Therapeutic cannabis use by patients with cancer in Canada: A national survey of the experiences, opinions and information needs of Radiation Therapists.

Purpose: To understand the experiences, opinions and information needs of Canadian Radiation Therapists when caring for cancer patients who are taking cannabis for therapeutic purposes (CTP).

Methods: The study employed prospective data collection, via a single cross-sectional web-based questionnaire. After REB approval, the questionnaire was distributed electronically to all Radiation Therapists across Canada.

The dosimetric underpinning of bladder filling criteria for prostate image-guided volumetric modulated arc therapy.

Objectives: Repeated CT simulation imaging is common at our institution due to failure to achieve acceptable bladder filling in patients undergoing prostate radiotherapy. There is operational value in re-assessing the validity of the bladder filling assessment criteria by comparing the quality of two plans optimized based on either an "Accepted" or "Rejected" bladder status.

Methods: Twenty prostate patients with repeated CT simulation imaging were included.

Eliminating tattoos for short course palliative radiation therapy: Set-up error, satisfaction and cost.

Purpose: Palliative patients are living longer thanks to advancements in systemic therapies and radiotherapy technologies. Prior to image guided radiotherapy, permanent ink tattoos were used to ensure set up accuracy. Permanent marks can cause psychological damage, physical pain and can reduce a patient's quality of life.

Could knowledge of patient demographics facilitate a personalized approach to radiation therapy patient education?

Introduction: Using patient demographics to tailor cancer patient education processes results in improved patient outcomes. However, there is little information on how to successfully tailor radiation therapy (RT) educational content and delivery. The aim of this quality improvement project was to describe the information preferences of a diverse group of patients undergoing RT and determine if different RT education processes were associated with certain patient demographics.

The Raystation conversation: Multidisciplinary perceptions about training, leadership, and communication during implementation of new technology.

Purpose: There is very little information guiding cancer centres as they plan for costly and time consuming implementation programs for new technology. The purpose of this research was to explore the perspectives of multiple professional groups directly involved in the implementation of a next generation treatment planning system at a large academic cancer centre .

Methods: This research was a single centre, prospective study using a qualitative design and three-phased approach (interviews, questionnaire, and focus groups).

Pre-radiotherapy pain intensity and health-related quality of life in patients with bone metastases at various vertebral levels.

Purpose: The spine is the most common site of bone metastasis from cancer and can be divided into 5 locational subsections, varying in mobility. The purpose of this research was to determine if the mobility of the metastases-bearing vertebral segment influenced pre-treatment pain intensity or health-related quality of life (HR-QoL) for patients about to receive palliative radiation therapy for painful spine metastasis.

Methods: This study was a retrospective chart review of patients referred to the Palliative Radiation Oncology Program, about to receive radiation therapy for vertebral metastasis between January 2014 and June 2016.

Prostate or bone? Comparing the efficacy of image guidance surrogates for pelvis and prostate radiotherapy using accumulated delivered dose.

Introduction: This study assessed the impact of dosimetry to both the target and normal tissue when either bony anatomy (BA) or prostate (PRO) was used as surrogates for image guidance for pelvis and prostate radiotherapy using a dose accumulation process.

Methods: Thirty patients who were prescribed 50-54Gy to the pelvic lymph nodes (PLN) and 78Gy to the prostate/seminal vesicles were included. Daily acquired CBCTs were rigidly registered to the CT using BA and PRO to simulate two different treatment positions.

Can Conformity-Based Volumetric Modulated Arc Therapy Improve Dosimetry and Speed of Delivery in Radiation Therapy to Lumbosacral Spine Compared with Conventional Techniques?

Purpose: Volumetric modulated arc therapy (VMAT) has generally been perceived as too time and resource intensive for palliative radiation therapy mainly because of the need for extensive organs at risk contouring. Dose-limiting conformity-based objectives can be automatically generated and are commonly used to conform isodoses closely around the target volumes during inverse planning. The aim of this study was to determine if conformity-based objectives can be used to create VMAT plans for lumbosacral spine palliative radiation therapy without organs at risk contours, which will improve conformity, dose homogeneity, and speed of delivery compared with standard forward planning approaches.

Cannabis and Radiation Therapy: A Scoping Review of Human Clinical Trials.

Introduction: It is estimated that at least 20% of Canadian patients with cancer use cannabis to alleviate symptoms of their disease and/or cope with the side effects of their treatment. Most patients want to learn more about cannabis from their healthcare team, but most oncology professionals feel too uninformed to make recommendations. The purpose of this scoping review was to address this oncology professionals' knowledge gap, by summarizing the literature on evaluations of the benefits and harms of cannabis use before, during, or after radiation therapy (RT).

Implementing Workshops to Improve Radiation Therapists' Knowledge and Attitudes about Sexual Health Issues in Cancer Patients.

Objectives: Although it is widely acknowledged that radiotherapy treatments can have a negative impact on a patient's sexual health, this aspect of side effect management is not commonly addressed by radiation therapists or by other cancer specialists. It is important for radiation therapists to recognize and address possible sexual health issues to provide a holistic approach to care. This quality-improvement project was designed to help radiation therapists discuss the sexual health needs of patients undergoing radiotherapy by improving their clinical knowledge, skills, and comfort level about the topic.

The Educational Utility of Blogging for MRI Technologists.

Introduction: The value of a blog as an educational tool is thought to be underestimated by health care professionals. This research aimed to explore the MRI educational utility of blogs, and to determine who was participating in writing those blogs. It was hoped that this research would increase awareness of alternative education formats that would be useful for MRI technologists.

A Phase 1 Pilot Study of Preoperative Radiation Therapy for Prostate Cancer: Long-Term Toxicity and Oncologic Outcomes.

Purpose: Neoadjuvant radiation therapy (RT) improves disease control in various cancers and has become an established oncologic treatment strategy. During 2001 to 2004, we conducted a phase 1 pilot study assessing the role of short-course preoperative RT (PreORT) for men with unfavorable intermediate- and high-risk localized prostate cancer. Herein, we present long-term follow-up toxicity and oncologic outcomes.

Efficient and Effective Personalization of PTV Margins During Radiation Therapy for Bladder Cancer.

Introduction: The magnitude of bladder filling variation during bladder cancer radiation therapy varies considerably between patients. Population-based approaches for planning target volume (PTV) margin calculation may be suboptimal for this disease site, and a strategy for personalizing PTV margins for each patient may be particularly beneficial. The purpose of this study was to identify the optimal number and sampling pattern of cone beam CT image data sets that are required when generating personalized PTV margins for whole bladder (WB) and partial bladder (PB) radiation therapy.

"I'm Just Guessing These Answers!" An Evaluation of the (In)Accuracy of Patient-Reported Medical History Collected as Part of a Breast Imaging Program.

Introduction: Hundreds of thousands of Ontario women receive breast screening imaging each year. The patient's medical history is a vital tool used to personalize breast screening approaches. This study evaluated the accuracy of self-reported medical and imaging history in patients about to receive breast imaging procedures in a large urban Canadian hospital.

Treating Too Lightly? Radiation Therapists' Experiences of Workplace Violence When Providing Care to Cancer Patients and Their Families.

Introduction: Workplace violence (WPV) is defined as any act in which a person is abused, threatened, intimidated, or assaulted during their employment. Despite an absence of published evidence, radiation therapists (RTs) are considered a "low-risk" profession for WPV. The aim of this research was to determine the incidence, severity, and impact of WPV on RTs perpetrated by patients and/or their caregivers.

Quantification of interobserver variability in image registration using cone beam CT for partial bladder radiotherapy-a comparison between lipiodol and bladder wall surface.

Objective:: The use of lipiodol or bladder wall surface (BWS) for image guidance has improved the treatment quality for partial bladder irradiation. Currently, this procedure is manually performed by different users. This study assessed the interobserver variability of using image guidance for partial bladder irradiation.

Evaluation of resource burden for bladder adaptive strategies: A timing study.

Introduction: Interfraction bladder motion is substantial and therefore many different adaptive radiotherapy approaches have been developed to accommodate that motion. Previous studies comparing the efficacy of those adaptive strategies have demonstrated that reoptimization (ReOpt) was dosimetrically superior when compared to Plan of the Day (POD) and Patient-specific PTV (PS-PTV). However, the feasibility of clinical implementation is dependent upon assessment of the resource burden.

Comparison of 3 image-guided adaptive strategies for bladder locoregional radiotherapy.

The objective of this study was to compare the dosimetric differences of a population-based planning target volume (PTV) approach and 3 proposed adaptive strategies: plan of the day (POD), patient-specific PTV (PS-PTV), and daily reoptimization (ReOpt). Bladder patients (n = 10) were planned and treated to 46 Gy in 23 fractions with a full bladder in supine position by the standard strategy using a population-based PTV. For each patient, the adaptive strategy was executed retrospectively as follows: (1) POD-multiple distributions of various PTV sizes were generated, and the appropriate distribution based on the bladder of the day was selected for each fraction; (2) PS-PTV-population-based PTV was used for the first 5 fractions and a new PTV derived using information from these fractions was used to deliver the remaining 18 fractions; and (3) ReOpt-distribution was reoptimized for each fraction based on the bladder of the day.

From Computed Tomography-Guided to Magnetic Resonance Imaging-Guided Intracavitary Brachytherapy for Cervical Cancer: What Do the Key Stakeholders Have to Say about the Transition?

Background: International brachytherapy consortiums are advocating for the incorporation of magnetic resonance imaging (MRI) into the cervical brachytherapy process as a standard-of-care. Although some evaluations have been performed to quantify the effect on procedural time, little is known about the views and experiences of key stakeholders during the transition from computed tomography to MR-guided brachytherapy. This qualitative research project explored insights from key stakeholders related to a change in the gynaecologic brachytherapy process.

Adaptive Radiotherapy for Bladder Cancer-A Systematic Review.

Introduction: Radiotherapy has been offered as a multimodality treatment for bladder cancer patients. Due to the significant variation of bladder volume observed throughout the course of treatment, large margins in the range of 20-30 mm have been used, unnecessarily irradiating a large volume of normal tissue. With the capability of visualizing soft tissue in cone beam computed tomography, there is opportunity to modify or to adapt the plan based on the variation observed during the course of treatment for quality improvement.

The effect of bowel preparation regime on interfraction rectal filling variation during image guided radiotherapy for prostate cancer.

Background: This study aimed to investigate the tolerability and impact of milk of magnesia (MoM) on interfraction rectal filling during prostate cancer radiotherapy.

Methods: Two groups were retrospectively identified, each consisting of 40 patients with prostate cancer treated with radiotherapy to prostate+/-seminal vesicles, with daily image-guidance in 78Gy/39fractions/8 weeks. The first-group followed anti-flatulence diet with MoM started 3-days prior to planning-CT and continued during radiotherapy, while the second-group followed the same anti-flatulence diet only.

Exploring the Experiences of Left-Sided Breast Cancer Patients Receiving Radiation Therapy Using the Active Breathing Coordinator.

Background: The Active Breathing Coordinator (ABC) to induce breath hold during radiation therapy is used with the intent to reduce the risk of long-term, radiation-induced cardiovascular morbidity. Many studies have explored the dosimetric and toxicity benefits of using the device, but limited research has been done on the patient's perspective. The aim of this study was to explore the patient's experience using the ABC device and to evaluate the teaching provided.