Journal of Radiotherapy in Practice最新文献

{"title":"A Monte Carlo study of the dose enhancement effects of high-z foils in proton therapy","authors":"Kristen Duke, Salahuddin Ahmad, A. Lau","doi":"10.1017/S1460396923000134","DOIUrl":"https://doi.org/10.1017/S1460396923000134","url":null,"abstract":"Abstract Background: This investigation quantifies the dose enhancement effect and dose distribution modifications due to the presence of high-z nanospheres in a proton beam. Methods: Various proton pencil beams of therapeutic energies (60–226 MeV) and spatial distribution of 2·7 mm spot size diameter were simulated onto a water phantom utilising the TOPAS Monte Carlo toolkit version 3.6.1. The simulation modelled either water or nanospheres of high-z materials (gold, silver or platinum) at the location of the Bragg Peak (BP) to compare the differences of the resulting dose distributions. Results: The introduction of the nanospheres increases the maximum dose, narrows the BP and shifts the BP location upstream compared to the water phantom with no nanospheres. Conclusions: This work shows that the local dose can be enhanced with the use of high-z nanoparticles in proton therapy, thereby increasing patient safety and decreasing side effects with the same amount of delivered radiation.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46880924","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":"Use of split-course hypofractionated radiotherapy in palliative treatment of head and neck cancers: how does our regimen compare with others?","authors":"Sankalp Singh, N. Bisht, A. Sarin, Rekha Vashisht, Nishant Lohia, Vikas Gupta, G. Trivedi","doi":"10.1017/S1460396922000322","DOIUrl":"https://doi.org/10.1017/S1460396922000322","url":null,"abstract":"Abstract Introduction: Head and neck cancers (HNCs) are some of the commonest cases requiring palliative radiotherapy (PRT) in an Indian radiotherapy practice. A variety of PRT protocols have been explored with varying success. Methods: The study objective was to evaluate the efficacy and tolerability of a short-course hypofractionated PRT schedule in HNC patients in terms of symptom relief, tumour response, acute side effects and survival and to compare results with other PRT regimens. All patients received 30 Gy in 10 fractions over 2 weeks followed by another 20 Gy in 5 fractions after a 4 weeks gap. Results: Seventy-five percent of patients completed both phases of treatment. Symptom relief was seen in 71% (pain) to 76% (dysphagia) of patients. Tumour response was recorded in 73% of patients. At 12 months, the mean overall survival was 10·29 months for patients who responded to PRT compared to 7·87 months for those who did not. Results were comparable to other regimens reported in the literature, but no radiobiological advantage of a higher dose was discernible. Conclusions: Short-course hypofractionated PRT is effective in reducing tumour burden and relieving symptoms in HNC patients and possibly in lengthening survival. Selection of any schedule should be decided by treating oncologists based on clinical, logistic and socio-economic factors.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45344337","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":"Can the use of knowledge-based planning systems improve stereotactic radiotherapy planning? A systematic review","authors":"A. Robinson, I. Gleeson, Thankamma Ajithkuma","doi":"10.1017/S1460396922000437","DOIUrl":"https://doi.org/10.1017/S1460396922000437","url":null,"abstract":"Abstract Introduction: This study aimed to systematically review the literature to synthesise and summarise whether using knowledge-based planning (KBP) can improve the planning of stereotactic radiotherapy treatments. Methods: A systematic literature search was carried out using Medline, Scopus and Cochrane databases to evaluate the use of KBP planning in stereotactic radiotherapy. Three hundred twenty-five potential studies were identified and screened to find 25 relevant studies. Results: Twenty-five studies met the inclusion criteria. Where a commercial KBP was used, 72.7% of studies reported a quality improvement, and 45.5% reported a reduction in planning time. There is evidence that when used as a quality control tool, KBP can highlight stereotactic plans that need revision. In studies that use KBP as the starting point for radiotherapy planning optimisation, the radiotherapy plans generated are typically equal to or superior to those planned manually. Conclusions: There is evidence that KBP has the potential to improve the quality and speed of stereotactic radiotherapy planning. Further research is required to accurately quantify such systems’ quality improvements and time savings. Notably, there has been little research into their use for prostate, spinal or liver stereotactic radiotherapy, and research in these areas would be desirable. It is recommended that future studies use the ICRU 91 level 2 reporting format and that blinded physician review could add a qualitative assessment of KBP system performance.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49022719","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":"Patient wait times for daily outpatient radiotherapy appointments (a single-centre study)","authors":"S. Roy, B. Sarkar, Anirudh Pradhan, A. Munshi, R. Chauhan","doi":"10.1017/S1460396923000055","DOIUrl":"https://doi.org/10.1017/S1460396923000055","url":null,"abstract":"Abstract Purpose: Patient wait time for every single fraction of every patient treated at our centre for the past year has been presented in this study. The waiting time data were analysed across different treatment sites and modalities. Materials and Methods: Between March 2021 and March 2022, all patients and their corresponding recorded measurements of waiting time were analysed. Times recorded included check-in time (CK), scheduled time to start treatment (SC) and beam-on time for the first beam of therapy (ST). SPSS version 18 was used for statistical calculations, correlations and assessing significance. Results: A total of 181 patients were treated during this duration. The total number of radiotherapy (RT) sessions recorded was 3011. Out of these 3011 sessions, number of times treated by rapid arc (RA), intensity-modulated radiotherapy (IMRT), three-dimensional conformal radiotherapy (3DCRT), stereotactic body radiotherapy (SBRT), stereotactic radiosurgery and stereotactic radiotherapy (SRS/SRT) were 68.18%, 30.19%, 0.167%, 0.565% and 0.19%, respectively. The mean (± standard deviation) times for scheduled time to start treatment (SC) to check-in time (CK), SC to ST (beam-on time for the first beam of treatment), CK to ST and (CK or SC) to ST were −14 ± 48 min, 6 ± 50 min, 19 ± 24 min and −4 ± 31 min, respectively. Conclusion: Patient wait times during RT were presented in this study. This study covered the daily waiting times before RT during modern-day RT treatment sessions. This vast series of consecutive patient data will be a valuable resource for the future planning and management of any modern RT department.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48960413","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":"Hypofractionated stereotactic radiotherapy for large vestibular schwannomas and the impact of pre-radiation debulking surgery on dosimetry and clinical outcomes","authors":"M. Mallory, K. Kauweloa, H. Staecker, P. Camarata, R. Chamoun, Rishi Neeranjun, R. Badkul, M. Tennapel, Shary Shelton, Fen Wang","doi":"10.1017/S1460396922000383","DOIUrl":"https://doi.org/10.1017/S1460396922000383","url":null,"abstract":"Abstract Introduction: This study was aimed to evaluate the outcomes of patients with large (>2 cm in great diameter) vestibular schwannomas (VSs) treated with hypofractionated stereotactic radiotherapy (HFSRT) compared to small (<2 cm) ones and the impact of debulking surgery prior to radiation for large VSs. Methods: Fifty-nine patients with VSs treated with HFSRT (25 Gy in 5 fractions) were evaluated by tumour size and surgical status. Patients were divided based on tumour size: small VSs (n = 42) and large VSs (n = 17). The large group was further divided into the groups of pre-treatment debulking surgery (n = 8) and no surgery (n = 9). Rates of tumour control, brainstem necrosis and neurologic dysfunction were assessed following treatment. Pre-surgical magnetic resonance imaging (MRI) were used to generate hypothetical HFSRT plans to compare the effect of debulking surgery on dosimetry. Normal tissue complication probability (NTCP) modelling was performed to compare toxicity probabilities with and without surgical debulking in large VSs. Results: There was no statistical difference of tumour control rate between small and large VSs with 100% for small tumours and 94·1% for large tumours (p = 0·12), respectively. In large VSs patient, the tumour control rate of HFSRT was 100% (8/8) for surgically debulked patients and 89% (8/9) for non-surgically debulked patients (p = 0·35). There were no patients who experienced brainstem necrosis or progression of facial and trigeminal nerve symptoms after HFSRT in the entire groups of patients. Surgical debulking large VSs did not change the maximum point dose of brainstem (p = 0·98), but significantly decreased volumes of VSs and changed the minimum dose to the hottest 0·5 cc of tumour (p = 0·016) as well as the volume receiving at least 23 Gy (p = 0·023). NTCP modelling revealed very low rates (average < 1%) of brainstem toxicity with or without surgical debulking, but there was a significant difference favoring surgery (p < 0·05). Conclusions: HFSRT is a safe and effective treatment for both small and large VSs and is a viable option for patients with large VSs who cannot undergo surgery, if NTCP of pre-debulking HFSRT dosimetry is lower.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42342060","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":"A review of the results from a patient experience survey of the palliative radiotherapy bone metastases service","authors":"Sarah Jayne Griffiths","doi":"10.1017/S1460396922000425","DOIUrl":"https://doi.org/10.1017/S1460396922000425","url":null,"abstract":"Abstract Introduction: A patient experience survey was undertaken as part of the role of the Macmillan Consultant Therapy Radiographer for the bone and brain metastases patients to inform future development of the service. Method: A questionnaire was developed and approved by the Trust’s local Questionnaire, Interview and Survey Group to survey the experiences and satisfaction of the service including the informed consent process, radiotherapy appointments and overall experience and satisfaction. The survey used qualitative and quantitative methods, including Likert Scales and free comment boxes. The responses were analysed by counting the frequency of each response and identifying any themes in free text responses. Results: Most patients were satisfied with the consent process with 1/36 patients reporting a lack of understandable information and 4/36 wanting more side effect information. The option of plan and treat was a preference of 53% of patients due to travelling back and forth to the centre; however, only 6% stated that they wanted two separate appointments. Ninety-four percent of patients felt that they had complete confidence and trust in the professional who consented them and 86% did not feel fully involved in the decision-making process. Overall, the service was rated as 10/10 by 61% of patients (n = 36). Conclusions: The patients surveyed were satisfied with their experience of the Palliative Radiotherapy Service; however, it needs to be developed further to meet the needs and expectations of the service users.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48122787","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":"UroLift implants as surrogate fiducial markers for cone-beam CT-based prostate image-guided radiotherapy","authors":"Ahmed A. Al-Balushi, M. Cain, Phil Reynolds, P. Bridge","doi":"10.1017/S1460396923000092","DOIUrl":"https://doi.org/10.1017/S1460396923000092","url":null,"abstract":"Abstract Introduction: UroLift implants are a novel treatment for the obstructive lower urinary tract symptoms arising from benign prostatic hyperplasia. This case study aimed to assess their effectiveness as fiducial marker (FM) surrogates in prostate image-guided radiotherapy (IGRT). Method: Cone-beam CT images from a patient receiving prostate radiation therapy underwent manual alignment using UroLift implants and also prostate soft-tissue matching by five experienced therapeutic radiographers. The match values of both methods were compared using Bland–Altman analysis. All five observers were also asked to score the ease of matching using both approaches. Results: The 95% mean level of agreement for the UroLift matches were within a 2-mm threshold in all dimensions. Comparison of UroLift and prostate matches had 95% limit of agreement values of −0·98 to 1·78, −0·58 to 0·49 and −1·83 to 1·04 mm in the vertical, longitudinal and lateral planes, respectively. All of the UroLift matches were rated as ‘very easy’ or ‘possible with little difficulty’ by the five observers. Conclusion: A small difference between the CBCT UroLift and CBCT prostate match was found. It has been shown that IGRT to the prostate with the aid of the UroLift system implants and CBCT is feasible and can eliminate the need for FM implants. Wider evaluation in a large cohort is recommended.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49289875","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":"Monte-Carlo techniques for radiotherapy applications II: equipment and source modelling, dose calculations and radiobiology","authors":"A. Fielding","doi":"10.1017/S1460396923000080","DOIUrl":"https://doi.org/10.1017/S1460396923000080","url":null,"abstract":"Abstract Introduction: This is the second of two papers giving an overview of the use of Monte-Carlo techniques for radiotherapy applications. Methods: The first paper gave an introduction and introduced some of the codes that are available to the user wishing to model the different aspects of radiotherapy treatment. It also aims to serve as a useful companion to a curated collection of papers on Monte-Carlo that have been published in this journal. Results and Conclusions: This paper focuses on the application of Monte-Carlo to specific problems in radiotherapy. These include radiotherapy and imaging beam production, brachytherapy, phantom and patient dosimetry, detector modelling and track structure calculations for micro-dosimetry, nano-dosimetry and radiobiology.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43159774","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":"Monte-Carlo techniques for radiotherapy applications I: introduction and overview of the different Monte-Carlo codes","authors":"A. Fielding","doi":"10.1017/S1460396923000079","DOIUrl":"https://doi.org/10.1017/S1460396923000079","url":null,"abstract":"Abstract Introduction: The dose calculation plays a crucial role in many aspects of contemporary clinical radiotherapy treatment planning process. It therefore goes without saying that the accuracy of the dose calculation is of very high importance. The gold standard for absorbed dose calculation is the Monte-Carlo algorithm. Methods: This first of two papers gives an overview of the main openly available and supported codes that have been widely used for radiotherapy simulations. Results: The paper aims to provide an overview of Monte-Carlo in the field of radiotherapy and point the reader in the right direction of work that could help them get started or develop their existing understanding and use of Monte-Carlo algorithms in their practice. Conclusions: It also serves as a useful companion to a curated collection of papers on Monte-Carlo that have been published in this journal.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42650278","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":"Working in a UK national proton radiotherapy facility: the therapeutic radiographer perspective","authors":"R. Bailey","doi":"10.1017/S1460396923000018","DOIUrl":"https://doi.org/10.1017/S1460396923000018","url":null,"abstract":"Abstract The first national UK proton beam therapy centre opened at The Christie NHS Foundation Trust in 2018, which alongside University College London Hospitals NHS Foundation Trust (UCLH) proton beam therapy centre, is expected to treat approximately seven-hundred and fifty patients per year at service ramp up. The aim of this editorial is to share with a wider audience the role of a Band 6 proton senior treatment radiographer working in a national NHS service and future developments of the service. Prior to the service being clinical, a range of processes were followed, including the creation of quality documents, departmental training and end-to-end testing, with the first patient receiving treatment in December 2018. Proton senior radiographers are responsible for the delivery of safe and accurate radiotherapy and ensuring a smooth patient pathway, through a multi-collaborative team approach. Although there are key differences between proton and photon radiotherapy, the fundamental aspects, including radiation principles, governance and patient advice are the same. The training package for proton senior radiographers includes an individual local induction as part of the proton education and competency framework, which incorporates practical learning, including clinical supervision and workshops, plus audio-visual presentations and workbooks to complete. Future developments of proton beam therapy include proton arc therapy and flash therapy, alongside educational developments, such as training the future workforce and advanced practice consultant radiographer roles. Shared learning through multi-collaboration of international proton beam therapy centres is crucial to improve care for future service users.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44376969","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}