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Radiotherapy and Oncology

Douglas R Spitz, Garry R Buettner, Michael S Petronek, Joël J St-Aubin, Ryan T Flynn, Timothy J Waldron, Charles L Limoli
For decades the field of radiation oncology has sought to improve the therapeutic ratio through innovations in physics, chemistry, and biology. To date, technological advancements in image guided beam delivery techniques have provided clinicians with their best options for improving this critical tool in cancer care. Medical physics has focused on the preferential targeting of tumors while minimizing the collateral dose to the surrounding normal tissues, yielding only incremental progress. However, recent developments involving ultra-high dose rate irradiation termed FLASH radiotherapy (FLASH-RT), that were initiated nearly 50 years ago, have stimulated a renaissance in the field of radiotherapy, long awaiting a breakthrough modality able to enhance therapeutic responses and limit normal tissue injury...
April 19, 2019: Radiotherapy and Oncology
Te-Chun Hsia, Chih-Yen Tu, Chia-Chin Li, Chun-Ru Chien
No abstract text is available yet for this article.
April 10, 2019: Radiotherapy and Oncology
Shayna E Rich, Ronald Chow, Srinivas Raman, K Liang Zeng, Stephen Lutz, Henry Lam, Maurício F Silva, Edward Chow
No abstract text is available yet for this article.
April 10, 2019: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
(no author information available yet)
No abstract text is available yet for this article.
April 5, 2019: Radiotherapy and Oncology
Hanxi Zhao, Li Jia, Guanxuan Chen, Xiaolin Li, Xiangjiao Meng, Xianguang Zhao, Ligang Xing, Wanqi Zhu
BACKGROUND AND PURPOSE: This trial investigated whether epigallocatechin-3-gallate (EGCG), a radioprotector, could be effective in the prevention and treatment of acute radiation-induced esophagitis (ARIE). METHODS AND MATERIALS: This is a phase II study of EGCG combined with chemoradiation in unresectable stage III non-small-cell lung cancer or limited stage small cell lung cancer. Patients were randomized into a prophylactic EGCG group (arm A), a therapeutic EGCG group after the occurrence of esophagitis (arm B) or conventional therapy group (arm C)...
March 19, 2019: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Manuela Buonanno, Veljko Grilj, David J Brenner
BACKGROUND: Radiotherapy outcomes are limited by toxicity in the healthy tissues surrounding the irradiated tumor. Recent pre-clinical studies have shown that irradiations with electrons or photons delivered at so called FLASH dose rates (i.e. >40 Gy/s) dramatically reduce adverse side effects in the normal tissues while being equally efficient for tumor control as irradiations at conventional dose rates (3-5 cGy/s). In the case of protons however, FLASH effects have not been investigated partially because of the limited availability of facilities that can achieve such high dose rates...
March 5, 2019: Radiotherapy and Oncology
Mirjana Josipovic, Gitte F Persson, Jenny Dueck, Jens Peter Bangsgaard, Gunnar Westman, Lena Specht, Marianne C Aznar
No abstract text is available yet for this article.
February 14, 2019: Radiotherapy and Oncology
Michael Lempart, Börje Blad, Gabriel Adrian, Sven Bäck, Tommy Knöös, Crister Ceberg, Kristoffer Petersson
OBJECTIVES: The purpose of this study was to modify a clinical linear accelerator, making it capable of electron beam ultra-high dose rate (FLASH) irradiation. Modifications had to be quick, reversible, and without interfering with clinical treatments. METHODS: Performed modifications: (1) reduced distance with three setup positions, (2) adjusted/optimized gun current, modulator charge rate and beam steering values for a high dose rate, (3) delivery was controlled with a microcontroller on an electron pulse level, and (4) moving the primary and/or secondary scattering foils from the beam path...
February 9, 2019: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Jan C Peeken, Michael Bernhofer, Matthew B Spraker, Daniela Pfeiffer, Michal Devecka, Ahmed Thamer, Mohammed A Shouman, Armin Ott, Fridtjof Nüsslin, Nina A Mayr, Burkhard Rost, Matthew J Nyflot, Stephanie E Combs
PURPOSE: In soft tissue sarcoma (STS) patients systemic progression and survival remain comparably low despite low local recurrence rates. In this work, we investigated whether quantitative imaging features ("radiomics") of radiotherapy planning CT-scans carry a prognostic value for pre-therapeutic risk assessment. METHODS: CT-scans, tumor grade, and clinical information were collected from three independent retrospective cohorts of 83 (TUM), 87 (UW) and 51 (McGill) STS patients, respectively...
February 5, 2019: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Adomas Bunevicius
No abstract text is available yet for this article.
January 31, 2019: Radiotherapy and Oncology
Ali Ajdari, Maximilian Niyazi, Nils Henrik Nicolay, Christian Thieke, Robert Jeraj, Thomas Bortfeld
A typical fractionated radiotherapy (RT) course is a long and arduous process, demanding significant financial, physical, and mental commitments from patients. Each additional session of RT significantly increases the physical and psychological burden on patients and leads to higher radiation exposure in organs-at-risk (OAR), while, in some cases, the therapeutic benefits might not be high enough to justify the risks. Today, through technological advancements in molecular biology, imaging, and genetics more information is gathered about individual patient response before, during, and after the treatment...
May 2019: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Christopher L Tinkle, Noelle L Williams, Huiyun Wu, Jianrong Wu, Sue C Kaste, Barry L Shulkin, Aimee C Talleur, Jamie E Flerlage, Melissa M Hudson, Monika L Metzger, Matthew J Krasin
BACKGROUND AND PURPOSE: The use of radiotherapy (RT) for pediatric patients with Hodgkin lymphoma (HL) experiencing disease progression or recurrence (15%) is controversial. We report treatment patterns and outcomes for pediatric patients with refractory/recurrent HL (rrHL) treated with curative-intent RT. MATERIALS AND METHODS: Forty-six patients with rrHL treated with salvage RT at our institution were identified. All received risk-adapted, response-based frontline therapy and were retrieved with cytoreductive regimens followed by RT to failure sites, with or without autologous hematopoietic cell transplantation (AHCT)...
May 2019: Radiotherapy and Oncology
Prashant Gabani, Alexander J Lin, Justin Barnes, Peter Oppelt, Douglas R Adkins, Jason T Rich, Jose P Zevallos, Mackenzie D Daly, Hiram A Gay, Wade L Thorstad
BACKGROUND: Despite existing evidence that human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) has a favorable prognosis compared to HPV-negative OPSCC, randomized studies have yet to report the effect of de-escalating radiation therapy (RT) dose for definitive treatment. The aim of this study was to assess the effectiveness of dose de-escalated RT (DDRT) vs. standard dose RT (SDRT) in patients with HPV-positive OPSCC. METHODS: This was an observational study using the National Cancer Database (Year 2010-2014) to identify patients who had HPV-positive OPSCC and were treated with definitive RT or chemo-RT...
May 2019: Radiotherapy and Oncology
Baruch Brenner, Ofer Purim, Noa Gordon, Tal Goshen-Lago, Efraim Idelevich, Hanoch Kashtan, Nikolai Menasherov, Eyal Fenig, Aaron Sulkes, Yulia Kundel
AIM: This phase IB/II study evaluated the safety and efficacy of the addition of cetuximab to standard preoperative chemoradiotherapy (CRT) in locally advanced esophageal cancer (LAEC). METHODS: Patients (pts) with resectable LAEC (T2-3 N0-1 M0 , T1-3 N1 M0 or T1-3 N0-1 M1A) received an induction cycle of cisplatin 100 mg/m2 , day 1, and 5-fluorouracil (5-FU) 1000 mg/m2 /day, days 1-5, followed 4 weeks later by radiotherapy, 50.4 Gy, given with 2 cycles of cisplatin 75 mg/m2 and escalating doses of 5-FU, days 1-4 and 29-32...
May 2019: Radiotherapy and Oncology
Mauro Loi, Alba Magallon-Baro, Mustafa Suker, Casper van Eijck, Aman Sharma, Mischa Hoogeman, Joost Nuyttens
BACKGROUND AND PURPOSE: Interfraction shape and position variations of organs at risk (OARs) may increase uncertainty in dose delivery during stereotactic body radiotherapy (SBRT), potentially leading to overirradiation or concessions in planned tumor dose and/or coverage to prevent clinical constraints violation. The aim of our study was to quantitatively analyze the impact of anatomical interfraction variations on dose to OARs in pancreatic cancer (PC) treated by SBRT using a CyberKnife with integrated CT-on-rails...
May 2019: Radiotherapy and Oncology
Elysia K Donovan, Julianna Sienna, Gunita Mitera, Nidhi Kumar-Tyagi, Sameer Parpia, Anand Swaminath
BACKGROUND: While multifraction radiotherapy (RT) regimens (MFRT) have been considered the standard of care in patients with metastatic epidural spinal cord compression (MESCC) with limited prognosis, recent randomized evidence has demonstrated that single fraction RT (SFRT) may be equivalent in terms of functional and overall outcomes. A systematic review and meta-analysis was conducted to determine the effects of SFRT compared to short course MFRT in patients with MESCC. METHODS: A search of OVID, EMBASE, and the Cochrane Central Register of Controlled Trials from inception to February 2018 was conducted...
May 2019: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Anita M Werensteijn-Honingh, Petra S Kroon, Dennis Winkel, Ellart M Aalbers, Bram van Asselen, Gijsbert H Bol, Kevin J Brown, Wietse S C Eppinga, Corine A van Es, Markus Glitzner, Eline N de Groot-van Breugel, Sara L Hackett, Martijn Intven, Jan G M Kok, Charis Kontaxis, Alexis N Kotte, Jan J W Lagendijk, Mariëlle E P Philippens, Rob H N Tijssen, Jochem W H Wolthaus, Simon J Woodings, Bas W Raaymakers, Ina M Jürgenliemk-Schulz
Online adaptive radiotherapy using the 1.5 Tesla MR-linac is feasible for SBRT (5 × 7 Gy) of pelvic lymph node oligometastases. The workflow allows full online planning based on daily anatomy. Session duration is less than 60 min. Quality assurance tests, including independent 3D dose calculations and film measurements were passed.
May 2019: Radiotherapy and Oncology
Benjamin H Kann, Vivek Verma, John M Stahl, Rudi Ross, Arie P Dosoretz, Timothy D Shafman, Cary P Gross, Henry S Park, James B Yu, Roy H Decker
PURPOSE: Although stereotactic body radiation therapy (SBRT) is the standard of care for inoperable early-stage non-small cell lung carcinoma (NSCLC), its role for medically operable patients remains controversial. To address this knowledge gap, we conducted a multi-institutional study to assess post-SBRT disease control and survival outcomes in medically operable patients. METHODS: We conducted a retrospective cohort study including patients with biopsy-proven cT1-2N0M0 NSCLC treated with definitive SBRT (2006-2015)...
May 2019: Radiotherapy and Oncology
Hao-Jiang Li, Ying-Ying Hu, Ling Huang, Jian Zhou, Jian-Jun Li, Chuan-Bo Xie, Ming-Yuan Chen, Ying Sun, Li-Zhi Liu, Li Tian
PURPOSE: To investigate the prognostic value of skull-base invasion (SBI) for nasopharyngeal carcinoma (NPC), propose a subclassification of SBI. METHODS: 792 and 433 patients with pathologically proven NPC and complete clinical and magnetic resonance imaging records at Sun Yat-sen University Cancer Center and Foshan Hospital were enrolled, and investigated using heat map/cluster, network and survival analyses. RESULTS: The results of heat map/cluster analyses and network analysis showed that T3 patients with pterygoid process and/or base of the sphenoid bone invasion (T3 slight) had better treatment outcomes than those with other SBIs (T3 severe)...
May 2019: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
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