Translation of dynamic contrast-enhanced imaging onto a magnetic resonance-guided linear accelerator in patients with head and neck cancer.

Background And Purpose: Magnetic resonance imaging - linear accelerator (MRI-linac) systems permit imaging of tumours to guide treatment. Dynamic contrast enhanced (DCE)-MRI allows investigation of tumour perfusion. We assessed the feasibility of performing DCE-MRI on a 1.

Development of a prediction model for tube feeding dependence in HPV-associated oropharyngeal cancer patients undergoing chemoradiotherapy.

Objectives: This study aimed to develop a prediction model for feeding tube dependence in a large homogenous cohort of HPV-associated oropharyngeal squamous cell carcinoma (HPV + OPSCC) patients receiving chemoradiotherapy (CRT). We further aimed to externally validate three previously published feeding tube prediction models on this cohort.

Materials And Methods: p16-confirmed HPV + OPSCC patients treated with definitive CRT at a tertiary cancer centre between April 2017 and February 2022 were identified.

Impact of Postoperative Neck Radiotherapy Volumes on Long-Term Unstimulated Saliva Flow Following Primary Surgery and Ipsilateral Neck Dissection for Oral Cavity Squamous Cell Carcinoma.

Background: We investigate the association of postoperative radiotherapy (PORT) volumes and salivary function in oral cavity SCC (OSCC).

Methods: OSCC patients undergoing PORT 2005-2021 underwent modified Schirmer test (MST) pre-PORT, 6 and/or 12 months post-PORT. Hyposalivation rates were compared by PORT volumes.

Lymphatic mapping in second primary or recurrent oral cavity cancer with prior neck treatment: A case series and scoping review.

Objectives: Lymphatic mapping is an established technique to map drainage patterns in oral cancer. Its utility in patients who have undergone prior radiation or neck dissection is not well studied.

Methods: Patients presenting to a single tertiary cancer center between 2021-2023 for a recurrent/second oral cancer that underwent lymphatic mapping were considered.

The prognostic value of image-identified extranodal extension in laryngeal and hypopharyngeal carcinoma following definitive (chemo-)radiotherapy.

Objectives: Clinical extranodal extension (cENE) is a cN modifier in TNM-8 for laryngo-hypopharygeal carcinoma (LHC). We hypothesize that image-detected ENE (iENE) can provide additional prognostic value over cENE in LHC.

Methods: Baseline CTs/MRIs of cN+ LHC patients treated with definitive (chemo-)radiotherapy between 2010-2019 were re-reviewed by a neuroradiologist using internationally accepted criteria for iENE-positive/negative (iENE+/iENE-).

Simultaneous implementation of unrelated tumour sites on the MR Linac: A review of the commissioning process from a radiographer perspective and lessons learned.

Introduction: This work reports on a systematic approach to select MRI sequences, quantify inter-observer image registration variation and determine patient positioning for the clinical implementation of MR-guided adaptive radiotherapy (MRgRT) in patients with oropharyngeal (H&N) and lung cancer.

Methods: A total of 30 participants (N=10 H&N and N=10 lung cancer patients and N=10 healthy participants) were scanned on the Elekta Unity Magnetic Resonance Linear Accelerator (MRL). Participant experience questionnaires were used to determine the most appropriate positioning device for lung treatments and tolerability of H&N immobilization devices within the confined MR Linac environment.

Evaluation of a Virtual Tai Chi Program for Older Veterans at Risk of Loneliness or Physical Deconditioning: A Quality Improvement Project.

This Quality Improvement project evaluated the implementation of a virtual Tai Chi program for older Veterans (OVs) at risk of loneliness and/or physical deconditioning. A 12-week Tai Chi course was conducted virtually at three Veterans Affairs sites using VA Video Connect (VVC). Changes in physical function based on the 30-Second Chair Stand (30CST) and loneliness based on the De Jong Gierveld Loneliness Scale (DJGS) were measured, as were the OVs' satisfaction and adherence.

Development and Standardization of an Osteoradionecrosis Classification System in Head and Neck Cancer: Implementation of a Risk-Based Model.

Purpose: Osteoradionecrosis of the jaw (ORN) can manifest in varying severity. The aim of this study is to identify ORN risk factors and develop a novel classification to depict the severity of ORN.

Methods: Consecutive patients with head and neck cancer (HNC) treated with curative-intent intensity-modulated radiation therapy (IMRT) (≥45 Gy) from 2011 to 2017 were included.

Causes and impact of delays during the COVID-19 pandemic on head and neck cancer diagnosis.

Background: The causes for delays during the COVID19 pandemic and their impact on head and neck cancer (HNC) diagnosis and staging are not well described.

Methods: Two cohorts were defined a priori for review and analysis-a Pre-Pandemic cohort (June 1 to December 31, 2019) and a Pandemic cohort (June 1 to December 31, 2020). Delays were categorized as COVID-19 related or not, and as clinician, patient, or policy related.

Association of follow-up imaging frequency with temporal incidence and patterns of distant failure following (chemo) radiotherapy for HPV related oropharyngeal cancer.

Objectives: Emerging data supports radical intent therapy for oligometastatic (OM) relapsed human papilloma virus (HPV+) related oropharyngeal cancer (OPC). We assess the association of follow-up imaging frequency amongst HPV + OPC, with temporal and spatial patterns of distant relapse, to inform rationalisation of routine post-treatment imaging.

Materials And Methods: A retrospective single centre cohort study was carried out of consecutive HPV + OPC patients treated with radical intent (chemo)radiotherapy ((CT)RT) between 2011 and 2019.

A feasibility study of adaptive radiation therapy for postprostatectomy prostate cancer.

Postoperative prostate radiotherapy requires large planning target volume (PTV) margins to account for motion and deformation of the prostate bed. Adaptive radiation therapy (ART) can incorporate image-guidance data to personalize PTVs that maintain coverage while reducing toxicity. We present feasibility and dosimetry results of a prospective study of postprostatectomy ART.

Development and Standardization of a Classification System for Osteoradionecrosis: Implementation of a Risk-Based Model.

Purpose: Osteoradionecrosis of the jaw (ORN) can manifest in varying severity. The aim of this study is to identify ORN risk factors and develop a novel classification to depict the severity of ORN.

Methods: Consecutive head-and-neck cancer (HNC) patients treated with curative-intent IMRT (≥ 45Gy) in 2011-2018 were included.

Dysphagia at 1 Year is Associated With Mean Dose to the Inferior Section of the Brain Stem.

Purpose: Dysphagia is a common toxicity after head and neck (HN) radiation therapy that negatively affects quality of life. We explored the relationship between radiation therapy dose to normal HN structures and dysphagia 1 year after treatment using image-based datamining (IBDM), a voxel-based analysis technique.

Methods And Materials: We used data from 104 patients with oropharyngeal cancer treated with definitive (chemo)radiation therapy.

Practice-based training strategy for therapist-driven prostate MR-Linac adaptive radiotherapy.

Purpose: To develop a practice-based training strategy to transition from radiation oncologist to therapist-driven prostate MR-Linac adaptive radiotherapy.

Methods And Materials: In phase 1, 7 therapists independently contoured the prostate and organs-at-risk on T2-weighted MR images from 11 previously treated MR-Linac prostate patients. Contours were evaluated quantitatively (i.

First-in-human technique translation of oxygen-enhanced MRI to an MR Linac system in patients with head and neck cancer.

Background And Purpose: Tumour hypoxia is prognostic in head and neck cancer (HNC), associated with poor loco-regional control, poor survival and treatment resistance. The advent of hybrid MRI - radiotherapy linear accelerator or 'MR Linac' systems - could permit imaging for treatment adaptation based on hypoxic status. We sought to develop oxygen-enhanced MRI (OE-MRI) in HNC and translate the technique onto an MR Linac system.

TORPEdO: A phase III trial of intensity-modulated proton beam therapy versus intensity-modulated radiotherapy for multi-toxicity reduction in oropharyngeal cancer.

•There is a lack of prospective level I evidence for the use of PBT for most adult cancers including oropharyngeal squamous cell carcinoma (OPSCC).•TORPEdO is the UK's first PBT clinical trial and aims to determine the benefits of PBT for OPSCC.•Training and support has been provided before and during the trial to reduce variations of contouring and radiotherapy planning.

Larynx cancer survival model developed through open-source federated learning.

Introduction: Federated learning has the potential to perfrom analysis on decentralised data; however, there are some obstacles to survival analyses as there is a risk of data leakage. This study demonstrates how to perform a stratified Cox regression survival analysis specifically designed to avoid data leakage using federated learning on larynx cancer patients from centres in three different countries.

Methods: Data were obtained from 1821 larynx cancer patients treated with radiotherapy in three centres.

Open-source distributed learning validation for a larynx cancer survival model following radiotherapy.

Introduction: Prediction models are useful to design personalised treatment. However, safe and effective implementation relies on external validation. Retrospective data are available in many institutions, but sharing between institutions can be challenging due to patient data sensitivity and governance or legal barriers.

Baseline MD Anderson Symptom Inventory Score is Strongly Associated With Patient-reported Acute and Late Toxicity Following (Chemo) Radiotherapy for Head and Neck Cancers.

Aims: Patient-reported outcomes measures (PROMs) are an increasingly recognised end point of radiotherapy studies. We hypothesised that the baseline PROMs score is the strongest predictor for acute and late scores after treatment. We assessed the strength of association of baseline MD Anderson Symptom Inventory (MDASI) scores, alongside other known factors for patient- or clinician-reported toxicity, with acute (6-week) and late (12-month) scores in head and neck cancer (HNC) patients following (chemo)radiotherapy.