Radiotherapy and Oncology最新文献

{"title":"IMPROVING PHYSICIAN ATTENDANCE AND PARTICIPATION IN CLINICAL TRIAL RESEARCH MEETINGS: A ROLE FOR A PHYSICIAN STAFF ENGAGEMENT, A QUALITY IMPROVEMENT PROJECT","authors":"Dylan Narinesingh ,&nbsp;Sarah Baker ,&nbsp;Paris Ingledew ,&nbsp;Andrea Pollock ,&nbsp;Will Jiang ,&nbsp;Dan Le","doi":"10.1016/S0167-8140(25)04730-9","DOIUrl":"10.1016/S0167-8140(25)04730-9","url":null,"abstract":"<div><h3>Purpose:</h3><div>The literature has identified multiple barriers to participation in clinical trials such as a lack of time, lack of resources, communication difficulties, conflicts between the role of clinician and scientist, inadequate research experience and training for physicians, lack of rewards and recognition for physicians. Engagement in clinical trials and attendance at Clinical Trial Activation Group (CTAG) meetings at our regional cancer centre was poor. The purpose of this study was to assess the efficacy of a quality improvement project utilizing quarterly in-person, lunch meetings to improve physician attendance and engagement at CTAG meetings.</div></div><div><h3>Materials and Methods:</h3><div>Funding was obtained through a provincial physician engagement initiative aimed to strengthen the relationships between physicians and health authority leaders. The clinical trials unit identified a fixed date, time and venue for a lunch meeting every 3 months for a 9-month period (3 meetings total). Meetings were structured to update medical staff on new and ongoing clinical trials and research, to promote open dialogue between medical staff and the trials unit and allow interinstitutional collaborative presentations on shared priorities to improve patient care in an effective collaborative way. Success of the intervention was defined as a 100% increase in average physician attendance at the end of the intervention compared to the 6 months prior at monthly morning meetings. The intervention started in the spring of 2024.</div></div><div><h3>Results:</h3><div>The average physician attendance prior to the intervention was 6. Following the intervention, average attendance rose to 23, far exceeding the 100% increase threshold for intervention success. The maximum number of physicians attending a meeting was 32. At the same time the number of patients enrolled in clinical trials increased in the last 6 months of 2024 with clinical trials benchmarks met for the first time.</div></div><div><h3>Conclusions:</h3><div>The intervention of moving the meeting to a more favourable, fixed time and providing lunch resulted in an almost 4-fold increase in physician attendance and an increase in accrual to clinical trials. This simple cost-effective intervention improved physician engagement with clinical trials unit and health organizations and resulted in high quality health care and improved patient recruitment to clinical trials. Further evaluation with provider feedback would be a next step. This engagement approach may be adopted as a method for increasing engagement for other regular physician meetings.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"210 ","pages":"Pages S31-S32"},"PeriodicalIF":5.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100241","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":"THE INTERNATIONAL CONSENSUS ON PALLIATIVE RADIOTHERAPY ENDPOINTS FOR FUTURE CLINICAL TRIALS IN BONE METASTASES: A SECOND UPDATE","authors":"Jane Jomy ,&nbsp;Eva Oldenburger ,&nbsp;Inmaculada Navarro-Domenech ,&nbsp;Joanne Van der Velden ,&nbsp;Shing Fung Lee ,&nbsp;Henry Wong ,&nbsp;Mateusz Spalek ,&nbsp;Gustavo Marta ,&nbsp;Peter Hoskin ,&nbsp;Yvette Van der Linden ,&nbsp;Johan Menten ,&nbsp;Charles Simone II ,&nbsp;Dirk Rades ,&nbsp;Edward Chow ,&nbsp;Philip Wong ,&nbsp;Srinivas Raman","doi":"10.1016/S0167-8140(25)04694-8","DOIUrl":"10.1016/S0167-8140(25)04694-8","url":null,"abstract":"<div><h3>Purpose:</h3><div>External beam radiotherapy (EBRT) is a well-established palliative treatment for symptomatic bone metastases. As radiation techniques and clinical practices evolve standardized endpoints are essential for ensuring accurate reporting and facilitate comparability across clinical trials. To address this, the International Bone Metastases Consensus Group developed consensus guidelines for EBRT trial endpoints. This study presents the latest revision of these guidelines, incorporating advancements in clinical practice and technology to further refine consensus-based endpoints for future clinical trials.</div></div><div><h3>Materials and Methods:</h3><div>Applying the Delphi Method, a structured, two-phase electronic survey was conducted to update the consensus. Expert participants, including prior consensus contributors and globally recognized specialists in bone irradiation, provided input. Statements required a consensus threshold of &gt;75% agreement. Consensus was defined as ≥75% agreement. Statements that did not reach consensus in Phase I were revised and reassessed in Phase II after Working Panel discussions. Descriptive statistics summarized the results, categorizing statements by consensus level.</div></div><div><h3>Results:</h3><div>A total of 58 experts participated in Phase I, 44 in Phase II. Consensus was achieved 38 of 47 (81%) of statements, including 18 newly introduced or modified items. Key consensus areas included eligibility criteria, pain and analgesic assessments, radiation techniques and dose specifications, follow-up protocols, assessment timing, and cost-effectiveness considerations. Notably, net pain relief was introduced as a critical endpoint, quality of life measures were recommended for all trials, and skeletal-related events were deemed as essential additional endpoints. Despite broad consensus, several areas remained unresolved. Debate persisted over the optimal duration for pain assessment (3-day versus 7-day) and whether worst pain, mean pain or both should be reported. Additionally, the timeframe for pre-treatment assessment could not be agreed upon. While pain response evaluations at 1, 2, and 3 months were widely accepted, alternative assessment intervals generated discussion. And while de-intensification of follow-up after 6 months was thought to be a consideration, the optimal follow-up duration beyond those 6 months remained a point of contention, with some advocating for extended monitoring to assess long-term outcomes.</div></div><div><h3>Conclusions:</h3><div>This updated consensus provides a refined framework for the design of clinical trials in EBRT for bone metastases, promoting standardized reporting and identifying research priorities. The inclusion of new endpoints, such as standardized dose thresholds, reflects contemporary clinical practice. Ongoing re-evaluation is planned to maintain relevance with evolving treatment paradigms.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"210 ","pages":"Pages S16-S17"},"PeriodicalIF":5.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100250","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":"ASSOCIATION OF EXERCISE WITH DEVELOPING METABOLIC SYNDROME IN PROSTATE CANCER PATIENTS ON ANDROGEN DEPRIVATION THERAPY: A SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL","authors":"Nawaid Usmani ,&nbsp;Arun Elangovan ,&nbsp;Kerry Courneya ,&nbsp;Ayoola Ademola ,&nbsp;Shuang Lu ,&nbsp;Sunita Ghosh ,&nbsp;Julian Kim ,&nbsp;John Thoms ,&nbsp;Myriam Bouchard ,&nbsp;Michael Peacock ,&nbsp;Neil Fleshner ,&nbsp;Holly Campbell ,&nbsp;Eric Vigneault ,&nbsp;Francois Vincent ,&nbsp;Alan So ,&nbsp;Fabio Cury ,&nbsp;Harvey Quon ,&nbsp;Ryan Carlson ,&nbsp;Carole Lambert ,&nbsp;Laurence Klotz ,&nbsp;Bernhard Eigl","doi":"10.1016/S0167-8140(25)04724-3","DOIUrl":"10.1016/S0167-8140(25)04724-3","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose:&lt;/h3&gt;&lt;div&gt;To determine if prostate cancer (PCa) patients on androgen deprivation therapy (ADT) have lower odds of developing metabolic syndrome (MS) if they were meeting exercise guidelines.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Methods:&lt;/h3&gt;&lt;div&gt;This is an exploratory analysis of a Phase III multicentre double blind, randomized controlled trial where normoglycemic men with prostate cancer planned for at least 9 months ADT were randomized 2:1 to receive metformin 850 mg or placebo BID orally for 18 months (NCT03031821; The PRIME study). At baseline, all study participants were provided a copy of the Canadian Physical Activity Guideline. At baseline and 12 months, participants completed the modified Godin Leisure Time Exercise Questionnaire which was used to calculate whether they were meeting the aerobic and strength exercise guidelines. The associations between meeting the exercise guidelines and the development of MS at 12 months was analyzed as the primary outcome using logistic regression. The associations between meeting the exercise guidelines and body weight (BW), waist circumference (WC), and hemoglobin A1C (HbA1c) were analyzed as secondary outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results:&lt;/h3&gt;&lt;div&gt;At baseline, 87/90 (96.6%) and 45/45 (100%) patients in the metformin and placebo arms completed the exercise questionnaires. At baseline, aerobic exercise guidelines were met by 26/87 (29.9%) and 12/45 (26.7%) patients in the metformin and placebo arms, respectively. Strength exercise guidelines at baseline were met by 40/87 (46%) and 14/45 (31.1%) in the metformin and placebo arms. At 12 months, aerobic exercise guidelines were met by 31/84 (36.9%) and 17/42 (40.5%) patients in the metformin and placebo arms, respectively. Strength exercise guidelines at 12 months were met by 22/84 (26.2%) and 13/42 (30.9%) in the metformin and placebo arms. The association of exercise (either strength or aerobic) with the outcome (MS) was not modified by the intervention (metformin versus placebo), or vice versa, on testing for interactions. Proportion of patients with MS in the metformin and placebo arms were 37/87 (42.5%) versus 26/45 (57.8%) at baseline and 44/83 (51.0%) versus 25/44 (56.8%) at 12 months, respectively. The likelihood of developing MS at 12 months was significantly reduced in the patients meeting aerobic exercise guidelines [odds ratio 0.38 (95% CI: 0.18 - 0.79); p=0.01], but not in those who met the strength exercise guidelines. Significant reductions in BW [-7.13 (95% CI -13.46 – -0.79); p&lt;0.03] and WC [-6.88 (95% CI -11.61 – -2.15); p&lt;0.001] were associated with meeting the strength exercise guidelines. Significant reductions in WC [-6.37 (95% CI -1.72 – -2.02); p&lt;0.001] and HbA1c [-0.16 (95% CI -0.29 – -0.02); p=0.02] were associated with meeting the aerobic exercise guidelines.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions:&lt;/h3&gt;&lt;div&gt;This exploratory analysis shows favourable differences in MS, BW, WC, and HbA1c at 12 months in PCa patie","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"210 ","pages":"Page S29"},"PeriodicalIF":5.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099945","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":"WITHDRAW","authors":"","doi":"10.1016/S0167-8140(25)04750-4","DOIUrl":"10.1016/S0167-8140(25)04750-4","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"210 ","pages":"Page S39"},"PeriodicalIF":5.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100261","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":"PATTERNS OF PROTON THERAPY UTILIZATION AND OUTCOMES IN CANADIAN PEDIATRIC PATIENTS","authors":"Yina Shan ,&nbsp;Ralph P. Ermoian ,&nbsp;Daniel J. Indelicato ,&nbsp;Arnold C. Paulino ,&nbsp;Torunn I. Yock ,&nbsp;Derek S. Tsang","doi":"10.1016/S0167-8140(25)04709-7","DOIUrl":"10.1016/S0167-8140(25)04709-7","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose:&lt;/h3&gt;&lt;div&gt;Proton beam therapy (PBT) is a precise radiotherapy modality that minimizes radiation dose to normal tissues compared to photon radiotherapy. Currently, there are no PBT centres in Canada, and Canadian patients must be referred to the United States (US). There is a limited understanding of patterns of PBT utilization and outcomes in Canadian pediatric patients. Our study aims to characterize these patterns and to estimate the survival of patients who receive PBT in the US.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Methods:&lt;/h3&gt;&lt;div&gt;Our study population includes all patients residing in Canada who were enrolled in the Pediatric Proton/Photon Consortium Registry (PPCR), a prospective, multi-institutional registry of pediatric patients treated with PBT. Eligible individuals were age &lt;22 at time of starting treatment, treated between 2012 July 1 and 2024 Sep 1, and received PBT at a PPCR institution. We conducted a descriptive analysis of patient demographics, diagnoses, and time of treatment. We estimated overall survival from time of first proton treatment using the Kaplan-Meier method and compared survival between groups using the log-rank test.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results:&lt;/h3&gt;&lt;div&gt;214 patients were included, 64% male and 36% female. Mean age at diagnosis was 8.6 years (range 0-20). Mean age at first proton treatment was 9.5 years (range 1-21). The primary diagnoses included 143 (66.8%) CNS and 71 (33.2%) non-CNS tumours. The most common CNS histologic subtypes were medulloblastoma (45 [31.5%]), craniopharyngioma (23 [16.1%]), ependymoma (23 [16.1%]), and germ cell (23 [16.1%]). The most common non-CNS tumours were rhabdomyosarcoma (25 [35.2%]), other soft tissue or bone sarcoma (17 [23.9%]), and neuroblastoma (11 [15.5%]). 37 (17.3%) patients had metastatic disease. The number of patients treated per year peaked at 38 in 2019, decreased to 13 in 2020, and then steadily increased to 30 in 2023. The survival analysis included 106 patients with available follow-up data. Five-year overall survival (OS) from time of proton treatment was 76.9% (95% CI: 0.673-0.880) for all patients. Five-year OS in patients with CNS tumours was 85.9% (95% CI: 0.744-0.969) compared to 62.0% (95% CI: 0.450-0.853) in patients with non-CNS tumours (p=0.04). Patients with metastatic disease had inferior OS, with 3-year estimates of 64.7% (95% CI: 0.426-0.982) versus 82.8% (95% CI: 0.738-0.929) for localized tumours (p=0.03).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions:&lt;/h3&gt;&lt;div&gt;This is the first study reporting patient-level data from US proton centres regarding children living in Canada, with data on demographics, diagnoses treated, and survival. Since 2020, the number of patients treated per year has been increasing. Most patients treated with PBT, particularly those with CNS or non-metastatic tumours, remain alive five years after their proton treatment. PBT should continue to be offered as a treatment option for Canadian pediatric patients with curable tumour","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"210 ","pages":"Pages S22-S23"},"PeriodicalIF":5.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100090","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":"DURATION OF SYSTEMIC THERAPY IN PATIENTS WITH METASTATIC EGFR-MUTATED NSCLC AND BRAIN METASTASES: FIRST VERSUS THIRD GENERATION TKIS","authors":"Michael Yan ,&nbsp;Ambika Parmar ,&nbsp;Lena Nguyen ,&nbsp;Natalie Coburn ,&nbsp;Alexander Louie","doi":"10.1016/S0167-8140(25)04710-3","DOIUrl":"10.1016/S0167-8140(25)04710-3","url":null,"abstract":"<div><h3>Purpose:</h3><div>New-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs), such as Osimertinib, demonstrate high central nervous system (CNS) activity in EGFR-mutated non-small cell lung cancer (NSCLC). Clinical guidelines recommend TKI monotherapy as an effective option for small, asymptomatic brain metastases (BM). We hypothesize that patients receiving Osimertinib remain on therapy longer than those on first- or second-generation TKIs. This study evaluates treatment duration in a real-world setting using a healthcare administrative database.</div></div><div><h3>Materials and Methods:</h3><div>We analyzed data from the Institute for Clinical Evaluative Sciences (ICES), a provincial health administrative database, identifying patients diagnosed with non-squamous NSCLC from 2002 to 2022. Eligible patients received first-line EGFR-targeted therapy with either Gefitinib or Osimertinib. Brain radiotherapy receipt was used as a surrogate for BM presence. Patients under 18 or those with a prior cancer diagnosis within five years were excluded. The primary outcome was the duration of first-line systemic therapy. Overall survival (OS) was estimated using the Kaplan-Meier method. Propensity score matching adjusted for baseline factors influencing systemic therapy duration, including age, sex, rurality index, Charlson and Elixhauser comorbidity indices, income quintile, and treatment year.</div></div><div><h3>Results:</h3><div>Among 3,088 screened patients with EGFR-mutated NSCLC, 1,243 received Osimertinib and 1,845 received Gefitinib as first-line therapy. A total of 761 patients had BM and met inclusion criteria (Osimertinib: 308; Gefitinib: 453). The median first-line systemic therapy duration was significantly longer in the Osimertinib cohort (327 versus 190 days, p&lt;0.001). Median OS was also higher with Osimertinib (21.8 versus 14.0 months, p&lt;0.001). After propensity score matching (n=168, 84 in each cohort), patients on Osimertinib first line had a median duration of 390 days versus 154 days per patients receiving Gefitinib. There was no longer a significant difference in OS, with a median OS of 16.2m versus 14.7m in the same respective cohorts (p=0.36).</div></div><div><h3>Conclusions:</h3><div>Patient with brain metastases treated with Osimertinib remained on this line of systemic therapy longer than patients treated with Gefitinib. These findings remained consistent after propensity score matching. These findings suggest that despite BM, patients on Osimertinib may have sustained efficacy in this patient population.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"210 ","pages":"Page S23"},"PeriodicalIF":5.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100091","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":"LEANING IN THE RIGHT DIRECTION: A PROSPECTIVE FEASIBILITY TRIAL OF THE TRENDELENBURG POSITION FOR REDUCING SMALL BOWEL DOSE IN PELVIC RADIOTHERAPY PATIENTS","authors":"Daniel Tesolin ,&nbsp;Rabbiya Aslam ,&nbsp;Kristopher Dennis ,&nbsp;Shawn Malone ,&nbsp;Sondos Zayed ,&nbsp;Gordon Locke ,&nbsp;Alain Haddad ,&nbsp;Jamie Bahm ,&nbsp;Steve Andruysk ,&nbsp;Madeleine Van De Kleut ,&nbsp;Sarah Spooner ,&nbsp;Tim Ramsay ,&nbsp;Katie Lekx-Toniolo ,&nbsp;Claire Footit ,&nbsp;Geoff Reid ,&nbsp;Ron Romain ,&nbsp;Nikitha Moideen","doi":"10.1016/S0167-8140(25)04669-9","DOIUrl":"10.1016/S0167-8140(25)04669-9","url":null,"abstract":"<div><h3>Purpose:</h3><div>In genitourinary, gastrointestinal and gynecologic malignancies, pelvic radiotherapy (RT) is frequently a component of treatment. This often results in acute and chronic gastrointestinal symptoms from small bowel irradiation. We investigated a novel simulation technique using Trendelenburg position to decrease small bowel dose. This study compares comfort and dosimetric differences of supine, prone and the Trendelenburg position in patients planned for pelvic RT with volumetric modulated arc therapy (VMAT).</div></div><div><h3>Materials and Methods:</h3><div>In this REB approved prospective trial, 20 patients were recruited. Patients that undergoing pelvic RT with elective nodal radiation were included. Those with severe limitation in mobility were excluded. CT simulation was completed in the supine, prone and Trendelenburg positions. The Trendelenburg position was achieved using a foam wedge at a 20-degree angle. Patients answered a Likert scale questionnaire on comfort after the scans. The treatment volumes, small bowel, large bowel and bowel bag structures were contoured for each scan set and VMAT plans were then developed.</div></div><div><h3>Results:</h3><div>Twenty patients were recruited with a median age of 73 (45-90) and median BMI of 26 (19.3-33.5). Primary sites were prostate (40%, n=8), rectal (45%, n=9) and endometrial (15%, n=3). Most patients found the supine position at least somewhat comfortable (95%, n=19) and over half felt the prone (55% n=11) and Trendelenburg positions (65%, n=13) to be at least somewhat comfortable. Most patients felt they could complete an entire course of RT in all positions (supine 100%, prone 90%, Trendelenburg 95%). One patient could not tolerate prone and another patient could not tolerate Trendelenburg position. Of the patients that found supine or prone uncomfortable, 80% found Trendelenburg position comfortable. On average, there was reduction in several small bowel dose parameters when comparing supine to prone or Trendelenburg position respectively (small bowel Dmean: 1802.9 cGy, 1484.3 cGy, 1424.9 cGy, p=0.0026), (small bowel D0.03: 4933.6 cGy, 4455.1 cGy, 4465.2 cGy, p=0.0085), (small bowel V15: 315.6 cc, 175.3 cc, 185.2 cc, p=0.0001), (bowel bag V45: 76.6 cc, 76.2 cc, 65.1 cc, p=0.2042).</div></div><div><h3>Conclusions:</h3><div>Overall, this study suggests the Trendelenburg is a more comfortable treatment position than prone while demonstrating lower small bowel doses compared to supine position on dosimetric analysis. Future studies are required to assess reproducibility and clinical benefit to patients treated in the Trendelenburg position.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"210 ","pages":"Page S6"},"PeriodicalIF":5.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100183","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":"DOSIMETRIC PREDICTORS OF SEXUAL TOXICITY IN CERVICAL CANCER PATIENTS TREATED WITH DEFINITIVE CHEMORADIATION AND MRI-GUIDED BRACHYTHERAPY","authors":"Stephanie Gulstene ,&nbsp;Elizabeth Chuk ,&nbsp;Jessica L. Conway ,&nbsp;Jennifer Hanuschak ,&nbsp;Kathy Han ,&nbsp;Michael Milosevic ,&nbsp;Helena Lukovic ,&nbsp;Nauman Malik ,&nbsp;Sarah E. Ferguson ,&nbsp;Ailya Salman ,&nbsp;Anna T. Santiago ,&nbsp;Alexandra Rink ,&nbsp;Jennifer Croke","doi":"10.1016/S0167-8140(25)04684-5","DOIUrl":"10.1016/S0167-8140(25)04684-5","url":null,"abstract":"<div><h3>Purpose:</h3><div>Definitive radiotherapy for cervical cancer results in significant vaginal and sexual toxicity. Prior work has investigated dosimetric predictors of vaginal toxicity; however, sexual health outcomes are lacking. We assessed dosimetric predictors of sexual toxicity in cervical cancer patients treated with definitive radiation.</div></div><div><h3>Materials and Methods:</h3><div>Stage IB-IVA cervical cancer patients treated with definitive chemoradiation and MR-guided brachytherapy were enrolled in a prospective, cross-sectional study. Sexual toxicity was assessed using 2 validated patient reported outcome measures (PROMs): Female Sexual Function Index (FSFI) (scores &gt;11 indicating distress) and Female Sexual Distress Scale-Revised (FSDS-R) (scores &lt;26 indicating dysfunction). Clinical and treatment data were collected by chart review. Vaginal dosimetry was abstracted from individual treatment plans including cumulative dose (EQD2) and maximum dose per fraction for vaginal D2cc, ICRU recto-vaginal point (RV point), vaginal lateral point (5mm from applicator), posterior-inferior border of symphysis (PIBS), and PIBS±2cm. Vaginal Total Reference Air Kerma (TRAK) assessed dose loading within the vagina. Descriptive statistics summarized the data and correlations were evaluated using logistic regression analyses.</div></div><div><h3>Results:</h3><div>Between August 2018 and April 2022, 73 patients were eligible for analysis. Median age at diagnosis was 50 (range: 23-80), median Stage was IIB (49%), 61% had vaginal involvement at diagnosis, and 33% had involvement at brachytherapy. Mean EQD2 for vaginal D2cc, ICRU RV point, lateral point, PIBS+2cm, PIBS, and PIBS-2cm were 78.3 Gy (SD±13.7), 63.5Gy (±10.1), 118.5 Gy (±98.4), 55.7 Gy (±22.5), 28.4 Gy (±19.6), and 5.5 Gy (±6.9), respectively. Patients completed PROMs a median of 19 months (range 3–63) after treatment. Criteria for sexual dysfunction and distress was met in 85% and 55% of participants, respectively. Cumulative ICRU RV point dose &gt;65 Gy (p=0.012) and vaginal TRAK (p=0.003) were associated with increased sexual distress on multivariable analysis.</div></div><div><h3>Conclusions:</h3><div>Sexual health following radiotherapy for cervical cancer is an important and multifactorial issue. Here we highlight the importance of vaginal dosimetry in post-treatment sexual health. Attention to and evaluation of vaginal doses could improve our understanding of sexual health outcomes.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"210 ","pages":"Pages S12-S13"},"PeriodicalIF":5.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100225","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":"SKIN DEEP: AN EVALUATION OF YOUTUBE VIDEOS ON ACUTE RADIATION DERMATITIS IN PATIENTS WITH BREAST CANCER","authors":"Sandy Lum-Wang ,&nbsp;Brandon Chai ,&nbsp;Paris-Ann Ingledew","doi":"10.1016/S0167-8140(25)04728-0","DOIUrl":"10.1016/S0167-8140(25)04728-0","url":null,"abstract":"<div><h3>Purpose:</h3><div>Acute radiation dermatitis (ARD) is a common adverse effect of radiation therapy in patients with breast cancer. As YouTube increasingly serves as a health information resource, relevant and reliable videos may play an important role in patient education. This study aims to characterize YouTube videos that are intended to inform patients with breast cancer about ARD, including assessing congruence with current consensus guidelines.</div></div><div><h3>Materials and Methods:</h3><div>The first 50 results of seven YouTube searches related to ARD in patients with breast cancer were web-scraped using a custom Python script, yielding a total of 350 videos. These were rank-ordered based on frequency across searches and position in the results. After applying pre-determined inclusion criteria, the top 50 videos were analyzed using a validated video assessment tool to assess general parameters, video source/presentation, content, and reliability. Recent International and National Delphi consensus literature was reviewed to inform content analysis. Two independent reviewers were used for inter-rater reliability.</div></div><div><h3>Results:</h3><div>35% (n=18) of videos were published within 3 years of the search date. The median video length was 5 minutes and 51 seconds, with a median of 9,725 views. 60% (n=30) were published by American channels, 52% (n=26) featured physician presenters, and 42% (n=21) were from commercially affiliated channels. Few videos offered prevention or management recommendations consistent with International consensus-based clinical practice guidelines. Several key recommendations such as the use of olive oil or photobiomodulation therapy were entirely absent from all videos reviewed, while only a few addressed barrier films and dressings.</div></div><div><h3>Conclusions:</h3><div>Several YouTube videos address breast cancer-associated ARD. About one third were published recently, many from a single country and with commercial affiliations. Prevention and management strategies had low congruence with current consensus guidelines. This study may enhance efforts to improve online patient education for ARD and can inform physician-patient conversations regarding gaps in online health information.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"210 ","pages":"Page S31"},"PeriodicalIF":5.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100245","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":"Title Page","authors":"","doi":"10.1016/S0167-8140(25)04662-6","DOIUrl":"10.1016/S0167-8140(25)04662-6","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"210 ","pages":"Page S2"},"PeriodicalIF":5.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100059","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}