Background: For decades, Anterior-Posterior/Posterior-Anterior (AP/PA) photon beams were standard-of-care for flank irradiation in children with renal cancer. Recently, highly conformal flank target volumes were defined correcting for postoperative organ shift and intra-fraction motion.By radiotherapy treatment plan comparison, this study aims to estimate the clinical benefits and potential risks of combining highly conformal target volumes with Volumetric-Modulated Arc Therapy (VMAT) versus conventional target volumes with AP/PA beams for flank irradiation.
Materials And Methods: Twenty consecutive renal tumor cases (left/right-sided:10/10; median age:3.2 years) were selected. Highly conformal flank target volumes were generated for VMAT, while conventional target volumes were used for AP/PA. For each case, the dose to the organs at risk (OARs) and Total Body Volume (TBV) was calculated to compare VMAT with AP/PA treatment plans for a prescribed dose (PD) of 14.4/1.8 Gy. Dose constraint violation of the tail of the pancreas and spleen (D < 10 Gy), heart (D < 5 Gy) or mammary buds (D < 10 Gy) were prioritized as potentially beneficial for clinics.
Results: Highly conformal Planning Target Volumes (PTV) were smaller than conventional volumes (mean ΔPTV-PTV: 555 mL, Δ60%, p=<0.01). A mean dose reduction favoring VMAT was observed for almost all OARs. Dose constraints to the tail of the pancreas, spleen, heart and mammary buds were fulfilled in 8/20, 12/20, 16/20 and 19/20 cases with AP/PA, versus 14/20, 17/20, 20/20 and 20/20 cases with VMAT, respectively. In 12/20 cases, VMAT prevented the dose constraint violation of one or more OARs otherwise exceeded by AP/PA. VMAT increased the TBV receiving 10% of the PD, but reduced the amount of irradiated TBV for all higher doses.
Conclusion: Compared to 14.4 Gy flank irradiation using conventional AP/PA photon beams, an estimated clinical benefit by dose reduction to the OARs can be expected in 60% of the pediatric renal tumor cases using highly conformal flank target volumes combined with VMAT.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8134033 | PMC |
http://dx.doi.org/10.1016/j.ctro.2021.04.007 | DOI Listing |
Nat Commun
January 2025
Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, CA, USA.
Myocardial fibrosis leads to cardiac dysfunction and arrhythmias in heart failure with preserved ejection fraction (HFpEF), but the underlying mechanisms remain poorly understood. Here, RNA sequencing identifies Forkhead Box1 (FoxO1) signaling as abnormal in male HFpEF hearts. Genetic suppression of FoxO1 alters the intercellular communication between cardiomyocytes and fibroblasts, alleviates abnormal diastolic relaxation, and reduces arrhythmias.
View Article and Find Full Text PDFJ Vasc Surg
January 2025
Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester MN, USA. Electronic address:
Objectives: Celiac artery (CA) incorporation during FB-EVAR for complex abdominal aortic aneurysms (cAAA) is typically performed with fenestrations. Double-wide scallops (DWS) can be used when appropriate. We aimed to assess outcomes of patients treated with DWS for the CA during FB-EVAR for cAAA.
View Article and Find Full Text PDFJ Vasc Interv Radiol
January 2025
Inonu University, Faculty of Medicine, Department of Biostatistics and Medical Informatics, Malatya, Türkiye.
Purpose: To evaluate changes in non-target hepatic hemangiomas, which are neither subjected to embolization nor targeted for treatment, following selective bleomycin-lipiodol transarterial chemoembolization (TACE) of a giant hepatic hemangioma.
Materials And Methods: This single-center retrospective study included 24 patients with non-target hepatic hemangiomas distinct from primary giant hemangiomas treated with selective bleomycin-lipiodol TACE between 2009 and 2022. The size and volume of the lesions were assessed using computed tomography scans obtained before treatment, and at 6, 12 and 24 months.
J Chromatogr A
January 2025
Environmental Health Laboratory Branch, Center for Laboratory Sciences, California Department of Public Health, Richmond, CA 94804, USA.
A solvent-free, thermal extraction method for analysis of polycyclic aromatic hydrocarbons (PAHs) in gas phase airborne samples was developed. A fully automated thermal desorber (TD) coupled with highly selective and sensitive gas chromatography-tandem mass spectrometry (GC-MS/MS) was used to determine the concentration of trace level PAHs. Air sampling was conducted to tune the sampling and analytical conditions.
View Article and Find Full Text PDFNeurosurg Rev
January 2025
Department of Neurosurgery, Pamukkale University School of Medicine, Kim Burchiel Gamma Knife Center, Denizli, Türkiye, Turkey.
This study aims to demonstrate the effect of gamma knife radiosurgery (GKRS) on symptoms, hemorrhage rates, and histopathological changes in patients with cavernous malformations (CMs), regardless of whether the symptomatic lesions are hemorrhagic. This single-center retrospective study evaluated symptomatic patients with single CMs treated with GKRS between 2016 and 2023. The patients' demographic data, presenting symptoms, GKRS radiation dose, complications developed during follow-up (hemorrhage, radiotoxicity), the rate of symptom improvement, and histopathological changes of surgically removed CMs were recorded.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!