Purpose/Objective
Although considerable research exists regarding the role of women in the medical profession in the United States, little work has described the participation of women in academic radiation oncology. We examined women’s participation in authorship of radiation oncology literature, a visible and influential activity that merits specific attention.
Methods and Materials
We examined the gender of first and senior U.S. physician-authors of articles published in the Red Journal in 1980, 1990, 2000, 2004, 2010 and 2012. The significance of trends over time was evaluated using logistic regression. Results were compared to female representation in journals of general medicine and other major medical specialties. Findings were also placed in the context of trends in the representation of women among radiation oncology faculty and residents over the last three decades, using AAMC data.
Results
The proportion of women among Red Journal first authors increased from 13.4% in 1980 to 29.7% in 2012, and the proportion among senior authors increased from 3.2% to 22.6%. The proportion of women among radiation oncology full-time faculty increased from 11% to 26.7% from 1980 to 2012. The proportion of women among radiation oncology residents increased from 27.1% to 33.3% from 1980 to 2010.
Conclusion
Female first and senior authorship in the Red Journal has increased significantly, as has women’s participation among full-time faculty, but women remain under-represented among radiation oncology residents as compared to their representation in the medical student body. Understanding such trends is necessary to develop appropriately targeted interventions to improve gender equity in radiation oncology.
Although MS knowledge of general RT principles improves from the first to the fourth year, a large knowledge gap still exists between MSs, current PCPs, and ROs. Some basic misconceptions of RT persist among a minority of MSs and PCPs. We recommend implementing formal education in RO fundamentals during the core curriculum of medical school.
PurposeTo report outcomes following adjuvant high-dose-rate vaginal brachytherapy (VBT) with or without chemotherapy for high-intermediate risk (HIR) and high-risk, early stage endometrial cancer as defined in Gynecologic Oncology Group trial 0249.Material and methodsFrom May 2000 to January 2014, 68 women with HIR and high-risk endometrial cancer underwent surgical staging followed by VBT. Median VBT dose was 21 Gy delivered in three fractions prescribed to 0.5 cm depth. Paclitaxel 175 mg/m2 and carboplatin area under the curve 6 was administered every 21 days in sequence with VBT. Actuarial survival estimates were calculated using the Kaplan-Meier method.ResultsPatient demographics included a median age of 66 years (range: 36-91) and stages IA (49%), IB (38%), and II (13%), respectively. Thirty-one (46%) patients had HIR disease with endometrioid histology, and 33 (48%) patients had serous or clear cell histology. Thirty-seven (54%) patients received a median 3 cycles (range: 3-6) of chemotherapy in addition to VBT, and 65 patients (96%) completed all prescribed therapy. During a median follow up of 33.1 months (range: 4.0-161.7), four patients have recurred, including one vaginal recurrence. The 3-year estimates of vaginal, pelvic, and distant recurrences were 1.9%, 2.4%, and 9.1%, respectively. The 3-year rates of disease-free and overall survival were 87.7% and 93.9%, respectively.ConclusionsEarly outcomes with adjuvant VBT with or without chemotherapy demonstrate high rates of vaginal and pelvic control for women with HIR disease. Early vaginal and pelvic relapses in high-risk patients suggest that pelvic external beam radiotherapy is warranted in this subgroup, but additional data from large phase III trials is warranted.
Purpose/Objective(s)
To establish the prevalence of SARS-CoV-2 in asymptomatic patients scheduled to receive radiation therapy and its impact on management decisions.
Materials/Methods
Between April 2020 and July 2020, patients without influenza-like-illness (ILI) symptoms at four radiation oncology departments (2 academic university hospitals and 2 community hospitals) underwent polymerase chain reaction (PCR) testing for SARS-CoV-2 prior to the initiation of treatment. Patients were tested either prior to radiotherapy simulation or after simulation but prior to treatment initiation. Patients tested for indications of ILI symptoms were excluded from this analysis. Management of SARS-CoV-2-positive patients was individualized based on disease site and acuity.
Results
Over a three-month period, a total of 385 tests were performed in 336 asymptomatic patients either prior to simulation (n=75), post-simulation, prior to treatment (n=230), or on-treatment (n=49). A total of 5 patients tested positive for SARS-CoV-2, for a pre-treatment prevalence of 1.3% (2.6% in North/Central NJ and 0.4% in Southern NJ/Southeast PA). The median age of positive patients was 58 years (range: 38-78 years). All positive patients were white and were relatively equally distributed with regard to gender (2 male, 3 female) and ethnicity (2 Hispanic and 3 non-Hispanic). The median Charlson comorbidity score among positive patients was 5. All 5 patients were treated for different primary tumor sites, the large majority had advanced disease (80%), and all were treated for curative intent. The majority of positive patients were being treated with either sequential or concurrent immunosuppressive systemic therapy (80%). Initiation of treatment was delayed for 14 days with the addition of re-testing for 4 patients, while one patient was treated without delay but with additional infectious-disease precautions.
Conclusion
Broad-based pre-treatment asymptomatic testing of radiation oncology patients for SARS-CoV-2 is of limited value, even in a high-incidence region. Future strategies may include focused risk-stratified asymptomatic testing.
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