Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
-
To define the maximal tolerated dose of hypofractionated thoracic radiotherapy given with concurrent chemotherapy for limited-stage small cell lung cancer. ⋯ The maximal tolerated hypofractionated thoracic radiotherapy dose in this trial was 58 Gy in 25 daily fractions.
-
Comparative Study
Improving target delineation on 4-dimensional CT scans in stage I NSCLC using a deformable registration tool.
Correct target definition is crucial in stereotactic radiotherapy for lung tumors. We evaluated use of deformable registration (DR) for target contouring on 4-dimensional (4D) CT scans. ⋯ ITVs created in stage I tumors using DR were closer to 'clinically optimal' ITVs than was the case with a MIP-modified approach.
-
To assess the completeness and accuracy of stage and outcome data in the Anthology of Outcomes (AOs), a prospective point-of-care physician-collected electronic data system for patients at the Princess Margaret Hospital. ⋯ Our experience has demonstrated the feasibility of real-time outcome recording at point-of-care. New processes needed to improve the completeness of capture of patient outcomes in the AO have more recently been introduced. This successful system has been expanded to other disease sites.
-
Comparative Study
Single Arc Volumetric Modulated Arc Therapy of head and neck cancer.
The quality of Volumetric Modulated Arc Therapy (VMAT) plans is highly dependent on the performance of the optimization algorithm used. Recently new algorithms have become available which are capable of generating VMAT plans for Elekta accelerators. The VMAT algorithm in Pinnacle is named SmartArc and its capability to generate treatment plans for head and neck cancer was tested. ⋯ The target coverages obtained in the IMRT and VMAT plans were found to be very similar. SmartArc generated single arc VMAT plans with equivalent or better target coverage and sparing of OARs compared to IMRT, while both delivery time and MUs were decreased. Very good dose accuracy results were obtained delivering the plans on an Elekta accelerator.
-
Elective nodal irradiation (ENI) and involved field radiotherapy (IFRT) are definitive radiotherapeutic approaches used to treat patients with locally advanced non-small cell lung cancer (NSCLC). ENI delivers prophylactic radiation to clinically uninvolved lymph nodes, while IFRT only targets identifiable gross nodal disease. Because clinically uninvolved nodal stations may harbor microscopic disease, IFRT raises concerns for increased nodal failures. This retrospective cohort analysis evaluates failure rates and treatment-related toxicities in patients treated at a single institution with ENI and IFRT. ⋯ Nodal failure rates in clinically uninvolved nodal stations were not increased with IFRT when compared to ENI. IFRT also resulted in significantly decreased esophageal toxicity, suggesting that IFRT may allow for integration of concurrent systemic chemotherapy in a greater proportion of patients.