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Practical Radiation Oncology

Shireen Parsai, Sheen Cherian, Ryan K Berglund, Byron Lee, Matthew Kolar, Nancy Nagle-Hernan, Allan Wilkinson, Jay Ciezki
OBJECTIVES: To allow for organ preservation, high dose rate brachytherapy may be used in the treatment of localized penile cancer. Penile cancer is a rare malignancy, accounting for less than one percent of cancers in men in the United States. The standard treatment for localized disease is partial amputation of the penis. However, patients with T1b or T2 disease, less than 4 cm in maximum dimension and confined to the glans penis may be treated with brachytherapy as an organ-sparing approach...
June 8, 2018: Practical Radiation Oncology
Isabella Zhang, Philip Gilbo, Nina Kohn, Brett Cox
PURPOSE/OBJECTIVE: Radium-223 prolongs survival and decreases symptomatic skeletal events in men with metastatic castrate-resistant prostate cancer and is indicated in patients with painful bone metastases. However, pain responses are rarely reported and often asked about by patients. Further, patients and their physicians are concerned about a lack of pain response portending a poor treatment response and may be inclined to change systemic therapies before completing 6 cycles. We evaluated the likelihood and time course of pain response, potential predictors of response, and its prognostic value in patients receiving radium-223...
May 16, 2018: Practical Radiation Oncology
Robert J Amdur, Bhishamjit S Chera
No abstract text is available yet for this article.
May 16, 2018: Practical Radiation Oncology
Gregg S Tracton, Lukasz M Mazur, Prithima Mosaly, Lawrence B Marks, Shiva Das
PURPOSE: The aim of this study is to propose a set of innovative principles for the effective design of electronic checklists to enhance safety mindfulness (a specific safety mindful mindset that offers the opportunity to operate more preemptively during routine quality assurance tasks) and discuss some of our preliminary results from testing our proposed electronic checklist with dosimetrists and physicists. METHODS AND MATERIALS: A multidisciplinary team designed, developed, and evaluated the utility of the electronic checklist (vs paper-based checklist) to promote safety mindfulness...
May 16, 2018: Practical Radiation Oncology
Jean L Wright, Arti Parekh, Byung-Han Rhieu, Valentina Opris, Annette Souranis, Amanda Choflet, Akila N Viswanathan, Theodore L DeWeese, Todd McNutt, Stephanie A Terezakis
PURPOSE: The optimal approach to managing incident learning system (ILS) reports remains unclear. Here, we describe our experience with prospective coding of events reported to the ILS with comparisons of risk scores on the basis of event type and process map location. METHODS AND MATERIALS: Reported events were coded by type, origin, and method of discovery. Events were given a risk priority number (RPN) and near-miss risk index (NMRI) score. We compared workflow versus near-miss events with respect to origin and detection in the process map and by risk scores...
May 8, 2018: Practical Radiation Oncology
Kevin Conley, Chester Chambers, Shereef Elnahal, Amanda Choflet, Kayode Williams, Theodore DeWeese, Joseph Herman, Maqbool Dada
PURPOSE: Common performance metrics for outpatient clinics define the time between patient arrival and entry into an examination room as "waiting time." Time spent in the room is considered processing time. This characterization systematically ignores time spent in the examination room waiting for service. If these definitions are used, performance will consistently understate total waiting times and overstate processing times. Correcting such errors will provide a better understanding of system behavior...
May 5, 2018: Practical Radiation Oncology
David E Long, Mark Tann, Ke Colin Huang, Gregory Bartlett, James O Galle, Yukie Furukawa, Mary Maluccio, John A Cox, Feng-Ming Spring Kong, Susannah G Ellsworth
PURPOSE: Hepatobiliary iminodiacetic acid (HIDA) scans provide global and regional assessments of liver function that can serve as a road map for functional avoidance in stereotactic body radiation therapy (SBRT) planning. Functional liver image guided hepatic therapy (FLIGHT), an innovative planning technique, is described and compared with standard planning using functional dose-volume histograms. Thresholds predicting for decompensation during follow up are evaluated. METHODS AND MATERIALS: We studied 17 patients who underwent HIDA scans before SBRT...
May 1, 2018: Practical Radiation Oncology
Neha Vapiwala
No abstract text is available yet for this article.
April 30, 2018: Practical Radiation Oncology
Susan G R McDuff, Kyla A Remillard, Hui Zheng, Ann C Raldow, Jennifer Y Wo, Christine E Eyler, Lorraine C Drapek, Lipika Goyal, Lawrence S Blaszkowsky, Jeffrey W Clark, Jill N Allen, Aparna R Parikh, David P Ryan, Cristina R Ferrone, Kenneth K Tanabe, John A Wolfgang, Andrew X Zhu, Theodore S Hong
PURPOSE: This study aimed to assess the safety and efficacy of administering liver reirradiation to patients with primary liver tumors or liver metastasis. METHODS AND MATERIALS: A total of 49 patients (with 64 individual tumors) who received liver reirradiation at our institution between June 2008 and December 2016 were identified for retrospective review. Patients were treated to the same, different, or a combination of previously treated liver tumors for recurrent primary (53%) or metastatic (47%) disease using photons or protons...
April 26, 2018: Practical Radiation Oncology
Tezontl Rosario, Lineke van der Weide, Marjan Admiraal, Maartje Piet, Ben Slotman, Johan Cuijpers
PURPOSE: The imaging application Auto Beam Hold (ABH) allows for the online analysis of 2-dimensional kV images acquired during treatment. ABH can automatically detect fiducial markers and initiate a beam interrupt. In this study, we investigate the practical use and results of this intrafraction monitoring tool for patients with prostate cancer who have implanted gold seeds treated with a RapidArc technique. METHODS AND MATERIALS: A total of 105 patients were included...
April 25, 2018: Practical Radiation Oncology
Wenji Guo, Xuan Hui, Salem Alfaifi, Lori Anderson, Scott Robertson, Russell Hales, Chen Hu, Todd McNutt, Stephen Broderick, Jarushka Naidoo, Richard Battafarano, Stephen Yang, K Ranh Voong
PURPOSE: In patients with non-small cell lung cancer (NSCLC) who undergo trimodality therapy (chemoradiation followed by surgical resection), it is unknown whether limiting preoperative radiation dose to the uninvolved lung reduces postsurgical morbidity. This study evaluated whether radiation fall-off dose parameters to the contralateral lung that is unaffected by NSCLC are associated with postoperative complications in NSCLC patients treated with trimodality therapy. METHODS AND MATERIALS: We retrospectively reviewed NSCLC patients who underwent trimodality therapy between March 2008 and October 2016, with available restored digital radiation plans...
July 2018: Practical Radiation Oncology
Michael T Milano, Alina Mihai, Feng-Ming Spring Kong
Reirradiation of thoracic malignancies is clinically challenging in balancing the risks and efficacy. Stereotactic body radiation therapy (SBRT) can facilitate ablative dosing of discrete targets while minimizing normal tissue exposure; thus, SBRT is an attractive, minimally invasive option to consider for patients with recurrent or new malignancies within a previously irradiated field. Published data are summarized from 28 studies on the use of SBRT for thoracic reirradiation. We review clinical outcomes with a primary focus on toxicity risks, dosimetric correlates of normal tissue complication probability (NTCP), and other factors that correlate with NTCP...
July 2018: Practical Radiation Oncology
Twyla R Willoughby, Sanford L Meeks, Patrick Kelly, Tomas Dvorak, Keith Muller, Thomas M Dana, Frank Bova
No abstract text is available yet for this article.
July 2018: Practical Radiation Oncology
Stephen Doggett, Shigeru Chino, Todd Lempert, Kunal Sidhar
INTRODUCTION: A painful maxillary sinus metastasis in previously irradiated tissue required palliation. METHODS AND MATERIALS: Lesion was treated by computed tomography-guided palladium103 implantation as an outpatient procedure; the lesion and its attendant facial pain and swelling resolved completely. CONCLUSION: Computed tomography-guided permanent seed brachytherapy is a novel, rapid, effective, and low resource cost method of treating paranasal malignancy...
July 2018: Practical Radiation Oncology
Amy S Yu, Peter G Maxim, Billy W Loo, Michael F Gensheimer
PURPOSE: Stereotactic ablative radiation therapy (SABR) to lung tumors close to the chest wall can cause rib fractures or chest wall pain. We evaluated and propose a clinically practical solution of using noncoplanar volumetric modulated arc radiation therapy (VMAT) to reduce chest wall dose from lung SABR. METHODS AND MATERIALS: Twenty lung SABR VMAT plans in which the chest wall volume receiving 30 Gy or higher (V30) exceeded 30 mL were replanned by noncoplanar VMAT with opposite 15° couch kicks...
July 2018: Practical Radiation Oncology
David J Sher, David J Adelstein, Gopal K Bajaj, David M Brizel, Ezra E Cohen, Aditya Halthore, Louis B Harrison, Charles Lu, Benjamin J Moeller, Harry Quon, James W Rocco, Erich M Sturgis, Roy B Tishler, Andy Trotti, John Waldron, Avraham Eisbruch
No abstract text is available yet for this article.
May 2018: Practical Radiation Oncology
Zachary D Horne, Michael J Dohopolski, David A Clump, Steven A Burton, Dwight E Heron
PURPOSE: Local failure following concurrent chemoradiation and in-lobe failures following stereotactic body radiation therapy (SBRT) are common. We evaluated our institutional experience using SBRT as salvage in this setting. METHODS AND MATERIALS: Seventy-two patients were reirradiated with SBRT for residual, locally recurrent, or new primary non-small cell lung cancer within or adjacent to a high-dose external beam radiation therapy or SBRT field. Kaplan-Meier analysis with log-rank test were used to estimate endpoints and differentiate cohorts...
May 2018: Practical Radiation Oncology
(no author information available yet)
No abstract text is available yet for this article.
May 2018: Practical Radiation Oncology
Benjamin D Smith, Jennifer R Bellon, Rachel Blitzblau, Gary Freedman, Bruce Haffty, Carol Hahn, Francine Halberg, Karen Hoffman, Kathleen Horst, Jean Moran, Caroline Patton, Jane Perlmutter, Laura Warren, Timothy Whelan, Jean L Wright, Reshma Jagsi
INTRODUCTION: The purpose of this guideline is to offer recommendations on fractionation for whole breast irradiation (WBI) with or without a tumor bed boost and guidance on treatment planning and delivery. METHODS AND MATERIALS: The American Society for Radiation Oncology (ASTRO) convened a task force to address 5 key questions focused on dose-fractionation for WBI, indications and dose-fractionation for tumor bed boost, and treatment planning techniques for WBI and tumor bed boost...
May 2018: Practical Radiation Oncology
Trevor J Royce, Ronald C Chen
No abstract text is available yet for this article.
May 2018: Practical Radiation Oncology
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