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Tariq MR, Ali SW, Fatima N, Jabeen A, Qazi AS, Hameed A, Safdar W. Radiation Therapies in Cancer. Cancer Treat Res 2023; 185:59-77. [PMID: 37306904 DOI: 10.1007/978-3-031-27156-4_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
A crucial element of cancer treatment is radiation therapy that is used to destroy tumors and cancer cells through radiation. Another essential component is immunotherapy that helps immune system to combat cancer. The combination of both radiation therapy and immunotherapy is being focused recently for the treatment of many tumors. Chemotherapy includes the use of some chemical agent to control the growth of cancer, whereas irradiation involves the use of radiations of high energy to kill cancer cells. The union of both became the strongest practice in cancer treatment techniques. Specific chemotherapies are combined with radiation in the treatment of cancer after proper preclinical assessment of their effectiveness. Some classes of compounds include platinum-based drugs, antimicrotubules, antimetabolites (5-Fluorouracil, Capecitabine, Gemcitabine, Pemetrexed), topoisomerase I inhibitors, alkylating agents (Temozolomide), and other agents (Mitomycin-C, Hypoxic Sensitizers, Nimorazole).
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Affiliation(s)
- Muhammad Rizwan Tariq
- Department of Food Sciences, University of the Punjab, Quid-I-Azam Campus, Lahore, Pakistan.
| | - Shinawar Waseem Ali
- Department of Food Sciences, University of the Punjab, Quid-I-Azam Campus, Lahore, Pakistan
| | - Noor Fatima
- Department of Food Sciences, University of the Punjab, Quid-I-Azam Campus, Lahore, Pakistan
| | - Aqsa Jabeen
- Department of Food Sciences, University of the Punjab, Quid-I-Azam Campus, Lahore, Pakistan
| | - Asma Saleem Qazi
- Department of Biological Sciences, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Amna Hameed
- Department of Diet and Nutritional Sciences, Ibadat International University, Islamabad, Pakistan
| | - Waseem Safdar
- Department of Biological Sciences, National University of Medical Sciences, Rawalpindi, Pakistan
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Rosenberg DM, Braunstein SE, Fields EC, Gillespie EF, Gunther JR, Jimenez RB, Yechieli RL, Golden DW. Radiation Oncology Education Collaborative Study Group Annual Spring Symposium: Initial Impact and Feedback. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1504-1509. [PMID: 33728871 DOI: 10.1007/s13187-021-01990-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/02/2021] [Indexed: 06/12/2023]
Abstract
The Radiation Oncology Education Collaborative Study Group (ROECSG) is an international collaborative network of radiation oncology (RO) professionals with the goal of improving RO education. This report summarizes the first two ROECSG annual symposia including an overview of presentations and analysis of participant feedback. One-day symposia were held in June 2018 and May 2019. Programs included oral and poster presentations, RO education leadership perspectives, and keynote addresses. Post-symposia surveys were collected. Research presentations were recorded and made available online. The 2018 symposium was had 36 attendees from 25 institutions in three countries. The 2019 symposium had 76 individuals from 41 institutions in five countries. Attendees represented diverse backgrounds including attending physicians (46%), residents (13%), medical students (14%), physicists (2%), nurses (1%), and program coordinators (1%). Fifty-five oral presentations were given with 53 released online. Ninety percent of attendees rated the symposium as improving their knowledge of RO educational scholarship, 98% felt the symposium provided the opportunity to receive feedback on RO education scholarship, and 99% felt that the symposium fostered the development of collaborative RO education projects. ROECSG was rated higher than professional organizations in fostering educational scholarship (p<0.001). All attendees felt that the symposium produced new RO education scholarship ideas and provided unique networking opportunities. The first two ROECSG symposia drew a diverse population of attendees and provided unique opportunities for presentation of RO education scholarship. Future ROECSG symposia will be designed to enhance opportunities to present RO education scholarship and to facilitate networking.
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Affiliation(s)
- David M Rosenberg
- College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Steve E Braunstein
- Department of Radiation Oncology, University of California, San Francisco, CA, USA
| | - Emma C Fields
- Department of Radiation Oncology, Virginia Commonwealth University, Richmond, VA, USA
| | - Erin F Gillespie
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Jillian R Gunther
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rachel B Jimenez
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA
| | - Raphael L Yechieli
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Daniel W Golden
- Department of Radiation and Cellular Oncology, The University of Chicago, 5758 South Maryland Avenue MC 9006, Chicago, IL, 60637, USA.
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Miyazawa M, Ozaki D, Murata K, Habano Y, Hoshino Y, Oike T, Sutou T, Ohno T. [Usefulness of Metal Artifact-reduced Reconstruction for Image-guided Brachytherapy for Cervical Cancer]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2022; 78:72-80. [PMID: 35046224 DOI: 10.6009/jjrt.780107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To evaluate the usefulness of single-energy metal artifact reduction (SEMAR) for target delineation in brachytherapy for cervical cancer patients with metal hip implants. MATERIAL AND METHODS A series of four definitive brachytherapy sessions in the same patient was analyzed. At each brachytherapy session, the identical set of computed tomography images was subjected with or without SEMAR treatment. For both SEMAR-treated and -untreated sets, five radiation oncologists delineated the high-risk clinical target volume (HR-CTV), bladder, and rectum, for which the volume, Dice coefficient, and the dose volume parameters were compared between SEMAR-treated and -untreated datasets. RESULTS The bladder volume was significantly greater in the SEMAR-treated datasets compared with the SEMAR-untreated datasets. Importantly, for the bladder, Dice coefficient among five radiation oncologists was significantly higher for the SEMAR-treated datasets compared with the SEMAR-untreated datasets. These effects of SEMAR treatment were not evident for HR-CTV and the rectum. CONCLUSIONS These data indicate that SEMAR treatment contributes to improve delineation of the bladder in brachytherapy for cervical cancer patients with metal hip implants.
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Affiliation(s)
| | | | - Kazutoshi Murata
- National Institutes for Quantum and Radiological Science and Technology QST Hospital
| | - Youji Habano
- Department of Radiology, Gunma University Hospital
| | | | - Takahiro Oike
- Department of Radiation Oncology, Gunma University Hospital
| | | | - Tatsuya Ohno
- Department of Radiation Oncology, Gunma University Hospital
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Arifin AJ, Liubchenko K, Boldt G, Nguyen TK. A Scoping Review of Radiation Oncology Educational and Career-Planning Interventions in Undergraduate Medical Education. ACTA ACUST UNITED AC 2021; 28:740-749. [PMID: 33572574 PMCID: PMC7985784 DOI: 10.3390/curroncol28010072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 01/27/2021] [Indexed: 11/16/2022]
Abstract
Radiation oncology (RO) teaching in undergraduate medical education (UME) is lacking worldwide with potentially detrimental effects on medical student career choices and patient care. The objective of this scoping review is to examine the extent of published literature describing RO educational and career-planning interventions in UME. Online databases were searched from respective dates of inception to June 2020 for articles that reported outcomes from RO educational and career-planning interventions in UME. Two independent reviewers screened entries for inclusion. Following full-text reviews, 25 articles were analyzed. Most interventions were a single session, involved clinical medical students, and were based in North America. Didactic teaching was most commonly used, though a majority included interactive learning in addition to or in place of didactic teaching. As expected, there was a heterogeneity of outcomes reported, and most studies collected data using surveys alone. Recurring topics included the multidisciplinary nature of oncology and psychosocial oncology. There was a paucity of studies reporting on formal mentorship programs and research programs. The data collated in this study can help develop new initiatives based on what has succeeded in the past. Areas that may benefit from future studies include mentorship programs, research programs, and interventions from outside North America.
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Affiliation(s)
- Andrew J. Arifin
- Department of Radiation Oncology, London Regional Cancer Program, London, ON N6A 3W9, Canada; (A.J.A.); (G.B.)
| | - Karina Liubchenko
- Schulich School of Medicine & Dentistry, Western University, London, ON N6A 5C1, Canada;
| | - Gabriel Boldt
- Department of Radiation Oncology, London Regional Cancer Program, London, ON N6A 3W9, Canada; (A.J.A.); (G.B.)
| | - Timothy K. Nguyen
- Department of Radiation Oncology, London Regional Cancer Program, London, ON N6A 3W9, Canada; (A.J.A.); (G.B.)
- Correspondence: ; Tel.: +1-519-685-8500
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Kozan AA, Chan LH, Biyani CS. Current Status of Simulation Training in Urology: A Non-Systematic Review. Res Rep Urol 2020; 12:111-128. [PMID: 32232016 PMCID: PMC7085342 DOI: 10.2147/rru.s237808] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 02/20/2020] [Indexed: 12/15/2022] Open
Abstract
Simulation has emerged as an effective solution to increasing modern constraints in surgical training. It is recognized that a larger proportion of surgical complications occur during the surgeon's initial learning curve. The simulation takes the learning curve out of the operating theatre and facilitates training in a safe and pressure-free environment whilst focusing on patient safety. The cost of simulation is not insignificant and requires commitment in funding, human resources and logistics. It is therefore important for trainers to have evidence when selecting various simulators or devices. Our non-systematic review aims to provide a comprehensive up-to-date picture on urology simulators and the evidence for their validity. It also discusses emerging technologies and future directions. Urologists should embed evidence-based simulation in training programs to shorten learning curves while maintaining patient safety and work should be directed toward a validated and agreed curriculum.
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Affiliation(s)
- Andrei Adrian Kozan
- Department of Urology, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Cottingham, UK
| | - Luke Huiming Chan
- Department of Urology, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Sheffield, UK
| | - Chandra Shekhar Biyani
- Department of Urology, The Leeds Teaching Hospitals NHS Trust, St James’s University Hospital, Leeds, UK
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Hagen M, Kretschmer M, Würschmidt F, Gauer T, Giro C, Karsten E, Lorenzen J. Clinical relevance of metal artefact reduction in computed tomography (iMAR) in the pelvic and head and neck region: Multi-institutional contouring study of gross tumour volumes and organs at risk on clinical cases. J Med Imaging Radiat Oncol 2019; 63:842-851. [PMID: 31265214 DOI: 10.1111/1754-9485.12924] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 06/03/2019] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Artefacts caused by dental implants and hip replacements may impede target volume definition and dose calculation accuracy. The iterative metal artefact reduction (iMAR) algorithm can provide a solution for this problem. The present study compares delineation of gross tumour volumes (GTVs) and organs at risk (OARs) in the pelvic and the head and neck (H & N) regions using computed tomography (CT) with and without iMAR, and thus the practical applicability of iMAR for routine clinical use. METHODS The native planning CT and CT-iMAR data of two typical clinical cases with image-distorting artefacts were used for multi-institutional contouring and analysis using the Dice similarity coefficient (DSC). GTV/OAR contours were compared with an intraobserver approach and compared to predefined reference structures. RESULTS Mean volume for GTVprostate in the intraobserver approach decreased from 87 ± 44 cm3 (native CT) to 75 ± 22 cm3 (CT-iMAR) (P = 0.168). Compared to the reference, DSC values for GTVP rostate increased from 0.68 ± 0.15 to 0.78 ± 0.07 (CT vs. iMAR) (P < 0.05). In the H & N region, the reference for GTVT ongue (34 cm3 ) was underestimated on both data sets. No significant improvement in DSC values (0.83 ± 0.06 (native CT) versus 0.86 ± 0.06 (CT-iMAR)) was observed. CONCLUSION The use of iMAR improves the anatomical delineation at the transition of prostate and bladder in cases of bilateral hip replacement. In the H & N region, anatomical residual structures and experience were apparently sufficient for precise contouring.
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Affiliation(s)
| | | | | | - Tobias Gauer
- Department of Radiotherapy and Radio-Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Elias Karsten
- Department of Radiotherapy, University Medical Center Schleswig-Holstein, Kiel, Germany
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Abugideiri M, Schreibmann E, Switchenko J, McDonald MW, Beitler JJ, Curran WJ, Bruner D, Patel P, Tigeneh W, Mijena M, Tian S, Dhabaan A, Esiashvili N, Liu T, Ali AN. Prospective International Pilot Study Evaluating the Efficacy of a Self-Guided Contouring Teaching Module With Integrated Feedback for Transitioning From 2D to 3D Treatment Planning. J Glob Oncol 2019; 5:1-16. [PMID: 31082303 PMCID: PMC6550062 DOI: 10.1200/jgo.18.00224] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Transitioning from two-dimensional to three-dimensional treatment planning requires developing contouring skills. Contouring atlases are excellent resources, but they do not provide users active feedback. Developing countries may not have many radiation oncologists experienced in three-dimensional planning to provide training. We sought to develop a standardized self-guided educational module with integrated feedback to teach contouring skills. METHODS AND MATERIALS All 18 oncology residents at Black Lion Hospital/Addis Ababa University in Ethiopia were trained to contour the level II lymph node station. Residents took a baseline pretest quiz, survey, and contouring evaluation. Residents then watched an instructional contouring lecture and performed three additional cases with integrated feedback by comparing their contours to gold-standard contours. Residents then took a post-training quiz, survey, and contouring evaluation. Paired t tests and analysis of variance were used for analysis. RESULTS Before training, the average number of total cases ever contoured was 2.4 and the average number of head and neck cases contoured was 0.5. Comfort with contouring improved from being “not at all comfortable” to “quite comfortable” after the 3-hour training (P < .001). The standard deviation between the resident contours and gold standard improved from 72.6 cm3 (pretest) to 7.4 cm3 (post-test). The average percentage overlap with the gold-standard contours and Dice similarity coefficient improved with each case performed, from 27.7% and 0.26 (pretest) to 80.1% and 0.77 (post-test), respectively (P < .001). After training, 16 of 18 (88.9%) residents produced a Dice similarity coefficient greater than 0.7, the threshold generally accepted for excellent agreement. CONCLUSION This self-guided teaching module was an effective tool for developing level II lymph node contouring skills by providing active feedback and resulted in improved user confidence and accuracy compared with a gold standard. This module can be expanded to other disease sites and countries to further facilitate transitioning to three-dimensional treatment planning in developing countries.
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Affiliation(s)
| | | | | | | | | | | | - Deborah Bruner
- Winship Cancer Institute of Emory University, Atlanta, GA
| | - Pretesh Patel
- Winship Cancer Institute of Emory University, Atlanta, GA
| | | | - Miressa Mijena
- Black Lion Hospital/Addis Ababa University, Addis Ababa, Ethiopia
| | - Sibo Tian
- Winship Cancer Institute of Emory University, Atlanta, GA
| | - Anees Dhabaan
- Winship Cancer Institute of Emory University, Atlanta, GA
| | | | - Tian Liu
- Winship Cancer Institute of Emory University, Atlanta, GA
| | - Arif N Ali
- Winship Cancer Institute of Emory University, Atlanta, GA
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Rooney MK, Zhu F, Gillespie EF, Gunther JR, McKillip RP, Lineberry M, Tekian A, Golden DW. Simulation as More Than a Treatment-Planning Tool: A Systematic Review of the Literature on Radiation Oncology Simulation-Based Medical Education. Int J Radiat Oncol Biol Phys 2018; 102:257-283. [PMID: 30191859 DOI: 10.1016/j.ijrobp.2018.05.064] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 04/17/2018] [Accepted: 05/20/2018] [Indexed: 12/22/2022]
Abstract
PURPOSE Simulation-based medical education (SBME) is gaining prominence as a tool to meet Accreditation Council for Graduate Medical Education-mandated competency-based assessment educational goals. SBME is used in radiation oncology, although the type and extent are not clear. This study reports a systematic literature review designed to clarify the type and extent of radiation oncology SBME. METHODS AND MATERIALS The systematic review focused on radiation oncology SBME literature. The methods followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The inclusion criteria were identified according to the PICOS (population, intervention, comparison, outcome, and setting) framework. The population included undergraduate, graduate, and continuing medical education learners. Studies were limited to English-language studies published on or after January 1, 1990, in peer-reviewed journals. PubMed, MedEdPORTAL, and in-press articles were searched. The PubMed search was conducted using predefined search terms. References and similar articles were examined. Medical Subject Headings terms in selected articles were reviewed to ensure relevant terms were included. RESULTS Fifty-four SBME publications met the inclusion criteria. Only 9 of 54 studies (17%) self-identified as SBME. SBME types included screen-based simulators (56%), simulated environments (13%), virtual reality and haptic systems (13%), simulated patients (11%), part-task trainers (6%), and computer-based systems with mannequins (2%). A variety of radiation oncology skill sets were addressed, including contouring (54%), treatment planning (20%), clinical decision making (17%), anatomy and/or radiology (13%), radiation biology and/or physics (13%), communication skills and/or patient education (13%), brachytherapy (13%), and immobilization (11%). A target learning population was defined in 47 studies, including residents (53%), attending physicians (36%), medical students (21%), medical physicists (11%), radiation therapists (9%), nurses (6%), administrative staff (4%), and dosimetrists (4%). Learner feedback was reported in 32 studies. CONCLUSIONS Overall, this systematic literature review provides context and guidance for future radiation oncology SBME development. Appropriately framing SBME reports in the radiation oncology literature will facilitate development, implementation, and evaluation of SBME interventions. SBME resources should be centralized to facilitate dissemination and share resources.
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Affiliation(s)
- Michael K Rooney
- College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Fan Zhu
- College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Erin F Gillespie
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jillian R Gunther
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas
| | - Ryan P McKillip
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois
| | - Matthew Lineberry
- Zamierowski Institute for Experiential Learning, University of Kansas, Kansas City, Kansas
| | - Ara Tekian
- Department of Medical Education, University of Illinois at Chicago, Chicago, Illinois
| | - Daniel W Golden
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, Illinois.
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Swanick CW, Castle KO, Vedam S, Munsell MF, Turner LM, Rauch GM, Jhingran A, Eifel PJ, Klopp AH. Comparison of Computed Tomography- and Magnetic Resonance Imaging-based Clinical Target Volume Contours at Brachytherapy for Cervical Cancer. Int J Radiat Oncol Biol Phys 2016; 96:793-800. [PMID: 27788952 DOI: 10.1016/j.ijrobp.2016.07.035] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 07/15/2016] [Accepted: 07/26/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE We prospectively compared computed tomography (CT)- and magnetic resonance imaging (MRI)-based high-risk clinical target volume (HR-CTV) contours at the time of brachytherapy for cervical cancer in an effort to identify patients who might benefit most from MRI-based planning. METHODS AND MATERIALS Thirty-seven patients who had undergone a pretreatment diagnostic MRI scan were included in the analysis. We delineated the HR-CTV on the brachytherapy CT and brachytherapy MRI scans independently for each patient. We then calculated the absolute volumes for each HR-CTV and the Dice coefficient of similarity (DC, a measure of spatial agreement) for the HR-CTV contours. We identified the clinical and tumor factors associated with (1) a discrepancy in volume between the CT HR-CTV and MRI HR-CTV contours; and (2) DC. The mean values were compared using 1-way analysis of variance or paired or unpaired t tests, as appropriate. Simple and multivariable linear regression analyses were used to model the effects of covariates on the outcomes. RESULTS Patients with International Federation of Gynecology and Obstetrics stage IB to IVA cervical cancer were treated with intracavitary brachytherapy using tandem and ovoid (n=33) or tandem and cylinder (n=4) applicators. The mean CT HR-CTV volume (44.1 cm3) was larger than the mean MRI HR-CTV volume (35.1 cm3; P<.0001, paired t test). On multivariable analysis, a higher body mass index (BMI) and tumor size ≥5 cm with parametrial invasion on the MRI scan at diagnosis were associated with an increased discrepancy in volume between the HR-CTV contours (P<.02 for both). In addition, the spatial agreement (as measured by DC) between the HR-CTV contours decreased with an increasing BMI (P=.013). CONCLUSIONS We recommend MRI-based brachytherapy planning for patients with tumors >5 cm and parametrial invasion on MRI at diagnosis and for those with a high BMI.
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Affiliation(s)
- Cameron W Swanick
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Sastry Vedam
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mark F Munsell
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lehendrick M Turner
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Gaiane M Rauch
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Anuja Jhingran
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Patricia J Eifel
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ann H Klopp
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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