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https://www.readbyqxmd.com/read/29595145/feasibility-of-online-impt-adaptation-using-fast-automatic-and-robust-dose-restoration
#1
Kinga Bernatowicz, Xavier Geets, Ana Barragan, Guillaume Janssens, Kevin Souris, Edmond Sterpin
Intensity-modulated proton therapy (IMPT) offers excellent dose conformity and healthy tissue sparing, but it can be substantially compromised in the presence of anatomical changes. A major dosimetric effect is caused by density changes, which alter the planned proton range in the patient. Three different methods, which automatically restore an IMPT plan dose on a daily CT image were implemented and compared: (1) simple dose restoration (DR) using optimization objectives of the initial plan, (2) voxel-wise dose restoration (vDR), and (3) isodose volume dose restoration (iDR)...
March 29, 2018: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29594226/prognostic-impact-of-leukocyte-counts-before-and-during-radiotherapy-for-oropharyngeal-cancer
#2
Garrett L Jensen, Pierre Blanchard, G Brandon Gunn, Adam S Garden, C David Fuller, Erich M Sturgis, Maura L Gillison, Jack Phan, William H Morrison, David I Rosenthal, Steven J Frank
Introduction: Peripheral blood count components are accessible and evidently predictive in other cancers but have not been explored in oropharyngeal carcinoma. We examine if there is an association between the use of intensity-modulated radiotherapy (IMRT) or intensity-modulated proton therapy (IMPT) and lymphopenia, as well as if there is an association between baseline neutrophilia, baseline leukocytosis and lymphocyte nadir in oropharyngeal cancer. Materials and Methods: Analysis started with 150 patients from a previous case to case study design, which retrospectively identified adults with oropharyngeal carcinoma, 100 treated with IMRT in 2010-2012 and 50 treated with IMPT in 2011-2014...
December 2017: Clinical and Translational Radiation Oncology
https://www.readbyqxmd.com/read/29550033/impact-of-spot-size-and-spacing-on-the-quality-of-robustly-optimized-intensity-modulated-proton-therapy-plans-for-lung-cancer
#3
Chenbin Liu, Steven E Schild, Joe Y Chang, Zhongxing Liao, Shawn Korte, Jiajian Shen, Xiaoning Ding, Yanle Hu, Yixiu Kang, Sameer R Keole, Terence T Sio, William W Wong, Narayan Sahoo, Martin Bues, Wei Liu
PURPOSE: To investigate how spot size and spacing affect plan quality, robustness, and interplay effects of robustly optimized intensity modulated proton therapy (IMPT) for lung cancer. METHODS AND MATERIALS: Two robustly optimized IMPT plans were created for 10 lung cancer patients: first by a large-spot machine with in-air energy-dependent large spot size at isocenter (σ: 6-15 mm) and spacing (1.3 σ), and second by a small-spot machine with in-air energy-dependent small spot size (σ: 2-6 mm) and spacing (5 mm)...
February 14, 2018: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29486782/improve-dosimetric-outcome-in-stage-iii-non-small-cell-lung-cancer-treatment-using-spot-scanning-proton-arc-sparc-therapy
#4
Xiaoqiang Li, Peyman Kabolizadeh, Di Yan, An Qin, Jun Zhou, Ye Hong, Thomas Guerrero, Inga Grills, Craig Stevens, Xuanfeng Ding
BACKGROUND: To evaluate spot-scanning proton arc therapy (SPArc) and multi-field robust optimized intensity modulated proton therapy (RO-IMPT) in treating stage III non-small-cell lung cancer (NSCLC) patients. METHODS: Two groups of stage IIIA or IIIB NSCLC patients (group 1: eight patients with tumor motion less than 5 mm; group 2: six patients with tumor motion equal to or more than 5 mm) were re-planned with SPArc and RO-IMPT. Both plans were generated using robust optimization to achieve an optimal coverage with 99% of internal target volume (ITV) receiving 66 Gy (RBE) in 33 fractions...
February 27, 2018: Radiation Oncology
https://www.readbyqxmd.com/read/29470095/subacromial-local-anesthetics-do-not-interfere-with-rotator-cuff-healing-after-arthroscopic-repair
#5
Sung-Min Rhee, Nam Yun Chung, Hyeon Jang Jeong, Joo Han Oh
BACKGROUND: Subacromial pain pumps are used for analgesia after arthroscopic rotator cuff surgery. However, there is controversy about myotoxic or tendinotoxic effects of local anesthetics. HYPOTHESIS: Ropivacaine administered via a subacromial pain pump would have no adverse effect on rotator cuff tendon healing, fatty degeneration, strength, or functional outcomes after arthroscopic repair. STUDY DESIGN: Cohort study; Level of evidence, 3...
February 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29436852/comparing-photon-and-proton-based-hypofractioned-sbrt-for-prostate-cancer-accounting-for-robustness-and-realistic-treatment-deliverability
#6
Lee Goddard, Nils P Brodin, William R Bodner, Madhur Garg, Wolfgang A Tomé
OBJECTIVE: To investigate whether photon or proton based SBRT is the preferred modality for high dose hypofractionation prostate cancer treatment. Achievable dose distributions were compared when uncertainties in target positioning and range uncertainties were appropriately accounted for. METHODS: Ten patients with prostate cancer previously treated at our institution with photon SBRT using volumetric modulated arc therapy (VMAT) were identified. MRI images fused to the treatment planning CT allowed for accurate target and organ-at-risk (OAR) delineation...
February 13, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29394454/integrated-beam-orientation-and-scanning-spot-optimization-in-intensity-modulated-proton-therapy-for-brain-and-unilateral-head-and-neck-tumors
#7
Wenbo Gu, Daniel O'Connor, Dan Nguyen, Victoria Y Yu, Dan Ruan, Lei Dong, Ke Sheng
PURPOSE: Intensity Modulated Proton Therapy (IMPT) is the state-of-the-art method of delivering proton radiotherapy. Previous research has been mainly focused on optimization of scanning spots with manually selected beam angles. Due to the computational complexity, the potential benefit of simultaneously optimizing beam orientations and spot pattern could not be realized. In this study, we developed a novel integrated beam orientation optimization (BOO) and scanning-spot optimization algorithm for intensity modulated proton therapy (IMPT)...
February 2, 2018: Medical Physics
https://www.readbyqxmd.com/read/29370987/optimization-of-combined-proton-photon-treatments
#8
Jan Unkelbach, Mark Bangert, Karen De Amorim Bernstein, Nicolaus Andratschke, Matthias Guckenberger
PURPOSE: Proton treatment slots are a limited resource. Therefore, we consider combined proton-photon treatments in which most fractions are delivered with photons and only a few with protons. We demonstrate how both modalities can be combined to optimally capitalize on the proton's ability to reduce normal tissue dose. METHODS: An optimal combined treatment must account for fractionation effects. We therefore perform simultaneous optimization of intensity-modulated proton (IMPT) and photon (IMRT) plans based on their cumulative biologically effective dose (BED)...
January 19, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/29313556/does-obesity-affect-outcomes-in-patients-undergoing-innovative-multi-modal-physical-therapy-following-primary-total-knee-arthroplasty
#9
Nirav K Patel, Morad Chughtai, Anton Khlopas, Chukwuweike Gwam, Nipun Sodhi, Assem A Sultan, Tanner McGinn, Anil Bhave, Jaydev B Mistry, Ronald E Delanois, Michael A Mont
INTRODUCTION: Knee stiffness following total knee arthroplasty (TKA) is a common complication, especially in obese patients. The initial, non-operative treatments for this complication includes splinting and physical therapy. If these measures fail, manipulation under anesthesia (MUA) or surgical exploration can be considered to restore range of motion (ROM). However, it is generally desirable to avoid these procedures. For these reasons, newer physical therapy protocols have been developed...
December 22, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29300277/developing-a-core-outcome-domain-set-to-assessing-effectiveness-of-interdisciplinary-multimodal-pain-therapy-the-vapain-consensus-statement-on-core-outcome-domains
#10
Ulrike Kaiser, Christian Kopkow, Stefanie Deckert, Katrin Neustadt, Lena Jacobi, Paul Cameron, Valerio De Angelis, Christian Apfelbacher, Bernhard Arnold, Judy Birch, Anna Bjarnegård, Sandra Christiansen, Amanda C de C Williams, Gudrun Gossrau, Andrea Heinks, Michael Hüppe, Henri Kiers, Ursula Kleinert, Paolo Martelletti, Lance McCracken, Nelleke de Meij, Bernd Nagel, Jo Nijs, Heike Norda, Jasvinder A Singh, Ellen Spengler, Caroline B Terwee, Peter Tugwell, Johan W S Vlaeyen, Heike Wandrey, Edmund Neugebauer, Rainer Sabatowski, Jochen Schmitt
Interdisciplinary multimodal pain therapy (IMPT) is a biopsychosocial treatment approach for patients with chronic pain that comprises at least psychological and physiotherapeutic interventions. Core outcome sets (COSs) are currently developed in different medical fields to standardize and improve the selection of outcome domains, and measurement instruments in clinical trials, to make trial results meaningful, to pool trial results, and to allow indirect comparison between interventions. The objective of this study was to develop a COS of patient-relevant outcome domains for chronic pain in IMPT clinical trials...
April 2018: Pain
https://www.readbyqxmd.com/read/29248169/simultaneous-integrated-boost-for-radiation-dose-escalation-to-the-gross-tumor-volume-with-intensity-modulated-photon-radiation-therapy-or-intensity-modulated-proton-therapy-and-concurrent-chemotherapy-for-stage-ii-to-iii-non-small-cell-lung-cancer-a-phase
#11
Melenda D Jeter, Daniel Gomez, Quynh-Nhu Nguyen, Ritsuko Komaki, Xiaodong Zhang, Xiaorong Zhu, Michael O'Reilly, Frank V Fossella, Ting Xu, Xiong Wei, Hui Wang, Wenjuan Yang, Anne Tsao, Radhe Mohan, Zhongxing Liao
PURPOSE: To establish, in the phase 1 portion of a prospective phase 1/2 study, the maximum tolerated dose of image guided intensity modulated radiation therapy (IMRT) or proton therapy (IMPT), both with a simultaneous integrated boost (SIB), for patients with stage II to IIIB non-small cell lung cancer receiving concurrent chemoradiation therapy. METHODS AND MATERIALS: Patients had pathologically proven non-small cell lung cancer, either unresectable stage II to IIIB disease or recurrent disease after surgical resection, and could tolerate concurrent chemoradiation...
March 1, 2018: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29219119/density-overwrites-of-internal-tumor-volumes-in-intensity-modulated-proton-therapy-plans-for-mobile-lung-tumors
#12
Pablo Botas, Clemens Grassberger, Gregory Sharp, Harald Paganetti
The purpose of this study was to investigate internal tumor volume density overwrite strategies to minimize intensity modulated proton therapy (IMPT) plan degradation of mobile lung tumors. Four planning paradigms were compared for nine lung cancer patients. Internal gross tumor volume (IGTV) and internal clinical target volume (ICTV) structures were defined encompassing their respective volumes in every 4DCT phase. The paradigms use different planning CT (pCT) created from the average intensity projection (AIP) of the 4DCT, overwriting the density within the IGTV to account for movement...
January 30, 2018: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29188150/a-rare-case-of-unresectable-adenoid-cystic-carcinoma-of-the-nasopharynx-treated-with-intensity-modulated-proton-therapy
#13
Jae Phan, Sweet Ping Ng, Courtney Pollard, Jack Phan
Adenoid cystic carcinoma (ACC) is generally treated with surgical resection followed by postoperative radiotherapy. In cases where surgical management is precluded due to the location of the tumor and/or patient factors, radiation therapy can be offered to achieve local control. Here, we present a case of unresectable Stage T4N0 ACC of the nasopharynx with skull base and intracranial extension treated with intensity modulated proton therapy (IMPT), which achieved good local control with no significant late toxicity...
September 15, 2017: Curēus
https://www.readbyqxmd.com/read/29178546/evaluation-of-dosimetric-advantages-of-using-patient-specific-aperture-system-with-intensity-modulated-proton-therapy-for-the-shallow-depth-tumor
#14
Keisuke Yasui, Toshiyuki Toshito, Chihiro Omachi, Kensuke Hayashi, Kenichiro Tanaka, Kumiko Asai, Akira Shimomura, Rie Muramatsu, Naoki Hayashi
In this study, we evaluate dosimetric advantages of using patient-specific aperture system with intensity-modulated proton therapy (IMPT) for head and neck tumors at the shallow depth. We used four types of patient-specific aperture system (PSAS) to irradiate shallow regions less than 4 g/cm2 with a sharp lateral penumbra. Ten head and neck IMPT plans with or without aperture were optimized separately with the same 95% prescription dose and same dose constraint for organs at risk (OARs). The plans were compared using dose volume histograms (DVHs), dose distributions, and some dose indexes such as volume receiving 50% of the prescribed dose (V50 ), mean or maximum dose (Dmean and Dmax ) to the OARs...
January 2018: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/29165322/treatment-planning-with-intensity-modulated-particle-therapy-for-multiple-targets-in-stage-iv-non-small-cell-lung-cancer
#15
Kristjan Anderle, Joep Stroom, Sandra Vieira, Nuno Pimentel, Carlo Greco, Marco Durante, Christian Graeff
Intensity modulated particle therapy (IMPT) can produce highly conformal plans, but is limited in advanced lung cancer patients with multiple lesions due to motion and planning complexity. A 4D IMPT optimization including all motion states was expanded to include multiple targets, where each target (isocenter) is designated to specific field(s). Furthermore, to achieve stereotactic treatment planning objectives, target and OAR weights plus objective doses were automatically iteratively adapted. Finally, 4D doses were calculated for different motion scenarios...
January 17, 2018: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29160775/anatomical-robust-optimization-to-account-for-nasal-cavity-filling-variation-during-intensity-modulated-proton-therapy-a-comparison-with-conventional-and-adaptive-planning-strategies
#16
Steven van de Water, Francesca Albertini, Damien C Weber, Ben J M Heijmen, Mischa S Hoogeman, Antony J Lomax
The aim of this study is to develop an anatomical robust optimization method for intensity-modulated proton therapy (IMPT) that accounts for interfraction variations in nasal cavity filling, and to compare it with conventional single-field uniform dose (SFUD) optimization and online plan adaptation. We included CT data of five patients with tumors in the sinonasal region. Using the planning CT, we generated for each patient 25 'synthetic' CTs with varying nasal cavity filling. The robust optimization method available in our treatment planning system 'Erasmus-iCycle' was extended to also account for anatomical uncertainties by including (synthetic) CTs with varying patient anatomy as error scenarios in the inverse optimization...
January 11, 2018: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29159011/proton-therapy-for-malignant-pleural-mesothelioma-a-three-case-series-describing-the-clinical-and-dosimetric-advantages-of-proton-based-therapy
#17
Howard Lee, Jing Zeng, Stephen R Bowen, Ramesh Rengan
Malignant pleural mesothelioma (MPM) is a malignancy of the pleural cavity that typically presents at an advanced stage. Due to its large, circumferential clinical target volume (CTV) and proximity to major structures, including the heart and contralateral lung, delivering hemithoracic intensity-modulated radiotherapy (IMRT) with photon therapy to achieve loco-regional control following macroscopic complete resection is challenging. Intensity-modulated proton therapy (IMPT) has been shown to be a method for achieving higher therapeutic doses while limiting exposure to organs at risk (OARs), but patient outcomes after treatment have yet to be reported...
September 20, 2017: Curēus
https://www.readbyqxmd.com/read/29159005/field-specific-intensity-modulated-proton-therapy-optimization-technique-for-breast-cancer-patients-with-tissue-expanders-containing-metal-ports
#18
Maura Kirk, Gary Freedman, Thorsten Ostrander, Lei Dong
This report aims to propose and present an evaluation of a robust pencil beam scanning proton multi-field optimized treatment planning technique for postmastectomy radiation of breast cancer patients with implanted tissue expanders containing an internal metal port. Field-specific split targets were created for optimization to prevent spots from traveling through the metal port, while providing uniform coverage of the target with the use of a multi-field intensity modulated optimization approach. Two beam angles were strategically selected to provide complementary target coverage and plan robustness...
September 18, 2017: Curēus
https://www.readbyqxmd.com/read/29152442/combination-intensity-modulated-proton-therapy-and-passive-scatter-boost-for-rapidly-progressing-nasal-cavity-squamous-cell-carcinoma
#19
Sweet Ping Ng, Ethan B Ludmir, Manuel A Oyervides, Richard Y Wu, Steve Frank, G Brandon Gunn
Cancers of the nasal cavity and septum are associated with poor prognosis and are usually treated with surgery followed by post-operative radiotherapy with or without concurrent chemotherapy. Definitive radiotherapy is used in cases where the tumor is unresectable, patient is unfit for surgery, and/or the patient declines surgical intervention. Here, we present a case of a patient, who for non-medical reasons, opted to have non-surgical management of his rapidly progressing nasal cavity tumor. He was successfully treated with concurrent chemoradiotherapy utilizing a combination of intensity modulated proton therapy (IMPT) with passive scatter boost to reduce dose to the adjacent critical neural structures...
September 14, 2017: Curēus
https://www.readbyqxmd.com/read/29152431/intensity-modulated-proton-therapy-with-advanced-planning-techniques-in-a-challenging-hepatocellular-carcinoma-patient
#20
Smith Apisarnthanarax, Jatinder Saini, Avril O'Ryan-Blair, Jackie Castro, Stephen R Bowen
The use of radiation therapy has been increasing over recent years for the treatment of hepatocellular carcinoma (HCC). Proton beam therapy (PBT) has emerged as a promising treatment option for HCC patients due to its dosimetric advantages of sparing more normal liver tissue from radiation at low to moderate doses compared to photon-based treatments while still delivering high doses of radiation to tumors. The PBT therapy may be particularly beneficial in high-risk HCC cirrhotic patients with large, bulky tumors and/or vascular invasion complicated by surrounding perfusion abnormalities...
September 10, 2017: Curēus
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