Avoiding prostate bed radiation for the PSMA-PET detected nodal recurrence patient post prostatectomy.

Background: Nodal only recurrence post radical prostatectomy (RP) is increasingly recognised in the PSMA scan era. Management is controversial with a curative approach usually incorporating prostate bed and nodal irradiation (PB + NRT) in combination with long-term hormonal therapy. It is unknown whether omitting prostate-bed irradiation (PBRT) is safe in a subgroup of these patients.

MuscleMap: An Open-Source, Community-Supported Consortium for Whole-Body Quantitative MRI of Muscle.

Disorders affecting the neurological and musculoskeletal systems represent international health priorities. A significant impediment to progress in trials of new therapies is the absence of responsive, objective, and valid outcome measures sensitive to early disease changes. A key finding in individuals with neuromuscular and musculoskeletal disorders is the compositional changes to muscles, evinced by the expression of fatty infiltrates.

Prospective Randomized Trial Comparing 2 Devices for Deep Inspiration Breath Hold Management in Breast Radiation Therapy: Results of the BRAVEHeart Trial.

Purpose: The Breast Radiotherapy Audio Visual Enhancement for sparing the Heart (BRAVEHeart) trial prospectively randomized patients with left-sided breast cancer to 1 of 2 deep inspiration breath hold biofeedback devices: a novel chest surface tracking system and an abdominal block tracking system. The primary hypothesis was that the accuracy of chest tracking would be higher than that of abdominal tracking as the chest is a more direct surrogate of the breast target.

Methods And Materials: Patients with left-sided breast cancer were treated in deep inspiration breath hold with intensity modulated radiation therapy delivery.

Comparing immobilisation devices in gynaecological external beam radiotherapy: improving inter-fraction reproducibility of pelvic tilt.

Introduction: The aim was to determine which immobilisation device improved inter-fraction reproducibly of pelvic tilt and required the least pre-treatment setup and planning interventions.

Methods: Sixteen patients were retrospectively reviewed, eight immobilised using the BodyFIX system (BodyFIX®, Elekta, Stockholm, Sweden) and eight using the Butterfly Board (BB) (Bionix Radiation Therapy, Toledo, OH, USA). The daily pre-treatment images were reviewed to assess setup variations between each patient and groups for pelvic tilt, pubic symphysis, sacral promontory and the fifth lumbar spine (L5).

Safety and efficacy of single insertion accelerated MR-image guided brachytherapy following chemo-radiation in locally advanced cervix cancer: modifying our EMBRACE during the COVID pandemic.

Background: Utero-vaginal brachytherapy (BT) is an irreplaceable care component for the curative treatment of locally advanced cervix cancer (LACC). Magnetic Resonance Imaging (MRI)-image guided adaptive BT (IGABT) using the GYN-GEC-ESTRO EMBRACE guidelines is the international care standard. Usually following chemo-radiation therapy (CRT), IGABT has high proven utility in LACC but requires significant health system resources.

BRAVEHeart: a randomised trial comparing the accuracy of Breathe Well and RPM for deep inspiration breath hold breast cancer radiotherapy.

Background: Deep inspiration breath hold (DIBH) reduces radiotherapy cardiac dose for left-sided breast cancer patients. The primary aim of the BRAVEHeart (Breast Radiotherapy Audio Visual Enhancement for sparing the Heart) trial is to assess the accuracy and usability of a novel device, Breathe Well, for DIBH guidance for left-sided breast cancer patients. Breathe Well will be compared to an adapted widely available monitoring system, the Real-time Position Management system (RPM).

Early Outcomes and Decision Regret Using PSMA/MRI-Guided Focal Boost for Prostate Cancer SBRT.

Purpose: Stereotactic body radiation therapy (SBRT) is a recognized treatment for low- and intermediate-risk prostate cancer, with 36.25 Gy in 5 fractions the most commonly used regimen. We explored the preliminary efficacy, patient recorded toxicity, and decision regret in intermediate- and high-risk prostate cancer receiving SBRT with prostate-specific membrane antigen (PSMA)/magnetic resonance imaging (MRI) guided focal gross tumor volume boost to 45 Gy.

Improving efficiency in the radiation management of multiple brain metastases using a knowledge-based planning solution for single-isocentre volumetric modulated arc therapy (VMAT) technique.

Introduction: This study aimed to develop a single-isocentre volumetric modulated arc therapy (si-VMAT) technique for multiple brain metastases using knowledge-based planning software, comparing it with a multiple-isocentre stereotactic radiosurgery (mi-SRS) planning approach.

Methods: Twenty-six si-VMAT plans were created and uploaded into RapidPlan (RP) to create a si-VMAT model. Ten patients, with 2 to 6 metastases (mets), were planned with a si-VMAT technique utilising RP, and a mi-SRS technique on Brainlab iPlan.

Potential gains: Comparison of a mono-isocentric three-dimensional conformal radiotherapy (3D-CRT) planning technique to hybrid intensity-modulated radiotherapy (hIMRT) to the whole breast and supraclavicular fossa (SCF) region.

Introduction: Until late 2018, standard of practice at the Northern Sydney Cancer Centre (NSCC) for breast and nodal treatment was a conformal mono-isocentric technique. A planning study comparing an existing mono-isocentric three-dimensional conformal radiotherapy (3D-CRT) planning technique to a hybrid intensity-modulated radiotherapy (hIMRT) approach for the whole breast and supraclavicular fossa (SCF) region was undertaken with the aim to improve plan quality by improving dose conformity/homogeneity across target volumes and reducing hotspots outside the target.

Methods: A cohort of 17 patients was retrospectively planned using the proposed hIMRT technique, keeping the same planning constraints as the original treated breast and SCF 3D-CRT plan and normalising the 3D-CRT plans to achieve minimum breast/SCF target coverage to compare organs at risk (OARs).

Diagnostic Computed Tomography Enabled Planning for Palliative Radiation Therapy: Removing the Need for a Planning Computed Tomography Scan.

Purpose: This study aimed to investigate the feasibility of using diagnostic computed tomography (dCT) for palliative radiation planning, removing the need for a planning computed tomography (pCT) scan.

Methods And Materials: A sequential 2-stage study was performed. Stage 1 was a retrospective analysis of 150 patients' dCTs and pCTs to review potential barriers to radiation planning, as well as assess the field of view (FOV), patient positioning, couch curvature, and Hounsfield unit (HU) variation, and its dosimetric impact.

Developing knowledge-based planning for gynaecological and rectal cancers: a clinical validation of RapidPlan.

Introduction: To create and clinically validate knowledge-based planning (KBP) models for gynaecologic (GYN) and rectal cancer patients. Assessment of ecologic generalisability and predictive validity of conventional planning versus single calculation KBP was reviewed against practical metrics of planning time (PT) and radiation oncologist plan preference.

Method: Study cohorts were 34 and 42 consecutively treated GYN and rectal cancer patients dosimetrically archived within the centre's research databank.

Parotid sparing in RapidPlan Oropharynx models: To split or not to split.

Introduction: Differences in knowledge and experience, patient anatomy and tumour location and manipulation of inverse planning objectives and priorities will lead to a variability in the quality of radiation planning. The aim of this study was to investigate whether parotid glands should be treated as separate or combined structures when using knowledge-based planning (KBP) to create oropharyngeal plans, based on the dose they receive.

Method: Two separate RapidPlan (RP) models were created using the same 70 radical oropharyngeal patients.

Results of a Prospective Dose Escalation Study of Linear Accelerator-Based Virtual Brachytherapy (BOOSTER) for Prostate Cancer; Virtual HDR Brachytherapy for Prostate Cancer.

Purpose: To demonstrate feasibility and toxicity of linear accelerator-based stereotactic radiation therapy boost (SBRT) for prostate cancer, mimicking a high-dose-rate brachytherapy boost.

Methods And Materials: A phase 1 sequential dose escalation study of SBRT compared 20 Gy, 22 Gy, and 24 Gy to the prostate and 25 Gy, 27.5 Gy, and 30 Gy to the gross tumor volume in 2 fractions, combined with 46 Gy in 23 fractions of external beam radiation.

A comparison between radiation therapists and medical specialists in the use of kilovoltage cone-beam computed tomography scans for potential lung cancer radiotherapy target verification and adaptation.

Target volume matching using cone-beam computed tomography (CBCT) is the preferred treatment verification method for lung cancer in many centers. However, radiation therapists (RTs) are trained in bony matching and not soft tissue matching. The purpose of this study was to determine whether RTs were equivalent to radiation oncologists (ROs) and radiologists (RDs) in alignment of the treatment CBCT with the gross tumor volume (GTV) defined at planning and in delineating the GTV on the treatment CBCT, as may be necessary for adaptive radiotherapy.

A clip-based protocol for breast boost radiotherapy provides clear target visualisation and demonstrates significant volume reduction over time.

Introduction: The clinical target volume (CTV) for early stage breast cancer is difficult to clearly identify on planning computed tomography (CT) scans. Surgical clips inserted around the tumour bed should help to identify the CTV, particularly if the seroma has been reabsorbed, and enable tracking of CTV changes over time.

Methods: A surgical clip-based CTV delineation protocol was introduced.

A dosimetric comparison of 3D-CRT, IMRT, and static tomotherapy with an SIB for large and small breast volumes.

Radiation therapy to the breast is a complex task, with many different techniques that can be employed to ensure adequate dose target coverage while minimizing doses to the organs at risk. This study compares the dose planning outcomes of 3 radiation treatment modalities, 3 dimensional conformal radiation therapy (3D-CRT), intensity-modulated radiation therapy (IMRT), and static tomotherapy, for left-sided whole-breast radiation treatment with a simultaneous integrated boost (SIB). Overall, 20 patients with left-sided breast cancer were separated into 2 cohorts, small and large, based on breast volume.

Inter- and intra-fraction motion during radiation therapy to the whole breast in the supine position: a systematic review.

Inter- and intra-fraction motion during radiation therapy for breast cancer has been a widely researched topic. Recently, however, with the emergence of new technologies and techniques such as intensity modulated radiation therapy (IMRT), field in field, volumetric modulated arc therapy (VMAT), tomotherapy and partial breast irradiation (PBI), the magnitude of this movement has become more important. The aim of this study is to provide a comprehensive summary of the literature relating to the magnitude of motion during radiation therapy for a breast cancer patient.

Evaluation of patient preferences towards treatment during extended hours for patients receiving radiation therapy for the treatment of cancer: a time trade-off study.

Background: To reduce the waiting time between diagnosis and the start of radiation therapy, some departments have introduced appointments outside of conventional working hours, but the inconvenience this may cause to patients is unknown. We examined, from the patient's perspective, whether reduced waiting times to treatment would be sufficient to trade off against potentially inconvenient appointment times.

Method: We interviewed patients receiving radiation therapy at a major teaching hospital between January and May 2005.

Clinician and therapist perceptions on radiation therapist-led treatment reviews in radiation oncology practice.

Background And Purpose: To determine whether radiation therapists (RTTs) and radiation oncologists (ROs) believe RTTs can lead patient treatment reviews.

Materials And Methods: Phase 1 involved the construction of a checklist of the procedures followed during RO treatment reviews. Phase 2 employed the checklist to monitor the frequency of review procedures.

Implications for tertiary education: managerial competencies required of beginning practitioners in the health service sector.

Five hundred and three experienced practitioners involved in management from four professional fields (medical radiation science, occupational therapy, speech pathology and physiotherapy) representing a range of health care settings participated in a survey. The survey examined the importance attached to managerial competencies for the beginning practitioner. The most important grouping related to management of future planning.