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A Multi-Institutional Analysis on the Use of Stereotactic Body Radiotherapy (SBRT) for the Treatment of Lymph Node Oligometastases in Prostate Cancer Patients. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1850] [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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The Potential Role of Intensity-modulated Proton Therapy in the Regional Nodal Irradiation of Breast Cancer: A Treatment Planning Study. Clin Oncol (R Coll Radiol) 2019; 32:26-34. [PMID: 31377082 DOI: 10.1016/j.clon.2019.07.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 06/13/2019] [Accepted: 07/18/2019] [Indexed: 10/26/2022]
Abstract
AIMS To investigate the role of intensity-modulated proton therapy (IMPT) for regional nodal irradiation in patients with breast carcinoma in comparison with volumetric-modulated arc therapy (VMAT). MATERIALS AND METHODS A cohort of 20 patients (10 in the breast-conserving surgery group and 10 post-mastectomy patients with tissue expander implants) was investigated. Proton plans were also computed using robust optimisation methods. Plan quality was assessed by means of dose-volume histograms and scored with conventional metrics. Estimates of the risk of secondary cancer induction (excess absolute risk, EAR) were carried out, taking into account fractionation, repopulation and repair. RESULTS Concerning target coverage, the data proved a substantial equivalence of VMAT and IMPT: for example, coverage for the 50 Gy target, expressed in terms of V98%, was 47.8 ± 0.4, 47.6 ± 0.4, 47.3 ± 0.8, consistent with the objective of 47.5 Gy, for post-mastectomy patients for the three groups of patients. Also, the conformality of the dose distributions was similar for the two techniques, about 1.1, without statistically significant differences. Organ at risk planning aims were achieved for all structures for both techniques. The mean dose to the ipsilateral lung was 10.8 ± 1.1, 6.2 ± 0.8, 7.2 ± 1.0; for the contralateral lung was 3.2 ± 0.7, 0.3 ± 0.2, 0.4 ± 0.2; for the contralateral breast was: 3.1 ± 0.7, 0.3 ± 0.3 and 0.3 ± 0.3, whereas it was 3.9 ± 0.9, 0.4 ± 0.3 and 0.5 ± 0.5, respectively, for the heart for VMAT, IMPT and robust IMPT plans over the whole group of patients. Robust optimisation affected the near-to-maximum dose values for contralateral lung and breast, the mean dose for the heart and ipsilateral lung, with a deterioration ranging from 20 to 40% of the nominal value of IMPT plans (e.g. from 8.1 ± 6.4 to 11.4 ± 8.8 for the heart compared with 16.2 ± 5.2 for the VMAT plans). The numerical values of EAR per 10 000 patient-years were about one order of magnitude higher for VMAT than for IMPT for contralateral structures: 11.66 ± 2.01, 0.89 ± 0.80, 0.98 ± 0.77 for the contralateral breast and the three groups of plans, respectively; 14.31 ± 2.75, 1.42 ± 0.80, 1.78 ± 0.87 for the contralateral lung; and 34.86 ± 2.64, 18.85 ± 2.15, 20.98 ± 2.35 for the ipsilateral lung. CONCLUSION IMPT with or without robust optimisation seems to be a potentially promising approach for the radiation treatment of breast cancer when nodal volumes should be irradiated. This was measured in terms of dosimetric advantage and predicted clinical benefit. In fact, the significant reduction in estimated EAR could add further clinical value to the dosimetric sparing of the organs at risk achievable with IMPT.
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Role of stereotactic body radiation therapy in the management of oligometastatic pancreatic cancer: single institution experience. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.392] [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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PO-0876 Stereotactic Body Radiation Therapy for thoracic nodes metastases, a multi-institutional experience. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31296-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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EP-1171 Toxicity profile of locally advanced head and neck cancer patients treated in 30 or 33 fractions RT. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31591-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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EP-1916 Predictive model of the dose to the heart based on geometry evaluation in left breast radiotherapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32336-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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PO-0955 Radiomics signature as predictors of survival and local control after pancreatic carcinoma SBRT. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31375-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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EP-1457 Moderate hypofractionation and SIB with volumetric modulated arc therapy (RapidArc) for anal cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31877-8] [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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EP-1559 SBRT for lymph node metastases from prostate cancer: a multi-institutional retrospective analysis. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31979-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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PO-0925 On the ability of a knowledge based planning process to improve itself. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31345-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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62
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PO-0883 Phase II trial of stereotactic body radiation therapy for abdomino-pelvic lymph node oligometastases. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31303-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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63
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EP-1605 Adjuvant RT for soft tissue sarcomas: volumetric modulated arc therapy vs 3D conformal radiotherapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32025-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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64
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PO-0936 To be or not to be homogeneous in SBRT plans? a systematic multi-planning study. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31356-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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65
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EP-1850 Intensity modulated protons: feasibility for hypofractionated hepatocellular carcinoma treatment. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32270-4] [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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66
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EP-1493 SBRT for oligometastatic gynecological cancer: a single institution experience. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31913-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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67
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EP-1430 Can SBRT improve the prognosis of unresectable pancreatic cancer? Clinical results on 106 patients. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31850-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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68
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EP-1772 MLC parameters evaluation in a RT-dedicated MC environment (PRIMO) from static fields to VMAT plans. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32192-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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69
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External Beam Re-Irradiation of Locally Recurrent Prostate Cancer with FFF-VMAT. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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P3.08-02 Oligometastatic Non Small Cell Lung Cancer Patients Treated with Stereotactic Body Radiotherapy (SBRT), a Single Institution Experience. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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71
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P05.36 Skull base meningiomas: prognostic factors analysis for recurrence with multimodality treatment. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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P01.073 Hypofractionated radiation therapy (over 3 weeks) can replace conventional radiation therapy schedule (over 6 weeks) in newly diagnosed glioblastoma patients? The times are ripe. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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P05.75 Surgery followed by fractionated radiosurgery on the tumor bed in patients with single large brain metastases from solid tumor: preliminary results of a phase II study. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.401] [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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P05.50 Hypofractionated stereotactic radiation therapy (HSRT) in skull base meningiomas. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.376] [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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P01.043 Is surgical resection useful in elderly newly diagnosed glioblastoma patients? Outcome evaluation and prognostic factors assesment. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.085] [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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P05.30 Intracranial meningiomas: a systematic analysis of prognostic factors for recurrence in a large surgical series. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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OS6.5 Randomized phase III trial comparing GAMMA KNIFE (GK) and LINAC based (EDGE) radiosurgery for brain metastases from solid tumors: results from the GADGET trial. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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78
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Collimator scatter factor: Monte Carlo and in-air measurements approaches. Radiat Oncol 2018; 13:126. [PMID: 29996873 PMCID: PMC6042423 DOI: 10.1186/s13014-018-1070-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 06/29/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Linac output as a function of field sizes has a phantom and a head scatter component. This last term can be measured in-air with appropriate build-up ensuring a complete electron equilibrium and the absence of the contaminant electrons. Equilibrium conditions could be achieved using a build-up cap or a mini-phantom. Monte Carlo simulations in a virtual phantom mimicking a mini-phantom were analysed with the aim of better understanding the setup conditions for measuring the collimator scatter factor that is the head scatter component of the linac output factors. METHODS Beams of 6 and 15 MV from a TrueBeam, with size from 4 × 4 to 40 × 40 cm2 were simulated in cylindrical acrylic phantoms 20 cm long, of different diameters, from 0.5 to 4 cm, with the cylinder axis coincident with the beam central axis. The PRIMO package, based on PENELOPE Monte Carlo code, was used. The phase-space files for a Varian TrueBeam linac, provided by the linac vendor, were used for the linac head simulation. Depth dose curves were analysed, and collimator scatter factors estimated at different depth in the different phantom conditions. Additionally, in-air measurements using acyrilic and brass build-up caps, as well as acrylic mini-phantom were acquired for 6 and 18 MV beams from a Varian Clinac DHX. RESULTS The depth dose curves along the cylinders were compared, showing, in each phantom, very similar curves for all analysed field sizes, proving the correctness in estimating the collimator scatter factor in the mini-phantom, provided to position the detector to a sufficient depth to exclude electron contamination. The results were confirmed by the measurements, where the acrylic build-up cap showed to be inadequate to properly estimate the collimator scatter factors, while the mini-phantom and the brass caps gave reasonable measurements. CONCLUSION A better understanding of the beam characteristics inside a virtual mini-phantom through the analysis of depth dose curves, showed the critical points of using the acrylic build-up cap, and suggested the use of the mini-phantom for the collimator scatter factor measurements in the medium-large field size range.
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Evaluation of target dose inhomogeneity in breast cancer treatment due to tissue elemental differences. Radiat Oncol 2018; 13:92. [PMID: 29764450 PMCID: PMC5952506 DOI: 10.1186/s13014-018-1022-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 04/11/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Monte Carlo simulations were run to estimate the dose variations generated by thedifference arising from the chemical composition of the tissues. METHODS CT datasets of five breast cancer patients were selected. Mammary gland was delineated as clinical target volume CTV, as well as CTV_lob and CTV_fat, being the lobular and fat fractions of the entire mammary gland. Patients were planned for volumetric modulated arc therapy technique, optimized in the Varian Eclipse treatment planning system. CT, structures and plans were imported in PRIMO, based on Monte Carlo code Penelope, to run three simulations: AdiMus, where the adipose and muscle tissues were automatically assigned to fat and lobular fractions of the breast; Adi and Mus, where adipose and muscle, respectively were assigned to the whole mammary gland. The specific tissue density was kept identical from the CT dataset. Differences in mean doses in the CTV_lob and CTV_fat structures were evaluated for the different tissue assignments. Differences generated by the tissue composition and estimated by Acuros dose calculations in Eclipse were also analysed. RESULTS From Monte Carlo simulations, the dose in the lobular fraction of the breast, when adipose tissue is assigned in place of muscle, is overestimated by 1.25 ± 0.45%; the dose in the fat fraction of the breast with muscle tissue assignment is underestimated by 1.14 ± 0.51%. Acuros showed an overestimation of 0.98 ± 0.06% and an underestimation of 0.21 ± 0.14% in the lobular and fat portions, respectively. Reason of this dissimilarity resides in the fact that the two calculations, Monte Carlo and Acuros, differently manage the range of CT numbers and the material assignments, having Acuros an overlapping range, where two tissues are both present in defined proportions. CONCLUSION Although not clinically significant, the dose deposition difference in the lobular and connective fat fraction of the breast tissue lead to an improved knowledge of the possible dose distribution and homogeneity in the breast radiation treatment.
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Small field characterization of a Nanochamber prototype under flattening filter free photon beams. Phys Med 2018; 49:139-146. [DOI: 10.1016/j.ejmp.2017.08.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 08/04/2017] [Accepted: 08/16/2017] [Indexed: 11/28/2022] Open
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EP-1270: Randomized phase II study of hypofractionated WBI versus APBI using VMAT: early toxicity results. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31580-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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EP-1175: Role of Radiotherapy in the management of metastases from salivary gland carcinoma. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31485-3] [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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83
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EP-1589: VMAT SBRT For Localized Prostate Cancer: 4-Year Follow-Up And Correlation With WHO2016 Grade Groups. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31898-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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84
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OC-0160: DCIS treated with breast conservative surgery and radiotherapy: a national multicentre experience. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30470-5] [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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85
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EP-1511: SBRT In Oligometastatic Ovarian Cancer: A Promising Therapeutic Approach. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31820-6] [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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OC-0591: Phase III randomized trial comparing two modalities of RS for brain metastases: Gammaknife vs Linac. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30901-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Adjuvant chemotherapy and hypofractionated VMAT treatment with SIB for early stage breast cancer: A prospective evaluation of acute toxicity and cosmetic results. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30403-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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88
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PO-0898: Second cancer induction risk from breast radiotherapy with VMAT and 3D conformal therapy. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31208-8] [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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EP-1636: Role of preoperative radiotherapy in rare retroperitoneal sarcoma. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31945-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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EP-1635: Stereotactic body radiation therapy for lung metastases from soft tissue sarcoma: long term results. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31944-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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91
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Ductal carcinoma in situ treated with breast conservative surgery and radiotherapy: A national multicentre experience. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30392-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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EP-1967: VMAT technique on left sided breast focusing on the dose to the heart. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32276-x] [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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EP-2154: Lean-six-sigma methodology for improving quality in RT: the breast daily repositioning case. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32463-0] [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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PV-0472: Role of SBRT in the treatment of liver metastases: clinical results and prognostic factors. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30782-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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EP-1426: ChemoRadiotherapy for Oesophageal cancer followed by Surgery Study (CROSS): Single Center Experience. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31735-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Can Stereotactic Body Radiation Therapy Be a Viable and Efficient Therapeutic Option for Unresectable Locally Advanced Pancreatic Adenocarcinoma? Results of a Phase 2 Study. Technol Cancer Res Treat 2017; 16:295-301. [PMID: 27311310 PMCID: PMC5616043 DOI: 10.1177/1533034616650778] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 03/14/2016] [Accepted: 04/22/2016] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To assess the efficacy of stereotactic body radiotherapy in patients with unresectable locally advanced pancreatic cancer. MATERIALS AND METHODS All patients received a prescription dose of 45 Gy in 6 fractions. Primary end point was freedom from local progression. Secondary end points were overall survival, progression-free survival, and toxicity. Actuarial survival analysis and univariate or multivariate analysis were investigated. RESULTS Forty-five patients were enrolled in a phase 2 trial. Median follow-up was 13.5 months. Freedom from local progression was 90% at 2 years. On univariate ( P < .03) and multivariate analyses ( P < .001), lesion size was statistically significant for freedom from local progression. Median progression-free survival and overall survival were 8 and 13 months, respectively. On multivariate analysis, tumor size ( P < .001) and freedom from local progression ( P < .002) were significantly correlated with overall survival. Thirty-two (71%) patients with locally advanced pancreatic cancer received chemotherapy before stereotactic body radiotherapy. Median overall survival from diagnosis was 19 months. Multivariate analysis showed that freedom from local progression ( P < .035), tumor diameter ( P < .002), and computed tomography before stereotactic body radiotherapy ( P < .001) were significantly correlated with overall survival from diagnosis. CONCLUSION Stereotactic body radiotherapy is a safe and effective treatment for patients with locally advanced pancreatic cancer with no G3 toxicity or greater and could be a promising therapeutic option in multimodality treatment regimen.
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EP-1439: Small field dosimetry: preliminary characterization of a nano-chamber with a focus on stem effect. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31874-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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98
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EP-1469: Flattening filter free beam profile analysis using two different normalization methods. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31904-7] [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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EP-1296: Adjuvant radiotherapy in endometrial cancer: Volumetric Modulated Intensity Arc Therapy vs 3DRT. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31731-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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100
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EP-1337: High hypofractionation using beacon transponders in intermediate-risk prostate cancer: first results. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31772-3] [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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