Oncology Vol 30 No 4_Suppl_1

(S002) A 15-Year Review of Radiation Therapy for Keloids at Two Institutions

April 15, 2016

For many individuals, keloids present a symptomatic and cosmetic issue after tissue injury. Surgical excision followed by immediate adjuvant RT provides excellent local control and cosmesis with minimal toxicity. Treatment with both prescribed regimens yielded equal results.

(S003) Single-Fraction Radiation Therapy for the Treatment of Multiple Myeloma Bony Metastases Provides Pain Control and Decreases Time to Chemotherapy

April 15, 2016

A hypofractionated course of 8 Gy/1 fx radiation therapy in the treatment of bony multiple myeloma metastases is an efficient and effective way to reduce pain and reduce the time from the completion of radiation therapy to the start of chemotherapy in patients with multiple myeloma.

(S001) Prognostic Value of Pretreatment Serum Inflammatory Markers in Patients Receiving Radiation Therapy for Oropharyngeal Cancer

April 15, 2016

Systemic inflammatory markers are independent prognostic factors for survival in oropharyngeal cancer patients treated with radiation therapy. Future investigations to validate the identified cut points and to develop risk-adaptive treatment strategies are needed.

(S004) Trend in Second Malignancy Risk for Head and Neck Cancer With Increased Utilization of IMRT: Analysis of SEER Database

April 15, 2016

Assuming IMRT became more prevalent from 2000 to 2002, the annual incidence rate of second malignancy remains consistently below that of patients who receive no radiation. This pattern contradicts the argument that IMRT significantly increases the risk for second malignancy.

(S005) Comparison of Legal Needs of a Group of Patients With Cancer: Economic and Geographic Factors

April 15, 2016

Differences in the legal needs of economically and geographically diverse patients with cancer suggest that those needs are not determined solely by disease state but that they also correspond with geographic and economic characteristics.

(S011) Comparative Study Between Ileal Conduit and Indiana Pouch After Cystectomy for Patients With Carcinoma of Urinary Bladder

April 15, 2016

We conclude that every patient has the right to have continent diversion. An orthotopic bladder approach should be considered first, and if it is not feasible, then the Indiana pouch could be a suitable alternative with no additional complications, unless this procedure is contraindicated.

(S012) Quantitative Imaging to Evaluate the Malignant Potential of Pancreatic Cysts

April 15, 2016

Intraductal papillary mucinous neoplasms with high malignant potential appear to have distinct imaging properties. Further validation of these findings may address a major clinical need in this population by identifying those most likely to benefit from surgical resection.

(S016) The Impact of Stereotactic Body Radiation Therapy on Overall Survival in Patients With Locally Advanced Pancreatic Cancer

April 15, 2016

SBRT appears to have a survival benefit in patients with locally advanced pancreatic cancer, especially after the delivery of maximal multiagent chemotherapy. SBRT may play a role in tumor downstaging and allow patients with locally advanced pancreatic cancer to undergo surgery.

(S017) A Margin Reduction Study for the Treatment of Gastric Marginal Zone Lymphoma Utilizing a Magnetic Resonance Imaging–Guided Radiation Therapy (MRIgRT) System

April 15, 2016

Significant variability in clinical target volume localization of gastric marginal zone lymphoma occurs if daily RT is delivered based on alignment to bony anatomy. MRI-guided RT allows for significant reduction in planning target volumes expansions without compromising coverage.

(S020) The Role of Adjuvant Radiotherapy in T4 Colon Cancer

April 15, 2016

In this large population dataset, adjuvant radiation was associated with an improvement in OS in a modern cohort of patients. Patients with distal tumors, higher-grade disease, negative lymph nodes, and larger tumors may derive a greater benefit with radiation.

(S052) Pseudoprogression and Radiation Necrosis in Adult Brain Tumor Patients Treated With Proton Beam Radiation Therapy

April 15, 2016

Central nervous system PRT appears to be well tolerated. Radiographic findings suggest that periventricular white matter may be more sensitive to radiation injury. Strategies to further reduce dose are warranted, as is the development of imaging and molecular biomarkers to identify patients at higher risk.

(P004) A Comparison of Postmastectomy Radiation Therapy (PMRT) With Protons vs Photons

April 15, 2016

Protons for postmastectomy radiation therapy, particularly in cases of challenging anatomy, result in decreased dose to normal structures compared with photon plans, with acceptable acute toxicity. Dose escalation after double-scattered proton should be used with caution to avoid skin toxicity.

(S021) Success of Prophylactic Single-Fraction Radiation Therapy in the Prevention of Pathologic Femoral Fractures

April 15, 2016

Single-fraction RT to the femur was effective in the prevention of femoral fractures. The pain score was also decreased in our patient population. Further studies are needed to explore 8 Gy/1 fx against standard radiation as a more effective means of delivering therapeutic and convenient treatment in metastatic patients.

(S022) Gender Differences in Time to Promotion and Scholarly Activity Among Academic Radiation Oncologists

April 15, 2016

Although the female RO full professors in our cohort were similar overall in terms of productivity and NIH funding to their male colleagues, they tended to have longer times to promotion earlier in their careers at lower academic ranks. Women may experience barriers to productivity early in their careers that may delay promotion.

(S024) Axillary Lymph Node Coverage With 3D Tangential Field Irradiation and Correlation With Heart and Lung Dose

April 15, 2016

Less than 50% of the level I LN volume was covered by 90% PD; less than 30% was covered by 95% PD. Mean (29 Gy) and median (30 Gy) doses to the level I LN were subtherapeutic. There was a moderate correlation between V20 ipsilateral lung and coverage of level I LNs.

(S023) The Radium Chemical Company: 1913–1981

April 15, 2016

The Standard Chemical Company was organized in 1911 to produce and sell radium. It was the first American company to do so. Most of the radium went to Europe, as there was little demand in America.

(S026) Medical Malpractice in Radiation Oncology

April 15, 2016

To promote legal decisions in favor of the radiation oncologist, we recommend: accreditation by the American Society for Radiation Oncology (ASTRO) Accreditation Program for Excellence (APEx); use of the ASTRO Radiation Oncology Incident Learning System (RO-ILS); and physician-patient discussion about treatment toxicity (eg, timing, etiologies, and risk of morbidity and mortality), with diligent documentation.

(S027) The Emotional Intelligence of Chairs of Academic Radiation Oncology Programs

April 15, 2016

Academic radiation oncology chairs have high emotional Intelligence, and increased emotional Intelligence correlates significantly with decreased rates of self-reported burnout. In the future, emotional Intelligence scores may be of increasing importance when it comes to recruitment and retention of academic medical leadership.

(S025) Quality of Life Following GammaKnife Radiosurgery for Single and Multiple Brain Metastases

April 15, 2016

QOL preservation in patients with terminal illnesses, such as brain metastasis, must remain paramount as healthcare technology continues to progress. In the present investigation, 72% of patients maintained their QOL following GKRS, with 24% of patients experiencing clinically significant improvement.

(S029) Dosimetric Comparison Between Vaginal Balloons and Rectal Retractors in Intracavitary Brachytherapy

April 15, 2016

There is no significant difference between D2cc%, D1cc%, and D0.1cc% to the rectum and sigmoid colon for VBs and RRs. There was a significant difference in ICRU% rectal point dose between VBs and RRs, but differences in clinical outcome, if present, will require additional investigation.

(S039) Patterns of Care and Outcomes Among Patients Diagnosed With Cutaneous T-Cell Lymphoma (CTCL)

April 15, 2016

Receipt of EBRT for CTCL varies by sociodemographic factors and the centers where patients receive their care. Among those receiving EBRT, there are variations in dose, and median survival may vary by race. Further research is needed to assess differences in receipt, outcomes, and dose.

(S036) Increasing Representation of Randomized Controlled Trials Targeting Oligometastatic Disease

April 15, 2016

The number of new trials examining treatment of oligometastatic disease has risen since 2011, signifying a paradigm shift in the local treatment of oligometastatic disease. RT continues to be the primary intervention in RCTs evaluating oligometastatic disease.

(S035) Validity of Current Stereotactic Body Radiation Therapy (SBRT) Dose Constraints for Aorta and Major Vessels

April 15, 2016

From logistic modeling of 625 major vessels, the Radiation Therapy Oncology Group 0813 trial limit of Dmax = 52.5 Gy in five fractions was found to have a 1.2% risk of grade 3–5 toxicity, and the 2008 Timmerman limit of Dmax = 45 Gy in three fractions had a 2.3% risk. Further investigation is warranted, especially for the pulmonary artery, which might not have a dose tolerance as high as other major vessels.

(S038) Treatment of Gastric Marginal Zone Lymphoma Utilizing a Magnetic Resonance Imaging–Guided Radiation Therapy (MRIgRT) System: Evaluation of Interfractional Target Volume Changes

April 15, 2016

This analysis demonstrates that significant interfractional target variation exists in the treatment of GMZL; this variation could lead to difficulties in target localization and/or reproducibility of treatment. MRIgRT is a promising method to evaluate and allow for adaptation to these variations.

(S041) Intensity-Modulated Involved-Site Radiation Therapy for Non-Hodgkin Lymphoma of the Head and Neck

April 15, 2016

Outcomes for head and neck NHL were maintained using ISRT with IMRT, with no marginal failures. ISRT reduces dose to normal tissues, and our results suggest that further reductions can be achieved with IMRT. This approach may be most valuable for definitive treatment of early-stage NHL, as the excellent prognosis highlights the importance of minimizing RT sequelae.

(S043) Is There a Benefit to Prolonging the Interval Between Neoadjuvant Chemoradiation and Esophagectomy in Esophageal Cancer?

April 15, 2016

While treatment at an academic center and increasing the time interval from chemoradiation to surgery were associated with a higher pCR rate, only treatment at an academic center improved survival. Overall, these data do not support routinely increasing the time interval between neoadjuvant chemoradiation and surgery.

(S045) Specialty Biases Influence Recommended Treatment Strategies for Patients With High-Risk Prostate Cancer: A Patterns-of-Care Study

April 15, 2016

Specialty-specific differences were identified for both upfront management and management after biochemical recurrences for high-risk prostate cancer, with specialists more likely to recommend the treatments they could deliver for nearly all clinical scenarios, whether these recommendations were based on high-level evidence or not.

(S046) Prospective Evaluation of Stereotactic Radiation Therapy for Spinal Metastases in the Postoperative Setting: A Secondary Analysis of Mature Phase I/II Trials

April 15, 2016

On univariate and multivariate competing risks analysis, sarcoma histology and larger preoperative tumor volumes were significantly associated with worse local control. Radioresistant histology and Karnofsky performance status were significant predictors for OS on multivariate analysis.

(S047) Clinical Outcomes Following One or More Courses of Stereotactic Radiosurgery for Brain Metastases From Breast Cancer

April 15, 2016

SRS is effective in treating BMs from breast cancer, and multiple courses of SRS are feasible and safe in select patients. Since this population can have a prolonged survival, aggressive local treatment with SRS can lead to improved survival and prevention of neurologic deficits.

(S049) Comparison of Central Nervous System Toxicity Profiles Following Radiosurgery vs Whole-Brain Radiation Among Patients Treated With Immunotherapy

April 15, 2016

GammaKnife radiosurgery appears to be safe regardless of whether it is delivered before or after checkpoint inhibitor immunotherapy. Conversely, WBRT delivered after immunotherapy was associated with heightened rates of grade ≥ 3 toxicity, including life-threatening cerebral edema, in approximately one-quarter of courses in this sample.

(S050) Stereotactic Radiosurgery in the Setting of Immune Checkpoint Blockade Results in Improved Intracranial Control Compared With Whole-Brain Irradiation for Greater Than Three Melanoma Brain Metastases

April 15, 2016

SRS, in the setting of systemic immunotherapy, may provide improved intracranial control compared with WBRT in patients with ≥ 3 melanoma brain metastases. Future prospective studies may expand the utility of SRS and spare selective patients with large intracranial disease burdens from toxicities associated with WBRT.

(S051) Disparities in Access and Treatment of Patients With High-Risk Prostate Cancer: Results From a Population-Based Cohort

April 15, 2016

Our findings suggest that differential treatment access alone does not explain racial disparities and that sociodemographic forces, such as referral patterns and provider biases, may heavily influence what should be a clinical decision regarding treatment provision and receipt.

(P012) Contralateral Liver Hypertrophy Following Intra-arterial Radioembolization for Liver Tumors

April 15, 2016

In addition to treating the tumors, radioembolization is a safe procedure with a predictable effect on contralateral liver hypertrophy. At 3 months post-radioembolization, degree of hypertrophy is significant, achieving the necessary threshold for safe liver resection.

(P015) Observations in Irradiation of Prostate Cancer (PC) Patients With Existing Prosthetic Penile Implants

April 15, 2016

Prostate cancer patients with penile prostheses who had pre-existing urologic problems (incontinence, penile pain, pelvic pain) and/or prior insertion of artificial urinary sphincters were more likely to experience urologic issues during RT until the 1-month follow-up.

(P035) The Prognostic Value of Pretreatment Peripheral Blood Neutrophil-to-Lymphocyte Ratio in Patients With Soft Tissue Sarcoma

April 15, 2016

While our results do not demonstrate high neutrophil-to-lymphocyte ratio to be an independent risk factor for worsened clinical outcomes, they do show high neutrophil-to-lymphocyte ratio to have statistically and clinically significant predictive value for RFS and OS in patients with recently diagnosed soft tissue sarcoma.

(P040) Hyperbaric Oxygen Treatment for Reducing Side Effects of Breast Radiation Therapy

April 11, 2016

Hyperbaric oxygen treatment is a well-tolerated treatment for delayed radiation injuries of breast cancer patients. Side effects are minimal and reversible. Patient-reported outcomes for patients receiving hyperbaric oxygen treatment are positive.

(S032) Value of Frequent Follow-Up Mammogram Schedule Following Breast-Conserving Surgery and Radiation Therapy

April 15, 2016

Our observations show a low incidence of BI-RADS 4 recommendations and a very low yield (0.8%) of cancer noted on pathology using a frequent follow-up mammogram schedule. We noted a trend of BI-RADS 4 returning positive for cancer in younger patients. This suggests that 6-month follow-up schedules are not necessary and that there may be value in defining risk-adaptive follow-up schedules after BCT.

(P019) Patterns and Predictors of Local Failure in Cervical Cancer

April 15, 2016

Para-aortic lymphatic failure occurred in 14.5% of patients in our study. Para-aortic failures occurred in 17.7% of patients with ≥ 3 lymph nodes and in 19.5% of patients with pelvic lymph nodes ≥ 1.5 cm. This may suggest the need for escalation of radiotherapy or chemotherapy in these patients.