首页 > 最新文献

International Journal of Particle Therapy最新文献

英文 中文
Novel Monthly Quality Assurance Regimen and 5-Year Analysis Using a Proton Metrology System 新的每月质量保证方案和使用质子计量系统的5年分析
Q2 Medicine Pub Date : 2023-10-30 DOI: 10.14338/ijpt-23-00004.1
Ozgur Ates, Jackie Faught, Fakhriddin Pirlepesov, David Sobczak, Chia-ho Hua, Thomas E. Merchant
Purpose To develop a novel, monthly quality assurance (QA) regimen for a proton therapy system that uses 2 custom phantoms, each housing a commercial scintillator detector and a charge-coupled device camera. The novel metrology system assessed QA trends at a pediatric proton therapy center from 2018 to 2022. Materials and Methods The measurement system was designed to accommodate horizontal and vertical positioning of the commercial device and to enable gantry and couch isocentricity measurements (using a star shot procedure), proton spot profile verification, and imaging and radiation congruence tests to be performed simultaneously in the dual-phantom setup. Gantry angles and proton beam energies were varied and alternated each month, using gantry angles of 0°, 30°, 60°, 90°, 120°, 150°, and 180° and discrete beam energies of 69.4, 84.5, 100, 139.1, 180.4, 200.4, and 221.3 MeV after radiographic verification. A total of 1176 individual monthly QA measurements of gantry and couch isocentricity, spot size, and congruence were analyzed. Results Gantry and couch star shot measurements showed beam isocentricities of 0.3 ± 0.2 mm and 0.2 ± 0.2 mm, respectively, which were within the threshold of 1.0 mm. Spot sizes for each discrete energy were within the threshold of ± 10% of the baseline values for all 3 proton rooms. The imaging and radiation coincidence test results for the 1176 individual monthly QA measurements were 0.5 mm for the 50th percentile and 1.2 mm (the clinical threshold) for the 97.6th percentile. Conclusions Integrating a commercial device with custom phantoms improved the quality of proton system checks compared with previous methods using radiochromic films, loose ball bearings, and foam. The scheme of alternating beam angles with discrete energies in the monthly QA-enabled, clinically meaningful verification of beam energy and gantry angle combinations while the machine performance and accuracy were being checked.
目的为质子治疗系统开发一种新颖的、每月质量保证(QA)方案,该系统使用2个定制的幻影,每个幻影包含一个商业闪烁体探测器和一个电荷耦合器件相机。新型计量系统评估了2018年至2022年儿科质子治疗中心的QA趋势。测量系统被设计为适应商业设备的水平和垂直定位,并使龙门和沙发等心性测量(使用星射程序)、质子点轮廓验证、成像和辐射一致性测试在双幻影设置中同时进行。门架角度和质子束能量每月变化和交替,门架角度为0°,30°,60°,90°,120°,150°和180°,放射学验证后的离散光束能量为69.4,84.5,100,139.1,180.4,200.4和221.3 MeV。本研究分析了1176个个体每月的龙门架和沙发等心度、斑点大小和一致性的QA测量结果。结果龙门和沙发星射测得的光束等心度分别为0.3±0.2 mm和0.2±0.2 mm,均在1.0 mm的阈值范围内。每个离散能量的光斑大小在所有3个质子室基线值的±10%的阈值内。1176个个体每月QA测量的成像和辐射一致性测试结果为0.5 mm(第50百分位数)和1.2 mm(临床阈值)为97.6百分位数。结论:与以往使用放射致色膜、滚珠轴承和泡沫的方法相比,将商业设备与定制的幻影集成可以提高质子系统检查的质量。在检查机器性能和精度的同时,每月qa中具有离散能量的交变光束角方案使光束能量和龙门角组合具有临床意义的验证。
{"title":"Novel Monthly Quality Assurance Regimen and 5-Year Analysis Using a Proton Metrology System","authors":"Ozgur Ates, Jackie Faught, Fakhriddin Pirlepesov, David Sobczak, Chia-ho Hua, Thomas E. Merchant","doi":"10.14338/ijpt-23-00004.1","DOIUrl":"https://doi.org/10.14338/ijpt-23-00004.1","url":null,"abstract":"Purpose To develop a novel, monthly quality assurance (QA) regimen for a proton therapy system that uses 2 custom phantoms, each housing a commercial scintillator detector and a charge-coupled device camera. The novel metrology system assessed QA trends at a pediatric proton therapy center from 2018 to 2022. Materials and Methods The measurement system was designed to accommodate horizontal and vertical positioning of the commercial device and to enable gantry and couch isocentricity measurements (using a star shot procedure), proton spot profile verification, and imaging and radiation congruence tests to be performed simultaneously in the dual-phantom setup. Gantry angles and proton beam energies were varied and alternated each month, using gantry angles of 0°, 30°, 60°, 90°, 120°, 150°, and 180° and discrete beam energies of 69.4, 84.5, 100, 139.1, 180.4, 200.4, and 221.3 MeV after radiographic verification. A total of 1176 individual monthly QA measurements of gantry and couch isocentricity, spot size, and congruence were analyzed. Results Gantry and couch star shot measurements showed beam isocentricities of 0.3 ± 0.2 mm and 0.2 ± 0.2 mm, respectively, which were within the threshold of 1.0 mm. Spot sizes for each discrete energy were within the threshold of ± 10% of the baseline values for all 3 proton rooms. The imaging and radiation coincidence test results for the 1176 individual monthly QA measurements were 0.5 mm for the 50th percentile and 1.2 mm (the clinical threshold) for the 97.6th percentile. Conclusions Integrating a commercial device with custom phantoms improved the quality of proton system checks compared with previous methods using radiochromic films, loose ball bearings, and foam. The scheme of alternating beam angles with discrete energies in the monthly QA-enabled, clinically meaningful verification of beam energy and gantry angle combinations while the machine performance and accuracy were being checked.","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136105606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Proton Therapy in the Treatment of Men with Breast Cancer 质子疗法治疗男性乳腺癌
Q2 Medicine Pub Date : 2023-10-25 DOI: 10.14338/ijpt-23-00007.1
Julie A. Bradley, Jayden Gracie, Raymond B. Mailhot Vega, Eric D. Brooks, Tenna Burchianti, Oluwadamilola T. Oladeru, Xiaoying Liang, Nancy P. Mendenhall
Abstract Purpose Male breast cancer treatment involves multimodality therapy, including radiation therapy; nevertheless, few men have received proton therapy (PT) for it. Further, heart disease is an established leading cause of death in men, and radiation therapy heart dose correlates with cardiac toxicity, highlighting the need for cardiac-sparing radiation techniques. Thus, we provide a descriptive analysis of PT in a male breast cancer cohort. Patients and Methods Men who received PT for localized breast cancer between 2012 and 2022 were identified from a prospective database. Toxicities were prospectively recorded by using the Common Terminology Criteria for Adverse Events (CTCAE), version 4.0. Results Five male patients were identified. All had estrogen receptor (ER)–positive, Her2neu-negative disease and received adjuvant endocrine therapy. One had genetic testing positive for BRCA2, one had a variant of unknown significance (VUS) in the APC gene, and one had a VUS in MSH2. Median age was 73 years (range, 41–80). Baseline comorbidities included obesity (n = 1), diabetes (n = 1), hypertension (n = 4), history of deep vein thrombosis (n = 1), personal history of myocardial infarction (n = 3; 1 with a pacemaker), and a history of lung cancer (n = 1). All received PT to the left chest wall and comprehensive regional lymphatics. One received passive-scattering PT, and 4 received pencil beam scanning. One patient received a boost to the mastectomy incision via electrons. Median heart dose was 1 GyRBE (range, 0–1.0), median 0.1-cm3 dose to the left anterior descending artery was 7.5 GyRBE (range, 0–14.2), and median follow-up was 2 years (range, 0.75–6.5); no patient experienced a new cardiac event, and all remain free from breast cancer recurrence and progression. Conclusion In a small case series for a rare diagnosis, PT to the chest wall and regional lymphatics, including internal mammary nodes, resulted in low cardiac exposure, high local regional disease control rates, and minimal toxicity. Proton therapy should be considered for treating men with breast cancer to achieve cardiac sparing.
【摘要】目的男性乳腺癌的治疗涉及多模式治疗,包括放射治疗;然而,很少有男性接受质子治疗(PT)。此外,心脏病是男性死亡的主要原因,心脏放射治疗剂量与心脏毒性相关,突出了对心脏保护放射技术的需求。因此,我们对男性乳腺癌队列中的PT进行了描述性分析。患者和方法从前瞻性数据库中确定2012年至2022年间接受局部乳腺癌PT治疗的男性。使用不良事件通用术语标准(CTCAE) 4.0版本前瞻性记录毒性。结果男性患者5例。所有患者均为雌激素受体(ER)阳性,her2new阴性,并接受辅助内分泌治疗。其中一人的BRCA2基因检测呈阳性,一人在APC基因中有未知意义的变异(VUS),一人在MSH2中有VUS。中位年龄为73岁(范围41-80岁)。基线合并症包括肥胖(n = 1)、糖尿病(n = 1)、高血压(n = 4)、深静脉血栓形成史(n = 1)、个人心肌梗死史(n = 3);1例(带起搏器),并有肺癌病史(n = 1)。所有患者均接受左胸壁PT和全面的局部淋巴管。1例接受被动散射PT, 4例接受铅笔束扫描。一名患者通过电子对乳房切除术切口进行了增强。心脏中位剂量为1gyrbe(范围0-1.0),左前降支0.1-cm3中位剂量为7.5 GyRBE(范围0-14.2),中位随访时间为2年(范围0.75-6.5);没有患者发生新的心脏事件,并且所有患者都没有乳腺癌复发和进展。结论:在一个罕见诊断的小病例系列中,胸壁和局部淋巴管,包括乳腺内淋巴结,导致心脏暴露低,局部区域疾病控制率高,毒性小。治疗男性乳腺癌应考虑质子治疗,以达到心脏保护。
{"title":"Proton Therapy in the Treatment of Men with Breast Cancer","authors":"Julie A. Bradley, Jayden Gracie, Raymond B. Mailhot Vega, Eric D. Brooks, Tenna Burchianti, Oluwadamilola T. Oladeru, Xiaoying Liang, Nancy P. Mendenhall","doi":"10.14338/ijpt-23-00007.1","DOIUrl":"https://doi.org/10.14338/ijpt-23-00007.1","url":null,"abstract":"Abstract Purpose Male breast cancer treatment involves multimodality therapy, including radiation therapy; nevertheless, few men have received proton therapy (PT) for it. Further, heart disease is an established leading cause of death in men, and radiation therapy heart dose correlates with cardiac toxicity, highlighting the need for cardiac-sparing radiation techniques. Thus, we provide a descriptive analysis of PT in a male breast cancer cohort. Patients and Methods Men who received PT for localized breast cancer between 2012 and 2022 were identified from a prospective database. Toxicities were prospectively recorded by using the Common Terminology Criteria for Adverse Events (CTCAE), version 4.0. Results Five male patients were identified. All had estrogen receptor (ER)–positive, Her2neu-negative disease and received adjuvant endocrine therapy. One had genetic testing positive for BRCA2, one had a variant of unknown significance (VUS) in the APC gene, and one had a VUS in MSH2. Median age was 73 years (range, 41–80). Baseline comorbidities included obesity (n = 1), diabetes (n = 1), hypertension (n = 4), history of deep vein thrombosis (n = 1), personal history of myocardial infarction (n = 3; 1 with a pacemaker), and a history of lung cancer (n = 1). All received PT to the left chest wall and comprehensive regional lymphatics. One received passive-scattering PT, and 4 received pencil beam scanning. One patient received a boost to the mastectomy incision via electrons. Median heart dose was 1 GyRBE (range, 0–1.0), median 0.1-cm3 dose to the left anterior descending artery was 7.5 GyRBE (range, 0–14.2), and median follow-up was 2 years (range, 0.75–6.5); no patient experienced a new cardiac event, and all remain free from breast cancer recurrence and progression. Conclusion In a small case series for a rare diagnosis, PT to the chest wall and regional lymphatics, including internal mammary nodes, resulted in low cardiac exposure, high local regional disease control rates, and minimal toxicity. Proton therapy should be considered for treating men with breast cancer to achieve cardiac sparing.","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134972610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pencil Beam Scanning Proton Therapy for Adolescents and Young Adults with Head and Neck Sarcomas 铅笔束扫描质子治疗青少年头颈部肉瘤
Q2 Medicine Pub Date : 2023-10-25 DOI: 10.14338/ijpt-23-00010.1
Miriam Vázquez, Katja Baust, Amaia Ilundain, Dominic Leiser, Barbara Bachtiary, Alessia Pica, Ulrike L. Kliebsch, Gabriele Calaminus, Damien C. Weber
Abstract Purpose To assess clinical outcomes of adolescents and young adults (AYAs) with head and neck sarcomas (HNSs) treated with pencil beam scanning proton therapy (PBSPT) and to report quality of life (QoL). Materials and Methods Twenty-eight AYAs (aged 15 to 39 years) with HNS treated between January 2001 and July 2022 at our institution were included. The median age was 21.6 years. Rhabdomyosarcoma (39.3%), Ewing sarcoma (17.9%), chondrosarcoma (14.3%), and osteosarcoma (14.3%) were the most frequent diagnoses. Three (10.7%) patients were metastatic before PBSPT and 13 (46.4%) patients had a tumor with intracranial extension. The median total radiation dose was 63 GyRBE (range, 45 to 74 GyRBE). Thirteen (46.4%) patients received concomitant chemotherapy. Toxicity was reported according to the Common Terminology Criteria for Adverse Events (CTCAE), version 5.0 (US National Institutes of Health, Bethesda, Maryland). Survival was estimated using the Kaplan-Meier method. QoL was assessed using a PEDQOL (Pediatric Quality of Life Questionnaire) questionnaire. Self-reported outcomes were assessed using institutional questionnaires. Results With a median follow-up of 57 months (range, 3.7 to 243 months), 5 patients (17.8%) had local failure (LF) only, 2 (7.1%) experienced distant failure (DF) only, and 2 (7.1%) had LF and DF. The estimated 5-year local control (LC) and distant control (DC) rates were 71.8% and 80.5%, respectively. The median times to LF and DF were 13.4 and 22.2 months, respectively. Four (14.3%) patients died, all but one from their HNS. Estimated 5-year overall survival was 90.7%. Six (21.4%) patients developed nonocular grade ≥3 toxicity, which consisted of otitis media (n = 2), hearing impairment (n = 2), osteoradionecrosis (n = 1), and sinusitis (n = 1). Four (14.3%) patients developed cataracts that required surgery. The 5-year freedom from nonocular grade 3 toxicity was 91.1%. No grade 4 or higher toxicity was observed. Adolescents rated their quality of life before treatment worse than their parents did. Conclusion Excellent outcomes with acceptable late-toxicity rates were observed for AYAs with HNS after PBSPT.
目的评价青少年头颈部肉瘤(HNSs)接受铅笔束扫描质子治疗(PBSPT)的临床疗效,并报告其生活质量(QoL)。材料与方法纳入我院2001年1月至2022年7月收治的28例患有HNS的aya患者(年龄15 ~ 39岁)。中位年龄为21.6岁。横纹肌肉瘤(39.3%)、尤文氏肉瘤(17.9%)、软骨肉瘤(14.3%)和骨肉瘤(14.3%)是最常见的诊断。3例(10.7%)患者在PBSPT前已转移,13例(46.4%)患者肿瘤延伸至颅内。中位总辐射剂量为63 GyRBE(范围为45 ~ 74 GyRBE)。13例(46.4%)患者同时接受化疗。毒性根据不良事件通用术语标准(CTCAE) 5.0版(美国国立卫生研究院,Bethesda, Maryland)报告。生存率采用Kaplan-Meier法估计。QoL采用儿科生活质量问卷(PEDQOL)进行评估。自我报告的结果使用机构问卷进行评估。结果中位随访57个月(范围3.7 ~ 243个月),5例(17.8%)患者仅发生局部衰竭(LF), 2例(7.1%)患者仅发生远处衰竭(DF), 2例(7.1%)患者同时发生LF和DF。估计5年的局部控制率(LC)和远处控制率(DC)分别为71.8%和80.5%。到LF和DF的中位时间分别为13.4个月和22.2个月。4例(14.3%)患者死亡,除1例外均死于HNS。估计5年总生存率为90.7%。6例(21.4%)患者出现非眼部≥3级毒性,包括中耳炎(n = 2)、听力障碍(n = 2)、骨放射性坏死(n = 1)和鼻窦炎(n = 1)。4例(14.3%)患者发生白内障,需要手术治疗。5年无3级非眼毒性为91.1%。未见4级或以上毒性。青少年对治疗前生活质量的评价比他们的父母差。结论经PBSPT治疗合并HNS的AYAs患者预后良好,晚期毒性率可接受。
{"title":"Pencil Beam Scanning Proton Therapy for Adolescents and Young Adults with Head and Neck Sarcomas","authors":"Miriam Vázquez, Katja Baust, Amaia Ilundain, Dominic Leiser, Barbara Bachtiary, Alessia Pica, Ulrike L. Kliebsch, Gabriele Calaminus, Damien C. Weber","doi":"10.14338/ijpt-23-00010.1","DOIUrl":"https://doi.org/10.14338/ijpt-23-00010.1","url":null,"abstract":"Abstract Purpose To assess clinical outcomes of adolescents and young adults (AYAs) with head and neck sarcomas (HNSs) treated with pencil beam scanning proton therapy (PBSPT) and to report quality of life (QoL). Materials and Methods Twenty-eight AYAs (aged 15 to 39 years) with HNS treated between January 2001 and July 2022 at our institution were included. The median age was 21.6 years. Rhabdomyosarcoma (39.3%), Ewing sarcoma (17.9%), chondrosarcoma (14.3%), and osteosarcoma (14.3%) were the most frequent diagnoses. Three (10.7%) patients were metastatic before PBSPT and 13 (46.4%) patients had a tumor with intracranial extension. The median total radiation dose was 63 GyRBE (range, 45 to 74 GyRBE). Thirteen (46.4%) patients received concomitant chemotherapy. Toxicity was reported according to the Common Terminology Criteria for Adverse Events (CTCAE), version 5.0 (US National Institutes of Health, Bethesda, Maryland). Survival was estimated using the Kaplan-Meier method. QoL was assessed using a PEDQOL (Pediatric Quality of Life Questionnaire) questionnaire. Self-reported outcomes were assessed using institutional questionnaires. Results With a median follow-up of 57 months (range, 3.7 to 243 months), 5 patients (17.8%) had local failure (LF) only, 2 (7.1%) experienced distant failure (DF) only, and 2 (7.1%) had LF and DF. The estimated 5-year local control (LC) and distant control (DC) rates were 71.8% and 80.5%, respectively. The median times to LF and DF were 13.4 and 22.2 months, respectively. Four (14.3%) patients died, all but one from their HNS. Estimated 5-year overall survival was 90.7%. Six (21.4%) patients developed nonocular grade ≥3 toxicity, which consisted of otitis media (n = 2), hearing impairment (n = 2), osteoradionecrosis (n = 1), and sinusitis (n = 1). Four (14.3%) patients developed cataracts that required surgery. The 5-year freedom from nonocular grade 3 toxicity was 91.1%. No grade 4 or higher toxicity was observed. Adolescents rated their quality of life before treatment worse than their parents did. Conclusion Excellent outcomes with acceptable late-toxicity rates were observed for AYAs with HNS after PBSPT.","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134972773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cognition and Brain System Segregation in Pediatric Brain Tumor Patients Treated with Proton Therapy. 质子治疗儿童脑肿瘤患者的认知和脑系统分离。
IF 1.7 Q2 Medicine Pub Date : 2023-07-24 eCollection Date: 2023-01-01 DOI: 10.14338/IJPT-22-00039.1
Anna V Dowling, Benjamin A Seitzman, Timothy J Mitchell, Michael Olufawo, Donna L Dierker, Hari Anandarajah, Ally Dworetsky, Alana McMichael, Catherine Jiang, Dennis L Barbour, Bradley L Schlaggar, David D Limbrick, Jennifer M Strahle, Joshua B Rubin, Joshua S Shimony, Stephanie M Perkins

Purpose: Pediatric brain tumor patients often experience significant cognitive sequelae. Resting-state functional MRI (rsfMRI) provides a measure of brain network organization, and we hypothesize that pediatric brain tumor patients treated with proton therapy will demonstrate abnormal brain network architecture related to cognitive outcome and radiation dosimetry.

Participants and methods: Pediatric brain tumor patients treated with proton therapy were enrolled on a prospective study of cognitive assessment using the NIH Toolbox Cognitive Domain. rsfMRI was obtained in participants able to complete unsedated MRI. Brain system segregation (BSS), a measure of brain network architecture, was calculated for the whole brain, the high-level cognition association systems, and the sensory-motor systems.

Results: Twenty-six participants were enrolled in the study for cognitive assessment, and 18 completed rsfMRI. There were baseline cognitive deficits in attention and inhibition and processing speed prior to radiation with worsening performance over time in multiple domains. Average BSS across the whole brain was significantly decreased in participants compared with healthy controls (1.089 and 1.101, respectively; P = 0.001). Average segregation of association systems was significantly lower in participants than in controls (P < 0.001) while there was no difference in the sensory motor networks (P = 0.70). Right hippocampus dose was associated with worse attention and inhibition (P < 0.05) and decreased segregation in the dorsal attention network (P < 0.05).

Conclusion: Higher mean dose to the right hippocampus correlated with worse dorsal attention network segregation and worse attention and inhibition cognitive performance. Patients demonstrated alterations in brain network organization of association systems measured with rsfMRI; however, somatosensory system segregation was no different from healthy children. Further work with preradiation rsfMRI is needed to assess the effects of surgery and presence of a tumor on brain network architecture.

目的:儿童脑肿瘤患者经常会出现严重的认知后遗症。静息状态功能性MRI(rsfMRI)提供了一种脑网络组织的测量方法,我们假设接受质子治疗的儿童脑肿瘤患者将表现出与认知结果和辐射剂量测定相关的异常脑网络结构。参与者和方法:使用NIH Toolbox cognitive Domain对接受质子治疗的儿童脑肿瘤患者进行认知评估的前瞻性研究。rsfMRI是在能够完成未过时MRI的参与者中获得的。计算了整个大脑、高级认知联想系统和感觉运动系统的脑系统分离(BSS),这是一种衡量大脑网络结构的指标。结果:26名参与者被纳入该研究进行认知评估,18人完成了rsfMRI。辐射前,在注意力、抑制和处理速度方面存在基线认知缺陷,随着时间的推移,在多个领域的表现不断恶化。与健康对照组相比,参与者整个大脑的平均BSS显著降低(分别为1.089和1.101;P = 0.001)。参与者的平均关联系统分离显著低于对照组(P P = 0.70)。右侧海马剂量与更差的注意力和抑制有关(P P 结论:右海马平均剂量越高,背侧注意网络分离越差,注意和抑制认知表现越差。患者表现出用rsfMRI测量的关联系统的脑网络组织的改变;然而,体感系统分离与健康儿童没有什么不同。需要对预辐射rsfMRI进行进一步的研究,以评估手术和肿瘤对脑网络结构的影响。
{"title":"Cognition and Brain System Segregation in Pediatric Brain Tumor Patients Treated with Proton Therapy.","authors":"Anna V Dowling, Benjamin A Seitzman, Timothy J Mitchell, Michael Olufawo, Donna L Dierker, Hari Anandarajah, Ally Dworetsky, Alana McMichael, Catherine Jiang, Dennis L Barbour, Bradley L Schlaggar, David D Limbrick, Jennifer M Strahle, Joshua B Rubin, Joshua S Shimony, Stephanie M Perkins","doi":"10.14338/IJPT-22-00039.1","DOIUrl":"10.14338/IJPT-22-00039.1","url":null,"abstract":"<p><strong>Purpose: </strong>Pediatric brain tumor patients often experience significant cognitive sequelae. Resting-state functional MRI (rsfMRI) provides a measure of brain network organization, and we hypothesize that pediatric brain tumor patients treated with proton therapy will demonstrate abnormal brain network architecture related to cognitive outcome and radiation dosimetry.</p><p><strong>Participants and methods: </strong>Pediatric brain tumor patients treated with proton therapy were enrolled on a prospective study of cognitive assessment using the NIH Toolbox Cognitive Domain. rsfMRI was obtained in participants able to complete unsedated MRI. Brain system segregation (BSS), a measure of brain network architecture, was calculated for the whole brain, the high-level cognition association systems, and the sensory-motor systems.</p><p><strong>Results: </strong>Twenty-six participants were enrolled in the study for cognitive assessment, and 18 completed rsfMRI. There were baseline cognitive deficits in attention and inhibition and processing speed prior to radiation with worsening performance over time in multiple domains. Average BSS across the whole brain was significantly decreased in participants compared with healthy controls (1.089 and 1.101, respectively; <i>P</i> = 0.001). Average segregation of association systems was significantly lower in participants than in controls (<i>P</i> < 0.001) while there was no difference in the sensory motor networks (<i>P</i> = 0.70). Right hippocampus dose was associated with worse attention and inhibition (<i>P</i> < 0.05) and decreased segregation in the dorsal attention network (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Higher mean dose to the right hippocampus correlated with worse dorsal attention network segregation and worse attention and inhibition cognitive performance. Patients demonstrated alterations in brain network organization of association systems measured with rsfMRI; however, somatosensory system segregation was no different from healthy children. Further work with preradiation rsfMRI is needed to assess the effects of surgery and presence of a tumor on brain network architecture.</p>","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10563667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41215074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Analysis of Performance and Failure Modes of the IROC Proton Liver Phantom. IROC质子肝模型的性能和失效模式分析。
IF 1.7 Q2 Medicine Pub Date : 2023-07-14 eCollection Date: 2023-01-01 DOI: 10.14338/IJPT-22-00043.1
Hunter Mehrens, Paige Taylor, Paola Alvarez, Stephen Kry

Purpose: To analyze trends in institutional performance and failure modes for the Imaging and Radiation Oncology Core's (IROC's) proton liver phantom.

Materials and methods: Results of 66 phantom irradiations from 28 institutions between 2015 and 2020 were retrospectively analyzed. Univariate analysis and random forest models were used to associate irradiation conditions with phantom results. Phantom results included pass/fail classification, average thermoluminescent dosimeter (TLD) ratio of both targets, and percentage of pixels passing gamma of both targets. The following categories were evaluated in terms of how they predicted these outcomes: irradiation year, treatment planning system (TPS), TPS algorithm, treatment machine, number of irradiations, treatment technique, motion management technique, number of isocenters, and superior-inferior extent (in cm) of the 90% TPS isodose line for primary target 1 (PTV1) and primary target 2 (PTV2). In addition, failures were categorized by failure mode.

Results: Average pass rate was approximately 52% and average TLD ratio for both targets had slightly improved. As the treatment field increased to cover the target, the pass rate statistically significantly fell. Lower pass rates were observed for Mevion machines, scattered irradiation techniques, and gating and internal target volume (ITV) motion management techniques. Overall, the accuracy of the random forest modeling of the phantom results was approximately 73% ± 14%. The most important predictor was the superior-inferior extent for both targets and irradiation year. Three failure modes dominated the failures of the phantom: (1) systematic underdosing, (2) poor localization in the superior-inferior direction, and (3) range error. Only 44% of failures have similar failure modes between the 2 targets.

Conclusion: Improvement of the proton liver phantom has been observed; however, the pass rate remains the lowest among all IROC phantoms. Through various analysis techniques, range uncertainty, motion management, and underdosing are the main culprits of failures of the proton liver phantom. Clinically, careful consideration of the influences of liver proton therapy is needed to improve phantom performance and patient outcome.

目的:分析成像和放射肿瘤核心(IROC)质子肝模型的机构性能和失败模式的趋势。材料和方法:回顾性分析2015年至2020年间来自28家机构的66次体模照射的结果。使用单变量分析和随机森林模型将照射条件与体模结果相关联。体模结果包括通过/失败分类、两个目标的平均热致发光剂量计(TLD)比率以及两个目标通过伽马射线的像素百分比。以下类别根据其预测这些结果的方式进行了评估:主要目标1(PTV1)和主要目标2(PTV2)的辐照年份、治疗计划系统(TPS)、TPS算法、治疗机、辐照次数、治疗技术、运动管理技术、等中心数和90%TPS等剂量线的上下范围(以厘米为单位)。此外,还按故障模式对故障进行了分类。结果:平均通过率约为52%,两个靶点的平均TLD比率略有改善。随着治疗范围的扩大以覆盖目标,通过率在统计学上显著下降。Mevion机器、散射照射技术以及门控和内部目标体积(ITV)运动管理技术的通过率较低。总体而言,体模结果的随机森林建模的准确性约为73% ± 14%。最重要的预测因素是靶点和照射年份的优劣势程度。三种失效模式主导了体模的失效:(1)系统性剂量不足,(2)上下方向定位不良,以及(3)测距误差。只有44%的故障在两个目标之间具有相似的故障模式。结论:对质子肝体模进行了改进;然而,通过率仍然是所有IROC幻影中最低的。通过各种分析技术,范围不确定性、运动管理和剂量不足是质子肝体模失败的主要原因。临床上,需要仔细考虑肝脏质子治疗的影响,以提高体模性能和患者的预后。
{"title":"Analysis of Performance and Failure Modes of the IROC Proton Liver Phantom.","authors":"Hunter Mehrens, Paige Taylor, Paola Alvarez, Stephen Kry","doi":"10.14338/IJPT-22-00043.1","DOIUrl":"10.14338/IJPT-22-00043.1","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze trends in institutional performance and failure modes for the Imaging and Radiation Oncology Core's (IROC's) proton liver phantom.</p><p><strong>Materials and methods: </strong>Results of 66 phantom irradiations from 28 institutions between 2015 and 2020 were retrospectively analyzed. Univariate analysis and random forest models were used to associate irradiation conditions with phantom results. Phantom results included pass/fail classification, average thermoluminescent dosimeter (TLD) ratio of both targets, and percentage of pixels passing gamma of both targets. The following categories were evaluated in terms of how they predicted these outcomes: irradiation year, treatment planning system (TPS), TPS algorithm, treatment machine, number of irradiations, treatment technique, motion management technique, number of isocenters, and superior-inferior extent (in cm) of the 90% TPS isodose line for primary target 1 (PTV1) and primary target 2 (PTV2). In addition, failures were categorized by failure mode.</p><p><strong>Results: </strong>Average pass rate was approximately 52% and average TLD ratio for both targets had slightly improved. As the treatment field increased to cover the target, the pass rate statistically significantly fell. Lower pass rates were observed for Mevion machines, scattered irradiation techniques, and gating and internal target volume (ITV) motion management techniques. Overall, the accuracy of the random forest modeling of the phantom results was approximately 73% ± 14%. The most important predictor was the superior-inferior extent for both targets and irradiation year. Three failure modes dominated the failures of the phantom: (1) systematic underdosing, (2) poor localization in the superior-inferior direction, and (3) range error. Only 44% of failures have similar failure modes between the 2 targets.</p><p><strong>Conclusion: </strong>Improvement of the proton liver phantom has been observed; however, the pass rate remains the lowest among all IROC phantoms. Through various analysis techniques, range uncertainty, motion management, and underdosing are the main culprits of failures of the proton liver phantom. Clinically, careful consideration of the influences of liver proton therapy is needed to improve phantom performance and patient outcome.</p>","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10563664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41215072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Case-Matched Outcomes of Proton Beam and Intensity-Modulated Radiation Therapy for Localized Prostate Cancer. 局部前列腺癌症质子束和强度调制放射治疗的病例匹配结果。
IF 1.7 Q2 Medicine Pub Date : 2023-05-18 eCollection Date: 2023-01-01 DOI: 10.14338/IJPT-23-00002.1
Alicia Bao, Andrew R Barsky, Stefan Both, John P Christodouleas, Curtiland Deville, Zelig A Tochner, Neha Vapiwala, Russell Maxwell

Purpose: Although both intensity-modulated radiation therapy (IMRT) and proton beam therapy (PBT) offer effective long-term disease control for localized prostate cancer (PCa), there are limited data directly comparing the 2 modalities.

Methods: The data from 334 patients treated with conventionally fractionated (79.2 GyRBE in 44 fractions) PBT or IMRT were retrospectively analyzed. Propensity score matching was used to balance factors associated with biochemical failure-free survival (BFFS). Age, race, and comorbidities (not BFFS associates) remained imbalanced after matching. Univariable and covariate-adjusted multivariable (MVA) Cox regression models were used to determine if modality affected BFFS.

Results: Of 334 patients, 176 (52.7%) were included in the matched cohort with exact matching to National Comprehensive Cancer Network (NCCN) risk group. With a median follow-up time of 9.0 years (interquartile range [IQR]: 7.8-10.2 years), long-term BFFS was similar between the IMRT and PBT matched arms with 8-year estimates of 85% (95% CI: 76%-91%) and 91% (95% CI: 82%-96%, P = .39), respectively. On MVA, modality was not significantly associated with BFFS in both the unmatched (hazard ratio [HR] = 0.75, 95% CI: 0.35-1.63, P = .47) and matched (HR = 0.87, 95% CI: 0.33-2.33, P = .78) cohorts. Prostate cancer-specific survival (PCSS) and overall survival (OS) were also similar (P > .05). However, in an unmatched analysis, the PBT arm had significantly fewer incidences of secondary cancers within the irradiated field (0.6%, 95% CI: 0.0%-3.1% versus 4.5%, 95% CI: 1.8%-9.0%, P = .028).

Conclusions: Both PBT and IMRT offer excellent long-term disease control for PCa, with no significant differences between the 2 modalities in BFFS, PCSS, and OS in matched patients. In the unmatched cohort, fewer incidences of secondary malignancy were noted in the PBT group; however, owing to overall low incidence of secondary cancer and imbalanced patient characteristics between the 2 groups, these data are strictly hypothesis generating and require further investigation.

目的:尽管强度调制放射治疗(IMRT)和质子束治疗(PBT)都能有效地长期控制局部前列腺癌症(PCa)的疾病,但直接比较这两种治疗方式的数据有限。方法:回顾性分析334例接受常规分级(79.2 GyRBE,44个分级)PBT或IMRT治疗的患者的数据。倾向性评分匹配用于平衡与生化无故障生存率(BFFS)相关的因素。匹配后,年龄、种族和合并症(与BFFS无关)仍然不平衡。使用单变量和协变量调整的多变量(MVA)Cox回归模型来确定模式是否影响BFFS。结果:在334名患者中,176名(52.7%)患者被纳入与国家综合癌症网络(NCCN)风险组完全匹配的匹配队列。中位随访时间为9.0年(四分位间距[IQR]:7.8-10.2年),IMRT和PBT匹配组的长期BFFS相似,8年估计值分别为85%(95%CI:76%-91%)和91%(95%CI:82%-96%,P = .39)。在MVA方面,在两种不匹配(危险比[HR] = 0.75,95%CI:0.35-1.63,P = .47)和匹配(HR = 0.87,95%置信区间0.33-2.33,P = .78)队列。前列腺癌特异性生存率(PCSS)和总生存率(OS)也相似(P > .05)。然而,在一项不匹配的分析中,PBT臂在照射区域内的继发性癌症发生率显著降低(0.6%,95%CI:0.0%-3.1%与4.5%,95%CI:1.8%-9.0%,P = .028)。结论:PBT和IMRT都为前列腺癌提供了良好的长期疾病控制,在匹配患者中,两种模式在BFFS、PCSS和OS方面没有显著差异。在不匹配的队列中,PBT组的继发性恶性肿瘤发生率较低;然而,由于癌症的继发发病率总体较低,并且两组患者的特征不平衡,这些数据是严格的假设生成,需要进一步研究。
{"title":"Case-Matched Outcomes of Proton Beam and Intensity-Modulated Radiation Therapy for Localized Prostate Cancer.","authors":"Alicia Bao,&nbsp;Andrew R Barsky,&nbsp;Stefan Both,&nbsp;John P Christodouleas,&nbsp;Curtiland Deville,&nbsp;Zelig A Tochner,&nbsp;Neha Vapiwala,&nbsp;Russell Maxwell","doi":"10.14338/IJPT-23-00002.1","DOIUrl":"10.14338/IJPT-23-00002.1","url":null,"abstract":"<p><strong>Purpose: </strong>Although both intensity-modulated radiation therapy (IMRT) and proton beam therapy (PBT) offer effective long-term disease control for localized prostate cancer (PCa), there are limited data directly comparing the 2 modalities.</p><p><strong>Methods: </strong>The data from 334 patients treated with conventionally fractionated (79.2 GyRBE in 44 fractions) PBT or IMRT were retrospectively analyzed. Propensity score matching was used to balance factors associated with biochemical failure-free survival (BFFS). Age, race, and comorbidities (not BFFS associates) remained imbalanced after matching. Univariable and covariate-adjusted multivariable (MVA) Cox regression models were used to determine if modality affected BFFS.</p><p><strong>Results: </strong>Of 334 patients, 176 (52.7%) were included in the matched cohort with exact matching to National Comprehensive Cancer Network (NCCN) risk group. With a median follow-up time of 9.0 years (interquartile range [IQR]: 7.8-10.2 years), long-term BFFS was similar between the IMRT and PBT matched arms with 8-year estimates of 85% (95% CI: 76%-91%) and 91% (95% CI: 82%-96%, <i>P</i> = .39), respectively. On MVA, modality was not significantly associated with BFFS in both the unmatched (hazard ratio [HR] = 0.75, 95% CI: 0.35-1.63, <i>P</i> = .47) and matched (HR = 0.87, 95% CI: 0.33-2.33, <i>P</i> = .78) cohorts. Prostate cancer-specific survival (PCSS) and overall survival (OS) were also similar (<i>P</i> > .05). However, in an unmatched analysis, the PBT arm had significantly fewer incidences of secondary cancers within the irradiated field (0.6%, 95% CI: 0.0%-3.1% versus 4.5%, 95% CI: 1.8%-9.0%, <i>P</i> = .028).</p><p><strong>Conclusions: </strong>Both PBT and IMRT offer excellent long-term disease control for PCa, with no significant differences between the 2 modalities in BFFS, PCSS, and OS in matched patients. In the unmatched cohort, fewer incidences of secondary malignancy were noted in the PBT group; however, owing to overall low incidence of secondary cancer and imbalanced patient characteristics between the 2 groups, these data are strictly hypothesis generating and require further investigation.</p>","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10563661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41215073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Racial and Ethnic Demographic Reporting in Phase 2 Proton Therapy Clinical Trials: A Review. 2期质子治疗临床试验中的种族和民族人口学报告:综述。
IF 1.7 Q2 Medicine Pub Date : 2023-05-15 eCollection Date: 2023-01-01 DOI: 10.14338/IJPT-22-00042.1
Jonathan S Fakhry, M Juliana Pena, Ariel Pomputius, Fantine Giap, Raymond B Mailhot Vega

Purpose: Equitable inclusion of racial and ethnic participation in clinical trials is crucial to improving disparities in health care, especially for historically marginalized populations. Our study aims to describe the racial and ethnic demographics of patients enrolled in published phase 2 clinical trials involving proton therapy in the United States.

Materials and methods: Published manuscripts were identified in PubMed, Embase, World of Science, and Cochrane. Phase 2 trials evaluating proton therapy for US patients were included. For each article in the study, data were collected comprising authors, title, and publication year, and clinical trial numbers were verified. Additional data included tumor site, primary institution, sample size, reported race/ethnicity, and raw number/percentile of race/ethnicity. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used.

Results: Overall, 970 titles were identified; 636 remained after duplicate screening, and 75 full-text articles were assessed. We identified 38 eligible manuscripts for inclusion comprising 2648 patients. Only 15 (39%) of the publications reported race/ethnicity. Of these, 8 (21%) and 10 (26%) documented Hispanic or Black trial participants, respectively; however, only 6 (16%) documented trial participation for both Hispanic and Black patients. Of the 1409 patients with a documented race/ethnicity, 89.0% (n = 1254) were non-Hispanic white, 5.3% (n = 75) were Black, and 2.2% (n = 31) were Hispanic. Other and unknown race/ethnicity comprised the remaining patients (3.5%; n = 49).

Conclusion: We identified underreporting of demographic data in published phase 2 proton therapy trials, which unfortunately mirrored underreporting for cancer drug clinical trials. We also noted dramatic Black and Hispanic patient underrepresentation across the trials in which race and ethnicity are reported. Findings highlight the urgent need to identify and address barriers to proton therapy trials for Black and Hispanic patients ensuring clinical trials in radiation oncology are representative of the patients seen in clinical practice.

目的:公平地将种族和族裔参与纳入临床试验对于改善医疗保健的差距至关重要,尤其是对于历史上处于边缘地位的人群。我们的研究旨在描述美国已发表的涉及质子治疗的2期临床试验中患者的种族和民族人口统计。材料和方法:已发表的手稿发表在PubMed、Embase、World of Science和Cochrane上。包括评估美国患者质子治疗的2期试验。对于研究中的每一篇文章,都收集了包括作者、标题和发表年份在内的数据,并验证了临床试验编号。其他数据包括肿瘤部位、主要机构、样本量、报告的种族/民族以及种族/民族的原始数量/百分位数。使用了系统评价和荟萃分析(PRISMA)指南的首选报告项目。结果:总共确定了970个标题;重复筛选后仍有636篇,评估了75篇全文文章。我们确定了38份符合入选条件的手稿,包括2648名患者。只有15份(39%)出版物报告了种族/民族。其中,分别有8名(21%)和10名(26%)记录在案的西班牙裔或黑人试验参与者;然而,只有6名(16%)西班牙裔和黑人患者参与了试验。在1409名有种族/民族记录的患者中,89.0%(n = 1254)为非西班牙裔白人,5.3%(n = 75)为黑色,2.2%(n = 31)为西班牙裔。其余患者为其他未知种族/民族(3.5%;n = 49).结论:我们在已发表的2期质子治疗试验中发现了人口统计学数据的少报,不幸的是,这反映了癌症药物临床试验的少报。我们还注意到,在报告种族和族裔的试验中,黑人和西班牙裔患者的代表性显著不足。研究结果强调,迫切需要确定和解决黑人和西班牙裔患者质子治疗试验的障碍,确保放射肿瘤学的临床试验能够代表临床实践中的患者。
{"title":"Racial and Ethnic Demographic Reporting in Phase 2 Proton Therapy Clinical Trials: A Review.","authors":"Jonathan S Fakhry, M Juliana Pena, Ariel Pomputius, Fantine Giap, Raymond B Mailhot Vega","doi":"10.14338/IJPT-22-00042.1","DOIUrl":"10.14338/IJPT-22-00042.1","url":null,"abstract":"<p><strong>Purpose: </strong>Equitable inclusion of racial and ethnic participation in clinical trials is crucial to improving disparities in health care, especially for historically marginalized populations. Our study aims to describe the racial and ethnic demographics of patients enrolled in published phase 2 clinical trials involving proton therapy in the United States.</p><p><strong>Materials and methods: </strong>Published manuscripts were identified in PubMed, Embase, World of Science, and Cochrane. Phase 2 trials evaluating proton therapy for US patients were included. For each article in the study, data were collected comprising authors, title, and publication year, and clinical trial numbers were verified. Additional data included tumor site, primary institution, sample size, reported race/ethnicity, and raw number/percentile of race/ethnicity. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used.</p><p><strong>Results: </strong>Overall, 970 titles were identified; 636 remained after duplicate screening, and 75 full-text articles were assessed. We identified 38 eligible manuscripts for inclusion comprising 2648 patients. Only 15 (39%) of the publications reported race/ethnicity. Of these, 8 (21%) and 10 (26%) documented Hispanic or Black trial participants, respectively; however, only 6 (16%) documented trial participation for both Hispanic and Black patients. Of the 1409 patients with a documented race/ethnicity, 89.0% (n = 1254) were non-Hispanic white, 5.3% (n = 75) were Black, and 2.2% (n = 31) were Hispanic. Other and unknown race/ethnicity comprised the remaining patients (3.5%; n = 49).</p><p><strong>Conclusion: </strong>We identified underreporting of demographic data in published phase 2 proton therapy trials, which unfortunately mirrored underreporting for cancer drug clinical trials. We also noted dramatic Black and Hispanic patient underrepresentation across the trials in which race and ethnicity are reported. Findings highlight the urgent need to identify and address barriers to proton therapy trials for Black and Hispanic patients ensuring clinical trials in radiation oncology are representative of the patients seen in clinical practice.</p>","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10563665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41215085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Proton Beam Therapy for Unresectable Mediastinal and Pericardial Spindle Cell Sarcoma: A Case Report. 质子束治疗纵隔和心包纺锤细胞肉瘤一例报告。
IF 1.7 Q2 Medicine Pub Date : 2023-05-09 eCollection Date: 2023-01-01 DOI: 10.14338/IJPT-23-00001.1
Brady S Laughlin, Joshua Stoker, Tamara Vern-Gross

Unresectable mediastinal soft tissue sarcomas are often aggressive and associated with a poor prognosis. A 17-year-old male presented with progressive fatigue, shortness of breath, and heart palpitations secondary to an extensive mass involving the mediastinum and pericardium. He was treated with chemotherapy per protocol Children's Oncology Group Protocol ARST0332 and proton beam therapy to the involved mediastinum, pericardium, and heart. At the 5-year follow-up evaluation, he remained disease-free on surveillance imaging. An echocardiogram revealed a 55% to 60% left ventricular ejection fraction. Given the patient's extended survival, we present the oncologic rationale for treatment and considerations of late toxicity.

无法切除的纵隔软组织肉瘤通常具有侵袭性,预后不良。一名17岁男性,表现为进行性疲劳、呼吸急促和心悸,继发于纵隔和心包的大面积肿块。根据儿童肿瘤组方案ARST0332,他接受了化疗,并对纵隔、心包和心脏进行了质子束治疗。在5年的随访评估中,他在监测成像上仍然没有疾病。超声心动图显示左心室射血分数为55%至60%。考虑到患者的延长生存期,我们提出了治疗的肿瘤学原理和晚期毒性的考虑因素。
{"title":"Proton Beam Therapy for Unresectable Mediastinal and Pericardial Spindle Cell Sarcoma: A Case Report.","authors":"Brady S Laughlin,&nbsp;Joshua Stoker,&nbsp;Tamara Vern-Gross","doi":"10.14338/IJPT-23-00001.1","DOIUrl":"10.14338/IJPT-23-00001.1","url":null,"abstract":"<p><p>Unresectable mediastinal soft tissue sarcomas are often aggressive and associated with a poor prognosis. A 17-year-old male presented with progressive fatigue, shortness of breath, and heart palpitations secondary to an extensive mass involving the mediastinum and pericardium. He was treated with chemotherapy per protocol Children's Oncology Group Protocol ARST0332 and proton beam therapy to the involved mediastinum, pericardium, and heart. At the 5-year follow-up evaluation, he remained disease-free on surveillance imaging. An echocardiogram revealed a 55% to 60% left ventricular ejection fraction. Given the patient's extended survival, we present the oncologic rationale for treatment and considerations of late toxicity.</p>","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10563663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41215084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Proton Beam Radiation Therapy for Oropharyngeal Squamous Cell Carcinoma. 质子束放射治疗口咽鳞状细胞癌
IF 2.1 Q3 ONCOLOGY Pub Date : 2023-04-27 eCollection Date: 2023-01-01 DOI: 10.14338/IJPT-22-00030.1
William M Mendenhall, Jonathan J Beitler, Nabil F Saba, Ashok R Shaha, Sandra Nuyts, Primož Strojan, Heleen Bollen, Oded Cohen, Robert Smee, Sweet Ping Ng, Avraham Eisbruch, Wai Tong Ng, Jessica M Kirwan, Alfio Ferlito

Purpose: To discuss the role of proton beam therapy (PBT) in the treatment of patients with oropharyngeal squamous cell carcinoma (OPSCC).

Materials and methods: A review of the pertinent literature.

Results: Proton beam therapy likely results in reduced acute and late toxicity as compared with intensity-modulated radiation therapy (IMRT). The extent of the reduced toxicity, which may be modest, depends on the endpoint and technical factors such as pencil beam versus passive scattered PBT and adaptive replanning. The disease control rates after PBT are likely similar to those after IMRT.

Conclusion: Proton beam therapy is an attractive option to treat patients with OPSCC. Whether it becomes widely available depends on access.

目的:探讨质子束疗法(PBT)在口咽鳞状细胞癌(OPSCC)患者治疗中的作用:回顾相关文献:与调强放射疗法(IMRT)相比,质子束疗法可能会减少急性和晚期毒性。毒性降低的程度可能不大,这取决于终点和技术因素,如铅笔束与被动散射质子束治疗和自适应重新扫描。质子束疗法的疾病控制率可能与 IMRT 相似:质子束疗法是治疗OPSCC患者的一种极具吸引力的选择。结论:质子束疗法是治疗 OPSCC 患者的一种极具吸引力的选择,但能否广泛应用还取决于治疗的可及性。
{"title":"Proton Beam Radiation Therapy for Oropharyngeal Squamous Cell Carcinoma.","authors":"William M Mendenhall, Jonathan J Beitler, Nabil F Saba, Ashok R Shaha, Sandra Nuyts, Primož Strojan, Heleen Bollen, Oded Cohen, Robert Smee, Sweet Ping Ng, Avraham Eisbruch, Wai Tong Ng, Jessica M Kirwan, Alfio Ferlito","doi":"10.14338/IJPT-22-00030.1","DOIUrl":"10.14338/IJPT-22-00030.1","url":null,"abstract":"<p><strong>Purpose: </strong>To discuss the role of proton beam therapy (PBT) in the treatment of patients with oropharyngeal squamous cell carcinoma (OPSCC).</p><p><strong>Materials and methods: </strong>A review of the pertinent literature.</p><p><strong>Results: </strong>Proton beam therapy likely results in reduced acute and late toxicity as compared with intensity-modulated radiation therapy (IMRT). The extent of the reduced toxicity, which may be modest, depends on the endpoint and technical factors such as pencil beam versus passive scattered PBT and adaptive replanning. The disease control rates after PBT are likely similar to those after IMRT.</p><p><strong>Conclusion: </strong>Proton beam therapy is an attractive option to treat patients with OPSCC. Whether it becomes widely available depends on access.</p>","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10166016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9446618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Preclinical Dosimetry for Small Animal Radiation Research in Proton Therapy: A Feasibility Study. 质子治疗中小动物辐射研究的临床前剂量测定:可行性研究。
IF 1.7 Q2 Medicine Pub Date : 2023-04-03 eCollection Date: 2023-01-01 DOI: 10.14338/IJPT-22-00035.1
Fatih Biltekin, Christian Bäumer, Johannes Esser, Osamah Ghanem, Gokhan Ozyigit, Beate Timmermann

Purpose: To evaluate the feasibility of the three-dimensional (3D) printed small animal phantoms in dosimetric verification of proton therapy for small animal radiation research.

Materials and methods: Two different phantoms were modeled using the computed-tomography dataset of real rat and tumor-bearing mouse, retrospectively. Rat phantoms were designed to accommodate both EBT3 film and ionization chamber. A subcutaneous tumor-bearing mouse phantom was only modified to accommodate film dosimetry. All phantoms were printed using polylactic-acid (PLA) filament. Optimal printing parameters were set to create tissue-equivalent material. Then, proton therapy plans for different anatomical targets, including whole brain and total lung irradiation in the rat phantom and the subcutaneous tumor model in the mouse phantom, were created using the pencil-beam scanning technique. Point dose and film dosimetry measurements were performed using 3D-printed phantoms. In addition, all phantoms were analyzed in terms of printing accuracy and uniformity.

Results: Three-dimensionally printed phantoms had excellent uniformity over the external body, and printing accuracy was within 0.5 mm. According to our findings, two-dimensional dosimetry with EBT3 showed acceptable levels of γ passing rate for all measurements except for whole brain irradiation (γ passing rate, 89.8%). In terms of point dose analysis, a good agreement (<0.1%) was found between the measured and calculated point doses for all anatomical targets.

Conclusion: Three-dimensionally printed small animal phantoms show great potential for dosimetric verifications of clinical proton therapy for small animal radiation research.

目的:评价三维(3D)打印小动物模型在小动物放射研究质子治疗剂量验证中的可行性。材料和方法:使用真实大鼠和荷瘤小鼠的计算机断层扫描数据集,对两种不同的体模进行回顾性建模。大鼠模型设计用于容纳EBT3薄膜和电离室。皮下荷瘤小鼠模型仅被修改以适应胶片剂量测定。所有模型均使用聚乳酸(PLA)细丝进行打印。设置最佳打印参数以创建组织等效材料。然后,使用铅笔束扫描技术创建了不同解剖靶点的质子治疗计划,包括大鼠体模的全脑和全肺照射以及小鼠体模的皮下肿瘤模型。使用3D打印体模进行点剂量和胶片剂量测定。此外,从印刷精度和均匀性的角度对所有模型进行了分析。结果:三维打印的体模在体外具有良好的均匀性,打印精度在0.5mm以内。根据我们的研究结果,EBT3二维剂量测定显示,除全脑照射外,所有测量的γ通过率均处于可接受水平(γ通过率为89.8%)。在点剂量分析方面,结论:三维打印的小动物模型在小动物放射研究的临床质子治疗的剂量测定验证中显示出巨大的潜力。
{"title":"Preclinical Dosimetry for Small Animal Radiation Research in Proton Therapy: A Feasibility Study.","authors":"Fatih Biltekin,&nbsp;Christian Bäumer,&nbsp;Johannes Esser,&nbsp;Osamah Ghanem,&nbsp;Gokhan Ozyigit,&nbsp;Beate Timmermann","doi":"10.14338/IJPT-22-00035.1","DOIUrl":"https://doi.org/10.14338/IJPT-22-00035.1","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the feasibility of the three-dimensional (3D) printed small animal phantoms in dosimetric verification of proton therapy for small animal radiation research.</p><p><strong>Materials and methods: </strong>Two different phantoms were modeled using the computed-tomography dataset of real rat and tumor-bearing mouse, retrospectively. Rat phantoms were designed to accommodate both EBT3 film and ionization chamber. A subcutaneous tumor-bearing mouse phantom was only modified to accommodate film dosimetry. All phantoms were printed using polylactic-acid (PLA) filament. Optimal printing parameters were set to create tissue-equivalent material. Then, proton therapy plans for different anatomical targets, including whole brain and total lung irradiation in the rat phantom and the subcutaneous tumor model in the mouse phantom, were created using the pencil-beam scanning technique. Point dose and film dosimetry measurements were performed using 3D-printed phantoms. In addition, all phantoms were analyzed in terms of printing accuracy and uniformity.</p><p><strong>Results: </strong>Three-dimensionally printed phantoms had excellent uniformity over the external body, and printing accuracy was within 0.5 mm. According to our findings, two-dimensional dosimetry with EBT3 showed acceptable levels of γ passing rate for all measurements except for whole brain irradiation (γ passing rate, 89.8%). In terms of point dose analysis, a good agreement (<0.1%) was found between the measured and calculated point doses for all anatomical targets.</p><p><strong>Conclusion: </strong>Three-dimensionally printed small animal phantoms show great potential for dosimetric verifications of clinical proton therapy for small animal radiation research.</p>","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10563666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41215083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
International Journal of Particle Therapy
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1