scholarly journals Rectal Dose Is the Other Dosimetric Factor in Addition to Small Bowel for Prediction of Acute Diarrhea during Postoperative Whole-Pelvic Intensity-Modulated Radiotherapy in Gynecologic Patients

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 497
Author(s):  
Eng-Yen Huang ◽  
Yu-Ming Wang ◽  
Shih-Chen Chang ◽  
Shu-Yu Liu ◽  
Ming-Chung Chou
Keyword(s):  
Small Bowel ◽  
Acute Diarrhea ◽  
Intensity Modulated Radiotherapy ◽  
Gynecologic Malignancies ◽  
Image Guided Radiotherapy ◽  
Image Guided ◽  
Intensity Modulated ◽  
Rectal Dose ◽  
Different Levels ◽  
Gynecologic Patients

We studied the association of rectal dose with acute diarrhea in patients with gynecologic malignancies undergoing whole-pelvic (WP) intensity-modulated radiotherapy (IMRT). From June 2006 to April 2019, 108 patients with previous hysterectomy who underwent WP IMRT were enrolled in this cohort study. WP irradiation of 39.6–45 Gy/22–25 fractions was initially delivered to the patients. Common Terminology Criteria for Adverse Events (CTCAE) version 3 was used to evaluate acute diarrhea during radiotherapy. Small bowel volume at different levels of isodose curves (Vn%) and mean rectal dose (MRD) were measured for statistical analysis. The multivariate analysis showed that the MRD ≥ 32.75 Gy (p = 0.005) and small bowel volume of 100% prescribed (V100%) ≥ 60 mL (p = 0.008) were independent factors of Grade 2 or higher diarrhea. The cumulative incidence of Grade 2 or higher diarrhea at 39.6 Gy were 70.5%, 42.2%, and 15.0% (p < 0.001) in patients with both high (V100% ≥ 60 mL and MRD ≥ 32.75 Gy), either high, and both low volume-dose factors, respectively. Strict constraints for the rectum/small bowel or image-guided radiotherapy to reduce these doses are suggested.

scholarly journals Tumor motion in lung cancers: An overview of four-dimensional radiotherapy treatment of lung cancers

2017 ◽  
Vol 03 (02) ◽  
pp. 128-132
Author(s):  
Anusheel Munshi ◽  
Nilaxi Khataniar ◽  
Tharmar Ganesh
Keyword(s):  
Intensity Modulated Radiotherapy ◽  
Critical Question ◽  
Active Motion ◽  
Image Guided Radiotherapy ◽  
Lung Cancers ◽  
Image Guided ◽  
Intensity Modulated ◽  
A Site ◽  
Head Neck ◽  
Radiotherapy Treatment

AbstractMost modern radiotherapy centers have adopted contouring based treatment. Sparing of the normal structures has been made more achievable than ever before by use of technologies such as Intensity Modulated Radiotherapy (IMRT) and Image guided radiotherapy (IGRT). However, unlike, sites such as brain or head neck, thorax is a site in active motion, mostly contributed by patient's respiratory movement. 4 D radiotherapy, that addresses the issues of motion in thoracic tumours answers this critical question. The present article outlines the scope of need for 4 D radiotherapy and discusses the options available for 4 D treatments of cancer patients.

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.

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 Use of hydrogel spacer for improved rectal dose-sparing in patients undergoing radical radiotherapy for localized prostate cancer: First Canadian experience

2017 ◽  
Vol 11 (12) ◽  
pp. 373-5 ◽  
Author(s):  
Alejandro Berlin ◽  
Anne Di Tomasso ◽  
Heather Ballantyne ◽  
Susan Patterson ◽  
Tony Lam ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Intensity Modulated Radiotherapy ◽  
Initial Experience ◽  
Radical Radiotherapy ◽  
Image Guided ◽  
Intensity Modulated ◽  
Canadian Experience ◽  
Rectal Dose ◽  
Canadian Setting ◽  
The Impact

We describe the initial experience using a hydrogel spacer (SpaceOAR) to separate the prostate-rectum interspace in patients planned to undergo radical hypofractionated image-guided intensity-modulated radiotherapy (IG-IMRT). We depict and discuss the impact of SpaceOAR in the context of hypofractionated IG-IMRT, and the particular considerations for its applications in the Canadian setting.

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