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dc.contributor.authorHafeez, S
dc.contributor.authorWarren-Oseni, K
dc.contributor.authorMcNair, HA
dc.contributor.authorHansen, VN
dc.contributor.authorJones, K
dc.contributor.authorTan, M
dc.contributor.authorKhan, A
dc.contributor.authorHarris, V
dc.contributor.authorMcDonald, F
dc.contributor.authorLalondrelle, S
dc.contributor.authorMohammed, K
dc.contributor.authorThomas, K
dc.contributor.authorThompson, A
dc.contributor.authorKumar, P
dc.contributor.authorDearnaley, D
dc.contributor.authorHorwich, A
dc.contributor.authorHuddart, R
dc.date.accessioned2017-03-01T12:11:11Z
dc.date.issued2016-04
dc.identifier.citationInternational journal of radiation oncology, biology, physics, 2016, 94 (5), pp. 1022 - 1030
dc.identifier.issn0360-3016
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/436
dc.identifier.eissn1879-355X
dc.identifier.doi10.1016/j.ijrobp.2015.12.379
dc.description.abstractPurpose Image guided adaptive radiation therapy offers individualized solutions to improve target coverage and reduce normal tissue irradiation, allowing the opportunity to increase the radiation tumor dose and spare normal bladder tissue.Methods and materials A library of 3 intensity modulated radiation therapy plans were created (small, medium, and large) from planning computed tomography (CT) scans performed at 30 and 60 minutes; treating the whole bladder to 52 Gy and the tumor to 70 Gy in 32 fractions. A "plan of the day" approach was used for treatment delivery. A post-treatment cone beam CT (CBCT) scan was acquired weekly to assess intrafraction filling and coverage.Results A total of 18 patients completed treatment to 70 Gy. The plan and treatment for 1 patient was to 68 Gy. Also, 1 patient's plan was to 70 Gy but the patient was treated to a total dose of 65.6 Gy because dose-limiting toxicity occurred before dose escalation. A total of 734 CBCT scans were evaluated. Small, medium, and large plans were used in 36%, 48%, and 16% of cases, respectively. The mean ± standard deviation rate of intrafraction filling at the start of treatment (ie, week 1) was 4.0 ± 4.8 mL/min (range 0.1-19.4) and at end of radiation therapy (ie, week 5 or 6) was 1.1 ± 1.6 mL/min (range 0.01-7.5; P=.002). The mean D98 (dose received by 98% volume) of the tumor boost and bladder as assessed on the post-treatment CBCT scan was 97.07% ± 2.10% (range 89.0%-104%) and 99.97% ± 2.62% (range 96.4%-112.0%). At a median follow-up period of 19 months (range 4-33), no muscle-invasive recurrences had developed. Two patients experienced late toxicity (both grade 3 cystitis) at 5.3 months (now resolved) and 18 months after radiation therapy.Conclusions Image guided adaptive radiation therapy using intensity modulated radiation therapy to deliver a simultaneous integrated tumor boost to 70 Gy is feasible, with acceptable toxicity, and will be evaluated in a randomized trial.
dc.formatPrint-Electronic
dc.format.extent1022 - 1030
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0
dc.subjectHumans
dc.subjectNeoplasm Invasiveness
dc.subjectNeoplasm Recurrence, Local
dc.subjectRadiation Injuries
dc.subjectCisplatin
dc.subjectDeoxycytidine
dc.subjectRadiation-Sensitizing Agents
dc.subjectRadiography
dc.subjectChemotherapy, Adjuvant
dc.subjectRadiotherapy Dosage
dc.subjectRadiotherapy Planning, Computer-Assisted
dc.subjectFollow-Up Studies
dc.subjectProspective Studies
dc.subjectFeasibility Studies
dc.subjectMaximum Tolerated Dose
dc.subjectTime Factors
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectMiddle Aged
dc.subjectRadiotherapy, Intensity-Modulated
dc.subjectUrinary Bladder
dc.subjectUrinary Bladder Neoplasms
dc.subjectOrgans at Risk
dc.subjectRadiotherapy, Image-Guided
dc.subjectOrgan Sparing Treatments
dc.titleProspective Study Delivering Simultaneous Integrated High-dose Tumor Boost (≤70 Gy) With Image Guided Adaptive Radiation Therapy for Radical Treatment of Localized Muscle-Invasive Bladder Cancer.
dc.typeJournal Article
dcterms.dateAccepted2015-12-29
rioxxterms.versionofrecord10.1016/j.ijrobp.2015.12.379
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by-nc-nd/4.0
rioxxterms.licenseref.startdate2016-04
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfInternational journal of radiation oncology, biology, physics
pubs.issue5
pubs.notesNo embargo
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams/Clinical Academic Radiotherapy (Dearnaley)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Clinical Academic Radiotherapy (Huddart)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Gynaecological Cancer
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Gynaecological Cancer/Gynaecological Cancer (hon.)
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Closed research teams/Clinical Academic Radiotherapy (Dearnaley)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Clinical Academic Radiotherapy (Huddart)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Gynaecological Cancer
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Gynaecological Cancer/Gynaecological Cancer (hon.)
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublished
pubs.volume94
pubs.embargo.termsNo embargo
icr.researchteamClinical Academic Radiotherapy (Dearnaley)en_US
icr.researchteamClinical Academic Radiotherapy (Huddart)en_US
icr.researchteamGynaecological Canceren_US
dc.contributor.icrauthorMcNair, Helenen
dc.contributor.icrauthorDearnaley, Daviden
dc.contributor.icrauthorKumar, Pardeepen
dc.contributor.icrauthorLalondrelle, Susanen
dc.contributor.icrauthorHuddart, Roberten
dc.contributor.icrauthorHafeez, Shaistaen


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