Advances in Radiation Oncology最新文献

{"title":"Identifying Nutritional Inequities of Patients with Cancer Residing in Food Deserts","authors":"Lara LePore BS ,&nbsp;Dahlia Kronfli MD ,&nbsp;Kaysee Baker MS ,&nbsp;Caitlin Eggleston BS ,&nbsp;Kaitlin Schotz RD, LDN, CSO ,&nbsp;Amber S. Kleckner PhD ,&nbsp;Søren M. Bentzen PhD, DMSc, FASTRO ,&nbsp;Pranshu Mohindra MD, MBBS ,&nbsp;Melissa A.L. Vyfhuis MD, PhD","doi":"10.1016/j.adro.2024.101641","DOIUrl":"10.1016/j.adro.2024.101641","url":null,"abstract":"<div><h3>Purpose</h3><div>Nutrition is essential for cancer care, and patients who reside in food priority areas (FPAs) may experience limited access to healthy meals. There are few data evaluating the consequence of residing in FPAs because it relates to perceived food insecurity, psychosocial needs, or nutritional status of patients with cancer. This study aimed to determine the nutritional and psychosocial needs of patients with cancer who do and do not reside in FPAs.</div></div><div><h3>Methods and Materials</h3><div>From May 2019 to December 2022, a cross-sectional analysis was conducted using a validated questionnaire, offered at various time points before and after therapy, evaluating the psychosocial needs of patients with curable cancers. Groups were compared using X² and Mann-Whitney <em>U</em> tests as appropriate. Binary logistic regression was used to identify predictors of food insecurity.</div></div><div><h3>Results</h3><div>Survey compliance was 74% (n = 320 of 434 patients). Patients who resided in FPAs (26%; n = 114) were more likely to self-identify as Black (60.5% vs 39.5%; <em>P</em> &lt; .001), single (70% vs 37%; <em>P</em> &lt; .001), and have a lower median income ($47,225 vs $91,305; <em>P</em> &lt; .001) when compared with non-FPA residents. Residents of FPAs had a higher unmet nutritional needs index (median nutritional unmet needs score: 2.42 vs 2.00; <em>P</em> = .003), which included higher demands for healthier food choices (67.6% vs 54.4; <em>P</em> = .047) and greater food insecurity (44.4% vs 19.9%; <em>P</em> = .002). FPA residence was associated with a 3-fold increased risk of food insecurity (odds ratio [OR], 3.23; 95% confidence interval [CI], 1.59-6.57; <em>P</em> &lt; .001). On multivariate analysis, predictors for food insecurity included Black race (OR, 9.46; 95% CI, 3.93-22.76; <em>P</em> &lt; .001), stage (stage IV vs l OR, 4.27; 95% CI, 1.12-16.34; <em>P</em> = .034), and recurrent disease (OR, 10.26; 95% CI, 2.29-46.09; <em>P</em> = .002).</div></div><div><h3>Conclusions</h3><div>Inequities were identified in patients residing in FPAs, where race and higher stage were important predictors of food insecurity. Demographics can be readily used by clinicians to identify high-risk patients early in their cancer care in order to provide continuous nutritional resources to improve food insecurity perceptions. Future prospective studies are needed to confirm if such interventions improve cancer outcomes.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 1","pages":"Article 101641"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143174835","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}

{"title":"Hypofractionated Radiation Therapy for Subcutaneous Rosai-Dorfman Disease: A Case Report","authors":"Rachael M. Guenzel DNP ,&nbsp;William G. Breen MD ,&nbsp;Ronald S. Go MD ,&nbsp;Andrew L. Feldman MD ,&nbsp;Scott C. Lester MD","doi":"10.1016/j.adro.2024.101710","DOIUrl":"10.1016/j.adro.2024.101710","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 3","pages":"Article 101710"},"PeriodicalIF":2.2,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078256","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}

{"title":"Dosimetric Comparison of Noncoplanar VMAT Without Rotating the Patient Couch Versus Conventional Coplanar/Noncoplanar VMAT for Head and Neck Cancer: First Report of Dynamic Swing Arc","authors":"Kouta Hirotaki MS ,&nbsp;Kento Tomizawa MD, PhD ,&nbsp;Satoe Kitou BS ,&nbsp;Shunta Jinno MS ,&nbsp;Shunsuke Moriya PhD ,&nbsp;Takeshi Fujisawa MD ,&nbsp;Sadamoto Zenda MD, PhD ,&nbsp;Takeji Sakae PhD ,&nbsp;Masashi Ito BS","doi":"10.1016/j.adro.2024.101706","DOIUrl":"10.1016/j.adro.2024.101706","url":null,"abstract":"<div><h3>Purpose</h3><div>This retrospective planning study aimed to verify the usefulness of a clinically available method, dynamic swing arc (DSA), a noncoplanar volumetric modulated arc therapy (VMAT) technique, of the new accelerator OXRAY for head and neck squamous cell carcinoma (HNSCC). We performed dosimetric comparisons between DSA and conventional coplanar/noncoplanar VMAT (C-VMAT/NC-VMAT) plans for HNSCC.</div></div><div><h3>Methods and Materials</h3><div>We selected 32 patients with oropharyngeal and hypopharyngeal cancer treated with C-VMAT at National Cancer Center Hospital East between September 2018 and July 2023. DSA and C/NC-VMAT plans were generated using OXRAY and TrueBeam, respectively. DSA employed noncoplanar 2-arc beams with an O-ring gantry swing, whereas C-VMAT and NC-VMAT used coplanar and noncoplanar 2-arc beams, respectively. Dosimetric parameters, normal tissue complication probability, and delivery times were compared pairwise using the Wilcoxon signed-rank test with Bonferroni correction.</div></div><div><h3>Results</h3><div>For high-risk planning target volume (PTV), D98 values in NC-VMAT plans were closest to the prescribed dose, significantly differing from C-VMAT and DSA plans. DSA plans showed significantly better median conformity and homogeneity indices (0.97 and 7.33, respectively) compared to C-VMAT (0.95 and 8.36) and NC-VMAT (0.96 and 7.96) plans. DSA plans significantly reduced the mean ipsilateral/contralateral parotid gland dose by 5.78/6.93 and 2.88/1.56 Gy (median) compared to C-VMAT and NC-VMAT. NC-VMAT and DSA plans significantly decreased the mean oral cavity dose by 2.16 and 3.22 Gy (median) compared to C-VMAT. DSA plans had the lowest median normal tissue complication for xerostomia with significant differences, followed by NC-VMAT and C-VMAT. The delivery time for DSA plans was longer than VMAT (151 seconds vs 124 seconds), but shorter than NC-VMAT.</div></div><div><h3>Conclusions</h3><div>DSA plans using OXRAY for HNSCC maintained PTV coverage while reducing parotid gland and oral cavity mean doses compared to coplanar VMAT plans, although delivery times increased. DSA plans reduced parotid gland doses and delivery times compared to noncoplanar VMAT plans.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 3","pages":"Article 101706"},"PeriodicalIF":2.2,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143094115","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}

{"title":"Impact of the Number of Administered Systemic Treatment Lines on Local Response to Radiation Therapy for Multiple Myeloma","authors":"Andrea Emanuele Guerini MD ,&nbsp;Eneida Mataj MD ,&nbsp;Paolo Borghetti MD ,&nbsp;Luca Triggiani ,&nbsp;Ludovica Pegurri MD ,&nbsp;Stefania Nici ,&nbsp;Stefano Riga ,&nbsp;Alessandra Tucci MD ,&nbsp;Angelo Belotti MD ,&nbsp;Marco Lorenzo Bonù MD ,&nbsp;Giorgio Facheris MD ,&nbsp;Stefano Maria Magrini ,&nbsp;Luigi Spiazzi ,&nbsp;Michela Buglione","doi":"10.1016/j.adro.2024.101696","DOIUrl":"10.1016/j.adro.2024.101696","url":null,"abstract":"<div><h3>Purpose</h3><div>Multiple myeloma (MM) tends to develop resistance to systemic therapy through multiple mechanisms that might as well induce radioresistance, as suggested by preclinical studies. The aim of the present analysis was to elucidate whether the number of systemic treatment lines received prior to radiation therapy (RT) might confer radioresistance and influence local response.</div></div><div><h3>Methods and Materials</h3><div>This single-center retrospective study enrolled patients who received RT for MM at our institution between January 1, 2005, and January 31, 2023. Information regarding RT, systemic therapy, and characteristics of the patients and disease were retrieved from medical records. The primary outcome for this analysis was radiologic local response at 6 months after RT, according to RECIST 1.1 (Response Evaluation Criteria in Solid Tumors) or PERCIST 1.0 (Positron Emission Tomography Response Criteria in Solid Tumors) criteria. The secondary outcome was toxicity reported during the RT course.</div></div><div><h3>Results</h3><div>Data from 665 MM lesions from 366 patients were analyzed. Data regarding local response at 6 months were available for 217 lesions, reporting 29 complete responses (13.4%), 141 partial responses (65%), 42 stable diseases (19.4%), and only 5 disease progressions (2.3%). The number of previous systemic treatment lines had no impact on radiologic response at 6 months (<em>p</em> = .721). RT BED₁₀ (Biologically Effective Dose) had a significant impact on response at 6 months (<em>p</em> = .007). The toxicity profile was optimal, as grade &gt; 2 events during RT were reported only in 0.9% of cases.</div></div><div><h3>Conclusions</h3><div>In this large retrospective cohort of MM patients, the number of systemic treatment lines administered before RT had no impact on the local response, confuting concerns of cross-resistance raised by multiple preclinical studies. Disease control after RT was optimal, and instances of severe toxicities during treatment were rare.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 3","pages":"Article 101696"},"PeriodicalIF":2.2,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143094117","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}

{"title":"Image Guidance is Associated with Improved Freedom From Recurrence After Superficial Radiation Therapy for Nonmelanoma Skin Cancer","authors":"Erin M. McClure MD ,&nbsp;Geoffrey Sedor MD ,&nbsp;Mairead Moloney BS ,&nbsp;Yuxuan Jin MS ,&nbsp;Lio Yu MD ,&nbsp;Michael W. Kattan PhD","doi":"10.1016/j.adro.2024.101463","DOIUrl":"10.1016/j.adro.2024.101463","url":null,"abstract":"<div><h3>Purpose</h3><div>This is the first study to quantify the 2-year freedom from recurrence for individuals with nonmelanoma skin cancer (NMSC) such as basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and squamous carcinoma in situ (SCCIS) treated with image guided superficial radiation therapy (IGSRT) versus SRT without image guidance.</div></div><div><h3>Methods and Materials</h3><div>This retrospective cohort study evaluates the 2-year freedom recurrence rate of NMSCs treated by IGSRT (March 2016 to January 2022) and compares it to existing data on NMSCs treated by SRT via 1 sample proportion tests. Individuals &gt;18 years old with biopsy-proven SCC, SCCIS, and/or BCC treated with IGSRT were included in the study, and 1602 patients/2880 treated lesions were followed until January 14, 2022. SRT literature was identified through an Ovid Medline search.</div></div><div><h3>Results</h3><div>All NMSCs treated by IGSRT in this cohort had an aggregate 2-year freedom from recurrence of 99.23%. The recurrence rate for BCC (N = 1382) was 1.1%, for SCC (N = 904) 0.8%, and for SCCIS (N = 594) 0.0%. These recurrence rates are significantly improved compared with a pooled study that evaluated NMSCs across histology and BCCs alone treated without image guidance (standard SRT) (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>IGSRT offers a paradigm-shifting treatment option for patients with NMSCs – offering statistically significantly improved outcomes compared with standard SRT and a more desirable toxicity profile to surgical options. This study demonstrates that IGSRT is associated with remarkably low recurrence rates, which are statistically significantly improved from the previous generation of SRT and in line with modern outcomes for Mohs micrographic surgery.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"9 12","pages":"Article 101463"},"PeriodicalIF":2.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139873758","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}

{"title":"Cardiopulmonary Substructure Doses are Not Correlated With Cardiorespiratory Fitness Among Breast Cancer Survivors Treated With Contemporary Radiation Therapy","authors":"Maria Thor PhD ,&nbsp;Jessica M. Scott PhD ,&nbsp;Anne S. Reiner MPH ,&nbsp;Linda Hong PhD ,&nbsp;Anthony F. Yu MD ,&nbsp;Aditya Apte PhD ,&nbsp;Beryl McCormick MD ,&nbsp;Angelica Perez-Andujar PhD ,&nbsp;Catherine P. Lee BS ,&nbsp;Laura Cervino PhD ,&nbsp;Jenna Harrison BS ,&nbsp;Xiaolin Liang MA ,&nbsp;Prusha Patel MPH ,&nbsp;Lawrence T. Dauer PhD ,&nbsp;Chaya S. Moskowitz PhD ,&nbsp;Jonine L. Bernstein PhD","doi":"10.1016/j.adro.2024.101613","DOIUrl":"10.1016/j.adro.2024.101613","url":null,"abstract":"<div><h3>Purpose</h3><div>Breast cancer radiation therapy (RT) techniques have historically delivered mean heart doses (MHDs) in the range of 5 Gy, which have been found to predispose patients to cardiopulmonary toxicities. The purpose of this study was to apply artificial intelligence (AI) cardiac substructure auto-segmentation to evaluate the corresponding substructure doses, whether there are laterality- and technique-specific differences in these doses, and if the doses are significantly associated with cardiorespiratory fitness after state-of-the-art RT planning and delivery for breast cancer.</div></div><div><h3>Methods and Materials</h3><div>Cardiopulmonary substructures were AI auto-segmented. Cardiorespiratory fitness was evaluated at a median of 2.3 (range, 1.1-9.8) years following RT from 2007 to 2021 among 65 breast cancer survivors. The associations between the mean dose to each of the 9 AI auto-segmented cardiopulmonary substructures, the contralateral, and the ipsilateral lung with cardiorespiratory fitness were evaluated using linear regression.</div></div><div><h3>Results</h3><div>The median MHD was 0.64 Gy (range, 0.12-7.1). Among the auto-segmented substructures, the highest mean doses were observed for the left ventricle (median, 0.88 Gy). The mean dose to each of the 11 structures was significantly higher for women treated with volumetric modulated arc therapy (MHD median, 3.8 Gy vs 0.57 Gy; <em>P</em> &lt; .0001). Women with left-sided breast cancer had significantly higher MHDs (0.97 vs 0.38 Gy; <em>P</em> &lt; .0001) due to higher doses in 3 of 4 cardiac chambers and also due to significantly higher pulmonary artery doses (median, 0.93 vs 0.32 Gy; <em>P</em> = .0003); women with right-sided breast cancer had significantly higher vena cava and right atrium doses (eg, right atrium median, 0.74 vs 0.29 Gy; <em>P</em> = .0002). No cardiopulmonary structure dose was significantly associated with reduced cardiorespiratory fitness after adjusting for age, chemotherapy agent, volumetric modulated arc therapy, RT position, and RT extent.</div></div><div><h3>Conclusions</h3><div>State-of-the-art breast cancer RT reduces cardiopulmonary dose, and there is a technique and cancer laterality RT dose dependence throughout the cardiopulmonary system.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"9 12","pages":"Article 101613"},"PeriodicalIF":2.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942546","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}

{"title":"Advances in Radiation Oncology in 2023","authors":"Rachel B. Jimenez MD","doi":"10.1016/j.adro.2024.101578","DOIUrl":"10.1016/j.adro.2024.101578","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"9 12","pages":"Article 101578"},"PeriodicalIF":2.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942540","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}

{"title":"ASTRO's Advances in Radiation Oncology Outstanding Reviewers for 2023","authors":"Rachel B. Jimenez MD","doi":"10.1016/j.adro.2024.101686","DOIUrl":"10.1016/j.adro.2024.101686","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"9 12","pages":"Article 101686"},"PeriodicalIF":2.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942545","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}

{"title":"Time to Next Systemic Therapy After Stereotactic Body Radiation Therapy for Oligoprogressive Metastatic Castrate-Resistant Prostate Cancer","authors":"Corbin J. Eule MD ,&nbsp;Nellowe Candelario MD ,&nbsp;Sameer K. Nath MD ,&nbsp;Tyler P. Robin MD, PhD","doi":"10.1016/j.adro.2024.101655","DOIUrl":"10.1016/j.adro.2024.101655","url":null,"abstract":"<div><h3>Purpose</h3><div>Patients with metastatic castrate-resistant prostate cancer (CRPC) with progressive disease generally require a change or escalation in systemic therapy. For patients with limited (1-3) sites of progressive disease (oligoprogression), metastasis-directed therapy with stereotactic body radiation therapy (SBRT) may allow a longer interval before next-line systemic therapy.</div></div><div><h3>Methods and Materials</h3><div>This is a retrospective study of patients with oligoprogressive metastatic CRPC (mCRPC) treated with SBRT at a single center between 2011 and 2022. The primary endpoint was time to next systemic therapy (TTNST) after SBRT stratified by the presence/absence of untreated nonprogressing metastases. Secondary endpoints included TTNST of the overall cohort and median overall survival (OS) after SBRT.</div></div><div><h3>Results</h3><div>Thirty-two patients with oligoprogressive mCRPC received SBRT to 38 metastases. Patients had a median age of 72.5 years (range, 50.6-84.3) and a median PSA of 6.85 ng/mL (range, 0.39-922.0) at the time of SBRT. The most commonly used SBRT regimen was 3000 cGy in 5 fractions (18 metastases, 47.4%). Sixteen patients were treated to all known sites of disease, whereas 16 patients received SBRT to oligoprogressive metastases but had at least 1 untreated nonprogressing metastasis at the time of SBRT. Patients had received a median of 1.0 prior line of androgen receptor signaling inhibitors and were predominantly (26 patients, 81.3%) chemotherapy naïve. Following SBRT, the median TTNST was 10.1 months and the median OS was 41.3 months. For patients with 0 versus ≥1 untreated nonprogressing metastasis, TTNST was 11.3 versus 8.7 months, respectively (HR, 0.67; 95% CI, 0.33-1.36, logrank <em>P</em> = .24). There was no grade ≥3 toxicities because of SBRT.</div></div><div><h3>Conclusions</h3><div>In this cohort, patients with oligoprogressive mCRPC treated with SBRT delayed the next line of systemic therapy for a median of 10.1 months. SBRT in patients with oligoprogressive mCRPC may delay initiation of the next-line systemic therapy in well-selected patients, including those with ≥1 untreated nonprogressing metastasis.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"9 12","pages":"Article 101655"},"PeriodicalIF":2.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765504","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}

{"title":"Cherenkov Imaged Bio-Morphological Features Verify Patient Positioning With Deformable Tissue Translocation in Breast Radiation Therapy","authors":"Yao Chen BE ,&nbsp;Savannah M. Decker PhD ,&nbsp;Petr Bruza PhD ,&nbsp;David J. Gladstone ScD ,&nbsp;Lesley A. Jarvis MD, PhD ,&nbsp;Brian W. Pogue PhD ,&nbsp;Kimberley S. Samkoe PhD ,&nbsp;Rongxiao Zhang PhD","doi":"10.1016/j.adro.2024.101684","DOIUrl":"10.1016/j.adro.2024.101684","url":null,"abstract":"<div><h3>Purpose</h3><div>Accurate patient positioning is crucial for precise radiation therapy dose delivery, as errors in positioning can profoundly influence treatment outcomes. This study introduces a novel application for loco-regional tissue deformation tracking via Cherenkov image analysis during fractionated breast cancer radiation therapy. The primary objective of this research was to develop and test an algorithmic method for Cherenkov-based position accuracy quantification, particularly for loco-regional deformations, which do not have an ideal method for quantification during radiation therapy.</div></div><div><h3>Methods and Materials</h3><div>Bio-morphological features in the Cherenkov images, such as vessels, were segmented. A rigid/nonrigid combined registration technique was employed to pinpoint both inter- and intrafractional positioning variations. The methodology was tested on an anthropomorphic chest phantom experiment via shifting a treatment couch with known distances and inducing respiratory motion to simulate interfraction setup uncertainties and intrafraction motions, respectively. It was then applied to a data set of fractionated whole breast radiation therapy human imaging (n = 10 patients).</div></div><div><h3>Results</h3><div>The methodology provided quantified positioning variations comprising 2 components: a global shift determined through rigid registration and a 2-dimensional variation map illustrating loco-regional tissue deformation quantified via nonrigid registration. Controlled phantom testing yielded an average accuracy of 0.83 mm for couch translations up to 20 mm in various directions. Analysis of clinical Cherenkov imaging data from 10 breast cancer patients compared with their first imaged fraction revealed an interfraction setup variation of 3.7 ± 2.4 mm in the global shift and loco-regional deformation up to 3.3 ± 1.9 mm (95th percentile of all regional deformation).</div></div><div><h3>Conclusions</h3><div>This study introduces the use of Cherenkov visualized bio-morphological features to quantify the global and local variations in patient positioning based on rigid and nonrigid registrations. This new approach demonstrates the feasibility of providing quantitative guidance for inter/intrafraction positioning, particularly for the loco-regional deformations that have been unappreciated in current practice with conventional imaging techniques.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 4","pages":"Article 101684"},"PeriodicalIF":2.2,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680270","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}