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Boisbouvier S, Corbin S, Charpentier M, Billaud P, Dolpierre B, Douir N, De Oliveira A, Sousa F. [The first steps towards advanced practice for radiation therapists]. Cancer Radiother 2023; 27:583-587. [PMID: 37481343 DOI: 10.1016/j.canrad.2023.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/09/2023] [Accepted: 06/13/2023] [Indexed: 07/24/2023]
Abstract
The implementation of advanced practice in RT requires evidence regarding the clinical practices of radiation therapists (RTT) in the field. In this context, the goal of this article is to report the roles assigned to RTT in order to meet the demands of patients, RT services, and/or healthcare professionals. As part of the French Society of Oncologic Radiotherapy's congress, the Radiotherapy Committee of the French Association of radiographers presented a scientific program encompassing three main themes: patient follow-up by a RTT, the expertise of an RTT in Image Guided Radiation Therapy (IGRT), Adaptive Radiotherapy (ART), and the involvement of a RTT in research. This article presents an overview of five oral presentations that highlight concrete examples of roles assigned to RTTs in these specific domains. The follow-up of patients has been assigned to RTT. Research and development have been recognized as activities in which RTT play a significant role. The establishment of RTT specializing in IGRT has been reported to facilitate decision-making and is essential in ensuring professional expertise. Lastly, there is a need to enhance RTT skills in adaptive RT to support the implementation of this technique. These roles described as advanced practice meet needs and require a specific organisational framework and appropriate education and training (master type). Activities such as post-RT follow-up, validation of positioning imaging, delineation, writing research protocols, and involvement in the development of technological innovations were identified as essential tasks that can be assigned to RTT.
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Affiliation(s)
- S Boisbouvier
- Département de radiothérapie, centre Léon-Bérard, rue Laënnec, 69008 Lyon, France.
| | - S Corbin
- Département de radiothérapie, institut Gustave-Roussy, Villejuif, France
| | - M Charpentier
- Département de radiothérapie, assistance publique des hôpitaux de Marseille, Marseille, France
| | - P Billaud
- Département de radiothérapie, institut régional du cancer de Montpellier, Montpellier, France
| | - B Dolpierre
- Département de radiothérapie, institut régional du cancer de Montpellier, Montpellier, France
| | - N Douir
- Département de radiothérapie, institut Gustave-Roussy, Villejuif, France
| | - A De Oliveira
- Département de radiothérapie, institut Curie, Paris, France
| | - F Sousa
- Département de radiothérapie, institut Jules-Bordet, université libre de Bruxelles (ULB), hôpital universitaire de Bruxelles (H.U.B), rue Meylemeersch, 90, 1070 Bruxelles, Belgique
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de Crevoisier R, Lafond C, Mervoyer A, Hulot C, Jaksic N, Bessières I, Delpon G. Image-guided radiotherapy. Cancer Radiother 2021; 26:34-49. [PMID: 34953701 DOI: 10.1016/j.canrad.2021.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We present the updated recommendations of the French society for oncological radiotherapy on image-guided radiotherapy (IGRT). The objective of the IGRT is to take into account the anatomical variations of the target volume occurring between or during the irradiation fractions, such as displacements and/or deformations, so that the delivered dose corresponds to the planned dose. This article presents the different IGRT devices, their use and quality control, and quantify the possible additional dose generated by each of them. The practical implementation of IGRT in various tumour locations is summarised, from the different "RecoRad™" guideline articles. Adaptive radiotherapy is then detailed, due to its complexity and its probable development in the next years. The place of radiation technologist in the practice of IGRT is then specified. Finally, a brief update is proposed on the delicate question of the additional dose linked to the in-room imaging, which must be estimated and documented at a minimum, as long as it is difficult to integrate it into the calculation of the dose distribution.
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Affiliation(s)
- R de Crevoisier
- Radiotherapy department, centre régional de lutte contre le cancer Eugène Marquis, 35042 Rennes, France.
| | - C Lafond
- Radiotherapy department, centre régional de lutte contre le cancer Eugène Marquis, 35042 Rennes, France
| | - A Mervoyer
- Radiotherapy department, institut de cancérologie de l'Ouest René-Gauducheau, boulevard Jacques-Monod, 44805 Saint Herblain, France; Medical physics department, institut de cancérologie de l'Ouest René-Gauducheau, boulevard Jacques-Monod, 44805 Saint Herblain, France
| | - C Hulot
- Radiotherapy department, centre régional de lutte contre le cancer Eugène Marquis, 35042 Rennes, France
| | - N Jaksic
- Radiotherapy department, centre régional de lutte contre le cancer Eugène Marquis, 35042 Rennes, France
| | - I Bessières
- Medical physics department, centre Georges-François Leclerc, rue du Professeur-Marion, 21000 Dijon, France
| | - G Delpon
- Radiotherapy department, institut de cancérologie de l'Ouest René-Gauducheau, boulevard Jacques-Monod, 44805 Saint Herblain, France; Medical physics department, institut de cancérologie de l'Ouest René-Gauducheau, boulevard Jacques-Monod, 44805 Saint Herblain, France
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Zhang S, He L, Bo C, Yang S, An Y, Li N, Zhao Y, Zhao L, Ma W, Zheng Z. Comparison of stereotactic body radiation therapy versus fractionated radiation therapy for primary liver cancer with portal vein tumor thrombus. Radiat Oncol 2021; 16:149. [PMID: 34391452 PMCID: PMC8364096 DOI: 10.1186/s13014-021-01874-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 07/30/2021] [Indexed: 01/22/2023] Open
Abstract
Background To compare the clinical outcomes of stereotactic body radiation therapy (SBRT) and fractionated radiation therapy (FRT) for primary liver cancer with portal vein tumor thrombus (PVTT). Methods This retrospective study included 36 patients who underwent SBRT and 36 patients who underwent FRT from August 2016 to June 2018. Patients were evaluated for short-term efficacy, long-term efficacy, AEs, and quality of life before and after treatment.
Results With a median follow-up of 28.8 months (26–36 months), 27 patients survived in the SBRT group while 19 patients survived in the FRT group. The survival rate in the SBRT group was statistically higher than that of the FRT group after 6 months (80.56% vs. 58.33%; P = 0.041), 12 months (77.78% vs. 55.56%; P = 0.046) and 24 months 75.00% vs. 52.78%; P = 0.049). The median whole survival time of the SBRT group was 13.3 months (95% CI 12.83–13.97), which was statistically longer than 9.8 months in the FRT group (95% CI 8.83–10.97, P < 0.05) based on the Kaplan–Meier method. The SBRT group had better survival quality and fewer adverse events than the FRT group. Conclusion SBRT had better clinical outcomes than FRT for primary liver cancer with PVTT.
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Affiliation(s)
- Sujing Zhang
- Department of Oncology, The First Hospital of Hebei Medical University, No.89 Donggang Road, Yuhua District, Shijiazhuang, 050031, Hebei, China
| | - Li He
- Department of Oncology, The First Hospital of Hebei Medical University, No.89 Donggang Road, Yuhua District, Shijiazhuang, 050031, Hebei, China
| | - Changwen Bo
- Department of Oncology, The First Hospital of Hebei Medical University, No.89 Donggang Road, Yuhua District, Shijiazhuang, 050031, Hebei, China
| | - Shufang Yang
- Department of Laboratory Medicine, Handan Hospital of Traditional Chinese Medicine, Handan, Hebei, China
| | - Yonghui An
- Department of Oncology, The First Hospital of Hebei Medical University, No.89 Donggang Road, Yuhua District, Shijiazhuang, 050031, Hebei, China
| | - Na Li
- Department of Oncology, The First Hospital of Hebei Medical University, No.89 Donggang Road, Yuhua District, Shijiazhuang, 050031, Hebei, China
| | - Yingchun Zhao
- Department of Oncology, The First Hospital of Hebei Medical University, No.89 Donggang Road, Yuhua District, Shijiazhuang, 050031, Hebei, China
| | - Liping Zhao
- Department of Oncology, The First Hospital of Hebei Medical University, No.89 Donggang Road, Yuhua District, Shijiazhuang, 050031, Hebei, China
| | - Wenhua Ma
- Department of Oncology, The First Hospital of Hebei Medical University, No.89 Donggang Road, Yuhua District, Shijiazhuang, 050031, Hebei, China
| | - Zheng Zheng
- Department of Oncology, The First Hospital of Hebei Medical University, No.89 Donggang Road, Yuhua District, Shijiazhuang, 050031, Hebei, China.
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Khalifa J, Supiot S, Pignot G, Hennequin C, Blanchard P, Pasquier D, Magné N, de Crevoisier R, Graff-Cailleaud P, Riou O, Cabaillé M, Azria D, Latorzeff I, Créhange G, Chapet O, Rouprêt M, Belhomme S, Mejean A, Culine S, Sargos P. Recommendations for planning and delivery of radical radiotherapy for localized urothelial carcinoma of the bladder. Radiother Oncol 2021; 161:95-114. [PMID: 34118357 DOI: 10.1016/j.radonc.2021.06.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 05/05/2021] [Accepted: 06/03/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE Curative radio-chemotherapy is recognized as a standard treatment option for muscle-invasive bladder cancer (MIBC). Nevertheless, the technical aspects for MIBC radiotherapy are heterogeneous with a lack of practical recommendations. METHODS AND MATERIALS In 2018, a workshop identified the need for two cooperative groups to develop consistent, evidence-based guidelines for irradiation technique in the delivery of curative radiotherapy. Two radiation oncologists performed a review of the literature addressing several topics relative to radical bladder radiotherapy: planning computed tomography acquisition, target volume delineation, radiation schedules (total dose and fractionation) and dose delivery (including radiotherapy techniques, image-guided radiotherapy (IGRT) and adaptive treatment modalities). Searches for original and review articles in the PubMed and Google Scholar databases were conducted from January 1990 until March 2020. During a meeting conducted in October 2020, results on 32 topics were presented and discussed with a working group involving 15 radiation oncologists, 3 urologists and one medical oncologist. We applied the American Urological Association guideline development's method to define a consensus strategy. RESULTS A consensus was obtained for all 34 except 4 items. The group did not obtain an agreement on CT enhancement added value for planning, PTV margins definition for empty bladder and full bladder protocols, and for pelvic lymph-nodes irradiation. High quality evidence was shown in 6 items; 8 items were considered as low quality of evidence. CONCLUSION The current recommendations propose a homogenized modality of treatment both for routine clinical practice and for future clinical trials, following the best evidence to date, analyzed with a robust methodology. The XXX group formulates practical guidelines for the implementation of innovative techniques such as adaptive radiotherapy.
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Affiliation(s)
- Jonathan Khalifa
- Department of Radiotherapy, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, France
| | - Stéphane Supiot
- Department of Radiotherapy, Institut de Cancérologie de l'Ouest, Nantes Saint-Herblain, France
| | - Géraldine Pignot
- Department of Urology, Institut Paoli Calmettes, Marseille, France
| | | | - Pierre Blanchard
- Department of Radiotherapy, Institut Gustave Roussy, Villejuif, France
| | - David Pasquier
- Department of Radiotherapy, Centre Oscar Lambret, Lille, France
| | - Nicolas Magné
- Department of Radiotherapy, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France
| | | | - Pierre Graff-Cailleaud
- Department of Radiotherapy, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, France
| | - Olivier Riou
- Department of Radiotherapy, Institut du Cancer de Montpellier, France
| | | | - David Azria
- Department of Radiotherapy, Institut du Cancer de Montpellier, France
| | - Igor Latorzeff
- Department of Radiotherapy, Clinique Pasteur, Toulouse, France
| | | | - Olivier Chapet
- Department of Radiotherapy, Hospices Civils de Lyon, France
| | - Morgan Rouprêt
- Department of Urology, Hôpital Pitié-Salpétrière, APHP Sorbonne Université, Paris, France
| | - Sarah Belhomme
- Department of Medical Physics, Institut Bergonié, Bordeaux, France
| | - Arnaud Mejean
- Department of Urology, Hôpital Européen Georges-Pompidou, Paris, France
| | - Stéphane Culine
- Department of Medical Oncology, Hôpital Saint-Louis, Paris, France
| | - Paul Sargos
- Department of Radiotherapy, Institut Bergonié, Bordeaux, France.
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Vaugier L, Ferrer L, Mengue L, Jouglar E. Radiomics for radiation oncologists: are we ready to go? BJR Open 2020; 2:20190046. [PMID: 33178967 PMCID: PMC7594896 DOI: 10.1259/bjro.20190046] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 03/06/2020] [Accepted: 03/09/2020] [Indexed: 12/19/2022] Open
Abstract
Radiomics have emerged as an exciting field of research over the past few years, with very wide potential applications in personalised and precision medicine of the future. Radiomics-based approaches are still however limited in daily clinical practice in oncology. This review focus on how radiomics could be incorporated into the radiation therapy pipeline, and globally help the radiation oncologist, from the tumour diagnosis to follow-up after treatment. Radiomics could impact on all steps of the treatment pipeline, once the limitations in terms of robustness and reproducibility are overcome. Major ongoing efforts should be made to collect and share data in the most standardised manner possible.
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Affiliation(s)
- Loïg Vaugier
- Department of Radiation Oncology, Institut de Cancérologie de l'Ouest, Nantes - Saint Herblain, France
| | - Ludovic Ferrer
- Department of Medical Physics, Institut de Cancérologie de l'Ouest, Nantes - Saint Herblain, France
| | - Laurence Mengue
- Department of Radiation Oncology, Institut de Cancérologie de l'Ouest, Nantes - Saint Herblain, France
| | - Emmanuel Jouglar
- Department of Radiation Oncology, Institut de Cancérologie de l'Ouest, Nantes - Saint Herblain, France
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Noël G, Thariat J, Antoni D. [Uncertainties in the current concept of radiotherapy planning target volume]. Cancer Radiother 2020; 24:667-675. [PMID: 32828670 DOI: 10.1016/j.canrad.2020.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/01/2020] [Accepted: 06/07/2020] [Indexed: 12/12/2022]
Abstract
The planning target volume is an essential notion in radiotherapy, that requires a new conceptualization. Indeed, the variability and diversity of the uncertainties involved or improved with the development of the new modern technologies and devices in radiotherapy suggest that random and systematic errors cannot be currently generalized. This article attempts to discuss these various uncertainties and tries to demonstrate that a redefinition of the concept of planning target volume toward its personalization for each patient and the robustness notion are likely an improvement basis to take into account the radiotherapy uncertainties.
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Affiliation(s)
- G Noël
- Service d'oncologie radiothérapie, Institut de cancérologie Strasbourg Europe (Icans), 17, rue Albert-Calmette, 67033 Strasbourg, France.
| | - J Thariat
- Département de radiothérapie, centre François-Baclesse, 3, avenue General-Harris, 14000 Caen, France; Association Advance Resource Centre for Hadrontherapy in Europe (Archade), 3, avenue General-Harris, 14000 Caen, France; Laboratoire de physique corpusculaire, Institut national de physique nucléaire et de physique des particules (IN2P3), 6, boulevard Maréchal-Juin, 14000 Caen, France; École nationale supérieure d'ingénieurs de Caen (ENSICaen), 6, boulevard Maréchal-Juin, CS 45053 14050 Caen cedex 4, France; Centre national de la recherche scientifique (CNRS), UMR 6534, 6, boulevard Maréchal-Juin, 14000 Caen, France; Université de Caen Normandie (Unicaen), esplanade de la Paix, CS 14032, 14032 Caen, France
| | - D Antoni
- Service d'oncologie radiothérapie, Institut de cancérologie Strasbourg Europe (Icans), 17, rue Albert-Calmette, 67033 Strasbourg, France
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