A systematic post-QUANTEC review of tolerance doses for late toxicity after prostate cancer radiotherapy
The aim of this study was to systematically review tolerance doses for late distinct gastrointestinal, genitourinary, and sexual dysfunction (GI/GU/SD) symptoms following external-beam RT (EBRT) alone and treatments involving brachytherapy (BT ±EBRT) for prostate cancer post-QUANTEC, and to ultimately perform quantitative syntheses of identified dose/volume tolerances represented by dose-volume histogram (DVH) thresholds, i.e., statistically significant (p≤0.05) cutoff points between symptomatic and asymptomatic patients in a certain s tudy. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 17, 2018 Category: Radiology Authors: Caroline E. Olsson, Andrew Jackson, Joseph O. Deasy, Maria Thor Tags: Physics Contribution Source Type: research

The prognostic significance of p16 status in patients with vulvar cancer treated with vulvectomy and adjuvant radiation
This is a retrospective analysis from a single institution examining 39 women with vulvar squamous cell carcinoma treated with adjuvant radiation therapy noting how outcomes differed according to p16 status —measured through immunohistochemistry. We observed fewer in-field relapses and improved progression-free survival in women whose tumors were p16 positive. There was no difference in overall survival between groups. This is the largest cohort of patients treated with adjuvant radiation therapy wit h known p16 status. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 16, 2018 Category: Radiology Authors: Michael J. Dohopolski, Zachary D. Horne, Dinesh Pradhan, Rohit Bhargava, Robert P. Edwards, Joseph L. Kelley, John T. Comerci, Alexander B. Olawaiye, Madeleine Courtney-Brooks, Jessica L. Berger, Paniti Sukumvanich, Sushil Beriwal Source Type: research

Acute toxicity profiles of hypofractionated adjuvant and salvage radiotherapy after radical prostatectomy: results of a prospective study
Moderate hypofractionated adjuvant and salvage RT, as administered with Helical Tomotherapy, was acutely safe after RP as it was associated with acceptable rates of slight-to-moderate acute GU and GI toxicity in 112 patients. Uroflowmetry emerged as a reliable test for RT-related GU toxicity. A longer follow-up is needed to confirm these promising clinical outcomes. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 16, 2018 Category: Radiology Authors: Simonetta Saldi, Rita Bellavita, Valentina Lancellotta, Isabella Palumbo, Marco Lupattelli, Sara Chierchini, Lorenzo Falcinelli, Claudio Zucchetti, Vittorio Bini, Cynthia Aristei Source Type: research

FDG / PET-CT based lymph node atlas in breast cancer patients
The aim of this study was to localize loco-regional lymph node metastases (LN) using FDG-PET datasets in 235 patients with 580 lymph nodes. A comprehensive LN atlas was created in this study comprising the largest number of lymph node metastases so far. Our quantitative data illustrate where lymph node metastases occur in different clinical situations and present areas at high risk (i.e “hot spots” of lymph node metastases). The ESTRO CTV and RTOG CTV do not provide coverage of the whole loco-regional lymphatic drainage. Whether target volumes that cover the whole loco-regional lymphatic drainage system are nec...
Source: International Journal of Radiation Oncology * Biology * Physics - August 14, 2018 Category: Radiology Authors: Kai Joachim Borm, Julia Voppichler, Mathias D üsberg, Markus Oechsner, Tibor Vag, Wolfgang Weber, Stephanie Elisabeth Combs, Marciana Nona Duma Tags: Physics Contribution Source Type: research

Secondary Neutron Dose from a Dynamic Collimation System During Intracranial Pencil Beam Scanning Proton Therapy: A Monte Carlo Investigation
This study presents a unique application of Monte Carlo methods to study secondary neutron generation and dose equivalence distributions resulting from single field uniform dose and intensity modulated proton therapy treatments using a Dynamic Collimation System. Expected neutron doses are compared to aperture-collimated proton therapy techniques. The excess relative risk from an intracranial treatment plan ’s neutron dose distribution is compared against that of a traditional uncollimated intracranial proton therapy treatment using a graphite range shifter. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 14, 2018 Category: Radiology Authors: Blake R. Smith, Daniel E. Hyer, Patrick M. Hill, Wesley S. Culberson Source Type: research

Knowledge-based planning for identifying high-risk stereotactic ablative radiotherapy treatment plans for lung tumors larger than 5cm
We retrospectively investigated the relationship between dosimetry and toxicity for Stereotactic ablative body radiotherapy (SABR) for lung tumors ≥5cm using a knowledge-based planning solution. This allowed to perform individualized treatment plan quality assurance and identified in nearly 50% of historical treatment plans from patients with grade≥3 toxicity where planning could have been improved. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 14, 2018 Category: Radiology Authors: Saar van t Hof, Alexander R. Delaney, Hil âl Tekatli, Jos Twisk, Ben J. Slotman, Suresh Senan, Max Dahele, Wilko FAR. Verbakel Source Type: research

Towards biomarker-informed trimodality therapy (TMT) approaches for muscle-invasive bladder cancer
(Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 10, 2018 Category: Radiology Authors: Kent W. Mouw Source Type: research

17 α-Ethinyl-androst-5-ene-3β, 17β-diol, a novel potent oral radioprotective agent, confers radioprotection of hematopoietic stem and progenitor cells in a granulocyte colony stimulating factor-independent manner
To develop a novel oral radioprotector, the radioprotective effects of 17 α-Ethinyl-androst-5-ene-3β,17β-diol (EAD) were evaluated in mice subjected to total-body irradiated mice. Oral administration of EAD before irradiation significantly improved survival after lethal irradiation and promoted multilineage reconstitution by stimulating hematopoietic stem and progenito r cells in a G-CSF independent manner. Given its oral efficacy and low toxicity, EAD has potential as an optimal radioprotector for use by first responders as well as at-risk civilian populations. (Source: International Journal of Radiation O...
Source: International Journal of Radiation Oncology * Biology * Physics - August 10, 2018 Category: Radiology Authors: Fan Bai, Limei Wang, Zhongtang Li, Lirong Yi, Zongchao Zuo, Cheng Zhang, Yajun Shan, Chao Yang, Renjun Peng, Rifang Yang, Zuyin Yu, Yuwen Cong Tags: Biology Contribution Source Type: research

Cardiovascular Preventive Care and Coordination Of Care In Prostate Cancer Survivors: A Multi-Institutional Prospective Study
Prostate cancer survivors who receive androgen deprivation therapy (ADT) are at increased risk of cardiovascular disease. We prospectively enrolled 103 men receiving ADT to assess cardiovascular risk factors and survivorship care. Cardiovascular disease and risk factors were prevalent at baseline and 1 year, and less than two thirds received guideline concordant monitoring. In addition, patient ’s perception of coordination of care between primary care and specialists were low. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 9, 2018 Category: Radiology Authors: Jordan A. Holmes, Roger F. Anderson, Leroy G. Hoffman, Timothy N. Showalter, Mohit Kasibhatla, Sean P. Collins, Michael A. Papagikos, Brittany D. Barbosa, Lori J. Stravers, Zahra Mahbooba, Andrew Z. Wang, Ronald C. Chen Source Type: research

Patterns of Failure following Postoperative Radiation Therapy Based on “Tumor Bed with Margin” for Stage II-IV Type C Thymic Epithelial Tumor
This retrospective study to report failure patterns and suitability of radiation target volume of “tumor bed only with margin” in Masaoka stage II-IV type C thymic epithelial tumor following postoperative radiation therapy indicated that most failures occurred out of radiation field, mostly in pleura not regional lymph nodes. Policy of target volume confined to tumor bed only seems reasonabl e in treating these patients although development of more effective systemic therapy regimen would be warranted. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 9, 2018 Category: Radiology Authors: Kyung Hwa Lee, Jae Myoung Noh, Yong Chan Ahn, Dongryul Oh, Jhingook Kim, Young Mog Shim, Jung-ho Han Tags: Clinical Investigation Source Type: research

Phase 1 study of spinal cord constraint relaxation with single session spine stereotactic radiosurgery in the primary management of patients with inoperable, previously unirradiated metastatic epidural spinal cord compression
In this Phase 1 prospective clinical trial, spinal cord dose constraint relaxation up to 16 Gy was not associated with any myelopathy events and may be considered in high risk inoperable patients with epidural disease, or metastatic epidural spinal cord compression to optimize local control. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 9, 2018 Category: Radiology Authors: Amol J. Ghia, Nandita Guha-Thakurta, Kenneth Hess, James N. Yang, Stephen H. Settle, Hadley J. Sharpe, Jing Li, MaryFrances McAleer, Eric L. Chang, Claudio E. Tatsui, Paul D. Brown, Laurence D. Rhines Tags: Clinical Investigation Source Type: research

Comparative effectiveness of prostate cancer treatment options: limitations of retrospective analysis of cancer registry data
This study highlights an important limitation of studies using pop ulation-based cancer registry data, especially when comparing survival outcomes of vastly different treatment modalities. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 9, 2018 Category: Radiology Authors: Kevin A. Pearlstein, Ramsankar Basak, Ronald C. Chen Source Type: research

Challenging Case: Mediastinal Mammary Malignancy
A 47-year-old woman presented with a left-sided, 10-cm breast mass with inflammatory skin changes. She had palpable left axillary and supraclavicular lymph nodes. Biopsy of the breast mass and both nodes demonstrated invasive ductal carcinoma, grade 3, estrogen receptor positive, progesterone receptor positive, and HER-2/neu negative. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 8, 2018 Category: Radiology Authors: Mark T. Corkum, Louis Fenkell Tags: Gray Zone Source Type: research

Systemic Therapy with Radiation to the Chest Wall Alone
This case highlights the therapeutic dilemma encountered in patients with limited metastatic disease, who have both a substantial risk of local –regional recurrence (LRR) and a large competing risk of distant metastases (1). If the patient had presented without metastatic disease, her initial tumor burden would have warranted radiation. However, in the setting of metastatic disease, treatment recommendations are less clear. The available retrospective literature in women with inflammatory disease suggests that aggressive local treatment improves local control (2) and may even benefit overall survival (3), but these d...
Source: International Journal of Radiation Oncology * Biology * Physics - August 8, 2018 Category: Radiology Authors: Rachel B. Jimenez, Jennifer R. Bellon Tags: Gray Zone Source Type: research

Putting the “BR” in SBRT
This patient presents with stage IV, cT4dN3cM1 oligometastatic inflammatory breast cancer (IBC) (1). The initial treatment would be neoadjuvant chemotherapy (NAC). In the absence of progression with NAC, we would recommend mastectomy with axillary lymph node dissection and postmastectomy radiation therapy (PMRT). Given IBC's penchant for locoregional recurrence and progression to carcinoma en cuirasse, an aggressive approach to PMRT is warranted, despite the presence of initial limited metastatic disease. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 8, 2018 Category: Radiology Authors: Corey C. Foster, Steven J. Chmura Tags: Gray Zone Source Type: research

Two Sides of the Same Coin: Head and Neck Cancer Treatment De-Intensification and Intensification with Induction Chemotherapy
The terms “intensification” and “de-intensification” are ubiquitous in the lexicon of head and neck oncology as the field moves toward individualizing treatment strategies on the basis of clinical factors such as TNM staging and biomarkers such as human papillomavirus (HPV). In this edition of Oncolo gy Scan, we feature 3 articles linked by the theme of induction chemotherapy (IC), a treatment paradigm used for both intensification and de-intensification. The first 2 articles, by Marur et al (1) and Chen et al (2), study HPV-associated oropharyngeal cancer and examine the ro...
Source: International Journal of Radiation Oncology * Biology * Physics - August 8, 2018 Category: Radiology Authors: Danielle N. Margalit, Alexander Lin Tags: Feature Source Type: research

Erratum to: Schreibmann E, Schuster D, Rossi P, et  al. Image Guided Planning for Prostate Carcinomas With Incorporation of Anti-3-[18F]FACBC (Fluciclovine) Positron Emission Tomography: Workflow and Initial Findings From a Randomized Trial. Int J Radiat Oncol Biol Phys 2016;96:206-213.
En error was identified by the authors in the abstract. Instead of “11 (20%) in the prostate bed, 10 (18%) in the prostate,” the text should read “21 (38%) in the prostate bed.” All patients in this study underwent radical retropubic prostatectomy. The authors regret the error. The data is written correctly in the body of the paper. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 8, 2018 Category: Radiology Tags: Erratum Source Type: research

In Regard to Beadle and Anderson
We were pleased to read the thoughtful editorial by Drs Beadle and Anderson entitled “CTV Guidance for Head and Neck Cancers” (1) and wanted to call attention to the availability of these guidelines for download by the worldwide oncology community at the Head and Neck Cancer Intergroup (HNCIG) website. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 8, 2018 Category: Radiology Authors: Quynh-Thu Le, Sue S. Yom, Joseph T.S. Wee, Anne W.M. Lee, Cai Grau, Vincent Gr égoire, Sandro Porceddu, John J. Welch, Hisham Mehanna Tags: Comments Source Type: research

Radiation Oncology in Mexico: Toward a Unified Model
The United Mexican States, best known as Mexico, has a population of approximately 120 million and a territory of approximately 750,000 square miles, encompassing a wide variety of natural and human-made wonders. The size, geographical location, and geology of the territory allows for a great variety of landscapes, from desert to rainforest to dramatic coastlines, that are habitats for diverse animal and plant species (10% of all those that exist on the planet). Although Mexico is located in North America, from cultural and economic points of view, it is considered a part of Latin America and is the principal tourist desti...
Source: International Journal of Radiation Oncology * Biology * Physics - August 8, 2018 Category: Radiology Authors: Daniel Gallegos, Mar ía Adela Poitevin Chacón, Jean L. Wright Tags: Feature Source Type: research

Erratum to: Ho AY, Olm-Shipman M, Zhang Z, et  al. A Randomized Trial of Mometasone Furoate 0.1% to Reduce High Grade Acute Radiation Dermatitis in Breast Cancer Patients Receiving Postmastectomy Radiation. Int J Radiat Oncol Biol Phys 2018;101;325-333.
This study was designed, performed, conducted and analyzed at the Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 8, 2018 Category: Radiology Tags: Erratum Source Type: research

Lymphedema: Time for an Update
Improvements in cancer survivorship have led to increased recognition of treatment-related toxicities, some of which may not occur until years after the conclusion of treatment (1, 2). For breast cancer survivors, lymphedema is one of the most dreaded complications of surgery, radiation therapy, and taxane-based chemotherapy. Lymphedema involves a build-up of extracellular fluid within the upper extremity and results in swelling and, at times, chronic skin changes, fibrosis, loss of sensation, deformity, and pain (3). (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 8, 2018 Category: Radiology Authors: Simona F. Shaitelman Tags: Clinical Investigation Source Type: research

Aggressive Systemic Therapy with Response-Based Radiation
Kirk: I take it the odds are against us and the situation is grim.Picard: You could say that.Kirk: You know if Spock were here, he'd say I was an irrational, illogical human being for going on a mission like that. [pause] Sounds like fun!- Star Trek: Generations (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 8, 2018 Category: Radiology Authors: Gary M. Freedman Tags: Gray Zone Source Type: research

Issue Highlights
Margalit and Lin (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 8, 2018 Category: Radiology Source Type: research

Meetings
September 5-8, 2018 (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 8, 2018 Category: Radiology Source Type: research

Secondary Breast Cancers in Childhood Cancer Male Survivors – Characteristics and Risks
Male breast cancer (MBC) is uncommon, accounting for less than 1% of all breast cancers. Secondary breast cancers among childhood cancer survivors have been well described in the literature but less is known about MBC. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 7, 2018 Category: Radiology Authors: Charlotte Demoor-Goldschmidt, Rodrigue S. Allodji, Angela Jackson, Giao Vu-Bezin, Vincent Souchard, Brice Fresneau, Chiraz le Fayech, Nadia Haddy, Carole Rubino, Hel ène Pacquement, Cristina Veres, Damien Llanas, Ibrahima Diallo, Florent de Vathaire Tags: Clinical Investigation Source Type: research

Dimethyl Sulfoxide Prevents Radiation-induced Oral Mucositis through Facilitating DNA Double-strand Break Repair in Epithelial Stem Cell
We show that dimethyl sulfoxide (DMSO) exhibits marked protective activity against radiation-induced oral mucositis in mice without tumor protection, and the efficacy of DMSO is superior to that of rhKGF and amifostine. Administration of DMSO significantly prevents the loss of proliferative lingual epithelial stem and progenitor cells upon irradiation by facilitating DNA double-strand breaks repair. High efficacy and low toxicity of DMSO suggest possible therapeutic application. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 6, 2018 Category: Radiology Authors: Chao Yang, Hongwei Tang, Limei Wang, Renjun Peng, Fan Bai, Yajun Shan, Zuyin Yu, Pingkun Zhou, Yuwen Cong Tags: Biology Contribution Source Type: research

Development of a “ready to use” graphical tool based on artificial neural network classification: application for the prediction of late fecal incontinence after prostate cancer radiotherapy
In this study, we develop a readable ANN-based graphical tool for the prediction of late faecal incontinence after prostate cancer radiotherapy. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 6, 2018 Category: Radiology Authors: Mauro Carrara, Eleonora Massari, Alessandro Cicchetti, Tommaso Giandini, Barbara Avuzzi, Federica Palorini, Claudio Stucchi, Giovanni Fellin, Pietro Gabriele, Vittorio Vavassori, Claudio Degli Esposti, Cesare Cozzarini, Emanuele Pignoli, Claudio Fiorino, Source Type: research

Effectiveness of Rotating Shield Brachytherapy for Prostate Cancer Dose Escalation and Urethral Sparing
A 26-patient treatment planning study comparing rotating shield brachytherapy (RSBT) to conventional high-dose-rate brachytherapy (HDR-BT) for dose escalation, simulating monotherapy, and urethra sparing, simulating boost therapy. The radiobiological effects of dose protraction and source age were accounted for. RSBT can increase PTV EQD90% or decrease urethral D10% relative to HDR-BT at the cost of increased treatment time. Source aging reduces RSBT benefit, but RSBT remains theoretically superior to HDR-BT by>20% after one-half-life has elapsed. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 6, 2018 Category: Radiology Authors: Quentin Adams, Karolyn M. Hopfensperger, Yusung Kim, Xiaodong Wu, Weiyu Xu, Hemant Shukla, James McGee, Joseph M. Caster, Ryan T. Flynn Source Type: research

Radiation Induced Cerebral Microbleeds in Pediatric Patients with Brain Tumors Treated with Proton Radiotherapy
This study investigates radiation-induced cerebral microbleeds (CMBs) in pediatric patients with primary brain tumors treated with proton radiotherapy. This complication of radiotherapy has not been significantly studied following proton radiotherapy in the pediatric patient population, particularly with regards to timing, incidence and associated risk factors. CMBs have been associated with decreased neurocognitive function indicating the potential clinical significance. This research establishes an estimate for the timing and incidence of CMBs, evaluates how CMBs accrue over time, investigates risk factors associated wit...
Source: International Journal of Radiation Oncology * Biology * Physics - August 6, 2018 Category: Radiology Authors: Stephen F. Kralik, Todd R. Mereniuk, Laurent Grignon, Chie-Schin Shih, Chang Y. Ho, Whitney Finke, Peter W. Coleman, Gordon A. Watson, Jeffrey Buchsbaum Source Type: research

Short Hypofractionated Radiotherapy in Palliation of Pediatric Malignancies: Outcomes and Toxicities
This study analyzed outcomes in 62 pediatric patients who were treated with a total of 104 courses of short hypofractionated radiotherapy to the sites of recurrent or metastatic disease. Hypofractionation to a median cumulative biologically effective dose (BED10) of 43 Gy produced robust short-term local control and resulted in favorable treatment response and toxicities. Nevertheless, survival outcomes remained dismal. Large-scale prospective studies are required to identify optimal dose schemes for palliation of incurable childhood tumors. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 2, 2018 Category: Radiology Authors: Stanislav Lazarev, Brian H. Kushner, Suzanne L. Wolden Tags: Clinical Investigation Source Type: research

A Phase I Study of Nilotinib plus Radiation in High-Risk Chordoma
In this phase I study we treated 23 high-risk chordoma patients with nilotinib plus radiation therapy. We determined the maximum tolerated dose was 200 mg per day when combined with radiation. The median progression free survival was 58.15 months (95% CI: 39.10-inf) and 2-year overall survival rate was 95%. Nilotinib plus radiotherapy is safe in this population. Further study will be required to determine if this is superior than radiation with or without surgery alone. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 2, 2018 Category: Radiology Authors: Gregory M. Cote, Constance M. Barysauskas, Thomas DeLaney, Joseph Schwab, Kevin Raskin, Santiago Lozano-Calderon, Karen Bernstein, John Mullen, Alex B. Haynes, Francis Hornicek, Yen-Lin Chen, Edwin Choy Tags: Clinical Investigation Source Type: research

Tumor control probability analysis for single fraction carbon ion radiotherapy of early-stage non-small cell lung cancer
The suitability of the LQ and USC models to accurately forecast the 3-year local control rate of early stage NSCLC after CIRT is investigated in this study. The results suggest that the USC model is more appropriate in predicting the single fraction clinical outcome. However, for the 4, 9 and 18 fractionation schedules, the LQ and USC models predicted comparable local control rates. An USC-based SOBP was then developed, providing a better clinical dose estimate for optimum local control. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 1, 2018 Category: Radiology Authors: Athena Paz, Naoyoshi Yamamoto, Makoto Sakama, Naruhiro Matsufuji, Tatsuaki Kanai Source Type: research

Effects of 10 MV and Flattening-Filter-Free Beams on Peripheral Dose in a Cohort of Pediatric Patients
This study assesses peripheral photon and neutron doses from volumetric modulated arc therapy (VMAT) deliveries for 10 MV FFF (flattening-filter-free) and 6 MV FFF x-ray beams compared to 6 MV-flattened beams. A significant reduction in peripheral dose was found in FFF beams compared to 6 MV-flattened beams (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - July 30, 2018 Category: Radiology Authors: Youssef Ben Bouchta, Karen Goddard, M Peter Petric, Alanah M. Bergman Tags: Physics Contribution Source Type: research

Utilization of a web-based conferencing platform to improve global radiation oncology education and quality —proof of principle through implementation in India
Chartrounds (www.chartrounds.com) is a free web-based platform for radiation oncologists to review cases with leading disease-site experts. Chartrounds has been well-utilized in the US since 2010 and is now expanding internationally. A dedicated site for India (ind.chartrounds.com) was launched in June 2017. Herein, we report our initial experience with this initiative and demonstrate that an online platform for radiation oncology case review and education can be successfully implemented globally with utilization of local disease-site experts. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - July 30, 2018 Category: Radiology Authors: Tyler P. Robin, Surbhi Grover, Vijay Anand Reddy Palkonda, Christine M. Fisher, Brigitta Gehl, Kausik Bhattacharya, Indranil Mallick, Onita Bhattasali, Akila N. Viswanathan, Supriya Sastri (Chopra), Umesh Mahantshetty, Patricia H. Hardenbergh Source Type: research

Non-measurable speckled contrast-enhancing lesions appearing during course of disease are associated with IDH mutation in high-grade astrocytoma patients
Clinically asymptomatic, speckled contrast-enhancing lesions ( ≤ 0.5 cm) (SCEs) appeared frequently during course of disease in patients with gliomas and challenge the definition of progression and clinical management. Appearance of SCEs was significantly associated with IDH mutation in astrocytoma WHO °III and glioblastoma and with a favorable prognosis in glioblastoma. Most SCEs remained stable or disappeared without treatment necessitating a careful definition of progression and its confirmation in follow-up MRIs prior to initiation of treatment. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - July 30, 2018 Category: Radiology Authors: Anne Berberich, Thomas Hielscher, Philipp Kickingereder, Frank Winkler, Katharina Dr üschler, Lars Riedemann, Marlene Arzt, Tobias Kessler, Michael Platten, Andreas von Deimling, Wolfgang Wick, Felix Sahm, Martin Bendszus, Antje Wick Tags: Clinical Investigation Source Type: research

Phase I/II Study of Stereotactic Ablative Radiotherapy Including Regional Lymph Node Irradiation in Patients with High-Risk Prostate Cancer (SATURN): Early Toxicity and Quality of Life
Two-year toxicity and quality of life (QOL) results are reported from a dose-escalated prostate SABR study for high-risk prostate cancer. Prostate, seminal vesicles, and pelvic lymph nodes were treated using a dose-painting schema up to 40Gy and 25Gy in 5 fractions, respectively, delivered weekly, in combination with androgen deprivation therapy. No grade 3 or higher CTCAE v 3.0 toxicity was noted. EPIC quality of life in all 4 domains was comparable to baseline at 24 months. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - July 30, 2018 Category: Radiology Authors: H.B. Musunuru, L. D ’Alimonte, M. Davidson, L. Ho, P. Cheung, D. Vesprini, S. Liu, W. Chu, H. Chung, A. Ravi, A. Deabreu, L. Zhang, K. Commisso, D.A. Loblaw Tags: Clinical Investigation Source Type: research

Daily versus weekly prostate cancer image-guided radiotherapy: Phase 3 multicenter randomized trial
The optimal frequency of prostate cancer image-guided radiation therapy (IGRT) has not yet been clearly identified. This phase 3 trial compared the efficacy of daily versus weekly IGRT. Compared to weekly control, daily control, by improving prostate targeting, decreases the risks of recurrences as well as rectal toxicity. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - July 30, 2018 Category: Radiology Authors: Renaud de Crevoisier, Mohamed Amine Bayar, Pascal Pommier, Xavier Muracciole, Fran çoise Pêne, Philippe Dudouet, Igor Latorzeff, Véronique Beckendorf, Jean-Marc Bachaud, Agnès Laplanche, Stéphane Supiot, Bruno Chauvet, Tan-Dat Nguyen, Alberto Bossi, Tags: Clinical Investigation Source Type: research

A Call To Arms: Radiation Therapy Quality Assurance In The Next Generation Of Clinical Trials
The fervor surrounding immunotherapy has resulted in an unprecedented progression from safety and efficacy studies to large-scale randomized trials across the oncology trials landscape. As we embark on the journey of investigating these new agents, we should pause to remember the successes and mistakes of the past. Championing the role of the quality assurance in radiotherapy (RT-QA) clinical trials is one of these successes. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - July 28, 2018 Category: Radiology Authors: Lachlan J. McDowell, June Corry Tags: Report Source Type: research

Patient and dosimetric predictors of genitourinary and bowel quality of life after prostate SBRT: Secondary analysis of a multi-institutional trial
We investigated associations between dosimetric parameters and quality of life (QOL) in patients treated with prostate SBRT on a prospective phase II trial. Rectal doses (e.g. Dmax) were significantly associated with decreased bowel QOL at both 1 month and 2 years. Patients with rectum Dmax greater than the median 37.4 Gy were more likely to have bowel symptoms at 2 years. Patient factors, but not bladder or urethral doses, were associated with urinary QOL. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - July 26, 2018 Category: Radiology Authors: Kyle Wang, Ronald C. Chen, Brent L. Kane, Clinton A. Medbery, Kelly J. Underhill, James R. Gray, Anuj V. Peddada, Donald B. Fuller Source Type: research

Blocking cyclin-dependent kinase 4/6 during single dose vs. fractionated radiation therapy leads to opposite effects on acute gastrointestinal toxicity in mice
Pharmacological inhibition of CDK4/6 using palbociclib before a single dose of radiation ameliorates the GI-ARS, but it exacerbates the GI-ARS when given before and during fractionated radiation. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - July 26, 2018 Category: Radiology Authors: Chang-Lung Lee, Patrick Oh, Eric Xu, Yan Ma, Yongbaek Kim, Andrea R. Daniel, David G. Kirsch Source Type: research

Intra-treatment response assessment with 18F-FDG PET: Correlation of semi-quantitative PET features with pathologic response of esophageal cancer to neoadjuvant chemoradiotherapy
We extracted semi-quantitative PET features from 18F-FDG PET scans performed before and during neoadjuvant chemoradiotherapy for esophageal cancer and compared their accuracy in predicting histopathologic response. Volumetric PET features including metabolic tumor volume and total lesion glycolysis from the intra-treatment PET were the most accurate predictors of histopathologic response. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - July 25, 2018 Category: Radiology Authors: Daniel J. Tandberg, Yunfeng Cui, Christel N. Rushing, Julian C. Hong, Bradley G. Ackerson, Daniele Marin, Xuenfeng Zhang, Brian G. Czito, Christopher W. Willett, Manisha Palta Source Type: research

Concurrent daily Cisplatin and high dose radiotherapy in patients with stage III non-small cell lung cancer.
Concurrent chemoradiotherapy (CCRT) including low-dose daily cisplatin (6mg/m2) and high dose radiotherapy (24 fractions of 2,75 Gy to a total dose of 66 Gy) for locally advanced stage III NSCLC resulted in good overall survival (3-year survival rate of 52%(95%CI: 43%-60%) with low toxicity. Prognostic factors for overall survival include GTV lymph nodes and Gender. GTV lymph nodes is the prognostic factor for toxicity. Prognostic factor for distant metastasis is the GTV of the tumor. The incidence of gastrointestinal disorders(grade 3-5) was 11% among which radiation esophagitis grade 3 was 8,4%. The incidence of respirat...
Source: International Journal of Radiation Oncology * Biology * Physics - July 25, 2018 Category: Radiology Authors: E.M.T. Dieleman, A.L.J. Uitterhoeve, M.W. van Hoek, R.M. van Os, J. Wiersma, M.G.J. Koolen, M.W. Kolff, C.C.E. Koning, J.A. Adam, H.J. Verberne, J.T. Annema, C.R.N. Rasch Source Type: research

A dose prediction model for duodenum sparing with a biodegradable hydrogel spacer for pancreatic cancer radiotherapy
We established an OVH prediction model to guide the selection of pancreatic cancer patients who may benefit from hydrogel spacer injection before radiation for duodenum sparing. We evaluated the model ’s accuracy by verifying predictions of the required hydrogel spacer thickness to achieve clinical dose constraints. Our upcoming clinical trials can utilize this technique to ensure sufficient separation between the duodenum and pancreas for consideration of dose-escalated radiation therapy. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - July 18, 2018 Category: Radiology Authors: Ziwei Feng, Avani D. Rao, Zhi Cheng, Eun Ji Shin, Joseph Moore, Lin Su, Seong-Hun Kim, John Wong, Amol Narang, Joseph M. Herman, Todd McNutt, Dengwang Li, Kai Ding Tags: Physics Contribution Source Type: research

VEGF-Grab enhances the efficacy of radiotherapy by blocking VEGF-A and treatment-induced PlGF
The rationale and efficacy of combining VEGF-Grab, a VEGF-A- and PlGF-neutralizing antibody, and radiotherapy were studied. Changes in PlGF level were studied in cells, mouse models, and patients with solid tumors after radiotherapy and the efficacy of combination treatment was tested using syngeneic and human tumor models in mice. Our data indicate that PlGF is increased in response to radiation, rationalizing the use of VEGF-Grab, and that VEGF-Grab and radiotherapy mutually potentiate their anti-tumor effects. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - July 12, 2018 Category: Radiology Authors: Intae Park, Hannah Yang, Jin-Sung Park, Gou Young Koh, Eun Kyung Choi Tags: Biology Contribution Source Type: research

Experimental set-up for FLASH proton irradiation of small animals using a clinical system
Recent in vivo investigations have shown that short pulses of electrons at very high dose-rate (FLASH) are less harmful to healthy tissues, but just as efficient as conventional dose-rate radiation to inhibit tumor growth. In view of the potential clinical value of FLASH and the availability of modern proton therapy infrastructures to achieve this goal, we herein describe a series of technological developments required to investigate the biology of FLASH irradiation, using a commercially available clinical proton therapy system. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - July 12, 2018 Category: Radiology Authors: Annalisa Patriarca, Charles Fouillade, Michel Auger, Fr édéric Martin, Frédéric Pouzoulet, Catherine Nauraye, Sophie Heinrich, Vincent Favaudon, Samuel Meyroneinc, Rémi Dendale, Alejandro Mazal, Philip Poortmans, Pierre Verrelle, Ludovic De Marzi Tags: Biology Contribution Source Type: research

Kinetics of intratumoral immune cell activation during chemoradiation for cervical cancer
Cytobrush methodology identified dynamic changes in intratumoral T cell and myeloid cell populations and their activation status in cervical cancer patients undergoing chemoradiation treatment. These changes were not evident from the analyses of peripheral blood. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - July 12, 2018 Category: Radiology Authors: Stephanie Dorta-Estremera, Lauren E. Colbert, Nookala Sita Mahalakshmi Krishna, Ananta V. Yanamandra, Guojun Yang, Andrea Delgado, Megan Mikkelson, Patricia Eifel, Anuja Jhingran, Lilie Lin, James Welsh, Kathleen Schmeler, K. Jagannadha Sastry, Ann Klopp Tags: Biology Contribution Source Type: research

Magnetic Resonance Imaging –Guided Radiation Therapy: A Short Strengths, Weaknesses, Opportunities, and Threats Analysis
A number of magnetic resonance (MR)-guided radiation therapy devices are under development, and the ViewRay system (ViewRay, Oakwood Village, OH), combining 3  multileaf collimated cobalt sources and 0.3 T MR imaging (MRI) with a split magnet system, has been in clinical use for some time, with a linear accelerator (linac) version announced (1). In contrast, the Elekta (AB, Sweden)/Philips (The Netherlands) Unity device consists of a 7-MV linac that rot ates around a closed bore 1.5 T MR imager (2) and is expected to be European conformity marked later this year. (Source: International Journal of Radiat...
Source: International Journal of Radiation Oncology * Biology * Physics - July 11, 2018 Category: Radiology Authors: Marcel van Herk, Alan McWilliam, Michael Dubec, Corinne Faivre-Finn, Ananya Choudhury Tags: Physics Contribution Source Type: research

The Long and Short of It: New Lessons on the Optimal Duration of Androgen Deprivation Therapy for High-Risk Prostate Cancer and Where We Need to Go From Here
Recently in the International Journal of Radiation Oncology, Biology, Physics, we have seen 3 articles providing updates or reanalyses from landmark trials testing the optimal duration of androgen deprivation therapy (ADT) with radiation in high-risk prostate cancer. Although it was started more than 25  years ago by Dr Gerald Hanks, the pioneering radiation oncology leader and former American Society for Radiation Oncology president who sadly passed away on December 20, 2017, the Radiation Therapy Oncology Group (RTOG) protocol 92-02 continues to provide valuable insights through its updates, as does the more recent ...
Source: International Journal of Radiation Oncology * Biology * Physics - July 11, 2018 Category: Radiology Authors: Paul L. Nguyen Tags: Feature Source Type: research

The Air Out There: Treatment Planning When Target Volumes Extend Beyond the Skin
A patient presented with squamous cell carcinoma of the vulva, pT2pN2c, stage IIIC status post radical vulvectomy and bilateral groin dissection. The pathology report revealed close and positive margins and lymphovascular space invasion at the primary site, as well as multiple positive lymph nodes with extracapsular extension. The patient was simulated head-first supine in the frog-legged position, with the assistance of a custom immobilization device. Simulation also included 5  mm of water-equivalent bolus applied to the right groin, corresponding to a region suspicious for positive nodes and extracapsular extension...
Source: International Journal of Radiation Oncology * Biology * Physics - July 11, 2018 Category: Radiology Authors: Justin Sick, Jonas Fontenot Tags: Gray Zone Source Type: research

Employ Piece-wise Optimization
Difficult planning scenarios like the vulva patient presented  here are discussed at our daily physics, dosimetry, and therapy huddle, to encourage collaborative solutions (1). (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - July 11, 2018 Category: Radiology Authors: Michael Price, Adam Yock Tags: Gray Zone Source Type: research