SBRT LIVER PLAN EVALUATION SHEET.docx
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This document contains a checklist for evaluating hepatocellular carcinoma stereotactic body radiation therapy plans. It includes sections on patient information, tumor details, liver volumes, plan parameters, dose constraints for the gross tumor volume and planning target volume, and acceptable dose limits for nearby organs at risk like the stomach, duodenum, small bowel and kidneys. The checklist specifies dose and volume criteria that must be met for a plan to be considered acceptable for treatment.
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![HCC SBRT PLAN EVALUATION CHECK LIST
1. NAME UMR
2. DIAGNOSIS
3. PRIOR TREATMENT
4. IMAGING FINDING
NUMBER
SIZE
LOBE
SEGMENT
CHIRHOSIS
THROMBUS BLAND TUMOR
VOLUME GTV NORMAL FUNCTIONAL FUNCTIONAL-GTV
ARTERIAL PHASE ENHANCEMENT
VENOUS WASHOUT
DELAYED PSEUDOCAPSULE
5. CHILD SCORE[BEAP]
6. MOTION MANAGEMENT
7. LIVER VOLUME LIVER-GTV VOLUME LIVER-PTV VOLUME
8. LOCATION SIDE SIZE max [mm] PTV MARGIN VOLUME-CC DOSE
GTV PTV
9. PLAN TYPE-[3DCRT/VMAT/DCR/IMRS]
10. PRESCRIBED MARGINAL ISODOSE BED
D MAX
D95%
D100%
V95%
V100%
V120%
V130%
DISTANCE BETWEEN 80% ISODOSE AND 60% ISODOSE-[<2mm]
DISTANCE BETWEEN 80% ISODOSE AND 40% ISODOSE-[<8mm]
CONFIRMITY INDEX [IDEAL 1] VOLUME OF PRESCRIPTION ISODOSE/VOLUME OF PTV
HOMOGENITY INDEX [BETWEEN 1.1-1.3] MAX DOSE/ PRESCRIPTION DOSE
GRADIENT INDEX [BETWEEN 0.3-0.9] [RADIUS OF PRESCRIPTION ISODOSE - RADIUS OF HALF PRESCRIPTION ISODOSE]
PRESCRIPTION DOSE LIVER-GTV [>700CC]
NEEDED ACCEPTABLE UNACCEPTABLE ACHIEVED
50 Gy ≤13 Gy 13-13.2 Gy > 13.2 Gy
45 Gy ≤15 Gy 15-15.2 Gy > 15.2 Gy
40 Gy ≤15 Gy 15-15.2 Gy > 15.2 Gy
35 Gy ≤15.5 Gy 15.5-15.7 Gy > 15.7 Gy
30 Gy ≤16 Gy 16-16.2 Gy > 16.2 Gy
27.5 Gy ≤17 Gy 17-17.2 Gy > 17.2 Gy
11. NON-LIVER OAR CONSTARINTS NEEDED ACCEPTABLE UNACCEPTABLE ACHIEVED
Esophagus max (to 0.5 cc): 32 Gy > 32 but ≤34 Gy > 34 Gy
Stomach max (to 0.5 cc): 30 Gy >30 but ≤32 Gy > 32 Gy
Duodenum max (to 0.5 cc): 30 Gy >30 but ≤32 Gy > 32 Gy
Small bowel max (to 0.5 cc): 30 Gy >30 but ≤32 Gy > 32 Gy
Large bowel max (to 0.5 cc): 32 Gy >32 but ≤34 Gy > 34 Gy
Cord + 5 mm max (0.5cc): 25 Gy >25 but ≤28 Gy > 28 Gy
Kidneys: Bilateral mean ≤10 Gy >10 but ≤12 Gy > 12 Gy
Chest wall
Gall bladder
CBD <50Gy](https://image.slidesharecdn.com/sbrtliverplanevaluationsheet-221026032546-beddb277/85/SBRT-LIVER-PLAN-EVALUATION-SHEET-docx-1-320.jpg)
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Oncology cartoons by Dr Kanhu Charan Patro
This document provides guidance on target volume delineation for vulval cancer from the Royal College of Radiologists. It outlines the clinical target volume (CTV) for different disease sites, including the vulva, mons pubis, vagina, anorectum, urethra and pelvic nodes. Contouring workflows and organ-at-risk constraints are also discussed. Recommendations are given for radiation dose and treatment of resectable and unresectable head and neck cancer. The final item notes that smoking increases the risk of kidney cancer.
RADIATION THERAPY IN BILIARY TRACT CANCER
This document provides information on biliary tract cancers and the role of chemoradiotherapy in their treatment. It discusses the anatomy and types of biliary cancers, risk factors, presentation, diagnosis, staging, and standard treatment approaches including surgery. It then focuses on the evidence and guidelines for use of radiation therapy, including as adjuvant therapy after surgery for positive margins or nodes, as radical/definitive therapy for unresectable disease, and for palliation of symptoms from local or metastatic disease. Key findings are that chemoradiation improves local control and survival as adjuvant or radical therapy, and brachytherapy and external beam radiation are effective for palliation. Optimal regimens involve fluorouracil or capec
FEBRUARY 2024 ONCOLOGY CARTOON /95TH VOLUME
Dr Kanhu Charan Patro provides summaries of statistical concepts in 3 sentences or less, beginning each summary with the date. Summaries from January 19th to February 15th are presented, covering topics such as p-values, censoring in survival analysis, hazard ratios, and ISRS guidelines for stereotactic radiosurgery. On February 15th, a 3 sentence summary of World Cancer Day is provided, noting the date it is held, the organization that leads it, and the 2024 slogan of "Close the care gap".
Molecular Profile of Endometrial cancer.
The document discusses molecular analysis and classification of endometrial cancer, which impacts staging and treatment decisions. It describes aggressive histological subtypes and how molecular markers like POLE mutations, MMRd, and p53 abnormalities determine low, intermediate, or high risk stratification. Ongoing PORTEC trials are exploring the impact of molecular profiling on adjuvant treatment, with POLE mutations potentially downstaging while p53 mutations upstage disease. Molecular analysis provides predictive significance for personalized adjuvant therapies in endometrial cancer.
ONCOLOGY CARTOONS JANUARY 2024 BY DR KANHU CHARAN PATRO
This document discusses cervical cancer awareness month in January and provides 3 recommendations: 1) Be loyal to your partner to reduce risk of HPV infection, 2) Maintain genital hygiene, 3) Get vaccinated against HPV to prevent cervical cancer, and 4) Get screened regularly to detect cervical cancer early.
TYPES OF STATISTICAL DATA BY DR KANHU CHARAN PATRO
This document discusses types of data in statistics. It defines qualitative and quantitative data, and describes different types of quantitative data like discrete, continuous, ordinal, and nominal. Examples of love and fight data are provided to illustrate these concepts. The document concludes with a short poem about not fighting in marriage.
WHY STEREOTATXY IN CRANIAL AVM / DR KANHU CHARAN PATRO
This document discusses stereotactic radiosurgery (SRS) for the treatment of cerebral arteriovenous malformations (AVMs). It begins by explaining what an AVM is and the risks they pose if untreated, such as bleeding in the brain. It then covers treatment options for AVMs and why SRS is often preferred for certain cases, such as when the AVM is in an eloquent or deep brain area. The document provides details on patient selection, imaging and planning for SRS, anticipated outcomes, and risks of treatment complications. It emphasizes the importance of multidisciplinary discussion and informed consent when determining if SRS is appropriate for a patient's individual AVM.
PORTAL VEIN TUMOR THROMBOSIS SBRT/DR KANHU CHRAN PATRO
1) SBRT is an effective treatment for hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT). In a study of 70 HCC patients with PVTT treated with SBRT, median survival was 10 months and 6-month and 12-month survival rates were 67.3% and 40% respectively.
2) Patients who received SBRT combined with transarterial chemoembolization (TACE) had significantly longer survival compared to those who did not receive TACE after SBRT.
3) SBRT is a promising bridging therapy prior to liver transplantation or hepatectomy by downstaging PVTT to make these curative procedures possible.
DR KANHU CHARTAN PATRO/ FOR ENT SURGEONS
1. Radiotherapy plays a crucial role in the treatment of head and neck cancers, both as a primary treatment and in combination with surgery. It is used for cancers of the nasopharynx, larynx, hypopharynx, and as postoperative treatment for most oral cancers.
2. Advances in radiotherapy technology such as IMRT have allowed for better tumor targeting while minimizing doses to surrounding healthy tissues, reducing treatment toxicities. Imaging techniques such as PET-CT provide improved visualization of tumors and affected lymph nodes, helping determine accurate target volumes.
3. Organ preservation approaches using radiotherapy and chemotherapy are increasingly used to treat head and neck cancers, avoiding disfiguring surgeries while achieving high
DECEMBER 2023 ONCOLOGY CARTOONS DRKANHU CHARAN PATRO
Here are the key points about the hepatitis B vaccine and liver cancer:
- Hepatitis B virus (HBV) infection can lead to chronic hepatitis B and significantly increase the risk of developing liver cancer later in life.
- The hepatitis B vaccine is effective at preventing HBV infection and therefore helps prevent liver cancers caused by the virus. It was the first vaccine referred to as an "anti-cancer" vaccine by the FDA.
- Around 25% of people with chronic HBV infection may develop liver cancer according to the CDC. Getting vaccinated helps avoid this risk.
- The hepatitis B vaccine is available and affordable in India, ranging from around 45 rupees per pediatric dose to 250 rupees for the
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June 2024 Oncology Cartoons By Dr Kanhu Charan Patro
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MAY 2024 ONCOLOGY CARTOONS BY DR KANHU CHARAN PATRO
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April 2024 ONCOLOGY CARTOON by DR KANHU CHARAN PATRO
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TARGET DELINEATION IN ANAL CANAL CANCER BY DR KANHU
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WHY STEREOTATXY IN CRANIAL AVM / DR KANHU CHARAN PATRO
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PORTAL VEIN TUMOR THROMBOSIS SBRT/DR KANHU CHRAN PATRO
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DECEMBER 2023 ONCOLOGY CARTOONS DRKANHU CHARAN PATRO
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