Prospective Assessment of Deep Inspiration Breath Hold to Prevent Radiation Associated Cardiac Perfusion Defects in Patients With Left-Sided Breast Cancer

Zagar, Timothy M.; Tang, Xiaoli; Jones, Ellen L.; Matney, Jason; Das, Shiva K.; Green, R.; Sheikh, Arif; Khandani, Amir H.; McCartney, William; Wong, Terence Z.; Marks, Lawrence B.

doi:10.1016/j.ijrobp.2015.07.572

Cited by 5 publications

(3 citation statements)

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“…The reasons for SGRT technology adoption in the present study included online monitoring of patient positioning, to reduce patient X-ray exposure, to reduce treatment time, to achieve more precise treatment delivery and for clinical research purposes. A prospective study by Zagar showed that RT treatment with AlignRT ® and DIBH in 18 left sided breast cancer patients resulted in no RT-induced cardiac perfusion abnormalities 6 months post-RT [16]. The results are based on Post-RT SPECT in 8 out of 16 evaluable patients.…”

Section: Discussionmentioning

confidence: 99%

Multi-Institutional Case Studies of Surface Guided Radiotherapy in USA and Germany

Taqaddas¹

2021

J Oncol Res Rev Rep

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AlignRT® is a form of Surface Guided Radiotherapy (SGRT). Its use has recently been increased in various parts of the world. The aim of this study is to find out the current status of Surface Guided Radiotherapy especially AlignRT® in Proton therapy treatment and identify challenges and benefits associated with the application of Align RT from point of view of Radiation oncology professionals. A survey was created to assess clinical, technical, organizational and Educational strategies and resources employed to provide Surface Guided RT mainly AlignRT® based Proton therapy treatment in the responders’ Radiation Oncology centres . Another objective of the study is to discover if AlignRT® can completely replace IGRT. Survey was sent to four Radiation oncology professionals in USA and Germany. This has led to four case studies. The responses provide understanding of the current AlignRT® practices and though these responses are important they should not be considered to be representative of radiation oncology as a whole. The study was conducted in 2020.

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Section: Discussionmentioning

confidence: 99%

Multi-Institutional Case Studies of Surface Guided Radiotherapy in USA and Germany

Taqaddas¹

2021

J Oncol Res Rev Rep

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“…There is less data on long-term SPECT changes, although in one study a proportion of patients at 3 and 6 years had perfusion defects after radiation treatments in which the heart was not excluded from the treatment fields (70). Two prospective studies that used cardiac sparing techniques and excluded the entire heart from the radiation beams found no myocardial perfusion defects (71,72). A recent study using echocardiogram with strain to examine cardiac function in breast cancer patients receiving contemporary radiation and cardiotoxicity systemic therapy did not reveal differences in strain post-radiation, although patients were examined only at 6 months after radiation (73).…”

Section: Discussionmentioning

confidence: 99%

A Pilot Study of Cardiac MRI in Breast Cancer Survivors After Cardiotoxic Chemotherapy and Three-Dimensional Conformal Radiotherapy

et al. 2020

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Purpose/Objectives: Node-positive breast cancer patients often receive chemotherapy and regional nodal irradiation. The cardiotoxic effects of these treatments, however, may offset some of the survival benefit. Cardiac magnetic resonance (CMR) is an emerging modality to assess cardiac injury. This is a pilot trial assessing cardiac damage using CMR in patients who received anthracycline-based chemotherapy and three-dimensional conformal radiotherapy (3DCRT) regional nodal irradiation using heart constraints. Materials and Methods: Node-positive breast cancer patients (2000-2008) treated with anthracycline-based chemotherapy and 3DCRT regional nodal irradiation (including the internal mammary chain nodes) with heart ventricular constraints (V25 < 10%) were invited to participate. Cardiac tissues were contoured and analyzed separately for whole heart (pericardium) and for combined ventricles and left atrium (myocardium). CMR obtained ventricular function/dimensions, late gadolinium enhancement (LGE), global longitudinal strain (GLS), and extracellular volume fraction (ECV) as measures of cardiac injury and/or early fibrosis. CMR parameters were correlated with dose-volume constraints using Spearman correlations. Results: Fifteen left-sided and five right-sided patients underwent CMR. Median diagnosis age was 50 (32-77). No patients had baseline cardiac disease before regional nodal irradiation. Median time after 3DCRT was 8.3 years (5.2-14.4). Median left-sided mean heart dose (MHD) was 4.8 Gy (1.1-11.2) and V25 was 5.7% (0-12%). Median left ventricular ejection fraction (LVEF) was 63%. No abnormal LGE was observed.

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“…6,7 The primary advantage of this technique is that it is noninvasive and does not utilize ionizing radiation for image capture. Several recent publications have documented a benefit for various disease sites including left breast cancer, 8,9 brain cancer, 10,11 and lung cancer, 12 The benefits come from two perspectives namely setup and monitoring. Quicker patient setup can potentially reduce the imaging dose while active patient monitoring can potentially enhance localization and treatment delivery accuracy.…”

Section: Introductionmentioning

confidence: 99%

Quantifying the impact of optical surface guidance in the treatment of cancers of the head and neck

Wei

Ioannides

Sehgal

et al. 2020

J Applied Clin Med Phys

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Surface guided radiation therapy (SGRT) is increasingly being adopted for use in radiation treatment delivery for Head and Neck (H&N) cancer patients. This study investigated the improvement of patient setup accuracy and reduction of setup time for SGRT compared to a conventional setup. A total of 60 H&N cancer patients were retrospectively included. Patients were categorized into three groups: oral cavity, oropharynx and nasopharynx/sinonasal sites with 20 patients in each group.They were further separated into two (2) subgroups, depending on whether they were set up with the aid of SGRT. The Align-RT™ system was used for SGRT in this work. Positioning was confirmed by daily kV-kV imaging in conjunction with weekly CBCT scans. Translational and rotational couch shifts along with patient setup times were recorded. Imaging setup time, which was defined as the elapsed time from the acquisition of the first image set to the end of the last image set, was recorded.Average translational shifts were larger in the non-SGRT group. Vertical shifts showed the most significant reduction in the SGRT group for both oropharynx and oral cavity groups. Pitch corrections were significantly higher in the SGRT group for oropharynx patients and higher pitch corrections were also observed in the SGRT groups of oral cavity and nasopharynx/sinonasal patients. The average setup time when SGRT guidance was employed was shorter for all three treatment sites although this did not reach statistical significance. The largest time reduction between the SGRT and non-SGRT groups was seen in the nasopharynx/sinonasal group. This study suggests that the use of SGRT decreases the magnitude of translational couch shifts during patient setup. However, the rotational corrections needed were generally higher with SGRT group. When SGRT was employed, a definite reduction in patient setup time was observed for nasopharynx/sinonasal and hypopharynx cancer patients. K E Y W O R D S head and neck cancer, patient setup, radiation therapy, surface guided radiation therapy (SGRT) ---

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Prospective Assessment of Deep Inspiration Breath Hold to Prevent Radiation Associated Cardiac Perfusion Defects in Patients With Left-Sided Breast Cancer

Cited by 5 publications

References 0 publications

Multi-Institutional Case Studies of Surface Guided Radiotherapy in USA and Germany

Multi-Institutional Case Studies of Surface Guided Radiotherapy in USA and Germany

A Pilot Study of Cardiac MRI in Breast Cancer Survivors After Cardiotoxic Chemotherapy and Three-Dimensional Conformal Radiotherapy

Quantifying the impact of optical surface guidance in the treatment of cancers of the head and neck

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