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Sample records for 3d conformal radiotherapy

  1. Nasopharyngeal carcinoma. Treatment planning with IMRT and 3D conformal radiotherapy

    DEFF Research Database (Denmark)

    Kristensen, Claus A; Kjaer-Kristoffersen, Flemming; Sapru, Wendy

    2007-01-01

    The study was undertaken in order to compare dose plans for intensity-modulated radiotherapy (IMRT) with 3D conformal radiotherapy (3D-CRT) dose plans in patients with nasopharyngeal carcinoma (NPC). Clinical data from 20 consecutive patients treated with IMRT are presented. For 11 patients 3D-CR...

  2. Clinical application of 3-D conformal radiotherapy for carcinoma of the ethmoid sinus: 1. Comparative analysis between conventional 2-D and 3-D conformal plans

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    Lee, S. W.; Kim, G. E.; Keum, K. C.; Park, H. C.; Cho, J. H.; Han, S. U.; Lee, K. K.; Suh, C. O.; Hong, W. P.; Park, I. Y. [Yonsei Univ., Seoul (Korea, Republic of). Coll. of Medicine

    1997-12-01

    This is study of whether 3-D conformal radiotherapy for carcinomas of the ethmoid sinus were better than those treated with conventional 2-D plan. The 3-D conformal treatment plans were compared with conventional 2-D plans in 4 patients with malignancy of the ethmoid sinus. Isodose distribution , dose statistics, and dose volume histogram of the planning target volume were used to evaluate differences between 2-D and 3-D plans. In addition, the risk of radiation exposure of surrounding normal critical organs are evaluated by means of point dose calculation and dose volume histogram. 3-D conformal treatment plans for each patient that the better tumor coverages by the planning target volume with improved dose homogeneity, compared to 2-D conventional treatment plans in the same patient. On the other hand, the radiation dose distributions to the surrounding normal tissue organs, such as the orbit and optic nerves are not significantly reduced with our technique, but a substantial sparing in the brain stem and optic chiasm for each patient. Our findings represented the potential advantage of 3-D treatment planning for dose homogeneity as well as sparing of the normal tissue surrounding the tumor. However, further investigational studies are required to define the clinical benefit. (author).

  3. SURVIVAL AND QUALITY OF LIFE AFTER STEREOTACTIC OR 3D-CONFORMAL RADIOTHERAPY FOR INOPERABLE EARLY-STAGE LUNG CANCER

    NARCIS (Netherlands)

    Widder, Joachim; Postmus, Douwe; Ubbels, Jan F.; Wiegman, Erwin M.; Langendijk, Johannes A.

    2011-01-01

    Purpose: To investigate survival and local recurrence after stereotactic ablative radiotherapy (SABR) or threedimensional conformal radiotherapy (3D-CRT) administered for early-stage primary lung cancer and to investigate longitudinal changes of health-related quality of life (HRQOL) parameters

  4. SURVIVAL AND QUALITY OF LIFE AFTER STEREOTACTIC OR 3D-CONFORMAL RADIOTHERAPY FOR INOPERABLE EARLY-STAGE LUNG CANCER

    NARCIS (Netherlands)

    Widder, Joachim; Postmus, Douwe; Ubbels, Jan F.; Wiegman, Erwin M.; Langendijk, Johannes A.

    2011-01-01

    Purpose: To investigate survival and local recurrence after stereotactic ablative radiotherapy (SABR) or threedimensional conformal radiotherapy (3D-CRT) administered for early-stage primary lung cancer and to investigate longitudinal changes of health-related quality of life (HRQOL) parameters afte

  5. Comparison of Three-Dimensional (3D) Conformal Proton Radiotherapy (RT), 3D Conformal Photon RT, and Intensity-Modulated RT for Retroperitoneal and Intra-Abdominal Sarcomas

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    Swanson, Erika L. [Department of Radiation Oncology, University of Florida, Gainesville, Florida (United States); Indelicato, Daniel J., E-mail: dindelicato@floridaproton.org [Department of Radiation Oncology, University of Florida, Gainesville, Florida (United States); University of Florida Proton Therapy Institute, Jacksonville, Florida (United States); Louis, Debbie; Flampouri, Stella; Li, Zuofeng [University of Florida Proton Therapy Institute, Jacksonville, Florida (United States); Morris, Christopher G.; Paryani, Nitesh [Department of Radiation Oncology, University of Florida, Gainesville, Florida (United States); Slopsema, Roelf [University of Florida Proton Therapy Institute, Jacksonville, Florida (United States)

    2012-08-01

    Purpose: To compare three-dimensional conformal proton radiotherapy (3DCPT), intensity-modulated photon radiotherapy (IMRT), and 3D conformal photon radiotherapy (3DCRT) to predict the optimal RT technique for retroperitoneal sarcomas. Methods and Materials: 3DCRT, IMRT, and 3DCPT plans were created for treating eight patients with retroperitoneal or intra-abdominal sarcomas. The clinical target volume (CTV) included the gross tumor plus a 2-cm margin, limited by bone and intact fascial planes. For photon plans, the planning target volume (PTV) included a uniform expansion of 5 mm. For the proton plans, the PTV was nonuniform and beam-specific. The prescription dose was 50.4 Gy/Cobalt gray equivalent CGE. Plans were normalized so that >95% of the CTV received 100% of the dose. Results: The CTV was covered adequately by all techniques. The median conformity index was 0.69 for 3DCPT, 0.75 for IMRT, and 0.51 for 3DCRT. The median inhomogeneity coefficient was 0.062 for 3DCPT, 0.066 for IMRT, and 0.073 for 3DCRT. The bowel median volume receiving 15 Gy (V15) was 16.4% for 3DCPT, 52.2% for IMRT, and 66.1% for 3DCRT. The bowel median V45 was 6.3% for 3DCPT, 4.7% for IMRT, and 15.6% for 3DCRT. The median ipsilateral mean kidney dose was 22.5 CGE for 3DCPT, 34.1 Gy for IMRT, and 37.8 Gy for 3DCRT. The median contralateral mean kidney dose was 0 CGE for 3DCPT, 6.4 Gy for IMRT, and 11 Gy for 3DCRT. The median contralateral kidney V5 was 0% for 3DCPT, 49.9% for IMRT, and 99.7% for 3DCRT. Regardless of technique, the median mean liver dose was <30 Gy, and the median cord V50 was 0%. The median integral dose was 126 J for 3DCPT, 400 J for IMRT, and 432 J for 3DCRT. Conclusions: IMRT and 3DCPT result in plans that are more conformal and homogenous than 3DCRT. Based on Quantitative Analysis of Normal Tissue Effects in Clinic benchmarks, the dosimetric advantage of proton therapy may be less gastrointestinal and genitourinary toxicity.

  6. Skin-sparing Helical Tomotherapy vs 3D-conformal Radiotherapy for Adjuvant Breast Radiotherapy: In Vivo Skin Dosimetry Study

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    Capelle, Lisa [Division of Radiation Oncology, Cross Cancer Institute and University of Alberta, Edmonton, Alberta (Canada); Warkentin, Heather; MacKenzie, Marc [Division of Medical Physics, Cross Cancer Institute and University of Alberta, Edmonton, Alberta (Canada); Joseph, Kurian; Gabos, Zsolt; Pervez, Nadeem; Tankel, Keith; Chafe, Susan [Division of Radiation Oncology, Cross Cancer Institute and University of Alberta, Edmonton, Alberta (Canada); Amanie, John [Division of Statistics and Epidemiology, Cross Cancer Institute and University of Alberta, Edmonton, Alberta (Canada); Ghosh, Sunita; Parliament, Matthew [Division of Radiation Oncology, Cross Cancer Institute and University of Alberta, Edmonton, Alberta (Canada); Abdulkarim, Bassam, E-mail: bassam.abdulkarim@mcgill.ca [Division of Radiation Oncology, Cross Cancer Institute and University of Alberta, Edmonton, Alberta (Canada)

    2012-08-01

    Purpose: We investigated whether treatment-planning system (TPS)-calculated dose accurately reflects skin dose received for patients receiving adjuvant breast radiotherapy (RT) with standard three-dimensional conformal RT (3D-CRT) or skin-sparing helical tomotherapy (HT). Methods and Materials: Fifty patients enrolled in a randomized controlled trial investigating acute skin toxicity from adjuvant breast RT with 3D-CRT compared to skin-sparing HT, where a 5-mm strip of ipsilateral breast skin was spared. Thermoluminescent dosimetry or optically stimulated luminescence measurements were made in multiple locations and were compared to TPS-calculated doses. Skin dosimetric parameters and acute skin toxicity were recorded in these patients. Results: With HT there was a significant correlation between calculated and measured dose in the medial and lateral ipsilateral breast (r = 0.67, P<.001; r = 0.44, P=.03, respectively) and the medial and central contralateral breast (r = 0.73, P<.001; r = 0.88, P<.001, respectively). With 3D-CRT there was a significant correlation in the medial and lateral ipsilateral breast (r = 0.45, P=.03; r = 0.68, P<.001, respectively); the medial and central contralateral breast (r = 0.62, P=.001; r = 0.86, P<.001, respectively); and the mid neck (r = 0.42, P=.04, respectively). On average, HT-calculated dose overestimated the measured dose by 14%; 3D-CRT underestimated the dose by 0.4%. There was a borderline association between highest measured skin dose and moist desquamation (P=.05). Skin-sparing HT had greater skin homogeneity (homogeneity index of 1.39 vs 1.65, respectively; P=.005) than 3D-CRT plans. HT plans had a lower skin{sub V50} (1.4% vs 5.9%, respectively; P=.001) but higher skin{sub V40} and skin{sub V30} (71.7% vs 64.0%, P=.02; and 99.0% vs 93.8%, P=.001, respectively) than 3D-CRT plans. Conclusion: The 3D-CRT TPS more accurately reflected skin dose than the HT TPS, which tended to overestimate dose received by 14% in patients

  7. Dosimetric and radiobiologic comparison of 3D conformal versus intensity modulated planning techniques for prostate bed radiotherapy.

    Science.gov (United States)

    Koontz, Bridget F; Das, Shiva; Temple, Kathy; Bynum, Sigrun; Catalano, Suzanne; Koontz, Jason I; Montana, Gustavo S; Oleson, James R

    2009-01-01

    Adjuvant radiotherapy for locally advanced prostate cancer improves biochemical and clinical disease-free survival. While comparisons in intact prostate cancer show a benefit for intensity modulated radiation therapy (IMRT) over 3D conformal planning, this has not been studied for post-prostatectomy radiotherapy (RT). This study compares normal tissue and target dosimetry and radiobiological modeling of IMRT vs. 3D conformal planning in the postoperative setting. 3D conformal plans were designed for 15 patients who had been treated with IMRT planning for salvage post-prostatectomy RT. The same computed tomography (CT) and target/normal structure contours, as well as prescription dose, was used for both IMRT and 3D plans. Normal tissue complication probabilities (NTCPs) were calculated based on the dose given to the bladder and rectum by both plans. Dose-volume histogram and NTCP data were compared by paired t-test. Bladder and rectal sparing were improved with IMRT planning compared to 3D conformal planning. The volume of the bladder receiving at least 75% (V75) and 50% (V50) of the dose was significantly reduced by 28% and 17%, respectively (p = 0.002 and 0.037). Rectal dose was similarly reduced, V75 by 33% and V50 by 17% (p = 0.001 and 0.004). While there was no difference in the volume of rectum receiving at least 65 Gy (V65), IMRT planning significant reduced the volume receiving 40 Gy or more (V40, p = 0.009). Bladder V40 and V65 were not significantly different between planning modalities. Despite these dosimetric differences, there was no significant difference in the NTCP for either bladder or rectal injury. IMRT planning reduces the volume of bladder and rectum receiving high doses during post-prostatectomy RT. Because of relatively low doses given to the bladder and rectum, there was no statistically significant improvement in NTCP between the 3D conformal and IMRT plans.

  8. Accuracy in the reproducibility of daily patients' setup in 3D conformal radiotherapy for prostate cancer

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    Giordani, Adelmo Jose; Dias, Rodrigo Souza; Segreto, Roberto Araujo, E-mail: adelmogiordani@ig.com.b [Universidade Federal de Sao Paulo (UNIFESP), SP (Brazil). Unidade de Radioterapia; Segreto, Helena Regina Comodo [Universidade Federal de Sao Paulo (UNIFESP), SP (Brazil). Dept. de Oncologia Clinica e Experimental

    2010-07-15

    Objective: to evaluate the reproducibility of daily patients' setup in 3D conformal radiotherapy for prostate cancer. Materials and methods: the present study evaluated a total of 960 radiological images (anterior and lateral views) of 120 patients submitted to conformal radiotherapy for prostate cancer with the isocentric technique. A 6 MV particle accelerator was utilized in the process. A specific protocol for prostate radiotherapy planning and treatment was applied, with the patients placed in supine position, hands on the chest and legs placed on and appropriate support. Daily, the patients were positioned according to previously made skin markings in alignment with the in-room laser. The portal images were compared with digitally reconstructed radiographs (DRR) in the Eclipse treatment planning system based on the tomographic images. Radiography was performed at the first day, and weekly afterwards until the treatment was completed. Results: the following average position shifts were observed: 1.99 +- 1.25 mm craniocaudally, 1.37 +- 0.84 mm laterally, and 1.94 +- 1.10 mm anteroposteriorly. Conclusion: the use of specific protocols for patients' setup is feasible in the clinical practice, allowing appropriate reproducibility and quick correction of possible errors in conformal radiotherapy for prostate cancer. (author)

  9. Analysis of Intensity-Modulated Radiation Therapy (IMRT), Proton and 3D Conformal Radiotherapy (3D-CRT) for Reducing Perioperative Cardiopulmonary Complications in Esophageal Cancer Patients

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    Ling, Ted C.; Slater, Jerry M.; Nookala, Prashanth; Mifflin, Rachel; Grove, Roger; Ly, Anh M.; Patyal, Baldev; Slater, Jerry D.; Yang, Gary Y., E-mail: gyang@llu.edu [Department of Radiation Medicine, Loma Linda University Medical Center, 11234 Anderson Street, A875, Loma Linda, CA 92354 (United States)

    2014-12-05

    Background. While neoadjuvant concurrent chemoradiotherapy has improved outcomes for esophageal cancer patients, surgical complication rates remain high. The most frequent perioperative complications after trimodality therapy were cardiopulmonary in nature. The radiation modality utilized can be a strong mitigating factor of perioperative complications given the location of the esophagus and its proximity to the heart and lungs. The purpose of this study is to make a dosimetric comparison of Intensity-Modulated Radiation Therapy (IMRT), proton and 3D conformal radiotherapy (3D-CRT) with regard to reducing perioperative cardiopulmonary complications in esophageal cancer patients. Materials. Ten patients with esophageal cancer treated between 2010 and 2013 were evaluated in this study. All patients were simulated with contrast-enhanced CT imaging. Separate treatment plans using proton radiotherapy, IMRT, and 3D-CRT modalities were created for each patient. Dose-volume histograms were calculated and analyzed to compare plans between the three modalities. The organs at risk (OAR) being evaluated in this study are the heart, lungs, and spinal cord. To determine statistical significance, ANOVA and two-tailed paired t-tests were performed for all data parameters. Results. The proton plans showed decreased dose to various volumes of the heart and lungs in comparison to both the IMRT and 3D-CRT plans. There was no difference between the IMRT and 3D-CRT plans in dose delivered to the lung or heart. This finding was seen consistently across the parameters analyzed in this study. Conclusions. In patients receiving radiation therapy for esophageal cancer, proton plans are technically feasible while achieving adequate coverage with lower doses delivered to the lungs and cardiac structures. This may result in decreased cardiopulmonary toxicity and less morbidity to esophageal cancer patients.

  10. Advantage of deep inspiration breath hold in left-sided breast cancer patients treated with 3D conformal radiotherapy.

    Science.gov (United States)

    Lastrucci, Luciana; Borghesi, Simona; Bertocci, Silvia; Gasperi, Chiara; Rampini, Andrea; Buonfrate, Giovanna; Pernici, Paola; De Majo, Roberta; Gennari, Pietro Giovanni

    2017-01-21

    To compare 3D-conformal radiotherapy (3D-CRT) treatment plans based on free-breathing (FB) and deep inspiration breath hold (DIBH) and investigated whether DIBH technique enables a decrease of cardiac left anterior descending coronary artery (LADCA) and lungs dose with respect to the FB. Twenty-three left-sided breast cancer patients referred for breast radiotherapy were included. The planning target volume (PTV) encompassed the breast and organs at risk including heart, LADCA, lungs, and contralateral breast, which were contoured in FB and DIBH CT scans. Dose to PTV was 50 Gy in 25 fractions. Two treatment plans were generated for each patient: FB-3D-CRT and DIBH-3D-CRT. Dosimetry parameters were obtained from dose volume histograms. Data were compared using the paired-sample Wilcoxon signed rank test. For heart, LADCA, and left lung, a significant dose reduction was found using DIBH technique. By using DIBH, an average reduction of 25% was observed in LADCA for the volume receiving 20 Gy and of 48% considering the mean heart dose. The DIBH technique results in a significant decrease of dose to the heart, LADCA, and left lung compared to FB.

  11. A comparative dosimetric study of neoadjuvant 3D conformal radiotherapy for operable rectal cancer patients versus conventional 2D radiotherapy in NCI-airo

    Institute of Scientific and Technical Information of China (English)

    Mohamed Mahmoud; Hesham A. EL-Hossiny; Nashaat A. Diab; Marwa A. EL Razek

    2012-01-01

    Objective: This study was to compare this multiple-field conformal technique to the AP-PA technique with respect to target volume coverage and dose to normal tissues.Methods: We conducted a single institutional prospective comparative dosimetric analysis of 22 patients who received neoadjuvant radiation therapy for rectal cancer presented to radiotherapy department in National Cancer Institute, Cairo in period between June 2010 to September 2011 using 3D conformal radiotherapy technique for each patient, a second radiotherapy treatment plan was done using an anteroposterior (AP-PA) fields, the two techniques were then compared using dose volume histogram (DVH) analysis.Results: Comparing different DVHs, it was found that the planning target volume (PTV) was adequately covered in both ( 3D & 2D ) plans while it was demonstrates that this multiple field conformal technique produces superior distribution compared to 2D technique, with considerable sparing of bladder, ovaries and head of both femora.Conclusion: From the present study, it shows that it is recommended to use 3D planning for preoperative cases of cancer rectum so far it produces good coverage of the target as well as good sparing of the surrounding critical organs.

  12. Preliminary study of the 270 Bloom Fricke xylenol gel phantom performance for 3D conformal radiotherapy using multiple radiation fields

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    Cavinato, Christianne C.; Campos, Leticia L., E-mail: ccavinato@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (DIRF/IPEN/CNEN-SP), Sao Paulo, SP (Brazil). Gerencia de Metrologia das Radiacoes; Souza, Benedito H.; Carrete Junior, Henrique; Daros, Kellen A.C.; Medeiros, Regina B. [Universidade Federal de Sao Paulo (UNIFESP), SP (Brazil). Dept. de Diagnostico por Imagens; Giordani, Adelmo J. [Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, SP (Brazil). Servico de Radioterapia

    2011-07-01

    The complex cancer treatment techniques require rigorous quality control (QC). The Fricke xylenol gel (FXG) dosimeter has been studied to be applied as a three-dimensional (3D) dosimeter since it is possible to produce 3D FXG phantoms of various shapes and sizes. In this preliminary study, the performance of the FXG spherical phantom developed at IPEN, prepared using 270 Bloom gelatin from porcine skin made in Brazil, was evaluated using magnetic resonance imaging technique, aiming to use this phantom to 3D conformal radiotherapy (3DCRT) with multiple radiation fields and clinical photon beams. The obtained results indicate that for all magnetic resonance images of the FXG phantom irradiated with 6 MV clinical photon beam can be observed clearly the target volume and, in the case of coronal image, can also be observed the radiation beam projection and the overlap of different radiation fields used. The Fricke xylenol gel phantom presented satisfactory results for 3DCRT and clinical photon beams in this preliminary study. These results encourage the additional tests using complex treatment techniques and indicate the viability of applying the phantom studied to routine quality control measurements and in 3DCRT and intensity modulated radiotherapy treatment planning. (author)

  13. Comparison of 3D conformal radiotherapy vs. intensity modulated radiation therapy (IMRT) of a stomach cancer treatment;Comparacion dosimetrica de radioterapia conformal 3D versus radioterapia de intensidad modulada (IMRT) de un tratamiento de cancer de estomago

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    Bernui de V, Maria Giselle; Cardenas, Augusto; Vargas, Carlos [Hospital Nacional Carlos Alberto Seguin Escobedo (ESSALUD), Arequipa (Peru). Servicio de Radioterapia

    2009-07-01

    The purpose of this work was to compare the dosimetry in 3D Conformal Radiotherapy with Intensity Modulated Radiation Therapy (IMRT) in a treatment of stomach cancer. For this comparison we selected a patient who underwent subtotal gastrectomy and D2 dissection for a T3N3 adenocarcinoma Mx ECIIIB receiving treatment under the scheme Quimio INT 0116 - in adjuvant radiotherapy. In the treatment plan was contouring the Clinical Target Volume (CTV) and the Planning Target Volume (PTV) was generated from the expansion of 1cm of the CTV, the risky organs contouring were: the liver, kidneys and spinal cord, according to the consensus definition of volumes in gastric cancer. The 3D Conformal Radiotherapy planning is carried out using 6 half beams following the Leong Trevol technique; for the IMRT plan was used 8 fields, the delivery technique is step-and-shoot. In both cases the fields were coplanar, isocentric and the energy used was 18 MV. Intensity Modulated Radiation Therapy (IMRT), in this case has proved to be a good treatment alternative to the technique of 3D Conformal Radiotherapy; the dose distributions with IMRT have better coverage of PTV and positions of the hot spots, as well as the kidneys volume that received higher doses to 2000 cGy is lower, but the decrease in dose to the kidneys is at the expense of increased dose in other organs like the liver. (author)

  14. A Comparison of Helical Intensity-Modulated Radiotherapy, Intensity-Modulated Radiotherapy, and 3D-Conformal Radiation Therapy for Pancreatic Cancer

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    Poppe, Matthew M.; Narra, Venkat; Yue, Ning J.; Zhou Jinghao; Nelson, Carl [Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, UT (United States); Department of Radiation Oncology, Cancer Institute of New Jersey, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, New Brunswick, NJ (United States); Jabbour, Salma K., E-mail: jabbousk@umdnj.edu [Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, UT (United States); Department of Radiation Oncology, Cancer Institute of New Jersey, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, New Brunswick, NJ (United States)

    2011-01-01

    We assessed dosimetric differences in pancreatic cancer radiotherapy via helical intensity-modulated radiotherapy (HIMRT), linac-based IMRT, and 3D-conformal radiation therapy (3D-CRT) with regard to successful plan acceptance and dose to critical organs. Dosimetric analysis was performed in 16 pancreatic cases that were planned to 54 Gy; both post-pancreaticoduodenectomy (n = 8) and unresected (n = 8) cases were compared. Without volume modification, plans met constraints 75% of the time with HIMRT and IMRT and 13% with 3D-CRT. There was no statistically significantly improvement with HIMRT over conventional IMRT in reducing liver V35, stomach V45, or bowel V45. HIMRT offers improved planning target volume (PTV) dose homogeneity compared with IMRT, averaging a lower maximum dose and higher volume receiving the prescription dose (D100). HIMRT showed an increased mean dose over IMRT to bowel and liver. Both HIMRT and IMRT offer a statistically significant improvement over 3D-CRT in lowering dose to liver, stomach, and bowel. The results were similar for both unresected and resected patients. In pancreatic cancer, HIMRT offers improved dose homogeneity over conventional IMRT and several significant benefits to 3D-CRT. Factors to consider before incorporating IMRT into pancreatic cancer therapy are respiratory motion, dose inhomogeneity, and mean dose.

  15. Survival and Quality of Life After Stereotactic or 3D-Conformal Radiotherapy for Inoperable Early-Stage Lung Cancer

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    Widder, Joachim, E-mail: j.widder@rt.umcg.nl [Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen (Netherlands); Postmus, Douwe [Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen (Netherlands); Ubbels, Jan F.; Wiegman, Erwin M.; Langendijk, Johannes A. [Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen (Netherlands)

    2011-11-15

    Purpose: To investigate survival and local recurrence after stereotactic ablative radiotherapy (SABR) or three-dimensional conformal radiotherapy (3D-CRT) administered for early-stage primary lung cancer and to investigate longitudinal changes of health-related quality of life (HRQOL) parameters after either treatment. Methods and Materials: Two prospective cohorts of inoperable patients with T1-2N0M0 primary lung tumors were analyzed. Patients received 70 Gy in 35 fractions with 3D-CRT or 60 Gy in three to eight fractions with SABR. Global quality of life (GQOL), physical functioning (PF), and patient-rated dyspnea were assessed using the respective dimensions of European Organization for Research and Treatment of Cancer Core Questionnaire-C30 and LC13. HRQOL was analyzed using multivariate linear mixed-effects modeling, survival and local control (LC) using the Kaplan-Meier method, Cox proportional hazards analysis, and Fine and Gray multivariate competing risk analysis as appropriate. Results: Overall survival (OS) was better after SABR compared with 3D-CRT with a HR of 2.6 (95% confidence interval [CI]: 1.5-4.8; p < 0.01). 3D-CRT conferred a subhazard ratio for LC of 5.0 (95% CI: 1.7-14.7; p < 0.01) compared with SABR. GQOL and PF were stable after SABR (p = 0.21 and p = 0.62, respectively). Dyspnea increased after SABR by 3.2 out of 100 points (95% CI: 1.0-5.3; p < 0.01), which is clinically insignificant. At 1 year, PF decreased by an excess of 8.7 out of 100 points (95% CI: 2.8-14.7; p < 0.01) after 3D-CRT compared with SABR. Conclusion: In this nonrandomized comparison of two prospective cohorts of medically inoperable patients with Stage I lung cancer, OS and LC were better after SABR. GQOL, PF, and patient-rated dyspnea were stable after SABR, whereas PF decreased after 3D-CRT approaching clinical significance already at 1 year.

  16. Hypofractionated Dose Escalated 3D Conformal Radiotherapy for Prostate Cancer: Outcomes from a Mono-Institutional Phase II Study.

    Science.gov (United States)

    Tramacere, Francesco; Arcangeli, Stefano; Pignatelli, Antonietta; Castagna, Roberta; Portaluri, Maurizio

    2015-05-01

    Based on a radiobiological assumption of a low alpha/beta (α/β) ratio for prostate cancer, hypofractionated radiotherapy has increasingly gained traction in the clinical practice and recent guidelines have confirmed the non-inferiority of this approach. Nevertheless, the largest studies that have used hypofractionation so far, employed image-guided radiation therapy/intensity modulated radiation therapy (IGRT/IMRT) facilities that might have overcome the radiobiological advantages, which remain to be fully confirmed. The aim of this trial was to evaluate the feasibility of a hypofractionated schedule delivered with 3D-Conformal Radiotherapy to prostate and seminal vesicles in combination with hormonal therapy. The study included 97 consecutive patients with localized prostate cancer (PCa), irrespective of risk class, treated with a schedule of 62 Gy in 20 fractions over 5 weeks (4 fractions of 3.1 Gy each per week). According to National Comprehensive Cancer Network (NCCN) prognostic classification, patients were divided into a favourable group (19%), intermediate group (41%) and unfavourable group (40%). Early and late toxicities were scored using the radiation toxicity grading/European Organisation for Research and Treatment of Cancer (RTOG/EORTC) criteria. Additionally, the international prostate symptom index (IPSS) for benign prostate hypertrophy was used to evaluate obstructive urinary symptoms. Biochemical outcome was reported according to the Phoenix definition for biochemical failure. Hormonal therapy (HT) was administrated in 92% of patients. After a median follow-up of 39 months (range=25-52), maximum ≥G2 late genitourinary (GU) and gastrointestinal (GI) toxicities occurred in 8% and 11% patients, respectively. The corresponding figures for acute toxicities were 24% and 15%. Patients with higher IPSS score before enrolment had significantly worse urinary function after treatment. Only 2% of patients died from PCa. Biochemical non-evidence of disease

  17. Intensity-modulated radiotherapy vs. parotid-sparing 3D conformal radiotherapy. Effect on outcome and toxicity in locally advanced head and neck cancer

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    Lambrecht, M.; Nevens, D.; Nuyts, S. [University Hospitals Leuven (Belgium). Dept. of Radiation Oncology

    2013-03-15

    Background and purpose: Intensity-modulated radiotherapy (IMRT) has rapidly become standard of care in the management of locally advanced head and neck squamous cell carcinoma (HNSCC). In this study, our aim was to retrospectively investigate the effect of the introducing IMRT on outcome and treatment-related toxicity compared to parotid-sparing 3D conformal radiotherapy (3DCRT). Material and methods: A total of 245 patients with stage III and IV HNSCC treated with primary radiotherapy between January 2003 and December 2010 were included in this analysis: 135 patients were treated with 3DCRT, 110 patients with IMRT. Groups were compared for acute and late toxicity, locoregional control (LRC), and overall survival (OS). Oncologic outcomes were estimated using Kaplan-Meier analysis and compared using a log-rank test. Acute toxicity was analyzed according to the Common Terminology Criteria for Adverse Events v3.0 and late toxicity was scored using the RTOG/EORTC late toxicity scoring system. Results: Median follow-up was 35 months in the IMRT group and 68 months in the 3DCRT group. No significant differences were found in 3-year LRC and OS rates between the IMRT group and 3DCRT group. Significantly less acute mucositis {>=} grade 3 was observed in the IMRT group (32% vs. 44%, p = 0.03). There was significantly less late xerostomia {>=} grade 2 in the IMRT group than in the 3DCRT group (23% vs. 68%, p < 0.001). After 24 months, there was less dysphagia {>=} grade 2 in the IMRT group although differences failed to reach statistical significance. Conclusion: The introduction of IMRT in the radiotherapeutic management of locally advanced head and neck cancer significantly improved late toxicity without compromising tumor control compared to a parotid-sparing 3D conformal radiotherapy technique. (orig.)

  18. Accelerated partial breast irradiation using 3D conformal radiotherapy: initial clinical experience

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    Gatti, M.; Madeddu, A.; Malinverni, G.; Delmastro, E.; Bona, C.; Gabriele, P. [IRCC-Radiotherapy, Candiolo, TO (Italy); Baiotto, B.; Stasi, M. [IRCC-Medical Physics, Candiolo, TO (Italy); Ponzone, R.; Siatis, D. [IRCC-Surgery, Candiolo, TO (Italy)

    2006-11-15

    Accelerated partial breast irradiation using 3D-C.R.T. is technically sophisticate but feasible and acute toxicity to date has been minimal. A C.T.V.-to-P.T.V. margin of 10 mm seems to provide coverage for analyzed patients. However, more patients and additional studies will be needed to validate the accuracy of this margin, and longer follow-up will be needed to assess acute and chronic toxicity, tumor control, and cosmetic results. (author)

  19. Comparison of dosimetric parameters and toxicity in esophageal cancer patients undergoing 3D conformal radiotherapy or VMAT

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    Muench, Stefan; Aichmeier, Sylvia; Duma, Marciana-Nona; Oechsner, Markus; Habermehl, Daniel [TU Muenchen, Department of Radiation Oncology, Klinikum rechts der Isar, Muenchen (Germany); Hapfelmeier, Alexander [TU Muenchen, Institute of Medical Statistics and Epidemiology (IMSE), Klinikum rechts der Isar, Muenchen (Germany); Feith, Marcus [TU Muenchen, Department of Visceral Surgery, Klinikum rechts der Isar, Muenchen (Germany); Combs, Stephanie E. [TU Muenchen, Department of Radiation Oncology, Klinikum rechts der Isar, Muenchen (Germany); Helmholtz Zentrum Muenchen, Institute of Innovative Radiotherapy (iRT), Oberschleissheim (Germany)

    2016-10-15

    Volumetric-modulated arc therapy (VMAT) achieves high conformity to the planned target volume (PTV) and good sparing of organs at risk (OAR). This study compares dosimetric parameters and toxicity in esophageal cancer (EC) patients treated with VMAT and 3D conformal radiotherapy (3D-CRT). Between 2007 and 2014, 17 SC patients received neoadjuvant chemoradiation (CRT) with VMAT. Dose-volume histograms and toxicity were compared between these patients and 20 treated with 3D-CRT. All patients were irradiated with a total dose of 45 Gy. All VMAT patients received simultaneous chemotherapy with cisplatin and 5-fluorouracil (5-FU) in treatment weeks 1 and 5. Of 20 patients treated with 3D-CRT, 13 (65 %) also received CRT with cisplatin and 5-FU, whereas 6 patients (30 %) received CRT with weekly oxaliplatin and cetuximab, and a continuous infusion of 5-FU (OE-7). There were no differences in baseline characteristics between the treatment groups. For the lungs, VMAT was associated with a higher V{sub 5} (median 90.1 % vs. 79.7 %; p = 0.013) and V{sub 10} (68.2 % vs. 56.6 %; p = 0.014), but with a lower V{sub 30} (median 6.6 % vs. 11.0 %; p = 0.030). Regarding heart parameters, VMAT was associated with a higher V{sub 5} (median 100.0 % vs. 91.0 %; p = 0.043), V{sub 10} (92.0 % vs. 79.2 %; p = 0.047), and D{sub max} (47.5 Gy vs. 46.3 Gy; p = 0.003), but with a lower median dose (18.7 Gy vs. 30.0 Gy; p = 0.026) and V{sub 30} (17.7 % vs. 50.4 %; p = 0.015). Complete resection was achieved in 16 VMAT and 19 3D-CRT patients. Due to systemic progression, 2 patients did not undergo surgery. The most frequent postoperative complication was anastomosis insufficiency, occurring in 1 VMAT (6.7 %) and 5 3D-CRT patients (27.8 %; p = 0.180). Postoperative pneumonia was seen in 2 patients of each group (p = 1.000). There was no significant difference in 3-year overall (65 % VMAT vs. 45 % 3D-CRT; p = 0.493) or 3-year progression-free survival (53 % VMAT vs. 35 % 3D-CRT; p = 0

  20. A comparison of liver protection among 3-D conformal radiotherapy, intensity-modulated radiotherapy and RapidArc for hepatocellular carcinoma

    Science.gov (United States)

    2014-01-01

    Purpose The analysis was designed to compare dosimetric parameters among 3-D conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT) and RapidArc (RA) to identify which can achieve the lowest risk of radiation-induced liver disease (RILD) for hepatocellular carcinoma (HCC). Methods Twenty patients with HCC were enrolled in this study. Dosimetric values for 3DCRT, IMRT, and RA were calculated for total dose of 50 Gy/25f. The percentage of the normal liver volume receiving >40, >30, >20, >10, and >5 Gy (V40, V30, V20, V10 and V5) were evaluated to determine liver toxicity. V5, V10, V20, V30 and Dmean of liver were compared as predicting parameters for RILD. Other parameters included the conformal index (CI), homogeneity index (HI), and hot spot (V110%) for the planned target volume (PTV) as well as the monitor units (MUs) for plan efficiency, the mean dose (Dmean) for the organs at risk (OARs) and the maximal dose at 1% volume (D1%) for the spinal cord. Results The Dmean of IMRT was higher than 3DCRT (p = 0.045). For V5, there was a significant difference: RA > IMRT >3DCRT (p delivery time than 3DCRT or IMRT (p 8 cm in our study, the value of Dmean for 3DCRT was lower than IMRT or RapidArc. This may indicate that 3DCRT is more suitable for larger tumors. PMID:24502643

  1. Volumetric Modulation Arc Radiotherapy With Flattening Filter-Free Beams Compared With Static Gantry IMRT and 3D Conformal Radiotherapy for Advanced Esophageal Cancer: A Feasibility Study

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    Nicolini, Giorgia, E-mail: giorgia.nicolini@eoc.ch [Oncology Institute of Southern Switzerland, Medical Physics Unit, Bellinzona (Switzerland); Ghosh-Laskar, Sarbani; Shrivastava, Shyam Kishore; Banerjee, Sushovan; Chaudhary, Suresh; Agarwal, Jai Prakash; Munshi, Anusheel [Tata Memorial Hospital, Mumbai (India); Clivio, Alessandro; Fogliata, Antonella [Oncology Institute of Southern Switzerland, Medical Physics Unit, Bellinzona (Switzerland); Mancosu, Pietro [Department of Radiation Oncology, Istituto Clinico Humanitas, Milano-Rozzano (Italy); Vanetti, Eugenio; Cozzi, Luca [Oncology Institute of Southern Switzerland, Medical Physics Unit, Bellinzona (Switzerland)

    2012-10-01

    Purpose: A feasibility study was performed to evaluate RapidArc (RA), and the potential benefit of flattening filter-free beams, on advanced esophageal cancer against intensity-modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3D-CRT). Methods and Materials: The plans for 3D-CRT and IMRT with three to seven and five to seven fixed beams were compared against double-modulated arcs with avoidance sectors to spare the lungs for 10 patients. All plans were optimized for 6-MV photon beams. The RA plans were studied for conventional and flattening filter-free (FFF) beams. The objectives for the planning target volume were the volume receiving {>=}95% or at most 107% of the prescribed dose of <1% with a dose prescription of 59.4 Gy. For the organs at risk, the lung volume (minus the planning target volume) receiving {>=}5 Gy was <60%, that receiving 20 Gy was <20%-30%, and the mean lung dose was <15.0 Gy. The heart volume receiving 45 Gy was <20%, volume receiving 30 Gy was <50%. The spinal dose received by 1% was <45 Gy. The technical delivery parameters for RA were assessed to compare the normal and FFF beam characteristics. Results: RA and IMRT provided equivalent coverage and homogeneity, slightly superior to 3D-CRT. The conformity index was 1.2 {+-} 0.1 for RA and IMRT and 1.5 {+-} 0.2 for 3D-CRT. The mean lung dose was 12.2 {+-} 4.5 for IMRT, 11.3 {+-} 4.6 for RA, and 10.8 {+-} 4.4 for RA with FFF beams, 18.2 {+-} 8.5 for 3D-CRT. The percentage of volume receiving {>=}20 Gy ranged from 23.6% {+-} 9.1% to 21.1% {+-} 9.7% for IMRT and RA (FFF beams) and 39.2% {+-} 17.0% for 3D-CRT. The heart and spine objectives were met by all techniques. The monitor units for IMRT and RA were 457 {+-} 139, 322 {+-} 20, and 387 {+-} 40, respectively. RA with FFF beams showed, compared with RA with normal beams, a {approx}20% increase in monitor units per Gray, a 90% increase in the average dose rate, and 20% reduction in beam on time (owing to different

  2. A precision 3D conformal treatment technique in rats: application to whole brain radiotherapy with hippocampal avoidance.

    Science.gov (United States)

    Yoon, Suk W; Cramer, Christina K; Miles, Devin A; Reinsvold, Michael H; Joo, Kyeung M; Kirsch, David G; Oldham, Mark

    2017-08-24

    To develop and validate 3D conformal hippocampal sparing whole-brain radiation therapy (HA-WBRT) for Wistar rats utilizing precision 3D printed immobilization and micro-blocks. This technique paves the way for future pre-clinical studies investigating brain treatments that reduce neurotoxicity. A novel pre-clinical treatment planning and delivery process was developed to enable precision 3D conformal treatment and hippocampal avoidance capability for the Xrad 225cx small animal irradiator. A range of conformal avoidance plans were evaluated consisting of equi-angularly spaced co-planar axial beams, with plans containing 2, 4, 7, and 8 fields. The hippocampal sparing and coverage of these plans were investigated through Monte Carlo dose calculation (SmART-Plan Xrad 225cx planning system). Treatment delivery was implemented through a novel process where hippocampal block shapes were computer-generated from an MRI rat atlas which was registered to on-board cone-beam-CT of the rat in treatment position. The blocks were 3D-printed with a tungsten-doped filament at lateral resolution of 80μm. Precision immobilization was achieved utilizing a 3D-printed support system which enabled angled positioning of the rat head in supine position and bite-block to improve coverage of the central diencephalon. Treatment delivery was verified on rodent-morphic Presage(®) 3D dosimeters optically scanned at 0.2mm isotropic resolution. Biological verification of hippocampal avoidance was performed with immunohistologic staining. All simulated plans spared the hippocampus while delivering high dose to the brain (22.5-26.2Gy mean dose to brain at mean hippocampal dose of 7Gy). No significant improvement in hippocampal sparing was observed by adding beams beyond 4 fields. Dosimetric sparing of hippocampal region of the 4-field plan was verified with the Presage(®) dosimeter (mean dose = 9.6Gy, D100% = 7.1Gy). Simulation and dosimeter match at distance-to-agreement of 2mm and dose

  3. Prone Hypofractionated Whole-Breast Radiotherapy Without a Boost to the Tumor Bed: Comparable Toxicity of IMRT Versus a 3D Conformal Technique

    Energy Technology Data Exchange (ETDEWEB)

    Hardee, Matthew E.; Raza, Shahzad; Becker, Stewart J.; Jozsef, Gabor; Lymberis, Stella C. [Department of Radiation Oncology, New York University School of Medicine, New York, NY (United States); Hochman, Tsivia; Goldberg, Judith D. [Division of Biostatistics, New York University School of Medicine, New York, NY (United States); DeWyngaert, Keith J. [Department of Radiation Oncology, New York University School of Medicine, New York, NY (United States); Formenti, Silvia C., E-mail: silvia.formenti@nyumc.org [Department of Radiation Oncology, New York University School of Medicine, New York, NY (United States)

    2012-03-01

    Purpose: We report a comparison of the dosimetry and toxicity of three-dimensional conformal radiotherapy (3D-CRT) vs. intensity-modulated radiotherapy (IMRT) among patients treated in the prone position with the same fractionation and target of the hypofractionation arm of the Canadian/Whelan trial. Methods and Materials: An institutional review board-approved protocol identified a consecutive series of early-stage breast cancer patients treated according to the Canadian hypofractionation regimen but in the prone position. Patients underwent IMRT treatment planning and treatment if the insurance carrier approved reimbursement for IMRT; in case of refusal, a 3D-CRT plan was used. A comparison of the dosimetric and toxicity outcomes during the acute, subacute, and long-term follow-up of the two treatment groups is reported. Results: We included 97 consecutive patients with 100 treatment plans in this study (3 patients with bilateral breast cancer); 40 patients were treated with 3D-CRT and 57 with IMRT. IMRT significantly reduced the maximum dose (Dmax median, 109.96% for 3D-CRT vs. 107.28% for IMRT; p < 0.0001, Wilcoxon test) and improved median dose homogeneity (median, 1.15 for 3D-CRT vs. 1.05 for IMRT; p < 0.0001, Wilcoxon test) when compared with 3D-CRT. Acute toxicity consisted primarily of Grade 1 to 2 dermatitis and occurred in 92% of patients. Grade 2 dermatitis occurred in 13% of patients in the 3D-CRT group and 2% in the IMRT group. IMRT moderately decreased rates of acute pruritus (p = 0.03, chi-square test) and Grade 2 to 3 subacute hyperpigmentation (p = 0.01, Fisher exact test). With a minimum of 6 months' follow-up, the treatment was similarly well tolerated in either group, including among women with large breast volumes. Conclusion: Hypofractionated breast radiotherapy is well tolerated when treating patients in the prone position, even among those with large breast volumes. Breast IMRT significantly improves dosimetry but yields only a modest

  4. Predictive parameters in hypofractionated whole-breast 3D conformal radiotherapy according to the Ontario Canadian trial

    Science.gov (United States)

    Lazzari, Grazia; Terlizzi, Angela; Della Vittoria Scarpati, Giuseppina; Perri, Francesco; De Chiara, Vincenzo; Turi, Barbara; Silvano, Giovanni

    2017-01-01

    Aim To evaluate the possible role of dosimetric parameters according Normal Tissue Complication Probability (NTCP) model as predictive of late toxicity and cosmesis in hypofractionated whole-breast three-dimensional conformal radiotherapy. Patients and methods A retrospective analysis on 215 consecutive early breast cancer patients treated with breast conserving surgery and adjuvant hypofractionated whole-breast radiotherapy (according the Ontario Canadian trial), with a 6 years median follow-up was conducted. To assess the impact of 10%–20% dose hotspots on different percent values of planning target volume (PTV) of the breast, we retrospectively employed the NTCP model of Lyman. PTV breast (PTVbr), V110 were identified. For statistical analysis the χ2 and paired t-test were used to find a correlation between late skin and subcutaneous toxicity and cosmetic outcome with dosimetrical parameters Multivariate analysis was performed with the aim to assess independently the impact of dosimetric and clinical parameters on late toxicity and cosmesis using Pearson’s covariance. Results Late skin toxicity was recorded in 47/215 (22%); and G3 toxicity occurred in 11 patients (5%). Cosmesis with excellent–good score was found in 172 patients (80%) while fair–poor score was found in 43 patients (20%). In univariate χ2 analysis the V110 >10% of the PTV breast significantly correlated with higher toxicity (P10% and PTV breast volume over 1,300 cc was significant at multivariate analysis (Phypofractionated radiotherapy schedules, we found some predictive paramaters on the basis of NTCP model by Lyman. These parameters may be useful in selection of elegible patients. PMID:28392704

  5. Dose verification in carcinoma of uterine cervix patients undergoing 3D conformal radiotherapy with Farmer type ion chamber

    Directory of Open Access Journals (Sweden)

    Challapalli Srinivas

    2014-01-01

    Full Text Available External beam radiotherapy (EBRT for carcinoma of uterine cervix is a basic line of treatment with three dimensional conformal radiotherapy (3DCRT in large number of patients. There is need for an established method for verification dosimetry. We tried to document absorbed doses in a group of carcinoma cervix patients by inserting a 0.6 cc Farmer type ion chamber in the vaginal cavity. A special long perspex sleeve cap is designed to cover the chamber for using in the patient′s body. Response of ionization chamber is checked earlier in water phantom with and without cap. Treatment planning was carried out with X-ray computed tomography (CT scan and with the chamber along with cap in inserted position, and with the images Xio treatment planning system. Three measurements on 3 days at 5-6 fraction intervals were recorded in 12 patients. Electrometer measured charges are converted to absorbed dose at the chamber center, in vivo. Our results show good agreement with planned dose within 3% against prescribed dose. This study, is a refinement over our previous studies with transmission dosimetry and chemicals in ampules. This preliminary work shows promise that this can be followed as a routine dose check with special relevance to new protocols in the treatment of carcinoma cervix with EBRT.

  6. 3D-conformal-intensity modulated radiotherapy with compensators for head and neck cancer: clinical results of normal tissue sparing

    Directory of Open Access Journals (Sweden)

    Koscielny Sven

    2006-06-01

    Full Text Available Abstract Background To investigate the potential of parotic gland sparing of intensity modulated radiotherapy (3D-c-IMRT performed with metallic compensators for head and neck cancer in a clinical series by analysis of dose distributions and clinical measures. Materials and methods 39 patients with squamous cell cancer of the head and neck irradiated using 3D-c-IMRT were evaluable for dose distribution within PTVs and at one parotid gland and 38 patients for toxicity analysis. 10 patients were treated primarily, 29 postoperatively, 19 received concomittant cis-platin based chemotherapy, 20 3D-c-IMRT alone. Initially the dose distribution was calculated with Helax ® and photon fluence was modulated using metallic compensators made of tin-granulate (n = 22. Later the dose distribution was calculated with KonRad ® and fluence was modified by MCP 96 alloy compensators (n = 17. Gross tumor/tumor bed (PTV 1 was irradiated up to 60–70 Gy, [5 fractions/week, single fraction dose: 2.0–2.2 (simultaneously integrated boost], adjuvantly irradiated bilateral cervical lymph nodes (PTV 2 with 48–54 Gy [single dose: 1.5–1.8]. Toxicity was scored according the RTOG scale and patient-reported xerostomia questionnaire (XQ. Results Mean of the median doses at the parotid glands to be spared was 25.9 (16.3–46.8 Gy, for tin graulate 26 Gy, for MCP alloy 24.2 Gy. Tin-granulate compensators resulted in a median parotid dose above 26 Gy in 10/22, MCP 96 alloy in 0/17 patients. Following acute toxicities were seen (°0–2/3: xerostomia: 87%/13%, dysphagia: 84%/16%, mucositis: 89%/11%, dermatitis: 100%/0%. No grade 4 reaction was encountered. During therapy the XQ forms showed °0–2/3: 88%/12%. 6 months postRT chronic xerostomia °0–2/3 was observed in 85%/15% of patients, none with °4 xerostomia. Conclusion 3D-c-IMRT using metallic compensators along with inverse calculation algorithm achieves sufficient parotid gland sparing in virtually all advanced

  7. IMRT and 3D conformal radiotherapy with or without elective nodal irradiation in locally advanced NSCLC. A direct comparison of PET-based treatment planning

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    Fleckenstein, Jochen; Kremp, Katharina; Kremp, Stephanie; Palm, Jan; Ruebe, Christian [Saarland University Medical School, Department of Radiotherapy and Radiation Oncology, Homburg/Saar (Germany)

    2016-02-15

    The potential of intensity-modulated radiation therapy (IMRT) as opposed to three-dimensional conformal radiotherapy (3D-CRT) is analyzed for two different concepts of fluorodeoxyglucose positron emission tomography (FDG PET)-based target volume delineation in locally advanced non-small cell lung cancer (LA-NSCLC): involved-field radiotherapy (IF-RT) vs. elective nodal irradiation (ENI). Treatment planning was performed for 41 patients with LA-NSCLC, using four different planning approaches (3D-CRT-IF, 3D-CRT-ENI, IMRT-IF, IMRT-ENI). ENI included a boost irradiation after 50 Gy. For each plan, maximum dose escalation was calculated based on prespecified normal tissue constraints. The maximum prescription dose (PD), tumor control probability (TCP), conformal indices (CI), and normal tissue complication probabilities (NTCP) were analyzed. IMRT resulted in statistically significant higher prescription doses for both target volume concepts as compared with 3D-CRT (ENI: 68.4 vs. 60.9 Gy, p < 0.001; IF: 74.3 vs. 70.1 Gy, p < 0.03). With IMRT-IF, a PD of at least 66 Gy was achieved for 95 % of all plans. For IF as compared with ENI, there was a considerable theoretical increase in TCP (IMRT: 27.3 vs. 17.7 %, p < 0.00001; 3D-CRT: 20.2 vs. 9.9 %, p < 0.00001). The esophageal NTCP showed a particularly good sparing with IMRT vs. 3D-CRT (ENI: 12.3 vs. 30.9 % p < 0.0001; IF: 15.9 vs. 24.1 %; p < 0.001). The IMRT technique and IF target volume delineation allow a significant dose escalation and an increase in TCP. IMRT results in an improved sparing of OARs as compared with 3D-CRT at equivalent dose levels. (orig.) [German] Das Potenzial der intensitaetsmodulierten Strahlentherapie (IMRT) soll im Rahmen der FDG-PET basierten Bestrahlungsplanung des lokal fortgeschrittenen nichtkleinzelligen Bronchialkarzinoms (LA-NSCLC) fuer 2 Zielvolumenansaetze (Involved-Field-Bestrahlung, IF) sowie elektive Nodalbestrahlung (ENI) geprueft und mit der 3-D-konformalen Strahlentherapie (3-D

  8. Radiological response and dosimetry in physical phantom of head and neck for 3D conformational radiotherapy; Resposta radiologica e dosimetria em phantom fisico de cabeca e pescoco para radioterapia conformacional 3D

    Energy Technology Data Exchange (ETDEWEB)

    Thompson, Larissa

    2013-07-01

    Phantoms are tools for simulation of organs and tissues of the human body in radiology and radiotherapy. This thesis describes the development, validation and, most importantly, the use of a physical head and neck phantom in radiology and radiotherapy, with the purpose of evaluating dose distribution using Gafchromic EBT2 film in 15 MV 3D conformal radiotherapy. The work was divided in two stages, (1) development of new equivalent tissues and improvement of the physical phantom, and (2) use of the physical phantom in experimental dosimetry studies. In phase (1) parameters such as mass density, chemical composition of tissues, anatomical and biometric measurements were considered, as well as aspects of imaging by computed tomography (CT) and radiological response representation in Hounsfield Units (HU), which were compared with human data. Radiological experiments of in-phantom simulated brain pathologies were also conducted. All those results matched human-sourced data, therefore the physical phantom is a suitable simulator that may be used to enhance radiological protocols and education in medical imaging. The main objective in phase (2) was to evaluate the spatial dose distribution in a brain tumor simulator inserted inside the head and neck phantom developed by the Ionizing Radiation Research Group (NRI), exposed to 15 MV 3D conformal radiotherapy, for internal dose assessment. Radiation planning was based on CT images of the physical phantom with a brain tumor simulator made with equivalent material. The treatment planning system (TPS), CAT3D software, used CT images and prescribed a dose of 200 cGy, distributed in three fields of radiation, in a T-shaped pattern. The TPS covered the planning treatment volume (PTV) with 97% of the prescribed dose. A solid water phantom and radiochromic Gafchromic EBT2 film were used for calibration procedures, generating a dose response curve as a function of optical density (OD). After calibration and irradiation, the film

  9. Clinical observation of three-dimensional conformal radiotherapy(3D-CRT)with concurrent chemotherapy in treatment of recurrent cervical cancers

    Institute of Scientific and Technical Information of China (English)

    Hongbing Ma; Minghua Bai; Xijing Wang; Hongtao Ren

    2010-01-01

    Objective:The aim of the study was to explore the efficacy of three-dimensional conformal radiotherapy(3DCRT)combined with TP concurrent chemotherapy in treatment of recurrent cervical cancers.Methods:From May 2005 to May 2009,36 patients with recurrent cervical cancer were treated by 3D-CRT of 60-66 Gy and TP(docetaxel 70 mg/m2,d1;cisplatin 20 mg/m2,d1-d3;21 days per cycle,totally 2 cycles)concurrent chemotherapy.Results:All of the patients had finished the 3D-CRT,the total response rate,complete response rate and partial response rate were 80.0%(28/35),45.7%(16/35),and 34.3%(12/35),respectively.The pain-alleviation rate was 91.4%(32/35).The hemorrhage control rate was 94.3%(33/35).The median overall survival was 21.2 months.The 1-,2- and 3-year survival rates were 54.3%,37.1% and 22.8%,respectively.The life qualities of the patients were improved,without any treatment related death.Conclusion:Radiotherapy is effective and well-tolerated for recurrent cervical cancers,and it can promote regional control of the disease and prolong survival time.

  10. Different IMRT solutions vs. 3D-Conformal Radiotherapy in early stage Hodgkin’s lymphoma: dosimetric comparison and clinical considerations

    Directory of Open Access Journals (Sweden)

    Fiandra Christian

    2012-11-01

    Full Text Available Abstract Background Radiotherapy in Hodgkin’s Lymphoma (HL is currently evolving with new attempts to further reduce radiation volumes to the involved-node concept (Involved Nodes Radiation Therapy, INRT and with the use of intensity modulated radiotherapy (IMRT. Currently, IMRT can be planned and delivered with several techniques, and its role is not completely clear. We designed a planning study on a typical dataset drawn from clinical routine with the aim of comparing different IMRT solutions in terms of plan quality and treatment delivery efficiency. Methods A total of 10 young female patients affected with early stage mediastinal HL and treated with 30 Gy INRT after ABVD-based chemotherapy were selected from our database. Five different treatment techniques were compared: 3D-CRT, VMAT (single arc, B-VMAT (“butterfly”, multiple arcs, Helical Tomotherapy (HT and Tomodirect (TD. Beam energy was 6 MV, and all IMRT planning solutions were optimized by inverse planning with specific dose-volume constraints on OAR (breasts, lungs, thyroid gland, coronary ostia, heart. Dose-Volume Histograms (DVHs and Conformity Number (CN were calculated and then compared, both for target and OAR by a statistical analysis (Wilcoxon’s Test. Results PTV coverage was reached for all plans (V95% ≥ 95%; highest mean CN were obtained with HT (0.77 and VMAT (0.76. B-VMAT showed intermediate CN mean values (0.67, while the lowest CN were obtained with TD (0.30 and 3D-CRT techniques (0.30. A trend of inverse correlation between higher CN and larger healthy tissues volumes receiving low radiation doses was shown for lungs and breasts. For thyroid gland and heart/coronary ostia, HT, VMAT and B-VMAT techniques allowed a better sparing in terms of both Dmean and volumes receiving intermediate-high doses compared to 3D-CRT and TD. Conclusions IMRT techniques showed superior target coverage and OAR sparing, with, as an expected consequence, larger volumes of healthy

  11. The use of radiochromic EBT2 film for the quality assurance and dosimetric verification of 3D conformal radiotherapy using Microtek ScanMaker 9800XL flatbed scanner.

    Science.gov (United States)

    Sim, G S; Wong, J H D; Ng, K H

    2013-07-08

    Radiochromic and radiographic films are widely used for radiation dosimetry due to the advantage of high spatial resolution and two-dimensional dose measurement. Different types of scanners, including various models of flatbed scanners, have been used as part of the dosimetry readout procedure. This paper focuses on the characterization of the EBT2 film response in combination with a Microtek ScanMaker 9800XL scanner and the subsequent use in the dosimetric verification of a 3D conformal radiotherapy treatment. The film reproducibility and scanner uniformity of the Microtek ScanMaker 9800XL was studied. A three-field 3D conformal radiotherapy treatment was planned on an anthropomorphic phantom and EBT2 film measurements were carried out to verify the treatment. The interfilm reproducibility was found to be 0.25%. Over a period of three months, the films darkened by 1%. The scanner reproducibility was ± 2% and a nonuniformity was ±1.9% along the direction perpendicular to the scan direction. EBT2 measurements showed an underdose of 6.2% at high-dose region compared to TPS predicted dose. This may be due to the inability of the treatment planning system to predict the correct dose distribution in the presence of tissue inhomogeneities and the uncertainty of the scanner reproducibility and uniformity. The use of EBT2 film in conjunction with the axial CT image of the anthropomorphic phantom allows the evaluation of the anatomical location of dose discrepancies between the EBT2 measured dose distribution and TPS predicted dose distribution.

  12. Prospective study on the dose distribution to the acoustic structures during postoperative 3D conformal radiotherapy for parotid tumors. Dosimetric and audiometric aspects

    Energy Technology Data Exchange (ETDEWEB)

    Jereczek-Fossa, Barbara A. [European Inst. of Oncology, Milan (Italy). Division of Radiotherapy; Milan Univ. (Italy). Faculty of Medicine; Rondi, Elena [European Inst. of Oncology, Milan (Italy). Division of Medical Physics; Zarowski, Andrzej [Univ. Dept. of Otolaryngology, Head and Neck Surgery, St. Augustinus Hospital, Antwerp (BE)] (and others)

    2011-06-15

    To analyze dose distribution in the hearing organ and to evaluate the dose effect on the hearing thresholds in patients treated with post-parotidectomy 3-dimensional conformal radiotherapy (3D-CRT). A total of 17 patients received post-parotidectomy 3D-CRT (median dose: 63 Gy). The audiometric evaluation comprised pure tone audiometry and tympanometry performed before radiotherapy (RT) and 3, 6, and 24 months after RT. The ear structures were delineated on planning computer tomography scans. Mean and maximum doses were calculated and dose-volume histograms were plotted. Before RT, the median baseline audiometric thresholds were normal. At 3 months post-RT, 3 patients were diagnosed as having middle ear underpressure and/or effusion that resolved completely by 6 months. During 2-year follow-up, none of the ears showed perceptive hearing loss at speech frequencies. The mean doses at ipsilateral external auditory canal, mastoids cells, tympanic case, Eustachian tube, semicircular canals, and cochlea were 44.8 Gy, 39.0 Gy, 30.9 Gy, 33.0 Gy, 19.6 Gy, and 19.2 Gy, respectively. The doses to the contralateral ear were negligible, except for the Eustachian tube (up to 28.2 Gy). Post-parotidectomy 3D-CRT is associated with relatively low doses to the ear and the surrounding structures. Post-RT audiometry did not show any permanent (neither conductive nor perceptive) hearing impairment. Only in 3 patients were there signs of transient unilateral dysfunction of the Eustachian tube observed during the first few months after RT. Longer follow-up and larger patient series are warranted to confirm these preliminary findings. (orig.)

  13. Comparing morbidity and cancer control after 3D-conformal (70/74 Gy) and intensity modulated radiotherapy (78/82 Gy) for prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Dolezel, Martin [Multiscan Alpha Pardubice Regional Hospital, Oncology Centre, Pardubice (Czech Republic); Charles University in Prague, First Faculty of Medicine, Prague (Czech Republic); Faculty of Medicine and Dentistry, Department of Oncology, Olomouc (Czech Republic); Odrazka, Karel [Multiscan Alpha Pardubice Regional Hospital, Oncology Centre, Pardubice (Czech Republic); Charles University in Prague, First Faculty of Medicine, Prague (Czech Republic); Charles University in Prague, Third Faculty of Medicine, Prague (Czech Republic); Zouhar, Milan; Jansa, Jan; Paluska, Petr [University Hospital Hradec Kralove, Department of Oncology and Radiotherapy, Hradec Kralove (Czech Republic); Vaculikova, Miloslava [Hospital Trutnov, Department of Oncology, Trutnov (Czech Republic); Sefrova, Jana [Hospital Prachatice, Department of Oncology, Prachatice (Czech Republic); Kohlova, Tereza [Proton Therapy Center, Prague (Czech Republic); Vanasek, Jaroslav [Multiscan Alpha Pardubice Regional Hospital, Oncology Centre, Pardubice (Czech Republic); Kovarik, Josef [The Freeman Hospital, Northern Centre for Cancer Care, Newcastle upon Tyne (United Kingdom)

    2015-04-01

    The purpose of this work was to compare toxicity and cancer control between patients with prostate cancer treated using three-dimensional conformal radiotherapy (3D-CRT) and those treated using intensity-modulated radiation therapy (IMRT). A total of 553 patients with prostate cancer were treated with 3D-CRT 70-74 Gy (3D-CRT 70, 3D-CRT 74) or IMRT 78-82 Gy (IMRT 78, IMRT/SIB 82). Late toxicity was scored according to FC-RTOG/LENT criteria. Biochemical failure was defined using the Phoenix and ASTRO definitions. The 5-year risk of grade 2-4 genitourinary toxicity was 26.3 % (3D-CRT 70), 27.2 % (3D-CRT 74), 17.3 % (IMRT 78), and 25.1 % (IMRT/SIB 82) without statistical differences. The 5-year risk of grade 2-4 gastrointestinal toxicity was 19.4 % (3D-CRT 70), 42.1 % (3D-CRT 74), 20.5 % (IMRT 78), and 26.6 % (IMRT/SIB 82). The differences between 3D-CRT 74 and 3D-CRT 70 and between 3D-CRT 74 and IMRT 78 were statistically significant (log rank p = 0.03). The 5-year Phoenix PSA relapse-free survival (PSA-RFS) in low-risk, intermediate-risk, and high-risk patients treated using 3D-CRT were 89.4, 65.5, and 57.8 %, respectively. Patients treated with IMRT achieved the following results: 90.9, 89.4, and 83.9 %. Clinical relapse-free survival (C-RFS) in patients treated using 3D-CRT vs. IMRT for the aforementioned groups were 94.7 vs. 100 %, 86.8 vs. 98.6 %, and 84.4 vs. 94.5 %. Disease-free survival (DFS) for patients treated using 3D-CRT were 83.1, 70.9, and 71.5 %. The IMRT group reached 95.8, 89.1, and 87.6 %. The PSA-RFS for intermediate- and high-risk patients were statistically significant, while C-RFS and DFS were marginally better. Dose escalation with IMRT was associated with improved cancer control in intermediate- and high-risk patients in comparison with 3D-CRT, without compromising toxicity. (orig.) [German] Es erfolgte ein Vergleich von Toxizitaet und Tumorkontrolle bei Patienten mit Prostatakarzinom nach der Behandlung mit dreidimensionaler konformaler

  14. SU-E-T-346: Effect of Jaw Position On Dose to Critical Structures in 3-D Conformal Radiotherapy Treatment of Pancreatic Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Paudel, N; Han, E; Liang, X; Morrill, S; Zhang, X; Hardee, M; Penagaricano, J; Ratanatharathorn, V [Vaneerat, University of Arkansas for Medical Sciences, Little Rock, AR (United States)

    2015-06-15

    Purpose: Three-dimensional conformal therapy remains a valid and widely used modality for pancreatic radiotherapy treatment. It usually meets dose constraints on critical structures. However, careful positioning of collimation jaws can reduce dose to the critical structures. Here we investigate the dosimetric effect of jaw position in MLC-based 3-D conformal treatment planning on critical structures. Methods: We retrospectively selected seven pancreatic cancer patients treated with 3-D conformal radiotherapy. We started with treatment plans (Varian Truebeam LINAC, Eclipse TPS, AAA, 18MV) having both x and y jaws aligned with the farthest extent of the block outline (8mm around PTV). Then we subsequently moved either both x-jaws or all x and y jaws outwards upto 3 cm in 1 cm increments and investigated their effect on average and maximum dose to neighboring critical structures keeping the same coverage to treatment volume. Results: Lateral displacement of both x-jaws by 1cm each increased kidney and spleen mean dose by as much as 1.7% and 1.3% respectively and superior inferior displacement increased liver, right kidney, stomach and spleen dose by as much as 2.1%, 2%, 5.2% and 1.6% respectively. Displacement of all x and y-jaws away by 1cm increased the mean dose to liver, right kidney, left kidney, bowels, cord, stomach and spleen by as much as 4.9%, 5.9%, 2.1%, 2.8%, 7.4%, 10.4% and 4.2% respectively. Percentage increase in mean dose due to 2 and 3cm jaw displacement increased almost linearly with the displaced distance. Changes in maximum dose were much smaller (mostly negligible) than the changes in mean dose. Conclusion: Collimation jaw position affects dose mostly to critical structures adjacent to it. Though treatment plans with MLCs conforming the block margin usually meet dose constraints to critical structures, keeping jaws all the way in, to the edge of the block reduces dose to the critical structures during radiation treatment.

  15. Impact of inter- and intrafraction deviations and residual set-up errors on PTV margins. Different alignment techniques in 3D conformal prostate cancer radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Langsenlehner, T.; Doeller, C.; Winkler, P.; Kapp, K.S. [Graz Medical Univ. (Austria). Dept. of Therapeutic Radiology and Oncology; Galle, G. [Graz Medical Univ. (Austria). Dept. of Urology

    2013-04-15

    The aim of this work was to analyze interfraction and intrafraction deviations and residual set-up errors (RSE) after online repositioning to determine PTV margins for 3 different alignment techniques in prostate cancer radiotherapy. The present prospective study included 44 prostate cancer patients with implanted fiducials treated with three-dimensional (3D) conformal radiotherapy. Daily localization was based on skin marks followed by marker detection using kilovoltage (kV) imaging and subsequent patient repositioning. Additionally, in-treatment megavoltage (MV) images were obtained for each treatment field. In an off-line analysis of 7,273 images, interfraction prostate motion, RSE after marker-based prostate localization, prostate position during each treatment session, and the effect of treatment time on intrafraction deviations were analyzed to evaluate PTV margins. Margins accounting for interfraction deviation, RSE and intrafraction motion were 14.1, 12.9, and 15.1 mm in anterior-posterior (AP), superior-inferior (SI), and left-right (LR) direction for skin mark alignment and 9.6, 8.7, and 2.6 mm for bony structure alignment, respectively. Alignment to implanted markers required margins of 4.6, 2.8, and 2.5 mm. As margins to account for intrafraction motion increased with treatment prolongation PTV margins could be reduced to 3.9, 2.6, and 2.4 mm if treatment time was {<=} 4 min. With daily online correction and repositioning based on implanted fiducials, a significant reduction of PTV margins can be achieved. The use of an optimized workflow with faster treatment techniques such as volumetric modulated arc techniques (VMAT) could allow for a further decrease. (orig.)

  16. IMRT vs. 2D-radiotherapy or 3D-conformal radiotherapy of nasopharyngeal carcinoma. Survival outcome in a Korean multi-institutional retrospective study (KROG 11-06)

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Sung Ho; Cho, Kwan Ho [Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Ilsandong-gu, Goyang-si Gyeonggi-do (Korea, Republic of); Lee, Chang-Geol; Keum, Ki Chang [Yonsei University College of Medicine, Department of Radiation Oncology, Seodaemun-gu, Seoul (Korea, Republic of); Kim, Yeon-Sil [Seoul St. Mary' s Hospital, College of Medicine, the Catholic University of Korea, Department of Radiation Oncology, Seocho-gu, Seoul (Korea, Republic of); Wu, Hong-Gyun; Kim, Jin Ho [Seoul National University College of Medicine, Department of Radiation Oncology, Jongno-gu, Seoul (Korea, Republic of); Ahn, Yong Chan; Oh, Dongryul [Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Radiation Oncology, Gangnam-gu, Seoul (Korea, Republic of); Lee, Jong Hoon [The Catholic University of Korea, College of Medicine, Department of Radiation Oncology, Paldal-gu, Suwon, Gyeonggi-do (Korea, Republic of)

    2016-06-15

    We compared treatment outcomes of two-dimensional radiotherapy (2D-RT), three-dimensional conformal radiotherapy (3D-CRT), and intensity-modulated radiotherapy (IMRT) in patients with nasopharyngeal carcinoma (NPC). In total, 1237 patients with cT1-4N0-3M0 NPC were retrospectively analyzed. Of these, 350, 390, and 497 were treated with 2D-RT, 3D-CRT, and IMRT, respectively. 3D-CRT and IMRT showed better 5-year overall survival (OS) rates (73.6 and 76.7 %, respectively) than did 2D-RT (5-year OS of 59.7 %, all p < 0.001). In T3-4 subgroup, IMRT was associated with a significantly better 5-year OS than was 2D-RT (70.7 vs. 50.4 %, respectively; p ≤ 0.001) and 3D-CRT (70.7 vs. 57.8 %, respectively; p = 0.011); however, the difference between the 2D-RT and 3D-CRT groups did not reach statistical significance (p = 0.063). In multivariate analyses of all patients, IMRT was a predictive factor for OS when compared with 2D-RT or 3D-CRT, as was 3D-CRT when compared with 2D-RT. Our study showed that 3D-CRT and IMRT were associated with a better local progression-free survival and OS than was 2D-RT in NPC. IMRT was significantly superior in terms of OS for advanced primary tumors (T3-4). (orig.) [German] Wir verglichen die Behandlungsergebnisse von zweidimensionaler Strahlentherapie (2D-RT), dreidimensionaler konformer Strahlentherapie (3D-CRT) und intensitaetsmodulierter Strahlentherapie (IMRT) bei Patienten mit Nasopharynxkarzinom (NPC). Insgesamt 1237 Patienten mit NPC im Stadium cT1-4/N0-3/M0 wurden rueckwirkend analysiert. Von diesen wurden jeweils 350, 390 und 497 mit 2D-RT, 3D-CRT und IMRT behandelt. 3D-CRT und IMRT zeigten eine bessere 5-Jahres-Gesamtueberlebensrate (5y-OS; jeweils 73,6 und 76,7%) als 2D-RT (59,7%; alle p < 0,001). In der Untergruppe T3-4 war die IMRT mit einer erheblich besseren 5y-OS verbunden als 2D-RT (jeweils 70,7 vs. 50,4%; p ≤ 0,001) und 3D-CRT (jeweils 70,7 vs. 57,8%; p = 0,011); jedoch gab es keinen Unterschied zwischen den Gruppen 2D

  17. Factors of influence on acute skin toxicity of breast cancer patients treated with standard three-dimensional conformal radiotherapy (3D-CRT) after breast conserving surgery (BCS)

    National Research Council Canada - National Science Library

    Kraus-Tiefenbacher, Uta; Sfintizky, Andreas; Welzel, Grit; Simeonova, Anna; Sperk, Elena; Siebenlist, Kerstin; Mai, Sabine; Wenz, Frederik

    2012-01-01

    .... In order to reduce these side effects it is mandatory to identify potential factors of influence in breast cancer patients undergoing standard three-dimensional conformal radiation therapy (3D-CRT...

  18. Intensity-modulated proton therapy, volumetric-modulated arc therapy, and 3D conformal radiotherapy in anaplastic astrocytoma and glioblastoma. A dosimetric comparison

    Energy Technology Data Exchange (ETDEWEB)

    Adeberg, S.; Debus, J. [Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg (Germany); Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg (Germany); University Hospital Heidelberg, Department of Radiation Oncology, Heidelberg (Germany); German Cancer Research Center (DKFZ), Clinical Cooperation Unit Radiation Oncology, Heidelberg (Germany); Harrabi, S.B.; Bougatf, N.; Rieber, J.; Koerber, S.A.; Herfarth, K.; Rieken, S. [Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg (Germany); Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg (Germany); University Hospital Heidelberg, Department of Radiation Oncology, Heidelberg (Germany); Bernhardt, D.; Syed, M.; Sprave, T.; Mohr, A. [Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg (Germany); University Hospital Heidelberg, Department of Radiation Oncology, Heidelberg (Germany); Abdollahi, A. [University Hospital Heidelberg, Department of Radiation Oncology, Heidelberg (Germany); Haberer, T. [Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg (Germany); Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg (Germany); Combs, S.E. [Technische Universitaet Muenchen, Department of Radiation Oncology, Muenchen (Germany); Helmholtz Zentrum Muenchen, Institut fuer Innovative Radiotherapie (iRT), Department of Radiation Sciences (DRS), Neuherberg (Germany)

    2016-11-15

    The prognosis for high-grade glioma (HGG) patients is poor; thus, treatment-related side effects need to be minimized to conserve quality of life and functionality. Advanced techniques such as proton radiation therapy (PRT) and volumetric-modulated arc therapy (VMAT) may potentially further reduce the frequency and severity of radiogenic impairment. We retrospectively assessed 12 HGG patients who had undergone postoperative intensity-modulated proton therapy (IMPT). VMAT and 3D conformal radiotherapy (3D-CRT) plans were generated and optimized for comparison after contouring crucial neuronal structures important for neurogenesis and neurocognitive function. Integral dose (ID), homogeneity index (HI), and inhomogeneity coefficient (IC) were calculated from dose statistics. Toxicity data were evaluated. Target volume coverage was comparable for all three modalities. Compared to 3D-CRT and VMAT, PRT showed statistically significant reductions (p < 0.05) in mean dose to whole brain (-20.2 %, -22.7 %); supratentorial (-14.2 %, -20,8 %) and infratentorial (-91.0 %, -77.0 %) regions; brainstem (-67.6 %, -28.1 %); pituitary gland (-52.9 %, -52.5 %); contralateral hippocampus (-98.9 %, -98.7 %); and contralateral subventricular zone (-62.7 %, -66.7 %, respectively). Fatigue (91.7 %), radiation dermatitis (75.0 %), focal alopecia (100.0 %), nausea (41.7 %), cephalgia (58.3 %), and transient cerebral edema (16.7 %) were the most common acute toxicities. Essential dose reduction while maintaining equal target volume coverage was observed using PRT, particularly in contralaterally located critical neuronal structures, areas of neurogenesis, and structures of neurocognitive functions. These findings were supported by preliminary clinical results confirming the safety and feasibility of PRT in HGG. (orig.) [German] Die Prognose bei ''High-grade''-Gliomen (HGG) ist infaust. Gerade bei diesen Patienten sollten therapieassoziierte Nebenwirkungen minimiert werden

  19. Gel dosimetry for conformal radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Gambarini, G. [Department of Physics of the University and INFN, Milan (Italy)]. e-mail: grazia.gambarini@mi.infn.it

    2005-07-01

    With the continuum development of conformal radio therapies, aimed at delivering high dose to tumor tissue and low dose to the healthy tissue around, the necessities has appeared of suitable improvement of dosimetry techniques giving the possibility of obtaining dose images to be compared with diagnostic images. Also if wide software has been developed for calculating dose distributions in the fields of various radiotherapy units, experimental verifications are necessary, in particular in the case of complex geometries in conformal radiotherapy. Gel dosimetry is a promising method for imaging the absorbed dose in tissue-equivalent phantoms, with the possibility of 3D reconstruction of the spatial dose distribution, with milli metric resolution. Optical imaging of gel dosimeters, based on visible light absorbance analysis, has shown to be a reliable technique for achieving dose distributions. (Author)

  20. PubChem3D: Similar conformers

    Directory of Open Access Journals (Sweden)

    Bolton Evan E

    2011-05-01

    Full Text Available Abstract Background PubChem is a free and open public resource for the biological activities of small molecules. With many tens of millions of both chemical structures and biological test results, PubChem is a sizeable system with an uneven degree of available information. Some chemical structures in PubChem include a great deal of biological annotation, while others have little to none. To help users, PubChem pre-computes "neighboring" relationships to relate similar chemical structures, which may have similar biological function. In this work, we introduce a "Similar Conformers" neighboring relationship to identify compounds with similar 3-D shape and similar 3-D orientation of functional groups typically used to define pharmacophore features. Results The first two diverse 3-D conformers of 26.1 million PubChem Compound records were compared to each other, using a shape Tanimoto (ST of 0.8 or greater and a color Tanimoto (CT of 0.5 or greater, yielding 8.16 billion conformer neighbor pairs and 6.62 billion compound neighbor pairs, with an average of 253 "Similar Conformers" compound neighbors per compound. Comparing the 3-D neighboring relationship to the corresponding 2-D neighboring relationship ("Similar Compounds" for molecules such as caffeine, aspirin, and morphine, one finds unique sets of related chemical structures, providing additional significant biological annotation. The PubChem 3-D neighboring relationship is also shown to be able to group a set of non-steroidal anti-inflammatory drugs (NSAIDs, despite limited PubChem 2-D similarity. In a study of 4,218 chemical structures of biomedical interest, consisting of many known drugs, using more diverse conformers per compound results in more 3-D compound neighbors per compound; however, the overlap of the compound neighbor lists per conformer also increasingly resemble each other, being 38% identical at three conformers and 68% at ten conformers. Perhaps surprising is that the average

  1. Biochemical response after 3-D conformal radiotherapy of localized prostate cancer to a total dose of 66 Gy. 4 year results

    Energy Technology Data Exchange (ETDEWEB)

    Wachter-Gerstner, N.; Wachter, S.; Goldner, G.; Nechvile, E.; Poetter, R. [Universitaetsklinik fuer Strahlentherapie und Strahlenbiologie, AKH Wien (Austria)

    2002-10-01

    Background: Since the introduction of 3-D conformal radiotherapy (CRT) doses of {<=}70 Gy have been used in many European countries. In this analysis, the impact of a short-term neoadjuvant hormonal treatment in combination with CRT to a moderate dose level of 66 Gy was examined. Patients and methods: From January 1994 to February 1999 397 patients were treated for carcinoma of the prostate. In 279 patients a definitive curative treatment (T1=38, T2=165, T3=50, Tx=11) with or without androgen deprivation was performed. 164 patients with radiotherapy of the prostate{+-}seminal vesicles to a total dose of 66 Gy (n=109) alone or in combination with a short-term hormonal treatment (n=55) were included in this analysis. Biochemical relapse was defined as three rising PSA values or reintroduction of hormonal treatment. A low-risk subgroup was defined for patients with maximum serum PSA level {<=}10 and ct{<=}2 and G{<=}2, all other patients were summarized as high-risk patients. Results: The median follow-up of alive patients was 40 months (12-72 months). There was a total of 29/164 deaths, two were cause-specific and 27 were considered unrelated to prostate cancer. The 4-year rates of no biochemical evidence of disease for all patients was 58%. For the high-risk group the 4-year rates could be improved with borderline significance from 35% to 66% (p=0.057) by additional neoadjuvant hormonal treatment. In contrast for the low-risk group no significant improvement was observed: 73% and 82%, respectively (p=0.5). Conclusion: Especially in high-risk patients doses <70 Gy for radiotherapy alone seem not to be sufficient for curative treatment. Additional hormonal treatment and doses >70 Gy should be considered. As a consequence of our earlier analysis a prospective multicenter treatment optimization protocol has been initiated in 1999. The protocol includes a risk-adapted dose increase from 70 Gy in low-risk patients to 74 Gy in high-risk patients including short

  2. 中上段食管癌3D-CRT与IMRT肺损伤剂量学的对比研究%Dosimetric Comparison of Intensity-modulated Radiotherapy Versus 3D Conformal Radiotherapy in Treatment of Cancer of Upper/Mid Esophagus

    Institute of Scientific and Technical Information of China (English)

    张莉; 罗辉

    2011-01-01

    Objective To compared 3D-conformal radiotherapy (3D-CRT)-induced and intensity-modulated radiotherapy (IMRT)-induced pulmonary injury by using 3D treatment planning system,and to explore the optimum treatment strategy for upper/mid esophageal carcinoma.Methods Eight patients with upper/mid esophageal carcinoma were selected in this study. Four different radiotherapy plans were developed for each patient,including 5-field 3D-CRT(CRT5),7-field 3D-CRT(CRT7), 5-field IMRT (IMRT5) and 7-field IMRT (IMRT7). The planning target volume (PTV) received at least 95% of the prescription dose. The mean lung dose (MLD),V5,V10,V20 and V30 were evaluated using dose volume histogram(DVH). All statistics were analyzed using the SPSS version 11.5 software. Results CRT5 plan reduced lung V10 compared with CRT7 (P=0. 006), but V5, V20, V30 and MLD were not different between the two plans(P>0. 008 3). There were no significant differences in lung parameters between IMRT5 and IMRT7.Compared with IMRT plans, V20, V30 and MLD were increased by 3D-CRT, while V5 was decreased by 3D-CRT(P<0. 0083). Conclusion Compared with 3D-CRT, IMRT can reduce the MLD,V20 and V30 to achieve lung sparing in treatment of upper/mid esophageal carcinoma.There were no significant differences in the protection of lung tissues between 5-field and 7-field techniques for both 3D-CRT and IMRT plans.%目的 应用三维适形放疗(3D-CRT)计划比较中上段食管鳞癌3D-CRT和调强放疗(IMRT)的放射性肺损伤情况从而探讨理想的治疗计划模式.方法 8例患者每例分别设计4个放疗计划(CRT-5 、CRT-7、IMRT-5及 IMRT-7),规定PTV至少达到95%处方剂量前提下用DVH评价每个计划的V5 、V10 、V20 、V30及肺 MLD.采用SPSS 11.5软件包进行数据统计与分析.结果 采用3D-CRT技术时,5野的V10优于7野(P=0.006);5野与7野的肺Mean、肺V5、V20、V30(P>0.0083)之间无统计学意义;采用IMRT技术时,5野与7野之间各参数的对

  3. Estimate of the damage in organs induced by neutrons in three-dimensional conformal radiotherapy; Estimacion del dano en organos inducido por neutrones en radioterapia conformada en 3D

    Energy Technology Data Exchange (ETDEWEB)

    Benites R, J. L. [Centro Estatal de Cancerologia de Nayarit, Servicio de Seguridad Radiologica, Calzada de la Cruz 118 sur, 63000 Tepic, Nayarit (Mexico); Vega C, H. R. [Universidad Autonoma de Zacatecas, Unidad Academica de Estudios Nucleares, Cipres No. 10, Fracc. La Penuela, 98068 Zacatecas (Mexico); Uribe, M. del R., E-mail: jlbenitesr@prodigy.net.mx [Instituto Tecnico Superior de Radiologia, Calle Leon No. 129, 63000 Tepic, Nayarit (Mexico)

    2014-08-15

    By means of Monte Carlo methods was considered the damage in the organs, induced by neutrons, of patients with cancer that receive treatment in modality of three-dimensional conformal radiotherapy (3D-CRT) with lineal accelerator Varian Ix. The objective of this work was to estimate the damage probability in radiotherapy patients, starting from the effective dose by neutrons in the organs and tissues out of the treatment region. For that a three-dimensional mannequin of equivalent tissue of 30 x 100 x 30 cm{sup 3} was modeled and spherical cells were distributed to estimate the Kerma in equivalent tissue and the absorbed dose by neutrons. With the absorbed dose the effective dose was calculated using the weighting factors for the organ type and radiation type. With the effective dose and the damage factors, considered in the ICRP 103, was considered the probability of damage induction in organs. (Author)

  4. Dose comparison between three planing prostate: 3-D conformational radiotherapy, coplanar arc therapy and non-coplanar arc therapy; Comparaison dosimetrique de trois balistiques prostatiques: radiotherapie conformationnelle tridimensionnelle, arctherapie coplanaire et arctherapie non-coplanaire

    Energy Technology Data Exchange (ETDEWEB)

    Voyant, C.; Baadj, A.; Biffi, K.; Leschi, D.; Lantieri, C. [Centre Hospitalier Dept. Castelluccio, Service de Radiotherapie, Ajaccio (France); Voyant, C. [Universite de Corse, Lab. SPE, CNRS-UMR 6134, Corte (France)

    2008-09-15

    Purpose: Comparative study between a classical conformational prostate radiotherapy (3 D.R.T.C.) and two arc therapy techniques, a coplanar (A.T.-C) and the other non-coplanar (A.T.-N.C.). Patients and Methods:The comparison has been made retrospectively on 30 patients with localized prostate cancer (T.2-T.3a, P.S.A. < 20 ng/ml, Gleason < 7). The objective criteria for comparison were the N.T.C.P., E.U.D., and dose volume (on D.V.H.), for the volumes of bladder wall, rectal wall, femoral heads, small bowel, prostate (P) and seminal vesicles (V.S.). The treatment was 46 Gy on P.T.V.1 (V.S. + P + margins), and then an overdose of 30 Gy on P.T.V.1 (P + margins). Results: For prostate volumes exceeding 75 cm{sup 3}, arc therapy leads to a decrease in uniformity in the target volume and an increase in the dose received by the femoral heads, this method does not seem appropriate. For prostate volumes less than 75 cm{sup 3}, in addition to the coverage almost tumor, and radiation toxicity equivalent to the bladder and the small intestine, there is a significant increase in the dose to the femoral heads, while the remaining is still within limits, such as clinically tolerable. The contribution of arc therapy is mainly observed at the level of rectal doses. The dose received by 30% of the rectum is reduced by - 12% for A.T.-C and - 11.7% for A.T-N.C., and E.U.D. rectum - 5.2% and - 4.8%. Conclusion: In this virtual study, the arc therapy seems to generate a true dose reduction in the rectum wall. These results encourage us to continue the investigation for a possible integration in a dynamic clinical routine. (authors)

  5. 三维适形放疗单用或与不同时段热疗联合治疗局部晚期非小细胞肺癌%Thermotherapy combined with 3-D conformal radiotherapy in different time and sequence in the treatment of locally advanced non-small-cell lung cancer

    Institute of Scientific and Technical Information of China (English)

    刘仙明; 郭建平; 孙建刚; 周尔玺; 王晓燕

    2011-01-01

    目的:评价不同时段深部热疗联合三维适形放疗治疗局部晚期非小细胞肺癌(NSCLC)的临床疗效.方法:回顾性分析我院2006年9月~2010年3月采用三维适形放疗单用或与不同时段深部热疗联合治疗局部晚期 NSCLC患者 91例,其中,单纯行放疗组(A组)31例,放疗后即刻行热疗组(B组)37例,热疗后2 h行放疗组(C组)23例.完成治疗后0~2个月通过CT对近期疗效进行评价.结果:3组有效率分别为A组 51.6%,B组 75.7%和C组78.3%.B组与A组,C组与A组的有效率比较,差异有统计学意义(P0.05).结论:热疗联合三维适形放疗比单纯行三维适形放疗在治疗局部晚期NSCLC短期疗效上更具优势,而热疗联合放疗的时间和顺序对短期疗效无明显影响.%Objective: To evaluate the efficacy of thermotherapy combined with 3-D conformal radiotherapy in different time and sequence in the treatment of locally advanced non-small-cell lung cancer (NSCLC).Methods: 91 patients with locally advanced NSCLC were analyzed retrospectively, who were treated with 3-D conformal radiotherapy only or combined with thermotherapy in different time and sequence in our hospital from September 2006 to March 2010.31 patients were treated with 3-D conformal radiotherapy only (group A), 37 patients were treated with thermotherapy after 3-D conformal radiotherapy immediately (group B), 23 patients were treated with 3-D conformal radiotherapy after thermotherapy at an interval of about 2 hours (group C).The short-term effects were evaluated through CT scan after therapy of 0-2 months.Results: The effective rate of group A was 51.6%, and that of group B and group C was 75.7% and 78.3%, the differences between group A and B, group A and C were significant (P<0.05), and there was no significant difference between group B and C (P>0.05).Conclusion: The patients treated with thermotherapy combined with 3-D conformal radiotherapy can obtain better short-term effects than those

  6. Acurácia na reprodutibilidade do posicionamento diário de pacientes submetidos a radioterapia conformada (RT3D para câncer de próstata Accuracy in the reproducibility of daily patients' setup in 3D conformal radiotherapy for prostate cancer

    Directory of Open Access Journals (Sweden)

    Adelmo José Giordani

    2010-08-01

    Full Text Available OBJETIVO: Avaliar a reprodutibilidade do posicionamento de pacientes com diagnóstico de câncer de próstata submetidos a radioterapia conformada. MATERIAIS E MÉTODOS: Foram avaliados 960 (posições anterior e lateral filmes radiológicos, de um total de 120 pacientes que receberam radioterapia conformada na próstata com técnica isocêntrica. As imagens foram obtidas em acelerador linear de partículas 6 MV. Aplicou-se protocolo específico para planejamento e tratamento da próstata, com o paciente em posição supina, mãos colocadas sobre o tórax, pés apoiados em suporte apropriado. Diariamente, os pacientes foram posicionados conforme demarcações na pele, coincidentes com os lasers da sala. Os filmes radiológicos foram comparados com as radiografias reconstruídas digitalmente (digitally reconstructed radiography - DRR em sistema de planejamento computadorizado Eclipse, a partir das tomografias. As radiografias de posicionamento foram realizadas no primeiro dia e após, semanalmente, até o término do tratamento. RESULTADOS: As médias dos deslocamentos observados foram de 1,99 ± 1,25 mm no sentido crânio-caudal, 1,37 ± 0,84 mm no látero-lateral e 1,94 ± 1,10 mm no ântero-posterior. CONCLUSÃO: O uso de protocolos específicos para posicionamento dos pacientes é possível na prática clínica, possibilita reprodutibilidade adequada e rápida correção dos possíveis erros.OBJECTIVE: To evaluate the reproducibility of daily patients' setup in 3D conformal radiotherapy for prostate cancer. MATERIALS AND METHODS: The present study evaluated a total of 960 radiological images (anterior and lateral views of 120 patients submitted to conformal radiotherapy for prostate cancer with the isocentric technique. A 6 MV particle accelerator was utilized in the process. A specific protocol for prostate radiotherapy planning and treatment was applied, with the patients placed in supine position, hands on the chest and legs placed on and

  7. Axillary Irradiation with High Tangent Fields for Clinically Node-Negative Breast Cancer: Can 3-D Conformal Radiotherapy with a Field-in-Field Technique Better Control the Axilla?

    Science.gov (United States)

    Sanuki, Naoko; Takeda, Atsuya; Amemiya, Atsushi; Ofuchi, Toru; Ono, Masato; Ogata, Haruki; Yamagami, Ryo; Hatayama, Jun; Eriguchi, Takahisa; Kunieda, Etsuo

    2013-10-01

    The target volume for postoperative breast irradiation is the remaining breast tissue, and the axillary region is not an intentional target volume. Between 2001 and 2009, eligible women with pT1-2cN0/pN0(sn) breast cancer underwent breast-conserving therapy without axillary dissection. Treatment outcomes between 2 radiotherapy planning groups, high tangent fields with 2-dimensional (2-D) simulation-based planning and 3-dimensional (3-D) computed tomography-based planning with a field-in-field technique, were compared. The correlating factors for axillary failure were also calculated. In total, 678 patients were eligible. As of May 2009, the median follow-up times for the 2-D (n = 346) and 3-D (n = 332) groups were 94 and 52 months, respectively. Patient characteristics were balanced, except for a younger population in the 2-D group and more lymphovascular invasion in the 3-D group. On multivariate analysis, 2-D planning was the only risk factor for axillary failure. In the 2-D and 3-D groups, the 5-year cumulative incidences of axillary failure were 8 (3.1%) and 1 (0.3%) (log-rank p = 0.009), respectively. The respective 5-year overall survival rates were 97.4 and 98.4% (p = 0.4). High tangent irradiation with 3-D planning improved axillary control compared to that with 2-D planning, suggesting that optimizing axillary dose distribution may impact outcomes.

  8. Automatic respiration tracking for radiotherapy using optical 3D camera

    Science.gov (United States)

    Li, Tuotuo; Geng, Jason; Li, Shidong

    2013-03-01

    Rapid optical three-dimensional (O3D) imaging systems provide accurate digitized 3D surface data in real-time, with no patient contact nor radiation. The accurate 3D surface images offer crucial information in image-guided radiation therapy (IGRT) treatments for accurate patient repositioning and respiration management. However, applications of O3D imaging techniques to image-guided radiotherapy have been clinically challenged by body deformation, pathological and anatomical variations among individual patients, extremely high dimensionality of the 3D surface data, and irregular respiration motion. In existing clinical radiation therapy (RT) procedures target displacements are caused by (1) inter-fractional anatomy changes due to weight, swell, food/water intake; (2) intra-fractional variations from anatomy changes within any treatment session due to voluntary/involuntary physiologic processes (e.g. respiration, muscle relaxation); (3) patient setup misalignment in daily reposition due to user errors; and (4) changes of marker or positioning device, etc. Presently, viable solution is lacking for in-vivo tracking of target motion and anatomy changes during the beam-on time without exposing patient with additional ionized radiation or high magnet field. Current O3D-guided radiotherapy systems relay on selected points or areas in the 3D surface to track surface motion. The configuration of the marks or areas may change with time that makes it inconsistent in quantifying and interpreting the respiration patterns. To meet the challenge of performing real-time respiration tracking using O3D imaging technology in IGRT, we propose a new approach to automatic respiration motion analysis based on linear dimensionality reduction technique based on PCA (principle component analysis). Optical 3D image sequence is decomposed with principle component analysis into a limited number of independent (orthogonal) motion patterns (a low dimension eigen-space span by eigen-vectors). New

  9. Comparación de costes de tres tratamientos del cáncer de próstata localizado en España: prostatectomía radical, braquiterapia prostática y radioterapia conformacional externa 3D Cost comparison of three treatments for localized prostate cancer in Spain: radical prostatectomy, prostate brachytherapy and external 3D conformal radiotherapy

    Directory of Open Access Journals (Sweden)

    Virginia Becerra Bachino

    2011-02-01

    statistically significant: medians were €3,229.10, €5,369.00 and €6,265.60, respectively, for the groups of patients treated with external 3D conformal radiotherapy, brachytherapy and radical retropublic prostatectomy, (p<0.001. In the multivariate analysis (adjusted R²=0.8, the average costs of brachytherapy and external radiotherapy were significantly lower than that of prostatectomy (coefficient -0.212 and -0.729, respectively. Conclusions: Radical prostatectomy proved to be the most expensive treatment option. Overall, the estimated costs in our study were lower than those published elsewhere. Most of the costs were explained by the therapeutic option and neither comorbidity nor risk groups showed an effect on total costs independent of treatment.

  10. 3D Cadastral Data Model Based on Conformal Geometry Algebra

    Directory of Open Access Journals (Sweden)

    Ji-yi Zhang

    2016-02-01

    Full Text Available Three-dimensional (3D cadastral data models that are based on Euclidean geometry (EG are incapable of providing a unified representation of geometry and topological relations for 3D spatial units in a cadastral database. This lack of unification causes problems such as complex expression structure and inefficiency in the updating of 3D cadastral objects. The inability of current cadastral data models to express cadastral objects in a unified manner can be attributed to the different expressions of dimensional objects. Because the hierarchical Grassmann structure corresponds to the hierarchical structure of dimensions in conformal geometric algebra (CGA, geometric objects in different dimensions can be constructed by outer products in a unified expression form, which enables the direct extension of two-dimensional (2D spatial representations to 3D spatial representations. The multivector structure in CGA can be employed to organize and store different dimensional objects in a multidimensional and unified manner. With the advantages of CGA in multidimensional expressions, a new 3D cadastral data model that is based on CGA is proposed in this paper. The geometries and topological relations of 3D spatial units can be represented in a unified form within the multivector structure. Detailed methods for 3D cadastral data model design based on CGA and data organization in CGA are introduced. The new cadastral data model is tested and analyzed with experimental data. The results indicate that the geometry and topological relations of 3D cadastral objects can be represented in a multidimensional manner with an intuitive topological structure and a unified dimensional expression.

  11. Comparative analysis of dose-volume histograms between 3D conformal and conventional non-conformal radiotherapy planning for prostate cancer; Analise comparativa dos histogramas de dose e volume entre planejamentos tridimensionais conformados e convencionais nao conformados na radioterapia do cancer de prostata

    Energy Technology Data Exchange (ETDEWEB)

    Feitosa, Silvia Moreira; Giordani, Adelmo Jose; Dias, Rodrigo Sousa; Segreto, Helena Regina Comodo; Segreto, Roberto Araujo [Universidade Federal de Sao Paulo (UNIFESP-EPM), Sao Paulo, SP (Brazil)], e-mail: silviamfeitosa@yahoo.com.br

    2009-03-15

    Objective: The present study was aimed at comparing conformal and non-conformal radiotherapy plans designed for patients with prostate cancer, by analyzing radiation doses in target volumes and organs at risk. Materials and methods: Radiotherapy plans for 40 patients with prostate cancer were analyzed. Conformal, conformal isocentric and non-conformal plans utilizing the source-surface distance were simulated for each of the patients for comparison of radiation dose in target volumes and organs at risk. For comparison purposes, dose-volume histograms for target volumes and organs at risk were analyzed. Results: Median doses were significantly lower in the conformal planning, with 25%, 40% and 60% volumes in the rectum and 30% and 60% in the bladder. The median doses were significantly lower in the conformal planning analyzing the right and left coxofemoral joints. Maximum, mean and median doses in the clinical target volume and in the planned target volume were significantly higher in the conformal planning. Conclusion: The present study has demonstrated that the conformal radiotherapy planning for prostate cancer allows the delivery of higher doses to the target volume and lower doses to adjacent healthy tissues. (author)

  12. [Conformal radiotherapy of prostatic cancer: a general review].

    Science.gov (United States)

    Chauvet, B; Oozeer, R; Bey, P; Pontvert, D; Bolla, M

    1999-01-01

    Recent progress in radiotherapeutic management of localized prostate cancer is reviewed. Clinical aspects--including dose-effect beyond 70 Gy, relative role of conformal radiation therapy techniques and of early hormonal treatment--are discussed as well as technical components--including patient immobilization, organ motion, prostate contouring, beam arrangement, 3-D treatment planning and portal imaging. The local control and biological relapse-free survival rates appear to be improved by high dose conformal radiotherapy from 20 to 30% for patients with intermediate and high risk of relapse. A benefit of overall survival is expected but not yet demonstrated. Late reactions, especially the rectal toxicity, remain moderate despite the dose escalation. However, conformal radiotherapy demands a high precision at all steps of the procedure.

  13. Film dosimetry in conformal radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Danciu, C.; Proimos, B.S. [Patras Univ. (Greece). Dept. of Medical Physics

    1995-12-01

    Dosimetry, through a film sandwiched in a transverse cross-section of a solid phantom, is a method of choice in Conformal Radiotherapy because: (a) the blackness (density) of the film at each point offers a measure of the total dose received at that point, and (b) the film is easily calibrated by exposing a film strip in the same cross-section, through a stationary field. The film must therefore have the following properties: (a) it must be slow, in order not to be overexposed, even at a therapeutic dose of 200 cGy, and (b) the response of the film (density versus dose curve) must be independent of the photon energy spectrum. A few slow films were compared. It was found that the Kodak X-Omat V for therapy verification was the best choice. To investigate whether the film response was independent of the photon energy, response curves for six depths, starting from the depth of maximum dose to the depth of 25 cm, in solid phantom were derived. The vertical beam was perpendicular to the anterior surface of the phantom, which was at the distance of 100 cm from the source and the field was 15x15 cm at that distance. This procedure was repeated for photon beams emitted by a Cobalt-60 unit, two 6 MV and 15 MV Linear Accelerators, as well as a 45 MV Betatron. For each of those four different beams the film response was the same for all six depths. The results, as shown in the diagrams, are very satisfactory. The response curve under a geometry similar to that actually applied, when the film is irradiated in a transverse cross-section of the phantom, was derived. The horizontal beam was almost parallel (angle of 85) to the plane of the film. The same was repeated with the central ray parallel to the film (angle 90) and at a distance of 1.5 cm from the horizontal film. The field size was again 15x15 at the lateral entrance surface of the beam. The response curves remained the same, as when the beam was perpendicular to the films.

  14. [Dosimetric evaluation of conformal radiotherapy: conformity factor].

    Science.gov (United States)

    Oozeer, R; Chauvet, B; Garcia, R; Berger, C; Felix-Faure, C; Reboul, F

    2000-01-01

    The aim of three-dimensional conformal therapy (3DCRT) is to treat the Planning Target Volume (PTV) to the prescribed dose while reducing doses to normal tissues and critical structures, in order to increase local control and reduce toxicity. The evaluation tools used for optimizing treatment techniques are three-dimensional visualization of dose distributions, dose-volume histograms, tumor control probabilities (TCP) and normal tissue complication probabilities (NTCP). These tools, however, do not fully quantify the conformity of dose distributions to the PTV. Specific tools were introduced to measure this conformity for a given dose level. We have extended those definitions to different dose levels, using a conformity index (CI). CI is based on the relative volumes of PTV and outside the PTV receiving more than a given dose. This parameter has been evaluated by a clinical study including 82 patients treated for lung cancer and 82 patients treated for prostate cancer. The CI was low for lung dosimetric studies (0.35 at the prescribed dose 66 Gy) due to build-up around the GTV and to spinal cord sparing. For prostate dosimetric studies, the CI was higher (0.57 at the prescribed dose 70 Gy). The CI has been used to compare treatment plans for lung 3DCRT (2 vs 3 beams) and prostate 3DCRT (4 vs 7 beams). The variation of CI with dose can be used to optimize dose prescription.

  15. Conformal radiotherapy of prostate carcinoma: Procedure description

    Directory of Open Access Journals (Sweden)

    Erak Marko

    2011-01-01

    Full Text Available Introduction. Today, three-dimensional conformal radiotherapy is a standard way in the radical treatment of localized prostate cancer, and it is an alternative to the radical prostatectomy. This method of radiotherapy treatment is widely accepted in the treatment of prostate cancer patients, and provides irradiation of targeted volume (prostate, seminal vesicles with dose escalation sparing the surrounding healthy tissues (rectum, bladder at the same time. That is not possible with the conventional twodimension technique. Procedure description. Three-dimensional conformal radiotherapy is a volumetric, visual simulation according to the computed tomography slices; it defines the tumour and organ at risk individually in each patient. Results of several studies have shown that there is a significant decrease in the development of acute toxicity when prostate cancer patients are treated with conformal radiotherapy. High dose irradiation gives excellent results in treatment of localized prostate carcinoma and improves treatment results in the patients with locally advanced carcinoma of prostate. Discussion. Prostate carcinoma irradiation techniques have been changed dramatically during recent years. Data obtained by computed tomography are important since the size and shapes of the prostate as well as its anatomic relations towards the rectum and bladder are considerably different in individual patients. The three-dimension plan of irradiation can be designed for each patient individually by performing computed tomography technique when planning radiotherapy. Conclusion. The advanced planning systems for conformal radiotherapy can reconstruct the anatomic structures of pelvis in three-dimension technique on the basis of computed tomography scans, which provides better conformality between the irradiation beam and geometrical shape of the tumour with minimal irradiation of the surrounding healthy tissue.

  16. Three dimensional conformal postoperative radiotherapy for ...

    African Journals Online (AJOL)

    Azza Helal

    2013-06-17

    Jun 17, 2013 ... showed the best dose homogeneity and conformity and lowest max dose to PTV and to the ... nique, size of treatment field, total dose and dose/fraction.6,7 ..... Cooperative Group: the role of radiotherapy in the treatment of.

  17. Estimated risk of cardiovascular disease and secondary cancers with modern highly conformal radiotherapy for early-stage mediastinal Hodgkin lymphoma

    DEFF Research Database (Denmark)

    Maraldo, M V; Brodin, N P; Aznar, M C;

    2013-01-01

    Hodgkin lymphoma (HL) survivors have an increased morbidity and mortality from secondary cancers and cardiovascular disease (CD). We evaluate doses with involved node radiotherapy (INRT) delivered as 3D conformal radiotherapy (3D CRT), volumetric modulated arc therapy (VMAT), or proton therapy (PT...

  18. Adjuvant radiotherapy for gallbladder cancer: A dosimetric comparison of conformal radiotherapy and intensity-modulated radiotherapy

    Institute of Scientific and Technical Information of China (English)

    Xiao-Nan Sun; Qi Wang; Ben-Xing Gu; Yan-Hong Zhu; Jian-Bin Hu; Guo-Zhi Shi; Shu Zheng

    2011-01-01

    AIM: To assess the efficacy and toxicity of conformal radiotherapy (CRT) and compare with intensity-modulated radiotherapy (IMRT) in the treatment of gallbladder cancer.METHODS: Between November 2003 and January 2010, 20 patients with gallbladder cancer were treated with CRT with or without chemotherapy after surgical resection. Preliminary survival data were collected and examined using both Kaplan-Meier and actuarial analysis. Demographic and treatment parameters were collected. All patients were planned to receive 46-56 Gy in 1.8 or 2.0 Gy per fraction. CRT planning was compared with IMRT.RESULTS: The most common reported acute toxicities requiring medication (Radiation Therapy Oncology Group, Radiation Therapy Oncology Group Grade2) were nausea (10/20 patients) and diarrhea (3/20).There were no treatment-related deaths. Compared with CRT planning, IMRT significantly reduced the volume of right kidney receiving > 20 Gy and the volume of liver receiving > 30 Gy. IMRT has a negligible impact on the volume of left kidney receiving > 20 Gy. The 95% of prescribed dose for a planning tumor volume using either 3D CRT or IMRT planning were 84.0% ±6.7%, 82.9% ± 6.1%, respectively (P > 0.05).CONCLUSION: IMRT achieves similar excellent target coverage as compared with CRT planning, while reducingthe mean liver dose and volume above threshold dose. IMRT offers better sparing of the right kidney compared with CRT planning, with a significantly lower mean dose and volume above threshold dose.

  19. Class solution to decrease rectal dose in prostate radiotherapy treatments 3D-CRT; Solucion de clase para disminuir dosis en recto en tratamientos de prostata con radioterapia 3D-CRT

    Energy Technology Data Exchange (ETDEWEB)

    Andres Rodriguez, C.; Tortosa Oliver, R.; Alonso Hernandez, D.; Mari Palacios, A.; Castillo Belmonte, A. del

    2011-07-01

    This paper contains a method developed in our center with conventional 3D radiotherapy techniques to increase the dose conformation around the target volume in prostate cancer treatments significantly reduced the doses to the rectum. To evaluate the goodness of the method, the results are compared with two classical techniques of treatment.

  20. A dosimetric comparison of 3D conformal vs intensity modulated vs volumetric arc radiation therapy for muscle invasive bladder cancer

    Directory of Open Access Journals (Sweden)

    Foroudi Farshad

    2012-07-01

    Full Text Available Abstract Background To compare 3 Dimensional Conformal radiotherapy (3D-CRT with Intensity Modulated Radiotherapy (IMRT with Volumetric-Modulated Arc Therapy (VMAT for bladder cancer. Methods Radiotherapy plans for 15 patients with T2-T4N0M0 bladder cancer were prospectively developed for 3-DCRT, IMRT and VMAT using Varian Eclipse planning system. The same radiation therapist carried out all planning and the same clinical dosimetric constraints were used. 10 of the patients with well localised tumours had a simultaneous infield boost (SIB of the primary tumour planned for both IMRT and VMAT. Tumour control probabilities and normal tissue complication probabilities were calculated. Results Mean planning time for 3D-CRT, IMRT and VMAT was 30.0, 49.3, and 141.0 minutes respectively. The mean PTV conformity (CI index for 3D-CRT was 1.32, for IMRT 1.05, and for VMAT 1.05. The PTV Homogeneity (HI index was 0.080 for 3D-CRT, 0.073 for IMRT and 0.086 for VMAT. Tumour control and normal tissue complication probabilities were similar for 3D-CRT, IMRT and VMAT. The mean monitor units were 267 (range 250–293 for 3D-CRT; 824 (range 641–1083 for IMRT; and 403 (range 333–489 for VMAT (P  Conclusions VMAT is associated with similar dosimetric advantages as IMRT over 3D-CRT for muscle invasive bladder cancer. VMAT is associated with faster delivery times and less number of mean monitor units than IMRT. SIB is feasible in selected patients with localized tumours.

  1. Acute side effects during 3-D-planned conformal radiotherapy of prostate cancer. Differences between patient's self-reported questionnaire and the corresponding doctor's report

    Energy Technology Data Exchange (ETDEWEB)

    Goldner, G.; Wachter-Gerstner, N.; Wachter, S.; Dieckmann, K.; Janda, M.; Poetter, R. [Dept. of Radiotherapy and Radiobiology, General Hospital of Vienna, Medical School, Univ. of Vienna (Austria)

    2003-05-01

    Background: Radiotherapy-induced side effects are often scored retrospectively according to the EORTC/RTOG scores for organs at risk by reviewing the medical records. Some studies could prove an over- or underestimation of side effects as assessed by the medical professionals. The aim of this study was to prospectively evaluate differences in side effects as described by the doctors and the patients. Patients and Methods: 47 patients with prostate cancer were questioned about their side effects by a radiotherapist and asked to fill in a questionnaire at the start, in the middle and at the end of radiotherapy. The data of this questionnaire and the doctor's report were scored according to the German version of the EORTC/RTOG scores for gastrointestinal (GI) and genitourinary (GU) side effects and subsequently compared. We distinguished between ''moderate'' disagreement (better/worse by one grade, assessed by the doctor) and ''pronounced'' disagreement (better/worse by two grades, assessed by the doctor). Results: The number of GI and GU side effects increased during radiotherapy both according to data obtained from the doctor and the patient questionnaire. Comparing doctors' reports with patients' questionnaires, for GI side effects an agreement was found in 22/47 patients, ''moderately better'' scores by the doctor's report were found in 13/47 patients, and ''moderately worse'' scores in 9/47 patients on average. ''Pronouncedly better and worse'' scores were found in 2/47 patients. For GU side effects an agreement was seen in 22/47 patients, ''moderately better'' scores in 17/47 patients and ''moderately worse'' scores in 3/47 patients. Regarding GU side effects, only pronouncedly better scores, as assessed by the doctor, were found in a mean of 4/47 patients. If the EORTC/RTOG score is used in its original

  2. Análise comparativa dos histogramas de dose e volume entre planejamentos tridimensionais conformados e convencionais não conformados na radioterapia do câncer de próstata Comparative analysis of dose-volume histograms between 3D conformal and conventional non-conformal radiotherapy plannings for prostate cancer

    Directory of Open Access Journals (Sweden)

    Sílvia Moreira Feitosa

    2009-04-01

    Full Text Available OBJETIVO: Analisar, comparativamente, doses de radiação em volumes alvos e órgãos de risco entre planejamentos conformados e não conformados em pacientes com câncer de próstata. MATERIAIS E MÉTODOS: No presente trabalho foram analisados planejamentos de 40 pacientes portadores de câncer de próstata. Foram realizados planejamentos conformados, não conformados isocêntricos e não conformados utilizando a distância fonte-superfície, simulados para cada caso, para comparação das doses em volumes alvos e órgãos de risco. Para a comparação foram analisados os histogramas de dose e volume para volumes alvos e órgãos de risco. RESULTADOS: As medianas das doses foram significativamente menores no planejamento conformado analisando-se os seguintes volumes no reto: 25%, 40% e 60%. As medianas das doses foram significativamente menores no planejamento conformado analisando-se os seguintes volumes na bexiga: 30% e 60%. As doses medianas foram significativamente menores no planejamento conformado analisando-se as articulações coxofemorais direita e esquerda. As doses máximas, médias e medianas no volume alvo clínico e no volume alvo planejado foram significativamente maiores no planejamento conformado. CONCLUSÃO: O presente estudo demonstrou que por meio do planejamento conformado em pacientes com câncer de próstata é possível entregar doses maiores no volume alvo e doses menores em órgãos de risco.OBJECTIVE: The present study was aimed at comparing conformal and non-conformal radiotherapy plans designed for patients with prostate cancer, by analyzing radiation doses in target volumes and organs at risk. MATERIALS AND METHODS: Radiotherapy plans for 40 patients with prostate cancer were analyzed. Conformal, conformal isocentric and non-conformal plans utilizing the source-surface distance were simulated for each of the patients for comparison of radiation dose in target volumes and organs at risk. For comparison purposes

  3. Evaluation of isocenter reproducibility in telemedicine of 3D-radiotherapy treatment planning

    Energy Technology Data Exchange (ETDEWEB)

    Hirota, Saeko; Tsujino, Kayoko; Kimura, Kouji; Takada, Yoshiki; Hishikawa, Yoshio; Kono, Michio [Hyogo Medical Center for Adults, Akashi (Japan); Soejima, Toshinori; Kodama, Akihisa

    2000-09-01

    To evaluate the utility in telemedicine of Three-Dimensional Radiotherapy Treatment Planning (tele-3D-RTP) and to examine the accuracy of isocenter reproducibility in its offline trial. CT data of phantoms and patients in the satellite hospital were transferred to our hospital via floppy-disk and 3D-radiotherapy plans were generated by 3D-RTP computer in our hospital. Profile data of CT and treatment beams in the satellite hospital were pre-installed into the computer. Tele-3D-RTPs were performed in 3 phantom plans and 14 clinical plans for 13 patients. Planned isocenters were well reproduced, especially in the immobilized head and neck/brain tumor cases, whose 3D-vector of aberration was 1.96{+-}1.38 (SD) mm. This teletherapy system is well applicable for practical use and can provides cost-reduction through sharing the resources of expensive equipment and radiation oncologists. (author)

  4. Dosimetric comparison of preoperative single-fraction partial breast radiotherapy techniques: 3D CRT, noncoplanar IMRT, coplanar IMRT, and VMAT.

    Science.gov (United States)

    Yoo, Sua; Blitzblau, Rachel; Yin, Fang-Fang; Horton, Janet K

    2015-01-08

    The purpose of this study was to compare dosimetric parameters of treatment plans among four techniques for preoperative single-fraction partial breast radiotherapy in order to select an optimal treatment technique. The techniques evaluated were noncoplanar 3D conformal radiation therapy (3D CRT), noncoplanar intensity-modulated radiation therapy (IMRTNC), coplanar IMRT (IMRTCO), and volumetric-modulated arc therapy (VMAT). The planning CT scans of 16 patients in the prone position were used in this study, with the single-fraction prescription doses of 15 Gy for the first eight patients and 18 Gy for the remaining eight patients. Six (6) MV photon beams were designed to avoid the heart and contralateral breast. Optimization for IMRT and VMAT was performed to reduce the dose to the skin and normal breast. All plans were normalized such that 100% of the prescribed dose covered greater than 95% of the clinical target volume (CTV) consisting of gross tumor volume (GTV) plus 1.5 cm margin. Mean homogeneity index (HI) was the lowest (1.05 ± 0.02) for 3D CRT and the highest (1.11 ± 0.04) for VMAT. Mean conformity index (CI) was the lowest (1.42 ± 0.32) for IMRTNC and the highest (1.60 ± 0.32) for VMAT. Mean of the maximum point dose to skin was the lowest (73.7 ± 11.5%) for IMRTNC and the highest (86.5 ± 6.68%) for 3D CRT. IMRTCO showed very similar HI, CI, and maximum skin dose to IMRTNC (differences radiotherapy, we can conclude that noncoplanar or coplanar IMRT were optimal in this study as IMRT plans provided homogeneous and conformal target coverage, skin sparing, and relatively short treatment delivery time.

  5. Conformal Radiotherapy: Physics, Treatment Planning and Verification. Proceedings book

    Energy Technology Data Exchange (ETDEWEB)

    De Wagter, C. [ed.

    1995-12-01

    The goal of conformal radiotherapy is to establish radiation dose distributions that conform tightly to the target volume in view of limiting radiation to normal tissues. Conformal radiotherapy significantly improves both local control and palliation and thus contributes to increase survival and to improve the quality of life. The subjects covered by the symposium include : (1) conformal radiotherapy and multi-leaf collimation; (2) three dimensional imaging; (3) treatment simulation, planning and optimization; (4) quality assurance; and (5) dosimetry. The book of proceedings contains the abstracts of the invited lectures, papers and poster presentations as well as the full papers of these contributions.

  6. Hypofractionated radiotherapy for localized prostate cancer using three-dimensional conformal radiotherapy technique: 3 years toxicity analysis

    Directory of Open Access Journals (Sweden)

    R White

    2015-01-01

    Full Text Available BACKGROUND: Hypofractionated radiotherapy in the radical treatment of localized prostate cancer has potential biological advantages relative to conventional fractionation. We report prospectively collected toxicity data from a cohort of patients treated with a 3D conformal technique (3DCRT. MATERIALS AND METHODS: 90 patients receiving curative intent hypofractionated radiotherapy with 57Gy in 19 daily fractions over 3.8 weeks were evaluated prospectively for the development of radiation related toxicity over a 3 year period. RESULTS: All patients completed treatment. Maximal acute toxicity experienced was 58.6, 10 and 1.1% for grade 1, 2 and 3 genitourinary (GU toxicity respectively and 75.6, 9 and 0% for gastrointestinal (GI toxicity. For late toxicity the three year actuarial rates of grade 1, 2 and 3 GU and GI toxicity respectively were 47.3, 2.4 and 0%; and 40, 9.3 and 4.7%. There were no grade 4 or worse acute or late toxicities. 97.6% of evaluable patients remained free of biochemical failure 36 months post radiotherapy. CONCLUSIONS: A 57Gy in 19 daily fraction radiotherapy schedule using 3D conformal radiotherapy for the definitive treatment of localized prostate cancer has acceptable early and late toxicity.

  7. Optimisation of beam-orientations in conformal radiotherapy treatment planning

    Energy Technology Data Exchange (ETDEWEB)

    Rowbottom, C.G

    1999-07-01

    Many synergistic advances have led to the beginnings of the routine use of conformal radiotherapy. These include advances in diagnostic imaging, in 3D treatment planning, in the technology for complex treatment delivery and in computer assessment of rival treatment plans. A conformal radiotherapy treatment plan more closely conforms the high-dose volume to the target volume, reducing the dose to normal healthy tissue. Traditionally, human planners have devised the treatment parameters used in radiotherapy treatment plans via a manually iterative process. Computer 'optimisation' algorithms have been shown to improve treatment plans as they can explore much more of the search space in a relatively short time. This thesis examines beam-orientation computer 'optimisation' in radiotherapy treatment planning and several new techniques were developed. Using these techniques a comparison was performed between treatment plans with 'standard', fixed beam-orientations and treatment plans with 'optimised' beam-orientations for patients with cancer of the prostate, oesophagus and brain. Plans were compared on the basis of dose-distributions and in some cases biological models for the probability of damage to the target volume and the major organs-at-risk (OARs) in each patient group. A cohort of patients was considered in each group to avoid bias from a specific patient geometry. In the case of the patient cohort with cancer of the prostate, a coplanar beam-orientation 'optimisation' scheme led to an average increase in the TCP of (5.7{+-}1.4)% compared to the standard plans after the dose to the isocentre had been scaled to produce a rectal NTCP of 1%. For the patient cohort with cancer of the oesophagus, the beam-orientation 'optimisation' scheme reduced the average lung NTCP by (0.7{+-}0.2)% at the expense of a modest increase in the average spinal cord NTCP of (0.1{+-}0.2)%. A non-coplanar beam-orientation &apos

  8. Effects of multiple conformers per compound upon 3-D similarity search and bioassay data analysis

    Directory of Open Access Journals (Sweden)

    Kim Sunghwan

    2012-11-01

    Full Text Available Abstract Background To improve the utility of PubChem, a public repository containing biological activities of small molecules, the PubChem3D project adds computationally-derived three-dimensional (3-D descriptions to the small-molecule records contained in the PubChem Compound database and provides various search and analysis tools that exploit 3-D molecular similarity. Therefore, the efficient use of PubChem3D resources requires an understanding of the statistical and biological meaning of computed 3-D molecular similarity scores between molecules. Results The present study investigated effects of employing multiple conformers per compound upon the 3-D similarity scores between ten thousand randomly selected biologically-tested compounds (10-K set and between non-inactive compounds in a given biological assay (156-K set. When the “best-conformer-pair” approach, in which a 3-D similarity score between two compounds is represented by the greatest similarity score among all possible conformer pairs arising from a compound pair, was employed with ten diverse conformers per compound, the average 3-D similarity scores for the 10-K set increased by 0.11, 0.09, 0.15, 0.16, 0.07, and 0.18 for STST-opt, CTST-opt, ComboTST-opt, STCT-opt, CTCT-opt, and ComboTCT-opt, respectively, relative to the corresponding averages computed using a single conformer per compound. Interestingly, the best-conformer-pair approach also increased the average 3-D similarity scores for the non-inactive–non-inactive (NN pairs for a given assay, by comparable amounts to those for the random compound pairs, although some assays showed a pronounced increase in the per-assay NN-pair 3-D similarity scores, compared to the average increase for the random compound pairs. Conclusion These results suggest that the use of ten diverse conformers per compound in PubChem bioassay data analysis using 3-D molecular similarity is not expected to increase the separation of non

  9. Evaluation of 3D-CRT, IMRT and VMAT radiotherapy plans for left breast cancer based on clinical dosimetric study.

    Science.gov (United States)

    Liu, Haiyun; Chen, Xinde; He, Zhijian; Li, Jun

    2016-12-01

    This paper aims to compare dosimetric differences based on three types of radiotherapy plans for postoperative left breast cancer. In particular, based on a clinical dosimetric study, the three-dimensional conformal radiotherapy (3D-CRT), intensity- modulated radiation therapy (IMRT) and VMAT plans were implemented on 15 cases of postoperative patients with left breast cancer with prescription doses of 5000cGy. Dose volume histogram (DVH) was used to analyze each evaluation index of clinical target volume (CTV) and organs at risk (OARs). Except for homogeneous index (HI), D2, each CTV evaluation index of 3D-CRT plan was inferior to IMRT and VMAT plans (Pplans, IMRT has a statistical significance only in Dmean, V95 (Pplan is much closer to the prescription dose with a V95 coverage rate as high as 97.44%. For the infected lung, V5, V10 of 3D-CRT were the lowest (Pplans. Here, the V5, V10 of infected lung were slightly higher (Pplans. Each evaluation index of the contralateral lung and heart in 3D-CRT was the lowest (Pplans, which were 1770.89±121.16cGy and 1839.92±92.77cGy, respectively. While D1 of the spinal cord in IMRT and VMAT plans was higher, which were 1990.12±61.52cGy and 1927.38±43.67cGy, respectively. When the radiation dose of 500-1500cGy was delivered to the normal tissues, 3D-CRT significantly shows the lowest volume, VMAT is relatively higher. Monitor Units (MU) and treatment time (T) of VMAT were the least, only 49.33% and 55.86% of those of IMRT. The three types of plans can meet the clinical dosimetry demands of postoperative radiotherapy for left breast cancer. The target of IMRT and VMAT plans has a better conformity, and the VMAT plan takes the advantages of less MU and treatment time. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Applications of three-dimensional image correlation in conformal radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Van Herk, M.; Gilhuijs, K.; Kwa, S.; Lebesque, J.; Muller, S.; De Munck, J.; Touw, A. [Nederlands Kanker Inst. `Antoni van Leeuwenhoekhuis`, Amsterdam (Netherlands); Kooy, H. [Harvard Medical School, Boston, MA (United States)

    1995-12-01

    The development of techniques for the registration of CT, MRI and SPECT creates new possibilities for improved target volume definition and quantitative image analysis. The discussed technique is based on chamfer matching and is suitable for automatic 3-D matching of CT with CT, CT with MRI, CT with SPECT and MRI with SPECT. By integrating CT with MRI, the diagnostic qualities of MRI are combined with the geometric accuracy of the planning CT. Significant differences in the delineation of the target volume for brain, head and neck and prostate tumors were demonstrated when using integrated CT and MRI compared with using CT alone. In addition, integration of the planning CT with pre-operative scans improves knowledge of possible tumor extents. By first matching scans based on the bony anatomy and subsequently matching on an organ of study, relative motion of the organ is quantified accurately. In a study with 42 CT scans of 11 patients, magnitude and causes of prostate motion were analysed. The most important motion of the prostate is a forward-backward rotation around a point near the apex caused by rectal volume difference. Significant correlations were also found between motion of the legs and the prostate. By integrating functional images made before and after radiotherapy with the planning CT, the relation between local change of lung function and delivered dose has been quantified accurately. The technique of chamfer matching is a convenient and more accurate alternative for the use of external markers in a CT/SPECT lung damage study. Also, damage visible in diagnostic scans can be related to radiation dose, thereby improving follow-up diagnostics. It can be concluded that 3-D image integration plays an important role in assessing and improving the accuracy of radiotherapy and is therefore indispensable for conformal therapy. However, user-friendly implementation of these techniques remains to be done to facilitate clinical application on a large scale.

  11. Estimating the costs of intensity-modulated and 3-dimensional conformal radiotherapy in Ontario.

    Science.gov (United States)

    Yong, J H E; McGowan, T; Redmond-Misner, R; Beca, J; Warde, P; Gutierrez, E; Hoch, J S

    2016-06-01

    Radiotherapy is a common treatment for many cancers, but up-to-date estimates of the costs of radiotherapy are lacking. In the present study, we estimated the unit costs of intensity-modulated radiotherapy (imrt) and 3-dimensional conformal radiotherapy (3D-crt) in Ontario. An activity-based costing model was developed to estimate the costs of imrt and 3D-crt in prostate cancer. It included the costs of equipment, staff, and supporting infrastructure. The framework was subsequently adapted to estimate the costs of radiotherapy in breast cancer and head-and-neck cancer. We also tested various scenarios by varying the program maturity and the use of volumetric modulated arc therapy (vmat) alongside imrt. From the perspective of the health care system, treating prostate cancer with imrt and 3D-crt respectively cost $12,834 and $12,453 per patient. The cost of radiotherapy ranged from $5,270 to $14,155 and was sensitive to analytic perspective, radiation technique, and disease site. Cases of head-and-neck cancer were the most costly, being driven by treatment complexity and fractions per treatment. Although imrt was more costly than 3D-crt, its cost will likely decline over time as programs mature and vmat is incorporated. Our costing model can be modified to estimate the costs of 3D-crt and imrt for various disease sites and settings. The results demonstrate the important role of capital costs in studies of radiotherapy cost from a health system perspective, which our model can accommodate. In addition, our study established the need for future analyses of imrt cost to consider how vmat affects time consumption.

  12. Estimating the costs of intensity-modulated and 3-dimensional conformal radiotherapy in Ontario

    Science.gov (United States)

    Yong, J.H.E.; McGowan, T.; Redmond-Misner, R.; Beca, J.; Warde, P.; Gutierrez, E.; Hoch, J.S.

    2016-01-01

    Background Radiotherapy is a common treatment for many cancers, but up-to-date estimates of the costs of radiotherapy are lacking. In the present study, we estimated the unit costs of intensity-modulated radiotherapy (imrt) and 3-dimensional conformal radiotherapy (3D-crt) in Ontario. Methods An activity-based costing model was developed to estimate the costs of imrt and 3D-crt in prostate cancer. It included the costs of equipment, staff, and supporting infrastructure. The framework was subsequently adapted to estimate the costs of radiotherapy in breast cancer and head-and-neck cancer. We also tested various scenarios by varying the program maturity and the use of volumetric modulated arc therapy (vmat) alongside imrt. Results From the perspective of the health care system, treating prostate cancer with imrt and 3D-crt respectively cost $12,834 and $12,453 per patient. The cost of radiotherapy ranged from $5,270 to $14,155 and was sensitive to analytic perspective, radiation technique, and disease site. Cases of head-and-neck cancer were the most costly, being driven by treatment complexity and fractions per treatment. Although imrt was more costly than 3D-crt, its cost will likely decline over time as programs mature and vmat is incorporated. Conclusions Our costing model can be modified to estimate the costs of 3D-crt and imrt for various disease sites and settings. The results demonstrate the important role of capital costs in studies of radiotherapy cost from a health system perspective, which our model can accommodate. In addition, our study established the need for future analyses of imrt cost to consider how vmat affects time consumption. PMID:27330359

  13. A novel conformal arc technique for postoperative whole pelvic radiotherapy for endometrial cancer.

    Science.gov (United States)

    Yang, Ruijie; Jiang, Weijuan; Wang, Junjie

    2009-12-01

    Conventional whole pelvic radiotherapy (WPRT) with 3-dimensional conformal radiotherapy (3D-CRT) exposes most of the contents of the true pelvis to the prescribed dose. Intensity-modulated radiation therapy (IMRT) provides more conformal dose distribution and better sparing of critical structures for WPRT. However, IMRT is more complicated in planning and delivery, requiring more expensive equipment and time-consuming quality assurance. We explore and evaluate a novel conformal arc radiotherapeutic technique for postoperative WPRT for endometrial cancer in this study. This technique involves 2-axis conformal arc therapy (2A-CAT) with 180-degree rotation around 2 isocenters each in 2 separate dose-shaping structures. Dosimetric comparison with 3D-CRT and IMRT for 10 endometrial cancer patients undergoing postoperative WPRT was performed to evaluate this new 2A-CAT technique. The mean conformity indices were 0.83, 0.61, and 0.88 for 2A-CAT, 3D-CRT, and IMRT, respectively. The mean homogeneity indices were 1.15, 1.08, and 1.10. The mean doses to bowel, rectum, bladder, and pelvic bone marrow were, respectively, 1.19, 3.39, 4.65, and 1.64 Gy lower with 2A-CAT than with 3D-CRT (P endometrial cancer, 2A-CAT significantly improves the dose conformity and sparing of bowel, rectum, and bladder compared with 3D-CRT. Despite dose uniformity and conformity being still inferior to those of IMRT, its simplicity and extensive availability combined with further improvement warrant it as a potential shortcut alternative to IMRT.

  14. Factors influencing conformity index in radiotherapy for non-small cell lung cancer.

    LENUS (Irish Health Repository)

    Brennan, Sinead M

    2010-01-01

    The radiotherapy conformity index (CI) is a useful tool to quantitatively assess the quality of radiotherapy treatment plans, and represents the relationship between isodose distributions and target volume. A conformity index of unity implies high planning target volume (PTV) coverage and minimal unnecessary irradiation of surrounding tissues. We performed this analysis to describe the CI for lung cancer 3-dimensional conformal radiotherapy (3DCRT) and to identify clinical and technical determinants of CI, as it is not known which factors are associated with good quality 3D conformal radiotherapy treatment planning. Radiotherapy treatment plans from a database of 52 patients with inoperable Stage 1 to 3b lung cancer, on a hypofractionated 3DCRT trial were evaluated. A CI was calculated for all plans using the definition of the ICRU 62:CI = (TV\\/PTV), which is the quotient of the treated volume (TV) and the PTV. Data on patient, tumor, and planning variables, which could influence CI, were recorded and analyzed. Mean CI was 2.01 (range = 1.06-3.8). On univariate analysis, PTV (p = 0.023), number of beams (p = 0.036), medial vs. lateral tumor location (p = 0.016), and increasing tumor stage (p = 0.041) were associated with improved conformity. On multiple regression analysis, factors found to be associated with CI included central vs. peripheral tumor location (p = 0.041) and PTV size (p = 0.058). The term 3DCRT is used routinely in the literature, without any indication of the degree of conformality. We recommend routine reporting of conformity indices. Conformity indices may be affected by both planning variables and tumor factors.

  15. Factors influencing conformity index in radiotherapy for non-small cell lung cancer.

    Science.gov (United States)

    Brennan, Sinead M; Thirion, Pierre; Buckney, Steve; Shea, Carmel O; Armstrong, John

    2010-01-01

    The radiotherapy conformity index (CI) is a useful tool to quantitatively assess the quality of radiotherapy treatment plans, and represents the relationship between isodose distributions and target volume. A conformity index of unity implies high planning target volume (PTV) coverage and minimal unnecessary irradiation of surrounding tissues. We performed this analysis to describe the CI for lung cancer 3-dimensional conformal radiotherapy (3DCRT) and to identify clinical and technical determinants of CI, as it is not known which factors are associated with good quality 3D conformal radiotherapy treatment planning. Radiotherapy treatment plans from a database of 52 patients with inoperable Stage 1 to 3b lung cancer, on a hypofractionated 3DCRT trial were evaluated. A CI was calculated for all plans using the definition of the ICRU 62:CI = (TV/PTV), which is the quotient of the treated volume (TV) and the PTV. Data on patient, tumor, and planning variables, which could influence CI, were recorded and analyzed. Mean CI was 2.01 (range = 1.06-3.8). On univariate analysis, PTV (p = 0.023), number of beams (p = 0.036), medial vs. lateral tumor location (p = 0.016), and increasing tumor stage (p = 0.041) were associated with improved conformity. On multiple regression analysis, factors found to be associated with CI included central vs. peripheral tumor location (p = 0.041) and PTV size (p = 0.058). The term 3DCRT is used routinely in the literature, without any indication of the degree of conformality. We recommend routine reporting of conformity indices. Conformity indices may be affected by both planning variables and tumor factors.

  16. Dosimetric comparison of postoperative whole pelvic radiotherapy for endometrial cancer using three-dimensional conformal radiotherapy, intensity-modulated radiotherapy, and helical tomotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Ruijie Yang; Weijuan Jiang; Junjie Wang [Dept. of Radiation Oncology, Cancer Center, Peking Univ. Third Hospital, Beijing (China)], E-mail: ruijyang@yahoo.com; Shouping Xu; Chuanbin Xie [Dept. of Radiation Oncology, General Hospital of the People' s Liberation ArmyBeijing (China)

    2010-02-15

    Background. The use of Intensity-modulated radiotherapy (IMRT) and Helical tomotherapy (HT) is increasing in gynecological cancer patients. No published studies have performed a dosimetric evaluation of whole pelvic radiotherapy (WPRT) using HT for postoperative endometrial cancer. The purpose of this study was to perform a direct dosimetric comparison of three-dimensional conformal radiotherapy (3D-CRT), IMRT and HT plans for WPRT in postoperative endometrial cancer patients, and to evaluate the integral dose to organs at risk (OARs) and normal tissue. Material and methods. We selected ten patients with endometrial cancer undergoing postoperative WPRT. Plans for 3D-CRT, IMRT and HT were developed for each patient. All plans were normalized to deliver 50 Gy to 95% of the PTV. The dosimetry and integral dose to OARs and normal tissue were compared. The significance of differences was tested using a paired two-tailed Student t-test. Results. IMRT were superior to 3D-CRT in dose conformity (conformity index: 0.87 vs. 0.61, p 0.00) and integral dose to OARs and normal tissue, although a greater volume of normal tissue receiving dose below 10 Gy was observed. The results were similar in HT except that the integral dose to normal tissue increased slightly. Compared directly with IMRT, HT showed better dose homogeneity and lower integral dose to rectum and bladder, but the integral dose to pelvic bones and normal tissue slightly increased. Conclusions. In postoperative WPRT of endometrial cancer, IMRT and HT result in better conformity and lower integral dose to OARs compared with 3D-CRT. The integral dose to normal tissue did not increase significantly in IMRT, although a greater volume of normal tissue is irradiated to the dose below 10 Gy. HT further improves the dose homogeneity and integral dose to rectum and bladder, at the expense of a slightly higher integral dose to pelvic bones and normal tissue.

  17. Dosimetric comparison of postoperative whole pelvic radiotherapy for endometrial cancer using three-dimensional conformal radiotherapy, intensity-modulated radiotherapy, and helical tomotherapy.

    Science.gov (United States)

    Yang, Ruijie; Xu, Shouping; Jiang, Weijuan; Wang, Junjie; Xie, Chuanbin

    2010-01-01

    The use of Intensity-modulated radiotherapy (IMRT) and Helical tomotherapy (HT) is increasing in gynecological cancer patients. No published studies have performed a dosimetric evaluation of whole pelvic radiotherapy (WPRT) using HT for postoperative endometrial cancer. The purpose of this study was to perform a direct dosimetric comparison of three-dimensional conformal radiotherapy (3D-CRT), IMRT and HT plans for WPRT in postoperative endometrial cancer patients, and to evaluate the integral dose to organs at risk (OARs) and normal tissue. We selected ten patients with endometrial cancer undergoing postoperative WPRT. Plans for 3D-CRT, IMRT and HT were developed for each patient. All plans were normalized to deliver 50 Gy to 95% of the PTV. The dosimetry and integral dose to OARs and normal tissue were compared. The significance of differences was tested using a paired two-tailed Student t-test. IMRT were superior to 3D-CRT in dose conformity (conformity index: 0.87 vs. 0.61, p = 0.00) and integral dose to OARs and normal tissue, although a greater volume of normal tissue receiving dose below 10 Gy was observed. The results were similar in HT except that the integral dose to normal tissue increased slightly. Compared directly with IMRT, HT showed better dose homogeneity and lower integral dose to rectum and bladder, but the integral dose to pelvic bones and normal tissue slightly increased. In postoperative WPRT of endometrial cancer, IMRT and HT result in better conformity and lower integral dose to OARs compared with 3D-CRT. The integral dose to normal tissue did not increase significantly in IMRT, although a greater volume of normal tissue is irradiated to the dose below 10 Gy. HT further improves the dose homogeneity and integral dose to rectum and bladder, at the expense of a slightly higher integral dose to pelvic bones and normal tissue.

  18. Dosimetric comparison of postoperative whole pelvic radiotherapy for endometrial cancer using three-dimensional conformal radiotherapy, intensity-modulated radiotherapy, and helical tomotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Ruijie Yang; Weijuan Jiang; Junjie Wang (Dept. of Radiation Oncology, Cancer Center, Peking Univ. Third Hospital, Beijing (China)), E-mail: ruijyang@yahoo.com; Shouping Xu; Chuanbin Xie (Dept. of Radiation Oncology, General Hospital of the People' s Liberation ArmyBeijing (China))

    2010-02-15

    Background. The use of Intensity-modulated radiotherapy (IMRT) and Helical tomotherapy (HT) is increasing in gynecological cancer patients. No published studies have performed a dosimetric evaluation of whole pelvic radiotherapy (WPRT) using HT for postoperative endometrial cancer. The purpose of this study was to perform a direct dosimetric comparison of three-dimensional conformal radiotherapy (3D-CRT), IMRT and HT plans for WPRT in postoperative endometrial cancer patients, and to evaluate the integral dose to organs at risk (OARs) and normal tissue. Material and methods. We selected ten patients with endometrial cancer undergoing postoperative WPRT. Plans for 3D-CRT, IMRT and HT were developed for each patient. All plans were normalized to deliver 50 Gy to 95% of the PTV. The dosimetry and integral dose to OARs and normal tissue were compared. The significance of differences was tested using a paired two-tailed Student t-test. Results. IMRT were superior to 3D-CRT in dose conformity (conformity index: 0.87 vs. 0.61, p 0.00) and integral dose to OARs and normal tissue, although a greater volume of normal tissue receiving dose below 10 Gy was observed. The results were similar in HT except that the integral dose to normal tissue increased slightly. Compared directly with IMRT, HT showed better dose homogeneity and lower integral dose to rectum and bladder, but the integral dose to pelvic bones and normal tissue slightly increased. Conclusions. In postoperative WPRT of endometrial cancer, IMRT and HT result in better conformity and lower integral dose to OARs compared with 3D-CRT. The integral dose to normal tissue did not increase significantly in IMRT, although a greater volume of normal tissue is irradiated to the dose below 10 Gy. HT further improves the dose homogeneity and integral dose to rectum and bladder, at the expense of a slightly higher integral dose to pelvic bones and normal tissue

  19. 3D conformal planning using low segment multi-criteria IMRT optimization

    CERN Document Server

    Khan, Fazal

    2014-01-01

    Purpose: To evaluate automated multicriteria optimization (MCO)-- designed for intensity modulated radiation therapy (IMRT), but invoked with limited segmentation -- to efficiently produce high quality 3D conformal treatment (3D-CRT) plans. Methods: Ten patients previously planned with 3D-CRT were replanned with a low-segment inverse multicriteria optimized technique. The MCO-3D plans used the same number of beams, beam geometry and machine parameters of the corresponding 3D plans, but were limited to an energy of 6 MV. The MCO-3D plans were optimized using a fluence-based MCO IMRT algorithm and then, after MCO navigation, segmented with a low number of segments. The 3D and MCO-3D plans were compared by evaluating mean doses to individual organs at risk (OARs), mean doses to combined OARs, homogeneity indexes (HI), monitor units (MUs), physician preference, and qualitative assessments of planning time and plan customizability. Results: The MCO-3D plans significantly reduced the OAR mean doses and monitor unit...

  20. Pelvic Ewing sarcomas. Three-dimensional conformal vs. intensity-modulated radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Mounessi, F.S.; Lehrich, P.; Haverkamp, U.; Eich, H.T. [Muenster Univ. (Germany). Dept. of Radiation Oncology; Willich, N. [Muenster Univ. (Germany). Dept. of Radiation Oncology; Universitaetsklinikum Muenster (Germany). RiSK - Registry for the Evaluation of Late Side Effects after Radiotherapy in Childhood and Adolescence; Boelling, T. [Center for Radiation Oncology, Osnabrueck (Germany)

    2013-04-15

    The goal of the present work was to assess the potential advantage of intensity-modulated radiotherapy (IMRT) over three-dimensional conformal radiotherapy (3D-CRT) planning in pelvic Ewing's sarcoma. A total of 8 patients with Ewing sarcoma of the pelvis undergoing radiotherapy were analyzed. Plans for 3D-CRT and IMRT were calculated for each patient. Dose coverage of the planning target volume (PTV), conformity and homogeneity indices, as well as further parameters were evaluated. Results The average dose coverage values for PTV were comparable in 3D-CRT and IMRT plans. Both techniques had a PTV coverage of V{sub 95} > 98 % in all patients. Whereas the IMRT plans achieved a higher conformity index compared to the 3D-CRT plans (conformity index 0.79 {+-} 0.12 vs. 0.54 {+-} 0.19, p = 0.012), the dose distribution across the target volumes was less homogeneous with IMRT planning than with 3D-CRT planning. This difference was statistically significant (homogeneity index 0.11 {+-} 0.03 vs. 0.07 {+-} 0.0, p = 0.035). For the bowel, D{sub mean} and D{sub 1%}, as well as V{sub 2} to V{sub 60} were reduced in IMRT plans. For the bladder and the rectum, there was no significant difference in D{sub mean}. However, the percentages of volumes receiving at least doses of 30, 40, 45, and 50 Gy (V{sub 30} to V{sub 50}) were lower for the rectum in IMRT plans. The volume of normal tissue receiving at least 2 Gy (V{sub 2}) was significantly higher in IMRT plans compared with 3D-CRT, whereas at high dose levels (V{sub 30}) it was significantly lower. Compared to 3D-CRT, IMRT showed significantly better results regarding dose conformity (p = 0.012) and bowel sparing at dose levels above 30 Gy (p = 0.012). Thus, dose escalation in the radiotherapy of pelvic Ewing's sarcoma can be more easily achieved using IMRT. (orig.)

  1. Algoritmo evolucionário para otimização do plano de tratamento em radioterapia conformal 3D

    Directory of Open Access Journals (Sweden)

    Marco César Goldbarg

    2009-08-01

    Full Text Available O planejamento do tratamento por radioterapia tem por objetivo atingir um volume alvo com altas doses de radiação tomando cuidado para não expor órgãos sadios a doses elevadas. É, portanto, muito importante que se encontre um balanço ideal entre esses objetivos conflitantes. O presente trabalho relata um modelo de programação matemática multiobjetivo e introduz um Algoritmo Transgenético para o problema de seleção do direcionamento dos feixes de radiação no planejamento em radioterapia conformal 3D. A seleção das direções dos feixes é feita através de uma técnica denominada de isocentros variáveis. Com a finalidade de testar o potencial do algoritmo desenvolvido, realiza-se um experimento comparativo com um Algoritmo Genético Multiobjetivo. O experimento computacional obtém dados quantitativos e qualitativos que são analisados no trabalho.The radiotherapy treatment planning aims to achieve a target volume with high doses of radiation taking care not to expose healthy organs to high doses. It is therefore very important to find an optimal balance between these conflicting goals. This paper reports a mathematical model of multiobjective programming and presents a Transgenetic Algorithm for the problem of selecting the direction of radiation beams in 3D conformal radiotherapy planning. The selection of beams directions is done with a technique called variable isocenters. In order to test the potential of the developed algorithm, a comparative experiment with a multiobjective genetic algorithm was done. The computational experiment obtains quantitative and qualitative data that are analyzed in this paper.

  2. The role of stereotactically guided conformal radiotherapy for local tumor control of esthesioneuroblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Zabel, A.; Thilmann, C.; Zuna, I. [Deutsches Krebsforschungszentrum, Heidelberg (Germany). Dept. of Radiotherapy; Milker-Zabel, S.; Wannenmacher, M. [Heidelberg Univ. (Germany). Dept. of Radiotherapy; Schlegel, W. [Deutsches Krebsforschungszentrum, Heidelberg (Germany). Dept. of Medical Physics; Debus, J. [Deutsches Krebsforschungszentrum, Heidelberg (Germany). Dept. of Radiotherapy; Heidelberg Univ. (Germany). Dept. of Radiotherapy

    2002-04-01

    Background: In a retrospective analysis we compared conventional radiotherapy and stereotactically guided conformal radiotherapy (SCRT) in patients with esthesioneuroblastoma. Patients and Methods: Between 1991 and 1999 14 patients with esthesioneuroblastoma underwent radiotherapy at our institution. Median follow-up was 30 months (range 12-107 months). Treatment included adjuvant radiotherapy (9), adjuvant radiochemotherapy (3) or radiotherapy alone (2). Eight patients received SCRT with 3-D treatment planning. For comparison a standard three-field plan for these patients and dose-volume histogram analyses were performed. Median total dose was 64 Gy using SCRT and 56 Gy with standard technique. Results: Local tumor control rate was 50% with conventional radiotherapy and 75% with SCRT. Overall survival was 33.3% and 62.5%, respectively. Target coverage could be improved statistically significant (p < 0.05) and dose to critical structures was reduced using SCRT. Greatest differences were seen regarding volume above the 30%-isodose as well as mean dose of brain stem (p < 0.05). A reduction of maximum dose was seen using SCRT as consequence of a more homogeneous treatment. Conclusions: SCRT improves target coverage and sparing of organs at risk. Our clinical data although with low patient numbers suggest that the technical advantage translates into a clinical advantage. The use of SCRT appears to facilitate higher dose prescriptions without risking major acute and late side effects. Thus the risk of complications in this area is minimized. Adjuvant radiotherapy is a save and effective treatment modality for local control of esthesioneuroblastoma. (orig.)

  3. Virtual 3D tumor marking-exact intraoperative coordinate mapping improve post-operative radiotherapy

    Directory of Open Access Journals (Sweden)

    Essig Harald

    2011-11-01

    Full Text Available Abstract The quality of the interdisciplinary interface in oncological treatment between surgery, pathology and radiotherapy is mainly dependent on reliable anatomical three-dimensional (3D allocation of specimen and their context sensitive interpretation which defines further treatment protocols. Computer-assisted preoperative planning (CAPP allows for outlining macroscopical tumor size and margins. A new technique facilitates the 3D virtual marking and mapping of frozen sections and resection margins or important surgical intraoperative information. These data could be stored in DICOM format (Digital Imaging and Communication in Medicine in terms of augmented reality and transferred to communicate patient's specific tumor information (invasion to vessels and nerves, non-resectable tumor to oncologists, radiotherapists and pathologists.

  4. Image-driven, model-based 3D abdominal motion estimation for MR-guided radiotherapy

    Science.gov (United States)

    Stemkens, Bjorn; Tijssen, Rob H. N.; de Senneville, Baudouin Denis; Lagendijk, Jan J. W.; van den Berg, Cornelis A. T.

    2016-07-01

    Respiratory motion introduces substantial uncertainties in abdominal radiotherapy for which traditionally large margins are used. The MR-Linac will open up the opportunity to acquire high resolution MR images just prior to radiation and during treatment. However, volumetric MRI time series are not able to characterize 3D tumor and organ-at-risk motion with sufficient temporal resolution. In this study we propose a method to estimate 3D deformation vector fields (DVFs) with high spatial and temporal resolution based on fast 2D imaging and a subject-specific motion model based on respiratory correlated MRI. In a pre-beam phase, a retrospectively sorted 4D-MRI is acquired, from which the motion is parameterized using a principal component analysis. This motion model is used in combination with fast 2D cine-MR images, which are acquired during radiation, to generate full field-of-view 3D DVFs with a temporal resolution of 476 ms. The geometrical accuracies of the input data (4D-MRI and 2D multi-slice acquisitions) and the fitting procedure were determined using an MR-compatible motion phantom and found to be 1.0-1.5 mm on average. The framework was tested on seven healthy volunteers for both the pancreas and the kidney. The calculated motion was independently validated using one of the 2D slices, with an average error of 1.45 mm. The calculated 3D DVFs can be used retrospectively for treatment simulations, plan evaluations, or to determine the accumulated dose for both the tumor and organs-at-risk on a subject-specific basis in MR-guided radiotherapy.

  5. SU-E-T-538: Lung SBRT Dosimetric Comparison of 3D Conformal and RapidArc Planning

    Energy Technology Data Exchange (ETDEWEB)

    Jiang, R; Zhan, L; Osei, E [Grand River Hospital, Kitchener, ON (Canada)

    2015-06-15

    Purpose: Dose distributions of RapidArc Plan can be quite different from standard 3D conformal radiation therapy. SBRT plans can be optimized with high conformity or mimic the 3D conformal treatment planning with very high dose in the center of the tumor. This study quantifies the dosimetric differences among 3D conformal plan; flattened beam and FFF beam RapidArc Plans for lung SBRT. Methods: Five lung cancer patients treated with 3D non-coplanar SBRT were randomly selected. All the patients were CT scanned with 4DCT to determine the internal target volume. Abdominal compression was applied to minimize respiratory motion for SBRT patients. The prescription dose was 48 Gy in 4 fractions. The PTV coverage was optimized by two groups of objective function: one with high conformity, another mimicking 3D conformal dose distribution with high dose in the center of PTV. Optimization constraints were set to meet the criteria of the RTOG-0915 protocol. All VMAT plans were optimized with the RapidArc technique using four full arcs in Eclipse treatment planning system. The RapidArc SBRT plans with flattened 6MV beam and 6MV FFF beam were generated and dosimetric results were compared with the previous treated 3D non-coplanar plans. Results: All the RapidArc plans with flattened beam and FFF beam had similar results for the PTV and OARs. For the high conformity optimization group, The DVH of PTV exhibited a steep dose fall-off outside the PTV compared to the 3D non-coplanar plan. However, for the group mimicking the 3D conformal target dose distribution, although the PTV is very similar to the 3D conformal plan, the ITV coverage is better than 3D conformal plan. Conclusion: Due to excellent clinical experiences of 3D conformal SBRT treatment, the Rapid Arc optimization mimicking 3D conformal planning may be suggested for clinical use.

  6. Effect of intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy on clinical outcomes in patients with glioblastoma multiforme

    Institute of Scientific and Technical Information of China (English)

    CHEN Yi-dong; FENG Jin; FANG Tong; YANG Ming; QIU Xiao-guang; JIANG Tao

    2013-01-01

    Background Few studies were reported on the comparison of clinical outcomes between intensity-modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3D-CRT) in the treatment of glioblastoma multiforme (GBM).This study aimed to determine whether IMRT improves clinical outcomes compared with 3D-CRT in patients with GBM.Methods The records of 54 patients with newly-diagnosed GBM from July 2009 to December 2010 were reviewed.The patients underwent postoperative IMRT or 3D-CRT with concurrent and adjuvant temozolomide.Kaplan-Meier method and log rank test were used to estimate differences of patients' survival.Results The median follow-up was 13 months.Of the 54 patients,fifty (92.6%) completed the combined modality treatment.The 1-year overall survival rate (OS) was 79.6%.The pattern of failure was predominantly local.A comparative analysis revealed that no statistical difference was observed between the IMRT group (n=21) and the 3D-CRT group (n=33) for 1-year OS (89.6% vs.75.8%,P=0.795),or 1-year progression-free survival (PFS) (61.0% vs.45.5%,P=0.867).In dosimetric comparison,IMRT seemed to allow better sparing of organs at risk than 3D-CRT did (P=0.050,P=0.055).However,there was no significant difference for toxicities of irradiation between the IMRT group and the 3D-CRT group.Conclusions Our preliminary results suggested that delivering standard radiation doses by IMRT is unlikely to improve local control or overall survival for GBM compared with 3D-CRT.Given this lack of survival benefit and increased costs of IMRT,the utilization of IMRT treatment for GBM needs to be carefully rationalized.

  7. Characterizing 3D printing in the fabrication of variable density phantoms for quality assurance of radiotherapy.

    Science.gov (United States)

    Madamesila, Joseph; McGeachy, Philip; Villarreal Barajas, J Eduardo; Khan, Rao

    2016-01-01

    To present characterization, process flow, and applications of 3D fabricated low density phantoms for radiotherapy quality assurance (QA). A Rostock 3D printer using polystyrene was employed to print slabs of varying relative electron densities (0.18-0.75). A CT scan was used to calibrate infill-to-density and characterize uniformity of the print. Two printed low relative density rods (0.18, 0.52) were benchmarked against a commercial CT-electron-density phantom. Density scaling of Anisotropic Analytical Algorithm (AAA) was tested with EBT3 film for a 0.57 slab. Gamma criterion of 3% and 3 mm was used for analysis. 3D printed slabs demonstrated uniformity for densities 0.4-0.75. The printed 0.52 rod had close agreement with the commercial phantom. Dosimetric comparison for 0.57 density slab showed >95% agreement between calculation and measurements. 3D printing allows fabrication of variable density phantoms for QA needs of a small clinic. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  8. Influences of Motion Artifacts on Three-Dimensional Reconstruction Volume and Conformal Radiotherapy Planning

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To investigate the influences of motion artifacts on three-dimensional (3D) reconstruction volume and conformal radiotherapy planning. Methods: A phantom which can mimic the clip motion of lung tumor along the cranial-caudal direction is constructed by step motor, small ball of polyethylene and potato. Ten different scan protocols were set and CT data of the phantom were acquired by using a commercial GE LightSpeed16 CT scanner. The 3D reconstruction of the CT data was implemented by adopting volume-rendering technology of GE AdvantageSim 6.0 system. The reconstructed volumes of each target in different scan protocols were measured through 3D measuring tools. Thus, relative deviations of the reconstruction volumes between moving targets and static ones were determined. The three-dimensional conformal radiation therapy (3DCRT) plans and conformal fields were created and compared for a static/moving target with the WiMRT treatment planning system (TPS). Results:For a static target, there was no obvious difference among the 3D reconstruction volumes when the CT data were acquired with different pitches and slices. The appearance of 3D reconstruction volume and 3D conformal field of a moving target was quite different from that of static one. The maximum relative deviation is nearly 90% for a moving target scanned with different scan protocols. The relative deviations are variable among the different targets, about from -39.8% to 89.5% for a smaller target and from -18.4% to 20.5% for a larger one.Conclusion:The motion artifacts have great effects on 3D-CRT planning and reconstruction volume, which will greatly induce distorted conformal radiation fields and false DVHs for a moving target.

  9. Dosimetric evaluation of the skin-sparing effects of 3-dimensional conformal radiotherapy and intensity-modulated radiotherapy for left breast cancer.

    Science.gov (United States)

    Jo, In Young; Kim, Shin-Wook; Son, Seok Hyun

    2017-01-10

    The purpose of this study was to evaluate the skin-sparing effects of 3-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) in patients with early left-sided breast cancer. Twenty left breast cancer patients treated with whole breast radiotherapy following breast-conserving surgery were enrolled in this study, and the 3D-CRT and IMRT plans were generated for each patient. To evaluate the dose delivered to the skin, 2 mm thickness skin (2-mm skin) and 3 mm thickness skin (3-mm skin) were contoured and a dosimetric comparison between the 2 plans was performed. The target volume coverage was better in IMRT than in 3D-CRT. The mean dose was 50.8 Gy for 3D-CRT and 51.1 Gy for IMRT. V40Gy was 99.4% for 3D-CRT and 99.9% for IMRT. In the case of skin, the mean dose was higher in 3D-CRT than in IMRT (mean dose of 2-mm skin: 32.8 Gy and 24.2 Gy; mean dose of 3-mm skin: 37.2 Gy and 27.8 Gy, for 3D-CRT and IMRT, respectively). These results indicated that the skin-sparing effect is more prominent in IMRT compared to 3D-CRT without compromising the target volume coverage.

  10. Selection of candidate wells and optimization of conformance treatment design in the Barrancas Field using a 3D conformance simulator

    Energy Technology Data Exchange (ETDEWEB)

    Crosta, Dante; Elitseche, Luis [Repsol YPF (Argentina); Gutierrez, Mauricio; Ansah, Joe; Everett, Don [Halliburton Argentina S.A., Buenos Aires (Argentina)

    2004-07-01

    Minimizing the amount of unwanted water production is an important goal at the Barrancas field. This paper describes a selection process for candidate injection wells that is part of a pilot conformance project aimed at improving vertical injection profiles, reducing water cut in producing wells, and improving ultimate oil recovery from this field. The well selection process is based on a review of limited reservoir information available for this field to determine inter-well communications. The methodology focuses on the best use of available information, such as production and injection history, well intervention files, open hole logs and injectivity surveys. After the candidate wells were selected and potential water injection channels were identified, conformance treatment design and future performance of wells in the selected pilot area were evaluated using a new 3 -D conformance simulator, developed specifically for optimization of the design and placement of unwanted fluid shut-off treatments. Thus, when acceptable history match ing of the pilot area production was obtained, the 3 -D simulator was used to: evaluate the required volume of selected conformance treatment fluid; review expected pressures and rates during placement;. model temperature behavior; evaluate placement techniques, and forecast water cut reduction and incremental oil recovery from the producers in this simulated section of the pilot area. This paper outlines a methodology for selecting candidate wells for conformance treatments. The method involves application of several engineering tools, an integral component of which is a user-friendly conformance simulator. The use of the simulator has minimized data preparation time and allows the running of sensitivity cases quickly to explore different possible scenarios that best represent the reservoir. The proposed methodology provides an efficient means of identifying conformance problems and designing optimized solutions for these individual

  11. CONSERVATIVE TREATMENT IN LOCALLY AND LOCALLY-ADVANCED PROSTATE CANCER USING CONFORMAL RADIOTHERAPY

    Directory of Open Access Journals (Sweden)

    Tkachev Sergey Ivanovich

    2013-01-01

    Full Text Available The combination of androgen deprivation and radiotherapy increase the probability of diseases full regresses and survival rate. Modern technical and technological opportunities of 3D CRT allow to increase total dose to prostate up to 72-76Gy vs. radiotherapy of 66-70Gy. In this study we compare the rates of post radiation toxicity and the efficiency of treatment for the patients receiving conventional radiotherapy and 3D CRT. The use of 3D CRT has not only result to increase of 10-years recurrence free survival rate from 74% (I grope to 86,5% (II grope, р=0,01, but also to increase of 10-years overall survival, 70% versus 78,4% (р=0,04. The proposed version of conformal 3D CRT radiation therapy made ​​it possible compared to conventional 2D RT radiation therapy by increasing SOD radiation to the tumor, accuracy and compliance with the quality assurance of radiation therapy significantly reduce rates of recurrence and significantly increase the performance of 10-year overall and disease-free survival.

  12. Conformal perturbation of off-critical correlators in the 3D Ising universality class

    CERN Document Server

    Caselle, Michele; Magnoli, Nicodemo

    2016-01-01

    Thanks to the impressive progress of conformal bootstrap methods we have now very precise estimates of both scaling dimensions and OPE coefficients for several 3D universality classes. We show how to use this information to obtain similarly precise estimates for off-critical correlators using conformal perturbation. We discuss in particular the $$, $$ and $$ two point functions in the high and low temperature regimes of the 3D Ising model and evaluate the leading and next to leading terms in the $s = t r^{\\Delta_{t}}$ expansion, where $t$ is the reduced temperature. Our results for $$ agree both with Monte Carlo simulations and with a set of experimental estimates of the critical scattering function.

  13. Dosimetric Comparison of 3D Tangential Radiotherapy of Post-Lumpectomy Breast at Two Different Energies

    Directory of Open Access Journals (Sweden)

    Robab Anbiaee

    2011-06-01

    Full Text Available Introduction: Radiation therapy following breast conserving surgery is one of the most common procedures performed in any radiation oncology department. A tangential parallel-opposed pair is almost always the technique of choice for this purpose. This technique is often performed based on 3D treatment planning. The aim of this study was to compare 3D treatment planning for two different energies (Cobalt 60 versus 6 MV photon beams in tangential irradiation of breast conserving radiotherapy. In this comparison, homogeneity of isodoses within the breast volume and dose received by lungs were considered. Materials and Methods: In this study, twenty patients with breast cancer treated with conservative surgery were included. A CT scan was performed on selected patients. Three-dimensional treatment planning with 6 MV photon beams was carried out for patients on the  Eclipse 3D treatment planning system (TPS. The volumes receiving lower than 95% (Vol105 (hot areas of the reference dose, and the volume of lung receiving ≥30Gy (Vol≥30Gy were derived from dose volume histograms (DVHs. Dose homogeneity index was calculated as: DHI = 100 – (Vol>105 + Vol

  14. 3D Pattern Synthesis of Time-Modulated Conformal Arrays with a Multiobjective Optimization Approach

    Directory of Open Access Journals (Sweden)

    Wentao Li

    2014-01-01

    Full Text Available This paper addresses the synthesis of the three-dimensional (3D radiation patterns of the time-modulated conformal arrays. Due to the nature of periodic time modulation, harmonic radiation patterns are generated at the multiples of the modulation frequency in time-modulated arrays. Thus, the optimization goal of the time-modulated conformal array includes the optimization of the sidelobe level at the operating frequency and the sideband levels (SBLs at the harmonic frequency, and the design can be regarded as a multiobjective problem. The multiobjective particle swarm optimization (MOPSO is applied to optimize the switch-on instants and pulse durations of the time-modulated conformal array. To significantly reduce the optimization variables, the modified Bernstein polynomial is employed in the synthesis process. Furthermore, dual polarized patch antenna is designed as radiator to achieve low cross-polarization level during the beam scanning. A 12 × 13 (156-element conical conformal microstrip array is simulated to demonstrate the proposed synthesis mechanism, and good results reveal the promising ability of the proposed algorithm in solving the synthesis of the time-modulated conformal arrays problem.

  15. Intensity modulated radiotherapy as neoadjuvant chemoradiation for the treatment of patients with locally advanced pancreatic cancer. Outcome analysis and comparison with a 3D-treated patient cohort

    Energy Technology Data Exchange (ETDEWEB)

    Combs, S.E.; Habermehl, D.; Kessel, K.; Brecht, I. [Univ. Hospital of Heidelberg (Germany). Dept. of Radiation Oncology; Bergmann, F.; Schirmacher, P. [Univ. Hospital of Heidelberg (Germany). Dept. of Pathology; Werner, J.; Buechler, M.W. [Univ. Hospital of Heidelberg (Germany). Dept. of Surgery; Jaeger, D. [National Center for Tumor Diseases (NCT), Heidelberg (Germany); Debus, J. [Univ. Hospital of Heidelberg (Germany). Dept. of Radiation Oncology; Deutsches Krebsforschungszentrum (DKFZ), Heidelberg (Germany). Clinical Cooperation Unit Radiation Oncology

    2013-09-15

    Background: To evaluate outcome after intensity modulated radiotherapy (IMRT) compared to 3D conformal radiotherapy (3D-RT) as neoadjuvant treatment in patients with locally advanced pancreatic cancer (LAPC). Materials and methods: In total, 57 patients with LAPC were treated with IMRT and chemotherapy. A median total dose of 45 Gy to the PTV {sub baseplan} and 54 Gy to the PTV {sub boost} in single doses of 1.8 Gy for the PTV {sub baseplan} and median single doses of 2.2 Gy in the PTV {sub boost} were applied. Outcomes were evaluated and compared to a large cohort of patients treated with 3D-RT. Results: Overall treatment was well tolerated in all patients and IMRT could be completed without interruptions. Median overall survival was 11 months (range 5-37.5 months). Actuarial overall survival at 12 and 24 months was 36 % and 8 %, respectively. A significant impact on overall survival could only be observed for a decrease in CA 19-9 during treatment, patients with less pre-treatment CA 19-9 than the median, as well as weight loss during treatment. Local progression-free survival was 79 % after 6 months, 39 % after 12 months, and 13 % after 24 months. No factors significantly influencing local progression-free survival could be identified. There was no difference in overall and progression-free survival between 3D-RT and IMRT. Secondary resectability was similar in both groups (26 % vs. 28 %). Toxicity was comparable and consisted mainly of hematological toxicity due to chemotherapy. Conclusion: IMRT leads to a comparable outcome compared to 3D-RT in patients with LAPC. In the future, the improved dose distribution, as well as advances in image-guided radiotherapy (IGRT) techniques, may improve the use of IMRT in local dose escalation strategies to potentially improve outcome. (orig.)

  16. Comparison of heart and coronary artery doses associated with intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy for distal esophageal cancer.

    Science.gov (United States)

    Kole, Thomas P; Aghayere, Osarhieme; Kwah, Jason; Yorke, Ellen D; Goodman, Karyn A

    2012-08-01

    To compare heart and coronary artery radiation exposure using intensity-modulated radiotherapy (IMRT) vs. four-field three-dimensional conformal radiotherapy (3D-CRT) treatment plans for patients with distal esophageal cancer undergoing chemoradiation. Nineteen patients with distal esophageal cancers treated with IMRT from March 2007 to May 2008 were identified. All patients were treated to 50.4 Gy with five-field IMRT plans. Theoretical 3D-CRT plans with four-field beam arrangements were generated. Dose-volume histograms of the planning target volume, heart, right coronary artery, left coronary artery, and other critical normal tissues were compared between the IMRT and 3D-CRT plans, and selected parameters were statistically evaluated using the Wilcoxon rank-sum test. Intensity-modulated radiotherapy treatment planning showed significant reduction (p coronary artery (average mean dose, 23.8 Gy vs. 35.5 Gy), whereas the left coronary artery showed no significant improvement (mean dose, 11.2 Gy vs. 9.2 Gy), p = 0.11. There was no significant difference in percentage of total lung volume receiving at least 10, 15, or 20 Gy or in the mean lung dose between the planning methods. There were also no significant differences observed for the kidneys, liver, stomach, or spinal cord. Intensity-modulated radiotherapy achieved a significant improvement in target conformity as measured by the conformality index (ratio of total volume receiving 95% of prescription dose to planning target volume receiving 95% of prescription dose), with the mean conformality index reduced from 1.56 to 1.30 using IMRT. Treatment of patients with distal esophageal cancer using IMRT significantly decreases the exposure of the heart and right coronary artery when compared with 3D-CRT. Long-term studies are necessary to determine how this will impact on development of coronary artery disease and other cardiac complications. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. 3D dosimetric validation of motion compensation concepts in radiotherapy using an anthropomorphic dynamic lung phantom.

    Science.gov (United States)

    Mann, P; Witte, M; Moser, T; Lang, C; Runz, A; Johnen, W; Berger, M; Biederer, J; Karger, C P

    2017-01-21

    In this study, we developed a new setup for the validation of clinical workflows in adaptive radiation therapy, which combines a dynamic ex vivo porcine lung phantom and three-dimensional (3D) polymer gel dosimetry. The phantom consists of an artificial PMMA-thorax and contains a post mortem explanted porcine lung to which arbitrary breathing patterns can be applied. A lung tumor was simulated using the PAGAT (polyacrylamide gelatin gel fabricated at atmospheric conditions) dosimetry gel, which was evaluated in three dimensions by magnetic resonance imaging (MRI). To avoid bias by reaction with oxygen and other materials, the gel was collocated inside a BAREX(™) container. For calibration purposes, the same containers with eight gel samples were irradiated with doses from 0 to 7 Gy. To test the technical feasibility of the system, a small spherical dose distribution located completely within the gel volume was planned. Dose delivery was performed under static and dynamic conditions of the phantom with and without motion compensation by beam gating. To verify clinical target definition and motion compensation concepts, the entire gel volume was homogeneously irradiated applying adequate margins in case of the static phantom and an additional internal target volume in case of dynamically operated phantom without and with gated beam delivery. MR-evaluation of the gel samples and comparison of the resulting 3D dose distribution with the planned dose distribution revealed a good agreement for the static phantom. In case of the dynamically operated phantom without motion compensation, agreement was very poor while additional application of motion compensation techniques restored the good agreement between measured and planned dose. From these experiments it was concluded that the set up with the dynamic and anthropomorphic lung phantom together with 3D-gel dosimetry provides a valuable and versatile tool for geometrical and dosimetrical validation of motion compensated

  18. 3D dosimetric validation of motion compensation concepts in radiotherapy using an anthropomorphic dynamic lung phantom

    Science.gov (United States)

    Mann, P.; Witte, M.; Moser, T.; Lang, C.; Runz, A.; Johnen, W.; Berger, M.; Biederer, J.; Karger, C. P.

    2017-01-01

    In this study, we developed a new setup for the validation of clinical workflows in adaptive radiation therapy, which combines a dynamic ex vivo porcine lung phantom and three-dimensional (3D) polymer gel dosimetry. The phantom consists of an artificial PMMA-thorax and contains a post mortem explanted porcine lung to which arbitrary breathing patterns can be applied. A lung tumor was simulated using the PAGAT (polyacrylamide gelatin gel fabricated at atmospheric conditions) dosimetry gel, which was evaluated in three dimensions by magnetic resonance imaging (MRI). To avoid bias by reaction with oxygen and other materials, the gel was collocated inside a BAREX™ container. For calibration purposes, the same containers with eight gel samples were irradiated with doses from 0 to 7 Gy. To test the technical feasibility of the system, a small spherical dose distribution located completely within the gel volume was planned. Dose delivery was performed under static and dynamic conditions of the phantom with and without motion compensation by beam gating. To verify clinical target definition and motion compensation concepts, the entire gel volume was homogeneously irradiated applying adequate margins in case of the static phantom and an additional internal target volume in case of dynamically operated phantom without and with gated beam delivery. MR-evaluation of the gel samples and comparison of the resulting 3D dose distribution with the planned dose distribution revealed a good agreement for the static phantom. In case of the dynamically operated phantom without motion compensation, agreement was very poor while additional application of motion compensation techniques restored the good agreement between measured and planned dose. From these experiments it was concluded that the set up with the dynamic and anthropomorphic lung phantom together with 3D-gel dosimetry provides a valuable and versatile tool for geometrical and dosimetrical validation of motion compensated

  19. A 2-D/3-D cartesian geometry non-conforming spherical harmonic neutron transport solver

    Energy Technology Data Exchange (ETDEWEB)

    Van Criekingen, S. [Laboratoire J.-L. Lions, Universite Pierre et Marie Curie, 175 rue du Chevaleret, 75013 Paris (France)]. E-mail: vancriekingen@ann.jussieu.fr

    2007-03-15

    A new 2-D/3-D transport core solver for the time-independent Boltzmann transport equation is presented. This solver, named FIESTA, is based on the second-order even-parity form of the transport equation. The angular discretization is performed through the expansion of the angular neutron flux into spherical harmonics (P {sub N} method). The novelty of this solver is the use of non-conforming finite elements for the spatial discretization. Such elements lead to a discontinuous scalar flux approximation. This interface continuity requirement relaxation property is shared with mixed-dual formulations discretized using Raviart-Thomas finite elements. Encouraging numerical results are presented.

  20. Fast 3D Pattern Synthesis with Polarization and Dynamic Range Ratio Control for Conformal Antenna Arrays

    Directory of Open Access Journals (Sweden)

    Massimiliano Comisso

    2014-01-01

    Full Text Available This paper proposes an iterative algorithm for the 3D synthesis of the electric far-field pattern of a conformal antenna array in the presence of requirements on both the polarization and the dynamic range ratio (DRR of the excitations. Thanks to the use of selectable weights, the algorithm allows a versatile control of the DRR and of the polarization in a given angular region and requires a low CPU time to provide the array excitations. Furthermore, a modified version of the algorithm is developed to enable the optimization of the polarization state by phase-only control. Numerical results are presented to verify the usefulness of the proposed approach for the joint pattern and polarization synthesis of conformal arrays with reduced or even unitary DRR.

  1. 3-D conformal HDR brachytherapy as monotherapy for localized prostate cancer. A pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Martin, T.; Baltas, D.; Kurek, R.; Roeddiger, S.; Kontova, M.; Anagnostopoulos, G.; Skazikis, G.; Zamboglou, N. [Dept. of Radiation Oncology, Klinikum Offenbach, Offenbach/Main (Germany); Dannenberg, T.; Buhleier, T.; Tunn, U. [Dept. of Urology, Klinikum Offenbach, Offenbach/Main (Germany)

    2004-04-01

    Purpose: pilot study to evaluate feasibility, acute toxicity and conformal quality of three-dimensional (3-D) conformal high-dose-rate (HDR) brachytherapy as monotherapy for localized prostate cancer using intraoperative real-time planning. Patients and methods: between 05/2002 and 05/2003, 52 patients with prostate cancer, prostate-specific antigen (PSA) {<=} 10 ng/ml, Gleason score {<=} 7 and clinical stage {<=} T2a were treated. Median PSA was 6.4 ng/ml and median Gleason score 5. 24/52 patients had stage T1c and 28/52 stage T2a. For transrectal ultrasound-(TRUS-)guided transperineal implantation of flexible plastic needles into the prostate, the real-time HDR planning system SWIFT trademark was used. After implantation, CT-based 3-D postplanning was performed. All patients received one implant for four fractions of HDR brachytherapy in 48 h using a reference dose (D{sub ref}) of 9.5 Gy to a total dose of 38.0 Gy. Dose-volume histograms (DVHs) were analyzed to evaluate the conformal quality of each implant using D{sub 90}, D{sub 10} urethra, and D{sub 10} rectum. Acute toxicity was evaluated using the CTC (common toxicity criteria) scales. Results: median D{sub 90} was 106% of D{sub ref} (range: 93-115%), median D{sub 10} urethra 159% of D{sub ref} (range: 127-192%), and median D{sub 10} rectum 55% of D{sub ref} (range: 35-68%). Median follow-up is currently 8 months. In 2/52 patients acute grade 3 genitourinary toxicity was observed. No gastrointestinal toxicity > grade 1 occurred. Conclusion: 3-D conformal HDR brachytherapy as monotherapy using intraoperative real-time planning is a feasible and highly conformal treatment for localized prostate cancer associated with minimal acute toxicity. Longer follow-up is needed to evaluate late toxicity and biochemical control. (orig.)

  2. A nanofiber based artificial electronic skin with high pressure sensitivity and 3D conformability.

    Science.gov (United States)

    Zhong, Weibin; Liu, Qiongzhen; Wu, Yongzhi; Wang, Yuedan; Qing, Xing; Li, Mufang; Liu, Ke; Wang, Wenwen; Wang, Dong

    2016-06-16

    Pressure sensors with 3D conformability are highly desirable components for artificial electronic skin or e-textiles that can mimic natural skin, especially for application in real-time monitoring of human physiological signals. Here, a nanofiber based electronic skin with ultra-high pressure sensitivity and 3D conformability is designed and built by interlocking two elastic patterned nanofibrous membranes. The patterned membrane is facilely prepared by casting conductive nanofiber ink into a silicon mould to form an array of semi-spheroid-like protuberances. The protuberances composed of intertwined elastic POE nanofibers and PPy@PVA-co-PE nanofibers afford a tunable effective elastic modulus that is capable of capturing varied strains and stresses, thereby contributing to a high sensitivity for pressure sensing. This electronic skin-like sensor demonstrates an ultra-high sensitivity (1.24 kPa(-1)) below 150 Pa with a detection limit as low as about 1.3 Pa. The pixelated sensor array and a RGB-LED light are then assembled into a circuit and show a feasibility for visual detection of spatial pressure. Furthermore, a nanofiber based proof-of-concept wireless pressure sensor with a bluetooth module as a signal transmitter is proposed and has demonstrated great promise for wireless monitoring of human physiological signals, indicating a potential for large scale wearable electronic devices or e-skin.

  3. Volumetric-modulated arc radiotherapy for pancreatic malignancies: Dosimetric comparison with sliding-window intensity-modulated radiotherapy and 3-dimensional conformal radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Nabavizadeh, Nima, E-mail: nabaviza@ohsu.edu; Simeonova, Anna O.; Waller, Joseph G.; Romer, Jeanna L.; Monaco, Debra L.; Elliott, David A.; Tanyi, James A.; Fuss, Martin; Thomas, Charles R.; Holland, John M.

    2014-10-01

    Volumetric-modulated arc radiotherapy (VMAT) is an iteration of intensity-modulated radiotherapy (IMRT), both of which deliver highly conformal dose distributions. Studies have shown the superiority of VMAT and IMRT in comparison with 3-dimensional conformal radiotherapy (3D-CRT) in planning target volume (PTV) coverage and organs-at-risk (OARs) sparing. This is the first study examining the benefits of VMAT in pancreatic cancer for doses more than 55.8 Gy. A planning study comparing 3D-CRT, IMRT, and VMAT was performed in 20 patients with pancreatic cancer. Treatments were planned for a 25-fraction delivery of 45 Gy to a large field followed by a reduced-volume 8-fraction external beam boost to 59.4 Gy in total. OARs and PTV doses, conformality index (CI) deviations from 1.0, monitor units (MUs) delivered, and isodose volumes were compared. IMRT and VMAT CI deviations from 1.0 for the large-field and the boost plans were equivalent (large field: 0.032 and 0.046, respectively; boost: 0.042 and 0.037, respectively; p > 0.05 for all comparisons). Both IMRT and VMAT CI deviations from 1.0 were statistically superior to 3D-CRT (large field: 0.217, boost: 0.177; p < 0.05 for all comparisons). VMAT showed reduction of the mean dose to the boost PTV (VMAT: 61.4 Gy, IMRT: 62.4 Gy, and 3D-CRT: 62.3 Gy; p < 0.05). The mean number of MUs per fraction was significantly lower for VMAT for both the large-field and the boost plans. VMAT delivery time was less than 3 minutes compared with 8 minutes for IMRT. Although no statistically significant dose reduction to the OARs was identified when comparing VMAT with IMRT, VMAT showed a reduction in the volumes of the 100% isodose line for the large-field plans. Dose escalation to 59.4 Gy in pancreatic cancer is dosimetrically feasible with shorter treatment times, fewer MUs delivered, and comparable CIs for VMAT when compared with IMRT.

  4. Multiple receptor conformation docking, dock pose clustering and 3D QSAR studies on human poly(ADP-ribose) polymerase-1 (PARP-1) inhibitors.

    Science.gov (United States)

    Fatima, Sabiha; Jatavath, Mohan Babu; Bathini, Raju; Sivan, Sree Kanth; Manga, Vijjulatha

    2014-10-01

    Poly(ADP-ribose) polymerase-1 (PARP-1) functions as a DNA damage sensor and signaling molecule. It plays a vital role in the repair of DNA strand breaks induced by radiation and chemotherapeutic drugs; inhibitors of this enzyme have the potential to improve cancer chemotherapy or radiotherapy. Three-dimensional quantitative structure activity relationship (3D QSAR) models were developed using comparative molecular field analysis, comparative molecular similarity indices analysis and docking studies. A set of 88 molecules were docked into the active site of six X-ray crystal structures of poly(ADP-ribose)polymerase-1 (PARP-1), by a procedure called multiple receptor conformation docking (MRCD), in order to improve the 3D QSAR models through the analysis of binding conformations. The docked poses were clustered to obtain the best receptor binding conformation. These dock poses from clustering were used for 3D QSAR analysis. Based on MRCD and QSAR information, some key features have been identified that explain the observed variance in the activity. Two receptor-based QSAR models were generated; these models showed good internal and external statistical reliability that is evident from the [Formula: see text], [Formula: see text] and [Formula: see text]. The identified key features enabled us to design new PARP-1 inhibitors.

  5. Treatment of left sided breast cancer for a patient with funnel chest: Volumetric-modulated arc therapy vs. 3D-CRT and intensity-modulated radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Haertl, Petra M., E-mail: petra.haertl@klinik.uni-regensburg.de [Department of Radiotherapy, Regensburg University Medical Center, Regensburg (Germany); Pohl, Fabian; Weidner, Karin; Groeger, Christian; Koelbl, Oliver; Dobler, Barbara [Department of Radiotherapy, Regensburg University Medical Center, Regensburg (Germany)

    2013-04-01

    This case study presents a rare case of left-sided breast cancer in a patient with funnel chest, which is a technical challenge for radiation therapy planning. To identify the best treatment technique for this case, 3 techniques were compared: conventional tangential fields (3D conformal radiotherapy [3D-CRT]), intensity-modulated radiotherapy (IMRT), and volumetric-modulated arc therapy (VMAT). The plans were created for a SynergyS® (Elekta, Ltd, Crawley, UK) linear accelerator with a BeamModulator™ head and 6-MV photons. The planning system was Oncentra Masterplan® v3.3 SP1 (Nucletron BV, Veenendal, Netherlands). Calculations were performed with collapsed cone algorithm. Dose prescription was 50.4 Gy to the average of the planning target volume (PTV). PTV coverage and homogeneity was comparable for all techniques. VMAT allowed reducing dose to the ipsilateral organs at risk (OAR) and the contralateral breast compared with IMRT and 3D-CRT: The volume of the left lung receiving 20 Gy was 19.3% for VMAT, 26.1% for IMRT, and 32.4% for 3D-CRT. In the heart, a D{sub 15%} of 9.7 Gy could be achieved with VMAT compared with 14 Gy for IMRT and 46 Gy for 3D-CRT. In the contralateral breast, D{sub 15%} was 6.4 Gy for VMAT, 8.8 Gy for IMRT, and 10.2 Gy for 3D-CRT. In the contralateral lung, however, the lowest dose was achieved with 3D-CRT with D{sub 10%} of 1.7 Gy for 3D-CRT, and 6.7 Gy for both IMRT and VMAT. The lowest number of monitor units (MU) per 1.8-Gy fraction was required by 3D-CRT (192 MU) followed by VMAT (518 MU) and IMRT (727 MU). Treatment time was similar for 3D-CRT (3 min) and VMAT (4 min) but substantially increased for IMRT (13 min). VMAT is considered the best treatment option for the presented case of a patient with funnel chest. It allows reducing dose in most OAR without compromising target coverage, keeping delivery time well below 5 minutes.

  6. Treatment of left sided breast cancer for a patient with funnel chest: volumetric-modulated arc therapy vs. 3D-CRT and intensity-modulated radiotherapy.

    Science.gov (United States)

    Haertl, Petra M; Pohl, Fabian; Weidner, Karin; Groeger, Christian; Koelbl, Oliver; Dobler, Barbara

    2013-01-01

    This case study presents a rare case of left-sided breast cancer in a patient with funnel chest, which is a technical challenge for radiation therapy planning. To identify the best treatment technique for this case, 3 techniques were compared: conventional tangential fields (3D conformal radiotherapy [3D-CRT]), intensity-modulated radiotherapy (IMRT), and volumetric-modulated arc therapy (VMAT). The plans were created for a SynergyS® (Elekta, Ltd, Crawley, UK) linear accelerator with a BeamModulator™ head and 6-MV photons. The planning system was Oncentra Masterplan® v3.3 SP1 (Nucletron BV, Veenendal, Netherlands). Calculations were performed with collapsed cone algorithm. Dose prescription was 50.4 Gy to the average of the planning target volume (PTV). PTV coverage and homogeneity was comparable for all techniques. VMAT allowed reducing dose to the ipsilateral organs at risk (OAR) and the contralateral breast compared with IMRT and 3D-CRT: The volume of the left lung receiving 20 Gy was 19.3% for VMAT, 26.1% for IMRT, and 32.4% for 3D-CRT. In the heart, a D(15%) of 9.7 Gy could be achieved with VMAT compared with 14 Gy for IMRT and 46 Gy for 3D-CRT. In the contralateral breast, D(15%) was 6.4 Gy for VMAT, 8.8 Gy for IMRT, and 10.2 Gy for 3D-CRT. In the contralateral lung, however, the lowest dose was achieved with 3D-CRT with D(10%) of 1.7 Gy for 3D-CRT, and 6.7 Gy for both IMRT and VMAT. The lowest number of monitor units (MU) per 1.8-Gy fraction was required by 3D-CRT (192 MU) followed by VMAT (518 MU) and IMRT (727 MU). Treatment time was similar for 3D-CRT (3 min) and VMAT (4 min) but substantially increased for IMRT (13 min). VMAT is considered the best treatment option for the presented case of a patient with funnel chest. It allows reducing dose in most OAR without compromising target coverage, keeping delivery time well below 5 minutes.

  7. MO-H-19A-03: Patient Specific Bolus with 3D Printing Technology for Electron Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Zou, W; Swann, B; Siderits, R; McKenna, M; Khan, A; Yue, N; Zhang, M [Rutgers University, New Brunswick, NJ (United States); Fisher, T [Memorial Medical Center, Modesto, CA (United States)

    2014-06-15

    Purpose: Bolus is widely used in electron radiotherapy to achieve desired dose distribution. 3D printing technologies provide clinicians with easy access to fabricate patient specific bolus accommodating patient body surface irregularities and tissue inhomogeneity. This study presents the design and the clinical workflow of 3D printed bolus for patient electron therapy in our clinic. Methods: Patient simulation CT images free of bolus were exported from treatment planning system (TPS) to an in-house developed software package. Bolus with known material properties was designed in the software package and then exported back to the TPS as a structure. Dose calculation was carried out to examine the coverage of the target. After satisfying dose distribution was achieved, the bolus structure was transferred in Standard Tessellation Language (STL) file format for the 3D printer to generate the machine codes for printing. Upon receiving printed bolus, a quick quality assurance was performed with patient resimulated with bolus in place to verify the bolus dosimetric property before treatment started. Results: A patient specific bolus for electron radiotherapy was designed and fabricated in Form 1 3D printer with methacrylate photopolymer resin. Satisfying dose distribution was achieved in patient with bolus setup. Treatment was successfully finished for one patient with the 3D printed bolus. Conclusion: The electron bolus fabrication with 3D printing technology was successfully implemented in clinic practice.

  8. A method to generate conformal finite-element meshes from 3D measurements of microstructurally small fatigue-crack propagation: 3D Meshes of Microstructurally Small Crack Growth

    Energy Technology Data Exchange (ETDEWEB)

    Spear, A. D. [Department of Mechanical Engineering, University of Utah, Salt Lake City UT USA; Hochhalter, J. D. [NASA Langley Research Center, Hampton VA USA; Cerrone, A. R. [GE Global Research Center, Niskayuna NY USA; Li, S. F. [Lawrence Livermore National Laboratory, Livermore CA USA; Lind, J. F. [Lawrence Livermore National Laboratory, Livermore CA USA; Suter, R. M. [Department of Physics, Carnegie Mellon University, Pittsburgh PA USA; Ingraffea, A. R. [School of Civil & Environmental Engineering, Cornell University, Ithaca NY USA

    2016-04-27

    In an effort to reproduce computationally the observed evolution of microstructurally small fatigue cracks (MSFCs), a method is presented for generating conformal, finite-element (FE), volume meshes from 3D measurements of MSFC propagation. The resulting volume meshes contain traction-free surfaces that conform to incrementally measured 3D crack shapes. Grain morphologies measured using near-field high-energy X-ray diffraction microscopy are also represented within the FE volume meshes. Proof-of-concept simulations are performed to demonstrate the utility of the mesh-generation method. The proof-of-concept simulations employ a crystal-plasticity constitutive model and are performed using the conformal FE meshes corresponding to successive crack-growth increments. Although the simulations for each crack increment are currently independent of one another, they need not be, and transfer of material-state information among successive crack-increment meshes is discussed. The mesh-generation method was developed using post-mortem measurements, yet it is general enough that it can be applied to in-situ measurements of 3D MSFC propagation.

  9. 3D conformation of a flexible fiber in a turbulent flow

    Science.gov (United States)

    Verhille, Gautier; Bartoli, Adrien

    2016-07-01

    A growing number of studies is devoted to anisotropic particles in turbulent flows. In most cases, the particles are assumed to be rigid and their deformations are neglected. We present an adaptation of classical computer vision tools to reconstruct from two different images the 3D conformation of a fiber distorted by the turbulent fluctuations in a von Kármán flow. This technique allows us notably to characterize the fiber deformation by computing the correlation function of the orientation of the tangent vector. This function allows us to tackle the analogy between polymers and flexible fibers proposed by Brouzet et al. (Phys Rev Lett 112(7):074501, 2014). We show that this function depends on an elastic length ℓ _e which characterizes the particle flexibility, as is the case for polymers, but also on the fiber length L, contrary to polymers.

  10. A nanofiber based artificial electronic skin with high pressure sensitivity and 3D conformability

    Science.gov (United States)

    Zhong, Weibin; Liu, Qiongzhen; Wu, Yongzhi; Wang, Yuedan; Qing, Xing; Li, Mufang; Liu, Ke; Wang, Wenwen; Wang, Dong

    2016-06-01

    Pressure sensors with 3D conformability are highly desirable components for artificial electronic skin or e-textiles that can mimic natural skin, especially for application in real-time monitoring of human physiological signals. Here, a nanofiber based electronic skin with ultra-high pressure sensitivity and 3D conformability is designed and built by interlocking two elastic patterned nanofibrous membranes. The patterned membrane is facilely prepared by casting conductive nanofiber ink into a silicon mould to form an array of semi-spheroid-like protuberances. The protuberances composed of intertwined elastic POE nanofibers and PPy@PVA-co-PE nanofibers afford a tunable effective elastic modulus that is capable of capturing varied strains and stresses, thereby contributing to a high sensitivity for pressure sensing. This electronic skin-like sensor demonstrates an ultra-high sensitivity (1.24 kPa-1) below 150 Pa with a detection limit as low as about 1.3 Pa. The pixelated sensor array and a RGB-LED light are then assembled into a circuit and show a feasibility for visual detection of spatial pressure. Furthermore, a nanofiber based proof-of-concept wireless pressure sensor with a bluetooth module as a signal transmitter is proposed and has demonstrated great promise for wireless monitoring of human physiological signals, indicating a potential for large scale wearable electronic devices or e-skin.Pressure sensors with 3D conformability are highly desirable components for artificial electronic skin or e-textiles that can mimic natural skin, especially for application in real-time monitoring of human physiological signals. Here, a nanofiber based electronic skin with ultra-high pressure sensitivity and 3D conformability is designed and built by interlocking two elastic patterned nanofibrous membranes. The patterned membrane is facilely prepared by casting conductive nanofiber ink into a silicon mould to form an array of semi-spheroid-like protuberances. The

  11. Extracranial stereotactic radiotherapy: evaluation of PTV coverage and dose conformity.

    Science.gov (United States)

    Hädinger, Ulrich; Thiele, Wibke; Wulf, Jörn

    2002-01-01

    During the past few years the concept of cranial stereotactic radiotherapy has been successfully extended to extracranial tumoral targets. In our department, hypofractionated treatment of tumours in lung, liver, abdomen, and pelvis is performed in the Stereotactic Body Frame (ELEKTA Instrument AB) since 1997. We present the evaluation of 63 consecutively treated targets (22 lung, 21 liver, 20 abdomen/pelvis) in 58 patients with respect to dose coverage of the planning target volume (PTV) as well as conformity of the dose distribution. The mean PTV coverage was found to be 96.3% +/- 2.3% (lung), 95.0% +/- 4.5% (liver), and 92.1% +/- 5.2% (abdomen/pelvis). For the so-called conformation number we obtained values of 0.73 +/- 0.09 (lung), 0.77 +/- 0.10 (liver), and 0.70 +/- 0.08 (abdomen/pelvis). The results show that highly conformal treatment techniques can be applied also in extracranial stereotactic radiotherapy. This is primarily due to the relatively simple geometrical shape of most of the targets. Especially lung and liver targets turned out to be approximately spherically/cylindrically shaped, so that the dose distribution can be easily tailored by rotational fields.

  12. Postoperative Radiotherapy for Prostate Cancer: A Comparison of Four Consensus Guidelines and Dosimetric Evaluation of 3D-CRT Versus Tomotherapy IMRT

    Energy Technology Data Exchange (ETDEWEB)

    Malone, Shawn, E-mail: smalone@ottawahospital.on.ca [Division of Radiation Oncology, Ottawa Hospital, University of Ottawa, Ottawa, Ontario (Canada); Croke, Jennifer [Division of Radiation Oncology, Ottawa Hospital, University of Ottawa, Ottawa, Ontario (Canada); Roustan-Delatour, Nicolas; Belanger, Eric [Department of Pathology, Ottawa Hospital, University of Ottawa, Ottawa, Ontario (Canada); Avruch, Leonard [Department of Radiology, Ottawa Hospital, University of Ottawa, Ottawa, Ontario (Canada); Malone, Colin [Division of Radiation Oncology, Ottawa Hospital, University of Ottawa, Ottawa, Ontario (Canada); Morash, Christopher [Division of Urology, Ottawa Hospital, University of Ottawa, Ottawa, Ontario (Canada); Kayser, Cathleen; Underhill, Kathryn; Li Yan; Malone, Kyle [Division of Radiation Oncology, Ottawa Hospital, University of Ottawa, Ottawa, Ontario (Canada); Nyiri, Balazs [Department of Medical Physics, Ottawa Hospital, University of Ottawa, Ottawa, Ontario (Canada); Spaans, Johanna [Division of Radiation Oncology, Ottawa Hospital, University of Ottawa, Ottawa, Ontario (Canada)

    2012-11-01

    Purpose: Despite the benefits of adjuvant radiotherapy after radical prostatectomy, approximately one-half of patients relapse. Four consensus guidelines have been published (European Organization for Research and Treatment of Cancer, Faculty of Radiation Oncology Genito-Urinary Group, Princess Margaret Hospital, Radiation Therapy Oncology Group) with the aim of standardizing the clinical target volume (CTV) delineation and improve outcomes. To date, no attempt has been made to compare these guidelines in terms of treatment volumes or organ at risk (OAR) irradiation. The extent to which the guideline-derived plans meet the dosimetric constraints of present trials or of the Quantitative Analysis of Normal Tissue Effects in the Clinic (QUANTEC) trial is also unknown. Our study also explored the dosimetric benefits of intensity-modulated radiotherapy (IMRT). Methods and Materials: A total of 20 patients treated with postoperative RT were included. The three-dimensional conformal radiotherapy (3D-CRT) plans were applied to cover the guideline-generated planning target volumes (66 Gy in 33 fractions). Dose-volume histograms (DVHs) were analyzed for CTV/planning target volume coverage and to evaluate OAR irradiation. The OAR DVHs were compared with the constraints proposed in the QUANTEC and Radiotherapy and Androgen Deprivation In Combination After Local Surgery (RADICALS) trials. 3D-CRT plans were compared with the tomotherapy plans for the Radiation Therapy Oncology Group planning target volume to evaluate the advantages of IMRT. Results: The CTV differed significantly between guidelines (p < 0.001). The European Organization for Research and Treatment of Cancer-CTVs were significantly smaller than the other CTVs (p < 0.001). Differences in prostate bed coverage superiorly accounted for the major volumetric differences between the guidelines. Using 3D-CRT, the DVHs rarely met the QUANTEC or RADICALS rectal constraints, independent of the guideline used. The RADICALS

  13. Conventional and conformal technique of external beam radiotherapy in locally advanced cervical cancer: Dose distribution, tumor response, and side effects

    Science.gov (United States)

    Mutrikah, N.; Winarno, H.; Amalia, T.; Djakaria, M.

    2017-08-01

    The objective of this study was to compare conventional and conformal techniques of external beam radiotherapy (EBRT) in terms of the dose distribution, tumor response, and side effects in the treatment of locally advanced cervical cancer patients. A retrospective cohort study was conducted on cervical cancer patients who underwent EBRT before brachytherapy in the Radiotherapy Department of Cipto Mangunkusumo Hospital. The prescribed dose distribution, tumor response, and acute side effects of EBRT using conventional and conformal techniques were investigated. In total, 51 patients who underwent EBRT using conventional techniques (25 cases using Cobalt-60 and 26 cases using a linear accelerator (LINAC)) and 29 patients who underwent EBRT using conformal techniques were included in the study. The distribution of the prescribed dose in the target had an impact on the patient’s final response to EBRT. The complete response rate of patients to conformal techniques was significantly greater (58%) than that of patients to conventional techniques (42%). No severe acute local side effects were seen in any of the patients (Radiation Therapy Oncology Group (RTOG) grades 3-4). The distribution of the dose and volume to the gastrointestinal tract affected the proportion of mild acute side effects (RTOG grades 1-2). The urinary bladder was significantly greater using conventional techniques (Cobalt-60/LINAC) than using conformal techniques at 72% and 78% compared to 28% and 22%, respectively. The use of conformal techniques in pelvic radiation therapy is suggested in radiotherapy centers with CT simulators and 3D Radiotherapy Treatment Planning Systems (RTPSs) to decrease some uncertainties in radiotherapy planning. The use of AP/PA pelvic radiation techniques with Cobalt-60 should be limited in body thicknesses equal to or less than 18 cm. When using conformal techniques, delineation should be applied in the small bowel, as it is considered a critical organ according to RTOG

  14. Modeling simulation and visualization of conformal 3D lung tumor dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Santhanam, Anand; Willoughby, Twyla R; Meeks, Sanford L; Kupelian, Patrick A [Department of Radiation Oncology, M D Anderson Cancer Center Orlando, 1400S Orange Ave., Orlando, FL 32806 (United States); Rolland, Jannick P [College of Optics and Photonics, University of Central Florida, 4000 Central Florida Blvd, Orlando, FL 32816 (United States)

    2009-10-21

    Lung tumors move during breathing depending on the patient's patho-physiological condition and orientation, thereby compromising the accurate deposition of the radiation dose during radiotherapy. In this paper, we present and validate a computer-based simulation framework to calculate the delivered dose to a 3D moving tumor and its surrounding normal tissues. The computer-based simulation framework models a 3D volumetric lung tumor and its surrounding tissues, simulates the tumor motion during a simulated dose delivery both as a self-reproducible motion and a random motion using the dose extracted from a treatment plan, and predicts the amount and location of radiation doses deposited. A radiation treatment plan of a small lung tumor (1-3 cm diameter) was developed in a commercial planning system (iPlan software, BrainLab, Munich, Germany) to simulate the radiation dose delivered. The dose for each radiation field was extracted from the software. The tumor motion was simulated for varying values of its rate, amplitude and direction within a single breath as well as from one breath to another. Such variations represent the variations in tumor motion induced by breathing variations. During the simulation of dose delivery, the dose on the target was summed to generate the real-time dose to the tumor for each beam independently. The simulation results show that the dose accumulated on the tumor varies significantly with both the tumor size and the tumor's motion rate, amplitude and direction. For a given tumor motion rate, amplitude and direction, the smaller the tumor size the smaller is the percentage of the radiation dose accumulated. The simulation results are validated by comparing the center plane of the 3D tumor with 2D film dosimetry measurements using a programmable 4D motion phantom moving in a self-reproducible pattern. The results also show the real-time capability of the framework at 40 discrete tumor motion steps per breath, which is higher than

  15. Volumetric modulated arc planning for lung stereotactic body radiotherapy using conventional and unflattened photon beams: a dosimetric comparison with 3D technique

    Directory of Open Access Journals (Sweden)

    Zhang Geoffrey G

    2011-11-01

    Full Text Available Abstract Purpose Frequently, three-dimensional (3D conformal beams are used in lung cancer stereotactic body radiotherapy (SBRT. Recently, volumetric modulated arc therapy (VMAT was introduced as a new treatment modality. VMAT techniques shorten delivery time, reducing the possibility of intrafraction target motion. However dose distributions can be quite different from standard 3D therapy. This study quantifies those differences, with focus on VMAT plans using unflattened photon beams. Methods A total of 15 lung cancer patients previously treated with 3D or VMAT SBRT were randomly selected. For each patient, non-coplanar 3D, coplanar and non-coplanar VMAT and flattening filter free VMAT (FFF-VMAT plans were generated to meet the same objectives with 50 Gy covering 95% of the PTV. Two dynamic arcs were used in each VMAT plan. The couch was set at ± 5° to the 0° straight position for the two non-coplanar arcs. Pinnacle version 9.0 (Philips Radiation Oncology, Fitchburg WI treatment planning system with VMAT capabilities was used. We analyzed the conformity index (CI, which is the ratio of the total volume receiving at least the prescription dose to the target volume receiving at least the prescription dose; the conformity number (CN which is the ratio of the target coverage to CI; and the gradient index (GI which is the ratio of the volume of 50% of the prescription isodose to the volume of the prescription isodose; as well as the V20, V5, and mean lung dose (MLD. Paired non-parametric analysis of variance tests with post-tests were performed to examine the statistical significance of the differences of the dosimetric indices. Results Dosimetric indices CI, CN and MLD all show statistically significant improvement for all studied VMAT techniques compared with 3D plans (p Conclusion Besides the advantage of faster delivery times, VMAT plans demonstrated better conformity to target, sharper dose fall-off in normal tissues and lower dose to

  16. Conformal radiotherapy for 6 cases of bile duct carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kawasaki, Yoshiyuki; Suzuki, Takashi; Sugahara, Shinji [Hitachi General Hospital, Ibaraki (Japan)] [and others

    1998-08-01

    Authors performed the conformal radiotherapy using the multileaf collimator for inoperable patients with bile duct carcinoma and examined the usefulness of this treatment. Forty one patients were examined, whose age was from 45 to 80 years (mean: 69.5 years), and whose ratio of men to women was 1 to 1.6. Patients in Group I (palliative irradiation, 30 cases) received bilateral irradiation using the linac with 4 MV-x-ray of total 50.0 Gy (2.0 Gy a dose, 5 times a week), those in Group II (palliative irradiation, 5 cases) using the microtron with 10 MV-x-ray of total 50.0 Gy (2.0 Gy a dose, 5 times a week). And those in Group III (radial irradiation, 6 cases) were first irradiated using the microtron with total 40.0 Gy (2.0 Gy a dose, 5 times a week) and secondly by the conformal radiotherapy with total 20.0 Gy (2.0 Gy a dose, 5 times a week). Patients in Group III were irradiated with total 60.0 Gy. Patients in all Groups showed mild side-effects including nausea and vomiting. And patients in Group III, who were irradiated 10 Gy more than other Group, showed no severe side-effects as alimentary bleeding, liver function disorders and cholangitis. In Group I, one year survivors were 3 (10.0%) and two years survivors were none. The median survival month was 7.2 months. In Group II, one year survivor was 1 (20.0%) and two years survivors were none. The median survival month was 8.1 months. In Group III, one year survivors were 2 (33.3%), and two years survivors were 2 (33.3%). The median survival month was 11.2 months. Two patients are survival at present (March, 1998), 2 years and 10 months, and 2 years and 9 months, respectively. The conformal radiotherapy gave better results than the ordinary radiotherapy. (K.H.)

  17. Conformal radiotherapy for locally advanced juvenile nasopharyngeal angio-fibroma

    Directory of Open Access Journals (Sweden)

    Supriya Mallick

    2015-01-01

    Full Text Available Purpose: To assess the efficacy of radiation in the treatment of juvenile nasopharyngeal angiofibroma (JNA. Materials and Methods: Data were retrieved for JNA treated with radiotherapy from 1987-2012. The demographics, treatment and outcome data were recorded in predesigned proforma. Results: Data of 32 patients were retrieved. Median age was 17 years (range: 12-33 years. All patients received radiation because of refractory, residual or unresectable locally advanced disease. All patients were planned with a three-dimensional conformal technique (3DCRT. The median radiation dose was 30 Gray (range: 30-45 Gray. Median follow-up was 129 months (range: 1-276 months. At the last follow-up, 13 patients were found to have a radiological complete response. Two patients progressed 38 and 43 months after completion of treatment and opted for alternative treatment. One patient developed squamous cell carcinoma of the nasal ale 15 years after radiation. Conclusion: Conformal radiotherapy shows promise as an alternative treatment approach for locally advanced JNA and confers long-term disease control with minimal toxicity.

  18. Comparison of Heart and Coronary Artery Doses Associated With Intensity-Modulated Radiotherapy Versus Three-Dimensional Conformal Radiotherapy for Distal Esophageal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kole, Thomas P.; Aghayere, Osarhieme; Kwah, Jason [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Yorke, Ellen D. [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Goodman, Karyn A., E-mail: goodmank@mskcc.org [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

    2012-08-01

    Purpose: To compare heart and coronary artery radiation exposure using intensity-modulated radiotherapy (IMRT) vs. four-field three-dimensional conformal radiotherapy (3D-CRT) treatment plans for patients with distal esophageal cancer undergoing chemoradiation. Methods and Materials: Nineteen patients with distal esophageal cancers treated with IMRT from March 2007 to May 2008 were identified. All patients were treated to 50.4 Gy with five-field IMRT plans. Theoretical 3D-CRT plans with four-field beam arrangements were generated. Dose-volume histograms of the planning target volume, heart, right coronary artery, left coronary artery, and other critical normal tissues were compared between the IMRT and 3D-CRT plans, and selected parameters were statistically evaluated using the Wilcoxon rank-sum test. Results: Intensity-modulated radiotherapy treatment planning showed significant reduction (p < 0.05) in heart dose over 3D-CRT as assessed by average mean dose (22.9 vs. 28.2 Gy) and V30 (24.8% vs. 61.0%). There was also significant sparing of the right coronary artery (average mean dose, 23.8 Gy vs. 35.5 Gy), whereas the left coronary artery showed no significant improvement (mean dose, 11.2 Gy vs. 9.2 Gy), p = 0.11. There was no significant difference in percentage of total lung volume receiving at least 10, 15, or 20 Gy or in the mean lung dose between the planning methods. There were also no significant differences observed for the kidneys, liver, stomach, or spinal cord. Intensity-modulated radiotherapy achieved a significant improvement in target conformity as measured by the conformality index (ratio of total volume receiving 95% of prescription dose to planning target volume receiving 95% of prescription dose), with the mean conformality index reduced from 1.56 to 1.30 using IMRT. Conclusions: Treatment of patients with distal esophageal cancer using IMRT significantly decreases the exposure of the heart and right coronary artery when compared with 3D

  19. Conformal radiotherapy using multileaf collimation: quality assurance and in vivo dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Aletti, P. [Centre A. Vautrin, Nancy (France)

    1995-12-01

    The application of quality assurance principles in three dimensional conformal therapy is discussed.Critical requirements in three dimensional radiotherapy are the patient immobilization, the location, and the delivered dose. General recommendations with respect to the equipment for conformal radiotherapy and personnel are made.

  20. Time trial: A prospective comparative study of the time-resource burden for three-dimensional conformal radiotherapy and intensity-modulated radiotherapy in head and neck cancers

    Directory of Open Access Journals (Sweden)

    Murthy Vedang

    2009-01-01

    Full Text Available Introduction: An ongoing institutional randomized clinical trial comparing three-dimensional conformal radiotherapy (3D CRT and intensity-modulated radiotherapy (IMRT provided us an opportunity to document and compare the time-manpower burden with these high-precision techniques in head and neck cancers. Materials and Methods: A cohort of 20 consecutive patients in the ongoing trial was studied. The radiotherapy planning and delivery process was divided into well-defined steps and allocated human resource based on prevalent departmental practice. Person-hours for each step were calculated. Results: Twelve patients underwent IMRT and eight patients had 3D CRT. The prerandomization steps (upto and including approval of contours were common between the two arms, and expectedly, the time taken to complete each step was similar. The planning step was carried out postrandomization and the median times were similar for 3D CRT (312 min, 5.2 person-hours and IMRT (325.6 min, 5.4 person-hours. The median treatment delivery time taken per fraction varied between the two arms, with 3D CRT taking 15.2 min (0.6 person-hours, while IMRT taking 27.8 min (0.9 person-hours (P< 0.001. The total treatment time was also significantly longer in the IMRT arm (median 27.7 versus 17.8 person-hours, P< 0.001. The entire process of IMRT took 48.5 person-hours while 3D CRT took a median of 37.3 person-hours. The monitor units delivered per fraction and the actual "beam-on" time was also statistically longer with IMRT. Conclusions: IMRT required more person-hours than 3D CRT, the main difference being in the time taken to deliver the step-and-shoot IMRT and the patient-specific quality assurance associated with IMRT.

  1. A FAST MORPHING-BASED INTERPOLATION FOR MEDICAL IMAGES: APPLICATION TO CONFORMAL RADIOTHERAPY

    Directory of Open Access Journals (Sweden)

    Hussein Atoui

    2011-05-01

    Full Text Available A method is presented for fast interpolation between medical images. The method is intended for both slice and projective interpolation. It allows offline interpolation between neighboring slices in tomographic data. Spatial correspondence between adjacent images is established using a block matching algorithm. Interpolation of image intensities is then carried out by morphing between the images. The morphing-based method is compared to standard linear interpolation, block-matching-based interpolation and registrationbased interpolation in 3D tomographic data sets. Results show that the proposed method scored similar performance in comparison to registration-based interpolation, and significantly outperforms both linear and block-matching-based interpolation. This method is applied in the context of conformal radiotherapy for online projective interpolation between Digitally Reconstructed Radiographs (DRRs.

  2. Dosimetric characterization of 3D printed bolus at different infill percentage for external photon beam radiotherapy.

    Science.gov (United States)

    Ricotti, Rosalinda; Ciardo, Delia; Pansini, Floriana; Bazani, Alessia; Comi, Stefania; Spoto, Ruggero; Noris, Samuele; Cattani, Federica; Baroni, Guido; Orecchia, Roberto; Vavassori, Andrea; Alicja Jereczek-Fossa, Barbara

    2017-07-01

    3D printing is rapidly evolving and further assessment of materials and technique is required for clinical applications. We evaluated 3D printed boluses with acrylonitrile butadiene styrene (ABS) and polylactide (PLA) at different infill percentage. A low-cost 3D printer was used. The influence of the air inclusion within the 3D printed boluses was assessed thoroughly both with treatment planning system (TPS) and with physical measurements. For each bolus, two treatment plans were calculated with Monte Carlo algorithm, considering the computed tomography (CT) scan of the 3D printed bolus or modelling the 3D printed bolus as a virtual bolus structure with a homogeneous density. Depth dose measurements were performed with Gafchromic films. High infill percentage corresponds to high density and high homogeneity within bolus material. The approximation of the bolus in the TPS as a homogeneous material is satisfying for infill percentages greater than 20%. Measurements performed with PLA boluses are more comparable to the TPS calculated profiles. For boluses printed at 40% and 60% infill, the discrepancies between calculated and measured dose distribution are within 5%. 3D printing technology allows modulating the shift of the build-up region by tuning the infill percentage of the 3D printed bolus in order to improve superficial target coverage. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  3. Conformal three dimensional radiotherapy treatment planning in Lund

    Energy Technology Data Exchange (ETDEWEB)

    Knoos, T.; Nilsson, P. [Lund Univ. (Sweden). Dept. of Radiation Physics; Anders, A. [Lund Univ. (Sweden). Dept. of Oncology

    1995-12-01

    The use of conformal therapy is based on 3-dimensional treatment planning as well as on methods and routines for 3-dimensional patient mapping, 3-dimensional virtual simulation and others. The management of patients at the Radiotherapy Department at the University Hospital in Lund (Sweden) is discussed. About 2100 new patients are annually treated with external radiotherapy using seven linear accelerators. Three of the accelerators have dual photon energies and electron treatment facilities. A multi-leaf collimator as well as an electronic portal imaging device are available on one machine. Two simulators and an in-house CT-scanner are used for treatment planning. From 1988 to 1992 Scandiplan (Umplan) was used. Since 1992, the treatment planning system is TMS (HELAX AB, Sweden), which is based on the pencil beam algorithm of Ahnesjo. The calculations use patient modulated accelerator specific energy fluence spectra which are compiled with pencil beams from Monte Carlo generated energy absorption kernels. Heterogeneity corrections are performed with results close to conventional algorithms. Irregular fields, either from standard or individual blocks and from multi-leaf collimators are handled by the treatment planning system. The field shape is determined conveniently using the beam`s eye view. The final field shape is exported electronically to either the block cutting machine or the multileaf collimator control computer. All patient fields are checked against the beam`s eye view during simulation using manual methods. Treatment verification is performed by portal films and in vivo dosimetry with silicon diodes or TL-dosimetry. Up to now, approximately 4400 patients have received a highly individualized 3-dimensional conformal treatment.

  4. Three-dimensional conformal radiotherapy for portal vein tumor thrombosis alone in advanced hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ju Hye Kim Dong Hyun; Ki, Yong Kan; Kim, Dong Won; Kim, Won Taek; Heo, Jeong; Woo, Hyun Young [Pusan National University Hospital, Pusan National University School of Medicine, Busan (Korea, Republic of); Nam, Ji Ho [Dept.of Radiation Oncology, Pusan National University Yangsan Hospital, Yangsan (Korea, Republic of)

    2014-09-15

    We sought to evaluate the clinical outcomes of 3-dimensional conformal radiation therapy (3D-CRT) for portal vein tumor thrombosis (PVTT) alone in patients with advanced hepatocellular carcinoma. We retrospectively analyzed data on 46 patients who received 3D-CRT for PVTT alone between June 2002 and December 2011. Response was evaluated following the Response Evaluation Criteria in Solid Tumors. Prognostic factors and 1-year survival rates were compared between responders and non-responders. Thirty-seven patients (80.4%) had category B Child-Pugh scores. The Eastern Cooperative Oncology Group performance status score was 2 in 20 patients. Thirty patients (65.2%) had main or bilateral PVTT. The median irradiation dose was 50 Gy (range, 35 to 60 Gy) and the daily median dose was 2 Gy (range, 2.0 to 2.5 Gy). PVTT response was classified as complete response in 3 patients (6.5%), partial response in 12 (26.1%), stable disease in 19 (41.3%), and progressive disease in 12 (26.1%). There were 2 cases of grade 3 toxicities during or 3 months after radiotherapy. Twelve patients in the responder group (15 patients) received at least 50 Gy irradiation, but about 84% of patients in the non-responder group received less than 50 Gy. The 1-year survival rate was 66.8% in responders and 27.4% in non-responders constituting a statistically significant difference (p = 0.008). Conformal radiotherapy for PVTT alone could be chosen as a palliative treatment modality in patients with unfavorable conditions (liver, patient, or tumor factors). However, more than 50 Gy of radiation may be required.

  5. 3D printed facial laser scans for the production of localised radiotherapy treatment masks - A case study.

    Science.gov (United States)

    Briggs, Matthew; Clements, Helen; Wynne, Neil; Rennie, Allan; Kellett, Darren

    This study investigates the use of 3D printing for patients that require localised radiotherapy treatment to the face. The current process involves producing a lead mask in order to protect the healthy tissue from the effects of the radiotherapy. The mask is produced by applying a thermoplastic sheet to the patient's face and allowing to set hard. This can then be used as a mould to create a plaster impression of the patient's face. A sheet of lead is then hammered on to the plaster to create a bespoke fitted face mask. This process can be distressing for patients and can be problematic when the patient is required to remain motionless for a prolonged time while the thermoplastic sets. In this study, a 1:1 scale 3D print of a patient's face was generated using a laser scanner. The lead was hammered directly on to the surface of the 3D print in order to create a bespoke fitted treatment mask. This eliminated the thermoplastic moulding stage and significantly reduced the time needed for the patient to be in clinic. The higher definition impression of the the face resulted in a more accurate, better fitting treatment mask.

  6. 3-D conformal treatment of prostate cancer to 74 Gy vs. high-dose-rate brachytherapy boost: A cross-sectional quality-of-life survey

    Energy Technology Data Exchange (ETDEWEB)

    Vordermark, Dirk [Univ. of Wuerzburg (DE). Dept. of Radiation Oncology] (and others)

    2006-09-15

    The effects of two modalities of dose-escalated radiotherapy on health-related quality of life (HRQOL) were compared. Forty-one consecutive patients were treated with a 3-D conformal (3-DC) boost to 74 Gy, and 43 with high-dose rate (HDR) brachytherapy boost (2x9 Gy), following 3-D conformal treatment to 46 Gy. Median age was 70 years in both groups, median initial PSA was 7.9 {mu}g/l in 3-DC boost patients and 8.1 {mu}g/l in HDR boost patients. Stage was 7 in 52% and 47%, respectively. HRQOL was assessed cross-sectionally using EORTC QLQ-C30 and organ-specific PR25 modules 3-32 (median 19) and 4-25 (median 14) months after treatment, respectively. Questionnaires were completed by 93% and 97% of patients, respectively. Diarrhea and insomnia scores were significantly increased in both groups. In the PR25 module, scores of 3-DC boost and HDR boost patients for urinary, bowel and treatment-related symptoms were similar. Among responders, 34% of 3-DC boost patients and 86% of HDR boost patients had severe erectile problems. Dose escalation in prostate cancer by either 3-DC boost to 74 Gy or HDR brachytherapy boost appears to result in similar HRQOL profiles.

  7. 3D radiation therapy or intensity-modulated radiotherapy for recurrent and metastatic cervical cancer: the Shanghai Cancer Hospital experience.

    Directory of Open Access Journals (Sweden)

    Su-Ping Liu

    Full Text Available We evaluate the outcomes of irradiation by using three-dimensional radiation therapy (3D-RT or intensity-modulated radiotherapy (IMRT for recurrent and metastatic cervical cancer. Between 2007 and 2010, 50 patients with recurrent and metastatic cervical cancer were treated using 3D-RT or IMRT. The median time interval between the initial treatment and the start of irradiation was 12 (6-51 months. Salvage surgery was performed before irradiation in 5 patients, and 38 patients received concurrent chemotherapy. Sixteen patients underwent 3D-RT, and 34 patients received IMRT. Median follow-up for all the patients was 18.3 months. Three-year overall survival and locoregional control were 56.1% and 59.7%, respectively. Three-year progression-free survival and disease-free survival were 65.3% and 64.3%, respectively. Nine patients developed grade 3 leukopenia. Grade 5 acute toxicity was not observed in any of the patients; however, 2 patients developed Grade 3 late toxicity. 3D-RT or IMRT is effective for the treatment of recurrent and metastatic cervical cancer, with the 3-year overall survival of 56.1%, and its complications are acceptable. Long-term follow-up and further studies are needed to confirm the role of 3D-RT or IMRT in the multimodality management of the disease.

  8. A novel 3D-printed phantom insert for 4D PET/CT imaging and simultaneous integrated boost radiotherapy.

    Science.gov (United States)

    Cerviño, Laura; Soultan, Dima; Cornell, Mariel; Yock, Adam; Pettersson, Niclas; Song, William Y; Aguilera, Joseph; Advani, Sunil; Murphy, James; Hoh, Carl; James, Claude; Paravati, Anthony; Coope, Robin; Gill, Bradford; Moiseenko, Vitali

    2017-08-02

    To construct a 3D-printed phantom insert designed to mimic the variable PET tracer uptake seen in lung tumor volumes and a matching dosimetric insert to be used in simultaneous integrated boost (SIB) phantom studies, and to evaluate the design through end-to-end tests. A set of phantom inserts was designed and manufactured for a realistic representation of gated radiotherapy steps from 4D PET/CT scanning to dose delivery. A cylindrical phantom (φ80 × 120 mm) holds inserts for PET/CT scanning. The novel 3D printed insert dedicated to 4D PET/CT mimics high PET tracer uptake in the core and low uptake in the periphery. This insert is a variable density porous cylinder (φ44.5 × 70.0 mm), ABS-P430 thermoplastic, 3D printed by fused deposition modeling an inner (φ11 × 42 mm) cylindrical void. The square pores (1.8 × 1.8 mm(2) each) fill 50% of outer volume, resulting in a 2:1 PET tracer concentration ratio in the void volume with respect to porous volume. A matching cylindrical phantom insert is dedicated to validate gated radiotherapy. It contains eight peripheral holes and one central hole, matching the location of the porous part and the void part of the 3D printed insert, respectively. These holes accommodate adaptors for Farmer-type ion chamber and cells vials. End-to-end tests were designed for imaging, planning, and dose measurements. End-to-end test were performed from 4D PET/CT scanning to transferring data to the planning system, target volume delineation, and dose measurements. 4D PET/CT scans were acquired of the phantom at different respiratory motion patterns and gating windows. A measured 2:1 18F-FDG concentration ratio between inner void and outer porous volume matched the 3D printed design. Measured dose in the dosimetric insert agreed well with planned dose on the imaging insert, within 3% for the static phantom and within 5% for most breathing patterns. The novel 3D printed phantom insert mimics variable PET tracer uptake typical of tumors

  9. Clinical application of 3D-printed-step-bolus in post-total-mastectomy electron conformal therapy.

    Science.gov (United States)

    Park, Kwangwoo; Park, Sungjin; Jeon, Mi-Jin; Choi, Jinhyun; Kim, Jun Won; Cho, Yoon Jin; Jang, Won-Seok; Keum, Yo Sup; Lee, Ik Jae

    2017-04-11

    The 3D-printed boluses were used during the radiation therapy of the chest wall in six patients with breast cancer after modified radical mastectomy (MRM). We measured the in-vivo skin doses while both conventional and 3D-printed boluses were placed on the chest wall and compared the mean doses delivered to the ipsilateral lung and the heart. The homogeneity and conformity of the dose distribution in the chest wall for both types of boluses were also evaluated. The uniformity index on the chest skin was improved when the 3D-printed boluses were used, with the overall average skin dose being closer to the prescribed one in the former case (-0.47% versus -4.43%). On comparing the dose-volume histogram (DVH), it was found that the 3D-printed boluses resulted in a reduction in the mean dose to the ipsilateral lung by up to 20%. The precision of dose delivery was improved by 3% with the 3D-printed boluses; in contrast, the conventional step bolus resulted in a precision level of 5%. In conclusion, the use of the 3D-printed boluses resulted in better dose homogeneity and conformity to the chest wall as well as the sparing of the normal organs, especially the lung. This suggested that their routine use on the chest wall as a therapeutic approach during post-mastectomy radiation therapy offers numerous advantages over conventional step boluses.

  10. Determining inter-fractional motion of the uterus using 3D ultrasound imaging during radiotherapy for cervical cancer

    DEFF Research Database (Denmark)

    Baker, Mariwan; Jensen, Jørgen Arendt; Behrens, Claus F.

    2014-01-01

    Uterine positional changes can reduce the accuracy of radiotherapy for cervical cancer patients. The purpose of this study was to; 1) Quantify the inter-fractional uterine displacement using a novel 3D ultrasound (US) imaging system, and 2) Compare the result with the bone match shift determined...... to the bone structures. Since the US images were significantly better than the CBCT images in terms of soft-tissue visualization, the US system can provide an optional image-guided radiation therapy (IGRT) system. US imaging might be a better IGRT system than CBCT, despite difficulty in capturing the entire...

  11. Technical and Dosimetric Study of Four Facio-cervical Fields Conformal Radiotherapy for Nasopharyngeal Carcinoma

    Institute of Scientific and Technical Information of China (English)

    WANG Fang-zheng; FU Zhen-fu; WANG Lei; PIAO Yong-feng; HUA Yong-hong; CHEN Wei-jun; XU Min

    2015-01-01

    Objective: The aim of this study is to establish the methods of four facio-cervical field's conformal radiotherapy (4F-CRT) for nasopharyngeal carcinoma (NPC), and to optimize the methods for clinical practiceMaterials and Methods:40 patients with untreated NPC of T1-T4 (1997 AJCC Staging System) were rolled into this study.Conventional and four facio-cervical fields conform plans were designed for each patient using Pinnacle 8.0 three-dimension treatment planning system (3D-TPS) as follows:1Improved plan, four facio-cervical field's conform plan, anterior, posterior facio-cervical and two lateral opposing facio-cervical fields; 2Conventional plan, two lateral opposing facio-cervical fields delivered to the target in each plan, only with the same dose dose volume histograms (DVHs) of the targets and normal organs, brain stem, spinal cord, parotid glands, and temporal mandibular joints (TMJs) were compared and the dose distribution were evaluatedResults: 1.The dose distribution of the improved plan could meet the requirements for the target volume2There was not any significant difference in the dose of spinal cord between the two plans.The mean doses of D max for brain stem in conventional plan were much lower than those in the improved plan, though both were within safety limits3Compared with the conventional plans, the improved plan significantly decreased the hotspot areas in the target volume and had better parotid glands and temporal mandibular joints sparing effectConclusion:Compared with the conventional plan, the improved plan provides satisfactory dose coverage to the tumor volume and better sparing of the parotid gland, TMJs and other normal tissues in external beam radiotherapy of NPC.

  12. Comparison of 3D and 4D Monte Carlo optimization in robotic tracking stereotactic body radiotherapy of lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chan, Mark K.H. [Tuen Mun Hospital, Department of Clinical Oncology, Hong Kong (S.A.R) (China); Werner, Rene [The University Medical Center Hamburg-Eppendorf, Department of Computational Neuroscience, Hamburg (Germany); Ayadi, Miriam [Leon Berard Cancer Center, Department of Radiation Oncology, Lyon (France); Blanck, Oliver [University Clinic of Schleswig-Holstein, Department of Radiation Oncology, Luebeck (Germany); CyberKnife Center Northern Germany, Guestrow (Germany)

    2014-09-20

    To investigate the adequacy of three-dimensional (3D) Monte Carlo (MC) optimization (3DMCO) and the potential of four-dimensional (4D) dose renormalization (4DMC{sub renorm}) and optimization (4DMCO) for CyberKnife (Accuray Inc., Sunnyvale, CA) radiotherapy planning in lung cancer. For 20 lung tumors, 3DMCO and 4DMCO plans were generated with planning target volume (PTV{sub 5} {sub mm}) = gross tumor volume (GTV) plus 5 mm, assuming 3 mm for tracking errors (PTV{sub 3} {sub mm}) and 2 mm for residual organ deformations. Three fractions of 60 Gy were prescribed to ≥ 95 % of the PTV{sub 5} {sub mm}. Each 3DMCO plan was recalculated by 4D MC dose calculation (4DMC{sub recal}) to assess the dosimetric impact of organ deformations. The 4DMC{sub recal} plans were renormalized (4DMC{sub renorm}) to 95 % dose coverage of the PTV{sub 5} {sub mm} for comparisons with the 4DMCO plans. A 3DMCO plan was considered adequate if the 4DMC{sub recal} plan showed ≥ 95 % of the PTV{sub 3} {sub mm} receiving 60 Gy and doses to other organs at risk (OARs) were below the limits. In seven lesions, 3DMCO was inadequate, providing < 95 % dose coverage to the PTV{sub 3} {sub mm}. Comparison of 4DMC{sub recal} and 3DMCO plans showed that organ deformations resulted in lower OAR doses. Renormalizing the 4DMC{sub recal} plans could produce OAR doses higher than the tolerances in some 4DMC{sub renorm} plans. Dose conformity of the 4DMC{sub renorm} plans was inferior to that of the 3DMCO and 4DMCO plans. The 4DMCO plans did not always achieve OAR dose reductions compared to 3DMCO and 4DMC{sub renorm} plans. This study indicates that 3DMCO with 2 mm margins for organ deformations may be inadequate for Cyberknife-based lung stereotactic body radiotherapy (SBRT). Renormalizing the 4DMC{sub recal} plans could produce degraded dose conformity and increased OAR doses; 4DMCO can resolve this problem. (orig.) [German] Untersucht wurde die Angemessenheit einer dreidimensionalen (3-D) Monte

  13. Preparation and fabrication of a full-scale, sagittal-sliced, 3D-printed, patient-specific radiotherapy phantom.

    Science.gov (United States)

    Craft, Daniel F; Howell, Rebecca M

    2017-09-01

    Patient-specific 3D-printed phantoms have many potential applications, both research and clinical. However, they have been limited in size and complexity because of the small size of most commercially available 3D printers as well as material warping concerns. We aimed to overcome these limitations by developing and testing an effective 3D printing workflow to fabricate a large patient-specific radiotherapy phantom with minimal warping errors. In doing so, we produced a full-scale phantom of a real postmastectomy patient. We converted a patient's clinical CT DICOM data into a 3D model and then sliced the model into eleven 2.5-cm-thick sagittal slices. The slices were printed with a readily available thermoplastic material representing all body tissues at 100% infill, but with air cavities left open. Each slice was printed on an inexpensive and commercially available 3D printer. Once the printing was completed, the slices were placed together for imaging and verification. The original patient CT scan and the assembled phantom CT scan were registered together to assess overall accuracy. The materials for the completed phantom cost $524. The printed phantom agreed well with both its design and the actual patient. Individual slices differed from their designs by approximately 2%. Registered CT images of the assembled phantom and original patient showed excellent agreement. Three-dimensional printing the patient-specific phantom in sagittal slices allowed a large phantom to be fabricated with high accuracy. Our results demonstrate that our 3D printing workflow can be used to make large, accurate, patient-specific phantoms at 100% infill with minimal material warping error. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

  14. Strategies to evaluate the impact of rectal volume on prostate motion during three-dimensional conformal radiotherapy for prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Poli, Ana Paula Diniz Fortuna, E-mail: anapaulafortuna@yahoo.com.br [Universidade Estadual de Campinas (CAISM/UNICAMP), Campinas, SP (Brazil). Centro de Atencao Integrada a Saude da Mulher. Divisao de Radioterapia; Dias, Rodrigo Souza; Giordani, Adelmo Jose; Segreto, Helena Regina Comodo; Segreto, Roberto Araujo [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Medicina. Divisao de Radioterapia

    2016-01-15

    Objective: To evaluate the rectal volume influence on prostate motion during three-dimensional conformal radiotherapy (3D-CRT) for prostate cancer. Materials and Methods: Fifty-one patients with prostate cancer underwent a series of three computed tomography scans including an initial planning scan and two subsequent scans during 3D-CRT. The organs of interest were outlined. The prostate contour was compared with the initial CT images considering the anterior, posterior, superior, inferior and lateral edges of the organ. Variations in the anterior limits and volume of the rectum were assessed and correlated with prostate motion in the anteroposterior direction. Results: The maximum range of prostate motion was observed in the superoinferior direction, followed by the anteroposterior direction. A significant correlation was observed between prostate motion and rectal volume variation (p = 0.037). A baseline rectal volume superior to 70 cm{sup 3} had a significant influence on the prostate motion in the anteroposterior direction (p = 0.045). Conclusion: The present study showed a significant interfraction motion of the prostate during 3D-CRT with greatest variations in the superoinferior and anteroposterior directions, and that a large rectal volume influences the prostate motion with a cutoff value of 70 cm{sup 3}. Therefore, the treatment of patients with a rectal volume > 70 cm{sup 3} should be re-planned with appropriate rectal preparation. Keywords: Rectal volume; Prostate cancer; Three-dimensional conformal radiotherapy. (author)

  15. A 3D quantitative evaluation for assessing the changes of treatment planning system and irradiation techniques in radiotherapy

    Directory of Open Access Journals (Sweden)

    Abdulhamid Chaikh

    2014-08-01

    proposed in this study provide useful tools for radiotherapy to compare two dose distributions obtained using different algorithms or different irradiation techniques. The χ-index was (~190 times faster than γ-index. The χ-index is thus a valuable and more convenient method for 3D global analysis compared with γ-index.------------------------Cite this article as: Chaikh A, Giraud JY, Balosso J. A 3D quantitative evaluation for assessing the changes of treatment planning system and irradiation techniques in radiotherapy. Int J Cancer Ther Oncol 2014; 2(3:02033. DOI: 10.14319/ijcto.0203.3

  16. 肺部恶性肿瘤三维适形放射治疗近期疗效观察%Observation of the short-term therapeutic effect of 3D conformal hypofractionated single high-dose radiotherapy on lung tumors

    Institute of Scientific and Technical Information of China (English)

    吴德华; 邓燕; 陈龙华

    2003-01-01

    目的探讨三维适形放射治疗(3DCRT)肺部恶性肿瘤的近期疗效.方法对34例不能行手术切除的肺部恶性肿瘤患者采用三维适形放射治疗,观察近期疗效及生存率.结果肿瘤局部缓解率91.2%(3l/34),1、2、3年生存率分别是88.2%(30/34)、353%(12/34)、26.5%(9/34).结论 3D CRT治疗肺部恶性肿瘤有较好的近期疗效,远期疗效尚待进一步观察.

  17. SU-E-T-460: Isoeffective Dose Display (EQD2) for Composite Plan of Radiosurgery and Conventional 3D Radiotherapy.

    Science.gov (United States)

    Zheng, Y; Yuan, J; Woods, C; Machtay, M; Wessels, B

    2012-06-01

    Direct addition of doses between plans with different fractionation fails to provide accurate dose-response information to anticipate clinical outcome. To combine different fractionation patterns, first-order biological model correction for dose-rate must be included. Moreover, 3-D isoeffect patterns of the combined doses must be displayed so that overlap area to elegant volumes can be avoided. The linear quadratic (LQ) model and biologically effective dose (BED) method were used to produce a combined plan in equivalent 2 Gy fractions (EQD2) for radiosurgery and conventional 3D radiotherapy. For patients with multiple courses of radiotherapy, dose distributions of the prior and boost treatment plans were converted to BED. The fraction size specified by the prescription was applied globally for each BED calculation, α/β ratio of 10 and 2.5 was used for early and late effect, respectively. Image registration with CT or MR was performed for initial and boost plans. The registration information was applied to dose distributions to obtain the composite EQD2. As a demonstration of this method, two patients were selected who had combined treatments from substantially different modalities. A patient with liver cancer initially received radiotherapy of 30 Gy/10 Fx and re-irradiation with CyberKnife radiosurgery (15 Gy/1 Fx). The combined plan showed that the PTV received EQD2 of 63.8 Gy. Another patient had brain metastasis treated with GammaKnife of 18 Gy (50% isodose) followed by conventional 3D whole brain radiation of 30 Gy/10 Fx. The minimal combined tumor EQD2 was 74.5 Gy. Early and late calculated responses showed that all critical organ doses were within tolerance. For patients receiving radiation with different fractionation schemes, combined isoeffective dose distributions were calculated and displayed. In both cases, crucial information regarding 3-D dose distributions assisted the physicians in determining whether tolerance limits of overlap areas of retreated

  18. Intensity modulated radiotherapy in early stage Hodgkin lymphoma patients: Is it better than three dimensional conformal radiotherapy?

    Directory of Open Access Journals (Sweden)

    De Sanctis Vitaliana

    2012-08-01

    Full Text Available Abstract Background Cure rate of early Hodgkin Lymphoma are high and avoidance of late toxicities is of paramount importance. This comparative study aims to assess the normal tissue sparing capability of intensity-modulated radiation therapy (IMRT versus standard three-dimensional conformal radiotherapy (3D-CRT in terms of dose-volume parameters and normal tissue complication probability (NTCP for different organs at risk in supradiaphragmatic Hodgkin Lymphoma (HL patients. Methods Ten HL patients were actually treated with 3D-CRT and all treatments were then re-planned with IMRT. Dose-volume parameters for thyroid, oesophagus, heart, coronary arteries, lung, spinal cord and breast were evaluated. Dose-volume histograms generated by TPS were analyzed to predict the NTCP for the considered organs at risk, according to different endpoints. Results Regarding dose-volume parameters no statistically significant differences were recorded for heart and origin of coronary arteries. We recorded statistically significant lower V30 with IMRT for oesophagus (6.42 vs 0.33, p = 0.02 and lungs (4.7 vs 0.1 p = 0.014 for the left lung and 2.59 vs 0.1 p = 0.017 for the right lung and lower V20 for spinal cord (17.8 vs 7.2 p = 0.02. Moreover the maximum dose to the spinal cord was lower with IMRT (30.2 vs 19.9, p Conclusions In HL male patients IMRT seems feasible and accurate while for women HL patients IMRT should be used with caution.

  19. Efficacy and safety of transarterial chemoembolization combined to conformal radiotherapy for uninodular hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Philippe Merle

    2014-12-01

    Full Text Available Purpose: A proportion of patients with uninodular hepatocellular carcinoma (HCC cannot benefit from potential curative therapies such as liver transplantation, surgical resection or radiofrequency ablation. Thus, they are prone to receive transarterial chemoembolization (TACE that is a palliative option with low probability of both complete response and prolonged local control. Herein, we assessed the combination of TACE and 3D-high dose conformal radiotherapy (3D-HDCRT for efficacy and safety in HCC. Methods: We retrospectively analyzed the outcome of 35 consecutive patients with uninodular HCC ≤ 100 mm, treated by one course of TACE combined to 3D-HDCRT. The follow-up consisted on clinics, biology, hepatic CT-scan or MRI at month-1 and -3, and thereafter every 3 months. Results: Complete response was obtained in 80% of patients following mRECIST criteria (95% in HCC ≤ 50 mm, and 60% in HCC > 50 mm with uncommon local recurrence (11%, overall survival rates of 79%, 59% and 44% at respectively 1, 2 and 3 years (median, 37.3 months, and 11.4% grade-3/4 toxicities. Pre-therapeutic α-fetoprotein level ≥ 200 ng/mL was found as a strong predictor of poorer outcome. Conclusion: We showed that TACE combined to 3D-HDCRT can be highly efficient to reach local control and interesting overall survival rates for uninodular HCC, with limited severe toxicities for Child-Pugh A patients. Subsequent prospective controlled trials are warranted for comparison with therapeutic standards.

  20. Propensity Score-based Comparison of Long-term Outcomes With 3-Dimensional Conformal Radiotherapy vs Intensity-Modulated Radiotherapy for Esophageal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Steven H., E-mail: SHLin@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Wang Lu [Department of Biostatistics, University of Michigan, Ann Arbor, Michigan (United States); Myles, Bevan [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Thall, Peter F. [Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hofstetter, Wayne L.; Swisher, Stephen G. [Department of Thoracic Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Ajani, Jaffer A. [Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Cox, James D.; Komaki, Ritsuko; Liao Zhongxing [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2012-12-01

    Purpose: Although 3-dimensional conformal radiotherapy (3D-CRT) is the worldwide standard for the treatment of esophageal cancer, intensity modulated radiotherapy (IMRT) improves dose conformality and reduces the radiation exposure to normal tissues. We hypothesized that the dosimetric advantages of IMRT should translate to substantive benefits in clinical outcomes compared with 3D-CRT. Methods and Materials: An analysis was performed of 676 nonrandomized patients (3D-CRT, n=413; IMRT, n=263) with stage Ib-IVa (American Joint Committee on Cancer 2002) esophageal cancers treated with chemoradiotherapy at a single institution from 1998-2008. An inverse probability of treatment weighting and inclusion of propensity score (treatment probability) as a covariate were used to compare overall survival time, interval to local failure, and interval to distant metastasis, while accounting for the effects of other clinically relevant covariates. The propensity scores were estimated using logistic regression analysis. Results: A fitted multivariate inverse probability weighted-adjusted Cox model showed that the overall survival time was significantly associated with several well-known prognostic factors, along with the treatment modality (IMRT vs 3D-CRT, hazard ratio 0.72, P<.001). Compared with IMRT, 3D-CRT patients had a significantly greater risk of dying (72.6% vs 52.9%, inverse probability of treatment weighting, log-rank test, P<.0001) and of locoregional recurrence (P=.0038). No difference was seen in cancer-specific mortality (Gray's test, P=.86) or distant metastasis (P=.99) between the 2 groups. An increased cumulative incidence of cardiac death was seen in the 3D-CRT group (P=.049), but most deaths were undocumented (5-year estimate, 11.7% in 3D-CRT vs 5.4% in IMRT group, Gray's test, P=.0029). Conclusions: Overall survival, locoregional control, and noncancer-related death were significantly better after IMRT than after 3D-CRT. Although these results need

  1. Integral Dose and Radiation-Induced Secondary Malignancies: Comparison between Stereotactic Body Radiation Therapy and Three-Dimensional Conformal Radiotherapy

    Science.gov (United States)

    D’Arienzo, Marco; Masciullo, Stefano G.; de Sanctis, Vitaliana; Osti, Mattia F.; Chiacchiararelli, Laura; Enrici, Riccardo M.

    2012-01-01

    The aim of the present paper is to compare the integral dose received by non-tumor tissue (NTID) in stereotactic body radiation therapy (SBRT) with modified LINAC with that received by three-dimensional conformal radiotherapy (3D-CRT), estimating possible correlations between NTID and radiation-induced secondary malignancy risk. Eight patients with intrathoracic lesions were treated with SBRT, 23 Gy × 1 fraction. All patients were then replanned for 3D-CRT, maintaining the same target coverage and applying a dose scheme of 2 Gy × 32 fractions. The dose equivalence between the different treatment modalities was achieved assuming α/β = 10Gy for tumor tissue and imposing the same biological effective dose (BED) on the target (BED = 76Gy10). Total NTIDs for both techniques was calculated considering α/β = 3Gy for healthy tissue. Excess absolute cancer risk (EAR) was calculated for various organs using a mechanistic model that includes fractionation effects. A paired two-tailed Student t-test was performed to determine statistically significant differences between the data (p ≤ 0.05). Our study indicates that despite the fact that for all patients integral dose is higher for SBRT treatments than 3D-CRT (p = 0.002), secondary cancer risk associated to SBRT patients is significantly smaller than that calculated for 3D-CRT (p = 0.001). This suggests that integral dose is not a good estimator for quantifying cancer induction. Indeed, for the model and parameters used, hypofractionated radiotherapy has the potential for secondary cancer reduction. The development of reliable secondary cancer risk models seems to be a key issue in fractionated radiotherapy. Further assessments of integral doses received with 3D-CRT and other special techniques are also strongly encouraged. PMID:23202843

  2. Evaluation of the optimal field arrangement for conformal radiotherapy for prostate cancer patients

    Institute of Scientific and Technical Information of China (English)

    M. Mahmoud; K Elshahat; H. William; M.Barsum; Amr Gaber

    2012-01-01

    Objective: The aim of this study was to evaluate the optimal field arrangement for conformal radiotherapy (CFRT) for prostate cancer patients. Methods: Thirty patients with prostate cancer of different grades and stages were treated with 3D conformal radiotherapy to minimize the dose to bladder, rectum and head of both femora using four fields (4F), five fields (5F), six fields (6F) and ARC techniques to minimize the risk of over dose to bladder, rectum and femoral heads. Patients received a total dose between 76 to 78 Gy given in 38 to 39 fractions over 7.5 to 8 weeks. Results: It was observed that V95, D95, D50 and D5 values for planning target volume (PTV) were comparatively higher when planned by 5 fields technique than when planned by fixed field technique (91%, 91%, 90% and 91.4% for skip-scan technique versus 85%, 87%, 86% and 88% by fixed field). The organs like rectum and urinary bladder get much higher dose when treated by fixed field techniques than rotation or 5 fields technique, when comparison was made for V95, V50 and DM values for rectum and urinary bladder obtained by 5 fields technique planning and 4/6 field planning, the value for 5 fields technique was found to be lower than 4/6 field technique (1%, 70% and 51% versus 13%, 91% and 55% for rectum and 4%, 25% and 51% versus 16%, 38% and 56% for urinary bladder respectively). Conclusion: Similarly for femoral heads, planning by full rotational technique had been observed to be beneficial as compared to when planning was done by fixed field technique (0%, 0% and 29% versus 0%, 1% and 28%).

  3. Intensity-Modulated Radiotherapy Causes Fewer Side Effects than Three-Dimensional Conformal Radiotherapy When Used in Combination With Brachytherapy for the Treatment of Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Forsythe, Kevin; Blacksburg, Seth [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, NY (United States); Stone, Nelson [Department of Urology, Mount Sinai School of Medicine, New York, NY (United States); Stock, Richard G., E-mail: richard.stock@moutsinai.org [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, NY (United States)

    2012-06-01

    Purpose: To measure the benefits of intensity-modulated radiotherapy (IMRT) compared with three-dimensional conformal radiotherapy (3D-CRT) when used in combination with brachytherapy for the treatment of prostate cancer. Methods and Materials: We conducted a retrospective review of all patients with localized prostate cancer who received external-beam radiotherapy (EBRT) in combination with brachytherapy with at least 1 year follow-up (n = 812). Combination therapy consisted of {sup 103}Pd or {sup 125}I implant, followed by a course of EBRT. From 1993 to March 2003 521 patients were treated with 3D-CRT, and from April 2003 to March 2009 291 patients were treated with IMRT. Urinary symptoms were prospectively measured with the International Prostate Symptom Score questionnaire with a single quality of life (QOL) question; rectal bleeding was assessed per the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer Late Radiation Morbidity Scoring Schema. The Pearson {chi}{sup 2} test was used to compare toxicities experienced by patients who were treated with either IMRT or 3D-CRT. Logistic regression analyses were also performed to rule out possible confounding factors. Results: Within the first 3 months after treatment, patients treated with 3D-CRT scored their urinary symptoms as follows: 19% mild, 44% moderate, and 37% severe; patients treated with IMRT scored their urinary symptoms as follows: 36% mild, 47% moderate, and 17% severe (p < 0.001). The 3D-CRT patients rated their QOL as follows: 35% positive, 20% neutral, and 45% negative; IMRT patients rated their QOL as follows: 51% positive, 18% neutral, and 31% negative (p < 0.001). After 1 year of follow-up there was no longer any difference in urinary morbidity between the two groups. Logistic regression confirmed the differences in International Prostate Symptom Score and QOL in the acute setting (p < 0.001 for both). Grade {>=}2 rectal bleeding was reported by 11% of 3D

  4. Semiautomatic registration of 3D transabdominal ultrasound images for patient repositioning during postprostatectomy radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Presles, Benoît, E-mail: benoit.presles@creatis.insa-lyon.fr; Rit, Simon; Sarrut, David [Université de Lyon, CREATIS, CNRS UMR5220, Inserm U1044, INSA-Lyon, Université Lyon 1, Lyon F-69621, France and Léon Bérard Cancer Center, Université de Lyon, Lyon F-69373 (France); Fargier-Voiron, Marie; Liebgott, Hervé [Université de Lyon, CREATIS, CNRS UMR5220, Inserm U1044, INSA-Lyon, Université Lyon 1, Lyon F-69621 (France); Biston, Marie-Claude; Munoz, Alexandre; Pommier, Pascal [Léon Bérard Cancer Center, Université de Lyon, Lyon F-69373 (France); Lynch, Rod [The Andrew Love Cancer Centre, University Hospital Geelong, Geelong 3220 (Australia)

    2014-12-15

    Purpose: The aim of the present work is to propose and evaluate registration algorithms of three-dimensional (3D) transabdominal (TA) ultrasound (US) images to setup postprostatectomy patients during radiation therapy. Methods: Three registration methods have been developed and evaluated to register a reference 3D-TA-US image acquired during the planning CT session and a 3D-TA-US image acquired before each treatment session. The first method (method A) uses only gray value information, whereas the second one (method B) uses only gradient information. The third one (method C) combines both sets of information. All methods restrict the comparison to a region of interest computed from the dilated reference positioning volume drawn on the reference image and use mutual information as a similarity measure. The considered geometric transformations are translations and have been optimized by using the adaptive stochastic gradient descent algorithm. Validation has been carried out using manual registration by three operators of the same set of image pairs as the algorithms. Sixty-two treatment US images of seven patients irradiated after a prostatectomy have been registered to their corresponding reference US image. The reference registration has been defined as the average of the manual registration values. Registration error has been calculated by subtracting the reference registration from the algorithm result. For each session, the method has been considered a failure if the registration error was above both the interoperator variability of the session and a global threshold of 3.0 mm. Results: All proposed registration algorithms have no systematic bias. Method B leads to the best results with mean errors of −0.6, 0.7, and −0.2 mm in left–right (LR), superior–inferior (SI), and anterior–posterior (AP) directions, respectively. With this method, the standard deviations of the mean error are of 1.7, 2.4, and 2.6 mm in LR, SI, and AP directions, respectively

  5. Clinical Outcome of Patients Treated With 3D Conformal Radiation Therapy (3D-CRT) for Prostate Cancer on RTOG 9406

    Energy Technology Data Exchange (ETDEWEB)

    Michalski, Jeff, E-mail: michalski@wustl.edu [Radiation Oncology, Washington University Medical School, St. Louis, Missouri (United States); Image-guided Therapy Center, St. Louis, Missouri (United States); Winter, Kathryn [Department of Statistics, Radiation Therapy Oncology Group, Philadelphia, Pennsylvania (United States); Roach, Mack [Radiation Oncology, University of California-San Francisco, San Francisco, California (United States); Markoe, Arnold [University of Miami, Miami, Florida (United States); Sandler, Howard M. [University of Michigan, Ann Arbor, Michigan (United States); Cedars-Sinai Medical Center, Los Angeles, California (United States); Ryu, Janice [Radiation Oncology, University of California-Davis, Davis, California (United States); Radiation Oncology Associates, Sacramento, California (United States); Parliament, Matthew [Radiation Oncology, University of Alberta, Edmonton, Alberta (Canada); Purdy, James A. [Radiation Oncology, University of California-Davis, Davis, California (United States); Image-guided Therapy Center, St. Louis, Missouri (United States); Valicenti, Richard K. [Radiation Oncology, University of California-Davis, Davis, California (United States); Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Cox, James D. [Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2012-07-01

    Purpose: Report of clinical cancer control outcomes on Radiation Therapy Oncology Group (RTOG) 9406, a three-dimensional conformal radiation therapy (3D-CRT) dose escalation trial for localized adenocarcinoma of the prostate. Methods and Materials: RTOG 9406 is a Phase I/II multi-institutional dose escalation study of 3D-CRT for men with localized prostate cancer. Patients were registered on five sequential dose levels: 68.4 Gy, 73.8 Gy, 79.2 Gy, 74 Gy, and 78 Gy with 1.8 Gy/day (levels I-III) or 2.0 Gy/day (levels IV and V). Neoadjuvant hormone therapy (NHT) from 2 to 6 months was allowed. Protocol-specific, American Society for Therapeutic Radiation Oncology (ASTRO), and Phoenix biochemical failure definitions are reported. Results: Thirty-four institutions enrolled 1,084 patients and 1,051 patients are analyzable. Median follow-up for levels I, II, III, IV, and V was 11.7, 10.4, 11.8, 10.4, and 9.2 years, respectively. Thirty-six percent of patients received NHT. The 5-year overall survival was 90%, 87%, 88%, 89%, and 88% for dose levels I-V, respectively. The 5-year clinical disease-free survival (excluding protocol prostate-specific antigen definition) for levels I-V is 84%, 78%, 81%, 82%, and 82%, respectively. By ASTRO definition, the 5-year disease-free survivals were 57%, 59%, 52%, 64% and 75% (low risk); 46%, 52%, 54%, 56%, and 63% (intermediate risk); and 50%, 34%, 46%, 34%, and 61% (high risk) for levels I-V, respectively. By the Phoenix definition, the 5-year disease-free survivals were 68%, 73%, 67%, 84%, and 80% (low risk); 70%, 62%, 70%, 74%, and 69% (intermediate risk); and 42%, 62%, 68%, 54%, and 67% (high risk) for levels I-V, respectively. Conclusion: Dose-escalated 3D-CRT yields favorable outcomes for localized prostate cancer. This multi-institutional experience allows comparison to other experiences with modern radiation therapy.

  6. Predictors of IMRT and Conformal Radiotherapy Use in Head and Neck Squamous Cell Carcinoma: A SEER-Medicare Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Sher, David J., E-mail: dsher@lroc.harvard.edu [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, MA (United States); Center for Outcomes and Policy Research, Dana Farber Cancer Institute, Boston, MA (United States); Neville, Bridget A. [Center for Outcomes and Policy Research, Dana Farber Cancer Institute, Boston, MA (United States); Chen, Aileen B. [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, MA (United States); Center for Outcomes and Policy Research, Dana Farber Cancer Institute, Boston, MA (United States); Schrag, Deborah [Center for Outcomes and Policy Research, Dana Farber Cancer Institute, Boston, MA (United States)

    2011-11-15

    Purpose: The extent to which new techniques for the delivery of radiotherapy for head and neck squamous cell carcinoma (HNSCC) have diffused into clinical practice is unclear, including the use of 3-dimensional conformal RT (3D-RT) and intensity-modulated radiation therapy (IMRT). Methods and Materials: Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database, we identified 2,495 Medicare patients with Stage I-IVB HNSCC diagnosed at age 65 years or older between 2000 and 2005 and treated with either definitive (80%) or adjuvant (20%) radiotherapy. Our primary aim was to analyze the trends and predictors of IMRT use over this time, and the secondary aim was a similar description of the trends and predictors of conformal radiotherapy (CRT) use, defined as treatment with either 3D-RT or IMRT. Results: Three hundred sixty-four (15%) patients were treated with IMRT, and 1,190 patients (48%) were treated with 3D-RT. Claims for IMRT and CRT rose from 0% to 33% and 39% to 86%, respectively, between 2000 and 2005. On multivariable analysis, IMRT use was associated with SEER region (West 18%; Northeast 11%; South 12%; Midwest 13%), advanced stage (advanced, 21%; early, 9%), non-larynx site (non-larynx, 23%; larynx, 7%), higher median census tract income (highest vs. lowest quartile, 18% vs. 10%), treatment year (2003-2005, 31%; 2000-2002, 6%), use of chemotherapy (26% with; 9% without), and higher radiation oncologist treatment volume (highest vs. lowest tertile, 23% vs. 8%). With CRT as the outcome, only SEER region, treatment year, use of chemotherapy, and increasing radiation oncologist HNSCC volume were significant on multivariable analysis. Conclusions: The use of IMRT and CRT by Medicare beneficiaries with HNSCC rose significantly between 2000 and 2005 and was associated with both clinical and non-clinical factors, with treatment era and radiation oncologist HNSCC treatment volume serving as the strongest predictors of IMRT use.

  7. Involved-Site Image-Guided Intensity Modulated Versus 3D Conformal Radiation Therapy in Early Stage Supradiaphragmatic Hodgkin Lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Filippi, Andrea Riccardo, E-mail: andreariccardo.filippi@unito.it [Department of Oncology, University of Torino, Torino (Italy); Ciammella, Patrizia [Radiation Therapy Unit, Department of Oncology and Advanced Technology, ASMN Hospital IRCCS, Reggio Emilia (Italy); Piva, Cristina; Ragona, Riccardo [Department of Oncology, University of Torino, Torino (Italy); Botto, Barbara [Hematology, Città della Salute e della Scienza, Torino (Italy); Gavarotti, Paolo [Hematology, University of Torino and Città della Salute e della Scienza, Torino (Italy); Merli, Francesco [Hematology Unit, ASMN Hospital IRCCS, Reggio Emilia (Italy); Vitolo, Umberto [Hematology, Città della Salute e della Scienza, Torino (Italy); Iotti, Cinzia [Radiation Therapy Unit, Department of Oncology and Advanced Technology, ASMN Hospital IRCCS, Reggio Emilia (Italy); Ricardi, Umberto [Department of Oncology, University of Torino, Torino (Italy)

    2014-06-01

    Purpose: Image-guided intensity modulated radiation therapy (IG-IMRT) allows for margin reduction and highly conformal dose distribution, with consistent advantages in sparing of normal tissues. The purpose of this retrospective study was to compare involved-site IG-IMRT with involved-site 3D conformal RT (3D-CRT) in the treatment of early stage Hodgkin lymphoma (HL) involving the mediastinum, with efficacy and toxicity as primary clinical endpoints. Methods and Materials: We analyzed 90 stage IIA HL patients treated with either involved-site 3D-CRT or IG-IMRT between 2005 and 2012 in 2 different institutions. Inclusion criteria were favorable or unfavorable disease (according to European Organization for Research and Treatment of Cancer criteria), complete response after 3 to 4 cycles of an adriamycin- bleomycin-vinblastine-dacarbazine (ABVD) regimen plus 30 Gy as total radiation dose. Exclusion criteria were chemotherapy other than ABVD, partial response after ABVD, total radiation dose other than 30 Gy. Clinical endpoints were relapse-free survival (RFS) and acute toxicity. Results: Forty-nine patients were treated with 3D-CRT (54.4%) and 41 with IG-IMRT (45.6%). Median follow-up time was 54.2 months for 3D-CRT and 24.1 months for IG-IMRT. No differences in RFS were observed between the 2 groups, with 1 relapse each. Three-year RFS was 98.7% for 3D-CRT and 100% for IG-IMRT. Grade 2 toxicity events, mainly mucositis, were recorded in 32.7% of 3D-CRT patients (16 of 49) and in 9.8% of IG-IMRT patients (4 of 41). IG-IMRT was significantly associated with a lower incidence of grade 2 acute toxicity (P=.043). Conclusions: RFS rates at 3 years were extremely high in both groups, albeit the median follow-up time is different. Acute tolerance profiles were better for IG-IMRT than for 3D-CRT. Our preliminary results support the clinical safety and efficacy of advanced RT planning and delivery techniques in patients affected with early stage HL, achieving complete

  8. Neutron measurements with ultra-thin 3D silicon sensors in a radiotherapy treatment room using a Siemens PRIMUS linac

    Science.gov (United States)

    Guardiola, C.; Gómez, F.; Fleta, C.; Rodríguez, J.; Quirion, D.; Pellegrini, G.; Lousa, A.; Martínez-de-Olcoz, L.; Pombar, M.; Lozano, M.

    2013-05-01

    The accurate detection and dosimetry of neutrons in mixed and pulsed radiation fields is a demanding instrumental issue with great interest both for the industrial and medical communities. In recent studies of neutron contamination around medical linacs, there is a growing concern about the secondary cancer risk for radiotherapy patients undergoing treatment in photon modalities at energies greater than 6 MV. In this work we present a promising alternative to standard detectors with an active method to measure neutrons around a medical linac using a novel ultra-thin silicon detector with 3D electrodes adapted for neutron detection. The active volume of this planar device is only 10 µm thick, allowing a high gamma rejection, which is necessary to discriminate the neutron signal in the radiotherapy peripheral radiation field with a high gamma background. Different tests have been performed in a clinical facility using a Siemens PRIMUS linac at 6 and 15 MV. The results show a good thermal neutron detection efficiency around 2% and a high gamma rejection factor.

  9. Conformal symmetry of the critical 3D Ising model inside a sphere

    CERN Document Server

    Cosme, Catarina; Penedones, Joao

    2015-01-01

    We perform Monte-Carlo simulations of the three-dimensional Ising model at the critical temperature and zero magnetic field. We simulate the system in a ball with free boundary conditions on the two dimensional spherical boundary. Our results for one and two point functions in this geometry are consistent with the predictions from the conjectured conformal symmetry of the critical Ising model.

  10. On the development of a VIPARnd radiotherapy 3D polymer gel dosimeter

    Science.gov (United States)

    Kozicki, Marek; Jaszczak, Malwina; Maras, Piotr; Dudek, Mariusz; Cłapa, Marian

    2017-02-01

    This work presents an improvement of the VIPARnd (‘nd’ stands for ‘normoxic, double’, or VIP) polymer gel dosimeter. The gel composition was altered by increasing the concentration of the monomeric components, N-vinylpyrrolidone (NVP) and N,N‧-methylenebisacrylamide (MBA), in co-solvent solutions. The optimal composition (VIPARCT, where ‘CT’ stands for computed tomography, or VIC) comprised: 17% NVP, 8% MBA, 12% t-BuOH, 7.5% gelatine, 0.007% ascorbic acid, 0.0008% CuSO4  ×  5H2O and 0.02% hydroquinone. The following characteristics of VIC were achieved: (i) linear dose range of 0.9_30 Gy, (ii) saturation for radiation doses of over 50 Gy, (iii) threshold dose of about 0.5 Gy, (iv) dose sensitivity of 0.171 Gy-1 s-1, which is roughly 2.2 times higher than that of VIP (for nuclear magnetic resonance measurements). It was also found that VIC is dose- rate-independent, and its dose response does not alter if the radiation source is changed from electrons to photons for external beam radiotherapy. The gel responded similarly to irradiation with small changes in radiation energy but was sensitive to larger energy changes. The VIC gel retained temporal stability from 20 h until at least 10 d after irradiation, whereas spatial stability was retained from 20 h until at least 6 d after irradiation. The scheme adopted for VIC manufacturing yields repeatable gels in terms of radiation dose response. The VIC was also shown to perform better than VIP using x-ray computed tomography as a readout method; the dose sensitivity of VIC (0.397 HU Gy-1) was 1.5 times higher than that of VIP. Also, the dose resolution of VIC was better than that of VIP in the whole dose range examined.

  11. 3-D superposition for radiotherapy treatment planning using fast Fourier transforms.

    Science.gov (United States)

    Murray, D C; Hoban, P W; Metcalfe, P E; Round, W H

    1989-09-01

    Currently used radiotherapy treatment planning algorithms based on effective path length or scatter function methods do not model electron ranging from photon interaction sites. The superposition (or convolution) technique does model this effect, which is especially important at higher (linear accelerator) energies since the electron range is significant. Another advantage of this method is that it is conceptually simple and models the physical processes directly, rather than using empirically derived methods. A major disadvantage of superposition lies in the large amount of computer time required to generate a plan, especially in three dimensions. To help solve this problem, superposition using an invariant dose spread array (kernel) can be achieved by performing a convolution in Fourier space using fast Fourier transforms (FFTs). A method for 3 dimensional calculation of dose using FFTs is presented. Dose spread arrays are calculated using the EGS Monte Carlo code, and convolved with the TERMA (total energy released per unit mass). In both cases a 10 MV nominal beam energy is modelled by a 10 component spectrum, which is compared to the result obtained using monochromatic energy only (3.0 MeV at the surface). The FFT technique is shown to be significantly faster than standard convolution for medium to large TERMA and dose spread array sizes. The method is shown to be highly accurate for small fields in homogeneous media. For larger fields the central axis depth dose is accurate but the profile shape in the penumbral region becomes slightly distorted. This is because photons incident near the beam edges are not parallel to the cartesian coordinate system used as the convolution framework. However, this effect is sufficiently small to indicate that the convolution method is suitable for use in routine treatment planning.

  12. A GPU-based finite-size pencil beam algorithm with 3D-density correction for radiotherapy dose calculation

    CERN Document Server

    Gu, Xuejun; Li, Jinsheng; Jia, Xun; Jiang, Steve B

    2011-01-01

    Targeting at developing an accurate and efficient dose calculation engine for online adaptive radiotherapy, we have implemented a finite size pencil beam (FSPB) algorithm with a 3D-density correction method on GPU. This new GPU-based dose engine is built on our previously published ultrafast FSPB computational framework [Gu et al. Phys. Med. Biol. 54 6287-97, 2009]. Dosimetric evaluations against MCSIM Monte Carlo dose calculations are conducted on 10 IMRT treatment plans with heterogeneous treatment regions (5 head-and-neck cases and 5 lung cases). For head and neck cases, when cavities exist near the target, the improvement with the 3D-density correction over the conventional FSPB algorithm is significant. However, when there are high-density dental filling materials in beam paths, the improvement is small and the accuracy of the new algorithm is still unsatisfactory. On the other hand, significant improvement of dose calculation accuracy is observed in all lung cases. Especially when the target is in the m...

  13. Dose escalation in prostate radiotherapy up to 82 Gy using simultaneous integrated boost. Direct comparison of acute and late toxicity with 3D-CRT 74 Gy and IMRT 78 Gy

    Energy Technology Data Exchange (ETDEWEB)

    Dolezel, Martin; Odrazka, Karel; Vanasek, Jaroslav [Oncology Center, Multiscan and Pardubice Regional Hospital, Pardubice (Czech Republic); Vaculikova, Miloslava [Dept. of Oncology, Hospital Nachod (Czech Republic); Sefrova, Jana; Paluska, Petr; Zouhar, Milan; Jansa, Jan; Macingova, Zuzana; Jarosova, Lida [Dept. of Oncology and Radiotherapy, Univ. Hospital Hradec Kralove (Czech Republic); Brodak, Milos; Moravek, Petr [Dept. of Urology, Univ. Hospital Hradec Kralove (Czech Republic); Hartmann, Igor [Dept. of Urology, Univ. Hospital Olomouc (Czech Republic)

    2010-04-15

    Purpose: To compare acute and late toxicity after three-dimensional conformal radiotherapy to the prostate to 74 Gy (3D-CRT) with intensity-modulated radiotherapy to 78 Gy (IMRT 78) and IMRT using simultaneous integrated boost to 82 Gy (IMRT/SIB 82). Patients and methods: 94 patients treated with 3D-CRT to the prostate and base of seminal vesicles to 74 Gy represented the first group. The second group consisted of 138 patients subjected to IMRT covering the prostate and base of seminal vesicles to 78 Gy. The last group was treated with IMRT using SIB. The prescribed doses were 82 Gy and 73.8 Gy in 42 fractions to the prostate and seminal vesicles. Late toxicity was prospectively scored according to the RTOG/FC-LENT scale. Results: Acute gastrointestinal toxicity {>=} grade 2 occurred in 35.1% of patients treated with 3D-CRT, in 16% subjected to IMRT 78, and in 7.7% receiving IMRT/SIB 82. Acute genitourinary toxicity {>=} grade 2 was observed in 26.6% (3D-CRT), 33% (IMRT 78), and 30.7% (IMRT/SIB 82). At 3 years, the estimated cumulative incidence of grade 3 late gastrointestinal toxicity was 14% for 3D-CRT, 5% for IMRT 78, and 2% for IMRT/SIB 82. The difference became significant (log rank p = 0.02). The estimated cumulative incidence of grade 3 late genitourinary toxicity was 9% (3D-CRT), 7% (IMRT 78), and 6% (IMRT/SIB 82) without statistical differences (log rank p = 0.32). Conclusion: SIB enables dose escalation up to 82 Gy with a lower rate of gastrointestinal toxicity grade 3 in comparison with 3D-CRT up to 74 Gy. (orig.)

  14. Treating benign optic nerve tumors with a 3-D conformal plan

    Energy Technology Data Exchange (ETDEWEB)

    Millunchick, Cheryl Hope, E-mail: mordechaimillunchick@gmail.com [Rush University Medical Center, Radiation Oncology, Chicago, IL (United States)

    2013-07-01

    A 68 year old male patient presented for radiation therapy for treatment of a benign tumor, a glioma of his left optic nerve. The radiation oncologist intended to prescribe 52.2 Gy to the planning target volume, while maintaining a maximum of 54 Gy to the optic nerves and the optic chiasm and a maximum of 40–45 Gy to the globes in order to minimize the possibility of damaging the optic system, which is especially important as this is a benign tumor. The dosimetrist devised a conformal non-coplanar three-dimensional plan with a slightly weighted forward planning component. This plan was created in approximately 15 minutes after the critical organs and the targets were delineated and resulted in an extremely conformal and homogenous plan, treating the target while sparing the nearby critical structures. This approach can also be extended to other tumors in the brain - benign or malignant.

  15. The Comparison 2D and 3D Treatment Planning in Breast Cancer Radiotherapy with Emphasis on Dose Homogeneity and Lung Dose

    Directory of Open Access Journals (Sweden)

    Zahra Falahatpour

    2010-09-01

    Full Text Available Introduction: Breast conserving radiotherapy is one of the most common procedures performed in any radiation oncology department. A tangential parallel-opposed pair is usually used for this purpose. This technique is performed using 2D or 3D treatment planning systems. The aim of this study was to compare 2D treatment planning with 3D treatment planning in tangential irradiation in breast conserving radiotherapy. In this comparison, homogeneity of isodoses in the breast volume and lung dose were considered. Material and Methods: Twenty patients with breast cancer treated with conservative surgery were included in this study. The patients were CT scanned. Two-dimensional treatment planning with the Alfard 2D TPS was performed for each patient using a single central CT slice. The data used on the Alfard 2D TPS was imported into the Eclipse 3D TPS, on which 3D treatment planning was performed. Cobalt-60 beams were used in all plans. Results: Comparing 2D and 3D treatment planning, homogeneity of isodoses was improved in 3D treatment planning (p30Gy was increased in 3D treatment planning (p< 0.01. Discussion and Conclusion: 3D treatment planning is a more suitable option for patients with breast cancer treated with conservative surgery because of improved dose homogeneity in 3D treatment planning. The results of the treatment can be improved with reduced recurrence probability and skin problems.

  16. SAMPL5: 3D-RISM partition coefficient calculations with partial molar volume corrections and solute conformational sampling

    Science.gov (United States)

    Luchko, Tyler; Blinov, Nikolay; Limon, Garrett C.; Joyce, Kevin P.; Kovalenko, Andriy

    2016-11-01

    Implicit solvent methods for classical molecular modeling are frequently used to provide fast, physics-based hydration free energies of macromolecules. Less commonly considered is the transferability of these methods to other solvents. The Statistical Assessment of Modeling of Proteins and Ligands 5 (SAMPL5) distribution coefficient dataset and the accompanying explicit solvent partition coefficient reference calculations provide a direct test of solvent model transferability. Here we use the 3D reference interaction site model (3D-RISM) statistical-mechanical solvation theory, with a well tested water model and a new united atom cyclohexane model, to calculate partition coefficients for the SAMPL5 dataset. The cyclohexane model performed well in training and testing (R=0.98 for amino acid neutral side chain analogues) but only if a parameterized solvation free energy correction was used. In contrast, the same protocol, using single solute conformations, performed poorly on the SAMPL5 dataset, obtaining R=0.73 compared to the reference partition coefficients, likely due to the much larger solute sizes. Including solute conformational sampling through molecular dynamics coupled with 3D-RISM (MD/3D-RISM) improved agreement with the reference calculation to R=0.93. Since our initial calculations only considered partition coefficients and not distribution coefficients, solute sampling provided little benefit comparing against experiment, where ionized and tautomer states are more important. Applying a simple pK_{ {a}} correction improved agreement with experiment from R=0.54 to R=0.66, despite a small number of outliers. Better agreement is possible by accounting for tautomers and improving the ionization correction.

  17. Sensor based 3D conformal cueing for safe and reliable HC operation specifically for landing in DVE

    Science.gov (United States)

    Münsterer, Thomas; Kress, Martin; Klasen, Stephanus

    2013-05-01

    The paper describes the approach of a sensor based landing aid for helicopters in degraded visual conditions. The system concept presented employs a long range high resolution ladar sensor allowing for identifying obstacles in the flight and in the approach path as well as measuring landing site conditions like slope, roughness and precise position relative to the helicopter during long final approach. All these measurements are visualized to the pilot. Cueing is done by 3D conformal symbology displayed in a head-tracked HMD enhanced by 2D symbols for data which is perceived easier by 2D symbols than by 3D cueing. All 3D conformal symbology is placed on the measured landing site surface which is further visualized by a grid structure for displaying landing site slope, roughness and small obstacles. Due to the limited resolution of the employed HMD a specific scheme of blending in the information during the approach is employed. The interplay between in flight and in approach obstacle warning and CFIT warning symbology with this landing aid symbology is also investigated and exemplarily evaluated for the NH90 helicopter which has already today implemented a long range high resolution ladar sensor based obstacle warning and CFIT symbology. The paper further describes the results of simulator and flight tests performed with this system employing a ladar sensor and a head-tracked head mounted display system. In the simulator trials a full model of the ladar sensor producing 3D measurement points was used working with the same algorithms used in flight tests.

  18. CoMFA 3D-QSAR Analysis of Epothilones Based on Docking Conformation and Alignment

    Institute of Scientific and Technical Information of China (English)

    YUAN,Wei; LUAN,Lin-Bo; LI,Yan-Ni

    2007-01-01

    Epothilones belong to a class of novel microtubule stabilizing and anti-mitotic agents.which have a paclitaxel-like mechanism of action.A three-dimensional quantitative structure-activity relationship(3D-QSAR)model was built for epothilones by the method of comparative molecular field analysis (CoMFA)combined with the flexible docking technology.The docking CoMFA model gave a good cross-validated value of q2=0.784 with an optimized component of 6 and the conventional correlation coefficient of r2=0.985.The statistical results show that the model has good ability to predict the activity of the studied compounds.At last.the docking CoMFA model was analyzed through contour maps complemented with MOLCAD-generated active site potential surface in the α,β-tubulin receptor,which can provide important information for the structure-based drug design.

  19. Prediction of conformational B-cell epitopes from 3D structures by random forests with a distance-based feature

    Directory of Open Access Journals (Sweden)

    Zou Hua

    2011-08-01

    Full Text Available Abstract Background Antigen-antibody interactions are key events in immune system, which provide important clues to the immune processes and responses. In Antigen-antibody interactions, the specific sites on the antigens that are directly bound by the B-cell produced antibodies are well known as B-cell epitopes. The identification of epitopes is a hot topic in bioinformatics because of their potential use in the epitope-based drug design. Although most B-cell epitopes are discontinuous (or conformational, insufficient effort has been put into the conformational epitope prediction, and the performance of existing methods is far from satisfaction. Results In order to develop the high-accuracy model, we focus on some possible aspects concerning the prediction performance, including the impact of interior residues, different contributions of adjacent residues, and the imbalanced data which contain much more non-epitope residues than epitope residues. In order to address above issues, we take following strategies. Firstly, a concept of 'thick surface patch' instead of 'surface patch' is introduced to describe the local spatial context of each surface residue, which considers the impact of interior residue. The comparison between the thick surface patch and the surface patch shows that interior residues contribute to the recognition of epitopes. Secondly, statistical significance of the distance distribution difference between non-epitope patches and epitope patches is observed, thus an adjacent residue distance feature is presented, which reflects the unequal contributions of adjacent residues to the location of binding sites. Thirdly, a bootstrapping and voting procedure is adopted to deal with the imbalanced dataset. Based on the above ideas, we propose a new method to identify the B-cell conformational epitopes from 3D structures by combining conventional features and the proposed feature, and the random forest (RF algorithm is used as the

  20. Probing Protein 3D Structures and Conformational Changes Using Electrochemistry-Assisted Isotope Labeling Cross-Linking Mass Spectrometry

    Science.gov (United States)

    Zheng, Qiuling; Zhang, Hao; Wu, Shiyong; Chen, Hao

    2016-05-01

    This study presents a new chemical cross-linking mass spectrometry (MS) method in combination with electrochemistry and isotope labeling strategy for probing both protein three-dimensional (3D) structures and conformational changes. For the former purpose, the target protein/protein complex is cross-linked with equal mole of premixed light and heavy isotope labeled cross-linkers carrying electrochemically reducible disulfide bonds (i.e., DSP-d0 and DSP-d8 in this study, DSP = dithiobis[succinimidyl propionate]), digested and then electrochemically reduced followed with online MS analysis. Cross-links can be quickly identified because of their reduced intensities upon electrolysis and the presence of doublet isotopic peak characteristics. In addition, electroreduction converts cross-links into linear peptides, facilitating MS/MS analysis to gain increased information about their sequences and modification sites. For the latter purpose of probing protein conformational changes, an altered procedure is adopted, in which the protein in two different conformations is cross-linked using DSP-d0 and DSP-d8 separately, and then the two protein samples are mixed in 1:1 molar ratio. The merged sample is subjected to digestion and electrochemical mass spectrometric analysis. In such a comparative cross-linking experiment, cross-links could still be rapidly recognized based on their responses to electrolysis. More importantly, the ion intensity ratios of light and heavy isotope labeled cross-links reveal the conformational changes of the protein, as exemplified by examining the effect of Ca2+ on calmodulin conformation alternation. This new cross-linking MS method is fast and would have high value in structural biology.

  1. 3D quantitative assessment of response to fractionated stereotactic radiotherapy and single-session stereotactic radiosurgery of vestibular schwannoma

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, T. [The Johns Hopkins Hospital School of Medicine, Russell H. Morgan Department of Radiology and Radiological Sciences, Division of Neuroradiology, Baltimore, MD (United States); University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Neuroradiology, Hamburg (Germany); Chapiro, J. [The Johns Hopkins Hospital School of Medicine, Russell H. Morgan Department of Radiology and Radiological Sciences, Division of Interventional Radiology, Baltimore, MD (United States); Lin, M. [Philips Research North America, Ultrasound Imaging and Interventions (UII), Briarcliff Manor, NY (United States); Geschwind, J.F. [The Johns Hopkins Hospital School of Medicine, Russell H. Morgan Department of Radiology and Radiological Sciences, Division of Interventional Radiology, Baltimore, MD (United States); Yale University School of Medicine, Department of Radiology and Imaging Science, New Haven, CT (United States); Kleinberg, L. [The Johns Hopkins University School of Medicine, Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD (United States); Rigamonti, D.; Jusue-Torres, I.; Marciscano, A.E. [The Johns Hopkins University School of Medicine, Department of Neurological Surgery, Baltimore, MD (United States); Yousem, D.M. [The Johns Hopkins Hospital School of Medicine, Russell H. Morgan Department of Radiology and Radiological Sciences, Division of Neuroradiology, Baltimore, MD (United States)

    2016-03-15

    To determine clinical outcome of patients with vestibular schwannoma (VS) after treatment with fractionated stereotactic radiotherapy (FSRT) and single-session stereotactic radiosurgery (SRS) by using 3D quantitative response assessment on MRI. This retrospective analysis included 162 patients who underwent radiation therapy for sporadic VS. Measurements on T1-weighted contrast-enhanced MRI (in 2-year post-therapy intervals: 0-2, 2-4, 4-6, 6-8, 8-10, 10-12 years) were taken for total tumour volume (TTV) and enhancing tumour volume (ETV) based on a semi-automated technique. Patients were considered non-responders (NRs) if they required subsequent microsurgical resection or developed radiological progression and tumour-related symptoms. Median follow-up was 4.1 years (range: 0.4-12.0). TTV and ETV decreased for both the FSRT and SRS groups. However, only the FSRT group achieved significant tumour shrinkage (p < 0.015 for TTV, p < 0.005 for ETV over time). The 11 NRs showed proportionally greater TTV (median TTV pre-treatment: 0.61 cm{sup 3}, 8-10 years after: 1.77 cm{sup 3}) and ETV despite radiation therapy compared to responders (median TTV pre-treatment: 1.06 cm{sup 3}; 10-12 years after: 0.81 cm{sup 3}; p = 0.001). 3D quantification of VS showed a significant decrease in TTV and ETV on FSRT-treated patients only. NR had significantly greater TTV and ETV over time. (orig.)

  2. Radiation-induced fibrosis in the boost area after three-dimensional conformal radiotherapy with a simultaneous integrated boost technique for early-stage breast cancer : A multivariable prediction model

    NARCIS (Netherlands)

    Hammer, C.; Maduro, J. H.; Bantema-Joppe, E. J.; van der Schaaf, A.; van der Laan, H. P.; Langendijk, J. A.; Crijns, A. P. G.

    2017-01-01

    Background and purpose: To develop a multivariable prediction model for the risk of grade >= 2 fibrosis in the boost area after breast conserving surgery (BCS) followed by three-dimensional conformal radiotherapy (RT) with a simultaneous integrated photon boost (3D-CRT-SIB), five years after RT. Mat

  3. Twisted compactifications of 3d N = 4 theories and conformal blocks

    CERN Document Server

    Gaiotto, Davide

    2016-01-01

    Three-dimensional N = 4 supersymmetric quantum field theories admit two topological twists, the Rozansky-Witten twist and its mirror. Either twist can be used to define a supersymmetric compactification on a Riemann surface and a corre- sponding space of supersymmetric ground states. These spaces of ground states can play an interesting role in the Geometric Langlands program. We propose a description of these spaces as conformal blocks for certain non-unitary Vertex Operator Algebras and test our conjecture in some important examples. The two VOAs can be constructed respectively from a UV Lagrangian description of the N = 4 theory or of its mirror. We further conjecture that the VOAs associated to an N = 4 SQFT inherit properties of the theory which only emerge in the IR, such as enhanced global symmetries. Thus knowledge of the VOAs should allow one to compute the spaces of supersymmetric ground states for a theory coupled to supersymmetric background connections for the full symmetry group of the IR SCFT. ...

  4. A positioning QA procedure for 2D/2D (kV/MV) and 3D/3D (CT/CBCT) image matching for radiotherapy patient setup.

    Science.gov (United States)

    Guan, Huaiqun; Hammoud, Rabih; Yin, Fang-Fang

    2009-10-06

    A positioning QA procedure for Varian's 2D/2D (kV/MV) and 3D/3D (planCT/CBCT) matching was developed. The procedure was to check: (1) the coincidence of on-board imager (OBI), portal imager (PI), and cone beam CT (CBCT)'s isocenters (digital graticules) to a linac's isocenter (to a pre-specified accuracy); (2) that the positioning difference detected by 2D/2D (kV/MV) and 3D/3D(planCT/CBCT) matching can be reliably transferred to couch motion. A cube phantom with a 2 mm metal ball (bb) at the center was used. The bb was used to define the isocenter. Two additional bbs were placed on two phantom surfaces in order to define a spatial location of 1.5 cm anterior, 1.5 cm inferior, and 1.5 cm right from the isocenter. An axial scan of the phantom was acquired from a multislice CT simulator. The phantom was set at the linac's isocenter (lasers); either AP MV/R Lat kV images or CBCT images were taken for 2D/2D or 3D/3D matching, respectively. For 2D/2D, the accuracy of each device's isocenter was obtained by checking the distance between the central bb and the digital graticule. Then the central bb in orthogonal DRRs was manually moved to overlay to the off-axis bbs in kV/MV images. For 3D/3D, CBCT was first matched to planCT to check the isocenter difference between the two CTs. Manual shifts were then made by moving CBCT such that the point defined by the two off-axis bbs overlay to the central bb in planCT. (PlanCT can not be moved in the current version of OBI1.4.) The manual shifts were then applied to remotely move the couch. The room laser was used to check the accuracy of the couch movement. For Trilogy (or Ix-21) linacs, the coincidence of imager and linac's isocenter was better than 1 mm (or 1.5 mm). The couch shift accuracy was better than 2 mm.

  5. Dosimetric comparison between conventional and conformal radiotherapy for carcinoma cervix: Are we treating the right volumes?

    Directory of Open Access Journals (Sweden)

    Jyotirup Goswami

    2013-01-01

    Full Text Available Background and Purpose: Conventional portals, based on bony anatomy, for external beam radiotherapy for cervical cancer have been repeatedly demonstrated as inadequate. Conversely, with image-based conformal radiotherapy, better target coverage may be offset by the greater toxicities and poorer compliance associated with treating larger volumes. This study was meant to dosimetrically compare conformal and conventional radiotherapy. Materials and Methods: Five patients of carcinoma cervix underwent planning CT scan with IV contrast and targets, and organs at risk (OAR were contoured. Two sets of plans-conventional and conformal were generated for each patient. Field sizes were recorded, and dose volume histograms of both sets of plans were generated and compared on the basis of target coverage and OAR sparing. Results: Target coverage was significantly improved with conformal plans though field sizes required were significantly larger. On the other hand, dose homogeneity was not significantly improved. Doses to the OARs (rectum, urinary bladder, and small bowel were not significantly different across the 2 arms. Conclusion: Three-dimensional conformal radiotherapy gives significantly better target coverage, which may translate into better local control and survival. On the other hand, it also requires significantly larger field sizes though doses to the OARs are not significantly increased.

  6. Comparative study of four advanced 3d-conformal radiation therapy treatment planning techniques for head and neck cancer.

    Science.gov (United States)

    Herrassi, Mohamed Yassine; Bentayeb, Farida; Malisan, Maria Rosa

    2013-04-01

    For the head-and-neck cancer bilateral irradiation, intensity-modulated radiation therapy (IMRT) is the most reported technique as it enables both target dose coverage and organ-at-risk (OAR) sparing. However, during the last 20 years, three-dimensional conformal radiotherapy (3DCRT) techniques have been introduced, which are tailored to improve the classic shrinking field technique, as regards both planning target volume (PTV) dose conformality and sparing of OAR's, such as parotid glands and spinal cord. In this study, we tested experimentally in a sample of 13 patients, four of these advanced 3DCRT techniques, all using photon beams only and a unique isocentre, namely Bellinzona, Forward-Planned Multisegments (FPMS), ConPas, and field-in-field (FIF) techniques. Statistical analysis of the main dosimetric parameters of PTV and OAR's DVH's as well as of homogeneity and conformity indexes was carried out in order to compare the performance of each technique. The results show that the PTV dose coverage is adequate for all the techniques, with the FPMS techniques providing the highest value for D95%; on the other hand, the best sparing of parotid glands is achieved using the FIF and ConPas techniques, with a mean dose of 26 Gy to parotid glands for a PTV prescription dose of 54 Gy. After taking into account both PTV coverage and parotid sparing, the best global performance was achieved by the FIF technique with results comparable to that of IMRT plans. This technique can be proposed as a valid alternative when IMRT equipment is not available or patient is not suitable for IMRT treatment.

  7. Dosimetric Comparison of Three-Dimensional Conformal Proton Radiotherapy, Intensity-Modulated Proton Therapy, and Intensity-Modulated Radiotherapy for Treatment of Pediatric Craniopharyngiomas

    Energy Technology Data Exchange (ETDEWEB)

    Boehling, Nicholas S. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Grosshans, David R., E-mail: dgrossha@mdanderson.org [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Bluett, Jaques B. [Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Palmer, Matthew T. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Song, Xiaofei; Amos, Richard A.; Sahoo, Narayan [Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Meyer, Jeffrey J.; Mahajan, Anita; Woo, Shiao Y. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)

    2012-02-01

    Purpose: Cranial irradiation in pediatric patients is associated with serious long-term adverse effects. We sought to determine whether both three-dimensional conformal proton radiotherapy (3D-PRT) and intensity-modulated proton therapy (IMPT) compared with intensity-modulated radiotherapy (IMRT) decrease integral dose to brain areas known to harbor neuronal stem cells, major blood vessels, and other normal brain structures for pediatric patients with craniopharyngiomas. Methods and Materials: IMRT, forward planned, passive scattering proton, and IMPT plans were generated and optimized for 10 pediatric patients. The dose was 50.4 Gy (or cobalt Gy equivalent) delivered in 28 fractions with the requirement for planning target volume (PTV) coverage of 95% or better. Integral dose data were calculated from differential dose-volume histograms. Results: The PTV target coverage was adequate for all modalities. IMRT and IMPT yielded the most conformal plans in comparison to 3D-PRT. Compared with IMRT, 3D-PRT and IMPT plans had a relative reduction of integral dose to the hippocampus (3D-PRT, 20.4; IMPT, 51.3%{sup Asterisk-Operator }), dentate gyrus (27.3, 75.0%{sup Asterisk-Operator }), and subventricular zone (4.5, 57.8%{sup Asterisk-Operator }). Vascular organs at risk also had reduced integral dose with the use of proton therapy (anterior cerebral arteries, 33.3{sup Asterisk-Operator }, 100.0%{sup Asterisk-Operator }; middle cerebral arteries, 25.9%{sup Asterisk-Operator }, 100%{sup Asterisk-Operator }; anterior communicating arteries, 30.8{sup Asterisk-Operator }, 41.7%{sup Asterisk-Operator }; and carotid arteries, 51.5{sup Asterisk-Operator }, 77.6{sup Asterisk-Operator }). Relative reduction of integral dose to the infratentorial brain (190.7{sup Asterisk-Operator }, 109.7%{sup Asterisk-Operator }), supratentorial brain without PTV (9.6, 26.8%{sup Asterisk-Operator }), brainstem (45.6, 22.4%{sup Asterisk-Operator }), and whole brain without PTV (19.4{sup Asterisk

  8. Heat- and pH-induced BSA conformational changes, hydrogel formation and application as 3D cell scaffold.

    Science.gov (United States)

    Navarra, Giovanna; Peres, Chiara; Contardi, Marco; Picone, Pasquale; San Biagio, Pier Luigi; Di Carlo, Marta; Giacomazza, Daniela; Militello, Valeria

    2016-09-15

    Aggregation and gelation of globular proteins can be an advantage to generate new forms of nanoscale biomaterials based on the fibrillar architecture. Here, we report results obtained by exploiting the proteins' natural tendency to self-organize in 3D network, for the production of new material based on BSA for medical application. In particular, at five different pH values the conformational and structural changes of the BSA during all the steps of the thermal aggregation and gelation have been analyzed by FTIR spectroscopy. The macroscopic mechanical properties of these hydrogels have been obtained by rheological measurements. The microscopic structure of the gels have been studied by AFM and SEM images to have a picture of their different spatial arrangement. Finally, the use of the BSA hydrogels as scaffold has been tested in two different cell cultures.

  9. ForceGen 3D structure and conformer generation: from small lead-like molecules to macrocyclic drugs

    Science.gov (United States)

    Cleves, Ann E.; Jain, Ajay N.

    2017-03-01

    We introduce the ForceGen method for 3D structure generation and conformer elaboration of drug-like small molecules. ForceGen is novel, avoiding use of distance geometry, molecular templates, or simulation-oriented stochastic sampling. The method is primarily driven by the molecular force field, implemented using an extension of MMFF94s and a partial charge estimator based on electronegativity-equalization. The force field is coupled to algorithms for direct sampling of realistic physical movements made by small molecules. Results are presented on a standard benchmark from the Cambridge Crystallographic Database of 480 drug-like small molecules, including full structure generation from SMILES strings. Reproduction of protein-bound crystallographic ligand poses is demonstrated on four carefully curated data sets: the ConfGen Set (667 ligands), the PINC cross-docking benchmark (1062 ligands), a large set of macrocyclic ligands (182 total with typical ring sizes of 12-23 atoms), and a commonly used benchmark for evaluating macrocycle conformer generation (30 ligands total). Results compare favorably to alternative methods, and performance on macrocyclic compounds approaches that observed on non-macrocycles while yielding a roughly 100-fold speed improvement over alternative MD-based methods with comparable performance.

  10. Strategies to evaluate the impact of rectal volume on prostate motion during three-dimensional conformal radiotherapy for prostate cancer

    Directory of Open Access Journals (Sweden)

    Ana Paula Diniz Fortuna Poli

    2016-02-01

    Full Text Available Abstract Objective: To evaluate the rectal volume influence on prostate motion during three-dimensional conformal radiotherapy (3D-CRT for prostate cancer. Materials and Methods: Fifty-one patients with prostate cancer underwent a series of three computed tomography scans including an initial planning scan and two subsequent scans during 3D-CRT. The organs of interest were outlined. The prostate contour was compared with the initial CT images considering the anterior, posterior, superior, inferior and lateral edges of the organ. Variations in the anterior limits and volume of the rectum were assessed and correlated with prostate motion in the anteroposterior direction. Results: The maximum range of prostate motion was observed in the superoinferior direction, followed by the anteroposterior direction. A significant correlation was observed between prostate motion and rectal volume variation ( p = 0.037. A baseline rectal volume superior to 70 cm3 had a significant influence on the prostate motion in the anteroposterior direction ( p = 0.045. Conclusion: The present study showed a significant interfraction motion of the prostate during 3D-CRT with greatest variations in the superoinferior and anteroposterior directions, and that a large rectal volume influences the prostate motion with a cutoff value of 70 cm3. Therefore, the treatment of patients with a rectal volume > 70 cm3 should be re-planned with appropriate rectal preparation.

  11. Strategies to evaluate the impact of rectal volume on prostate motion during three-dimensional conformal radiotherapy for prostate cancer*

    Science.gov (United States)

    Poli, Ana Paula Diniz Fortuna; Dias, Rodrigo Souza; Giordani, Adelmo José; Segreto, Helena Regina Comodo; Segreto, Roberto Araujo

    2016-01-01

    Objective To evaluate the rectal volume influence on prostate motion during three-dimensional conformal radiotherapy (3D-CRT) for prostate cancer. Materials and Methods Fifty-one patients with prostate cancer underwent a series of three computed tomography scans including an initial planning scan and two subsequent scans during 3D-CRT. The organs of interest were outlined. The prostate contour was compared with the initial CT images considering the anterior, posterior, superior, inferior and lateral edges of the organ. Variations in the anterior limits and volume of the rectum were assessed and correlated with prostate motion in the anteroposterior direction. Results The maximum range of prostate motion was observed in the superoinferior direction, followed by the anteroposterior direction. A significant correlation was observed between prostate motion and rectal volume variation (p = 0.037). A baseline rectal volume superior to 70 cm3 had a significant influence on the prostate motion in the anteroposterior direction (p = 0.045). Conclusion The present study showed a significant interfraction motion of the prostate during 3D-CRT with greatest variations in the superoinferior and anteroposterior directions, and that a large rectal volume influences the prostate motion with a cutoff value of 70 cm3. Therefore, the treatment of patients with a rectal volume > 70 cm3 should be re-planned with appropriate rectal preparation. PMID:26929456

  12. Comparison of intensity-modulated radiotherapy with conventional conformal radiotherapy for postoperative retroperitoneal soft tissue; Etude theorique d'une radiotherapie postoperatoire avec modulation d'intensite d'un sarcome retroperitoneal

    Energy Technology Data Exchange (ETDEWEB)

    Musat, E.; Kantor, G.; Caron, J.; Lagarde, P.; Laharie, H.; Angles, J.; Gilbeau, L. [Centre Regional de Lutte Contre le Cancer, Institut Bergonie, Dept. de Radiotherapie, 33 - Bordeaux (France); Stoeckle, E. [Centre Regional de Lutte Contre le Cancer, Institut Bergonie, Dept. de Chirurgie, 33 - Bordeaux (France); Bui, B.N. [Centre Regional de Lutte Contre le Cancer, Institut Bergonie, Dept. de Medecine, 33 - Bordeaux (France)

    2004-08-01

    External postoperative radiation therapy for retroperitoneal sarcoma is an example of treatment using large fields for complex shaped volumes of irradiation, Prescribed dose is limited by tolerance of adjacent organs at risk (OAR). From a recent case treated by conventional conformal radiotherapy (3D-CRT), we evaluate the benefit of five theoretical IMRT plans. Criteria used are calculated from DVH related to delineated PTV and OAR, IMRT should permit to enhance the prescribed dose without increasing dose in the OAR (especially residual kidney, spinal cord and small bowel). This theoretical study show the feasibility of a dose escalation from a treatment dose of 45 Gy delivered by 3D-CRT up to a planning dose of 54 Gy calculated by IMRT with: - for the PTV: an improvement of the dose homogeneity about 5% (range 2 %) and moreover the coverage factor (CF) about 13% (range 9 6%); - for the OAR: an improvement of the protection factor (PF) about 20% (range 11-24%); - and thus an improved conformity index (CI = CF x PF) about 25% (range 15-32%). (author)

  13. Comparison between conventional and three-dimensional conformal treatment planning for radiotherapy of cerebral tumors; Comparaison entre dosimetries classique et conformationnelle dans l'irradiation de tumeurs cerebrales

    Energy Technology Data Exchange (ETDEWEB)

    Caudrelier, J.M.; Auliard, A.; Sarrazin, T.; Gibon, D.; Coche-Dequeant, B.; Castelain, B. [Centre de Lutte Contre le Cancer Oscar-Lambret, 59 - Lille (France)

    2001-06-01

    Comparison between conventional and three-dimensional conformal treatment planning for radiotherapy of cerebral tumors. Purpose. - We prospectively compared a conventional treatment planning (PT2D) and 3-dimensional conformal treatment planning (PT3D) for radiotherapy of cerebral tumours. Patients and methods.- Patients treated between 1/10/98 and 1/4/99 by irradiation for cerebral tumours were analysed. For each case, we planned PT2D using conventional orthogonal x-ray films, and afterward, PT3D using CT scan. Gross tumor volume, planning target volume and normal tissue volumes were defined. Dose was prescribed according to report 50 of the International Commission on Radiation Units and Measurements (ICRU). We compared surfaces of sagittal view targets defined on PT2D and PT3D and called them S2D and S3D, respectively. Irradiated volumes by 90% isodoses (VE-90%) and normal tissue volumes irradiated by 20, 50, 90% isodoses were calculated and compared using Student's paired t-test. Results. -There was a concordance of 84% of target surfaces defined on PT2D and PT3D. Percentages of target surface under- or-over defined by PT2D were 16 and 13% respectively. VE-90% was decreased by 15% (p = 0.07) with PT3D. Normal brain volume irradiated by 90% isodose was decreased by 27% with PT3D (p = 0.04). Conclusion.- For radiotherapy of cerebral tumors using only coplanar beams, PT3D leads to a reduction of normal brain tissue irradiated. We recommend PT3D for radiotherapy of cerebral tumors, particularly for low-grade or benign tumors (meningiomas, neuromas, etc.). (authors)

  14. Feasibility of a 3D-printed anthropomorphic patient-specific head phantom for patient-specific quality assurance of intensity-modulated radiotherapy

    Science.gov (United States)

    Yea, Ji Woon; Park, Jae Won; Kim, Sung Kyu; Kim, Dong Youn; Kim, Jae Gu; Seo, Chan Young; Jeong, Won Hyo; Jeong, Man Youl

    2017-01-01

    This study evaluated the feasibility of utilizing a 3D-printed anthropomorphic patient-specific head phantom for patient-specific quality assurance (QA) in intensity-modulated radiotherapy (IMRT). Contoured left and right head phantoms were converted from DICOM to STL format. Fused deposition modeling (FDM) was used to construct an anthropomorphic patient-specific head phantom with a 3D printer. An established QA technique and the patient-specific head phantom were used to compare the calculated and measured doses. When the established technique was used to compare the calculated and measured doses, the gamma passing rate for γ ≤ 1 was 97.28%, while the gamma failure rate for γ > 1 was 2.72%. When the 3D-printed patient-specific head phantom was used, the gamma passing rate for γ ≤ 1 was 95.97%, and the gamma failure rate for γ > 1 was 4.03%. The 3D printed patient-specific head phantom was concluded to be highly feasible for patient-specific QA prior to complicated radiotherapy procedures such as IMRT. PMID:28727787

  15. Normal tissue dose conformality measures to guide radiotherapy fractionation decisions

    Energy Technology Data Exchange (ETDEWEB)

    Myerson, Robert J. [Department of Radiation Oncology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri 63110 (United States)

    2011-04-15

    Purpose: To determine conditions under which hypofractionation could be favorable for a normal tissue--even if tumor [{alpha}/{beta}] exceeds the normal tissue's [{alpha}/{beta}]. Methods: The hypofractionation sufficiency condition (HSC) for an organ is defined as a dose conformality constraint such that, if satisfied, a family of tumor control probability isoeffective fractionation schemes will show decreasing normal tissue complication probability with decreasing number of fractions. Results: In the extended equivalent uniform dose (EUD) model [obtained by replacing dose with linear quadratic (LQ) 2 Gy equivalent dose], the HSC for a normal organ is proven to be satisfied if a suitably weighted average of the relative dose [hypofractionation sufficiency index (HSI)] is less than the ratio of normal tissue to tumor [{alpha}/{beta}]. The HSI is determined solely by dose distribution and the normal tissue volume factor, ''a.'' If the HSC is satisfied for every normal tissue of concern, then there is a therapeutic gain with hypofractionation. The corresponding multifractionation sufficiency condition (therapeutic gain with increasing number of fractions) and multifractionation sufficiency index (MSI) are also derived. A sample clinical case is presented. Conclusions: Within the context of the LQ/EUD models, conformality measures (HSI and MSI) can be used to inform fractionation decisions.

  16. Continuous table acquisition MRI for radiotherapy treatment planning: Distortion assessment with a new extended 3D volumetric phantom

    Energy Technology Data Exchange (ETDEWEB)

    Walker, Amy, E-mail: aw554@uowmail.edu.au; Metcalfe, Peter [Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2522, Australia and Liverpool and Macarthur Cancer Therapy Centres and Ingham Institute for Applied Medical Research, Liverpool, NSW 2170 (Australia); Liney, Gary [Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2522 (Australia); Liverpool and Macarthur Cancer Therapy Centres and Ingham Institute for Applied Medical Research, Liverpool, NSW 2170 (Australia); South West Clinical School, University of New South Wales, Sydney, NSW 2170 (Australia); Holloway, Lois [Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2522 (Australia); Liverpool and Macarthur Cancer Therapy Centres and Ingham Institute for Applied Medical Research, Liverpool, NSW 2170 (Australia); South West Clinical School, University of New South Wales, Sydney, NSW 2170 (Australia); Institute of Medical Physics, School of Physics, University of Sydney, Sydney, NSW 2006 (Australia); Dowling, Jason; Rivest-Henault, David [Commonwealth Scientific and Industrial Research Organisation, Australian E-Health Research Centre, Herston, QLD 4029 (Australia)

    2015-04-15

    Purpose: Accurate geometry is required for radiotherapy treatment planning (RTP). When considering the use of magnetic resonance imaging (MRI) for RTP, geometric distortions observed in the acquired images should be considered. While scanner technology and vendor supplied correction algorithms provide some correction, large distortions are still present in images, even when considering considerably smaller scan lengths than those typically acquired with CT in conventional RTP. This study investigates MRI acquisition with a moving table compared with static scans for potential geometric benefits for RTP. Methods: A full field of view (FOV) phantom (diameter 500 mm; length 513 mm) was developed for measuring geometric distortions in MR images over volumes pertinent to RTP. The phantom consisted of layers of refined plastic within which vitamin E capsules were inserted. The phantom was scanned on CT to provide the geometric gold standard and on MRI, with differences in capsule location determining the distortion. MRI images were acquired with two techniques. For the first method, standard static table acquisitions were considered. Both 2D and 3D acquisition techniques were investigated. With the second technique, images were acquired with a moving table. The same sequence was acquired with a static table and then with table speeds of 1.1 mm/s and 2 mm/s. All of the MR images acquired were registered to the CT dataset using a deformable B-spline registration with the resulting deformation fields providing the distortion information for each acquisition. Results: MR images acquired with the moving table enabled imaging of the whole phantom length while images acquired with a static table were only able to image 50%–70% of the phantom length of 513 mm. Maximum distortion values were reduced across a larger volume when imaging with a moving table. Increased table speed resulted in a larger contribution of distortion from gradient nonlinearities in the through

  17. Sensor-enhanced 3D conformal cueing for safe and reliable HC operation in DVE in all flight phases

    Science.gov (United States)

    Münsterer, Thomas; Schafhitzel, Tobias; Strobel, Michael; Völschow, Philipp; Klasen, Stephanus; Eisenkeil, Ferdinand

    2014-06-01

    Low level helicopter operations in Degraded Visual Environment (DVE) still are a major challenge and bear the risk of potentially fatal accidents. DVE generally encompasses all degradations to the visual perception of the pilot ranging from night conditions via rain and snowfall to fog and maybe even blinding sunlight or unstructured outside scenery. Each of these conditions reduce the pilots' ability to perceive visual cues in the outside world reducing his performance and finally increasing risk of mission failure and accidents, like for example Controlled Flight Into Terrain (CFIT). The basis for the presented solution is a fusion of processed and classified high resolution ladar data with database information having a potential to also include other sensor data like forward looking or 360° radar data. This paper reports on a pilot assistance system aiming at giving back the essential visual cues to the pilot by means of displaying 3D conformal cues and symbols in a head-tracked Helmet Mounted Display (HMD) and a combination with synthetic view on a head-down Multi-Function Display (MFD). Each flight phase and each flight envelope requires different symbology sets and different possibilities for the pilots to select specific support functions. Several functionalities have been implemented and tested in a simulator as well as in flight. The symbology ranges from obstacle warning symbology via terrain enhancements through grids or ridge lines to different waypoint symbols supporting navigation. While some adaptations can be automated it emerged as essential that symbology characteristics and completeness can be selected by the pilot to match the relevant flight envelope and outside visual conditions.

  18. Dynamic MLC tracking of moving targets with a single kV imager for 3D conformal and IMRT treatments

    Energy Technology Data Exchange (ETDEWEB)

    Poulsen, Per R. (Dept. of Oncology, Aarhus Univ. Hospital (Denmark)), E-mail: perpolse@rm.dk; Cho, Byungchul; Sawant, Amit; Ruan, Dan; Keall, Paul J. (Dept. of Radiation Oncology, Stanford Univ., Stanford (United States))

    2010-10-15

    Background. Tumor motion during radiotherapy is a major challenge for accurate dose delivery, in particular for hypofractionation and dose painting. The motion may be compensated by dynamic multileaf collimator (DMLC) tracking. Previous work has demonstrated that a single kV imager can accurately localize moving targets for DMLC tracking during rotational delivery, however this method has not been investigated for the static gantry geometry used for conformal and IMRT treatments. In this study we investigate the accuracy of single kV-imager based DMLC tracking for static-gantry delivery. Material and methods. A 5-field treatment plan with circular field shape and 200 MU per field was delivered in 20 s per field to a moving phantom with an embedded gold marker. Fluoroscopic kV images were acquired at 5 Hz perpendicular to the treatment beam axis during a 120 deg pre-treatment gantry rotation, during treatment delivery, and during inter-field gantry rotations. The three-dimensional marker position was estimated from the kV images and used for MLC adaptation. Experiments included 12 thoracic/abdominal tumor trajectories and five prostate trajectories selected from databases with 160 and 548 trajectories, respectively. The tracking error was determined as the mismatch between the marker position and the MLC aperture center in portal images. Simulations extended the study to all trajectories in the databases and to treatments with prolonged duration of 60 s per field. Results. In the experiments, the mean root-mean-square (rms) tracking error was 0.9 mm (perpendicular to MLC) and 1.1 mm (parallel to MLC) for thoracic/abdominal tumor trajectories and 0.6 mm (perpendicular) and 0.5 mm (parallel) for prostate trajectories. Simulations of these experiments agreed to within 0.1 mm. Simulations of all trajectories in the databases resulted in mean rms tracking errors of 0.6 mm (perpendicular) and 0.9 mm (parallel) for thorax/abdomen tumors and 0.4 mm (perpendicular) and 0

  19. Dosimetric study of volumetric arc modulation with RapidArc and intensity-modulated radiotherapy in patients with cervical cancer and comparison with 3-dimensional conformal technique for definitive radiotherapy in patients with cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Guy, Jean-Baptiste [Department of Radiation Oncology, Institut de Cancérologie de la Loire Lucien Neuwirth, Saint-Priest en Jarez (France); Falk, Alexander T. [Department of Radiation Oncology, Centre Antoine Lacassagne, Nice (France); Auberdiac, Pierre [Department of Radiation Oncology, Clinique Claude Bernard, Albi (France); Cartier, Lysian; Vallard, Alexis [Department of Radiation Oncology, Institut de Cancérologie de la Loire Lucien Neuwirth, Saint-Priest en Jarez (France); Ollier, Edouard [Department of Pharmacology-Toxicology, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Priest en Jarez (France); Trone, Jane-Chloé; Khodri, Moustapha [Department of Radiation Oncology, Institut de Cancérologie de la Loire Lucien Neuwirth, Saint-Priest en Jarez (France); Chargari, Cyrus [Department of Radiation Oncology, Hôpital d’instruction de Armées du Val-de-Grâce, Paris (France); Magné, Nicolas, E-mail: nicolas.magne@icloire.fr [Department of Radiation Oncology, Institut de Cancérologie de la Loire Lucien Neuwirth, Saint-Priest en Jarez (France)

    2016-04-01

    Introduction: For patients with cervical cancer, intensity-modulated radiation therapy (IMRT) improves target coverage and allows dose escalation while reducing the radiation dose to organs at risk (OARs). In this study, we compared dosimetric parameters among 3-dimensional conformal radiotherapy (3D-CRT), “step-and-shoot” IMRT, and volumetric intensity-modulated arc radiotherapy (VMAT) in a series of patients with cervical cancer receiving definitive radiotherapy. Computed tomography (CT) scans of 10 patients with histologically proven cervical cancer treated with definitive radiation therapy (RT) from December 2008 to March 2010 at our department were selected for this study. The gross tumor volume (GTV) and clinical target volume (CTV) were delineated following the guidelines of the Gyn IMRT consortium that included cervix, uterus, parametrial tissues, and the pelvic nodes including presacral. The median age was 57 years (range: 30 to 85 years). All 10 patients had squamous cell carcinoma with Federation of Gynecology and Obstetrics (FIGO) stage IB-IIIB. All patients were treated by VMAT. OAR doses were significantly reduced for plans with intensity-modulated technique compared with 3D-CRT except for the dose to the vagina. Between the 2 intensity-modulated techniques, significant difference was observed for the mean dose to the small intestine, to the benefit of VMAT (p < 0.001). There was no improvement in terms of OARs sparing for VMAT although there was a tendency for a slightly decreased average dose to the rectum: − 0.65 Gy but not significant (p = 0.07). The intensity modulation techniques have many advantages in terms of quality indexes, and particularly OAR sparing, compared with 3D-CRT. Following the ongoing technologic developments in modern radiotherapy, it is essential to evaluate the intensity-modulated techniques on prospective studies of a larger scale.

  20. Conformal radiotherapy made easy through gravity oriented absorbers

    Energy Technology Data Exchange (ETDEWEB)

    Proimos, B.S. [Patras Univ. (Greece). Dept. of Medical Physics

    1995-12-01

    In the 50`s and the 60`s simple techniques modulating the beam intensity in synchronism with the rotation, either of the vertical patient or of the machine around the horizontal patient were developed. An absorber, which is similar in shape to a vital organ, intercepts the beam, casting its protective `shade` over the organ, for all positions of rotation. In this way, the organ is protected during the irradiation time. On any transverse cross, any point outside of the organ`s cross-section is protected for only a fraction of T, which is decreasing with the distance of that point from the organ. Consequently, the dose to the protected organ is smaller than (a) the dose it would absorb without protection (b) the dose to the surrounding (less vital) healthy tissue and (c), the dose to the neighbouring tumour. Consider a plane perpendicular to the principal plane and passing through the source. It cuts the organ and its protector in two cross-sections, which remain always homiotheta, with centre of homiothesis the source. In this way, the protector`s cross-section is projected by the beam on the organ`s cross-section for all positions of rotation. The larger the cross-section of the organ and the smaller the required protection, the smaller must be the attenuation coefficient of the material the protector is made of. The dose distributions in a series of actual cases, such as head tumours with eyes protection, neck or chest tumours with spinal cord protection, cervix tumours with rectum and bladder protection, are discussed. In most cases, if the vital organs are not overprotected, the 90% or 80% isodose surface fits to or conforms with the surface of the Planning Target Volume (PTV) no matter how irregular (convex and concave) it is.

  1. The Effect of Flattening Filter Free on Three-dimensional Conformal Radiation Therapy (3D-CRT), Intensity-Modulated Radiation Therapy (IMRT), and Volumetric Modulated Arc Therapy (VMAT) Plans for Metastatic Brain Tumors from Non-small Cell Lung Cancer.

    Science.gov (United States)

    Shi, Li-Wan; Lai, You-Qun; Lin, Qin; Ha, Hui-Ming; Fu, Li-Rong

    2015-07-01

    Flattening filter free (FFF) may affect outcome measures of radiotherapy. The objective of this study is to compare the dosimetric parameters in three types of radiotherapy plans, three-dimensional conformal radiation therapy (3D-CRT), intensity-modulated radiation therapy (IMRT), and volumetric modulated arc therapy (VMAT), with or without the flattening filter (FF), developed for the treatment of metastatic brain tumors from non-small cell lung cancer (NSCLC). From July 2013 to October 2013, 3D-CRT, IMRT, and VMAT treatment plans were designed using 6 MV and 10 MV, with and without FF, for 10 patients with brain metastasis from NSCLC. The evaluation of the treatment plans included homogeneity index (HI), conformity index (CI), monitor units (MU), mean dose (Dmean), treatment time, and the influence of FFF on volumes. There was no difference in CI or HI between FFF and FF models with 3D-CRT, IMRT, and VMAT plans. At 6 MV, a lower Dmean was seen in the FFF model of 3D-CRT and in the VMAT plan at 10 MV. In the IMRT 6 MV, IMRT 10 MV, and VMAT 10 MV plans, higher MUs were seen in the FFF models. FFF treatments are similar in quality to FF plans, generally lead to more monitor units, and are associated with shorter treatment times. FFF plans ranked by the order of superiority in terms of a time advantage are VMAT, 3D-CRT, and IMRT.

  2. WE-F-16A-06: Using 3D Printers to Create Complex Phantoms for Dose Verification, Quality Assurance, and Treatment Planning System Commissioning in Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kassaee, A; Ding, X; McDonough, J; Reiche, M; Witztum, A; Teo, B [University Pennsylvania, Philadelphia, PA (United States)

    2014-06-15

    Purpose: To use 3D printers to design and construct complex geometrical phantoms for commissioning treatment planning systems, dose calculation algorithms, quality assurance (QA), dose delivery, and patient dose verifications. Methods: In radiotherapy, complex geometrical phantoms are often required for dose verification, dose delivery and calculation algorithm validation. Presently, fabrication of customized phantoms is limited due to time, expense and challenges in machining of complex shapes. In this work, we designed and utilized 3D printers to fabricate two phantoms for QA purposes. One phantom includes hills and valleys (HV) for verification of intensity modulated radiotherapy for photons, and protons (IMRT and IMPT). The other phantom includes cylindrical cavities (CC) of various sizes for dose verification of inhomogeneities. We evaluated the HV phantoms for an IMPT beam, and the CC phantom to study various inhomogeneity configurations using photon, electron, and proton beams. Gafcromic ™ films were used to quantify the dose distributions delivered to the phantoms. Results: The HV phantom has dimensions of 12 cm × 12 cm and consists of one row and one column of five peaks with heights ranging from 2 to 5 cm. The CC phantom has a size 10 cm × 14 cm and includes 6 cylindrical cavities with length of 7.2 cm and diameters ranging from 0.6 to 1.2 cm. The IMPT evaluation using the HV phantom shows good agreement as compared to the dose distribution calculated with treatment planning system. The CC phantom also shows reasonable agreements for using different algorithms for each beam modalities. Conclusion: 3D printers with submillimiter resolutions are capable of printing complex phantoms for dose verification and QA in radiotherapy. As printing costs decrease and the technology becomes widely available, phantom design and construction will be readily available to any clinic for testing geometries that were not previously feasible.

  3. Post-mastectomy radiotherapy in Denmark: From 2D to 3D treatment planning guidelines of The Danish Breast Cancer Cooperative Group

    DEFF Research Database (Denmark)

    Thomsen, Mette Skovhus; Berg, Martin; Nielsen, Hanne M.;

    2008-01-01

    with PWT. The dose to the internal mammary nodes (IMN) was not satisfactory for five of the seven patients for 3F, whereas only two of the seven patients had a minimum dose lower than 95% of the prescribed dose with PWT. Finally, the dose to the contralateral breast was increased when using PWT compared...... to 3F. It was concluded that PWT was an appropriate choice of technique for future radiation treatment of post-mastectomy patients. A working group was formed and guidelines for 3D planning were developed during a series of workshops where radiation oncologists and physicists from all radiotherapy...

  4. Prostate and seminal vesicle volume based consideration of prostate cancer patients for treatment with 3D-conformal or intensity-modulated radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Reddy, Nandanuri M. S.; Nori, Dattatreyudu; Chang, Hyesook; Lange, Christopher S.; Ravi, Akkamma [Department of Radiation Oncology, New York Hospital Queens, Flushing, New York 11355 (United States); Department of Radiation Oncology, State University of New York Downstate Medical Center, Brooklyn, New York 11203 (United States); Department of Radiation Oncology, New York Hospital Queens, Flushing, New York 11355 (United States)

    2010-07-15

    Purpose: The purpose of this article was to determine the suitability of the prostate and seminal vesicle volumes as factors to consider patients for treatment with image-guided 3D-conformal radiation therapy (3D-CRT) or intensity-modulated radiation therapy (IMRT), using common dosimetry parameters as comparison tools. Methods: Dosimetry of 3D and IMRT plans for 48 patients was compared. Volumes of prostate, SV, rectum, and bladder, and prescriptions were the same for both plans. For both 3D and IMRT plans, expansion margins to prostate+SV (CTV) and prostate were 0.5 cm posterior and superior and 1 cm in other dimensions to create PTV and CDPTV, respectively. Six-field 3D plans were prepared retrospectively. For 3D plans, an additional 0.5 cm margin was added to PTV and CDPTV. Prescription for both 3D and IMRT plans was the same: 45 Gy to CTV followed by a 36 Gy boost to prostate. Dosimetry parameters common to 3D and IMRT plans were used for comparison: Mean doses to prostate, CDPTV, SV, rectum, bladder, and femurs; percent volume of rectum and bladder receiving 30 (V30), 50 (V50), and 70 Gy (V70), dose to 30% of rectum and bladder, minimum and maximum point dose to CDPTV, and prescription dose covering 95% of CDPTV (D95). Results: When the data for all patients were combined, mean dose to prostate and CDPTV was higher with 3D than IMRT plans (P<0.01). Mean D95 to CDPTV was the same for 3D and IMRT plans (P>0.2). On average, among all cases, the minimum point dose was less for 3D-CRT plans and the maximum point dose was greater for 3D-CRT than for IMRT (P<0.01). Mean dose to 30% rectum with 3D and IMRT plans was comparable (P>0.1). V30 was less (P<0.01), V50 was the same (P>0.2), and V70 was more (P<0.01) for rectum with 3D than IMRT plans. Mean dose to bladder was less with 3D than IMRT plans (P<0.01). V30 for bladder with 3D plans was less than that of IMRT plans (P<0.01). V50 and V70 for 3D plans were the same for 3D and IMRT plans (P>0.2). Mean dose to femurs

  5. Comparison of 2D and 3D modeled tumor motion estimation/prediction for dynamic tumor tracking during arc radiotherapy

    Science.gov (United States)

    Liu, Wu; Ma, Xiangyu; Yan, Huagang; Chen, Zhe; Nath, Ravinder; Li, Haiyun

    2017-05-01

    Many real-time imaging techniques have been developed to localize a target in 3D space or in a 2D beam’s eye view (BEV) plane for intrafraction motion tracking in radiation therapy. With tracking system latency, the 3D-modeled method is expected to be more accurate even in terms of 2D BEV tracking error. No quantitative analysis, however, has been reported. In this study, we simulated co-planar arc deliveries using respiratory motion data acquired from 42 patients to quantitatively compare the accuracy between 2D BEV and 3D-modeled tracking in arc therapy and to determine whether 3D information is needed for motion tracking. We used our previously developed low kV dose adaptive MV-kV imaging and motion compensation framework as a representative of 3D-modeled methods. It optimizes the balance between additional kV imaging dose and 3D tracking accuracy and solves the MLC blockage issue. With simulated Gaussian marker detection errors (zero mean and 0.39 mm standard deviation) and ~155/310/460 ms tracking system latencies, the mean percentage of time that the target moved  >2 mm from the predicted 2D BEV position are 1.1%/4.0%/7.8% and 1.3%/5.8%/11.6% for the 3D-modeled and 2D-only tracking, respectively. The corresponding average BEV RMS errors are 0.67/0.90/1.13 mm and 0.79/1.10/1.37 mm. Compared to the 2D method, the 3D method reduced the average RMS unresolved motion along the beam direction from ~3 mm to ~1 mm, resulting in on average only  <1% dosimetric advantage in the depth direction. Only for a small fraction of the patients, when tracking latency is long, the 3D-modeled method showed significant improvement of BEV tracking accuracy, indicating potential dosimetric advantage. However, if the tracking latency is short (~150 ms or less), those improvements are limited. Therefore, 2D BEV tracking has sufficient targeting accuracy for most clinical cases. The 3D technique is, however, still important in solving the MLC blockage problem

  6. Incidental irradiation of internal mammary lymph nodes in breast cancer: conventional two-dimensional radiotherapy versus conformal three-dimensional radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Leite, Elton Trigo Teixeira; Ugino, Rafael Tsuneki; Lopes, Mauricio Russo; Pelosi, Edilson Lopes; Silva, Joao Luis Fernandes da, E-mail: eltontt@gmail.com [Hospital Sirio-Libanes, Sao paulo, SP (Brazil). Departamento de Radiologia e Oncologia; Santana, Marco Antonio; Ferreira, Denis Vasconcelos; Carvalho, Heloisa de Andrade [Universidade de Sao Paulo (FM/USP), Sao Paulo, SP (Brazil). Faculdade de Medicina. Departamento de Radiologia e Oncologia

    2016-05-15

    Objective: to evaluate incidental irradiation of the internal mammary lymph nodes (IMLNs) through opposed tangential fields with conventional two-dimensional (2D) or three-dimensional (3D) radiotherapy techniques and to compare the results between the two techniques. Materials and Methods: This was a retrospective study of 80 breast cancer patients in whom radiotherapy of the IMLNs was not indicated: 40 underwent 2D radiotherapy with computed tomography for dosimetric control, and 40 underwent 3D radiotherapy. The total prescribed dose was 50.0 Gy or 50.4 Gy (2.0 or 1.8 Gy/day, respectively). We reviewed all plans and defined the IMLNs following the Radiation Therapy Oncology Group recommendations. For the IMLNs, we analyzed the proportion of the volume that received 45 Gy, the proportion of the volume that received 25 Gy, the dose to 95% of the volume, the dose to 50% of the volume, the mean dose, the minimum dose (Dmin), and the maximum dose (Dmax). Results: Left-sided treatments predominated in the 3D cohort. There were no differences between the 2D and 3D cohorts regarding tumor stage, type of surgery (mastectomy, breast-conserving surgery, or mastectomy with immediate reconstruction), or mean delineated IMLN volume (6.8 vs. 5.9 mL; p = 0.411). Except for the Dmin, all dosimetric parameters presented higher mean values in the 3D cohort (p < 0.05). The median Dmax in the 3D cohort was 50.34 Gy. However, the mean dose to the IMLNs was 7.93 Gy in the 2D cohort, compared with 20.64 Gy in the 3D cohort. Conclusion: Neither technique delivered enough doses to the IMLNs to achieve subclinical disease control. However, all of the dosimetric parameters were significantly higher for the 3D technique. (author)

  7. Incidental irradiation of internal mammary lymph nodes in breast cancer: conventional two-dimensional radiotherapy versus conformal three-dimensional radiotherapy*

    Science.gov (United States)

    Leite, Elton Trigo Teixeira; Ugino, Rafael Tsuneki; Santana, Marco Antônio; Ferreira, Denis Vasconcelos; Lopes, Maurício Russo; Pelosi, Edilson Lopes; da Silva, João Luis Fernandes; Carvalho, Heloisa de Andrade

    2016-01-01

    Objective To evaluate incidental irradiation of the internal mammary lymph nodes (IMLNs) through opposed tangential fields with conventional two-dimensional (2D) or three-dimensional (3D) radiotherapy techniques and to compare the results between the two techniques. Materials and Methods This was a retrospective study of 80 breast cancer patients in whom radiotherapy of the IMLNs was not indicated: 40 underwent 2D radiotherapy with computed tomography for dosimetric control, and 40 underwent 3D radiotherapy. The total prescribed dose was 50.0 Gy or 50.4 Gy (2.0 or 1.8 Gy/day, respectively). We reviewed all plans and defined the IMLNs following the Radiation Therapy Oncology Group recommendations. For the IMLNs, we analyzed the proportion of the volume that received 45 Gy, the proportion of the volume that received 25 Gy, the dose to 95% of the volume, the dose to 50% of the volume, the mean dose, the minimum dose (Dmin), and the maximum dose (Dmax). Results Left-sided treatments predominated in the 3D cohort. There were no differences between the 2D and 3D cohorts regarding tumor stage, type of surgery (mastectomy, breast-conserving surgery, or mastectomy with immediate reconstruction), or mean delineated IMLN volume (6.8 vs. 5.9 mL; p = 0.411). Except for the Dmin, all dosimetric parameters presented higher mean values in the 3D cohort (p < 0.05). The median Dmax in the 3D cohort was 50.34 Gy. However, the mean dose to the IMLNs was 7.93 Gy in the 2D cohort, compared with 20.64 Gy in the 3D cohort. Conclusion Neither technique delivered enough doses to the IMLNs to achieve subclinical disease control. However, all of the dosimetric parameters were significantly higher for the 3D technique. PMID:27403017

  8. Incidental irradiation of internal mammary lymph nodes in breast cancer: conventional two-dimensional radiotherapy versus conformal three-dimensional radiotherapy

    Directory of Open Access Journals (Sweden)

    Elton Trigo Teixeira Leite

    2016-06-01

    Full Text Available Abstract Objective: To evaluate incidental irradiation of the internal mammary lymph nodes (IMLNs through opposed tangential fields with conventional two-dimensional (2D or three-dimensional (3D radiotherapy techniques and to compare the results between the two techniques. Materials and Methods: This was a retrospective study of 80 breast cancer patients in whom radiotherapy of the IMLNs was not indicated: 40 underwent 2D radiotherapy with computed tomography for dosimetric control, and 40 underwent 3D radiotherapy. The total prescribed dose was 50.0 Gy or 50.4 Gy (2.0 or 1.8 Gy/day, respectively. We reviewed all plans and defined the IMLNs following the Radiation Therapy Oncology Group recommendations. For the IMLNs, we analyzed the proportion of the volume that received 45 Gy, the proportion of the volume that received 25 Gy, the dose to 95% of the volume, the dose to 50% of the volume, the mean dose, the minimum dose (Dmin, and the maximum dose (Dmax. Results: Left-sided treatments predominated in the 3D cohort. There were no differences between the 2D and 3D cohorts regarding tumor stage, type of surgery (mastectomy, breast-conserving surgery, or mastectomy with immediate reconstruction, or mean delineated IMLN volume (6.8 vs. 5.9 mL; p = 0.411. Except for the Dmin, all dosimetric parameters presented higher mean values in the 3D cohort (p < 0.05. The median Dmax in the 3D cohort was 50.34 Gy. However, the mean dose to the IMLNs was 7.93 Gy in the 2D cohort, compared with 20.64 Gy in the 3D cohort. Conclusion: Neither technique delivered enough doses to the IMLNs to achieve subclinical disease control. However, all of the dosimetric parameters were significantly higher for the 3D technique.

  9. Conformal radiotherapy for prostate cancer - Longer duration of acute genitourinary toxicity in patients with prior history of invasive urological procedure

    Energy Technology Data Exchange (ETDEWEB)

    Odrazka, Karel; Vanasek, Jaroslav; Vaculikova, Miloslava; Petera, Jiri; Zouhar, Milan; Zoul, Zdenk; Stejskal, Jan; Skrabkova, Zuzana; Kadeka, David [Charles Univ. Medical School and Teaching Hospital, Hradec Kralove (Czech Republic). Dept. of Radiotherapy and Oncology

    2001-11-01

    The incidence and predictors of acute toxicity were evaluated in patients treated with three-dimensional conformal radiotherapy (3D-CRT) for localized prostate cancer. Between December 1997 and November 1999, 116 patients with T1-T3 prostatic carcinoma were enrolled in the study. Ninety patients were treated with 70 Gy and 26 patients with T3 tumors received 74 Gy. Of the 116 patients 42 (36.2%) had a prior history of invasive urological procedure (IUP) (transurethral resection of the prostate or transvesical prostatectomy for benign prostatic hyperplasia). Acute gastrointestinal (GI) and genitourinary (GU) symptoms were graded according to the EORTC/RTOG scoring system. Toxicity duration after the completion of 3D-CRT was recorded. The majority of patients experienced only mild or no (Grade 1) acute toxicities. Medications for GI and GU symptoms (Grade 2) were required by 28.4% and 12.9% of patients, respectively. Only one case of Grade 3 GI toxicity (0.9%) was observed. Seven patients (6.1%) experienced severe GU toxicity (Grade 3 or 4). No correlation was found between acute toxicity and age, stage, dose (70 Gy vs. 74 Gy), IUP and pelvic lymphadenectomy. A significant relationship was observed between the duration of acute GU toxicity and prior IUP. Symptoms persisted for more than 4 weeks in 51.9% and 26.0% of patients with and without a prior history of IUP, respectively (p = 0.02). The incidence of acute complications, associated with 3D-CRT for prostate cancer, was acceptable in our cohort of patients. A prior history of IUP resulted in a significantly longer duration of acute GU toxicity.

  10. SU-C-18A-04: 3D Markerless Registration of Lung Based On Coherent Point Drift: Application in Image Guided Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Nasehi Tehrani, J; Wang, J [UT Southwestern Medical Center, Dallas, TX (United States); Guo, X [University of Texas at Dallas, Richardson, TX (United States); Yang, Y [The University of New Mexico, New Mexico, NM (United States)

    2014-06-01

    Purpose: This study evaluated a new probabilistic non-rigid registration method called coherent point drift for real time 3D markerless registration of the lung motion during radiotherapy. Method: 4DCT image datasets Dir-lab (www.dir-lab.com) have been used for creating 3D boundary element model of the lungs. For the first step, the 3D surface of the lungs in respiration phases T0 and T50 were segmented and divided into a finite number of linear triangular elements. Each triangle is a two dimensional object which has three vertices (each vertex has three degree of freedom). One of the main features of the lungs motion is velocity coherence so the vertices that creating the mesh of the lungs should also have features and degree of freedom of lung structure. This means that the vertices close to each other tend to move coherently. In the next step, we implemented a probabilistic non-rigid registration method called coherent point drift to calculate nonlinear displacement of vertices between different expiratory phases. Results: The method has been applied to images of 10-patients in Dir-lab dataset. The normal distribution of vertices to the origin for each expiratory stage were calculated. The results shows that the maximum error of registration between different expiratory phases is less than 0.4 mm (0.38 SI, 0.33 mm AP, 0.29 mm RL direction). This method is a reliable method for calculating the vector of displacement, and the degrees of freedom (DOFs) of lung structure in radiotherapy. Conclusions: We evaluated a new 3D registration method for distribution set of vertices inside lungs mesh. In this technique, lungs motion considering velocity coherence are inserted as a penalty in regularization function. The results indicate that high registration accuracy is achievable with CPD. This method is helpful for calculating of displacement vector and analyzing possible physiological and anatomical changes during treatment.

  11. The bound conformation of microtubule-stabilizing agents: NMR insights into the bioactive 3D structure of discodermolide and dictyostatin.

    Science.gov (United States)

    Canales, Angeles; Matesanz, Ruth; Gardner, Nicola M; Andreu, José Manuel; Paterson, Ian; Díaz, J Fernando; Jiménez-Barbero, Jesús

    2008-01-01

    A protocol based on a combination of NMR experimental data with molecular mechanics calculations and docking procedures has been employed to determine the microtubule-bound conformation of two microtubule-stabilizing agents, discodermolide (DDM) and dictyostatin (DCT). The data indicate that tubulin in assembled microtubules recognizes DDM through a conformational selection process, with minor changes in the molecular skeleton between the major conformer in water solution and that bound to assembled microtubules. For DCT, the deduced bound geometry presents some key conformation differences around certain torsion angles, with respect to the major conformer in solution, and still displays mobility even when bound. The bound conformer of DCT resembles that of DDM and provides very similar contacts with the receptor. Competition experiments indicate that both molecules compete with the taxane-binding site. A model of the binding mode of DDM and DCT to tubulin is proposed.

  12. SU-E-T-562: Motion Tracking Optimization for Conformal Arc Radiotherapy Plans: A QUASAR Phantom Based Study

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Z; Wang, I; Yao, R; Podgorsak, M [Roswell Park Cancer Institute, Buffalo, NY (United States)

    2015-06-15

    Purpose: This study is to use plan parameters optimization (Dose rate, collimator angle, couch angle, initial starting phase) to improve the performance of conformal arc radiotherapy plans with motion tracking by increasing the plan performance score (PPS). Methods: Two types of 3D conformal arc plans were created based on QUASAR respiratory motion phantom with spherical and cylindrical targets. Sinusoidal model was applied to the MLC leaves to generate motion tracking plans. A MATLAB program was developed to calculate PPS of each plan (ranges from 0–1) and optimize plan parameters. We first selected the dose rate for motion tracking plans and then used simulated annealing algorithm to search for the combination of the other parameters that resulted in the plan of the maximal PPS. The optimized motion tracking plan was delivered by Varian Truebeam Linac. In-room cameras and stopwatch were used for starting phase selection and synchronization between phantom motion and plan delivery. Gaf-EBT2 dosimetry films were used to measure the dose delivered to the target in QUASAR phantom. Dose profiles and Truebeam trajectory log files were used for plan delivery performance evaluation. Results: For spherical target, the maximal PPS (PPSsph) of the optimized plan was 0.79: (Dose rate: 500MU/min, Collimator: 90°, Couch: +10°, starting phase: 0.83π). For cylindrical target, the maximal PPScyl was 0.75 (Dose rate: 300MU/min, Collimator: 87°, starting phase: 0.97π) with couch at 0°. Differences of dose profiles between motion tracking plans (with the maximal and the minimal PPS) and 3D conformal plans were as follows: PPSsph=0.79: %ΔFWHM: 8.9%, %Dmax: 3.1%; PPSsph=0.52: %ΔFWHM: 10.4%, %Dmax: 6.1%. PPScyl=0.75: %ΔFWHM: 4.7%, %Dmax: 3.6%; PPScyl=0.42: %ΔFWHM: 12.5%, %Dmax: 9.6%. Conclusion: By achieving high plan performance score through parameters optimization, we can improve target dose conformity of motion tracking plan by decreasing total MLC leaf travel distance

  13. Assessment and Comparison of Homogeneity and Conformity Indexes in Step-and-Shoot and Compensator-Based Intensity Modulated Radiation Therapy (IMRT) and Three-Dimensional Conformal Radiation Therapy (3D CRT) in Prostate Cancer.

    Science.gov (United States)

    Salimi, Marzieh; Abi, Kaveh Shirani Tak; Nedaie, Hassan Ali; Hassani, Hossein; Gharaati, Hussain; Samei, Mahmood; Shahi, Rezgar; Zarei, Hamed

    2017-01-01

    Intensity modulated radiation therapy (IMRT) and three-dimensional conformal radiation therapy (3D CRT) are two treatment modalities in prostate cancer, which provide acceptable dose distribution in tumor region with sparing the surrounding normal tissues. IMRT is based on inverse planning optimization; in which, intensity of beams is modified by using multileaf collimators and also compensators with optimum shapes in step and shoot (SAS) and compensator-based method, respectively. In the recent study, some important parameters were compared in two IMRT and 3D CRT methods. Prescribed dose was 80 Gy for both IMRT procedures and 70 Gy for 3D CRT. Treatment plans of 15 prostate cancer candidates were compared to target the minimum dose, maximum dose, V 76 Gy (for IMRT plans) V 66.5 Gy (for 3D CRT), mean dose, conformity index (CI), and homogeneity index (HI). Dose conformity in compensators-based IMRT was better than SAS and 3D CRT. The same outcome was also achieved for homogeneity index. The target coverage was achieved 95% of prescribed dose to 95% of planning target volume (PTV) in 3D CRT and 95% of prescribed dose to 98% of PTV in IMRT methods. IMRT increases maximum dose of tumor region, improves CI and HI of target volume, and also reduces dose of organs at risks.

  14. 3D tumor localization through real-time volumetric x-ray imaging for lung cancer radiotherapy

    CERN Document Server

    Li, Ruijiang; Jia, Xun; Gu, Xuejun; Folkerts, Michael; Men, Chunhua; Song, William Y; Jiang, Steve B

    2011-01-01

    Recently we have developed an algorithm for reconstructing volumetric images and extracting 3D tumor motion information from a single x-ray projection. We have demonstrated its feasibility using a digital respiratory phantom with regular breathing patterns. In this work, we present a detailed description and a comprehensive evaluation of the improved algorithm. The algorithm was improved by incorporating respiratory motion prediction. The accuracy and efficiency were then evaluated on 1) a digital respiratory phantom, 2) a physical respiratory phantom, and 3) five lung cancer patients. These evaluation cases include both regular and irregular breathing patterns that are different from the training dataset. For the digital respiratory phantom with regular and irregular breathing, the average 3D tumor localization error is less than 1 mm. On an NVIDIA Tesla C1060 GPU card, the average computation time for 3D tumor localization from each projection ranges between 0.19 and 0.26 seconds, for both regular and irreg...

  15. Investigating the accuracy of microstereotactic-body-radiotherapy utilizing anatomically accurate 3D printed rodent-morphic dosimeters

    Energy Technology Data Exchange (ETDEWEB)

    Bache, Steven T.; Juang, Titania; Belley, Matthew D. [Duke University Medical Physics Graduate Program, Durham, North Carolina 27705 (United States); Koontz, Bridget F.; Yoshizumi, Terry T.; Kirsch, David G.; Oldham, Mark, E-mail: mark.oldham@duke.edu [Duke University Medical Center, Durham, North Carolina 27710 (United States); Adamovics, John [Rider University, Lawrenceville, New Jersey 08648 (United States)

    2015-02-15

    Purpose: Sophisticated small animal irradiators, incorporating cone-beam-CT image-guidance, have recently been developed which enable exploration of the efficacy of advanced radiation treatments in the preclinical setting. Microstereotactic-body-radiation-therapy (microSBRT) is one technique of interest, utilizing field sizes in the range of 1–15 mm. Verification of the accuracy of microSBRT treatment delivery is challenging due to the lack of available methods to comprehensively measure dose distributions in representative phantoms with sufficiently high spatial resolution and in 3 dimensions (3D). This work introduces a potential solution in the form of anatomically accurate rodent-morphic 3D dosimeters compatible with ultrahigh resolution (0.3 mm{sup 3}) optical computed tomography (optical-CT) dose read-out. Methods: Rodent-morphic dosimeters were produced by 3D-printing molds of rodent anatomy directly from contours defined on x-ray CT data sets of rats and mice, and using these molds to create tissue-equivalent radiochromic 3D dosimeters from Presage. Anatomically accurate spines were incorporated into some dosimeters, by first 3D printing the spine mold, then forming a high-Z bone equivalent spine insert. This spine insert was then set inside the tissue equivalent body mold. The high-Z spinal insert enabled representative cone-beam CT IGRT targeting. On irradiation, a linear radiochromic change in optical-density occurs in the dosimeter, which is proportional to absorbed dose, and was read out using optical-CT in high-resolution (0.5 mm isotropic voxels). Optical-CT data were converted to absolute dose in two ways: (i) using a calibration curve derived from other Presage dosimeters from the same batch, and (ii) by independent measurement of calibrated dose at a point using a novel detector comprised of a yttrium oxide based nanocrystalline scintillator, with a submillimeter active length. A microSBRT spinal treatment was delivered consisting of a 180

  16. Design and implementation of a rotational radiotherapy technique for breast cancer treatment and their comparison with 3-D-Crt irradiation technique; Diseno e implementacion de una tecnica de radioterapia rotacional para tratamiento de cancer de mama y su comparacion contra la tecnica 3D-CRT de irradiacion

    Energy Technology Data Exchange (ETDEWEB)

    Gutierrez M, J. G.; Lopez V, A.; Rivera M, T. [IPN, Centro de Investigacion en Ciencia Aplicada y Tecnologia Avanzada, Av. Legaria 694, Col. Irrigacion, 11500 Mexico D. F. (Mexico); Velazquez T, J. J.; Adame G, C. S. [Centro Medico Nacional Siglo XXI, Hospital de Oncologia, Departamento de Fisica Medica, Av. Cuauhtemoc No. 330, Col. Doctores, 06720 Mexico D. F. (Mexico); Rubio N, O.; Chagoya G, A.; Hernandez G, J. C., E-mail: jggm25@yahoo.com.mx [Centro Medico Nacional Siglo XXI, Hospital de Oncologia, Departamento de Radioterapia, Av. Cuauhtemoc No. 330, Col. Doctores, 06720 Mexico D. F. (Mexico)

    2015-10-15

    Breast cancer is one of oncological diseases worldwide, as well in Mexico, which causes even more deaths than cervical cancer; this condition is the second death cause in women aged 30-54 years and threatens all socio-economic groups. The treatment is highly dependent on the stage which is detected and based on protocols that include a combination of surgery, chemotherapy and radiotherapy. This paper studies the main irradiation technique for patients with mastectomy, breast full cycle (irradiation of the chest well and supraclavicular nodes) in their mode Three Dimensional - Conformal Radiation Therapy (3-D-Crt), and compared with the Volumetric Modulated Arc Therapy (VMAT) technique proposed in this paper. In both techniques the prescription was 50 Gy divided into 25 fractions. The techniques were applied in three female patients (being an initial study) with disease of the left side, the target volume and organs at risk were delineated by the medical treating radiation oncologist, the planning system used was Eclipse version 10; for quantitative comparison of both plans indexes of homogeneity were used, con formality, the target volume coverage and normal tissue, sub factors and overdosing, the conformation number and coverage quality. They were evaluated and compared the media, maximum and minimum dose of the organs at risk, based on the fact that the coverage of the target volume, dose gradient and dose at risk organs are acceptable (prescription dose greater that 90% coverage, gradient less that 20% and organs at risk in accordance with the Quantec limitations for both versions). (Author)

  17. Therapeutic effects and prognostic factors in three-dimensional conformal radiotherapy combined with transcatheter arterial chemoembolization for hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    De-Hua Wu; Li Liu; Long-Hua Chen

    2004-01-01

    AIM: To evaluate the therapeutic efficacy of threedimensional conformal radiotherapy (3D-CRT) combined with transcatheter arterial chemoembolization (TACE) on the patients with hepatocellular carcinoma (HCC).METHODS: Between 1998 and 2001, 94 patients with HCC received 3D-CRT combined with TACE. A total 63 patients had a Okuda stage Ⅰ lesion and 31 patients had stage Ⅱ. The median tumor size was 10.7 cm (range 3.0-18 cm), and liver cirrhosis was present in all the patients. There were 43 cases of class A and 51 class B. TACE was performed using lipiodol,5-fluorouracil, cisplatin, doxorubicin hydrochloride and mitomycin, followed by gelatin sponge cubes. Fifty-nine patients received TACE only one time, while the others 2 to 3 times. 3D-CRT was started 3-4 wk after TACE. All patients were irradiated with a stereotactic body frame and received 4-8 Gy single high-dose radiation for 8-12 times at the isocenter during a period of 17-26 d (median 22 d).RESULTS: The median follow-up was 37 mo (range 10-48 mo)after diagnosis. The response rate was 90.5%. The overall survival rate at 1-, 2-, and 3- year was 93.6%, 53.8% and 26.0% respectively, with the median survival of 25 mo. On univariate analysis, age (P=0.026), Child-Pugh classification for cirrhosis of liver (P=0.010), Okuda stage (P=0.026),tumor size (P=0.000), tumor type (P=0.029), albuminemia (P=0.035), and radiation dose (P=0.000) proved to be significant factors for survival. On multivariate analysis,age (P=0.024), radiation dose (P=0.001), and tumor size (P=0.000) were the significant factors.CONCLUSION: 3D-CRT combined with TACE is an effective and feasible approach for HCC. Age, radiation dose and tumor size were found to be significant prognostic factors for survival of patients with HCC treated by 3D-CRT combined with TACE. Further study for HCC is needed to improve the treatment efficacy.

  18. Conformal radiotherapy of locally advanced bile duct carcinoma; Radiotherapie conformationnelle des cholangiocarcinomes de la voie biliaire principale localement evolues

    Energy Technology Data Exchange (ETDEWEB)

    Bouras, N.; Caudry, M.; Bonnel, C.; Trouette, R.; Demeaux, H.; Maire, J.P. [Centre Hospitalier Universitaire, Hopital Saint-Andre, Service de Radiotherapie, 33 - Bordeaux (France); Saric, J.; Rullier, E. [Centre Hospitalier Universitaire, Hopital Saint-Andre, Service de Chirurgie Viscerale et de Transplantation Hepatique, 33 - Bordeaux (France)

    2002-02-01

    Purpose. - Retrospective study of 23 patients treated with conformal radiotherapy for a locally advanced bile duct carcinoma. Patients and methods. - Eight cases were irradiated after a radical resection (RO), because they were N+; seven after microscopically incomplete resection (R1) ; seven were not resected (R2). A dose of 45 of 50 Gy was delivered, followed by a boost up to 60 Gy in R1 and R2 groups. Concomitant chemotherapy was given in 15 cases. Results.-Late toxicity included a stenosis of the duodenum, and one of the biliary anastomosis. Two patients died from cholangitis, the mechanism of which remains unclear. Five patients are in complete remission, six had a local relapse, four developed a peritoneal carcinosis, and six distant metastases. Actuarial survival rate is 75%, 28% and 7% at 1, 3 and 5 years, respectively (median: 16.5 months). Seven patients are still alive with a 4 to 70 months follow-up. Survival is similar in the 3 small subgroups. The poor local control among RON+ cases might be related to the absence of a boost to the 'tumor bed'. In R1 patients, relapses were mainly distant metastases, where'as local and peritoneal recurrences predominated in R2. Conclusion. - Conformal radio-chemotherapy delivering 60 Gy represents a valuable palliative approach in locally advanced biliary carcinoma. (authors)

  19. Comparative evaluation of a novel 3D segmentation algorithm on in-treatment radiotherapy cone beam CT images

    Science.gov (United States)

    Price, Gareth; Moore, Chris

    2007-03-01

    Image segmentation and delineation is at the heart of modern radiotherapy, where the aim is to deliver as high a radiation dose as possible to a cancerous target whilst sparing the surrounding healthy tissues. This, of course, requires that a radiation oncologist dictates both where the tumour and any nearby critical organs are located. As well as in treatment planning, delineation is of vital importance in image guided radiotherapy (IGRT): organ motion studies demand that features across image databases are accurately segmented, whilst if on-line adaptive IGRT is to become a reality, speedy and correct target identification is a necessity. Recently, much work has been put into the development of automatic and semi-automatic segmentation tools, often using prior knowledge to constrain some grey level, or derivative thereof, interrogation algorithm. It is hoped that such techniques can be applied to organ at risk and tumour segmentation in radiotherapy. In this work, however, we make the assumption that grey levels do not necessarily determine a tumour's extent, especially in CT where the attenuation coefficient can often vary little between cancerous and normal tissue. In this context we present an algorithm that generates a discontinuity free delineation surface driven by user placed, evidence based support points. In regions of sparse user supplied information, prior knowledge, in the form of a statistical shape model, provides guidance. A small case study is used to illustrate the method. Multiple observers (between 3 and 7) used both the presented tool and a commercial manual contouring package to delineate the bladder on a serially imaged (10 cone beam CT volumes ) prostate patient. A previously presented shape analysis technique is used to quantitatively compare the observer variability.

  20. The clinical observation of three-dimensional conformal radiotherapy combined with FOLFOX chemotherapy for rectal cancer of postoperative local recurrence

    Institute of Scientific and Technical Information of China (English)

    Yeqin Zhou; Mi Liu; Daiyuan Ma; Tao Ren; Xiaojie Ma; Xianfu Li; Bangxian Tan

    2012-01-01

    Objective: The aim of this study was to explore the three-dimensional conformal radiotherapy combined with FOLFOX scheme chemotherapy in the treatment of postoperative recurrence of rectal cancer. Methods: Sixty-eight cases of recurrent rectal cancer were divided randomly into two groups: 34 cases of conformal radiotherapy plus FOLFOX chemotherapy group (experiment group) and 34 cases of conformal radiotherapy (control group). After 6 MvX line with three-dimensional conformal radiotherapy technologies for recurrent lesions and pelvic cavity around subclinical lymphatic drainage radiotherapy after radiotherapy to DT 40 Gy to reposit was made use of between both groups, experiment group was made the new treatment plan to continue to irradiate to 50 Gy, and then Shrinkage GTV was pushed quantity in the field 66 Gy. Researchers took chemotherapy in the first week and the fourth week after radiotherapy, with 5-fluorouracil 500 mg/m2, calcium leucovorin 200 mg, d1-5 with intravenous drip, Oxaliplatin 130 mg/m2 and d1 with intravenous drip 2 h, 21 days was one cycle. Kaplan-Meier method was used for survival analysis. Results: The survival rates for 1, 2 and 3 years for experiment group and control group were 88.2%, 64.7%, 47.1% and 66.7%, 38.2%, 29.4% (P = 0.03), the 2-year rate of distant metastases was 32.4% and 58.8% (P = 0.032) respectively. The median survival time was 33 and 20 months respectively. There were some side effects between the groups, but there was no statistical difference. Conclusion: Three-dimensional conformal radiotherapy plus FOLFOX chemotherapy can be considered as a safe and effective approach to treat rectal cancer patients of postoperative recurrence, and can improve the survival rates of patients and reduce distant metastasis rate obviously and make the acute adverse reaction rate insignificantly.

  1. Conformal fields in prostate radiotherapy: A comparison between measurement, calculation and simulation

    Directory of Open Access Journals (Sweden)

    Seied R Mahdavi

    2012-01-01

    Full Text Available Aims: The objective of this study is to evaluate the accuracy of a treatment planning system (TPS for calculating the dose distribution parameters in conformal fields (CF. Dosimetric parameters of CF′s were compared between measurement, Monte Carlo simulation (MCNP4C and TPS calculation. Materials and Methods: Field analyzer water phantom was used for obtaining percentage depth dose (PDD curves and beam profiles (BP of different conformal fields. MCNP4C was used to model conformal fields dose specification factors and head of linear accelerator varian model 2100C/D. Results: Results showed that the distance to agreement (DTA and dose difference (DD of our findings were well within the acceptance criteria of 3 mm and 3%, respectively. Conclusions: According to this study it can be revealed that TPS using equivalent tissue air ratio calculation method is still convenient for dose prediction in non small conformal fields normally used in prostate radiotherapy. It was also showed that, since there is a close correlation with Monte Carlo simulation, measurements and TPS, Monte Carlo can be further confirmed for implementation and calculation dose distribution in non standard and complex conformal irradiation field for treatment planning systems.

  2. Tumor control probability and the utility of 4D vs 3D dose calculations for stereotactic body radiotherapy for lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Valdes, Gilmer, E-mail: gilmer.valdes@uphs.upenn.edu [Department of Radiation Oncology, Perelman Center for Advanced Medicine, University of Pennsylvania, Philadelphia, PA (United States); Robinson, Clifford [Department of Radiation Oncology, Siteman Cancer Center, Washington University in St. Louis, St. Louis, MO (United States); Lee, Percy [Department of Radiation Oncology, David Geffen School of Medicine, UCLA, Los Angeles, CA (United States); Morel, Delphine [Department of Biomedical Engineering, AIX Marseille 2 University, Marseille (France); Department of Medical Physics, Joseph Fourier University, Grenoble (France); Low, Daniel; Iwamoto, Keisuke S.; Lamb, James M. [Department of Radiation Oncology, David Geffen School of Medicine, UCLA, Los Angeles, CA (United States)

    2015-04-01

    Four-dimensional (4D) dose calculations for lung cancer radiotherapy have been technically feasible for a number of years but have not become standard clinical practice. The purpose of this study was to determine if clinically significant differences in tumor control probability (TCP) exist between 3D and 4D dose calculations so as to inform the decision whether 4D dose calculations should be used routinely for treatment planning. Radiotherapy plans for Stage I-II lung cancer were created for 8 patients. Clinically acceptable treatment plans were created with dose calculated on the end-exhale 4D computed tomography (CT) phase using a Monte Carlo algorithm. Dose was then projected onto the remaining 9 phases of 4D-CT using the Monte Carlo algorithm and accumulated onto the end-exhale phase using commercially available deformable registration software. The resulting dose-volume histograms (DVH) of the gross tumor volume (GTV), planning tumor volume (PTV), and PTV{sub setup} were compared according to target coverage and dose. The PTV{sub setup} was defined as a volume including the GTV and a margin for setup uncertainties but not for respiratory motion. TCPs resulting from these DVHs were estimated using a wide range of alphas, betas, and tumor cell densities. Differences of up to 5 Gy were observed between 3D and 4D calculations for a PTV with highly irregular shape. When the TCP was calculated using the resulting DVHs for fractionation schedules typically used in stereotactic body radiation therapy (SBRT), the TCP differed at most by 5% between 4D and 3D cases, and in most cases, it was by less than 1%. We conclude that 4D dose calculations are not necessary for most cases treated with SBRT, but they might be valuable for irregularly shaped target volumes. If 4D calculations are used, 4D DVHs should be evaluated on volumes that include margin for setup uncertainty but not respiratory motion.

  3. Conformal Radiotherapy for Squamous Cell Carcinoma of Gallbladder: A Case Report

    Directory of Open Access Journals (Sweden)

    Jia-zhou Hou

    2010-01-01

    Case report. We describe a 58-year-old male with a 5-week history of hypodynamia. He was found to have squamous cell carcinoma of the gallbladder with liver invasion and lymph node metastases. He underwent treatment with 3-dimensional conformal radiation therapy (CRT. A follow-up computer tomography (CT scan showed complete tumor remission 2 months after the completion of CRT. The patient survived for 14 months after the end of treatment and died of multiple liver metastases. Conclusion. The efficacy of radiotherapy in this case is encouraging and suggests a potential role for such therapy in similar cases. The benefit in terms of survival warrants further study.

  4. [Clinical experience in image-guided ultra-conformal hypofractionated radiotherapy in case of metastatic diseases at the University of Pécs].

    Science.gov (United States)

    László, Zoltán; Boronkai, Árpád; Lõcsei, Zoltán; Kalincsák, Judit; Szappanos, Szabolcs; Farkas, Róbert; Al Farhat, Yousuf; Sebestyén, Zsolt; Sebestyén, Klára; Kovács, Péter; Csapó, László; Mangel, László

    2015-06-01

    With the development of radiation therapy technology, the utilization of more accurate patient fixation, inclusion of PET/CT image fusion into treatment planning, 3D image-guided radiotherapy, and intensity-modulated dynamic arc irradiation, the application of hypofractionated stereotactic radiotherapy can be extended to specified extracranial target volumes, and so even to the treatment of various metastases. Between October 2012 and August 2014 in our institute we performed extracranial, hypofractionated, image-többguided radiotherapy with RapidArc system for six cases, and 3D conformal multifield technique for one patient with Novalis TX system in case of different few-numbered and slow-growing metastases. For the precise definition of the target volumes we employed PET/CT during the treatment planning procedure. Octreotid scan was applied in one carcinoid tumour patient. Considering the localisation of the metastases and the predictable motion of the organs, we applied 5 to 20 mm safety margin during the contouring procedure. The average treatment volume was 312 cm3. With 2.5-3 Gy fraction doses we delivered 39-45 Gy total dose, and the treatment duration was 2.5 to 3 weeks. The image guidance was carried out via ExacTrac, and kV-Cone Beam CT equipment based on an online protocol, therefore localisation differences were corrected before every single treatment. The patients tolerated the treatments well without major (Gr>2) side effects. Total or near total regression of the metastases was observed at subsequent control examinations in all cases (the median follow-up time was 5 months). According to our first experience, extracranial, imageguided hypofractionated radiotherapy is well-tolerated by patients and can be effectively applied in the treatment of slow-growing and few-numbered metastases.

  5. A hybrid conformal planning technique with solitary dynamic portal for postmastectomy radiotherapy with regional nodes

    Directory of Open Access Journals (Sweden)

    K Mohamathu Rafic

    2017-01-01

    Full Text Available Purpose: This study focuses on incorporation of a solitary dynamic portal (SDP in conformal planning for postmastectomy radiotherapy (PMRT with nodal regions with an intention to overcome the treatment planning limitations imposed by conventional techniques. Materials and Methods: Twenty-four patients who underwent surgical mastectomy followed by PMRT were included in this study. Initially, a treatment plan comprising tangential beams fitted to beam's-eye-view (BEV of chest wall (CW and a direct anterior field fitted to BEV of nodal region, both sharing a single isocenter was generated using Eclipse treatment planning system. Multiple field-in-fields with optimum beam weights (5% per field were added primarily from the medial tangent, fitted to BEV of entire target volume, and finally converted into a dynamic portal. Dosimetric analysis for the treatment plans and fluence verification for the dynamic portals were performed. Results and Discussion: Conformal plans with SDP showed excellent dose coverage (V95%>95%, higher degree of tumor dose conformity (≤1.25 and homogeneity (≤0.12 without compromising the organ at risk sparing for PMRT with nodal region. Treatment plans with SDP considerably reduced the lower isodose spread to the ipsilateral lung, heart, and healthy tissue without affecting the dose homogeneity. Further, gamma evaluation showed more than 96% pixel pass rate for standard 3%/3 mm dose difference and distance-to-agreement criteria. Moreover, this plan offers less probability of “geometrical miss” at the highly irregular CW with regional nodal radiotherapy. Conclusion: Hybrid conformal plans with SDP would facilitate improved dose distribution and reduced uncertainty in delivery and promises to be a suitable treatment option for complex postmastectomy CW with regional nodal irradiation.

  6. Radiotherapy of intensity modulated VS conformational in the treatment of carcinoma of the prostate. A dosimetric comparison; Radioterapia de intensidad modulada VS conformacional en el tratamiento de carcinoma de prostata. Una camparacion dosimetrica

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez Martin, G.; Garcia Vicente, F.; Zapatero Laborda, A.; Bermudez Luna, R.; Roch Gonzalez, M.; Perez Gonzalez, L.; Torres Escobar, J. J.

    2013-07-01

    The intensity modulated (IMRT) radiation therapy is a technique of high conformation which, by its nature, has as one of its main directions prostate cancer radiotherapy treatment. The purpose of this work is presents results of the dosimetric indicators collected in our hospital a number of patients of carcinoma of the prostate with standard three-dimensional Conformal technique (3D-CRT) and IMRT. Aims to demonstrate and quantify with a statistical methodology that, establishing an adequate Protocol of IMRT, significant reductions in risk organ doses can be obtained by keeping the same prescription to the white volume. (Author)

  7. Nasopharynx carcinoma treatment: from the conventional radiotherapy to the conformal radiotherapy with intensity modulation; Traitement du carcinome du nasopharynx: de la radiotherapie conventionnelle a la radiotherapie conformationnelle avec modulation d'intensite

    Energy Technology Data Exchange (ETDEWEB)

    Mokaouim, K.; Grehange, G.; Truc, G.; Peingnaux, K.; Martin, E.; Zanetta, S.; Bruchon, Y.; Bonnetain, F.; Maingon, P. [Centre Georges-Francois Leclerc, 21 - Dijon (France)

    2009-10-15

    The objective of this study was to evaluate retrospectively the impact of factors linked to the radiotherapy realisation on the local and locoregional control, the global survival, the survival without disease of patients suffering of naso-pharynx carcinoma. Conclusion: the patients suffering of a nasopharynx carcinoma treated by irradiation associated to chemotherapy have an improved global survival and an improved survival without disease. The conformal radiotherapy with or without modulated intensity reduce the risk of serous otitis, trismus and xerostomia at long term. It seems necessary to realize multi centric studies with a longer period of follow up before asserting the advantages of the I.M.R.T. in comparison to the classical and conformal technique in the treatment of naso-pharynx carcinomas. (N.C.)

  8. SU-E-T-348: Verification MU Calculation for Conformal Radiotherapy with Multileaf Collimator Using Report AAPM TG 114

    Energy Technology Data Exchange (ETDEWEB)

    Adrada, A; Tello, Z; Medina, L; Garrigo, E; Venencia, D [Instituto de Radioterapia - Fundacion Marie Curie, Cordoba (Argentina)

    2014-06-01

    Purpose: The purpose of this work was to develop and validate an open source independent MU dose calculation software for 3D conformal radiotherapy with multileaf high and low resolution according to the report of AAPM TG 11 Methods: Treatment plans were done using Iplan v4.5 BrainLAB TPS. A 6MV photon beam produced by Primus and Novalis linear accelerators equipped with an Optifocus MLC and HDMLC, respectively. TPS dose calculation algorithms were pencil beam and Monte Carlo. 1082 treatments plans were selected for the study. The algorithm was written in free and open source CodeBlocks C++ platform. Treatment plans were imported by the software using RTP format. Equivalent size field is obtained from the positions of the leaves; the effective depth of calculation can be introduced by TPS's dosimetry report or automatically calculated starting from SSD. The inverse square law is calculated by the 3D coordinates of the isocenter and normalization point of the treatment plan. The dosimetric parameters TPR, Sc, Sp and WF are linearly interpolated. Results: 1082 plans of both machines were analyzed. The average uncertainty between the TPS and the independent calculation was −0.43% ± 2.42% [−7.90%, 7.50%]. Specifically for the Primus the variation obtained was −0.85% ± 2.53% and for the Novalis 0.00% ± 2.23%. Data show that 94.8% of the cases the uncertainty was less than or equal to 5%, while 98.9% is less than or equal to 6%. Conclusion: The developed software is appropriate for use in calculation of UM. This software can be obtained upon request.

  9. Comment on genetic and global algorithms for optimization of three-dimensional conformal radiotherapy treatment planning

    Energy Technology Data Exchange (ETDEWEB)

    Vaarkamp, Jaap [Joint Department of Physics, Royal Marsden NHS Trust, Sutton, Surrey (United Kingdom). E-mail: jaap@icr.ac.uk

    2001-06-01

    Full text: I would like to make four comments on three papers by two authors (Wu and Zhu 2000, 2001, Wu et al 2000) on one topic: optimization of 3D conformal radiotherapy treatment planning. In the papers, genetic and global algorithms are proposed for this optimization, and the authors claim to be able to generate better treatment plans than those produced manually and used for patient treatment (Wu and Zhu 2000). However, the data in the papers do not warrant such a conclusion and the work contains such serious methodological flaws that only the opposite can have been true. First, in the papers a few treatment plans for patients with different brain tumours are discussed. Dose volume histograms (DVHs) are presented for the target, sometimes the planning target volume, sometimes the clinical target volume, and the organs at risk (OARs): left and right eye, and thyroid or spinal cord. However, other OARs limit dose more in clinical treatment planning, and it is those OARs to which the planner must direct all effort when optimizing the treatment plan. One such important OAR when treating children is the temporal lobes because the dose to the temporal lobes has been associated with a reduction in IQ points (Fuss et al 2000). Also particularly important when treating children are the hypothalamus and pituitary, because they influence growth and the further hormonal development (Schmiegelow et al 1999, 2000). Furthermore, rather than the eyes themselves, the optic chiasm usually gets more serious attention (Fuss et al 1999) and is considered so important that it is often blocked from the treatment fields during the final fractions, thus compromising dose homogeneity in the target. Finally, irradiating the auditory apparatus can lead to a loss of hearing (Lin et al 2000), and, in particular when one side receives a high dose, every effort is made to at least spare the other side. Hence, it is not surprising to find a treatment plan that is superior in some of the

  10. A comparative analysis of 3D conformal deep inspiratory–breath hold and free-breathing intensity-modulated radiation therapy for left-sided breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Reardon, Kelli A.; Read, Paul W.; Morris, Monica M. [Department of Radiation Oncology, University of Virginia, Charlottesville, VA (United States); Reardon, Michael A. [Department of Radiology, University of Virginia, Charlottesville, VA (United States); Geesey, Constance [Department of Radiation Oncology, University of Virginia, Charlottesville, VA (United States); Wijesooriya, Krishni, E-mail: kw5wx@hscmail.mcc.virginia.edu [Department of Radiation Oncology, University of Virginia, Charlottesville, VA (United States)

    2013-07-01

    Patients undergoing radiation for left-sided breast cancer have increased rates of coronary artery disease. Free-breathing intensity-modulated radiation therapy (FB-IMRT) and 3-dimensional conformal deep inspiratory–breath hold (3D-DIBH) reduce cardiac irradiation. The purpose of this study is to compare the dose to organs at risk in FB-IMRT vs 3D-DIBH for patients with left-sided breast cancer. Ten patients with left-sided breast cancer had 2 computed tomography scans: free breathing and voluntary DIBH. Optimization of the IMRT plan was performed on the free-breathing scan using 6 noncoplanar tangential beams. The 3D-DIBH plan was optimized on the DIBH scan and used standard tangents. Mean volumes of the heart, the left anterior descending coronary artery (LAD), the total lung, and the right breast receiving 5% to 95% (5% increments) of the prescription dose were calculated. Mean volumes of the heart and the LAD were lower (p<0.05) in 3D-DIBH for volumes receiving 5% to 80% of the prescription dose for the heart and 5% for the LAD. Mean dose to the LAD and heart were lower in 3D-DIBH (p≤0.01). Mean volumes of the total lung were lower in FB-IMRT for dose levels 20% to 75% (p<0.05), but mean dose was not different. Mean volumes of the right breast were not different for any dose; however, mean dose was lower for 3D-DIBH (p = 0.04). 3D-DIBH is an alternative approach to FB-IMRT that provides a clinically equivalent treatment for patients with left-sided breast cancer while sparing organs at risk with increased ease of implementation.

  11. Practical application of the tool calculation Monte Carlo MCVerif for checking for radiotherapy treatment; Aplicacion practica de la herramienta de calculo Monte Carlo MCVerif para la verificacion de tratamientos de radioterapia

    Energy Technology Data Exchange (ETDEWEB)

    Laliena Bielsa, V. M.; Garcia Romero, A.; Villa Gazulla, D.; Ortega Pardilla, P.; Calvo Carrillo, S.; Millan Cebrian, E.; Hernandez Vitorial, A.; Canellas Aznoz, M.

    2013-07-01

    The object of this work is to verify a patient group representative of the usual techniques of 3D conformal radiotherapy and IMRT performed in the radiotherapy service our hospital and thus validate the algorithm used commercial planning system. (Author)

  12. Three-dimensional conformal radiotherapy in the treatment of prostate cancer in Australia and New Zealand: Report on a survey of radiotherapy centres and the proceedings of a consensus workshop.

    Science.gov (United States)

    Tai, K-H; Duchesne, G; Turner, S; Kneebone, A; See, A; Gogna, K; Berry, M

    2004-12-01

    There is an increasing use of 3-D conformal radiotherapy (3DCRT) in the radiotherapeutic management of prostate cancer. The Faculty of Radiation Oncology Genito-Urinary Group carried out a survey of Australian and New Zealand radiotherapy centres in the preparation of a consensus workshop. Of the 19 centres that were represented, there were 24 radiation oncologists, 16 radiation therapists and 12 medical physicists. The survey collected demographic information and data on the practices undertaken at those centres when delivering curative radiotherapy in the treatment of prostate cancer. There was much variation in the delivery of treatment in the areas of patient set-up, contouring of target volumes and organs of interest during computer planning, the techniques and the dose constraints used in these techniques, the use of adjuvant androgen deprivation therapy and the quality assurance processes used in monitoring effects of treatment. This variability reflects the range of data in the published literature. Emerging trends of practices were also identified. This is a first report on a multi-disciplinary approach to the development of guidelines in 3DCRT of prostate cancer.

  13. Improved local control without elective nodal radiotherapy in patients with unresectable NSCLC treated by 3D-CRT

    Institute of Scientific and Technical Information of China (English)

    YANG Kunyu; CAO Fengjun; WANG Jianhua; LIU Li; ZHANG Tao; WU Gang

    2007-01-01

    To investigate the influence of prophylactic elective nodal irradiation on the therapeutic results of definitive radiotherapy for patients with stage IliA or stage IIIB unresectable non-small-cell lung cancer,55 patients with clinically inoperable advanced non-small-cell lung cancer were studied.After four cycles of induction chemotherapy,the patients were divided into two groups at random.In one group,the elective nodal irradiation was included in clinical tumor volume(CTV)of definitive radiotherapy(ENI group);and in the other group,elective nodal irradiation was not included in CTV(non-ENI group).For the patients in the ENI group,the mean prescription dose for gross tumor volumes was 58.4 Gy,while for the patients in the non-ENI group,it was 65.8 Gy(P<0.05).The responsive rates were 45.8% and 74.0%(P<0.05),and the rate of the elective nodal failure (ENF)was 4.2% and 11.1%,respectively.Kaplan-Meier analysis showed that the mean local-progression-free survival time was 11.0 and 15.0 months,and one-year local-failure rates were 51.9% and 24.5%(P<0.05).The median overall survival time was 13.0 and 15.0 months,respectively (P=0.084).The one-year survival rates were 55.7% and 72.5%,and two-year survival rates were 0% and 19.9%.There was no significant difference in the occurrences of radiation-associated complications between the two groups.Our results showed that omitting elective nodal irradiation did not result in a high incidence of elective nodal failure.On the contrary,it decreased local failure by increasing prescription doses to the primary diseases and lymphadenopaphy,and thereby it may further prolong the patients' survival.

  14. DG-AMMOS: A New tool to generate 3D conformation of small molecules using Distance Geometry and Automated Molecular Mechanics Optimization for in silico Screening

    Directory of Open Access Journals (Sweden)

    Villoutreix Bruno O

    2009-11-01

    Full Text Available Abstract Background Discovery of new bioactive molecules that could enter drug discovery programs or that could serve as chemical probes is a very complex and costly endeavor. Structure-based and ligand-based in silico screening approaches are nowadays extensively used to complement experimental screening approaches in order to increase the effectiveness of the process and facilitating the screening of thousands or millions of small molecules against a biomolecular target. Both in silico screening methods require as input a suitable chemical compound collection and most often the 3D structure of the small molecules has to be generated since compounds are usually delivered in 1D SMILES, CANSMILES or in 2D SDF formats. Results Here, we describe the new open source program DG-AMMOS which allows the generation of the 3D conformation of small molecules using Distance Geometry and their energy minimization via Automated Molecular Mechanics Optimization. The program is validated on the Astex dataset, the ChemBridge Diversity database and on a number of small molecules with known crystal structures extracted from the Cambridge Structural Database. A comparison with the free program Balloon and the well-known commercial program Omega generating the 3D of small molecules is carried out. The results show that the new free program DG-AMMOS is a very efficient 3D structure generator engine. Conclusion DG-AMMOS provides fast, automated and reliable access to the generation of 3D conformation of small molecules and facilitates the preparation of a compound collection prior to high-throughput virtual screening computations. The validation of DG-AMMOS on several different datasets proves that generated structures are generally of equal quality or sometimes better than structures obtained by other tested methods.

  15. A semi-automated 2D/3D marker-based registration algorithm modelling prostate shrinkage during radiotherapy for prostate cancer.

    Science.gov (United States)

    Budiharto, Tom; Slagmolen, Pieter; Hermans, Jeroen; Maes, Frederik; Verstraete, Jan; Heuvel, Frank Van den; Depuydt, Tom; Oyen, Raymond; Haustermans, Karin

    2009-03-01

    Currently, most available patient alignment tools based on implanted markers use manual marker matching and rigid registration transformations to measure the needed translational shifts. To quantify the particular effect of prostate gland shrinkage, implanted gold markers were tracked during a course of radiotherapy including an isotropic scaling factor to model prostate shrinkage. Eight patients with prostate cancer had gold markers implanted transrectally and seven were treated with (neo) adjuvant androgen deprivation therapy. After patient alignment to skin tattoos, orthogonal electronic portal images (EPIs) were taken. A semi-automated 2D/3D marker-based registration was performed to calculate the necessary couch shifts. The registration consists of a rigid transformation combined with an isotropic scaling to model prostate shrinkage. The inclusion of an isotropic shrinkage model in the registration algorithm cancelled the corresponding increase in registration error. The mean scaling factor was 0.89+/-0.09. For all but two patients, a decrease of the isotropic scaling factor during treatment was observed. However, there was almost no difference in the translation offset between the manual matching of the EPIs to the digitally reconstructed radiographs and the semi-automated 2D/3D registration. A decrease in the intermarker distance was found correlating with prostate shrinkage rather than with random marker migration. Inclusion of shrinkage in the registration process reduces registration errors during a course of radiotherapy. Nevertheless, this did not lead to a clinically significant change in the proposed table translations when compared to translations obtained with manual marker matching without a scaling correction.

  16. Guidelines for target volume definition in post-operative radiotherapy for prostate cancer, on behalf of the EORTC Radiation Oncology Group

    NARCIS (Netherlands)

    Poortmans, Philip; Bossi, Alberto; Vandeputte, Katia; Bosset, Mathieu; Miralbell, Raymond; Maingon, Philippe; Boehmer, Dirk; Budiharto, Tom; Symon, Zvi; van den Bergh, Alfons C. M.; Scrase, Christopher; Van Poppel, Hendrik; Bolla, Michel

    2007-01-01

    The appropriate application of 3-D conformal radiotherapy, intensity modulated radiotherapy or image guided radiotherapy for patients undergoing post-operative radiotherapy for prostate cancer requires a standardisation of the target volume definition and delineation as well as stanclardisation of t

  17. Breast cancer and funnel chest. Comparing helical tomotherapy and three-dimensional conformal radiotherapy with regard to the shape of pectus excavatum

    Energy Technology Data Exchange (ETDEWEB)

    Uhl, M.; Sterzing, F.; Habl, G.; Schubert, K.; Hof, H.; Debus, J.; Herfarth, K. [Univ. of Heidelberg (Germany). Dept. of Radiation Oncology

    2012-02-15

    Preserving lung, heart, and the contralateral breast from toxicity is a technical challenge in women with funnel chest, who require breast irradiation. The purpose of this study was to determine whether helical tomotherapy (HT) offers an advantage compared to three-dimensional (3D) conformal radiotherapy (CRT) for patients with pectus excavatum with regard to its shape. Ten breast cancer patients with pectus excavatum were graded into a low or high deformation group using different indices, measured and calculated by using the planning CT. A planning comparison was performed, creating plans for CRT and HT. Target uniformity, target conformity, and exposure to the organs at risk (OARs) were compared. The uniformity and conformity of the target dose distribution and the median/average dose of the planning target volume (PTV) was inferior in CRT compared to HT in both deformation groups. By using tomotherapy, the volume of the lungs, the contralateral breast, and the heart, which received high dose exposure, could be significantly reduced. Tomotherapy plans led to a significantly higher low dose exposure to the lungs and contralateral breast. This is the first study which evaluates a group of 10 breast cancer patients with funnel chest. Better uniformity and conformity combined with a significant reduction of high dose exposure to the OARs can be reached using tomotherapy. However, tomotherapy plans have a significantly larger volume of low dose to the lungs and contralateral breast. Therefore, the stochastic risk should be considered after low dose exposure in women with low deformation. (orig.)

  18. Real-time volumetric image reconstruction and 3D tumor localization based on a single x-ray projection image for lung cancer radiotherapy

    CERN Document Server

    Li, Ruijiang; Lewis, John H; Gu, Xuejun; Folkerts, Michael; Men, Chunhua; Jiang, Steve B

    2010-01-01

    Purpose: To develop an algorithm for real-time volumetric image reconstruction and 3D tumor localization based on a single x-ray projection image for lung cancer radiotherapy. Methods: Given a set of volumetric images of a patient at N breathing phases as the training data, we perform deformable image registration between a reference phase and the other N-1 phases, resulting in N-1 deformation vector fields (DVFs). These DVFs can be represented efficiently by a few eigenvectors and coefficients obtained from principal component analysis (PCA). By varying the PCA coefficients, we can generate new DVFs, which, when applied on the reference image, lead to new volumetric images. We then can reconstruct a volumetric image from a single projection image by optimizing the PCA coefficients such that its computed projection matches the measured one. The 3D location of the tumor can be derived by applying the inverted DVF on its position in the reference image. Our algorithm was implemented on graphics processing units...

  19. Dosimetry in radiotherapy using a-Si EPIDs: Systems, methods, and applications focusing on 3D patient dose estimation

    Science.gov (United States)

    McCurdy, B. M. C.

    2013-06-01

    An overview is provided of the use of amorphous silicon electronic portal imaging devices (EPIDs) for dosimetric purposes in radiation therapy, focusing on 3D patient dose estimation. EPIDs were originally developed to provide on-treatment radiological imaging to assist with patient setup, but there has also been a natural interest in using them as dosimeters since they use the megavoltage therapy beam to form images. The current generation of clinically available EPID technology, amorphous-silicon (a-Si) flat panel imagers, possess many characteristics that make them much better suited to dosimetric applications than earlier EPID technologies. Features such as linearity with dose/dose rate, high spatial resolution, realtime capability, minimal optical glare, and digital operation combine with the convenience of a compact, retractable detector system directly mounted on the linear accelerator to provide a system that is well-suited to dosimetric applications. This review will discuss clinically available a-Si EPID systems, highlighting dosimetric characteristics and remaining limitations. Methods for using EPIDs in dosimetry applications will be discussed. Dosimetric applications using a-Si EPIDs to estimate three-dimensional dose in the patient during treatment will be overviewed. Clinics throughout the world are implementing increasingly complex treatments such as dynamic intensity modulated radiation therapy and volumetric modulated arc therapy, as well as specialized treatment techniques using large doses per fraction and short treatment courses (ie. hypofractionation and stereotactic radiosurgery). These factors drive the continued strong interest in using EPIDs as dosimeters for patient treatment verification.

  20. Rapid Arc, helical tomotherapy, sliding window intensity modulated radiotherapy and three dimensional conformal radiation for localized prostate cancer: A dosimetric comparison

    Directory of Open Access Journals (Sweden)

    Rajesh A Kinhikar

    2014-01-01

    Full Text Available Objective: The objective of this study was to investigate the potential role of RapidArc (RA compared with helical tomotherapy (HT, sliding window intensity modulated radiotherapy (SW IMRT and three-dimensional conformal radiation therapy (3D CRT for localized prostate cancer. Materials and Methods: Prescription doses ranged from 60 Gy to planning target volume (PTV and 66.25 Gy for clinical target volume prostate (CTV-P over 25-30 fractions. PTV and CTV-P coverage were evaluated by conformity index (CI and homogeneity index (HI. Organ sparing comparison was done with mean doses to rectum and bladder. Results: CI 95 were 1.0 ± 0.01 (RA, 0.99 ± 0.01 (HT, 0.97 ± 0.02 (IMRT, 0.98 ± 0.02 (3D CRT for PTV and 1.0 ± 0.00 (RA, HT, SW IMRT and 3D CRT for CTV-P. HI was 0.11 ± 0.03 (RA, 0.16 ± 0.08 (HT, 0.12 ± 0.03 (IMRT, 0.06 ± 0.01 (3D CRT for PTV and 0.03 ± 0.00 (RA, 0.05 ± 0.01 (HT, 0.03 ± 0.01 (SW IMRT and 3D CRT for CTV-P. Mean dose to bladder were 23.68 ± 13.23 Gy (RA, 24.55 ± 12.51 Gy (HT, 19.82 ± 11.61 Gy (IMRT and 23.56 ± 12.81 Gy (3D CRT, whereas mean dose to rectum was 36.85 ± 12.92 Gy (RA, 33.18 ± 11.12 Gy (HT, IMRT and 38.67 ± 12.84 Gy (3D CRT. Conclusion: All studied intensity-modulated techniques yield treatment plans of significantly improved quality when compared with 3D CRT, with HT providing best organs at risk sparing and RA being the most efficient treatment option, reducing treatment time to 1.45-3.7 min and monitor unit to <400 for a 2 Gy fraction.

  1. Toxicity and cosmetic outcome of three-dimensional conformal radiotherapy for accelerated partial breast irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Gatti, M.; Bresciani, S.; Ponzone, R.; Panaia, R.; Salatino, A.; Stasi, M.; Gabriele, P. [IRCC, Candiolo (Italy)

    2011-10-15

    Full text of publication follows: Purpose.- To analyse the incidence and severity of acute and late normal tissue toxicity and cosmetic outcome using three - dimensional conformal radiotherapy to deliver accelerated partial breast irradiation. Patients and Methods.- 70 patients with stage I disease were treated with three-dimensional conformal radiotherapy for accelerated partial breast irradiation, in an approved protocol. The prescribed dose was 34 Gy in all patients delivered in 10 fractions over 5 consecutive days. On all CT scans gross tumor volume (GTV ) was defined around surgical clips. A 1.5 cm margin was added in order to account for clinical target volume (CTV) . A margin of 1 cm was added to CTI to define the planning target volume (PTV). The dose-volume constraints were followed in accordance with the specifications as dictated in the NSABP/RTOG protocol. After treatment, patients underwent a clinical and cosmetic evaluation every 3 months. Late toxicity was evaluated according to the RTOG grading schema. The cosmetic assessment was performed by the physicians using the controlateral untreated breast as the reference (Harvard scale). Results.- Median patient age was 66 years (range 51-80). Median follow-up was 15 months (range 6-46). Tumor size was < 10 mm in 33 patients (53%) and > 2 cm in 4(6%). The mean value of the ratio between the PTV and the whole ipsilateral breast volume was 38 % and the median percentage whole breast volume that received 95 % of prescribed dose was 34% (range 16%-55%). The rate of G1 and G2 acute skin toxicity was 28% and 2% respectively and the late toxicity was 17% (G1). G2 or greater toxicities were not observed. The most pronounced G1 late toxicity was subcutaneous fibrosis, developed in 3 patients. The cosmetic outcome was excellent in 83% and good in 17%. Conclusion.- Accelerated partial breast irradiation using three-dimensional conformal radiotherapy is technically feasible with very low acute and late toxicity. Long

  2. Technological advances in radiotherapy of rectal cancer

    DEFF Research Database (Denmark)

    Appelt, Ane L; Sebag-Montefiore, David

    2016-01-01

    PURPOSE OF REVIEW: This review summarizes the available evidence for the use of modern radiotherapy techniques for chemoradiotherapy for rectal cancer, with specific focus on intensity-modulated radiotherapy (IMRT) and volumetric arc therapy (VMAT) techniques. RECENT FINDINGS: The dosimetric....... Overall results are encouraging, as toxicity levels - although varying across reports - appear lower than for 3D conformal radiotherapy. Innovative treatment techniques and strategies which may be facilitated by the use of IMRT/VMAT include simultaneously integrated tumour boost, adaptive treatment...

  3. Loco-regional conformal radiotherapy of the breast: delineation of the regional lymph node clinical target volumes in treatment position.

    NARCIS (Netherlands)

    Dijkema, I.M.; Hofman, P.; Raaijmakers, C.P.; Lagendijk, J.J.; Battermann, J.J.; Hillen, B.

    2004-01-01

    BACKGROUND AND PURPOSE: As the location of the regional lymph nodes (LNs) of the breast varies largely between patients and may be dependant on the position of the arm, adequate localization of these nodes is mandatory in order to fully take advantage of optimized conformal radiotherapy. For this

  4. FXG dosimeter response for three-dimensional conformal radiotherapy using different evaluation techniques

    Energy Technology Data Exchange (ETDEWEB)

    Cavinato, Christianne C.; Campos, Leticia L., E-mail: ccavinato@ipen.b, E-mail: lcrodri@ipen.b [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Souza, Benedito H.; Carrete Junior, Henrique; Daros, Kellen A.C.; Medeiros, Regina B., E-mail: bhsouza@unifesp.b, E-mail: daros.kellen@unifesp.b, E-mail: rbitel-li.ddi@epm.b [Universidade Federal de Sao Paulo (UNIFESP), SP (Brazil). Dept. de Diagnostico por Imagem; Giordani, Adelmo J. [Universidade Federal de Sao Paulo (UNIFESP), SP (Brazil). Servico de Radioterapia

    2011-07-01

    This work aims to compare the dose-response of the Fricke xylenol gel (FXG) dosimeter developed at IPEN using 270 Bloom gelatin from porcine skin made in Brazil evaluated using the magnetic resonance imaging (MRI) technique with the dosimetric response evaluated using the optical absorption (OA) spectrophotometry technique, in order to verify the possibility of quality assurance (QA) and reproducibility of FXG dosimeter to be carried out routinely using the OA technique for three-dimensional conformal radiotherapy (3DCRT) application using a 6 MV photons linear accelerator. The response in function of the absorbed dose of FXG dosimeter developed at IPEN presents linear behavior in clinical interest dose range when irradiated with Co-60 gamma radiation and 6 MV photons and evaluated using the MRI and OA techniques. The results indicate that the optical technique can be used for QA of FXG dosemeter when used in the possible application in QA of 3DCRT. (author)

  5. Gemcitabine with a specific conformal 3D 5FU radiochemotherapy technique is safe and effective in the definitive management of locally advanced pancreatic cancer.

    Science.gov (United States)

    Goldstein, D; Van Hazel, G; Walpole, E; Underhill, C; Kotasek, D; Michael, M; Shapiro, J; Davies, T; Reece, W; Harvey, J; Spry, N

    2007-08-20

    The aim of this phase II study was to assess the feasibility and efficacy of a specific three-dimensional conformal radiotherapy technique with concurrent continuous infusion of 5-fluorouracil (CI 5FU) sandwiched between gemcitabine chemotherapy in patients with locally advanced pancreatic cancer. Patients with inoperable cancer in the pancreatic head or body without metastases were given gemcitabine at 1000 mg m(-2) weekly for 3 weeks followed by a 1-week rest and a 6-week period of radiotherapy and concurrent CI 5FU (200 mg m(-2) day(-1)). The defined target volume was treated to 54 Gy in 30 daily fractions of 1.8 Gy. After 4 weeks' rest, gemcitabine treatment was re-initiated for three cycles (days 1, 8, 15, q28). Forty-one patients were enrolled. At the end of radiotherapy, one patient (2.4%) had a complete response and four patients (9.6%) had a partial response; at the end of treatment, three patients (7.3%) had a complete response and two patients (4.9%) had a partial response. Median survival time was 11.7 months, median time to progression was 7.1 months, and median time to failure of local control was 11.9 months. The 1- and 2-year survival rates were 46.3 and 9.8%, respectively. Treatment-related grade 3 and 4 toxicities were reported by 16 (39.0%) and four (9.8%) patients, respectively. Sixteen out of 41 patients did not complete the planned treatment and nine due to disease progression. This approach to treatment of locally advanced pancreatic cancer is safe and promising, with good local control for a substantial proportion of patients, and merits testing in a randomised trial.

  6. A GPU-based framework for modeling real-time 3D lung tumor conformal dosimetry with subject-specific lung tumor motion

    Energy Technology Data Exchange (ETDEWEB)

    Min Yugang; Santhanam, Anand; Ruddy, Bari H [University of Central Florida, FL (United States); Neelakkantan, Harini; Meeks, Sanford L [M D Anderson Cancer Center Orlando, FL (United States); Kupelian, Patrick A, E-mail: anand.santhanam@orlandohealth.co [Department of Radiation Oncology, University of California, Los Angeles, CA (United States)

    2010-09-07

    In this paper, we present a graphics processing unit (GPU)-based simulation framework to calculate the delivered dose to a 3D moving lung tumor and its surrounding normal tissues, which are undergoing subject-specific lung deformations. The GPU-based simulation framework models the motion of the 3D volumetric lung tumor and its surrounding tissues, simulates the dose delivery using the dose extracted from a treatment plan using Pinnacle Treatment Planning System, Phillips, for one of the 3DCTs of the 4DCT and predicts the amount and location of radiation doses deposited inside the lung. The 4DCT lung datasets were registered with each other using a modified optical flow algorithm. The motion of the tumor and the motion of the surrounding tissues were simulated by measuring the changes in lung volume during the radiotherapy treatment using spirometry. The real-time dose delivered to the tumor for each beam is generated by summing the dose delivered to the target volume at each increase in lung volume during the beam delivery time period. The simulation results showed the real-time capability of the framework at 20 discrete tumor motion steps per breath, which is higher than the number of 4DCT steps (approximately 12) reconstructed during multiple breathing cycles.

  7. Significant negative impact of adjuvant chemotherapy on Health-Related Ouality of Life (HR-OoL) in women with breast cancer treated by conserving surgery and postoperative 3-D radiotherapy. A prospective measurement

    Energy Technology Data Exchange (ETDEWEB)

    Galalae, R.M.; Michel, J.; Kimmig, B. [Clinic for Radiation Therapy (Radiooncology), Univ. Hospital Schleswig-Holstein, Campus Kiel (Germany); Siebmann, J.U.; Kuechler, T.; Eilf, K. [Dept. of General and Thoracic Surgery/Reference Center on Quality of Life in Oncology, Univ. Hospital Schleswig-Holstein, Campus Kiel (Germany)

    2005-10-01

    Purpose: to prospectively assess health-related quality of life (HR-QoL) in women after conserving surgery for breast cancer during/after postoperative 3-D radiotherapy. Patients and methods: 109 consecutively treated patients were analyzed. HR-QoL was assessed at initiation (t1), end (t2), and 6 weeks after radiotherapy (t3) using the EORTC modules QLQ-C30/BR23. Patients were divided into three therapy groups. Group I comprised 41 patients (radiotherapy and adjuvant chemotherapy), group II 45 patients (radiotherapy and adjuvant hormonal therapy), and group III 23 patients (radiotherapy alone). Reliability was tested. Scale means were calculated. Univariate (ANOVA) and multivariate (MANCOVA) analyses were performed. Results: reliability testing revealed mean Cronbach's {alpha} > 0.70 at all measurement points. ANOVA/MANCOVA statistics revealed significantly better HR-QoL for patients in group II versus I. Patients receiving radiotherapy alone (group III) showed the best results in HR-QoL. However, scale mean differences between groups II and III were not significant. Conclusion: HR-QoL measurement using EORTC instruments during/after radiotherapy is reliable. Adjuvant chemotherapy significantly lowered HR-QoL versus hormones or radiotherapy alone. Chemotherapy patients did not recover longitudinally (from t1 to t3). (orig.)

  8. Treatment techniques for 3D conformal radiation to breast and chest wall including the internal mammary chain.

    Science.gov (United States)

    Sonnik, Deborah; Selvaraj, Raj N; Faul, Clare; Gerszten, Kristina; Heron, Dwight E; King, Gwendolyn C

    2007-01-01

    Breast, chest wall, and regional nodal irradiation have been associated with an improved outcome in high-risk breast cancer patients. Complex treatment planning is often utilized to ensure complete coverage of the target volume while minimizing the dose to surrounding normal tissues. The 2 techniques evaluated in this report are the partially wide tangent fields (PWTFs) and the 4-field photon/electron combination (the modified "Kuske Technique"). These 2 techniques were evaluated in 10 consecutive breast cancer patients. All patients had computerized tomographic (CT) scans for 3D planning supine on a breast board. The breast was defined clinically by the physician and confirmed radiographically with radiopaque bebes. The resulting dose-volume histograms (DVHs) of normal and target tissues were then compared. The deep tangent field with blocks resulted in optimal coverage of the target and the upper internal mammary chain (IMC) while sparing of critical and nontarget tissues. The wide tangent technique required less treatment planning and delivery time. We compared the 2 techniques and their resultant DVHs and feasibility in a busy clinic.

  9. Fractal Dimensions of Self-Avoiding Walks and Ising High-Temperature Graphs in 3D Conformal Bootstrap

    Science.gov (United States)

    Shimada, Hirohiko; Hikami, Shinobu

    2016-12-01

    The fractal dimensions of polymer chains and high-temperature graphs in the Ising model both in three dimension are determined using the conformal bootstrap applied for the continuation of the O( N) models from N=1 (Ising model) to N=0 (polymer). Even for non-integer N, the O( N) sum rule allows one to study the unitarity bound formally defined from the positivity, which may be violated in a non-unitary CFT. This unitarity bound of the scaling dimension for the O( N)-symmetric-tensor develops a kink as a function of the fundamental field as in the case of the energy operator dimension in the Z_2 (Ising) sum rule. Although this kink structure becomes less pronounced as N tends to zero, we found instead an emerging asymmetric minimum in the current central charge C_J. Despite the non-unitarity of the O( N) model at non-integer N, we find the C_J-kink along the unitarity bound lies very close to the location of the infrared (IR) O( N) CFT estimated by other methods. It is pointed out that certain level degeneracies at the IR CFT should induce these singular shapes of the unitarity bounds. As an application to the quantum and classical spin systems, we also predict critical exponents associated with the N=1 supersymmetry, which could be relevant for locating the corresponding fixed point in the phase diagram.

  10. Comparison of intensity-modulated tomotherapy with stereotactically guided conformal radiotherapy for brain tumors.

    Science.gov (United States)

    Khoo, V S; Oldham, M; Adams, E J; Bedford, J L; Webb, S; Brada, M

    1999-09-01

    Intensity-modulated radiotherapy (IMRT) offers the potential to more closely conform dose distributions to the target, and spare organs at risk (OAR). Its clinical value is still being defined. The present study aims to compare IMRT with stereotactically guided conformal radiotherapy (SCRT) for patients with medium size convex-shaped brain tumors. Five patients planned with SCRT were replanned with the IMRT-tomotherapy method using the Peacock system (Nomos Corporation). The planning target volume (PTV) and relevant OAR were assessed, and compared relative to SCRT plans using dose statistics, dose-volume histograms (DVH), and the Radiation Therapy Oncology Group (RTOG) stereotactic radiosurgery criteria. The median and mean PTV were 78 cm3 and 85 cm3 respectively (range 62-119 cm3). The differences in PTV doses for the whole group (Peacock-SCRT +/-1 SD) were 2%+/-1.8 (minimum PTV), and 0.1%+/-1.9 (maximum PTV). The PTV homogeneity achieved by Peacock was 12.1%+/-1.7 compared to 13.9%+/-1.3 with SCRT. Using RTOG guidelines, Peacock plans provided acceptable PTV coverage for all 5/5 plans compared to minor coverage deviations in 4/5 SCRT plans; acceptable homogeneity index for both plans (Peacock = 1.1 vs. SCRT = 1.2); and comparable conformity index (1.4 each). As a consequence of the transaxial method of arc delivery, the optic nerves received mean and maximum doses that were 11.1 to 11.6%, and 10.3 to 15.2% higher respectively with Peacock plan. The maximum optic lens, and brainstem dose were 3.1 to 4.8% higher, and 0.6% lower respectively with Peacock plan. However, all doses remained below the tolerance threshold (5 Gy for lens, and 50 Gy for optic nerves) and were clinically acceptable. The Peacock method provided improved PTV coverage, albeit small, in this group of convex tumors. Although the OAR doses were higher using the Peacock plans, all doses remained within the clinically defined threshold and were clinically acceptable. Further improvements may be

  11. A dynamic compensation strategy to correct patient-positioning errors in conformal prostate radiotherapy.

    Science.gov (United States)

    Lauve, A D; Siebers, J V; Crimaldi, A J; Hagan, M P; Kealla, P J

    2006-06-01

    Traditionally, pretreatment detected patient-positioning errors have been corrected by repositioning the couch to align the patient to the treatment beam. We investigated an alternative strategy: aligning the beam to the patient by repositioning the dynamic multileaf collimator and adjusting the beam weights, termed dynamic compensation. The purpose of this study was to determine the geometric range of positioning errors for which the dynamic compensation method is valid in prostate cancer patients treated with three-dimensional conformal radiotherapy. Twenty-five previously treated prostate cancer patients were replanned using a four-field technique to deliver 72 Gy to 95% of the planning target volume (PTV). Patient-positioning errors were introduced by shifting the patient reference frame with respect to the treatment isocenter. Thirty-six randomly selected isotropic displacements with magnitudes of 1.0, 2.0, 4.0, 6.0, 8.0, and 10.0 cm were sampled for each patient, for a total of 5400 errors. Dynamic compensation was used to correct each of these errors by conforming the beam apertures to the new target position and adjusting the monitor units using inverse-square and off-axis factor corrections. The dynamic compensation plans were then compared with the original treatment plans via dose-volume histogram (DVH) analysis. Changes of more than 5% of the prescription dose, 3.6 Gy, were deemed significant. Compared with the original treatment plans, dynamic compensation produced small discrepancies in isodose distributions and DVH analyses. These differences increased with the magnitudes of the initial patient-positioning errors. Coverage of the PTV was excellent: D95 and Dmean were not increased or decreased by more than 5% of the prescription dose, and D5 was not decreased by more than 5% of the prescription dose for any of the 5400 simulated positioning errors. D5 was increased by more than 5% of the prescription dose in only three of the 5400 positioning errors

  12. Changes in Pulmonary Function After Three-Dimensional Conformal Radiotherapy, Intensity-Modulated Radiotherapy, or Proton Beam Therapy for Non-Small-Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lopez Guerra, Jose L. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Radiation Oncology, Hospitales Universitarios Virgen del Rocio, Seville (Spain); Department of Medicine, Universitat Autonoma de Barcelona, Barcelona (Spain); Gomez, Daniel R., E-mail: dgomez@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Zhuang Yan; Levy, Lawrence B. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Eapen, George [Department of Pulmonary Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Liu, Hongmei; Mohan, Radhe; Komaki, Ritsuko; Cox, James D.; Liao Zhongxing [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2012-07-15

    Purpose: To investigate the extent of change in pulmonary function over time after definitive radiotherapy for non-small-cell lung cancer (NSCLC) with modern techniques and to identify predictors of changes in pulmonary function according to patient, tumor, and treatment characteristics. Patients and Methods: We analyzed 250 patients who had received {>=}60 Gy radio(chemo)therapy for primary NSCLC in 1998-2010 and had undergone pulmonary function tests before and within 1 year after treatment. Ninety-three patients were treated with three-dimensional conformal radiotherapy, 97 with intensity-modulated radiotherapy, and 60 with proton beam therapy. Postradiation pulmonary function test values were evaluated among individual patients compared with the same patient's preradiation value at the following time intervals: 0-4 (T1), 5-8 (T2), and 9-12 (T3) months. Results: Lung diffusing capacity for carbon monoxide (DLCO) was reduced in the majority of patients along the three time periods after radiation, whereas the forced expiratory volume in 1 s per unit of vital capacity (FEV1/VC) showed an increase and decrease after radiation in a similar percentage of patients. There were baseline differences (stage, radiotherapy dose, concurrent chemotherapy) among the radiation technology groups. On multivariate analysis, the following features were associated with larger posttreatment declines in DLCO: pretreatment DLCO, gross tumor volume, lung and heart dosimetric data, and total radiation dose. Only pretreatment DLCO was associated with larger posttreatment declines in FEV1/VC. Conclusions: Lung diffusing capacity for carbon monoxide is reduced in the majority of patients after radiotherapy with modern techniques. Multiple factors, including gross tumor volume, preradiation lung function, and dosimetric parameters, are associated with the DLCO decline. Prospective studies are needed to better understand whether new radiation technology, such as proton beam therapy or

  13. 2D mapping of the MV photon fluence and 3D dose reconstruction in real time for quality assurance during radiotherapy treatment

    Science.gov (United States)

    Alrowaili, Z. A.; Lerch, M. L. F.; Carolan, M.; Fuduli, I.; Porumb, C.; Petasecca, M.; Metcalfe, P.; Rosenfeld, A. B.

    2015-09-01

    Summary: the photon irradiation response of a 2D solid state transmission detector array mounted in a linac block tray is used to reconstruct the projected 2D dose map in a homogenous phantom along rays that diverge from the X-ray source and pass through each of the 121 detector elements. A unique diode response-to-dose scaling factor, applied to all detectors, is utilised in the reconstruction to demonstrate that real time QA during radiotherapy treatment is feasible. Purpose: to quantitatively demonstrate reconstruction of the real time radiation dose from the irradiation response of the 11×11 silicon Magic Plate (MP) detector array operated in Transmission Mode (MPTM). Methods and Materials: in transmission mode the MP is positioned in the block tray of a linac so that the central detector of the array lies on the central axis of the radiation beam. This central detector is used to determine the conversion factor from measured irradiation response to reconstructed dose at any point on the central axis within a homogenous solid water phantom. The same unique conversion factor is used for all MP detector elements lying within the irradiation field. Using the two sets of data, the 2D or 3D dose map is able to be reconstructed in the homogenous phantom. The technique we have developed is illustrated here for different depths and irradiation field sizes, (5 × 5 cm2 to 40 × 40 cm2) as well as a highly non uniform irradiation field. Results: we find that the MPTM response is proportional to the projected 2D dose map measured at a specific phantom depth, the "sweet depth". A single factor, for several irradiation field sizes and depths, is derived to reconstruct the dose in the phantom along rays projected from the photon source through each MPTM detector element. We demonstrate that for all field sizes using the above method, the 2D reconstructed and measured doses agree to within ± 2.48% (2 standard deviation) for all in-field MP detector elements. Conclusions: a

  14. Highly conformal and high-ionic conductivity thin-film electrolyte for 3D-structured micro batteries: Characterization of LiPON film deposited by MOCVD method

    Science.gov (United States)

    Fujibayashi, Takashi; Kubota, Yusuke; Iwabuchi, Katsuhiko; Yoshii, Naoki

    2017-08-01

    This paper reports a lithium phosphorus oxynitride (LiPON) thin-film electrolyte deposited using a metalorganic-chemical vapor deposition (MOCVD) method for 3D-structured micro batteries. It is shown that the MOCVD-LiPON film has both highly-conformal step coverage on a patterned substrate with line/space=2μm/2μm and aspect ratio=1 (51±3 nm) and high-ionic conductivity for very thin films deposited at 4.7 nm/min (5.9×10-6 S/cm for 190 nm and 5.3×10-6 S/cm for 95 nm). Detailed material characterization attributes the enhancement in ionic conductivity to a decrease in nanocrystallite size and improvement in chemical-composition uniformity in the film. In addition, electrochemical characterization of an all-solid-state thin-film battery fabricated with the 190 nm-thick LiPON film (Si substrate/Ti/Pt/LiCoO2/LiPON/a-Si:H/Cu) demonstrates that the LiPON film can successfully act as the electrolyte for lithium-ion batteries. Therefore, the MOCVD-LiPON film is a promising candidate material to realize 3D-structured micro batteries in the near future.

  15. Highly conformal and high-ionic conductivity thin-film electrolyte for 3D-structured micro batteries: Characterization of LiPON film deposited by MOCVD method

    Directory of Open Access Journals (Sweden)

    Takashi Fujibayashi

    2017-08-01

    Full Text Available This paper reports a lithium phosphorus oxynitride (LiPON thin-film electrolyte deposited using a metalorganic-chemical vapor deposition (MOCVD method for 3D-structured micro batteries. It is shown that the MOCVD-LiPON film has both highly-conformal step coverage on a patterned substrate with line/space=2μm/2μm and aspect ratio=1 (51±3 nm and high-ionic conductivity for very thin films deposited at 4.7 nm/min (5.9×10-6 S/cm for 190 nm and 5.3×10-6 S/cm for 95 nm. Detailed material characterization attributes the enhancement in ionic conductivity to a decrease in nanocrystallite size and improvement in chemical-composition uniformity in the film. In addition, electrochemical characterization of an all-solid-state thin-film battery fabricated with the 190 nm-thick LiPON film (Si substrate/Ti/Pt/LiCoO2/LiPON/a-Si:H/Cu demonstrates that the LiPON film can successfully act as the electrolyte for lithium-ion batteries. Therefore, the MOCVD-LiPON film is a promising candidate material to realize 3D-structured micro batteries in the near future.

  16. Radiotherapy

    Directory of Open Access Journals (Sweden)

    Rema Jyothirmayi

    1999-01-01

    Full Text Available Purpose. Conservative treatment in the form of limited surgery and post-operative radiotherapy is controversial in hand and foot sarcomas, both due to poor radiation tolerance of the palm and sole, and due to technical difficulties in achieving adequate margins.This paper describes the local control and survival of 41 patients with soft tissue sarcoma of the hand or foot treated with conservative surgery and radiotherapy. The acute and late toxicity of megavoltage radiotherapy to the hand and foot are described. The technical issues and details of treatment delivery are discussed. The factors influencing local control after radiotherapy are analysed.

  17. Definitive conformation radiotherapy combined with chemo-hormonal therapy in the treatment of adenocarcinoma of the prostate

    Energy Technology Data Exchange (ETDEWEB)

    Karasawa, Katsuyuki; Kodaira, Takeshi [Tokyo Metropolitan Komagome Hospital (Japan); Nakagawa, Keiichi; Onogi, Yuzo; Hara, Hiroshi; Matsumoto, Hidetsugu; Sasaki, Yasuhito

    1996-12-01

    To ascertain the clinical benefits of photon conformation radiotherapy, since 1988 we have been conducting a clinical trial of photon conformation radiotherapy for adenocarcinoma of the prostate, and we have analyzed the findings thus far. Between 1988 and 1993, 33 evaluable patients with prostate cancer were treated with definitive radiotherapy at the Dept. of Radiology, Social Health Insurance Medical Center. Their ages ranged from 54 to 86, and averaged 69.3 y.o. (median 67). Their stages were as follows: 3 stage-B, 25 stage-C, and 5 stage-D cases. The minimum follow-up period was 1 year. Patients received 40 to 50 Gy (fraction dose ranged from 1.8 Gy to 2 Gy) to the pelvis using the AP-PA technique followed by a 20 to 30 Gy conformal boost (fraction dose 2 Gy) to the prostate gland. Total dose ranged from 68 Gy to 70.4 Gy, with an average of 70 Gy. Systemic multiagent chemotherapy with CDDP, ADR, MTX, 5FU, and CPM was administered concurrently and adjuvantly. Hormonal therapy was also adjuvantly administered. Overall survival rates at 3 years for stage B, C, and D were 100%, 100%, and 60%, respectively. and was 85% at 5 years for stage C. Relapse-free survival rates at 3 years for stage B and C were 100% and 96%, respectively, and was 61% at 5 years for stage C. Regarding stage C cases, the initial site of recurrence was bone in 5 cases. As for complications, there were 5 (15%) grade 1, 4 (12%) grade 2, and 1 (3%) grade 3 rectal complications. Although the number of cases is rather small and the follow-up period is rather short, definitive conformal radiotherapy with adjuvant chemo-hormonal therapy appears promising in the treatment of prostate cancer by improving survival rates with acceptable normal tissue toxicity. (author)

  18. Comparison of dose contribution to normal pelvic tissues among conventional, conformal and intensity-modulated radiotherapy techniques in prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yungan Tao; Lefkopoulos, Dimitri; Ibrahima, Diallo; Bridier, Andre; Polizzi, Maria del Pilar; Wibault, Pierre; Crevoisier, Renaud de; Arriagada, Rodrigo; Bourhis, Jean (Dept. of Radiotherapy, Institut Gustave-Roussy, Villejuif (France))

    2008-03-15

    High-energy external radiotherapy has become one of the most common treatment in localized prostate cancer. We compared the difference of dose distribution, mainly at the 5-30 Gy dose level, in the irradiated pelvic volume among three modalities of radiotherapy for patients with prostate cancer: conventional, conformal and intensity-modulated radiotherapy (IMRT). We selected six patients with prostate cancer treated by conformal radiotherapy at the doses of 46 Gy to PTVN (prostate and seminal vesicles), and 70 Gy to PTV-T (prostate). The conventional technique: an 8-field arrangement was used; the conformal technique 4 fields with a boost through 6 fields. For IMRT, a five-beam arrangement was used. Dose-volume histograms (DVH) were analyzed and compared among the three techniques. The IMRT technique significantly increased the pelvic volume covered by the isodose surfaces below 15 Gy as compared with the conventional and conformal techniques. The mean absolute increase for the pelvic volume included between 5-30 Gy for the IMRT technique, was about 2 900 ml as compared with the conventional technique. However, IMRT significantly reduced the irradiated volume of the rectum in the dose range of 5 to 40 Gy, also significantly reduced the irradiated volume of bladder and femoral heads, and obtained a similar or improved isodose distribution in the PTVs. In addition, the use of IMRT slightly increased the relative dose delivered to the body volume outside the pelvis, as estimated by the use of specific software. A long-term follow-up will be needed to evaluate potential late treatment complications related to the use of IMRT and the low or moderate irradiation dose level obtained in the pelvis and in the whole body

  19. A comparative dosimetric study of 3-dimensional conformal radical radiotherapy for bladder cancer patients versus conventional 2-dimensional radical radiotherapy in NCI-Cairo, Egypt%埃及开罗国家癌症研究所膀胱癌患者的三维适形根治性放疗与传统的二维根治性放疗的比较剂量学研究

    Institute of Scientific and Technical Information of China (English)

    Mohamed Mahmoud; Hesham A. El-Hossiny; Nashaat A. Diab; Marwa A. El Razek

    2012-01-01

    Objective: This study was to compare this multiple-field conformal technique to the 2-dimensional (2D) conventional technique with respect to target volume coverage and dose to normal tissues. Methods: We conducted a single institutional prospective comparative dosimetric analysis of 15 patients who received radical radiation therapy for bladder cancer presented to Radiotherapy Department in National Cancer Institute, Cairo (Egypt), in period between November 2011 to July 2012 using 3-dimensional (3D) conformal radiotherapy technique for each patient, a second 2D conventional radiotherapy treatment plan was done, the two techniques were then compared using dose volume histogram (DVH) analysis. Results: Comparing different DVHs, it was found that the planning target volume (PTV) was adequately covered in both (3D & 2D) plans while it was demonstrated that this multiple field conformal technique produced superior distribution compared to 2D technique, with considerable sparing of rectum and to lesser extent for the head of both femora. Conclusion: From the present study, it is recommended to use 3D planning for cases of bladder cancer especially in elderly patients as it produces good coverage of the target volume as well as good sparing of the surrounding critical organs.

  20. Toward a Rational Design of Highly Folded Peptide Cation Conformations. 3D Gas-Phase Ion Structures and Ion Mobility Characterization.

    Science.gov (United States)

    Pepin, Robert; Laszlo, Kenneth J; Marek, Aleš; Peng, Bo; Bush, Matthew F; Lavanant, Helène; Afonso, Carlos; Tureček, František

    2016-10-01

    Heptapeptide ions containing combinations of polar Lys, Arg, and Asp residues with non-polar Leu, Pro, Ala, and Gly residues were designed to study polar effects on gas-phase ion conformations. Doubly and triply charged ions were studied by ion mobility mass spectrometry and electron structure theory using correlated ab initio and density functional theory methods and found to exhibit tightly folded 3D structures in the gas phase. Manipulation of the basic residue positions in LKGPADR, LRGPADK, KLGPADR, and RLGPADK resulted in only minor changes in the ion collision cross sections in helium. Replacement of the Pro residue with Leu resulted in only marginally larger collision cross sections for the doubly and triply charged ions. Disruption of zwitterionic interactions in doubly charged ions was performed by converting the C-terminal and Asp carboxyl groups to methyl esters. This resulted in very minor changes in the collision cross sections of doubly charged ions and even slightly diminished collision cross sections in most triply charged ions. The experimental collision cross sections were related to those calculated for structures of lowest free energy ion conformers that were obtained by extensive search of the conformational space and fully optimized by density functional theory calculations. The predominant factors that affected ion structures and collision cross sections were due to attractive hydrogen bonding interactions and internal solvation of the charged groups that overcompensated their Coulomb repulsion. Structure features typically assigned to the Pro residue and zwitterionic COO-charged group interactions were only secondary in affecting the structures and collision cross sections of these gas-phase peptide ions. Graphical Abstract ᅟ.

  1. Toward a Rational Design of Highly Folded Peptide Cation Conformations. 3D Gas-Phase Ion Structures and Ion Mobility Characterization

    Science.gov (United States)

    Pepin, Robert; Laszlo, Kenneth J.; Marek, Aleš; Peng, Bo; Bush, Matthew F.; Lavanant, Helène; Afonso, Carlos; Tureček, František

    2016-10-01

    Heptapeptide ions containing combinations of polar Lys, Arg, and Asp residues with non-polar Leu, Pro, Ala, and Gly residues were designed to study polar effects on gas-phase ion conformations. Doubly and triply charged ions were studied by ion mobility mass spectrometry and electron structure theory using correlated ab initio and density functional theory methods and found to exhibit tightly folded 3D structures in the gas phase. Manipulation of the basic residue positions in LKGPADR, LRGPADK, KLGPADR, and RLGPADK resulted in only minor changes in the ion collision cross sections in helium. Replacement of the Pro residue with Leu resulted in only marginally larger collision cross sections for the doubly and triply charged ions. Disruption of zwitterionic interactions in doubly charged ions was performed by converting the C-terminal and Asp carboxyl groups to methyl esters. This resulted in very minor changes in the collision cross sections of doubly charged ions and even slightly diminished collision cross sections in most triply charged ions. The experimental collision cross sections were related to those calculated for structures of lowest free energy ion conformers that were obtained by extensive search of the conformational space and fully optimized by density functional theory calculations. The predominant factors that affected ion structures and collision cross sections were due to attractive hydrogen bonding interactions and internal solvation of the charged groups that overcompensated their Coulomb repulsion. Structure features typically assigned to the Pro residue and zwitterionic COO-charged group interactions were only secondary in affecting the structures and collision cross sections of these gas-phase peptide ions.

  2. Accelerated partial breast irradiation with external beam three-dimensional conformal radiotherapy. Five-year results of a prospective phase II clinical study

    Energy Technology Data Exchange (ETDEWEB)

    Mozsa, Emoeke [National Institute of Oncology, Centre of Radiotherapy, Budapest (Hungary); Landesklinikum Wiener Neustadt, Department of Radiooncology and Radiotherapy, Wiener Neustadt (Austria); Meszaros, Norbert; Major, Tibor; Froehlich, Georgina; Stelczer, Gabor; Fodor, Janos; Polgar, Csaba [National Institute of Oncology, Centre of Radiotherapy, Budapest (Hungary); Sulyok, Zoltan [National Institute of Oncology, Centre of Surgery, Budapest (Hungary)

    2014-05-15

    The aim of this study was to report the 5-year results of accelerated partial breast irradiation (APBI) using external beam three-dimensional conformal radiotherapy (3D-CRT). Between 2006 and 2011, 44 patients with low-risk, stage I-II breast cancer underwent breast-conserving surgery. Postoperative APBI was given by means of 3D-CRT using three to five non-coplanar fields. The total dose of APBI was 36.9 Gy (nine fractions of 4.1 Gy b.i.d.). The mean follow-up time was 58.2 months for surviving patients. Survival results, side effects, and cosmetic results were assessed. One (2.3 %) local recurrence was observed, for a 5-year actuarial rate of 3.7 %. Neither regional nor distant failure was observed. Two patients died of internal disease. The 5-year disease-free, cancer-specific, and overall survival rates were 96.3, 100, and 95.1 %, respectively. Acute side effects included grade 1 (G1) erythema in 75 %, G1 parenchymal induration in 46 %, and G1 pain in 46 % of patients. No G2 or higher acute side effect occurred. Late side effects included G1, G2, and G3 fibrosis in 44, 7, and 2 % of patients, respectively, G1 skin pigmentation in 12 %, and G1 pain in 2 %. Asymptomatic fat necrosis occurred in 14 %. Cosmetic results were rated excellent or good in 86 % of cases by the patients themselves and 84 % by the physicians. The 5-year local tumor control, toxicity profile, and cosmetic results of APBI delivered with external beam 3D-CRT are encouraging and comparable to other APBI series. (orig.) [German] Evaluation der 5-Jahres-Ergebnisse bezueglich Ueberleben, Tumorkontrolle, Nebenwirkungen und Kosmetik nach Teilbrustbestrahlung (APBI) mittels 3-D-konformaler, akzelerierter Radiotherapie (3D-CRT). Zwischen 2006 und 2011 wurden 44 Patienten mit Brustkrebs im Stadium I-II und niedrigem Risikoprofil brusterhaltend operiert. Die adjuvante, 3-D-konformale APBI wurde mittels 3-5 nonkoplanarer Feldern durchgefuehrt. Die Gesamtdosis betrug 36,9 Gy bei 9 -mal 4,1 Gy b.i.d.. Nach

  3. FIRE: an open-software suite for real-time 2D/3D image registration for image guided radiotherapy research

    Science.gov (United States)

    Furtado, H.; Gendrin, C.; Spoerk, J.; Steiner, E.; Underwood, T.; Kuenzler, T.; Georg, D.; Birkfellner, W.

    2016-03-01

    Radiotherapy treatments have changed at a tremendously rapid pace. Dose delivered to the tumor has escalated while organs at risk (OARs) are better spared. The impact of moving tumors during dose delivery has become higher due to very steep dose gradients. Intra-fractional tumor motion has to be managed adequately to reduce errors in dose delivery. For tumors with large motion such as tumors in the lung, tracking is an approach that can reduce position uncertainty. Tumor tracking approaches range from purely image intensity based techniques to motion estimation based on surrogate tracking. Research efforts are often based on custom designed software platforms which take too much time and effort to develop. To address this challenge we have developed an open software platform especially focusing on tumor motion management. FLIRT is a freely available open-source software platform. The core method for tumor tracking is purely intensity based 2D/3D registration. The platform is written in C++ using the Qt framework for the user interface. The performance critical methods are implemented on the graphics processor using the CUDA extension. One registration can be as fast as 90ms (11Hz). This is suitable to track tumors moving due to respiration (~0.3Hz) or heartbeat (~1Hz). Apart from focusing on high performance, the platform is designed to be flexible and easy to use. Current use cases range from tracking feasibility studies, patient positioning and method validation. Such a framework has the potential of enabling the research community to rapidly perform patient studies or try new methods.

  4. Adjuvant external beam radiotherapy after therapeutic groin lymphadenectomy for patients with melanoma: a dosimetric comparison of three-dimensional conformal and intensity-modulated radiotherapy techniques.

    Science.gov (United States)

    Adams, Gerard; Foote, Matthew; Brown, Simon; Burmeister, Bryan

    2017-02-01

    Radiotherapy after lymph node dissection is recommended in high-risk melanoma cases. The aim of this study is to assess whether intensity-modulated radiotherapy (IMRT) offers advantages over three-dimensional conformal radiotherapy (3DCRT) in the groin nodal basin. Fifteen consecutively treated patients (5 3DCRT and 10 IMRT) were selected. Optimized theoretical plans using the other modality were created - enabling direct comparisons of 3DCRT and IMRT. Target volume and organs at risk constraints were assessed as achieved or as having minor (≤5%) or major (>5%) deviations. The Wilcoxon signed-rank test was used to compare the dose received from each patient plan (3DCRT vs. IMRT), whereas the Mann-Whitney U-test was used to compare clinical plans with theoretical plans. Fisher's exact test was used to compare categorical data. Target coverage was achievable in most patients (major deviations - 1 IMRT and 3 3DCRT). Conformity index improved with IMRT - median 0.65, range 0.48-0.81, versus median 0.44, range 0.29-0.60 for 3DCRT; P value less than 0.001. All 3DCRT plans had major deviations for femoral head/neck constraints. Twelve and 13 IMRT plans achieved the high (V42numbers used nor dosimetric endpoints measured when clinical plans were compared with theoretical plans. IMRT appears to allow superior conformity of dose to the target volume while relatively sparing the adjacent the bowel and femoral head/neck. This may reduce toxicity while maintaining control rates.

  5. Dosimetric study of the protection level of the bone marrow in patients with cervical or endometrial cancer for three radiotherapy techniques - 3D CRT, IMRT and VMAT. Study protocol.

    Science.gov (United States)

    Jodda, Agata; Urbański, Bartosz; Piotrowski, Tomasz; Malicki, Julian

    2016-03-01

    Background: The paper shows the methodology of an in-phantom study of the protection level of the bone marrow in patients with cervical or endometrial cancer for three radiotherapy techniques: three-dimensional conformal radiotherapy, intensity modulated radiotherapy, and volumetric modulated arc therapy, preceded by the procedures of image guidance. Methods/Design: The dosimetric evaluation of the doses will be performed in an in-house multi-element anthropomorphic phantom of the female pelvic area created by three-dimensional printing technology. The volume and position of the structures will be regulated according to the guidelines from the Bayesian network. The input data for the learning procedure of the model will be obtained from the retrospective analysis of imaging data obtained for 96 patients with endometrial cancer or cervical cancer treated with radiotherapy in our centre in 2008-2013. Three anatomical representations of the phantom simulating three independent clinical cases will be chosen. Five alternative treatment plans (1 × three-dimensional conformal radiotherapy, 2 × intensity modulated radiotherapy and 2 × volumetric modulated arc therapy) will be created for each representation. To simulate image-guided radiotherapy, ten specific recombinations will be designated, for each anatomical representation separately, reflecting possible changes in the volume and position of the phantom components. Discussion: The comparative analysis of planned measurements will identify discrepancies between calculated doses and doses that were measured in the phantom. Finally, differences between the doses cumulated in the hip plates performed by different techniques simulating the gynaecological patients' irradiation of dose delivery will be established. The results of this study will form the basis of the prospective clinical trial that will be designed for the assessment of hematologic toxicity and its correlation with the doses cumulated in the hip plates

  6. Quality assurance of computerized planning systems for radiotherapy treatments according the IAEA-TECDOC-1583: application to PCRT3D; Garantaa de calidad de sistemas de planificacion de tratamientos de radioterapia segun el documento IAEA-TECDOC-1583: aplicacion a PCRT3D

    Energy Technology Data Exchange (ETDEWEB)

    Laliena Bielsa, V.; Millan Cebrian, E.; Garcia Romero, A.; Cortes Rodicio, J.; Villa Gazulla, D.; Ortega Pardina, P.; Jimenez Alberico, J.; Hernandez Vitoria, A.; Canellas Anoz, M.

    2012-07-01

    The quality of the PCRT3D radiotherapy treatment planning system is analyzed following the guidelines of IAEA-TECDOC-1583. The two main algorithms for photon beams implemented by the system, Preciso and Superposicion, perform well in heterogeneities, especially Superposicion. The results are similar to those published for algorithms of the same type. The good performance in heterogeneities for high energy X-ray beams is remarkable: both algorithms perform better for 15 MV than for 6 MV. (Author)

  7. A dosimetric comparison between 3D-Conformal radiation therapy and intensity modulated radiation therapy plans in the treatment of posterior fossa boost in children with high risk medulloblastom

    Institute of Scientific and Technical Information of China (English)

    Saad El Din I; Abd El AAl H; Makaar W; Mashhour K; El Beih D; Hashem W

    2013-01-01

    Objective:The work is a comparative study between two modalities of radiation therapy, the aim of which is to compare 3D conformal radiation therapy (3D-CRT) and intensity modulated radiation therapy (IMRT) in treating posterior fossa boost in children with high risk medul oblastoma;dosimetrical y evaluating and comparing both techniques as regard target coverage and doses to organs at risk (OAR). Methods:Twenty patients with high risk medul oblastoma were treated by 3D-CRT technique. A dosimetric comparison was done by performing two plans for the posterior fossa boost, 3D-CRT and IMRT plans, for the same patient using Eclipse planning system (version 8.6). Results:IMRT had a better conformity index compared to 3D-CRT plans (P value of 0.000). As for the dose homogeneity it was also better in the IMRT plans, yet it hasn’t reached the statistical significant value. Also, doses received by the cochleae, brainstem and spinal cord were significantly less in the IMRT plans than those of 3D-CRT (P value<0.05). Conclusion:IMRT technique was clearly able to improve conformity and homogeneity index, spare the cochleae, reduce dose to the brainstem and spinal cord in comparison to 3D-CRT technique.

  8. Conformational radiotherapy in the case of prostate cancer: experience gained by the Blida Oncology Radiotherapy Department, Algeria; La radiotherapie conformationnelle dans le cancer de la prostate: experience du service de radiotherapie oncologique de Blida, Algerie

    Energy Technology Data Exchange (ETDEWEB)

    Ayad, M.; Abbas, L.; Mesli, S.; Boualga, K. [Centre anti cancer, Blida (Algeria)

    2010-10-15

    Conformational radiotherapy is used as the first method for the treatment of localized prostate cancers. It preserves some life quality and allows a significant reduction of the dose applied to healthy organs, and therefore a drastic reduction of late and severe effects of irradiation. The authors report a prospective study which aims at describing therapeutic modalities and assessing preliminary results in terms of biochemical control and toxicity. They discuss the results obtained on 34 patients who have been treated between January 2008 and January 2009. In comparison with conventional therapy, they observe an absence of grade 3 and 4 side effects, and a normalization of biological criteria which indicates a good tumour response. Short communication

  9. Clinical outcomes for gastric cancer following adjuvant chemoradiation utilizing intensity modulated versus three-dimensional conformal radiotherapy.

    Directory of Open Access Journals (Sweden)

    Gene-Fu F Liu

    Full Text Available PURPOSE/OBJECTIVES: To determine if intensity modulated radiation therapy (IMRT in the post-operative setting for gastric cancer was associated with reduced toxicity compared to 3D conformal radiation therapy (3DCRT. MATERIALS/METHODS: This retrospective study includes 24 patients with stage IB-IIIB gastric cancer consecutively treated from 2001-2010. All underwent surgery followed by adjuvant chemoradiation. Concurrent chemotherapy consisted of 5-FU/leucovorin (n = 21, epirubicin/cisplatin/5FU (n = 1, or none (n = 2. IMRT was utilized in 12 patients and 3DCRT in 12 patients. For both groups, the target volume included the tumor bed, anastomosis, gastric stump, and regional lymphatics. RESULTS: Median follow-up for the entire cohort was 19 months (range 0.4-8.5 years, and 49 months (0.5-8.5 years in surviving patients. The 3DCRT group received a median dose of 45 Gy, and the IMRT group received a median dose of 50.4 Gy (p = 0.0004. For the entire cohort, 3-year overall survival (OS was 40% and 3-year disease free survival (DFS was 41%. OS and DFS did not differ significantly between the groups. Acute toxicity was similar. Between 3DCRT and IMRT groups, during radiotherapy, median weight lost (3.2 vs. 3.3 kg, respectively; p = 0.47 and median percent weight loss were similar (5.0% vs. 4.3%, respectively; p = 0.43. Acute grade 2 toxicity was experienced by 8 patients receiving 3DCRT and 11 receiving IMRT (p = 0.32; acute grade 3 toxicity occurred in 1 patient receiving 3DCRT and none receiving IMRT (p = 1.0. No patients in either cohort experienced late grade 3 toxicity, including renal or gastrointestinal toxicity. At last follow up, the median increase in creatinine was 0.1 mg/dL in the IMRT group and 0.1 mg/dL in the 3DCRT group (p = 0.78. CONCLUSION: This study demonstrates that adjuvant chemoradiation for gastric cancer with IMRT to 50.4 Gy was well-tolerated and compared similarly in toxicity with 3DCRT to

  10. Comparison of Radiation Treatment Plans for Breast Cancer between 3D Conformal in Prone and Supine Positions in Contrast to VMAT and IMRT Supine Positions

    Science.gov (United States)

    Bejarano Buele, Ana Isabel

    The treatment regimen for breast cancer patients typically involves Whole Breast Irradiation (WBI). The coverage and extent of the radiation treatment is dictated by location of tumor mass, breast tissue distribution, involvement of lymph nodes, and other factors. The current standard treatment approach used at our institution is a 3D tangential beam geometry, which involves two fields irradiating the breast, or a four field beam arrangement covering the whole breast and involved nodes, while decreasing the dose to organs as risk (OARs) such as the lung and heart. The coverage of these targets can be difficult to achieve in patients with unfavorable thoracic geometries, especially in those cases in which the planning target volume (PTV) is extended to the chest wall. It is a well-known fact that exposure of the heart to ionizing radiation has been proved to increase the subsequent rate of ischemic heart disease. In these cases, inverse planned treatments have become a proven alternative to the 3D approach. The goal of this research project is to evaluate the factors that affect our current techniques as well as to adapt the development of inverse modulated techniques for our clinic, in which breast cancer patients are one of the largest populations treated. For this purpose, a dosimetric comparison along with the evaluation of immobilization devices was necessary. Radiation treatment plans were designed and dosimetrically compared for 5 patients in both, supine and prone positions. For 8 patients, VMAT and IMRT plans were created and evaluated in the supine position. Skin flash incorporation for inverse modulated plans required measurement of the surface dose as well as an evaluation of breast volume changes during a treatment course. It was found that prone 3D conformal plans as well as the VMAT and IMRT plans are generally superior in sparing OARs to supine plans with comparable PTV coverage. Prone setup leads to larger shifts in breast volume as well as in

  11. Outcomes After Intensity-Modulated Versus Conformal Radiotherapy in Older Men With Nonmetastatic Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Bekelman, Justin E., E-mail: bekelman@uphs.upenn.edu [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States); Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA (United States); Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA (United States); Mitra, Nandita [Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA (United States); Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA (United States); Efstathiou, Jason [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Liao Kaijun [Division of General Internal Medicine, University of Pennsylvania, Philadelphia, PA (United States); Sunderland, Robert; Yeboa, Deborah N. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States); Armstrong, Katrina [Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA (United States); Division of General Internal Medicine, University of Pennsylvania, Philadelphia, PA (United States); Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA (United States); Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA (United States)

    2011-11-15

    Purpose: There is little evidence comparing complications after intensity-modulated (IMRT) vs. three-dimensional conformal radiotherapy (CRT) for prostate cancer. The study objective was to test the hypothesis that IMRT, compared with CRT, is associated with a reduction in bowel, urinary, and erectile complications in elderly men with nonmetastatic prostate cancer. Methods and Materials: We undertook an observational cohort study using registry and administrative claims data from the SEER-Medicare database. We identified men aged 65 years or older diagnosed with nonmetastatic prostate cancer in the United States between 2002 and 2004 who received IMRT (n = 5,845) or CRT (n = 6,753). The primary outcome was a composite measure of bowel complications. Secondary outcomes were composite measures of urinary and erectile complications. We also examined specific subsets of bowel (proctitis/hemorrhage) and urinary (cystitis/hematuria) events within the composite complication measures. Results: IMRT was associated with reductions in composite bowel complications (24-month cumulative incidence 18.8% vs. 22.5%; hazard ratio [HR] 0.86; 95% confidence interval [CI], 0.79-0.93) and proctitis/hemorrhage (HR 0.78; 95% CI, 0.64-0.95). IMRT was not associated with rates of composite urinary complications (HR 0.93; 95% CI, 0.83-1.04) or cystitis/hematuria (HR 0.94; 95% CI, 0.83-1.07). The incidence of erectile complications involving invasive procedures was low and did not differ significantly between groups, although IMRT was associated with an increase in new diagnoses of impotence (HR 1.27, 95% CI, 1.14-1.42). Conclusion: IMRT is associated with a small reduction in composite bowel complications and proctitis/hemorrhage compared with CRT in elderly men with nonmetastatic prostate cancer.

  12. Hypofractionated conformal radiotherapy (HCRT) for primary and metastatic lung cancers with small dimension. Efficacy and toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Mirri, Maria Alessandra; Arcangeli, Giorgio; Pinzi, Valentina [S.C. Radioterapia Oncologica, Regina Elena National Cancer Inst., Rome (Italy); Benassi, Marcello; D' Angelo, Annelisa; Strigari, Lidia [S.C. Lab. di Fisica Medica e Sistemi Esperti, Regina Elena National Cancer Inst., Rome (Italy); Caterino, Mauro [S.C. Radiologia e Diagnostica per Immagini, Regina Elena National Cancer Inst., Rome (Italy); Rinaldi, Massimo [S.C. Oncologia Medica B. Regina Elena National Cancer Inst., Rome (Italy); Ceribelli, Anna [S.C. Oncologia Medica A. Regina Elena National Cancer Inst., Rome (Italy)

    2009-01-15

    Purpose: to report on the clinical outcome of hypofractionated conformal radiotherapy (HCRT) for medically inoperable stage I non-small cell lung carcinoma (NSCLC) or limited pulmonary metastases {<=} 5 cm in diameter. Patients and methods: from June 2003 to March 2007, 40 patients (42 lesions) underwent HCRT consisting of 40 Gy in five fractions over 2.5 weeks received by at least 95% of planning target volume. All patients underwent CT simulation and treatment under free shallow breathing. To evaluate target displacement under respiratory activity, two additional CT scans were performed with breath-holding during the expiratory and inspiratory phases. Of all patients enrolled, those with a follow-up {>=} 4 months were considered suitable for analysis. Local response was evaluated with CT imaging 4 months after the end of HCRT and every 3 months thereafter. Local relapse-free survival (LRFS) and overall survival (OS) were calculated with the Kaplan-Meier method. Results: local response to the treatment was complete response, partial response, no change, and progressive disease as seen in 29%, 43%, 14%, and 7% of tumors, respectively. LRFS at 1 year and 3 years was 76% and 63%, respectively. Lung toxicities {>=} grade 2 were observed in 4/40 patients, but no grade 4. Pericardial effusion occurred in one patient. In stage I NSCLC patients (n = 15) with a median follow-up of 25 months, the 1-year LRFS and OS rates were 88% and 81%, respectively, and the 3-year rates 72% and 61%, respectively. Conclusion: HCRT is an effective and low-toxic treatment for medically inoperable early-stage lung cancers and pulmonary metastases for all clinicians lacking the aid of a dedicated stereotactic system. (orig.)

  13. Three dimensional conformal photon radiotherapy at a moderate dose level of 66 Gy for prostate carcinoma: early results

    Energy Technology Data Exchange (ETDEWEB)

    Wachter, S.; Gerstner, N.; Goldner, G.; Dieckmann, K.; Colotto, A.; Poetter, R. [Dept. of Radiotherapy and Radiobiology, Univ. Hospital Vienna (Austria)

    1999-06-01

    We present our experience of 291 patients treated between January 1994 and August 1997 with a 3-D planned four-field box technique and a central dose of 66 Gy. Biochemical response of patients with radiotherapy alone (group 1, n=72 pts.) has been analyzed in detail. Acute radiation side effects are given for all patients (n=291), late radiation side effects are given for patients treated between Jan 1994 and Jan 1996 with a median follow-up of 22 months (n=115 pts). Results: We have observed a biochemical response (nadir PSA < 1 after 12 months, < 2 after 6 months) for patients treated with radiotherapy alone without hormone manipulation in 67%. Incidence of late rectal and bladder morbidity (grade 2 and 3) was 9.4% and 4%, respectively. (orig.)

  14. SU-D-213-03: Towards An Optimized 3D Scintillation Dosimetry Tool for Quality Assurance of Dynamic Radiotherapy Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Rilling, M [Département de physique, de génie physique et d’optique, Université Laval, Quebec City, QC (Canada); Centre de Recherche sur le Cancer, Hôtel-Dieu de Québec, Quebec City, QC (Canada); Département de radio-oncologie, CHU de Québec, Quebec City, QC (Canada); Center for Optics, Photonics and Lasers, Université Laval, Quebec City, QC, CA (Canada); Goulet, M [Département de radio-oncologie, CHU de Québec, Quebec City, QC (Canada); Thibault, S [Département de physique, de génie physique et d’optique, Université Laval, Quebec City, QC (Canada); Center for Optics, Photonics and Lasers, Université Laval, Quebec City, QC, CA (Canada); Archambault, L [Département de physique, de génie physique et d’optique, Université Laval, Quebec City, QC (Canada); Centre de Recherche sur le Cancer, Hôtel-Dieu de Québec, Quebec City, QC (Canada); Département de radio-oncologie, CHU de Québec, Quebec City, QC (Canada)

    2015-06-15

    specifications. This work leads the way to improving the 3D dosimeter’s achievable resolution, efficiency and build for providing a quality assurance tool fully meeting clinical needs. M.R. is financially supported by a Master’s Canada Graduate Scholarship from the NSERC. This research is also supported by the NSERC Industrial Research Chair in Optical Design.

  15. SU-E-T-596: Axillary Nodes Radiotherapy Boost Field Dosimetric Impact Study: Oblique Field and Field Optimization in 3D Conventional Breast Cancer Radiation Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Su, M [Mount Sinai School of Medicine, Elmhurst, NY (United States); Sura, S

    2014-06-01

    Purpose: To evaluate dosimetric impact of two axillary nodes (AX) boost techniques: (1) posterior-oblique optimized field boost (POB), (2) traditional posterior-anterior boost (PAB) with field optimization (O-PAB), for a postmastectomy breast patient with positive axillary lymph nodes. Methods: Five patients, 3 left and 2 right chest walls, were included in this study. All patients were simulated in 5mm CT slice thickness. Supraclavicular (SC) and level I/II/III AX were contoured based on the RTOG atlas guideline. Five treatment plans, (1) tangential chest wall, (2) oblique SC including AX, (3) PAB, O-PAB and POB, were created for each patient. Three plan sums (PS) were generated by sum one of (3) plan with plan (1) and (2). The field optimization was done through PS dose distribution, which included a field adjustment, a fractional dose, a calculation location and a gantry angle selection for POB. A dosimetric impact was evaluated by comparing a SC and AX coverage, a PS maximum dose, an irradiated area percentage volume received dose over 105% prescription dose (V105), an ipsi-laterial mean lung dose (MLD), an ipsi-laterial mean humeral head dose (MHHD), a mean heart dose (MHD) (for left case only) and their DVH amount these three technique. Results: O-PAB, POB and PAB dosimetric results showed that there was no significant different on SC and AX coverage (p>0.43) and MHD (p>0.16). The benefit of sparing lung irradiation from PAB to O-PAB to POB was significant (p<0.004). PAB showed a highest PS maximum dose (p<0.005), V105 (p<0.023) and MLD (compared with OPAB, p=0.055). MHHD showed very sensitive to the patient arm positioning and anatomy. O-PAB convinced a lower MHHD than PAB (p=0.03). Conclusion: 3D CT contouring plays main role in accuracy radiotherapy. Dosimetric advantage of POB and O-PAB was observed for a better normal tissue irradiation sparing.

  16. Superiority of helical tomotherapy on liver sparing and dose escalation in hepatocellular carcinoma: a comparison study of three-dimensional conformal radiotherapy and intensity-modulated radiotherapy

    Science.gov (United States)

    Zhao, Qianqian; Wang, Renben; Zhu, Jian; Jin, Linzhi; Zhu, Kunli; Xu, Xiaoqing; Feng, Rui; Jiang, Shumei; Qi, Zhonghua; Yin, Yong

    2016-01-01

    Background and purpose To compare the difference of liver sparing and dose escalation between three-dimensional conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT), and helical tomotherapy (HT) for hepatocellular carcinoma. Patients and methods Sixteen unresectable HCC patients were enrolled in this study. First, some evaluation factors of 3DCRT, IMRT, and HT plans were calculated with prescription dose at 50 Gy/25 fractions. Then, the doses were increased using HT or IMRT independently until either the plans reached 70 Gy or any normal tissue reached the dose limit according to quantitative analysis of normal tissue effects in the clinic criteria. Results The conformal index of 3DCRT was lower than that of IMRT (PV50% (fraction of normal liver treated to at least 50% of the isocenter dose) of the normal liver, there was a significant difference: 3DCRT > IMRT > HT (P<0.001). HT had a lower Dmean (mean dose) and V20 (Vn, the percentage of organ volume receiving ≥n Gy) of liver compared with 3DCRT (P=0.005 and P=0.005, respectively) or IMRT (P=0.508 and P=0.007, respectively). Dmean of nontarget normal liver and V30 of liver were higher for 3DCRT than IMRT (P=0.005 and P=0.005, respectively) or HT (P=0.005 and P=0.005, respectively). Seven patients in IMRT (43.75%) and nine patients in HT (56.25%) reached the isodose 70 Gy, meeting the dose limit of the organs at risk. Conclusion HT may provide significantly better liver sparing and allow more patients to achieve higher prescription dose in HCC radiotherapy. PMID:27445485

  17. Dosimetric study comparing intensity modulated and conformal pelvic radiotherapy boost plans in locally advanced cancer cervix in NCI-Cairo

    Institute of Scientific and Technical Information of China (English)

    Mohamed Mahmoud; Hesham A. EL-Hossiny; Nashaat A. Diab; Mahmoud Shosha

    2013-01-01

    Objective: This study was to compare 5 field conformal technique to the intensity modulated radiotherapy (IMRT) 8 fields technique in boosting locally advanced cancer cervix cases after external beam radiotherapy with respect to target volume coverage and dose to normal tissues. Methods: We conducted a single institutional comparative dosimetric analysis of 10 patients with cancer cervix who was presented to radiotherapy department in National Cancer Institute, Cairo in period between June 2012 to September 2012 and received a CRT boost in the place of planned brachytherapy after large field pelvic radiotherapy (PRT) with concurrent chemotherapy were retrospectively identified. All tumors were situated in the low central pelvis. Two plans were done for every patient; one using the 8 fields IMRT and the second one using 5 fields' 3DCRT the two techniques were then compared using dose volume histogram (DVH) analysis for the PTV, bladder, rectum and both femoral heads. Results: Comparing different DVHs, it was found that the planning target volume (PTV) was adequately covered in both plans while it was demonstrates that the 8 fields IMRT technique carried less doses reaching OARs (rectum, bladder, both femoral heads). Conclusion: From the present study, it is concluded that IMRT technique spared more efficiently OARs than CRT technique but both techniques covered the PTV adequately so whenever possible IMRT technique should be used.

  18. Dose-volume histogram constrains for small intestine in postoperative transcutaneous radiotherapy of endometrial carcinoma: comparison between conventional and conformal techniques

    Directory of Open Access Journals (Sweden)

    Anela Ramić

    2013-09-01

    Full Text Available Introduction: The aim of this study was to determine the dose-volume histogram (DVH constrains of conventional and conformal transcutaneous radiotherapy for small intestine and perform their comparison.Methods: This retrospective-prospective study included patients who were treated for endometrial cancer using conventional transcutaneous radiotherapy at the Department of Radiotherapy Clinic of Oncology,Hematology and Radiotherapy, University Clinical Center Tuzla in the period from 2009 to 2011. The study was performed on patients of all ages suffering from this condition. The study involved 35 patients. DVHparameters which were analyzed are: minimum dose (Dmin, maximum dose (Dmax, medium dose (Daver of the small intestine, as well as the volume of the small intestine, which is included in 75%, 95% and 100%dose (V33,75Gy, V42,75Gy, V45Gy expressed in percentages and cubic centimeters of the affected organ. Working hypothesis was tested with paired t test. The difference between the variables at the level of p Results: DVH constrains of transcutaneous conformal radiotherapy showed signifi cantly smaller dose contribution on small intestine than DVH parameters of conventional transcutaneous radiotherapy (pConclusion: The dose contribution on small intestine was signifi cantly lower by planning three-dimensional conformal transcutaneous radiotherapy in comparison to the conventional planning.

  19. Dose-volume histogram constrains for small intestine in postoperative transcutaneous radiotherapy of endometrial carcinoma: comparison between conventional and conformal techniques

    Directory of Open Access Journals (Sweden)

    Anela Ramić

    2013-09-01

    Full Text Available Introduction: The aim of this study was to determine the dose-volume histogram (DVH constrains of conventional and conformal transcutaneous radiotherapy for small intestine and perform their comparison.Methods: This retrospective-prospective study included patients who were treated for endometrial cancer using conventional transcutaneous radiotherapy at the Department of Radiotherapy Clinic of Oncology,Hematology and Radiotherapy, University Clinical Center Tuzla in the period from 2009 to 2011. The study was performed on patients of all ages suffering from this condition. The study involved 35 patients. DVHparameters which were analyzed are: minimum dose (Dmin, maximum dose (Dmax, medium dose (Daver of the small intestine, as well as the volume of the small intestine, which is included in 75%, 95% and 100%dose (V33,75Gy, V42,75Gy, V45Gy expressed in percentages and cubic centimeters of the affected organ. Working hypothesis was tested with paired t test. The difference between the variables at the level of p <0.05 was considered statistically significant.Results: DVH constrains of transcutaneous conformal radiotherapy showed signifi cantly smaller dose contribution on small intestine than DVH parameters of conventional transcutaneous radiotherapy (p<0.0001.Conclusion: The dose contribution on small intestine was signifi cantly lower by planning three-dimensional conformal transcutaneous radiotherapy in comparison to the conventional planning.

  20. Superiority of helical tomotherapy on liver sparing and dose escalation in hepatocellular carcinoma: a comparison study of three-dimensional conformal radiotherapy and intensity-modulated radiotherapy

    Directory of Open Access Journals (Sweden)

    Zhao QQ

    2016-06-01

    Full Text Available Qianqian Zhao,1,2 Renben Wang,2 Jian Zhu,2 Linzhi Jin,1,2 Kunli Zhu,2 Xiaoqing Xu,2 Rui Feng,2 Shumei Jiang,2 Zhonghua Qi,1,2 Yong Yin2 1School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, 2Department of Radiation Oncology, Shandong Cancer Hospital affiliated to Shandong University, Jinan, People’s Republic of China Background and purpose: To compare the difference of liver sparing and dose escalation between three-dimensional conformal radiotherapy (3DCRT, intensity-modulated radiotherapy (IMRT, and helical tomotherapy (HT for hepatocellular carcinoma.Patients and methods: Sixteen unresectable HCC patients were enrolled in this study. First, some evaluation factors of 3DCRT, IMRT, and HT plans were calculated with prescription dose at 50 Gy/25 fractions. Then, the doses were increased using HT or IMRT independently until either the plans reached 70 Gy or any normal tissue reached the dose limit according to quantitative analysis of normal tissue effects in the clinic criteria.Results: The conformal index of 3DCRT was lower than that of IMRT (P<0.001 or HT (P<0.001, and the homogeneity index of 3DCRT was higher than that of IMRT (P<0.001 or HT (P<0.001. HT took the longest treatment time (P<0.001. For V50% (fraction of normal liver treated to at least 50% of the isocenter dose of the normal liver, there was a significant difference: 3DCRT > IMRT > HT (P<0.001. HT had a lower Dmean (mean dose and V20 (Vn, the percentage of organ volume receiving ≥n Gy of liver compared with 3DCRT (P=0.005 and P=0.005, respectively or IMRT (P=0.508 and P=0.007, respectively. Dmean of nontarget normal liver and V30 of liver were higher for 3DCRT than IMRT (P=0.005 and P=0.005, respectively or HT (P=0.005 and P=0.005, respectively. Seven patients in IMRT (43.75% and nine patients in HT (56.25% reached the isodose 70 Gy, meeting the dose limit of the organs at risk.Conclusion: HT may provide significantly better

  1. Uncertainty in 3D gel dosimetry

    Science.gov (United States)

    De Deene, Yves; Jirasek, Andrew

    2015-01-01

    Three-dimensional (3D) gel dosimetry has a unique role to play in safeguarding conformal radiotherapy treatments as the technique can cover the full treatment chain and provides the radiation oncologist with the integrated dose distribution in 3D. It can also be applied to benchmark new treatment strategies such as image guided and tracking radiotherapy techniques. A major obstacle that has hindered the wider dissemination of gel dosimetry in radiotherapy centres is a lack of confidence in the reliability of the measured dose distribution. Uncertainties in 3D dosimeters are attributed to both dosimeter properties and scanning performance. In polymer gel dosimetry with MRI readout, discrepancies in dose response of large polymer gel dosimeters versus small calibration phantoms have been reported which can lead to significant inaccuracies in the dose maps. The sources of error in polymer gel dosimetry with MRI readout are well understood and it has been demonstrated that with a carefully designed scanning protocol, the overall uncertainty in absolute dose that can currently be obtained falls within 5% on an individual voxel basis, for a minimum voxel size of 5 mm3. However, several research groups have chosen to use polymer gel dosimetry in a relative manner by normalizing the dose distribution towards an internal reference dose within the gel dosimeter phantom. 3D dosimetry with optical scanning has also been mostly applied in a relative way, although in principle absolute calibration is possible. As the optical absorption in 3D dosimeters is less dependent on temperature it can be expected that the achievable accuracy is higher with optical CT. The precision in optical scanning of 3D dosimeters depends to a large extend on the performance of the detector. 3D dosimetry with X-ray CT readout is a low contrast imaging modality for polymer gel dosimetry. Sources of error in x-ray CT polymer gel dosimetry (XCT) are currently under investigation and include inherent

  2. Cardiac Exposure in the Dynamic Conformal Arc Therapy, Intensity-Modulated Radiotherapy and Volumetric Modulated Arc Therapy of Lung Cancer.

    Directory of Open Access Journals (Sweden)

    Xin Ming

    Full Text Available To retrospectively evaluate the cardiac exposure in three cohorts of lung cancer patients treated with dynamic conformal arc therapy (DCAT, intensity-modulated radiotherapy (IMRT, or volumetric modulated arc therapy (VMAT at our institution in the past seven years.A total of 140 lung cancer patients were included in this institutional review board approved study: 25 treated with DCAT, 70 with IMRT and 45 with VMAT. All plans were generated in a same commercial treatment planning system and have been clinically accepted and delivered. The dose distribution to the heart and the effects of tumor laterality, the irradiated heart volume and the beam-to-heart distance on the cardiac exposure were investigated.The mean dose to the heart among all 140 plans was 4.5 Gy. Specifically, the heart received on average 2.3, 5.2 and 4.6 Gy in the DCAT, IMRT and VMAT plans, respectively. The mean heart doses for the left and right lung tumors were 4.1 and 4.8 Gy, respectively. No patients died with evidence of cardiac disease. Three patients (2% with preexisting cardiac condition developed cardiac disease after treatment. Furthermore, the cardiac exposure was found to increase linearly with the irradiated heart volume while decreasing exponentially with the beam-to-heart distance.Compared to old technologies for lung cancer treatment, modern radiotherapy treatment modalities demonstrated better heart sparing. But the heart dose in lung cancer radiotherapy is still higher than that in the radiotherapy of breast cancer and Hodgkin's disease where cardiac complications have been extensively studied. With strong correlations of mean heart dose with beam-to-heart distance and irradiated heart volume, cautions should be exercised to avoid long-term cardiac toxicity in the lung cancer patients undergoing radiotherapy.

  3. Three-dimensional treatment planning for postoperative radiotherapy in patients with node-positive cervical cancer. Comparison between a conventional and a conformal technique

    Energy Technology Data Exchange (ETDEWEB)

    Olofsen-van Acht, M.J.J.; Quint, S.; Seven, M.; Berg, H.A. van den; Levendag, P.C. [University Hospital Rotterdam (Netherlands). Dept. of Radiation Oncology; Santvoort, J.P.C. van [University Hospital Rotterdam (Netherlands). Subdivision of Clinical Physics; Logmans, A. [University Hospital Rotterdam (Netherlands). Dept. of Gynecologic Oncology

    1999-09-01

    Purpose: Reduction of irradiated small bowel volume, using a conformal three-dimensional treatment planning technique in postoperative radiotherapy of cervical cancer patients. Patients and Methods: Large gynecological treatment fields including the para-aortic nodes were analyzed in 15 patients. A conventional treatment plan with anterior and posterior (AP-PA) parallel opposed fields and a 3D 4-field conformal radiotherapy plan with a central blocking of small bowel were compared for each patient. Dose-volume histograms and dose parameters were established. Because of the tolerance constraints of the small bowel, the cumulative dose applied to the target was 48.6 Gy. Results: The mean Tumor Control Probability (TCP) values for both the conventional and the conformal technique were 0.60 and 0.61, respectively, with ranges of 0.56 to 0.67 and 0.57 to 0.66, respectively. The mean volume receiving 95% or more of the prescribed dose (V95) of the small bowel was 47.6% (32.5 to 66.3%) in the AP-PA technique and 14.9% (7.0 to 22.5%) in the conformal technique (p<0.001), indicating a significant reduction in irradiated volume of small bowel in the higher dose range. The mean Normal Tissue Complication Probability (NTCP) decreased from 0.11 to 0.03 with the conformal plan. In patients who received a pedicled omentoplasty during surgery, the mean V95 for small bowel could be reduced to 8.5% (7.0 to 9.9%). The mean median dose to the kidneys was only slightly elevated in the conformal treatment. Especially the mean dose to the right kidney in conventional vs conformal treatment was 3.3 vs 7.9 Gy. The mean near-minimum dose (D95) to the rectosigmoid decreased from 48.4 to 30.1 Gy in the conformal plan compared to the conventional plan. Conclusion: The small bowel dose can be significantly reduced with 3D treatment planning, particularly if a predicled omentoplasty is performed. This allows dose escalation to the tumor region without unacceptable toxicity for the small bowel

  4. Doses to head and neck normal tissues for early stage Hodgkin lymphoma after involved node radiotherapy

    DEFF Research Database (Denmark)

    Maraldo, M. V.; Brodin, N. P.; Aznar, M. C.;

    2014-01-01

    To evaluate dose plans for head and neck organs at risk (OARs) for classical Hodgkin lymphoma (HL) patients using involved node radiotherapy (INRT) delivered as 3D conformal radiotherapy (3DCRT), volumetric modulated arc therapy (VMAT), and intensity modulated proton therapy (PT), in comparison t...... to the past mantle field (MF)....

  5. 宫颈癌术后三维适形放疗和共面等分设野调强放疗计划的对比分析%Dosimetric study of postoperative 3-dimensional conformal radiotherapy and coplanar decile intensity-modulated radiotherapy for cervical cancer

    Institute of Scientific and Technical Information of China (English)

    蒋军; 张利文; 廖珊; 黄荣

    2012-01-01

    目的 探讨宫颈癌术后三维适形放射治疗(3D-CRT)和共面等分设野调强放射治疗(IMRT)计划靶区及其周围危及器官受照剂量的差异.方法 随机选择10例宫颈癌术后患者,进行CT扫描、靶区和危及器官的勾画,处方剂量50 Gy.分别进行3D-CRT和共面等分设野IMRT计划设计,计算靶区剂量均匀度指数(HI)、适形度指数(CI)、最大受照剂量、最小受照剂量、平均受照剂量和危及器官照射体积等并对结果进行比较分析.结果 5F-IMRT、7F-IMRT和9F-IMRT在靶区适形度方面明显优于3D-CRT;在危及器官(膀胱V30 、V40 、V50,小肠V50和直肠V30、V40、V50)保护方面,5F-IMRT、7F-IMRT和9F-IMRT明显优于3D-CRT,P<0.05.而各IMRT计划之间差异无统计学意义,P>0.05.结论 宫颈癌术后辅助放疗共面等分IMRT计划无论在靶区适形度还是正常组织保护方面均优于3D-CRT,同时也证实7野或9野IMRT未必较5野获益更多.5野与7、9野的IMRT相比、在治疗时间及费用方面有独特的优势,值得在临床上推广.%Objective To compare the difference of the dose distribution in clinical target volume and organ at risk (OAR) between coplanar decile field intensity-modulated radiotherapy (IMRT) and conventional three-dimensional conformal radiotherapy (3D-CRT) for postoperative radiotherapy of cervical cancer. Methods Ten postoperative patients with cervical cancer were selected randomly to undergo CT scan and planning target volume (PTV) and OAR contouring. 3D-CRT and coplanar decile IMRT planning was performed for each patient with a prescribed dose of 50 Gy. The homogeneity index (HI), conformity index (CI), maximum dose, minimum dose, mean dose of PTV, and irradiated volume of OARs were calculated and the results were compared. Results 5-field IMRT, 7-field IMRT and 9-field IMRT plans had a significant better conformity index (CI) of PTV compared with 3D-CRT (P0.05). Conclusion Coplanar decile IMRT plans is superior

  6. Evaluation of late rectal toxicity after conformal radiotherapy for prostate cancer. A comparison between dose-volume constraints and NTCP use

    Energy Technology Data Exchange (ETDEWEB)

    Cambria, Raffaella; Cattani, Federica; Garibaldi, Cristina; Pedroli, Guido [Dept. of Medical Physics, Ist. Europeo di Oncologia, Milan (Italy); Jereczek-Fossa, Barbara A.; Orecchia, Roberto [Dept. of Radiation Oncology, Ist. Europeo di Oncologia, Milan (Italy); Univ. degli Studi di Milano, Milan (Italy); Zerini, Dario; Fodor, Cristiana; Serafini, Flavia [Dept. of Radiation Oncology, Ist. Europeo di Oncologia, Milan (Italy)

    2009-06-15

    Purpose: to analyze the reliability of different methods used in evaluating the risk of late rectal toxicity. Patients and methods: the treatment plans of 57 patients treated at the authors' institute between September 1999 and September 2000 for localized prostate cancer using three-dimensional conformal radiotherapy (3D-CRT) were analyzed retrospectively. The expected rate of late rectal toxicity was analyzed (a) by means of the dose-volume histogram (DVH) constraints; (b) by calculating the normal-tissue complication probability (NTCP) using the Lyman-Kutcher-Burman (LKB) model with the radiobiological parameters of either Emami (1991; for toxicity of grade {>=} 2) or Rancati (2004; for toxicity of grade {>=} 2 and {>=} 3). Patients were divided into high-/low-risk (HR/LR) groups and the results were compared to the clinical outcome. Results: (a) The HR percentages were 24% and 5% for radical and postsurgical 3D-CRT, respectively. When applying high-dose constraints only, HR percentages were 18% and 5%, respectively. (b) In the case of the NTCP (grade {>=} 2), Emami (1991) HR rates were 16% and 11%, and Rancati (2004) HR rates 29% and 11%, for radical and postsurgical treatment, respectively. Only one case with higher-grade toxicity was found. The reported clinical toxicity was 17.8% and 6.7% for grade {>=} 2 toxicity, and 3.7% and 0.7% for grade {>=} 3 toxicity, for radical and postsurgical treatment, respectively. Conclusion: this study demonstrated that there is an agreement between the toxicity rate evaluated by DVH constraints and by the LKB model and the clinical outcome. In this case, the use of the LKB model can be as reliable as the use of DVH constraints. (orig.)

  7. Comparison and evaluation between 3D-bolus and step-bolus, the assistive radiotherapy devices for the patients who had undergone modified radical mastectomy surgery

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Won Seok; Park, Kwang Woo; Shin, Dong Bong; Kim, Jong Dae; Kim, Sei Joon; Ha, Jin Sook; Jeon, Mi Jin; Cho, Yoojin; Jung, Inho [Dept. of Radiation Oncology, Gangnam Severance Hospital, Seoul, (Korea, Republic of)

    2016-06-15

    This study aimed to compare and evaluate between the efficiency of two respective devices, 3D-bolus and step-bolus when the devices were used for the treatment of patients whose chest walls were required to undergo the electron beam therapy after the surgical procedure of modified radical mastectomy, MRM. The treatment plan of reverse hockey stick method, using the photon beam and electron beam, had been set for six breast cancer patients and these 6 breast cancer patients were selected to be the subjects for this study. The prescribed dose of electron beam for anterior chest wall was set to be 180 cGy per treatment and both the 3D-bolus, produced using 3D printer(CubeX, 3D systems, USA) and the self-made conventional step-bolus were used respectively. The surface dose under 3D-bolus and step-bolus was measured at 5 measurement spots of iso-center, lateral, medial, superior and inferior point, using GAFCHROMIC EBT3 film (International specialty products, USA) and the measured value of dose at 5 spots was compared and analyzed. Also the respective treatment plan was devised, considering the adoption of 3D-bolus and stepbolus and the separate treatment results were compared to each other. The average surface dose was 179.17 cGy when the device of 3D-bolus was adopted and 172.02 cGy when step-bolus was adopted. The average error rate against the prescribed dose of 180 cGy was -(minus) 0.47% when the device of 3D-bolus was adopted and it was -(minus) 4.43% when step-bolus was adopted. It was turned out that the maximum error rate at the point of iso-center was 2.69%, in case of 3D-bolus adoption and it was 5,54% in case of step-bolus adoption. The maximum discrepancy in terms of treatment accuracy was revealed to be about 6% when step-bolus was adopted and to be about 3% when 3D-bolus was adopted. The difference in average target dose on chest wall between 3D-bolus treatment plan and step-bolus treatment plan was shown to be insignificant as the difference was only 0

  8. A framework for inverse planning of beam-on times for 3D small animal radiotherapy using interactive multi-objective optimization

    NARCIS (Netherlands)

    Balvert, Marleen; van Hoof, S.J.; Granton, Patrick V.; Trani, Daniela; den Hertog, Dick; Hoffmann, A.L.; Verhaegen, Frank

    2015-01-01

    Advances in precision small animal radiotherapy hardware enable the delivery of increasingly complicated dose distributions on the millimeter scale. Manual creation and evaluation of treatment plans becomes difficult or even infeasible with an increasing number of degrees of freedom for dose deliver

  9. Probability of mediastinal involvement in non-small-cell lung cancer: a statistical definition of the clinical target volume for 3-dimensional conformal radiotherapy?

    Science.gov (United States)

    Giraud, Philippe; De Rycke, Yann; Lavole, Armelle; Milleron, Bernard; Cosset, Jean-Marc; Rosenzweig, Kenneth E

    2006-01-01

    Conformal irradiation (3D-CRT) of non-small-cell lung carcinoma (NSCLC) is largely based on precise definition of the nodal clinical target volume (CTVn). A reduction of the number of nodal stations to be irradiated would facilitate tumor dose escalation. The aim of this study was to design a mathematical tool based on documented data to predict the risk of metastatic involvement for each nodal station. We reviewed the large surgical series published in the literature to identify the main pretreatment parameters that modify the risk of nodal invasion. The probability of involvement for the 17 nodal stations described by the American Thoracic Society (ATS) was computed from all these publications. Starting with the primary site of the tumor as the main characteristic, we built a probabilistic tree for each nodal station representing the risk distribution as a function of each tumor feature. Statistical analysis used the inversion of probability trees method described by Weinstein and Feinberg. Validation of the software based on 134 patients from two different populations was performed by receiver operator characteristic (ROC) curves and multivariate logistic regression. Analysis of all of the various parameters of pretreatment staging relative to each level of the ATS map results in 20,000 different combinations. The first parameters included in the tree, depending on tumor site, were histologic classification, metastatic stage, nodal stage weighted as a function of the sensitivity and specificity of the diagnostic examination used (positron emission tomography scan, computed tomography scan), and tumor stage. Software is proposed to compute a predicted probability of involvement of each nodal station for any given clinical presentation. Double cross validation confirmed the methodology. A 10% cutoff point was calculated from ROC and logistic model giving the best prediction of mediastinal lymph node involvement. To more accurately define the CTVn in NSCLC three

  10. SU-E-J-55: End-To-End Effectiveness Analysis of 3D Surface Image Guided Voluntary Breath-Holding Radiotherapy for Left Breast

    Energy Technology Data Exchange (ETDEWEB)

    Lin, M; Feigenberg, S [University of Maryland School of Medicine, Baltimore, MD (United States)

    2015-06-15

    Purpose To evaluate the effectiveness of using 3D-surface-image to guide breath-holding (BH) left-side breast treatment. Methods Two 3D surface image guided BH procedures were implemented and evaluated: normal-BH, taking BH at a comfortable level, and deep-inspiration-breath-holding (DIBH). A total of 20 patients (10 Normal-BH and 10 DIBH) were recruited. Patients received a BH evaluation using a commercialized 3D-surface- tracking-system (VisionRT, London, UK) to quantify the reproducibility of BH positions prior to CT scan. Tangential 3D/IMRT plans were conducted. Patients were initially setup under free-breathing (FB) condition using the FB surface obtained from the untaged CT to ensure a correct patient position. Patients were then guided to reach the planned BH position using the BH surface obtained from the BH CT. Action-levels were set at each phase of treatment process based on the information provided by the 3D-surface-tracking-system for proper interventions (eliminate/re-setup/ re-coaching). We reviewed the frequency of interventions to evaluate its effectiveness. The FB-CBCT and port-film were utilized to evaluate the accuracy of 3D-surface-guided setups. Results 25% of BH candidates with BH positioning uncertainty > 2mm are eliminated prior to CT scan. For >90% of fractions, based on the setup deltas from3D-surface-trackingsystem, adjustments of patient setup are needed after the initial-setup using laser. 3D-surface-guided-setup accuracy is comparable as CBCT. For the BH guidance, frequency of interventions (a re-coaching/re-setup) is 40%(Normal-BH)/91%(DIBH) of treatments for the first 5-fractions and then drops to 16%(Normal-BH)/46%(DIBH). The necessity of re-setup is highly patient-specific for Normal-BH but highly random among patients for DIBH. Overall, a −0.8±2.4 mm accuracy of the anterior pericardial shadow position was achieved. Conclusion 3D-surface-image technology provides effective intervention to the treatment process and ensures

  11. Conformity analysis to demonstrate reproducibility of target volumes for Margin-Intense Stereotactic Radiotherapy for borderline-resectable pancreatic cancer.

    Science.gov (United States)

    Holyoake, Daniel L P; Robinson, Maxwell; Grose, Derek; McIntosh, David; Sebag-Montefiore, David; Radhakrishna, Ganesh; Patel, Neel; Partridge, Mike; Mukherjee, Somnath; Hawkins, Maria A

    2016-10-01

    Margin-directed neoadjuvant radiotherapy for borderline-resectable pancreatic cancer (BRPC) aims to facilitate clear surgical margins. A systematic method was developed for definition of a boost target volume prior to a formal phase-I study. Reference structures were defined by two oncologists and one radiologist, target structures were submitted by eight oncologist investigators and compared using conformity indices. Resultant risk of duodenal bleed (NTCP) was modelled. For GTV, reference volume was 2.1cm(3) and investigator mean was 6.03cm(3) (95% CI 3.92-8.13cm(3)), for boost volume 1.1cm(3) and 1.25cm(3) (1.02-1.48cm(3)). Mean Dice conformity coefficient for GTV was 0.47 (0.38-0.56), and for boost volume was significantly higher at 0.61 (0.52-0.70, p=0.01). Discordance index (DI) for GTV was 0.65 (0.56-0.75) and for boost volume was significantly lower at 0.39 (0.28-0.49, p=0.001). NTCP using reference contours was 2.95%, with mean for investigator contour plans 3.93% (3.63-4.22%). Correlations were seen between NTCP and GTV volume (p=0.02) and NTCP and DI (correlation coefficient 0.83 (0.29-0.97), p=0.01). Better conformity with reference was shown for boost volume compared with GTV. Investigator GTV volumes were larger than reference, had higher DI scores and modelled toxicity risk. A consistent method of target structure definition for margin-directed pancreatic radiotherapy is demonstrated. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  12. Low-Dose-Rate Californium-252 Neutron Intracavitary Afterloading Radiotherapy Combined With Conformal Radiotherapy for Treatment of Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Zhang Min [Department of Oncology, Armed Police Hospital of Hangzhou, Hangzhou, Zhejiang Province (China); Xu Hongde [Cancer Center, Armed Police Hospital of Hangzhou, Hangzhou, Zhejiang Province (China); Pan Songdan; Lin Shan; Yue Jianhua [Department of Oncology, Armed Police Hospital of Hangzhou, Hangzhou, Zhejiang Province (China); Liu Jianren, E-mail: liujianren0571@hotmail.com [Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province (China)

    2012-07-01

    Purpose: To study the efficacy of low-dose-rate californium-252 ({sup 252}Cf) neutron intracavitary afterloading radiotherapy (RT) combined with external pelvic RT for treatment of cervical cancer. Methods and Materials: The records of 96 patients treated for cervical cancer from 2006 to 2010 were retrospectively reviewed. For patients with tumors {<=}4 cm in diameter, external beam radiation was performed (1.8 Gy/day, five times/week) until the dose reached 20 Gy, and then {sup 252}Cf neutron intracavitary afterloading RT (once/week) was begun, and the frequency of external beam radiation was changed to four times/week. For patients with tumors >4 cm, {sup 252}Cf RT was performed one to two times before whole-pelvis external beam radiation. The tumor-eliminating dose was determined by using the depth limit of 5 mm below the mucosa as the reference point. In all patients, the total dose of the external beam radiation ranged from 46.8 to 50 Gy. For {sup 252}Cf RT, the dose delivered to point A was 6 Gy/fraction, once per week, for a total of seven times, and the total dose was 42 Gy. Results: The mean {+-} SD patient age was 54.7 {+-} 13.7 years. Six patients had disease assessed at stage IB, 13 patients had stage IIA, 49 patients had stage IIB, 3 patients had stage IIIA, 24 patients had stage IIIB, and 1 patient had stage IVA. All patients obtained complete tumor regression (CR). The mean {+-} SD time to CR was 23.5 {+-} 3.4 days. Vaginal bleeding was fully controlled in 80 patients within 1 to 8 days. The mean {+-} SD follow-up period was 27.6 {+-} 12.7 months (range, 6-48 months). Five patients died due to recurrence or metastasis. The 3-year survival and disease-free recurrence rates were 89.6% and 87.5 %, respectively. Nine patients experienced mild radiation proctitis, and 4 patients developed radiocystitis. Conclusions: Low-dose-rate {sup 252}Cf neutron RT combined with external pelvic RT is effective for treating cervical cancer, with a low incidence of

  13. Clinical implementation of 3D printing in the construction of patient specific bolus for electron beam radiotherapy for non-melanoma skin cancer

    NARCIS (Netherlands)

    Canters, R.A.M.; Lips, I.M.; Wendling, M.; Kusters, M.; Zeeland, M. van; Gerritsen, R.M.; Poortmans, P.; Verhoef, C.G.

    2016-01-01

    BACKGROUND AND PURPOSE: Creating an individualized tissue equivalent material build-up (i.e. bolus) for electron beam radiation therapy is complex and highly labour-intensive. We implemented a new clinical workflow in which 3D printing technology is used to create the bolus. MATERIAL AND METHODS: A

  14. Clinical implementation of 3D printing in the construction of patient specific bolus for electron beam radiotherapy for non-melanoma skin cancer

    NARCIS (Netherlands)

    Canters, R.A.M.; Lips, I.M.; Wendling, M.; Kusters, M.; Zeeland, M. van; Gerritsen, R.M.; Poortmans, P.; Verhoef, C.G.

    2016-01-01

    BACKGROUND AND PURPOSE: Creating an individualized tissue equivalent material build-up (i.e. bolus) for electron beam radiation therapy is complex and highly labour-intensive. We implemented a new clinical workflow in which 3D printing technology is used to create the bolus. MATERIAL AND METHODS: A

  15. Contribution to the development and the modelling of an ultrasonic conformable phased array transducer for the contact inspection of 3D complex geometry components; Contribution au developpement et a la modelisation d'un traducteur ultrasonore multielements conformable pour l'inspection au contact de composants a geometrie complexe 3D

    Energy Technology Data Exchange (ETDEWEB)

    Guedes, O

    2005-04-15

    With the difficulties encountered for the exploration of complex shape surfaces, particularly in nuclear industry, the ultrasonic conformable phased array transducer allows a non destructive evaluation of parts with 3D complex parts. For this, one can use the Smart Contact Transducer principle to generate an ultrasonic field by adaptive dynamic focalisation, with a matrix array composed of independent elements moulded in a soft resin. This work deals with the electro-acoustic conception, with the realization of such a prototype and with the study of it's mechanical and acoustic behaviour. The array design is defined using a radiation model adapted to the simulation of contact sources on a free surface. Once one have defined the shape of the radiating elements, a vibratory analysis using finite elements method allows the determination of the emitting structure with 1-3 piezocomposite, witch leads to the realization of emitting-receiving elements. With the measurement of the field transmitted by such elements, we deduced new hypothesis to change the model of radiation. Thus one can take into account normal and tangential stresses calculated with finite element modelling at the interface between the element and the propagation medium, to use it with the semi-analytical model. Some vibratory phenomena dealing with fluid coupling of contact transducers have been studied, and the prediction of the transverse wave radiation profile have been improved. The last part of this work deals with the realization of the first prototype of the conformable phased array transducer. For this a deformation measuring system have been developed, to determine the position of each element on real time with the displacement of the transducer on complex shape surfaces. With those positions, one can perform the calculation of the a delay law intended for the adaptive dynamic focusing of the desired ultrasonic field. The conformable phased array transducer have been characterized in

  16. Radiobiologic comparison of helical tomotherapy, intensity modulated radiotherapy, and conformal radiotherapy in treating lung cancer accounting for secondary malignancy risks

    Energy Technology Data Exchange (ETDEWEB)

    Komisopoulos, Georgios [Department of Medical Physics, Medical School, University of Patras, Patras (Greece); Mavroidis, Panayiotis, E-mail: mavroidis@uthscsa.edu [Department of Radiation Oncology, University of Texas Health Sciences Center at San Antonio, San Antonio, TX (United States); Department of Medical Radiation Physics, Karolinska Institutet and Stockholm University, Stockholm (Sweden); Rodriguez, Salvador; Stathakis, Sotirios; Papanikolaou, Nikos [Department of Radiation Oncology, University of Texas Health Sciences Center at San Antonio, San Antonio, TX (United States); Nikiforidis, Georgios C.; Sakellaropoulos, Georgios C. [Department of Medical Physics, Medical School, University of Patras, Patras (Greece)

    2014-01-01

    The aim of the present study is to examine the importance of using measures to predict the risk of inducing secondary malignancies in association with the clinical effectiveness of treatment plans in terms of tumor control and normal tissue complication probabilities. This is achieved by using radiobiologic parameters and measures, which may provide a closer association between clinical outcome and treatment delivery. Overall, 4 patients having been treated for lung cancer were examined. For each of them, 3 treatment plans were developed based on the helical tomotherapy (HT), multileaf collimator-based intensity modulated radiation therapy (IMRT), and 3-dimensional conformal radiation therapy (CRT) modalities. The different plans were evaluated using the complication-free tumor control probability (p{sub +}), the overall probability of injury (p{sub I}), the overall probability of control/benefit (p{sub B}), and the biologically effective uniform dose (D{sup ¯¯}). These radiobiologic measures were used to develop dose-response curves (p-D{sup ¯¯} diagram), which can help to evaluate different treatment plans when used in conjunction with standard dosimetric criteria. The risks for secondary malignancies in the heart and the contralateral lung were calculated for the 3 radiation modalities based on the corresponding dose-volume histograms (DVHs) of each patient. Regarding the overall evaluation of the different radiation modalities based on the p{sub +} index, the average values of the HT, IMRT, and CRT are 67.3%, 61.2%, and 68.2%, respectively. The corresponding average values of p{sub B} are 75.6%, 70.5%, and 71.0%, respectively, whereas the average values of p{sub I} are 8.3%, 9.3%, and 2.8%, respectively. Among the organs at risk (OARs), lungs show the highest probabilities for complications, which are 7.1%, 8.0%, and 1.3% for the HT, IMRT, and CRT modalities, respectively. Similarly, the biologically effective prescription doses (D{sub B}{sup ¯¯}) for the

  17. Stereotactic body radiotherapy for lung cancer: how much does it really cost?

    Science.gov (United States)

    Lievens, Yolande; Obyn, Caroline; Mertens, Anne-Sophie; Van Halewyck, Dries; Hulstaert, Frank

    2015-03-01

    Despite the lack of randomized evidence, stereotactic body radiotherapy (SBRT) is being accepted as superior to conventional radiotherapy for patients with T1-2N0 non-small-cell lung cancer in the periphery of the lung and unfit or unwilling to undergo surgery. To introduce SBRT in a system of coverage with evidence development, a correct financing had to be determined. A time-driven activity-based costing model for radiotherapy was developed. Resource cost calculation of all radiotherapy treatments, standard and innovative, was conducted in 10 Belgian radiotherapy centers in the second half of 2012. The average cost of lung SBRT across the 10 centers (6221&OV0556;) is in the range of the average costs of standard fractionated 3D-conformal radiotherapy (5919&OV0556;) and intensity-modulated radiotherapy (7379&OV0556;) for lung cancer. Hypofractionated 3D-conformal radiotherapy and intensity-modulated radiotherapy schemes are less costly (3993&OV0556; respectively 4730&OV0556;). The SBRT cost increases with the number of fractions and is highly dependent of personnel and equipment use. SBRT cost varies more by centre than conventional radiotherapy cost, reflecting different technologies, stages in the learning curve and a lack of clear guidance in this field. Time-driven activity-based costing of radiotherapy is feasible in a multicentre setup, resulting in real-life resource costs that can form the basis for correct reimbursement schemes, supporting an early yet controlled introduction of innovative radiotherapy techniques in clinical practice.

  18. An investigation of intensity-modulated radiation therapy versus conventional two-dimensional and 3D-conformal radiation therapy for early stage larynx cancer

    Directory of Open Access Journals (Sweden)

    Gomez Daniel

    2010-08-01

    Full Text Available Abstract Introduction Intensity modulated radiation therapy (IMRT has been incorporated at several institutions for early stage laryngeal cancer (T1/T2N0M0, but its utility is controversial. Methods In three representative patients, multiple plans were generated: 1 Conventional 2D planning, with the posterior border placed at either the anterior aspect ("tight" plan or the mid-vertebral body ("loose" plan, 2 3D planning, utilizing both 1.0 and 0.5 cm margins for the planning target volume (PTV, and 3 IMRT planning, utilizing the same margins as the 3D plans. A dosimetric comparison was performed for the target volume, spinal cord, arytenoids, and carotid arteries. The prescription dose was 6300 cGy (225 cGy fractions, and the 3D and IMRT plans were normalized to this dose. Results For PTV margins of 1.0 cm and 0.5 cm, the D95 of the 2D tight/loose plans were 3781/5437 cGy and 5372/5869 cGy, respectively (IMRT/3D plans both 6300 cGy. With a PTV margin of 1.0 cm, the mean carotid artery dose was 2483/5671/5777/4049 cGy in the 2D tight, 2D loose, 3D, and IMRT plans, respectively. When the PTV was reduced to 0.5 cm, the the mean carotid artery dose was 2483/5671/6466/2577 cGy to the above four plans, respectively. The arytenoid doses were similar between the four plans, and spinal cord doses were well below tolerance. Conclusions IMRT provides a more ideal dose distribution compared to 2D treatment and 3D planning in regards to mean carotid dose. We therefore recommend IMRT in select cases when the treating physician is confident with the GTV.

  19. Technical Note: Partial body irradiation of mice using a customized PMMA apparatus and a clinical 3D planning/LINAC radiotherapy system

    Energy Technology Data Exchange (ETDEWEB)

    Karagounis, Ilias V.; Koukourakis, Michael I., E-mail: targ@her.forthnet.gr, E-mail: mkoukour@med.duth.gr [Department of Radiotherapy–Oncology, Radiopathology and Radiobiology Unit, Medical School, Democritus University of Thrace, Alexandroupolis 68100 (Greece); Abatzoglou, Ioannis M., E-mail: abadzoglou@yahoo.gr [Medical Physics Department, University General Hospital of Alexandroupolis, Alexandroupolis 68100 (Greece)

    2016-05-15

    Purpose: In vivo radiobiology experiments involving partial body irradiation (PBI) of mice are of major importance because they allow for the evaluation of individual organ tolerance; overcoming current limitations of experiments using lower dose, whole body irradiation. In the current study, the authors characterize and validate an effective and efficient apparatus for multiple animal PBI, directed to the head, thorax, or abdomen of mice. Methods: The apparatus is made of polymethylmethacrylate and consists of a rectangular parallelepiped prism (40 cm × 16 cm × 8 cm), in which five holes were drilled to accomodate standard 60 ml syringes, each housing an unanesthetized, fully immobilized mouse. Following CT-scanning and radiotherapy treatment planning, radiation fields were designed to irradiate the head, thorax, or abdomen of the animal. Thermoluminescent dosimeters (TLDs) were used to confirm the treatment planning dosimetry for primary beam and scattered radiation. Results: Mice are efficiently placed into 60 ml syringes and immobilized, without the use of anesthetics. Although partial rotational movement around the longitudinal axis and a minor 2 mm forward/backward movement are permitted, this does not compromise the irradiation of the chosen body area. TLDs confirmed the dose values predicted by the treatment planning dosimetry, both for primary beam and scattered radiation. Conclusions: The customized PMMA apparatus described and validated is cost-effective, convenient to use, and efficient in performing PBI without the use of anesthesia. The developed apparatus permits the isolated irradiation of the mouse head, thorax, and abdomen. Importantly, the apparatus allows the delivery of PBI to five mice, simultaneously, representing an efficient way to effectively expose a large number of animals to PBI through multiple daily fractions, simulating clinical radiotherapy treatment schedules.

  20. Evaluation of deformable image registration between external beam radiotherapy and HDR brachytherapy for cervical cancer with a 3D-printed deformable pelvis phantom.

    Science.gov (United States)

    Kadoya, Noriyuki; Miyasaka, Yuya; Nakajima, Yujiro; Kuroda, Yoshihiro; Ito, Kengo; Chiba, Mizuki; Sato, Kiyokazu; Dobashi, Suguru; Yamamoto, Takaya; Takahashi, Noriyoshi; Kubozono, Masaki; Takeda, Ken; Jingu, Keiichi

    2017-04-01

    In this study, we developed a 3D-printed deformable pelvis phantom for evaluating spatial DIR accuracy. We then evaluated the spatial DIR accuracies of various DIR settings for cervical cancer. A deformable female pelvis phantom was created based on patient CT data using 3D printing. To create the deformable uterus phantom, we first 3D printed both a model of uterus and a model of the internal cavities of the vagina and uterus. We then made a mold using the 3D printed uterus phantom. Finally, urethane was poured into the mold with the model of the internal cavities in place, creating the deformable uterus phantom with a cavity into which an applicator could be inserted. To create the deformable bladder phantom, we first 3D printed models of the bladder and of the same bladder scaled down by 2 mm. We then made a mold using the larger bladder model. Finally, silicone was poured into the mold with the smaller bladder model in place to create the deformable bladder phantom with a wall thickness of 2 mm. To emulate the anatomical bladder, water was poured into the created bladder. We acquired phantom image without applicator for EBRT. Then, we inserted the applicator into the phantom to simulate BT. In this situation, we scanned the phantom again to obtain the phantom image for BT. We performed DIR using the two phantom images in two cases: Case A, with full bladder (170 ml) in both EBRT and BT images; and Case B with full bladder in the BT image and half-full bladder (100 ml) in the EBRT image. DIR was evaluated using Dice similarity coefficients (DSCs) and 31 landmarks for the uterus and 25 landmarks for the bladder. A hybrid intensity and structure DIR algorithm implemented in RayStation with four DIR settings was evaluated. On visual inspection, reasonable agreement in shape of the uterus between the phantom and patient CT images was observed for both EBRT and BT, although some regional disagreements in shape of the bladder and rectum were apparent. The created

  1. High-Dose Conformal Radiotherapy Reduces Prostate Cancer-Specific Mortality: Results of a Meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Viani, Gustavo Arruda, E-mail: gusviani@gmail.com [Department of Radiation Oncology, Marilia Medical School, Marilia, Sao Paulo (Brazil); Godoi Bernardes da Silva, Lucas; Stefano, Eduardo Jose [Department of Radiation Oncology, Marilia Medical School, Marilia, Sao Paulo (Brazil)

    2012-08-01

    Purpose: To determine in a meta-analysis whether prostate cancer-specific mortality (PCSM), biochemical or clinical failure (BCF), and overall mortality (OM) in men with localized prostate cancer treated with conformal high-dose radiotherapy (HDRT) are better than those in men treated with conventional-dose radiotherapy (CDRT). Methods and Materials: The MEDLINE, Embase, CANCERLIT, and Cochrane Library databases, as well as the proceedings of annual meetings, were systematically searched to identify randomized, controlled studies comparing conformal HDRT with CDRT for localized prostate cancer. Results: Five randomized, controlled trials (2508 patients) that met the study criteria were identified. Pooled results from these randomized, controlled trials showed a significant reduction in the incidence of PCSM and BCF rates at 5 years in patients treated with HDRT (p = 0.04 and p < 0.0001, respectively), with an absolute risk reduction (ARR) of PCSM and BCF at 5 years of 1.7% and 12.6%, respectively. Two trials evaluated PCSM with 10 years of follow up. The pooled results from these trials showed a statistical benefit for HDRT in terms of PCSM (p = 0.03). In the subgroup analysis, trials that used androgen deprivation therapy (ADT) showed an ARR for BCF of 12.9% (number needed to treat = 7.7, p < 0.00001), whereas trials without ADT had an ARR of 13.6% (number needed to treat = 7, p < 0.00001). There was no difference in the OM rate at 5 and 10 years (p = 0.99 and p = 0.11, respectively) between the groups receiving HDRT and CDRT. Conclusions: This meta-analysis is the first study to show that HDRT is superior to CDRT in preventing disease progression and prostate cancer-specific death in trials that used conformational technique to increase the total dose. Despite the limitations of our study in evaluating the role of ADT and HDRT, our data show no benefit for HDRT arms in terms of BCF in trials with or without ADT.

  2. MR vs CT imaging: low rectal cancer tumour delineation for three-dimensional conformal radiotherapy.

    LENUS (Irish Health Repository)

    O'Neill, B D P

    2009-06-01

    Modern three-dimentional radiotherapy is based upon CT. For rectal cancer, this relies upon target definition on CT, which is not the optimal imaging modality. The major limitation of CT is its low inherent contrast resolution. Targets defined by MRI could facilitate smaller, more accurate, tumour volumes than CT. Our study reviewed imaging and planning data for 10 patients with locally advanced low rectal cancer (defined as < 6 cm from the anal verge on digital examination). Tumour volume and location were compared for sagittal pre-treatment MRI and planning CT. CT consistently overestimated all tumour radiological parameters. Estimates of tumour volume, tumour length and height of proximal tumour from the anal verge were larger on planning CT than on MRI (p < 0.05). Tumour volumes defined on MRI are smaller, shorter and more distal from the anal sphincter than CT-based volumes. For radiotherapy planning, this may result in smaller treatment volumes, which could lead to a reduction in dose to organs at risk and facilitate dose escalation.

  3. Three dimensional conformal radiotherapy for synchronous bilateral breast irradiation using a mono iso-center technique

    Science.gov (United States)

    Mani, Karthick Raj; Basu, Saumen; Bhuiyan, Md Anisuzzaman; Ahmed, Sharif; Sumon, Mostafa Aziz; Haque, Kh Anamul; Sengupta, Ashim Kumar; Un Nabi, Md Rashid; Das, K. J. Maria

    2017-06-01

    Objective: The purpose of this study is to demonstrate the synchronous bilateral breast irradiation radiotherapy technique using a single isocenter. Materials and Methods: Six patients of synchronous bilateral breast were treated with single isocenter technique from February 2011 to June 2016. All the patients underwent a CT-simulation using appropriate positioning device. Target volumes and critical structures like heart, lung, esophagus, thyroid, etc., were delineated slice by slice in the CT data. An isocenter was placed above the sternum on the skin and both medial tangential and lateral tangential of the breast / chest wall were created using asymmetrical jaws to avoid the beam divergence through the lung and heart. The field weighting were adjusted manually to obtain a homogenous dose distribution. The planning objectives were to deliver uniform doses around the target and keep the doses to the organ at risk within the permissible limit. The beam energy of 6 MV or combination of 6 MV and 15 MV photons were used in the tangential fields according to the tangential separation. Boluses were used for all the mastectomy patients to increase the doses on the chest wall. In addition to that enhanced dynamic wedge and field in field technique were also used to obtain a homogenous distribution around the target volume and reduce the hot spots. The isocenter was just kept on the skin, such that the beam junctions will be overlapped only on the air just above the sternum. Acute toxicity during the treatment and late toxicity were recorded during the patient's follow-up. Results: During the radiotherapy treatment follow-up there were no acute skin reactions in the field junctions, but one patient had grade 1 esophagitis and two patients had grade 2 skin reactions in the chest wall. With a median follow-up of 38.5 months (range: 8 - 49 months), no patients had a local recurrence, but one patients with triple negative disease had a distant metastases in brain and died

  4. Classification of conformational stability of protein mutants from 3D pseudo-folding graph representation of protein sequences using support vector machines.

    Science.gov (United States)

    Fernández, Michael; Caballero, Julio; Fernández, Leyden; Abreu, Jose Ignacio; Acosta, Gianco

    2008-01-01

    This work reports a novel 3D pseudo-folding graph representation of protein sequences for modeling purposes. Amino acids euclidean distances matrices (EDMs) encode primary structural information. Amino Acid Pseudo-Folding 3D Distances Count (AAp3DC) descriptors, calculated from the EDMs of a large data set of 1363 single protein mutants of 64 proteins, were tested for building a classifier for the signs of the change of thermal unfolding Gibbs free energy change (DeltaDeltaG) upon single mutations. An optimum support vector machine (SVM) with a radial basis function (RBF) kernel well recognized stable and unstable mutants with accuracies over 70% in crossvalidation test. To the best of our knowledge, this result for stable mutant recognition is the highest ever reported for a sequence-based predictor with more than 1000 mutants. Furthermore, the model adequately classified mutations associated to diseases of human prion protein and human transthyretin.

  5. Tumor-tracking radiotherapy of moving targets; verification using 3D polymer gel, 2D ion-chamber array and biplanar diode array

    Energy Technology Data Exchange (ETDEWEB)

    Ceberg, Sofie; Falk, Marianne; Af Rosenschoeld, Per Munck; Cattell, Herbert; Gustafsson, Helen; Keall, Paul; Korreman, Stine S; Medin, Joakim; Nordstroem, Fredrik; Persson, Gitte; Sawant, Amit; Svatos, Michelle; Zimmerman, Jens; Baeck, Sven AJ, E-mail: sofie.ceberg@med.lu.s

    2010-11-01

    The aim of this study was to carry out a dosimetric verification of a dynamic multileaf collimator (DMLC)-based tumor-tracking delivery during respiratory-like motion. The advantage of tumor-tracking radiation delivery is the ability to allow a tighter margin around the target by continuously following and adapting the dose delivery to its motion. However, there are geometric and dosimetric uncertainties associated with beam delivery system constraints and output variations, and several investigations have to be accomplished before a clinical integration of this tracking technique. Two types of delivery were investigated in this study I) a single beam perpendicular to a target with a one dimensional motion parallel to the MLC moving direction, and II) an intensity modulated arc delivery (RapidArc (registered)) with a target motion diagonal to the MLC moving direction. The feasibility study (I) was made using an 2D ionisation chamber array and a true 3D polymer gel. The arc delivery (II) was verified using polymer gel and a biplanar diode array. Good agreement in absorbed dose was found between delivery to a static target and to a moving target with DMLC tracking using all three detector systems. However, due to the limited spatial resolution of the 2D array a detailed comparison was not possible. The RapidArc (registered) plan delivery was successfully verified using the biplanar diode array and true 3D polymer gel, and both detector systems could verify that the DMLC-based tumor-tracking delivery system has a very good ability to account for respiratory target motion.

  6. The European Society of Therapeutic Radiology and Oncology-European Institute of Radiotherapy (ESTRO-EIR) report on 3D CT-based in-room image guidance systems: a practical and technical review and guide.

    Science.gov (United States)

    Korreman, Stine; Rasch, Coen; McNair, Helen; Verellen, Dirk; Oelfke, Uwe; Maingon, Philippe; Mijnheer, Ben; Khoo, Vincent

    2010-02-01

    The past decade has provided many technological advances in radiotherapy. The European Institute of Radiotherapy (EIR) was established by the European Society of Therapeutic Radiology and Oncology (ESTRO) to provide current consensus statement with evidence-based and pragmatic guidelines on topics of practical relevance for radiation oncology. This report focuses primarily on 3D CT-based in-room image guidance (3DCT-IGRT) systems. It will provide an overview and current standing of 3DCT-IGRT systems addressing the rationale, objectives, principles, applications, and process pathways, both clinical and technical for treatment delivery and quality assurance. These are reviewed for four categories of solutions; kV CT and kV CBCT (cone-beam CT) as well as MV CT and MV CBCT. It will also provide a framework and checklist to consider the capability and functionality of these systems as well as the resources needed for implementation. Two different but typical clinical cases (tonsillar and prostate cancer) using 3DCT-IGRT are illustrated with workflow processes via feedback questionnaires from several large clinical centres currently utilizing these systems. The feedback from these clinical centres demonstrates a wide variability based on local practices. This report whilst comprehensive is not exhaustive as this area of development remains a very active field for research and development. However, it should serve as a practical guide and framework for all professional groups within the field, focussed on clinicians, physicists and radiation therapy technologists interested in IGRT.

  7. [Advances in highly conformal radiotherapy for prostate cancer: past, current, and future].

    Science.gov (United States)

    Ishikawa, Hitoshi; Hashimoto, Takayuki; Makishima, Hirokazu; Mizumoto, Masashi; Okumura, Toshiyuki; Sakurai, Hideyuki

    2012-01-01

    Recent advance in the field of radiation oncology, especially in medical physics for radiation therapy (RT), has considerably improved treatment outcomes of various cancers including prostate cancer with regard to both of tumor control and morbidity. Three-dimensionally conformal RT with image-guided radiotherapeutic modalities for accurate tumor localization, such as brachytherapy, intensity-modulated radiation therapy (IMRT), and charged particle beam RT can thereby deliver a large dose to the tumor and allow the sparing of surrounding normal tissues. It is thought that prostate cancer is one of representative cancers which have been treated with RT as a curative intent and benefited from novel conformal RT techniques. Because the number of prostate cancer patients has been increasing year by year in Japan as results from wide spread of PSA screening and rapid change in life style, RT has been recently playing much more important roles in the curative treatment for patients with prostate cancer. Hence, we will review the outcomes of RT for prostate cancer and introduce the benefit of modern RT modalities from clinical aspect. In addition, our future prospect to further yield better disease control with minimum morbidity compared with present RT will be also mentioned in the report.

  8. Application of 2D/3D Image Registration in the Radiotherapy of Nasopharyngeal Carcinoma%2D/3D影像配准在鼻咽癌放疗中的应用

    Institute of Scientific and Technical Information of China (English)

    马广栋; 洪莉; 王亮和

    2013-01-01

    目的:研究2D/3D像配准方法对鼻咽癌放疗中计划靶区PTV外扩距离的影响。方法应用OBI (On Board Image,OBI)系统获取2D影像(kV图像和PV图像)和3D影像(CBCT图像),将获取的2D和3D影像分别经DRR配准系统和模拟定位CT进行图像配准,确定前后、头脚、左右3个方向上的摆位误差,再由2种PTV外扩公式计算3个方向上的PTV外扩距离。结果2D和3D影像配准的PTV外扩值有所不同。kV,PV,CBCT三者配准误差相互比较P>0.05,无统计学意义。结论kV图像和PV图像和CBCT图像都能很好地验证照射野位置。CBCT图像可以分析三维方向的影像误差,降低了2D图像影像重叠产生的摆位误差的影响。%Objective To study the effect of 2D/3D image registration on the extended distance of planning target volume (PTV) in the radiotherapy of nasopharyngeal carcinoma (NPC). Methods Using OBI system to obtain two-dimensional images (kV images and PV images) and three-dimensional images (CBCT images). Then registering 2D and 3D images by using DRR registration system and simulation positioning CT respectively to get the set-up errors of VRT, LNG, LAT. Then calculating the values of PTV extended distance of VRT, LNG, LAT with two kinds of PTV expansion formulas. Results The values of PTV extended distance between 2D and 3D images are different while there is no signiifcance in registration errors among kV, PV, CBCT images (P>0.05). Conclusion Both of 2D images (kV images and PV images) and 3D images (CBCT images) can verify the radiation field well. 3D image errors can be analyzed with CBCT images, which can reduce the inlfuence of set-up errors caused by image overlapping of 2D images.

  9. Efficiency of Stereotactic Conformal Radiotherapy in Lung Metastases with Active Breathing Control

    Directory of Open Access Journals (Sweden)

    Olga Yu. Anikeeva, PhD

    2013-06-01

    Full Text Available Twenty four patients with lung metastases underwent radiosurgery treatment between October 2010 and December 2012. Stereotactic conformal high-dose radiation therapy with Active Breathing Control (ABC was conducted using the volumetric modulated arc therapy (VMAT technique. The median overall follow-up was 18 months (range 6-24 months, overall survival was 75%, and local control rate was 92%. The median time to progression was 4 months (range 1-18 months.There have been no cases of leucopenia, radiation esophagitis, mediastinitis or severe acute radiation pneumonitis. The late radiation effects Grade 2, according to the LENT SOMA scales, was observed in one patient (4%. The results of this study indicate that the usage of the stereotactic high-dose radiation therapy with ABC is safe and effective in the treatment of lung metastases.

  10. Phase I Study of Concurrent High-Dose Three-Dimensional Conformal Radiotherapy With Chemotherapy Using Cisplatin and Vinorelbine for Unresectable Stage III Non-Small-Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Sekine, Ikuo, E-mail: isekine@ncc.go.jp [Division of Internal Medicine and Thoracic Oncology, National Cancer Center Hospital, Tokyo (Japan); Sumi, Minako; Ito, Yoshinori [Division of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan); Horinouchi, Hidehito; Nokihara, Hiroshi; Yamamoto, Noboru; Kunitoh, Hideo; Ohe, Yuichiro; Kubota, Kaoru; Tamura, Tomohide [Division of Internal Medicine and Thoracic Oncology, National Cancer Center Hospital, Tokyo (Japan)

    2012-02-01

    Purpose: To determine the maximum tolerated dose in concurrent three-dimensional conformal radiotherapy (3D-CRT) with chemotherapy for unresectable Stage III non-small-cell lung cancer (NSCLC). Patients and Methods: Eligible patients with unresectable Stage III NSCLC, age {>=}20 years, performance status 0-1, percent of volume of normal lung receiving 20 GY or more (V{sub 20}) {<=}30% received three to four cycles of cisplatin (80 mg/m{sup 2} Day 1) and vinorelbine (20 mg/m{sup 2} Days 1 and 8) repeated every 4 weeks. The doses of 3D-CRT were 66 Gy, 72 Gy, and 78 Gy at dose levels 1 to 3, respectively. Results: Of the 17, 16, and 24 patients assessed for eligibility, 13 (76%), 12 (75%), and 6 (25%) were enrolled at dose levels 1 to 3, respectively. The main reasons for exclusion were V{sub 20} >30% (n = 10) and overdose to the esophagus (n = 8) and brachial plexus (n = 2). There were 26 men and 5 women, with a median age of 60 years (range, 41-75). The full planned dose of radiotherapy could be administered to all the patients. Grade 3-4 neutropenia and febrile neutropenia were noted in 24 (77%) and 5 (16%) of the 31 patients, respectively. Grade 4 infection, Grade 3 esophagitis, and Grade 3 pulmonary toxicity were noted in 1 patient, 2 patients, and 1 patient, respectively. The dose-limiting toxicity was noted in 17% of the patients at each dose level. The median survival and 3-year and 4-year survival rates were 41.9 months, 72.3%, and 49.2%, respectively. Conclusions: 72 Gy was the maximum dose that could be achieved in most patients, given the predetermined normal tissue constraints.

  11. The effect of beam energy on the quality of IMRT plans for prostate conformal radiotherapy.

    Science.gov (United States)

    de Boer, Steven F; Kumek, Yunus; Jaggernauth, Wainwright; Podgorsak, Matthew B

    2007-04-01

    Three dimensional conformal radiation therapy (3DCRT) for prostate cancer is most commonly delivered with high-energy photons, typically in the range of 10-21 MV. With the advent of Intensity Modulated Radiation Therapy (IMRT), an increase in the number of monitor units (MU) relative to 3DCRT has lead to a concern about secondary malignancies. This risk becomes more relevant at higher photon energies where there is a greater neutron contribution. Subsequently, the majority of IMRT prostate treatments being delivered today are with 6-10 MV photons where neutron production is negligible. However, the absolute risk is small [Hall, E. J. Intensity Modulated Radiation Therapy, Protons, and the Risk of Second Cancers. Int J Radiat Oncol Bio Phys 65, 1-7 (2006); Kry, F. S., Salehpour, M., Followill, D. S., Stovall, M., Kuban, D. A., White, R. A., and Rosen, I. I. The Calculated Risk of Fatal Secondary Malignancies From Intensity Modulated Radiation Therapy. Int J Radiat Oncol Bio Phys 62, 1195-1203 (2005).] and therefore it has been suggested that the use of an 18MV IMRT may achieve better target coverage and normal tissue sparing such that this benefit outweighs the risks. This paper investigates whether 18MV IMRT offer better target coverage and normal tissue sparing. Computed Tomography (CT) image sets of ten prostate cancer patients were acquired and two separate IMRT plans were created for each patient. One plan used 6 MV beams, and the other used 18 MV, both in a coplanar, non-opposed beam geometry. Beam arrangements and optimization constraints were the same for all plans. This work includes a comparison and discussion of the total integral dose, neutron dose conformity index, and total number of MU for plans generated with both energies.

  12. Is Karnofsky Performance Status Correlate with Better Overall Survival in Palliative Conformal Whole Brain Radiotherapy? Our Experience

    Science.gov (United States)

    Reali, Alessia; Allis, Simona; Girardi, Andrea; Verna, Roberta; Bianco, Lavinia; Redda, Maria Grazia Ruo

    2015-01-01

    Aim: Brain metastases (BMs) are a common event in the progression of many human cancers. The aim of this study was to evaluate the potential prognostic factors for the clinical identification of a subgroup of patients that could benefit from whole brain conformal radiotherapy (WBRT). Materials and Methods: From January 2010 to February 2014, 80 patients with a diagnosis of BMs underwent WBRT at our Radiation Oncology Department, San Luigi Hospital, Italy. Among them, 36 medical records were retrospective reviewed. Gender, age, Karnofsky performance status (KPS), number of BMs on computed tomography and/or magnetic resonance images, presence or absence of perilesional edema, presence or absence of necrosis pattern, and histology of primary tumor were analyzed. Univariate and multivariate analyses were performed. Results: In our cohort of patients, significant prognostic factors for 20 months overall survival was KPS> 70, while a statistical trend (P = 0.098) was registered regarding primary breast. Conclusion: WBRT can be still considered a standard and effective treatment in patients with BMs. High KPS and breast cancer primary tumor seem to be useful parameters for characterize a subgroup of patients with more favorable prognosis. PMID:26600700

  13. Acute Toxicity After Image-Guided Intensity Modulated Radiation Therapy Compared to 3D Conformal Radiation Therapy in Prostate Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    Wortel, Ruud C.; Incrocci, Luca [Department of Radiation Oncology, Erasmus Medical Center Cancer Institute, Rotterdam (Netherlands); Pos, Floris J.; Lebesque, Joos V.; Witte, Marnix G.; Heide, Uulke A. van der; Herk, Marcel van [Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam (Netherlands); Heemsbergen, Wilma D., E-mail: w.heemsbergen@nki.nl [Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam (Netherlands)

    2015-03-15

    Purpose: Image-guided intensity modulated radiation therapy (IG-IMRT) allows significant dose reductions to organs at risk in prostate cancer patients. However, clinical data identifying the benefits of IG-IMRT in daily practice are scarce. The purpose of this study was to compare dose distributions to organs at risk and acute gastrointestinal (GI) and genitourinary (GU) toxicity levels of patients treated to 78 Gy with either IG-IMRT or 3D-CRT. Methods and Materials: Patients treated with 3D-CRT (n=215) and IG-IMRT (n=260) receiving 78 Gy in 39 fractions within 2 randomized trials were selected. Dose surface histograms of anorectum, anal canal, and bladder were calculated. Identical toxicity questionnaires were distributed at baseline, prior to fraction 20 and 30 and at 90 days after treatment. Radiation Therapy Oncology Group (RTOG) grade ≥1, ≥2, and ≥3 endpoints were derived directly from questionnaires. Univariate and multivariate binary logistic regression analyses were applied. Results: The median volumes receiving 5 to 75 Gy were significantly lower (all P<.001) with IG-IMRT for anorectum, anal canal, and bladder. The mean dose to the anorectum was 34.4 Gy versus 47.3 Gy (P<.001), 23.6 Gy versus 44.6 Gy for the anal canal (P<.001), and 33.1 Gy versus 43.2 Gy for the bladder (P<.001). Significantly lower grade ≥2 toxicity was observed for proctitis, stool frequency ≥6/day, and urinary frequency ≥12/day. IG-IMRT resulted in significantly lower overall RTOG grade ≥2 GI toxicity (29% vs 49%, respectively, P=.002) and overall GU grade ≥2 toxicity (38% vs 48%, respectively, P=.009). Conclusions: A clinically meaningful reduction in dose to organs at risk and acute toxicity levels was observed in IG-IMRT patients, as a result of improved technique and tighter margins. Therefore reduced late toxicity levels can be expected as well; additional research is needed to quantify such reductions.

  14. Dosimetric Comparison of Volumetric Modulated Arc Therapy, Static Field Intensity Modulated Radiation Therapy, and 3D Conformal Planning for the Treatment of a Right-Sided Reconstructed Chest Wall and Regional Nodal Case

    Directory of Open Access Journals (Sweden)

    Vishruta A. Dumane

    2014-01-01

    Full Text Available We compared 3D conformal planning, static field intensity modulated radiation therapy (IMRT, and volumetric modulated arc therapy (VMAT to investigate the suitable treatment plan and delivery method for a right-sided reconstructed chest wall and nodal case. The dose prescribed for the reconstructed chest wall and regional nodes was 50.4 Gy. Plans were compared for target coverage and doses of the lungs, heart, contralateral breast, and healthy tissue. All plans achieved acceptable coverage of the target and IMNs. The best right lung sparing achieved with 3D was a V20 Gy of 31.09%. Compared to it, VMAT reduced the same by 10.85% and improved the CI and HI over 3D by 18.75% and 2%, respectively. The ipsilateral lung V5 Gy to V20 Gy decreased with VMAT over IMRT by as high as 17.1%. The contralateral lung V5 Gy was also lowered with VMAT compared to IMRT by 16.22%. The MU and treatment beams were lowered with VMAT over IMRT by 30% and 10, respectively, decreasing the treatment time by >50%. VMAT was the treatment plan and delivery method of choice for this case due to a combination of improved lung sparing and reduced treatment time without compromising target coverage.

  15. Late radiation side effects, cosmetic outcomes and pain in breast cancer patients after breast-conserving surgery and three-dimensional conformal radiotherapy. Risk-modifying factors

    Energy Technology Data Exchange (ETDEWEB)

    Hille-Betz, Ursula; Soergel, Philipp; Kundu, Sudip; Klapdor, Ruediger; Hillemanns, Peter [Hannover Medical School, Department of Obstetrics and Gynaecology, Hannover (Germany); Vaske, Bernhard [Hannover Medical School, Institute of Medical Biometry and Informatics, Hannover (Germany); Bremer, Michael; Henkenberens, Christoph [Hannover Medical School, Department of Radiation Oncology and Special Oncology, Hannover (Germany)

    2016-01-15

    The purpose of this work was to identify parameters influencing the risk of late radiation side effects, fair or poor cosmetic outcomes (COs) and pain in breast cancer patients after breast-conserving therapy (BCT) and three-dimensional conformal radiotherapy (3D-CRT). Between 2006 and 2013, 159 patients were treated at the Hannover Medical School. Physician-rated toxicity according to the LENT-SOMA criteria, CO and pain were assessed by multivariate analysis. LENT-SOMA grade 1-4 toxicity was observed as follows: fibrosis 10.7 %, telangiectasia 1.2 %, arm oedema 8.8 % and breast oedema 5.0 %. In addition, 15.1 % of patients reported moderate or severe breast pain, and 21.4 % complained about moderate or severe pain in the arm or shoulder. In multivariate analysis, axillary clearing (AC) was significantly associated with lymphoedema of the arm [odds ratio (OR) 4.37, p = 0.011, 95 % confidence interval (CI) 1.4-13.58]. Breast oedema was also highly associated with AC (OR 10.59, p = 0.004, 95 % CI 2.1-53.36), a ptosis grade 2/3 or pseudoptosis and a bra size ≥ cup C (OR 5.34, p = 0.029, 95 % CI 1.2-24.12). A ptosis grade 2/3 or pseudoptosis and a bra size ≥ cup C were the parameters significantly associated with an unfavourable CO (OR 3.19, p = 0.019, 95 % CI 1.2-8.4). Concerning chronic breast pain, we found a trend related to the prescribed radiation dose including boost (OR 1.077, p = 0.060, 95 % CI 0.997-1.164). Chronic shoulder or arm pain was statistically significantly associated with lymphoedema of the arm (OR 3.9, p = 0.027, 95 % CI 1.17-13.5). Chronic arm and breast oedema were significantly influenced by the extent of surgery (AC). Ptotic and large breasts were significantly associated with unfavourable COs and chronic breast oedema. Late toxicities exclusive breast pain were not associated with radiotherapy parameters. (orig.) [German] Ziel dieser Arbeit war es, Parameter zu identifizieren, die Spaetschaeden nach Radiotherapie, ein unguenstiges

  16. Combined weekly paclitaxel and radiotherapy of stage III inoperable non-small-cell lung cancer (NSCLC). Results of a dose escalation study; Sequentielle Chemo- und Radiochemotherapie mit Paclitaxel/Carboplat und 3D-konformer Bestrahlung beim inoperablen nichtkleinzelligen Bronchialkarzinom. Ergebnisse einer Dosiseskalationsstudie

    Energy Technology Data Exchange (ETDEWEB)

    Willner, J.; Flentje, M. [Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Strahlentherapie; Schmidt, M.; Wirtz, H. [Wuerzburg Univ. (Germany). Abt. Pneumologie; Huber, R.M.; Fischer, R.; Lang, S. [Muenchen Univ. (Germany). Medizinische Klinik

    1997-11-01

    Purpose: Determination of the maximum tolerable dose of weekly paclitaxel infusions in combination with 3D-conformal radiotherapy in NSCLC. Evaluation of tumor response and side effects of this combined radio-chemotherapeutic approach. Materials and Methods: Patients with inoperable NSCLC, UICC-Stadium IIIA/B received 2 cycles of combined chemotherapy with paclitaxel (175 mg/m{sup 2}, 3-hour infusion)/carboplatin (AUC 5) followed by a combined radio-chemotherapy with 6 weekly paclitaxel infusions with dose escalation of paclitaxel from 40 to 80 mg/m{sup 2}. Radiotherapy was individually 3D-conformally planned. Primary tumor and regional lymphatics received a dose of 50 Gy (fractionation 2 Gy, 5 times per week), followed by a boost dose of 10 to 16 Gy to the primary tumor and involved lymph nodes (5 to 8 times 2 Gy). Toxicity of treatment was determined using WHO criteria. Results: Thirty-five patients have been treated until now. Two patients went off-study before completion of treatment for manifestation of distant metastases during initial chemotherapy and underwent palliative treatment, 30 patients are evaluable. The study has been closed in the paclitaxel 70 mg/m{sup 2} dose level. In 2 patients (level 50 mg/m{sup 2}) paclitaxel infusion was aborted for hypersensitivity reactions, 1 patient (60 mg/m{sup 2} paclitaxel) developed Grade III leucopenia and therefore received incomplete low-dose Taxol {sup trademark}, whereas radiotherapy of these 3 patients was completed. One patient (60 mg/m{sup 2}, 50 Gy) did not complete the treatment for a pneumonic infection, with Grade II esophagitis, Grade II leucopenia and a reduction in performance status. Three patients developed a Grade II esophagitis. Two patients in the paclitaxel 40 mg/m{sup 2} level and the 2 patients in the 70 mg level developed a Grade III esophagitis. Six patients developed clinical signs of radiation pneumonitis. Initial tumor response (PR and CR) was 87% (26/30). Survival rate at 12 months in 75

  17. Dosimetric comparison of intensity-modulated, conformal, and four-field pelvic radiotherapy boost plans for gynecologic cancer: a retrospective planning study

    Directory of Open Access Journals (Sweden)

    Perkins Gregory

    2006-05-01

    Full Text Available Abstract Purpose To evaluate intensity-modulated radiation therapy (IMRT as an alternative to conformal radiotherapy (CRT or 4-field box boost (4FB in women with gynecologic malignancies who are unsuitable for brachytherapy for technical or medical reasons. Methods Dosimetric and toxicity information was analyzed for 12 patients with cervical (8, endometrial (2 or vaginal (2 cancer previously treated with external beam pelvic radiotherapy and a CRT boost. Optimized IMRT boost treatment plans were then developed for each of the 12 patients and compared to CRT and 4FB plans. The plans were compared in terms of dose conformality and critical normal tissue avoidance. Results The median planning target volume (PTV was 151 cm3 (range 58–512 cm3. The median overlap of the contoured rectum with the PTV was 15 (1–56 %, and 11 (4–35 % for the bladder. Two of the 12 patients, both with large PTVs and large overlap of the contoured rectum and PTV, developed grade 3 rectal bleeding. The dose conformity was significantly improved with IMRT over CRT and 4FB (p ≤ 0.001 for both. IMRT also yielded an overall improvement in the rectal and bladder dose-volume distributions relative to CRT and 4FB. The volume of rectum that received the highest doses (>66% of the prescription was reduced by 22% (p Conclusion These results indicate that IMRT can improve target coverage and reduce dose to critical structures in gynecologic patients receiving an external beam radiotherapy boost. This dosimetric advantage will be integrated with other patient and treatment-specific factors, particularly internal tumor movement during fractionated radiotherapy, in the context of a future image-guided radiation therapy study.

  18. 宫颈癌术后快速旋转调强放疗和三维适形放疗计划的对比研究%RapidArc radiotherapy for postoperative cervical cancer: comparison with three-dimensional conformal radiotherapy

    Institute of Scientific and Technical Information of China (English)

    蒋军; 李莉; 张利文; 廖珊; 黄荣

    2013-01-01

    Objective To compare the differences of dose distribution in clinical target volume and organ at risk (OAR) between volumetric-modulated arc therapy(RapidArc) and conventional three-dimensional conformal radiotherapy (3D-CRT) in the radiotherapy of postoperative cervical cancer.Methods Ten postoperative patients with cervical cancer were chosen randomly.The next steps were CT scan,PTV and OAR contouring.The RapidArc plan and 3D-CRT plan were performed for each patient with the prescribed dose 50Gy,respectively.Homogeneity index (HI),conformity index (CI),maximum dose (PTVmax),minimum dose (PTVmin),mean dose(PTVmean) of PTV and irradiated volume of OARs were calculated and the results were compared.Results Conformity index (CI) of PTV and PTV Dmean in RapidArc plan were better than those in 3D-CRT plan with statistically significant difference (P < 0.05).Compared with 3D-CRT plans,V20 of the left and right femoral head,V50 of the bladder and V40,V50 of rectumin RapidArc plans all reduced and the differences were statistically significant (P < 0.05).While there were no significant difference on the PTV Dmax,PTV Dmin,HI and OARs(V10,V20,V30,V40,V50 of the small bowel,V10,V20,V30 of the rectum,V1o,V20,V30,V40 of the bladder,V10,V30,V40,V50 of the left and right femoral head) between 3D-CRT and RapidArc group (P > 0.05).Conclusion RapidArc plans are better than 3D-CRT plans in CI of PTV and PTV Dmean in the radiotherapy of postoperative cervical cancer.Meanwhile,compared with 3D-CRT plans,there are more advantages in sparing the OAR in RapidArc plans.%目的 探讨宫颈癌术后快速旋转调强放疗(RapidArc)和三维适形放疗(3D-CRT)计划靶区及其周围危及器官(0AR)受照剂量的差异.方法 随机选择10例宫颈癌术后患者,进行CT扫描、靶区(PTV)和OAR的勾画,处方剂量50Gy.分别进行RapidArc和3D-CRT计划设计,计算并比较两种计划的PTV剂量均匀度指数(HI)、适形度指数(CI)、最大受照剂量(PTV Dmax

  19. Clinical Research on Three-Dimensional Conformal Radiotherapy of Non-Small Cell Lung Cancer

    Institute of Scientific and Technical Information of China (English)

    Baolin Yuan; Tao Zhang; Jianqi Luo; Liang Zhang; Suqun Chen; Lina Yang; Yong Wu; Yuying Ma

    2008-01-01

    OBJECTIVE To investigate the clinical efficacy and toxic effect of the 3-dimensional conformal radiation therapy (3DCRT) for non-small cell lung cancer (NSCLC).METHODS Fifty-two patients with the Stage-I and W NSCLC were treated with 3DCRT. Cross analysis of the clinical data was conducted in the comparison between the 52 cases with 3DCRT and the other 50 cases with the conventional radiation therapy (CRT). In the 3DCRT group, only the primary tumor and positive lymph-node draining area were included in the clinical target area, setting 4 to 6 coplanar or non-coplanar irradiation fields, with 2 Gy or 3 Gy/fraction, 1 fraction a day and 5 fractions per week.The total dose ranged from a test dose (DT) of 66 Gy to 72 Gy. In the CRT group, the field area contained the primary tumor plus the homolateral hilum of the lung, the mediastinum superior or hol-mediastinum, and opposed anteroposterior irradiation. When the dosage reached DT 36~40 Gy, an oblique portal administered radiation was conducted in order to avoid injuring the spinal cord.The DT was 1.8~2.0 Gy/fraction, 1 fraction a day, 5 fractions per week, with a total dose of 60 Gy to 70 Gy.RESULTS The therapeutic effect (CR + PR) was 90.4% in the 3DCRT group, and was 72% in the CRT group. There was statistically significant difference between the two groups, P 0.05. The toxic reaction was 12.5% and 23.7% respectively in the 3DCRT and CRT groups.Acute radioactive esophagitis and leucopenia were markedly lower in the 3DCRT group than in the CRT group. There was a statistically significant difference between the groups, P <0.05. Notoxic reaction of Stage-Ⅲ and over was found in the 3DCRT group during radiation therapy.CONCLUSION The 3DCRT method has a satisfactory short-term efficacy and improvement of clinical symptoms in treating NSCLC, with a mild toxic reaction and good tolerance in patients.It can be used for enhancing the tumor-control rate and bettering the quality of life.

  20. 3D-conformal radiation therapy in prostate cancer. Technical considerations after 5 years of experience and 334 patients treated at the Istituto Europeo di Oncologia of Milan, Italy.

    Science.gov (United States)

    Ghilezan, M; Ivaldi, G; Cattani, F; Greco, C; Castiglioni, S; Leonardi, M C; Tosi, G; Marsiglia, H; Orecchia, R

    2001-01-01

    To report the technique of 3D-conformal radiation therapy (3D-CRT) currently used at our Institute for the treatment of prostate cancer with a curative intent. A critical review of the technical aspects of the technique is provided. Between December 1995 and October 2000, 334 patients with biopsy-proven adenocarcinoma of the prostate were treated with 3D-CRT. All patients were treated in a prone position with 15 MV X-ray beams and a 6-field technique for all but 20 patients, who were treated with a 3-field technique. Patients were simulated with the rectum and bladder empty. To ensure reproducible positioning, custom-made polyurethane foam or thermoplastic casts were produced for each patient. Subsequently, consecutive CT scan slices were obtained. The clinical target volume and critical organs (rectum and bladder) were identified on each CT slice. The beam's eye view technique was used to spatially display these structures, and the treatment portals were manually shaped based on the images obtained. The beam apertures were initially realized by conventional Cerrobend blocks (48 patients), which were replaced in October 1997 by a computer-driven multi-leaf collimator. The total target dose prescribed at the ICRU point is 76 Gy, delivered in 38 fractions and 54 days. The seminal vesicles are excluded at 70 Gy. Dose-volume histograms were obtained for all patients. If more than 30% of the bladder and/or more than 20% of the rectum receive >95% of the prescribed total dose, the treatment plan is judged as unsatisfactory and is adjusted. The dose-volume histogram can be improved by changing the beam's arrangement and/or weights or by introducing or modifying the wedge filters. 3D-CRT in prostate cancer patients is a highly sophisticated and time-consuming method of dose delivery. Important technical issues remain to be clarified.

  1. Evaluation of errors set-up and setting margins calculation in treatments 3-D conformal radiotherapy; Evaluacion de errores de set-up y calculo de margenes de configuracion en tratamientos de radioterapia CONFORMADA 3-D

    Energy Technology Data Exchange (ETDEWEB)

    Donis, S.; Robayna, B.; Gonzalez, A.; Hernandez Armas, J.

    2011-07-01

    The use of IGRT techniques provide knowledge of the mistakes made in the positioning of a patient, to population studies and estimate the margins for each population.In this paper we evaluate the errors of set-up in 3 different locations and from these margins are calculated configuration (SM).

  2. Interobserver comparison of CT and MRI-based prostate apex definition. Clinical relevance for conformal radiotherapy treatment planning

    Energy Technology Data Exchange (ETDEWEB)

    Wachter, S.; Wachter-Gerstner, N.; Goldner, G.; Poetter, R. [University Hospital Vienna (Austria). Dept. of Radiotherapy and Radiobiology; Bock, T. [University Hospital Vienna (Austria). Dept. of Radiotherapy and Radiobiology; University Hospital Kiel (Germany). Interdisziplinary Center of Brachytherapy; Kovacs, G. [University Hospital Kiel (Germany). Interdisziplinary Center of Brachytherapy; Fransson, A. [University Hospital Vienna (Austria). Dept. of Radiotherapy and Radiobiology; Karolinska Hospital, Stockholm (Sweden). Dept. of Hospital

    2002-05-01

    Background: CT is widely used for conformal radiotherapy treatment planning of prostate carcinoma. Its limitations are especially at the prostatic apex which cannot be separated from the urogenital diaphragm. The aim of this study was to compare the localization of the prostatic apex in CT and axial MRI to the sagittal MRI in an interobserver analysis. Patients and Methods: 22 patients with pathologically proven prostatic carcinoma were included in the analysis. In all patients sagittal and axial T2-weighted MRI and conventional CT were performed. The position of the MRI and CT apices were localized independently by three observers in relation to the intertrochanteric line. Additional subjective judgement of the ability to define the apical border of the prostatic gland was performed by a five-scaled score. Results: The apex of the prostate could be discriminated statistically significant (p<0.001) better in the MRI as compared to CT with best judgement for the sagittal MRI. The interobserver variation for the definition of the prostatic apex was statistically significant (p=0.009) smaller for the sagittal MRI compared to axial MRI and CT. On the average the apex as determined by sagittal MRI, axial MRI and CT was located 29 mm, 27 mm and 24 mm above the intertrochanteric line. The apex defined by CT would have led to an additional treatment of 6-13 mm in 10/22 patients compared to the sagittal MRI, defined by axial MRI only in five patients. Conclusion: Additional MRI provides a superior anatomic information especially in the apical portion of the prostate. It should be recommended for every single patient in the treatment planning process. It helps to avoid an unnecessary irradiation of healthy tissue and could lead to a decrease of anal side effects and radiation-induced impotency due to a reduction of the extent of irradiated penile structures. (orig.)

  3. Comparison of Rapid Arc and Intensity-modulated Radiotherapy Plans Using Unified Dosimetry Index and the Impact of Conformity Index on Unified Dosimetry Index Evaluation.

    Science.gov (United States)

    Krishnan, Jayapalan; Shetty, Jayarama; Rao, Suresh; Hegde, Sanath; Shambhavi, C

    2017-01-01

    The aim of this study was to evaluate the impact of conformity index in the unified dosimetry index (UDI) score for two different planning techniques namely intensity-modulated radiotherapy (IMRT) and Rapid Arc. Rapid Arc and IMRT plans of 57 patients were evaluated and compared using UDI score which incorporates four indices. To determine the impact of conformity index on the IMRT and Rapid Arc plans, UDI at conformity index one of all plan (UDIunit_CI) score was calculated by assuming conformity index is equal to one. Mean and standard deviations of all indices were calculated. Rapid Arc technique plans of different treatment sites of all patients scored lesser UDI than IMRT plans, and the conformity index of Rapid Arc plan was significantly better than IMRT plan. The average dose gradient, homogeneity, coverage, and conformity index of all sites with Rapid Arc plans were 0.212 ± 0.05, 1.123 ± 0.03, 0.959 ± 0.03, and 1.056 ± 0.09; with IMRT plans were 0.190 ± 0.05, 1.113 ± 0.04, 0.950 ± 0.04, and 1.172 ± 0.16, respectively. UDI score value with actual conformity index of Rapid Arc and IMRT plans differed significantly (P conformity index equal to one did not differ significantly (P = 0.528). In the comparison of IMRT and Rapid Arc plans using the UDI score, the impact of conformity index was significant.

  4. Biological in-vivo measurement of dose distribution in patients' lymphocytes by gamma-H2AX immunofluorescence staining: 3D conformal- vs. step-and-shoot IMRT of the prostate gland

    Directory of Open Access Journals (Sweden)

    Huber Peter E

    2011-06-01

    Full Text Available Abstract Background Different radiation-techniques in treating local staged prostate cancer differ in their dose- distribution. Physical phantom measurements indicate that for 3D, less healthy tissue is exposed to a relatively higher dose compared to SSIMRT. The purpose is to substantiate a dose distribution in lymphocytes in-vivo and to discuss the possibility of comparing it to the physical model of total body dose distribution. Methods For each technique (3D and SSIMRT, blood was taken from 20 patients before and 10 min after their first fraction of radiotherapy. The isolated leukocytes were fixed 2 hours after radiation. DNA double-strand breaks (DSB in lymphocytes' nuclei were stained immunocytochemically using the gamma-H2AX protein. Gamma-H2AX foci inside each nucleus were counted in 300 irradiated as well as 50 non-irradiated lymphocytes per patient. In addition, lymphocytes of 5 volunteer subjects were irradiated externally at different doses and processed under same conditions as the patients' lymphocytes in order to generate a calibration-line. This calibration-line assigns dose-value to mean number of gamma-H2AX foci/ nucleus. So the dose distributions in patients' lymphocytes were determined regarding to the gamma-H2AX foci distribution. With this information a cumulative dose-lymphocyte-histogram (DLH was generated. Visualized distribution of gamma-H2AX foci, correspondingly dose per nucleus, was compared to the technical dose-volume-histogram (DVH, related to the whole body-volume. Results Measured in-vivo (DLH and according to the physical treatment-planning (DVH, more lymphocytes resulted with low-dose exposure ( 80% was equal in both radiation techniques. The mean number of gamma-H2AX foci per lymphocyte was 0.49 (3D and 0.47 (SSIMRT without significant difference. Conclusions In-vivo measurement of the dose distribution within patients' lymphocytes can be performed by detecting gamma-H2AX foci. In case of 3D and SSIMRT, the

  5. Dosimetric comparison of 3-dimensional conformal and field-in-field radiotherapy techniques for the adjuvant treatment of early stage endometrial cancer.

    Science.gov (United States)

    Yavas, Guler; Yavas, Cagdas; Acar, Hilal; Buyukyoruk, Ahmet; Cobanoglu, Gokcen; Kerimoglu, Ozlem Secilmis; Yavas, Ozlem; Celik, Cetin

    2013-11-01

    The purpose of this study is to compare field-in-field radiotherapy (FIF) with conformal radiotherapy (CRT) in terms of dosimetric benefits for early stage endometrial cancer patients. Ten consecutive early stage endometrial cancer patients who underwent adjuvant external beam radiotherapy were included in the study. For each patient, two different treatment plans were created. FIF and CRT plans were compared for doses in the planning target volume (PTV), the organ at risk (OAR) volumes including rectum, bladder, bowel, bilateral femurs and bone marrow, the dose homogeneity index, and the monitor unit counts required for the treatment. The FIF technique significantly reduced the maximum dose of the PTV, rectum, bladder, bowel, left femur, right femur and bone marrow (p values were: 30 and >45 Gy were compared, the results were in favor of the FIF technique. The volumes of rectum, bladder, bowel, left femur, right femur and bone marrow receiving more than the prescription dose of 45 Gy were significantly reduced with FIF technique (p values were 0.016, 0.039, 0.01, 0.04, 0.037 and 0.01 respectively). The dose homogeneity index (DHI) was significantly improved with FIF technique (p radiotherapy for early stage endometrial cancer patients. Copyright © 2012 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  6. FlexyDos3D: a deformable anthropomorphic 3D radiation dosimeter: radiation properties

    DEFF Research Database (Denmark)

    De Deene, Yves; Skyt, Peter Sandegaard; Hill, Robin

    2015-01-01

    Three dimensional radiation dosimetry has received growing interest with the implementation of highly conformal radiotherapy treatments. The radiotherapy community faces new challenges with the commissioning of image guided and image gated radiotherapy treatments (IGRT) and deformable image...... and oxygen concentration has also been investigated. The radiophysical properties of this new dosimeter are discussed including stability, spatial integrity, temperature dependence of the dosimeter during radiation, readout and storage, dose rate dependence and tissue equivalence....

  7. Hepatic arterial infusion chemotherapy using 5-fluorouracil and systemic interferon-α for advanced hepatocellular carcinoma in combination with or without three-dimensional conformal radiotherapy to venous tumor thrombosis in hepatic vein or inferior vena cava.

    Science.gov (United States)

    Murakami, Eisuke; Aikata, Hiroshi; Miyaki, Daisuke; Nagaoki, Yuko; Katamura, Yoshio; Kawaoka, Tomokazu; Takaki, Shintaro; Hiramatsu, Akira; Waki, Koji; Takahashi, Shoichi; Kimura, Tomoki; Kenjo, Masahiro; Nagata, Yasushi; Ishikawa, Masaki; Kakizawa, Hideaki; Awai, Kazuo; Chayama, Kazuaki

    2012-05-01

      We investigated the efficacy of hepatic arterial infusion chemotherapy (HAIC) using 5-fluorouracil (5-FU) and systemic interferon (IFN)-α (HAIC-5-FU/IFN) for advanced hepatocellular carcinoma (HCC) with venous tumor thrombosis (VTT) in the hepatic vein trunk (Vv2) or inferior vena cava (Vv3).   Thirty-three patients with HCC/Vv2/3 underwent HAIC with 5-FU (500 mg/body weight/day, into hepatic artery on days 1-5 on the first and second weeks) and IFN-α (recombinant IFN-α-2b 3 000 000 U or natural IFN-α 5 000 000 U, intramuscularly on days 1, 3 and 5 of each week). Three-dimensional conformal radiotherapy (3D-CRT) was used in combination with HAIC-5-FU/IFN in 14 of 33 patients to reduce VTT.   The median survival time (MST) was 7.9 months, and 1- and 2-year survival rates were 30% and 20%, respectively. Evaluation of intrahepatic response after two cycles of HAIC-5-FU/IFN showed complete response (CR) in three (9%) and partial response (PR) in seven (21%), with an objective response rate of 30%. Multivariate analysis identified reduction of VTT (P = 0.0006), size of largest tumor (P = 0.013) and intrahepatic response CR/PR (P = 0.030) as determinants of survival. CR/PR correlated significantly with tumor liver occupying rate (P = 0.016) and hepatitis C virus Ab (P = 0.010). Reduction of VTT correlated significantly with radiotherapy (P = 0.021) and platelet count (P = 0.015). Radiotherapy-related reduction in VTT significantly improved survival of 16 patients with Vv3 and non-CR/PR response of HAIC-5-FU/IFN (P = 0.028).   As for advanced HCC with VTT of Vv2/3, HAIC-5-FU/IFN responsive patients could obtain favorable survival. Despite ineffective HAIC-5-FU/IFN, the combination with effective radiotherapy to VTT might improve patients' prognosis. © 2011 The Japan Society of Hepatology.

  8. PubChem3D: Biologically relevant 3-D similarity

    Directory of Open Access Journals (Sweden)

    Kim Sunghwan

    2011-07-01

    Full Text Available Abstract Background The use of 3-D similarity techniques in the analysis of biological data and virtual screening is pervasive, but what is a biologically meaningful 3-D similarity value? Can one find statistically significant separation between "active/active" and "active/inactive" spaces? These questions are explored using 734,486 biologically tested chemical structures, 1,389 biological assay data sets, and six different 3-D similarity types utilized by PubChem analysis tools. Results The similarity value distributions of 269.7 billion unique conformer pairs from 734,486 biologically tested compounds (all-against-all from PubChem were utilized to help work towards an answer to the question: what is a biologically meaningful 3-D similarity score? The average and standard deviation for the six similarity measures STST-opt, CTST-opt, ComboTST-opt, STCT-opt, CTCT-opt, and ComboTCT-opt were 0.54 ± 0.10, 0.07 ± 0.05, 0.62 ± 0.13, 0.41 ± 0.11, 0.18 ± 0.06, and 0.59 ± 0.14, respectively. Considering that this random distribution of biologically tested compounds was constructed using a single theoretical conformer per compound (the "default" conformer provided by PubChem, further study may be necessary using multiple diverse conformers per compound; however, given the breadth of the compound set, the single conformer per compound results may still apply to the case of multi-conformer per compound 3-D similarity value distributions. As such, this work is a critical step, covering a very wide corpus of chemical structures and biological assays, creating a statistical framework to build upon. The second part of this study explored the question of whether it was possible to realize a statistically meaningful 3-D similarity value separation between reputed biological assay "inactives" and "actives". Using the terminology of noninactive-noninactive (NN pairs and the noninactive-inactive (NI pairs to represent comparison of the "active/active" and

  9. IMAGE-GUIDED RADIOTHERAPY AND -BRACHYTHERAPY FOR CERVICAL CANCER

    Directory of Open Access Journals (Sweden)

    Suresh eDutta

    2015-03-01

    Full Text Available Conventional radiotherapy for cervical cancer relies on clinical examination, 3-dimensional conformal radiotherapy (3D-CRT, and 2-dimensional intracavitary brachytherapy.Excellent local control and survival have been obtained for small early stage cervical cancer with definitive radiotherapy. For bulky and locally advanced disease, the addition of chemotherapy has improved the prognosis but toxicity remains significant. New imaging technology such as positron emission tomography (PET and magnetic resonance imaging (MRI has improved tumor delineation for radiotherapy planning. Image-guided radiotherapy (IGRT may decrease treatment toxicity of whole pelvic radiation because of its potential for bone marrow, bowel, and bladder sparring. Tumor shrinkage during whole pelvic IGRT may optimize image-guided brachytherapy (IGBT, allowing for better local control and reduced toxicity for patients with cervical cancer. IGRT and IGBT should be integrated in future prospective studies for cervical cancer.

  10. Dosimetric benefits of IMRT and VMAT in the treatment of middle thoracic esophageal cancer: is the conformal radiotherapy still an alternative option?

    Science.gov (United States)

    Wu, Zhiqin; Xie, Congying; Hu, Meilong; Han, Ce; Yi, Jinling; Zhou, Yongqiang; Yuan, Huawei; Jin, Xiance

    2014-05-08

    The purpose of this study is to investigate the dosimetric differences among conformal radiotherapy (CRT), intensity-modulated radiotherapy (IMRT), and volumetric-modulated radiotherapy (VMAT) in the treatment of middle thoracic esophageal cancer, and determine the most appropriate treatment modality. IMRT and one-arc VMAT plans were generated for eight middle thoracic esophageal cancer patients treated previous with CRT. The planning target volume (PTV) coverage and protections on organs at risk of three planning schemes were compared. All plans have sufficient PTV coverage and no significant differences were observed, except for the conformity and homogeneity. The lung V5, V10, and V13 in CRT were 47.9% ± 6.1%, 36.5% ± 4.6%, and 33.2% ± 4.2%, respectively, which were greatly increased to 78.2% ± 13.7% (p VMAT, respectively. The lung V20 (p = 0.03) in VMAT and the V30 (p = 0.04) in IMRT were lower than those in CRT. Both IMRT and VMAT achieved a better protection on heart. However, the volumes of the healthy tissue outside of PTV irradiated by a low dose were higher for IMRT and VMAT. IMRT and VMAT also had a higher MU, optimization time, and delivery time compared to CRT. In conclusion, all CRT, IMRT, and VMAT plans are able to meet the prescription and there is no clear distinction on PTV coverage. IMRT and VMAT can only decrease the volume of lung and heart receiving a high dose, but at a cost of delivering low dose to more volume of lung and normal tissues. CRT is still a feasible option for middle thoracic esophageal cancer radiotherapy, especially for the cost-effective consideration.

  11. Late xerostomia after intensity-modulated conformational radiotherapy of upper aero-digestive tract cancers: study 2004-03 by the head and neck oncology and radiotherapy Group (Gortec); Xerostomie tardive apres radiotherapie conformationnelle avec modulation d'intensite des cancers des voies aero-digestives superieures: etude 2004-03 du Groupe oncologie et radiotherapie de la tete et du cou (Gortec)

    Energy Technology Data Exchange (ETDEWEB)

    Toledano, I.; Lapeyre, M. [Centre Jean-Perrin, 63 - Clermont-Ferrand (France); Graff, P. [Centre Alexis-Vautrin, 54 - Vandoeuvre-les-Nancy (France); Serre, C. [Centre Val d' Aurelle, 34 - Montpellier (France); Bensadoun, R.J. [CHU La Miletrie, 86 - Poitiers (France); Bensadoun, R.J.; Ortholan, C. [Centre Antoine-Lacassagne, 06 - Nice (France); Calais, G. [CHU Bretonneau, 37 - Tours (France); Alfonsi, M. [Institut Sainte-Catherine, 84 - Avignon (France); Giraud, P. [Institut Curie, 75 - Paris (France); Hopital europeen Georges-Pompidou, 75 - Paris (France); Racadot, S. [Centre Leon-Berrard, 69 - Lyon (France)

    2010-10-15

    The authors report a retrospective assessment of late xerostomia according to the RTOG (Radiation Therapy Oncology Group) classification of the European Organization for Research and Treatment of Cancer (EORTC) among patients treated by intensity-modulated conformational radiotherapy (IMRT) and suffering from upper aero-digestive tract carcinomas of different stages. Some of these patients have bee operated, and some have been treated by chemotherapy. It appears that the IMRT results in a reduction of late xerostomia, and even in an absence of salivary toxicity. Short communication

  12. Dosimetric Study of Current Treatment Options for Radiotherapy in Retinoblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Eldebawy, Eman [Department of Radiation Oncology, McGill University Health Centre, Montreal, Quebec (Canada); Department of Radiation Oncology, Children' s Cancer Hospital, Cairo (Egypt); Parker, William, E-mail: william.parker@mcgill.ca [Department of Medical Physics, McGill University Health Centre, Montreal, Quebec (Canada); Abdel Rahman, Wamied [Department of Medical Physics, McGill University Health Centre, Montreal, Quebec (Canada); Freeman, Carolyn R. [Department of Radiation Oncology, McGill University Health Centre, Montreal, Quebec (Canada)

    2012-03-01

    Purpose: To determine the best treatment technique for patients with retinoblastoma requiring radiotherapy to the whole eye. Methods and Materials: Treatment plans for 3 patients with retinoblastoma were developed using 10 radiotherapy techniques including electron beams, photon beam wedge pair (WP), photon beam three-dimensional conformal radiotherapy (3D-CRT), fixed gantry intensity-modulated radiotherapy (IMRT), photon volumetric arc therapy (VMAT), fractionated stereotactic radiotherapy, and helical tomotherapy (HT). Dose-volume analyses were carried out for each technique. Results: All techniques provided similar target coverage; conformity was highest for VMAT, nine-field (9F) IMRT, and HT (conformity index [CI] = 1.3) and lowest for the WP and two electron techniques (CI = 1.8). The electron techniques had the highest planning target volume dose gradient (131% of maximum dose received [D{sub max}]), and the CRT techniques had the lowest (103% D{sub max}) gradient. The volume receiving at least 20 Gy (V{sub 20Gy}) for the ipsilateral bony orbit was lowest for the VMAT and HT techniques (56%) and highest for the CRT techniques (90%). Generally, the electron beam techniques were superior in terms of brain sparing and delivered approximately one-third of the integral dose of the photon techniques. Conclusions: Inverse planned image-guided radiotherapy delivered using HT or VMAT gives better conformity index, improved orbital bone and brain sparing, and a lower integral dose than other techniques.

  13. 3D video

    CERN Document Server

    Lucas, Laurent; Loscos, Céline

    2013-01-01

    While 3D vision has existed for many years, the use of 3D cameras and video-based modeling by the film industry has induced an explosion of interest for 3D acquisition technology, 3D content and 3D displays. As such, 3D video has become one of the new technology trends of this century.The chapters in this book cover a large spectrum of areas connected to 3D video, which are presented both theoretically and technologically, while taking into account both physiological and perceptual aspects. Stepping away from traditional 3D vision, the authors, all currently involved in these areas, provide th

  14. 3D Animation Essentials

    CERN Document Server

    Beane, Andy

    2012-01-01

    The essential fundamentals of 3D animation for aspiring 3D artists 3D is everywhere--video games, movie and television special effects, mobile devices, etc. Many aspiring artists and animators have grown up with 3D and computers, and naturally gravitate to this field as their area of interest. Bringing a blend of studio and classroom experience to offer you thorough coverage of the 3D animation industry, this must-have book shows you what it takes to create compelling and realistic 3D imagery. Serves as the first step to understanding the language of 3D and computer graphics (CG)Covers 3D anim

  15. 保角特征结合改进差分进化算法的三维人脸识别%3D face recognition based on fusion of conformal features and improved differential evolution algorithm

    Institute of Scientific and Technical Information of China (English)

    刘述木; 杨建; 陈跃

    2016-01-01

    As the problem of the high complexity of 3D face recognition and 2D face recognition not providing granular clues, this paper proposed a fully automatic 3D facial expression recognition algorithm.It provided more clues than that of 2D face recognition and reduced the computational complexity at the same time.Firstly,it transformed 3D face into a 2D plane by con-formal mapping,retaining the changing of facial clues.Secondly,it proposed an optimization algorithm based on differential e-volution (DE)algorithm to improve the recognition efficiency,while extracting the best facial feature set and classification pa-rameters,and speed up robust features (SURF)described all the expected facial feature points.Experimental results on the data sets of Bosphorus,FRGC v2 and gathered face data sets show that the proposed algorithm solves high computational com-plexity of 3D face recognition and low clues of 2D face recognition.This algorithm greatly reduces the cost without lowering the recognition performance,compared to several more advanced 3D face recognition algorithm,the algorithm achieves better reco-gnition results,expecting to be applied to commercial face recognition systems.%针对三维人脸识别的高复杂度和二维人脸识别无法提供粒状线索的问题,提出一种全自动3D 人脸表情识别算法,该算法主要是提供比2D 人脸识别更多的线索,同时降低计算复杂度。通过保角映射将3D 人脸转换到2D 平面,保留了面部变化的线索,提出了基于优化算法的差分进化(DE)算法用于提高识别效率,同时提取最优人脸特征集和分类器参数,加速鲁棒特征池描述了所有预期的人脸特征点。在博斯普鲁斯、FRGC v2及笔者搜集的人脸数据集上的实验结果表明,算法解决了三维人脸识别的高计算复杂度和二维人脸识别的线索低的问题,并在不降低识别性能的前提下大大地节约了成本,相比几种较为先进的三

  16. SU-E-T-63: Carotid Sparing Tomohelical Three Dimensional Conformal Radiotherapy for T1N0 Glottic Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hong, C; Ju, S; Ahn, Y; Oh, D; Noh, J; Chung, K; Kim, J; Han, Y; Choi, D [Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2014-06-01

    Purpose: We investigated the dosimetric benefit and treatment efficiency of carotid-sparing TomoHelical (TH) three-dimensional conformal radiotherapy (3DCRT) for early glottic cancer. Methods: Computed tomography (CT) simulation was performed for 10 patients with early-stage (T1N0M0) glottic squamous cell carcinoma. The clinical target volume, planning target volume (PTV), carotid artery (CA), and spinal cord (SP) were delineated for each CT data set. Two-field 3DCRT (2F-3DCRT), three-field intensity-modulated radiation therapy (IMRT) (3F-IMRT), TomoHelical-IMRT (TH-IMRT), and TH-3DCRT plans were generated, with a total prescribed dose of 67.5 Gy in 30 fractions to the PTV for each patient. In order to evaluate plan quality, dosimetric characteristics were compared in terms of the conformity index (CI) and homogeneity index (HI) for the PTV, V35, V50, and V63 for the CAs and in terms of the maximum dose for the SP. Additionally, treatment planning and delivery times were compared to evaluate treatment efficiency. Results: The CIs for 3F-IMRT (0.650±0.05), TH-IMRT (0.643±0.03), and TH-3DCRT (0.631±0.03) were much better than that for 2F-3DCRT (0.318±0.03). The HIs for TH-IMRT (1.053±0.01) and TH-3DCRT (1.055±0.01) were slightly better than those for 2F-3DCRT (1.062±0.01) and 3F-IMRT (1.091±0.007). 2F-3DCRT showed poor CA sparing in terms of the V35, V50, and V63 compared to 3F-IMRT, TH-IMRT, and TH-3DCRT (p<0.05), whereas there was no significant dose difference between 3F-IMRT, TH-IMRT, and TH-3DCRT (p>0.05). The maximum dose to the SP with all plans was below 45 Gy. The treatment planning times for 2F-3DCRT (5.9±0.66 min) and TH-3DCRT (7.32±0.94 min) were much lower than those for 3F-IMRT (45.51±2.76 min) and TH-IMRT (35.58±4.41 min), whereas the delivery times with all plans was below 3 minutes. Conclusion: TH-3DCRT showed excellent carotid sparing capability, comparable to that with TH-IMRT, with high treatment efficiency and short planning and

  17. Delineation of target volumes and organs at risk in adjuvant radiotherapy of early breast cancer

    DEFF Research Database (Denmark)

    Nielsen, Mette H; Berg, Martin; Pedersen, Anders N

    2013-01-01

    During the past decade planning of adjuvant radiotherapy (RT) of early breast cancer has changed from two-dimensional (2D) to 3D conformal techniques. In the planning computerised tomography (CT) scan both the targets for RT and the organs at risk (OARs) are visualised, enabling an increased focu...

  18. Prone Whole-Breast Irradiation Using Three-Dimensional Conformal Radiotherapy in Women Undergoing Breast Conservation for Early Disease Yields High Rates of Excellent to Good Cosmetic Outcomes in Patients With Large and/or Pendulous Breasts

    Energy Technology Data Exchange (ETDEWEB)

    Bergom, Carmen; Kelly, Tracy; Morrow, Natalya; Wilson, J. Frank [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States); Walker, Alonzo [Department of Surgery, Medical College of Wisconsin, Milwaukee, WI (United States); Xiang Qun; Ahn, Kwang Woo [Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WI (United States); White, Julia, E-mail: jwhite@mcw.edu [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States)

    2012-07-01

    Purpose: To report our institution's experience using prone positioning for three-dimensional conformal radiotherapy (3D-CRT) to deliver post-lumpectomy whole breast irradiation (WBI) in a cohort of women with large and/or pendulous breasts, to determine the rate of acute and late toxicities and, more specifically, cosmetic outcomes. We hypothesized that using 3D-CRT for WBI in the prone position would reduce or eliminate patient and breast size as negative prognostic indicators for toxicities associated with WBI. Methods and Materials: From 1998 to 2006, 110 cases were treated with prone WBI using 3D-CRT. The lumpectomy, breast target volumes, heart, and lung were contoured on all computed tomography scans. A dose of 45-50 Gy was prescribed to the breast volume using standard fractionation schemes. The planning goals were {>=}95% of prescription to 95% of the breast volume, and 100% of boost dose to 95% of lumpectomy planning target volume. Toxicities and cosmesis were prospectively scored using the Common Terminology Criteria for Adverse Effects Version 3.0 and the Harvard Scale. The median follow-up was 40 months. Results: The median body mass index (BMI) was 33.6 kg/m{sup 2}, and median breast volume was 1396 cm{sup 3}. The worst toxicity encountered during radiation was Grade 3 dermatitis in 5% of our patient population. Moist desquamation occurred in 16% of patients, with only 2% of patients with moist desquamation outside the inframammary/axillary folds. Eleven percent of patients had Grade {>=}2 late toxicities, including Grade 3 induration/fibrosis in 2%. Excellent to good cosmesis was achieved in 89%. Higher BMI was associated with moist desquamation and breast pain, but BMI and breast volume did not impact fibrosis or excellent to good cosmesis. Conclusion: In patients with higher BMI and/or large-pendulous breasts, delivering prone WBI using 3D-CRT results in favorable toxicity profiles and high excellent to good cosmesis rates. Higher BMI was

  19. Proton Radiotherapy for Pediatric Sarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Ladra, Matthew M.; Yock, Torunn I., E-mail: tyock@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA 02114 (United States)

    2014-01-14

    Pediatric sarcomas represent a distinct group of pathologies, with approximately 900 new cases per year in the United States alone. Radiotherapy plays an integral role in the local control of these tumors, which often arise adjacent to critical structures and growing organs. The physical properties of proton beam radiotherapy provide a distinct advantage over standard photon radiation by eliminating excess dose deposited beyond the target volume, thereby reducing both the dose of radiation delivered to non-target structures as well as the total radiation dose delivered to a patient. Dosimetric studies comparing proton plans to IMRT and 3D conformal radiation have demonstrated the superiority of protons in numerous pediatric malignancies and data on long-term clinical outcomes and toxicity is emerging. In this article, we review the existing clinical and dosimetric data regarding the use of proton beam radiation in malignant bone and soft tissue sarcomas.

  20. EUROPEANA AND 3D

    Directory of Open Access Journals (Sweden)

    D. Pletinckx

    2012-09-01

    Full Text Available The current 3D hype creates a lot of interest in 3D. People go to 3D movies, but are we ready to use 3D in our homes, in our offices, in our communication? Are we ready to deliver real 3D to a general public and use interactive 3D in a meaningful way to enjoy, learn, communicate? The CARARE project is realising this for the moment in the domain of monuments and archaeology, so that real 3D of archaeological sites and European monuments will be available to the general public by 2012. There are several aspects to this endeavour. First of all is the technical aspect of flawlessly delivering 3D content over all platforms and operating systems, without installing software. We have currently a working solution in PDF, but HTML5 will probably be the future. Secondly, there is still little knowledge on how to create 3D learning objects, 3D tourist information or 3D scholarly communication. We are still in a prototype phase when it comes to integrate 3D objects in physical or virtual museums. Nevertheless, Europeana has a tremendous potential as a multi-facetted virtual museum. Finally, 3D has a large potential to act as a hub of information, linking to related 2D imagery, texts, video, sound. We describe how to create such rich, explorable 3D objects that can be used intuitively by the generic Europeana user and what metadata is needed to support the semantic linking.

  1. The European Society of Therapeutic Radiology and Oncology-European Institute of Radiotherapy (ESTRO-EIR) report on 3D CT-based in-room image guidance systems: a practical and technical review and guide

    DEFF Research Database (Denmark)

    Korreman, Stine; Rasch, Coen; McNair, Helen

    2010-01-01

    The past decade has provided many technological advances in radiotherapy. The European Institute of Radiotherapy (EIR) was established by the European Society of Therapeutic Radiology and Oncology (ESTRO) to provide current consensus statement with evidence-based and pragmatic guidelines on topics...

  2. Advances in conformal radiotherapy using Monte Carlo Code to design new IMRT and IORT accelerators and interpret CT numbers

    CERN Document Server

    Wysocka-Rabin, A

    2013-01-01

    The introductory chapter of this monograph, which follows this Preface, provides an overview of radiotherapy and treatment planning. The main chapters that follow describe in detail three significant aspects of radiotherapy on which the author has focused her research efforts. Chapter 2 presents studies the author worked on at the German National Cancer Institute (DKFZ) in Heidelberg. These studies applied the Monte Carlo technique to investigate the feasibility of performing Intensity Modulated Radiotherapy (IMRT) by scanning with a narrow photon beam. This approach represents an alternative to techniques that generate beam modulation by absorption, such as MLC, individually-manufactured compensators, and special tomotherapy modulators. The technical realization of this concept required investigation of the influence of various design parameters on the final small photon beam. The photon beam to be scanned should have a diameter of approximately 5 mm at Source Surface Distance (SSD) distance, and the penumbr...

  3. IZDELAVA TISKALNIKA 3D

    OpenAIRE

    Brdnik, Lovro

    2015-01-01

    Diplomsko delo analizira trenutno stanje 3D tiskalnikov na trgu. Prikazan je razvoj in principi delovanja 3D tiskalnikov. Predstavljeni so tipi 3D tiskalnikov, njihove prednosti in slabosti. Podrobneje je predstavljena zgradba in delovanje koračnih motorjev. Opravljene so meritve koračnih motorjev. Opisana je programska oprema za rokovanje s 3D tiskalniki in komponente, ki jih potrebujemo za izdelavo. Diploma se oklepa vprašanja, ali je izdelava 3D tiskalnika bolj ekonomična kot pa naložba v ...

  4. Evaluation of homogeneity and dose conformity in IMRT planning in prostate radiotherapy; Avaliacao da homogeneidade e conformidade de dose em planejamentos de IMRT de prostata em radioterapia

    Energy Technology Data Exchange (ETDEWEB)

    Lopes, Juliane S.; Leidens, Matheus; Estacio, Daniela R., E-mail: juliane.lopes@pucrs.br [Hospital Sao Lucas (PUC-RS), Porto Alegre, RS (Brazil). Servico de Radioterapia; Razera, Ricardo A.Z.; Streck, Elaine E.; Silva, Ana M.M. da [Pontificia Universidade Catolica do Rio Grande do Sul (PUC-RS), Porto Alegre, RS (Brazil). Faculdade de Fisica

    2015-12-15

    The goal of this study was to evaluate the dose distribution homogeneity and conformity of radiation therapy plans of prostate cancer using IMRT. Data from 34 treatment plans of Hospital Sao Lucas of PUCRS, where those plans were executed, were retrospectively analyzed. All of them were done with 6MV X-rays from a linear accelerator CLINAC IX, and the prescription doses varied between 60 and 74 Gy. Analyses showing the homogeneity and conformity indices for the dose distribution of those plans were made. During these analyses, some comparisons with the traditional radiation therapy planning technic, the 3D-CRT, were discussed. The results showed that there is no correlation between the prescribed dose and the homogeneity and conformity indices, indicating that IMRT works very well even for higher doses. Furthermore, a comparison between the results obtained and the recommendations of ICRU 83 was carried out. It has also been observed that the indices were really close to the ideal values. 82.4% of the cases showed a difference below 5% of the ideal value for the index of conformity, and 88.2% showed a difference below 10% for the homogeneity index. Concluding, it is possible to confirm the quality of the analyzed radiation therapy plans of prostate cancer using IMRT. (author)

  5. 三维适形放疗和适形调强放疗技术对鼻咽癌放疗后颞颌关节损伤的影响%Comparison of temporomandibular joint injuries after three-dimensional conformal and intensity-modulated radiotherapies for nasopharyngeal carcinoma

    Institute of Scientific and Technical Information of China (English)

    陈冬平; 余意; 齐斌; 刘锦全; 李铭仪; 梁玉莹

    2012-01-01

    Objective To compare the radiation injuries of the temporomandibular joint (TMJ) following three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) in patients with nasopharyngeal carcinoma (NPC). Methods Thirty-nine NPC patients without previous radiotherapy underwent 3D-CRT and another 32 received IMRT in our institute. The distance between the 2 dens incisivus medialis (DDIM) and LENT SOMA criteria were employed to evaluate TMJ injuries, clinical outcomes, and the performance-to-price ratios. Results The short-term local response rates were similar between the two groups (P=0.878). The mean radiation doses of the TMJ were significantly higher in 3D-CRT group than in IMRT group (57.06 us 40.90 Gy, P0.05). Conclusion Radiation injuries of the TMJ are tolerable in both 3D-CRT and IMRT groups, and 3D-CRT is a more economic choice for patients who can not afford IMRT.%目的 观察不同放疗方式对患者颞颌关节损伤的影响,为不同条件的患者制定个体化的放疗计划提供参考.方法 回顾性分析71例初治鼻咽癌患者,三维适形放疗(3D-CRT)组39例,适形调强放疗(IMRT)组32例,以门齿距及LENT SOMA标准为评价指标,比较两组之间疗效及性价比.结果 3D-CRT组近期局部控制率与IMRT组无差异(P=0.878);3D-CRT组的颞颌关节受量高于IMRT组(平均57.06 Gy和40.90 Gy,P<0.001);比较两组放疗后1年与放疗前 门齿距差值,3D-CRT组缩小较明显,具有统计学意义(P<0.05);两组患者颞颌关节损伤按SOMA分级标准比较,无统计学差异(P>0 05).结论 相对于IMRT技术来说,3D-CRT技术具有很好的经济优势,颞颌关节的损伤可耐受,3D-CRT技术对于经济条件较差的患者仍是性价比较好的治疗选择.

  6. 3D and Education

    Science.gov (United States)

    Meulien Ohlmann, Odile

    2013-02-01

    Today the industry offers a chain of 3D products. Learning to "read" and to "create in 3D" becomes an issue of education of primary importance. 25 years professional experience in France, the United States and Germany, Odile Meulien set up a personal method of initiation to 3D creation that entails the spatial/temporal experience of the holographic visual. She will present some different tools and techniques used for this learning, their advantages and disadvantages, programs and issues of educational policies, constraints and expectations related to the development of new techniques for 3D imaging. Although the creation of display holograms is very much reduced compared to the creation of the 90ies, the holographic concept is spreading in all scientific, social, and artistic activities of our present time. She will also raise many questions: What means 3D? Is it communication? Is it perception? How the seeing and none seeing is interferes? What else has to be taken in consideration to communicate in 3D? How to handle the non visible relations of moving objects with subjects? Does this transform our model of exchange with others? What kind of interaction this has with our everyday life? Then come more practical questions: How to learn creating 3D visualization, to learn 3D grammar, 3D language, 3D thinking? What for? At what level? In which matter? for whom?

  7. Influence of gross tumor volume and radiotherapy dose on prognosis of three dimensional conformal ;radiation therapy for locally advanced non-small cell lung cancer%肿瘤体积和放疗剂量对局部晚期非小细胞肺癌三维适形放疗预后的影响

    Institute of Scientific and Technical Information of China (English)

    刘兴祥

    2015-01-01

    Objective To investigate influence of gross tumor volume and radiotherapy dose on prognosis of three dimensional conformal radiation therapy (3D-CRT) for locally advanced non-small cell lung cancer (NSCLC). Methods There were 78 locally advanced NSCLC patients receiving 3D-CRT as study subjects. Three dimensional conformal radiation planning system and CT screening were applied for delineating corresponding target sections, as GTV-T, GTV-P and GTV-N. Gross tumor volume and radiotherapy dose in each target section were analyzed for their prognosis effects. Results Patients with tumor diameter<5.00 cm had higher survival rate than those with tumor diameter≥5.00 cm (P<0.05). Patients with GTV-T<100.00 cm3 had obviously higher survival rate than those with GTV-T≥100.00 cm3 (P<0.05). Stratification analysis showed that in subgroup with radiotherapy dose ≤66 Gy, the survival rate increased while gross tumor volume declined. Conclusion Gross tumor volume shown by three dimensional conformal radiation planning system and CT screening has remarkable influence on long-term survival rate in NSCLC patients. It is also beneficial for locally advanced NSCLC patients receiving large radiotherapy dose for small tumor volume.%目的:探讨肿瘤体积和放疗剂量对局部晚期非小细胞肺癌(NSCLC)三维适形放疗(3D-CRT)预后的影响。方法78例接受3D-CRT的局部晚期NSCLC患者为研究对象,利用三维适形放射计划系统和CT扫描勾画相应靶区,分别定义为GTV-T、GTV-P和GTV-N,分析各靶区肿瘤体积和放疗剂量对3D-CRT的预后效果。结果全组研究对象中肿瘤最大直径<5.00 cm的患者生存率高于肿瘤最大直径≥5.00 cm的患者(P<0.05);GTV-T<100.00 cm3的患者生存率明显高于GTV-T≥100.00 cm3的患者(P<0.05)。分层分析显示放疗处方剂量≤66 Gy亚组中,肿瘤大体体积越小,生存率越高。结论应用三维适形放射计划系统和CT扫描所勾画的大体肿瘤体积对接受

  8. Evaluation of conformal radiotherapy techniques through physics and biologic criteria; Avaliacao de tecnicas radioterapicas conformacionais utilizando criterios fisicos e biologicos

    Energy Technology Data Exchange (ETDEWEB)

    Bloch, Jonatas Carrero

    2012-07-01

    In the fight against cancer, different irradiation techniques have been developed based on technological advances and aiming to optimize the elimination of tumor cells with the lowest damage to healthy tissues. The radiotherapy planning goal is to establish irradiation technical parameters in order to achieve the prescribed dose distribution over the treatment volumes. While dose prescription is based on radiosensitivity of the irradiated tissues, the physical calculations on treatment planning take into account dosimetric parameters related to the radiation beam and the physical characteristics of the irradiated tissues. To incorporate tissue's radiosensitivity into radiotherapy planning calculations can help particularize treatments and establish criteria to compare and elect radiation techniques, contributing to the tumor control and the success of the treatment. Accordingly, biological models of cellular response to radiation have to be well established. This work aimed to study the applicability of using biological models in radiotherapy planning calculations to aid evaluating radiotherapy techniques. Tumor control probability (TCP) was studied for two formulations of the linear-quadratic model, with and without repopulation, as a function of planning parameters, as dose per fraction, and of radiobiological parameters, as the α/β ratio. Besides, the usage of biological criteria to compare radiotherapy techniques was tested using a prostate planning simulated with Monte Carlo code PENELOPE. Afterwards, prostate planning for five patients from the Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto, USP, using three different techniques were compared using the tumor control probability. In that order, dose matrices from the XiO treatment planning system were converted to TCP distributions and TCP-volume histograms. The studies performed allow the conclusions that radiobiological parameters can significantly influence tumor control

  9. TEHNOLOGIJE 3D TISKALNIKOV

    OpenAIRE

    Kolar, Nataša

    2016-01-01

    Diplomsko delo predstavi razvoj tiskanja skozi čas. Podrobneje so opisani 3D tiskalniki, ki uporabljajo različne tehnologije 3D tiskanja. Predstavljene so različne tehnologije 3D tiskanja, njihova uporaba in narejeni prototipi oz. končni izdelki. Diplomsko delo opiše celoten postopek, od zamisli, priprave podatkov in tiskalnika do izdelave prototipa oz. končnega izdelka.

  10. 3D virtuel udstilling

    DEFF Research Database (Denmark)

    Tournay, Bruno; Rüdiger, Bjarne

    2006-01-01

    3d digital model af Arkitektskolens gård med virtuel udstilling af afgangsprojekter fra afgangen sommer 2006. 10 s.......3d digital model af Arkitektskolens gård med virtuel udstilling af afgangsprojekter fra afgangen sommer 2006. 10 s....

  11. PET/CT对非小细胞肺癌三维适形放疗中治疗计划参数的影响%Impact of PET/CT on dosimetric parameters of three-dimensional conformal radiotherapy planning in patients with non-small cell lung cancer

    Institute of Scientific and Technical Information of China (English)

    王天禄; 李光; 宋颖秋; 党军; 陈延治; 白露

    2012-01-01

    目的:观察PET/CT对非小细胞肺癌(NSCLC)三维适形放疗(3D-CRT)中治疗计划参数的影响.方法:对83例在PET/CT定位下拟行根治性3D-CRT的NSCLC患者,分别以CT图像和PET/CT融合图像勾画大体肿瘤靶区(GTVCT和GTVPET/CT),分别制定放疗计划,并对两者进行比较.结果:PET/CT明显改变44例(53.01%)患者GTV或PTV,31例PTV和(或)GTV减小,13例PTV和(或)GTV增加.根据PET/CT和CT分别制定的放疗计划在VGTV、VE50、SCM和ESM的差异有统计学意义,P值分别为0.001、0.001、0.000和0.002.结论:应用PET/CT制定NSCLC3D-CRT治疗计划可降低食管和脊髓的受照射剂量,从而有利于放疗剂量的提升.%OBJECTIVE: To investigate the impact of PET/CT on three-dimensional conformal radiotherapy (3D-CRT) planning of non-small cell lung cancer(NSCLC). METHODS: PET/CT scanning was performed in 83 pathologically proven NSCLC patients for radical radiotherapy. The gross tumor volume(GTV) was delineated on the CT images (GTVct) alone and then coregestered CT and 18F-FDG-PET data(GTVpET/cT). For each patient, two three-dimensional conformal radiotherapy plans were made: one with a CT-based target volume and one with a PET/CT-based target volume. From the dose-volume histograms and dose distributions on each plan, the dosimetric factors were analyzed and compared. RESULTS: PET/CT clearly altered the radiation therapy volume in 44 (53. 01% ,44/83) cases, while 31 with the reduction of planning target volume (PTV) and/or GTV, and 13 with the enlargement. Between the PET/CT and CT radiotherapy planning, the difference of volume of GTV (VCTv) and dosimetric parameters including esophageal volume receiving at least 50 Gy (Ve50), the maximum dose of spinal cord receiving(SCM) and the maximum dose of esophagus re-ceiving(ESM) were statistically significant (P were 0. 001, 0. 001, 0. 000 and 0. 002). CONCLUSION: The incorporation of 18 F-FDG-PET information in CT-based radiotherapy planning reduced the radiation

  12. 三维适形放疗配合全脑照射治疗脑转移瘤的疗效观察%The effects of three-dimensional conformal radiotherapy combined with whole brain irradiation on brain metastases

    Institute of Scientific and Technical Information of China (English)

    Jin Hu; Yeqing Zhou; Mi Liu

    2009-01-01

    Objective: To observe the recently therapeutic effects and toxicity of three-dimensional conformal radiotherapy combined with whole brain irradiation for patients with brain metastasis. Methods: 33 cases were treated by whole brain irradiation at first, the dose of which was 36-40 Gy (18-20 f). Then three-dimensional conformal radiotherapy was added to the focus with a total dose of 20-25 Gy, whose fractionated dose was 2-5 Gy/time, 5 times/week or 3 times/week. Results: Within 1 month after radiotherapy, according to imaging of the brain, the CR of all patients was 45.5%, PR 36.4%, NC 15.1%, and PD 3%. For the 32 cases with neural symptoms before radiation, the CR of the symptoms was 40.6% and PR 59.4%. All patients gained different increases in KPS grade. By the end of the follow-up period, there were 22 deaths with the mean survival time up to 9.3 months. Conclusion: Three-dimensional conformal radiotherapy combined with whole brain irradiation can not only effectively control brain metastases and improve life quality, but also tends to prolong survival time.

  13. Blender 3D cookbook

    CERN Document Server

    Valenza, Enrico

    2015-01-01

    This book is aimed at the professionals that already have good 3D CGI experience with commercial packages and have now decided to try the open source Blender and want to experiment with something more complex than the average tutorials on the web. However, it's also aimed at the intermediate Blender users who simply want to go some steps further.It's taken for granted that you already know how to move inside the Blender interface, that you already have 3D modeling knowledge, and also that of basic 3D modeling and rendering concepts, for example, edge-loops, n-gons, or samples. In any case, it'

  14. Three-dimensional conformal radiotherapy plus concurrent DICE chemotherapy for early-stage nasal-type natural killer/T-cell lymphoma of Waldeyer’s ring:A single-institution study

    Institute of Scientific and Technical Information of China (English)

    Ji Zhou; Daiyuan Ma; Yeqin Zhou; Xianfu Li; Bangxian Tan; Mi Liu; Tao Ren

    2015-01-01

    Objective Nasal-type natural kil er/T-cel lymphoma of Waldeyer’s ring (WR-NK/TL) has dif erent clinico-pathological characteristics from those of other subtypes of NK/T lymphoma; thus, the optimal treatment remains unclear. To find a more ef ective treatment model for WR-NK/TL, we conducted a single-center study of concurrent radiochemotherapy. Methods Forty-five patients with newly diagnosed stage IE to IIE WR-NKTL were randomly divided into two groups. The 23 cases in the concurrent radiochemotherapy group were treated with three-dimensional conformal radiotherapy (48–52 Gy) and 2 courses of DICE (dexamethasone, ifosfamide, cisplatin, and etoposide) synchronous chemotherapy. The 22 cases in the radiotherapy group only received three-dimen-sional conformal radiotherapy (50–54 Gy). The primary end points were overal survival (OS), progression-free survival (PFS), and toxicity. Results The 1-, 3-, and 4-year OS and PFS rates were 95.5%, 65.6%, and 45.9%, and 86.4%, 56.0%, and 46.7% in the radiotherapy group, and 100%, 88.5%, and 88.5%, and 100%, 82.0%, and 73.8% in the concurrent radiochemotherapy group, respectively. The OS (P = 0.0477) and PFS rates (P = 0.0488) were higher in the concurrent radiochemotherapy group than in the radiotherapy group. The overal re-sponse rate was 100% in both the radiotherapy group [complete response (CR), 18 cases] and concurrent radiochemotherapy group (CR, 22 cases). The concurrent radiochemotherapy group had more severe side ef ects, especial y grade 3 + 4 events, such as leukopenia, anorexia, and stomatitis. However, side ef ects benefiting from excel ent oral care were endurable. Conclusion Radiotherapy plus concurrent DICE chemotherapy may be an ef ective and safe compre-hensive treatment for patients with WR-NKTL.

  15. Phase I Study of Conformal Radiotherapy and Concurrent Full-Dose Gemcitabine With Erlotinib for Unresected Pancreatic Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Robertson, John M., E-mail: jrobertson@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Margolis, Jeffrey [Division of Medical Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Jury, Robert P. [Department of Surgery, William Beaumont Hospital, Royal Oak, MI (United States); Balaraman, Savitha; Cotant, Matthew B.; Ballouz, Samer; Boxwala, Iqbal G.; Jaiyesimi, Ishmael A.; Nadeau, Laura [Division of Medical Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Hardy-Carlson, Maria [Division of Radiation Oncology, M. D. Anderson Cancer Center, Houston, TX (United States); Marvin, Kimberly S.; Wallace, Michelle; Ye Hong [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)

    2012-02-01

    Purpose: To determine the recommended dose of radiotherapy when combined with full-dose gemcitabine and erlotinib for unresected pancreas cancer. Methods and Materials: Patients with unresected pancreatic cancer (Zubrod performance status 0-2) were eligible for the present study. Gemcitabine was given weekly for 7 weeks (1,000 mg/m{sup 2}) with erlotinib daily for 8 weeks (100 mg). A final toxicity assessment was performed in Week 9. Radiotherapy (starting at 30 Gy in 2-Gy fractions, 5 d/wk) was given to the gross tumor plus a 1-cm margin starting with the first dose of gemcitabine. A standard 3 plus 3 dose escalation (an additional 4 Gy within 2 days for each dose level) was used, except for the starting dose level, which was scheduled to contain 6 patients. In general, Grade 3 or greater gastrointestinal toxicity was considered a dose-limiting toxicity, except for Grade 3 anorexia or Grade 3 fatigue alone. Results: A total of 20 patients were treated (10 men and 10 women). Nausea, vomiting, and infection were significantly associated with the radiation dose (p = .01, p = .03, and p = .03, respectively). Of the 20 patients, 5 did not complete treatment and were not evaluable for dose-escalation purposes (3 who developed progressive disease during treatment and 2 who electively discontinued it). Dose-limiting toxicity occurred in none of 6 patients at 30 Gy, 2 of 6 at 34 Gy, and 1 of 3 patients at 38 Gy. Conclusion: The results of the present study have indicated that the recommended Phase II dose is 30 Gy in 15 fractions.

  16. 3D Digital Modelling

    DEFF Research Database (Denmark)

    Hundebøl, Jesper

    wave of new building information modelling tools demands further investigation, not least because of industry representatives' somewhat coarse parlance: Now the word is spreading -3D digital modelling is nothing less than a revolution, a shift of paradigm, a new alphabet... Research qeustions. Based...... on empirical probes (interviews, observations, written inscriptions) within the Danish construction industry this paper explores the organizational and managerial dynamics of 3D Digital Modelling. The paper intends to - Illustrate how the network of (non-)human actors engaged in the promotion (and arrest) of 3......D Modelling (in Denmark) stabilizes - Examine how 3D Modelling manifests itself in the early design phases of a construction project with a view to discuss the effects hereof for i.a. the management of the building process. Structure. The paper introduces a few, basic methodological concepts...

  17. DELTA 3D PRINTER

    Directory of Open Access Journals (Sweden)

    ȘOVĂILĂ Florin

    2016-07-01

    Full Text Available 3D printing is a very used process in industry, the generic name being “rapid prototyping”. The essential advantage of a 3D printer is that it allows the designers to produce a prototype in a very short time, which is tested and quickly remodeled, considerably reducing the required time to get from the prototype phase to the final product. At the same time, through this technique we can achieve components with very precise forms, complex pieces that, through classical methods, could have been accomplished only in a large amount of time. In this paper, there are presented the stages of a 3D model execution, also the physical achievement after of a Delta 3D printer after the model.

  18. Professional Papervision3D

    CERN Document Server

    Lively, Michael

    2010-01-01

    Professional Papervision3D describes how Papervision3D works and how real world applications are built, with a clear look at essential topics such as building websites and games, creating virtual tours, and Adobe's Flash 10. Readers learn important techniques through hands-on applications, and build on those skills as the book progresses. The companion website contains all code examples, video step-by-step explanations, and a collada repository.

  19. AE3D

    Energy Technology Data Exchange (ETDEWEB)

    2016-06-20

    AE3D solves for the shear Alfven eigenmodes and eigenfrequencies in a torodal magnetic fusion confinement device. The configuration can be either 2D (e.g. tokamak, reversed field pinch) or 3D (e.g. stellarator, helical reversed field pinch, tokamak with ripple). The equations solved are based on a reduced MHD model and sound wave coupling effects are not currently included.

  20. Sucralfate versus mesalazine versus hydrocortisone in the prevention of acute radiation proctitis during conformal radiotherapy for prostate carcinoma. A randomized study

    Energy Technology Data Exchange (ETDEWEB)

    Sanguineti, G.; Franzone, P.; Marcenaro, M.; Vitale, V. [Dept. of Radiation Oncology, National Inst. for Cancer Research, Genova (Italy); Foppiano, F. [Dept. of Physics, National Inst. for Cancer Research, Genova (Italy)

    2003-07-01

    Purpose: To assess whether the topical use of steroids or 5-aminosalicylic acid (5-ASA) is superior to sucralfate in preventing acute rectal toxicity during three-dimensional conformal radiotherapy (3DCRT) to 76 Gy. Patients and Methods: Patients undergoing 3DCRT for prostate carcinoma at our institution were offered to be randomized to sucralfate 3 g in 15 ml suspension enema (Antepsin {sup trademark}), mesalazine 4 g gel enema (Enterasyn trademark), or hydrocortisone 100 mg foam enema (Colifoam {sup trademark}). Randomization was blind to the treating physician but not to the patient. Sucralfate was chosen as control arm. Topical treatment had to be performed once daily, starting on day 1 of 3DCRT. Acute rectal toxicity was scored weekly according to RTOG criteria. Time to occurrence of grade 2+ acute rectal toxicity was taken as endpoint. Results: The trial was opened in August 1999, and after the first 24 patients had been treated, arm 2 was discontinued because of eight patients receiving mesalazine, seven actually developed acute rectal toxicity (five patients grade 3 and two patients grade 2). Until May 2001, 134 consecutive patients were randomly assigned to sucralfate (63 patients), mesalazine (eight patients) or hydrocortisone (63 patients). The cumulative incidence of acute rectal toxicity at the end of treatment by arm is 61.9 {+-} 6.1%, 87.5 {+-} 11.7%, and 52.4 {+-} 6.2% for arms 1, 2, and 3, respectively. The difference between the mesalazine group and the sucralfate group is highly significant (hazard ratio [HR] 2.5, 95% confidence interval [CI] 1.1-5.7; p = 0.03). At both uni- and multivariate analysis taking into account several patients and treatment covariates, the difference between hydrocortisone and sucralfate is not significant (HR 0.7, 95% CI 0.5-1.2; p = 0.2). Conclusion: Topical mesalazine is contraindicated during radiotherapy. Hydrocortisone enema is not superior to sucralfate in preventing acute rectal toxicity. (orig.)

  1. Selection and delineation of lymph node target volume for lung cancer conformal radiotherapy. Proposal for standardizing terminology based on surgical experience

    Energy Technology Data Exchange (ETDEWEB)

    Kiricuta, I.C. [Inst. of Radiation Oncology, St. Vincenz Hospital, Limburg/Lahn (Germany)

    2001-08-01

    Purpose: To select and delineate the target volumes for definitive or postoperative radiotherapy for lung cancer. Methods and Materials: The lymphatics of the lung and the dissemination of tumor cells to the intra- and extrathoracic lymph nodes are described. The incidence of involvement of the different lymph node sites in the chest is analyzed. The involvement of the contralateral hilar and/or supraclavicular lymph nodes and the consequences for target volume selection for curative radiotherapy are discussed. CT-based nodal classification and distribution of lymph nodes in the chest in CT-axial slices are presented. The sentinel node concept (SNC) and the preliminary data available for lung cancer are described. Results: A critical review of the current TNM classification for lung cancer and the implications for target volume selection is given. The individual target volume selection and delineation have to be based on clinical and pathological data from large surgical studies and upon the individual pathological and diagnostic patient data. The selection and delineation of the clinical target volumes for definitive and for postoperative radiotherapy, dependent on the lymph node involvement, are presented. Conclusions: Criteria for the selection and delineation of the clinical target volumes for definitive and for postoperative conformal radiotherapy in axial CT slices under consideration of site, size and stage of the lung cancer are described. Recommendations for target volume selection for definitive or postoperative radiotherapy are presented. (orig.) [German] Ziel: Die Selektion und Bestimmung der klinischen Zielvolumina fuer die alleinige oder postoperative Strahlentherapie beim Bronchialkarzinom. Material und Methode: Die Lymphabflusswege der Lunge und das Verteilungsmuster der Tumorzellen in den regionalen Lymphknoten werden beschrieben. Die CT-Klassifikation und die Verteilung der intrathorakalen Lymphknoten werden vorgestellt. Der Befall der einzelnen

  2. Pulmonary Toxicity in Stage III Non-Small Cell Lung Cancer Patients Treated With High-Dose (74 Gy) 3-Dimensional Conformal Thoracic Radiotherapy and Concurrent Chemotherapy Following Induction Chemotherapy: A Secondary Analysis of Cancer and Leukemia Group B (CALGB) Trial 30105

    Energy Technology Data Exchange (ETDEWEB)

    Salama, Joseph K., E-mail: joseph.salama@duke.edu [Duke University Medical Center, Durham, NC (United States); Stinchcombe, Thomas E. [University of North Carolina at Chapel Hill, Chapel Hill, NC (United States); Gu Lin; Wang Xiaofei [CALGB Statistical Center, Duke University Medical Center, Durham, NC (United States); Morano, Karen [Quality Assurance Review Center, Lincoln, RI (United States); Bogart, Jeffrey A. [State University of New York Upstate Medical University, Syracuse, NY (United States); Crawford, Jeffrey C. [Duke University Medical Center, Durham, NC (United States); Socinski, Mark A. [University of North Carolina at Chapel Hill, Chapel Hill, NC (United States); Blackstock, A. William [Wake Forest University School of Medicine, Winston-Salem, NC (United States); Vokes, Everett E. [University of Chicago, Chicago, IL (United States)

    2011-11-15

    Purpose: Cancer and Leukemia Group B (CALGB) 30105 tested two different concurrent chemoradiotherapy platforms with high-dose (74 Gy) three-dimensional conformal radiotherapy (3D-CRT) after two cycles of induction chemotherapy for Stage IIIA/IIIB non-small cell lung cancer (NSCLC) patients to determine if either could achieve a primary endpoint of >18-month median survival. Final results of 30105 demonstrated that induction carboplatin and gemcitabine and concurrent gemcitabine 3D-CRT was not feasible because of treatment-related toxicity. However, induction and concurrent carboplatin/paclitaxel with 74 Gy 3D-CRT had a median survival of 24 months, and is the basis for the experimental arm in CALGB 30610/RTOG 0617/N0628. We conducted a secondary analysis of all patients to determine predictors of treatment-related pulmonary toxicity. Methods and Materials: Patient, tumor, and treatment-related variables were analyzed to determine their relation with treatment-related pulmonary toxicity. Results: Older age, higher N stage, larger planning target volume (PTV)1, smaller total lung volume/PTV1 ratio, larger V20, and larger mean lung dose were associated with increasing pulmonary toxicity on univariate analysis. Multivariate analysis confirmed that V20 and nodal stage as well as treatment with concurrent gemcitabine were associated with treatment-related toxicity. A high-risk group comprising patients with N3 disease and V20 >38% was associated with 80% of Grades 3-5 pulmonary toxicity cases. Conclusions: Elevated V20 and N3 disease status are important predictors of treatment related pulmonary toxicity in patients treated with high-dose 3D-CRT and concurrent chemotherapy. Further studies may use these metrics in considering patients for these treatments.

  3. 3D-Nanomachining using corner lithography

    NARCIS (Netherlands)

    Berenschot, Johan W.; Tas, Niels Roelof; Jansen, Henricus V.; Elwenspoek, Michael Curt

    2008-01-01

    We present a fabrication method to create 3D nano structures without the need for nano lithography. The method, named "corner lithography" is based on conformal deposition and subsequent isotropic thinning of a thin film. The material that remains in sharp concave corners is either used as a mask or

  4. Independent dose calculation of the Tps Iplan in radiotherapy conformed with MLC; Calculo independiente de dosis del TPS Iplan en radioterapia conformada con MLC

    Energy Technology Data Exchange (ETDEWEB)

    Adrada, A.; Tello, Z.; Medina, L.; Garrigo, E.; Venencia, D., E-mail: jorge.alberto.adrada@gmail.com [Instituto Privado de Radioterapia, Obispo Oro 423, X5000BFI Cordoba (Argentina)

    2014-08-15

    The systems utilization of independent dose calculation in three dimensional-Conformal Radiation Therapy (3D-Crt) treatments allows a direct verification of the treatments times. The utilization of these systems allows diminishing the probability of errors occurrence generated by the treatment planning system (Tps), allowing a detailed analysis of the dose to delivering and review of the normalization point (Np) or prescription. The independent dose calculation is realized across the knowledge of dosimetric parameters of the treatment machine and particular characteristics of every individual field. The aim of this work is develops a calculation system of punctual doses for isocentric fields conformed with multi-leaf collimation systems (MLC), where the dose calculation is in conformity with the suggested ones by ICRU Report No. 42, 1987. Calculation software was realized in C ++ under a free platform of programming (Code::Blocks). The system uses files in format Rtp, exported from the Tps to systems of record and verification (Lantis). This file contains detailed information of the dose, Um, position of the MLC sheets and collimators for every field of treatment. The size of equivalent field is obtained from the positions of every sheet; the effective depth of calculation can be introduced from the dosimetric report of the Tps or automatically from the DFS of the field. The 3D coordinates of the isocenter and the Np for the treatment plan must be introduced manually. From this information the system looks the dosimetric parameters and calculates the Um. The calculations were realized in two accelerators a NOVALIS Tx (Varian) with 120 sheets of high definition (hd-MLC) and a PRIMUS Optifocus (Siemens) with 82 sheets. 705 patients were analyzed for a total of 1082, in plans made for both equipment s, the average uncertainty with regard to the calculation of the Tps is-0.43% ± 2.42% in a range between [-7.90 %, 7.50 %]. The major uncertainty was in Np near of the

  5. 3D Projection Installations

    DEFF Research Database (Denmark)

    Halskov, Kim; Johansen, Stine Liv; Bach Mikkelsen, Michelle

    2014-01-01

    Three-dimensional projection installations are particular kinds of augmented spaces in which a digital 3-D model is projected onto a physical three-dimensional object, thereby fusing the digital content and the physical object. Based on interaction design research and media studies, this article...... contributes to the understanding of the distinctive characteristics of such a new medium, and identifies three strategies for designing 3-D projection installations: establishing space; interplay between the digital and the physical; and transformation of materiality. The principal empirical case, From...... Fingerplan to Loop City, is a 3-D projection installation presenting the history and future of city planning for the Copenhagen area in Denmark. The installation was presented as part of the 12th Architecture Biennale in Venice in 2010....

  6. 3D Spectroscopic Instrumentation

    CERN Document Server

    Bershady, Matthew A

    2009-01-01

    In this Chapter we review the challenges of, and opportunities for, 3D spectroscopy, and how these have lead to new and different approaches to sampling astronomical information. We describe and categorize existing instruments on 4m and 10m telescopes. Our primary focus is on grating-dispersed spectrographs. We discuss how to optimize dispersive elements, such as VPH gratings, to achieve adequate spectral resolution, high throughput, and efficient data packing to maximize spatial sampling for 3D spectroscopy. We review and compare the various coupling methods that make these spectrographs ``3D,'' including fibers, lenslets, slicers, and filtered multi-slits. We also describe Fabry-Perot and spatial-heterodyne interferometers, pointing out their advantages as field-widened systems relative to conventional, grating-dispersed spectrographs. We explore the parameter space all these instruments sample, highlighting regimes open for exploitation. Present instruments provide a foil for future development. We give an...

  7. Radiochromic 3D Detectors

    Science.gov (United States)

    Oldham, Mark

    2015-01-01

    Radiochromic materials exhibit a colour change when exposed to ionising radiation. Radiochromic film has been used for clinical dosimetry for many years and increasingly so recently, as films of higher sensitivities have become available. The two principle advantages of radiochromic dosimetry include greater tissue equivalence (radiologically) and the lack of requirement for development of the colour change. In a radiochromic material, the colour change arises direct from ionising interactions affecting dye molecules, without requiring any latent chemical, optical or thermal development, with important implications for increased accuracy and convenience. It is only relatively recently however, that 3D radiochromic dosimetry has become possible. In this article we review recent developments and the current state-of-the-art of 3D radiochromic dosimetry, and the potential for a more comprehensive solution for the verification of complex radiation therapy treatments, and 3D dose measurement in general.

  8. Later Outcomes and Alpha/Beta Estimate From Hypofractionated Conformal Three-Dimensional Radiotherapy Versus Standard Fractionation for Localized Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Leborgne, Felix [Department of Radiation Oncology, Hospital Italiano, Montevideo (Uruguay); Fowler, Jack, E-mail: jackfowlersbox@gmail.com [Department of Human Oncology, University of Wisconsin Medical School, Madison, WI (United States); Leborgne, Jose H.; Mezzera, Julieta [Department of Radiation Oncology, Hospital Italiano, Montevideo (Uruguay)

    2012-03-01

    Purpose: Now that the follow-up time has exceeded 5 years, an estimate of the {alpha}/{beta} ratio can be presented. The additional late outcomes in patients treated with three-dimensional conformal external beam radiotherapy for localized prostate cancer using a hypofractionated vs. a standard fractionation regimen are reported from this prospective nonrandomized contemporary comparison. Methods and Materials: A total of 114 nonrandomized patients chose hypofractionation delivered in 20 fractions of 3 Gy or 3.15 Gy (mean 3.06 Gy) for localized prostate cancer within a median overall time of 32 days (range, 29-49) using four fractions weekly. A total of 160 comparable patients were contemporarily treated within a median of 55 days (range 49-66). The median follow-up was 66 months (range, 24-95) for the hypofractionated arm and 63 months (range, 36-92) for the standard arm. The percentage of patients in the low-, medium-, and high-risk groups was 36%, 46%, and 18% in the hypofractionated arm and 44%, 50%, and 6% in standard arm (2 Gy), respectively. Results: The 5-year actuarial biochemical absence of disease (prostate-specific antigen nadir + 2 ng/mL) and disease-free survival rate was the same at 89% in both arms, making the {alpha}/{beta} calculation unambiguous. The point ratio of {alpha}/{beta} was 1.86 (95% confidence interval, 0.7-5.1 Gy). The 95% confidence interval was determined entirely by the binomial confidence limits in the numbers of patients. Rectal reactions of grade 3 and 4 occurred in 1 of 114 (hypofractionated) and 2 of 160 (standard) patients. Conclusions: The presented three-dimensional conformal regimen was acceptable, and the {alpha}/{beta} value was 1.8, in agreement with other very recent low meta-analyses (reviewed in the '' section).

  9. Practical recommendations for breathing-adapted radiotherapy; Bonnes pratiques pour la radiotherapie asservie a la respiration

    Energy Technology Data Exchange (ETDEWEB)

    Simon, L.; Giraud, P.; Rosenwald, J.C. [Institut Curie, Dept. d' Oncologie-radiotherapie, 75 - Paris (France); Dumas, J.L.; Lorchel, F. [CHU de Besancon, Hopital Jean-Minjoz, Service Radiotherapie, 25 - Besancon (France); Marre, D. [Institut Claudius-Regaud, Dept. des Radiations, 31 - Toulouse (France); Dupont, S. [Hopital Europeen Georges-Pompidou, Service d' Oncoradiotherapie, 75 - Paris (France); Varmenot, N. [Centre Henri-Becquerel, UnitE de Physique Medicale, 76 - Rouen (France); Ginestet, C. [Centre Leon-Berard, Dept. de Radiotherapie, 69 - Lyon (France); Caron, J. [Institut Bergonie, Dept. de Radiotherapie, 33 - Bordeaux (France); Marchesi, V. [Centre Alexis-Vautrin, Dept. de Radiotherapie, 54 - Vandoeuvre-les-Nancy (France); Ferreira, I. [Institut Gustave-Roussy, Dept. d' Oncologie Radiotherapie, 94 - Villejuif (France); Garcia, R. [Institut Sainte-Catherine, Service de Radiotherapie, 84 - Avignon (France)

    2007-06-15

    Respiration-gated radiotherapy offers a significant potential for improvement in the irradiation of tumor sites affected by respiratory motion such as lung, breast and liver tumors. An increased conformality of irradiation fields leading to decreased complications rates of organs at risk (lung, heart) is expected. Respiratory gating is in line with the need for improved precision required by radiotherapy techniques such as 3D conformal radiotherapy or intensity modulated radiotherapy. Reduction of respiratory motion can be achieved by using either breath-hold techniques or respiration synchronized gating techniques. Breath-hold techniques can be achieved with active techniques, in which airflow of the patient is temporarily blocked by a valve, or passive techniques, in which the patient voluntarily holds his/her breath. Synchronized gating techniques use external devices to predict the phase of the respiration cycle while the patient breaths freely. This work summarizes the different experiences of the centers of the STIC 2003 project. It describes the different techniques, gives an overview of the literature and proposes a practice based on our experience. (authors)

  10. Interaktiv 3D design

    DEFF Research Database (Denmark)

    Villaume, René Domine; Ørstrup, Finn Rude

    2002-01-01

    Projektet undersøger potentialet for interaktiv 3D design via Internettet. Arkitekt Jørn Utzons projekt til Espansiva blev udviklet som et byggesystem med det mål, at kunne skabe mangfoldige planmuligheder og mangfoldige facade- og rumudformninger. Systemets bygningskomponenter er digitaliseret som...... 3D elementer og gjort tilgængelige. Via Internettet er det nu muligt at sammenstille og afprøve en uendelig  række bygningstyper som  systemet blev tænkt og udviklet til....

  11. Solving a 3D structural puzzle

    DEFF Research Database (Denmark)

    Hoeck, Casper

    to spatial structural information using NMR spectroscopy. Experimental distances from nuclear Overhauser effect (NOE) correlations, and dihedral angles from 3JHH-coupling constants, were used to obtain 3D structural information for several natural and synthetic compounds. The stereochemistry of novel natural...... samples, which allows for RDCs to be extracted. The number of internuclear vectors for the correlation of RDCs to 3D structures is often limited for small molecules. Homonuclear RDCs were extracted by use of the homonuclear S3 HMBC that correlated well to alignment tensors from 1DCH-coupling constants......-calculation of RDCs from 3D structures was developed and tested, which copes better with multiple conformers than the commonly used SVD methodology. The approach thus resulted in good conformer populations for several small molecules, including multiple cinchona alkaloids....

  12. Phase II Trial of Cetuximab and Conformal Radiotherapy Only in Locally Advanced Pancreatic Cancer with Concurrent Tissue Sampling Feasibility Study.

    Science.gov (United States)

    Rembielak, Agata I; Jain, Pooja; Jackson, Andrew S; Green, Melanie M; Santorelli, Gillian R; Whitfield, Gillian A; Crellin, Adrian; Garcia-Alonso, Angel; Radhakrishna, Ganesh; Cullen, James; Taylor, M Ben; Swindell, Ric; West, Catharine M; Valle, Juan; Saleem, Azeem; Price, Patricia M

    2014-02-01

    Preclinical data have indicated the anti-epidermal growth factor receptor (EGFR) agent cetuximab (Erbitux) as a radiosensitizer in pancreatic cancer, but this has not been specifically addressed in a clinical study. We report the results of an original study initiated in 2007, where cetuximab was tested with radiotherapy (RT) alone in locally advanced pancreatic cancer in a phase II trial (PACER). Patients (n = 21) received cetuximab loading dose (400 mg/m(2)) and weekly dose (250 mg/m(2)) during RT (50.4 Gy in 28 fractions). Toxicity and disease response end point data were prospectively assessed. A feasibility study of on-trial patient blood and skin sampling was incorporated. Treatment was well tolerated, and toxicity was low; most patients (71%) experienced acute toxicities of grade 2 or less. Six months posttreatment, stable local disease was achieved in 90% of evaluable patients, but only 33% were free from metastatic progression. Median overall survival was 7.5 months, and actuarial survival was 33% at 1 year and 11% at 3 years, reflecting swift metastatic progression in some patients but good long-term control of localized disease in others. High-grade acneiform rash (P = .0027), posttreatment stable disease (P = .0059), and pretreatment cancer antigen 19.9 (CA19.9) level (P = .0042) associated with extended survival. Patient skin and blood samples yielded sufficient RNA and good quality protein, respectively. The results indicate that cetuximab inhibits EGFR-mediated radioresistance to achieve excellent local control with minimal toxicity but does not sufficiently control metastatic progression in all patients. Translational studies of patient tissue samples may yield molecular information that may enable individual treatment response prediction.

  13. Profiles and Time Course of Acute Radiation Toxicity Symptoms during Conformal Radiotherapy for Cancer of the Prostate

    Energy Technology Data Exchange (ETDEWEB)

    Hovdenak, Nils; Karlsdottir, Aasa; Soerbye, Halfdan; Dahl, Olav [Univ. of Bergen (Norway). Div. of Gastroenterology

    2003-11-01

    Symptoms of gastrointestinal toxicity are dose-limiting for pelvic radiotherapy (RT). Existing toxicity registrations (RTOG/EORTC) are helpful in defining maximal tolerated doses, but tend to underestimate the total toxicity burden by excluding several minor complaints. We have applied a more detailed and quantitative recording of symptoms and related these scores to RT-induced endoscopic and histopathologic changes. Prevalence and severity of specific toxicity symptoms were recorded before, during (weeks 2 and 6) and 2 and 8 weeks after RT in 96 patients undergoing external beam RT for localized prostate cancer. RTOG/EORTC acute toxicity and ad hoc total toxicity scores (TTS) were recorded. TTS scores were calculated by adding scores based on visual analog scale (VAS) grading of individual symptoms. Fifty of the patients also underwent sequential proctoscopy with mucosal biopsy. Individual symptoms increased, but differed in prevalence and intensity during and after RT. TTS increased during the entire treatment course in spite of normalizing histopathologic and endoscopic changes from week 2 onwards. Twenty-seven patients had no RTOG/EORTC toxicity, four had grade 3 and none had grade 4 toxicity. All patients with grade 0 had increased TTS. Thus, TTS appeared more sensitive than RTOG/EORTC scoring. The study demonstrates that multiple toxicity symptoms contribute to total toxicity in response to pelvic RT. TTS is a feasible and sensitive method for detecting and quantifying acute toxicity and unveils morbidity which remains hidden with the RTOG/EORTC score system. The development and timing of symptoms may give clues to pathogenesis, treatment, and prophylaxis.

  14. Long-term results in three-dimensional conformal radiotherapy of localized prostate cancer at moderate dose (66 Gy)

    Energy Technology Data Exchange (ETDEWEB)

    Goldner, G.; Wachter, S.; Wachter-Gerstner, N.; Dieckmann, K.; Poetter, R. [Dept. of Radiotherapy and Radiobiology, Univ. of Vienna, Medical School, Vienna (Austria)

    2006-09-15

    Purpose: biochemical control (bNED), disease-specific survival (DSS), overall survival (OS), and late gastrointestinal (GI) and urogenital (UG) side effects (EORTC/RTOG) of patients with long-term follow-up were evaluated. Patients and methods: three-dimensional radiotherapy up to 66 Gy with/without additional hormonal therapy was performed in 154 prostate cancer (T1-3 NO MO) patients. According to T-stage, pretreatment prostate-specific antigen (PSA) and grading, patients were divided into a low-, intermediate-, and high-risk group. The 5-, 8-, and 10-year actuarial rates of bNED, DSS and OS and late side effects were calculated. Results: median follow-up was 80 months. Additional hormonal therapy was given in 57% of patients. Distribution concerning risk groups (low, intermediate, high) showed 15%, 49%, and 36% of patients, respectively. bNED 5-, 8-, and 10-year actuarial rates were 46%, 44%, and 44%. DSS 5-, 8- and 10-year rates amounted to 96%, 90%, and 82%. OS 5-, 8- and 10-year rates were 81%, 64%, and 56%. In uni- and multivariate analysis, only pretreatment PSA (< 10 vs. {>=} 10 ng/ml; p < 0.05) and PSA nadir (< 0.5 vs. {>=} 0.5 ng/ml; p < 0.0001) affected bNED significantly. Age, risk group, T-stage, grading, and hormonal therapy had no significant influence on bNED, DSS, and OS. Rates of late GI and UG side effects grade {>=} 2 at 5 years were 17% and 15%. Conclusion: current dose escalation studies with better bNED rates may be able to further increase long-term clinical outcome. (orig.)

  15. 3D Wire 2015

    DEFF Research Database (Denmark)

    Jordi, Moréton; F, Escribano; J. L., Farias

    This document is a general report on the implementation of gamification in 3D Wire 2015 event. As the second gamification experience in this event, we have delved deeply in the previous objectives (attracting public areas less frequented exhibition in previous years and enhance networking) and ha......, improves socialization and networking, improves media impact, improves fun factor and improves encouragement of the production team....

  16. Shaping 3-D boxes

    DEFF Research Database (Denmark)

    Stenholt, Rasmus; Madsen, Claus B.

    2011-01-01

    Enabling users to shape 3-D boxes in immersive virtual environments is a non-trivial problem. In this paper, a new family of techniques for creating rectangular boxes of arbitrary position, orientation, and size is presented and evaluated. These new techniques are based solely on position data...

  17. Tangible 3D Modelling

    DEFF Research Database (Denmark)

    Hejlesen, Aske K.; Ovesen, Nis

    2012-01-01

    This paper presents an experimental approach to teaching 3D modelling techniques in an Industrial Design programme. The approach includes the use of tangible free form models as tools for improving the overall learning. The paper is based on lecturer and student experiences obtained through facil...

  18. 3D photoacoustic imaging

    Science.gov (United States)

    Carson, Jeffrey J. L.; Roumeliotis, Michael; Chaudhary, Govind; Stodilka, Robert Z.; Anastasio, Mark A.

    2010-06-01

    Our group has concentrated on development of a 3D photoacoustic imaging system for biomedical imaging research. The technology employs a sparse parallel detection scheme and specialized reconstruction software to obtain 3D optical images using a single laser pulse. With the technology we have been able to capture 3D movies of translating point targets and rotating line targets. The current limitation of our 3D photoacoustic imaging approach is its inability ability to reconstruct complex objects in the field of view. This is primarily due to the relatively small number of projections used to reconstruct objects. However, in many photoacoustic imaging situations, only a few objects may be present in the field of view and these objects may have very high contrast compared to background. That is, the objects have sparse properties. Therefore, our work had two objectives: (i) to utilize mathematical tools to evaluate 3D photoacoustic imaging performance, and (ii) to test image reconstruction algorithms that prefer sparseness in the reconstructed images. Our approach was to utilize singular value decomposition techniques to study the imaging operator of the system and evaluate the complexity of objects that could potentially be reconstructed. We also compared the performance of two image reconstruction algorithms (algebraic reconstruction and l1-norm techniques) at reconstructing objects of increasing sparseness. We observed that for a 15-element detection scheme, the number of measureable singular vectors representative of the imaging operator was consistent with the demonstrated ability to reconstruct point and line targets in the field of view. We also observed that the l1-norm reconstruction technique, which is known to prefer sparseness in reconstructed images, was superior to the algebraic reconstruction technique. Based on these findings, we concluded (i) that singular value decomposition of the imaging operator provides valuable insight into the capabilities of

  19. The evolution of rectal and urinary toxicity and immune response in prostate cancer patients treated with two three-dimensional conformal radiotherapy techniques

    Directory of Open Access Journals (Sweden)

    Starec Miroslav

    2011-07-01

    Full Text Available Abstract Background Our research compared whole pelvic (WP and prostate-only (PO 3-dimensional conformal radiotherapy (3DCRT techniques in terms of the incidence and evolution of acute and late toxicity of the rectum and urinary bladder, and identified the PTV-parameters influencing these damages and changes in antitumor immune response. Methods We analyzed 197 prostate cancer patients undergoing 3DCRT for gastrointestinal (GI and genitourinary (GU toxicities, and conducted a pilot immunological study including flow cytometry and an NK cell cytotoxicity assay. Acute and late toxicities were recorded according to the RTOG and the LENT-SOMA scales, respectively. Univariate and multivariate analyses were conducted for factors associated with toxicity. Results In the WP group, an increase of acute rectal toxicity was observed. A higher incidence of late GI/GU toxicity appeared in the PO group. Only 18 patients (WP-7.76% and PO-11.11% suffered severe late GI toxicity, and 26 patients (WP-11.21% and PO-16.05% severe late GU toxicity. In the majority of acute toxicity suffering patients, the diminution of late GI/GU toxicity to grade 1 or to no toxicity after radiotherapy was observed. The 3DCRT technique itself, patient age, T stage of TNM classification, surgical intervention, and some dose-volume parameters emerged as important factors in the probability of developing acute and late GI/GU toxicity. The proportion and differentiation of NK cells positively correlated during 3DCRT and negatively so after its completion with dose-volumes of the rectum and urinary bladder. T and NKT cells were down-regulated throughout the whole period. We found a negative correlation between leukocyte numbers and bone marrow irradiated by 44-54 Gy and a positive one for NK cell proportion and doses of 5-25 Gy. The acute GU, late GU, and GI toxicities up-regulated the T cell (CTL numbers and NK cytotoxicity. Conclusion Our study demonstrates the association of acute and

  20. Unoriented 3d TFTs

    CERN Document Server

    Bhardwaj, Lakshya

    2016-01-01

    This paper generalizes two facts about oriented 3d TFTs to the unoriented case. On one hand, it is known that oriented 3d TFTs having a topological boundary condition admit a state-sum construction known as the Turaev-Viro construction. This is related to the string-net construction of fermionic phases of matter. We show how Turaev-Viro construction can be generalized to unoriented 3d TFTs. On the other hand, it is known that the "fermionic" versions of oriented TFTs, known as Spin-TFTs, can be constructed in terms of "shadow" TFTs which are ordinary oriented TFTs with an anomalous Z_2 1-form symmetry. We generalize this correspondence to Pin+ TFTs by showing that they can be constructed in terms of ordinary unoriented TFTs with anomalous Z_2 1-form symmetry having a mixed anomaly with time-reversal symmetry. The corresponding Pin+ TFT does not have any anomaly for time-reversal symmetry however and hence it can be unambiguously defined on a non-orientable manifold. In case a Pin+ TFT admits a topological bou...

  1. Three-dimensional conformal radiotherapy for loco-regionally recurrent esophageal cancer after initial radiotherapy%42例放疗后复发食管癌三维适形放疗的疗效分析

    Institute of Scientific and Technical Information of China (English)

    沈文斌; 祝淑钗; 万钧; 李娟; 苏景伟; 王玉祥; 李任

    2010-01-01

    目的 探讨三维适形放疗(3DCRT)在食管癌首程放疗后局部复发患者中应用的可行性、疗效和放射损伤及影响因素.方法 42例首程放疗后局部复发的食管癌患者,采用3DCRT技术进行二程放疗.放疗处方剂量中位值54 Gy(50~64 Gy),1.8~2.0 Gy/次,5次/周.结果 随访截至2008年12月31日,随访率为100%,其中随访满1、2年者分别为20、22例.42例患者中完全缓解7例,部分缓解31例,无进展4例.全组患者1、2年总生存率分别为60%和24%.全组≥2级放射性食管炎15例,其中2级13例,3级2例.≥2级放射性肺炎9例,其中2级8例,3级1例.≥2级血液学副反应3例,其中2级2例,3级1例.本组共死亡28例,其中死于局部复发9例、远处转移7例、食管瘘1例、食管狭窄1例、全身衰竭4例、心脏病3例、电解质紊乱1例、死因不明1例.结论 食管癌首程放疗后局部复发采用3DCRT二程放疗是可行的,有较好临床症状缓解率和即时疗效,部分患者可延长生存期;但再程放疗并发症较高,临床应用时应严格掌握其适应证.%Objective To evaluate the feasibility, therapeutic effects and normal tissue complications of three-dimensional conformal radiotherapy (3DCRT) for loco-regionally recurrent esophageal cancer after initial radiotherapy. Methods Between March 2001 and May 2007, 42 patients with loco-reigonal recurrent esophageal cancer after initial radiotherapy were treated with 3DCRT, including 27 male and 15 female with a median age of 67.5 years. Radiotherapy was delivered at 1.8 -2.0 Gy per fraction, 5 fractions per week, with a median total dose of 54 Gy. Treatment outcomes and normal tissue complications were assessed with WHO and RTOG/EORTC criteria. Results By December 31,2008, the follow-up rate was 100%. Twenty patients had follow-up time of 1 year and the remaining 22 had 2 years. The clinical symptom relief rate was 60%, and the response rate was 90.5% with a complete remission rate of 17

  2. 鼻咽癌后程三维适形放疗正向计划的设计及优化%The plan and optimization of late course three-dimensional conformal radiotherapy for nasopharyngeal carcinoma

    Institute of Scientific and Technical Information of China (English)

    唐世强; 成浩; 王志芳

    2012-01-01

    目的:探讨鼻咽癌后程三维适形放射治疗正向计划的设计及优化方法.方法:随机选取20例鼻咽癌后程加量的患者,在PROWESS PANTHER计划系统上进行三维适形放射治疗正向计划的设计及优化,通过射野数目、射野方向、射野权重因子的合理设定及选择,结合DVH图和剂量曲线分布情况选择最优方案.结果:分析患者的DVH图,显示各靶区均能达到较好的剂量曲线分布,在给予靶区致死剂量的同时,周围危及器官受量都在其耐受剂量范围内.结论:在没有开展调强放疗技术的单位,根据鼻咽癌患者病变侵犯情况,选择合适的射野进行三维适形放疗正向计划设计及优化,也能得到符合临床要求的较佳的治疗计划,从而可提高鼻咽癌局部控制率,有效保护危及器宫,提高病人的生存质量.%Objective:To investigate the plan and method of optimization of three - dimensional conformal radiotherapy (3DCRT)for nasopharyngeal carcinoma. Methods: Twenty patients with nasopharyngeal carcinoma were treated by late course 3DCRT. 3D plans were designed using PROWESS PANTHER treatment planning system. To select careful beam angle,beams number selection and beam weighting factor settings, combined with DVHs and dose curve distribution map, then choose the best option. Results: Analysis of the 20 patients' DVHs showed the targets all could be wrapped by better dose line and the surrounding organs at risk were within the scope of its tolerance dose. Conclusion: In the departments which can not carry out IMRT, to choose the right beams also can produce a high - quality 3DCRT plan, which can improve the control rate of nasopharyngeal carcinoma, protect organs at risk and improve patients quality of life.

  3. Hippocampal sparing radiotherapy for pediatric medulloblastoma: impact of treatment margins and treatment technique

    DEFF Research Database (Denmark)

    Brodin, N. Patrik; af Rosenschold, Per Munck; Blomstrand, Malin

    2014-01-01

    BackgroundWe investigated how varying the treatment margin and applying hippocampal sparing and proton therapy impact the risk of neurocognitive impairment in pediatric medulloblastoma patients compared with current standard 3D conformal radiotherapy.MethodsWe included 17 pediatric medulloblastoma...... boost. Neurocognitive impairment risk was estimated based on dose-response models from pediatric CNS malignancy survivors and compared among different margins and treatment techniques.ResultsMean hippocampal dose and corresponding risk of cognitive impairment were decreased with decreasing treatment...

  4. Towards a Noninvasive Intracranial Tumor Irradiation Using 3D Optical Imaging and Multimodal Data Registration

    Science.gov (United States)

    Posada, R.; Daul, Ch.; Wolf, D.; Aletti, P.

    2007-01-01

    Conformal radiotherapy (CRT) results in high-precision tumor volume irradiation. In fractioned radiotherapy (FRT), lesions are irradiated in several sessions so that healthy neighbouring tissues are better preserved than when treatment is carried out in one fraction. In the case of intracranial tumors, classical methods of patient positioning in the irradiation machine coordinate system are invasive and only allow for CRT in one irradiation session. This contribution presents a noninvasive positioning method representing a first step towards the combination of CRT and FRT. The 3D data used for the positioning is point clouds spread over the patient's head (CT-data usually acquired during treatment) and points distributed over the patient's face which are acquired with a structured light sensor fixed in the therapy room. The geometrical transformation linking the coordinate systems of the diagnosis device (CT-modality) and the 3D sensor of the therapy room (visible light modality) is obtained by registering the surfaces represented by the two 3D point sets. The geometrical relationship between the coordinate systems of the 3D sensor and the irradiation machine is given by a calibration of the sensor position in the therapy room. The global transformation, computed with the two previous transformations, is sufficient to predict the tumor position in the irradiation machine coordinate system with only the corresponding position in the CT-coordinate system. Results obtained for a phantom show that the mean positioning error of tumors on the treatment machine isocentre is 0.4 mm. Tests performed with human data proved that the registration algorithm is accurate (0.1 mm mean distance between homologous points) and robust even for facial expression changes. PMID:18364992

  5. Predictors of grade {>=}2 and grade {>=}3 radiation pneumonitis in patients with locally advanced non-small cell lung cancer treated with three-dimensional conformal radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Dang, Jun; Li, Guang; Ma, Lianghua; Han, Chong; Zhang, Shuo; Yao, Lei [Dept. of Radiation Oncology, The First Hospital of China Medical Univ., Shenyang (China)], e-mail: gl1963516@yahoo.cn; Diao, Rao [Dept. of Experimental Technology Center, China Medical Univ., Shenyang (China); Zang, Shuang [Dept. of Nursing, China Medical Univ., Shenyang (China)

    2013-08-15

    Grade {>=}3 radiation pneumonitis (RP) is generally severe and life-threatening. Predictors of grade {>=}2 are usually used for grade {>=}3 RP prediction, but it is unclear whether these predictors are appropriate. In this study, predictors of grade {>=}2 and grade {>=}3 RP were investigated separately. The increased risk of severe RP in elderly patients compared with younger patients was also evaluated. Material and methods: A total of 176 consecutive patients with locally advanced non-small cell lung cancer were followed up prospectively after three-dimensional conformal radiotherapy. RP was graded according to Common Terminology Criteria for Adverse Events version 3.0. Results: Mean lung dose (MLD), mean heart dose, ratio of planning target volume to total lung volume (PTV/Lung), and dose-volume histogram comprehensive value of both heart and lung were associated with both grade {>=}2 and grade {>=}3 RP in univariate analysis. In multivariate logistic regression analysis, age and MLD were predictors of both grade {>=}2 RP and grade {>=}3 RP; receipt of chemotherapy predicted grade {>=}3 RP only; and sex and PTV/Lung predicted grade {>=}2 RP only. Among patients who developed high-grade RP, MLD and PTV/Lung were significantly lower in patients aged {>=}70 years than in younger patients (p<0.05 for both comparisons). Conclusions: The predictors were not completely consistent between grade {>=}2 RP and grade {>=}3 RP. Elderly patients had a higher risk of severe RP than younger patients did, possibly due to lower tolerance of radiation to the lung.

  6. 3D and beyond

    Science.gov (United States)

    Fung, Y. C.

    1995-05-01

    This conference on physiology and function covers a wide range of subjects, including the vasculature and blood flow, the flow of gas, water, and blood in the lung, the neurological structure and function, the modeling, and the motion and mechanics of organs. Many technologies are discussed. I believe that the list would include a robotic photographer, to hold the optical equipment in a precisely controlled way to obtain the images for the user. Why are 3D images needed? They are to achieve certain objectives through measurements of some objects. For example, in order to improve performance in sports or beauty of a person, we measure the form, dimensions, appearance, and movements.

  7. 3D measurement of absolute radiation dose in grid therapy

    Energy Technology Data Exchange (ETDEWEB)

    Trapp, J V [Joint Department of Physics, Institute of Cancer Research and Royal Marsden Foundation Trust, Downs Road, Sutton, Surrey SM2 5PT (United Kingdom); Department of Applied Physics, RMIT University, GPO Box 2476V, Melbourne 3001 (Australia); Warrington, A P [Joint Department of Physics, Institute of Cancer Research and Royal Marsden Foundation Trust, Downs Road, Sutton, Surrey SM2 5PT (United Kingdom); Partridge, M [Joint Department of Physics, Institute of Cancer Research and Royal Marsden Foundation Trust, Downs Road, Sutton, Surrey SM2 5PT (United Kingdom); Philps, A [Joint Department of Physics, Institute of Cancer Research and Royal Marsden Foundation Trust, Downs Road, Sutton, Surrey SM2 5PT (United Kingdom); Leach, M O [Cancer Research UK Clinical MR Research Group, Institute of Cancer Research and Royal Marsden Foundation Trust, Downs Road, Sutton, Surrey SM2 5PT (United Kingdom); Webb, S [Joint Department of Physics, Institute of Cancer Research and Royal Marsden Foundation Trust, Downs Road, Sutton, Surrey SM2 5PT (United Kingdom)

    2004-01-01

    Spatially fractionated radiotherapy through a grid is a concept which has a long history and was routinely used in orthovoltage radiation therapy in the middle of last century to minimize damage to the skin and subcutaneous tissue. With the advent of megavoltage radiotherapy and its skin sparing effects the use of grids in radiotherapy declined in the 1970s. However there has recently been a revival of the technique for use in palliative treatments with a single fraction of 10 to 20 Gy. In this work the absolute 3D dose distribution in a grid irradiation is measured for photons using a combination of film and gel dosimetry.

  8. Reply to 'Comment on genetic and global algorithms for optimization of three-dimensional conformal radiotherapy treatment planning'

    Energy Technology Data Exchange (ETDEWEB)

    Wu Xingen; Zhu Yunping [Department of Radiation Oncology, St. Jude Children' s Research Hospital, Memphis, TN (United States)

    2001-06-01

    . Response to the second and third comments: The objective function is a big issue. Dr. Vaarkamp thinks that our cost functions seem too simple to be capable of finding any clinically meaningful solutions. We do not agree with him on this issue. Finding clinically meaningful solutions is mainly the task of optimization methods, not of just the cost function. The cost function we used is the most common least-squares function. It has been used not only in radiotherapy optimization research but also in some commercial planning systems. It can be used to impose the dose homogeneity to planning target volume (PTV), and to ensure that the doses in OARs do not surpass the maximum allowable dose (or DVH in our new investigations). In terms of beam weighting optimization, we started out with existing manually placed beams that were conformal to the PTV. The optimization procedure tends to keep those beams that will contribute to the dose uniformity within the PTV while sparing OARs. Because our patients do not normally have a 'perfectly' shaped small PTV in the exact centre of a small sized ('ideally' cubic shaped) brain, we normally do not find a solution that will eliminate all beams except two lateral beams. Radiotherapy optimization problems based on objective function are usually non-convex because of the addition of some constraints. There exist many local extremes. Traditional methods based on gradient are easily trapped into local minima. Other methods, like simulated annealing, genetic algorithm and global optimization methods, usually find better solutions, because they adopt some mechanism to avoid such local traps. Our efforts in these three papers were intended mainly to prove in principle that the new methods presented are applicable to our radiotherapy planning optimization problems. Many researchers have been devoting their efforts to similar goals. Response to the fourth comment: Because the patient contour and the tumour are not exactly

  9. 3D Surgical Simulation

    Science.gov (United States)

    Cevidanes, Lucia; Tucker, Scott; Styner, Martin; Kim, Hyungmin; Chapuis, Jonas; Reyes, Mauricio; Proffit, William; Turvey, Timothy; Jaskolka, Michael

    2009-01-01

    This paper discusses the development of methods for computer-aided jaw surgery. Computer-aided jaw surgery allows us to incorporate the high level of precision necessary for transferring virtual plans into the operating room. We also present a complete computer-aided surgery (CAS) system developed in close collaboration with surgeons. Surgery planning and simulation include construction of 3D surface models from Cone-beam CT (CBCT), dynamic cephalometry, semi-automatic mirroring, interactive cutting of bone and bony segment repositioning. A virtual setup can be used to manufacture positioning splints for intra-operative guidance. The system provides further intra-operative assistance with the help of a computer display showing jaw positions and 3D positioning guides updated in real-time during the surgical procedure. The CAS system aids in dealing with complex cases with benefits for the patient, with surgical practice, and for orthodontic finishing. Advanced software tools for diagnosis and treatment planning allow preparation of detailed operative plans, osteotomy repositioning, bone reconstructions, surgical resident training and assessing the difficulties of the surgical procedures prior to the surgery. CAS has the potential to make the elaboration of the surgical plan a more flexible process, increase the level of detail and accuracy of the plan, yield higher operative precision and control, and enhance documentation of cases. Supported by NIDCR DE017727, and DE018962 PMID:20816308

  10. TOWARDS: 3D INTERNET

    Directory of Open Access Journals (Sweden)

    Ms. Swapnali R. Ghadge

    2013-08-01

    Full Text Available In today’s ever-shifting media landscape, it can be a complex task to find effective ways to reach your desired audience. As traditional media such as television continue to lose audience share, one venue in particular stands out for its ability to attract highly motivated audiences and for its tremendous growth potential the 3D Internet. The concept of '3D Internet' has recently come into the spotlight in the R&D arena, catching the attention of many people, and leading to a lot of discussions. Basically, one can look into this matter from a few different perspectives: visualization and representation of information, and creation and transportation of information, among others. All of them still constitute research challenges, as no products or services are yet available or foreseen for the near future. Nevertheless, one can try to envisage the directions that can be taken towards achieving this goal. People who take part in virtual worlds stay online longer with a heightened level of interest. To take advantage of that interest, diverse businesses and organizations have claimed an early stake in this fast-growing market. They include technology leaders such as IBM, Microsoft, and Cisco, companies such as BMW, Toyota, Circuit City, Coca Cola, and Calvin Klein, and scores of universities, including Harvard, Stanford and Penn State.

  11. Tolerance and efficacy of conformal radiotherapy for hepatocellular carcinoma in cirrhotic patients. Results of the French RTF1 phase 2 trial; Tolerance et efficacite de la radiotherapie de conformation en cas de carcinome hepatocellulaire chez le patient cirrhotique. Resultats de l'essai de phase II RTF1

    Energy Technology Data Exchange (ETDEWEB)

    Mornex, F.; Girard, N.; Wautot, V.; Khodri, M. [Centre Hospitalier Lyon-Sud, Dept. de Radiotherapie-Oncologie, 69 - Pierre-Benite (France); Merle, P.; Kubas, A.; Trepo, C. [Hopital de l' Hotel-Dieu, Service d' hepatogastroenterologie, 69 - Lyon (France); Beziat, C. [Hopital de l' Hotel-Dieu, Dept. de Radiologie, 69 - Lyon (France)

    2005-11-15

    Purpose. - While some patients presenting with hepatocellular carcinoma (HCC) benefit from curative therapies (transplantation, surgery, percutaneous ablation), others are only candidates for palliative options such as chemo-embolization or symptomatic care. Although conventional external-beam radiotherapy of the liver is regarded as little efficient and potentially toxic in cirrhotic patients, 3-dimensional conformal radiotherapy (CRT), by decreasing the amount of normal liver included in the radiation portal, allows dose escalation to occur without increasing the risk of radiation-induced hepatitis. This trial was designed to assess the efficacy and tolerance of CRT for small-size HCC in cirrhotic patients. Patients and methods. - Prospective phase II trial including stage A/B cirrhotic patients with small-size HCC not suitable for curative treatments; CRT consisted in a standard fractionation radiation, with a total dose of 66 Gy. Results. - Twenty-seven patients were included, 15 of whom had previously been treated for HCC; mean age was 68. Among the 23 assessable patients, 18 (78%) presented with complete response, 3 (13%) with partial response, and 2 with no response. Acute complications occurred in 24 patients, and were mainly acceptable (grade 1/2: 22 patients, grade 3/4: 11 patients, 4 (15%) of whom had clinical and/or hematological toxicities). Only 2 (9%) grade 3/4 clinical and/or hematological late toxicities are reported. Conclusion. - CRT is a non-invasive curative technique highly suitable for small-size HCC in cirrhotic patients; further investigations are needed to compare it to the other available treatments, and to integrate it into the curative therapeutic algorithm of HCC. (author)

  12. Lattice Radial Quantization: 3D Ising

    CERN Document Server

    Brower, Richard; Neuberger, Herbert

    2012-01-01

    Lattice radial quantization is introduced as a nonperturbative method intended to numerically solve Euclidean conformal field theories that can be realized as fixed points of known Lagrangians. As an example, we employ a lattice shaped as a cylinder with a 2D Icosahedral cross-section to discretize dilatations in the 3D Ising model. Using this method, we obtain the preliminary estimate eta=0.034(10).

  13. 3D-kompositointi

    OpenAIRE

    Piirainen, Jere

    2015-01-01

    Opinnäytetyössä käydään läpi yleisimpiä 3D-kompositointiin liittyviä tekniikoita sekä kompositointiin käytettyjä ohjelmia ja liitännäisiä. Työssä esitellään myös kompositoinnin juuret 1800-luvun lopulta aina nykyaikaiseen digitaaliseen kompositointiin asti. Kompositointi on yksinkertaisimmillaan usean kuvan liittämistä saumattomasti yhdeksi uskottavaksi kokonaisuudeksi. Vaikka prosessi vaatii visuaalista silmää, vaatii se myös paljon teknistä osaamista. Tämän lisäksi perusymmärrys kamera...

  14. Shaping 3-D boxes

    DEFF Research Database (Denmark)

    Stenholt, Rasmus; Madsen, Claus B.

    2011-01-01

    Enabling users to shape 3-D boxes in immersive virtual environments is a non-trivial problem. In this paper, a new family of techniques for creating rectangular boxes of arbitrary position, orientation, and size is presented and evaluated. These new techniques are based solely on position data......, making them different from typical, existing box shaping techniques. The basis of the proposed techniques is a new algorithm for constructing a full box from just three of its corners. The evaluation of the new techniques compares their precision and completion times in a 9 degree-of-freedom (Do......F) docking experiment against an existing technique, which requires the user to perform the rotation and scaling of the box explicitly. The precision of the users' box construction is evaluated by a novel error metric measuring the difference between two boxes. The results of the experiment strongly indicate...

  15. Quantitative MR imaging in planning and assessing novel cancer treatments Radiotherapy

    CERN Document Server

    Baustert, I C

    2001-01-01

    Novel treatments in cancer, like conformal radiotherapy and anticancer drugs, require new MRI techniques to assess their benefits and potential. In conformal radiotherapy, MRI can be used to measure the shape and dose of the conformed radiation field in dose sensitive gel test-objects thus validating the predicted dose computed by complex programs. In antiangiogenic drug treatment, the vascular dysfunction of the tumour can be assessed by MRI prior to treatment. Response to treatment may also be monitored by measuring the changes in vascular function. In this thesis, MRI of polyacrylamide gels is investigated as a 3D dosimeter for conformal radiotherapy treatment planning. Quantitative MRI sequences capable of measuring the wide range of T2 values typically expected in gel dosimetry, are identified. Different T2 measurement methods are compared in terms of accuracy, signal to noise ratio and acquisition time. Examples of a complex dose distribution in 2D and 3D are presented and compared to the planned dose p...

  16. Volumetric intensity-modulated arc therapy vs. 3-dimensional conformal radiotherapy for primary chemoradiotherapy of anal carcinoma. Effects on treatment-related side effects and survival

    Energy Technology Data Exchange (ETDEWEB)

    Weber, Hanne Elisabeth; Droege, Leif Hendrik; Hennies, Steffen; Herrmann, Markus Karl; Wolff, Hendrik Andreas [University Medical Center Goettingen, Dept. of Radiotherapy and Radiooncology, Goettingen (Germany); Gaedcke, Jochen [University Medical Center Goettingen, Dept. of General Surgery, Goettingen (Germany)

    2015-11-15

    Primary chemoradiotherapy (CRT) is the standard treatment for locally advanced anal carcinoma. This study compared volumetric intensity-modulated arc therapy (VMAT) to 3-dimensional conformal radiotherapy (3DCRT) in terms of treatment-related side effects and survival. From 1992-2014, 103 consecutive patients with anal carcinoma UICC stage I-III were treated. Concomitant CRT consisted of whole pelvic irradiation, including the iliac and inguinal lymph nodes, with 50.4 Gy (1.8 Gy per fractions) by VMAT (n = 17) or 3DCRT (n = 86) as well as two cycles of 5-fluorouracil and mitomycin C. Acute organ and hematological toxicity were assessed according to the Common Terminology Criteria (CTC) for Adverse Events version 3.0. Side effects ≥ grade 3 were scored as high-grade toxicity. High-grade acute organ toxicity CTC ≥ 3 (P < 0.05), especially proctitis (P = 0.03), was significantly reduced in VMAT patients. The 2-year locoregional control (LRC) and disease-free survival (DFS) were both 100 % for VMAT patients compared with 80 and 73 % for 3DCRT patients. VMAT was shown to be a feasible technique, achieving significantly lower rates of acute organ toxicity and promising results for LRC and DFS. Future investigations will aim at assessing the advantages of VMAT with respect to late toxicity and survival after a prolonged follow-up time. (orig.) [German] Die primaere Radiochemotherapie (RCT) gilt als Standardtherapie fuer lokal fortgeschrittene Analkarzinome. In dieser Studie wurde die volumetrisch modulierte Rotationstherapie (''volumetric intensity-modulated arc therapy'', VMAT) mit der klassischen dreidimensionalen konformalen Radiotherapie (3DCRT) hinsichtlich therapieassoziierter Nebenwirkungen und Ueberleben verglichen. Von 1992-2014 wurden 103 aufeinanderfolgende Patienten mit einem Analkarzinom im UICC-Stadium I-III behandelt. Die kombinierte RCT bestand aus der Bestrahlung des gesamten Beckens inklusive der iliakalen und der inguinalen

  17. Intraoral 3D scanner

    Science.gov (United States)

    Kühmstedt, Peter; Bräuer-Burchardt, Christian; Munkelt, Christoph; Heinze, Matthias; Palme, Martin; Schmidt, Ingo; Hintersehr, Josef; Notni, Gunther

    2007-09-01

    Here a new set-up of a 3D-scanning system for CAD/CAM in dental industry is proposed. The system is designed for direct scanning of the dental preparations within the mouth. The measuring process is based on phase correlation technique in combination with fast fringe projection in a stereo arrangement. The novelty in the approach is characterized by the following features: A phase correlation between the phase values of the images of two cameras is used for the co-ordinate calculation. This works contrary to the usage of only phase values (phasogrammetry) or classical triangulation (phase values and camera image co-ordinate values) for the determination of the co-ordinates. The main advantage of the method is that the absolute value of the phase at each point does not directly determine the coordinate. Thus errors in the determination of the co-ordinates are prevented. Furthermore, using the epipolar geometry of the stereo-like arrangement the phase unwrapping problem of fringe analysis can be solved. The endoscope like measurement system contains one projection and two camera channels for illumination and observation of the object, respectively. The new system has a measurement field of nearly 25mm × 15mm. The user can measure two or three teeth at one time. So the system can by used for scanning of single tooth up to bridges preparations. In the paper the first realization of the intraoral scanner is described.

  18. Martian terrain - 3D

    Science.gov (United States)

    1997-01-01

    This area of terrain near the Sagan Memorial Station was taken on Sol 3 by the Imager for Mars Pathfinder (IMP). 3D glasses are necessary to identify surface detail.The IMP is a stereo imaging system with color capability provided by 24 selectable filters -- twelve filters per 'eye.' It stands 1.8 meters above the Martian surface, and has a resolution of two millimeters at a range of two meters.Mars Pathfinder is the second in NASA's Discovery program of low-cost spacecraft with highly focused science goals. The Jet Propulsion Laboratory, Pasadena, CA, developed and manages the Mars Pathfinder mission for NASA's Office of Space Science, Washington, D.C. JPL is an operating division of the California Institute of Technology (Caltech). The Imager for Mars Pathfinder (IMP) was developed by the University of Arizona Lunar and Planetary Laboratory under contract to JPL. Peter Smith is the Principal Investigator.Click below to see the left and right views individually. [figure removed for brevity, see original site] Left [figure removed for brevity, see original site] Right

  19. 3D Printing and 3D Bioprinting in Pediatrics.

    Science.gov (United States)

    Vijayavenkataraman, Sanjairaj; Fuh, Jerry Y H; Lu, Wen Feng

    2017-07-13

    Additive manufacturing, commonly referred to as 3D printing, is a technology that builds three-dimensional structures and components layer by layer. Bioprinting is the use of 3D printing technology to fabricate tissue constructs for regenerative medicine from cell-laden bio-inks. 3D printing and bioprinting have huge potential in revolutionizing the field of tissue engineering and regenerative medicine. This paper reviews the application of 3D printing and bioprinting in the field of pediatrics.

  20. 3D printing for dummies

    CERN Document Server

    Hausman, Kalani Kirk

    2014-01-01

    Get started printing out 3D objects quickly and inexpensively! 3D printing is no longer just a figment of your imagination. This remarkable technology is coming to the masses with the growing availability of 3D printers. 3D printers create 3-dimensional layered models and they allow users to create prototypes that use multiple materials and colors.  This friendly-but-straightforward guide examines each type of 3D printing technology available today and gives artists, entrepreneurs, engineers, and hobbyists insight into the amazing things 3D printing has to offer. You'll discover methods for

  1. 3D game environments create professional 3D game worlds

    CERN Document Server

    Ahearn, Luke

    2008-01-01

    The ultimate resource to help you create triple-A quality art for a variety of game worlds; 3D Game Environments offers detailed tutorials on creating 3D models, applying 2D art to 3D models, and clear concise advice on issues of efficiency and optimization for a 3D game engine. Using Photoshop and 3ds Max as his primary tools, Luke Ahearn explains how to create realistic textures from photo source and uses a variety of techniques to portray dynamic and believable game worlds.From a modern city to a steamy jungle, learn about the planning and technological considerations for 3D modelin

  2. 3D Printing an Octohedron

    OpenAIRE

    Aboufadel, Edward F.

    2014-01-01

    The purpose of this short paper is to describe a project to manufacture a regular octohedron on a 3D printer. We assume that the reader is familiar with the basics of 3D printing. In the project, we use fundamental ideas to calculate the vertices and faces of an octohedron. Then, we utilize the OPENSCAD program to create a virtual 3D model and an STereoLithography (.stl) file that can be used by a 3D printer.

  3. Salient Local 3D Features for 3D Shape Retrieval

    CERN Document Server

    Godil, Afzal

    2011-01-01

    In this paper we describe a new formulation for the 3D salient local features based on the voxel grid inspired by the Scale Invariant Feature Transform (SIFT). We use it to identify the salient keypoints (invariant points) on a 3D voxelized model and calculate invariant 3D local feature descriptors at these keypoints. We then use the bag of words approach on the 3D local features to represent the 3D models for shape retrieval. The advantages of the method are that it can be applied to rigid as well as to articulated and deformable 3D models. Finally, this approach is applied for 3D Shape Retrieval on the McGill articulated shape benchmark and then the retrieval results are presented and compared to other methods.

  4. FEASIBILITY OF IMAGE-GUIDED RADIOTHERAPY FOR CARDIAC SPARING IN PATIENTS WITH LEFT-SIDED BREAST CANCER

    Directory of Open Access Journals (Sweden)

    Claire eLEMANSKI

    2014-09-01

    Full Text Available Patients with left-sided breast cancer are at risk of cardiac toxicity because of cardiac irradiation during radiotherapy with the conventional 3-dimensional conformal technique (3D-CRT. In addition, many patients may receive chemotherapy prior to radiation which may damage the myocardium and may increase the potential for late cardiac complications. New radiotherapy techniques such as intensity-modulated radiotherapy (IMRT may decrease the risk of cardiac toxicity because of the steep dose gradient limiting the volume of the heart irradiated to a high dose. Image-guided radiotherapy (IGRT is a new technique of IMRT delivery with daily imaging which may further reduce excessive cardiac irradiation. Preliminary results of IGRT for cardiac sparing in patients with left-sided breast cancer are promising and need to be investigated in future prospective clinical studies.

  5. 3D-GNOME: an integrated web service for structural modeling of the 3D genome.

    Science.gov (United States)

    Szalaj, Przemyslaw; Michalski, Paul J; Wróblewski, Przemysław; Tang, Zhonghui; Kadlof, Michal; Mazzocco, Giovanni; Ruan, Yijun; Plewczynski, Dariusz

    2016-07-08

    Recent advances in high-throughput chromosome conformation capture (3C) technology, such as Hi-C and ChIA-PET, have demonstrated the importance of 3D genome organization in development, cell differentiation and transcriptional regulation. There is now a widespread need for computational tools to generate and analyze 3D structural models from 3C data. Here we introduce our 3D GeNOme Modeling Engine (3D-GNOME), a web service which generates 3D structures from 3C data and provides tools to visually inspect and annotate the resulting structures, in addition to a variety of statistical plots and heatmaps which characterize the selected genomic region. Users submit a bedpe (paired-end BED format) file containing the locations and strengths of long range contact points, and 3D-GNOME simulates the structure and provides a convenient user interface for further analysis. Alternatively, a user may generate structures using published ChIA-PET data for the GM12878 cell line by simply specifying a genomic region of interest. 3D-GNOME is freely available at http://3dgnome.cent.uw.edu.pl/.

  6. Application of hypofractionated conformal radiotherapy in non-small cell lung cancer%大分割适形放射治疗在非小细胞肺癌中的应用

    Institute of Scientific and Technical Information of China (English)

    盛李明; 许亚萍; 马胜林

    2011-01-01

    大分割适形放疗技术较常规分割技术能给予肿瘤更高的生物有效剂量,近年来研究显示,对早期不能手术非小细胞肺癌(NSCLC)患者,大分割适形放疗高效低毒,是可选择的治疗方案.许多临床Ⅰ、Ⅱ期研究显示,局部晚期NSCLC患者对大分割适形放疗耐受性良好.放射物理学模型和相关临床研究显示,与常规分割放疗模式相比大分割适形放疗不会增加放射性肺炎发生率.%Hypofractionated conformal radiotherapy is capable to deliver much higher doses to the cancer than is possible with standard techniques. Recently there is data suggesting that the early stage nonsmall cell lung cancer ( NSCLC) which is not suitable to surgery is likely to benefit from this regimen, with low lung toxicity. Manyphase Ⅰ-Ⅱ studies showed that the patients with locally advanced NSCLC are well-tolerated to hypofractionated conformal radiotherapy. The model of radio-physic and relative clinical studies suggest that hy-pofractionation would not increase the risk of radiation pneumonitis compared to standard therapy.

  7. Therapeutic efficacy of three - dimensional conformal hypofractionation radiotherapy ( 3 D - CHRT ) for chest tumor%三维适形低分割放射治疗胸部肿瘤的疗效观察

    Institute of Scientific and Technical Information of China (English)

    曾子君; 李伟雄

    2006-01-01

    目的观察胸部肿瘤应用三维适形低分割放射治疗的近期疗效和早期放射损伤.方法35例胸部肿瘤病人(包括非小细胞肺癌13例、食管癌、纵隔淋巴结转移癌各8例、肺转移癌6例)采用三维适形低分割放射治疗,单次剂量250~400cGy(中位剂量300cGy),5次/周,总剂量40~57Gy(中位剂量52Gy).结果完全缓解(CR)16例,部分缓解(PR)13例,稳定(SD)6例,总有效率82.9%.严重的早期放射损伤为放射性肺炎Ⅱ级6例,Ⅲ级5例;放射性食管炎Ⅱ级8例,Ⅲ级8例,Ⅳ级1例.结论三维适形低分割放射治疗胸部肿瘤效果较好,但要注意肺部、食管单次剂量及受照射体积的耐受量,否则易引起严重的放射损伤.

  8. Holography of 3d-3d correspondence at Large N

    OpenAIRE

    Gang, Dongmin; Kim, Nakwoo; Lee, Sangmin

    2014-01-01

    We study the physics of multiple M5-branes compactified on a hyperbolic 3-manifold. On the one hand, it leads to the 3d-3d correspondence which maps an N = 2 $$ \\mathcal{N}=2 $$ superconformal field theory to a pure Chern-Simons theory on the 3-manifold. On the other hand, it leads to a warped AdS 4 geometry in M-theory holographically dual to the superconformal field theory. Combining the holographic duality and the 3d-3d correspondence, we propose a conjecture for the large N limit of the p...

  9. [Efficacy of whole body gamma-knife radiotherapy combined with thermochemotherapy on locally advanced pancreatic cancer].

    Science.gov (United States)

    Zhang, Li-Ping; Nie, Qing; Kang, Jing-Bo; Wang, Bin; Cai, Chang-Lan; Li, Jian-Guo; Qi, Wen-Jie

    2008-11-01

    Radiotherapy and chemotherapy are major therapies for locally advanced pancreatic cancer. This study was to evaluate the efficacy of three-dimensional conformal gamma-knife radiotherapy combined with thermochemotherapy on locally advanced pancreatic cancer. From December 2001 to January 2006, 75 patients with locally advanced pancreatic cancer were divided into radiotherapy group (37 patients) and combination group (38 patients). All patients received gamma-knife radiotherapy using Stereotactic Radiotherapy Gamma Rays System, with iso-dose curves of 50%-60%, tumor encircling dose of 3.0-4.5 Gy per fraction, 8-11 fractions. The patients in combination group received simultaneous thermotherapy at 41.5-43.5 celsius (1 h/fraction, twice a week for 6 times), and chemotherapy with venous administration of tegafur (0.5-1.0 g) and calcium folinate (CF, 0.2 g) for 4-6 times, or venous administration of gemcitabine (0.6-1.0 g/m2) on Days 1 and 8 and cisplatin (DDP) (20-30 mg/m2) on Days 1-3, repeated every 28 days for 3-6 cycles. At 3 months after treatment, the total response (complete remission and partial remission) rate was 70.7% (53/75); the response rate was 73.7% in combination group and 67.5% in radiotherapy group. The 1-year survival rate was 48.3%, and the 2-year survival rate was 22.1%. The 1-and 2-year survival rates were 51.2% and 26.5% in combination group, and 45.2% and 17.6% in radiotherapy group. No serious complications, such as perforation, bleeding and high fever, were seen during treatment and follow-up. 3-D