American Radium Society ™ Appropriate Use Criteria on Radiation Therapy in Oligometastatic or Oligoprogressive Non-Small Cell Lung Cancer
Recent randomized studies have suggested improvements in progression-free and overall survival with the addition of stereotactic body radiation therapy (SBRT, also known as stereotactic ablative radiotherapy, SABR) in oligometastatic NSCLC patients. Given the novelty and complexity of incorporating SBRT in the oligometastatic setting, the multidisciplinary American Radium Society (ARS) Lung Cancer Panel was assigned to create Appropriate Use Criteria (AUC) on SBRT as part of consolidative local therapy for oligometastatic and oligoprogressive NSCLC patients. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - September 24, 2021 Category: Radiology Authors: Arya Amini, Vivek Verma, Charles B. Simone, Indrin J. Chetty, Stephen G. Chun, Jessica Donington, Martin J. Edelman, Kristin A. Higgins, Larry L. Kestin, Benjamin Movsas, George B. Rodrigues, Kenneth E. Rosenzweig, Igor I. Rybkin, Benjamin J. Slotman, And Source Type: research

Parotid gland stem cell sparing radiotherapy for head and neck cancer patients: a double-blind randomized controlled trial
Radiotherapy for head and neck cancer (HNC) frequently leads to salivary gland damage and subsequent xerostomia. The radiation response of parotid glands of rats, mice, and patients critically depends on dose to its stem cells, mainly located in the gland's main ducts (stem cell rich (SCR) region). Therefore, this double-blind randomized controlled trial aimed to test the hypothesis that parotid gland stem cell sparing radiotherapy preserves parotid gland function better than currently-used whole parotid gland sparing radiotherapy. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - September 23, 2021 Category: Radiology Authors: Roel J.H.M. Steenbakkers, Maria I. van Rijn – Dekker, Monique A. Stokman, Roel G.J. Kierkels, Arjen van der Schaaf, Johanna G.M. van den Hoek, Hendrik P. Bijl, Maria C.A. Kramer, Rob P. Coppes, Johannes A. Langendijk, Peter van Luijk Tags: Clinical Investigation Source Type: research

A novel role for RNF126 in the promotion of G2 arrest via interaction with 14-3-3 σ
Cell cycle checkpoints and DNA repair are important for cell survival after exogenous DNA damage. Both rapid blockage of G2 to M phase transition in the cell cycle and the maintenance of relatively slow G2 arrest are critical in order to protect cells from lethal ionizing radiation (IR). Checkpoint kinase 1 (CHK1) is pivotal in blocking the transition from G2 to M phases in response to IR. The 14-3-3 σ protein is important for IR-induced G2 arrest maintenance in which p53-dependent 14-3-3σ transcription is involved. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - September 23, 2021 Category: Radiology Authors: Pengyan Fa, Zhaojun Qiu, Qi-En Wang, Chunhong Yan, Junran Zhang Tags: Biology Contribution Source Type: research

Primary Mediastinal B-Cell Lymphoma: The Role of Consolidative Radiation for a “Terrible” Lymphoma
A 26-year-old male presented with shortness of breath, cough, and chest pain with a 2-year history of diffuse skin lesions. He underwent evaluation with computed tomography (CT) and follow-up positron emission tomography (PET)/CT imaging, identifying a 17.3 × 8.0 cm anterior mediastinal mass (Fig. 1A). Biopsy identified a diffuse large B-cell lymphoma, positive for CD45, CD20, and CD23 with a Ki-67 of 35%. There was partial positivity of BC-6 and CD30. The biopsy was negative for CD10, CD15, C-MYC, CD5, CD13, and EBER. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - September 21, 2021 Category: Radiology Authors: Garrett Anderson, Ashwin Shinde Source Type: research

PET/CT Responses in Primary Mediastinal Large B-Cell Lymphoma: What ’s Negative?
The next step in management for this patient1 should be observation. Although it is tempting to use combined modality therapy for this patient, the choice of the dose-adjusted (DA) R-EPOCH regimen was made to avoid radiation. There are limited data on the value of interim imaging in this setting; however, the best data are based on end-of-chemotherapy positron emission tomography (PET)/computed tomography (CT). There is an emerging consensus that the definition of a negative end-of-chemotherapy PET/CT is Deauville score (DS) 1 to 3. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - September 21, 2021 Category: Radiology Authors: John P. Plastaras, Jakub Svoboda Source Type: research

Biopsy, as Deauville May Deceive
The authors present a case of a 26-year-old with primary mediastinal B-cell lymphoma treated with R-EPOCH.1 The interim positron emission tomography/computed tomography (PET/CT) scan showed Deauville 3 in an 8-cm mass. Two months after R-EPOCH, the PET/CT scan showed Deauville 3 in a 4.2-cm mass. The next step in the management and the role of PET/CT in determining prognosis are controversial owing to a lack of large prospective randomized trials. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - September 21, 2021 Category: Radiology Authors: Mohammad K. Khan, Waleed F. Mourad Source Type: research

To Radiate or Not to Radiate? Implications of PET Biomarkers in Primary Mediastinal B-cell Lymphoma
This patient1 has clinical (eg, skin lesions that resolved after dose-adjusted R-EPOCH) and imaging features (probably a high maximum standardized uptake value) that make us nervous about an increased risk of relapse, but a posttreatment score of 3 on the 5-point scale has been associated with excellent outcomes. We do not think that the lack of improvement between the interval and posttreatment positron emission tomography/computed tomography (PET/CT) affects his prognosis. We would also want to know the baseline and posttreatment functional PET/CT parameters, such as the maximum standardized uptake value, metabolic tumor...
Source: International Journal of Radiation Oncology * Biology * Physics - September 21, 2021 Category: Radiology Authors: Ryan Kraus, Randa Tao Tags: Gray Zone Source Type: research

Carbon Ion Radiation Therapy: One Decade of Research and Clinical Experience at Heidelberg Ion Beam Therapy Center
Because several institutions for radiation oncology worldwide have demonstrated interest in the Heidelberg Ion Beam Therapy Center (HIT) experiences with carbon ion radiation therapy, this article aims to describe the carbon ion experience at HIT in Germany during the past decade as well as the current clinical status worldwide of carbon ion radiation therapy. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - September 21, 2021 Category: Radiology Authors: Tanja Eichkorn, Laila K önig, Thomas Held, Patrick Naumann, Semi Harrabi, Malte Ellerbrock, Klaus Herfarth, Thomas Haberer, Jürgen Debus Source Type: research

Hypofractionated Irradiation and Immune Modulation Therapies: Let's Work Together!
These are exciting times in oncology. Our ability to modify the antitumor immune response is rapidly advancing. Moreover, improvements in imaging and radiation delivery allow us to explore the use of hypofractionated radiation therapy (RT) in an increasing number of tumor types and tumor sites. RT may not only contribute to tumor control through tumor cell death, cell senescence, and vascular breakdown, but also induce anticancer immunity in the tumor microenvironment and draining lymph nodes, which can lead to an immune response against metastases. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - September 21, 2021 Category: Radiology Authors: Sean S. Park, Marjan Boerma Tags: Editorial Source Type: research

The Fallacy of the Consultation and Informed Consent Process in Radiation Oncology Through the Lens of Prostate Cancer
Treatment decision making in prostate cancer (PCa) is complicated by the multitude of options and the extensive controversies surrounding the relative merits and limitations of each. This complexity creates a need for a balanced consultation and informed consent process, and provides a lens through which to assess the process's effectiveness. During consultation visits, physicians are believed (or better said, hoped) to provide patients with the best available objective evidence for their particular medical condition and the expected outcomes with various treatments, after which patients reach a decision and provide inform...
Source: International Journal of Radiation Oncology * Biology * Physics - September 21, 2021 Category: Radiology Authors: Ronald D. Ennis, Neha Vapiwala Tags: Editorial Source Type: research

For the Love of Radiation Oncology: A Resident Trainee Perspective
Radiation oncology was considered among the most competitive specialties in medicine by most National Residency Matching Program (NRMP) metrics for over a decade, frequently attracting more applicants than available training positions.1,2 However, recent years have seen radiation oncology residency spots going unfilled in the NRMP match. In the most recent NRMP cycle, of 188 positions offered, 38 (20.2%) went unfilled. The surplus of residency slots has led to disproportionate use of the Supplemental Offer and Acceptance Program (SOAP) compared with other specialties. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - September 21, 2021 Category: Radiology Authors: Alexander Yaney, Nikol Mladkova, Sachin R. Jhawar Source Type: research

In Regard to Choudhury et al.
I read the editorial on the management of prostate cancer by Choudhury et al.1 with great interest. The section “Opinion Versus Evidence” particularly resonated with me. I commend the authors for emphasizing the importance of evidenced-based practice and wanted to add insight from the organizational psychology literature. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - September 21, 2021 Category: Radiology Authors: Varun Kumar Chowdhry Tags: Evidence-Based Practice Source Type: research

In Regard to Hathout et al.
We read the article by Hathout et al.1 with great interest. With a median follow-up of 45.3 months, the authors found no difference in overall survival or relapse-free survival rates according to sequence and type of combined adjuvant therapy. We have some concerns regarding the findings of this study, given the patient population's relative heterogeneity. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - September 21, 2021 Category: Radiology Authors: Cem Onal, Ezgi Oymak, Guler Yavas Tags: Aduvant Chemoradiation in Endometrial Cancer Source Type: research

In reply to Onal et al.
The majority of patients in our study received external beam radiation (EBRT) with or without brachytherapy (BT) (n  = 592; 86%), whereas a small proportion of patients were treated with chemotherapy and BT (chemo-brachy) (n = 94; 14%). A subgroup analysis was performed excluding patients treated with chemo-brachy and upfront radiation therapy. No differences in outcomes were found for overall survival (OS) a nd disease-free survival for the main 3 sequencing approaches (upfront chemotherapy, concurrent and sandwich). (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - September 21, 2021 Category: Radiology Authors: Lara Hathout, Mohamed A. Elshaikh, Kevin V. Albuquerque Source Type: research

Does Bigger Practice Size Mean Better for Patients and Providers?
Health care markets have seen increasing consolidation over the last 20 years, a trend that has only accelerated recently and is projected to continue for the foreseeable future. Increased awareness of this issue has sparked ongoing critical analysis and discussions regarding impacts on patients and providers. Over time, a more detailed picture of health care consolidation at the specialty level has begun to emerge, with a trend toward greater consolidation in most specialties, although the degree of change and overall impact varies substantially, and reports focused on radiation oncology are notably absent. (Source: Inter...
Source: International Journal of Radiation Oncology * Biology * Physics - September 21, 2021 Category: Radiology Authors: Andrew C. Hoover, Amar Rewari, Ronald C. Chen Tags: Editorial Source Type: research

Issue Highlights page
(Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - September 21, 2021 Category: Radiology Source Type: research

Meetings page
(Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - September 21, 2021 Category: Radiology Source Type: research

Exercise: A Treatment That Should Be Prescribed With Radiation Therapy
Schumacher et al1 performed a systematic review and meta-analysis on the effects of exercise therapy during radiation therapy on physical function and treatment-related side effects in men with prostate cancer. The authors highlighted that exercise therapy improved physical function and mitigated urinary toxicity in 6 randomized controlled trials including 391 patients with prostate cancer. The meta-analysis had several major findings from exercise therapy (vs control): (1) improved cardiorespiratory fitness, (2) improved muscle function (eg, upper and lower body muscle strength, flexibility), and (3) decreased urinary tox...
Source: International Journal of Radiation Oncology * Biology * Physics - September 20, 2021 Category: Radiology Authors: Nicholas G. Zaorsky, Sara Garrett, Daniel E. Spratt, Paul L. Nguyen, Chris Sciamanna, Kathryn Schmitz Tags: Editorial Source Type: research

AI-based quantification of planned radiotherapy dose to cardiac structures and coronary arteries in breast cancer patients
To develop and evaluate an automatic deep learning method for segmentation of cardiac chambers and large arteries, and localization of the three main coronary arteries in radiotherapy planning CT. To determine the planned radiotherapy dose to cardiac structures for breast cancer therapy. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - September 18, 2021 Category: Radiology Authors: Sanne G.M. van Velzen, Steffen Bruns, Jelmer M. Wolterink, Tim Leiner, Max A. Viergever, Helena M. Verkooijen, Ivana I šgum Source Type: research

Increasing demand on human capital and resource utilization in radiotherapy: The past decade
To quantify the change resource utilization in radiotherapy in the context of advancing technologies and techniques over the last decade. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - September 17, 2021 Category: Radiology Authors: Kundan Thind, M. Roumeliotis, T. Mann, L. Van Dyke, K. Martell, W. Smith, L. Barbera, S. Quirk Tags: Physics Contribution Source Type: research

Hypofractionated Stereotactic Radiotherapy for Intact Brain Metastases in 5 Daily Fractions: Impact of Dose on Treatment Response
Background: Multi-leaf collimator (MLC) linear accelerator (Linac) based hypofractionated stereotactic radiotherapy (HSRT) is increasingly practiced not only for large brain metastases or those adjacent to critical structures, but also for those metastases that would otherwise be considered for single fraction radiosurgery (SRS). However, outcomes in general are limited and there is a lack of understanding as to optimal dosing. Our aim was to report mature image-based outcomes for MLC-Linac HSRT with a focus on clinical and dosimetric factors associated with local failure (LF). (Source: International Journal of Radiation O...
Source: International Journal of Radiation Oncology * Biology * Physics - September 16, 2021 Category: Radiology Authors: Sten Myrehaug, John Hudson, Hany Soliman, Mark Ruschin, Chia-Lin Tseng, Jay Detsky, Zain Husain, Julia Keith, Eshetu G. Atenafu, Pejman Maralani, Chris Heyn, Sunit Das, Nir Lipsman, Arjun Sahgal Source Type: research

Radioresistance and transcriptional reprograming of invasive glioblastoma cells
Infiltrative growth pattern is a hallmark of glioblastoma (GBM). Radiotherapy aims to eradicate microscopic residual GBM cells post-surgical removal of the visible tumor bulk. However, in field recurrences remain the major pattern of therapy failure. We hypothesized that the radiosensitivity of peripheral invasive tumor cells (peri) may differ from predominantly investigated tumor bulk. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - September 14, 2021 Category: Radiology Authors: Zili Tang, Ivana Dokic, Maximilian Knoll, Federica Ciamarone, Christian Schwager, Carmen Klein, Gina Cebulla, Dirk C Hoffmann, Julian Schlegel, Philipp Seidel, Christiane Rutenberg, Stephan Brons, Christel Herold-Mende, Wolfgang Wick, J ürgen Debus, Diet Tags: Biology Contribution Source Type: research

Diaphragm Based Position Verification to Improve Daily Target Dose Coverage in Proton and Photon Radiotherapy Treatment of Distal Esophageal Cancer
In modern conformal radiotherapy of distal esophageal cancer, target coverage can be affected by variations in the diaphragm position. We investigated if daily position verification (PV) extended by a diaphragm position correction would optimize target dose coverage for esophageal cancer treatment. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - September 13, 2021 Category: Radiology Authors: Sabine Visser, Lydia A. den Otter, C ássia O. Ribeiro, Erik W. Korevaar, Stefan Both, Johannes A. Langendijk, Christina T. Muijs, Nanna M. Sijtsema, Antje Knopf Source Type: research

Boosting the abscopal effect using immunogenic biomaterials with varying radiotherapy field sizes
Persistent immunosuppression in the tumor micro-environment is a major limitation to boosting the abscopal effect, whereby radiotherapy at one site can lead to regression of tumors at distant sites. Here, we investigate the use of radiation and immunogenic biomaterials (IBM) targeting only the gross tumor sub-volume for boosting the abscopal effect in immunologically cold tumors. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - September 13, 2021 Category: Radiology Authors: Sayeda Yasmin-Karim, Bashkim Ziberi, Johanna Wirtz, Noella Bih, Michele Moreau, Romy Mueller, Victoria Anisworth, Juergen Hesser, G. Mike Makrigiorgos, Michael D Chuong, Xiao Xiao Wei, Paul L. Nguyen, Wilfred Ngwa Tags: Biology Contribution Source Type: research

Cardiac MRI and blood biomarkers for evaluation of radiation-induced cardiotoxicity in breast cancer patients: results of a phase II clinical trial
We report results from a prospective clinical trial evaluating early magnetic resonance imaging (MRI) and serum biomarker changes as predictors of cardiac injury and risk of subsequent cardiac events following RT for left-sided disease. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - September 9, 2021 Category: Radiology Authors: Corey Speers, Venkatesh L. Murthy, Eleanor M. Walker, Carri K. Glide-Hurst, Robin Marsh, Ming Tang, Emily L. Morris, Matthew J. Schipper, Richard L. Weinberg, Hunter C. Gits, James Hayman, Mary Feng, James Balter, Jean Moran, Reshma Jagsi, Lori J. Pierce Tags: Clinical Investigation Source Type: research

Accurate Dosimetry for Radiobiology
Accurate radiation dose is required to ensure reproducibility in establishing the radiobiological effect in biological systems among institutions. The dose should be the most precise and accurate parameter of the entire process. The goal is a system to provide uniform radiation dose verification among institutions that is traceable to NIST through an ADCL. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - September 8, 2021 Category: Radiology Authors: Larry A. DeWerd, Keith Kunugi Tags: Physics Contribution Source Type: research

International Multi-institutional Patterns of Contouring Practice and Clinical Target Volume Recommendations for Stereotactic Body Radiotherapy for Non-Spine Bone Metastases
The objective of this study was to provide consensus recommendations on clinical target volume (CTV) delineation based on international expert contours. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - September 8, 2021 Category: Radiology Authors: Timothy K Nguyen, Lee Chin, Arjun Sahgal, Roi Dagan, Wietse Eppinga, Matthias Guckenberger, Jin Ho Kim, Simon S Lo, Kristin J Redmond, Shankar Siva, Bradley J Stish, Rachel Chan, Liam Lawrence, Angus Lau, Chia-Lin Tseng Tags: Clinical Investigation Source Type: research

Cognitive and imaging differences after proton and photon whole brain irradiation in a preclinical model
This study aims to identify cognitive, functional MR and PET imaging markers and molecular differences between the radiation modalities. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - September 8, 2021 Category: Radiology Authors: Tien T. Tang, Janice A. Zawaski, Shelli Kesler, Christine A. Beamish, Taeko Inoue, Emma C. Perez, Lawrence Bronk, Falk Poenisch, Tina M. Briere, Omaima M. Sabek, David R. Grosshans, M. Waleed Gaber Tags: Biology Contribution Source Type: research

Radiosensitivity-specific proteomic and signaling pathway network of non-small cell lung cancer
An unmet clinical need in non-small cell lung cancer (NSCLC) management is the accurate prediction of radiation response in patients receiving radical radiotherapy. We explored the intrinsic radiosensitivity of NSCLC from the proteomic profiles of NSCLC cell lines and paraffin-embedded human samples. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - September 7, 2021 Category: Radiology Authors: Xueru Zhu, Yiting Wang, Chang Jiang, Xiaoyang Li, Linying Sun, Guangzhong Wang, Xiaolong Fu Tags: Biology Contribution Source Type: research

Therapy-na ïve and radioresistant 3D pancreatic cancer cell cultures are effectively radiosensitized by β1 integrin targeting
In this study, we investigated the radiochemosensitizing potential of β1 integrin targeting in therapy-naïve and radioresistant PDAC cell cultures grown in three-dimensional (3D) extracellular matrix (ECM). (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - September 2, 2021 Category: Radiology Authors: Josephine G örte, Erik Danen, Nils Cordes Tags: Biology Contribution Source Type: research

Adding short-term androgen deprivation therapy to RT in men with localized prostate cancer: long-term update of the NRG/RTOG 9408 randomized clinical trial
This study was performed to determine whether the short-term ADT continued to improve OS, DSM, BF, and freedom from DM with longer follow-up. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 31, 2021 Category: Radiology Authors: Christopher U Jones, Stephanie L Pugh, Howard M Sandler, Michael P Chetner, Mahul B Amin, Deborah W Bruner, Anthony L Zietman, Robert B Den, Mark H Leibenhaut, John M Longo, Jean-Paul Bahary, Seth A Rosenthal, Luis Souhami, Jeff M Michalski, Alan C Hartfo Tags: Clinical Investigation Source Type: research

Impact of vaginal symptoms and hormonal replacement therapy on sexual outcomes in locally advanced cervical cancer patients after definitive chemoradiotherapy – results from the EMBRACE-I study
To evaluate patient-reported sexual outcomes following chemoradiotherapy and image-guided adaptive brachytherapy for locally advanced cervical cancer (LACC) in the observational, prospective, multi-center XXXX-study. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 31, 2021 Category: Radiology Authors: Kathrin Kirchheiner, St éphanie Smet, Ina M. Jürgenliemk-Schulz, Christine Haie-Meder, Cyrus Chargari, Jacob C. Lindegaard, Lars U. Fokdal, Sofia Spampinato, Maximilian P. Schmid, Alina Sturdza, Umesh Mahantshetty, Barbara Segedin, Kjersti Bruheim, Bhav Tags: Clinical Investigation Source Type: research

Low-dose lung radiotherapy for COVID-19 lung disease: a preclinical efficacy study in a bleomycin model of pneumonitis.
Low-dose whole lung radiotherapy (LDLR) has been proposed as a treatment for patients with acute respiratory distress syndrome associated with SARS-CoV-2 infection and clinical trials are underway. There is an urgent need for preclinical evidence to justify this approach and inform dose, scheduling and mechanisms of action. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 31, 2021 Category: Radiology Authors: Mark R Jackson, Katrina Stevenson, Sandeep K. Chahal, Emer Curley, George E Finney, Rodrigo Gutierrez-Quintana, Evarest Onwubiko, Angie Rupp, Karen Strathdee, Karin Williams, Megan KL MacLeod, Charles McSharry, Anthony J Chalmers Tags: Biology Contribution Source Type: research

In the Hot Seat
A 58-year-old, male, nonsmoking journalist presents with a 6-week history of mild odynophagia and dysphagia and palpable right-sided lymphadenopathy. He has minimal ( (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 30, 2021 Category: Radiology Authors: Lachlan J. McDowell Source Type: research

A Two-Headed Heated Debate
“Whenever you find yourself on the side of the majority, it is time to pause and reflect.”Mark Twain (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 30, 2021 Category: Radiology Authors: David Raben, Adam Raben Tags: Editorial Source Type: research

EXTREME-ly Hot
(Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 30, 2021 Category: Radiology Authors: Juliette Thariat Source Type: research

Reports From Four International Clinical Trials for Cancers of the Cervix, Uterus and Vulva, and a New Guideline for Cervical Cancer
This article will review reports from 4 recent international clinical trials, 2 for cervical cancer, and 1 each for uterine and vulvar cancers, all of which add to our understanding of how to maximize the therapeutic ratio for each patient. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 30, 2021 Category: Radiology Authors: Shari Damast, Emma Fields, Elizabeth Kidd, Matthew Harkenrider, Supriya Chopra, Junzo Chino Tags: Editorial Source Type: research

In Regard to Dinh et al.
We concur with the expert panel of the American Radium Society that there are significant areas of controversy, particularly in relation to radiation therapy dose and fractionation in bladder cancer.1 A recent meta-analysis of 2 pivotal bladder radiation therapy trials advocates 55 Gy in 20 fractions (55 Gy/20 fx) as the standard of care for bladder preservation,2 but we urge caution for the following reasons. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 30, 2021 Category: Radiology Authors: Santhanam Sundar, Paul Symonds Tags: Radiation Dose and Fractionation for Bladder Cancer Source Type: research

In Regard to Shuryak et al.
This commentary expresses our concerns regarding the article titled “Lung Cancer and Heart Disease Risks Associated With Low-Dose Pulmonary Radiotherapy to COVID-19 Patients With Different Background Risks,” by Shuryak et al., published in the International Journal of Radiation Oncology, Biology, Physics.1 The authors aim to evaluate the benefit–risk balance o f low-dose radiation therapy (LDRT) for COVID-19. To do so, they estimated the lifetime risk of radiation-induced lung cancer and heart disease for patients with different background risks (e.g., sex, age, and the existence of other risk factors suc...
Source: International Journal of Radiation Oncology * Biology * Physics - August 30, 2021 Category: Radiology Authors: James S. Welsh, Joe Bevelacqua, S.M.J. Mortazavi, Bill Sacks Tags: Risks of Low-Dose Pulmonary Radiotherapy for COVID-19 Source Type: research

In Reply to Halperin
Halperin1 begins a very important dialogue on relevant topics regarding conflicts of interest in radiation oncology. Physician-industry interactions and other financial drivers of proton therapy utilization may play a role in medical decision-making2 and capital equipment purchases. Although Open Payments may provide limited insight into the extent of relationships between proton equipment manufacturers and physicians, the database does not fully capture relationships with institutions, high-ranking officials, medical physicists, and administrators. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 30, 2021 Category: Radiology Authors: Deborah C. Marshall Source Type: research

In Regard to Marshall et al.
Marshall et al's article “Trends in Financial Relationships Between Industry and Radiation Oncologists Versus Other Physicians in the United States from 2014 to 2018”1 is simultaneously remarkably incisive, meticulously researched, and beautifully written and presented. I would be grateful if the authors might share the ir thoughts in reference to 2 issues. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 30, 2021 Category: Radiology Authors: Edward C. Halperin Tags: Comments Source Type: research

In Reply to Welsh et al.
We appreciate the comments1 regarding our article “Lung Cancer and Heart Disease Risks Associated with Low-Dose Pulmonary Radiotherapy to COVID-19 Patients With Different Background Risks.”2 It is indeed true that the effects of very low radiation doses are uncertain, and epidemiologic evidence at these very low doses is limited. However, the p ulmonary and cardiac doses relevant to pulmonary radiation therapy for patients with COVID-19 are not in that “very low” dose range. Specifically, the pulmonary and cardiac doses are very similar to the prescription dose, typically in the range from 0.5 to 1....
Source: International Journal of Radiation Oncology * Biology * Physics - August 30, 2021 Category: Radiology Authors: Igor Shuryak, Lisa A. Kachnic, David J. Brenner Source Type: research

Peas in the Pod: Systemic Therapy for Systemic Disease, Radiation for Local Disease
I would initiate systemic therapy (TPF) with docetaxel, cisplatin, and fluorouracil (FU) to treat known sites of disease in addition to unidentified distant metastases that are likely present.1 After 3 cycles of TPF, obtain a positron emission tomography. An alternative to TPF is pembrolizumab combined with carboplatin alone or with FU. If the patient has a complete or partial metabolic response, treat local-regional disease to 66 Gy in 33 once-daily fractions using an ipsilateral field arrangement if the tonsil cancer is well lateralized. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 30, 2021 Category: Radiology Authors: William M. Mendenhall Source Type: research

In Regard to Small et al.
I read the article by Small et al,1 and the authors are to be commended for addressing the barriers of psychological treatment. However, this study might not be reflective of the many barriers to treatment, and the results need to be taken with a grain of salt. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 30, 2021 Category: Radiology Authors: Abdulla Al-Rashdan Tags: Barriers to Psychological Support for Cancer Patients Source Type: research

In Reply to Al-Rashdan
We wish to thank the author(s) who took the time to comment1 on our article, “Psychological Treatment for Patients Receiving Radiation: Results of NRG Oncology/RTOG 0841.”2 The trial recruited 463 patients from 37 sites and was primarily a feasibility trial assessing screening for major depression in patients receiving radiation therapy. The trial noted that a simple 2-i tem screening tool effectively screened for mood disorders. As part of this trial, the availability of and barriers to psychological care were collected. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 30, 2021 Category: Radiology Authors: William Small, Lynne I. Wagner, Deborah Watkins Bruner Source Type: research

Erratum to: Walshaw RC, Hoskin PJ, Choudhury A. Can Hypofractionation and Immune Modulation Coexist? Int J Radiat Oncol Biol Phys 2021;110(3):742 –744.
In paragraph 7: Bloggs et al should be Marcq et al (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 30, 2021 Category: Radiology Source Type: research

In Reply to Wang et al.
We appreciate the opportunity to reply to the letter1 regarding  our manuscript.2 We strongly agree with the author's opinion concerning the reassessment of a preoperative radiation dose of more than 41.4 Gy for patients with operable esophageal cancer and carcinoma of the gastroesophageal junction (EC/GEJ) receiving neoadjuvant concurrent chemoradiation therap y (nCRT) because of the uncertain benefit of an additional 5 to 10 Gy escalation. Two important randomized trials (CROSS and NEOCRTEC5010 trial) using 41.4 or 40 Gy demonstrated promising data regarding numerically non-inferior survival compared with>41.4 Gy...
Source: International Journal of Radiation Oncology * Biology * Physics - August 30, 2021 Category: Radiology Authors: Xudong Yin, Ying Li, Jiandong Tong, Yong Chen Source Type: research

In Regard to Ying Li et al.
We read with great interest the systematic review by Li et al.1 The authors found that a dose of 40.0 to 41.4 Gy with conventional fractionation (1.8-2.0 Gy daily) gave the best prognosis compared with other dose-fractionation schedules and recommended this radiation strategy for patients with operable esophageal cancer and carcinoma of the gastroesophageal junction (EC/GEJ) receiving neoadjuvant concurrent chemoradiation therapy (nCRT). Because nCRT with a relatively wide dose range (41.4-50.4 Gy with 1.8-2.0 Gy per daily fraction) followed by surgery is a standard treatment for patients with resectable EC/GEJ according t...
Source: International Journal of Radiation Oncology * Biology * Physics - August 30, 2021 Category: Radiology Authors: Tao Wang, Guangyu Tian, Xiaojun Chen Source Type: research

In Regard to Frankart et al.
We read with great interest the recent review by Frankart et al dealing with the diagnosis and management of osteoradionecrosis (ORN) after radiation therapy for head and neck carcinomas.1 This undoubtedly represents a comprehensive and multidisciplinary work in exposing all aspects of one of the most relevant late toxicities related to head and neck radiation therapy. In this regard, this work should be considered as a benchmark pointing out the current state of knowledge and future directions in this field. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 30, 2021 Category: Radiology Authors: Pierre-Antoine Laurent, Kanta Ka, Bertrand Gachot, Quitterie de Kerangal, Pierre Descols, Jean-Jacques Brau, Pierre Blanchard, Nadia Benmoussa Tags: Osteoradionecrosis After Radiation for Head and Neck Cancer Source Type: research

In Reply to Chow and Simone
We thank Chow and Simone for their critical but helpful  comment1 on our manuscript.2 Their concerns were based on data on definitive concurrent chemoradiation therapy (dCRT) for inoperable esophageal carcinoma (EC) but not neoadjuvant concurrent chemoradiation therapy (nCRT) for operable patients. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - August 30, 2021 Category: Radiology Authors: Xin Yuan, Ying Li, Xudong Yin, Jiandong Tong, Zhengrong Zhang, Rui Wang, Yong Chen Source Type: research