Body mass index, dose to organs at risk during vaginal brachytherapy, and the role of three-dimensional CT-based treatment planning

Modern computer networks provide satisfying levels of data recording and verification between the treatment planning system (TPS) and the accelerators, while the main weakness of the preparation chain remains the simulation. When a conventional simulator is employed, it may adversely affect the three-dimensional treatment planning system (3DPS) process because of the difficulty to document the leaf positions on the simulator location films and on the patient's skin. With a conventional simulator, hard copies of the DRRs of each field and CT scans at isocenter level are needed. In an attempt to transfer more information displayed from a BEV perspective from the 3DPS to simulator radiographs, this study aimed to reduce the quality loss by using a 2D conventional simulator in a 3DPS process. We realized an acetate photocopy of TPS data for each field, from a BEV perspective, containing: DRR, wire frames of the PTV, organs at risk and MLC aperture. The photocopies, with an appropriate magnification factor to obtain a correct projective value (ratio 1:1) at isocenter level, are carefully placed on the radiographic images on the same hard copy which allows us to better understand possible setup errors and obliges us to correct these. The method provides reliable documentation, facilitates treatment verification, and fulfils the criteria for MLC simulation. It is accurate, simple, and very inexpensive.

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EP-1171: The impact of body mass index on organs at risk in breast axillary nodal radiotherapy

Radiotherapy and Oncology ◽

10.1016/s0167-8140(16)32421-5 ◽

2016 ◽

Vol 119 ◽

pp. S558

Author(s):

L. Pettit ◽

A. Welsh ◽

C. Puzey-Kibble ◽

M. Williams ◽

J. Santos ◽

...

Keyword(s):

Body Mass Index ◽

At Risk ◽

Body Mass ◽

Organs At Risk ◽

The Impact

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Body Mass Index and Doses at Organs at Risk Evaluated by CT in a Mediterranean Postoperative Vaginal Cuff Brachytherapy (VCB) Cancer Population

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2014.05.1523 ◽

2014 ◽

Vol 90 (1) ◽

pp. S494

Author(s):

S. Sabater ◽

R. Berenguer ◽

I. Andres ◽

M. Sevillano ◽

A. Rovirosa ◽

...

Keyword(s):

Body Mass Index ◽

At Risk ◽

Body Mass ◽

Organs At Risk ◽

Vaginal Cuff

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Body Mass Index and Doses at Organs at Risk in a Mediterranean Population Treated with Postoperative Vaginal Cuff Brachytherapy

Cancer Research and Treatment ◽

10.4143/crt.2014.115 ◽

2014 ◽

Vol 47 (3) ◽

pp. 473-479 ◽

Cited By ~ 3

Author(s):

Sebastia Sabater ◽

Meritxell Arenas ◽

Roberto Berenguer ◽

Ignacio Andres ◽

Esther Jimenez-Jimenez ◽

...

Keyword(s):

Body Mass Index ◽

At Risk ◽

Body Mass ◽

Organs At Risk ◽

Mediterranean Population ◽

Vaginal Cuff

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Atlas Sampling for Prone Breast Automatic Segmentation of Organs at Risk: The Importance of Patients’ Body Mass Index and Breast Cup Size for an Optimized Contouring of the Heart and the Coronary Vessels

Technology in Cancer Research & Treatment ◽

10.1177/1533033820920624 ◽

2020 ◽

Vol 19 ◽

pp. 153303382092062

Author(s):

Xinzhuo Wang ◽

Raymond Miralbell ◽

Odile Fargier-Bochaton ◽

Shelley Bulling ◽

Jean Paul Vallée ◽

...

Keyword(s):

Body Mass Index ◽

At Risk ◽

Body Mass ◽

Clinical Target Volume ◽

Organs At Risk ◽

Automatic Segmentation ◽

Coronary Vessels ◽

Target Volume ◽

Breast Volume ◽

Mean Similarity

Objective: Delineation of organs at risk is a time-consuming task. This study evaluates the benefits of using single-subject atlas-based automatic segmentation of organs at risk in patients with breast cancer treated in prone position, with 2 different criteria for choosing the atlas subject. Together with laterality (left/right), the criteria used were either (1) breast volume or (2) body mass index and breast cup size. Methods: An atlas supporting different selection criteria for automatic segmentation was generated from contours drawn by a senior radiation oncologist (RO_A). Atlas organs at risk included heart, left anterior descending artery, and right coronary artery. Manual contours drawn by RO_A and automatic segmentation contours of organs at risk and breast clinical target volume were created for 27 nonatlas patients. A second radiation oncologist (RO_B) manually contoured (M_B) the breast clinical target volume and the heart. Contouring times were recorded and the reliability of the automatic segmentation was assessed in the context of 3-D planning. Results: Accounting for body mass index and breast cup size improved automatic segmentation results compared to breast volume-based sampling, especially for the heart (mean similarity indexes >0.9 for automatic segmentation organs at risk and clinical target volume after RO_A editing). Mean similarity indexes for the left anterior descending artery and the right coronary artery edited by RO_A expanded by 1 cm were ≥0.8. Using automatic segmentation reduced contouring time by 40%. For each parameter analyzed (eg, D2%), the difference in dose, averaged over all patients, between automatic segmentation structures edited by RO_A and the same structure manually drawn by RO_A was <1.5% of the prescribed dose. The mean heart dose was reliable for the unedited heart segmentation, and for right-sided treatments, automatic segmentation was adequate for treatment planning with 3-D conformal tangential fields. Conclusions: Automatic segmentation for prone breast radiotherapy stratified by body mass index and breast cup size improved segmentation accuracy for the heart and coronary vessels compared to breast volume sampling. A significant reduction in contouring time can be achieved by using automatic segmentation.

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Three-dimensional treatment planning for vaginal cuff brachytherapy: Dosimetric effects on organs at risk according to patients position

Brachytherapy ◽

10.1016/j.brachy.2014.06.001 ◽

2014 ◽

Vol 13 (6) ◽

pp. 568-571 ◽

Cited By ~ 5

Author(s):

Giuseppe Iatì ◽

Antonio Pontoriero ◽

Stefania Mondello ◽

Anna Brogna ◽

Andrea Di Pasquale ◽

...

Keyword(s):

At Risk ◽

Treatment Planning ◽

Organs At Risk ◽

Three Dimensional ◽

Vaginal Cuff

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STEROID RECEPTOR PHENOTYPE, EXPRESSION OF HER-2/NEU, PD-1, PD-L1 AND LYMPHOCYTIC-MACROPHAGAL INFILTRATION OF ENDOMETRIAL CARCINOMAS: COMPARISON OF MODERN MOLECULAR BIOLOGICAL TYPES OF THE DISEASE (THE ROLE OF BODY MASS INDEX)

Problems in oncology ◽

10.37469/0507-3758-2020-66-1-71-78 ◽

2020 ◽

Vol 66 (1) ◽

pp. 71-78

Author(s):

Lev Bershteyn ◽

Aleksandr Ivantsov ◽

Aglaya Ievleva ◽

A. Venina ◽

I. Berlev

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Tumor Tissue ◽

Immunohistochemical Analysis ◽

The Body ◽

Molecular Profile ◽

Total N ◽

Number Of Patients ◽

Her 2

The aim of this study was to evaluate steroid receptors’ status of tumor tissue in different molecular biological types of endometrial cancer (EC), subdivided according to the current classification, and their colonization by lymphocytic and macrophage cells, taking into account body mass index of the patients. Materials and methods: Material from treatment-naive patients with EC (total n = 229) was included; the number of sick persons varied depending on the method used. The average age of patients was close to 60 years, and about 90% of them were postmenopausal. It was possible to divide the results of the work into two main subgroups: a) depending on the molecular biological type of the tumor (determined on the basis of genetic and immunohistochemical analysis), and b) depending on the value of the body mass index (BMI). The latter approach was used in patients with EC type demonstrating a defective mismatch repair of the incorrectly paired nucleotides (MMR-D) and with a type without characteristic molecular profile signs (WCMP), but was not applied (due to the smaller number of patients) in EC types with a POLE gene mutation or with expression of the oncoprotein p53. According to the data obtained, when comparing various types of EC, the lowest values of Allred ER and PR scores were revealed for POLE-mutant and p53 types, while the “triple-negative” variant of the tumor (ER-, PR-, HER2/neu-) was most common in POLE-mutant (45.5% of cases) and WCMP (19.4%) types of EC. The p53+ type of EC is characterized by inclination to the higher expression of the macrophage marker CD68 and lymphocytic Foxp3, as well as mRNA of PD-1 and SALL4. In addition to the said above, for WCMP type of EC is peculiar, on the contrary, a decrease in the expression of lymphocytic markers CD8 (protein) and PD-L1 (mRNA). When assessing the role of BMI, its value of >30.0 (characteristic for obesity) was combined with an inclination to the increase of HER-2/neu expression in the case of MMR-D EC type and to the decrease of HER-2 /neu, FOXp3 and ER expression in WCMP type. Conclusions: The accumulated information (mainly describing here hormonal sensitivity of the tumor tissue and its lymphocytic-macrophage infiltration) additionally confirms our earlier expressed opinion that the differences between women with EC are determined by both the affiliation of the neoplasm to one or another molecular biological type (subdivided according to the contemporary classification), as well as by body mass value and (very likely) the associated hormonal and metabolic attributes.

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Combination of sleep duration, TV time and body mass index is associated with cardiometabolic risk moderated by age in youth

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2020-0399 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Ana P. Sehn ◽

Anelise R. Gaya ◽

Caroline Brand ◽

Arieli F. Dias ◽

Roya Kelishadi ◽

...

Keyword(s):

Body Mass Index ◽

Risk Factor ◽

Sleep Duration ◽

Body Mass ◽

Cardiometabolic Risk ◽

High Systolic Blood Pressure ◽

Television Time ◽

The Relationship ◽

Moderating Role

AbstractObjectivesThe combination of sleep duration, television (TV) time and body mass index (BMI) may be related to the alteration of cardiometabolic risk. However, there are few studies that use these variables grouped, and showing the moderating role of age. This study aimed to verify if the combination of sleep duration, TV time and BMI is associated with cardiometabolic risk and the moderating role of age in this relationship in youth.MethodsCross-sectional study conducted with 1411 adolescents (611 male), aged 10–17 years. Sleep duration, TV time and BMI were assessed and grouped into eight categories. Cardiometabolic risk was assessed by a continuous metabolic risk score, including the following variables: low HDL-cholesterol, elevated triglycerides, dysglycemia, high systolic blood pressure, high waist circumference and low cardiorespiratory fitness. Generalized linear models were used to test moderation of age in the relationship between the eight categories of sleep duration/television time/BMI with cardiometabolic risk.ResultsCardiometabolic risk factor showed association with all overweight or obesity independent of sleep time and TV time. Age moderated the relationship between sleep duration/television time/BMI with cardiometabolic risk. This association was stronger in younger adolescents (11 and 13 years), indicating that individuals with inadequate sleep, prolonged TV time and overweight/obesity present higher cardiometabolic risk values when compared to 15-year-old adolescents.ConclusionOverweight/obesity, independently of sleep duration and TV time, is the main risk factor for cardiometabolic disorders in adolescence. When moderated by age, younger adolescents that presented the combination of risk factors had higher cardiometabolic risk.

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