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- Radiotherapy & Oncology

Radiotherapy and Oncology
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  • Response to Golden DW et al “A global call for increased interdisciplinary oncologic education”
    We appreciate the comments of colleagues Akthar and Golden [1] supporting interdisciplinary training for clinical cancer specialists. Although the lack of such training is widely recognised, the potential consequences of this deficiency have been acknowledged only recently.

  • A global call for increased interdisciplinary oncologic education
    We thank you for the opportunity to comment on the article titled “Interdisciplinary training for cancer specialists: The time has come” by O’Higgins et al. [1]. We commend the authors on bringing to the forefront a deficiency in interdisciplinary education among current oncology trainees. Previous work by our group has revealed similar deficiencies in the curricula of United States oncology trainees. In 2013, we distributed a web-based survey to oncology trainees across the country with the amount of formal education received by trainees outside their oncologic discipline shown in Fig.

  • Corrigendum to “Dose painting by numbers based on retrospectively determined recurrence probabilities” [Radiother Oncol 122 (2017) 236–241]
    The authors regret that in the above article a data processing error was done in gathering the retrospective 18FDG-PET images such that the SUV data were not corrected for radioactive decay. The error has no impact on any of the conclusions made but affects the data values given in the text and the figures. The corrected values for text data are given in the table below. Corrected figures are provided in a supplement.

  • Functional Swallowing Units (FSUs) as organs-at-risk for radiotherapy. PART 2: Advanced delineation guidelines for FSUs
    Since radiation-based, organ-preserving treatment protocols for head and neck cancer, with or without chemotherapy, yield comparable oncological results to surgery, many patients can be cured from the disease with definitive (chemo)radiotherapy [1,2]. However, a substantial percentage of survivors suffer from, often severe, treatment-related (late) toxicity [3]. One of commonly observed side effects are broadly definable, swallowing problems, significantly deteriorating the quality of life of the patients [4,5].

  • Editorial Board
  • Acknowledgement of Reviewers
  • Contents
  • 4D liver tumor localization using cone-beam projections and a biomechanical model
    Primary liver carcinoma is a leading cause of morbidity worldwide that affects an increasingly large population [1], with incidence and mortality both on the rise in the United States [2]. The liver is also one of the most common sites of metastatic disease from primary cancers such as breast, colorectal, and melanoma. Historically, radiation therapy has played a limited role in treating liver cancer, especially primary liver cancer, because of normal liver tissues’ low tolerance for radiation [3].

  • Independent knowledge-based treatment planning QA to audit Pinnacle autoplanning
    Conventional inverse treatment planning is a manual trial and error process [2]. This makes the treatment planning process in practice time consuming and subject to a substantial amount of variation between dosimetrists [3,4]. To increase treatment planning efficiency and plan consistency several different ‘auto-planning’ approaches have emerged in the past years [5–9]. The basic aim of all these approaches is that a single auto-planning protocol results in good plans for all patients for a given treatment site, without further adjustments; in contrast to conventional planning where a treatment site class solution needs to be manually adjusted on a per patient basis.

  • Survival impact of radiotherapy interruption in nasopharyngeal carcinoma in the intensity-modulated radiotherapy era: A big-data intelligence platform-based analysis
    Nasopharyngeal carcinoma (NPC) is an endemic malignancy in southern China [1,2]. Currently, radiotherapy (RT) is the foundation of radical treatment technique for NPC patients [3]. Radiotherapy interruption (RTI) often occurs because of severe acute treatment-related toxicity, machinery malfunctions, limited medical resources, and public holidays. Additionally, RTI and prolonged radiotherapy treatment time (RTT) were found to be associated with inferior prognosis of NPC patients treated by two-dimensional RT (2DRT) [4–6].

  • Influence of volumetric modulated arc therapy and FET-PET scanning on treatment outcomes for glioblastoma patients
    Glioblastomas are the most common primary brain tumor in adults. The median survival is only about 14–15 months despite combined surgery and chemo-radiotherapy [1]. Considerable technological advances have been made in the radiotherapy field [2], including IMRT [3], VMAT and IGRT[4], which have enabled high-precision radiotherapy [5,6], improved target dose conformity and reduction of radiation dose to selected organs at risk (OAR) [7–11]. In addition to the radiation delivery technology improvements, the use of amino acid-tracers such as 11C-methionine (MET) and O-(2-18F-flouroethyl)-L-tyrosine (FET) positron emission tomography (PET) for target definition of glioblastoma has recently been proposed and used in radiotherapy planning [12–15].

  • Patterns of re-irradiation for recurrent gliomas and validation of a prognostic score
    The diagnosis of high grade glioma is usually associated with an extremely poor prognosis, with a median overall survival time for glioblastoma patients of 14.6 months [1,2]. Despite multimodality treatments, the local recurrence rate persists to be high (nearly 90% within 2 years) and mostly occurs adjacent to the original tumor bed [1,3]. Additionally, for tumors presenting as low grade gliomas (WHO grade II), ultimately transformation to a more malignant phenotype will occur and eventually recur at a median of 61 months after primary treatment [4,5].

  • Reply to Laprie A. et al
    We thank our colleagues Laprie et al. for their valuable comments on the paper reporting on the activities explored by the European Proton Therapy Network and we are glad to notice that they confirm the need and importance of this initiative.

  • Quantification of cardiac subvolume dosimetry using a 17 segment model of the left ventricle in breast cancer patients receiving tangential beam radiotherapy
    An increased incidence of cardiovascular disease (CVD) following radiotherapy [1,2], particularly in patients with left sided breast cancer [3] has been reported. Darby et al. [4] demonstrated a 7.4% increase in rate of major coronary events occurred with every Gray increase in mean heart dose (MHD).

  • Corrigendum to: “Nuclear EGFR as a molecular target in cancer” [Radiother Oncol 108 (2013) 370–77]
    In the original version of this article, two figures are incorrect. In Fig. 2B and Fig. 5 the blots for purification controls (a-tubulin and Histone H3) were inadvertently duplicated. Below the authors have provided the journal with the corrected files for Fig. 2B. The authors were unable to identify the correct purity control blots for Fig. 5. However, it was determined by the University of Wisconsin committee that these errors did not impact the scientific interpretation of the data of Fig. 5.

  • Location of arm draining lymph node in relation to breast cancer radiotherapy field and target volume
    Lymphoedema of the ipsilateral arm following axillary surgery or radiotherapy remains a risk affecting some women after breast cancer treatment. Axillary reverse mapping (ARM) is a technique used to identify the lymph nodes and lymphatic channels draining the upper limb (ARM node) with the aim of preserving these during axillary surgery in breast cancer patients to prevent lymphoedema. A previous study from our institution [1] investigated the prevalence and predictors of ARM node involvement with breast cancer metastases in patients undergoing an axillary lymph node dissection (ALND).

  • Comment on Long-term risks of secondary cancer for various whole and partial breast irradiation techniques
    Nienke Hoekstra et al., recently have published (Long-term risks of secondary cancer for various whole and partial breast irradiation techniques) paper in Radiotherapy and Oncology journal, Volume 128, Issue 3, Pages 428–433. The aim of this study was to evaluate secondary cancer for organs at risk that were placed partially in and out of field. The authors for measuring of LAR, used BEIR VII model. This model was basically used for organs that received low dose (below 1 Gy) [1]. Based on the same paper, it’s clear that organs like thyroid and contralateral breast and lung received a low dose but ipsilateral lung received a higher dose, about several Gy [2,3].

  • External validation of a prognostic model incorporating quantitative PET image features in oesophageal cancer
    The prognosis of patients with oesophageal cancer is poor with overall 5-year survival approximately 15% [1]. Oesophageal cancer is the eighth most common malignancy worldwide, accounting for around 400,000 deaths each year [2].

  • Functional Swallowing Units (FSUs) as organs-at-risk for radiotherapy. PART 1: Physiology and anatomy
    Swallowing disorders are common among patients undergoing definitive (chemo-) radiation for head and neck cancer even before treatment. The treatment may further deteriorate their swallowing function. To achieve better local control, treatment regimens have become more aggressive, resulting in higher rates of long-term dysphagia. Dysphagia has a negative impact on health-related quality of life (HRQL) and it is associated with a higher risk of malnutrition, tube feeding dependence and aspiration [1–3].

  • Use of a novel atlas for muscles of mastication to reduce inter observer variability in head and neck radiotherapy contouring
    Radiotherapy to the head and neck is challenging due to complex anatomy and large number of organs at risk (OARs). Current radiotherapy techniques such as Intensity Modulated Radiotherapy (IMRT) increase dose conformity allowing improved loco-regional tumour control as well as reduced normal tissue effects [1,2]. To fully exploit the advantages of IMRT, accurate and consistent target delineation is required. Manual target volume and OAR delineation are affected by clinician variability [3]. Minimising interobserver variability will improve the accuracy of the dose delivered, maximise tumour control, limit toxicities and increase knowledge of organ at risk (OAR) dose [4–6].

  • High-dose-rate brachytherapy monotherapy versus low-dose-rate brachytherapy with or without external beam radiotherapy for clinically localized prostate cancer
    Prostate cancer is one of the major malignancies in men in Western counties. The current common curative treatment options include radical prostatectomy, external beam radiotherapy (EBRT), and interstitial brachytherapy (BT), which can be divided into permanent implantation, low-dose-rate (LDR) and temporary implantation, high-dose-rate (HDR) [1]. BT can deliver a higher radiation dose to the prostate gland while avoiding surrounding normal tissue and is, therefore, considered an effective radiotherapy treatment option [2] and may improve outcome in long-term biochemical control.

  • Vulnerabilities of radiomic signature development: The need for safeguards
    Cancer imaging features used to inform medical decisions are generated by experienced radiologists, often involving qualitative and experiential interpretation [1,2]. However, utilization of quantified patient imaging data for pattern recognition has recently increased. Radiomics involves the automated extraction of imaging features for use in multivariate predictions models and has demonstrated promise in defining predictive and prognostic factors [3] for disease relapse and mortality after treatment [4–7], and biological correlates [8,9].

  • Doses of radiation to the pericardium, instead of heart, are significant for survival in patients with non-small cell lung cancer
    Lung cancer is the leading cause of cancer-related mortality worldwide [1]. Approximately two-thirds of lung cancer patients receive radiation therapy (RT) at least once during the course of treatment with either definitive or palliative intent [2]. Biological and clinical evidence suggest that a higher radiation dose might provide better local tumor control and may prolong survival in patients with non-small cell lung cancer (NSCLC) [3]. However, delivery of higher dose RT also increases the risk of radiation-related damage to organs at risk (OARs), including the heart and pericardium [4,5].

  • Patterns of proton therapy use in pediatric cancer management in 2016: An international survey
    Several national guidelines consider proton therapy an optimal radiation modality for treating pediatric tumors and reducing treatment toxicities [1–6]. Compared with photons, protons have better physical properties providing clear dosimetric advantages to improve treatment conformality and lower doses to surrounding normal tissues [7–9]. This could have considerable clinical benefits to reduce treatment toxicities while maintaining or improving cure rates, especially when treating young patients with a tumor located close to critical normal tissues, such as the brain stem, eyes and spinal cord.

  • Persistent reduction in global longitudinal strain in the longer term after radiation therapy in patients with breast cancer
    Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death in women globally, accounting for 23% (∼1.38 million) of the total of new cancer cases [1]. More than 80% of breast cancer patients receive radiation therapy (RT) as part of disease management [2]. RT reduces breast cancer recurrence and improves survival [3,4]. However, RT can lead to cardiotoxicity, with adverse events often observed in a dose-dependent manner [5–7]. Radiation-induced cardiac injury usually develops over a prolonged period of time, making diagnosis more difficult, and initial compensatory cardiac response can further delay the recognition of injury for many years [5].

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