Practical Radiation Oncology最新文献

{"title":"Use of Magnetic Resonance Imaging for Postoperative Radiation Therapy Planning in Patients with Carbon Fiber-Reinforced Polyetheretherketone Instrumentation","authors":"Jacob Ward BS ,&nbsp;Mark Damante MD ,&nbsp;Seth Wilson BS ,&nbsp;Ahmed Nader Elguindy MD ,&nbsp;Dominic Franceschelli BS ,&nbsp;Vicente de Paulo Martins Coelho Junior MD ,&nbsp;Santino Cua MD ,&nbsp;Daniel Kreatsoulas MD ,&nbsp;Wesley Zoller BS, CMD ,&nbsp;Sasha Beyer MD, PhD ,&nbsp;Dukagjin Blakaj MD, PhD ,&nbsp;Joshua Palmer MD ,&nbsp;Raj Singh MD ,&nbsp;Evan Thomas MD, PhD ,&nbsp;Vikram Chakravarthy MD","doi":"10.1016/j.prro.2024.10.011","DOIUrl":"10.1016/j.prro.2024.10.011","url":null,"abstract":"<div><h3>Purpose</h3><div>Carbon fiber-reinforced polyetheretherketone (CFR-PEEK) instrumentation is being used more frequently in the spinal oncology landscape. Better visualization with this material allows for more precise postoperative stereotactic body radiation therapy (SBRT) planning using either computed tomography (CT)-myelography or magnetic resonance imaging (MRI) studies. We compared the dosimetric planning equivalencies and outcomes.</div></div><div><h3>Methods and Materials</h3><div>Thirty-six consecutively treated patients were reviewed who underwent spinal fusion using CFR-PEEK instrumentation for spine metastases followed by postoperative SBRT between January 1, 2022, and April 3, 2023. Patients were divided into 2 cohorts based on the imaging modality, MRI versus CT-myelogram, used for postoperative SBRT planning. Surgical, demographic, postoperative radiation dosimetry, complication, and survival data were collected. Statistical analysis was performed in SPSS (v29.0.1.0).</div></div><div><h3>Results</h3><div>Eleven patients underwent CT-myelograms, and 25 patients underwent MR-spine imaging for SBRT planning. The median follow-up was 145.5 days (13-530). There were no significant differences between baseline demographic, surgical characteristics, or SBRT dosimetry between the MRI spine and CT-myelogram groups. There was no significant difference between the cohorts for survival (<em>P</em> = .402).</div></div><div><h3>Conclusions</h3><div>MR scans are an effective choice for postoperative SBRT contouring patients using CFR-PEEK instrumentation for oncologic spinal fusions. Avoidance of CT-myelography reduces the need for an invasive procedure and potential risks including cerebrospinal fluid (CSF) leak, nerve root injury, and increased procedural burden.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 2","pages":"Pages e131-e137"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632543","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":"In Regard to Booth et al","authors":"Dimitri Alex Dimitroyannis PhD, MBA","doi":"10.1016/j.prro.2024.10.017","DOIUrl":"10.1016/j.prro.2024.10.017","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 2","pages":"Page 211"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705173","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":"Primary Cutaneous Diffuse Large B-Cell Lymphoma, Leg Type","authors":"Xiaoling Cao MM ,&nbsp;Jie Yu MD ,&nbsp;Xuan Zhou MM ,&nbsp;Nan Chen MD ,&nbsp;Ying Wang MD, PhD ,&nbsp;Guojie Wang MM","doi":"10.1016/j.prro.2024.06.019","DOIUrl":"10.1016/j.prro.2024.06.019","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 2","pages":"Pages 111-112"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705176","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":"Reirradiation in the Management of Locally Recurrent Rectal Adenocarcinoma","authors":"Michael S. Rutenberg MD, PhD ,&nbsp;Michael D. Chuong MD ,&nbsp;Jessica M. Frakes MD","doi":"10.1016/j.prro.2024.11.008","DOIUrl":"10.1016/j.prro.2024.11.008","url":null,"abstract":"<div><div>Rectal cancer recurrence after prior radiation therapy presents a difficult treatment challenge. Salvage treatment can be curative; however, it often requires multimodality therapy which can come with significant treatment-related morbidity. Reirradiation is a common part of treatment considerations in this setting and presents challenges in balancing appropriately aggressive therapy to improve disease control and cure rates with the addition of excess toxicity. Surgery remains the mainstay of curative salvage therapy for locally recurrent rectal cancer (LRRC) after prior radiation. Preoperative reirradiation improves R0 resection rates and local control and is associated with improved disease control outcomes. Altered fractionation and intraoperative radiation therapy are often used to improve the therapeutic ratio in the setting of reirradiation for LRRC. Herein, we discuss the evidence supporting multimodality salvage therapy for LRRC, including the importance of surgical salvage, the benefits of reirradiation, various approaches for reirradiation, and treatment-associated toxicities. Finally, we provide our recommendations for how to approach reirradiation for locally recurrent rectal cancer.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 2","pages":"Pages e166-e171"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822839","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":"In Regard to Margalit et al.","authors":"Vincent Gregoire MD, PhD,&nbsp;Luca Tagliaferi MD,&nbsp;Mererid Evans MD, PhD","doi":"10.1016/j.prro.2024.08.014","DOIUrl":"10.1016/j.prro.2024.08.014","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 2","pages":"Pages 205-208"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705171","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 a Digital Tool Improve the Understanding of Treatment Option for Patients With Head/Neck Cancer and Increase Providers’ Self-perceived Ability to Communicate With Patients?","authors":"Camille Hardy-Abeloos MD ,&nbsp;Aishwarya Shah MD ,&nbsp;Xiaochun Li PhD ,&nbsp;Jason Gurewitz MD ,&nbsp;Julie Xiao BS ,&nbsp;Judith D. Goldberg PhD ,&nbsp;Kenneth Hu MD","doi":"10.1016/j.prro.2024.09.006","DOIUrl":"10.1016/j.prro.2024.09.006","url":null,"abstract":"<div><div>A digital visual communication tool was recently developed by MyCareGorithm that incorporates explanations of treatments and procedures for cancer patients. This study evaluated if this novel tool can enhance both patient and provider satisfaction. In an IRB approved, prospective, pilot study, patients and caregivers at a single institution receiving head and neck cancer radiation underwent an initial consult using this digital tool and completed a survey of 6 questions to evaluate their understanding of their disease. Providers completed a 7-question survey to rate their satisfaction. Patients and caregivers with 4 or more “Yes” answers and providers with 5 or more “Yes” answers were defined as “Satisfied.” To obtain 90% power to detect that the proportion of “Satisfied” patients (assumed 75%) is greater than 50% with a significance level 5% using a 1-sided Z test, we planned to enroll 30 patients. Thirty patients enrolled and completed all surveys. Most patients were male (66%), White (60%), and spoke English as a primary language (93%). Patients most commonly had oropharyngeal cancer (23%). Overall, 27 of the 30 patients (90%; 1-sided 95% CI, 76.1%) were satisfied (z = 4.38, <em>P</em> &lt; .05), 16 of the 17 caregivers (94%; 1-sided 95% CI, 74.8%) were satisfied, and 100% of providers were satisfied with the digital tool. Most patients (90%) and caregivers (94%) felt that the tool improved their understanding of the disease. One man answered “No” for all 6 questions, commenting that it was only marginally helpful. One woman also answered “No” for all questions, commenting that she did not find it helpful on its own without the provider's explanation. Of the 30 patients, 26 (87%) stayed at our institution to receive treatment. These findings showed high rates of patient, caregiver, and provider satisfaction with their initial consult when incorporating a digital visual tool. Its routine use in clinical practice should be strongly considered.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 2","pages":"Pages e138-e142"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401957","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":"Simulation of Focal Boosting in Online Adaptive MRI-Guided SBRT for Patients With Locally Advanced Prostate Cancer With Seminal Vesicle Involvement","authors":"Mathijs G. Dassen MSc ,&nbsp;Ben Neijndorff MSc ,&nbsp;Anja Betgen RTT ,&nbsp;Lisa Wiersema RTT ,&nbsp;Peter de Ruiter RTT ,&nbsp;Joeke van der Linden RTT ,&nbsp;Tomas Janssen PhD ,&nbsp;Leontien Abbenhuis RTT ,&nbsp;Peter van Kollenburg RTT ,&nbsp;Casper Reijnen MD, PhD ,&nbsp;Floris Pos MD, PhD ,&nbsp;Robert J. Smeenk MD, PhD ,&nbsp;Uulke A. van der Heide PhD ,&nbsp;Ellen Brunenberg PhD","doi":"10.1016/j.prro.2024.10.009","DOIUrl":"10.1016/j.prro.2024.10.009","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the feasibility and accuracy of focal boosting in online adaptive MRI-guided stereotactic body radiation therapy (SBRT) for patients with prostate cancer (PCa) with seminal vesicle invasion (T3b) by analyzing the impact of intrafraction motion on the dose planned for the gross tumor volume (GTV) and clinical target volume (CTV).</div></div><div><h3>Methods and Materials</h3><div>Data from 23 patients with T1-T3a PCa who received focal boosting SBRT on a 1.5T MR-Linac was used. A radiation oncologist replaced clinical GTVs with artificial GTVs representative for T3b tumor(s). For each MRI used for daily adaptation (MRI_adapt), an automated treatment plan was generated (D_f1-5) using the adapted contours. Patients were planned to receive 35 Gy to the CTV, with an isotoxic focal boost to the GTV up to 50 Gy. During each fraction, an additional MRI was acquired to assess intrafraction motion (MRI_during). Dose accumulation of all fractions was performed by deformable registration of MRI_adapt, _f2-5 to MRI_adapt, _f1 (D_{ACC, planned})_. The D_f1-₅ were projected to their corresponding MRI_during, which were used to reconstruct D_{ACC, delivered}, likewise. Our results were compared to patients with tumor(s) without seminal vesicle invasion (T1-T3a).</div></div><div><h3>Results</h3><div>The median (10th-90th percentile) D98%_{ACC, planned} to the GTV, which correlates most strongly with outcome, was 41.1 Gy (40.1-43.0 Gy) in the plans for patients with artificial T3b tumors, compared to 43.0 Gy (40.4-47.2 Gy) in the plans for patients with T1-T3a tumors. The D98%_{ACC, delivered} to the GTV, taking into account intrafraction motion, was 41.0 Gy (39.3-42.6 Gy) and 42.5 Gy (40.0-46.6 Gy) in the plans for the artificial and clinical GTVs, respectively.</div></div><div><h3>Conclusions</h3><div>MRI-guidance can ensure high accuracy of focal boosting in patients with T3b disease. Because of the unfavorable location of the GTV, a lower boost dose was feasible compared to patients with T1-T3a PCa.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 2","pages":"Pages 196-204"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appropriateness Criteria for Radiation Therapy in the Setting of Presumed Early-Stage Lung Cancer","authors":"Laura L. Dover MD, MSPH ,&nbsp;Christopher Abraham MD ,&nbsp;Adam J. Kole MD, PhD ,&nbsp;Ashley Weiner MD, PhD","doi":"10.1016/j.prro.2024.10.010","DOIUrl":"10.1016/j.prro.2024.10.010","url":null,"abstract":"<div><div>Low-dose chest computed tomography imaging for lung cancer screening is revealing increasing numbers of radiographic early-stage lung cancers. This topic discussion describes when a clinical scenario merits radiation therapy without a histologic diagnosis, with an emphasis on pragmatic algorithms in settings without readily available advanced biopsy techniques.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 2","pages":"Pages 155-159"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632520","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":"Time to Slash SABR From Our Lexicon","authors":"Paul E. Wallner DO ,&nbsp;Michael L. Steinberg MD","doi":"10.1016/j.prro.2024.10.015","DOIUrl":"10.1016/j.prro.2024.10.015","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 2","pages":"Pages 117-119"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640431","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":"Consensus Guidelines for Delineation of Clinical Target Volumes for Intensity Modulated Radiation Therapy for Intact Cervical Cancer: An Update","authors":"Emma C. Fields MD ,&nbsp;Walter R. Bosch PhD ,&nbsp;Kevin V. Albuquerque MD ,&nbsp;Rohini Bhatia MD ,&nbsp;Junzo Chino MD ,&nbsp;Brandon Dyer MD ,&nbsp;Beth Erickson MD ,&nbsp;Denise Fabian MD ,&nbsp;David Gaffney MD, PhD ,&nbsp;Scott Glaser MD ,&nbsp;Kathy Han MD, MSc ,&nbsp;Lara Hathout MD ,&nbsp;I-Chow Hsu MD ,&nbsp;Naresh Jegadeesh MD ,&nbsp;Jenna Kahn MD ,&nbsp;Elizabeth Kidd MD ,&nbsp;Ann Klopp MD, PhD ,&nbsp;Eric Leung MD ,&nbsp;Lilie Lin MD ,&nbsp;Michelle Ludwig MD, MPH, PhD ,&nbsp;Christine M. Fisher MD, MPH","doi":"10.1016/j.prro.2024.11.004","DOIUrl":"10.1016/j.prro.2024.11.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Accurate target delineation is essential when using intensity modulated radiation therapy for intact cervical cancer. In 2011, the Radiation Therapy Oncology Group published a consensus guideline using magnetic resonance imaging (MRI). The current project expands on the previous atlas by including computed tomography (CT)-based contours, contours with MRI and positron emission tomography (PET) registrations, the addition of common and complex scenarios, and incorporating information on simulation and treatment planning techniques.</div></div><div><h3>Methods and Materials</h3><div>Twenty-eight experts in gynecologic radiation oncology contoured 3 cases, first on a noncontrast CT simulation scan and then with registered diagnostic scans. The cases included (1) International Federation of Gynecology and Obstetrics (FIGO) IIIC1 with a bulky tumor and vaginal metastasis, (2) FIGO IIB with calcified uterine fibromas, and (3) FIGO IIIC2 with large lymph nodes. The contours on all 6 data sets (3 CT simulations without diagnostic images and 3 with registered images) were analyzed for consistency of delineation using an expectation-maximization algorithm for simultaneous truth and performance level estimation with kappa statistics as a measure of agreement. The contours were reviewed, discussed, and edited in a group meeting prior to finalizing.</div></div><div><h3>Results</h3><div>Contours showed considerable agreement among experts in each of the cases, with kappa statistics from 0.67 to 0.72. For each case, diagnostic PET ± MRI was associated with an increase in volume. The largest increase was the clinical target volume (CTV) primary for case 2, with a 20% increase in volume and a 54% increase in simultaneous truth and performance level estimation volume, which may be due to variance in registration priorities. For the third case, 92.9% increased their CTVs based on the addition of the diagnostic PET scan. The main areas of variance were in determining the superior extent of CTV coverage, coverage of the mesorectum, and simulation and planning protocols.</div></div><div><h3>Conclusions</h3><div>This study shows the value and the challenges of using coregistered diagnostic imaging, with an average increase in volumes when incorporating MRI and PET.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 2","pages":"Pages 171-179"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640430","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}