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Cozzi L, Reggiori G, Franzese C, Lobefalo F, Scorsetti M, Fogliata A. EP-1528: RapidPlan Head and Neck model: the objectives and possible clinical benefits. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31963-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Fogliata A, Seppala J, Reggiori G, Lobefalo F, Palumbo V, De Rose F, Franceschini D, Scorsetti M, Cozzi L. EP-1560: Left breast cancer planning with VMAT technique: the dosimetric trade-offs. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31995-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Fogliata A, Reggiori G, Stravato A, Lobefalo F, Franzese C, Franceschini D, Tomatis S, Mancosu P, Scorsetti M, Cozzi L. RapidPlan head and neck model: the objectives and possible clinical benefit. Radiat Oncol 2017; 12:73. [PMID: 28449704 PMCID: PMC5408433 DOI: 10.1186/s13014-017-0808-x] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 04/14/2017] [Indexed: 11/27/2022] Open
Abstract
Background To evaluate a knowledge based planning model for RapidPlan (RP) generated for advanced head and neck cancer (HNC) patient treatments, as well its ability to possibly improve the clinical plan quality. The stability of the model was assessed also for a different beam geometry, different dose fractionation and different management of bilateral structures (parotids). Methods Dosimetric and geometric data from plans of 83 patients presenting HNC were selected for the model training. All the plans used volumetric modulated arc therapy (VMAT, RapidArc) to treat two targets at dose levels of 69.96 and 54.45 Gy in 33 fractions with simultaneous integrated boost. Two models were generated, the first separating the ipsi- and contra-lateral parotids, while the second associating the two parotids to a single structure for training. The optimization objectives were adjusted to the final model to better translate the institutional planning and dosimetric strategies and trade-offs. The models were validated on 20 HNC patients, comparing the RP generated plans and the clinical plans. RP generated plans were also compared between the clinical beam arrangement and a simpler geometry, as well as for a different fractionation scheme. Results RP improved significantly the clinical plan quality, with a reduction of 2 Gy, 5 Gy, and 10 Gy of the mean parotid, oral cavity and laryngeal doses, respectively. A simpler beam geometry was deteriorating the plan quality, but in a small amount, keeping a significant improvement relative to the clinical plan. The two models, with one or two parotid structures, showed very similar results. NTCP evaluations indicated the possibility of improving (NTCP decreasing of about 7%) the toxicity profile when using the RP solution. Conclusions The HNC RP model showed improved plan quality and planning stability for beam geometry and fractionation. An adequate choice of the objectives in the model is necessary for the trade-offs strategies.
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Sollini M, Cozzi L, Antunovic L, Chiti A, Kirienko M. PET Radiomics in NSCLC: state of the art and a proposal for harmonization of methodology. Sci Rep 2017; 7:358. [PMID: 28336974 PMCID: PMC5428425 DOI: 10.1038/s41598-017-00426-y] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 02/23/2017] [Indexed: 12/21/2022] Open
Abstract
Imaging with positron emission tomography (PET)/computed tomography (CT) is crucial in the management of cancer because of its value in tumor staging, response assessment, restaging, prognosis and treatment responsiveness prediction. In the last years, interest has grown in texture analysis which provides an "in-vivo" lesion characterization, and predictive information in several malignances including NSCLC; however several drawbacks and limitations affect these studies, especially because of lack of standardization in features calculation, definitions and methodology reporting. The present paper provides a comprehensive review of literature describing the state-of-the-art of FDG-PET/CT texture analysis in NSCLC, suggesting a proposal for harmonization of methodology.
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De Rose F, Franceschini D, Cozzi L, Comito T, D'Agostino G, Navarria P, Ascolese A, Tozzi A, Iftode C, Franzese C, Clerici E, Tomatis S, Fogliata A, Scorsetti M. Is There a Role for Stereotactic Body Radiation Therapy (SBRT) in Oligometastatic Breast Cancer? Results From an Observational Study. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pessina F, Navarria P, Ascolese A, Cozzi L, Tomatis S, Riva M, Rossi M, Scorsetti M, Bello L. P08.27 The role of supramarginal resection for single large brain metastases: feasibility, morbidity and local control evaluation. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Navarria P, Ascolese A, Cozzi L, Tomatis S, Picozzi P, Pecchioli G, Attuati L, Clerici E, Maggi G, Scorsetti M. P19.03 Randomized double arm phase III study to evaluate feasibility and safety of Gamma Knife radiosurgery versus Linac Based (Edge) radiosurgery in brain metastatic patients. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Navarria P, Pessina F, Ascolese A, Cozzi L, Tomatis S, Riva M, Bello L, Clerici E, Lobefalo F, Scorsetti M. P13.11 Outcome evaluation of oligometastatic patients with single, large brain metastases treated with gross total resection (GTR) followed by hypofractionated stereotactic radiosurgery (HSRS) on the tumor bed. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Franzese C, Cozzi L, Clerici E, D'Agostino G, Navarria P, Comito T, De Rose F, Ascolese A, Franceschini D, Mancosu P, Tomatis S, Scorsetti M. Role of Stereotactic Body Radiation Therapy With Volumetric Modulated Arc Therapy Technique and FFF Beams for Abdomino-Pelvic Lymph Node Metastases in Oligometastatic Patients. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Pessina F, Navarria P, Ascolese A, Cozzi L, Tomatis S, Riva M, Simonelli M, Scorsetti M, Bello L. P08.28 Role of surgical resection in recurrent glioblastoma: prognostic factors and outcome evaluation. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Gilles M, Fayad H, Miglierini P, Clement JF, Scheib S, Cozzi L, Bert J, Boussion N, Schick U, Pradier O, Visvikis D. Patient positioning in radiotherapy based on surface imaging using time of flight cameras. Med Phys 2016; 43:4833. [DOI: 10.1118/1.4959536] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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D'Agostino G, Franzese C, De Rose F, Franceschini D, Comito T, Villa E, Alongi F, Liardo R, Tomatis S, Navarria P, Mancosu P, Reggiori G, Cozzi L, Scorsetti M. High-quality Linac-based Stereotactic Body Radiation Therapy with Flattening Filter Free Beams and Volumetric Modulated Arc Therapy for Low-Intermediate Risk Prostate Cancer. A Mono-institutional Experience with 90 Patients. Clin Oncol (R Coll Radiol) 2016; 28:e173-e178. [PMID: 27389021 DOI: 10.1016/j.clon.2016.06.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 05/30/2016] [Accepted: 06/01/2016] [Indexed: 12/29/2022]
Abstract
AIMS The aim of this phase II study was to evaluate the efficacy and toxicity of stereotactic body radiotherapy in patients with low or intermediate risk prostate cancer. MATERIALS AND METHODS Biopsy-confirmed prostate cancer patients were enrolled, provided that they had the following characteristics: initial prostate-specific antigen (PSA) ≤ 20 ng/ml, Gleason Score < 7, International Prostate Symptom Score < 7. The treatment schedule was 35 Gy in five fractions, delivered with volumetric modulated arcs with flattening filter free beams. Toxicity was recorded according to CTCAE criteria v4.0. Biochemical failure was calculated according to the Phoenix definition. The Expanded Prostate Cancer Index Composite questionnaire was used to record health-related quality of life. RESULTS Between December 2011 and March 2015, 90 patients were enrolled (53 low risk, 37 intermediate risk). The median age was 71 years (range 48-82). In total, 58 (64.5%) of the patients had Gleason Score=6, the remaining had Gleason Score=7.The median initial PSA was 6.9 ng/ml (range 2.7-17.0). Acute toxicity was mild, with 32.2 patients presenting grade 1 urinary toxicity and 32.2% of patients presenting grade 2 urinary toxicity, mainly represented by urgency, dysuria and stranguria. Rectal grade 1 toxicity was found in 15.5% of patients, whereas grade 2 toxicity was recorded in 6.6% of patients. Regarding late toxicity, grade 1 proctitis was recorded in 11.1% of patients and grade 1 urinary in 38.8%; only two events of grade 2 urinary toxicity were observed (transient urethral stenosis, resolved by a 24 h catheterisation). At a median follow-up of 27 months (6-62 months) only two intermediate risk patients experienced a biochemical failure. Health-related quality of life revealed a slight worsening in all the domains during treatment, with a return to baseline 3 months after treatment. CONCLUSIONS Stereotactic body radiotherapy delivered using linac-based flattening filter free volumetric modulated arc radiotherapy in low and intermediate risk prostate cancer patients is associated with mild toxicity profiles and good patient-reported quality of life.
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Botti A, Cagni E, Micera R, Nicola S, Orsingher L, Orlandi M, Iotti C, Cozzi L, Iori M. EP-1643: Rapidplan: 'knowledge-based' model with Tomotherapy plans. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32894-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ascolese A, Franceschini D, De rose F, Cozzi L, Navarria P, Tozzi A, Iftode C, Villa E, Franzese C, Comito T, D'agostino G, Tomatis S, Liardo L, Scorsetti M. EP-1443: Radical hypofractionated VMAT-RA for stage III NSCLC in the elderly: feasibility and toxicity. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32693-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Franceschini D, Clerici E, Cozzi L, Tozzi A, Iftode C, Franzese C, Comito T, De Rose F, Navarria P, D'Agostino G, Villa E, Rocco Luca L, Ascolese A, Zucconi F, Scorsetti M. EP-1442: Oligometastatic colorectal cancer in elderly patients: role of stereotactic body radiation therapy. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32692-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fogliata A, Fleckenstein J, Schneider F, Pachoud M, Ghandour S, Krauss H, Reggiori G, Stravato A, Lohr F, Scorsetti M, Cozzi L. PO-0809: FFF beams from TrueBeam and Versa HD units: evaluation of the parameters for quality assurance. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32059-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Comito T, Franzese C, Clerici E, De Rose F, Tozzi A, D'Agostino G, Navarria P, Iftode C, Villa E, Ascolese A, Franceschini D, Liardo R, Cozzi L, Foglliata A, Stravato A, Zucconi F, Reggiori G, Tomatis S, Scorsetti M. PO-0705: Clinical outcomes for inoperable HCC treated with SBRT: results on 71 patients and 102 lesions. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31955-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Clerici E, Comito T, Cozzi L, Fogliata A, Tozzi A, Iftode C, Franzese C, Navarria P, D'Agostino G, Mancosu P, Lobefalo F, Tomatis S, Scorsetti M. EP-1279: SABR in inoperable liver oligometastatic patients and radioresistant primary tumors. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32529-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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De Rose F, Cozzi L, Navarria P, Ascolese A, Clerici E, Infante M, Alloisio M, Testori A, Toschi L, Finocchiaro G, Santoro A, Scorsetti M. Clinical Outcome of Stereotactic Ablative Body Radiotherapy for Lung Metastatic Lesions in Non-small Cell Lung Cancer Oligometastatic Patients. Clin Oncol (R Coll Radiol) 2016; 28:13-20. [DOI: 10.1016/j.clon.2015.08.011] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 07/22/2015] [Accepted: 08/26/2015] [Indexed: 12/25/2022]
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Rubini S, Barbieri S, Pavoni E, Bertasi B, Cozzi L, Bergamini M, Suffredini E. Risk associated to Vibrio parahaemolyticus in shellfish in Ferrara (Emilia Romagna). Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv176.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Rodriguez M, Sempau J, Fogliata A, Cozzi L, Sauerwein W, Brualla L. A geometrical model for the Monte Carlo simulation of the TrueBeam linac. Phys Med Biol 2015; 60:N219-29. [PMID: 25984796 DOI: 10.1088/0031-9155/60/11/n219] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Monte Carlo simulation of linear accelerators (linacs) depends on the accurate geometrical description of the linac head. The geometry of the Varian TrueBeam linac is not available to researchers. Instead, the company distributes phase-space files of the flattening-filter-free (FFF) beams tallied at a plane located just upstream of the jaws. Yet, Monte Carlo simulations based on third-party tallied phase spaces are subject to limitations. In this work, an experimentally based geometry developed for the simulation of the FFF beams of the Varian TrueBeam linac is presented. The Monte Carlo geometrical model of the TrueBeam linac uses information provided by Varian that reveals large similarities between the TrueBeam machine and the Clinac 2100 downstream of the jaws. Thus, the upper part of the TrueBeam linac was modeled by introducing modifications to the Varian Clinac 2100 linac geometry. The most important of these modifications is the replacement of the standard flattening filters by ad hoc thin filters. These filters were modeled by comparing dose measurements and simulations. The experimental dose profiles for the 6 MV and 10 MV FFF beams were obtained from the Varian Golden Data Set and from in-house measurements performed with a diode detector for radiation fields ranging from 3 × 3 to 40 × 40 cm(2) at depths of maximum dose of 5 and 10 cm. Indicators of agreement between the experimental data and the simulation results obtained with the proposed geometrical model were the dose differences, the root-mean-square error and the gamma index. The same comparisons were performed for dose profiles obtained from Monte Carlo simulations using the phase-space files distributed by Varian for the TrueBeam linac as the sources of particles. Results of comparisons show a good agreement of the dose for the ansatz geometry similar to that obtained for the simulations with the TrueBeam phase-space files for all fields and depths considered, except for the 40 × 40 cm(2) field where the ansatz geometry was able to reproduce the measured dose more accurately. Our approach overcomes some of the limitations of using the Varian phase-space files. It makes it possible to: (i) adapt the initial beam parameters to match measured dose profiles; (ii) reduce the statistical uncertainty to arbitrarily low values; and (iii) assess systematic uncertainties (type B) by using different Monte Carlo codes. One limitation of using phase-space files that is retained in our model is the impossibility of performing accurate absolute dosimetry simulations because the geometrical description of the TrueBeam ionization chamber remains unknown.
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Nicolini G, Clivio A, Vanetti E, Tomatis S, Reggiori G, Cozzi L, Fogliata A. PO-0863: Dosimetric testing of the new aS1200 MV imager with FF and FFF beams. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40855-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Stravato A, Reggiori G, Pimpinella M, Lobefalo F, Cozzi L, Fogliata A, Gaudino A, Mancosu P, Palumbo V, Scorsetti M, Tomatis S. PO-0827: Dosimetric characterization of PTW MicroDiamond for FFF beams and small fields: experimental and Monte Carlo study. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40819-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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De Rose F, Navarria P, Ascolese A, Comito T, Franzese C, Tozzi A, Clerici E, Iftode C, D'Agostino G, Villa E, Tomatis S, Cozzi L, Scorsetti M. EP-1177: SABR for lung lesions in NSCLC oligometastatic patients: toxicity and clinical outcomes. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41169-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Clivio A, Fogliata A, Nicolini G, Vanetti E, Laksar S, Tozzi A, Scorsetti M, Cozzi L. PD-0449: A knowledge based model for VMAT in esophageal cancer: plan quality assessment among different centres. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40445-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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