Didactic Instruction's Impact on Medicolegal Quality of Radiation Oncology Resident Physician Documentation.

Effective documentation serves as a cornerstone for communication and patient care, especially in radiation oncology (RO). Studies have shown room for improvement in documentation practices, and although documentation guidelines exist, it is uncertain if RO physicians are aware of or adhere to them. We aimed to assess RO resident physicians' medicolegal knowledge and the impact of an educational intervention on documentation practices.

The Impact on Peer Mentorship After Implementation of a Competency-Based Residency Curriculum in Canadian Radiation Oncology Training Programs.

Purpose: Peer mentorship provides professional and personal support between physicians with similar experiences and levels of training. While peer mentorship has shown to benefit academic success and professional growth, little data has examined contextual factors, such as curricular change, that may affect the quality of these relationships. This study aims to explore the impact of a new, nationwide radiation oncology (RO) residency curriculum, known as competence by design (CBD), on peer mentorship experiences between Canadian RO residents.

Supply and Demand for Radiation Oncologists in Canada: Workforce Planning Projections From 2020 to 2040.

Purpose: The number of Canadians diagnosed with cancer, and subsequent demand for radiation therapy, are expected to increase over time. This study aimed to update our needs-based workforce planning model to ensure appropriate staffing levels in the future.

Methods And Materials: The supply of radiation oncologists, by age group, sex, and full-time equivalent status, was projected from 2020 to 2040 using a recursive-aging, input-output model developed with seeding parameters derived from national sources.

Representation of Women in Canadian Radiation Oncology Trainees and Radiation Oncologists: Progress or Regress?

Purpose: The study objective was to determine the representation of women in Canadian radiation oncology (RO) trainees and the radiation oncologist workforce over time.

Methods And Materials: Gender data for Canadian RO trainees (residents and fellows) and radiation oncologists were collected from the Canadian Post-MD Education Registry (1994-2021) and Canadian Medical Association (1994-2019). Visa trainees were excluded.

Employment Outcomes for Canadian Radiation Oncology Graduates: 2020 Assessment and Longitudinal Trends.

Purpose: Canadian radiation oncology (RO) trainees have experienced employment challenges after residency training. The present study was conducted to evaluate current employment trends and perform comparisons to prior reported assessments.

Methods And Materials: A survey was administered to all 13 Canadian RO program directors requesting the employment status and location of their graduates during the past 3 years, and their perceptions on graduates' employment challenges.

Clinical Learning, Didactic Education, and Research Experiences of Radiation Oncology Resident Physicians in Canada.

Changes in the field of radiation oncology (RO) impacts residency training. Assessing trainee experiences is essential to inform curriculum development. We aim to explore gaps and strengths in current Canadian RO training, as we move towards competency-based medical education (CBME).

Motivations, Well-Being, and Career Aspirations of Radiation Oncology Resident Physicians in Canada.

Prior Pan-Canadian surveys of Radiation Oncology (RO) residents reveal a decrease in Canadian RO employment opportunities. Canadian RO resident levels increased from 130 in 2003, peaked at 209 in 2009, then decreased to 130 in 2017. Recognizing that RO has entered another period of transition, we re-examined resident motivations and perspectives on the job market and explored well-being and career aspirations among a contemporary cohort of Canadian RO residents.

The Role of Coaches within Academic Medical Departments: Is There Value to Integrating This into Academic Mentorship Programs?

This study evaluated the benefits of formal coaching within a mentorship program in a Canadian academic medical department. Between April 2016 and September 2018, an executive coach was made available to members of the Department of Oncology at the University of Calgary. Thirty-seven individuals sought and received formal coaching during this period, using up an average of four hourly sessions; of these individuals, 13% (20/150) are full-time faculty.

Institutional review of glial tumors treated with chemotherapy: the first description of PCV-related pseudoprogression.

Background: Pseudoprogression refers to areas of enhancement on MRI postadjuvant chemoradiation that arise as a result of treatment-related effects. Pseudoprogression has been well described with temozolomide-based chemoradiation but has not been studied in the setting of procarbazine, lomustine, and vincristine (PCV) chemotherapy. We reviewed patients treated with PCV to investigate the occurrence of pseudoprogression.

Transition to practice in radiation oncology: Mind the gap.

Introduction: Physicians entering independent practice often express apprehension in managing the non-clinical aspects of practice. This study examined the perceived preparedness of radiation oncology (RO) residents for independent practice, identified education gaps, and discussed how these deficiencies could be addressed.

Materials And Methods: Focus groups with senior RO residents, fellows, new-to-practice radiation oncologists (ROs), and residency program directors were conducted.

Taking Stock: The Canadian Association of Radiation Oncology 2017 Radiation Oncologist Workforce Study.

Purpose: To identify and report radiation oncologist (RO) workforce demographics, clinical workload trends, and equipment inventory in Canada.

Methods And Materials: The Canadian Association of Radiation Oncology (CARO) distributed an online survey to RO administrative leaders at 47 Canadian cancer centers providing radiation therapy services from June to December 2017. The survey queried RO staff demographics, clinical workload, and equipment inventory from 2014 to 2016.

National Trends and Dynamic Responses in the Canadian Radiation Oncology Workforce From 1990 to 2018.

Purpose: To report radiation oncology (RO) workforce and cancer incidence trends in Canada and explore the relationship between the two.

Methods And Materials: Canadian radiation oncologist, trainee, and cancer incidence data from 1990 to 2018 were collected from the following publicly accessible administrative and health information databases: Canadian Post-MD Education Registry (1990-2018), Canadian Medical Association Physician Data Centre (1994-2018), Canadian Institute for Health Information/Scott's Medical Database (1990-2017), Canadian Cancer Registry (1990-2017), and Statistics Canada (1990-2017). Descriptive statistics were used to summarize the data.

Management of Medical Oncology Services in Canada: Redefined Workload With a Novel Supply-and-Demand Workforce Projection Model.

Purpose: We developed a workforce-planning model to predict Canadian medical oncologist (MO) supply and clinical demand during the next 10 years.

Materials And Methods: A forward calculation model was created to forecast the balance of MO supply and demand. MO supply was estimated by using Canadian Institute for Health Information, Canadian Medical Association, and Canadian Post-MD Education Registry data.

Does Motion Assessment With 4-Dimensional Computed Tomographic Imaging for Non-Small Cell Lung Cancer Radiotherapy Improve Target Volume Coverage?

Introduction: Modern radiotherapy with 4-dimensional computed tomographic (4D-CT) image acquisition for non-small cell lung cancer (NSCLC) captures respiratory-mediated tumor motion to provide more accurate target delineation. This study compares conventional 3-dimensional (3D) conformal radiotherapy (3DCRT) plans generated with standard helical free-breathing CT (FBCT) with plans generated on 4D-CT contoured volumes to determine whether target volume coverage is affected.

Materials And Methods: Fifteen patients with stage I to IV NSCLC were enrolled in the study.

Clinical Implementation of a Model-Based In Vivo Dose Verification System for Stereotactic Body Radiation Therapy-Volumetric Modulated Arc Therapy Treatments Using the Electronic Portal Imaging Device.

Purpose: To report findings from an in vivo dosimetry program implemented for all stereotactic body radiation therapy patients over a 31-month period and discuss the value and challenges of utilizing in vivo electronic portal imaging device (EPID) dosimetry clinically.

Methods And Materials: From December 2013 to July 2016, 117 stereotactic body radiation therapy-volumetric modulated arc therapy patients (100 lung, 15 spine, and 2 liver) underwent 602 EPID-based in vivo dose verification events. A developed model-based dose reconstruction algorithm calculates the 3-dimensional dose distribution to the patient by back-projecting the primary fluence measured by the EPID during treatment.

Prospective swallowing outcomes after IMRT for oropharyngeal cancer: Dosimetric correlations in a population-based cohort.

Objectives: To identify dose constraints to preserve swallowing after head and neck (H&N) radiotherapy using prospectively collected functional outcomes.

Materials And Methods: Stage III-IV oropharyngeal cancer patients were prospectively evaluated using the Royal Brisbane Hospital Outcome Measure for Swallowing and Performance Status Scale for H&N Cancer Patients at pre-treatment and 3, 6, 12, and 24months after intensity-modulated radiotherapy. Dosimetric parameters were correlated with swallowing function.

Delayed Workforce Entry and High Emigration Rates for Recent Canadian Radiation Oncology Graduates.

Purpose: To determine the employment status and location of recent Canadian radiation oncology (RO) graduates and to identify current workforce entry trends.

Methods And Materials: A fill-in-the-blank spreadsheet was distributed to all RO program directors in December 2013 and June 2014, requesting the employment status and location of their graduates over the last 3 years. Visa trainee graduates were excluded.

Liver toxicity prediction with stereotactic body radiation therapy: The impact of accounting for fraction size.

Purpose: Current liver SBRT protocols rely on the calculation of "effective volume" without accounting for the biologic effect of fraction size to estimate the risk of liver toxicity, which subsequently defines tumor prescription doses. This study compared effective volume and liver toxicity predictions with and without correction for fraction size.

Methods And Materials: The effective volume was determined for 18 liver SBRT plans with and without biologic normalization using the linear quadratic formula.

Specific mutations in transmembrane helix 8 of human concentrative Na+/nucleoside cotransporter hCNT1 affect permeant selectivity and cation coupling.

The Na+/nucleoside cotransporters hCNT1 (650 residues) and hCNT2 (658 residues) are 72% identical in amino acid sequence and contain 13 putative transmembrane helices (TMs). Both transport uridine and adenosine but are otherwise selective for pyrimidine (system cit) and purine (system cif) nucleosides, respectively. Previously, we used site-directed mutagenesis and functional expression in Xenopus oocytes to identify two pairs of adjacent residues in TMs 7 and 8 of hCNT1 (Ser319-Gln320 and Ser353-Leu354) that, when converted to the corresponding residues in hCNT2 (Gly-Met and Thr-Val, respectively), changed the permeant selectivity of the transporter from cit to cif.

The broadly selective human Na+/nucleoside cotransporter (hCNT3) exhibits novel cation-coupled nucleoside transport characteristics.

The concentrative nucleoside transporter (CNT) protein family in humans is represented by three members, hCNT1, hCNT2, and hCNT3. hCNT3, a Na+/nucleoside symporter, transports a broad range of physiological purine and pyrimidine nucleosides as well as anticancer and antiviral nucleoside drugs, and belongs to a different CNT subfamily than hCNT1/2. H+-dependent Escherichia coli NupC and Candida albicans CaCNT are also CNT family members.

Allelic isoforms of the H+/nucleoside co-transporter (CaCNT) from Candida albicans reveal separate high- and low-affinity transport systems for nucleosides.

Contigs 19-10196 and 19-20196 of the Stanford Candida albicans genome sequence databank encode two putative allelic isoforms of C. albicans CaCNT, a recently characterized 608 amino acid residue H+-coupled fungal member of the CNT family of concentrative nucleoside transport proteins. The single Ser/Gly difference between CaCNT/19-20196 and CaCNT occurs at position 328 in putative TM 7, and corresponds to a Ser/Gly substitution previously shown to contribute to the contrasting pyrimidine and purine nucleoside selectivities of human (h) and rat (r) Na+-dependent CNT1 and CNT2.

Transport of physiological nucleosides and anti-viral and anti-neoplastic nucleoside drugs by recombinant Escherichia coli nucleoside-H(+) cotransporter (NupC) produced in Xenopus laevis oocytes.

The recently identified human and rodent plasma membrane proteins CNT1, CNT2 and CNT3 belong to a gene family (CNT) that also includes the bacterial nucleoside transport protein NupC. Heterologous expression in Xenopus oocytes has established that CNT1-3 correspond functionally to the three major concentrative nucleoside transport processes found in human and other mammalian cells (systems cit, cif and cib, respectively) and mediate Na(+) - linked uptake of both physiological nucleosides and anti-viral and anti-neoplastic nucleoside drugs. Here, one describes a complementary Xenopus oocyte transport study of Escherichia coli NupC using the plasmid vector pGEM-HE in which the coding region of NupC was flanked by 5'- and 3'-untranslated sequences from a Xenopus beta-globin gene.

Functional characterization of a H+/nucleoside co-transporter (CaCNT) from Candida albicans, a fungal member of the concentrative nucleoside transporter (CNT) family of membrane proteins.

Human and other mammalian concentrative (Na(+)-linked) nucleoside transport proteins belong to a membrane protein family (CNT, TC 2.A.41) that also includes Escherichia coli H(+)-dependent nucleoside transport protein NupC.