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https://www.readbyqxmd.com/read/28529896/advances-in-radiotherapy-techniques-and-delivery-for-non-small-cell-lung-cancer-benefits-of-intensity-modulated-radiation-therapy-proton-therapy-and-stereotactic-body-radiation-therapy
#1
REVIEW
Tejan P Diwanji, Pranshu Mohindra, Melissa Vyfhuis, James W Snider, Chaitanya Kalavagunta, Sina Mossahebi, Jen Yu, Steven Feigenberg, Shahed N Badiyan
The 21st century has seen several paradigm shifts in the treatment of non-small cell lung cancer (NSCLC) in early-stage inoperable disease, definitive locally advanced disease, and the postoperative setting. A key driver in improvement of local disease control has been the significant evolution of radiation therapy techniques in the last three decades, allowing for delivery of definitive radiation doses while limiting exposure of normal tissues. For patients with locally-advanced NSCLC, the advent of volumetric imaging techniques has allowed a shift from 2-dimensional approaches to 3-dimensional conformal radiation therapy (3DCRT)...
April 2017: Translational Lung Cancer Research
https://www.readbyqxmd.com/read/28527523/advances-in-radiation-oncology-what-to-consider
#2
REVIEW
John V Hegde, Allen M Chen, Robert K Chin
Treatment of squamous cell carcinoma of the head and neck is rapidly evolving due to changing patient populations, an emphasis on quality of life-related outcomes, and advances in radiotherapy concepts and techniques to meet these new demands. This review includes recent and ongoing studies that are potentially practice changing, including improvements in intensity-modulated radiotherapy planning, the use of deintensified regimens in the human papilloma virus-related setting, and adjuvant therapy after transoral robotic surgery...
May 17, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28526616/stereotactic-ablative-radiotherapy-in-treatment-of-early-stage-non-small-cell-lung-cancer-unsolved-questions-and-frontiers-ahead
#3
Jingze Zhang, Li Kong, Qinghua Jiao, Minghuan Li, Jingming Yu
Stereotactic ablative radiotherapy (SABR) has been recognized as a standard alternative treatment to surgery for inoperable early stage non-small cell lung cancer (NSCLC). Guaranteed local control rates over 90% makes oncologists wonder whether SABR is qualified enough to challenge surgery in operable patients. The role of SABR for centrally located lesions would be another question because of the increased risk of severe toxic effect. Plenty of studies suggest that optimization of dose regimen and appropriate case selection would be helpful...
May 16, 2017: Cancer Letters
https://www.readbyqxmd.com/read/28514929/five-year-outcomes-from-a-prospective-trial-of-image-guided-accelerated-hypofractionated-proton-therapy-for-prostate-cancer
#4
Randal H Henderson, Curtis Bryant, Bradford S Hoppe, R Charles Nichols, William M Mendenhall, Stella Flampouri, Zhong Su, Zuofeng Li, Christopher G Morris, Nancy P Mendenhall
PURPOSE: To report 5-year outcomes of a prospective trial of image-guided accelerated hypofractionated proton therapy (AHPT) for prostate cancer. PATIENTS AND METHODS: 215 prostate cancer patients accrued to a prospective institutional review board-approved trial of 70Gy(RBE) in 28 fractions for low-risk disease (n = 120) and 72.5Gy(RBE) in 29 fractions for intermediate-risk disease (n = 95). This trial excluded patients with prostate volumes of ≥60 cm(3) or International Prostate Symptom Scores (IPSS) of ≥15, patients on anticoagulants or alpha-blockers, and patients in whom dose-constraint goals for organs at risk (OAR) could not be met...
July 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28509599/a-review-of-dosimetric-and-toxicity-modeling-of-proton-versus-photon-craniospinal-irradiation-for-pediatrics-medulloblastoma
#5
Evangeline S Q Ho, Sarah A Barrett, Laura M Mullaney
BACKGROUND: Craniospinal irradiation (CSI) is the standard radiation therapy treatment for medulloblastoma. Conventional CSI photon therapy (Photon-CSI) delivers significant dose to surrounding normal tissue (NT). Research into pediatric CSI with proton therapy (Proton-CSI) has increased, with the aim of exploiting the potential to reduce NT dose and associated post-treatment complications. This review aims to compare treatment outcomes of pediatric medulloblastoma patients between Proton- and Photon-CSI treatments...
May 16, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28506520/the-evolving-role-of-proton-beam-therapy-for-sarcomas
#6
S Frisch, B Timmermann
As an alternative to conventional photon-based radiotherapy, radiation with protons is recognised to offer considerable advantages. Today, central nervous system tumours, various sarcomatous tumours, childhood cancer and head and neck tumours are commonly treated with proton therapy. This review evaluates current data from clinical and dosimetric trials on the treatment of selected sarcomatous tumours like rhabdomyosarcoma, osteosarcoma, chordoma, chondrosarcoma and Ewing sarcoma. Special considerations for paediatric tumours and future prospects of proton therapy are outlined...
May 12, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28503964/recent-advances-in-intensity-modulated-radiotherapy-and-proton-therapy-for-esophageal-cancer
#7
Mian Xi, Steven H Lin
Radiotherapy is an important component of the standard of care for esophageal cancer. In the past decades, significant improvements in the planning and delivery of radiation techniques have led to better dose conformity to the target volume and improved normal tissue sparing. Areas covered: This review focuses on the advances in radiotherapy techniques and summarizes the availably dosimetric and clinical outcomes of intensity-modulated radiation therapy (IMRT), volumetric modulated arc therapy, proton therapy, and four-dimensional radiotherapy for esophageal cancer, and discusses the challenges and future development of proton therapy...
May 13, 2017: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/28503258/feasibility-of-pancreatectomy-following-high-dose-proton-therapy-for-unresectable-pancreatic-cancer
#8
Kathryn E Hitchcock, R Charles Nichols, Christopher G Morris, Debashish Bose, Steven J Hughes, John A Stauffer, Scott A Celinski, Elizabeth A Johnson, Robert A Zaiden, Nancy P Mendenhall, Michael S Rutenberg
AIM: To review surgical outcomes for patients undergoing pancreatectomy after proton therapy with concomitant capecitabine for initially unresectable pancreatic adenocarcinoma. METHODS: From April 2010 to September 2013, 15 patients with initially unresectable pancreatic cancer were treated with proton therapy with concomitant capecitabine at 1000 mg orally twice daily. All patients received 59.40 Gy (RBE) to the gross disease and 1 patient received 50.40 Gy (RBE) to high-risk nodal targets...
April 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28480067/radiation-therapy-for-hepatobiliary-malignancies
#9
REVIEW
Jonathan W Lischalk, Michael C Repka, Keith Unger
Hepatobiliary malignancies represent a heterogeneous group of diseases, which often arise in a background of underlying hepatic dysfunction complicating their local management. Surgical resection continues to be the standard of care for hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC); unfortunately the majority of patients are inoperable at presentation. The aggressiveness of these lesions makes locoregional control of particular importance. Historical experience with less sophisticated radiotherapy resulted in underwhelming efficacy and oftentimes prohibitive liver toxicity...
April 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28472381/a-simulation-study-on-the-dosimetric-benefit-of-real-time-motion-compensation-in-spot-scanning-proton-therapy-for-prostate
#10
Yusuke Fujii, Taeko Matsuura, Seishin Takao, Yuka Matsuzaki, Takaaki Fujii, Naoki Miyamoto, Kikuo Umegaki, Kentaro Nishioka, Shinichi Shimizu, Hiroki Shirato
For proton spot scanning, use of a real-time-image gating technique incorporating an implanted marker and dual fluoroscopy facilitates mitigation of the dose distribution deterioration caused by interplay effects. This study explored the advantages of using a real-time-image gating technique, with a focus on prostate cancer. Two patient-positioning methods using fiducial markers were compared: (i) patient positioning only before beam delivery, and (ii) patient positioning both before and during beam delivery using a real-time-gating technique...
May 4, 2017: Journal of Radiation Research
https://www.readbyqxmd.com/read/28464744/impact-of-beam-angle-choice-on-pencil-beam-scanning-breath-hold-proton-therapy-for-lung-lesions
#11
Jenny Gorgisyan, Rosalind Perrin, Antony J Lomax, Gitte F Persson, Mirjana Josipovic, Svend Aage Engelholm, Damien C Weber, Per Munck Af Rosenschold
INTRODUCTION: The breath-hold technique inter alia has been suggested to mitigate the detrimental effect of motion on pencil beam scanned (PBS) proton therapy dose distributions. The aim of this study was to evaluate the robustness of incident proton beam angles to day-to-day anatomical variations in breath-hold. MATERIALS AND METHODS: Single field PBS plans at five degrees increments in the transversal plane were made and water-equivalent path lengths (WEPLs) were derived on the planning breath-hold CT (BHCT) for 30 patients diagnosed with locally-advanced non-small cell lung cancer (NSCLC), early stage NSCLC or lung metastasis...
June 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28464743/monte-carlo-simulations-of-a-low-energy-proton-beamline-for-radiobiological-experiments
#12
Tordis J Dahle, Anne Marit Rykkelid, Camilla H Stokkevåg, Andrea Mairani, Andreas Görgen, Nina J Edin, Eivind Rørvik, Lars Fredrik Fjæra, Eirik Malinen, Kristian S Ytre-Hauge
BACKGROUND: In order to determine the relative biological effectiveness (RBE) of protons with high accuracy, radiobiological experiments with detailed knowledge of the linear energy transfer (LET) are needed. Cell survival data from high LET protons are sparse and experiments with low energy protons to achieve high LET values are therefore required. The aim of this study was to quantify LET distributions from a low energy proton beam by using Monte Carlo (MC) simulations, and to further compare to a proton beam representing a typical minimum energy available at clinical facilities...
June 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28464742/functional-image-guided-dose-escalation-in-gliomas-using-of-state-of-the-art-photon-vs-proton-therapy
#13
Anne Ivalu Sander Holm, Jørgen Breede Baltzer Petersen, Ludvig Paul Muren, Klaus Seiersen, Per Borghammer, Slávka Lukacova
BACKGROUND: Recurrences of glioma are usually local, suggesting the need for higher tumor dose. We investigated the boundaries for dose escalation of an (18)F-fluoro-ethyl-tyrosine positron emission tomography defined target by intensity-modulated photon therapy (IMRT), volumetric modulated arc therapy (VMAT) and intensity-modulated proton therapy (IMPT). MATERIALS AND METHODS: Standard dose (60 Gy) and dose-escalated plans were calculated for seven patients using IMRT, VMAT and IMPT...
June 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28464736/incorporation-of-relative-biological-effectiveness-uncertainties-into-proton-plan-robustness-evaluation
#14
Jakob Ödén, Kjell Eriksson, Iuliana Toma-Dasu
BACKGROUND: The constant relative biological effectiveness (RBE) of 1.1 is typically assumed in proton therapy. This study presents a method of incorporating the variable RBE and its uncertainties into the proton plan robustness evaluation. MATERIAL AND METHODS: The robustness evaluation was split into two parts. In part one, the worst-case physical dose was estimated using setup and range errors, including the fractionation dependence. The results were fed into part two, in which the worst-case RBE-weighted doses were estimated using a Monte Carlo method for sampling the input parameters of the chosen RBE model...
June 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28464735/varying-relative-biological-effectiveness-in-proton-therapy-knowledge-gaps-versus-clinical-significance
#15
Clemens Grassberger, Harald Paganetti
No abstract text is available yet for this article.
June 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28464734/beam-angle-evaluation-to-improve-inter-fraction-motion-robustness-in-pelvic-lymph-node-irradiation-with-proton-therapy
#16
Andreas Gravgaard Andersen, Oscar Casares-Magaz, Jørgen Petersen, Jakob Toftegaard, Lise Bentzen, Sara Thörnqvist, Ludvig Paul Muren
BACKGROUND: Proton therapy dose distributions are sensitive to range variations, e.g. arising from inter-fraction organ motion. The aim of this study was to evaluate the inter-fraction motion robustness of proton beams from different beam angles in irradiation of pelvic lymph nodes (LNs). MATERIAL AND METHODS: Planning CT (pCT) and multiple repeat CT (rCT) scans of 18 prostate cancer patients were used. Considering left and right LNs separately, the average water equivalent path length (WEPL) over all ray paths in the beams eye view of the LNs were calculated for all gantry/couch angle combinations across all rCTs versus the corresponding pCT...
June 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28464733/evaluating-the-influence-of-organ-motion-during-photon-vs-proton-therapy-for-locally-advanced-prostate-cancer-using-biological-models
#17
Kia Busch, Andreas G Andersen, Oscar Casares-Magaz, Jørgen B B Petersen, Lise Bentzen, Sara Thörnqvist, Ludvig P Muren
BACKGROUND: Proton therapy (PT) may have a normal tissue sparing potential when co-irradiating pelvic lymph nodes in patients with locally advanced prostate cancer, but may also be more sensitive towards organ motion in the pelvis. Building upon a previous study identifying motion-robust proton beam angles for pelvic irradiation, we aimed to evaluate the influence of organ motion for PT using biological models, and to compare this with contemporary photon-based RT. MATERIAL AND METHODS: Eight locally advanced prostate cancer patients with a planning CT (pCT) and 8-9 repeated CT scans (rCTs) were included...
June 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28456587/proton-therapy-for-head-and-neck-cancer-expanding-the-therapeutic-window
#18
REVIEW
Jonathan E Leeman, Paul B Romesser, Ying Zhou, Sean McBride, Nadeem Riaz, Eric Sherman, Marc A Cohen, Oren Cahlon, Nancy Lee
Use of proton beam therapy has expanded, with the number of proton centres rapidly increasing not only in the USA but also worldwide. The physical characteristics of the proton beam offer important advantages versus widely used photon techniques in terms of radiation precision. In head and neck cancer in particular, proton beam therapy is uniquely suited for the complex anatomy of tumours and sensitive surrounding organs. De-intensification and personalisation of treatment to limit toxicity are of renewed importance in the context of human papilloma virus-associated disease, in which young patients will be cured but bear the consequences of adverse effects for decades...
April 26, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28449824/primary-mucosal-melanoma-of-the-palatine-tonsil-report-of-a-case-and-review-of-the-literature
#19
Marcela Osorio, Sami P Moubayed, Juan Hernandez-Prera, John C Scott, Mark L Urken
BACKGROUND: Mucosal melanoma of the palatine tonsil is extremely rare. Due to its poor prognosis, primary tonsillar melanoma requires prompt recognition and treatment. METHODS: A 62-year-old female presented with a deeply pigmented and exophytic lesion in the left tonsillar fossa. The patient underwent a partial pharyngectomy through a midline labio-mandibulotomy approach along with a left level I-V neck dissection. Reconstruction with a left radial forearm free flap and a pharyngeal constrictor advancement pharyngoplasty was performed...
April 21, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28444840/topas-simulation-of-the-mevion-s250-compact-proton-therapy-unit
#20
Michael Prusator, Salahuddin Ahmad, Yong Chen
As proton therapy becomes increasingly popular, so does the need for Monte Carlo simulation studies involving accurate beam line modeling of proton treatment units. In this study, the 24 beam configurations of the Mevion S250 proton therapy system installed recently at our institution were modeled using the TOolkit for PArticle Simulation (TOPAS) code. Pristine Bragg peak, spread out Bragg peak (SOBP), and lateral beam profile dose distributions were simulated and matched to the measurements taken during commissioning of the unit...
April 26, 2017: Journal of Applied Clinical Medical Physics
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