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Pesquisa : H02.403.429.515.500 [Categoria DeCS]
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PMID:28463163
Autor:Connor MJ; Tringale K; Moiseenko V; Marshall DC; Moore K; Cervino L; Atwood T; Brown D; Mundt AJ; Pawlicki T; Recht A; Hattangadi-Gluth JA
Endereço:Department of Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, California; University of California Irvine School of Medicine, Irvine, California.
Título:Medical Device Recalls in Radiation Oncology: Analysis of US Food and Drug Administration Data, 2002-2015.
Fonte:Int J Radiat Oncol Biol Phys; 98(2):438-446, 2017 06 01.
ISSN:1879-355X
País de publicação:United States
Idioma:eng
Resumo:PURPOSE: To analyze all recalls involving radiation oncology devices (RODs) from the US Food and Drug Administration (FDA)'s recall database, comparing these with non-radiation oncology device recalls to identify discipline-specific trends that may inform improvements in device safety. METHODS AND MATERIALS: Recall data on RODs from 2002 to 2015 were sorted into 4 product categories (external beam, brachytherapy, planning systems, and simulation systems). Outcomes included determined cause of recall, recall class (severity), quantity in commerce, time until recall termination (date FDA determines recall is complete), and time since 510(k) approval. Descriptive statistics were performed with linear regression of time-series data. Results for RODs were compared with those for other devices by Pearson χ test for categorical data and 2-sample Kolmogorov-Smirnov test for distributions. RESULTS: There were 502 ROD recalls and 9534 other class II device recalls during 2002 to 2015. Most recalls were for external beam devices (66.7%) and planning systems (22.9%), and recall events peaked in 2011. Radiation oncology devices differed significantly from other devices in all recall outcomes (P≤.04). Recall cause was commonly software related (49% vs 10% for other devices). Recall severity was more often moderate among RODs (97.6% vs 87.2%) instead of severe (0.2% vs 4.4%; P<.001). Time from 510(k) market approval to recall was shorter among RODs (P<.001) and progressively shortened over time. Radiation oncology devices had fewer recalled devices in commerce than other devices (P<.001). CONCLUSIONS: Compared with other class II devices, RODs experience recalls sooner after market approval and are trending sooner still. Most of these recalls were moderate in severity, and software issues are prevalent. Comprehensive analysis of recall data can identify areas for device improvement, such as better system design among RODs.
Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, N.I.H., EXTRAMURAL


  2 / 3386 MEDLINE  
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PMID:28463141
Autor:Pan HY; Mazur LM; Martin NE; Mayo CS; Santanam L; Pawlicki T; Marks LB; Smith BD
Endereço:Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Título:Radiation Oncology Health Information Technology: Is It Working For or Against Us?
Fonte:Int J Radiat Oncol Biol Phys; 98(2):259-262, 2017 06 01.
ISSN:1879-355X
País de publicação:United States
Idioma:eng
Tipo de publicação: JOURNAL ARTICLE


  3 / 3386 MEDLINE  
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PMID:29351341
Autor:Bibault JE; Zapletal E; Rance B; Giraud P; Burgun A
Endereço:Radiation Oncology Department, Georges Pompidou European Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris Descartes University, Paris Sorbonne Cité, Paris, France.
Título:Labeling for Big Data in radiation oncology: The Radiation Oncology Structures ontology.
Fonte:PLoS One; 13(1):e0191263, 2018.
ISSN:1932-6203
País de publicação:United States
Idioma:eng
Resumo:PURPOSE: Leveraging Electronic Health Records (EHR) and Oncology Information Systems (OIS) has great potential to generate hypotheses for cancer treatment, since they directly provide medical data on a large scale. In order to gather a significant amount of patients with a high level of clinical details, multicenter studies are necessary. A challenge in creating high quality Big Data studies involving several treatment centers is the lack of semantic interoperability between data sources. We present the ontology we developed to address this issue. METHODS: Radiation Oncology anatomical and target volumes were categorized in anatomical and treatment planning classes. International delineation guidelines specific to radiation oncology were used for lymph nodes areas and target volumes. Hierarchical classes were created to generate The Radiation Oncology Structures (ROS) Ontology. The ROS was then applied to the data from our institution. RESULTS: Four hundred and seventeen classes were created with a maximum of 14 children classes (average = 5). The ontology was then converted into a Web Ontology Language (.owl) format and made available online on Bioportal and GitHub under an Apache 2.0 License. We extracted all structures delineated in our department since the opening in 2001. 20,758 structures were exported from our "record-and-verify" system, demonstrating a significant heterogeneity within a single center. All structures were matched to the ROS ontology before integration into our clinical data warehouse (CDW). CONCLUSION: In this study we describe a new ontology, specific to radiation oncology, that reports all anatomical and treatment planning structures that can be delineated. This ontology will be used to integrate dosimetric data in the Assistance Publique-Hôpitaux de Paris CDW that stores data from 6.5 million patients (as of February 2017).
Tipo de publicação: JOURNAL ARTICLE


  4 / 3386 MEDLINE  
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PMID:29420985
Autor:Ménard C; Paulson E; Nyholm T; McLaughlin P; Liney G; Dirix P; van der Heide UA
Endereço:Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 St-Denis, Room 11.442, Montréal, QC H2X 0A9, Canada; TECHNA Institute, University of Toronto, 124-100 College Street, Toronto, ON M5G 1L5, Canada. Electronic address: Cynthia.Menard@UMontreal.ca.
Título:Role of Prostate MR Imaging in Radiation Oncology.
Fonte:Radiol Clin North Am; 56(2):319-325, 2018 Mar.
ISSN:1557-8275
País de publicação:United States
Idioma:eng
Resumo:The use of prostate MR imaging in radiotherapy continues to evolve. This article describes its current application in the selection of treatment regimens, integration in treatment planning or simulation, and assessment of response. An expert consensus statement from the annual MR in RT symposium is presented, as a list of 21 key quality indicators for the practice of MR imaging simulation in prostate cancer. Although imaging requirements generally follow PIRADSv2 guidelines, additional requirements specific to radiotherapy planning are described. MR imaging-only workflows and MR imaging-guided treatment systems are expected to replace conventional computed tomography-based practice, further adding specific requirements for MR imaging in radiotherapy.
Tipo de publicação: JOURNAL ARTICLE; REVIEW


  5 / 3386 MEDLINE  
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PMID:27771243
Autor:Spratt DE; Soni PD; McLaughlin PW; Merrick GS; Stock RG; Blasko JC; Zelefsky MJ
Endereço:Department of Radiation Oncology, University of Michigan, Ann Arbor, MI.
Título:American Brachytherapy Society Task Group Report: Combination of brachytherapy and external beam radiation for high-risk prostate cancer.
Fonte:Brachytherapy; 16(1):1-12, 2017 Jan - Feb.
ISSN:1873-1449
País de publicação:United States
Idioma:eng
Resumo:PURPOSE: To review outcomes for high-risk prostate cancer treated with combined modality radiation therapy (CMRT) utilizing external beam radiation therapy (EBRT) with a brachytherapy boost. METHODS AND MATERIALS: The available literature for high-risk prostate cancer treated with combined modality radiation therapy was reviewed and summarized. RESULTS: At this time, the literature suggests that the majority of high-risk cancers are curable with multimodal treatment. Several large retrospective studies and three prospective randomized trials comparing CMRT to dose-escalated EBRT have demonstrated superior biochemical control with CMRT. Longer followup of the randomized trials will be required to determine if this will translate to a benefit in metastasis-free survival, disease-specific survival, and overall survival. Although greater toxicity has been associated with CMRT compared to EBRT, recent studies suggest that technological advances that allow better definition and sparing of critical adjacent structures as well as increasing experience with brachytherapy have improved implant quality and the toxicity profile of brachytherapy. The role of androgen deprivation therapy is well established in the external beam literature for high-risk disease, but there is controversy regarding the applicability of these data in the setting of dose escalation. At this time, there is not sufficient evidence for the omission of androgen deprivation therapy with dose escalation in this population. Comparisons with surgery remain limited by differences in patient selection, but the evidence would suggest better disease control with CMRT compared to surgery alone. CONCLUSIONS: Due to a series of technological advances, modern combination series have demonstrated unparalleled rates of disease control in the high-risk population. Given the evidence from recent randomized trials, combination therapy may become the standard of care for high-risk cancers.
Tipo de publicação: JOURNAL ARTICLE; REVIEW
Nome de substância:0 (Androgen Antagonists); EC 3.4.21.77 (Prostate-Specific Antigen)


  6 / 3386 MEDLINE  
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PMID:28455152
Autor:Turner S; Seel M; Trotter T; Giuliani M; Benstead K; Eriksen JG; Poortmans P; Verfaillie C; Westerveld H; Cross S; Chan MK; Shaw T
Endereço:Department of Radiation Oncology, Westmead Hospital, Sydney, Australia; University of Sydney, Australia. Electronic address: sandra.turner1@optusnet.com.au.
Título:Defining a Leader Role curriculum for radiation oncology: A global Delphi consensus study.
Fonte:Radiother Oncol; 123(2):331-336, 2017 05.
ISSN:1879-0887
País de publicação:Ireland
Idioma:eng
Resumo:BACKGROUND AND PURPOSE: The need for radiation oncologists and other radiation oncology (RO) professionals to lead quality improvement activities and contribute to shaping the future of our specialty is self-evident. Leadership knowledge, skills and behaviours, like other competencies, can be learned (Blumenthal et al., 2012). The objective of this study was to define a globally applicable competency set specific to radiation oncology for the CanMEDS Leader Role (Frank et al., 2015). METHODS: A modified Delphi consensus process delivering two rounds of on-line surveys was used. Participants included trainees, radiation/clinical oncologists and other RO team members (radiation therapists, physicists, and nurses), professional educators and patients. RESULTS: 72 of 95 (76%) invitees from nine countries completed the Round 1 (R1) survey. Of the 72 respondents to RI, 70 completed Round 2 (R2) (97%). In R1, 35 items were deemed for 'inclusion' and 21 for 'exclusion', leaving 41 'undetermined'. After review of items, informed by participant comments, 14 competencies from the 'inclusion' group went into the final curriculum; 12 from the 'undetermined' group went to R2. In R2, 6 items reached consensus for inclusion. CONCLUSION: This process resulted in 20 RO Leader Role competencies with apparent global applicability. This is the first step towards developing learning, teaching and assessment tools for this important area of training.
Tipo de publicação: JOURNAL ARTICLE


  7 / 3386 MEDLINE  
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PMID:28971825
Autor:Abdel-Wahab M; Lahoupe B; Polo A; Zubizarreta E; Adnan RR; Johnston P; Juric A; Haffar FE; Andre M; Meghzifene A
Endereço:Division of Human Health, International Atomic Energy Agency, Vienna, Austria. Electronic address: wahabmay@hotmail.com.
Título:Assessment of cancer control capacity and readiness: the role of the International Atomic Energy Agency.
Fonte:Lancet Oncol; 18(10):e587-e594, 2017 Oct.
ISSN:1474-5488
País de publicação:England
Idioma:eng
Resumo:During the past six decades, the International Atomic Energy Agency (IAEA) has helped to address the growing cancer burden, by delivering substantial cancer-related assistance to low-income and middle-income member states. IAEA assistance has primarily been facilitated through sustainable radiotherapy and nuclear medicine programmes to establish safe and effective diagnostic imaging, nuclear medicine, and radiotherapy capacity to safely treat patients with cancer. Planning of a National Cancer Control Programme starts with a needs assessment of all aspects of cancer control in the country to ensure evidence-based strategies are adapted to the country's specific needs. The IAEA offers its member states a tool, known as an integrated mission of Programme of Action for Cancer Therapy Review, to assess the status of national capacities for implementation and delivery of cancer control plans and activities and the readiness to develop and implement a long-term radiation medicine infrastructure and plan to improve capacity.
Tipo de publicação: EVALUATION STUDIES; JOURNAL ARTICLE; REVIEW


  8 / 3386 MEDLINE  
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PMID:28890091
Autor:Lisbona A
Endereço:Département de physique médicale, institut de cancérologie de l'Ouest René-Gauducheau, 44805 Saint-Herblain, France. Electronic address: albert.lisbona@ico.unicancer.fr.
Título:[What does the medical physicist expect from the radiation oncologist and vice versa?]
Título:Qu'attend le physicien médical de l'oncologue radiothérapeute et inversement ?.
Fonte:Cancer Radiother; 21(6-7):560-562, 2017 Oct.
ISSN:1769-6658
País de publicação:France
Idioma:fre
Resumo:The cooperation between radiation oncologist and medical physicist is essential to guarantee the quality and safety of the irradiation of our patients. It would be wrong to consider that the intervention of medical physicists in the patient management process is limited to the provision of calibrated and controlled equipment and to guarantee the validity of the dose distribution and the treatment time, while the radiation oncologist has the complete control of all clinical activities related to irradiation. The intervention of physicists at the stage of acquisition of anatomical data and throughout the phase of optimization of the treatment is already a reality. The recognition of the profession of medical physicist as a health profession comes to legitimize this intervention. Should physician-physicist cooperation be limited to these common tasks and participation in continuing care? Can we envisage a true synergy of action that goes beyond the field of care? The answer to the question: what does the physicist expect from the radiation oncologist and vice versa may bring elements to reinforce tomorrow's cooperation. This article is the second part of the question.
Tipo de publicação: JOURNAL ARTICLE


  9 / 3386 MEDLINE  
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PMID:28890087
Autor:Créhange G; Cormier L
Endereço:Département d'oncologie radiothérapie, centre Georges-François-Leclerc, 1, rue Pr-Marion, 21000 Dijon, France; Le2i, CNRS FR2005, allée Alain-Savary, 21000 Dijon, France; UFR sciences et techniques, université de Bourgogne, allée Alain-Savary, 21000 Dijon, France. Electronic address: gcrehange@cgfl.fr.
Título:[Therapeutic innovations in radiation oncology for localized prostate cancer].
Título:Innovations thérapeutiques en radiothérapie du cancer de la prostate localisé..
Fonte:Cancer Radiother; 21(6-7):454-461, 2017 Oct.
ISSN:1769-6658
País de publicação:France
Idioma:fre
Resumo:Intensity-modulated radiation therapy, image-guided radiation therapy with fiducial markers and prostate brachytherapy allow the delivery of dose escalation for localized prostate cancer with very low rates of long-term toxicity and sequelae. Nowadays, modern radiotherapy techniques make it possible to shorten treatment time with hypofractionation, to better protect surrounding healthy tissues and to escalate the dose even further. Advances in radiotherapy are closely linked to advances in magnetic resonance imaging (MRI) and/or PET imaging. Functional imaging makes it possible to deliver personalised pelvic nodal radiotherapy, targeting the nodal areas at higher risk of microscopic involvement. In patients with an index lesion at baseline or at failure, MR-based focal therapy or focal dose escalation with brachytherapy or stereotactic body radiation therapy is also currently investigated. MR-based adaptive radiotherapy, which makes it possible to track prostate shifts during radiation delivery, is another step forward in the integration of MR imaging in radiation delivery.
Tipo de publicação: JOURNAL ARTICLE; REVIEW


  10 / 3386 MEDLINE  
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PMID:28871988
Autor:Solanki AA; Martin B; Korpics M; Small C; Harkenrider MM; Mitin T
Endereço:Department of Radiation Oncology, Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois. Electronic address: abhishek.solanki@lumc.edu.
Título:Bladder-Preserving Therapy Patterns of Care: A Survey of US Radiation Oncologists.
Fonte:Int J Radiat Oncol Biol Phys; 99(2):383-387, 2017 Oct 01.
ISSN:1879-355X
País de publicação:United States
Idioma:eng
Resumo:PURPOSE: Clinical trials have demonstrated the efficacy of bladder-preserving chemoradiation therapy (BPT) in muscle-invasive bladder cancer but have differed in the radiation therapy dose/fractionations, radiation therapy targets, and concurrent chemotherapy regimens used. No data exist on the technical and practical approaches actually used in clinical practice throughout the United States when delivering BPT. We performed a survey to explore radiation oncologists' practice patterns. METHODS AND MATERIALS: We conducted an electronic survey of US radiation oncologists regarding the management of patients with cT2-3N0M0 transitional cell muscle-invasive bladder cancer. The instrument included questions regarding the types of patients treated with BPT, as well as several aspects of treatment delivery. Descriptive statistics were reported for all responses. Pearson χ tests were used for univariate analysis. RESULTS: In total, 277 physicians completed our survey. Most respondents (58%) stated that they only treated 1 to 3 patients in the prior year. Seventy-four percent of respondents primarily treated patients deemed unfit for cystectomy, while only 28% saw patients prior to cystectomy for consultation to discuss BPT. The majority of radiation oncologists used conventional fractionation (91%) instead of hypofractionation (7.6%), but more variability existed for radiation therapy targets. Sixty percent used a small pelvis field, 29% used a whole-pelvis field, and 12% treated the bladder only. There was increased use of hypofractionation (29%) and bladder-only radiation therapy (34%) in patients who were not candidates for cystectomy or chemotherapy (P<.001). Cisplatin-based concurrent chemotherapy was most commonly preferred (89%). In non-cisplatin candidates, most respondents preferred 5-fluorouracil plus mitomycin C (32%) or carboplatin (32%). Intensity modulated radiation therapy use and midtreatment cystoscopic re-evaluation were variable, while hyperfractionation use was low. CONCLUSIONS: Our study describes radiation oncologists' practice patterns for patients undergoing BPT. Although there are areas of consistency, variability exists in many technical and practical aspects of treatment delivery. Further research and education are needed to determine the optimal radiation therapy target, dose/fractionation, and concurrent chemotherapy regimen.
Tipo de publicação: JOURNAL ARTICLE



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