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  1. Article: Novel Clinically Weight-Optimized Dynamic Conformal Arcs (WO-DCA) for Liver SBRT: A Comparison with Volumetric Modulated Arc Therapy (VMAT).

    Saglam, Yucel / Bolukbasi, Yasemin / Atasoy, Ali Ihsan / Karakose, Fatih / Budak, Mustafa / Alpan, Vildan / Topkan, Erkan / Selek, Ugur

    Therapeutics and clinical risk management

    2021  Volume 17, Page(s) 1053–1064

    Abstract: Purpose: To evaluate the feasibility of shortening the duration of liver stereotactic radiotherapy (SBRT) without jeopardizing dosimetry or conformity by utilizing weight-optimized dynamic conformal arcs (WO-DCA) as opposed to volumetric modulated arc ... ...

    Abstract Purpose: To evaluate the feasibility of shortening the duration of liver stereotactic radiotherapy (SBRT) without jeopardizing dosimetry or conformity by utilizing weight-optimized dynamic conformal arcs (WO-DCA) as opposed to volumetric modulated arc therapy (VMAT) for tumors away from critical structures.
    Methods: Nineteen patients with liver metastasis were included, previously treated with 50 Gy in 4 fractions with VMAT technique using two partial coplanar arcs of 6 MV beams delivered in high-definition multi-leaf collimator (HD-MLC). Two coplanar partial WO-DCA were generated on Pinnacle treatment planning system (TPS) for each patient; and MLC aperture around the planning target volume (PTV) was automatically generated at different margins for both arcs and maintained dynamically around the target during arc rotation. Weight of the two arcs using optimization method was adjusted between the arcs to maximize tumor coverage and protect organs at risk (OAR) based on the RTOG-0438 protocol.
    Results: The WO-DCA plans successfully "agreed" with the standard VMAT for OAR (liver, spinal cord, stomach, duodenum, small bowel, and heart) and PTV (D
    Conclusion: The WO-DCA plans might minimize small-field dosimetry errors and defeat patient-specific VMAT QA requirements due to the omission of MLC beam modulation through the target volume. The WO-DCA plans may additionally enable faster treatment delivery times and lower OAR without sacrificing target doses in SBRT of liver tumors away from critical structures.
    Language English
    Publishing date 2021-09-28
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2186560-7
    ISSN 1178-203X ; 1176-6336
    ISSN (online) 1178-203X
    ISSN 1176-6336
    DOI 10.2147/TCRM.S328375
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 6067: Show issues Location:
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  2. Article ; Online: Current practices of craniospinal irradiation techniques in Turkey: a comprehensive dosimetric analysis.

    Şenkesen, Öznur / Tezcanlı, Evrim / Alkaya, Fadime / İspir, Burçin / Çatlı, Serap / Yeşil, Abdullah / Bezirganoglu, Ebrar / Turan, Sezgi / Köksal, Canan / Güray, Gülay / Hacıislamoğlu, Emel / Durmuş, İsmail Faruk / Çavdar, Şeyma / Aksu, Telat / Çolak, Nurten / Küçükmorkoç, Esra / Doğan, Mustafa / Ercan, Tülay / Karaköse, Fatih /
    Alpan, Vildan / Ceylan, Cemile / Poyraz, Gökhan / Nalbant, Nilgül / Kınay, Şeyda / İpek, Servet / Kayalılar, Namık / Tatlı, Hamza / Zhu, Mingyao

    Radiation oncology (London, England)

    2024  Volume 19, Issue 1, Page(s) 49

    Abstract: Objective: This study evaluates various craniospinal irradiation (CSI) techniques used in Turkish centers to understand their advantages, disadvantages and overall effectiveness, with a focus on enhancing dose distribution.: Methods: Anonymized CT ... ...

    Abstract Objective: This study evaluates various craniospinal irradiation (CSI) techniques used in Turkish centers to understand their advantages, disadvantages and overall effectiveness, with a focus on enhancing dose distribution.
    Methods: Anonymized CT scans of adult and pediatric patients, alongside target volumes and organ-at-risk (OAR) structures, were shared with 25 local radiotherapy centers. They were tasked to develop optimal treatment plans delivering 36 Gy in 20 fractions with 95% PTV coverage, while minimizing OAR exposure. The same CT data was sent to a US proton therapy center for comparison. Various planning systems and treatment techniques (3D conformal RT, IMRT, VMAT, tomotherapy) were utilized. Elekta Proknow software was used to analyze parameters, assess dose distributions, mean doses, conformity index (CI), and homogeneity index (HI) for both target volumes and OARs. Comparisons were made against proton therapy.
    Results: All techniques consistently achieved excellent PTV coverage (V95 > 98%) for both adult and pediatric patients. Tomotherapy closely approached ideal Dmean doses for all PTVs, while 3D-CRT had higher Dmean for PTV_brain. Tomotherapy excelled in CI and HI for PTVs. IMRT resulted in lower pediatric heart, kidney, parotid, and eye doses, while 3D-CRT achieved the lowest adult lung doses. Tomotherapy approached proton therapy doses for adult kidneys and thyroid, while IMRT excelled for adult heart, kidney, parotid, esophagus, and eyes.
    Conclusion: Modern radiotherapy techniques offer improved target coverage and OAR protection. However, 3D techniques are continued to be used for CSI. Notably, proton therapy stands out as the most efficient approach, closely followed by Tomotherapy in terms of achieving superior target coverage and OAR protection.
    MeSH term(s) Adult ; Humans ; Child ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted/methods ; Craniospinal Irradiation/methods ; Turkey ; Radiotherapy, Conformal/methods ; Radiotherapy, Intensity-Modulated/methods
    Language English
    Publishing date 2024-04-16
    Publishing country England
    Document type Journal Article
    ZDB-ID 2224965-5
    ISSN 1748-717X ; 1748-717X
    ISSN (online) 1748-717X
    ISSN 1748-717X
    DOI 10.1186/s13014-024-02435-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Double isocenter optimization with HD-MLC linear accelerator to treat extended fields in patients with head and neck cancers.

    Saglam, Yucel / Selek, Ugur / Bolukbasi, Yasemin / Atasoy, Ali Ihsan / Karakose, Fatih / Alpan, Vildan / Akdemir, Eyub Yasar / Senyurek, Sukran / Kilic Durankus, Nulifer / Sezen, Duygu / Kucuk, Ahmet / Topkan, Erkan

    Journal of B.U.ON. : official journal of the Balkan Union of Oncology

    2021  Volume 26, Issue 4, Page(s) 1571–1581

    Abstract: Purpose: For departments with a congested patient burden or with a limited number of eligible LINACs, we investigated whether LINACS dedicated for SRS-SBRT with limited field high-definition (HD) multi-leaf collimator (MLC) could help to carry this load, ...

    Abstract Purpose: For departments with a congested patient burden or with a limited number of eligible LINACs, we investigated whether LINACS dedicated for SRS-SBRT with limited field high-definition (HD) multi-leaf collimator (MLC) could help to carry this load, and utilized a double-isocenter (DI) optimization with a limited field size of HD-MLC to defeat the craniocaudal field size restriction to match treated plans in a wide-field MLC LINAC for head and neck cancer patients.
    Methods: Fourteen patients with locally advanced head and neck cancers were included, previously treated with simultaneous integrated boost volumetric modulated arc treatment (VMAT) in 33 fractions of clinical target volumes (CTV) of 70Gy, 63Gy, and 57Gy, via single isocenter (SI) plans in Millennium MLC-120 of Varian Trilogy. The DI plans were generated on Pinnacle TPS to be delivered in HD 120 leaves MLC on Varian Truebeam. The organs at risk (OAR) doses and the prescription volume parameters were compared.
    Results: The DI plans in HD-MLC LINACs were successfully matching the previously treated plans for OAR and CTV constraints. The CI (1.18 versus 1.26; p=0.004) and HI (0.23 versus 0.29; p<0.001) were significantly improved with DI, while the MUs (1321.5 versus 800.3; p<0.001) and the treatment delivery times (6.1 versus 3.7 min; p<0.001) per fraction increased modestly with DI compared to SI, respectively.
    Conclusions: We revealed that DI optimization plans prepared for HD-MLC could effectively accomplish our goal dosimetrically in locoregionally advanced head and neck cases, despite a modest increase in the MU and treatment delivery times per fraction. This technique may provide an alternative in case of downtimes of standard MLC systems or a standalone treatment machine in case of high volumes requiring extended-field IMRT procedures, or possibly shorten the lengthy waiting times in facilities with limited SRS or SBRT patients.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Head and Neck Neoplasms/radiotherapy ; Humans ; Middle Aged ; Particle Accelerators
    Language English
    Publishing date 2021-10-22
    Publishing country Cyprus
    Document type Journal Article
    ZDB-ID 2040386-0
    ISSN 2241-6293 ; 1107-0625
    ISSN (online) 2241-6293
    ISSN 1107-0625
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5438: Show issues Location:
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  4. Article ; Online: Reproducible deep-inspiration breath-hold irradiation with forward intensity-modulated radiotherapy for left-sided breast cancer significantly reduces cardiac radiation exposure compared to inverse intensity-modulated radiotherapy.

    Bolukbasi, Yasemin / Saglam, Yucel / Selek, Ugur / Topkan, Erkan / Kataria, Anglina / Unal, Zeynep / Alpan, Vildan

    Tumori

    2014  Volume 100, Issue 2, Page(s) 169–178

    Abstract: Aims and background: To investigate the objective utility of our clinical routine of reproducible deep-inspiration breath-hold irradiation for left-sided breast cancer patients on reducing cardiac exposure.: Methods and study design: Free-breathing ... ...

    Abstract Aims and background: To investigate the objective utility of our clinical routine of reproducible deep-inspiration breath-hold irradiation for left-sided breast cancer patients on reducing cardiac exposure.
    Methods and study design: Free-breathing and reproducible deep-inspiration breath-hold scans were evaluated for our 10 consecutive left-sided breast cancer patients treated with reproducible deep-inspiration breath-hold. The study was based on the adjuvant dose of 50 Gy in 25 fractions of 2 Gy/fraction. Both inverse and forward intensity-modulated radiotherapy plans were generated for each computed tomography dataset.
    Results: Reproducible deep-inspiration breath-hold plans with forward intensity-modulated radiotherapy significantly spared the heart and left anterior descending artery compared to generated free-breathing plans based on mean doses - free-breathing vs reproducible deep-inspiration breath-hold, left ventricle (296.1 vs 94.5 cGy, P = 0.005), right ventricle (158.3 vs 59.2 cGy, P = 0.005), left anterior descending artery (171.1 vs 78.1 cGy, P = 0.005), and whole heart (173.9 vs 66 cGy, P = 0.005), heart V20 (2.2% vs 0%, P = 0.007) and heart V10 (4.2% vs 0.3%, P = 0.007) - whereas they revealed no additional burden on the ipsilateral lung. Reproducible deep-inspiration breath-hold and free-breathing plans with inverse intensity-modulated radiotherapy provided similar organ at risk sparing by reducing the mean doses to the left ventricle, left anterior descending artery, heart, V10-V20 of the heart and right ventricle. However, forward intensity-modulated radiotherapy showed significant reduction in doses to the left ventricle, left anterior descending artery, heart, right ventricle, and contralateral breast (mean dose, 248.9 to 12.3 cGy, P = 0.005). The mean doses for free-breathing vs reproducible deep-inspiration breath-hold of the proximal left anterior descending artery were 1.78 vs 1.08 Gy and of the distal left anterior descending artery were 8.11 vs 3.89 Gy, whereas mean distances to the 50 Gy isodose line of the proximal left anterior descending artery were 6.6 vs 3.3 cm and of the distal left anterior descending artery were 7.4 vs 4.1 cm, with forward intensity-modulated radiotherapy. Overall reduction in mean doses to proximal and distal left anterior descending artery with deep-inspiration breath-hold irradiation was 39% (P = 0.02) and 52% (P = 0.002), respectively.
    Conclusions: We found a significant reduction of radiation exposure to the contralateral breast, left and right ventricles, as well as of proximal and especially distal left anterior descending artery with the deep-inspiration breath-hold technique with forward intensity-modulated radiotherapy planning.
    MeSH term(s) Adult ; Aged ; Breast Neoplasms/pathology ; Breast Neoplasms/radiotherapy ; Breath Holding ; Female ; Heart/radiation effects ; Humans ; Inhalation ; Middle Aged ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Intensity-Modulated/adverse effects ; Radiotherapy, Intensity-Modulated/methods ; Tomography, X-Ray Computed
    Language English
    Publishing date 2014-03-13
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 280962-x
    ISSN 2038-2529 ; 0300-8916
    ISSN (online) 2038-2529
    ISSN 0300-8916
    DOI 10.1700/1491.16405
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

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    Zs.MO 287: Show issues

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