Can knowledge-based planning models validated on ethnically diverse patients lead to global standardisation of external beam radiation therapy for locally advanced cervix cancer?

Background And Purpose: Knowledge-based planning (KBP) can consistently and efficiently create high-quality Volumetric Arc Therapy (VMAT) plans for cervix cancer. This study describes the cross-validation of two KBP models on geographically distinct populations and their comparison to manual plans from 67 centers. The purpose was to determine the universal applicability of a generic KBP model.

Impact of a National Virtual Oncology Course on Medical Student Competency and Interest in Oncology.

Globally, surveys have identified that medical learners of all levels perceive their oncology instruction to be inadequate. To address these gaps, we systematically developed and implemented the Oncology National Course for Advocacy, Research, and Education (ONCARE), a novel, nationally organized virtual course available to all Canadian medical students and evaluated its impact on oncology competency and interest. ONCARE was designed utilizing Kern's Six-Step Model for Curriculum Development.

Adjuvant Treatment of Stage I-II Serous Endometrial Cancer: A Single Institution 20-Year Experience.

Serous endometrial carcinoma (SEC) is a high-risk subtype of endometrial cancer. The effectiveness of multiple adjuvant therapies, namely chemotherapy (CT), radiotherapy (RT), and sequential/concurrent chemotherapy with radiotherapy (CRT), have previously been investigated. However, optimal management of early-stage SEC remains unclarified.

Prognostic impact and causality of age on oncological outcomes in women with endometrial cancer: a multimethod analysis of the randomised PORTEC-1, PORTEC-2, and PORTEC-3 trials.

Background: Numerous studies have shown that older women with endometrial cancer have a higher risk of recurrence and cancer-related death. However, it remains unclear whether older age is a causal prognostic factor, or whether other risk factors become increasingly common with age. We aimed to address this question with a unique multimethod study design using state-of-the-art statistical and causal inference techniques on datasets of three large, randomised trials.

Survival in esophageal cancer with nonregional lymphadenopathy: a propensity score-matched analysis.

Background: Survival among patients with esophageal cancer with stage IV nonregional lymphadenopathy treated with neoadjuvant therapy and surgical resection is not well described. This study aimed to compare the survival outcomes of patients with nonregional lymphadenopathy with a propensity-matched cohort of patients with locoregional disease.

Methods: This was a retrospective cohort analysis of a prospectively maintained database from a regional upper gastrointestinal cancer network in Quebec, Canada.

The Impact on Peer Mentorship After Implementation of a Competency-Based Residency Curriculum in Canadian Radiation Oncology Training Programs.

Purpose: Peer mentorship provides professional and personal support between physicians with similar experiences and levels of training. While peer mentorship has shown to benefit academic success and professional growth, little data has examined contextual factors, such as curricular change, that may affect the quality of these relationships. This study aims to explore the impact of a new, nationwide radiation oncology (RO) residency curriculum, known as competence by design (CBD), on peer mentorship experiences between Canadian RO residents.

A Qualitative Analysis of Medical Student Reflections Following Participation in a Canadian Radiation Oncology Studentship.

Exposure to radiation oncology in medical school curricula is limited; thus, mentorship and research opportunities like the Dr. Pamela Catton Summer Studentship Program attempt to bridge this gap and stimulate interest in the specialty. In 2021, the studentship was redesigned as virtual research, mentorship, and case-based discussions due to the COVID-19 pandemic.

Survival and perioperative outcomes of octo- and nonagenarians with resectable esophageal carcinoma.

The outcomes of different treatment modalities for patients aged 80 and above with locally advanced and resectable esophageal carcinoma are not well described. The aim of this study was to explore survival and perioperative outcomes among this specific group of patients. A retrospective, cohort analysis was performed on a prospectively maintained esophageal cancer database from the McGill regional upper gastroinestinal cancer network.

Safety and Efficacy of 2D Brachytherapy vs. 3D Image-Guided Adaptive Brachytherapy for Locally Advanced Cervical Cancer-A Single Institution Retrospective Study.

Background: The treatment paradigm for locally advanced cervical cancer (LACC) has shifted from two-dimensional-brachytherapy (2D-BT) to three-dimensional-image-guided adaptive BT (3D-IGABT). In this retrospective study, we report our experience with the change from 2D-BT to 3D-IGABT.

Methods: We reviewed 146 LACC patients (98 3D-IGABT and 48 2D-BT) who received chemoradiation between 2004 and 2019.

Advances in Radiation Oncology for the Treatment of Cervical Cancer.

Background: Over the past two decades, there has been significant advancement in the management of cervical cancer, particularly in the domain of definitive chemoradiotherapy for locally advanced cervical cancer (LACC). Indeed, radiation treatment paradigms have shifted from a two-dimensional (2D) approach solely based on anatomical bony landmarks, to an image-guided three-dimensional (3D) approach, with the goal of delivering doses more precisely to clinical targets with an increased sparing of organs-at-risk.

Methods: This is a narrative review on the advances in radiation technologies for the treatment of cervical cancer.

A guide to curriculum inquiry for brachytherapy simulation-based medical education.

Purpose: Brachytherapy is a required clinical competency within radiation oncology training but decreased utilization and volume have limited trainee exposure. Simulation-based medical education is an established educational tool that allows learners to engage in higher-order learning in a safe space and has unique application in brachytherapy instruction.

Methods And Materials: We reviewed best practices in curriculum development for simulation-based medical education in brachytherapy, current works in brachytherapy simulation, and identify areas for future development.

A transfer learning approach to facilitate ComBat-based harmonization of multicentre radiomic features in new datasets.

Purpose: To facilitate the demonstration of the prognostic value of radiomics, multicenter radiomics studies are needed. Pooling radiomic features of such data in a statistical analysis is however challenging, as they are sensitive to the variability in scanner models, acquisition protocols and reconstruction settings, which is often unavoidable in a multicentre retrospective analysis. A statistical harmonization strategy called ComBat was utilized in radiomics studies to deal with the "center-effect".

Satisfaction among Cancer Patients Undergoing Radiotherapy during the COVID-19 Pandemic: An Institutional Experience.

The COVID-19 pandemic has shifted oncology practices to prioritize patient safety while maintaining necessary treatment delivery. We obtained patient feedback on pandemic-based practices in our radiotherapy department to improve quality of patient care and amend policies as needed. We developed a piloted questionnaire which quantitatively and qualitatively assessed patients' pandemic-related concerns and satisfaction with specific elements of their care.

Convolutional neural networks for PET functional volume fully automatic segmentation: development and validation in a multi-center setting.

Purpose: In this work, we addressed fully automatic determination of tumor functional uptake from positron emission tomography (PET) images without relying on other image modalities or additional prior constraints, in the context of multicenter images with heterogeneous characteristics.

Methods: In cervical cancer, an additional challenge is the location of the tumor uptake near or even stuck to the bladder. PET datasets of 232 patients from five institutions were exploited.

Promoting Career Selection Through a Comprehensive Enrichment Experience: A Review of the Canadian Radiation Oncology Summer Studentship.

Purpose: The impact that early clinical exposure to radiation oncology has on medical students' understanding of oncology and career choice is understudied. This study aims to review the experience and outcomes of medical students who participated in the Canadian Association of Radiation Oncology-Canadian Radiation Oncology Foundation 6-week summer studentship.

Methods And Materials: Medical students who participated in the nationally funded studentship from 2014 to 2018 were asked to fill out a survey after completing the program.

Can intermediate-energy sources lead to elevated bone doses for prostate and head & neck high-dose-rate brachytherapy?

Purpose: Several radionuclides with high (Co, Se) and intermediate (Yb, Gd) energies have been investigated as alternatives to Ir for high-dose-rate brachytherapy. The purpose of this study was to evaluate the impact of tissue heterogeneities for these five high- to intermediate-energy sources in prostate and head & neck brachytherapy.

Methods And Materials: Treatment plans were generated for a cohort of prostate (n = 10) and oral tongue (n = 10) patients.

Creation and Pilot-testing of Virtual Patients for Learning Oncologic Emergency Management.

Purpose or objective Management of oncologic emergencies becomes critical at the start of the second year of a radiation oncology residency. Considering the limited exposure to oncology in the medical school curriculum, this knowledge gap needs to be filled prior to managing real patients. The aim of this project was to create virtual patients (VPs) to ease this transition and improve learner readiness for independently managing oncologic emergencies on call.

Tumor Board Shadowing: A Unique Approach for Integrating Radiation Oncologists Into General Medical Student Education.

Purpose: Radiation oncology is often overlooked in US medical school curricula, with few opportunities for most students to learn about the specialty or the value of radiation therapy in cancer care. Tumor boards represent a potential avenue not only to increase students' exposure to radiation oncologists but also to provide a fundamental understanding of the multidisciplinary nature of cancer care and effective collaboration in clinical practice.

Methods And Materials: In this study, we evaluated a novel radiation oncologist-driven tumor board shadowing experience at 3 medical schools in the United States and Canada.

External validation of a combined PET and MRI radiomics model for prediction of recurrence in cervical cancer patients treated with chemoradiotherapy.

Purpose: The aim of this study was to validate previously developed radiomics models relying on just two radiomics features from F-fluorodeoxyglucose positron emission tomography (PET) and magnetic resonance imaging (MRI) images for prediction of disease free survival (DFS) and locoregional control (LRC) in locally advanced cervical cancer (LACC).

Methods: Patients with LACC receiving chemoradiotherapy were enrolled in two French and one Canadian center. Pre-treatment imaging was performed for each patient.

Adjuvant therapy in stage III endometrial cancer confined to the pelvis.

Objective: To review outcomes of patients with stage III endometrial cancer confined to the pelvis treated with adjuvant pelvic radiotherapy (RT) or sequential chemoradiotherapy (CRT).

Methods: Between 1990 and 2012, 144 patients diagnosed with stage IIIA, B or C1 endometrial cancer were treated in our institution. All were treated with total hysterectomy, bilateral salpingo-oophorectomy ± lymph node dissection.

Clinical significance of isolated tumor cells and micrometastasis in low-grade, stage I endometrial cancer.

Introduction: Ultrastaging in endometrial cancer (EC) led to increased detection of isolated tumor cells (ITC, ≤0.2 mm) and micrometastases (MM, 0.2-2 mm), with unclear effect on prognosis.