75 research outputs found

    Feasibility of tomotherapy-based image-guided radiotherapy for small cell lung cancer

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    Background: To assess the tolerance of patients with small cell lung cancer undergoing chemoradiation with tomotherapy-based image-guided radiotherapy (IGRT). Materials and Methods: A retrospective review of the toxicity profile for nine patients with small cell lung cancer of the limited stage who underwent chemoradiation delivered with helical tomotherapy (HT) has been conducted. Results: Acute grade 3–4 hematologic and esophagitis toxicities developed in two and three patients respectively. One patient developed a pulmonary embolism during radiotherapy. Seven patients had weight loss ranging from 0 to 30 pounds (median: 4 pounds). Three patients had treatment breaks ranging from 2 to 12 days. At a median follow-up of 11 months (range: 2–24 months), no patients developed any radiation related toxicities such as grade 3–4 pneumonitis or other long-term complications. The median survival was estimated to be 15 months. There were two local recurrences, three mediastinal recurrences, and six distant metastases. Conclusion: Grade 3–4 toxicities remained significant during chemoradiation when radiation was delivered with tomotherapy-based IGRT. However, the absence of grade 3–4 pneumonitis is promising and the use of HT needs to be investigated in future prospective studies

    The impact of concomitant chronic total occlusion on clinical outcomes in patients undergoing transcatheter aortic valve replacement: a large single-center analysis

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    BackgroundCoronary artery disease (CAD) is a common finding in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR). However, the impact on prognosis of chronic total occlusions (CTOs), a drastic expression of CAD, remains unclear.Methods and resultsWe retrospectively reviewed 1,487 consecutive TAVR cases performed at a single tertiary care medical center. Pre-TAVR angiograms were analyzed for the presence of a CTO. At the time of TAVR, 11.2% (n = 167) patients had a CTO. There was no significant association between the presence of a CTO and in-hospital or 30-day mortality. There was also no difference in long-term survival. LV ejection fraction and mean aortic gradients were lower in the CTO group.ConclusionsOur analysis suggests that concomitant CTO lesions in patients undergoing TAVR differ in their risk profile and clinical findings to patients without CTO. CTO lesion per se were not associated with increased mortality, nevertheless CTOs which supply non-viable myocardium in TAVR population were associated with increased risk of death. Additional research is needed to evaluate the prognostic significance of CTO lesions in TAVR patients

    Using virtual reality to design and evaluate a lunar lander: the EL3 case study

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    The European Large Logistics Lander (EL3) is being designed to carry out cargo delivery missions in support of future lunar ground crews. The capacity of virtual reality (VR) to visualize and interactively simulate the unique lunar environment makes it a potentially powerful design tool during the early development stages of EL3, as well as other relevant technologies. Based on input from the EL3 development team, we have produced a VR-based operational scenario featuring a hypothetical configuration of the lander. Relying on HCI research methods, we have subsequently evaluated this scenario with relevant experts (n=10). Qualitative findings from this initial pilot study have demonstrated the usefulness of VR as a design tool in this context, but likewise surfaced a number of limitations in the form of potentially impaired validity and generalizability. We conclude by outlining our future research plan and reflect on the potential use of physical stimuli to improve the validity of VR-based simulations in forthcoming design activities

    Using Virtual Reality to Shape Humanity's Return to the Moon: Key Takeaways from a Design Study

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    Revived interest in lunar exploration is heralding a new generation of design solutions in support of human operations on the Moon. While space system design has traditionally been guided by prototype deployments in analogue studies, the resource-intensive nature of this approach has largely precluded application of proficient user-centered design (UCD) methods from human-computer interaction (HCI). This paper explores possible use of Virtual Reality (VR) to simulate analogue studies in lab settings and thereby bring to bear UCD in this otherwise engineering-dominated field. Drawing on the ongoing development of the European Large Logistics Lander, we have recreated a prospective lunar operational scenario in VR and evaluated it with a group of astronauts and space experts (n=20). Our qualitative findings demonstrate the efficacy of VR in facilitating UCD, enabling efficient contextual inquiries and improving project team coordination. We conclude by proposing future directions to further exploit VR in lunar systems design

    Feasibility of Image-Guided Radiotherapy for Elderly Patients with Locally Advanced Rectal Cancer

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    PURPOSE: The study aims to assess the tolerance of elderly patients (70 years or older) with locally advanced rectal cancers to image-guided radiotherapy (IGRT). A retrospective review of 13 elderly patients with locally advanced rectal cancer who underwent preoperative chemoradiation using IGRT was performed. Grade 3-4 acute toxicities, survival, and long-term complications were compared to 17 younger patients (<70 years) with the same disease stage. RESULTS: Grade 3-4 hematologic toxicities occurred in 7.6% and 0% (p = 0.4) and gastrointestinal toxicities, and, in 15.2% and 5% (p = 0.5), of elderly and younger patients, respectively. Surgery was aborted in three patients, two in the elderly group and one in the younger group. One patient in the elderly group died after surgery from cardiac arrhythmia. After a median follow-up of 34 months, five patients had died, two in the elderly and three in the younger group. The 3-year survival was 90.9% and 87.5% (p = 0.7) for the elderly and younger group respectively. Two patients in the younger group developed ischemic colitis and fecal incontinence. There was no statistically significant difference in acute and late toxicities as well as survival between the two groups. CONCLUSIONS AND CLINICAL RELEVANCE: Elderly patients with locally advanced rectal cancers may tolerate preoperative chemoradiation with IGRT as well as younger patients. Further prospective studies should be performed to investigate the potential of IGRT for possible cure in elderly patients with locally advanced rectal cancer

    Feasibility of intensity-modulated and image-guided radiotherapy for locally advanced esophageal cancer

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    BACKGROUND:In this study the feasibility of intensity-modulated radiotherapy (IMRT) and tomotherapy-based image-guided radiotherapy (IGRT) for locally advanced esophageal cancer was assessed.METHODS:A retrospective study of ten patients with locally advanced esophageal cancer who underwent concurrent chemotherapy with IMRT (1) and IGRT (9) was conducted. The gross tumor volume was treated to a median dose of 70Gy (62.4-75Gy).RESULTS:At a median follow-up of 14months (1-39 months), three patients developed local failures, six patients developed distant metastases, and complications occurred in two patients (1 tracheoesophageal fistula, 1 esophageal stricture requiring repeated dilatations). No patients developed grade 3-4 pneumonitis or cardiac complications.CONCLUSIONS:IMRT and IGRT may be effective for the treatment of locally advanced esophageal cancer with acceptable complications.This item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at [email protected]
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