Interpretable Machine Learning Model for Locoregional Relapse Prediction in Oropharyngeal Cancers.

Background: There is no evidence to support surgery or radiotherapy as the best treatment for resectable oropharyngeal cancers with a negative HPV status. Predictive algorithms may help to decide which strategy to choose, but they will only be accepted by caregivers and European authorities if they are interpretable. As a proof of concept, we developed a predictive and interpretable algorithm to predict locoregional relapse at 18 months for oropharyngeal cancers as a first step towards that goal.

Comparison of CBCT-based dose calculation methods in head and neck cancer radiotherapy: from Hounsfield unit to density calibration curve to deep learning.

Purpose: Anatomical variations occur during head and neck (H&N) radiotherapy treatment. kV cone-beam computed tomography (CBCT) images can be used for daily dose monitoring to assess dose variations owing to anatomic changes. Deep learning methods (DLMs) have recently been proposed to generate pseudo-CT (pCT) from CBCT to perform dose calculation.

Difference in toxicity between HIV-positive and HIV-negative patients with squamous-cell cancer of the anal canal treated with concomitant radio-chemotherapy.

Background: The incidence of squamous cell carcinoma of the anal canal has been increasing over the last 30 years. HIV has been found to be a risk factor for the development of this disease; radio-chemotherapy (RTCT) may also be more toxic than in HIV-negative patients. The study aims at assessing whether there are any differences in terms of toxicity between HIV-positive and HIV-negative patients treated with concomitant RTCT.

Pretreatment F-FDG PET/CT Radiomics Predict Local Recurrence in Patients Treated with Stereotactic Body Radiotherapy for Early-Stage Non-Small Cell Lung Cancer: A Multicentric Study.

The aim of this retrospective multicentric study was to develop and evaluate a prognostic F-FDG PET/CT radiomic signature in early-stage non-small cell lung cancer patients treated with stereotactic body radiotherapy (SBRT). Patients from 3 different centers ( = 27, 29, and 8) were pooled to constitute the training set, whereas the patients from a fourth center ( = 23) were used as the testing set. The primary endpoint was local control.

Optimized radiotherapy to improve clinical outcomes for locally advanced lung cancer.

Background: We aimed to evaluate the toxicity, loco-regional control (LRC) and overall survival (OS) associated with accelerated intensity-modulated radiotherapy (IMRT) for locally advanced lung cancer.

Methods: Seventy-three patients were consecutively treated with IMRT from November 2011 to August 2016. A total dose of 66 Gy was delivered using two different schedules of radiotherapy: simultaneous modulated accelerated radiotherapy (SMART) (30 × 2.

Clinical Outcomes of Several IMRT Techniques for Patients With Head and Neck Cancer: A Propensity Score-Weighted Analysis.

Purpose: The Advanced Radiotherapy Oto-Rhino-Laryngologie (ART-ORL) study (NCT02024035) was performed to prospectively evaluate the clinical and economic aspects of helical TomoTherapy and volumetric modulated arc therapy (RapidArc, Varian Medical Systems, Palo Alto, CA) for patients with head and neck cancer.

Methods And Materials: Fourteen centers participated in this prospective comparative study. Randomization was not possible based on the availability of equipment.

The synergistic effect of radiotherapy and immunotherapy: A promising but not simple partnership.

Radiotherapy (RT) is one of the main components in the treatment of cancer. The better understanding of the immune mechanisms associated with tumor establishment and how RT affects inflammation and immunity has led to the development of novel treatment strategies. Several preclinical studies support the use of RT in combination with immunotherapy obtaining better local and systemic tumor control.

Phase II Study of a Radiotherapy Total Dose Increase in Hypoxic Lesions Identified by F-Misonidazole PET/CT in Patients with Non-Small Cell Lung Carcinoma (RTEP5 Study).

See an invited perspective on this article on page 1043.This multicenter phase II study investigated a selective radiotherapy dose increase to tumor areas with significant F-misonidazole (F-FMISO) uptake in patients with non-small cell lung carcinoma (NSCLC). Eligible patients had locally advanced NSCLC and no contraindication to concomitant chemoradiotherapy.

Cost Analysis of Complex Radiation Therapy for Patients With Head and Neck Cancer.

Purpose: This cost analysis aimed to prospectively assess differences in costs between TomoTherapy and volumetric modulated arc therapy (VMAT) in patients with head and neck cancer.

Methods And Materials: Economic data were gathered from a multicenter study. However, randomization was not possible due to the availability of equipment.

Simultaneously modulated accelerated radiation therapy reduces severe oesophageal toxicity in concomitant chemoradiotherapy of locally advanced non-small-cell lung cancer.

Objective: The aim of this study was to evaluate the potential of simultaneously modulated accelerated radiation therapy (SMART) to reduce the incidence of severe acute oesophagitis in the treatment of unresectable locally advanced non-small-cell lung cancer (LANSCLC).

Methods: 21 patients were treated with SMART and concomitant platinum-based chemotherapy. The prescribed doses were limited to 54 Gy at 1.

Impact of head and neck cancer adaptive radiotherapy to spare the parotid glands and decrease the risk of xerostomia.

Background: Large anatomical variations occur during the course of intensity-modulated radiation therapy (IMRT) for locally advanced head and neck cancer (LAHNC). The risks are therefore a parotid glands (PG) overdose and a xerostomia increase. The purposes of the study were to estimate: - the PG overdose and the xerostomia risk increase during a "standard" IMRT (IMRTstd); - the benefits of an adaptive IMRT (ART) with weekly replanning to spare the PGs and limit the risk of xerostomia.

Impact of MLC leaf width on volumetric-modulated arc therapy planning for head and neck cancers.

This dosimetric study investigated the impact of multileaf collimators (MLC) leaf width in volumetric-modulated arc therapy (VMAT) for head and neck cancers (HNC), either with a "standard" simultaneously integrated boost technique (S-SIB) or with a "dose painting" SIB technique (DP-SIB). HNC patients were planned either with an S-SIB comprising three dose levels, from 56 to 70 Gy (16 patients), or with a DP-SIB comprising five dose levels, from 56 to 84 Gy (8 patients), in 35 fractions. Two VMAT plans were calculated for each SIB technique using two Elekta MLCs: MLCi2 with 10 mm leaf width and Beam Modulator (BM) with 4 mm leaf width.

Salivary gland-sparing other than parotid-sparing in definitive head-and-neck intensity-modulated radiotherapy does not seem to jeopardize local control.

Background: The objective was to analyze locoregional (LR) failure patterns in patients with head-and-neck cancer (HNC) treated using intensity-modulated radiotherapy (IMRT) with whole salivary gland-sparing: parotid (PG), submandibular (SMG), and accessory salivary glands represented by the oral cavity (OC).

Methods: Seventy consecutive patients with Stage I-II (23%) or III/IV (77%) HNC treated by definitive IMRT were included. For all LR failure patients, the FDG-PET and CT scans documenting recurrence were rigidly registered to the initial treatment planning CT.

Patterns of care and outcome in elderly cervical cancer patients: a special focus on brachytherapy.

Background: The mean age of the general population has been prolonged and the incidence of cancer in elderly patients has increased. The purpose was to evaluate outcome of brachytherapy (BT) as an integrated part of the treatment of elderly patients with cervical cancer.

Patients And Methods: From November 1997 to January 2006, 1073 patients diagnosed with uterine cervical cancer with stages I-IV (FIGO) have completed BT at the Institut Gustave Roussy.

Inverse planning approach for 3-D MRI-based pulse-dose rate intracavitary brachytherapy in cervix cancer.

Purpose: The purpose of this study was to evaluate the inverse planning simulated annealing (IPSA) software for the optimization of dose distribution in patients with cervix carcinoma treated with MRI-based pulsed-dose rate intracavitary brachytherapy.

Methods And Materials: Thirty patients treated with a technique using a customized vaginal mold were selected. Dose-volume parameters obtained using the IPSA method were compared with the classic manual optimization method (MOM).