Medicine › Radiology, Nuclear Medicine and Imaging

Advances in Oncology and Radiotherapy

Works Count: 69668

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Description

This cluster of papers focuses on the global access to radiotherapy, including its role in cancer treatment, the expansion of access in low- and middle-income countries, workforce analysis, health economics, and infrastructure assessment. The papers also address the demand estimation for radiotherapy, medical education in oncology, and resource planning for optimal utilization.

Keywords

Radiotherapy; Global Access; Cancer Treatment; Medical Education; Health Economics; Resource Planning; Workforce Analysis; Low- and Middle-Income Countries; Infrastructure Assessment; Demand Estimation

Radiation oncology: a century of achievements

2004-09-01

Jacques Bernier , Eric J. Hall , Amato J. Giaccia

The role of radiotherapy in cancer treatment

2005-08-03

Geoff P. Delaney , Susannah Jacob , C. Featherstone +1 more

Abstract Radiotherapy utilization rates for cancer vary widely internationally. It has previously been suggested that approximately 50% of all cancer patients should receive radiation. However, this estimate was not evidence‐based. … Abstract Radiotherapy utilization rates for cancer vary widely internationally. It has previously been suggested that approximately 50% of all cancer patients should receive radiation. However, this estimate was not evidence‐based. The aim of this study was to estimate the ideal proportion of new cases of cancer that should receive radiotherapy at least once during the course of their illness based on the best available evidence. An optimal radiotherapy utilization tree was constructed for each cancer based upon indications for radiotherapy taken from evidence‐based treatment guidelines. The proportion of patients with clinical attributes that indicated a possible benefit from radiotherapy was obtained by adding epidemiologic data to the radiotherapy utilization tree. The optimal proportion of patients with cancer that should receive radiotherapy was then calculated using TreeAge (TreeAge Software, Williamstown, MA) software. Sensitivity analyses using univariate analysis and Monte Carlo simulations were performed. The proportion of patients with cancer in whom external beam radiotherapy is indicated according to the best available evidence was calculated to be 52%. Monte Carlo analysis indicated that the 95% confidence limits were from 51.7% to 53.1%. The tightness of the confidence interval suggests that the overall estimate is robust. Comparison with actual radiotherapy utilization data suggests a shortfall in actual radiotherapy delivery. This methodology allows comparison of optimal rates with actual rates to identify areas where improvements in the evidence‐based use of radiotherapy can be made. It provides valuable data for radiotherapy service planning. Actual rates need to be addressed to ensure better radiotherapy utilization. Cancer 2005. © 2005 American Cancer Society.

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Medical physiology : a cellular and molecular approach

2012-01-01

Walter F. Boron , Emile L. Boulpaep

Burnout syndrome in the practice of oncology: results of a random survey of 1,000 oncologists.

1991-10-01

Deborah Whippen , George P. Canellos

Burnout, the end result of stress, can occur in any profession. We set out to determine the extent of burnout among a representative group of American oncologists. A questionnaire with … Burnout, the end result of stress, can occur in any profession. We set out to determine the extent of burnout among a representative group of American oncologists. A questionnaire with 12 specific points was designed and prepared by the authors. It was mailed to 1,000 randomly selected physician subscribers to the Journal of Clinical Oncology. Five hundred ninety-eight completed surveys (60%) were returned before the cut-off date and included in the analysis. Overall, 56% of the respondents reported experiencing burnout in their professional life. No significance was found between the incidence of burnout and specialty within oncology, year medical training ended, or practice location. Significance was found, however, between type of practice and the incidence of burnout; institution- or university-based oncologists reported a lower incidence of burnout (47%) versus all other types of practice (66% burnout rate for oncology plus internal medicine, 63% for private adult oncology only, 39% for pediatric oncologists [there were too few pediatric oncologists for this rate to be significant], and 64% for others; P = .0003). Frustration or a sense of failure was the most frequently chosen (56%) description of burnout, and insufficient personal and/or vacation time was the most frequent reason (57%) chosen to explain the existence of burnout. To alleviate burnout, the majority (69%) of respondents indicated the need for more vacation or personal time. Administering palliative or terminal care, reimbursement issues, and a heavy work load were identified as contributing factors to burnout. Given the high response to the questionnaire and a 56% incidence of burnout in the surveyed population, it is concluded that further research on this issue is required.

Global cancer surgery: delivering safe, affordable, and timely cancer surgery

2015-09-01

Richard Sullivan , Olusegun Isaac Alatise , Benjamin O. Anderson +7 more

Cancer: Principles and Practice of Oncology

1990-04-25

Walter G. Gunn

The third edition of DeVita, Hellman, and Rosenberg's by now classic text on cancer preserves the multimodal, integrated approach to clinical evaluation and treatment of that disease. The editors see … The third edition of DeVita, Hellman, and Rosenberg's by now classic text on cancer preserves the multimodal, integrated approach to clinical evaluation and treatment of that disease. The editors see to that approach by close supervision of the 66 individual chapters, each of which is written by one or more recognized experts. For a multiauthored text to be successful, information presented must be cogent and up-to-date. For the busy practitioner, it helps to read a scientific style that is lucid, if not graceful, succinct but not overwhelming. Most of us have tried to look up specific material and find information that will help us deal with daily clinical problems. Too often a comprehensive text leaves us no better off than we began—bogged down with excess cumbersome detail and without the help we had hoped to find. Happily, such is not the case with this text, nor was it a problem

Clinical Cancer Research

1941-03-29

Horder , William Harnett

The basic science of oncology

1987-06-14

Ian F. Tannock , Rićhard P. Hill

Review the fast-moving and critically important scientific advances in cancer causation, cancer biology, and the biology underlying cancer treatment in the third edition of The Basic Science of Oncology by … Review the fast-moving and critically important scientific advances in cancer causation, cancer biology, and the biology underlying cancer treatment in the third edition of The Basic Science of Oncology by Ian F. Tannock and Richard P. Hill. You'll review these cutting-edge advances and see how they apply to the daily fight against cancer in the clinical setting.

Estimating the demand for radiotherapy from the evidence: A review of changes from 2003 to 2012

2014-05-12

Michael Bartoň , Susannah Jacob , Jesmin Shafiq +4 more

Principles and Practice of Radiation Oncology

1999-11-01

Carlos Pérez , Luther W. Brady

Principles and practice of radiation oncology , Principles and practice of radiation oncology , کتابخانه دیجیتال جندی شاپور اهواز Principles and practice of radiation oncology , Principles and practice of radiation oncology , کتابخانه دیجیتال جندی شاپور اهواز

CLINICAL CANCER RESEARCH

1956-02-01

D. W. Smithers

Introduction to Health Physics

2003-01-01

Michael G. Stabin

Radiation Biology in Cancer Research

1980-10-01

A.H.W. Nias

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The Essential Physics of Medical Imaging

2003-07-01

Jerrold T. Bushberg , J. Anthony Seibert , Edwin M. Leidholdt +2 more

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Thyroid cancer after Chernobyl

1992-09-01

Keith Baverstock , B Egloff , Aldo Pinchera +2 more

The multistep nature of cancer development.

1984-10-01

Emmanuel Farber

Dose, time and fractionation: A clinical hypothesis

1969-01-01

Frank Ellis

Quality of Care Management Decisions by Multidisciplinary Cancer Teams: A Systematic Review

2011-03-25

Benjamin W. Lamb , Katrina Brown , Kamal Nagpal +3 more

Principles and Practice of Gynecologic Oncology

1997-07-01

William F. Moore

A policy framework for commissioning cancer services

1995-06-03

Michael R. Whitehouse

Hippocrates cannot have been overconfident about the provision of care for patients with cancer. In one of his aphorisms he pointed out that patients with internal cancers who were treated … Hippocrates cannot have been overconfident about the provision of care for patients with cancer. In one of his aphorisms he pointed out that patients with internal cancers who were treated survived a shorter time than those who were left alone. Some 25 centuries later informed voices have decried Britain's cancer services, some likening progress through them to the vagaries of the lottery. While this analogy is overly pessimistic, the failure of health planners to respond to the improved understanding and treatment of cancers has more than justified much of the recent criticism. Many doctors also remain ignorant of what is achievable with good cancer care, which is hardly surprising, given the low …

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Annual Report to the Nation on the Status of Cancer, 1975-2007, Featuring Tumors of the Brain and Other Nervous System

2011-03-31

Betsy Kohler , Elizabeth Ward , Bridget J. McCarthy +7 more

BackgroundThe American Cancer Society, the Centers for Disease Control and Prevention (CDC), the National Cancer Institute, and the North American Association of Central Cancer Registries (NAACCR) collaborate annually to provide … BackgroundThe American Cancer Society, the Centers for Disease Control and Prevention (CDC), the National Cancer Institute, and the North American Association of Central Cancer Registries (NAACCR) collaborate annually to provide updated information on cancer occurrence and trends in the United States. This year's report highlights brain and other nervous system (ONS) tumors, including nonmalignant brain tumors, which became reportable on a national level in 2004.

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Expanding global access to radiotherapy

2015-09-01

Rifat Atun , David A. Jaffray , Michael Bartoň +7 more

Reducing the Health Consequences of Smoking: 25 Years of Progress. A Report of the Surgeon General.

1989-03-01

R. Eric Heidel

International Committee of Medical Journal Editors.

1990-02-05

P Riis

Proceedings of the Royal Society of Medicine

1912-01-01

A visit with Dr. Richard Wesley Te Linde.

1959-08-01

Berkow Sg

Cancer: Principles and Practice of Oncology

1987-01-01

John A. Levi

Global Oncology Research and Training Collaborations Led by the National Cancer Institute (NCI)–Designated Cancer Centers: Results From the 2018 NCI/ASCO Global Oncology Survey of NCI-Designated Cancer Centers

2019-10-01

Kalina Duncan , Rachel Abudu , Mishka K. Cira +1 more

PURPOSE The National Cancer Institute (NCI)–Designated Cancer Centers (NDCCs) are active in global oncology research and training, leading collaborations that contribute to the evidence to support global cancer control. To … PURPOSE The National Cancer Institute (NCI)–Designated Cancer Centers (NDCCs) are active in global oncology research and training, leading collaborations that contribute to the evidence to support global cancer control. To better understand global oncology activities led by NDCCs, the National Cancer Institute Center for Global Health (NCI-CGH) collaborated with ASCO to conduct the 2018 NCI/ASCO Global Oncology Survey of NDCCs. METHODS The 70 NDCCs received a two-part survey that focused on global oncology programs at NDCCs and non–National Institutes of Health (NIH)–funded global oncology projects with an international collaborator led by the NDCCs. Sixty-five NDCCs responded to the survey, and 57 reported non–NIH-funded global oncology projects. Data were cleaned, coded, and analyzed by NCI-CGH staff. RESULTS Thirty NDCCs (43%) report having a global oncology program, and 538 non–NIH-funded global oncology projects were reported. Of the NDCCs with global oncology programs, 17 report that trainees complete rotations outside the United States, and the same number enroll trainees from low- and middle-income countries (LMICs). In addition, 147 (28%) of the non–NIH-funded projects focused on capacity building or training, the second highest category after research. Of the 30 top project collaborator countries, 17 were LMICs. Compared with the NCI-funded international grant portfolio, non–NIH-funded global oncology projects were more likely to focus on prevention (12% NCI-funded v 20% non–NIH-funded); early detection, diagnosis, and prognosis (23% v 30%); and cancer control, survivorship, and outcomes research (13% v 22%). CONCLUSION This survey shows that there is a substantial amount of global oncology research and training supported by NDCCs, and much of this is happening in LMICs. Results of the 2018 Global Oncology Survey can be used to foster opportunities for NDCCs to work collaboratively on activities and to share their findings with relevant stakeholders in their LMIC collaborator countries.

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American Joint Committee on Cancer

2015-01-01

Oliver H. Beahrs

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Mortality due to cancer treatment delay: systematic review and meta-analysis

2020-11-04

Timothy P. Hanna , Will D. King , Stéphane Thibodeau +7 more

Abstract Objective To quantify the association of cancer treatment delay and mortality for each four week increase in delay to inform cancer treatment pathways. Design Systematic review and meta-analysis. Data … Abstract Objective To quantify the association of cancer treatment delay and mortality for each four week increase in delay to inform cancer treatment pathways. Design Systematic review and meta-analysis. Data sources Published studies in Medline from 1 January 2000 to 10 April 2020. Eligibility criteria for selecting studies Curative, neoadjuvant, and adjuvant indications for surgery, systemic treatment, or radiotherapy for cancers of the bladder, breast, colon, rectum, lung, cervix, and head and neck were included. The main outcome measure was the hazard ratio for overall survival for each four week delay for each indication. Delay was measured from diagnosis to first treatment, or from the completion of one treatment to the start of the next. The primary analysis only included high validity studies controlling for major prognostic factors. Hazard ratios were assumed to be log linear in relation to overall survival and were converted to an effect for each four week delay. Pooled effects were estimated using DerSimonian and Laird random effect models. Results The review included 34 studies for 17 indications (n=1 272 681 patients). No high validity data were found for five of the radiotherapy indications or for cervical cancer surgery. The association between delay and increased mortality was significant (P<0.05) for 13 of 17 indications. Surgery findings were consistent, with a mortality risk for each four week delay of 1.06-1.08 (eg, colectomy 1.06, 95% confidence interval 1.01 to 1.12; breast surgery 1.08, 1.03 to 1.13). Estimates for systemic treatment varied (hazard ratio range 1.01-1.28). Radiotherapy estimates were for radical radiotherapy for head and neck cancer (hazard ratio 1.09, 95% confidence interval 1.05 to 1.14), adjuvant radiotherapy after breast conserving surgery (0.98, 0.88 to 1.09), and cervix cancer adjuvant radiotherapy (1.23, 1.00 to 1.50). A sensitivity analysis of studies that had been excluded because of lack of information on comorbidities or functional status did not change the findings. Conclusions Cancer treatment delay is a problem in health systems worldwide. The impact of delay on mortality can now be quantified for prioritisation and modelling. Even a four week delay of cancer treatment is associated with increased mortality across surgical, systemic treatment, and radiotherapy indications for seven cancers. Policies focused on minimising system level delays to cancer treatment initiation could improve population level survival outcomes.

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Thyroid cancer after Chernobyl

1992-09-01

Vasili S. Kazakov , Evgeni P. Demidchik , Larisa Astakhova

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Journal of the Royal Society of Medicine

1978-01-01

J. V. Dacie

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Principles and Practice of Radiation Oncology

1998-05-06

W. Gunn

Cancer: Principles and Practice of Oncology

1997-09-10

Walter G. Gunn

The encyclopedic tome popularly known among clinical cancer workers as "DeVita" has now reached a fifth edition just 14 years from its beginnings in 1982. This edition encompasses some 3125 … The encyclopedic tome popularly known among clinical cancer workers as "DeVita" has now reached a fifth edition just 14 years from its beginnings in 1982. This edition encompasses some 3125 pages plus a 92-page index. In its single-volume version, it weighs 11 pounds. A more comfortable two-volume version is available for a few dollars more. This textbook on the scientific under-pinnings of oncology and clinical cancer management long ago put its competition in the shade. It is monumental in every sense: clear concise writing, superb photos and illustrations, excellent tables and graphs, comprehensive—if sometimes overwhelming—literature references, and an adequate index. All that said, it is heavy going, perhaps primarily because of the dense and concentrated nature of the material. It is certainly not a text one would pick up and read for pleasure. It is chock-full of information, and references are current through the mid 1990s. The

Journal of the national cancer institute

1993-01-01

Journal of the National Cancer Institute

1993-04-01

Journal of the National Medical Association

2010-07-01

Journal of the National Cancer Institute

1969-12-01

Journal Article Journal of the National Cancer Institute Get access JNCI: Journal of the National Cancer Institute, Volume 43, Issue 6, December 1969, Pages 1379–1382, https://doi.org/10.1093/jnci/43.6.1379 Published: 01 December 1969 Journal Article Journal of the National Cancer Institute Get access JNCI: Journal of the National Cancer Institute, Volume 43, Issue 6, December 1969, Pages 1379–1382, https://doi.org/10.1093/jnci/43.6.1379 Published: 01 December 1969

Proceedings of the Royal Society of Medicine

1942-07-01

Cancer: Principles and Practice of Oncology.

1988-03-01

Cancer: Principles and Practice of Oncology.

1986-01-01

The principles and practice of oncology

2001-07-05

Patrick G. Johnston , Ultan McDermott

Abstract In the UK cancer is a major problem today. Approximately a quarter of a million people are diagnosed with cancer and 120 000 die each year. While improvements in … Abstract In the UK cancer is a major problem today. Approximately a quarter of a million people are diagnosed with cancer and 120 000 die each year. While improvements in cardiovascular disease have resulted in a decline in mortality from heart disease, cancer mortality continues to rise and is expected to be the major cause of death across the next decade. Currently one person in three living in the UK will develop cancer during their lifetime and one in five will die from the disease. Over 60% of all cancers will occur in the over-65 age group and as our populations get older clinicians will be faced with increasing numbers of patients at risk or presenting with malignant disease.

Celebrate 40 Years with TPEL

2025-06-25

| IEEE Transactions on Power Electronics

Cancer Rehabilitation Educational Needs of Latin American Physicians

2025-06-25

Giuseppe Belmonte , Ana Carolina Méndez Silva , Vanessa Uclés Villalobos +1 more | Current Physical Medicine and Rehabilitation Reports

In Regard to Igarashi et al

2025-06-24

Erik van der Bijl , Tim Stobernack , Johan Bussink | International Journal of Radiation Oncology*Biology*Physics

In Regard to Lee et al

2025-06-24

Amnuay Kleebayoon , Viroj Wiwanitkit | International Journal of Radiation Oncology*Biology*Physics

In Regard to Thomson et al

2025-06-24

Kalani J Bassi , Benjamin H L Harris | International Journal of Radiation Oncology*Biology*Physics

Improving efficacy and safety of surgery in benign gynaecology: the case for indocyanine green

2025-06-24

Rebecca Mallick , B Kim , Ian Nouvel | Facts Views and Vision in ObGyn

Indocyanine green (ICG) with near-infrared imaging is a valuable adjunct in minimally invasive gynaecological surgery, enhancing anatomical visualisation and surgical precision. This narrative review synthesises current evidence on ICG's clinical … Indocyanine green (ICG) with near-infrared imaging is a valuable adjunct in minimally invasive gynaecological surgery, enhancing anatomical visualisation and surgical precision. This narrative review synthesises current evidence on ICG's clinical applications, safety, and practical implementation in benign gynaecology. ICG supports bladder and ureteric identification, cavity integrity checks, and assessment of bowel and ovarian perfusion. It also aids detection of endometriosis lesions, though diagnostic accuracy remains variable. ICG is safe and feasible, with growing evidence supporting its role across a range of procedures. Further research is needed to standardise protocols, assess cost-effectiveness, and support broader adoption in clinical practice.

A Work (in Progress) of ART: The Role of Adaptive Radiation Therapy in Genitourinary Cancers

2025-06-24

Alison Tree , Amar U. Kishan | International Journal of Radiation Oncology*Biology*Physics

The European OMFS Trainee Forum of Union of European Medical Specialists (UEMS) – a political innovation to promote fellowship, friendship and communication

2025-06-24

Dirk Stephanus Brandsma , Milad Tavakoli , E. Trainee Forum | International Journal of Oral and Maxillofacial Surgery

Key Strategies for determining surgical resection margins in OSCC

2025-06-24

Rui Shi , Wenhao Ren , Keqian Zhi | International Journal of Surgery

Niche No More? Adaptive Radiation Therapy as a Mainstream Proposition

2025-06-24

Sue S. Yom | International Journal of Radiation Oncology*Biology*Physics

The risks of telehealth in radiation oncology: challenges and mitigation strategies

2025-06-24

S Stathakis , Niko Papanikolaou , J. Wesson Ashford +2 more | Frontiers in Oncology

The integration of telehealth into radiation oncology represents a significant evolution in healthcare delivery, driven by the potential for enhanced patient accessibility, convenience, and improved multidisciplinary collaboration and operational efficiency. … The integration of telehealth into radiation oncology represents a significant evolution in healthcare delivery, driven by the potential for enhanced patient accessibility, convenience, and improved multidisciplinary collaboration and operational efficiency. Telehealth modalities support a wide range of activities, from remote consultations and treatment planning discussions to on-treatment checks, toxicity management, and follow-up care. However, the successful adoption of telehealth is predicated upon the effective identification and management of substantial challenges. These include safeguarding sensitive patient data against cybersecurity threats, navigating the inherent limitations of remote clinical assessments, overcoming technological barriers that contribute to the digital divide, adhering to a complex and evolving regulatory and reimbursement environment, maintaining the crucial therapeutic patient-provider relationship, seamlessly integrating telehealth workflows into existing clinical operations, and upholding ethical principles, particularly concerning equitable access and algorithmic bias. While initial concerns about potential risks, such as increased rates of misdiagnosis or reduced patient satisfaction, were prominent during the early phase of rapid adoption, a growing body of recent empirical literature provides valuable insights into the actual impact of telehealth in radiation oncology and the effectiveness of various mitigation strategies. This paper offers a comprehensive and updated review of these multifaceted challenges, analyzing their potential influence on clinical outcomes, healthcare operations, and the patient experience. Drawing upon the latest evidence, it details proactive, evidence-based mitigation strategies – encompassing the strategic implementation of hybrid care models, investments in secure and user-friendly technological infrastructure, the development and adherence to standardized clinical and operational protocols, targeted training for providers and staff, and robust support mechanisms for patients. A structured, continuous risk management framework is presented as an essential component for navigating these complexities. By thoroughly understanding these challenges and actively implementing evidence-informed mitigation approaches, radiation oncology practices can successfully harness the considerable benefits of telehealth while rigorously protecting patient safety, ensuring the delivery of high-quality care, and promoting equitable access to cancer treatment for all individuals.

Podcast: Breast Cancer Research Poised to Change Practice From ASCO25

2025-06-23

| Default Digital Object Group

Advert ESSO-EYSAC Hands on Course on Surgical Technique - Abdominal Surgery

2025-06-21

| European Journal of Surgical Oncology

A comparative cost analysis of 25-fraction vs 5-fraction postoperative radiotherapy regimens for breast cancer

2025-06-20

Dem Aliaj , G. Schüpfer , Gabriela Studer | Schweizerische medizinische Wochenschrift

To compare the costs of 25-fraction vs 5-fraction postoperative radiotherapy regimens in breast cancer patients. Several clinical trials have confirmed at least comparable safety and efficacy of short hypofractionated partial … To compare the costs of 25-fraction vs 5-fraction postoperative radiotherapy regimens in breast cancer patients. Several clinical trials have confirmed at least comparable safety and efficacy of short hypofractionated partial and whole breast radiation regimens. This study was focused on providing detailed cost data and analysing the advantages or disadvantages of either treatment strategy for patients. Calculations were performed based on patient and infra-structure data collected from the department of radiation oncology at Lucerne Cantonal Hospital (LUKS) in Switzerland from 1 July to 31 December 2020. The process maps were created to identify resources used for each radiation therapy option, from initial consultation to treatment completion. Cost comparisons represent the viewpoints of the hospital, insurance coverages and societal costs. To estimate hospital costs, time-driven activity-based costing was used, including equipment purchase and personnel costs. For insurers, estimates were based on the TARMED tariff system in Switzerland, which is used for billing ambulatory services and reflecting insurance coverage. The social cost was defined as productivity loss (e.g. absence from work) due to treatment appointments. The 5-fraction regimens resulted in a total of 53% (972 CHF) lower hospital costs, including personnel and equipment resources, a 42% (3153 CHF) reduction of charges to insurers and a 62% (372 CHF) lower social burden in terms of productivity losses due to the patient's absence from work. The major findings from studies using 5-fraction regimens have shown a comparable result in terms of local control and treatment tolerance. A5-fraction radiotherapy regimen in breast cancer patients results in a lower cost than a conventional 25-fraction regimen.

Invisible in the Metrics of Academic Oncology

2025-06-20

Shruti Patel , Stephanie L. Graff | JCO Oncology Practice

Radiation Protection Knowledge for Nurses at King Abdulaziz Medical City-Jeddah in Saudi Arabia: A Cross-Sectional Study

2025-06-19

Dalal Alamoudi , Amani Y. Alhalwani , Mohamed Eldigire Ahmed +5 more | Journal of Radiation Protection and Research

No Longer Safe Before the Screen?

2025-06-19

Theresa Krampe | Routledge eBooks

Response to comments made on the topical debate: “In Australia professional registration for qualified medical physicists should be mandated through the Australian health practitioner regulation agency (AHPRA)”

2025-06-19

Robin Hill , Cathryn Barbagallo | Physical and Engineering Sciences in Medicine

Farewell reflections from a medical radiation technologist on a career of learning, leadership and lasting gratitude

2025-06-18

Lisa Pyke | Journal of medical imaging and radiation sciences

From Radiation Therapist to a transformational healthcare leader: Expanding the MRT horizon

2025-06-18

Yasir Khalid | Journal of medical imaging and radiation sciences

How should I deal with a rude colleague?

2025-06-18

| BMJ

Spektrum Onkologie - wissenswert, kompakt, anregend

2025-06-17

| Kompass Onkologie

Optimizing energy consumption in radiotherapy: standard vs. hypo-/ultra-hypofractionation and becoming SMART (specific, measurable, achievable in radiotherapy)

2025-06-17

Ann-Katrin Exeli , Andreas Lurtz , Linda Agolli +1 more | Strahlentherapie und Onkologie

Abstract Purpose The healthcare sector is a large greenhouse gas producer. Especially in radiotherapy (RT), a lot of electricity is consumed by the medical linear accelerator (linac) and associated patient … Abstract Purpose The healthcare sector is a large greenhouse gas producer. Especially in radiotherapy (RT), a lot of electricity is consumed by the medical linear accelerator (linac) and associated patient travel. Our aim was to ascertain by how much electrical energy consumption and patient travel can be reduced by replacing normofractionated (NF) with emerging moderately hypofractionated (UF) or ultra-hypofractionated (UHF) concepts. Methods We connected an energy meter to our linac (VersaHD, Elekta©, Stockholm, Sweden) and evaluated different fractionation concepts (NF, HF, UHF) for 30 patients with target volumes of the prostate, breast, and spine. In addition to the energy measurements, we also conducted an analysis of the carbon dioxide (CO 2 ) emissions associated with the variations in patient travel. Results This study measured the energy consumption of a linac (in kWh) and its impact on CO 2 emissions for various radiotherapy fractionation concepts. Ultra-hypofractionated regimens consistently showed the lowest energy consumption and variability across prostate, breast, and bone metastasis treatment courses, while NF regimens had significantly higher energy consumption and variability. Transitioning from NF to UHF regimens reduced CO 2 emissions by up to 75%, driven by fewer patient visits and lower electricity consumption. These findings highlight the environmental and logistical benefits of HF and UHF treatment protocols. Conclusion The adoption of HF and UHF treatment concepts can significantly reduce energy consumption and CO 2 emissions, achieving an up to 75% reduction per treatment course. This is primarily due to decreased patient travel and electricity consumption at the linac. Extrapolated globally, these changes offer further potential to mitigate climate change.

In Memoriam of Edward H. Koo, MD 1954–2025

2025-06-16

Hui Zheng , Douglas Galasko , Sangram S. Sisodia | Molecular Neurodegeneration

JHEP at a glance (July 2025)

2025-06-16

| Journal of Hepatology

Cancer in the elderly in Slovakia

2025-06-15

Martina Ondrušová , Soňa Vándor Svidová , Adriána Blažová +1 more | Klinicka onkologie

Variations in Outcomes of Surgical Oncology Fellowship Graduates Performing Hepatopancreatic Surgery in the United States Based on Fellowship Training Program

2025-06-14

Diamantis I. Tsilimigras , Selamawit Woldesenbet , Odysseas P Chatzipanagiotou +4 more | Annals of Surgical Oncology

Abstract Background Exposure in hepatopancreatic (HP) surgery can vary among Complex General Surgical Oncology (CGSO) fellowship graduates. Real-world outcomes of fellowship graduates performing HP surgery have not been previously examined. … Abstract Background Exposure in hepatopancreatic (HP) surgery can vary among Complex General Surgical Oncology (CGSO) fellowship graduates. Real-world outcomes of fellowship graduates performing HP surgery have not been previously examined. Methods Medicare beneficiaries undergoing HP surgery for cancer between 2016 and 2021 were identified. Surgeon-level data, including fellowship training information, were linked to patient-level Medicare data. Trends and variations in severe complications and 90-day mortality according to fellowship training were examined. Results Overall, 9954 HP cancer operations (pancreatectomy: 7,566, 76%; hepatectomy: 2,388, 24%) were performed between 2016 and 2021. A total of 609 CGSO fellowship graduates trained at 42 different CGSO programs in the United States or Canada were identified. Most cases (93.2%) were performed by surgeons who had completed an ACGME-accredited CGSO program. Almost half of HP operations were performed by graduates of two specific CGSO programs ( n = 4,769, 47.9%), whereas 92.1% ( n = 9,166) of HP operations were performed by graduates of 15 CGSO programs. After adjusting for relevant, multilevel characteristics, marked variations in outcomes by CGSO fellowship program were noted following both hepatectomy and pancreatectomy. The adjusted probability of serious complications decreased from 2016 to 2021 (16.4% vs. 12.9%; p < 0.05), however, the likelihood of 90-day mortality remained relatively stable during the study period (2016: 6.4% vs. 2021: 5.3%; p = 0.19). Conclusions While outcomes of CGSO graduates improved over time, a marked variation in outcomes of graduates performing HP surgery was noted based on their fellowship training. Further efforts should be made to enhance and standardize HP surgery exposure and training in CGSO programs for fellows intending to perform HP surgery in practice.

ESMRMB 2025 focus topic: cycle of quality—from concept to clinical and scientific impact

2025-06-14

Thomas Küstner , Roy A.M. Haast , Nikos Priovoulos +2 more | Magnetic Resonance Materials in Physics Biology and Medicine

Abstract P5-11-07: A longitudinal analysis of the specific types of anxiety towards radiotherapy in patients with breast cancer before, during, and after radiotherapy

2025-06-13

Shijia Wang , Xin Feng , Wei Zhang +7 more | Clinical Cancer Research

Abstract Backgrounds: Most patients have many concerns about radiotherapy (RT) because they know little about it. Radiotherapy Categorical Anxiety Scale (RCAS) was formulated to evaluate the specific types of anxiety … Abstract Backgrounds: Most patients have many concerns about radiotherapy (RT) because they know little about it. Radiotherapy Categorical Anxiety Scale (RCAS) was formulated to evaluate the specific types of anxiety among cancer patients receiving RT. This study aims to apply the RCAS to breast cancer patients in China and assess the reliability and validity of the Chinese version; and to investigate its longitudinal changes throughout treatment. Methods: This prospective, longitudinal study enrolled 504 eligible breast cancer patients receiving RT in China. Patients completed questionnaires assessing the specific types of RCAS, depression (9-item Patient Health Questionnaire [PHQ-9]), and anxiety (7-item Generalized Anxiety Disorder [GAD-7]) before, during, and after RT. Psychometric properties of RCAS including internal consistency, construct validity, convergent validity, and discriminant validity, were assessed. Generalized estimating equations were performed to evaluate dynamic changes in RCAS total and sub-scale scores. Univariate and multivariate regression analyses were conducted to explore factors associated with RCAS score before and after RT. Results: The Chinese version of RCAS demonstrated its excellent reliability (Chronbach’s α 0.89 to 0.92) and construct validity (Bartlett sphericity test P&lt;0.001; Kaiser-Meyer-Olkin index = 0.95). Confirmatory factor analysis further demonstrated its adequate convergent and discriminant validity. RCAS scores decreased significantly during RT over time. RCAS-F3 (treatment effects of RT) remained stable, while RCAS-F1 (adverse effects of RT) and RCAS-F2 (environment of RT) decreased significantly over time. Patients presented higher scores in items about side effects, after-effects, and treatment effects of RT compared with other items in RCAS. Multivariate analysis revealed that only high PHQ-9 and GAD-7 scores were independent factors for high RCAS scores, no matter before or after RT. Conclusions: The Chinese version of RCAS was eligible for quantitatively evaluating the specific types of anxiety in breast cancer patients receiving RT in China. Clinicians should pay more attention to dispelling patients’ concerns of side-effect, after-effects, and treating efficacy of RT, especially for patients with depression and anxiety. Citation Format: Shi-Jia Wang, Xin Feng, Wei Zhang, Yan Liu, Hong-Xia Gao, Hao Jing, Yi-Rui Zhai, Wen-Wen Zhang, Hui Fang, Yu Tang, Yong-Wen Song, Yue-Ping Liu, Bo Chen, Shu-Nan Qi, Yuan Tang, Ning-Ning Lu, Fu-Kui Huan, Ye-Xiong Li, Shu-Lian Wang. A longitudinal analysis of the specific types of anxiety towards radiotherapy in patients with breast cancer before, during, and after radiotherapy [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P5-11-07.

Abstract P2-08-01: Engaging breast cancer survivors in the United States in research: clinical characteristics and demographics from Susan G. Komen’s ShareForCures® first cohort

2025-06-13

Jessica Epps , Emily Marks , Carlita Proctor McIlwain +7 more | Clinical Cancer Research

Abstract Background: Lack of diversity in research and reliance on small, siloed datasets limits the availability of real-world evidence, hampering the practice of precision medicine and optimization of treatments and … Abstract Background: Lack of diversity in research and reliance on small, siloed datasets limits the availability of real-world evidence, hampering the practice of precision medicine and optimization of treatments and care for all breast cancer patients. To address these limitations, the Susan G. Komen® breast cancer foundation launched ShareForCures® (SFC). This online, IRB-approved, patient-centered breast cancer research registry engages breast cancer survivors and patients from diverse backgrounds as research partners. By facilitating the exchange of information between survivors, patients and researchers, SFC aims to drive innovative breast cancer research and improve outcomes. Guided by focus groups and pilot testing, SFC began enrolling adults living in the U.S. and diagnosed with breast cancer in July 2023. Methods: We implemented a mixture of tactics to recruit eligible individuals to SFC. Emails, earned and paid media, digital advertising, social media posts, blogs, and in-person events were used to spread awareness and educate individuals about the registry. Potential participants could connect with the SFC team via contact forms, email, and phone for assistance. To fully onboard, participants had to register by creating an account in the SFC online platform, accept the informed consent and medical records release forms, and complete the “About You” survey. We implemented tailored communication strategies to aid potential participants in completing the onboarding process. Once fully onboarded, participants were assigned tasks to provide additional data: surveys (quality of life, family health history, social determinants of health), medical records, and a saliva sample for germline whole genome sequencing were collected. Integrated data from the first cohort of SFC participants were analyzed to evaluate recruitment and engagement efforts and to provide descriptive statistics. Results: As of June 26, 2024, 773 participants registered, with 399 fully onboarding (median age = 56 years [range: 27-82], 99% women, 81% non-Hispanic White) and 31 declining (92% participation, average of 33 enrolled/month). Most participants (92%) enrolled with no assistance, and only 3 withdrew after completing enrollment (99% retention). Participants were geographically dispersed across 86% of U.S. states. Fifty percent of participants were from communities historically under-represented in biomedical research. Most participants self-reported their first breast cancer diagnosis as invasive ductal carcinoma (61%), with 39% self-reporting ER+/HER2– disease and 77% reporting early stage (Stage 0, 1, or 2) disease. Participants also self-reported living with metastatic breast cancer (17%) and experiencing a recurrence (19%). At least one survey or data collection activity (saliva or medical records) was completed by 62% of participants (45% saliva samples, 35% medical records collected). Conclusions: In the first year of SFC, we recruited breast cancer survivors and patients from across the U.S. using a variety of broad, direct-to-patient methods, and participants remained engaged with the registry through completion of surveys and data collection activities at or above expected rates. Continued focused recruitment of participants from communities historically under-represented in biomedical research is still needed. Participants’ breast cancer diagnoses were consistent with national prevalence estimates, with an over-representation of metastatic breast cancer in SFC. Citation Format: Jessica Epps, Emily Marks, Carlita McIlwain, Natalia Ballón, Taylor Jennings, Natalia Iannucci, Brady Kazar, Natasha Mmeje,Victoria Wolodzko Smart, Kimberly Sabelko, Melissa Bondy, Jerome Jourquin. Engaging breast cancer survivors in the United States in research: clinical characteristics and demographics from Susan G. Komen’s ShareForCures® first cohort [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P2-08-01.

Abstract P5-02-06: Investigating the Impact of a Culturally Tailored Education Intervention Cancer Clinical Trial Participation

2025-06-13

Jesutomisola Onafowokan , Nikita Nikita , Iqra Siddiqui +1 more | Clinical Cancer Research

Abstract Background: Cancer clinical trials (CCT) advance knowledge in cancer care. Access to CCT may be facilitated by patient knowledge. We evaluated the impact of a culturally tailored CCT educational … Abstract Background: Cancer clinical trials (CCT) advance knowledge in cancer care. Access to CCT may be facilitated by patient knowledge. We evaluated the impact of a culturally tailored CCT educational video intervention via a pre- and post-test survey on CCT interest and knowledge dissemination. Methods: A CCT education intervention was developed with community engagement from persons who identified as Black, Hispanic, or Chinese, the predominant background of persons in our immediate catchment area. The video educational intervention was available in Spanish and Chinese. Community input was to make the survey available prior to the diagnosis of cancer; therefore, participants included a general population (GP), persons who did not have a cancer diagnosis. Pre and post knowledge assessments were utilized to evaluate knowledge (11 questions) and intention-to-share information/participate in a CCT (6 questions) using a Fisher-exact test. Data were analyzed after stratifying by race. Results: The sample size included: 148 (70%) men, 58 (28%) women, 2 (1%) transgender, 2 (1%) non-binary; white, non-Latinx 125 (60%), Black 60 (29%), Asian 2 (1%), Latinx 52 (25%). Significant findings included, for Black participants, the score for the question "Once I sign a consent form, I must stay in the clinical trial until my doctor tells me I'm done" improved significantly between pre- and post-intervention (p=0.0104). For white, non-Latinx participants, CCT knowledge improved for the following questions "Once I sign a consent form, I must stay in the clinical trial until my doctor tells me I'm done." (p = 0.0181), "Clinical trials of new medicines or treatments are carefully reviewed for safety by a group of research experts and community members." (p = 0.0314) and "You can only join a clinical trial after you have tried all other options." (p = 0.0316). The intention to gain more information about CT from their physicians and discussing CT with family (p&lt;0.05) improved significantly in all groups. Conclusion: A tailored educational intervention significantly knowledge based questions and impacted the intention to learn more about CCT and to share the CCT information learned. Citation Format: Jesutomisola Onafowokan, Nikita Nikita, Iqra Siddiqui, Ana María López. Investigating the Impact of a Culturally Tailored Education Intervention Cancer Clinical Trial Participation [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P5-02-06.

Abstract P1-01-01: Mainstream Cancer Genetics Testing in Primary Care at a Federally Qualified Health Center: Preliminary Findings from the TestMiGenes Study

2025-06-13

Pamela Ganschow , Vivian Pan , Angelina Izguerra +2 more | Clinical Cancer Research

Abstract Introduction: Mainstream genetic testing (MGT) has been proposed as an alternative model to scale access to cancer genetic services utilizing established care providers to provide point-of-care genetic testing at … Abstract Introduction: Mainstream genetic testing (MGT) has been proposed as an alternative model to scale access to cancer genetic services utilizing established care providers to provide point-of-care genetic testing at the time of risk identification. However, MGT has primarily been adopted in the oncology setting. Expanding MGT into the primary care (PC) setting leverages the trusted relationship of providers within the patient’s medical home increasing the opportunity for primary prevention. In 2023, the University of Illinois Cancer Center partnered with the Mile Square Health Center, a system of federally qualified health centers, to initiate a quality improvement (QI) initiative promoting the prevention and early detection of cancer through universal hereditary cancer risk assessment (HCRA) across PC sites. Building off this QI initiative is the TestMiGenes study, which compares the effectiveness of a standard-of-care referral model enhanced with navigation support to a mainstream/point-of-care testing (MGT) model on the uptake of genetic testing among adults identified at risk for hereditary cancer syndromes in PC settings. Methods: A digital HCRA tool, developed in English and Spanish at a 7th-grade reading level, was administered by navigators to patients aged 25 and older presenting for routine PC visits across multiple FQHC sites. The HCRA tool identified patients meeting National Comprehensive Cancer Network (NCCN) criteria for genetic testing eligibility based on reported personal and family history. Patients who met NCCN criteria for genetic testing (GT) on HCRA received either a referral to genetic counseling or were offered GT by their PC provider (MGT). From January to December 2023, the referral model was implemented with 10 PC providers across 2 clinics. Eight PC providers from these 2 clinics transitioned to the MGT model from September 2023 to mid-May 2024. PC providers were trained to provide brief education and conduct shared decision-making around HCRA, placing GT orders, and GT result disclosure via multiple educational sessions with cancer genetic counselors and cancer risk specialists. Results: Overall, 1555 patients received HCRA, and 300 were eligible for GT. The majority of screened patients were Black or Hispanic (84%), under the age of fifty (52%), and female (68%). Of those eligible for GT, 68 received cancer genetic services under the MGT model and 232 received services under the referral model. Uptake of genetic testing was significantly higher among patients cared for in the MGT model (35%, n=24) compared to the referral model (23%, n=53) (p&lt;0.05). Time from identification of GT eligibility to completion of GT also differed significantly from 7 days in the MGT model to 93 days in the referral model (p &lt; 0.05). Of note, only 40% (n=69) of those eligible for GT in the referral model completed a GC visit, pointing to additional barriers in the current standard of care process. Conclusion: Preliminary data suggests that an MGT model is feasible in the PC setting and can potentially increase uptake and reduce wait time for GT. Notably, cancer genetic services are underutilized in both models likely due to multilevel barriers. Further research is needed to explore acceptability, sustainability, facilitators and barriers, and potential harms of both MGT and referral models in PC. The TestMiGenes study is currently conducting patient and provider interviews to explore stakeholder perceptions of GT in primary care. Citation Format: Pamela Ganschow, Vivian Pan, Angelina Izguerra, , Genesis Rios , Neha Awati. Mainstream Cancer Genetics Testing in Primary Care at a Federally Qualified Health Center: Preliminary Findings from the TestMiGenes Study [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P1-01-01.

Abstract P4-04-07: Harnessing Cognitive Engineering to Understand Breast Cancer Patient Decision Making

2025-06-13

Megan E. Salwei , Barbara Voigtman , Janelle Faiman +3 more | Clinical Cancer Research

Abstract Introduction: As the number of available treatment options for breast cancer increases, decision-making for patients has become complex. Patients often struggle to make decisions as treatment options can vary … Abstract Introduction: As the number of available treatment options for breast cancer increases, decision-making for patients has become complex. Patients often struggle to make decisions as treatment options can vary in terms of short- and long-term side effects, risks of recurrence, and impact on daily life.1 Numerous decision aids have been developed to support patient decision-making.2 However, sustained implementation and use of these tools remains limited. We propose that cognitive engineering approaches, such as naturalistic decision making (NDM), can provide a deeper understanding of how patients make treatment decisions, which can improve the design of decision support tools. Naturalistic decision making (NDM) is a theoretical perspective and methodological approach used to understand how people make decisions in the real world. Originally developed to understand decision-making of expert firefighters during crises, NDM approaches have been used to understand complex decision-making across domains including the military, offshore oil rigs, and healthcare.3,4 In this study, we used an NDM approach, the critical decision method (CDM), to gain an in-depth understanding of how breast cancer patients make treatment decisions following diagnosis. Methods: We conducted CDM interviews,5 with breast cancer patients diagnosis in the last 12 years. CDM interviews aim to understand critical or difficult events by unpacking the event using structured probes. One researcher conducted each interview over Zoom. We started each interview by asking the patient to reflect back on the beginning of their cancer journey and what they remember about their diagnosis. We then drew a timeline and asked the patient to relay the different treatments they considered or underwent for breast cancer. We then asked “Can you think of a time during your breast cancer journey when you had to make a difficult decision?” and probed patients about that decision. We continued asking patients about their treatment decision-making as time allowed. Each interview was audio-recorded and transcribed. A researcher and a patient advocate coded each interview and created a decision requirements table,6 which detailed the decisions made by the patient, what made that decision challenging, what strategies and information they used, and what their goals were at the time. We then met to discuss and come to consensus. Once a decision requirements table was created for each transcript, we developed aggregate tables and identified key themes. Results: We conducted 20 interviews, averaging 57 minutes each; patient age ranged from 42 to 81 years. Patients described an average of 8 decisions that they made following breast cancer diagnosis. Despite many patients facing the same decisions (e.g., mastectomy vs. lumpectomy), we found variability in which decisions were most difficult for patients. We identified 11 categories of difficult decisions for patients including whether to receive chemotherapy, getting genetic testing, stopping a medication due to side effects, and deciding where to receive treatment. Patients reported feeling time pressure and urgency to make treatment decisions and a fear of regretting their decisions. We found that patients’ firsthand experiences from friends who had cancer influenced their treatment decision-making. Given the heterogeneous nature of breast cancer treatment, this often presented a barrier to decision-making as patients expected to have the same experience and treatment options as their friends. Patients expressed variable goals when making treatment decisions, which often changed throughout their treatment journey. Conclusion: In this study, we explored how breast cancer patients made treatment decisions using NDM methods. This cognitive engineering approach revealed intricacies in the decision-making process of patients that will be valueable for improving the design of decision support tools. Next steps include collaborative design with patients to develop a tool that supports the broad spectrum of treatment decisions made across the patient journey. Citation Format: Megan Salwei, Barbara Voigtman, Janelle Faiman, Carrie Reale, Shilo Anders, Matthew Weinger. Harnessing Cognitive Engineering to Understand Breast Cancer Patient Decision Making [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P4-04-07.