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intensity-modulated radiation therapy

Satoru Utsunomiya, Jun Yamamoto, Satoshi Tanabe, Mayu Oishi, Aruha Satsuma, Motoki Kaidu, Eisuke Abe, Atsushi Ohta, Naotaka Kushima, Hidefumi Aoyama
PURPOSE: The purpose of this work is to demonstrate quantitatively the complementary relation between the introduction of intensity-modulated radiation therapy (IMRT) and planning target volume (PTV) margin reduction with an image-guided technique in reducing the risk of rectal toxicity in dose-escalating prostate radiation therapy. METHODS AND MATERIALS: 3D-CRT and IMRT plans were generated for 10 prostate cancer patients based on two PTV margin protocols (10/8 mm and 6/5 mm) and two dose prescriptions (70 Gy and 78 Gy)...
February 14, 2019: Practical Radiation Oncology
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
Takeshi Kodaira
Intensity modulated radiation therapy(IMRT)is considered as standard care for locally advanced head and neck cancer, and its advantage was reported as reducing late toxicity such as xerostomia. IMRT was reported improving outcome for nasopharyngeal cancer. Although insufficient man power of radiation oncologists and medical physicists limit spared of IMRT in Japanese clinical practice. Further investigation such as particle therapy is believed to be encouraging.
January 2019: Gan to Kagaku Ryoho. Cancer & Chemotherapy
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
Scott C Morgan, Karen Hoffman, D Andrew Loblaw, Mark K Buyyounouski, Caroline Patton, Daniel Barocas, Soren Bentzen, Michael Chang, Jason Efstathiou, Patrick Greany, Per Halvorsen, Bridget F Koontz, Colleen Lawton, C Marc Leyrer, Daniel Lin, Michael Ray, Howard Sandler
PURPOSE: The aim of this guideline is to present recommendations regarding moderately hypofractionated (240-340 cGy per fraction) and ultrahypofractionated (500 cGy or more per fraction) radiation therapy for localized prostate cancer. METHODS AND MATERIALS: The American Society for Radiation Oncology convened a task force to address 8 key questions on appropriate indications and dose-fractionation for moderately and ultrahypofractionated radiation therapy, as well as technical issues, including normal tissue dose constraints, treatment volumes, and use of image guided and intensity modulated radiation therapy...
March 2019: Journal of Urology
Abdallah S R Mohamed, Blaine D Smith, Joshua B Smith, Parag Sevak, Jessica S Malek, Aasheesh Kanwar, Theodora Browne, G Brandon Gunn, Adam S Garden, Steven J Frank, William H Morrison, Jack Phan, Mark Zafereo, Heath Skinner, Stephen Y Lai, Katherine A Hutcheson, Jan S Lewin, Amy E Hessel, Apurva A Thekdi, Randal S Weber, Clifton D Fuller, David I Rosenthal
OBJECTIVES: We aim to report oncologic outcomes after conventional radiotherapy (ConRT) using opposed lateral beams and intensity-modulated radiation therapy (IMRT) for tumor (T)1 nodal (N)0 T1 N0 glottic squamous cell carcinoma. STUDY DESIGN: Retrospective case-control study. METHODS: We retrospectively reviewed demographic, disease, and treatment characteristics for patients treated at our institution during 2000 to 2013. RESULTS: One hundred fifty-three patients (71%) were treated using ConRT and 62 (29%) using IMRT...
February 12, 2019: Laryngoscope
Jianyang Wang, Yongwen Song, Xinfan Liu, Jing Jin, Weihu Wang, Zihao Yu, Yueping Liu, Ning Li, Hui Fang, Hua Ren, Yuan Tang, Yu Tang, Bo Chen, Ningning Lu, Shunan Qi, Shulian Wang, Yexiong Li
BACKGROUND: To compare the survival outcomes and late toxicities of postoperative intensity-modulated radiation therapy (IMRT) with two-dimensional radiotherapy (2D-RT) for patients with soft tissue sarcoma (STS) of extremities and trunk. METHODS: 274 consecutive patients with nonmetastatic STS of extremities and trunk treated with postoperative IMRT (n = 187) and 2D-RT (n = 87) were analyzed. Survival was calculated by using Kaplan-Meier method. Independent prognostic factors were identified using Cox stepwise regression analysis for variables with a P-value <0...
February 10, 2019: Cancer Medicine
R B Ross, A Juloori, V Varra, M C Ward, S Campbell, N M Woody, E Murray, P Xia, J F Greskovich, S A Koyfman, N P Joshi
INTRODUCTION: The conformality of modern intensity modulated radiation therapy (IMRT) allows avoidance of the submandibular glands (SMG) in select patients, potentially improving late xerostomia. This study explores the safety and efficacy of this approach in select oropharyngeal carcinoma (OPC) patients. METHODS: Patients with T1-2N+ human papillomavirus (HPV)-associated OPC treated with definitive IMRT at one institution from 2009 to 2014 were identified. Patients were divided into 3 groups: bilateral level IB targeted (A, n = 16), a single level IB targeted (B, n = 61), and bilateral IB spared (C, n = 9)...
February 2019: Oral Oncology
Taoran Li, Ryan Scheuermann, Alexander Lin, Boon-Keng Kevin Teo, Wei Zou, Samuel Swisher-McClure, Michelle Alonso-Basanta, John N Lukens, Alireza Fotouhi Ghiam, Chris Kennedy, Michele M Kim, Dimitris Mihailidis, James M Metz, Lei Dong
Purpose A new dual-layer multi-leaf collimator (MLC) system with several improved characteristics was introduced with the Varian Halcyon™ treatment platform. This study evaluated this new MLC's impact on head and neck plan quality and delivery efficiency. Methods Nine patients were retrospectively studied with Institutional Review Board (IRB) approval. To compare plan quality between the Halcyon dual-layer MLC and Truebeam® MLC, all patients were replanned with the same prescription and target coverage following the institutional clinical protocol for both platforms and using both intensity modulated radiation therapy (IMRT) or volumetrically modulated arc therapy (VMAT) techniques...
November 28, 2018: Curēus
Ting Martin Ma, Matthew M Harkenrider, Catheryn M Yashar, Akila N Viswanathan, Jyoti S Mayadev
PURPOSE: To understand the reasons behind current low utilization of brachytherapy for locally advanced cervical cancer in the United States. METHODS AND MATERIALS: A 17-item survey was e-mailed to the American Brachytherapy Society (ABS) listserv of active members in 2018. Responses of attending physicians in the United States were included in the analysis. RESULTS: Among a total of 135 respondents, 81 completed the survey. Eighty-four percent agree/strongly agree that cervical brachytherapy is underutilized, and 46...
February 2, 2019: Brachytherapy
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
I Mallick, A Das, M Arunsingh
AIMS: Node-positive prostate cancer is a unique subgroup, with varied practice on locoregional treatment. Definitive treatment with hypofractionated radiotherapy has not been widely reported. We have routinely used standard regimens of hypofractionated radiotherapy for node-positive disease and report our results of toxicity, biochemical control and survival. MATERIALS AND METHODS: Medical records of patients diagnosed with prostate cancer between February 2011 and April 2016 with radiologically involved pelvic nodes on magnetic resonance imaging/computed tomography without distant metastases were analysed...
February 1, 2019: Clinical Oncology: a Journal of the Royal College of Radiologists
Georgios Ntentas, Katerina Dedeckova, Michal Andrlik, Marianne C Aznar, Ben George, Jiří Kubeš, Sarah C Darby, David J Cutter
PURPOSE: Radiotherapy (RT) improves control of Hodgkin lymphoma (HL), but patients undergoing RT are at risk of late effects, including cardiovascular disease and second cancers, due to radiation dose to organs at risk (OAR). Proton therapy (PT) can reduce OAR dose compared to conventional photon RT. However, access to PT is currently limited so referral must be appropriately selective. We aim to identify subgroups of HL patients who could benefit most dosimetrically from RT with PT based on their pre-chemotherapy disease characteristics...
January 29, 2019: Practical Radiation Oncology
Alison K Yoder, Jillian R Gunther, Sarah A Milgrom, Mary Pham, Donald Hancock, Kelli McSpadden, John Garcia, Dragan Mirkovic, Bouthaina S Dabaja, Chelsea C Pinnix
Mesenteric masses can considerably shift positions between fractions of radiation therapy (RT). With image-guided RT, we can adapt our treatment delivery daily to target the mass while avoiding surrounding structures. We report the case of a highly-mobile mesenteric mass which required adaptive planning from a traditional "butterfly" intensity modulated radiation therapy (IMRT) plan to an anterior "rainbow" beam arrangement to permit shifting of the isocenter without compromising target coverage or increasing dose to organs-at-risk...
January 29, 2019: Practical Radiation Oncology
Michael R Folkert, Dana L Casey, Sean L Berry, Aimee Crago, Nicola Fabbri, Samuel Singer, Kaled M Alektiar
PURPOSE: This study was designed to compare the observed risk of femoral fracture in primary soft-tissue sarcoma (STS) of the thigh/groin treated with intensity-modulated radiation therapy (IMRT) to expected risk calculated using the Princess Margaret Hospital (PMH) nomogram. METHODS: Expected femoral fracture risk was calculated by using the PMH nomogram. Cumulative risk of fracture was estimated by using Kaplan-Meier statistics. Prognostic factors were assessed with univariate and multivariate analysis using Cox's stepwise regression...
January 31, 2019: Annals of Surgical Oncology
David M Routman, Aurelie Garant, Scott C Lester, Courtney N Day, William S Harmsen, Cristobal T Sanheuza, Harry H Yoon, Michelle A Neben-Wittich, James A Martenson, Michael G Haddock, Christopher L Hallemeier, Kenneth W Merrell
Purpose: Grade 4 lymphopenia (G4L) during radiation therapy (RT) is associated with higher rates of distant metastasis and decreased overall survival in a number of malignancies, including esophageal cancer (EC). Through a reduction in integral radiation dose, proton RT (PRT) may reduce G4L relative to photon RT (XRT). The purpose of this study was to compare G4L in patients with EC undergoing PRT versus XRT. Methods and materials: Patients receiving curative-intent RT and concurrent chemotherapy for EC were identified...
January 2019: Advances in Radiation Oncology
Tommy Sheu, Tina M Briere, Adenike M Olanrewaju, Mary Frances McAleer
Purpose: Volumetric modulated arc therapy (VMAT) has been shown by multiple planning studies to hold dosimetric advantages over intensity modulated radiation therapy (IMRT) in the management of brain tumors, including glioblastoma (GBM). Although promising, the clinical impact of these findings has not been fully elucidated. Methods and Materials: We retrospectively reviewed consecutive patients with a pathologic-confirmed diagnosis of GBM who were treated between 2014 and 2015, a period that encompassed the transition from IMRT to VMAT at a single institution...
January 2019: Advances in Radiation Oncology
Dan Nguyen, Troy Long, Xun Jia, Weiguo Lu, Xuejun Gu, Zohaib Iqbal, Steve Jiang
With the advancement of treatment modalities in radiation therapy for cancer patients, outcomes have improved, but at the cost of increased treatment plan complexity and planning time. The accurate prediction of dose distributions would alleviate this issue by guiding clinical plan optimization to save time and maintain high quality plans. We have modified a convolutional deep network model, U-net (originally designed for segmentation purposes), for predicting dose from patient image contours of the planning target volume (PTV) and organs at risk (OAR)...
January 31, 2019: Scientific Reports
Christopher N Kabat, Dewayne L Defoor, Pamela Myers, Neil Kirby, Karl Rasmussen, Daniel L Saenz, Panayiotis Mavroidis, Niko Papanikolaou, Sotirios Stathakis
PURPOSE: With the advent of volumetric modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT) treatment techniques, the requirement for more elaborate approaches in reviewing linac components' integrity has become even more stringent. A possible solution to this challenge is to employ the usage of log files generated during treatment. The log files generated by the new generation of Elekta linacs record events at a higher frequency (25 Hz) than their predecessors, which allows for retrospective analysis and identification of subtle changes and provides another means of quality assurance...
January 31, 2019: Medical Physics
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