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Song Y, Peng J, Chen Q, Luo H. Compare of Interfractional Setup Reproducibility Between Vacuum-Lock Bag and Thermoplastic Mask in Radiotherapy for Breast Cancer. Technol Cancer Res Treat 2021; 20:15330338211043037. [PMID: 34554027 PMCID: PMC8490727 DOI: 10.1177/15330338211043037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background: This study aimed to analyze the difference of setup
reproducibility between Vacuum-lock bag and Thermoplastic mask in the
radiotherapy for breast cancer. Methods: A total of 100 invasive
breast carcinoma patients were collected, among whom 50 patients were
immobilized with Vacuum-lock bag (VB group), and the other 50 patients were
immobilized with Thermoplastic mask (TM group). Set up reproducibility in
different axes and comfort levels between two groups at three treatment progress
points during the radiation therapy were collected and analyzed.
Results: The linear regression model showed that fixed device
was an independent factor of radiotherapy setup error (SE). Further subgroup
analysis based on different axes showed that the SE caused by the fixed device
was obvious in all directions. The comfort level in the VB group was
significantly larger than that in the TM group at the beginning of treatment,
reduced as the treatment progress going on, and finally disappeared within three
weeks. Conclusions: Thermoplastic mask could significantly reduce
positioning errors in the radiotherapy of breast cancer. Although more
discomfort was found in the TM group, it could be eliminated as the treatment
progresses.
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Affiliation(s)
- Yaqi Song
- The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical
University, Huaian, Jiangsu, China
| | - Jin Peng
- The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical
University, Huaian, Jiangsu, China
| | - Qianfeng Chen
- The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical
University, Huaian, Jiangsu, China
| | - Honglei Luo
- The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical
University, Huaian, Jiangsu, China
- Honglei Luo, Department of Radiation
Oncology, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical
University, Jiangsu, Huaian 223300, China.
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Zhu F, Wu W, Zhu F, Wang Y, Wang Y, Xia T. Influence of computed tomography contrast agent on radiotherapy dose calculation for pancreatic carcinoma: A dosimetric study based on tomotherapy and volumetric-modulated arc therapy techniques. Med Dosim 2017; 42:317-325. [PMID: 28818321 DOI: 10.1016/j.meddos.2017.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 04/18/2017] [Accepted: 07/03/2017] [Indexed: 11/30/2022]
Abstract
The main purpose of our investigation was to quantify the dosimetric influence of intravenous contrast agent for pancreatic cancer radiotherapy treatment. This study focused on complex modulated irradiation techniques of tomotherapy (TOMO) and volumetric-modulated arc therapy (VMAT) to investigate if novel conformal treatment methods could reduce the influence of contrast agent. In our study, patients with pancreatic cancer were enrolled to have 2 computed tomography (CT) scans in the same position without and with intravenous contrast agent for treatment planning. Then tumors and organ at risks were countered on contrast-enhanced CT (CECT) images. Each patient's CECT was assigned a TOMO plan and a VMAT plan. Then these plans were copied onto the non-CECT image and dose distribution was calculated with the same algorithm and structure sets. Finally, the dose distribution and the dose difference were analyzed for the target volume and organs at risk between the 2 sets of images. The statistic dosimetric result showed that for both TOMO and VMAT, no significant dose difference between CECT and non-CECT-based plan was observed. Dose difference was clinically negligible because the average relative percentage dose difference was 1% ± 1% for target volume, except a blurring effect at the higher dose region of the target volume. It implied that intravenous contrast agent will not affect dose calculation for pancreatic cancer radiotherapy significantly. Also the dose deviation based on TOMO showed no statistical difference compared with that on VMAT. For both superposition/conversation algorithm used by TOMO and Monte Carlo algorithm used by VMAT, the dosimetric difference was nonsignificant. A full analysis demonstrated a negligible dose difference of less than 1% between CECT-based plan and non-CECT-based plan. Therefore, contrast-enhanced CT image can be used directly for dose calculation of TOMO and VMAT plans for pancreatic cancer. It is unnecessary to scan twice then make a fusion of CECT and non-CECT, which would result to additional unnecessary radiation dose to patient and decrease work efficiency.
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Affiliation(s)
- Feng Zhu
- Department of Radiation Oncology, PLA General Airforce Hospital, 30 Fucheng Street, Beijing 100142, China
| | - Weizhang Wu
- Department of Radiation Oncology, PLA General Airforce Hospital, 30 Fucheng Street, Beijing 100142, China
| | - Fuhai Zhu
- Department of Radiation Oncology, PLA General Airforce Hospital, 30 Fucheng Street, Beijing 100142, China
| | - Yong Wang
- Department of Radiation Oncology, PLA General Airforce Hospital, 30 Fucheng Street, Beijing 100142, China
| | - Yingjie Wang
- Department of Radiation Oncology, PLA General Airforce Hospital, 30 Fucheng Street, Beijing 100142, China
| | - Tingyi Xia
- Department of Radiation Oncology, PLA General Airforce Hospital, 30 Fucheng Street, Beijing 100142, China.
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Martínez E, Martínez M, Rico M, Hernández B, Casas F, Viñolas N, Pérez-Casas A, Dómine M, Mínguez J. Feasibility, tolerability, and efficacy of the concurrent addition of erlotinib to thoracic radiotherapy in locally advanced unresectable non-small-cell lung cancer: a Phase II trial. Onco Targets Ther 2016; 9:1057-66. [PMID: 27042098 PMCID: PMC4780183 DOI: 10.2147/ott.s89755] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Although many studies have confirmed the synergic effects of combining chemotherapy (CT) and radiotherapy (RT), clinical data evaluating safety and efficacy of erlotinib in combination with RT in locally advanced non-small-cell lung cancer (NSCLC) are limited. The aim of this study was to determine the feasibility, tolerability, and efficacy of the concurrent addition of erlotinib to the standard three-dimensional conformal thoracic RT in patients with unresectable or locally advanced NSCLC who are not candidates for receiving standard CT. Patients and methods Feasibility and tolerability, assessed by evaluating adverse events (AEs), and effectiveness, by calculating progression-free survival (PFS), overall survival (OS), cancer-specific survival (CSS), and objective response rate (ORR), were analyzed in 30 patients receiving RT alone and 60 receiving RT and erlotinib. Results Erlotinib with RT showed an extended CSS and a higher rate of complete responses compared with RT alone. No differences between groups were found regarding OS, PFS, and ORR. AEs were significantly higher in the combined treatment, which mainly included cutaneous toxicity, dyspnea, fatigue, hyporexia, diarrhea, and infection. Erlotinib did not increase the toxicity produced by RT. Conclusion The combination of erlotinib with RT produced, in our study, a scarce clinical benefit in the treatment of unresectable or locally advanced NSCLC, limited to complete responses and longer CSS rate compared with RT alone. Increased toxicity events were associated with combined therapy, which mainly included cutaneous toxicity. In our opinion, further studies in molecularly unselected lung cancer patients treated with EGFR TKIs and RT are not indicated. The use of biomarkers for the identification of patients that are most likely to benefit from this treatment is an essential next step in the research of this condition.
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Affiliation(s)
- Enrique Martínez
- Radiation Oncology Services, Hospital of Navarra, Pamplona, Spain
| | - Maite Martínez
- Radiation Oncology Services, Hospital of Navarra, Pamplona, Spain
| | - Mikel Rico
- Radiation Oncology Services, Hospital of Navarra, Pamplona, Spain
| | - Berta Hernández
- Radiation Oncology Services, Hospital of Navarra, Pamplona, Spain
| | - Francesc Casas
- Medical Oncology Department, Clinical Hospital of Barcelona, Barcelona, Spain
| | - Nuria Viñolas
- Medical Oncology Department, Clinical Hospital of Barcelona, Barcelona, Spain
| | - Ana Pérez-Casas
- Department of Radiation Oncology, Jiménez Díaz Foundation, Madrid, Spain
| | - Manuel Dómine
- Department of Radiation Oncology, Jiménez Díaz Foundation, Madrid, Spain
| | - Julián Mínguez
- Department of Radiation Oncology, University Hospital of Donostia, San Sebastian, Spain
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4
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Lievens Y, Grau C. Health Economics in Radiation Oncology: Introducing the ESTRO HERO project. Radiother Oncol 2012; 103:109-12. [DOI: 10.1016/j.radonc.2011.12.026] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Revised: 12/03/2011] [Accepted: 12/23/2011] [Indexed: 10/14/2022]
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De Ruysscher D, Faivre-Finn C, Nestle U, Hurkmans CW, Le Péchoux C, Price A, Senan S. European Organisation for Research and Treatment of Cancer Recommendations for Planning and Delivery of High-Dose, High-Precision Radiotherapy for Lung Cancer. J Clin Oncol 2010; 28:5301-10. [DOI: 10.1200/jco.2010.30.3271] [Citation(s) in RCA: 203] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Purpose To derive recommendations for routine practice and clinical trials for techniques used in high-dose, high-precision thoracic radiotherapy for lung cancer. Methods A literature search was performed to identify published articles considered both clinically relevant and practical to use. Recommendations were categorized under the following headings: patient selection, patient positioning and immobilization, tumor motion, computed tomography and [18F]fluorodeoxyglucose–positron emission technology scanning, generating target volumes, radiotherapy treatment planning, treatment delivery, and scoring of response and toxicity. The American College of Chest Physicians grading of recommendations was used. Results Recommendations were identified for each of the recommendation categories. Although most of the recommended techniques have not been evaluated in multicenter clinical trials, their use in high-precision thoracic radiotherapy and stereotactic body radiotherapy (SBRT) appears to be justified on the basis of available evidence. Conclusion Recommendations to facilitate the clinical implementation of high-precision conformal radiotherapy and SBRT for lung tumors were identified from the literature. Some techniques that are considered investigational at present were also highlighted.
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Affiliation(s)
- Dirk De Ruysscher
- From the Maastricht University Medical Center, GROW Research Institute, Maastricht; Free University Medical Center, Amsterdam; and Catharina Hospital, Eindhoven, the Netherlands; the Christie, Manchester; and Edinburgh Cancer Centre, Western General Hospital, Edinburgh, United Kingdom; Freiburg University Medical Center, Freiburg, Germany; and Gustave Roussy Institute, Villejuif, France
| | - Corinne Faivre-Finn
- From the Maastricht University Medical Center, GROW Research Institute, Maastricht; Free University Medical Center, Amsterdam; and Catharina Hospital, Eindhoven, the Netherlands; the Christie, Manchester; and Edinburgh Cancer Centre, Western General Hospital, Edinburgh, United Kingdom; Freiburg University Medical Center, Freiburg, Germany; and Gustave Roussy Institute, Villejuif, France
| | - Ursula Nestle
- From the Maastricht University Medical Center, GROW Research Institute, Maastricht; Free University Medical Center, Amsterdam; and Catharina Hospital, Eindhoven, the Netherlands; the Christie, Manchester; and Edinburgh Cancer Centre, Western General Hospital, Edinburgh, United Kingdom; Freiburg University Medical Center, Freiburg, Germany; and Gustave Roussy Institute, Villejuif, France
| | - Coen W. Hurkmans
- From the Maastricht University Medical Center, GROW Research Institute, Maastricht; Free University Medical Center, Amsterdam; and Catharina Hospital, Eindhoven, the Netherlands; the Christie, Manchester; and Edinburgh Cancer Centre, Western General Hospital, Edinburgh, United Kingdom; Freiburg University Medical Center, Freiburg, Germany; and Gustave Roussy Institute, Villejuif, France
| | - Cécile Le Péchoux
- From the Maastricht University Medical Center, GROW Research Institute, Maastricht; Free University Medical Center, Amsterdam; and Catharina Hospital, Eindhoven, the Netherlands; the Christie, Manchester; and Edinburgh Cancer Centre, Western General Hospital, Edinburgh, United Kingdom; Freiburg University Medical Center, Freiburg, Germany; and Gustave Roussy Institute, Villejuif, France
| | - Allan Price
- From the Maastricht University Medical Center, GROW Research Institute, Maastricht; Free University Medical Center, Amsterdam; and Catharina Hospital, Eindhoven, the Netherlands; the Christie, Manchester; and Edinburgh Cancer Centre, Western General Hospital, Edinburgh, United Kingdom; Freiburg University Medical Center, Freiburg, Germany; and Gustave Roussy Institute, Villejuif, France
| | - Suresh Senan
- From the Maastricht University Medical Center, GROW Research Institute, Maastricht; Free University Medical Center, Amsterdam; and Catharina Hospital, Eindhoven, the Netherlands; the Christie, Manchester; and Edinburgh Cancer Centre, Western General Hospital, Edinburgh, United Kingdom; Freiburg University Medical Center, Freiburg, Germany; and Gustave Roussy Institute, Villejuif, France
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Xiao J, Zhang H, Gong Y, Fu Y, Tang B, Wang S, Jiang Q, Li P. Feasibility of using intravenous contrast-enhanced computed tomography (CT) scans in lung cancer treatment planning. Radiother Oncol 2010; 96:73-7. [PMID: 20347496 DOI: 10.1016/j.radonc.2010.02.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2009] [Revised: 02/16/2010] [Accepted: 02/21/2010] [Indexed: 11/27/2022]
Affiliation(s)
- Jianghong Xiao
- Radiation Physics Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, PR China
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González JA, Chust M, Delgado R, Gómez A, Rodríguez N, Ruiz MJ, Casas F. Spanish radiobiological pattern of care in lung cancer: a GOECP/SEOR study. Clin Transl Oncol 2010; 12:292-8. [PMID: 20462839 DOI: 10.1007/s12094-010-0506-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION A survey regarding radiobiological questions in the treatment of lung cancer (LC) was done to study the clinical aspects of radiotherapy in Spain, in order to standardise treatment decisions. METHODS AND MATERIALS From November 2007 to March 2008, a survey was performed among radiation oncologists in Spain specialising in LC treatment via e-mail, which included questions regarding different radiobiological aspects of radiotherapy LC treatment. The extent of the resulting material made it necessary to divide it into two parts; the first is presented in this article. The second, which includes items about alpha/beta-NTCP/TCP values and reirradiation criteria, will be reported elsewhere. RESULTS Thirty-one radiation therapists from 29 radiation oncology departments answered the survey. 77.4-93.5% of responders used the basic formula from the linear-quadratic model and/or computer software for radiobiological calculations; 100% used lung (mostly V20, median <30%) and spinal cord constraints (mostly a median of physical maximum dose <45.5 Gy); and 90.3% used heart and oesophagus constraints (very heterogeneous parameters in both organs). CONCLUSIONS Radiobiological considerations are clearly present in the planning process of radiotherapy of LC in Spain, with a high coincidence with the literature regarding lung and spinal cord constraints. The heterogeneity shown for oesophagus and heart results demonstrates the need for continuing investigation into the standardisation of clinical, dosimetric and radiobiologic aspects of the treatment of this cancer.
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Affiliation(s)
- J A González
- Department of Radiation Oncology, Instituto Madrileño de Oncología Unidad Regional de Guadalajara, Guadalajara, Spain.
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Abstract
Spain's radiation oncology infrastructure has evolved in terms of both quantity and structure since the last analysis was carried out in 1999. The purpose of this paper is to describe the current facilities, basically consisting of external radiotherapeutic units, and to present a calculation model for estimating the number of irradiation units required to guarantee equitable cover for radiotherapeutic treatment. An electronic questionnaire was designed to be accessed via a link on the Spanish Association of Radiotherapy and Oncology Web page. The questionnaire provides details of the current state of Spain's radiotherapeutic facilities, and a descriptive study has been performed with analytical data. The scope of the study included all the centres providing oncology-radiotherapy in Spain. The units analysed encompassed the centres and irradiation units actively providing care in 2004. Ninety-seven centres were detected, in which 177 external radiotherapy units were registered. Forty-five of these were cobalt units and 132 were accelerators. The rate of radiotherapy use in Spain based on the best scientific evidence available and on its rate of use with cancer has been estimated at 61%. The number of external irradiation units available in 2004 (177) is clearly lower than the number desirable (266-316).
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Report From the International Atomic Energy Agency (IAEA) Consultants' Meeting on Elective Nodal Irradiation in Lung Cancer: Non–Small-Cell Lung Cancer (NSCLC). Int J Radiat Oncol Biol Phys 2008; 72:335-42. [DOI: 10.1016/j.ijrobp.2008.04.081] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2008] [Revised: 04/04/2008] [Accepted: 04/07/2008] [Indexed: 12/25/2022]
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Shibamoto Y, Naruse A, Fukuma H, Ayakawa S, Sugie C, Tomita N. Influence of contrast materials on dose calculation in radiotherapy planning using computed tomography for tumors at various anatomical regions: a prospective study. Radiother Oncol 2007; 84:52-5. [PMID: 17532496 DOI: 10.1016/j.radonc.2007.05.015] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2007] [Revised: 05/14/2007] [Accepted: 05/14/2007] [Indexed: 11/23/2022]
Abstract
Influences of iodinated contrast media on dose calculation were studied in 26 patients. Mean increases in monitor units by contrast media administration were less than 1% and considered negligible in planning of whole-brain, whole-neck, mediastinal, and whole-pelvic irradiation. However, mean increases over 2% were seen in planning of upper-abdominal radiotherapy.
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Affiliation(s)
- Yuta Shibamoto
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
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Kepka L, Danilova V, Saghatelyan T, Bajcsay A, Utehina O, Stojanovic S, Yalman D, Demiral A, Bondaruk O, Kuddu M, Jeremic B. Resources and management strategies for the use of radiotherapy in the treatment of lung cancer in Central and Eastern European countries: Results of an International Atomic Energy Agency (IAEA) survey. Lung Cancer 2007; 56:235-45. [PMID: 17267070 DOI: 10.1016/j.lungcan.2006.12.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2006] [Revised: 12/07/2006] [Accepted: 12/20/2006] [Indexed: 11/22/2022]
Abstract
PURPOSE To assess resources and management strategies for the use of radiotherapy (RT) in the treatment of lung cancer in developing Central and Eastern European countries. MATERIALS/METHODS Questionnaires on patterns of care of NSCLC and SCLC were sent to radiation oncologists of Central and Eastern Europe. Comparisons were made between two groups of countries-ex-USSR states and other Eastern and Central European countries. RESULTS Twenty-four out of twenty-eight surveyed countries responded. There were significant differences in access to modern treatment facilities (3D planning systems, number of linear accelerators), percentage of patients with lung cancer receiving radiotherapy, schedules of palliative RT, use of postoperative RT for early stages between both analysed groups of countries. 3D systems were in use in 25% of centres for an entire treatment, in 28% for a part of the treatment, and in 47% curative RT was 2D planned. Sequential chemo-RT was the most common approach to radical management of NSCLC, followed by RT alone and concomitant chemo-RT; median percentages of patients receiving respective treatments per centre were 57%, 30%, and 10%. For SCLC, the concurrent approach was declared by 56%, and the sequential approach by 42% of responders. CONCLUSIONS Patterns of care of lung cancer in the analysed countries differed in some part from existing, evidence-based data on lung cancer. In particular, this difference was observed between ex-USSR countries and the rest of European developing countries in the equipment available and specific diagnostic and treatment parameters in radiotherapy of lung cancer, the latter group's practices more resembling those of developed European countries.
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Affiliation(s)
- Lucyna Kepka
- Department of Radiotherapy, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, ul. Roentgena 5, 02-781 Warsaw, Poland.
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