Pub Date : 2025-03-01Epub Date: 2024-12-31DOI: 10.1016/j.tipsro.2024.100298
Yolanda Surjan , Sandra Ndarukwa
{"title":"Global professional issues in radiation therapy: Collaboration, adaptation and innovation","authors":"Yolanda Surjan , Sandra Ndarukwa","doi":"10.1016/j.tipsro.2024.100298","DOIUrl":"10.1016/j.tipsro.2024.100298","url":null,"abstract":"","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"33 ","pages":"Article 100298"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143172500","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}
Pub Date : 2024-12-01Epub Date: 2024-08-30DOI: 10.1016/j.tipsro.2024.100273
Siddhant Sen , Ethan Stolen , Jaehee Chun , Jin Sung Kim , James J. Sohn
Due to anatomical changes between pre-planning and implantation, there exists a need for tools that can streamline the adjustment of needle and seed configurations in low dose rate brachytherapy for prostate cancer. Specifically, upon taking a second ultrasound on the day of treatment, the distribution of seeds and needles will differ drastically from the original plan. Clinics that employ this method must then spend time and resources to generate a workflow to manipulate the original configuration to the new configuration. ONCOSEED extracts data from VariSeed treatment plans, calculating a labor score (LScore) to optimize adjustments to needle configurations. A case study of three simulated VariSeed treatment plans was used to compare the ONCOSEED software to the manual method of generating a workflow. In the same method that was used at the authors’ clinic, several assistants annotated by hand the original plan to convert it to the new plan. The time taken to do so was recorded and compared to the runtime of the software when generating a workflow for the same plan. Results showed that ONCOSEED was on average 28 times faster than generating a workflow by hand. ONCOSEED enhances the efficiency of seed replacement in LDR brachytherapy, promoting the adoption of adaptive brachytherapy practices.
{"title":"Optimized needle configuration for operational seed (ONCOSEED) efficiency and deployment for prostate seed implants","authors":"Siddhant Sen , Ethan Stolen , Jaehee Chun , Jin Sung Kim , James J. Sohn","doi":"10.1016/j.tipsro.2024.100273","DOIUrl":"10.1016/j.tipsro.2024.100273","url":null,"abstract":"<div><p>Due to anatomical changes between pre-planning and implantation, there exists a need for tools that can streamline the adjustment of needle and seed configurations in low dose rate brachytherapy for prostate cancer. Specifically, upon taking a second ultrasound on the day of treatment, the distribution of seeds and needles will differ drastically from the original plan. Clinics that employ this method must then spend time and resources to generate a workflow to manipulate the original configuration to the new configuration. ONCOSEED extracts data from VariSeed treatment plans, calculating a labor score (LScore) to optimize adjustments to needle configurations. A case study of three simulated VariSeed treatment plans was used to compare the ONCOSEED software to the manual method of generating a workflow. In the same method that was used at the authors’ clinic, several assistants annotated by hand the original plan to convert it to the new plan. The time taken to do so was recorded and compared to the runtime of the software when generating a workflow for the same plan. Results showed that ONCOSEED was on average 28 times faster than generating a workflow by hand. ONCOSEED enhances the efficiency of seed replacement in LDR brachytherapy, promoting the adoption of adaptive brachytherapy practices.</p></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"32 ","pages":"Article 100273"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405632424000404/pdfft?md5=07aef45c04b54114bac9cc376fd4fd18&pid=1-s2.0-S2405632424000404-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142148227","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}
There is an increase in demand for Radiotherapy (RT) and it is a time critical treatment with a complex scheduling process. RT workflow is inter-dependent and involves various steps including pre-treatment and treatment-related tasks which adds to these challenges. Globally, scheduling delays are reported as one of the most common issues in RT. We aim to create and evaluate an automated strategy which generates a patient allocation list to assist the scheduling staff to create an efficient scheduling process.
Methods and Materials
We used historical data from a large RT department in Sweden from January to December 2022 with 11–13 operational linear accelerators. The algorithm was developed in C# language. It utilizes patient and treatment-related characteristics including the patient timeline (referral date, preferred treatment start dates), booking category, diagnosis group and intent. Based on this, the algorithm assigns patient priority individually.
Results
The algorithm’s output resulted in a scheduling list sorted by high to low patient priority per week. We evaluated the algorithm with historical manual allocations from the same year. The comparison between manual and algorithm allocations showed that the number of delayed patients reduced by 10 % in the algorithm suggestion with an average delay reduction of 2 weeks. Furthermore, the focus on patient-related characteristics resulted in diagnosis groups being better balanced.
Conclusion
The algorithm’s ability to produce quick results may save significant time that the scheduling staff otherwise need to assess individual patient profiles. RT departments can incorporate such algorithms to accelerate their scheduling decisions and enhance their overall scheduling performance before going through major organizational changes.
{"title":"A data-driven approach to solve the RT scheduling problem","authors":"Mruga Gurjar , Jesper Lindberg , Thomas Björk-Eriksson , Caroline Olsson","doi":"10.1016/j.tipsro.2024.100282","DOIUrl":"10.1016/j.tipsro.2024.100282","url":null,"abstract":"<div><h3>Introduction</h3><div>There is an increase in demand for Radiotherapy (RT) and it is a time critical treatment with a complex scheduling process. RT workflow is inter-dependent and involves various steps including pre-treatment and treatment-related tasks which adds to these challenges. Globally, scheduling delays are reported as one of the most common issues in RT. We aim to create and evaluate an automated strategy which generates a patient allocation list to assist the scheduling staff to create an efficient scheduling process.</div></div><div><h3>Methods and Materials</h3><div>We used historical data from a large RT department in Sweden from January to December 2022 with 11–13 operational linear accelerators. The algorithm was developed in C# language. It utilizes patient and treatment-related characteristics including the patient timeline (referral date, preferred treatment start dates), booking category, diagnosis group and intent. Based on this, the algorithm assigns patient priority individually.</div></div><div><h3>Results</h3><div>The algorithm’s output resulted in a scheduling list sorted by high to low patient priority per week. We evaluated the algorithm with historical manual allocations from the same year. The comparison between manual and algorithm allocations showed that the number of delayed patients reduced by 10 % in the algorithm suggestion with an average delay reduction of 2 weeks. Furthermore, the focus on patient-related characteristics resulted in diagnosis groups being better balanced.</div></div><div><h3>Conclusion</h3><div>The algorithm’s ability to produce quick results may save significant time that the scheduling staff otherwise need to assess individual patient profiles. RT departments can incorporate such algorithms to accelerate their scheduling decisions and enhance their overall scheduling performance before going through major organizational changes.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"32 ","pages":"Article 100282"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527428","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}
In 2019, the International Atomic Energy Agency approved a technical co-operation project, aimed at supporting clinical decision making and continuing professional education of radiation oncologists, medical physicists and radiation therapists (RTs) in Low-and-Middle Income Countries (LMICs) in the Asia Pacific region. From this, the Asia-Pacific Radiation Oncology Network (ASPRONET) was formed in 2020. An RT co-ordination group administered 16 online, one-hour seminars between December 2021 and November 2023 for an RT audience. Analysis of online registration and attendance data from each seminar was used to co-ordinate group review meetings, improve seminar proceedings, and promote attendance and engagement. 772 attendees from 20 different countries were recorded in total across the seminars. Gathered data and observations indicated the success of the seminars and supported their continuation.
{"title":"ASPRONET: A facilitated online education project for radiation therapists in the Asia-Pacific region","authors":"Craig Opie , Aidan Leong , Chetana Vartak , Iain Ward , Sandra Ndarukwa","doi":"10.1016/j.tipsro.2024.100283","DOIUrl":"10.1016/j.tipsro.2024.100283","url":null,"abstract":"<div><div>In 2019, the International Atomic Energy Agency approved a technical co-operation project, aimed at supporting clinical decision making and continuing professional education of radiation oncologists, medical physicists and radiation therapists (RTs) in Low-and-Middle Income Countries (LMICs) in the Asia Pacific region. From this, the Asia-Pacific Radiation Oncology Network (ASPRONET) was formed in 2020.<!--> <!-->An RT co-ordination group administered 16 online, one-hour seminars between December 2021 and November 2023 for an RT audience. Analysis of online registration and attendance data from each seminar was used to co-ordinate group review meetings, improve seminar proceedings, and promote attendance and engagement.<!--> <!-->772 attendees from 20 different countries were recorded in total across the seminars. Gathered data and observations indicated the success of the seminars and supported their continuation.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"32 ","pages":"Article 100283"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527429","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}
Pub Date : 2024-12-01Epub Date: 2024-09-06DOI: 10.1016/j.tipsro.2024.100276
Bailey A. Loving, Allison J. Hazy, Kamran F. Salari, Hong Ye, Shaveena Sivapalan, Jacob F. Oyeniyi, Elizabeth Rutka, John M. Robertson
Purpose
Despite the importance of patient satisfaction (PS) on healthcare outcomes, the factors that influence PS in radiation oncology remain unexplored. This study assesses the influence of socioeconomic status (SES) on PS in radiation oncology, using the Area Deprivation Index (ADI) as a measure of SES.
Methods
This single-institution cross-sectional study used the National Research Council (NRC) PS survey at four radiation oncology sites from 2021 to 2023. SES was measured using ADI data from the Neighborhood Atlas. Univariate (UVA) and multivariable (MVA) logistic regression analyses were conducted on recommendation scores (0–10 scale, with 9 or higher indicating a likelihood to recommend).
Results
In our analysis of 7,501 survey responses, most patients were female (55.3 %), had curative treatment intent (81.5 %), and were diagnosed with breast cancer (30.4 %), with most being follow-up visits (69.0 %). Average scores for state and national ADI were 3.94 and 50.75, respectively. UVA identified factors such as curative intent (OR 1.68, p < 0.001), follow-up visits (OR 1.69, p < 0.001), and breast cancer diagnosis (OR 1.42, p = 0.018) as enhancing the likelihood of recommending the facility or provider. Those with a national ADI above the mean showed lower propensity to recommend the facility (OR 0.81, p = 0.050) or provider (OR 0.71, p = 0.002). MVA confirmed the significance of national ADI on provider recommendations (OR 0.730, p = 0.005) but not facility recommendations (OR 0.832, p = 0.089).
Conclusion
Patients facing higher SES disadvantages are less inclined to recommend their healthcare provider. These results highlight the role of SES in PS assessments and advocate for further investigation into how SES impacts PS and patient-provider relationships.
{"title":"Socioeconomic disadvantage and its impact on patient satisfaction at a multi-site radiation oncology center","authors":"Bailey A. Loving, Allison J. Hazy, Kamran F. Salari, Hong Ye, Shaveena Sivapalan, Jacob F. Oyeniyi, Elizabeth Rutka, John M. Robertson","doi":"10.1016/j.tipsro.2024.100276","DOIUrl":"10.1016/j.tipsro.2024.100276","url":null,"abstract":"<div><h3>Purpose</h3><p>Despite the importance of patient satisfaction (PS) on healthcare outcomes, the factors that influence PS in radiation oncology remain unexplored. This study assesses the influence of socioeconomic status (SES) on PS in radiation oncology, using the Area Deprivation Index (ADI) as a measure of SES.</p></div><div><h3>Methods</h3><p>This single-institution cross-sectional study used the National Research Council (NRC) PS survey at four radiation oncology sites from 2021 to 2023. SES was measured using ADI data from the Neighborhood Atlas. Univariate (UVA) and multivariable (MVA) logistic regression analyses were conducted on recommendation scores (0–10 scale, with 9 or higher indicating a likelihood to recommend).</p></div><div><h3>Results</h3><p>In our analysis of 7,501 survey responses, most patients were female (55.3 %), had curative treatment intent (81.5 %), and were diagnosed with breast cancer (30.4 %), with most being follow-up visits (69.0 %). Average scores for state and national ADI were 3.94 and 50.75, respectively. UVA identified factors such as curative intent (OR 1.68, p < 0.001), follow-up visits (OR 1.69, p < 0.001), and breast cancer diagnosis (OR 1.42, p = 0.018) as enhancing the likelihood of recommending the facility or provider. Those with a national ADI above the mean showed lower propensity to recommend the facility (OR 0.81, p = 0.050) or provider (OR 0.71, p = 0.002). MVA confirmed the significance of national ADI on provider recommendations (OR 0.730, p = 0.005) but not facility recommendations (OR 0.832, p = 0.089).</p></div><div><h3>Conclusion</h3><p>Patients facing higher SES disadvantages are less inclined to recommend their healthcare provider. These results highlight the role of SES in PS assessments and advocate for further investigation into how SES impacts PS and patient-provider relationships.</p></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"32 ","pages":"Article 100276"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S240563242400043X/pdfft?md5=88efb89a04100f6514f2cffd0fe7aaf5&pid=1-s2.0-S240563242400043X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142163457","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}
Pub Date : 2024-12-01Epub Date: 2024-10-19DOI: 10.1016/j.tipsro.2024.100281
Mary Coffey , Colleen Dickie , Elena Fidarova , Velimir Karadža , Philipp Scherer , Michelle Leech
The European Society of Radiotherapy and Oncology (ESTRO) and the International Atomic Energy Agency (IAEA) project on ‘best practice in radiation oncology: a project to train the radiation therapist trainers’ commenced in 2008.
The aim of the project was to influence education programmes throughout, mainly, eastern Europe to increase the radiation therapy-specific education of their programmes. This is to enable graduates of these programmes to be radiation therapists that are fit for purpose in the clinic. This paper provides an update on the successes of the project to date, the challenges that remain and the new approaches to project delivery by the faculty over this period.
{"title":"Best practice in radiation oncology: A project to train the trainers: Review of 2008–2023","authors":"Mary Coffey , Colleen Dickie , Elena Fidarova , Velimir Karadža , Philipp Scherer , Michelle Leech","doi":"10.1016/j.tipsro.2024.100281","DOIUrl":"10.1016/j.tipsro.2024.100281","url":null,"abstract":"<div><div>The European Society of Radiotherapy and Oncology (ESTRO) and the International Atomic Energy Agency (IAEA) project on ‘best practice in radiation oncology: a project to train the radiation therapist trainers’ commenced in 2008.</div><div>The aim of the project was to influence education programmes throughout, mainly, eastern Europe to increase the radiation therapy-specific education of their programmes. This is to enable graduates of these programmes to be radiation therapists that are fit for purpose in the clinic. This paper provides an update on the successes of the project to date, the challenges that remain and the new approaches to project delivery by the faculty over this period.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"32 ","pages":"Article 100281"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142537506","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}
Pub Date : 2024-12-01Epub Date: 2024-11-17DOI: 10.1016/j.tipsro.2024.100293
Ntumsi Akundoh Tontu , William W.Y. Cheung , Marcus Jones , Linda Grossheim , Dennis Palmer , Earnest Chukwudi N. Okonkwo , Eric Moore , Keith Streatfield , Laurie Elit
Although radiotherapy is critical for cancer cure and palliation, access to such expensive and sophisticated technology is very limited in low- and middle-income countries (LMIC). Cancer incidence in Africa is currently 1.5 million case per year, thus urgent and innovative solutions are required to build necessary infrastructure needed to address this global health challenge. We describe our approach and challenges as a faith based non-government organization in setting up a modern radiotherapy department in a rural hospital in Cameroon to mitigate this unmet need. We highlite our engagement with international bodies and individuals for fund raising and volunteerism, local radiotherapy workforce development and training (radiation oncology, dosimetrists, radiation therapist and medical physicists) and the expertise required for construction of the bunker and installation of the Linac machine.
{"title":"Developing a modern radiotherapy department in a rural hospital in Cameroon: The Mbingo experience","authors":"Ntumsi Akundoh Tontu , William W.Y. Cheung , Marcus Jones , Linda Grossheim , Dennis Palmer , Earnest Chukwudi N. Okonkwo , Eric Moore , Keith Streatfield , Laurie Elit","doi":"10.1016/j.tipsro.2024.100293","DOIUrl":"10.1016/j.tipsro.2024.100293","url":null,"abstract":"<div><div>Although radiotherapy is critical for cancer cure and palliation, access to such expensive and sophisticated technology is very limited in low- and middle-income countries (LMIC). Cancer incidence in Africa is currently 1.5 million case per year, thus urgent and innovative solutions are required to build necessary infrastructure needed to address this global health challenge. We describe our approach and challenges as a faith based non-government organization in setting up a modern radiotherapy department in a rural hospital in Cameroon to mitigate this unmet need. We highlite our engagement with international bodies and individuals for fund raising and volunteerism, local radiotherapy workforce development and training (radiation oncology, dosimetrists, radiation therapist and medical physicists) and the expertise required for construction of the bunker and installation of the Linac machine.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"32 ","pages":"Article 100293"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142701654","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}
To study the local control, toxicity, organ and functional preservation and cosmetic outcomes after interstitial brachytherapy for periocular nonmelanoma skin cancers.
Methods and Materials
Patients with skin cancers of upper and lower eyelid, medial and lateral canthus and the infra-orbital region treated with high dose rate (HDR) interstitial brachytherapy (ISBT) using 192-Iridium (192Ir) between December 2010 and July 2022 were included and data collected from a prospectively maintained database. Local control, survival outcomes, acute and late RTOG toxicity, functional and cosmetic outcomes were analysed.
Results
Sixteen patients were included. Nine patients had lower eyelid tumors, 5 patients had tumors in canthi and two patients had skin tumor in the infra-orbital region. The median dose for definitive ISBT was 49 Gy in 14 fractions. After a median follow up of 73 months, all patients treated with definitive and adjuvant ISBT were locally controlled. Three of the four patients who received salvage ISBT for post-surgical failure had local recurrences and all were effectively managed with salvage re-surgery. Of the two deaths, none were disease related. Organ and function preservation was achieved in 15 (93.7 %) and 13 (81.2 %), respectively, with one patient being lost to follow up. Excellent, good, fair and poor cosmesis was seen in 6 (40 %) patients, 6 (40 %) patients, 2 (14 %) patients and 1(6 %) patient, respectively.
Conclusion
HDR-ISBT was safe and effective for skin tumors around the eye and resulted in excellent local control and survival outcomes preserving organ and function in majority of patients with good-excellent cosmesis.
{"title":"Interstitial brachytherapy for periocular nonmelanoma skin cancers: Impact on organ and function preservation","authors":"Ashwini Budrukkar , Maneesh Singh , Monali Swain , Sarbani Ghosh Laskar , Vedang Murthy , Shrikant Kale , Rituraj Upreti , Shwetabh Sinha , Anuj Kumar , Samarpita Mohanty , Tejpal Gupta , Jai Prakash Agarwal","doi":"10.1016/j.tipsro.2024.100280","DOIUrl":"10.1016/j.tipsro.2024.100280","url":null,"abstract":"<div><h3>Purpose</h3><div>To study the local control, toxicity, organ and functional preservation and cosmetic outcomes after interstitial brachytherapy for periocular nonmelanoma skin cancers.</div></div><div><h3>Methods and Materials</h3><div>Patients with skin cancers of upper and lower eyelid, medial and lateral canthus and the infra-orbital region treated with high dose rate (HDR) interstitial brachytherapy (ISBT) using 192-Iridium (<sup>192</sup>Ir) between December 2010 and July 2022 were included and data collected from a prospectively maintained database. Local control, survival outcomes, acute and late RTOG toxicity, functional and cosmetic outcomes were analysed.</div></div><div><h3>Results</h3><div>Sixteen patients were included. Nine patients had lower eyelid tumors, 5 patients had tumors in canthi and two patients had skin tumor in the infra-orbital region. The median dose for definitive ISBT was 49 Gy in 14 fractions. After a median follow up of 73 months, all patients treated with definitive and adjuvant ISBT were locally controlled. Three of the four patients who received salvage ISBT for post-surgical failure had local recurrences and all were effectively managed with salvage re-surgery. Of the two deaths, none were disease related. Organ and function preservation was achieved in 15 (93.7 %) and 13 (81.2 %), respectively, with one patient being lost to follow up. Excellent, good, fair and poor cosmesis was seen in 6 (40 %) patients, 6 (40 %) patients, 2 (14 %) patients and 1(6 %) patient, respectively.</div></div><div><h3>Conclusion</h3><div>HDR-ISBT was safe and effective for skin tumors around the eye and resulted in excellent local control and survival outcomes preserving organ and function in majority of patients with good-excellent cosmesis.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"32 ","pages":"Article 100280"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142416383","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}
Pub Date : 2024-12-01Epub Date: 2024-09-25DOI: 10.1016/j.tipsro.2024.100277
Julien Pierrard , Sofie Heylen , Ad Vandermeulen , Geneviève Van Ooteghem
Introduction
Intra- and inter-fraction rectum motion is important for pelvic radiotherapy (RT). This study assesses how RT session duration, the presence or the absence of an intra-rectal tumour, and the distance from the anorectal junction (ARJd) impact rectal motion.
Materials and methods
Analyses used cone-beam computed tomographies (CBCTs) from RT patients treated for rectal and prostate cancer. Three structures were evaluated: (1) the entire rectum in patients without a rectal tumour (RectumProstate); (2) the non-invaded portion (RectumRectum) and (3) the tumour-invaded portion (RectumTumour) in rectal cancer patients.
Intrafraction motion was assessed using the Hausdorff distance 95% and the Mean distance-to-agreement between structures delineated on the first CBCT and the 2 subsequent CBCTs within a same RT session. Interfraction motion was quantified by comparing structures delineated on the planning-CT and the first CBCT of each session.
Linear mixed model evaluated rectum motion in relation to time, tumour presence, and ARJd, respectively.
Results
We included 10 patients with and 10 without rectal cancer, collecting 385 CBCTs. A significant correlation (p < 0.05) between rectum motion and RT session duration was found. Intrafraction motion was significantly higher in prostate cancer patients (RectumProstate motion > RectumRectum and RectumTumour, p < 0.01). For interfraction motion, only the mean distance to agreement was significantly higher for RectumProstate (p < 0.05). Motion increased significantly with ARJd for all three structures (p < 0.001).
Conclusions
Session duration, absence of a tumour, and ARJd are associated with larger intra- and interfraction rectal motion. This highlights the need for tailored RT treatment, including online-adaptive RT, to manage intra- and interfraction variations. Rectal motion should be handled differently for patients with prostate cancer and those with rectal cancer.
{"title":"Dealing with rectum motion during radiotherapy: How can we anticipate it?","authors":"Julien Pierrard , Sofie Heylen , Ad Vandermeulen , Geneviève Van Ooteghem","doi":"10.1016/j.tipsro.2024.100277","DOIUrl":"10.1016/j.tipsro.2024.100277","url":null,"abstract":"<div><h3>Introduction</h3><div>Intra- and inter-fraction rectum motion is important for pelvic radiotherapy (RT). This study assesses how RT session duration, the presence or the absence of an intra-rectal tumour, and the distance from the anorectal junction (ARJd) impact rectal motion.</div></div><div><h3>Materials and methods</h3><div>Analyses used cone-beam computed tomographies (CBCTs) from RT patients treated for rectal and prostate cancer. Three structures were evaluated: (1) the entire rectum in patients without a rectal tumour (Rectum<sub>Prostate</sub>); (2) the non-invaded portion (Rectum<sub>Rectum</sub>) and (3) the tumour-invaded portion (Rectum<sub>Tumour</sub>) in rectal cancer patients.</div><div>Intrafraction motion was assessed using the Hausdorff distance 95% and the Mean distance-to-agreement between structures delineated on the first CBCT and the 2 subsequent CBCTs within a same RT session. Interfraction motion was quantified by comparing structures delineated on the planning-CT and the first CBCT of each session.</div><div>Linear mixed model evaluated rectum motion in relation to time, tumour presence, and ARJd, respectively.</div></div><div><h3>Results</h3><div>We included 10 patients with and 10 without rectal cancer, collecting 385 CBCTs. A significant correlation (p < 0.05) between rectum motion and RT session duration was found. Intrafraction motion was significantly higher in prostate cancer patients (Rectum<sub>Prostate</sub> motion > Rectum<sub>Rectum</sub> and Rectum<sub>Tumour</sub>, p < 0.01). For interfraction motion, only the mean distance to agreement was significantly higher for Rectum<sub>Prostate</sub> (p < 0.05). Motion increased significantly with ARJd for all three structures (p < 0.001).</div></div><div><h3>Conclusions</h3><div>Session duration, absence of a tumour, and ARJd are associated with larger intra- and interfraction rectal motion. This highlights the need for tailored RT treatment, including online-adaptive RT, to manage intra- and interfraction variations. Rectal motion should be handled differently for patients with prostate cancer and those with rectal cancer.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"32 ","pages":"Article 100277"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142326870","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}
Pub Date : 2024-12-01Epub Date: 2024-11-10DOI: 10.1016/j.tipsro.2024.100288
Lucinda Morris , Sandra Turner , Jane L. Phillips , Anamika Parmar , Meera Agar
Purpose
To identify potential gaps in geriatric radiation oncology (RO) education worldwide, as measured by geriatric oncology (GO) content within postgraduate RO training program (TP) curricula across 8 focus countries.
Methods and materials
The need for improved education around GO is internationally recognized and is a key strategic priority of the International Society of Geriatric Oncology (SIOG).
Two reviewers undertook a systematic scoping review from March to September 2023. Focus countries were selected using predefined selection criteria based on national radiation therapy (RT) service provision, RT access and post-graduate specialty training standards. This review is in accordance with evidence-based curriculum design methodology and represents the initial phase i.e., problem identification and needs assessment.
Results
Overall RO TP and curriculum elements varied by jurisdiction. Common elements included length of training, summative assessments and prerequisite requirements. Considerable variability exists across TPs around identified learning outcomes, content, TP organization, training networks and accreditation.
Across 6 TPs, only 2 had any documented GO curriculum content. Of these, only one contained geriatric RO content scoring moderate to high based on accepted quality benchmarks. Outside official RO TPs, there is considerable GO online education content, including face to face courses, peer-reviewed articles, learning materials and resources relevant to RO postgraduate training worldwide. However accessibility to these learning interventions may be region specific and content is not standardized.
Conclusions
As expected, this systematic scoping review has identified significant gaps in GO education within RO TPs worldwide. These findings represent an essential step in the development of evidence-based recommendations for updating standards for GO training within RO training programs and establishing a globally accepted, standardized benchmarks for minimal geriatric RO education. In turn, this will ensure future radiation oncologists are able to deliver a high standard of care to and improve outcomes for older people with cancer.
目的根据8个重点国家的放射肿瘤学研究生培训计划（TP）课程中的老年肿瘤学（GO）内容，确定全球老年放射肿瘤学（RO）教育的潜在差距。方法和材料围绕老年肿瘤学改进教育的必要性已得到国际公认，并且是国际老年肿瘤学会（SIOG）的一项关键战略重点。根据国家放射治疗（RT）服务提供情况、放射治疗普及率和研究生专业培训标准，采用预定义的选择标准选定了重点国家。本次审查符合循证课程设计方法，是问题识别和需求评估的初始阶段。共同要素包括培训时间、终结性评估和前提要求。在 6 个培训方案中，只有 2 个有记录的全球老年医学课程内容。在 6 个培训课程中，只有 2 个有记录的 GO 课程内容，其中只有一个包含老年 RO 内容，根据公认的质量基准，得分在中等到高等之间。在官方的 RO 培训课程之外，还有大量的 GO 在线教育内容，包括面对面课程、同行评审文章、学习材料以及与全球 RO 研究生培训相关的资源。然而，这些学习干预措施的可及性可能因地区而异，而且内容也没有标准化。这些发现代表了在制定循证建议方面迈出的重要一步，这些建议旨在更新区域放射治疗培训计划中的全球放射治疗培训标准，并为最低限度的老年区域放射治疗教育建立全球公认的标准化基准。反过来，这将确保未来的放射肿瘤学家能够为老年癌症患者提供高标准的治疗，并改善治疗效果。
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