Academic literature on the topic 'Normal tissue complication probabil'
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Journal articles on the topic "Normal tissue complication probabil"
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Andreassen, C. N. "SP-0555 SNPS FOR PREDICTION OF NORMAL TISSUE COMPLICATION RISK –PROBABLY NOT THE QUICK FIX THAT WE ONCE IMAGINED." Radiotherapy and Oncology 103 (May 2012): S222. http://dx.doi.org/10.1016/s0167-8140(12)70894-0.
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Gurluler, Ercüment, Nazim Gures, Ilknur Citil, Ozgur Kemik, Ibrahim Berber, Aziz Sumer, and Alihan Gurkan. "Desmoid Tumor in Puerperium Period: A Case Report." Clinical Medicine Insights: Case Reports 7 (January 2014): CCRep.S13593. http://dx.doi.org/10.4137/ccrep.s13593.
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Desmoid tumors (DTs) are rare tumors classified as deep fibromatoses taking origin from fascial or musculoaponeurotic structures. With pregnancy and surgical scars considered in the etiology, most anterior abdominal wall DTs occur in women in their reproductive years, especially during a pregnancy or post-partum. Herein, we present development of DT in a female patient in the post-partum period following cesarean delivery, which manifested itself with a growing mass in anterior abdominal wall. In our case, possibility of hematoma most probably located beneath the fascia was considered initially as a complication of cesarean section based on ultrasonographic examination and location of the lesion, while upon lack of either spontaneous regression with eventual diminish in size or resolve of symptoms within six weeks, further investigation via MRI and tru-cut biopsy revealed the diagnosis of abdominal DT. Radical tumor extirpation with resection of an adequate margin of surrounding normal tissue was applied, and the post-operative period was uneventful.
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Liden, Brock A., and Melitta Simmons. "Histologic Evaluation of a 6-Month GraftJacket Matrix Biopsy Used for Achilles Tendon Augmentation." Journal of the American Podiatric Medical Association 99, no. 2 (March 1, 2009): 104–7. http://dx.doi.org/10.7547/0980104.
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Background: Assessing implanted biological reinforcement graft success in soft-tissue repairs is typically limited to noninvasive measurements and functional outcome measures. However, there are times when a histologic snapshot of the graft incorporation may be possible owing to a nongraft-related postoperative complication, such as hardware failure. Methods: We histologically evaluated a 6-month biopsy sample from an Achilles tendon repair augmented with an acellular human dermal matrix (AHDM). A 57-year-old woman was treated for Haglund’s deformity of the Achilles tendon. The Achilles tendon was fixed to the calcaneus using a plate, and an AHDM was used to augment the primary repair of the tendon. At 6 months, the hardware was removed owing to prominence, and a biopsy of the AHDM was performed. The specimen was prepared and stained using hematoxylin and eosin, Verhoeff-van Gieson, Movat’s pentachrome, and toluidine blue stains. Results: Visually, the graft appeared normal and incorporated with the native tendon. No repeated tear was observed, and results of tests for infection were negative. Histologically, the graft was infiltrated predominantly with fibroblasts and demonstrated numerous blood vessels. Positive proteoglycan staining in the AHDM and at sites of vascularity indicated probable transformation to tendon-like tissue. Conclusions: These histologic findings suggest that the AHDM is highly biocompatible, supports revascularization and repopulation with noninflammatory host cells, and becomes incorporated by surrounding tendon tissue. (J Am Podiatr Med Assoc 99(2): 104–107, 2009)
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Cabac, Vasile, Veronica Polovei, and Ala Istratenco. "Empty nose syndrome." Romanian Journal of Rhinology 7, no. 27 (September 27, 2017): 135–41. http://dx.doi.org/10.1515/rjr-2017-0015.
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Abstract Empty nose syndrome (ENS) is a clinical entity lacking consensual meaning, illustrating a rare nose surgery complication, particularly of nasal conchae surgery, which results in the destruction of the normal nasal tissue. In severe forms it may become debilitating; the inability in identification and appreciation of this syndrome turns detrimental to the patient. Physiopathology remains controversial, which probably implies disorders caused by excessive nasal permeability, affecting neurosensory receptors as well as the humidification functions and conditioning of inhaled air. Neuropsychological involvement is being suspected. Symptomatology is both variable and changeable, the most evident sign outlining paradoxical nasal obstruction. The diagnosis is based on a series of symptoms that need to be collected precisely, the objective examination that highlights the permeability of nasal fossae. The management is problematic; there are implemented a complete range of simple hygiene and humidification techniques of the nasal cavity and, for more severe cases, surgery is provided, regardless of technique, the surgery targeting partial filling of the nasal airways. Prevention is the most essential strategy along with basic conservative surgical techniques.
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Rollin, Jérôme, Claire Pouplard, and Yves Gruel. "Risk factors for heparin-induced thrombocytopenia: Focus on Fcγ receptors." Thrombosis and Haemostasis 116, no. 11 (September 2016): 799–805. http://dx.doi.org/10.1160/th16-02-0109.
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SummaryFcγ receptors have critical roles in the pathophysiology of heparin-induced thrombocytopenia (HIT), a severe immune-mediated complication of heparin treatment. Activation of platelets, monocytes and neutrophils by platelet-activating anti-PF4/heparin IgG antibodies results in thrombocytopenia, hypercoagulability and thrombosis in susceptible patients, effects that depend on FcγRIIA. In addition, FcγRIIIA receptors probably contribute to clearance of platelets sensitised by HIT immune complexes. FcγRI has also been reported to be involved in monocyte activation by HIT IgG antibodies and synthesis of tissue factor. This review focuses on the role of these FcγRs in HIT pathophysiology, including the potential influence of several gene variations associated with variable risk of HIT and related thrombosis. In particular, the 276P and 326Q alleles of CD148, a protein tyrosine phosphatase that regulates FcγRIIA signalling, are associated with a lower risk of HIT, and platelets from healthy donors expressing these alleles are hyporesponsive to anti-PF4/H antibodies. It was also recently demonstrated that the risk of thrombosis is higher in HIT patients expressing the R isoform of the FcγRIIA H131R polymorphism, with HIT antibodies shown to activate RR platelets more efficiently, mainly explained by an inhibitory effect of normal IgG2, which bound to the FcγRIIA 131H isoform more efficiently. Environmental risk factors probably interact with these gene polymorphisms affecting FcγRs, thereby increasing thrombosis risk in HIT.
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Ghanaati, Shahram, Adorján Kovács, Mike Barbeck, Jonas Lorenz, Anna Teiler, Nader Sadeghi, Charles James Kirkpatrick, and Robert Sader. "Bilayered, non-cross-linked collagen matrix for regeneration of facial defects after skin cancer removal: a new perspective for biomaterial-based tissue reconstruction." Journal of Cell Communication and Signaling 10, no. 1 (December 9, 2015): 3–15. http://dx.doi.org/10.1007/s12079-015-0313-7.
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Abstract Classically skin defects are covered by split thickness skin grafts or by means of local or regional skin flaps. In the presented case series for the first time a bilayered, non-crossed-linked collagen matrix has been used in an off-label fashion in order to reconstruct facial skin defects following different types of skin cancer resection. The material is of porcine origin and consists of a spongy and a compact layer. The ratio of the two layers is 1:3 in favour of the spongy layer. The aim of the study was to investigate the potential of this matrix for skin regeneration as an alternative to the standard techniques of skin grafts or flaps. Six patients between 39 and 83 years old were included in the study based on a therapeutic trial. The collagen matrix was used in seven defects involving the nose, eyelid, forehead- and posterior scalp regions, and ranging from 1,2 to 6 cm in diameter. Two different head and neck surgeons at two different institutions performed the operations. Each used a different technique in covering the wound following surgery, i.e. with and without a latex-based sheet under the pressure dressing. In three cases cylindrical biopsies were taken after 14 days. In all cases the biomaterial application was performed without any complication and no adverse effects were observed. Clinically, the collagen matrix contributed to a tension-free skin regeneration, independent of the wound dressing used. The newly regenerated skin showed strong similarity to the adjacent normal tissue both in quality and colour. Histological analysis indicated that the spongy layer replaced the defective connective tissue, by providing stepwise integration into the surrounding implantation bed, while the compact layer was infiltrated by mononuclear cells and contributed to its epithelialization by means of a „conductive“process from the surrounding epithelial cells. The clinical and histological data demonstrate that the collagen bilayered matrix used in this series contributes to a „Guided-Integrative-Regeneration-Process“, which still needs to be further understood. The biomimetic nature of this material seems to contribute to physiological matrix remodelling, which probably involves other matricellular proteins essential for soft tissue regeneration. A deeper understanding of the mechanism, involved in the tissue integration of this material and its contribution to soft tissue regeneration based on the direct and indirect effect of matricellular proteins could open new therapeutic avenues for biomaterial-based soft tissue regeneration as an alternative to traditional flap-based plastic surgery.
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Kukołowicz, Paweł. "Clinical aspects of normal tissue complication probability." Reports of Practical Oncology & Radiotherapy 9, no. 6 (2004): 261–67. http://dx.doi.org/10.1016/s1507-1367(04)71038-x.
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Xu, Cheng-Jian, Arjen van der Schaaf, Aart A. van't Veld, Johannes A. Langendijk, and Cornelis Schilstra. "Statistical Validation of Normal Tissue Complication Probability Models." International Journal of Radiation Oncology*Biology*Physics 84, no. 1 (September 2012): e123-e129. http://dx.doi.org/10.1016/j.ijrobp.2012.02.022.
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Lyman, John T. "Normal tissue complication probabilities: Variable dose per fraction." International Journal of Radiation Oncology*Biology*Physics 22, no. 2 (January 1992): 247–50. http://dx.doi.org/10.1016/0360-3016(92)90040-o.
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Alexander, M. A. R., W. A. Brooks, and S. W. Blake. "Normal tissue complication probability modelling of tissue fibrosis following breast radiotherapy." Physics in Medicine and Biology 52, no. 7 (March 7, 2007): 1831–43. http://dx.doi.org/10.1088/0031-9155/52/7/005.
Full textDissertations / Theses on the topic "Normal tissue complication probabil"
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Troeller, Almut [Verfasser], and Katia [Akademischer Betreuer] Parodi. "Normal tissue complication probability modelling : influence of treatment technique, fractionation, and dose calculation algorithm / Almut Troeller ; Betreuer: Katia Parodi." München : Universitätsbibliothek der Ludwig-Maximilians-Universität, 2017. http://d-nb.info/1138195510/34.
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Hornby, Colin, and n/a. "Tumour Control and Normal Tissue Complication Probabilities: Can they be correlated with the measured clinical outcomes of prostate cancer radiotherapy?" RMIT University. Medical Sciences, 2006. http://adt.lib.rmit.edu.au/adt/public/adt-VIT20080702.123739.
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The chief aim in developing radiation treatment plans is to maximise tumour cell kill while minimising the killing of normal cells. The acceptance by a radiation oncologist of a radiation therapy treatment plan devised by the radiation therapist, at present is largely based on the oncologists' previous clinical experience with reference to established patterns of treatment and their clinical interpretation of the dose volume histogram. Some versions of radiotherapy planning computer software now incorporate a function that permits biologically based predictions about the probability of tumour control (TCP) and/or normal tissue complications (NTCP). The biological models used for these probabilities are founded upon statistical and mathematical principles as well as radiobiology concepts. TCP and NTCP potentially offer the capability of being able to better optimise treatments for an individual patient's tumour and normal anatomy. There have been few attempts in the past to correlate NTCPs to actual treatment complications, and the reported complications have generally not shown any significant correlation. Thus determining whether either or both NTCPs and TCPs could be correlated with the observed clinical outcomes of prostate radiotherapy is the central topic of this thesis. In this research, TCPs and NTCPs were prospectively calculated for prostate cancer patients receiving radiation therapy, and subsequently assessed against the clinical results of the delivered treatments. This research was conducted using two different types of NTCP models, which were correlated against observed treatment-induced complications in the rectum and bladder. The two NTCP models were also compared to determine their relative efficacy in predicting the recorded toxicities. As part of this research the refinement of some of the published bladder parameters required for NTCP calculations was undertaken to provide a better fit between predicted and observed complication rates for the bladder wall which was used in this research. TCPs were also calculated for each patient using the best available estimate of the radiosensitivity of the prostate gland from recent research. The TCP/NTCP data was analysed to determine if any correlations existed between the calculated probabilities and the observed clinical data. The results of the analyses showed that a correlation between the NTCP and a limited number of toxicities did occur. Additionally the NTCP predictions were compared to existing parameters and methods for radiotherapy plan evaluation - most notably DVHs. It is shown that NTCPs can provide superior discriminatory power when utilised for prospective plan evaluation. While the TCP could not be correlated with clinical outcomes due to insufficient follow-up data, it is shown that there was a correlation between the TCP and the treatment technique used.
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Gabryś, Hubert [Verfasser], and Markus [Akademischer Betreuer] Alber. "Machine learning using radiomics and dosiomics for normal tissue complication probability modeling of radiation-induced xerostomia / Hubert Gabrys ; Betreuer: Markus Alber." Heidelberg : Universitätsbibliothek Heidelberg, 2020. http://d-nb.info/1203958528/34.
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Herwiningsih, Sri. "Dosimetric verification of stereotactic body radiotherapy treatment plans for early stage non-small cell lung cancer using Monte Carlo simulation." Thesis, Queensland University of Technology, 2017. https://eprints.qut.edu.au/109755/1/Sri_Herwiningsih_Thesis.pdf.
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This thesis is an evaluation of the dosimetric accuracy of the dose calculation algorithm used for planning of lung stereotactic body radiotherapy treatments. It specifically investigates the accuracy of the collapsed cone convolution algorithm employed in the Pinnacle3 Radiotherapy Treatment Planning System by using Monte Carlo techniques as an independent verification tool. The thesis also investigates the impact of dose calculation uncertainties on treatment outcome estimation through the use of radiobiological modelling.
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Benadjaoud, Mohamed Amine. "Modélisation flexible du risque d’événements iatrogènes radio-induits." Thesis, Paris 11, 2015. http://www.theses.fr/2015PA11T017/document.
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La radiothérapie occupe une place majeure dans l’arsenal thérapeutique des cancers.Malgré des progrès technologiques importants depuis près de vingt ans, des tissus sains au voisinage ou à distance de la tumeur cible continuent à être inévitablement irradiés à des niveaux de doses très différents. Ces doses sont à l’origine d’effets secondaires précoces (Œdème, radionécrose, Dysphagie, Cystite) ou tardifs (rectorragies, télangiectasie, effets carcinogènes, les pathologie cérébrovasculaires).Il est donc primordial de quantifier et de prévenir ces effets secondaires afin d'améliorer la qualité de vie des patients pendant et après leur traitement.La modélisation du risque d'événements iatrogènes radio-induits repose sur la connaissance précise de la distribution de doses au tissu sain d'intérêt ainsi que sur un modèle de risque capable d'intégrer un maximum d'informations sur le profil d'irradiation et des autres facteurs de risques non dosimétriques. L'objectif de ce travail de thèse a été de développer des méthodes de modélisation capables de répondre à des questions spécifiques aux deux aspects, dosimétriques et statistiques, intervenant dans la modélisation du risque de survenue d'événements iatrogènes radio-induits.Nous nous sommes intéressé dans un premier temps au développement d'un modèle de calcul permettant de déterminer avec précision la dose à distance due au rayonnements de diffusion et de fuite lors d'un traitement par radiothérapie externe et ce, pour différentes tailles des champs et à différentes distances de l'axe du faisceau. Ensuite, nous avons utilisé des méthodes d'analyse de données fonctionnelles pour développer un modèle de risque de toxicité rectales après irradiation de la loge prostatique. Le modèle proposé a montré des performances supérieures aux modèles de risque existants particulièrement pour décrire le risque de toxicités rectales de grade 3. Dans le contexte d'une régression de Cox flexible sur données réelles, nous avons proposé une application originale des méthodes de statistique fonctionnelle permettant d'améliorer les performances d'une modélisation via fonctions B-splines de la relation dose-effet entre la dose de radiation à la thyroïde.Nous avons également proposé dans le domaine de la radiobiologie une méthodes basée sur l’analyse en composantes principales multiniveau pour quantifier la part de la variabilité expérimentale dans la variabilité des courbes de fluorescence mesuréesRadiotherapy plays a major role in the therapeutic arsenal against cancer. Despite significant advances in technology for nearly twenty years, healthy tissues near or away from the target tumor remain inevitably irradiated at very different levels of doses. These doses are at the origin of early side effects (edema, radiation necrosis, dysphagia, cystitis) or late (rectal bleeding, telangiectasia, carcinogenic, cerebrovascular diseases). It is therefore essential to quantify and prevent these side effects to improve the patient quality of life after their cancer treatment.The objective of this thesis was to propose modelling methods able to answer specific questions asked in both aspects, dosimetry and statistics, involved in the modeling risk of developing radiation-induced iatrogenic pathologies.Our purpose was firstly to assess the out-of-field dose component related to head scatter radiation in high-energy photon therapy beams and then derive a multisource model for this dose component. For measured doses under out-of-field conditions, the average local difference between the calculated and measured photon dose is 10%, including doses as low as 0.01% of the maximum dose on the beam axis. We secondly described a novel method to explore radiation dose-volume effects. Functional data analysis is used to investigate the information contained in differential dose-volume histograms. The method is applied to the normal tissue complication probability modeling of rectal bleeding for In the flexible Cox model context, we proposed a new dimension reduction technique based on a functional principal component analysis to estimate a dose-response relationship. A two-stage knots selection scheme was performed: a potential set of knots is chosen based on information from the rotated functional principal components and the final knots selection is then based on statistical model selection. Finally, a multilevel functional principal component analysis was applied to radiobiological data in order to quantify the experimental Variability for replicate measurements of fluorescence signals of telomere length
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Cheng, Chia-Hsien. "Probability Model for Biology Integrated Normal Tissue Complication Based on Radiation-Induced Liver Disease." 2005. http://www.cetd.com.tw/ec/thesisdetail.aspx?etdun=U0001-1001200514234200.
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Cheng, Chia-Hsien, and 成佳憲. "Probability Model for Biology Integrated Normal Tissue Complication Based on Radiation-Induced Liver Disease." Thesis, 2005. http://ndltd.ncl.edu.tw/handle/06887570882134127601.
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博士國立臺灣大學
電機工程學研究所
93
Radiotherapy has been one of the most important treatment modalities in cancer patients. The scientific method to estimate the risk of radiation-induced organ complication is using the dose-volume data from the computerized treatment planning system to perform calculations with certain thresholds and criteria. The current commonly used dosimetric parameters have the defects of non-volumetric criteria and the lack of volume effect integrated into the radiation-related organ damage. Normal tissue complication probability (NTCP) model has been proposed as a more comprehensive way to calculate the risk of complication by the use of the serial dose-volume data with a few parameters to weigh the risk between low-dose and high-dose damage. In our past patients with radiation-induced liver disease (RILD) after three-dimensional conformal radiotherapy (3DCRT), we found that the NTCP was more useful than the conventionally used parameters. However, the risk of RILD in Taiwan seemed underestimated with the NTCP model parameters developed in the Unites States. This means the tolerance of liver to radiation for patients in Taiwan different from the patients’ tolerance in the western countries, and the indication of generating the unique model parameters based on the biological features of RILD in Taiwanese patients. Our first step was to establish the biology-integrated NTCP in the two different databases, 89 patients with hepatocellular carcinoma (HCC) and 62 patients with gastric carcinoma (GC) undergoing 3DCRT. Hepatitis B viral (HBV) carriers have been the unique feature of Taiwanese patients in their liver tolerance as compared to the western countries. We first used the three-parameter Lyman NTCP model to recalculate the NTCP of RILD in 89 HCC patients by their original dose-volume data retrieved from the conformal design of 3DCRT. Logistic regression was used for significant factors of RILD. Maximal likelihood analysis was conducted to obtain the best estimates of NTCP model parameters based on the true occurrence of RILD in 17 of 89 HCC patients. In multivariate analysis, HBV carrier remained statistically significant as the susceptible factor to RILD. The best estimates of NTCP parameters (n, m, TD50(1)) were 0.35, 0.39, and 49.4 Gy. The parameters specifically estimated from HBV carriers were 0.26, 0.40, and 50.0 Gy, as compared to 0.86, 0.31, and 46.1 Gy for non-carrier patients. The main difference in volume effect parameter (n) between the two subgroups indicated the impact of this biological factor (HBV carrier) on modeling NTCP. The second step was to apply the Lyman NTCP model in 62 GC patients. HBV carrier status was the only independent factor associated with RILD. The parameters (n, m, TD50(1)) specifically estimated from HBV carriers were 0.11, 6.88, and 20.5 Gy, as compared to 1.99, 0.09, and 21.5 Gy for non-carrier patients. The difference in volume effect parameter similarly described the biological integration of HBV carrier into the NTCP model. The third step was to use the four-parameter parallel-architecture NTCP model, specifically designed for the organ with parallel feature like liver, in a combined group of 151 patients with either HCC or GC. HBV carrier was the only independent factor with statistically significant susceptibility to RILD in multivariate test. The NTCP model parameters, mean functional reserve (v50), width of functional reserve distribution ( ), dose at which half of liver subunits are damaged (d1/2), slope parameter for subunit dose response (k), were 0.54, 0.14, 50Gy, 0.13 (whole group); 0.53, 0.07, 50Gy, 4.6 10-7 (HBV carriers); 0.59, 0.12, 25Gy, 59.8 (non-HBV carriers), respectively. The main difference in slope parameter demonstrated the biological influence of HBV carrier on RILD. The threshold effect of fraction of liver damaged (f) became evident after integrating biological factor (HBV carrier) into the modeling process. We concluded the effectiveness of the two NTCP models in RILD, and the unique importance of HBV carrier in estimating the two NTCP model parameters. It is emphasized that physical and mathematical NTCP methods should be cautiously used with appropriate integration of biological factors. The biology integrated NTCP models are extremely important for HBV carrier patients undergoing 3DCRT or the other new technology of radiotherapy to the liver. Such importance of biological factor in radiation-induced liver damage also implies the corresponding biological pathogenesis and warrants the ongoing basic cellular or molecular research on RILD.
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Da, Chuang Ho, and 莊和達. "Probability Model for Biology Integrated Normal Tissue Complication Based on Radiation Induced Sensorineural Hearing Loss." Thesis, 2008. http://ndltd.ncl.edu.tw/handle/07681532086873442640.
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碩士輔仁大學
應用統計學研究所
96
Sensori-neural hearing loss (SNHL) is a common complication of radiation therapy in the upper head and neck region. To determine the relationship between the radiation dose to the inner ear and long-term hearing loss, in this thesis, we estimated the dose response relationship for SNHL using Lyman model. Patients with newly diagnosed AJCC Stage I–IV Nasopharynx carcinoma treated from 2000–2003 were identified. The records of 348 ears in 174 patients who received a pre-irradiation pure tone audiogram and follow up audiograms 36 months post-irradiation were included in the analysis. All patients were treated with conventional radiotherapy to 70-74.4 Gy and received cis-diamino-dichloro-platinum (CDDP) and 5-fluorouracil (5-FU) chemotherapy. Pre-treatment and post-radiotherapy audiograms at 1 year, 2 years, and 3 years were obtained. The audiograms included assessment of bone conduction thresholds at 0.25, 0.5, 1, 2, 4, and 8 kHz. We fitted the probability of developing late toxicity within 3 years with the radiation induced SNHL by using Lyman NTCP model. A maximum likelihood analysis yielded good estimates for the Lyman NTCP model parameters for the inner ear for the entire patient population. Statistical analysis of the Lyman model was performed. Evaluation of goodness of fit and confidence intervals were conducted. The Lyman model parameters TD50(1) (the dose to the whole organ leading to a complication probability of 50%) was found to be 57, 56, 47Gy at 1st year, 2nd year and 3rd year post-radiotherapy at 8kHz and 65, 62, 50Gy at 4kHz. The volume dependence parameter n and the slope of the dose response relationship m were estimated to be nearly 0.02 and 0.85, respectively. The inner ear is a critical structure in patients with nasopharyngeal carcinoma. The dose to the inner ear should be carefully considered when planning radiation treatment in this region.
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Takam, Rungdham. "Evaluation of normal tissue complication probability and risk of second primary cancer in prostate radiotherapy." Thesis, 2010. http://hdl.handle.net/2440/64721.
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The probabilities of developing radiation-induced normal tissue complications and second primary cancers were evaluated using dose-volume histograms as well as dose measurements covering a range of radiotherapy techniques including External Beam Radiotherapy (EBRT) and Brachytherapy (BT) for prostate cancer. There are two major parts in this thesis. In the first part, the Dose-Volume Histograms (DVHs) of the Organs-At-Risk (OARs) such as rectum, bladder, urethra, and femoral heads were retrieved from the radiation treatment plans of 4-field standard
fractionated (2 Gy/fraction) Three-Dimensional Conformal Radiotherapy (3D-CRT) to total dose of 64 Gy, 4-field hypofractionated (2.75 Gy/fraction) 3D-CRT to total dose of 55 Gy, 5-field 3D-CRT to total dose of 70 Gy, 4-field 3D-CRT to total dose of 70 and 74 Gy, Low-Dose-Rate Brachytherapy (LDR-BT) with I-125, High-Dose-Rate Brachytherapy (HDR-BT) with Ir-192, and combined-modality treatment (3D-CRT & HDR-BT) techniques. The DVHs of these normal organs/tissues were converted to Biologically Effective Dose based DVHs (BEffDVHs) and Equivalent Dose based DVHs (DeqVHs) respectively in order to account for differences in radiation treatment modality and fractionation schedule. For assessment of the Normal Tissue Complication Probability (NTCP), the Lyman and Relative Seriality NTCP models were applied to the differential DeqVHs of the OARs. For the assessment of risk of radiation-induced Second Primary Cancer (SPC), the Competitive Risk model was used. In total, 223 DVHs from 101 patients were analysed in this thesis. In the second part, a radiation dosimetry technique was developed and used in measuring the doses delivered to distant organs/tissues (e.g. lungs and thyroid) as a result of prostate irradiation. In this case, simulation of prostate cancer radiotherapy was performed with the anthropomorphic Rando phantom using 4-field 3D-CRT technique to the total dose of 80 Gy with the 18 MV X-ray beam from Varian iX linear accelerator (linac). Radiation doses at different locations in the Rando phantom resulting from scattered and leakage photon and neutron radiations were measured using enriched 6Li and 7Li LiF:Mg,Cu,P glass-rod thermoluminescence dosimeters (TLDs). Results indicated that with hypofractionated 3D-CRT (20 fractions of 2.75-Gy fraction and 5 times/week to total dose of 55 Gy) NTCP of rectum, bladder and urethra were less than those for standard fractionated 3D-CRT using 4-field technique (32 fractions of 2-Gy fraction and 5 times/week to total dose of 64 Gy) and dose-escalated 3D-CRT. Rectal and bladder NTCPs (5.2% and 6.6% respectively) following the dose-escalated 4-field 3D-CRT (2 Gy per fraction to total dose of 74 Gy) were the highest amongst the analysed treatment techniques. The average NTCP for rectum and urethra were 0.6% and 24.7% for LDR-BT and 0.5% and 11.2% for HDR-BT. Although brachytherapy techniques resulted in delivering larger equivalent doses to normal tissues, the corresponding NTCPs were lower than those of external beam techniques except in the case of urethra due to much smaller volumes irradiated to higher doses. Amongst normal tissues analysed, femoral heads were found to have the lowest probability of complications as most of their volume was irradiated to lower equivalent doses compared to other tissues. The average estimated radiation-induced SPC risk was no greater than 0.6% for all treatment plans corresponding to various treatment techniques but was lower for either LDR or HDR brachytherapy alone compared with any EBRT technique. For LDR and HDR brachytherapy alone, the risk of SPC for rectum was approximately 2.0 x 10-4% and 8.3 x 10-5% respectively compared with 0.2% for EBRT using 5-field 3D-CRT to total dose 74 Gy. Treatment plans which deliver equivalent doses of around 3 – 5 Gy to normal tissues were associated with higher risks of development of cancers. Results from TLDs measurements in the Rando phantom indicated that photon doses were highest close to the irradiation volume and the photon dose equivalent ratio (dose equivalent per unit of target dose) decreases proportionally with the distance from the isocentre (e.g. 6.5 mSv/Gy for small intestine to 0.2 mSv/Gy for thyroid). In contrast, the dose equivalent ratio of neutrons in the Rando phantom was observed to be constant at approximately 5.7 mSv/Gy for up to 50 centimeters from the edge of the treatment field (from pancreas to oesophagus). The total dose equivalent (photon and neutron) for each organ/tissue approximated for the 4-field standard fractionated 3D-CRT technique to total dose of 80 Gy using 18 MV X-ray beam from Varian iX linac ranged between 323.0 mSv (for thyroid) and 1203.7 mSv (for colon). Based on the competitive risk model and on the assumptions that the dose equivalents were uniformly distributed in the volumes of these organs/tissues, the estimated risks of SPC range from 1.5% (in thyroid) up to 4.5% (in colon). Different radiation treatment techniques for prostate cancer are associated with different probabilities of developing radiation-induced normal tissue complications and second primary cancers. In the case of brachytherapy for prostate cancer, due to its specific dose-volume characteristics in addition to not having the leakage or neutron radiation associated with external beam radiotherapy, this treatment modality is associated with a reduced risk of NTCP and SPC compared with EBRT techniques for both organs situated close to and organs situated at a distance from the treatment field. In this current work, the radiation dosimetry technique based on the 6LiF:Mg,Cu,P and 7LiF:Mg,Cu,P glass-rod TLDs was developed to determine the radiation doses received by organs/tissues positioned away from the irradiation field due to scattered and leakage photons and neutrons. This radiation measurement technique enables the evaluation of the prostate radiation treatment plan to include the assessment of organs/tissues of interest in both high and low dose regions. It was demonstrated in this thesis that the relative seriality (NTCP) and the competitive risk (SPC) are useful models which can be used for the purpose of relative comparison and evaluation of prostate radiation treatment plans even though they may need to be further verified and fine tuned against clinical data.Thesis (Ph.D.) -- University of Adelaide, School of Chemistry and Physics, 2010
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Guo, Shih-Sian, and 郭仕賢. "Comparison of dose-response characteristics of five normal tissue complication probability models through outcomes of radiation pneumonitis in breast cancer patients." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/ttda7v.
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碩士國立高雄應用科技大學
電子工程系碩士班
103
Purpose : To investigate the relationship between lung dose and radiation pneumonitis in breast cancer patients after radiotherapy. Materials and methods : We built and compared five normal tissue complication probability (NTCP) models through outcomes of radiation pneumonitis in breast cancer patients, and defined the best predictive NTCP model for local population in this study. 87 patients with breast cancer were evaluated and 5 outlier samples were excluded. In total, 82 patient data were used in this study. The patients were treated by intensity-modulated radiotherapy or hybrid intensity-modulated radiotherapy techniques. The patients were evaluated by chest computed tomography (CT) at 3 months after completion of radiation therapy. Density changes on chest CT were evaluated by comparing with the CT image prior to radiation therapy for radiation therapy treatment planning. Clinically complication was defined according to the modified Common Toxicity Criteria of the National Cancer Institute (CTC-NCIC). We used the sample data to build five NTCP models. The five models were LKB (Lyman Kutcher-Burman), Logistic, Schultheiss, Poisson and Kallman-s model, respectively. The five NTCP models were compared by different model performance validation tools. We also built LKB - Veff model based on the LKB model. LKB - Veff model provided the correlation of effective volume and dose at the same complication probability for clinical phycisian. Results : The fitted parameters of five NTCP models were (1) LKB model : TD50 = 21.42 Gy (95% CI, 20.13 - 22.83), m = 0.27 (95% CI, 0.18 - 0.56)；(2) Logistic model : TD50 = 21.41 Gy (95% CI, 20.12 - 22.86), γ= 1.48 (95% CI, 0.71 - 2.35)；(3) Schultheiss model : TD50 = 21.26 Gy (95% CI, 19.89 - 22.74), k = 5.65 (95% CI, 2.67 - 9.07)；(4) Poisson model : TD50 = 21.21 Gy (95% CI, 19.83 - 22.68), γ= 1.46 (95% CI, 0.74 - 2.21) ；(5) Kallman-s model : TD50 = 21.66 Gy (95% CI, 20.25 - 23.15), γ= 1.46 (95% CI, 0.74 - 2.20), s = 1.01. Overall performance Akaike's Information Criterion (AIC) of Kallman-s model was better than the other four models, but other performance validation were equal in five models. Conclusions : Reducing lung radiation dose in breast cancer patients can effectively reduce the probability of radiation pneumonitis. The dose of 50% probability of complications of radiation pneumonitis was 21.66 Gy in Kallman-s model, which was the best model in our study. Reducing the effective volume of irradiated lung could improve the quality of life of breast cancer patients.
Book chapters on the topic "Normal tissue complication probabil"
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Troicki, Filip T., Filip T. Troicki, Filip T. Troicki, Carlos A. Perez, Wade L. Thorstad, Brandon J. Fisher, Larry C. Daugherty, et al. "Normal Tissue Complication Probability (NTCP)." In Encyclopedia of Radiation Oncology, 560. Berlin, Heidelberg: Springer Berlin Heidelberg, 2013. http://dx.doi.org/10.1007/978-3-540-85516-3_341.
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Deasy, Joseph O., and Issam El Naqa. "Image-Based Modeling of Normal Tissue Complication Probability for Radiation Therapy." In Cancer Treatment and Research, 211–52. Boston, MA: Springer US, 2008. http://dx.doi.org/10.1007/978-0-387-36744-6_11.
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Gulliford, Sarah. "Modelling of Normal Tissue Complication Probabilities (NTCP): Review of Application of Machine Learning in Predicting NTCP." In Machine Learning in Radiation Oncology, 277–310. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-18305-3_17.
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Hensley, F. W., G. Becker, R. Lohrum, J. T. Lyman, G. Gademann, D. Fehrentz, W. Schlegel, M. Flentje, and W. J. Lorenz. "Biological Treatment Planning: Calculation of Normal Tissue Complication Probabilities Based on Dose-Volume Analysis of Three-Dimensional Treatment Plans." In Tumor Response Monitoring and Treatment Planning, 441–46. Berlin, Heidelberg: Springer Berlin Heidelberg, 1992. http://dx.doi.org/10.1007/978-3-642-48681-4_73.
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Andreassen, Christian Nicolaj. "The Biological Basis for Differences in Normal Tissue Response to Radiation Therapy and Strategies to Establish Predictive Assays for Individual Complication Risk." In Pathobiology of Cancer Regimen-Related Toxicities, 19–33. New York, NY: Springer New York, 2012. http://dx.doi.org/10.1007/978-1-4614-5438-0_2.
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"Normal Tissue Complication Probability." In Handbook of Disease Burdens and Quality of Life Measures, 4271. New York, NY: Springer New York, 2010. http://dx.doi.org/10.1007/978-0-387-78665-0_6213.
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"Tumor Control and Normal Tissue Complication Probability Models in Radiation Therapy." In Tutorials in Radiotherapy Physics, 235–96. Boca Raton, FL : CRC Press, Taylor & Francis Group, 2016. |: CRC Press, 2016. http://dx.doi.org/10.1201/9781315381961-13.
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Balosso, Jacques, Valentin Calugaru, Abdulhamid Chaikh, and Juliette Thariat. "Normal Tissue Complication Probability Reduction in Advanced Head and Neck Cancer Patients Using Proton Therapy." In Advances in Particle Therapy, 145–54. CRC Press, 2018. http://dx.doi.org/10.1201/b22229-11.
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Englert, Joshua A., and Rebecca Marlene Baron. "Sepsis Syndrome." In The Brigham Intensive Review of Internal Medicine, 395–402. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199358274.003.0039.
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Sepsis is a clinical syndrome characterized by systemic inflammation leading to tissue injury that arises as a complication of an infection. According to current paradigms, sepsis arises as a result of the infection of a normally sterile body compartment. Infection leads to activation of the innate immune system to produce a systemic inflammatory response. This response is a necessary component of the body's defense against infection under normal conditions, but it is the lack of regulation of this response that is central to the pathogenesis of sepsis. As discussed in more detail below, this dysregulated inflammatory state can lead to tissue injury and dysfunction in organs not involved in the original infectious insult. Although sepsis remains a condition with exceedingly high morbidity and mortality, recent early management and treatment strategies have demonstrated exciting improvements in overall outcomes.
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Dutta, Debnarayan, and Yarlagadda Sreenija. "Radiation Induced Liver Toxicity." In Hepatotoxicity [Working Title]. IntechOpen, 2022. http://dx.doi.org/10.5772/intechopen.105410.
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Liver was always considered to be ‘highly sensitive’ to radiation therapy (RT) and was not considered ‘safe’ for radiation therapy treatment. The most significant radiation induced liver toxicity was described by Ingold et al. as “Radiation hepatitis.” Historically, radiation to liver lesions with curative intent or incidental exposure during adjacent organ treatment or total body irradiation implied whole organ irradiation due to lack of high precision technology. Whole organ irradiation led to classic clinical picture termed as “Radiation Induced Liver Disease (RILD).” In conventional fractionation, the whole liver could be treated only to the doses of 30–35Gy safely, which mostly serves as palliation rather than cure. With the advent of technological advancements like IMRT, especially stereotactic radiation therapy (SBRT), the notion of highly precise and accurate treatment has been made practically possible. The toxicity profile for this kind of focused radiation was certainly different from that of whole organ irradiation. There have been attempts made to characterize the effects caused by the high precision radiation. Thus, the QUANTEC liver paper distinguished RILD to ‘classic’ and ‘non-classic’ types. Classic RILD is defined as ‘anicteric hepatomegaly and ascites’, and also can also have elevated alkaline phosphatase (more than twice the upper limit of normal or baseline value). This is the type of clinical picture encountered following irradiation of whole or greater part of the organ. Non-classic RILD is defined by elevated liver transaminases more than five times the upper limit of normal or a decline in liver function (measured by a worsening of Child-Pugh score by 2 or more), in the absence of classic RILD. In patients with baseline values more than five times the upper limit of normal, CTCAE Grade 4 levels are within 3 months after completion of RT. This is the type of RILD that is encountered typically after high-dose radiation to a smaller part of liver. It is commonly associated with infective etiology. Emami et al. reported the liver tolerance doses or TD 5/5 (5% complication rate in 5 years) as 50 Gy for one-third (33%) of the liver, 35 Gy for two-thirds (67%) of the liver, and 30 Gy for the whole liver (100%). Liver function (Child Pugh Score), infective etiology, performance status and co-morbidities influence the radiation induced toxicity. Lyman–Kutcher–Burman (LKB)-NTCP model was used to assess dose-volume risk of RILD. Lausch et al. at London Regional Cancer Program (LRCP), developed a logistic TCP model. Quantitative Analysis of Normal Tissue Effects in the Clinic (QUANTEC) reported recommendations that mean normal liver dose should be <18 Gy for baseline CP-A patients and < 6 Gy for those with CP-B, for a 6-fraction SBRT regimen. The University of Colorado phase 1 clinical trial of SBRT for liver metastases described the importance of the liver volume spared, that is, ‘critical volume model.’ It is estimated that a typical normal liver volume is approximately 2000 mL and specified that a minimum volume of 700 mL or 35% of normal liver should remain uninjured by SBRT i.e. at least 700 mL of normal liver (entire liver minus cumulative GTV) had to receive at total dose less than 15 Gy. In treatment regimen of 48 Gy in 3 fractions, CP-A patients were required to either limit the dose to 33% of the uninvolved liver (D33%) < 10 Gy and maintain the liver volume receiving <7 Gy to <500 cc. In more conservative treatment regimen, such as in 40 Gy in 5 fractions schedule, CP-B7 patients had to meet constraints of D33% < 18 Gy and/or > 500 cc receiving <12 Gy. The concept of body surface area (BSA) and Basal Metabolic Index (BMI) guided estimation of optimal liver volume is required to estimate the liver volume need to be spared during SBRT treatment. Radiation induced liver injury is potentially hazardous complication. There is no definitive treatment and a proportion of patient may land up in gross decompensation. Usually supportive care, diuretics, albumin supplement, and vitamin K replacement may be useful. Better case selection will avert incidence of RILD. Precise imaging, contouring, planning and respecting normal tissue constraints are critical. Radiation delivery with motion management and image guidance will allow delivery of higher dose and spare normal liver and hence will improve response to treatment and reduce RILD.
Conference papers on the topic "Normal tissue complication probabil"
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Li Bing Zhou, Zhengdong, Shen Junshu, and Dai Wei. "A simple program to calculate normal tissue complication probability in external beam radiotherapy for nasopharyngeal carcinoma." In 2010 International Conference on Computer Application and System Modeling (ICCASM 2010). IEEE, 2010. http://dx.doi.org/10.1109/iccasm.2010.5619029.
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Dinapoli, Nicola, Anna Rita Alitto, Mauro Vallati, Rosa Autorino, Roberto Gatta, Luca Boldrini, Andrea Damiani, Giovanna Mantini, and Vincenzo Valentini. "RadioBio data: A Moddicom Module to Predict Tumor Control Probability and Normal Tissue Complication Probability in Radiotherapy." In 9th International Conference on Health Informatics. SCITEPRESS - Science and and Technology Publications, 2016. http://dx.doi.org/10.5220/0005693502770281.
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Ford, I., P. G. Newrick, R. Malik, F. E. Preston, J. D. Ward, and M. Greaves. "HAEMOSTATIC PARAMETERS, ENDONEURIAL OXYGEN TENSION AND SURAL NERVE HISTOLOGY IN DIABETES MELLITUS." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1643107.
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We have examined coagulation parameters in 15 neuropathic (Group A) and 10 complication-free diabetic patients (Group B). Venesection and sample testing were performed under standard conditions. Group A underwent sural nerve biopsy and 14 also had measurements of endoneurial oxygen tension. Factor VIII related antigen was higher in Group A (l-617u/ml ± 0.67) compared to Group B (0.944u/ml ± 0.26); (mean ± SD; p<.0.05) perhaps suggesting endothelial cell damage, although this did not correlate with capillary basement membrane thickness or endothelial cell number nor with endoneurial oxygen levels. Platelets from Group A were more sensitive to arachidonate than those of Group B, showing aggregation thresholds in platelet rich plasma of 0.36 ± 0.17mM and 0.57 ± 0.9mM respectively compared with 0.65 ± 0.37mM in non-diabetic controls.Platelets from Group A subjects also produced more thromboxane B2 in response to arachidonate than Group B or normal controls (37.95 ± 27.5; 25.5 ± 13.0; 16.55 ± 15-5pmol/107 platelets). Blood fibrinolytic capacity measured by euglobulin clot lysis time, was diminished in NIDDs (post-occlusion ECLT 165.7 mins ± 116.0), compared to IDDs (55.5 ± 34.5) (p<0.05) due at least in part to excess of tissue plasminogen-activator inhibitor, although we found no significant difference in ECLT between Group A and Group B. Interaction between haemostatic and microvascular abnormalities in diabetes may contribute to the pathogenesis of diabetic neuropathy.
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Giannelli, B. F. "MOLECULAR GENETICS OF HAEMOPHILIA." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1643981.
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Haemophilia B, an X-linked recessive disease with an incidence of 1/30,000 newborn males, is due to defects in the gene for coagulation factor IX, which is on the long am of the X chromosome at band Xq27.1. This gene consists of approximately 34 Kb and contains 8 exons which specify a mRtfc of 2803 residues coding for a protein of 415 aa preceded by a prepro signal peptide of 46 aa. Coripanson of the functional domains of the factor IX protein with the exon structure of the gene supports the exon/protein domain hypothesis of gene evolution. The factor IX gene seems to be formed by a number of functionally and evolutionally independent modules. The signal peptide and the gla (γcarboxy-glutamic) region encoded in the first three exons are homologous to those of factor X, protein C and prothrombin. Thevfourth and fifth exons which code for the connecting peptide are homologous to one another and to the epidermal growth factor, a module that has been used in the construction of a great variety of proteins including different members of the coagulation and fibrinolytic pathways. The sixth exon encodes the activation peptide region, while the catalytic region of factor IX is coded by the seventh and eighth exon. This is at variance with other serine protease genes that have different exons for the segments containing the cardinal ami no-acids of the active centre (histidine, aspartic acid and serine).Natural selection acts against detrimental mutations of the factor IX gene and at each generation a proportion of haemophilia B genes is eliminated, as a significant number of patients does not reproduce. There appears to be no selective advantage to the heterozygote and therefore haemophilia B is maintained in the population by new mutations. Consequently, a significant proportion of patients should be born to non-carrier mothers, and unrelated patients should carry different gene defects, as recently verified by detailed analysis of individual haemophilia B genes.The defects of factor IX described so far comprise both point mutations and gene deletions. The latter affect either part or the whole of the gene and are often associated with the development of antibodies against therapeutically adninistered factor IX (the inhibitor complication). Since gene deletions may result in the complete absenceof factor IX synthesis or in the production of an extremely abnormal product, it has been suggested that mutationspreventing the synthesis of a factor IX gene product capable of inducing immune tolerance to normal factor IX is important in predisposing to the inhibitor complication.Among the point mutations described so far, those affecting the signal peptide are of particular interest. Substitutions of the arginine at positions -4 and -1 cause failure of propeptide cleavage. Thus they indicate that the propeptide consists of 18 aa an(lthat lts excision is necessary for factor IX function. It appears also that the propeptide contains a signal for γcarboxylation which has been conserved during the evolution of different γcarboxylated proteins.In spite of coagulant treatment, haemophilia B is a serious disease and one for which genetic counselling is required. Paramount for this is the detection of carriers and the diagnosis ofaffected male fetuses. DNA probes derived from the cloned factor IX gene have been used for this purpose. Carrier and first or second trimester prenatal diagnoses have been done using factors IX gene markers to follow the transmission of haemophilia B genes. Six sequence variations causing restriction fragment length polymorphisms (RFLP) in the factor IX gene have been detected and used as markers for such indirect diagnoses The efficiency of the above markers is reduced by linkage disequilibrium but, nevertheless, they offer definite carrier and nremtal diagnoses in 75-80% of the relatives of familial cases of haemophilia B.The indirect detection of gene defects is of modest help in the counselling of individuals from the families of isolated patients, but new methods for the direct detection of gene mutations promise better results in such families and also the attainment of % diagnostic success in relatives of familial cases.Finally the successful expression of recombinant factor IX genes in tissue culture and transgenic mammals raises hopes of therapeutic advances.
Reports on the topic "Normal tissue complication probabil"
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Zhang, Chunxi, Fangfang Xie, Runchang Li, Ningxin Cui, and Jiayuan Sun. Robotic-assisted bronchoscopy for the diagnosis of peripheral pulmonary lesions: A systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, September 2022. http://dx.doi.org/10.37766/inplasy2022.9.0115.
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Review question / Objective: What is the overall diagnostic yield and complication rate of robotic-assisted bronchoscopy for peripheral pulmonary lesions? Condition being studied: Many of peripheral pulmonary lesions (PPLs) may represent early-stage lung cancer. Lung cancer is the leading cause of cancer mortality globally. Early diagnosis and treatment of lung cancer are crucial for a better prognosis. With the widespread use of low-dose computed tomography (LDCT), the detection rate of PPLs is increasing. As a result, the number of PPLs requiring biopsy is progressively increasing. Transbronchial lung biopsy (TBLB) and transthoracic needle aspiration (TTNA) are the main modalities of non-surgical biopsy for PPLs. TTNA has a diagnostic yield of 90%, however, it also has a pneumothorax rate of 25%. Since TBLB avoids destroying the structure of normal pleura and lung tissue, the incidence of complications is lower. Unfortunately, traditional flexible bronchoscopy has a modest sensitivity of 34% and 63% for lesions 2 cm, respectively. The advent of guided bronchoscopy has increased the diagnostic yield to 70%. However, there is still a gap in diagnostic yield compared with TTNA. The advent of robotic-assisted bronchoscopy (RAB) is expected to further improve the diagnostic yield of TBLB for PPLs. However, the diagnostic performance of RAB for PPLs has not reached a consensus.