Practical implementation of quality improvement for high-dose-rate brachytherapy.

Purpose: High-dose-rate (HDR) brachytherapy is a high-risk procedure with serious errors reported in the medical literature. Our goal was to develop a quality improvement framework for HDR brachytherapy using a multidisciplinary approach. This work describes the time, personnel, and materials involved in implementation as well as staff-reported safety benefits of quality improvement checklists.

Effect of induction chemotherapy on estimated risk of radiation pneumonitis in bulky non-small cell lung cancer.

Patients with bulky non-small cell lung cancer (NSCLC) may be at a high risk for radiation pneumonitis (RP) if treated with up-front concurrent chemoradiation. There is limited information about the effect of induction chemotherapy on the volume of normal lung subsequently irradiated. This study aims to estimate the reduction in risk of RP in patients with NSCLC after receiving induction chemotherapy.

Impact of induction chemotherapy on estimated risk of radiation pneumonitis in small cell lung cancer.

Introduction: Induction chemotherapy in patients with bulky small cell lung cancer (SCLC) could lead to decreased tumor burden, smaller radiation fields, and less pulmonary toxicity. This study compared radiation therapy (RT) plans based on pre- and postchemotherapy computed tomography (CT) scans of patients with SCLC to estimate the reduced risk of radiation pneumonitis (RP) after receiving chemotherapy.

Methods: Between 2003 and 2009, 23 patients with stage IV SCLC were treated with chemotherapy alone (no surgery or RT) and had computed tomography scans pre- and post two cycles of platin-based chemotherapy.

Supine craniospinal irradiation setup with two spine fields.

Craniospinal irradiation is an integral part of treatment for a number of cancers. Typically, patients are positioned prone, which allows visualization of field matches. However, a supine position allows better airway access for patients requiring anesthesia, and is more comfortable for patients.