Kelly Andrianu, Duncan Works, Andrew Christiansen, Charles Enke, Lisa Chaiken, Michael Baine
Radiation therapy is a common treatment modality offered to patients with localized prostate cancer. It can be associated with early radiation-induced toxicities including dysuria, nocturia, frequency, urgency, spasm, and, rarely, hematuria. Early toxicities usually resolve once the treatment period has ended. Chronic toxicities are less common, and rarely, patients may experience radiation-induced hemorrhagic cystitis and hematuria months or years after radiation. We herein describe the case of a 65-year-old man with a past medical history of type-2 diabetes mellitus who experienced hemorrhagic cystitis for months following his radiation therapy...
May 16, 2024: Practical Radiation Oncology
David J Crompton, Homan Mohammadi, Phillip Pirgousis, Samip Patel, Jeffery Janus, Yujie Zhao, Lisa A McGee, Samir H Patel, David M Routman, Daniel J Ma, Adam Holtzman
Treatment of squamous cell carcinoma of the tonsil involves primary radiotherapy (RT) or surgical resection. Historically, if radiotherapy was the primary or adjuvant treatment modality, most of the bilateral retropharyngeal lymph nodes (RPLN) were treated electively with a therapeutic dose for subclinical disease, regardless of if radiographically pathologic lymph nodes were seen on initial diagnostic imaging. De-escalation strategies include the incorporation of transoral surgery (TOS) with the goal to either eliminate or reduce the dose of adjuvant RT or chemotherapy...
May 13, 2024: Practical Radiation Oncology
Juhi M Purswani, Eliana Goldberg, Oren Cahlon, Freya Schnabel, Deborah Axelrod, Amber Guth, Carmen A Perez, Fauzia Shaikh, Moses Tam, Silvia Formenti, Bea Reig, Naamit K Gerber
PURPOSE: With transition from supine to prone, tenting of the pectoralis major occurs displacing the muscle from the chest wall and shifting the level I-II axillary spaces. For patients whom we aim to treat the level I-II axilla using the prone technique, accurate delineation of these nodal regions is necessary. While different consensus guidelines exist for delineation of nodal anatomy supine, to our knowledge there are no contouring guidelines in the prone position that account for this change in nodal anatomy...
May 8, 2024: Practical Radiation Oncology
Nicholas Bucknell, Nicholas Hardcastle, Lachlan McIntosh, David Ball, Michael S Hofman, Tomas Kron, Shankar Siva
Functional lung avoidance (FLA) radiation therapy is an evolving field. The aim of FLA planning is to reduce dose to areas of functioning lung, with comparable target coverage and dose to organs at risk. Multi-criteria optimisation (MCO) is a planning tool that may assist with FLA planning. This study assessed the feasibility of using MCO to adapt radiation therapy plans in order to avoid functional regions of lung that were identified using a 68 Ga-4D-V/Q PET/CT. Methods A prospective clinical trial [anonymized for review] was performed in which patients had a 68 Ga-4D-V/Q PET/CT prior to radiation treatment...
May 3, 2024: Practical Radiation Oncology
Eyub Yasar Akdemir, Yazmin Odia, Matthew D Hall, Minesh P Mehta, Rupesh Kotecha
H3K27-altered diffuse midline glioma (DMG H3K27-altered) is a relatively newly-designated WHO entity which primarily affects the midline structures of the central nervous system (CNS), including the brainstem (predominantly pontine region), thalamus, midbrain, or spinal cord, and primarily affects children and young adults. Despite the proximity of these tumors to eloquent areas in the CNS, novel stereotactic approaches have facilitated the ability to obtain tissue diagnoses without significant morbidity, providing molecular diagnostic information in more than half of patients...
May 3, 2024: Practical Radiation Oncology
Rachel S Wallwork, Brandi R Page, Fredrick M Wigley, Laura K Hummers, Julie J Paik, Zsuzsanna McMahan, Robyn T Domsic, Ami A Shah
OBJECTIVE: Systemic sclerosis (SSc) is considered a relative, or in some cases, absolute contraindication for radiation therapy for various cancers; however, radiation is standard of care and the best option for tumor control for locally advanced head and neck (H&N) cancer. We present a case series to document the post-radiation outcomes in patients with SSc and H&N cancer. METHODS: Patients with SSc and H&N cancer treated with radiation were identified from two large Scleroderma Center research registries...
May 2, 2024: Practical Radiation Oncology
Joongyo Lee, Na Young Shin, Seo Jin Lee, Yoon Jin Cho, In Ho Jung, Ji Won Sung, Sei Joon Kim, Jun Won Kim
PURPOSE: We aimed to develop and investigate positional reproducibility using a fixation device (Unity Brain Tumor Immobilization Device, UBID) in brain tumor patients undergoing magnetic resonance (MR)-guided radiotherapy (RT) with a 1.5 Tesla (T) MR-linear accelerator (LINAC) to evaluate its feasibility in clinical practice and report representative cases of central nervous system (CNS) tumor patients. MATERIALS AND METHODS: Quantitative analysis was performed by comparing images obtained by placing only the MR phantom on the couch with those obtained by placing UBID next to the MR phantom...
April 30, 2024: Practical Radiation Oncology
Sara Booth, Jincong Q Freeman, James L Li, Dezheng Huo
PURPOSE: We aimed to update the trend of hypofractionated whole-breast irradiation (HF-WBI) use over time in the US and examine factors associated with lack of HF-WBI adoption for patients with early-stage invasive breast cancer (IBC) or ductal carcinoma in situ (DCIS) undergoing a lumpectomy. METHODS AND MATERIALS: Among patients who underwent a lumpectomy, we identified 928,034 early-stage IBC patients and 330,964 DCIS patients in the 2004-2020 National Cancer Database...
April 27, 2024: Practical Radiation Oncology
Divya Yadav, Rituraj Upadhyay, Vinodh A Kumar, Melissa M Chen, Jason M Johnson, Holly Langshaw, Brandon J Curl, Maguy Farhat, Wasif Talpur, Thomas H Beckham, Debra N Yeboa, Todd A Swanson, Amol J Ghia, Jing Li, Caroline Chung
BACKGROUND: A dedicated MRI Simulation(MRsim) for radiation treatment(RT) planning in high-grade glioma(HGG) patients can detect early radiological changes, including tumor progression after surgery and before standard of care chemoradiation. This study aimed to determine the impact of using post-op MRI vs. MRsim as the baseline for response assessment and reporting pseudo-progression on follow-up imaging at one month(FU1) after chemoradiation. METHODS: Histologically confirmed HGG patients were planned for six weeks of RT in a prospective study for adaptive RT planning...
April 27, 2024: Practical Radiation Oncology
Fan Yang, Richard J Wong, Kaveh Zakeri, Annu Singh, Cherry L Estilo, Nancy Y Lee
Osteoradionecrosis (ORN) is a severe late complication of head and neck radiotherapy shown to have profound negative impact on the quality of life of cancer survivors. Over the past few decades, improvements in radiation delivery techniques have resulted in a decrease in the incidence of ORN. However, even with modern radiotherapy techniques, ORN remains an important clinical concern. In recent literature, there is a wide range of reported ORN rates from 0% to as high as 20%. With such a high level of variability in the reported incidence of ORN, oncologists often encounter difficulties estimating the risk of this serious radiotherapy toxicity...
April 20, 2024: Practical Radiation Oncology
Steven M Nguyen, Riley McDougall, Christopher Morrison, Victor Gonzalez
No abstract text is available yet for this article.
April 20, 2024: Practical Radiation Oncology
Xuguang Scott Chen, David Sher, Christopher Blake Sullivan, Michael C Repka, Colette Shen, Bhisham Chera
No abstract text is available yet for this article.
April 16, 2024: Practical Radiation Oncology
Susan L Richardson, Walter R Bosch, Charles S Mayo, Todd R McNutt, Jean M Moran, Richard A Popple, Ying Xiao, Elizabeth L Covington
While standardization has been shown to improve patient safety and improve the efficiency of workflows, implementation of standards can take considerable effort and requires the engagement of all clinical stakeholders. Engaging team members includes increasing awareness of the proposed benefit of the standard, a clear implementation plan, monitoring for improvements, and open communication to support successful implementation. The benefits of standardization often focus on large institutions to improve research endeavors, yet all clinics can benefit from standardization to increase quality and implement more efficient or automated workflow...
April 16, 2024: Practical Radiation Oncology
Abigail Pepin, Vivan Lee, Sophia O'Brien, Philipose Mulugeta, Neil K Taunk
Treatment options for patients with metastatic castration-resistant prostate cancer include use of radioligand therapy with 177Lu-PSMA-617. 177Lu-PSMA-617 is used to selectively target prostate cancer cells by targeting prostate specific membrane antigen (PSMA); however, PSMA is also expressed on lacrimal glands among other tissues. Herein, we report on a case of a CTCAE v5 grade 3 dry eye event with concomitant blepharitis following administration of 177Lu-PSMA-617. He was managed with neomycin-polymyxin-dexamethasone 3...
April 15, 2024: Practical Radiation Oncology
Ruiqi Li, Tingliang Zhuang, Steven Montalvo, Kai Wang, David Parsons, Yuanyuan Zhang, Puneeth Iyengar, Jing Wang, Andrew Godley, Bin Cai, Mu-Han Lin, Kenneth Westover
PURPOSE: Real time adaptation of thoracic radiation plans is compelling because offline adaptive experiences show that tumor volumes and lung anatomy can change during therapy. We present and analyze a novel adaptive-on-demand (AOD) workflow combining online adaptive radiotherapy (ART) on the ETHOS system with image-guided radiotherapy (IGRT) delivery on a Halcyon unit for conventional fractionated radiotherapy of locally advanced lung cancer (LALC). METHOD: We analyzed 26 LALC patients treated with the AOD workflow, adapting weekly...
April 3, 2024: Practical Radiation Oncology
Varun Kumar Chowdhry
No abstract text is available yet for this article.
March 23, 2024: Practical Radiation Oncology
Swarupa Mitra
No abstract text is available yet for this article.
March 23, 2024: Practical Radiation Oncology
Yevgeniy Vinogradskiy, Leah Schubert, Amy Taylor, Shari Rudoler, James Lamb PhD
INTRODUCTION: There have been numerous significant ransomware attacks impacting Radiation Oncology in the last 5 years. Research into ransomware attack response in Radiation Oncology has consisted of case reports and descriptive articles and has lacked quantitative studies. The purpose of this work was to identify the significant safety risks to patients being treated with radiotherapy during a ransomware attack scenario, using Failure Modes and Effects Analysis (FMEA). METHODS: A multi-institutional and multi-disciplinary team conducted a FMEA by developing process maps and using Risk Priority Number (RPN) scores to quantify the increased likelihood of incidents in a ransomware attack scenario...
March 18, 2024: Practical Radiation Oncology
James B Yu, David J Grew, Erin Sculley, Kathryn Hitchcock, Minsun Kim, Simon S Lo
The purpose of this paper is to summarize three methods for treating adrenal metastases with stereotactic body radiotherapy (SBRT). This article is not meant to provide consensus guidelines, but rather to present four practical examples of treatment techniques using different treatment platforms from three institutions.
March 15, 2024: Practical Radiation Oncology
Sara L Thrower, Brigid A McDonald, Minsun Kim
The 65th annual meeting of the American Association of Physicists in Medicine took place in July 2023 with a theme of "The Art of Science, The Science of Care." We review a sample of the more than 1000 talks and 1600 posters, focusing on a few topics of interest. Recent legislative changes across the country regarding reproductive health care have led to questions about how these regulations may affect your practice. A fantastic multidisciplinary session addressed these issues with experts in the areas of legal, administration, physics, and medicine...
March 14, 2024: Practical Radiation Oncology
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