Importance: Radiotherapy (RT) plan quality is an established predictive factor associated with cancer recurrence and survival outcomes. The addition of radiologists to the peer review (PR) process may increase RT plan quality.
Objective: To determine the rate of changes to the RT plan with and without radiology involvement in PR of radiation targets.
Objective: Gamma Knife radiosurgery (GKRS) is a treatment option for refractory trigeminal neuralgia (TN). However, there is a paucity of data regarding the effectiveness of GKRS for relapsing TN following microvascular decompression (MVD). The aim of this study was to characterize the response rate, complications, pain relief durability, and predictors of pain relapse for salvage GKRS following MVD for TN.
View Article and Find Full Text PDFObjective: Opportunity exists for improved local control rates of grade 2 meningiomas that recur despite maximal surgical resection and adjuvant fractionated radiotherapy (RT). We describe a dose escalation strategy of increasing the total tumor radiation dose by adding a stereotactic radiosurgery (SRS) boost targeting gross disease to fractionated RT.
Methods: A single-institution retrospective cohort of patients from 2009-2023 with grade 2 meningioma treated with surgical resection, fractionated RT, and SRS boost were evaluated for baseline characteristics, local disease control, and adverse events (AE).
Aims: During the COVID-19 public health emergency, we previously identified decreased rates of radiotherapy (RT) peer review (PR) discussion and plan changes in virtual versus in-person PR conferences. To expand on these findings, we continued to prospectively collect data on all PR conferences from 2021 to 2023 and performed a follow-up analysis before and after the transition back to in-person PR.
Materials And Methods: A prospectively maintained database of weekly PR cases was queried for consecutive cases reviewed before and after the transition from virtual to in-person conferences.
Background And Purpose: Histology was found to be an important prognostic factor for local tumor control probability (TCP) after stereotactic body radiotherapy (SBRT) of early-stage non-small-cell lung cancer (NSCLC). A histology-driven SBRT approach has not been explored in routine clinical practice and histology-dependent fractionation schemes remain unknown. Here, we analyzed pooled histologic TCP data as a function of biologically effective dose (BED) to determine histology-driven fractionation schemes for SBRT and hypofractionated radiotherapy of two predominant early-stage NSCLC histologic subtypes adenocarcinoma (ADC) and squamous cell carcinoma (SCC).
View Article and Find Full Text PDFBackground: Clinical biomarkers for brain metastases remain elusive. Increased availability of genomic profiling has brought discovery of these biomarkers to the forefront of research interests.
Method: In this single institution retrospective series, 130 patients presenting with brain metastasis secondary to Non-Small Cell Lung Cancer (NSCLC) underwent comprehensive genomic profiling conducted using next generation circulating tumor deoxyribonucleic acid (DNA) (Guardant Health, Redwood City, CA).
Organic dosimeters offer unique advantages over traditional technologies, and they can be used to expand the capabilities of current radiation detection systems. In-depth knowledge of the mechanisms underlying the interaction between radiation and organic materials is essential for their widespread adoption. Here, we identified and quantitatively characterized the electronic traps generated during the operation of radiation dosimeters based on organic field-effect transistors.
View Article and Find Full Text PDFInt J Radiat Oncol Biol Phys
March 2024
Purpose: A series of radiobiological models were developed to study tumor control probability (TCP) for stereotactic body radiation therapy (SBRT) of early-stage non-small cell lung cancer (NSCLC) per the Hypofractionated Treatment Effects in the Clinic (HyTEC) working group. This study was conducted to further validate 3 representative models with the recent clinical TCP data ranging from conventional radiation therapy to SBRT of early-stage NSCLC and to determine systematic optimal fractionation regimens in 1 to 30 fractions for radiation therapy of early-stage NSCLC that were found to be model-independent.
Methods And Materials: Recent clinical 1-, 2-, 3-, and 5-year actuarial or Kaplan-Meier TCP data of 9808 patients from 56 published papers were collected for radiation therapy of 2 to 4 Gy per fraction and SBRT of early-stage NSCLC.
Rationale And Objectives: The treatment of locally advanced lung cancer (LALC) with radiotherapy (RT) can be challenging. Multidisciplinary collaboration between radiologists and radiation oncologists (ROs) may optimize RT planning, reduce uncertainty in follow-up imaging interpretation, and improve outcomes.
Materials And Methods: In this prospective clinical treatment trial (clinicaltrials.
Purpose: Head and neck (HN) radiotherapy (RT) is complex, involving multiple target and organ at risk (OAR) structures delineated by the radiation oncologist. Site-agnostic peer review after RT plan completion is often inadequate for thorough review of these structures. In-depth review of RT contours is critical to maintain high-quality RT and optimal patient outcomes.
View Article and Find Full Text PDFBackground: Re-irradiation for recurrent gliomas is a controversial treatment option with no clear standard dose or concurrent systemic therapy.
Methods: This series represents a single-institution retrospective review of patients treated with re-irradiation for recurrent high-grade glioma. After 2012, patients were commonly offered concurrent bevacizumab as a cytoprotective agent against radiation necrosis.
Background: To describe intensity-modulated radiotherapy (IMRT) with Gamma Knife Radiosurgery (GKRS) boost for locally advanced head and neck cancer (HNC) with disease near dose-limiting structures.
Methods: Patients with HNC treated with IMRT/GKRS as part of a combined modality approach between 2011 and 2021 were reviewed. Local control, overall survival and disease-specific survival were estimated using the Kaplan Meier method.
Splenic metastases from oligometastatic ovarian carcinoma are a rare occurrence. Usual treatment for splenic metastases includes splenectomy, but some patients are either unable or unwilling to undergo surgery. Stereotactic body radiotherapy (SBRT) is an effective ablative modality for treating metastatic disease.
View Article and Find Full Text PDFTech Innov Patient Support Radiat Oncol
September 2018
The purpose of this study was to determine if medical linear accelerators (linac) produced by the same manufacturer exhibit operational consistency within their subsystems and components. Two linacs that were commissioned together and installed at the same facility were monitored. Each machine delivered a daily robust quality assurance (QA) irradiation.
View Article and Find Full Text PDFPurpose: The purpose of this study was to experimentally examine the reliability of the gradient chamber alignment point (gCAP) determination method for accurately identifying water surface location with a range of ionization chambers (ICs).
Materials And Methods: Twelve cylindrical ICs were scanned from depth through a water surface into air using a customized high-accuracy scanning system which allows for accurate alignment of the IC with respect to the true water surface. Thirteen other cylindrical ICs and five parallel-plate ICs were scanned using a standard commercially available scanning system.
Purpose: To examine the response properties of cylindrical cavity ionization chambers (ICs) in the depth-ionization buildup region so as to obtain a robust chamber-signal - based method for definitive water surface identification, hence absolute ionization chamber depth localization.
Method & Materials: An analytical model with simplistic physics and geometry is developed to explore the theoretical aspects of ionization chamber response near a phantom water surface. Monte Carlo simulations with full physics and ionization chamber geometry are utilized to extend the model's findings to realistic ion chambers in realistic beams and to study the effects of IC design parameters on the entrance dose response.
Textbook examples of adaptive radiation often show rapid morphological changes in response to environmental perturbations. East Africa's Lake Victoria, famous for its stunning adaptive radiation of cichlids, has suffered from human-induced eutrophication over the past decades. This cultural eutrophication is thought to be partly responsible for the dramatically reduced cichlid biodiversity, but climatic variability in itself might also have contributed to the eutrophication which resulted in low oxygen levels and decreased water transparency.
View Article and Find Full Text PDFThe objective of this study is to present a method to reduce the setup error inherent in clinical depth dose measurements and, in doing so, to improve entrance dosimetry measurement reliability. Ionization chamber (IC) depth dose measurements are acquired with the depth scan extended into the air above the water surface. An inflection region is obtained in each resulting percent depth ionization (PDI) curve that can be matched against other measurements or to an inflection region obtained from an analogous Monte Carlo (MC) simulation.
View Article and Find Full Text PDFBackground: The aim was to explore measurements of arm circumference and shoulder abduction as indicators of quality of life after axillary lymph node dissection for invasive breast cancer.
Methods: Differences in arm circumference and shoulder abduction were measured in 465 consecutive women who underwent axillary lymph node dissection. These women received a treatment-specific questionnaire on the severity of physical disability and the effects on their daily life and well-being.
The aim of this study was to investigate the nature and severity of the arm complaints among breast cancer patients after axillary lymph node dissection (ALND) and to study the effects of this treatment-related morbidity on daily life and well-being. 400 women, who underwent ALND as part of breast cancer surgery, filled out a treatment-specific quality of life questionnaire. The mean time since ALND was 4.
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