International Journal of Radiation Oncology Biology Physics最新文献

{"title":"Geographic access to radiotherapy services in Canada.","authors":"Yang Xu, Oluwaseun Davies, Shaun K Loewen","doi":"10.1016/j.ijrobp.2025.08.041","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.08.041","url":null,"abstract":"<p><strong>Purpose: </strong>The vast geography and sparse population of Canada pose substantial challenges to delivering radiotherapy services. In this cross-sectional study, we sought to characterize the geographic accessibility of radiotherapy in Canada and investigate where future radiotherapy facilities can be optimally located.</p><p><strong>Methods and materials: </strong>Demographic and human geographic data were extracted from the 2021 Canadian Census for 57,937 dissemination areas (geographically stable regions of approximately 500-700 persons), and active facilities providing megavoltage external beam radiotherapy were located using national and international directories. Logistic regression models were then used to analyze demographic factors associated with poor access to radiotherapy, defined as the absence of radiotherapy facilities within a 2-hour one-way driving radius. To inform planning efforts, we evaluated the impact of constructing a new radiotherapy facility in each dissemination area using multiple metrics of geographic access.</p><p><strong>Results: </strong>The median driving time of the Canadian population to their nearest radiotherapy facility was 22.8 minutes. A total of 3,445,472 persons (9.3%) had poor access to radiotherapy in Canada, with significant variations by province (range, 4-48%). Seniors over age 65, males, low-income individuals, internal migrants within Canada, and Indigenous people had higher odds of experiencing poor access to radiotherapy. In contrast, visible minorities, immigrants to Canada, and individuals with post-secondary education had lower odds of experiencing poor access. We identified eight locations across Canada where a new radiotherapy facility could achieve change-in-access metrics comparable or superior to those of recently opened facilities; establishing new facilities at all eight locations could reduce the population with poor access by 1,127,127 (32.7%).</p><p><strong>Conclusion: </strong>We found significant geographic and demographic disparities in access to radiotherapy across Canada. This study provides evidence that additional radiotherapy facilities are required to address existing inequities and better serve vulnerable populations, and the potential locations for new facilities that we identified can guide stakeholders in planning these expansions.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chemoradiotherapy vs Radiotherapy Alone in T1-2 Oropharyngeal Cancer with Low Volume Neck Disease: A Population-Based Cohort Study Utilizing the XXXXX Head and Neck Cancer Register.","authors":"Gabriel Adrian, Niclas Rudolfson Falklind, Lachlan McDowell, Maria Gebre-Medhin","doi":"10.1016/j.ijrobp.2025.08.040","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.08.040","url":null,"abstract":"<p><strong>Purpose: </strong>The benefit of adding concurrent systemic therapy to definitive radiotherapy (RT) for patients with T1-2 oropharyngeal squamous cell carcinoma (OPSCC) and limited neck node involvement is uncertain. This study investigates if chemoradiotherapy (CRT) in patients with early-stage (T1-2) low-volume nodal disease (UICC7^th N1-2b) improves overall survival (OS) compared to RT alone.</p><p><strong>Methods: </strong>A cohort study with data from the prospective XxxxHead and Neck Cancer Register, leveraging variation of receiving CRT based on healthcare region. Propensity score matching (1:1) was applied to balance baseline characteristics between patients from regions favoring CRT and those receiving RT alone. Overall survival and loco-regional control (LRC) were compared between groups using Kaplan-Meier analyses and Cox-Regression models. Separate matching and analyses were conducted for patients with T1-2N1-2a (Cohort N1-2a, i.e. single node < 6cm) and T1-2N2b disease (Cohort N2b, i.e. multiple nodes <6 cm).</p><p><strong>Results: </strong>A total of 1,507 patients with T1-2N1-2b OPSCC were included. After propensity score matching, Cohort N1-2a consisted of 262 patients and Cohort N2b of 692 patients. Overall survival was similar for CRT and RT alone in both cohorts, with hazard ratios (HR) of 1.57 (95%CI 0.68-3.87, p=0.17) for Cohort N1-2a, and HR 0.95 (95%CI 0.66-1.35, p=0.77) for Cohort N2b. Loco-regional control was also similar in Cohort N1-2a (HR 0.98 (95%CI 0.34-2.78, p=0.98). In Cohort N2b, a statistical interaction (p<0.001) with age was found, with a benefit of CRT for patients aged ≤70 years (HR 0.30 (95%CI 0.16-0.58), but not for patients aged >70 years (HR 1.48 (95%CI 0.50-4.39). The difference in LRC was driven by failures at the primary tumor site. Exploratory analyses suggested a selective benefit of CRT for patients with T2N2b.</p><p><strong>Conclusions: </strong>The results from this large, robust, national register suggest that RT alone is a safe treatment option for patients with T1-2N1-2a OPSCC. In patients with multiple neck nodes (N2b) aged ≤70 years, CRT improved LRC, but not overall survival.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization and Clinical Translation of a Novel Prototype Kilovoltage Dual-Layer Imager for Onboard Imaging.","authors":"Thomas C Harris, Matthew Jacobson, Raphael Bruegger, Vera Birrer, Dianne Ferguson, Yue-Houng Hu, Marios Myronakis, Mathias Lehmann, Pablo Corral Arroyo, Roshanak Etemadpour, Rony Fueglistaller, Ross I Berbeco","doi":"10.1016/j.ijrobp.2025.08.042","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.08.042","url":null,"abstract":"<p><strong>Purpose: </strong>Dual-energy imaging offers several benefits, including artifact reduction and material decomposition. This imaging may be achieved via multiple detecting layers with beam hardening between layers creating spectral separation. We describe the construction, characterization, and clinical translation of a novel prototype dual-layer flat-panel detector for kV on-board radiotherapy imaging.</p><p><strong>Methods: </strong>The dual-layer imager (DLI) was designed with the first layer matching existing detector construction: CsI scintillator and a-Si TFT photodiode array. The second layer has a slightly thicker CsI scintillator, providing extra photon detection efficiency. The prototype DLI was built by an industry partner. For clinical deployment, top layer information was sent to the treatment console; data from both layers was sent to a research PC for retrospective analysis. Modulation transfer function (MTF(f)) and noise power spectrum (NPS(f)) were measured for the top, bottom, and combined layers. Detective quantum efficiency (DQE(f)) was calculated from the results. Leeds phantom imaging further assessed detector performance. Initial patient data was analyzed to determine material decomposition feasibility. Log-weighted subtraction and virtual monoenergetic images (VMIs) were generated.</p><p><strong>Results: </strong>The DLI was deployed on a clinical TrueBeam linac. For 120kVp the DQE(0) top layer:0.48; bottom layer (using initial fluence):0.13; combined:0.61. Leeds contrast-to-noise ratio with top layer as baseline: bottom layer:-45.8%; combined:+12.4%. MTF50 went from 1.38 top layer to 0.96 combined. Initial log-weighted subtraction of layers of patients' lung kV's successfully suppressed bone material. VMIs were generated: 40keV increased soft tissue contrast by 1.6x; 120keV increased uniformity in metal artifact regions by 41.4%.</p><p><strong>Conclusion: </strong>A novel kV DLI was constructed and translated on a clinical linac. Combining the layers increases DQE with an MTF reduction. More importantly, it adds dual-energy imaging capabilities to a linac. Preliminary results show promise for spectral imaging applications, such as metal artifact reduction and bone removal to enable better lung tumor visualization.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Radiation Pneumonitis Integrating Clinical Information, Medical Text, and 2.5D Deep Learning Features in Lung Cancer.","authors":"Wenting Wang, Mingcheng Ren, Jing Ren, Jun Dang, Xinyu Zhao, Cong Li, Yanli Wang, Guang Li","doi":"10.1016/j.ijrobp.2025.07.1437","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.07.1437","url":null,"abstract":"<p><strong>Purpose: </strong>To construct a prediction model for radiation pneumonitis (RP) in lung cancer patients based on clinical information, medical text, and 2.5D deep learning (DL) features.</p><p><strong>Methods and materials: </strong>A total of 356 patients with lung cancer from the Heping Campus of the First Hospital of China Medical University were randomly divided at a 7:3 ratio into training and validation cohorts, and 238 patients from 3 other centers were included in the testing cohort for assessing model generalizability. We used the term frequency-inverse document frequency method to generate numerical vectors from computed tomography (CT) report texts. The CT and radiation therapy dose slices demonstrating the largest lung region of interest across the coronal and transverse planes were considered as the central slice; moreover, 3 slices above and below the central slice were selected to create comprehensive 2.5D data. We extracted DL features via DenseNet121, DenseNet201, and Twins-SVT and integrated them via multi-instance learning (MIL) fusion. The performances of the 2D and 3D DL models were also compared with the performance of the 2.5D MIL model. Finally, RP prediction models based on clinical information, medical text, and 2.5D DL features were constructed, validated, and tested.</p><p><strong>Results: </strong>The 2.5D MIL model based on CT was significantly better than the 2D and 3D DL models in the training, validation, and test cohorts. The 2.5D MIL model based on radiation therapy dose was considered to be the optimal model in the test1 cohort, whereas the 2D model was considered to be the optimal model in the training, validation, and test3 cohorts, with the 3D model being the optimal model in the test2 cohort. A combined model achieved Area Under Curve values of 0.964, 0.877, 0.868, 0.884, and 0.849 in the training, validation, test1, test2, and test3 cohorts, respectively.</p><p><strong>Conclusion: </strong>We propose an RP prediction model that integrates clinical information, medical text, and 2.5D MIL features, which provides new ideas for predicting the side effects of radiation therapy.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Perceived Hearing Outcomes with Radiation and Cisplatin or Radiation and Cetuximab for Patients with HPV-Positive Oropharyngeal Cancer - Results from xxxxx.","authors":"Christina L Runge, Jessica A Lyness, Maura L Gillison, David J Adelstein, Paul M Harari, Jolie Ringash, Jessica L Geiger, Greg A Krempl, Dukagjin M Blakaj, James Edward Bates, Thomas J Galloway, Christopher U Jones, Michael F Gensheimer, Neal E Dunlap, Jack Phan, Jimmy J Caudell, J Daniel Pennington, Pedro A Torres-Saavedra, Sue S Yom, Quynh-Thu Le, Benjamin Movsas","doi":"10.1016/j.ijrobp.2025.08.021","DOIUrl":"10.1016/j.ijrobp.2025.08.021","url":null,"abstract":"<p><strong>Purpose: </strong>xxxx was a noninferiority phase 3 trial comparing the efficacy of radiation with either cisplatin (RT+Cis) or cetuximab (RT+Cetux) for patients with HPV+ oropharyngeal cancer (OPC). Perceived hearing handicap was included as a patient reported outcome (PRO) secondary endpoint. The primary hypothesis was that perceived hearing handicap would be greater for patients receiving RT+Cis compared to RT+Cetux.</p><p><strong>Methods and materials: </strong>Perceived hearing handicap was measured at baseline, end of treatment, 3-, 6-, and 12-months post-treatment using the Hearing Handicap Inventory for Adults Screening Version (HHIA-S), a 10-item self-assessment questionnaire designed to measure patients' reactions to their hearing loss. Mixed ordinal logistic models were used to determine the treatment effect on HHIA-S scores and handicap categories (0.05 two-sided alpha).</p><p><strong>Results: </strong>The PRO substudy included 375 eligible patients. No significant differences in patient/tumor characteristics were found between patients who participated in the HHIA-S study vs those excluded. For total HHIA-S scores and social and emotional subscales, RT+Cetux had significantly lower (i.e., better) scores from end of treatment. Change score from baseline to end of treatment for RT+Cis (4.32, 95% CI [2.57, 6.07]) was greater than RT+Cetux (0.08, 95% CI [-1.15, 1.31]). For hearing handicap category, RT+Cis had a significantly higher percentage of mild/moderate and severe cases at the end of treatment (32%) compared to RT+Cetux (20%) (p<.0001). Adjusted conditional odds of higher self-perceived hearing handicap category for RT+Cis compared to RT+Cetux was 3.73 (95% CI [2.10, 6.62]).</p><p><strong>Conclusion: </strong>Patients have significantly worse self-perceived hearing handicap after receiving RT+Cis treatment than with RT+Cetux. This was consistent across time through one-year post-treatment. These findings inform hearing-related outcomes for patients with HPV-associated OPC and indicate the need for ototoxicity monitoring with RT+Cis treatment.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Versus Postoperative Fractionated Stereotactic Radiation Therapy: A Single Institution Analysis of 534 Resected Metastases.","authors":"Haley K Perlow, Sarah Hennings, Jared Bradshaw, Sohil Reddy, Sydney Luu, Jennifer K Matsui, Brett G Klamer, Khaled Dibs, Marshall Harrell, John M McGregor, Russell R Lonser, Daniel M Prevedello, James B Elder, Kyle C Wu, Roshan Prabhu, Simeng Zhu, Raj Singh, Sasha J Beyer, John Grecula, Dukagjin M Blakaj, Evan M Thomas, Raju R Raval, Joshua D Palmer","doi":"10.1016/j.ijrobp.2025.08.010","DOIUrl":"10.1016/j.ijrobp.2025.08.010","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with large or symptomatic brain metastases typically have surgery followed by postoperative (post-op) stereotactic radiosurgery. However, post-op stereotactic radiosurgery leads to elevated rates of radiation necrosis (RN), nodular meningeal disease (nMD), and local failure (LF) when compared with whole brain radiation therapy. Fractionated stereotactic radiation therapy (FSRT) can deliver a higher biological effective dose and may reduce the risk of LF, and preoperative (pre-op) treatments may reduce the risk of RN and nMD through treating smaller volumes and tumor sterilization.</p><p><strong>Methods and materials: </strong>This single institution cohort study included patients who had surgical resection and FSRT to at least one brain metastasis. Pre-op or post-op FSRT was delivered with a dose of 27 Gy in 3 fractions or 30 Gy in 5 fractions. The primary endpoint was a composite endpoint defined by (1) LF, (2) nMD, and/or (3) grade 2 or higher (symptomatic) RN.</p><p><strong>Results: </strong>Of the 534 resected brain metastases from 458 patients were eligible for analysis, 235 and 299 metastases received pre-op and post-op FSRT, respectively. Notably, 4 (1.7%) pre-op and 14 (4.7%) post-op metastases were diagnosed with nMD (P = .088). Notably, 28 (12%) and 59 (20%) metastases that received pre-op and post-op FSRT, respectively, experienced the composite endpoint (P = .018). The 3-year composite endpoint for pre-op and post-op FSRT was 15% (95% CI, 10%-20%) and 20% (95% CI, 15%-25%), respectively.</p><p><strong>Conclusions: </strong>In our study, pre-op FSRT compares favorably to post-op FSRT primarily because of a lower incidence of nMD. Differences between treatment groups for symptomatic RN or LF endpoints were comparatively smaller. Prospective validation of pre-op FSRT is needed.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiosurgical Management of Cavernous Sinus Hemangioma: Systematic Review, Meta-analysis, and International Stereotactic Radiosurgery Society Practice Guideline.","authors":"Eyub Y Akdemir, Yanjia Zhang, Shoji Yomo, Laura Fariselli, Alessandra Gorgulho, Marc Levivier, Lijun Ma, Ian Paddick, Jean Regis, Arjun Sahgal, Rupesh Kotecha","doi":"10.1016/j.ijrobp.2025.08.011","DOIUrl":"10.1016/j.ijrobp.2025.08.011","url":null,"abstract":"<p><p>Cavernous sinus hemangiomas (CSHs) are rare benign vascular tumors and surgical resection carries substantial risks of morbidity and mortality. Stereotactic radiosurgery (SRS) and fractionated SRS (FSRS) have emerged as an effective non-invasive surgical alternative; however, appropriate patient selection, dosing, and outcomes remain unclear and underreported. A systematic review and meta-analysis was conducted following PRISMA guidelines to evaluate the efficacy and safety of SRS/FSRS for CSHs. A comprehensive literature search of PubMed and EMBASE was performed of peer-reviewed studies reporting outcomes of SRS or FSRS (≤5 fractions) in patients with histologically or radiographically-confirmed CSH published from January 1999 to August 2024. Primary outcomes included local tumor control (LC) and radiographic response, while secondary outcomes assessed symptom improvement and treatment-related toxicities. A total of 16 studies comprising 324 patients were included: 14 SRS (282 patients) and 2 FSRS (42 patients). The crude LC was 100% in the entire cohort and the pooled substantial radiographic response rate (>50% reduction) was 85.0% (95% CI: 68-94%, I² = 67%) for 14 studies. Among those with symptoms (13 studies, 202 patients), the pooled symptom improvement rate was 98.0% (95% CI: 87.0-100.0%, I2 < 1%). Meta-regression revealed a significant positive association between definitive SRS/FSRS and symptom improvement (vs. adjuvant treatment). Treatment-related toxicity was minimal, with only three reported cases of late toxicity and no occurrences of optic neuropathy. Despite significant heterogeneity among the included studies, excellent tumor control was achieved with minimal toxicity. On behalf of the International Stereotactic Radiosurgery Society, consensus clinical practice recommendations are provided to guide patient selection, treatment techniques, and dosing. In summary, we recommend a dose of 12-16 Gy in 1 fraction for tumor control for this entity.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bowel bag dosimetric parameters for ultrahypofractionated pelvic elective nodal irradiation in prostate cancer.","authors":"Wee Loon Ong, Melanie Davidson, Matt Wronski, Therese Kang, Patrick Cheung, William Chu, Hans Chung, Stanley Liu, Gerard Morton, Chia-Lin Tseng, Danny Vesprini, Liying Zhang, Courtney Poon, Andrew Loblaw","doi":"10.1016/j.ijrobp.2025.08.014","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.08.014","url":null,"abstract":"<p><strong>Purpose: </strong>Most prostate SABR trials with pelvic elective nodal irradiation (ENI) applied dose constraints to individual bowel loops. There is no evidence-based data to guide bowel bag dose constraint for ultrahypofractionated ENI for prostate cancer. We aim to correlate bowel bag dosimetric parameters with gastrointestinal toxicities and bowel quality of life (QOL).</p><p><strong>Methods and materials: </strong>We included 59 men enrolled in the XXX1 and XXX2 trials. The prescribed dose for ENI was 25Gy in 5 fractions, delivered in weekly fractionation. Bowel bag was retrospectively contoured as per the RTOG guidelines. Gastrointestinal toxicities and bowel QOL data were prospectively collected up to 5 years within the trial using the CTCAEv4 and EPIC26 questionnaire. Dosimetric parameters for bowel bag based on delivered treatment plans were extracted. Logistic regressions were performed to identify dosimetric parameters associated with gastrointestinal toxicities and bowel QOL.</p><p><strong>Results: </strong>Of the 59 men included in this analyses, 7/59 (12%) and 12/59 (20%) had acute and late grade 2 gastrointestinal toxicities, with no grade 3+ gastrointestinal toxicities. There were 21/55 (38%) and 10/55 (18%) men who had minimal clinical important changes (MCIC) in acute and late bowel QOL. No bowel bag dosimetric parameters were identified to be associated with acute/ late grade 2+ gastrointestinal toxicities or MCIC in bowel QOL. Based on bowel bag dosimetry of the delivered treatment plans, we proposed bowel bag dose constraints for ultrahypofractionated ENI, applying the median and interquartile range upper limit as optimal and mandatory constraints: V20Gy (optimal <320cc; mandatory <380cc), V24Gy (optimal <150cc; mandatory <200cc), V25Gy (optimal <80cc; mandatory <100cc), Dmax (optimal <27Gy; mandatory <35Gy).</p><p><strong>Conclusion: </strong>Using individual patient data from prospective trials, we did not identify bowel bag dosimetric parameters associated with gastrointestinal toxicities and bowel QOL; however, this provided us data for suggested dose constraints for future practice.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov XXX1 & XXX2.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Current Literature and Visibility of Anatomy Education in U.S. Radiation Oncology Residency Programs","authors":"Amanda M Acevedo ,&nbsp;Olivia U Trumble ,&nbsp;Michaela N Rechdan ,&nbsp;Aren S Saini","doi":"10.1016/j.ijrobp.2025.05.050","DOIUrl":"10.1016/j.ijrobp.2025.05.050","url":null,"abstract":"<div><h3>Background</h3><div>Anatomy knowledge is fundamental in radiation oncology (RO), especially for accurate contouring and treatment planning. Recent educational efforts include a 2-year gross anatomy curriculum at Duke University and a Canadian national anatomy and radiology contouring boot camp, which were associated, respectively, with improved satisfaction and contouring competencies among RO residents, underscoring the value of structured anatomy education. Despite its beneficial role, many residency programs appear to lack formalized anatomy curricula. This study examines how U.S. RO residency programs advertise their educational offerings, with a focus on anatomy and radiology, relative to other core subjects such as radiation biology and physics.</div></div><div><h3>Methods</h3><div>To assess the current literature on anatomy education, we conducted a PubMed MeSH search using anatomy, curriculum, or physiology/education with radiation oncology, brachytherapy, or neoplasms/radiotherapy/education. We then systematically reviewed publicly available websites for all 91 ACGME-accredited U.S. radiation oncology residency programs, documenting curriculum availability and the inclusion of anatomy, radiology, radiation biology, and radiation physics coursework.</div></div><div><h3>Results</h3><div>The pubmed MeSH search returned 315 articles, of which only 16 articles were applicable to the topic of this study. Of these, only 3 were primarily focused on anatomy education in RO. Out of 90 programs, 70 (77%) provided curriculum outlines online. Within these 70 programs, only 15 (21%) mentioned specific anatomy coursework, while 27 (39%) included radiology coursework. In stark contrast, nearly all programs highlighted radiation biology (69/70, 99%) and radiation physics (70/70, 100%). Anatomy education was the least consistently emphasized compared to other essential subjects within RO training.</div></div><div><h3>Discussion</h3><div>Our review highlights significant variability in anatomy education across radiation oncology programs and a relative lack of published literature on the topic. The limited emphasis on dedicated anatomy curricula-despite its importance in clinical practice-suggests educational inconsistencies that may affect resident competency in contouring and treatment planning. Addressing these gaps through curriculum development and standardization could enhance training and improve patient care. A key limitation of this study is its reliance on publicly available information, which may not fully reflect program curricula. Future directions for this research include developing a multi-institutional resident survey to assess anatomy training, self-perceived competencies, and educational satisfaction, to provide a clearer picture of current needs and areas for improvement.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"123 1","pages":"Pages e13-e14"},"PeriodicalIF":6.5,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144829293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Augmenting Medical and Surgical Oncology Fellow Didactics to Increase Clinical Radiation Oncology Knowledge","authors":"Stephanie O. Dudzinski","doi":"10.1016/j.ijrobp.2025.05.040","DOIUrl":"10.1016/j.ijrobp.2025.05.040","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Multidisciplinary care is essential for optimal cancer treatment, yet interdisciplinary training for oncology-focused fellows remains insufficient. This project aimed to enhance medical and surgical oncology fellows' confidence and understanding of radiation oncology through specialty-specific didactic lectures.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;One-hour in-person lectures introduced radiation oncology fundamentals, including radiation biology basics, clinic workflow, and radiation treatment indications. The medical oncology lecture highlighted radiation treatment in oligometastatic and oligoprogressive disease states as well as potential toxicities when combining systemic therapies with radiation. The surgical lecture focused on rectal cancer management and fractionations' effects on acute and late toxicities. Pre-lecture tests were given that included medical content questions and confidence of content questions using a 5-point Likert scale. Post-lecture tests contained the same set of questions. Paired t-tests were used to compare pre-test and post-test knowledge content, and Mann-Whitney tests assessed changes in confidence.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Twenty-two pre-lecture and 12 post-lecture surveys were completed by the medical oncology fellows. For surgical fellows, ten pre-lecture surveys and five post-lecture surveys were completed. The mean knowledge score for the medical oncology and surgical oncology pre-lecture tests was 28.2% and 18%, respectively. For the post-lecture surveys, the mean knowledge score for the medical oncology and surgical oncology post-lecture test both significantly improved with scores of 78.3% (p=0.006) and 55% (p=0.01). Medical oncology fellows all had significant improvement in confidence regarding radiation biology (p=0.03), radiation clinic workflow (p&lt;0.0001), possible systemic therapy and radiation side effects (p&lt;0.0001), clinical applications of radiation oncology (p=0.002), and indications of radiation for oligometastatic/oligoprogressive disease (p=0.0089). Surgical oncology fellows had significant improvement in confidence only regarding clinic workflow (p=0.02) and fractionations' effects on toxicities (0.007) but not radiation biology (p=0.21), clinical applications 0.75, or rectal cancer management (0.52). Notably, 0% of surgical fellows answered the fractionation toxicity question correctly pre-lecture, only improving to 20% post-lecture.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;The introduction to radiation oncology lectures significantly improved knowledge in both cohorts. Medical oncology fellows demonstrated greater confidence gains, likely due to a paucity of radiation oncology didactics in their training. However, surgery fellows complete a clinical rotation in radiation oncology. By improving interdisciplinary knowledge early in oncology training, we hope that these interdisciplinary educational interventions with improve collaboration and com","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"123 1","pages":"Pages e9-e10"},"PeriodicalIF":6.5,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144829556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}