Therapeutic radiology and oncology最新文献

{"title":"A retrospective bilateral breast proton pencil beam scanning and photon volumetric arc therapy planning comparison.","authors":"Dennis Mah, Laura Happersett, Gabriely Del Rosario, Seng Boh Lim, Linda Hong","doi":"10.21037/tro-22-23","DOIUrl":"10.21037/tro-22-23","url":null,"abstract":"<p><strong>Background: </strong>Advanced bilateral breast cancers with local and regional nodal involvement are rare and challenging to plan due to conflicting demands of conformality, uniformity and sparing of organs at risk such as heart and lungs. Pencil beam scanning (PBS) protons have been shown to provide improved organ at risk (OAR) sparing, conformality and homogeneity compared to photon techniques including three-dimensional conformal radiotherapy, intensity modulated radiation therapy (IMRT), volumetric arc therapy (VMAT), and tomotherapy. We performed a blinded comparison between VMAT and PBS plans and extend this comparison with a case study of a patient win expander <i>in situ</i> during radiotherapy.</p><p><strong>Methods: </strong>In this case-controlled study, five bilateral breast patients' clinical proton plan datasets were anonymized and replanned using VMAT. Additionally, for one patient with bilateral expanders, we compared two PBS planning techniques that are used clinically.</p><p><strong>Results: </strong>For the similar target volume coverage, significant differences were found for heart and lung sparing, particularly for lower isodoses. For instance, mean lung V5 was 96.7% <i>vs.</i> 39% for VMAT <i>vs.</i> PBS and mean heart dose was 11.4 <i>vs.</i> 0.69 Gy (RBE) for VMAT <i>vs.</i> protons. The expander patient's plan did not differ significantly from whole breast or chest wall patients in terms of coverage or in gains from PBS compared to VMAT. For example, for comparable homogeneity indexes (HIs) of 1.2 (VMAT) and 1.1 (PBS), the mean heart dose is 11 <i>vs.</i> 1 Gy. The gains from PBS are approximately a factor of 10 compared to a factor of <2 for estimated gains to VMAT plans using deep inspiration breath hold (DIBH) described in the literature.</p><p><strong>Conclusions: </strong>PBS provides better sparing of heart and lungs compared to VMAT in whole breast, chest wall and expander patients. Further study with more patients is required to validate these conclusions.</p>","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":"7 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802479","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":"Total scalp irradiation using pencil beam scanning proton therapy for dermatofibrosarcoma protuberans: case study and photon dosimetric comparison-a case report.","authors":"Sheng Huang, Erika Jang, Haibo Lin, Chin-Cheng Chen, Shaakir Hasan, J Isabelle Choi, Arpit M Chhabra, Charles B Simone, Robert H Press","doi":"10.21037/tro-22-20","DOIUrl":"10.21037/tro-22-20","url":null,"abstract":"<p><strong>Background: </strong>This report describes a patient with extensive dermatofibrosarcoma protuberans of the scalp treated with a technically challenging total scalp irradiation (TSI) plan using intensity-modulated proton therapy (IMPT).</p><p><strong>Case description: </strong>A 33-year-old female presented with a rapidly progressive extensive scalp lesion status post wide local excision with rotational flap reconstruction. Pathology identified diffuse positive margins and high-risk features. A 4-field multi-field-optimized IMPT plan was generated and planned to deliver 6,000 cGy in 30 fractions robustly optimized using 3 mm setup and 3.5% range uncertainty. A volumetric-modulated arc radiotherapy (VMAT) plan matched for target coverage was generated for comparison purposes. The patient successfully completed treatment and remains without evidence of disease at 9 months. IMPT achieved acceptable target coverage with adequate dose homogeneity and robustness. Optimal treatment planning utilized noncoplanar fields, overlapping field dose gradients, and Monte Carlo dose calculations. Organs at risks (OARs) doses with IMPT were significantly reduced compared to VMAT, particularly for the normal brain, hippocampus, pituitary gland, cochlea, and optic structures.</p><p><strong>Conclusions: </strong>TSI using IMPT is dosimetrically favorable with unique technical considerations. It achieves dramatic dose sparing to critical OARs compared to modern photon techniques and should be considered when irradiation of an extensive scalp volume is indicated to reduce the long-term toxicity risk of unintentional integral dose.</p>","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":"7 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842429","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":"Long term-control via successful salvage therapy with cytoreductive surgery, chemotherapy, and radiotherapy for recurrence with intraperitoneal carcinomatosis of synchronous advanced ovarian and endometrial cancer: a case report","authors":"Shih-Min Lin, Yun-Hsin Tang","doi":"10.21037/tro-22-35","DOIUrl":"https://doi.org/10.21037/tro-22-35","url":null,"abstract":"","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48910312","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":"Prophylactic single fraction radiotherapy for the prevention of pathologic femoral fractures","authors":"A. N. Ewongwo, T. Skrepnik, Brady B. Laughlin, Hitendra R. H. Patel, K. Howell, U. Goyal","doi":"10.21037/tro-22-40","DOIUrl":"https://doi.org/10.21037/tro-22-40","url":null,"abstract":"","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42495395","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":"Analyses of treatment outcomes in advanced vulvar cancer: treated with postoperative radiotherapy or definitive radiotherapy/ chemoradiotherapy","authors":"Hao-shen Cheng, L. Wang, Chien-Hsing Lu","doi":"10.21037/tro-22-28","DOIUrl":"https://doi.org/10.21037/tro-22-28","url":null,"abstract":"","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":"61 9-10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41294343","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":"Editorial: Prophylactic single fraction radiotherapy for the prevention of pathologic femoral fractures","authors":"C. McLaughlin","doi":"10.21037/tro-23-7","DOIUrl":"https://doi.org/10.21037/tro-23-7","url":null,"abstract":"","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46565555","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":"The impact of a mono-institutional experience in lung metastases treated with stereotactic body radiation therapy (SBRT): a retrospective analysis","authors":"Luca Capone, Sara Antonia Allegretta, F. Bianciardi, B. Tolu, F. Rea, M. Giraffa, V. Confaloni, G. Raza, C. D’ambrosio, F. Cavallo, D. Marchesano, G. Grimaldi, Randa El Gahwary, Elisa Cinelli, G. Minniti, P. Gentile","doi":"10.21037/tro-21-45","DOIUrl":"https://doi.org/10.21037/tro-21-45","url":null,"abstract":"","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45773818","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":"Childhood medulloblastoma in Morocco (middle-income country): therapeutic outcomes and survival","authors":"M. Jaafari, R. Razine, A. E. Haroun, Z. Tahiri, L. Hessissen","doi":"10.21037/tro-22-39","DOIUrl":"https://doi.org/10.21037/tro-22-39","url":null,"abstract":"","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49065243","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":"Dose escalation not improving outcome in esophageal cancer—still far from conclusive","authors":"Yun-Hsuan Lin, Shih-Yu Huang, S. Chou, Tzu-Ting Huang, Yu-Ming Wang","doi":"10.21037/tro-21-23","DOIUrl":"https://doi.org/10.21037/tro-21-23","url":null,"abstract":"","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48318225","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":"The risk of cardiovascular toxicity caused by cancer radiotherapy—a narrative review","authors":"Dai-Wei Liu, Yen-Rong Fu, Shu-Hsin Liu, M. Chen, Ren-Jun Hsu, W. Hsu","doi":"10.21037/tro-21-34","DOIUrl":"https://doi.org/10.21037/tro-21-34","url":null,"abstract":"","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47366402","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}