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Krista C J Wink, Erik Roelofs, Charles B Simone, David Dechambre, Alina Santiago, Judith van der Stoep, Wim Dries, Julia Smits, Stephen Avery, Filippo Ammazzalorso, Nicolas Jansen, Urszula Jelen, Timothy Solberg, Dirk de Ruysscher, Esther G C Troost
PURPOSE: To compare dose to organs at risk (OARs) and dose-escalation possibility for 24 stage I non-small cell lung cancer (NSCLC) patients in a ROCOCO (Radiation Oncology Collaborative Comparison) trial. METHODS: For each patient, 3 photon plans [Intensity-modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT) and CyberKnife], a double scattered proton (DSP) and an intensity-modulated carbon-ion (IMIT) therapy plan were created. Dose prescription was 60 Gy (equivalent) in 8 fractions...
March 12, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Wen-Zhao Sun, Dan-Dan Zhang, Ying-Lin Peng, Li Chen, De-Hua Kang, Bin Wang, Xiao-Wu Deng
BACKGROUND: Conventional phantom-based planar dosimetry (2D-PBD) quality assurance (QA) using gamma pass rate (GP (%)) is inadequate to reflect clinically relevant dose error in intensity-modulated radiation therapy (IMRT), owing to a lack of information regarding patient anatomy and volumetric dose distribution. This study aimed to evaluate the dose distribution accuracy of IMRT delivery for nasopharyngeal carcinoma (NPC), which passed the 2D-PBD verification, using a measurement-guided 3D dose reconstruction (3D-MGR) method...
March 15, 2018: Radiation Oncology
HaYeon Kim, John A Vargo, Sushil Beriwal, David A Clump, James P Ohr, Robert L Ferris, Dwight E Heron, M Saiful Huq, Kenneth J Smith
BACKGROUND: The purpose of this study was to present our evaluation of the cost-effectiveness of salvage therapies for patients with recurrent head and neck cancer. METHODS: A Markov model was developed with 5 salvage treatment strategies: (1) platinum-based chemotherapy alone; (2) chemotherapy plus cetuximab; (3) stereotactic body radiotherapy (SBRT) alone; (4) SBRT plus cetuximab; and (5) intensity-modulated radiotherapy (IMRT) plus chemotherapy. Clinical parameters were obtained from comprehensive literature review and 2016 Medicare reimbursement...
March 14, 2018: Head & Neck
Hadi Keivan, Daryoush Shahbazi-Gahrouei, Ahmad Shanei, Alireza Amouheidari
Background: Dosimetric accuracy in intensity-modulated radiation therapy (IMRT) is the main part of quality assurance program. Improper beam modeling of small fields by treatment planning system (TPS) can lead to inaccuracy in treatment delivery. This study aimed to evaluate of the dose delivery accuracy at small segments of IMRT technique using two-dimensional (2D) array as well as evaluate the capability of two TPSs algorithm in modeling of small fields. Methods: Irradiation were performed using 6 MV photon beam of Siemens Artiste linear accelerator...
January 2018: Journal of Medical Signals and Sensors
Keyvan Jabbari, Fakhereh Pashaei, Mohammad R Ay, Alireza Amouheidari, Mohammad B Tavakoli
Background: MapCHECK2 is a two-dimensional diode arrays planar dosimetry verification system. Dosimetric results are evaluated with gamma index. This study aims to provide comprehensive information on the impact of various factors on the gamma index values of MapCHECK2, which is mostly used for IMRT dose verification. Methods: Seven fields were planned for 6 and 18 MV photons. The azimuthal angle is defined as any rotation of collimators or the MapCHECK2 around the central axis, which was varied from 5 to -5°...
January 2018: Journal of Medical Signals and Sensors
Maria Thor, Andrew Jackson, Michael J Zelefsky, Gunnar Steineck, Asa Karlsdòttir, Morten Høyer, Mitchell Liu, Nicola J Nasser, Stine E Petersen, Vitali Moiseenko, Joseph O Deasy
PURPOSE: To investigate whether inter-institutional cohort analysis uncovers more reliable dose-response relationships exemplified for late rectal bleeding (LRB) following prostate radiotherapy. MATERIAL AND METHODS: Data from five institutions were used. Rectal dose-volume histograms (DVHs) for 989 patients treated with 3DCRT or IMRT to 70-86.4 Gy@1.8-2.0 Gy/fraction were obtained, and corrected for fractionation effects (α/β = 3 Gy). Cohorts with best-fit Lyman-Kutcher-Burman volume-effect parameter a were pooled after calibration adjustments of the available LRB definitions...
March 9, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Penny Fang, Wen Jiang, Rajayogesh Davuluri, Cai Xu, Sunil Krishnan, Radhe Mohan, Albert C Koong, Charles C Hsu, Steven H Lin
BACKGROUND AND PURPOSE: Neoadjuvant chemoradiation (nCRT) can reduce tumor infiltrating lymphocytes. We examined absolute lymphocyte count (ALC) nadir during nCRT for esophageal cancer (EC) and pathologic complete response (pCR). MATERIALS AND METHODS: Patients with stage I-IVA EC (n = 313) treated 2007-2013 with nCRT followed by surgery were analyzed. ALC was obtained before, during/weekly, and one month after CRT. pCR was defined as no viable tumor cells at surgery...
March 9, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Ai-Wen Wu, Yong Cai, Yong-Heng Li, Lin Wang, Zhong-Wu Li, Ying-Shi Sun, Jia-Fu Ji
BACKGROUND: The purpose of this study was to retrospectively analyze the pattern and the management of recurrence of rectal cancer treated with 22-fraction intensity-modulated radiation therapy (IMRT). PATIENTS AND METHODS: This study included patients who underwent IMRT with gross tumor volume of 50.6 Gy in 22 fractions with concurrent capecitabine treatment over a period of 30 days, after which the patients underwent total mesorectal excision at Peking University Cancer Hospital (2007-2015)...
March 7, 2018: Clinical Colorectal Cancer
K P Rooney, A B Miah, S A Bhide, M T Guerrero-Urbano, M T Sharabiani, K L Newbold, L Grove, K J Harrington, C M Nutting
BACKGROUND AND PURPOSE: To determine the safety and tolerability of dose-escalation using modestly accelerated IMRT in high-risk locally advanced thyroid cancer requiring post-operative radiotherapy, and to report preliminary data on efficacy. MATERIALS AND METHODS: A sequential Phase I dose-escalation design was used. Dose level one (DL1) received 58.8 Gy/28F to the post-operative bed and 50 Gy/28F to elective nodes. DL2 received 66.6 Gy/30F to the thyroid bed, 60 Gy/30F to post-operative nodal levels and 54 Gy/30F to elective nodal levels...
March 7, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Xin Zhang, Yi Rong, Steven Morrill, Jian Fang, Ganesh Narayanasamy, Edvaldo Galhardo, Sanjay Maraboyina, Christopher Croft, Fen Xia, Jose Penagaricano
Robust optimization generates scenario-based plans by a minimax optimization method to find optimal scenario for the trade-off between target coverage robustness and organ-at-risk (OAR) sparing. In this study, 20 lung cancer patients with tumors located at various anatomical regions within the lungs were selected and robust optimization photon treatment plans including intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) plans were generated. The plan robustness was analyzed using perturbed doses with setup error boundary of ±3 mm in anterior/posterior (AP), ±3 mm in left/right (LR), and ±5 mm in inferior/superior (IS) directions from isocenter...
March 10, 2018: Journal of Applied Clinical Medical Physics
Huai-Wen Zhang, Bo Hu, Chen Xie, Yun-Lai Wang
PURPOSE: This study aimed to evaluate dosimetric differences of intensity-modulated radiation therapy (IMRT) in target and normal tissues after breast-conserving surgery. METHODS: IMRT five-field plan I, IMRT six-field plan II, and field-in-field-direct machine parameter optimization-IMRT plan III were designed for each of the 50 patients. One-way analysis of variance was performed to compare differences, and P < 0.05 was considered statistically significant...
March 10, 2018: Journal of Applied Clinical Medical Physics
Hendrik Ballhausen, Minglun Li, Ute Ganswindt, Claus Belka
PURPOSE: To evaluate the impact of shorter treatment times on intra-fractional motion of the prostate during external beam radiotherapy. METHODS: 53 h of intra-fractional motion of the prostate were recorded in real-time by 4D ultrasound (4DUS) during 720 fractions in 28 patients, 14 of which whom treated with step-and-shoot intensity-modulated radiotherapy (IMRT) and 14 of whom were treated with volumetric arc therapy (VMAT). RESULTS: The average VMAT fraction was recorded for 2 min 43 s and was substantially shorter than the average step-and-shoot IMRT fraction at 6 min 13 s...
March 9, 2018: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Corey C Foster, Andrew Y Lee, Larissa V Furtado, John Hart, Lindsay Alpert, Shu-Yuan Xiao, Neil H Hyman, Manish R Sharma, Stanley Liauw
BACKGROUND: Intensity-modulated radiation therapy (IMRT) has been used to limit treatment-related toxicity for patients with anal squamous cell carcinoma (SCC). The treatment outcomes and HPV characteristics for a cohort of patients receiving definitive concurrent chemotherapy and IMRT are reported. MATERIALS AND METHODS: 52 patients with anal SCC were treated with IMRT and concurrent chemotherapy. Radiation was delivered sequentially to the pelvis and inguinal lymph nodes (45 Gy) and anal tumor (median dose, 54 Gy)...
2018: PloS One
Emilie A C Dronkers, Senada Koljenovic, Gerda M Verduijn, Robert J Baatenburg de Jong, Jose A U Hardillo
OBJECTIVES/HYPOTHESIS: This study aimed to analyze the effect of human papillomavirus (HPV)-associated T1-2 node-positive oropharyngeal squamous cell carcinoma (OPSCC) on nodal response, recurrent disease, and survival in patients treated according to the Rotterdam protocol. STUDY DESIGN: Retrospective cohort study. METHODS: In total, 77 patients with T1-2 OPSCC with nodal disease, treated between 2000 and 2012, were included in this study...
March 9, 2018: Laryngoscope
Michael Chao, Huong Ho, Yee Chan, Alwin Tan, Trung Pham, Damien Bolton, Andrew Troy, Catherine Temelcos, Shomik Sengupta, Kevin McMillan, Chee Wee Cham, Madalena Liu, Wei Ding, Brindha Subramanian, Jason Wasiak, Daryl Lim Joon, Sandra Spencer, Nathan Lawrenstchuk
OBJECTIVE: The purpose of this study was to report on the dosimetric benefits and late toxicity outcomes following injection of a hydrogel spacer (HS) between the prostate and rectum for patients treated with prostate radiotherapy. METHODS: A total of 76 patients with a clinical stage of T1-T3a prostate cancer underwent general anaesthesia for fiducial marker insertion plus injection of the HS into the peri-rectal space prior to intensity modulated radiation therapy (IMRT) or volumetric modulated radiation therapy (VMAT)...
March 9, 2018: BJU International
Manindra Bhushan, Girigesh Yadav, Deepak Tripathi, Lalit Kumar, Vimal Kishore, Abhinav Dewan, Gourav Kumar, Inderjit Kaur Wahi, Munish Gairola
PURPOSE: To evaluate the feasibility of flattening filter free beam (FFFB) for the treatment of gastric tumors and to review their benefits over 6MV flatten beam (6MV_FFB). METHODS: Fifteen patients with histologically proven gastric carcinoma were selected. CT scans with slice thickness of 0.3 cm were acquired and planning target volume (PTV) and organ at risk (OAR) were delineated. Plans were made retrospectively for each patient for the prescription dose of 45 Gy/25 fractions to the PTV...
March 8, 2018: Journal of Gastrointestinal Cancer
Jasna But-Hadzic, Vaneja Velenik
Background: The aim of the study was to investigate the feasibility and safety of experimental fractionation using intensity modulated radiation therapy with a simultaneous integrated boost (IMRT-SIB) to shorten the overall treatment time without dose escalation in preoperative radiochemotherapy of locally advanced rectal cancer. Patients and methods: Between January 2014 and November 2015, a total of 51 patients with operable stage II-III rectal adenocarcinoma were treated...
March 2018: Radiology and Oncology
Alessandro Magli, Eugenia Moretti, Annarita Tullio, Gianluca Giannarini, Fabrizio Tonetto, Mauro Urpis, Margherita Crespi, Claudio Foti, Agnese Prisco, Margherita Polsinelli, Gioacchino De Giorgi, Giulia Bravo, Paolo Scalchi, Marco Trovò
OBJECTIVE: The approach for treating high-risk prostate cancer still presents different unresolved issues. We report the safety and efficacy of a radiation therapy strategy based on the combination of moderate hypofractioned simultaneous integrated boost (SIB) and Image Guidance. MATERIALS AND METHODS: In this phase II trial of patients with high-risk prostate cancer, Image Guided SIB-IMRT plans (Simultaneous Intensity Modulated - Intensity Modulated Radiotherapy) were delivered between 2009 and 2012...
March 8, 2018: Prostate Cancer and Prostatic Diseases
Vyacheslav L Murzin, Kaley Woods, Vitali Moiseenko, Roshan Karunamuni, Kathryn R Tringale, Tyler M Seibert, Michael J Connor, Daniel R Simpson, Ke Sheng, Jona A Hattangadi-Gluth
BACKGROUND AND PURPOSE: Incidental irradiation of normal brain tissue during radiotherapy is linked to cognitive decline, and may be mediated by damage to healthy cortex. Non-coplanar techniques may be used for cortical sparing. We compared normal brain sparing and probability of cortical atrophy using 4π radiation therapy planning vs. standard fixed gantry intensity-modulated radiotherapy (IMRT). MATERIAL AND METHODS: Plans from previously irradiated brain tumor patients ("original IMRT", n = 13) were re-planned to spare cortex using both 4π optimization ("4π") and IMRT optimization ("optimized IMRT")...
March 5, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Sunil W Dutta, Kristine Bauer-Nilsen, Jason C Sanders, Daniel M Trifiletti, Bruce Libby, Donna H Lash, Melody Lain, Deborah Christodoulou, Constance Hodge, Timothy N Showalter
PURPOSE: To evaluate the delivery cost of frequently used radiotherapy options offered to patients with intermediate- to high-risk prostate cancer using time-driven activity-based costing and compare the results with Medicare reimbursement and relative value units (RVUs). METHODS AND MATERIALS: Process maps were created to represent each step of prostate radiotherapy treatment at our institution. Salary data, equipment purchase costs, and consumable costs were factored into the cost analysis...
March 5, 2018: Brachytherapy
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