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Ratosa I, Montero A, Ciervide R, Alvarez B, García-Aranda M, Valero J, Chen-Zhao X, Lopez M, Zucca D, Hernando O, Sánchez E, de la Casa MA, Alonso R, Fernandez-Leton P, Rubio C. Ultra-hypofractionated one-week locoregional radiotherapy for patients with early breast cancer: Acute toxicity results. Clin Transl Radiat Oncol 2024; 46:100764. [PMID: 38516338 PMCID: PMC10955656 DOI: 10.1016/j.ctro.2024.100764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/26/2024] [Accepted: 03/11/2024] [Indexed: 03/23/2024] Open
Abstract
Purpose Moderate hypofractionated radiotherapy is the standard of care for all patients with breast cancer, irrespective of stage or prior treatments. While extreme hypofractionation is accepted for early-stage tumours, its application in irradiating locoregional lymph nodes remains controversial. Materials and methods A prospective registry analysis from July 2020 to September 2023 included 276 patients with early-stage breast cancer treated with one-week ultra-hypofractionation (UHF) at 26 Gy in 5 fractions on the whole breast (58.3 %) or thoracic wall (41.7 %) and ipsilateral regional lymph nodes and simultaneous integrated boost (58.3 %). Primary endpoint was assessment of acute adverse events (AEs). Secondarily, onset of early-delayed toxicity was assessed. A minimum 6-month follow-up was required for assessing potential treatment-related early-delayed complications. Acute or late complications attributable to treatment were assessed at inclusion using the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 criteria. Results With a median follow-up of 19 months (range 1-49 months), 159 (57.6 %) patients reported AEs, predominantly grade (G) 1 (n = 139, 50.4 %) and G2 (n = 20, 7.8 %). Skin acute toxicity was common (G1/2: 134, G3: 14), while breast oedema occurred in 10 patients (G1: 9, G2: 1), and 15.9 % reported breast pain (G1: 42, G2: 2). Ipsilateral arm oedema was observed in 1.8 % patients. For patients with a follow-up beyond 6 months (n = 213), 23.4 % patients reported G1/G2 skin AEs, 8.8 % had G1/G2 breast/chest wall oedema, and 8.9 % experienced arm lymphedema. There were no cases of brachial plexopathy or G3 toxicity in this group of patients. Conclusions One-week UHF adjuvant locoregional radiation is well-tolerated, displaying low-toxicity profiles comparable to other studies using similar irradiation schedules.
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Affiliation(s)
- Ivica Ratosa
- Division of Radiation Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Angel Montero
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
- Facultad de Ciencias de la Salud, Universidad Camilo José Cela, Madrid, Spain
| | - Raquel Ciervide
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Beatriz Alvarez
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | | | | | - Xin Chen-Zhao
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Mercedes Lopez
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Daniel Zucca
- Department of Medical Physics, HM Hospitales, Madrid, Spain
| | - Ovidio Hernando
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | - Emilio Sánchez
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | | | - Rosa Alonso
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
| | | | - Carmen Rubio
- Department of Radiation Oncology, HM Hospitales, Madrid, Spain
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Rodríguez MCR, Chen-Zhao X, Hernando O, Flamarique S, Fernández-Letón P, Campo M, López M, Rodríguez M, Zucca D, Martínez D, Sánchez-Saugar E, Mañeru F, Ruiz-Zorrilla JG, de Acilu PG, Valero J, Montero A, Ciérvide R, Alvarez B, García-Aranda M, Alonso R, de la Casa MA, Alonso L, Nuñez M, Martí J, Arias F. SBRT-SG-01: final results of a prospective multicenter study on stereotactic body radiotherapy for liver metastases. Clin Transl Oncol 2024:10.1007/s12094-024-03403-w. [PMID: 38431539 DOI: 10.1007/s12094-024-03403-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/01/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVE This study aimed to assess the efficacy and tolerability of stereotactic body radiation therapy (SBRT) for the treatment of liver metastases. METHODS Patients with up to 5 liver metastases were enrolled in this prospective multicenter study and underwent SBRT. Efficacy outcomes included in-field local control (LC), progression-free survival (PFS), and overall survival (OS). Acute and late toxicities were evaluated using CTCAE v.4.0. RESULTS A total of 52 patients with 105 liver metastases were treated between 2015 and 2018. The most common primary tumor was colorectal cancer (72% of cases). Liver metastases were synchronous with the primary tumor diagnosis in 24 patients (46.2%), and 21 patients (40.4%) presented with other extrahepatic oligometastases. All patients underwent intensity-modulated radiation therapy (IMRT)/volumetric-modulated arc therapy (VMAT) with image-guided radiation therapy (IGRT) and respiratory gating, and a minimum biologically effective dose (BED10Gy) of 100 Gy was delivered to all lesions. With a median follow-up of 23.1 months (range: 13.4-30.9 months) since liver SBRT, the median actuarial local progression-free survival (local-PFS) was not reached. The actuarial in-field LC rates were 84.9% and 78.4% at 24 and 48 months, respectively. The median actuarial liver-PFS and distant-PFS were 11 and 10.8 months, respectively. The actuarial median overall survival (OS) was 27.7 months from SBRT and 52.5 months from metastases diagnosis. Patients with lesion diameter ≤ 5 cm had significantly better median liver-PFS (p = 0.006) and OS (p = 0.018). No acute or late toxicities of grade ≥ 3 were observed. CONCLUSIONS This prospective multicenter study confirms that liver SBRT is an effective alternative for the treatment of liver metastases, demonstrating high rates of local control and survival while maintaining a low toxicity profile.
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Affiliation(s)
| | - Xin Chen-Zhao
- Radiation Oncology, Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
| | - Ovidio Hernando
- Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Sonia Flamarique
- Radiation Oncology, Complejo Hospitalario de Navarra, Navarra, Spain
| | - Pedro Fernández-Letón
- Medical Physics, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Maider Campo
- Radiation Oncology, Complejo Hospitalario de Navarra, Navarra, Spain
| | - Mercedes López
- Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Maitane Rodríguez
- Radiation Oncology, Complejo Hospitalario de Navarra, Navarra, Spain
| | - Daniel Zucca
- Medical Physics, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Daniel Martínez
- Medical Physics, Complejo Hospitalario de Navarra, Navarra, Spain
| | - Emilio Sánchez-Saugar
- Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Fernando Mañeru
- Medical Physics, Complejo Hospitalario de Navarra, Navarra, Spain
| | | | - Paz García de Acilu
- Medical Physics, Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
| | - Jeannette Valero
- Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Angel Montero
- Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Raquel Ciérvide
- Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Beatriz Alvarez
- Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Mariola García-Aranda
- Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Rosa Alonso
- Radiation Oncology, Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
| | | | - Leyre Alonso
- Medical Physics, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Mónica Nuñez
- Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Jaime Martí
- Medical Physics, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Fernando Arias
- Radiation Oncology, Complejo Hospitalario de Navarra, Navarra, Spain
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Ciérvide R, Hernando O, López M, Montero Á, Zucca D, Sánchez E, Álvarez B, García-Aranda M, Chen Zhao X, Valero J, Alonso R, Martí J, de la Casa MÁ, Alonso L, García J, Garcia de Acilu P, Prado A, Fernandez Leton P, Rubio C. Stereotactic body radiation therapy (SBRT) for spinal metastases: 12 years of a single center experience. Clin Transl Oncol 2023; 25:3395-3404. [PMID: 37058207 DOI: 10.1007/s12094-023-03188-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 04/03/2023] [Indexed: 04/15/2023]
Abstract
OBJECTIVE To assess the clinical outcomes of patients with spine metastases treated with SBRT at our institution. MATERIALS AND METHODS Patients with spine metastases treated with SBRT (1 fraction/18 Gy or 5 fractions/7 Gy) during the last 12 years have been analyzed. All patients were simulated supine in a vacuum cushion or with a shoulder mask. CT scans and MRI image registration were performed. Contouring was based on International Spine-Radiosurgery-Consortium-Consensus-Guidelines. Highly conformal-techniques (IMRT/VMAT) were used for treatment planning. Intra and interfraction (CBCT or X-Ray-ExacTrac) verification were mandatory. RESULTS From February 2010 to January 2022, 129 patients with spinal metastases were treated with SBRT [1 fraction/18 Gy (75%) or 5 fractions/7 Gy] (25%). For patients with painful metastases (74/129:57%), 100% experienced an improvement in pain after SBRT. With a median follow-up of 14.2 months (average 22.9; range 0.5-140) 6 patients (4.6%) experienced local relapse. Local progression-free survival was different, considering metastases's location (p < 0.04). The 1, 2 and 3 years overall survival (OS) were 91.2%, 85.1% and 83.2%, respectively. Overall survival was significantly better for patients with spine metastases of breast and prostate cancers compared to other tumors (p < 0.05) and significantly worse when visceral metastases were present (p < 0.05), when patients were metastatic de novo (p < 0.05), and in those patients receiving single fraction SBRT (p: 0.01). CONCLUSIONS According to our experience, SBRT for patients with spinal metastases was effective in terms of local control and useful to reach pain relief. Regarding the intent of the treatment, an adequate selection of patients is essential to propose this ablative approach.
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Affiliation(s)
- Raquel Ciérvide
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain.
| | - Ovidio Hernando
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Mercedes López
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Ángel Montero
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Daniel Zucca
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Emilio Sánchez
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Beatriz Álvarez
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Mariola García-Aranda
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Xin Chen Zhao
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Jeannette Valero
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Rosa Alonso
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Jaime Martí
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Miguel Ángel de la Casa
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Leire Alonso
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Juan García
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Paz Garcia de Acilu
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Alejandro Prado
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Pedro Fernandez Leton
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Carmen Rubio
- Department of Radiation Oncology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
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Hernando-Requejo O, Chen X, López M, Sánchez E, García J, García P, Alonso R, Montero A, Ciervide R, Álvarez B, Zucca D, García Aranda M, Valero J, Fernández Letón P, Rubio C. Real-world effectiveness and safety of stereotactic body radiotherapy for liver metastases with different respiratory motion management techniques. Strahlenther Onkol 2023; 199:1000-1010. [PMID: 37728734 DOI: 10.1007/s00066-023-02147-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 08/13/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE Stereotactic body radiotherapy (SBRT) has been firmly established as a treatment choice for patients with oligometastases, as it has demonstrated both safety and efficacy by consistently achieving high rates of local control. Moreover, it offers potential survival benefits for carefully selected patients in real-world clinical settings. METHODS Between January 2008 and May 2020, a total of 149 patients (with 414 liver metastases) received treatment. The Active Breathing Coordinator device was used for 68 patients, while respiratory gating was used for 65 and abdominal compression was used for 16 patients. The most common histological finding was colorectal adenocarcinoma, with 37.6% of patients having three or more metastases, and 18% having two metastases. The prescribed dose ranged from 36 to 60 Gy, delivered in 3-5 fractions. RESULTS Local control rates at 2 and 3 years were 76.1% and 61.2%, respectively, with no instances of local recurrence after 3 years. Factors negatively impacting local control included colorectal histology, lower prescribed dose, and the occurrence of new liver metastases. The median overall survival from SBRT was 32 months, with the presence of metastases outside the liver and the development of new liver metastases after SBRT affecting survival. The median disease-free survival was 10 months. No substantial differences in both local control and survival were observed between the respiratory motion control techniques employed. Treatment tolerance was excellent, with only one patient experiencing acute grade IV thrombocytopenia and two patients suffering from ≥ grade II chronic toxicity. CONCLUSION For radical management of single or multiple liver metastases, SBRT is an effective and well-tolerated treatment option. Regardless of the technology employed, experienced physicians can achieve similarly positive outcomes. However, additional studies are required to elucidate prognostic factors that can facilitate improved patient selection.
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Affiliation(s)
- O Hernando-Requejo
- Radiation Oncology Department, University Hospital HM Puerta del Sur, Madrid, Spain.
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain.
| | - X Chen
- Radiation Oncology Department, University Hospital HM Puerta del Sur, Madrid, Spain
| | - M López
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - E Sánchez
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - J García
- Radiation Physics Department, University Hospital HM Puerta del Sur, Madrid, Spain
| | - P García
- Radiation Physics Department, University Hospital HM Puerta del Sur, Madrid, Spain
| | - R Alonso
- Radiation Oncology Department, University Hospital HM Puerta del Sur, Madrid, Spain
| | - A Montero
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - R Ciervide
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - B Álvarez
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - D Zucca
- Radiation Physics Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - M García Aranda
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - J Valero
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - P Fernández Letón
- Radiation Physics Department, University Hospital HM Sanchinarro, Madrid, Spain
| | - C Rubio
- Radiation Oncology Department, University Hospital HM Puerta del Sur, Madrid, Spain
- Radiation Oncology Department, University Hospital HM Sanchinarro, Madrid, Spain
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Azcona JD, Aguilar B, Perales Á, Polo R, Zucca D, Irazola L, Viñals A, Cabello P, Delgado JM, Pedrero D, Bermúdez R, Fayos-Solá R, Huesa-Berral C, Burguete J. Commissioning of a synchrotron-based proton beam therapy system for use with a Monte Carlo treatment planning system. Radiat Phys Chem Oxf Engl 1993 2022. [DOI: 10.1016/j.radphyschem.2022.110708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Prado Barragán A, Zucca D, De la Casa M, García P, García J, Alonso L, Martí J, Hernando O, Fernández-Letón P, Rubio C. PO-1696 Comparison of intra-fraction motion when using two distinct systems to perform DIBH in liver SBRT. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03660-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Prado A, Zucca D, De la Casa MÁ, Martí J, Alonso L, de Acilu PG, García J, Hernando O, Fernández-Letón P, Rubio C. Intrafraction target shift comparison using two breath-hold systems in lung stereotactic body radiotherapy. Phys Imaging Radiat Oncol 2022; 22:57-62. [PMID: 35514526 PMCID: PMC9065403 DOI: 10.1016/j.phro.2022.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 04/13/2022] [Accepted: 04/20/2022] [Indexed: 12/25/2022] Open
Abstract
Background and purpose In lung Stereotactic Body Radiotherapy (SBRT) respiratory management is used to reduce target motion due to respiration. This study aimed (1) to estimate intrafraction shifts through a Cone Beam Computed Tomography (CBCT) acquired during the first treatment arc when deep inspiration breath-hold (DIBH) was performed using spirometry-based (SB) or surface-guidance (SG) systems and (2) to analyze the obtained results depending on lesion localization. Material and methods A sample of 157 patients with 243 lesions was analyzed. A total of 860 and 410 fractions were treated using SB and SG. Averaged intrafraction shifts were estimated by the offsets obtained when registering a CBCT acquired during the first treatment arc with the planning CT. Offsets were recorded in superior-inferior (SI), left-right (LR) and anterior-posterior (AP). Significance tests were applied to account for differences in average offsets and variances between DIBH systems. Systematic and random errors were computed. Results Average offset moduli were 2.4 ± 2.2 mm and 3.5 ± 2.6 mm for SB and SG treatments (p < 0.001). When comparing SB and SG offset distributions in each direction no differences were found in average values (p > 0.3). However, variances were statistically smaller for SB than for SG (p < 0.001). The number of vector moduli offsets greater than 5 mm was 2.1 times higher for SG. Compared to other locations, lower lobe lesions moduli were at least 2.3 times higher. Conclusions Both systems were accuracy-equivalent but not precision-equivalent systems. Furthermore, the SB system was more precise than the SG one. Despite DIBH, patients with lower lobe lesions had larger offsets than superior lobe ones, mainly in SI.
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Affiliation(s)
- Alejandro Prado
- Medical Physics and Radiation Protection Department, HU HM Sanchinarro, HM Hospitales, c\ Oña n°10, 28050 Madrid, Spain
| | - Daniel Zucca
- Medical Physics and Radiation Protection Department, HU HM Sanchinarro, HM Hospitales, c\ Oña n°10, 28050 Madrid, Spain
| | - Miguel Ángel De la Casa
- Medical Physics and Radiation Protection Department, HU HM Sanchinarro, HM Hospitales, c\ Oña n°10, 28050 Madrid, Spain
| | - Jaime Martí
- Medical Physics and Radiation Protection Department, HU HM Sanchinarro, HM Hospitales, c\ Oña n°10, 28050 Madrid, Spain
| | - Leyre Alonso
- Medical Physics and Radiation Protection Department, HU HM Sanchinarro, HM Hospitales, c\ Oña n°10, 28050 Madrid, Spain
| | - Paz García de Acilu
- Medical Physics and Radiation Protection Department, HU HM Puerta del Sur, HM Hospitales, Av. Carlos V n° 70, 28938 Móstoles, Madrid, Spain
| | - Juan García
- Medical Physics and Radiation Protection Department, HU HM Puerta del Sur, HM Hospitales, Av. Carlos V n° 70, 28938 Móstoles, Madrid, Spain
| | - Ovidio Hernando
- Radiation Oncology Department, HU HM Puerta del Sur, HM Hospitales, Av. Carlos V n° 70, 28938 Móstoles, Madrid, Spain
| | - Pedro Fernández-Letón
- Medical Physics and Radiation Protection Department, HU HM Sanchinarro, HM Hospitales, c\ Oña n°10, 28050 Madrid, Spain
- Medical Physics and Radiation Protection Department, HU HM Puerta del Sur, HM Hospitales, Av. Carlos V n° 70, 28938 Móstoles, Madrid, Spain
| | - Carmen Rubio
- Radiation Oncology Department, HU HM Sanchinarro, HM Hospitales, c\ Oña n°10, 28050 Madrid, Spain
- Radiation Oncology Department, HU HM Puerta del Sur, HM Hospitales, Av. Carlos V n° 70, 28938 Móstoles, Madrid, Spain
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Aguilar-Redondo P, Viñals A, Cabello P, Delgado J, Azcona D, Polo R, Perales A, Zucca D. SPR stoichiometric calibration of a single energy CT and validation using fresh tissue samples. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00029-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Azcona J, Aguilar B, Irazola L, Viñals A, Cabello P, Zucca D, Perales A, Polo R, Delgado J, Burguete J. PO-1696 Clinical commissioning a synchrotron-based proton therapy system. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08147-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ciervide R, Montero A, Garcia-Aranda M, Alvarez B, Prado A, Chen-Zhaoi X, Alonso R, Lopez M, Hernando O, Sanchez E, Valero J, Nuñez M, Izquierdo M, Rossi K, Cañadillas C, Marti J, Zucca D, Alonso L, Fernandez-Leton P, Rubio C. PO-1143 One-week ultrahypofractionated RT for whole breast and simultaneous integrated boost in DCIS. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07594-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rubio Rodríguez M, Arias F, Chen-Zhao X, Flamarique S, Fernández-Letón P, Campo M, López M, Rodríguez M, Zucca D, Martínez D, Sánchez-Saugar E, Mañeru F, García Ruiz-Zorrilla J, García de Acilu P, Valero J, Montero A, Ciérvide R, Alvarez B, García-Aranda M, Alonso R, de la Casa M, Alonso L, Nuñez M, Martí J, Hernando O. OC-0416 Results of SBRT-SG-01, a prospective multicentric-study of SBRT for liver metastases. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06903-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hernando-Requejo O, Lopez M, Chen X, Alonso R, Sanchez E, Montero A, Ciervide R, Alvarez B, Valero J, Garcia M, Zucca D, Garcia J, Garcia de Azilu P, Alonso L, De la Casa M, Prado A, Marti J, Fernandez Leton P, Nuñez M, Izquierdo M, Rossi K, Cañadillas C, Rubio C. PO-1240 Complete pathological response after high dose radiotherapy for locally advanced esophageal cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07691-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Nuñez Baez M, Montero A, Chen-Zhao X, Acosta A, Alvarez B, Palma J, Lopez-Gonzalez M, Sanchez E, Hernando O, Valero J, Ciervide R, Garcia-Aranda M, Alonso R, De la Casa M, Zucca D, Martí J, Flores-Cacho I, Ruiz-Morales C, Fernandez-Leton P, Rubio Rodriguez M. PO-1233: Perioperative Radiotherapy with a Moderate Dose-Escalation for Retroperitoneal Sarcoma (RPS). Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01251-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Montero A, Nuñez M, Hernando O, Vicente E, Ciervide R, Zucca D, Sanchez E, López M, Quijano Y, Garcia-Aranda M, Alonso R, Valero J, Chen X, Alvarez B, Fernandez-Leton P, Rubio C. Retroperitoneal soft-tissue sarcomas: Radiotherapy experience from a tertiary cancer center and review of current evidence. Rep Pract Oncol Radiother 2020; 25:643-655. [PMID: 32565743 DOI: 10.1016/j.rpor.2020.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 04/14/2020] [Accepted: 05/25/2020] [Indexed: 12/19/2022] Open
Abstract
Background Surgery remains to be the main therapeutic approach for retroperitoneal sarcomas (RPS) although evidence supports that complementary radiotherapy increases local-control and survival. We present a multidisciplinary management and experience of a tertiary cancer center in the treatment of RPS and analyze current evidence of radiotherapy efficacy. Patients and methods We retrospectively reviewed 19 patients with primary or relapsed RPS treated between November 2009 and October 2018. Multidisciplinary approach comprised complete resection in 15 patients (79%) achieving resection R0 in 11 patients (58%), R1 in 4 patients (21%) and R2 in 2 patients (10%). Seven patients (37%) underwent a preoperative radiation (PRORT), 10 patients (53%), post-operative radiation (PORT) and 2 patients (10%), received radiotherapy exclusively. Ten patients (53%) received adjuvant chemotherapy. Results With a median follow-up of 24 months (2-114 months), actuarial rates of loco-regional relapse free survival (LRFS) at 1, 2 and 3 years were 77%, 77% and 67%, respectively. Actuarial rates of distant-metastases-free survival (DMFS), disease-free survival (DFS) and overall survival (OS) at 1, 2 and 3 years were 100%, 100% and 80% for DMFS; 94%, 77% and 67% for DFS and 100%, 91% and 91% for OS, respectively. Only surgical margins (negative vs. positive) showed significance for 3y-LRFS: 100% vs. 34.3%, p = 0.018. Treatment tolerance was acceptable with no acute or late toxicity higher than grade 2. Conclusions Complementary radiotherapy appears to be useful and well tolerated for the multidisciplinary management of RPS. Presence of positive surgical margins seems to be the most relevant prognostic factor through the follow-up.
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Affiliation(s)
- A Montero
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - M Nuñez
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - O Hernando
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - E Vicente
- Department of General Surgery, University Hospital HM Sanchinarro, Madrid, Spain
| | - R Ciervide
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - D Zucca
- Department of Medical Physics, University Hospital HM Sanchinarro, Madrid, Spain
| | - E Sanchez
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - M López
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - Y Quijano
- Department of General Surgery, University Hospital HM Sanchinarro, Madrid, Spain
| | - M Garcia-Aranda
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - R Alonso
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - J Valero
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - X Chen
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - B Alvarez
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - P Fernandez-Leton
- Department of Medical Physics, University Hospital HM Sanchinarro, Madrid, Spain
| | - C Rubio
- Department of Radiation Oncology, University Hospital HM Sanchinarro, Madrid, Spain
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Chen-Zhao X, Hernando O, López M, Sánchez E, Montero A, García-Aranda M, Ciérvide R, Valero J, Alonso R, Cárdenas-Rebollo JM, Vicente E, Quijano Y, Cubillo A, Álvarez R, Prados S, Plaza C, García J, Zucca D, Fernández-Letón P, Rubio C. A prospective observational study of the clinical and pathological impact of stereotactic body radiotherapy (SBRT) as a neoadjuvant strategy of chemoradiation in pancreatic cancer. Clin Transl Oncol 2020; 22:1499-1505. [PMID: 31974820 DOI: 10.1007/s12094-020-02287-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 01/01/2020] [Indexed: 01/30/2023]
Abstract
PURPOSE/OBJECTIVE(S) To improve the curative resection rates and prognoses, a variety of neoadjuvant (NA) strategies have been explored in PDAC. In our institution, non-metastatic PDACs have been treated with a NA intent with induction multiagent chemotherapy and SBRT. The primary endpoint was to increase R0 resection rate. The secondary endpoints were the analysis of the clinical tolerance, the pathological response, the local control (LC) and the OS. MATERIALS/METHODS All consecutive patients with non-metastatic PDAC underwent SBRT as part of the NA strategy were included. A total dose of 40-62 Gy were delivered in 5-10 fractions. Surgery was performed after SBRT and restaging. RESULTS Since February 2014 to December 2018, 45 patients were enrolled. Thirty-two patients underwent surgery (71.1%), 10 out of 15 were initially unresectable disease patients (66.75%). R0 resection rate was 93% (30 patients) and pN0 status was achieved in 20 patients (60.6%). Tumour regression grade (TRG): 12 patients with complete response or marked response (TRG 0-1: 37.5%), 16 patients with moderate response (TRG 2: 50%) and four patients with poor response (TRG 3: 12.5%). The median follow-up was 16.2 m (range 6.6-59.6 m) since diagnosis. The LC rate achieved was very high (95.5%). Actuarial 12 and 24 m OS was 67.4% and 35.9% respectively. No grade 3 or higher toxicity related to SBRT was observed. CONCLUSION The results are encouraging, suggesting that SBRT has a significant role in the management of these patients and further studies will be necessary to prove these findings.
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Affiliation(s)
- X Chen-Zhao
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain.
| | - O Hernando
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - M López
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - E Sánchez
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - A Montero
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - M García-Aranda
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - R Ciérvide
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - J Valero
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - R Alonso
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - J M Cárdenas-Rebollo
- Department of Applied Mathematics and Statistics, CEU San Pablo University, Madrid, Spain
| | - E Vicente
- General and Gastrointestinal Surgery, University Hospital HM Sanchinarro, Madrid, Spain
| | - Y Quijano
- General and Gastrointestinal Surgery, University Hospital HM Sanchinarro, Madrid, Spain
| | - A Cubillo
- Medical Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - R Álvarez
- Medical Oncology, University Hospital HM Sanchinarro, Madrid, Spain
| | - S Prados
- Gastroenterology, University Hospital HM Sanchinarro, Madrid, Spain
| | - C Plaza
- Anatomical Pathology, University Hospital HM Sanchinarro, Madrid, Spain
| | - J García
- Medical Physics, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - D Zucca
- Medical Physics, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - P Fernández-Letón
- Medical Physics, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
| | - C Rubio
- Radiation Oncology, University Hospital HM Sanchinarro-Puerta del Sur, Madrid, Spain
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Rubio C, Chen X, Lopez M, Hernando O, Sanchez E, Montero A, Aranda MG, Ciervide R, Valero J, Alonso R, Vicente E, Quijano Y, Cubillo A, Gallego RA, Prados S, Plaza C, Pérez J, Garcia J, Zucca D, Leton PF. A Prospective Observational Study of the Impact of Stereotactic Body Radiotherapy (SBRT) As a Neoadjuvant Strategy of Chemoradiation in Pancreatic Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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17
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Puig-Lozano R, Bernaldo de Quirós Y, Díaz-Delgado J, García-Álvarez N, Sierra E, De la Fuente J, Sacchini S, Suárez-Santana CM, Zucca D, Câmara N, Saavedra P, Almunia J, Rivero MA, Fernández A, Arbelo M. Retrospective study of foreign body-associated pathology in stranded cetaceans, Canary Islands (2000-2015). Environ Pollut 2018; 243:519-527. [PMID: 30216884 DOI: 10.1016/j.envpol.2018.09.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 09/01/2018] [Accepted: 09/03/2018] [Indexed: 06/08/2023]
Abstract
Marine pollution, overrepresented by plastic, is a growing concern worldwide. However, there is little knowledge on occurrence and detrimental impacts of marine debris in cetaceans. To partially fill in this gap of knowledge, we aimed to investigate the occurrence and pathologies associated with foreign bodies (FBs) in a large cohort of cetaceans (n = 465) stranded in the Canary Islands. The Canary Islands shelter the greatest cetacean biodiversity in Europe, with up to 30 different species, of which nine are regularly present year around. We found at least one ingested FB in 36 out of 465 (7.74%) studied cetaceans, involving 15 different species, including eight out of the nine (80%) cetacean species present year-round in the Canary Islands. Risso's dolphin was the species most affected, followed by sperm whale, beaked whale and mysticetes. Plastic FB were the most common item found (80.56%). FB was directly associated with death in 13/36 (36.11%) animals. Poor body condition and deep diving behavior were found to be risk factors for FB ingestion, whereas the adult age was a protective factor. To the authors knowledge this is the first study that use statistical analysis to investigate risk and protective factors for FB ingestion. This study also provides insights of the potential impact caused by ingested FBs on the animal's health and mortality. This knowledge is critical to better understand and assess the impact of FB in cetaceans setting the scientific basis for prospective impact monitoring and future conservation policies.
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Affiliation(s)
- R Puig-Lozano
- Division of Histology and Animal Pathology, University Institute for Animal Health and Food Security (IUSA), Veterinary School, University of Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Y Bernaldo de Quirós
- Division of Histology and Animal Pathology, University Institute for Animal Health and Food Security (IUSA), Veterinary School, University of Las Palmas de Gran Canaria, Canary Islands, Spain.
| | - J Díaz-Delgado
- Division of Histology and Animal Pathology, University Institute for Animal Health and Food Security (IUSA), Veterinary School, University of Las Palmas de Gran Canaria, Canary Islands, Spain
| | - N García-Álvarez
- Division of Histology and Animal Pathology, University Institute for Animal Health and Food Security (IUSA), Veterinary School, University of Las Palmas de Gran Canaria, Canary Islands, Spain
| | - E Sierra
- Division of Histology and Animal Pathology, University Institute for Animal Health and Food Security (IUSA), Veterinary School, University of Las Palmas de Gran Canaria, Canary Islands, Spain
| | - J De la Fuente
- Division of Histology and Animal Pathology, University Institute for Animal Health and Food Security (IUSA), Veterinary School, University of Las Palmas de Gran Canaria, Canary Islands, Spain
| | - S Sacchini
- Division of Histology and Animal Pathology, University Institute for Animal Health and Food Security (IUSA), Veterinary School, University of Las Palmas de Gran Canaria, Canary Islands, Spain
| | - C M Suárez-Santana
- Division of Histology and Animal Pathology, University Institute for Animal Health and Food Security (IUSA), Veterinary School, University of Las Palmas de Gran Canaria, Canary Islands, Spain
| | - D Zucca
- Division of Histology and Animal Pathology, University Institute for Animal Health and Food Security (IUSA), Veterinary School, University of Las Palmas de Gran Canaria, Canary Islands, Spain
| | - N Câmara
- Division of Histology and Animal Pathology, University Institute for Animal Health and Food Security (IUSA), Veterinary School, University of Las Palmas de Gran Canaria, Canary Islands, Spain
| | - P Saavedra
- Department of Mathematics, University of Las Palmas de Gran Canaria, Canary Islands, Spain
| | - J Almunia
- Loro Parque Foundation, Camino Burgado, 38400 Puerto de la Cruz (Tenerife), Santa Cruz de Tenerife, Spain
| | - M A Rivero
- Division of Histology and Animal Pathology, University Institute for Animal Health and Food Security (IUSA), Veterinary School, University of Las Palmas de Gran Canaria, Canary Islands, Spain
| | - A Fernández
- Division of Histology and Animal Pathology, University Institute for Animal Health and Food Security (IUSA), Veterinary School, University of Las Palmas de Gran Canaria, Canary Islands, Spain
| | - M Arbelo
- Division of Histology and Animal Pathology, University Institute for Animal Health and Food Security (IUSA), Veterinary School, University of Las Palmas de Gran Canaria, Canary Islands, Spain
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De La Casa M, Zucca D, García J, Martí J, Fernández-Letón P. PO-1004: Assessment Of A Commercially Available Algorithm For Deformable Image Registration. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31314-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rubio C, Hernando O, Sanchez E, Chen X, Valero J, Ciervide R, Aranda MG, Zucca D, Ruiz Zorrilla JG, Lopez M, Moreno JMP, Vicente E, Quijano Y, Cubillo A, Alvarez B, Madrigal L, Leton PF, Allona M, Torres M, Velilla MF. Clinical Experience and Long Follow-Up of Patients With Liver and Lung Metastasis Treated with Stereotactic Body Radiation Therapy with Intrafraction Control of Tumor Motion Guided By Internal Fiducials and a Gating Technique. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Albarrán JV, Montero A, Sanchez E, Acosta A, Alvarez B, Chen X, Hernando O, Pérez J, Zucca D, LÃpez M, Ciervide R, Aranda MDLOG, Garcia J, Leton PF, Rubio C. Hypofractionated IMRT-IGRT With Internal Markers in Prostate Cancer Treatment: Mature Results. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Díaz-Delgado J, Sierra E, Vela AI, Arbelo M, Zucca D, Groch KR, Fernández A. Coinfection by Streptococcus phocae and cetacean morbillivirus in a short-beaked common dolphin Delphinus delphis. Dis Aquat Organ 2017; 124:247-252. [PMID: 28492181 DOI: 10.3354/dao03124] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We describe gross, histopathological, and immunohistochemical features of Streptococcus phocae and cetacean morbillivirus coinfection in a short-beaked common dolphin Delphinus delphis. Major gross findings were cutaneous purulent nodules in the tail fluke, vegetative mitral valve endocarditis, and presumed postpartum pyometra. Histologic examination revealed bacterial septicemia characterized by widespread intravascular coccoid bacterial emboli. These were associated with fibrinonecrotizing to pyogranulomatous dermatitis and panniculitis, embolic pneumonia, neutrophilic and lymphoplasmacytic meningochoroiditis, random neutrophilic hepatitis, lymphoplasmacytic myocarditis and epicarditis, necrotizing adrenalitis, suppurative endometritis, and multicentric reactive lymphadenopathy. Bacteriology and molecular analysis with sequencing of the 16S rRNA gene identified S. phocae from lung, brain, and adrenal gland tissue. Immunohistochemical analysis for morbillivirus detection revealed positive immunolabeling in the epithelium of the choroid plexus of the fourth ventricle. Published reports on S. phocae infection in cetaceans are rare, and pathological details are limited. The present case indicates that S. phocae has potential pathogenic capacity in common dolphins. The pathogenesis is proposed to have involved cutaneous penetration after a skin trauma, leading to initial cutaneous disease and eventual systemic infection.
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Affiliation(s)
- J Díaz-Delgado
- Veterinary Histology and Pathology, Institute of Animal Health, Veterinary College, University of Las Palmas de Gran Canaria, Trasmontana s/n, Arucas 35413, Las Palmas de Gran Canaria, Spain
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Chen X, Montero A, Sanchez E, De las Heras J, Hernando O, Lopez M, Garcia J, Perez J, Ciervide R, Valero J, Garcia-Aranda M, Alonso R, Zucca D, De la Casa M, Alvarez B, Marti J, Alonso L, Fernandez-Leton P, Rubio C. EP-1803: Moderate dose-escalation with perioperative HDR brachytherapy in soft tissue sarcomas. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)32165-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Chen X, Sanchez E, Montero A, Hernando O, Lopez M, Garcia J, Perez J, Ciervide R, Valero J, Garcia-Aranda M, Alonso R, Zucca D, De la Casa M, Alvarez B, Marti J, Alonso L, Fernandez-Leton P, Rubio C. EP-1252: Update of Stereotactic body radiation therapy for pancreatic adenocarcinoma: efficacy and safety. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31687-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Garcia-Aranda M, CHEN X, Montero A, Valero J, Alonso R, Zucca D, Ciervide R, Lopez M, Alvarez B, Payano S, Sanchez E, Hernando O, Rubio C. EP-1331: Cancer of uterine cervix: PET-CT, IMRT and HDR. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32581-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ciérvide Jurío R, García-aranda M, Sanchez E, Lopez M, Hernando O, Valero J, Rodríguez A, Potdevin G, Zucca D, Rubio C. Locally advanced laryngeal cancer (LALC), with IMRT, IGRT and planning with 18 FDG PET-CT. Rep Pract Oncol Radiother 2013. [DOI: 10.1016/j.rpor.2013.03.272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Fernández A, Bernaldo de Quirós Y, Sierra E, Sacchini S, Andrada M, Rivero M, Zucca D, Arbelo M. Decompressive Pathology in Risso's Dolphin: Deadly Hunting. J Comp Pathol 2013. [DOI: 10.1016/j.jcpa.2012.11.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Moreno JP, Leton PF, Zucca D, Ruiz-Zorrilla JG, Minambres A. 1448 poster VERIFICATION OF INTENSITY MODULATED FIELDS DOSE DISTRIBUTIONS USING AN EPID. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)71570-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Moreno JP, Zucca D, Leton PF, Ruiz-Zorrilla JG, Minambres A. 1239 poster DETERMINATION OF TOLERANCE TABLE FOR TREATMENT COUCH POSITION USING AN IMAGE GUIDED SYSTEM. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)71361-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Moreno JP, Zucca D, Leton PF, Ruiz-Zorrilla JG, Minambres A. 1342 poster COMPARISON OF TWO INVERSE TREATMENT PLANNING SYSTEMS FOR STEP AND SHOOT TREATMENTS. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)71464-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Rubio M, Hernando O, Sánchez E, García-Aranda M, Valero J, López M, Zucca D, Moreno JP, Letón PF. Clinical Experience on the Treatment of Lung and Liver Lesions with Stereotactic Body Radiotherapy using a Novalis Exactrac Adaptive Gating Technique. Clin Oncol (R Coll Radiol) 2011. [DOI: 10.1016/j.clon.2011.01.352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Hernando-Requejo O, Sánchez E, Fernández P, Zucca D, Pérez JM, García-Aranda M, Valero J, López M, Ciérvide R, Rubio C. Institutional experience on the treatment of lung and liver lesions with stereotactic body radiotherapy and Novalis Exactrac Adaptive Gating technique. J Radiosurg SBRT 2011; 1:231-236. [PMID: 29296321 PMCID: PMC5725320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Accepted: 09/28/2011] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Gating technique can improve the accuracy of the treatment of lung and liver lesions with SBRT, by monitoring organ tumor motion and irradiating within a selected area of the respiratory cycle. METHODS We have treated 75 patients (34 lung and 41 liver) with Novalis LINAC SBRT Adaptive Gating Technique. A total of 130 lesions, 49 lung lesions (11 primary NSCLC and 38 metastases) and 81 liver lesions (10 primary and 71 metastases). Prior to treatment, a fiducial marker is implanted and CT simulation is performed in breatholding with infrared external skin markers. Based on these external markers, internal tumor motion is correlated with the external respiratory signal. The outlined PTV includes (CTV=GTV) + 5 mm margin. The following doses are prescribed: liver (5Gy x 10 or 12-20Gy x 3), peripheral lung lesions (15-20 Gy x 3), and central lung lesions (5Gy x 10 or 10 Gy x5). The dose was delivered with multiple coplanar static beams. During patient setup, infrared markers track the respiratory cycle. Exactrac X-Rays localize the internal marker, quantify the tumor movement, and define the "beam on area" by correlating the external marker motion to the internal marker position. Intrafraction verification of the validity of this model is performed in real time by ExacTrac X-Rays. RESULTS 130 lesions were evaluated with 90.5% local control at two years [93.8% in lung and 87.3% in liver lesions]. Clinical tolerance was excellent and no lung or liver toxicity grade 3 was observed. CONCLUSION Our clinical experience with Novalis SBRT Adaptive Gating shows that this technique is safe and efficient for the treatment of lung and liver lesions, while reducing the volume of irradiated healthy tissue. Intrafraction verification improves the treatment accuracy by a real time verification of tumor position.
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Affiliation(s)
| | - Emilio Sánchez
- Department of Radiation Oncology. University Hospital Madrid Sanchinarro, Madrid, Spain
| | - Pedro Fernández
- Department of Radiation Physics. University Hospital Madrid Sanchinarro, Madrid, Spain
| | - Daniel Zucca
- Department of Radiation Physics. University Hospital Madrid Sanchinarro, Madrid, Spain
| | - Juan M Pérez
- Department of Radiation Physics. University Hospital Madrid Sanchinarro, Madrid, Spain
| | - Mariola García-Aranda
- Department of Radiation Oncology. University Hospital Madrid Sanchinarro, Madrid, Spain
| | - Jeannette Valero
- Department of Radiation Oncology. University Hospital Madrid Sanchinarro, Madrid, Spain
| | - Mercedes López
- Department of Radiation Oncology. University Hospital Madrid Sanchinarro, Madrid, Spain
| | - Raquel Ciérvide
- Department of Radiation Oncology. University Hospital Madrid Sanchinarro, Madrid, Spain
| | - Carmen Rubio
- Department of Radiation Oncology. University Hospital Madrid Sanchinarro, Madrid, Spain
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