Technical Innovations and Patient Support in Radiation Oncology最新文献

{"title":"Single isocenter dynamic conformal arcs-based radiosurgery for brain metastases: Dosimetric comparison with Cyberknife and clinical investigation","authors":"Yoshiko Oshiro ,&nbsp;Masashi Mizumoto ,&nbsp;Yuichi Kato ,&nbsp;Yukihiro Tsuchida ,&nbsp;Koji Tsuboi ,&nbsp;Takeji Sakae ,&nbsp;Hideyuki Sakurai","doi":"10.1016/j.tipsro.2024.100235","DOIUrl":"https://doi.org/10.1016/j.tipsro.2024.100235","url":null,"abstract":"<div><h3>Purpose</h3><p>To compare the dosimetric quality of automatic multiple brain metastases planning (MBM) with that of Cyberknife (CK) based on the clinical tumor condition, such as the tumor number, size, and location.</p></div><div><h3>Methods</h3><p>76 treatment plans for 46 patients treated with CK were recalculated with the MBM treatment planning system. Conformity index (CI), homogeneity index (HI), gradient index (GI), lesion underdosage volume factor (LUF), healthy tissue overdose volume factor (HTOF), geometric conformity index (g) and mean dose to normal organs were compared between CK and MBM for tumor number, size, shape and distance from the brainstem or chiasm.</p></div><div><h3>Results</h3><p>The results showed that the mean brain dose was significantly smaller in MBM than CK. CI did not differ between MBM and CK; however, HI was significantly more ideal in CK (p = 0.000), and GI was significantly smaller in MBM (P = 0.000). LUF was larger in CK (p = 0.000) and HTOF and g was larger in MBM (p = 0.003, and 0.012). For single metastases, CK had significantly better HTOF (p = 0.000) and g (p = 0.002), but there were no differences for multiple tumors. Brain dose in MBM was significantly lower and CI was higher for tumors &lt; 30 mm (p = 0.000 and 0.000), whereas HTOF and g for tumors &lt; 10 mm were significantly smaller in CK (p = 0.041 and p = 0.016). Among oval tumors, brain dose, GI and LUF were smaller in MBM, but HTOF and g were smaller in CK. There were no particular trends for tumors close to the brainstem, but HTOF tended to be smaller in CK (0.03 vs. 0.29, p = 0.068) for tumors inside the brainstem.</p></div><div><h3>Conclusions</h3><p>MBM can reduce the brain dose while achieving a dose distribution quality equivalent to that with CK.</p></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"29 ","pages":"Article 100235"},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405632424000027/pdfft?md5=e64909107614f8627321cbab6c2de5a5&pid=1-s2.0-S2405632424000027-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139480195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real world challenges in maintaining data integrity in electronic health records in a cancer program","authors":"Harpriya Khela ,&nbsp;Justin Khalil ,&nbsp;Nathan Daxon ,&nbsp;Zdenka Neilson,&nbsp;Tina Shahrokhi,&nbsp;Peter Chung,&nbsp;Philip Wong","doi":"10.1016/j.tipsro.2023.100233","DOIUrl":"10.1016/j.tipsro.2023.100233","url":null,"abstract":"<div><p>Electronic Health Record (EHR) systems increase clerical workload, promote copy-paste and error propagation. Documentation error rate in cancer diagnosis and treatment was examined in 776 patient records. Fifteen percent of the charts contained an error. Modern EHR systems, patient portals and engagement tools may facilitate the maintenance of accurate information.</p></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"29 ","pages":"Article 100233"},"PeriodicalIF":0.0,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405632423000331/pdfft?md5=bffb4f850b6aeca37d32bbffc818cd0a&pid=1-s2.0-S2405632423000331-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139395133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smartphone-based augmented reality patient education in radiation oncology","authors":"Liam J. Wang ,&nbsp;Brian Casto ,&nbsp;Nancy Reyes-Molyneux ,&nbsp;William W. Chance ,&nbsp;Samuel J. Wang","doi":"10.1016/j.tipsro.2023.100229","DOIUrl":"https://doi.org/10.1016/j.tipsro.2023.100229","url":null,"abstract":"<div><p>We built an augmented reality (AR) patient education application for portable iOS and Android devices that allows patients to view a virtual simulation of themselves receiving radiation treatment. We created software that reads data from the clinical treatment planning system and renders the patient’s actual radiotherapy plan in AR on a tablet or smartphone. The patient's CT simulation data are converted into a 3D translucent virtual human shown being treated with visible radiation beams from a virtual linear accelerator. We conducted a patient study to determine if showing patients this AR simulation improves patient understanding of radiotherapy and/or reduces anxiety about treatment. A total of 75 patients completed this study. The most common plans were 3D breast tangents and intensity modulated radiotherapy lung plans. Patients were administered questionnaires both before and after their AR viewing experience. After their AR viewing, 95% of patients indicated that they had a better understanding of how radiotherapy will be used to treat their cancer. Of the 35 patients who expressed anxiety about radiotherapy beforehand, 21 (60%) indicated that they had decreased anxiety after the AR session. In our single-arm prospective patient study, we found that this simplified low-cost tablet-based personalized AR simulation can be a helpful educational tool for cancer patients undergoing radiotherapy.</p></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"29 ","pages":"Article 100229"},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S240563242300029X/pdfft?md5=467edf38da3f78c81067227c80bfeee6&pid=1-s2.0-S240563242300029X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139419185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of abdominal fat quantification on MRI and impact on effectiveness of abdominal compression for radiotherapy motion management","authors":"M. Daly ,&nbsp;L. McDaid ,&nbsp;C. Nelder ,&nbsp;R. Chuter ,&nbsp;A. Choudhury ,&nbsp;A. McWilliam ,&nbsp;G. Radhakrishna ,&nbsp;C.L. Eccles","doi":"10.1016/j.tipsro.2023.100232","DOIUrl":"https://doi.org/10.1016/j.tipsro.2023.100232","url":null,"abstract":"<div><p>The impact of fat on abdominal compression effectiveness in abdominal cancers was determined using magnetic resonance imaging (MRI). Visceral and subcutaneous fat were delineated on T2W 3D MRI, and motion change with compression was measured on 2D cine MRI. Results from 16 participants showed no correlation between fat percentage, body mass index (BMI), and motion change. Median BMI was 28.7 (SD, 4.9). Mean motion reduction was 7.8 mm (IQR, 5.0; p = 0.001) with compression. While no direct link was found between fat, BMI, and compression effectiveness, abdominal compression remains crucial for motion management in radiotherapy planning, providing dosimetric benefits.</p></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"29 ","pages":"Article 100232"},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S240563242300032X/pdfft?md5=6cec068f5241cc86d029d97ba0626ca0&pid=1-s2.0-S240563242300032X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139090202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dose-volume relationships of planned versus estimated delivered radiation doses to pelvic organs at risk and side effects in patients treated with salvage radiotherapy for recurrent prostate cancer","authors":"Vilberg Jóhannesson ,&nbsp;Adalsteinn Gunnlaugsson ,&nbsp;Per Nilsson ,&nbsp;Patrik Brynolfsson ,&nbsp;Elisabeth Kjellén ,&nbsp;Elinore Wieslander","doi":"10.1016/j.tipsro.2023.100231","DOIUrl":"https://doi.org/10.1016/j.tipsro.2023.100231","url":null,"abstract":"<div><h3>Purpose</h3><p>To investigate estimated delivered dose distributions using weekly cone-beam computed tomography (CBCT) scans for pelvic organs at risk (OARs) in salvage radiotherapy (SRT) after radical prostatectomy. Furthermore, to compare them with the originally planned dose distributions and analyse associations with gastrointestinal (GI) and genitourinary (GU) side effects.</p></div><div><h3>Methods</h3><p>This study is part of a phase II trial involving SRT for recurrent prostate cancer. Treatment was personalised based on PSA response during SRT, classifying patients as PSA responders or non-responders. Estimated radiation dose distributions were obtained using deformable image registration from weekly CBCT scans. GI and GU toxicities were assessed using the RTOG toxicity scale, while patient-reported symptoms were monitored through self-assessment questionnaires.</p></div><div><h3>Results</h3><p>The study included 100 patients, with similar treatment-related side effects observed in both responders and non-responders. Differences in dose-volume metrics between the planned and estimated delivered doses for the examined OARs were mostly modest, although generally statistically significant. We identified statistically significant associations between QUANTEC-recommended dose-volume constraints and acute bowel toxicity, as well as late urinary patient-reported symptoms, for both the estimated delivered and planned dose distributions.</p></div><div><h3>Conclusion</h3><p>We found small but statistically significant differences between estimated delivered and planned doses to OARs. These differences showed trends toward improved associations for estimated delivered dose distributions with side effects. Enhanced registration methods and imaging techniques could potentially further enhance the assessment of truly delivered doses and yield more reliable dose-volume constraints for future therapies.</p></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"29 ","pages":"Article 100231"},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405632423000318/pdfft?md5=6e1f85dd67882b0c5eebc18d06e91bc3&pid=1-s2.0-S2405632423000318-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138769607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring patient-reported barriers to participating in proton therapy clinical trials","authors":"Anne Wilhøft Kristensen ,&nbsp;Annesofie Lunde Jensen ,&nbsp;Kenneth Jensen ,&nbsp;Susanne Oksbjerre Dalton ,&nbsp;Jeppe Friborg ,&nbsp;Cai Grau","doi":"10.1016/j.tipsro.2023.100230","DOIUrl":"https://doi.org/10.1016/j.tipsro.2023.100230","url":null,"abstract":"<div><h3>Introduction</h3><p>Clinical trials lead the progress in healthcare. To ensure reliable research conclusions, it is essential to enroll diverse patient groups. Identifying and understanding patient-reported barriers to clinical trials may help enhance recruitment among diverse patient groups.</p><p>The clinical potential of proton therapy (PT) to reduce late effects is being investigated in clinical trials worldwide. Thus, for some patients, PT is only accessible by participating in clinical trials.</p><p>Individuals with smoking-related head and neck cancer (HNC) are sometimes socioeconomically deprived, leading to barriers to trial participation. This study aims to identify barriers to their participation in a randomised controlled trial (RCT) involving PT.</p></div><div><h3>Method</h3><p>Interviews were conducted with 14 HNC patients declining participation in an RCT involving PT. The interviews were transcribed and systematically analysed using an inductive approach identifying categories and themes.</p></div><div><h3>Results</h3><p>The identified barriers to RCT-participation are: (1) existential distress, which influenced participants' mental and cognitive capacities, (2) insufficient RCT-related knowledge arising from information overload during clinical consultations, (3) the wish for safety and familiarity during the treatment trajectory, particularly for participants needing accommodation during  radiotherapy, and (4) the motivation for study participation was impacted by uncertainty due to randomisation and clinical equipoise. Existential distress is identified as an overarching theme because it influences and amplifies the other three themes.</p></div><div><h3>Conclusion</h3><p>Existential distress is a central theme that influences and amplifies other participation barriers in PT RCTs. It affects participants' comprehension of trial information, their preference for familiar environments, and their motivation to participate in clinical trials.</p></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"29 ","pages":"Article 100230"},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405632423000306/pdfft?md5=4deca8042c68faae46b9b20dbf3b5314&pid=1-s2.0-S2405632423000306-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138769606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidental findings and safety events from magnetic resonance imaging simulation for head and neck radiation treatment planning: A single institution experience","authors":"Jonathan Massachi ,&nbsp;Lisa Singer ,&nbsp;Christine Glastonbury ,&nbsp;Jessica Scholey ,&nbsp;Kamal Singhrao ,&nbsp;Christina Calvin ,&nbsp;Sue S. Yom ,&nbsp;Jason W. Chan","doi":"10.1016/j.tipsro.2023.100228","DOIUrl":"https://doi.org/10.1016/j.tipsro.2023.100228","url":null,"abstract":"<div><h3>Purpose</h3><p>Having dedicated MRI scanners within radiation oncology departments may present unexpected challenges since radiation oncologists and radiation therapists are generally not trained in this modality and there are potential patient safety concerns. This study retrospectively reviews the incidental findings and safety events that were observed at a single institution during introduction of MRI sim for head and neck radiotherapy planning.</p></div><div><h3>Methods</h3><p>Consecutive patients from March 1, 2020, to May 31, 2022, who were scheduled for MRI sim after having completed CT simulation for head and neck radiotherapy were included for analysis. Patients first underwent a CT simulation with a thermoplastic mask and in most cases with an intraoral stent. The same setup was then reproduced in the MRI simulator. Safety events were instances where scheduled MRI sims were not completed due to the MRI technologist identifying MRI-incompatible devices or objects at the time of sim. Incidental findings were identified during weekly quality assurance rounds as a joint enterprise of head and neck radiation oncology and neuroradiology. Categorical variables between completed and not completed MRI sims were compared using the Chi-Square test and continuous variables were compared using the Mann-Whitney <em>U</em> test with a p-value of &lt; 0.05 considered to be statistically significant.</p></div><div><h3>Results</h3><p>148 of 169 MRI sims (88 %) were completed as scheduled and 21 (12 %) were not completed (Table 1). Among the 21 aborted MRI sims, the most common reason was due to safety events flagged by the MRI technologist (n = 8, 38 %) because of the presence of metal or a medical device that was not noted at the time of initial screening by the administrative coordinator. Patients who did not complete MRI sim were more likely to be treated for non-squamous head and neck primary tumor (p = 0.016) and were being treated post-operatively (p &lt; 0.001). CT and MRI sim scans each had 17 incidental findings. CT simulation detected 3 cases of new metastases in lungs, which were outside the scan parameters of MRI sim. MRI sim detected one case of dural venous thrombosis and one case of cervical spine epidural abscess, which were not detected by CT simulation.</p></div><div><h3>Conclusions</h3><p>Radiation oncology departments with dedicated MRI simulation scanners would benefit from diagnostic radiology review for incidental findings and having therapists with MRI safety credentialing to catch near-miss events.</p></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"29 ","pages":"Article 100228"},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405632423000288/pdfft?md5=7620981f0c31bc487050a1dd796ac5f2&pid=1-s2.0-S2405632423000288-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138678334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What does “Advanced” mean in 2023? reflecting on 10 years of the ESTRO advanced Skills in modern radiotherapy course","authors":"E. Forde ,&nbsp;M. Josipovic ,&nbsp;M. Kamphuis ,&nbsp;J. Lopez ,&nbsp;P. Remeijer ,&nbsp;S. Rivera ,&nbsp;P. Scherer ,&nbsp;L. Wiersema ,&nbsp;R. de Jong","doi":"10.1016/j.tipsro.2023.100227","DOIUrl":"https://doi.org/10.1016/j.tipsro.2023.100227","url":null,"abstract":"<div><p>The roles and responsibilities of radiation therapists (RTTs) are many and varied. Professional expectations are influenced by the technology available, as well as the level of autonomy RTTs have in their daily practice. This professional range requires RTTs to possess a unique set of ever evolving skills, posing challenges from an educational perspective.</p><p>Teaching these “advanced skills” has been the ambition the ESTRO Advanced Skills in Modern Radiotherapy course. In the 10th year of this course, the Faculty look back and reflect on how our programme has evolved and what it has achieved.</p></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"29 ","pages":"Article 100227"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405632423000276/pdfft?md5=4ffb8b35da01723985ab31f5aeb7b8e9&pid=1-s2.0-S2405632423000276-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138678405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences implementing a Radiation therapist-led oncology prehabilitation program during COVID-19","authors":"Erica Bennett ,&nbsp;Trish Clifford ,&nbsp;Fiona Cregan ,&nbsp;Ellen O'Neill ,&nbsp;Donna Spillane ,&nbsp;Kieran Harte ,&nbsp;Mary Hickey ,&nbsp;Paul J Kelly","doi":"10.1016/j.tipsro.2023.100226","DOIUrl":"https://doi.org/10.1016/j.tipsro.2023.100226","url":null,"abstract":"","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"29 ","pages":"Article 100226"},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405632423000264/pdfft?md5=05eaed772657f6bdf921445f796162de&pid=1-s2.0-S2405632423000264-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138480507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving referral rates for smoking cessation: A multifaceted intervention aimed at radiation oncologists","authors":"Iris Bronsema ,&nbsp;Luc van Lonkhuijzen ,&nbsp;Peter Scholten ,&nbsp;Janna Laan ,&nbsp;Henrike Westerveld ,&nbsp;Lukas Stalpers","doi":"10.1016/j.tipsro.2023.100225","DOIUrl":"https://doi.org/10.1016/j.tipsro.2023.100225","url":null,"abstract":"<div><h3>Objective</h3><p>Continuation of smoking after a cancer diagnosis increases the burdensome side effects from cancer treatment, and decreases the chances of cure. Smoking cessation may improve oncological outcomes in cancer patients. This study aims to evaluate if radiation oncologists can be motivated by a smoking cessation awareness intervention to discuss smoking status more frequently and increase the referral rate for smoking cessation-support.</p><p>Study design and Setting:</p><p>A multifaceted approach was used to improve awareness: First, current practice was evaluated by a retrospective chart review of 282 patients referred for radiotherapy to ascertain smoking status, discussion of smoking cessation support and referral rates. Secondly, radiation oncologists were interviewed about their motives and barriers to discuss smoking status and smoking cessation support. The results were fed back in a teaching lecture to the doctors involved. Finally, the effect of this smoking cessation awareness intervention was prospectively evaluated in 100 patients.</p></div><div><h3>Results</h3><p>After the smoking cessation awareness intervention, smoking cessation was more frequently discussed compared to baseline (77% (10/13)) and 39.5% (17/43) respectively. The referral rate for smoking cessation increased from 2.3% (1/43) to 69.2% (9/13)</p></div><div><h3>Conclusion</h3><p>Without an active smoking prevention awareness policy, referral for smoking cessation support for cancer patients by radiation oncologists is low. A relatively short and simple smoking awareness intervention for radiation oncologist may result in a more frequent discussion with patients about smoking cessation and an even larger increase in referrals for smoking cessation support.</p></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"29 ","pages":"Article 100225"},"PeriodicalIF":0.0,"publicationDate":"2023-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405632423000252/pdfft?md5=4b0b79957d025903f572c8fdb1fe58f1&pid=1-s2.0-S2405632423000252-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138678335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}