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https://www.readbyqxmd.com/read/28749375/towards-fast-online-intrafraction-replanning-for-free-breathing-stereotactic-body-radiation-therapy-with-the-mr-linac
#1
Charis Kontaxis, Gijsbert H Bol, Bjorn Stemkens, Markus Glitzner, Fieke M Prins, Linda G W Kerkmeijer, Jan J W Lagendijk, Bas W Raaymakers
The hybrid MRI-radiotherapy machines, like the MR-linac (Elekta AB, Stockholm, Sweden) installed at the UMC Utrecht (Utrecht, The Netherlands), will be able to provide real-time patient imaging during treatment. In order to take advantage of the system's capabilities and enable online adaptive treatments, a new generation of software should be developed, ranging from motion estimation to treatment plan adaptation. In this work we present a proof of principle adaptive pipeline designed for high precision Stereotactic Body Radiation Therapy (SBRT) suitable for sites affected by respiratory motion, like Renal Cell Carcinoma (RCC)...
July 27, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28749176/quantifying-potential-reduction-in-contrast-dose-with-monoenergetic-images-synthesized-from-duallayer-detector-spectral-ct
#2
Derek S Tsang, Thomas E Merchant, Sophie E Merchant, Hanna Smith, Yoad Yagil, Chia-Ho Hua
OBJECTIVES: To estimate the potential dose reduction in iodinated contrast when interpreting monoenergetic images from spectral CT. METHODS: 51 pediatric patients received contrast-enhanced CT simulation for radiation therapy using a single-source, dual-layer detector spectral CT. The contrast-to-noise ratios (CNR) of blood vessels were measured relative to surrounding soft tissue. CNRs on monoenergetic 40-70 keV images were compared with polychromatic 120 kVp images...
July 27, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28749174/microbeam-radiation-therapy-grid-therapy-and-beyond-a-clinical-perspective
#3
Elisabeth Schültke, Jacques Balosso, Thomas Breslin, Guido Cavaletti, Valentin Djonov, Francois Esteve, Michael Grotzer, Guido Hildebrandt, Alexander Valdman, Jean A Laissue
Microbeam irradiation is spatially fractionated radiation on a micrometer scale. Microbeam irradiation with therapeutic intent has become known as microbeam radiation therapy (MRT). The basic concept of MRT was developed in the 1980s, but it has not yet been tested in any human clinical trial, even although there is now a large number of animal studies demonstrating its marked therapeutic potential with an exceptional normal tissue sparing effect. Furthermore, MRT is conceptually similar to macroscopic grid based radiation therapy which has been used in clinical practice for decades...
July 27, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28749165/impact-of-robotic-ultrasound-image-guidance-on-plan-quality-in-sbrt-of-the-prostate
#4
Stefan Gerlach, Ivo Kuhlemann, Floris Ernst, Christoph Fürweger, Alexander Schlaefer
OBJECTIVES: Ultrasound provides good image quality, fast volumetric imaging, and is established for abdominal image guidance. Robotic transducer placement may facilitate intra-fractional motion compensation in radiation therapy. We consider integration with the CyberKnife and study whether the kinematic redundancy of a seven-degrees-of-freedom robot allows for acceptable plan quality for prostate treatments. METHODS: Reference treatment plans were generated for ten prostate cancer cases previously treated with the CyberKnife...
July 27, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28747265/pancreatic-adenocarcinoma-effects-of-neoadjuvant-therapy-on-post-pancreatectomy-outcomes-an-american-college-of-surgeons-national-surgical-quality-improvement-program-targeted-variable-review
#5
Nicholas M Czosnyka, Andrew J Borgert, Travis J Smith
BACKGROUND: As the incidence of pancreatic adenocarcinoma increases, so has the utilization of neoadjuvant therapy. The objective of this study was to evaluate outcomes in patients undergoing neoadjuvant therapy or surgery first for pancreatic adenocarcinoma. METHODS: The ACS-NSQIP 2014-2015 targeted pancreatectomy variables were queried for patients with pancreatic adenocarcinoma who underwent resection. Outcomes of those receiving neoadjuvant therapy were compared to surgery first using a multivariate, logistic regression model...
July 23, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28747130/body-composition-predictors-of-therapy-response-in-patients-with-primary-extremity-soft-tissue-sarcomas
#6
Karen De Amorim Bernstein, Stijn A Bos, Joyce Veld, Santiago A Lozano-Calderon, Martin Torriani, Miriam A Bredella
Background Recent studies have suggested that the quantity and quality of adipose tissue and muscle, assessed on non-contrast computed tomography (CT), may serve as imaging biomarkers of survival in patients with and without neoplasms. Purpose To assess body composition measures that could serve as predictors of therapy response in patients with extremity soft tissue sarcomas treated with radiation therapy and surgery. Material and Methods The study was IRB-approved. Sixty patients had a history of extremity soft tissue sarcoma and underwent FDG-PET/CT prior to radiation therapy and surgical resection...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28746702/identifying-an-optimal-adjuvant-radiotherapy-dose-for-extremity-and-trunk-merkel-cell-carcinoma-following-resection-an-analysis-of-the-national-cancer-database
#7
Sagar A Patel, Muhammad M Qureshi, Debjani Sahni, Minh Tam Truong
Importance: Merkel cell carcinoma (MCC) is a rare and aggressive cutaneous neuroendocrine neoplasm with a high risk of recurrence following resection. Despite a rising incidence over the past 3 decades, there is a paucity of prospective data owing to the rarity of this disease. Objective: To determine the optimal adjuvant radiation therapy (RT) dose following resection of localized MCC of the extremities or trunk. Design, Setting, and Participants: Using the National Cancer Database, a large national database consisting of a heterogeneous population and treatment settings, we retrospectively analyzed a cohort of 2093 patients 18 years or older with stage I to III MCC of the extremities and/or trunk treated with definitive surgery and adjuvant RT between 1998 and 2011...
July 26, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28746279/thy1-cd90-expression-is-elevated-in-radiation-induced-periprosthetic-capsular-contracture-implication-for-novel-therapeutics
#8
Trevor C Hansen, Collynn F Woeller, Shannon H Lacy, Peter F Koltz, Howard N Langstein, Richard P Phipps
BACKGROUND: Capsular contracture is a devastating complication of postmastectomy implant-based breast reconstruction. Unfortunately, capsular contracture rates are drastically increased by targeted radiotherapy, a standard postmastectomy treatment. Thy1 (also called CD90) is important in myofibroblast differentiation and scar tissue formation. However, the impact of radiotherapy on Thy1 expression and the role of Thy1 in capsular contracture are unknown. METHODS: The authors analyzed Thy1 expression in primary human capsular tissue and primary fibroblast explants by real-time quantitative polymerase chain reaction, Western blotting, and immunohistochemistry...
August 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28745610/clinically-non-functioning-pituitary-adenomas-pathogenic-diagnostic-and-therapeutic-aspects
#9
Moises Mercado, Virgilio Melgar, Latife Salame, Dalia Cuenca
Clinically non-functioning pituitary adenomas (NFPAs) are among the most common tumors in the sellar region. These lesions do not cause a hormonal hypersecretion syndrome, and are therefore found incidentally (particularly microadenomas) or diagnosed based on compressive symptoms such as headache and visual field defects, as well as clinical signs of pituitary hormone deficiencies. Immunohistochemically, more than 45% of these adenomas stain for gonadotropins or their subunits and are therefore called gonadotropinomas, while 30% of them show no immunostaining for any hormone and are known as null cell adenomas...
August 2017: Endocrinología, diabetes y nutrición
https://www.readbyqxmd.com/read/28745431/trabectedin-is-a-promising-antitumor-agent-potentially-inducing-melanocytic-differentiation-for-clear-cell-sarcoma
#10
Takaaki Nakai, Yoshinori Imura, Hironari Tamiya, Shutaro Yamada, Sho Nakai, Naohiro Yasuda, Keiko Kaneko, Hidetatsu Outani, Satoshi Takenaka, Kenichiro Hamada, Akira Myoui, Nobuhito Araki, Takafumi Ueda, Kazuyuki Itoh, Hideki Yoshikawa, Norifumi Naka
Clear cell sarcoma is an aggressive soft tissue sarcoma and highly resistant to conventional chemotherapy and radiation therapy. This devastating disease is defined by EWSR1-ATF1 fusion gene resulting from chromosomal translocation t(12;22)(q13;q12) and characterized by melanocytic differentiation. A marine-derived antineoplastic agent, trabectedin, inhibits the growth of myxoid liposarcoma and Ewing sarcoma by causing adipogenic differentiation and neural differentiation, respectively. In this study, we examined the antitumor effects and mechanism of action of trabectedin on human clear cell sarcoma cell lines...
July 26, 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28745084/patient-with-unresectable-cholangiocarcinoma-treated-with-radiofrequency-hyperthermia-in-combination-with-chemotherapy-a-case-report
#11
Juyoung Ryu, Kangwook Lee, Changmug Joe, JongCheon Joo, Namhun Lee, Hwa-Seung Yoo
Hyperthermia, which is a noninvasive treatment that causes tumor cells to become heated and that works in synergy with anticancer drugs and radiation therapy, is emerging as a promising treatment for patients with cancer. The purpose of this study is to report the efficacy of hyperthermia combined with chemotherapy (gemcitabine/cisplatin) for the treatment of a patient with unresectable cholangiocarcinoma. A 54-year-old man was diagnosed as hilar cholangiocarcinoma (Klatskin tumor) and was administered neoadjuvant and preoperative radiation with chemotherapy...
July 1, 2017: Integrative Cancer Therapies
https://www.readbyqxmd.com/read/28745064/therapeutic-potential-of-investigational-chk-1-inhibitors-for-the-treatment-of-solid-tumors
#12
Hani M Babiker, Ali McBride, Laurence S Cooke, Daruka Mahadevan
For several decades' cancer treatment targeting DNA repair pathways incorporated both chemo- and radiotherapy only. However, over the last decade improved knowledge of DNA repair processes has paved the way for the development of novel targeted drugs abrogating DNA repair signaling. Checkpoint kinase inhibitors are exciting molecules and hold promise in the treatment of both solid and hematologic malignancies. Herein, we discuss preclinical and clinical studies with this class of molecules. Areas Covered: In this review, we discuss the role of check point kinase 1 (CHK-1) in DNA repair and provide a comprehensive summary of pre-clinical and early phase clinical trials with CHK-1 inhibitors...
July 26, 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/28744863/classification-of-changes-occurring-in-lung-patient-during-radiotherapy-using-relative-%C3%AE-analysis-and-hidden-markov-models
#13
Nicolas Varfalvy, Ophelie Piron, Marc François Cyr, Anne Dagnault, Louis Archambault
PURPOSE: to present a new automated patient classification method based on relative gamma analysis and hidden Markov models (HMM) to identify patients undergoing important anatomical changes during radiation therapy. METHODS: daily EPID images of every treatment field were acquired for 52 patients treated for lung cancer. In addition, CBCT were acquired on a regular basis. Gamma analysis was performed relative to the first fraction given that no significant anatomical change was observed on the CBCT of the first fraction compared to the planning CT...
July 26, 2017: Medical Physics
https://www.readbyqxmd.com/read/28744829/early-initiation-of-chemoradiation-following-index-craniotomy-is-associated-with-decreased-survival-in-high-grade-glioma
#14
Jay K Nathan, Amanda L Brezzell, Michelle M Kim, Denise Leung, D Andrew Wilkinson, Shawn L Hervey-Jumper
The Stupp protocol of post-resection external beam radiation therapy and concomitant temozolomide is the standard of care for patients with newly-diagnosed glioblastoma, with expanded use in anaplastic astrocytoma. However, the optimal interval between surgery and these adjuvant therapies, and its impact on survival, is unknown. To investigate this, de-identified claims from a large, private health insurance database were queried to identify adult patients who underwent index craniotomy for resection of a supratentorial neoplasm during the period 2005-2014 and began postoperative radiation and temozolomide within 13 weeks of surgery...
July 25, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28744744/the-effect-of-neoadjuvant-chemoradiation-on-anastomotic-leak-and-additional-30-day-morbidity-and-mortality-in-patients-undergoing-total-gastrectomy-for-gastric-cancer
#15
Ivy N Haskins, Matthew D Kroh, Richard L Amdur, Jeffrey L Ponksy, John H Rodriguez, Khashayar Vaziri
INTRODUCTION: In addition to increased perioperative morbidity, anastomotic leak following gastric resection for gastric cancer can have detrimental effects on overall and disease-free survival. The risk of anastomotic leak following neoadjuvant therapy remains unknown. The purpose of this study is to investigate the association of preoperative chemotherapy and radiation therapy with postoperative anastomotic leak and additional 30-day morbidity and mortality outcomes following total gastrectomy with reconstruction for gastric cancer using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP)...
July 25, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28743588/determining-the-outcomes-of-post-mastectomy-radiation-therapy-delivered-to-the-definitive-implant-in-patients-undergoing-one-and-two-stage-implant-based-breast-reconstruction-a%C3%A2-systematic-review-and-meta-analysis
#16
REVIEW
Louise J Magill, Francis P Robertson, Gavin Jell, Afshin Mosahebi, Mohammed Keshtgar
BACKGROUND: Post-mastectomy radiation therapy (PMRT) is known to increase the complication rate and implant loss in implant-based breast reconstruction. The purpose of this study was to systematically review the literature regarding the outcome of PMRT delivered to the permanent/definitive implant. METHODS: Systematic review and meta-analysis of studies involving immediate implant-based reconstruction and PMRT when delivered to the permanent implant. RESULTS: Seven studies included 2921 patients (520 PMRT, 2401 control)...
June 9, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28743274/risk-factors-and-a-prediction-model-for-lower-limb-lymphedema-following-lymphadenectomy-in-gynecologic-cancer-a-hospital-based-retrospective-cohort-study
#17
Kenji Kuroda, Yasuhiro Yamamoto, Manami Yanagisawa, Akira Kawata, Naoya Akiba, Kensuke Suzuki, Kazutoshi Naritaka
BACKGROUND: Lower limb lymphedema (LLL) is a chronic and incapacitating condition afflicting patients who undergo lymphadenectomy for gynecologic cancer. This study aimed to identify risk factors for LLL and to develop a prediction model for its occurrence. METHODS: Pelvic lymphadenectomy (PLA) with or without para-aortic lymphadenectomy (PALA) was performed on 366 patients with gynecologic malignancies at Yaizu City Hospital between April 2002 and July 2014; we retrospectively analyzed 264 eligible patients...
July 25, 2017: BMC Women's Health
https://www.readbyqxmd.com/read/28743137/-surgical-methods-in-the-treatment-of-uveal-melanoma
#18
Georgios Blatsios, Gertrud Haas, Claus Zehetner, Nikolaos E Bechrakis
Significant advancements have been made in the last decades in the treatment of uveal melanoma. Radiation therapy can achieve, depending on the method, local tumour control in up to 98% of cases. Surgical modalities have been implemented in the ocular therapy for uveal melanoma either to treat/prevent radiation complications, such as so-called toxic tumour syndrome, or to primarily treat the tumour with or without adjunctive radiotherapy. These include endoresection and transscleral resection for melanomas of the choroid/ciliary body or irido-trabeculo-cyclectomy for melanomas of the iris-ciliary body...
July 2017: Klinische Monatsblätter Für Augenheilkunde
https://www.readbyqxmd.com/read/28742734/evaluation-of-gadolinium-retention-after-serial-administrations-of-a-macrocyclic-gadolinium-based-contrast-agent-gadobutrol-a-single-institution-experience-with-189-patients
#19
Roh-Eul Yoo, Chul-Ho Sohn, Koung Mi Kang, Tae Jin Yun, Seung Hong Choi, Ji-Hoon Kim, Sun-Won Park
OBJECTIVE: There has been controversy as to whether gadobutrol, one of the widely used macrocyclic gadolinium-based contrast agents, can lead to gadolinium retention after serial injections. Our aim was to validate whether serial administrations of gadobutrol can cause signal increase in the dentate nucleus (DN) and globus pallidus (GP) on unenhanced T1-weighted magnetic resonance (MR) images due to gadolinium retention. MATERIALS AND METHODS: A total of 189 patients who had undergone at least 2 contrast-enhanced MR scans using only gadobutrol between August 2009 and August 2016 were retrospectively included...
July 24, 2017: Investigative Radiology
https://www.readbyqxmd.com/read/28742703/organ-preservation-in-ct2n0-rectal-cancer-after-neoadjuvant-chemoradiation-therapy-the-impact-of-radiation-therapy-dose-escalation-and-consolidation-chemotherapy
#20
Angelita Habr-Gama, Guilherme Pagin São Julião, Bruna Borba Vailati, Jorge Sabbaga, Patricia Bailão Aguilar, Laura Melina Fernandez, Sergio Eduardo Alonso Araújo, Rodrigo Oliva Perez
OBJECTIVE: To demonstrate the difference in organ-preservation rates and avoidance of definitive surgery among cT2N0 rectal cancer patients undergoing 2 different chemoradiation (CRT) regimens. BACKGROUND: Patients with cT2N0 rectal cancer are more likely to develop complete response to neoadjuvant CRT. Organ preservation has been considered an alternative treatment strategy for selected patients. Radiation dose-escalation and consolidation chemotherapy have been associated with increased rates of response and may improve chances of organ preservation among these patients...
July 24, 2017: Annals of Surgery
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