Outcomes of Stereotactic Body Radiotherapy Compared with Surgical Resection in Patients with Hepatocellular Carcinoma and Macrovascular Invasion: A Propensity Score-Matched Analysis.

Introduction: Patients with advanced hepatocellular carcinoma (HCC) and macrovascular invasion (MVI) are recommended to receive systemic therapy according to guidelines. Stereotactic body radiotherapy (SBRT) and surgery are increasingly used in this patient population. This study compares outcomes from these local treatments.

Surgical Resection Followed by Stereotactic Radiosurgery (S+SRS) Versus SRS Alone for Large Posterior Fossa Brain Metastases: A Comparative Analysis of Outcomes and Factors Guiding Treatment Modality Selection.

Background/objectives: Around 20% of cancer patients will develop brain metastases (BrMs), with 15-25% occurring in the posterior fossa (PF). Although the effectiveness of systemic therapies is increasing, surgery followed by stereotactic radiosurgery (S+SRS) versus definitive SRS remains the mainstay of treatment. Given the space restrictions within the PF, patients with BrMs in this location are at higher risk of brainstem compression, hydrocephalus, herniation, coma, and death.

New Brunswick HEARS: outcomes of a community-delivered hearing intervention adapted for older adults in Atlantic Canada.

Objective: To assess acceptability and benefit of a community-based hearing intervention delivered at no cost to lower-income older adults with untreated hearing loss in New Brunswick, Canada.

Design: Mixed method pre-post intervention study investigating aspects of communication function and social support at baseline and three months post-intervention.

Study Sample: 124 of 175 independent-living older adults screened at the study site and in local community centres in low-income neighbourhoods were recruited into the study.

Dual Somatostatin Receptor/F-FDG PET/CT Imaging in Patients with Well-Differentiated, Grade 2 and 3 Gastroenteropancreatic Neuroendocrine Tumors.

Our purpose was to prospectively assess the distribution of NETPET scores in well-differentiated (WD) grade 2 and 3 gastroenteropancreatic (GEP) neuroendocrine tumors (NETs) and to determine the impact of the NETPET score on clinical management. This single-arm, institutional ethics review board-approved prospective study included 40 patients with histologically proven WD GEP NETs. Ga-DOTATATE PET and F-FDG PET were performed within 21 d of each other.

The incidence of brain metastases in breast cancer according to molecular subtype and stage: a 10-year single institution analysis.

Background: Breast cancer (BC) is the second most common etiology of brain metastases (BrM). We aimed to examine the incidence of BrM among all BC patients presenting to a large tertiary cancer centre over one decade.

Methods: We included all BC patients presenting consecutively between 2009 and 2019 and cross referenced that cohort to a radiotherapy database, identifying patients treated for BrM at any time following their initial presentation.

Evaluating the impact of a national geriatric mental health ECHO educational program on healthcare providers' practice.

Project Extension for Community Healthcare Outcomes (ECHO) enables healthcare providers to share knowledge and best practices via telementoring. The ECHO model builds provider capacity and improves care for patients with a variety of health conditions. This study describes a Canada-wide National ECHO pilot project in the area of geriatric mental health and reports on the program's impact on providers' care practices.

Repeatability and reproducibility of prostate apparent diffusion coefficient values on a 1.5 T magnetic resonance linear accelerator.

Background And Purpose: Integrated magnetic resonance linear accelerator (MR-Linac) systems offer potential for biologically based adaptive radiation therapy using apparent diffusion coefficient (ADC). Accurate tracking of longitudinal ADC changes is key to establishing ADC-driven dose adaptation. Here, we report repeatability and reproducibility of intraprostatic ADC using deformable image registration (DIR) to correct for inter-fraction prostate changes.

Connectedness to the young adult cancer community and post-traumatic growth: A young adults with cancer in their prime study.

Objective: For young adults (YAs) with cancer, connecting with peer cancer survivors can provide a unique sense of community and may enhance post-traumatic growth (PTG). This study examined the relationship between connectedness to the YA cancer community and PTG among YAs, independent of overall social support.

Methods: Data were obtained from the young adults with cancer in their prime study, a cross-Canada survey of YA cancer survivors.

A Prospective Study of Machine Learning-Assisted Radiation Therapy Planning for Patients Receiving 54 Gy to the Brain.

Purpose: The capacity for machine learning (ML) to facilitate radiation therapy (RT) planning for primary brain tumors has not been described. We evaluated ML-assisted RT planning with regard to clinical acceptability, dosimetric outcomes, and planning efficiency for adults and children with primary brain tumors.

Methods And Materials: In this prospective study, children and adults receiving 54 Gy fractionated RT for a primary brain tumor were enrolled.

Association of PSMA PET-derived Parameters and Outcomes of Patients Treated for Oligorecurrent Prostate Cancer.

Background Prostate-specific membrane antigen (PSMA) PET is useful in the early detection of oligorecurrent prostate cancer (PCa), but whether PSMA PET parameters can be used to identify patients who would benefit from metastasis-directed therapy (MDT) with radiation or surgery remains uncertain. Purpose To assess the association of PSMA PET parameters with outcomes of patients with oligorecurrent PCa after MDT. Materials and Methods In this retrospective analysis of a single-center phase II trial that enrolled patients with biochemical recurrence of PCa after maximal local therapy and with no evidence of disease at conventional imaging, patients underwent PSMA PET (between May 2017 and November 2021), and unveiled recurrences were treated with MDT.

Proton Therapy Mediates Dose Reductions to Brain Structures Associated With Cognition in Children With Medulloblastoma.

Purpose: Emerging evidence suggests proton radiation therapy may offer cognitive sparing advantages over photon radiation therapy, yet dosimetry has not been compared previously. The purpose of this study was to examine dosimetric correlates of cognitive outcomes in children with medulloblastoma treated with proton versus photon radiation therapy.

Methods And Materials: In this retrospective, bi-institutional study, dosimetric and cognitive data from 75 patients (39 photon and 36 proton) were analyzed.

Anal Cancers in Previously Screened Versus Unscreened Patients: Tumor Stage and Treatment Outcomes.

Background: Targeted screening programs for patients at high risk for anal squamous-cell carcinoma have been proposed; however, the evidence in support of screening remains unclear.

Objective: This study aimed to determine whether screening high-risk patients (predominantly those living with HIV) detected squamous-cell carcinoma at an earlier stage compared to the routine practice of not screening.

Design: This is a cohort study.

A total inverse planning paradigm: Prospective clinical trial evaluating the performance of a novel MR-based 3D-printed head immobilization device.

Background And Purpose: Brain radiotherapy (cnsRT) requires reproducible positioning and immobilization, attained through redundant dedicated imaging studies and a bespoke moulding session to create a thermoplastic mask (T-mask). Innovative approaches may improve the value of care. We prospectively deployed and assessed the performance of a patient-specific 3D-printed mask (3Dp-mask), generated solely from MR imaging, to replicate a reproducible positioning and tolerable immobilization for patients undergoing cnsRT.

The influence of the "cancer" label on perceptions and management decisions for low-grade prostate cancer.

Background: Grade Group 1 (GG1) prostate cancer should be managed with active surveillance (AS). Global uptake of AS remains disappointingly slow and heterogeneous. Removal of cancer labels has been proposed to reduce GG1 overtreatment.

Oligometastasis in Prostate Cancer: Can We Learn from Those "Excluded" from a Phase 2 Trial?

Unlabelled: We conducted and previously published a phase 2 trial of metastasis-directed therapy (MDT) in men with recurrence of prostate cancer at a low prostate-specific antigen level following radical prostatectomy and postoperative radiotherapy. All patients had negative conventional imaging and underwent prostate-specific membrane antigen (PSMA) positron emission tomography (PET). Patients without visible disease ( = 16) or with metastatic disease not amenable to MDT ( = 19) were excluded from the interventional study.

A Novel Instrument for Caregivers in Managing Neuropsychiatric Symptoms of Dementia: Baycrest Quick-Response Caregiver Tool.

Background: Family caregivers can experience significant stress related to behaviour changes in persons with dementia (PWD). Approaches to support caregivers with stress management when responding to changes in behaviours are needed. The Baycrest Quick-Response Caregiver Tool (BQRCT) was developed to provide caregivers with an online tool that can be used in real time to recognize and manage their emotions when managing neuropsychiatric symptoms of dementia.

MedSafer to Support Deprescribing for Residents of Long-Term Care: a Mixed-Methods Study.

Background: Polypharmacy is prevalent in long-term care homes (LTCH) and increases the risk of adverse drug events. Feasible and effective deprescribing interventions applicable in the LTCH environment are needed.

Methods: We performed a mixed methods study to evaluate the feasibility, applicability, and effectiveness of an electronic deprescribing tool, MedSafer, to facilitate quarterly medication reviews (QMRs) on two pilot units in an academic long-term care home (LTCH).

Enhancing Clinical Visibility of Hearing Loss in Cognitive Decline.

Background: Hearing loss is the largest potentially modifiable risk factor for dementia and is highly prevalent among older adults, yet it goes largely unreported, unidentified, and untreated, at great cost to health and quality of life. Hearing screening is a proven cost-effective solution to overcome delays in its identification and management yet is not typically recommended by physicians for older adults.

Objective: To demonstrate the feasibility and value of hearing screening for older adults at risk for dementia in order to enhance physicians' awareness of hearing loss and improve access to timely hearing care.

Cumulative Exposure to Neighborhood Conditions and Substance Use Initiation among Low-Income Latinx and African American Adolescents.

Purpose: While previous research underscores the important role that neighborhood contexts play for child and adolescent health and well-being, how these neighborhood contexts influence substance use initiation among adolescents from low-income and ethnic minority families has been understudied.

Methods: This study is a secondary analysis of data from the a retrospective survey that uses a natural experiment aimed at assessing neighborhood effects on developmental outcomes of Latinx and African American adolescents (N = 736). Cox cause-specific hazards models were estimated to test: (1) the effects of cumulative exposure to neighborhood social disorder, neighborhood violent and property crime rates, and neighborhood social capital during preadolescence (ages 8-11) on the likelihood of initiating alcohol, cigarette, and marijuana use during adolescence (ages 12-18), after controlling for youth, caregiver, and household factors; and (2) whether the effects of these cumulative neighborhood factors vary by Latinx and African American ethnicity.

Assessing the Impact of Neighborhood Conditions on Neurodevelopmental Disorders during Childhood.

Nearly three out of ten neurodevelopmental disabilities in the United States have been linked to environmental conditions, prompting emerging lines of research examining the role of the neighborhood on children's developmental outcomes. Utilizing data from a natural experiment in Denver, this study quantifies the impact of exposure to varied neighborhood contexts on the diagnosis of neurodevelopmental disorders over the course of childhood. Our analysis is based upon retrospective child, caregiver, household and neighborhood data derived from the for a sample of approximately 590 Latino and African American children and youth whose families were quasi-randomly assigned to subsidized housing operated by the Denver (CO) Housing Authority during part of their childhood.

Evaluation of a Workshop on Therapeutic Lying and Dementia Care for Long-Term Care Staff Supporting Persons With Dementia.

Background: Therapeutic lying is an intervention used by health care professionals (HCPs) when a person with dementia is disoriented and distressed and when all other interventions have not succeeded in deescalating the symptoms of dementia.

Method: The goal of this study was to evaluate a workshop on therapeutic lying and dementia care for HCPs specializing in the care of persons living with dementia with symptoms of dementia. Seventeen HPCs, including nurses and personal support workers (PSWs), participated in the workshop and evaluation survey.