Vandervoort, Jamie Bahm, Robert Zohr, John Sinclair, Jean-Michel Caudrelier, Janos Szanto, Shawn Malone
PURPOSE: The aim of this study is to compare the dosimetric differences between four techniques for spine stereotactic body radiotherapy (SBRT): CyberKnife (CK), volumetric modulated arc therapy (VMAT), and helical tomotherapy (HT) with dynamic jaws (HT-D) and fixed jaws (HT-F). MATERIALS/METHODS: Data from 10 patients were utilized. All patients were planned for 24 Gy in two fractions, with the primary objectives being: (a) restricting the maximum dose to the cord to ≤ 17 Gy and/or cauda equina to ≤ 20 Gy, and (b) to maximize the clinical target volume (CTV) to receive the prescribed dose...
February 7, 2018: Journal of Applied Clinical Medical Physics
Muhammad Mohsin Fareed, Ahmed A Eldib, Stephanie E Weiss, Shelly B Hayes, Jinsheng Li, Chang-Ming Charlie Ma
Purpose: To compare the dosimetric parameters of a novel Rotating Gamma Ray System (RGS) with well-established CyberKnife system (CK) for treating malignant brain lesions. Materials and Methods: RGS has a treatment head of 16 cobalt-60 sources focused to the isocenter, which can rotate 360° on the ring gantry and swing 35° in the superior direction. We compared several dosimetric parameters in 10 patients undergoing brain stereotactic radiosurgery including plan normalization, the number of beams and nodes for CK and shots for RGS, collimators used, estimated treatment time, D 2 cm and conformity index (CI) among two modalities...
January 4, 2018: Physics in Medicine and Biology
A Brito Delgado, D Cohen, T Y Eng, D N Stanley, Z Shi, M Charlton, A N Gutiérrez
There has been growing interest in the use of stereotactic body radiotherapy (SBRT) technique for the treatment of cervical cancer. The purpose of this study was to characterize dose distributions as well as model the target dose fall-off for intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) delivery techniques using 6 and 10 MV photon beam energies. Fifteen (n = 15) patients with non-bulky cervical tumors were planned in Pinnacle3 with a Varian Novalis Tx (HD120 MLC) using 6 and 10 MV photons with the following techniques: (1) IMRT with 10 non-coplanar beams (2) dual, coplanar 358° VMAT arcs (4° spacing), and (3) triple, non-coplanar VMAT arcs...
April 2018: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Meryem Aktan, Gul Kanyilmaz, Berrin Benli Yavuz, Mehmet Koc, Mehmet Akif Eryılmaz, Mustafa Adli
PURPOSE: To evaluate the prognostic value of maximal standardized uptake values (SUVmax ) from serial fluor-18-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG PET/CT) in patients with nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS: Fifty-two patients with NPC who underwent18 F-FDG PET/CT scan before radiotherapy with/without chemotherapy were reviewed retrospectively. Twenty-seven patients (52%) were applied 3-D conformal radiotherapy and 25 patients (48%) applied intensity-modulated radiotherapy (IMRT)...
November 25, 2017: La Radiologia Medica
Cem Onal, Yemliha Dölek, Berna Akkuş Yıldırım
PURPOSE: To compare dosimetric data for the planning target volume (PTV) and organs at risk (OARs) between 3-dimensional conformal radiotherapy (3DCRT), volumetric modulated arc therapy (VMAT), and helical tomotherapy [1]. MATERIALS AND METHODS: The dosimetric data for 15 gastric cancer patients treated with 3DCRT, VMAT, or HT techniques were used. Cumulative dosimetric parameters, homogeneity index (HI), and conformal index (CI) were compared for the PTV and OARs...
November 3, 2017: Japanese Journal of Radiology
D N Cagney, P G Thirion, M T Dunne, C Fleming, D Fitzpatrick, C M O'Shea, M A Finn, S O'Sullivan, C Booth, C D Collins, S J Buckney, A Shannon, J G Armstrong
AIMS: The objective of this phase II clinical trial was to prospectively evaluate the safety and efficacy of accelerated hypofractionated three-dimensional conformal radiation therapy (3DCRT) in localised non-resectable/non-operable non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Sixty patients with stage I-III NSCLC were enrolled in a prospective single-arm All Ireland Co-operative Oncology Research Group (ICORG 99-09) toxicity end point phase II trial...
October 30, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
X X Du, H Yang, H J Zhang, L A Li, W S Fan, Y G Meng
Objective: To compare the dose, clinical efficacy and acute adverse reactions of intensity modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3D-CRT) combined with three-dimensional brachytherapy (3D-BT) in the treatment of concurrent radiotherapy and chemotherapy for advanced stage cervical cancer patients. Methods: Data collection was performed from January 2011 to November 2015 in Chinese PLA General Hospital and Inner Mongolia Cancer Hospital. All 89 patients with advanced stage (Ⅱ b-Ⅲ b) cervical cancer were treated by pelvic radiotherapy and concurrent chemotherapy, 46 cases of them received IMRT and 3D-BT (IMRT group) , 43 cases received 3D-CRT and 3D-BT (3D-CRT group) , along with cisplatin chemotherapy...
October 25, 2017: Zhonghua Fu Chan Ke za Zhi
Anesa Ahamad, Donald T Weed, Darel D Pruett, Daniel Saulpaugh, Womah Neeranjun, Eduardo Fernandez
When contemplating how to treat head and neck primary cancers and regional lymph nodes with radiotherapy, we often select the contemporary intensity-modulated radiotherapy (IMRT) without much consideration of older methods that may give fewer side effects and be more cost-effective. For an 87-year-old female with a 1.5-cm Merkel cell carcinoma (MCC) located 1.5 cm lateral to the orbital rim, we were challenged to deliver 50 Gy to comprehensive elective nodal regions and 70 Gy to the primary. We were particularly concerned about the potential adverse acute effects of radiotherapy to mucosal structures in this elderly female...
October 11, 2017: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Hideya Yamazaki, Norihiro Aibe, Satoaki Nakamura, Naomi Sasaki, Gen Suzuki, Ken Yoshida, Kei Yamada, Masahiko Koizumi, Taichiro Arimoto, Yoshinobu Iwasaki, Yoshiko Kaneko, Koichi Takayama
The present study aimed to examine the role of exhaled nitric oxide (eNO) and serum surfactant protein D (SP-D) level in the determination of radiation pneumonitis (RP) after thoracic radiotherapy (RT). The study included 34 treatments for 33 patients, including 16 three-dimensional conformal and 18 stereotactic body RT treatments. eNO levels were measured prior to RT, immediately subsequent to RT, every week during the RT course and at 1, 3, 6, 9 and 12 months following the treatment. The therapy reduced the eNO from 24...
October 2017: Oncology Letters
L Duvergé, J Castelli, T Lizée, R de Crevoisier, D Azria
Bladder dose constraints in case of conformational radiotherapy/intensity-modulated radiotherapy and stereotactic radiotherapy are reported from the literature, in particular from the French radiotherapy society RECORAD recommendations, according to the treated pelvic tumor sites. The dose-volume effect on urinary toxicity is not clearly demonstrated, making difficult to establish absolute dose constraints for the bladder. In case of high-dose prostate cancer radiotherapy, the bladder dose constraints are: V60Gy<50% and maximum dose<80Gy for standard fractionation and V60Gy<5%, V48Gy<25% and V41Gy<50% for moderate hypofractionation (20 fractions of 3Gy)...
October 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Cheng-Chia Wu, Yen-Ruh Wuu, Theodore Yanagihara, Ashish Jani, Eric P Xanthopoulos, Akhil Tiwari, Jason D Wright, William M Burke, June Y Hou, Ana I Tergas, Israel Deutsch
Pelvic radiotherapy for gynecologic malignancies traditionally used a 4-field box technique. Later trials have shown the feasibility of using intensity-modulated radiotherapy (IMRT) instead. But vaginal movement between fractions is concerning when using IMRT due to greater conformality of the isodose curves to the target and the resulting possibility of missing the target while the vagina is displaced. In this study, we showed that the use of a rectal balloon during treatment can decrease vaginal displacement, limit rectal dose, and limit acute and late toxicities...
September 1, 2017: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Christopher L Tinkle, Israel Fernandez-Pineda, April Sykes, Zhaohua Lu, Chia-Ho Hua, Michael D Neel, Armita Bahrami, Barry L Shulkin, Sue C Kaste, Alberto Pappo, Sheri L Spunt, Matthew J Krasin
BACKGROUND: Indications for and delivery of adjuvant therapies for pediatric nonrhabdomyosarcoma soft tissue sarcoma (NRSTS) have been derived largely from adult studies; therefore, significant concern remains regarding radiation exposure to normal tissue. The authors report long-term treatment outcomes and toxicities for pediatric and young adult patients with high-grade NRSTS who were treated on a prospective trial using limited-margin radiotherapy. METHODS: Sixty-two patients (ages 3-22 years) with predominantly high-grade NRSTS requiring radiation were treated on a phase 2 institutional study of conformal external-beam radiotherapy and/or brachytherapy using a 1...
November 15, 2017: Cancer
Courtney Pollard, Theresa P Nguyen, Sweet Ping Ng, Steven J Frank, Adam S Garden, Gary B Gunn, Clifton D Fuller, Beth M Beadle, William H Morrison, Shah J Shah, He Wang, Sam Tung, Conjun Wang, Lawrence D Ginsberg, Mark E Zafereo, Erich M Sturgis, Shirley Y Su, Ehab Y Hanna, David I Rosenthal, Jack Phan
BACKGROUND: The purpose of this study was to present our experience with retropharyngeal node reirradiation using highly conformal radiotherapy (RT). METHODS: A retrospective screen of 2504 consecutively irradiated patients with head and neck malignancies between 2005 and 2015 identified 19 patients who underwent reirradiation for retropharyngeal node metastasis. Clinical and toxicity outcomes were assessed in these patients. RESULTS: Thirteen patients (68%) had squamous cell carcinoma...
October 2017: Head & Neck
B Guo, J B Li, W Wang, M Xu, Q Shao, T H Liu
Objective: To investigate the potential dosimetric benefits of four-dimensional computed tomography (4DCT) compared to three-dimensional CT (3DCT) in the planning of radiotherapy for external-beam partial breast irradiation (EB-PBI). Methods: Three-DCT and 4DCT scan sets were acquired for 20 patients who underwent EB-PBI. For each patient a conventional 3D conformal plan (3D-CRT) was generated based on end-inhalation phase (EI). The treatment plan based on the 4DCT EI phase images was copied and applied to the end-exhalation phase (EE) and 3DCT images (defined as EB-PBI(EI), EB-PBI(EE), EB-PBI(3D), respectively)...
April 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
Sukran Ulger, Eren Cetin, Serap Catli, Hilal Sarac, Diclehan Kilic, Huseyin Bora
PURPOSE: To investigate high conformality on target coverage and the ability on creating strict lung dose limitation of intensity-modulated radiation therapy in malignant pleural mesothelioma. PATIENTS AND METHODS: Twenty-four radiation therapy plannings were evaluated and compared with dosimetric outcomes of conformal radiation therapy and intensity-modulated radiation therapy. Hemithoracal radiation therapy was performed on 12 patients with a fraction of 1.8 Gy to a total dose of 50...
June 2017: Technology in Cancer Research & Treatment
B-Y Yuan, Y Hu, L Zhang, Y-H Chen, Y-Y Dong, Z-C Zeng
BACKGROUND: Several studies have found benefits of radiotherapy for adrenal metastasis from hepatocellular carcinoma (HCC). However, the efficacy, safety and outcome issues have not yet been fully addressed. Therefore, we performed this study to further elucidate the feasibility and outcome of radiotherapy in treating adrenal metastasis from HCC. METHODS: We retrospectively analyzed 81 patients with adrenal metastasis from HCC between 2001 and 2015. Eighteen patients received helical tomotherapy and 63 patients received conventional radiotherapy, including two-dimensional (2-D) or three-dimensional conformal radiotherapy (3-D CRT)...
September 2017: Clinical & Translational Oncology
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