Practical Radiation Oncology最新文献

{"title":"Management of Dry Eye Toxicity After Treatment With 177Lu-PSMA-617 Radioligand Therapy","authors":"Abigail Pepin MD ,&nbsp;Vivian Lee MD ,&nbsp;Sophia O'Brien MD ,&nbsp;Philipose Mulugeta MD ,&nbsp;Neil K. Taunk MD, MSCTS","doi":"10.1016/j.prro.2024.04.001","DOIUrl":"10.1016/j.prro.2024.04.001","url":null,"abstract":"<div><p>Treatment options for patients with metastatic castration-resistant prostate cancer include use of radioligand therapy with 177Lu-PSMA-617. 177Lu-PSMA-617 is used to target prostate cancer cells selectively by targeting prostate specific membrane antigen (PSMA); however, PSMA is also expressed on lacrimal glands among other tissues. Herein, we report on a case of a Common Terminology Criteria for Adverse Events version 5 grade 3 dry eye event with concomitant blepharitis after administration of 177Lu-PSMA-617. The patient was managed with neomycin-polymyxin-dexamethasone 3.5-10000-0.1 ophthalmic suspension, artificial tears, lubricating ointments, lid scrubs, and oral antihistamines.</p></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140788719","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 Reply to Chang and Liu","authors":"Daniel Moore-Palhares MD, MSc,&nbsp;Hanbo Chen MD, MPH,&nbsp;Ezra Hahn MD,&nbsp;Justin Lee MD, MSc,&nbsp;Danny Vesprini MD, MSc","doi":"10.1016/j.prro.2024.03.005","DOIUrl":"10.1016/j.prro.2024.03.005","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472590","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":"PRO's Top 20 Downloads of 2023","authors":"Robert J. Amdur MD ,&nbsp;James B. Yu MD, MHS","doi":"10.1016/j.prro.2024.04.011","DOIUrl":"10.1016/j.prro.2024.04.011","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472592","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 Dose Accumulation Assessment of Alignment Errors During Spatially Fractionated Radiation Therapy","authors":"John Ginn PhD ,&nbsp;Sai Duriseti MD, PhD ,&nbsp;Thomas Mazur PhD ,&nbsp;Matthew Spraker MD ,&nbsp;James Kavanaugh PhD","doi":"10.1016/j.prro.2023.11.015","DOIUrl":"10.1016/j.prro.2023.11.015","url":null,"abstract":"<div><h3>Purpose</h3><p>Spatially fractionated radiation therapy (SFRT) techniques produce high-dose peaks and low-dose valleys within a tumor. Lattice stereotactic body radiation therapy<span> (SBRT) is a form a SFRT delivered across 5 fractions. Because of the high spatial dose gradients associated with SFRT, it is critical for fractionated SFRT patients to be aligned correctly for treatment. Here we investigate the dosimetric effect of daily alignment uncertainty through a dose accumulation study.</span></p></div><div><h3>Methods and Materials</h3><p><span><span>Dose accumulation was retrospectively performed for 10 patients enrolled on a phase 1 trial. Lattice stereotactic body radiation therapy was completed in 5 fractions with 20 Gy prescribed to the entire tumor and a simultaneous integrated boost of 66.7 Gy prescribed to a set of regularly spaced high-dose spheres. Daily alignment error was quantified through manually selected landmarks in both the planning computed tomography scan and daily </span>cone beam computed tomography. The dosimetric effect of alignment errors was quantified by </span>translating<span> the isocenter in the treatment planning system by the daily average alignment error. Large errors were simulated by translating isocenter 5 and 10 mm for 1 and 2 fractions, independently assessing errors in the superior-inferior and axial directions. The reduction of dose gradients was quantified using the dose ratio (DR) of the mean dose in the high-dose and low-dose spheres.</span></p></div><div><h3>Results</h3><p>The average alignment error was 1.8 mm across the patient population resulting in minor smoothing of the high- and low-dose distributions in the dose accumulation. Quantitatively, the DR decreased from 3.42 to 3.32 (<em>P</em> = .093) in the dose accumulation study. The simulated worst case was an inferior-superior shift of 10 mm for 2 fractions where the average DR decreased to 2.72 (<em>P</em> = .0001).</p></div><div><h3>Conclusions</h3><p>The dose accumulation study revealed on average DR only decreased from 3.42 to 3.32. However, setup errors &gt;5 mm resulted in larger dosimetric degradation, reflecting a larger effect for individual high-dose spheres within regions exhibiting larger displacements.</p></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138579733","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":"Klara and the Sun: A Lesson in Friendship","authors":"Alexandra N. De Leo MD","doi":"10.1016/j.prro.2023.10.015","DOIUrl":"10.1016/j.prro.2023.10.015","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472591","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 Radiation Therapy for Kidney Cancer, Hypofractionated Postprostatectomy Radiation, Nasopharyngeal Carcinoma Treatment De-Intensification, Stereotactic Radiation Therapy and Interstitial Lung Disease, and Hyperbaric Oxygen Therapy","authors":"Laura Dover MD, MSPH ,&nbsp;Caleb Dulaney MD","doi":"10.1016/j.prro.2024.04.008","DOIUrl":"10.1016/j.prro.2024.04.008","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472593","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":"Weekly Versus Bolus Cisplatin Concurrent With Definitive Radiation Therapy for Squamous Carcinoma of the Head and Neck: A Systematic Review and Network Meta-Analysis.","authors":"Matthew C Ward, Roshan S Prabhu, Jennifer L Atlas, Daniel R Carrizosa, Zvonimir L Milas, Daniel S Brickman, Catherine H Frenkel, Steven S Hong, Benjamin J Moeller","doi":"10.1016/j.prro.2024.03.007","DOIUrl":"https://doi.org/10.1016/j.prro.2024.03.007","url":null,"abstract":"<p><strong>Purpose: </strong>The schedule of cisplatin concurrent with definitive radiation for squamous carcinoma of the head and neck remains controversial. Most institutions deliver either a high-dose \"bolus\" schedule once every 3 weeks or a low-dose weekly schedule. We compared these 2 schedules via a simplified network meta-analysis with a common comparator.</p><p><strong>Methods and materials: </strong>We performed a PRISMA-concordant systematic review to identify randomized controlled trials comparing cisplatin with cetuximab for nonmetastatic, locoregionally advanced squamous carcinoma of the head and neck treated with definitive radiation. Trials incorporating primary surgery or induction therapy were excluded. Patient survival times were extracted on a per-event basis from the published curves using a digitizer and validated against published point estimates and hazard ratios (HRs). Survival was compared using random effects Cox regression under a frequentist framework. Toxicity and secondary endpoints were analyzed qualitatively. The Cochrane method assessed the risk of bias. The analysis plan was preregistered with the Open Science Foundation.</p><p><strong>Results: </strong>Five randomized trials were identified, including 1678 patients. There was no statistical difference in overall survival between weekly and bolus regimens (HR, 0.90; 95% CI, 0.53-1.52, P = .345). This Cox model suggested that for the average patient in the cohort, the absolute difference in 5-year overall survival between weekly and bolus regimens was +1.2% (95% CI, -6.1%-+5.9%, P = .345). Secondary endpoints and toxicity were not obviously different by regimen, qualitatively.</p><p><strong>Conclusions: </strong>The cetuximab trials provide indirect data suggesting that the differences between cisplatin schedules are subtle.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421806","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 Practical Primer on Particle Therapy.","authors":"Timothy D Malouff, Mark Newpower, Aaron Bush, Danushka Seneviratne, Daniel K Ebner","doi":"10.1016/j.prro.2024.05.005","DOIUrl":"10.1016/j.prro.2024.05.005","url":null,"abstract":"<p><strong>Purpose: </strong>Particle therapy is a promising treatment technique that is becoming more commonly used. Although proton beam therapy remains the most commonly used particle therapy, multiple other heavier ions have been used in the preclinical and clinical settings, each with its own unique properties. This practical review aims to summarize the differences between the studied particles, discussing their radiobiological and physical properties with additional review of the available clinical data.</p><p><strong>Methods and materials: </strong>A search was carried out on the PubMed databases with search terms related to each particle. Relevant radiobiology, physics, and clinical studies were included. The articles were summarized to provide a practical resource for practicing clinicians.</p><p><strong>Results: </strong>A total of 113 articles and texts were included in our narrative review. Currently, proton beam therapy has the most data and is the most widely used, followed by carbon, helium, and neutrons. Although oxygen, neon, silicon, and argon have been used clinically, their future use will likely remain limited as monotherapy.</p><p><strong>Conclusions: </strong>This review summarizes the properties of each of the clinically relevant particles. Protons, helium, and carbon will likely remain the most commonly used, although multi-ion therapy is an emerging technique.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285328","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 Pneumonitis After Partial Breast Irradiation.","authors":"Tamar Brooks, Marie Wood, Rachel Rabinovitch","doi":"10.1016/j.prro.2024.04.024","DOIUrl":"10.1016/j.prro.2024.04.024","url":null,"abstract":"<p><p>This case presentation describes development of symptomatic radiation pneumonitis in a healthy woman who underwent partial breast irradiation with deep inspiration breath hold for early stage breast cancer meeting all published dose constraints. Risk factors for, diagnosis and management of radiation pneumonitis are discussed in detail. Radiation pneumonitis is rare, ranging from <1% to 1.5% (when regional nodal irradiation is included). Partial breast irradiation spares breast tissue, but may not spare lung tissue better than whole breast irradiation, depending upon treatment technique such as prone positioning. Dose constraints for normal and target structures from published trials are reviewed, however data specifically relating to pneumonitis in partial breast trials are limited.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201315","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":"Paolo Ghirardelli, Gianluca Costantino, Davide Franceschini, Elisa Villa, Annamaria Guaineri, Marta Scorsetti, Vittorio Vavassori, Giovanni Luca Ceresoli","doi":"10.1016/j.prro.2024.05.004","DOIUrl":"10.1016/j.prro.2024.05.004","url":null,"abstract":"<p><p>There is growing evidence of a role of stereotactic body radiation therapy (SBRT) in the treatment of patients with oligoprogressive 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 (>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 (p =.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 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.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-05-28","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}