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International Journal of Radiation Oncology, Biology, Physics

Celine Bourgier, Anne Auperin, Sofia Rivera, Pierre Boisselier, Benoit Petit, Philippe Lang, Nathalie Lassau, Patrice Taourel, Raphael Tetreau, David Azria, Jean Bourhis, Eric Deutsch, Marie-Catherine Vozenin
PURPOSE: The "xxx" phase II trial (NCTxxx) assessed the efficacy of pravastatin as anti-fibrotic agent in patients with established cutaneous and subcutaneous radiation-induced fibrosis (RIF) after head and neck squamous cell carcinoma (HNSCC) radiotherapy and/or radio-chemotherapy. METHODS AND MATERIALS: The main inclusion criteria were: patients with HNSCC in remission, with grade ≥2 cutaneous and subcutaneous neck RIF (NCI-CTCAE v4.0); no current treatment with statins or fibrates...
February 15, 2019: International Journal of Radiation Oncology, Biology, Physics
Igor Shuryak, Eric J Hall, David J Brenner
PURPOSE: Treatment of fast-growing HPV-negative head-and-neck cancers (HNC) remains challenging, both from the perspective of tumor control and late sequelae. Here we use systematic radiobiological optimization to identify fractionation schemes that markedly improve the radiotherapeutic effectiveness balance between tumor control probability (TCP) and late normal-tissue complication probability (LNTCP), as compared with standard fractionation. METHODS AND MATERIALS: We track the development after each treatment fraction of both tumor control and late sequelae...
February 15, 2019: International Journal of Radiation Oncology, Biology, Physics
Zaid A Siddiqui, Gary S Gustafson, Hong Ye, Alvaro A Martinez, Beth Mitchell, Evelyn Sebastian, Amy Limbacher, Daniel J Krauss
PURPOSE: To update outcome and toxicity results of a prospective trial of 19 Gy single-fraction high-dose-rate (HDR) brachytherapy for men with low- and intermediate-risk prostate cancer. MATERIALS AND METHODS: Patients were treated on a prospective study of single-fraction HDR brachytherapy. All patients had low- or intermediate-risk prostate cancer. Patients with prostate volumes > 50 cc, taking alpha-blockers for urinary symptoms, or baseline American Urologic Association (AUA) symptom scores > 12 were ineligible...
February 13, 2019: International Journal of Radiation Oncology, Biology, Physics
Chelsea C Pinnix, Jillian R Gunther, Sarah A Milgrom, Ruben J Cruz Chamorro, L Jeffrey Medeiros, Joseph D Khoury, Behrang Amini, Sattva Neelapu, Hun Lee, Jason Westin, Nathan Fowler, Loretta Nastoupil, Bouthaina Dabaja
PURPOSE/OBJECTIVES: In patients with gastric extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue lymphoma (MALT lymphoma), the standard radiation therapy (RT) dose is ≥ 30 Gy. We report the outcome of patients treated with reduced 24 Gy compared with ≥ 30 Gy. MATERIALS/METHODS: We reviewed 32 patients diagnosed between 2007 and 2017 with gastric MALT lymphoma and treated with involved site radiation therapy (ISRT) using intensity modulated radiation therapy (IMRT)...
February 12, 2019: International Journal of Radiation Oncology, Biology, Physics
Peter D Inskip, Lene H S Veiga, Alina V Brenner, Alice J Sigurdson, Evgenia Ostroumova, Eric J Chow, Marilyn Stovall, Susan A Smith, Wendy Leisenring, Leslie L Robison, Gregory T Armstrong, Charles A Sklar, Jay H Lubin
BACKGROUND: The association of hyperthyroidism with exposure to ionizing radiation is poorly understood. This study addresses the risk of hyperthyroidism in relation to incidental therapeutic radiation dose to the thyroid and pituitary glands in a large cohort of survivors of childhood cancer. METHODS: Utilizing the Childhood Cancer Survivor Study, a cohort of five-year survivors of childhood cancer diagnosed at hospitals in the United States and Canada between 1970 and 1986, the occurrence of hyperthyroidism through 2009 was ascertained among 12,183 survivors based on serial questionnaires...
February 12, 2019: International Journal of Radiation Oncology, Biology, Physics
N George Mikhaeel, Sarah A Milgrom, Stephanie Terezakis, Anne Kiil Berthelsen, David Hodgson, Hans Theodor Eich, Karin Dieckmann, Shu-Nan Qi, Joachim Yahalom, Lena Specht
Radiation therapy (RT) for the management of lymphomas has evolved over the past decades. Large extended or involved fields have been replaced by smaller involved site or nodal volumes. Currently, customized plans are created for each individual patient that encompass only the areas involved by disease. A critical factor that has enabled this shift in practice is the evolving use of imaging studies. Imaging plays a key role in patient selection, RT planning and delivery. The objective of this manuscript is to provide guidelines for best practice of use of imaging in pre-treatment evaluation, treatment choice, RT target volume definition, and RT treatment verification and delivery...
February 11, 2019: International Journal of Radiation Oncology, Biology, Physics
Baho Sidiqi, Erin Gillespie, Chunyu Wang, Melissa Dawson, Abraham J Wu
PURPOSE: Medical students may take a year off during medical school (a "gap year") to strengthen their applications for competitive specialties such as radiation oncology. This can incur significant financial and opportunity costs. We sought to understand the prevalence, nature, and funding of gap years undertaken by radiation oncology applicants. MATERIALS/METHODS: An anonymous survey was emailed to all applicants to a single radiation oncology program from 2015-2017...
February 11, 2019: International Journal of Radiation Oncology, Biology, Physics
Sadhna O Piryani, Yiqun Jiao, Angel Y F Kam, Yang Liu, Tuan Vo-Dinh, Benny J Chen, Nelson J Chao, Phuong L Doan
PURPOSE: Extracellular vesicles (EVs) are shed vesicles that bear a combination of nucleic acids and proteins. EVs are becoming recognized as a mode of cell-to-cell communication. Since hematopoietic stem cells (HSCs) reside in proximity to endothelial cells (ECs), we investigated whether EC-derived EVs could regulate HSC regeneration following ionizing radiation. METHODS AND MATERIALS: We generated EVs derived from primary murine marrow ECs. We sought to determine the response of irradiated hematopoietic stem and progenitor cells to syngeneic or allogeneic EVs in culture assays...
February 11, 2019: International Journal of Radiation Oncology, Biology, Physics
Dana L Casey, Brian H Kushner, Nai-Kong V Cheung, Shakeel Modak, Ellen M Basu, Stephen S Roberts, Michael P LaQuaglia, Suzanne L Wolden
PURPOSE: For patients with high-risk neuroblastoma (HR-NB), a dose of 21 Gy to the primary tumor site after gross total resection (GTR) provides excellent local control. However, no clinical trial has specifically evaluated the optimal dose of radiation therapy (RT), and RT-related long-term toxicities are of increasing concern. We sought to assess local control, survival outcomes, and toxicity after a reduction in dose to the primary site from 21 Gy to 18 Gy. METHODS AND MATERIALS: After induction chemotherapy and GTR, patients with HR-NB were enrolled and treated on a RT dose-reduction prospective trial with 18 Gy hyperfractionated RT given in twice-daily fractions of 1...
February 11, 2019: International Journal of Radiation Oncology, Biology, Physics
Nitika Paudel, Derek Schulze, Ryan D Gentzler, Andrew M Evens, Irene Helenowski, Gary Dillehay, Olga Frankfurt, Jayesh Mehta, Eric D Donnelly, Leo I Gordon, Jane N Winter, Bharat B Mittal
PURPOSE: The patterns of failure and long-term outcomes of patients with relapsed or refractory classical Hodgkin lymphoma (cHL) treated with total lymphoid irradiation (TLI) and high-dose chemotherapy (HDCT) followed by autologous stem cell transplantation (aSCT) is reported. METHODS AND MATERIALS: Patients with biopsy-proven primary refractory/relapsed cHL who received salvage chemotherapy and accelerated hyperfractionated TLI prior to HDCT and aSCT were included...
February 11, 2019: International Journal of Radiation Oncology, Biology, Physics
Veerle A B van den Bogaard, Peter van Luijk, Yoran M Hummel, Peter van der Meer, E Schuit, Liselotte M Boerman, Saskia W M C Maass, Jan F Nauta, Lars C Steggink, Jourik A Gietema, Geertruida H de Bock, Annette J Berendsen, Wilma G J M Smit, Nanna M Sijtsema, Roel G J Kierkels, Johannes A Langendijk, Anne P G Crijns, John H Maduro
PURPOSE: The main purpose of this study was to test the hypothesis that incidental cardiac irradiation is associated with changes in cardiac function in breast cancer (BC) survivors treated with radiotherapy (RT). METHODS AND MATERIALS: We conducted a cross-sectional study consisting of 109 BC survivors treated with RT between 2005 and 2011. The endpoint was cardiac function, assessed by echocardiography. Systolic function was assessed with the left ventricle ejection fraction (LVEF) (n=107) and the global longitudinal strain (GLS) of the left ventricle (LV) (n=52)...
February 11, 2019: International Journal of Radiation Oncology, Biology, Physics
Howard J Lee, Andrew Stacey, Todd R Klesert, Craig Wells, Alison Skalet, Charles Bloch, Angela Fung, Stephen R Bowen, Tony P Wong, Dean Shibata, Lia M Halasz, Ramesh Rengan
PURPOSE: The present study examines the relationship between dose to corneal substructures and incidence of corneal toxicity within six months of proton beam therapy (PBT) for uveal melanoma. We aim to develop clinically meaningful dose constraints that can be used to mitigate corneal toxicity. METHODS AND MATERIALS: Ninety-two patients were treated with PBT between 2015 and 2017 and evaluated for grade 2+ (GR2+), intervention-requiring corneal toxicity in our prospectively maintained database...
February 11, 2019: International Journal of Radiation Oncology, Biology, Physics
Christine E Hill-Kayser, Zelig Tochner, Yimei Li, Goldie Kurtz, Robert A Lustig, Paul James, Naomi Balamuth, Richard Womer, Peter Mattei, Stephen Grupp, Yael P Mosse, John M Maris, Rochelle Bagatell
BACKGROUND: Patients with high-risk neuroblastoma (HR-NBL) require radiation to the primary tumor site and sites of persistent metastatic disease. Proton radiotherapy (PRT) may promote organ sparing, but long-term outcomes have not been studied. METHODS: Sequential patients with HR-NBL received PRT: 2160 cGy(RBE) to primary tumor bed and persistent metastatic sites, with 3600 cGy(RBE) to gross residual disease. RESULTS: From 9/2010-9/2015, 45 patients with HR-NBL received PRT following systemic therapy, primary tumor resection, and high-dose chemotherapy with stem cell rescue...
February 7, 2019: International Journal of Radiation Oncology, Biology, Physics
Mark Newpower, Darshana Patel, Lawrence Bronk, Fada Guan, Pankaj Chaudhary, Stephen J McMahon, Kevin M Prise, Giuseppe Schettino, David R Grosshans, Radhe Mohan
PURPOSE: We introduce a methodology to calculate the microdosimetric quantity dose-mean lineal energy for input into the microdosimetric kinetic model (MKM) to model the relative biological effectiveness (RBE) of proton irradiation experiments. METHODS AND MATERIALS: The data from seven individual proton RBE experiments were included in this study. In each experiment, the RBE at several points along the Bragg curve was measured. Monte Carlo (MC) simulations to calculate the lineal energy probability density function of 172 different proton energies were carried out with use of Geant4 DNA...
February 4, 2019: International Journal of Radiation Oncology, Biology, Physics
Louis Potters, Zaker Rana, Lucille Lee, Brett W Cox
INTRODUCTION: This study presents a prospective phase I, IRB-approved dose-escalated stereotactic body radiotherapy (SBRT) trial for prostate cancer (CaP) to assess the impact of dose level on quality of life, toxicity, and clinical outcomes. MATERIALS/METHODS: From 2011-2016, 26 patients with low and intermediate-risk CaP received 40, 45, and 50 Gy in five fractions to the prostate in cohorts of 9, 10, and 7 patients. Self-reported QOL was prospectively measured from the Expanded Prostate Cancer Index Composite (EPIC) and American Urological Association (AUA)...
February 2, 2019: International Journal of Radiation Oncology, Biology, Physics
Ibrahim Abu-Gheida, Chandana A Reddy, Rupesh Kotecha, Michael A Weller, Chirag Shah, Patrick A Kupelian, Omar Mian, Jay P Ciezki, Kevin L Stephans, Rahul D Tendulkar
PURPOSE/OBJECTIVES: Long term outcomes with hypofractionated radiotherapy for prostate cancer are limited. We report 10-year outcomes for patients treated with intensity modulated radiation therapy (IMRT) for localized prostate cancer with 70 Gy in 28 fractions at 2.5 Gy/fraction. METHODS AND MATERIALS: The study included 854 consecutive patients with localized prostate cancer treated with moderately hypofractionated IMRT and daily image guidance at a single institution between 1998 and 2012...
February 2, 2019: International Journal of Radiation Oncology, Biology, Physics
Linda Dirven, Jaap C Reijneveld, Martin J B Taphoorn, Corneel Coens, Samy A El-Badawy, Tzahala Tzuk-Shina, Jose Bravo-Marques, Michael Back, Lukas J A Stalpers, Roger Stupp, Brigitta G Baumert, Clemens Seidel
BACKGROUND: It is currently unknown whether increasing radiotherapy volume has a negative impact on the health-related quality of life (HRQoL) of low-grade glioma (LGG) patients in the short-term. The aim was to examine if the size of the target volume is independently associated with HRQoL. METHODS: We included patients who were treated with radiotherapy in XXXX study, and who completed baseline HRQoL assessment. HRQoL was measured at baseline and every 3 months thereafter until progression, using the EORTC QLQ-C30 and QLQ-BN20 questionnaires...
February 1, 2019: International Journal of Radiation Oncology, Biology, Physics
Pragati G Advani, Xiudong Lei, Cameron W Swanick, Ying Xu, Yu Shen, Nathan A Goodwin, Grace L Smith, Sharon H Giordano, Kelly K Hunt, Reshma Jagsi, Benjamin D Smith
BACKGROUND: Older women with non-metastatic breast cancer can often choose among several surgery and radiation treatment options. Little is known regarding how these choices contribute to decisional regret, which is a negative emotion reflecting the idea that another surgery or radiation decision may have been preferable. We sought to characterize the burden of and examine potential risk-factors for local-therapy decisional regret among a population-based cohort of older breast cancer survivors...
February 1, 2019: International Journal of Radiation Oncology, Biology, Physics
Eugenia Mylona, Oscar Acosta, Thibaut Lizee, Caroline Lafond, Gilles Crehange, Nicolas Magné, Sophie Chiavassa, Stéphane Supiot, Juan David Arango Ospina, Borris Campillo-Gimenez, Joel Castelli, Renaud de Crevoisier
BACKGROUND AND PURPOSE: To apply a voxel-based analysis to identify urethro-vesical symptom-related subregions (SRSs) associated with acute and late urinary toxicity in prostate cancer radiotherapy. MATERIALS AND METHODS: A total of 272 prostate cancer patients treated with IMRT/IGRT were prospectively analyzed. Each patient's CT was spatially normalized to a common coordinate system (CCS) via nonrigid registration. The obtained deformation fields were used to map the dose of each patient to the CCS...
February 1, 2019: International Journal of Radiation Oncology, Biology, Physics
Ke Nie, Hania Al-Hallaq, X Allen Li, Stanley H Benedict, Jason W Sohn, Jean M Moran, Yong Fan, Mi Huang, Michael V Knopp, Jeff M Michalski, James Monroe, Ceferino Obcemea, Christina I Tsien, Timothy Solberg, Jackie Wu, Ping Xia, Ying Xiao, Issam El Naqa
Radiomics is a fast-growing research area based on converting standard-of-care imaging into quantitative minable data and building subsequent predictive models to personalize treatment. It has been proposed as a study objective in clinical trial concepts and a potential biomarker for stratifying patients across interventional treatment arms. In recognizing the growing importance of radiomics in oncology a group of medical physicists and clinicians from NRG Oncology reviewed the current status of the field and identified critical issues, providing general assessment and early recommendations for incorporation in oncology studies...
January 31, 2019: International Journal of Radiation Oncology, Biology, Physics
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