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1. Referral for “Neoadjuvant Chemotherapy” for Muscle-Invasive Bladder Cancer to a Multidisciplinary Board: Patterns, Management and Outcomes

Author

Dellis A, Zakopoulou R, Kougioumtzopoulou A, Tzannis K, Koutsoukos K, Fragkoulis C, Kostouros E, Papatsoris A, Varkarakis I, Stravodimos K, Boutati E, Pagoni S, Seferlis M, Chrisofos M, Kouloulias V, Ntoumas K, Deliveliotis C, Constantinides C, Dimopoulos MA, and Bamias A

Subjects
bladder cancer, neoadjuvant, chemotherapy, cystectomy, radiotherapy, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Athanasios Dellis,1 Roubini Zakopoulou,2 Andromahi Kougioumtzopoulou,3 Kimon Tzannis,2 Konstantinos Koutsoukos,2 Charalampos Fragkoulis,4 Efthymios Kostouros,5 Athanasios Papatsoris,6 Ioannis Varkarakis,6 Konstantinos Stravodimos,7 Eleni Boutati,8 Stamata Pagoni,5 Miltiadis Seferlis,9 Michael Chrisofos,10 Vasilios Kouloulias,3 Konstantinos Ntoumas,4 Charalambos Deliveliotis,6 Constantine Constantinides,7 Meletios A Dimopoulos,2 Aristotelis Bamias8 1 2nd Department of Surgery, National & Kapodistrian University of Athens, Aretaieion University Hospital, Athens, Greece; 2Oncology Unit, Department of Clinical Therapeutics, National & Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece; 3Radiotherapy Unit, 2nd Department of Radiology, National & Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece; 4Department of Urology, General Hospital of Athens “G. Gennimatas”, Athens, Greece; 5 3rd Department of Internal Medicine, General Hospital of Athens “G. Gennimatas”, Athens, Greece; 6 2nd Department of Urology, National & Kapodistrian University of Athens, Sismanoglio Hospital, Athens, Greece; 7First Department of Urology, National and Kapodistrian University of Athens, “Laiko” General Hospital, Athens, Greece; 8 2nd Propaedeutic Department of Internal Medicine, National & Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece; 9Department of Urology, Thriasion General Hospital, Athens, Greece; 10 3rd Department of Urology, National & Kapodistrian University of Athens, Attikon University Hospital, Athens, GreeceCorrespondence: Aristotelis Bamias 2nd Propaedeutic Department of Internal Medicine, National & Kapodistrian University of Athens, Attikon University Hospital, Athens, GreeceTel +30 2105831256 Fax +30 210 5326454Email abamias@med.uoa.grBackground: Utilization of neoadjuvant chemotherapy for the treatment of muscle invasive bladder cancer in everyday practice differs from that of clinical trials. We describe the patterns of referral for “neoadjuvant chemotherapy”, treatment and outcomes in a multidisciplinary tumor board.Methods: This was an observational study. Patients referred for neoadjuvant chemotherapy received 4 cycles of dose-dense gemcitabine/cisplatin and were then assessed for definitive local therapy. Patients had a minimum follow-up of 2 years. Primary objective was a 3-year disease-free survival rate.Results: Forty-six patients (clinical stages II: 28, IIIA: 9, IIIB: 4, IVA: 3, missing: 2) were included. Following chemotherapy, 30 underwent radical cystectomy, 8 radiotherapy and 8 no further therapy. Pathological downstaging was observed in 14 (46.6%) of the 30 patients who underwent radical cystectomy; clinical TNM staging was correlated with disease-free survival in the whole population, while clinical and pathological stages, as well as pathological downstaging, were correlated with disease-free survival in patients undergoing radical cystectomy. Three-year disease-free survival rates for the whole cohort and for patients undergoing radical cystectomy were 67.3% (95% confidence interval [CI]: 51– 79.2) and 65.2 (95% CI: 44.9– 79.6), respectively.Conclusion: Real-world muscle invasive bladder cancer patients who receive neoadjuvant chemotherapy are characterized by more advanced diseases and less frequent radical surgery than those included in clinical trials. Nevertheless, outcomes were comparable and, therefore, offering patients with stage II–IVA muscle invasive bladder cancer neoadjuvant chemotherapy after assessment by multidisciplinary tumor boards should be strongly encouraged.Keywords: bladder cancer, neoadjuvant, chemotherapy, cystectomy, radiotherapy

Published
2021

2. Unravelling Quality of Life for Head and Neck Cancer Patients after VMAT Radiation Therapy: Insights from Toxicity, Dosimetry and Symptoms Correlation

Author

Panagiota Kiafi, Maria Anthi Kouri, Georgios Patatoukas, Andromachi Kougioumtzopoulou, Marina Chalkia, Ourania Nicolatou-Galitis, Vassilis Kouloulias, Efthimios Kyrodimos, and Kalliopi Platoni

Subjects
quality of life, EORTC QLQ-C30, EORTC QLQ-H&N35, head and neck cancer, dosimetric toxicity, symptoms and toxicity, Medicine (General), R5-920
Abstract

(1) Background: Head and neck cancer treatment, including advanced techniques like Volumetric Modulated Arc Therapy (VMAT), presents challenges for maintaining patient quality of life (QoL). Thus, thoroughly investigating how radiation therapy (RT) affects patients has been proved essential. Derived by that, this study aims to understand the complex interactions between not only RT and QoL but also symptom severity, and treatment-related toxicities in three distinct time points of patient’s treatment; (2) Methods: To achieve that, EORTC-QLQ-C30 and EORTC QLQ-H&N35 questionnaires were used in combination with EORTC_RTOG scoring criteria and Spearman’s rho statistical analysis for 74 patients with cancer undergoing VMAT radiation therapy; (3) Results: The results revealed a significant improvement in the Overall Health Index post-treatment, indicating a temporary decline during therapy followed by subsequent recovery, often surpassing pre-treatment QoL levels. Concurrently a reduction in symptomatology was observed, notably in pain, swallowing difficulties, and dry mouth, aligning with prior research indicating decreased symptom burden post-treatment. However, Spearman’s correlation coefficient analysis at two distinct time points during therapy uncovered varying degrees of correlation between dosimetric data at Organs at Risk (OARs) and reported symptoms, highlighting potential limitations in using QoL questionnaires as sole indicators of treatment efficacy. Our investigation into the correlation between dosimetric data, toxicity, and symptoms focused on the relationship between radiation doses and oral mucositis levels, a common toxicity in head and neck cancer patients. Significant associations were identified between toxicity levels and dosimetric parameters, particularly with OARs such as the parotid glands, oral cavity, and swallowing muscles, underlining the utility of the EORTC method as a reliable toxicity assessment tool; (4) Conclusions: To summarize, current research attempts to underscore the importance of refining QoL assessments for enhanced patient care. The integration of dosimetric data, symptom severity, and treatment-related toxicities in the QoL outcomes of head and neck cancer patients undergoing VMAT radiation therapy, can lead towards the optimization of treatment strategies and the improvement of patient outcomes in future patient-centered radiation therapy practices.

Published
2024
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4. Radiotherapy and Testicular Function: A Comprehensive Review of the Radiation-Induced Effects with an Emphasis on Spermatogenesis

Author

Ioannis Georgakopoulos, Vassilios Kouloulias, Georgios-Nikiforos Ntoumas, Dimitra Desse, Ioannis Koukourakis, Andromachi Kougioumtzopoulou, George Kanakis, and Anna Zygogianni

Subjects
radiation, radiotherapy, testicular function, spermatogenesis, male fertility, Biology (General), QH301-705.5
Abstract

This comprehensive review explores the existing literature on the effects of radiotherapy on testicular function, focusing mainly on spermatogenic effects, but also with a brief report on endocrine abnormalities. Data from animal experiments as well as results on humans either from clinical studies or from accidental radiation exposure are included to demonstrate a complete perspective on the level of vulnerability of the testes and their various cellular components to irradiation. Even relatively low doses of radiation, produced either from direct testicular irradiation or more commonly from scattered doses, may often lead to detrimental effects on sperm count and quality. Leydig cells are more radioresistant; however, they can still be influenced by the doses used in clinical practice. The potential resultant fertility complications of cancer radiotherapy should be always discussed with the patient before treatment initiation, and all available and appropriate fertility preservation measures should be taken to ensure the future reproductive potential of the patient. The topic of potential hereditary effects of germ cell irradiation remains a controversial field with ethical implications, requiring future research.

Published
2024
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5. Unravelling Quality of Life for Head and Neck Cancer Patients after VMAT Radiation Therapy: Insights from Toxicity, Dosimetry and Symptoms Correlation

Author

Kiafi, Panagiota, primary, Kouri, Maria Anthi, additional, Patatoukas, Georgios, additional, Kougioumtzopoulou, Andromachi, additional, Chalkia, Marina, additional, Nicolatou-Galitis, Ourania, additional, Kouloulias, Vassilis, additional, Kyrodimos, Efthimios, additional, and Platoni, Kalliopi, additional

Published
2024
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6. Comprehensive 3DCRT Hypofractionated Radiotherapy Schedule for Localized Prostate Adenocarcinoma in the Era of IMRT: Dosimetric and Endoscopic Analysis

Author

Kougioumtzopoulou, Andromachi, primary, Syrigos, Nick, additional, Zygogianni, Anna, additional, Georgakopoulos, Ioannis, additional, Platoni, Kalliopi, additional, Patatoukas, George, additional, Tzannis, Kimon, additional, Bamias, Aristotelis, additional, Kelekis, Nikolaos, additional, and Kouloulias, Vasileios, additional

Published
2024
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9. Radiotherapy and Testicular Function: A Comprehensive Review of the Radiation-Induced Effects with an Emphasis on Spermatogenesis.

Author

Georgakopoulos, Ioannis, Kouloulias, Vassilios, Ntoumas, Georgios-Nikiforos, Desse, Dimitra, Koukourakis, Ioannis, Kougioumtzopoulou, Andromachi, Kanakis, George, and Zygogianni, Anna

Subjects
TESTIS physiology, LEYDIG cells, CELL anatomy, RADIATION exposure, FERTILITY preservation
Abstract

This comprehensive review explores the existing literature on the effects of radiotherapy on testicular function, focusing mainly on spermatogenic effects, but also with a brief report on endocrine abnormalities. Data from animal experiments as well as results on humans either from clinical studies or from accidental radiation exposure are included to demonstrate a complete perspective on the level of vulnerability of the testes and their various cellular components to irradiation. Even relatively low doses of radiation, produced either from direct testicular irradiation or more commonly from scattered doses, may often lead to detrimental effects on sperm count and quality. Leydig cells are more radioresistant; however, they can still be influenced by the doses used in clinical practice. The potential resultant fertility complications of cancer radiotherapy should be always discussed with the patient before treatment initiation, and all available and appropriate fertility preservation measures should be taken to ensure the future reproductive potential of the patient. The topic of potential hereditary effects of germ cell irradiation remains a controversial field with ethical implications, requiring future research. [ABSTRACT FROM AUTHOR]

Published
2024
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13. FIGURE 4 from Phase II Window Study of Olaparib Alone or with Cisplatin or Durvalumab in Operable Head and Neck Cancer

Author

Moutafi, Myrto, primary, Koliou, Georgia-Angeliki, primary, Papaxoinis, George, primary, Economopoulou, Panagiota, primary, Kotsantis, Ioannis, primary, Gkotzamanidou, Maria, primary, Anastasiou, Maria, primary, Pectasides, Dimitrios, primary, Kyrodimos, Efthymios, primary, Delides, Alexander, primary, Giotakis, Evangelos, primary, Papadimitriou, Nikolaos G., primary, Panayiotides, Ioannis G., primary, Perisanidis, Christos, primary, Fernandez, Aileen I., primary, Xirou, Vasiliki, primary, Poulios, Christos, primary, Gagari, Eleni, primary, Yaghoobi, Vesal, primary, Gavrielatou, Niki, primary, Shafi, Saba, primary, Aung, Thazin Nwe, primary, Kougioumtzopoulou, Andromachi, primary, Kouloulias, Vassilis, primary, Palialexis, Konstantinos, primary, Gkolfinopoulos, Stavros, primary, Strati, Areti, primary, Lianidou, Evi, primary, Fountzilas, George, primary, Rimm, David L., primary, Foukas, Periklis G., primary, and Psyrri, Amanda, primary

Published
2023
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14. FIGURE 3 from Phase II Window Study of Olaparib Alone or with Cisplatin or Durvalumab in Operable Head and Neck Cancer

Author

Moutafi, Myrto, primary, Koliou, Georgia-Angeliki, primary, Papaxoinis, George, primary, Economopoulou, Panagiota, primary, Kotsantis, Ioannis, primary, Gkotzamanidou, Maria, primary, Anastasiou, Maria, primary, Pectasides, Dimitrios, primary, Kyrodimos, Efthymios, primary, Delides, Alexander, primary, Giotakis, Evangelos, primary, Papadimitriou, Nikolaos G., primary, Panayiotides, Ioannis G., primary, Perisanidis, Christos, primary, Fernandez, Aileen I., primary, Xirou, Vasiliki, primary, Poulios, Christos, primary, Gagari, Eleni, primary, Yaghoobi, Vesal, primary, Gavrielatou, Niki, primary, Shafi, Saba, primary, Aung, Thazin Nwe, primary, Kougioumtzopoulou, Andromachi, primary, Kouloulias, Vassilis, primary, Palialexis, Konstantinos, primary, Gkolfinopoulos, Stavros, primary, Strati, Areti, primary, Lianidou, Evi, primary, Fountzilas, George, primary, Rimm, David L., primary, Foukas, Periklis G., primary, and Psyrri, Amanda, primary

Published
2023
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15. Supplementary Figure 2 from Phase II Window Study of Olaparib Alone or with Cisplatin or Durvalumab in Operable Head and Neck Cancer

Author

Moutafi, Myrto, primary, Koliou, Georgia-Angeliki, primary, Papaxoinis, George, primary, Economopoulou, Panagiota, primary, Kotsantis, Ioannis, primary, Gkotzamanidou, Maria, primary, Anastasiou, Maria, primary, Pectasides, Dimitrios, primary, Kyrodimos, Efthymios, primary, Delides, Alexander, primary, Giotakis, Evangelos, primary, Papadimitriou, Nikolaos G., primary, Panayiotides, Ioannis G., primary, Perisanidis, Christos, primary, Fernandez, Aileen I., primary, Xirou, Vasiliki, primary, Poulios, Christos, primary, Gagari, Eleni, primary, Yaghoobi, Vesal, primary, Gavrielatou, Niki, primary, Shafi, Saba, primary, Aung, Thazin Nwe, primary, Kougioumtzopoulou, Andromachi, primary, Kouloulias, Vassilis, primary, Palialexis, Konstantinos, primary, Gkolfinopoulos, Stavros, primary, Strati, Areti, primary, Lianidou, Evi, primary, Fountzilas, George, primary, Rimm, David L., primary, Foukas, Periklis G., primary, and Psyrri, Amanda, primary

Published
2023
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16. Supplementary Table 5 from Phase II Window Study of Olaparib Alone or with Cisplatin or Durvalumab in Operable Head and Neck Cancer

Author

Moutafi, Myrto, primary, Koliou, Georgia-Angeliki, primary, Papaxoinis, George, primary, Economopoulou, Panagiota, primary, Kotsantis, Ioannis, primary, Gkotzamanidou, Maria, primary, Anastasiou, Maria, primary, Pectasides, Dimitrios, primary, Kyrodimos, Efthymios, primary, Delides, Alexander, primary, Giotakis, Evangelos, primary, Papadimitriou, Nikolaos G., primary, Panayiotides, Ioannis G., primary, Perisanidis, Christos, primary, Fernandez, Aileen I., primary, Xirou, Vasiliki, primary, Poulios, Christos, primary, Gagari, Eleni, primary, Yaghoobi, Vesal, primary, Gavrielatou, Niki, primary, Shafi, Saba, primary, Aung, Thazin Nwe, primary, Kougioumtzopoulou, Andromachi, primary, Kouloulias, Vassilis, primary, Palialexis, Konstantinos, primary, Gkolfinopoulos, Stavros, primary, Strati, Areti, primary, Lianidou, Evi, primary, Fountzilas, George, primary, Rimm, David L., primary, Foukas, Periklis G., primary, and Psyrri, Amanda, primary

Published
2023
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17. Supplementary Table 1 from Phase II Window Study of Olaparib Alone or with Cisplatin or Durvalumab in Operable Head and Neck Cancer

Author

Moutafi, Myrto, primary, Koliou, Georgia-Angeliki, primary, Papaxoinis, George, primary, Economopoulou, Panagiota, primary, Kotsantis, Ioannis, primary, Gkotzamanidou, Maria, primary, Anastasiou, Maria, primary, Pectasides, Dimitrios, primary, Kyrodimos, Efthymios, primary, Delides, Alexander, primary, Giotakis, Evangelos, primary, Papadimitriou, Nikolaos G., primary, Panayiotides, Ioannis G., primary, Perisanidis, Christos, primary, Fernandez, Aileen I., primary, Xirou, Vasiliki, primary, Poulios, Christos, primary, Gagari, Eleni, primary, Yaghoobi, Vesal, primary, Gavrielatou, Niki, primary, Shafi, Saba, primary, Aung, Thazin Nwe, primary, Kougioumtzopoulou, Andromachi, primary, Kouloulias, Vassilis, primary, Palialexis, Konstantinos, primary, Gkolfinopoulos, Stavros, primary, Strati, Areti, primary, Lianidou, Evi, primary, Fountzilas, George, primary, Rimm, David L., primary, Foukas, Periklis G., primary, and Psyrri, Amanda, primary

Published
2023
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18. Supplementary Figure 4 from Phase II Window Study of Olaparib Alone or with Cisplatin or Durvalumab in Operable Head and Neck Cancer

Author

Moutafi, Myrto, primary, Koliou, Georgia-Angeliki, primary, Papaxoinis, George, primary, Economopoulou, Panagiota, primary, Kotsantis, Ioannis, primary, Gkotzamanidou, Maria, primary, Anastasiou, Maria, primary, Pectasides, Dimitrios, primary, Kyrodimos, Efthymios, primary, Delides, Alexander, primary, Giotakis, Evangelos, primary, Papadimitriou, Nikolaos G., primary, Panayiotides, Ioannis G., primary, Perisanidis, Christos, primary, Fernandez, Aileen I., primary, Xirou, Vasiliki, primary, Poulios, Christos, primary, Gagari, Eleni, primary, Yaghoobi, Vesal, primary, Gavrielatou, Niki, primary, Shafi, Saba, primary, Aung, Thazin Nwe, primary, Kougioumtzopoulou, Andromachi, primary, Kouloulias, Vassilis, primary, Palialexis, Konstantinos, primary, Gkolfinopoulos, Stavros, primary, Strati, Areti, primary, Lianidou, Evi, primary, Fountzilas, George, primary, Rimm, David L., primary, Foukas, Periklis G., primary, and Psyrri, Amanda, primary

Published
2023
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19. Supplementary Table 2 from Phase II Window Study of Olaparib Alone or with Cisplatin or Durvalumab in Operable Head and Neck Cancer

Author

Moutafi, Myrto, primary, Koliou, Georgia-Angeliki, primary, Papaxoinis, George, primary, Economopoulou, Panagiota, primary, Kotsantis, Ioannis, primary, Gkotzamanidou, Maria, primary, Anastasiou, Maria, primary, Pectasides, Dimitrios, primary, Kyrodimos, Efthymios, primary, Delides, Alexander, primary, Giotakis, Evangelos, primary, Papadimitriou, Nikolaos G., primary, Panayiotides, Ioannis G., primary, Perisanidis, Christos, primary, Fernandez, Aileen I., primary, Xirou, Vasiliki, primary, Poulios, Christos, primary, Gagari, Eleni, primary, Yaghoobi, Vesal, primary, Gavrielatou, Niki, primary, Shafi, Saba, primary, Aung, Thazin Nwe, primary, Kougioumtzopoulou, Andromachi, primary, Kouloulias, Vassilis, primary, Palialexis, Konstantinos, primary, Gkolfinopoulos, Stavros, primary, Strati, Areti, primary, Lianidou, Evi, primary, Fountzilas, George, primary, Rimm, David L., primary, Foukas, Periklis G., primary, and Psyrri, Amanda, primary

Published
2023
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20. Supplementary Materials and Methods from Phase II Window Study of Olaparib Alone or with Cisplatin or Durvalumab in Operable Head and Neck Cancer

Author

Moutafi, Myrto, primary, Koliou, Georgia-Angeliki, primary, Papaxoinis, George, primary, Economopoulou, Panagiota, primary, Kotsantis, Ioannis, primary, Gkotzamanidou, Maria, primary, Anastasiou, Maria, primary, Pectasides, Dimitrios, primary, Kyrodimos, Efthymios, primary, Delides, Alexander, primary, Giotakis, Evangelos, primary, Papadimitriou, Nikolaos G., primary, Panayiotides, Ioannis G., primary, Perisanidis, Christos, primary, Fernandez, Aileen I., primary, Xirou, Vasiliki, primary, Poulios, Christos, primary, Gagari, Eleni, primary, Yaghoobi, Vesal, primary, Gavrielatou, Niki, primary, Shafi, Saba, primary, Aung, Thazin Nwe, primary, Kougioumtzopoulou, Andromachi, primary, Kouloulias, Vassilis, primary, Palialexis, Konstantinos, primary, Gkolfinopoulos, Stavros, primary, Strati, Areti, primary, Lianidou, Evi, primary, Fountzilas, George, primary, Rimm, David L., primary, Foukas, Periklis G., primary, and Psyrri, Amanda, primary

Published
2023
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21. Supplementary Table 3 from Phase II Window Study of Olaparib Alone or with Cisplatin or Durvalumab in Operable Head and Neck Cancer

Author

Moutafi, Myrto, primary, Koliou, Georgia-Angeliki, primary, Papaxoinis, George, primary, Economopoulou, Panagiota, primary, Kotsantis, Ioannis, primary, Gkotzamanidou, Maria, primary, Anastasiou, Maria, primary, Pectasides, Dimitrios, primary, Kyrodimos, Efthymios, primary, Delides, Alexander, primary, Giotakis, Evangelos, primary, Papadimitriou, Nikolaos G., primary, Panayiotides, Ioannis G., primary, Perisanidis, Christos, primary, Fernandez, Aileen I., primary, Xirou, Vasiliki, primary, Poulios, Christos, primary, Gagari, Eleni, primary, Yaghoobi, Vesal, primary, Gavrielatou, Niki, primary, Shafi, Saba, primary, Aung, Thazin Nwe, primary, Kougioumtzopoulou, Andromachi, primary, Kouloulias, Vassilis, primary, Palialexis, Konstantinos, primary, Gkolfinopoulos, Stavros, primary, Strati, Areti, primary, Lianidou, Evi, primary, Fountzilas, George, primary, Rimm, David L., primary, Foukas, Periklis G., primary, and Psyrri, Amanda, primary

Published
2023
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22. Supplementary Figure 5 from Phase II Window Study of Olaparib Alone or with Cisplatin or Durvalumab in Operable Head and Neck Cancer

Author

Moutafi, Myrto, primary, Koliou, Georgia-Angeliki, primary, Papaxoinis, George, primary, Economopoulou, Panagiota, primary, Kotsantis, Ioannis, primary, Gkotzamanidou, Maria, primary, Anastasiou, Maria, primary, Pectasides, Dimitrios, primary, Kyrodimos, Efthymios, primary, Delides, Alexander, primary, Giotakis, Evangelos, primary, Papadimitriou, Nikolaos G., primary, Panayiotides, Ioannis G., primary, Perisanidis, Christos, primary, Fernandez, Aileen I., primary, Xirou, Vasiliki, primary, Poulios, Christos, primary, Gagari, Eleni, primary, Yaghoobi, Vesal, primary, Gavrielatou, Niki, primary, Shafi, Saba, primary, Aung, Thazin Nwe, primary, Kougioumtzopoulou, Andromachi, primary, Kouloulias, Vassilis, primary, Palialexis, Konstantinos, primary, Gkolfinopoulos, Stavros, primary, Strati, Areti, primary, Lianidou, Evi, primary, Fountzilas, George, primary, Rimm, David L., primary, Foukas, Periklis G., primary, and Psyrri, Amanda, primary

Published
2023
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23. Supplementary Figure 3 from Phase II Window Study of Olaparib Alone or with Cisplatin or Durvalumab in Operable Head and Neck Cancer

Author

Moutafi, Myrto, primary, Koliou, Georgia-Angeliki, primary, Papaxoinis, George, primary, Economopoulou, Panagiota, primary, Kotsantis, Ioannis, primary, Gkotzamanidou, Maria, primary, Anastasiou, Maria, primary, Pectasides, Dimitrios, primary, Kyrodimos, Efthymios, primary, Delides, Alexander, primary, Giotakis, Evangelos, primary, Papadimitriou, Nikolaos G., primary, Panayiotides, Ioannis G., primary, Perisanidis, Christos, primary, Fernandez, Aileen I., primary, Xirou, Vasiliki, primary, Poulios, Christos, primary, Gagari, Eleni, primary, Yaghoobi, Vesal, primary, Gavrielatou, Niki, primary, Shafi, Saba, primary, Aung, Thazin Nwe, primary, Kougioumtzopoulou, Andromachi, primary, Kouloulias, Vassilis, primary, Palialexis, Konstantinos, primary, Gkolfinopoulos, Stavros, primary, Strati, Areti, primary, Lianidou, Evi, primary, Fountzilas, George, primary, Rimm, David L., primary, Foukas, Periklis G., primary, and Psyrri, Amanda, primary

Published
2023
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24. Supplementary Table 4 from Phase II Window Study of Olaparib Alone or with Cisplatin or Durvalumab in Operable Head and Neck Cancer

Author

Moutafi, Myrto, primary, Koliou, Georgia-Angeliki, primary, Papaxoinis, George, primary, Economopoulou, Panagiota, primary, Kotsantis, Ioannis, primary, Gkotzamanidou, Maria, primary, Anastasiou, Maria, primary, Pectasides, Dimitrios, primary, Kyrodimos, Efthymios, primary, Delides, Alexander, primary, Giotakis, Evangelos, primary, Papadimitriou, Nikolaos G., primary, Panayiotides, Ioannis G., primary, Perisanidis, Christos, primary, Fernandez, Aileen I., primary, Xirou, Vasiliki, primary, Poulios, Christos, primary, Gagari, Eleni, primary, Yaghoobi, Vesal, primary, Gavrielatou, Niki, primary, Shafi, Saba, primary, Aung, Thazin Nwe, primary, Kougioumtzopoulou, Andromachi, primary, Kouloulias, Vassilis, primary, Palialexis, Konstantinos, primary, Gkolfinopoulos, Stavros, primary, Strati, Areti, primary, Lianidou, Evi, primary, Fountzilas, George, primary, Rimm, David L., primary, Foukas, Periklis G., primary, and Psyrri, Amanda, primary

Published
2023
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25. Supplementary Figure 6 from Phase II Window Study of Olaparib Alone or with Cisplatin or Durvalumab in Operable Head and Neck Cancer

Author

Moutafi, Myrto, primary, Koliou, Georgia-Angeliki, primary, Papaxoinis, George, primary, Economopoulou, Panagiota, primary, Kotsantis, Ioannis, primary, Gkotzamanidou, Maria, primary, Anastasiou, Maria, primary, Pectasides, Dimitrios, primary, Kyrodimos, Efthymios, primary, Delides, Alexander, primary, Giotakis, Evangelos, primary, Papadimitriou, Nikolaos G., primary, Panayiotides, Ioannis G., primary, Perisanidis, Christos, primary, Fernandez, Aileen I., primary, Xirou, Vasiliki, primary, Poulios, Christos, primary, Gagari, Eleni, primary, Yaghoobi, Vesal, primary, Gavrielatou, Niki, primary, Shafi, Saba, primary, Aung, Thazin Nwe, primary, Kougioumtzopoulou, Andromachi, primary, Kouloulias, Vassilis, primary, Palialexis, Konstantinos, primary, Gkolfinopoulos, Stavros, primary, Strati, Areti, primary, Lianidou, Evi, primary, Fountzilas, George, primary, Rimm, David L., primary, Foukas, Periklis G., primary, and Psyrri, Amanda, primary

Published
2023
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26. Data from Phase II Window Study of Olaparib Alone or with Cisplatin or Durvalumab in Operable Head and Neck Cancer

Author

Moutafi, Myrto, primary, Koliou, Georgia-Angeliki, primary, Papaxoinis, George, primary, Economopoulou, Panagiota, primary, Kotsantis, Ioannis, primary, Gkotzamanidou, Maria, primary, Anastasiou, Maria, primary, Pectasides, Dimitrios, primary, Kyrodimos, Efthymios, primary, Delides, Alexander, primary, Giotakis, Evangelos, primary, Papadimitriou, Nikolaos G., primary, Panayiotides, Ioannis G., primary, Perisanidis, Christos, primary, Fernandez, Aileen I., primary, Xirou, Vasiliki, primary, Poulios, Christos, primary, Gagari, Eleni, primary, Yaghoobi, Vesal, primary, Gavrielatou, Niki, primary, Shafi, Saba, primary, Aung, Thazin Nwe, primary, Kougioumtzopoulou, Andromachi, primary, Kouloulias, Vassilis, primary, Palialexis, Konstantinos, primary, Gkolfinopoulos, Stavros, primary, Strati, Areti, primary, Lianidou, Evi, primary, Fountzilas, George, primary, Rimm, David L., primary, Foukas, Periklis G., primary, and Psyrri, Amanda, primary

Published
2023
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27. FIGURE 2 from Phase II Window Study of Olaparib Alone or with Cisplatin or Durvalumab in Operable Head and Neck Cancer

Author

Moutafi, Myrto, primary, Koliou, Georgia-Angeliki, primary, Papaxoinis, George, primary, Economopoulou, Panagiota, primary, Kotsantis, Ioannis, primary, Gkotzamanidou, Maria, primary, Anastasiou, Maria, primary, Pectasides, Dimitrios, primary, Kyrodimos, Efthymios, primary, Delides, Alexander, primary, Giotakis, Evangelos, primary, Papadimitriou, Nikolaos G., primary, Panayiotides, Ioannis G., primary, Perisanidis, Christos, primary, Fernandez, Aileen I., primary, Xirou, Vasiliki, primary, Poulios, Christos, primary, Gagari, Eleni, primary, Yaghoobi, Vesal, primary, Gavrielatou, Niki, primary, Shafi, Saba, primary, Aung, Thazin Nwe, primary, Kougioumtzopoulou, Andromachi, primary, Kouloulias, Vassilis, primary, Palialexis, Konstantinos, primary, Gkolfinopoulos, Stavros, primary, Strati, Areti, primary, Lianidou, Evi, primary, Fountzilas, George, primary, Rimm, David L., primary, Foukas, Periklis G., primary, and Psyrri, Amanda, primary

Published
2023
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28. Supplementary Figure 1 from Phase II Window Study of Olaparib Alone or with Cisplatin or Durvalumab in Operable Head and Neck Cancer

Author

Moutafi, Myrto, primary, Koliou, Georgia-Angeliki, primary, Papaxoinis, George, primary, Economopoulou, Panagiota, primary, Kotsantis, Ioannis, primary, Gkotzamanidou, Maria, primary, Anastasiou, Maria, primary, Pectasides, Dimitrios, primary, Kyrodimos, Efthymios, primary, Delides, Alexander, primary, Giotakis, Evangelos, primary, Papadimitriou, Nikolaos G., primary, Panayiotides, Ioannis G., primary, Perisanidis, Christos, primary, Fernandez, Aileen I., primary, Xirou, Vasiliki, primary, Poulios, Christos, primary, Gagari, Eleni, primary, Yaghoobi, Vesal, primary, Gavrielatou, Niki, primary, Shafi, Saba, primary, Aung, Thazin Nwe, primary, Kougioumtzopoulou, Andromachi, primary, Kouloulias, Vassilis, primary, Palialexis, Konstantinos, primary, Gkolfinopoulos, Stavros, primary, Strati, Areti, primary, Lianidou, Evi, primary, Fountzilas, George, primary, Rimm, David L., primary, Foukas, Periklis G., primary, and Psyrri, Amanda, primary

Published
2023
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29. TABLE 1 from Phase II Window Study of Olaparib Alone or with Cisplatin or Durvalumab in Operable Head and Neck Cancer

Author

Moutafi, Myrto, primary, Koliou, Georgia-Angeliki, primary, Papaxoinis, George, primary, Economopoulou, Panagiota, primary, Kotsantis, Ioannis, primary, Gkotzamanidou, Maria, primary, Anastasiou, Maria, primary, Pectasides, Dimitrios, primary, Kyrodimos, Efthymios, primary, Delides, Alexander, primary, Giotakis, Evangelos, primary, Papadimitriou, Nikolaos G., primary, Panayiotides, Ioannis G., primary, Perisanidis, Christos, primary, Fernandez, Aileen I., primary, Xirou, Vasiliki, primary, Poulios, Christos, primary, Gagari, Eleni, primary, Yaghoobi, Vesal, primary, Gavrielatou, Niki, primary, Shafi, Saba, primary, Aung, Thazin Nwe, primary, Kougioumtzopoulou, Andromachi, primary, Kouloulias, Vassilis, primary, Palialexis, Konstantinos, primary, Gkolfinopoulos, Stavros, primary, Strati, Areti, primary, Lianidou, Evi, primary, Fountzilas, George, primary, Rimm, David L., primary, Foukas, Periklis G., primary, and Psyrri, Amanda, primary

Published
2023
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30. Phase II window study of olaparib alone or with cisplatin or durvalumab in operable Head and Neck Cancer

Author

Moutafi, Myrto, primary, Koliou, Georgia-Angeliki, additional, Papaxoinis, George, additional, Economopoulou, Panagiota, additional, Kotsantis, Ioannis, additional, Gkotzamanidou, Maria, additional, Anastasiou, Maria, additional, Pectasides, Dimitrios, additional, Kyrodimos, Efthymios, additional, Delides, Alexander, additional, Giotakis, Evangelos, additional, Papadimitriou, Nikolaos G., additional, Panayiotides, Ioannis G., additional, Perisanidis, Christos, additional, Fernandez, Aileen I., additional, Xirou, Vasiliki, additional, Poulios, Christos, additional, Gagari, Eleni, additional, Yaghoobi, Vesal, additional, Gavrielatou, Niki, additional, Shafi, Saba, additional, Aung, Thazin Nwe, additional, Kougioumtzopoulou, Andromachi, additional, Kouloulias, Vassilis, additional, Palialexis, Konstantinos, additional, Gkolfinopoulos, Stavros, additional, Strati, Areti, additional, Lianidou, Evi, additional, Fountzilas, George, additional, Rimm, David L., additional, Foukas, Periklis G., additional, and Psyrri, Amanda, additional

Published
2023
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33. Implementation, Dosimetric Assessment, and Treatment Validation of Knowledge-Based Planning (KBP) Models in VMAT Head and Neck Radiation Oncology

Author

Anna-Maria Fanou, Georgios Patatoukas, Marina Chalkia, Nikolaos Kollaros, Andromachi Kougioumtzopoulou, Vassilis Kouloulias, and Kalliopi Platoni

Subjects
plan deliverability, knowledge-based planning, RapidPlan™, Medicine (miscellaneous), head and neck cancer, General Biochemistry, Genetics and Molecular Biology
Abstract

The aim of this study was to evaluate knowledge-based treatment planning (KBP) models in terms of their dosimetry and deliverability and to investigate their clinical benefits. Three H&N KBP models were built utilizing RapidPlan™, based on the dose prescription, which is given according to the planning target volume (PTV). The training set for each model consisted of 43 clinically acceptable volumetric modulated arc therapy (VMAT) plans. Model quality was assessed and compared to the delivered treatment plans using the homogeneity index (HI), conformity index (CI), structure dose difference (PTV, organ at risk—OAR), monitor units, MU factor, and complexity index. Model deliverability was assessed through a patient-specific quality assurance (PSQA) gamma index-based analysis. The dosimetric assessment showed better OAR sparing for the RapidPlan™ plans and for the low- and high-risk PTV, and the HI, and CI were comparable between the clinical and RapidPlan™ plans, while for the intermediate-risk PTV, CI was better for clinical plans. The 2D gamma passing rates for RapidPlan™ plans were similar or better than the clinical ones using the 3%/3 mm gamma-index criterion. Monitor units, the MU factors, and complexity indices were found to be comparable between RapidPlan™ and the clinical plans. Knowledge-based treatment plans can be safely adapted into clinical routines, providing improved plan quality in a time efficient way while minimizing user variability.

Published
2023
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34. Dosimetric comparison and evaluation of two computational algorithms in VMAT treatment plans.

Author

Tsimpoukelli, Maria, Patatoukas, George, Chalkia, Marina, Kollaros, Nikolaos, Kougioumtzopoulou, Andromachi, Michaletou, Dimitra, Kouloulias, Vassilis, and Platoni, Kalliopi

Subjects
VOLUMETRIC-modulated arc therapy, FOAM, ALGORITHMS
Abstract

Purpose: This study aimed to assess the accuracy and dosimetric impact of the Acuros XB (AXB) algorithm compared to the Anisotropic Analytical Algorithm (AAA) in two situations. First, simple phantom geometries were set and analyzed; moreover, volumetric modulated arc therapy (VMAT) clinical plans for Head & Neck and lung cases were calculated and compared. Methods: First, a phantom study was performed to compare the algorithms with radiochromic EBT3 film doses using one PMMA slab phantom and two others containing foam or air gap. Subsequently, a clinical study was conducted, including 20 Head & Neck and 15 lung cases irradiated with the VMAT technique. The treatment plans calculated by AXB and AAA were evaluated in terms of planning target volume (PTV) coverage (V95%), dose received by relevant organs at risk (OARs), and the impact of using AXB with a grid size of 1 mm. Finally, patient‐specific quality assurance (PSQA) was performed and compared for 17 treatment plans. Results: Phantom dose calculations showed a better agreement of AXB with the film measurements. In the clinical study, AXB plans exhibited lower Conformity Index and PTV V95%, higher maximum PTV dose, and lower mean and minimum PTV doses for all anatomical sites. The most notable differences were detected in regions of intense heterogeneity. AXB predicted lower doses for the OARs, while the calculation time with a grid size of 1 mm was remarkably higher. Regarding PSQA, although AAA was found to exhibit slightly higher gamma passing rates, the difference did not affect the AXB treatment plan quality. Conclusions: AXB demonstrated higher accuracy than AAA in dose calculations of both phantom and clinical conditions, specifically in interface regions, making it suitable for sites with large heterogeneities. Hence, such dosimetric differences between the two algorithms should always be considered in clinical practice. [ABSTRACT FROM AUTHOR]

Published
2023
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36. Moderate Hypofractionated Radiotherapy for Localized Prostate Cancer: The Triumph of Radiobiology

Author

George Kounadis, Andromachi Kougioumtzopoulou, Kalliopi Platoni, Anna Zygogianni, Vasileios Kouloulias, Adamantia Psyrri, Aristotelis Bamias, Nikolaos Kelekis, and Konstantinos N. Syrigos

Subjects
Male, Oncology, Hypofractionated Radiotherapy, medicine.medical_specialty, Radiobiology, medicine.medical_treatment, Prostate cancer, Quality of life, Prostate, Internal medicine, medicine, Humans, Prospective Studies, Pharmacology, business.industry, Prostatic Neoplasms, General Medicine, medicine.disease, Radiation therapy, Clinical trial, Treatment Outcome, medicine.anatomical_structure, Toxicity, Radiation Dose Hypofractionation, business
Abstract

Background: Radiotherapy represents one of the main therapeutic modalities for localized prostate cancer. In the last two decades, emerging data regarding the radiobiology of prostate cancer suggests a very low α/β value, Objective: The aim of this manuscript is to present the rationale of prostate radiobiology and the medical evidence of moderate hypofractionation for prostate cancer. Methods: Existing literature was reviewed, including data from prospective clinical trials dealing with the efficacy and toxicity of hypofractionated radiotherapy. Fifteen prospective phase II studies, nine randomized phase III studies and ten meta-analyses were selected. For every study included, the equivalent dose was calculated for both biochemical control and late toxicity. Results: The efficacy of hypofractionated radiotherapy, compared to conventional radiotherapy, regarding biochemical control, was evaluated in five superiority and four non-inferiority randomized phase III studies. The majority of participants in these studies were patients with low- and intermediate- risk prostate cancer. Even though the superiority criterion of the hypofractionation was not met in all studies, the noninferiority criterion was met. Prospective phase II studies of hypofractionation reported a low rate of acute and late toxicity. In randomized phase III studies, acute and late toxicity grade 3 and higher for the bowel and bladder was comparable between hypofractionated and conventional radiotherapy. The included meta-analyses showed no difference in efficacy and toxicity. Conclusion: Moderate hypofractionation is feasible and safe, and may be considered as an alternative option in low- and intermediate-risk prostate cancer patients.

Published
2021

37. 1961O Nivolumab plus chemoradiotherapy in patients with non-metastatic muscle-invasive bladder cancer (nmMIBC), not undergoing cystectomy: A phase II, randomized study by the Hellenic GU Cancer Group.

Author

Kougioumtzopoulou, A., Koutsoukos, K., Zakopoulou, R., Tzannis, K., Kyriazoglou, A., Damatopoulou, A., Liontos, M., Pispirigkou, M.K., Ntoumas, K., Stravodimos, K., Mitropoulos, D., Dellis, A., Papatsoris, A., Chrisofos, M., Kardamakis, D., Zygogianni, A., Liakouli, Z., Pissakas, G., Bamias, A., and Kouloulias, V.

Subjects
*CANCER invasiveness, *BLADDER cancer, *NIVOLUMAB, *CYSTECTOMY, *CHEMORADIOTHERAPY
Published
2024
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38. Referral for 'Neoadjuvant Chemotherapy' for Muscle-Invasive Bladder Cancer to a Multidisciplinary Board: Patterns, Management and Outcomes

Author

V. Kouloulias, Meletios A. Dimopoulos, Konstantinos Stravodimos, Athanasios Papatsoris, Efthymios Kostouros, Konstantinos Koutsoukos, Eleni Boutati, Aristotelis Bamias, Ioannis M. Varkarakis, Michael Chrisofos, Stamata Pagoni, Charalampos Fragkoulis, Kimon Tzannis, Charalambos Deliveliotis, Konstantinos Ntoumas, Roubini Zakopoulou, Andromahi Kougioumtzopoulou, C. Constantinides, Miltiadis Seferlis, and Athanasios Dellis

Subjects
Oncology, medicine.medical_specialty, medicine.medical_treatment, Population, chemotherapy, Cystectomy, cystectomy, Internal medicine, medicine, Radical surgery, education, Survival rate, radiotherapy, Original Research, education.field_of_study, Bladder cancer, business.industry, neoadjuvant, medicine.disease, Gemcitabine, Radiation therapy, Clinical trial, Cancer Management and Research, bladder cancer, business, medicine.drug
Abstract

Athanasios Dellis,1 Roubini Zakopoulou,2 Andromahi Kougioumtzopoulou,3 Kimon Tzannis,2 Konstantinos Koutsoukos,2 Charalampos Fragkoulis,4 Efthymios Kostouros,5 Athanasios Papatsoris,6 Ioannis Varkarakis,6 Konstantinos Stravodimos,7 Eleni Boutati,8 Stamata Pagoni,5 Miltiadis Seferlis,9 Michael Chrisofos,10 Vasilios Kouloulias,3 Konstantinos Ntoumas,4 Charalambos Deliveliotis,6 Constantine Constantinides,7 Meletios A Dimopoulos,2 Aristotelis Bamias8 1 2nd Department of Surgery, National & Kapodistrian University of Athens, Aretaieion University Hospital, Athens, Greece; 2Oncology Unit, Department of Clinical Therapeutics, National & Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece; 3Radiotherapy Unit, 2nd Department of Radiology, National & Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece; 4Department of Urology, General Hospital of Athens “G. Gennimatas”, Athens, Greece; 5 3rd Department of Internal Medicine, General Hospital of Athens “G. Gennimatas”, Athens, Greece; 6 2nd Department of Urology, National & Kapodistrian University of Athens, Sismanoglio Hospital, Athens, Greece; 7First Department of Urology, National and Kapodistrian University of Athens, “Laiko” General Hospital, Athens, Greece; 8 2nd Propaedeutic Department of Internal Medicine, National & Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece; 9Department of Urology, Thriasion General Hospital, Athens, Greece; 10 3rd Department of Urology, National & Kapodistrian University of Athens, Attikon University Hospital, Athens, GreeceCorrespondence: Aristotelis Bamias 2nd Propaedeutic Department of Internal Medicine, National & Kapodistrian University of Athens, Attikon University Hospital, Athens, GreeceTel +30 2105831256 Fax +30 210 5326454Email abamias@med.uoa.grBackground: Utilization of neoadjuvant chemotherapy for the treatment of muscle invasive bladder cancer in everyday practice differs from that of clinical trials. We describe the patterns of referral for “neoadjuvant chemotherapy”, treatment and outcomes in a multidisciplinary tumor board.Methods: This was an observational study. Patients referred for neoadjuvant chemotherapy received 4 cycles of dose-dense gemcitabine/cisplatin and were then assessed for definitive local therapy. Patients had a minimum follow-up of 2 years. Primary objective was a 3-year disease-free survival rate.Results: Forty-six patients (clinical stages II: 28, IIIA: 9, IIIB: 4, IVA: 3, missing: 2) were included. Following chemotherapy, 30 underwent radical cystectomy, 8 radiotherapy and 8 no further therapy. Pathological downstaging was observed in 14 (46.6%) of the 30 patients who underwent radical cystectomy; clinical TNM staging was correlated with disease-free survival in the whole population, while clinical and pathological stages, as well as pathological downstaging, were correlated with disease-free survival in patients undergoing radical cystectomy. Three-year disease-free survival rates for the whole cohort and for patients undergoing radical cystectomy were 67.3% (95% confidence interval [CI]: 51– 79.2) and 65.2 (95% CI: 44.9– 79.6), respectively.Conclusion: Real-world muscle invasive bladder cancer patients who receive neoadjuvant chemotherapy are characterized by more advanced diseases and less frequent radical surgery than those included in clinical trials. Nevertheless, outcomes were comparable and, therefore, offering patients with stage II–IVA muscle invasive bladder cancer neoadjuvant chemotherapy after assessment by multidisciplinary tumor boards should be strongly encouraged.Keywords: bladder cancer, neoadjuvant, chemotherapy, cystectomy, radiotherapy

Published
2021

40. Acute and Late Rectal Toxicity Following Hypofractionated Radiotherapy in Patients With Prostate Cancer: Results of a Prospective Study

Author

GEORGIOS KOUNADIS, NIKOLAOS SYRIGOS, ANDROMACHI KOUGIOUMTZOPOULOU, GEORGIOS BAMIAS, ILIAS KOTTEAS, GEORGIOS PAPATHEODORIDIS, and DIMITRA GRAPSA

Subjects
Pharmacology, Male, Cancer Research, Gastrointestinal Diseases, Rectum, Humans, Prostatic Neoplasms, Radiation Dose Hypofractionation, Prospective Studies, General Biochemistry, Genetics and Molecular Biology, Research Article
Abstract

Background/Aim: Previous randomized clinical trials have shown that moderate hypofractionation has a non-inferior or even superior efficacy to conventionally fractionated external beam radiation therapy (EBRT) in low and intermediate-risk prostate cancer. We herein aimed to evaluate the acute and late gastrointestinal (GI) toxicity of hypofractionated radiotherapy (HRT) in a real-world setting. Patients and Methods: Patients with intermediate-risk prostate adenocarcinoma eligible to receive HRT were prospectively enrolled. All patients were submitted to rectoscopy after completion of HRT, every three months after radiotherapy for the first year and every six months for the second year. Toxicity events were classified as acute, when presenting during radiotherapy or within the first three months following its completion, and as late when appearing three months to three years post-HRT. Results: Twenty prostate cancer patients participated in this study and received 22 sessions of HRT (5 sessions a week; 2.75 Gy per session) and an overall dose of 60.5 Gy. None of our patients developed acute GI toxicity; late GI toxicity (RTOG/EORTC grade 3 rectal bleeding) was observed in 1 patient only (1/20, 5%), at 6- and 12-months post-HRT. No rectal mucosa damage was observed on follow-up rectoscopy in the acute phase in any of our patients; five patients (5/20, 25%) developed late telangiectasias. Vienna retroscopy score (VRS) was 1 in 4/5 patients (80%) and 2 in 1/5 (20%). Conclusion: Minimal radiation-induced rectal mucosal damage was observed in our patient population, and only as a late event, further attesting to the safety of HRT in this setting.

Published
2022

41. The need for a dose constraint in hip prosthesis to minimize later hip dysfunction. A retrospective analysis of relevant cases

Author

Andromachi Kougioumtzopoulou, Olga D. Savvidou, Maria Protopapa, Vassilis Kouloulias, Anna Zygogianni, Georgios Patatoukas, and Kalliopi Platoni

Subjects
musculoskeletal diseases, medicine.medical_specialty, Arthroplasty, Replacement, Hip, medicine.medical_treatment, Dose constraints, Prosthesis, Hip replacement (animal), 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Prospective cohort study, Pelvis, Retrospective Studies, Radiological and Ultrasound Technology, business.industry, Radiotherapy Planning, Computer-Assisted, Surgery, Radiation therapy, Treatment Outcome, medicine.anatomical_structure, Oncology, Harris Hip Score, 030220 oncology & carcinogenesis, Quality of Life, Hip Prosthesis, business
Abstract

Results from a single-institution study support the need of a dose constraint for patients who have previously undergone hip replacement surgery. Our study provides evidence that a dose above 30 Gy to the area of hip prosthesis is significantly correlated with later hip arthroplasty dysfunction as measured by the Harris Hip Score. As total hip arthroplasty becomes more and more common, it is urgent to further look into radiation therapy treatment parameters that can be modified to improve the quality of life of patients who receive pelvic irradiation after hip arthroplasty. Further prospective studies are needed to extract safe conclusions.

Published
2021

42. Implementation of TG-218 for patient-specific quality assurance tolerance and action limits determination: Gamma passing rate evaluation using 3DVH software

Author

Despoina Stasinou, George Patatoukas, Nikos Kollaros, Stefanos Diamantopoulos, Efrosyni Kypraiou, Andromachi Kougioumtzopoulou, Vasilios Kouloulias, Efstathios Efstathopoulos, and Kalliopi Platoni

Subjects
Male, Quality Assurance, Health Care, Radiotherapy Planning, Computer-Assisted, Humans, Prostatic Neoplasms, Radiotherapy Dosage, General Medicine, Radiotherapy, Intensity-Modulated, Radiometry, Software
Abstract

To determine the tolerance limit (TL) and action limit (AL) of gamma passing rates (%GP) for volumetric-modulated arc therapy (VMAT) patient-specific quality assurance (PSQA) according to the American Association of Physicists in Medicine (AAPM) Task Group (TG)-218 recommendations, and to comparatively evaluate the clinical relevance of 2D %GP and 3D %GP.PSQA was performed for 100 head and neck (HN) and 73 prostate cancer VMAT treatment plans. Measurements were acquired using a cylindrical water equivalent phantom, hollow in the center, allowing measurements with homogeneous or heterogeneous inserts. The LINAC-delivered dose distributions were compared to those calculated from the treatment planning system through the gamma index. TL and AL were determined through the computation of two-dimensional (2D) %GP using the recommended acceptance criteria. Dose-volume histograms were reconstructed from the measurements using a commercially available software to detect the dosimetric errors (%DE) between the compared dose distributions. Utilizing the estimated dose on the patient anatomy, structure-specific %GP (3D %GP) were calculated. The 3D %GP were compared to the 2D %GP ones based on their correlation with the %DE. Each metric's sensitivity was determined through receiver operator characteristic analysis.TL and AL were in concordance with the universal ones, regarding the prostate cancer cases, but were lower for the HN cases. Evaluation of %DE did not deem the plans unacceptable. The 2D %GP and the 3D %GP did not differ significantly regarding their correlation with %DE. For prostate plans, %GP sensitivity was higher than for HN cases.Determination of institutional-specific TL and AL allows the monitoring of the PSQA procedure, yet for plans close to the limits, clinically relevant metrics should be used before they are deemed unacceptable for the process to be of higher sensitivity and efficiency.

Published
2022

44. Implementation of TG‐218 for patient‐specific quality assurance tolerance and action limits determination: Gamma passing rate evaluation using 3DVH software

Author

Stasinou, Despoina, primary, Patatoukas, George, additional, Kollaros, Nikos, additional, Diamantopoulos, Stefanos, additional, Kypraiou, Efrosyni, additional, Kougioumtzopoulou, Andromachi, additional, Kouloulias, Vasilios, additional, Efstathopoulos, Efstathios, additional, and Platoni, Kalliopi, additional

Published
2022
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46. Impact of Hippocampal Avoidance - Prophylactic Cranial Irradiation in Small Cell Lung Cancer Patients

Author

EMMANOUIL MARAGKOUDAKIS, VASILEIOS KOULOULIAS, MARIA GRENZELIA, ANDROMACHI KOUGIOUMTZOPOULOU, ANNA ZYGOGIANNI, VASILEIOS RAMFIDIS, and ANDRIANNI CHARPIDOU

Subjects
Review Article
Abstract

Background/Aim: Prophylactic cranial irradiation (PCI) is a well-established treatment of small cell lung cancer (SCLC) patients following response to initial chemoradiotherapy. The benefit of PCI does, however, come at the cost of cognitive decline. This has been attributed to radiation-induced toxicity at the hippocampus, a crucial anatomic area for cognition. Modern radiotherapy techniques allow dose reduction at the hippocampal region. In this review, the safety profile, effect on cognition, and changes on brain imaging modalities of hippocampal avoidance-PCI (HA-PCI) will be presented, aiming to identify a potential clinical rationale for SCLC patients. Materials and Methods: A systematic review of the literature was performed in Pubmed, Cochrane library databases and ClinicalTrials.gov with no past date limitations until 07/01/2022. Principles as outlined in the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement were followed. Results: Eight studies published from 2015 to 2021 were included. Conclusion: HA-PCI is safe, yet its effect on neurocognition and imaging remains unclear, as studies have shown contradictory results.

Published
2022

47. Implementation of TG-218 for patient-specific quality assurance tolerance and action limits determination: Gamma passing rate evaluation using 3DVH software

Author

Stasinou, D. Patatoukas, G. Kollaros, N. Diamantopoulos, S. Kypraiou, E. Kougioumtzopoulou, A. Kouloulias, V. Efstathopoulos, E. Platoni, K.

Abstract

Purpose: To determine the tolerance limit (TL) and action limit (AL) of gamma passing rates (%GP) for volumetric-modulated arc therapy (VMAT) patient-specific quality assurance (PSQA) according to the American Association of Physicists in Medicine (AAPM) Task Group (TG)-218 recommendations, and to comparatively evaluate the clinical relevance of 2D %GP and 3D %GP. Methods: PSQA was performed for 100 head and neck (H&N) and 73 prostate cancer VMAT treatment plans. Measurements were acquired using a cylindrical water equivalent phantom, hollow in the center, allowing measurements with homogeneous or heterogeneous inserts. The LINAC-delivered dose distributions were compared to those calculated from the treatment planning system through the gamma index. TL and AL were determined through the computation of two-dimensional (2D) %GP using the recommended acceptance criteria. Dose–volume histograms were reconstructed from the measurements using a commercially available software to detect the dosimetric errors (%DE) between the compared dose distributions. Utilizing the estimated dose on the patient anatomy, structure-specific %GP (3D %GP) were calculated. The 3D %GP were compared to the 2D %GP ones based on their correlation with the %DE. Each metric's sensitivity was determined through receiver operator characteristic analysis. Results: TL and AL were in concordance with the universal ones, regarding the prostate cancer cases, but were lower for the H&N cases. Evaluation of %DE did not deem the plans unacceptable. The 2D %GP and the 3D %GP did not differ significantly regarding their correlation with %DE. For prostate plans, %GP sensitivity was higher than for H&N cases. Conclusions: Determination of institutional-specific TL and AL allows the monitoring of the PSQA procedure, yet for plans close to the limits, clinically relevant metrics should be used before they are deemed unacceptable for the process to be of higher sensitivity and efficiency. © 2022 American Association of Physicists in Medicine.

Published
2022

50. Oral mucositis-related neuropathic pain in head and neck cancer patients receiving radiotherapy or chemo-radiotherapy. A prospective study

Author

Maria, Kouri, Ourania, Nicolatou Galitis, Athina, Vadalouca, Vassilis, Kouloulias, Erofili, Papadopoulou, Emmanouil, Vardas, Euthimios, Kyrodimos, Miltiadis, Trichas, Anna, Zygogianni, Zoi, Liakouli, Evangelos, Galitis, Ioanna, Siafaka, Andromachi, Kougioumtzopoulou, and Amanda, Psyrri

Subjects
Adult, Aged, 80 and over, Male, Stomatitis, Cross-Sectional Studies, Head and Neck Neoplasms, Humans, Neuralgia, Female, Prospective Studies, Middle Aged, Aged
Abstract

Pain due to oral-mucositis (OM) in head and neck cancer (HNC) patients receiving radiotherapy (RT) /chemo-radiotherapy (CRT) can be nociceptive and/or neuropathic. Neuropathic pain (NP) often remains underdiagnosed and untreated. This study's purpose was to identify the presence of OM-induced NP in HNC patients under RT/CRT.Pain was assessed using a 0-10 numeric scale (NRS). At an NRS≥5 score, patients completed the Douleur Neuropathique 4 (DN4) questionnaire, where a score ≥4/10 indicates the presence of NP. Mucositis and xerostomia were assessed using the European Organization for Research and Treatment of Cancer and the NRS scales accordingly. Pain medication was documented.Forty patients were recruited; twenty-six (mean age 63.54±13.96 years) completed a DN4 (mean pain NRS 7.46±1.42); five (5/26, 19.23%) had a DN4≥4. The most common NP descriptors were "burning" (34.62%), "electric shocks" (30.77%) and "pins-and-needles" (30.77%). A direct correlation was observed between DN4 and pain, mucositis, and xerostomia (p0.02). Pain medication was administered to fifteen patients (15/26, 57.69%). Adjuvant medication was administered to one patient with positive DN4 score.Five (5/26, 19%) of the patients with NRS≥5 developed NP; adjuvant medication to address NP was prescribed to one patient. NP is likely underdiagnosed and undertreated in the HNC population undergoing RT/RC.

Published
2021

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