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https://www.readbyqxmd.com/read/28976574/robust-intensity-modulated-proton-therapy-to-reduce-high-linear-energy-transfer-in-organs-at-risk
#1
Yu An, Jie Shan, Samir H Patel, William Wong, Steven E Schild, Xiaoning Ding, Martin Bues, Wei Liu
PURPOSE: We propose a robust treatment planning model that simultaneously considers proton range and patient setup uncertainties and reduces high linear energy transfer (LET) exposure in organs at risk (OARs) to minimize the relative biological effectiveness (RBE) dose in OARs for intensity-modulated proton therapy (IMPT). Our method could potentially reduce the unwanted damage to OARs. METHODS: We retrospectively generated plans for 10 patients including 2 prostate, 4 head and neck, and 4 lung cancer patients...
October 4, 2017: Medical Physics
https://www.readbyqxmd.com/read/28964587/feasibility-of-pencil-beam-scanned-intensity-modulated-proton-therapy-in-breath-hold-for-locally-advanced-non-small-cell-lung-cancer
#2
Jenny Gorgisyan, Per Munck Af Rosenschold, Rosalind Perrin, Gitte F Persson, Mirjana Josipovic, Maria Francesca Belosi, Svend Aage Engelholm, Damien C Weber, Antony J Lomax
PURPOSE: We evaluated the feasibility of treating patients with locally advanced non-small cell lung cancer (NSCLC) with pencil beam scanned intensity modulated proton therapy (IMPT) in breath-hold. METHODS AND MATERIALS: Fifteen NSCLC patients who had previously received 66 Gy in 33 fractions with image guided photon radiation therapy were included in the present simulation study. In addition to a planning breath-hold computed tomography (CT) scan before the treatment start, a median of 6 (range 3-9) breath-hold CT scans per patient were acquired prospectively throughout the radiation therapy course...
August 24, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28951008/patient-specific-bolus-for-range-shifter-air-gap-reduction-in-intensity-modulated-proton-therapy-of-head-and-neck-cancer-studied-with-monte-carlo-based-plan-optimization
#3
Steven Michiels, Ana Maria Barragán, Kevin Souris, Kenneth Poels, Wouter Crijns, John A Lee, Edmond Sterpin, Sandra Nuyts, Karin Haustermans, Tom Depuydt
BACKGROUND & PURPOSE: Intensity-modulated proton therapy (IMPT) of superficial lesions requires pre-absorbing range shifter (RS) to deliver the more shallow spots. RS air gap minimization is important to avoid spot size degradation, but remains challenging in complex geometries such as in head-and-neck cancer (HNC). In this study, clinical endpoints were investigated for patient-specific bolus and for conventional RS solutions, making use of a Monte Carlo (MC) dose engine for IMPT optimization...
September 23, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28941739/the-influence-of-inter-fractional-anatomy-variation-on-secondary-cancer-risk-estimates-following-radiotherapy
#4
Camilla Hanquist Stokkevåg, Grete May Engeseth, Liv Bolstad Hysing, Kristian Smeland Ytre-Hauge, Ludvig Paul Muren
PURPOSE: In silico studies comparing estimated risks of radiation-induced secondary cancer (SC) are frequently performed in assessment of radiotherapy techniques. Since inter-patient anatomy variations can result in considerable differences in estimated risk we aimed to explore the influence of inter-fractional organ motion patterns on SC risk. METHODS: Volumetric modulated arc therapy (VMAT) and intensity-modulated proton therapy (IMPT) plans were generated on the planning CT (pCT) scans of eight prostate cancer patients...
September 20, 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28931343/impact-of-bowel-gas-and-body-outline-variations-on-total-accumulated-dose-with-intensity-modulated-proton-therapy-in-locally-advanced-cervical-cancer-patients
#5
Thomas Berger, Jørgen Breede Baltzer Petersen, Jacob Christian Lindegaard, Lars Ulrik Fokdal, Kari Tanderup
INTRODUCTION: Density changes occurring during fractionated radiotherapy in the pelvic region may degrade proton dose distributions. The aim of the study was to quantify the dosimetric impact of gas cavities and body outline variations. MATERIAL AND METHODS: Seven patients with locally advanced cervical cancer (LACC) were analyzed through a total of 175 daily cone beam computed tomography (CBCT) scans. Four-beams intensity-modulated proton therapy (IMPT) dose plans were generated targeting the internal target volume (ITV) composed of: primary tumor, elective and pathological nodes...
September 21, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28921843/potential-proton-and-photon-dose-degradation-in-advanced-head-and-neck-cancer-patients-by-intratherapy-changes
#6
Kristin Stützer, Annika Jakobi, Anna Bandurska-Luque, Steffen Barczyk, Carolin Arnsmeyer, Steffen Löck, Christian Richter
PURPOSE: Evaluation of dose degradation by anatomic changes for head-and-neck cancer (HNC) intensity-modulated proton therapy (IMPT) relative to intensity-modulated photon therapy (IMRT) and identification of potential indicators for IMPT treatment plan adaptation. METHODS: For 31 advanced HNC datasets, IMPT and IMRT plans were recalculated on a computed tomography scan (CT) taken after about 4 weeks of therapy. Dose parameter changes were determined for the organs at risk (OARs) spinal cord, brain stem, parotid glands, brachial plexus, and mandible, for the clinical target volume (CTV) and the healthy tissue outside planning target volume (PTV)...
September 18, 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28917586/dosimetric-comparison-to-the-heart-and-cardiac-substructure-in-a-large-cohort-of-esophageal-cancer-patients-treated-with-proton-beam-therapy-or-intensity-modulated-radiation-therapy
#7
Yutaka Shiraishi, Cai Xu, Jinzhong Yang, Ritsuko Komaki, Steven H Lin
PURPOSE: To compare heart and cardiac substructure radiation exposure using intensity-modulated radiotherapy (IMRT) vs. proton beam therapy (PBT) for patients with mid- to distal esophageal cancer who received chemoradiation therapy. METHODS AND MATERIALS: We identified 727 esophageal cancer patients who received IMRT (n=477) or PBT (n=250) from March 2004 to December 2015. All patients were treated to 50.4Gy with IMRT or to 50.4 cobalt Gray equivalents with PBT...
September 13, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28871980/empowering-intensity-modulated-proton-therapy-through-physics-and-technology-an-overview
#8
REVIEW
Radhe Mohan, Indra J Das, Clifton C Ling
Considering the clinical potential of protons attributable to their physical characteristics, interest in proton therapy has increased greatly in this century, as has the number of proton therapy installations. Until recently, passively scattered proton therapy was used almost entirely. Notably, the overall clinical results to date have not shown a convincing benefit of protons over photons. A rapid transition is now occurring with the implementation of the most advanced form of proton therapy, intensity modulated proton therapy (IMPT)...
October 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28869195/-proton-therapy-for-head-and-neck-cancers
#9
REVIEW
P Blanchard, S J Frank
The absence of exit dose and the sharp lateral penumbra are key assets for proton therapy, which are responsible for its dosimetric superiority over advanced photon radiotherapy. Dosimetric comparisons have consistently shown a reduction of the integral dose and the dose to organs at risk favouring intensity-modulated proton therapy (IMPT) over intensity-modulated radiotherapy (IMRT). The structures that benefit the most of these dosimetric improvements in head and neck cancers are the anterior oral cavity, the posterior fossa, the visual apparatus and swallowing structures...
October 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/28867546/reirradiation-of-thoracic-cancers-with-intensity-modulated-proton-therapy
#10
Jennifer C Ho, Quynh-Nhu Nguyen, Heng Li, Pamela K Allen, Xiaodong Zhang, Zhongxing Liao, X Ronald Zhu, Daniel Gomez, Steven H Lin, Michael Gillin, Ritsuko Komaki, Stephen Hahn, Joe Y Chang
PURPOSE: Reirradiation of thoracic malignancies is a treatment challenge, with concerns for toxicity and the inability to deliver definitive doses. Intensity modulated proton therapy (IMPT) may allow safe delivery of a higher dose of radiation to the tumor while minimizing toxicities. METHODS AND MATERIALS: Between 2011 and 2016, 27 patients who received IMPT for reirradiation of thoracic malignancies with definitive intent were retrospectively analyzed. Patients were included if they received a prior thoracic radiation course...
July 8, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28828923/impact-of-model-and-dose-uncertainty-on-model-based-selection-of-oropharyngeal-cancer-patients-for-proton-therapy
#11
Rik G Bijman, Sebastiaan Breedveld, Tine Arts, Eleftheria Astreinidou, Martin A de Jong, Patrick V Granton, Steven F Petit, Mischa S Hoogeman
BACKGROUND: Proton therapy is becoming increasingly available, so it is important to apply objective and individualized patient selection to identify those who are expected to benefit most from proton therapy compared to conventional intensity modulated radiation therapy (IMRT). Comparative treatment planning using normal tissue complication probability (NTCP) evaluation has recently been proposed. This work investigates the impact of NTCP model and dose uncertainties on model-based patient selection...
August 22, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28810881/comparison-of-photon-volumetric-modulated-arc-therapy-intensity-modulated-proton-therapy-and-intensity-modulated-carbon-ion-therapy-for-delivery-of-hypo-fractionated-thoracic-radiotherapy
#12
Alexander Chi, Lien-Chun Lin, Sijin Wen, Haijuan Yan, Wen-Chien Hsi
PURPOSE: The aim of the present study was to compare the dose distribution generated from photon volumetric modulated arc therapy (VMAT), intensity modulated proton therapy (IMPT), and intensity modulated carbon ion therapy (IMCIT) in the delivery of hypo-fractionated thoracic radiotherapy. METHODS AND MATERIALS: Ten selected patients who underwent thoracic particle therapy between 2015 and 2016 were re-planned to receive a relative biological effectiveness (RBE) weighted dose of 60 Gy (i...
August 15, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28740917/phase-1-trial-of-preoperative-image-guided-intensity-modulated-proton-radiation-therapy-with-simultaneously-integrated-boost-to-the-high-risk-margin-for-retroperitoneal-sarcomas
#13
Thomas F DeLaney, Yen-Lin Chen, Elizabeth H Baldini, Dian Wang, Judith Adams, Shea B Hickey, Beow Y Yeap, Stephen M Hahn, Karen De Amorim Bernstein, G Petur Nielsen, Edwin Choy, John T Mullen, Sam S Yoon
PURPOSE: To conduct phase 1 and 2 trials with photon intensity modulated radiation therapy and intensity modulated proton therapy (IMPT) arms to selectively escalate the retroperitoneal sarcoma preoperative radiation dose to tumor volume (clinical target volume [CTV] 2) that is judged to be at a high risk for positive margins and aim to reduce local recurrence. We report on the IMPT study arm in phase 1. METHODS AND MATERIALS: Patients aged ≥18 years with primary or locally recurrent retroperitoneal sarcoma were treated with preoperative IMPT, 50...
January 2017: Advances in Radiation Oncology
https://www.readbyqxmd.com/read/28684206/-patient-first-the-impact-of-characteristics-of-target-populations-on-decisions-about-therapy-effectiveness-of-complex-interventions-psychological-variables-to-assess-effectiveness-in-interdisciplinary-multimodal-pain-therapy
#14
Ulrike Kaiser, Rainer Sabatowski, Friedrich Balck
INTRODUCTION: The assessment of treatment effectiveness in public health settings is ensured by indicators that reflect the changes caused by specific interventions. These indicators are also applied in benchmarking systems. The selection of constructs should be guided by their relevance for affected patients (patient reported outcomes). The interdisciplinary multimodal pain therapy (IMPT) is a complex intervention based on a biopsychosocial understanding of chronic pain. For quality assurance purposes, psychological parameters (depression, general anxiety, health-related quality of life) are included in standardized therapy assessment in pain medicine (KEDOQ), which can also be used for comparative analyses in a benchmarking system...
August 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28681976/mixed-integer-programming-with-dose-volume-constraints-in-intensity-modulated-proton-therapy
#15
Pengfei Zhang, Neng Fan, Jie Shan, Steven E Schild, Martin Bues, Wei Liu
BACKGROUND: In treatment planning for intensity-modulated proton therapy (IMPT), we aim to deliver the prescribed dose to the target yet minimize the dose to adjacent healthy tissue. Mixed-integer programming (MIP) has been applied in radiation therapy to generate treatment plans. However, MIP has not been used effectively for IMPT treatment planning with dose-volume constraints. In this study, we incorporated dose-volume constraints in an MIP model to generate treatment plans for IMPT...
September 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28660417/-what-does-pain-intensity-mean-from-the-patient-perspective-a-qualitative-study-on-the-patient-perspective-of-pain-intensity-as-an-outcome-parameter-in-treatment-evaluation-and-on-the-interpretability-of-pain-intensity-measurements
#16
K Neustadt, S Deckert, C Kopkow, A Preißler, B Bosse, C Funke, L Jacobi, P Mattenklodt, B Nagel, P Seidel, R Sittl, E Steffen, R Sabatowski, J Schmitt, U Kaiser
BACKGROUND: Pain intensity (PI) is a common outcome parameter in effectiveness studies on interdisciplinary multimodal pain therapy (IMPT), despite the fact that IMPT highlights dealing with rather than reducing chronic pain. Moreover, the measurement of pain intensity as a highly subjective experience is problematic. Patient participation is absolutely essential to examine the relevance of PI as a criterion of treatment success as well as to select/develop suitable measurement methods...
June 28, 2017: Der Schmerz
https://www.readbyqxmd.com/read/28649976/efficiency-of-analytical-and-sampling-based-uncertainty-propagation-in-intensity-modulated-proton-therapy
#17
N Wahl, P Hennig, H P Wieser, M Bangert
The sensitivity of intensity-modulated proton therapy (IMPT) treatment plans to uncertainties can be quantified and mitigated with robust/min-max and stochastic/probabilistic treatment analysis and optimization techniques. Those methods usually rely on sparse random, importance, or worst-case sampling. Inevitably, this imposes a trade-off between computational speed and accuracy of the uncertainty propagation. Here, we investigate analytical probabilistic modeling (APM) as an alternative for uncertainty propagation and minimization in IMPT that does not rely on scenario sampling...
June 26, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28587051/evaluating-intensity-modulated-proton-therapy-relative-to-passive-scattering-proton-therapy-for-increased-vertebral-column-sparing-in-craniospinal-irradiation-in-growing-pediatric-patients
#18
Drosoula Giantsoudi, Joao Seco, Bree R Eaton, F Joseph Simeone, Hanne Kooy, Torunn I Yock, Nancy J Tarbell, Thomas F DeLaney, Judith Adams, Harald Paganetti, Shannon M MacDonald
PURPOSE: At present, proton craniospinal irradiation (CSI) for growing children is delivered to the whole vertebral body (WVB) to avoid asymmetric growth. We aimed to demonstrate the feasibility and potential clinical benefit of delivering vertebral body sparing (VBS) versus WVB CSI with passively scattered (PS) and intensity modulated proton therapy (IMPT) in growing children treated for medulloblastoma. METHODS AND MATERIALS: Five plans were generated for medulloblastoma patients, who had been previously treated with CSI PS proton radiation therapy: (1) single posteroanterior (PA) PS field covering the WVB (PS-PA-WVB); (2) single PA PS field that included only the thecal sac in the target volume (PS-PA-VBS); (3) single PA IMPT field covering the WVB (IMPT-PA-WVB); (4) single PA IMPT field, target volume including thecal sac only (IMPT-PA-VBS); and (5) 2 posterior-oblique (-35°, +35°) IMPT fields, with the target volume including the thecal sac only (IMPT2F-VBS)...
May 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28569997/impact-of-spot-charge-inaccuracies-in-impt-treatments
#19
Aafke C Kraan, Nicolas Depauw, Ben Clasie, Marina Giunta, Tom Madden, Hanne M Kooy
BACKGROUND: Spot charge is one parameter of pencil-beam scanning dose delivery system whose accuracy is typically high but whose required value has not been investigated. In this work we quantify the dose impact of spot charge inaccuracies on the dose distribution in patients. Knowing the effect of charge errors is relevant for conventional proton machines, as well as for new generation proton machines, where ensuring accurate charge may be challenging. METHODS: Through perturbation of spot charge in treatment plans for seven patients and a phantom, we evaluated the dose impact of absolute (up to 5× 10(6) protons) and relative (up to 30%) charge errors...
August 2017: Medical Physics
https://www.readbyqxmd.com/read/28549794/intensity-modulated-proton-therapy-and-osteoradionecrosis-in-oropharyngeal-cancer
#20
Wencheng Zhang, Xiaodong Zhang, Pei Yang, Pierre Blanchard, Adam S Garden, Brandon Gunn, C David Fuller, Mark Chambers, Katherine A Hutcheson, Rong Ye, Stephen Y Lai, Mohamed Abdallah Sherif Radwan, X Ron Zhu, Steven J Frank
PURPOSE: We compared mandibular doses and osteoradionecrosis in patients with oropharyngeal cancer after intensity-modulated radiation therapy (IMRT) or intensity-modulated proton therapy (IMPT). METHODS AND MATERIALS: We identified 584 patients who received definitive radiotherapy for oropharyngeal cancer from January 2011 through June 2014 at MD Anderson Cancer Center (534 IMRT and 50 IMPT). The dosimetric variables and osteoradionecrosis were compared with Chi-square test or Fisher's exact test...
May 23, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
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