Head-to-head: Anthropomorphic phantoms for evaluating the effect of skin tone on the accuracy of surface imaging systems.

Purpose: To study the localization accuracy of two commercial surface imaging (SI) systems used for intrafraction motion monitoring during stereotactic radiosurgery (SRS) and quantify the difference in accuracy due to skin tone.

Methods: Using a publicly available CT dataset, anthropomorphic phantoms were 3D printed using filament in four skin tones: rose tan, light brown, medium brown, and dark brown (3DUniverse, Chicago, IL, USA). Three SI systems from two vendors were utilized to measure the SI-reported offsets of the stationary phantoms in various gantry and couch configurations to create SRS-like conditions, including when the gantry obscured one camera pod.

ADAPT-marketplace - A web-application for XML-based template sharing in radiation oncology.

Purpose: The adaption of radiotherapy (RT) plans in response to anatomical and physiological changes during treatment marks a significant shift toward personalized cancer care. However, the complexity of Online Adaptive Radiotherapy (OART) procedures often leads to variability in treatment quality across institutions. The development of planning templates, particularly through the Ethos treatment planning system (TPS) and Intelligent Optimization Engine (IOE) (Varian Medical Systems, Palo Alto, CA), plays a crucial role in standardizing and streamlining OART.

Application of Photon-Derived Worst-Case Robustness Criteria to Proton Therapy Planning.

Purpose: Robustness evaluation is critical for proton beam therapy (PBT) planning, but ideal robustness criteria are not clearly defined. Here, we compared robustness of PBT plans to published intensity-modulated radiation therapy (IMRT)-derived clinical target volume (CTV) robustness benchmarks and assessed the dosimetric impact of meeting IMRT-derived benchmarks on adjacent organs at risk.

Patients And Methods: Patients receiving PBT to 70 GyE in 28 fractions to the prostate alone from 2021 to 2022 at our institution were evaluated.

Longitudinal brain volumetrics in glioma survivors.

Objective: Radiation therapy (RT) is used selectively for patients with low-grade glioma (LGG) given the concerns for potential cognitive effects in survivors, but prior cognitive outcome studies among LGG survivors have had inconsistent findings. Translational studies that characterize changes in brain anatomy and physiology after treatment of LGG may help to both contextualize cognitive findings and improve the overall understanding of radiation effects in normal brain tissue. This study aimed to investigate the hypothesis that patients with LGG who are treated with RT will experience greater brain volume loss than those who do not receive RT.

Clinical trials of R-(-)-gossypol (AT-101) in newly diagnosed and recurrent glioblastoma: NABTT 0602 and NABTT 0702.

Purpose: AT-101 is an oral bcl-2 family protein inhibitor (Bcl-2, Bcl-XL, Mcl-1, Bcl-W) and potent inducer of proapoptotic proteins. A prior study of the parent compound, racemic gossypol, demonstrated objective and durable responses in patients with malignant glioma. AT-101 has demonstrated synergy with radiation in animal models.

Characterization of Photon Intensity Modulated Radiation Therapy Robustness in Patients With Prostate Cancer as a Proposed Benchmark for Proton Therapy Robustness Evaluation.

Purpose: Robustness evaluation is increasingly used in particle therapy planning to assess clinical target volume (CTV) coverage in the setting of setup and range uncertainty. However, no clear standard exists as to an acceptable degree of plan robustness. The aim of this study is to quantify x-ray robustness parameters, as this could inform proton planning when held to a similar standard.

Understanding the Effect of Prescription Isodose in Single-Fraction Stereotactic Radiosurgery on Plan Quality and Clinical Outcomes for Solid Brain Metastases.

Background And Objectives: There is wide variation in treatment planning strategy for central nervous system (CNS) stereotactic radiosurgery. We sought to understand what relationships exist between intratumor maximum dose and local control (LC) or CNS toxicity, and dosimetric effects of constraining hotspots on plan quality of multiple metastases volumetric modulated arc therapy radiosurgery plans.

Methods: We captured brain metastases from 2015 to 2017 treated with single-isocenter volumetric modulated arc therapy radiosurgery.

Commissioning and clinical evaluation of the IDENTIFY surface imaging system for frameless stereotactic radiosurgery.

Purpose: To commission and assess the clinical performance of a new commercial surface imaging (SI) system by analyzing intra-fraction motion from the initial cohort of patients treated with frameless stereotactic radiosurgery (fSRS).

Methods: The IDENTIFY SI system was commissioned for clinical use on an Edge (Varian Medical Systems, Palo Alto, CA) linear accelerator. All patients who received intracranial radiotherapy with HyperArc (Varian Medical Systems, Palo Alto, CA) were immobilized with the Encompass (Qfix, Avondale, PA) thermoplastic mask and monitored for intra-fraction motion with SI.

Prostate Stereotactic Body Radiation Therapy With a Focal Simultaneous Integrated Boost: 5-Year Toxicity and Biochemical Recurrence Results From a Prospective Trial.

Purpose: Stereotactic body radiation therapy (SBRT) is increasingly used as a definitive treatment option for patients with prostate adenocarcinoma. The aim of this study was to assess the late toxicity, patient-reported quality of life outcomes, and biochemical recurrence rates after prostate SBRT with simultaneous integrated boost (SIB) targeting lesions defined by magnetic resonance imaging (MRI).

Methods And Materials: Patients were eligible if they had biopsy-proven low- or intermediate-risk prostate adenocarcinoma, one or more focal lesions on MRI, and an MRI-defined total prostate volume of <120 mL.

Racial and socioeconomic disparities in glioblastoma outcomes: A single-center, retrospective cohort study.

Background: Glioblastoma (GBM) is the most common malignant primary brain tumor. Emerging reports have suggested that racial and socioeconomic disparities influence the outcomes of patients with GBM. No studies to date have investigated these disparities controlling for isocitrate dehydrogenase (IDH) mutation and O-6-methylguanine-DNA methyltransferase (MGMT) status.

Improving Communication of Peer-Review Conference Outcomes: A Practical Experience.

Purpose: The aim of this work was to describe the design and implementation of a more robust workflow for communicating outcomes from a peer-review chart rounds conference. We also provide information regarding cycle times, plan revisions, and other key metrics that we have observed since initial implementation.

Methods And Materials: A multidisciplinary team of stakeholders including physicians, physicists, and dosimetrists developed a revised peer-review workflow that addressed key needs to improve the prior process.

Identifying research themes and trends in the top 20 cancer journals through textual analysis.

Background: The rapid growth in cancer research continues expanding the literature. Text mining approaches help make sense of large bodies of scientific literature and integrate the mounting data into the health care delivery system. Our objective is to generate a comprehensive understanding of the themes and trends in cancer research.

High-dose methotrexate and rituximab induction regimen in immunocompetent patients with primary CNS lymphoma: a retrospective single-center study of survival predictors.

Purpose: Primary Central Nervous System Lymphoma (PCNSL) is an aggressive tumor that is confined to the CNS. Although the provision of high-dose methotrexate (HD-MTX) has remarkably improved outcomes in PCNSL patients, the optimal treatment regimens and standard MTX dose for induction therapy have been largely controversial. Herein, we sought to explore the impact of adjuvant rituximab and different dosages of induction HD-MTX on survival outcomes of immunocompetent patients with PCNSL.

Practical Considerations for Single Isocenter LINAC Radiosurgery of Multiple Brain Metastases.

The purpose of this paper is to summarize treatment guidelines for the performance of single isocenter LINAC radiosurgery of multiple brain metastases developed and used by 3 experienced centers. This article is not meant to provide consensus guidelines. Rather, this is a practical, "how we do it" reference without substantial discussion.

Oncolytic HSV-1 G207 Immunovirotherapy for Pediatric High-Grade Gliomas.

Background: Outcomes in children and adolescents with recurrent or progressive high-grade glioma are poor, with a historical median overall survival of 5.6 months. Pediatric high-grade gliomas are largely immunologically silent or "cold," with few tumor-infiltrating lymphocytes.

Leptomeningeal disease and neurologic death after surgical resection and radiosurgery for brain metastases: A multi-institutional analysis.

Purpose: Postoperative stereotactic radiosurgery (SRS) is associated with up to 30% risk of subsequent leptomeningeal disease (LMD). Radiographic patterns of LMD (classical sugarcoating [cLMD] vs. nodular [nLMD]) in this setting has been shown to be prognostic.

Control and Toxicity in Melanoma Versus Other Brain Metastases in Response to Combined Radiosurgery and PD-(L)1 Immune Checkpoint Inhibition.

Purpose: Prior studies have mixed conclusions about the efficacy and central nervous system (CNS) toxicity profile of combining radiosurgery with anti-programed cell death 1 (PD-1) immune checkpoint inhibition (ICI) for brain metastases. This study evaluates the safety and efficacy of combined radiosurgery and anti-PD-1 ICI for melanoma, non-small cell lung cancer (NSCLC), and renal cell carcinoma (RCC) brain metastases (BM).

Methods And Materials: Forty-one patients with 153 radiation naïve melanoma BM and 33 patients with 118 BM of NSCLC and RCC origin from 2014 through 2019 received radiosurgery and either anti PD-1 receptor inhibition or anti PD-L1 inhibition targeting the PD-1 ligand with less than 4 months separating either therapy.

Transition From Manual to Automated Planning and Delivery of Volumetric Modulated Arc Therapy Stereotactic Radiosurgery: Clinical, Dosimetric, and Quality Assurance Results.

Purpose: Properly planned single isocenter volumetric modulated arc therapy (VMAT) radiosurgery plans exhibit high quality and efficiency. We report here the largest clinical experience to date, to our knowledge, comparing manual planning with a new automated platform designed to standardize and simplify radiosurgery planning and delivery processes.

Methods: We treated 693 patients with single isocenter VMAT radiosurgical plans generated by either our conventional manual (mVMAT) or a recently implemented automated (HyperArc) technique.

Accuracy of dose-volume metric calculation for small-volume radiosurgery targets.

Purpose: For stereotactic radiosurgery (SRS), accurate evaluation of dose-volume metrics for small structures is necessary. The purpose of this study was to compare the DVH metric capabilities of five commercially available SRS DVH analysis tools (Eclipse, Elements, Raystation, MIM, and Velocity).

Methods: DICOM RTdose and RTstructure set files created using MATLAB were imported and evaluated in each of the tools.

Surface guided imaging during stereotactic radiosurgery with automated delivery.

Purpose: To report on the use of surface guided imaging during frameless intracranial stereotactic radiotherapy with automated delivery via HyperArc (Varian Medical Systems, Palo Alto, CA).

Methods: All patients received intracranial radiotherapy with HyperArc and were monitored for intrafraction motion by the AlignRT® (VisionRT, London, UK) surface imaging (SI) system. Immobilization was with the Encompass (Qfix, Avondale, PA) aquaplast mask device.

Interinstitutional Plan Quality Assessment of 2 Linac-Based, Single-Isocenter, Multiple Metastasis Radiosurgery Techniques.

Purpose: Interest and application of stereotactic radiosurgery for multiple brain metastases continue to increase. Various planning systems are available for linear accelerator (linac)-based single-isocenter multiple metastasis radiosurgery. Two of the most advanced systems are BrainLAB Multiple Metastases Elements (MME), a dynamic conformal arc (DCA) approach, and Varian RapidArc (RA), a volumetric modulated arc therapy (VMAT) approach.