International Journal of Radiation Oncology Biology Physics最新文献

英文中文

Radiation Therapy for Pleuropulmonary Blastoma: A Case Report and Review of Literature

IF 6.4 1区医学 Q1 ONCOLOGY

International Journal of Radiation Oncology Biology Physics

Pub Date : 2025-02-03 DOI: 10.1016/j.ijrobp.2024.11.058

A. Ylanan , N. Cupino

Objectives

This study aims to (1) describe a case of pleuropulmonary blastoma (PPB), and (2) discuss the role of radiation therapy in PPB management through a review of existing literature.

Methods

We described a case of PPB and conducted a comprehensive search through PubMed, Scopus, Cochrane, and the Grey Literature Report databases. Data on the role of radiation therapy, particularly its timing and outcomes, were reviewed and synthesized.

Results

A 4-year-old female with recurrent respiratory symptoms was diagnosed with PPB. A month after complete excision of the thoracic tumor and right upper lobectomy, recurrence was observed. Despite adjuvant chemotherapy, there was disease progression. The patient underwent subtotal re-excision followed by radiation therapy, receiving 4500 cGy to the grossly apparent tumor and 3600 cGy to the postoperative tumor bed in 180 cGy fractions concurrently with chemotherapy. Significant tumor regression was observed post-radiation therapy, with no significant adverse effects. The patient remains well three years after treatment.

Discussion

The role of upfront radiation therapy for PPB is unclear. Although registry data suggest it has no impact on overall survival, it is often considered when surgical resection is incomplete or when tumors demonstrate chemotherapy resistance. Additionally, radiation therapy may be utilized in treating PPB metastases, including those to the brain. The good long-term control in our patient suggests that its role requires further exploration.

Conclusion

Integration of radiation therapy in a multimodal treatment approach for recurrent PPB yielded favorable outcomes, suggesting it is a viable option warranting further investigation.

{"title":"Radiation Therapy for Pleuropulmonary Blastoma: A Case Report and Review of Literature","authors":"A. Ylanan , N. Cupino","doi":"10.1016/j.ijrobp.2024.11.058","DOIUrl":"10.1016/j.ijrobp.2024.11.058","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to (1) describe a case of pleuropulmonary blastoma (PPB), and (2) discuss the role of radiation therapy in PPB management through a review of existing literature.</div></div><div><h3>Methods</h3><div>We described a case of PPB and conducted a comprehensive search through PubMed, Scopus, Cochrane, and the Grey Literature Report databases. Data on the role of radiation therapy, particularly its timing and outcomes, were reviewed and synthesized.</div></div><div><h3>Results</h3><div>A 4-year-old female with recurrent respiratory symptoms was diagnosed with PPB. A month after complete excision of the thoracic tumor and right upper lobectomy, recurrence was observed. Despite adjuvant chemotherapy, there was disease progression. The patient underwent subtotal re-excision followed by radiation therapy, receiving 4500 cGy to the grossly apparent tumor and 3600 cGy to the postoperative tumor bed in 180 cGy fractions concurrently with chemotherapy. Significant tumor regression was observed post-radiation therapy, with no significant adverse effects. The patient remains well three years after treatment.</div></div><div><h3>Discussion</h3><div>The role of upfront radiation therapy for PPB is unclear. Although registry data suggest it has no impact on overall survival, it is often considered when surgical resection is incomplete or when tumors demonstrate chemotherapy resistance. Additionally, radiation therapy may be utilized in treating PPB metastases, including those to the brain. The good long-term control in our patient suggests that its role requires further exploration.</div></div><div><h3>Conclusion</h3><div>Integration of radiation therapy in a multimodal treatment approach for recurrent PPB yielded favorable outcomes, suggesting it is a viable option warranting further investigation.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Page e16"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143099121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dosimetric Advantages of Proton Beam Therapy over Conventional X-ray Radiotherapy using Comparative Analysis in Pediatric Patients with Various Tumor Locations

IF 6.4 1区医学 Q1 ONCOLOGY

International Journal of Radiation Oncology Biology Physics

Pub Date : 2025-02-03 DOI: 10.1016/j.ijrobp.2024.11.056

H. Schievenin, R. Crain, E. Shierlaw, M. Penfold, S. Penfold, A. Santos, F. Saran

Objectives

To compare radiation dose to organs at risk, as well as total integral dose in proton beam therapy (PBT) when comparatively planned with conventional X-ray radiotherapy (XRT).

Methods

Data for 23 patients referred to the comparative planning service of the Australian Bragg Centre for Proton Therapy and Research (ABCPTR) between January 2022 and June 2023 were included in the analysis. Ages ranged from 0 – 17 years of age. 19 patients were referred from an Australian clinic and 4 patients from a New Zealand clinic. 18 patients had a target volume in the head and neck region, and 5 patients had a target volume outside this region. XRT plans were prepared by the referring clinic and PBT plans were prepared by the ABCPTR. Both plans underwent analysis of dose-volume metrics, including target volume coverage, dose to organs at risk (OaR) and integral dose.

Results

Dose prescriptions were identical between PBT and XRT in all cases, with comparable target volume coverage. PBT allowed for a reduction in the integral dose in all cases. A trend of OaR dose reduction with PBT relative to XRT was also evident, however, the degree of dose reduction with PBT strongly depended on location of the OaR with respect to the target volume.

Conclusion

Our data demonstrates the dosimetric advantages of PBT to OaR and overall integral dose when compared with XRT. In the setting of equal dose prescriptions, we hypothesize that this will result in a primary benefit from the reduction of late toxicities, which are especially impactful in paediatric populations.

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引用次数: 0

Surgical Intervention's Correlation with Subsequent Metastasis Development in Children with Diffuse Intrinsic Pontine Gliomas (DIPG)

IF 6.4 1区医学 Q1 ONCOLOGY

International Journal of Radiation Oncology Biology Physics

Pub Date : 2025-02-03 DOI: 10.1016/j.ijrobp.2024.11.034

S. BASHIR , J. Zhou , M. Lai , R. Al

Background

Diffuse intrinsic pontine glioma (DIPG) is a highly aggressive pediatric brain tumor with a poor prognosis. Currently, there is no curative treatment option available for these patients. These patients often undergo surgery to confirm the diagnosis pathologically. However, the relationship between surgery and dissemination is to be confirmed. This retrospective cohort determines if surgical intervention increases the risk of dissemination and what other factors may also be associated.

Methods

The final analysis included 142 pediatric (age ≤ 12) DIPG patients treated at Sanjiu Brain Hospital between January 2017 and June 2023. The data were retrospectively collected following the initial diagnosis. The diagnosis was established based on imaging studies. Three radiologists analyzed the imaging data. The endpoint was the occurrence of subsequent metastasis. Univariable and multivariable logistic regressions were performed to identify predictors of subsequent dissemination. All statistical assessments were two-tailed; only P < 0.05 was considered statistically significant.

Results

Of 142 patients, 28 (19.7%) developed metastasis, and 114 (80.3%) had no evidence of metastasis. There were 77 (54.2%) males and 65 (45.8%) females. The patients' median age was 7 years (1-12 yrs.). Patients were followed up for at least 6 months or until they developed subsequent metastasis or died without developing metastasis. Univariate logistic regression analysis demonstrated that surgery (OR 4.277, 95%CI 1.753 - 11.607, P=0.002), adjuvant temozolomide (OR 2.891, 95%CI 1.097 - 9.106, P=0.045), and adjuvant bevacizumab (OR 10.278, 95%CI 3.759 - 9.444, P=0.003) were the potential predictor of metastasis development. Multivariate logistic regression analysis showed that surgery (OR 5.061, 95%CI 1.966 - 14.508, P=0.001) and administration of adjuvant bevacizumab (OR 3.020, 95%CI 1.196 - 8.065, P=0.022) were the independent predictors of dissemination.

Conclusion

Surgery and adjuvant bevacizumab may increase the risk of subsequent metastasis in the pediatric DIPG population.

{"title":"Surgical Intervention's Correlation with Subsequent Metastasis Development in Children with Diffuse Intrinsic Pontine Gliomas (DIPG)","authors":"S. BASHIR , J. Zhou , M. Lai , R. Al","doi":"10.1016/j.ijrobp.2024.11.034","DOIUrl":"10.1016/j.ijrobp.2024.11.034","url":null,"abstract":"<div><h3>Background</h3><div>Diffuse intrinsic pontine glioma (DIPG) is a highly aggressive pediatric brain tumor with a poor prognosis. Currently, there is no curative treatment option available for these patients. These patients often undergo surgery to confirm the diagnosis pathologically. However, the relationship between surgery and dissemination is to be confirmed. This retrospective cohort determines if surgical intervention increases the risk of dissemination and what other factors may also be associated.</div></div><div><h3>Methods</h3><div>The final analysis included 142 pediatric (age ≤ 12) DIPG patients treated at Sanjiu Brain Hospital between January 2017 and June 2023. The data were retrospectively collected following the initial diagnosis. The diagnosis was established based on imaging studies. Three radiologists analyzed the imaging data. The endpoint was the occurrence of subsequent metastasis. Univariable and multivariable logistic regressions were performed to identify predictors of subsequent dissemination. All statistical assessments were two-tailed; only P < 0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>Of 142 patients, 28 (19.7%) developed metastasis, and 114 (80.3%) had no evidence of metastasis. There were 77 (54.2%) males and 65 (45.8%) females. The patients' median age was 7 years (1-12 yrs.). Patients were followed up for at least 6 months or until they developed subsequent metastasis or died without developing metastasis. Univariate logistic regression analysis demonstrated that surgery (OR 4.277, 95%CI 1.753 - 11.607, P=0.002), adjuvant temozolomide (OR 2.891, 95%CI 1.097 - 9.106, P=0.045), and adjuvant bevacizumab (OR 10.278, 95%CI 3.759 - 9.444, P=0.003) were the potential predictor of metastasis development. Multivariate logistic regression analysis showed that surgery (OR 5.061, 95%CI 1.966 - 14.508, P=0.001) and administration of adjuvant bevacizumab (OR 3.020, 95%CI 1.196 - 8.065, P=0.022) were the independent predictors of dissemination.</div></div><div><h3>Conclusion</h3><div>Surgery and adjuvant bevacizumab may increase the risk of subsequent metastasis in the pediatric DIPG population.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Page e9"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Challenges with Target Volume Delineation for Pelvic Rhabdomyosarcoma in the FaR-RMS Trial: A QUARTET Report

IF 6.4 1区医学 Q1 ONCOLOGY

International Journal of Radiation Oncology Biology Physics

Pub Date : 2025-02-03 DOI: 10.1016/j.ijrobp.2024.11.019

M. Lo Greco , S. Kelly , R. Dávila Fajardo , H. Magelssen , A. Cameron , C. Corning , J. Chisholm , M. Jenney , V. Bernier-Chastagner , G. Scarzello , M. Gaze , A. Safwat , H. Mandeville

Objectives

Radiotherapy Quality Assurance has been implemented for the FaR-RMS trial (EudraCT number 2018-000515-24) through the SIOPE QUARTET Project, including prospective Individual Case Review (ICR) for all randomized patients. A high rejection rate of target volume contours has been observed for pelvic RMS. We have undertaken to identify areas of uncertainty and variation in primary tumour and nodal target volumes.

Methods

All pelvic RMS patients (n=37) in the FaR-RMS trial submitted to QUARTET, up to 19/02/2024, where reviewers assessed primary tumour or nodal contours as unacceptable variations were identified. The ICR forms, submitted contours and plans were then assessed to identify the most common problem areas.

Results

Unacceptable variations were identified in 16/37 (43%) of Pelvic RMS cases, 69% of which were related to target delineation. Unacceptable variations were related to primary clinical target volume (CTVp) in 36% of these cases, whereas 73% had errors in nodal clinical target volume delineation (CTVn). Delineation errors for CTVn concerned geographical miss (70%), inclusion of excess normal tissue within the CTV (10%) or other reasons (20%). Following reviewer feedback and reassessment, 89% of plans, were considered acceptable.

Conclusion

The delineation of clinical target volume in patients with pelvic RMS represents a challenge for radiation oncologists. Prospective review allows early identification of contouring errors and provides feedback to correct these and refine treatment plans. Given the high proportion of nodal target volume delineation errors, QUARTET is developing a nodal target delineation atlas in collaboration with the EpSSG Radiotherapy Committee.

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引用次数: 0

Ewing's Sarcoma of the Head and Neck: Outcomes of 101 Patients Treated at a Tertiary Cancer Center

IF 6.4 1区医学 Q1 ONCOLOGY

International Journal of Radiation Oncology Biology Physics

Pub Date : 2025-02-03 DOI: 10.1016/j.ijrobp.2024.11.022

A. Krishnan , N. Khanna , J. Manjali , B. Parambil , G. Chinnaswamy , M. Prasad , K. Prabhash , S. Qureshi , G. Pantvaidya , D. Nair , R. Vaish , M. Ramadwar , P. Punjwani , S. Shah , A. Baheti , V. Patil , S. Laskar

Objective

This retrospective study evaluates the disease profile, treatment response, long term outcomes, and prognostic factors for patients ES of the head and neck region treated with curative intent and a homogeneous treatment protocol at our institute.

Methods

From January 2005 to December 2020, 101 patients in the age group of 2months – 42years (Median 14years) were analysed after institutional ethics committee approval.

Results

Out of 101 patients, 62 (61%) were males and the mean tumour size was 5cms. All patients received multi-modality treatment, EFT 2001 systemic chemotherapy (CTh) and local treatment comprising of either surgery (Sx, n = 10), radiation therapy (RT, n = 43) or both (n =47) followed by maintenance CTh. One patient died during Induction CTh due to toxicity. RT alone was offered in cases where Sx was either not feasible or was deemed to be associated with significant morbidity. After a median follow-up of 61 months, the 5-year local control (LC), event free survival (EFS) and overall survival (OS) were 84.4%, 74% and 88.2% respectively. At last follow up, 77 (76%) patients were alive and disease free. Ten patients had local relapse only, 8 had distant metastases and 5 had both local plus distant relapse. The choice of local treatment (5-year OS - RT (89.9%) vs Sx plus RT(86.1%), p = 0.51) did not affect outcomes. On univariate analysis, stage, raised platelet-to-lymphocyte ratio and partial response to RT were significant prognostic factors for OS. There were no ≥ Grade 4 acute or late toxicities owing to local treatment modality.

Conclusion

Multi-modality treatment using a combination of CTh, Sx and RT results in optimal disease control with acceptable toxicities. Definitive RT should be considered when surgery is not feasible or associated with significant morbidity.

{"title":"Ewing's Sarcoma of the Head and Neck: Outcomes of 101 Patients Treated at a Tertiary Cancer Center","authors":"A. Krishnan , N. Khanna , J. Manjali , B. Parambil , G. Chinnaswamy , M. Prasad , K. Prabhash , S. Qureshi , G. Pantvaidya , D. Nair , R. Vaish , M. Ramadwar , P. Punjwani , S. Shah , A. Baheti , V. Patil , S. Laskar","doi":"10.1016/j.ijrobp.2024.11.022","DOIUrl":"10.1016/j.ijrobp.2024.11.022","url":null,"abstract":"<div><h3>Objective</h3><div>This retrospective study evaluates the disease profile, treatment response, long term outcomes, and prognostic factors for patients ES of the head and neck region treated with curative intent and a homogeneous treatment protocol at our institute.</div></div><div><h3>Methods</h3><div>From January 2005 to December 2020, 101 patients in the age group of 2months – 42years (Median 14years) were analysed after institutional ethics committee approval.</div></div><div><h3>Results</h3><div>Out of 101 patients, 62 (61%) were males and the mean tumour size was 5cms. All patients received multi-modality treatment, EFT 2001 systemic chemotherapy (CTh) and local treatment comprising of either surgery (Sx, n = 10), radiation therapy (RT, n = 43) or both (n =47) followed by maintenance CTh. One patient died during Induction CTh due to toxicity. RT alone was offered in cases where Sx was either not feasible or was deemed to be associated with significant morbidity. After a median follow-up of 61 months, the 5-year local control (LC), event free survival (EFS) and overall survival (OS) were 84.4%, 74% and 88.2% respectively. At last follow up, 77 (76%) patients were alive and disease free. Ten patients had local relapse only, 8 had distant metastases and 5 had both local plus distant relapse. The choice of local treatment (5-year OS - RT (89.9%) vs Sx plus RT(86.1%), p = 0.51) did not affect outcomes. On univariate analysis, stage, raised platelet-to-lymphocyte ratio and partial response to RT were significant prognostic factors for OS. There were no ≥ Grade 4 acute or late toxicities owing to local treatment modality.</div></div><div><h3>Conclusion</h3><div>Multi-modality treatment using a combination of CTh, Sx and RT results in optimal disease control with acceptable toxicities. Definitive RT should be considered when surgery is not feasible or associated with significant morbidity.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Page e5"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143104052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Recent Landmark Trials in Gynecologic Cancer: Optimizing Combination or Sequencing of Systemic and Radiation Therapies

IF 6.4 1区医学 Q1 ONCOLOGY

International Journal of Radiation Oncology Biology Physics

Pub Date : 2025-02-03 DOI: 10.1016/j.ijrobp.2024.12.008

Lara Hathout MD, FRCPC , Eric Leung MD, FRCPC , Neil K. Taunk MD, MSCTS , Michelle S. Ludwig MD, MPH, PhD , Emma C. Fields MD

引用次数: 0

Proton-Photon Comparative Planning for Pediatric CNS Tumors: First Experiences of the Australian Bragg Centre for Proton Therapy and Research

IF 6.4 1区医学 Q1 ONCOLOGY

International Journal of Radiation Oncology Biology Physics

Pub Date : 2025-02-03 DOI: 10.1016/j.ijrobp.2024.11.047

H. Schievenin , R. Crain , S. Penfold , M. Penfold , P. Gorayski , E. Shierlaw , A. Santos , F. Saran

Objectives

To evaluate mean dose between focal proton beam therapy (PBT) and photon-based radiotherapy (XRT) using comparative planning in paediatric patients with central nervous system (CNS) tumours.

Methods

Between January 2022 and June 2023, 23 patients were referred to the Australian Bragg Centre for Proton Therapy and Research (ABCPTR) for comparative planning to be evaluated for consideration of focal PBT. Nineteen patients were from Australia and four from New Zealand. Eighteen patients proceeded with comparative planning based on locally defined target volumes and planning constraints. All calculated plans underwent prospective analysis of quality metrics, including target volume coverage, integral dose, and dose(s) to organs at risk (OAR).

Results

Comparable target volume metrics were achieved between PBT and XRT. PBT achieved a mean reduction in integral dose of 30.2% (range 15.0 – 54.0%) in all cases. Further, dose to most OAR favoured PBT. Notable areas of dose reduction to OARs were most commonly seen in the right optic nerve, right lens, right globe, left temporal lobe and left cochlea. Hippocampi were equally receiving lower mean doses when compared to XRT unless directly adjacent to the clinical and planning target volumes.

Conclusion

In this cohort, dosimetric advantages were identified using PBT when compared to XRT with respect to reduction in integral dose and OAR. This relative reduction in integral dose may translate into a reduced risk of second malignancies when compared with XRT and reduced mean doses to OAR have the potential to improve quality of survivorship. PBT should be considered the standard of care in Australian paediatric patients with CNS tumours requiring focal irradiation.

{"title":"Proton-Photon Comparative Planning for Pediatric CNS Tumors: First Experiences of the Australian Bragg Centre for Proton Therapy and Research","authors":"H. Schievenin , R. Crain , S. Penfold , M. Penfold , P. Gorayski , E. Shierlaw , A. Santos , F. Saran","doi":"10.1016/j.ijrobp.2024.11.047","DOIUrl":"10.1016/j.ijrobp.2024.11.047","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate mean dose between focal proton beam therapy (PBT) and photon-based radiotherapy (XRT) using comparative planning in paediatric patients with central nervous system (CNS) tumours.</div></div><div><h3>Methods</h3><div>Between January 2022 and June 2023, 23 patients were referred to the Australian Bragg Centre for Proton Therapy and Research (ABCPTR) for comparative planning to be evaluated for consideration of focal PBT. Nineteen patients were from Australia and four from New Zealand. Eighteen patients proceeded with comparative planning based on locally defined target volumes and planning constraints. All calculated plans underwent prospective analysis of quality metrics, including target volume coverage, integral dose, and dose(s) to organs at risk (OAR).</div></div><div><h3>Results</h3><div>Comparable target volume metrics were achieved between PBT and XRT. PBT achieved a mean reduction in integral dose of 30.2% (range 15.0 – 54.0%) in all cases. Further, dose to most OAR favoured PBT. Notable areas of dose reduction to OARs were most commonly seen in the right optic nerve, right lens, right globe, left temporal lobe and left cochlea. Hippocampi were equally receiving lower mean doses when compared to XRT unless directly adjacent to the clinical and planning target volumes.</div></div><div><h3>Conclusion</h3><div>In this cohort, dosimetric advantages were identified using PBT when compared to XRT with respect to reduction in integral dose and OAR. This relative reduction in integral dose may translate into a reduced risk of second malignancies when compared with XRT and reduced mean doses to OAR have the potential to improve quality of survivorship. PBT should be considered the standard of care in Australian paediatric patients with CNS tumours requiring focal irradiation.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 3","pages":"Page e13"},"PeriodicalIF":6.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143099108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Developing the Scope of Practice for a Specialized Pediatric and AYA Radiation Therapist

IF 6.4 1区医学 Q1 ONCOLOGY

International Journal of Radiation Oncology Biology Physics

Pub Date : 2025-02-03 DOI: 10.1016/j.ijrobp.2024.11.042

L. Murphy , J. Fernandez , D. Duff

Objectives

Specialised radiation therapists (RT) are necessary in the management of paediatric and adolescent young adult (AYA) patients. This unique population present with a heterogenous range of diagnoses and has needs different to older adults. This includes specific requirements for radiation therapy planning and treatment. Work has been done to establish the pathway to advanced practice (AP) in Australia however there are currently no guideline to outline core competencies of paediatric/AYA RTs. Scope of practice is determined by departments who choose to support advance practice roles and the skills of the individuals in those roles.

This review aims to identify areas of practice within the paediatric/AYA AP role which will be used to establish a scope of practice and lead to development of an education pathway for future radiation therapists.

Methods

Tasks and role descriptions were collected from current practicing paediatric/AYA specialist radiation therapists. This information was used to inform a survey which was sent to radiation oncologists and radiation therapists working in paediatric centres in Australia and New Zealand.

Results

Results show multiple areas where there can be impact by the advanced practitioner across the patient's treatment journey. This includes time savings for the radiation oncologist with tasks that would traditionally fall to them which could be carried out by an appropriately trained radiation therapist.

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引用次数: 0

Transition from 3D Conformal to Modern Modulated Craniospinal Radiotherapy

IF 6.4 1区医学 Q1 ONCOLOGY

International Journal of Radiation Oncology Biology Physics

Pub Date : 2025-02-03 DOI: 10.1016/j.ijrobp.2024.11.046

T. Naiker, A. Groenewald, H. Fakira, B. Smith

Background

Achieving optimal tumor coverage during craniospinal irradiation (CSI) is a challenge. Whilst several critical organs are at risk of radiation-induced toxicity, if target volume structures like the cribriform plate receive less than 95% of the prescribed dose, tumors could recur.

Aim

This single-institution study seeks to establish the most effective craniospinal radiotherapy amongst 3D conformal radiation therapy (CRT), intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) by comparing dosimetry across target volumes, organs at risk (OARs) and total irradiated volume. Time taken for contouring, generation and evaluation of treatment plans, quality assurance and treatment beam delivery is assessed.

Setting

The demographics of patients comprised of six children and one adult who underwent 3D CRT craniospinal radiotherapy at a Western Cape hospital.

Methods

Approval from the Human Research Ethics Committee was obtained. The 3D CRT plan consisted of two parallel opposing lateral fields at the cranial isocenter and a single posterior field at the spinal isocenter. Both the IMRT and VMAT plans comprised three isocenters, one cranial and two spinal, with a total of 15 fields.

Results

Volumetric modulated arc therapy was the most conformal (CI = 0.48) and IMRT the most homogeneous (HI = 0.06). Although the VMAT low-dose bath (58.1%) was highest at 2Gy, OARs were least exposed with VMAT. The total time taken for VMAT was the shortest.

Conclusion

Volumetric modulated arc therapy was recommended as the most effective CSI technique owing to its superior conformality, least OARs exposure and fastest planning times. Clinical investigation into possible late adverse effects arising from the VMAT low-dose bath should be conducted.

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引用次数: 0

In Regard to Woodford and Harden

IF 6.4 1区医学 Q1 ONCOLOGY

International Journal of Radiation Oncology Biology Physics

Pub Date : 2025-02-03 DOI: 10.1016/j.ijrobp.2024.11.083

Thilo Schuler MD , George Hruby MBChB , Shelley Wong MARTP , Stephanie Roderick MMedPhys , Thomas Eade MBChB

引用次数: 0

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