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Yesterday, 18 Ιουλίου 2016, 8:55:56 πμ
Prospective audit showing improved patient-assessed skin toxicity with use of betamethasone cream for those at high risk of radiation dermatitis
Παρασκευή, 15 Ιουλίου 2016, 11:48:43 μμ
Publication date: Available online 14 July 2016
Source:Radiotherapy and Oncology
Author(s): Sara C. Erridge, Marie McCabe, Mandy K. Porter, Patricia Simpson, Alison L. Stillie
This audit was conducted before and after introduction of a risk-based skincare policy with prophylactic steroids recommended for those at high risk. Comparison of the two cohorts confirmed results seen in trials with significant reduction in redness, itch, discomfort, sleep disturbance, and use of analgesia with the addition of steroids.
Clinical validation and benchmarking of knowledge-based IMRT and VMAT treatment planning in pelvic anatomy
Παρασκευή, 15 Ιουλίου 2016, 11:48:43 μμ
Publication date: Available online 14 July 2016
Source:Radiotherapy and Oncology
Author(s): Mohammad Hussein, Christopher P. South, Miriam A. Barry, Elizabeth J. Adams, Tom J. Jordan, Alexandra J. Stewart, Andrew Nisbet
PurposeThe aim of this work was to determine whether a commercial knowledge-based treatment planning (KBP) module can efficiently produce IMRT and VMAT plans in the pelvic region (prostate & cervical cancer), and to assess sensitivity of plan quality to training data and model parameters.MethodsInitial benchmarking of KBP was performed using prostate cancer cases. Structures and dose distributions from 40 patients previously treated using a 5-field IMRT technique were used for model training. Two types of model were created: one excluded statistical outliers (as identified by RapidPlan guidelines) and the other had no exclusions. A separate model for cervix uteri cancer cases was subsequently developed using 37 clinical patients treated for cervical cancer using RapidArc™ VMAT, with no exclusions. The resulting models were then used to generate plans for ten patients from each patient group who had not been included in the modelling process. Comparisons of generated RapidPlans with the corresponding clinical plans were carried out to indicate the required modifications to the models. Model parameters were then iteratively adjusted until plan quality converged with that obtained by experienced planners without KBP.ResultsInitial automated model generation settings led to poor conformity, coverage and efficiency compared to clinical plans. Therefore a number of changes to the initial KBP models were required. Before model optimisation, it was found that the PTV coverage was slightly reduced in the superior and inferior directions for RapidPlan compared with clinical plans and therefore PTV parameters were adjusted to improve coverage. OAR doses were similar for both RapidPlan and clinical plans (p>0.05). Excluding outliers had little effect on plan quality (p≫0.05). Manually fixing key optimisation objectives enabled production of clinically acceptable treatment plans without further planner intervention for 9 of 10 prostate test patients and all 10 cervix test patients.ConclusionsThe Varian RapidPlan™ system was able to produce IMRT & VMAT treatment plans in the pelvis, in a single optimisation, that had comparable sparing and comparable or better conformity than the original clinically acceptable plans. The system allows for better consistency and efficiency in the treatment planning process and has therefore been adopted clinically within our institute with over 100 patients treated.
Prospective audit showing improved patient-assessed skin toxicity with use of betamethasone cream for those at high risk of radiation dermatitis
Παρασκευή, 15 Ιουλίου 2016, 1:08:53 πμ | Sara C. Erridge, Marie McCabe, Mandy K. Porter, Patricia Simpson, Alison L. Stillie
This audit was conducted before and after introduction of a risk-based skincare policy with prophylactic steroids recommended for those at high risk. Comparison of the two cohorts confirmed results seen in trials with significant reduction in redness, itch, discomfort, sleep disturbance, and use of analgesia with the addition of steroids.
Clinical validation and benchmarking of knowledge-based IMRT and VMAT treatment planning in pelvic anatomy
Παρασκευή, 15 Ιουλίου 2016, 1:08:53 πμ | Mohammad Hussein, Christopher P. South, Miriam A. Barry, Elizabeth J. Adams, Tom J. Jordan, Alexandra J. Stewart, Andrew Nisbet
The aim of this work was to determine whether a commercial knowledge-based treatment planning (KBP) module can efficiently produce IMRT and VMAT plans in the pelvic region (prostate & cervical cancer), and to assess sensitivity of plan quality to training data and model parameters.
GEC-ESTRO multicenter phase 3-trial: Accelerated partial breast irradiation with interstitial multicatheter brachytherapy versus external beam whole breast irradiation: Early toxicity and patient compliance
Παρασκευή, 15 Ιουλίου 2016, 1:05:50 πμ
Publication date: Available online 12 July 2016
Source:Radiotherapy and Oncology
Author(s): Oliver J. Ott, Vratislav Strnad, Guido Hildebrandt, Daniela Kauer-Dorner, Hellen Knauerhase, Tibor Major, Jaroslaw Łyczek, José Luis Guinot, Jürgen Dunst, Cristina Gutierrez Miguelez, Pavel Slampa, Michael Allgäuer, Kristina Lössl, Bülent Polat, György Kovács, Arnt-René Fischedick, Thomas G. Wendt, Rainer Fietkau, Rolf-Dieter Kortmann, Alexandra Resch, Anna Kulik, Leo Arribas, Peter Niehoff, Ferran Guedea, Annika Schlamann, Richard Pötter, Christine Gall, Martina Malzer, Wolfgang Uter, Csaba Polgár
Background and purposeTo compare early side effects and patient compliance of accelerated partial breast irradiation (APBI) with multicatheter brachytherapy to external beam whole breast irradiation (WBI) in a low-risk group of patients with breast cancer.Material and methodsBetween April 2004 and July 2009, 1328 patients with UICC stage 0–IIA breast cancer were randomized to receive WBI with 50Gy and a boost of 10Gy or APBI with either 32.0Gy/8 fractions, or 30.1Gy/7 fractions (HDR-brachytherapy), or 50Gy/0.60–0.80Gy per pulse (PDR-brachytherapy). This report focuses on early side-effects and patient compliance observed in 1186 analyzable patients. ClinicalTrials.gov identifier: NCT00402519.ResultsPatient compliance was excellent in both arms. Both WBI and APBI were well tolerated with moderate early side-effects. No grade 4 toxicity had been observed. Grade 3 side effects were exclusively seen for early skin toxicity (radiation dermatitis) with 7% vs. 0.2% (p<0.0001), and breast infection with 0% vs. 0.2% (p=n.s.) for patients treated with WBI and APBI. The incidence of grades 1–2 early side effects for WBI and APBI was 86% vs. 21% (p<0.0001) for skin toxicity, 2% vs. 20% (p<0.0001) for mild hematoma, and 2% vs. 5% (p=0.01) for mild breast infection rates, respectively. No differences had been found regarding grades 1–2 early breast pain (26% vs. 29%, p=0.23).ConclusionsAPBI with interstitial multicatheter brachytherapy was tolerated very well and dramatically reduced early skin toxicity in comparison to standard WBI.
Modelling of organ-specific radiation-induced secondary cancer risks following particle therapy
Παρασκευή, 15 Ιουλίου 2016, 1:05:50 πμ
Publication date: Available online 13 July 2016
Source:Radiotherapy and Oncology
Author(s): Camilla H. Stokkevåg, Mai Fukahori, Takuma Nomiya, Naruhiro Matsufuji, Grete May Engeseth, Liv B. Hysing, Kristian S. Ytre-Hauge, Eivind Rørvik, Artur Szostak, Ludvig P. Muren
Background and purposeRadiation-induced cancer is a serious late effect that may follow radiotherapy. A considerable uncertainty is associated with carcinogenesis from photon-based treatment, and even less established when including relative biological effectiveness (RBE) for particle therapy. The aim of this work was therefore to estimate and in particular explore relative risks (RR) of secondary cancer (SC) following particle therapy as applied in treatment of prostate cancer.Material and methodsRRs of radiation-induced SC in the bladder and rectum were estimated using a bell-shaped dose–response model incorporating RBE and fractionation effects. The risks from volumetric modulated arc therapy (VMAT) were compared to intensity-modulated proton therapy (IMPT) and scanning carbon ions for ten patients.ResultsThe mean estimated RR (95% CI) of SC for VMAT/C-ion was 1.31 (0.65–2.18) for the bladder and 0.58 (0.41–0.80) for the rectum. Corresponding values for VMAT/IMPT were 1.72 (1.06–2.37) and 1.10 (0.78–1.43). The radio-sensitivity parameter α had the strongest influence on the results with decreasing RR for increasing values of α.ConclusionBased on the wide spread in RR between patients and variations across the included parameter values, the risk profiles of the rectum and bladder were not dramatically different for the investigated radiotherapy techniques.
Modelling of organ-specific radiation-induced secondary cancer risks following particle therapy
Πέμπτη, 14 Ιουλίου 2016, 2:49:21 πμ | Camilla H. Stokkevåg, Mai Fukahori, Takuma Nomiya, Naruhiro Matsufuji, Grete May Engeseth, Liv B. Hysing, Kristian S. Ytre-Hauge, Eivind Rørvik, Artur Szostak, Ludvig P. Muren
Radiation-induced cancer is a serious late effect that may follow radiotherapy. A considerable uncertainty is associated with carcinogenesis from photon-based treatment, and even less established when including relative biological effectiveness (RBE) for particle therapy. The aim of this work was therefore to estimate and in particular explore relative risks (RR) of secondary cancer (SC) following particle therapy as applied in treatment of prostate cancer.
Diffusion tensor imaging predicts cognitive function change following partial brain radiotherapy for low-grade and benign tumors
Τετάρτη, 13 Ιουλίου 2016, 1:59:46 μμ
Publication date: Available online 11 July 2016
Source:Radiotherapy and Oncology
Author(s): Christopher H. Chapman, Tong Zhu, Mohamad Nazem-Zadeh, Yebin Tao, Henry A. Buchtel, Christina I. Tsien, Theodore S. Lawrence, Yue Cao
Purpose/objectivesRadiation injury to parahippocampal cingulum white matter is associated with cognitive decline. Diffusion tensor imaging (DTI) detects micropathologic changes in white matter. Increased radial diffusion (RD) and decreased axial diffusion (AD) correspond to demyelination and axonal degeneration/gliosis respectively. We aimed to develop a predictive model for radiation-induced cognitive changes based upon DTI changes.Materials/methodsTwenty-seven adults with benign or low-grade tumors received partial brain radiation therapy (RT) to a median dose of 54Gy. Patients underwent DTI before RT, during RT, and at the end of RT. Cognitive testing was performed before RT, and 6 and 18months after RT. Parahippocampal cingulum white matter was contoured to obtain mean values of AD and RD.ResultsBy univariate analysis, decreasing AD and increasing RD during RT predicted declines in verbal memory and verbal fluency. By multivariate analysis, baseline neurocognitive score was the only clinical variable predicting verbal memory change; no clinical variables predicted verbal fluency change. In a multivariate model, increased RD at the end of RT significantly predicted decline in verbal fluency 18months after RT.ConclusionsImaging biomarkers of white matter injury contributed to predictive models of cognitive function change after RT.
GEC-ESTRO multicenter phase 3-trial: Accelerated partial breast irradiation with interstitial multicatheter brachytherapy versus external beam whole breast irradiation: Early toxicity and patient compliance
Τετάρτη, 13 Ιουλίου 2016, 2:30:14 πμ | Oliver J. Ott, Vratislav Strnad, Guido Hildebrandt, Daniela Kauer-Dorner, Hellen Knauerhase, Tibor Major, Jaroslaw Łyczek, José Luis Guinot, Jürgen Dunst, Cristina Gutierrez Miguelez, Pavel Slampa, Michael Allgäuer, Kristina Lössl, Bülent Polat, György Kovács, Arnt-René Fischedick, Thomas G. Wendt, Rainer Fietkau, Rolf-Dieter Kortmann, Alexandra Resch, Anna Kulik, Leo Arribas, Peter Niehoff, Ferran Guedea, Annika Schlamann, Richard Pötter, Christine Gall, Martina Malzer, Wolfgang Uter, Csaba Polgár, Groupe Européen de Curiethérapie of European Society for Radiotherapy and Oncology (GEC-ESTRO)
To compare early side effects and patient compliance of accelerated partial breast irradiation (APBI) with multicatheter brachytherapy to external beam whole breast irradiation (WBI) in a low-risk group of patients with breast cancer.
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