Predicting response to immunotherapy in non-small cell lung cancer- from bench to bedside.

Background: Immune checkpoint inhibitor (ICI) therapy is first-line treatment for many advanced non-small cell lung cancer (aNSCLC) patients. Predicting response could help guide selection of intensified or alternative anti-cancer regimens. We hypothesized that radiomics and laboratory variables predictive of ICI response in a murine model would also predict response in aNSCLC patients.

Abscopal effect observed in visceral and osseous metastases after liver SBRT in combination with nivolumab and relatlimab for sinonasal mucosal melanoma-a case report.

Background: Primary sinonasal mucosal melanoma (SNMM) is a rare, aggressive histology usually diagnosed at advanced stages and associated with poor prognosis. Evidence regarding etiology, diagnosis, and treatment mainly derives from case reports, retrospective series, and national databases. In the treatment of metastatic melanoma, anti-CTLA-4 and anti-PD-1 checkpoint blockade increased 5-year overall survival from ~10% (prior to 2011) to ~50% (between 2011 and 2016).

Lung Inflammation Predictors in Combined Immune Checkpoint-Inhibitor and Radiation Therapy-Proof-of-Concept Animal Study.

Purpose: Combined radiotherapy (RT) and immune checkpoint-inhibitor (ICI) therapy can act synergistically to enhance tumor response beyond what either treatment can achieve alone. Alongside the revolutionary impact of ICIs on cancer therapy, life-threatening potential side effects, such as checkpoint-inhibitor-induced (CIP) pneumonitis, remain underreported and unpredictable. In this preclinical study, we hypothesized that routinely collected data such as imaging, blood counts, and blood cytokine levels can be utilized to build a model that predicts lung inflammation associated with combined RT/ICI therapy.

Toward prediction of abscopal effect in radioimmunotherapy: Pre-clinical investigation.

Purpose: Immunotherapy (IT) and radiotherapy (RT) can act synergistically, enhancing antitumor response beyond what either treatment can achieve separately. Anecdotal reports suggest that these results are in part due to the induction of an abscopal effect on non-irradiated lesions. Systematic data on incidence of the abscopal effect are scarce, while the existence and the identification of predictive signatures or this phenomenon are lacking.

Longitudinal fan-beam computed tomography dataset for head-and-neck squamous cell carcinoma patients.

Purpose: To describe in detail a dataset consisting of longitudinal fan-beam computed tomography (CT) imaging to visualize anatomical changes in head-and-neck squamous cell carcinoma (HNSCC) patients throughout radiotherapy (RT) treatment course.

Acquisition And Validation Methods: This dataset consists of CT images from 31 HNSCC patients who underwent volumetric modulated arc therapy (VMAT). Patients had three CT scans acquired throughout the duration of the radiation treatment course.

Integral dose based inverse optimization objective function promises lower toxicity in head-and-neck.

Purpose: The voxels in a CT data sets contain density information. Besides its use in dose calculation density has no other application in modern radiotherapy treatment planning. This work introduces the use of density information by integral dose minimization in radiotherapy treatment planning for head-and-neck squamous cell carcinoma (HNSCC).

Automated inverse optimization facilitates lower doses to normal tissue in pancreatic stereotactic body radiotherapy.

Purpose: Inverse planning is trial-and-error iterative process. This work introduces a fully automated inverse optimization approach, where the treatment plan is closely tailored to the unique patient anatomy. The auto-optimization is applied to pancreatic stereotactic body radiotherapy (SBRT).

Assessment of Volumetric-Modulated Arc Therapy for Constant and Variable Dose Rates.

Purpose: The aim of this study is to compare the effects of dose rate on volumetric-modulated arc therapy plans to determine optimal dose rates for prostate and head and neck (HN) cases.

Materials And Methods: Ten prostate and ten HN cases were retrospectively studied. For each case, seven plans were generated: one variable dose rate (VDR) and six constant dose rate (CDR) (100-600 monitor units [MUs]/min) plans.

Integral Dose-Based Inverse Optimization May Reduce Side Effects in Radiotherapy of Prostate Carcinoma.

Purpose: The purpose of this work is to apply a novel inverse optimization approach, based on utilization of quantitative imaging information in the optimization function, to prostate carcinoma.

Materials And Methods: This new inverse optimization algorithm relies upon quantitative information derived from computed tomography (CT) imaging studies. The Hounsfield numbers of the CT voxels are converted to physical density, which in turn is used to calculate voxel mass and the corresponding integral dose, by summation over the product of dose and mass in each dose voxel.

A genome-based model for adjusting radiotherapy dose (GARD): a retrospective, cohort-based study.

Background: Despite its common use in cancer treatment, radiotherapy has not yet entered the era of precision medicine, and there have been no approaches to adjust dose based on biological differences between or within tumours. We aimed to assess whether a patient-specific molecular signature of radiation sensitivity could be used to identify the optimum radiotherapy dose.

Methods: We used the gene-expression-based radiation-sensitivity index and the linear quadratic model to derive the genomic-adjusted radiation dose (GARD).

New approach in lung cancer radiotherapy offers better normal tissue sparing.

Purpose: Medical images are more than pictures. They contain additional quantitative information which can be interrogated, quantified, and utilized. Besides anatomical information computed tomography (CT) imaging data provide electron density information.

Mathematical Formulation of DMH-Based Inverse Optimization.

Purpose: To introduce the concept of dose-mass-based inverse optimization for radiotherapy applications.

Materials And Methods: Mathematical derivation of the dose-mass-based formalism is presented. This mathematical representation is compared to the most commonly used dose-volume-based formulation used in inverse optimization.

Mathematical formulation of energy minimization - based inverse optimization.

Purpose: To introduce the concept of energy minimization-based inverse optimization for external beam radiotherapy.

Materials And Methods: Mathematical formulation of energy minimization-based inverse optimization is presented. This mathematical representation is compared to the most commonly used dose-volume based formulation used in inverse optimization.

Dosimetric effects caused by couch tops and immobilization devices: report of AAPM Task Group 176.

The dosimetric impact from devices external to the patient is a complex combination of increased skin dose, reduced tumor dose, and altered dose distribution. Although small monitor unit or dose corrections are routinely made for blocking trays, ion chamber correction factors, e.g.

The effect of gantry spacing resolution on plan quality in a single modulated arc optimization.

Volumetric-modulated arc technique (VMAT) is an efficient form of IMRT delivery. It is advantageous over conventional IMRT in terms of treatment delivery time. This study investigates the relation between the number of segments and plan quality in VMAT optimization for a single modulated arc.

Carbon fiber couch effects on skin dose for volumetric modulated arcs.

Purpose: The purpose of this study is to evaluate the dosimetric effect of carbon fiber couches (CFCs) on delivered skin dose as well as to explore potential venues for its minimization for volumetric modulated arc (VMAT) treatments.

Methods: A carbon fiber couch (BrainLab) was incorporated in Pinnacle treatment planning system (TPS) by autocontouring. A retrospective investigation on five lung and five prostate patient plans was performed.

Biological optimization in volumetric modulated arc radiotherapy for prostate carcinoma.

Purpose: To investigate the potential benefits achievable with biological optimization for modulated volumetric arc (VMAT) treatments of prostate carcinoma.

Methods And Materials: Fifteen prostate patient plans were studied retrospectively. For each case, planning target volume, rectum, and bladder were considered.

Lung dose for minimally moving thoracic lesions treated with respiration gating.

Purpose: To evaluate incidental doses to benign lung tissue for patients with minimally moving lung lesions treated with respiratory gating.

Methods And Materials: Seventeen lung patient plans were studied retrospectively. Tumor motion was less than 5 mm in all cases.

Monte Carlo dose verification of prostate patients treated with simultaneous integrated boost intensity modulated radiation therapy.

Background: To evaluate the dosimetric differences between Superposition/Convolution (SC) and Monte Carlo (MC) calculated dose distributions for simultaneous integrated boost (SIB) prostate cancer intensity modulated radiotherapy (IMRT) compared to experimental (film) measurements and the implications for clinical treatments.

Methods: Twenty-two prostate patients treated with an in-house SIB-IMRT protocol were selected. SC-based plans used for treatment were re-evaluated with EGS4-based MC calculations for treatment verification.

Quantification of the skin sparing effect achievable with high-energy photon beams when carbon fiber tables are used.

Purpose: To quantify the skin doses resulting from the use of carbon fiber couches (CFCs) for patient support.

Materials And Methods: BrainLab's CFC was evaluated for five prostate patients and five lung patients. For each patient PTV, organs at risk (OARs), and a 0.

Monte Carlo-based dosimetry of head-and-neck patients treated with SIB-IMRT.

Purpose: To evaluate the accuracy of previously reported superposition/convolution (SC) dosimetric results by comparing with Monte Carlo (MC) dose calculations for head-and-neck intensity-modulated radiation therapy (IMRT) patients treated with the simultaneous integrated boost technique.

Methods And Materials: Thirty-one plans from 24 patients previously treated on a phase I/II head-and-neck squamous cell carcinoma simultaneous integrated boost IMRT protocol were used. Clinical dose distributions, computed with an SC algorithm, were recomputed using an EGS4-based MC algorithm.