1
|
Patrick HM, Poon E, Kildea J. Experimental validation of a novel method of dose accumulation for the rectum. Acta Oncol 2023; 62:915-922. [PMID: 37504890 DOI: 10.1080/0284186x.2023.2238556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/08/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Dose-surface maps (DSMs) are an increasingly popular tool to evaluate spatial dose-outcome relationships for the rectum. Recently, DSM addition has been proposed as an alternative method of dose accumulation from deformable registration-based techniques. In this study, we performed the first experimental investigation of the accuracy at which DSM accumulation can capture the total dose delivered to a rectum's surface in the presence of inter-fraction motion. MATERIAL AND METHODS A custom PVC rectum phantom capable of representing typical rectum inter-fraction motion and filling variations was constructed for this project. The phantom allowed for the placement of EBT3 film sheets on the representative rectum surface to measure rectum surface dose. A multi-fraction prostate VMAT treatment was designed and delivered to the phantom in a water tank for a variety of inter-fraction motion scenarios. DSMs for each fraction were calculated in two ways using CBCT images acquired during delivery and summed to produce accumulated DSMs. Accumulated DSMs were then compared to film measurements using gamma analysis (3%/2 mm criteria). Similarity of isodose clusters between films and DSMs was also investigated. RESULTS Baseline agreement between film measurements and accumulated DSMs for a stationary rectum was 95.6%. Agreement between film and accumulated DSMs in the presence of different types of inter.-fraction motion was ≥92%, and isodose cluster mean distance to agreement was within 1.5 mm for most scenarios. Overall, DSM accumulation performed the best when using DSMs that accounted for changes in rectum path orientation. CONCLUSION Dose accumulation performed with DSMs was found to accurately replicate total delivered dose to a rectum phantom in the presence of inter-fraction motion.
Collapse
Affiliation(s)
- H M Patrick
- Medical Physics Unit, McGill University, Montreal, Québec, Canada
| | - E Poon
- Department of Medical Physics, McGill University Health Centre, Montreal, Québec, Canada
| | - J Kildea
- Medical Physics Unit, McGill University, Montreal, Québec, Canada
- Cancer Research Program, Research Institute of the McGill University Health Centre, Montreal, Québec, Canada
| |
Collapse
|
2
|
Implementation of Machine Learning Models to Ensure Radiotherapy Quality for Multicenter Clinical Trials: Report from a Phase III Lung Cancer Study. Cancers (Basel) 2023; 15:cancers15041014. [PMID: 36831358 PMCID: PMC9953775 DOI: 10.3390/cancers15041014] [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] [Received: 12/23/2022] [Revised: 01/30/2023] [Accepted: 01/30/2023] [Indexed: 02/09/2023] Open
Abstract
The outcome of the patient and the success of clinical trials involving RT is dependent on the quality assurance of the RT plans. Knowledge-based Planning (KBP) models using data from a library of high-quality plans have been utilized in radiotherapy to guide treatment. In this study, we report on the use of these machine learning tools to guide the quality assurance of multicenter clinical trial plans. The data from 130 patients submitted to RTOG1308 were included in this study. Fifty patient cases were used to train separate photon and proton models on a commercially available platform based on principal component analysis. Models evaluated 80 patient cases. Statistical comparisons were made between the KBP plans and the original plans submitted for quality evaluation. Both photon and proton KBP plans demonstrate a statistically significant improvement of quality in terms of organ-at-risk (OAR) sparing. Proton KBP plans, a relatively emerging technique, show more improvements compared with photon plans. The KBP proton model is a useful tool for creating proton plans that adhere to protocol requirements. The KBP tool was also shown to be a useful tool for evaluating the quality of RT plans in the multicenter clinical trial setting.
Collapse
|
3
|
Sun L, Quon H, Tran V, Kirkby C, Smith W. External beam radiation therapy treatment factors prognostic of biochemical failure free survival: a multi-institutional retrospective study for prostate cancer. Radiother Oncol 2022; 173:109-118. [PMID: 35662659 DOI: 10.1016/j.radonc.2022.05.030] [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: 08/08/2021] [Revised: 05/02/2022] [Accepted: 05/29/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE The goal of this work is to identify specific treatment planning and delivery features that are prognostic of biochemical failure-free survival (BFFS) for prostate cancer patients treated with external beam radiotherapy (EBRT). MATERIALS AND METHODS This study reviewed patients diagnosed with localized prostate adenocarcinoma between 2005 and 2016, and treated with EBRT on a Varian linear accelerator at one of the four cancer centers in Alberta, Canada. BFFS was calculated using the Kaplan-Meier estimator. Patient demographics, tumor characteristics, and EBRT treatment planning and delivery factors, were collected for each patient. The patient cohort was split into a training dataset with patients from two centers and a validation dataset with patients from another two centers. A random survival forest was used to identify features associated with BFFS. RESULTS This study included 2827 patients with a median follow-up of 6.4 years. The BFFS for this cohort collectively was 84.9% at 5 years and 69.3% at 10 years. 2519 patients from two centers were used for model training and 308 patients from two different centers were used for model validation. The prognostic features were Gleason score, prostate-specific antigen (PSA) at diagnosis, clinical T stage, CTV D99, pelvic irradiation, IGRT frequency, and PTV V98. Variables including bladder volume, dose calculation algorithm, PTV D99, age at diagnosis, hip prosthesis, number of malignancies, fiducial marker usage, PTV volume, RT modality, PTV HI, rectal volume, hormone treatment, PTV D1cc, equivalent PTV margin, IGRT type, and EQD2_1.5 were unlikely to be prognostic. A random survival forest using only the seven prognostic variables was built. The Harrell's concordance index for the model was 0.65 for the whole training dataset, 0.62 for out-of-bag samples of the training dataset, and 0.62 for the validation dataset. CONCLUSION EBRT features prognostic of BFFS were identified and a random survival forest was developed for predicting prostate cancer patients' BFFS after EBRT.
Collapse
Affiliation(s)
- Lingyue Sun
- Department of Physics and Astronomy, University of Calgary, Calgary, Alberta, Canada; Division of Medical Physics, Tom Baker Cancer Centre, Calgary, Alberta, Canada.
| | - Harvey Quon
- Department of Radiation Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada; Department of Oncology, University of Calgary, Calgary, Alberta, Canada
| | - Vicki Tran
- Department of Biological Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Charles Kirkby
- Department of Physics and Astronomy, University of Calgary, Calgary, Alberta, Canada; Department of Oncology, University of Calgary, Calgary, Alberta, Canada; Division of Medical Physics, Jack Ady Cancer Centre, Lethbridge, Alberta, Canada
| | - Wendy Smith
- Department of Physics and Astronomy, University of Calgary, Calgary, Alberta, Canada; Division of Medical Physics, Tom Baker Cancer Centre, Calgary, Alberta, Canada; Department of Oncology, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
4
|
Shao Y, Zhang X, Wu G, Gu Q, Wang J, Ying Y, Feng A, Xie G, Kong Q, Xu Z. Prediction of Three-Dimensional Radiotherapy Optimal Dose Distributions for Lung Cancer Patients With Asymmetric Network. IEEE J Biomed Health Inform 2021; 25:1120-1127. [PMID: 32966222 DOI: 10.1109/jbhi.2020.3025712] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The iterative design of radiotherapy treatment plans is time-consuming and labor-intensive. In order to provide a guidance to treatment planning, Asymmetric network (A-Net) is proposed to predict the optimal 3D dose distribution for lung cancer patients. A-Net was trained and tested in 392 lung cancer cases with the prescription doses of 50Gy and 60Gy. In A-Net, the encoder and decoder are asymmetric, able to preserve input information and to adapt the limitation of GPU memory. Squeeze and excitation (SE) units are used to improve the data-fitting ability. A loss function involving both the dose distribution and prescription dose as ground truth are designed. In the experiment, A-Net is separately trained and tested in the 50Gy and 60Gy dataset and most of the metrics A-Net achieve similar performance as HD-Unet and 3D-Unet, and some metrics slightly better. In the 50Gy-and-60Gy-combined dataset, most of the A-Net's metrics perform better than the other two. In conclusion, A-Net can accurately predict the IMRT dose distribution in the three datasets of 50Gy and 50Gy-and-60Gy-combined dataset.
Collapse
|
5
|
Deep learning dose prediction for IMRT of esophageal cancer: The effect of data quality and quantity on model performance. Phys Med 2021; 83:52-63. [DOI: 10.1016/j.ejmp.2021.02.026] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 02/15/2021] [Accepted: 02/24/2021] [Indexed: 12/15/2022] Open
|
6
|
Hedden N, Xu H. Radiation therapy dose prediction for left-sided breast cancers using two-dimensional and three-dimensional deep learning models. Phys Med 2021; 83:101-107. [DOI: 10.1016/j.ejmp.2021.02.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/05/2021] [Accepted: 02/23/2021] [Indexed: 10/21/2022] Open
|
7
|
Marcello M, Denham JW, Kennedy A, Haworth A, Steigler A, Greer PB, Holloway LC, Dowling JA, Jameson MG, Roach D, Joseph DJ, Gulliford SL, Dearnaley DP, Sydes MR, Hall E, Ebert MA. Reduced Dose Posterior to Prostate Correlates With Increased PSA Progression in Voxel-Based Analysis of 3 Randomized Phase 3 Trials. Int J Radiat Oncol Biol Phys 2020; 108:1304-1318. [PMID: 32739320 DOI: 10.1016/j.ijrobp.2020.07.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 07/13/2020] [Accepted: 07/20/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Reducing margins during treatment planning to decrease dose to healthy organs surrounding the prostate can risk inadequate treatment of subclinical disease. This study aimed to investigate whether lack of dose to subclinical disease is associated with increased disease progression by using high-quality prostate radiation therapy clinical trial data to identify anatomically localized regions where dose variation is associated with prostate-specific antigen progression (PSAP). METHODS AND MATERIALS Planned dose distributions for 683 patients of the Trans-Tasman Radiation Oncology Group 03.04 Randomized Androgen Deprivation and Radiotherapy (RADAR) trial were deformably registered onto a single exemplar computed tomography data set. These were divided into high-risk and intermediate-risk subgroups for analysis. Three independent voxel-based statistical tests, using permutation testing, Cox regression modeling, and least absolute shrinkage selection operator feature selection, were applied to identify regions where dose variation was associated with PSAP. Results from the intermediate-risk RADAR subgroup were externally validated by registering dose distributions from the RT01 (n = 388) and Conventional or Hypofractionated High Dose Intensity Modulated Radiotherapy for Prostate Cancer Trial (CHHiP) (n = 253) trials onto the same exemplar and repeating the tests on each of these data sets. RESULTS Voxel-based Cox regression revealed regions where reduced dose was correlated with increased prostate-specific androgen progression. Reduced dose in regions associated with coverage at the posterior prostate, in the immediate periphery of the posterior prostate, and in regions corresponding to the posterior oblique beams or posterior lateral beam boundary, was associated with increased PSAP for RADAR and RT01 patients, but not for CHHiP patients. Reduced dose to the seminal vesicle region was also associated with increased PSAP for RADAR intermediate-risk patients. CONCLUSIONS Ensuring adequate dose coverage at the posterior prostate and immediately surrounding posterior region (including the seminal vesicles), where aggressive cancer spread may be occurring, may improve tumor control. It is recommended that particular care be taken when defining margins at the prostate posterior, acknowledging the trade-off between quality of life due to rectal dose and the preferences of clinicians and patients.
Collapse
Affiliation(s)
- Marco Marcello
- Department of Physics, University of Western Australia, Perth, Western Australia, Australia; Department of Radiation Oncology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
| | - James W Denham
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Angel Kennedy
- Department of Radiation Oncology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Annette Haworth
- School of Physics, University of Sydney, Sydney, New South Wales, Australia
| | - Allison Steigler
- Prostate Cancer Trials Group, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Peter B Greer
- School of Mathematical and Physical Sciences, University of Newcastle, Newcastle, New South Wales, Australia; Department of Radiation Oncology, Calvary Mater Newcastle, Newcastle, New South Wales, Australia
| | - Lois C Holloway
- Department of Medical Physics, Liverpool Cancer Centre, Sydney, New South Wales, Australia; South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia; Centre for Medical Radiation Physics, University of Wollongong, Wollongong, New South Wales, Australia
| | - Jason A Dowling
- School of Mathematical and Physical Sciences, University of Newcastle, Newcastle, New South Wales, Australia; CSIRO, Brisbane, Queensland, Australia
| | - Michael G Jameson
- Department of Medical Physics, Liverpool Cancer Centre, Sydney, New South Wales, Australia; South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia; Centre for Medical Radiation Physics, University of Wollongong, Wollongong, New South Wales, Australia; Cancer Research Team, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
| | - Dale Roach
- Department of Medical Physics, Liverpool Cancer Centre, Sydney, New South Wales, Australia; South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia; Cancer Research Team, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
| | - David J Joseph
- School of Surgery, University of Western Australia, Perth, Western Australia, Australia; 5D Clinics, Claremont, Perth, Western Australia, Australia; GenesisCare WA, Perth, Western Australia, Australia
| | - Sarah L Gulliford
- Radiotherapy Department, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - David P Dearnaley
- Academic UroOncology Unit, The Institute of Cancer Research and the Royal Marsden NHS Trust, London, United Kingdom
| | - Matthew R Sydes
- MRC Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, London, United Kingdom
| | - Emma Hall
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, United Kingdom
| | - Martin A Ebert
- Department of Physics, University of Western Australia, Perth, Western Australia, Australia; Department of Radiation Oncology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia; 5D Clinics, Claremont, Perth, Western Australia, Australia
| |
Collapse
|
8
|
Marcello M, Denham JW, Kennedy A, Haworth A, Steigler A, Greer PB, Holloway LC, Dowling JA, Jameson MG, Roach D, Joseph DJ, Gulliford SL, Dearnaley DP, Sydes MR, Hall E, Ebert MA. Relationships between rectal and perirectal doses and rectal bleeding or tenesmus in pooled voxel-based analysis of 3 randomised phase III trials. Radiother Oncol 2020; 150:281-292. [PMID: 32745667 DOI: 10.1016/j.radonc.2020.07.048] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 07/25/2020] [Accepted: 07/28/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND PURPOSE This study aimed to identify anatomically-localised regions where planned radiotherapy dose is associated with gastrointestinal toxicities in healthy tissues throughout the pelvic anatomy. MATERIALS AND METHODS Planned dose distributions for up to 657 patients of the Trans Tasman Radiation Oncology Group 03.04 RADAR trial were deformably registered onto a single exemplar computed tomography dataset. Voxel-based multiple comparison permutation dose difference testing, Cox regression modelling and LASSO feature selection were used to identify regions where dose-increase was associated with grade ≥2 rectal bleeding (RB) or tenesmus, according to the LENT/SOMA scale. This was externally validated by registering dose distributions from the RT01 (n = 388) and CHHiP (n = 241) trials onto the same exemplar and repeating the tests on each of these data sets, and on all three datasets combined. RESULTS Voxel-based Cox regression and permutation dose difference testing revealed regions where increased dose was correlated with gastrointestinal toxicity. Grade ≥2 RB was associated with posteriorly extended lateral beams that manifested high doses (>55 Gy) in a small rectal volume adjacent to the clinical target volume. A correlation was found between grade ≥2 tenesmus and increased low-intermediate dose (∼25 Gy) at the posterior beam region, including the posterior rectum and perirectal fat space (PRFS). CONCLUSIONS The serial response of the rectum with respect to RB has been demonstrated in patients with posteriorly extended lateral beams. Similarly, the parallel response of the PRFS with respect to tenesmus has been demonstrated in patients treated with the posterior beam.
Collapse
Affiliation(s)
- Marco Marcello
- Department of Physics, University of Western Australia, Crawley, Australia; Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Australia.
| | - James W Denham
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Angel Kennedy
- Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Annette Haworth
- School of Physics, University of Sydney, Camperdown, Australia
| | - Allison Steigler
- Prostate Cancer Trials Group, School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Peter B Greer
- School of Mathematical and Physical Sciences, University of Newcastle, Callaghan, Australia; Department of Radiation Oncology, Calvary Mater Newcastle, Waratah, Australia
| | - Lois C Holloway
- Department of Medical Physics, Liverpool Cancer Centre, Australia; South Western Sydney Clinical School, University of New South Wales, Liverpool, Australia; Centre for Medical Radiation Physics, University of Wollongong, Australia
| | - Jason A Dowling
- School of Mathematical and Physical Sciences, University of Newcastle, Callaghan, Australia; CSIRO, Herston, Australia
| | - Michael G Jameson
- Department of Medical Physics, Liverpool Cancer Centre, Australia; South Western Sydney Clinical School, University of New South Wales, Liverpool, Australia; Centre for Medical Radiation Physics, University of Wollongong, Australia; Cancer Research Team, Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Dale Roach
- Department of Medical Physics, Liverpool Cancer Centre, Australia; South Western Sydney Clinical School, University of New South Wales, Liverpool, Australia; Cancer Research Team, Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - David J Joseph
- School of Surgery, University of Western Australia, Crawley, Australia; 5D Clinics, Claremont, Australia; GenesisCare WA, Wembley, Australia
| | - Sarah L Gulliford
- Radiotherapy Department, University College London Hospitals NHS Foundation Trust, United Kingdom; Department of Medical Physics and Biomedical Engineering, University College London, United Kingdom
| | - David P Dearnaley
- Academic UroOncology Unit, The Institute of Cancer Research and the Royal Marsden NHS Trust, London, Australia
| | - Mathew R Sydes
- MRC Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College, London, United Kingdom
| | - Emma Hall
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, Sutton, United Kingdom
| | - Martin A Ebert
- Department of Physics, University of Western Australia, Crawley, Australia; Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Australia; 5D Clinics, Claremont, Australia
| |
Collapse
|
9
|
Marcello M, Denham JW, Kennedy A, Haworth A, Steigler A, Greer PB, Holloway LC, Dowling JA, Jameson MG, Roach D, Joseph DJ, Gulliford SL, Dearnaley DP, Sydes MR, Hall E, Ebert MA. Increased Dose to Organs in Urinary Tract Associates With Measures of Genitourinary Toxicity in Pooled Voxel-Based Analysis of 3 Randomized Phase III Trials. Front Oncol 2020; 10:1174. [PMID: 32793485 PMCID: PMC7387667 DOI: 10.3389/fonc.2020.01174] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 06/09/2020] [Indexed: 12/21/2022] Open
Abstract
Purpose: Dose information from organ sub-regions has been shown to be more predictive of genitourinary toxicity than whole organ dose volume histogram information. This study aimed to identify anatomically-localized regions where 3D dose is associated with genitourinary toxicities in healthy tissues throughout the pelvic anatomy. Methods and Materials: Dose distributions for up to 656 patients of the Trans-Tasman Radiation Oncology Group 03.04 RADAR trial were deformably registered onto a single exemplar CT dataset. Voxel- based multiple comparison permutation dose difference testing, Cox regression modeling and LASSO feature selection were used to identify regions where 3D dose-increase was associated with late grade ≥ 2 genitourinary dysuria, incontinence and frequency, and late grade ≥ 1 haematuria. This was externally validated by registering dose distributions from the RT01 (up to n = 388) and CHHiP (up to n = 247) trials onto the same exemplar and repeating the voxel-based tests on each of these data sets. All three datasets were then combined, and the tests repeated. Results: Voxel-based Cox regression and multiple comparison permutation dose difference testing revealed regions where increased dose was correlated with genitourinary toxicity. Increased dose in the vicinity of the membranous and spongy urethra was associated with dysuria for all datasets. Haematuria was similarly correlated with increased dose at the membranous and spongy urethra, for the RADAR, CHHiP, and combined datasets. Some evidence was found for the association between incontinence and increased dose at the internal and external urethral sphincter for RADAR and the internal sphincter alone for the combined dataset. Incontinence was also strongly correlated with dose from posterior oblique beams. Patients with fields extending inferiorly and posteriorly to the CTV, adjacent to the membranous and spongy urethra, were found to experience increased frequency. Conclusions: Anatomically-localized dose-toxicity relationships were determined for late genitourinary symptoms in the urethra and urinary sphincters. Low-intermediate doses to the extraprostatic urethra were associated with risk of late dysuria and haematuria, while dose to the urinary sphincters was associated with incontinence.
Collapse
Affiliation(s)
- Marco Marcello
- Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
- Department of Physics, University of Western Australia, Perth, WA, Australia
| | - James W. Denham
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Angel Kennedy
- Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Annette Haworth
- School of Physics, University of Sydney, Sydney, NSW, Australia
| | - Allison Steigler
- Prostate Cancer Trials Group, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Peter B. Greer
- School of Mathematical and Physical Sciences, University of Newcastle, Callaghan, NSW, Australia
- Department of Radiation Oncology, Calvary Mater Newcastle, Waratah, NSW, Australia
| | - Lois C. Holloway
- Department of Medical Physics, Liverpool Cancer Centre, Liverpool, NSW, Australia
- South Western Sydney Clinical School, University of New South Wales, Kensington, NSW, Australia
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia
| | - Jason A. Dowling
- School of Mathematical and Physical Sciences, University of Newcastle, Callaghan, NSW, Australia
- CSIRO, St Lucia, QLD, Australia
| | - Michael G. Jameson
- Department of Medical Physics, Liverpool Cancer Centre, Liverpool, NSW, Australia
- South Western Sydney Clinical School, University of New South Wales, Kensington, NSW, Australia
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia
- Cancer Research Team, Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Dale Roach
- Department of Medical Physics, Liverpool Cancer Centre, Liverpool, NSW, Australia
- South Western Sydney Clinical School, University of New South Wales, Kensington, NSW, Australia
- Cancer Research Team, Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - David J. Joseph
- School of Surgery, University of Western Australia, Perth, WA, Australia
- 5D Clinics, Claremont, WA, Australia
- GenesisCare WA, Wembley, WA, Australia
| | - Sarah L. Gulliford
- Radiotherapy Department, University College London Hospitals NHS Foundation Trust, London, United Kingdom
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - David P. Dearnaley
- Academic UroOncology Unit, The Institute of Cancer Research and the Royal Marsden NHS Trust, London, United Kingdom
| | - Matthew R. Sydes
- MRC Clinical Trials Unit, Medical Research Council, London, United Kingdom
| | - Emma Hall
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, United Kingdom
| | - Martin A. Ebert
- Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
- Department of Physics, University of Western Australia, Perth, WA, Australia
- 5D Clinics, Claremont, WA, Australia
| |
Collapse
|
10
|
Barragán‐Montero AM, Nguyen D, Lu W, Lin MH, Norouzi‐Kandalan R, Geets X, Sterpin E, Jiang S. Three‐dimensional dose prediction for lung IMRT patients with deep neural networks: robust learning from heterogeneous beam configurations. Med Phys 2019; 46:3679-3691. [DOI: 10.1002/mp.13597] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 04/12/2019] [Accepted: 05/10/2019] [Indexed: 12/23/2022] Open
Affiliation(s)
- Ana María Barragán‐Montero
- Medical Artificial Intelligence and Automation (MAIA) Laboratory, Department of Radiation Oncology University of Texas Southwestern Medical Center Dallas TX USA
- Center of Molecular Imaging, Radiotherapy and Oncology (MIRO) UCLouvain Brussels Belgium
| | - Dan Nguyen
- Medical Artificial Intelligence and Automation (MAIA) Laboratory, Department of Radiation Oncology University of Texas Southwestern Medical Center Dallas TX USA
| | - Weiguo Lu
- Medical Artificial Intelligence and Automation (MAIA) Laboratory, Department of Radiation Oncology University of Texas Southwestern Medical Center Dallas TX USA
| | - Mu-Han Lin
- Medical Artificial Intelligence and Automation (MAIA) Laboratory, Department of Radiation Oncology University of Texas Southwestern Medical Center Dallas TX USA
| | - Roya Norouzi‐Kandalan
- Medical Artificial Intelligence and Automation (MAIA) Laboratory, Department of Radiation Oncology University of Texas Southwestern Medical Center Dallas TX USA
| | - Xavier Geets
- Center of Molecular Imaging, Radiotherapy and Oncology (MIRO) UCLouvain Brussels Belgium
- Department of Radiation Oncology Cliniques universitaires Saint‐Luc Brussels Belgium
| | - Edmond Sterpin
- Center of Molecular Imaging, Radiotherapy and Oncology (MIRO) UCLouvain Brussels Belgium
- Laboratory of Experimental Radiotherapy, Department of Oncology KU Leuven Leuven Belgium
| | - Steve Jiang
- Medical Artificial Intelligence and Automation (MAIA) Laboratory, Department of Radiation Oncology University of Texas Southwestern Medical Center Dallas TX USA
| |
Collapse
|
11
|
Evolution of definitive external beam radiation therapy in the treatment of prostate cancer. World J Urol 2019; 38:565-591. [PMID: 30850855 DOI: 10.1007/s00345-019-02661-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 01/30/2019] [Indexed: 12/30/2022] Open
Abstract
PURPOSE Although the clinical significance of a diagnosis of prostate cancer for some men is debated, for many men it leads to significant morbidity and mortality. Radical treatment of clinically localized prostate cancer has been shown to improve survival in men with intermediate or high-risk disease. There is no high level evidence to support the superiority of radical prostatectomy, with or without adjuvant or salvage external beam radiotherapy in comparison to definitive radiotherapy with or without androgen deprivation, and the choice should be individualized. External beam radiation therapy practices are in constant evolution, and numerous strategies have been investigated to improve either efficacy or reduce toxicity, or both. METHODS Randomized controlled trials investigating strategies to improve efficacy, reduce toxicity, or both of external beam radiotherapy have been reviewed in men with prostate cancer without nodal or distant metastases. These strategies include the use of neo-adjuvant and adjuvant androgen deprivation, dose-escalation, hypofractionation, whole pelvic radiation therapy, incorporation of improved imaging, image- guided radiation therapy, and adjuvant systemic therapy. The evidence to date for these strategies is discussed, noting limitations in applying the results of reported trials to men treated in contemporary settings. RESULTS A number of strategies have shown improvements in biochemical control using external beam radiotherapy. To date, only with the use of androgen deprivation therapy has this translated into improvements in disease specific and overall survival. This may reflect the long natural history of prostate cancer and high incidence of competing risks. Technological advances have enabled dose escalation with reduced toxicity, of paramount importance given the long natural history. RESULTS The use of external beam radiation therapy in prostate cancer is evolving with numerous strategies incorporated to improve outcomes. The optimum dose and fractionation and use of androgen deprivation or systemic adjuvants for each man is unclear based on current evidence and prognostic and predictive parameters. Patient preferences play an important role in chosen therapy. It is hoped that future studies better capture all prostate cancer- and treatment- related morbidity to clarify the optimal therapy choices for each man with prostate cancer.
Collapse
|