Journal of radiosurgery and SBRT最新文献

{"title":"Advances in treatment planning and management for the safety and accuracy of lung stereotactic body radiation therapy using proton pencil beam scanning: Simulation, planning, quality assurance, and delivery recommendations.","authors":"Minglei Kang, J Isabelle Choi, Kevin Souris, Jun Zhou, Gang Yu, Annemarie F Shepherd, Nitin Ohri, Stanislav Lazarev, Liyong Lin, Haibo Lin, Charles B Simone","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This study presents the clinical experiences of the New York Proton Center in employing proton pencil beam scanning (PBS) for the treatment of lung stereotactic body radiation therapy. It encompasses a comprehensive examination of multiple facets, including patient simulation, delineation of target volumes and organs at risk, treatment planning, plan evaluation, quality assurance, and motion management strategies. By sharing the approaches of the New York Proton Center and providing recommendations across simulation, treatment planning, and treatment delivery, it is anticipated that the valuable experience will be provided to a broader proton therapy community, serving as a useful reference for future clinical practice and research endeavors in the field of stereotactic body proton therapy for lung tumors.</p>","PeriodicalId":16917,"journal":{"name":"Journal of radiosurgery and SBRT","volume":"9 1","pages":"53-62"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10681141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138460582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and opportunities in stereotactic body proton radiotherapy of liver malignancies.","authors":"Heng Li, Rachel Ger, Amol Kumar Narang, Hao Chen, Jeffrey Meyer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Stereotactic body proton radiotherapy (SBPT) has the potential to be an effective tool for treating liver malignancies. While proton therapy enables near-zero exit dose and could improve normal tissue sparing, including liver and other surrounding structures, there are challenges in implementing the SBPT technique for proton therapy, including respiratory motion, range uncertainties, dose regimen, treatment planning, and image guidance. This article summarizes the technical and clinical challenges facing SBPT, along with the potential benefits of SBPT for liver malignancies. The clinical implementation of the technique is also described for the first six patients treated at the Johns Hopkins Proton Therapy Center using liver SBPT.</p>","PeriodicalId":16917,"journal":{"name":"Journal of radiosurgery and SBRT","volume":"9 1","pages":"83-90"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10681149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138460584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proton beam stereotactic body radiotherapy and hypofractionated therapy with pencil beam scanning is safe and effective for advanced hepatocellular carcinoma and intrahepatic cholangiocarcinoma: A single center experience.","authors":"Alexander H Yang, Nathalie H Urrunaga, Osman Siddiqui, Angela Wu, Matthew Schliep, Sina Mossahebi, Kirti Shetty, William F Regine, Jason K Molitoris, Zurabi Lominadze","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Proton beam therapy (PBT) is a non-surgical treatment that spares adjacent tissues compared to photon radiation and useful for Hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (iCCA). We present a single center experience in HCC and iCCA treated with Pencil Beam Scanning (PBS) PBT.</p><p><strong>Methods: </strong>Forty-four consecutive patients (22 patients in each group) receiving PBT were included and reviewed. PBT was delivered with hypofractionated or stereotactic body radiation therapy (SBRT) using PBS. Tumor size was approximated by clinical target volume (CTV). Outcomes were evaluated with Kaplan-Meier and liver toxicity was determined by MELD-Na and albumin-bilirubin (ALBI) grade.</p><p><strong>Results: </strong>Median follow up was 38.7 months, fourteen (35%) had multifocal disease and median CTV was 232.5cc. Four (9%) and 40 (91%) patients received SBRT and hypofractionated radiation, respectively. Two year overall survival was statistically higher for HCC (entire group: 68.9% months [95% CI: 61.3 - 76.3%]; iCCA: 49.8% [95% CI: 38.5% - 61.1%]; HCC: 89.4% [95% CI: 82.3 - 96.5%]; P <0.005). There was no statistical difference in progression-free survival or freedom from local failure. Biologically Equivalent Dose (BED) was greater than or equal to 80.5Gy in 37 (84%) patients. All iCCA patients had stable or improved ALBI grade following treatment. ALBI grade was stable in 83% of HCC patients and average MELD-Na score remained stable. Tumor size, pretreatment liver function, and total radiation dose were not associated with liver toxicity.</p><p><strong>Conclusions: </strong>PBT for unresectable HCC and iCCA is safe and effective, even for large and multifocal tumors. Liver function was preserved even in those with baseline cirrhosis in this advanced population with large tumors.</p>","PeriodicalId":16917,"journal":{"name":"Journal of radiosurgery and SBRT","volume":"9 1","pages":"43-52"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10681150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138460585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proton liver stereotactic body radiation therapy: Treatment techniques and dosimetry feasibility from a single institution.","authors":"Jun Zhou, Minglei Kang, Yinan Wang, Kristin A Higgins, Charles B Simone, Pretesh Patel, Mark W McDonald, Liyong Lin, Duncan Bohannon","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the resulting dosimetry characteristics of simulation and planning techniques for proton stereotactic body radiation therapy (SBRT) of primary and secondary liver tumors.</p><p><strong>Methods: </strong>Consecutive patients treated under volumetric daily image guidance with liver proton SBRT between September 2019 and March 2022 at Emory Proton Therapy Center were included in this study. Prescriptions ranged from 40 Gy to 60 Gy in 3- or 5-fraction regimens, and motion management techniques were used when target motion exceeded 5 mm. 4D robust optimization was used when necessary. Dosimetry evaluation was conducted for ITV V100, D99, Dmax, and liver-ITV mean dose and D700cc. Statistical analysis was performed using independent-samples Mann-Whitney U tests.</p><p><strong>Results: </strong>Thirty-six tumors from 29 patients were treated. Proton therapy for primary and secondary liver tumors using motion management techniques and robust optimization resulted in high target coverage and low doses to critical organs. The median ITV V100% was 100.0%, and the median ITV D99% was 111.3%. The median liver-ITV mean dose and D700cc were 499 cGy and 5.7 cGy, respectively. The median conformity index (CI) was 1.03, and the median R50 was 2.56. Except for ITV D99% (primary 118.1% vs. secondary 107.2%, p = 0.005), there were no significant differences in age, ITV volume, ITV V100%, ITV maximum dose, liver-ITV mean dose, or D700cc between primary and secondary tumor groups.</p><p><strong>Conclusion: </strong>The study demonstrated that proton therapy with motion management techniques and robust optimization achieves excellent target coverage with low normal liver doses for primary and secondary liver tumors. The results showed high target coverage, high conformality, and low doses to the liver.</p>","PeriodicalId":16917,"journal":{"name":"Journal of radiosurgery and SBRT","volume":"9 1","pages":"33-42"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10681147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138460586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proton SBRT is ready to move past uncertainties and towards improved clinical outcomes.","authors":"Charles B Simone, Liyong Lin","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":16917,"journal":{"name":"Journal of radiosurgery and SBRT","volume":"9 1","pages":"3-6"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10681151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138460587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of stereotactic body proton therapy for high-risk lung tumors.","authors":"Matthew T McMillan, Annemarie F Shepherd, Minglei Kang, Liyong Lin, Narek Shaverdian, Abraham J Wu, Daphna Y Gelblum, Nitin Ohri, Stanislav Lazarev, Lee Xu, Arpit M Chhabra, Shaakir Hasan, J Isabelle Choi, Daniel R Gomez, Andreas Rimner, Haibo Lin, Charles B Simone","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose: </strong>Stereotactic body proton therapy (SBPT) is an emerging treatment strategy for lung tumors that aims to combine the excellent local control benefits of ultra-hypofractionation with the physical advantages of protons, which reduce the integral dose to organs at risk (OARs) compared to photons. To date, however, very little data delivering SBPT in 5 or fewer fractions to lung tumors have been reported. Given that photon stereotactic body radiation therapy can struggle to deliver ablative doses to high-risk tumors (i.e., central/ultra-central location, prior in-field radiation, tumor size >5 cm, or the presence of severe pulmonary comorbidities) while adhering to OAR dose constraints, we hypothesized that SBPT would be an effective alternative for patients with high-risk tumors.</p><p><strong>Methods and materials: </strong>Twenty-seven high-risk patients with 29 lung tumors treated with SBPT at the New York Proton Center between December 2019 and November 2022 were retrospectively identified. Patients were divided into three major subgroups: early-stage non-small cell lung cancer (NSCLC), locally recurrent NSCLC, and metastatic cancer from lung cancer or other histologies. Patient characteristics were reported using descriptive statistics, actuarial methods were used to quantify disease control rates, and toxicities were scored using CTCAE v 5.0.</p><p><strong>Results: </strong>The most common high-risk indications for SBPT were central/ultra-central tumor location (69.0%), severe COPD (48.1%), reirradiation (44.4%), significant pulmonary fibrosis (22.2%), and large tumor size > 5 cm (18.5%). In total, 96.6% of tumors were fully covered by the prescription dose without compromising target coverage. Three-year actuarial rates of local control for early-stage NSCLC, locally recurrent NSCLC, and metastatic patients were 89%, 100%, and 43%, respectively. Three-year actuarial rates of regional control were 89%, 67%, and 86%. Three-year actuarial rates of distant metastasis-free survival were 79%, 100%, and 0%. Two patients (7.4%), both of whom had clinically significant baseline interstitial lung disease and pre-treatment continuous oxygen demand, experienced grade ≥2 pulmonary toxicity (1 grade 3, 1 grade 5). There were no acute or late grade ≥2 toxicities related to esophagitis, cardiac injury, airway injury, pulmonary fibrosis, bronchopulmonary hemorrhage or brachial plexopathy.</p><p><strong>Conclusions: </strong>In the largest study of proton SBRT reported to date, SBPT has a favorable toxicity profile while being an effective approach for treating most high-risk tumors without requiring dose de-escalation or compromising tumor coverage and warrants further investigation.</p>","PeriodicalId":16917,"journal":{"name":"Journal of radiosurgery and SBRT","volume":"9 1","pages":"63-74"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10681142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138460590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are we ready for the SBRT option using proton beams?","authors":"Kristin A Higgins, Fang-Fang Yin","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":16917,"journal":{"name":"Journal of radiosurgery and SBRT","volume":"9 1","pages":"7-8"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10681143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138460583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stereotactic body proton therapy for early stage non-small cell lung cancer - Technical challenges and solutions: The MD Anderson experience.","authors":"X Ronald Zhu, Yuting Li, Ming Yang, Thomas J Whitaker, Paige A Taylor, Xiaodong Zhang, Falk Poenisch, Narayan Sahoo, Zhongxing Liao, Joe Y Chang","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Our randomized clinical study comparing stereotactic body radiotherapy (SBRT) and stereotactic body proton therapy (SBPT) for early stage non-small cell lung cancer (NSCLC) was closed prematurely owing to poor enrollment, largely because of lack of volumetric imaging and difficulty in obtaining insurance coverage for the SBPT group. In this article, we describe technology improvements in our new proton therapy center, particularly in image guidance with cone beam CT (CBCT) and CT on rail (CTOR), as well as motion management with real-time gated proton therapy (RGPT) and optical surface imaging. In addition, we have a treatment planning system that provides better treatment plan optimization and more accurate dose calculation. We expect to re-start the SBPT program, including for early stage NSCLC as well as for other disease sites soon after starting patient treatment at our new proton therapy center.</p>","PeriodicalId":16917,"journal":{"name":"Journal of radiosurgery and SBRT","volume":"9 1","pages":"75-82"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10681148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138460591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of intrafraction motion for spine and non-spine bone metastases treated with image-guided stereotactic body radiotherapy without 6 degrees-of-freedom couch correction.","authors":"R. Cereno, Quinn Bartlett, M. Lamey, D. Hyde, B. Mou","doi":"10.1016/s0167-8140(22)04422-x","DOIUrl":"https://doi.org/10.1016/s0167-8140(22)04422-x","url":null,"abstract":"","PeriodicalId":16917,"journal":{"name":"Journal of radiosurgery and SBRT","volume":"8 4 1","pages":"313-319"},"PeriodicalIF":1.2,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41805635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overview of the current role of stereotactic body radiotherapy in the treatment of unfavorable intermediate- and high-risk prostate cancer.","authors":"Maris Mezeckis,&nbsp;Vesprini Danny,&nbsp;Buryk Vladyslav,&nbsp;Miszczyk Leszek,&nbsp;Vjaters Egils","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Stereotactic body radiotherapy (SBRT) is well accepted for low- and intermediate-favorable risk prostate cancer. Available evidence about the application of SBRT in unfavorable- and high-risk prostate cancer is less solid. During last year's multiple variations in treatment, techniques have been reported making comparisons more complicated. This review's objective is to review current evidence in application of SBRT in intermediate unfavourable and high-risk prostate cancer and to outline variations in SBRT treatment techniques and relevant results.</p>","PeriodicalId":16917,"journal":{"name":"Journal of radiosurgery and SBRT","volume":"8 2","pages":"95-103"},"PeriodicalIF":1.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9489076/pdf/rsbrt-8-95.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10451048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}