Novel irradiation techniques in the treatment of solid tumours. Radiotherapy of metastases

2014 ◽  
Vol 155 (8) ◽  
pp. 283-290
Author(s):  
Árpád Mayer ◽  
Zsuzsa Póti
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Clinical Target Volume ◽  
Primary Tumour ◽  
Target Volume ◽  
Solid Tumours ◽  
Cone Beam ◽  
Image Guided Radiotherapy ◽  
Image Guided ◽  
Technical Developments

Novel developments in percutaneous radiotherapy, such as positron emission tomography/computed tomography, adaptive radiation planning, intensity modulation radiotherapy and intensity modulated arc therapy (RapidArc), as well as the newer generation of image control (cone-beam computed tomography) and image guided radiotherapy ensure increased dosages of planning target volume and clinical target volume of solid tumours without damaging surrounding tissues and providing maximal protection. By raising the dosages of planned target volume and clinical target volume, these novel technical developments have created new indications in the treatment of solid tumours. With the aid of the cone-beam computed tomography and image guided radiotherapy the organ metastasis (lung, liver, spinal cord) and the primary tumour can be treated safety and effectively. Hypofractionation, dose escalation and the use of stereotactic devices can probably decrease radiation damage. The authors review the most common forms of evidence-based fractionation schemes used in irradiation therapy. Orv. Hetil., 2014, 155(8), 283–290.

scholarly journals Target coverage of daily cone-beam computed tomography in breath-hold image-guided radiotherapy for gastric lymphoma

BJR|Open ◽  
2021 ◽  
Vol 3 (1) ◽  
pp. 20200062
Author(s):  
Shigeo Takahashi ◽  
Takamasa Nishide ◽  
Masato Tsuzuki ◽  
Hiroki Katayama ◽  
Masahide Anada ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Gastric Lymphoma ◽  
Target Volume ◽  
Cone Beam ◽  
Breath Hold ◽  
Target Coverage ◽  
Image Guided Radiotherapy ◽  
Image Guided ◽  
The Mean

Objectives: We evaluated retrospectively the daily target coverage using cone-beam computed tomography (CBCT) in breath-hold image-guided radiotherapy (BH-IGRT) for gastric lymphoma. Methods: BH-IGRT was performed using a prescribed dose of 30.6 Gy in 17 fractions for the whole stomach. We assessed the target coverage of the whole stomach on daily CBCT images [daily clinical target volume (CTV)], which was delineated individually by two observers. We evaluated V95% (percentage of volume receiving ≥95% of the prescribed dose) of daily CTV. Results: In total, 102 fractions from 6 patients were assessed. The mean V95% of daily CTV was 97.2%, which was over 95%. In two of six patients, the V95% of daily CTV was over 95% for either observer in all fractions. One patient had significant interobserver variation (p = 0.013). In 95 fractions (93%), the V95% of daily CTV was over 95% for either observer. Conclusion: Daily target coverage for CTV in BH-IGRT for gastric lymphoma seems to be favorable, even when using CBCT. Advances in knowledge: A previous study ascertained good daily target coverage in BH-IGRT for gastric lymphoma using in-room CT. Even when using CBCT in our study, daily target coverage for CTV in BH-IGRT for gastric lymphoma seems to be favorable.

scholarly journals Low-Dose Image-Guided Pediatric CNS Radiation Therapy: Final Analysis From a Prospective Low-Dose Cone-Beam CT Protocol From a Multinational Pediatrics Consortium

2020 ◽  
Vol 19 ◽  
pp. 153303382092065 ◽  
Author(s):  
Sara R. Alcorn ◽  
Xian Chiong Zhou ◽  
Casey Bojechko ◽  
Rodrigo A. Rubo ◽  
Michael J. Chen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Central Nervous System ◽  
Nervous System ◽  
Cone Beam Computed Tomography ◽  
Target Volume ◽  
Cone Beam ◽  
Image Guided Radiotherapy ◽  
Image Guided ◽  
Setup Accuracy ◽  
Vector Magnitude

Background: Lower-dose cone-beam computed tomography protocols for image-guided radiotherapy may permit target localization while minimizing radiation exposure. We prospectively evaluated a lower-dose cone-beam protocol for central nervous system image-guided radiotherapy across a multinational pediatrics consortium. Methods: Seven institutions prospectively employed a lower-dose cone-beam computed tomography central nervous system protocol (weighted average dose 0.7 mGy) for patients ≤21 years. Treatment table shifts between setup with surface lasers versus cone-beam computed tomography were used to approximate setup accuracy, and vector magnitudes for these shifts were calculated. Setup group mean, interpatient, interinstitution, and random error were estimated, and clinical factors were compared by mixed linear modeling. Results: Among 96 patients, with 2179 pretreatment cone-beam computed tomography acquisitions, median age was 9 years (1-20). Setup parameters were 3.13, 3.02, 1.64, and 1.48 mm for vector magnitude group mean, interpatient, interinstitution, and random error, respectively. On multivariable analysis, there were no significant differences in mean vector magnitude by age, gender, performance status, target location, extent of resection, chemotherapy, or steroid or anesthesia use. Providers rated >99% of images as adequate or better for target localization. Conclusions: A lower-dose cone-beam computed tomography protocol demonstrated table shift vector magnitude that approximate clinical target volume/planning target volume expansions used in central nervous system radiotherapy. There were no significant clinical predictors of setup accuracy identified, supporting use of this lower-dose cone-beam computed tomography protocol across a diverse pediatric population with brain tumors.

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