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adaptive radiation therapy of breast cancer by repeated imaging during irradiation

World Journal of Radiology 2020年第5期12卷 68-75页

作者： Omer Sager Ferrat Dincoglan Selcuk Demiral Bora Uysal Hakan Gamsiz Fatih Ozcan Onurhan Colak Yelda Elcim Esin Gundem Bahar Dirican Murat Beyzadeoglu Department of radiation Oncology Gulhane Medical FacultyUniversity of Health SciencesEtlikAnkara 06018Turkey

Breast cancer is the most frequent cancer among females and also a leading cause of cancer related mortality worldwide.A multimodality treatment approach may be utilized for optimal management of patients with combinations of surgery,radiation therapy(RT)and systemic *** composes an integral part of breast conserving treatment,and is typically used after breast conserving surgery to improve local *** years have witnessed significant improvements in the discipline of radiation oncology which allow for more focused and precise treatment *** radiation therapy(ART)is among the most important RT techniques which may be utilized for redesigning of treatment plans to account for dynamic changes in tumor size and anatomy during the course of *** the context of breast cancer,ART may serve as an excellent tool for patients receiving breast irradiation followed by a sequential boost to the tumor *** benefits of ART include more precise boost localization and potential for improved normal tissue sparing with adapted boost target volumes particularly in the setting of seroma reduction during the course of ***,we provide a concise review of ART for breast cancer in light of the literature.

关键词： Breast cancer adaptive radiation therapy Tumor bed boost Computed tomography Imaging Replanning

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Stereotactic ablative radiotherapy for hepatocellular carcinoma

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Hepatoma Research 2019年第1期5卷 36-48页

作者： Benjamin Spieler Eric A.Mellon Patricia D.Jones Huan Giap Lynn Feun Shree Venkat LorrainePortelance Department of radiation Oncology Sylvester Comprehensive Cancer CenterUniversity of MiamiMiamiFL 33136USA Department of Medicine Division of HepatologyUniversity of MiamiMiamiFL 33136USA Department of Medical Oncology Sylvester Comprehensive Cancer CenterUniversity of MiamiMiamiFL 33136USA Department of radiation Sylvester Comprehensive Cancer CenterUniversity of MiamiMiamiFL 33136USA

Patients with hepatocellular carcinoma(HCC)often present with underlying liver disease and significant comorbidities,limiting treatment *** the development of improved toxicity models and highly conformal radiation delivery systems,external beam radiotherapy has become a valuable treatment option for liver *** cutting edge technology,stereotactic ablative radiotherapy(SABR)allows for the delivery of ablative doses in few fractions while sparing uninvolved liver *** approach permits dose escalation and precise tumor targeting with minimal risk of radiation induced liver *** review clarifies SABR's role alongside liver-directed treatments such as radiofrequency ablation,transarterial radioembolization,and transarterial chemoembolization in the management of *** also examines the promising potential of SABR combined with immunotherapy to treat advanced HCC.

关键词： Hepatocellular carcinoma stereotactic ablative body radiation therapy image guided radiation therapy adaptive radiation therapy radiation toxicity multidisciplinary cancer treatment

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adaptive Dose-Compensation Technique for Image-Guided Radiotherapy of Prostate Cancer

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Chinese Journal of Biomedical Engineering(English Edition) 2018年第2期27卷 74-80页

作者： WU Qiu-wen Department of radiation Oncology Duke University Medical Center

Background: For image-guided radiotherapy(IGRT) of prostate cancer, the current standard is online image guidance which can effectively correct setup errors and inter-fraction rigid organ motion. However, planning margins are still necessary for deformation and intra-fraction motion. Objective: This paper aims to investigate an adaptive planning technique incorporating offline dose feedback to manage interfraction motion and residuals from online corrections. Methods:Repeated CT scans from 28 patients were studied. Online IG was simulated by matching center-of-mass of prostate. A seven-beam IMRT plan with zero margins was designed for each patient. Dose distribution at each fraction was evaluated based on actual target and OARs from that fraction. Cumulative dose was calculated using deformable registration and compared to initial plan. If deviation exceeded pre-defined 2% threshold in prostate D99 an adaptive planning technique called dose compensation was invoked, in which cumulative dose was fed back to the planning system and dose deficit was made up through boost radiation in future fractions through IMRT. Results: If 2% under-dose was allowed at the end of course, then 11 patients failed. If the same criteria was assessed at the end of each week(every 5 fractions), then 14 patients failed. The average dose deficit for these 14 patients was4.4%. They improved to 2% after weekly compensation. 10(out of 14) patients passed criterion after weekly dose compensation; 3 failed marginally; 1 failed significantly(10% deficit). A more aggressive compensation frequency(every 3 fractions) could reduce the dose deficit to the acceptable level for this patient. The doses to OARs were not significantly different from online IG only without dose ***: We demonstrated an offline dose compensation technique in prostate IGRT which can effectively account for residual uncertainties uncorrectable in online IG. Dose compensation allows further margin reduction an

关键词： adaptive radiation therapy image-guided radiation therapy intensity modulated radiation therapy prostate inter-fraction motion

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Comparison of Volumetric and Dosimetric Variations in Nasopharyngeal Carcinoma during Intensity-modulated radiation therapy with and without Neoadjuvant Chemotherapy

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Chinese Journal of Biomedical Engineering(English Edition) 2020年第3期29卷 24-32页

作者： Zhaodong Fei Yi Li Xiufang Qiu Yingying Huang Li Li Chuanben Chen Department of Radiotherapy Fujian Medical University Cancer HospitalFujian Provincial Cancer HospitalFuzhou Fujian Province 350014China Department of radiation Oncology Fujian Medical University Cancer HospitalFujian Provincial Cancer HospitalFuzhou Fujian Province 350014China

Objective Patients with nasopharyngeal carcinoma(NPC)undergoing intensity-modulated radiation therapy(IMRT)may experience significant volumetric and dosimetric variations throughout the treatment ***,neoadjuvant chemotherapy may reduce the extent of these *** study was carried out to evaluate volumetric and dosimetric changes in target volumes and organs at risk(OARs)during IMRT in patients with locally advanced NPC who received concurrent chemoradiotherapy(CCRT)alone or in combination with neoadjuvant chemotherapy(NACT).Methods 35 NPC patients were recruited for this study and divided into the NACT(n=15)and CCRT(n=20)*** tomography(CT)scans were performed before neoadjuvant chemotherapy,before IMRT,before the 24 th fraction of IMRT,and after *** original plan(plan 0)was based on CT images collected before *** plan 1(plan 1)and hybrid plan 2(plan 2)were generated by applying the beam configurations of plan0 to the CT scans collected before the 24 th fraction of IMRT and after *** and dosimetric variations were assessed by comparing the results of plan 0 with those of plan 1 and plan *** In the NACT group,compared with that in plan 0,the primary gross tumor volume(GTVnx)decreased by 33.2%±18.4%and 50.5%±12.6%in plan1 and plan 2,*** the CCRT group,the corresponding reduction rates in plan 1 and plan 2 were 49.4%±8.0%and 77.8%±28.1%,*** volume decrease rates in the NACT group were less than those in the CCRT group(P<0.001).In the NACT group,compared with that of plan0,the dose to 95%of the volume(D95)for the planning target volume of the primary tumor(PTVnx)decreased by 1.0%±0.7%and 0.6%±0.6%in plan 1 and plan 2,*** the CCRT group,the corresponding decrease rates in plan 1 and plan 2 were 4.2%±3.8%and 6.1%±6.3%,*** decrease rate of D95 for PTVnx in the NACT group was less than that in the CCRT group(P<0.001).Similar results among the plans were

关键词： Nasopharyngeal carcinoma Intensity-modulated radiation therapy adaptive radiation therapy Neoadjuvant chemotherapy Concurrent chemoradiotherapy

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