Radiation Oncology Journal最新文献

{"title":"Re-irradiation for recurrent or second primary head and neck cancer.","authors":"Hye In Lee,&nbsp;Jin Ho Kim,&nbsp;Soon-Hyun Ahn,&nbsp;Eun-Jae Chung,&nbsp;Bhumsuk Keam,&nbsp;Keun-Yong Eom,&nbsp;Woo-Jin Jeong,&nbsp;Ji-Won Kim,&nbsp;Chan Woo Wee,&nbsp;Hong-Gyun Wu","doi":"10.3857/roj.2021.00640","DOIUrl":"https://doi.org/10.3857/roj.2021.00640","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the efficacy and safety of intensity-modulated radiotherapy (IMRT)-based re-irradiation (reRT) for recurrent or second primary head and neck cancer (HNC).</p><p><strong>Materials and methods: </strong>Patients who underwent IMRT-based reRT for recurrent or second primary HNC between 2007 and 2019 at two institutions were included. Medical records and dosimetric data were retrospectively reviewed. Overall survival (OS), progression-free survival (PFS), severe late toxicities, and clinicopathological prognostic factors were analyzed.</p><p><strong>Results: </strong>A total of 42 patients were analyzed. With a median follow-up of 15.1 months (range, 3.7 to 85.8 months), the median OS was 28.9 months with a 2-year OS rate of 54.6%. The median PFS and 2-year PFS rates were 10.0 months and 30.9%, respectively. Multivariate analysis showed that good performance (Eastern Cooperative Oncology Group [ECOG] 0 or 1), a longer time interval (≥24 months) between radiotherapy courses, and higher reRT dose (>60 Gy) were significantly favorable factors for OS (all p < 0.05). Higher reRT dose and salvage surgery were significantly associated with improved PFS (all p < 0.05). Regarding the Multi-Institution Reirradiation (MIRI) Collaborative RPA classification, the 2-year OS rates of each class were 87.5% in class I, 51.8% in class II, and 0% in class III (p = 0.008). Grade ≥3 late toxicity was reported in 10 (23.8%) patients. There was no significant factor associated with increased late toxicities.</p><p><strong>Conclusion: </strong>IMRT-based reRT should be considered as a treatment option for patients with recurrent or second primary HNC. Further trials are needed to establish a subset of patients who may benefit from reRT without severe late toxicity.</p>","PeriodicalId":46572,"journal":{"name":"Radiation Oncology Journal","volume":"39 4","pages":"279-287"},"PeriodicalIF":2.3,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6f/93/roj-2021-00640.PMC8743457.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39787646","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":"Prognostic value of the maximum standardized uptake value for the locoregional control in early glottic cancer.","authors":"Donghyun Kim,&nbsp;Yongkan Ki,&nbsp;Jihyeon Joo,&nbsp;Hosang Jeon,&nbsp;Dahl Park,&nbsp;Jiho Nam,&nbsp;Wontaek Kim","doi":"10.3857/roj.2021.00507","DOIUrl":"https://doi.org/10.3857/roj.2021.00507","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the prognostic value of the pretreatment maximum standardized uptake value (SUVmax) for locoregional control (LRC) of early glottic cancer treated with primary radiotherapy.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed the medical records of 101 patients with T1-T2N0 glottic cancer treated with helical tomotherapy between 2013 and 2016. The clinical T-stages were T1 in 87 (86.1%) and T2 in 14 (13.9%) patients. The median total dose was 63 Gy (63-67.5 Gy) in 2.25 Gy per fraction. The survival outcomes were plotted using Kaplan-Meier curves. Receiver operating characteristic curves were used to assess the optimal SUVmax cut-off value for predicting locoregional recurrence.</p><p><strong>Results: </strong>The median follow-up period was 58 months (range, 11 to 90 months). The 5-year overall survival (OS) and locoregional recurrence-free survival rates were 96.8% and 85.4%, respectively. The median pretreatment SUVmax of the primary tumor for all 101 patients was 2.3 (range, 1.1 to 9.1). The best cut-off value for SUVmax for predicting LRC was 3.3, with a sensitivity of 78.6% and specificity of 73.6%. Univariate analysis showed that T-stage, overall treatment time (≥43 days), and high SUVmax (≥3.3) were significant predictors of LRC. Multivariate analysis showed that LRC was independently affected by a high SUVmax (≥3.3) (hazard ratio = 5.505, p = 0.020).</p><p><strong>Conclusion: </strong>High pretreatment SUVmax (≥3.3) is a negative prognostic factor for LRC in early glottic cancer patients treated with primary radiotherapy.</p>","PeriodicalId":46572,"journal":{"name":"Radiation Oncology Journal","volume":"39 4","pages":"297-303"},"PeriodicalIF":2.3,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fd/d6/roj-2021-00507.PMC8743459.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39875985","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":"Abscopal effect in the radio and immunotherapy.","authors":"Alina M Pevzner,&nbsp;Matvey M Tsyganov,&nbsp;Marina K Ibragimova,&nbsp;Nikolai V Litvyakov","doi":"10.3857/roj.2021.00115","DOIUrl":"https://doi.org/10.3857/roj.2021.00115","url":null,"abstract":"<p><p>This review is devoted to a rare in clinical practice, but promising phenomenon of regression distant non-irradiated metastases in combination therapy of cancer patients. R. H. Mole in 1953 suggested introducing the term \"abscopal effect\" to denote the effect of ionizing radiation \"at a distance from the irradiated volume but within the same organism.\" Currently, it is a hypothesis in the treatment of metastatic cancer, when there is a regression of untreated areas simultaneously with a decrease in the tumor. After the discovery of immune checkpoint cases were increase with patients treated with check-point blockade (especially lymphocyte associated protein 4, programmed cell death 1/programmed cell death 1 ligand 1) and which have an abscopal effect. This review systematizes works covering the time period from 1969 to 2019, which give cases of the abscopal effect at different localizations. However, abscopal effect is a poorly understood phenomenon. In this review, the authors tried to collect all information about the possible mechanisms of the abscopal effect, possible role in antitumor response and frequency abscopal effect at radio/immunotherapy or combined both.</p>","PeriodicalId":46572,"journal":{"name":"Radiation Oncology Journal","volume":"39 4","pages":"247-253"},"PeriodicalIF":2.3,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0e/9e/roj-2021-00115.PMC8743454.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39787184","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":"Efficacy and safety of sequential neoadjuvant chemotherapy and short-course radiation therapy followed by delayed surgery in locally advanced rectal cancer: a single-arm phase II clinical trial with subgroup analysis between the older and young patients.","authors":"Alimohammad Bananzadeh,&nbsp;Ali Akbar Hafezi,&nbsp;NamPhong Nguyen,&nbsp;Shapour Omidvari,&nbsp;Ahmad Mosalaei,&nbsp;Niloofar Ahmadloo,&nbsp;Mansour Ansari,&nbsp;Mohammad Mohammadianpanah","doi":"10.3857/roj.2021.00654","DOIUrl":"https://doi.org/10.3857/roj.2021.00654","url":null,"abstract":"<p><strong>Purpose: </strong>This study was performed to investigate the efficacy and safety of short-course radiation therapy (SCRT) and sequential chemotherapy followed by delayed surgery in locally advancer rectal cancer with subgroup analysis between the older and young patients.</p><p><strong>Materials and methods: </strong>In this single-arm phase II clinical trial, eligible patients with locally advanced rectal cancer (T3-4 and/or N1-2) were enrolled. All the patients received a median three sequential cycles of neoadjuvant CAPEOX (capecitabine + oxaliplatin) chemotherapy. A total dose of 25 Gy in five fractions during 1 week was prescribed to the gross tumor and regional lymph nodes. Surgery was performed about 8 weeks following radiotherapy. Pathologic complete response rate (pCR) and grade 3-4 toxicity were compared between older patients (≥65 years) and younger patients (<65 years).</p><p><strong>Results: </strong>Ninety-six patients with locally advanced rectal cancer were enrolled. There were 32 older patients and 64 younger patients. Overall pCR was 20.8% for all the patients. Older patients achieved similar pCR rate (18.7% vs. 21.8; p = 0.795) compared to younger patients. There was no statistically significance in terms of the tumor and the node downstaging or treatment-related toxicity between older patients and younger ones; however, the rate of sphincter-saving surgery was significantly more frequent in younger patients (73% vs. 53%; p=0.047) compared to older ones. All treatment-related toxicities were manageable and tolerable among older patients.</p><p><strong>Conclusion: </strong>Neoadjuvant SCRT and sequential chemotherapy followed by delayed surgery was safe and effective in older patients compared to young patients with locally advanced rectal cancer.</p>","PeriodicalId":46572,"journal":{"name":"Radiation Oncology Journal","volume":"39 4","pages":"270-278"},"PeriodicalIF":2.3,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f7/2e/roj-2021-00654.PMC8743455.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39787645","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":"Computed tomography-based radiomic model predicts radiological response following stereotactic body radiation therapy in early-stage non-small-cell lung cancer and pulmonary oligo-metastases.","authors":"Ben Man Fei Cheung,&nbsp;Kin Sang Lau,&nbsp;Victor Ho Fun Lee,&nbsp;To Wai Leung,&nbsp;Feng-Ming Spring Kong,&nbsp;Mai Yee Luk,&nbsp;Kwok Keung Yuen","doi":"10.3857/roj.2021.00311","DOIUrl":"https://doi.org/10.3857/roj.2021.00311","url":null,"abstract":"<p><strong>Purpose: </strong>Radiomic models elaborate geometric and texture features of tumors extracted from imaging to develop predictors for clinical outcomes. Stereotactic body radiation therapy (SBRT) has been increasingly applied in the ablative treatment of thoracic tumors. This study aims to identify predictors of treatment responses in patients affected by early stage non-small cell lung cancer (NSCLC) or pulmonary oligo-metastases treated with SBRT and to develop an accurate machine learning model to predict radiological response to SBRT.</p><p><strong>Materials and methods: </strong>Computed tomography (CT) images of 85 tumors (stage I-II NSCLC and pulmonary oligo-metastases) from 69 patients treated with SBRT were analyzed. Gross tumor volumes (GTV) were contoured on CT images. Patients that achieved complete response (CR) or partial response (PR) were defined as responders. One hundred ten radiomic features were extracted using PyRadiomics module based on the GTV. The association of features with response to SBRT was evaluated. A model using support vector machine (SVM) was then trained to predict response based solely on the extracted radiomics features. Receiver operating characteristic curves were constructed to evaluate model performance of the identified radiomic predictors.</p><p><strong>Results: </strong>Sixty-nine patients receiving thoracic SBRT from 2008 to 2018 were retrospectively enrolled. Skewness and root mean squared were identified as radiomic predictors of response to SBRT. The SVM machine learning model developed had an accuracy of 74.8%. The area under curves for CR, PR, and non-responder prediction were 0.86 (95% confidence interval [CI], 0.794-0.921), 0.946 (95% CI, 0.873-0.978), and 0.857 (95% CI, 0.789-0.915), respectively.</p><p><strong>Conclusion: </strong>Radiomic analysis of pre-treatment CT scan is a promising tool that can predict tumor response to SBRT.</p>","PeriodicalId":46572,"journal":{"name":"Radiation Oncology Journal","volume":"39 4","pages":"254-264"},"PeriodicalIF":2.3,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bf/83/roj-2021-00311.PMC8743458.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39787185","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":"Hyperfractionated radiotherapy for re-irradiation of recurrent esophageal cancer.","authors":"Kazuya Takeda,&nbsp;Haruo Matsushita,&nbsp;Rei Umezawa,&nbsp;Takaya Yamamoto,&nbsp;Yojiro Ishikawa,&nbsp;Noriyoshi Takahashi,&nbsp;Yu Suzuki,&nbsp;Keiichi Jingu","doi":"10.3857/roj.2021.00325","DOIUrl":"https://doi.org/10.3857/roj.2021.00325","url":null,"abstract":"<p><strong>Purpose: </strong>Re-irradiation is a treatment option for recurrent esophageal cancer patients with a history of radiotherapy, but there is a risk of severe late adverse effects. This study focused on the efficacy and safety of re-irradiation using hyperfractionated radiotherapy.</p><p><strong>Materials and methods: </strong>Twenty-six patients who underwent re-irradiation by the hyperfraction technique using twice-daily irradiation of 1.2 Gy per fraction for recurrent esophageal cancer were retrospectively included in this study. The overall survival period after the start of secondary radiotherapy and the occurrence of late adverse effects were investigated.</p><p><strong>Results: </strong>Of 26 patients, 21 (81%) received re-irradiation with definitive intention and 21 (81%) underwent concurrent chemotherapy. The median re-irradiation dose was 60 Gy in 50 fractions in 25 treatment days, and the median accumulated irradiation dose in equivalent dose in 2 Gy per fraction was 85.4 Gy with an α/β value of 3. The median interval between two courses of radiotherapy was 21.0 months. The median overall survival period was 15.8 months and the 1-year and 3-year overall survival rates were 64.3% and 28.3%, respectively. Higher dose of re-irradiation and concurrent chemotherapy significantly improved survival (p < 0.001 and p = 0.019, respectively). Severe late adverse effects with the Common Terminology Criteria for Adverse Events grade 3 or higher were observed in 5 (19.2%) patients, and 2 (7.7%) of them developed a grade 5 late adverse effect.</p><p><strong>Conclusion: </strong>High-dose re-irradiation using a hyperfractionated schedule with concurrent chemotherapy might be related to good prognosis, while the rate of late severe adverse effects is not high compared with the rates in past reports.</p>","PeriodicalId":46572,"journal":{"name":"Radiation Oncology Journal","volume":"39 4","pages":"265-269"},"PeriodicalIF":2.3,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d6/b2/roj-2021-00325.PMC8743462.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39787186","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":"Clinical features and treatment outcomes of resected large cell neuroendocrine carcinoma of the lung.","authors":"Jin Young Moon,&nbsp;Seo Hee Choi,&nbsp;Tae Hyung Kim,&nbsp;Joongyo Lee,&nbsp;Ji Hoon Pyo,&nbsp;Yong Tae Kim,&nbsp;Seo Jin Lee,&nbsp;Hong In Yoon,&nbsp;Jaeho Cho,&nbsp;Chang Geol Lee","doi":"10.3857/roj.2021.00423","DOIUrl":"https://doi.org/10.3857/roj.2021.00423","url":null,"abstract":"<p><strong>Purpose: </strong>Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a high-grade lung neuroendocrine tumor with a poor prognosis, similar to small cell lung cancer (SCLC). However, it remains unclear whether to treat LCNEC as non-small-cell lung cancer (NSCLC) or as SCLC. We reviewed our experiences to suggest appropriate treatment strategy for resected pulmonary LCNEC.</p><p><strong>Materials and methods: </strong>Forty-four patients were treated for pathologically diagnosed pulmonary LCNEC during 2005‒2018. We considered curative surgery first in early-stage or some locally advanced tumors, unless medically inoperable. Adjuvant treatments were decided considering patient's clinical and pathological features. After excluding two stage I tumors with radiotherapy alone and three stage III tumors with upfront chemotherapy, we analyzed 39 patients with stage I‒III pulmonary LCNEC, who underwent curative resection first.</p><p><strong>Results: </strong>Adjuvant chemotherapy (NSCLC-based 91%, SCLC-based 9%) was performed in 62%, and adjuvant radiotherapy was done in three patients for pN2 or positive margin. None received prophylactic cranial irradiation (PCI). With a median follow-up of 30 months, the 2- and 5-year overall survival (OS) rates were 68% and 51%, and the 2- and 5-year recurrence-free survival (RFS) rates were 49% and 43%, respectively. Aged ≥67 years and SCLC-mixed pathology were significant poor prognostic factors for OS or RFS (p < 0.05). Among 17 recurrences, regional failures were most common (n = 6), and there were five brain metastases.</p><p><strong>Conclusions: </strong>Surgery and adjuvant treatment (without PCI) could achieve favorable outcomes in pulmonary LCNEC, which was more similar to NSCLC, although some factors worsened the prognosis. The importance of intensified adjuvant therapies with multidisciplinary approach remains high.</p>","PeriodicalId":46572,"journal":{"name":"Radiation Oncology Journal","volume":"39 4","pages":"288-296"},"PeriodicalIF":2.3,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/85/b4/roj-2021-00423.PMC8743456.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39787647","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 radiosurgery for limited brain metastasis using three different techniques: helical tomotherapy, volumetric modulated arc therapy, and cone-based LINAC radiosurgery","authors":"Bongkot Jia-Mahasap, Chakri Madla, Patumrat Sri, I. Chitapanarux, E. Tharavichitkul, Somvilai Chakrabandhu, P. Klunklin, W. Onchan","doi":"10.21203/rs.3.rs-1051990/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-1051990/v1","url":null,"abstract":"Purpose Specific radiation delivered to tumors by stereotactic radiosurgery (SRS) has become widely used in the treatment of brain metastasis. This study aimed to compare radiation therapy planning and its parameters from SRS using three different modalities: helical tomotherapy (HT), volumetric modulated arc therapy (VMAT), and cone-based linac radiosurgery (Cone-based). Materials and Methods Each contouring dataset of patents who experienced one to four brain metastasis received SRS in our center was re-planned to create radiation therapy planning in all three treatment systems (HT, VMAT, and Cone-based). The parameters of conformity index (CI), homogeneity index (HI), CI50, and gradient index (CGI) were analyzed to compare the effects of the three techniques. Decision score analysis was used to evaluate the performance on dosimetric and organs-at-risk parameters among the different techniques by applying the Cone-based technique as a benchmark. Results A total of 21 patients with 39 lesions were included in this study. The results from the decision score analysis demonstrated statistically identical CI, CI50, and CGI values between Cone-based and VMAT for single lesions. For multiple lesions, VMAT also provided better CI when compared to Cone-based technique while HT exhibited the poorest dosimetric parameters. Moreover, VMAT exhibited the lowest BrainV5Gy value and displayed the shortest beam-on time calculation. Conclusion We have conducted a comprehensive comparison of SRS planning approaches. The Cone-based technique revealed the highest HI value, while VMAT provided the best estimated beam-on time value. HT displayed a feasible SRS modality for single lesions, but not for multiple lesions.","PeriodicalId":46572,"journal":{"name":"Radiation Oncology Journal","volume":"35 1","pages":"232 - 241"},"PeriodicalIF":2.3,"publicationDate":"2021-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78056660","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":"Survey of radiation field and dose in human papillomavirus-positive oropharyngeal cancer: is de-escalation actually applied in clinical practice?","authors":"Kyu Hye Choi,&nbsp;Jin Ho Song,&nbsp;Yeon-Sil Kim,&nbsp;Sung Ho Moon,&nbsp;Jeongshim Lee,&nbsp;Young-Taek Oh,&nbsp;Dongryul Oh,&nbsp;Jin Ho Kim,&nbsp;Jun Won Kim","doi":"10.3857/roj.2021.00556","DOIUrl":"https://doi.org/10.3857/roj.2021.00556","url":null,"abstract":"<p><strong>Purpose: </strong>Studies on de-escalation in radiation therapy (RT) for human papillomavirus-related (HPV(+)) oropharyngeal cancer (OPC) are currently ongoing. This study investigated the current practice regarding the radiation dose and field in the treatment of HPV(+) OPC.</p><p><strong>Materials and methods: </strong>The Korean Society for Head and Neck Oncology conducted a questionnaire on the primary treatment policy. Among them, for HPV(+) OPC scenarios, radiation oncologists were questioned regarding the field and dose of RT.</p><p><strong>Results: </strong>Forty-two radiation oncologists responded to the survey. In definitive concurrent chemoradiotherapy (CCRT) treatment for stage T2N1M0 OPC, most respondents prescribed a dose of >60 Gy to the primary tonsil and involved ipsilateral lymph nodes. However, eight of the respondents prescribed a relatively low dose of ≤54 Gy. For stage T2N1M0 OPC, postoperative adjuvant RT was prescribed by eight and nine respondents with a lower dose of ≤50 Gy for the ipsilateral tonsil and involved neck, respectively. In definitive CCRT in complete remission after induction chemotherapy for initial stage T2N3M0 OPC, de-escalation of the tonsil and involved neck were performed by eight and seven respondents, respectively. Regarding whether de-escalation is applied in radiotherapy for HPV(+) OPC, 27 (64.3%) did not do it at present, and 15 (35.7%) were doing or considering it.</p><p><strong>Conclusion: </strong>The field and dose of prescribed treatment varied between institutions in Korea. Among them, dose de-escalation of RT in HPV(+) OPC was observed in approximately 20% of the respondents. Consensus guidelines will be set in the near future after the completion of ongoing prospective trials.</p>","PeriodicalId":46572,"journal":{"name":"Radiation Oncology Journal","volume":"39 3","pages":"174-183"},"PeriodicalIF":2.3,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a1/32/roj-2021-00556.PMC8497865.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39511384","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":"Tailored stereotactic radiotherapy technique using deep inspiration breath-hold to reduce stomach dose for cardiac radioablation.","authors":"Myung-Jin Cha,&nbsp;Phillip S Cuculich,&nbsp;Clifford G Robinson,&nbsp;Ji Hyun Chang","doi":"10.3857/roj.2021.00276","DOIUrl":"https://doi.org/10.3857/roj.2021.00276","url":null,"abstract":"<p><strong>Purpose: </strong>To provide a new insight on a novel safe cardiac radioablation using deep inspiration breath-hold (DIBH) to reduce gastrointestinal dose.</p><p><strong>Materials and methods: </strong>For treating incessant ventricular tachycardia (VT) originated from left ventricle inferior scar abutting the stomach, a target delineation and treatment planning for cardiac radioablation was performed. With four different computed tomography (CT) scan protocols-DIBH, full expiration breath-hold, four-dimensional (4D) CT without and with abdominal compression, the distances between the target and the stomach were compared.</p><p><strong>Results: </strong>Among the protocols, the CT scan with DIBH showed largest distance between the target and the stomach and selected for the treatment planning. The prescribed dose was 25 Gy in a single fraction, and satisfactory dosimetric parameters were achieved with the DIBH. The patient was successfully treated with the DIBH, and experienced no acute toxicity.</p><p><strong>Conclusion: </strong>To gain the best benefit from cardiac radioablation, understanding the possible toxicity in the adjacent organs is crucial. By moving the heart with thoraco-diaphragmatic movement by DIBH, the target could be physically separated from the stomach.</p>","PeriodicalId":46572,"journal":{"name":"Radiation Oncology Journal","volume":"39 3","pages":"167-173"},"PeriodicalIF":2.3,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/91/06/roj-2021-00276.PMC8497870.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39511382","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}