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Alsaihaty Z, Abdul Manan H, Sabarudin A, Yahya N. Hybrid Treatment Planning for Chest Wall Irradiation Utilizing Three-Dimensional Conformal Radiotherapy (3DCRT), Intensity-Modulated Radiation Therapy (IMRT), and Volumetric Modulated Arc Therapy (VMAT): A Systematic Review. Cureus 2024; 16:e59583. [PMID: 38832195 PMCID: PMC11144584 DOI: 10.7759/cureus.59583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2024] [Indexed: 06/05/2024] Open
Abstract
Novel hybrid approaches for chest wall irradiation show promising outcomes regarding target coverage and sparing organs at risk (OARs). In this systematic review, we compared hybrid volumetric modulated arc therapy (H-VMAT) or hybrid intensity-modulated radiotherapy (H-IMRT) techniques with non-hybrid techniques, such as three-dimensional conformal radiation therapy (3DCRT), field-in-field (FIF), intensity-modulated arc therapy (IMRT), and volumetric modulated arc therapy (VMAT), for breast cancer patients with mastectomy. Our focus was the plan quality and dose distribution to the OARs. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, we performed a systematic review and quality appraisal of primary studies evaluating hybrid therapy to the chest wall and the OARs. An extensive online search of PubMed and Scopus databases was conducted using appropriate keywords. The dose to the OARs (lung, heart, and contralateral breast), planning target volume (PTV), homogeneity index (HI), and conformity index (CI) were extracted. The data were then tabulated and compared for the outcomes between modalities among the studies. Nine studies that met the search criteria were selected to evaluate the PTV coverage and dosimetric results of hybrid and non-hybrid techniques. In terms of 95% PTV coverage, among nine reviewed studies, the largest difference between the two techniques was between VMAT (47.6 Gy) and H-VMAT (48.4 Gy); for the conformity index, the largest difference was noted between 3DCRT (0.58) and H-VMAT (0.79). In both cases, differences were statistically significant (P < 0.005). Two studies showed dose homogeneity improvement within the treatment target in H-VMAT (0.15 and 0.07) compared with 3DCRT (0.41 and 0.12), with a P value of <0.001. Two studies did not report on the homogeneity index, and three others observed no statistical difference. Regarding OARs, in the comparison of H-VMAT and VMAT, the largest significant change was in the volume receiving 5 Gy (V5Gy) of the ipsilateral lung and the V10Gy of the contralateral lung. For the ipsilateral lung, V5Gy was 90.7% with VMAT versus 51.45% with H-VMAT. For the contralateral lung, V10Gy was 54.9% with VMAT versus 50.5% with H-VMAT. In six studies, the mean dose of the contralateral breast was lower in hybrid techniques than in single modalities: VMAT (4.2%, 6.0%, 1.9%, 7.1%, 4.57%) versus H-VMAT (1.4%, 3.4%, 1.8%, 3.5%, 2.34%) and IMRT (9.1%) versus H-IMRT (4.69%). Although most studies did not report on monitor units and treatment time, those that included them showed that hybrids had lower monitor units and shorter treatment times. Hybrid techniques in radiotherapy, such as combining two modalities, can indeed facilitate lower doses to OARs for patients with a high risk of toxicities. Prospective clinical studies are needed to determine the outcomes of breast cancer treated with hybrid techniques.
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Affiliation(s)
- Zainab Alsaihaty
- Radiation Therapy, King Fahad Specialist Hospital, Dammam, SAU
- Diagnostic Imaging and Radiotherapy, Centre for Diagnostic, Therapeutic and Investigative Sciences, Faculty of Health Sciences, National University of Malaysia, Kuala Lumpur, MYS
| | - Hanani Abdul Manan
- Functional Image Processing Laboratory, Department of Radiology, National University of Malaysia, Kuala Lumpur, MYS
| | - Akmal Sabarudin
- Diagnostic Imaging and Radiotherapy, Centre for Diagnostic, Therapeutic and Investigative Sciences, Faculty of Health Sciences, National University of Malaysia, Kuala Lumpur, MYS
| | - Noorazrul Yahya
- Diagnostic Imaging and Radiotherapy, Centre for Diagnostic, Therapeutic and Investigative Sciences, Faculty of Health Sciences, National University of Malaysia, Kuala Lumpur, MYS
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DiBartolo D, Carpenter T, Santoro JP, Lischalk JW, Ebling D, Haas JA, Witten M, Rybstein M, Vaezi A, Repka MC. Novel VMAT planning technique improves dosimetry for head and neck cancer patients undergoing definitive chemoradiotherapy. Acta Oncol 2023; 62:189-193. [PMID: 36790072 DOI: 10.1080/0284186x.2023.2177973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- David DiBartolo
- Department of Medical Physics, Perlmutter Cancer Center at NYU Long Island, Mineola, NY
| | - Todd Carpenter
- Department of Radiation Oncology, Perlmutter Cancer Center at NYU Long Island, Mineola, NY
| | - Joseph P Santoro
- Department of Medical Physics, Perlmutter Cancer Center at NYU Long Island, Mineola, NY
| | - Jonathan W Lischalk
- Department of Radiation Oncology, Perlmutter Cancer Center at NYU Long Island, Mineola, NY.,NYCyberKnife at Perlmutter Cancer Center Manhattan, New York, NY, USA
| | - David Ebling
- Department of Radiation Oncology, Perlmutter Cancer Center at NYU Long Island, Mineola, NY
| | - Jonathan A Haas
- Department of Radiation Oncology, Perlmutter Cancer Center at NYU Long Island, Mineola, NY.,NYCyberKnife at Perlmutter Cancer Center Manhattan, New York, NY, USA
| | - Matthew Witten
- Department of Medical Physics, Perlmutter Cancer Center at NYU Long Island, Mineola, NY
| | - Marissa Rybstein
- Division of Hematology/Oncology, Perlmutter Cancer Center at NYU Long Island, Mineola, NY, USA
| | - Alec Vaezi
- Department of Otolaryngology-Head and Neck Surgery, Perlmutter Cancer Center at NYU Long Island, Mineola, NY, USA
| | - Michael C Repka
- Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
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Kavuma A, Kibudde S, Schmidt M, Zhao T, Gay H, Li B, Michalski J, Hugo G, Vanchinbazar E, Minjgee M, Nansalmaa E, Ssewamala F, Velarde A, De Fella V, Ixquiac M, Henke L, van Rheenen J, Sun B. Remote Global Radiation Oncology Education and Training: A Pathway to Increase Access to High-Quality Radiation Therapy Services in Low- and Middle-Income Countries. Adv Radiat Oncol 2023; 8:101180. [PMID: 36846439 PMCID: PMC9947225 DOI: 10.1016/j.adro.2023.101180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 01/05/2023] [Indexed: 01/19/2023] Open
Abstract
Purpose There is a vital need to train radiation therapy professionals in low- and middle-income countries (LMICs) to develop sustainable cancer treatment capacity and infrastructure. LMICs have started to introduce intensity modulated radiation therapy (IMRT), which is the standard of care in high-income countries, because of improved outcomes and reduced toxicities. This work reports the efficacy of a complementary asynchronous plus synchronous virtual-training approach on improving radiation therapy professions' self-confidence levels and evaluating participants' attitudes toward asynchronous and synchronous didactic hands-on learning in 3 LMICs. Methods and Materials Training was provided to 37 participants from Uganda, Guatemala, and Mongolia, which included 4 theoretical lectures, 4 hands-on sessions, and 8 self-guided online videos. The 36-day training focused on IMRT contouring, site-specific target/organ definition, planning/optimization, and quality assurance. Participants completed pre- and postsession confidence surveys on a 0 to 10 scale, which was converted to a 5-point Likert rating scale to evaluate the training outcomes. The pros and cons of the 3 different training formats were compared. Results The participants included 15 (40.5%) radiation oncologists, 11 (29.7%) medical physicists, 6 (16.2%) radiation therapists, and 5 (13.5%) dosimetrists. Approximately 50% had more than 10 years of radiation therapy experience, 70.8% had no formal IMRT training, and only 25% had IMRT at their institutions. The average experience and confidence levels in using IMRT at baseline were 3.2 and 2.9, which increased to 5.2 and 4.9 (P < .001) after the theoretical training. After the hands-on training, the experience and confidence levels further improved to 5.4 and 5.5 (P < .001). After the self-guided training, the confidence levels increased further to 6.9 (P < .01). Among the 3 different training sessions, hands-on trainings (58.3%) were most helpful for the development of participants' IMRT skills, followed by theoretical sessions with 25%. Conclusions After completing the training sessions, Uganda and Mongolia started IMRT treatments. Remote training provides an excellent and feasible e-learning platform to train radiation therapy professionals in LMICs. The training program improved the IMRT confidence levels and treatment delivery. The hands-on trainings were most preferred.
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Affiliation(s)
- Awusi Kavuma
- Department of Radiation Therapy, Uganda Cancer Institute, Kampala, Uganda
- Corresponding author: Awusi Kavuma, DPhil
| | - Solomon Kibudde
- Department of Radiation Therapy, Uganda Cancer Institute, Kampala, Uganda
| | - Matthew Schmidt
- Department of Radiation Oncology, School of Medicine, Washington University in St. Louis, St. Louis, Missouri
| | - Tianyu Zhao
- Department of Radiation Oncology, School of Medicine, Washington University in St. Louis, St. Louis, Missouri
| | - Hiram Gay
- Department of Radiation Oncology, School of Medicine, Washington University in St. Louis, St. Louis, Missouri
| | | | - Jeff Michalski
- Department of Radiation Oncology, School of Medicine, Washington University in St. Louis, St. Louis, Missouri
| | - Geoffrey Hugo
- Department of Radiation Oncology, School of Medicine, Washington University in St. Louis, St. Louis, Missouri
| | | | | | | | - Fred Ssewamala
- Brown School, Washington University in St. Louis, St. Louis, Missouri
| | - Angel Velarde
- Perelman School of Medicine, University of Pennsylvania & Center for Global Health, Philadelphia, Pennsylvania
| | - Vicky De Fella
- Liga Nacional Contra el Cancer/Instituto de Cancerologia, Guatemala City, Guatemala
| | - Milton Ixquiac
- Liga Nacional Contra el Cancer/Instituto de Cancerologia, Guatemala City, Guatemala
| | - Lauren Henke
- Liga Nacional Contra el Cancer/Instituto de Cancerologia, Guatemala City, Guatemala
| | - Jacaranda van Rheenen
- Global Health Center, Institute for Public Health, Washington University in St. Louis, St. Louis, Missouri
| | - Baozhou Sun
- Department of Radiation Oncology, School of Medicine, Washington University in St. Louis, St. Louis, Missouri
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U’wais FA, Radzi Y, Noor Rizan N, Zin HM. Validation of a digital method for patient-specific verification of VMAT treatment using a 2D ionisation detector array. Radiat Phys Chem Oxf Engl 1993 2023. [DOI: 10.1016/j.radphyschem.2022.110536] [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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5
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Zhang G, Jiang Z, Zhu J, Wang L. Dose prediction for cervical cancer VMAT patients with a full-scale 3D-cGAN-based model and the comparison of different input data on the prediction results. Radiat Oncol 2022; 17:179. [PMID: 36372897 PMCID: PMC9655866 DOI: 10.1186/s13014-022-02155-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 11/04/2022] [Indexed: 11/15/2022] Open
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Raina P, Singh S. Comparison between Three-Dimensional Conformal Radiation Therapy (3DCRT) and Intensity-Modulated Radiation Therapy (IMRT) for Radiotherapy of Cervical Carcinoma: A Heterogeneous Phantom Study. J Biomed Phys Eng 2022; 12:465-476. [PMID: 36313412 PMCID: PMC9589078 DOI: 10.31661/jbpe.v0i0.2101-1257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/13/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND Radiotherapy plays a major role in the treatment of the cervical cancer. OBJECTIVE Dosimetric comparison of intensity-modulated radiation therapy (IMRT) with three-dimensional conformal radiation therapy (3DCRT) in cervical cancer treatment was performed by modifying the beams arrangements to achieve better organ at risk (OAR) sparing. MATERIAL AND METHODS The analytical evaluation study was made by modifying the IMRT plan, subtracting the rectal volume from planning target volume (PTV), and applying the field-in-field technique in 3DCRT. Eight patients in various cervical cancer stages, from I‒III, were inducted for this investigation. The prescribed dose was 5000 cGy in 25 fractions. For all cases, both IMRT and 3DCRT plans were generated. For PTV and OARs, dose volume histogram (DVH) comparative analysis was carried out. For safety checks and quality control, pre-treatment verification of all the plans was performed using an indigenously developed pelvic phantom (for IMRT and 3DCRT) and gamma analysis with Delta4 phantom (for IMRT). RESULTS This study indicated that IMRT can treat cervical cancer more efficiently with less damage to OARs as compare to 3DCRT. CONCLUSION In this study, we observe that the IMRT plans with subtracting rectal volume achieve better OAR sparing.
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Affiliation(s)
- Payal Raina
- PhD, Department of Physics, Ranchi University, Ranchi- 834008, Jharkhand, India
| | - Sudha Singh
- PhD, Department of Physics, Ranchi University, Ranchi- 834008, Jharkhand, India
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Dias Domingues DR, Leech MM. Exploring the impact of metabolic imaging in head and neck cancer treatment. Head Neck 2022; 44:2228-2247. [PMID: 35775713 PMCID: PMC9545005 DOI: 10.1002/hed.27131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 06/09/2022] [Accepted: 06/16/2022] [Indexed: 11/14/2022] Open
Abstract
Background Target volume delineation is performed with anatomical imaging for head and neck cancer. Molecular imaging allows the recognition of specific tumor regions. Its inclusion in the pathway could lead to changes in delineation and resultant treatment plans. Methods PRISMA methodology was adhered to when selecting the articles for analysis and only full articles were quality assessed. Results Seventeen articles were included. Gross tumor volume (GTV) primary, GTV nodal, and other target volumes were evaluated. Positron emission tomography/computerized tomography (PET/CT) produced smaller primary GTVs, although not with diffusion‐weighted imaging‐magnetic resonance imaging (DWI‐MRI) or PET/MRI. The impact of these image modalities on GTV nodal did not display any consistency. Additionally, there was considerable heterogeneity in metrics comparing delineations. Four studies included appraised the dosimetric impact of the changes in target volume delineation. Conclusion Quantifying the impact of molecular imaging is difficult, due to heterogeneity in reporting metrics in molecular imaging modalities and a paucity of detail regarding delineation method and guideline adherence.
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8
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Parlar S, Uzal C. The effect of ion chamber volume on intensity-modulated radiotherapy small field dosimetry. JOURNAL OF RADIATION RESEARCH AND APPLIED SCIENCES 2022. [DOI: 10.1016/j.jrras.2022.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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9
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Sarti A, De Maria P, Battistoni G, De Simoni M, Di Felice C, Dong Y, Fischetti M, Franciosini G, Marafini M, Marampon F, Mattei I, Mirabelli R, Muraro S, Pacilio M, Palumbo L, Rocca L, Rubeca D, Schiavi A, Sciubba A, Tombolini V, Toppi M, Traini G, Trigilio A, Patera V. Deep Seated Tumour Treatments With Electrons of High Energy Delivered at FLASH Rates: The Example of Prostate Cancer. Front Oncol 2022; 11:777852. [PMID: 35024354 PMCID: PMC8744000 DOI: 10.3389/fonc.2021.777852] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/19/2021] [Indexed: 12/25/2022] Open
Abstract
Different therapies are adopted for the treatment of deep seated tumours in combination or as an alternative to surgical removal or chemotherapy: radiotherapy with photons (RT), particle therapy (PT) with protons or even heavier ions like 12C, are now available in clinical centres. In addition to these irradiation modalities, the use of Very High Energy Electron (VHEE) beams (100–200 MeV) has been suggested in the past, but the diffusion of that technique was delayed due to the needed space and budget, with respect to standard photon devices. These disadvantages were not paired by an increased therapeutic efficacy, at least when comparing to proton or carbon ion beams. In this contribution we investigate how recent developments in electron beam therapy could reshape the treatments of deep seated tumours. In this respect we carefully explored the application of VHEE beams to the prostate cancer, a well-known and studied example of deep seated tumour currently treated with high efficacy both using RT and PT. The VHEE Treatment Planning System was obtained by means of an accurate Monte Carlo (MC) simulation of the electrons interactions with the patient body. A simple model of the FLASH effect (healthy tissues sparing at ultra-high dose rates), has been introduced and the results have been compared with conventional RT. The study demonstrates that VHEE beams, even in absence of a significant FLASH effect and with a reduced energy range (70–130 MeV) with respect to implementations already explored in literature, could be a good alternative to standard RT, even in the framework of technological developments that are nowadays affordable.
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Affiliation(s)
- Alessio Sarti
- Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Roma, Italy.,Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Roma I, Roma, Italy
| | - Patrizia De Maria
- Scuola post-laurea in Fisica Medica, Dipartimento di Scienze e Biotecnologie medico-chirurgiche, Sapienza Università di Roma, Roma, Italy
| | - Giuseppe Battistoni
- Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Milano, Milano, Italy
| | - Micol De Simoni
- Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Roma I, Roma, Italy.,Dipartimento di Fisica, Sapienza Università di Roma, Roma, Italy
| | - Cinzia Di Felice
- Unità di Fisica Sanitaria, Azienda Ospedaliero-Universitaria Policlinico Umberto I, Roma, Italy
| | - Yunsheng Dong
- Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Milano, Milano, Italy
| | - Marta Fischetti
- Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Roma, Italy.,Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Roma I, Roma, Italy
| | - Gaia Franciosini
- Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Roma I, Roma, Italy.,Dipartimento di Fisica, Sapienza Università di Roma, Roma, Italy
| | - Michela Marafini
- Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Roma I, Roma, Italy.,Museo Storico della Fisica e Centro Studi e Ricerche "E. Fermi", Roma, Italy
| | - Francesco Marampon
- Dipartimento di Scienze Radiologiche, Oncologiche e Anatomo Patologiche, Sapienza Università di Roma, Roma, Italy
| | - Ilaria Mattei
- Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Milano, Milano, Italy
| | - Riccardo Mirabelli
- Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Roma I, Roma, Italy.,Dipartimento di Fisica, Sapienza Università di Roma, Roma, Italy
| | - Silvia Muraro
- Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Milano, Milano, Italy
| | - Massimiliano Pacilio
- Unità di Fisica Sanitaria, Azienda Ospedaliero-Universitaria Policlinico Umberto I, Roma, Italy
| | - Luigi Palumbo
- Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Roma, Italy.,Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Roma I, Roma, Italy
| | - Loredana Rocca
- Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Roma, Italy
| | - Damiana Rubeca
- Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Roma, Italy
| | - Angelo Schiavi
- Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Roma, Italy.,Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Roma I, Roma, Italy
| | - Adalberto Sciubba
- Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Roma, Italy.,Istituto Nazionale di Fisica Nucleare (INFN) Sezione dei Laboratori di Frascati, Roma, Italy
| | - Vincenzo Tombolini
- Dipartimento di Scienze Radiologiche, Oncologiche e Anatomo Patologiche, Sapienza Università di Roma, Roma, Italy
| | - Marco Toppi
- Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Roma, Italy.,Istituto Nazionale di Fisica Nucleare (INFN) Sezione dei Laboratori di Frascati, Roma, Italy
| | - Giacomo Traini
- Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Roma I, Roma, Italy
| | - Antonio Trigilio
- Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Roma I, Roma, Italy.,Dipartimento di Fisica, Sapienza Università di Roma, Roma, Italy
| | - Vincenzo Patera
- Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Roma, Italy.,Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Roma I, Roma, Italy
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10
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Li Q, Luo H, Liu X, Zhong M, Yang H, Tao D, Jin F. Evaluation of plan quality based on a novel plan difficulty index and its preliminary application in radiotherapy. JOURNAL OF RADIATION RESEARCH AND APPLIED SCIENCES 2021. [DOI: 10.1080/16878507.2021.1988818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Qicheng Li
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing,China
| | - Huanli Luo
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing,China
| | - Xianfeng Liu
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing,China
| | - Mingsong Zhong
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing,China
| | - Han Yang
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing,China
| | - Dan Tao
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing,China
| | - Fu Jin
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing,China
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11
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In Vitro Effects of Papaverine on Cell Proliferation, Reactive Oxygen Species, and Cell Cycle Progression in Cancer Cells. Molecules 2021; 26:molecules26216388. [PMID: 34770797 PMCID: PMC8587410 DOI: 10.3390/molecules26216388] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 11/23/2022] Open
Abstract
Papaverine (PPV) is an alkaloid isolated from the Papaver somniferum. Research has shown that PPV inhibits proliferation. However, several questions remain regarding the effects of PPV in tumorigenic cells. In this study, the influence of PPV was investigated on the proliferation (spectrophotometry), morphology (light microscopy), oxidative stress (fluorescent microscopy), and cell cycle progression (flow cytometry) in MDA-MB-231, A549, and DU145 cell lines. Exposure to 150 μM PPV resulted in time- and dose-dependent antiproliferative activity with reduced cell growth to 56%, 53%, and 64% in the MDA-MB-231, A549, and DU145 cell lines, respectively. Light microscopy revealed that PPV exposure increased cellular protrusions in MDA-MB-231 and A549 cells to 34% and 23%. Hydrogen peroxide production increased to 1.04-, 1.02-, and 1.44-fold in PPV-treated MDA-MB-231, A549, and DU145 cells, respectively, compared to cells propagated in growth medium. Furthermore, exposure to PPV resulted in an increase of cells in the sub-G1 phase by 46% and endoreduplication by 10% compared to cells propagated in growth medium that presented with 2.8% cells in the sub-G1 phase and less than 1% in endoreduplication. The results of this study contribute to understanding of effects of PPV on cancer cell lines.
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Zhang C, Hu W, Zhou Q, He J, Wang H, Qiu K, Wang L, Li X. The possibility of developing customized 3D-printed silicone hydrogel bolus for post-mastectomy radiotherapy. JOURNAL OF RADIATION RESEARCH AND APPLIED SCIENCES 2021. [DOI: 10.1080/16878507.2021.1962629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Caixun Zhang
- Department of Radiotherapy, Renmin Hospital of Wuhan University, Wuhan, P .R. China
| | - Weiguo Hu
- Department of Oncology Center, Renmin Hospital of Wuhan University, Wuhan, P .R. China
| | - Qing Zhou
- Department of Ultrasound, Renmin Hospital of Wuhan University, Wuhan, P .R. China
| | - Junxiang He
- Department of Radiotherapy, Renmin Hospital of Wuhan University, Wuhan, P .R. China
| | - Hao Wang
- Department of Ultrasound, Renmin Hospital of Wuhan University, Wuhan, P .R. China
| | - Kehu Qiu
- Department of Oncology Center, Renmin Hospital of Wuhan University, Wuhan, P .R. China
| | - Luzhou Wang
- Department of Radiotherapy, Renmin Hospital of Wuhan University, Wuhan, P .R. China
| | - Xiangpan Li
- Department of Radiotherapy, Renmin Hospital of Wuhan University, Wuhan, P .R. China
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13
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Cavinato S, Felser T, Fusella M, Paiusco M, Montangero S. Optimizing radiotherapy plans for cancer treatment with Tensor Networks. Phys Med Biol 2021; 66. [PMID: 34140431 DOI: 10.1088/1361-6560/ac01f2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 05/17/2021] [Indexed: 11/12/2022]
Abstract
We present a novel application of Tensor Network methods in cancer treatment as a potential tool to solve the dose optimization problem in radiotherapy. In particular, the intensity-modulated radiation therapy technique-that allows treating irregular and inhomogeneous tumors while reducing the radiation toxicity on healthy organs-is based on the optimization problem of the beamlets intensities that shall result in a maximal delivery of the therapy dose to cancer while avoiding the organs at risk of being damaged by the radiation. The resulting optimization problem is expressed as a cost function to be optimized. Here, we map the cost function into an Ising-like Hamiltonian, describing a system of long-range interacting qubits. Finally, we solve the dose optimization problem by finding the ground-state of the Hamiltonian using a Tree Tensor Network algorithm. In particular, we present an anatomical scenario exemplifying a prostate cancer treatment. A similar approach can be applied to future hybrid classical-quantum algorithms, paving the way for the use of quantum technologies in future medical treatments.
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Affiliation(s)
- Samuele Cavinato
- Dipartimento di Fisica e Astronomia 'G. Galilei', Università degli Studi di Padova, I-35131 Padova, Italy.,Medical Physics Department, Veneto Institute of Oncology IOV-IRCCS, I-35128 Padua, Italy
| | - Timo Felser
- Dipartimento di Fisica e Astronomia 'G. Galilei', Università degli Studi di Padova, I-35131 Padova, Italy.,INFN, Sezione di Padova, I-35131 Padova, Italy.,Theoretische Physik, Universität des Saarlandes, D-66123 Saarbrücken, Germany.,Tensor Solutions, Institute for Complex Quantum Systems, University of Ulm, D-89069 Ulm, Germany
| | - Marco Fusella
- Medical Physics Department, Veneto Institute of Oncology IOV-IRCCS, I-35128 Padua, Italy
| | - Marta Paiusco
- Medical Physics Department, Veneto Institute of Oncology IOV-IRCCS, I-35128 Padua, Italy
| | - Simone Montangero
- Dipartimento di Fisica e Astronomia 'G. Galilei', Università degli Studi di Padova, I-35131 Padova, Italy.,INFN, Sezione di Padova, I-35131 Padova, Italy.,Padua Quantum Technologies Research Center, Università degli Studi di Padova, I-35131 Padova, Italy
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14
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Optimising image-guidance frequency for patients treated with volumetric-modulated arc therapy for pelvic cancer. JOURNAL OF RADIOTHERAPY IN PRACTICE 2021. [DOI: 10.1017/s1460396920001223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Aim:
To determine the feasibility of non-daily image-guided radiotherapy (RT) with volumetric-modulated arc therapy for pelvic cancer.
Methods:
Daily cone beam computed tomography (CBCT) images data of 21 patients (542 fractions) with pelvic cancer were used to simulate 5 non-daily imaging (DL) protocols (Alternate day: AD, First 5 + Weekly: FF+WL, Weekly: WL, First 5 fractions: FF and Alternate week: AW protocol). The residual errors in the lateral (X), longitudinal (Y), and vertical (Z) directions and 3D vector shifts of each non-DL protocol were explored. The planning target volume (PTV) margins were calculated using the van Herk’s formula according to population systematic and random error. Finally, the average time of each process from the start to stop of the treatment was used to calculate the number of patients treated per day to assess the treatment delivery capacity for different imaging protocols.
Results:
The 3D vector shift for the FF+WL protocol produced the greatest proportion of residual error ≤ 0·5 cm and showed the smallest random error in all three directions. However, the FF protocol produced the greatest proportion of residual error > 0·5 cm and revealed the largest magnitudes of systematic error in all three directions. Only the AD protocol can explore the PTV margin of less than 0·5 cm in all three directions. The AW protocol showed the maximum capacity of the treatment delivery, showed the highest number of patients treated per day. In contrast, the AW protocol also affects the treatment accuracy, showed the large residual error and PTV margin.
Findings:
Reducing the frequency of image-guided RT results in a high residual error. Non-daily image-guided RT strategies for pelvic irradiation should be applied for margins more than 0·5 cm. The number of patients treated per day, residual error and PTV margin are information to determine non-daily protocol applications that balance treatment delivery capacity and treatment accuracy.
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15
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Volumetric modulated arc therapy: a dosimetric comparison with dynamic IMRT and step-and-shoot IMRT. JOURNAL OF RADIOTHERAPY IN PRACTICE 2020. [DOI: 10.1017/s1460396919000815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractAim:The aim of this study was to compare volumetric modulated arc therapy (VMAT) with dynamic intensity-modulated radiation therapy (dIMRT) and step-and-shoot IMRT (ssIMRT) for different treatment sites.Materials and methods:Twelve patients were selected for the planning comparison study. This included three head and neck, three brain, three rectal and three cervical cancer patients. Total dose of 50 Gy was given for all the plans. Plans were done for Elekta synergy with Monaco treatment planning system. All plans were generated with 6 MV photons beam. Plan evaluation was based on the ability to meet the dose volume histogram, dose homogeneity index, conformity index and radiation delivery time, and monitor unit needs to deliver the prescribed dose.Results:The VMAT and dIMRT plans achieved the better conformity (CI98% = 0·965 ± 0·023) and (CI98% = 0·939 ± 0·01), respectively, while ssIMRT plans were slightly inferior (CI98% = 0·901 ± 0·038). The inhomogeneity in the planning target volume (PTV) was highest with ssIMRT with HI equal to 0·097 ± 0·015 when compared to VMAT with HI equal to 0·092 ± 0·0369 and 0·095 ± 0·023 with dIMRT. The integral dose is found to be inferior with VMAT 105·31 ± 53·6 (Gy L) when compared with dIMRT 110·75 ± 52·9 (Gy L) and ssIMRT 115 38 ± 55·1(Gy L). All the techniques respected the planning objective for all organs at risk. The delivery time per fraction for VMAT was much lower than dIMRT and ssIMRT.Findings:Our results indicate that dIMRT and VMAT provide better sparing of normal tissue, homogeneity and conformity than ssIMRT with reduced treatment delivery time.
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16
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Wang X, Yang G, Zhang Y, Zhu L, Xue X, Zhang B, Cai C, Jin H, Zheng J, Wu J, Yang W, Dai Z. Automated delineation of nasopharynx gross tumor volume for nasopharyngeal carcinoma by plain CT combining contrast-enhanced CT using deep learning. JOURNAL OF RADIATION RESEARCH AND APPLIED SCIENCES 2020. [DOI: 10.1080/16878507.2020.1795565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Xuetao Wang
- Department of Radiotherapy, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Geng Yang
- Department of Radiotherapy, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yiwen Zhang
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China
| | - Lin Zhu
- Department of Radiotherapy, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaoguang Xue
- Department of Radiotherapy, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Bailin Zhang
- Department of Radiotherapy, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chunya Cai
- Department of Radiotherapy, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Huaizhi Jin
- Department of Radiotherapy, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jianxiao Zheng
- Department of Radiotherapy, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jian Wu
- Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, China
| | - Wei Yang
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China
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17
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Woven Natural Fibre Reinforced Composite Materials for Medical Imaging. MATERIALS 2020; 13:ma13071684. [PMID: 32260351 PMCID: PMC7178646 DOI: 10.3390/ma13071684] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 03/31/2020] [Accepted: 04/01/2020] [Indexed: 01/05/2023]
Abstract
Repeatable patient positioning is key to minimising the burden on planning radiotherapy treatment. There are very few materials commercially available which are suitable for use in all common imaging and treatment modalities such as magnetic resonance imaging (MRI), X-Ray computed tomography (CT) and radiotherapy. In this article, we present several such materials based on woven natural fibres embedded in a range of different resin materials which are suitable for such applications. By investigating a range of resins and natural fibre materials in combination and evaluating their performance in terms of MRI and X-Ray imaging, we show that a woven cotton material impregnated with a two-part epoxy resin provides a 15% improvement in passage of X-Rays and has no impact on the MRI signal (unlike the 40% MRI signal attenuation from carbon fibre), whilst also retaining a flexural modulus up to 71% of that of carbon fibre. These results demonstrate that natural fibre composites produced using such materials provide desirable properties for use in patient support and positioning devices for multi-modal imaging, without the need to significantly compromise on the strength of the material.
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18
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Popović-Vuković M, Nidžović B, Nikitović M. Modern radiotherapy for pediatric rhabdomyosarcoma. MEDICINSKI PODMLADAK 2020. [DOI: 10.5937/mp71-24163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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19
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Bazalova‐Carter M, Esplen N. On the capabilities of conventional x‐ray tubes to deliver ultra‐high (FLASH) dose rates. Med Phys 2019; 46:5690-5695. [DOI: 10.1002/mp.13858] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/13/2019] [Accepted: 10/14/2019] [Indexed: 12/13/2022] Open
Affiliation(s)
| | - Nolan Esplen
- Department of Physics and Astronomy University of Victoria Victoria BC Canada
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20
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Stelmes JJ, Gregoire V, Poorten VV, Golusiñski W, Szewczyk M, Jones T, Ansarin M, Broglie MA, Giger R, Klussmann JP, Evans M, Bourhis J, Leemans CR, Spriano G, Dietz A, Hunter K, Zimmermann F, Tinhofer I, Patterson JM, Quaglini S, Govaerts AS, Fortpied C, Simon C. Organ Preservation and Late Functional Outcome in Oropharyngeal Carcinoma: Rationale of EORTC 1420, the "Best of" Trial. Front Oncol 2019; 9:999. [PMID: 31696052 PMCID: PMC6817682 DOI: 10.3389/fonc.2019.00999] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 09/17/2019] [Indexed: 01/25/2023] Open
Abstract
Dysphagia represents one of the most serious adverse events after curative-intent treatments with a tremendous impact on quality of life in patients with head and neck cancers. Novel surgical and radiation therapy techniques have been developed to better preserve swallowing function, while not negatively influencing local control and/or overall survival. This review focuses on the current literature of swallowing outcomes after curative treatment strategies. Available results from recent studies relevant to this topic are presented, demonstrating the potential role of new treatment modalities for early- and intermediate-stage oropharyngeal cancers. Based on this, we present the rationale and design of the currently active EORTC 1420 "Best of" trial, and highlight the potential of this study to help prioritizing either surgery- or radiation-based treatment modalities for the treatment of oropharyngeal cancer in the future.
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Affiliation(s)
- Jean-Jacques Stelmes
- Department of Radiation Oncology, University Hospital Zurich (USZ), Zurich, Switzerland
| | - Vincent Gregoire
- Department of Radiation Oncology, Centre Léon Bérard, Lyon, France
| | | | - Wojciech Golusiñski
- Department of Head and Neck Surgery, The Greater Poland Cancer Centre, Poznan University of Medical Sciences, Poznań, Poland
| | - Mateusz Szewczyk
- Department of Head and Neck Surgery, The Greater Poland Cancer Centre, Poznan University of Medical Sciences, Poznań, Poland
| | - Terry Jones
- Liverpool Head and Neck Centre, University of Liverpool, Liverpool, United Kingdom
| | - Mohssen Ansarin
- Division of Otolaryngology Head and Neck Surgery, European Institute of Oncology, Milan, Italy
| | - Martina A Broglie
- Department of Otolaryngology-Head and Neck Surgery, University Hospital Zurich (USZ), Zurich, Switzerland
| | - Roland Giger
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Bern University Hospital and University of Bern, Inselspital, Bern, Switzerland
| | - Jens Peter Klussmann
- Department of Otolaryngology-Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Mererid Evans
- Velindre University NHS Trust, Wales, United Kingdom
| | - Jean Bourhis
- Department of Radiation Oncology, CHUV, Lausanne, Switzerland
| | - C René Leemans
- Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam, Amsterdam University Medical Centres, VU University, Amsterdam, Netherlands
| | - Giuseppe Spriano
- Department of Otolaryngology Head and Neck Surgery, Humanitas University Milan, Rozzano, Italy
| | - Andreas Dietz
- Department of Otolaryngology, Head and Neck Surgery, University Leipzig, Leipzig, Germany
| | - Keith Hunter
- Academic Unit of Oral Medicine, Pathology and Surgery, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | - Frank Zimmermann
- Department of Radiation Oncology, University of Basel, Basel, Switzerland
| | - Ingeborg Tinhofer
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Radiooncology and Radiotherapy, Berlin, Germany
| | - Joanne M Patterson
- Institute for Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Silvana Quaglini
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | | | | | - Christian Simon
- Service d'Oto-Rhino-Laryngologie - Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire Vaudois (CHUV), Université de Lausanne (UNIL), Lausanne, Switzerland
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