Journal of Medical Imaging and Radiation Oncology最新文献

{"title":"Moving beyond mean heart dose: The importance of cardiac substructures in radiation therapy toxicity.","authors":"Sarah Bowen Jones, Tom Marchant, Chris Saunderson, Alan McWilliam, Kathryn Banfill","doi":"10.1111/1754-9485.13737","DOIUrl":"https://doi.org/10.1111/1754-9485.13737","url":null,"abstract":"<p><p>Normal tissue tolerance dose limits to the heart have been established to reduce the risk of radiation-induced cardiac disease (RICD). Dose constraints have been developed based on either the mean dose delivered to the whole heart (MHD) or the dose delivered to a specific volume, for example, volume of heart receiving equal to or greater than 30 Gy (V30). There is increasing evidence that the impact of thoracic radiation on cardiac morbidity and mortality has been underestimated. Consequently, there is a need to reduce the dose delivered to the heart in radical radiotherapy treatment planning. The pathophysiology of RICD may relate to dose to specific cardiac substructures (CS) rather than the traditionally observed MHD for common toxicities. The MHD or V30 Gy threshold dose rarely represents the true dose delivered to individual CS. Studies have shown the dose to specific areas may be more strongly correlated with overall survival (OS). With advances in modern radiotherapy techniques, it is vital that we develop robust, evidence-based dose limits for CS, to fully understand and reduce the risk of RICD, particularly in high-risk populations with cardiac risk factors. The following review will summarise the existing evidence of dose limits to CS, explain how dose limits may vary according to different disease sites or radiation techniques and propose how radiotherapy plans can be optimised to reduce the dose to these CS in clinical practice.</p>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Getting to the heart of the matter.","authors":"Shalini K Vinod","doi":"10.1111/1754-9485.13749","DOIUrl":"https://doi.org/10.1111/1754-9485.13749","url":null,"abstract":"","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of dosimetric parameters for predicting radiation-induced cataract in paediatric patients","authors":"Siriphan Leangcharoensap,&nbsp;Kullathorn Thephamongkhol,&nbsp;Putthipong Chanwichu,&nbsp;Teeradon Treechairusame,&nbsp;Nan Suntornpong,&nbsp;Warissara Rongthong","doi":"10.1111/1754-9485.13748","DOIUrl":"10.1111/1754-9485.13748","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study compared the predictive ability of radiation-induced cataract between maximum point dose of the lens (Lens Dmax) ≥7 Gy, mean lens dose (Lens Dmean) ≥7 Gy, Lens Dmax ≥10 Gy, and Lens Dmean ≥10 Gy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients aged 3–18 years received cranial irradiation or radiation therapy at head and neck area between January 2010 and December 2019 at our institute were included. Patients without baseline and/or follow-up eye examination were excluded. Receiver operating characteristic (ROC) curves identified potential predictors and Cox regression analysed correlations between potential factors and cataract occurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-three patients (122 eyes) were analysed. Cataracts were detected in 14 eyes (11.5%). Median follow-up time was 4 years (range 0.5–10 years), with cataract developing in a median of 2.5 years (range 0.3–7 years). Three patients (21.4%) developed grade ≥3 cataract. Lens Dmean ≥10 Gy was associated with cataract formation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Lens Dmean ≥10 Gy showed the highest ability for predicting radiation-induced cataract in paediatric patients. Net reclassification improvement (NRI) suggested that changing lens dose constraint from Dmax &lt;7 Gy to Dmean &lt;10 Gy would miss 7% of cataract cases but avoid 28% of unnecessary restrictions. Adopting a mean lens dose &lt;10 Gy was suggested as a constraint for lens dose.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"68 7","pages":"835-842"},"PeriodicalIF":2.2,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1754-9485.13748","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimising central venous catheter placement by comparing cavoatrial junction position to chest X-ray landmarks: A cross-sectional study using CT chest reconstruction","authors":"Mayooran Kandasamy,&nbsp;Stanley Xue,&nbsp;Nigel McGregor,&nbsp;Hao Xiang","doi":"10.1111/1754-9485.13741","DOIUrl":"10.1111/1754-9485.13741","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Central venous catheter (CVC) tip placement guided by chest X-ray (CXR) landmarks is currently prone to inconsistency and malpositioning. This study aims to better define the relationship between the cavoatrial junction (CAJ) and selected X-ray landmarks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Chest CTs of 100 patients were retrospectively assessed. CT images were converted to a ‘virtual CXR’ using a digital workstation, enabling simultaneous localisation of the CAJ and evaluation of CXR landmarks. Vertical distances between the CAJ and selected landmarks were measured for each patient. Measurements were assessed for correlation with age and compared between age groups and sexes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean vertical distance of the following landmarks above the CAJ was found: the carina (46.2 mm), the intersection of the bronchus intermedius and the right heart border (7.6 mm) and the superior inflection of the right heart border (Sup-RHB) (13.0 mm). The maximum lateral bulge of the right heart border (Lat-RHB) was 18.4 mm below the CAJ. A new landmark: the mid-superior right heart border, defined as the mid-point between the Sup-RHB and Lat-RHB, was the closest to the CAJ, lying 2.6 mm below the CAJ.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We propose that the CVC tip can be placed at the mid-superior right heart border landmark.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"68 6","pages":"667-672"},"PeriodicalIF":2.2,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous atraumatic epipericardial fat necrosis in the context of recent oocyte retrieval and ovarian hyperstimulation syndrome","authors":"Lea Tiffany,&nbsp;Ranjit Singh,&nbsp;Lincoln J Lim","doi":"10.1111/1754-9485.13750","DOIUrl":"10.1111/1754-9485.13750","url":null,"abstract":"&lt;p&gt;Epipericardial fat necrosis (EFN) is a rare benign, self-limiting cause of acute chest pain that mimics serious clinical conditions such as acute coronary syndrome and pulmonary embolism.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The exact prevalence is unknown due to its rare occurrence.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Seventy to ninety per cent of EFN cases are misdiagnosed and often result in over-investigation and unnecessary invasive biopsies.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Clinically, EFN manifests as acute chest pain, tachycardia and diaphoresis.&lt;span&gt;&lt;sup&gt;1, 3&lt;/sup&gt;&lt;/span&gt; Blood results may include elevated D-dimer, CRP and white blood cell counts.&lt;span&gt;&lt;sup&gt;1, 3&lt;/sup&gt;&lt;/span&gt; Serum troponin levels are usually within normal limits.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Given the low specificity of clinical findings and blood tests, computed tomography (CT) is paramount for its opportunistic diagnosis. The main CT findings include an encapsulated or well-circumscribed ovoid fatty lesion with surrounding inflammatory changes within epicardial fat.&lt;span&gt;&lt;sup&gt;1, 3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;A 39-year-old woman (Gravida-2, Para-1) presented with acute retrosternal chest pain, pleurisy and palpitations 4 days after an egg retrieval procedure. Her past medical history includes stage four endometriosis and mild–moderate ovarian hyperstimulation syndrome (conservatively managed).&lt;/p&gt;&lt;p&gt;Her medications include Orgalutran (gonadotrophin-releasing hormone antagonist), and Ovidrel trigger shot (beta-human chorionic gonadotrophin) administered 48 h before oocyte retrieval. There was no history of sepsis or preceding trauma.&lt;/p&gt;&lt;p&gt;The patient was mildly hypertensive (143/92 mmHg) and tachycardic (107 bpm) with good oxygen saturation (98%) and normal respiratory rate (12/min). She had vague focal tenderness on palpation over the left parasternal region. She had an elevated white blood cell count 16.5 (×10&lt;sup&gt;9&lt;/sup&gt;/L) (4–11 × 10&lt;sup&gt;9&lt;/sup&gt;/L) with neutrophilia 15.5 (×10&lt;sup&gt;9&lt;/sup&gt;/L) (2–8 × 10&lt;sup&gt;9&lt;/sup&gt;/L), C-reactive protein 56 mg/L (&lt;10 mg/L), D-dimer 14.96 μg/mL (&lt;0.5 μg/mL) and troponin 4 ng/L (&lt;11 ng/L). ECG showed sinus tachycardia. The remaining clinical and biochemical profiles were unremarkable.&lt;/p&gt;&lt;p&gt;Computed tomography pulmonary angiogram was negative for pulmonary embolism. Within the epicardial fat, there was a 15 × 18 × 10 mm soft tissue density structure with surrounding extensive fat stranding (Figs 1-3). There was no pericardial effusion or overlying chondroosseous fracture.&lt;/p&gt;&lt;p&gt;The patient was discharged with a working diagnosis of EFN and had a 3-month follow-up CT which demonstrated complete resolution of the ovoid soft tissue structure with mild residual fat stranding (Figs 4,5).&lt;/p&gt;&lt;p&gt;The exact pathophysiology of EFN is not well understood. Major theories include inflammatory changes within the epipericardial fat and necrosis triggered by torsion of a vascularised fat appendage, Valsalva manoeuvre and trauma.&lt;span&gt;&lt;sup&gt;1, 3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Although ","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"68 6","pages":"696-698"},"PeriodicalIF":2.2,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1754-9485.13750","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced Practice Radiation Therapy roles offer a solution to improving patient care and impacting service delivery","authors":"Rebecca Height BAppSc(MedRad), MSc (Research),&nbsp;Kristie Matthews BAppSc(MedRad), MTrainDev, PhD,&nbsp;Sandro V Porceddu BSc, MBBS, FRANZCR MD (Research)","doi":"10.1111/1754-9485.13751","DOIUrl":"10.1111/1754-9485.13751","url":null,"abstract":"","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"68 6","pages":"770"},"PeriodicalIF":2.2,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ensuring a fit-for-purpose resource for consumers, clinicians and health services: The updated Osteoarthritis of the Knee Clinical Care Standard","authors":"Ilana N Ackerman,&nbsp;Fiona Doukas,&nbsp;Rachelle Buchbinder,&nbsp;Sally Dooley,&nbsp;Wendy Favorito,&nbsp;Phoebe Holdenson Kimura,&nbsp;David J Hunter,&nbsp;James Linklater,&nbsp;John B North,&nbsp;Louise Elvin-Walsh,&nbsp;Christopher Vertullo,&nbsp;Alice L Bhasale,&nbsp;Samantha Bunzli","doi":"10.1111/1754-9485.13732","DOIUrl":"10.1111/1754-9485.13732","url":null,"abstract":"&lt;p&gt;Knee osteoarthritis is a prevalent and disabling condition that impacts activities of daily living, participation in work and family roles and overall quality of life. With population growth and ageing, an increasing number of Australians are living with knee osteoarthritis (over 1.9 million people in 2019, representing 126% growth relative to 1990 numbers).&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; National estimates indicate that knee osteoarthritis is associated with over 59,000 years lived with disability annually, exceeding the disability burden of dementia, stroke or ischaemic heart disease.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Knee osteoarthritis also has a major economic impact in Australia, with over $3.5 billion spent annually on osteoarthritis-related hospital admissions&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; and an estimated productivity loss of $424 billion.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; International clinical guidelines consistently recommend non-surgical modalities as the mainstay of knee osteoarthritis management, with referral for consideration of joint replacement surgery reserved for people with late-stage disease.&lt;span&gt;&lt;sup&gt;4-6&lt;/sup&gt;&lt;/span&gt; Concerningly, low value care (care that is wasteful, ineffective and/or harmful) persists across the knee osteoarthritis journey. This is often fuelled by misconceptions about osteoarthritis, including inaccurate beliefs around diagnosis and management, that are amenable to change through education and effective communication.&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The Australian Commission on Safety and Quality in Health Care has developed a range of Clinical Care Standards. These aim to: (i) support the delivery of evidence-based clinical care for a health condition or procedure; (ii) reduce variation in clinical care across Australia; and (iii) promote shared decision making between health professionals and consumers. Unlike clinical guidelines, Clinical Care Standards do not describe all the components of care. Instead, they encompass a limited set of quality statements that describe the expected care for a health condition or procedure and highlight priorities for quality improvement.&lt;/p&gt;&lt;p&gt;Evidence of low value osteoarthritis care (specifically, high rates of knee arthroscopy among older Australians, with substantial geographic variation)&lt;span&gt;&lt;sup&gt;8&lt;/sup&gt;&lt;/span&gt; pointed to the need for the first Clinical Care Standard targeting knee osteoarthritis. In 2017, the Osteoarthritis of the Knee Clinical Care Standard was launched following a comprehensive development process that involved topic experts and consumers, wider stakeholder consultation and national peak body endorsement. Seven years on, we introduce the updated Osteoarthritis of the Knee Clinical Care Standard and indicator set (available at www.safetyandquality.gov.au/oak-ccs),&lt;span&gt;&lt;sup&gt;9&lt;/sup&gt;&lt;/span&gt; which have been carefully revised to ensure alignment with new evidence, contemporary international guidelines and advances in person-centred care. The updates also target current ","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"68 6","pages":"774-780"},"PeriodicalIF":2.2,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1754-9485.13732","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The trainee research curriculum: Time to ENHANCE it?","authors":"Daniel E Roos,&nbsp;Paulina Stehlik,&nbsp;Paul M Parizel","doi":"10.1111/1754-9485.13735","DOIUrl":"10.1111/1754-9485.13735","url":null,"abstract":"","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"68 6","pages":"771-773"},"PeriodicalIF":2.2,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141912976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical application of convolutional neural network lung nodule detection software: An Australian quaternary hospital experience","authors":"Peter Mark,&nbsp;Isabella Papalia,&nbsp;Jeffrey KC Lai,&nbsp;Diane M Pascoe","doi":"10.1111/1754-9485.13734","DOIUrl":"10.1111/1754-9485.13734","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Early-stage lung cancer diagnosis through detection of nodules on computed tomography (CT) remains integral to patient survivorship, promoting national screening programmes and diagnostic tools using artificial intelligence (AI) convolutional neural networks (CNN); the software of AI-Rad Companion™ (AIRC), capable of self-optimising feature recognition. This study aims to demonstrate the practical value of AI-based lung nodule detection in a clinical setting; a limited body of research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>One hundred and eighty-three non-contrast CT chest studies from a single centre were assessed for AIRC software analysis. Prospectively collected data from AIRC detection and characterisation of lung nodules (size: ≥3 mm) were assessed against the reference standard; reported findings of a blinded consultant radiologist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One hundred and sixty-seven CT chest studies were included; 52% indicated for nodule or lung cancer surveillance. Of 289 lung nodules, 219 (75.8%) nodules (mean size: 10.1 mm) were detected by both modalities, 28 (9.7%) were detected by AIRC alone and 42 (14.5%) by radiologist alone. Solid nodules missed by AIRC were larger than those missed by radiologist (11.5 mm vs 4.7 mm, <i>P</i> &lt; 0.001). AIRC software sensitivity was 87.3%, with significant false positive and negative rates demonstrating 12.5% specificity (PPV 0.6, NPV 0.4).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In a population of high nodule prevalence, AIRC lung nodule detection software demonstrates sensitivity comparable to that of consultant radiologist. The clinical significance of larger sized nodules missed by AIRC software presents a barrier to current integration in practice. We consider this research highly relevant in providing focus for ongoing software development, potentiating the future success of AI-based tools within diagnostic radiology.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"68 6","pages":"659-666"},"PeriodicalIF":2.2,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141912975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiotherapy protocol compliance in routine clinical practice for patients with stages I–III non-small-cell lung cancer","authors":"Xiaoshui Huang,&nbsp;Matthew Field,&nbsp;Shalini Vinod,&nbsp;Helen Ball,&nbsp;Vikneswary Batumalai,&nbsp;Paul Keall,&nbsp;Lois Holloway","doi":"10.1111/1754-9485.13727","DOIUrl":"10.1111/1754-9485.13727","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Despite the availability of radiotherapy treatment protocols for lung cancer, considerable treatment variation occurs in clinical practice. This study assessed compliance with a radiotherapy protocol for the treatment of patients with stages I–III non-small-cell lung cancer (NSCLC) in routine clinical practice and to identify factors that were associated with compliance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Cancer Institute New South Wales eviQ treatment protocol for external beam radiotherapy of stages I–III NSCLC was taken as the reference to measure compliance. All inoperable patients with stages I–III NSCLC and documented ECOG performance status treated with radiotherapy between 2007 and 2019 at two radiotherapy facilities were available for analysis. Protocol compliance rates were calculated. Univariate and multivariate logistic regression models with 23 input factors were used to determine factors significantly associated with compliance. Survival analysis was conducted for both compliant and non-compliant treatments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 656 patients met the inclusion criteria. Protocol compliance was 16%. Alternative dose/fractionation was responsible for 49% of non-compliant treatments with 30% receiving an alternative curative fractionation. Five of 23 factors (age at the start of radiotherapy, stage group, ECOG performance status, tumour location and alcoholism history) showed significant associations with protocol compliance on multivariate analysis. There was no significant difference in median survival between patients receiving protocol compliant treatment (15.1 months) and non-compliant treatment (15.6 months).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Adherence to the eviQ curative radiotherapy protocol for stages I–III NSCLC was low. Alternative dose/fractionation schemes were the main reason for non-compliance. Protocol compliance was not associated with outcome.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16218,"journal":{"name":"Journal of Medical Imaging and Radiation Oncology","volume":"68 6","pages":"729-739"},"PeriodicalIF":2.2,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1754-9485.13727","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}