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Kargar N, Zeinali A, Molazadeh M. Impact of Dose Calculation Algorithms and Radiobiological Parameters on Prediction of Cardiopulmonary Complications in Left Breast Radiation Therapy. J Biomed Phys Eng 2024; 14:129-140. [PMID: 38628897 PMCID: PMC11016826 DOI: 10.31661/jbpe.v0i0.2305-1616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 12/13/2023] [Indexed: 04/19/2024]
Abstract
Background Breast cancer requires evaluating treatment plans using dosimetric and biological parameters. Considering radiation dose distribution and tissue response, healthcare professionals can optimize treatment plans for better outcomes. Objective This study aimed to evaluate the effects of the different Dose Calculation Algorithms (DCAs) and Biologically Model-Related Parameters (BMRPs) on the prediction of cardiopulmonary complications due to left breast radiotherapy. Material and Methods In this practical study, the treatment plans of 21 female patients were simulated in the Monaco Treatment Planning System (TPS) with a prescribed dose of 50 Gy in 25 fractions. Dose distribution was extracted using the three DCAs [Pencil Beam (PB), Collapsed Cone (CC), and Monte Carlo (MC)]. Cardiopulmonary complications were predicted by Normal Tissue Complication Probability (NTCP) calculations using different dosimetric and biological parameters. The Lyman-Kutcher-Burman (LKB) and Relative-Seriality (RS) models were used to calculate NTCP. The endpoint for NTCP calculation was pneumonitis, pericarditis, and late cardiac mortality. The ANOVA test was used for statistical analysis. Results In calculating Tumor Control Probability (TCP), a statistically significant difference was observed between the results of DCAs in the Poisson model. The PB algorithm estimated NTCP as less than others for all Pneumonia BMRPs. Conclusion The impact of DCAs and BMRPs differs in the estimation of TCP and NTCP. DCAs have a stronger influence on TCP calculation, providing more effective results. On the other hand, BMRPs are more effective in estimating NTCP. Consequently, parameters for radiobiological indices should be cautiously used s to ensure the appropriate consideration of both DCAs and BMRPs.
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Affiliation(s)
- Niloofar Kargar
- Department of Medical Physics, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Ahad Zeinali
- Department of Medical Physics, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Mikaeil Molazadeh
- Department of Medical Physics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Li B, Huang J, Ruan J, Peng Q, Huang S, Li Y, Li F. Dosimetric impact of CT metal artifact reduction for spinal implants in stereotactic body radiotherapy planning. Quant Imaging Med Surg 2023; 13:8290-8302. [PMID: 38106297 PMCID: PMC10721987 DOI: 10.21037/qims-23-442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 09/14/2023] [Indexed: 12/19/2023]
Abstract
Background Metal artifacts due to spinal implants may affect the accuracy of dose calculation for radiotherapy. However, the dosimetric impact of metal artifact reduction (MAR) for spinal implants in stereotactic body radiotherapy (SBRT) plans has not been well studied. The objective of this study was to evaluate the dosimetric impact of MAR in spinal SBRT planning with three clinically common dose calculation algorithms. Methods Gammex phantom and 10 patients' computed tomography (CT) images were studied to investigate the effects of titanium implants. A commercial orthopedic MAR algorithm was employed to reduce artifacts. Dose calculations for SBRT were conducted on both artifact-corrected and uncorrected images using three commercial algorithms [analytical anisotropic algorithm (AAA), Acuros XB (AXB), and Monte Carlo (MC)]. Dose discrepancies between artifact-corrected and uncorrected cases were appraised using a dose-volume histogram (DVH) and 3-dimensional (3D) gamma analysis with different distance to agreement (DTA) and dose difference criteria. The gamma agreement index (GAI) was denoted as G(∆D, DTA). Statistical analysis of t-test was utilized to evaluate the dose differences of different algorithms. Results The phantom study demonstrated that titanium metal artifacts can be effectively reduced. The patient cases study showed that dose differences between the artifact-corrected and uncorrected datasets were small evaluated by gamma index and DVH. Gamma analysis found that even the strict criterion local G(1,1) had average values ≥93.9% for the three algorithms. For all DVH metrics, average differences did not exceed 0.7% in planning target volume (PTV) and 2.1% in planning risk volume of spinal cord (PRV-SC). Statistical analysis showed that the observed dose differences of MC method were significantly larger than those of AAA (P<0.01 for D98% of PTV and P<0.001 for D0.1cc of spinal cord) and AXB methods (P<0.001 for D98% and P<0.0001 for D0.1cc). Conclusions Dosimetric impact of artifacts caused by titanium implants is not significant in spinal SBRT planning, which indicates that dose calculation algorithms might not be very sensitive to CT number variation caused by titanium inserts.
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Affiliation(s)
- Bin Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jiexing Huang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
- Department of Radiation Oncology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Junjie Ruan
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Qinghe Peng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Sijuan Huang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yunfei Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Fanghua Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
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Inoue K, Matsukawa H, Kasai Y, Edamitsu K, Matsumoto K, Suetsugu Y, Hirose TA, Fukunaga JI, Shioyama Y, Sasaki T. Difference in target dose distributions between Acuros XB and collapsed cone convolution/superposition and the impact of the tumor locations in clinical cases of stereotactic ablative body radiotherapy for lung cancer. J Cancer Res Ther 2023; 19:1261-1266. [PMID: 37787293 DOI: 10.4103/jcrt.jcrt_1740_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Objectives The objective of the study is to analyze the difference in target dose distributions between Acuros XB (AXB) and collapsed cone convolution (CCC)/superposition and the impact of the tumor locations in clinical cases of stereotactic ablative body radiotherapy (SABR) for lung cancer. Materials and Methods Ninety-six patients underwent SABR for lung cancers Kyushu University Hospital from 2014 to 2017. We recalculated clinical plans originally calculated by AXB using CCC with the identical monitor units (MUs) and beam arrangements. We calculated the following dosimetric parameters: maximum dose (Dmax), minimum dose (Dmin), homogeneity index (HI), conformity index (CI), and D95 of the planning target volume (PTV). We investigated the difference between the results of two calculations and examined the impact of tumor location. Moreover, we determined the target central dose using a thorax phantom and assessed the calculation accuracy of the two algorithms for each fraction. Results CCC significantly overestimated the dose to PTV, compared to AXB (P < 0.05). The mean differences of Dmax, Dmin, and D95 were 1.17, 1.95, and 1.85 Gy, respectively. The mean differences of HI and CI were 0.02 and - 0.06. Dmin, HI, and D95 had significant correlations with the tumor location, and the difference was greater when the PTV was included the chest wall (P < 0.05). The discrepancy between the calculated and irradiated dose was 2.48% for CCC, whereas it was 0.14% for AXB. Conclusions We demonstrated that CCC significantly overestimated the dose to PTV relative to AXB in clinical cases of lung SABR.
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Affiliation(s)
- Keiki Inoue
- Department of Health Sciences, Division of Medical Quantum Radiation Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hideaki Matsukawa
- Department of Radiology, Hospital of University of Occupational and Environmental Health, Fukuoka, Japan
| | - Yuki Kasai
- Department of Radiology, Nagoya City University Hospital, Nagoya, Japan
| | - Kana Edamitsu
- Department of Radiology, Kitakyushu Municipal Medical Center, Japan
| | | | - Yoshiki Suetsugu
- Department of Health Sciences, Division of Medical Quantum Radiation Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Taka-Aki Hirose
- Department of Radiology, Medical Technology, Kyush University Hospital, Fukuoka, Japan
| | - Jun-Ichi Fukunaga
- Department of Radiology, Medical Technology, Kyush University Hospital, Fukuoka, Japan
| | | | - Tomonari Sasaki
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
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Chen D, Cai SB, Soon YY, Cheo T, Vellayappan B, Tan CW, Ho F. Dosimetric comparison between Intensity Modulated Radiation Therapy (IMRT) vs dual arc Volumetric Arc Therapy (VMAT) for nasopharyngeal cancer (NPC): Systematic review and meta-analysis. J Med Imaging Radiat Sci 2023; 54:167-177. [PMID: 36456460 DOI: 10.1016/j.jmir.2022.10.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND AND PURPOSE Previous non-randomised studies comparing dosimetric outcomes between advanced techniques such as IMRT and VMAT reported conflicting findings. We thus sought to perform a systematic review and meta-analysis to consolidate the findings of these studies. MATERIALS AND METHODS We searched PUBMED and EMBASE for eligible studies from their time of inception to 10 March 2022. A random effects model was used to estimate the pooled mean differences (MDs) and their 95% confidence intervals(CIs) for target volume coverage, organ-at-risk(OAR) doses, monitor units(MUs) and treatment delivery times. We also performed a subgroup analysis to evaluate if different treatment planning systems (TPS) (Eclipse, Monaco and Pinnacle) used affected the pooled mean differences. RESULTS A total of 17 studies (383 patients) were eligible to be included. The pooled results showed that dual arc VMAT reduced D2% of PTV (MD=0.71Gy,95%CI=0.14-1.27,P=0.01), mean left cochlea dose (MD=2.6Gy,95%CI=0.03-5.16,P=0.05), mean right cochlea dose (MD=3.4Gy,95%CI=0.7-6.1,P=0.01), MUs (MD=554.9,95%CI=245.8-863.9,P=0.0004), treatment delivery times (MD=6.7mins,95%CI=4.5-8.9,P<0.0001) and integral dose (MD=0.97Gy,95%CI=0.28-1.67,P=0.006). None of the other indices were significantly better for the IMRT plans. The subgroup analysis showed that the integral dose was significantly lower only for Eclipse (MD=0.88Gy, 95%CI=0.14-1.63, P=0.02). The total MUs was significantly lower only for Eclipse (MD=1035.2, 95%CI=624.6-1445.9, P<0.0001) and Pinnacle (MD=293, 95%CI=15.6-570.5, P=0.04). Similarly, delivery time was also significantly lower only for Eclipse (MD=6.1mins, 95%CI=5.7-6.5, P<0.0001) and Pinnacle (MD=4.9mins, 95%CI=2.6-7.2, P<0.0001). The subgroup analysis however showed that target coverage was superior for the IMRT plans for both Pinnacle (MD=0.48Gy, 95%CI=0.31-0.66, P<0.0001) and Monaco (MD=0.12Gy, 95%CI=0.07-0.17, P<0.0001). CONCLUSION Dual-arc VMAT plans improved OAR doses, MUs and treatment times as compared to IMRT plans. The different TPS used may modify dosimetric outcomes.
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Affiliation(s)
- Desiree Chen
- Department of Radiation Oncology, National University Health System, Singapore.
| | - Shao Bin Cai
- Department of Radiation Oncology, National University Health System, Singapore
| | - Yu Yang Soon
- Department of Radiation Oncology, National University Health System, Singapore
| | - Timothy Cheo
- Department of Radiation Oncology, National University Health System, Singapore
| | | | - Chek Wee Tan
- Department of Radiation Oncology, National University Health System, Singapore
| | - Francis Ho
- Department of Radiation Oncology, National University Health System, Singapore
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Dosimetric accuracy of Acuros ® XB and AAA algorithms for stereotactic body radiotherapy (SBRT) lung treatments: evaluation with PRIMO Monte Carlo code. JOURNAL OF RADIOTHERAPY IN PRACTICE 2023. [DOI: 10.1017/s1460396922000346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Abstract
Purpose:
The study aimed to compare the dosimetric performance of Acuros® XB (AXB) and anisotropic analytical algorithm (AAA) for lung SBRT plans using Monte Carlo (MC) simulations.
Methods:
We compared the dose calculation algorithms AAA and either of the dose reporting modes of AXB (dose to medium (AXB-Dm) or dose to water (AXB-Dw)) algorithms implemented in Eclipse® (Varian Medical Systems, Palo Alto, CA) Treatment planning system (TPS) with MC. PRIMO code was used for the MC simulations. The TPS-calculated dose profiles obtained with a multi-slab heterogeneity phantom were compared to MC. A lung phantom with a tumour was used to validate TPS algorithms using different beam delivery techniques. 2D gamma values obtained from Gafchromic film measurements in the tumour isocentre plane were compared with TPS algorithms and MC. Ten VMAT SBRT plans generated in TPS with each algorithm were recalculated with a PRIMO MC system for identical beam parameters for the clinical plan validation. A dose–volume histogram (DVH) based plan comparison and a 3D global gamma analysis were performed.
Results:
AXB demonstrated better agreement with MC and film measurements in the lung phantom validation, with good agreement in PDD, profiles and gamma analysis. AAA showed an overestimated PDD, a significant difference in dose profiles and a lower gamma pass rate near the field borders. With AAA, there was a dose overestimation at the periphery of the tumour. For clinical plan validation, AXB demonstrated higher agreement with MC than AAA.
Conclusions:
AXB provided better agreement with MC than AAA in the phantom and clinical plan evaluations.
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Ruiz Boiset G, V S Batista D, Coutinho Cardoso S. Clinical verification of treatment planning dose calculation in lung SBRT with GATE Monte Carlo simulation code. Phys Med 2021; 87:1-10. [PMID: 34091196 DOI: 10.1016/j.ejmp.2021.05.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 05/04/2021] [Accepted: 05/21/2021] [Indexed: 12/31/2022] Open
Abstract
PURPOSE This study aims to use GATE/Geant4 simulation code to evaluate the performance of dose calculations with Anisotropic Analytical Algorithm (AAA) in the context of lung SBRT for complex treatments considering images of patients. METHODS Four cases of non-small cell lung cancer treated with SBRT were selected for this study. Irradiation plans were created with AAA and recalculated end to end using Monte Carlo (MC) method maintaining field configurations identical to the original plans. Each treatment plan was evaluated in terms of PTV and organs at risk (OARs) using dose-volume histograms (DVH). Dosimetric parameters obtained from DVHs were used to compare AAA and MC. RESULTS The comparison between the AAA and MC DVH using gamma analysis with the passing criteria of 3%/3% showed an average passing rate of more than 90% for the PTV structure and 97% for the OARs. Tightening the criteria to 2%/2% showed a reduction in the average passing rate of the PTV to 86%. The agreement between the AAA and MC dose calculations for PTV dosimetric parameters (V100; V90; Homogeneity index; maximum, minimum and mean dose; CIPaddick and D2cm) was within 18.4%. For OARs, the biggest differences were observed in the spinal cord and the great vessels. CONCLUSIONS In general, we did not find significant differences between AAA and MC. The results indicate that AAA could be used in complex SBRT cases that involve a larger number of small treatment fields in the presence of tissue heterogeneities.
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Affiliation(s)
- Gisell Ruiz Boiset
- Instituto de Fı́sica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Delano V S Batista
- Instituto de Radioproteção e Dosimetria, IRD/CNEN, Rio de Janeiro, Brazil; Oncologia D'Or São Cristóvão, Rede D'Or São Luiz, Rio de Janeiro, Brazil
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Yu R, Wang M, Wang M, Han L. Melittin suppresses growth and induces apoptosis of non-small-cell lung cancer cells via down-regulation of TGF-β-mediated ERK signal pathway. ACTA ACUST UNITED AC 2020; 54:e9017. [PMID: 33331417 PMCID: PMC7747877 DOI: 10.1590/1414-431x20209017] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 09/15/2020] [Indexed: 02/06/2023]
Abstract
The purpose of this study was to investigate the anti-cancer effect of melittin on growth, migration, invasion, and apoptosis of non-small-cell lung cancer (NSCLC) cells. This study also explored the potential anti-cancer mechanism of melittin in NSCLC cells. The results demonstrated that melittin suppressed growth, migration, and invasion, and induced apoptosis of NSCLC cells in vitro. Melittin increased pro-apoptotic caspase-3 and Apaf-1 gene expression. Melittin inhibited tumor growth factor (TGF)-β expression and phosphorylated ERK/total ERK (pERK/tERK) in NSCLC cells. However, TGF-β overexpression (pTGF-β) abolished melittin-decreased TGF-β expression and pERK/tERK in NSCLC cells. Treatment with melittin suppressed tumor growth and prolonged mouse survival during the 120-day observation in vivo. Treatment with melittin increased TUNEL-positive cells and decreased expression levels of TGF-β and ERK in tumor tissue compared to the control group. In conclusion, the findings of this study indicated that melittin inhibited growth, migration, and invasion, and induced apoptosis of NSCLC cells through down-regulation of TGF-β-mediated ERK signaling pathway, suggesting melittin may be a promising anti-cancer agent for NSCLC therapy.
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Affiliation(s)
- Renzhi Yu
- Department of Respiratory Medicine, Mudanjiang Medical University Affiliated Hongqi Hospital, Mudanjiang, China
| | - Miao Wang
- Department of Respiratory Medicine, Mudanjiang Medical University Affiliated Hongqi Hospital, Mudanjiang, China
| | - Minghuan Wang
- Community Health Service Center, Mudanjiang Medical University Affiliated Hongqi Hospital, Mudanjiang, China
| | - Lei Han
- Department of Respiratory Medicine, Mudanjiang Medical University Affiliated Hongqi Hospital, Mudanjiang, China
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Rostamzadeh M, Ishihara Y, Nakamura M, Popescu IA, Mestrovic A, Gete E, Fedrigo R, Bergman AM. Monte Carlo simulation of 6-MV dynamic wave VMAT deliveries by Vero4DRT linear accelerator using EGSnrc moving sources. J Appl Clin Med Phys 2020; 21:206-218. [PMID: 33219743 PMCID: PMC7769401 DOI: 10.1002/acm2.13090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 08/12/2020] [Accepted: 10/06/2020] [Indexed: 12/02/2022] Open
Abstract
The commissioning and benchmark of a Monte Carlo (MC) model of the 6‐MV Brainlab‐Mitsubishi Vero4DRT linear accelerator for the purpose of quality assurance of clinical dynamic wave arc (DWA) treatment plans is reported. Open‐source MC applications based on EGSnrc particle transport codes are used to simulate the medical linear accelerator head components. Complex radiotherapy irradiations can be simulated in a single MC run using a shared library format combined with BEAMnrc “source20.” Electron energy tuning is achieved by comparing measured vs simulated percentage depth doses (PDDs) for MLC‐defined field sizes in a water phantom. Electron spot size tuning is achieved by comparing measured and simulated inplane and crossplane beam profiles. DWA treatment plans generated from RayStation (RaySearch) treatment planning system (TPS) are simulated on voxelized (2.5 mm3) patient CT datasets. Planning target volume (PTV) and organs at risk (OAR) dose–volume histograms (DVHs) are compared to TPS‐calculated doses for clinically deliverable dynamic volumetric modulated arc therapy (VMAT) trajectories. MC simulations with an electron beam energy of 5.9 MeV and spot size FWHM of 1.9 mm had the closest agreement with measurement. DWA beam deliveries simulated on patient CT datasets results in DVH agreement with TPS‐calculated doses. PTV coverage agreed within 0.1% and OAR max doses (to 0.035 cc volume) agreed within 1 Gy. This MC model can be used as an independent dose calculation from the TPS and as a quality assurance tool for complex, dynamic radiotherapy treatment deliveries. Full patient CT treatment simulations are performed in a single Monte Carlo run in 23 min. Simulations are run in parallel using the Condor High‐Throughput Computing software1 on a cluster of eight servers. Each server has two physical processors (Intel Xeon CPU E5‐2650 0 @2.00 GHz), with 8 cores per CPU and two threads per core for 256 calculation nodes.
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Affiliation(s)
- Maryam Rostamzadeh
- Department of Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada
| | | | | | | | - Ante Mestrovic
- Medical Physics Department, BC Cancer-Vancouver, Vancouver, Canada
| | - Ermias Gete
- Medical Physics Department, BC Cancer-Vancouver, Vancouver, Canada
| | - Roberto Fedrigo
- Department of Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada
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Kairn T, Livingstone AG, Crowe SB. Monte Carlo calculations of radiotherapy dose in "homogeneous" anatomy. Phys Med 2020; 78:156-165. [PMID: 33035927 DOI: 10.1016/j.ejmp.2020.09.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/05/2020] [Accepted: 09/21/2020] [Indexed: 01/27/2023] Open
Abstract
Given the substantial literature on the use of Monte Carlo (MC) simulations to verify treatment planning system (TPS) calculations of radiotherapy dose in heterogeneous regions, such as head and neck and lung, this study investigated the potential value of running MC simulations of radiotherapy treatments of nominally homogeneous pelvic anatomy. A pre-existing in-house MC job submission and analysis system, built around BEAMnrc and DOSXYZnrc, was used to evaluate the dosimetric accuracy of a sample of 12 pelvic volumetric arc therapy (VMAT) treatments, planned using the Varian Eclipse TPS, where dose was calculated with both the Analytical Anisotropic Algorithm (AAA) and the Acuros (AXB) algorithm. In-house TADA (Treatment And Dose Assessor) software was used to evaluate treatment plan complexity, in terms of the small aperture score (SAS), modulation index (MI) and a novel exposed leaf score (ELS/ELA). Results showed that the TPS generally achieved closer agreement with the MC dose distribution when treatments were planned for smaller (single-organ) targets rather than larger targets that included nodes or metastases. Analysis of these MC results with reference to the complexity metrics indicated that while AXB was useful for reducing dosimetric uncertainties associated with density heterogeneity, the residual TPS dose calculation uncertainties resulted from treatment plan complexity and TPS model simplicity. The results of this study demonstrate the value of using MC methods to recalculate and check the dose calculations provided by commercial radiotherapy TPSs, even when the treated anatomy is assumed to be comparatively homogeneous, such as in the pelvic region.
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Affiliation(s)
- Tanya Kairn
- Royal Brisbane and Women's Hospital, Butterfield Street, Herston, QLD 4029, Australia; Queensland University of Technology, 2 George Street, Brisbane, QLD 4000, Australia.
| | | | - Scott B Crowe
- Royal Brisbane and Women's Hospital, Butterfield Street, Herston, QLD 4029, Australia; Queensland University of Technology, 2 George Street, Brisbane, QLD 4000, Australia
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Al Feghali KA, Wu Q(C, Devpura S, Liu C, Ghanem AI, Wen N(W, Ajlouni M, Simoff MJ, Movsas B, Chetty IJ. Correlation of normal lung density changes with dose after stereotactic body radiotherapy (SBRT) for early stage lung cancer. Clin Transl Radiat Oncol 2020; 22:1-8. [PMID: 32140574 PMCID: PMC7047141 DOI: 10.1016/j.ctro.2020.02.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 02/04/2020] [Accepted: 02/09/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND AND PURPOSE To investigate the correlation between normal lung CT density changes with dose accuracy and outcome after stereotactic body radiation therapy (SBRT) for patients with early stage non-small-cell lung cancer (NSCLC). MATERIALS AND METHODS Thirty-one patients (with a total of 33 lesions) with non-small cell lung cancer were selected out of 270 patients treated with SBRT at a single institution between 2003 and 2009. Out of these 31 patients, 10 patients had developed radiation pneumonitis (RP). Dose distributions originally planned using a 1-D pencil beam-based dose algorithm were retrospectively recomputed using different algorithms. Prescription dose was 48 Gy in 4 fractions in most patients. Planning CT images were rigidly registered to follow-up CT datasets at 3-9 months after treatment. Corresponding dose distributions were mapped from planning to follow-up CT images. Hounsfield Unit (HU) changes in lung density in individual, 5 Gy, dose bins from 5 to 45 Gy were assessed in the peri-tumoral region. Correlations between HU changes in various normal lung regions, dose indices (V20, MLD, generalized equivalent uniform dose (gEUD)), and RP grade were investigated. RESULTS Strong positive correlation was found between HU changes in the peri-tumoral region and RP grade (Spearman's r = 0.760; p < 0.001). Positive correlation was also observed between RP and HU changes in the region covered by V20 for all algorithms (Spearman's r ≥ 0.738; p < 0.001). Additionally, V20, MLD, and gEUD were significantly correlated with RP grade (p < 0.01). MLD in the peri-tumoral region computed with model-based algorithms was 5-7% lower than the PB-based methods. CONCLUSION Changes of lung density in the peri-tumoral lung and in the region covered by V20 were strongly associated with RP grade. Relative to model-based methods, PB algorithms over-estimated mean peri-tumoral dose and showed displacement of the high-dose region, which correlated with HU changes on follow-up CT scans.
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Affiliation(s)
- Karine A. Al Feghali
- Department of Radiation Oncology, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI, USA
| | - Qixue (Charles) Wu
- Department of Radiation Oncology, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI, USA
| | - Suneetha Devpura
- Department of Radiation Oncology, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI, USA
| | - Chang Liu
- Department of Radiation Oncology, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI, USA
| | - Ahmed I. Ghanem
- Department of Radiation Oncology, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI, USA
- Department of Clinical Oncology, Alexandria University, Alexandria, Egypt
| | - Ning (Winston) Wen
- Department of Radiation Oncology, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI, USA
| | - Munther Ajlouni
- Department of Radiation Oncology, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI, USA
| | - Michael J. Simoff
- Department of Internal Medicine, Division of Interventional Pulmonology, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI, USA
| | - Benjamin Movsas
- Department of Radiation Oncology, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI, USA
| | - Indrin J. Chetty
- Department of Radiation Oncology, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI, USA
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Han L, Fang S, Li G, Wang M, Yu R. Total flavonoids suppress lung cancer growth via the COX-2-mediated Wnt/β-catenin signaling pathway. Oncol Lett 2020; 19:1824-1830. [PMID: 32194676 PMCID: PMC7039044 DOI: 10.3892/ol.2020.11271] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 08/08/2019] [Indexed: 12/16/2022] Open
Abstract
The aim of the present study was to explore the anti-cancer effects of total flavonoids (TF) on lung cancer and to investigate the underlying mechanism. The inhibitory effect of TF on the proliferation of A549 cells in vitro was measured using an MTT assay. The apoptotic rate of TF-treated A549 cells was analyzed using flow cytometry and terminal deoxynucleotidyl transferase-mediated biotinylated UTP nick end labeling. Migration and invasion assays were performed to investigate the anti-migration effect of TF on A549 cells. Reverse-transcription quantitative PCR was used to analyze BCL2-like 2, BCL2, Bax, Bad, cyclooxygenase 2 (COX-2), Wnt and β-catenin mRNA expression levels in A549 cells. The in vivo anti-cancer effect of TF was investigated in a subcutaneous xenograft model of lung cancer in BALB/c nude mice. The results obtained in the present study revealed that TF exerted a significant inhibitory effect on the proliferation of A549 cells in a dose-dependent manner (P<0.01). TF induced apoptosis of A549 cells, which exhibited increased and decreased expression of pro- and anti- apoptotic genes, respectively. Furthermore, TF had a significant inhibitory effect on the migration and invasion of A549 cells (P<0.01). The mRNA expression levels of COX-2, Wnt and β-catenin were significantly downregulated in TF-treated A549 cells compared with controls. Additionally, treatment with TF inhibited tumor growth in mice, with a tumor inhibition rate of 64.07% compared with the controls. TF exhibited significant tumor inhibitory effects in vivo by promoting the apoptosis of tumor cells. In conclusion, the results suggested that TF may regulate lung cancer growth via the COX-2-Wnt/β-catenin signaling pathway. TF may serve as a novel anti-cancer agent for the treatment of lung cancer.
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Affiliation(s)
- Lei Han
- Department of Respiratory Medicine, Mudanjiang Medical University Affiliated Hongqi Hospital, Mudanjiang, Heilongjiang 157000, P.R. China
| | - Shu Fang
- Department of Respiratory Medicine, Mudanjiang Medical University Affiliated Hongqi Hospital, Mudanjiang, Heilongjiang 157000, P.R. China
| | - Guangtao Li
- Community Health Service Center, Mudanjiang Medical University Affiliated Hongqi Hospital, Mudanjiang, Heilongjiang 157000, P.R. China
| | - Minghuan Wang
- Department of Respiratory Medicine, Kangan Hospital, Mudanjiang, Heilongjiang 157000, P.R. China
| | - Renzhi Yu
- Department of Respiratory Medicine, Mudanjiang Medical University Affiliated Hongqi Hospital, Mudanjiang, Heilongjiang 157000, P.R. China
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12
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Galpayage Dona KNU, Shang C, Leventouri T. Dosimetric Comparison of Treatment Plans Computed With Finite Size Pencil Beam and Monte Carlo Algorithms Using the InCise™ Multileaf Collimator-Equipped Cyberknife ® System. J Med Phys 2020; 45:7-15. [PMID: 32355430 PMCID: PMC7185708 DOI: 10.4103/jmp.jmp_64_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 11/02/2019] [Accepted: 11/19/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose: InCise™ multileaf collimator (MLC) was introduced for CyberKnife® (CK) Robotic Radiosurgery System (CK-MLC) in 2015, and finite size pencil beam (FSPB) was the only available dose computation algorithm for treatment plans of CK-MLC system. The more advanced Monte Carlo (MC) dose calculation algorithm of lnCise™ was initially released in 2017 for the CK Precision™ treatment planning system (TPS) (v1.1) with new graphic processing unit (GPU) platform. GPU based TPS of the CK offers more accurate, faster treatment planning time and intuitive user interface with smart three-dimensional editing tools and fully automated autosegmentation tools. The MC algorithm used in CK TPS simulates the energy deposited by each individual photon and secondary particles to calculate more accurate dose. In the present study, the dose disparities between MC and FSPB algorithms for selected Stereotactic Ablative Radiation Therapy (SABR) CK-MLC treatment plans are quantified. Materials and Methods: A total of 80 CK-MLC SABR plans computed with FSPB were retrospectively reviewed and compared with MC computed results, including plans for detached lung cancer (or tumors fully surrounded by lung tissues, n = 21), nondetached lung cancer (or tumor touched the chest wall or mediastinum, n = 23), intracranial (n = 21), and pancreas lesions (n = 15). Dosimetric parameters of each planning target volume and major organs at risk (OAR) are compared in terms of normalized percentage deviations (Ndev). Results: This study revealed an average of 24.4% overestimated D95 values in plans using FSPB over MC for detached lung (n = 21) and 14.9% for nondetached lung (n = 23) lesions. No significant dose differences are found in intracranial (0.3%, n = 21) and pancreatic (0.9%, n = 15) cases. Furthermore, no significant differences were found in Ndev of OARs. Conclusion: In this study, it was found that FSPB overestimates dose to inhomogeneous treatment sites. This indicates, the employment of MC algorithm in CK-MLC-based lung SABR treatment plans is strongly suggested.
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Affiliation(s)
| | - Charles Shang
- Department of Physics, Florida Atlantic University, Boca Raton, Florida, USA.,South Florida Proton Therapy Institute, Delray Beach, Florida, USA
| | - Theodora Leventouri
- Department of Physics, Florida Atlantic University, Boca Raton, Florida, USA
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13
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Zhang D, Zhang Y, Cai Z, Tu Y, Hu Z. Dexamethasone and lenvatinib inhibit migration and invasion of non-small cell lung cancer by regulating EKR/AKT and VEGF signal pathways. Exp Ther Med 2019; 19:762-770. [PMID: 31853327 DOI: 10.3892/etm.2019.8225] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Accepted: 02/24/2017] [Indexed: 12/22/2022] Open
Abstract
Migration and invasion is one of the most important features in tumor metastasis and development. Non-small cell lung cancer (NSCLC) is one of the most common types of cancer globally, and has been linked to air contamination. Evidence indicates that cysteine-rich angiogenic inducer 61 (CYR61) is associated with the migration and invasion of NSCLC. Overexpression of CYR61 protein promotes the migration and the transition of tumor-derived vascular endothelial cells in NSCLC. However, the association between CYR61 and NSCLC remains poorly understood. Lenvatinib is an oral multi-target drug that targets various receptors upon tumor angiogenesis. Dexamethasone is widely approved for combination therapy in patients with NSCLC. In the current study, the expression and function of CYR61 in NSCLC was analyzed during the progression of NSCLC. Inhibitory effects on migration and invasion induced by lenvatinib and dexamethasone were determined by migratory and invasion assays. Migratory pathways of extracellular signal-regulated kinases (ERK) and protein kinase B (AKT) were also investigated by targeting vascular endothelial growth factor (VEGF) and CYR61 via synergistic treatment with transforming growth factor-β1 (TGF-β1) and dexamethasone. Therapeutic outcomes of combined treatment with lenvatinib and dexamethasone were assessed in NSCLC-bearing mice. The results of the present study indicate that cooperative treatment of lenvatinib and dexamethasone significantly inhibited TGF-β1-induced cell migration and suppressed tumor growth (P<0.01). Notably, the results demonstrated that dexamethasone eradicated the promotion effects of TGF-β1 on the AKT/epithelial-mesenchymal transition process and lenvatinib extinguished tumor cell metastasis by targeting VEGF. The results of the current study also demonstrate that dexamethasone suppressed the expression of CAG-I and enhanced expression of matrix metalloproteinase-1. Synergistic treatment for NSCLC was demonstrated to be efficacious. In conclusion, dexamethasone inhibited AKT/ERK phosphorylation and lenvatinib antagonism bound VEGF leading to the limitation of migration and invasion of cancer cells in NSCLC.
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Affiliation(s)
- Daye Zhang
- Department of Pharmacy, Tianjin Chest Hospital, Tianjin 300222, P.R. China
| | - Yongxiang Zhang
- Respiratory and Clinical Care Unit, Tianjin Chest Hospital, Tianjin 300222, P.R. China
| | - Zeyuan Cai
- Department of Cardiovascular Institute, Tianjin Chest Hospital, Tianjin 300222, P.R. China
| | - Ying Tu
- Department of Pharmacy, Tianjin Chest Hospital, Tianjin 300222, P.R. China
| | - Zhansong Hu
- Department of Pharmacy, Tianjin Chest Hospital, Tianjin 300222, P.R. China
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14
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Local control rates in stereotactic body radiotherapy (SBRT) of lung metastases associated with the biologically effective dose. Rep Pract Oncol Radiother 2019; 24:142-150. [PMID: 30723385 DOI: 10.1016/j.rpor.2019.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 01/02/2019] [Indexed: 12/20/2022] Open
Abstract
Aim To evaluate dose differences in lung metastases treated with stereotactic body radiotherapy (SBRT), and the correlation with local control, regarding the dose algorithm, target volume and tissue density. Background Several studies showed excellent local control rates in SBRT for lung metastases, with different fractionation schemes depending on the tumour location or size. These results depend on the dose distributions received by the lesions in terms of the tissue heterogeneity corrections performed by the dose algorithms. Materials and methods Forty-seven lung metastases treated with SBRT, using intrafraction control and respiratory gating with internal fiducial markers as surrogates (ExacTrac, BrainLAB AG), were calculated using Pencil Beam (PB) and Monte Carlo (MC) (iPlan, BrainLAB AG).Dose differences between both algorithms were obtained for the dose received by 99% (D 99%) and 50% (D 50%) of the planning treatment volume (PTV). The biologically effective dose delivered to 99% (BED99%) and 50% (BED50%) of the PTV were estimated from the MC results. Local control was evaluated after 24 months of median follow-up (range: 3-52 months). Results The greatest variations (40.0% in ΔD 99% and 38.4% in ΔD 50%) were found for the lower volume and density cases. The BED99% and BED50% were strongly correlated with observed local control rates: 100% and 61.5% for BED99% > 85 Gy and <85 Gy (p < 0.0001), respectively, and 100% and 58.3% for BED50% > 100 Gy and <100 Gy (p < 0.0001), respectively. Conclusions Lung metastases treated with SBRT, with delivered BED99% > 85 Gy and BED50% > 100 Gy, present better local control rates than those treated with lower BED values (p = 0.001).
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15
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Matsuoka T, Araki F, Ohno T, Sakata J, Tominaga H. Dependence of volume dose indices on dose calculation algorithms for VMAT-SBRT plans for peripheral lung tumor. Med Dosim 2018; 44:284-290. [PMID: 30455092 DOI: 10.1016/j.meddos.2018.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 10/20/2018] [Accepted: 10/23/2018] [Indexed: 11/24/2022]
Abstract
The purpose of this study was to investigate the dependence of volume dose indices on dose calculation algorithms for volumetric modulated arc therapy (VMAT) for stereotactic body radiotherapy (SBRT) plans to treat peripheral lung tumors by comparing them with those of Monte Carlo (MC) calculations. VMAT-SBRT plans for peripheral lung tumors were created using the Eclipse treatment planning system (TPS) for 24 patients with nonsmall cell lung cancer. VMAT dose distributions for gross tumor volume (GTV), internal target volume (ITV), and planning target volume (PTV) were calculated using the analytical anisotropic algorithm (AAA), the Acuros XB (AXB) algorithm, and a MC algorithm. VMAT dose distributions of the 3 algorithms were compared using their volume dose indices from dose volume histograms (DVHs), a dose difference map, and 3-dimensional gamma analysis. The DVHs for GTV and ITV from AAA, AXB, and MC were in good agreement. The difference between the ITV and PTV volume dose indices from AAA and MC increased as D98, D95, D80, D50, and D2. In particular, the difference between D98 for PTV from AAA and MC was up to 48%. A >5% difference between D95 for PTV from AAA and MC was 11 patients, but only 2 patients for ITV. The volume dose indices for AXB were near those of MC. AAA tended to overestimate the PTV volume dose indices compared to AXB and MC. Thus, we propose that the volume dose indices for the ITV be used because they are independent of dose calculation algorithms.
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Affiliation(s)
- Takanori Matsuoka
- Graduate School of Health Sciences, Kumamoto University, Kumamoto, Japan
| | - Fujio Araki
- Department of Health Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
| | - Takeshi Ohno
- Department of Health Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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16
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Xi Y, Niu J, Li D, He J, Qin L, Peng X. Mixed lineage kinase-4 promotes gastric carcinoma tumorigenesis through suppression of the c-Jun N-terminal kinase signaling pathway. Exp Ther Med 2018; 16:3317-3324. [PMID: 30233678 PMCID: PMC6143876 DOI: 10.3892/etm.2018.6618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 04/21/2017] [Indexed: 01/08/2023] Open
Abstract
Mixed lineage kinase-4 (MLK-4) is an important member of the mixed-lineage family of kinases that regulates the extracellular signal-regulated kinases and c-Jun N-terminal kinase (JNK) signaling pathways. The functions and mechanisms of MLK-4 in cancer initiation and progression have not been well understood. The present study investigated the expression, function and regulatory mechanism of MLK-4 in gastric carcinoma cells. Biochemical data indicated that normal MLK-4 was downregulated, which exerted dominant negative effects on gastric carcinoma cell viability, migration and invasion. The experimental data demonstrated that MLK-4 supplement abrogated activity of these mutants and induced inhibitory effects on gastric carcinoma cell viabilty, migration and invasion in vitro and in vivo. In addition, to determine the regulatory mechanism of MLK-4, its signaling pathway was assessed in gastric carcinoma cancer cells by regulating MLK-4. The present observations indicated that restoring MLK-4 activity by supplemental MLK-4 reduced gastric carcinoma cell colony formation in vitro and suppressed tumor viability, migration and invasion in vivo. The results of the present study indicated that MLK-4 may be a potential protein for targeting gastric carcinoma by suppressing kinases, which may lead to reduction of JNK signaling and enhance therapeutic efficacy in gastric carcinoma.
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Affiliation(s)
- Yu Xi
- Department of General Surgery, Tongji Hospital, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
- Department of General Surgery, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang 832008, P.R. China
| | - Jianhua Niu
- Department of General Surgery, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang 832008, P.R. China
| | - Dongmei Li
- Department of General Surgery, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang 832008, P.R. China
| | - Jiagen He
- Department of General Surgery, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang 832008, P.R. China
| | - Le Qin
- Department of General Surgery, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang 832008, P.R. China
| | - Xinyu Peng
- Department of General Surgery, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang 832008, P.R. China
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17
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Liu F, Wang K, Zhang L, Yang YL. Bone morphogenetic protein and activin membrane-bound inhibitor suppress bone cancer progression in MG63 and SAOS cells via regulation of the TGF-β-induced EMT signaling pathway. Oncol Lett 2018; 16:5113-5121. [PMID: 30250579 PMCID: PMC6144885 DOI: 10.3892/ol.2018.9268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Accepted: 05/30/2018] [Indexed: 12/03/2022] Open
Abstract
Bone cancer is one of the most common tumor types that occurs in bones and their affiliated tissues. The prognosis remains poor due to the limited number of effective therapeutic targets. Downregulation of bone morphogenetic protein and activin membrane-bound inhibitor (BAMBI) has been observed in human cancer cells and BAMBI reconstitution can inhibit growth and metastasis of human cancer cells. In the present study, a potential mechanism mediated by BAMBI in osteosarcoma cells was investigated. The data demonstrated that BAMBI reconstitution suppressed the cell growth, migration and invasion of the osteosarcoma cell lines SAOS2 and MG63. Alterations to the epithelial-to-mesenchymal transition (EMT) marker expression were observed in BAMBI-treated osteosarcoma SAOS2 and MG63 cells. The apoptosis rate of SAOS2 and MG63 cells induced by cisplatin were increased in BAMBI-treated osteosarcoma SAOS2 and MG63 cells via downregulation of the anti-apoptosis genes P16, P21 and B-cell lymphoma 2. The potential mechanism investigated indicated that BAMBI administration downregulated the transforming growth factor-β (TGF-β) signaling pathway, whilst knockdown of BAMBI upregulated the TGF-β signaling pathway in SAOS2 and MG63 cells. Reconstitution of BAMBI in SAOS2 and MG63 cells resulted in a notable reduction of TGF-β-induced EMT, cell growth, migration and invasion in vitro. In conclusion, the results demonstrated that BAMBI reconstitution inhibited growth and invasiveness of osteosarcoma, as well as promoted the apoptotic sensibility, which indicated that the TGF-β-induced EMT signaling pathway may be regarded as a potential target for osteosarcoma therapy.
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Affiliation(s)
- Fengsong Liu
- Department of Orthopedics, The Second Hospital of Tianjin Medical University, Tianjin 300211, P.R. China
| | - Kai Wang
- Department of Orthopedics, The Second Hospital of Tianjin Medical University, Tianjin 300211, P.R. China
| | - Liang Zhang
- Department of Orthopedics, The Second Hospital of Tianjin Medical University, Tianjin 300211, P.R. China
| | - Ya-Lin Yang
- Department of Orthopedics, The Second Hospital of Tianjin Medical University, Tianjin 300211, P.R. China
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18
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Li X, Yuan N, Lin L, Yin L, Qu Y. Targeting cysteine-rich angiogenic inducer-61 by antibody immunotherapy suppresses growth and migration of non-small cell lung cancer. Exp Ther Med 2018; 16:730-738. [PMID: 30116327 PMCID: PMC6090314 DOI: 10.3892/etm.2018.6274] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 03/17/2017] [Indexed: 02/04/2023] Open
Abstract
Non-small cell lung cancer (NSCLC) is the most frequent type of human lung cancer; lung cancer is responsible for the highest rates of cancer-associated mortality in the world. Cysteine-rich angiogenic inducer-61 (CYR-61) has been identified as a tumorigenesis-, development- and metastasis-related gene, and is reported to enhance proliferation, migration and invasion through hepatocyte growth factor (HGF)-induced scattering and the metastasis-inducing HGF/Met signaling pathway in tumor cells and xenograft models. CYR-61 is a protein that promotes human lung cancer cell metastasis and is closely related to the patient's prognosis in NSCLC. The purpose of the present study was to investigate whether CYR-61 may serve as a dual potential target for gene therapy of human NSCLC. In the present study, an antibody targeted against CYR-61 (anti-CYR-61) was constructed and the therapeutic effects and underlying mechanism of this antibody in NSCLC cells and mice with NSCLC was investigated. It was observed that NSCLC cell viability, migration and invasion were inhibited while cell apoptosis was induced by the neutralization of CYR-61 protein by anti-CYR-61. Western blotting demonstrated that extracellular signal-regulated kinase (ERK) and protein kinase B (AKT) expression levels in NSCLC cells were decreased following treatment with anti-CYR-61. In addition, it was observed that inhibition of NSCLC cell viability was achieved by the suppression of the epithelial-mesenchymal transition signaling pathway. ERK and AKT phosphorylation levels were downregulated in NSCLC cells and tumors following anti-CYR-61 treatment. Analysis of a murine model indicated that tumor growth was inhibited and tumor metastasis was significantly suppressed (P<0.01) following anti-CYR-61 treatment for CYR-61. In conclusion, CYR-61 may serve as a potential target for gene therapy for the treatment of human NSCLC.
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Affiliation(s)
- Xinpeng Li
- Department of Respiration, Qilu Hospital of Shandong University, Jinan, Shandong 250012, P.R. China.,Department of Respiration, Dezhou People's Hospital, Dezhou, Shandong 253014, P.R. China
| | - Naxin Yuan
- Department of Respiration, Dezhou People's Hospital, Dezhou, Shandong 253014, P.R. China
| | - Lingdan Lin
- Department of Cardiology, Dezhou People's Hospital, Dezhou, Shandong 253014, P.R. China
| | - Lixia Yin
- Department of Respiration, Dezhou People's Hospital, Dezhou, Shandong 253014, P.R. China
| | - Yiqing Qu
- Department of Respiration, Qilu Hospital of Shandong University, Jinan, Shandong 250012, P.R. China
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19
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Tian L, Xie XH, Zhu ZH. Calotropin regulates the apoptosis of non‑small cell cancer by regulating the cytotoxic T‑lymphocyte associated antigen 4‑mediated TGF‑β/ERK signaling pathway. Mol Med Rep 2018; 17:7683-7691. [PMID: 29620207 PMCID: PMC5983968 DOI: 10.3892/mmr.2018.8853] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 02/09/2018] [Indexed: 01/27/2023] Open
Abstract
Non-small-cell lung cancer (NSCLC) is one of the most common malignancies that is responsible for a high level of cancer-associated mortalities worldwide. Previous evidence has shown that Calotropin is an upstream activator of protein kinase B, which can further inhibit the growth and promote the apoptosis of NSCLC cells. In the present study, the efficacy of Calotropin on growth, aggressiveness and apoptosis of NSCLC cells was investigated, as well as the potential underlying mechanism. The results demonstrated that Calotropin inhibited H358 cell growth, migration and invasion. Flow cytometry assay showed that Calotropin promoted the apoptosis of H358 cells in vitro. Western blot analysis demonstrated that Calotropin inhibited fibronectin (FN), Vimentin (VIM) and E-cadherin (Eca) protein expression levels in H358 cells in vitro. In addition, Calotropin treatment upregulated pro-apoptosis gene expression, including caspase-3, caspase-8 and apoptotic protease activating factor-1, and downregulated anti-apoptosis gene expression, including P53, B-cell lymphoma (Bcl) 2 and Bcl-2-like protein 2 in H358 cells. The results also revealed that the expression levels of cytotoxic T-lymphocyte associated antigen 4 (CTLA-4) were decreased by Calotropin treatment in H358 cells. Analyses of the underlying mechanism indicated that Calotropin inhibited transforming growth factor-β (TGF-β) and extracellular signal-regulated kinase (ERK) expression. Overexpression of CTLA-4 inhibited Calotropin-mediated downregulation of TGF-β and ERK expression in H358 cells. In vivo assay revealed that Calotropin administration significantly inhibited tumor growth and prolonged animal survival over the 120-day observation period. Immunohistochemistry demonstrated that the number of apoptotic cells increased and the expression levels of CTLA-4 were decreased in the Calotropin-treated tumor group when compared with control. In addition, the expression levels of TGF-β and ERK were downregulated in the Calotropin-treated tumor group compared with control. In conclusion, the results of the present study indicated that Calotropin administration regulated NSCLC apoptosis by downregulating the CTLA-4-mediated TGF-β/ERK signaling pathway, suggesting that Calotropin may be a potential anti-cancer agent for the treatment of NSCLC.
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Affiliation(s)
- Lu Tian
- Department of Respiratory Medicine, The Fourth People's Hospital of Guiyang, Guiyang, Guizhou 550002, P.R. China
| | - Xiao-Hong Xie
- Department of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Disease, Guangzhou, Guangdong 510120, P.R. China
| | - Ze-Hao Zhu
- Department of Respiratory Medicine, The Affiliated Zhoushan Hospital of Wenzhou Medical University, Zhoushan, Zhejiang 316000, P.R. China
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20
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Zhang J, Li Z. β-inducible gene-h3 promotes human breast carcinoma cell metastasis by activating the phosphatidylinositol 3-kinase/protein kinase B signaling pathway. Exp Ther Med 2018; 15:2910-2916. [PMID: 29599830 PMCID: PMC5867474 DOI: 10.3892/etm.2018.5786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 11/17/2017] [Indexed: 11/15/2022] Open
Abstract
Metastatic breast cancer is one of the most common metastatic tumors. Although studies have validated the role of β-inducible gene-h3 (βig-h3) in human biology and disease, the detailed mechanisms mediated by βig-h3 in breast carcinoma metastasis remain unclear. Thus, the present study investigated the role and potential mechanism of βig-h3 during breast carcinoma cell metastasis. The results indicated that the upregulation of βig-h3 significantly promotes the growth and inhibits the cisplatin-induced apoptosis of breast carcinoma cells. It was also demonstrated that βig-h3 promoted the migration and invasion of human breast carcinoma cells in vitro and in vivo. Furthermore, the results demonstrated that βig-h3 upregulated the overall expression and phosphorylation of phosphatidylinositol 3-kinase (PI3K) and protein kinase B (Akt) in human breast carcinoma cells. By contrast, βig-h3 knockdown reversed the βig-h3-mediated characteristics of breast carcinoma cells. Thus, the current study demonstrated that the PI3K/Akt signaling pathway serves a role in βig-h3-induced human breast cancer cell metastasis and that βig-h3 transfection enhances the metastatic potential of human breast carcinoma cells via the PI3K/Akt signaling pathway. These observations contribute to the understanding of the potential mechanism of human breast carcinoma cell growth and metastasis and suggest that βig-h3 may be a promising therapeutic target for the treatment of human breast carcinoma.
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Affiliation(s)
- Jiaxin Zhang
- Department of Breast Surgery, Weifang People's Hospital, Weifang, Shandong 261000, P.R. China
| | - Zhaojiangbo Li
- Department of General Surgery Ward Two, Pingdu People's Hospital, Qingdao, Shandong 266700, P.R. China
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21
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Yu B, Jiang K, Zhang J. MicroRNA-124 suppresses growth and aggressiveness of osteosarcoma and inhibits TGF-β-mediated AKT/GSK-3β/SNAIL-1 signaling. Mol Med Rep 2018; 17:6736-6744. [PMID: 29488603 DOI: 10.3892/mmr.2018.8637] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 09/13/2017] [Indexed: 11/05/2022] Open
Abstract
Osteosarcoma is one of the most common malignant tumors in adolescent populations and the prognosis remains incompletely understand. Previous reports have demonstrated that microRNA‑124 (miR‑124) has inhibitory effects on various human malignancies and is associated with tumor progression. However, the clinical significance and potential mechanisms of miR‑124 in the progression of osteosarcoma is not clearly understood. In this study, the potential molecular mechanism of miR‑124 in osteosarcoma tumorigenesis, growth and aggressiveness was investigated. The growth, proliferation, apoptosis, migration and invasion of osteosarcoma cells were investigated following miR‑124 transfection were determined by colony formation assay, western blotting, immunofluorescence, migration/invasion assays and reverse transcription‑quantitative polymerase chain reaction. In vivo anti‑cancer effects of miR‑124 were analyzed by a tumor growth assay, immunohistochemistry and survival rate observations. The results demonstrated that miR‑124 transfection significantly decreased integrin expression in osteosarcoma cells, and further inhibited growth, proliferation, migration and invasion of osteosarcoma cells. Flow cytometry assays indicated that miR‑124 transfection attenuated apoptosis resistance of osteosarcoma to tunicamycin, potentially via the downregulation of P53 and Bcl‑2 apoptosis regulator expression. Mechanistic assays demonstrated that miR‑124 transfection suppressed TGF‑β expression in osteosarcoma. An animal study revealed that tumor growth was reduced in tumor cells transfected with miR‑124 compared with control cells, and the survival rate was prolonged in mice with miR‑124 transfected xenografts compared with control tumors. In conclusion, these results indicate that miR‑124 transection inhibits the growth and aggressive of osteosarcoma, potentially via suppression of TGF‑β‑mediated AKT/GSK‑3β/snail family transcriptional repressor 1 (SNAIL‑1) signaling, suggesting miR‑124 may be a potential anti‑cancer agent/target for osteosarcoma therapy.
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Affiliation(s)
- Bo Yu
- Department of Orthopedics, Renji Hospital Shanghai Jiao Tong University School of Medicine, Shanghai 200127, P.R. China
| | - Kaibiao Jiang
- Department of Orthopedics, Renji Hospital Shanghai Jiao Tong University School of Medicine, Shanghai 200127, P.R. China
| | - Jidong Zhang
- Department of Orthopedics, Renji Hospital Shanghai Jiao Tong University School of Medicine, Shanghai 200127, P.R. China
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22
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Zhuang T, Woody NM, Liu H, Cherian S, Reddy CA, Qi P, Magnelli A, Djemil T, Stephans KL, Xia P, Videtic GM. Dosimetric differences between local failure and local controlled non-small cell lung cancer patients treated with stereotactic body radiotherapy: A matched-pair study. J Med Imaging Radiat Oncol 2018; 62:420-424. [PMID: 29399972 DOI: 10.1111/1754-9485.12706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 01/02/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Concerns were raised about the accuracy of pencil beam (PB) calculation and potential underdosing of medically inoperable non-small cell lung cancer (NSCLC) treated with stereotactic body radiation therapy (SBRT). From our institutional series, we designed a matched-pair study where each local failure and controlled patient was matched based upon several clinical factors, to investigate the dose difference between the matched-pair. METHODS Eighteen pairs of NSCLC patients, treated with 50 Gy in five fractions, were selected. These patients were matched based on treatment intent, tumour size, histology and clinical follow-up. All PB calculated clinical plans were retrospectively recalculated with a MC algorithm. The D99 and DMean of the gross tumour volume (GTV) and D95 and DMean of the planning tumour volume (PTV) from PB and Monte Carlo (MC) calculation were compared between local failures and controls using the Mann-Whitney test. RESULTS The mean PB calculated D95 of PTV was 50.4 Gy for both failures and controls (P = 0.85), indicating no planning differences between the groups. From MC calculations, the mean (±SD) of GTV D99 , GTV DMean , PTV D95 , PTV DMean were 47.6 ± 2.6/46.3 ± 2.4, 50.4 ± 2.1/49.8 ± 1.6, 44.4 ± 2.7/43.6 ± 3.1, 48.7 ± 2.4/48.2 ± 2.4 Gy for failure/controlled groups, respectively, and there was no significant difference between two groups (all P > 0.1). The dose differences between MC and PB calculations were in agreement with other literatures and there was no significant difference between two groups. CONCLUSIONS While PB algorithms may overestimate tumour doses relative to MC algorithms, our matched-pair study did not find dose differences between local failure and local controlled cases.
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Affiliation(s)
- Tingliang Zhuang
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Neil M Woody
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Han Liu
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Sheen Cherian
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Chandana A Reddy
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Peng Qi
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Anthony Magnelli
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Toufik Djemil
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Kevin L Stephans
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Ping Xia
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Gregory Mm Videtic
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA
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23
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Zhang B, Tao F, Zhang H. Metastasis-associated protein 2 promotes the metastasis of non-small cell lung carcinoma by regulating the ERK/AKT and VEGF signaling pathways. Mol Med Rep 2018; 17:4899-4908. [PMID: 29393472 PMCID: PMC5865949 DOI: 10.3892/mmr.2018.8535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 05/23/2017] [Indexed: 01/05/2023] Open
Abstract
Non-small cell lung carcinoma (NSCLC) is the most common cause of cancer‑associated mortality in the world and accounts for ~85% of human lung cancers. Metastasis‑associated protein 2 (MTA2) is a component of the histone deacetylase complex and serves a role in tumor progression; however, the mechanism through which MTA2 is involved in the progression of NSCLC remains unclear. The aim of the present study was to investigate the expression and function of MTA2 and the MTA2‑mediated signaling pathway in NSCLC cells. Expression of MTA2 and its target genes was analyzed in MTA2‑overexpressing and anti‑MTA2 antibody (AbMTA2)‑treated NSCLC cells, as well as growth, migration, invasion and apoptotic‑resistance. The inhibitory effects on tumor formation were analyzed using AbMTA2‑treated NSCLC cells and in a mouse model. Histological assessment was conducted to analyze the expressions levels of extracellular signal‑regulated kinase (ERK), RAC‑α serine/threonine protein kinase (AKT) and vascular endothelial growth factor (VEGF) in experimental tumors. Results of the present study demonstrated that MTA2 was overexpressed in NSCLC cells. The growth, migration and invasion of NSCLC cells were markedly inhibited by AbMTA2. In addition, it was observed that the ERK/AKT and VEGF signaling pathways were both upregulated in MTA2‑overexpressing NSCLC cells, and downregulated following silencing of MTA2 activation. ERK and AKT phosphorylation levels were downregulated in NSCLC cells and tumors following MTA2 silencing. The in vivo study demonstrated that tumor growth was markedly inhibited following siRNA‑MTA2 treatment. In conclusion, the results of the present study suggested that MTA2 silencing may significantly inhibit the growth and aggressiveness of NSCLC cells. Results from the present study indicated that the mechanism underlying the MTA2‑mediated invasive potential of NSCLC cells involved the ERK/AKT and VEGF signaling pathways, which may be a potential therapeutic target for the treatment of NSCLC.
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Affiliation(s)
- Bin Zhang
- Department of Respiratory Disease, The Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, Zhejiang 120070, P.R. China
| | - Feng Tao
- Department of Respiratory Disease, The First Hospital of Jiaxing, Jiaxing, Zhejiang 320090, P.R. China
| | - Hao Zhang
- Department of Respiratory Disease, The Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, Zhejiang 120070, P.R. China
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24
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Dechambre D, Janvary LZ, Jansen N, Berkovic P, Mievis C, Baart V, Cucchiaro S, Coucke AP, Gulyban A. Prediction of GTV median dose differences eases Monte Carlo re-prescription in lung SBRT. Phys Med 2017; 45:88-92. [PMID: 29472096 DOI: 10.1016/j.ejmp.2017.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 11/08/2017] [Accepted: 12/03/2017] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND AND PURPOSE The use of Monte Carlo (MC) dose calculation algorithm for lung patients treated with stereotactic body radiotherapy (SBRT) can be challenging. Prescription in low density media and time-consuming optimization conducted CyberKnife centers to propose an equivalent path length (EPL)-to-MC re-prescription method based on GTV median dose. Unknown at the time of planning, GTV D50% practical application remains difficult. The current study aims at creating a re-prescription predictive model in order to limit conflicting dose value during EPL optimization. MATERIAL AND METHODS 129 patients planned with EPL algorithm were recalculated with MC. Relative GTV_D50% discrepancies were assessed and influencing parameters identified using wrapper feature selection. Based on best descriptive parameters, predictive nomogram was built from multivariate linear regression. EPL-to-MC OARs near max-dose discrepancies were reported. RESULTS The differences in GTV_D50% (median 10%, SD: 9%) between MC and EPL were significantly (p < .001) impacted by the lesion's surface-to-volume ratio and the average relative electronic density of the GTV and the GTV's 15 mm shell. Built upon those parameters, a nomogram (R2 = 0.79, SE = 4%) predicting the GTV_D50% discrepancies was created. Furthermore EPL-to-MC OAR dose tolerance limit showed a strong linear correlation with coefficient range [0.84-0.99]. CONCLUSION Good prediction on the required re-prescription can be achieved prior planning using our nomogram. Based on strong linear correlation between EPL and MC for OARs near max-dose, further restriction on dose constraints during the EPL optimization can be warranted. This a priori knowledge eases the re-prescription process in limiting conflicting dose value.
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Affiliation(s)
- D Dechambre
- Liege University Hospital, Department of Radiation Oncology, Liège, Belgium.
| | - L Z Janvary
- Debrecen University Hospital, Department of Radiation Oncology, Debrecen, Hungary
| | - N Jansen
- Liege University Hospital, Department of Radiation Oncology, Liège, Belgium
| | - P Berkovic
- University of Leuven, Department of Oncology, Leuven, Belgium
| | - C Mievis
- Liege University Hospital, Department of Radiation Oncology, Liège, Belgium
| | - V Baart
- Liege University Hospital, Department of Radiation Oncology, Liège, Belgium
| | - S Cucchiaro
- Liege University Hospital, Department of Radiation Oncology, Liège, Belgium
| | - A P Coucke
- Liege University Hospital, Department of Radiation Oncology, Liège, Belgium
| | - A Gulyban
- Liege University Hospital, Department of Radiation Oncology, Liège, Belgium
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25
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Zhang Y, Wang Y, Xue J. Paclitaxel inhibits breast cancer metastasis via suppression of Aurora kinase-mediated cofilin-1 activity. Exp Ther Med 2017; 15:1269-1276. [PMID: 29434713 PMCID: PMC5776659 DOI: 10.3892/etm.2017.5588] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 10/24/2017] [Indexed: 12/14/2022] Open
Abstract
The main problem in breast cancer treatment is the recurrence of tumor growth and metastases. Previous studies have suggested that Paclitaxel is widely used to treat various cancers. The present study analyzed the potential signaling pathway of Paclitaxel-inhibited breast cancer metastasis. It was demonstrated that Paclitaxel treatment significantly inhibited growth of breast cancer cell lines including MCF-7 and SKBR3 cells. Results demonstrated that Paclitaxel significantly inhibited breast cancer cell migration and invasion. Results additionally demonstrated that Paclitaxel treatment suppressed Aurora kinase and cofilin-1 activity in breast cancer cells. The potential mechanism indicated that activation of Aurora kinase activity stimulated cofilin-1 activity, which canceled Paclitaxel-inhibited growth and aggressiveness of breast cancer cells. An in vivo assay revealed that Paclitaxel treatment significantly inhibited breast cancer growth. Immunohistochemistry demonstrated that Paclitaxel treatment increased apoptosis of tumor cells in tumor tissue. Notably, Aurora kinase and cofilin-1 activity were downregulated by Paclitaxel in tumor tissues. In conclusion, these results indicated that Paclitaxel inhibited breast cancer cell growth and metastasis via suppression of Aurora kinase-mediated cofilin-1 activity, suggesting Paclitaxel may be an efficient anticancer agent for the treatment of this disease.
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Affiliation(s)
- Yue Zhang
- Department of Mammography Surgery, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei 075000, P.R. China
| | - Yaoyi Wang
- Department of Radiology, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei 075000, P.R. China
| | - Jun Xue
- Department of Vessels and Glands Surgery, The First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei 075000, P.R. China
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26
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Shi W, Song J, Wang W, Zhang Y, Zheng S. MACC‑1 antibody target therapy suppresses growth and migration of non‑small cell lung cancer. Mol Med Rep 2017; 16:7329-7336. [PMID: 28944826 PMCID: PMC5865862 DOI: 10.3892/mmr.2017.7517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 08/14/2017] [Indexed: 12/31/2022] Open
Abstract
Non‑small‑cell lung cancer (NSCLC) accounts for ~80% of human lung cancers that result in mortalities worldwide. Metastasis‑associated in colon cancer‑1 (MACC‑1) has been demonstrated to be significantly expressed in cases of NSCLC and promotes tumor cell migration and metastasis through transactivation of the metastasis‑inducing hepatocyte growth factor/MET proto‑gene, receptor tyrosine kinase (HGF/MET) signaling pathway. The present study constructed a chimeric antibody (Chanti‑MACC‑1) targeting MACC‑1 and investigated its potential as a molecular therapeutic target in the treatment of NSCLC therapy. The expression of MACC‑1 was detected by reverse transcription‑quantitative polymerase chain reaction and western blotting in lung cancer cell lines and tissues. MTT assay was used to detect proliferation of A549 cells treated by Chanti‑MACC‑1, whereas the functional and regulatory effects of Chanti‑MACC‑1 in the migration and metastasis of NSCLC cells was investigated by a cell invasion assay. The therapeutic effect and survival time was observed in animal models. The results demonstrated that MACC‑1 expression was increased and overexpression of MACC‑1 promoted the progression of the cell cycle, significantly promoted NSCLC cell growth and enhanced tumor migration and invasion through the HGF/MET signaling pathway. It was further demonstrated that Chanti‑MACC‑1 efficiently suppressed MACC‑1 expression and significantly inhibited NSCLC cell proliferation, migration and invasion by blocking the HGF/MET signaling pathway. The data revealed that Chanti‑MACC‑1 was not only beneficial for tumor remission, however additionally contributed to the long‑term survival of NSCLC ‑bearing mice. The findings of the present study indicated that MACC‑1 was significantly upregulated and promoted tumor cell growth and migration in NSCLC cells and tissues via transactivation of the metastasis‑inducing HGF/MET signaling pathway. However, Chanti‑MACC‑1significantly inhibited tumor growth and metastasis, which suggested that MACC‑1 may be essential for tumor initiation and progression by negatively regulating tumor suppressors.
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MESH Headings
- A549 Cells
- Animals
- Antibodies, Monoclonal/genetics
- Antibodies, Monoclonal/metabolism
- Antibodies, Monoclonal/pharmacology
- Antibodies, Monoclonal/therapeutic use
- Carcinoma, Non-Small-Cell Lung/drug therapy
- Carcinoma, Non-Small-Cell Lung/metabolism
- Carcinoma, Non-Small-Cell Lung/pathology
- Cell Line, Tumor
- Cell Movement/drug effects
- Cell Proliferation/drug effects
- Down-Regulation/drug effects
- Epithelial-Mesenchymal Transition/drug effects
- Female
- Hepatocyte Growth Factor/metabolism
- Humans
- Lung Neoplasms/drug therapy
- Lung Neoplasms/metabolism
- Lung Neoplasms/pathology
- Mice
- Mice, Inbred C57BL
- Microscopy, Fluorescence
- Proto-Oncogene Proteins c-met/metabolism
- Recombinant Fusion Proteins/biosynthesis
- Recombinant Fusion Proteins/genetics
- Recombinant Fusion Proteins/pharmacology
- Recombinant Fusion Proteins/therapeutic use
- Signal Transduction/drug effects
- Trans-Activators
- Transcription Factors/genetics
- Transcription Factors/immunology
- Transcription Factors/metabolism
- Transplantation, Heterologous
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Affiliation(s)
- Woda Shi
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Jianxiang Song
- Department of Cardiothoracic Surgery, The Third People's Hospital, Yancheng, Jiangsu 224001, P.R. China
| | - Wencai Wang
- Department of Cardiothoracic Surgery, The Third People's Hospital, Yancheng, Jiangsu 224001, P.R. China
| | - Yajun Zhang
- Department of Cardiothoracic Surgery, The Third People's Hospital, Yancheng, Jiangsu 224001, P.R. China
| | - Shiying Zheng
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
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27
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Tsuruta Y, Nakamura M, Miyabe Y, Nakata M, Ishihara Y, Mukumoto N, Akimoto M, Ono T, Yano S, Higashimura K, Matsuo Y, Mizowaki T, Hiraoka M. Use of a second-dose calculation algorithm to check dosimetric parameters for the dose distribution of a first-dose calculation algorithm for lung SBRT plans. Phys Med 2017; 44:86-95. [PMID: 28760507 DOI: 10.1016/j.ejmp.2017.07.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 07/06/2017] [Accepted: 07/22/2017] [Indexed: 12/25/2022] Open
Abstract
PURPOSE To verify lung stereotactic body radiotherapy (SBRT) plans using a secondary treatment planning system (TPS) as an independent method of verification and to define tolerance levels (TLs) in lung SBRT between the primary and secondary TPSs. METHODS A total of 147 lung SBRT plans calculated using X-ray voxel Monte Carlo (XVMC) were exported from iPlan to Eclipse in DICOM format. Dose distributions were recalculated using the Acuros XB (AXB) and the anisotropic analytical algorithm (AAA), while maintaining monitor units (MUs) and the beam arrangement. Dose to isocenter and dose-volumetric parameters, such as D2, D50, D95 and D98, were evaluated for each patient. The TLs of all parameters between XVMC and AXB (TLAXB) and between XVMC and AAA (TLAAA) were calculated as the mean±1.96 standard deviations. RESULTS AXB values agreed with XVMC values within 3.5% for all dosimetric parameters in all patients. By contrast, AAA sometimes calculated a 10% higher dose in PTV D95 and D98 than XVMC. The TLAXB and TLAAA of the dose to isocenter were -0.3±1.4% and 0.6±2.9%, respectively. Those of D95 were 1.3±1.8% and 1.7±3.6%, respectively. CONCLUSIONS This study quantitatively demonstrated that the dosimetric performance of AXB is almost equal to that of XVMC, compared with that of AAA. Therefore, AXB is a more appropriate algorithm for an independent verification method for XVMC.
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Affiliation(s)
- Yusuke Tsuruta
- Division of Clinical Radiology Service, Kyoto University Hospital, Kyoto 606-8507, Japan
| | - Mitsuhiro Nakamura
- Department of Radiation Oncology and Image-applied Therapy, Kyoto University Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan.
| | - Yuki Miyabe
- Department of Radiation Oncology and Image-applied Therapy, Kyoto University Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
| | - Manabu Nakata
- Division of Clinical Radiology Service, Kyoto University Hospital, Kyoto 606-8507, Japan
| | - Yoshitomo Ishihara
- Department of Radiation Oncology and Image-applied Therapy, Kyoto University Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
| | - Nobutaka Mukumoto
- Department of Radiation Oncology and Image-applied Therapy, Kyoto University Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
| | - Mami Akimoto
- Department of Radiation Oncology and Image-applied Therapy, Kyoto University Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
| | - Tomohiro Ono
- Department of Radiation Oncology and Image-applied Therapy, Kyoto University Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
| | - Shinsuke Yano
- Division of Clinical Radiology Service, Kyoto University Hospital, Kyoto 606-8507, Japan
| | - Kyoji Higashimura
- Division of Clinical Radiology Service, Kyoto University Hospital, Kyoto 606-8507, Japan
| | - Yukinori Matsuo
- Department of Radiation Oncology and Image-applied Therapy, Kyoto University Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
| | - Takashi Mizowaki
- Department of Radiation Oncology and Image-applied Therapy, Kyoto University Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
| | - Masahiro Hiraoka
- Department of Radiation Oncology and Image-applied Therapy, Kyoto University Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
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28
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Zhou C, Bennion N, Ma R, Liang X, Wang S, Zvolanek K, Hyun M, Li X, Zhou S, Zhen W, Lin C, Wahl A, Zheng D. A comprehensive dosimetric study on switching from a Type-B to a Type-C dose algorithm for modern lung SBRT. Radiat Oncol 2017; 12:80. [PMID: 28476138 PMCID: PMC5420128 DOI: 10.1186/s13014-017-0816-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 05/01/2017] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Type-C dose algorithms provide more accurate dosimetry for lung SBRT treatment planning. However, because current dosimetric protocols were developed based on conventional algorithms, its applicability for the new generation algorithms needs to be determined. Previous studies on this issue used small sample sizes and reached discordant conclusions. Our study assessed dose calculation of a Type-C algorithm with current dosimetric protocols in a large patient cohort, in order to demonstrate the dosimetric impacts and necessary treatment planning steps of switching from a Type-B to a Type-C dose algorithm for lung SBRT planning. METHODS Fifty-two lung SBRT patients were included, each planned using coplanar VMAT arcs, normalized to D95% = prescription dose using a Type-B algorithm. These were compared against three Type-C plans: re-calculated plans (identical plan parameters), re-normalized plans (D95% = prescription dose), and re-optimized plans. Dosimetric endpoints were extracted and compared among the four plans, including RTOG dosimetric criteria: (R100%, R50%, D2cm, V105%, and lung V20), PTV Dmin, Dmax, Dmean, V% and D90%, PTV coverage (V100%), homogeneity index (HI), and Paddick conformity index (PCI). RESULTS Re-calculated Type-C plans resulted in decreased PTV Dmin with a mean difference of 5.2% and increased Dmax with a mean difference of 3.1%, similar or improved RTOG dose compliance, but compromised PTV coverage (mean D95% and V100% reduction of 2.5 and 8.1%, respectively). Seven plans had >5% D95% reduction (maximum reduction = 16.7%), and 18 plans had >5% V100% reduction (maximum reduction = 60.0%). Re-normalized Type-C plans restored target coverage, but yielded degraded plan conformity (average PCI reduction 4.0%), and RTOG dosimetric criteria deviation worsened in 11 plans, in R50%, D2cm, and R100%. Except for one case, re-optimized Type-C plans restored RTOG compliance achieved by the original Type-B plans, resulting in similar dosimetric values but slightly higher target dose heterogeneity (mean HI increase = 13.2%). CONCLUSIONS Type-B SBRT lung plans considerably overestimate target coverage for some patients, necessitating Type-C re-normalization or re-optimization. Current RTOG dosimetric criteria appear to remain appropriate.
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Affiliation(s)
- Christina Zhou
- School of Biological Sciences, University of Chicago, Chicago, IL USA
| | - Nathan Bennion
- Department of Radiation Oncology, University of Nebraska Medical Center, 42nd and Emile St, Omaha, NE 68198 USA
| | - Rongtao Ma
- Department of Radiation Oncology, University of Nebraska Medical Center, 42nd and Emile St, Omaha, NE 68198 USA
| | - Xiaoying Liang
- University of Florida Health Proton Therapy Institute, Jacksonville, FL USA
| | - Shuo Wang
- Department of Radiation Oncology, University of Nebraska Medical Center, 42nd and Emile St, Omaha, NE 68198 USA
| | - Kristina Zvolanek
- Department of Biological Systems Engineering, University of Nebraska Lincoln, Lincoln, NE USA
| | - Megan Hyun
- Department of Radiation Oncology, University of Nebraska Medical Center, 42nd and Emile St, Omaha, NE 68198 USA
| | - Xiaobo Li
- Department of Radiation Oncology, University of Nebraska Medical Center, 42nd and Emile St, Omaha, NE 68198 USA
- Department of Radiation Oncology, Fujian Medical University Union Hospital, Fuzhou, Fujian China
| | - Sumin Zhou
- Department of Radiation Oncology, University of Nebraska Medical Center, 42nd and Emile St, Omaha, NE 68198 USA
| | - Weining Zhen
- Department of Radiation Oncology, University of Nebraska Medical Center, 42nd and Emile St, Omaha, NE 68198 USA
| | - Chi Lin
- Department of Radiation Oncology, University of Nebraska Medical Center, 42nd and Emile St, Omaha, NE 68198 USA
| | - Andrew Wahl
- Department of Radiation Oncology, University of Nebraska Medical Center, 42nd and Emile St, Omaha, NE 68198 USA
| | - Dandan Zheng
- Department of Radiation Oncology, University of Nebraska Medical Center, 42nd and Emile St, Omaha, NE 68198 USA
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29
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Distefano G, Lee J, Jafari S, Gouldstone C, Baker C, Mayles H, Clark CH. A national dosimetry audit for stereotactic ablative radiotherapy in lung. Radiother Oncol 2017; 122:406-410. [PMID: 28117079 DOI: 10.1016/j.radonc.2016.12.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 11/16/2016] [Accepted: 12/05/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND PURPOSE A UK national dosimetry audit was carried out to assess the accuracy of Stereotactic Ablative Body Radiotherapy (SABR) lung treatment delivery. METHODS AND MATERIALS This mail-based audit used an anthropomorphic thorax phantom containing nine alanine pellets positioned in the lung region for dosimetry, as well as EBT3 film in the axial plane for isodose comparison. Centres used their local planning protocol/technique, creating 27 SABR plans. A range of delivery techniques including conformal, volumetric modulated arc therapy (VMAT) and Cyberknife (CK) were used with six different calculation algorithms (collapsed cone, superposition, pencil-beam (PB), AAA, Acuros and Monte Carlo). RESULTS The mean difference between measured and calculated dose (excluding PB results) was 0.4±1.4% for alanine and 1.4±3.4% for film. PB differences were -6.1% and -12.9% respectively. The median of the absolute maximum isodose-to-isodose distances was 3mm (-6mm to 7mm) and 5mm (-10mm to +19mm) for the 100% and 50% isodose lines respectively. CONCLUSIONS Alanine and film is an effective combination for verifying dosimetric and geometric accuracy. There were some differences across dose algorithms, and geometric accuracy was better for VMAT and CK compared with conformal techniques. The alanine dosimetry results showed that planned and delivered doses were within ±3.0% for 25/27 SABR plans.
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Affiliation(s)
- Gail Distefano
- Department of Medical Physics, Royal Surrey County Hospital NHS Trust, Guildford, UK.
| | - Jonny Lee
- Clatterbridge Cancer Centre, Liverpool, UK
| | - Shakardokht Jafari
- Department of Physics, University of Surrey, Guildford, UK; Radiology Department, Faculty of Medicine, Kabul Medical University, Afghanistan
| | | | - Colin Baker
- Clatterbridge Cancer Centre, Liverpool, UK; Radiotherapy Physics, Royal Berkshire NHS Foundation Trust, Reading, UK
| | | | - Catharine H Clark
- Department of Medical Physics, Royal Surrey County Hospital NHS Trust, Guildford, UK; Department of Physics, University of Surrey, Guildford, UK; National Physical Laboratory, Teddington, UK
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30
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Kawahara D, Ozawa S, Kimura T, Saito A, Nishio T, Nakashima T, Ohno Y, Murakami Y, Nagata Y. Marginal prescription equivalent to the isocenter prescription in lung stereotactic body radiotherapy: preliminary study for Japan Clinical Oncology Group trial (JCOG1408). JOURNAL OF RADIATION RESEARCH 2017; 58:149-154. [PMID: 28115532 PMCID: PMC5321195 DOI: 10.1093/jrr/rrw096] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 05/12/2016] [Accepted: 09/14/2016] [Indexed: 05/27/2023]
Abstract
A new randomized Phase III trial, the Japan Clinical Oncology Group (JCOG) 1408, which compares two dose fractionations (JCOG 0403 and JCOG 0702) for medically inoperable Stage IA NSCLC or small lung lesions clinically diagnosed as primary lung cancer, involves the introduction of a prescribed dose to the D95% of the planning target volume (PTV) using a superposition/convolution algorithm. Therefore, we must determine the prescribed dose in the D95% prescribing method to begin JCOG1408. JCOG 0702 uses density correction and the D95% prescribing method. However, JCOG 0403 uses no density correction and isocenter- prescribing method. The purpose of this study was to evaluate the prescribed dose to the D95% of the PTV equivalent to a dose of 48 Gy to the isocenter (JCOG 0403) using a superposition algorithm. The peripheral isodose line, which has the highest conformity index, and the D95% of the PTV were analyzed by considering the weighting factor, i.e. the inverse of the difference between the doses obtained using the superposition and Clarkson algorithms. The average dose at the isodose line of the highest conformity index and the D95% of the PTV were 41.5 ± 0.3 and 42.0 ± 0.3 Gy, respectively. The D95% of the PTV had a small correlation with the target volume (r2 = 0.0022) and with the distance between the scatterer and tumor volumes (r2 = 0.19). Thus, the prescribed dose of 48 Gy using the Clarkson algorithm (JCOG0403) was found to be equivalent to the prescribed dose of 42 Gy to the D95% of the PTV using the superposition algorithm.
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Affiliation(s)
- Daisuke Kawahara
- Section of Radiation Therapy, Department of Clinical Support, Hiroshima University Hospital 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan
- Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Shuichi Ozawa
- Department of Radiation Oncology, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan
- Hiroshima High-Precision Radiotherapy Cancer Center, 3-2-2, Futabanosato, Higashi-ku, Hiroshima 732-0057, Japan
| | - Tomoki Kimura
- Department of Radiation Oncology, Hiroshima University Hospital , 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Akito Saito
- Department of Radiation Oncology, Hiroshima University Hospital , 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Teiji Nishio
- Department of Radiation Oncology, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Takeo Nakashima
- Section of Radiation Therapy, Department of Clinical Support, Hiroshima University Hospital 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Yoshimi Ohno
- Section of Radiation Therapy, Department of Clinical Support, Hiroshima University Hospital 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Yuji Murakami
- Department of Radiation Oncology, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Yasushi Nagata
- Department of Radiation Oncology, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan
- Hiroshima High-Precision Radiotherapy Cancer Center, 3-2-2, Futabanosato, Higashi-ku, Hiroshima 732-0057, Japan
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Zheng D, Zhang Q, Liang X, Zhu X, Verma V, Wang S, Zhou S. Effect of the normalized prescription isodose line on the magnitude of Monte Carlo vs. pencil beam target dose differences for lung stereotactic body radiotherapy. J Appl Clin Med Phys 2016; 17:48-58. [PMID: 27455476 PMCID: PMC5690053 DOI: 10.1120/jacmp.v17i4.5965] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 02/15/2016] [Accepted: 02/14/2016] [Indexed: 12/26/2022] Open
Abstract
In lung stereotactic body radiotherapy (SBRT) cases, the pencil beam (PB) dose calculation algorithm is known to overestimate target dose as compared to the more accurate Monte Carlo (MC) algorithm. We investigated whether changing the normalized prescription isodose line affected the magnitude of MC vs. PB target dose differences. Forty‐eight patient plans and twenty virtual‐tumor phantom plans were studied. For patient plans, four alternative plans prescribed to 60%, 70%, 80%, and 90% isodose lines were each created for 12 patients who previously received lung SBRT treatments. Using 6 MV dynamic conformal arcs, the plans were individually optimized to achieve similar dose coverage and conformity for all plans of the same patient, albeit at the different prescription levels. These plans, having used a PB algorithm, were all recalculated with MC to compare the target dose differences. The relative MC vs. PB target dose variations were investigated by comparing PTV D95, Dmean, and D5 loss at the four prescription levels. The MC‐to‐PB ratio of the plan heterogeneity index (HI) was also evaluated and compared among different isodose levels. To definitively demonstrate the cause of the isodose line dependence, a simulated phantom study was conducted using simple, spherical virtual tumors planned with uniform block margins. The tumor size and beam energy were also altered in the phantom study to investigate the interplay between these confounding factors and the isodose line effect. The magnitude of the target dose overestimation by PB was greater for higher prescription isodose levels. The MC vs. PB reduction in the target dose coverage indices, D95 and V100 of PTV, were found to monotonically increase with increasing isodose lines from 60% to 90%, resulting in more pronounced target dose coverage deficiency at higher isodose prescription levels. No isodose level‐dependent trend was observed for the dose errors in the target mean or high dose indices, Dmean or D5. The phantom study demonstrated that the observed isodose level dependence was caused by different beam margins used for the different isodose levels: a higher prescription line required a larger beam margin, leading to more low‐density lung tissues in the field and, therefore, larger dose errors at the target periphery (when calculated with PB). The phantom study also found that the observed isodose level dependence was greater for smaller targets and for higher beam energies. We hereby characterized the effect of normalized prescription isodose line on magnitude of PTV dose coverage as calculated by MC vs. PB. When comparing reported MC dose deficiency values for different patients, the selection of prescription isodose line should be considered in addition to other factors known to affect differences in calculated doses between various algorithms. PACS number(s): 87.55.kh, 87.55.dk, 87.55.de
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Liu H, Zhuang T, Stephans K, Videtic G, Raithel S, Djemil T, Xia P. Dose differences in intensity-modulated radiotherapy plans calculated with pencil beam and Monte Carlo for lung SBRT. J Appl Clin Med Phys 2015; 16:91–99. [PMID: 26699560 PMCID: PMC5690987 DOI: 10.1120/jacmp.v16i6.5514] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 09/21/2015] [Accepted: 08/07/2015] [Indexed: 11/23/2022] Open
Abstract
For patients with medically inoperable early‐stage non‐small cell lung cancer (NSCLC) treated with stereotactic body radiation therapy, early treatment plans were based on a simpler dose calculation algorithm, the pencil beam (PB) calculation. Because these patients had the longest treatment follow‐up, identifying dose differences between the PB calculated dose and Monte Carlo calculated dose is clinically important for understanding of treatment outcomes. Previous studies found significant dose differences between the PB dose calculation and more accurate dose calculation algorithms, such as convolution‐based or Monte Carlo (MC), mostly for three‐dimensional conformal radiotherapy (3D CRT) plans. The aim of this study is to investigate whether these observed dose differences also exist for intensity‐modulated radiotherapy (IMRT) plans for both centrally and peripherally located tumors. Seventy patients (35 central and 35 peripheral) were retrospectively selected for this study. The clinical IMRT plans that were initially calculated with the PB algorithm were recalculated with the MC algorithm. Among these paired plans, dosimetric parameters were compared for the targets and critical organs. When compared to MC calculation, PB calculation overestimated doses to the planning target volumes (PTVs) of central and peripheral tumors with different magnitudes. The doses to 95% of the central and peripheral PTVs were overestimated by 9.7%±5.6% and 12.0%±7.3%, respectively. This dose overestimation did not affect doses to the critical organs, such as the spinal cord and lung. In conclusion, for NSCLC treated with IMRT, dose differences between the PB and MC calculations were different from that of 3D CRT. No significant dose differences in critical organs were observed between the two calculations. PACS number: 87.53.Ly
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Yang YM, Geurts M, Smilowitz JB, Sterpin E, Bednarz BP. Monte Carlo simulations of patient dose perturbations in rotational-type radiotherapy due to a transverse magnetic field: a tomotherapy investigation. Med Phys 2015; 42:715-25. [PMID: 25652485 DOI: 10.1118/1.4905168] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Several groups are exploring the integration of magnetic resonance (MR) image guidance with radiotherapy to reduce tumor position uncertainty during photon radiotherapy. The therapeutic gain from reducing tumor position uncertainty using intrafraction MR imaging during radiotherapy could be partially offset if the negative effects of magnetic field-induced dose perturbations are not appreciated or accounted for. The authors hypothesize that a more rotationally symmetric modality such as helical tomotherapy will permit a systematic mediation of these dose perturbations. This investigation offers a unique look at the dose perturbations due to homogeneous transverse magnetic field during the delivery of Tomotherapy(®) Treatment System plans under varying degrees of rotational beamlet symmetry. METHODS The authors accurately reproduced treatment plan beamlet and patient configurations using the Monte Carlo code geant4. This code has a thoroughly benchmarked electromagnetic particle transport physics package well-suited for the radiotherapy energy regime. The three approved clinical treatment plans for this study were for a prostate, head and neck, and lung treatment. The dose heterogeneity index metric was used to quantify the effect of the dose perturbations to the target volumes. RESULTS The authors demonstrate the ability to reproduce the clinical dose-volume histograms (DVH) to within 4% dose agreement at each DVH point for the target volumes and most planning structures, and therefore, are able to confidently examine the effects of transverse magnetic fields on the plans. The authors investigated field strengths of 0.35, 0.7, 1, 1.5, and 3 T. Changes to the dose heterogeneity index of 0.1% were seen in the prostate and head and neck case, reflecting negligible dose perturbations to the target volumes, a change from 5.5% to 20.1% was observed with the lung case. CONCLUSIONS This study demonstrated that the effect of external magnetic fields can be mitigated by exploiting a more rotationally symmetric treatment modality.
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Affiliation(s)
- Y M Yang
- Department of Medical Physics, Wisconsin Institutes for Medical Research, University of Wisconsin, Madison, Wisconsin 53703
| | - M Geurts
- Department of Medical Physics, Wisconsin Institutes for Medical Research, University of Wisconsin, Madison, Wisconsin 53703
| | - J B Smilowitz
- Department of Medical Physics, Wisconsin Institutes for Medical Research, University of Wisconsin, Madison, Wisconsin 53703
| | - E Sterpin
- Molecular Imaging, Radiotherapy and Oncology, Université catholique de Louvain, Brussels, Belgium 1348
| | - B P Bednarz
- Department of Medical Physics, Wisconsin Institutes for Medical Research, University of Wisconsin, Madison, Wisconsin 53703
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Shen ZL, Xia P, Klahr P, Djemil T. Dosimetric impact of orthopedic metal artifact reduction (O-MAR) on Spine SBRT patients. J Appl Clin Med Phys 2015; 16:106-116. [PMID: 26699295 PMCID: PMC5690188 DOI: 10.1120/jacmp.v16i5.5356] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 05/01/2015] [Accepted: 04/21/2015] [Indexed: 12/02/2022] Open
Abstract
The dosimetric impact of orthopedic metal artifact reduction (O‐MAR) on spine SBRT patients has not been comprehensively studied, particularly with spinal prostheses in high‐dose gradient regions. Using both phantom and patient datasets, we investigated dosimetric effects of O‐MAR in combination of various metal locations and dose calculation algorithms. A physical phantom, with and without a titanium insert, was scanned. A clinical patient plan was applied to the artifact‐free reference, non‐O‐MAR, and O‐MAR phantom images with the titanium located either inside or outside of the tumor. Subsequently, five clinical patient plans were calculated with pencil beam and Monte Carlo (iPlan) on non‐O‐MAR and O‐MAR patient images using an extended CT‐density table. The dose differences for phantom plans and patient plans were analyzed using dose distributions, dose‐volume histograms (DVHs), gamma index, and selected dosimetric endpoints. From both phantom plans and patient plans, O‐MAR did not affect dose distributions and DVHs while minimizing metal artifacts. Among patient plans, we found that, when the same dose calculation method was used, the difference in the dosimetric endpoints between non‐O‐MAR and O‐MAR datasets were small. In conclusion, for spine SBRT patients with spinal prostheses, O‐MAR image reconstruction does not affect dose calculation accuracy while minimizing metal artifacts. Therefore, O‐MAR images can be safely used for clinical spine SBRT treatment planning. PACS numbers: 87.53.Bn, 87.55.K‐, 87.57.Q‐, 87.57.cp
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Li Y, Tian Z, Shi F, Song T, Wu Z, Liu Y, Jiang S, Jia X. A new Monte Carlo-based treatment plan optimization approach for intensity modulated radiation therapy. Phys Med Biol 2015; 60:2903-19. [DOI: 10.1088/0031-9155/60/7/2903] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Comparison of pencil beam–based homogeneous vs inhomogeneous target dose planning for stereotactic body radiotherapy of peripheral lung tumors through Monte Carlo–based recalculation. Med Dosim 2015; 40:248-55. [DOI: 10.1016/j.meddos.2015.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Revised: 12/28/2014] [Accepted: 02/02/2015] [Indexed: 11/22/2022]
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Rana S, Simpson H, Larson G, Zheng Y. Dosimetric impact of number of treatment fields in uniform scanning proton therapy planning of lung cancer. J Med Phys 2014; 39:212-8. [PMID: 25525308 PMCID: PMC4258728 DOI: 10.4103/0971-6203.144483] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 10/06/2014] [Accepted: 10/12/2014] [Indexed: 12/28/2022] Open
Abstract
The main purpose of this study was to perform a treatment planning study for lung cancer comparing 2-field (2F) versus 3-field (3F) techniques in uniform scanning proton therapy (USPT). Ten clinically approved lung cancer treatment plans delivered using USPT at our proton center were included in this retrospective study. All 10 lung cases included 4D computed tomography (CT) simulation. The delineation of target volumes was done based on the maximum intensity projection (MIP) images. Both the 3F and 2F treatment plans were generated for the total dose of 74 cobalt-gray-equivalent (CGE) with a daily dose of 2 CGE. 3F plan was generated by adding an extra beam in the 2F plan. Various dosimetric parameters between 2F and 3F plans were evaluated. 3F plans produced better target coverage and conformality as well as lower mean dose to the lung, with absolute difference between 3F and 2F plans within 2%. In contrast, the addition of third beam led to increase of low-dose regions (V20 and V5) in the lung in 3F plans compared to the ones in 2F plans with absolute difference within 2%. Maximum dose to the spinal cord was lower in 2F plans. Mean dose to the heart and esophagus were comparable in both 3F and 2F plans. In conclusion, the 3F technique in USPT produced better target coverage and conformality, but increased the low-dose regions in the lung when compared to 2F technique.
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Affiliation(s)
- Suresh Rana
- Department of Medical Physics, ProCure Proton Therapy Center, Oklahoma City, Oklahoma, USA
| | - Hilarie Simpson
- Department of Medical Dosimetry, ProCure Proton Therapy Center, Oklahoma City, Oklahoma, USA
| | - Gary Larson
- Department of Radiation Oncology, ProCure Proton Therapy Center, Oklahoma City, Oklahoma, USA
| | - Yuanshui Zheng
- Department of Medical Physics, ProCure Proton Therapy Center, Oklahoma City, Oklahoma, USA
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Lacornerie T, Lisbona A, Mirabel X, Lartigau E, Reynaert N. GTV-based prescription in SBRT for lung lesions using advanced dose calculation algorithms. Radiat Oncol 2014; 9:223. [PMID: 25319444 PMCID: PMC4205279 DOI: 10.1186/s13014-014-0223-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 09/29/2014] [Indexed: 12/31/2022] Open
Abstract
Background The aim of current study was to investigate the way dose is prescribed to lung lesions during SBRT using advanced dose calculation algorithms that take into account electron transport (type B algorithms). As type A algorithms do not take into account secondary electron transport, they overestimate the dose to lung lesions. Type B algorithms are more accurate but still no consensus is reached regarding dose prescription. The positive clinical results obtained using type A algorithms should be used as a starting point. Methods In current work a dose-calculation experiment is performed, presenting different prescription methods. Three cases with three different sizes of peripheral lung lesions were planned using three different treatment platforms. For each individual case 60 Gy to the PTV was prescribed using a type A algorithm and the dose distribution was recalculated using a type B algorithm in order to evaluate the impact of the secondary electron transport. Secondly, for each case a type B algorithm was used to prescribe 48 Gy to the PTV, and the resulting doses to the GTV were analyzed. Finally, prescriptions based on specific GTV dose volumes were evaluated. Results When using a type A algorithm to prescribe the same dose to the PTV, the differences regarding median GTV doses among platforms and cases were always less than 10% of the prescription dose. The prescription to the PTV based on type B algorithms, leads to a more important variability of the median GTV dose among cases and among platforms, (respectively 24%, and 28%). However, when 54 Gy was prescribed as median GTV dose, using a type B algorithm, the variability observed was minimal. Conclusion Normalizing the prescription dose to the median GTV dose for lung lesions avoids variability among different cases and treatment platforms of SBRT when type B algorithms are used to calculate the dose. The combination of using a type A algorithm to optimize a homogeneous dose in the PTV and using a type B algorithm to prescribe the median GTV dose provides a very robust method for treating lung lesions. Electronic supplementary material The online version of this article (doi:10.1186/s13014-014-0223-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Albert Lisbona
- Service de Physique Médicale, Institut de Cancérologie de l'Ouest, Nantes, France.
| | - Xavier Mirabel
- Département Universitaire de Radiothérapie, Centre Oscar Lambret, Lille, France.
| | - Eric Lartigau
- Département Universitaire de Radiothérapie, Centre Oscar Lambret, Lille, France.
| | - Nick Reynaert
- Service de Physique Médicale, Centre Oscar Lambret, Lille, France.
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Wiant D, Vanderstraeten C, Maurer J, Pursley J, Terrell J, Sintay BJ. On the validity of density overrides for VMAT lung SBRT planning. Med Phys 2014; 41:081707. [DOI: 10.1118/1.4887778] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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40
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Latifi K, Oliver J, Baker R, Dilling TJ, Stevens CW, Kim J, Yue B, DeMarco M, Zhang GG, Moros EG, Feygelman V. Study of 201 Non-Small Cell Lung Cancer Patients Given Stereotactic Ablative Radiation Therapy Shows Local Control Dependence on Dose Calculation Algorithm. Int J Radiat Oncol Biol Phys 2014; 88:1108-13. [DOI: 10.1016/j.ijrobp.2013.12.047] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 12/07/2013] [Accepted: 12/27/2013] [Indexed: 12/14/2022]
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Solberg TD, Medin PM, Ramirez E, Ding C, Foster RD, Yordy J. Commissioning and initial stereotactic ablative radiotherapy experience with Vero. J Appl Clin Med Phys 2014; 15:4685. [PMID: 24710458 PMCID: PMC5875460 DOI: 10.1120/jacmp.v15i2.4685] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 12/29/2013] [Accepted: 11/01/2013] [Indexed: 12/31/2022] Open
Abstract
The purpose of this study is to describe the comprehensive commissioning process and initial clinical performance of the Vero linear accelerator, a new radiotherapy device recently installed at UT Southwestern Medical Center specifically developed for delivery of image‐guided stereotactic ablative radiotherapy (SABR). The Vero system utilizes a ring gantry to integrate a beam delivery platform with image guidance systems. The ring is capable of rotating ± 60° about the vertical axis to facilitate noncoplanar beam arrangements ideal for SABR delivery. The beam delivery platform consists of a 6 MV C‐band linac with a 60 leaf MLC projecting a maximum field size of 15×15 cm2 at isocenter. The Vero planning and delivery systems support a range of treatment techniques, including fixed beam conformal, dynamic conformal arcs, fixed gantry IMRT in either SMLC (step‐and‐shoot) or DMLC (dynamic) delivery, and hybrid arcs, which combines dynamic conformal arcs and fixed beam IMRT delivery. The accelerator and treatment head are mounted on a gimbal mechanism that allows the linac and MLC to pivot in two dimensions for tumor tracking. Two orthogonal kV imaging subsystems built into the ring facilitate both stereoscopic and volumetric (CBCT) image guidance. The system is also equipped with an always‐active electronic portal imaging device (EPID). We present our commissioning process and initial clinical experience focusing on SABR applications with the Vero, including: (1) beam data acquisition; (2) dosimetric commissioning of the treatment planning system, including evaluation of a Monte Carlo algorithm in a specially‐designed anthropomorphic thorax phantom; (3) validation using the Radiological Physics Center thorax, head and neck (IMRT), and spine credentialing phantoms; (4) end‐to‐end evaluation of IGRT localization accuracy; (5) ongoing system performance, including isocenter stability; and (6) clinical SABR applications. PACS number: 87.53.Ly
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Affiliation(s)
- Timothy D Solberg
- University of Pennsylvania, University of Texas Southwestern Medical Center.
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