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  1. AU="Neil K. Taunk, MD"
  2. AU="Letourneau-Guillon, Laurent"
  3. AU="Dziuba, Marina V"
  4. AU="Aleksander Zińczuk"
  5. AU="Rowe, Logan M."
  6. AU="Sharma N." AU="Sharma N."
  7. AU=Yuan Shu
  8. AU="Ye Liu"
  9. AU="Bezerra, Antônio Diego M"
  10. AU="HE Xiufeng"
  11. AU=Freeman Hugh J AU=Freeman Hugh J
  12. AU="Choi, John Kim"
  13. AU="Streng, Bianca M M"
  14. AU="Franklin, Renty B"
  15. AU="Tetri, Laura H"
  16. AU="Badve, Sunil V"
  17. AU=Zhang Yinan
  18. AU="Piquero, Nicole Leeper"
  19. AU="Russo, Giorgio Ivan" AU="Russo, Giorgio Ivan"
  20. AU=Pourdowlat Guitti
  21. AU="Frisenda, Riccardo"
  22. AU=Palmucci Stefano

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  1. Artikel ; Online: Breast Reconstruction Complications After Postmastectomy Proton Radiation Therapy for Breast Cancer

    Eva Berlin, MD / Nikhil Yegya-Raman, MD / Casey Hollawell, MD / Allison Haertter, MS / Joshua Fosnot, MD / Sylvia Rhodes, BA / Seung Won Seol, MD, PhD / Michelle Gentile, MD, PhD / Taoran Li, PhD / Gary M. Freedman, MD / Neil K. Taunk, MD, MSCTS

    Advances in Radiation Oncology, Vol 9, Iss 3, Pp 101385- (2024)

    2024  

    Abstract: Purpose: Our purpose was to report complications requiring surgical intervention among patients treated with postmastectomy proton radiation therapy (PMPRT) for breast cancer in the setting of breast reconstruction (BR). Methods and Materials: Patients ... ...

    Abstract Purpose: Our purpose was to report complications requiring surgical intervention among patients treated with postmastectomy proton radiation therapy (PMPRT) for breast cancer in the setting of breast reconstruction (BR). Methods and Materials: Patients enrolled on a prospective proton registry who underwent BR with immediate autologous flap, tissue expander (TE), or implant in place during PMPRT (50/50.4 Gy +/- chest wall boost) were eligible. Major reconstruction complication (MRC) was defined as a complication requiring surgical intervention. Absolute reconstruction failure was an MRC requiring surgical removal of BR. A routine revision (RR) was a plastic surgery refining cosmesis of the BR. Kaplan-Meier method was used to assess disease outcomes and MRC. Cox regression was used to assess predictors of MRC. Results: Seventy-three courses of PMPRT were delivered to 68 women with BR between 2013 and 2021. Median follow-up was 42.1 months. Median age was 47 years. Fifty-six (76.7%) courses used pencil beam scanning PMPRT. Of 73 BR, 29 were flaps (39.7%), 30 implants (41.1%), and 14 TE (19.2%) at time of irradiation. There were 20 (27.4%) RR. There were 9 (12.3%) MRC among 5 implants, 2 flaps, and 2 TE, occurring a median of 29 months from PMPRT start. Three-year freedom from MRC was 86.9%. Three (4.1%) of the MRC were absolute reconstruction failure. Complications leading to MRC included capsular contracture in 5, fat necrosis in 2, and infection in 2. On univariable analysis, BR type, boost, proton technique, age, and smoking status were not associated with MRC, whereas higher body mass index trended toward significance (hazard ratio, 1.07; 95% CI, 0.99-1.16; P = .10). Conclusions: Patients undergoing PMPRT to BR had a 12.3% incidence of major complications leading to surgical intervention, and total loss of BR was rare. MRC rates were similar among reconstruction types. Minor surgery for RR is common in our practice.
    Schlagwörter Medical physics. Medical radiology. Nuclear medicine ; R895-920 ; Neoplasms. Tumors. Oncology. Including cancer and carcinogens ; RC254-282
    Thema/Rubrik (Code) 616 ; 610
    Sprache Englisch
    Erscheinungsdatum 2024-03-01T00:00:00Z
    Verlag Elsevier
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  2. Artikel ; Online: Proton Reirradiation for Locoregionally Recurrent Breast Cancer

    Michael J. LaRiviere, MD / Alexandra Dreyfuss, MD / Neil K. Taunk, MD, MS / Gary M. Freedman, MD

    Advances in Radiation Oncology, Vol 6, Iss 4, Pp 100710- (2021)

    2021  

    Abstract: Purpose: Local-regional recurrence (LRR) of breast cancer after prior adjuvant radiation (RT) can present a clinical challenge. Proton therapy is recommended by the American Society for Radiation Oncology in cases where reirrradiation is needed; however, ...

    Abstract Purpose: Local-regional recurrence (LRR) of breast cancer after prior adjuvant radiation (RT) can present a clinical challenge. Proton therapy is recommended by the American Society for Radiation Oncology in cases where reirrradiation is needed; however, data are limited. We present the toxicity and outcomes after reirradiation for local-regional recurrence of breast cancer with proton therapy. Methods and Materials: A single-institution retrospective review identified patients with the following criteria: LRR of breast cancer, prior photon radiation to the same region, proton beam reirradiation, and definitive intent. Surgery or systemic therapy at the time of recurrence was used when indicated. The log-rank test was used to compare Kaplan-Meier survival estimates. Kruskal-Wallis tests were performed to compare worst reported toxicities with clinical variables. Results: The population included 27 patients with a history of prior radiation and treated with proton therapy for LRR between 2012 and 2019. The median interval between courses was 9.7 years. Proton reirradiation regimens included whole breast/chest wall (WB/CW) with regional nodal RT (22/27), nodal RT alone (2/27), or WB/CW alone (3/27). The median dose was 51 Gy, and the most common fractionation was 1.5 Gy twice daily. Median follow-up after reirradiation was 16.6 months. Acute grade 3 toxicities included dermatitis in 2 patients and breast pain in 2 patients. Grade 2 or higher late toxicities included 6 G2 rib fractures and 1 G2 brachial plexopathy, 1 G3 dermatitis, 1 G3 breast pain, and 1 G4 dermatitis. Twelve patients had new documented recurrences of which 1 was a second in-field LRR, and there were 7 deaths. Conclusions: Proton salvage reirradiation to median 51 Gy in 1.5 Gy twice daily appears to be safe with acceptable acute and late toxicity, and effective with >95% local-regional control.
    Schlagwörter Medical physics. Medical radiology. Nuclear medicine ; R895-920 ; Neoplasms. Tumors. Oncology. Including cancer and carcinogens ; RC254-282
    Thema/Rubrik (Code) 616 ; 610
    Sprache Englisch
    Erscheinungsdatum 2021-07-01T00:00:00Z
    Verlag Elsevier
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  3. Artikel ; Online: Simultaneous Multiple Liver Metastasis Treated with Pencil Beam Proton Stereotactic Body Radiotherapy (SBRT)

    Neil K. Taunk, MD, MSCTS / Brendan Burgdorf, MMP / Lei Dong, PhD / Edgar Ben-Josef, MD

    International Journal of Particle Therapy, Vol 8, Iss 2, Pp 89-

    2021  Band 94

    Abstract: Compared with photon stereotactic body radiotherapy (SBRT) plans that may have to use many more penetrating x-ray beams for each isocenter, proton SBRT with ultrahypofractionated doses use fewer beam angles and offer significantly reduced low-dose ... ...

    Abstract Compared with photon stereotactic body radiotherapy (SBRT) plans that may have to use many more penetrating x-ray beams for each isocenter, proton SBRT with ultrahypofractionated doses use fewer beam angles and offer significantly reduced low-dose radiation bath to normal liver tissue. We demonstrate techniques to deliver safe and effective proton SBRT, where planning and organ motion complexity further increased with multiple liver lesions. For treatment planning, we recommend robust and logical beam angles, avoiding devices and encouraging entry perpendicular to the dominant motion, as well as volumetric repainting to mitigate the interplay effect to clinically acceptable levels. This report highlights the significant technical challenges with ultrahypofractionated proton pencil beam scanning liver therapy, how they are managed, and the effectiveness of this treatment.
    Schlagwörter proton therapy ; liver metastasis ; sbrt ; stereotactic body radiotherapy ; pbs ; pencil beam scanning ; Medical physics. Medical radiology. Nuclear medicine ; R895-920 ; Nuclear and particle physics. Atomic energy. Radioactivity ; QC770-798
    Thema/Rubrik (Code) 535
    Sprache Englisch
    Erscheinungsdatum 2021-04-01T00:00:00Z
    Verlag Particle Therapy Co-operative Group
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  4. Artikel ; Online: Effect of COVID-19 on Gynecologic Oncology Care

    Jeffrey V. Brower, MD, PhD / Sylvia S. Rhodes, BA / Jill S. Remick, MD / Andrea L. Russo, MD / Emily F. Dunn, MD / Diandra N. Ayala-Peacock, MD / Daniel G. Petereit, MD / Kristin A. Bradley, MD / Neil K. Taunk, MD

    Advances in Radiation Oncology, Vol 8, Iss 4, Pp 101188- (2023)

    A Survey of Practicing Gynecologic Radiation Oncologists in the United States

    2023  

    Abstract: Purpose: The COVID-19 pandemic has placed demands and limitations on the delivery of health care. We sought to assess the effect of COVID-19 on the delivery of gynecologic oncologic care from the perspective of practicing radiation oncologists in the ... ...

    Abstract Purpose: The COVID-19 pandemic has placed demands and limitations on the delivery of health care. We sought to assess the effect of COVID-19 on the delivery of gynecologic oncologic care from the perspective of practicing radiation oncologists in the United States. Methods and Materials: An anonymous online survey was created and distributed to preidentified radiation oncologists in the United States with clinical expertise in the management of gynecologic patients. The survey consisted of demographic questions followed by directed questions to assess specific patterns of care related to the COVID-19 pandemic. Results: A total of 47 of 96 invited radiation oncologists responded to the survey for a response rate of 49%. Fifty-six percent of respondents reported an increase in locally advanced cervical cancer with no similar increase for endometrial, vulvar, or vaginal patients. Most respondents (66%) reported a pause in surgical management, with a duration of 1 to 3 months being most common (61%). There was a reported increased use of shorter brachytherapy regimens during the pandemic. Most providers (61%) reported caring for at least 1 patient with a positive COVID-19 test. A pause or delay in treatment due to COVID-19 positivity was reported by 45% of respondents, with 55% reporting that patients chose to delay their own care because of COVID-19–related concerns. Total treatment times >8 weeks for patients with cervical cancer were observed by 33% of respondents, but occurred in >25% of patients. Conclusions: Data from this prospectively collected anonymous survey of practice patterns among radiation oncologists reveal that the COVID-19 pandemic resulted in delays initiating care, truncated brachytherapy treatment courses, and a reported increase in locally advanced cervical cancer cases at presentation. These data can be used as a means of self-assessment to ensure appropriate decision making for gynecologic patients during the endemic phase of COVID-19.
    Schlagwörter Medical physics. Medical radiology. Nuclear medicine ; R895-920 ; Neoplasms. Tumors. Oncology. Including cancer and carcinogens ; RC254-282
    Thema/Rubrik (Code) 310
    Sprache Englisch
    Erscheinungsdatum 2023-07-01T00:00:00Z
    Verlag Elsevier
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    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  5. Artikel ; Online: Factors Associated With Travel Distance in the Receipt of Proton Breast Radiation Therapy

    Sylvia S. Rhodes, BA / Eva Berlin, MD / Nikhil Yegya-Raman, MD / Abigail Doucette, MPH / Michelle Gentile, MD, PhD / Gary M. Freedman, MD / Neil K. Taunk, MD, MSCTS

    International Journal of Particle Therapy, Pp 1-

    2022  Band 9

    Abstract: Introduction: Proton radiation therapy (PBT) may reduce cardiac doses in breast cancer treatment. Limited availability of proton facilities could require significant travel distances. This study assessed factors associated with travel distances for ... ...

    Abstract Introduction: Proton radiation therapy (PBT) may reduce cardiac doses in breast cancer treatment. Limited availability of proton facilities could require significant travel distances. This study assessed factors associated with travel distances for breast PBT. Materials and Methods: Patients receiving breast PBT at the University of Pennsylvania from 2010 to 2021 were identified. Demographic, cancer, and treatment characteristics were summarized. Straight-line travel distances from the department to patients’ addresses were calculated using BatchGeo. Median and mean travel distances were reported. Given non-normality of distribution of travel distances, Wilcoxon rank sum or Kruskal-Wallis test was used to determine whether travel distances differed by race, clinical trial participation, disease laterality, recurrence, and prior radiation. Results: Of 1 male and 284 female patients, 67.8% were White and 21.7% Black. Median travel distance was 13.5 miles with interquartile range of 6.1 to 24.8 miles, and mean travel distance was 13.5 miles with standard deviation of 261.4 miles. 81.1% of patients traveled less than 30 and 6.0% more than 100 miles. Black patients’ travel distances were significantly shorter than White patients’ and non-Black or non-White patients’ travel distances (median = 4.5, 16.5, and 11.3 miles, respectively; P < .0001). Patients not on clinical trials traveled more those on clinical trials (median = 14.7 and 10.2 miles, respectively; P = .032). There was no difference found between travel distances of patients with left-sided versus right-sided versus bilateral disease (P = .175), with versus without recurrent disease (P = .057), or with versus without prior radiation (P = .23). Conclusion: This study described travel distances and demographic and clinicopathologic characteristics of patients receiving breast PBT at the University of Pennsylvania. Black patients traveled less than White and non-Black or non-White patients and comprised a small portion of the cohort, suggesting barriers to ...
    Schlagwörter breast cancer ; proton radiation therapy ; travel distance ; Medical physics. Medical radiology. Nuclear medicine ; R895-920 ; Nuclear and particle physics. Atomic energy. Radioactivity ; QC770-798
    Thema/Rubrik (Code) 610 ; 616
    Sprache Englisch
    Erscheinungsdatum 2022-09-01T00:00:00Z
    Verlag Particle Therapy Co-operative Group
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    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  6. Artikel ; Online: Complete Response After Stereotactic Body Radiation Therapy With Concurrent Immunotherapy for Vaginal Melanoma

    Caitlin A. Schonewolf, MD, MSCTS / Elizabeth M. Jaworski, MD / Steven G. Allen, MD, PhD / Karen McLean, MD / Christopher D. Lao, MD / Lynn M. Schuchter, MD / Janos Tanyi, MD, PhD / Neil K. Taunk, MD, MSCTS

    Advances in Radiation Oncology, Vol 7, Iss 2, Pp 100839- (2022)

    2022  

    Schlagwörter Medical physics. Medical radiology. Nuclear medicine ; R895-920 ; Neoplasms. Tumors. Oncology. Including cancer and carcinogens ; RC254-282
    Sprache Englisch
    Erscheinungsdatum 2022-03-01T00:00:00Z
    Verlag Elsevier
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  7. Artikel ; Online: Palliative Radiation Therapy for Metastatic, Persistent, or Recurrent Epithelial Ovarian Cancer

    Anish A. Butala, MD / Roshal R. Patel, BA / Shwetha Manjunath, MD / Nawar A. Latif, MD, MPH, MSCE / Ashley F. Haggerty, MD, MSCE / Joshua A. Jones, MD, FAAHPM / Neil K. Taunk, MD, MSCTS

    Advances in Radiation Oncology, Vol 6, Iss 1, Pp 100624- (2021)

    Efficacy in the Era of Modern Technology and Targeted Agents

    2021  

    Abstract: Purpose: Metastatic, persistent, or recurrent epithelial ovarian cancer (MPR-EOC) remains a significant threat to patient mortality despite advances in novel targeted agents. Radiation therapy (RT) is often used as a palliative option. We report outcomes ...

    Abstract Purpose: Metastatic, persistent, or recurrent epithelial ovarian cancer (MPR-EOC) remains a significant threat to patient mortality despite advances in novel targeted agents. Radiation therapy (RT) is often used as a palliative option. We report outcomes of a large series of MPR-EOC patients treated with modern palliative RT (PRT) in an era of novel systemic therapies. Methods and Materials: A retrospective review was conducted of women treated with PRT for MPR-EOC between 2007 and 2019 at an academic institution. Clinical response rates were recorded at <1 month, 1 to 3 months, and >3 months. Radiographic responses were categorized by RECIST 1.1 criteria. Overall response rate (ORR) was the sum of complete and partial response. Linear regression analyses of baseline characteristics were conducted for statistical testing. Results: Eighty-six patients with PMR-OC received 120 courses of palliative RT. Median follow-up was 8.6 months. Median age was 61 (range, 22-82). Thirty-six percent of women received central nervous system (CNS)-directed RT. In addition, 43% received targeted therapies before RT. Clinical ORR within 1 month and at last follow-up for non-CNS lesions was 79% and 61% (69% and 88% for CNS lesions, respectively). High-grade serous lesions were more likely to have clinical response (P = .04). Biologically effective doses (BED) >39 Gy were associated with improved clinical response in CNS lesions (P = .049). Bony sites were associated with worse clinical (P = .004) response in non-CNS lesions compared with soft tissue or nodal sites. Acute or late grade 3+ toxicities with bevacizumab were low (8.7%/4.3%). Conclusions: PRT offers excellent rates of response for symptomatic patients with MPR-EOC within 1 month of treatment, with durable responses beyond 3 months. High-grade serous lesions were associated with improved response in all patients. Higher BED and soft tissue or nodal sites were associated with improved response in CNS and non-CNS patients, respectively. Acute or late toxicities with bevacizumab and PRT were low. Prospective investigation is warranted to determine the optimal PRT regimen.
    Schlagwörter Medical physics. Medical radiology. Nuclear medicine ; R895-920 ; Neoplasms. Tumors. Oncology. Including cancer and carcinogens ; RC254-282
    Sprache Englisch
    Erscheinungsdatum 2021-01-01T00:00:00Z
    Verlag Elsevier
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  8. Artikel ; Online: Initial Clinical Experience Treating Patients With Gynecologic Cancers on a 6MV Flattening Filter Free O-Ring Linear Accelerator

    Andrew R. Barsky, MD / Michele M. Kim, PhD / Alexandra Dreyfuss, BSE / Lei Dong, PhD / James M. Metz, MD / Shibu Anamalayil, MS / Taoran Li, PhD / Neil K. Taunk, MD, MS

    Advances in Radiation Oncology, Vol 5, Iss 5, Pp 920-

    2020  Band 928

    Abstract: Purpose: Radiation therapy (RT) is commonly used in the treatment of gynecologic cancers. Intensity-modulated RT (IMRT) has been shown to reduce gastrointestinal toxicity compared with 2-dimensional and 3-dimensional RT modalities. We report the initial ... ...

    Abstract Purpose: Radiation therapy (RT) is commonly used in the treatment of gynecologic cancers. Intensity-modulated RT (IMRT) has been shown to reduce gastrointestinal toxicity compared with 2-dimensional and 3-dimensional RT modalities. We report the initial clinical experience using IMRT for gynecologic cancers with a novel 6MV flattening filter free O-ring linear accelerator (6X-FFF ORL). Methods and Materials: We retrospectively identified consecutive women with uterine or cervical cancer who received pelvic RT on Halcyon (Varian Medical Systems, Palo Alto, CA), a novel 6X-FFF ORL. We report their clinicopathologic data, RT details, early disease-control outcomes, acute toxicities, dose-volume histogram data, couch corrections, and treatment times. Results: Seventeen women received RT on a 6X-FFF ORL for uterine cancer (76%) or cervical cancer (24%) between January 2017 and September 2019. RT was delivered postoperatively (82%) or to intact disease (18%), to a median dose of 50.4 Gy (range, 19.8-55.0 Gy) in 25 fractions (range, 11-28), with 12% receiving extended-field RT and 65% receiving chemotherapy. Target and organ-at-risk constraints were met in all plans. The 3-dimensional vector couch correction average was 0.90 ± 0.37 cm. The mean beam-on time was 2.9 ± 0.4 min and mean treatment time, from imaging start to beam-off, was 3.6 ± 0.4 min. Grade 2 fatigue, anorexia, diarrhea, bloating, and nausea occurred in 41%, 12%, 12%, 6%, and 6% of patients, respectively. There were no grade ≥3 toxicities. Conclusions: In the initial clinical report of pelvic RT for gynecologic cancers using a 6X-FFF ORL, the linac showed versatility in treatment; comparability to flattening-filtered IMRT for early disease-control, toxicity, and dosimetry; and treatment speed that compared favorably to IMRT on a C-arm gantry. Accordingly, a 6X-FFF ORL may increase throughput or reduce day length in departments with high gynecologic cancer volumes, without compromising clinical outcomes.
    Schlagwörter Medical physics. Medical radiology. Nuclear medicine ; R895-920 ; Neoplasms. Tumors. Oncology. Including cancer and carcinogens ; RC254-282
    Thema/Rubrik (Code) 610
    Sprache Englisch
    Erscheinungsdatum 2020-09-01T00:00:00Z
    Verlag Elsevier
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  9. Artikel ; Online: Initial Clinical Experience Treating Patients with Breast Cancer on a 6-MV Flattening-Filter-Free O-Ring Linear Accelerator

    Andrew R. Barsky, MD / Fionnbarr O'Grady, PhD / Christopher Kennedy, PhD / Neil K. Taunk, MD, MS / Lei Dong, PhD / James M. Metz, MD / Taoran Li, PhD / Gary M. Freedman, MD

    Advances in Radiation Oncology, Vol 4, Iss 4, Pp 571-

    2019  Band 578

    Abstract: Purpose: Three-dimensional (3D) conformal radiation therapy is the standard technique used for adjuvant breast radiation. We report the clinical use of a novel 6-MV flattening-filter-free O-ring linear accelerator (6X-FFF ORL) for breast cancer that may ... ...

    Abstract Purpose: Three-dimensional (3D) conformal radiation therapy is the standard technique used for adjuvant breast radiation. We report the clinical use of a novel 6-MV flattening-filter-free O-ring linear accelerator (6X-FFF ORL) for breast cancer that may improve upon 3D conformal radiation therapy with its higher dose rate and faster rotation and leaf speed than traditional C-arm gantries. Methods and Materials: We retrospectively identified consecutive women with breast cancer who underwent surgery followed by radiation therapy to the breast or chest wall on Halcyon (Varian Medical Systems, Palo Alto, CA), a novel 6X-FFF ORL. We report their clinicopathologic information, radiation therapy details, acute toxicities, dose-volume histogram data, couch corrections, and treatment times. Results: Thirty-four women were treated for breast cancer on a 6X-FFF ORL between February 2018 and September 2018. All patients underwent lumpectomy (92%) or mastectomy (8%). Tumors were left sided in 44% and bilateral in 9%, and 9% included comprehensive nodal radiation therapy. Twelve percent of patients were treated prone and 29% with deep-inspiration breath hold. Standard target and normal-tissue constraints were met in nearly all plans. The 3D vector couch correction average was 0.77 ± 0.05 cm. The mean beam-on time was 2.0 ± 0.3 minutes, and mean treatment time from start of imaging to beam-off was 4.4 ± 0.4 minutes. Grade 2 dermatitis, fatigue, and breast pain occurred in 18%, 9%, and 3% of patients, respectively. Conclusions: In this first clinical report of breast radiation therapy with a 6X-FFF ORL, treatment was versatile and fast for complex setups and techniques, with acceptable toxicity and organ-at-risk doses. Thus, a 6X-FFF ORL can increase throughput or reduce length of day compared with a conventional C-arm linear accelerator in departments with a busy breast service.
    Schlagwörter Medical physics. Medical radiology. Nuclear medicine ; R895-920 ; Neoplasms. Tumors. Oncology. Including cancer and carcinogens ; RC254-282
    Thema/Rubrik (Code) 616 ; 610
    Sprache Englisch
    Erscheinungsdatum 2019-10-01T00:00:00Z
    Verlag Elsevier
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  10. Artikel ; Online: Increase in Superficial Dose in Whole-Breast Irradiation With Halcyon Straight-Through Linac Compared With Traditional C-arm Linac With Flattening Filter

    Fionnbarr O'Grady, PhD / Andrew R. Barsky, MD / Shibu Anamalayil, MS / Gary M. Freedman, MD / Christopher Kennedy, PhD / Bin Cai, PhD / Eric Laugeman, MS / Lei Dong, PhD / Geoffrey D. Hugo, PhD / James M. Metz, MD / Sasa Mutic, PhD / Neil K. Taunk, MD, MS / Taoran Li, PhD

    Advances in Radiation Oncology, Vol 5, Iss 1, Pp 120-

    In vivo Dosimetry and Planning Study

    2020  Band 126

    Abstract: Purpose: Superficial dose is an important parameter in breast cancer radiation therapy. When treated with conventional linacs, bolus is commonly applied to improve target coverage near the surface while also managing the risk of severe skin reactions and ...

    Abstract Purpose: Superficial dose is an important parameter in breast cancer radiation therapy. When treated with conventional linacs, bolus is commonly applied to improve target coverage near the surface while also managing the risk of severe skin reactions and negative cosmesis. With the introduction of modern linacs with 6X flattening filter free (FFF) photon beams, the effect on superficial dose and the need for bolus must be evaluated. Methods and Materials: In vivo measurements of superficial dose were made with optically stimulated luminescence dosimeters on 11 breast cancer patients treated with the Halcyon 6X FFF linac (Varian Medical Systems, Palo Alto, CA). Additionally, measurements were made with the Halycon 6X FFF beam and a 6X beam with flattening filter (FF) delivered to an anthropomorphic phantom. A planning study was carried out in which 14 patients treated on the Halcyon were replanned with a conventional linac to determine the difference in superficial dose predicted by the treatment planning system. Measures were taken to increase the accuracy of the treatment planning system superficial dose. Results: The use of the Halcyon 6X FFF beam led to higher superficial dose compared with 6X FF beams. The in vivo measurements show an average superficial dose of 83.8% ± 0.6%, which is an increase of approximately 10% compared with published measurements for a 6X FF linac. Comparison of superficial dose for 6X FF and 6X FFF beams in the phantom measurements show an increase from 70% ± 1.3% to 84% ± 1.3%, which is consistent with the in vivo measurements. The planning comparison shows an increase in V70%Rx from 62% ± 4.4% to 81% ± 2.2% for the superficial breast tissue for the Halcyon 6X FFF beam compared with a standard C-arm linac with FF. Conclusions: The use of the Halcyon 6X FFF beam was associated with higher superficial dose which may obviate the use of bolus.
    Schlagwörter Medical physics. Medical radiology. Nuclear medicine ; R895-920 ; Neoplasms. Tumors. Oncology. Including cancer and carcinogens ; RC254-282
    Thema/Rubrik (Code) 616
    Sprache Englisch
    Erscheinungsdatum 2020-01-01T00:00:00Z
    Verlag Elsevier
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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