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102. Heart dose and cardiac comorbidities influence death with a cardiac cause following hypofractionated radiotherapy for lung cancer

Author

Banfill, Kathryn, Abravan, Azadeh, van Herk, Marcel, Sun, Fei, Franks, Kevin, McWilliam, Alan, Faivre-Finn, Corinne, and Biomedical Engineering and Physics

Subjects
cardiac toxicity, Cancer Research, lung cancer, cardiac comorbidities, Oncology, dose constraint, radiotherapy
Abstract

BackgroundThere is increasing evidence of cardiac toxicity of thoracic radiotherapy however, it is difficult to draw conclusions on cardiac dose constraints due to the heterogeneity of published studies. Moreover, few studies record data on cause of death. The aim of this paper is to investigate the relationship between conventional cardiac dosimetric parameters and death with cardiac causes using data from the UK national cause of death registry.MethodsData on cancer diagnosis, treatment and cause of death following radical lung cancer radiotherapy were obtained from Public Health England for all patients treated at the Christie NHS Foundation Trust between 1/1/10 and 31/12/16. Individuals with metastatic disease and those who received multiple courses of thoracic radiotherapy where excluded. All patients who received > 45Gy in 20 fractions were included. Cardiac cause of death was defined as the following ICD-10 codes on death certificate: I20-I25; I30-I32; I34-I37; I40-I52. Cardiac V5Gy, V30Gy, V50Gy and mean heart dose (MHD) were extracted. Cumulative incidence of death with cardiac causes were plotted for each cardiac dosimetric parameter. Multi-variable Fine and Gray competing risk analysis was used to model predictors for cardiac death with non-cardiac death as a competing risk.ResultsCardiac dosimetric parameters were available for 967 individuals, 110 died with a cardiac cause (11.4%). Patients with a cardiac comorbidity had an increased risk of death with a cardiac cause compared with those without a cardiac comorbidity (2-year cumulative incidence 21.3% v 6.2%, pConclusionThe effect of cardiac radiation dose on cardiac-related death following thoracic radiotherapy is different in patients with and without cardiac comorbidities. Therefore patients’ cardiovascular risk factors should be identified and managed alongside radiotherapy for lung cancer.

Published
2022

105. The impact of an educational tool in cervix image registration across three imaging modalities

Author

Benson, Rebecca, primary, Rodgers, John, additional, Nelder, Claire, additional, Clough, Abigael, additional, Pitt, Eleanor, additional, Parker, Jacqui, additional, Whiteside, Lee, additional, Davies, Lucy, additional, Bailey, Rachael, additional, McMahon, John, additional, Kolbe, Hope, additional, Cree, Anthea, additional, Dubec, Michael, additional, Van Herk, Marcel, additional, Choudhury, Ananya, additional, Hoskin, Peter, additional, and Eccles, Cynthia, additional

Published
2022
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111. On-the-Fly Motion-Compensated Cone-Beam CT Using an a Priori Motion Model

Author

Rit, Simon, Wolthaus, Jochem, van Herk, Marcel, Sonke, Jan-Jakob, Hutchison, David, editor, Kanade, Takeo, editor, Kittler, Josef, editor, Kleinberg, Jon M., editor, Mattern, Friedemann, editor, Mitchell, John C., editor, Naor, Moni, editor, Nierstrasz, Oscar, editor, Pandu Rangan, C., editor, Steffen, Bernhard, editor, Sudan, Madhu, editor, Terzopoulos, Demetri, editor, Tygar, Doug, editor, Vardi, Moshe Y., editor, Weikum, Gerhard, editor, Metaxas, Dimitris, editor, Axel, Leon, editor, Fichtinger, Gabor, editor, and Székely, Gábor, editor

Published
2008
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115. Predicting cancer relapse following lung stereotactic radiotherapy: an external validation study using real-world evidence.

Author

Davey, Angela, Thor, Maria, van Herk, Marcel, Faivre-Finn, Corinne, Rimner, Andreas, Deasy, Joseph O., and McWilliam, Alan

Subjects
CANCER relapse, STEREOTACTIC radiotherapy, PROPORTIONAL hazards models, NON-small-cell lung carcinoma, LUNGS
Abstract

Purpose: For patients receiving lung stereotactic ablative radiotherapy (SABR), evidence suggests that high peritumor density predicts an increased risk of microscopic disease (MDE) and local-regional failure, but only if there is low or heterogenous incidental dose surrounding the tumor (GTV). A data-mining method (Cox-per-radius) has been developed to investigate this dose-density interaction. We apply the method to predict local relapse (LR) and regional failure (RF) in patients with non-small cell lung cancer. Methods: 199 patients treated in a routine setting were collated from a single institution for training, and 76 patients from an external institution for validation. Three density metrics (mean, 90th percentile, standard deviation (SD)) were studied in 1mm annuli between 0.5cm inside and 2cm outside the GTV boundary. Dose SD and fraction of volume receiving less than 30Gy were studied in annuli 0.5-2cm outside the GTV to describe incidental MDE dosage. Heat-maps were created that correlate with changes in LR and RF rates due to the interaction between dose heterogeneity and density at each distance combination. Regions of significant improvement were studied in Cox proportional hazards models, and explored with and without re-fitting in external data. Correlations between the dose component of the interaction and common dose metrics were reported. Results: Local relapse occurred at a rate of 6.5% in the training cohort, and 18% in the validation cohort, which included larger and more centrally located tumors. High peritumor density in combination with high dose variability (0.5 - 1.6cm) predicts LR. No interactions predicted RF. The LR interaction improved the predictive ability compared to using clinical variables alone (optimism-adjusted C-index; 0.82 vs 0.76). Re-fitting model coefficients in external data confirmed the importance of this interaction (C-index; 0.86 vs 0.76). Dose variability in the 0.5-1.6 cm annular region strongly correlates with heterogeneity inside the target volume (SD; r = 0.53 training, r = 0.65 validation). Conclusion: In these real-world cohorts, the combination of relatively high peritumor density and high dose variability predicts increase in LR, but not RF, following lung SABR. This external validation justifies potential use of the model to increase low-dose CTV margins for high-risk patients. [ABSTRACT FROM AUTHOR]

Published
2023
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116. Dose outside of the prostate is associated with improved outcomes for high-risk prostate cancer patients treated with brachytherapy boost.

Author

Shortall, Jane, Osorio, Eliana Vasquez, Green, Andrew, McWilliam, Alan, Elumalai, Thriaviyam, Reeves, Kimberley, Johnson-Hart, Corinne, Beasley, William, Hoskin, Peter, Choudhury, Ananya, and van Herk, Marcel

Subjects
PROSTATE cancer patients, RADIOISOTOPE brachytherapy, INTENSITY modulated radiotherapy, PROSTATE, SEMINAL vesicles
Abstract

Background: One in three high-risk prostate cancer patients treated with radiotherapy recur. Detection of lymph node metastasis and microscopic disease spread using conventional imaging is poor, and many patients are under-treated due to suboptimal seminal vesicle or lymph node irradiation. We use Image Based Data Mining (IBDM) to investigate association between dose distributions, and prognostic variables and biochemical recurrence (BCR) in prostate cancer patients treated with radiotherapy. We further test whether including dose information in risk-stratification models improves performance. Method: Planning CTs, dose distributions and clinical information were collected for 612 high-risk prostate cancer patients treated with conformal hypofractionated radiotherapy, intensity modulated radiotherapy (IMRT), or IMRT plus a single fraction high dose rate (HDR) brachytherapy boost. Dose distributions (including HDR boost) of all studied patients were mapped to a reference anatomy using the prostate delineations. Regions where dose distributions significantly differed between patients that did and did-not experience BCR were assessed voxel-wise using 1) a binary endpoint of BCR at four-years (dose only) and 2) Cox-IBDM (dose and prognostic variables). Regions where dose was associated with outcome were identified. Cox proportionalhazard models with and without region dose information were produced and the Akaike Information Criterion (AIC) was used to assess model performance. Results: No significant regions were observed for patients treated with hypofractionated radiotherapy or IMRT. Regions outside the target where higher dose was associated with lower BCR were observed for patients treated with brachytherapy boost. Cox-IBDM revealed that dose response was influenced by age and T-stage. A region at the seminal vesicle tips was identified in binaryand Cox-IBDM. Including the mean dose in this region in a risk-stratification model (hazard ratio=0.84, p=0.005) significantly reduced AIC values (p=0.019), indicating superior performance, compared with prognostic variables only. The region dose was lower in the brachytherapy boost patients compared with the external beam cohorts supporting the occurrence of marginal misses. Conclusion: Association was identified between BCR and dose outside of the target region in high-risk prostate cancer patients treated with IMRT plus brachytherapy boost. We show, for the first-time, that the importance of irradiating this region is linked to prognostic variables. [ABSTRACT FROM AUTHOR]

Published
2023
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117. Imaging for IMRT

Author

Remeijer, Peter, van Herk, Marcel, Bortfeld, Thomas, editor, Schmidt-Ullrich, Rupert, editor, De Neve, Wilfried, editor, and Wazer, David E., editor

Published
2006
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122. Identifying predictive factors for treatment failure in early-stage non-small cell lung cancer patients treated with stereotactic body radiotherapy

Author

Davey, Angela, Thor, Maria, van Herk, Marcel, Faivre-Finn, Corinne, Rimner, Andreas, Deasy, Joseph, and McWilliam, Alan

Subjects
lung cancer, SBRT, Physical Sciences and Mathematics, Medicine and Health Sciences, biomarkers, imaging, outcome modelling, radiotherapy, SABR
Abstract

The primary goal is to validate prediction models of treatment failure following stereotactic radiotherapy (SABR) for patients with early-stage non-small cell lung cancer (NSCLC). Models include clinical variables, tumour and peritumour biomarkers on pre-treatment computed tomography (CT), and dosimetric parameters, and account for spatial interactions between biomarkers and dose.

Published
2022
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126. Causal relation between heart irradiation and survival of lung cancer patients after radiotherapy

Author

Brink, Carsten, primary, Bernchou, Uffe, additional, Bertelsen, Anders, additional, Hansen, Olfred, additional, Schytte, Tine, additional, Hjelmborg, Jacob v.B., additional, Holloway, Lois, additional, van Herk, Marcel, additional, Johnson-Hart, Corinne, additional, Price, Gareth J., additional, Aznar, Marianne C., additional, McWilliam, Alan, additional, Faivre-Finn, Corinne, additional, and Hansen, Christian R., additional

Published
2022
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130. 443 Exploring Impact of Dose Deposition and Breast Composition on Acute Breast Oedema after Radiotherapy

Author

Jaikuna, Tanwiwat, Azria, David, Chang-Claude, Jenny, De Santis, Maria Carmen, Gutiérrez-Enríque, Sara, van Herk, Marcel, Hoskin, Peter, Lambrecht, Maarten, Seibold, Petra, Seoane, Alejandro, Sperk, Elena, Symonds, R. Paul, Talbot, Christopher J., Rancati, Tiziana, Rattay, Tim, Reyes, Victoria, Rosenstein, Barry S., de Ruysscher, Dirk, Vega, Ana, Veldeman, Liv, Webb, Adam, West, Catharine M.L., Osorio, Eliana Vasquez, and Aznar, Marianne C.

Published
2024
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131. Image Guided Radiotherapy of the Prostate

Author

Jaffray, David, van Herk, Marcel, Lebesque, Joos, Martinez, Alvaro, Goos, Gerhard, editor, Hartmanis, Juris, editor, van Leeuwen, Jan, editor, Niessen, Wiro J., editor, and Viergever, Max A., editor

Published
2001
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134. Imaging biomarker roadmap for cancer studies

Author

OʼConnor, James P. B., Aboagye, Eric O., Adams, Judith E., Aerts, Hugo J. W. L., Barrington, Sally F., Beer, Ambros J., Boellaard, Ronald, Bohndiek, Sarah E., Brady, Michael, Brown, Gina, Buckley, David L., Chenevert, Thomas L., Clarke, Laurence P., Collette, Sandra, Cook, Gary J., deSouza, Nandita M., Dickson, John C., Dive, Caroline, Evelhoch, Jeffrey L., Faivre-Finn, Corinne, Gallagher, Ferdia A., Gilbert, Fiona J., Gillies, Robert J., Goh, Vicky, Griffiths, John R., Groves, Ashley M., Halligan, Steve, Harris, Adrian L., Hawkes, David J., Hoekstra, Otto S., Huang, Erich P., Hutton, Brian F., Jackson, Edward F., Jayson, Gordon C., Jones, Andrew, Koh, Dow-Mu, Lacombe, Denis, Lambin, Philippe, Lassau, Nathalie, Leach, Martin O., Lee, Ting-Yim, Leen, Edward L., Lewis, Jason S., Liu, Yan, Lythgoe, Mark F., Manoharan, Prakash, Maxwell, Ross J., Miles, Kenneth A., Morgan, Bruno, Morris, Steve, Ng, Tony, Padhani, Anwar R., Parker, Geoff J. M., Partridge, Mike, Pathak, Arvind P., Peet, Andrew C., Punwani, Shonit, Reynolds, Andrew R., Robinson, Simon P., Shankar, Lalitha K., Sharma, Ricky A., Soloviev, Dmitry, Stroobants, Sigrid, Sullivan, Daniel C., Taylor, Stuart A., Tofts, Paul S., Tozer, Gillian M., van Herk, Marcel, Walker-Samuel, Simon, Wason, James, Williams, Kaye J., Workman, Paul, Yankeelov, Thomas E., Brindle, Kevin M., McShane, Lisa M., Jackson, Alan, and Waterton, John C.

Published
2017
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139. In Reply to Ebert et al.

Author

Shortall, Jane, primary, Palma, Giuseppe, additional, Mistry, Hitesh, additional, Osorio, Eliana Vasquez, additional, McWilliam, Alan, additional, Choudhury, Ananya, additional, Aznar, Marianne, additional, van Herk, Marcel, additional, and Green, Andrew, additional

Published
2022
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