Applying Non-Homogeneous Dose Optimization to Improve Conventionally Fractionated Radiation Plan Quality in Patients with Non-Small Cell Lung Cancer

Publication date: Available online 25 June 2019Source: Practical Radiation OncologyAuthor(s): Sarah Z. Hazell, Russell K. Hales, William T. Hrinivich, Kristy Ford, Ken Kang-Hsin Wang, Todd R. McNutt, Peijin Han, Lori J. Anderson, Adam C. Ferro, Joseph Moore, Khinh Ranh VoongAbstractPurposeNonhomogeneous dose optimization (NHDO) is exploited in stereotactic body radiation therapy (SBRT) to increase dose delivery to the tumor and allow rapid dose falloff to surrounding normal tissues. We investigate changes in plan quality when NHDO is applied to inverse-planned conventionally fractionated radiation therapy (CF-RT) plans in patients with non-small cell lung cancer.Methods and MaterialsPatients with near-central non-small cell lung cancer treated with CF-RT in 2018 at a single institution were identified. CF-RT plans were replanned using NHDO techniques, including normalizing to a lower isodose line, while maintaining clinically acceptable normal tissue constraints and target coverage. Tumor control probabilities were calculated. We compared delivered CF-RT plans using homogenous dose optimization (HDO) versus NHDO using Wilcoxon signed-rank tests. Median values are reported.ResultsThirteen patients were replanned with NHDO techniques. Planning target volume coverage by the prescription dose was similar (NHDO = 96% vs HDO = 97%, P = .3). All normal-tissue dose constraints were met. NHDO plans were prescribed to a lower-prescription isodose line comp...
Source: Practical Radiation Oncology - Category: Cancer & Oncology Source Type: research

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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
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
Opinion statementNon-small cell lung cancer (NSCLC) accounts for 85% of new lung cancer cases and has 5-year survival rates ranging from 92% in early-stage disease to as low as 13% in locally advanced cases. Radiation therapy is a key component in the treatment repertoire for NSCLC, where it is currently used alone or in combinations with chemotherapy and surgery. Despite the broad use of modern photon radiation techniques, as many as 25% of patients experience isolated locoregional recurrences, and toxicity has been proven to be a limiting factor in many cases. Proton beam therapy (PBT) has emerged as a potential solution...
Source: Current Treatment Options in Oncology - Category: Cancer & Oncology Source Type: research
AbstractA systematic literature was performed to assess the benefit in terms of effectiveness and feasibility of hypofractionated radiotherapy (HypoRT), with or without chemotherapy (CT), in the treatment of locally advanced non-small cell lung cancer (NSCLC). We have identified all studies, published from 2007 onwards, on patients with locally advanced NSCLC treated with HypoRT with radical intent, with a minimal dose per fraction of 2.4  Gy, with or without concurrent chemotherapy. Twenty-nine studies were identified, for a total of 2614 patients. Patients were divided in the concurrent chemo-radiation therapy group...
Source: La Radiologia Medica - Category: Radiology Source Type: research
Publication date: Available online 23 August 2018Source: Practical Radiation OncologyAuthor(s): Nikhil Yegya-Raman, Meral Reyhan, Sinae Kim, Matthew P. Deek, Ning Yue, Wei Zou, Jyoti Malhotra, Joseph Aisner, Salma K. JabbourPurposeTo investigate the association between target volume margins and clinical outcomes for patients with inoperable non-small cell lung cancer (NSCLC) treated with concurrent chemoradiation therapy.Methods/Materials: We reviewed records of 82 patients with inoperable NSCLC treated from 2009-2016 with concurrent chemoradiation. All patients received positron emission tomography-based treatment plannin...
Source: Practical Radiation Oncology - Category: Cancer & Oncology Source Type: research
Publication date: Available online 1 March 2018Source: Practical Radiation OncologyAuthor(s): Soumyajit Roy, Iulian Badragan, Sheikh Nisar Ahmed, Michael Sia, Jorawur Singh, Gaurav BahlAbstractPurposeThe purpose of this article was to generate an algorithm to calculate radiobiological endpoints and composite indices and use them to compare volumetric modulated arc therapy (VMAT) and 3-dimensional conformal radiation therapy (3D-CRT) techniques in patients with locally advanced non-small cell lung cancer.Methods and materialsThe study included 25 patients with locally advanced non-small cell lung cancer treated with 3D-CRT ...
Source: Practical Radiation Oncology - Category: Cancer & Oncology Source Type: research
CONCLUSIONS: This trial is the first of its kind showing that 3-DCRT provides patients with lower rates of oesophageal toxicity whilst yielding acceptable rates of symptom control. (Sponsored by Cancer Trials Ireland (ICORG) Study number 06-34, the Friends of St. Luke's and the St. Luke's Institute of Cancer Research.). PMID: 29548561 [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
CONCLUSIONS: DVH- and DMH-dose indices differ by>5% in lung and lung target volumes for fixed dose distributions, but optimizing DMH did not reduce dose to OARs. The primary difference observed in DVH- and DMH-optimized plans were variations in fluence to the periphery of lung target PTVs, where low density lung surrounds tumor. PMID: 29031611 [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
Source: International Journal of Radiation Oncology * Biology * Physics - Category: Radiology Authors: Tags: Physics Contribution Source Type: research
ConclusionsFDGwk4 SUVmax and radiation dose were associated with ≥ grade 2 ARO. Compared to subjective assessments, future interim FDG PET/CT acquired for disease response assessment may also be utilized to objectively characterize ARO severity and image‐guided oesophageal dose constraints.
Source: Australasian Radiology - Category: Radiology Authors: Tags: Radiation Oncology —Original Article Source Type: research
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