Practical Radiation Oncology最新文献

{"title":"Management of Venous Thrombosis and Pulmonary Embolism During Cervical Brachytherapy.","authors":"Jeffrey V Brower, Andrea L Russo, Kristin A Bradley, Christine M Fisher, Richard Carlson, Lindsay W Brubaker, Patrick A Hagen, Rebecca K Leaf, William Small, Ann H Klopp","doi":"10.1016/j.prro.2025.04.013","DOIUrl":"10.1016/j.prro.2025.04.013","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Near-miss Event in Lung Cancer Radiation Therapy Because of a Random Outlier of Target Volume.","authors":"Savino Cilla, Carmela Romano, Gabriella Macchia, Donato Pezzulla, Marica Ferro, Pietro Viola, Erika Galietta, Costanza M Donati, Alessio G Morganti, Francesco Deodato","doi":"10.1016/j.prro.2025.05.012","DOIUrl":"10.1016/j.prro.2025.05.012","url":null,"abstract":"<p><p>Accurate tumor and organ-at-risk contouring is a critical step in radiation therapy. Contouring procedures, both manual and automated, are prone to errors and to a large degree of interobserver and intraobserver variability. Radiation oncologists and/or medical physicists have to perform independent reviews of all contours for each patient before using them for treatment planning, which is a time-consuming, labor-intensive, and still not error-free process. We presented the tracing of a subtle near-miss event because of the presence of a random outlier in the contours of a lung tumor, very far from the actual gross tumor volume. The treatment plan was performed with an automated treatment engine using the volumetric-modulated arc therapy technique. Despite the implementation and adoption of systematic procedures of quality assurance in our clinical routine, the error crossed the barriers of peer review and was identified subsequently only in the step of pretreatment dosimetric verification. The error was corrected, and the patient was replanned before treatment initiation. In this case study, we showed that the random creation of false-positive target outliers may have a detrimental impact on patient dose when automated planning is performed. This risk is not negligible, and all strategies for improving the robustness of target segmentation should be pursued.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rosai-Dorfman Disease: The Role of Radiation Therapy.","authors":"Elizabeth Thompson, Daniel J Indelicato, Mark T Scarborough, Elham Nasri, Joanne Lagmay, David P Horowitz, Robert J Amdur","doi":"10.1016/j.prro.2025.06.001","DOIUrl":"10.1016/j.prro.2025.06.001","url":null,"abstract":"<p><p>Rosai-Dorfman disease is a rare condition caused by abnormal proliferation of a type of white blood cell - the histiocyte - in lymph nodes and/or other tissues. This Topic Discussion reviews published data and guidelines on radiation therapy for Rosai-Dorfman disease and presents current treatment policies at the authors institutions.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Online Adaptive Radiation Therapy Eliminate Intrafractional Deformation in Gastric Mucosa-Associated Lymphoid Tissue Lymphoma?","authors":"Yusuke Shibayama, Hidetaka Arimura, Taka-Aki Hirose, Masanori Takaki, Jun-Ichi Fukunaga, Tadamasa Yoshitake, Toyoyuki Kato, Kousei Ishigami","doi":"10.1016/j.prro.2025.05.008","DOIUrl":"10.1016/j.prro.2025.05.008","url":null,"abstract":"<p><strong>Purpose: </strong>We hypothesized that online adaptive radiation therapy (oART) could eliminate errors associated with interfractional deformation in gastric mucosa-associated lymphoid tissue (MALT) lymphoma, but errors in intrafractional deformation remained in 6 directions (anterior, posterior, superior, inferior, left, and right). This study aimed to quantify the anisotropic deformation errors of the clinical target volume (CTV) for MALT lymphoma using oART to determine deformations in the planning target volume (PTV) margins.</p><p><strong>Methods and materials: </strong>Thirty fractional scans from 4 consecutive patients (a total of 120 cone beam computed tomography scans) with gastric MALT lymphoma treated with oART were chosen for this retrospective study. The CTV contours were manually delineated on the pretreatment and posttreatment cone beam computed tomography images. The center-of-mass matching of the CTVs was performed following the bone anatomy matching. Systematic and random errors of intrafractional deformations of the CTV were quantified using displacement vectors between the pretreatment and posttreatment CTV surfaces for each fraction. The PTV margins for oART were anisotropically calculated using the van Herk formula: 2.5Σ + 0.7σ, accounting for intrafractional errors.</p><p><strong>Results: </strong>For intrafractional deformation, the means of standard deviations of systematic errors ranged from 1.2 mm to 2.2 mm, whereas those of random errors ranged from 2.9 mm to 3.6 mm. The PTV margins were up to 13.1 mm in the inferior direction, whereas in other directions, they ranged from 9.7 mm to 12.8 mm. The PTV margin in integer achieved posttreatment CTV coverage for 90% of the fractions, with undercoverage volumes remaining below 0.6 cm³ in all fractions.</p><p><strong>Conclusions: </strong>This study suggests that the impact of intrafractional CTV deformation can not be eliminated even with oART. This highlights the need to set the appropriate anisotropic PTV margins.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician- and Patient-Reported Outcomes of Stereotactic Ablative Radiation Therapy for High-Risk Prostate Cancer.","authors":"Helena B Z Logar, Angel Montero, Ovidio Hernando, Mercedes Lopez, Jeannette Valero, Raquel Ciervide, Beatriz Alvarez, Xin Chen-Zhao, Emilio Sanchez, Mariola Garcia-Aranda, Carmen Saiz, Daniel Zucca, Leyre Alonso, Miguel Sanchez, Rosa Alonso, Pedro Fernandez-Leton, Carmen Rubio","doi":"10.1016/j.prro.2025.05.007","DOIUrl":"10.1016/j.prro.2025.05.007","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated the feasibility and tolerability of SABR in patients with high- and very-high-risk prostate cancer.</p><p><strong>Methods and materials: </strong>A prospective study included patients with high-risk and N1 prostate cancer. SABR was delivered as 40 Gy in 8 Gy fractions, with optional elective nodal irradiation (26 Gy in 5.2 Gy fractions) and a 40 Gy nodal boost for N1 disease. The treatment protocol involved 24 to 36 months of androgen deprivation therapy, premedication with alpha-1 receptor antagonists, and dexamethasone (4 mg on treatment days). Adverse events were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events v5.0, while quality of life was assessed using the EORTC QLQ-C30 and QLQ-PR25 questionnaires at the final check-up.</p><p><strong>Results: </strong>The study included 96 patients (median age 77.2 years) with a median follow-up of 29.8 months. Elective nodal radiation therapy was delivered to 66.7% of patients, and 16.8% received a nodal boost. Acute grade 2 (G2) genitourinary and gastrointestinal (GI) events occurred in 5.2% and 7.3% of patients, respectively, with no grade ≥3 acute events. Late grade ≥2 genitourinary and GI events were observed in 7.8% and 15.7% of patients, respectively, including 1 grade 4 GI event. Common late symptoms included nocturia and rectal bleeding. Most patients (86.5%) reported no or minor difficulties posttreatment, though challenges with sexual activity, nocturia, and incontinence were noted. Physicians underestimated urgency and nocturia and overestimated rectal bleeding.</p><p><strong>Conclusions: </strong>SABR delivering 40 Gy in 5 fractions is feasible and well-tolerated for high-risk prostate cancer, with minimal additional toxicity from elective nodal irradiation and a boost to N1 disease. These findings support SABR as an effective treatment, warranting further long-term studies.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deconstructing Barriers to 12 Weeks of Parental Leave for Birthing and Nonbirthing Parents in Radiation Oncology Residency Training.","authors":"Daniella Klebaner, Reshma Jagsi, Parul N Barry, Hilary Bagshaw, Adrianna H Masters, Iris C Gibbs, William Small, Anthony Giuliano, Katarina T Nguyen, Claire Baniel","doi":"10.1016/j.prro.2025.05.009","DOIUrl":"10.1016/j.prro.2025.05.009","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Medicare Reimbursement Trends in Medical and Radiation Oncology.","authors":"Jacob S Hogan, John C Baumann, Neha Vapiwala, Jeff M Michalski, Benjamin W Fischer-Valuck, Patty Karraker, Minesh P Mehta, Jeffrey D Bradley, Brian C Baumann","doi":"10.1016/j.prro.2025.05.011","DOIUrl":"https://doi.org/10.1016/j.prro.2025.05.011","url":null,"abstract":"<p><strong>Purpose: </strong>Radiation and medical oncology face pressure from payment changes, which aim to increase the value of care and curb rising spending. Multiple models have been proposed or implemented, with mixed results for cost saving and financial stability. While previous studies have quantified changes in Medicare reimbursement for radiation oncology on a per-code basis, this has not been done in medical oncology to our knowledge, and no direct comparisons have been made between oncology subspecialties at this level. Our study aims to quantify and analyze Medicare reimbursement changes for medical and radiation oncology billing codes.</p><p><strong>Materials/methods: </strong>In this longitudinal study of reimbursement, the publicly available Physician/Supplier Procedure Summary database was used to obtain Medicare reimbursement data for 2010, 2016, and 2020. All reimbursement for providers with primary provider codes 92 (radiation oncology), 83 (hematology oncology), and 90 (medical oncology) were analyzed, combining hematology and medical oncology. Inflation- and utilization-adjusted changes in reimbursement were calculated from 2010-2020 and 2016-2020 on a per-code basis with results grouped by specialty and billing category.</p><p><strong>Results: </strong>From 2010-2020, inflation- and utilization-adjusted Medicare reimbursement decreased by $1.2B (-16%) for all codes, $705M (-29%) for radiation oncology-specific codes, and $541M (-10%) for medical oncology-specific codes. From 2016-2020, inflation- and utilization-adjusted reimbursement decreased by $299M (-3%) for all codes, $108M (-5.6%) for radiation oncology-specific codes, and $191M (-2.2%) for medical oncology-specific codes. Chemotherapy (-40%) and radiotherapy (-33%) saw the largest decreases in inflation- and utilization-adjusted reimbursement from 2010-2020, while immunotherapy (+21%) saw the largest increase.</p><p><strong>Conclusions: </strong>Our analysis shows continually decreasing Medicare reimbursement for both radiation and medical oncology from 2010-2020 and 2016-2020. This decade-long continuous decline highlights the need for payment system stabilization-whether through episode-based payment models or another avenue.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective Assessment of MR Guided Single-Fraction Stereotactic Ablative Radiation Therapy for Peripheral Lung Metastases: Dosimetric and Clinical Outcomes.","authors":"Svenja Hering, Richard Gaus, Jan Hofmaier, Sina Mansoorian, Sebastian Marschner, Nina-Sophie Schmidt-Hegemann, Vanessa da Silva Mendes, Amanda Tufman, Niels Reinmuth, Guillaume Landry, Maximilian Niyazi, Claus Belka, Stefanie Corradini, Chukwuka Eze","doi":"10.1016/j.prro.2025.05.006","DOIUrl":"10.1016/j.prro.2025.05.006","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the feasibility and safety of online MR guided single-fraction stereotactic ablative radiation therapy (SABR) and to assess acute changes in pulmonary function tests (PFTs), inflammatory markers, patient-reported quality of life (QoL), and dosimetric outcomes.</p><p><strong>Methods and materials: </strong>Patients with lung metastases were included in this single-center prospective study. Patients underwent MR guided single-fraction SABR. The primary endpoints encompassed local control (LC) and overall survival. Secondary endpoints included acute toxicity (Common Terminology Criteria for Adverse Events version 5.0), changes in PFTs, inflammatory markers, QoL, and dosimetric outcomes.</p><p><strong>Results: </strong>Between 10/2020 and 10/2022, 26 patients with 30 lung metastases were prospectively enrolled. At a median follow-up of 19.9 months (range, 16.1 to 25.6 months), the 1- and 2-year LC rates were 96.2% (95% CI, 88.7% to 100.0%) and 77.5% (95% CI, 55.9% to 99.1%). No Common Terminology Criteria for Adverse Events grade 3+ side effects were observed. While there was a slight median reduction of 4% in forced expiratory volume in 1 second (L) (P = .009, range, -24% to 20%), other PFT parameters remained stable. The neutrophil-to-lymphocyte ratio increased by a median of 13% (P = .002, range, -10% to 207%), while serum C-reactive protein and albumin levels remained unchanged. Patient-reported QoL did not exhibit significant changes, except for a minimal increase in the median score for cognitive functioning from 1 to 1.5 (P = .041).</p><p><strong>Conclusions: </strong>MR guided single-fraction SABR is a safe and effective treatment option for peripheral lung metastases, demonstrating encouraging LC.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Not Just a Doctor, But a Friend.","authors":"Ajitesh Avinash, Kanhu Charan Patro","doi":"10.1016/j.prro.2025.05.003","DOIUrl":"10.1016/j.prro.2025.05.003","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Society for Women in Radiation Oncology 5 Years Later: Connection, Representation, and Inclusivity Matter.","authors":"Rebecca Krc, Claire C Baniel, Katie Lichter, Simran Jatar, Gabrielle W Peters, Crystal Seldon Taswell, Sara Beltrán Ponce, Emily MacDuffie, Michael C LeCompte, Jie Jane Chen, Kaidi Wang, Amy LoTemplio, Anjali Saripalli, Erin Kaya, Parul Barry, Adrianna Henson Masters, Reshma Jagsi, Jenna M Kahn","doi":"10.1016/j.prro.2025.05.005","DOIUrl":"10.1016/j.prro.2025.05.005","url":null,"abstract":"<p><strong>Purpose: </strong>The Society for Women in Radiation Oncology (SWRO) was founded in 2017 with a mission to promote representation and gender equity in the field of radiation oncology (RO). We aimed to assess the current experiences of SWRO members 5 years after the founding of SWRO using a comprehensive survey of gender-related workforce issues.</p><p><strong>Methods and materials: </strong>From January to February 2023, an anonymous survey was distributed to all current SWRO members. Questions included demographics, family planning/fertility issues, perceptions of the field, and membership needs. Results pertaining to demographics, job satisfaction, mentorship, SWRO membership satisfaction, and future directions are reported in this analysis. Descriptive statistics were used to summarize frequencies of the multiple-choice items on the survey.</p><p><strong>Results: </strong>The survey was distributed to 461 SWRO members, with a total of 144 responses, resulting in a response rate of 31.3%. The majority of respondents identified as female (96.5%), RO attending physicians (54.2%), located in the United States (76.4%), and with employment in either a private or community-based practice (50.7%). Top reasons for SWRO membership included networking (91%), leadership/professional development (83%), and mentorship (79%). After clinical responsibilities, insufficient institutional mentorship was cited as the second most common limitation to professional productivity, and only a minority of respondents (46.5%) reported being either \"extremely\" or \"somewhat\" satisfied with the current mentorship available to them at their current institution. A majority (69.3%) reported seeking female mentorship outside their current institution. Unwanted sexual comments, attention, or advances by superiors or colleagues were reported by 35.7% of respondents, and 53.6% reported either \"strongly\" or \"somewhat\" agreeing that gender-specific biases exist within their program.</p><p><strong>Conclusions: </strong>This study highlights opportunities for improvement related to gender-based obstacles, education and advocacy, support of family-friendly culture shifts, mentorship, and increased physicist engagement which will ultimately promote representation, inclusivity, and gender equity in RO.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}