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Mitin T, Degnin C, Chen Y, Shirvani S, Gillespie E, Hoffe S, Latifi K, Nabavizadeh N, Dengina N, Chernich M, Usychkin S, Kharitonova E, Egorova Y, Pankratov A, Tsimafeyeu I, Thomas CR, Tjulandin S, Likhacheva A. Radiotherapy for Hepatocellular Carcinoma in Russia: a Survey-Based Analysis of Current Practice and the Impact of an Educational Workshop on Clinical Expertise. J Cancer Educ 2020; 35:105-111. [PMID: 30467774 DOI: 10.1007/s13187-018-1447-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Radiation therapy (RT) is an effective treatment modality for hepatocellular carcinoma (HCC), but globally, it is underutilized. In Russia, practice patterns with regard to liver-directed radiation are unknown. Under the auspices of Russian Society of Clinical Oncology (RUSSCO), our team conducted an IRB-approved contouring workshop for Russian radiation oncologists. Pre- and post-workshop surveys were analyzed to determine baseline clinical experience and patterns of care for liver-directed RT among Russian providers. The effect of the contouring workshop on participants' knowledge was tested using mixed effects model. Forty pre-workshop and 24 post-workshop questionnaires were analyzable with a 100% response rate. Sixty percent of respondents had never evaluated a patient with HCC and only 8% (3 out of 40) reported treating an HCC patient with liver-directed RT. Nonetheless, 73% of respondents were comfortable offering liver-directed RT prior to the workshop. After the workshop, 85% of respondents felt comfortable treating a patient with HCC with liver-directed RT and 50% were comfortable recommending stereotactic body radiation therapy (SBRT). Measures of knowledge pertaining to evaluation of HCC patients and selection for appropriate liver-directed therapies were dramatically improved after the workshop. Liver-directed RT is not commonly used in Russia in the management of patients with HCC, and few centers are equipped for motion management. Our contouring workshop resulted in dramatically improved understanding of the evaluation and management of HCC patients. We recommend starting with a more protracted fractionated RT and building experience through attendance of additional educational activities, participation in multidisciplinary liver tumor boards, and prospective analysis of treatment toxicity and outcomes.
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Affiliation(s)
- Timur Mitin
- Department of Radiation Medicine, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
- International Design and Implementation Group for Radiation Oncology workshops (INDIGO), Moscow, Russia
| | - Catherine Degnin
- Biostatistics Shared Resources, OHSU Knight Cancer Institute, Portland, OR, USA
| | - Yiyi Chen
- Biostatistics Shared Resources, OHSU Knight Cancer Institute, Portland, OR, USA
| | - Shervin Shirvani
- Department of Radiation Oncology, Banner MD Anderson Cancer Center, 2946 E Banner Gateway Dr, Gilbert, AZ, 85234, USA
| | - Erin Gillespie
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sarah Hoffe
- Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Kujtim Latifi
- Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Nima Nabavizadeh
- Department of Radiation Medicine, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - Natalia Dengina
- International Design and Implementation Group for Radiation Oncology workshops (INDIGO), Moscow, Russia
- Department of Radiotherapy, Ulyanovsk Regional Cancer Center, Ulyanovsk Oblast, Russia
| | - Marina Chernich
- International Design and Implementation Group for Radiation Oncology workshops (INDIGO), Moscow, Russia
- N.N. Blokhin Russian Cancer Center, Moscow, Russia
| | - Sergey Usychkin
- International Design and Implementation Group for Radiation Oncology workshops (INDIGO), Moscow, Russia
- Medscan Clinic, Moscow, Russia
| | | | - Yulia Egorova
- Russian Society of Clinical Oncology (RUSSCO), Moscow, Russia
| | - Alexandr Pankratov
- International Design and Implementation Group for Radiation Oncology workshops (INDIGO), Moscow, Russia
- PET-Technology Center, Balashikha, Russia
| | - Ilya Tsimafeyeu
- Russian Society of Clinical Oncology (RUSSCO), Moscow, Russia
- PET-Technology Center, Balashikha, Russia
- Kidney Cancer Research Bureau, Moscow, Russia
| | - Charles R Thomas
- Department of Radiation Medicine, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | | | - Anna Likhacheva
- International Design and Implementation Group for Radiation Oncology workshops (INDIGO), Moscow, Russia.
- Department of Radiation Oncology, Banner MD Anderson Cancer Center, 2946 E Banner Gateway Dr, Gilbert, AZ, 85234, USA.
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De Bari B, Dahele M, Palmu M, Kaylor S, Schiappacasse L, Guckenberger M; ESTRO FALCON core. Short interactive workshops reduce variability in contouring treatment volumes for spine stereotactic body radiation therapy: Experience with the ESTRO FALCON programme and EduCase™ training tool. Radiother Oncol 2018; 127:150-3. [PMID: 29169657 DOI: 10.1016/j.radonc.2017.10.038] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 10/29/2017] [Accepted: 10/31/2017] [Indexed: 11/20/2022]
Abstract
We report the results of 4, 2-h contouring workshops on target volume definition for spinal stereotactic radiotherapy. They combined traditional teaching methods with a web-based contouring/contour-analysis platform and led to a significant reduction in delineation variability. Short, interactive workshops can reduce interobserver variability in spine SBRT target volume delineation.
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Conrad T, MacLellan S, Kassam Z, Mackay H, Khalili I, Sykes J, Purdie T, Okrainec A, Ringash J. Retrospective assessment of patterns of recurrence relative to radiotherapy volumes for adjuvant conformal chemoradiotherapy in gastric cancer. Gastric Cancer 2016; 19:887-93. [PMID: 26362272 DOI: 10.1007/s10120-015-0534-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 08/07/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Since the Intergroup 0116 study was published in 2000, adjuvant postoperative chemoradiotherapy using CT-planned and 3D conformal/intensity-modulated radiotherapy has been offered routinely to fit patients with resected gastric cancer at Princess Margaret Hospital .The objective of this study was to analyze patterns of disease recurrence with respect to the radiotherapy volumes. METHODS For the date and site (local, locoregional, or distant) of the first recurrence, medical records were reviewed for all patients treated at Princess Margaret Hospital with adjuvant chemoradiotherapy for resected gastric adenocarcinoma (January 1, 2000 to November 30, 2009). Patients whose recurrences were limited to local and/or regional sites were selected for further analysis. Available diagnostic imaging of the recurrence site was registered to the original planning radiotherapy dataset for contouring. If necessary to respect changes in anatomy, the contour was translocated on the basis of anatomic descriptors. The center of mass for each recurrence was identified as a point and its location was categorized according to the isodose encompassing it; in field (90 % or more), marginal (50-89 %), or out of field (less than 50 %). RESULTS Of all 197 patients, 14 (7 %) had isolated locoregional failure, constituting 20 % of all 71 patients with a recurrence. Successful fusions were feasible in five cases. Of these recurrences, four were in field and one was marginal. In a further four cases, visual inspection was used, showing one in-field recurrence, one marginal recurrence, and two out-of-field recurrences. In five patients, either a useable original dataset or diagnostic imaging of the recurrence was not available. CONCLUSIONS The rates of isolated local/locoregional tumor recurrence in this study were low. Of the small number of recurrences available for analysis, most (five of nine) were in field. Further studies involving a larger cohort of patients might allow a more meaningful analysis of trends in the recurrence site with evolving radiotherapy techniques.
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