Publications by authors named "Charles S Mayo"
Purpose/objectives: Tracking patient dose in radiation oncology is challenging due to disparate electronic systems from various vendors. Treatment planning systems (TPS), radiation oncology information systems (ROIS), and electronic health records (EHR) lack uniformity, complicating dose tracking and reporting. To address this, we examined practices in multiple radiation oncology settings and proposed guidelines for current systems.
View Article and Find Full Text PDFArticle Synopsis
- New technologies in radiation oncology can create health care disparities, particularly affecting vulnerable patient populations, necessitating the assessment of these disparities for both existing and new technologies.* -
- A health disparity risk assessment metric was developed, allowing clinics to determine the potential disparities among patient populations and providing guidelines for addressing these disparities in technology use.* -
- This metric calculates a disparity risk priority number based on patient impact, the quality of radiation plans, and clinical reliance on technology, enabling clinics to prioritize interventions to enhance equitable care.*
Although standardization has been shown to improve patient safety and improve the efficiency of workflows, implementation of standards can take considerable effort and requires the engagement of all clinical stakeholders. Engaging team members includes increasing awareness of the proposed benefit of the standard, a clear implementation plan, monitoring for improvements, and open communication to support successful implementation. The benefits of standardization often focus on large institutions to improve research endeavors, yet all clinics can benefit from standardization to increase quality and implement more efficient or automated workflow.
View Article and Find Full Text PDFPurpose: Radiation myelitis (RM) is a rare complication of radiation therapy (RT). The Pediatric Normal Tissue Effects in the Clinic spinal cord task force aimed to identify RT dose effects and assess risk factors for RM in children. Through systematic review, we analyzed RT dose, fraction size, latency between completion of RT and toxicity, chemotherapy use, age when irradiated, and sex.
View Article and Find Full Text PDFBackground: As cancer therapies have improved, spinal metastases are increasingly common. Resulting complications have a significant impact on patient's quality of life. Optimal methods of surveillance and avoidance of neurologic deficits are understudied.
View Article and Find Full Text PDFPurpose: Few reports describe the risks of late ocular toxicities after radiation therapy (RT) for childhood cancers despite their effect on quality of life. The Pediatric Normal Tissue Effects in the Clinic (PENTEC) ocular task force aims to quantify the radiation dose dependence of select late ocular adverse effects. Here, we report results concerning retinopathy, optic neuropathy, and cataract in childhood cancer survivors who received cranial RT.
View Article and Find Full Text PDFPurpose: We hypothesized that optimizing the utility of stereotactic body radiotherapy (SBRT) based on the individual patient's probability for tumor control and risk of liver injury would decrease toxicity without sacrificing local control in patients with impaired liver function or tumors not amenable to thermal ablation.
Patients And Methods: Patients with Child-Pugh (CP) A to B7 liver function with aggregate tumor size >3.5 cm, or CP ≥ B8 with any size tumor were prospectively enrolled on an Institutional Review Board-approved phase II clinical trial to undergo SBRT with baseline and midtreatment dose optimization using a quantitative, individualized utility-based analysis.
Background Aims: Early-stage HCC can be treated with thermal ablation or stereotactic body radiation therapy (SBRT). We retrospectively compared local progression, mortality, and toxicity among patients with HCC treated with ablation or SBRT in a multicenter, US cohort.
Approach Results: We included adult patients with treatment-naïve HCC lesions without vascular invasion treated with thermal ablation or SBRT per individual physician or institutional preference from January 2012 to December 2018.
Purpose: Liver-directed radiation therapy is an effective treatment for hepatocellular carcinoma (HCC), but metachronous lesions develop outside the irradiated field in >50% of patients. We hypothesized that irradiation of these new lesions would produce an outcome like that of patients receiving a first course (C1) of treatment.
Methods And Materials: We included patients with HCC who received a second course (C2) of radiation therapy >1 month after C1.
Purpose: The ongoing lack of data standardization severely undermines the potential for automated learning from the vast amount of information routinely archived in electronic health records (EHRs), radiation oncology information systems, treatment planning systems, and other cancer care and outcomes databases. We sought to create a standardized ontology for clinical data, social determinants of health, and other radiation oncology concepts and interrelationships.
Methods And Materials: The American Association of Physicists in Medicine's Big Data Science Committee was initiated in July 2019 to explore common ground from the stakeholders' collective experience of issues that typically compromise the formation of large inter- and intra-institutional databases from EHRs.
Article Synopsis
- The study aimed to evaluate how dose-volume histogram (DVH) data relates to patient outcomes in radiation oncology, identifying the challenges in statistical analysis and the need for better reporting standards.
- A review of 325 studies published between 2015 and 2021 found that logistic regression was the most commonly used statistical method, with many studies lacking thorough reporting on model fit and multicollinearity issues.
- The findings suggest that improvements in statistical reporting and transparency are necessary to enhance the reliability and replicability of DVH toxicity outcome studies.
Purpose: To use a hybrid method, combining statistical profiling, machine learning (ML), and clinical evaluation to predict emergency department (ED) visits among patients with head and neck cancer undergoing radiotherapy.
Materials And Methods: Patients with head and neck cancer treated with radiation therapy from 2015 to 2019 were identified using electronic health record data. Records from 60 days before 90 days after treatment were analyzed.
Purpose: Head and neck (HN) radiation (RT) treatment planning is complex and resource intensive. Deviations and inconsistent plan quality significantly affect clinical outcomes. We sought to develop a novel automated virtual integrative (AVI) knowledge-based planning application to reduce planning time, increase consistency, and improve baseline quality.
View Article and Find Full Text PDFPurpose: Recent clinical trials suggest hypofractionated treatment regimens are appropriate for treatment of many cancers. It is important to understand and document hypofractionation adoption because of its implications for treatment center patient volumes. There is no recent U.
View Article and Find Full Text PDFPurpose: Due to a gap in published guidance, we describe our robust cycle of in-house clinical software development and implementation, which has been used for years to facilitate the safe treatment of all patients in our clinics.
Methods And Materials: Our software development and implementation cycle requires clarity in communication, clearly defined roles, thorough commissioning, and regular feedback. Cycle phases include design requirements and use cases, development, physics evaluation testing, clinical evaluation testing, and full clinical release.
Purpose: Our individualized functional response adaptive approach to liver stereotactic body radiation therapy (SBRT) with assessment of indocyanine green (ICG) retention at baseline and midtreatment to detect subclinical changes in liver function, permitting dose adjustment, has decreased toxicity while preserving efficacy. We hypothesized that assessment of the albumin-bilirubin (ALBI) score at baseline and midtreatment would allow for more practical identification of patients at risk for treatment-related toxicity (TRT).
Methods And Materials: Patients with hepatocellular carcinoma were treated on 3 prospective institutional review board-approved trials using baseline and midtreatment ICG to deliver individualized functional response adaptive liver SBRT.
Purpose: We hypothesized that dose-intensified chemoradiation therapy targeting adversely prognostic hypercellular (TV) and hyperperfused (TV) tumor volumes would improve outcomes in patients with glioblastoma.
Methods And Materials: This single-arm, phase 2 trial enrolled adult patients with newly diagnosed glioblastoma. Patients with a TV/TV >1 cm, identified using high b-value diffusion-weighted magnetic resonance imaging (MRI) and dynamic contrast-enhanced perfusion MRI, were treated over 30 fractions to 75 Gy to the TV/TV with temozolomide.
Purpose: We combined clinical practice changes, standardizations, and technology to automate aggregation, integration, and harmonization of comprehensive patient data from the multiple source systems used in clinical practice into a big data analytics resource system (BDARS). We then developed novel artificial intelligence algorithms, coupled with the BDARS, to identify structure dose volume histograms (DVH) metrics associated with dysphagia.
Methods And Materials: From the BDARS harmonized data of ≥22,000 patients, we identified 132 patients recently treated for head and neck cancer who also demonstrated dysphagia scores that worsened from base line to a maximum grade ≥2.
Purpose: Previous reports of stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma (HCC) suggest unacceptably high rates of toxicity in patients with Child-Turcotte-Pugh (CTP) B liver disease. We hypothesized that an individualized adaptive treatment approach based on midtreatment liver function would maintain good local control while limiting toxicity in this population.
Methods And Materials: Patients with CTP-B liver disease and HCC were treated on prospective trials of individualized adaptive SBRT between 2006 and 2018.
Article Synopsis
- * A study involving 93 patients revealed that 15.1% experienced moderate to severe dysphagia after this timeframe, with significant correlations found between dysphagia severity and factors like tumor stage and radiation doses to specific areas.
- * The research indicates that at least 7.5% of patients developed worsening dysphagia over time, emphasizing the need for better long-term monitoring and care strategies for those treated with chemoradiation for OPSCC.
Article Synopsis
- The study investigates the link between PET scan biomarkers of the parotid gland and chronic dry mouth (xerostomia) after radiation therapy in patients with HPV-related oropharyngeal cancer.
- It analyzes PET data from 47 patients to understand how pre- and post-treatment parotid gland uptake values and radiation doses contribute to the severity of xerostomia, using advanced statistical methods for model prediction.
- The findings show that including pre-treatment PET biomarkers significantly enhances the prediction accuracy for late xerostomia, suggesting these biomarkers are useful for anticipating patient outcomes.
Purpose: The radiation treatment summary provides a clinical and technical overview of a patient's full course of radiation therapy. Despite its importance to multiple stakeholders, there is no widely followed radiation treatment summary template.
Methods And Materials: The Commission on Cancer convened a multistakeholder workgroup to develop a synoptic radiation treatment summary template.