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Combs Katie Massey Buckley Pamela R. Lain Marion Amanda Drewelow Karen M. Urano Grace Kerns Suzanne E. U. 《Prevention science》2022,23(6):969-981
Prevention Science - As evidence-based interventions (EBIs) become more widely disseminated, fidelity of implementation (FOI) often wanes. This study explores the association between FOI and... 相似文献
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Rick L. Haas Suzanne van Beek Anja Betgen Shaheen Ali Christoph J. Schneider Fenna Heres Diddens Astrid N. Scholten Folkert Koetsveld Peter Remeijer 《Practical radiation oncology》2019,9(2):115-122
Purpose
Many authors suggest that extremity soft tissue sarcomas (ESTS) do not change significantly in size during preoperative radiation therapy (RT). This cone beam computed tomography study investigates the justification to deliver the entire course with 1 initial RT plan by observing anatomic changes during RT.Methods and Materials
Between 2015 and 2017, 99 patients with ESTS were treated with either curative (n = 80) or palliative intent (n = 19) with a regimen of at least 6 fractions. The clinical target volume to planning target volume margin was 1 cm. Action levels were assigned by radiation technicians. An extremity contour change of >1 cm and/or tumor size change >0.5 cm required a physician's action before the next fraction.Results
A total of 982 cone beam computed tomography logfiles were studied. In 41 of 99 patients, the dose coverage of the initial treatment plan was fully satisfactory throughout the RT course. However, action levels were observed in 58 patients (59%). In 41 of these 58 patients, a contour increase of 5 to 23 mm was noted (29 tumor size increase only, 3 extremity contour increase, and 9 both). In 21 of 58 patients, a decrease of 5 to 33 mm was observed (20 tumor size decrease only and 1 tumor size decrease and extremity contour decrease). In 4 cases, contours initially increased and subsequently decreased. In 33 of 41 patients with increasing contours, the dose distribution adequately covered gross tumor volume because of the 1 cm planning target volume margin applied. For the remaining 8 patients (8%), the plan needed to be adapted.Conclusions
ESTS volumes may change substantially during RT in 59% of all patients, leading to plan adaptations resulting from increased volumes in 8%. Daily critical observation of these patients is mandatory to avoid geographic misses because of increases in size and overdosing of normal tissues when masses shrink. 相似文献4.
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Vassiliki A. Papadimitrakopoulou MD Ji-Youn Han MD PhD Myung-Ju Ahn MD PhD Suresh S. Ramalingam MD Angelo Delmonte MD PhD Te-Chun Hsia MD Janessa Laskin MD Sang-We Kim MD PhD Yong He MD Chun-Ming Tsai MD Toyoaki Hida MD PhD Makoto Maemondo MD PhD Terufumi Kato MD Suzanne Jenkins DPhil Sabina Patel PhD Xiangning Huang PhD Gianluca Laus MD Aleksandra Markovets PhD Kenneth S. Thress PhD Yi-Long Wu MD Tony Mok MD 《Cancer》2020,126(2):373-380
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