Multidimensional fatigue and its impact on work productivity, mood and quality of life in long-term survivors following definitive intensity-modulated radiotherapy for oropharyngeal cancer: A cross-sectional study.

Purpose: Radiotherapy (RT) for oropharyngeal cancer (OPC) can lead to late toxicity. Fatigue is a known debilitating issue for many cancer survivors, yet prevalence and severity of long-term fatigue in patients treated for OPC is unknown.

Method: As part of a mixed-methods study, fatigue in OPC patients ≥ 2 years post RT + / - chemotherapy was evaluated.

Pelvis Or Involved Node Treatment: Eradicating Recurrence in Prostate Cancer (POINTER-PC) - study protocol paper for a phase III multicentre, open-label randomised controlled trial.

Introduction: Prostate cancer (PCa) is the most common cancer in men. Recurrence may occur in up to half of patients initially treated with curative intent for high-risk localised/locally advanced PCa. Pelvic nodal recurrence is common in this setting, but no clear standard of care exists for these patients, with potential therapeutic approaches including stereotactic body radiotherapy (SBRT) to the involved node(s) alone, extended nodal irradiation (ENI) to treat sites of potential micrometastatic spread in addition to involved node(s) and androgen deprivation therapy with or without additional systemic anticancer therapies.

Ongoing prospective studies on reirradiation: A systematic review of a clinical trials database.

Introduction: Reirradiation has gained increasing interest, as advances in systemic therapy increase the survival of patients with cancer, and modern radiation techniques allow more precise treatments. However, high-quality prospective evidence on the safety and efficacy of reirradiation to guide clinical practice remains scarce. This systematic review evaluates ongoing prospective studies on reirradiation to identify research gaps and priorities.

Automated confidence estimation in deep learning auto-segmentation for brain organs at risk on MRI for radiotherapy.

Purpose: We have built a novel AI-driven QA method called AutoConfidence (ACo), to estimate segmentation confidence on a per-voxel basis without gold standard segmentations, enabling robust, efficient review of automated segmentation (AS). We have demonstrated this method in brain OAR AS on MRI, using internal and external (third-party) AS models.

Methods: Thirty-two retrospectives, MRI planned, glioma cases were randomly selected from a local clinical cohort for ACo training.

Dosimetric impact of contour editing on CT and MRI deep-learning autosegmentation for brain OARs.

Purpose: To establish the clinical applicability of deep-learning organ-at-risk autocontouring models (DL-AC) for brain radiotherapy. The dosimetric impact of contour editing, prior to model training, on performance was evaluated for both CT and MRI-based models. The correlation between geometric and dosimetric measures was also investigated to establish whether dosimetric assessment is required for clinical validation.

"Why am I still suffering?": Experience of long-term fatigue and neurocognitive changes in oropharyngeal cancer survivors following (chemo)radiotherapy.

Background: Late effects of cancer treatment, such as neurocognitive deficits and fatigue, can be debilitating. Other than head and neck-specific functional deficits such as impairments in swallowing and speech, little is known about survivorship after oropharyngeal cancer. This study examines the lived experience of fatigue and neurocognitive deficits in survivors of oropharyngeal squamous cell cancer and impact on their daily lives.

Brain Re-Irradiation Or Chemotherapy: a phase II randomised trial of re-irradiation and chemotherapy in patients with recurrent glioblastoma (BRIOChe) - protocol for a multi-centre open-label randomised trial.

Introduction: Glioblastoma (GBM) is the most common adult primary malignant brain tumour. The condition is incurable and, despite aggressive treatment at first presentation, almost all tumours recur after a median of 7 months. The aim of treatment at recurrence is to prolong survival and maintain health-related quality of life (HRQoL).

Long-term health-related quality of life in meningioma survivors: A mixed-methods systematic review.

Background: Meningiomas account for ~25% of all primary brain tumors. These tumors have a relatively favorable prognosis with ~92% of meningioma patients surviving >5 years after diagnosis. Yet, patients can report high disease burden and survivorship issues even years after treatment, affecting health-related quality of life (HRQOL).

Technical note: Optimization functions for re-irradiation treatment planning.

Background: Although re-irradiation is increasingly used in clinical practice, almost no dedicated planning software exists.

Purpose: Standard dose-based optimization functions were adjusted for re-irradiation planning using accumulated equivalent dose in 2-Gy fractions (EQD2) with rigid or deformable dose mapping, tissue-specific α/β, treatment-specific recovery coefficients, and voxelwise adjusted EQD2 penalization levels based on the estimated previously delivered EQD2 (EQD2 ).

Methods: To demonstrate proof-of-concept, 35 Gy in 5 fractions was planned to a fictitious spherical relapse planning target volume (PTV) in three separate locations following previous prostate treatment on a virtual human phantom.

Neurocognitive function following (chemo)radiotherapy for nasopharyngeal cancer and other head and neck cancers: A systematic review.

When radiotherapy is used in the treatment of head and neck cancers, the brain commonly receives incidental doses of radiotherapy with potential for neurocognitive changes and subsequent impact on quality of life. This has not been widely investigated to date. A systematic search of MEDLINE, EMBASE, Psycinfo Info and the Cochrane Central Register of Controlled Trials (CENTRAL) electronic databases was conducted.

Geometric evaluations of CT and MRI based deep learning segmentation for brain OARs in radiotherapy.

Deep-learning auto-contouring (DL-AC) promises standardisation of organ-at-risk (OAR) contouring, enhancing quality and improving efficiency in radiotherapy. No commercial models exist for OAR contouring based on brain magnetic resonance imaging (MRI). We trained and evaluated computed tomography (CT) and MRI OAR autosegmentation models in RayStation.

Brain Re-Irradiation Robustly Accounting for Previously Delivered Dose.

(1) Background: The STRIDeR (Support Tool for Re-Irradiation Decisions guided by Radiobiology) planning pathway aims to facilitate anatomically appropriate and radiobiologically meaningful re-irradiation (reRT). This work evaluated the STRIDeR pathway for robustness compared to a more conservative manual pathway. (2) Methods: For ten high-grade glioma reRT patient cases, uncertainties were applied and cumulative doses re-summed.

The role and potential of using quantitative MRI biomarkers for imaging guidance in brain cancer radiotherapy treatment planning: A systematic review.

Background And Purpose: Improving the accuracy of brain tumour radiotherapy (RT) treatment planning is important to optimise patient outcomes. This systematic review investigates primary studies providing clinical evidence for the integration of quantitative magnetic resonance imaging (qMRI) biomarkers and MRI radiomics to optimise brain tumour RT planning.

Materials And Methods: PubMed, Scopus, Embase and Web of Science databases were searched for all years until June 21, 2022.

Imaging Spectrum of the Developing Glioblastoma: A Cross-Sectional Observation Study.

Glioblastoma (GBM) has the typical radiological appearance (TRA) of a centrally necrotic, peripherally enhancing tumor with surrounding edema. The objective of this study was to determine whether the developing GBM displays a spectrum of imaging changes detectable on routine clinical imaging prior to TRA GBM. Patients with pre-operative imaging diagnosed with GBM (1 January 2014-31 March 2022) were identified from a neuroscience center.

Treatment plan optimisation for reirradiation.

Background: The STRIDeR (Support Tool for Re-Irradiation Decisions guided by Radiobiology) project aims to create a clinically viable re-irradiation planning pathway within a commercial treatment planning system (TPS). Such a pathway should account for previously delivered dose, voxel-by-voxel, taking fractionation effects, tissue recovery and anatomical changes into account. This work presents the workflow and technical solutions in the STRIDeR pathway.

Communication in the context of glioblastoma treatment: A qualitative study of what matters most to patients, caregivers and health care professionals.

Background: Patients with glioblastoma have a poor prognosis and treatment is palliative in nature from diagnosis. It is therefore critical that the benefits and burdens of treatments are clearly discussed with patients and caregivers.

Aim: To explore experiences and preferences around glioblastoma treatment communication in patients, family caregivers and healthcare professionals.

Neurocognitive Performance in Adults Treated With Radiation for a Primary Brain Tumor.

Purpose: The contributory effects of radiation dose to different brain regions on neurocognitive performance after radiation therapy (RT) for primary brain tumors is not well known.

Methods And Materials: In this retrospective cohort study, 30 patients with brain tumors treated with photon RT were identified, and radiation dosimetric parameters across brain regions were calculated. All patients had longitudinal neurocognitive evaluations at baseline and after treatment.

Exploratory Analysis of Serial F-fluciclovine PET-CT and Multiparametric MRI during Chemoradiation for Glioblastoma.

Anti-1-amino-3-fluorine-fluorocyclobutane-1-carboxylic acid (F-fluciclovine) positron emission tomography (PET) shows preferential glioma uptake but there is little data on how uptake correlates with post-contrast T1-weighted (Gd-T1) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) activity during adjuvant treatment. This pilot study aimed to compare F-fluciclovine PET, DCE-MRI and Gd-T1 in patients undergoing chemoradiotherapy for glioblastoma (GBM), and in a parallel pre-clinical GBM model, to investigate correlation between F-fluciclovine uptake, MRI findings, and tumour biology. F-fluciclovine-PET-computed tomography (PET-CT) and MRI including DCE-MRI were acquired before, during and after adjuvant chemoradiotherapy (60 Gy in 30 fractions with temozolomide) in GBM patients.

Volumetric and dosimetric impact of post-surgical MRI-guided radiotherapy for glioblastoma: A pilot study.

Objectives: Glioblastoma (GBM) radiotherapy (RT) target delineation requires MRI, ideally concurrent with CT simulation (pre-RT MRI). Due to limited MRI availability, <72 h post-surgery MRI is commonly used instead. Whilst previous investigations assessed volumetric differences between post-surgical and pre-RT delineations, dosimetric impact remains unknown.

Optimising tumour coverage and organ at risk sparing for hypofractionated re-irradiation in glioblastoma.

Background And Purpose: Re-irradiation may be used for recurrent glioblastoma (GBM) patients. In some cases Planning Target Volume (PTV) under-coverage is necessary to meet organ at risk (OAR) constraints. This study aimed to develop a Volumetric Modulated Arc Therapy planning solution for GBM re-irradiation including a means of assessing if target coverage would be achievable and how much PTV 'cropping' would be required to meet OAR constraints, based on PTV volume and OAR proximity.

Long-term impact of adult WHO grade II or III gliomas on health-related quality of life: A systematic review.

Background: Glioma diagnosis can be devastating and result in a range of symptoms. Relatively little is known about the long-term health-related quality of life (HRQOL) challenges faced by these patients. Establishing the impact of diagnosis on HRQOL could help positively tailor clinical decision making regarding patient support and treatment.

The Added Value of Family Caregivers' Level of Mastery in Predicting Survival of Glioblastoma Patients: A Validation Study.

Background: Glioblastoma multiforme (GBM) is an aggressive brain tumor. Patients commonly rely on family caregivers for physical and emotional support. We previously demonstrated that caregiver mastery measured shortly after diagnosis was predictive of GBM patient survival, corrected for known predictors of survival (n = 88).

Dose summation and image registration strategies for radiobiologically and anatomically corrected dose accumulation in pelvic re-irradiation.

Background: Re-irradiation (reRT) is a promising technique for patients with localized recurrence in a previously irradiated area but presents major challenges. These include how to deal with anatomical change between two courses of radiotherapy and integration of radiobiology when summating original and re-irradiation doses. The Support Tool for Re-Irradiation Decisions guided by Radiobiology (STRIDeR) project aims to develop a software tool for use in a commercial treatment planning system to facilitate more informed reRT by accounting for anatomical changes and incorporating radiobiology.