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المؤلفون: Steffen Löck, Beate Timmermann, Almut Dutz, Armin Lühr, M.R. Bussiere, Helen A. Shih, Xavier Vermeren, Mechthild Krause, Dirk Geismar, Michael H. Baumann, L. Agolli, Chiara Valentini, Emily S. Lebow, Esther G.C. Troost, Jillian E. Daly, Nayan Lamba, Rebecca Bütof, Marc R. Bussière
المصدر: Radiotherapy and Oncology. 157:15-23
مصطلحات موضوعية: Mild hearing impairment, medicine.medical_specialty, Medizin, Estimating equations, Logistic regression, 030218 nuclear medicine & medical imaging, Cohort Studies, Optic neuropathy, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Proton Therapy, medicine, Humans, Radiology, Nuclear Medicine and imaging, Probability, Receiver operating characteristic, Brain Neoplasms, business.industry, Hematology, medicine.disease, Oncology, 030220 oncology & carcinogenesis, Cohort, Quality of Life, Radiology, Complication, business
الوصف: Background The limited availability of proton beam therapy (PBT) requires individual treatment selection strategies that can be based on normal tissue complication probability (NTCP) models. We developed and externally validated NTCP models for common late side-effects following PBT in brain tumour patients to optimise patients’ quality of life. Methods Cohorts from three PBT centres (216 patients) were investigated for several physician-rated endpoints at 12 and 24 months after PBT: alopecia, dry eye syndrome, fatigue, headache, hearing and memory impairment, and optic neuropathy. Dose-volume parameters of associated normal tissues and clinical factors were used for logistic regression modelling in a development cohort. Statistically significant parameters showing high area under the receiver operating characteristic curve (AUC) values in internal cross-validation were externally validated. In addition, analyses of the pooled cohorts and of time-dependent generalised estimating equations including all patient data were performed. Results In the validation study, mild alopecia was related to high dose parameters to the skin [e.g. the dose to 2% of the volume (D2%)] at 12 and 24 months after PBT. Mild hearing impairment at 24 months after PBT was associated with the mean dose to the ipsilateral cochlea. Additionally, the pooled analyses revealed dose–response relations between memory impairment and intermediate to high doses to the remaining brain as well as D2% of the hippocampi. Mild fatigue at 24 months after PBT was associated with D2% to the brainstem as well as with concurrent chemotherapy. Moreover, in generalised estimating equations analysis, dry eye syndrome was associated with the mean dose to the ipsilateral lacrimal gland. Conclusion We developed and in part validated NTCP models for several common late side-effects following PBT in brain tumour patients. Validation studies are required for further confirmation.
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المؤلفون: Christoph Henkenberens, Martin Stuschke, Claus Belka, Daniel Martin, Bülent Polat, Panagiotis Balermpas, Christian Weiß, Guido Hildebrandt, Cihan Gani, Stephanie E. Combs, Thomas Brunner, Chiara Valentini, David Krug, Claus Rödel, Jürgen Debus, Matthias G. Hautmann, Thomas Kuhnt, Emmanouil Fokas, Ursula Nestle, Henning Schäfer, Tilman Bostel, Rita Engenhart-Cabillic, Johannes Gollrad
المساهمون: University of Zurich, Fokas, Emmanouil
المصدر: Clinical and Translational Radiation Oncology
Clinical and Translational Radiation Oncology, Vol 23, Iss, Pp 43-49 (2020)مصطلحات موضوعية: Oncology, Durvalumab, DFS, disease-free survival, medicine.medical_treatment, R895-920, Medizin, RT, radiotherapy, PD-1, programmed death receptor 1, 030218 nuclear medicine & medical imaging, law.invention, Medical physics. Medical radiology. Nuclear medicine, 0302 clinical medicine, Randomized controlled trial, law, Disease, RC254-282, free survival, cCR, clinical complete response, HPV infection, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, 10044 Clinic for Radiation Oncology, Primary tumor, CT, computed tomography, 030220 oncology & carcinogenesis, 2730 Oncology, Immunotherapy, medicine.medical_specialty, Disease-free survival, PD-L1, programmed death receptor ligand 1, 610 Medicine & health, Phase 2, Article, OS, overall survival, 03 medical and health sciences, Internal medicine, medicine, 2741 Radiology, Nuclear Medicine and Imaging, Anal cancer, Radiology, Nuclear Medicine and imaging, Radiochemotherapy, MMC, mitomycin C, business.industry, Mitomycin C, Anal Squamous Cell Carcinoma, medicine.disease, Radiation therapy, RCT, radiochemotherapy, ASCC, anal squamous cell carcinoma, 5-FU, 5-fluorouracil, business, MRI, magnetic resonance imaging
الوصف: Highlights • The 3-year disease-free survival of locally-advanced anal carcinoma is about 60%. • Anal carcinoma is considered an immunogenic tumor due to its association with HPV. • The PD-L1 inhibitor durvalumab may synergize with radiochemotherapy. • The RADIANCE trial will test durvalumab with radiochemotherapy in anal carcinoma.
Purpose Anal squamous cell carcinomas (ASCC) are increasing in frequency across the developed world. The 3-year disease-free survival (DFS) in patients with locally-advanced disease is approximately 60% after primary radiochemotherapy (RCT). There is a strong rationale for combining immunotherapy with RCT in patients with ASCC due to its association with human papilloma virus (HPV) infection. Methods/design RADIANCE is an investigator initiated, prospective, multicenter, randomized phase II trial testing the addition of Durvalumab, a PD-L1 immune checkpoint inhibitor, to standard RCT in 178 patients with locally advanced ASCC (T2 ≥ 4 cm Nany, cT3-4 and/or cN+). In the control arm, patients will be treated with standard mitomycin C (MMC)/5-fluorouracil (5-FU)-based RCT. Intensity-modulated radiotherapy (IMRT) will be applied as follows: PTV_A (primary tumor) T1-T2وصف الملف: 1-s2.0-S2405630820300343-main.pdf - application/pdf
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المؤلفون: L. Agolli, Rebecca Bütof, Steffen Löck, Armin Lühr, Mechthild Krause, Michael H. Baumann, Chiara Valentini, Almut Dutz
المصدر: Radiotherapy and Oncology. 143:108-116
مصطلحات موضوعية: Adult, Oncology, medicine.medical_specialty, medicine.medical_treatment, Irradiated Volume, Lateralization of brain function, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Relative Volume, Surveys and Questionnaires, Internal medicine, Proton Therapy, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Brain Neoplasms, business.industry, Montreal Cognitive Assessment, Cognition, Hematology, Radiation therapy, 030220 oncology & carcinogenesis, Quality of Life, Neoplasm Recurrence, Local, business, Neurocognitive
الوصف: Background Neurocognitive function of adult patients with brain tumours may deteriorate after radiotherapy. Proton beam therapy (PBT) reduces the volume of irradiated healthy brain tissue and could potentially preserve neurocognition and quality of life (QoL). As present data are still limited, the impact of clinical factors and dosimetric parameters on neurocognitive function and QoL during recurrence-free follow-up after PBT is investigated. Methods The current study includes 62 brain tumour patients treated with PBT between 2015 and 2017. Neurocognition and QoL were assessed at baseline and every 3 months after PBT using the Montreal Cognitive Assessment (MoCA) test together with EORTC-QLQ-C30 and BN20 questionnaires, respectively. Objective and self-reported measures of neurocognitive functions were correlated. During two years of follow-up, the impact of clinical co-factors as well as dosimetric parameters of several brain structures were analysed using a mixed-model approach. Results At baseline, mean MoCA total score was 24.8/30 and self-reported cognitive function was 68.9/100. Both remained stable over time. Patients with impaired neurocognition on the MoCA test reported significantly lower global health status, cognitive, physical and role function as well as more fatigue, pain, headache and communication deficits compared to normal performing patients. For most follow-up time points, the majority of MoCA subitems correlated significantly to QoL items regarding neurocognition. Slight deterioration of the MoCA score was associated with tumours located in the left hemisphere and with an increase in relative volume of the anterior cerebellum that received doses of 30–40 Gy(RBE). Conclusion Self-reported and objectively measured neurocognition and most other QoL domains remained largely stable over time during recurrence-free follow-up for brain tumour patients treated with PBT. The association between reduced cognitive function and irradiated volume of the anterior cerebellum requires validation in larger studies and comparison to patients treated with photon therapy.
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المؤلفون: Mechthild Krause, Ute Ganswindt, Florian Exner, Jonas Haehnle, Esther G.C. Troost, Philipp Süss, Florian Kamp, Jan Hofmaier, Christian Thieke, Katrin Teichert, Christian Richter, Karl-Heinz Küfer, Claus Belka, Tobias Hölscher, Christopher Kurz, Carolin Arnsmeyer, Chiara Valentini, Katia Parodi, Lucas Hille, Guillaume Landry
المساهمون: Publica
المصدر: Zeitschrift für Medizinische Physik 29(2019)3, 216-228
مصطلحات موضوعية: Male, medicine.medical_treatment, Biophysics, Patient positioning, Radiation Dosage, Multi-objective optimization, Patient Positioning, 030218 nuclear medicine & medical imaging, Cohort Studies, 03 medical and health sciences, Imaging, Three-Dimensional, 0302 clinical medicine, Treatment plan, Histogram, Proton Therapy, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Head and neck, Proton therapy, Radiological and Ultrasound Technology, business.industry, Radiotherapy Planning, Computer-Assisted, Prostatic Neoplasms, Radiotherapy Dosage, Radiation therapy, Head and Neck Neoplasms, Radiotherapy, Intensity-Modulated, Tomography, X-Ray Computed, business, Nuclear medicine, Interpolation
الوصف: Proton radiotherapy (PT) requires accurate target alignment before each treatment fraction, ideally utilizing 3D in-room X-ray computed tomography (CT) imaging. Typically, the optimal patient position is determined based on anatomical landmarks or implanted markers. In the presence of non-rigid anatomical changes, however, the planning scenario cannot be exactly reproduced and positioning should rather aim at finding the optimal position in terms of the actually applied dose. In this work, dose-guided patient alignment, implemented as multicriterial optimization (MCO) problem, was investigated in the scope of intensity-modulated and double-scattered PT (IMPT and DSPT) for the first time. A method for automatically determining the optimal patient position with respect to pre-defined clinical goals was implemented. Linear dose interpolation was used to access a continuous space of potential patient shifts. Fourteen head and neck (H&N) and eight prostate cancer patients with up to five repeated CTs were included. Dose interpolation accuracy was evaluated and the potential dosimetric advantages of dose-guided over bony-anatomy-based patient alignment investigated by comparison of clinically relevant target and organ-at-risk (OAR) dose-volume histogram (DVH) parameters. Dose interpolation was found sufficiently accurate with average pass-rates of 90% and 99% for an exemplary H&N and prostate patient, respectively, using a 2% dose-difference criterion. Compared to bony-anatomy-based alignment, the main impact of automated MCO-based dose-guided positioning was a reduced dose to the serial OARs (spinal cord and brain stem) for the H&N cohort. For the prostate cohort, under-dosage of the target structures could be efficiently diminished. Limitations of dose-guided positioning were mainly found in reducing target over-dosage due to weight loss for H&N patients, which might require adaptation of the treatment plan. Since labor-intense online quality-assurance is not required for dose-guided patient positioning, it might, nevertheless, be considered an interesting alternative to full online re-planning for initially mitigating the effects of anatomical changes.
وصف الملف: application/pdf
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المؤلفون: Stefano Maffini, Giovanni Magnani, Alessia Mattivi, Chiara Valentini, Matteo Burigotto, Alexander Schmidt, Andreas Villunger, Massimo Pizzato, Daniele Migliorati, Luca L. Fava, Martin Offterdinger, Michela Roccuzzo
المصدر: The EMBO Journal
مصطلحات موضوعية: p53, proteolysis, Multiprotein complex, DNA damage, Cell fate determination, Biology, Cleavage (embryo), General Biochemistry, Genetics and Molecular Biology, Article, 03 medical and health sciences, 0302 clinical medicine, Neoplastic transformation, Molecular Biology, 030304 developmental biology, Centrosome, 0303 health sciences, General Immunology and Microbiology, General Neuroscience, Articles, Cell cycle, PIDDosome, Cell biology, centrosome, cell cycle, Autophagy & Cell Death, Cell Adhesion, Polarity & Cytoskeleton, 030217 neurology & neurosurgery, Cytokinesis, DNA Damage
الوصف: Centrosome amplification results into genetic instability and predisposes cells to neoplastic transformation. Supernumerary centrosomes trigger p53 stabilization dependent on the PIDDosome (a multiprotein complex composed by PIDD1, RAIDD and Caspase‐2), whose activation results in cleavage of p53’s key inhibitor, MDM2. Here, we demonstrate that PIDD1 is recruited to mature centrosomes by the centriolar distal appendage protein ANKRD26. PIDDosome‐dependent Caspase‐2 activation requires not only PIDD1 centrosomal localization, but also its autoproteolysis. Following cytokinesis failure, supernumerary centrosomes form clusters, which appear to be necessary for PIDDosome activation. In addition, in the context of DNA damage, activation of the complex results from a p53‐dependent elevation of PIDD1 levels independently of centrosome amplification. We propose that PIDDosome activation can in both cases be promoted by an ANKRD26‐dependent local increase in PIDD1 concentration close to the centrosome. Collectively, these findings provide a paradigm for how centrosomes can contribute to cell fate determination by igniting a signalling cascade.
ANKRD26‐dependent PIDD1 recruitment is involved in p53 activation both upon genotoxic stress and in the presence of supernumerary centrosomes.URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::07afb911a22bfbe2cc03a5dd6c48a921
https://www.embopress.org/doi/full/10.15252/embj.2020104844 -
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المؤلفون: Linda Agolli, Mechthild Krause, Rebecca Bütof, Esther G.C. Troost, Dirk Geismar, Beate Timmermann, Xavier Vermeren, Michael H. Baumann, Almut Dutz, Steffen Löck, Armin Lühr, Chiara Valentini
المصدر: Radiotherapy and Oncology 160(2021), 69-77
مصطلحات موضوعية: Organs at Risk, medicine.medical_specialty, Erythema, Medizin, cranial radiotherapy, 030218 nuclear medicine & medical imaging, Temporal lobe, 03 medical and health sciences, 0302 clinical medicine, Proton Therapy, Endocrine system, Medicine, Humans, NTCP models, Radiology, Nuclear Medicine and imaging, Clinical significance, model-based-approach, Probability, Retrospective Studies, Cranial radiotherapy, business.industry, Brain Neoplasms, Radiotherapy Planning, Computer-Assisted, Hematology, proton beam therapy, Patient benefit, Oncology, 030220 oncology & carcinogenesis, Radiology, Radiotherapy, Intensity-Modulated, medicine.symptom, business, Complication, Tinnitus
الوصف: Background The limited availability of proton beam therapy (PBT) requires individual treatment selection strategies, such as the model-based approach. In this study, we assessed the dosimetric benefit of PBT compared to photon therapy (XRT), analysed the corresponding changes in normal tissue complication probability (NTCP) on a variety of available models, and illustrated model-based patient selection in an in-silico study for patients with brain tumours. Methods For 92 patients treated at two PBT centres, volumetric modulated arc therapy treatment plans were retrospectively created for comparison with the clinically applied PBT plans. Several dosimetric parameters for the brain excluding tumour and margins, cerebellum, brain stem, frontal and temporal lobes, hippocampi, cochleae, chiasm, optic nerves, lacrimal glands, lenses, pituitary gland, and skin were compared between both modalities using Wilcoxon signed-rank tests. NTCP differences (ΔNTCP) were calculated for 11 models predicting brain necrosis, delayed recall, temporal lobe injury, hearing loss, tinnitus, blindness, ocular toxicity, cataract, endocrine dysfunction, alopecia, and erythema. A patient was assumed to be selected for PBT if ΔNTCP exceeded a threshold of 10 percentage points for at least one of the side-effects. Results PBT substantially reduced the dose in almost all investigated OARs, especially in the low and intermediate dose ranges and for contralateral organs. In general, NTCP predictions were significantly lower for PBT compared to XRT, in particular in ipsilateral organs. Considering ΔNTCP of all models, 80 patients (87.0%) would have been selected for PBT in this in-silico study, mainly due to predictions of a model on delayed recall (51 patients). Conclusion In this study, substantial dose reductions for PBT were observed, mainly in contralateral organs. However, due to the sigmoidal dose response, NTCP was particularly reduced in ipsilateral organs. This underlines that physical dose-volume parameters alone may not be sufficient to describe the clinical relevance between different treatment techniques and highlights potential benefits of NTCP models. Further NTCP models for different modern treatment techniques are mandatory and existing models have to be externally validated in order to implement the model-based approach in clinical practice for cranial radiotherapy.
وصف الملف: application/pdf
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المؤلفون: Gian Carlo Mattiucci, Alessio G. Morganti, Lorenzo Fuccio, Michele Reni, Alessia Re, Felipe A. Calvo, Alessandra Arcelli, Francesco Cellini, Sergio Alfieri, Robert C. Miller, William F. Regine, Massimo Falconi, Vincenzo Valentini, Giancarmine Di Gioia, F. Bertini, Chiara Valentini, Joseph M. Herman, Riccardo Casadei, Milly Buwenge, Francesco Minni, Paolo Passoni, Mariacristina Di Marco, Savino Cilla, Francesco Deodato, Bert W. Maidment, Gabriella Macchia, Alessandra Guido
المساهمون: Morganti A.G., Cellini F., Buwenge M., Arcelli A., Alfieri S., Calvo F.A., Casadei R., Cilla S., Deodato F., Di Gioia G., Di Marco M., Fuccio L., Bertini F., Guido A., Herman J.M., Macchia G., Maidment B.W., Miller R.C., Minni F., Passoni P., Valentini C., Re A., Regine W.F., Reni M., Falconi M., Valentini V., Mattiucci G.C., Morganti, A. G., Cellini, F., Buwenge, M., Arcelli, A., Alfieri, S., Calvo, F. A., Casadei, R., Cilla, S., Deodato, F., Di Gioia, G., Di Marco, M., Fuccio, L., Bertini, F., Guido, A., Herman, J. M., Macchia, G., Maidment, B. W., Miller, R. C., Minni, F., Passoni, P., Valentini, C., Re, A., Regine, W. F., Reni, M., Falconi, M., Valentini, V., Mattiucci, G. C.
المصدر: BMC Cancer
BMC Cancer, Vol 19, Iss 1, Pp 1-10 (2019)مصطلحات موضوعية: Male, 0301 basic medicine, Cancer Research, medicine.medical_treatment, Kaplan-Meier Estimate, Gastroenterology, law.invention, 0302 clinical medicine, Randomized controlled trial, law, Surgical oncology, 80 and over, Stage (cooking), Pancreatic neoplasm, Adjuvant, Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA, Aged, 80 and over, Univariate analysis, Radiation, Radiotherapy Dosage, Chemoradiotherapy, Middle Aged, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Tumor Burden, Treatment Outcome, Oncology, Pancreatic Ductal, 030220 oncology & carcinogenesis, Female, Dose effect, Research Article, Carcinoma, Pancreatic Ductal, Adult, medicine.medical_specialty, CA-19-9 Antigen, lcsh:RC254-282, Dose-Response Relationship, 03 medical and health sciences, Radiotherapy, Aged, Chemoradiotherapy, Adjuvant, Dose-Response Relationship, Radiation, Follow-Up Studies, Humans, Lymph Nodes, Multivariate Analysis, Neoplasm Grading, Pancreatic Neoplasms, Retrospective Studies, Pancreatic cancer, Internal medicine, Genetics, medicine, business.industry, Carcinoma, Retrospective cohort study, medicine.disease, Radiation therapy, 030104 developmental biology, business
الوصف: Background: To evaluate the impact of radiation dose on overall survival (OS) in patients treated with adjuvant chemoradiation (CRT) for pancreatic ductal adenocarcinoma (PDAC). Methods: A multicenter retrospective analysis on 514 patients with PDAC (T1-4; N0-1; M0) treated with surgical resection with macroscopically negative margins (R0-1) followed by adjuvant CRT was performed. Patients were stratified into 4 groups based on radiotherapy doses (group 1: < 45 Gy, group 2: ≥ 45 and < 50 Gy, group 3: ≥ 50 and < 55 Gy, group 4: ≥ 55 Gy). Adjuvant chemotherapy was prescribed to 141 patients. Survival functions were plotted using the Kaplan-Meier method and compared through the log-rank test. Results: Median follow-up was 35 months (range: 3-120 months). At univariate analysis, a worse OS was recorded in patients with higher preoperative Ca 19.9 levels (≥ 90 U/ml; p < 0.001), higher tumor grade (G3-4, p = 0.004), R1 resection (p = 0.004), higher pT stage (pT3-4, p = 0.002) and positive nodes (p < 0.001). Furthermore, patients receiving increasing doses of CRT showed a significantly improved OS. In groups 1, 2, 3, and 4, median OS was 13.0 months, 21.0 months, 22.0 months, and 28.0 months, respectively (p = 0.004). The significant impact of higher dose was confirmed by multivariate analysis. Conclusions: Increasing doses of CRT seems to favorably impact on OS in adjuvant setting. The conflicting results of randomized trials on adjuvant CRT in PDAC could be due to < 45 Gy dose generally used.
وصف الملف: ELETTRONICO
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المؤلفون: Julia Thiele, Daniela Aust, Chiara Valentini, Stefan Brückner, Jochen Hampe, Fabian Lohaus, Rudi Apolle, Esther G.C. Troost, Susanne Frosch, Jana Babatz, Maximilian Rehm
المصدر: Radiotherapy and Oncology 133(2019), 28-34
مصطلحات موضوعية: Male, Esophageal Neoplasms, medicine.medical_treatment, 030218 nuclear medicine & medical imaging, Fluorodeoxyglucose positron emission tomography, Cohort Studies, fiducial markers, 03 medical and health sciences, 0302 clinical medicine, Fiducial Markers, Fluorodeoxyglucose F18, proton therapy, Proton Therapy, Medicine, Humans, Radiology, Nuclear Medicine and imaging, Proton therapy, Aged, Retrospective Studies, business.industry, Radiotherapy Planning, Computer-Assisted, image-guided radiotherapy, Implanted Fiducial, Hematology, Oesophageal carcinoma, Gold marker, Middle Aged, Radiation therapy, oesophageal carcinoma, Oncology, Treatment delivery, 030220 oncology & carcinogenesis, Positron-Emission Tomography, Gold, Protons, Radiopharmaceuticals, Fiducial marker, business, Nuclear medicine, Radiotherapy, Image-Guided
الوصف: Background and purpose Oesophageal mobility relative to bony anatomy is a major source of geometrical uncertainty in proton radiotherapy of oesophageal carcinoma. To mitigate this uncertainty we investigated the use of implanted fiducial markers for direct target verification in terms of safety, visibility, and stability. Materials and methods A total of 19 helical gold markers were endoscopically implanted in ten patients. Their placement at the proximal and distal tumour borders was compared to tumour demarcations derived from [18F]Fluorodeoxyglucose positron emission tomography, their visibility quantified via the contrast-to-noise ratio on daily orthogonal X-ray imaging, and their mobility relative to bony anatomy analysed by means of retrospective triangulation. Results Marker implantation proceeded without complications, but the distal tumour border could not be reached in two patients. Marker locations corresponded reasonably well with metabolic tumour edges (mean: 5.4 mm more distally). Marker visibility was limited but mostly sufficient (mean contrast-to-noise ratio: 1.5), and sixteen markers (84%) remained in situ until the end of treatment. Overall, marker excursions from their planned position were larger than 5(10) mm in 59(17)% of all analysed fractions. On one occasion severe target displacement was only identified via markers and was corrected before treatment delivery. Conclusion Implanted helical gold fiducial markers are a safe and reliable method of providing target-centric positioning verification in proton beam therapy of oesophageal carcinoma.
وصف الملف: application/pdf
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المؤلفون: Stefania Manfrida, Bruce D. Minsky, Vincenzo Valentini, D. Pasini, Chiara Valentini, N. Caria, Maria Antonietta Gambacorta, G.C. Mattiucci, Luca Boldrini, N. Dinapoli, Giuditta Chiloiro
المصدر: Oncotarget
مصطلحات موضوعية: Male, Quality Control, medicine.medical_specialty, Colorectal cancer, clinical use of automatic delineation software, Locally advanced, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Software, independent check, Radiation oncology, medicine, Humans, Computer Simulation, Medical physics, Prospective Studies, automatic delineation software, rectal cancer, rectal cancer delineation, Prospective cohort study, Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA, Aged, Lumbar Vertebrae, Radiotherapy, Rectal Neoplasms, business.industry, Radiotherapy Planning, Computer-Assisted, Computational Biology, Reproducibility of Results, Middle Aged, medicine.disease, Clinical Practice, Oncology, 030220 oncology & carcinogenesis, Radiation Oncology, Automatic segmentation, Female, Tomography, X-Ray Computed, business, Quality assurance, Algorithms, Research Paper
الوصف: To validate autocontouring software (AS) in a clinical practice including a two steps delineation quality assurance (QA) procedure. The existing delineation agreement among experts for rectal cancer and the overlap and time criteria that have to be verified to allow the use of AS were defined. Median Dice Similarity Coefficient (MDSC), Mean slicewise Hausdorff Distances (MSHD) and Total-Time saving (TT) were analyzed. Two expert Radiation Oncologists reviewed CT-scans of 44 patients and agreed the reference-CTV: the first 14 consecutive cases were used to populate the software Atlas and 30 were used as Test. Each expert performed a manual (group A) and an automatic delineation (group B) of 15 Test patients. The delineations were compared with the reference contours. The overlap between the manual and automatic delineations with MDSC and MSHD and the TT were analyzed. Three acceptance criteria were set: MDSC ≥ 0.75, MSHD ≤1mm and TT sparing ≥ 50%. At least 2 criteria had to be met, one of which had to be TT saving, to validate the system. The MDSC was 0.75, MSHD 2.00 mm and the TT saving 55.5% between group A and group B. MDSC among experts was 0.84. Autosegmentation systems in rectal cancer partially met acceptability criteria with the present version.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dba744e5e6308c4a86ff80886896b80b
https://doi.org/10.18632/oncotarget.9938 -
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المؤلفون: Antje Sommerer, C. Gumina, Rebecca Bütof, Michael Baumann, Steffen Appold, Steffen Löck, Esther G.C. Troost, Daniel Zips, Chiara Valentini
المصدر: Clinical and Translational Radiation Oncology
Clinical and Translational Radiation Oncology 7(2017), 36-42
Radiotherapy and Oncology 123(2017), S658-S659
Clinical and Translational Radiation Oncology, Vol 7, Iss, Pp 36-42 (2017)مصطلحات موضوعية: Oncology, medicine.medical_specialty, Prognostic variable, medicine.medical_treatment, overall survival, R895-920, Selective node irradiation, Article, 030218 nuclear medicine & medical imaging, Medical physics. Medical radiology. Nuclear medicine, 03 medical and health sciences, 0302 clinical medicine, Recurrence, Internal medicine, medicine, Recurrent disease, distant metastases, Radiology, Nuclear Medicine and imaging, RC254-282, Small cell lung cancer, Radiotherapy, business.industry, site of relapse, Standard treatment, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Mediastinum, prognostic factors, SCLC, medicine.disease, Primary tumor, Radiation therapy, medicine.anatomical_structure, 030220 oncology & carcinogenesis, radiochemotherapy, Lymph, locoregional control, NODAL, business
الوصف: Highlights • Most recurrences occurred within the primary tumor or initially affected lymph nodes. • All sites of loco-regional recurrence had received 92–106% of the prescribed dose. • No isolated nodal failure occurred, supporting the use of selective nodal irradiation.
Objectives Concurrent radiochemotherapy (RCHT) is standard treatment in locally advanced small cell lung cancer (SCLC) patients. Due to conflicting results on elective nodal irradiation (ENI) or selective node irradiation (SNI) there is no clear evidence on optimal target volumes. Therefore, the purposes of this study were to assess the sites of recurrent disease in SCLC and to evaluate the feasibility of SNI versus ENI. Methods A retrospective single-institution study of 43 consecutive patients treated with RCHT was performed. After state-of-the-art staging including FDG-PET/CT, all patients underwent three-dimensional conformal radiotherapy to a total dose of 45 Gy in twice-daily fractions of 1.5 Gy starting concurrently with the first or second chemotherapy cycle. All sites of loco-regional recurrences were correlated to the initial tumor and dose delivered. The impact of potential prognostic variables on outcome was evaluated using the Cox-regression model. Results 13 patients (30%) relapsed locally or regionally: six within the initial primary tumor volume, five within the initially affected lymph nodes, one metachronously within primary tumor and initially affected lymph nodes, and one both inside and outside of the initial nodal disease. All sites of loco-regional recurrence had received 92–106% of the prescribed dose. Conclusion In our study most recurrences occurred within the primary tumor or initially affected lymph nodes, or distantly. We did not register any case of isolated nodal failure, supporting the use of selective nodal irradiation, possibly with the addition of supraclavicular irradiation in patients with nodal disease in the upper mediastinum.وصف الملف: application/pdf; application/vnd.openxmlformats-officedocument.wordprocessingml.document
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