Profile of European proton and carbon ion therapy centers assessed by the EORTC facility questionnaire

We performed a survey using the modified EORTC Facility questionnaire (pFQ) to evaluate the human, technical and organizational resources of particle centers in Europe.

http://ift.tt/2eXtobo

Partial breast irradiation with interstitial multi-catheter high-dose-rate brachytherapy. Long-term results of a phase II prospective study

We report the long-term results of phase II prospective study with accelerated partial breast irradiation (APBI) using interstitial multi-catheter high-dose-rate brachytherapy.

http://ift.tt/2hc1wku

Improving the prediction of overall survival for head and neck cancer patients using image biomarkers in combination with clinical parameters

To develop and validate prediction models of overall survival (OS) for head and neck cancer (HNC) patients based on image biomarkers (IBMs) of the primary tumor and positive lymph nodes (Ln) in combination with clinical parameters.

http://ift.tt/2eXtkZc

Angiogenesis Inhibition in the Second-Line Treatment of Metastatic Colorectal Cancer. A Definite Conclusion?

Publication date: Available online 29 July 2017
Source:Seminars in Oncology
Author(s): M. Ducreux, P. Österlund, J.P. Pignon




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Stab injury to the preauricular region with laceration of the external carotid artery without involvement of the facial nerve: a case report

Open injuries to the face involving the external carotid artery are uncommon. These injuries are normally associated with laceration of the facial nerve because this nerve is more superficial than the external...

http://ift.tt/2tM6EgZ

Reirradiation for Recurrent Pediatric CNS Malignancies: A Multi-Institutional Review

Publication date: Available online 29 July 2017
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Avani D. Rao, Arif Rashid, Qinyu Chen, Rosangela C. Villar, Daria Kobyzeva, Kristina Nilsson, Karin Dieckmann, Alexey Nechesnyuk, Ralph Ermoian, Sara Alcorn, Shannon M. MacDonald, Matthew M. Ladra, Eric C. Ford, Brian A. Winey, Maria Luisa S. Figueiredo, Michael J. Chen, Stephanie A. Terezakis
PurposeReirradiation has been proposed as an effective modality for recurrent CNS malignancies for adults. We evaluated toxicity and outcomes of CNS reirradiation in pediatric patients.Methods and MaterialsPediatric patients age <21 years at time of initial diagnosis who developed a recurrent CNS malignancy treated with repeat radiation therapy (RT) across 5 facilities in an international pediatric research consortium were retrospectively reviewed.ResultsSixty-seven pediatric patients were treated with CNS reirradiation. Primary diagnoses included medulloblastoma/primitive neuroendocrine tumor (n=20, 30%), ependymoma (n=19, 28%), germ cell tumor (n=8, 12%), high grade glioma (n=9, 13%), low grade glioma (n=5, 7%), and other (n=6, 9%). Median age at first course of RT was 8.5 years (range:0.5-19.5 years) and 12.3 years (range:3.3-30.2 years) at time of reirradiation. The median time interval between RT courses was 2.0 years (range: 0.3-16.5). Median dose and fractionation of RT in equivalent 2 Gy fractions (EQD2) was 63.7 Gy (range 27.6-74.8 Gy) for initial RT and 53.1 Gy (range 18.6-70.1 Gy) for repeat RT. Location of relapse was infield in 52 patients (78%) and surrounding initial RT field in 15 patients (22%). Thirty-seven patients (58%) underwent gross- or sub-total resection at time of recurrence. Techniques for reirradiation were IMRT (n=46), 3D-CRT (n=9), SRS (n=4, 12-13Gyx1 or 5 Gyx5), protons (n=4), combined modality (n=3), 2D-RT (n=1), and brachytherapy (n=1). Radiation necrosis was detected in 2 cases after first course of RT and 1 additional patient after reirradiation. Six patients (9%) experienced secondary neoplasms following initial RT (1 hematologic, 5 intracranial neoplasms). One patient developed a secondary neoplasm identified shortly after repeat RT. Median overall survival following end of reirradiation was 12.8 months in the entire cohort and 20.5 and 8.4 months for patients with recurrent ependymoma and medulloblastoma following reirradiation.ConclusionsCNS reirradiation in pediatric patients may be a reasonable treatment option with moderate survival noted following repeat RT; although, prospective data characterizing rates of local control and toxicity are needed.

Teaser

This is a unique study evaluating the treatment parameters, toxicity, and outcomes of pediatric CNS reirradiation through a multi-national, multi-institutional pediatric research consortium. Low rates of radiation necrosis were observed and patients experienced reasonable survival rates following repeat radiation therapy to recurrent CNS tumors that may justify the risks of reirradiation.


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The potential of proton therapy to reduce acute haematological toxicity in concurrent chemoradiotherapy for oesophageal cancer

Publication date: Available online 29 July 2017
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Samantha Warren, Christopher N. Hurt, Thomas Crosby, Mike Partridge, Maria A. Hawkins
Radiotherapy dose escalation using a simultaneous integrated boost (SIB) is predicted to improve local tumour control in oesophageal cancer, yet any increase in acute haematological toxicity (HT) could limit the predicted improvement in patient outcome. Proton therapy has been shown to significantly reduce HT in lung cancer patients receiving concurrent chemotherapy, we therefore investigated the potential of bone marrow sparing with protons for oesophageal tumours.21 mid-oesophageal cancer patients treated with conformal radiotherapy (3D50) were selected. Two surrogates for bone marrow were created by outlining thoracic bones (bone) and only the body of the thoracic vertebrae (TV) in Eclipse (Varian). The % overlap of TV with the PTV was recorded for each patient. Additional plans were created retrospectively: a volumetric modulated arctherapy plan (VMAT50) with the same dose as 3D50; a VMAT SIB plan with a dose prescription of 62.5 Gy to the high risk sub-region within the planning treatment volume (VMAT62.5); a re-optimised TV sparing VMAT plan (VMAT62.5bm) and a proton therapy plan (SFO62.5) with the same SIB dose prescription. Bone and TV dose-metrics were recorded and compared across all plans and variation with respect to PTV size and % overlap for each patient was studied.3D50 plans show the highest bone mean dose and TV V30Gy values for each patient. VMAT plans irradiate a larger bone V10Gy volume than 3D50 plans. Re-optimised VMAT62.5bm plans showed improved sparing of the TV volume, but only proton plans showed significant sparing for bone V10Gy and bone mean dose, especially for patients with larger PTV size.

Teaser

Radiotherapy dose escalation is predicted to improve local tumour control in oesophageal cancer, yet any increase in acute haematological toxicity (HT) could limit the predicted improvement in patient outcome. We investigated the bone marrow dose of VMAT, proton plans, and marrow-sparing VMAT plans for oesophageal tumours. Improved marrow sparing was possible with VMAT, but only protons showed significant sparing for bone V10Gy and bone mean dose, especially for patients with larger PTV size.


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