scholarly journals Image Guided Radiotherapy by CBCT based Position Verification in High Risk Carcinoma Prostate - an Indian experience and review of literature

2013 ◽  
Vol 5 (2) ◽  
pp. 14-20
Author(s):  
Rashi Agrawal ◽  
Dinesh Singh ◽  
Sudarsan De ◽  
Sweety Gupta
Keyword(s):  
External Beam Radiotherapy ◽  
Treatment Options ◽  
Locally Advanced ◽  
Medical Science ◽  
Intensity Modulated Radiotherapy ◽  
Target Volume ◽  
Rectal Toxicity ◽  
Image Guided Radiotherapy ◽  
Image Guided

Introduction-External beam radiotherapy is one of the principle treatment options for locally advanced prostate cancer. Over the past several decades, RT techniques have evolved to allow higher doses of radiation to be administered safely. We report our experience of Image guided intensity modulated radiotherapy (IGRT) and CBCT based position verification. Material and methods- In this study we are presenting data of 17 consecutive patients that were treated from august 2009 to october 2010. All patients received 76 -78 Gy Gy to clinical target volume for primary disease. Daily online matching was performed by using KV CBCT scan before treatment. In each patient, soft tissue (prostate) matching was done by the radiation oncologist. Results – Median Follow up of our patients is 16 months with minimum follow up of 13 months. 3(17.6%) patients developed grade 2 acute rectal toxicity and 4 (23.5%) bladder toxicity. Till date none of our patients had late bladder or rectal toxicity. None of our patient developed local recurrence. Conclusion-Our study concludes that we can follow the dose escalation with CBCT based position verification .With CBCT we can consider entire prostate and normal structures volume for localization. DOI: http://dx.doi.org/10.3126/ajms.v5i2.8382 Asian Journal of Medical Science, Volume-5(2014): 14-20

Feasibility of tomotherapy to reduce cochlea radiation dose in patients with locally advanced nasopharyngeal cancer

2012 ◽  
Vol 98 (6) ◽  
pp. 709-714 ◽  
Author(s):  
Nam P Nguyen ◽  
Misty Ceizyk ◽  
Vincent Vinh-Hung ◽  
Thomas Sroka ◽  
Siyoung Jang ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Radiation Dose ◽  
Locally Advanced ◽  
Nasopharyngeal Cancer ◽  
Target Volume ◽  
Image Guided Radiotherapy ◽  
Image Guided ◽  
The Mean ◽  
The Right

Aims and background To evaluate the effectiveness of tomotherapy-based image-guided radiotherapy (IGRT) on the radiation dose to the cochlea in patients with nasopharyngeal cancer. Methods and study design A retrospective review of five patients undergoing concurrent chemoradiation with tomotherapy for locally advanced nasopharyngeal cancer was performed. Results The mean dose to the right and left cochlea was 25 Gy and 35.3 Gy respectively, while the dose to the gross tumor ranged from 70 to 75 Gy. All patients had excellent clinical response to the treatment at a median follow-up of five months. Conclusions IGRT for head and neck cancer delivered by tomotherapy can significantly decrease the radiation dose to the cochlea without sacrificing target volume coverage.

Treatment delivery, intensity-modulated radiotherapy, and image-guided radiotherapy

2013 ◽  
Author(s):  
Carl Rowbottom
Keyword(s):  
Radiation Dose ◽  
External Beam Radiotherapy ◽  
Intensity Modulated Radiotherapy ◽  
External Beam ◽  
Treatment Delivery ◽  
Image Guided Radiotherapy ◽  
Cancer Management ◽  
Image Guided ◽  
Intensity Modulated ◽  
Complex Processes

Chapter 3 discusses how successful delivery of external beam radiotherapy involves a number of complex processes beginning with the decision by the clinical oncologist to use radiotherapy as part of the patient’s cancer management, through the preparation and planning of the patient’s treatment, to the verification of the patient position and radiation dose delivered at the time of treatment.

An evaluation of ultrasound localisation for verification of external beam radiotherapy to the prostate

2006 ◽  
Vol 5 (2) ◽  
pp. 109-116
Author(s):  
J. Richards
Keyword(s):  
External Beam Radiotherapy ◽  
Three Dimensional ◽  
Intensity Modulated Radiotherapy ◽  
Invasive Technique ◽  
Portal Imaging ◽  
Image Guided Radiotherapy ◽  
Image Guided ◽  
Electronic Portal Imaging ◽  
Physiological Processes ◽  
Accurate Treatment

The recent advent of highly conformal three-dimensional radiotherapy techniques and Intensity Modulated Radiotherapy now allows higher radiation doses to be delivered. It is well-documented that the prostate is susceptible to both interfraction and intrafraction movements due to various physiological processes. Therefore there has been a recent general consensus that good immobilisation and electronic portal imaging is no longer sufficient to ensure accurate treatment verification. This idea has led to the concept of image-guided radiotherapy, which includes modalities such as cone-beam computed tomography and ultrasound to localise the prostate prior to treatment.There has been considerable research undertaken to determine the effectiveness of each of the image guided modalities and these studies have identified the benefit and limitations of each modality. Ultrasound is a non-invasive technique using a suprapubic ultrasound probe, which seems to be quite promising in terms of cost and time. However until large scales studies are performed which demonstrate the value of using ultrasound localisation, as an alternative to electronic portal imaging, it is likely that current practice will remain unchanged.

scholarly journals Intensity-Modulated and Image-Guided Radiotherapy in Patients with Locally Advanced Inoperable Pancreatic Cancer after Preradiation Chemotherapy

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
M. Sinn ◽  
R. Ganeshan ◽  
R. Graf ◽  
U. Pelzer ◽  
J. M. Stieler ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Locally Advanced ◽  
Advanced Pancreatic Cancer ◽  
Intensity Modulated Radiotherapy ◽  
Image Guided Radiotherapy ◽  
Image Guided ◽  
Intensity Modulated ◽  
Kaplan Meier ◽  
Median Dosage

Background. Radiotherapy (RT) in patients with pancreatic cancer is still a controversial subject and its benefit in inoperable stages of locally advanced pancreatic cancer (LAPC), even after induction chemotherapy, remains unclear. Modern radiation techniques such as image-guided radiotherapy (IGRT) and intensity-modulated radiotherapy (IMRT) may improve effectiveness and reduce radiotherapy-related toxicities.Methods. Patients with LAPC who underwent radiotherapy after chemotherapy between 09/2004 and 05/2013 were retrospectively analyzed with regard to preradiation chemotherapy (PRCT), modalities of radiotherapy, and toxicities. Progression-free (PFS) and overall survival (OS) were estimated by Kaplan-Meier curves.Results. 15 (68%) women and 7 men (median age 64 years; range 40–77) were identified. Median duration of PRCT was 11.1 months (range 4.3–33.0). Six patients (27%) underwent conventional RT and 16 patients (73%) advanced IMRT and IGRT; median dosage was 50.4 (range 9–54) Gray. No grade III or IV toxicities occurred. Median PFS (estimated from the beginning of RT) was 5.8 months, 2.6 months in the conventional RT group (conv-RT), and 7.1 months in the IMRT/IGRT group (P=0.029); median OS was 11.0 months, 4.2 months (conv-RT), and 14.0 months (IMRT/IGRT);P=0.141. Median RT-specific PFS for patients with prolonged PRCT>9 months was 8.5 months compared to 5.6 months for PRCT<9 months (P=0.293). This effect was translated into a significantly better median RT-specific overall survival of patients in the PRCT>9 months group, with 19.0 months compared to 8.5 months in the PRCT  <  9 months group (P=0.049).Conclusions. IGRT and IMRT after PRCT are feasible and effective options for patients with LAPC after prolonged preradiation chemotherapy.

scholarly journals Prostatic fiducial markers implantation by transrectal ultrasound for adaptive image guided radiotherapy in localized cancer: 7-years experience

2014 ◽  
Vol 86 (4) ◽  
pp. 349 ◽  
Author(s):  
Vito Lacetera ◽  
Massimo Cardinali ◽  
Giovanna Mantello ◽  
Francesco Fenu ◽  
Giulia Sbrollini ◽  
...  
Keyword(s):  
Clinical Stage ◽  
Transrectal Ultrasound ◽  
Late Toxicity ◽  
Target Volume ◽  
Late Complications ◽  
Fiducial Markers ◽  
Image Guided Radiotherapy ◽  
Image Guided ◽  
The Mean

Objective: we present our 7-years’ experience with fiducial gold markers inserted before Image-Guided Radiotherapy (IGRT) focusing on our echo-guided technique reporting early and late complications. Material and methods: 78 prostate cancer (PCA) patients who underwent fiducial markers placement for adaptive IGRT (period 2007-2014) were selected. Mean patient age was 75 years (range 60-81), mean PSA 7.8 ng/ml (range 3.1-10), clinical stage &lt; T3, mean Gleason Score 6.4 (range 6-7). We recorded early and late complications. Maximum distance between the Clinical Target Volume (CTV) and Planning Target Volume (PTV) was assessed for each direction and the mean PTV reduction was estimated. Results: we describe in details our echo-guided technique of intraprostatic gold fiducial markers insertion prior to adaptative IGRT. We report rare early toxicity (5-7% grade 1-2), a mean PTV reduction of 37% and a very low late toxicity (only 3.4% bladder G3 and 8% rectal G2 side effects). Conclusion: Our technique of fiducial gold markers implantation for adaptative IGRT is safe and well-tolerated and it resulted helpful to reduce CTV-PTV margin in all cases; the effects on clinical practice seem significant in terms of late toxicity but further investigations are needed with longer follow-up.

Treatment delivery, intensity-modulated radiotherapy, and image-guided radiotherapy

2019 ◽  
pp. 27-52
Author(s):  
Yat Man Tsang
Keyword(s):  
Radiation Dose ◽  
External Beam Radiotherapy ◽  
Intensity Modulated Radiotherapy ◽  
External Beam ◽  
Treatment Delivery ◽  
Image Guided Radiotherapy ◽  
Cancer Management ◽  
Image Guided ◽  
Intensity Modulated ◽  
Complex Processes

Chapter 3 discusses how successful delivery of external beam radiotherapy such as intensity-modulated radiotherapy and image-guided radiotherapy involves a number of complex processes beginning with the decision by the clinical oncologist to use radiotherapy as part of the patient’s cancer management, through the preparation and planning of the patient’s treatment, to the verification of the patient position and radiation dose delivered at the time of treatment.

scholarly journals Interstitial HDR Brachytherapy in the Treatment of Non-Melanocytic Skin Cancers around the Eye

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1425
Author(s):  
Paweł Cisek ◽  
Dariusz Kieszko ◽  
Mateusz Bilski ◽  
Radomir Dębicki ◽  
Ewelina Grywalska ◽  
...  
Keyword(s):  
External Beam Radiotherapy ◽  
Late Complication ◽  
Target Volume ◽  
Lower Eyelid ◽  
High Dose Rate ◽  
High Dose ◽  
Hdr Brachytherapy ◽  
Lateral Canthus ◽  
Skin Cancers

Background: Eyelid tumors are rare skin cancers, the most common of which is basal cell carcinoma characterized primarily by local growth. In addition to surgery, radiotherapy is among the basic methods of treatment. External beam radiotherapy is associated with the risk of complications within ocular structures, especially the lens. In the case of interstitial brachytherapy, it is possible to administer a high dose to the clinical target volume (CTV), while reducing it in the most sensitive structures. Methods: This paper presents the results of an analysis of 28 patients treated with interstitial high dose rate (HDR) brachytherapy for skin cancers of the upper and lower eyelid; medial and lateral canthus; and the cheek, nose and temples with the infiltration of ocular structures. The patients were treated according to two irradiation schedules: 49 Gy in 14 fractions of 3.5 Gy twice a day for 7 days of treatment, and 45 Gy in 5 Gy fractions twice a day for 5 days. The mean follow-up was 22 months (3–49 months). Results: two patients (6%) had a relapse: a local recurrence within the irradiated area in one of them, and metastases to lymph nodes in the other. The most common early complication was conjunctivitis (74%), and the most common late complication was dry eye syndrome (59%). Conclusions: Interstitial HDR brachytherapy for skin cancers of the upper and lower eyelid; medial and lateral cants; and the cheek, nose and temples with infiltration of ocular structures is a highly effective, short and relatively low burden type of treatment.

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