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Azzarouali S, Goudschaal K, Visser J, Hulshof M, Admiraal M, van Wieringen N, Nieuwenhuijzen J, Wiersma J, Daniëls L, den Boer D, Bel A. Online adaptive radiotherapy for bladder cancer using a simultaneous integrated boost and fiducial markers. Radiat Oncol 2023; 18:165. [PMID: 37803392 PMCID: PMC10557331 DOI: 10.1186/s13014-023-02348-8] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 09/10/2023] [Indexed: 10/08/2023] Open
Abstract
PURPOSE The aim was to assess the feasibility of online adaptive radiotherapy (oART) for bladder cancer using a focal boost by focusing on the quality of the online treatment plan and automatic target delineation, duration of the workflow and performance in the presence of fiducial markers for tumor bed localization. METHODS Fifteen patients with muscle invasive bladder cancer received daily oART with Cone Beam CT (CBCT), artificial intelligence (AI)-assisted automatic delineation of the daily anatomy and online plan reoptimization. The bladder and pelvic lymph nodes received a total dose of 40 Gy in 20 fractions, the tumor received an additional simultaneously integrated boost (SIB) of 15 Gy. The dose distribution of the reference plan was calculated for the daily anatomy, i.e. the scheduled plan. Simultaneously, a reoptimization of the plan was performed i.e. the adaptive plan. The target coverage and V95% outside the target were evaluated for both plans. The need for manual adjustments of the GTV delineation, the duration of the workflow and the influence of fiducial markers were assessed. RESULTS All 300 adaptive plans met the requirement of the CTV-coverage V95%≥98% for both the boost (55 Gy) and elective volume (40 Gy). For the scheduled plans the CTV-coverage was 53.5% and 98.5%, respectively. Significantly less tissue outside the targets received 55 Gy in case of the adaptive plans as compared to the scheduled plans. Manual corrections of the GTV were performed in 67% of the sessions. In 96% of these corrections the GTV was enlarged and resulted in a median improvement of 1% for the target coverage. The median on-couch time was 22 min. A third of the session time consisted of reoptimization of the treatment plan. Fiducial markers were visible on the CBCTs and aided the tumor localization. CONCLUSIONS AI-driven CBCT-guided oART aided by fiducial markers is feasible for bladder cancer radiotherapy treatment including a SIB. The quality of the adaptive plans met the clinical requirements and fiducial markers were visible enabling consistent daily tumor localization. Improved automatic delineation to lower the need for manual corrections and faster reoptimization would result in shorter session time.
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Affiliation(s)
- Sana Azzarouali
- Radiation Oncology, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.
- Cancer Center Amsterdam, Cancer Therapy, Treatment and quality of life, Amsterdam, The Netherlands.
- Radiation Oncology, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
| | - Karin Goudschaal
- Cancer Center Amsterdam, Cancer Therapy, Treatment and quality of life, Amsterdam, The Netherlands
- Radiation Oncology, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Jorrit Visser
- Cancer Center Amsterdam, Cancer Therapy, Treatment and quality of life, Amsterdam, The Netherlands
- Radiation Oncology, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Maarten Hulshof
- Cancer Center Amsterdam, Cancer Therapy, Treatment and quality of life, Amsterdam, The Netherlands
- Radiation Oncology, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Marjan Admiraal
- Radiation Oncology, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Cancer Therapy, Treatment and quality of life, Amsterdam, The Netherlands
| | - Niek van Wieringen
- Cancer Center Amsterdam, Cancer Therapy, Treatment and quality of life, Amsterdam, The Netherlands
- Radiation Oncology, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Jakko Nieuwenhuijzen
- Cancer Center Amsterdam, Cancer Therapy, Treatment and quality of life, Amsterdam, The Netherlands
- Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Urology, Amsterdam, The Netherlands
| | - Jan Wiersma
- Cancer Center Amsterdam, Cancer Therapy, Treatment and quality of life, Amsterdam, The Netherlands
- Radiation Oncology, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Laurien Daniëls
- Cancer Center Amsterdam, Cancer Therapy, Treatment and quality of life, Amsterdam, The Netherlands
- Radiation Oncology, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Duncan den Boer
- Radiation Oncology, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Cancer Therapy, Treatment and quality of life, Amsterdam, The Netherlands
| | - Arjan Bel
- Cancer Center Amsterdam, Cancer Therapy, Treatment and quality of life, Amsterdam, The Netherlands
- Radiation Oncology, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
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Godinas L, Bos S, Sacreas A, Beeckmans H, Daniëls L, Vanstapel A, Dierickx D, Dupont L, Neyrinck A, Ceulemans L, Van Raemdonck D, Vanaudenaerde B, Verleden G, Vos R. Characteristics of AMR Predicts Prognosis and Phenotype of CLAD. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.706] [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] Open
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Bos S, Daniëls L, Michaux L, Bempt IV, Vermeer S, Woei-A-Jin S, Schöffski P, Weynand B, Sciot R, Declercq S, Van Raemdonck D, Ceulemans L, Dupont L, Verleden G, Vos R. An Unusual Course of Donor-Transmitted Angiosarcoma after Lung Transplantation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.2044] [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] Open
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Sacreas A, Taupin J, Van Herck A, Kaes J, Heigl T, Vanstapel A, Emonds M, Daniëls L, Vos R, Verleden G, Vanaudenaerde B, Roux A, Verleden S. Intragraft IgG Levels and Donor-Specific anti-HLA Antibodies in Different Phenotypes of Chronic Lung Allograft Dysfunction. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.056] [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] Open
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van de Poll-Franse L, Oerlemans S, Bredart A, Kyriakou C, Sztankay M, Pallua S, Daniëls L, Creutzberg CL, Cocks K, Malak S, Caocci G, Molica S, Chie W, Efficace F. International development of four EORTC disease-specific quality of life questionnaires for patients with Hodgkin lymphoma, high- and low-grade non-Hodgkin lymphoma and chronic lymphocytic leukaemia. Qual Life Res 2017; 27:333-345. [PMID: 29127596 PMCID: PMC5846994 DOI: 10.1007/s11136-017-1718-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE This paper describes the international, cross-cultural development of four disease-specific EORTC QoL questionnaires, to supplement the EORTC QLQ-C30, for patients with Hodgkin lymphoma (HL), high- or low-grade non-Hodgkin lymphoma (HG/LG-NHL), and CLL. METHODS Questionnaire development was conducted according to guidelines from the EORTC Quality of Life Group. Phase I comprised generation of QoL issues relevant to patients. Phase II included operationalization and assessment of item relevance. In phase III, items were pretested in a cross-cultural sample. RESULTS In Phase I, 75 issues were identified through focus groups and systematic literature searches. Interviews with 80 health-care professionals and 245 patients resulted in a provisional module of 38 items (phase II) representing items relevant for all or at least one of the four malignancies. In Phase III, this was tested in 337 patients from five European countries and resulted in a questionnaire with 27 items for HL (EORTC QLQ-HL27), 29 items for HG-NHL (EORTC QLQ-NHL-HG29), 20 items for LG-NHL (EORTC QLQ-NHL-LG20) and 17 items for CLL (EORTC QLQ-CLL17). CONCLUSIONS This study provides four new EORTC modules for use in clinical research and routine practice in conjunction with the EORTC QLQ-C30 for assessing QoL in patients with lymphoma and CLL.
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Affiliation(s)
- Lonneke van de Poll-Franse
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
- Department of Psychosocial Research, Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Simone Oerlemans
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Anne Bredart
- Psycho-Oncology Unit, Institut Curie, Paris, France
- Psycho-pathology and Health Process Laboratory Psychology Institute, University Paris Descartes, Paris, France
| | - Charalampia Kyriakou
- Royal Free and North West London Hospitals, National Health Service Trust, London, UK
| | - Monika Sztankay
- Department of Psychiatry, Psychotherapy and Psychosomatics, Innsbruck Medical University, Innsbruck, Austria
| | - Stephan Pallua
- Department of Psychiatry, Psychotherapy and Psychosomatics, Innsbruck Medical University, Innsbruck, Austria
| | - Laurien Daniëls
- Department of Radiation Oncology, Leiden University Medical Centre (LUMC), Leiden, the Netherlands
| | - Carien L. Creutzberg
- Department of Radiation Oncology, Leiden University Medical Centre (LUMC), Leiden, the Netherlands
| | - Kim Cocks
- KCStats Consultancy, York, UK
- University of York, York, UK
| | - Sandra Malak
- Hôpital René Huguenin-Institut Curie- Hématologie, Saint-Cloud, France
| | - Giovanni Caocci
- Hematology, Department of Medical Sciences, University of Cagliari, Cagliari, Italy
| | | | | | - Fabio Efficace
- Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA) Data Centre, Rome, Italy
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Daniëls L, Guerti K, Vermeulen K, De Raeve H, Van Assche E, Van de Velde AL, Berneman ZN, Van Der Planken M. Acute myeloid leukaemia of mixed megakaryocytic and erythroid origin: a case report and review of the literature. Acta Clin Belg 2007; 62:308-14. [PMID: 18229464 DOI: 10.1179/acb.2007.047] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
We report the case of a 78-year-old man who presented with acute myeloid leukaemia showing subpopulations of cells expressing platelet-associated markers and the presence of a pan-myeloid component, besides glycophorin A-positive cells. Most of the immature cells had a proerythroblast-like morphology and we classified this case as an FAB-M6 variant, as suggested by Bain (1). According to the WHO classification, this leukaemia fulfilled the criteria of'AML with multilineage dysplasia' (2). Immunophenotyping characteristics showed two distinct aberrant subpopulations, a young pan-myeloid (CD45+ with low density, CD34+, CD117+, CD13+, CD33+, partial cytoplasmic myeloperoxidase (MPO)+) population with platelet-associated markers (CD41+, CD42+, CD61+) and a CD45+, CD117+, CD34- population with partial CD235a positivity indicative for erythroid maturation. This case belongs to the group of 'early' erythroblastic leukaemias where a subset of progenitor cells present with erythroid-megakaryocyte bipotentiality or are blocked at an early BFU-E (burst-forming unit erythrocyte)-like stage of erythroid differentiation (11, 12, 13).
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MESH Headings
- Aged
- Biopsy, Needle
- Bone Marrow Cells/pathology
- Diagnosis, Differential
- Fatal Outcome
- Humans
- Immunophenotyping
- Leukemia, Erythroblastic, Acute/complications
- Leukemia, Erythroblastic, Acute/diagnosis
- Leukemia, Erythroblastic, Acute/immunology
- Leukemia, Megakaryoblastic, Acute/complications
- Leukemia, Megakaryoblastic, Acute/diagnosis
- Leukemia, Megakaryoblastic, Acute/immunology
- Male
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Affiliation(s)
- L Daniëls
- Laboratory of Haematology, Antwerp University Hospital, Edegem, Belgium.
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