Publishing type：Research paper (scientific journal)   Publisher：Wiley  

Abstract

Background

Acceleration treatment (AT) is a novel treatment planning parameter introduced in the tomotherapy‐dedicated treatment planning system, Precision. This study explores the effects of AT on tomotherapy plans using helical (TomoHelical) and direct (TomoDirect) irradiation techniques.

Methods

This study enrolled 20 patients with lung cancer. Initially, 10 TomoHelical and 10 TomoDirect treatment plans were created for each patient, utilizing patient‐specific field width and pitch with an AT setting of 0. These original plans were subsequently reoptimized by changing only the AT values to 1, 4, 7, and 10 without changing other calculation parameters to assess the impact of AT on dosimetric and delivery parameters. Additionally, the deliverability of all plans was evaluated through patient‐specific quality assurance using gamma analysis.

Results

Increasing the AT from 0 to 10 led to a slight increase in maximum doses and a decrease in minimum doses within the target volume, thereby impairing dose homogeneity. Dose conformity to the target also deteriorated. Conversely, target coverage and delivery time improved considerably with higher AT values. Moreover, doses to organs at risk, including the lung, spinal cord, heart, and esophagus, remained clinically acceptable across all plans. Changes in these doses and the gamma pass rate in patient‐specific quality assurance were negligible with variations in AT. This trend was consistent across both delivery techniques.

Conclusion

AT is a crucial parameter in tomotherapy planning for modulating plan and delivery qualities. Higher AT values can enhance target coverage and delivery time efficiency.

DOI： 10.1002/acm2.70049

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Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.radonc.2024.110121

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Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: This study aimed to analyze treatment outcomes and prognostic markers, including immune and inflammatory factors, of postoperative radiation therapy (RT) administered to patients with cholangiocarcinoma (CCA). METHODS: We retrospectively included 59 patients with CCA who underwent surgery and postoperative RT with curative intent from 2004 to 2019. Patients received external irradiation (50 Gy in 25 fractions) using three-dimensional RT. We analyzed prognostic factors of inflammation, such as pre-RT platelet count, hemoglobin, lymphocyte count ratio (LCR) of the leukocyte count, platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR). RESULTS: Tumor stages were distributed as follows: I (n = 8), II (n = 25), III (n = 15), and IVA (n = 11). The median follow-up was 24 months. Two-year overall survival (OS), cause-specific survival (CSS), progression-free survival (PFS), and locoregional control (LRC) rates were 59.5%, 62.0%, 40.1%, and 66.7%, respectively. Univariate analysis revealed that lower LCR was significantly associated with shorter PFS (p = 0.0446). There was no significant difference between the median baseline values of PLR and NLR; and age ≥75, positive regional lymph node metastases (N+), and chemotherapy after RT were significantly associated with poor OS. Multivariate analysis revealed a significant association of N+ with worse OS, PFS, and CSS and that lower LCR was significantly associated with better PFS (p = 0.0234). Among late toxicity events, two patients (3.38%) were suspected with therapy-related liver toxicity. CONCLUSIONS: Lower LCR before RT was a better prognostic factor for postoperative RT of patients with CCA.

DOI： 10.1111/ajco.13809

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND/AIM: This study aimed to evaluate the outcome of radiation therapy for patients with distant lymph node (LN) metastases, without organ metastases from uterine cervical cancer (UCC). PATIENTS AND METHODS: Twenty-six patients with UCC with distant LN metastases received radiotherapy and were retrospectively analyzed. The sites of distant LN metastasis were as follows; Supraclavicular in 19, inguinal in nine, axillary in four, and others in three. The mean dose prescribed for these was 50 (range=40-60) Gy. RESULTS: The 2-year overall, cause-specific, and progression-free survival, and local control of primary tumor rates were 51.3%, 51.3%, 46.9%, and 67.9%. In multivariate analysis, performance status ≥1 (p=0.007), para-aortic LN metastases (p=0.001), and lack of high-dose-rate intracavitary brachytherapy (p=0.033) were significantly associated with poor overall survival. Performance status ≥1 (p=0.004), and para-aortic LN metastases (p=0.014) were significantly associated with poor cause-specific survival. CONCLUSION: This study demonstrated favorable local control in patients with UCC with distant LN metastases.

DOI： 10.21873/invivo.12365

PubMed

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Publisher：Frontiers Media SA  

<jats:p>Radiation therapy (RT)-induced cardiopulmonary toxicities remain dose-limiting toxicities for patients receiving radiation dosages to the thorax, especially for lung cancer. Means of monitoring and predicting for those receiving RT or concurrent chemoradiation therapy before treatment begins in individual patients could benefit early intervention to prevent or minimize RT-induced side effects. Another aspect of an individual’s susceptibility to the adverse effects of thoracic irradiation is the immune system as reflected by phenotypic factors (patterns of cytokine expressions), genotypic factors (single nucleotide variants SNVs; formerly single nucleotide polymorphisms [SNPs]), and aspects of quantitative cellular imaging. Levels of transcription, production, and functional activity of cytokines are often influenced by SNVs that affect coding regions in the promoter or regulatory regions of cytokine genes. SNVs can also lead to changes in the expression of the inflammatory cytokines, interferons, interleukins (IL-6, IL-17) and tumor necrosis factors (TNF-α) at the protein level. RT-induced cardiopulmonary toxicities could be quantified by the uptake of <jats:sup>18</jats:sup>F-fluorodeoxyglucose (FDG), however, FDG is a sensitive but not specific biomarker in differential diagnosis between inflammation/infection and tumor recurrence. FDG is suitable for initial diagnosis of predisposed tissue injuries in non-small cell lung cancer (NSCLC). <jats:sup>99m</jats:sup>Tc-ethylenedicysteine-glucosamine (<jats:sup>99m</jats:sup>Tc-EC-G) was able to measure tumor DNA proliferation and myocardial ischemia <jats:italic>via</jats:italic> hexosamine biosynthetic pathways (HBP). Thus, <jats:sup>99m</jats:sup>Tc-EC-G could be an alternative to FDG in the assessment of RT doses and select patients in HBP-directed targets for optimal outcomes. This article reviewed correlative analyses of pro-inflammatory cytokines, genotype SNVs, and cellular imaging to improve the diagnosis, prognosis, monitoring, and prediction of RT-induced cardiopulmonary toxicities in NSCLC.</jats:p>

DOI： 10.3389/fonc.2022.984364

PubMed

CiNii Research

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：ELSEVIER SCIENCE INC  

Web of Science

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：ELSEVIER SCIENCE INC  

Web of Science

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Web of Science

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：ELSEVIER SCI LTD  

Web of Science

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Language：English  

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Language：English   Presentation type：Poster presentation  

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Language：English   Presentation type：Poster presentation  

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Language：English   Presentation type：Poster presentation  

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