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Practical Radiation Oncology

Margaret M Kozak, Julie L Koenig, Rie von Eyben, Elizabeth A Kidd
OBJECTIVE: To evaluate whether our institutional standard of less than whole uterus (LTWU) irradiation affects locoregional control in patients with locally advanced cervical cancer. METHODS AND MATERIALS: We retrospectively reviewed 53 patients with stage IB-IVB cervical carcinoma treated with image-guided IMRT and brachytherapy. The entire uterus was not included in the clinical target volume (CTV), as is our institutional standard. Dosimetric parameters were obtained, including: GTV PET tumor volume, uterus volume excluding GTV, proportion of uterus included in the planning target volume (PTV, %), volume of overlap between uterus and prescription dose (cc), minimum and mean dose to the uterus, and bowel V40 and D200cc...
November 2, 2018: Practical Radiation Oncology
Ahsan Farooqi, Andrew J Bishop, Saphal Narang, Pamela K Allen, Jing Li, Mary Frances McAleer, Claudio E Tatsui, Laurence Rhines, Behrang Amini, Xin A Wang, Amol J Ghia
PURPOSE: Spine stereotactic radiosurgery (SSRS) delivers an ablative dose of radiation (RT) with high conformity relative to standard fractionated RT. This technique is suboptimal for extended targets (>3 vertebral levels) owing to treatment alignment concerns, or for patients with marked epidural extension. In these patients, we hypothesized that use of hypofractionated IMRT/VMAT to dose escalate the GTV to 40 Gy as a spinal simultaneous integrated boost (SSIB) would allow for durable local control and palliation...
October 29, 2018: Practical Radiation Oncology
Mark Sueyoshi, Arthur J Olch, Kevin X Liu, Alisha Chlebik, Desirae Clark, Kenneth K Wong
PURPOSE: The Radiation Oncology Incident Learning System demonstrated that incorrect or omitted patient shifts during treatment are common near-misses or incidents. This single pediatric hospital quality improvement experience evaluated a markless isocenter localization workflow to improve safety and streamline treatment, obviating the need for daily shifts. METHODS AND MATERIALS: Patients undergoing radiation therapy were simulated and treated with indexed immobilization devices...
October 19, 2018: Practical Radiation Oncology
Rajni Sethi, Jyoti Mayadev, Suresh Sethi, Dominique Rash, Lee-May Chen, Rebecca Brooks, Stefanie Ueda, I-Chow Hsu
OBJECTIVE: We assessed the effect of elective extended field radiation (EFRT) and nodal dose escalation on locoregional control and survival in node positive cervical cancer patients treated with definitive chemoradiation at two academic institutions. METHODS AND MATERIALS: Cervical cancer patients with pelvic and/or para-aortic lymph node (PALN) metastases treated with definitive chemoradiation between 2004-2011 were retrospectively reviewed. Patterns of failure were recorded...
October 17, 2018: Practical Radiation Oncology
Joseph F Levy, Rahul Khairnar, Alexander V Louie, Timothy N Showalter, C Daniel Mullins, Mark V Mishra
PURPOSE: A hydrogel rectal spacer (HRS) is a medical device approved by the FDA to increase the separation between the prostate and rectum. We conducted a cost-effectiveness analysis of HRS use for reduction in radiation therapy (RT) toxicities in prostate cancer (PC) patients undergoing external beam radiation therapy (EBRT). METHODS AND MATERIALS: A multi-state Markov model was constructed from the US payers' perspective to examine the cost-effectiveness of HRS in men with localized PC receiving EBRT (EBRT alone vs...
October 17, 2018: Practical Radiation Oncology
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No abstract text is available yet for this article.
October 17, 2018: Practical Radiation Oncology
Narek Shaverdian, Eric M Chang, Fang-I Chu, Elizabeth Grace Morasso, Michael A Pfeffer, Eric M Cheng, Allan Wu, Susan A McCloskey, Ann C Raldow, Michael L Steinberg
PURPOSE: There is an increasing effort to allow patients open access to their physician notes through electronic medical record portals; however, limited data exist on the impact of such access on oncology patients and concerns remain regarding potential harms. We therefore determined baseline perceptions and the impact of open access to oncology notes on radiation oncology patients. METHODS: Patients receiving radiation therapy were provided instructional materials on accessing oncology notes at the time of their initial evaluation...
October 15, 2018: Practical Radiation Oncology
Daphne Levin, Gili Grinfeld, Vladislav Greenberg, Yoav Lipsky, Svetlana Zalmanov-Fayerman, Yonina Tova, Rephael Pfeffer
PURPOSE: For high dose per fraction treatments such as stereotactic body radiotherapy (SBRT) in our department we require a physician to perform the pre-treatment on board imaging (OBI) match. The purpose of this study was to determine if patient matching positioning performed by radiation therapists (RTTs) is as accurate as physician matching. METHODS: Sixteen RTTs and five physicians participated in this study. Data were collected from 113 patients totaling 324 measurements...
October 15, 2018: Practical Radiation Oncology
Shingo Hashimoto, Masaki Katsurada, Rie Muramatsu, Kumiko Asai, Kenichiro Tanaka, Kensuke Hayashi, Yoshiaki Kibe, Koichiro Nakajima, Yukiko Hattori, Hiromitsu Iwata, Jun-Etsu Mizoe, Hiroyuki Ogino, Yuta Shibamoto
PURPOSE: Suppression of respiratory movement of the liver would be desirable for high-precision radiation therapy for liver tumors. We aimed to investigate the effect of our original device-free compressed shell fixation method and breathing instruction on suppression of respiratory movement. The characteristics of liver motion based on the movement of a fiducial marker were also analyzed. METHODS: First, respiratory amplitudes of the liver with the device-free compressed shell were analyzed from the data of 146 patients...
October 15, 2018: Practical Radiation Oncology
Yan Zhang, Robert W Mutter, Sean S Park, Tina J Hieken, Elizabeth S Yan, Kimberly S Corbin, Debra H Brinkmann, Deanna H Pafundi
No abstract text is available yet for this article.
October 1, 2018: Practical Radiation Oncology
Foster Benjamin, Sindhu Kunal, Hepel Jaroslaw, Wazer David, Theresa Graves, Charu Taneja, Doreen Wiggins, Leonard Kara
PURPOSE: The BioZorb® (Therapeutics, Aliso Viejo, CA), is an implantable 3D bioabsorbable marker used for tumor bed volume (TBV) identification during postoperative radiotherapy (RT) planning. We aimed to calculate and compare RT TBVs between two cohorts managed with and without the device. METHODS AND MATERIALS: Breast cancer patients treated at XXXX between May 1, 2015 and April 30, 2016 were retrospectively reviewed and grouped based upon 3D bioabsorbable marker placement...
September 27, 2018: Practical Radiation Oncology
Yazid Belkacemi, Laurianne Colson-Durand, Maryse Fayolle-Campana, Pascale Pons, Amandine Rialland, Sylvie Bastuji-Garin, Quy Nguyen Hoang, Delphine Lerouge, Françoise Jaffré, Marc Bollet, David Azria
PURPOSE: Morbidity and mortality review (MMR) meetings in Radiotherapy (RT) departments aim to monitor radiation-induced toxicities and identify potential factors that may be correlated with their development and severity, particularly treatment planning errors. The aim of the PROUST Survey was to make an inventory of existing MMR procedures and to describe their procedures. MATERIALS AND METHODS: The link to the web-questionnaire of the PROUST survey was sent to 351 radiation oncologists working in 172 centers...
September 27, 2018: Practical Radiation Oncology
Sean M Parker, R Alfredo Siochi, Sijin Wen, Malcolm D Mattes
PURPOSE: Stereotactic body radiation therapy (SBRT) is commonly used to treat primary or oligometastatic malignancies in the lung, but most of the available data that describe the safety and efficacy of SBRT are for smaller tumors. The purpose of this study was to evaluate the impact of tumor size, among other factors, on local control (LC) and radiation pneumonitis (RP) in patients who received lung SBRT. METHODS AND MATERIALS: This retrospective study included 144 patients with 100 primary (57...
September 27, 2018: Practical Radiation Oncology
Fieke M Prins, Bjorn Stemkens, Linda G W Kerkmeijer, Maurits M Barendrecht, Hans J de Boer, Evert-Jan P A Vonken, Jan J W Lagendijk, Rob H N Tijssen
PURPOSE: One of the major challenges in stereotactic body radiation therapy (SBRT) of renal cell carcinoma is internal motion during treatment. Previous literature has aimed to mitigate the effects of motion by expanding the treatment margins or respiratory tracking. Online magnetic resonance imaging (MRI)-guided radiation therapy has the potential to further improve the treatment of renal cell carcinoma by direct visualization of the tumor during treatment. The efficacy of 2 motion management techniques were assessed: tumor trailing and respiratory tracking...
September 25, 2018: Practical Radiation Oncology
Todd A DeWees, John Nikitas, Sana Rehman, Jeffrey D Bradley, Cliff G Robinson, Michael C Roach
INTRODUCTION: Comparison of overall survival (OS) between SBRT and other treatments for early stage NSCLC is confounded by differences in age, performance status, and medical comorbidity. We sought to define the most robust measurement for this population amongst five indices: age, Eastern Cooperative Oncology Group (ECOG) performance status, Adult Comorbidity Evaluation-27 (ACE-27), Charlson Comorbidity Index (CCI), and age adjusted CCI (CCIa). METHODS: 548 patients with stage I NSCLC treated with SBRT were analyzed...
September 19, 2018: Practical Radiation Oncology
Hannah Dahn, Angela McGibbon, David Bowes
PURPOSE: This study aimed to measure the burnout rates and resiliency scores of Canadian oncology residents and advance the knowledge on resiliency and wellness training in Canadian oncology residency programs. METHODS AND MATERIALS: Online surveys were circulated to all Canadian radiation oncology, medical oncology, and hematology residents and program directors. Oncology resident burnout rates and resiliency scores were measured using the abbreviated Maslach Burnout Inventory and Connor-Davidson Resiliency Scale...
August 30, 2018: Practical Radiation Oncology
Nancy El-Bared, Lorraine Portelance, Benjamin O Spieler, Deukwoo Kwon, Kyle R Padgett, Karen M Brown, Eric A Mellon
PURPOSE: Magnetic resonance imaging guided (MRI-g) radiation therapy provides visualization of the target and organs at risk (OARs), allowing for daily online adaptive radiation therapy (OART). We hypothesized that MRI-g OART would improve OAR sparing and target coverage in patients with pancreatic cancer treated with stereotactic body radiation therapy (SBRT). METHODS AND MATERIALS: Ten patients received pancreas SBRT to a dose of 33 to 40 Gy in 5 fractions. The dose was prescribed to 90% coverage of the planning target volume at 100% isodose (PTV100)...
August 25, 2018: Practical Radiation Oncology
Nikhil Yegya-Raman, Meral Reyhan, Sinae Kim, Matthew P Deek, Ning Yue, Wei Zou, Jyoti Malhotra, Joseph Aisner, Salma K Jabbour
PURPOSE: This study aimed to investigate the association between target volume margins and clinical outcomes for patients with inoperable non-small cell lung cancer (NSCLC) treated with concurrent chemoradiation therapy. METHODS AND MATERIALS: We reviewed the records of 82 patients with inoperable NSCLC treated between 2009 and 2016 with concurrent chemoradiation. All patients received positron emission tomography-based treatment planning, 4-dimensional computed tomography simulation to define an internal target volume, and daily cone beam computed tomography...
August 23, 2018: Practical Radiation Oncology
Baoshe Zhang, Sung-Woo Lee, Shifeng Chen, Jinghao Zhou, Karl Prado, Warren D'Souza, Byongyong Yi
PURPOSE: To develop action levels for re-planning to accommodate dosimetric variations resulting from anatomic changes during the course of treatments, using daily cone-beam computed tomography (CBCT). METHODS: Daily or weekly CBCT images of 20 patients (10 head and neck, 5 lung, and 5 prostate cancers) who underwent re-simulation by physicians' clinical decisions mainly from the comparison of CBCTs, were used to determine action levels. The first CBCT image acquired prior to the first treatment was used as the reference image to rule out the effects of dose inaccuracy from the CBCT...
August 21, 2018: Practical Radiation Oncology
Xiaoying Liang, Dandan Zheng, Maria Mamalui-Hunter, Stella Flampouri, Bradford S Hoppe, Nancy Mendenhall, Zuofeng Li
PURPOSE: Utilizing PTV to account for setup uncertainties in SBRT of lung cancer has been questioned, since a significant portion of the PTV contains low-density lung tissue. The purpose of this study is to: (1) investigate the feasibility of using robust optimization to account for setup uncertainties in VMAT plan for lung SBRT; and (2) evaluate the potential normal tissue-sparing benefit of a robust optimized plan compared to a conventional PTV-based optimized plan. METHOD AND MATERIALS: The study was carried out on both phantom and patient cases...
August 20, 2018: Practical Radiation Oncology
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