Modified Delphi Consensus on Interventions for Acute Radiation Dermatitis in Breast Cancer: A Canadian Expert Perspective.

Acute radiation dermatitis (ARD) is a prevalent adverse effect of radiotherapy in patients with breast cancer, and there is a lack of high-quality data regarding its prevention and management. This study employs a systematic and iterative process to compile the perspectives of Canadian radiation oncology, nursing, and dermatology experts, aiming to establish consensus-based recommendations for the prevention and management of ARD in breast cancer patients. A modified Delphi consensus was conducted with the participation of 19 experts from across Canada.

Combination of Elastic Nail(s) and Cementoplasty to Treat Pathological Fractures in Long Bones of the Upper Limb.

Objective: To describe and study retrospectively the combination of elastic nails and cementoplasty to stabilize pathological fractures in the upper limb and present the results on pain and mobility.

Materials And Methods: Between January 2022 and April 2024, six patients with a median age of 65 were treated with elastic nailing and cement injection. Pathological fractures were located in the clavicle (n = 3), humerus (n = 1) and radius (n = 2).

A Randomized Trial Comparing Concurrent versus Sequential Radiation and Endocrine Therapy in Early-Stage, Hormone-Responsive Breast Cancer.

Concerns exist regarding increased toxicities, including endocrine therapy toxicity, with concurrent radiation and endocrine therapy in early breast cancer (EBC). We present a pragmatic, randomized trial comparing concurrent versus sequential endocrine and radiotherapy in hormone-responsive EBC. In this multicenter trial, patients were randomized to receive adjuvant endocrine therapy concurrent with, or sequential to, radiotherapy.

The COVID-19 pandemic and its effects on follow-up of patients with early breast cancer: A patient survey.

Purpose: Despite limited evidence supporting its effectiveness, most guidelines recommend long-term, routinely scheduled in-person surveillance of patients with early breast cancer (EBC). The COVID-19 pandemic led to increased use of virtual care. This survey evaluated patient perspectives on follow-up care.

Percutaneous image-guided cryoablation with temporary balloon occlusion of the renal artery for the treatment of central renal tumors.

Purpose: The purpose of this study was to report the technical feasibility and outcomes of percutaneous image-guided cryoablation with temporary balloon occlusion of the renal artery for the treatment of central renal tumors.

Materials And Methods: All consecutive patients with central renal tumors treated with cryoablation and temporary renal artery occlusion from January 2017 to October 2021 were retrospectively included. Patient demographics, tumor's characteristics, procedural data, technical success, primary and secondary clinical efficacy, complications (according to Cardiovascular and Interventional Radiology Society of Europe [CIRSE] classification) and follow-up were investigated.

Safety and Efficacy of Percutaneous Cryoablation of Extraspinal Thyroid Cancer Bone Metastases with Curative Intent: Single-Center Experience with a Median Follow-up of More than 5 Years.

Purpose: To determine the oncologic outcomes and safety profile of image-guided percutaneous cryoablation (PCA) for extraspinal thyroid cancer bone metastases with curative intent.

Materials And Methods: Between January 2010 and January 2020, 16 consecutive patients (8 men, 8 women; mean age, 61 years ± 19; range, 30-84 years) with 18 bone metastases (median bone tumor size, 19 mm; interquartile range [IQR], 12-29 mm; range, 7-58 mm) underwent PCA of oligometastatic extraspinal bone metastases. Thirteen (81%) patients were radioiodine therapy resistant.

Percutaneous cryoablation for advanced and refractory extra-abdominal desmoid tumors.

Purpose: To assess efficacy and safety of percutaneous cryoablation (CA) for advanced and refractory extra-abdominal desmoid tumors.

Materials And Methods: This retrospective study reviewed 30 consecutive patients with symptomatic desmoid tumors evolving after "wait and watch" periods, and despite medical treatment, treated by CA between 2007 and 2019. Progression free survival (PFS), objective response rate, pain reduction (decreased of visual analogic scale pain (VAS)[Formula: see text] 3 or disappearance of pain), total volume lesion (TVL) and complications were documented.

Complications of percutaneous image-guided screw fixation: An analysis of 94 consecutive patients.

Purpose: The purpose of this study was to retrospectively assess the safety profile of percutaneous image-guided screw fixation (PIGSF) for insufficiency, impending or pathological fractures.

Materials And Methods: From July 2012 to April 2020, all consecutive patients who underwent PIGSF were retrospectively included in the study. Patient characteristics, fracture type, procedural data and complications were analyzed.

Can we rely on surgical clips placed during oncoplastic breast surgery to accurately delineate the tumor bed for targeted breast radiotherapy?

Purpose: Oncoplastic breast surgery (OBS) is gaining popularity among surgeons for breast-conserving surgery treatments. OBS relies on complex relocation and deformation of breast tissue involving the tumor bed (TB). In this study, we investigate the validity of using surgical clips with OBS for accurate TB delineation in adjuvant, targeted breast radiotherapy.

Radiological, dosimetric and mechanical properties of a deformable breast phantom for radiation therapy and surgical applications.

The displacement of tumor bed walls during oncoplastic breast surgery (OBS) decreases the accuracy of using surgical clips as the sole surrogate for tumor bed location. This highlights the need for better communication of OBS techniques to radiation oncologists. To facilitate OBS practice and investigate clip placement reliability, a realistic silicone-based breast phantom was constructed with components emulating a breast parenchyma, epidermis, areola, nipple, chest wall, and a tumor.

Dose-sparing effect of deep inspiration breath hold technique on coronary artery and left ventricle segments in treatment of breast cancer.

Background And Purpose: The risk of radiation-induced cardiac injury remains a challenging problem in the treatment of breast cancer. Certain cardiac structures receive higher doses than others, which results in variable frequencies of radiation-induced injuries across these structures. Radiation dose can be reduced using the deep inspiration breath hold (DIBH) technique.

Percutaneous hydrodissection for thermoprotection during cryoablation of periureteric and pyeloureteric junction renal cell carcinomas.

Objective: To report our experience of percutaneous image-guided cryoablation of renal tumors located within 10 mm of the pyeloureteric junction (PUJ) and/or ureter, with hydrodissection as a stand-alone thermoprotective technique.

Materials And Methods: All patients who were offered combined hydrodissection and cryoablation of the PUJ/ureter to treat stage-1 renal cell carcinoma were retrospectively reviewed. Data regarding patients, lesions, and outcomes were collected.

Biomechanics of the Osseous Pelvis and Its Implication for Consolidative Treatments in Interventional Oncology.

The osseous pelvis is a frequent site of metastases. Alteration of bone integrity may lead to pain but also to functional disability and pathological fractures. Percutaneous image-guided minimally invasive procedures, such as cementoplasty and screw fixation, have emerged as a viable option to provide bone reinforcement and fracture fixation, as stand-alone or combined techniques.

Consensus statement on tumour bed localization for radiation after oncoplastic breast surgery.

Background: Oncoplastic surgery (ops) is becoming the new standard of care for breast-conserving surgery, leading to some challenges with adjuvant radiation, particularly when accurate tumour bed (tbd) delineation is needed for focused radiation (that is, accelerated partial breast irradiation or boost radiation). Currently, no guidelines have been published concerning tbd localization for adjuvant targeted radiation after ops.

Methods: A modified Delphi method was used to establish consensus by a panel of 20 experts in surgical and radiation oncology at the Canadian Locally Advanced Breast Cancer National Consensus Group and in a subsequent online member survey.

Hydrodissection of the Retro-Sternal Space to Protect the Pericardium During Sternal Cryoablation.

Purpose: To report the retro-sternal space hydrodissection technique used to displace the heart and the pericardium posteriorly for thermoprotection ahead of sternal cryoablation (CA).

Methods And Materials: Between May 2015 and March 2020, hydrodissection of the retro-sternal space was performed in 5 consecutive patients (5 female; mean age 55.2 ± 9.

Performance of a New Blunt-Tip Needle for the Displacement of Critical Structure in Thermal Ablation.

Purpose: To ascertain the performance of a new blunt-tip needle (HydroGuard), which allows injection of fluids during needle advancement in order to safely approach, displace and insulate nearby critical structures during thermal ablation (TA).

Materials And Methods: This study included 27 consecutive patients treated by TA [cryoablation (CA), radiofrequency (RFA), and microwave MWA)] between April 2018 and January 2019. During TA, hydro- or gas dissection was performed with HydroGuard needle to displace and protect critical structures close to the tumor (< 10 mm).

Hypofractionated radiotherapy for elderly breast cancer patients: from early stages disease to local palliation for unresectable disease.

There is a lack of clear guidelines on optimal radiotherapy dose regimen for elderly breast cancer patients. This review summarizes the current evidence on role of hypofractionated radiotherapy in elderly breast cancer. Also, suggestions have been provided on the best fractionation approaches based on current evidence.

[Percutaneous tumor ablation].

Percutaneous tumor ablation has faced a major growth in recent years with progressive expansion of clinical indications and subsequent adoption by national and international guidelines. Such techniques have become popular due to their minimally invasive profile and precise image-guided targeting resulting into a significant decrease of the procedure-related morbidity. Traditionally, malignant, and to lesser extent benign tumors, have been treated with these new techniques in several different organs including liver, kidney, lung and bone.

Exploring reasons for overuse of contralateral prophylactic mastectomy in Canada.

Background: Contralateral prophylactic mastectomy (cpm) in women with known unilateral breast cancer (bca) has been increasing despite the lack of supportive evidence. The purpose of the present study was to identify the determinants of cpm in women with unilateral bca.

Methods: This qualitative descriptive study used semi-structured interviews informed by the Theoretical Domains Framework.

Preclinical evaluation of the atraumatic nature of a spring loaded blunt tip coaxial needle in a swine model.

Purpose: To test in vivo in an animal model the inherent atraumatic characteristics of the spring loaded blunt tip of a coaxial needle (Gangi-SoftGuard®, Apriomed, Sweden) against a conventional sharp stylet coaxial needle.

Material And Methods: The study was conducted on a 40kg male swine that was its own control for a vascular trauma model. The procedure consisted of voluntary attempts to transfix and traverse the artery/aorta under continuous real-time angiogram.

Efficacy of the Vertebral Body Stenting System for the Restoration of Vertebral Height in Acute Traumatic Compression Fractures in a Non-osteoporotic Population.

Introduction: To evaluate the effectiveness of percutaneous image-guided vertebral body stenting (VBS) at restoring vertebral height in acute, stable, traumatic thoracolumbar fractures in a young, non-osteoporotic population.

Materials And Methods: A single-centre retrospective review of all traumatic non-osteoporotic fractures treated with VBS between 2010 and 2017 was performed. Inclusion criteria included patients with recent (< 10 days), symptomatic and stable thoracolumbar compression fractures.

Patient decision aid for contralateral prophylactic mastectomy for use in the consultation: a feasibility study.

Background: Rates of contralateral prophylactic mastectomy (cpm) continue to rise internationally despite evidence-based guidance strongly discouraging its use in most women with unilateral breast cancer. The purpose of the present study was to develop and assess the feasibility of a knowledge translation tool [a patient decision aid (da)] designed to enhance evidence-informed shared decision-making about cpm.

Methods: A consultation da was developed using the Ottawa Patient Decision Aid Development eTraining in consultation with clinicians and knowledge translation experts.

Hydrodissection of the Gallbladder Bed: A Technique for Ablations Located Close to the Gallbladder.

Objective: To report the technique of hydrodissection of the gallbladder bed, in order to separate the gallbladder wall from the liver surface during microwave ablation of liver malignancies located in segment V.

Materials And Methods: Between January 2018 and March 2018, percutaneous hydrodissection of the gallbladder fossa was performed during four microwave ablation procedures in three patients (One patient was treated twice for the same lesion, making a total of four procedures for three lesions.) All treated lesions were located in segment V and abutting the gallbladder.

Complications of Percutaneous Bone Tumor Cryoablation: A 10-year Experience.

Background Percutaneous cryoablation has been shown to be effective in the management of painful bone tumors. However, knowledge of the complication rate and risk factors for complication is currently lacking. Purpose To report the complication rate and associated risk factors for bone tumor cryoablation.