Plan Selection in Proton Therapy of Locally Advanced Prostate Cancer with Simultaneous Treatment of Multiple Targets

Pilskog, Sara; Abal, Bonny; Øvrelid, Kaja S.; Engeseth, Grete May; Ytre-Hauge, Kristian S.; Hysing, L.B.

doi:10.1016/j.ijrobp.2019.11.007

Cited by 3 publications

(2 citation statements)

References 34 publications

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“…Most studies addressing anatomic change during proton therapy have used CT-based offline adaptive approaches and have focused on adult cancers. [15][16][17][18] However, MRI-based adaptive therapy would be more appropriate for children because MRI enables better visualization of brain tumors and sarcomas, both of which are common in this patient population. In addition, MRI is not associated with additional radiation exposure, which is an important consideration in children.…”

Section: Discussionmentioning

confidence: 99%

Adaptive Proton Therapy for Pediatric Patients: Improving the Quality of the Delivered Plan With On-Treatment MRI

Acharya

Wang

Quesada

et al. 2021

International Journal of Radiation Oncology*Biology*Physics

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Pencil-beam scanning proton therapy is particularly sensitive to anatomic changes, which may negatively affect plan quality. We hypothesized that magnetic resonance imaging (MRI)-based adaptation can improve plan quality for pediatric patients. By evaluating 230 MRI scans acquired in treatment position during proton therapy, we found that onefourth of patients exhibited anatomic change, more than half of which result in suboptimal delivered plans. This highlights the potential role for MRI-guided proton Purpose: Pencil-beam scanning proton therapy is particularly sensitive to anatomic changes, which may affect the delivered dose distribution. This study examined whether offline adaptation using on-treatment magnetic resonance imaging (MRI) scan during proton therapy could improve plan quality for pediatric patients. Methods and Materials: Pediatric patients with at least 1 MRI scan in the treatment position (MRI tx ) during proton therapy between January 2017 and July 2019 were retrospectively reviewed. Patients underwent MRI and computed tomography simulation. Cases were planned with scenario-based optimization with 3 mm/3% positional/ range uncertainty. Patients demonstrating anatomic change on MRI tx were recontoured. The original plans were applied to the anatomy-of-the-day for dose recalculation (delivered plans). Plans were subsequently reoptimized offline, using original beam angles and dose-volume constraints (adapted plans). Delivered plans were compared with adapted plans to detect significant changes in plan quality, defined as a 5% decrease in the clinical target volume (CTV) receiving 95% of the prescription dose (V95) or a 5% increase in the dose-volume parameter used as an organ-atrisk constraint. Results: Seventy-three pediatric patients were eligible, with 303 MRI scans (73 simulation and 230 MRI tx scans) available for analysis. The median MRI tx scans per patient was 3 (range, 1-7). Twenty patients (27%) showed anatomic change, with 11 (55%) demonstrating a significant change in delivered plan quality. Significant changes were noted on MRI tx from week 2 (n Z 3) or week 3 (n Z 8). Seven of these 11 patients

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Section: Discussionmentioning

confidence: 99%

Adaptive Proton Therapy for Pediatric Patients: Improving the Quality of the Delivered Plan With On-Treatment MRI

Acharya

Wang

Quesada

et al. 2021

International Journal of Radiation Oncology*Biology*Physics

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“…Recently, known clinical effects of acute radiation exposure, such as mucositis and diarrhea, were shown to be affected by the gut microbiota in correlation with conditions of treatment and disease [132][133][134]; but little is known about the subsequently penetrating effects on functional metagenomics initiated by enteric microbial products and systemic metabolomics for the treatment of, for example, prostate cancer [135][136][137], which has been treated with conventional intensity-modulated radiation therapy [137] and intensitymodulated proton therapy [138]. Analyses between the gut microbiota and bone microstructure revealed that Bacteroides massiliensis and Muribaculum sp.…”

Section: Discussionmentioning

confidence: 99%

Radiation Impacts Microbiota Compositions That Activate Transforming Growth Factor-Beta Expression in the Small Intestine

Maier

2023

Microbiology Research

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The composition of the gut microbiota represents an early indicator of chronic post-radiation outcomes in elderly bone and gastrointestinal homeostasis. Fecal microbiota analyses revealed that the relative abundances of Bacteroides massiliensis, Muribaculum sp., or Prevotella denticola were different between conventional microbiota (CM) and anti-inflammatory restricted microbiota (RM). The murine RM was found conditional on mucosa-associated dysbiosis under both, disturbances of interleukin (IL)-17 signaling and exposure to radiation alone. This review discusses the hypothesis that intestinal microbiota induced alterations in DNA repair and expressed transforming growth factor (TGF)-β in the small intestine, thereby impacting bone microstructure and osteoblast dysfunction in silicon ion (1.5 Gy 28Si ions of 850 MeV/u) irradiated mice. Bacterial microbiota compositions influenced therapeutic approaches, correlated with clinical outcomes in radiotherapy and were associated with alterations of the immune response to severe acute respiratory syndrome coronavirus (SARS-CoV)-2 infections during the last global pandemics. In the absence of TGF-β, functional metagenomics, cytokine profiles, bacterial community analyses in human and murine mucosa cells, and inflammatory markers in rat intestines were analyzed. This research finally showed radiation-induced osteolytic damage to correlated with specific features of intestinal bacterial composition, and these relationships were expatiated together with radiation effects on normal tissue cell proliferation.

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Reduction of PTV margins for elective pelvic lymph nodes in online adaptive radiotherapy of prostate cancer patients

Brennsæter,

Dahle,

Moi

et al. 2023

Acta Oncologica

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Plan Selection in Proton Therapy of Locally Advanced Prostate Cancer with Simultaneous Treatment of Multiple Targets

Cited by 3 publications

References 34 publications

Adaptive Proton Therapy for Pediatric Patients: Improving the Quality of the Delivered Plan With On-Treatment MRI

Adaptive Proton Therapy for Pediatric Patients: Improving the Quality of the Delivered Plan With On-Treatment MRI

Radiation Impacts Microbiota Compositions That Activate Transforming Growth Factor-Beta Expression in the Small Intestine

Reduction of PTV margins for elective pelvic lymph nodes in online adaptive radiotherapy of prostate cancer patients

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