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213 results on '"Panizza D"'

1. Dosimetric commissioning and quality assurance of scanned ion beams at the Italian National Center for Oncological Hadrontherapy

Author

Mirandola, Alfredo, Molinelli, S., Freixas, G. Vilches, Donetti, M., Mairani, A., Gallio, E., Panizza, D., Russo, S., Magro, G., Giordanengo, S., Ciocca, M., and Orecchia, R.

Subjects
Physics - Medical Physics
Abstract

Purpose: To describe the dosimetric commissioning and quality assurance (QA) of the actively scanned proton and carbon ion beams at the Italian National Center for Oncological Hadrontherapy. Methods: The laterally integrated depth-dose-distributions (IDDs) were acquired with the PTW Peakfinder, a variable depth water column, equipped with two Bragg peak ionization chambers. FLUKA MC code was used to generate the energy libraries, the IDDs in water, and the fragment spectra for carbon beams. EBT3 films were used for spot size measurements, beam position over the scan field, and homogeneity in 2D-fields. Beam monitor calibration was performed in terms of number of particles per MU using both a Farmer-type and an Advanced Markus ionization chamber. The beam position at the isocenter, beam monitor calibration curve, dose constancy in the center of the spread-out-Bragg-peak, dose homogeneity in 2D-fields, beam energy, spot size, and spot position over the scan field are all checked on a daily basis for both protons and carbon ions and on all beam lines. Results: The simulated IDDs showed an excellent agreement with the measured experimental curves. The measured FWHM of the pencil beam in air at the isocenter was from 0.7 to 2.2 cm for protons. For carbon ions, two sets of spot size are available: from 0.4 to 0.8 cm (for the smaller) and from 0.8 to 1.1 cm (for the larger one). The spot position was within +/-1 mm over the whole 20x20 cm2 scan field; homogeneity in a uniform squared field was within +/-5% for both particle types at any energy. QA results exceeding tolerance levels were rarely found. In the reporting period, the machine downtime was around 6%, of which 4.5% was due to planned maintenance shutdowns. Conclusions: After successful dosimetric beam commissioning, quality assurance measurements performed during a 24-month period show very stable beam characteristics.

Published
2022
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6. Side Effects and Quality of Life in a Post-Prostatectomy Ablative Radiation Therapy (POPART) Multicentric Trial

Author

Ferrario, F., primary, Franzese, C., additional, Vukcaj, S., additional, Magli, A., additional, Belmonte, M., additional, Lucchini, R., additional, Purrello, G., additional, Faccenda, V., additional, Panizza, D., additional, Andreoli, S., additional, Poli, G.L., additional, Baldaccini, D., additional, Lo Faro, L., additional, Tomatis, S., additional, Cazzaniga, L.F., additional, Scorsetti, M., additional, and Arcangeli, S., additional

Published
2023
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11. Association between treatment-related lymphopenia and survival in glioblastoma patients following postoperative chemoradiotherapy

Author

Mapelli, R, Julita, C, Bianchi, S, Gallina, N, Lucchini, R, Midulla, M, Puci, F, Saddi, J, Trivellato, S, Panizza, D, De Ponti, E, Arcangeli, S, Mapelli R., Julita C., Bianchi S. P., Gallina N., Lucchini R., Midulla M., Puci F., Saddi J., Trivellato S., Panizza D., De Ponti E., Arcangeli S., Mapelli, R, Julita, C, Bianchi, S, Gallina, N, Lucchini, R, Midulla, M, Puci, F, Saddi, J, Trivellato, S, Panizza, D, De Ponti, E, Arcangeli, S, Mapelli R., Julita C., Bianchi S. P., Gallina N., Lucchini R., Midulla M., Puci F., Saddi J., Trivellato S., Panizza D., De Ponti E., and Arcangeli S.

Abstract

Purpose: Our study investigated the association between treatment-related lymphopenia and overall survival (OS) in a series of glioblastoma (GBM) patients. We also explored clinical and dosimetric predictors of lymphocytes depletion. Methods: Between 2015 and 2019, 64 patients were treated at the same institution with postoperative chemoradiotherapy. Peripheral lymphocyte count (PLC) data and dose–volume histogram parameters were collected. Radiotherapy (RT) schedule consisted in standard total dose of 60 Gy in 30 daily fractions, with concomitant and adjuvant temozolomide (TMZ). Posttreatment acute absolute lymphopenia (nadir AAL) was calculated as a PLC lower than 1.0 × 103/mm3. Acute relative lymphopenia (ARL) was expressed by the nadir-PLC/baseline-PLC ratio < 0.5. Nadir-PLC was the lowest PLC registered between the end of RT and the first month of follow-up. Survival rates were estimated with Kaplan–Meier curves. Clinical and dosimetric variables related to AAL/ARL and OS were identified by univariate and multivariate analyses. Results: A total of 57 patients were eligible and included in the analyses. The median PLC was significantly decreased following chemoradiotherapy (2180/mm3 vs 900/mm3). Median OS was 16 months (range 5–55 months), with no significant difference between patients who developed nadir AAL and those who did not (16 months vs 16.5 months; p = 0.304). When considering ARL vs non-ARL, median OS was 14 months vs 26 months (p = 0.013), respectively. In multivariate Cox regression only age, sex, extent of surgery, access to adjuvant chemotherapy and brain D98% were independently associated with OS. Conclusion: Although iatrogenic immunosuppression could be associated with inferior clinical outcomes, our data show that treatment-related lymphopenia does not adversely affect GBM survival. Prospective studies are required to confirm these findings.

Published
2022

12. PO-1452 Toxicity and early findings in a post-prostatectomy ablative radiation therapy multicentric trial

Author

Lucchini, R., primary, Franzese, C., additional, Vukcaj, S., additional, Purrello, G., additional, Panizza, D., additional, Faccenda, V., additional, Andreoli, S., additional, Poli, G.L., additional, Baldaccini, D., additional, Lo Faro, L., additional, Tomatis, S., additional, Cazzaniga, L.F., additional, Scorsetti, M., additional, and Arcangeli, S., additional

Published
2023
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24. Treatment outcome and compliance to dose-intensified linac-based SBRT for unfavorable prostate tumors using a novel real-time organ-motion tracking

Author

Lucchini, R, Panizza, D, Colciago, R, Vernier, V, Daniotti, M, Faccenda, V, Arcangeli, S, Lucchini R., Panizza D., Colciago R. R., Vernier V., Daniotti M. C., Faccenda V., Arcangeli S., Lucchini, R, Panizza, D, Colciago, R, Vernier, V, Daniotti, M, Faccenda, V, Arcangeli, S, Lucchini R., Panizza D., Colciago R. R., Vernier V., Daniotti M. C., Faccenda V., and Arcangeli S.

Abstract

Purpose/objectives: To report preliminary data on treatment outcome and compliance to dose-intensified organ sparing SBRT for prostate cancer using a novel electromagnetic transmitter-based tracking system (RayPilotÒ System) to account for intra-fractional organ motion. Material/methods: Thirteen patients with intermediate unfavorable (9) and selected high-risk (4) prostate cancer underwent dose-escalated SBRT in 4 or 5 fractions (BED1.5 = 279 Gy and 253 Gy, respectively). The VMAT treatment consisted in two 6FFF or 10FFF full arcs optimized to have the 95% isodose covering at least 95% of the PTV (2 mm isotropic expansion of the CTV). Whenever the real-time tracking registered a displacement that exceeded 2 mm during the setup and/or the beam delivery, the treatment was interrupted and the prostate motion was promptly corrected. The incidence of treatment-related genitourinary (GU) and gastrointestinal (GI) toxicity, patient QoL and PSA outcomes were computed from the start of treatment to the last follow-up date. Results: All patients completed the treatment in the expected time (10.2 +/− 4.2 minutes) and their compliance to the procedure was excellent. No clinically significant acute Grade 2 or higher GI (rectal) and GU side effects were observed within 90 days from the treatment completion. The median IPSS increased from 8 at baseline to 12 one-month after treatment and settled to 6 at 3 months. EPIC-26 scores in the urinary domain decreased from a median baseline of 86 pre-treatment to 79 at one-month and returned to baseline at a later timepoint (median score of 85 at 3 months). EPIC-26 scores in the bowel domains did not show significant changes within 3 months following RT. The prostate was found within 1 mm from its initial position in 78% of the beam-on time, between 1 and 2 mm in 20%, and exceeded 2 mm only in 2%, after correction for motion which was performed in 45% of

Published
2021

33. In vivo dosimetry of total body irradiation patients: A 10 year retrospective analysis.

Author

Carminati, S., Trivellato, S., Ingraito, C., Montanari, G., Morzenti, S., Paruccini, N., Panizza, D., Villa, R., Tremolada, V., Julita, C., Arcangeli, S., and De Ponti, E.

Abstract

• Total Body Irradiation in-vivo dosimetry data over 10 years were analyzed. • Monitor Units' median percentage difference from planned was limited. • Median percentage dose difference at six anatomical locations was inside 10 % range. • The neck region showed the highest dosimetric differences from planned. • In-vivo dosimetry omission impact was evaluated, leading to interesting results. Myeloablative Total Body Irradiation (TBI) used in our Institution, as part of the conditioning scheme for haematopoietic stem cell transplantation, is an extended-distance supine technique that has been implemented using a 15 MV LINAC beam, lead lung compensators, PMMA, and water bolus to improve homogeneity. This study reviews in-vivo dosimetry (IVD) over 10 years of treatments, assessing the technique's robustness, accuracy, and efficiency. A 2-lateral opposite fields plan was calculated from planning CT with validated Oncentra TPS (Elekta AB, Sweden). Monitor units (MUs), lung compensators shape and thickness were calculated to deliver the prescription dose (12 Gy in 6 bi-daily fractions or 9.9 Gy in 3 daily fractions) to the patient's abdomen midline at the umbilical level, maintaining lung dose within ±5 % range of prescription. Data from 103 patients, of which more than 87 % were pediatric, were retrieved and analyzed for a total of 537 treatment fractions. The impact of IVD omission was evaluated, supposing doing it only once or in the first two fractions, if necessary. Median ΔMU from planned was −1.2 %. Median percentage dose deviation from prescription in 6 anatomical regions was below 2 %. IVD omission could have resulted in an increase of 7 patients registering at least one anatomical region outside the ±5 % dose range at the end of treatment. It is possible to confirm the implemented technique's robustness and accuracy in delivering the prescribed dose under IVD monitoring. Nevertheless, this technique and associated IVD are time-consuming and IVD omission could be assessed with limited drawbacks. [ABSTRACT FROM AUTHOR]

Published
2024
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36. Evaluation of patients setup accuracy and determination of planning target volume (PTV) margin in moderate hypofractionated volumetric arc therapy (VMAT) of localized prostate cancer using CBCT

Author

Caricato, P., primary, Faccenda, V., additional, Testa, A., additional, Pisoni, V., additional, Trivellato, S., additional, Montanari, G., additional, Panizza, D., additional, Lucchini, R., additional, De Ponti, E., additional, and Arcangeli, S., additional

Published
2021
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38. Clinical kick-off of Ra yPilot® HypoCath® real time tracking: a novel electromagnetic device without surgical intervention to evaluate the intrafraction motion during extreme hypofractionation of localized prostate cancer stereotactic body radiation therapy (SBRT)

Author

Panizza, D., primary, Trivellato, S., additional, Montanari, G., additional, Pisoni, V., additional, Faccenda, V., additional, Caricato, P., additional, Daniotti, M.C., additional, Lucchini, R., additional, De Ponti, E., additional, and Arcangeli, S., additional

Published
2021
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49. Automated segmentation in pelvic radiotherapy: A comprehensive evaluation of ATLAS-, machine learning-, and deep learning-based models.

Author

Bordigoni, B., Trivellato, S., Pellegrini, R., Meregalli, S., Bonetto, E., Belmonte, M., Castellano, M., Panizza, D., Arcangeli, S., and De Ponti, E.

Abstract

• Pelvis auto-segmentation tools were compared, from atlas-techniques to deep learning. • Deep learning showed better and faster segmentation results. • Differences found in cervical cancer tapered off in prostate cancer contouring. • Expert radiation oncologists qualitatively preferred deep learning. • Automated tools allow for faster radiotherapy workflow and high-quality treatments. Artificial intelligence can standardize and automatize highly demanding procedures, such as manual segmentation, especially in an anatomical site as common as the pelvis. This study investigated four automated segmentation tools on computed tomography (CT) images in female and male pelvic radiotherapy (RT) starting from simpler and well-known atlas-based methods to the most recent neural networks-based algorithms. The evaluation included quantitative, qualitative and time efficiency assessments. A mono-institutional consecutive series of 40 cervical cancer and 40 prostate cancer structure sets were retrospectively selected. After a preparatory phase, the remaining 20 testing sets per each site were auto-segmented by the atlas-based model STAPLE, a Random Forest-based model, and two Deep Learning-based tools (DL), MVision and LimbusAI. Setting manual segmentation as the Ground Truth, 200 structure sets were compared in terms of Dice Similarity Coefficient (DSC), Hausdorff Distance (HD), and Distance-to-Agreement Portion (DAP). Automated segmentation and manual correction durations were recorded. Expert clinicians performed a qualitative evaluation. In cervical cancer CTs, DL outperformed the other tools with higher quantitative metrics, qualitative scores, and shorter correction times. On the other hand, in prostate cancer CTs, the performance across all the analyzed tools was comparable in terms of both quantitative and qualitative metrics. Such discrepancy in performance outcome could be explained by the wide range of anatomical variability in cervical cancer with respect to the strict bladder and rectum filling preparation in prostate Stereotactic Body Radiation Therapy (SBRT). Decreasing segmentation times can reduce the burden of pelvic radiation therapy routine in an automated workflow. [ABSTRACT FROM AUTHOR]

Published
2024
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