Practical Radiation Oncology最新文献

{"title":"In Reply to Fastner et al","authors":"Simona F. Shaitelman MD, EdM , Alvin R. Cabrera MD , Kilian E. Salerno MD , Janice A. Lyons MD","doi":"10.1016/j.prro.2024.11.005","DOIUrl":"10.1016/j.prro.2024.11.005","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 1","pages":"Pages 50-53"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958692","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":"Relevance of ORATOR Trial Results in a Developing Country Like India","authors":"Sagar Raut MD, DNB , Sai Kumar Samala MD","doi":"10.1016/j.prro.2024.10.003","DOIUrl":"10.1016/j.prro.2024.10.003","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 1","pages":"Pages e88-e89"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958697","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":"Pharyngeal Constrictor-Sparing Salvage Stereotactic Body Radiation Therapy With Tongue-Out for In-Field Recurrence After Definitive Radiation Therapy for Head and Neck Cancer: Guide to Tongue-Out Radiation Therapy","authors":"Whoon Jong Kil MD ,&nbsp;Subarna Eisaman MD ,&nbsp;Christopher Wilke MD ,&nbsp;Yvonne Mowery MD ,&nbsp;Wyatt Smith CMD ,&nbsp;Craig Herndon PhD ,&nbsp;David Cousins MD","doi":"10.1016/j.prro.2024.06.014","DOIUrl":"10.1016/j.prro.2024.06.014","url":null,"abstract":"<div><div>This report details a pharyngeal constrictor muscle (PCM)–sparing stereotactic body radiation therapy (SBRT) using our institutional technique of “tongue-out” radiation therapy (TORT) for treating a local recurrent cancer in the uvula (GTV_uvula) in a patient with history of a definitive chemotherapy with radiation therapy (70 Gy with weekly cisplatin) for a locally advanced laryngeal cancer 4 years ago. TORT includes optimizing the patients’ reproducible tongue-out position using readily available medicine cup (30 cc) followed by sculping the thermoplastic mask with tongue-out, and real-time visual monitoring of the tongue position during the computed tomography simulation scan, cone beam computed tomography acquisition, and treatment. Between arcs during volumetric modulated arc therapy, time for tongue relaxation and saliva swallowing can be given to the patient. Without TORT, the patient's GTV_uvula abutted the medial aspect of superior PCM (medial-sPCM) and a substantial volume of the previously irradiated superior PCM (sPCM) would have received high radiation dose from this salvage SBRT (32.5 Gy in 5 fractions). Comparing without TORT, the shortest distance between medial-sPCM-to-GTV_uvula was increased by 13 mm with TORT, which reduced radiation dose to sPCM in the salvage SBRT plan. The mean dose to sPCM was decreased from 20.5 Gy without TORT to 12.7 Gy with TORT. With TORT, minimal sPCM volumes fell within higher isodose line: volume receiving ≥ 60% prescription dose (V_60%Rx), V_80%Rx, and V_100%Rx to sPCM was, 4.8 versus 0.7 cc (without vs with TORT, respectively), 2.9 versus 0.19 cc, and 1.6 versus 0.04 cc, respectively. Maximum dose (<em>D</em>_max) to medial-sPCM was 34.6 Gy without TORT versus 22.7 Gy with TORT. These high doses to the sPCM and intrafractional swallowing-related geographic misses of GTV_uvula were avoided through the application of TORT in this salvage reirradiation setting. The patient successfully finished salvage SBRT with TORT resulting in no dysphagia or mucositis and maintained complete response at 12 months after treatment.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 1","pages":"Pages e21-e28"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762638","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":"PROshot: Hypofractionated Postmastectomy Radiation, Palliative Liver Radiation, Celiac Plexus Radiosurgery, Perioperative Chemoradiation for Gastric Cancer, and Prostate Stereotactic Body Radiation Therapy Versus Prostatectomy","authors":"Caleb Dulaney MD ,&nbsp;Laura Dover MD, MSPH","doi":"10.1016/j.prro.2024.10.001","DOIUrl":"10.1016/j.prro.2024.10.001","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 1","pages":"Pages 3-7"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958694","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 Black Car (Children Playing)","authors":"Stephan Bodis MD","doi":"10.1016/j.prro.2024.09.014","DOIUrl":"10.1016/j.prro.2024.09.014","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 1","pages":"Pages 8-9"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958699","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":"Masthead/Sub page","authors":"","doi":"10.1016/S1879-8500(24)00311-4","DOIUrl":"10.1016/S1879-8500(24)00311-4","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 1","pages":"Page A1"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143129723","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":"Patient Positional Uncertainty and Margin Reduction in Lung Stereotactic Ablative Radiation Therapy Using Pneumatic Abdominal Compression.","authors":"Yohan A Walter, Chiachien J Wang, Daniel B Speir, William E Burrell, Carlos D Palomeque, James C Henry, Megan M Rodrigues, Troy D Jacobs, Bethany L Broekhoven, Joseph P Dugas, Anne N Hubbard, Philip F Durham, Hsinshun T Wu","doi":"10.1016/j.prro.2024.12.001","DOIUrl":"10.1016/j.prro.2024.12.001","url":null,"abstract":"<p><strong>Purpose: </strong>Motion management presents a significant challenge in thoracic stereotactic ablative radiation therapy (SABR). Currently, a 5.0-mm standard planning target volume (PTV) margin is widely used to ensure adequate dose to the tumor. Considering recent advancements in tumor localization and motion management, there is merit to reassessing the necessary PTV margins for modern techniques. This work presents a large-scale analysis of intrafraction repositioning for lung SABR under forced shallow breathing to determine the margin requirements for modern delivery techniques.</p><p><strong>Methods and materials: </strong>Treatment data for 124 lung SABR patients treated in 607 fractions on a linear accelerator were retrospectively collected for analysis. All patients were treated using pneumatic abdominal compression and intrafraction 4-dimensional (4D) cone beam computed tomography (4D CBCT)-guided repositioning halfway through treatment. Executed repositioning shifts were collected and used to calculate margin requirements using the 2-SD method and an analytical model which accounts for systematic and random errors in treatment.</p><p><strong>Results: </strong>A total of 85.7% of treated fractions had 3-dimensional repositioning shifts under 5.0 mm. Fifty-three fractions (8.7%) had shifts ≥ 5.0 mm in at least 1 direction. Margins in the right-left, inferior-superior, and posterior-anterior directions were 3.62 mm, 4.34 mm, and 3.50 mm, respectively, calculated using the 2-SD method. The analytical approach estimated that 4.01 mm, 4.37 mm, and 3.95 mm margins were appropriate for our workflow. Executing intrafraction repositioning reduced margin requirements by 0.73 ± 0.07 mm.</p><p><strong>Conclusions: </strong>Clinical data suggest that the uniform 5.0-mm margin is conservative for our workflow. Using modern techniques such as 4D CT, 4D CBCT, and effective motion management can significantly reduce required margins, and therefore necessary healthy tissue dose. However, the limitations of margin calculation models must be considered, and margin reduction must be approached with caution. Users should conduct a formal risk assessment prior to adopting new standard PTV margins.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903455","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":"Radiopharmaceutical and Radioembolization Therapy: Clinical Guidance for Medical Physicists in Radiation Oncology.","authors":"Jonathan A Polignani, Kenneth J Nichols","doi":"10.1016/j.prro.2024.12.005","DOIUrl":"10.1016/j.prro.2024.12.005","url":null,"abstract":"<p><p>Recent advances in radiopharmaceutical therapy (RPT) and radioembolization (RE) will make these forms of therapy more prevalent in radiation oncology and nuclear medicine clinics. This article guides medical physicists in radiation oncology by summarizing current RPT and RE techniques, processes, safety, quality assurance, equipment, and others. The summarized guidance, which addresses technical considerations, may be applied broadly to develop a clinical RPT/RE program that offers multiple types of such therapies.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903660","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":"Defining an Undergraduate Radiation Oncology Microclerkship Using the Delphi Method.","authors":"Julia Willcox, Austin T Gregg, Steve Braunstein, Malcolm D Mattes, Jillian Gunther, Matthew Abrams","doi":"10.1016/j.prro.2024.12.003","DOIUrl":"10.1016/j.prro.2024.12.003","url":null,"abstract":"<p><strong>Purpose: </strong>Many medical students in the US lack formal exposure to radiation oncology (RO). In contrast to multi-week electives, microclerkships, defined here as brief (<1 week) observerships, could provide exposure to RO. The primary objective of this study was to establish expert consensus for the duration, curriculum, target audience, and goals/objectives of an RO microclerkship. With these components, the microclerkship aims to provide medical students with the necessary exposure to RO.</p><p><strong>Methods and materials: </strong>A needs assessment evaluating the demand for, and essential elements of, an RO microclerkship was distributed to medical student clerkship directors. Based on responses, the authors developed a preliminary set of 7 goals, 5 objectives, and 4 curricular items. These were refined through an iterative Delphi process. Three surveys were sent to 7 medical education experts across several institutions and medical specialties. Surveys asked experts to rank elements for inclusion, comment on clarity, and suggest new ones. The consensus threshold was defined as 83% of respondents selecting \"Definitely Include\" or \"Maybe Include.\" The final survey asked experts to explain the selection of exclusionary options.</p><p><strong>Results: </strong>Surveys demonstrated that third-year medical students and 3 to 5 days were the ideal target audience and duration for an RO microclerkship. The final goals emphasized the following: the role/value of RO, understanding of RO mechanisms, RO integration in care, interdisciplinary management, longitudinal care, and workflow. Final objectives included seeing a consult, follow-up, and on-treatment visit; participating in a simulation; and observing contouring, treatment planning, and radiation plan review. Curricular items were preclinic/postclinic quizzes, a 1-hour introduction to RO lecture, and a shadowing experience.</p><p><strong>Conclusions: </strong>Through the Delphi process, we have established a framework for an RO microclerkship with a consensus duration, curriculum, target audience, and goals/objectives. Integration of this 3- to 5-day microclerkship into third-year medical school curricula would provide an avenue for increased exposure to RO during undergraduate medical education.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902870","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":"Patterns of Recurrence Following Radiation and ADT for Pathologic Lymph Node-Positive Prostate Cancer: A Multi-institutional Study.","authors":"Leslie K Ballas, Chandana A Reddy, Hye Ri Han, Jelena B Makar, Omar Mian, James Broughman, Conchita de Bustamante, Scott Eggener, Stanley L Liauw, Matthew Abramowitz, Christopher Montoya, Rahul Tendulkar","doi":"10.1016/j.prro.2024.12.006","DOIUrl":"10.1016/j.prro.2024.12.006","url":null,"abstract":"<p><strong>Purpose: </strong>We evaluate prognostic factors and patterns of recurrence in patients who received RT ± androgen deprivation therapy (ADT) for pathologic node-positive (pN1) prostate cancer (PCa) in a multi-institutional cohort.</p><p><strong>Methods and materials: </strong>Data from patients with pN1 PCa and received RT with short-term (ST, ≤6 mo) or long-term (LT, >6 mo) ADT were obtained from 4 academic institutions. Biochemical progression-free survival (bPFS) and distant metastasis-free survival (DMFS) were evaluated.</p><p><strong>Results: </strong>Two hundred seventy patients were included, with a median follow-up of 48 months. Two hundred fifty-six (95%) patients had extracapsular extension, 70% had seminal vesicle invasion, 59% had positive surgical margins, 49% had grade group 5, and 64% had a detectable (>0.1 ng/mL) postoperative prostate-specific antigen (PSA). ADT was ST (20%) or LT (68%, median 24 months), whereas 26 (10%) received no ADT. Biochemical failure (bF) was observed in 29%, with 5% having pelvic nodal failure and 11% having distant metastases. The 4-year bPFS was 72% overall, and was 83% for a pre-RT PSA of <0.1 ng/mL, 76% for PSA 0.1 to <0.5 ng/mL, 60% for PSA 0.5 to 2 ng/mL, and 35% for PSA > 2 ng/mL (P < .0001). On multivariable analysis, pre-RT PSA > 0.5 (0.5-2.0 vs <0.1 hazard ratio (HR), 2.97; >2.0 vs <0.1 HR, 7.63), use of LT ADT versus no ADT (HR, 0.43) and use of LT ADT compared to ST ADT (HR, 0.34), Grade group 4 versus 2 (HR, 4.11), and positive surgical margins (HR, 1.773) were significantly associated with bPFS.</p><p><strong>Conclusions: </strong>Postprostatectomy RT at PSA < 0.5 ng/mL is associated with favorable bPFS in pN1 PCa.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903383","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}