Radiotherapeutic treatment options for oligotopic malignant liver lesions

Abstract Background Several radiotherapeutic approaches for patients with oligotopic malignant liver lesions unfit for surgical resection exist. The most advanced competitive techniques are high-dose-rate (HDR) brachytherapy, Cyberknife, volume-modulated-arc therapy (VMAT) and Tomotherapy. We evaluated the optimal technique by a planning study for a single ablative dose with different lesion sizes. Methods We compared dose distributions of HDR-brachytherapy with stereotactic ablative radiotherapy using the Cyberknife, VMAT or Tomotherapy. Tumor-control-probabilities (TCP), normal-tissue-complication-probabilities (NTCP) were determined in a theoretical framework applying a single dose of 20 Gy (demanding 95% coverage) for intrahepatic lesions of 1–5 cm in size. We evaluated therapeutic ratios by TCP (mean dose in the lesion) relative to high-dose (conformality) or low-dose liver exposition in dependency on the lesion size for each technique. In addition, we considered treatment times and accuracy (clinical target volume vs planning target volume). Results HDR-brachtherapy has the highest therapeutic ratios with respect to high-dose as well as low-dose liver exposition even for extended lesions, and the Cyberknife being suited second best. However, for lesions ≥ 3 cm diameter the therapeutic ratios of all ablative techniques are increasingly converging, and better tolerance and shorter treatment times of noninvasive external techniques become more important. On the other hand, mean tumor doses of HDR-brachytherapy of near 60 Gy are unattainable by the other techniques gaining only 22–34 Gy, and the conformality of HDR-brachytherapy is still rather good for lesions ≥ 3 cm diameter. Conclusions HDR-brachytherapy is by far the most effective technique to treat intrahepatic lesions by a single fraction, but sparing of the surroundings declines with increasing lesion size and approaches the benchmarks of external beam radiosurgery techniques. External beam radiotherapy has the advantage to use suitable fractionation schedules. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Peter Wust [verfasserIn] Marcus Beck [verfasserIn] Robert Dabrowski [verfasserIn] Oliver Neumann [verfasserIn] Sebastian Zschaeck [verfasserIn] David Kaul [verfasserIn] Dominik P. Modest [verfasserIn] Carmen Stromberger [verfasserIn] Bernhard Gebauer [verfasserIn] Pirus Ghadjar [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2021

Schlagwörter:	Liver metastasis Oligometastasis Brachytherapy Radiation therapy Colorectal cancer

Übergeordnetes Werk:	In: Radiation Oncology - BMC, 2006, 16(2021), 1, Seite 10
Übergeordnetes Werk:	volume:16 ; year:2021 ; number:1 ; pages:10

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1186/s13014-021-01779-5

Katalog-ID:	DOAJ056444001

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520			\|a Abstract Background Several radiotherapeutic approaches for patients with oligotopic malignant liver lesions unfit for surgical resection exist. The most advanced competitive techniques are high-dose-rate (HDR) brachytherapy, Cyberknife, volume-modulated-arc therapy (VMAT) and Tomotherapy. We evaluated the optimal technique by a planning study for a single ablative dose with different lesion sizes. Methods We compared dose distributions of HDR-brachytherapy with stereotactic ablative radiotherapy using the Cyberknife, VMAT or Tomotherapy. Tumor-control-probabilities (TCP), normal-tissue-complication-probabilities (NTCP) were determined in a theoretical framework applying a single dose of 20 Gy (demanding 95% coverage) for intrahepatic lesions of 1–5 cm in size. We evaluated therapeutic ratios by TCP (mean dose in the lesion) relative to high-dose (conformality) or low-dose liver exposition in dependency on the lesion size for each technique. In addition, we considered treatment times and accuracy (clinical target volume vs planning target volume). Results HDR-brachtherapy has the highest therapeutic ratios with respect to high-dose as well as low-dose liver exposition even for extended lesions, and the Cyberknife being suited second best. However, for lesions ≥ 3 cm diameter the therapeutic ratios of all ablative techniques are increasingly converging, and better tolerance and shorter treatment times of noninvasive external techniques become more important. On the other hand, mean tumor doses of HDR-brachytherapy of near 60 Gy are unattainable by the other techniques gaining only 22–34 Gy, and the conformality of HDR-brachytherapy is still rather good for lesions ≥ 3 cm diameter. Conclusions HDR-brachytherapy is by far the most effective technique to treat intrahepatic lesions by a single fraction, but sparing of the surroundings declines with increasing lesion size and approaches the benchmarks of external beam radiosurgery techniques. External beam radiotherapy has the advantage to use suitable fractionation schedules.
650		4	\|a Liver metastasis
650		4	\|a Oligometastasis
650		4	\|a Brachytherapy
650		4	\|a Radiation therapy
650		4	\|a Colorectal cancer
653		0	\|a Medical physics. Medical radiology. Nuclear medicine
653		0	\|a Neoplasms. Tumors. Oncology. Including cancer and carcinogens
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allfields	10.1186/s13014-021-01779-5 doi (DE-627)DOAJ056444001 (DE-599)DOAJ2d219c5ab8a64b6e9e31f293db927ec1 DE-627 ger DE-627 rakwb eng R895-920 RC254-282 Peter Wust verfasserin aut Radiotherapeutic treatment options for oligotopic malignant liver lesions 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Several radiotherapeutic approaches for patients with oligotopic malignant liver lesions unfit for surgical resection exist. The most advanced competitive techniques are high-dose-rate (HDR) brachytherapy, Cyberknife, volume-modulated-arc therapy (VMAT) and Tomotherapy. We evaluated the optimal technique by a planning study for a single ablative dose with different lesion sizes. Methods We compared dose distributions of HDR-brachytherapy with stereotactic ablative radiotherapy using the Cyberknife, VMAT or Tomotherapy. Tumor-control-probabilities (TCP), normal-tissue-complication-probabilities (NTCP) were determined in a theoretical framework applying a single dose of 20 Gy (demanding 95% coverage) for intrahepatic lesions of 1–5 cm in size. We evaluated therapeutic ratios by TCP (mean dose in the lesion) relative to high-dose (conformality) or low-dose liver exposition in dependency on the lesion size for each technique. In addition, we considered treatment times and accuracy (clinical target volume vs planning target volume). Results HDR-brachtherapy has the highest therapeutic ratios with respect to high-dose as well as low-dose liver exposition even for extended lesions, and the Cyberknife being suited second best. However, for lesions ≥ 3 cm diameter the therapeutic ratios of all ablative techniques are increasingly converging, and better tolerance and shorter treatment times of noninvasive external techniques become more important. On the other hand, mean tumor doses of HDR-brachytherapy of near 60 Gy are unattainable by the other techniques gaining only 22–34 Gy, and the conformality of HDR-brachytherapy is still rather good for lesions ≥ 3 cm diameter. Conclusions HDR-brachytherapy is by far the most effective technique to treat intrahepatic lesions by a single fraction, but sparing of the surroundings declines with increasing lesion size and approaches the benchmarks of external beam radiosurgery techniques. External beam radiotherapy has the advantage to use suitable fractionation schedules. Liver metastasis Oligometastasis Brachytherapy Radiation therapy Colorectal cancer Medical physics. Medical radiology. Nuclear medicine Neoplasms. Tumors. Oncology. Including cancer and carcinogens Marcus Beck verfasserin aut Robert Dabrowski verfasserin aut Oliver Neumann verfasserin aut Sebastian Zschaeck verfasserin aut David Kaul verfasserin aut Dominik P. Modest verfasserin aut Carmen Stromberger verfasserin aut Bernhard Gebauer verfasserin aut Pirus Ghadjar verfasserin aut In Radiation Oncology BMC, 2006 16(2021), 1, Seite 10 (DE-627)508725739 (DE-600)2224965-5 1748717X nnns volume:16 year:2021 number:1 pages:10 https://doi.org/10.1186/s13014-021-01779-5 kostenfrei https://doaj.org/article/2d219c5ab8a64b6e9e31f293db927ec1 kostenfrei https://doi.org/10.1186/s13014-021-01779-5 kostenfrei https://doaj.org/toc/1748-717X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2021 1 10
spelling	10.1186/s13014-021-01779-5 doi (DE-627)DOAJ056444001 (DE-599)DOAJ2d219c5ab8a64b6e9e31f293db927ec1 DE-627 ger DE-627 rakwb eng R895-920 RC254-282 Peter Wust verfasserin aut Radiotherapeutic treatment options for oligotopic malignant liver lesions 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Several radiotherapeutic approaches for patients with oligotopic malignant liver lesions unfit for surgical resection exist. The most advanced competitive techniques are high-dose-rate (HDR) brachytherapy, Cyberknife, volume-modulated-arc therapy (VMAT) and Tomotherapy. We evaluated the optimal technique by a planning study for a single ablative dose with different lesion sizes. Methods We compared dose distributions of HDR-brachytherapy with stereotactic ablative radiotherapy using the Cyberknife, VMAT or Tomotherapy. Tumor-control-probabilities (TCP), normal-tissue-complication-probabilities (NTCP) were determined in a theoretical framework applying a single dose of 20 Gy (demanding 95% coverage) for intrahepatic lesions of 1–5 cm in size. We evaluated therapeutic ratios by TCP (mean dose in the lesion) relative to high-dose (conformality) or low-dose liver exposition in dependency on the lesion size for each technique. In addition, we considered treatment times and accuracy (clinical target volume vs planning target volume). Results HDR-brachtherapy has the highest therapeutic ratios with respect to high-dose as well as low-dose liver exposition even for extended lesions, and the Cyberknife being suited second best. However, for lesions ≥ 3 cm diameter the therapeutic ratios of all ablative techniques are increasingly converging, and better tolerance and shorter treatment times of noninvasive external techniques become more important. On the other hand, mean tumor doses of HDR-brachytherapy of near 60 Gy are unattainable by the other techniques gaining only 22–34 Gy, and the conformality of HDR-brachytherapy is still rather good for lesions ≥ 3 cm diameter. Conclusions HDR-brachytherapy is by far the most effective technique to treat intrahepatic lesions by a single fraction, but sparing of the surroundings declines with increasing lesion size and approaches the benchmarks of external beam radiosurgery techniques. External beam radiotherapy has the advantage to use suitable fractionation schedules. Liver metastasis Oligometastasis Brachytherapy Radiation therapy Colorectal cancer Medical physics. Medical radiology. Nuclear medicine Neoplasms. Tumors. Oncology. Including cancer and carcinogens Marcus Beck verfasserin aut Robert Dabrowski verfasserin aut Oliver Neumann verfasserin aut Sebastian Zschaeck verfasserin aut David Kaul verfasserin aut Dominik P. Modest verfasserin aut Carmen Stromberger verfasserin aut Bernhard Gebauer verfasserin aut Pirus Ghadjar verfasserin aut In Radiation Oncology BMC, 2006 16(2021), 1, Seite 10 (DE-627)508725739 (DE-600)2224965-5 1748717X nnns volume:16 year:2021 number:1 pages:10 https://doi.org/10.1186/s13014-021-01779-5 kostenfrei https://doaj.org/article/2d219c5ab8a64b6e9e31f293db927ec1 kostenfrei https://doi.org/10.1186/s13014-021-01779-5 kostenfrei https://doaj.org/toc/1748-717X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2021 1 10
allfields_unstemmed	10.1186/s13014-021-01779-5 doi (DE-627)DOAJ056444001 (DE-599)DOAJ2d219c5ab8a64b6e9e31f293db927ec1 DE-627 ger DE-627 rakwb eng R895-920 RC254-282 Peter Wust verfasserin aut Radiotherapeutic treatment options for oligotopic malignant liver lesions 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Several radiotherapeutic approaches for patients with oligotopic malignant liver lesions unfit for surgical resection exist. The most advanced competitive techniques are high-dose-rate (HDR) brachytherapy, Cyberknife, volume-modulated-arc therapy (VMAT) and Tomotherapy. We evaluated the optimal technique by a planning study for a single ablative dose with different lesion sizes. Methods We compared dose distributions of HDR-brachytherapy with stereotactic ablative radiotherapy using the Cyberknife, VMAT or Tomotherapy. Tumor-control-probabilities (TCP), normal-tissue-complication-probabilities (NTCP) were determined in a theoretical framework applying a single dose of 20 Gy (demanding 95% coverage) for intrahepatic lesions of 1–5 cm in size. We evaluated therapeutic ratios by TCP (mean dose in the lesion) relative to high-dose (conformality) or low-dose liver exposition in dependency on the lesion size for each technique. In addition, we considered treatment times and accuracy (clinical target volume vs planning target volume). Results HDR-brachtherapy has the highest therapeutic ratios with respect to high-dose as well as low-dose liver exposition even for extended lesions, and the Cyberknife being suited second best. However, for lesions ≥ 3 cm diameter the therapeutic ratios of all ablative techniques are increasingly converging, and better tolerance and shorter treatment times of noninvasive external techniques become more important. On the other hand, mean tumor doses of HDR-brachytherapy of near 60 Gy are unattainable by the other techniques gaining only 22–34 Gy, and the conformality of HDR-brachytherapy is still rather good for lesions ≥ 3 cm diameter. Conclusions HDR-brachytherapy is by far the most effective technique to treat intrahepatic lesions by a single fraction, but sparing of the surroundings declines with increasing lesion size and approaches the benchmarks of external beam radiosurgery techniques. External beam radiotherapy has the advantage to use suitable fractionation schedules. Liver metastasis Oligometastasis Brachytherapy Radiation therapy Colorectal cancer Medical physics. Medical radiology. Nuclear medicine Neoplasms. Tumors. Oncology. Including cancer and carcinogens Marcus Beck verfasserin aut Robert Dabrowski verfasserin aut Oliver Neumann verfasserin aut Sebastian Zschaeck verfasserin aut David Kaul verfasserin aut Dominik P. Modest verfasserin aut Carmen Stromberger verfasserin aut Bernhard Gebauer verfasserin aut Pirus Ghadjar verfasserin aut In Radiation Oncology BMC, 2006 16(2021), 1, Seite 10 (DE-627)508725739 (DE-600)2224965-5 1748717X nnns volume:16 year:2021 number:1 pages:10 https://doi.org/10.1186/s13014-021-01779-5 kostenfrei https://doaj.org/article/2d219c5ab8a64b6e9e31f293db927ec1 kostenfrei https://doi.org/10.1186/s13014-021-01779-5 kostenfrei https://doaj.org/toc/1748-717X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2021 1 10
allfieldsGer	10.1186/s13014-021-01779-5 doi (DE-627)DOAJ056444001 (DE-599)DOAJ2d219c5ab8a64b6e9e31f293db927ec1 DE-627 ger DE-627 rakwb eng R895-920 RC254-282 Peter Wust verfasserin aut Radiotherapeutic treatment options for oligotopic malignant liver lesions 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Several radiotherapeutic approaches for patients with oligotopic malignant liver lesions unfit for surgical resection exist. The most advanced competitive techniques are high-dose-rate (HDR) brachytherapy, Cyberknife, volume-modulated-arc therapy (VMAT) and Tomotherapy. We evaluated the optimal technique by a planning study for a single ablative dose with different lesion sizes. Methods We compared dose distributions of HDR-brachytherapy with stereotactic ablative radiotherapy using the Cyberknife, VMAT or Tomotherapy. Tumor-control-probabilities (TCP), normal-tissue-complication-probabilities (NTCP) were determined in a theoretical framework applying a single dose of 20 Gy (demanding 95% coverage) for intrahepatic lesions of 1–5 cm in size. We evaluated therapeutic ratios by TCP (mean dose in the lesion) relative to high-dose (conformality) or low-dose liver exposition in dependency on the lesion size for each technique. In addition, we considered treatment times and accuracy (clinical target volume vs planning target volume). Results HDR-brachtherapy has the highest therapeutic ratios with respect to high-dose as well as low-dose liver exposition even for extended lesions, and the Cyberknife being suited second best. However, for lesions ≥ 3 cm diameter the therapeutic ratios of all ablative techniques are increasingly converging, and better tolerance and shorter treatment times of noninvasive external techniques become more important. On the other hand, mean tumor doses of HDR-brachytherapy of near 60 Gy are unattainable by the other techniques gaining only 22–34 Gy, and the conformality of HDR-brachytherapy is still rather good for lesions ≥ 3 cm diameter. Conclusions HDR-brachytherapy is by far the most effective technique to treat intrahepatic lesions by a single fraction, but sparing of the surroundings declines with increasing lesion size and approaches the benchmarks of external beam radiosurgery techniques. External beam radiotherapy has the advantage to use suitable fractionation schedules. Liver metastasis Oligometastasis Brachytherapy Radiation therapy Colorectal cancer Medical physics. Medical radiology. Nuclear medicine Neoplasms. Tumors. Oncology. Including cancer and carcinogens Marcus Beck verfasserin aut Robert Dabrowski verfasserin aut Oliver Neumann verfasserin aut Sebastian Zschaeck verfasserin aut David Kaul verfasserin aut Dominik P. Modest verfasserin aut Carmen Stromberger verfasserin aut Bernhard Gebauer verfasserin aut Pirus Ghadjar verfasserin aut In Radiation Oncology BMC, 2006 16(2021), 1, Seite 10 (DE-627)508725739 (DE-600)2224965-5 1748717X nnns volume:16 year:2021 number:1 pages:10 https://doi.org/10.1186/s13014-021-01779-5 kostenfrei https://doaj.org/article/2d219c5ab8a64b6e9e31f293db927ec1 kostenfrei https://doi.org/10.1186/s13014-021-01779-5 kostenfrei https://doaj.org/toc/1748-717X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2021 1 10
allfieldsSound	10.1186/s13014-021-01779-5 doi (DE-627)DOAJ056444001 (DE-599)DOAJ2d219c5ab8a64b6e9e31f293db927ec1 DE-627 ger DE-627 rakwb eng R895-920 RC254-282 Peter Wust verfasserin aut Radiotherapeutic treatment options for oligotopic malignant liver lesions 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Several radiotherapeutic approaches for patients with oligotopic malignant liver lesions unfit for surgical resection exist. The most advanced competitive techniques are high-dose-rate (HDR) brachytherapy, Cyberknife, volume-modulated-arc therapy (VMAT) and Tomotherapy. We evaluated the optimal technique by a planning study for a single ablative dose with different lesion sizes. Methods We compared dose distributions of HDR-brachytherapy with stereotactic ablative radiotherapy using the Cyberknife, VMAT or Tomotherapy. Tumor-control-probabilities (TCP), normal-tissue-complication-probabilities (NTCP) were determined in a theoretical framework applying a single dose of 20 Gy (demanding 95% coverage) for intrahepatic lesions of 1–5 cm in size. We evaluated therapeutic ratios by TCP (mean dose in the lesion) relative to high-dose (conformality) or low-dose liver exposition in dependency on the lesion size for each technique. In addition, we considered treatment times and accuracy (clinical target volume vs planning target volume). Results HDR-brachtherapy has the highest therapeutic ratios with respect to high-dose as well as low-dose liver exposition even for extended lesions, and the Cyberknife being suited second best. However, for lesions ≥ 3 cm diameter the therapeutic ratios of all ablative techniques are increasingly converging, and better tolerance and shorter treatment times of noninvasive external techniques become more important. On the other hand, mean tumor doses of HDR-brachytherapy of near 60 Gy are unattainable by the other techniques gaining only 22–34 Gy, and the conformality of HDR-brachytherapy is still rather good for lesions ≥ 3 cm diameter. Conclusions HDR-brachytherapy is by far the most effective technique to treat intrahepatic lesions by a single fraction, but sparing of the surroundings declines with increasing lesion size and approaches the benchmarks of external beam radiosurgery techniques. External beam radiotherapy has the advantage to use suitable fractionation schedules. Liver metastasis Oligometastasis Brachytherapy Radiation therapy Colorectal cancer Medical physics. Medical radiology. Nuclear medicine Neoplasms. Tumors. Oncology. Including cancer and carcinogens Marcus Beck verfasserin aut Robert Dabrowski verfasserin aut Oliver Neumann verfasserin aut Sebastian Zschaeck verfasserin aut David Kaul verfasserin aut Dominik P. Modest verfasserin aut Carmen Stromberger verfasserin aut Bernhard Gebauer verfasserin aut Pirus Ghadjar verfasserin aut In Radiation Oncology BMC, 2006 16(2021), 1, Seite 10 (DE-627)508725739 (DE-600)2224965-5 1748717X nnns volume:16 year:2021 number:1 pages:10 https://doi.org/10.1186/s13014-021-01779-5 kostenfrei https://doaj.org/article/2d219c5ab8a64b6e9e31f293db927ec1 kostenfrei https://doi.org/10.1186/s13014-021-01779-5 kostenfrei https://doaj.org/toc/1748-717X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2021 1 10
language	English
source	In Radiation Oncology 16(2021), 1, Seite 10 volume:16 year:2021 number:1 pages:10
sourceStr	In Radiation Oncology 16(2021), 1, Seite 10 volume:16 year:2021 number:1 pages:10
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Liver metastasis Oligometastasis Brachytherapy Radiation therapy Colorectal cancer Medical physics. Medical radiology. Nuclear medicine Neoplasms. Tumors. Oncology. Including cancer and carcinogens
isfreeaccess_bool	true
container_title	Radiation Oncology
authorswithroles_txt_mv	Peter Wust @@aut@@ Marcus Beck @@aut@@ Robert Dabrowski @@aut@@ Oliver Neumann @@aut@@ Sebastian Zschaeck @@aut@@ David Kaul @@aut@@ Dominik P. Modest @@aut@@ Carmen Stromberger @@aut@@ Bernhard Gebauer @@aut@@ Pirus Ghadjar @@aut@@
publishDateDaySort_date	2021-01-01T00:00:00Z
hierarchy_top_id	508725739
id	DOAJ056444001
language_de	englisch
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The most advanced competitive techniques are high-dose-rate (HDR) brachytherapy, Cyberknife, volume-modulated-arc therapy (VMAT) and Tomotherapy. We evaluated the optimal technique by a planning study for a single ablative dose with different lesion sizes. Methods We compared dose distributions of HDR-brachytherapy with stereotactic ablative radiotherapy using the Cyberknife, VMAT or Tomotherapy. Tumor-control-probabilities (TCP), normal-tissue-complication-probabilities (NTCP) were determined in a theoretical framework applying a single dose of 20 Gy (demanding 95% coverage) for intrahepatic lesions of 1–5 cm in size. We evaluated therapeutic ratios by TCP (mean dose in the lesion) relative to high-dose (conformality) or low-dose liver exposition in dependency on the lesion size for each technique. In addition, we considered treatment times and accuracy (clinical target volume vs planning target volume). 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callnumber-first	R - Medicine
author	Peter Wust
spellingShingle	Peter Wust misc R895-920 misc RC254-282 misc Liver metastasis misc Oligometastasis misc Brachytherapy misc Radiation therapy misc Colorectal cancer misc Medical physics. Medical radiology. Nuclear medicine misc Neoplasms. Tumors. Oncology. Including cancer and carcinogens Radiotherapeutic treatment options for oligotopic malignant liver lesions
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topic_title	R895-920 RC254-282 Radiotherapeutic treatment options for oligotopic malignant liver lesions Liver metastasis Oligometastasis Brachytherapy Radiation therapy Colorectal cancer
topic	misc R895-920 misc RC254-282 misc Liver metastasis misc Oligometastasis misc Brachytherapy misc Radiation therapy misc Colorectal cancer misc Medical physics. Medical radiology. Nuclear medicine misc Neoplasms. Tumors. Oncology. Including cancer and carcinogens
topic_unstemmed	misc R895-920 misc RC254-282 misc Liver metastasis misc Oligometastasis misc Brachytherapy misc Radiation therapy misc Colorectal cancer misc Medical physics. Medical radiology. Nuclear medicine misc Neoplasms. Tumors. Oncology. Including cancer and carcinogens
topic_browse	misc R895-920 misc RC254-282 misc Liver metastasis misc Oligometastasis misc Brachytherapy misc Radiation therapy misc Colorectal cancer misc Medical physics. Medical radiology. Nuclear medicine misc Neoplasms. Tumors. Oncology. Including cancer and carcinogens
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title	Radiotherapeutic treatment options for oligotopic malignant liver lesions
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title_full	Radiotherapeutic treatment options for oligotopic malignant liver lesions
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journal	Radiation Oncology
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author_browse	Peter Wust Marcus Beck Robert Dabrowski Oliver Neumann Sebastian Zschaeck David Kaul Dominik P. Modest Carmen Stromberger Bernhard Gebauer Pirus Ghadjar
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doi_str_mv	10.1186/s13014-021-01779-5
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title_sort	radiotherapeutic treatment options for oligotopic malignant liver lesions
callnumber	R895-920
title_auth	Radiotherapeutic treatment options for oligotopic malignant liver lesions
abstract	Abstract Background Several radiotherapeutic approaches for patients with oligotopic malignant liver lesions unfit for surgical resection exist. The most advanced competitive techniques are high-dose-rate (HDR) brachytherapy, Cyberknife, volume-modulated-arc therapy (VMAT) and Tomotherapy. We evaluated the optimal technique by a planning study for a single ablative dose with different lesion sizes. Methods We compared dose distributions of HDR-brachytherapy with stereotactic ablative radiotherapy using the Cyberknife, VMAT or Tomotherapy. Tumor-control-probabilities (TCP), normal-tissue-complication-probabilities (NTCP) were determined in a theoretical framework applying a single dose of 20 Gy (demanding 95% coverage) for intrahepatic lesions of 1–5 cm in size. We evaluated therapeutic ratios by TCP (mean dose in the lesion) relative to high-dose (conformality) or low-dose liver exposition in dependency on the lesion size for each technique. In addition, we considered treatment times and accuracy (clinical target volume vs planning target volume). Results HDR-brachtherapy has the highest therapeutic ratios with respect to high-dose as well as low-dose liver exposition even for extended lesions, and the Cyberknife being suited second best. However, for lesions ≥ 3 cm diameter the therapeutic ratios of all ablative techniques are increasingly converging, and better tolerance and shorter treatment times of noninvasive external techniques become more important. On the other hand, mean tumor doses of HDR-brachytherapy of near 60 Gy are unattainable by the other techniques gaining only 22–34 Gy, and the conformality of HDR-brachytherapy is still rather good for lesions ≥ 3 cm diameter. Conclusions HDR-brachytherapy is by far the most effective technique to treat intrahepatic lesions by a single fraction, but sparing of the surroundings declines with increasing lesion size and approaches the benchmarks of external beam radiosurgery techniques. External beam radiotherapy has the advantage to use suitable fractionation schedules.
abstractGer	Abstract Background Several radiotherapeutic approaches for patients with oligotopic malignant liver lesions unfit for surgical resection exist. The most advanced competitive techniques are high-dose-rate (HDR) brachytherapy, Cyberknife, volume-modulated-arc therapy (VMAT) and Tomotherapy. We evaluated the optimal technique by a planning study for a single ablative dose with different lesion sizes. Methods We compared dose distributions of HDR-brachytherapy with stereotactic ablative radiotherapy using the Cyberknife, VMAT or Tomotherapy. Tumor-control-probabilities (TCP), normal-tissue-complication-probabilities (NTCP) were determined in a theoretical framework applying a single dose of 20 Gy (demanding 95% coverage) for intrahepatic lesions of 1–5 cm in size. We evaluated therapeutic ratios by TCP (mean dose in the lesion) relative to high-dose (conformality) or low-dose liver exposition in dependency on the lesion size for each technique. In addition, we considered treatment times and accuracy (clinical target volume vs planning target volume). Results HDR-brachtherapy has the highest therapeutic ratios with respect to high-dose as well as low-dose liver exposition even for extended lesions, and the Cyberknife being suited second best. However, for lesions ≥ 3 cm diameter the therapeutic ratios of all ablative techniques are increasingly converging, and better tolerance and shorter treatment times of noninvasive external techniques become more important. On the other hand, mean tumor doses of HDR-brachytherapy of near 60 Gy are unattainable by the other techniques gaining only 22–34 Gy, and the conformality of HDR-brachytherapy is still rather good for lesions ≥ 3 cm diameter. Conclusions HDR-brachytherapy is by far the most effective technique to treat intrahepatic lesions by a single fraction, but sparing of the surroundings declines with increasing lesion size and approaches the benchmarks of external beam radiosurgery techniques. External beam radiotherapy has the advantage to use suitable fractionation schedules.
abstract_unstemmed	Abstract Background Several radiotherapeutic approaches for patients with oligotopic malignant liver lesions unfit for surgical resection exist. The most advanced competitive techniques are high-dose-rate (HDR) brachytherapy, Cyberknife, volume-modulated-arc therapy (VMAT) and Tomotherapy. We evaluated the optimal technique by a planning study for a single ablative dose with different lesion sizes. Methods We compared dose distributions of HDR-brachytherapy with stereotactic ablative radiotherapy using the Cyberknife, VMAT or Tomotherapy. Tumor-control-probabilities (TCP), normal-tissue-complication-probabilities (NTCP) were determined in a theoretical framework applying a single dose of 20 Gy (demanding 95% coverage) for intrahepatic lesions of 1–5 cm in size. We evaluated therapeutic ratios by TCP (mean dose in the lesion) relative to high-dose (conformality) or low-dose liver exposition in dependency on the lesion size for each technique. In addition, we considered treatment times and accuracy (clinical target volume vs planning target volume). Results HDR-brachtherapy has the highest therapeutic ratios with respect to high-dose as well as low-dose liver exposition even for extended lesions, and the Cyberknife being suited second best. However, for lesions ≥ 3 cm diameter the therapeutic ratios of all ablative techniques are increasingly converging, and better tolerance and shorter treatment times of noninvasive external techniques become more important. On the other hand, mean tumor doses of HDR-brachytherapy of near 60 Gy are unattainable by the other techniques gaining only 22–34 Gy, and the conformality of HDR-brachytherapy is still rather good for lesions ≥ 3 cm diameter. Conclusions HDR-brachytherapy is by far the most effective technique to treat intrahepatic lesions by a single fraction, but sparing of the surroundings declines with increasing lesion size and approaches the benchmarks of external beam radiosurgery techniques. External beam radiotherapy has the advantage to use suitable fractionation schedules.
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title_short	Radiotherapeutic treatment options for oligotopic malignant liver lesions
url	https://doi.org/10.1186/s13014-021-01779-5 https://doaj.org/article/2d219c5ab8a64b6e9e31f293db927ec1 https://doaj.org/toc/1748-717X
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Radiotherapeutic treatment options for oligotopic malignant liver lesions

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