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Nakamura M, Kageyama SI, Hirata H, Tochinai T, Hojo H, Motegi A, Kanai A, Suzuki Y, Tsuchihara K, Akimoto T. Detection of Pretreatment Circulating Tumor DNA Predicts Recurrence after High-Dose Proton Beam Therapy for Early-Stage Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2023:S0360-3016(23)00166-9. [PMID: 36822372 DOI: 10.1016/j.ijrobp.2023.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 02/07/2023] [Accepted: 02/10/2023] [Indexed: 02/23/2023]
Affiliation(s)
- Masaki Nakamura
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan; Division of Particle Therapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Chiba, Japan.
| | - Shun-Ichiro Kageyama
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan; Division of Particle Therapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Chiba, Japan
| | - Hidenari Hirata
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan; Division of Particle Therapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Chiba, Japan
| | - Taku Tochinai
- Department of Radiological Technology, National Cancer Center Hospital East, Chiba, Japan
| | - Hidehiro Hojo
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan; Division of Particle Therapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Chiba, Japan
| | - Atsushi Motegi
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan; Division of Particle Therapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Chiba, Japan
| | - Akinori Kanai
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, University of Tokyo, Chiba, Japan
| | - Yutaka Suzuki
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, University of Tokyo, Chiba, Japan
| | - Katsuya Tsuchihara
- Division of Translational Informatics, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Chiba, Japan
| | - Tetsuo Akimoto
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan; Division of Particle Therapy, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Chiba, Japan
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Badajena A, Raturi VP, Sirvastava K, Hojo H, Ohyoshi H, Bei Y, Rachi T, Wu CT, Tochinai T, Okumura M, Zhang H, Kouta H, Verma P, Singh G, Anand A, Sachan A. Prospective evaluation of the setup errors and its impact on safety margin for cervical cancer pelvic conformal radiotherapy. Rep Pract Oncol Radiother 2020; 25:260-265. [PMID: 32140083 DOI: 10.1016/j.rpor.2020.02.006] [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: 04/02/2019] [Revised: 10/22/2019] [Accepted: 02/19/2020] [Indexed: 12/25/2022] Open
Abstract
Aim The primary objective was to assess set-up errors (SE) and secondary objective was to determine optimal safety margin (SM). Background To evaluate the SE and its impact on the SM utilizing electronic portal imaging (EPI) for pelvic conformal radiotherapy. Material and methods 20 cervical cancer patients were enrolled in this prospective study. Supine position with ankle and knee rest was used during CT simulation. The contouring was done using consensus guideline for intact uterus. 50 Gy in 25 fractions were delivered at the isocenter with ≥95% PTV coverage. Two orthogonal (Anterior and Lateral) digitally reconstructed radiograph (DRR) was constructed as a reference image. The pair of orthogonal [Anterior-Posterior and Right Lateral] single exposure EPIs during radiation was taken. The reference DRR and EPIs were compared for shifts, and SE was calculated in the X-axis, Y-axis, and Z-axis directions. Results 320 images (40 DRRs and 280 EPIs) were assessed. The systematic error in the Z-axis (AP EPI), X-axis (AP EPI), and Y-axis (Lat EPI) ranged from -12.0 to 11.8 mm, -10.3 to 7.5 mm, and -8.50 to 9.70 mm, while the random error ranged from 1.60 to 6.15 mm, 0.59 to 4.93 mm, and 1.02 to -4.35 mm. The SM computed were 7.07, 6.36, and 7.79 mm in the Y-axis, X-axis, and Z-axis by Van Herk's equation, and 6.0, 5.51, and 6.74 mm by Stroom's equation. Conclusion The computed SE helps defining SM, and it may differ between institutions. In our study, the calculated SM was approximately 8 mm in the Z-axis, 7 mm in X and Y axis for pelvic conformal radiotherapy.
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Affiliation(s)
- Avinash Badajena
- Department of Radiation Oncology, King George's Medical University, Lucknow, India
| | - Vijay Parshuram Raturi
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Chiba-ken, Japan
| | - Kirti Sirvastava
- Department of Radiation Oncology, King George's Medical University, Lucknow, India
| | - Hidehiro Hojo
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Chiba-ken, Japan
| | - Hajime Ohyoshi
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Chiba-ken, Japan
| | - Yanping Bei
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Chiba-ken, Japan
| | - Toshiya Rachi
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Chiba-ken, Japan
| | - Chen-Ta Wu
- Department of Radiation Oncology, Graduate School of Medicine, Keio University, Tokyo, Japan
| | - Taku Tochinai
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Chiba-ken, Japan
| | - Masayuki Okumura
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Chiba-ken, Japan
| | - Haiqin Zhang
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Chiba-ken, Japan
| | - Hirotaki Kouta
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Chiba-ken, Japan
| | - Pragya Verma
- Department of Radiation Oncology, King George's Medical University, Lucknow, India
| | - Geeta Singh
- Department of Radiation Oncology, King George's Medical University, Lucknow, India
| | - Abhishek Anand
- Department of Radiation Oncology, King George's Medical University, Lucknow, India
| | - Anjali Sachan
- Department of Radiation Oncology, King George's Medical University, Lucknow, India
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Raturi VP, Tochinai T, Hojo H, Rachi T, Hotta K, Nakamura N, Zenda S, Motegi A, Ariji T, Hirano Y, Baba H, Ohyoshi H, Nakamura M, Okumura M, Bei Y, Akimoto T. Dose-Volume and Radiobiological Model-Based Comparative Evaluation of the Gastrointestinal Toxicity Risk of Photon and Proton Irradiation Plans in Localized Pancreatic Cancer Without Distant Metastasis. Front Oncol 2020; 10:517061. [PMID: 33194580 PMCID: PMC7645056 DOI: 10.3389/fonc.2020.517061] [Citation(s) in RCA: 2] [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: 12/03/2019] [Accepted: 09/01/2020] [Indexed: 12/25/2022] Open
Abstract
Background: Radiobiological model-based studies of photon-modulated radiotherapy for pancreatic cancer have reported reduced gastrointestinal (GI) toxicity, although the risk is still high. The purpose of this study was to investigate the potential of 3D-passive scattering proton beam therapy (3D-PSPBT) in limiting GI organ at risk (OAR) toxicity in localized pancreatic cancer based on dosimetric data and the normal tissue complication probability (NTCP) model. Methods: The data of 24 pancreatic cancer patients were retrospectively analyzed, and these patients were planned with intensity-modulated radiotherapy (IMRT), volume-modulated arc therapy (VMAT), and 3D-PSPBT. The tumor was targeted without elective nodal coverage. All generated plans consisted of a 50.4-GyE (Gray equivalent) dose in 28 fractions with equivalent OAR constraints, and they were normalized to cover 50% of the planning treatment volume (PTV) with 100% of the prescription dose. Physical dose distributions were evaluated. GI-OAR toxicity risk for different endpoints was estimated by using published NTCP Lyman-Kutcher-Burman (LKB) models. Analysis of variance (ANOVA) was performed to compare the dosimetric data, and ΔNTCPIMRT-PSPBT and ΔNTCPVMAT-PSPBT were also computed. Results: Similar homogeneity and conformity for the clinical target volume (CTV) and PTV were exhibited by all three planning techniques (P > 0.05). 3D-PSPBT resulted in a significant dose reduction for GI-OARs in both the low-intermediate dose range (below 30 GyE) and the highest dose region (D max and V 50 GyE) in comparison with IMRT and VMAT (P < 0.05). Based on the NTCP evaluation, the NTCP reduction for GI-OARs by 3D-PSPBT was minimal in comparison with IMRT and VMAT. Conclusion: 3D-PSPBT results in minimal NTCP reduction and has less potential to substantially reduce the toxicity risk of upper GI bleeding, ulceration, obstruction, and perforation endpoints compared to IMRT and VMAT. 3D-PSPBT may have the potential to reduce acute dose-limiting toxicity in the form of nausea, vomiting, and diarrhea by reducing the GI-OAR treated volume in the low-to-intermediate dose range. However, this result needs to be further evaluated in future clinical studies.
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Affiliation(s)
- Vijay P. Raturi
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital, Chiba, Japan
- Course of Advanced Clinical Research of Cancer, Graduate School of Medicine, Juntendo University, Tokyo, Japan
- *Correspondence: Vijay P. Raturi
| | - Taku Tochinai
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital, Chiba, Japan
| | - Hidehiro Hojo
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital, Chiba, Japan
| | - Toshiya Rachi
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital, Chiba, Japan
| | - Kenji Hotta
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital, Chiba, Japan
| | - Naoki Nakamura
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital, Chiba, Japan
| | - Sadamoto Zenda
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital, Chiba, Japan
| | - Atsushi Motegi
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital, Chiba, Japan
| | - Takaki Ariji
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital, Chiba, Japan
| | - Yasuhiro Hirano
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital, Chiba, Japan
| | - Hiromi Baba
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital, Chiba, Japan
| | - Hajime Ohyoshi
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital, Chiba, Japan
| | - Masaki Nakamura
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital, Chiba, Japan
| | - Masayuki Okumura
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital, Chiba, Japan
| | - Yanping Bei
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital, Chiba, Japan
| | - Tetsuo Akimoto
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital, Chiba, Japan
- Course of Advanced Clinical Research of Cancer, Graduate School of Medicine, Juntendo University, Tokyo, Japan
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