Journal of Radiotherapy in Practice (J Radiother Pract)

Publisher: EDP Sciences

Journal description

The Journal of Radiotherapy in Practice is a peer-reviewed journal covering all of the current modalities specific to clinical oncology and radiotherapy. The journal aims to publish research from a wide range of styles and encourage debate and the exchange of information and opinion from within the field of radiotherapy practice and clinical oncology. The journal also aims to encourage technical evaluations and case studies as well as equipment reviews that will be of interest to an international radiotherapy market.

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Website Journal of Radiotherapy in Practice website
Other titles Journal of radiotherapy in practice (Online), Radiotherapy in practice
ISSN 1467-1131
OCLC 57696122
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

EDP Sciences

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • On author's personal website or institutional website or OAI compliant website
    • Some journals require an embargo for deposit in funder's designated repositories (see journal)
    • Publisher's version/PDF may be used (see journal)
    • Must link to publisher version
    • Publisher copyright and source must be acknowledged
    • Non-commercial
  • Classification

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose It is common for head and neck patients to be affected by time trend errors as a result of weight loss during a course of radiation treatment. The objective of this planning study was to investigate the impact of weight loss on volumetric modulated arc therapy (VMAT) as well as intensity modulated radiation therapy (IMRT) for locally advanced head and neck cancer using automatic co-registration of the cone beam computed tomography. Materials and methods A retrospective analysis of previously treated IMRT plans for ten patients with locally advanced head and neck cancer was done. A VMAT plan was also produced for all patients. We calculated the dose–volume histograms (DVH) indices for spinal cord planning at risk volumes (PRVs), the brainstem PRVs (SC+0·5 cm and BS+0·5 cm, respectively) as well as mean dose to the parotid glands. Results The results show that the mean difference in dose to the SC+0·5 cm was 1·03% and 1·27% for the IMRT and VMAT plans, respectively. As for dose to the BS+0·5, the percentage difference was 0·63% for the IMRT plans and 0·61% for the VMAT plans. The analysis of the parotid gland doses shows that the percentage change in mean dose to left parotid was −8·0% whereas that of the right parotid was −6·4% for the IMRT treatment plans. In the VMAT plans, the percentages change for the left and the right parotid glands were −6·6 and −6·7% respectively. Conclusions This study shows a clinically significant impact of weight loss on DVH indices analysed in head and neck organs at risk. It highlights the importance of adaptive radiotherapy in head and neck patients if organ at risk sparing is to be maintained.
    Journal of Radiotherapy in Practice 07/2015; DOI:10.1017/s1460396915000291
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    ABSTRACT: Introduction Head and neck cancer patients receiving radiotherapy can experience a number of toxicities, including weight loss and malnutrition, which can impact upon the quality of treatment. The purpose of this retrospective cohort study is to evaluate weight loss and identify predictive factors for this patient group. Materials and methods A total of 40 patients treated with radiotherapy since 2012 at the study centre were selected for analysis. Data were collected from patient records. The association between potential risk factors and weight loss was investigated. Results Mean weight loss was 5 kg (6%). In all, 24 patients lost >5% starting body weight. Age, T-stage, N-stage, chemotherapy and starting body weight were individually associated with significant differences in weight loss. On multiple linear regression analysis age and nodal status were predictive. Conclusion Younger patients and those with nodal disease were most at risk of weight loss. Other studies have identified the same risk factors along with several other variables. The relative significance of each along with a number of other potential factors is yet to be fully understood. Further research is required to help identify patients most at risk of weight loss; and assess interventions aimed at preventing weight loss and malnutrition.
    Journal of Radiotherapy in Practice 06/2015; DOI:10.1017/S146039691500031X
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    ABSTRACT: Introduction Proliferating trichilemmal tumour (PTT) is a benign tumour originating from the outer root sheath of a hair follicle. In rare instances, malignant transformation has been reported, evidenced by regional or distant metastases. Malignant transformation of PTT is often confused with squamous cell carcinoma. PTT usually occur as a solitary lesion on the scalp. It was first described as a proliferating epidermoid cyst by Wilson-Jones in 1966. Case description A female patient presented with a growing lesion on scalp in the right parietal region. She had already undergone excision for the same 8 months ago. The cyst was surgically removed and scalp was treated with electron therapy using a field dimension of 8×8 cm in 2011. Now, the patient is disease free with good quality of life. Conclusion Oncologists can consider electron therapy in management of PTT. This can improve cosmesis and quality of life of these patients.
    Journal of Radiotherapy in Practice 05/2015; 14(3). DOI:10.1017/S1460396915000229
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    ABSTRACT: Background There is no consensus on how long the initiation of radiotherapy (RT) can be delayed after surgery without a negative impact on survival. Materials and methods We conducted a retrospective study of 278 patients with stage 0-II breast cancer, all of whom were treated with surgery and RT, with those at stages I-II also receiving chemotherapy. Patients were followed-up for 5 years after diagnosis to assess disease-free and overall survival.The independent variable was the delay in the initiation of RT, assessed by two criteria: time since the last treatment, considered acceptable if ≤6 weeks, and time since surgery, considered acceptable if ≤7 months, these cut-offs being used to categorise patients into two groups according to the length of delay. Results No statistically significant differences were observed in the probability of disease-free survival (p=0·412) or overall survival (p=0·890). The appearance of recurrence was 5-59 months, with an average of 38·50 (14·31). Conclusions Delaying the initiation of RT for more than 6 weeks after last treatment does not seem to have a negative impact on disease-free or overall survival.
    Journal of Radiotherapy in Practice 03/2015; 14(3):244-251. DOI:10.1017/S1460396915000230
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    ABSTRACT: Background Monte Carlo (MC) simulations have been used extensively for benchmarking photon dose calculations in modern radiotherapy using linear accelerators (linacs). Moreover, a major barrier to widespread clinical implementation of MC dose calculation is the difficulty in characterising the radiation source using data reported from manufacturers. Purpose This work aims to develop a generalised full MC histogram source model of an Elekta Precise SL-25 linac (electron exit window, target, flattening filter, monitor chambers and collimators) for 6 MV photon beams used in standard therapies. The inclusion of many different probability processes such as scatter, nuclear reactions, decay, capture cross-sections and more led to more realistic dose calculations in treatment planning and quality assurance. Materials and methods Two different codes, MCNPX 2·6 and EGSr-BEAM, were used for the calculation of particle transport, first in the geometry of the internal/external accelerator source, and then followed by tracking the transport and energy deposition in phantom-equivalent tissues. A full phase space file was scored directly above the upper multilayer collimator's jaws to derive the beam characteristics such as planar fluence, angular distribution and energy spectrum. To check the quality of the generated photon beam, its depth dose curves and cross-beam profiles were calculated and compared with measured data. Results In-field dose distributions calculated using the accelerator models were tuned to match measurement data with preliminary calculations performed using the accelerator information provided by the manufacturer. Field sizes of 3×3, 5×5, 10×10, 15×15 and 20×20 cm2 were analysed. Local differences between calculated and measured curve doses beneath 2% were obtained for all the studied field sizes. Higher discrepancies were obtained in the air-water interface, where measurements of dose distributions with the ionisation chamber need to be shifted for the effective point of measurement. Conclusion The agreements between MC-calculated and measured dose distributions were excellent for both codes, showing the strength and stability of the proposed model. Beam reconstruction methods as direct input to dose-calculation codes using the recorded histograms can be implemented for more accurate patient dose estimation.
    Journal of Radiotherapy in Practice 03/2015; 14(3):311-322. DOI:10.1017/S146039691500014X
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    ABSTRACT: Background and purpose Accurate delineation of the target volume and organs at risk (OARs) are vital to ensure systematic errors are small. The use of contrast agents (CAs) in the bladder and rectum may aid contouring and reduce inter and intra-observer variability. The aim of this study was to evaluate the dosimetric effect of the presence of such contrast on the monitor units (MUs), planning target volume (PTV), rectum and bladder.Materials and methods The prostate, seminal vesicles, rectum and bladder were contoured by a single observer on ten patients with bladder and rectal contrast. To evaluate the dosimetric effect of the presence of contrast, the density of the ten patients with contrast in the bladder and rectum was virtually changed to 1 g/cm3. A four-field 15 MV conformal radiation therapy technique was applied in which dose volume histograms and MUs were compared using computed tomographic (CT) density and the 1 g/cm3 density.Results The presence of contrast resulted in a 0·09% (<1 MU) increase in anterior MUs and decrease of 1% (<1 MU) in the posterior beam MUs. Lateral beams were not affected. The PTV and bladder dose increased slightly without contrast. The rectum showed a maximum change of 0·62% dose among the measured dose values. A maximum dose of 0·3 Gy at the 30% volume was also seen.Conclusions The dosimetric effect of bladder and rectal CAs on MUs, dose to the PTV and OARs in using this technique was very small. This would not be clinically significant, but only if the extreme limits of dose volume constraints were being reached.
    Journal of Radiotherapy in Practice 12/2013; 12(04). DOI:10.1017/S1460396912000428
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    ABSTRACT: Background and purpose To assess the reliability of post-implant CT (PICT) dosimetry for I-125 prostate seed brachytherapy by investigating the variation between centres in performing PICT through a multi-centre audit.Materials and methods Computerised tomography data sets from four I-125 prostate brachytherapy patients were circulated to nine participating centres. Centres followed local protocol for PICT outlining and seed identification, dosimetry for D90, V100 and V150 for the prostate was reported. Outlines were compared to determine the variation in: quality parameters (D90, V100 and V150), dose-volume histograms and approach to PICT dosimetry between the centres.Results There was significant variation in the prostate outlines drawn by the nine centres; for a prostate with mean volume 43 cm3, the range was 39–57 cm3 which led to variations of D90 of 119–154 Gy (mean 140 Gy) and V100 of 80–93% (mean of 88%). Using automatic seedfinder software reduced discrepancies between centres identifying seeds; overall consistency in seed location was good.Conclusions There was a significant uncertainty in the outlining of the prostate volume for PICT dosimetry with an uncertainty value of around ± 20 Gy on D90. PICT is a valuable technique but its accuracy and consistency limitations must be appreciated.
    Journal of Radiotherapy in Practice 12/2013; 12(04). DOI:10.1017/S1460396912000489
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    ABSTRACT: Background Radiotherapy departments are having to work more efficiently to cope with increasing demand for radiotherapy resources. Radiotherapy treatment room efficiency may be increased by the introduction of hospital clothing as this negates the need for patient changing in the treatment room. However, studies have shown that hospital clothing can have a negative effect on patient dignity. It is therefore important to balance potential time saving with any detriment to patients.Purpose This study examined the effect that hospital clothing had on the time patients spend in the treatment room and aimed to identify patients’ opinions of the clothing.Materials and methods Potential time saving was determined by covertly timing patients currently undergoing radiotherapy treatment as they entered and exited the treatment room. A total of 348 patients were timed in their own clothing and 341 were timed when they wore hospital clothing. The timings of these two groups were compared to determine whether hospital clothing saved treatment unit time. Patient opinions of the clothing were examined by issuing a short questionnaire, designed to gather ordinal data, at the end of their course of treatment. Questionnaires were issued only to patients who had worn hospital clothing in the radiotherapy department.Results Introducing hospital clothing saved a significant amount of treatment room time and patients were generally positive about wearing the clothing.Conclusion It is suggested that hospital clothing is a welcome addition to the radiotherapy department to increase efficiency without detriment to patients.
    Journal of Radiotherapy in Practice 12/2013; 12(04). DOI:10.1017/S1460396912000477
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    ABSTRACT: Purpose To analyse interfraction setup using two different image guidance modalities for prostate and head-and-neck (H&N) cancer treatment.Materials and methods Seventy-two prostate and 60 H&N cancer patients, imaged with kilovoltage cone beam computed tomography (KVCBCT) or megavoltage fan beam computed tomography (MVFBCT), were studied retrospectively. The daily displacements in mediolateral (ML), craniocaudal (CC) and anteroposterior (AP) dimensions were investigated. The setup errors were calculated to determine the clinical target volume to planning target volume (CTV-to-PTV) margins.Results Based on 1,606 KVCBCT and 2,054 MVFBCT scans, average interfraction shifts in ML, CC and AP direction for H&N cases were 0·5 ± 1·5, −0·3 ± 2·0, 0·3 ± 1·7 mm using KVCBCT, 0·2 ± 1·9, −0·2 ± 2·4 and 0·0 ± 1·7 mm using MVFBCT. For prostate cases, average interfraction displacements were −0·3 ± 3·9, 0·2 ± 2·4, 0·4 ± 3·8 mm for MVFBCT and −0·2 ± 2·7, −0·6 ± 2·9, −0·5 ± 3·4 mm for KVCBCT. The calculated CTV-to-PTV margins, if determined by image-guided radiotherapy (IGRT) data, were 5·6 mm (H&N) and 7·8 mm (prostate) for MVFBCT, compared with 4·8 mm and 7·2 mm for KVCBCT. We observed no statistically significant difference in daily repositioning using KVCBCT and MVFBCT in early, middle and late stages of the treatment course.Conclusion In the absence of IGRT, the CTV-to-PTV margin determined using IGRT data, may be varied for different imaging modalities for prostate and H&N irradiation.
    Journal of Radiotherapy in Practice 12/2013; 12(04). DOI:10.1017/S1460396912000337