Robust Proton Treatment Planning: Physical and Biological Optimization

Accurate prediction of tumor control and toxicities in radiation therapy faces many uncertainties. Besides interpatient variability in the response to radiation, there are also dosimetric uncertainties, that is, differences between the dose displayed in a treatment planning system and the dose actually delivered to the patient. These uncertainties originate from several sources including imperfect knowledge of the patient geometry, approximation in the physics of radiation interaction with tissues, and uncertainties in the biological effectiveness of radiation.
Source: Seminars in Radiation Oncology - Category: Cancer & Oncology Authors: Source Type: research

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AbstractWhole brain irradiation (WBI, also known as whole brain radiation therapy or WBRT) is a mainstream therapy for patients with identifiable brain metastases and as a prophylaxis for microscopic malignancies. WBI accelerates brain aging, causing progressive cognitive dysfunction in ~  50% of surviving patients, thus compromising quality of life. The mechanisms responsible for this WBI side effect remain obscure, and there are no effective treatments or prevention strategies. Here, we test the hypothesis that WBI induces astrocyte senescence, which contributes to impaired astro cytic neurovascular coupling (NVC)...
Source: AGE - Category: Geriatrics Source Type: research
Adjuvant radiation therapy decreases breast cancer mortality.1 Recent rotational techniques, such as volumetric modulated arc therapy (VMAT) and helical tomotherapy, additionally spare the heart.2,3 Hypofractionated breast rotational intensity modulated radiation therapy (IMRT) was well tolerated in prospective trials,4-6 but follow-up is insufficient and late cardiotoxicity remains unclear. With this in mind, we compared corrected mean doses to cardiac substructure between hypo- and normofractionated breast rotational IMRT.
Source: International Journal of Radiation Oncology * Biology * Physics - Category: Radiology Authors: Tags: Brief Report Source Type: research
AbstractIntroductionWhile the current standard of care after maximal safe resection for glioblastoma (GBM) is concomitant radiation and chemotherapy, the ideal therapy for patients with poor performance status remains in question due to concerns about treatment tolerance. We sought to evaluate an alternative regimen, sequential radiation and chemotherapy, to assess its efficacy as a treatment option for poorly performing patients.MethodsWe performed a retrospective analysis using the 2015 National Cancer Database in which the survival of patients with a KPS  ≤ 70 who received sequential radiation and chemo...
Source: Journal of Neuro-Oncology - Category: Cancer & Oncology Source Type: research
Publication date: Available online 18 January 2020Source: Seminars in Cancer BiologyAuthor(s): Zhenchang Wang, Kangkang Zhi, Zhongyang Ding, Yi Sun, Shuang Li, Manyuan Li, Kefeng Pu, Jun ZouAbstractCancer has thwarted as a major health problem affecting the global population. With an alarming increase in the patient population suffering from diverse varieties of cancers, the global demographic data predicts sharp escalation in the number of cancer patients. This can be expected to reach 420 million cases by 2025. Among the diverse types of cancers, the most frequently diagnosed cancers are the breast, colorectal, prostate ...
Source: Seminars in Cancer Biology - Category: Cancer & Oncology Source Type: research
ConclusionsThe review of the benchmark and rapid review QA submissions indicates that acceptable variations or unacceptable deviations for the ipsilateral lung and heart dose constraints were the most commonly observed cause of benchmark QA failure, and unacceptable deviations in target contouring, rather than normal structure contouring, were the most common cause of rapid review QA failure. These findings suggest that a rigorous QA process is necessary for high quality and homogeneity in radiation therapy in multi-institutional trials of breast cancer to ensure that the benefits of radiation therapy far outweigh the risks.
Source: Practical Radiation Oncology - Category: Cancer & Oncology Source Type: research
Publication date: Available online 10 December 2019Source: Practical Radiation OncologyAuthor(s): Stephanie M. Ntoukas, Tatiana Ritchie, Susan Awrey, David C. Hodgson, Normand Laperriere, Ryan Yee, Vijay Ramaswamy, Barbara-Ann Millar, Nathan Becker, Derek S. TsangAbstractPurposeAt our institution, a multifaceted approach is used to reduce general anesthetic (GA) use for children receiving photon radiation therapy (RT) as standard-of-care treatment. The purpose of this study was to evaluate the effectiveness of our methods.Methods and MaterialsPatients treated as part of the pediatric radiation therapy program from 2010 to ...
Source: Practical Radiation Oncology - Category: Cancer & Oncology Source Type: research
Publication date: Available online 16 January 2020Source: Journal of Clinical NeuroscienceAuthor(s): Frances Anne McHugh, Chien Yew Kow, Anthony Falkov, Peter Heppner, Andrew Law, Ari Bok, Patrick SchwederAbstractNew Zealand has one of the highest rates of melanoma in the world. In up to 10% of cases, the disease is metastatic at diagnosis. Cerebral metastatic involvement carries a particularly poor prognosis. 110 patients were included in the analysis. A retrospective consecutive series of patients treated surgically at Auckland City Hospital were studied, with parameters of demographics, tumour characteristics, surgery, ...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
Thermoplastic medical devices used during patient therapy have been shown to harbor microbes, including those causing healthcare –associated infections (HAI). This issue has not been previously evaluated for immobilization forms used during radiation therapy. The present study addresses this matter by sampling immobilization forms used during patient treatment to see if any microbes could be similarly recovered.
Source: Journal of Medical Imaging and Radiation Sciences - Category: Radiology Authors: Tags: Research Article Source Type: research
ConclusionThe autologous fascial wrap technique is efficient and easy to harvest, with comparable clinical outcomes to other techniques. The medium-term results have been encouraging, but longer-term follow up is needed.
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research
Interview with Trevor J. Royce, MD MS MPH, author of Analysis of Price Transparency via National Cancer Institute–Designated Cancer Centers’ Chargemasters for Prostate Cancer Radiation Therapy
Source: JAMA Specialty Journals Author Interviews - Category: General Medicine Authors: Source Type: podcasts
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