Practical Radiation Oncology最新文献

{"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}

{"title":"Combining Radiation Therapy With Immune Checkpoint Inhibitors for the Management of Muscle-Invasive Bladder Cancer: A Comprehensive Systematic Review From the Y-ECI ROSC EORTC Group.","authors":"Vérane Achard, Hoda Abdel-Aty, Victor Duque-Santana, Marko Bebek, Tiuri E Kroese, Miha Orazem, Piet Dirix, Piet Ost, Andrea Lancia","doi":"10.1016/j.prro.2025.05.004","DOIUrl":"10.1016/j.prro.2025.05.004","url":null,"abstract":"<p><strong>Purpose: </strong>This review aims to evaluate the efficacy and safety of combining immune checkpoint inhibitors (ICI) with RT in the treatment of non-metastatic MIBC, focusing on neoadjuvant and bladder preservation strategies.</p><p><strong>Methods and materials: </strong>A systematic literature review was conducted from January 2000 to December 2023 using PubMed and Clinicaltrials.gov databases. Studies investigating outcomes after combining immunotherapy with RT for non-metastatic MIBC were selected. Data extraction included study identifiers, patient characteristics, intervention and control arm details, and primary outcomes.</p><p><strong>Results: </strong>Among 28 selected studies, diverse approaches were observed, including neoadjuvant and bladder preservation strategies. Neoadjuvant trials, such as RACE IT, explored the feasibility of combining ICI with RT before radical cystectomy, showing promising efficacy and safety outcomes. In bladder preservation strategies, completed as well as ongoing trials demonstrated acceptable toxicity profiles and promising early efficacy data for combining ICI with chemoradiotherapy or RT alone.</p><p><strong>Conclusions: </strong>Combining ICI with RT holds significant promise as a treatment strategy for non-metastatic MIBC. Preliminary evidence suggests favorable efficacy and safety profiles, supporting further exploration and potential integration into standard care. Ongoing phase III trials will provide crucial insights into the comparative effectiveness of adding ICI to conventional definitive treatments. In the evolving landscape of MIBC management, the combination of ICI and RT has the potential to reshape therapeutic paradigms and improve outcomes for patients.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144292","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 New Paradigm of Simulation-Free Radiation Therapy: Practical Recommendations for Successful Clinical Implementation.","authors":"Stephanie Roderick, Shelley Wong, Alannah Kejda, Kylie Grimberg, Toby Lowe, Sarah Bergamin, George Hruby, Jeremy Booth, Thilo Schuler, Thomas Eade","doi":"10.1016/j.prro.2025.05.002","DOIUrl":"10.1016/j.prro.2025.05.002","url":null,"abstract":"<p><p>Simulation-free radiation therapy (SFRT) is an emerging patient-centered paradigm for palliative radiation therapy. Feasibility and clinical benefits have been demonstrated by several groups; however, guidance to overcome technical barriers to adoption is limited. This report describes practical recommendations for offline preliminary studies, patient selection, image selection and formatting, planning and treatment considerations, and quality control. These suggestions aim to enable safe, scalable, and effective clinical implementation of SFRT.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103170","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 Current and Future State of Radiation Therapy Practice-An Analysis of the Professional Workforce Survey.","authors":"Samantha Skubish, Shaun Caldwell, Sandra Hayden, Melissa Culp, John Culbertson, Jason Paisley, Sheryl Green, Nora Uricchio","doi":"10.1016/j.prro.2025.04.008","DOIUrl":"10.1016/j.prro.2025.04.008","url":null,"abstract":"<p><strong>Purpose: </strong>In 2023, the American Society of Radiologic Technologists and the American Registry of Radiologic Technologists conducted a Professional Workforce Survey to define current and assess future practices of radiation therapists. The survey focused on the evolving role of radiation therapists, amid staffing constraints and advancements in radiation oncology technologies, exploring clinical duties, knowledge levels, comfort with specific tasks, and the call for advanced practice roles.</p><p><strong>Methods and materials: </strong>In October 2023, the American Registry of Radiologic Technologists sent 14,822 survey invitations to certified radiation therapists, using a questionnaire based on the American Society of Radiologic Technologists' 2016 pilot survey and current trends in technology and practice. By November 2023, 403 responses were received, resulting in a 2.7% response rate. With an estimated 23,000 radiation therapists, the sample size of 403 provides a ±4.8% margin of error at a 95% confidence level.</p><p><strong>Results: </strong>The survey identifies areas where radiation therapist's excel with high knowledge, comfort, and low supervision while highlighting opportunities to strengthen clinical and technical skills to meet evolving technology and standards. It emphasized the need to define advanced practice roles (advanced practice radiation therapist) for radiation therapists to improve care delivery, address staffing shortages, and provide career growth. Expanding radiation therapy's scope in research and care coordination could help fill gaps, alleviate workforce challenges, and improve outcomes.</p><p><strong>Conclusions: </strong>The findings suggest that the future of radiation therapy practice lies in maximizing the potential of radiation therapists, with additional development needed to define new clinical career pathways and improve patient outcomes. Further research and resources are necessary to establish evidence-based models that leverage radiation therapists' expertise to the level of advanced practice.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026365","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":"Practical Considerations for the Treatment of Primary Renal Cell Carcinoma With SABR.","authors":"James B Yu, David Grew, Erin Sculley, Shankar Siva, Nicholas Hardcastle, Chad Tang, Jinzhong Yang, Minsun Kim, Simon S Lo","doi":"10.1016/j.prro.2025.03.007","DOIUrl":"https://doi.org/10.1016/j.prro.2025.03.007","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057951","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":"Comparison of Acute and Late Toxicities With Daily Versus Every-Other-Day 5-Fraction Partial Breast Radiation Therapy","authors":"Sean M. Parker MD ,&nbsp;Ahmed Halima MD ,&nbsp;Sudha Amarnath MD ,&nbsp;Maria Claudia Moncaliano BS ,&nbsp;Arya Patel BS ,&nbsp;Connor Spera BS ,&nbsp;Elizabeth Obi MD ,&nbsp;Cole Billena MD ,&nbsp;Zahraa Al-Hilli MD, MBA ,&nbsp;Sheen Cherian MD ,&nbsp;Rahul Tendulkar MD ,&nbsp;Chirag Shah MD","doi":"10.1016/j.prro.2025.01.006","DOIUrl":"10.1016/j.prro.2025.01.006","url":null,"abstract":"<div><h3>Purpose</h3><div>Partial breast irradiation (PBI) delivered with intensity modulated radiation therapy over 5 fractions every other day represents an attractive, convenient method of delivering adjuvant radiation therapy for well-selected patients without compromising oncologic or toxicity outcomes. Condensing this regimen to a week of treatment through consecutive daily delivery may further increase patient convenience, though a comparison of toxicities between daily and every other day regimens is limited.</div></div><div><h3>Methods and Materials</h3><div>We retrospectively reviewed 507 patients from an institutional registry undergoing PBI for ductal carcinoma in situ (DCIS) or early-stage breast cancer (T1-2N0/x) from 2015 to 2022. All patients received 30 Gy in 5 fractions with intensity modulated radiation therapy. Acute (toxicity within 90 days of treatment) and chronic toxicity were recorded.</div></div><div><h3>Results</h3><div>Of the 507 patients, 351 were treated every other day, and 159 were treated daily. Median follow-up was longer in the every-other-day group (2.4 vs 1.9 years, <em>P</em> &lt; .001). With regards to acute toxicity, there was slightly reduced grade 1 to 2 dermatitis with daily treatment (39% every other day vs 35% daily, <em>P</em> = .06), while rates of fatigue (18% every other day vs 20% daily, <em>P</em> = .09) were similar. Rates of chronic toxicities were comparable between the two approaches, with no differences in the rates of chronic hyperpigmentation (14% every other day vs 14% daily, <em>P</em> = .97), telangiectasias (1% every other day vs 1% daily, <em>P</em> = .92), mild fibrosis/induration (13% every other day vs 13% daily, <em>P</em> = .91), and lymphedema (0% every other day vs 1% daily, <em>P</em> = .31).</div></div><div><h3>Conclusions</h3><div>Overall, 5-fraction PBI delivered daily appears to be well tolerated with similar acute and chronic toxicity to every other day fractionation.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 3","pages":"Pages e240-e244"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054284","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}