Practical Radiation Oncology最新文献

{"title":"Appropriateness Criteria for Radiation Therapy in the Setting of Presumed Early-Stage Lung Cancer.","authors":"Laura L Dover, Christopher Abraham, Adam J Kole, Ashley Weiner","doi":"10.1016/j.prro.2024.10.010","DOIUrl":"10.1016/j.prro.2024.10.010","url":null,"abstract":"<p><p>Low-dose chest computed tomography imaging for lung cancer screening is revealing increasing numbers of radiographic early-stage lung cancers. This topic discussion describes when a clinical scenario merits radiation therapy without a histologic diagnosis, with an emphasis on pragmatic algorithms in settings without readily available advanced biopsy techniques.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulation of Focal Boosting in Online Adaptive MRI-Guided SBRT for Patients With Locally Advanced Prostate Cancer With Seminal Vesicle Involvement.","authors":"Mathijs G Dassen, Ben Neijndorff, Anja Betgen, Lisa Wiersema, Peter de Ruiter, Joeke van der Linden, Tomas Janssen, Leontien Abbenhuis, Peter van Kollenburg, Casper Reijnen, Floris Pos, Robert J Smeenk, Uulke A van der Heide, Ellen Brunenberg","doi":"10.1016/j.prro.2024.10.009","DOIUrl":"10.1016/j.prro.2024.10.009","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the feasibility and accuracy of focal boosting in online adaptive MRI-guided stereotactic body radiation therapy (SBRT) for patients with prostate cancer (PCa) with seminal vesicle invasion (T3b) by analyzing the impact of intrafraction motion on the dose planned for the gross tumor volume (GTV) and clinical target volume (CTV).</p><p><strong>Methods and materials: </strong>Data from 23 patients with T1-T3a PCa who received focal boosting SBRT on a 1.5T MR-Linac was used. A radiation oncologist replaced clinical GTVs with artificial GTVs representative for T3b tumor(s). For each MRI used for daily adaptation (MRI_adapt), an automated treatment plan was generated (D_f1-5) using the adapted contours. Patients were planned to receive 35 Gy to the CTV, with an isotoxic focal boost to the GTV up to 50 Gy. During each fraction, an additional MRI was acquired to assess intrafraction motion (MRI_during). Dose accumulation of all fractions was performed by deformable registration of MRI_adapt, _f2-5 to MRI_adapt, _f1 (D_{ACC, planned})_. The D_f1-₅ were projected to their corresponding MRI_during, which were used to reconstruct D_{ACC, delivered}, likewise. Our results were compared to patients with tumor(s) without seminal vesicle invasion (T1-T3a).</p><p><strong>Results: </strong>The median (10th-90th percentile) D98%_{ACC, planned} to the GTV, which correlates most strongly with outcome, was 41.1 Gy (40.1-43.0 Gy) in the plans for patients with artificial T3b tumors, compared to 43.0 Gy (40.4-47.2 Gy) in the plans for patients with T1-T3a tumors. The D98%_{ACC, delivered} to the GTV, taking into account intrafraction motion, was 41.0 Gy (39.3-42.6 Gy) and 42.5 Gy (40.0-46.6 Gy) in the plans for the artificial and clinical GTVs, respectively.</p><p><strong>Conclusions: </strong>MRI-guidance can ensure high accuracy of focal boosting in patients with T3b disease. Because of the unfavorable location of the GTV, a lower boost dose was feasible compared to patients with T1-T3a PCa.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiation Therapy for the Treatment of Osteoarthritis.","authors":"James B Yu, David J Grew, Matthew B Spraker, Jason M Beckta, Chirag Shah, Jeffrey V Brower","doi":"10.1016/j.prro.2024.09.003","DOIUrl":"https://doi.org/10.1016/j.prro.2024.09.003","url":null,"abstract":"<p><p>Osteoarthritis is a common cause of pain and disability in the United States. Many patients experience pain that is refractory or unable to be treated by traditional treatments such as exercise, physical therapy, nonsteroidal anti-inflammatory drugs, and/or cyclooxygenase-2 inhibitors. For patients with medically refractory disease, intra-articular corticosteroid therapy, hyaluronic acid, or surgery can be considered. However, for many older patients with significant impairment in quality of life related to osteoarthritis, radiation therapy is a noninvasive treatment option that has a long history of global use. In this topic discussion, we review the clinical evidence supporting treatment of osteoarthritis, as well as considerations for how to select which patient and joint to treat. We discuss technical considerations for treatment including dose and immobilization, assessment of treatment response, and the role of retreatment.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurostimulators and Radiation Therapy: Is There Any Risk?","authors":"Hanan Rida, Alexander Bennassi, Chahrazed Boukhobza, Fatima Zahra Bellefkih, Kamel Debbi, Yazid Belkacemi","doi":"10.1016/j.prro.2024.09.013","DOIUrl":"10.1016/j.prro.2024.09.013","url":null,"abstract":"<p><p>The use of neurostimulators has increased in recent decades. However, safety guidelines in patients undergoing radiation therapy (RT) are lacking. We report 2 cases of pelvic RT for prostate cancer in patients with spinal cord neurostimulators. The implantable pulse generator was placed close to the irradiated volume in the gluteal region and received a median and maximal dose of 2.8 and 5.68 Gy, respectively for patient 1; and 3.65 and 5.15 Gy, respectively for patient 2. During and after RT, No dysfunction of the device was recorded. Based on the similarity with the cardiac implantable electric devices, we recommend similar safety procedures, this include the following: (i) a cumulative dose <5 Gy, (ii) avoiding neutron-producing RT, (iii) ensuring the implantable pulse generator positioning outside the direct beams, (iv) switching the device to \"off-mode\" during treatment delivery, and (v) in vivo verification in case of implantable pulse generator close to irradiation volume. The final decision should involve neurology specialist.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum to: Shaitelman SF, Anderson BM, Arthur DW, Bazan JG, Bellon JR, Bradfield L, Coles CE, Gerber NK, Kathpal M, Kim L, Laronga C, Meattini I, Nichols EM, Pierce LJ, Poppe MM, Spears PA, Vinayak S, Whelan T, Lyons JA. Partial Breast Irradiation for Patients With Early-Stage Invasive Breast Cancer or Ductal Carcinoma In Situ: An ASTRO Clinical Practice Guideline. Pract Radiat Oncol 2024;14:112-132.","authors":"","doi":"10.1016/j.prro.2024.06.011","DOIUrl":"10.1016/j.prro.2024.06.011","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"14 6","pages":"Page 613"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142551868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stereotactic Body Radiation Therapy for Oligoprogressive Pleural Mesothelioma: Fine-Tuning the Optimal Doses","authors":"","doi":"10.1016/j.prro.2024.05.004","DOIUrl":"10.1016/j.prro.2024.05.004","url":null,"abstract":"<div><div><span><span>There is growing evidence of a role of stereotactic body radiation therapy (SBRT) in the treatment of patients with oligoprogressive </span>pleural mesothelioma (PM). The objective of this study was to investigate the optimal radiation therapy doses and schedules in this setting. The records of patients treated with SBRT (&gt;5 Gy per fraction) for oligoprogression of PM at 2 institutions from June 2014 to September 2022 were reviewed. Patients were divided into 2 groups: “intermediate-dose” SBRT (i-SBRT; total dose, 30-36 Gy in 5-6 fractions) and “high-dose” SBRT (h-SBRT; total dose, 45-50 Gy in 4-8 fractions). The comparison between the 2 groups in terms of local control (LC) and toxicity was the primary endpoint of the study. Overall, 23 patients were treated for 25 pleural lesions. All had received upfront chemotherapy with platinum/pemetrexed. Fifteen patients were treated with i-SBRT and 8 patients with h-SBRT. The median equivalent dose was 40 Gy (range, 40-49.6) in the i-SBRT group and 74.46 Gy (range, 64-88) in the h-SBRT group. Six-month, 1-year, and 2-year LC were 100%, 100%, and 80% in the i-SBRT group and 100%, 100%, and 67% in the h-SBRT group, respectively (</span><em>p</em><span> =.94). Only 2 patients (1 for each dose group) had a recurrence in the radiation therapy field, both after experiencing a distant relapse. No severe acute and late toxicities were observed in the i-SBRT group, whereas in the h-SBRT group, 2 patients experienced G2 acute and late thoracic pain<span> and 1 patient experienced G2 acute and G3 chronic thoracic pain. In our experience, SBRT is a safe and effective option for selected patients with oligoprogressive PM. Use of intermediate total doses keeping the dose per fraction high seems to offer an excellent LC, avoiding the risk of severe toxicity.</span></span></div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"14 6","pages":"Pages e487-e491"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141181226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Readability and Writing Quality in Radiation Oncology Journal Articles from 2004 to 2024","authors":"Derek A. Mumaw MD,&nbsp;Thomas J. Quinn MD","doi":"10.1016/j.prro.2024.06.013","DOIUrl":"10.1016/j.prro.2024.06.013","url":null,"abstract":"<div><h3>Purpose</h3><div>Scientific literature is a vital tool that we rely on to communicate the findings of our studies; however, we rarely direct our study to the writing itself.</div></div><div><h3>Methods and Materials</h3><div>Here, we make use of modern natural language processing algorithms coupled with the large, open access PubMed Central corpus to analyze trends in writing complexity within the field of radiation oncology from 2004 to 2024. Changes in 1) required grade level to comprehend, 2) lexical complexity, and 3) information content were assessed. Articles were also classified, and then analyzed, by disease subsite.</div></div><div><h3>Results</h3><div>We found significant increases in the 3 domains over the 20-year collection period. Genitourinary literature had the greatest readability, while gastrointestinal literature was the most complex.</div></div><div><h3>Conclusions</h3><div>This analysis reveals broad increases in the complexity of our writing. This study demonstrates metrics to use and benchmark values to refer to when evaluating the complexity of radiation oncology journal articles.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"14 6","pages":"Pages e426-e433"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PROshot: Intensity Modulated Radiation Therapy for Vulvar Cancer, Completion Axillary Dissection, Ultracentral Lung Radiation, Concurrent Chemotherapy for Endometrial cancer, and Neoadjuvant Therapy for Esophageal Squamous Cell Carcinoma","authors":"Laura Dover ,&nbsp;Caleb Dulaney","doi":"10.1016/j.prro.2024.08.001","DOIUrl":"10.1016/j.prro.2024.08.001","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"14 6","pages":"Pages 471-475"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142555620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pilot Trial of Proton-Based Cardiac Sparing Accelerated Fractionated Radiation Therapy in Unresectable Non-small Cell Lung Cancer With Extended Durvalumab Therapy (PARTICLE-D)","authors":"Debora S. Bruno MD, MS ,&nbsp;Carley Mitchell MD ,&nbsp;Afshin Dowlati MD ,&nbsp;Stephen Shamp MD ,&nbsp;Pingfu Fu PhD ,&nbsp;John Rindeau BS ,&nbsp;Yiran Zheng PhD ,&nbsp;Mitchell Machtay MD ,&nbsp;Tithi Biswas MD","doi":"10.1016/j.prro.2024.06.007","DOIUrl":"10.1016/j.prro.2024.06.007","url":null,"abstract":"<div><h3>Purpose</h3><div>Concurrent chemoradiation therapy is the current nonsurgical standard of care for locally advanced non-small cell lung cancer. However, this is a difficult regimen to tolerate, especially for those who are elderly, have multiple comorbidities, or have poor performance status. Alternative treatment regimens are needed for this vulnerable population. We report initial results of concurrent durvalumab, an immune checkpoint inhibitor, and hypofractionated, dose-escalating, proton external beam radiation therapy (EBRT).</div></div><div><h3>Methods and Materials</h3><div>This phase 1, pilot dose escalation trial enrolled 7 patients with newly diagnosed stage IIIA to IIIC non-small cell lung cancer and who were unable or unwilling to undergo concurrent chemoradiation therapy. Patients previously treated with immunotherapy were excluded. Five patients in this 3 + 3 study design received a fixed dose of durvalumab on day 1 of each 28-day cycle plus hypofractionated proton EBRT with initial dose of 60 Gy (Arm 1) in 20 fractions while 2 patients received the escalation dose of 69 Gy in 23 fractions (Arm 2). The primary objective was to assess safety and the secondary objective was to assess feasibility and adverse events.</div></div><div><h3>Results</h3><div>All patients experienced treatment-related adverse events, primarily grades 1 and 2. Pneumonitis and anemia were the most common. Only 1 dose-limiting toxicity occurred in arm 1, which was a grade 3 pneumonitis leading to grade 5 pneumonia. Additionally, 2 delayed-onset grade 5 tracheal necrosis events occurred &gt;13 months after treatment initiation.</div></div><div><h3>Conclusions</h3><div>Concurrent durvalumab plus hypofractionated proton EBRT was well tolerated in the short term. However, 3 treatment-related deaths, including 2 delayed-onset grade 5 tracheal necroses negatively impacted overall safety. A dose de-escalation protocol of proton-based radiation therapy plus durvalumab is warranted.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"14 6","pages":"Pages e470-e479"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Regard to Tam et al.","authors":"Charlotte Rivers MD,&nbsp;Samuel Lewis Cooper MD,&nbsp;Bhishamjit Chera MD, FASTRO","doi":"10.1016/j.prro.2024.04.026","DOIUrl":"10.1016/j.prro.2024.04.026","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"14 6","pages":"Pages e530-e531"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142551864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}