Stereotactic body radiotherapy for stage I lung cancer and small lung metastasis: evaluation of an immobilization system for suppression of respiratory tumor movement and preliminary results

Background:
In stereotactic body radiotherapy (SBRT) for lung tumors, reducing tumor movement is necessary. In this study, we evaluated changes in tumor movement and percutaneous oxygen saturation (SpO2) levels, and preliminary clinical results of SBRT using the BodyFIX immobilization system.
Methods:
Between 2004 and 2006, 53 consecutive patients were treated for 55 lesions; 42 were stage I non-small cell lung cancer (NSCLC), 10 were metastatic lung cancers, and 3 were local recurrences of NSCLC. Tumor movement was measured with fluoroscopy under breath holding, free breathing on a couch, and free breathing in the BodyFIX system. SpO2 levels were measured with a finger pulseoximeter under each condition. The delivered dose was 44, 48 or 52 Gy, depending on tumor diameter, in 4 fractions over 10 or 11 days.
Results:
By using the BodyFIX system, respiratory tumor movements were significantly reduced compared with the free-breathing condition in both craniocaudal and lateral directions, although the amplitude of reduction in the craniocaudal direction was 3 mm or more in only 27% of the patients. The average SpO2 did not decrease by using the system. At 3 years, the local control rate was 80% for all lesions. Overall survival was 76%, cause-specific survival was 92%, and local progression-free survival was 76% at 3 years in primary NSCLC patients. Grade 2 radiation pneumonitis developed in 7 patients.
Conclusions:
Respiratory tumor movement was modestly suppressed by the BodyFIX system, while the SpO2 level did not decrease. It was considered a simple and effective method for SBRT of lung tumors. Preliminary results were encouraging.

Lung Cancer Alliance Calls American Cancer Society’s Claim Of Progress Selective

WASHINGTON — Lung Cancer Alliance (LCA) said that the American Cancer Society’s claim of “progress in cancer fight” earlier this week was based on “selective culling of statistics and ignores the dismal truth that we have made very little progress on the most lethal cancers, including lung cancer, which causes one in every two cancer deaths, or in metastatic cancer of any kind.” LCA President & CEO Laurie Fenton Ambrose agreed that progress has been made with certain cancers such as breast, prostate and colon which have widely accepted screening tests for early detection and ACS deserves credit for promulgating information to the public on the importance of these tests. “But this is not time to be celebrating when hal…

MRI Best To Detect Cancer Spread Into Breast Ducts

MRI is better than MDCT for determining if and how far breast cancer has spread into the breast ducts and should be used before patients receive breast conserving treatment, a new study shows. “Patients have a lower survival rate if their surgical margins are positive for tumor cells. A positive surgical margin is commonly the result of inadequate resection of the cancer’s intraductal component,” said Akiko Shimauchi, MD, at Tohoku University in Sendai, Miyagi, Japan. “Accurate preoperative diagnosis of the intraductal component allows the surgeon to achieve a cancer-free surgical margin,” she said……..

MRI Best To Detect Cancer Spread Into Breast Ducts

MRI is better than MDCT for determining if and how far breast cancer has spread into the breast ducts and should be used before patients receive breast conserving treatment, a new study shows. “Patients have a lower survival rate if their surgical margins are positive for tumor cells. A positive surgical margin is commonly the result of inadequate resection of the cancer’s intraductal component,” said Akiko Shimauchi, MD, at Tohoku University in Sendai, Miyagi, Japan. “Accurate preoperative diagnosis of the intraductal component allows the surgeon to achieve a cancer-free surgical margin,” she said……..

Proven Prostate Cancer Treatment Options

Did you know with the prostate cancer treatment options available today a cure or total remission is almost a 100% foregone conclusion? The truth is astonishing at what has taken place in treatment options over the last 2 decades. You will read about some of the medical therapy used to fight prostate cancer in this article.

First let’s get this out of the way. This article is not intended as medical advice, nor should it be taken as medical advice. It is for informational purposes only. As always with a physical illness you should consult your personal physician right away. Please read on for more information.

In order for you to grasp the impact of the remarkable remission stats (5 years or longer) for prostate cancer against other organ cancers, take a look at these comparisons:

Prostate Cancer – 98%
Breast Cancer – 87%
Esophagus -14%
Lung and Bronchus – 15 %
Pancreas – 4%
Testis – 96%
Urinary Bladder – 82%
Liver – 7%
Ovary – 53 %
* These stats may vary by a plus or minus factor depending on the latest studies.

Those types of cancer listed above are just a few of the many different types of organ cancers. But the remission factor for prostate cancer victims is dramatically higher than any of those not listed. These remission results are primarily because of early detection of the disease and the phenomenal prostate cancer treatment options of today.

Each of the treatments available today can be used during the varying stages of development of the cancer. However, there is one therapy that is used very rarely and this is Chemo Therapy.

Chemo is normally used as a last resort type of therapy for prostate cancer. When the other therapies or combination of therapies, such as removal of the prostate gland and hormonal treatment have failed, then chemo becomes the drug of choice for your doctor. However, before it is prescribed, in most cases, the cancer has masticated into other parts of the body including the bones.

Many times a radical prostatectomy (removal) with or without hormonal treatment will do the trick. You may also find, depending on the stage of development of your cancer, your doctor will discuss the option of using Cryotherapy.

Cryotherapy is a newer therapy and may be recommended if you cannot tolerate radiation, hormonal therapy or surgical removal of the prostate gland. The way this is done is by using a probe through the skin to target the tumors. Then the tumor or tumors are frozen. If you use this type of therapy your hospital stay will be shorter, there will be less pain and the recovery period will be shorter.

However, the long term results of this type of therapy are not known as of yet, because it is a newer form of therapy.

Incredibly the prostate cancer treatment options discussed in this article are only a few of the options available to you. You should discuss these options, as well as the others, with your medical team.

Phase II Trial Of ASA404 Published In Lung Cancer

LONDON and CAMBRIDGE, MA — Antisoma plc announces that the journal Lung Cancer has published the results of a single-arm phase II trial of ASA404 in non-small cell lung cancer (NSCLC). The trial included patients with both major histological forms of NSCLC: squamous and non-squamous. Positive data from this trial supported the progress of ASA404 into phase III trials in patients with NSCLC of all histologies. ASA404 is a Tumour-Vascular Disrupting Agent (Tumour-VDA) that destroys tumours by selectively collapsing the tumour blood vessels on which they depend to survive and grow. A randomised phase II trial of ASA404 in patients with previously untreated, advanced NSCLC was published recently in the British Journal of C…

Multivitamins May Help Women Live Longer: Study

LOS ANGELES — Multivitamins might prolong life for women by preventing parts of their DNA from shortening, a new study has found. Researchers at the U.S. National Institute of Environmental Health Sciences (NIEHS) analyzed data on 586 women participating in the Sisters Study, which included women who had breast cancer and their cancer-free siblings, according to the HealthDay News on Monday. As part of that study, the women were asked about their use of vitamin supplements over a 12-year span. The researchers also took blood samples and tested DNA. “We found that multivitamin use was associated with longer leukocyte telomeres,” said lead researcher Dr. Honglei Chen, head of the Aging & Neuroepidemiology Group at…

Comparison of rectal volume definition techniques and their influence on rectal toxicity in patients with prostate cancer treated with 3D conformal radiotherapy: a dose-volume analysis

Background:
To evaluate the impact of four different rectum contouring techniques and rectal toxicities in patients with treated with 3D conformal radiotherapy (3DCRT).
Methods:
Clinical and dosimetric data were evaluated for 94 patients who received a total dose 3DCRT of 70 Gy, and rectal doses were compared in four different rectal contouring techniques: the prostate-containing CT sections (method 1); 1 cm above and below the planning target volume (PTV) (method 2); 110 mm starting from the anal verge (method 3); and from the anal verge to the sigmoid flexure (method 4). The percentage of rectal volume receiving RT doses (30-70 Gy) and minimum, mean rectal doses were assessed.
Results:
Median age was 69 years. Percentage of rectal volume receiving high doses (>70 Gy) were higher with the techniques that contoured smaller rectal volumes. In methods 2 and 3, the percentage of rectal volume receiving > 70 Gy was significantly higher in patients with than without rectal bleeding (method 2: 30.8% vs. 22.5%, respectively (p = 0.03); method 3: 26.9% vs. 18.1%, respectively (p = 0.006)). Mean rectal dose was significant predictor of rectal bleeding only in method 3 (48.8 Gy in patients with bleeding vs. 44.4 Gy in patients without bleeding; p = 0.02).
Conclusions:
Different techniques of rectal contouring significantly influence the calculation of radiation doses to the rectum and the prediction of rectal toxicity. Rectal volume receiving higher doses (>70 Gy) and mean rectal doses may significantly predict rectal bleeding for techniques contouring larger rectal volumes, as was in method 3.

Personalized Treatment For Early Lung Cancer

Cancer vaccines and targeted therapies are beginning to offer new treatment options following surgery for patients with early stages of lung cancer, experts said at the first European Multidisciplinary Conference in Thoracic Oncology (EMCTO) in Lugano, Switzerland (1-3 May 2009). “Personalizing therapy is the key strategy for longer and better survival in lung cancer,” said Prof Paris Kosmidis, head of the second Medical Oncology Department at Hygeia Hospital in Athens, Greece. “This is particularly important for early stage disease when following surgery, decisions about preventive therapy are based on specific prognostic and predictive factors.” Prof Walter Weder, head of thoracic surgery at the University of Zurich in Switzerland,…

Dietary Acrylamide Not Associated With Increased Lung Cancer Risk In Men

Dietary acrylamide was not associated with an increased risk of lung cancer, according to data from a large prospective case-cohort study in the April 28 online issue of the Journal of the National Cancer Institute. Acrylamide is formed in some starchy foods, such as potato chips and French fries, during high-temperature cooking. Epidemiological studies have found a positive association between dietary acrylamide intake and the risk of endometrial, ovarian, renal cell, and estrogen-receptor positive breast cancers. To investigate whether dietary acrylamide intake is associated with lung cancer risk, Janneke G. F. Hogervorst, M.Sc., of Maastricht University in the Netherlands, and colleagues conducted a case-cohort study among 58,279 m…

Potentials of on-line repositioning based on implanted fiducial markers and electronic portal imaging in prostate cancer radiotherapy

Background:
To evaluate the benefit of an on-line correction protocol based on implanted markers and weekly portal imaging in external beam radiotherapy of prostate cancer. To compare the use of bony anatomy versus implanted markers for calculation of setup-error plus/minus prostate movement. To estimate the error reduction (and the corresponding margin reduction) by reducing the total error to 3 mm once a week, three times per week or every treatment day.
Methods:
23 patients had three to five, 2.5 mm diameter spherical gold markers transrectally inserted into the prostate before radiotherapy. Verification and correction of treatment position by analysis of orthogonal portal images was performed on a weekly basis. We registered with respect to the bony contours (setup error) and to the marker position (prostate motion) and determined the total error. The systematic and random errors are specified. Positioning correction was applied with a threshold of 5 mm displacement.
Results:
The systematic error (1 standard deviation, SD) in left-right (LR), superior-inferior (SI) and anterior-posterior (AP) direction contributes for the setup 1.6 mm, 2.1 mm and 2.4 mm and for prostate motion 1.1 mm, 1.9 mm and 2.3 mm. The ran-dom error (1 SD) in LR, SI and AP direction amounts for the setup 2.3 mm, 2.7 mm and 2.7 mm and for motion 1.4 mm, 2.3 mm and 2.7 mm. The resulting total error suggests margins of 7.0 mm (LR), 9.5 mm (SI) and 9.5 mm (AP) between clinical target volume (CTV) and planning target volume (PTV). After correction once a week the margins were lowered to 6.7, 8.2 and 8.7 mm and furthermore down to 4.9, 5.1 and 4.8 mm after correcting every treatment day.
Conclusions:
prostate movement relative to adjacent bony anatomy is significant and contributes substantially to the target position variability. Performing on-line setup correction using implanted radioopaque markers and megavoltage radiography results in reduced treatment margins depending on the online imaging protocol (once a week or more frequently).

Joining Forces To Improve Lung Cancer Treatment

Prevention, personalized therapies and closer collaborations between surgeons, medical oncologists and radiation oncologists will result in better outcomes for lung cancer patients and those at risk, a leading European expert says. “Lung cancer is a complex disease. It is one of the most complex cancers, and the more we learn about the biology of the disease, the more we realize that improved cancer care will result from multidisciplinary treatment,” said Prof Robert Pirker, from the Medical University of Vienna, Austria. Prof Pirker is co-chair of the scientific committee of a new medical conference, the European Multidisciplinary Conference in Thoracic Oncology (EMCTO), being held for the first time this year, 1-3 May, in Lugano, Sw…

Exercise May Benefit Lung Cancer Patients

BOSTON — Exercise, which plays an important role in both primary and secondary prevention of cancer, may be beneficial to lung cancer patients, U.S. researchers say. Dr. Jennifer Temel at Massachusetts General Hospital found that exercise impacts the health and quality of life of patients with an advanced or incurable lung cancer diagnosis. Between October 2004 and August 2007, Temel and colleagues enrolled 25 lung cancer patients in a study to evaluate the feasibility, efficacy and safety of a structured, hospital-based exercise program in these patients. The evaluation consisted of twice-weekly sessions of aerobic exercise and weight training over an eight-week period. The baseline evaluation included assessments…

Kidney Disease Link To Cancer In Older Men

WESTMEAD, Australia — Australian researchers suggest moderate kidney disease raises an older man’s risk of cancer. The study, published in the Journal of the American Society of Nephrology, finds the risk for lung and urinary tract cancers — but not prostate cancer — was higher among men with kidney disease. The researchers discovered that men with moderate kidney dysfunction had a 39 percent increased risk of developing cancer over the risk seen in men with normal kidney function. Inflammation associated with chronic kidney disease may contribute to the development of cancer, or a lack of vitamin D — highly prevalent among people with moderately reduced kidney function — might increase cancer risk. Additional…

Concurrent chemoradiotherapy in adjuvant treatment of breast cancer

Background:
The optimal sequencing of chemotherapy and radiotherapy after breast surgery was largely studied but remains controversial. Concurrent chemo-radiotherapy is a valuable method for adjuvant treatment of breast cancer which is under ongoing research program in our hospital. We are evaluating the feasibility of the concomitant use of chemotherapy retrospectively.
Methods:
Two hundred forty four women having breast cancer were investigated in a retrospective study. All patients were either treated by radical surgery or breast conservative surgery. The study compares two adjuvant treatments associating concomitant chemotherapy and radiotherapy. In the first group (group A) the patients were treated by chemotherapy and radiotherapy in concomitant way using anthracycline (n=110). In the second group (group B) the patients were treated by chemotherapy and radiotherapy in concomitant way using CMF treatment (n=134). Chemotherapy was administered in six cycles, one each 3 weeks. Radiotherapy delivered a radiation dose of 50 Gy on the whole breast (or on the external wall) and/or on the lymphatic region. The Kaplan-Meier method was used to estimate the rates of disease free survival, loco-regional recurrence-free survival and overall survival. The Pearson Khi^2 test was used to analyse the homogeneity between the two groups. The log-rank test was used to evaluate the differences between the two groups A and B.
Results:
After 76.4 months median follow-up (65.3 months mean follow up), only one patient relapsed to loco-regional breast cancer when the treatment was based on anthracycline. However, 8 patients relapsed to loco-regional breast cancer when the treatment was based on CMF. In the anthracycline group, the disease free survival after 5 years, was 80.4% compared to 76.4% in the CMF group (Log-rank test: p=0.136). The overall survival after 5 years was 82.5% and 81.1% in the anthracycline and CMF groups respectively (Log-rank test: p=0.428). The loco-regional free survival at 5 years was equal to 98.6% in group A and 94% in group B (Log-rank test: p=0,033). The rate of grade II and grade III anaemia was 13.9% and 6.7% in anthracycline group and CMF group respectively (Khi^2-test: p=0.009). The rate of grade II and grade III skin dermatitis toxicity was 4.5% in the group A and 0% in the group B (Khi^2-test: p=0.013).
Conclusions:
From the 5 years retrospective investigation we showed similar disease free survival and overall survival in the two concurrent chemo-radiotherapy treatments based on anthracycline and CMF. However in the loco-regional breast cancer the treatment based on anthracycline was significantly better than that of the treatment based on CMF. There was more haematological and skin dermatitis toxicity in the anthracycline group.

Women Smokers Have A Greater Cancer Risk Than Men, Says New Report

Women smokers are more vulnerable to fatal cancers than men, according to new research. Scientists who studied lung cancer patients found females tended to be younger than males when they developed the disease, despite the fact that on average they smoked significantly less. The findings are particularly important in Scotland, which is one of the world’s most cancer-prone nations, with around 2000 women developing lung cancers each year. Approximately 90 percent of lung cancer cases are caused by smoking, and the majority of patients are male, but researchers now believe that women are more easily affected by the harmful carcinogens contained in tobacco smoke. Dr Martin Fueh, from St Gallen Canton Hospital in Swi…

Peregrine Pharmaceuticals Reports Positive Preliminary Data From Phase II Bavituximab Lung Cancer Trial

Peregrine Pharmaceuticals, Inc., announced that updated preliminary data from the initial cohort of 21 patients in its Phase II trial evaluating bavituximab in combination with carboplatin and paclitaxel showed that 11 of 17 evaluable patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) achieved an objective tumor response according to RECIST criteria, after completing the maximum six treatment cycles. The company also reported that patient dosing is underway in the expansion stage of the trial, which will enroll an additional 28 patients for a total of 49 patients overall. “We are very pleased to see these additional objective tumor responses in this difficult-to-treat cancer following the full regimen of six…

Stereotactic radiosurgery for glioblastoma: retrospective analysis

Purpose:
This retrospective study was done to better understand the conditions for which stereotactic radiosurgery (SRS) for glioblastoma may be efficacious.
Methods:
Between 2000 and 2007, 33 patients with a pathological diagnosis of glioblastoma received SRS with the Novalis(R) Shaped Beam Radiosurgery system. Eighteen patients (54%) underwent salvage SRS for recurrence while 15 (45%) patients received upfront SRS following standard fractionated RT for newly diagnosed glioblastoma.
Results:
There were no RTOG grade >2 acute side effects. The median survival after SRS was 6.7 months (range 1.4 – 74.7). There was no significant difference in overall survival (from the time of initial diagnosis) with respect to the timing of SRS (p=0.2). There was significantly better progression free survival in patients treated with SRS as consolidation versus at the time of recurrence (p=0.04). The majority of patients failed within or at the margin of the SRS treatment volume (21/26 evaluable for recurrence).
Conclusions:
SRS is well tolerated in the treatment of glioblastoma. As there was no difference in survival whether SRS is delivered upfront or at recurrence, the treatment for each patient should be individualized. Future studies are needed to identify patients most likely to respond to SRS.

Urine Test May Determine If A Smoker Is At Risk For Lung Cancer

Researchers may have uncovered why lung cancer afflicts some smokers and not others, according to data presented at the American Association for Cancer Research 100th Annual Meeting 2009 (see also American Association for Cancer Research). “A history of smoking has always been thought of as a predictor of lung cancer, but it is actually not very accurate,” said Jian-Min Yuan, Ph.D., M.D., associate professor of public health at the University of Minnesota. “Smoking absolutely increases your risk, but why it does so in some people but not others is a big question.” Yuan and colleagues hypothesized that the presence of the metabolite NNAL in a patient’s urine might predict risk of lung cancer. This metabolite has been shown to induce lung…

Racial Disparities Persist In The Treatment Of Lung Cancer

Black patients suffering from lung cancer are less likely to receive recommended chemotherapy and surgery than white lung cancer patients, a disparity that shows no signs of lessening. That is the conclusion of a new study published in the May 15, 2009 issue of CANCER, a peer-reviewed journal of the American Cancer Society. The study’s findings indicate that efforts are needed to provide appropriate treatments for black patients and to educate them about the value of those treatments. Researchers led by Dale Hardy, Ph.D., of the University of Texas School of Public Health analyzed data from 83,101 patients 65 years old or older who were diagnosed with non-small cell lung cancer, the most common type of lung cancer, between 1991 and 2002….

Prognostic indices for brain metastases – usefulness and challenges

Background:
This review addresses the strengths and weaknesses of 6 different prognostic indices, published since the Radiation Therapy Oncology Group (RTOG) developed and validated the widely used 3-tiered prognostic index known as recursive partitioning analysis (RPA) classes, i.e. between 1997 and 2008. In addition, other analyses of prognostic factors in groups of patients, which typically are underrepresented in large trials or databases, published in the same time period are reviewed.
Methods:
Based on a systematic literature search, studies with more than 20 patients were included. The methods and results of prognostic factor analyses were extracted and compared. The authors discuss why current data suggest a need for a more refined index than RPA.
Results:
So far, none of the indices has been derived from analyses of all potential prognostic factors. The 3 most recently published indices, including the RTOG’s graded prognostic assessment (GPA), all expanded from the primary 3-tiered RPA system to a 4-tiered system. The authors’ own data confirm the results of the RTOG GPA analysis and support further evaluation of this tool.
Conclusion:
This review provides a basis for further refinement of the current prognostic indices by identifying open questions regarding, e.g., performance of the ideal index, evaluation of new candidate parameters, and separate analyses for different cancer types. Unusual primary tumors and their potential differences in biology or unique treatment approaches are not well represented in large pooled analyses.

Celera Presents Data Describing An Immunodiagnostic Assay To Detect Lung Cancer From Blood Serum

ALAMEDA, Calif. — Celera Corporation today announced the presentation of data describing a novel mass spectrometry-based approach to identify and validate circulating protein biomarkers that detect non-small cell lung cancer (NSCLC). A key outcome of the study was the assembly of an immunoassay test for a panel of 6 biomarkers that detected lung cancer with 94% sensitivity and 93% specificity in a blinded analysis. In addition to detecting all stages of lung cancer studied and all major histological subtypes, the panel also accurately distinguished malignant cases from benign lung disease. The data will be presented from 8:00 a.m. to 12:00 p.m. MDT today as poster #3542 at the 100th Annual American Association for Cancer…

Nicotine Compound May Signal Smoker’s Risk Of Lung Cancer

A nicotine compound called NNAL appears to be a bellwether for smokers of their risk of lung cancer, according to new University of Minnesota research results. Evaluating urine samples from 491 smokers, U tobacco researcher Jian-Min Yuan found that high levels of NNAL doubled the risk of lung cancer. Even moderate levels of the compound increased the cancer risk among the smokers by 43 percent. “We’ve known for a long time that smoking increases a person’s risk for getting lung cancer, but we have not been able to clearly answer why one smoker would eventually develop lung cancer and another one would not,” Yuan said. “Now we know one definitive link.” The results were presented Sunday at a national cancer research convention and p…

Allos Therapeutics’ Pralatrexate Demonstrates Anticancer Activity In Multiple Cancer Cell Lines

WESTMINSTER, Colo. — Allos Therapeutics, Inc. today announced new data demonstrating the anticancer activity of its investigational drug, pralatrexate, in colon, ovarian, lung, prostate, and head and neck cancer cell lines. The preclinical research further showed that the antiproliferative effects against these cancer lines were achieved at drug concentrations that are attainable in humans. These data were presented today at the American Association for Cancer Research (AACR) Annual Meeting in Denver, CO. The results, outlined in a poster titled “Cytotoxicity of Pralatrexate, a Novel Synthetic Antifolate, in Human Cancer Cell Lines (abstract #1686),” demonstrate anticancer activity of pralatrexate in nine of 15 human cel…

Reproducibility of patient setup by surface image registration system in conformal radiotherapy of prostate cancer

Background:
The reproducibility of patient setup for radiotherapy is based on various methods including external markers, X-rays with planar or computerized image acquisition, and, more recently, surface matching imaging. We analyzed the setup reproducibility of 16 patients affected by prostate cancer who underwent conformal radiotherapy with curative intent by using a surface image registration system.
Methods:
We analyzed the setup reproducibility of 16 patients affected by prostate cancer candidates for conformal radiotherapy by using a surface image registration system. At the initial setup, EPID images were compared with DRRs and a reference 3D surface image was obtained by the AlignRT system (Vision RT, London, UK). Surface images were acquired prior to every subsequent setup procedure. EPID acquisition was repeated when errors > 5 mm were reported.
Results:
The mean random and systematic errors were 1.2+/-2.3 mm and 0.3+/-3.0 mm along the X axis, 0.0+/-1.4 mm and 0.5+/-2.0 mm along the Y axis, and 2.0+/-1.8 mm and -0.7+/-2.4 mm along the Z axis respectively. The positioning error detected by AlignRT along the 3 axes X, Y, and Z exceeded the value of 5 mm in 14.1%, 2.0%, and 5.1% measurements and the value of 3 mm in 36.9%, 13.6% and 27.8% measurements, respectively. Correlation factors calculated by linear regression between the errors measured by AlignRT and EPID ranged from 0.77 to 0.92 with a mean of 0.85 and SD of 0.13. The setup measurements by surface imaging are highly reproducible and correlate with the setup errors detected by EPID.
Conclusions:
Surface image registration system appears to be a simple, fast, non-invasive, and reproducible method to analyze the set-up alignment in 3DCRT of prostate cancer patients.

Multifocal Lung Cancers Appear To Originate From Single Cancer Clone

Multiple, anatomically distinct lung cancer tumors may frequently arise from a single cancer cell, according to a retrospective analysis of patient tumor samples published in the April 7 online issue of the Journal of the National Cancer Institute. Some lung cancer patients have multiple anatomically distinct tumors at the time of diagnosis. Although such multiple tumors usually share a common appearance, it has been unclear whether they arise from a single tumor or are independent primary cancers. In the current study, Liang Cheng, M.D., of the Indiana University School of Medicine in Indianapolis, and colleagues examined 70 lung cancer tumors from 23 female and seven male patients to determine whether multiple tumors from an individ…

Skin Cancer Chart

Skin cancer is a deadly and common disease. Skin cancer charts graphs is at least partially preventable. Overexposure to the sun and tanning beds are two causes of the disease. Some forms of the disease are also hereditary.

High-Dose Radiation Improves Lung Cancer Survival, Study Finds

Higher doses of radiation combined with chemotherapy improve survival in patients with stage III lung cancer, according to a new study by researchers at the University of Michigan Comprehensive Cancer Center. Standard treatment for this stage of lung cancer — when the tumor is likely too large to be removed through surgery — involves a combination of radiation therapy with chemotherapy. But, this new study finds, giving chemotherapy at the same time as the radiation enhances the effect of both. Further, increasing the dose of radiation over the course of treatment also increased survival. “When patients are diagnosed with stage III lung cancer, surgery is often not an option, and survival rates are typically quite low. Finding new w…

Direct aperture optimization as a means of reducing the complexity of intensity modulated radiation therapy plans

Intensity Modulated Radiation Therapy (IMRT) is a means of delivering radiation therapy where the intensity of the beam is varied within the treatment field. This is done by dividing a large beam into many small beamlets. Dose constraints are assigned to both the target and sensitive structures and computerised inverse optimization is performed to find the individual weights of this large number of beamlets. The computer adjusts the intensities of these beamlets according to the required planning dose objectives. The optimized intensity patterns are then decomposed into a series of deliverable multi leaf collimator (MLC) shapes in the sequencing step.
One of the main problems of IMRT, which becomes even more apparent as the complexity of the IMRT plan increases, is the dramatic increase in the number of Monitor Units (MU) required to deliver a fractionated treatment. The difficulty with this increase in MU is its association with increased treatment times and a greater leakage of radiation from the MLCs increasing the total body dose and the risk of secondary cancers in patients. Therefore one attempts to find ways of reducing these MU without compromising plan quality.
The design of inverse planning systems where the beam is divided into small beamlets to produce the required intensity map automatically introduces complexity into IMRT treatment planning. Plan complexity is associated with many negative factors such as dosimetric uncertainty and delivery issues A large search space is required necessitating much computing power. However, the limitations of the delivery technology are not taken into consideration when designing the ideal intensity map therefore a further step termed the sequencing step is required to convert the ideal intensity map into a deliverable one.
Many approaches have been taken to reduce the complexity. These include setting intensity limits, putting penalties on the cost function and using smoothing filters Direct Aperture ptimization (DAO) incorporates the limitations of the delivery technology at the initial design of the intensity map thereby eliminating the sequencing step. It also gives control over the number of segments and hence control over the complexity of the plan although the design of the segments is independent of the person preparing the plan.

National Cancer Institute: Multifocal Lung Cancers Appear To Originate From Single Cancer Clone

Multiple, anatomically distinct lung cancer tumors may frequently arise from a single cancer cell, according to a retrospective analysis of patient tumor samples published in the April 7 online issue of the Journal of the National Cancer Institute. Some lung cancer patients have multiple anatomically distinct tumors at the time of diagnosis. Although such multiple tumors usually share a common appearance, it has been unclear whether they arise from a single tumor or are independent primary cancers. In the current study, Liang Cheng, M.D., of the Indiana University School of Medicine in Indianapolis, and colleagues examined 70 lung cancer tumors from 23 female and seven male patients to determine whether multiple tumors from an individ…