The clinical added-value of 18 F-fluoro-2-deoxy-D-glucose positron emission tomography (18 FDG PET) in the management of oncology patients is increasingly documented. In the present review, we discuss both the benefits and the limitations of 18 FDG PET in different cancers. Considering the literature data and our own experience, we also indicate the best clinical approach to optimize the use of metabolic imaging in oncology. Contents 1. Introduction 2. Key factors influencing the 18 FDG uptake 3. Indications of 18 FDG PET in oncology 4. Conclusion

Background The objective of the current study was to compare the safety and efficacy between 2 analgesic regimens for patients with head and neck cancer (HNC) undergoing definitive chemoradiation (CRT). Methods The current study was a prospective, single‐institution, 2‐arm, randomized pilot study. Patients with American Joint Committee on Cancer seventh edition stage II to stage IV squamous cell carcinoma of the head and neck who were undergoing CRT were randomized to either arm 1, which entailed high‐dose gabapentin (2700 mg daily) with the institutional standard of care (hydrocodone and/or acetaminophen progressing to fentanyl as needed), or arm 2, which comprised low‐dose gabapentin (900 mg daily) with methadone. The primary endpoints were safety and toxicity. Secondary endpoints were pain, opioid requirement, and quality of life (QOL). Differences between the treatment arms at multiple time points were compared using a generalized linear mixed regression model with Sidak correction. Results A total of 60 patients (31 in arm 1 and 29 in arm 2) were enrolled from April 2015 to August 2017. There was no difference between the treatment arms with regard to adverse events or serious adverse events. Pain was not found to be different between the treatment arms. More patients in arm 1 did not require an opioid during treatment (42% vs 7%; P = .002). Patients in arm 2 experienced significantly better QOL outcomes across multiple domains, including overall health (P = .05), physical functioning (P = .04), role functioning (P = .01), and social functioning (P = .01). Conclusions High‐dose prophylactic gabapentin increased the percentage of patients who required no opioid during treatment. Methadone may improve QOL compared with a regimen of short‐acting opioids and fentanyl. However, pain was found to significantly worsen throughout treatment regardless of treatment arm, necessitating further studies to identify a more optimal regimen.

Postmastectomy radiotherapy (PMRT) has been shown to improve the overall survival for invasive breast cancer patients, and many advanced radiotherapy technologies were adopted for PMRT. The purpose of our study is to compare various advanced PMRT techniques including fixed-beam intensity-modulated radiotherapy (IMRT), non-coplanar volumetric modulated arc therapy (NC-VMAT), multiple arc VMAT (MA-VMAT), and tomotherapy (TOMO). Results of standard VMAT and mixed beam therapy that were published by our group previously were also included in the plan comparisons. Treatment plans were produced for nine PMRT patients previously treated in our clinic. The plans were evaluated based on planning target volume (PTV) coverage, dose homogeneity index (DHI), conformity index (CI), dose to organs at risk (OARs), normal tissue complication probability (NTCP) of pneumonitis, lifetime attributable risk (LAR) of second cancers, and risk of coronary events (RCE). All techniques produced clinically acceptable PMRT plans. Overall, fixed-beam IMRT delivered the lowest mean dose to contralateral breast (1.56 ± 0.4 Gy) and exhibited lowest LAR (0.6 ± 0.2%) of secondary contralateral breast cancer; NC-VMAT delivered the lowest mean dose to lungs (7.5 ± 0.8 Gy), exhibited lowest LAR (5.4 ± 2.8%) of secondary lung cancer and lowest NTCP (2.1 ± 0.4%) of pneumonitis; mixed beam therapy delivered the lowest mean dose to heart (7.1 ± 1.3 Gy) and exhibited lowest RCE (8.6 ± 7.1%); TOMO plans provided the most optimal target coverage while delivering higher dose to OARs than other techniques. Both NC-VMAT and MA-VMAT exhibited lower values of all OARs evaluation metrics compare to standard VMAT. Fixed-beam IMRT, NC-VMAT, and mixed beam therapy could be the optimal radiation technique for certain breast cancer patients after mastectomy.

Despite an increase in the number of formal research courses and the support services that institutions provide, the success that students achieve is modest suggesting the involvement of other factors. The authors seek to determine the extent to which barriers and resources affect the ability for students to be successful in research endeavors. The authors distributed a cross-sectional survey via the Internet to members of the American Medical Association-Medical Student Section (AMA-MSS) and the American Medical Student Association. The authors also distributed a paper version of the survey during the AMA-MSS national conference in San Diego, CA, October 2010. The primary outcome was selfidentified successful research. The authors also assessed the supportive factors and barriers the respondents faced. 422 students completed the survey and identified having mentorship (OR 1.38, 95% CI 1.11-1.60), student funding (OR 1.52, 95% CI 1.26-1.69), and having an office or director of student research (OR 1.52, 95% CI 1.26-1.70) as factors associated with successfully publishing as a medical student. Barriers to success in student research included being unaware what research occurs locally (OR 1.36, 95% CI 1.05-1.76), lacking faculty mentors (OR 1.45, 95% CI 1.07-1.95), and lack of a research office/coordinator (OR 1.53, 95% CI 1.18-2.00). The effects of the barriers were not offset by the research curricula provided. To improve the success of medical students involved in involved in research, academic medical institutions must address barriers directly in addition to offering curricula in research methods.