is a common complication after treatment for breast cancer. Factors associated with increased risk of lymphedema include extent of axillary surgery, axillary radiation, infection, and patient obesity. 2,3 The panel recommends educating the patients on lymphedema, monitoring for lymphedema, and referring for lymphedema management as needed.”

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines

Durvalumab plus platinum–etoposide versus platinum–etoposide in first-line treatment of extensive-stage small-cell lung cancer (CASPIAN): a randomised, controlled, open-label, phase 3 trial

Small Cell Lung Cancer

Brain metastases are one of the most common neurologic complications of cancer. The incidence is 9%–17% based on various studies, although the exact incidence is thought to be higher. The incidence is increasing with the availability of improved imaging techniques which aid early diagnosis, and effective systemic treatment regimens which prolong life, thus allowing cancer to disseminate to the brain. Lung cancer, breast cancer, and melanoma are the most frequent to develop brain metastases, and account for 67%–80% of all cancers. Most patients with brain metastases have synchronous extracerebral metastases. Some patients present with no known primary cancer diagnosis. In children, brain metastases are rare; germ cell tumors, sarcomas, and neuroblastoma are the common offenders.

Epidemiology of Brain Metastases

Purpose: To compare calculated and delivered dose distributions from RapidArc™ (a form of volumetric modulated arc therapy, Varian Medical Systems). RapidArc is a novel approach for delivering single arc therapy in less than 2 minutes, while achieving dose distributions comparable to current IMRT. We report the first detailed dosimetric validation for 5 different tumour sites with RapidArc plans. Method and Materials: Clinical RapidArc plans were generated with a pre‐clinical version for single cases with glioblastoma multiforme, multiple brain metastases, nasopharynx‐, oropharynx‐ and pancreas carcinoma. All five plans were delivered with a Varian Linac and measured in a solid water phantom for 5 coronal planes, 2 cm separated, using double Gafchromic®EBT films. Plans were also measured using ionisation chamber arrays (MatriXX). Measured and calculated dose distributions were compared using 2D gamma evaluation with limits of 2mm and 3.5% (of typical PTV dose in phantom). Results: All 25 film measurements showed high agreement with calculations, with a mean gamma of 0.29 and on average 1% (maximum 3%) of the film surface exceeding a gamma of 1.0. Relatively strong spatial dose modulations could be measured, within 95–107% dose range in the PTV, which were not completely predicted by calculations. This could lead to local dose changes >3% when changing a plane by 2mm. MatriXX measurements corresponded better with dose calculations than film measurements, which may be due to the limited resolution of 7.6mm of MatriXX. Conclusion: RapidArc accurately delivers the planned dose distributions. Film measurements may be preferred for dosimetric verification as more dose modulation is detectable than with ionisation array measurements. A “2.5D” gamma evaluation taking into account multiple adjacent dose planes would show better agreement for film dosimetry. Our results indicate that RapidArc can be introduced into clinical practice. Conflict of Interest: Research was a collaboration with Varian Medical Systems.

TH‐C‐350‐03: A Dosimetric Validation of RapidArc Treatment Plans for 5 Treatment Sites

Conventional IMRT versus Volumetric Modulated Arc Therapy (RapidArc) for Pancreatic Cancer

Identifying Patients With Extensive-Stage Small Cell Lung Cancer (ES-SCLC) Most Likely to Benefit From Intensive Radiation Therapy

The Impact of Introducing Stereotactic Body Radiotherapy in Elderly Patients with Stage I NSCLC: A Population-Based Time-Trend Analysis

Advantages of Respiration-Gated Radiotherapy for Stage III Lung Cancer

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