Publications by authors named "M Ladra"
Purpose: The purpose of this study was to determine whether virtual computed tomography (vCT) derived from daily cone beam computed tomography (CBCT), or on-treatment magnetic resonance imaging (MRI) can replace quality assurance computed tomography (qCT) in our clinical workflow to minimize imaging dose and potentially anesthesia exposure in patients requiring plan adaptation.
Methods And Materials: Pediatric patients (age <24 years) treated from 2020 to 2023 with intensity modulated proton therapy with at least 1 qCT during proton therapy were eligible. For cases that required plan adaptation, the dose was recalculated on vCT and compared with same-day qCT as well as the original planning computed tomography (pCT).
Article Synopsis
- The study reviewed six pediatric osteosarcoma patients with brain metastases at Johns Hopkins Hospital, revealing a grim median survival of just 2.5 months post-diagnosis.
- Despite various treatments like chemotherapy, surgery, and radiation, most outcomes were fatal, although one patient showed a remarkable 13-month survival with a combination treatment, suggesting the potential of multimodal therapies.
- The findings stress the importance of careful monitoring for neurological symptoms and highlight the need for further research into new treatment strategies and the biology of metastasis to improve patient outcomes.
Purpose: Proton therapy is the preferred treatment modality for most pediatric central nervous system tumors. The risk of radiation necrosis may be increased at the distal end of the beam because of an increase in linear energy transfer (LET) and relative biological effectiveness (RBE) dose. We report on the association of LET and dose with radiation necrosis after pencil beam scanning proton therapy in pediatric posterior fossa tumors using a case-control framework.
View Article and Find Full Text PDFPurpose: Despite the urgent need for improved outcomes in patients with metastatic Ewing sarcoma (EWS) and rhabdomyosarcoma (RMS), it is unknown how to best approach metastatic-site radiation therapy for these patients and whether such treatment provides a significant oncologic benefit that outweighs the toxicities.
Methods And Materials: We gathered a panel of pediatric radiation oncologists from academic hospitals to identify and discuss current controversies regarding the role of radiation in the management of metastatic EWS and RMS. The panel reviewed existing clinical data and ongoing trials to address 5 key questions: (1) the role of whole lung irradiation (WLI) in treating lung metastases; (2) the number of metastatic sites warranting radiation therapy and the radicality of such an approach; (3) radiation techniques, including stereotactic body radiation therapy (SBRT); (4) the timing of metastatic-site radiation therapy; and (5) the utility of metastatic-site radiation therapy for relapsed metastatic disease.
Purpose: To describe early tumor volume change in patients with rhabdomyosarcoma (RMS) and investigate its association with overall survival (OS) and local failure.
Methods And Materials: This retrospective study included patients who received diagnoses of group III/IV RMS with available computed tomography and/or magnetic resonance imaging scans at 2 time points: (1) pretherapy and (2) early therapy (acquired during weeks 8-12 of chemotherapy). Relative volumetric change (RVC) was calculated as the percentage of (early therapy - pretherapy volume) / (pretherapy volume).