Journals Highlights

Read the highlights of recent articles in ASTRO's Journals.

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International Journal of Radiation Oncology • Biology • Physics

Practical Radiation Oncology

Advances in Radiation Oncology

Highlights from International Journal of Radiation Oncology• Biology • Physics

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A Primer on Radiopharmaceutical Therapy
Salerno et al.

This article by Salerno et al. serves as a primer for the United States-based radiation oncologist who may be interested in learning more about radiopharmaceutical therapy (RPT). RPT represents an opportunity for radiation oncologists to leverage two key areas of expertise, namely therapeutic radiation therapy and oncology, and apply them in a distinct context in collaboration with nuclear medicine and medical oncology colleagues. Although not every radiation oncologist will incorporate RPT into their day-to-day practice, it is important to understand the role for this modality and how it can be appropriately used in select patients.

Milestones 2.0: Refining the Competency-Based Assessment of Radiation Oncology Medical Residents
Thomas et al.

This editorial from Thomas et al. examines the Accreditation Council for Graduate Medical Education’s (ACGME) further development of the Milestones program as a model of professional development for physicians. The primary goals of the Milestones 2.0 working group were to revise specialty-specific subcompetencies to reflect current and future expectations, to ensure that anchors within the five levels describe the expected sequential acquisition of clinical skills, and to clarify and simplify implementation. Throughout this process, the ACGME aimed to diversify the working group for Milestones 2.0, increase public involvement and provide additional tools and resources to guide implementation.

Variations in Medical Necessity Determinations Across Commercial Insurance Carriers for Prostate Cancer Procedures
Shen et al.

This brief report from Shen et al. evaluated commercial insurance coverage determinations to assess the degree of variation across a national sample. The authors identified the predominant carrier of commercial insurance in each state based on the 2020 U.S. Government Accounting Office (GAO-21-34) report on insurance. For each state, publicly available medical policies from January 1, 2021, to January 31, 2021, were analyzed for coverage of three widely accepted procedures: hydrogel spacer, fluciclovine-positron emission tomography (PET) and intensity modulated radiation in low volume metastatic prostate cancer.

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Radiation Therapy for Endometrial Cancer: An American Society for Radiation Oncology Clinical Practice Guideline
Harkenrider et al.

In this new ASTRO guideline, the authors inform on the use of adjuvant radiation therapy (RT) and systemic therapy in the treatment of endometrial cancer. Updated evidence-based recommendations provide indications for adjuvant RT and the associated techniques, the utilization and sequencing of adjuvant systemic therapies and the effect of surgical staging techniques and molecular tumor profiling.

Patterns of Recurrence After Primary Local Therapy for Pancreatic Ductal Adenocarcinoma – A Critical Review of Rationale and Target Delineation for (Neo)Adjuvant Radiation Therapy
Jethwa et al.

This Critical Review from Jethwa et al. describes pancreatic ductal adenocarcinoma (PDAC) patterns of locoregional spread and recurrence to help guide clinicians on (neo)adjuvant radiation therapy planning strategies and target volume delineation. A comprehensive review of clinical data was performed to describe PDAC patterns of locoregional spread, including extrapancreatic tumor extension, perineural invasion, regional lymph node involvement and patterns of disease recurrence as influenced by (neo)adjuvant treatment strategy.

Veterans Affairs Radiation Oncology Quality Surveillance Program and American Society for Radiation Oncology Quality Measures Initiative
Park et al.

This article from Park et al. discusses how the Department of Veterans Affairs National Radiation Oncology Program (VA-NROP) established a quality surveillance initiative to address the challenge and necessity of providing the highest quality of care for veterans treated for cancer. As part of this initiative, the VA-NROP contracted with the American Society for Radiation Oncology to commission five Blue Ribbon Panels for lung, prostate, rectal, breast and head and neck cancers experts. This group worked collaboratively with the VA-NROP to develop consensus quality measures.

Highlights from Advances in Radiation Oncology

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Single and Multifraction Spine Stereotactic Body Radiation Therapy and the Risk of Radiation Induced Myelopathy
Lucido et al.

In this article from our November/December issue, Lucido et al. reported on the risk of radiation-induced myelitis (RM) of the spinal cord from a large single-institutional experience with 1 to 5 fraction stereotactic body radiation therapy (SBRT) to the spine. The use of SBRT for management of spinal metastases may provide improvements in pain relief and local tumor control compared with conventional spine radiation therapy. Safe delivery of spine SBRT requires the use of appropriate high-resolution planning images, prioritization of the sparing of the spinal cord in planning, and high-precision image guidance and patient repositioning technology during treatment delivery.

Decreasing the Adverse Effects in Pelvic Radiation Therapy: A Randomized Controlled Trial Evaluating the Use of Probiotics
Ahrén et al.

In this article from Ahrén et al., the authors evaluated the potential benefit from two probiotic bacteria of the species Lactiplantibacillus plantarum against radiation therapy-induced comorbidities. Women (>18 years of age) scheduled for radiation therapy because of gynecologic cancer were randomly allocated to consume placebo or either low-dose probiotics (1 × 1010 colony-forming unit/capsule twice daily) or high-dose probiotics (5 × 1010 colony-forming unit/capsule twice daily). The intervention started approximately one week before the onset of radiation therapy and continued until two weeks after completion. The primary endpoint was the probiotic effect on the mean number of loose stools during radiation therapy.

Simulation-Free Radiation Therapy: An Emerging Form of Treatment Planning to Expedite Plan Generation for Patients Receiving Palliative Radiation Therapy
Schiff et al.

This scientific article from Schiff et al. reported the clinical and dosimetric experience for patients with metastases treated with palliative simulation-free radiation therapy (SFRT) at a single institution. Palliative SFRT is an emerging technique that allowed for a statistically significant lower time to plan generation and was dosimetrically acceptable. This benefit must be weighed against increased total treatment time for patients receiving SFRT compared with CTRT, and appropriate patient selection is critical.