Pub Date : 2023-01-06DOI: 10.1017/S1460396922000401
M. Trombetta, J. Verhoeff
recep-tor, and the Notch pathway regulates cell proliferation and cell death. In cardiomyocytes, Notch activation reprogrammes/reacti-vates cells contributing to electrical stability.
{"title":"STereotactic Arrhythmia Radioablation: current status of the art. The old world and the new world connected","authors":"M. Trombetta, J. Verhoeff","doi":"10.1017/S1460396922000401","DOIUrl":"https://doi.org/10.1017/S1460396922000401","url":null,"abstract":"recep-tor, and the Notch pathway regulates cell proliferation and cell death. In cardiomyocytes, Notch activation reprogrammes/reacti-vates cells contributing to electrical stability.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42099325","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}
Pub Date : 2023-01-01DOI: 10.1017/s1460396923000316
Takayuki Harada, Akihiro Takemura
Abstract Introduction: In image-guided radiotherapy (IGRT), the imaging conditions of computed tomography (CT) may impact the positioning uncertainty, but verification methods are currently unavailable. This study aimed to propose a validation method for the imaging conditions of helical CT for IGRT. Predicting the impact of image distortion on image guidance may reduce uncertainty in radiotherapy planning. Methods: Image guidance was performed on the reference images of four Duracon balls by changing the imaging conditions and the positions on the CT images by helical scanning. The predictors of image guidance error and those of the contour mismatch between the reference and cone-beam CT (CBCT) images were analysed. Results: The image guidance error exceeded 1 mm when the contour centre of the ball was shifted by more than 1 mm. The mismatch between the contours of the reference and CBCT images occurred with the imaging conditions wherein the first slice of the ball was distorted. Conclusions: Mismatch can be predicted by the coefficient of variation of the radii in the first and centre slices of the ball. Moreover, the image guidance error can be predicted by the contour centre shift of the ball.
{"title":"Distortion verification of helical computed tomography for image-guided radiotherapy","authors":"Takayuki Harada, Akihiro Takemura","doi":"10.1017/s1460396923000316","DOIUrl":"https://doi.org/10.1017/s1460396923000316","url":null,"abstract":"Abstract Introduction: In image-guided radiotherapy (IGRT), the imaging conditions of computed tomography (CT) may impact the positioning uncertainty, but verification methods are currently unavailable. This study aimed to propose a validation method for the imaging conditions of helical CT for IGRT. Predicting the impact of image distortion on image guidance may reduce uncertainty in radiotherapy planning. Methods: Image guidance was performed on the reference images of four Duracon balls by changing the imaging conditions and the positions on the CT images by helical scanning. The predictors of image guidance error and those of the contour mismatch between the reference and cone-beam CT (CBCT) images were analysed. Results: The image guidance error exceeded 1 mm when the contour centre of the ball was shifted by more than 1 mm. The mismatch between the contours of the reference and CBCT images occurred with the imaging conditions wherein the first slice of the ball was distorted. Conclusions: Mismatch can be predicted by the coefficient of variation of the radii in the first and centre slices of the ball. Moreover, the image guidance error can be predicted by the contour centre shift of the ball.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135700474","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}
Pub Date : 2023-01-01DOI: 10.1017/s1460396923000262
David Flinton, Ricardo Khine, Liam Mannion, Chris O’Sullivan, Pam Cherry
Abstract Introduction: Educational gamification is the introduction of game elements into other activities such as teaching and learning. VERT is a tool in therapeutic radiography that lends itself to gamification as it allows students to experiment and learn at no risk to the patient. The aim of this study was to evaluate the use of a gamified simulation using competitive task elements. Method: A total of 78 participants undertook the study which involved a demonstration and practice patient set-up followed by an unassisted timed patient set-up. Once complete the students score was added to a leaderboard. Results: Results show very good students’ feedback on the simulation elements, and that skills were transferable and would improve clinical performance. Gender differences were observed in the competitive feedback on two items, satisfaction from competing and competition encouraging performance. Conclusion: Overall the competitive aspect was viewed positively by students, although females appeared to enjoy the competitive aspects less than the male students, deriving significantly less satisfaction from the competitive element of the simulation. Despite the emphasis on teamwork within the profession, competitive gamification does appear to have a role within the undergraduate curriculum if carried out correctly.
{"title":"Gamification in radiotherapy education: adopting competitive task elements in simulation using the virtual environment of a radiotherapy treatment room (VERT) system","authors":"David Flinton, Ricardo Khine, Liam Mannion, Chris O’Sullivan, Pam Cherry","doi":"10.1017/s1460396923000262","DOIUrl":"https://doi.org/10.1017/s1460396923000262","url":null,"abstract":"Abstract Introduction: Educational gamification is the introduction of game elements into other activities such as teaching and learning. VERT is a tool in therapeutic radiography that lends itself to gamification as it allows students to experiment and learn at no risk to the patient. The aim of this study was to evaluate the use of a gamified simulation using competitive task elements. Method: A total of 78 participants undertook the study which involved a demonstration and practice patient set-up followed by an unassisted timed patient set-up. Once complete the students score was added to a leaderboard. Results: Results show very good students’ feedback on the simulation elements, and that skills were transferable and would improve clinical performance. Gender differences were observed in the competitive feedback on two items, satisfaction from competing and competition encouraging performance. Conclusion: Overall the competitive aspect was viewed positively by students, although females appeared to enjoy the competitive aspects less than the male students, deriving significantly less satisfaction from the competitive element of the simulation. Despite the emphasis on teamwork within the profession, competitive gamification does appear to have a role within the undergraduate curriculum if carried out correctly.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136302704","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}
Abstract Purpose: To analyse the dosimetric benefit of the hybrid inverse planning optimisation (HIPO) planning method over the graphical optimisation (GrO) planning method for 3D volume-based intravaginal brachytherapy (IVBT) in a mono-centre patient cohort. Material and methods: Twenty-five patients surgically staged with endometrial cancer were considered for the study. All the patients had received adjuvant IVBT for three fractions with one-time computed tomography image-based planning. The data on the patient, tumour, plan, and treatment characteristics were retrieved from the database. All the plans were re-optimised with GrO and HIPO techniques for this comparison study. The different dosimetric parameters were compared between the two methods, and the collected data were tabulated and shown graphically. The statistical evaluation was performed with IBM SPSS version 26, and Origin Pro 8.5 was employed for plots. Results: HIPO plans show similar target coverage in terms of D 90(%) , V 95(%) and conformity index with no significant statistical difference from the GrO plans with an acceptable increase in homogeneity index (0·087 ± 0·062%). It succeeds in achieving a statistically significant reduction of dose to organs at risk such as D0·1 cc, D1·0 cc and D2·0 cc for the bladder (11·59%, 4·8% and 3·99%), rectum (41·33%, 16·9% and 16·05%) and sigmoid (20·97%, 13·53% and 11·21%), respectively, in comparison with GrO optimisation. Conclusion: Considering the dosimetric outcome of 3D-based IVBT, it is suggested to adopt inverse optimisation techniques like HIPO over GrO to achieve higher quality treatment plan in terms of adequate target dose and lesser dose to OARs.
目的:在单中心患者队列中，分析基于三维体积的阴道内近距离放射治疗(IVBT)中，混合逆规划优化(HIPO)规划方法比图形优化(GrO)规划方法的剂量学效益。材料和方法:25例手术分期的子宫内膜癌患者被纳入研究。所有患者均接受了三次辅助IVBT，并进行了一次基于计算机断层成像的计划。从数据库中检索患者、肿瘤、计划和治疗特征的数据。采用GrO和HIPO技术对所有方案进行重新优化。比较两种方法的不同剂量学参数，并将收集到的数据制成表格并以图形显示。采用IBM SPSS version 26进行统计评价，绘图采用Origin Pro 8.5。结果:HIPO计划在d90(%)、v95(%)和符合性指数方面的目标覆盖率与GrO计划相似，均质性指数增加可接受(0.087±0.062%)，差异无统计学意义。与GrO优化相比，它成功地实现了具有统计学意义的危险器官剂量减少，例如膀胱(11.59%，4.8%和3.99%)，直肠(41.33%，16.9%和16.05%)和乙状结肠(20.97%，13.53%和11.21%)的d0.1 cc, D1·0 cc和D2·0 cc。结论:考虑到3d IVBT的剂量学结果，建议采用HIPO over GrO等逆优化技术，在靶剂量充足、桨叶剂量较小的情况下获得更高质量的治疗方案。
{"title":"Single catheter 3D volume-based hybrid inverse planning optimisation in IVBT can improve organ sparing","authors":"Bijay Kumar Barik, Juliepriya Jena, Dillip Kumar Sahoo, Anupam Kumar Muraleedharan, Santosh Kumar Parida, Bikash Ranjan Mohapatra, Sandip Kumar Barik, Deepak Kumar Das, Saroj Kumar Das Majumdar, Dillip Kumar Parida","doi":"10.1017/s1460396923000353","DOIUrl":"https://doi.org/10.1017/s1460396923000353","url":null,"abstract":"Abstract Purpose: To analyse the dosimetric benefit of the hybrid inverse planning optimisation (HIPO) planning method over the graphical optimisation (GrO) planning method for 3D volume-based intravaginal brachytherapy (IVBT) in a mono-centre patient cohort. Material and methods: Twenty-five patients surgically staged with endometrial cancer were considered for the study. All the patients had received adjuvant IVBT for three fractions with one-time computed tomography image-based planning. The data on the patient, tumour, plan, and treatment characteristics were retrieved from the database. All the plans were re-optimised with GrO and HIPO techniques for this comparison study. The different dosimetric parameters were compared between the two methods, and the collected data were tabulated and shown graphically. The statistical evaluation was performed with IBM SPSS version 26, and Origin Pro 8.5 was employed for plots. Results: HIPO plans show similar target coverage in terms of D 90(%) , V 95(%) and conformity index with no significant statistical difference from the GrO plans with an acceptable increase in homogeneity index (0·087 ± 0·062%). It succeeds in achieving a statistically significant reduction of dose to organs at risk such as D0·1 cc, D1·0 cc and D2·0 cc for the bladder (11·59%, 4·8% and 3·99%), rectum (41·33%, 16·9% and 16·05%) and sigmoid (20·97%, 13·53% and 11·21%), respectively, in comparison with GrO optimisation. Conclusion: Considering the dosimetric outcome of 3D-based IVBT, it is suggested to adopt inverse optimisation techniques like HIPO over GrO to achieve higher quality treatment plan in terms of adequate target dose and lesser dose to OARs.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136366372","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}
Pub Date : 2023-01-01DOI: 10.1017/s1460396923000389
A Aziz Sait, Glenn W. Jones, Nikhil Rastogi, Rebecca Mathew, Sunil Mani, Jason Berilgen
Abstract Introduction: A small number of studies have confirmed the advantage of generalised equivalent uniform dose (gEUD) optimisation for some standard clinical scenarios; however, its performance with complicated stereotactic treatments is yet to be explored. Therefore, this study compared two planning optimisation methods, gEUD and Physical dose, in stereotactic treatments for several complex anatomical locations. Methods: Thirty patients were selected, ten each for sites of brain, lung and spine. Two stereotactic plans were generated for each case using the gEUD objective and Physical objective cost functions. Within each of the three sites, dosimetric indices for conformity, gradient and homogeneity, along with parameters of monitor units and dose–volume histograms (DVHs), were compared for statistical significance. Additionally, patient-specific quality assurance was conducted using portal dosimetry, and the gamma passing rate between the two plans was evaluated. Results: Optimisation was better with a gEUD objective as compared with Physical objective, notably sparing critical organs. Overall, the differences in mean values for six critical organs at risk favoured gEUD-based over Physical-based plans (all six 2-tailed p -values were < 0·0002). Furthermore, all differences in mean values for DVH parameters favoured gEUD-based plans: GTVmean, GTVmax, PTVD100V, homogeneity index, gradient index and monitor unit (treatment time) (each 2-tailed p < 0·05). Conclusions: gEUD optimisation in stereotactic treatment plans has a clear and general statistical advantage over Physical dose optimisation.
{"title":"Potential advantages of gEUD optimisation as compared with conventional physical optimisation for stereotactic treatment planning","authors":"A Aziz Sait, Glenn W. Jones, Nikhil Rastogi, Rebecca Mathew, Sunil Mani, Jason Berilgen","doi":"10.1017/s1460396923000389","DOIUrl":"https://doi.org/10.1017/s1460396923000389","url":null,"abstract":"Abstract Introduction: A small number of studies have confirmed the advantage of generalised equivalent uniform dose (gEUD) optimisation for some standard clinical scenarios; however, its performance with complicated stereotactic treatments is yet to be explored. Therefore, this study compared two planning optimisation methods, gEUD and Physical dose, in stereotactic treatments for several complex anatomical locations. Methods: Thirty patients were selected, ten each for sites of brain, lung and spine. Two stereotactic plans were generated for each case using the gEUD objective and Physical objective cost functions. Within each of the three sites, dosimetric indices for conformity, gradient and homogeneity, along with parameters of monitor units and dose–volume histograms (DVHs), were compared for statistical significance. Additionally, patient-specific quality assurance was conducted using portal dosimetry, and the gamma passing rate between the two plans was evaluated. Results: Optimisation was better with a gEUD objective as compared with Physical objective, notably sparing critical organs. Overall, the differences in mean values for six critical organs at risk favoured gEUD-based over Physical-based plans (all six 2-tailed p -values were < 0·0002). Furthermore, all differences in mean values for DVH parameters favoured gEUD-based plans: GTVmean, GTVmax, PTVD100V, homogeneity index, gradient index and monitor unit (treatment time) (each 2-tailed p < 0·05). Conclusions: gEUD optimisation in stereotactic treatment plans has a clear and general statistical advantage over Physical dose optimisation.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135102817","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}
Pub Date : 2023-01-01DOI: 10.1017/s146039692300033x
Asmaa M. Ali, Jason B. Greenwood, Mohammad Varasteh, Sergio Esteve, Prakash Jeevanandam, Fabian Göpfert, Denise M. Irvine, Alan R. Hounsell, Conor K. McGarry
Abstract Introduction: Stereotactic ablative radiotherapy (SABR) is susceptible to challenges for tumours affected by intrafraction organ motion. This study aims to investigate the effect of breathing characteristics and plan complexity on the interplay effect. Methods: A patient-specific interplay effect evaluation was performed using in-house software with an alpha version of the treatment planning verification software Verisoft (PTW-Freiburg, Germany) on VMAT plans. The OCTAVIUS 4D phantom was used to acquire the static dose distribution, and the simulation approach was utilised to generate the moving dose distribution. The influence of plan complexity, PTV size, number of breaths, and motion amplitudes on the interplay effect were examined. The dose distribution of two extreme phases—end-inhale and end-exhale—was considered using the gamma criteria of 2%/2 mm for the interplay effect evaluation. Results: A strong correlation was found between the motion amplitude ( p < 0.001) and the NBs ( p < 0.001) with the gamma-passing rate. No correlation was found between the gamma-passing rate and the PTV size or plan complexity. Conclusion: The simulation tool allowed the analysis of a large number of breathing traces, demonstrating how free-breathing patients, suspected of high interplay, could be selected for other motion management solutions. The simulated cases showed strong interplay effects for long breathing periods with extended motion amplitudes in a small group of patients.
{"title":"Analysis of the interplay effect in lung stereotactic ablative radiation therapy based on both breathing motion and plan characteristics","authors":"Asmaa M. Ali, Jason B. Greenwood, Mohammad Varasteh, Sergio Esteve, Prakash Jeevanandam, Fabian Göpfert, Denise M. Irvine, Alan R. Hounsell, Conor K. McGarry","doi":"10.1017/s146039692300033x","DOIUrl":"https://doi.org/10.1017/s146039692300033x","url":null,"abstract":"Abstract Introduction: Stereotactic ablative radiotherapy (SABR) is susceptible to challenges for tumours affected by intrafraction organ motion. This study aims to investigate the effect of breathing characteristics and plan complexity on the interplay effect. Methods: A patient-specific interplay effect evaluation was performed using in-house software with an alpha version of the treatment planning verification software Verisoft (PTW-Freiburg, Germany) on VMAT plans. The OCTAVIUS 4D phantom was used to acquire the static dose distribution, and the simulation approach was utilised to generate the moving dose distribution. The influence of plan complexity, PTV size, number of breaths, and motion amplitudes on the interplay effect were examined. The dose distribution of two extreme phases—end-inhale and end-exhale—was considered using the gamma criteria of 2%/2 mm for the interplay effect evaluation. Results: A strong correlation was found between the motion amplitude ( p < 0.001) and the NBs ( p < 0.001) with the gamma-passing rate. No correlation was found between the gamma-passing rate and the PTV size or plan complexity. Conclusion: The simulation tool allowed the analysis of a large number of breathing traces, demonstrating how free-breathing patients, suspected of high interplay, could be selected for other motion management solutions. The simulated cases showed strong interplay effects for long breathing periods with extended motion amplitudes in a small group of patients.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135601323","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}
Pub Date : 2023-01-01DOI: 10.1017/s1460396923000390
Joseph Purden, Tristan Jackson, Andrea Tales, Ryan Lewis
Abstract Introduction: It is already well-understood that patients requiring multiple hospital visits deal with several barriers. This paper considers a new methodology for determining the barrier that travel can cause, applying it to the mixed rural-city population of South-West Wales, calculating the travel burden for patients accessing radiotherapy. Travel burden could factor into conversations around optimisation of appointments and the impact of changes to treatment pathways. Methods: Patient-specific travel data were calculated using Google Maps, for 1516 patients attending South-West Wales Cancer Centre for radiotherapy, modelled for 5-fraction and 15-fraction regimes. Results: 28% of patients travelled for longer than 60 minutes. Moving to a 5-fraction treatment regime saves 20 one-way trips to the hospital, resulting in an average time saving of 15.9 hours for those travelling by car and 39.3 hours for those travelling by public transport. On average, this reduces carbon dioxide emissions by 91 kg per patient. Conclusions: Implementation of a 5-fraction treatment regime has significantly reduced the travel burden for some patients receiving radiotherapy, as well as emissions related to travel. However, access to radiotherapy services in South-West Wales varies, with certain regions facing substantial travel burdens. Further research exploring other potential options to reduce travel burden is needed.
{"title":"Access and travel burden associated with breast radiotherapy attendance pre- and post-COVID-19 pandemic","authors":"Joseph Purden, Tristan Jackson, Andrea Tales, Ryan Lewis","doi":"10.1017/s1460396923000390","DOIUrl":"https://doi.org/10.1017/s1460396923000390","url":null,"abstract":"Abstract Introduction: It is already well-understood that patients requiring multiple hospital visits deal with several barriers. This paper considers a new methodology for determining the barrier that travel can cause, applying it to the mixed rural-city population of South-West Wales, calculating the travel burden for patients accessing radiotherapy. Travel burden could factor into conversations around optimisation of appointments and the impact of changes to treatment pathways. Methods: Patient-specific travel data were calculated using Google Maps, for 1516 patients attending South-West Wales Cancer Centre for radiotherapy, modelled for 5-fraction and 15-fraction regimes. Results: 28% of patients travelled for longer than 60 minutes. Moving to a 5-fraction treatment regime saves 20 one-way trips to the hospital, resulting in an average time saving of 15.9 hours for those travelling by car and 39.3 hours for those travelling by public transport. On average, this reduces carbon dioxide emissions by 91 kg per patient. Conclusions: Implementation of a 5-fraction treatment regime has significantly reduced the travel burden for some patients receiving radiotherapy, as well as emissions related to travel. However, access to radiotherapy services in South-West Wales varies, with certain regions facing substantial travel burdens. Further research exploring other potential options to reduce travel burden is needed.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135447632","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}
Pub Date : 2023-01-01DOI: 10.1017/s1460396923000407
Maria Stella Sammut, Susan Mercieca
Abstract Introduction: This study aimed to investigate the patient’s perception of the usefulness and limitations of a mobile application as part of the supportive care provided to patients undergoing radiotherapy. Methods: Patients undergoing radiotherapy between February 2023 and March 2023 at a local oncology hospital ( n = 150) were invited to complete a questionnaire that assessed the patient’s smartphone knowledge, willingness to use an app during radiotherapy, perceptions of the usefulness of specific app features, and barriers to using such applications. For quantitative analysis, frequencies were obtained for all areas of interest, and the results were correlated with the patient’s demographics. Results: Of the 39 participants who completed the questionnaire, 82·1% had a smartphone device, 59% could use their smartphones with minimal to no help and 41% had not used their smartphones for medical purposes before. However, 79·5% of patients showed a strong interest in using a mobile app during radiotherapy. Age, gender and level of education had no significant impact on the acceptability of using the mobile application for radiotherapy purposes. Conclusion: Overall, the findings indicate that most patients have access to mobile technology and are willing to use the mobile app as an additional supportive care tool.
{"title":"Patients’ perspective on the use of mobile applications for the provision of supportive care in radiotherapy","authors":"Maria Stella Sammut, Susan Mercieca","doi":"10.1017/s1460396923000407","DOIUrl":"https://doi.org/10.1017/s1460396923000407","url":null,"abstract":"Abstract Introduction: This study aimed to investigate the patient’s perception of the usefulness and limitations of a mobile application as part of the supportive care provided to patients undergoing radiotherapy. Methods: Patients undergoing radiotherapy between February 2023 and March 2023 at a local oncology hospital ( n = 150) were invited to complete a questionnaire that assessed the patient’s smartphone knowledge, willingness to use an app during radiotherapy, perceptions of the usefulness of specific app features, and barriers to using such applications. For quantitative analysis, frequencies were obtained for all areas of interest, and the results were correlated with the patient’s demographics. Results: Of the 39 participants who completed the questionnaire, 82·1% had a smartphone device, 59% could use their smartphones with minimal to no help and 41% had not used their smartphones for medical purposes before. However, 79·5% of patients showed a strong interest in using a mobile app during radiotherapy. Age, gender and level of education had no significant impact on the acceptability of using the mobile application for radiotherapy purposes. Conclusion: Overall, the findings indicate that most patients have access to mobile technology and are willing to use the mobile app as an additional supportive care tool.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135711975","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}
Abstract Introduction: Nodal boost is being increasingly employed to escalate the dose to involved nodes in node-positive cervical cancer. The study aimed to compare the dosimetric differences between sequential boost intensity-modulated radiation therapy (SeB-IMRT) and simultaneous integrated boost IMRT (SIB-IMRT) in terms of target coverage and organs-at-risk (OARs) with special emphasis on the effect of nodal shrinkage and anatomical change of normal tissues during radiotherapy. Methods: Two computed tomography (CT) datasets (of phase I and phase II) of 40 patients of node-positive cervical cancer treated with SeB-IMRT [planning target volume (PTV) 45/25] followed by SeB to residual nodes (PTV 12·6/7) were utilised. SIB-IMRT1 plan consisted of PTV pelvis and para-aortic nodal region (PTV 45/25) and SIB to gross nodes (PTV 55/25). In order to account for the change in nodal and normal tissue topography during treatment, a third plan (SIB-IMRT2) was generated by utilising the SIB-IMRT1 plan for 44 Gy in 20 fractions and reproducing the plan on the second CT dataset for 11 Gy in 5 fractions. Dosimetric parameters of the three plans were compared using the Friedman test with Bonferroni correction. Results: We observed that the doses to OARs (bowel, rectum and bladder) were significantly higher in SeB-IMRT plan as compared to the SIB-IMRT plans. V40 Gy of bowel for SeB-IMRT, SIB-IMRT1 and SIB-IMRT2 plans were 354·8 cc, 271 cc and 321·8 cc, respectively ( p = 0·001), whereas V30 Gy were 687·8 cc, 635·5 cc and 680 cc, respectively ( p = 0·001). The target coverage was marginally better in SeB-IMRT plan as compared to SIB-IMRT1 and SIB-IMRT2 plans (V95% = 99·2 versus 97·7 versus 97·9, respectively, p = 0·000) Conclusion: SIB-IMRT led to better sparing of OARs, especially bowel. However, the magnitude of benefit decreases if the change in nodal and normal tissue topography during radiotherapy is not considered implying the need for frequent image guidance when SIB-IMRT is planned for node-positive cervical cancer.
{"title":"Dosimetric comparison of sequential intensity-modulated radiation therapy (IMRT) and simultaneous integrated boost IMRT for lymph node-positive cervical cancer","authors":"Samarpita Mohanty, Raghavendra Hajare, Lavanya Gurram, Dheera Aravindakshan, Vanisha Midha, Supriya Chopra, Umesh Mahantshetty","doi":"10.1017/s1460396923000365","DOIUrl":"https://doi.org/10.1017/s1460396923000365","url":null,"abstract":"Abstract Introduction: Nodal boost is being increasingly employed to escalate the dose to involved nodes in node-positive cervical cancer. The study aimed to compare the dosimetric differences between sequential boost intensity-modulated radiation therapy (SeB-IMRT) and simultaneous integrated boost IMRT (SIB-IMRT) in terms of target coverage and organs-at-risk (OARs) with special emphasis on the effect of nodal shrinkage and anatomical change of normal tissues during radiotherapy. Methods: Two computed tomography (CT) datasets (of phase I and phase II) of 40 patients of node-positive cervical cancer treated with SeB-IMRT [planning target volume (PTV) 45/25] followed by SeB to residual nodes (PTV 12·6/7) were utilised. SIB-IMRT1 plan consisted of PTV pelvis and para-aortic nodal region (PTV 45/25) and SIB to gross nodes (PTV 55/25). In order to account for the change in nodal and normal tissue topography during treatment, a third plan (SIB-IMRT2) was generated by utilising the SIB-IMRT1 plan for 44 Gy in 20 fractions and reproducing the plan on the second CT dataset for 11 Gy in 5 fractions. Dosimetric parameters of the three plans were compared using the Friedman test with Bonferroni correction. Results: We observed that the doses to OARs (bowel, rectum and bladder) were significantly higher in SeB-IMRT plan as compared to the SIB-IMRT plans. V40 Gy of bowel for SeB-IMRT, SIB-IMRT1 and SIB-IMRT2 plans were 354·8 cc, 271 cc and 321·8 cc, respectively ( p = 0·001), whereas V30 Gy were 687·8 cc, 635·5 cc and 680 cc, respectively ( p = 0·001). The target coverage was marginally better in SeB-IMRT plan as compared to SIB-IMRT1 and SIB-IMRT2 plans (V95% = 99·2 versus 97·7 versus 97·9, respectively, p = 0·000) Conclusion: SIB-IMRT led to better sparing of OARs, especially bowel. However, the magnitude of benefit decreases if the change in nodal and normal tissue topography during radiotherapy is not considered implying the need for frequent image guidance when SIB-IMRT is planned for node-positive cervical cancer.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135267196","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}
Abstract Introduction: Advanced treatment modalities involve applying small fields which might be shaped by collimators or circular cones. In these techniques, high-energy photons produce unwanted neutrons. Therefore, it is necessary to know neutron parameters in these techniques. Materials and methods: Different parts of Varian linac were simulated by MCNPX, and different neutron parameters were calculated. The results were then compared to photoneutron production in the same nominal fields created by circular cones. Results: Maximum neutron fluence for 1 × 1, 2 × 2, 3 × 3 cm 2 field sizes was 165, 40.4, 19.78 (cm –2 .Gy -1 × 10 6 ), respectively. The maximum values of neutron equivalent doses were 17.1, 4.65, 2.44 (mSv/Gy of photon dose) for 1 × 1, 2 × 2, 3 × 3 cm 2 field size, respectively, and maximum neutron absorbed doses reached 903, 253, 131 (µGy/Gy photon dose) for 1 × 1, 2 × 2, 3 × 3 cm 2 field sizes, respectively. Conclusion: Comparing the results with those in the presence of circular cones showed that circular cones reduce photoneutron production for the same nominal field sizes.
{"title":"Comparison of neutron contamination in small photon fields of secondary collimator jaws and circular cones","authors":"Nooshin Banaee, Kiarash Goodarzi, Elham Hosseinzadeh","doi":"10.1017/s1460396923000328","DOIUrl":"https://doi.org/10.1017/s1460396923000328","url":null,"abstract":"Abstract Introduction: Advanced treatment modalities involve applying small fields which might be shaped by collimators or circular cones. In these techniques, high-energy photons produce unwanted neutrons. Therefore, it is necessary to know neutron parameters in these techniques. Materials and methods: Different parts of Varian linac were simulated by MCNPX, and different neutron parameters were calculated. The results were then compared to photoneutron production in the same nominal fields created by circular cones. Results: Maximum neutron fluence for 1 × 1, 2 × 2, 3 × 3 cm 2 field sizes was 165, 40.4, 19.78 (cm –2 .Gy -1 × 10 6 ), respectively. The maximum values of neutron equivalent doses were 17.1, 4.65, 2.44 (mSv/Gy of photon dose) for 1 × 1, 2 × 2, 3 × 3 cm 2 field size, respectively, and maximum neutron absorbed doses reached 903, 253, 131 (µGy/Gy photon dose) for 1 × 1, 2 × 2, 3 × 3 cm 2 field sizes, respectively. Conclusion: Comparing the results with those in the presence of circular cones showed that circular cones reduce photoneutron production for the same nominal field sizes.","PeriodicalId":44597,"journal":{"name":"Journal of Radiotherapy in Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135840029","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}
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