Preoperative Radiation Therapy With Simultaneous Integrated Boost Dose Escalation for Optimal Local Control of Retroperitoneal Dedifferentiated Liposarcoma

2017 ◽  
Vol 98 (2) ◽  
pp. 272-273 ◽  
Author(s):  
Ivy A. Petersen
Keyword(s):  
Radiation Therapy ◽  
Local Control ◽  
Dose Escalation ◽  
Simultaneous Integrated Boost ◽  
Dedifferentiated Liposarcoma ◽  
Preoperative Radiation ◽  
Preoperative Radiation Therapy ◽  
Integrated Boost ◽  
Boost Dose

scholarly journals Comparison of Simultaneous Integrated Boost and Late-course Boost Intensity-modulated Radiation Therapy in the Treatment of Esophageal Carcinoma

2021 ◽  
Author(s):  
Yu Xiao ◽  
Guobo Du ◽  
Jianping Hu ◽  
Tingting Wu ◽  
Xue Meng ◽  
...  
Keyword(s):  
Overall Survival ◽  
Radiation Therapy ◽  
Esophageal Carcinoma ◽  
Local Control ◽  
Intensity Modulated Radiation Therapy ◽  
Simultaneous Integrated Boost ◽  
Entire Group ◽  
Target Area ◽  
Intensity Modulated ◽  
Integrated Boost

Abstract This paper aimed to analyze and compare the outcomes of esophageal carcinoma treated with simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT) and late-course boost intensity-modulated radiation therapy (LCB-IMRT). The retrospective study was designed to analyze the clinical data of 274 esophageal cancer patients who received radical radiotherapy in the Oncology Department of our hospital, from January 2014 to December 2017. Propensity score matching analysis was used to balance the variable differences in the two groups. Survival, toxicities, and target dose were observed and compared between the two groups. Statistical analysis was performed using SPSS 24.0 software. P<0.05 judged to be statistically significant. 200 patients were finally included after propensity scores matching , The 1-, 3-, and 5-year overall survival and local control rates of the entire group were 80.5% vs. 67.6%, 38.2% vs. 31.3%，and 22.2% vs. 20.4%, respectively. The 1-, 3-, and 5-year overall survival rates of the SIB-IMRT and LCB-IMRT group were 85.0% vs. 76.0%, 41.8% vs. 34.5%, and 25.5% vs. 21.3%, respectively (P＞0.05). The 1-, 3-, and 5- year local control rates of the SIB-IMRT and LCB-IMRT group were 77.3% vs. 58.0%, 31.4% vs. 30.1%, and 20.0% vs. 20.7%, respectively (P＞0.05). The recent total effective rates of the SIB-IMRT and LCB-IMRT group were 96.0% vs. 92.0% (P＞0.05). There were statistically significant differences in the incidence of ≥2 grade acute radiation esophagitis and pneumonia between the two groups (P＜0.05). The does of lung V5, lung V10, lung Dmean, and spinal cord Dmax in the SIB-IMRT group were significantly lower than those in LCB-IMRT group (P＜0.05). Patients age, tumor location, tumor length, gross tumor target volume, N stage were independent prognostic factors of overall survival and local control. Compared with the LCB-IMRT group, the survival prognosis of the SIB-IMRT group has benefit trend, patients in the SIB-IMRT group received less radiation dose to the normal organs around the target area, and the toxicities effects of radiotherapy were lighter, which is more conducive to the protection of normal tissues around the target area.

Effect of intensity-modulated radiation therapy with SIB technique on local control and toxicity for neoadjuvant pelvic radiation with concurrent 5-fluorouracil based chemotherapy for rectal cancer compared with three-dimensional conformal radiation therapies.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 632-632
Author(s):  
Nitika Thawani ◽  
Vyas Shilpa ◽  
Shaakir Hasan ◽  
Gabriel Axelrud ◽  
Deb Niloyjyoti ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Radiation Therapy ◽  
Local Control ◽  
Intensity Modulated Radiation Therapy ◽  
Simultaneous Integrated Boost ◽  
P Value ◽  
Hematologic Toxicity ◽  
Pelvic Radiation ◽  
Intensity Modulated ◽  
Integrated Boost

632 Background: To compare the areas of residual disease after neoadjuvant pelvic radiation with 5-FU based chemotherapy for rectal cancer using Intensity Modulated Radiation Therapy (IMRT) with simultaneous integrated boost (SIB) technique compared to 3D Conformal Radiation Therapy (3DCRT) Methods: Fourty nine (49) consecutive rectal cancer patients treated with pelvic radiation and concurrent 5-FU based chemotherapy were analyzed. We compared twenty-eight (28) patients treated on an institutional IMRT protocol versus twenty-one (21) patients treated with 3DCRT. All patients received 45-50.4 Gy to the pelvis in 3DCRT group. All patients with IMRT received 45 Gy in 25 fractions to the pelvic no des. The primary rectal tumor recieved a simultaneous integrated boost to a dose of 50 Gy in 25 fractions. IMRT planning was done with dose constraints for bladder, rectum, and small bowel and bone marrow. All patients in both groups received 5-FU based chemotherapy during radiation. Evaluation of toxicity was based on RTOG criteria. 2 patients in the 3DCRT group and 2 in IMRT group received either growth factors or blood-products transfusion and needed hospitalization during treatment secondary to acute toxicities. Results: All patients completed their prescribed course of radiation. CR rates were 5/21(23%) in 3DCRT and 4/28(25%) in the IMRT-SIB (p-value 0.74). 9/21(42%) in 3D and 19/29(65%) in the IMRT group underwent Low anterior resection according to the location of the tumor. There was no grade 4 toxicity in the IMRT-SIB group. Overall grade 2 toxicity in 3D Vs IMRT-SIB group was - GI -52% Vs 19%, GU- 8% Vs 8%, skin 42 Vs 4%, hematologic 33 Vs 47%. Overall Grade 1 toxicity in 3DCRT Vs IMRT group was- GI- 33% Vs 52%, GU 23% vs 28%, Skin 52% Vs 38%, hematologic 4% Vs 33%. Conclusions: Neoadjuvant pelvic radiation with 5 FU for rectal cancer has similar local control rates. There is less GI, skin and hematologic toxicity when delivered via IMRT-SIB versus 3DCRT. IMRT is safe and may allow dose escalation with potential probability of increased tumor response.

scholarly journals Preoperative radiation therapy with selective dose escalation to the margin at risk for retroperitoneal sarcoma

Cancer ◽  
2006 ◽  
Vol 107 (2) ◽  
pp. 371-379 ◽  
Author(s):  
Ching-Wei D. Tzeng ◽  
John B. Fiveash ◽  
Richard A. Popple ◽  
J. Pablo Arnoletti ◽  
Suzanne M. Russo ◽  
...  
Keyword(s):  
At Risk ◽  
Radiation Therapy ◽  
Dose Escalation ◽  
Retroperitoneal Sarcoma ◽  
Preoperative Radiation ◽  
Preoperative Radiation Therapy

scholarly journals Simultaneous integrated boost concepts in definitive radiation therapy for esophageal cancer: outcomes and toxicity

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
J. Ristau ◽  
M. Thiel ◽  
S. Katayama ◽  
I. Schlampp ◽  
K. Lang ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Radiation Therapy ◽  
Retrospective Analysis ◽  
Dose Escalation ◽  
Cancer Survival ◽  
Intensity Modulated Radiotherapy ◽  
Progression Free Survival ◽  
Distant Metastases ◽  
Simultaneous Integrated Boost ◽  
Integrated Boost

Abstract Background Radiation therapy and chemoradiation therapy play a major role in the definitive management of esophageal cancer. Survival in esophageal cancer patients is still relatively poor, mostly due to high rates of local recurrence and distant metastases. It is hypothesized that dose escalation in radiotherapy could improve outcomes. Therefore, this retrospective analysis aimed to investigate the outcomes and toxicity in patients treated with local dose escalation by means of using simultaneous integrated boost concepts. Methods Between 2012 and 2018, 101 patients with esophageal carcinoma were analyzed in this monocentric, retrospective study. All patients received definitive chemoradiation or radiation therapy alone as intensity modulated radiotherapy. The prescribed dose was 50.4 Gy in 28 fractions to the primary tumor and the elective lymph nodes as well as a simultaneous integrated boost (SIB) with 58.8 Gy to macroscopic tumor and lymph node metastases. Endpoints were overall survival (OS), progression free survival (PFS), local control rate (LCR) and toxicity. Results 60 patients (59.4%) received chemoradiation, 41 patients (40.6%) radiotherapy alone. The median follow up was 17 months (range 0–75 months). OS, PFS and LCR were at 63.9%, 53.9% and 59.9% after 1 year and 37.6%, 34.5% and 36.1%, respectively after 3 years. 16 patients (15.8%) in total developed a locoregional recurrence within the field of radiation. In 48 patients (47.5%) at least one grade III° (CTCAE) toxicity was documented during radiotherapy, mostly dysphagia (36 pat., 75%). One patient suffered from a grade IV° pneumonia. Conclusion This retrospective analysis demonstrates that a SIB concept in definitive (chemo)radiation therapy is safe and feasible, showing acceptable outcomes in this patient cohort. Considering that this cohort mainly consists of elderly patients not eligible for chemotherapy in many cases, we emphasize the aspect of SIB radiation therapy as potential partial compensation for omitted simultaneous chemotherapy. Prospective studies are needed for validation.

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