3DCRT

PURPOSE/OBJECTIVE(S): Radiation cardiotoxicity is a significant clinical dilemma in non-small cell lung cancer (NSCLC) radiation therapy (RT). Baseline cardiovascular (CV) status may influence the risk of cardiotoxicity, and may be ascertainable from the appearance of the heart on simulation computed tomography (CT). We examined the association of CT features with incidental heart dose and risk of cardiac events in NSCLC. MATERIALS/METHODS: Patients treated with curative-intent RT between 2015 and 2020 at a regional center were identified...

PURPOSE/OBJECTIVE(S): Most small cell lung cancer cases present as Stage IV (M1) or extensive stage (ES-SCLC), which are defined as tumor extending outside the hemithorax without a tolerable radiation portal. The CREST trial demonstrated improved local control with a modest overall survival (OS) benefit at the 2-year secondary endpoint of 14% survival with consolidative thoracic radiotherapy (CTRT) compared to 3% without CTRT. Low toxicity rates were also observed. This study reports our institutional ES-SCLC experience for patients treated with CTRT...

PURPOSE/OBJECTIVE(S): Cutaneous squamous cell carcinoma (cSCC) represents 20% of skin cancers of the head and neck, and metastatic spread to the parotid area lymph nodes (PALN) are found in 1-3% of cases. Herein, we present the updated results of the largest single institution experience using radiation therapy (RT) in the management of patients (pts) with PALN metastases from cSCC in North America. Our hypothesis is the addition of pts treated with modern RT would maintain acceptable efficacy with a favorable toxicity profile...

PURPOSE/OBJECTIVE(S): There is paucity of data on management of human immunodeficiency virus (HIV) positive cervical cancer and its clinical outcomes in Indian women. The primary objective of this study was to compare disease free survival (DFS) and overall survival (OS) between HIV-positive and HIV-negative patients receiving radiotherapy (RT) for cervical cancer. The secondary endpoints were toxicity and various factors affecting DFS and OS. MATERIALS/METHODS: Patients diagnosed with cervical cancer on histopathology and treated with RT with or without concomitant chemotherapy (CT) at an institution between 2015 and 2020 were included in this retrospective analysis...

PURPOSE/OBJECTIVE(S): The mainstays of treatment for Non-Hodgkin (NHL) and Hodgkin (HL) lymphoma are chemotherapy, radiotherapy (RT), or a combination of both. Thanks to improvements in treatment options many patients outlive their diagnosis by several decades. As treatments are de-intensified and cardiac sparing techniques have improved, the impact of RT on cardiac mortality should be re-visited. In this study, we sought to investigate the potential association between thoracic irradiation and cardiac-specific mortality (CSM) in patients with lymphoma...

PURPOSE/OBJECTIVE(S): To determine the effect of delays in radiation treatment preparation task timeliness on reported safety events. MATERIALS/METHODS: For 2022, all patients treated at four community-based radiation oncology clinics were included for analysis. Safety reports which occurred during treatment preparation tasks (i.e., between CT simulation and the first treatment) were included for this analysis. Patients with a reported safety event were the report cohort and those without were the control cohort...

PURPOSE/OBJECTIVE(S): Pretreatment Peer review meeting at our radiation oncology department is a weekly meeting, where the initial radiation treatment (RT) planning process for every patient is discussed including: Computed Tomography (CT) simulation and treatment planning. In this study, we are aiming to evaluate our peer review process and to report the compliance to the suggested modifications. MATERIALS/METHODS: All RT plans for all patients indicated for radiotherapy accepted by the primary radiation oncology team then presented in our weekly peer review meeting for final approval...

PURPOSE/OBJECTIVE(S): Low anterior resection syndrome (LARS) describes disordered bowel function including tenesmus, frequent, clustered, incomplete, urgent or incontinent bowel movements. The impact of clinical and radiation dosimetric factors on LARS score is unknown. We aimed to evaluate the radiation plans for patients who received long course chemoradiation (LC-CRT) to identify potential dosimetric predictors of LARS. MATERIALS/METHODS: We identified patients with rectal cancer treated with LC-CRT (50...

PURPOSE/OBJECTIVE(S): Both interstitial multi-catheter brachytherapy based accelerated partial breast irradiation (APBI) and ultra-hypo-fractionated whole breast irradiation (WBI) with 5 fractions can complete treatment in a short time and result in lower treatment-related costs. Although data are available on their toxicity compared with conventional and hypo-fractionated regimens, there are few data directly comparing these two techniques. MATERIALS/METHODS: This prospective cohort study enrolled early breast cancer patients with negative ink margin, T1 or T2 stage, and tumor size of 3 cm or less, with 0 to 3 positive lymph nodes after adequate axillary dissection or negative sentinel lymph node biopsy (N0-1), regardless of receptor status (ER, PR, HER2neu)...

PURPOSE/OBJECTIVE(S): In India, carcinoma of breast is the commonest malignancy among women. In multidisciplinary approach of its management, radiotherapy (RT) is an important component. Different cooperative groups have defined dose constraints to lungs and heart to minimize these late side effects such as radiation pneumonitis and coronary artery disease. To assess the achievability of dose constraints given for lung and heart by RTOG, EORTC and DBCG in our cohort of breast cancer patients who underwent conformal radiation therapy to chest wall / breast along with supraclavicular nodal region...

PURPOSE/OBJECTIVE(S): Patients (pts) with advanced lung cancer often receive combined palliative thoracic radiotherapy (RT) and immune checkpoint inhibitors (ICI). There are limited data assessing the toxicities of combined ICI-RT in this setting. We sought to compare the rates of clinically significant pneumonitis among pts with lung cancer receiving palliative thoracic RT with or without recent or concomitant ICI. We hypothesized there would be a higher rate of grade 2+ pneumonitis among RT pts who received recent or concomitant ICI compared to those who did not...

PURPOSE/OBJECTIVE(S): Variations in healthcare delivery by provider and patient-level characteristics have been well studied in the US health system as a whole, though these patterns are not as well defined in radiation oncology. We evaluated the association of provider zip-code level sociodemographic characteristics with variations in radiation therapy (RT) modality use. MATERIALS/METHODS: We used the Centers for Medicare & Medicaid Services (CMS) Physician and Other Supplier Public Use File, CMS Physician Compare, and National Neighborhood Data Archive databases to link non-facility based radiation oncologists and their submitted Medicare charges in 2020 with sociodemographic information of the provider's zip code...

PURPOSE/OBJECTIVE(S): Patients with localized prostate cancer (PCA) treated with RT alone have excellent outcomes, making quality of life and minimization of toxicities of great concern. The risk of developing toxicity may evolve with time from treatment which is of interest to patients seen in follow up. The primary objective of this study is to determine the conditional risk of grade 2+ GI or GU toxicity for patients treated with RT. A secondary objective is to determine risk factors associated with the development of late toxicities...

PURPOSE/OBJECTIVE(S): NRG/RTOG 0126, a phase III trial for men with localized prostate cancer testing whether dose escalation to 79.2 Gy with 3DCRT/IMRT improved overall survival (OS). Long-term results of this trial are presented. MATERIALS/METHODS: Patients with clinical stage T1b-T2b and either Gleason Score (GS) 2-6 and 10 ≤ PSA < 20 or GS 7 and PSA < 15 were eligible and randomized to receive 79.2 Gy or 70.2 Gy. No previous or concurrent androgen withdrawal therapy was administered...

BACKGROUND: Radiation therapy (RT) is an important step in the treatment of primary breast cancer as it is one of the leading contributors to cancer incidence among women. Most patients with this disease acquire radiation-induced lymphopenia in the early post-radiation period; however, little is known about the effect of RT on the composition of lymphocyte populations in such patients. This study was aimed at investigating the effect of adjuvant remote RT-performed in the classical mode for patients with primary breast cancer-on the main components of cell-mediated immunity (major lymphocyte populations), including those in patients receiving chemotherapy...

OBJECTIVES: We search the current literature on data regarding the role of RT in OM treatment, focusing on the improvement of symptoms and patient quality of life. METHODS: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. RESULTS: From 340 citations, 60 papers were finally selected: 45 case reports and 15 case series. The case reports accounted for 47 patients...

PURPOSE: The goal of this study was to obtain maximum allowed shift deviations from planning position in six degrees of freedom (DOF), that can serve as threshold values in surface guided radiation therapy (SGRT) of breast cancer patients. METHODS: The robustness of conformal treatment plans of 50 breast cancer patients against 6DOF shifts was investigated. For that, new dose distributions were calculated on shifted computed tomography scans and evaluated with respect to target volume and spinal cord dose...

INTRODUCTION: 85-90% of local recurrences after breastconserving surgery occurs within the index quadrant. Intraoperative radiotherapy may be a good alternative for eligible patients avoiding long course of adjuvant radiation. PATIENTS AND METHODS: Eligible patients were early stage node negative at least 50 years at time of inclusion, unicentric less than 30mm in diameter any hormone receptor status. 21 Gy was delivered intraoperatively, biologically equivalent to 58 to 60 Gy in standard fractionation using electron beam to 90% isodose line...

PURPOSE: The Ocean Road Cancer Institute (ORCI) in Tanzania began offering 3D conformal radiation therapy (3DCRT) in 2018. Steep learning curves, high patient volume, and a limited workforce resulted in long radiation therapy (RT) planning workflows. We aimed to establish the feasibility of implementing an automation-assisted cervical cancer 3DCRT planning system. MATERIALS AND METHODS: We performed chart abstractions on 30 patients with cervical cancer treated with 3DCRT at ORCI...

Comprehensive nodal breast irradiation is traditionally treated utilizing 3DCRT planning with a three or four field technique. While the three or four field photon technique may be the standard of care for comprehensive nodal breast treatment, the ipsilateral lung dose and heart mean can often be of concern dependent on patient's anatomy. Standard dose constraints (200cGy x25) per the Alliance A221505 trial strive to maintain the ipsilateral V20<35% and heart mean <3Gy. Double scattering proton therapy treatment has a significant advantage over photons in reducing the ipsilateral lung and heart dose due the Spread-Out Bragg Peak and rapid dose drop off...