Survival (Time-To-Event) Curve Names and Endpoints.

In oncology, "survival curves" frequently appear in journal articles and meeting presentations. The most common labels on survival curves are overall survival, relapse-free survival, progression-free survival, distant metastasis-free survival, and local and/or regional control. Unfortunately, consistency in the definition of an event differs between authors for the same prescribed survival analyses.

Flap Reconstruction Results in Longer Overall Treatment Time in Patients Treated With Surgery and Adjuvant Radiotherapy for Carcinoma of the Oral Cavity and Larynx.

Objective: There is an inverse relationship between cancer cure and overall treatment time (OTT) in patients treated with surgical resection and radiotherapy (RT).

Methods: OTT was evaluated based on the reconstruction procedure in 420 patients with oral cavity and larynx cancers treated with surgery and RT between 1991 and 2020.

Results: With OTT >85 days, the difference between no versus yes flap reconstruction was ~20 percentage points and significant for all comparisons: primary closure (+/- skin graft), 49%, vs.

NTCP modelling of xerostomia after radiotherapy for oropharyngeal cancer using the PRO-CTCAE and CTCAE scoring systems at different time-points post-RT.

Purpose: This study aims at determining the parameter values of three normal tissue complication probability (NTCP) models for the contralateral parotid gland, contralateral submandibular gland (SMG) and contralateral salivary glands regarding the endpoint of xerostomia 6-24 months after radiotherapy for oropharynx cancer.

Methods: The treatment and outcome data of 231 patients with favorable risk, HPV-associated oropharyngeal squamous cell carcinoma are analyzed. 60 Gy intensity modulated radiotherapy was delivered to all the patients.

Stereotactic Radiosurgery for Vestibular Schwannoma With Radiographic Brainstem Compression.

Objective: The safety of single-treatment stereotactic radiosurgery (SRS) for vestibular schwannoma (VS) with radiographic evidence of brainstem compression but without motor deficit is controversial. Data on linear accelerator (linac)-based SRS in this setting are scarce. We address this with an outcomes report from an unselected series of patients with VS with radiographic brainstem compression treated with linac SRS.

Association of Suppressive Myeloid Cell Enrichment with Aggressive Oropharynx Squamous Cell Carcinoma.

Background: While immune-cell infiltrated tumors, such as human papillomavirus positive (HPV+) ororpharyngeal squamous cell carcinomas (OPSCC) have been associated with an improved clinical prognosis, there is evidence to suggest that OPSCCs are also subjected to increased immunoregulatory influence. The objective of this study was to assess whether patients with clinically aggressive OPSCC have a distinct immunosuppressive immune signature in the primary tumor.

Methods: This retrospective case-control study analyzed 37 pre-treatment tissue samples from HPV+ and HPV-negative OPSCC patients treated at a single institution.

Predictors of an Academic Career in Radiation Oncology 5 to 10 Years After Residency.

Objective: To report the percentage of resident graduates in the modern era who establish careers in academic radiation oncology 5 to 10 years after residency.

Materials And Methods: The study population included 1147 radiation oncologists who completed residency between 2011 and 2017 and were practicing radiation oncologists in 2021.

Results: The percentage of 2011-2017 graduates with an academic career in 2021 (5 to 10 y after residency): Holman Pathway resident: Yes, 74% versus No, 43% ( P <0.

Repeat single-fraction stereotactic radiosurgery for recurrent vestibular schwannoma.

Background: Data are scarce on the efficacy of a second radiosurgery (SRS) treatment of vestibular schwannoma that has progressed following initial treatment with SRS. We sought to report the outcome of our repeat SRS series with long-term imaging follow-up.

Materials And Methods: We retrospectively analyzed 6 patients who met the following criteria: Repeat SRS at our institution between 1995 and 2018; solitary unilateral tumor; no evidence of neurofibromatosis; and magnetic resonance (MR) planning for both SRS treatments.

Early-stage vocal cord cancer treated with hypofractionated radiotherapy to the larynx with or without concurrent chemotherapy.

Background: We report outcomes among patients with T2 and select T3 glottic squamous cell carcinoma (SCC) treated with radiotherapy.

Methods: We reviewed T2 and T3 (only paraglottic space invasion) N0 M0 glottic SCC patients treated with curative-intent hypofractionated larynx radiotherapy, with or without concurrent systemic therapy.

Results: Of 71 patients, those who received concurrent chemotherapy (23/71; 32%) had worse prognostic factors, including impaired cord mobility (70% vs.

Esophageal Damage From Thoracic Spine Stereotactic Body Radiation Therapy.

The risk of serious esophageal damage from stereotactic body radiation therapy for a spine metastasis increases when the target is in the upper thoracic or cervical spine because the esophagus almost touches the anterior edge of the vertebral body at these levels. This report describes a case of severe esophageal damage from stereotactic body radiation therapy to the T-2 vertebral body, reviews pertinent literature, and suggests implications for future research and practice.

Adjuvant I-131 therapy for T0-3 N1b M0 differentiated thyroid cancer with many (≥ 5) positive nodes.

Background: In patients with well-differentiated thyroid cancer, there is controversy about the prognostic importance of a large number of positive neck nodes and the potential value of radioiodine therapy. The purpose of this study was to evaluate this issue in the group of patients for whom it is most clinically important - those with classic histology and favorable T and M stage.

Materials And Methods: Twenty-five patients met the following inclusion criteria: classic histology of papillary or follicular thyroid carcinoma treated with total thyroidectomy and neck dissection followed by adjuvant I-131 treatment in our department between January 1, 2003, and December 31, 2013; adult age of > 21 years; and American Joint Committee on Cancer (AJCC ) stage (8 edition) of T0-3, N1b with ≥ 5 positive nodes, and M0.

Disease Control after Radiotherapy for Adult Craniopharyngioma: Clinical Outcomes from a Large Single-Institution Series.

Purpose: To report disease control and treatment-related side effects among adult patients with craniopharyngioma treated with radiotherapy.

Methods: We performed a single-institution review of adult patients (> 21 years old) with craniopharyngioma treated with radiotherapy either definitively or postoperatively for gross residual disease. We report disease control, survival, and radiotherapy-related side effects.

How 3 Academic Centers Prescribe Stereotactic Body Radiation Therapy for Primary Lung Cancer.

Stereotactic body radiation therapy (SBRT) is commonly used to treat early-stage, node-negative primary lung cancer, but society guidelines provide limited information regarding several technical aspects of SBRT, leading to potential variation in practice. In this report, we present the technical details used by 3 academic institutions when treating a solitary primary lung tumor up to 5 cm in dimension with curative-intent SBRT. We provide specifications outlined in major active or recently completed clinical trials.

Postoperative Radiotherapy for Cutaneous Melanoma in Patients at High Risk of Local-Regional Recurrence after Surgery Alone.

We evaluated outcomes in 131 patients with cutaneous melanoma (median follow-up, 3.6 years) considered at high risk of recurrence after surgery alone treated with surgery and postoperative radiotherapy. Eligible patients had one or more of the following: recurrence after surgery, positive lymph nodes, extracapsular extension, incomplete regional node dissection, microscopically positive margins, gross residual disease, or in-transit metastases.

Potential Financial Implications of Substituting Cognitive Medicine for Technical Radiation Oncology Billing Services.

Respected authors recommend broadening the radiation oncology (RO) scope-of-practice by taking more responsibility for the general medical care of our patients, directing the delivery of systemic cancer treatments that avoid the high toxicity of cytotoxic chemotherapy, managing palliative care, and supervising inpatient services for brachytherapy cases and problems related to radiation toxicity. The purpose of these changes is to increase RO involvement in clinical decision making and to avoiding becoming pigeon-holed as technicians instead of oncologists. There are no data estimating the financial implications of substituting traditional radiation oncology practice with that of an expanded clinical role.

Human Papillomavirus-Negative Oropharyngeal Cancer Survival Outcomes Based on Primary Treatment: National Cancer Database Analysis.

Objective: To compare survival outcomes between primary surgery and primary radiation therapy (RT) in patients with human papillomavirus (HPV)-negative oropharyngeal squamous cell carcinoma (OPSCC).

Study Design: A retrospective observational cohort study.

Setting: National Cancer Database.

Increased Resident Diversity Precedes Increased Faculty Diversity: Data From a University Radiation Oncology Department.

Objectives: Increasing the percentage of academic faculty who are female and/or an under-represented minority (URM) is a goal in radiation oncology. When studying diversity changes in our University Radiation Oncology Department, we found that increases in resident diversity preceded changes in faculty diversity in every major category. To illustrate these findings, we plotted resident versus faculty diversity each year over the 52-year history of our program.