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Is current clinical practice modified about intraoperative breast irradiation?

Chinese Journal of Cancer Research 2016年第2期28卷 146-149页

作者： Michela Massa Simonetta Franchelli Renzo Panizza Tiberio Massa Plastic and Reconstructive Surgery SS.Antonio e Biagio e Cesare Arrigo Hospital Plastic and Reconstructive Surgery IRCCS AOU San Martino-ISTNational Institute of Cancer Research Diagnostic Mammography Department IRCCS AOU San Martino-ISTNational Institute of Cancer Research

After the results obtained in the two randomized clinical trial, the ELIOT trial and the TARGIT-A trial, a heated debate is going on concerning the question of applying intraoperative radiotherapy （IORT） instead of postoperative whole breast irradiation （WBI） after breast conservative treatment. Currently, many centers are applying the IORT following the strict selection criteria dictated by the working groups American Society for radiation Ontology （ASTRO） and Groupe Europeen de Curietherapie-European Society for Therapeutic Radiology and Oncology （GEC-ESTRO） and monitoring the oncological outcome together with radiation toxicity on breast tissue. The clinical experience of the Geneva University Hospital regarding the use of the Intrabeam system is evaluated and compared with current evidences.

关键词： Breast cancer intraoperative radiotherapy (IORT) radiation toxicity

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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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Using Novel Statistical Techniques to Accurately Determine the Predictive Dose Range in a Study of Overall Survival after Definitive Radiotherapy for Stage III Non-Small Cell Lung Cancer in Association with Heart Dose

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Journal of Cancer Therapy 2021年第9期12卷 505-529页

作者： Joshua R. Niska Jiuyun Hu Jing Li Michael G. Herman Cameron S. Thorpe Steven E. Schild Mirek Fatyga Department of radiation Oncology Banner MD Anderson Cancer Center Phoenix Arizona USA School of Computing Informatics and Decision Systems Engineering Tempe Arizona USA School of Industrial and Systems Engineering Georgia Institute of Technology Atlanta Georgia USA Department of radiation Oncology Mayo Clinic Rochester Minnesota USA Department of radiation Oncology Mayo Clinic Phoenix Arizona USA

Purpose: Recent studies of radiotherapy (RT) for stage III non-small-cell lung cancer (NSCLC) have associated high dose to the heart with cardiac toxicity and decreased overall survival (OS). We used advanced statistical techniques to account for correlations between dosimetric variables and more accurately determine the range of heart doses which are associated with reduced OS in patients receiving RT for stage III NSCLC. Methods: From 2006 to 2013, 119 patients with stage III NSCLC received definitive RT at our institution. OS data was obtained from institutional tumor registry. We used multivariate Cox model to determine patient specific covariates predictive for reduced overall survival. We examined age, prescription dose, mean lung dose, lung V20, RT technique, stage, chemotherapy, tumor laterality, tumor volume, and tumor site as candidate covariates. We subsequently used novel statistical techniques within multivariate Cox model to systematically search the whole heart dose-volume histogram (DVH) for dose parameters associated with OS. Results: Patients were followed until death or 2.5 to 81.2 months (median 30.4 months) in those alive at last follow up. On multivariate analysis of whole heart DVH, the dose of 51 Gy was identified as a threshold dose above which the dose volume relationship becomes predictive for OS. We identified

关键词： Lung Cancer Cardiac toxicity Lung radiation Therapy Non-Small Cell Lung Cancer radiation toxicity

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