Knowledge-Based Quality Assurance and Model Maintenance in Lung Cancer Radiation Therapy in a Statewide Quality Consortium of Academic and Community Practice Centers.

Purpose: Locally advanced lung cancer (LALC) treatment planning is often complex due to challenging tradeoffs related to large targets near organs at risk, making the judgment of plan quality difficult. The purpose of this work was to update and maintain a multi-institutional knowledge-based planning (KBP) model developed by a statewide consortium of academic and community practices for use as a plan quality assurance (QA) tool.

Methods And Materials: Sixty LALC volumetric-modulated arc therapy plans from 2021 were collected from 24 institutions.

Contemporary Practice Patterns for Palliative Radiation Therapy of Bone Metastases: Impact of a Quality Improvement Project on Extended Fractionation.

Purpose: Radiation therapy effectively palliates bone metastases, although variability exists in practice patterns. National recommendations advocate against using extended fractionation (EF) with courses greater than 10 fractions. We previously reported EF use of 14.

Modeling AeroForm tissue expander for postmastectomy radiation therapy.

The AeroForm chest wall tissue expander (TE) is a silicon shell containing a metallic CO reservoir, placed surgically after mastectomy. The patient uses a remote control to release compressed CO from the reservoir to inflate the expander. AeroForm poses challenges in a radiation therapy setting: The high density of the metallic reservoir causes imaging artifacts on the planning CT, which encumber structure definition and cause misrepresentation of density information, in turn affecting dose calculation.

Changes in pharyngeal constrictor volumes during head and neck radiation therapy: Implications for dose delivery.

Objective: The objective of this study was to evaluate the anatomical changes and associated dosimetric consequences to pharyngeal constrictor muscles (PCMs) that occur during head and neck (H and N) radiotherapy (RT).

Materials And Methods: A cohort of 13 oropharyngeal cancer patients with daily cone beam computed tomography (CBCT) was retrospectively studied. On every 5th CBCT image, PCM was manually delineated by a radiation oncologist.

Intrafraction variability and deformation quantification in the breast.

Purpose: To evaluate intrafraction variability and deformation of the lumpectomy cavity (LC), breast, and nearby organs.

Methods And Materials: Sixteen left-sided postlumpectomy and 1 bilateral breast cancer cases underwent free-breathing CT (FBCT) and 10-phase 4-dimensional CT (4DCT). Deformable image registration was used for deformation analysis and contour propagation of breast, heart, lungs, and LC between end-exhale and end-inhale 4DCT phases.

Correlation of dose computed using different algorithms with local control following stereotactic ablative radiotherapy (SABR)-based treatment of non-small-cell lung cancer.

Purpose: To retrospectively compute dose distributions for lung cancer patients treated with SABR, and to correlate dose distributions with outcome using a tumor control probability (TCP) model.

Methods: Treatment plans for 133 NSCLC patients treated using 12 Gy/fxn × 4 (BED=106 Gy), and planned using a pencil-beam (1D-equivalent-path-length, EPL-1D) algorithm were retrospectively re-calculated using model-based algorithms (including convolution/superposition, Monte Carlo). 4D imaging was performed to manage motion.