{"title":"Integrated radiomic model for predicting the prognosis of esophageal squamous cell carcinoma patients undergoing neoadjuvant chemoradiation","authors":"T. Hou, Wen-Chien Huang, H. Tai, Yu-Jen Chen","doi":"10.21037/TRO.2019.07.03","DOIUrl":"https://doi.org/10.21037/TRO.2019.07.03","url":null,"abstract":"Background: To establish a feasible prediction model for prognoses of esophageal squamous cell carcinoma (ESCC) patients undergoing neoadjuvant concomitant chemoradiation (NACCRT). \u0000 Methods: Post-chemoradiation computed tomography (CT) radiomics features and clinical parameters were investigated. CT images from advanced thoracic ESCC patients treated with NACCRT and esophagectomy were extracted for radiomics features. Least absolute shrinkage and selection operator regression were used to select features and build signatures. Radiomics signatures and clinical factors were integrated into Cox regression analysis for prognosis; the prediction model’s performance was examined via receiver-operating characteristic (ROC) curve analysis. \u0000 Results: A total of 46 radiomics features and 25 clinical parameters were extracted from 62 cases, of which 59 passed image processing and became eligible for model testing. Eight selected radiomics features showed good prediction power [area under the curve (AUC) =0.851] and reliability in predicting pathological complete response (pCR). The radiomics signature and clinical parameter combination model showed increased prediction power of radiomics signature alone for local regional failure (LRF) (AUC=0.804) and distant failure (DF) (AUC=0.754). Following were the strongest contributors of prediction power for prognostic endpoints: (I) resection status multiplied by long-run emphasis in grey-level run length matrix (GLRLM_LRE) for progression (hazard ratio=8.776); (II) non-uniformity of the grey-levels (GLRLM_GLNU) (hazard ratio=6.888); and (III) sphericity (hazard ratio=0.152) for overall survival (OS). \u0000 Conclusions: The integrated prediction model for prognosis may aid clinicians in decision making regarding post-operative adjuvant therapy for ESCC patients undergoing NACCRT.","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/TRO.2019.07.03","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47088685","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":"Solitary plasmacytoma of bone over sacrum: a case report","authors":"Hsin-Lin Chen, Y. Chou, Yueh-Chun Lee, H. Tseng","doi":"10.21037/TRO.2019.02.04","DOIUrl":"https://doi.org/10.21037/TRO.2019.02.04","url":null,"abstract":"Solitary plasmacytoma of bone (SPB), also called osseous plasmacytoma, is more common in males than in females with an estimated ratio of 2:1. The median age of SPB patients is approximately 55 years. Localized radiation therapy is the first-line treatment to avoid progression to multiple myeloma. A 46-year-old man visited our hospital due to lower back pain radiating to his lower limbs for 3 months. L-spine MRI showed S2 to S4 bone erosion with a large (8.8×6.2 centimeter) tumor over sacrum. Following partial tumor removal, pathology showed plasmacytoma. Adjuvant radiotherapy with 50 Gy in 25 fractions was administered to the gross tumor based on volumetric modulated arc therapy (VMAT). No adjuvant chemotherapy was given. Pelvic CT was arranged every 3 months during 24-month follow-up. There was no distant metastasis or newly diagnosed multiple myeloma during the follow-up period.","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/TRO.2019.02.04","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44612614","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":"Predicting survival with the Heidelberg prognostic model after salvage radiosurgery of previously irradiated progressive high-grade gliomas","authors":"F. Ampil, T. Richards, N. Cruz, G. Caldito","doi":"10.21037/TRO.2019.02.02","DOIUrl":"https://doi.org/10.21037/TRO.2019.02.02","url":null,"abstract":"The study aimed to determine which patients with previously irradiated progressive high-grade gliomas (PHGG) are likely to benefit from salvage stereotactic radiosurgery (SSRS) using the Heidelberg prognostication model (HPM). Twenty-five study participants with PHGG underwent SSRS between 2000 and 2010. There were 5 and 20 patients with determined low or high HPM prognostic scores, respectively. Overall median survival (MS) was 7 months (range, 1 to 32 months). The 6-, 12- and 24-month crude survival rates (CSR) were 60%, 28% and 16%, respectively. The MS and CSRs for the low-scoring patients were 20 months, 100%, 100% and 20%, respectively; for the 20 individuals with higher scores, the corresponding findings were 8 months, 75%, 35% and 10%, respectively. Among the evaluable 11 patients, the quality of remaining life after therapy was acceptable in approximately half of the cases. Acute and late toxicity were not observed in the retreated subjects. A trend towards improved survival, even if not statistically significant, was observed in the low HPM scoring patients. More documentation of favorable effects from the application of SSRS in people with PHGG is required to support its useful role as a second line treatment.","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/TRO.2019.02.02","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41460945","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":"Application of the CARE guideline as reporting standard in the Therapeutic Radiology and Oncology","authors":"","doi":"10.21037/tro.2019.11.02","DOIUrl":"https://doi.org/10.21037/tro.2019.11.02","url":null,"abstract":"","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67572975","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}
Juei-Shan Chang, H. Tai, Ching-Jung Wu, K. Hua, Yu-Jen Chen
{"title":"Active contouring and 3D model deformable registration of radiotherapy planning and cone-beam computed tomography images","authors":"Juei-Shan Chang, H. Tai, Ching-Jung Wu, K. Hua, Yu-Jen Chen","doi":"10.21037/tro.2019.07.06","DOIUrl":"https://doi.org/10.21037/tro.2019.07.06","url":null,"abstract":"Background: To ensure high accuracy during radiation therapy (RT), the image-guided RT (IGRT) technique uses on-board cone-beam computed tomography (CBCT) scanning as an image guidance procedure for target localization before and during treatment. Adaptive RT aiming to modify RT target volumes according to kinetic changes in tumor shape during RT course is based on registration of CBCT and planning CT images. However, the re-contouring and re-planning procedures are extensively time and cost consuming. We developed a novel automatic contouring and image registration method to replace the manual re-contouring with accurate image registration. Methods: For the image sets with format of Digital Imaging and Communications in Medicine (DICOM) standard, we wrote a program in MATLAB language (Version R2016a) to read and convert CBCT images into cross-sectional (tomographic) images similar to those obtained via planning CT. For image enhancement, the active contouring by using Chan-Vese model with level set formulation was applied. To overcome the variations in spatial location of these two sets of CT images, the iterative closest point (ICP) algorithm was used for 3D model registration. The deformable image registration (DIR) with Double force Demons algorithm was performed for auto-transformation of contours from planning CT to CBCT images. Results: The customized program accurately converted the format of CBCT to planning CT. Image enhancement was achieved by our modified active contour model which solved the energy minimization problem. In 3D model registration, the variations in spatial location of the CBCT and planning CT images were corrected. After selection of most similar images, the planning CT images were registered to corresponding CBCT images. The registered images were clearer than CBCT images with removal of other confounding structures outside body contours. Conclusions: The planning CT and CBCT images could be precisely registered by using a novel established technique consisting of active contouring with 3D model and DIR. This technique would enable the on-line radiation treatment planning for adaptive radiotherapy.","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45370156","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}
A. Schwint, M. A. Garabalino, A. M. Hughes, E. C. Pozzi, E. Heber, M. Palmieri, V. Trivillin
{"title":"Teachings of our translational studies on boron neutron capture therapy (BNCT): thinking “outside the box”","authors":"A. Schwint, M. A. Garabalino, A. M. Hughes, E. C. Pozzi, E. Heber, M. Palmieri, V. Trivillin","doi":"10.21037/TRO.2019.05.03","DOIUrl":"https://doi.org/10.21037/TRO.2019.05.03","url":null,"abstract":"BNCT is a technique for the treatment of solid tumors. BNCT is considered a binary technique because it involves two components that exert little or no action individually but induce a significant effect when they combine. BNCT is based on the combination of neutron irradiation and the administration of 10 B compounds that are incorporated selectively by tumor tissue via different mechanisms, depending on the boron carrier.","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/TRO.2019.05.03","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44862974","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 comparison of spatial resolution of ion chamber, diode, and EBT3 film based on the dose profile","authors":"Han-Ping Hsueh, S. Yeh, Liyun Chang","doi":"10.21037/tro.2019.09.02","DOIUrl":"https://doi.org/10.21037/tro.2019.09.02","url":null,"abstract":"Background: It is essential for the physicist to quantify the dose of the radiation prior and during cancer treatment to ensure proper execution of the treatment plan. The most common way to measure the dose is utilizing Farmer chamber. The limitation of Farmer chamber is that it only provides dose of a specific point, while the beam dose profile is needed for the planning system. The Gafchromic EBT3 film can provide a quantitative dose profile in a 2D space. The EBT3 film has low energy dependence, similar effective atomic number to water, and self-developing; making it an ideal candidate for dose profile measurement. \u0000 Methods: Dose profiles of EBT3 was measured, analyzed and compared to semiflex chamber and EDGE detector under same conditions. The EBT3 films were placed at the center of RW3 water phantom (30×30×30 cm 3 ) under flattening filter free (FFF) Mode of Linac. The EBT3 films were calibrated by additional RW3 with a Farmer chamber under the stacked RW3 water phantom. Percentage depth dose (PDD) and Matlab were used to fit the dose curve of EBT3 and the results are presented. \u0000 Results: The penumbra of the measured dose profile through EBT3 film demonstrated little differences when comparing with that of the EDGE detector and noticeable differences when compared to that of the semiflex chamber. For a field size of 2×2 cm 2 , (b=0.08, depth of 5 cm, beam off central axis 0.8 cm), the measured difference of dose profile between EBT3 and EDGE detector is –2.24%. Under the same conditions, the dose profile difference between EBT3 and semiflex chamber is 10.59%. \u0000 Conclusions: This study shows that EDGE detector has the highest spatial resolution to the dose profile. EBT3 film in combination with solid phantom can quickly sample dose profile in 2D. EBT3 film can be considered to be an excellent quality assurance (QA) tool with accurate dosimetry, a good spatial resolution and tolerable dose uncertainty.","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/tro.2019.09.02","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46657531","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":"Minimal late effects of stereotactic body radiation therapy for spine metastases years post treatment","authors":"S. Chao, M. Naik","doi":"10.21037/tro.2019.09.03","DOIUrl":"https://doi.org/10.21037/tro.2019.09.03","url":null,"abstract":"Stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) delivers high doses of radiation in 5 or fewer sessions or fractions. To do this safely, inherently it has to minimize dose to the surrounding normal tissue through very conformal and accurate delivery which have been developed and refined over the last decade.","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/tro.2019.09.03","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43956493","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":"Key immune system markers in immunotherapy: absolute lymphocyte count, neutrophil to lymphocyte ratio, and alternative immune system metrics","authors":"V. Chen, B. Greenberger, James M. Taylor, B. Lu","doi":"10.21037/tro.2019.09.01","DOIUrl":"https://doi.org/10.21037/tro.2019.09.01","url":null,"abstract":"Immunotherapy is an increasingly popular therapeutic strategy in modern cancer care, with significant research and development invested in optimizing its application in combination with existing modalities, including radiation therapy.","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/tro.2019.09.01","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41737161","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":"Radiotherapy of malignant pheochromocytoma—a case report","authors":"C. Yeh","doi":"10.21037/tro.2019.08.02","DOIUrl":"https://doi.org/10.21037/tro.2019.08.02","url":null,"abstract":"Pheochromocytomas (PCC) are rare tumors with an estimated incidence of 0.4 to 9.5 cases per 1 million per year. About 5–26% of PCC are malignant and presents with metastasis, for which there is currently no effective therapy. The treatment of choice is for PCC is radical surgery to reduce tumor burden, to provide symptomatic relief of catecholamine excess although complete eradication of the lesions is often not feasible. A number of case reports have been published on the role of radiotherapy for the treatment of PCC. Here we present a 53-year-old male stage III malignant PCC patient who received postoperative adjuvant radiotherapy. A review of current literature is also presented.","PeriodicalId":93236,"journal":{"name":"Therapeutic radiology and oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46355176","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}