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Practical Radiation Oncology

Abram Recht, Elizabeth A Comen, Richard E Fine, Gini F Fleming, Patricia H Hardenbergh, Alice Y Ho, Clifford A Hudis, E Shelley Hwang, Jeffrey J Kirshner, Monica Morrow, Kilian E Salerno, George W Sledge, Lawrence J Solin, Patricia A Spears, Timothy J Whelan, Mark R Somerfield, Stephen B Edge
: A joint American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology panel convened to develop a focused update of the American Society of Clinical Oncology guideline concerning use of postmastectomy radiotherapy (PMRT). METHODS: A recent systematic literature review by Cancer Care Ontario provided the primary evidentiary basis. The joint panel also reviewed targeted literature searches to identify new, potentially practice-changing data...
September 15, 2016: Practical Radiation Oncology
William W Chance, Quynh-Nhu Nguyen, Reza Mehran, James W Welsh, Daniel R Gomez, Peter Balter, Ritsuko Komaki, Zhongxing Liao, Joe Y Chang
PURPOSE: We report our single-institution experience with stereotactic ablative radiotherapy (SABR) for adrenal metastasis and identify factors influencing outcomes, patterns of failure, and dosimetric thresholds for toxicity. METHODS AND MATERIALS: We identified patients with adrenal metastases treated with SABR from 2009 to 2015. Toxicity was evaluated with Common Terminology Criteria for Adverse Events v4.0. Local failures were categorized as in-field, marginal, or out-of-field...
September 13, 2016: Practical Radiation Oncology
Eleanor M Osborne, Ann H Klopp, Anuja Jhingran, Larissa A Meyer, Patricia J Eifel
PURPOSE: Treatment for locoregionally advanced cervical cancer has changed dramatically since 2000. In that year, delivery of radiation therapy with concurrent chemotherapy became standard, and in the early 2000s, use of intensity modulated RT (IMRT) and positron emission tomography (PET) became more prevalent. We sought to determine the impact of these changes on disease-specific survival (DSS) and treatment-related adverse effects in patients with cervical cancer with para-aortic lymph node (PAN) metastases treated with definitive extended-field radiation therapy...
September 7, 2016: Practical Radiation Oncology
Feng Liu, An Tai, Ergun Ahunbay, Elizabeth Gore, Candice Johnstone, X Allen Li
PURPOSE: To quantify interfractional independent motions between multiple primary targets in radiation therapy (RT) of lung cancer and to study the dosimetric benefits of an online adaptive replanning method to account for these variations. METHODS AND MATERIALS: Ninety-five on-treatment diagnostic-quality computed tomography (CT) scans acquired for 9 lung cancer patients treated with image-guided RT (IGRT) using a CT-on-rails (CTVision, Siemens) were analyzed. On each on-treatment CT set, contours of the targets (gross tumor volume, clinical target volume, or involved nodes), and organs at risk were generated by populating the planning contours using an autosegmentation tool (ABAS, Elekta) with manual editing...
September 2, 2016: Practical Radiation Oncology
Apoorva Trivedi, Takamura Ashikaga, Daphne Hard, Jessica Archambault, Martin Lachaine, David T Cooper, Harold James Wallace
PURPOSE: Transperineal ultrasound (TPUS) allows for continuous imaging of the prostate gland, but the accuracy of TPUS has not been rigorously studied. We determined the feasibility of prostate imaging with TPUS and subsequently compared prostate localization with TPUS and computed tomography (CT). METHODS AND MATERIALS: We completed 2 sequential evaluations of TPUS. The feasibility study included 15 men with localized prostate cancer and tested if TPUS adequately imaged the prostate...
September 2, 2016: Practical Radiation Oncology
Jeffrey V Siebers, J James Gordon
No abstract text is available yet for this article.
September 2, 2016: Practical Radiation Oncology
Victor J Gonzalez, Krisha Howell
No abstract text is available yet for this article.
August 31, 2016: Practical Radiation Oncology
Amit Roy, Pawinee Mahasittiwat, Ashley A Weiner, Steven R Hunt, Matthew G Mutch, Elisa H Birnbaum, Ira J Kodner, Thomas E Read, James W Fleshman, Jeffrey R Olsen, Robert J Myerson, Parag J Parikh
PURPOSE: Preoperative short-course radiation therapy (SCRT) has rarely been used for rectal cancer in the United States, although 2 randomized phase 3 trials demonstrate equivalence to conventional chemoradiation (CRT), and recent updates to national guidelines include this regimen as a treatment option. We sought to evaluate the efficacy and safety of preoperative SCRT followed by immediate surgery within 1 week to treat rectal cancer in the US setting. METHODS AND MATERIALS: All patients treated with preoperative SCRT (4 Gy × 5 fractions for total 20 Gy) followed by planned surgery within 1 week at our institution were retrospectively evaluated...
August 31, 2016: Practical Radiation Oncology
James D Mitchell, Thomas J Chesnut, David V Eastham, Carlo N Demandante, David J Hoopes
PURPOSE: In 2012, we instituted detailed prospective peer review of new cases. We present the outcomes of peer review on patient management and time required for peer review. METHODS AND MATERIALS: Peer review rounds were held 3 to 4 days weekly and required 2 physicians to review pertinent information from the electronic medical record and treatment planning system. Eight aspects were reviewed for each case: 1) workup and staging; 2) treatment intent and prescription; 3) position, immobilization, and simulation; 4) motion assessment and management; 5) target contours; 6) normal tissue contours; 7) target dosimetry; and 8) normal tissue dosimetry...
August 31, 2016: Practical Radiation Oncology
Suzanne B Evans, Benedick A Fraass, Paula Berner, Kevin S Collins, Teamour Nurushev, Michael J O'Neill, Jing Zeng, Lawrence B Marks
This white paper recommends the standardization (content and presentation order) of several "key components" of the radiation therapy prescription to facilitate accurate communication between radiation therapy care providers. The rationale, other similar efforts, and detailed considerations are described. In brief, the Task Force recommends that the prescription's "elements" include: treatment site, method of delivery, dose per fraction, total number of fractions, total dose (eg, right breast, tangent photons, 267 cGy * 16 = 4272 cGy)...
August 24, 2016: Practical Radiation Oncology
Lijun Ma, Steve E Braunstein, Philip V Theodosopoulos, Michael W McDermott, Penny K Sneed
PURPOSE: Various cochlear dose surrogates have been reported as associated with hearing outcome in studies of stereotactic radiosurgery (SRS) for vestibular schwannomas. In this study, we investigated whether an inherent functional relationship exists among these reported surrogates. METHODS AND MATERIALS: A cohort of 85 serial patient cases treated with single-fraction stereotactic radiosurgery from 1997 through 2013 at our institution was analyzed. For all the cases, the mean prescription dose was 12...
August 20, 2016: Practical Radiation Oncology
Guozhen Luo, Joseph S Neimat, Anthony Cmelak, Austin N Kirschner, Albert Attia, Manuel Morales-Paliza, George X Ding
PURPOSE: To report on radiosurgery delivery positioning accuracy in the treatment of tremor patients with frameless image guided radiosurgery using the linear accelerator (LINAC) based ExacTrac system and to describe quality assurance (QA) procedures used. METHODS AND MATERIALS: Between 2010 and 2015, 20 patients underwent radiosurgical thalamotomy targeting the ventral intermediate nucleus for the treatment of severe tremor. The median prescription dose was 140 Gy (range, 120-145 Gy) in a single fraction...
August 20, 2016: Practical Radiation Oncology
Stephen Lutz, Tracy Balboni, Joshua Jones, Simon Lo, Joshua Petit, Shayna E Rich, Rebecca Wong, Carol Hahn
PURPOSE: The purpose is to provide an update the Bone Metastases Guideline published in 2011 based on evidence complemented by expert opinion. The update will discuss new high-quality literature for the 8 key questions from the original guideline and implications for practice. METHODS AND MATERIALS: A systematic PubMed search from the last date included in the original Guideline yielded 414 relevant articles. Ultimately, 20 randomized controlled trials, 32 prospective nonrandomized studies, and 4 meta-analyses/pooled analyses were selected and abstracted into evidence tables...
August 5, 2016: Practical Radiation Oncology
Stephen A Rosenberg, David M Francis, Craig R Hullet, Zachary S Morris, Jeffrey V Brower, Bethany M Anderson, Kristin A Bradley, Michael F Bassetti, Randall J Kimple
PURPOSE: Nearly two-thirds of cancer patients seek information about their diagnosis online. We assessed the readability of online patient education materials found on academic radiation oncology department Web sites to determine whether they adhered to guidelines suggesting that information be presented at a sixth-grade reading level. METHODS AND MATERIALS: The Association of American Medical Colleges Web site was used to identify all academic radiation oncology departments in the United States...
August 1, 2016: Practical Radiation Oncology
Joseph Weiner, David Schwartz, Manuel Martinez, Joseph Safdieh, Ayse Aytaman, David Schreiber
PURPOSE: This study was designed to assess the efficacy and outcomes of argon plasma coagulation (APC) in the management of chronic radiation proctitis after conventionally fractionated, dose-escalated radiation therapy (≥7560 cGy). METHODS AND MATERIALS: We retrospectively reviewed the charts on all patients treated with external beam radiation therapy (minimum dose, 7560 cGy) for histologically confirmed prostate cancer at our institution from 2003 to 2011. Five hundred patients met these criteria; of these, 35 patients (7...
August 1, 2016: Practical Radiation Oncology
Shannon E Fogh, Christopher H Pope, Seth A Rosenthal, Patrick D Conway, Peter R Hulick, Jennifer L Johnson, Tariq A Mian, Indra J Das, Ann Lazar, Nikhil G Thaker, Brian T Monzon
PURPOSE: The American College of Radiology (ACR) Radiation Oncology Practice Accreditation (ROPA) program has accredited more than 600 sites since 2006, including practices within academic, hospital-based, and freestanding settings. The purpose of this report is to evaluate and compare patterns of change in common deficiencies over time. METHODS AND MATERIALS: The ACR database was queried to analyze the common deficiencies noted by the ACR ROPA program between 2012 and 2014...
September 2016: Practical Radiation Oncology
Jennifer Croke, Anthony Fyles, Lisa Barbera, David D'Souza, Robert Pearcey, Teri Stuckless, Brenda Bass, Michael Brundage, Michael Milosevic
PURPOSE: Radiation therapy plays an important curative role for patients with locally advanced cervical cancer (LACC). There are no standards to define best practice. The purpose of this study was to develop a suite of radiation therapy key quality-of-care indicators (KQIs) for the curative management of LACC based on expert consensus. METHODS AND MATERIALS: A modified Delphi method was used after identifying candidate KQIs. Round 1 involved surveying all Canadian gynecology radiation oncologists...
September 2016: Practical Radiation Oncology
Reshma Jagsi
No abstract text is available yet for this article.
September 2016: Practical Radiation Oncology
Monica Morrow, Kimberly J Van Zee, Lawrence J Solin, Nehmat Houssami, Mariana Chavez-MacGregor, Jay R Harris, Janet Horton, Shelley Hwang, Peggy L Johnson, M Luke Marinovich, Stuart J Schnitt, Irene Wapnir, Meena S Moran
PURPOSE: Controversy exists regarding the optimal negative margin width for ductal carcinoma in situ (DCIS) treated with breast-conserving surgery and whole-breast irradiation. METHODS AND MATERIALS: A multidisciplinary consensus panel used a meta-analysis of margin width and ipsilateral breast tumor recurrence (IBTR) from a systematic review of 20 studies including 7883 patients and other published literature as the evidence base for consensus. RESULTS: Negative margins halve the risk of IBTR compared with positive margins defined as ink on DCIS...
September 2016: Practical Radiation Oncology
Ellen Kim, Tithi Biswas, Paul Bakaki, Afshin Dowlati, Neelesh Sharma, Mitchell Machtay
PURPOSE: Standard therapy for limited-stage small cell lung cancer (SCLC) (American Joint Committee on Cancer stages I-III) is concurrent chemoradiation therapy (CRT) with cisplatin/etoposide (EP), but carboplatin/etoposide (EC) is often used in clinical practice. Though a growing proportion of this disease is diagnosed in older patients, there are limited studies of older patients comparing cisplatin to carboplatin. This study compared survival outcomes of elderly patients with limited-stage SCLC treated with concurrent EC or EP and radiation...
September 2016: Practical Radiation Oncology
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