Advances in Radiation Oncology最新文献

{"title":"High-Dose Direct Irradiation to a Cardiac Resynchronization Therapy Defibrillator Infiltrated by Metastatic Thyroid Papillary Carcinoma in the Sternum: A Case Report","authors":"Masaaki Goto MD , Kayoko Ohnishi MD, PhD , Masatoshi Nakamura MD, PhD , Daisuke Kobayashi PhD , Yukiko Tsushima MD, PhD , Hiro Yamasaki MD, PhD , Keiko Nemoto Murofushi MD, PhD , Masashi Mizumoto MD, PhD , Hitoshi Ishikawa MD, PhD , Toshiyuki Okumura MD, PhD , Hideyuki Sakurai MD, PhD","doi":"10.1016/j.adro.2024.101672","DOIUrl":"10.1016/j.adro.2024.101672","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 1","pages":"Article 101672"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142722501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report of a Woman With Anastrozole-Associated Radiation Recall","authors":"Parisa Shamsesfandabadi MD , Arpeet Patel , Veronica R. Eisen MD , Sushil Beriwal MD , Colin E. Champ MD, CSCS","doi":"10.1016/j.adro.2024.101667","DOIUrl":"10.1016/j.adro.2024.101667","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 1","pages":"Article 101667"},"PeriodicalIF":2.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142703105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatially Fractionated Radiation Therapy for Palliation in Patients With Large Cancers: A Retrospective Study","authors":"Federico Iori MD ,&nbsp;Valeria Trojani MSc ,&nbsp;Alice Zamagni PhD ,&nbsp;Patrizia Ciammella MD ,&nbsp;Mauro Iori PhD ,&nbsp;Andrea Botti MSc ,&nbsp;Cinzia Iotti MD","doi":"10.1016/j.adro.2024.101665","DOIUrl":"10.1016/j.adro.2024.101665","url":null,"abstract":"<div><h3>Purpose</h3><div>Spatially fractionated radiation therapy (SFRT) is an irradiation technique developed to improve large cancer response. Although preliminary studies report highly positive results, data are still limited. The aim of this retrospective monocentric study was to investigate SFRT safety and activity.</div></div><div><h3>Methods and Materials</h3><div>We analyzed all patients who underwent SFRT as a palliative treatment for large solid extracranial cancer (&gt;4.5 cm) at our institution. The primary endpoint was objective response rate assessment at 3 months. Additionally, patients’ antalgic response, target volume reduction, and performance status modification were measured. Toxicity data were recorded.</div></div><div><h3>Results</h3><div>From November 2021 to August 2023, 20 consecutive patients (20 lesions) underwent SFRT. We prescribed a minimum dose of 20 Gy in 5 fractions to 95% of the Planning Target Volume (PTV_20) and a minimum dose of 50 Gy to 50% of the sphere volume. The median beam-on time was 5 minutes (IQR_1-3, 4-7 minutes; range, 3-16 minutes). Patients’ median age was 70 years (range, 18-85 years). The median lesion volume was 560.4 cm3 (IQR_1-3, 297.4-931.5 cc; range, 168.3-3838.3 cm3). Of the 20 patients, 14 and 10 were alive at 3 and 6 months, respectively. The 3-month objective response rate was 79% (95% CI, 49%-95%), with a median target volume reduction of 54% (IQR_1-3, 32%-69%; range, 6%-80%). At 6 months, all patients were free from local disease progression. All patients reported an antalgic response with a rapid onset. All treatment-related toxicities occurred within 1 month after SFRT and quickly recovered. No acute toxicity ≥ grade 3 and late toxicity was reported. No patient experienced a worsening in performance status.</div></div><div><h3>Conclusions</h3><div>Our results provide further evidence supporting SFRT as a safe and promising option for palliative patients affected by large neoplastic lesions.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 1","pages":"Article 101665"},"PeriodicalIF":2.2,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pegylated Interferon Combined With Low-Dose Total Skin Electron Beam Therapy for Advanced Stage Mycosis Fungoides: Two Case Reports and Literature Review","authors":"Khaled Elsayad PhD ,&nbsp;Rudolf Stadler PhD ,&nbsp;Hans Theodor Eich PhD","doi":"10.1016/j.adro.2024.101663","DOIUrl":"10.1016/j.adro.2024.101663","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 1","pages":"Article 101663"},"PeriodicalIF":2.2,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142661572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of Pelvic Bone Dose-volume Parameters on Bone Marrow Suppression During Radiation Therapy in Patients With Stage I to III Rectal Cancer Based on Real-world Data","authors":"Botian Huang MD ,&nbsp;Jiansheng Lv MM ,&nbsp;Jianqi Xiong MM ,&nbsp;Fang Peng MD ,&nbsp;Liyang Zhuo MM ,&nbsp;Zhuangzhuang Yang MM ,&nbsp;Xiaowu Deng MD ,&nbsp;Yong Bao PdD, MM ,&nbsp;Shaoqing Niu MD, PhD","doi":"10.1016/j.adro.2024.101662","DOIUrl":"10.1016/j.adro.2024.101662","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study was to evaluate the effect of pelvic bone dose-volume parameters on bone marrow suppression during radiation therapy (RT) in patients with rectal cancer stage I to III disease receiving either neoadjuvant radiation therapy (neo-RT) or curative-intent radiation therapy (cur-RT).</div></div><div><h3>Methods and Materials</h3><div>This was a retrospective study with data mined from an electronic medical record review at a single institution. Between January 2016 and September 2022, patients with rectal cancer who consecutively received neo-RT or cur-RT in our department were included. The data collected included complete baseline peripheral blood counts and hematologic toxicity (HT) data collected during RT. The radiation dose-volume parameters of 3 pelvic bone marrow subsites (iliac bone marrow [IBM], lumbosacral bone marrow, and lower pelvis bone marrow) were collected. The primary endpoint was grade ≥ 2 HT (HT2+), including leukopenia, neutropenia, anemia, thrombocytopenia, and total HTs. Logistic regression was employed to analyze the associations of HT2+ with dosimetric parameters and clinicopathologic characteristics. Receiver operating characteristic curves and the area under the curve (AUC) were generated to verify the prediction efficacy of the pelvic bone dose-volume parameters combined with clinicopathologic indices.</div></div><div><h3>Results</h3><div>A total of 130 patients with stage I to III rectal cancer with complete clinical data were included. During neo-RT and cur-RT, 57 (43.8%) of these patients experienced HT2+. Multivariate analysis revealed that gender, the IBM-Dmean, the IBM-V15, and the IBM-V40 were significantly associated with grade 2+ leukopenia (<em>P</em> &lt; .05), and the AUC of gender combined with the IBM-Dmean, the IBM-V15, and the IBM-V40 in predicting grade 2+ leukopenia was 0.834. The optimal cutoff values were an IBM-Dmean = 2692.75 cGy, an IBM-V15 = 86.65%, and an IBM-V40 = 20.75%. Patients who received oxaliplatin-containing concurrent chemotherapy (ChT) regimens were more likely to experience grade 2+ thrombocytopenia (<em>P</em> = .054). The AUC of concurrent ChT regimens in predicting grade 2+ thrombocytopenia was 0.678. Female gender was significantly associated with grade 2+ anemia and total HT2+ status.</div></div><div><h3>Conclusions</h3><div>Among patients with rectal cancer stage I to III disease who received neo-RT or cur-RT, female patients with higher IBM-Dmean, IBM-V15, and IBM-V40 were more likely to experience grade 2+ leukopenia, and oxaliplatin-containing concurrent ChT regimens were identified as a potential factor for increasing the incidence of grade 2+ thrombocytopenia.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 1","pages":"Article 101662"},"PeriodicalIF":2.2,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142703683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cone Beam Computed Tomography-Based Online Adaptive Radiation Therapy of Esophageal Cancer: First Clinical Experience and Dosimetric Benefits","authors":"Nicolas Bachmann MD ,&nbsp;Daniel Schmidhalter BE ,&nbsp;Frédéric Corminboeuf MD ,&nbsp;Martin D. Berger MD ,&nbsp;Yves Borbély MD ,&nbsp;Ekin Ermiş MD ,&nbsp;Emanuel Stutz MD ,&nbsp;Binaya K. Shrestha MD ,&nbsp;Daniel M. Aebersold MD ,&nbsp;Peter Manser MD ,&nbsp;Hossein Hemmatazad MD","doi":"10.1016/j.adro.2024.101656","DOIUrl":"10.1016/j.adro.2024.101656","url":null,"abstract":"<div><h3>Purpose</h3><div>Radiation therapy (RT) plays a key role in the management of esophageal cancer (EC). However, toxicities caused by proximity of organs at risk (OAR) and daily target coverage caused by interfractional anatomic changes are of concern. Daily online adaptive RT (oART) addresses these concerns and has the potential to increase OAR sparing and improve target coverage. We present the first clinical experience and dosimetric investigations of cone beam CT-based oART in EC using the ETHOS platform.</div></div><div><h3>Methods and Materials</h3><div>Treatment fractions of the first 10 EC patients undergoing cone beam CT-based oART at our institution were retrospectively analyzed. The prescription dose was 50.4 Gy in 28 fractions. The same clinical target volume (CTV) and planning target volume (PTV) margins as for nonadaptive treatments were used. For all sessions, the timestamp of each oART workflow step, PTV size, target volume doses, mean heart dose, and lung V_20Gy of both the scheduled and the adapted treatment plan were analyzed.</div></div><div><h3>Results</h3><div>Following automatic propagation, the CTV was adapted by the physician in 164 (59%) fractions. The adapted treatment plan was selected in 276 (99%) sessions. The median time needed for an oART session was 28 minutes (range, 14.8-43.3). Compared to the scheduled plans, a significant relative reduction of 9.5% in mean heart dose (absolute, 1.6 Gy; <em>P</em> = .006) and 16.9% reduction in mean lung V_20Gy (absolute, 2.3%; <em>P</em> &lt; .001) was achieved with the adapted treatment plans. Simultaneously, we observed a significant relative improvement in D99%PTV and D99%CTV by 15.3% (<em>P</em> &lt; .001) and 5.0% (<em>P</em> = .008), respectively, along with a significant increase in D95%PTV by 5.1% (<em>P</em> = .003).</div></div><div><h3>Conclusions</h3><div>Although being resource-intensive, oART for EC is feasible in a reasonable timeframe and results in increased OAR sparing and improved target coverage, even without a reduction of margins. Further studies are planned to evaluate the potential clinical benefits.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 1","pages":"Article 101656"},"PeriodicalIF":2.2,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142661571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time to Next Systemic Therapy After Stereotactic Body Radiation Therapy for Oligoprogressive Metastatic Castrate-Resistant Prostate Cancer.","authors":"Corbin J Eule, Nellowe Candelario, Sameer K Nath, Tyler P Robin","doi":"10.1016/j.adro.2024.101655","DOIUrl":"https://doi.org/10.1016/j.adro.2024.101655","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with metastatic castrate-resistant prostate cancer (CRPC) with progressive disease generally require a change or escalation in systemic therapy. For patients with limited (1-3) sites of progressive disease (oligoprogression), metastasis-directed therapy with stereotactic body radiation therapy (SBRT) may allow a longer interval before next-line systemic therapy.</p><p><strong>Methods and materials: </strong>This is a retrospective study of patients with oligoprogressive metastatic CRPC (mCRPC) treated with SBRT at a single center between 2011 and 2022. The primary endpoint was time to next systemic therapy (TTNST) after SBRT stratified by the presence/absence of untreated nonprogressing metastases. Secondary endpoints included TTNST of the overall cohort and median overall survival (OS) after SBRT.</p><p><strong>Results: </strong>Thirty-two patients with oligoprogressive mCRPC received SBRT to 38 metastases. Patients had a median age of 72.5 years (range, 50.6-84.3) and a median PSA of 6.85 ng/mL (range, 0.39-922.0) at the time of SBRT. The most commonly used SBRT regimen was 3000 cGy in 5 fractions (18 metastases, 47.4%). Sixteen patients were treated to all known sites of disease, whereas 16 patients received SBRT to oligoprogressive metastases but had at least 1 untreated nonprogressing metastasis at the time of SBRT. Patients had received a median of 1.0 prior line of androgen receptor signaling inhibitors and were predominantly (26 patients, 81.3%) chemotherapy naïve. Following SBRT, the median TTNST was 10.1 months and the median OS was 41.3 months. For patients with 0 versus ≥1 untreated nonprogressing metastasis, TTNST was 11.3 versus 8.7 months, respectively (HR, 0.67; 95% CI, 0.33-1.36, logrank <i>P</i> = .24). There was no grade ≥3 toxicities because of SBRT.</p><p><strong>Conclusions: </strong>In this cohort, patients with oligoprogressive mCRPC treated with SBRT delayed the next line of systemic therapy for a median of 10.1 months. SBRT in patients with oligoprogressive mCRPC may delay initiation of the next-line systemic therapy in well-selected patients, including those with ≥1 untreated nonprogressing metastasis.</p>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"9 12","pages":"101655"},"PeriodicalIF":2.2,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective Trial on the Impact of Weekly Cone Beam Computed Tomography-Guided Correction on Mean Heart Dose in Breast Cancer Breath-Hold Radiation Therapy","authors":"Adrian Wai Chan MBBS ,&nbsp;Anh Hoang BSc ,&nbsp;Hanbo Chen MD ,&nbsp;Merrylee McGuffin MSc ,&nbsp;Danny Vesprini MD ,&nbsp;Liying Zhang PhD ,&nbsp;Matt Wronski PhD ,&nbsp;Irene Karam MD","doi":"10.1016/j.adro.2024.101651","DOIUrl":"10.1016/j.adro.2024.101651","url":null,"abstract":"<div><h3>Purpose</h3><div>Surface guided radiation therapy (SGRT) in breast cancer radiation therapy (RT) may decrease the need for image guidance such as cone beam computed tomography (CBCT). The goal of this study was to evaluate the impact of CBCT image guidance on the cumulative and interfractional variation of mean heart dose (MHD) during breath-hold RT in patients with breast cancer. We hypothesized that weekly CBCT is not necessary for SGRT-assisted breath-hold but is still needed in patients treated with voluntary deep inspiration breath-hold (vDIBH) and active breathing control (ABC) to maintain a stable MHD.</div></div><div><h3>Methods and Materials</h3><div>This was a prospective, single-center trial that sequentially assigned breast cancer patients to adjuvant RT 40 to 50 Gy in 15 to 25 fractions using vDIBH, ABC, or SGRT to reproduce the breath-hold. The MHD was estimated on each of the weekly CBCT images before and after online correction. The cumulative and interfractional variation of MHD, which were represented by the average and SD of MHD in each patient, were compared in the series of CBCT before and after online correction to evaluate whether online CBCT-guided correction could lead to a more reproducible MHD.</div></div><div><h3>Results</h3><div>Fifty-five patients were included (vDIBH = 16, ABC = 19, and SGRT = 20). The CBCT-guided online correction was associated with a significant decrease in the interfractional variation of MHD in vDIBH (SD difference, 22.6 cGy; <em>p</em> = .0389) and ABC (SD difference, 9.9 cGy; <em>p</em> = .0262), but not in SGRT (<em>p</em> = .2272). The CBCT-guided online correction had no impact on the cumulative MHD in all 3 groups.</div></div><div><h3>Conclusions</h3><div>This study demonstrated that CBCT-guided online correction could reduce the interfractional variation of MHD in ABC or vDIBH. When SGRT was available, CBCT-guided correction had no impact on the stability of MHD across the treatment fractions. Future studies may explore whether the CBCT frequency could be reduced to less than weekly in SGRT to decrease treatment time and the radiation dose associated with CBCT.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"9 12","pages":"Article 101651"},"PeriodicalIF":2.2,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142554264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early-Stage Extranodal NK/T-Cell Lymphoma, Nasal Type: A Role for Elective Nodal Irradiation?","authors":"Penny Fang MD, MBA ,&nbsp;Sonal S. Noticewala MD ,&nbsp;Susan Y. Wu MD ,&nbsp;Jillian R. Gunther MD, PhD ,&nbsp;Ethan B. Ludmir MD ,&nbsp;L. Jeffrey Medeiros MD ,&nbsp;Paolo Strati MD ,&nbsp;Ranjit Nair MD ,&nbsp;Chijioke Nze MD ,&nbsp;Loretta J. Nastoupil MD ,&nbsp;Sairah Ahmed MD ,&nbsp;Luis Malpica Castillo MD ,&nbsp;Luis Fayad MD ,&nbsp;Jason Westin MD ,&nbsp;Sattva Neelapu MD ,&nbsp;Christopher Flowers MD ,&nbsp;Auris Huen MD ,&nbsp;Swaminathan P. Iyer MD ,&nbsp;Bouthaina Dabaja MD ,&nbsp;Chelsea C. Pinnix MD, PhD","doi":"10.1016/j.adro.2024.101650","DOIUrl":"10.1016/j.adro.2024.101650","url":null,"abstract":"<div><h3>Purpose</h3><div>Extranodal NK/T-cell lymphoma (ENKTCL) is rare in the Western Hemisphere and is commonly treated with combined modality therapy (CMT).</div></div><div><h3>Methods and Materials</h3><div>We retrospectively reviewed 35 patients treated with Ann Arbor stage I/II ENKTCL between 1994 and 2015 at a large academic cancer center in the United States.</div></div><div><h3>Results</h3><div>With 11.6 years median follow-up, median overall survival and progression-free survival were 13.5 and 7.5 years, respectively. Eighteen (51%) patients experienced disease relapse, with 5 regional nodal relapses, of which 2 experienced combined regional and distant relapses. All 5 regional nodal relapses occurred exclusively among patients not treated with elective nodal irradiation (ENI). ENI was associated with improved progression-free survival (hazard ratio [HR], 0.21; 95% CI, 0.09-0.52; <em>P</em> = .018) without significant association with OS (HR, 0.33; 95% CI, 0.11-0.94; <em>P</em> = .11). There was a trend toward improved local control with radiation dose to the primary tumor ≥50 Gy (HR, 0.29; 95% CI, 0.08-1.08; <em>P</em> = .098).</div></div><div><h3>Conclusions</h3><div>In this Western Hemisphere cohort of early-stage ENKTCL patients treated with CMT, ENI may have a potential clinical benefit, particularly in patients who are treated with non–asparaginase-containing CMT, such as in patients treated with radiation alone, patients treated with less intensive chemotherapy concurrently, or patients who are unable to tolerate intensive chemotherapy.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"9 12","pages":"Article 101650"},"PeriodicalIF":2.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142572719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship Between Travel Distance for Treatment and Outcomes in Patients Undergoing Radiation Therapy: A Systematic Review","authors":"Sierra M. Silverwood BA ,&nbsp;Kathleen Waeldner BA ,&nbsp;Sasha K. Demeulenaere BS ,&nbsp;Shavit Keren BA ,&nbsp;Jason To BS ,&nbsp;Jie Jane Chen MD ,&nbsp;Zakaria El Kouzi MD ,&nbsp;Alan Ayoub MD ,&nbsp;Surbhi Grover MD ,&nbsp;Katie E. Lichter MD, MPH ,&nbsp;Osama Mohamad MD, PhD","doi":"10.1016/j.adro.2024.101652","DOIUrl":"10.1016/j.adro.2024.101652","url":null,"abstract":"<div><h3>Purpose</h3><div>Although recent technological advances in radiation therapy have significantly improved treatment outcomes, the global distribution of radiation therapy is unbalanced, making access especially challenging for patients in rural or low-resource settings because of travel burden. This systematic review aimed to explore the impact of geographic distance to treatment facilities on survival, as well as other treatment outcomes, among patients undergoing radiation therapy.</div></div><div><h3>Methods and Materials</h3><div>A search of four databases (PubMed, Embase, CINAHL, and Web of Science) was performed. Studies were included if they were primary literature, published between May 2000 and May 2023, and reported the travel distances for patients undergoing radiation therapy for malignant conditions and its influence on survival outcomes. Studies were excluded if they did not report primary outcomes, were published before 2000, or were non-English.</div></div><div><h3>Results</h3><div>After review, 23 studies were included. Most studies were conducted in the United States, with cervical cancer being the most frequently studied disease site. Data suggested that travel distances vary significantly, with patients often traveling a median distance of 20 miles to radiation therapy. Among the studies, 5 reported a negative impact on overall survival, often associating greater travel with nonadherence to recommended care. Other survival metrics, including progression-free survival and all-cause mortality, were also assessed, demonstrating similar variability in relation to travel distance. Conversely, seven studies found no significant impact on overall survival, and four suggested a positive impact on overall survival, with improved outcomes at centers with higher case volumes. Some data also revealed an inverse correlation between travel distance and the likelihood of receiving guideline-concordant radiation therapy.</div></div><div><h3>Conclusions</h3><div>The impact of travel distance on radiation therapy outcomes is varied. Our findings underscore the challenges posed by travel in accessing radiation therapy and the disparities affecting particular patient demographic groups. Additional studies are needed to thoroughly assess the impacts of geographic disparities and to identify effective measures to address these challenges.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"9 12","pages":"Article 101652"},"PeriodicalIF":2.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}