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FLASH radiotherapy: Considerations for multibeam and hypofractionation dose delivery
RanaldMacKayaNeilBurnetbMatthewLoweacBethanyRothwellcNormanKirkbycKarenKirkbycJolyonHendrya
doi : 10.1016/j.radonc.2021.09.011
Volume 164, November 2021, Pages 122-127
Total neoadjuvant therapy for initially inoperable pancreatic cancer: A systematic review of phase 2–3 studies
GianlucaTomaselloaMicheleGhidiniaAntonioGhidinibfFrancescaTrevisancAndreaCelottidAlessandroRussodDonatellaGambiniaAliceIndiniaErikaRijavecaClaudiaBareggiaBarbaraGalassiaFaustoPetrellief
doi : 10.1016/j.radonc.2021.09.001
Volume 164, November 2021, Pages 13-19
Patients with initially inoperable non-metastatic pancreatic cancer (PC) have a poor prognosis, often similar to those with metastatic disease. Neoadjuvant chemotherapy (CT) plus concomitant or sequential radiotherapy (RT) may cause tumor shrinkage and allow for radical surgery. We pooled data of studies in which patients with locally advanced (unresectable) or borderline resectable PC were treated with a course of induction (or consolidation) CT followed or preceded by neoadjuvant CTRT regimen.
Current status and application of proton therapy for esophageal cancer
XinWangabBrianHobbscSaumil J.GandhiaChristina T.MuijsdJohannes A.LangendijkdSteven H.Lina
doi : 10.1016/j.radonc.2021.09.004
Volume 164, November 2021, Pages 27-36
Esophageal cancer remains one of the leading causes of death from cancer across the world despite advances in multimodality therapy. Although early-stage disease can often be treated surgically, the current state of the art for locally advanced disease is concurrent chemoradiation, followed by surgery whenever possible. The uniform midline tumor location puts a strong importance on the need for precise delivery of radiation that would minimize dose to the heart and lungs, and the biophysical properties of proton beam makes this modality potential ideal for esophageal cancer treatment. This review covers the current state of knowledge of proton therapy for esophageal cancer, focusing on published retrospective single- and multi-institutional clinical studies, and emerging data from prospective clinical trials, that support the benefit of protons vs photon-based radiation in reducing postoperative complications, cardiac toxicity, and severe radiation induced immune suppression, which may improve survival outcomes for patients. In addition, we discuss the incorporation of immunotherapy to the curative management of esophageal cancers in the not-too-distant future. However, there is still a lack of high-level evidence to support proton therapy in the treatment of esophageal cancer, and proton therapy has its limitations in clinical application. It is expected to see the results of future large-scale randomized clinical trials and the continuous improvement of proton radiotherapy technology.
Correlations between bone marrow radiation dose and hematologic toxicity in locally advanced cervical cancer patients receiving chemoradiation with cisplatin: a systematic review
AnoukCorbeauaSander C.KuipersaStephanie M.de BoerbNandaHorewegbMischa S.HoogemanacJérémyGodartacRemi A.Nouta
doi : 10.1016/j.radonc.2021.09.009
Volume 164, November 2021, Pages 128-137
Patients with locally advanced cervical cancer (LACC) treated with chemoradiation often experience hematologic toxicity (HT), as chemoradiation can induce bone marrow (BM) suppression. Studies on the relationship between BM dosimetric parameters and clinically significant HT might provide relevant indices for developing BM sparing (BMS) radiotherapy techniques. This systematic review studied the relationship between BM dose and HT in patients with LACC treated with primary cisplatin-based chemoradiation. A systematic search was conducted in Embase, Medline, and Web of Science. Eligibility criteria were treatment of LACC-patients with cisplatin-based chemoradiation and report of HT or complete blood cell count (CBC). The search identified 1346 papers, which were screened on title and abstract before two reviewers independently evaluated the full-text. 17 articles were included and scored according to a selection of the TRIPOD criteria. The mean TRIPOD score was 12.1 out of 29. Fourteen studies defining BM as the whole pelvic bone contour (PB) detected significant associations with V10 (3/14), V20 (6/14), and V40 (4/11). Recommended cut-off values were V10 > 95–75%, V20 > 80–65%, and V40 > 37–28%. The studies using lower density marrow spaces (PBM) or active bone marrow (ABM) as a proxy for BM only found limited associations with HT. Our study was the first literature review providing an overview of articles evaluating the correlation between BM and HT for patients with LACC undergoing cisplatin-based chemoradiation. There is a scarcity of studies independently validating developed prediction models between BM dose and HT. Future studies may use PB contouring to develop normal tissue complication probability models.
Learning healthcare systems and rapid learning in radiation oncology: Where are we and where are we going?
GarethPriceRanaldMackayMarianneAznarAlanMcWilliamCorinneJohnson-HartMarcelvan HerkCorinneFaivre-Finn
doi : 10.1016/j.radonc.2021.09.030
Volume 164, November 2021, Pages 183-195
Learning health systems and rapid-learning are well developed at the conceptual level. The promise of rapidly generating and applying evidence where conventional clinical trials would not usually be practical is attractive in principle. The connectivity of modern digital healthcare information systems and the increasing volumes of data accrued through patients’ care pathways offer an ideal platform for the concepts. This is particularly true in radiotherapy where modern treatment planning and image guidance offers a precise digital record of the treatment planned and delivered. The vision is of real-world data, accrued by patients during their routine care, being used to drive programmes of continuous clinical improvement as part of standard practice. This vision, however, is not yet a reality in radiotherapy departments. In this article we review the literature to explore why this is not the case, identify barriers to its implementation, and suggest how wider clinical application might be achieved.
Stereotactic body radiotherapy to treat breast cancer oligometastases: A systematic review with meta-analysis
Gustavo A.VianiabAndre G.GouveiabcAlexander V.LouiedMartinKorzeniowskieJuliana F.PavonifAna CarolinaHamamuraaFabio Y.Moraesbe
doi : 10.1016/j.radonc.2021.09.031
Volume 164, November 2021, Pages 245-250
Stereotactic ablative radiotherapy (SABR) has been reported to be an effective treatment for oligometastatic disease from different primary cancer sites. Here we assess the effectiveness and safety of SABR for oligometastatic breast cancer patients by performing a meta-analysis.
Exposure of the oesophagus in breast cancer radiotherapy: A systematic review of oesophagus doses published 2010–2020
Frances K.Duaneabc1AmandaKerrd1ZheWangdSarah C.DarbydGeorgiosNtentasdeMarianne C.Aznarf1Carolyn W.Taylord1
doi : 10.1016/j.radonc.2021.09.032
Volume 164, November 2021, Pages 261-267
Breast cancer radiotherapy can increase the risk of subsequent primary oesophageal cancer, with risk increasing according to oesophagus radiation dose. We describe oesophagus exposure from modern breast cancer regimens and discuss the risks of oesophageal cancer for women irradiated recently.
ESTRO ACROP guidelines for the delineation of lymph nodal areas in upper gastrointestinal malignancies
VincenzoValentiniabFrancescoCelliniabAngelaRiddellcThomas B.BrunnerdFalkRoedereFeliceGiulianteftSergioAlfieriguvRiccardoManfredibFrancescoArditoftClaudioFiorilloguvVenanzioPorziellahiAlessio G.MorgantijsKarinHaustermanskStefanoMargaritorahBerardinoDe BarilOscarMatzingermEleniGkikanClausBelkaoWilliamAllumpMarcelVerheijqr
doi : 10.1016/j.radonc.2021.08.026
Volume 164, November 2021, Pages 92-97
The European SocieTy for Radiation and Oncology -Advisory Committee on Radiation Oncology Practice (ESTRO-ACROP) endorsed a project to provide guidelines (GL) for the identification and delineation of clinically negative lymph-nodal stations (LNs) involved in upper gastrointestinal clinical scenarios. The presented GL is focused on preoperative (or definitive) setting. The project aim is to improve the consistency of clinical target volume (CTV) delineation by providing: a description of the anatomical boundaries of the LNs; a radiological computed tomography-based atlas depicting the LNs areas; a free, web-based, interactive example case for independent training of radiation oncologists on LNs delineation according to the presented GL, by both qualitative and quantitative analysis (through the FALCON EduCase platform).
An international Delphi consensus for pelvic stereotactic ablative radiotherapy re-irradiation
FinbarSlevinabKatharineAitkencdFilippoAlongiefStefanoArcangeligEliotChadwickhAh RamChangiPatrickCheungjChristopherCranekMatthiasGuckenbergerlBarbara AlicjaJereczek-FossamnSophia C.KamranoRémyKinjpMauroLoiqAnandMahadevanrMariangelaMassaccesisLucas C.MendeztRebeccaMuirheaduDavidPasquiervwAntonioPontorieroxDaniel E.SprattyYat ManTsangzMichael J.ZelefskykJohnLilleyaPeterDickinsonaMaria A.HawkinsaaAnn M.HenryabLouise J.Murrayab
doi : 10.1016/j.radonc.2021.09.010
Volume 164, November 2021, Pages 104-114
Stereotactic Ablative Radiotherapy (SABR) is increasingly used to treat metastatic oligorecurrence and locoregional recurrences but limited evidence/guidance exists in the setting of pelvic re-irradiation. An international Delphi study was performed to develop statements to guide practice regarding patient selection, pre-treatment investigations, treatment planning, delivery and cumulative organs at risk (OARs) constraints.
A Delphi study and International Consensus Recommendations: The use of bolus in the setting of postmastectomy radiation therapy for early breast cancer
OritKaidar-PersonabHannah M.DahncAlan M.NicholdLiesbeth J.BoersmaeDirkde RuysschereIcroMeattinifJean-PhilippePignolcCynthiaAristeigYazidBelkacemih1DoriBenjaminiNuranBesejCharlotte E.ColeskPierfrancescoFrancolAlice Y.HomSandraHolnReshmaJagsioAnna M.KirbypLiviaMarrazzoqGustavo N.MartarMeena S.Morans1Henrik D.NissentVratislavStrnaduYvonneZissiadisvPhilip M.PoortmanswBirgitte V.Offersenx
doi : 10.1016/j.radonc.2021.09.012
Volume 164, November 2021, Pages 115-121
Bolus serves as a tissue equivalent material that shifts the 95–100% isodose line towards the skin and subcutaneous tissue. The need for bolus for all breast cancer patients planned for postmastectomy radiation therapy (PMRT) has been questioned. The work was initiated by the faculty of the European SocieTy for Radiotherapy & Oncology (ESTRO) breast cancer courses and represents a multidisciplinary international breast cancer expert collaboration to optimize PMRT. Due to the lack of randomised trials evaluating the benefits of bolus, we designed a stepwise project to evaluate the existing evidence about the use of bolus in the setting of PMRT to achieve an international consensus for the indications of bolus in PMRT, based on the Delphi method.
A novel approach for radiotherapy dose escalation in rectal cancer using online MR-guidance and rectal ultrasound gel filling – Rationale and first in human
CihanGaniab1MonicaLo RussoaSimonBoekeaDanielWegeneraSergiosGatidiscSarahButzeraJessicaBoldtaDavidMönnichdDanielaThorwarthdKonstantinNikolaoucDanielZipsabMarcelNachbard
doi : 10.1016/j.radonc.2021.09.002
Volume 164, November 2021, Pages 37-42
Dose escalated radiotherapy has previously been investigated as a strategy to increase complete response rates in rectal cancer. However large safety margins are required using cone-beam computed tomography guided radiotherapy leading to high doses to organs at risk or insufficient target volume coverage in order to keep dose constraints. We herein present the first clinical application of a new technique for dose escalation in rectal cancer using online magnetic resonance (MR)-guidance and rectal ultrasound gel filling.
Long term results of a phase II trial of hypofractionated adjuvant radiotherapy for early-stage breast cancer with volumetric modulated arc therapy and simultaneous integrated boost
D.FranceschiniaA.FogliataaR.SpotoaL.DominiciaL.Lo FaroaC.FranzeseabT.ComitoaF.LobefaloaG.ReggioriaL.CozziabA.SagonacD.GentilebcM.Scorsettiab
doi : 10.1016/j.radonc.2021.09.006
Volume 164, November 2021, Pages 50-56
to report toxicity and cosmetic outcome with a median follow-up of 6 years of a phase II trial of hypofractionated radiotherapy with volumetric modulated arc therapy (VMAT) and simultaneous integrated boost (SIB) for early-stage breast cancer after conservative surgery.
Quality assurance program and early toxicities in the phase III BONBIS randomized trial evaluating the role of a localized radiation boost in ductal carcinoma in situ
CelineBourgierabcDidierCowendFlorenceCastaneClaireLemanskibcSophieGourgoueSofiaRiverafgAlainLabibhKarinePeignauxiMagali LeBlanc-OnfroyjAhmedBenyoucefkAliceMegelZinebDouadi-GacimSeverineRacadotnIgorLatorzeffoUlrikeSchickpStephaneJacquotqCaroleMassabeaurPhilippeGuilbertsJulienGeffrelottStephenEllisuIsabelleLecouillardvChristelBreton-CalluwAgnèsRichard-TalletxyFatihaBoulbairzJacquesCretinaaYazidBelkacémiabFrançoiseBonscacDavidAzriaabcPascalFenogliettobc
doi : 10.1016/j.radonc.2021.09.014
Volume 164, November 2021, Pages 57-65
To describe the quality assurance (QA) program and early toxicities in the phase III randomized trial BONBIS (NCT00907868) on the role of a localized radiation boost in ductal carcinoma in situ (DCIS).
Association of different fractionation schedules for prophylactic cranial irradiation with toxicity and brain metastases-free survival in stage III non-small cell lung cancer: A pooled analysis of individual patient data from three randomized trials
Willem J.A.WitloxabBram L.T.RamaekersaBenjaminLacascdCecile LePechouxeAlexanderSunfSi-YuWanggChenHuhiMaryRedmanjVincentvan der NoortkNingLilMatthiasGuckenbergermHarmvan TinterennHarry J.M.GroenoManuela A.JooreapDirk K.M.De Ruysscherb
doi : 10.1016/j.radonc.2021.09.029
Volume 164, November 2021, Pages 163-166
We assessed the impact of different PCI fractionation schedules (30 Gy in 10 versus 15 fractions) on brain metastases-free survival (BMFS) and toxicity in stage III NSCLC. Our results suggest that 30 Gy in 10 fractions is associated with increased toxicity, while no conclusive evidence of improving BMFS was seen with this schedule.
Impact of body-mass index on treatment and outcome in locally advanced rectal cancer: A secondary, post-hoc analysis of the CAO/ARO/AIO-04 randomized phase III trial
MarkusDiefenhardtafEthan B.LudmirbRalf-DieterHofheinzcMichaelGhadimidBruce D.MinskybMaxFleischmannaEmmanouilFokasaefClausRödelaef
doi : 10.1016/j.radonc.2021.09.028
Volume 164, November 2021, Pages 223-231
A better understanding of the impact of body-mass index (BMI) on the course of multimodal therapy and oncologic outcome in locally advanced rectal cancer could provide new insights for optimization of treatment and supportive strategies.
Preoperative radiotherapy 5 × 5 Gy and short versus long interval between surgery for resectable rectal cancer: 10-Year follow-up of the randomised controlled trial
RadoslawPachMarekSierzegaAntoniSzczepanikTadeuszPopielaPiotrRichter
doi : 10.1016/j.radonc.2021.10.006
Volume 164, November 2021, Pages 268-274
Studies on short-course preoperative radiotherapy in combination with total mesorectal excision for rectal cancer reported improved local control without clear survival benefits. The optimal fractionation and interval between radiotherapy and surgery are still under debate. We, therefore, aimed to report 10-year results of a randomized clinical trial (RCT, NCT01444495) comparing different time intervals between irradiation and surgery for rectal cancer.
Implementing stereotactic accelerated partial breast irradiation using magnetic resonance guided radiation therapy
Alex T.PriceWilliam R.KennedyLauren E.HenkeSean R.BrownOlga L.GreenMaria A.ThomasJohnGinnImranZoberi
doi : 10.1016/j.radonc.2021.09.023
Volume 164, November 2021, Pages 275-281
Accelerated partial breast irradiation (APBI) seeks to reduce irradiated volumes and radiation exposure for patients while maintaining acceptable clinical outcomes. Magnetic resonance image-guided radiotherapy (MRgRT) provides excellent soft-tissue contrast for treatment localization, which can reduce setup uncertainty, thus reducing margins in the external beam setting. Additionally, stereotactic body radiotherapy (SBRT)-style regimens with high gradients can also be executed. This MR-guided stereotactic APBI (MRgS-APBI) approach can be utilized for a lower number of fractions and spare a greater volume of healthy tissues compared to conventional 3D external beam APBI.
Unintended dose to the lower axilla in adjuvant radiotherapy for breast cancer: Differences between tangential beam and VMAT
ImaneAhrouchaDirkVan GestelaOlgaKoshariukbCarineKirkovecAntoineDesmetaCatherinePhilippsonaNickReynaertdAlexDe Caluwea
doi : 10.1016/j.radonc.2021.10.005
Volume 164, November 2021, Pages 282-288
To evaluate dosimetric differences in unintended dose to the lower axilla between 3D-standard (3DCRT), tangential beam forward intensity modulated radiotherapy (F-IMRT) and volumetric modulated arc therapy (VMAT). The objective is to evaluate whether results of clinical trials, such as the ACOSOG-Z011 trial, that evaluated omission of axillary clearance can be extrapolated towards more conformal techniques like VMAT.
Outcomes of and treatment planning considerations for a hybrid technique delivering proton pencil-beam scanning radiation to women with metal-containing tissue expanders undergoing post-mastectomy radiation
Cristina M.DeCesarisa1SinaMossahebibJennaJatczakcAvani D.RaodMingyaoZhueMark V.MishrafElizabethNicholsf
doi : 10.1016/j.radonc.2021.07.012
Volume 164, November 2021, Pages 289-298
Following mastectomy, immediate breast reconstruction often involves the use of temporary tissue expanders (TEs). TEs contain metallic ports (MPs), which complicate proton pencil-beam scanning (PBS) planning. A technique was implemented for delivering PBS post-mastectomy radiation (PMRT) to patients with TEs and MPs.
Reduced diffusion in white matter after radiotherapy with photons and protons
L.DüngerabA.SeidlitzbcC.JentschbcI.PlatzekdJ.KotzerkeeB.Beuthien-BaumannfM.BaumannbghM.KrausebcijkE.G.C.TroostbcijkF.Raschkebc
doi : 10.1016/j.radonc.2021.09.007
Volume 164, November 2021, Pages 66-72
Radio(chemo)therapy is standard in the adjuvant treatment of glioblastoma. Inevitably, brain tissue surrounding the target volume is also irradiated, potentially causing acute and late side-effects. Diffusion imaging has been shown to be a sensitive method to detect early changes in the cerebral white matter (WM) after radiation. The aim of this work was to assess possible changes in the mean diffusivity (MD) of WM after radio(chemo)therapy using Diffusion-weighted imaging (DWI) and to compare these effects between patients treated with proton and photon irradiation.
The impact of anatomical changes during photon or proton based radiation treatment on tumor dose in glioblastoma dose escalation trials
Eline D.HessenaSebastianMakockibcUulke A.van der HeideaBasJaspersejLotte J.LutkenhausaEmmyLamersaEugèneDamenaEsther G.C.TroostbcdefghiGerben R.Borstakl
doi : 10.1016/j.radonc.2021.09.022
Volume 164, November 2021, Pages 202-208
Most dose-escalation trials in glioblastoma patients integrate the escalated dose throughout the standard course by targeting a specific subvolume. We hypothesize that anatomical changes during irradiation may affect the dose coverage of this subvolume for both proton- and photon-based radiotherapy.
Radiotherapy as nose preservation treatment strategy for cancer of the nasal vestibule: The Dutch experience
Michal D.CzerwinskiaPeter P.JansenbEllen M.ZwijnenburgaAbrahimAl-MamganicMarije R.VergeerdJohannes A.LangendijkeFrederik W.R.WesselingfJohannes H.A.M.KaandersaCornelia G.Verhoefa
doi : 10.1016/j.radonc.2021.08.018
Volume 164, November 2021, Pages 20-26
Primary radiotherapy is often preferred for early-stage cancer of the nasal vestibule (CNV), combining high disease control with preservation of nasal anatomy. However, due to practice variation and an absence of comparative trials, no consensus exists on preference for brachytherapy (BT) or external beam radiotherapy (EBRT). We compared these modalities in terms of disease control, nose preservation rates and toxicity.
The baseline oral microbiota predicts the response of locally advanced oral squamous cell carcinoma patients to induction chemotherapy: A prospective longitudinal study
MengyuRuiabcXinyiZhangadJinyunHuangabcDongliangWeiabcZhiLiadZiyangShaoabcHouyuJuabcGuoxinRenabc
doi : 10.1016/j.radonc.2021.09.013
Volume 164, November 2021, Pages 83-91
Among oral squamous cell carcinoma (OSCC) patients who receive docetaxel, cisplatin, and 5-fluorouracil (TPF) induction chemotherapy, those with a favorable pathological response tend to obtain satisfactory clinical outcomes, while the total population exhibit no survival benefit. Thus, there is an urgent need to improve the therapeutic effect of TPF by applying personalized treatment according to distinct biomarkers.
DCE-MRI quantitative transport mapping for noninvasively detecting hypoxia inducible factor-1?, epidermal growth factor receptor overexpression, and Ki-67 in nasopharyngeal carcinoma patients
WeiyuanHuangad1QihaoZhangac1GangWue1Pian PianChenfJiaoLifKellyMcCabe GillenaPascalSpincemailleaGloria C.ChiangbAjayGuptabYiWangacFengChend
doi : 10.1016/j.radonc.2021.09.016
Volume 164, November 2021, Pages 146-154
Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has the potential to noninvasively detect expression of hypoxia inducible factor-1-alpha (HIF-1?), epidermal growth factor receptor (EGFR), and Ki-67 in nasopharyngeal carcinoma (NPC) by quantitatively measuring tumor blood flow, vascularity, and permeability.
Should the HPV positive oropharyngeal cancer patient be considered for a two-stage dental assessment for their radiation treatment?
VinodPatelaJerryKwokaMaryBurkebTeresa GuerreroUrbanocMichaelFenlond
doi : 10.1016/j.radonc.2021.09.021
Volume 164, November 2021, Pages 232-235
Patients due to commence head and neck radiation treatment are expected to undergo a dental assessment and be deemed ‘dentally fit’. Though this intervention is welcomed by the dental fraternity it is not without its challenges especially in human papilloma virus (HPV) related oropharyngeal cancer (OPC) which has seen a phenomenal rise over the past decade. This perspective piece presents these challenges and proposes a potential adaption of the dental assessment for HPV OPC patients though not necessarily exclusive to this tumour sub-site.
Relationship between videofluoroscopic and subjective (physician- and patient- rated) assessment of late swallowing dysfunction after (chemo) radiation: Results of a prospective observational study
AgataGawryszukaHendrik P.BijlaArjenvan der SchaafaNathaliePerdokbJanWedmanbIrma M.Verdonck-de LeeuwcRico N.RinkelcRoel J.H.M.SteenbakkersaJohanna G.M.van den HoekaHans Paulvan der LaanaJohannes A.Langendijka
doi : 10.1016/j.radonc.2021.09.017
Volume 164, November 2021, Pages 253-260
Primary (chemo)radiation (CHRT) for HNC may lead to late dysphagia. The purpose of this study was to assess the pattern of swallowing disorders based on prospectively collected objective videofluoroscopic (VF) assessment and to assess the correlations between VF findings and subjective (physician- and patient-rated) swallowing measures.
Development and prospective validation of a spatial dose pattern based model predicting acute pulmonary toxicity in patients treated with volumetric arc-therapy for locally advanced lung cancer
VincentBourbonneab1FrançoisLuciaabVincentJaouenbcJulienBertbMartinRehnaOlivierPradierabDimitrisVisvikisbUlrikeSchickab
doi : 10.1016/j.radonc.2021.09.008
Volume 164, November 2021, Pages 43-49
(Chemo)-radiotherapy is the standard treatment for patients with locally advanced lung cancer (LALC) not accessible to surgery. Despite strict application of dose constraints, acute toxicities such as acute pulmonary toxicity (APT) remain frequent, and may impact treatment’s compliance and patients’ quality of life. Previously, on a population treated with intensity-modulated photon therapy or passive scattering proton therapy, spatial dose patterns associated with APT were identified in the lower lungs, especially in the posterior right lung. In the present study, we aim to define these spatial dose patterns on a retrospective cohort treated by volumetric-arctherapy (VMAT) and to validate our findings prospectively.
Survival impact of concurrent chemoradiotherapy for elderly patients with synchronous oligometastatic esophageal squamous cell carcinoma: A propensity score matching and landmark analyses?
ZhenguoShiabXiaojuanZhubShaoboKeaHuQiuaGaokeCaiaYutianZhangcaiaYongshunChena
doi : 10.1016/j.radonc.2021.09.033
Volume 164, November 2021, Pages 236-244
To evaluate the potential benefits of concurrent chemoradiotherapy (CCRT), and to establish a nomogram for predicting survival outcomes of elderly patients with synchronous oligometastatic esophageal squamous cell carcinoma (SOEC).
Toxicity of carbon ion radiotherapy and immune checkpoint inhibitors in advanced melanoma
StefanoCavalieriaSaraRonchibAmeliaBarcellinibMariaBonorabBarbaraVischionibVivianaVitolobRiccardoVillabMicheleDel VecchiocLisaLicitraadEsterOrlandib
doi : 10.1016/j.radonc.2021.08.021
Volume 164, November 2021, Pages 1-5
We analyzed CTCAE adverse events of sequential Carbon Ion radiotherapy (CIRT) and immune checkpoint inhibitors (ICIs) in advanced melanoma patients. The frequencies of early and late adverse events (AEs) were 100% and 82% of patients, respectively. The frequency of G3+ AEs was in line with the literature.
An international pooled analysis of SBRT outcomes to oligometastatic spine and non-spine bone metastases
YilinCaoaHanboChenbArjunSahgalbDarbyErlerbSerenaBadellinocTithiBiswasdRoiDaganeMatthew C.FootefAlexander V.LouiebIanPoonbUmbertoRicardicKristin J.Redmonda
doi : 10.1016/j.radonc.2021.08.011
Volume 164, November 2021, Pages 98-103
There is a paucity of data on SBRT to non-spine bone (NSB) lesions compared to spine metastases. We report local recurrence (LR), widespread progression (WSP), and overall survival (OS) for oligometastatic patients treated to bone lesions with SBRT and investigate the hypothesis that outcomes are different between patients with spine and non-spine bone oligometastatic disease.
Outcomes of osteosarcoma, chondrosarcoma and chordoma treated with image guided-intensity modulated radiation therapy
SiddharthaLaskaraSangeetaKakotiaNehalKhannaaJifmi JoseManjaliaAkshayMangajaAjayPuribAshishGuliabPrakashNayakbPrathameshPaicDeepaNaircSajidQureshidGirishChinnaswamyeJyotiBajpaifKumarPrabhashfBharatRekhigMuktaRamadwargNirmalaJambhekargAmitJanuhSashikantJuvekarhNilenduPurandareiVenkateshRangarajani
doi : 10.1016/j.radonc.2021.09.018
Volume 164, November 2021, Pages 216-222
To evaluate the efficacy and toxicity of dose-escalated image guided-intensity modulated radiation therapy (IG-IMRT) in osteosarcoma (OGS), chondrosarcoma (CS) and chordoma (CH) of head and neck (H&N) and pelvis.
Markerless 3D tumor tracking during single-fraction free-breathing 10MV flattening-filter-free stereotactic lung radiotherapy
I.F.Remmerts de Vriesa1MaxDaheleaHassanMostafavibBenSlotmanaWilkoVerbakela
doi : 10.1016/j.radonc.2021.08.025
Volume 164, November 2021, Pages 6-12
Positional verification during single fraction lung SBRT could increase confidence and reduce the chance of geographic miss. As planar 2DkV imaging during VMAT irradiation is already available on current linear accelerators, markerless tracking based on these images could offer widely available and low-cost verification. We evaluated treatment delivery data and template matching and triangulation for 3D-positional verification during free-breathing, single fraction (34 Gy), 10 MV flattening-filter-free VMAT lung SBRT.
MRI-guided cardiac-induced target motion tracking for atrial fibrillation cardiac radioablation
SuzanneLydiardaBeauPontrébNicholasHindleyaBoris SLowecGiuseppeSassobdePaulKealla
doi : 10.1016/j.radonc.2021.09.025
Volume 164, November 2021, Pages 138-145
Atrial fibrillation (AF) cardiac radioablation (CR) challenges radiotherapy tracking: multiple small targets close to organs-at-risk undergo rapid differential cardiac contraction and respiratory motion. MR-guidance offers a real-time target tracking solution. This work develops and investigates MRI-guided tracking of AF CR targets with cardiac-induced motion.
Accuracy and precision of apparent diffusion coefficient measurements on a 1.5 T MR-Linac in central nervous system tumour patients
Liam S.P.LawrenceaRachel W.ChanbHanboChencBrianKellercJamesStewartcMarkRuschincBrigeChughcdMikkiCampbellcAimeeTheriaultabeGreg J.StaniszabeScottMacKenziecStenMyrehaugcJayDetskycPejman J.MaralanifChia-LinTsengcGreg J.CzarnotaabcArjunSahgalcAngus Z.Lauab
doi : 10.1016/j.radonc.2021.09.020
Volume 164, November 2021, Pages 155-162
MRI linear accelerators (MR-Linacs) may allow treatment adaptation to be guided by quantitative MRI including diffusion-weighted imaging (DWI). The aim of this study was to evaluate the accuracy and precision of apparent diffusion coefficient (ADC) measurements from DWI on a 1.5 T MR-Linac in patients with central nervous system (CNS) tumours through comparison with a diagnostic scanner.
A novel semi auto-segmentation method for accurate dose and NTCP evaluation in adaptive head and neck radiotherapy
YongGanaJohannes A.LangendijkaEdwinOldehinkelaDanielScandurraaNanna M.SijtsemaaZhixiongLinbStefanBothaCharlotte L.Brouwera
doi : 10.1016/j.radonc.2021.09.019
Volume 164, November 2021, Pages 167-174
Accurate segmentation of organs-at-risk (OARs) is crucial but tedious and time-consuming in adaptive radiotherapy (ART). The purpose of this work was to automate head and neck OAR-segmentation on repeat CT (rCT) by an optimal combination of human and auto-segmentation for accurate prediction of Normal Tissue Complication Probability (NTCP).
Real-time dose-guidance in radiotherapy: Proof of principle
Casper GammelmarkMuurholmaThomasRavkildebSimonSkouboecEsbenWormbRuneHansenbMortenHøyercdPaul J.KeallePer R.Poulsenacd
doi : 10.1016/j.radonc.2021.09.024
Volume 164, November 2021, Pages 175-182
The outcome of radiotherapy is a direct consequence of the dose delivered to the patient. Yet image-guidance and motion management to date focus on geometrical considerations as a practical surrogate for dose. Here, we propose real-time dose-guidance realized through continuous motion-including dose reconstructions and demonstrate this new concept in simulated liver stereotactic body radiotherapy (SBRT) delivery.
Comparisons of normal tissue complication probability models derived from planned and delivered dose for head and neck cancer patients
TakahiroKanehira1Simonvan KranenTomasJansenOlgaHamming-VriezeAbrahimAl-MamganiJan-JakobSonke
doi : 10.1016/j.radonc.2021.09.015
Volume 164, November 2021, Pages 209-215
Normal tissue complication probability (NTCP) models are typically derived from the planned dose distribution, which can deviate from the delivered dose due to anatomical day-to-day variations. The aim of this study was to compare NTCP models derived from the planned and the delivered dose for head and neck cancer (HNC) patients.
MRI-based delta-radiomics predicts pathologic complete response in high-grade soft-tissue sarcoma patients treated with neoadjuvant therapy
Jan C.PeekenabcdeRebeccaAsadpouraKatjaSpechtfEleanor Y.ChengOlenaKlymenkoaVictorAkinkuoroyeaDaniel S.HippehMatthew BSprakeriStephanie K.SchaubdHendrikDapperaCarolinKnebeljNina A.MayrdAlexandra S.GersingkHenry C.WoodruffelPhilippeLambinelMatthew J.Nyflotdm1Stephanie E.Combsabc1
doi : 10.1016/j.radonc.2021.08.023
Volume 164, November 2021, Pages 73-82
In high-grade soft-tissue sarcomas (STS) the standard of care encompasses multimodal therapy regimens. While there is a growing body of evidence for prognostic pretreatment radiomic models, we hypothesized that temporal changes in radiomic features following neoadjuvant treatment (“delta-radiomics”) may be able to predict the pathological complete response (pCR).
Correlation between tumor voxel dose response matrix and tumor biomarker profile in patients with head and neck squamous cell carcinoma
ArthurYanAlaaHannaThomas G.WilsonRohanDeraniyagalaDaniel J.KraussVincent P.GrzywaczDiYanGeorge D.Wilson
doi : 10.1016/j.radonc.2021.09.027
Volume 164, November 2021, Pages 196-201
We have developed a novel imaging analysis procedure that is highly predictive of local failure after chemoradiation in head and neck cancer. In this study we investigated whether any pretreatment biomarkers correlated with key imaging parameters.
Second malignancy (SM) in prostate cancer patients treated with SBRT and other contemporary radiation techniques
PierreBlanchardaMichael J.ZelefskybAlbertoBossicCyrusChargariaJean-MarcCossetc
doi : 10.1016/j.radonc.2021.10.001
Volume 164, November 2021, Pages 251-252
