Prediction of Received Heart and Lung Radiation Dose in Breast Cancer Patients Undergoing Radiation Therapy Using Supervised Machine Learning

Purpose: Brachial plexopathy in breast cancer patients undergoing radiation therapy is an important side effect. The primary objective of this study was to compare the dose of two different treatment methods, the wedge and field-in-field methods, in breast cancer patients undergoing radiotherapy. Specifically, the study aimed to evaluate the impact of these methods on the radiation dose received by the brachial plexus, a critical organ at risk in breast cancer treatment. Materials and Methods: The study involved 100 breast cancer patients who underwent 25 radiation therapy fractions. The total radiation dose delivered throughout the therapy was 50 Gy, with 2 Gy per fraction. Results: The mean of maximum dose delivered to the brachial plexus was 5302.18-±2.8 cGy in the wedge group, and 5242.5 ±1.37cGy in the field-in-field group. Although the field-in-field method appeared to be less risky, statistically there was no significant difference between the two methods (P > 0.05). Additionally, the mean dose delivered using the wedge method was 4169.98 ±5.33cGy, while the field-in-field method had a mean dose of 4351.9±4.65 cGy and their difference was not statistically significant (P > 0.05). Conclusion: It must be noted that even though the field-in-field technique decreased radiation exposure to the brachial plexus more than the wedge technique, further studies are still needed to determine the practical significance of these findings.

BackgroundThe prognostic significance of radiation dose to the lung or heart is unknown in esophageal cancer patients receiving neoadjuvant chemoradiotherapy followed by surgery (trimodal therapy). This study aimed to determine the association between lung and heart radiation dose volumes and prognosis of esophageal cancer after trimodal therapy.MethodsThis study reviewed 123 esophageal cancer patients treated with trimodal therapy in two tertiary institutions between 2010 and 2015. The dose-volume histogram parameter of Vx was defined as the percentage of total organ volume receiving a radiation dose of x (Gy) or more. Predictors of overall survival (OS) were identified using Cox regression models. Receiver-operating characteristic curves were used to select cut-off values for dose-volume.ResultsMedian follow-up was 28.3 months (range: 4.7–92.8 months). Median OS and progression-free survival were 34.0 months (95% confidence interval [CI]: 27.4–40.6 months) and 24.8 months (95% CI, 18.9–30.7 months), respectively. Multivariate analyses showed that lung V20 (hazard ratio, 1.09; 95% CI: 1.04–1.14; p < 0.001) and lung V5 (hazard ratio, 1.02; 95% CI: 1.00–1.05; p = 0.03) were associated with OS when adjusting for surgical margin and pathological treatment response. The 5-year OS for patients with lung V20 ≤ 23% vs. patients with lung V20 > 23% was 54.4% vs. 5% (p < 0.001) whereas that for patients with lung V5 ≤ 56% vs. patients with lung V5 > 56% was 81.5% vs. 23.4% (p < 0.001). Mean heart dose showed no association with survival outcomes.ConclusionsLung radiation dose was independently associated with survival outcomes in esophageal cancer patients treated with neoadjuvant chemoradiotherapy and surgery.

Context:Incidence of breast cancer is very high among women around the world. Breast cancer patients experience cancer-related fatigue at some points during the treatment for breast cancer. Since cancer-related fatigue is of multifactorial origin, there are no evidence-based treatment strategies for fatigue. This study tested the effectiveness of certain pranayama techniques in reducing cancer-related fatigue among breast cancer patients undergoing radiation therapy.Aims:The objective of this study was to determine the effectiveness of pranayama on cancer-related fatigue among breast cancer patients undergoing radiation therapy as measured by cancer fatigue scale.Settings and Design:Shirdi Sai Baba Cancer Hospital and Research Center, Kasturba Hospital Manipal.Materials and Methods:Study was a randomized controlled trial done among breast cancer patients receiving radiation therapy.Statistical Analysis Used:Demographic characteristics of the participants are presented as frequency and percentage. Comparison of means of cancer-related fatigue between the two groups is done by Mann-Whitney U-test and comparison of pre- and pos t-test means of cancer-related fatigue among the experimental group is done by Wilcoxon sign rank test.Results:There was a significant difference between the two groups with regard to the scores of cancer-related fatigue. The experimental group of patients who performed pranayama along with radiation therapy experienced less fatigue.Conclusions:Pranayama can be used as a supportive therapy for breast cancer patients undergoing radiation therapy.

ObjectiveTo investigate psychological state of hospitalized cancer patients undergoing radiation therapy and evaluate effects of customized psychological intervention on patients' psychological state during novel Coronavirus (COVID‐19) outbreak.MethodFifty‐eight hospitalized head and neck cancer patients undergoing radiation therapy were included and received online and offline psychological intervention. General information questionnaire and the Self‐Report Symptom Inventory, Symptom Check‐List90 (SCL‐90) were utilized to investigate and analyze psychological state of hospitalized head and neck cancer patients undergoing radiation therapy before and after intervention. Self‐Rating Depression Scale (SDS) and Self‐Rating Anxiety Scale (SAS) were used to evaluate depression severity and anxiety severity of them.ResultsOverall psychological state of patients (include nine symptom dimensions: somatization, obsessive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism) was improved significantly after intervention (P < .05). Moreover, scores of SAS and SDS were lowered.ConclusionCustomized psychological intervention helped to improve overall psychological state of hospitalized cancer patients undergoing radiation therapy during COVID‐19 outbreak and showed encouraging effects on reduction severity of depression and anxiety.

Does clinical indication play a role in CT radiation dose in pediatric patients?

With increasing rates of cancer patients undergoing radiation therapy, the treatment itself can cause patients significant amounts of anxiety and distress. This can be attributed to the diagnosis of the disease, lack of knowledge of what radiation therapy is, expectations and management of side effects, and the lack of knowledge of supportive care for patients and their families. Providing patients with effective educational tools to meet the informational needs of cancer patients undergoing radiation therapy can empower patients and allow them to participate in treatment decision-making and their own healthcare. This discussion paper will evaluate several studies on the psychological impact of cancer patients undergoing radiation therapy and how video material can effectively meet the informational and educational needs of this patient population group.

Emotional aspects and pranayama in breast cancer patients undergoing radiation therapy: A randomized controlled trial

BACKGROUND: Radiation therapy is a critical component of breast cancer treatment but often leads to side effects such as radiation dermatitis and fibrosis. These adverse effects negatively impact upper limb function and reduce patients’ quality of life. Preventing radiation-induced reactions and fibrosis requires a multidisciplinary approach. While the effectiveness of comprehensive medical rehabilitation—including physiotherapeutic prevention, psychological correction, therapeutic exercises, and nutritional support — is well-documented, research on the application of low-temperature argon plasma remains limited. AIM: To evaluate the effects of low-temperature argon plasma on neuromuscular excitability in breast cancer patients undergoing external radiation therapy. MATERIALS AND METHODS: The study included 60 women undergoing radiation therapy for breast cancer. All participants received a medical rehabilitation program that included general magnetotherapy, therapeutic exercises, training on biofeedback-based weight-bearing platforms, nutritional support, and psychological correction. Patients in the main group (n=30) additionally underwent low-temperature argon plasma treatments. Outcomes were assessed using the Visual Analog Scale (VAS), the Radiation Therapy Oncology Group (RTOG) scale, and neuromuscular excitability testing conducted with the Eleskulap-Med TeKo device (Med TeKo,Russia; registration certificate No. FSR 2011/09988, dated February 4, 2011). RESULTS: At the completion of radiation therapy and comprehensive rehabilitation, statistically significant differences were observed in radiation reaction severity between the main group and the comparison group (p=0.016), as assessed by the RTOG scale. Significant improvements were also noted in neuromuscular excitability parameters of the pectoralis major muscle (pars sternocostalis) and pars clavicularis in the main group. CONCLUSION: Low-temperature argon plasma therapy reduces neuromuscular system impairments in breast cancer patients undergoing radiation therapy, supporting its role as an effective component of multidisciplinary medical rehabilitation.

BackgroundPatients with prostate cancer treated with stereotactic body radiation therapy (SBRT) may experience gastrointestinal (GI) toxicity. The hydrogel may mitigate this toxicity by reducing the rectal radiation dose. The purpose of this study is to compare rectal radiation dose and GI toxicity in patients receiving prostate SBRT with and without hydrogel.MethodsConsecutive patients treated with SBRT between February 2017 and January 2020 with and without hydrogel were retrospectively identified. Baseline characteristics including prostate volume, rectal diameter, body mass index (BMI), age, pretreatment prostate-specific antigen (PSA), Gleason score, T-stage, and androgen deprivation therapy (ADT) usage were compared. Dosimetric outcomes (V40Gy, V36Gy, V32Gy, V38Gy, and V20Gy), rates of acute (≤90 days) and late (>90 days) GI toxicity, and PSA outcomes were evaluated for patients with and without hydrogel.ResultsA total of 92 patients were identified (51 hydrogel and 41 non-hydrogel). There were no significant differences in baseline characteristics. Rectal V38(cc) was significantly less in the hydrogel group (mean 0.44 vs. mean 1.41 cc, p = 0.0002), and the proportion of patients with V38(cc) < 2 cc was greater in the hydrogel group (92% vs. 72%, p = 0.01). Rectal dose was significantly lower for all institutional dose constraints in the hydrogel group (p < 0.001). The hydrogel group experienced significantly less acute overall GI toxicity (16% hydrogel vs. 28% non-hydrogel, p = 0.006), while the difference in late GI toxicity trended lower with hydrogel but was not statistically significant (4% hydrogel vs. 10% non-hydrogel, p = 0.219). At a median follow-up of 14.8 months, there were no biochemical recurrences in either group.ConclusionHydrogel reduces rectal radiation dose in patients receiving prostate SBRT and is associated with a decreased rate of acute GI toxicity.

Association of Heart and Lung Radiation Dose With COVID-Related Mortality

Technical Challenges of Heart Avoidance for Synchronous Breast and Lung Cancers in a Postmenopausal Female: A Planning Case Report From a Safety-Net Hospital

Associations between patient-reported outcomes and radiation dose in patients treated with radiation therapy for primary brain tumours

Sleep problems are a common complaint in cancer patients that have been understudied. This study examined changes in sleep in 33 breast cancer (BC) patients and 23 prostate cancer (PC) patients during radiation therapy and over a 6-month followup. Coping processes were examined as predictors of sleep. Self-reported sleep was assessed at eight time-points before, during, and after treatment using the Medical Outcomes Study-Sleep Scale. The COPE Scale was used to assess coping processes before treatment onset. Mixed effects linear modeling analyses revealed that both BC and PC patients reported the most sleep problems prior to and during the early weeks of treatment. Coping strategies predicted sleep trajectories in both groups. In particular, approach coping predicted better sleep in PC patients, whereas avoidance coping predicted worst sleep in both PC and BC patients (p's<0.05). These findings highlight the importance of evaluating sleep in patients as they undergo treatment for cancer. Additionally, they suggest that interventions aimed at increasing the use of approach-oriented coping strategies may improve sleep and quality of life in these patients.

This is a pilot study investigating the effect of healing touch (HT) on fatigue in breast cancer patients undergoing radiation therapy (RT). This study presents the results of a within-subjects design randomized clinical trial where the treatment group was treated with HT, whereas the control group experienced sham therapy. The setting was a university RT clinic. The participants were breast cancer patients treated with lumpectomy or mastectomy, 21 to 75 years old with an Eastern Cooperative Oncology Group (ECOG) score of 0 to 2. The intervention was a 45-minute session of HT or sham therapy once a week during RT. Outcome measures included fatigue, quality of life (QOL), and anxiety/depression. A total of 70 patients were approached, with 41 completing the study. At completion, the HT participants tended to report higher levels of fatigue, statistically significant for interference ( : = .010) and usual fatigue ( : = .024). The control group tended to report greater reductions in fatigue relative to their own means than the HT group (Cohen's : = 0.30 to 0.49 vs 0.06 to 0.18, respectively). There were no statistically significant differences between the groups for QOL. Our enrollment and retention indicate that HT is feasible for women during RT. Our pilot findings do not support a beneficial effect of HT on fatigue or QOL. Future research may explore increasing dose and teasing out therapist effect.

IntroductionDance movement therapy (DMT) is a movement-based psychosocial intervention that incorporates the therapeutic components of dance movements and group psychotherapy. DMT, also known as creative movement therapy (CMT) is a psychotherapy used as a complementary therapy in cancer care. It helps in enhancing mood, emotions, self-expression and helps to rebuild self-confidence. Besides, it allows the patients to recognise their own strengths and weaknesses as well as helps to improve physical capabilities.MethodsBy simple random sampling method, 30 breast cancer patients were recruited at Pravara Rural Hospital, Loni, Maharashtra, India. The participants were in the age range of 30-60 years based on the inclusion and exclusion criteria. Pre-intervention scores of cancer-related fatigue (CRF) were taken using the Brief Fatigue Inventory (BFI) scale and intervention was given for 45 minutes each day for 5 days a week, over a span of 2 weeks. Thereafter, post-intervention assessment was done and the scores were noted. Pre-intervention and post-intervention scores were compared using paired t-test.ResultsThe mean and standard deviation (SD) of pre- and post-BFI scores derived by using paired t-test was 73.76 (8.6) and 69.33 (9.8), respectively, with a p-value of < 0.001, which is highly significant.ConclusionThe results of the present study revealed that DMT seems to be effective in reducing some amount of CRF in breast cancer patients undergoing radiation therapy. Besides, it turned out to be an engaging, entertaining and cost-effective approach. The investigation showed that DMT appears to be beneficial in reducing the side effects of radiation therapy such as pain, stress, anxiety and fear, giving a psychotherapeutic relief but did not completely remove the persistent fatigue experienced by the breast cancer patients. Thus, further investigation with long-term follow-up is recommended.