Technical Innovations and Patient Support in Radiation Oncology最新文献

{"title":"Incidental dose to internal mammary nodes in post-operative radiation therapy for breast cancer","authors":"L.Di Lena ,&nbsp;A.W.M. Nielsen ,&nbsp;C.P.L. Fulcheri ,&nbsp;M. Marcantonini ,&nbsp;I. Palumbo ,&nbsp;S. Saldi ,&nbsp;V. Bini ,&nbsp;B.V. Offersen ,&nbsp;C. Aristei","doi":"10.1016/j.tipsro.2025.100346","DOIUrl":"10.1016/j.tipsro.2025.100346","url":null,"abstract":"<div><h3>Aims</h3><div>The incidental dose to the internal mammary nodes (IMN) is understudied in patients treated with newer radiation therapy (RT) techniques. The aim of this study was to quantify the incidental IMN dose in a series of breast cancer (BC) patients receiving post-operative RT to the chest wall/breast and regional nodes (level III-IV).</div></div><div><h3>Methods</h3><div>We retrospectively analyzed data from 95 high-risk BC patients treated between 2015 and 2022. Patients received RT (50 Gy/25fr or 40.05 Gy/15fr) to the breast/chest wall and nodal levels III-IV after mastectomy or breast conserving surgery (BCS). Exclusion criteria were IMN irradiation and pre-operative systemic therapy. One radiation oncologist contoured the CTV_IMN according to ESTRO guidelines and divided it into four sub-regions based on intercostal spaces (ICS): IMNupper, ICS1, ICS2, ICS3. Dosimetric parameters collected were Dmean, V90, V95, D90, and D95. The Dmean was correlated to tumor laterality and location, type of surgery and reconstruction, RT technique (3D-CRT, IMRT, helical RT) and boost.</div></div><div><h3>Results</h3><div>Mean Dmean to IMN was 71.4 % (range 19.6–118.6) of the prescription dose. Among sub-region, ICS2 and ICS3 received significantly higher doses than ICS1 and IMN upper (p = 0.04). V90 of over 90 % was achieved in only 4/95 patients, 3 were treated with helical RT, and the other with IMRT. The mean V95 and V90 were 15.4 % and 26.2 % respectively. Univariate analysis showed that mastectomy (p = 0.002), omission of boost (p = 0.001), and helical RT (p &lt; 0.0001) were associated with significantly higher IMN Dmean. No significant correlation emerged with laterality, tumor location and type of reconstruction.</div></div><div><h3>Conclusions</h3><div>In our series, incidental IMN doses were highest after mastectomy and with helical RT delivery, possibly due to more medial margin in chest wall delineation and the helical dose distribution. Nevertheless, incidental doses to the IMN were below recommended doses, thus highlighting the need for IMN contouring when identified as targets.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"36 ","pages":"Article 100346"},"PeriodicalIF":2.8,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145221916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prospective audit of thoracic reirradiation practice and peer-review in a high-volume academic center","authors":"Geraldine Murphy ,&nbsp;Daniel Tong ,&nbsp;Grace Wu ,&nbsp;B.C. John Cho ,&nbsp;Meredith Giuliani ,&nbsp;Andrew Hope ,&nbsp;Benjamin H. Lok ,&nbsp;Alexander Sun ,&nbsp;Jean-Pierre Bissonnette ,&nbsp;Andrea Bezjak","doi":"10.1016/j.tipsro.2025.100345","DOIUrl":"10.1016/j.tipsro.2025.100345","url":null,"abstract":"<div><h3>Background</h3><div>Reirradiation is an increasingly common challenge with limited prospective evidence to guide practice, which varies internationally. This paper presents the patterns of practice in thoracic reirradiation within a high-volume academic center.</div></div><div><h3>Methods</h3><div>Thoracic reirradiation cases, discussed at the thoracic radiotherapy quality assurance (QA) meeting, were prospectively collected over 12 months between April 2024 and March 2025. Data collected included patient demographics, primary tumor site, details of previous and current planned radiotherapy, the extent and type of overlap and any treatment plan modifications. The data was analyzed using descriptive statistics.</div></div><div><h3>Results</h3><div>85 (18.2 % of 466 cases) reirradiation cases were identified at 26 QA meetings. Most reirradiation plans (68.2 %) were of radical intent, with dose overlap (89.4 %, n = 76). Challenges included unreliable registration of prior radiotherapy datasets (16.5 %) and deciding appropriate plan modifications to improve safety: 24.7 % optimized dose distribution to an OAR, 23.5 % involved dose reductions from standard prescriptions and 15.3 % compromised target volume coverage. The most frequently identified dose-limiting OARs were the proximal bronchial tree, esophagus, and spinal cord. Concerns about a lack of normal tissue recovery arose in 7.1 % of cases. In 10.6 % of cases there was explicit discussion of a dose discount for OARs for presumed partial tissue recovery. Peer-review prompted revision of the treatment plan in 11.8 % of cases.</div></div><div><h3>Conclusion</h3><div>These findings underscore the complexity of thoracic reirradiation and highlight the need for further guidance in the area and the role of QA rounds in optimizing safety and treatment decisions while best practice remains uncertain.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"36 ","pages":"Article 100345"},"PeriodicalIF":2.8,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient perspectives on participation in the Danish Breast Cancer Group Proton Trial: A qualitative research study","authors":"Kristine W. Høgsbjerg ,&nbsp;Anne W. Kristensen ,&nbsp;Mette Møller ,&nbsp;Else Maae ,&nbsp;Maja V. Maraldo ,&nbsp;Louise W. Matthiessen ,&nbsp;Sami Al-Rawi ,&nbsp;Mette H. Nielsen ,&nbsp;Cai Grau ,&nbsp;Birgitte V. Offersen","doi":"10.1016/j.tipsro.2025.100344","DOIUrl":"10.1016/j.tipsro.2025.100344","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Participation in clinical trials is essential to advancing oncological treatments, yet equitable trial access remains challenging. Diverse patient inclusion strengthens external validity and enhances the generalisability of trial outcomes. However, barriers to trial participation persist, and the factors influencing patient enrolment are not fully understood. This study investigates the patient perspective on participation in the Danish Breast Cancer Group (DBCG) Proton Trial.</div></div><div><h3>Materials and methods</h3><div>Patients eligible for the DBCG Proton Trial were invited to participate in interviews. Patients were selected to ensure geographical and perspective-based diversity, including randomised and non-randomised patients from eight radiotherapy clinics in Denmark. Semi-structured interviews were conducted via telephone, transcribed, and analysed using an inductive approach to identify the patient perspective on trial participation.</div></div><div><h3>Results</h3><div>A total of fifteen patients were interviewed. The analysis identified five themes encompassing patients’ motivators and barriers to trial participation: distance to the treatment facility, timing of trial information, decisional support, clinical equipoise and patient needs. These factors were reported by both randomised and non-randomised patients.</div></div><div><h3>Interpretation</h3><div>Participation in the DBCG Proton Trial was determined by both logistical and personal factors. Distance to the proton treatment facility was the most important barrier, while the potential for reduced late effects was the main motivator. The decision was difficult for most patients, often guided by one dominant concern rather than a balanced consideration of multiple factors. These findings suggest that improved trial communication, decisional support, and attention to geographical barriers are essential for promoting equitable participation in clinical trials.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"36 ","pages":"Article 100344"},"PeriodicalIF":2.8,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the first course: Re-irradiation practices in Ontario — Insights from a provincial survey","authors":"Brian Liszewski ,&nbsp;Timothy P Hanna ,&nbsp;Nareesa Ishmail ,&nbsp;Kyle Malkoske ,&nbsp;Laura D’Alimonte ,&nbsp;Jason Pantarotto ,&nbsp;Eric Gutierrez ,&nbsp;Julie Kraus ,&nbsp;Angelica Ramprashad ,&nbsp;Kristin Berry","doi":"10.1016/j.tipsro.2025.100343","DOIUrl":"10.1016/j.tipsro.2025.100343","url":null,"abstract":"<div><div>Re-irradiation is an increasingly important aspect of cancer care, as more patients undergo more complex, multi-course radiation therapy, often across multiple cancer centres. To better understand how re-irradiation is planned and delivered, Ontario Health (Cancer Care Ontario)’s Radiation Treatment Program conducted a provincial review using administrative data and a structured survey of all 15 Regional Cancer Centres (RCC) that provide all radiation therapy to Ontario’s 16 million people. The findings offered insight into current practices, including institutional policies, clinical workflows, technical planning methods, and interprofessional collaboration. As the complexity of care continues to grow, there is a clear need to harmonize these elements across institutions to support the safe, effective, and consistent delivery of re-irradiation. These findings are helping inform system-wide efforts to strengthen coordination and improve quality across the RCCs within Ontario.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"36 ","pages":"Article 100343"},"PeriodicalIF":2.8,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145047860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI based sentiment analysis of online discussions related to cervical brachytherapy","authors":"R. Kouzy ,&nbsp;M.K. Rooney ,&nbsp;E.E. Cha ,&nbsp;S. Vinjamuri ,&nbsp;H. Wu ,&nbsp;Z.El Kouzi ,&nbsp;O. Mohamad ,&nbsp;T.T. Sims ,&nbsp;C.R. Weil ,&nbsp;N. Taku ,&nbsp;L.L. Lin ,&nbsp;A. Jhingran ,&nbsp;P. Eifel ,&nbsp;M. Joyner ,&nbsp;L.E. Colbert ,&nbsp;A.H. Klopp","doi":"10.1016/j.tipsro.2025.100340","DOIUrl":"10.1016/j.tipsro.2025.100340","url":null,"abstract":"<div><h3>Purpose/Objective(s)</h3><div>Few studies have documented the experiences of patients receiving cervical brachytherapy. While evidence regarding quality of life issues in this population has emerged, traditional structured questionnaires often fail to capture the full range of patient perspectives. We hypothesized that analyzing unfiltered patient discussions from online forums would reveal unique insights into patient experiences, including previously unidentified emotional responses, concerns, and coping strategies. This study applied an artificial intelligence (AI) workflow to analyze cervical cancer and brachytherapy discussions from an online forum.</div></div><div><h3>Materials/Methods</h3><div>We extracted posts and comments from the subreddit r/cervicalcancer, focusing on discussions about brachytherapy between November 2020 and January 2024. We applied a processing pipeline to prepare the data for analysis. The content was analyzed using RoBERTa, a pre-trained deep learning model, to categorize sentiments as positive, negative, or neutral. We further evaluated posts using pre-defined keyword tagging to identify dominant topics within conversations based on recent literature.</div></div><div><h3>Results</h3><div>The analysis encompassed 898 unique posts and comments from an initial dataset of 1075 entries. Overall sentiments were categorized as 40.4% positive, 29.9% negative, and 29.7% neutral. Discussions related to “Bowel Domain” showed the highest proportion of negative sentiments (51.2%) among all topics. “Urinary Domain” (46.8%), “Pain” (43.4%), “Fatigue” (42.4%), and “Anesthesia” (41.4%) discussions also reflected predominantly negative sentiments. In contrast, “Recovery” and “Survivorship” discussions were predominantly positive. The sentiments on “Sex” and “Mental Health” related topics displayed a more balanced distribution between positive and negative perspectives.</div></div><div><h3>Conclusion</h3><div>Our study demonstrates the value of analyzing unstructured patient narratives from online forums related to cervical brachytherapy. We identified patterns of concerns that can inform clinical practice, particularly regarding patient education about bowel and urinary side effects. These findings can improve informed consent discussions and help clinicians better address patients’ significant concerns. Further work will focus on developing automated systems to bridge the gap between clinicians’ understanding and patients’ lived experiences.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"36 ","pages":"Article 100340"},"PeriodicalIF":2.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145047859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective review of patient factors impacting free-breathing respiratory motion magnitude for MR-guided radiotherapy","authors":"Mairead Daly ,&nbsp;Holly Egan ,&nbsp;Ananya Choudhury ,&nbsp;Ganesh Radhakrishna ,&nbsp;Cynthia L. Eccles","doi":"10.1016/j.tipsro.2025.100339","DOIUrl":"10.1016/j.tipsro.2025.100339","url":null,"abstract":"<div><div>Patient factors may influence motion management strategy selection for abdominal stereotactic ablative radiotherapy (SABR). This retrospective evaluation investigated the impact of body mass index (BMI), sex, and cirrhosis in 16 patients imaged with cine-magnetic resonance imaging (MRI) on a 1.5 T magnetic resonance linear accelerator (MR Linac). Male patients, those with cirrhosis, and higher BMI tended to exhibit greater motion magnitude, although this was not statistically significant, suggesting that these patients should be prioritised for motion management strategies. Further investigation in larger cohorts is warranted to confirm these trends and guide personalised motion management in abdominal radiotherapy.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"35 ","pages":"Article 100339"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Correspondence by Kleebayoon and Wiwanitkit","authors":"Andreea C. Ciobanu ,&nbsp;Virgil Sivoglo ,&nbsp;Diana Maican ,&nbsp;Ferenc Járai-Szabó ,&nbsp;Zoltán Bálint","doi":"10.1016/j.tipsro.2025.100342","DOIUrl":"10.1016/j.tipsro.2025.100342","url":null,"abstract":"","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"35 ","pages":"Article 100342"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145044368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correspondence on “Custom-made, 3D-printed bolus cap for a case of scalp metastasis: A single-institution study”","authors":"Amnuay Kleebayoon ,&nbsp;Viroj Wiwanitkit","doi":"10.1016/j.tipsro.2025.100341","DOIUrl":"10.1016/j.tipsro.2025.100341","url":null,"abstract":"","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"35 ","pages":"Article 100341"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standard operating procedure (SOP) for immobilisation, scanning, verification and treatment of breast cancer patients undergoing proton beam therapy","authors":"Kathryn Osborn ,&nbsp;Jaymisha Davda ,&nbsp;Rita Simoes ,&nbsp;Michael O’Connor ,&nbsp;Olivia Willis ,&nbsp;Sarah Gulliford ,&nbsp;Syed Ali Moinuddin ,&nbsp;Turmi Patel ,&nbsp;Sarah Petty ,&nbsp;Mahbubl Ahmed ,&nbsp;Thomas Richards ,&nbsp;Sairanne Wickers","doi":"10.1016/j.tipsro.2025.100331","DOIUrl":"10.1016/j.tipsro.2025.100331","url":null,"abstract":"<div><div>The use of proton beam therapy (PBT) for breast cancer is not currently included for standard consideration on the NHS England indication list. However, there are occasions where the use of PBT may be approved in the United Kingdom (UK), such as breast sarcoma, as part of a clinical trial or due to a photon plan meeting a threshold for significant risk of acute and late toxicities (e.g. pre-existing co-morbidities). Due to the beam characteristics, the use of PBT for breast treatment poses challenges in terms of the immobilisation, pre-treatment scanning, treatment verification and delivery. This standard operating procedure (SOP) details strategies to mitigate these that were developed as part of the implementation of breast PBT at our institution. This SOP will support existing and new PBT services when treating this patient cohort, by providing a detailed step-by-step guide to improve consistency and efficiency in the management of breast PBT.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"35 ","pages":"Article 100331"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A standardised workflow to manage the complexity of reirradiation and radiotherapy retreatments in clinical practice","authors":"Madalyne Day,&nbsp;Jonas Willmann,&nbsp;Panagiotis Balermpas,&nbsp;Riccardo Dal Bello,&nbsp;Anja Joye,&nbsp;Laura Motisi,&nbsp;Jens von der Grün,&nbsp;Crystal Sulaiman,&nbsp;Lotte Wilke,&nbsp;Nazanin Rahnama,&nbsp;Matthias Guckenberger,&nbsp;Stephanie Tanadini-Lang,&nbsp;Nicolaus Andratschke","doi":"10.1016/j.tipsro.2025.100336","DOIUrl":"10.1016/j.tipsro.2025.100336","url":null,"abstract":"<div><div>As cancer patients survive longer, the number of radiotherapy retreatments is steadily increasing [<span><span>1</span></span>], requiring laborious review of previous treatments, decisions regarding image registration, dose accumulation and assessment of such composite dose distributions. This work presents the development, and implementation of a standardised dedicated workflow for reirradiation (reRT) and radiotherapy retreatment based on the EORTC/ESTRO consensus on reRT.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"35 ","pages":"Article 100336"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}