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This study will analyze the feasibility of evaluating dose-volume parameters for the heart and left ventricular myocardium (LVM) by applying DIR. The electrocardiograph-gated four-dimensional CT (ECG-gated 4DCT) data of 21 patients were analyzed retrospectively. The heart and LVM were contoured on 20 phases of 4DCT (0%, 5%,…,95%). The heart and LVM in the minimum volume\u002Fdice similarity coefficient (DSC) phase (Volume min\u002FDSC min) were deformed to the maximum volume\u002FDSC phase (Volume max\u002F DSC max), which used the intensity-based free-form DIR algorithm of MIM software. The dose was deformed according to the deformation vector. The variations in volume, mean dose (Dmean), V20, V30 and V40 for the heart and LVM before and after DIR were compared, and the reference phase was the Volume max\u002FDSC max phase. For the heart, the difference between the pre- and post-registration Volume min and Volume max were reduced from 13.87 to 1.72%; the DSC was increased from 0.899 to 0.950 between the pre- and post-registration DSC min phase relative to the DSC max phase. The post-registration Dmean, V20, V30 and V40 of the heart were statistically significant compared to those in the Volume max\u002FDSC max phase (p \u003C 0.05). For the LVM, the difference between the pre- and post-registration Volume min and Volume max were only reduced from 18.77 to 17.38%; the DSC reached only 0.733 in the post-registration DSC min phase relative to the DSC max phase. The pre- and post-registration volume, Dmean, V20, V30 and V40 of the LVM were all statistically significant compared to those in the Volume max\u002FDSC max phase (p \u003C 0.05). There was no significant relationship between the variation in dose-volume parameters and the variation in the volume and morphology for the heart; however, the inconsistency of the variation in the volume and morphology for the LVM was a major factor that led to uncertainty in the dose-volume evaluation. In addition, the individualized local deformation registration technology should be applied in dose accumulation for the heart and LVM.",{"EN":174},"Impact of deformable image registration on dose accumulation applied electrocardiograph-gated 4DCT in the heart and left ventricular myocardium during esophageal cancer radiotherapy",{"VOID":176},"[\"1374692540340467107\"]",{"VOID":178},"10.1186\u002Fs13014-018-1093-z","PUBLICATION","VERIFIED","2024-05-04T12:27:39.578+00:00","Auto 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Radiotherapy for breast cancer: the predictable consequences of an unmet need. Breast. 2016;29:120–2.","https:\u002F\u002Flink.springer.com\u002F10.1007\u002Fs10440-022-00541-7",{"doi":311},"10.1007\u002Fs10440-022-00541-7",{"id":313,"text":314,"url":315,"identifiers":316},"e1c7f990-493d-46f0-bb95-1813a8abdeb1","Bronsart E, Dureau S, Xu HP, Bazire L, Chilles A, Costa E, et al. Whole breast radiotherapy in the lateral isocentric lateral decubitus position: long-term efficacy and toxicity results. Radiother Oncol. 2017;124(2):214–9.","https:\u002F\u002Fwww.sciencedirect.com\u002Fscience\u002Farticle\u002Fpii\u002FS0167814017324490",{"doi":317},"10.1016\u002Fj.radonc.2017.07.001",{"id":307,"text":319,"url":309,"identifiers":320},"Maciejczyk A, Skrzypczyńska I, Janiszewska M. Lung cancer. Radiotherapy in lung cancer: actual methods and future trends. Rep Pract Oncol Radiother. 2014;19(6):353–60.",{"doi":311},{"id":307,"text":322,"url":309,"identifiers":323},"Darby SC, Ewertz M, Mcgale P, et al. Risk of ischemic heart disease in women after radiotherapy for breast cancer. N Engl J Med. 2013;368(11):987–98.",{"doi":311},{"id":307,"text":325,"url":309,"identifiers":326},"Madan R, Benson R, Sharma DN, Julka PK, Rath GK. Radiation induced heart disease: pathogenesis, management and review literature. J Egypt Natl Canc Inst. 2015;27(4):187–93.",{"doi":311},{"id":328,"text":329,"url":330,"identifiers":331},"4db82042-7ad7-43ee-aca0-39e3ebcb1e57","McGale P, Darby SC, Hall P, Adolfsson J, Bengtsson NO, Bennet AM, et al. Incidence of heart disease in 35,000 women treated with radiotherapy for breast cancer in Denmark and Sweden. Radiother Oncol. 2011;100(2):167–75.","https:\u002F\u002Fwww.sciencedirect.com\u002Fscience\u002Farticle\u002Fpii\u002FS0167814011003276",{"doi":332},"10.1016\u002Fj.radonc.2011.06.016",{"id":307,"text":334,"url":309,"identifiers":335},"Nolan MT, Russell DJ, Marwick TH. Long-term risk of heart failure and myocardial dysfunction after thoracic radiotherapy: a systematic review. Can J Cardiol. 2016;32:908–20.",{"doi":311},{"id":307,"text":337,"url":309,"identifiers":338},"Kataria T, Bisht SS, Gupta D, et al. Quantification of coronary artery motion and internal risk volume from ECG gated radiotherapy planning scans. Radiother Oncol. 2016;121:59–63.",{"doi":311},{"id":307,"text":340,"url":309,"identifiers":341},"Rosu M, Hugo GD. Advances in 4D radiation therapy for managing respiration: part II - 4D treatment planning. Z Med Phys. 2012;22(4):272–80.",{"doi":311},{"id":307,"text":343,"url":309,"identifiers":344},"Hugo GD, Rosu M. Advances in 4D radiation therapy for managing respiration: part I - 4D imaging. Z Med Phys. 2012;22(4):258–71.",{"doi":311},{"id":307,"text":346,"url":309,"identifiers":347},"Cole AJ, O'Hare JM, McMahon SJ, McGarry CK, Butterworth KT, McAleese J, et al. Investigating the potential impact of four-dimensional computed tomography (4DCT) on toxicity, outcomes and dose escalation for radical lung cancer radiotherapy. Clin Oncol (R Coll Radiol). 2014;26(3):142–50.",{"doi":311},{"id":349,"text":350,"url":351,"identifiers":352},"19af5409-dc31-4c44-9dcd-e7be0fbde08f","Funabashi N, Komiyama N, Kato H, Umekita H, Asano M, Komuro I. Retrospective ECG-gated left ventriculography using multislice CT following left ventricular bolus injection and evaluation of its utility and motion artifact at every cardiac phase. Int J Cardiol. 2006;113(1):132–8.","https:\u002F\u002Fwww.sciencedirect.com\u002Fscience\u002Farticle\u002Fpii\u002FS0167527305011812",{"doi":353},"10.1016\u002Fj.ijcard.2005.08.044",{"id":307,"text":355,"url":309,"identifiers":356},"van Dam IE, van Sörnsen de Koste JR, Hanna GG, Muirhead R, Slotman BJ, Senan S. Improving target delineation on 4-dimensional CT scans in stage I NSCLC using a deformable registration tool. Radiother Oncol. 2010;96(1):67–72.",{"doi":311},{"id":307,"text":358,"url":309,"identifiers":359},"Zhong H, Siebers JV. Monte Carlo dose mapping on deforming anatomy. Phys Med Biol. 2009;54(19):5815–30.",{"doi":311},{"id":307,"text":361,"url":309,"identifiers":362},"Balik S, Weiss E, Jan N, Roman N, Sleeman WC, Fatyga M, et al. Evaluation of 4-dimensional computed tomography to 4-dimensional cone-beam computed tomography deformable image registration for lung cancer adaptive radiation therapy. Int J Radiat Oncol Biol Phys. 2013;86(2):372–9.",{"doi":311},{"id":307,"text":364,"url":309,"identifiers":365},"Brock KK, Mutic S, Mcnutt TR, Li H, Kessler ML. Use of image registration and fusion algorithms and techniques in radiotherapy: report of the AAPM radiation therapy committee task group no. 132. Med Phys. 2017;44(7):e43–76.",{"doi":311},{"id":307,"text":367,"url":309,"identifiers":368},"Wang H, Garden AS, Zhang L, Wei X, Ahamad A, Kuban DA, et al. Performance evaluation of automatic anatomy segmentation algorithm on repeat or four-dimensional computed tomography images using deformable image registration method. Int J Radiat Oncol Biol Phys. 2008;72(1):210–9.",{"doi":311},{"id":18,"text":370,"url":18,"identifiers":371},"Piper J. Evaluation of an intensity-based free-form deformable registration algorithm. Med Phys. 2007;34(6):2353–4.",{},false,{"id":374,"createTime":375,"updateTime":376,"relativeEntities":377,"slug":378,"properties":379,"entityType":179,"verifyStatus":180,"verifyTime":388,"verifyNote":182,"languages":18,"translateLanguages":18,"viewCount":19,"primaryUrl":389,"fullTextUrl":18,"authors":390,"publicationType":245,"publisherRelationship":494,"citationCount":544,"citationInfo":545,"publishDate":548,"publishYear":546,"citationAnalyzeStatus":302,"lastCitationAnalyze":376,"indexDatabases":549,"openAccess":18,"references":550,"isForceReanalyzing":372},"151179c2-941b-40b5-8065-b9b6b7ee0855","2023-12-22T02:04:02.711+00:00","2026-07-28T04:41:53.235+00:00",[],"Effect-of-stereotactic-body-radiotherapy-on-regional-metabolic-liver-function-investigated-in-patients-by-dynamic-18F-FDGal-PET-CT",{"abstract":380,"title":382,"gsPaper":384,"doi":386},{"EN":381},"Stereotactic body radiotherapy (SBRT) is increasingly used for treatment of liver tumors but the effect on metabolic liver function in surrounding tissue is largely unknown. Using 2-deoxy-2-[18F]fluoro-d-galactose ([18F]FDGal) positron emission tomography (PET)\u002Fcomputed tomography (CT), we aimed to determine a dose–response relationship between radiation dose and metabolic liver function as well as recovery. Procedures. One male subject with intrahepatic cholangiocarcinoma and five subjects (1 female, 4 male) with liver metastases from colorectal cancer (mCRC) underwent [18F]FDGal PET\u002FCT before SBRT and after 1 and 3 months. The dose response was calculated using the data after 1 month and the relative recovery was evaluated after 3 months. All patients had normal liver function at time of inclusion. A linear dose–response relationship for the individual liver voxel dose was seen until approximately 30 Gy. By fitting a polynomial curve to data, a mean TD50 of 18 Gy was determined with a 95% CI from 12 to 26 Gy. After 3 months, a substantial recovery was observed except in tissue receiving more than 25 Gy. [18F]FDGal PET\u002FCT makes it possible to determine a dose–response relationship between radiation dose and metabolic liver function, here with a TD50 of 18 Gy (95% CI 12–26 Gy). Moreover, the method makes it possible to estimate metabolic recovery in liver tissue.",{"EN":383},"Effect of stereotactic body radiotherapy on regional metabolic liver function investigated in patients by dynamic [18F]FDGal 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Denmark",[],{"id":404,"sortIndex":203,"affiliation":405,"properties":411},"161f33d3-0276-4791-aaa3-ebeb44ba7d66",{"id":404,"createTime":18,"updateTime":18,"relativeEntities":406,"slug":18,"properties":407,"entityType":18,"verifyStatus":18,"verifyTime":18,"verifyNote":18,"languages":18,"translateLanguages":18,"viewCount":18,"url":18,"parentIds":410,"statistic":18},[],{"title":408},{"VI":409},"Departement of Hepatology & Gastroenterology, Aarhus University Hospital, Aarhus N, Denmark",[],{},{"id":413,"sortIndex":217,"affiliation":414,"properties":420},"98d27cf2-2215-49ba-89ca-d9822f3f0aca",{"id":413,"createTime":18,"updateTime":18,"relativeEntities":415,"slug":18,"properties":416,"entityType":18,"verifyStatus":18,"verifyTime":18,"verifyNote":18,"languages":18,"translateLanguages":18,"viewCount":18,"url":18,"parentIds":419,"statistic":18},[],{"title":417},{"VI":418},"Department of Internal Medicine, Viborg Regional Hospital, Viborg, Denmark",[],{},{"title":422},{"VI":423},"Michael Sørensen",{"id":425,"sortIndex":203,"researcher":18,"roles":426,"affiliations":427,"properties":436,"displayName":438,"givenName":18,"familyName":18},"191630fd-6f71-4b71-be1d-7c8e8712e04a",[188],[428],{"id":429,"sortIndex":19,"affiliation":430,"properties":18},"ed6ec094-f9ff-49db-9bbd-f6982dc90c0b",{"id":429,"createTime":18,"updateTime":18,"relativeEntities":431,"slug":18,"properties":432,"entityType":18,"verifyStatus":18,"verifyTime":18,"verifyNote":18,"languages":18,"translateLanguages":18,"viewCount":18,"url":18,"parentIds":435,"statistic":18},[],{"title":433},{"VI":434},"Departement of Oncology, Aarhus University Hospital, Aarhus N, Denmark",[],{"title":437},{"VI":438},"Mette Marie Fode",{"id":440,"sortIndex":217,"researcher":18,"roles":441,"affiliations":442,"properties":451,"displayName":453,"givenName":18,"familyName":18},"dbe0eb9b-4610-4217-a0e7-0e534cf8f72e",[188],[443],{"id":444,"sortIndex":19,"affiliation":445,"properties":18},"12b56fc0-c33e-4082-86dd-50f05eb7c09d",{"id":444,"createTime":18,"updateTime":18,"relativeEntities":446,"slug":18,"properties":447,"entityType":18,"verifyStatus":18,"verifyTime":18,"verifyNote":18,"languages":18,"translateLanguages":18,"viewCount":18,"url":18,"parentIds":450,"statistic":18},[],{"title":448},{"VI":449},"Departement of Medical Physics, Aarhus University Hospital, Aarhus N, Denmark",[],{"title":452,"gsAuthor":454},{"VI":453},"Jørgen Baltzer Petersen",{"VOID":455},"[\"KJyZUnYAAAAJ\"]",{"id":457,"sortIndex":233,"researcher":18,"roles":458,"affiliations":459,"properties":475,"displayName":477,"givenName":18,"familyName":18},"8a0e012a-e24d-4168-9570-36a93b6bbd2e",[188],[460,466],{"id":429,"sortIndex":19,"affiliation":461,"properties":18},{"id":429,"createTime":18,"updateTime":18,"relativeEntities":462,"slug":18,"properties":463,"entityType":18,"verifyStatus":18,"verifyTime":18,"verifyNote":18,"languages":18,"translateLanguages":18,"viewCount":18,"url":18,"parentIds":465,"statistic":18},[],{"title":464},{"VI":434},[],{"id":467,"sortIndex":203,"affiliation":468,"properties":474},"eca52c23-8d7f-4dca-97d3-2db36754d85b",{"id":467,"createTime":18,"updateTime":18,"relativeEntities":469,"slug":18,"properties":470,"entityType":18,"verifyStatus":18,"verifyTime":18,"verifyNote":18,"languages":18,"translateLanguages":18,"viewCount":18,"url":18,"parentIds":473,"statistic":18},[],{"title":471},{"VI":472},"Department of Genetics, Vejle Hospital, Vejle, Denmark",[],{},{"title":476},{"VI":477},"Marianne Ingerslev Holt",{"id":479,"sortIndex":480,"researcher":18,"roles":481,"affiliations":482,"properties":491,"displayName":493,"givenName":18,"familyName":18},"58ed72d4-18e1-4c87-b417-1d99a1ec3784",4,[188],[483],{"id":484,"sortIndex":19,"affiliation":485,"properties":18},"bca9865d-745f-4f20-8601-b19f63f7dd42",{"id":484,"createTime":18,"updateTime":18,"relativeEntities":486,"slug":18,"properties":487,"entityType":18,"verifyStatus":18,"verifyTime":18,"verifyNote":18,"languages":18,"translateLanguages":18,"viewCount":18,"url":18,"parentIds":490,"statistic":18},[],{"title":488},{"VI":489},"Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus N, Denmark",[],{"title":492},{"VI":493},"Morten 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N, Dawson LA, Krishnan S, et al. Radiotherapy for hepatocellular carcinoma: new indications and directions for future study. J Natl Cancer Inst. 2016;108:djw133.",{"doi":311},{"id":307,"text":555,"url":309,"identifiers":556},"Høyer M, Swaminath A, Bydder S, et al. Radiotherapy for liver metastases: a review of evidence. Int J Radiat Oncol Biol Phys. 2012;82:1047–57.",{"doi":311},{"id":307,"text":558,"url":309,"identifiers":559},"Fode MM, Høyer M. Survival and prognostic factors in 321 patients treated with stereotactic body radiotherapy for oligo-metastases. Radiother Oncol. 2015;114:155–60.",{"doi":311},{"id":307,"text":561,"url":309,"identifiers":562},"Pan CC, Kavanagh BD, Dawson LA, et al. Radiation-associated liver injury. Int J Radiat Oncol Biol Phys. 2010;76:94–100.",{"doi":311},{"id":307,"text":564,"url":309,"identifiers":565},"Tygstrup N. Determination of the hepatic elimination capacity (Lm) of galactose by single injection. Scand J Clin Lab Invest. 1966;18:118–25.",{"doi":311},{"id":307,"text":567,"url":309,"identifiers":568},"Ranek L, Andreasen PB, Tygstrup N. Galactose elimination capacity as a prognostic index in patients with fulminant liver failure. Gut. 1976;17:959–64.",{"doi":311},{"id":570,"text":571,"url":572,"identifiers":573},"a09e5105-60f9-4bdb-a50f-c66c9606d862","Schmidt LE, Ott P, Tygstrup N. Galactose elimination capacity as a prognostic marker in patients with severe acetaminophen-induced hepatotoxicity: 10 years’ experience. Clin Gastroenterol Hepatol. 2004;2:418–24.","https:\u002F\u002Fwww.sciencedirect.com\u002Fscience\u002Farticle\u002Fpii\u002FS1542356504001284",{"doi":574},"10.1016\u002Fs1542-3565(04)00128-4",{"id":307,"text":576,"url":309,"identifiers":577},"Merkel C, Marchesini G, Fabbri A, et al. The course of galactose elimination capacity in patients with alcoholic cirrhosis: possible use as a surrogate marker for death. Hepatology. 1996;24:820–3.",{"doi":311},{"id":579,"text":580,"url":581,"identifiers":582},"f1b5aa90-dd1e-45d6-90e4-c8c5b369d975","Jepsen P, Vilstrup H, Ott P, et al. The galactose elimination capacity and mortality in 781 Danish patients with newly-diagnosed liver cirrhosis: a cohort study. BMC Gastroenterol. 2009;30:50.","https:\u002F\u002Fbmcgastroenterol.biomedcentral.com\u002Farticles\u002F10.1186\u002F1471-230X-9-50",{"doi":583},"10.1186\u002F1471-230X-9-50",{"id":307,"text":585,"url":309,"identifiers":586},"Redaelli CA, Dufour JF, Wagner M, Schilling M, Hüsler J, Krähenbühl L, et al. Preoperative galactose elimination capacity predicts complications and survival after hepatic resection. Ann Surg. 2002;235:77–85.",{"doi":311},{"id":307,"text":588,"url":309,"identifiers":589},"Sørensen M, Munk OL, Mortensen FV, et al. Hepatic uptake and metabolism of galactose can be quantified in vivo by 2-[18F]fluoro-2-deoxygalactose positron emission tomography. Am J Physiol Gastrointest Liver Physiol. 2008;295:G27–36.",{"doi":311},{"id":18,"text":591,"url":18,"identifiers":592},"Sørensen M, Mikkelsen KS, Frisch K, Bass L, Bibby BM, Keiding S. Hepatic galactose metabolism quantified in humans using 2–18F-fluoro-2-deoxy-d-galactose PET\u002FCT. J Nucl Med. 2011;52:1566–72.",{},{"id":307,"text":594,"url":309,"identifiers":595},"Sørensen M, Mikkelsen KS, Frisch K, Villadsen GE, Keiding S. Regional metabolic liver function measured in patients with cirrhosis by 2-[18F]fluoro-2-deoxy-d-galactose PET\u002FCT. J Hepatol. 2013;58:1119–24.",{"doi":311},{"id":307,"text":597,"url":309,"identifiers":598},"Mikkelsen KS, Sørensen M, Frisch K, Villadsen GE, Bibby BM, Keiding S. The lumped constant for the galactose analog 2–18F-fluoro-2-deoxy-d-galactose is increased in patients with parenchymal liver disease. J Nucl Med. 2014;55:590–4.",{"doi":311},{"id":307,"text":600,"url":309,"identifiers":601},"Sørensen M. Determination of hepatic galactose elimination capacity using 2-[18F]fluoro-2-deoxy-d-galactose PET\u002FCT. Reproducibility of the method and metabolic heterogeneity in a normal pig liver model. Scand J Gastroenterol. 2011;46:98–103.",{"doi":311},{"id":307,"text":603,"url":309,"identifiers":604},"Bak-Fredslund KP, Lykke Eriksen P, Munk OL, Villadsen GE, Keiding S, Sørensen M. Metabolic liver function in humans measured by 2–18F-2-deoxy-d-galactose PET\u002FCT—Reproducibility and clinical potential. EJNMMI Res. 2017;27:71.",{"doi":311},{"id":307,"text":606,"url":309,"identifiers":607},"Frisch K, Bender D, Keiding S, Sørensen M. Nucleophilic radiosynthesis of 2–18F-fluoro-2-deoxy-d-galactose from Talose triflate and biodistribution in a porcine model. Nuc Med Biol. 2011;38:477–83.",{"doi":311},{"id":18,"text":609,"url":18,"identifiers":610},"Joiner M, van der Koge A. Clinical radiobiology. 4th edition, p. 115, Taylor and Francis Group.",{},{"id":307,"text":612,"url":309,"identifiers":613},"Buus S, Grau C, Munk OL, Rodell A, Jensen K, Mouridsen K, Keiding S. Individual radiation response of parotid glands investigated by dynamic 11C-methionine PET. Radiother Oncol. 2006;78:262–9.",{"doi":311},{"id":18,"text":615,"url":18,"identifiers":616},"Reed GB Jr, Cox AJ Jr. The human liver after radiation injury. A form of veno-occlusive disease. Am J Pathol. 1966;48:597–611.",{},{"id":307,"text":618,"url":309,"identifiers":619},"Herfarth KK, Hof H, Bahner ML, et al. Assessment of focal liver reaction by multiphasic CT after stereotactic single-dose radiotherapy of liver tumors. Int J Radiat Oncol Biol Phys. 2003;57:444–51.",{"doi":311},{"id":307,"text":621,"url":309,"identifiers":622},"Cao Y, Platt JF, Francis IR, et al. The prediction of radiation-induced liver dysfunction using a local dose and regional venous perfusion model. Med Phys. 2007;34:604.",{"doi":311},{"id":307,"text":624,"url":309,"identifiers":625},"Yildirim SI, Poulsen HE. Quantitative liver functions after 70% hepatectomy. Eur J Clin Invest. 1981;11:469–72.",{"doi":311},{"id":307,"text":627,"url":309,"identifiers":628},"de Graaf W, Bennink RJ, Heger M, Maas A, de Bruin K, van Gulik TM. Quantitative assessment of hepatic function during liver regeneration in a standardized rat model. J Nucl Med. 2011;52:294–302.",{"doi":311},{"id":307,"text":630,"url":309,"identifiers":631},"Jansen PL, Chamuleau RA, van Leeuwen DJ, Schipper HG, Busemann-Sokole E, van der Heyde MN. Liver regeneration and restoration of liver function after partial hepatectomy in patients with liver tumors. Scand J Gastroenterol. 1990;25:112–8.",{"doi":311},{"id":307,"text":633,"url":309,"identifiers":634},"Nadalin S, Testa G, Malagó M, Beste M, Frilling A, Schroeder T, Jochum C, Gerken G, Broelsch CE. Volumetric and functional recovery of the liver after right hepatectomy for living donation. Liver Transpl. 2004;10:1024–9.",{"doi":311},{"id":307,"text":636,"url":309,"identifiers":637},"Fode MM, Bak-Fredslund K, Pedersen JB, Worm E, Sørensen M, Høyer M. A phase I study on stereotactic body radiotherapy of liver metastases based on functional treatment planning using positron emission tomography with 2-[18F]fluoro-2-deoxy-d-galactose. Acta Oncol. 2017;56:1614–20.",{"doi":311},{"id":307,"text":639,"url":309,"identifiers":640},"Feng M, Ben-Josef E. Radation therapy for hepatocellular carcinoma. Semin Radiat Oncol. 2011;21:271–7.",{"doi":311},{"id":307,"text":642,"url":309,"identifiers":643},"Bujold A, Massey CA, Kim JJ, et al. Sequential phase I and II trials of stereotactic body radiotherapy for locally advanced hepatocellular carcinoma. J Clin Oncol. 2013;31:1631–9.",{"doi":311},{"id":307,"text":645,"url":309,"identifiers":646},"Partridge M, Yamamoto T, Grau C, Høyer M, Muren LP. Imaging of normal lung, liver and parotid gland function for radiotherapy. Acta Oncol. 2010;49:997–1011.",{"doi":311},{"id":307,"text":648,"url":309,"identifiers":649},"Fode MM, Petersen JB, Sørensen M, Holt MI, Keiding S, Høyer M. 2-[18F]fluoro-2-deoxy-d-galactose positron emission tomography guided functional treatment planning of stereotactic body radiotherapy of liver tumours. Phys Imag Radiat Oncol. 2017;1:28–33.",{"doi":311},{"id":307,"text":651,"url":309,"identifiers":652},"Brade AM, Ng S, Brierley J, et al. Phase 1 trial of sorafenib and stereotactic body radiation therapy for hepatocellular carcinoma. Int J Radiat Oncol Biol Phys. 2016;94:580–7.",{"doi":311},{"id":307,"text":654,"url":309,"identifiers":655},"Miften M, Vinogradskiy Y, Moiseenko V, et al. Radiation dose-volume effects for liver SBRT. Int J Radiat Oncol Biol Phys. 2019;110:196–205.",{"doi":311},{"id":657,"createTime":658,"updateTime":659,"relativeEntities":660,"slug":661,"properties":662,"entityType":179,"verifyStatus":180,"verifyTime":673,"verifyNote":182,"languages":18,"translateLanguages":18,"viewCount":19,"primaryUrl":674,"fullTextUrl":18,"authors":675,"publicationType":245,"publisherRelationship":909,"citationCount":19,"citationInfo":959,"publishDate":961,"publishYear":299,"citationAnalyzeStatus":962,"lastCitationAnalyze":963,"indexDatabases":964,"openAccess":18,"references":18,"isForceReanalyzing":372},"cd214288-df09-4e30-80e3-92503c5ad066","2024-01-04T09:52:45.929+00:00","2026-07-27T17:56:19.277+00:00",[],"The-influence-of-fractionated-radiotherapy-on-the-stability-of-spinal-bone-metastases-a-retrospective-analysis-from-1047-cases",{"abstract":663,"title":665,"gsPaper":667,"references":669,"doi":671},{"EN":664},"The effect of radiotherapy, in particular the application of different multi-fraction schedules in the management of unstable spinal bone metastases (SBM), is incompletely understood. This study aims to compare the radiological response regarding various dose and fractionation schedules of radiotherapy in the palliative treatment of SBM. We retrospectively assessed 1047 patients with osteolytic SBM, treated with palliative radiotherapy at our department between 2000 and 2015. Lung cancer (40.2%), breast (16.7%) and renal cancer (15.2%) were the most common solid tumors in this study. Different common multi-fraction regimen (5x4Gy, 10x3Gy, 14 × 2.5Gy and 20x2Gy) were compared with regard to radiological response and recalcification at 3 and 6 months after radiotherapy. The Taneichi score was used for classification of osteolytic SBM. Median follow up was 6.3 months. The median overall survival (OS) in the short-course radiotherapy (SCR) group using less than 10 treatment fractions was 5.5 months vs. 9.5 months in the long-course radiotherapy (LCR) group using in excess of 10 fractions (log rank p \u003C .0001). Overall survival (OS) in the SCR group after 3 and 6 months was 66.8 and 49.1%, respectively vs 80.9 and 61.5%, respectively in the LCR group. 17.6% (n = 54\u002F306) and 31.1% (n = 89\u002F286) of unstable SBM were classified as stable in the SCR group at 3 and 6 months post radiotherapy, respectively (p \u003C .001 for both). In the LCR group, 24.1% (n = 28\u002F116) and 34.2% (n = 38\u002F111) of unstable SBM were stabilized after 3 and 6 months, respectively (p \u003C .001 for both). Our study shows no significant difference in stabilization achieving recalcification rates between multi-fraction schedules (SCR vs. LCR) in the palliative management of unstable SBM. Both groups with multi-fraction regimen demonstrate a stabilizing effect following 3 and 6 months after radiotherapy.",{"EN":666},"The influence of fractionated radiotherapy on the stability of spinal bone metastases: a retrospective analysis from 1047 cases",{"VOID":668},"[\"9135506327453211063\"]",{"VOID":670},"Wong DA, Fornasier VL, MacNab I. Spinal metastases: the obvious, the occult, and the impostors. Spine. 1990;15(1):1–4.\nWu X, Ye Z, Pu F, Chen S, Wang B, Zhang Z, Yang C, Yang S, Shao Z. Palliative surgery in treating painful metastases of the upper cervical spine: case report and review of the literature. Medicine. 2016;95(18):e3558.\nBernard F, Lemee JM, Lucas O, Menei P. Postoperative quality-of-life assessment in patients with spine metastases treated with long-segment pedicle-screw fixation. J Neurosurg Spine. 2017;26(6):725–35.\nKlimo P Jr, Schmidt MH. Surgical management of spinal metastases. Oncologist. 2004;9(2):188–96.\nChow E, Holden L, Rubenstein J, Christakis M, Sixel K, Vidmar M, Finkelstein J, Hayter C, Loblaw A, Wong R, et al. Computed tomography (CT) evaluation of breast cancer patients with osteolytic bone metastases undergoing palliative radiotherapy--a feasibility study. Radiother Oncol. 2004;70(3):291–4.\nReinbold R-D, Wannemacher M, Hodapp N, Adler C-P. Osteodensitometry of vertebral metastases after radiotherapy using quantitave computed tomography. Skelet Radiol. 1989;18:517–21.\nFoerster R, Eisele C, Bruckner T, Bostel T, Schlampp I, Wolf R, Debus J, Rief H. Bone density as a marker for local response to radiotherapy of spinal bone metastases in women with breast cancer: a retrospective analysis. Radiat Oncol. 2015;10:62.\nKoswig S, Budach V. Remineralization and pain relief in bone metastases after after different radiotherapy fractions (10 times 3 Gy vs. 1 time 8 Gy). A prospective study. Strahlenther Onkol. 1999;175(10):500–8.\nSchlampp I, Rieken S, Habermehl D, Bruckner T, Forster R, Debus J, Rief H. Stability of spinal bone metastases in breast cancer after radiotherapy: a retrospective analysis of 157 cases. Strahlenther Onkol. 2014;190(9):792–7.\nWolf RJ, Foerster R, Bruckner T, Bostel T, Schlampp I, Debus J, Rief H, Group GB. Survival and prognostic factors in patients with stable and unstable spinal bone metastases from solid tumors: a retrospective analysis of 915 cases. BMC Cancer. 2016;16:528.\nHarada H, Katagiri H, Kamata M, Yoshioka Y, Asakura H, Hashimoto T, Furutani K, Takahashi M, Sakahara H, Nishimura T. Radiological response and clinical outcome in patients with femoral bone metastases after radiotherapy. J Radiat Res. 2010;51(2):131–6.\nForo Arnalot P, Fontanals AV, Galceran JC, Lynd F, Latiesas XS, de Dios NR, Castillejo AR, Bassols ML, Galan JL, Conejo IM, et al. Randomized clinical trial with two palliative radiotherapy regimens in painful bone metastases: 30 Gy in 10 fractions compared with 8 Gy in single fraction. Radiother Oncol. 2008;89(2):150–5.\nGuckenberger M, Mantel F, Gerszten PC, Flickinger JC, Sahgal A, Letourneau D, Grills IS, Jawad M, Fahim DK, Shin JH, et al. Safety and efficacy of stereotactic body radiotherapy as primary treatment for vertebral metastases: a multi-institutional analysis. Radiat Oncol. 2014;9:226.\nGutierrez Bayard L, Salas Buzon Mdel C, Angulo Pain E, de Ingunza Baron L. Radiation therapy for the management of painful bone metastases: results from a randomized trial. Rep Pract Oncol Radiother. 2014;19(6):405–11.\nHartsell WF, Scott CB, Bruner DW, Scarantino CW, Ivker RA, Roach M 3rd, Suh JH, Demas WF, Movsas B, Petersen IA, et al. Randomized trial of short- versus long-course radiotherapy for palliation of painful bone metastases. J Natl Cancer Inst. 2005;97(11):798–804.\nHoskin P, Rojas A, Fidarova E, Jalali R, Mena Merino A, Poitevin A, Oucrif S, Abdelwahab S, Kochbati L, Plieskiene A, et al. IAEA randomised trial of optimal single dose radiotherapy in the treatment of painful bone metastases. Radiother Oncol. 2015;116(1):10–4.\nKaasa S, Brenne E, Lund JA, Fayers P, Falkmer U, Holmberg M, Lagerlund M, Bruland O. Prospective randomised multicenter trial on single fraction radiotherapy (8 Gy x 1) versus multiple fractions (3 Gy x 10) in the treatment of painful bone metastases. Radiother Oncol. 2006;79(3):278–84.\nKougioumtzopoulou A, Zygogianni A, Liakouli Z, Kypraiou E, Kouloulias V. The role of radiotherapy in bone metastases: a critical review of current literature. Eur J Cancer Care (Engl). 2017;26(6). https:\u002F\u002Fdoi.org\u002F10.1111\u002Fecc.12724\nLutz S, Berk L, Chang E, Chow E, Hahn C, Hoskin P, Howell D, Konski A, Kachnic L, Lo S, et al. Palliative radiotherapy for bone metastases: an ASTRO evidence-based guideline. Int J Radiat Oncol Biol Phys. 2011;79(4):965–76.\nMcQuay HJ, Collins SL, Carroll D, Moore RA. Radiotherapy for the palliation of painful bone metastases. Cochrane Database Syst Rev. 2000;2:Cd001793.\nNielsen OS, Bentzen SM, Sandberg E, Gadeberg CC, Timothy AR. Randomized trial of single dose versus fractionated palliative radiotherapy of bone metastases. Radiother Oncol. 1998;47(3):233–40.\nNiewald M, Tkocz HJ, Abel U, Scheib T, Walter K, Nieder C, Schnabel K, Berberich W, Kubale R, Fuchs M. Rapid course radiation therapy vs. more standard treatment: a randomized trial for bone metastases. Int J Radiat Oncol Biol Phys. 1996;36(5):1085–9.\nWu JS, Wong RK, Lloyd NS, Johnston M, Bezjak A, Whelan T, Supportive Care Guidelines Group of Cancer Care O. Radiotherapy fractionation for the palliation of uncomplicated painful bone metastases - an evidence-based practice guideline. BMC cancer. 2004;4:71.\nTaneichi H, Kaneda K, Takeda N, Abumi K, Satoh S. Risk factors and probability of vertebral body collapse in metastases of the thoracic and lumbar spine. Spine. 1997;22(3):239–45.\nFoerster R, Habermehl D, Bruckner T, Bostel T, Schlampp I, Welzel T, Debus J, Rief H. Spinal bone metastases in gynecologic malignancies: a retrospective analysis of stability, prognostic factors and survival. Radiat Oncol. 2014;9:194.\nRief H, Bischof M, Bruckner T, Welzel T, Askoxylakis V, Rieken S, Lindel K, Combs S, Debus J. The s of osseous metastases of the spine in lung cancer--a retrospective analysis of 338 cases. Radiat Oncol. 2013;8(1):200.\nYates JW, Chalmer B, McKegney FP. Evaluation of patients with advanced cancer using the Karnofsky performance status. Cancer. 1980;45(8):2220–4.\nWachenfeld I, Sanner G, Bottcher HD, Kollath J. The remineralization of the vertebral metastases of breast carcinoma after radiotherapy. Strahlenther Onkol. 1996;172(6):332–41.\nRudzianskiene M, Inciura A, Gerbutavicius R, Rudzianskas V, Macas A, Simoliuniene R, Dambrauskiene R, Kiavialaitis GE, Juozaityte E. Single vs. multiple fraction regimens for palliative radiotherapy treatment of multiple myeloma: A prospective randomised study. Strahlenther Onkol. 2017;193(9):742–9.\nGroenen KH, Pouw MH, Hannink G, Hosman AJ, van der Linden YM, Verdonschot N, Tanck E. The effect of radiotherapy, and radiotherapy combined with bisphosphonates or RANK ligand inhibitors on bone quality in bone metastases. A systematic review. Radiother Oncol. 2016;119(2):194–201.\nRief H, Förster R, Rieken S, Bruckner T, Schlampp I, Bostel T, Debus J. The influence of orthopedic corsets on the incidence of pathological fracture in patients with spinal bone metastases after radiotherapy. BMC Cancer. 2015;15:745.\nSprave T, Welte SE, Bruckner T, Förster R, Bostel T, Schlampp I, Nicolay NH, Debus J, Rief H. Intensity-modulated radiotherapy with integrated-boost in patients with bone metastasis of the spine: study protocol for a randomized controlled trial. Trials. 2018;19(1):59.\nUdagawa H, Niho S, Kirita K, Umemura S, Matsumoto S, Yoh K, Goto K. Impact of denosumab use on the survival of untreated non-squamous non-small cell lung cancer patients with bone metastases. J Cancer Res Clin Oncol. 2017;143(6):1075–82.\nSchröder J, Fietz T, Köhler A, Petersen V, Tesch H, Spring L, Fleitz A, Jänicke M, Marschner N, TMK-group (tumour registry breast Cancer). Treatment and pattern of bone metastases in 1094 patients with advanced breast cancer-results from the prospective German tumour registry breast Cancer cohort study. 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pre-clinical animal experiments, radiation delivery is usually delivered with kV photon beams, in contrast to the MV beams used in clinical irradiation, because of the small size of the animals. At this medium energy range, however, the contribution of the photoelectric effect to absorbed dose is significant. Accurate dose calculation therefore requires a more detailed tissue definition because both density (ρ) and elemental composition (Zeff) affect the dose distribution. Moreover, when applied to cone beam CT (CBCT) acquisitions, the stoichiometric calibration of HU becomes inefficient as it is designed for highly collimated fan beam CT acquisitions. In this study, we propose an automatic tissue segmentation method of CBCT imaging that assigns both density (ρ) and elemental composition (Zeff) in small animal dose calculation. The method is based on the relationship found between CBCT number and ρ*Zeff product computed from known materials. Monte Carlo calculations were performed to evaluate the impact of ρZeff variation on the absorbed dose in tissues. These results led to the creation of a tissue database composed of artificial tissues interpolated from tissue values published by the ICRU. The ρZeff method was validated by measuring transmitted doses through tissue substitute cylinders and a mouse with EBT3 film. Measurements were compared to the results of the Monte Carlo calculations. The study of the impact of ρZeff variation over the range of materials, from ρZeff = 2 g.cm− 3 (lung) to 27 g.cm− 3 (cortical bone) led to the creation of 125 artificial tissues. For tissue substitute cylinders, the use of ρZeff method led to maximal and average relative differences between the Monte Carlo results and the EBT3 measurements of 3.6% and 1.6%. Equivalent comparison for the mouse gave maximal and average relative differences of 4.4% and 1.2%, inside the 80% isodose area. Gamma analysis led to a 94.9% success rate in the 10% isodose area with 4% and 0.3 mm criteria in dose and distance. Our new tissue segmentation method was developed for 40kVp CBCT images. Both density and elemental composition are assigned to each voxel by using a relationship between HU and the product ρZeff. The method, validated by comparing measurements and calculations, enables more accurate small animal dose distribution calculated on low energy CBCT images.",{"EN":975},"A new tissue segmentation method to calculate 3D dose in small animal radiation therapy",{"VOID":977},"4957458798906472497",{"VOID":979},"10.1186\u002Fs13014-018-0971-8","2024-04-28T06:36:08.218+00:00","https:\u002F\u002Fro-journal.biomedcentral.com\u002Farticles\u002F10.1186\u002Fs13014-018-0971-8",[983,1006,1025,1048,1069,1090],{"id":984,"sortIndex":19,"researcher":18,"roles":985,"affiliations":986,"properties":1003,"displayName":1005,"givenName":18,"familyName":18},"7d7d28cb-4d1b-477b-993c-43a8e6e2b714",[188],[987,995],{"id":988,"sortIndex":19,"affiliation":989,"properties":18},"e926aa9e-426d-4f8f-8225-0893c381e4cc",{"id":988,"createTime":18,"updateTime":18,"relativeEntities":990,"slug":18,"properties":991,"entityType":18,"verifyStatus":18,"verifyTime":18,"verifyNote":18,"languages":18,"translateLanguages":18,"viewCount":18,"url":18,"parentIds":994,"statistic":18},[],{"title":992},{"VI":993},"Medical Physics Department, Institut de Cancérologie de l’Ouest Centre René Gauducheau, Saint-Herblain, France",[],{"id":996,"sortIndex":203,"affiliation":997,"properties":18},"374cdfe1-b2cc-450b-8ab5-a0ce2451cec7",{"id":996,"createTime":18,"updateTime":18,"relativeEntities":998,"slug":18,"properties":999,"entityType":18,"verifyStatus":18,"verifyTime":18,"verifyNote":18,"languages":18,"translateLanguages":18,"viewCount":18,"url":18,"parentIds":1002,"statistic":18},[],{"title":1000},{"VI":1001},"CRCINA, INSERM U1232, Université de Nantes, Nantes, France",[],{"title":1004},{"VI":1005},"C. 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Small animal radiotherapy research platforms. Phys Med Biol. 2011;56:R55–83.",{"doi":311},{"id":307,"text":1169,"url":309,"identifiers":1170},"Koontz BF, Verhaegen F, De Ruysscher D. Tumour and normal tissue radiobiology in mouse models: how close are mice to mini-humans? Br J Radiol. 2016;26:20160441.",{"doi":311},{"id":307,"text":1172,"url":309,"identifiers":1173},"Chow JCL, Leung MKK, Lindsay PE, Jaffray DA. Dosimetric variation due to photon beam energy in the small-animal irradiation: a Monte Carlo study. Med Phys. 2010;37:5322–9.",{"doi":311},{"id":307,"text":1175,"url":309,"identifiers":1176},"Bazalova M, Graves EE. The importance of tissue segmentation for dose calculations for kilovoltage radiation therapy. Med Phys. 2011;38:3039–49.",{"doi":311},{"id":307,"text":1178,"url":309,"identifiers":1179},"Noblet C, Chiavassa S, Paris F, Suhard J, Lisbona A, Delpon G. Impact of tissue assignment for preclinical radiotherapy: a dose-volume histogram analysis. Radiother Oncol. 2014;111:S68.",{"doi":311},{"id":307,"text":1181,"url":309,"identifiers":1182},"Vanderstraeten B, Chin PW, Fix M, Leal A, Mora G, Reynaert N, Seco J, Soukup M, Spezi E, De Neve W, Thierens H. Conversion of CT numbers into tissue parameters for monte carlo dose calculations: a multi-centre study. Phys Med Biol. 2007;52:539–62.",{"doi":311},{"id":307,"text":1184,"url":309,"identifiers":1185},"Schneider U, Pedroni E, Lomax A. The calibration of CT Hounsfield units for radiotherapy treatment planning. Phys Med Biol. 1996;41:111–24.",{"doi":311},{"id":1187,"text":1188,"url":1189,"identifiers":1190},"dc10c87f-e012-45fe-b91c-1f9876dd9b2f","Jackson DF, Hawkes DJ. X-ray attenuation coefficients of elements and mixtures. Phys Rep. 1981;70(3):169–233.","https:\u002F\u002Fwww.sciencedirect.com\u002Fscience\u002Farticle\u002Fpii\u002F0370157381900144",{"doi":1191},"10.1016\u002F0370-1573(81)90014-4",{"id":307,"text":1193,"url":309,"identifiers":1194},"Yohannes I, Kolditz D, Langner O, Kalender WA. A formulation of tissue- and water-equivalent materials using the stoichiometric analysis method for CT-number calibration in radiotherapy treatment planning. Phys Med Biol. 2012;57:1173–90.",{"doi":311},{"id":307,"text":1196,"url":309,"identifiers":1197},"Noblet C, Chiavassa S, Smekens F, Sarrut D, Passal V, Suhard J, Lisbona A, Paris F, Delpon G. Validation of fast Monte Carlo dose calculation in small animal radiotherapy with EBT3 radiochromic films. Phys Med Biol. 2016;61:3521–35.",{"doi":311},{"id":307,"text":1199,"url":309,"identifiers":1200},"Smekens F, Létang JM, Noblet C, Chiavassa S, Delpon G, Freud N, Rit S, Sarrut D. Split exponential track length estimator for Monte-Carlo simulations of small-animal radiation therapy Phys. Med Biol. 2014;59:7703–15.",{"doi":311},{"id":307,"text":1202,"url":309,"identifiers":1203},"International Commission on Radiation Units and Measurements (ICRU). Report 44. Tissue substitutes in radiation dosimetry. Washington: International Commission on Radiation Units and Measurements; 1989.",{"doi":311},{"id":18,"text":1205,"url":18,"identifiers":1206},"International Commission on Radiation Units and Measurements (ICRU). Report 46. Photon, electron, proton and neutron interaction data for body tissues. Washington: International Commission on Radiation Units and Measurements; 1992.",{},{"id":307,"text":1208,"url":309,"identifiers":1209},"Andreo P, Burns DT, Hohlfield K, Huq MS, Kanai T, Laitano F, Smyth V, Vynckier S. Absorbed dose determination in external beam radiotherapy, an international code of practice for dosimetry based on standards of absorbed dose to water technical report series no 398. Vienna: IAEA; 2000.",{"doi":311},{"id":307,"text":1211,"url":309,"identifiers":1212},"Perichon N, Rapp B, Denoziere M, Daures J, Ostrowsky A, Bordy JM. Comparison between absorbed dose to water standards established by water calorimetry at the LNE-LNHB and by application of international air-kerma based protocols for kilovoltage medium energy x-rays. Phys Med Biol. 2013;58:2787–806.",{"doi":311},{"id":307,"text":1214,"url":309,"identifiers":1215},"Rapp B, Perichon N, Denoziere M, Daures J. Ostrowsky a and Bordy J M. The LNE-LNHB water calorimeter for primary measurement of absorbed dose at low depth in water: application to medium-energy x-rays Phys Med Biol. 2013;58:2769–86.",{"doi":311},{"id":307,"text":1217,"url":309,"identifiers":1218},"Micke A, Lewis DF, Yu X. Multichannel film dosimetry with nonuniformity correction. Med Phys. 2011;38:2523–34.",{"doi":311},{"id":307,"text":1220,"url":309,"identifiers":1221},"van Hoof S, Granton P, Landry G, Podesta M, Verhaegen F. Evaluation of a novel triple-channel radiochromic film analysis procedure using EBT2. Phys Med Biol. 2012;57:4353–68.",{"doi":311},{"id":307,"text":1223,"url":309,"identifiers":1224},"Low DA, Harms WB, Mutic S, Purdy JA. A technique for the quantitative evaluation of dose distributions. Med Phys. 1998;25:656–61.",{"doi":311},{"id":307,"text":1226,"url":309,"identifiers":1227},"Verhaegen F, Devic S. Sensitivity study for CT image use in Monte Carlo treatment planning. Phys Med Biol. 2005;50:937–46.",{"doi":311},{"id":307,"text":1229,"url":309,"identifiers":1230},"Zhou H, Keall PJ, Graves EE. A bone composition model for monte carlo x-ray transport simulations. Med Phys. 2008;36:1008–18.",{"doi":311},{"id":307,"text":1232,"url":309,"identifiers":1233},"De Marzi L, Lesven C, Ferrand R, Sage J, Boulé T, Mazal A. Calibration of CT Hounsfield units for proton therapy treatment planning: use of kilovoltage and megavoltage images and comparison of parameterized methods. Phys Med Biol. 2013;58:4255–76.",{"doi":311},{"id":307,"text":1235,"url":309,"identifiers":1236},"Yang M, Zhu XR, Park PC, Titt U, Mohan R, Virshup G, Clayton JE, Dong L. Comprehensive analysis of proton range uncertainties related to patient stopping-power-ratio estimation using the stoichiometric calibration. Phys Med Biol. 2012;57:4095–115.",{"doi":311},{"id":1238,"text":1239,"url":1240,"identifiers":1241},"ac1467ea-816a-462a-a3e1-dad47e21d8b7","Vaniqui A, Schyns LEJR, Almeida IP, van der Heyden B, van Hoof SJ, Verhaegen F. The impact of dual energy CT imaging on dose calculations for pre-clinical studies. Radiat Oncol. 2017;12:181.","https:\u002F\u002Fro-journal.biomedcentral.com\u002Farticles\u002F10.1186\u002Fs13014-017-0922-9",{"doi":1242},"10.1186\u002Fs13014-017-0922-9",{"id":1244,"createTime":1245,"updateTime":1246,"relativeEntities":1247,"slug":1248,"properties":1249,"entityType":179,"verifyStatus":180,"verifyTime":1260,"verifyNote":182,"languages":18,"translateLanguages":18,"viewCount":19,"primaryUrl":1261,"fullTextUrl":18,"authors":1262,"publicationType":245,"publisherRelationship":1341,"citationCount":1391,"citationInfo":1392,"publishDate":1395,"publishYear":1393,"citationAnalyzeStatus":962,"lastCitationAnalyze":1396,"indexDatabases":1397,"openAccess":18,"references":18,"isForceReanalyzing":372},"44ddde82-92d3-40f8-8158-3733a751c1f5","2024-01-11T07:36:26.234+00:00","2026-07-25T23:04:36.233+00:00",[],"Changes-of-lung-parenchyma-density-following-high-dose-radiation-therapy-for-thoracic-carcinomas-an-automated-analysis-of-follow-up-CT-scans",{"abstract":1250,"title":1252,"gsPaper":1254,"references":1256,"doi":1258},{"EN":1251},"An objective way to qualify the effect of radiotherapy (RT) on lung tissue is the analysis of CT scans after RT. In this analysis we focused on the changes in Hounsfield units (ΔHU) and the correlation with the corresponding radiation dose after RT. Pre- and post-RT CT scans were matched and ΔHU was calculated using customized research software. ΔHU was calculated in 5-Gy-intervals and the correlation between ΔHU and the corresponding dose was calculated as well as the regression coefficients. Additionally the mean ΔHU and ΔHU in 5-Gy-intervals were calculated for each tumor entity. The mean density changes at 12 weeks and 6 months post RT were 28,16 HU and 32,83 HU. The correlation coefficient between radiation dose and ΔHU at 12 weeks and 6 months were 0,166 (p = 0,000) and 0,158 (p = 0,000). The resulting regression coefficient were 1439 HU\u002FGy (p = 0,000) and 1612 HU\u002FGy (p = 0,000). The individual regression coefficients for each patient range from − 2,23 HU\u002FGy to 7,46 HU\u002FGy at 12 weeks and − 0,45 HU\u002FGy to 10,51 HU\u002FGy at 6 months. When looking at the three tumor entities individually the highest ΔHU at 12 weeks was seen in patients with SCLC (38,13 HU) and at 6 month in those with esophageal carcinomas (40,98 HU). For most dose intervals there was an increase of ΔHU with an increased radiation dose. This is reflected by a statistically significant, although low correlation coefficient. The regression coefficients of all patients show large interindividual differences.",{"EN":1253},"Changes of lung parenchyma density following high dose radiation therapy for thoracic carcinomas – an automated analysis of follow up CT scans",{"VOID":1255},"[\"12737263104975895790\"]",{"VOID":1257},"Mazeron R, Etienne-Mastroianni B, Pérol D, et al. Predictive factors of late radiation fibrosis: a prospective study in non-small cell lung cancer. Int J Radiat Oncol Biol Phys. 2010;77:38–43. https:\u002F\u002Fdoi.org\u002F10.1016\u002Fj.ijrobp.2009.04.019.\nMehta V. Radiation pneumonitis and pulmonary fibrosis in non–small-cell lung cancer: pulmonary function, prediction, and prevention. Int J Radiat Oncol Biol Phys. 2005;63:5–24. https:\u002F\u002Fdoi.org\u002F10.1016\u002Fj.ijrobp.2005.03.047.\nKong F-M, Hayman JA, Griffith KA, et al. Final toxicity results of a radiation-dose escalation study in patients with non–small-cell lung cancer (NSCLC): predictors for radiation pneumonitis and fibrosis. Int J Radiat Oncol Biol Phys. 2006;65:1075–86. https:\u002F\u002Fdoi.org\u002F10.1016\u002Fj.ijrobp.2006.01.051.\nRobnett TJ, Machtay M, Vines EF, et al. Factors predicting severe radiation pneumonitis in patients receiving definitive chemoradiation for lung cancer. Int J Radiat Oncol Biol Phys. 2000;48:89–94. https:\u002F\u002Fdoi.org\u002F10.1016\u002FS0360-3016(00)00648-9.\nLeprieur EG, Fernandez D, Chatellier G, et al. Acute radiation pneumonitis after conformational radiotherapy for nonsmall cell lung cancer: clinical, dosimetric, and associated-treatment risk factors. J Cancer Res Ther. 2013;9:447–51. https:\u002F\u002Fdoi.org\u002F10.4103\u002F0973-1482.119339.\nHernando ML, Marks LB, Bentel G, et al. Radiation-induced pulmonary toxicity: a dose-volume histogram analysis in 201 patients with lung cancer. Int J Radiat Oncol Biol Phys. 2001;51:650–9. https:\u002F\u002Fdoi.org\u002F10.1016\u002FS0360-3016(01)01685-6.\nLuis Lopez Guerra J, Gomez D, Zhuang Y, et al. Change in diffusing capacity after radiation as an objective measure for grading radiation pneumonitis in patients treated for non-small-cell lung Cancer. Int J Radiat Oncol Biol Phys. 2012;83:1573–9. https:\u002F\u002Fdoi.org\u002F10.1016\u002Fj.ijrobp.2011.10.065.\nGraham MV, Purdy JA, Emami B, Harms W. Clinical dose–volume histogram analysis for pneumonitis after 3D treatment for non-small cell lung cancer (NSCLC). Int J Radiat Oncol Biol Phys. 1999;45:323–9.\nSchröder C, Engenhart-Cabillic R, Vorwerk H, et al. Changes in pulmonary function and influencing factors after high-dose intrathoracic radio(chemo)therapy. Strahlenther Onkol. 2017;193:125–31. https:\u002F\u002Fdoi.org\u002F10.1007\u002Fs00066-016-1067-8.\nDhami G, Zeng J, Vesselle HJ, et al. Framework for radiation pneumonitis risk stratification based on anatomic and perfused lung dosimetry. Strahlenther Onkol. 2017;193:410–8. https:\u002F\u002Fdoi.org\u002F10.1007\u002Fs00066-017-1114-0.\nSas-Korczyńska B, Łuczyńska E, Kamzol W, Sokołowski A. Analysis of risk factors for pulmonary complications in patients with limited-stage small cell lung cancer : a single-Centre retrospective study. Strahlenther Onkol. 2017;193:141–9. https:\u002F\u002Fdoi.org\u002F10.1007\u002Fs00066-016-1069-6.\nDe Ruysscher D, Sharifi H, Defraene G, et al. Quantification of radiation-induced lung damage with CT scans: the possible benefit for radiogenomics. Acta Oncol. 2013;52:1405–10. https:\u002F\u002Fdoi.org\u002F10.3109\u002F0284186X.2013.813074.\nBernchou U, Schytte T, Bertelsen A, Bentzen SM. Time evolution of regional CT density changes in normal lung after IMRT for NSCLC. Radiother Oncol. 2013;109:89–94.\nPhernambucq ECJ, Palma DA, Vincent A, et al. Time and dose-related changes in radiological lung density after concurrent chemoradiotherapy for lung cancer. Lung Cancer. 2011;74:451–6. https:\u002F\u002Fdoi.org\u002F10.1016\u002Fj.lungcan.2011.05.010.\nPalma DA, van Sörnsen de Koste JR, Verbakel WFAR, Senan S (2011) A new approach to quantifying lung damage after stereotactic body radiation therapy. Acta Oncol 50:509–517. doi: https:\u002F\u002Fdoi.org\u002F10.3109\u002F0284186X.2010.541934.\nMa J, Zhang J, Zhou S, et al. Regional lung density changes after radiation therapy for tumors in and around thorax. Int J Radiat Oncol Biol Phys. 2010;76:116–22. https:\u002F\u002Fdoi.org\u002F10.1016\u002Fj.ijrobp.2009.01.025.\nBertelsen A, Schytte T, Bentzen SM, et al. Radiation dose response of normal lung assessed by cone beam CT – a potential tool for biologically adaptive radiation therapy. Radiother Oncol. 2011;100:351–5. https:\u002F\u002Fdoi.org\u002F10.1016\u002Fj.radonc.2011.08.012.\nVågane R, Danielsen T, Fosså SD, et al. Late regional density changes of the lung after radiotherapy for breast cancer. Radiother Oncol. 2009;90:148–52. https:\u002F\u002Fdoi.org\u002F10.1016\u002Fj.radonc.2007.12.031.\nKrengli M, Sacco M, Loi G, et al. Pulmonary changes after radiotherapy for conservative treatment of breast Cancer: a prospective study. Int J Radiat Oncol Biol Phys. 2008;70:1460–7. https:\u002F\u002Fdoi.org\u002F10.1016\u002Fj.ijrobp.2007.08.050.\nSeppenwoolde Y, Muller SH, Theuws J, et al. Radiation dose-effect relations and local recovery in perfusion for patients with non–small-cell lung cancer. Int J Radiat Oncol Biol Phys. 2000;47:681–90.\nWennberg B, Gagliardi G, Sundbom L, et al. Early response of lung in breast cancer irradiation: radiologic density changes measured by CT and symptomatic radiation pneumonitis. Int J Radiat Oncol Biol Phys. 2002;52:1196–206. https:\u002F\u002Fdoi.org\u002F10.1016\u002FS0360-3016(01)02770-5.\nDefraene G, van Elmpt W, Crijns W, et al. CT characteristics allow identification of patient-specific susceptibility for radiation-induced lung damage. Radiother Oncol. 2015;117:29–35. https:\u002F\u002Fdoi.org\u002F10.1016\u002Fj.radonc.2015.07.033.\nGeara FB, Komaki R, Tucker SL, et al. Factors influencing the development of lung fibrosis after chemoradiation for small cell carcinoma of the lung: evidence for inherent interindividual variation. Int J Radiat Oncol Biol Phys. 1998;41:279–86. https:\u002F\u002Fdoi.org\u002F10.1016\u002FS0360-3016(97)00741-4.\nRosen II, Fischer TA, Antolak JA, et al. Correlation between lung fibrosis and radiation therapy dose after concurrent radiation therapy and chemotherapy for limited small cell lung cancer. Radiology. 2001;221:614–22. https:\u002F\u002Fdoi.org\u002F10.1148\u002Fradiol.2213992043.",{"VOID":1259},"10.1186\u002Fs13014-019-1276-2","2024-06-24T23:00:22.421+00:00","https:\u002F\u002Fro-journal.biomedcentral.com\u002Farticles\u002F10.1186\u002Fs13014-019-1276-2",[1263,1287,1300,1315,1328],{"id":1264,"sortIndex":19,"researcher":18,"roles":1265,"affiliations":1266,"properties":1284,"displayName":1286,"givenName":18,"familyName":18},"17d922dc-fe28-4dc5-ae58-81fc594e0a04",[188],[1267,1275],{"id":1268,"sortIndex":19,"affiliation":1269,"properties":18},"f3ace39f-fc27-4990-8923-7b5e8a7c83da",{"id":1268,"createTime":18,"updateTime":18,"relativeEntities":1270,"slug":18,"properties":1271,"entityType":18,"verifyStatus":18,"verifyTime":18,"verifyNote":18,"languages":18,"translateLanguages":18,"viewCount":18,"url":18,"parentIds":1274,"statistic":18},[],{"title":1272},{"VI":1273},"Clinic for Radiotherapy and Radiation Oncology, University Clinic Giessen and Marburg, Marburg, 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literature regarding pericardial effusion after definitive concurrent chemotherapy and intensity modulated radiotherapy (IMRT) for esophageal cancer was lacking. This study aimed to investigate the risk factors of pericardial effusion in esophageal cancer patients undergoing definitive concurrent chemotherapy and IMRT. A total of 126 consecutive esophageal cancer patients treated with definitive concurrent chemotherapy and IMRT between 2008 and 2018 were reviewed. The pericardial effusion was determined on computed tomography scan of the chest and graded by the Common Terminology Criteria for Adverse Events, version 4.0. The cumulative incidence of pericardial effusion was estimated by the Kaplan–Meier method and compared between groups by the log-rank test. The risk factors of pericardial effusion were determined with multivariate Cox proportional hazards regression analysis. The median follow-up time was 14.0 months. Thirty-seven (29.4%) patients had pericardial effusion after a median interval of 6.6 months since the end of IMRT. The cumulative incidence of pericardial effusion of any grade was higher in patients with mean heart dose > 23.45 Gy (p = 0.00018), heart V30 > 33.55% (p = 0.00015), mean pericardium dose > 20.33 Gy (p = 0.00027), and pericardium V20 > 42.55% (p = 0.00018). Furthermore, eight (6.3%) patients had symptoms related to pericardial effusion and were considered as cases with pericardial effusion ≥ grade 3. The cumulative incidence of pericardial effusion ≥ grade 3 was higher in patients with pericardium V30 > 65.80% (p = 0.00028), V40 > 55.35% (p \u003C 0.0001), and V60 > 24.70% (p = 0.0021). Multivariate analyses showed the above dose-volume parameters predicted the risk of pericardial effusion in esophageal cancer. Dose-volume parameters predicting the risk of pericardial effusion were identified in esophageal cancer treated with definitive concurrent chemotherapy and IMRT. They could be applied as constraints of IMRT for esophageal cancer.",{"EN":1408},"Pericardial effusion after definitive concurrent chemotherapy and intensity modulated radiotherapy for esophageal cancer",{"VOID":1410},"[\"16412065218725225966\"]",{"VOID":1412},"Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.\nConroy T, Galais MP, Raoul JL, Bouche O, Gourgou-Bourgade S, Douillard JY, et al. Definitive chemoradiotherapy with FOLFOX versus fluorouracil and cisplatin in patients with oesophageal cancer (PRODIGE5\u002FACCORD17): final results of a randomised, phase 2\u002F3 trial. Lancet Oncol. 2014;15(3):305–14.\nSuntharalingam M, Winter K, Ilson D, Dicker AP, Kachnic L, Konski A, et al. Effect of the addition of Cetuximab to paclitaxel, Cisplatin, and radiation therapy for patients with esophageal Cancer: the NRG oncology RTOG 0436 phase 3 randomized clinical trial. JAMA Oncol. 2017;3(11):1520–8.\nIlson DH, van Hillegersberg R. Management of Patients with Adenocarcinoma or squamous Cancer of the esophagus. Gastroenterology. 2018;154(2):437–51.\nKonski A, Li T, Christensen M, Cheng JD, Yu JQ, Crawford K, et al. Symptomatic cardiac toxicity is predicted by dosimetric and patient factors rather than changes in 18F-FDG PET determination of myocardial activity after chemoradiotherapy for esophageal cancer. Radiother Oncol. 2012;104(1):72–7.\nBeukema JC, van Luijk P, Widder J, Langendijk JA, Muijs CT. Is cardiac toxicity a relevant issue in the radiation treatment of esophageal cancer? Radiother Oncol. 2015;114(1):85–90.\nFukada J, Shigematsu N, Takeuchi H, Ohashi T, Saikawa Y, Takaishi H, et al. Symptomatic pericardial effusion after chemoradiation therapy in esophageal cancer patients. Int J Radiat Oncol Biol Phys. 2013;87(3):487–93.\nWei X, Liu HH, Tucker SL, Wang S, Mohan R, Cox JD, et al. Risk factors for pericardial effusion in inoperable esophageal cancer patients treated with definitive chemoradiation therapy. Int J Radiat Oncol Biol Phys. 2008;70(3):707–14.\nHayashi Y, Iijima H, Isohashi F, Tsujii Y, Fujinaga T, Nagai K, et al. The heart's exposure to radiation increases the risk of cardiac toxicity after chemoradiotherapy for superficial esophageal cancer: a retrospective cohort study. BMC Cancer. 2019;19(1):195.\nTamari K, Isohashi F, Akino Y, Suzuki O, Seo Y, Yoshioka Y, et al. Risk factors for pericardial effusion in patients with stage I esophageal cancer treated with chemoradiotherapy. Anticancer Res. 2014;34(12):7389–93.\nOgino I, Watanabe S, Iwahashi N, Kosuge M, Sakamaki K, Kunisaki C, et al. Symptomatic radiation-induced cardiac disease in long-term survivors of esophageal cancer. Strahlenther Onkol. 2016;192(6):359–67.\nKato K, Muro K, Minashi K, Ohtsu A, Ishikura S, Boku N, et al. Phase II study of chemoradiotherapy with 5-fluorouracil and cisplatin for stage II-III esophageal squamous cell carcinoma: JCOG trial (JCOG 9906). Int J Radiat Oncol Biol Phys. 2011;81(3):684–90.\nMorota M, Gomi K, Kozuka T, Chin K, Matsuura M, Oguchi M, et al. Late toxicity after definitive concurrent chemoradiotherapy for thoracic esophageal carcinoma. Int J Radiat Oncol Biol Phys. 2009;75(1):122–8.\nFeng M, Moran JM, Koelling T, Chughtai A, Chan JL, Freedman L, et al. Development and validation of a heart atlas to study cardiac exposure to radiation following treatment for breast cancer. Int J Radiat Oncol Biol Phys. 2011;79(1):10–8.\nAtlases for Organs at Risk (OARs) in Thoracic Radiation Therapy. Radiation Therapy Oncology Group (RTOG) 2011. https:\u002F\u002Fwww.rtog.org\u002FLinkClick.aspx?fileticket=qlz0qMZXfQs%3d&tabid=361. Accessed 12 Nov 2018.\nTakata N, Kataoka M, Hamamoto Y, Tsuruoka S, Kanzaki H, Uwatsu K, et al. Risk factors for pericardial effusion after chemoradiotherapy for thoracic esophageal cancer-comparison of four-field technique and traditional two opposed fields technique. J Radiat Res. 2018;59(3):291–7.\nBorkenhagen JF, Bergom C, Rapp CT, Klawikowski SJ, Rein LE, Gore EM. Dosimetric predictors of Cardiotoxicity in thoracic radiotherapy for lung Cancer. Clin Lung Cancer. 2019;20(6):435–41.\nDess RT, Sun Y, Matuszak MM, Sun G, Soni PD, Bazzi L, et al. Cardiac events after radiation therapy: combined analysis of prospective multicenter trials for locally advanced non-small-cell lung Cancer. J Clin Oncol. 2017;35(13):1395–402.\nChun SG, Hu C, Choy H, Komaki RU, Timmerman RD, Schild SE, et al. Impact of intensity-modulated radiation therapy technique for locally advanced non-small-cell lung Cancer: a secondary analysis of the NRG oncology RTOG 0617 randomized clinical trial. J Clin Oncol. 2017;35(1):56–62.",{"VOID":1414},"10.1186\u002Fs13014-020-01498-3","2024-08-30T18:01:24.486+00:00","https:\u002F\u002Fro-journal.biomedcentral.com\u002Farticles\u002F10.1186\u002Fs13014-020-01498-3",[1418,1433,1448,1470,1485,1500,1513],{"id":1419,"sortIndex":19,"researcher":18,"roles":1420,"affiliations":1421,"properties":1430,"displayName":1432,"givenName":18,"familyName":18},"58df09fa-dbad-4cbb-9c92-2fa117a75afd",[188],[1422],{"id":1423,"sortIndex":19,"affiliation":1424,"properties":18},"174cd3c6-2386-4d75-a533-c6bc4d96bd87",{"id":1423,"createTime":18,"updateTime":18,"relativeEntities":1425,"slug":18,"properties":1426,"entityType":18,"verifyStatus":18,"verifyTime":18,"verifyNote":18,"languages":18,"translateLanguages":18,"viewCount":18,"url":18,"parentIds":1429,"statistic":18},[],{"title":1427},{"VI":1428},"Department of Radiation Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan",[],{"title":1431},{"VI":1432},"Tzu-Hui Pao",{"id":1434,"sortIndex":203,"researcher":18,"roles":1435,"affiliations":1436,"properties":1445,"displayName":1447,"givenName":18,"familyName":18},"412a1a67-33ec-4ded-ac03-2f79e90a9e72",[188],[1437],{"id":1438,"sortIndex":19,"affiliation":1439,"properties":18},"3248244e-4789-42ea-a7fa-566dd7c85bf3",{"id":1438,"createTime":18,"updateTime":18,"relativeEntities":1440,"slug":18,"properties":1441,"entityType":18,"verifyStatus":18,"verifyTime":18,"verifyNote":18,"languages":18,"translateLanguages":18,"viewCount":18,"url":18,"parentIds":1444,"statistic":18},[],{"title":1442},{"VI":1443},"Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan",[],{"title":1446},{"VI":1447},"Wei-Lun 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data guide radiotherapy choices for patients with brain metastases. This survey aimed to identify patient, physician, and practice setting variables associated with reported preferences for different treatment techniques. 277 members of the American Society for Radiation Oncology (6% of surveyed physicians) completed a survey regarding treatment preferences for 21 hypothetical patients with brain metastases. Treatment choices included combinations of whole brain radiation therapy (WBRT), stereotactic radiosurgery (SRS), and surgery. Vignettes varied histology, extracranial disease status, Karnofsky Performance Status (KPS), presence of neurologic deficits, lesion size and number. Multivariate generalized estimating equation regression models were used to estimate odds ratios. For a hypothetical patient with 3 lesions or 8 lesions, 21% and 91% of physicians, respectively, chose WBRT alone, compared with 1% selecting WBRT alone for a patient with 1 lesion. 51% chose WBRT alone for a patient with active extracranial disease or KPS=50%. 40% chose SRS alone for an 80 year-old patient with 1 lesion, compared to 29% for a 55 year-old patient. Multivariate modeling detailed factors associated with SRS use, including availability of SRS within one’s practice (OR 2.22, 95% CI 1.46-3.37). Poor prognostic factors, such as advanced age, poor performance status, or active extracranial disease, correspond with an increase in physicians’ reported preference for using WBRT. When controlling for clinical factors, equipment access was independently associated with choice of SRS. The large variability in preferences suggests that more information about the relative harms and benefits of these options is needed to guide decision-making.",{"EN":1593},"Physician self-reported treatment of brain metastases according to patients’ clinical and demographic factors and physician practice setting",{"VOID":1595},"[\"14074309687502125866\"]",{"VOID":1597},"Nussbaum ES, Djalilian HR, Cho KH, et al.: Brain metastases. Histology, multiplicity, surgery, and survival. Cancer 1996, 78: 1781-1788. 10.1002\u002F(SICI)1097-0142(19961015)78:8\u003C1781::AID-CNCR19>3.0.CO;2-U\nWeissman DE: Glucocorticoid treatment for brain metastases and epidural spinal cord compression: a review. J Clin Oncol 1988, 6: 543-551.\nBorgelt B, Gelber R, Kramer S, et al.: The palliation of brain metastases: final results of the first two studies by the Radiation Therapy Oncology Group. Int J Radiat Oncol Biol Phys 1980, 6: 1-9. 10.1016\u002F0360-3016(80)90195-9\nRades D, Kieckebusch S, Haatanen T, et al.: Surgical resection followed by whole brain radiotherapy versus whole brain radiotherapy alone for single brain metastasis. J Radiat Oncol Biol Phys 2008, 70: 1319-1324. 10.1016\u002Fj.ijrobp.2007.08.009\nPatchell RA, Tibbs PA, Regine WF, et al.: Postoperative radiotherapy in the treatment of single metastases to the brain: a randomized trial. JAMA 1998, 280: 1485-1489. 10.1001\u002Fjama.280.17.1485\nPatchell RA, Tibbs PA, Walsh JW, et al.: A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med 1990, 322: 494-500. 10.1056\u002FNEJM199002223220802\nGaspar L, Scott C, Rotman M, et al.: Recursive partitioning analysis (RPA) of prognostic factors in three Radiation Therapy Oncology Group (RTOG) brain metastases trials. Int J Radiat Oncol Biol Phys 1997, 37: 745-751. 10.1016\u002FS0360-3016(96)00619-0\nSperduto PW, Chao ST, Sneed PK, et al.: Diagnosis-specific prognostic factors, indexes, and treatment outcomes for patients with newly diagnosed brain metastases: a multi-institutional analysis of 4,259 patients. Int J Radiat Oncol Biol Phys 2010, 77: 655-661. 10.1016\u002Fj.ijrobp.2009.08.025\nKondziolka D, Patel A, Lunsford LD, et al.: Stereotactic radiosurgery plus whole brain radiotherapy versus radiotherapy alone for patients with multiple brain metastases. Int J Radiat Oncol Biol Phys 1999, 45: 427-434.\nSanghavi SN, Miranpuri SS, Chappell R, et al.: Radiosurgery for patients with brain metastases: a multi-institutional analysis, stratified by the RTOG recursive partitioning analysis method. Int J Radiat Oncol Biol Phys 2001, 51: 426-434. 10.1016\u002FS0360-3016(01)01622-4\nAndrews DW, Scott CB, Sperduto PW, et al.: Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: phase III results of the RTOG 9508 randomised trial. Lancet 2004, 363: 1665-1675. 10.1016\u002FS0140-6736(04)16250-8\nChang EL, Wefel JS, Hess KR, et al.: Neurocognition in patients with brain metastases treated with radiosurgery or radiosurgery plus whole-brain irradiation: A randomised controlled trial. Lancet Oncology 2009, 10: 1037-1044. 10.1016\u002FS1470-2045(09)70263-3\nKondziolka D, Niranjan A, Flickinger JC, et al.: Radiosurgery with or without whole-brain radiotherapy for brain metastases: The patients’ perspective regarding complications. Am J Clin Oncol 2005, 28: 173-179. 10.1097\u002F01.coc.0000143016.15783.5b\nChow E, Davis L, Holden L, et al.: Propsective assessment of patient-rated symptoms following whole brain radiotherapy for brain metastases. Journal of Pain and Symptom Management 2005, 30: 19-23.\nAoyama H, Shirato H, Tago M, et al.: Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases: a randomized controlled trial. JAMA 2006, 295: 2486-2491.\nSneed PK, Suh JH, Goetsch SF, et al.: A multi-institutional review of radiosurgery alone vs. radiosurgery with whole brain radiotherapy as the initial management of brain metastases. Int J Radiat Oncol Biol Phys 2002, 53: 519-526. 10.1016\u002FS0360-3016(02)02770-0\nLewis RS, Sunshine JH: Radiation Oncologists in the United States. Int J Radiat Oncol Biol Phys 2007, 69: 518-527. 10.1016\u002Fj.ijrobp.2007.02.053\nPeabody JW, Luck J, Glassman P, et al.: Measuring the quality of physician practice by using clinical vignettes: a prospective validation study. Ann Intern Med 2004, 141: 771-780.\nKuss O, McLerran D: A note on the estimation of the multinomial logistic model with correlated responses in SAS Computer Methods and Programs. Biomedicine 2007, 87: 262-269.\nKocher M, Soffiette R, Abacioglu U, et al.: Adjuvant whole-brain radiotherapy versus observation after radiosurgery or surgical resection of one to three cerebral metastases: results of the EORTC 22952–26001 study. J Clin Oncol 2011, 29: 134-141. 10.1200\u002FJCO.2010.30.1655\nAoyama H, Tago M, Kato N, et al.: Neurocognitive function of patients with brain metastasis who received either whole brain radiotherapy plus stereotactic radiosurgery or radiosurgery alone. Int J Radiat Oncol Biol Phys 2007, 68: 1388-1395. 10.1016\u002Fj.ijrobp.2007.03.048\nRegine WF, Scott C, Murray K, et al.: Neurocognitive outcome in brain metastases patients treated with accelerated-fractionation vs. accelerated-hyperfractionated radiotherapy: An analysis from Radiation Therapy Oncology Group Study 91–04. Int J Radiat Oncol Biol Phys 2001, 51: 711-717. 10.1016\u002FS0360-3016(01)01676-5\nNational Comprehensive Cancer Network: NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Central Nervous System Cancers Version 2.2011. National Comprehensive Cancer Network; 2001.\nNieder C, Spanne O, Mehta MP, et al.: Presentation, patterns of care, and survival in patients with brain metastases: what has changed in the last 20 years? Cancer 2010. Epub ahead of print\nKnisely JP, Yamamoto M, Gross CP, et al.: Radiosurgery alone for 5 or more brain metastases: expert opinion survey. J Neurosurg 2010, 113: 84-89.\nPesce GA, Klingbiel D, Ribi K, et al.: Outcome, quality of life and cognitive function of patients with brain metastases from non-small cell lung cancer treated with whole brain radiotherapy combined with gefitinib or temozolomide. A randomised phase II trial of the Swiss Group for Clinical Cancer Research (SAKK 70\u002F03). Eur J Cancer 2012, 48: 377-384. 10.1016\u002Fj.ejca.2011.10.016\nWasif N, Tamurian RM, Christensen S, et al.: Influence of Specialty and Clinical Experience on Treatment Sequencing in the Multimodal Management of Soft Tissue Extremity Sarcoma. Ann Surg Oncol 2011, 19: 504-510.\nChuah TK, Lee T, Wirtzfeld D, et al.: Management of primary rectal cancer by surgeons in Atlantic Canada: results of a regional survey. Can J Surg 2010, 53: 396-402.\nKilani RK, Paxton BE, Stinnett SS, et al.: Self-referral in medical imaging: a meta-analysis of the literature. J Am Coll Radiol 2011, 8: 469-476. 10.1016\u002Fj.jacr.2011.01.016\nHalasz LM, Weeks JC, Neville BA, et al.: Use of Stereotactic Radiosurgery For Brain Metastases: A SEER-Medicare Analysis. Poster Presentation, ASTRO; 2011.",{"VOID":1599},"10.1186\u002F1748-717X-7-188","2024-05-07T07:25:36.965+00:00","https:\u002F\u002Fro-journal.biomedcentral.com\u002Farticles\u002F10.1186\u002F1748-717X-7-188",[1603,1618,1633,1648,1663],{"id":1604,"sortIndex":19,"researcher":18,"roles":1605,"affiliations":1606,"properties":1615,"displayName":1617,"givenName":18,"familyName":18},"4aef1a82-eb0f-41e6-89d5-090fa83c820f",[188],[1607],{"id":1608,"sortIndex":19,"affiliation":1609,"properties":18},"3b00f76d-e91a-45fb-a6f1-775c6a162dec",{"id":1608,"createTime":18,"updateTime":18,"relativeEntities":1610,"slug":18,"properties":1611,"entityType":18,"verifyStatus":18,"verifyTime":18,"verifyNote":18,"languages":18,"translateLanguages":18,"viewCount":18,"url":18,"parentIds":1614,"statistic":18},[],{"title":1612},{"VI":1613},"Department of Radiation Oncology, Georgetown University Medical Center, Washington, USA",[],{"title":1616},{"VI":1617},"Marie-Adele S 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         \u003Cjats:sec>\n            \u003Cjats:title>Background\u003C\u002Fjats:title>\n            \u003Cjats:p>Treating prostate cancer with SBRT could potentially minimize radiation proctitis by reducing high-dose rectal irradiation. In addition, it offers the potential radiobiologic benefits of hypofractionation. This study reports the endoscopic changes and the associated clinical rectal toxicity in these patients.\u003C\u002Fjats:p>\n          \u003C\u002Fjats:sec>\n          \u003Cjats:sec>\n            \u003Cjats:title>Methods\u003C\u002Fjats:title>\n            \u003Cjats:p>We reviewed the records of patients treated from 2008–2011 for localized prostate cancer who had rectal endoscopy following SBRT. SBRT was delivered either as primary treatment in 5 fractions of 7–7.25 Gy, or as an initial boost in 3 fractions of 6.5 Gy followed by conventionally fractionated radiotherapy to 45–50.4 Gy. Endoscopic changes were graded using the Vienna Rectoscopy Score (VRS). Rectal toxicity was graded via CTCAEv.4. Rectal quality of life (QOL) was assessed via the bowel domain of the EPIC-26 questionnaire.\u003C\u002Fjats:p>\n          \u003C\u002Fjats:sec>\n          \u003Cjats:sec>\n            \u003Cjats:title>Results\u003C\u002Fjats:title>\n            \u003Cjats:p>Fifty-one patients with a median 23 months follow-up were analyzed. Thirty-five patients completed SBRT monotherapy and 16 patients received SBRT as a boost to conventionally fractionated IMRT. The median interval from SBRT to rectal endoscopy was 13 months. Endoscopy revealed VRS Grade 1–2 telangiectasias for 10 patients and VRS Grade 1–2 mucosal edema for 12 patients. No rectal ulcerations, strictures or necrosis were observed. Grade 1–2 late rectal bleeding occurred in 10 patients. There were no CTCAEv.4 Grade ≥3 toxicities. Mean EPIC bowel scores decreased from a baseline value of 96.9 to 82.3 at 1-month, but subsequently increased to 91.0 at 24 months.\u003C\u002Fjats:p>\n          \u003C\u002Fjats:sec>\n          \u003Cjats:sec>\n            \u003Cjats:title>Conclusions\u003C\u002Fjats:title>\n            \u003Cjats:p>In this cohort that is skewed towards patients with rectal complaints, the rate and severity of endoscopic changes following SBRT is low. Rectal toxicity and QOL were comparable to patients treated with other radiation modalities. Prospective trials examining the endoscopic outcomes following SBRT for prostate cancer are needed for confirmation of the findings of this study.\u003C\u002Fjats:p>\n          \u003C\u002Fjats:sec>\n          \u003Cjats:sec>\n            \u003Cjats:title>Trial registration\u003C\u002Fjats:title>\n            \u003Cjats:p>The Georgetown Institutional Review Board has approved this retrospective study (IRB 2009–510).\u003C\u002Fjats:p>\n          \u003C\u002Fjats:sec>",{"EN":1751},"Rectal endoscopy findings following stereotactic body radiation therapy for clinically localized prostate 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Int J Radiat Oncol Biol Phys 2000, 46: 995-998. 10.1016\u002FS0360-3016(99)00374-0",{"doi":2008},"10.1016\u002FS0360-3016(99)00374-0",{"id":18,"text":2010,"url":18,"identifiers":2011},"Choe KS, Jani AB, Liauw SL: External beam radiotherapy for prostate cancer patients on anticoagulation therapy: how significant is the bleeding toxicity? Int J Radiat Oncol Biol Phys 2010, 76: 755-760. 10.1016\u002Fj.ijrobp.2009.02.026",{"doi":2012},"10.1016\u002Fj.ijrobp.2009.02.026",{"id":18,"text":2014,"url":18,"identifiers":2015},"Goldner G, Tomicek B, Becker G, Geinitz H, Wachter S, Zimmermann F, Wachter-Gerstner N, Reibenwein J, Glocker S, Bamberg M, et al.: Proctitis after external-beam radiotherapy for prostate cancer classified by Vienna Rectoscopy Score and correlated with EORTC\u002FRTOG score for late rectal toxicity: results of a prospective multicenter study of 166 patients. Int J Radiat Oncol Biol Phys 2007, 67: 78-83. 10.1016\u002Fj.ijrobp.2006.08.055",{"doi":2016},"10.1016\u002Fj.ijrobp.2006.08.055",{"id":18,"text":2018,"url":18,"identifiers":2019},"Kuban DA, Tucker SL, Dong L, Starkschall G, Huang EH, Cheung MR, Lee AK, Pollack A: Long-Term Results of the M. D. Anderson Randomized Dose-Escalation Trial for Prostate Cancer. Int J Radiat Oncol Biol Phys 2008, 70: 67-74. 10.1016\u002Fj.ijrobp.2007.06.054",{"doi":2020},"10.1016\u002Fj.ijrobp.2007.06.054",{"id":18,"text":2022,"url":18,"identifiers":2023},"Dearnaley DP, Sydes MR, Graham JD, Aird EG, Bottomley D, Cowan RA, Huddart RA, Jose CC, Matthews JH, Millar J, et al.: Escalated-dose versus standard-dose conformal radiotherapy in prostate cancer: first results from the MRC RT01 randomised controlled trial. 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Int J Radiat Oncol Biol Phys 2011, 79: 1013-1021. 10.1016\u002Fj.ijrobp.2009.12.045",{"doi":2044},"10.1016\u002Fj.ijrobp.2009.12.045",{"id":18,"text":2046,"url":18,"identifiers":2047},"Brenner DJ, Hall EJ: Fractionation and protraction for radiotherapy of prostate carcinoma. Int J Radiat Oncol Biol Phys 1999, 43: 1095-1101. 10.1016\u002FS0360-3016(98)00438-6",{"doi":2048},"10.1016\u002FS0360-3016(98)00438-6",{"id":18,"text":2050,"url":18,"identifiers":2051},"Corner C, Rojas AM, Bryant L, Ostler P, Hoskin P: A phase II study of high-dose-rate afterloading brachytherapy as monotherapy for the treatment of localized prostate cancer. Int J Radiat Oncol Biol Phys 2008, 72: 441-446. 10.1016\u002Fj.ijrobp.2007.12.026",{"doi":2052},"10.1016\u002Fj.ijrobp.2007.12.026",{"id":18,"text":2054,"url":18,"identifiers":2055},"Grills IS, Martinez AA, Hollander M, Huang R, Goldman K, Chen PY, Gustafson GS: High dose rate brachytherapy as prostate cancer monotherapy reduces toxicity compared to low dose rate palladium seeds. J Urol 2004, 171: 1098-1104. 10.1097\u002F01.ju.0000113299.34404.22",{"doi":2056},"10.1097\u002F01.ju.0000113299.34404.22",{"id":18,"text":2058,"url":18,"identifiers":2059},"Yoshioka Y, Konishi K, Sumida I, Takahashi Y, Isohashi F, Ogata T, Koizumi M, Yamazaki H, Nonomura N, Okuyama A, Inoue T: Monotherapeutic high-dose-rate brachytherapy for prostate cancer: five-year results of an extreme hypofractionation regimen with 54 Gy in nine fractions. Int J Radiat Oncol Biol Phys 2011, 80: 469-475. 10.1016\u002Fj.ijrobp.2010.02.013",{"doi":2060},"10.1016\u002Fj.ijrobp.2010.02.013",{"id":18,"text":2062,"url":18,"identifiers":2063},"Xie Y, Djajaputra D, King CR, Hossain S, Ma L, Xing L: Intrafractional motion of the prostate during hypofractionated radiotherapy. Int J Radiat Oncol Biol Phys 2008, 72: 236-246. 10.1016\u002Fj.ijrobp.2008.04.051",{"doi":2064},"10.1016\u002Fj.ijrobp.2008.04.051",{"id":18,"text":2066,"url":18,"identifiers":2067},"Chen LN, Suy S, Uhm S, Oermann EK, Ju AW, Chen VJ, Hanscom HN, Laing S, Kim JS, Lei S, et al.: Stereotactic Body Radiation Therapy (SBRT) for clinically localized prostate cancer: the Georgetown University experience. Radiat Oncol 2013., 8:",{},{"id":18,"text":2069,"url":18,"identifiers":2070},"Katz AJ, Santoro M, Ashley R, Diblasio F, Witten M: Stereotactic body radiotherapy for organ-confined prostate cancer. BMC Urol 2010, 10: 1. 10.1186\u002F1471-2490-10-1",{"doi":2071},"10.1186\u002F1471-2490-10-1",{"id":18,"text":2073,"url":18,"identifiers":2074},"King CR, Brooks JD, Gill H, Presti JC Jr: Long-term outcomes from a prospective trial of stereotactic body radiotherapy for low-risk prostate cancer. Int J Radiat Oncol Biol Phys 2012, 82: 877-882. 10.1016\u002Fj.ijrobp.2010.11.054",{"doi":2075},"10.1016\u002Fj.ijrobp.2010.11.054",{"id":18,"text":2077,"url":18,"identifiers":2078},"Katz AJ, Santoro M, Ashley R, Diblasio F, Witten M: Stereotactic body radiotherapy as boost for organ-confined prostate cancer. Technol Cancer Res Treat 2010, 9: 575-582.",{"doi":2079},"10.1177\u002F153303461000900605",{"id":18,"text":2081,"url":18,"identifiers":2082},"Lei S, Piel N, Oermann EK, Chen VJ, Ju AW, Dahal KN, Hanscom HN, Kim JS, Yu X, Zhang G, et al.: Six-dimensional correction of intra-fractional prostate motion with CyberKnife stereotactic body radiation therapy. Frontiers Oncol 2011., 1:",{},{"id":18,"text":2084,"url":18,"identifiers":2085},"Oermann EK, Suy S, Hanscom HN, Kim JS, Lei S, Yu X, Zhang G, Ennis B, Rohan JP, Piel N, et al.: Low incidence of new biochemical and clinical hypogonadism following hypofractionated stereotactic body radiation therapy (SBRT) monotherapy for low- to intermediate-risk prostate cancer. J Hematol Oncol 2011, 4: 12. 10.1186\u002F1756-8722-4-12",{"doi":2086},"10.1186\u002F1756-8722-4-12",{"id":18,"text":2088,"url":18,"identifiers":2089},"Oermann EK, Slack RS, Hanscom HN, Lei S, Suy S, Park HU, Kim JS, Sherer BA, Collins BT, Satinsky AN, et al.: A pilot study of intensity modulated radiation therapy with hypofractionated stereotactic body radiation therapy (SBRT) boost in the treatment of intermediate- to high-risk prostate cancer. Technol Cancer Res Treat 2010, 9: 453-462.",{"doi":2090},"10.1177\u002F153303461000900503",{"id":18,"text":2092,"url":18,"identifiers":2093},"Wachter S, Gerstner N, Goldner G, Potzi R, Wambersie A, Potter R: Endoscopic scoring of late rectal mucosal damage after conformal radiotherapy for prostatic carcinoma. Radiother Oncol 2000, 54: 11-19. 10.1016\u002FS0167-8140(99)00173-5",{"doi":2094},"10.1016\u002FS0167-8140(99)00173-5",{"id":18,"text":2096,"url":18,"identifiers":2097},"Wei JT, Dunn RL, Litwin MS, Sandler HM, Sanda MG: Development and validation of the expanded prostate cancer index composite (EPIC) for comprehensive assessment of health-related quality of life in men with prostate cancer. Urology 2000, 56: 899-905. 10.1016\u002FS0090-4295(00)00858-X",{"doi":2098},"10.1016\u002FS0090-4295(00)00858-X",{"id":18,"text":2100,"url":18,"identifiers":2101},"Norman GR, Sloan JA, Wyrwich KW: Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation. Med Care 2003, 41: 582-592.",{},{"id":18,"text":2103,"url":18,"identifiers":2104},"van Lin EN, Kristinsson J, Philippens ME, de Jong DJ, van der Vight LP, Kaanders JH, Leer JW, Visser AG: Reduced late rectal mucosal changes after prostate three-dimensional conformal radiotherapy with endorectal balloon as observed in repeated endoscopy. Int J Radiat Oncol Biol Phys 2007, 67: 799-811. 10.1016\u002Fj.ijrobp.2006.09.034",{"doi":2105},"10.1016\u002Fj.ijrobp.2006.09.034",{"id":18,"text":2107,"url":18,"identifiers":2108},"O’Brien PC, Hamilton CS, Denham JW, Gourlay R, Franklin CI: Spontaneous improvement in late rectal mucosal changes after radiotherapy for prostate cancer. Int J Radiat Oncol Biol Phys 2004, 58: 75-80. 10.1016\u002FS0360-3016(03)01445-7",{"doi":2109},"10.1016\u002FS0360-3016(03)01445-7",{"id":18,"text":2111,"url":18,"identifiers":2112},"Ippolito E, Deodato F, Macchia G, Massaccesi M, Digesu C, Pirozzi GA, Spera G, Marangi S, Annoscia E, Cilla S, et al.: Early radiation-induced mucosal changes evaluated by proctoscopy: predictive role of dosimetric parameters. Radiother Oncol 2012, 104: 103-108. 10.1016\u002Fj.radonc.2012.05.010",{"doi":2113},"10.1016\u002Fj.radonc.2012.05.010",{"id":18,"text":2115,"url":18,"identifiers":2116},"Ippolito E, Massaccesi M, Digesu C, Deodato F, Macchia G, Pirozzi GA, Cilla S, Cuscuna D, Di Lallo A, Mattiucci GC, et al.: Early proctoscopy is a surrogate endpoint of late rectal toxicity in prostate cancer treated with radiotherapy. Int J Radiat Oncol Biol Phys 2012, 83: e191-e195. 10.1016\u002Fj.ijrobp.2011.06.1960",{"doi":2117},"10.1016\u002Fj.ijrobp.2011.12.046",{"id":2119,"createTime":2120,"updateTime":2121,"relativeEntities":2122,"slug":2123,"properties":2124,"entityType":179,"verifyStatus":180,"verifyTime":2135,"verifyNote":182,"languages":18,"translateLanguages":18,"viewCount":19,"primaryUrl":2136,"fullTextUrl":18,"authors":2137,"publicationType":245,"publisherRelationship":2279,"citationCount":19,"citationInfo":2328,"publishDate":2330,"publishYear":1579,"citationAnalyzeStatus":17,"lastCitationAnalyze":2331,"indexDatabases":2332,"openAccess":18,"references":18,"isForceReanalyzing":372},"127fb0b1-abcd-4b82-80ff-075e547685f8","2024-01-22T02:10:59.315+00:00","2026-07-22T15:57:48.677+00:00",[],"The-role-of-carbon-ion-radiotherapy-for-unresectable-locally-recurrent-rectal-cancer-a-single-institutional-experience",{"abstract":2125,"title":2127,"gsPaper":2129,"references":2131,"doi":2133},{"EN":2126},"Treatment for locally recurrent rectal cancer after surgery is still a challenge. With the physical and biological advantages, carbon-ion radiotherapy (CIRT) could be a choice for these patients. The purpose of this study was to investigate the efficacy and safety of CIRT for unresectable locally recurrent rectal cancer in Chinese patients. Date from 25 patients with unresectable locally recurrent rectal cancer treated by CIRT from July 2015 to April 2019 were analyzed retrospectively. The endpoints of this study were overall survival (OS), local control (LC) and acute and late toxicity. With the median follow-up of 19.6 (range 5.1–52.5) months, data of all 25 patients were collected. Median prescribed dose for tumor was 72Gy (relative biologic efficacy (RBE)) (range 48–75.6Gy (RBE)). The LC rates at 1 and 2 years were 90.4 and 71.8%. Overall LC at 1- and 2-year were 76.2 and 30.5% for 9 patients whose prescribed tumor doses of CIRT\u003C 66 Gy (RBE), 100 and 100% for 16 patients whose prescribed doses of CIRT≥66 Gy (RBE). Patients received ≥66 Gy (RBE) had obviously better LC rates than those received \u003C 66 Gy (RBE) (P = 0.001). The OS rates at 1 and 2 years were 82.9 and 65.1%, respectively. No acute toxicity over grade 2 was observed, grade 3 late toxicity were observed in 3 patients: gastrointestinal toxicity (n = 1), neuropathy (n = 1), pelvic infection (n = 1). No Grade 4 or higher toxicity was observed. Our study shows that CIRT is effective for unresectable locally recurrent rectal cancer patients with acceptable toxicity.",{"EN":2128},"The role of carbon ion radiotherapy for unresectable locally recurrent rectal cancer: a single institutional experience",{"VOID":2130},"[\"10287912628554920560\"]",{"VOID":2132},"van den Brink M, Stiggelbout AM, van den Hout WB, Kievit J, Klein Kranenbarg E, Marijnen CA, Nagtegaal ID, Rutten HJ, Wiggers T, van de Velde CJ. Clinical nature and prognosis of locally recurrent rectal cancer after total mesorectal excision with or without preoperative radiotherapy. J Clin Oncol. 2004;22(19):3958–64. https:\u002F\u002Fdoi.org\u002F10.1200\u002FJCO.2004.01.023.\nBolognese A, Cardi M, Muttillo IA, Barbarosos A, Bocchetti T, Valabrega S. Total mesorectal excision for surgical treatment of rectal cancer. J Surg Oncol. 2000;74(1):21–3.\nKapiteijn E, Marijnen CA, Colenbrander AC, Klein Kranenbarg E, Steup WH, van Krieken JH, van Houwelingen JC, Leer JW, van de Velde CJ. Local recurrence in patients with rectal cancer diagnosed between 1988 and 1992: a population-based study in the West Netherlands. Eur J Surg Oncol. 1998;24(6):528–35.\nGalandiuk S, Wieand HS, Moertel CG, Cha SS, Fitzgibbons RJ Jr, Pemberton JH, Wolff BG. Patterns of recurrence after curative resection of carcinoma of the colon and rectum. Surg Gynecol Obstet. 1992;174(1):27–32.\nBozzetti F, Mariani L, Miceli R, Doci R, Montalto F, Andreola S, Gennari L. Cancer of the low and middle rectum: local and distant recurrences, and survival in 350 radically resected patients. J Surg Oncol. 1996;62(3):207–13. https:\u002F\u002Fdoi.org\u002F10.1002\u002F(SICI)1096-9098(199607)62:3\u003C207::AID-JSO11>3.0.CO;2-3.\nShinoto M, Terashima K, Suefuji H, Matsunobu A, Toyama S, Fukunishi K, Shioyama Y. A single institutional experience of combined carbon-ion radiotherapy and chemotherapy for unresectable locally advanced pancreatic cancer. Radiother Oncol. 2018;129(2):333–9. https:\u002F\u002Fdoi.org\u002F10.1016\u002Fj.radonc.2018.08.026.\nShiba S, Okamoto M, Kiyohara H, Ohno T, Kaminuma T, Asao T, Ojima H, Shirabe K, Kuwano H, Nakano T. Prospective observational study of high-dose carbon-ion radiotherapy for pelvic recurrence of rectal Cancer (GUNMA 0801). Front Oncol. 2019;9:702. https:\u002F\u002Fdoi.org\u002F10.3389\u002Ffonc.2019.00702.\nZhu XG, Li YH, Li XF, Cai Y. Intensity-modulated radiation therapy for pelvic oligo-recurrence from rectal cancer: long-term results from a single institution. Am J Transl Res. 2016;8(2):1265–72.\nJimenez RB, Hickey S, DePauw N, Yeap BY, Batin E, Gadd MA, Specht M, Isakoff SJ, Smith BL, Liao EC, Colwell AS, Ho A, Januzzi JL, Passeri J, Neilan T, Taghian AG, Lu HM, MacDonald SM. Phase II study of proton beam radiation therapy for patients with breast Cancer requiring regional nodal irradiation. J Clin Oncol:JCO1802366. 2019. https:\u002F\u002Fdoi.org\u002F10.1200\u002FJCO.18.02366.\nHockel M, Schlenger K, Hockel S, Aral B, Schaffer U, Vaupel P. Tumor hypoxia in pelvic recurrences of cervical cancer. Int J Cancer. 1998;79(4):365–9.\nShinoto M, Yamada S, Okamoto M, Shioyama Y, Ohno T, Nakano T, Nemoto K, Isozaki Y, Kawashiro S, Tsuji H, Kamada T. Carbon-ion radiotherapy for locally recurrent rectal cancer: Japan carbon-ion radiation oncology study group (J-CROS) study 1404 rectum. Radiother Oncol. 2019;132:236–40. https:\u002F\u002Fdoi.org\u002F10.1016\u002Fj.radonc.2018.10.007.\nTsujii H, Kamada T. A review of update clinical results of carbon ion radiotherapy. Jpn J Clin Oncol. 2012;42(8):670–85. https:\u002F\u002Fdoi.org\u002F10.1093\u002Fjjco\u002Fhys104.\nYamada S, Kamada T, Ebner DK, Shinoto M, Terashima K, Isozaki Y, Yasuda S, Makishima H, Tsuji H, Tsujii H, Isozaki T, Endo S, Takahashi K, Sekimoto M, Saito N, Matsubara H, Working Group on Locally Recurrent Rectal C. Carbon-ion radiation therapy for pelvic recurrence of rectal Cancer. Int J Radiat Oncol Biol Phys. 2016;96(1):93–101. https:\u002F\u002Fdoi.org\u002F10.1016\u002Fj.ijrobp.2016.04.022.\nHabermehl D, Wagner M, Ellerbrock M, Buchler MW, Jakel O, Debus J, Combs SE. Reirradiation using carbon ions in patients with locally recurrent rectal Cancer at HIT: first results. Ann Surg Oncol. 2015;22(6):2068–74. https:\u002F\u002Fdoi.org\u002F10.1245\u002Fs10434-014-4219-z.\nWenzl T, Wilkens JJ. Modelling of the oxygen enhancement ratio for ion beam radiation therapy. Phys Med Biol. 2011;56(11):3251–68. https:\u002F\u002Fdoi.org\u002F10.1088\u002F0031-9155\u002F56\u002F11\u002F006.\nNakano T, Suzuki Y, Ohno T, Kato S, Suzuki M, Morita S, Sato S, Oka K, Tsujii H. Carbon beam therapy overcomes the radiation resistance of uterine cervical cancer originating from hypoxia. Clin Cancer Res. 2006;12(7 Pt 1):2185–90. https:\u002F\u002Fdoi.org\u002F10.1158\u002F1078-0432.CCR-05-1907.\nCai G, Zhu J, Palmer JD, Xu Y, Hu W, Gu W, Cai S, Zhang Z. CAPIRI-IMRT: a phase II study of concurrent capecitabine and irinotecan with intensity-modulated radiation therapy for the treatment of recurrent rectal cancer. Radiat Oncol. 2015;10:57. https:\u002F\u002Fdoi.org\u002F10.1186\u002Fs13014-015-0360-5.\nSun DS, Zhang JD, Li L, Dai Y, Yu JM, Shao ZY. Accelerated hyperfractionation field-involved re-irradiation combined with concurrent capecitabine chemotherapy for locally recurrent and irresectable rectal cancer. Br J Radiol. 2012;85(1011):259–64. https:\u002F\u002Fdoi.org\u002F10.1259\u002Fbjr\u002F28173562.\nDefoe SG, Bernard ME, Rwigema JC, Heron DE, Ozhasoglu C, Burton S. Stereotactic body radiotherapy for the treatment of presacral recurrences from rectal cancers. J Cancer Res Ther. 2011;7(4):408–11. https:\u002F\u002Fdoi.org\u002F10.4103\u002F0973-1482.92000.",{"VOID":2134},"10.1186\u002Fs13014-020-01653-w","2024-05-15T04:36:26.032+00:00","https:\u002F\u002Fro-journal.biomedcentral.com\u002Farticles\u002F10.1186\u002Fs13014-020-01653-w",[2138,2162,2177,2197,2217,2237,2257],{"id":2139,"sortIndex":19,"researcher":18,"roles":2140,"affiliations":2141,"properties":2159,"displayName":2161,"givenName":18,"familyName":18},"eeb95ae9-51ca-4ff8-9c36-685f3bca1b2c",[188],[2142,2150],{"id":2143,"sortIndex":19,"affiliation":2144,"properties":18},"2420e2bf-ed39-4a98-878b-275ccb874814",{"id":2143,"createTime":18,"updateTime":18,"relativeEntities":2145,"slug":18,"properties":2146,"entityType":18,"verifyStatus":18,"verifyTime":18,"verifyNote":18,"languages":18,"translateLanguages":18,"viewCount":18,"url":18,"parentIds":2149,"statistic":18},[],{"title":2147},{"VI":2148},"Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China",[],{"id":2151,"sortIndex":203,"affiliation":2152,"properties":2158},"4d9d43b5-a705-41f8-8089-ab494cd3c679",{"id":2151,"createTime":18,"updateTime":18,"relativeEntities":2153,"slug":18,"properties":2154,"entityType":18,"verifyStatus":18,"verifyTime":18,"verifyNote":18,"languages":18,"translateLanguages":18,"viewCount":18,"url":18,"parentIds":2157,"statistic":18},[],{"title":2155},{"VI":2156},"Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China",[],{},{"title":2160},{"VI":2161},"Xin Cai",{"id":2163,"sortIndex":203,"researcher":18,"roles":2164,"affiliations":2165,"properties":2174,"displayName":2176,"givenName":18,"familyName":18},"f615b19d-020e-4968-9363-24b1cac42dd1",[188],[2166],{"id":2167,"sortIndex":19,"affiliation":2168,"properties":18},"0542809b-5aeb-4245-98b3-53f9e847a6b9",{"id":2167,"createTime":18,"updateTime":18,"relativeEntities":2169,"slug":18,"properties":2170,"entityType":18,"verifyStatus":18,"verifyTime":18,"verifyNote":18,"languages":18,"translateLanguages":18,"viewCount":18,"url":18,"parentIds":2173,"statistic":18},[],{"title":2171},{"VI":2172},"Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China",[],{"title":2175},{"VI":2176},"Yueyao 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spine is the most common site for bone metastases. Radiation therapy is a common treatment for palliation of pain and for prevention or treatment of spinal cord compression. Helical tomotherapy (HT), a new image-guided intensity modulated radiotherapy (IMRT), delivers highly conformal dose distributions and provides an impressive ability to spare adjacent organs at risk, thus increasing the local control of spinal column metastases and decreasing the potential risk of critical organs under treatment. However, there are a lot of non-target organs at risk (OARs) occupied by low dose with underestimate in this modern rotational IMRT treatment. Herein, we report a case of a pathologic compression fracture of the T9 vertebra in a 55-year-old patient with cholangiocarcinoma. The patient underwent HT at a dose of 30 Gy\u002F10 fractions delivered to T8-T10 for symptom relief. Two weeks after the radiotherapy had been completed, the first course of chemotherapy comprising gemcitabine, fluorouracil, and leucovorin was administered. After two weeks of chemotherapy, however, the patient developed progressive dyspnea. A computed tomography scan of the chest revealed an interstitial pattern with traction bronchiectasis, diffuse ground-glass opacities, and cystic change with fibrosis. Acute radiation pneumonitis was diagnosed. Oncologists should be alert to the potential risk of radiation toxicities caused by low dose off-targets and abscopal effects even with highly conformal radiotherapy.",{"EN":2343},"Toxicity risk of non-target organs at risk receiving low-dose radiation: case report",{"VOID":2345},"[\"8803592794258121989\"]",{"VOID":2347},"Kataria T, Rawat S, Sinha SN, Garg C, Bhalla NK, Negi PS: Dose reduction to normal tissues as compared to the gross tumor by using intensity modulated radiotherapy in thoracic malignancies. Radiat Oncol. 2006, 1: 31-10.1186\u002F1748-717X-1-31.\nGong Y, Wang J, Bai S, Jiang X, Xu F: Conventionally-fractionated image-guided intensity modulated radiotherapy (IG-IMRT): a safe and effective treatment for cancer spinal metastasis. Radiat Oncol. 2008, 3: 11-10.1186\u002F1748-717X-3-11.\nShueng PW, Lin SC, Chong NS, Lee HY, Tien HJ, Wu LJ, Chen CA, Lee JJ, Hsieh CH: Total marrow irradiation with helical tomotherapy for bone marrow transplantation of multiple myeloma: first experience in Asia. Technol Cancer Res Treat. 2009, 8: 29-38.\nLee IJ, Seong J, Lee CG, Kim YB, Keum KC, Suh CO, Kim GE, Cho J: Early clinical experience and outcome of helical tomotherapy for multiple metastatic lesions. Int J Radiat Oncol Biol Phys. 2009, 73: 1517-24. 10.1016\u002Fj.ijrobp.2008.07.035.\nSchwarte S, Wagner K, Karstens JH, Bremer M: Radiation recall pneumonitis induced by gemcitabine. Strahlenther Onkol. 2007, 183: 215-7. 10.1007\u002Fs00066-007-1688-z.\nKaminski JM, Shinohara E, Summers JB, Niermann KJ, Morimoto A, Brousal J: The controversial abscopal effect. Cancer Treat Rev. 2005, 31: 159-72. 10.1016\u002Fj.ctrv.2005.03.004.\nAlberts SR, Al-Khatib H, Mahoney MR, Burgart L, Cera PJ, Flynn PJ, Finch TR, Levitt R, Windschitl HE, Knost JA, Tschetter LK: Gemcitabine, 5-fluorouracil, and leucovorin in advanced biliary tract and gallbladder carcinoma: a North Central Cancer Treatment Group phase II trial. Cancer. 2005, 103: 111-8. 10.1002\u002Fcncr.20753.\nJeter MD, Janne PA, Brooks S, Burstein HJ, Wen P, Fuchs CS, Loeffler JS, Devlin PM, Salgia R: Gemcitabine-induced radiation recall. Int J Radiat Oncol Biol Phys. 2002, 53: 394-400. 10.1016\u002FS0360-3016(02)02773-6.\nBen-Josef E, Shamsa F, Williams AO, Porter AT: Radiotherapeutic management of osseous metastases: a survey of current patterns of care. Int J Radiat Oncol Biol Phys. 1998, 40: 915-21. 10.1016\u002FS0360-3016(97)00927-9.\nHayashi S, Hoshi H, Iida T, Kajiura Y: Multi-fractionated wide-field radiation therapy for palliation of multiple symptomatic bone metastases from solid tumors. Radiat Med. 1999, 17: 411-6.\nTsujino K, Hirota S, Endo M, Obayashi K, Kotani Y, Satouchi M, Kado T, Takada Y: Predictive value of dose-volume histogram parameters for predicting radiation pneumonitis after concurrent chemoradiation for lung cancer. Int J Radiat Oncol Biol Phys. 2003, 55: 110-5. 10.1016\u002FS0360-3016(02)03807-5.\nBelderbos JS, Heemsbergen WD, De Jaeger K, Baas P, Lebesque JV: Final results of a Phase I\u002FII dose escalation trial in non-small-cell lung cancer using three-dimensional conformal radiotherapy. Int J Radiat Oncol Biol Phys. 2006, 66: 126-34. 10.1016\u002Fj.ijrobp.2006.04.034.\nFriedlander PA, Bansal R, Schwartz L, Wagman R, Posner J, Kemeny N: Gemcitabine-related radiation recall preferentially involves internal tissue and organs. Cancer. 2004, 100: 1793-9. 10.1002\u002Fcncr.20229.\nChoi YW, Munden RF, Erasmus JJ, Park KJ, Chung WK, Jeon SC, Park CK: Effects of radiation therapy on the lung: radiologic appearances and differential diagnosis. Radiographics. 2004, 24: 985-97. 10.1148\u002Frg.244035160. discussion 98\nKhan MA, Hill RP, Van Dyk J: Partial volume rat lung irradiation: an evaluation of early DNA damage. Int J Radiat Oncol Biol Phys. 1998, 40: 467-76. 10.1016\u002FS0360-3016(97)00736-0.\nMorgan GW, Breit SN: Radiation and the lung: a reevaluation of the mechanisms mediating pulmonary injury. Int J Radiat Oncol Biol Phys. 1995, 31: 361-9. 10.1016\u002F0360-3016(94)00477-3.\nEckert F, Muller AC: SCLC extensive disease--treatment guidance by extent or\u002Fand biology of response?. Radiat Oncol. 2008, 3: 33-10.1186\u002F1748-717X-3-33.\nSedelnikova OA, Nakamura A, Kovalchuk O, Koturbash I, Mitchell SA, Marino SA, Brenner DJ, Bonner WM: DNA double-strand breaks form in bystander cells after microbeam irradiation of three-dimensional human tissue models. Cancer Res. 2007, 67: 4295-302. 10.1158\u002F0008-5472.CAN-06-4442.\nPrise KM, O'Sullivan JM: Radiation-induced bystander signalling in cancer therapy. Nat Rev Cancer. 2009, 9: 351-60. 10.1038\u002Fnrc2603.\nKim JY, Kim YS, Kim YK, Park HJ, Kim SJ, Kang JH, Wang YP, Jang HS, Lee SN, Yoon SC: The TGF-beta1 dynamics during radiation therapy and its correlation to symptomatic radiation pneumonitis in lung cancer patients. Radiat Oncol. 2009, 4: 59-10.1186\u002F1748-717X-4-59.\nSchuring D, Hurkmans CW: Developing and evaluating stereotactic lung RT trials: what we should know about the influence of inhomogeneity corrections on dose. Radiat Oncol. 2008, 3: 21-10.1186\u002F1748-717X-3-21.\nMilano MT, Constine LS, Okunieff P: Normal tissue toxicity after small field hypofractionated stereotactic body radiation. Radiat Oncol. 2008, 3: 36-10.1186\u002F1748-717X-3-36.\nYamashita H, Nakagawa K, Nakamura N, Koyanagi H, Tago M, Igaki H, Shiraishi K, Sasano N, Ohtomo K: Exceptionally high incidence of symptomatic grade 2-5 radiation pneumonitis after stereotactic radiation therapy for lung tumors. 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