Novel bioabsorbable, low-dose rate brachytherapy device (CivaSheet) with radical prostatectomy and adjuvant external beam radiation for the management of prostate cancer.

Objective: To investigate the safety and cancer control of a novel bioabsorbable, low-dose rate brachytherapy device, CivaSheet (CivaTech Oncology Inc., Durham, NC, USA), in combination with radical prostatectomy (RP) with or without adjuvant external beam radiation therapy (EBRT) for the management of prostate cancer (PCa).

Patients And Methods: This is an initial, single-centre experience, two-dose level, two-stage study conducted on patients with intermediate- and high-risk PCa.

Quantification of the environmental impact of radiotherapy and associated secondary human health effects: a multi-institutional retrospective analysis and simulation.

Background: The health-care industry is a substantial contributor to global greenhouse gas emissions, yet the specific environmental impact of radiotherapy, a cornerstone of cancer treatment, remains under-explored. We aimed to quantify the emissions associated with the delivery of radiotherapy in the USA and propose a framework for reducing the environmental impact of oncology care.

Methods: In this multi-institutional retrospective analysis and simulation study, we conducted a lifecycle assessment of external beam radiotherapy (EBRT) for ten anatomical disease sites, adhering to the International Organization for Standardization's standards ISO 14040 and ISO 14044.

Head and Neck Cancer Patient Population, Management, and Oncologic Outcomes from the COVID-19 Pandemic.

The COVID-19 pandemic precipitated drastic changes in cancer care. Its impact on the U.S.

Improved safety and quality in intravascular brachytherapy: A multi-institutional study using failure modes and effects analysis.

Purpose: Highlight safety considerations in intravascular brachytherapy (IVBT) programs, provide relevant quality assurance (QA) and safety measures, and establish their effectiveness.

Methods And Materials: Radiation oncologists, medical physicists, and cardiologists from three institutions performed a failure modes and effects analysis (FMEA) on the radiation delivery portion of IVBT. We identified 40 failure modes and rated the severity, occurrence, and detectability before and after consideration of safety practices.

Tracking and Reducing SF Usage in Radiation Oncology: A Step Toward Net-Zero Health Care Emissions.

Sulfur hexafluoride (SF) is a widely used insulating gas in medical linear accelerators (LINACs) due to its high dielectric strength, heat transfer capabilities, and chemical stability. However, its long lifespan and high Global Warming Potential (GWP) make it a significant contributor to the environmental impact of radiation oncology. SF has an atmospheric lifespan of 3200 years and a GWP 23,000 times that of carbon dioxide.

Dosimetric comparison of two afterloaders and treatment planning systems in vaginal high-dose-rate brachytherapy.

Purpose: In treatment planning for high-dose-rate (HDR) single-channel vaginal cylinder brachytherapy, dose distribution along the cylinder is influenced by the anisotropy of the source. Differences in anisotropy are due to differences in source dimensions and characteristics. In this study, we compared HDR vaginal cylinder brachytherapy treatment plans from two afterloader/treatment planning systems.

Premature discontinuation of curative radiation therapy: Insights from head and neck irradiation.

Purpose: Factors related to premature discontinuation of curative radiation therapy (PDCRT) are understudied. This study aimed to examine causes and clinical outcomes of PDCRT at our institution by investigating the most common anatomical site associated with PDCRT.

Methods And Materials: Among the 161 patients with PDCRT of various anatomic sites at our institution between 2010 and 2017, 36% received radiation to the head and neck region.

Long-term outcomes of acromegaly treated with fractionated stereotactic radiation: case series and literature review.

Background: Growth hormone (GH)-secreting pituitary adenomas represent an uncommon subset of pituitary neoplasms. Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) have been used as primary or adjuvant treatment. The purpose of this study is to report the long-term tumor control and toxicity from our institution and to perform a systematic literature review of acromegaly patients treated with FSRT.

Computed tomography-based treatment planning for high-dose-rate brachytherapy using the tandem and ring applicator: influence of applicator choice on organ dose and inter-fraction adaptive planning.

Three dimensional planning for high-dose-rate (HDR) brachytherapy in cervical cancer has been highly recommended by consensus guidelines such as the American Brachytherapy Society (ABS) and the Groupe Européen de Curiethérapie - European Society for Radiotherapy and Oncology (GEC-ESTRO). In this document, we describe our experience with computed tomography (CT)-based planning using the tandem/ring applicator. We discuss the influence of applicator geometry on doses to organs at risk (OARs), namely the bladder, rectum, and sigmoid.

Low-dose cranial boost in high-risk adult acute lymphoblastic leukemia patients undergoing bone marrow transplant.

Purpose: Acute lymphoblastic leukemia (ALL) has a predilection for CNS involvement. Patients with high-risk ALL are often managed with transplant using a radiation-based conditioning regimen. Historically, a high-dose prophylactic cranial boost (CB) of ≥12 Gy was given to reduce risk of central nervous system (CNS) recurrence.

The use of isodose levels to interpret radiation induced lung injury: a quantitative analysis of computed tomography changes.

Background: Patients treated with stereotactic body radiation therapy (SBRT) for lung cancer are often found to have radiation-induced lung injury (RILI) surrounding the treated tumor. We investigated whether treatment isodose levels could predict RILI.

Methods: Thirty-seven lung lesions in 32 patients were treated with SBRT and received post-treatment follow up (FU) computed tomography (CT).

Intracoronary brachytherapy for in-stent restenosis of drug-eluting stents.

Purpose: Given the limited salvage options for in-stent restenosis (ISR) of drug-eluting stents (DES), our high-volume cardiac catheterization laboratory has been performing intracoronary brachytherapy (ICBT) in patients with recurrent ISR of DES. This study analyzes their baseline characteristics and assesses the safety/toxicity of ICBT in this high-risk population.

Methods And Materials: A retrospective analysis of patients treated with ICBT between September 2012 and December 2014 was performed.

Lhermitte's Sign following VMAT-Based Head and Neck Radiation-Insights into Mechanism.

Purpose/objectives: We observed a number of patients who developed Lhermitte's sign (LS) following radiation to the head and neck (H/N), since instituting volumetric modulated arc therapy (VMAT). We aimed to investigate the incidence of LS following VMAT-based RT without chemotherapy, and determine the dosimetric parameters that predict its development. We explored whether the role of inhomogeneous dose distribution across the spinal cord, causing a "bath-and-shower" effect, explains this finding.

A Feasibility Study of Tumor Motion Estimate With Regional Deformable Registration Method for 4-Dimensional Radiation Therapy of Lung Cancer.

This study aims to employ 4-dimensional computed tomography to quantify intrafractional tumor motion for patients with lung cancer to improve target localization in radiation therapy. A multistage regional deformable registration was implemented to calculate the excursion of gross tumor volume (GTV) during a breathing cycle. GTV was initially delineated on 0% phase of 4-dimensional computed tomography manually, and a subregion with 20 mm margin supplemented to GTV was generated with Eclipse treatment planning system (Varian Medical Systems, Palo Alto, California).

Tracking fuzzy borders using geodesic curves with application to liver segmentation on planning CT.

Purpose: This work aims to develop a robust and efficient method to track the fuzzy borders between liver and the abutted organs where automatic liver segmentation usually suffers, and to investigate its applications in automatic liver segmentation on noncontrast-enhanced planning computed tomography (CT) images.

Methods: In order to track the fuzzy liver-chestwall and liver-heart borders where oversegmentation is often found, a starting point and an ending point were first identified on the coronal view images; the fuzzy border was then determined as a geodesic curve constructed by minimizing the gradient-weighted path length between these two points near the fuzzy border. The minimization of path length was numerically solved by fast-marching method.

Commissioning a 50-100 kV X-ray unit for skin cancer treatment.

This study provides the authors' experience along with dosimetric data from the commissioning of two Sensus SRT-100 50-100 kV X-ray units. Data collected during the commissioning process included: a) HVL, b) output (dose rate), c) applicator cone factors, and d) percentage depth dose. A Farmer-type chamber (PTW-N23333), and a thin-window parallel plate ion chamber (PTW-N23342) were used for dose rate measurements and dose profiles were measured with EBT3 GafChromic film.

Microdosimetric characteristics of 50 kV X rays at different depths for breast intraoperative radiotherapy.

An intraoperative radiation therapy (IORT) device with 50 kV X rays was designed to deliver a single dose to the tumour bed after local excision of breast cancer. The quality of a radiation can be determined by the microscopic distribution of energy transfers along and across the charged particle tracks. The lineal energy, y, serves as an accurate measure of local energy concentration.

Implementation of EPID transit dosimetry based on a through-air dosimetry algorithm.

Purpose: A method to perform transit dosimetry with an electronic portal imaging device (EPID) by extending the commercial implementation of a published through-air portal dose image (PDI) prediction algorithm Van Esch et al. [Radiother. Oncol.