Reproducibility of Deep-Inspiration Breath Hold treatments on Halcyon™ performed using the first clinical version of AlignRT InBore™: Results of CYBORE study.

Background and purpose: To investigate the reproducibility of deep-inspiration breath hold (DIBH) breast cancer treatments on Halcyon™ performed using the first clinical version of AlignRT InBore™ (Vision RT Ltd., London, UK), a Halcyon's SGRT dedicated solution. Materials and methods: The ease and feasibility of DIBH treatments was retrospectively investigated for the initial 22 left breast cancer patients treated on Halcyon™ using AlignRT InBore™. Setup time, Cone beam computed tomography (CBCT) imaging and analysis time as well as overall treatment time were recorded. Online and offline review of CBCT images was undertaken to verify the compliance of breast, heart, spine, sternum and diaphragmatic domes positions. Results: Mean duration of patient setup, CBCT analysis and overall treatment time were 4 min, 1.1 min and 14 min respectively. Online review of 520 CBCT acquisitions by therapists showed minimal positioning shifts with AlignRT InBore™ guidance with mean value of vertical, longitudinal, and lateral shifts of 1.7 mm, -1.7 mm, and -0.2 mm respectively. Meanwhile, offline review of 115 CBCTs by the radiation oncologist, showed reproducible breath hold (BH) with average deviation of breast, heart, spine, sternum and diaphragmatic domes respectively within 2.4 mm, 2.9 mm, 3.3 mm, 3.2 mm and 4.5 mm in magnitude. Conclusion: AlignRT InBore™ allows for accurate and reproducible DIBH on Halcyon™ with breast and heart organs' positions within 3 mm in magnitude of expected position and fully compliant with planning margins (5 mm anisotropic CTV-PTV margins).

[Best practice guide for radiation therapy of non-small cell bronchial cancers]. / Guide de bonne pratique pour la radiothérapie thoracique exclusive ou postopératoire des carcinomes non à petites cellules.

The objective was the drafting of a practical document intended for radiotherapists and radiophysicists, describing the technique of irradiation of a non small cell bronchial cancer. The good practices concern the care of patients affected by bronchial cancer localized in the thorax and inoperable or patients who must undergo postoperative irradiation. The document has been developed according to a methodology aiming to join the current scientific data from an analysis of the literature on the subject and the assessment of radiotherapists, radiophysicists, lung specialists and methodologists from Rhône-Alpes area. From the stages necessary for the good progress of a radiotherapy, the writers of this document proposed common definitions concerning the centering and the location of the zone to be treated, the calculation of the dose distribution, the preparation of the patient for the treatment, the treatment and the surveillance during the treatment. The recommendations of this guide took into account the peculiarities bound to the nature of the treated region and more particularly the lung heterogeneity, respiratory movements and the radiosensibility of healthy lung tissue. Even if the technical aspect of the radiotherapy was particularly developed, the interest accorded to patient information takes on all its importance for a therapeutic coverage of quality. The authors of the document wished that this Guide of Good Practices, which will be regularly updated, helps the radiotherapists and allows them to harmonize their practices.

[Treatment of soft tissue sarcomas of the extremities and the trunk by conservative surgery and postoperative irradiation. Apropos of a series of 96 patients]. / Traitement des sarcomes des parties molles des extrémités et du tronc par chirurgie conservatrice et irradiation postopératoire. A propos d'une série de 96 patients.

AIM OF STUDY: Retrospective study of a series of 96 patients presenting with soft tissues sarcoma. Homogeneous treatment between 1980-1992 with conservative surgery and post operative irradiation. PATIENTS AND METHODS: Median age of the 96 patients was 58 years. Tumor site was: upper limb 20, lower limb 46, trunk 30. In 35 cases largest diameter of the tumor was 5 cm or less (T1). All patients were M0. The most frequent pathological sub type was: malignant histiocytofibroma 28, liposarcoma 28. A gross complete surgery was performed in 89 cases. Radiotherapy was performed with cobalt or x 18 MV photons. The dose delivered was 50 Gy with a boost of 10 Gy. No adjuvant chemotherapy was given. RESULTS: Mean follow up was 68 months. Local relapse was seen in 19 patients, six were salvaged by surgery, a limb amputation rates were necessary in 4 cases. The 5 and 10 year-overall survival was 70% and 64%. There was no severe radiation toxicity requiring surgery. A good function of the limb was preserved in all cases. CONCLUSION: These results are in agreement with those of the literature and justify a conservative approach for these soft tissues sarcomas.