Hypoxia-targeted radiotherapy dose painting for head and neck cancer using FMISO PET is technically feasible, increases the TCP without increasing the NTCP, and increases the UTCP. This approach is superior to uniform dose escalation.

Recent technological advances in radiation therapy have allowed for greater accuracy in planning and treatment delivery. The development of hypofractionated radiation treatment regimens is an example, and has the potential to decrease the cost per episode of care, relative to conventional treatments. Our aim was to analyse published literature on the cost‐effectiveness and budgetary implications of hypofractionated radiation therapy. As such, this article will quantify the projected health care cost savings and address the optimal means of treatment delivery, associated patient outcomes, and implications arising from an increased use of hypofractionated regimens.

In all cases accepted manuscripts should:  link to the formal publication via its DOI  bear a CC-BY-NC-ND license -this is easy to do, click here to find out how  if aggregated with other manuscripts, for example in a repository or other site, be shared in alignment with our hosting policy  not be added to or enhanced in any way to appear more like, or to substitute for, the published journal article CONFLICT OF INTEREST NOTIFICATIONThe authors declare that there are no conflicts of interest.Chang 4 SUMMARY 11 C-choline PET scans can be used to identify foci of cancer within the prostate. A planning study on eight patients with localized prostate cancer compared the use of 11 C-choline PET-guided IMRT dose painting to 90 Gy with standard radiotherapy to 78 Gy in terms of technical feasibility and biological modeling. IMRT dose painting using 11 C-choline PET is technically feasible, results in higher tumor control probability, and does not raise the rectal normal tissue complication probability.Chang 5 ABSTRACT Purpose: To demonstrate the technical feasibility of IMRT dose painting using 11 Ccholine PET scans in patients with localized prostate cancer.Methods and materials: This was a radiotherapy planning study of eight patients with prostate cancer who had 11 C-choline PET scans prior to radical prostatectomy. Two contours were semi-automatically generated on the basis of the PET scans for each patient: 60% and 70% of the maximum standardized uptake values (SUV60% and SUV70%). Three IMRT plans were generated for each patient: PLAN78 which consisted of whole prostate radiotherapy to 78 Gy; PLAN78-90 which consisted of whole prostate radiotherapy to 78 Gy, a boost to the SUV60% to 84 Gy and a further boost to the SUV70% to 90 Gy; and PLAN72-90 which consisted of whole prostate radiotherapy to 72 Gy, a boost to the SUV60% to 84 Gy and a further boost to the SUV70% to 90 Gy. The feasibility of these plans was judged by their ability to reach prescription doses while adhering to published dose constraints. Tumor control probabilities based on PET scan-defined volumes (TCPPET) and on prostatectomydefined volumes (TCPpath), and rectal normal tissue complication probabilities (NTCP)were compared between the plans.Results: All plans for all patients reached prescription doses while adhering to dose constraints. The TCPPET values for PLAN78, PLAN78-90 and PLAN72-90 were 65%, 97% and 96%, respectively. The TCPpath values were 71%, 97% and 89%, respectively. Both PLAN78-90 and PLAN72-90 had significantly higher TCPPET (p = 0.002 and 0.001) and TCPpath (p < 0.001 and 0.014) than PLAN78. PLAN78-90 and Chang 6 PLAN72-90 were not significantly different in terms of TCPPET or TCPpath. There were no significant differences in rectal NTCPs between the three plans.Conclusions: IMRT dose painting for localized prostate cancer using 11 C-choline PET scans is technically feasible. Dose painting results in higher TCPs without higherNTCPs.

The novel coronavirus (COVID‐19) has rapidly impacted all of our lives following its escalation to pandemic status on 11 March 2020. Government guidelines and restrictions implemented to mitigate the risk of COVID‐19 community transmission have forced radiation therapy departments to promptly adjust to the significant impact on our ability to deliver best clinical care. The inherent nature of our tri‐partied professions relies heavily on multidisciplinary teamwork and patient–clinician interactions. Teamwork and patient interaction are critical to the role of a radiation therapist. The aim of this paper is to describe the experience of the Peter MacCallum Cancer Centre’s (Peter Mac) radiation therapy services during the preliminary stages of the COVID‐19 pandemic in minimising risk to patients, staff and our clinical service. Four critical areas were identified in developing risk mitigation strategies across our service: (a) Workforce planning, (b) Workforce communication, (c) Patient safety and wellbeing, and (d) Staff safety and wellbeing. Each of these initiatives had a focus on continuum of clinical care, whilst minimising risk of cross infection for our radiation therapy workforce and patients alike. Initiatives included, but were not limited to, establishing COVID‐Eclipse clinical protocols, remote access to local applications, implementation of Microsoft Teams, personal protective equipment (PPE) guidelines and virtual ‘Division of Radiation Oncology’ briefing/updates. The COVID‐19 pandemic has dictated change in conventional radiation therapy practice. It is hoped that by sharing our experiences, the radiation therapy profession will continue to learn, adapt and navigate this period together, to ensure optimal outcomes for ourselves and our patients.

Background: Procedural anxiety in children undergoing radiation therapy (RT) is common and is associated with poor procedural compliance and an increased used of general anaesthesia (GA). There is emerging evidence that Virtual Reality (VR) technology may reduce medical procedural distress through realistic and educative exposure to actual procedures via virtual simulation. Objective: To examine the feasibility, acceptability and efficacy of an Immersive VR exposure intervention aimed at reducing anxiety and enhancing preparedness for pediatric patients undergoing radiation therapy, and their parents. Method: A convenience sample of patients (6-18 years) scheduled for RT, and their parent caregivers, were recruited consecutively over a 14-month period. Patients were exposed to a virtual simulation of both CT Simulation (Phase 1) and RT (Phase 2), prior to these procedures occurring. Pre-and-post VR intervention measures (anxiety, health literacy) were administered across multiple time points. GA requirement following VR intervention was also recorded. Results: Thirty children and adolescents were recruited (88% participation rate). High VR acceptability and satisfaction was reported by patients, parents and radiation therapists. There were minimal adverse effects associated with VR. The VR intervention was found to improve children's understanding of the RT procedures (health literacy) and lower pre-procedural child and parental anxiety. Only one child in the study required GA (3.33%). Conclusions: This study provides novel and preliminary support for utilizing VR to prepare children and families for RT. Subsequent implementation of VR into routine paediatric RT has the potential to improve clinical and operational outcomes.