An investigation of high-Z material for bolus in electron beam therapy.

. Electron beam treatment often requires bolus to augment surface dose to nearly 100%. There are no optimum bolus materials and hence a high-Z based clothlike material is investigated to reduce air column in treatment that provides optimum surface dose.

Quality of Large Language Model Responses to Radiation Oncology Patient Care Questions.

Importance: Artificial intelligence (AI) large language models (LLMs) demonstrate potential in simulating human-like dialogue. Their efficacy in accurate patient-clinician communication within radiation oncology has yet to be explored.

Objective: To determine an LLM's quality of responses to radiation oncology patient care questions using both domain-specific expertise and domain-agnostic metrics.

Determining risk and predictors of head and neck cancer treatment-related lymphedema: A clinicopathologic and dosimetric data mining approach using interpretable machine learning and ensemble feature selection.

Background And Purpose: The ability to determine the risk and predictors of lymphedema is vital in improving the quality of life for head and neck (HN) cancer patients. However, selecting robust features is challenging due to the multicollinearity and high dimensionality of radiotherapy (RT) data. This study aims to overcome these challenges using an ensemble feature selection technique with machine learning (ML).

Comparative Analysis of US Guidelines for the Management of Cutaneous Squamous Cell and Basal Cell Carcinoma.

Background: This study presents a comparative analysis of recently published guidelines to manage cutaneous squamous cell carcinoma (cSCC) and cutaneous basal cell carcinoma (cBCC) within the United States (US).

Methods: A PubMed database search was performed for the time period between June 1, 2016, and December 1, 2022. A comprehensive comparison was performed in the following clinical interest areas: staging and risk stratification, management of primary tumor and regional nodes with curative intent, and palliative treatment.

Dosimetric evaluation of high-Z inhomogeneity with modern algorithms: A collaborative study.

Purpose: To evaluate modern dose calculation algorithms with high-Z prosthetic devices used in radiation treatment.

Methods: A bilateral hip prosthetic patient was selected to see the effect of modern algorithms from the commercial system for plan comparisons. The CT data with dose constraints were sent to various institutions for dose calculations.

Hippocampus sparing volumetric modulated arc therapy in patients with loco-regionally advanced oropharyngeal cancer.

This study aimed to assess the incidental radiation exposure of the hippocampus (HC) in locoregionally-advanced oropharyngeal cancer patients undergoing volumetric modulated arc therapy and the feasibility of HC-sparing plan optimization. The initial plans were generated without dose-volume constraints to the HC and were compared with the HC-sparing plans. The incidental D_median doses to the bilateral, ipsilateral and contralateral HC were 2.

Emergence of MR-Linac in Radiation Oncology: Successes and Challenges of Riding on the MRgRT Bandwagon.

The special issue of on "Advances of MRI in Radiation Oncology" provides a unique forum for scientific literature related to MR imaging in radiation oncology. This issue covered many aspects, such as MR technology, motion management, economics, soft-tissue-air interface issues, and disease sites such as the pancreas, spine, sarcoma, prostate, head and neck, and rectum from both camps-the Unity and MRIdian systems. This paper provides additional information on the success and challenges of the two systems.

Development of a core outcome set for basal cell carcinoma.

Background: There is variation in the outcomes reported in clinical studies of basal cell carcinoma. This can prevent effective meta-analyses from answering important clinical questions.

Objective: To identify a recommended minimum set of core outcomes for basal cell carcinoma clinical trials.

NCCN Guidelines® Insights: Head and Neck Cancers, Version 1.2022.

The NCCN Guidelines for Head and Neck Cancers address tumors arising in the oral cavity (including mucosal lip), pharynx, larynx, and paranasal sinuses. Occult primary cancer, salivary gland cancer, and mucosal melanoma (MM) are also addressed. The specific site of disease, stage, and pathologic findings guide treatment (eg, the appropriate surgical procedure, radiation targets, dose and fractionation of radiation, indications for systemic therapy).

Magnetic Resonance Guided Radiotherapy for Head and Neck Cancers.

Radiotherapy is an integral component of head/neck squamous cell carcinomas (HNSCCs) treatment, and technological developments including advances in image-guided radiotherapy over the past decades have offered improvements in the technical treatment of these cancers. Integration of magnetic resonance imaging (MRI) into image guidance through the development of MR-guided radiotherapy (MRgRT) offers further potential for refinement of the techniques by which HNSCCs are treated. This article provides an overview of the literature supporting the current use of MRgRT for HNSCC, challenges with its use, and developing research areas.

Transferability of patients for radiation treatment between unmatched machines.

Purpose: The feasibility of transferring patients between unmatched machines for a limited number of treatment fractions was investigated for three-dimensional conformal radiation therapy (3DCRT) and volumetric modulated arc therapy (VMAT) treatments.

Methods: Eighty patient-plans were evaluated on two unmatched linacs: Elekta Versa HD and Elekta Infinity. Plans were equally divided into pelvis 3DCRT, prostate VMAT, brain VMAT, and lung VMAT plans.

Evidence-Based Clinical Practice Guidelines for Extramammary Paget Disease.

Importance: Extramammary Paget disease (EMPD) is a frequently recurring malignant neoplasm with metastatic potential that presents in older adults on the genital, perianal, and axillary skin. Extramammary Paget disease can precede or occur along with internal malignant neoplasms.

Objective: To develop recommendations for the care of adults with EMPD.

Evaluating dysphagia and xerostomia outcomes following transoral robotic surgery for patients with oropharyngeal cancer.

Background: We assessed long-term patient-reported dysphagia and xerostomia outcomes following definitive surgical management with transoral robotic surgery (TORS) in patients with oropharyngeal cancer (OPC) via a cross-sectional survey study.

Methods: Patients with OPC managed with primary oropharyngeal surgery as definitive treatment at least 1 year ago between 2015 and 2019 were identified. The M.

Single Fraction Radiation for Myeloid Sarcoma Is as Effective as Multi-Fraction Regimens for Tumor Regression and Control.

Introduction/background: Myeloid sarcoma is a rare extramedullary manifestation of immature myeloid/monocyte cells. Radiotherapy (RT) yields good local control, but data on different fractionation schemes are limited. The goal of this retrospective study was to share our institutional experience and assess volumetric regression with differential fractionation.

Adaptability and Resilience of Academic Radiation Oncology Personnel and Procedures during COVID-19 Pandemic.

Background: A comprehensive response to the unprecedented SARS-CoV-2 (COVID-19) challenges for public health and its impact on radiation oncology patients and personnel for resilience and adaptability is presented.

Methods: The general recommendations included working remotely when feasible, implementation of screening/safety and personal protective equipment (PPE) guidelines, social distancing, regular cleaning of treatment environment, and testing for high-risk patients/procedures. All teaching conferences, tumor boards, and weekly chart rounds were conducted using a virtual platform.

Treatment plan quality control using multivariate control charts.

Purpose: Statistical process control tools such as control charts were recommended by the American Association of Physicists in Medicine (AAPM) Task Group 218 for radiotherapy quality assurance. However, the tools needed to analyze multivariate, correlated data that are often encountered in treatment plan quality measures, are lacking. In this study, we develop quality control tools that can model multivariate plan quality measures with correlations and account for patient-specific risk factors, without adding a significant burden to clinical workflow.

Caution warranted for low-dose radiation therapy for Covid-19.

Covid-19 is a morbid respiratory disease that has caused desperate times on a global scale due to the lack of any effective medical treatment. Some in the radiation community are actively proposing low-dose radiation therapy (LDRT) for managing the viral pneumonia associated with Covid-19. This commentary provides a rationale for exercising caution against such a decision as the efficacy of LDRT for viral diseases is unknown, while its long-term adverse risks are well known.

A Risk-Adjusted Control Chart to Evaluate Intensity Modulated Radiation Therapy Plan Quality.

Purpose: This study aimed to develop a quality control framework for intensity modulated radiation therapy plan evaluations that can account for variations in patient- and treatment-specific risk factors.

Methods And Materials: Patient-specific risk factors, such as a patient's anatomy and tumor dose requirements, affect organs-at-risk (OARs) dose-volume histograms (DVHs), which in turn affects plan quality and can potentially cause adverse effects. Treatment-specific risk factors, such as the use of chemotherapy and surgery, are clinically relevant when evaluating radiation therapy planning criteria.

Head and Neck Cancers, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology.

Treatment is complex for patients with head and neck (H&N) cancers with specific site of disease, stage, and pathologic findings guiding treatment decision-making. Treatment planning for H&N cancers involves a multidisciplinary team of experts. This article describes supportive care recommendations in the NCCN Guidelines for Head and Neck Cancers, as well as the rationale supporting a new section on imaging recommendations for patients with H&N cancers.

Activation of DNA damage repair factors in HPV positive oropharyngeal cancers.

The mechanisms regulating viral pathogenesis of human papillomavirus (HPV) associated oropharyngeal squamous cell cancers (OPSCC) are not well understood. In the cervix, activation of DNA damage repair pathways is critical for viral replication but little is known about their role in OPSCC. APOBEC factors have been shown to be increased in OPSCC but the significance of this is unclear.