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Gkika E, Kostyszyn D, Fechter T, Moustakis C, Ernst F, Boda-Heggemann J, Sarria G, Dieckmann K, Dobiasch S, Duma MN, Eberle F, Kroeger K, Häussler B, Izaguirre V, Jazmati D, Lautenschläger S, Lohaus F, Mantel F, Menzel J, Pachmann S, Pavic M, Radlanski K, Riesterer O, Gerum S, Röder F, Willner J, Barczyk S, Imhoff D, Blanck O, Wittig A, Guckenberger M, Grosu AL, Brunner TB. Interobserver agreement on definition of the target volume in stereotactic radiotherapy for pancreatic adenocarcinoma using different imaging modalities. Strahlenther Onkol 2023; 199:973-981. [PMID: 37268767 PMCID: PMC10598103 DOI: 10.1007/s00066-023-02085-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 04/11/2023] [Indexed: 06/04/2023]
Abstract
PURPOSE The aim of this study was to evaluate interobserver agreement (IOA) on target volume definition for pancreatic cancer (PACA) within the Radiosurgery and Stereotactic Radiotherapy Working Group of the German Society of Radiation Oncology (DEGRO) and to identify the influence of imaging modalities on the definition of the target volumes. METHODS Two cases of locally advanced PACA and one local recurrence were selected from a large SBRT database. Delineation was based on either a planning 4D CT with or without (w/wo) IV contrast, w/wo PET/CT, and w/wo diagnostic MRI. Novel compared to other studies, a combination of four metrics was used to integrate several aspects of target volume segmentation: the Dice coefficient (DSC), the Hausdorff distance (HD), the probabilistic distance (PBD), and the volumetric similarity (VS). RESULTS For all three GTVs, the median DSC was 0.75 (range 0.17-0.95), the median HD 15 (range 3.22-67.11) mm, the median PBD 0.33 (range 0.06-4.86), and the median VS was 0.88 (range 0.31-1). For ITVs and PTVs the results were similar. When comparing the imaging modalities for delineation, the best agreement for the GTV was achieved using PET/CT, and for the ITV and PTV using 4D PET/CT, in treatment position with abdominal compression. CONCLUSION Overall, there was good GTV agreement (DSC). Combined metrics appeared to allow a more valid detection of interobserver variation. For SBRT, either 4D PET/CT or 3D PET/CT in treatment position with abdominal compression leads to better agreement and should be considered as a very useful imaging modality for the definition of treatment volumes in pancreatic SBRT. Contouring does not appear to be the weakest link in the treatment planning chain of SBRT for PACA.
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Affiliation(s)
- E Gkika
- Department of Radiation Oncology, University Medical Center Freiburg, Robert Koch Str 3, Freiburg, Germany.
| | - D Kostyszyn
- Department of Radiation Oncology, University Medical Center Freiburg, Robert Koch Str 3, Freiburg, Germany
| | - T Fechter
- Department of Radiation Oncology, University Medical Center Freiburg, Robert Koch Str 3, Freiburg, Germany
| | - C Moustakis
- Department of Radiation Oncology, University Medical Center Muenster, Muenster, Germany
| | - F Ernst
- Institute for Robotics and Cognitive Systems, University of Luebeck, Luebeck, Germany
| | - J Boda-Heggemann
- Department of Radiation Oncology, Faculty of Medicine Mannheim, Department of Radiation Oncology, University of Heidelberg, Mannheim, Germany
| | - G Sarria
- Department of Radiation Oncology, University Hospital Bonn, Bonn, Germany
| | - K Dieckmann
- Department of Radiation Oncology, University Departments of the MedUni Vienna, Vienna General Hospital, Vienna, Austria
| | - S Dobiasch
- Department of Radiation Oncology, Klinikum Rechts der Isar, TU Munich, Munich, Germany
| | - M N Duma
- Department of Radiotherapy and Radiation Oncology, University Hospital Jena, Friedrich-Schiller University, Jena, Germany
| | - F Eberle
- Department of Radiation Oncology, University Hospital Marburg, Marburg, Germany
| | - K Kroeger
- Department of Radiation Oncology, University Medical Center Muenster, Muenster, Germany
| | - B Häussler
- Radiation Oncology Dr. Häussler/Dr. Schorer, Munich, Germany
| | - V Izaguirre
- Department of Radiation Oncology, University Hospital Halle, Halle, Germany
| | - D Jazmati
- Proton Therapy Centre, University Hospital Essen, Essen, Germany
| | - S Lautenschläger
- Department of Radiation Oncology, University Hospital, Marburg, Germany
| | - F Lohaus
- Department of Radiation Oncology, University Hospital Dresden, Dresden, Germany
| | - F Mantel
- Department of Radiation Oncology, University Hospital Würzburg, Würzburg, Germany
| | - J Menzel
- Department of Radiation Oncology, University Hospital Hannover, Hannover, Germany
| | - S Pachmann
- Department of Radiation Oncology, Weilheim Clinic, Weilheim, Germany
| | - M Pavic
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - K Radlanski
- Department of Radiation Oncology, Charite, University Hospital Berlin, Berlin, Germany
| | - O Riesterer
- Centre for Radiation Oncology KSA-KSB, Kantonsspital Aarau, Aarau, Switzerland
| | - S Gerum
- Department of Radiation Oncology, University Clinic, Paracelsus Medical University (PMU), Salzburg, Austria
| | - F Röder
- Department of Radiation Oncology, University Clinic, Paracelsus Medical University (PMU), Salzburg, Austria
| | - J Willner
- Department of Radiation Oncology, University Hospital Bayreuth, Bayreuth, Germany
| | - S Barczyk
- Center for Radiation Oncology, Belegklinik am St. Agnes-Hospital, Bocholt, Germany
| | - D Imhoff
- Department of Radiation Oncology, Saphir Radiosurgery, University Hospital Frankfurt, Frankfurt, Germany
| | - O Blanck
- Saphir Radiosurgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - A Wittig
- Department of Radiotherapy and Radiation Oncology, University Hospital Jena, Friedrich-Schiller University, Jena, Germany
| | - M Guckenberger
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Anca-L Grosu
- Department of Radiation Oncology, University Medical Center Freiburg, Robert Koch Str 3, Freiburg, Germany
| | - T B Brunner
- Department of Therapeutic Radiology and Oncology, Comprehensive Cancer Center, Medical University of Graz, Graz, Austria
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Bernhardt D, Peeken JC, Kehl V, Eitz K, Guckenberger M, Andratschke N, Mayinger MC, Lindel K, Dieckmann K, El Shafie R, Debus J, Riesterer O, Rogers S, Blanck O, Wolff R, Grosu A, Bilger A, Henkenberens C, Schulze K, Gani C, Müller AC, Radlanski K, Janssen S, Ferentinos K, Combs SE. Post-Operative Stereotactic Radiotherapy for Resected Brain Metastases: Results of the Multicenter Analysis (AURORA) of the German Working Group "Stereotactic Radiotherapy". Int J Radiat Oncol Biol Phys 2023; 117:e87-e88. [PMID: 37786203 DOI: 10.1016/j.ijrobp.2023.06.842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) While the results of prospective studies support the use of postoperative stereotactic radiotherapy (RT) to the resection cavity (RC) as the standard of care after surgery, there are several issues that need to be investigated such as factors for improving local control, risk of leptomeningeal disease and radiation necrosis. Further, the optimal dose and fractionation is still under debate. MATERIALS/METHODS The working group "Stereotactic Radiotherapy" of the German Society of Radiation Oncology (DEGRO) analyzed its multi-institutional database with 661 patients who received postoperative stereotactic RT to the RC. Treatment was performed at 13 centers between 2008 and 2021. Patient characteristics, treatment details, and follow-up data including overall survival (OS), local control (LC) were evaluated. Cox Regression and Kaplan-Meier curves with Log-rank Tests were calculated for selected variables. RESULTS In this retrospective study, overall survival was 61.5% at 1 year, 47.6% at 2 years, and 35.5% at 3 years, and local control was 84.6% at 1 year, 74.8% at 2 years, and 72.8% at 3 years. 96% of patients were treated with hypofractionated stereotactic radiotherapy (HSRT), only 26 patients received single fraction radiosurgery (4%). Prognostic factors associated with overall survival were Karnofsky Performance Status, RPA and GPA class, controlled primary tumor and absence of extracranial metastases, whereas prognostic factor associated with local control was planning target volume (23 mL or less). CONCLUSION HSRT is the most common fractionation form in the treatment of RCs in this multicenter analysis. This approach results in excellent OS and LC outcomes. OS in patients with resected brain metastases is mainly influenced by performance status. In regard to local control, RT of large cavities remain a challenge with significantly worse outcome.
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Affiliation(s)
- D Bernhardt
- Department of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; German Cancer Consortium (DKTK), Partner Site Munich, Germany, Munich, Germany
| | - J C Peeken
- Department of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; Institute of Radiation Medicine (IRM), Department of Radiation Sciences (DRS), Helmholtz Center Munich, Munich, Germany
| | - V Kehl
- Institute for AI and Informatics in Medicine, Munich, NA, Germany
| | - K Eitz
- Department of Radiation Oncology - Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| | - M Guckenberger
- Department of Radiation Oncology, University Hospital Zurich (USZ), University of Zurich (UZH), Zurich, Switzerland
| | - N Andratschke
- Department of Radiation Oncology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | - M C Mayinger
- Department of Radiation Oncology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | - K Lindel
- Municipal Hospital, Department for Radiation Oncology, Karlsruhe, Germany
| | - K Dieckmann
- Department of Radiation Oncology, Vienna, Austria
| | - R El Shafie
- 8Department of Radiation Oncology, University Hospital Göttingen, Göttingen, Germany
| | - J Debus
- CCU Translational Radiation Oncology, German Cancer Consortium (DKTK) Core-Center Heidelberg, National Center for Tumor Diseases (NCT), Heidelberg University Hospital (UKHD) and German Cancer Research Center (DKFZ), Heidelberg, Germany; Radiation Oncology University Hospital Heidelberg, Heidelberg, Germany
| | - O Riesterer
- Center for Radiation Oncology KSA-KSB, Cantonal Hospital Aarau, Aarau, Switzerland
| | - S Rogers
- Radiation Oncology Center KSA-KSB, Kantonsspital Aarau, Aarau, Switzerland
| | - O Blanck
- Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - R Wolff
- University Hospital Frankfurt, Department of Neurosurgery, Frankfurt, Germany
| | - A Grosu
- German Cancer Consortium (DKTK), Partner Site Freiburg, Freiburg, Germany; Department of Radiation Oncology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - A Bilger
- Department of Radiation Oncology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - C Henkenberens
- Department of Radiotherapy and Special Oncology, Medical School Hannover, Hannover, Germany
| | - K Schulze
- Klinikum Fulda, 36251 Bad Hersfeld, Germany
| | - C Gani
- Department of Radiation Oncology, University Hospital and Medical Faculty Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany
| | - A C Müller
- Department of Radiotherapy, Klinikum Ludwigsburg, Ludwigsburg, Germany
| | - K Radlanski
- Radiation Oncology and Radiotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - S Janssen
- Department of Radiation Oncology, University of Lübeck, Lübeck, Germany
| | - K Ferentinos
- Radiation Oncology Department, German Oncology Center, Limassol, Cyprus
| | - S E Combs
- Department of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; Institute of Innovative Radiotherapy (iRT), Department of Radiation Sciences (DRS), Helmholtz Zentrum München, Neuherberg, Germany
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Rogers S, Baumert B, Blanck O, Böhmer D, Boström J, Engenhart-Cabillic R, Ermis E, Exner S, Guckenberger M, Habermehl D, Hemmatazad H, Henke G, Lohaus F, Lux S, Mai S, Minasch D, Rezazadeh A, Steffal C, Temming S, Wittig A, Zweifel C, Riesterer O, Combs SE. Correction to: Stereotactic radiosurgery and radiotherapy for resected brain metastases: current pattern of care in the Radiosurgery and Stereotactic Radiotherapy Working Group of the German Association for Radiation Oncology (DEGRO). Strahlenther Onkol 2023; 199:113-114. [PMID: 36374315 DOI: 10.1007/s00066-022-02021-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- S Rogers
- Radio-Onkologie-Zentrum KSA-KSB, Kantonsspital Aarau, 5001, Aarau, Switzerland.
| | - B Baumert
- Kantonsspital Graubünden, 7000, Chur, Switzerland
| | - O Blanck
- Campus Kiel, Universitätsklinikum Schleswig-Holstein, 24105, Kiel, Germany
| | - D Böhmer
- Campus Benjamin Franklin, Charite University Medicine, 12203, Berlin, Germany
| | - J Boström
- Gamma Knife Zentrum, 44892, Bochum, Germany
| | | | - E Ermis
- Bern University Hospital (Inselspital), 3010, Bern, Switzerland
| | - S Exner
- Strahlenzentrum Hamburg, 22419, Hamburg, Germany
| | | | | | - H Hemmatazad
- Bern University Hospital (Inselspital), 3010, Bern, Switzerland
| | - G Henke
- Kantonsspital St. Gallen, 9000, St Gallen, Switzerland
| | - F Lohaus
- University Hospital Dresden, 01307, Dresden, Germany
| | - S Lux
- Radprax Strahlentherapie, 42697, Solingen, Germany
| | - S Mai
- Universitätsmedizin Mannheim, 68167, Mannheim, Germany
| | - D Minasch
- University Hospital Innsbruck, 6020, Innsbruck, Austria
| | - A Rezazadeh
- University Hospital of Cologne, 50937, Cologne, Germany
| | - C Steffal
- KFJ/SMZ-Süd Vienna, Klinik Favoriten, 1100, Vienna, Austria
| | - S Temming
- Robert Janker Klinik, 53129, Bonn, Germany
| | - A Wittig
- University Hospital Jena, 07743, Jena, Germany
| | - C Zweifel
- Kantonsspital Graubünden, 7000, Chur, Switzerland
| | - O Riesterer
- Radio-Onkologie-Zentrum KSA-KSB, Kantonsspital Aarau, 5001, Aarau, Switzerland
| | - S E Combs
- Kinik an der Isaar, Technisches Universität München, Munich, Germany
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vanNiekerk W, Lazeroms T, Rogers S, Lomax N, Hälg R, Gajdos V, Özden I, Kessler E, Riesterer O. Optimized workflow to minimise intra-fractional motion during stereotactic body radiotherapy of spinal metastases. Tech Innov Patient Support Radiat Oncol 2022; 24:40-47. [PMID: 36203742 PMCID: PMC9530958 DOI: 10.1016/j.tipsro.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/30/2022] [Accepted: 09/26/2022] [Indexed: 11/29/2022] Open
Abstract
More frequent mid-treatment image guidance improved accuracy of treatment delivery 97 % of treatment fractions showed an intra-fraction motion of less than 1 mm /1° using mid-arc image guidance Treatment delivery was optimized within a standard treatment timeslot without applying substantial additional radiation dose ExacTrac portal verifications during and between arcs to monitor and correct patient position, limits additional dose to the patient and OAR
Background and purpose This study evaluated translational and rotational intra-fractional patient movement during spinal stereotactic body radiotherapy (SBRT) using 6D positioning based on 3D cone beam computerized tomography (CBCT) and stereoscopic kilovoltage imaging (ExacTrac). The aim was to determine whether additional intra-fractional image verification reduced intra-fractional motion without significantly prolonging treatment time, whilst maintaining acceptable imaging related dose. Materials and methods A retrospective analysis of 38 patients with 41 primary tumour volumes treated with SBRT between September 2018 and May 2021 was performed. Three different image-guided radiotherapy (IGRT) workflows were assessed. The translational and rotational positioning errors for the different imaging workflows, 3D translational vectors and estimates of imaging dose delivered for the different imaging workflows were evaluated. Results As the frequency of intra-fractional imaging increased from workflow 1 to 3, the mean intra-fraction 3D translational vector improved from 0.91 mm (±0.52 mm), to 0.64 (±0.34 mm). 85 %, 83 % and 97 % of images were within a tolerance of 1 mm/1° for workflows 1, 2 and 3 respectively, based on post treatment CBCT images. The average treatment time for workflow 3 was 13 min, as compared to 12 min for workflows 1 and 2. The effective dose per treatment for IGRT workflows 1, 2 and 3 measured 0.6 mSv, 0.95 mSv and 1.8 mSv respectively. Conclusion The study demonstrated that the use of additional intra-fractional stereoscopic kilovoltage image-guidance during spinal SBRT, reduced the number of measurements deemed “out of tolerance” and treatment delivery could be optimized within a standard treatment timeslot without applying substantial additional radiation dose.
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Affiliation(s)
- W.M. vanNiekerk
- Radio-Onkologie-Zentrum KSA-KSB, Kantonsspital Aarau, Switzerland
- Corresponding author.
| | - T. Lazeroms
- Radio-Onkologie-Zentrum KSA-KSB, Kantonsspital Aarau, Switzerland
| | - S.J. Rogers
- Radio-Onkologie-Zentrum KSA-KSB, Kantonsspital Aarau, Switzerland
| | - N. Lomax
- Radio-Onkologie-Zentrum KSA-KSB, Kantonsspital Aarau, Switzerland
| | - R.A. Hälg
- Radio-Onkologie-Zentrum KSA-KSB, Kantonsspital Aarau, Switzerland
| | - V. Gajdos
- Klinik für Strahlentherapie und Radioonkologie, Universitätsspital Basel, Switzerland
| | - I. Özden
- Fachstelle Strahlenschutz, Kantonsspital Aarau, Switzerland
| | - E. Kessler
- Radio-Onkologie-Zentrum KSA-KSB, Kantonsspital Aarau, Switzerland
| | - O. Riesterer
- Radio-Onkologie-Zentrum KSA-KSB, Kantonsspital Aarau, Switzerland
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Rogers S, Baumert B, Blanck O, Böhmer D, Boström J, Engenhart-Cabillic R, Ermis E, Exner S, Guckenberger M, Habermehl D, Hemmatazad H, Henke G, Lohaus F, Lux S, Mai S, Minasch D, Rezazadeh A, Steffal C, Temming S, Wittig A, Zweifel C, Riesterer O, Combs S. Stereotactic radiosurgery and radiotherapy for resected brain metastases: current pattern of care in the Radiosurgery and Stereotactic Radiotherapy Working Group of the German Association for Radiation Oncology (DEGRO). Strahlenther Onkol 2022; 198:919-925. [PMID: 36006436 DOI: 10.1007/s00066-022-01991-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/17/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE Preoperative stereotactic radiosurgery (SRS) of brain metastases may achieve similar local control and better leptomeningeal control rates than postoperative fractionated stereotactic radiotherapy (FSRT) in patients treated with elective metastasectomy. To plan a multicentre trial of preoperative SRS compared with postoperative FSRT, a survey of experts was conducted to determine current practice. METHODS A survey with 15 questions was distributed to the DEGRO Radiosurgery and Stereotactic Radiotherapy Working Group. Participants were asked under what circumstances they offered SRS, FSRT, partial and/or whole brain radiotherapy before or after resection of a brain metastasis, as well as the feasibility of preoperative stereotactic radiosurgery and neurosurgical resection within 6 days. RESULTS Of 25 participants from 24 centres, 22 completed 100% of the questions. 24 respondents were radiation oncologists and 1 was a neurosurgeon. All 24 centres have one or more dedicated radiosurgery platform and all offer postoperative FSRT. Preoperative SRS is offered by 4/24 (16.7%) centres, and 9/24 (37.5%) sometimes recommend single-fraction postoperative SRS. Partial brain irradiation is offered by 8/24 (33.3%) centres and 12/24 (50%) occasionally recommend whole-brain irradiation. Two centres are participating in clinical trials of preoperative SRS. SRS techniques and fractionation varied between centres. CONCLUSION All responding centres currently offer postoperative FSRT after brain metastasectomy. Approximately one third offer single-fraction postoperative SRS and four already perform preoperative SRS. With regard to potential co-investigators, 18 were identified for the PREOP‑2 multicentre trial, which will randomise between preoperative SRS and postoperative FSRT.
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Affiliation(s)
- S Rogers
- Radio-Onkologie-Zentrum KSA-KSB, Kantonsspital Aarau, 5001, Aarau, Switzerland.
| | - B Baumert
- Kantonsspital Graubünden, 7000, Chur, Switzerland
| | - O Blanck
- Universitätsklinikum Schleswig-Holstein, Campus Kiel, 24105, Kiel, Germany
| | - D Böhmer
- Charite University Medicine, Campus Benjamin Franklin, 12203, Berlin, Germany
| | - J Boström
- Gamma Knife Zentrum, 44892, Bochum, Germany
| | | | - E Ermis
- Bern University Hospital (Inselspital), 3010, Bern, Switzerland
| | - S Exner
- Strahlenzentrum Hamburg, 22419, Hamburg, Germany
| | | | | | - H Hemmatazad
- Bern University Hospital (Inselspital), 3010, Bern, Switzerland
| | - G Henke
- Kantonsspital St. Gallen, 9000, St Gallen, Switzerland
| | - F Lohaus
- University Hospital Dresden, 01307, Dresden, Germany
| | - S Lux
- Radprax Strahlentherapie, 42697, Solingen, Germany
| | - S Mai
- Universitätsmedizin Mannheim, 68167, Mannheim, Germany
| | - D Minasch
- University Hospital Innsbruck, 6020, Innsbruck, Austria
| | - A Rezazadeh
- University Hospital of Cologne, 50937, Cologne, Germany
| | - C Steffal
- KFJ/SMZ-Süd Vienna; Klinik Favoriten, 1100, Vienna, Austria
| | - S Temming
- Robert Janker Klinik, 53129, Bonn, Germany
| | - A Wittig
- University Hospital Jena, 07743, Jena, Germany
| | - C Zweifel
- Kantonsspital Graubünden, 7000, Chur, Switzerland
| | - O Riesterer
- Radio-Onkologie-Zentrum KSA-KSB, Kantonsspital Aarau, 5001, Aarau, Switzerland
| | - S Combs
- Kinik an der Isaar, Technisches Universität München, Munich, Germany
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Rogers S, Stauffer A, Lomax N, Alonso S, Eberle B, Gomez Ordoñez S, Lazeroms T, Kessler E, Brendel M, Schwyzer L, Riesterer O. Five fraction stereotactic radiotherapy after brain metastasectomy: a single-institution experience and literature review. J Neurooncol 2021; 155:35-43. [PMID: 34546498 DOI: 10.1007/s11060-021-03840-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 09/01/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The outcomes of five fraction stereotactic radiotherapy (hfSRT) following brain metastasectomy were evaluated and compared with published series. METHODS 30 Gy in 5 fractions HfSRT prescribed to the surgical cavity was reduced to 25 Gy if the volume of 'brain-GTV' receiving 20 Gy exceeded 20 cm3. Endpoints were local recurrence, nodular leptomeningeal recurrence, new brain metastases and radionecrosis. The literature was searched for reports of clinical and dosimetric outcomes following postoperative hfSRT in 3-5 fractions. RESULTS 39 patients with 40 surgical cavities were analyzed. Cavity local control rate at 1 year was 33/40 (82.5%). 3 local failures followed 30 Gy/5 fractions and 4 with 25 Gy/5 fractions. The incidence of leptomeningeal disease (LMD) was 7/40 (17.5%). No grade 3-4 toxicities, particularly no radionecrosis, were reported. The incidence of distant brain metastases was 15/40 (37.5%). The median overall survival was 15 months. Across 13 published series, the weighted mean local control was 83.1% (adjusted for sample size), the mean incidence of LMD was 14.9% (7-34%) and the mean rate of radionecrosis was 10.3% (0-20.6%). CONCLUSION Postoperative hfSRT can be delivered with 25-30 Gy in 5 fractions with efficacy in excess of 82% and no significant toxicity when the dose to 'brain-GTV' does not exceed 20 cm3.
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Affiliation(s)
- S Rogers
- Radiation Oncology Center KSA-KSB, Kantonsspital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland.
| | - A Stauffer
- Department of Neurosurgery, Kantonsspital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland
| | - N Lomax
- Radiation Oncology Center KSA-KSB, Kantonsspital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland
| | - S Alonso
- Radiation Oncology Center KSA-KSB, Kantonsspital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland
| | - B Eberle
- Radiation Oncology Center KSA-KSB, Kantonsspital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland
| | - S Gomez Ordoñez
- Radiation Oncology Center KSA-KSB, Kantonsspital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland
| | - T Lazeroms
- Radiation Oncology Center KSA-KSB, Kantonsspital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland
| | - E Kessler
- Radiation Oncology Center KSA-KSB, Kantonsspital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland
| | - M Brendel
- Department of Neuroradiology, Kantonsspital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland
| | - L Schwyzer
- Department of Neurosurgery, Kantonsspital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland
| | - O Riesterer
- Radiation Oncology Center KSA-KSB, Kantonsspital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland.,Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
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Vuong D, Bogowicz M, Wee L, Riesterer O, Vlaskou Badra E, D’Cruz L, Balermpas P, van Timmeren J, Burgermeister S, Dekker A, de Ruysscher D, Unkelbach J, Thierstein S, Eboulet E, Peters S, Pless M, Guckenberger M, Tanadini-Lang S. PO-1803 Voxel-wise quantification of anatomical tumor lung location is associated with overall survival. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08254-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rogers SJ, Datta NR, Puric E, Timm O, Marder D, Khan S, Mamot C, Knuchel J, Siebenhüner A, Pestalozzi B, Guckenberger M, Bodis S, Riesterer O. The addition of deep hyperthermia to gemcitabine-based chemoradiation may achieve enhanced survival in unresectable locally advanced adenocarcinoma of the pancreas. Clin Transl Radiat Oncol 2021; 27:109-113. [PMID: 33598571 PMCID: PMC7868682 DOI: 10.1016/j.ctro.2021.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 02/07/2023] Open
Abstract
Intensification of chemoradiation with hyperthermia was feasible in nine patients with LAPC. Only one grade three toxicity was reported and two tumours became resectable. The 24 months median OS and 100% 1 year OS are superior to historical series.
Introduction Driven by the current unsatisfactory outcomes for patients with locally advanced pancreatic cancer (LAPC), a biologically intensified clinical protocol was developed to explore the feasibility and efficacy of FOLFORINOX chemotherapy followed by deep hyperthermia concomitant with chemoradiation and subsequent FOLFORINOX chemotherapy in patients with LAPC. Methods Nine patients with LAPC were treated according to the HEATPAC Phase II trial protocol which consists of 4 cycles of FOLFORINOX chemotherapy followed by gemcitabine-based chemoradiation to 56 Gy combined with weekly deep hyperthermia and then a further 8 cycles of FOLFORINOX chemotherapy. Results One grade three related toxicity was reported and two tumours became resectable. The median overall survival was 24 months and 1 year overall survival was 100%. Conclusions Intensification of chemoradiation with deep hyperthermia was feasible in nine consecutive patients with LAPC.
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Affiliation(s)
- S J Rogers
- Centre for Radiation Oncology KSA-KSB, Kantonsspital Aarau, 5001 Aarau, Switzerland
| | - N R Datta
- Centre for Radiation Oncology KSA-KSB, Kantonsspital Aarau, 5001 Aarau, Switzerland
| | - E Puric
- Centre for Radiation Oncology KSA-KSB, Kantonsspital Aarau, 5001 Aarau, Switzerland
| | - O Timm
- Centre for Radiation Oncology KSA-KSB, Kantonsspital Aarau, 5001 Aarau, Switzerland
| | - D Marder
- Centre for Radiation Oncology KSA-KSB, Kantonsspital Aarau, 5001 Aarau, Switzerland
| | - S Khan
- Centre for Radiation Oncology KSA-KSB, Kantonsspital Aarau, 5001 Aarau, Switzerland
| | - C Mamot
- Department of Medical Oncology and Haematology, Kantonsspital Aarau, Tellstrasse, 5001 Aarau, Switzerland
| | - J Knuchel
- Department of Gastroenterology, Kantonsspital Aarau, Tellstrasse, 5001 Aarau, Switzerland
| | - A Siebenhüner
- Department of Medical Oncology and Haematology, University Hospital Zurich, Rämistrasse 100, 8091 Zürich, Switzerland
| | - B Pestalozzi
- Department of Medical Oncology and Haematology, University Hospital Zurich, Rämistrasse 100, 8091 Zürich, Switzerland
| | - M Guckenberger
- Department of Radiation Oncology, University Hospital Zürich, University of Zürich, Switzerland
| | - S Bodis
- Centre for Radiation Oncology KSA-KSB, Kantonsspital Aarau, 5001 Aarau, Switzerland
| | - O Riesterer
- Centre for Radiation Oncology KSA-KSB, Kantonsspital Aarau, 5001 Aarau, Switzerland.,Department of Radiation Oncology, University Hospital Zürich, University of Zürich, Switzerland
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Bogowicz M, Pavic M, Riesterer O, Finazzi T, Schüler HG, Holz-Sapra E, Rudofsky L, Glatz S, Basler L, Spaniol M, Hüllner M, Guckenberger M, Tanadini-Lang S. PD-0429: CT radiomics differentiates levels of radiocurability in tumor subvolumes in head and neck cancer. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00451-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Rogers S, Lomax N, Alonso S, Hancock T, Khan S, Schürkens J, Kessler E, Eberle B, Ordonez SG, Riesterer O, Fandino J, Bodis S. PO-0857: Leptomeningeal disease following stereotactic radiotherapy for resected brain metastases. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00874-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Attenberger UI, Tavakoli A, Stocker D, Stieb S, Riesterer O, Turina M, Schoenberg SO, Pilz L, Reiner CS. Reduced and standard field-of-view diffusion weighted imaging in patients with rectal cancer at 3 T-Comparison of image quality and apparent diffusion coefficient measurements. Eur J Radiol 2020; 131:109257. [PMID: 32947092 DOI: 10.1016/j.ejrad.2020.109257] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 06/30/2020] [Accepted: 08/24/2020] [Indexed: 01/03/2023]
Abstract
PURPOSE To compare a zoomed EPI-DWI (z-EPI) with a standard EPI-DWI (s-EPI) in the primary diagnostics of rectal cancer and assess its potential of reduced image artifacts. METHOD 22 therapy-naïve patients with rectal cancer underwent rectal MRI at a 3 T-system. The protocols consisted of a z-EPI DWI and s-EPI DWI sequence. Images were assessed by two independent and experienced readers regarding overall image quality and artifacts on a 5-point Likert scale, as well as overall sequence preference. In a lesion-based analysis, tumor and lymph node detection were rated on a 4-point Likert scale. Apparent diffusion coefficient (ADC) measurements were performed. RESULTS Overall Image quality score for z-EPI and s-EPI showed no statistically significant differences (p = 0.80/0.54, reader 1/2) with a median score of 4 ("good" image quality) for both sequences. The image quality preference rank for z-EPI and s-EPI was given the category 'no preference' in 64 % (reader 1) and 50 % (reader 2). Most artifact-related scores (susceptibility, motion and distortion) did not show reproducible significant differences between z-EPI and s-EPI. The two sequences exhibited comparable, mostly good and excellent quality scores for tumor and lymph node detection (p = 0.19-0.99). ADC values were significantly lower for z-EPI than for s-EPI (p = 0.001/0.002, reader 1/2) with good agreement of ADC measurements between both readers. CONCLUSION Our data showed comparable image quality and lesion detection for the z-EPI and the s-EPI sequence in MRI of rectal cancer, whereas the mean ADC of the tumor was significantly lower in z-EPI compared to s-EPI.
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Affiliation(s)
- U I Attenberger
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany.
| | - A Tavakoli
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Germany; Department of Radiology, German Cancer Research Center (DKFZ), Germany.
| | - D Stocker
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.
| | - S Stieb
- Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland
| | - O Riesterer
- Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland.
| | - M Turina
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland.
| | - S O Schoenberg
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Germany.
| | - L Pilz
- Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
| | - C S Reiner
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.
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Bogowicz M, Tanadini-Lang S, Veit-Haibach P, Pruschy M, Bender S, Sharma A, Hüllner M, Studer G, Stieb S, Hemmatazad H, Glatz S, Guckenberger M, Riesterer O. Perfusion CT radiomics as potential prognostic biomarker in head and neck squamous cell carcinoma. Acta Oncol 2019; 58:1514-1518. [PMID: 31304860 DOI: 10.1080/0284186x.2019.1629013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- M. Bogowicz
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - S. Tanadini-Lang
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - P. Veit-Haibach
- Department of Nuclear Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - M. Pruschy
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - S. Bender
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - A. Sharma
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - M. Hüllner
- Department of Nuclear Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - G. Studer
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
- Institute for Radiation Oncology, Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - S. Stieb
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - H. Hemmatazad
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - S. Glatz
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - M. Guckenberger
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - O. Riesterer
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
- Center for Radiation Oncology, KSA-KSB, Cantonal Hospital Aarau, Aarau, Switzerland
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Eberle B, Rogers S, Vogt D, Meier E, Moser L, Gomez S, Desborough S, Riesterer O, Takacs I, Hasler P, Bodis S. Low Dose Radiotherapy Achieves Analgesia and Gain of Function in Epicondylitis, Finger Arthritis and Plantar Fasciitis. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Riesterer O, Pruschy M, Bender S, Sharma A, Bogowicz M, Tanadini-Lang S, Stieb S, Bertogg K, Ikenberg K, Huber G, Bredell M, Schmid S, Veit-Haibach P, Rordorf T, Held U, Glanzmann C, Studer G. A Randomized Phase II Translational Research Study in Patients with Advanced Head and Neck Cancer to Investigate the Effects of Standard Chemoradiation and Add-on Concurrent Epidermal Growth Factor Receptor (EGFR) Inhibitor ± Consolidation EGFR Inhibitor. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Rogers S, Lomax N, Alonso S, Eberle B, Gomez Ordonez S, Schürkens J, Rabe E, Fandino J, Riesterer O, Lutters G, Bodis S. EP-1223 Clinical experience and outcomes of radiosurgery with a single isocentre for 2-10 brain metastases. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31643-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Pouymayou B, Riesterer O, Guckenberger M, Unkelbach J. PV-0315 A risk assessment method including credible intervals for lymphatic metastatic spread for HNSCC. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30735-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Gkika E, Brunner T, Abbasi-Senger N, Alheit H, Baus W, Blanck O, Gerum S, Guckenberger M, Habermehl D, Ostheimer C, Riesterer O, Tamihardja J, Pinato D, Rimassa L, Pressiani T, Schultheiss M, Sharma R, Burlone M, Pirisi M, Kudo M, Park J, Neumann-Haefelin C, Grosu A, Thimme R, Bettinger D. PO-0811 SBRT compared to sorafenib in locally advanced hepatocellular carcinoma: a propensity score analysis. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31231-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Bogowicz M, Jochems A, Huang S, Chan B, Waldron J, O'Sullivan B, Tanadini-Lang S, Riesterer O, Studer G, Unkelbach J, Brakenhoff R, Nauta I, Gazzani S, Calareso G, Scheckenbach K, Hoebers F, Barakat S, Keek S, Sanduleanu S, Vergeer M, Leemans R, Terhaard C, Van den Brekel M, Guckenberger M, Lambin P. PV-0312 Distributed learning in radiomics to predict overall survival in head and neck cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30732-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Bogowicz M, Riesterer O, Studer G, Unkelbach J, Schröder C, Guckenberger M, Tanadini-Lang S. PO-0980: Primary tumor and lymph nodes CT radiomics to predict loco-regional control in head and neck cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31290-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pouymayou B, Riesterer O, Guckenberger M, Unkelbach J. EP-2001: A Bayesian network model for personalized elective CTV definition in head and neck cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32310-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rothschild S, Helfenstein S, Riesterer O, Meier U, Papachristofilou A, Kasenda B, Pless M. 3-weekly or weekly cisplatin concurrently with radiotherapy for patients with locally advanced squamous cell carcinoma of the head and neck: A multicentre, retrospective analysis. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx374.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ehrbar S, Schmid S, Klöck S, Guckenberger M, Riesterer O, Tanadini-Lang S. OC-0305: Validation of Dynamic Treatment-Couch Tracking for Prostate SBRT. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30747-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Habraken S, Sharfo A, Buijsen J, Verbakel W, Haasbeek C, Ollers M, Westerveld G, Van Wieringen N, Reerink O, Seravalli E, Braam P, Wendling M, Lacornerie T, Mirabel X, Weytjens R, Depuydt L, Lang S, Riesterer O, Haustermans K, Depuydt T, Heijmen B, Méndez Romero A. OC-0541: Automated treatment planning for prospective QA in the TRENDY randomized trial on liver-SBRT for HCC. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30981-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Leijenaar R, Nesteruk M, Feliciani G, Hoebers F, Van Timmeren J, Van Elmpt W, Walsh S, Jochems A, Huang S, Chan B, Waldron J, O'Sullivan B, Rietveld D, Leemans C, Riesterer O, Ikenberg K, Lambin P. EP-1608: Deriving HPV status from standard CT imaging: a radiomic approach with independent validation. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)32043-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tanadini-Lang S, Nesteruk M, Studer G, Guckenberger M, Riesterer O. EP-1697: Does contrast agent influence the prognostic accuracy of CT radiomics based outcome modelling? Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)32229-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Bogowicz M, Riesterer O, Bundschuh RA, Veit-Haibach P, Hüllner M, Studer G, Stieb S, Glatz S, Pruschy M, Guckenberger M, Tanadini-Lang S. Stability of radiomic features in CT perfusion maps. Phys Med Biol 2016; 61:8736-8749. [PMID: 27893446 DOI: 10.1088/1361-6560/61/24/8736] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This study aimed to identify a set of stable radiomic parameters in CT perfusion (CTP) maps with respect to CTP calculation factors and image discretization, as an input for future prognostic models for local tumor response to chemo-radiotherapy. Pre-treatment CTP images of eleven patients with oropharyngeal carcinoma and eleven patients with non-small cell lung cancer (NSCLC) were analyzed. 315 radiomic parameters were studied per perfusion map (blood volume, blood flow and mean transit time). Radiomics robustness was investigated regarding the potentially standardizable (image discretization method, Hounsfield unit (HU) threshold, voxel size and temporal resolution) and non-standardizable (artery contouring and noise threshold) perfusion calculation factors using the intraclass correlation (ICC). To gain added value for our model radiomic parameters correlated with tumor volume, a well-known predictive factor for local tumor response to chemo-radiotherapy, were excluded from the analysis. The remaining stable radiomic parameters were grouped according to inter-parameter Spearman correlations and for each group the parameter with the highest ICC was included in the final set. The acceptance level was 0.9 and 0.7 for the ICC and correlation, respectively. The image discretization method using fixed number of bins or fixed intervals gave a similar number of stable radiomic parameters (around 40%). The potentially standardizable factors introduced more variability into radiomic parameters than the non-standardizable ones with 56-98% and 43-58% instability rates, respectively. The highest variability was observed for voxel size (instability rate >97% for both patient cohorts). Without standardization of CTP calculation factors none of the studied radiomic parameters were stable. After standardization with respect to non-standardizable factors ten radiomic parameters were stable for both patient cohorts after correction for inter-parameter correlations. Voxel size, image discretization, HU threshold and temporal resolution have to be standardized to build a reliable predictive model based on CTP radiomics analysis.
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Affiliation(s)
- M Bogowicz
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zürich, Switzerland
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Riesterer O, Nesteruk M, Studer G, Guckenberger M, Lang S. Predictive Value of Radiomics Analysis for Local Tumor Control After Radiochemotherapy in Patients With Head and Neck cancer. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Nesteruk M, Riesterer O, Bundschuh R, Veit-Haibach P, Huellner M, Studer G, Stieb S, Glatz S, Pruschy M, Guckenberger M, Tanadini-Lang S. SU-F-R-51: Radiomics in CT Perfusion Maps of Head and Neck Cancer. Med Phys 2016. [DOI: 10.1118/1.4955822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Habraken S, Heijmen B, Buijsen J, Verbakel W, Haasbeek C, Ollers M, Westerveld G, Van Wieringen N, Reerink O, Seravalli E, Braam P, Wendling M, Lacornerie T, Mirabel X, Weytjens R, Depuydt L, Lang S, Riesterer O, Haustermans K, Depuydt T, Méndez Romero A. PO-0950: QA and dummy-run results of the TRENDY randomized trial on SBRT vs. chemoembolization for HCC. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32200-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bredell M, Ikenberg K, Apel B, Riesterer O, Studer G, Ernst J, Wenger R, Borsig L, Schumann D. Hypoxia related biomarkers in tongue cancer, prognostic relevance? Int J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.ijom.2015.08.483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Stieb S, Malla M, Graydon S, Riesterer O, Klöck S, Studer G, Lang S. PO-0783: Dosimetric influence of pitch for radiotherapy of long treatment volumes. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40775-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ehrbar S, Jöhl A, Stieb S, Riesterer O, Stark L, Guckenberger M, Klöck S, Lang S. PO-0926: Dosimetric comparison of different motion management techniques. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40918-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sharma A, Bender S, Riesterer O, Broggini-Tenzer A, Pruschy M. 206 Identification of novel targets for radiosensitisation of non-small cell lung cancer by secretome analysis. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70332-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Stahel R, Riesterer O, Alexandros X, Opitz I, Beyeler M, Ochsenbein A, Früh M, Cathomas R, Nackaerts K, Peters S, Mamot C, Zippelius A, Mordasini C, Clemens K, Eckhardt K, Schmid R, Nagel W, Aebersold D, Gautschi O, Weder W. Neoadjuvant Chemotherapy and Extrapleural Pneumonectomy (Epp) of Malignant Pleural Mesothelioma (Mpm) with or Without Hemithoracic Radiotherapy: Final Results of the Randomized Multicenter Phase Ii Trial Sakk17/04. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu438.65] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Pruschy M, Bender S, Broggini-Tenzer A, Riesterer O, Sharma A. 162: Radiosensitization of Non–Small Cell Lung Cancers by Targeting Ionizing Radiation-Induced Activation of ADAM17. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)34183-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lang S, Zeimetz J, Ochsner G, Schmid-Daners M, Klöck S, Riesterer O. EP-1661: Effect of couch tracking upon volunteers. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)31779-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Voorjans Leconte E, Wipf S, Lang S, Stüssi A, Riesterer O, Winter C. PD-0473: Comparing the reproducibility of respiratory pattern during SBRT verses 4DCT. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30578-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Herráiz Lablanca M, Streller T, Najafi Y, Riesterer O. PO-0723: Stability of dose to the rectum during salvage radiotherapy with endorectal balloon after prostatectomy. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)33029-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Krayenbuehl J, Loewenich K, Norton I, Zamburlini M, Riesterer O, Klöck S. PO-0885: Implementation and validation of Pinnacle for stereotactic body radiotherapy with a flattening filter free linac. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)33191-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Riesterer O, Bertogg K, Shrestha B, Weber S, Glanzmann C, Studer G. PO-088: Acute Toxicity in Head and Neck Cancer Patients Treated with Chemoradiation/Cetuximab ± Consolidation Cetuximab. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)34707-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Krayenbuehl J, Hartmann M, Riesterer O, Lomax T, Kloeck S, Hug E, Ciernik I. Evaluation of Different External Radiation Therapy Techniques for the Treatment of Malignant Pleural Mesothelioma After Extrapleural Pleuropneumonectomy. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.2316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Studer G, Linsenmeier C, Riesterer O, Najafi Y, Brown M, Kati E, Zwahlen D, Huber G, Schmid S, Glanzmann C. Late Term Tolerance Following Radiation Using Intensity Modulation in >700 Head-and-Neck Cancer patients. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.1351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Riesterer O. [Angiogenesis inhibitors and radiotherapy]. Praxis (Bern 1994) 2012; 101:1031-1037. [PMID: 22878946 DOI: 10.1024/1661-8157/a001023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Tumor angiogenesis, i.e. the formation of new blood vessels, is a promising therapeutic target. Whereas angiogenesis inhibitors (AI) are selectively aimed against the tumors' vascular system, irradiation targets both, tumor cells and tumor vasculature. Biological interaction of both modalities has been shown on the level of tumor endothelial cells and the microenvironment. The clinical testing of this novel combined treatment strategy so far has been hindered, because AI intuitively increase tumor hypoxia and hypoxic tumors are radio-resistant. However preclinical studies demonstrate that AI can even induce vascular normalization. Furthermore, consolidation therapy with AI after radiotherapy is a promising approach due to the specific biology of irradiated tumor bed. Based on these findings clinical studies are now increasingly been conducted.
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Affiliation(s)
- O Riesterer
- Klinik und Poliklinik für Radio-Onkologie, Universitätsspital Zürich.
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Hrbacek J, Lang S, Graydon S, Klöck S, Riesterer O. 405 poster CONTRIBUTION OF FLATTENING FILTER FREE BEAMS TO EXTRACRANIAL STEREOTACTIC VMAT TREATMENT OF NSCLC PATIENTS. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70527-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kuijpers A, Lang S, Walker A, Hrbacek J, Linsenmeier C, Riesterer O, Winter C. 482 poster TREATMENT DELIVERY FOR FRAMELESS INTRA-CRANIAL STEREOTACTIC PATIENTS: A FASTER AND MORE ACCURATE APPROACH. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70604-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Tini A, Walker A, Cavelaars F, Lang S, Winter C, Riesterer O. 255 oral SBRT WITH VARIAN TRUEBEAM: TIME-EFFICIENCY AND PATIENT STABILITY. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70377-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Chen S, Hiley C, Petusksiri J, Andic F, Riesterer O, Torres M. Influence of Breast Reconstruction on Postmastectomy Radiotherapy: Global Perceptions and Practice Patterns. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Raju U, Riesterer O, Molkentine D, Milas L, Ang K. 351 POSTER Identification of kinases that are potential molecular determinants of cellular response to radiation using antibody arrays. EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)72285-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Pruschy M, Oehler C, Vuong V, Broggini-Tenzer A, Jochum W, Honer M, Riesterer O. 22 Optimization of the treatment modality combining ionizing radiation with inhibitors of angiogenesis. Radiother Oncol 2006. [DOI: 10.1016/s0167-8140(06)80516-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Riesterer O, Honer M, Oehler C, Djonov V, Ametamey S, Bodis S, Pruschy M. 647 Modulation of tumor hypoxia in response to treatment with ionizing radiation and the VEGFR inhibitor PTK787/ZK222584. EJC Suppl 2004. [DOI: 10.1016/s1359-6349(04)80655-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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