Dysphagia in Head and Neck Radiotherapy: The Influence of Pharyngeal Constrictor Anatomy and Dosimetry.

The goal of this study was to identify which anatomical and dosimetric changes correlated with late patient-reported dysphagia throughout the course of head and neck chemo-radiotherapy treatment. The patient cohort (n = 64) considered oropharyngeal and nasopharyngeal patients treated with curative intent, exhibiting no baseline dysphagia with a follow-up time greater than one year. Patients completed the MD Anderson Dysphagia Inventory during a follow-up visit.

Developing and validating multi-omics prediction models for late patient-reported dysphagia in head and neck radiotherapy.

. To investigate models developed using radiomic and dosiomic (multi-omics) features from planning and treatment imaging for late patient-reported dysphagia in head and neck radiotherapy..

An updated approach for deriving PTV margins using image guidance and deformable dose accumulation.

To demonstrate an updated approach for deriving planning target volume (PTV) margins for a patient population treated with volumetric image-guided radiotherapy.The approach uses a semi-automated workflow within commercial radiotherapy applications that combines dose accumulation with the bidirectional local distance (BLD) metric. The patient cohort is divided into derivation and validation datasets.

Comparing the M.D. Anderson Symptom and Dysphagia Inventories for Head and Neck Cancer Patients.

Objectives: Where patient-reported outcome measures (PROMs) may be administered at multiple patient visits, it is advantageous to capture these symptoms with as few questions as possible. In this study, the M.D.

Patient-Reported Outcomes-Guided Adaptive Radiation Therapy for Head and Neck Cancer.

Purpose: To identify which patient-reported outcomes (PROs) may be most improved through adaptive radiation therapy (ART) with the goal of reducing toxicity incidence among head and neck cancer patients.

Methods: One hundred fifty-five head and neck cancer patients receiving radical VMAT (chemo)radiotherapy (66-70 Gy in 30-35 fractions) completed the MD Anderson Symptom Inventory, MD Anderson Dysphagia Inventory (MDADI), and Xerostomia Questionnaire while attending routine follow-up clinics between June-October 2019. Hierarchical clustering characterized symptom endorsement.

Determining Clinical Patient Selection Guidelines for Head and Neck Adaptive Radiation Therapy Using Random Forest Modelling and a Novel Simplification Heuristic.

Purpose: To determine which head and neck adaptive radiotherapy (ART) correction objectives are feasible and to derive efficient ART patient selection guidelines.

Methods: We considered various head and neck ART objectives including independent consideration of dose-sparing of the brainstem/spinal cord, parotid glands, and pharyngeal constrictor, as well as prediction of patient weight loss. Two-hundred head and neck cancer patients were used for model development and an additional 50 for model validation.

Lasso logistic regression to derive workflow-specific algorithm performance requirements as demonstrated for head and neck cancer deformable image registration in adaptive radiation therapy.

As automation in radiation oncology becomes more common, it is important to determine which algorithms are equivalent for a given workflow. Often, algorithm comparisons are performed in isolation; however, clinical context can provide valuable insight into the importance of algorithm features and error magnification in subsequent workflow steps. We propose a strategy for deriving workflow-specific algorithm performance requirements.

Data clustering to select clinically-relevant test cases for algorithm benchmarking and characterization.

Algorithm benchmarking and characterization are an important part of algorithm development and validation prior to clinical implementation. However, benchmarking may be limited to a small collection of test cases due to the resource-intensive nature of establishing 'ground-truth' references. This study proposes a framework for selecting test cases to assess algorithm and workflow equivalence.

Radiation Oncology Device Approval in the United States and Canada.

Background Medical devices are a crucial component in the field of radiation oncology. The review and licensing of radiation oncology devices (RODs) is managed on a national basis in Canada by Health Canada and in the United States by the Food and Drug Administration (FDA). The purpose of this study was to examine differences in ROD licensing timelines between Health Canada and the FDA that may impact the ability of Canadians to access the most up-to-date radiation oncology care.

Framework for the quantitative assessment of adaptive radiation therapy protocols.

Background: Adaptive radiation therapy (ART) "flags," such as change in external body contour or relative weight loss, are widely used to identify which head and neck cancer (HNC) patients may benefit from replanned treatment. Despite the popularity of ART, few published quantitative approaches verify the accuracy of replan candidate identification, especially with regards to the simple flagging approaches that are considered current standard of practice. We propose a quantitative evaluation framework, demonstrated through the assessment of a single institution's clinical ART flag: change in body contour exceeding 1.

Clinical implementation of AXB from AAA for breast: Plan quality and subvolume analysis.

Purpose: Two dose calculation algorithms are available in Varian Eclipse software: Anisotropic Analytical Algorithm (AAA) and Acuros External Beam (AXB). Many Varian Eclipse-based centers have access to AXB; however, a thorough understanding of how it will affect plan characteristics and, subsequently, clinical practice is necessary prior to implementation. We characterized the difference in breast plan quality between AXB and AAA for dissemination to clinicians during implementation.