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1. May we routinely spare hippocampal region in primary central nervous system lymphoma during whole brain radiotherapy?

Author

Mazzarella, Ciro, Chiesa, Silvia, Toppi, Lucrezia, Hohaus, Stefan, Gaudino, Simona, D’Alo, Francesco, Dinapoli, Nicola, Davide, Resta, Zinicola, Tiziano, Bracci, Serena, Martino, Antonella, Beghella Bartoli, Francesco, Lepre, Elisabetta, Bertolini, Roberta, Mariani, Silvia, Colosimo, Cesare, Frascino, Vincenzo, Mattiucci, Gian Carlo, Gambacorta, Maria Antonietta, Valentini, Vincenzo, and Balducci, Mario

Published
2023
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2. Magnetic resonance guided SBRT reirradiation in locally recurrent prostate cancer: a multicentric retrospective analysis

Author

Boldrini, Luca, Romano, Angela, Chiloiro, Giuditta, Corradini, Stefanie, De Luca, Viola, Verusio, Valeria, D’Aviero, Andrea, Castelluccia, Alessandra, Alitto, Anna Rita, Catucci, Francesco, Grimaldi, Gianmarco, Trapp, Christian, Hörner-Rieber, Juliane, Marchesano, Domenico, Frascino, Vincenzo, Mattiucci, Gian Carlo, Valentini, Vincenzo, Gentile, Piercarlo, and Gambacorta, Maria Antonietta

Published
2023
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4. Interventional radiotherapy (brachytherapy) for re-irradiation of recurrent head and neck malignancies: oncologic outcomes and morbidity

Author

Bussu, Francesco, primary, Fionda, Bruno, additional, Rigante, Mario, additional, Rizzo, Davide, additional, Loperfido, Antonella, additional, Gallus, Roberto, additional, De Luca, Laura Maria, additional, Corbisiero, Michaele Francesco, additional, Lancellotta, Valentina, additional, Tondo, Andrea, additional, D’Aviero, Andrea, additional, Mattiucci, Gian Carlo, additional, Kovacs, Gyorgy, additional, Galli, Jacopo, additional, and Tagliaferri, Luca, additional

Published
2024
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6. Artificial Intelligence in magnetic Resonance guided Radiotherapy: Medical and physical considerations on state of art and future perspectives

Author

Cusumano, Davide, Boldrini, Luca, Dhont, Jennifer, Fiorino, Claudio, Green, Olga, Güngör, Görkem, Jornet, Núria, Klüter, Sebastian, Landry, Guillaume, Mattiucci, Gian Carlo, Placidi, Lorenzo, Reynaert, Nick, Ruggieri, Ruggero, Tanadini-Lang, Stephanie, Thorwarth, Daniela, Yadav, Poonam, Yang, Yingli, Valentini, Vincenzo, Verellen, Dirk, and Indovina, Luca

Published
2021
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9. A Deep Learning Approach for the Fast Generation of Synthetic Computed Tomography from Low-Dose Cone Beam Computed Tomography Images on a Linear Accelerator Equipped with Artificial Intelligence.

Author

Vellini, Luca, Zucca, Sergio, Lenkowicz, Jacopo, Menna, Sebastiano, Catucci, Francesco, Quaranta, Flaviovincenzo, Pilloni, Elisa, D'Aviero, Andrea, Aquilano, Michele, Di Dio, Carmela, Iezzi, Martina, Re, Alessia, Preziosi, Francesco, Piras, Antonio, Boschetti, Althea, Piccari, Danila, Mattiucci, Gian Carlo, and Cusumano, Davide

Subjects
CONE beam computed tomography, DEEP learning, COMPUTED tomography, ARTIFICIAL intelligence, LINEAR accelerators, GENERATIVE adversarial networks
Abstract

Featured Application: The neural network proposed allows for the removal of the CT simulation from the clinical workflow, paving the way for fast-track radiotherapy. Artificial Intelligence (AI) is revolutionising many aspects of radiotherapy (RT), opening scenarios that were unimaginable just a few years ago. The aim of this study is to propose a Deep Leaning (DL) approach able to quickly generate synthetic Computed Tomography (CT) images from low-dose Cone Beam CT (CBCT) acquired on a modern linear accelerator integrating AI. Methods: A total of 53 patients treated in the pelvic region were enrolled and split into training (30), validation (9), and testing (14). A Generative Adversarial Network (GAN) was trained for 200 epochs. The image accuracy was evaluated by calculating the mean and mean absolute error (ME and ME) between sCT and CT. RT treatment plans were calculated on CT and sCT images, and dose accuracy was evaluated considering Dose Volume Histogram (DVH) and gamma analysis. Results: A total of 4507 images were selected for training. The MAE and ME values in the test set were 36 ± 6 HU and 7 ± 6 HU, respectively. Mean gamma passing rates for 1%/1 mm, 2%/2 mm, and 3%/3 mm tolerance criteria were respectively 93.5 ± 3.4%, 98.0 ± 1.3%, and 99.2 ± 0.7%, with no difference between curative and palliative cases. All the DVH parameters analysed were within 1 Gy of the difference between sCT and CT. Conclusion: This study demonstrated that sCT generation using the DL approach is feasible on low-dose CBCT images. The proposed approach can represent a valid tool to speed up the online adaptive procedure and remove CT simulation from the RT workflow. [ABSTRACT FROM AUTHOR]

Published
2024
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11. Validation of the “Rome” Classification for Squamous Cell Carcinoma of the Nasal Vestibule

Author

Scheurleer, Willem Frederik Julius, primary, de Ridder, Mischa, additional, Tagliaferri, Luca, additional, Crescio, Claudia, additional, Parrilla, Claudio, additional, Mattiucci, Gian Carlo, additional, Fionda, Bruno, additional, Deganello, Alberto, additional, Galli, Jacopo, additional, de Bree, Remco, additional, Rijken, Johannes A., additional, and Bussu, Francesco, additional

Published
2023
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12. Magnetic Resonance, Vendor-independent, Intensity Histogram Analysis Predicting Pathologic Complete Response After Radiochemotherapy of Rectal Cancer

Author

Dinapoli, Nicola, Barbaro, Brunella, Gatta, Roberto, Chiloiro, Giuditta, Casà, Calogero, Masciocchi, Carlotta, Damiani, Andrea, Boldrini, Luca, Gambacorta, Maria Antonietta, Dezio, Michele, Mattiucci, Gian Carlo, Balducci, Mario, van Soest, Johan, Dekker, Andre, Lambin, Philippe, Fiorino, Claudio, Sini, Carla, De Cobelli, Francesco, Di Muzio, Nadia, Gumina, Calogero, Passoni, Paolo, Manfredi, Riccardo, and Valentini, Vincenzo

Published
2018
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13. Validation of the "Rome" Classification for Squamous Cell Carcinoma of the Nasal Vestibule.

Author

Scheurleer, Willem Frederik Julius, de Ridder, Mischa, Tagliaferri, Luca, Crescio, Claudia, Parrilla, Claudio, Mattiucci, Gian Carlo, Fionda, Bruno, Deganello, Alberto, Galli, Jacopo, de Bree, Remco, Rijken, Johannes A., and Bussu, Francesco

Subjects
HEAD & neck cancer diagnosis, STATISTICS, RESEARCH methodology, MULTIVARIATE analysis, HEAD & neck cancer, NASAL cavity, TUMOR classification, COMPARATIVE studies, CANCER patients, DESCRIPTIVE statistics, NASAL tumors, SENSITIVITY & specificity (Statistics), PROGRESSION-free survival, SQUAMOUS cell carcinoma, OVERALL survival
Abstract

Simple Summary: Nasal vestibule cancer is considered to be a rare form of cancer. There are several different staging systems in place for categorizing these tumors, which can result in inconsistencies and unreliable data due to variations in registration. The "Rome" classification is the most recent addition. This study aimed to assess the effectiveness of this new staging system and to compare it to the UICC/AJCC system. One hundred and forty-nine patients with a squamous cell carcinoma of the nasal vestibule were included. There was a significant association between an increased disease stage as staged per the Rome classification and decreased survival. This association persisted when correcting for various covariates (i.e., age at the time of diagnosis, sex, the presence of lymph node metastases, and treatment modality) in multivariable analysis. The Rome classification appears to be capable of adequately categorizing and stratifying patients for different outcome measures. Nevertheless, additional research with a larger number of patients is required before any definitive conclusions can be drawn. Squamous cell carcinoma of the nasal vestibule is considered a rare malignancy that differs from other sinonasal malignancies in many respects. Four staging systems currently exist for this disease, the most recent addition being the "Rome" classification. This study assesses the use of this new classification and its prognostic value regarding various outcome measures. A retrospective multicenter cohort study of patients with a primary squamous cell carcinoma of the nasal vestibule who were treated in three tertiary head and neck oncology referral centers was conducted. A total of 149 patients were included. The median follow-up duration was 27 months. Five-year locoregional control (LRC), disease-specific survival (DSS), and overall survival (OS) were 81.6%, 90.1, and 62.5% respectively. A statistically significant association was observed between the Rome classification and all survival outcomes in both univariable and multivariable analyses. Moreover, it appeared to perform better than the Union for International Cancer Control TNM classification for tumors of the nasal cavity and paranasal sinuses. The new Rome classification can be used effectively and is associated with LRC, DSS, and OS. However, it requires further validation in a larger (prospective) study population. [ABSTRACT FROM AUTHOR]

Published
2024
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16. New standards for the management of nose vestibule malignancies

Author

Bussu, Francesco, primary, Tagliaferri, Luca, additional, Crescio, Claudia, additional, Rizzo, Davide, additional, Gallus, Roberto, additional, Parrilla, Claudio, additional, Fionda, Bruno, additional, Lancellotta, Valentina, additional, Mattiucci, Gian Carlo, additional, and Galli, Jacopo, additional

Published
2023
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18. Adjuvant chemoradiation in pancreatic cancer: impact of radiotherapy dose on survival

Author

Morganti, Alessio G., Cellini, Francesco, Buwenge, Milly, Arcelli, Alessandra, Alfieri, Sergio, Calvo, Felipe A., Casadei, Riccardo, Cilla, Savino, Deodato, Francesco, Di Gioia, Giancarmine, Di Marco, Mariacristina, Fuccio, Lorenzo, Bertini, Federica, Guido, Alessandra, Herman, Joseph M., Macchia, Gabriella, Maidment, III, Bert W., Miller, Robert C., Minni, Francesco, Passoni, Paolo, Valentini, Chiara, Re, Alessia, Regine, William F., Reni, Michele, Falconi, Massimo, Valentini, Vincenzo, and Mattiucci, Gian Carlo

Published
2019
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22. A deep learning approach to generate synthetic CT in low field MR-guided radiotherapy for lung cases

Author

Lenkowicz, Jacopo, primary, Votta, Claudio, additional, Nardini, Matteo, additional, Quaranta, Flaviovincenzo, additional, Catucci, Francesco, additional, Boldrini, Luca, additional, Vagni, Marica, additional, Menna, Sebastiano, additional, Placidi, Lorenzo, additional, Romano, Angela, additional, Chiloiro, Giuditta, additional, Gambacorta, Maria Antonietta, additional, Mattiucci, Gian Carlo, additional, Indovina, Luca, additional, Valentini, Vincenzo, additional, and Cusumano, Davide, additional

Published
2022
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24. Clinical Validation of a Deep-Learning Segmentation Software in Head and Neck: An Early Analysis in a Developing Radiation Oncology Center

Author

D’Aviero, Andrea, primary, Re, Alessia, additional, Catucci, Francesco, additional, Piccari, Danila, additional, Votta, Claudio, additional, Piro, Domenico, additional, Piras, Antonio, additional, Di Dio, Carmela, additional, Iezzi, Martina, additional, Preziosi, Francesco, additional, Menna, Sebastiano, additional, Quaranta, Flaviovincenzo, additional, Boschetti, Althea, additional, Marras, Marco, additional, Miccichè, Francesco, additional, Gallus, Roberto, additional, Indovina, Luca, additional, Bussu, Francesco, additional, Valentini, Vincenzo, additional, Cusumano, Davide, additional, and Mattiucci, Gian Carlo, additional

Published
2022
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26. Evaluation of Staging Systems for Cancer of the Nasal Vestibule.

Author

Scheurleer, Willem Frederik Julius, Tagliaferri, Luca, Rijken, Johannes A., Crescio, Claudia, Rizzo, Davide, Mattiucci, Gian Carlo, Pameijer, Frank A., de Bree, Remco, Fionda, Bruno, de Ridder, Mischa, and Bussu, Francesco

Subjects
RESEARCH, HUMAN research subjects, RETROSPECTIVE studies, MAGNETIC resonance imaging, TUMOR classification, CANCER patients, INFORMED consent (Medical law), MEDICAL records, POSITRON emission tomography, DESCRIPTIVE statistics, NASAL tumors, SQUAMOUS cell carcinoma, LONGITUDINAL method
Abstract

Simple Summary: Cancer of the nasal vestibule is thought to be rare. Multiple staging systems exist for the staging of these tumors, which can lead to variability and, therefore, the poor reliability of data. This retrospective study aimed to evaluate these staging systems. One hundred and forty-eight patients with carcinoma of the nasal vestibule were included and re-staged per the available staging systems. Stage distribution varied widely between the four evaluated staging systems. The classification per Bussu et al. had the most balanced allocation of patients amongst the stages. The widespread adoption of a single system and the introduction of a designated topography code for this disease could lead to greater uniformity in data reporting and an improved understanding of the incidence and disease outcome. Further analysis of survival data is needed to assess which classification system is the best suited for nasal vestibule carcinoma. Squamous cell carcinoma of the nasal vestibule is reported to account for less than one percent of all head and neck malignancies. It lacks a designated WHO ICD-O topography code, and multiple systems are available for the staging of this disease, which results in unwanted variability and the subsequent poor reliability of data. The aim of this study was to evaluate the currently available staging systems for cancer of the nasal vestibule, including the recently introduced classification by Bussu et al., which built on Wang's original concept but with clearer anatomical cutoffs. Different staging systems for cancer of the nasal vestibule (UICC nasal cavity, UICC skin cancer of the head and neck, Wang and Bussu et al.) were evaluated via a retrospective analysis of 148 patients. The staging system, per Bussu et al., had the most balanced allocation of patients among the stages. When using the Wang classification as a reference, stage migration occurred less frequently with the Bussu classification. The widespread adoption of a single staging system, as well as the introduction of a designated topography code for cancer of the nasal vestibule, could lead to more uniformity in data reporting and improve an understanding of the incidence and disease outcome. The newly proposed carcinoma of the nasal vestibule classification by Bussu et al. has the potential to improve the staging and allocation among stages. Further analysis of survival data is needed to assess which classification system is best suited for nasal vestibule carcinoma. [ABSTRACT FROM AUTHOR]

Published
2023
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27. Comparative Effectiveness of Chemotherapy Alone Versus Radiotherapy-Based Regimens in Locally Advanced Pancreatic Cancer: A Real-World Multicenter Analysis (PAULA-1).

Author

Arcelli, Alessandra, Tarantino, Giuseppe, Cellini, Francesco, Buwenge, Milly, Macchia, Gabriella, Bertini, Federica, Guido, Alessandra, Deodato, Francesco, Cilla, Savino, Scotti, Valerio, Rosetto, Maria Elena, Djan, Igor, Parisi, Salvatore, Mattiucci, Gian Carlo, Fiore, Michele, Bonomo, Pierluigi, Belgioia, Liliana, Niespolo, Rita Marina, Gabriele, Pietro, and Di Marco, Mariacristina

Subjects
PANCREATIC cancer, STEREOTACTIC radiotherapy, CANCER chemotherapy, CHEMORADIOTHERAPY, OVERALL survival
Abstract

Different options for locally advanced pancreatic cancer (LAPC) are available based on international guidelines: chemotherapy (CHT), chemoradiation (CRT), and stereotactic body radiotherapy (SBRT). However, the role of radiotherapy is debated in LAPC. We retrospectively compared CHT, CRT, and SBRT ± CHT in a real-world setting in terms of overall survival (OS), local control (LC), and distant metastasis-free survival (DMFS). LAPC patients from a multicentric retrospective database were included (2005–2018). Survival curves were calculated using the Kaplan–Meier method. Multivariable Cox analysis was performed to identify predictors of LC, OS, and DMFS. Of the 419 patients included, 71.1% were treated with CRT, 15.5% with CHT, and 13.4% with SBRT. Multivariable analysis showed higher LC rates for CRT (HR: 0.56, 95%CI 0.34–0.92, p = 0.022) or SBRT (HR: 0.27, 95%CI 0.13–0.54, p < 0.001), compared to CHT. CRT (HR: 0.44, 95%CI 0.28–0.70, p < 0.001) and SBRT (HR: 0.40, 95%CI 0.22–0.74, p = 0.003) were predictors of prolonged OS with respect to CHT. No significant differences were recorded in terms of DMFS. In selected patients, the addition of radiotherapy to CHT is still an option to be considered. In patients referred for radiotherapy, CRT can be replaced by SBRT considering its duration, higher LC rate, and OS rate, which are at least comparable to that of CRT. [ABSTRACT FROM AUTHOR]

Published
2023
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29. Dosimetric Impact of Inter-Fraction Variability in the Treatment of Breast Cancer: Towards New Criteria to Evaluate the Appropriateness of Online Adaptive Radiotherapy

Author

Iezzi, Martina, primary, Cusumano, Davide, additional, Piccari, Danila, additional, Menna, Sebastiano, additional, Catucci, Francesco, additional, D’Aviero, Andrea, additional, Re, Alessia, additional, Di Dio, Carmela, additional, Quaranta, Flaviovincenzo, additional, Boschetti, Althea, additional, Marras, Marco, additional, Piro, Domenico, additional, Tomei, Flavia, additional, Votta, Claudio, additional, Valentini, Vincenzo, additional, and Mattiucci, Gian Carlo, additional

Published
2022
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32. Prevalence of HPV Infection and p16INK4a Overexpression in Surgically Treated Laryngeal Squamous Cell Carcinoma

Author

Gallus, Roberto, primary, Gheit, Tarik, additional, Holzinger, Dana, additional, Petrillo, Marco, additional, Rizzo, Davide, additional, Petrone, Gianluigi, additional, Miccichè, Francesco, additional, Mattiucci, Gian Carlo, additional, Arciuolo, Damiano, additional, Capobianco, Giampiero, additional, Delogu, Giovanni, additional, Valentini, Vincenzo, additional, Tommasino, Massimo, additional, and Bussu, Francesco, additional

Published
2022
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33. Modern Management of Esophageal Cancer: Radio-Oncology in Neoadjuvancy, Adjuvancy and Palliation

Author

Cellini, Francesco, primary, Manfrida, Stefania, additional, Casà, Calogero, additional, Romano, Angela, additional, Arcelli, Alessandra, additional, Zamagni, Alice, additional, De Luca, Viola, additional, Colloca, Giuseppe Ferdinando, additional, D’Aviero, Andrea, additional, Fuccio, Lorenzo, additional, Lancellotta, Valentina, additional, Tagliaferri, Luca, additional, Boldrini, Luca, additional, Mattiucci, Gian Carlo, additional, Gambacorta, Maria Antonietta, additional, Morganti, Alessio Giuseppe, additional, and Valentini, Vincenzo, additional

Published
2022
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34. The impact of radiomics in diagnosis and staging of pancreatic cancer

Author

Casà, Calogero, primary, Piras, Antonio, additional, D’Aviero, Andrea, additional, Preziosi, Francesco, additional, Mariani, Silvia, additional, Cusumano, Davide, additional, Romano, Angela, additional, Boskoski, Ivo, additional, Lenkowicz, Jacopo, additional, Dinapoli, Nicola, additional, Cellini, Francesco, additional, Gambacorta, Maria Antonietta, additional, Valentini, Vincenzo, additional, Mattiucci, Gian Carlo, additional, and Boldrini, Luca, additional

Published
2022
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35. Role of Chemoradiation in the Adjuvant Treatment of Radically Resected Pancreatic Cancer Patients: A Mono-Institutional Retrospective Analysis

Author

Mattiucci, Gian Carlo, primary, Salvatore, Lisa, additional, D’Aviero, Andrea, additional, Bagalà, Cinzia, additional, Bensi, Maria, additional, Castronovo, Francesco Mosè, additional, Cellini, Francesco, additional, De Franco, Paola, additional, Di Stefano, Brunella, additional, Macchia, Gabriella, additional, Masiello, Valeria, additional, Menghi, Roberta, additional, Quero, Giuseppe, additional, Reina, Sara, additional, Morganti, Alessio Giuseppe, additional, Alfieri, Sergio, additional, Tortora, Giampaolo, additional, and Valentini, Vincenzo, additional

Published
2022
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41. Patients’ Satisfaction by SmileInTM Totems in Radiotherapy: A Two-Year Mono-Institutional Experience

Author

Chiloiro, Giuditta, primary, Romano, Angela, additional, D’Aviero, Andrea, additional, Dinapoli, Loredana, additional, Zane, Elisa, additional, Tenore, Angela, additional, Boldrini, Luca, additional, Balducci, Mario, additional, Gambacorta, Maria Antonietta, additional, Mattiucci, Gian Carlo, additional, Malavasi, Pierluigi, additional, Cesario, Alfredo, additional, and Valentini, Vincenzo, additional

Published
2021
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43. Radiation therapy for prostate cancer: What’s the best in 2021

Author

Cellini, Francesco, primary, Tagliaferri, Luca, additional, Frascino, Vincenzo, additional, Alitto, Anna Rita, additional, Fionda, Bruno, additional, Boldrini, Luca, additional, Romano, Angela, additional, Casà, Calogero, additional, Catucci, Francesco, additional, Mattiucci, Gian Carlo, additional, and Valentini, Vincenzo, additional

Published
2021
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44. Patterns of radiotherapy practice for pancreatic cancer: Results of the Gastrointestinal Radiation Oncology Study Group multi-institutional survey

Author

MACCHIA, GABRIELLA, SAINATO, ALDO, TALAMINI, RENATO, BOZ, GIOVANNI, BACIGALUPO, ALMALINA, CARAVATTA, LUCIANA, FIORE, MICHELE, FRISO, MARIA LUISA, FUSCO, VINCENZO, LUPATTELLI, MARCO, MANTELLO, GIOVANNA, MATTIUCCI, GIAN CARLO, SLIM, NAJLA, SCIACERO, PIERA, TURRI, LUCIA, VALENTINI, VINCENZO, MORGANTI, ALESSIO GIUSEPPE, and GENOVESI, DOMENICO

Published
2015
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45. Adjuvant chemoradiotherapy in gastric cancer: a pooled analysis of the AIRO Gastrointestinal Group experience

Author

Mattiucci, Gian Carlo, Valentini, Chiara, DʼAgostino, Giuseppe Roberto, Augurio, Antonietta, Capirci, Carlo, De Paoli, Antonino, Genovesi, Domenico, Huscher, Alessandra, Iannone, Tiziana, Pani, Giuseppe, Rosetto, Maria Elena, Sciacero, Piera, Manfrida, Stefania, Corazzi, Francesca, Fusco, Vincenzo, Luppattelli, Marco, Mangiacotti, Maria Grazia, Melano, Antonella, Murino, Paola, Niespolo, Rita, Osti, Mattia Falchetto, Picardi, Vincenzo, Morganti, Alessio Giuseppe, and Valentini, Vincenzo

Published
2015
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47. Correction to: Hypofractionated sequential radiotherapy boost: a promising strategy in inoperable locally advanced pancreatic cancer patients (Journal of Cancer Research and Clinical Oncology, (2021), 147, 3, (661-667), 10.1007/s00432-020-03411-7)

Author

Mattiucci, Gian Carlo, Boldrini, Luca, Nardangeli, A., D'Aviero, A., Buwenge, M., Cellini, Francesco, Deodato, Francesco, Dinapoli, Nicola, Frascino, Vincenzo, Macchia, Gabriella, Morganti, Alessio Giuseppe, and Valentini, Vincenzo

Subjects
n/a, Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA
Published
2021

49. Impact of age and co-morbidities in patients with newly diagnosed glioblastoma: a pooled data analysis of three prospective mono-institutional phase II studies

Author

Balducci, Mario, Fiorentino, Alba, De Bonis, Pasquale, Chiesa, Silvia, Manfrida, Stefania, D’Agostino, Giuseppe Roberto, Mantini, Giovanna, Frascino, Vincenzo, Mattiucci, Gian Carlo, De Bari, Berardino, Mangiola, Annunziato, Miccichè, Francesco, Gambacorta, Maria Antonietta, Colicchio, Gabriella, Morganti, Alessio Giuseppe, Anile, Carmelo, and Valentini, Vincenzo

Published
2012
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50. New fractionations in breast cancer: a dosimetric study of 3D‐CRT versus VMAT.

Author

Piras, Antonio, Menna, Sebastiano, D'Aviero, Andrea, Marazzi, Fabio, Mazzini, Alberto, Cusumano, Davide, Massaccesi, Mariangela, Mattiucci, Gian Carlo, Daidone, Antonino, Valentini, Vincenzo, and Boldrini, Luca

Subjects
VOLUMETRIC-modulated arc therapy, BREAST cancer, RADIATION dosimetry, LUNGS, RADIOTHERAPY, BREAST
Abstract

Introduction: Adjuvant radiation therapy (RT) following primary surgery in women affected by early breast cancer (EBC) plays a central role in reducing local recurrences and overall mortality. The FAST‐FORWARD trial recently demonstrated that 1‐week hypofractionated adjuvant RT is not inferior to the standard schedule in terms of local relapse, cosmetic outcomes and toxicity. The aim of this in silico study was to evaluate the dosimetric aspects of a 1‐week RT course, administered through volumetric modulated arc therapy (VMAT), compared with traditional three‐dimensional conformal radiation therapy (3D‐CRT) with tangential fields. Methods: Patients affected by left‐side EBC undergoing adjuvant RT were selected. ESTRO guidelines for the clinical target volume (CTV) delineation and FAST‐FORWARD protocol for CTV to planning target volume (PTV) margin definition were followed. Total prescribed dose was 26 Gy in five fractions. The homogeneity index (HI) and the global conformity index (GCI) were taken into account for planning and dose distribution optimisation purposes. Both 3D‐CRT tangential fields and VMAT plans were generated for each patient. Results: The analysis included 21 patients. PTV coverage comparison between 3D‐CRT and VMAT plans showed significant increases for GCI (P < 0.05) in VMAT technique; no statistically significant differences were observed regarding HI. For organs at risks (OAR), statistically significant increases were observed in terms of skin V103% (P < 0.002) and ipsilateral lung V30% (P < 0.05) with 3D‐CRT and of heart V5% (P < 0.05) with VMAT technique. Conclusions: This in silico study showed that both 3D‐CRT and VMAT are dosimetrically feasible techniques in the framework of 1‐week hypofractionated treatments for left EBC. [ABSTRACT FROM AUTHOR]

Published
2022
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