Purpose In 2009, the Radiation Therapy Oncology Group (RTOG) genitourinary members published a consensus atlas for contouring prostate pelvic nodal clinical target volumes (CTVs). Data have emerged further informing nodal recurrence patterns. The objective of this study is to provide an updated prostate pelvic nodal consensus atlas. Methods and Materials A literature review was performed abstracting data on nodal recurrence patterns. Data were presented to a panel of international experts, including radiation oncologists, radiologists, and urologists. After data review, participants contoured nodal CTVs on 3 cases: postoperative, intact node positive, and intact node negative. Radiation oncologist contours were analyzed qualitatively using count maps, which provided a visual assessment of controversial regions, and quantitatively analyzed using Sorensen-Dice similarity coefficients and Hausdorff distances compared with the 2009 RTOG atlas. Diagnostic radiologists generated a reference table outlining considerations for determining clinical node positivity. Results Eighteen radiation oncologists’ contours (54 CTVs) were included. Two urologists’ volumes were examined in a separate analysis. The mean CTV for the postoperative case was 302 cm3, intact node positive case was 409 cm3, and intact node negative case was 342 cm3. Compared with the original RTOG consensus, the mean Sorensen-Dice similarity coefficient for the postoperative case was 0.63 (standard deviation [SD] 0.13), the intact node positive case was 0.68 (SD 0.13), and the intact node negative case was 0.66 (SD 0.18). The mean Hausdorff distance (in cm) for the postoperative case was 0.24 (SD 0.13), the intact node positive case was 0.23 (SD 0.09), and intact node negative case was 0.33 (SD 0.24). Four regions of CTV controversy were identified, and consensus for each of these areas was reached. Conclusions Discordance with the 2009 RTOG consensus atlas was seen in a group of experienced NRG Oncology and international genitourinary radiation oncologists. To address areas of variability and account for new data, an updated NRG Oncology consensus contour atlas was developed.

NRG Oncology Updated International Consensus Atlas on Pelvic Lymph Node Volumes for Intact and Postoperative Prostate Cancer.

Purpose The CHHiP trial randomized 3216 men with localized prostate cancer (1:1:1) to 3 radiation therapy fractionation schedules: 74 Gy in 37 fractions over 7.4 weeks; 60 Gy in 20 fractions over 4 weeks; and 57 Gy in 19 fractions over 3.8 weeks. Literature-based dose constraints were applied with arithmetic adjustment for the hypofractionated arms. This study aimed to derive anorectal dose constraints using prospectively collected clinician-reported outcomes (CROs) and patient-reported outcomes (PROs) and to assess the added predictive value of spatial dose metrics. Methods and Materials A case–control study design was used; 7 CRO and 5 PRO bowel symptoms were evaluated. Cases experienced a moderate or worse symptom 1 to 5 years after–radiation therapy and did not have the symptom before radiation therapy. Controls did not experience the symptom at baseline or between 1 to 5 years after radiation therapy. The anorectum was recontoured from the anal verge to the rectosigmoid junction; dose/volume parameters were extracted. Univariate logistic regression, atlases of complication indices, and bootstrapped receiver-operating-characteristic analysis (1000 replicates, balanced outcomes) were used to derive dose constraints for the whole cohort (hypofractionated schedules were converted to 2-Gy equivalent schedules using α/β = 3 Gy) and separate hypofractionated/conventional fractionation cohorts. Only areas under the curve with 95% confidence interval lower limits >0.5 were considered statistically significant. Any constraint derived in Results Statistically significant dose constraints were derived for CROs but not PROs. Intermediate to high doses were important for rectal bleeding, whereas intermediate doses were important for increased bowel frequency, fecal incontinence, and rectal pain. Spatial dose metrics did not improve prediction of CROs or PROs. A new panel of dose constraints for hypofractionated schedules to 60 Gy or 57 Gy are V20Gy Conclusions Dose constraints differed among symptoms, indicating potentially different pathogenesis of radiation-induced side effects. Derived dose constraints were stricter than those used in CHHiP and may reduce bowel symptoms after radiation therapy.

Derivation of Dose/Volume Constraints for the Anorectum from Clinician- and Patient-Reported Outcomes in the CHHiP Trial of Radiation Therapy Fractionation.

Impact of Hypofractionated Radiotherapy on Patient-reported Outcomes in Prostate Cancer: Results up to 5 yr in the CHHiP trial (CRUK/06/016).

Photodisintegration reaction rates involving charged particles are relevant to the p-process nucleosynthesis that aims at explaining the production of stable neutron-deficient nuclides heavier than iron. In this study, considering the compound and pre-equilibrium reaction mechanisms, the cross sections and astrophysical rates of $(\ensuremath{\gamma},p)$ and $(\ensuremath{\gamma},\ensuremath{\alpha})$ reactions for about 3000 target nuclei with $10\ensuremath{\le}Z\ensuremath{\le}100$ ranging from stable to proton dripline nuclei are computed. To study the sensitivity of the calculations to the optical model potentials (OMPs), both the phenomenological Woods-Saxon and the microscopic folding OMPs are taken into account. The systematic comparisons show that the reaction rates, especially for the $(\ensuremath{\gamma},\ensuremath{\alpha})$ reaction, are dramatically influenced by the OMPs. Thus, better determination of the OMP is crucial to reduce the uncertainties of the photodisintegration reaction rates involving charged particles. Meanwhile, a $\ensuremath{\gamma}$-beam facility at Extreme Light Infrastructure--Nuclear Physics (ELI-NP) is being developed which will open new opportunities to experimentally study the photodisintegration reactions of astrophysical interest. Considering both the important reactions identified by the nucleosynthesis studies and the purpose of complementing the experimental results for the reactions involving $p$ nuclei, the measurements of six $(\ensuremath{\gamma},p)$ and eight $(\ensuremath{\gamma},\ensuremath{\alpha})$ reactions based on the $\ensuremath{\gamma}$-beam facility and the Extreme Light Infrastructure Silicon Strip Array (ELISSA) for the detection of charged particles at ELI-NP are proposed. Furthermore, the geant4 simulations on these $(\ensuremath{\gamma},p)$ and $(\ensuremath{\gamma},\ensuremath{\alpha})$ reactions are performed using the calculated cross sections and the features of the $\ensuremath{\gamma}$-beam facility and the ELISSA detector at ELI-NP. Simultaneously satisfying the minimum detectable limit of the experimental yield and the particle identification of protons and $\ensuremath{\alpha}$ particles, the minimum required energies of the $\ensuremath{\gamma}$ beam to measure the six $(\ensuremath{\gamma},p)$ and eight $(\ensuremath{\gamma},\ensuremath{\alpha})$ reactions are estimated. It is shown that the direct measurements of these photonuclear reactions based on the $\ensuremath{\gamma}$-beam facility at ELI-NP within the Gamow windows at the typical temperature of ${T}_{9}=2.5$ for the p-process are fairly feasible and promising. We believe that this pivotal work will guide the future photodisintegration experiments at ELI-NP. Furthermore, the expected experimental results will be used to constrain the OMPs of the charged particles, which can eventually reduce the uncertainties of the reaction rates for the p-process nucleosynthesis.

/pdf/determination-of-the-photodisintegration-reaction-rates-bb4734sgt5.pdf

Determination of the photodisintegration reaction rates involving charged particles: Systematic calculations and proposed measurements based on the facility for Extreme Light Infrastructure-Nuclear Physics

Objective:We aim to test the hypothesis that neurovascular bundle (NVB) displacement by rectal hydrogel spacer combined with NVB delineation as an organ at risk (OAR) is a feasible method for NVB-s...

https://www.birpublications.org/doi/pdf/10.1259/bjr.20200433

Dosimetric feasibility of neurovascular bundle-sparing stereotactic body radiotherapy with periprostatic hydrogel spacer for localized prostate cancer to preserve erectile function.

A randomised assessment of image guided radiotherapy within a phase 3 trial of conventional or hypofractionated high dose intensity modulated radiotherapy for prostate cancer.

Evaluation of erectile potency and radiation dose to the penile bulb using image guided radiotherapy in the CHHiP trial

1 University of Edinburgh, School of Physics and Astronomy, Edinburgh, United Kingdom 2 STFC Rutherford Appleton Laboratory, Detectors and Electronics Division, Didcot, United Kingdom 3 STFC Daresbury Laboratory, Nuclear Physics Group, Warrington, United Kingdom 4 University of Liverpool, School of Physical Sciences, Liverpool, United Kingdom 5 University of Brighton, School of Computing, Engineering and Mathematics, Brighton, United Kingdom

/pdf/beta-decay-studies-of-r-process-nuclei-using-the-advanced-fomibj5zxk.pdf

Beta-Decay Studies of R-Process Nuclei Using the Advanced Implantation Detector Array

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A randomised assessment of image guided radiotherapy within a phase 3 trial of conventional or hypofractionated high dose intensity modulated radiotherapy for prostate cancer.

Evaluation of erectile potency and radiation dose to the penile bulb using image guided radiotherapy in the CHHiP trial

Beta-Decay Studies of R-Process Nuclei Using the Advanced Implantation Detector Array