Effect of Multimodal Prehabilitation on Muscle Mass in Rectal Cancer Patients Receiving Neoadjuvant Treatment.

Colorectal cancer is the second most prevalent type of cancer in the world. Surgical complications occur in up to 50% of patients which results in increased morbidity, mortality, and poor health-related quality of life. The negative impact on survival and physical function is exacerbated in those receiving neoadjuvant treatment.

Total ablative stereotactic body radiotherapy to primary and oligometastatic renal cell carcinoma in medically inoperable cases: An institutional analysis.

Introduction: Stereotactic body radiotherapy (SBRT) has been found to be an effective and safe modality with excellent oncological outcome in medically inoperable primary renal cell carcinoma (RCC) and oligometastases. There is scarcity of data on the synchronous delivery of SBRT to primary and oligometastatic RCC in patients unfit for nephrectomy. Here, we report the findings of a retrospective study of prospectively collected data on "total ablative SBRT.

Optimal Combination of Pitch, Modulation Factor and Dosimetric Considerations in Treatment Planning for Total Body Irradiation Using Helical Tomotherapy.

Objective: The aim of this study is to makethe standard total body irradiation (TBI) protocol for Helical tomotherapy© (HT) and to analyze the optimal pitch and modulation factor (MF) with respect to dose homogeneity index (HI), target dose coverage, target overdose, beam on time (BOT) and mean lung dose.

Materials And Methods: Ten patients who underwent high-dose TBI were taken for this study. For each patient, 35 dose plans were created by different combination of pitch and MF.

Commissioning and Dosimetric Results of an Indigenously Developed Intra-Vaginal Template for Interstitial Plus Intracavitary High dose Rate Image-Guided Brachytherapy of Advanced Cervix Cancer.

Aim: The goal of this study is to discuss the commissioning and dosimetric parameters achieved during the clinical implementation of an indigenously developed intracavitary (IC) plus interstitial (IS) template for high dose rate (HDR) image-guided brachytherapy (IGBT) in cancer (Ca) cervix. We want to discuss our achieved values of cumulative equi-effective doses (EQD2) for high-risk clinical target volume (HRCTV) and organ at risk (OAR) and compare it with available published results.

Materials And Methods: Medanta anterior oblique/lateral oblique template has a total of 19 needles including the central tandem.

Diagrammatic Approach to Delineate Phrenic Nerve in Central Lung Tumors.

Incremental use of high-dose radiation therapy (RT) with SABR in thoracic tumors has led to identification of many unusual toxicities (chest wall pain, rib fractures, vascular perforation, brachial plexopathy) and consequently additional organs at risk (OARs; chest wall, ribs, bronchial wall, carotid artery, brachial plexus). Phrenic nerve is another structure that may be affected at any point during its long course from origin until end, although symptomatic toxicities have been reported rarely in the setting of reirradiation, large-volume irradiation such as mantle field, or SABR. We undertook a prospective study to describe the delineation of phrenic nerve course on RT planning computed tomography scan as an OAR.

Nidus delineation and dosimetric comparison in arteriovenous malformation in stereotactic radiosurgery by using MRI and 3DCT angiography.

Purpose/objectives: Accurate delineation of target is key to any successful radiosurgery. C-arm Dyna CT/ 3DCT angiography (3DCTA) has the potential of improving the accuracy of nidus delineation in intracranial arteriovenous malformations (AVM) due to high temporo-spatial resolution of vessel architecture. Here, we present a comparison of nidus delineation and dosimetric parameters between digital 3DCTA and MRI.

CyberKnife Stereotactic Ablative Radiotherapy for Recurrent or Oligometastatic Gynecological Cancers.

Use of stereotactic ablative radiotherapy (SABR) in the treatment of recurrent or metastatic lesions from a primary gynecologic cancer is a relatively new concept. The present study aims to assess the safety, efficacy, and possible toxicity profile of CyberKnife SABR, recurrent or metastatic disease. CyberKnife VSI-based SABR was offered to 20 oligometastatic/recurrent gynecological cancer patients between 2013 and 2019.

Radiation-Induced Pan-Valvular Involvement: A Rare Case Report.

Radiotherapy is an important treatment modality for various thoracic malignancies but is associated with long-term risk of radiation-associated valve disease (RAVD). We hereby report a case of a lady who had received radiotherapy 30 years back for carcinoma breast and was now found to be having clinically significant RAVD involving all the four cardiac valves. Simultaneous involvement of all the four valves in RAVD is extremely rare and has not been reported previously.

Dosimetric Comparison of Robotic and Linear Accelerator Multi-Leaf Collimator-Based Stereotactic Radiosurgery for Arteriovenous Malformation.

Purpose: To investigate the dosimetric comparison of different collimators which are used in robotic radiosurgery (cyberknife-CK) and linear accelerator (LINAC) for stereotactic radiosurgery (SRS) in arteriovenous malformation (AVM).

Materials And Methods: Twenty-five AVM patients were planned in CK using FIXED cone, IRIS collimator, and multi-leaf collimator (MLC) based in LINAC. Dosimetric comparison was performed using Paddick conformity index (CI) and International Commission on Radiation Units and measurements (ICRU) homogeneity index (HI), gradient score (GS), normal brain dose received by 10cc (D) and critical structure (brain stem, optic chiasma, optic nerves) doses.

Artificial intelligence in brachytherapy: a summary of recent developments.

Artificial intelligence (AI) applications, in the form of machine learning and deep learning, are being incorporated into practice in various aspects of medicine, including radiation oncology. Ample evidence from recent publications explores its utility and future use in external beam radiotherapy. However, the discussion on its role in brachytherapy is sparse.

Phase I/II Study of Extreme Hypofractionated Stereotactic Body Radiation Therapy Boost to Prostate for Locally Advanced, Node-Positive and Oligometastatic Cancer.

Introduction:  Stereotactic body radiation therapy (SBRT) is increasingly being utilized to deliver escalated radiation doses for improving outcomes in various malignancies. We analyzed our cohort of locally advanced, node-positive, and bone oligometastatic prostate cancer patients, that were treated with a combination of pelvic RT using conventional fractionation (CF) and SBRT boost to prostate using extreme hypofractionation (EH), along with hormone therapy (HT).

Materials And Methods:  Outcomes of 44 prospectively treated patients were analyzed.

Artificial intelligence in oncology, its scope and future prospects with specific reference to radiation oncology.

Objective: Artificial intelligence (AI) seems to be bridging the gap between the acquisition of data and its meaningful interpretation. These approaches, have shown outstanding capabilities, outperforming most classification and regression methods to date and the ability to automatically learn the most suitable data representation for the task at hand and present it for better correlation. This article tries to sensitize the practising radiation oncologists to understand where the potential role of AI lies and what further can be achieved with it.

Modulated Radiotherapy with Concurrent and Adjuvant Temozolomide for Anaplastic Gliomas: Indian Single-center Data.

Objective: To evaluate early clinical outcome for anaplastic gliomas (AG) treated in the era of modulated radiotherapy (RT) and concurrent plus adjuvant temozolomide (TMZ) in an Indian setting.

Materials And Methods: Fifty-three patients with AGs treated with modulated RT and concurrent (95%) and adjuvant TMZ (90%) were analyzed. About 80% of patients had Karnofsky performance status (KPS) at least 90 with 30% seizure at presentation.

Use of ultrasound in image-guided high-dose-rate brachytherapy: enumerations and arguments.

Inherently, brachytherapy is the most conformal radiotherapeutic technique. As an aid to brachytherapy, ultrasonography (USG) serves as a portable, inexpensive, and simple to use method allowing for accurate, reproducible, and adaptive treatments. Some newer brachytherapy planning systems have incorporated USG as the sole imaging modality.

Cardiovascular sequel of neck irradiation in head and neck cancer patients.

Purpose: The baroreflex is an important afferent mechanism controlling autonomic functions. As afferent nerves course through the neck, they are susceptible to damage by neck irradiation in head and neck cancer patients. With increased survival of head and neck cancer patients because of improved therapy, the cardiovascular morbidity and mortality in them have become apparent and this is of clinical concern.

Quantification of coronary artery motion and internal risk volume from ECG gated radiotherapy planning scans.

Background: Radiotherapy for carcinoma of breast and thoracic structures involves inadvertent radiation to heart and coronary arteries (CA). Coronary artery stenosis in high radiation dose segments has been documented. Cardiac and respiratory motion induced displacement of CA and internal risk volume (IRV) margin remains inadequately quantified.

Simple diagrammatic method to delineate male urethra in prostate cancer radiotherapy: an MRI based approach.

Stereotactic body radiotherapy (SBRT) is being increasingly utilized in the treatment of prostate cancer. With the advent of high-precision radiosurgery systems, it is possible to obtain dose distributions akin to high-dose rate brachytherapy with SBRT. However, urethral toxicity has a significant impact on the quality of life in patients with prostate cancer.

Clinical outcomes of adaptive radiotherapy in head and neck cancers.

Objective: The present study evaluated the efficacy and toxicity of adaptive radiotherapy (RT) among patients with head and neck cancer.

Methods: 36 patients eligible for radical RT underwent RT planning scans and were planned for 54-Gy dose to both high-risk and low-risk target volumes in Phase I. All patients underwent a second (adaptive) scan during the fifth week of RT.

Analysis of intrafraction motion in CyberKnife-based stereotaxy using mask based immobilization and 6D-skull tracking.

Purpose: Analysis of intrafraction motion in patients with intracranial targets treated with frameless, mask based stereotactic radiosurgery / radiotherapy using standard couch and 6D-skull tracking on CyberKnife.

Materials And Methods: Twenty-seven treatment datasets of fifteen patients were analyzed. For each sequential pair of images, the correction to the target position (position "offset") in six-degrees of motion was obtained.

Simple diagrammatic approach to delineate duodenum on a radiotherapy planning CT scan.

In recent years, there has been increasing application of intensity-modulated radiotherapy and stereotactic body radiotherapy for the treatment of abdominal malignancies (stomach, pancreas, liver, spinal metastases). This warrants accurate delineation of organs at risk, especially the duodenum. The tortuous and curvy anatomy of duodenum often indistinguishable from adjoining organs is a practical challenge.

Dosimetric comparison between Volumetric Modulated Arc Therapy (VMAT) vs Intensity Modulated Radiation Therapy (IMRT) for radiotherapy of mid esophageal carcinoma.

Aims: Dosimetric comparison of VMAT with IMRT in middle third esophageal cancer for planning target volume (PTV) and organs at risk (OAR).

Materials And Methods: Ten patients in various stages from I‒III were inducted in the neo-adjuvant chemoradiation protocol for this study. The prescribed dose was 4500 cGy in 25 fractions.