Questions may be submitted anytime during the presentation.
|
|
- Godfrey Strickland
- 5 years ago
- Views:
Transcription
1 Understanding Radiation Therapy and its Role in Treating Patients with Pancreatic Cancer Presented by Pancreatic Cancer Action Network August 18, 2014 If you experience technical difficulty during the presentation: Contact WebEx Technical Support directly at: US Toll Free: Toll Only: or Submit a question to the Event Producer via the Q&A Panel For international support numbers visit: Questions may be submitted anytime during the presentation. To submit questions: Type your questions in the text entry box Click the Send Button Please direct your questions to All Panelists in the drop down 1
2 Understanding Radiation Therapy and its Role in Treating Patients with Pancreatic Cancer Christopher Crane, MD Associate Professor Department of Radiation Oncology Outline How does radiation work? How is radiation given? 2
3 How does radiation work? Types of Radiation Non-ionizing Do not produce ions in matter Microwaves, ultrasound, radio waves Ionizing Eject orbital electrons and produce ions Directly ionizing Charged particles (electrons, protons, alpha particles) Indirectly ionizing Uncharged particles (neutrons, gamma rays, x-rays) 3
4 Effects of Ionizing Radiation Radiation Ionizations Free Radicals DNA Damage Biologic Effects Radiation and DNA Free radicals produce DNA strand breaks Single strand breaks are repaired easily Double strand breaks difficult to repair Most important lesion produced by radiation Can lead to cell death, mutation or carcinogenesis Affects tumor and normal tissue 4
5 Factors Affecting Biologic Effects of Radiation Fraction Size A lower total dose in large fractions can have the same biologic effect as a higher total dose in small fractions Single Fractions vs. Multiple Fractions/ Day Randomized trials in head and neck cancers Dose Rate High Dose Rate vs. Low Dose Rate brachytherapy Overall Treatment Time Head and neck cancers, anal cancer Factors Affecting Biologic Effects of Radiation Type of tissue Bone marrow cells most sensitive Early responding vs. late responding tissues Oxygenation Enhances effects of radiation Radiosensitization Chemotherapy agents: 5-FU, cisplatin Biologic agents: Cetuximab Multiple randomized trials 5
6 How is radiation given? Goals Maximize damage to tumor cells Minimize damage to normal tissues 6
7 Simulation: Positioning and Immobilization Simulation: Imaging 7
8 Treatment Planning Contour radiation targets, other organs Design beam arrangement Number, size, orientation Design blocks to protect normal structures Cerrobend, Multi-leaf collimators (MLC) Treatment Machines Cobalt-60 Linear Accelerators Photons Electrons 8
9 Localized Pancreatic Cancer: Role of XRT vs Arterial Involvement T 1-3 T4 borderline T4 Surgery helpful? Yes Maybe No XRT helpful? Maybe HELPS the MOST Yes MS Borderline Resectable Healthy 52yo man, no past medical history. Painless jaundice Nov with weight loss. CA19-9: 168 T4 borderline 9
10 Borderline Resectable Pancreatic Cancer MDACC Results for All Patients Not resected (MS = 13 mos.) Finished NAJ Tx and Resected (MS = 41 mos.) Time from Initial Dx (months) Survival of all borderline patients (156), resected (40%) v. not resected (60%) Katz, et al 2008 Case Study: Pancreatic Ca 66 yo man, borderline resectable pancreatic ca Plan: Pre-op chemo-rt Surgery CT simulation Supine, arms up, body cradle Contouring Tumor, LN, kidneys, liver, spinal cord 4-field technique 10
11 Fields AP LAT Dosimetric Plan 11
12 DVH Tumor/LN Right Kidney Liver Spinal Cord Left Kidney Case#2: 74 y.o. male, NED at 7 years (72 Gy, no surgery or maintenance chemotherapy) Initial Scan 50months 12
13 13
14 IMRT Intensity Modulated Radiation Therapy Computer aided optimization Reverse Planning Multiple beams, Multi-Leaf Collimation Highly conformal RT to targets Minimizes dose to normal tissues Dose painting of targets IMRT MLC Shape Cumulative Dose Courtesy of Dr. Boyer 14
15 IMRT IMRT Beams 15
16 Why use IMRT? Reduce toxicity Anal cancer - genitalia Gastric and GE junction Ca heart and liver Rectal cancer? bowel? Increase dose tumor control Selected pancreatic cancers Liver cancers MDACC Dose Escalation LAPC (BED Gy) N=30 Median 31mo 3 yr OS 34% (95% CI 13 to 49mo) Crane, unpublished 16
17 67 yo WM with Neck/Body LAPC 63 Gy in 28 fx IGRT - Monitoring Stomach Position IMRT PancCa 63Gy - 28fx - 55Gy 17
18 What is steriotactic body radiotherapy (SBRT)? Increased precision Organ motion control Higher doses per treatment Ablates surrounding tissue Great for CNS, lung, liver tumors Not for tumors near the GI tract cyberknife SBRT Blue ITV Colon Red PTV Yellow 25Gy Isodose line Liver Duo Kidney Small Bowel Kidney Green Isodose line Lt. Blue 12.5 Gy Isodose line 1. An ITV using a 4DCT, a CT-PET and end expiration CT scans 2. Gold fiducials were placed and respiratory gating with 9 Field IMRT Schellenberg, ASTRO,
19 Fractionated SBRT (All retrospective) Study N stages Regimen MS >G2 Late GI tox Mahadevan, III 8-12Gy x mo 5% crude G3 Polistna, Italy III Gem, 10 x mo 0% Didolkar, mixed Gy /4 fx Rwigema, mixed 20-24Gy /1fx 8.7mo 22.3% crude G2/3 10.3mo 2% G2 Phase II Trial: SBRT / LAPC JHU/Stanford/MSKCC (33Gy/1 week) Overall survival: 13.9 Months (95% CI months) Herman, pastr0,
20 MDACC Dose Escalation LAPC (BED Gy) N=30 Median 31mo 3 yr OS 34% (95% CI 13 to 49mo) OS: 13.9 mos (95% CI mos) RTOG 1201: SMAD4 Directed Treatment Approved Trial: Stratification Variable LAPC Stratify: SMAD4 Status Ca 19-9 < 90 Gem x 3 mo Gem x 3 mo FOLFIRINOX x 3 mo IMRT 63Gy 50.4 Gy 3D CRT 50.4 Gy Eligibility: Locally Advanced Unresectable No prior Chemotherapy or RT, PS
21 RTOG 1201 modification LAPC Gem/Abraxane x 3 mo IMRT 63Gy Stratify: SMAD4 Status Ca 19-9 < Gy 3D CRT *Maintenance chemo until progression in all arms Eligibility: Locally Advanced Unresectable No prior Chemotherapy or RT, PS 0-1 Complications from RT Complications mainly occur locally, in organs that are in the RT field Some complications occur during treatment or within days or weeks Some complications appear after months or years 21
22 Examples of Complications Fatigue Skin: Erythema, desquamation CNS: Somnolence, cognitive loss Head & Neck: Mucositis, xerostomia Lung: Pneumonitis Upper GI: Nausea, esophagitis Lower GI: Diarrhea, proctitis GU: Cystitis, urethritis Hem: Myelosuppression Cardiovascular toxicity Second malignancies Indications for Urgent RT Spinal cord compression Brain metastasis with symptoms SVC syndrome with progression Uncontrolled bleeding Peripheral nerves with symptoms 22
23 Thank you for your participation! Pancreatic Cancer Action Network If you have questions, please contact our Patient and Liaison Services (PALS) programat (877) or 23
First, how does radiation work?
Hello, I am Prajnan Das, Faculty Member in the Department of Radiation Oncology at The University of Texas MD Anderson Cancer Center. We are going to talk today about some of the basic principles regarding
More informationRadiation Therapy: From Fallacy to Science
27 th Annual Management of Colon and Rectal Diseases 2.23.2019 Radiation Therapy: From Fallacy to Science Hadi Zahra, MD, DABR Radiation Oncologist CHI Health Henry Lynch Cancer Center Assistant Clinical
More informationAblative Radiation Therapy For Inoperable Cholangiocarcinoma. Christopher H. Crane, M.D. Program Director, GI Section Department of Radiation Oncology
Ablative Radiation Therapy For Inoperable Cholangiocarcinoma Christopher H. Crane, M.D. Program Director, GI Section Department of Radiation Oncology Facts about radiation treatment High doses (2x the
More informationTHE ROLE OF RADIATION THERAPY IN MANAGEMENT OF PANCREATIC ADENOCARCINOMA. TIMUR MITIN, MD, PhD
THE ROLE OF RADIATION THERAPY IN MANAGEMENT OF PANCREATIC ADENOCARCINOMA TIMUR MITIN, MD, PhD RESECTABLE DISEASE MANAGEMENT: RESECTABLE DISEASE Resection offers the only possibility of long term survival
More informationWhere are we with radiotherapy for biliary tract cancers?
Where are we with radiotherapy for biliary tract cancers? Professor Maria A. Hawkins Associate Professor in Clinical Oncology MRC Group Leader/Honorary Consultant Clinical Oncologist CRUK MRC Oxford Institute
More informationPancreatic Cancer and Radiation Therapy
Pancreatic Cancer and Radiation Therapy Why? Is there a role for local therapy with radiation in a disease with such a high rate of distant metastases? When? Resectable Disease Is there a role for post-op
More informationAdvances in external beam radiotherapy
International Conference on Modern Radiotherapy: Advances and Challenges in Radiation Protection of Patients Advances in external beam radiotherapy New techniques, new benefits and new risks Michael Brada
More informationSarcoma and Radiation Therapy. Gabrielle M Kane MB BCh EdD FRCPC Muir Professorship in Radiation Oncology University of Washington
Sarcoma and Radiation Therapy Gabrielle M Kane MB BCh EdD FRCPC Muir Professorship in Radiation Oncology University of Washington Objective: Helping you make informed decisions Introduction Process Radiation
More informationSide effects of radiotherapy.
Side effects of radiotherapy. Paweł Potocki, MD Jagiellonian University Medical College Kraków University Hospital Departament of Clinical Oncology ppotocki@su.krakow.pl Basics Techniques: Radiation type:
More informationHALF. Who gets radiotherapy? Who gets radiotherapy? Half of all cancer patients get radiotherapy. By 1899 X rays were being used for cancer therapy
The Physical and Biological Basis of By 1899 X rays were being used for cancer therapy David J. Brenner, PhD, DSc Center for Radiological Research Department of Radiation Oncology Columbia University Medical
More informationRadiotherapy physics & Equipments
Radiotherapy physics & Equipments RAD 481 Lecture s Title: An Overview of Radiation Therapy for Health Care Professionals Dr. Mohammed Emam Vision :IMC aspires to be a leader in applied medical sciences,
More informationDose escalation for NSCLC using conformal RT: 3D and IMRT. Hasan Murshed
Dose escalation for NSCLC using conformal RT: 3D and IMRT. Hasan Murshed Take home message Preliminary data shows CRT technique in NSCLC allows dose escalation to an unprecedented level maintaining cancer
More informationExternal Beam Radiotherapy for Prostate Cancer
External Beam Radiotherapy for Prostate Cancer Chomporn Sitathanee, Radiation Oncology Unit Ramathibodi Hospital, Mahidol University Roles of RT in prostate cancer Definitive RT; intact prostate Post radical
More informationStereotactic radiotherapy
Stereotactic radiotherapy Influence of patient positioning and fixation on treatment planning - clinical results Frank Zimmermann Institut für Radioonkologie Universitätsspital Basel Petersgraben 4 CH
More informationRadiotherapy for Gastric Cancer. Nitin Ohri, M.D. Montefiore Medical Center Albert Einstein College of Medicine 12/15/2012
Radiotherapy for Gastric Cancer Nitin Ohri, M.D. Montefiore Medical Center Albert Einstein College of Medicine 12/15/2012 Disclosures I have no conflicts of interest to disclose. Outline Background Treatment
More informationThe role of Radiation Oncologist: Hi-tech treatments for liver metastases
The role of Radiation Oncologist: Hi-tech treatments for liver metastases Icro Meattini, MD Radiotherapy-Oncology Unit AOU Careggi Hospital Florence University, Italy Liver Metastases - Background The
More informationI. Equipments for external beam radiotherapy
I. Equipments for external beam radiotherapy 5 linear accelerators (LINACs): Varian TrueBeam 6, 10 & 18 MV photons, 6-18 MeV electrons, image-guided (IGRT) and intensity modulated radiotherapy (IMRT),
More informationNCCN GUIDELINES ON PROTON THERAPY (AS OF 4/23/18) BONE (Version , 03/28/18)
BONE (Version 2.2018, 03/28/18) NCCN GUIDELINES ON PROTON THERAPY (AS OF 4/23/18) Radiation Therapy Specialized techniques such as intensity-modulated RT (IMRT); particle beam RT with protons, carbon ions,
More informationPrinciple of Radiation Therapy
Principle of Radiation Therapy Janjira Petsuksiri, M.D. Division of Radiation Therapy Faculty of Medicine Siriraj Hospital Basic sciences for residents Aug 11, 2010 Outlines Basic Radiation physics Basic
More informationSBRT in early stage NSCLC
SBRT in early stage NSCLC Optimal technique and tumor dose Frank Zimmermann Clinic of Radiotherapy and Radiation Oncology University Hospital Basel Petersgraben 4 CH 4031 Basel radioonkologiebasel.ch Techniques
More informationClinical Aspects of Proton Therapy in Lung Cancer. Joe Y. Chang, MD, PhD Associate Professor
Clinical Aspects of Proton Therapy in Lung Cancer Joe Y. Chang, MD, PhD Associate Professor Clinical Service Chief Thoracic Radiation Oncology Lung Cancer Basic Factors No. 1 cancer killer 161,840 patients
More informationDemands and Perspectives of Hadron Therapy
Demands and Perspectives of Hadron Therapy Alexander Lin, M.D. Assistant Professor University of Pennsylvania Direction of Operations Roberts Proton Therapy Center Disclosures Teva Pharmaceuticals: Advisory
More informationStereotaxy. Outlines. Establishing SBRT Program: Physics & Dosimetry. SBRT - Simulation. Body Localizer. Sim. Sim. Sim. Stereotaxy?
Establishing SBRT Program: Physics & Dosimetry Lu Wang, Ph.D. Radiation Oncology Department Fox Chase Cancer Center Outlines Illustrate the difference between SBRT vs. CRT Introduce the major procedures
More informationADVANCES IN RADIATION TECHNOLOGIES IN THE TREATMENT OF CANCER
ADVANCES IN RADIATION TECHNOLOGIES IN THE TREATMENT OF CANCER Bro. Dr. Collie Miller IARC/WHO Based on trends in the incidence of cancer, the International Agency for Research on Cancer (IARC) and WHO
More informationThe Evolution of SBRT and Hypofractionation in Thoracic Radiation Oncology
The Evolution of SBRT and Hypofractionation in Thoracic Radiation Oncology (specifically, lung cancer) 2/10/18 Jeffrey Kittel, MD Radiation Oncology, Aurora St. Luke s Medical Center Outline The history
More informationMEDICAL MANAGEMENT POLICY
PAGE: 1 of 8 This medical policy is not a guarantee of benefits or coverage, nor should it be deemed as medical advice. In the event of any conflict concerning benefit coverage, the employer/member summary
More informationImplementing SBRT Protocols: A NRG CIRO Perspective. Ying Xiao, Ph.D. What is NRG Oncology?
Implementing SBRT Protocols: A NRG CIRO Perspective Ying Xiao, Ph.D. What is NRG Oncology? One of five new NCI-supported National Clinical Trials Network (NCTN) groups. NCTN officially started March 1,
More informationProstate Cancer Treatments. Hasan Murshed, MD., DABR Radiation Oncology Residency, UAB Fellowship, MDACC Board Certified, ABR
Prostate Cancer Treatments Hasan Murshed, MD., DABR Radiation Oncology Residency, UAB Fellowship, MDACC Board Certified, ABR A Brief History of Radiation Wilhelm Roentgen discovered X- rays on November
More informationDisclosures 5/13/2013. Principles and Practice of Radiation Oncology First Annual Cancer Rehabilitation Symposium May 31, 2013
Principles and Practice of Radiation Oncology First Annual Cancer Rehabilitation Symposium May 31, 2013 Josh Yamada MD FRCPC Department of Radiation Oncology Memorial Sloan Kettering Cancer Center Disclosures
More informationLung Cancer Radiotherapy
Lung Cancer Radiotherapy Indications, Outcomes, and Impact on Survivorship Care Malcolm Mattes, MD Assistant Professor WVU Department of Radiation Oncology When people think about radiation, they think
More informationLinac or Non-Linac Demystifying And Decoding The Physics Of SBRT/SABR
Linac or Non-Linac Demystifying And Decoding The Physics Of SBRT/SABR PhD, FAAPM, FACR, FASTRO Department of Radiation Oncology Indiana University School of Medicine Indianapolis, IN, USA Indra J. Das,
More informationAndrew K. Lee, MD, MPH Associate Professor Department tof fradiation Oncology M.D. Anderson Cancer Center
Proton Therapy for Prostate Cancer Andrew K. Lee, MD, MPH Associate Professor Department tof fradiation Oncology M.D. Anderson Cancer Center Seungtaek Choi, MD Assistant Professor Department tof fradiation
More informationThoracic Recurrences. Soft tissue recurrence
Stereotactic body radiotherapy for thoracic and soft malignancies Alexander Gottschalk, M.D., Ph.D. Associate Professor Director of CyberKnife Radiosurgery Department of Radiation Oncology University of
More information8/1/2017. Clinical Indications and Applications of Realtime MRI-Guided Radiotherapy
Clinical Indications and Applications of Realtime MRI-Guided Radiotherapy Michael F Bassetti MD PhD Assistant Professor, Department of Human Oncology University of Wisconsin, Madison. Carbone Cancer Center
More informationIntroduction to clinical Radiotherapy
Introduction to clinical Radiotherapy Sarah Brothwood Radiotherapy Practice Educator Rosemere Cancer Centre Sarah.brothwood@lthtr.nhs.uk 01772 522694 Radiotherapy We have been able to see and document
More informationResults of Stereotactic radiotherapy for Stage I and II NSCLC Is There a Need for Image Guidance?
Results of Stereotactic radiotherapy for Stage I and II NSCLC Is There a Need for Image Guidance? Frank Zimmermann Institute of Radiation Oncolgy University Clinic Basel Petersgraben 4 CH 4031 Basel radioonkologiebasel.ch
More informationMRI Applications in Radiation Oncology:
MRI Applications in Radiation Oncology: Physician s Perspective Jeff Olsen, MD Department of Radiation Oncology Washington University, St. Louis, MO Disclosures Washington University has research and service
More informationAccuracy Requirements and Uncertainty Considerations in Radiation Therapy
Departments of Oncology and Medical Biophysics Accuracy Requirements and Uncertainty Considerations in Radiation Therapy Introduction and Overview 6 August 2013 Jacob (Jake) Van Dyk Conformality 18 16
More informationParticle (proton) Therapy Randomized trials vs. Prospective registry. Andrew K. Lee, MD, MPH Associate Professor Department of Radiation Oncology
Particle (proton) Therapy Randomized trials vs. Prospective registry Andrew K. Lee, MD, MPH Associate Professor Department of Radiation Oncology Should we do randomized trials? Are randomized trials needed
More informationPancreas SBRT. Rakendu Shukla, MD KyNam Nguyen, MD Brandon Dyer, MD Faculty Advisor: Arta Monjazeb, MD PhD University of California - Davis
Pancreas SBRT Rakendu Shukla, MD KyNam Nguyen, MD Brandon Dyer, MD Faculty Advisor: Arta Monjazeb, MD PhD University of California - Davis December 19, 2018 Clinical Presentation 48 year old woman initially
More informationRadiation Therapy for Liver Malignancies
Outline Radiation Therapy for Liver Malignancies Albert J. Chang, M.D., Ph.D. Department of Radiation Oncology, UCSF March 23, 2014 Rationale for developing liver directed therapies Liver directed therapies
More informationRole of Belly Board Device in the Age of Intensity Modulated Radiotherapy for Pelvic Irradiation
Role of Belly Board Device in the Age of Intensity Modulated Radiotherapy for Pelvic Irradiation 2017 AAMD 42 nd Annual Meeting Neil C. Estabrook, MD 6 / 14 / 2017 7/5/2017 1 Conflicts of Interest None
More informationOutline. WBRT field. Brain Metastases. Whole Brain RT Prophylactic WBRT Stereotactic radiosurgery (SRS) 1 fraction Stereotactic frame
Radiation Therapy for Advanced NSC Lung Ca Alexander Gottschalk, M.D., Ph.D. Associate Professor Director of CyberKnife Radiosurgery Department of Radiation Oncology University of California San Francisco
More informationARROCase: Borderline Resectable Pancreatic Cancer
ARROCase: Borderline Resectable Pancreatic Cancer Resident: Jordan Kharofa, MD Staff: Beth Erickson, MD 8/2012 Medical College of Wisconsin Department of Radiation Oncology Case Presentation: 60 year old
More informationDefining Target Volumes and Organs at Risk: a common language
Defining Target Volumes and Organs at Risk: a common language Eduardo Rosenblatt Section Head Applied Radiation Biology and Radiotherapy (ARBR) Section Division of Human Health IAEA Objective: To introduce
More informationPTCOG 46. Educational Workshop Session IV. Head & Neck CLINICAL. J. Mizoe (NIRS, Japan)
PTCOG 46 Educational Workshop Session IV CLINICAL Head & Neck J. Mizoe (NIRS, Japan) Photon X-Ray γ-ray Fast Neutron Non-Charged Radiation Electron Proton Helium Light Ion Heavy Particle Carbon Neon Argon
More informationTherapeutic Medical Physics. Stephen J. Amadon Jr., Ph.D., DABR
Therapeutic Medical Physics Stephen J. Amadon Jr., Ph.D., DABR Outline 1. Why physicists are needed in medicine 2. Branches of medical physics 3. Physics in Radiation Oncology 4. Treatment types and Treatment
More informationIntensity Modulated RadioTherapy
Intensity Modulated RadioTherapy A clinical application of a small accelerator University Medical Center Groningen A.A. van t Veld PhD I. Hoveijn PhD part 1 part2 CERN/KVI accelerator school, Zeegse, June
More informationImplementing New Technologies for Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy
Implementing New Technologies for Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy Implementation of radiosurgery and SBRT requires a fundamentally sound approach Errors don t blur out
More informationCredentialing for the Use of IGRT in Clinical Trials
Credentialing for the Use of IGRT in Clinical Trials James M. Galvin, DSc Thomas Jefferson University Hospital Jefferson Medical College Philadelphia, PA and The Radiation Therapy Oncology Group RADIATION
More informationCURRICULUM OUTLINE FOR TRANSITIONING FROM 2-D RT TO 3-D CRT AND IMRT
CURRICULUM OUTLINE FOR TRANSITIONING FROM 2-D RT TO 3-D CRT AND IMRT Purpose The purpose of this curriculum outline is to provide a framework for multidisciplinary training for radiation oncologists, medical
More informationStereotactic Body Radiotherapy (SBRT) For HCC T A R E K S H O U M A N P R O F. R A D I A T I O N O N C O L O G Y N C I, C A I R O U N I V.
Stereotactic Body Radiotherapy (SBRT) For HCC T A R E K S H O U M A N P R O F. R A D I A T I O N O N C O L O G Y N C I, C A I R O U N I V. Hepatocellular carcinoma (HCC), is a major health problem worldwide.
More informationTOPICS. Primary Radiation Therapy. Targeted Therapy in Oncology. Principles of Radiation Therapy. Principles of Radiation Therapy
Peter B. Schiff, M.D., Ph.D. Department of Radiation Oncology Columbia University College of Physicians & Surgeons May 4, 2007 Targeted Therapy in Oncology Surgical Oncology Minimal invasive techniques
More information肺癌放射治療新進展 Recent Advance in Radiation Oncology in Lung Cancer 許峰銘成佳憲國立台灣大學醫學院附設醫院腫瘤醫學部
肺癌放射治療新進展 Recent Advance in Radiation Oncology in Lung Cancer 許峰銘成佳憲國立台灣大學醫學院附設醫院腫瘤醫學部 Outline Current status of radiation oncology in lung cancer Focused on stage III non-small cell lung cancer Radiation
More informationUnderstanding Radiation Therapy. For Patients and the Public
Understanding Radiation Therapy For Patients and the Public Introduction to Radiation Oncology Radiation has been an effective tool for treating cancer for more than 100 years. Radiation oncologists are
More informationOverview of Clinical and Research Activities at Georgetown University Hospital
Overview of Clinical and Research Activities at Georgetown University Hospital Dalong Pang, Ph.D. Department of Radiation Medicine Georgetown University Hospital Clinical Operation Two Varian linear accelerators
More informationSBRT in Pancreas Cancer Role of The Radiosurgery Society
SBRT in Pancreas Cancer Role of The Radiosurgery Society Anand Mahadevan MD FRCS FRCR Chairman Division of Radiation Oncology Geisinger Health System, Danville, PA, USA. Past President and Chairman: The
More informationStereotactic MR-guided adaptive radiation therapy (SMART) for locally advanced pancreatic tumors
Stereotactic MR-guided adaptive radiation therapy (SMART) for locally advanced pancreatic tumors Anna Bruynzeel, Radiation Oncologist VU University Medical Center, Amsterdam, The Netherlands Current standard
More informationPage 1. Helical (Spiral) Tomotherapy. UW Helical Tomotherapy Unit. Helical (Spiral) Tomotherapy. MVCT of an Anesthetized Dog with a Sinus Tumor
Helical (Spiral) Tomotherapy Novel Clinical Applications of IMRT Linac Ring Gantry CT Detector X-Ray Fan Beam Binary Multileaf Collimator Binary MLC Leaves James S Welsh, MS, MD Department of Human Oncology
More informationWho Should Know Radiation Oncology Coding?
Why Should We Learn Radiation Oncology Coding? Terry Wu, Ph.D. Chief Physicist Radiation Oncology Department Willis-Knighton Cancer Center Who Should Know Radiation Oncology Coding? Radiation Oncologist
More informationSBRT TREATMENT PLANNING: TIPS + TRICKS. Rachel A. Hackett CMD, RT(T)
SBRT TREATMENT PLANNING: TIPS + TRICKS Rachel A. Hackett CMD, RT(T) OUTLINE Brief radiobiology review 3D CRT Tx Planning VMAT Tx Planning Protocols Other Sites Oligomets Spine Liver Kidney Adrenal Gland
More informationThe TomoTherapy System as a Tool of Differentiation in Quality and Marketability
The TomoTherapy System as a Tool of Differentiation in Quality and Marketability John J. Kresl, MD, PhD, FACRO, FACR Medical Director Phoenix CyberKnife & Radiation Oncology Center Managing Partner Phoenix,
More informationReena Phurailatpam. Intensity Modulated Radiation Therapy of Medulloblastoma using Helical TomoTherapy: Initial Experience from planning to delivery
Intensity Modulated Radiation Therapy of Medulloblastoma using Helical TomoTherapy: Initial Experience from planning to delivery Reena Phurailatpam Tejpal Gupta, Rakesh Jalali, Zubin Master, Bhooshan Zade,
More informationCorporate Medical Policy
Corporate Medical Policy Intensity Modulated Radiation Therapy (IMRT) of Abdomen and File Name: Origination: Last CAP Review: Next CAP Review: Last Review: intensity_modulated_radiation_therapy_imrt_of_abdomen_and_pelvis
More informationTreatment Planning Evaluation of Volumetric Modulated Arc Therapy (VMAT) for Craniospinal Irradiation (CSI)
Treatment Planning Evaluation of Volumetric Modulated Arc Therapy (VMAT) for Craniospinal Irradiation (CSI) Tagreed AL-ALAWI Medical Physicist King Abdullah Medical City- Jeddah Aim 1. Simplify and standardize
More informationASTRO Andrew J. Hope, M.D.
IGRT for lung cancer; does XRT dose escalation improve outcome? Jeffrey Bradley, M.D. Associate Professor Department of Radiation Oncology Washington University and The Alvin J. Siteman Comprehensive Cancer
More informationTecniche Radioterapiche U. Ricardi
Tecniche Radioterapiche U. Ricardi UNIVERSITA DEGLI STUDI DI TORINO Should we always rely on stage? T4N0M0 Stage IIIB T2N3M0 Early stage NSCLC The treatment of choice for early-stage NSCLC is anatomic
More informationUpper Gastrointestinal. Friday, March 2, :00 p.m. 2:45 p.m.
Upper Gastrointestinal Friday, March 2, 2018 2:00 p.m. 2:45 p.m. Social Q&A Use your phone, tablet, or laptop to Submit questions to speakers and moderators Answer interactive questions / audience response
More informationRadiation Therapy for Thyroid Cancer. When is Radiation Therapy indicated in Thyroid Cancer of Follicular or Parafollicular Cell Origin?
When is Radiation Therapy indicated in Thyroid Cancer of Follicular or Parafollicular Cell Origin? Jeanne Marie Quivey MD FACR October 200 Radiation Therapy for Thyroid Cancer Radioactive 3- I (RAI) External
More informationRadiotherapy for Rectal Cancer. Kevin Palumbo Adelaide Radiotherapy Centre
Radiotherapy for Rectal Cancer Kevin Palumbo Adelaide Radiotherapy Centre Overview CRC are common (3 rd commonest cancer) rectal Ca approx 25-30% of all CRC. Presentation PR bleeding: beware attributing
More informationTechnological Advances in Radiotherapy for the Treatment of Localized Prostate Cancer - A Systematic Review
Technological Advances in Radiotherapy for the Treatment of Localized Prostate Cancer - A Systematic Review Jayatissa R.M.G.C.S.B. (B.Sc.) Department of Radiography/Radiotherapy, Faculty of Allied Health
More informationPalliative RT in Ovarian cancer
Outline Palliative RT in Ovarian cancer Case discussion Palliative treatment Radiation Techniques Asst Prof Pittaya Dankulchai, MD. Division of Radiation Oncology, Department of Radiology, Faculty of Medicine
More informationProton Therapy for Prostate Cancer. Andrew K. Lee, MD, MPH Director Proton Therapy Center
Proton Therapy for Prostate Cancer Andrew K. Lee, MD, MPH Director Proton Therapy Center Disclosures No relevant financial disclosures This presentation will not discuss off-label or investigational treatments
More informationEvaluation of Whole-Field and Split-Field Intensity Modulation Radiation Therapy (IMRT) Techniques in Head and Neck Cancer
1 Charles Poole April Case Study April 30, 2012 Evaluation of Whole-Field and Split-Field Intensity Modulation Radiation Therapy (IMRT) Techniques in Head and Neck Cancer Abstract: Introduction: This study
More informationAdvanced Technology Consortium (ATC) Credentialing Procedures for 3D Conformal Therapy Protocols 3D CRT Benchmark*
Advanced Technology Consortium (ATC) Credentialing Procedures for 3D Conformal Therapy Protocols 3D CRT Benchmark* Purpose: To evaluate an institution s 3D treatment planning process and the institution
More informationThe Physics of Oesophageal Cancer Radiotherapy
The Physics of Oesophageal Cancer Radiotherapy Dr. Philip Wai Radiotherapy Physics Royal Marsden Hospital 1 Contents Brief clinical introduction Imaging and Target definition Dose prescription & patient
More informationASTRO econtouring for Lymphoma. Stephanie Terezakis, MD
ASTRO econtouring for Lymphoma Stephanie Terezakis, MD Disclosures No conflicts to disclose 1970 Total Lymphoid Irradiation (TLI) 1995 Involved-Field Radiotherapy (IFRT) 2008 Involved Node Radiotherapy
More informationA Comparison of IMRT and VMAT Technique for the Treatment of Rectal Cancer
A Comparison of IMRT and VMAT Technique for the Treatment of Rectal Cancer Tony Kin Ming Lam Radiation Planner Dr Patricia Lindsay, Radiation Physicist Dr John Kim, Radiation Oncologist Dr Kim Ann Ung,
More informationCombined modality treatment for N2 disease
Combined modality treatment for N2 disease Dr Clara Chan Consultant in Clinical Oncology 3 rd March 2017 Overview Background The evidence base Systemic treatment Radiotherapy Future directions/clinical
More informationSan Antonio Breast Cancer Symposium 2010 Highlights Radiotherapy
San Antonio Breast Cancer Symposium 2010 Highlights Radiotherapy Kathleen C. Horst, M.D. Assistant Professor Department of Radiation Oncology Stanford University The Optimal SEquencing of Adjuvant Chemotherapy
More informationInnovations in Radiation Therapy, including SBRT, IMRT, and Proton Beam Therapy. Sue S. Yom, M.D., Ph.D.
Innovations in Radiation Therapy, including SBRT, IMRT, and Proton Beam Therapy Sue S. Yom, M.D., Ph.D. Disclosures Genentech: advisory, research support ImClone: research support Plexxikon: research support
More information4D Radiotherapy in early ca Lung. Prof. Manoj Gupta Dept of Radiotherapy & oncology I.G.Medical College Shimla
4D Radiotherapy in early ca Lung Prof. Manoj Gupta Dept of Radiotherapy & oncology I.G.Medical College Shimla Presentation focus on ---- Limitation of Conventional RT Why Interest in early lung cancer
More informationInsights into Thymic Epithelial Tumors: Radiation Therapy
Insights into Thymic Epithelial Tumors: Radiation Therapy Charles R. Thomas, MD Professor and Chairman, Department of Radiation Medicine Professor, Department of Medicine, Division of Hematology/Medical
More informationREVISITING ICRU VOLUME DEFINITIONS. Eduardo Rosenblatt Vienna, Austria
REVISITING ICRU VOLUME DEFINITIONS Eduardo Rosenblatt Vienna, Austria Objective: To introduce target volumes and organ at risk concepts as defined by ICRU. 3D-CRT is the standard There was a need for a
More informationDisclosures. Proton therapy advantages. Why are comparing therapies difficult? Proton Therapy for Low Risk Prostate Cancer
Proton Therapy for Low Risk Prostate Cancer Disclosures No relevant financial disclosures This presentation will not discuss off-label or investigational treatments Andrew K. Lee, MD, MPH Associate Professor
More informationCALGB Thoracic Radiotherapy for Limited Stage Small Cell Lung Cancer
CALGB 30610 Thoracic Radiotherapy for Limited Stage Small Cell Lung Cancer Jeffrey A. Bogart Department of Radiation Oncology Upstate Medical University Syracuse, NY Small Cell Lung Cancer Estimated 33,000
More informationPost-Lumpectomy Radiation Techniques and Toxicities
Post-Lumpectomy Radiation Techniques and Toxicities Laura Willson, MD Abbott Northwestern Hospital Dept. of Radiation Oncology February 2, 2019 Learning Objectives How radiation therapy works Standard
More informationPitfalls in SBRT Treatment Planning for a Moving Target
Pitfalls in SBRT Treatment Planning for a Moving Target Cynthia F. Chuang, Ph.D. Department of Radiation Oncology University of California-San Francisco I have no conflicts of interests to disclose In
More informationSBRT of Lung & Liver lesions using Novalis IGRT System. Patrick Silgen, M.S., DABR Park Nicollet Methodist Hospital
SBRT of Lung & Liver lesions using Novalis IGRT System Patrick Silgen, M.S., DABR Park Nicollet Methodist Hospital It could be worse!!! Acknowledgements Michael Weber, M.S., DABR Brenden Garrity, M.S.,
More informationQuality ID #156 (NQF 0382): Oncology: Radiation Dose Limits to Normal Tissues National Quality Strategy Domain: Patient Safety
Quality ID #156 (NQF 0382): Oncology: Radiation Dose Limits to Normal Tissues National Quality Strategy Domain: Patient Safety 2018 OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS ONLY MEASURE TYPE: Process DESCRIPTION:
More informationModern Dose Fractionation and Treatment Techniques for Definitive Prostate RT
Modern Dose Fractionation and Treatment Techniques for Definitive Prostate RT Daniel J Bourgeois, III MD, MPH Board Certified Radiation Oncologist Southeast Louisiana Radiation Oncology Group (SLROG) Disclosures
More informationRob Glynne-Jones Mount Vernon Cancer Centre
ESMO Preceptorship Programme Colorectal Cancer Barcelona October 2017 Interventional radiology and stereotactic radiotherapy Rob Glynne-Jones Mount Vernon Cancer Centre My Disclosures: last 5 years Speaker:
More informationTherapeutic ratio - An Overview. Past Present Future Prof Ramesh S Bilimaga
Therapeutic ratio - An Overview Past Present Future Prof Ramesh S Bilimaga Radiation Oncology Discipline of human medicine concerned with the generation, conservation and dissemination of knowledge concerning
More informationRadiation Therapy 2/20/2014. Disclosures. Therapeutic Ratio. Rules in Radiotherapy. Radiation oncology is a technology based specialty
Disclosures Proton therapy for Gastrointestinal tumors Ed Kim has no financial relationships, arrangements, or affiliations with commercial entities. Ed Kim, MD February 22 2014 Radiation Therapy Therapeutic
More informationFuture Directions in Prostate Cancer: The Case for Protons. John J. Coen, MD Helen & Harry Gray Cancer Center
Future Directions in Prostate Cancer: The Case for Protons John J. Coen, MD Helen & Harry Gray Cancer Center November 14, 2012 Protons and prostate cancer Early proton experience at the MGH The case for
More informationCase Conference: SBRT for spinal metastases D A N I E L S I M P S O N M D 3 / 2 7 / 1 2
Case Conference: SBRT for spinal metastases D A N I E L S I M P S O N M D 3 / 2 7 / 1 2 Case 79 yo M with hx of T3N0 colon cancer diagnosed in 2008 metastatic liver disease s/p liver segmentectomy 2009
More informationEDUCATIONAL COURSE TU-A-BRB-1
Brian D. Kavanagh, MD, MPH Department of Radiation Oncology University of Colorado School of Medicine EDUCATIONAL COURSE TU-A-BRB-1 Physics and Dosimetry of SBRT Part III: Planning Case Studies 3 of the
More informationIGRT Solution for the Living Patient and the Dynamic Treatment Problem
IGRT Solution for the Living Patient and the Dynamic Treatment Problem Lei Dong, Ph.D. Associate Professor Dept. of Radiation Physics University of Texas M. D. Anderson Cancer Center Houston, Texas Learning
More informationIMRT - the physician s eye-view. Cinzia Iotti Department of Radiation Oncology S.Maria Nuova Hospital Reggio Emilia
IMRT - the physician s eye-view Cinzia Iotti Department of Radiation Oncology S.Maria Nuova Hospital Reggio Emilia The goals of cancer therapy Local control Survival Functional status Quality of life Causes
More informationA TREATMENT PLANNING STUDY COMPARING VMAT WITH 3D CONFORMAL RADIOTHERAPY FOR PROSTATE CANCER USING PINNACLE PLANNING SYSTEM *
Romanian Reports in Physics, Vol. 66, No. 2, P. 394 400, 2014 A TREATMENT PLANNING STUDY COMPARING VMAT WITH 3D CONFORMAL RADIOTHERAPY FOR PROSTATE CANCER USING PINNACLE PLANNING SYSTEM * D. ADAM 1,2,
More information