1
|
Franzese C, Lucchini R, Roghi M, Badalamenti M, Baldaccini D, Comito T, Franceschini D, Navarria P, Di Cristina L, Lo Faro L, Galdieri C, Reggiori G, Mancosu P, Tomatis S, Scorsetti M. Oligometastatic Prostate Cancer Treated with Stereotactic Body Radiation Therapy: The Role of Three-Dimensional Tumour Volume in Patient Survival. Clin Oncol (R Coll Radiol) 2023; 35:e649-e656. [PMID: 37775459 DOI: 10.1016/j.clon.2023.09.004] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/25/2023] [Accepted: 09/13/2023] [Indexed: 10/01/2023]
Abstract
AIMS The definition of oligometastatic prostate cancer (OPCa) is currently based solely on the maximum number of detectable metastases, as there are no validated biomarkers available. The aim of this study was to identify novel predictive factors for OPCa patients who underwent metastases-directed therapy. MATERIALS AND METHODS This monocentre, retrospective study included consecutive OPCa patients with a maximum of five metastases in up to two organs, detected with choline- or PSMA-positron emission tomography, who were treated with metastases-directed stereotactic body radiation therapy. Endpoints were overall survival and progression-free survival, assessed with Kaplan-Meier analysis. Univariate and multivariable Cox regression was carried out to evaluate the association between clinical factors and survival outcomes. RESULTS Between 2009 and 2021, 163 patients and 320 metastases were treated with 226 stereotactic body radiation therapy courses. The median three-dimensional metastatic tumour volume was 4.1 cm3, with a range from 0.01 to 233.4 cm3. In total, 87 (53.4%), 21 (12.9%) and 55 (33.7%) metastases were classified as cN1, cM1a and cM1b, respectively. The median follow-up was 28.5 months. The rates of overall survival at 1, 3 and 5 years were 89.5% (95% confidence interval 83.4-93.4), 74.9% (95% confidence interval 66.1-81.7) and 57.2% (95% confidence interval 45.8-67.1), respectively. Multivariable analysis showed that overall survival reduced with the increase in three-dimensional total tumour volume (hazard ratio 1.93, 95% confidence interval 1.06-3.52; P = 0.030) and confirmed a significant difference between cN1 versus cM1a-b disease (hazard ratio 1.81, 95% confidence interval 1.01-3.25; P = 0.046). The cut-off value of total volume correlated with the highest risk of death was 20 cm3 (hazard ratio 2.37, 95% confidence interval 1.34-4.18; P = 0.003). The median progression-free survival was 17.8 months, with 1-, 3- and 5-year rates of 63.7% (95% confidence interval 55.4-70.9), 31.5% (95% confidence interval 22.8-40.6) and 24.7% (95% confidence interval 16.0-34.3). CONCLUSIONS This study identified three-dimensional total tumour volume and the site of oligometastases as significant predictors of survival in OPCa patients treated with metastases-directed therapy. These parameters can potentially be used to personalised treatment and improve patient outcome.
Collapse
Affiliation(s)
- C Franzese
- Department of Biomedical Sciences, Humanitas University, Milan, Italy; IRCCS Humanitas Research Hospital, Department of Radiotherapy and Radiosurgery, Milan, Italy.
| | - R Lucchini
- IRCCS Humanitas Research Hospital, Department of Radiotherapy and Radiosurgery, Milan, Italy
| | - M Roghi
- IRCCS Humanitas Research Hospital, Department of Radiotherapy and Radiosurgery, Milan, Italy
| | - M Badalamenti
- IRCCS Humanitas Research Hospital, Department of Radiotherapy and Radiosurgery, Milan, Italy
| | - D Baldaccini
- IRCCS Humanitas Research Hospital, Department of Radiotherapy and Radiosurgery, Milan, Italy
| | - T Comito
- IRCCS Humanitas Research Hospital, Department of Radiotherapy and Radiosurgery, Milan, Italy
| | - D Franceschini
- IRCCS Humanitas Research Hospital, Department of Radiotherapy and Radiosurgery, Milan, Italy
| | - P Navarria
- IRCCS Humanitas Research Hospital, Department of Radiotherapy and Radiosurgery, Milan, Italy
| | - L Di Cristina
- Department of Biomedical Sciences, Humanitas University, Milan, Italy; IRCCS Humanitas Research Hospital, Department of Radiotherapy and Radiosurgery, Milan, Italy
| | - L Lo Faro
- Department of Biomedical Sciences, Humanitas University, Milan, Italy; IRCCS Humanitas Research Hospital, Department of Radiotherapy and Radiosurgery, Milan, Italy
| | - C Galdieri
- IRCCS Humanitas Research Hospital, Department of Radiotherapy and Radiosurgery, Milan, Italy
| | - G Reggiori
- IRCCS Humanitas Research Hospital, Department of Radiotherapy and Radiosurgery, Milan, Italy
| | - P Mancosu
- IRCCS Humanitas Research Hospital, Department of Radiotherapy and Radiosurgery, Milan, Italy
| | - S Tomatis
- IRCCS Humanitas Research Hospital, Department of Radiotherapy and Radiosurgery, Milan, Italy
| | - M Scorsetti
- Department of Biomedical Sciences, Humanitas University, Milan, Italy; IRCCS Humanitas Research Hospital, Department of Radiotherapy and Radiosurgery, Milan, Italy
| |
Collapse
|
2
|
Franzese C, Stefanini S, Massaro M, Comito T, Navarria P, Clerici E, Teriaca A, Franceschini D, Reggiori G, Tomatis S, Lania A, Scorsetti M. PD-0582 Phase II trial of SBRT for adrenal metastases: efficacy and impact on hormonal production. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02897-3] [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: 11/26/2022]
|
3
|
Franzese C, Poretti D, Comito T, Muglia R, Lo Faro L, Ceriani C, Pedicini V, Teriaca A, Lanza E, D'antuono F, Solbiati L, Mancosu P, Tomatis S, Scorsetti M. MO-0222 Propensity score-based comparison of SBRT versus thermal ablation for hepatocellular carcinoma. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02324-6] [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: 10/18/2022]
|
4
|
Esposito E, Fogliata A, Paganini L, Reggiori G, Tomatis S, Scorsetti M, Cozzi L. The impact of commissioning measurements accuracy on the configurations of both Acuros-XB and AAA dose calculation algorithms for photon beams. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00114-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
5
|
Loi M, Comito T, Franzese C, Clerici E, Badalamenti M, Reggiori G, Mancosu P, Tomatis S, Rimassa L, Santoro A, Scorsetti M. PO-1069: SBRT in Hepatocellular Carcinoma: impact of dose regimen and treatment sequence. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01086-0] [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]
|
6
|
Franceschini D, Loi M, De Rose F, Franzese C, Giuseppe D, Navarria P, Mancosu P, Tomatis S, Scorsetti M. PO-1010: Stereotactic Body Radiation Therapy is safe and effective for ultracentral lung lesions. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01027-6] [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: 11/24/2022]
|
7
|
De Rose F, Fogliata A, Franceschini D, Iftode C, D'Agostino G, Comito T, Franzese C, Di Brina L, Clerici E, Loi M, Navarria P, Gatzemeier W, Testori A, Tinterri C, Lobefalo F, Tomatis S, Scorsetti M. PO-0952: Hypofractionated WBI in large-breasted patients: long-term toxicity of a prospective series. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00970-1] [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: 11/16/2022]
|
8
|
Franzese C, Comito T, Franceschini D, Loi M, Clerici E, Navarria P, De Rose F, Tozzi A, Di Brina L, Mancosu P, Reggiori G, Tomatis S, Scorsetti M. PO-1055: Recursive partitioning model based analysis for oligometastatic colorectal cancer treated with SBRT. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01072-0] [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]
|
9
|
Fogliata A, Esposito E, Paganini L, Reggiori G, Tomatis S, Scorsetti M, Cozzi L. The impact of scanning data measurements on the Acuros dose calculation algorithm configuration. Radiat Oncol 2020; 15:169. [PMID: 32650815 PMCID: PMC7350585 DOI: 10.1186/s13014-020-01610-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 07/02/2020] [Indexed: 11/24/2022] Open
Abstract
Background Many dose calculation algorithms for radiotherapy planning need to be configured for each clinical beam using pre-defined measurements. An optimization process adjusts the physical parameters able to estimate the energy released in the medium in any geometrical condition. This work investigates the impact of measured input data quality on the configuration of the type “c” Acuros-XB dose calculation algorithm in the Eclipse (Varian Medical Systems) treatment planning system. Methods Different datasets were acquired with the BeamScan water phantom (PTW) to configure 6 MV beams, for both flattened (6X) and flattening filter free mode (6FFF) for a Varian TrueBeam: (i) a correct dataset measured using a Semiflex-3D ion chamber, (ii) a set in missing lateral scatter conditions (MLS), (iii) a set with incorrect effective point of measurement (EPoM), (iv) sets acquired with PinPoint-3D chamber, DiodeP, microDiamond detectors. The Acuros-XB dose calculation algorithm (version 15.6) was configured using the reference dataset, the sets measured with the different detectors, with intentional errors, and using the representative beam data (RBD) made available by the vendor. The physical parameters obtained from each optimization process (spectrum, mean radial energy, electron contamination), were analyzed and compared. Calculated data were finally compared against the input and reference measurements. Results Concerning the physical parameters, the configurations presenting the largest differences were the MLS conditions (mean radial energy) and the incorrect EPoM (electron contamination). The calculation doses relative to the input data present low accuracy, with mean differences > 2% in some conditions. The PinPoint-3D ion chamber presented lower accuracy for the 6FFF beam. Regarding the RBD, calculations compared well with the input data used for the configuration, but not with the reference data. Conclusion The MLS conditions and the incorrect setting of the EPoM lead to erroneous configurations and should be avoided. The choice of an appropriate detector is important. Whenever the representative beam data is used, a careful check under more clinical geometrical conditions is advised.
Collapse
Affiliation(s)
- A Fogliata
- Radiotherapy and Radiosurgery Dept, Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, Milan-Rozzano, Italy.
| | - E Esposito
- Radiotherapy and Radiosurgery Dept, Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, Milan-Rozzano, Italy
| | - L Paganini
- Radiotherapy and Radiosurgery Dept, Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, Milan-Rozzano, Italy
| | - G Reggiori
- Radiotherapy and Radiosurgery Dept, Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, Milan-Rozzano, Italy
| | - S Tomatis
- Radiotherapy and Radiosurgery Dept, Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, Milan-Rozzano, Italy
| | - M Scorsetti
- Radiotherapy and Radiosurgery Dept, Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, Milan-Rozzano, Italy.,Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Milan-Pieve Emanuele, Italy
| | - L Cozzi
- Radiotherapy and Radiosurgery Dept, Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, Milan-Rozzano, Italy.,Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Milan-Pieve Emanuele, Italy
| |
Collapse
|
10
|
Fogliata A, Cozzi L, Reggiori G, Stravato A, Lobefalo F, Franzese C, Franceschini D, Tomatis S, Scorsetti M. RapidPlan knowledge based planning: iterative learning process and model ability to steer planning strategies. Radiat Oncol 2019; 14:187. [PMID: 31666094 PMCID: PMC6822368 DOI: 10.1186/s13014-019-1403-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [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: 07/22/2019] [Accepted: 10/21/2019] [Indexed: 01/23/2023] Open
Abstract
Purpose To determine if the performance of a knowledge based RapidPlan (RP) planning model could be improved with an iterative learning process, i.e. if plans generated by an RP model could be used as new input to re-train the model and achieve better performance. Methods Clinical VMAT plans from 83 patients presenting with head and neck cancer were selected to train an RP model, CL-1. With this model, new plans on the same patients were generated, and subsequently used as input to train a novel model, CL-2. Both models were validated on a cohort of 20 patients and dosimetric results compared. Another set of 83 plans was realised on the same patients with different planning criteria, by using a simple template with no attempt to manually improve the plan quality. Those plans were employed to train another model, TP-1. The differences between the plans generated by CL-1 and TP-1 for the validation cohort of patients were compared with respect to the differences between the original plans used to build the two models. Results The CL-2 model presented an improvement relative to CL-1, with higher R2 values and better regression plots. The mean doses to parallel organs decreased with CL-2, while D1% to serial organs increased (but not significantly). The different models CL-1 and TP-1 were able to yield plans according to each original strategy. Conclusion A refined RP model allowed the generation of plans with improved quality, mostly for parallel organs at risk and, possibly, also the intrinsic model quality.
Collapse
Affiliation(s)
- A Fogliata
- Radiotherapy Department, Humanitas Research Hospital and Cancer Center, Via Manzoni 56, 20089 Rozzano, Milan, Italy.
| | - L Cozzi
- Radiotherapy Department, Humanitas Research Hospital and Cancer Center, Via Manzoni 56, 20089 Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Rozzano, Italy
| | - G Reggiori
- Radiotherapy Department, Humanitas Research Hospital and Cancer Center, Via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - A Stravato
- Radiotherapy Department, Humanitas Research Hospital and Cancer Center, Via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - F Lobefalo
- Radiotherapy Department, Humanitas Research Hospital and Cancer Center, Via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - C Franzese
- Radiotherapy Department, Humanitas Research Hospital and Cancer Center, Via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - D Franceschini
- Radiotherapy Department, Humanitas Research Hospital and Cancer Center, Via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - S Tomatis
- Radiotherapy Department, Humanitas Research Hospital and Cancer Center, Via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - M Scorsetti
- Radiotherapy Department, Humanitas Research Hospital and Cancer Center, Via Manzoni 56, 20089 Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Rozzano, Italy
| |
Collapse
|
11
|
De Rose F, Cozzi L, Meattini I, Fogliata A, Franceschini D, Franzese C, Tomatis S, Becherini C, Livi L, Scorsetti M. The Potential Role of Intensity-modulated Proton Therapy in the Regional Nodal Irradiation of Breast Cancer: A Treatment Planning Study. Clin Oncol (R Coll Radiol) 2019; 32:26-34. [PMID: 31377082 DOI: 10.1016/j.clon.2019.07.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 06/13/2019] [Accepted: 07/18/2019] [Indexed: 10/26/2022]
Abstract
AIMS To investigate the role of intensity-modulated proton therapy (IMPT) for regional nodal irradiation in patients with breast carcinoma in comparison with volumetric-modulated arc therapy (VMAT). MATERIALS AND METHODS A cohort of 20 patients (10 in the breast-conserving surgery group and 10 post-mastectomy patients with tissue expander implants) was investigated. Proton plans were also computed using robust optimisation methods. Plan quality was assessed by means of dose-volume histograms and scored with conventional metrics. Estimates of the risk of secondary cancer induction (excess absolute risk, EAR) were carried out, taking into account fractionation, repopulation and repair. RESULTS Concerning target coverage, the data proved a substantial equivalence of VMAT and IMPT: for example, coverage for the 50 Gy target, expressed in terms of V98%, was 47.8 ± 0.4, 47.6 ± 0.4, 47.3 ± 0.8, consistent with the objective of 47.5 Gy, for post-mastectomy patients for the three groups of patients. Also, the conformality of the dose distributions was similar for the two techniques, about 1.1, without statistically significant differences. Organ at risk planning aims were achieved for all structures for both techniques. The mean dose to the ipsilateral lung was 10.8 ± 1.1, 6.2 ± 0.8, 7.2 ± 1.0; for the contralateral lung was 3.2 ± 0.7, 0.3 ± 0.2, 0.4 ± 0.2; for the contralateral breast was: 3.1 ± 0.7, 0.3 ± 0.3 and 0.3 ± 0.3, whereas it was 3.9 ± 0.9, 0.4 ± 0.3 and 0.5 ± 0.5, respectively, for the heart for VMAT, IMPT and robust IMPT plans over the whole group of patients. Robust optimisation affected the near-to-maximum dose values for contralateral lung and breast, the mean dose for the heart and ipsilateral lung, with a deterioration ranging from 20 to 40% of the nominal value of IMPT plans (e.g. from 8.1 ± 6.4 to 11.4 ± 8.8 for the heart compared with 16.2 ± 5.2 for the VMAT plans). The numerical values of EAR per 10 000 patient-years were about one order of magnitude higher for VMAT than for IMPT for contralateral structures: 11.66 ± 2.01, 0.89 ± 0.80, 0.98 ± 0.77 for the contralateral breast and the three groups of plans, respectively; 14.31 ± 2.75, 1.42 ± 0.80, 1.78 ± 0.87 for the contralateral lung; and 34.86 ± 2.64, 18.85 ± 2.15, 20.98 ± 2.35 for the ipsilateral lung. CONCLUSION IMPT with or without robust optimisation seems to be a potentially promising approach for the radiation treatment of breast cancer when nodal volumes should be irradiated. This was measured in terms of dosimetric advantage and predicted clinical benefit. In fact, the significant reduction in estimated EAR could add further clinical value to the dosimetric sparing of the organs at risk achievable with IMPT.
Collapse
Affiliation(s)
- F De Rose
- Radiotherapy and Radiosurgery Department, Humanitas Research Hospital and Cancer Center, Milan-Rozzano, Italy
| | - L Cozzi
- Radiotherapy and Radiosurgery Department, Humanitas Research Hospital and Cancer Center, Milan-Rozzano, Italy; Department of Biomedical Sciences, Humanitas University, Milan-Rozzano, Italy.
| | - I Meattini
- Department of Biomedical Experimental and Clinical Sciences, University of Florence, Florence, Italy; Radiation Oncology Unit, Az. Osp. Careggi, Florence, Italy
| | - A Fogliata
- Radiotherapy and Radiosurgery Department, Humanitas Research Hospital and Cancer Center, Milan-Rozzano, Italy
| | - D Franceschini
- Radiotherapy and Radiosurgery Department, Humanitas Research Hospital and Cancer Center, Milan-Rozzano, Italy
| | - C Franzese
- Radiotherapy and Radiosurgery Department, Humanitas Research Hospital and Cancer Center, Milan-Rozzano, Italy
| | - S Tomatis
- Radiotherapy and Radiosurgery Department, Humanitas Research Hospital and Cancer Center, Milan-Rozzano, Italy
| | - C Becherini
- Department of Biomedical Experimental and Clinical Sciences, University of Florence, Florence, Italy; Radiation Oncology Unit, Az. Osp. Careggi, Florence, Italy
| | - L Livi
- Department of Biomedical Experimental and Clinical Sciences, University of Florence, Florence, Italy; Radiation Oncology Unit, Az. Osp. Careggi, Florence, Italy
| | - M Scorsetti
- Radiotherapy and Radiosurgery Department, Humanitas Research Hospital and Cancer Center, Milan-Rozzano, Italy; Department of Biomedical Sciences, Humanitas University, Milan-Rozzano, Italy
| |
Collapse
|
12
|
Scorsetti M, Comito T, Franzese C, Franceschini D, De Rose F, Tomatis S, D’alessio A, Prete M, Bozzarelli S, Rimassa L, Personeni N, Santoro A. Role of stereotactic body radiation therapy in the management of oligometastatic pancreatic cancer: single institution experience. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
13
|
Franzese C, Fogliata A, Franceschini D, De Rose F, Comito T, Navarria P, Cozzi L, Tomatis S, Scorsetti M. EP-1171 Toxicity profile of locally advanced head and neck cancer patients treated in 30 or 33 fractions RT. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31591-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
14
|
Cozzi L, Comito T, Fogliata A, Franzese C, Franceschini D, Bonifacio C, Tozzi A, Di Brina L, Clerici E, Tomatis S, Reggiori G, Lobefalo F, Stravato A, Mancosu P, Zerbi A, Sollini M, Margarita K, Chiti A, Scorsetti M. PO-0955 Radiomics signature as predictors of survival and local control after pancreatic carcinoma SBRT. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31375-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
15
|
Alongi F, Nicosia L, Francese C, D'Agostino G, Di Brina L, Figlia V, Mazzola R, Tomatis S, Scorsetti M. EP-1559 SBRT for lymph node metastases from prostate cancer: a multi-institutional retrospective analysis. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31979-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
16
|
Fogliata A, Reggiori G, Franzese C, Franceschini D, Tomatis S, Scorsetti M, Cozzi L. PO-0925 On the ability of a knowledge based planning process to improve itself. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31345-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
17
|
Franzese C, Comito T, Tozzi A, De Rose F, Navarria P, Mancosu P, Tomatis S, Scorsetti M. PO-0883 Phase II trial of stereotactic body radiation therapy for abdomino-pelvic lymph node oligometastases. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31303-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
18
|
Mancosu P, Reggiori G, Gaudino A, Lobefalo F, Paganini L, Palumbo V, Stravato A, Tomatis S, Scorsetti M. PO-0936 To be or not to be homogeneous in SBRT plans? a systematic multi-planning study. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31356-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
19
|
Cozzi L, Comito T, Fogliata A, Franzese C, Tomatis S, Scorsetti M. EP-1850 Intensity modulated protons: feasibility for hypofractionated hepatocellular carcinoma treatment. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32270-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
20
|
Iftode C, Tozzi A, D'Agostino G, Comito T, Franzese C, De Rose F, Franceshini D, Di Brina L, Navarria P, Clerici E, Tomatis S, Scorsetti M. EP-1493 SBRT for oligometastatic gynecological cancer: a single institution experience. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31913-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
21
|
Comito T, Franzese C, Clerici E, Navarria P, D'Agostino G, Carrara S, Rimassa L, Tomatis S, Zerbi A, Scorsetti M. EP-1430 Can SBRT improve the prognosis of unresectable pancreatic cancer? Clinical results on 106 patients. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31850-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
22
|
Paganini L, Reggiori G, Stravato A, Palumbo V, Mancosu P, Lobefalo F, Gaudino A, Tomatis S, Scorsetti M. EP-1772 MLC parameters evaluation in a RT-dedicated MC environment (PRIMO) from static fields to VMAT plans. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32192-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
23
|
Russo S, Esposito M, Hernandez V, Saez J, Rossi F, Paoletti L, Bastiani P, Tomatis S, Mancosu P. 3. Is DIBH VMAT in left breast related to lower plan complexity than Free Breathing? A multicenter experience. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.013] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
24
|
D'Agostino G, Di Brina L, Franzese C, Tomatis S, Iftode C, Franceschini D, Clerici E, Reggiori G, Tozzi A, Navarria P, Scorsetti M. External Beam Re-Irradiation of Locally Recurrent Prostate Cancer with FFF-VMAT. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
25
|
Navarria P, Clerici E, Pessina F, Franzese C, Bello L, Simonelli M, Tomatis S, Leonetti A, Scorsetti M. P01.073 Hypofractionated radiation therapy (over 3 weeks) can replace conventional radiation therapy schedule (over 6 weeks) in newly diagnosed glioblastoma patients? The times are ripe. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - E Clerici
- Humanitas Cancer Center, Rozzano, Italy
| | - F Pessina
- Humanitas Cancer Center, Rozzano, Italy
| | | | - L Bello
- Humanitas Cancer Center, Rozzano, Italy
| | | | - S Tomatis
- Humanitas Cancer Center, Rozzano, Italy
| | | | - M Scorsetti
- Humanitas Cancer Center, Rozzano, Italy
- Humanitas University, Rozzano,Milan, Italy
| |
Collapse
|
26
|
Franzese C, Navarria P, Clerici E, Comito T, Pessina F, Bello L, Reggiori G, Tomatis S, Scorsetti M. P05.50 Hypofractionated stereotactic radiation therapy (HSRT) in skull base meningiomas. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C Franzese
- Humanitas Cancer Center and Research Hospital, Rozzano (MI), Italy
| | - P Navarria
- Humanitas Cancer Center and Research Hospital, Rozzano (MI), Italy
| | - E Clerici
- Humanitas Cancer Center and Research Hospital, Rozzano (MI), Italy
| | - T Comito
- Humanitas Cancer Center and Research Hospital, Rozzano (MI), Italy
| | - F Pessina
- Humanitas Cancer Center and Research Hospital, Rozzano (MI), Italy
| | - L Bello
- Humanitas Cancer Center and Research Hospital, Rozzano (MI), Italy
| | - G Reggiori
- Humanitas Cancer Center and Research Hospital, Rozzano (MI), Italy
| | - S Tomatis
- Humanitas Cancer Center and Research Hospital, Rozzano (MI), Italy
| | - M Scorsetti
- Humanitas Cancer Center and Research Hospital, Rozzano (MI), Italy
- Humanitas University, Rozzano, Milan, Italy
| |
Collapse
|
27
|
Clerici E, Navarria P, Franzese C, Carta GA, Mancosu P, Reggiori G, Picozzi P, Attuati L, Tomatis S, Scorsetti M. OS6.5 Randomized phase III trial comparing GAMMA KNIFE (GK) and LINAC based (EDGE) radiosurgery for brain metastases from solid tumors: results from the GADGET trial. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- E Clerici
- Humanitas Cancer Center and Research Hospital, Rozzano (MI), Italy
| | - P Navarria
- Humanitas Cancer Center and Research Hospital, Rozzano (MI), Italy
| | - C Franzese
- Humanitas Cancer Center and Research Hospital, Rozzano (MI), Italy
| | - G A Carta
- Humanitas Cancer Center and Research Hospital, Rozzano (MI), Italy
| | - P Mancosu
- Humanitas Cancer Center and Research Hospital, Rozzano (MI), Italy
| | - G Reggiori
- Humanitas Cancer Center and Research Hospital, Rozzano (MI), Italy
| | - P Picozzi
- Humanitas Cancer Center and Research Hospital, Rozzano (MI), Italy
| | - L Attuati
- Humanitas Cancer Center and Research Hospital, Rozzano (MI), Italy
| | - S Tomatis
- Humanitas Cancer Center and Research Hospital, Rozzano (MI), Italy
| | - M Scorsetti
- Humanitas Cancer Center and Research Hospital, Rozzano (MI), Italy
- Humanitas University, Rozzano, Milan, Italy
| |
Collapse
|
28
|
Fogliata A, Stravato A, Reggiori G, Tomatis S, Würfel J, Scorsetti M, Cozzi L. Collimator scatter factor: Monte Carlo and in-air measurements approaches. Radiat Oncol 2018; 13:126. [PMID: 29996873 PMCID: PMC6042423 DOI: 10.1186/s13014-018-1070-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [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: 04/05/2018] [Accepted: 06/29/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Linac output as a function of field sizes has a phantom and a head scatter component. This last term can be measured in-air with appropriate build-up ensuring a complete electron equilibrium and the absence of the contaminant electrons. Equilibrium conditions could be achieved using a build-up cap or a mini-phantom. Monte Carlo simulations in a virtual phantom mimicking a mini-phantom were analysed with the aim of better understanding the setup conditions for measuring the collimator scatter factor that is the head scatter component of the linac output factors. METHODS Beams of 6 and 15 MV from a TrueBeam, with size from 4 × 4 to 40 × 40 cm2 were simulated in cylindrical acrylic phantoms 20 cm long, of different diameters, from 0.5 to 4 cm, with the cylinder axis coincident with the beam central axis. The PRIMO package, based on PENELOPE Monte Carlo code, was used. The phase-space files for a Varian TrueBeam linac, provided by the linac vendor, were used for the linac head simulation. Depth dose curves were analysed, and collimator scatter factors estimated at different depth in the different phantom conditions. Additionally, in-air measurements using acyrilic and brass build-up caps, as well as acrylic mini-phantom were acquired for 6 and 18 MV beams from a Varian Clinac DHX. RESULTS The depth dose curves along the cylinders were compared, showing, in each phantom, very similar curves for all analysed field sizes, proving the correctness in estimating the collimator scatter factor in the mini-phantom, provided to position the detector to a sufficient depth to exclude electron contamination. The results were confirmed by the measurements, where the acrylic build-up cap showed to be inadequate to properly estimate the collimator scatter factors, while the mini-phantom and the brass caps gave reasonable measurements. CONCLUSION A better understanding of the beam characteristics inside a virtual mini-phantom through the analysis of depth dose curves, showed the critical points of using the acrylic build-up cap, and suggested the use of the mini-phantom for the collimator scatter factor measurements in the medium-large field size range.
Collapse
Affiliation(s)
- A Fogliata
- Radiotherapy and Radiosurgery Department, Humanitas Research Hospital and Cancer Center, Milan-Rozzano, Italy.
| | - A Stravato
- Radiotherapy and Radiosurgery Department, Humanitas Research Hospital and Cancer Center, Milan-Rozzano, Italy
| | - G Reggiori
- Radiotherapy and Radiosurgery Department, Humanitas Research Hospital and Cancer Center, Milan-Rozzano, Italy
| | - S Tomatis
- Radiotherapy and Radiosurgery Department, Humanitas Research Hospital and Cancer Center, Milan-Rozzano, Italy
| | - J Würfel
- PTW-Freiburg GmbH, Freiburg, Germany
| | - M Scorsetti
- Radiotherapy and Radiosurgery Department, Humanitas Research Hospital and Cancer Center, Milan-Rozzano, Italy.,Biomedical Science Faculty, Humanitas University, Milan-Rozzano, Italy
| | - L Cozzi
- Radiotherapy and Radiosurgery Department, Humanitas Research Hospital and Cancer Center, Milan-Rozzano, Italy.,Biomedical Science Faculty, Humanitas University, Milan-Rozzano, Italy
| |
Collapse
|
29
|
Fogliata A, De Rose F, Stravato A, Reggiori G, Tomatis S, Scorsetti M, Cozzi L. Evaluation of target dose inhomogeneity in breast cancer treatment due to tissue elemental differences. Radiat Oncol 2018; 13:92. [PMID: 29764450 PMCID: PMC5952506 DOI: 10.1186/s13014-018-1022-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [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: 02/13/2018] [Accepted: 04/11/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Monte Carlo simulations were run to estimate the dose variations generated by thedifference arising from the chemical composition of the tissues. METHODS CT datasets of five breast cancer patients were selected. Mammary gland was delineated as clinical target volume CTV, as well as CTV_lob and CTV_fat, being the lobular and fat fractions of the entire mammary gland. Patients were planned for volumetric modulated arc therapy technique, optimized in the Varian Eclipse treatment planning system. CT, structures and plans were imported in PRIMO, based on Monte Carlo code Penelope, to run three simulations: AdiMus, where the adipose and muscle tissues were automatically assigned to fat and lobular fractions of the breast; Adi and Mus, where adipose and muscle, respectively were assigned to the whole mammary gland. The specific tissue density was kept identical from the CT dataset. Differences in mean doses in the CTV_lob and CTV_fat structures were evaluated for the different tissue assignments. Differences generated by the tissue composition and estimated by Acuros dose calculations in Eclipse were also analysed. RESULTS From Monte Carlo simulations, the dose in the lobular fraction of the breast, when adipose tissue is assigned in place of muscle, is overestimated by 1.25 ± 0.45%; the dose in the fat fraction of the breast with muscle tissue assignment is underestimated by 1.14 ± 0.51%. Acuros showed an overestimation of 0.98 ± 0.06% and an underestimation of 0.21 ± 0.14% in the lobular and fat portions, respectively. Reason of this dissimilarity resides in the fact that the two calculations, Monte Carlo and Acuros, differently manage the range of CT numbers and the material assignments, having Acuros an overlapping range, where two tissues are both present in defined proportions. CONCLUSION Although not clinically significant, the dose deposition difference in the lobular and connective fat fraction of the breast tissue lead to an improved knowledge of the possible dose distribution and homogeneity in the breast radiation treatment.
Collapse
Affiliation(s)
- A Fogliata
- Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Dept, Via Manzoni 56, 20089, Milan, Rozzano, Italy.
| | - F De Rose
- Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Dept, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - A Stravato
- Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Dept, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - G Reggiori
- Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Dept, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - S Tomatis
- Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Dept, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - M Scorsetti
- Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Dept, Via Manzoni 56, 20089, Milan, Rozzano, Italy.,Humanitas University, Biomedical Science Faculty, Milan, Rozzano, Italy
| | - L Cozzi
- Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Dept, Via Manzoni 56, 20089, Milan, Rozzano, Italy.,Humanitas University, Biomedical Science Faculty, Milan, Rozzano, Italy
| |
Collapse
|
30
|
Reggiori G, Stravato A, Mancosu P, Lobefalo F, Paganini L, Zucconi F, Palumbo V, Gaudino A, Scorsetti M, Tomatis S. Small field characterization of a Nanochamber prototype under flattening filter free photon beams. Phys Med 2018; 49:139-146. [DOI: 10.1016/j.ejmp.2017.08.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 08/04/2017] [Accepted: 08/16/2017] [Indexed: 11/28/2022] Open
|
31
|
Tomatis S, Bono A, Bartoli C, Tragni G, Farina B, Marchesini R. Image Analysis in the RGB and HS Colour Planes for a Computer-Assisted Diagnosis of Cutaneous Pigmented Lesions. Tumori 2018; 84:29-32. [PMID: 9619710 DOI: 10.1177/030089169808400106] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and background A study was carried out to evaluate the effectiveness of image analysis performed by the two color representation models when a computer-assisted diagnosis of melanoma is involved. Methods Color images of 40 skin pigmented lesions, which included 12 melanomas, were acquired by a standard color RGB video camera and stored in a PC for off-line processing. Image analysis was performed in the red green and blue color representation model and using hue and saturation color components. To describe shape and color characteristics of each lesion, including area, roundness and color variegation, 16 parameters were derived from red, green, blue, hue and saturation color planes and tested as possible variables useful to differentiate melanomas from benign nevi. Results The test gave a result of significance for six of the 16 derived image descriptors. The general trend of our data was in agreement with clinical observations according to which melanoma is usually darker, more variegated and less round than a benign nevus, whereas lesion dimension of melanomas and benign lesions was not significantly different. Conclusions Our preliminary results suggested that image analysis performed on hue and saturation-derived and red green and blue-derived data could better discriminate melanoma from nevi than separately using the two color representation models.
Collapse
Affiliation(s)
- S Tomatis
- Division of Health Physics, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milano, Italy
| | | | | | | | | | | |
Collapse
|
32
|
De Rose F, Franceschini D, Iftode C, Comito T, Tozzi A, Franzese C, Di Brina L, Clerici E, D'Agostino G, Navarria P, Tomatis S, Scorsetti M. EP-1270: Randomized phase II study of hypofractionated WBI versus APBI using VMAT: early toxicity results. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31580-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
33
|
Franzese C, Tomatis S, Bossi P, Franco P, Bonomo P, Beltramo G, Bossi Zanetti I, Cante D, Argenone A, Musio D, Furlan C, Scorsetti M, Fallai C, Orlandi E. EP-1175: Role of Radiotherapy in the management of metastases from salivary gland carcinoma. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31485-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
34
|
D'Agostino G, Di Brina L, Franzese C, Franceschini D, Clerici E, Tomatis S, Iftode C, Tozzi A, Navarria P, De Rose F, Comito T, Scorsetti M. EP-1589: VMAT SBRT For Localized Prostate Cancer: 4-Year Follow-Up And Correlation With WHO2016 Grade Groups. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31898-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
35
|
Palumbo V, Navarria P, Tomatis S, Clerici E, Carta G, Picozzi P, Mancosu P, Scorsetti M. OC-0591: Phase III randomized trial comparing two modalities of RS for brain metastases: Gammaknife vs Linac. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30901-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
36
|
De Rose F, Franceschini D, Iftode C, Reggiori G, Masci G, Torrisi R, Testori A, Tinterri C, Tomatis S, Scorsetti M. Adjuvant chemotherapy and hypofractionated VMAT treatment with SIB for early stage breast cancer: A prospective evaluation of acute toxicity and cosmetic results. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30403-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
37
|
Stravato A, Palumbo V, Fogliata A, Reggiori G, Mancosu P, Paganini L, De Rose F, Franceschini D, Tomatis S, Scorsetti M. EP-1967: VMAT technique on left sided breast focusing on the dose to the heart. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32276-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
38
|
Mancosu P, Nicolini G, Goretti G, De Rose F, Franceschini D, Ferrari C, Tomatis S, Scorsetti M. EP-2154: Lean-six-sigma methodology for improving quality in RT: the breast daily repositioning case. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32463-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
39
|
Comito T, Cozzi L, Clerici E, Franzese C, Tozzi A, Iftode C, Navarria P, D’Agostino G, Rimassa L, Carnaghi C, Personeni N, Tronconi MC, De Rose F, Franceschini D, Ascolese AM, Fogliata A, Tomatis S, Santoro A, Zerbi A, Scorsetti M. Can Stereotactic Body Radiation Therapy Be a Viable and Efficient Therapeutic Option for Unresectable Locally Advanced Pancreatic Adenocarcinoma? Results of a Phase 2 Study. Technol Cancer Res Treat 2017; 16:295-301. [PMID: 27311310 PMCID: PMC5616043 DOI: 10.1177/1533034616650778] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 03/14/2016] [Accepted: 04/22/2016] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To assess the efficacy of stereotactic body radiotherapy in patients with unresectable locally advanced pancreatic cancer. MATERIALS AND METHODS All patients received a prescription dose of 45 Gy in 6 fractions. Primary end point was freedom from local progression. Secondary end points were overall survival, progression-free survival, and toxicity. Actuarial survival analysis and univariate or multivariate analysis were investigated. RESULTS Forty-five patients were enrolled in a phase 2 trial. Median follow-up was 13.5 months. Freedom from local progression was 90% at 2 years. On univariate ( P < .03) and multivariate analyses ( P < .001), lesion size was statistically significant for freedom from local progression. Median progression-free survival and overall survival were 8 and 13 months, respectively. On multivariate analysis, tumor size ( P < .001) and freedom from local progression ( P < .002) were significantly correlated with overall survival. Thirty-two (71%) patients with locally advanced pancreatic cancer received chemotherapy before stereotactic body radiotherapy. Median overall survival from diagnosis was 19 months. Multivariate analysis showed that freedom from local progression ( P < .035), tumor diameter ( P < .002), and computed tomography before stereotactic body radiotherapy ( P < .001) were significantly correlated with overall survival from diagnosis. CONCLUSION Stereotactic body radiotherapy is a safe and effective treatment for patients with locally advanced pancreatic cancer with no G3 toxicity or greater and could be a promising therapeutic option in multimodality treatment regimen.
Collapse
Affiliation(s)
| | - L. Cozzi
- Radiotherapy, Istituto Clinico Humanitas, Milano, Italy
| | - E. Clerici
- Radiotherapy, Istituto Clinico Humanitas, Milano, Italy
| | - C. Franzese
- Radiotherapy, Istituto Clinico Humanitas, Milano, Italy
| | - A. Tozzi
- Radiotherapy, Istituto Clinico Humanitas, Milano, Italy
| | - C. Iftode
- Radiotherapy, Istituto Clinico Humanitas, Milano, Italy
| | - P. Navarria
- Radiotherapy, Istituto Clinico Humanitas, Milano, Italy
| | - G. D’Agostino
- Radiotherapy, Istituto Clinico Humanitas, Milano, Italy
| | - L. Rimassa
- Oncology and Hematology, Istituto Clinico Humanitas, Milano, Italy
| | - C. Carnaghi
- Oncology and Hematology, Istituto Clinico Humanitas, Milano, Italy
| | - N. Personeni
- Oncology and Hematology, Istituto Clinico Humanitas, Milano, Italy
| | - M. C. Tronconi
- Oncology and Hematology, Istituto Clinico Humanitas, Milano, Italy
| | - F. De Rose
- Radiotherapy, Istituto Clinico Humanitas, Milano, Italy
| | | | | | - A. Fogliata
- Radiotherapy, Istituto Clinico Humanitas, Milano, Italy
| | - S. Tomatis
- Radiotherapy, Istituto Clinico Humanitas, Milano, Italy
| | - A. Santoro
- Oncology and Hematology, Istituto Clinico Humanitas, Milano, Italy
| | - A. Zerbi
- Pancreatic Surgery, Istituto Clinico Humanitas, Milano, Italy
| | - M. Scorsetti
- Radiotherapy, Istituto Clinico Humanitas, Milano, Italy
| |
Collapse
|
40
|
Stravato A, Reggiori G, Mancosu P, Lobefalo F, Paganini L, Zucconi F, Palumbo V, Tomatis S, Scorsetti M. EP-1439: Small field dosimetry: preliminary characterization of a nano-chamber with a focus on stem effect. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31874-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
41
|
Iftode C, Tozzi A, Clerici E, Di Brina L, D'Agostino G, Ascolese A, Comito T, Franceschini D, Franzese C, De Rose F, Tomatis S, Mancosu P, Navarria P, Scorsetti M. EP-1296: Adjuvant radiotherapy in endometrial cancer: Volumetric Modulated Intensity Arc Therapy vs 3DRT. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31731-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
42
|
Mancosu P, Nicollini G, De Rose F, Lobefalo F, Franceschini D, Scorsetti M, Tomatis S. EP-1637: Critical appraisal of deep inspiration breath hold CBCT for left breast using VMAT. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)32072-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
43
|
Ascolese A, Navarria P, Mancosu P, Tomatis S, Fogliata A, Colombo P, De Sanctis R, Marrari A, Franceschini D, D'Agostino G, Santoro A, Quagliuolo V, Scorsetti M. EP-1375: Volumetric-modulated-arc-therapy versus 3D-conformal-radiotherapy for sarcoma of extremities. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31810-8] [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: 11/28/2022]
|
44
|
Clerici E, Navarria P, Ascolese A, Pessina F, Tomatis S, Cozzi L, Simonelli M, Santoro A, Franzese C, Bello L, Scorsetti M. EP-1409: Prospective study of hypofractionated radiotherapy for elderly patients with High Grade Glioma. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31844-3] [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: 10/19/2022]
|
45
|
Fogliata A, Reggiori G, Stravato A, Lobefalo F, Franzese C, Franceschini D, Tomatis S, Mancosu P, Scorsetti M, Cozzi L. RapidPlan head and neck model: the objectives and possible clinical benefit. Radiat Oncol 2017; 12:73. [PMID: 28449704 PMCID: PMC5408433 DOI: 10.1186/s13014-017-0808-x] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [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: 01/06/2017] [Accepted: 04/14/2017] [Indexed: 11/27/2022] Open
Abstract
Background To evaluate a knowledge based planning model for RapidPlan (RP) generated for advanced head and neck cancer (HNC) patient treatments, as well its ability to possibly improve the clinical plan quality. The stability of the model was assessed also for a different beam geometry, different dose fractionation and different management of bilateral structures (parotids). Methods Dosimetric and geometric data from plans of 83 patients presenting HNC were selected for the model training. All the plans used volumetric modulated arc therapy (VMAT, RapidArc) to treat two targets at dose levels of 69.96 and 54.45 Gy in 33 fractions with simultaneous integrated boost. Two models were generated, the first separating the ipsi- and contra-lateral parotids, while the second associating the two parotids to a single structure for training. The optimization objectives were adjusted to the final model to better translate the institutional planning and dosimetric strategies and trade-offs. The models were validated on 20 HNC patients, comparing the RP generated plans and the clinical plans. RP generated plans were also compared between the clinical beam arrangement and a simpler geometry, as well as for a different fractionation scheme. Results RP improved significantly the clinical plan quality, with a reduction of 2 Gy, 5 Gy, and 10 Gy of the mean parotid, oral cavity and laryngeal doses, respectively. A simpler beam geometry was deteriorating the plan quality, but in a small amount, keeping a significant improvement relative to the clinical plan. The two models, with one or two parotid structures, showed very similar results. NTCP evaluations indicated the possibility of improving (NTCP decreasing of about 7%) the toxicity profile when using the RP solution. Conclusions The HNC RP model showed improved plan quality and planning stability for beam geometry and fractionation. An adequate choice of the objectives in the model is necessary for the trade-offs strategies.
Collapse
Affiliation(s)
- A Fogliata
- Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Department, Milan, Rozzano, Italy.
| | - G Reggiori
- Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Department, Milan, Rozzano, Italy
| | - A Stravato
- Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Department, Milan, Rozzano, Italy
| | - F Lobefalo
- Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Department, Milan, Rozzano, Italy
| | - C Franzese
- Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Department, Milan, Rozzano, Italy
| | - D Franceschini
- Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Department, Milan, Rozzano, Italy
| | - S Tomatis
- Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Department, Milan, Rozzano, Italy
| | - P Mancosu
- Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Department, Milan, Rozzano, Italy
| | - M Scorsetti
- Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Department, Milan, Rozzano, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Rozzano, Italy
| | - L Cozzi
- Humanitas Research Hospital and Cancer Center, Radiotherapy and Radiosurgery Department, Milan, Rozzano, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Rozzano, Italy
| |
Collapse
|
46
|
De Rose F, Franceschini D, Reggiori G, Stravato A, Navarria P, Ascolese AM, Tomatis S, Mancosu P, Scorsetti M. Organs at risk in lung SBRT. Phys Med 2017; 44:131-138. [PMID: 28433508 DOI: 10.1016/j.ejmp.2017.04.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 03/24/2017] [Accepted: 04/09/2017] [Indexed: 12/23/2022] Open
Abstract
Lung stereotactic body radiotherapy (SBRT) is an accurate and precise technique to treat lung tumors with high 'ablative' doses. Given the encouraging data in terms of local control and toxicity profile, SBRT has currently become a treatment option for both early stage lung cancer and lung oligometastatic disease in patients who are medically inoperable or refuse surgical resection. Dose-adapted fractionation schedules and ongoing prospective trials should provide further evidence of SBRT safety trying to reduce toxicities and complications. In this heterogeneous scenario, a non-systematic review of dose constraints for lung SBRT was performed, including the main organs at risk in the thorax.
Collapse
Affiliation(s)
- F De Rose
- Radiotherapy and Radiosurgery Department, Humanitas Cancer Center and Research Hospital, Milan, Italy
| | - D Franceschini
- Radiotherapy and Radiosurgery Department, Humanitas Cancer Center and Research Hospital, Milan, Italy
| | - G Reggiori
- Radiotherapy and Radiosurgery Department, Humanitas Cancer Center and Research Hospital, Milan, Italy
| | - A Stravato
- Radiotherapy and Radiosurgery Department, Humanitas Cancer Center and Research Hospital, Milan, Italy.
| | - P Navarria
- Radiotherapy and Radiosurgery Department, Humanitas Cancer Center and Research Hospital, Milan, Italy
| | - A M Ascolese
- Radiotherapy and Radiosurgery Department, Humanitas Cancer Center and Research Hospital, Milan, Italy
| | - S Tomatis
- Radiotherapy and Radiosurgery Department, Humanitas Cancer Center and Research Hospital, Milan, Italy
| | - P Mancosu
- Radiotherapy and Radiosurgery Department, Humanitas Cancer Center and Research Hospital, Milan, Italy
| | - M Scorsetti
- Radiotherapy and Radiosurgery Department, Humanitas Cancer Center and Research Hospital, Milan, Italy; Depart ment of Biomedical Sciences, Humanitas University, Milan, Italy
| |
Collapse
|
47
|
Navarria P, Pessina F, Tomatis S, Simonelli M, Santoro A, Ascolese A, Clerici E, Rossi M, Bello L, Scorsetti M. P09.36 A new therapeutic strategy for newly diagnosed glioblastoma patients: hypofractionated stereotactic radiation therapy (HSRT) delivered in 15 fractions respect to standard fractionation in 30 fractions, with concomitant temozolomide chemotherapy - A phase II study. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.292] [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
|
48
|
De Rose F, Franceschini D, Cozzi L, Comito T, D'Agostino G, Navarria P, Ascolese A, Tozzi A, Iftode C, Franzese C, Clerici E, Tomatis S, Fogliata A, Scorsetti M. Is There a Role for Stereotactic Body Radiation Therapy (SBRT) in Oligometastatic Breast Cancer? Results From an Observational Study. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.624] [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: 11/30/2022]
|
49
|
Pessina F, Navarria P, Ascolese A, Cozzi L, Tomatis S, Riva M, Rossi M, Scorsetti M, Bello L. P08.27 The role of supramarginal resection for single large brain metastases: feasibility, morbidity and local control evaluation. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.160] [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: 11/12/2022] Open
|
50
|
Navarria P, Ascolese A, Cozzi L, Tomatis S, Picozzi P, Pecchioli G, Attuati L, Clerici E, Maggi G, Scorsetti M. P19.03 Randomized double arm phase III study to evaluate feasibility and safety of Gamma Knife radiosurgery versus Linac Based (Edge) radiosurgery in brain metastatic patients. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.286] [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: 11/12/2022] Open
|