Practical Radiation Oncology最新文献

{"title":"Masthead/Sub page","authors":"","doi":"10.1016/S1879-8500(24)00109-7","DOIUrl":"https://doi.org/10.1016/S1879-8500(24)00109-7","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141484903","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 Effect of Wire Versus Magnetic Seed Localization on Lumpectomy Cavity Size","authors":"Michael Dykstra MD ,&nbsp;Jessica Thompson MD ,&nbsp;Jessica Aldous BS ,&nbsp;Shannon Jiang MD ,&nbsp;Tasha Hughes MD, MPH ,&nbsp;James Hayman MD, MBA ,&nbsp;Aleksandar Dragovic MD ,&nbsp;Jennifer Shah MD ,&nbsp;Alfred Chang MD ,&nbsp;Corey Speers MD, PhD ,&nbsp;Michael Sabel MD ,&nbsp;Lesly Dossett MD, MPH ,&nbsp;Matthew Schipper PhD ,&nbsp;Reshma Jagsi MD, DPhil","doi":"10.1016/j.prro.2023.12.004","DOIUrl":"10.1016/j.prro.2023.12.004","url":null,"abstract":"<div><h3>Purpose</h3><p><span>Our purpose was to assess whether an association exists between surgical localization technique and lumpectomy cavity size on </span>radiation therapy planning computed tomography (CT) scan.</p></div><div><h3>Methods and Materials</h3><p>A single-institution retrospective review was conducted of women undergoing breast conserving surgery<span> with wire or magnetic seed guided lumpectomy followed by adjuvant radiation therapy from 2018 to 2021. Patients of a surgeon only performing 1 localization technique or undergoing bracketed localization were excluded. The primary outcome was lumpectomy cavity size on simulation CT. Confounding due to imbalance in patient and tumor factors was addressed with overlap weights derived from a propensity score analysis and used in a weighted multivariable analysis. Secondary outcomes included positive margins, total pathologic volume, boost delivery, and boost modality.</span></p></div><div><h3>Results</h3><p>Of 617 women who received lumpectomy during the study period, 387 were included in final analysis. Tumors of patients undergoing seed localization were more likely unifocal, assessable by ultrasound, and smaller. Seed use rates ranged from 27.7% to 70.7% per surgeon. There was no difference in positive margins (6.4 vs 5.4%, <em>P</em> = .79) or second surgeries (9.4 vs 8.1%, <em>P</em><span> = .79) between groups. Close margin rates were similar for ductal carcinoma in situ (</span><em>P</em><span> = .35) and invasive carcinoma (</span><em>P</em> = .97). In unadjusted bivariable analyses, wire localization was associated with larger total pathology volume (<em>P</em> = .004), but localization technique showed no association with CT cavity volume (<em>P</em> = .15). After adjusting for potentially confounding variables, multivariable analysis failed to show an association between localization technique and either CT cavity (<em>P</em> = .35) or total path volume (<em>P</em> = .08). There was no difference in indicated-boost delivery (<em>P</em> = .15) or electron boost (<em>P</em> = .14) by localization technique.</p></div><div><h3>Conclusions</h3><p>There was no significant difference in CT cavity size by localization technique, suggesting choice between surgical techniques does not impede radiation therapy boost delivery.</p></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139070764","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":"A Multi-Institutional Safety and Feasibility Study Exploring the Use of Hydrogel to Create Spatial Separation between the Pancreas and Duodenum in Patients with Pancreatic Cancer","authors":"Amol Kumar Narang MD ,&nbsp;Theodore S. Hong MD ,&nbsp;Kai Ding MS, PhD ,&nbsp;Joseph Herman MD ,&nbsp;Jeffrey Meyer MS, MD ,&nbsp;Elizabeth Thompson MD ,&nbsp;Manoop S. Bhutani MD ,&nbsp;Kumar Krishnan MD ,&nbsp;Brenna Casey MD ,&nbsp;Eun Ji Shin MD, PhD ,&nbsp;Eugene J. Koay MD, PhD","doi":"10.1016/j.prro.2023.11.011","DOIUrl":"10.1016/j.prro.2023.11.011","url":null,"abstract":"<div><h3>Purpose</h3><p>The administration of dose-escalated radiation for pancreatic adenocarcinoma remains challenging because of the proximity of dose-limiting stomach and bowel, particularly the duodenum for pancreatic head tumors. We explore whether endoscopic injection of a temporary, absorbable hydrogel into the pancreatico-duodenal (PD) groove is safe and feasible for the purpose of increasing spatial separation between pancreatic head tumors and the duodenum.</p></div><div><h3>Methods and Materials</h3><p>Six patients with localized pancreatic adenocarcinoma underwent endoscopic injection of hydrogel into the PD groove. Safety was assessed based on the incidence of procedure-related adverse events resulting in a delay of radiation therapy initiation. Feasibility was defined as the ability to create spatial separation between the pancreas and duodenum, as assessed on simulation CT.</p></div><div><h3>Results</h3><p>All 6 patients were able to undergo endoscopic injection of hydrogel into the PD groove. No device-related events were experienced at any point in follow-up. Presence of hydrogel in the PD groove was apparent on simulation CT in all 6 patients. Mean space created by the hydrogel was 7.7 mm +/- 2.4 mm. In 3 patients who underwent Whipple resection, presence of hydrogel in the PD groove was pathologically confirmed with no evidence of damage to the duodenum.</p></div><div><h3>Conclusions</h3><p>Endoscopic injection of hydrogel into the PD groove is safe and feasible. Characterization of the dosimetric benefit that this technique may offer in the setting of dose-escalated radiation should also be pursued, as should the ability of such dosimetric benefit to translate into clinically improved tumor control.</p></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138479293","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":"Erratum to: Baty M, Pasquier D, Gnep K, et al. Achievable Dosimetric Constraints in Stereotactic Reirradiation for Recurrent Prostate Cancer. Pract Radiat Oncol. 2023;13:e515-e529.","authors":"","doi":"10.1016/j.prro.2024.03.003","DOIUrl":"10.1016/j.prro.2024.03.003","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1879850024000511/pdfft?md5=8a3df57b28a147bf1d555e9d35852347&pid=1-s2.0-S1879850024000511-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472585","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":"In Regard to Yu et al","authors":"Jason M. Beckta MD, PhD","doi":"10.1016/j.prro.2024.02.006","DOIUrl":"10.1016/j.prro.2024.02.006","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472588","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 Reply to Beckta","authors":"James B. Yu MD, MHS,&nbsp;Join Y. Luh MD,&nbsp;Constantine A. Mantz MD","doi":"10.1016/j.prro.2024.04.004","DOIUrl":"10.1016/j.prro.2024.04.004","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472589","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":"Extramedullary Hematopoiesis Spinal Cord Compression in Beta-thalassemia: Role of Reirradiation as a Challenging Therapeutic Approach in Recurrent Disease","authors":"Alexander Bennassi MD ,&nbsp;Kamel Debbi MD ,&nbsp;Galaad Bernard MD ,&nbsp;Yazid Belkacemi MD, PhD","doi":"10.1016/j.prro.2024.03.004","DOIUrl":"10.1016/j.prro.2024.03.004","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472586","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":"Osteoradionecrosis Rates After Head and Neck Radiation Therapy: Beyond the Numbers","authors":"Fan Yang MD ,&nbsp;Richard J. Wong MD ,&nbsp;Kaveh Zakeri MD, MAS ,&nbsp;Annu Singh BDS ,&nbsp;Cherry L. Estilo DMD ,&nbsp;Nancy Y. Lee MD, FASTRO","doi":"10.1016/j.prro.2024.02.008","DOIUrl":"10.1016/j.prro.2024.02.008","url":null,"abstract":"<div><h3>Purpose</h3><p>Osteoradionecrosis (ORN) is a severe late complication of head and neck radiation therapy shown to have profound negative effect on the quality of life of cancer survivors. Over the past few decades, improvements in radiation delivery techniques have resulted in a decrease in the incidence of ORN. However, even with modern radiation therapy techniques, ORN remains an important clinical concern. In recent literature, there is a wide range of reported ORN rates from 0% to as high as 20%. With such a high level of variability in the reported incidence of ORN, oncologists often encounter difficulties estimating the risk of this serious radiation therapy toxicity.</p></div><div><h3>Methods and Materials</h3><p>In this review, the authors present a summary of the factors that contribute to the high level of variability in the reported incidence of ORN.</p></div><div><h3>Results</h3><p>Variable definition, variable grading, and heterogeneity of both study inclusion criteria and treatment parameters can each significantly influence the reporting of ORN rates.</p></div><div><h3>Conclusions</h3><p>Given numerous factors can affect the reported incidence of ORN, a thorough understanding of the clinical context behind the reported ORN rates is needed to comprehend the true risk of this important radiation therapy toxicity.</p></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140780477","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":"On Teaching Narrative Oncology","authors":"Brian Quaranta MD, MA","doi":"10.1016/j.prro.2023.11.016","DOIUrl":"10.1016/j.prro.2023.11.016","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138685374","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":"An Automated, Dynamic Radiation Oncology Prescription Checking System","authors":"I.M. Pashtan MD ,&nbsp;T. Kosak MEd ,&nbsp;K.-Y. Shin MS ,&nbsp;C. Molodowitch BS ,&nbsp;J.H. Killoran PhD ,&nbsp;C. Hancox PhD ,&nbsp;M. Czerminska MS ,&nbsp;J.S. Bredfeldt PhD ,&nbsp;D.W. Cail MS ,&nbsp;M. Kearney MS ,&nbsp;R.B. Tishler MD, PhD ,&nbsp;R.H. Mak MD","doi":"10.1016/j.prro.2023.12.002","DOIUrl":"10.1016/j.prro.2023.12.002","url":null,"abstract":"<div><h3>Purpose</h3><p>Despite serving as a critical communication tool, radiation oncology prescriptions are entered manually and prone to error. An automated prescription checking system was developed and implemented to help address this problem.</p></div><div><h3>Methods and Materials</h3><p>Rules defining clinically appropriate prescriptions were generated, examining specific types of errors: (1) unapproved dose per fraction for a given disease site; (2) dose per fraction too large for nonstereotactic treatment technique; and (3) dose per fraction too low. With a goal of catching errors as upstream as possible to minimize their propagation, a report was created and ran every 30 minutes to check all newly written or approved prescriptions against the 3 rules. When a prescription violated these rules, an automated email was immediately sent to the prescriber alerting them of the potential error. System performance was continuously monitored and the criteria triggering an alert adjusted to balance error detection against false positives. Alerts leading to prescription amendment were considered true errors.</p></div><div><h3>Results</h3><p>From June 2021 to November 2022, the system checked 24,047 prescriptions. A total of 241 email alerts were triggered, for an average alert rate of 1%. Of the 241 alerts, 198 (82.2%) were unapproved doses per fraction for the disease site, 14 (5.8%) were doses per fraction that were too low, and 29 (12%) were doses too large for nonstereotactic treatment technique. Thirty-one percent of alerts led to a change of prescription, suggesting they were true errors. The baseline rate of erroneous prescription entry was 0.3%. A regression model showed that trainee prescription entry and dose per fraction &lt;150 cGy were significantly associated with true errors.</p></div><div><h3>Conclusions</h3><p>Given the significant consequences of erroneous prescription entry, which ranged from wasted resources and treatment delays to potentially serious misadministration, there is significant value in implementing automated prescription checking systems in radiation oncology clinics.</p></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139049778","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}