2021 AAPM Equity, Diversity, and Inclusion Climate Survey Executive Summary.

Purpose: The American Association of Physicists in Medicine (AAPM) shares the results, conclusions, and recommendations from the initial Equity, Diversity, and Inclusion Climate Survey conducted in 2021.

Methods And Materials: The climate survey targeted medical physicists who are full members of the AAPM and included demographic inquiries and questions intended to assess the working environmental climate in terms of a sense of belonging and inclusion, experiences of discrimination and harassment, and obstacles to participation within the AAPM. The survey invitation was sent to 5,500 members.

Dosimetric and radiobiologic comparison of Pd COMS plaque brachytherapy and Gamma Knife radiosurgery for choroidal melanoma.

Purpose: Plaque brachytherapy (BT) and Gamma Knife radiosurgery (GKRS) are highly conformal treatment options for choroidal melanoma. This study objectively compares physical dose and biologically effective dose (BED) distributions for these two modalities.

Methods And Materials: Tumor and organ-at-risk (OAR) dose distributions from a CT-defined reference right eye were compared between Pd COMS (Collaborative Ocular Melanoma Study Group) plaques delivering 70 Gy (plaque heterogeneity corrected) over 120 h to the tumor apex and GKRS plans delivering 22 Gy to the 40% isodose line for a representative sample of clinically relevant choroidal melanoma locations and sizes.

Brachytherapy vs. external beam radiotherapy for choroidal melanoma: Survival and patterns-of-care analyses.

Purpose: No modern randomized trials exist comparing external beam radiotherapy (EBRT) and plaque brachytherapy (BT) for choroidal melanoma, and the optimal treatment modality is currently unknown. This study compares the patterns of care and efficacy of EBRT vs. BT based on data in the Surveillance, Epidemiology, and End Results database.

COMS eye plaque brachytherapy dosimetric sensitivity to source photon energy and seed design.

This study explores the influence of source photon energy on eye plaque brachytherapy dose distributions for a 16 mm COMS plaque filled with (103)Pd, (125)I, or (131)Cs sources or monoenergetic photon emissions ranging from 12 keV to 100 keV. Dose distributions were similarly created for all permutations of three common brachytherapy seed designs. Within this range, sources with average energy ≤22 keV may reduce dose to the opposite eye wall by more than a factor of 2 while maintaining tolerable proximal sclera doses when prescribing to depths of 9 mm or less.

Quantifying the dosimetric influences of radiation coverage and brachytherapy implant placement uncertainty on eye plaque size selection.

Purpose: Quantify the dosimetric adequacy of the 2003 American Brachytherapy Society report tumor margin recommendations for Collaborative Ocular Melanoma Study (COMS) eye plaque size selection for radiation coverage and clinical plaque placement uncertainties.

Methods And Materials: Plaque heterogeneity-corrected dose distributions were generated for the range of available COMS plaque diameters (φplaque) and radionuclides. These dose distributions were used to determine the radiation dose distribution diameter (φ℞) at the eye surface for each plaque as a function of central axis prescription depth (d℞) to assess adequacy of a 2-3-mm margin for various gross tumor volume (GTV) basal diameters (φGTV).

Keeping an eye on the ring: COMS plaque loading optimization for improved dose conformity and homogeneity.

Purpose: To improve tumor dose conformity and homogeneity for COMS plaque brachytherapy by investigating the dosimetric effects of varying component source ring radionuclides and source strengths.

Material And Methods: The MCNP5 Monte Carlo (MC) radiation transport code was used to simulate plaque heterogeneity-corrected dose distributions for individually-activated source rings of 14, 16 and 18 mm diameter COMS plaques, populated with (103)Pd, (125)I and (131)Cs sources. Ellipsoidal tumors were contoured for each plaque size and MATLAB programming was developed to generate tumor dose distributions for all possible ring weighting and radionuclide permutations for a given plaque size and source strength resolution, assuming a 75 Gy apical prescription dose.

Radiobiology for eye plaque brachytherapy and evaluation of implant duration and radionuclide choice using an objective function.

Purpose: Clinical optimization of Collaborative Ocular Melanoma Study (COMS) eye plaque brachytherapy is currently limited to tumor coverage, consensus prescription dosage, and dose calculations to ocular structures. The biologically effective dose (BED) of temporary brachytherapy treatments is a function of both chosen radionuclide R and implant duration T. This study endeavored to evaluate BED delivered to the tumor volume and surrounding ocular structures as a function of plaque position P, prescription dose, R, and T.

BEDVH-A method for evaluating biologically effective dose volume histograms: application to eye plaque brachytherapy implants.

Purpose: A method is introduced to examine the influence of implant duration T, radionuclide, and radiobiological parameters on the biologically effective dose (BED) throughout the entire volume of regions of interest for episcleral brachytherapy using available radionuclides. This method is employed to evaluate a particular eye plaque brachytherapy implant in a radiobiological context.

Methods: A reference eye geometry and 16 mm COMS eye plaque loaded with (103)Pd, (125)I, or (131)Cs sources were examined with dose distributions accounting for plaque heterogeneities.

A 17-year retrospective study of institutional results for eye plaque brachytherapy of uveal melanoma using (125)I, (103)Pd, and (131)Cs and historical perspective.

Purpose: To compare overall survival, local and distant failure rates, ocular toxicity, and vision preservation in patients treated with eye plaque brachytherapy at Tufts Medical Center with those in the published literature.

Methods And Materials: Records were reviewed for 53 patients with the diagnosis of uveal melanoma treated with plaque brachytherapy at Tufts Medical Center over the past 17 years. American Joint Committee on Cancer staging (T1, T2, or T3) were 4, 39, and 10 patients, respectively.