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4 results on '"Monti AF"'

1. Universal evaluation of MLC models in treatment planning systems based on a common set of dynamic tests

Author

Universitat Rovira i Virgili, Saez, J; Bar-Deroma, R; Bogaert, E; Cayez, R; Chow, T; Clark, CH; Esposito, M; Feygelman, V; Monti, AF; -Miguel, JG; Gershkevitsh, E; Goossens, J; Herrero, C; Hussein, M; Khamphan, C; Kierkels, RGJ; Lechner, W; Lemire, M; Nevelsky, A; Nguyen, D; Paganini, L; Pasler, M; Azorín, JFP; Garcia, LIR; Russo, S; Shakeshaft, J; Vieillevigne, L; Hernandez, V, Universitat Rovira i Virgili, and Saez, J; Bar-Deroma, R; Bogaert, E; Cayez, R; Chow, T; Clark, CH; Esposito, M; Feygelman, V; Monti, AF; -Miguel, JG; Gershkevitsh, E; Goossens, J; Herrero, C; Hussein, M; Khamphan, C; Kierkels, RGJ; Lechner, W; Lemire, M; Nevelsky, A; Nguyen, D; Paganini, L; Pasler, M; Azorín, JFP; Garcia, LIR; Russo, S; Shakeshaft, J; Vieillevigne, L; Hernandez, V

Abstract

To demonstrate the feasibility of characterising MLCs and MLC models implemented in TPSs using a common set of dynamic beams.A set of tests containing synchronous (SG) and asynchronous sweeping gaps (aSG) was distributed among twenty-five participating centres. Doses were measured with a Farmer-type ion chamber and computed in TPSs, which provided a dosimetric characterisation of the leaf tip, tongue-and-groove, and MLC transmission of each MLC, as well as an assessment of the MLC model in each TPS. Five MLC types and four TPSs were evaluated, covering the most frequent combinations used in radiotherapy departments.Measured differences within each MLC type were minimal, while large differences were found between MLC models implemented in clinical TPSs. This resulted in some concerning discrepancies, especially for the HD120 and Agility MLCs, for which differences between measured and calculated doses for some MLC-TPS combinations exceeded 10%. These large differences were particularly evident for small gap sizes (5 and 10 mm), as well as for larger gaps in the presence of tongue-and-groove effects. A much better agreement was found for the Millennium120 and Halcyon MLCs, differences being within ±5% and ±2.5%, respectively.The feasibility of using a common set of tests to assess MLC models in TPSs was demonstrated. Measurements within MLC types were very similar, but TPS dose calculations showed large variations. Standardisation of the MLC configuration in TPSs is necessary. The proposed procedure can be readily applied in radiotherapy departments and can be a valuable tool in IMRT and credentialing audits.Copyright © 2023. Published by Elsevier B.V.

Published
2023

2. Report dose-to-medium in clinical trials where available; a consensus from the Global Harmonisation Group to maximize consistency

Author

Kry, SF, Lye, J, Clark, CH, Andratschke, N, Dimitriadis, A, Followill, D, Howell, R, Hussein, M, Ishikawa, M, Kito, S, Kron, T, Lee, J, Michalski, J, Monti, AF, Reynaert, N, Taylor, P, Venables, K, Xiao, Y, Lehmann, J, Kry, SF, Lye, J, Clark, CH, Andratschke, N, Dimitriadis, A, Followill, D, Howell, R, Hussein, M, Ishikawa, M, Kito, S, Kron, T, Lee, J, Michalski, J, Monti, AF, Reynaert, N, Taylor, P, Venables, K, Xiao, Y, and Lehmann, J

Abstract

PURPOSE: To promote consistency in clinical trials by recommending a uniform framework as it relates to radiation transport and dose calculation in water versus in medium. METHODS: The Global Quality Assurance of Radiation Therapy Clinical Trials Harmonisation Group (GHG; www.rtqaharmonization.org) compared the differences between dose to water in water (Dw,w), dose to water in medium (Dw,m), and dose to medium in medium (Dm,m). This was done based on a review of historical frameworks, existing literature and standards, clinical issues in the context of clinical trials, and the trajectory of radiation dose calculations. Based on these factors, recommendations were developed. RESULTS: No framework was found to be ideal or perfect given the history, complexity, and current status of radiation therapy. Nevertheless, based on the evidence available, the GHG established a recommendation preferring dose to medium in medium (Dm,m). CONCLUSIONS: Dose to medium in medium (Dm,m) is the preferred dose calculation and reporting framework. If an institution's planning system can only calculate dose to water in water (Dw,w), this is acceptable.

Published
2021

3. Lomustine with or without reirradiation for first progression of glioblastoma, LEGATO, EORTC-2227-BTG: study protocol for a randomized phase III study.

Author

Preusser M, Kazda T, Le Rhun E, Sahm F, Smits M, Gempt J, Koekkoek JA, Monti AF, Csanadi M, Pitter JG, Bulbek H, Fournier B, Quoilin C, Gorlia T, Weller M, and Minniti G

Subjects
Humans, Quality of Life, Randomized Controlled Trials as Topic, Chemoradiotherapy methods, Clinical Trials, Phase III as Topic, Pragmatic Clinical Trials as Topic, Time Factors, Glioblastoma pathology, Glioblastoma drug therapy, Glioblastoma mortality, Glioblastoma radiotherapy, Glioblastoma therapy, Lomustine administration & dosage, Lomustine therapeutic use, Lomustine adverse effects, Brain Neoplasms radiotherapy, Brain Neoplasms pathology, Brain Neoplasms mortality, Brain Neoplasms therapy, Disease Progression, Antineoplastic Agents, Alkylating therapeutic use, Multicenter Studies as Topic, Progression-Free Survival
Abstract

Background: Chemotherapy with lomustine is widely considered as standard treatment option for progressive glioblastoma. The value of adding radiotherapy to second-line chemotherapy is not known., Methods: EORTC-2227-BTG (LEGATO, NCT05904119) is an investigator-initiated, pragmatic (PRECIS-2 score: 34 out of 45), randomized, multicenter phase III trial in patients with first progression of glioblastoma. A total of 411 patients will be randomized in a 1:1 ratio to lomustine (110 mg/m 2 every 6 weeks) or lomustine (110 mg/m 2 every 6weeks) plus radiotherapy (35 Gy in 10 fractions). Main eligibility criteria include histologic confirmation of glioblastoma, isocitrate dehydrogenase gene (IDH) wild-type per WHO 2021 classification, first progression at least 6 months after the end of prior radiotherapy, radiologically measurable disease according to RANO criteria with a maximum tumor diameter of 5 cm, and WHO performance status of 0-2. The primary efficacy endpoint is overall survival (OS) and secondary endpoints include progression-free survival, response rate, neurocognitive function, health-related quality of life, and health economic parameters. LEGATO is funded by the European Union's Horizon Europe Research program, was activated in March 2024 and will enroll patients in 43 sites in 11 countries across Europe with study completion projected in 2028., Discussion: EORTC-2227-BTG (LEGATO) is a publicly funded pragmatic phase III trial designed to clarify the efficacy of adding reirradiation to chemotherapy with lomustine for the treatment of patients with first progression of glioblastoma., Trial Registration: ClinicalTrials.gov NCT05904119. Registered before start of inclusion, 23 May 2023., (© 2024. The Author(s).)

Published
2024
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4. Adaptive Staged-Dose Gamma Knife Radiosurgery for the Treatment of Large Brain Metastases: Report of 40 Consecutive Cases and Analysis of Literature.

Author

Crisà FM, Leocata F, Arienti VM, Picano M, Berta L, Brambilla MG, Mainardi HS, Monti AF, Cenzato M, Palazzi M, and La Camera A

Subjects
Humans, Retrospective Studies, Prospective Studies, Treatment Outcome, Follow-Up Studies, Radiosurgery methods, Brain Neoplasms radiotherapy, Brain Neoplasms surgery, Brain Neoplasms etiology
Abstract

Background: Brain metastases are the most common brain tumors, being one of the most frequent neurological complications of systemic cancer and an important cause of morbidity and mortality. Stereotactic radiosurgery is efficacious and safe in the treatment of brain metastases, with good local control rates and low adverse effects rate. Large brain metastases present some issues in balancing local control and treatment-related toxicity., Objective: Demonstrating adaptive staged-dose Gamma Knife radiosurgery (ASD-GKRS) being a safe and effective treatment for large brain metastases., Materials and Methods: We retrospectively analyzed our series of patients treated with two-stage Gamma Knife radiosurgery for large brain metastases in [BLINDED], between February 2018 and May 2020., Results: Forty patients with large brain metastases underwent adaptive staged-dose Gamma Knife radiosurgery, with median prescription dose of 12 Gy and a median interval between stages of 30 days. At three-month follow-up, the survival rate was 75.0% with a local control rate of 100%. At six-month follow-up, the survival rate was 75.0% with a local control rate of 96.7%. The mean volume reduction was 21.81 cm 3 (16.76-26.86; 95% CI). The difference between baseline volume and six-month follow-up volume was statistically significant., Conclusions: Adaptive staged-dose Gamma Knife radiosurgery is a safe, non-invasive and effective treatment for brain metastases, with a low rate of side effects. Large prospective trials are needed to strengthen data obtained about the effectiveness and safety of this technique in managing large brain metastases., Competing Interests: None

Published
2023
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