Salvage brachytherapy as a modern reirradiation technique for local cancer failure: The Phoenix is reborn from its ashes.

Salvage brachytherapy as a modern reirradiation technique for local cancer failure: The Phoenix is reborn from its ashes. Cancer Radiother. 2018 May 30;: Authors: Quivrin M, Peignaux-Casasnovas K, Martin É, Rouffiac M, Thibouw D, Chevalier C, Vulquin N, Aubignac L, Truc G, Créhange G Abstract The treatment of local recurrence of a previously irradiated cancer or a second cancer arising in-field remains challenging. Ultimately, the objective of salvage therapy is to control disease while ensuring minimal collateral damage, thereby optimizing both cancer and toxicity outcomes. Reirradiation has historically been associated with unacceptable toxicity and a limited benefit. Brachytherapy offers the best dose distribution and a high radiation dose to the target volume while better protecting surrounding previously irradiated healthy tissues. The management of local cancer recurrence in irradiated areas should be planned through multidisciplinary discussions and patients should be selected carefully. This overview of the literature describes brachytherapy as a reirradiation treatment in local recurrences of previously irradiated prostate, breast, head and neck and rectal cancers, or second primary cancers occurring in-field. For these cancers, the prognosis and therapeutic challenges are quite different and depend on the type of primary cancer. However, current data confirm that brachytherapy reirradiation is feasible and has acceptable toxicity....
Source: Cancer Radiotherapie - Category: Cancer & Oncology Authors: Tags: Cancer Radiother Source Type: research

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CONCLUSIONS: Dosimetric indices of RapidPlan model-based plans appear to be comparable to the ones based on clinical plans regardless of energies, MLC types, and disease sites. The results suggest that the RapidPlan model can generate treatment plans independent of the type of treatment machine.PMID:34151503 | DOI:10.1002/acm2.13316
Source: Journal of Applied Clinical Medical Physics - Category: Physics Authors: Source Type: research
CONCLUSION: The new autoplanning system was able to produce high-quality plans for four highly different planning protocols/treatment sites with a total of 194 patients investigated.PMID:33711413 | DOI:10.1016/j.radonc.2021.03.003
Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology - Category: Radiology Authors: Source Type: research
The presence or absence of lymph node metastases is a very important prognostic factor in patients with solid tumors. Current invasive and noninvasive diagnostic methods for N-staging like lymph node dissection, morphologic computed tomography/magnetic resonance imaging (MRI), or positron emission tomography–computed tomography have significant limitations because of technical, biological, or anatomical reasons. Therefore, there is a great clinical need for more precise, reliable, and noninvasive N-staging in patients with solid tumors. Using ultrasmall superparamagnetic particles of ironoxide (USPIO)-enhanced MRI of...
Source: Investigative Radiology - Category: Radiology Tags: Review Articles Source Type: research
warth D Abstract MR-guided radiotherapy requires novel QA methods for IMRT treatment plans (TPs). Here, an optimized method for TPs for a 1.5 T MR-linac was developed and implemented clinically. A static solid phantom and an MR-compatible 2D ionization chamber array were used. The array's response with respect to the incident beam gantry angles was characterized for four different orientations of the array relative to the beam. A lookup table was created identifying the optimum orientation for each gantry angle. For the QA of clinical MR-linac TPs, beams were grouped according to their gantry angles and measured w...
Source: Physics in Medicine and Biology - Category: Physics Authors: Tags: Phys Med Biol Source Type: research
ew D. Beggs Radiotherapy is routinely used as a neoadjuvant, adjuvant or palliative treatment in various cancers. There is significant variation in clinical response to radiotherapy with or without traditional chemotherapy. Patients with a good response to radiotherapy demonstrate better clinical outcomes universally across different cancers. The PI3K/AKT/mTOR pathway upregulation has been linked to radiotherapy resistance. We reviewed the current literature exploring the role of inhibiting targets along this pathway, in enhancing radiotherapy response. We identified several studies using in vitro cancer cell lines, in...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Review Source Type: research
ConclusionIFM 53BP1 foci analyses alone are not adequate to determine individual repair capacity after irradiation of PBLs, as a  DSB may be indicated by a 53BP1 focus but not every 53BP1 focus represents a DSB.
Source: Strahlentherapie und Onkologie - Category: Cancer & Oncology Source Type: research
Conclusions: This meta-analysis demonstrated that CD44 overexpression might be an unfavorable prognostic factor for CRC patients and could be used to predict poor differentiation, lymph node metastasis and distant metastasis. Introduction Although therapies for colorectal cancer (CRC) has improved in recent years, colorectal cancer is still the third most common cause of cancer related death worldwide (1). Metastasis are observed in 25% of patients at initial diagnosis and approximately 50% of patients will develop metastasis (2). Presently, the outcome prediction and the therapy schedule determination of CRC patie...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Conclusions: 3D-HDR-BT achieves favorable clinical outcomes with mild late toxicity in patients with locally rNPC. Introduction Nasopharyngeal carcinoma (NPC), a tumor of epithelial origin, is a malignant disease of the head and neck common in southern China, especially in Guangdong province (1). As a result of advances in modern imaging and irradiation techniques, the 5-year overall survival (OS) of patients with newly diagnosed NPC without metastasis has reached 75% after external beam radiotherapy (EBRT) in Asia (2, 3). However, local recurrence, which occurs in 18–40% of patients, remains a major reason for...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Conclusions: Catching errors prior to treatment is the only way to “chase zero” in radiation oncology. Various types of errors may exist in treatment plans and our GCPR model succeeds in preventing many errors of all shapes and sizes in target definition, dose prescriptions, and treatment plans from ever reaching the patients. Background and Introduction Since the release of the seminal report from the Institute of Medicine (IOM) titled, “To Err is Human,” in 1999, the importance of patient safety and avoiding medical errors have been recognized and endorsed by the physician community, as we...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Conclusions: The performance of AS AC generally increased as the population of the atlas library increased. However, the performance does not drastically vary in the larger atlas libraries in contrast to the logic that bigger atlas library should lead to better results. In fact, the results do not vary significantly toward the larger atlas library. It is necessary for the institutions to independently research the optimal number of subjects. Introduction Manual contouring of target and critical structures is resource intensive aspect of the radiotherapy planning process. In order to reduce time and workload imposed o...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
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