Should IMRT Be the New Standard in Esophageal Cancer?

This video discusses the use of intensity-modulated radiation therapy and whether it should be the new standard for treating patients with esophageal cancer.
Source: CancerNetwork - Category: Cancer & Oncology Authors: Tags: Videos Gastrointestinal Cancers Source Type: news

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Conclusion: IMRT-based CCRT resulted in higher survival rates in patients with advanced clinical stages of TESCC (i.e., IIIA–IIIC), namely, clinical T3, clinical T4, or lymph node involvement.
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Article Source Type: research
Proton Beam Therapy (PBT) is dosimetrically superior to Intensity Modulated Radiation Therapy (IMRT) in sparing critical organs in esophageal cancer (EC) patients (pts) treated with chemoradiation therapy (CRT). The extent to which better dosimetry translates into clinical benefit is not well established. We conducted a randomized trial to compare PBT to IMRT in terms of total toxicity burden (TTB) and progression free survival (PFS) time.
Source: International Journal of Radiation Oncology * Biology * Physics - Category: Radiology Authors: Source Type: research
Proton therapy has an important role in the management of head and neck cancer, where the dosimetric characteristics of proton particles are advantageous for treating tumors in complex anatomic areas. In addition to highly targeted dose depositions owing to the Bragg peak and superior lateral dose distribution of proton therapy, the introduction of spot-scanning techniques that allow intensity-modulated proton therapy (IMPT) further improve dose distributions and normal-tissue sparing relative to intensity-modulated (photon) radiation therapy (IMRT), a finding that has been validated in case-matched analyses showing lower ...
Source: Radiotherapy and Oncology - Category: Radiology Authors: Tags: Original Article Source Type: research
Conditions:   Esophagus Cancer;   Esophageal Cancer;   Cancer of the Esophagus Interventions:   Radiation: Intensity Modulated Radiation Therapy;   Drug: FOLFOX regimen;   Other: MD Anderson Symptom Inventory (MDASI)-Plus module;   Other: EuroQol (EQ-5D);   Other: SF-12;   Other: MOS Social Support Measure;   Other: CES-D;   Procedure: Blood for ctDNA;   Procedure:  Urine for ctDNA;   Procedure: Blood for SCCA Sponsor: &n...
Source: - Category: Research Source Type: clinical trials
Publication date: Available online 2 August 2019Source: Practical Radiation OncologyAuthor(s): Robert T. Dess, Yilun Sun, Daniel G. Muenz, Peter A. Paximadis, Michael M. Dominello, Inga S. Grills, Larry L. Kestin, Benjamin Movsas, Kathryn J. Masi, Martha M. Matuszak, Jeffrey D. Radawski, Jean M. Moran, Lori J. Pierce, James A. Hayman, Matthew J. Schipper, Shruti Jolly, Michigan Radiation Oncology Quality ConsortiumAbstractPurposeThe heart has been identified as a potential significant organ at risk in patients with locally-advanced non-small cell lung cancer (NSCLC) treated with radiation. Practice patterns and radiation d...
Source: Practical Radiation Oncology - Category: Cancer & Oncology Source Type: research
We performed a benchmark case procedure as part of a quality assurance procedure of the ongoing XXX trial assessing dose escalated radiation therapy in oesophageal cancer. Inconsistencies in delineating target and OARs volumes were found. Only one third of the plans were protocol compliant. The majority of deviations were minor and involved the CTVs cranio-caudal margins and dose constraints to the heart. More plans were accepted when IMRT was performed.
Source: International Journal of Radiation Oncology * Biology * Physics - Category: Radiology Authors: Source Type: research
This study is a prospective, multi-center, open, single-arm clinical trial designed to enroll 27 patients with locally recurrent ESCC after radiotherapy with or without chemotherapy. Re-irradiation will be performed using intensity modulated radiation therapy in 50 Gy/25 fractions. The strategy of PLDR includes dividing 2 Gy into 10 fractions, and administering each irradiating dose of 20 cGy at an interval of 3 minutes before the next low-dose irradiation. The actual dose rate of administration each time will be 16.67 cGy /minute. The primary endpoint in this study is the rate of esophageal perforation. The secondary endp...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research
Abstract Purpose: To analyze associations between heart and lung dose and overall survival (OS) in patients with esophageal cancer who received concurrent chemo-radiotherapy (CCRT) with or without surgery. Patients and methods: Patients received intensity-modulated radiation therapy (median dose 50.4 Gy) from 2004 through 2016. Cutoff points for continuous variables were calculated using the method of Contal and O'Quigley. Kaplan-Meier method with log-rank tests was used to calculate survival. OS was analyzed with both univariate and multivariable Cox models. Results: In all, 560 patients were analyzed...
Source: Clinical Lung Cancer - Category: Cancer & Oncology Authors: Tags: Clin Transl Radiat Oncol Source Type: research
Conclusions: To cover 94.5% of ESCC subclinical lesions in the CTVp, a 3-cm margin along the cranial-caudal axis should be added to the primary gross tumor volume as defined by FDG-PET/CT, as well as a cutoff SUVmax value of 2.5. Although preoperative FDG PET/CT images may not reveal lesions directly, the SUVmax and MTV measurements together could predict their presence. Background Esophageal carcinoma often occurs as squamous cell carcinoma (ESCC), a highly aggressive malignancy with a poor prognosis worldwide. The incidence rates of ESCC are particularly high in China (1). Most patients with ESCC have locally adv...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Viacheslav Soyfer1* and Benjamin W. Corn2 1Tel Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel 2Shaare Zedek Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel Outcomes for patients with locally-advanced Non Small Cell Lung Cancer (NSCLC) remain poor. In the context of definitive (as opposed to neoadjuvant) treatment, radiation oncologists have traditionally embraced dose escalation as a means to improve control of the primary tumor as well as draining nodal regions for this clinical problem. Yet we wonder: is it optimal—or even rational—to treat the primary and the medi...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
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