Planning Benchmark Study for Stereotactic Body Radiation Therapy of Pancreas Carcinomas With Simultaneously Integrated Boost and Protection: Results of the DEGRO/DGMP Working Group on Stereotactic Radiation Therapy and Radiosurgery.

Purpose: The proximity or overlap of planning target volume (PTV) and organs-at-risk (OARs) poses a major challenge in stereotactic body radiation therapy (SBRT) of pancreatic cancer (PACA). This international treatment planning benchmark study investigates whether simultaneous integrated boost (SIB) and simultaneous integrated protection (SIP) concepts in PACA SBRT can lead to improved and harmonized plan quality.

Methods And Materials: A multiparametric specification of desired target doses (gross target volume [GTV], GTV, PTV, and PTV) with 2 prescription doses of GTV = 5 × 9.

Is it still necessary to perform measured based pre-treatment patient-specific QA for SRS HyperArc treatments?

Purpose: The Mobius3D system was validated as a modern secondary check dosimetry system. In particular, our objective has been to assess the suitability of the M3D as pre-treatment patient-specific Quality Assurance (QA) tool for Stereotactic Radiosurgery (SRS) HyperArc (HA) treatments. We aimed to determine whether Mobius3D could safely replace the measurements-based patient-specific QA for this type of treatment.

Organ dose in CT: Comparison between measurements and computational methods.

Purpose: This study aims to compare two methods for the organ dose evaluation in computed tomography (CT) in the head- and thorax regions: an experimental method, using radiochromic films, and a computational one, using a commercial software.

Methods: Gafchromic® XR-QA2 and EBT-3 were characterized in terms of energetic, angular, and irradiation configurations dependence. Two free-in-air irradiation calibration configurations were employed using a CT scanner: with the sensitive surface of the film orthogonal (OC) and parallel (PC) to the beam axis.

HyperArc Dosimetric Validation for Multiple Targets Using Ionization Chamber and RT-100 Polymer Gel.

Multiple brain metastases single-isocenter stereotactic radiosurgery (SRS) treatment is increasingly employed in radiotherapy department. Before its use in clinical routine, it is recommended to perform end-to-end tests. In this work, we report the results of five HyperArcTM treatment plans obtained by both ionization chamber (IC) and polymer gel.

SBRT/SRS patient-specific QA using GAFchromic EBT3 and FilmQA Pro software.

The aim of this work is to verify the potential use of GAFchromic EBT3 and FILMQA pro software for patient specific quality assurance (QA) for stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT) treatment plans in clinical routine use. In particular, encephalic, pulmonary and lymph node treatments plans were selected for this study. The agreement between the calculated and measured dose distributions were evaluated in terms of ɣ index with 3%3mm, 2%2mm, 1.

Volumetric Modulated Arc Therapy Capabilities for Treating Lower-Extremity Skin Affected by Several Merkel Cell Carcinoma Nodules: When Technological Advances Effectively Achieve the Palliative Therapeutic Goal while Minimising the Risk of Potential Toxicities.

The peculiar and rare clinical condition below clearly requires a customized care approach in the context of personalized medicine. An 80-year-old female patient who was subjected in 2018 to surgical removal of a cutaneous Merkel cell carcinoma (MCC) nodule located on the posterior surface of the left thigh and to three subsequent palliative radiotherapy treatments developed a fourth relapse in October 2020, with fifteen nodular metastases located in the left thigh and leg. Since the overall macroscopic disease was still exclusively regionally located and microscopic spread was likely extended also to clinically negative skin of the thigh and leg, we performed an irradiation of the whole left lower extremity.

How Much Daily Image-guided Volumetric Modulated Arc Therapy Is Useful for Proctitis Prevention With Respect to Static Intensity Modulated Radiotherapy Supported by Topical Medications Among Localized Prostate Cancer Patients?

Background/aim: To evaluate if topical support therapy during static-intensity modulated radiotherapy (sIMRT) course is able to equal the characteristic minimum risk for radiation proctitis of Image-guided volumetric modulated arc therapy (IG-VMAT) treatment among localized prostate cancer patients.

Patients And Methods: Rectal toxicity data of the above patients were retrospectively collected throughout three different clinical periods at our Radiotherapy Deparment: from October 2011 to December 2012, prostate cancer patients were treated with sIMRT and in advance supported by means of daily topical corticosteroids; from January 2013 to November 2016, topical corticosteroids were replaced by daily hyaluronic acid enemas; from December 2016 to May 2018 eligible patients were treated with newly introduced IG-VMAT supported by only on-demand topical corticosteroids.

Results: Among 359 eligible patients, IG-VMAT was proven generally more effective than sIMRT supported by topical medications in terms of proctitis reduction, although without clinical and practical relevance.

Anatomical Predictors of Dosimetric Advantages for Deep-inspiration-breath-hold 3D-conformal Radiotherapy Among Women With Left Breast Cancer.

Background/aim: This study aimed to analyze the dosimetric gain of the deep-inspiration-breath-hold (DIBH) technique over the free-breathing (FB) one in left breast cancer (LBC) 3D-conformal-radiotherapy (3D-CRT), and simultaneously investigate the anatomical parameters related to heart RT-exposure.

Patients And Methods: Treatment plans were generated in both DIBH and FB scenarios for 116 LBC patients monitored by the Varian RPM™ respiratory gating system for delivery of conventional or moderately hypofractionated schedules (±sequential boost). For comparison, we considered cardiac and ipsilateral lung doses and volumes.

Lung stereotactic ablative body radiotherapy: A large scale multi-institutional planning comparison for interpreting results of multi-institutional studies.

Purpose: A large-scale multi-institutional planning comparison on lung cancer SABR is presented with the aim of investigating possible criticism in carrying out retrospective multicentre data analysis from a dosimetric perspective.

Methods: Five CT series were sent to the participants. The dose prescription to PTV was 54Gy in 3 fractions of 18Gy.