Radiation Therapy Patients Research Articles

Meeting radiation therapy patients informational needs through educational videos augmented by 3D visualisation software.

IntroductionMisconceptions and uncertainties about radiotherapy compound the anxiety patients experience at the commencement of treatment. This project investigated the utility of locally produced treatment process videos in meeting patients’ informational needs.MethodsIn‐house video production was conducted on a voluntary basis by staff and patients at a regional Australian radiotherapy centre. Videos included real footage and animated sections created with PEARLTM 3D visualisation software (Vertual Ltd, UK) to meet specific key content objectives. Quantitative cross sectional analysis was conducted. Patients attending for simulation watched a relevant video. After their first fraction of radiotherapy they were asked to complete an ethics‐reviewed questionnaire about how well the video addressed their information needs.ResultsThe survey completion rate was 29% (n = 61/212). Surveys were collected over 9 months from August 2014 to April 2015. Statistical analysis found 98% of patients reported that the video was useful in meeting one or more of the learning objectives. Forty‐nine percent of patients also reported a reduction in fear and anxiety as a result of watching the video. Patients reported subsequent review of videos at home (39%), primarily to explain treatment processes to loved ones (46%).ConclusionThe combination of real footage and 3D visualisation software assisted in meeting learning objectives regarding the treatment process. Standardised videos provided consistency of information provision to patients and facilitated multiple viewings of the video if desired.

National Trends and Predictors of Androgen Deprivation Therapy Use in Low-Risk Prostate Cancer

Androgen deprivation therapy (ADT) is not recommended for low-risk prostate cancer because of its lack of benefit and potential for harm. We evaluated the incidence and predictors of ADT use in low-risk disease. Using the National Cancer Database, we identified 197,957 patients with low-risk prostate cancer (Gleason score of 3+3=6, prostate-specific antigen level <10ng/mL, and cT1-T2a) diagnosed from 2004 to 2012 with complete demographic and treatment information.We used multiple logistic regression to evaluate predictors of ADT use and Cox regression to examine its association with all-cause mortality. Overall ADT use decreased from 17.6% in 2004 to 3.5% in 2012. In 2012, 11.5% of low-risk brachytherapy patients and 7.6% of external beam radiation therapy patients received ADT. Among 82,352 irradiation-managed patients, predictors of ADT use included treatment in a community versus academic cancer program (adjusted odds ratio [AOR], 1.60; 95% confidence interval [CI], 1.50-1.71; P<.001; incidence, 14.0% vs 6.0% in 2012); treatment in the South (AOR, 1.51), Midwest (AOR, 1.81), or Northeast (AOR, 1.90) versus West (P<.001); and brachytherapy use versus external beam radiation therapy (AOR, 1.32; 95% CI, 1.27-1.37; P<.001). Among 25,196 patients who did not receive local therapy, predictors of primary ADT use included a Charlson-Deyo comorbidity score of ≥2 versus 0 (AOR, 1.42; 95% CI, 1.06-1.91; P=.018); treatment in a community versus academic cancer program (AOR, 1.61; 95% CI, 1.37-1.90; P<.001); and treatment in the South (AOR, 1.26), Midwest (AOR, 1.52), or Northeast (AOR, 1.28) versus West (P≤.008). Primary ADT use was associated with increased all-cause mortality in patients who did not receive local therapy (adjusted hazard ratio, 1.28; 95% CI, 1.14-1.43; P<.001) after adjustment for age and comorbidity. ADT use in low-risk prostate cancer has declined nationally but may remain an issue of concern in certain populations and regions.

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

Toreport findings from an invivo dosimetry program implemented for all stereotactic body radiation therapy patients over a 31-month period and discuss the value and challenges of utilizing invivo electronic portal imaging device (EPID) dosimetry clinically. 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 invivo 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. The EPID frame-averaging was optimized in June 2015. For each treatment, a 3%/3-mm γ comparison between our EPID-derived dose and the Eclipse AcurosXB-predicted dose to the planning target volume (PTV) and the ≥20% isodose volume were performed. Alert levels were defined as γ pass rates <85% (lung and liver) and <80% (spine). Investigations were carried out for all fractions exceeding the alert level and were classified as follows: EPID-related, algorithmic, patient setup, anatomic change, or unknown/unidentified errors. The percentages of fractions exceeding the alert levels were 22.6% for lung before frame-average optimization and 8.0% for lung, 20.0% for spine, and 10.0% for liver after frame-average optimization. Overall, mean (± standard deviation) planning target volume γ pass rates were 90.7%±9.2%, 87.0%±9.3%, and 91.2%±3.4% for the lung, spine, and liver patients, respectively. Results from the clinical implementation of our model-based invivo dose verification method using on-treatment EPID images is reported. The method is demonstrated to be valuable for routine clinical use for verifying delivered dose as well as for detecting errors.

THE SURVEY OF CANCER PATIENTS IN THE REGION OF GUNTUR: BASED ON HOSPITAL REGISTRY

&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This survey was conducted to estimate the number of cancer patients in the region of Guntur-based on sex, age and cancer groups. The data were obtained from the hospital-based registries from Bommidala Cancer Institute, NRI Hospital&lt;strong&gt;, &lt;/strong&gt;Balaji Cancer Care Center&lt;strong&gt;, &lt;/strong&gt;and Govt. General Hospital, which was scrutinized and analysed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The hospital registry entry was considered suitable for assessing the cancer cases in the region of Guntur. In addition, data of NCRP were utilised for comparing the obtained results.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The data comprehensively constitutes of 309 patients. Out of which men were 74 (23.95%), and women were 235 (76.05%) who had obtained treatment for various cancer conditions between March-May, 2016. In these hospitals, cancers pertaining to the cervix-83 (31.32%), breast-52 (19.62%), ovary–17 (6.41%), lymphoid-11 (4.15%), pharynx-10 (3.77%), endometrium-10 (3.77%), astrocytoma-08 (3.02%), colon-07 (2.64%), larynx-06 (2.26%), rectum–06 (2.26%), oesophagus–05 (1.88%), post cricoids-04 (1.50%), stomach–04 (1.50%), liver–03 (1.13%) were the leading sites in order. While among these cases, radiation therapy patients were 194 (62.78%), chemotherapy patients were 78 (25.24%), and surgery patients were 37 (11.97 %).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Survey reports the highest incidence of cancer cases to be cervix cancer among the women while it was pharyngeal cancer which precedes lung cancer among the men. This hospital-based registry survey is a report that provided internal consistency, reliability and validity.&lt;/p&gt;

Treatment planning challenges for prosthesis prostate cancer patients in radiation therapy.

© 2017. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. https://creativecommons.org/licenses/by-nc-nd/4.0/.

Speculum Lubrication and Patient Comfort: A Meta-Analysis of Randomized Controlled Trials.

The aim of the study was to examine the effect of water-based gel lubrication in decreasing discomfort during speculum examination. Searches of standard databases were performed. Randomized controlled trials comparing speculums lubricated with water-based gel to no lubrication or water alone in women undergoing gynecologic examinations were included. Selected studies were required to report on the outcome of discomfort experienced during the examination. Six studies met the criteria. Two reviewers independently performed the search and excluded articles that did not meet the inclusion criteria. The primary outcome was change in the visual analog scale (VAS) measure of discomfort. Pooled mean differences and 95% confidence interval (CI) were calculated and heterogeneity was assessed. Five studies, totaling 2,383 subjects, each noted a significant decrease in the VAS score with use of lubrication. Pooling all studies, the VAS score with lubrication changed -0.87 (95% CI = -1.22 to -0.53, 6 studies, 2,453 subjects). Studies measured discomfort at different points in the examination and noted significant decreases with insertion (mean difference, -0.98; 95% CI = -1.13 to -0.83, 5 studies, 2,383 subjects), opening (mean difference, -1.52; 95% CI = -2.43 to -0.61, 3 studies, 1,864 subjects), and extraction (mean difference, -0.97; 95% CI = -1.29 to -0.65, 2 studies, 284 subjects). These significant decreases were consistent in subgroups of premenopausal, postmenopausal, gynecologic oncology, and radiation therapy patients. Water-based gel lubrication decreased discomfort for women undergoing a plastic speculum examination in all populations studied.

Risk stratification for disease progression in pT3 prostate cancer after robot-assisted radical prostatectomy.

The aim of this study is to identify optimal patients for adjuvant radiation therapy (ART) in pT3 prostate cancer. The role of ART for patients with adverse pathologic features after radical prostatectomy (RP) has been demonstrated, but over- or under-treatment remains a significant concern. Two-hundred and five patients with pT3N0M0 who underwent robot-assisted RP without ART were analyzed. Multivariate Cox proportional regression analyses were used to identify predictors of biochemical recurrence (BCR) and clinical progression (CP). The estimated 5-year BCR-free survival (BCRFS) and CP-free survival (CPFS) were 52.8% and 85.6%, respectively. Preoperative prostate-specifc antigen (PSA) ≥10 ng ml−1 (hazard ratio [HR]: 3.288–6.027; P = 0.003), pathologic Gleason score (pGS) ≥8 (HR: 4.146; P = 0.014), and lymphovascular invasion (LVI) (HR: 2.167; P = 0.026) were associated with BCR. Based on these factors, a risk stratification tool was developed. Patients with no risk factors (PSA <10 ng ml−1, pGS 6, and absent LVI) showed excellent BCRFS and CPFS at 5 years (91.9% and 100.0%, respectively), but those with two or more risk factors (PSA ≥10 ng ml−1, pGS ≥8, or present LVI) had poor BCRFS and CPFS (12.1% and 54.6%, respectively). In addition, the multivariate analysis revealed that pathologic stage pT3b (HR: 5.393; P = 0.025) was the only predictor of CP. Our study demonstrated the heterogeneity of oncologic outcomes in patients with pT3 prostate cancer. The proposed risk stratification can be used to identify patients who are at risk for disease progression and may aid in identifying the best patients for ART.

Patients' Experiences of Preparation for Radiation Therapy: A Qualitative Study.

To explore patients' experiences of and preferences for preparation for radiation therapy. . Qualitative study. . 26 individuals who recently received radiation therapy for cancer. . One Australian radiation oncology clinic located within a tertiary referral hospital in New South Wales. . Semistructured interviews were conducted and analyzed based on a qualitative descriptive approach and content analysis of the transcribed interviews. . Four main themes related to preparation techniques were identified. The information gained in this study indicates what strategies may best prepare patients for radiation therapy. . Providing patients with information that creates a realistic expectation of what radiation therapy involves both before and after treatment seems particularly important in helping them feel prepared.

Evaluation of inflammatory cytokines and oxidative stress markers in prostate cancer patients undergoing curative radiotherapy.

Prostate cancer is the second leading cause of cancer-related death in men. The present study was carried out to investigate the radiation response of serum cytokines and oxidative markers to find out if these novel biomarkers have significant applications regarding radiation outcome in prostate cancer patients. Significant elevations of prostatic specific antigen (PSA), asymmetric dimethyl arginine (ADMA) and nitric oxide (NO) were recorded in cancer prostate patients at the time of diagnosis compared to controls. Patients were subjected to radiotherapy post prostatectomy with a total dose of 66 Gy in 33 fractions (5 sessions/week) for 7 weeks. At the end of the seventh week post radiotherapy, ADMA levels were accentuated while the levels of PSA and NO were lower than before therapy. The level of inflammatory cytokines (interleukins IL-4, IL-5 and interferon-gamma) in post radiation therapy patients were significantly elevated compared to both controls and prostate cancer patients. A significant inverse correlation was observed in prostate cancer patients between ADMA and NO. Moreover, a significant inverse correlation in post radiation therapy patients was observed between IL-5 and PSA. These results are highly suggestive that there is a specific cytokine response in patients undergoing curative radiotherapy for prostate cancer.

Radiation Induced Second Malignancies (RISM): Risk, Diagnosis, Treatments and Review of Literature

Information concerning radiation-induced malignancies comes from the A-bomb survivors and from medically exposed individuals, including second malignancies in radiation therapy patients. The A-bomb survivors show an excess incidence of carcinomas in tissues such as the gastrointestinal tract, breast, thyroid, and bladder, which is linear with dose up to about 2.5 Sv. There is great uncertainty concerning the dose-response relationship for radiationinduced carcinogenesis at higher doses. Some animal and human data suggest a decrease at higher doses, usually attributed to cell killing; other data suggest a plateau in dose. Modern treatment modalities such as passive proton therapy and intensity modulated radiation therapy (IMRT) produce large amounts of scatter, leakage and neutron radiation, which has been found to be directly proportional to the risk of second malignancy incidence. Organs closer to the target typically receive higher and less homogeneous doses of cell killing and repopulation effects play an increasing role. The most common type of cancer caused by radiation is sarcoma, which is typically a cancer of muscle, bone, or blood vessel origin. We reviewed the literature with key words "Radiation induced second malignancies, second primary tumour, second cancer" to find relevant articles describing risk, diagnosis and treatments of radiation induced second malignancies.Faridpur Med. Coll. J. Jan 2016;11(1): 33-35

Functional Outcomes and Quality of Life After Radical Prostatectomy Only Versus a Combination of Prostatectomy with Radiation and Hormonal Therapy

BackgroundWhile the optimal use and timing of secondary therapy after radical prostatectomy (RP) remain controversial, there are limited data on patient-reported outcomes following multimodal therapy. ObjectiveTo assess the impact of additional radiation therapy (RT) and/or androgen deprivation therapy (ADT) on urinary continence, potency, and quality of life (QoL) after RP. Design, setting, and participantsAmong 13150 men who underwent RP from 1992 to 2013, 905 received RP + RT, 407 RP + ADT and 688 RP + RT + ADT. Outcome measurements and statistical analysesUrinary function, sexual function, and overall QoL were evaluated annually using self-administered validated questionnaires. Propensity score–matched and bootstrap analyses were performed, and the distributions for all functional outcomes were analyzed as a function of time after RP. Results and limitationsPatients who received RP + RT had a 4% higher overall incontinence rate 3 yr after surgery, and 1% higher rate for severe incontinence (>3 pads/24h) compared to matched RP-only patients. ADT further increased the overall and severe incontinence rates by 4% and 3%, respectively, compared to matched RP + RT patients. RP + RT was associated with an 18% lower rate of potency compared to RP alone, while RP + RT + ADT was associated with a further 17% reduction compared to RP + RT. Additional RT reduced QoL by 10% and additional ADT by a further 12% compared to RP only and RP + RT, respectively. The timing of RT after RP had no influence on continence, but adjuvant compared to salvage RT was associated with significantly lower potency (37% vs 45%), but higher QoL (60% vs 56%). Limitations of our study include the observational study design and potential for selection bias in the treatments received. ConclusionsSecondary RT and ADT after RP have an additive negative influence on urinary function, potency, and QoL. Patients with high-risk disease should be counseled before RP on the potential net impairment of functional outcomes due to multimodal treatment. Patient summaryMen with high-risk disease choosing surgery upfront should be counseled on the potential need for additional radiation and or androgen deprivation, and the potential net impairment of functional outcomes arising from multimodal treatment.

Sentinel Lymph Node Dissection to Select Clinically Node-negative Prostate Cancer Patients for Pelvic Radiation Therapy: Effect on Biochemical Recurrence and Systemic Progression

To assess the efficacy of robotic-assisted laparoscopic sentinel lymph node (SLN) dissection (SLND) to select those patients with prostate cancer (PCa) who would benefit from additional pelvic external beam radiation therapy and long-term androgen deprivation therapy (ADT). Radioisotope-guided SLND was performed in 224 clinically node-negative patients scheduled to undergo external beam radiation therapy. Patients with histologically positive SLNs (pN1) were also offered radiation therapy to the pelvic lymph nodes, combined with 3years of ADT. Biochemical recurrence (BCR), overall survival, and metastasis-free (including pelvic and nonregional lymph nodes) survival (MFS) rates were retrospectively calculated. The Briganti and Kattan nomogram predictions were compared with the observed pN status and BCR. The median prostate-specific antigen (PSA) value was 15.4ng/mL (interquartile range [IQR] 8-29). A total number of 834 SLNs (median 3 per patient; IQR 2-5) were removed. Nodal metastases were diagnosed in 42% of the patients, with 150 SLNs affected (median 1; IQR 1-2). The 5-year BCR-free and MFS rates for pN0 patients were 67.9% and 87.8%, respectively. The corresponding values for pN1 patients were 43% and 66.6%. The PSA level and number of removed SLNs were independent predictors of BCR and MFS, and pN status was an additional independent predictor of BCR. The 5-year overall survival rate was 97.6% and correlated only with pN status. The predictive accuracy of the Briganti nomogram was 0.665. Patients in the higher quartiles of Kattan nomogram prediction of BCR had better than expected outcomes. The complication rate from SLND was 8.9%. For radioisotope-guided SLND, the high staging accuracy is accompanied by low morbidity. The better than expected outcomes observed in the lower quartiles of BCR prediction suggest a role for SLN biopsy as a potential selection tool for the addition of pelvic radiation therapy and ADT intensification in pN1 patients.

Patient communication prior to initial consultation for palliative radiotherapy.

30 Background: For patients undergoing radiation treatment for advanced cancer, coordination between multiple care teams is required. The radiation therapy care pathway is complex, with numerous components, including consultation, planning, treatment delivery, and follow up care. Fragmented care can result from suboptimal communication among referring providers and patients. Prior to initial consult with a radiation oncologist, many patients are unaware of the complex logistics, resulting in additional distress. We conducted a survey to determine how to improve communication to better prepare patients for radiation therapy. Methods: In a pilot project to address communication barriers for patients receiving radiotherapy, a brief 10-question multiple choice survey was developed to gather patient-reported data at the time of initial consultation for palliative or primary CNS radiation treatment. The survey addressed patient understanding of the indication, logistics, and expected outcomes and toxicity of radiotherapy. Results: Our preliminary data is gathered from 16 patients who filled out a survey at the time of consult. Of this group, 10 patients received palliative radiotherapy for advanced malignant disease. Ninety percent of patients were able to correctly identify the role of the radiation oncologist in cancer care. Only 30% demonstrated understanding of the logistics of radiotherapy, including details of planning and multisession treatment delivery. Several patients noted concerns about the logistics and expected efficacy of treatment. No patients were previously informed of the indication of radiotherapy for pain palliation. Conclusions: Initial survey results suggest that advanced cancer patients are often mis- or under-informed about their disease status and the indication of radiotherapy in treatment and palliation of symptoms. Improved communication with patients referred for radiation therapy consultation may alleviate their concerns and enable them to set appropriate expectations for subsequent radiotherapy, minimizing distress. Ongoing survey results will be utilized to identify opportunities to educate providers towards better patient communication.

The Effect of Breast Irradiation on Cardiac Disease in Women Enrolled on BCIRG-001 at 10-Year Follow-up

Radiation therapy (RT) for breast cancer has been shown to increase the risk of long term cardiac morbidity. Modern techniques such as 3D-CRT and IMRT decrease cardiac dose from RT. This study investigated cardiac toxicity associated with breast RT at 10 year follow-up in BCIRG-001, a phase III trial comparing adjuvant anthracycline chemotherapy (FAC) with anthracycline-taxane chemotherapy (TAC) in women with lymph node (LN) positive early breast cancer. Prospectively collected data from all 746 patients in the control arm (FAC) of BCIRG-001 at 10 year follow up was analyzed from Project Data Sphere. Cardiac toxicities examined were grade 3 or 4 congestive heart failure (CHF), myocardial infarction (MI), and LVEF decrease of >20% from baseline. Toxicities were compared between patients who did and did not receive RT, left sided versus right sided RT, left sided versus no RT, and left internal mammary nodal (IMN) versus no RT. Statistical comparisons of categorical data were completed using the chi-square test and Fisher exact test, and multivariate analysis was performed using binomial logistic regression in the R statistical package. Of the 746 patients, 538 (72%) received RT to a median dose of 50 Gy (25-65 Gy). Among the RT patients, 266 (49%) received left sided RT, 393 (69%) received regional nodal irradiation (RNI), and 51 (13% of RNI group) were treated to the IMNs (31% left-sided). There was no significant difference in age, KPS, menopausal status, ER/PR, or HER2 status, tumor grade, history of diabetes, MI, obesity, hyperlipidemia, hypertension, or arrhythmia, between patients receiving RT and those that did not. Per protocol, nearly all patients who underwent lumpectomy received RT; 241/439 (55%) of patients who underwent mastectomy received RT. There was thus fewer RT patients (versus non-RT patients) who underwent mastectomy (55% vs. 95%, P < 0.001) and more RT patients with >3 positive LN (42% vs 28%, P = 0.001). MI occurred in 6 RT patients versus 8 patients non-RT patients (1% vs 4%, P = 0.8). No patient treated with left sided or left IMN RT experienced MI. Grade 3/4 CHF was seen in 14 RT patients versus 3 non-RT patients (3% vs. 1.5%, P = 0.9). Four of 14 RT patients (29%) died of complications of CHF versus no non-RT patients. Evaluable baseline echocardiograms were available in 270 patients. Among these, 35/198 RT patients had LVEF decrease of >20% baseline versus 6/72 who did not receive RT (18% vs. 8.3%, P = 0.09). There was no difference between LVEF decreases in right-sided versus left-sided RT. On multivariate logistic regression, MI is significantly associated with previous history of MI, obesity, and older age. There is no significant increase in risk of MI at 10 years in LN positive women treated with breast RT and uniform adjuvant doxorubicin-based chemotherapy in this modern prospective study with long-term cardiac outcomes. The higher incidence of CHF morbidity and mortality warrants further study with a larger randomized cohort.

Identifying High-Risk N0 and N1 Breast Cancer Patients for Postmastectomy Radiation Therapy by an 18-Gene Classifier

The definition of high-risk N0 and N1 breast cancer patients, who would benefit from regional node irradiation (RNI) or post-mastectomy radiotherapy (PMRT), is still no consensus. This study aims to identify the high-risk N0 and N1 mastectomy patients by an 18-gene panel. The high-risk patients would benefit from adjuvant radiotherapy. Three hundred fifty-nine (359) breast cancer patients who had microarray study for mRNA on the primary tumor tissues were chosen for this study. Eligible patients should have (1) an invasive breast cancer, (2) a mastectomy as first treatment, (3) pathology stages of T1-2N0 or T1-2N1, (4) frozen fresh tissues available and (5) an informed consent. Patients with N3, T4, or M1 disease were excluded in this analysis. Using pre-set cutoff of each gene and 18-gene scoring algorithm, we define scores of ≥ 44 as the high-risk group of locoregional recurrence (LRR) and scores of <21 as the low risk group of distant metastasis. This new 18-gene classifier identified 12% (24/200) of N0 patients and 26.4% (42/159) of N1 patients to be the high risk of LRR. The 5-year LRR-free probability, relapse-free probability, and overall survival for N0 patients were 82.8% (95% CI = 60.3 -93.2%), 62.2% (39.9-78.3%) and 69.8% (46.9-84.3%), respectively. The 5-year LRR-free probability, relapse-free probability, and overall survival for N1 patients were 72.2% (53.8-84.3%), 67.1% (48.7-80.2%), and 66.9% (46.2-81.1%), respectively. Among high-risk N0-N1 patients, PMRT reduced the 5-year probability of LRR from 33.1% to 17.2% (P = 0.09), and decreased the probability of any recurrence from 50.0% to 22.5% (P = 0.012). Multivariate analysis indicated that the 18-gene classifier with scores of ≥44 is independently associated with any recurrence in N0 and N1 mastectomy patients; the hazard ratio is 4.4 (2.4-8.1). N0 and N1 breast cancer patients with 18-gene scores of ≥44 would benefit from PMRT significantly by this study. The 18-gene classifier could identify the high-risk LRR patients for PMRT. More broad validation in other institutes is in underway.

Interfraction Variability of Motion Models Derived Using Patient 4-Dimensional Cone Beam Computed Tomography Images for Lung Cancer Stereotactic Body Radiation Therapy (SBRT) Patients

Interfraction Variability of Motion Models Derived Using Patient 4-Dimensional Cone Beam Computed Tomography Images for Lung Cancer Stereotactic Body Radiation Therapy (SBRT) Patients

The Role of Prostate-Specific Membrane Antigen (PSMA) Positron Emission Tomography/Computed Tomography in the Management of Patients With Prostate Cancer: Implications for Selection of Patients for Radiation Therapy

The Role of Prostate-Specific Membrane Antigen (PSMA) Positron Emission Tomography/Computed Tomography in the Management of Patients With Prostate Cancer: Implications for Selection of Patients for Radiation Therapy

Accuracy of Predicting Survival Outcomes in Palliative Radiation Therapy Patients

Accuracy of Predicting Survival Outcomes in Palliative Radiation Therapy Patients

Trends in Radiation-Induced Second Malignancy With Increased Utilization of Intensity Modulated Radiation Therapy for Localized Prostate Cancer

Trends in Radiation-Induced Second Malignancy With Increased Utilization of Intensity Modulated Radiation Therapy for Localized Prostate Cancer

Reducing Magnetic Field Dosimetric Impact on Real-Time MRI-Guided Radiation Therapy Patients by Reversing the MRI Magnetic Field Inside Patients Halfway Through Fractionated Radiation Therapy Delivery

Reducing Magnetic Field Dosimetric Impact on Real-Time MRI-Guided Radiation Therapy Patients by Reversing the MRI Magnetic Field Inside Patients Halfway Through Fractionated Radiation Therapy Delivery