Radiation Therapy for IDH-Mutant Grade 2 and Grade 3 Diffuse Glioma: An ASTRO Clinical Practice Guideline.

Purpose: This guideline provides evidence-based recommendations for adults with isocitrate dehydrogenase (IDH)-mutant grade 2 and grade 3 diffuse glioma, as classified in the 2021 World Health Organization (WHO) Classification of Tumours. It includes indications for radiation therapy (RT), advanced RT techniques, and clinical management of adverse effects.

Methods: The American Society for Radiation Oncology convened a multidisciplinary task force to address 4 key questions focused on the RT management of patients with IDH-mutant grade 2 and grade 3 diffuse glioma.

Association Between Regional Nodal Irradiation and Breast Cancer Recurrence-Free Interval for Patients With Low-Risk, Node-Positive Breast Cancer.

Purpose: Randomized clinical trials have shown that regional nodal irradiation (RNI) in patients with unselected N1 breast cancer improves breast cancer-specific survival. However, the benefit of RNI in women with biologically low-risk N1 breast cancer is uncertain. We conducted a population-based study to determine whether RNI is associated with improved breast cancer recurrence-free interval (BCRFI) in this population.

The Association Between Cardiac Mortality and Adjuvant Radiation Therapy Among Older Patients With Stage I Estrogen Positive Breast Cancer: A Surveillance, Epidemiology, and End Results (SEER)-Based Study on Cardiac Mortality and Radiation Therapy.

Purpose: We evaluated the risk of cardiac mortality in older patients who receive adjuvant radiation therapy (RT) for stage I breast cancer to determine whether this risk persists in the modern era.

Methods And Materials: Using the 2000 to 2015 Surveillance, Epidemiology, and End Results program data, we performed a population-based cohort study to evaluate the association between adjuvant breast RT, tumor laterality, and cardiac-specific survival (CSS) among patients 60 and older with stage I estrogen receptor positive breast cancer who received breast-conserving surgery and RT.

Results: At a median follow-up of 6 years (range, 0-15.

Analysis of Internet-Based Search Patterns Utilized by Glioma Patients as Information Source.

The aim of this study is to assess the Internet usage pattern amongst glioma patients and to characterize its impact in their decision-making and clinical interactions. Glioma patients attending a tertiary cancer center between June and December 2019 were invited to participate in this study. A 26-item survey consisting of closed and open-ended questions was distributed with a unique identifier.

Radiation dose for thymic tumours.

Thymomas and thymic carcinomas are rare epithelial cell tumours arising from the thymus. Definitive surgical resection continues to be the primary approach for the management of thymomas and thymic carcinomas. However, complete resection is not always achievable due to the complexity of the mediastinal anatomy and in rare cases local recurrences may occur which are often incurable.

Patients with pretreatment leukoencephalopathy and older patients have more cognitive decline after whole brain radiotherapy.

Purpose: To investigate predictors of cognitive decline after whole brain radiotherapy (WBRT) for brain metastases.

Methods: A secondary analysis of a phase 2 clinical trial was conducted in patients who received stereotactic radiosurgery for 1-10 brain metastases and WBRT (NCT01046123). The Montreal Cognitive Assessment (MoCA) was performed at baseline and every 3 months after WBRT.

Type and timing of systemic therapy use predict overall survival for patients with brain metastases treated with radiation therapy.

Introduction: This study aimed to investigate whether systemic therapy (ST) use surrounding radiation therapy (RT) predicts overall survival (OS) after RT for patients with brain metastases (BMs).

Methods: Provincial RT and pharmacy databases were used to review all adult patients in British Columbia, Canada, who received a first course of RT for BMs between 2012 and 2016 (n = 3095). Multivariate analysis on a randomly selected subset was used to develop an OS nomogram.

Clinical features of head and neck cancer patients with brain metastases: A retrospective study of 88 cases.

Objectives: Brain metastases (BM) arising from head and neck cancer (HNC) are rare and not well characterized. This study aims to describe the clinicopathological features, treatments, prognostic factors, and survival in HNC patients with BM.

Materials And Methods: Non-thyroid HNC patients referred to BC Cancer from 1998 to 2016 were retrospectively reviewed for BM.

Breast Cancer Molecular Subtype as a Predictor of Radiation Therapy Fractionation Sensitivity.

Purpose: The predictive benefit of breast cancer molecular subtypes for systemic therapy approaches has been well established; yet, there is a paucity of data regarding their use as a predictor of radiation therapy fractionation sensitivity. The purpose of this study was to determine whether rates of local recurrence (LR) for patients treated with hypofractionated (HF) radiation therapy, in comparison to conventional fractionation, differ across breast cancer molecular subtypes in a large, prospectively collected cohort treated with modern systemic therapy.

Methods And Materials: Patients who received a diagnosis of stage I-III breast cancer between 2005 and 2009 were identified.

Multiple foci of microinvasion is associated with an increased risk of invasive local recurrence in women with ductal carcinoma in situ treated with breast-conserving surgery.

Purpose: The impact of Ductal Carcinoma in Situ (DCIS) with multiple foci of microinvasion (MI) (≤ 1 mm) on the risks of local recurrence (LR) and invasive LR is unknown, leading to uncertainty if DCIS with multiple foci of MI requires more aggressive treatment. We report a population-based analysis of the impact of multiple foci of MI, confirmed by pathology review, on the 15-year risks of LR and invasive LR treated with breast-conserving surgery (BCS) ± radiotherapy (RT).

Methods: Cohort includes all women diagnosed with DCIS ± MI from 1994 to 2003 treated with BCS ± RT.

Gender, Professional Experiences, and Personal Characteristics of Academic Radiation Oncology Chairs: Data to Inform the Pipeline for the 21st Century.

Purpose: Understanding the pathways and gateways to leadership and challenges faced by individuals in such roles can inform efforts to promote diversity and equity. We sought to describe the professional experiences and personal characteristics of academic radiation oncology (RO) chairs and to evaluate whether differences exist by gender.

Methods And Materials: Anonymous surveys were distributed to 95 chairs of RO departments during the 2016 annual meeting of the Society of Chairs of Academic Radiation Oncology Programs.

Salary and Resources Provided to Junior Faculty in Radiation Oncology.

Purpose: Given the importance of access to key resources to ensure future academic success, we seek to describe what is currently provided to junior faculty in radiation oncology.

Methods And Materials: We present descriptive analyses from a survey of academic radiation oncologists in the United States and Canada who were within 5 years of board certification. We used a pretested questionnaire evaluating time, space, staff, start-up funding, and compensation.

Mentorship Experiences of Early-Career Academic Radiation Oncologists in North America.

Purpose: Given concerns about attrition and career outcomes of academic radiation oncologists, we sought to gather empirical evidence regarding mentorship experiences.

Methods And Materials: We surveyed academic radiation oncologists in the United States and Canada who were within 5 years of board certification, using a pretested questionnaire that included 14 questions evaluating the following aspects of mentorship: relationship development, peer mentorship, satisfaction with mentorship, sponsorship, relationship nature, informal interactions, mentoring roles, presence of a primary mentor, and primary mentor characteristics. We described responses and evaluated associations with gender in separate multivariable regression models that adjusted for years in practice, nature of research, possession of higher degrees, and race.

Skull base or cervical vertebral osteomyelitis following chemoradiotherapy for pharyngeal carcinoma: A serious but treatable complication.

Osteomyelitis, infection of the bone and marrow, following high dose (chemo-)radiotherapy for head and neck cancer is uncommon and rarely seen in the cervical spine or temporal bone. Due to its proximity to critical structures, osteomyelitis in the latter regions could carry potentially important consequences. Furthermore, involvement near the skull base (e.

Qualitative Assessment of Academic Radiation Oncology Department Chairs' Insights on Diversity, Equity, and Inclusion: Progress, Challenges, and Future Aspirations.

Purpose: A lack of diversity has been observed in radiation oncology (RO), with women and certain racial/ethnic groups underrepresented as trainees, faculty, and practicing physicians. We sought to gain a nuanced understanding of how to best promote diversity, equity, and inclusion (DEI) based on the insights of RO department chairs, with particular attention given to the experiences of the few women and underrepresented minorities (URMs) in these influential positions.

Methods And Materials: From March to June 2016, we conducted telephone interviews with 24 RO department chairs (of 27 invited).

Management and outcomes of women diagnosed with primary breast lymphoma: a multi-institution experience.

Purpose: Primary breast lymphoma (PBL) comprises < 1% of breast malignancies, leading to a paucity of data to guide management. We evaluated PBL recurrence patterns across two academic hospitals in the era of modern systemic-therapy and radiotherapy.

Methods: Patients diagnosed with PBL between October 1994 and June 2016 were identified.

Omitting radiation therapy after lumpectomy for pure DCIS does not reduce the risk of salvage mastectomy.

Purpose: Radiation therapy (RT) after breast-conserving surgery (BCS) for Ductal Carcinoma in Situ (DCIS) halves the risk of local recurrence (LR). The omission of RT is often supported by the paradigm that patients who develop LR can be salvaged with further breast-conserving therapy leading to higher rates of breast preservation and improved quality of life. However, population-based, long-term rates of breast preservation in women treated by upfront BCS ± RT are unknown.

Improving Therapeutic Ratios with the Oncotype DX® Ductal Carcinoma In Situ (DCIS) Score.

Ductal carcinoma in situ (DCIS) is a non-invasive breast cancer comprising nearly 25% of breast cancer diagnoses in the mammographic era. Current guidelines recommend breast-conserving surgery followed by adjuvant radiotherapy; however, controversy exists regarding the appropriateness of these recommendations. Some women with DCIS will never recur, which raises the concern of over-treatment.

Evaluation of kidney motion and target localization in abdominal SBRT patients.

The purpose of this study was to evaluate bilateral kidney and target translational/rotational intrafraction motion during stereotactic body radiation therapy treatment delivery of primary renal cell carcinoma and oligometastatic adrenal lesions for patients immobilized in the Elekta BodyFIX system. Bilateral kidney motion was assessed at midplane for 30 patients immobilized in a full-body dual-vacuum-cushion system with two patients immobilized via abdominal compression. Intrafraction motion was assessed for 15 patients using kilovoltage cone-beam computed tomography (kV-CBCT) datasets (n = 151) correlated to the planning CT.