Journal of Radiotherapy in Practice最新文献

{"title":"Head and neck radiotherapy quality assurance conference for dedicated review of delineated targets and organs at risk: results of a prospective study.","authors":"J C Farris, N B Razavian, M K Farris, J D Ververs, B A Frizzell, C M Leyrer, L F Allen, K M Greven, R T Hughes","doi":"10.1017/s1460396922000309","DOIUrl":"10.1017/s1460396922000309","url":null,"abstract":"<p><strong>Purpose: </strong>Head and neck (HN) radiotherapy (RT) is complex, involving multiple target and organ at risk (OAR) structures delineated by the radiation oncologist. Site-agnostic peer review after RT plan completion is often inadequate for thorough review of these structures. In-depth review of RT contours is critical to maintain high-quality RT and optimal patient outcomes.</p><p><strong>Materials and methods: </strong>In August 2020, the HN RT Quality Assurance Conference, a weekly teleconference that included at least one radiation oncology HN specialist, was activated at our institution. Targets and OARs were reviewed in detail prior to RT plan creation. A parallel implementation study recorded patient factors and outcomes of these reviews. A major change was any modification to the high-dose planning target volume (PTV) or the prescription dose/fractionation; a minor change was modification to the intermediate-dose PTV, low-dose PTV, or any OAR. We analysed the results of consecutive RT contour review in the first 20 months since its initiation.</p><p><strong>Results: </strong>A total of 208 patients treated by 8 providers were reviewed: 86·5% from the primary tertiary care hospital and 13·5% from regional practices. A major change was recommended in 14·4% and implemented in 25 of 30 cases (83·3%). A minor change was recommended in 17·3% and implemented in 32 of 36 cases (88·9%). A survey of participants found that all (<i>n</i> = 11) strongly agreed or agreed that the conference was useful.</p><p><strong>Conclusion: </strong>Dedicated review of RT targets/OARs with a HN subspecialist is associated with substantial rates of suggested and implemented modifications to the contours.</p>","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10827337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47092926","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":"Radiation therapy in non-traumatic myositis ossificans of popliteal region: a case report","authors":"Sonal Patel Shah, Asmita Kulshrestha, Monik Patel, Maitrik Mehta, Suryanarayana Kunikullaya, Ankit Sharma","doi":"10.1017/s1460396923000341","DOIUrl":"https://doi.org/10.1017/s1460396923000341","url":null,"abstract":"Abstract Introduction: Myositis ossificans (MO) is a rare disorder of ectopic ossification in soft tissue or muscle, usually associated with trauma or hereditary conditions. Surgical excision is the mainstay of treatment with anti-inflammatory medications. Radiotherapy is used as an adjuvant therapy, to treat residual lesions and to relieve symptoms. Methods: A 36-year-old male presented with a localised tender swelling in left popliteal fossa and progressive pain in lower limb for 6 weeks and restricted mobility for 3 weeks. A local excision of calcified mass arising from fascia of left popliteal fossa was consistent with MO features. Due to persistent symptoms and a residual lesion on imaging, adjuvant external beam radiation therapy (EBRT) was planned with a low dose of 10 Gy (Gray) in 2 fractions on 2 consecutive days in a prone position after 2 weeks using 6 MV (mega voltage) photon beam on linear accelerator (LINAC). Results: Radiotherapy resulted in a significant clinical improvement without any related acute toxicities. Patient is disease-free and on regular follow-up without any progression after 2 years. Conclusion: Post-operative EBRT can stabilise residual MO and treat intractable pain when lesion lies in the vicinity of a neurovascular bundle","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135908947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients’ self-reported overall wellbeing correlates with concurrent reported symptoms: analysis of the Edmonton Symptom Assessment System","authors":"Catherine B. McKenna, Ernest Osei, Brooklynn Fleury, Stephanie Swanson, Christabel Oghinan, Johnson Darko","doi":"10.1017/s1460396923000377","DOIUrl":"https://doi.org/10.1017/s1460396923000377","url":null,"abstract":"Abstract Background: The primary intent of cancer treatment is either curative, prolongation of patient life, or to improve patient quality of life; however, treatments are associated with various side effects that may impact patient wellbeing. Thus, understanding the patients’ wellbeing from the patient’s perspective is essential as it could help enable the provision of the necessary support for patients throughout their cancer journey. Materials and Method: We analysed Edmonton Symptom Assessment System (ESAS) questionnaire responses completed by 19,288 patients over 201,839 visits to our Cancer Centre. As part of their routine and standard of care, patients completing the questionnaire are asked to score 6 physical and 2 psychological symptoms as well as overall wellbeing using an 11-point numerical rating scale ranging from 0 to 10, where 0 means complete absence of the symptom or best overall wellbeing and 10 means worst possible symptom or worst overall wellbeing. We used the ESAS responses to characterise the relationship between the overall wellbeing score and concurrent symptoms scored by cancer patients. Results: Patients reported tiredness and nausea as the physical symptom causing the most and least distress respectively. Patients that reported severe (7–10) wellbeing also scored high mean scores for tiredness (6·2 ± 2·7), drowsiness (4·7 ± 3·1) and lack of appetite (4·4 ± 3·4). Univariate and multivariable logistic regression analysis suggests higher odds for patients to report moderate-to-severe (4–10) wellbeing when they report moderate-to-severe concurrent symptoms compared to none-to-mild concurrent symptoms. Conclusions: Our findings suggest that patients’ overall wellbeing as reported by the ESAS system is influenced by a number of concurrent symptoms. Tiredness was found to impact patients’ overall wellbeing to a greater extent than other concurrent symptoms. The sum of physical or psychological symptom scores was stronger indicators of a patient’s overall wellbeing compared to the scores of individual symptoms.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136368109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intramedullary spinal cord metastases from non-small cell lung carcinoma (NSCLC) associated with carcinomatous meningitis: a case report","authors":"R. D'Silva, J. Jaiswal, A. Turaka","doi":"10.1017/S1460396922000371","DOIUrl":"https://doi.org/10.1017/S1460396922000371","url":null,"abstract":"Abstract Background: Carcinomatous meningitis with metastases to the spinal cord [intramedullary spinal cord (IMSC)] is very rare, and a quick intervention to management of these patients is important in preventing neurological deterioration. Methods: We report a case of IMSC metastases from a stage IV non-small cell lung carcinoma in a 57-year-old man who presented with Brown-Sequard syndrome along with multiple brain metastases with associated carcinomatous meningitis and managed with urgent palliative external beam radiation therapy. Conclusion: A quick, short course of palliative radiation therapy for inoperable patients with IMSC metastases provides improvement in neurological function in the management of these oncologic emergencies in patients with short survival times.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45860485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dosimetric accuracy of Acuros® XB and AAA algorithms for stereotactic body radiotherapy (SBRT) lung treatments: evaluation with PRIMO Monte Carlo code","authors":"B. Sarin, B. Bindhu, P. Raghu Kumar, S. Sumeesh, B. Saju","doi":"10.1017/S1460396922000346","DOIUrl":"https://doi.org/10.1017/S1460396922000346","url":null,"abstract":"Abstract Purpose: The study aimed to compare the dosimetric performance of Acuros® XB (AXB) and anisotropic analytical algorithm (AAA) for lung SBRT plans using Monte Carlo (MC) simulations. Methods: We compared the dose calculation algorithms AAA and either of the dose reporting modes of AXB (dose to medium (AXB-Dm) or dose to water (AXB-Dw)) algorithms implemented in Eclipse® (Varian Medical Systems, Palo Alto, CA) Treatment planning system (TPS) with MC. PRIMO code was used for the MC simulations. The TPS-calculated dose profiles obtained with a multi-slab heterogeneity phantom were compared to MC. A lung phantom with a tumour was used to validate TPS algorithms using different beam delivery techniques. 2D gamma values obtained from Gafchromic film measurements in the tumour isocentre plane were compared with TPS algorithms and MC. Ten VMAT SBRT plans generated in TPS with each algorithm were recalculated with a PRIMO MC system for identical beam parameters for the clinical plan validation. A dose–volume histogram (DVH) based plan comparison and a 3D global gamma analysis were performed. Results: AXB demonstrated better agreement with MC and film measurements in the lung phantom validation, with good agreement in PDD, profiles and gamma analysis. AAA showed an overestimated PDD, a significant difference in dose profiles and a lower gamma pass rate near the field borders. With AAA, there was a dose overestimation at the periphery of the tumour. For clinical plan validation, AXB demonstrated higher agreement with MC than AAA. Conclusions: AXB provided better agreement with MC than AAA in the phantom and clinical plan evaluations.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45973596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of Buschke–Lowenstein tumour of vulva treated with radical radiotherapy","authors":"Sutanuka Chakrabarti, Asmita Kulshrestha, Sonal Patel, Suryanarayana Kunikullaya, Ankit Sharma","doi":"10.1017/S1460396922000358","DOIUrl":"https://doi.org/10.1017/S1460396922000358","url":null,"abstract":"Abstract Introduction: Buschke–Lowenstein tumour (BLT) is a rare verrucous lesion often associated with human papillomavirus infection. It is an indolent but locally aggressive lesion usually arising from the genitalia or anorectum, with a potential risk of recurrence and malignant transformation. The first line of management is surgical or laser excision. Topical agents cryotherapy, radiotherapy and chemo-immunomodulators are reserved for residual or recurrent cases and smaller lesions. Methods: A 24-year-old female on antiretroviral therapy presented in our department with a large cauliflower-shaped growth involving the perineum, vulva and lower vagina. A biopsy of the lesion was suggestive of a BLT. Due to the extensive nature of the disease, surgery was deferred. The lesion was treated with definitive external beam radiation therapy (EBRT) using a 6-megavoltage photon beam on a Cobalt-60 unit. Results: Radiotherapy resulted in a significant response without any acute toxicity, following which, topical podophyllin application was advised for the residual perianal lesion. The patient is disease free after 9 months of follow-up. Conclusions: A multidisciplinary approach is important to treat the BLT. Lesions not amenable to surgery or local therapies can be treated with EBRT with reasonable control and acceptable toxicities.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44575346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline cardiac risk profile determines radiation-induced cardiac toxicity in patients with mid-lower esophageal cancer","authors":"H. Ghaznavi, F. Allaveisi, F. Taghizadeh-Hesary","doi":"10.1017/S146039692200036X","DOIUrl":"https://doi.org/10.1017/S146039692200036X","url":null,"abstract":"Abstract Background: The radiotherapy techniques are evolving. Besides optimal tumour coverage, considering organs at risk (OAR) is pertinent to radiation oncologists. In mid-lower esophageal cancer (MLEC) radiotherapy, heart is the main OAR. Studies on excess absolute risk (EAR) of cardiovascular disease (CVD) in MLEC radiotherapy are limited in the main literature. Therefore, this study was conducted to estimate the EAR of CVD in patients with MLEC treated with the intensity-modulated radiation therapy (IMRT) technique. Results: Family history of heart disease and smoking increased the EAR of CVD significantly compared to the cholesterol and high-sensitivity C-reactive protein. The 10-year EAR of the high-risk group was more than four times of the low-risk group at all ages. In the low-risk group, EAR of CVD after radiotherapy of esophageal cancer can increase by up to 9·1%, while in the high-risk group, EAR increased by 34·89%. Conclusions: Adding the baseline CVD risk factors improved the estimation of EAR of heart disease after MLEC radiotherapy with the IMRT technique.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42103826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electronic Portal Imaging Device in Pre-Treatment Patient-Specific Quality Assurance of volumetric-modulated arc therapy delivery","authors":"M. Lau, R. Abdullah, J. Jayamani","doi":"10.1017/S1460396922000334","DOIUrl":"https://doi.org/10.1017/S1460396922000334","url":null,"abstract":"Abstract Background: Radiotherapy treatment delivery is evaluated by a pre-treatment patient-specific quality assurance (PSQA) procedure to ensure the patient receives an accurate radiation dose. The current PSQA practice by using conventional phantoms requires more set-up time and cost of purchasing the tools. Therefore, this study aimed to investigate the efficiency of an electronic portal imaging device (EPID) of linear accelerator (LINAC) as a PSQA tool for volumetric-modulated arc therapy (VMAT) planning technique for nasopharyngeal carcinoma (NPC) treatment delivery. Methods: A NPC VMAT plan on a Rando phantom was performed by following the Radiation Therapy Oncology Group (RTOG) 0615 protocol. The gamma passing rate of the EPID and PSQA phantom (ArcCHECK) were compared among the gamma criteria of 3%/3 mm, 2%/2 mm and 1%/1 mm, respectively. Results: Both EPID and ArcCHECK phantom had distinguishable gamma passing rates in 3%/3 mm and 2%/2 mm with a difference of 0·87% and 0·30%, respectively. Meanwhile, the EPID system had a lower gamma passing rate than the ArcCHECK phantom in 1%/1 mm (21·23% difference). Furthermore, the sensitivity of the EPID system was evaluated and had the largest deviation in gamma passing rate from the reference position in gamma criteria of 2%/2 mm (41·14%) compared to the 3%/3 mm (25·45%) and 1%/1 mm (31·78%), discretely. The best fit line of the linear regression model for EPID was steeper than the ArcCHECK phantom in 3%/3 mm and 2%/2 mm, and vice versa in gamma criteria of 1%/1 mm. This indicates that the EPID had a higher sensitivity than the ArcCHECK phantom in 3%/3 mm and 2%/2 mm but less sensitivity in 1%/1 mm. Conclusions: The EPID system was efficient in performing the PSQA test of VMAT treatment in HUSM with the gamma criteria of 3%/3 mm and 2%/2 mm.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47852465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adequacy of sexual care information given to prostate cancer patients receiving radical external beam radiotherapy","authors":"S. Greenwood-Wilson, P. Bridge","doi":"10.1017/S1460396922000310","DOIUrl":"https://doi.org/10.1017/S1460396922000310","url":null,"abstract":"Abstract Background: Despite the acknowledged value of providing prostate radiotherapy patients with sexual dysfunction (SD) information, there is little evidence related to patient perceptions of this or the extent to which information is provided to them. This study aimed to critically evaluate the quality and format of SD information given to patients before, during and after radical EBRT to treat prostate cancer. Method: Members of UK prostate cancer support groups were asked to complete an anonymous online survey tool seeking opinions of the SD information they were given before, during and after external beam radiotherapy (EBRT). Results: There were 56 responses to the survey with over 42% of respondents reporting that they had not received any SD information. Of those who did, 78·1% (25/32) received information before the start of EBRT. Physicians were the most involved in the provision of SD information, with nurses and therapeutic radiographers being underutilised. Responses were mostly negative, or neutral regarding the quality of SD information and the information received about impact on relationships, psychological and emotional health. Many participants wanted more information and support. Conclusion: This study demonstrates that prostate cancer patients who have undergone radical EBRT have not received adequate information relating to potential sexual function side effects and the psychological and emotional effects of SD. This information should be included in verbal and written information provided at all stages of the radiotherapy pathway.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49181624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RapidPlan models for prostate radiotherapy treatment planning with 10-MV photon beams","authors":"F. Pupillo, M. Piliero, M. Casiraghi, L. Bellesi, S. Presilla","doi":"10.1017/S1460396922000267","DOIUrl":"https://doi.org/10.1017/S1460396922000267","url":null,"abstract":"Abstract Introduction: The RapidPlan is a radiotherapy planning tool that uses a dataset of approved plans to predict the dose distribution and automatically generates the dose–volume constraints for optimisation of the new plan. This study compares three strategies of model building for the treatment of prostate cancer with the 10-MV photon beam. Methods: Three models for prostate treatment were compared: Model 6X, Model10X and Model6Xrefined. Model6X is already used in our department and was trained on treatment plans based on the 6-MV photon beam. Model10X was trained on treatment plans based on the 10-MV photon beam and manually optimised by an experienced medical physicist. Finally, Model6Xrefined was trained on plans automatically created by the Model6X, but using the 10-MV photon beam. The three models were used to generate 25 new plans with the 10-MV photon beam. Results: Model10X generated plans with 2 Gy lower mean dose to bladder-PTV and rectum-PTV volumes and 8% lower V15Gy at bladder and rectum volumes, although the number of monitor units increased by 170 on average. Conclusions: The model trained on manually optimised plans generated plans with higher normal tissue sparing. However, model building is a time-consuming process, so a cost–benefit balance should be performed.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44135336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}