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https://www.readbyqxmd.com/read/28335794/tumor-motion-changes-in-stereotactic-body-radiotherapy-for-liver-tumors-an-evaluation-based-on-four-dimensional-cone-beam-computed-tomography-and-fiducial-markers
#1
Yoshinobu Shimohigashi, Ryo Toya, Tetsuo Saito, Osamu Ikeda, Masato Maruyama, Keisuke Yonemura, Yuji Nakaguchi, Yudai Kai, Yasuyuki Yamashita, Natsuo Oya, Fujio Araki
BACKGROUND: For stereotactic body radiation therapy (SBRT) of liver tumors, tumor motion induced by respiration must be taken into account in planning and treatment. We evaluated whether liver tumor motion at the planning simulation represents liver tumor motion during SBRT, and estimated inter- and intrafractional tumor motion changes in patients undergoing liver SBRT. METHODS: Ten patients underwent four-dimensional cone-beam computed tomography (4D-CBCT) image-guided liver SBRT with abdominal compression (AC) and fiducial markers...
March 23, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28333016/predictors-of-liver-toxicity-following-stereotactic-body-radiation-therapy-for-hepatocellular-carcinoma
#2
Michael Velec, Carol R Haddad, Tim Craig, Lisa Wang, Patricia Lindsay, James Brierley, Anthony Brade, Jolie Ringash, Rebecca Wong, John Kim, Laura A Dawson
PURPOSE: To identify risk factors associated with a decline in liver function after stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma. METHODS AND MATERIALS: Data were analyzed from patients with hepatocellular carcinoma treated on clinical trials of 6-fraction SBRT. Liver toxicity was defined as an increase in Child-Pugh (CP) score ≥2 three months after SBRT. Clinical factors, SBRT details, and liver dose-volume histogram (DVH) parameters were tested for association with toxicity using logistic regression...
April 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28333015/role-of-stereotactic-body-radiation-therapy-before-orthotopic-liver-transplantation-retrospective-evaluation-of-pathologic-response-and-outcomes
#3
Edward Michael Mannina, Higinia Rosa Cardenes, Foster D Lasley, Benjamin Goodman, Jennifer Zook, Sandra Althouse, John Alvin Cox, Romil Saxena, Joseph Tector, Mary Maluccio
PURPOSE: To analyze the results of stereotactic body radiation therapy (SBRT) in patients with early-stage, localized hepatocellular carcinoma who underwent definitive orthotopic liver transplantation (OLT). METHODS AND MATERIALS: The subjects of this retrospective report are 38 patients diagnosed with hepatocellular carcinoma who underwent SBRT per institutional phase 1 to 2 eligibility criteria, before definitive OLT. Pre-OLT radiographs were compared with pathologic gold standard...
April 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28306547/synthetic-ct-for-mri-based-liver-stereotactic-body-radiotherapy-treatment-planning
#4
Jeremy S Bredfeldt, Lianli Liu, Mary Feng, Yue Cao, James M Balter
A technique for generating MRI-derived synthetic CT volumes (MRCTs) is demonstrated in support of adaptive liver stereotactic body radiation therapy (SBRT). Under IRB approval, 16 subjects with hepatocellular carcinoma were scanned using a single MR pulse sequence (T1 Dixon). Air-containing voxels were identified by intensity thresholding on T1-weighted, water and fat images. The envelope of the anterior vertebral bodies was segmented from the fat image and fuzzy-C-means (FCM) was used to classify each non-air voxel as mid-density, lower-density, bone, or marrow in the abdomen, with only bone and marrow classified within the vertebral body envelope...
March 17, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28297461/clinical-experience-with-planning-quality-assurance-and-delivery-of-burst-mode-modulated-arc-therapy
#5
Kristofer Kainz, Douglas Prah, Ergun Ahunbay, X Allen Li
"Burst-mode" modulated arc therapy (hereafter referred to as "mARC") is a form of volumetric-modulated arc therapy characterized by variable gantry rotation speed, static MLCs while the radiation beam is on, and MLC repositioning while the beam is off. We present our clinical experience with the planning techniques and plan quality assurance measurements of mARC delivery. Clinical mARC plans for five representative cases (prostate, low-dose-rate brain, brain with partial-arc vertex fields, pancreas, and liver SBRT) were generated using a Monte Carlo-based treatment planning system...
September 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28274491/stereotactic-body-radiotherapy-for-oligo-metastatic-liver-disease-influence-of-pre-treatment-chemotherapy-and-histology-on-local-tumor-control
#6
R J Klement, M Guckenberger, H Alheid, M Allgäuer, G Becker, O Blanck, J Boda-Heggemann, T Brunner, M Duma, S Gerum, D Habermehl, G Hildebrandt, V Lewitzki, C Ostheimer, A Papachristofilou, C Petersen, T Schneider, R Semrau, S Wachter, N Andratschke
INTRODUCTION: Stereotactic body radiation therapy (SBRT) is applied in the oligometastatic setting to treat liver metastases. However, factors influencing tumor control probability (TCP) other than radiation dose have not been thoroughly investigated. Here we set out to investigate such factors with a focus on the influence of histology and chemotherapy prior to SBRT using a large multi-center database from the German Society of Radiation Oncology. METHODS: 452 SBRT treatments in 363 patients were analyzed after collection of patient, tumor and treatment data in a multi-center database...
March 5, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28257902/stereotactic-body-radiotherapy-versus-tace-or-rfa-as-a-bridge-to-transplant-in-patients-with-hepatocellular-carcinoma-an-intention-to-treat-analysis
#7
G Sapisochin, A Barry, M Doherty, S Fischer, N Goldaracena, Roizar Rosales, Moises Russo, R Beecroft, A Ghanekar, M Bhat, J Brierley, P D Greig, J J Knox, L A Dawson, D R Grant
BACKGROUND AND AIMS: There is limited information on the use of stereotactic body radiotherapy (SBRT) as a bridge to liver transplantation (LT) for HCC and no study comparing its efficacy to transarterial chemoembolization (TACE) and radiofrequency ablation (RFA). We aimed to ascertain the safety and efficacy of SBRT on an intention-to-treat basis compared with TACE and RFA as a bridge to LT in a large cohort of patients with HCC. METHODS: Outcomes between groups were compared from the time of listing and from the time of transplant...
February 28, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28244421/dosimetric-implications-of-residual-tracking-errors-during-robotic-sbrt-of-liver-metastases
#8
Mark Chan, Melanie Grehn, Florian Cremers, Frank-Andre Siebert, Stefan Wurster, Stefan Huttenlocher, Jürgen Dunst, Guido Hildebrandt, Achim Schweikard, Dirk Rades, Floris Ernst, Oliver Blanck
PURPOSE: Although the metric precision of robotic stereotactic body radiation therapy in the presence of breathing motion is widely known, we investigated the dosimetric implications of breathing phase-related residual tracking errors. METHODS AND MATERIALS: In 24 patients (28 liver metastases) treated with the CyberKnife, we recorded the residual correlation, prediction, and rotational tracking errors from 90 fractions and binned them into 10 breathing phases. The average breathing phase errors were used to shift and rotate the clinical tumor volume (CTV) and planning target volume (PTV) for each phase to calculate a pseudo 4-dimensional error dose distribution for comparison with the original planned dose distribution...
March 15, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28202227/phase-i-trial-of-radiation-therapy-and-sorafenib-in-unresectable-liver-metastases
#9
Rebecca B Goody, Anthony M Brade, Lisa Wang, Tim Craig, James Brierley, Robert Dinniwell, Rebecca K S Wong, Charles Cho, John Kim, Zahra Kassam, Jolie Ringash, Jennifer J Knox, Laura A Dawson
BACKGROUND AND PURPOSE: To determine maximum tolerated dose (MTD) and toxicities of sorafenib combined with stereotactic radiotherapy (SBRT) or whole liver radiotherapy (WLRT) in patients with liver metastases. MATERIAL AND METHODS: Eligible patients had unresectable liver metastases. Sorafenib dose was escalated in 2 strata: I - SBRT: effective liver volume irradiated (Veff)<80% (30-60Gy in 6 fractions); II - WLRT: Veff>80% (21.6Gy in 6 fractions). Four weeks of sorafenib, with radiotherapy during weeks 2-3, was delivered at 3 escalating dose levels (200-400mg twice daily)...
February 12, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28123916/stereotactic-body-radiotherapy-for-inoperable-liver-tumors-results-of-a-single-institutional-experience
#10
Hussam Hijazi, Marie-Pierre Campeau, David Roberge, David Donath, Real Lapointe, Franck Vandenbroucke-Menu, Daniel Taussky, Karim Boudam, Gabriel Chan, Alexis Bujold, Guila Delouya
OBJECTIVES: Stereotactic body radiation therapy (SBRT) is an emerging treatment option for liver tumors unsuitable for ablation or surgery. We report our experience with SBRT in the treatment of liver tumors. MATERIALS AND METHODS: Patients with primary or secondary liver cancer were identified in our local SBRT database. Patients were included irrespective of prior liver-directed therapies. The primary endpoint of our review was in-field local control (LC). Secondary endpoints were progression-free survival (PFS), overall survival (OS), and toxicity...
December 20, 2016: Curēus
https://www.readbyqxmd.com/read/28114239/clinical-outcomes-of-stereotactic-body-radiotherapy-in-oligometastatic-gynecological-cancer
#11
Concetta Laliscia, Maria Grazia Fabrini, Durim Delishaj, Riccardo Morganti, Carlo Greco, Martina Cantarella, Roberta Tana, Fabiola Paiar, Angiolo Gadducci
OBJECTIVE: The objective of this study was to assess the role of stereotactic body radiotherapy (SBRT) in the treatment of distantly recurrent, oligometastatic gynecological cancer. METHODS: The hospital records of 45 patients with F-fluorodeoxyglucose (F-FDG) positron emission tomography positive, distantly recurrent, oligometastatic gynecological cancer were reviewed. All these patients had a number of target lesions less than 5, with largest diameter less than 6 cm...
February 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28102954/dosimetric-impact-of-lipiodol-in-stereotactic-body-radiation-therapy-on-liver-after-trans-arterial-chemoembolization
#12
Daisuke Kawahara, Shuichi Ozawa, Akito Saito, Teiji Nishio, Tomoki Kimura, Tatsuhiko Suzuki, Kazunari Hioki, Takeo Nakashima, Yoshimi Ohno, Yuji Murakami, Yasushi Nagata
PURPOSE: Stereotactic body radiation therapy (SBRT) combining trans-arterial chemoembolization (TACE) with Lipiodol is expected to improve local control. This study is aimed to estimate the dose enhancement in Lipiodol's proximity and to evaluate the dose calculation accuracy of the Acuros XB (AXB) algorithm and anisotropic analytical algorithm (AAA) in the Eclipse treatment planning system (TPS) (ver. 11, Varian Medical Systems, Palo Alto, USA), compared with that of the Monte Carlo (MC) calculation (using BEAMnrc/DOSXYZnrc code) for a virtual phantom and a treatment plan for liver SBRT after TACE...
January 2017: Medical Physics
https://www.readbyqxmd.com/read/28054139/-local-ablative-radiotherapy-of-oligometastatic-colorectal-cancer
#13
C Petersen, T Gauer
BACKGROUND: Colorectal cancer (CRC) often presents as oligometastatic disease. Currently available intensive systemic treatment regimens, including combination chemotherapy and molecular targeted agents, result in tumor response and transient to long-term disease control in a high percentage of patients, thus raising the question of further management. Secondary resection and ablation, e.g. by surgery or radiofrequency may contribute to long-term survival and even be curative or at least allow a relevant chemotherapy-free interval...
February 2017: Der Radiologe
https://www.readbyqxmd.com/read/28048711/tu-b-brb-01-panel-member
#14
A Brade
In this interactive session, liver SBRT patient cases will be presented to highlight real-world considerations for ensuring safe and accurate treatment delivery. An expert panel of speakers will discuss approaches to challenges specific to liver SBRT including motion management, target delineation and imaging strategies, online treatment alignment, and appropriate prescription regimens and OAR dose limits. Audience participation will be encouraged. LEARNING OBJECTIVES: This panel session is designed to provide case demonstration and review for liver SBRT in terms of 1...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048527/su-f-t-544-development-of-a-clinically-feasible-workflow-of-4d-mri-based-treatment-planning-for-liver-sbrt
#15
S Han, F Yin, B Czito, M Palta, J Cai
PURPOSE: To develop a clinically feasible workflow of 4D MRI-based treatment planning for liver SBRT. METHODS: A clinical workflow based on 4D MRI for liver SBRT was designed to largely simulate the same procedure as 4D CT for lung SBRT. Key features of the workflow include: (1) contouring tumor volume at each phases (2) contouring more structures, (3) assigning CT numbers to structures for dose calculation. Uncertainties (bone delineation, MRI distortion, CT number assignment, etc...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048462/su-d-brb-01-a-comparison-of-learning-methods-for-knowledge-based-dose-prediction-for-coplanar-and-non-coplanar-liver-radiotherapy
#16
A Tran, D Ruan, K Woods, V Yu, D Nguyen, K Sheng
PURPOSE: The predictive power of knowledge based planning (KBP) has considerable potential in the development of automated treatment planning. Here, we examine the predictive capabilities and accuracy of previously reported KBP methods, as well as an artificial neural networks (ANN) method. Furthermore, we compare the predictive accuracy of these methods on coplanar volumetric-modulated arc therapy (VMAT) and non-coplanar 4π radiotherapy. METHODS: 30 liver SBRT patients previously treated using coplanar VMAT were selected for this study...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048359/su-f-j-121-dosimetric-evaluation-of-active-breathing-coordinator-response-gating-system-linked-to-linear-accelerator-in-volumetric-modulated-arc-therapy
#17
S Lee, Y Zheng, D Albani, V Colussi, J Dorth, J Sohn
PURPOSE: To reduce internal target volume (ITV), respiratory management is a must in imaging and treatment for lung, liver, and breast cancers. We investigated the dosimetric accuracy of VMAT treatment delivery with a Response™ gating system linked to linear accelerator. METHODS: The Response™ gating module designed to directly control radiation beam by breath-holding with a ABC system (Elekta AB, Stockholm, Sweden) was tested for VMAT treatments. Seven VMAT plans including three conventional and four stereotactic body radiotherapy (SBRT) cases were evaluated...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048292/su-g-jep4-06-evaluation-of-interfractional-and-intrafractional-tumor-motion-in-stereotactic-liver-radiotherapy-based-on-four-dimensional-cone-beam-computed-tomography-using-fiducial-markers
#18
Y Shimohigashi, F Araki, R Toya, M Maruyama, Y Nakaguchi
PURPOSE: The purpose of this study was to evaluate the interfractional and intrafractional motion of liver tumors in stereotactic body radiation therapy (SBRT), based on four-dimensional cone-beam computed tomography using fiducial markers. (4D-CBCT). METHODS: Seven patients with liver tumors were treated by SBRT with abdominal compression (AC) in five fractions with image guidance based on 4D-CBCT. The 4D-CBCT studies were performed to determine the individualized internal margin for the planning simulation...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048247/we-fg-202-10-assessing-hepatocellular-carcinoma-hcc-response-to-sbrt-using-dce-mri
#19
Y Yuan, M Buckstein, M Chao, K Rosenzweig, Y Lo
PURPOSE: To investigate the feasibility of using DCE-MRI to assess treatment response of HCC to SBRT. METHODS: For seven liver HCC patients treated by photon SBRT with radiation dose ranging from 35 to 50 Gy in 5 fractions, T1-weighted DCE-MRI was performed before and at 1-3 months after the treatment. Each study included one pre-contrast and five post Gd-EOB-DTPA-enhanced imaging series. The target tumor and the liver were manually outlined on the arterial phase images...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048202/we-h-brc-02-failure-mode-and-effect-analysis-of-liver-stereotactic-body-radiotherapy
#20
I Rusu, T Thomas, J Roeske, J Price, C Perino, I Mescioglu, M Surucu
PURPOSE: To identify areas of improvement in our liver stereotactic body radiation therapy (SBRT) program, using failure mode and effect analysis (FMEA). METHODS: A multidisciplinary group consisting of one physician, three physicists, one dosimetrist and two therapists was formed. A process map covering 10 major stages of the liver SBRT program from the initial diagnosis to post treatment follow-up was generated. A total of 102 failure modes, together with their causes and effects, were identified...
June 2016: Medical Physics
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