Participant Evaluation of a Multi-disciplinary Oncology Preceptorship Training Program for Oncology Health Professionals from Kumasi, Ghana.

A critical shortage of skilled healthcare workers is a primary cause of disparate global cancer outcomes. We report participant evaluation of a multidisciplinary preceptorship program. In collaboration with the city of Kumasi, Ghana, Mayo Clinic and the City Cancer Challenge hosted a preceptorship program for comprehensive multidisciplinary breast and cervix cancer training.

Knowledge-based quality assurance of a comprehensive set of organ at risk contours for head and neck radiotherapy.

Introduction: Manual review of organ at risk (OAR) contours is crucial for creating safe radiotherapy plans but can be time-consuming and error prone. Statistical and deep learning models show the potential to automatically detect improper contours by identifying outliers using large sets of acceptable data (knowledge-based outlier detection) and may be able to assist human reviewers during review of OAR contours.

Methods: This study developed an automated knowledge-based outlier detection method and assessed its ability to detect erroneous contours for all common head and neck (HN) OAR types used clinically at our institution.

Sublobar Resection, Stereotactic Body Radiation Therapy, and Percutaneous Ablation Provide Comparable Outcomes for Lung Metastasis-Directed Therapy.

Background: Prolonged survival of patients with metastatic disease has furthered interest in metastasis-directed therapy (MDT).

Research Question: There is a paucity of data comparing lung MDT modalities. Do outcomes among sublobar resection (SLR), stereotactic body radiation therapy (SBRT), and percutaneous ablation (PA) for lung metastases vary in terms of local control and survival?

Study Design And Methods: Medical records of patients undergoing lung MDT at a single cancer center between January 2015 and December 2020 were reviewed.

Pencil Beam Scanning Proton Therapy for Pregnant Patients With Brain and Head and Neck Cancers.

Purpose: When radiation therapy is medically necessary for pregnant patients, photon-based treatments (XRT) have traditionally been used, whereas proton radiation therapy (PRT) is avoided due to concerns about neutron dose. This retrospective study analyzes pregnant patients treated with XRT and models the equivalent dose that would have been delivered to the fetus with proton radiation compared with XRT. The purpose of this work is to provide a comprehensive analysis of pencil beam scanning proton therapy (PBS-PRT) for pregnant patients and to evaluate whether PBS-PRT should be the new standard of practice for treating pregnant patients with brain and head and neck cancers.

Research Publication Rates Are Age- and Era-Dependent for Radiation Oncologists From Highly Ranked NCI-Designated Cancer Centers.

Purpose: Quantitative bibliometrics are increasingly used to evaluate faculty research productivity. This study benchmarks publication rates for radiation oncologists from highly ranked National Cancer Institute-designated cancer centers and reveals how productivity changes over the arc of a career and of the field over time.

Methods And Materials: Peer-reviewed articles from 1970 to 2022 were obtained using Scopus for the 348 radiation oncologists listed as faculty for the top 10 cancer hospitals ranked by US News and World Report in 2022.

Development and validation of a unifying pre-treatment decision tool for intracranial and extracranial metastasis-directed radiotherapy.

Background: Though metastasis-directed therapy (MDT) has the potential to improve overall survival (OS), appropriate patient selection remains challenging. We aimed to develop a model predictive of OS to refine patient selection for clinical trials and MDT.

Patients And Methods: We assembled a multi-institutional cohort of patients treated with MDT (stereotactic body radiation therapy, radiosurgery, and whole brain radiation therapy).

Development and validation of a recursive partitioning analysis-based pretreatment decision-making tool identifying ideal candidates for spine stereotactic body radiation therapy.

Background: This study was aimed at developing and validating a decision-making tool predictive of overall survival (OS) for patients receiving stereotactic body radiation therapy (SBRT) for spinal metastases.

Methods: Three hundred sixty-one patients at one institution were used for the training set, and 182 at a second institution were used for external validation. Treatments most commonly involved one or three fractions of spine SBRT.

Automated testing platform for radiotherapy treatment planning scripts.

Realizing the potential of user-developed automation software interacting with a treatment planning system (TPS) requires rigorous testing to ensure patient safety and data integrity. We developed an automated test platform to allow comparison of the treatment planning database before and after the execution of a write-enabled script interacting with a commercial TPS (Eclipse, Varian Medical Systems, Palo Alto, CA) using the vendor-provided Eclipse Scripting Application Programming Interface (ESAPI). The C#-application known as Write-Enable Script Testing Engine (WESTE) serializes the treatment planning objects (Patient, Structure Set, PlanSetup) accessible through ESAPI, and then compares the serialization acquired before and after the execution of the script being tested, documenting identified differences to highlight the changes made to the treatment planning data.

Single and Multifraction Spine Stereotactic Body Radiation Therapy and the Risk of Radiation Induced Myelopathy.

Purpose: This study reports on the risk of radiation-induced myelitis (RM) of the spinal cord from a large single-institutional experience with 1 to 5 fraction stereotactic body radiation therapy (SBRT) to the spine.

Methods And Materials: A retrospective review of patients who received spine SBRT to a radiation naïve level at or above the conus medullaris between 2007 and 2019 was performed. Local failure determination was based on SPIne response assessment in Neuro-Oncology criteria.

Scalable radiotherapy data curation infrastructure for deep-learning based autosegmentation of organs-at-risk: A case study in head and neck cancer.

In this era of patient-centered, outcomes-driven and adaptive radiotherapy, deep learning is now being successfully applied to tackle imaging-related workflow bottlenecks such as autosegmentation and dose planning. These applications typically require supervised learning approaches enabled by relatively large, curated radiotherapy datasets which are highly reflective of the contemporary standard of care. However, little has been previously published describing technical infrastructure, recommendations, methods or standards for radiotherapy dataset curation in a holistic fashion.

Development of transparent eye shields for total skin electron beam radiotherapy.

Purpose: For total skin electron (TSE) beam radiation therapy, the anterior eye and conjunctiva can be protected with eye shields to prevent keratitis, xerophthalmia, and cataractogenesis. Conventional metal eye shields can reduce patient balance by obscuring vision and thus increasing the risk for falls. We report on the design, fabrication, and clinical use of transparent acrylic eye shields for TSE.

Development and Internal Validation of a Recursive Partitioning Analysis-Based Model Predictive of Pain Flare Incidence After Spine Stereotactic Body Radiation Therapy.

Purpose: Pain flares are a common acute toxic effect after stereotactic body radiation therapy (SBRT) for spine metastasis. We aimed to identify a subset of patients with the highest rate of pain flare after spine SBRT to optimize prophylactic corticosteroid administration.

Methods And Materials: The data set included 428 patients with 610 treatments.

Development and Assessment of a Predictive Score for Vertebral Compression Fracture After Stereotactic Body Radiation Therapy for Spinal Metastases.

Importance: Vertebral compression fracture (VCF) is a potential adverse effect following treatment with stereotactic body radiation therapy (SBRT) for spinal metastases.

Objective: To develop and assess a risk stratification model for VCF after SBRT.

Design, Setting, And Participants: This retrospective cohort study conducted at a high-volume referral center included 331 patients who had undergone 464 spine SBRT treatments from December 2007 through October 2019.

Insights for the Growth of Stenotrophomonas maltophilia in a Diabetic Patient with Long-Term Antibiotic Use: A Case Study.

Background: Stenotrophomonas maltophilia is an uncommon gram-negative bacterium often found in individuals with long-standing broad-spectrum antibiotic use or catheter use; individuals undergoing hemodialysis; and individuals with prolonged respiratory disease, specifically, cystic fibrosis. To our knowledge, there are few reported cases of S maltophilia being the causative pathogen of infection in a diabetic foot wound.

Methods: Following multiple surgical procedures and deep tissue cultures, S maltophilia was determined to be a secondary opportunistic colonizer of the wound, necessitating a change in antibiotic therapy.

Utilization of bone scan and single photon emission computed tomography on amputation planning in acute microvascular injury: Two cases.

The use of single photon emission computer tomography (SPECT/CT) in acute vascular injury is not well documented. SPECT/CT combines the anatomic detail of computer tomography with the functional vascular perfusion of photon emission to determine the viability of osseous structures and surrounding soft tissue. The superimposed imaging provides the practitioner with a reliable anatomic image of viability of a specific anatomic area following insult or injury.

A method to perform multi-scale Monte Carlo simulations in the clinical setting.

In order to model the track structure of clinical mega-voltage photon beams in a reasonable time, it is necessary to use a multi-scale approach incorporating a track-structure algorithm for the regions of interest and a condensed history algorithm for the rest of the geometry. This paper introduces a multi-scale Monte Carlo system, which is used to hand off particle trajectory information between the two algorithms. Since condensed history algorithms ignore electrons with energy below a fixed threshold and those electrons are important to the track structure on the micrometre scale, it is necessary to hand over all charged particles to the track-structure algorithm only in a volume that extends beyond the scoring volume.

Chondroid Syringoma of the Foot: A Rare Diagnosis.

Chondroid syringoma is a rare tumor with the potential for malignant transformation and distant metastasis. The site of predilection for benign chondroid syringoma is the head and neck region, and it is less likely to involve the foot. In contrast, malignant chondroid syringoma is more commonly encountered in the extremities and is characterized by rapid growth, local invasion, and distant metastasis.

Monte Carlo calculation of dose distributions in oligometastatic patients planned for spine stereotactic ablative radiotherapy.

Dosimetric consequences of plans optimized using the analytical anisotropic algorithm (AAA) implemented in the Varian Eclipse treatment planning system for spine stereotactic body radiotherapy were evaluated by re-calculating with BEAMnrc/DOSXYZnrc Monte Carlo. Six patients with spinal vertebral metastases were planned using volumetric modulated arc therapy. The planning goal was to cover at least 80% of the planning target volume with a prescribed dose of 35 Gy in five fractions.