Predictors of Atrial Fibrillation After Thoracic Radiotherapy.

Background: Atrial fibrillation (AF) has been associated with thoracic radiotherapy, but the specific risk with irradiating different cardiac substructures remains unknown.

Objectives: This study sought to examine the relationship between irradiation of cardiac substructures and the risk of clinically significant (grade ≥3) AF.

Methods: We analyzed data from patients who underwent definitive radiotherapy for localized cancers (non-small cell lung, breast, Hodgkin lymphoma, or esophageal) at our institution between 2004 and 2022.

Hypofractionated vs Conventionally Fractionated Postmastectomy Radiation After Implant-Based Reconstruction: A Randomized Clinical Trial.

Importance: Postmastectomy radiation therapy (PMRT) improves local-regional disease control and patient survival. Hypofractionation (HF) regimens have comparable efficacy and complication rates with improved quality of life compared with conventional fractionation (CF) schedules. However, the use of HF after mastectomy in patients undergoing breast reconstruction has not been prospectively examined.

Risk of developing subsequent primary lung cancer after receiving radiation for breast cancer.

Background: Radiotherapy (RT) is integral to breast cancer treatment, especially in the current era that emphasizes breast conservation. The aim of our study was to determine the incidence of subsequent primary lung cancer after RT exposure for breast cancer over a time span of 3 decades to quantify this risk over time as modern oncologic treatment continues to evolve.

Methods: The SEER (Surveillance, Epidemiology, and End Results) database was queried from 1988 to 2014 for patients diagnosed with nonmetastatic breast cancer.

Omission of Radiotherapy After Breast-Conserving Surgery for Women With Breast Cancer With Low Clinical and Genomic Risk: 5-Year Outcomes of IDEA.

Purpose: Multiple studies have shown a low risk of ipsilateral breast events (IBEs) or other recurrences for selected patients age 65-70 years or older with stage I breast cancers treated with breast-conserving surgery (BCS) and endocrine therapy (ET) without adjuvant radiotherapy. We sought to evaluate whether younger postmenopausal patients could also be successfully treated without radiation therapy, adding a genomic assay to classic selection factors.

Methods: Postmenopausal patients age 50-69 years with pT1N0 unifocal invasive breast cancer with margins ≥2 mm after BCS whose tumors were estrogen receptor-positive, progesterone receptor-positive, and human epidermal growth factor receptor 2-negative with Oncotype DX 21-gene recurrence score ≤18 were prospectively enrolled in a single-arm trial of radiotherapy omission if they consented to take at least 5 years of ET.

Individualized Stereotactic Ablative Radiotherapy for Lung Tumors: The iSABR Phase 2 Nonrandomized Controlled Trial.

Importance: Stereotactic ablative radiotherapy (SABR) is used for treating lung tumors but can cause toxic effects, including life-threatening damage to central structures. Retrospective data suggested that small tumors up to 10 cm3 in volume can be well controlled with a biologically effective dose less than 100 Gy.

Objective: To assess whether individualizing lung SABR dose and fractionation by tumor size, location, and histological characteristics may be associated with local tumor control.

Using a Culture Committee to Improve and Maintain a Positive Workplace Environment During a Pandemic.

Workplace culture is often overlooked in interventions to improve the delivery of health care efficiency. Burnout and employee morale have been longstanding issues in health care and can negatively affect both provider and patient health. To address employee wellness and promote department unity, a culture committee was established within a radiation oncology department.

Incidence of Brain Metastases in Women Treated With Neoadjuvant Chemotherapy for Breast Cancer: Implications for Screening.

Purpose: Patients with metastatic breast cancer may develop brain metastases. Our study identified high-risk patients to refine selection criteria for BM screening approaches.

Patients: We reviewed breast cancer patients treated with neoadjuvant chemotherapy (NAC) at a single university center between 2005 and 2019.

Delays in Care Associated With Non-English-Speaking Patients With Breast Cancer.

Background: Breast cancer care requires coordination between multiple diagnostic and treatment modalities. Disparities such as age, race/ethnicity, and socioeconomic status are associated with delays in care. This study investigates whether primary language is associated with delays in breast cancer diagnosis and treatment before and through radiotherapy (RT).

Impact of Insurance on Stage of Breast Cancer Presentation for Different Races and Ethnicities.

Purpose: Survival in breast cancer is largely stage-dependent. Lack of insurance and Medicaid have been associated with later-stage breast cancer, but it is unknown to what degree this association varies by race or ethnicity.

Methods: We conducted a retrospective single-institution cohort analysis of women undergoing breast radiotherapy from 2012 to 2017 (n = 1,019).

Locoregional and Distant Outcomes in Women With cT1-3N1 Breast Cancer Treated With Neoadjuvant Chemotherapy With or Without Adjuvant Radiotherapy.

Background: We evaluated the impact of postmastectomy radiotherapy (PMRT) or supraclavicular radiation therapy (SCV RT) in women with cT1-3N1 breast cancer (BC) who became node negative (ypN0) after neoadjuvant chemotherapy (NAC).

Patients And Methods: We retrospectively reviewed 485 women treated with NAC for BC between 2005 and 2019. Radiation treatment fields were reviewed in detail.

Inflammation Mediates the Development of Aggressive Breast Cancer Following Radiotherapy.

Purpose: Women treated with radiotherapy before 30 years of age have increased risk of developing breast cancer at an early age. Here, we sought to investigate mechanisms by which radiation promotes aggressive cancer.

Experimental Design: The tumor microenvironment (TME) of breast cancers arising in women treated with radiotherapy for Hodgkin lymphoma was compared with that of sporadic breast cancers.

Association Between Patient Education Videos and Knowledge of Radiation Treatment.

Purpose: Patient knowledge of radiation therapy (RT) before consult is typically limited, with many having misconceptions or fears. There exists a need to improve patient education in RT. Our purpose was to study the impact of patient education videos on patient-reported knowledge of RT, anxiety/fear, and satisfaction.

Virtual Radiation Oncology Clerkship During the COVID-19 Pandemic and Beyond.

Purpose: We evaluated the impact of a virtual radiation oncology clerkship.

Methods And Materials: We developed a 2-week virtual radiation oncology clerkship that launched on April 27, 2020. Clerkship components included a virtual clinic with radiation oncology faculty and residents, didactic lectures, student talks, and supplemental sessions such as tumor boards and chart rounds.

Telemedicine in Radiation Oncology: Is It Here to Stay? Impacts on Patient Care and Resident Education.

Purpose: Telemedicine was rapidly and ubiquitously adopted during the COVID-19 pandemic. However, there are growing discussions as to its role postpandemic.

Methods And Materials: We surveyed patients, radiation oncology (RO) attendings, and RO residents to assess their experience with telemedicine.

Angiosarcoma of the Breast: Management and Outcomes.

Objective: Angiosarcoma of the breast is rare and has a poor prognosis. We reviewed our institution's experience with this disease to characterize presentation, identify management patterns, and report outcomes.

Methods: Fifty-eight patients with nonmetastatic angiosarcoma were identified from 1998 to 2019 and retrospectively reviewed.

Lymphopenia and clinical outcomes in patients with residual nodal disease after neoadjuvant chemotherapy for breast cancer.

Background: Patients with residual nodal disease after neoadjuvant chemotherapy for breast cancer have a poor prognosis. We wanted to evaluate whether lymphopenia after treatment for breast cancer impacted clinical outcomes.

Materials And Methods: We assessed 99 patients with node-positive disease after neoadjuvant chemotherapy.

Development of a Classification Tree to Predict Implant-Based Reconstruction Failure with or without Postmastectomy Radiation Therapy for Breast Cancer.

Purpose: The aim of this study was to determine the complications, incidence, and predictors of implant-based reconstruction failure (RF) among patients treated with mastectomy for breast cancer.

Methods: We retrospectively reviewed 108 patients who underwent mastectomy, tissue expander, and implant-based breast reconstruction with or without radiation therapy (RT) at our institution (2000-2014). Descriptive statistics determined complication incidences, with major complications defined as any complications requiring surgical intervention or inpatient management.

Impact of mastectomy for breast cancer on spinal curvature: Considerations when treating patients with scoliosis.

Objective: Mastectomy has been shown to influence body posture in women; however, there are limited data outlining changes in spine curvature after mastectomy in patients with scoliosis. We sought to quantify changes in spine curvature after mastectomy for breast cancer.

Methods: We conducted a retrospective review of 62 patients with scoliosis who underwent mastectomy for breast cancer at a single institution between 1995 and 2018.

Importance of a Culture Committee for Boosting Morale and Maintaining a Healthy Work Environment in Radiation Oncology.

During the unprecedented workplace disruption from the corona virus disease 2019 (COVID-19) pandemic, health care workers have been particularly vulnerable to increased work-related stress and anxiety. This may have a negative effect on job performance and personal well-being. Personal safety, job security, and childcare needs are essential concerns that must be addressed by health care organizations to ensure stability of its workforce.

Continuing Medical Student Education During the Coronavirus Disease 2019 (COVID-19) Pandemic: Development of a Virtual Radiation Oncology Clerkship.

Purpose: Our institution cancelled all in-person clerkships owing to the coronavirus disease 2019 pandemic. In response, we designed a virtual radiation oncology medical student clerkship.

Methods And Materials: We convened an advisory panel to design a virtual clerkship curriculum.

Patterns of Failure in Women Who Have Residual Nodal Disease After Neoadjuvant Chemotherapy for Breast Cancer According to Extent of Lymph Node Surgery.

Background: Optimal surgical management of limited axillary nodal disease following neoadjuvant chemotherapy (NAC) for breast cancer is evolving. Concerns exist with respect to leaving residual disease in the axilla when omitting axillary lymph node dissection (ALND) in this setting. We sought to determine whether extent of nodal surgery altered patterns of failure and patient outcomes.