Simultaneous tumor and surrogate motion tracking with dynamic MRI for radiation therapy planning.

In this study, we propose a method to simultaneously track the lung tumor and external surrogates to evaluate their spatial correlation in a quantitative way using dynamic MRI, which allows real-time acquisition without ionizing radiation exposure. To capture the lung and whole tumor, four MRI-compatible fiducials are placed on the patient's chest and upper abdomen. Two different types of acquisitions are performed in the sagittal orientation including multi-slice 2D cine MRIs to reconstruct 4D-MRI and two-slice 2D cine MRIs to simultaneously track the tumor and fiducials. A phase-binned 4D-MRI is first reconstructed from multi-slice MR images using body area as a respiratory surrogate and groupwise registration. The 4D-MRI provides 3D template volumes for different breathing phases. 3D tumor position is calculated by 3D-2D template matching in which 3D tumor templates in the 4D-MRI reconstruction and the 2D cine MRIs from the two-slice tracking dataset are registered. 3D trajectories of the external surrogates are derived via matching a 3D geometrical model of the fiducials to their segmentations on the 2D cine MRIs. We tested our method on ten lung cancer patients. Using a correlation analysis, the 3D tumor trajectory demonstrates a noticeable phase mismatch and significant cycle-to-cycle motion variation, while the external surrogate was not sensitive enough to capture such variations. Additionally, there was significant phase mismatch between surrogate signals obtained fr...
Source: Physics in Medicine and Biology - Category: Physics Authors: Tags: Phys Med Biol Source Type: research

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ConclusionsIn both investigated cohorts,VioS successfully linked shape morphology to patient survival.
Source: Journal of Cancer Research and Clinical Oncology - Category: Cancer & Oncology Source Type: research
Abstract Background: Patients with unresectable locally advanced NSCLC who refuse or are not candidates for chemotherapy often receive radiation therapy (RT) alone. Hypofractionated RT (HFRT) regimens are becoming increasingly common. An analysis of the National Cancer Database (NCDB) was performed to evaluate the practice patterns and outcomes of HFRT vs. conventionally fractionated RT (CFRT) in patients with stage III NSCLC undergoing definitive RT alone. Material and methods: The NCDB was queried for all patients with stage III NSCLC diagnosed between 2004 and 2014 who received RT alone. CFRT was defined as pat...
Source: Acta Oncologica - Category: Cancer & Oncology Authors: Tags: Acta Oncol Source Type: research
We report our prospectively collected toxicity and efficacy data.
Source: Clinical Oncology - Category: Radiology Authors: Tags: Original Article Source Type: research
CONCLUSIONS: This study confirms the activity and safety of SBRT in patients with MPR-OC and identifies clinical and treatment parameters able to predict CR and LC rate. IMPLICATIONS FOR PRACTICE: This study aimed to define activity and safety of stereotactic body radiotherapy (SBRT) in a very large, real life data set of patients with metastatic, persistent, recurrent ovarian cancer (MPR-OC). Patient age 25 Gy were associated with better local control (LC) rate. Mild toxicity was experienced in 20.7% of patients. In conclusion, this study confirms the activity and safety of SBRT in MPR-OC patients and identifies clin...
Source: The Oncologist - Category: Cancer & Oncology Authors: Tags: Oncologist Source Type: research
Abstract OBJECTIVES: To compare patterns and understand drivers of spending and utilization by month in the last 6 months of life between patients with lung cancer who used hospice versus those who did not. STUDY DESIGN: Retrospective cohort analysis using 2009 to 2013 Medicare claims. METHODS: We used a 10% random sample of Medicare fee-for-service beneficiaries with lung cancer who died between 2010 and 2013 (43 789 beneficiaries). Patients were assigned to 2 groups depending on whether they used hospice care in the last 6 months of life. The following outcomes were constructed by month: (1) all-cause ...
Source: The American Journal of Hospice and Palliative Care - Category: Palliative Care Authors: Tags: Am J Hosp Palliat Care Source Type: research
Conclusions: Use of acute-care services and rates of death in an acute-care facility are both high for lung cancer patients approaching end of life. In our study, interprofessional and patient-provider communication, earlier connection to homecare services, and improved access to community care were highlighted as having the potential to lower the need for acute-care resources. PMID: 31548804 [PubMed - in process]
Source: Current Oncology - Category: Cancer & Oncology Tags: Curr Oncol Source Type: research
This study aimed to investigate an improved setup protocol for maintaining patient setup accuracy, with minimal or no use of image-guided radiation therapy in conventional radiotherapy for lung cancer. A coordinate value for the treatment couch in the anterior –posterior (AP) direction was obtained from the first fraction using bony anatomy image guidance. The coordinate value was invariably used for patient positioning in the second and subsequent treatment fractions. The errors of 2410 setup image sets (anterior and lateral) from 105 patients with lun g cancer were analyzed. The systematic and random patient positi...
Source: Radiological Physics and Technology - Category: Physics Source Type: research
Nature Reviews Clinical Oncology, Published online: 20 September 2019; doi:10.1038/s41571-019-0277-2In the past few years, efforts have been made to combine two approaches — immune-checkpoint inhibition and locally ablative radiation therapy — to treat patients with metastatic non-small-cell lung cancer. Herein we discuss the implications of two studies that support the existence of a systemic therapy augmented by radiotherapy (STAR) effect in this setting.
Source: Nature Reviews Clinical Oncology - Category: Cancer & Oncology Authors: Source Type: research
Up till now, lung cancer remains as the leading cause of cancer-related mortality worldwide. According to the latest statistical report, there are 2.1  million new lung cancer cases and 1.8 million deaths predicted globally in 2018, nearly close to 1 in 5 (18.4%) of all cancer deaths [1]. China is among the countries with the highest lung cancer rates (above 40 per 100,000). For lung cancer patients, radiotherapy (RT) with or without chemother apy remains to be the fundamental treatment. However, the efficacy of radiotherapy is restrained due to a series of RT-related complications that result in patients’ intolerance.
Source: Radiotherapy and Oncology - Category: Radiology Authors: Tags: Original Article Source Type: research
CONCLUSION: IL4: rs2243250 was validated to be significantly related to RP of grade ≥3 in our cohort. Our results further emphasized the prevalence and clinical value of IL4: rs2243250 on RP, and may thus be one of the important predictors of severe RP before radiotherapy. PMID: 31540745 [PubMed - as supplied by publisher]
Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology - Category: Radiology Authors: Tags: Radiother Oncol Source Type: research
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