Information Needs Expressed During Patient-Oriented Oncology Consultations: Quantity, Variation, and Barriers.

High-quality oncology consultation includes patient-oriented communication tailored to patients' individualized needs. Common methods used in studies to increase question-asking are prompt lists and coaching pre-consultations. However, our patients were encouraged to ask questions by the physician during their visit.

Definitive radiotherapy for a head and neck Merkel cell carcinoma and comprehensive nodal volumes: a case for using a computer-designed variable-thickness compensator to reduce risk and severity of mucositis.

When contemplating how to treat head and neck primary cancers and regional lymph nodes with radiotherapy, we often select the contemporary intensity-modulated radiotherapy (IMRT) without much consideration of older methods that may give fewer side effects and be more cost-effective. For an 87-year-old female with a 1.5-cm Merkel cell carcinoma (MCC) located 1.

Routine bladder cancer treatment dictates divergence from trial-derived regimens: Results of treatment at 44 radiotherapy centers.

Purpose: To assess characteristics and outcome of patients treated with radiotherapy for muscle-invasive bladder cancer at 44 community-based radiotherapy centers and compare these to those on clinical trials.

Materials And Methods: We reviewed 155 patients who had been treated from 2010 to 2014. Overall survival and progression-free survival were estimated using the Kaplan-Meier method.

Prediction of neck dissection requirement after definitive radiotherapy for head-and-neck squamous cell carcinoma.

Background: This analysis was undertaken to assess the need for planned neck dissection in patients with a complete response (CR) of involved nodes after irradiation and to determine the benefit of a neck dissection in those with less than CR by tumor site.

Methods: Our cohort included 880 patients with T1-4, N1-3M0 squamous cell carcinoma of the oropharynx, larynx, or hypopharynx who received treatment between 1994 and 2004. Survival curves were calculated by the Kaplan-Meier Method, comparisons of rates with the log-rank test and prognostic factors by Cox's proportional hazard model.

Geographic access to cancer care: a disparity and a solution.

BACKGROUND The rising cancer incidence in developing countries outpaces easy access to care. Time and effort spent on travel for care is a burden to patients and detracts from patient centredness, efficiency, and equitability. In Trinidad and Tobago, significant distress was observed among patients who made long journeys to the single public cancer clinic.

Postoperative external beam radiotherapy for differentiated thyroid cancer: outcomes and morbidity with conformal treatment.

Purpose: To review institutional outcomes for patients treated for differentiated thyroid cancer with postoperative conformal external beam radiotherapy (EBRT).

Methods And Materials: This is a single-institution retrospective review of 131 consecutive patients with differentiated thyroid cancer who underwent EBRT between January 1996 and December 2005. Histologic diagnoses included 104 papillary, 21 follicular, and six mixed papillary-follicular types.

Performance evaluation of automatic anatomy segmentation algorithm on repeat or four-dimensional computed tomography images using deformable image registration method.

Purpose: Auto-propagation of anatomic regions of interest from the planning computed tomography (CT) scan to the daily CT is an essential step in image-guided adaptive radiotherapy. The goal of this study was to quantitatively evaluate the performance of the algorithm in typical clinical applications.

Methods And Materials: We had previously adopted an image intensity-based deformable registration algorithm to find the correspondence between two images.

IMRT reirradiation of head and neck cancer-disease control and morbidity outcomes.

Purpose: Institutional and cooperative group experience has demonstrated the feasibility of reirradiation for head and neck cancer. Limited data are available regarding the use of intensity-modulated radiotherapy (IMRT) for this indication. We reviewed our initial experience using IMRT for previously irradiated head and neck cancer patients.

Outcomes after radiotherapy for basaloid squamous cell carcinoma of the head and neck: a case-control study.

Background: Basaloid squamous cell carcinoma (BSCC) is an uncommon, high-grade variant of squamous cell carcinoma (SCC) of the head and neck. Its poorer prognosis compared with common SCC remains controversial. The authors investigated the outcomes of patients with BSCC who received radiotherapy and compared them with the outcomes of patients with SCC.

Comparison of 2D radiographic images and 3D cone beam computed tomography for positioning head-and-neck radiotherapy patients.

Purpose: To assess the positioning accuracy using two-dimensional kilovoltage (2DkV) imaging and three-dimensional cone beam CT (CBCT) in patients with head and neck (H&N) cancer receiving radiation therapy. To assess the benefit of patient-specific headrest.

Materials And Methods: All 21 patients studied were immobilized using thermoplastic masks with either a patient-specific vacuum bag (11 of 21, IMA) or standard clear plastic (10 of 21, IMB) headrests.

Parotid gland dose in intensity-modulated radiotherapy for head and neck cancer: is what you plan what you get?

Purpose: To quantify the differences between planned and delivered parotid gland and target doses, and to assess the benefits of daily bone alignment for head and neck cancer patients treated with intensity-modulated radiotherapy (IMRT).

Methods And Materials: Eleven head and neck cancer patients received two CT scans per week with an in-room CT scanner over the course of their radiotherapy. The clinical IMRT plans, designed with 3-mm to 4-mm planning margins, were recalculated on the repeat CT images.

Outcomes after radiotherapy for squamous cell carcinoma of the eyelid.

Background: Squamous cell carcinoma (SCC) of the eyelid is a rare malignancy with metastatic potential. In the current study, the outcomes of patients with SCC of the eyelid were evaluated after definitive and postoperative radiation therapy.

Methods: The medical records of all patients treated with radiotherapy for SCC of the eyelid at 1 institution between 1950 and 2005 were reviewed.

Reduce in variation and improve efficiency of target volume delineation by a computer-assisted system using a deformable image registration approach.

Purpose: To determine whether a computer-assisted target volume delineation (CAT) system using a deformable image registration approach can reduce the variation of target delineation among physicians with different head and neck (HN) IMRT experiences and reduce the time spent on the contouring process.

Materials And Methods: We developed a deformable image registration method for mapping contours from a template case to a patient case with a similar tumor manifestation but different body configuration. Eight radiation oncologists with varying levels of clinical experience in HN IMRT performed target delineation on two HN cases, one with base-of-tongue (BOT) cancer and another with nasopharyngeal cancer (NPC), by first contouring from scratch and then by modifying the contours deformed by the CAT system.

Postoperative radiotherapy for maxillary sinus cancer: long-term outcomes and toxicities of treatment.

Purpose: To determine the effects of three changes in radiotherapy technique on the outcomes for patients irradiated postoperatively for maxillary sinus cancer.

Methods And Materials: The data of 146 patients treated between 1969 and 2002 were reviewed. The patients were separated into two groups according to the date of treatment.

The effect of dental artifacts, contrast media, and experience on interobserver contouring variations in head and neck anatomy.

Objectives: To investigate interobserver variability in the delineation of head-and-neck (H&N) anatomic structures on CT images, including the effects of image artifacts and observer experience.

Methods: Nine observers (7 radiation oncologists, 1 surgeon, and 1 physician assistant) with varying levels of H&N delineation experience independently contoured H&N gross tumor volumes and critical structures on radiation therapy treatment planning CT images alongside reference diagnostic CT images for 4 patients with oropharynx cancer. Image artifacts from dental fillings partially obstructed 3 images.

Impact of changes to the American Joint Committee on Cancer T classification on outcome prediction in patients with oropharyngeal cancer.

Background: The efficacy of the current 6th edition of the American Joint Committee on Cancer (AJCC) tumor staging criteria in improving outcome prediction for patients with oropharyngeal cancer was analyzed.

Methods: From the database of the Department of Radiation Oncology at the University of Texas M. D.

Multiple regions-of-interest analysis of setup uncertainties for head-and-neck cancer radiotherapy.

Purpose: To analyze three-dimensional setup uncertainties for multiple regions of interest (ROIs) in head-and-neck region.

Methods And Materials: In-room computed tomography (CT) scans were acquired using a CT-on-rails system for 14 patients. Three separate bony ROIs were defined: C2 and C6 vertebral bodies and the palatine process of the maxilla.

Comparison of treatment volumes and techniques in prostate cancer radiation therapy.

Objective: To compare dose-volume histograms (DVHs) for 3 target volumes (group 1, prostate + seminal vesicles + pelvic lymph nodes; group 2, prostate + seminal vesicles; group 3, prostate only) to determine the difference in dose to normal structures (rectum, bladder, and femoral heads) while controlling for target dose using 3-dimensional conformal radiation therapy (3DCRT) versus intensity modulated radiation therapy (IMRT).

Methods: Ten patients with localized prostate cancer were randomly selected. 3DCRT and IMRT planning were done to deliver 75.

Effectiveness of noncoplanar IMRT planning using a parallelized multiresolution beam angle optimization method for paranasal sinus carcinoma.

Purpose: To determine the effectiveness of noncoplanar beam configurations and the benefit of plans using fewer but optimally placed beams designed by a parallelized multiple-resolution beam angle optimization (PMBAO) approach.

Methods And Materials: The PMBAO approach uses a combination of coplanar and noncoplanar beam configurations for intensity-modulated radiation therapy (IMRT) treatment planning of paranasal sinus cancers. A smaller number of beams (e.

Intensity-modulated radiation therapy after hysterectomy: comparison with conventional treatment and sensitivity of the normal-tissue-sparing effect to margin size.

Purpose: To determine the influence of target-volume expansion on the reduction in small-bowel dose achieved with use of intensity-modulated radiation therapy (IMRT) vs. standard conformal treatment of the pelvis after hysterectomy, and to investigate the influence of patient body habitus on the normal-tissue sparing achieved with use of IMRT.

Methods And Materials: A clinical target volume (CTV) was contoured on each of 10 planning computed tomography scans of patients who had been treated for cervical or endometrial cancer after a hysterectomy.

Feasibility of dose escalation using intensity-modulated radiotherapy in posthysterectomy cervical carcinoma.

Purpose: To evaluate retrospectively the utility of intensity-modulated radiotherapy (IMRT) in reducing the volume of normal tissues receiving radiation at varying dose levels when the female pelvis after hysterectomy is treated to doses of 50.4 Gy and 54 Gy.

Methods And Materials: Computed tomography scans from 10 patients who had previously undergone conventional postoperative RT were selected.

Intensity-modulated radiotherapy: is xerostomia still prevalent?

Conformal radiation with intensity-modulated radiotherapy (IMRT) is a technique that potentially can minimize the dose to salivary glands and thereby decrease the incidence of xerostomia. Precise target determination and delineation is most important when using salivary gland-sparing techniques of IMRT. Reduction of xerostomia can be achieved by sparing the salivary glands on the uninvolved oral cavity and keeping the mean parotid gland dose of less than 26 to 30 Gy as a planning criterion if the treatment of disease is not compromised and parotid function preservation is desired.

Promising early local control of malignant pleural mesothelioma following postoperative intensity modulated radiotherapy (IMRT) to the chest.

Purpose: Malignant pleural mesothelioma often recurs locally in spite of aggressive resection by extrapleural pneumonectomy and conventional radiotherapy. This may be due to failure to recognize the extent of clinical target volume (CTV) or suboptimal dose delivery to a target that abuts the heart, esophagus, liver, lung, kidney, and spinal cord. We report how these geometric/dosimetric constraints were overcome by exploiting intensity-modulated radiotherapy in the first cohort patient.

Intensity-modulated radiation therapy: a novel approach to the management of malignant pleural mesothelioma.

Purpose: Malignant pleural mesothelioma (MPM) causes symptoms and death mainly due to local progression, even after combined modality treatment. Poor local control after conventional radiotherapy may be due to the low dose of radiation that has been administered or to restriction of the target volume to avoid critical organs. Intensity-modulated radiation therapy (IMRT) has the potential to overcome these geometric/dosimetric constraints.