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https://www.readbyqxmd.com/read/29594231/radiotherapy-dose-distribution-to-the-perirectal-fat-space-prs-is-related-to-gastrointestinal-control-related-complications
#1
S L Gulliford, S Ghose, M A Ebert, A Kennedy, J Dowling, J Mitra, D J Joseph, J W Denham
Traditionally rectal symptoms following pelvic/prostate radiotherapy are correlated to the dosimetry of the anorectum or a substructure of this. It has been suggested that the perirectal fat space (PRS) surrounding the rectum may also be relevant. This study considers the delineation and dosimetry of the PRS related to both rectal bleeding and control-related toxicity. Initially, a case-control cohort of 100 patients from the RADAR study were chosen based on presence/absence of rectal control-related toxicity...
December 2017: Clinical and Translational Radiation Oncology
https://www.readbyqxmd.com/read/29520983/prospective-analysis-of-hydrogel-spacer-for-patients-with-prostate-cancer-undergoing-radiotherapy
#2
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: To report on the dosimetric benefits and late toxicity outcomes after injection of hydrogel spacer (HS) between the prostate and rectum for patients treated with prostate radiotherapy (RT). PATIENTS AND METHODS: In all, 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 perirectal space before intensity-modulated RT (IMRT) or volumetric-modulated arc RT (VMAT)...
March 9, 2018: BJU International
https://www.readbyqxmd.com/read/29230498/trans-rectal-ultrasound-guided-autologous-blood-injection-in-the-interprostatorectal-space-prior-to-percutaneous-mri-guided-cryoablation-of-the-prostate
#3
Julien Garnon, Roberto Luigi Cazzato, Guillaume Koch, Ishaq Fahmi Uri, Georgia Tsoumakidou, Jean Caudrelier, Thibault Tricard, Afshin Gangi, Hervé Lang
OBJECTIVE: To report a novel technique of ultrasound-guided injection of autologous blood in the interprostatorectal space, in an attempt to facilitate ablative prostatic procedures by widening durably the space between the rectum and the prostate. MATERIALS AND METHODS: Between April and November 2016, four consecutive patients underwent the haemoprotection injection technique. For each patient, we recorded the time to perform the technique, the amount of injected blood, the achieved distances between the rectum and the prostate post-injection at fixed defined points (apex, middle, and base of prostate at the midline, left, and right sides of the gland), the extension of the ice ball outside the prostate capsule at those fixed points, and whether any residual blood was present on 1-month follow-up MRI...
April 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29197849/retrovesical-malignant-fibrous-histiocytoma-a-rare-tumor
#4
Shuchita Pathak, Tej Prakash Soni, Anil Kumar Gupta, Lalit Mohan Sharma
Malignant fibrous histiocytoma (MFH) originating from the retrovesical space is a very rare tumour. A 61-year-old man presented to our hospital with complaints of retention of urine and burning sensation during micturition since 6 months. CT scan abdomen showed a large retrovesical mass between the urinary bladder and rectum, measuring 11×9×12 cm, displacing the urinary bladder. Serum PSA (Prostate Specific Antigen) value was within normal range. Biopsy from retrovesical mass and immunohistochemistry was suggestive of MFH...
December 2, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29174940/absorbable-hydrogel-spacer-use-in-prostate-radiotherapy-a-comprehensive-review-of-phase-3-clinical-trial-published-data
#5
Lawrence Karsh, Eric Gross, Christopher M Pieczonka, Philip J Aliotta, Christopher J Skomra, Lee E Ponsky, Peter T Nieh, Misop Han, Daniel A Hamstra, Neal D Shore
OBJECTIVES: To provide an update on SpaceOAR® System, a FDA approved hydrogel indicated to create distance between the prostate and rectum which has been studied in phase 2 and 3 clinical trials. Here we review and summarize these clinical results including: the safety of prostate-rectum spacer application technique, the implant quality and resulting rectal dose reduction, acute and long term rectal, urinary and sexual toxicity as well as patient reported outcomes. METHODS: A prospective, randomized patient-blinded clinical study was performed comparing image-guided intensity modulated prostate radiotherapy (IG-IMRT) (79...
November 23, 2017: Urology
https://www.readbyqxmd.com/read/29068554/internal-anal-sphincter-nerves-a-macroanatomical-and-microscopic-description-of-the-extrinsic-autonomic-nerve-supply-of-the-internal-anal-sphincter
#6
S Stelzner, M Böttner, J Kupsch, W Kneist, P Quirke, N P West, H Witzigmann, T Wedel
AIM: The internal anal sphincter (IAS) contributes substantially to anorectal functions. While its autonomic nerve supply has been studied at the microscopic level, little information is available concerning the macroscopic topography of extrinsic nerve fibres. This study was designed to identify neural connections between the pelvic plexus and the IAS, provide a detailed topographical description, and give histological proof of autonomic nerve tissue. METHODS: Macroscopic dissection of pelvic autonomic nerves was performed under magnification in seven (five male, two female) hemipelvises obtained from body donors (67-92 years)...
January 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29038832/dynamics-of-rectal-balloon-implant-shrinkage-in-prostate-vmat-influence-on-anorectal-dose-and-late-rectal-complication-risk
#7
Ben G L Vanneste, Y van Wijk, L C Lutgens, E J Van Limbergen, E N van Lin, K van de Beek, P Lambin, A L Hoffmann
PURPOSE: To assess the effect of a shrinking rectal balloon implant (RBI) on the anorectal dose and complication risk during the course of moderately hypofractionated prostate radiotherapy. METHODS: In 15 patients with localized prostate cancer, an RBI was implanted. A weekly kilovolt cone-beam computed tomography (CBCT) scan was acquired to measure the dynamics of RBI volume and prostate-rectum separation. The absolute anorectal volume encompassed by the 2 Gy equieffective 75 Gy isodose (V75Gy ) was recalculated as well as the mean anorectal dose...
January 2018: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/28982515/robotic-total-pelvic-exenteration-with-intracorporeal-sigmoid-conduit-and-colostomy-step-by-step-technique
#8
Matthew J Maurice, Daniel Ramirez, Emre Gorgun, Georges-Pascal Haber
OBJECTIVE: To describe our technique for robotic total pelvic exenteration with intracorporeal sigmoid conduit and colostomy using the da Vinci Si robot. METHODS: Three 8-mm robotic ports and two 12-mm laparoscopic ports are placed in a "W" configuration, approximately 2-3 cm more cephalad than for radical prostatectomy (Fig. 1). The robot is docked between the legs with the patient in steep Trendelenburg. The ureters are dissected out from the iliac vessels to the rectovesical pouch, where they are clipped and transected...
July 2017: Urology
https://www.readbyqxmd.com/read/28977739/denonvilliers-fascia-in-men-a-sheet-plastination-and-confocal-microscopy-study-of-the-prerectal-space-and-the-presence-of-an-optimal-anterior-plane-when-mobilizing-the-rectum-for-cancer
#9
Zhaoyang Xu, Pierre H Chapuis, Les Bokey, Ming Zhang
AIM: The aim of this study was to investigate the detailed, in situ, morphology of Denonvilliers fascia (DVF) in cadavers using sheet plastination and confocal microscopy and to review and describe the optimal anterior plane for mobilisation of the distal rectum.. METHOD: Six, male cadavers (age range, 46-87 years) were prepared as six sets of transverse (x2), coronal (x1) and sagittal (x3) plastinated sections which were examined under a confocal laser scanning microscope...
October 4, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28547933/hybrid-approach-using-laparoscopy-and-transanal-minimally-invasive-surgery-to-treat-rectal-cancer-with-invasion-to-the-seminal-vesicles
#10
Takuya Yamaguchi, Minoru Imai, Dai Uematsu
We treated a 64-year-old man for rectal cancer with direct invasion to the seminal vesicles and no distant metastases by complete resection with laparoscopy and transanal minimally invasive surgery (TAMIS). We inserted the TAMIS device into the anal canal to above the anorectal ring and dissected to prostate level. High ligation of the inferior mesenteric artery and vein was performed by standard medial laparoscopy. The sigmoid and descending colon were mobilized, and in the postrectal space, we dissected to the space made by TAMIS...
May 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28291917/rectal-dose-to-prostate-cancer-patients-treated-with-proton-therapy-with-or-without-rectal-spacer
#11
COMPARATIVE STUDY
Heeteak Chung, Jerimy Polf, Shahed Badiyan, Matthew Biagioli, Daniel Fernandez, Kujtim Latifi, Richard Wilder, Minesh Mehta, Michael Chuong
The purpose of this study was to evaluate whether a spacer inserted in the prerectal space could reduce modeled rectal dose and toxicity rates for patients with prostate cancer treated in silico with pencil beam scanning (PBS) proton therapy. A total of 20 patients were included in this study who received photon therapy (12 with rectal spacer (DuraSeal™ gel) and 8 without). Two PBS treatment plans were retrospectively created for each patient using the following beam arrangements: (1) lateral-opposed (LAT) fields and (2) left and right anterior oblique (LAO/RAO) fields...
January 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28092017/transanal-total-mesorectal-excision-for-a-large-leiomyosarcoma-at-the-lower-rectum-a-case-report-and-literature-review
#12
Nobuaki Hoshino, Koya Hida, Kenji Kawada, Takaki Sakurai, Yoshiharu Sakai
BACKGROUND: Rectal leiomyosarcoma (LMS) is an extremely rare disease. Previously, LMS was not properly distinguishable from gastrointestinal stromal tumor (GIST) until c-kit, a characteristic marker of GIST, was discovered in 1998. No standard therapeutic strategy for gastrointestinal LMS has been established except for surgical resection because of its rarity. Rectal LMS is often accompanied by symptoms, which can enable detection at a small size. However, when a large LMS is detected at the lower rectum, it is difficult to excise due to the narrow pelvic space...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28089528/hydrogel-spacer-distribution-within-the-perirectal-space-in-patients-undergoing-radiotherapy-for-prostate-cancer-impact-of-spacer-symmetry-on-rectal-dose-reduction-and-the-clinical-consequences-of-hydrogel-infiltration-into-the-rectal-wall
#13
RANDOMIZED CONTROLLED TRIAL
Benjamin W Fischer-Valuck, Anupama Chundury, Hiram Gay, Walter Bosch, Jeff Michalski
PURPOSE: Hydrogel prostate-rectum spacers, biomaterials placed between the prostate and rectum, continue to gain interest as a method to reduce or limit rectal dose during dose escalated prostate cancer radiation therapy. Because the spacer is initially injected into the perirectal space as a liquid, the final distribution can vary. The purpose of this study was to evaluate hydrogel spacer (SpaceOAR system) implantation and distribution from a recent prospective randomized control trial and correlate spacer symmetry with rectal dose reduction as well as rectal wall infiltration (RWI) to acute and late toxicity...
May 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28047073/we-ab-209-11-prostate-cancer-treatment-planning-sensitivity-and-representative-objective-function-weights
#14
A Goli, J J Boutilier, T Craig, M B Sharpe, T C Y Chan
PURPOSE: To develop an automated planning methodology that exploits patient sensitivity to objective function weights. METHODS: Given a treatment plan, we first create an acceptable treatment region that encompasses a set of treatment plans with similar clinical performance (e.g., +/-1% at V70Gy). We use inverse optimization to map this region in criterion space to the weight space and find a corresponding region of acceptable weight vectors (W). The shape and size of W describes how sensitive a patient is to perturbations in objective function weights...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046556/we-ab-209-09-optimization-of-rotational-arc-station-parameter-optimized-radiation-therapy
#15
P Dong, B Ungun, S Boyd, L Xing
PURPOSE: To develop a fast optimization method for station parameter optimized radiation therapy (SPORT) and show that SPORT is capable of improving VMAT in both plan quality and delivery efficiency. METHODS: The angular space from 0° to 360° was divided into 180 station points (SPs). A candidate aperture was assigned to each of the SPs based on the calculation results using a column generation algorithm. The weights of the apertures were then obtained by optimizing the objective function using a state-of-the-art GPU based Proximal Operator Graph Solver (POGS) within seconds...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046285/su-g-tep1-09-modality-specific-dose-gradient-modeling-for-prostate-imrt-using-spherical-distance-maps-of-ptv-and-isodose-contours
#16
M M Folkerts, X Gu, W Lu, R J Radke, S B Jiang
PURPOSE: Overlapping volume histogram (OVH) and distance-to-target histogram (DTH) calculations rely on the assumption that dose gradients are symmetric with respect to primary target volume (PTV) expansion and minimum distance to PTV surface, respectively. It is desirable to lift this assumption and instead account for achievable modality-specific dose gradients (MSDG) for a given PTV shape. METHODS: From a library of 96 prostate 7-beam IMRT plans, we computed spherical distance maps (SDMs) for PTVs and 3 iso-dose contours...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/27991454/a-novel-method-for-interactive-multi-objective-dose-guided-patient-positioning
#17
Jonas Haehnle, Philipp Süss, Guillaume Landry, Katrin Teichert, Lucas Hille, Jan Hofmaier, Dimitri Nowak, Florian Kamp, Michael Reiner, Christian Thieke, Ute Ganswindt, Claus Belka, Katia Parodi, Karl-Heinz Küfer, Christopher Kurz
In intensity-modulated radiation therapy (IMRT), 3D in-room imaging data is typically utilized for accurate patient alignment on the basis of anatomical landmarks. In the presence of non-rigid anatomical changes, it is often not obvious which patient position is most suitable. Thus, dose-guided patient alignment is an interesting approach to use available in-room imaging data for up-to-date dose calculation, aimed at finding the position that yields the optimal dose distribution. This contribution presents the first implementation of dose-guided patient alignment as multi-criteria optimization problem...
January 7, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/27587028/optimization-of-rotational-arc-station-parameter-optimized-radiation-therapy
#18
P Dong, B Ungun, S Boyd, L Xing
PURPOSE: To develop a fast optimization method for station parameter optimized radiation therapy (SPORT) and show that SPORT is capable of matching VMAT in both plan quality and delivery efficiency by using three clinical cases of different disease sites. METHODS: The angular space from 0° to 360° was divided into 180 station points (SPs). A candidate aperture was assigned to each of the SPs based on the calculation results using a column generation algorithm...
September 2016: Medical Physics
https://www.readbyqxmd.com/read/27317949/focal-or-whole-gland-salvage-prostate-brachytherapy-with-iodine-seeds-with-or-without-a-rectal-spacer-for-postradiotherapy-local-failure-how-best-to-spare-the-rectum
#19
Valentine Guimas, Magali Quivrin, Aurélie Bertaut, Etienne Martin, Damien Chambade, Philippe Maingon, Frédéric Mazoyer, Luc Cormier, Gilles Créhange
PURPOSE: Salvage prostate permanent implant (sPPI) for postradiation local failure provides high rates of biochemical control. The cumulative dose delivered to the prostate and the rectum is still unknown. METHODS AND MATERIALS: We reviewed the postimplant CT-based dosimetry of 18 selected patients who underwent sPPI with (125)I seeds for isolated biopsy-proven local failure several years after external beam radiation therapy. Ten patients had whole-prostate sPPI, and 8 patients had multiparametric MRI-based focal sPPI...
July 2016: Brachytherapy
https://www.readbyqxmd.com/read/27248158/implanted-spacer-approaches-for-pelvic-radiation-therapy
#20
REVIEW
Daniel M Trifiletti, Allison E Garda, Timothy N Showalter
INTRODUCTION: Recent clinical advances in radiation therapy have aimed to improve the therapeutic ratio through shortening the treatment duration through increasing the biologically effective dose (either through dose escalation or hypofractionation). However, despite using advanced techniques such as intensity modulated radiation therapy (IMRT) and image-guidance methods, dose escalation can be limited by its resultant gastrointestinal toxicity. In an effort to reduce rectal toxicity, biodegradable spacer materials and implantable balloons have been injected into the prostate-rectal space to increase the separation between the rectum and prostate thereby reducing rectal irradiation...
July 2016: Expert Review of Medical Devices
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