Introduction: Intensity modulated proton therapy (IMPT) is highly sensitive to anatomical variations which can cause inadequate target coverage during treatment. This study compares not-adapted (NA) robust plans to two adaptive IMPT methods - a fully-offline adaptive (FOA) and a simplified automatic online adaptive strategy (dose restoration (DR)) to determine the benefit of DR, in head and neck cancer (HNC).
Material/methods: Robustly optimized clinical IMPT doses in planning-CTs (pCTs) were available for a cohort of 10 HNC patients. During robust re-optimization, DR used isodose contours, generated from the clinical dose on pCTs, and patient specific objectives to reproduce the clinical dose in every repeated-CT(rCT). For each rCT(n = 50), NA, DR and FOA plans were robustly evaluated.
Results: An improvement in DVH-metrics and robustness was seen for DR and FOA plans compared to NA plans. For NA plans, 74%(37/50) of rCTs did not fulfill the CTV coverage criteria (D98%>95%Dprescription). DR improved target coverage, target homogeneity and variability on critical risk organs such as the spinal cord. After DR, 52%(26/50) of rCTs met all clinical goals. Because of large anatomical changes and/or inaccurate patient repositioning, 48%(24/50) of rCTs still needed full offline adaptation to ensure an optimal treatment since dose restoration was not able to re-establish the initial plan quality.
Conclusion: Robust optimization together with fully-automatized DR avoided offline adaptation in 52% of the cases. Implementation of dose restoration in clinical routine could ensure treatment plan optimality while saving valuable human and material resources to radiotherapy departments.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.radonc.2022.03.011 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
An IgM Cleaving Enzyme for Clearance of Anti-Pig Xenoreactive Antibodies in a Nonhuman Primate Model.
Xenotransplantation
January 2025
Department of Surgery, Duke University School of Medicine, Durham, North Carolina, USA.
Background: The removal of preformed antibodies with cleaving enzyme like IdeS (Imlifidase) has demonstrated therapeutic potential in organ transplantation for sensitized recipients. However, preformed xenoreactive antibodies (XAbs) against porcine glycans are predominantly IgM and considered detrimental in pig-to-human xenotransplantation.
Methods: Recombinant IceM, an endopeptidase cleaving IgM, was generated in Escherichia coli.
In image-guided radiotherapy (IGRT), four-dimensional cone-beam computed tomography (4D-CBCT) is critical for assessing tumor motion during a patients breathing cycle prior to beam delivery. However, generating 4D-CBCT images with sufficient quality requires significantly more projection images than a standard 3D-CBCT scan, leading to extended scanning times and increased imaging dose to the patient. To address these limitations, there is a strong demand for methods capable of reconstructing high-quality 4D-CBCT images from a 1-minute 3D-CBCT acquisition.
View Article and Find Full Text PDFOptimization of the extraction methods and evaluation of the hypoglycemic effect of extracts on artificially induced diabetic mice.
Heliyon
January 2025
Department of Chemical Engineering, Bangladesh University of Engineering and Technology, Dhaka, 1000, Bangladesh.
Synthetic antidiabetic drugs are often associated with various adverse side effects, including hypoglycemia, nausea, gastrointestinal disturbances, headaches, and even liver damage. In contrast, plant-derived natural antidiabetic bioactive compounds typically exhibit lower toxicity and fewer side effects and have been reported to aid effectively in diabetes management. These plant extracts regulate diabetes by restoring pancreatic function, enhancing insulin secretion, inhibiting intestinal glucose absorption, and facilitating insulin dependent metabolism.
View Article and Find Full Text PDFThe potential synergistic effect of combining doxorubicin with vorinostat in urothelial carcinoma therapy.
Heliyon
January 2025
Department of Microbiology, Immunology and Biopharmaceuticals, College of Life Sciences, National Chiayi University, Chiayi City, Taiwan.
Bladder cancer ranks as the 9th most common type of cancer worldwide. Approximately 70 % of bladder cancers are diagnosed as non-muscle invasive, and they are treated with transurethral resection followed by intravesical therapy. Doxorubicin is one of the effective cytotoxic drugs used in intravesical and systemic therapy, but its cardiotoxicity and nephrotoxicity limit therapeutic dosages.
View Article and Find Full Text PDFA case report of hyperammonemic encephalopathy induced by high-dose continuous infusion of 5-fluorouracil in a patient with rectal cancer.
AME Case Rep
October 2024
Department of Oncology, Wenzhou Traditional Chinese Medicine Hospital of Zhejiang Chinese Medical University, Wenzhou, China.
Background: Hyperammonemic encephalopathy caused by high-dose infusion of 5-fluorouracil (5-FU) is a rare adverse reaction in rectal cancer patients with an incidence rate of 5.7%. Although the patient could be restored to normal after supportive treatments, the occurrence of this side effect was still inevitable.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!