Purpose Fewer attendances for radiotherapy results in increased efficiency and less foot traffic within a radiotherapy department. We investigated outcomes after single fraction (SF) SBRT in patients with oligometastatic disease. Methods and Materials Between February 2010 and June 2019, patients who received SF SBRT to 1-5 sites of oligometastatic disease were included in this retrospective study. The primary objective was to describe patterns of first failure after SBRT. Secondary objectives included overall survival (OS) progression-free survival (PFS), high-grade treatment-related toxicity (≥grade 3 CTCAE) and freedom from systemic therapy (FFST). Results In total, 371 patients with 494 extracranial oligometastases received SF SBRT ranging from 16Gy to 28Gy. The most common primary malignancies were prostate (n=107), lung (n=63), kidney (n=52), gastrointestinal (n=51), and breast cancers (n = 42). The median follow-up was 3.1 years. The 1, 3 and 5 year OS was 93%, 69% and 55%, respectively, PFS was 48%, 19% and 14%, respectively, and FFST was 70%, 43% and 35%, respectively. Twelve patients (3%) developed grade 3-4 treatment-related toxicity, with no grade 5 toxicity. As the first site of failure, the cumulative incidence of local failure (irrespective of other failures) at 1, 3 and 5-years was 4%, 8% and 8%, locoregional relapse at the primary was 10%, 18% and 18%, and distant failure was 45%, 66% and 70%, respectively. Conclusions SF SBRT is safe, effective, and a significant proportion of patients remain FFST for several years after therapy. This approach could be considered in resource constrained or bundled payment environments. Locoregional failure of the primary site is the second most common pattern of failure, suggesting a role for optimization of primary control during metastasis-directed therapy.

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The current available evidence shows an LRFS benefit with NRT over no RT in patients with stage IV rectal cancer. The review also suggests a possible OS benefit with NRT, although this finding should be interpreted with caution.

PURPOSE The objectives of this study were to report the oncologic outcomes and the treatment-related toxicities after reirradiation (re-RT) for recurrent nasopharyngeal carcinoma (rNPC) at our institution and to apply a recently published prognostic model for survival in rNPC in our cohort. PATIENTS AND METHODS Thirty-two patients with rNPC treated at the authors' institution with re-RT were retrospectively reviewed. Treatment modalities for re-RT were intensity-modulated radiotherapy (n = 14), three-dimensional conformal radiotherapy (n = 9), single-fraction stereotactic radiosurgery (n = 6), fractionated stereotactic radiotherapy (n = 2), and high dose rate intracavitary brachytherapy (n = 1). Twenty-seven patients received re-RT with curative intent, whereas five patients were treated palliatively. RESULTS Median follow-up time was 15.5 months (range, 1 to 123 months) for the entire cohort and 20 months (range, 3 to 123 months) for patients treated with curative intent. For the entire cohort, median locoregional recurrence-free survival (LRRFS) was 14 months, with actuarial 1- and 2-year LRRFS estimates of 67.5% and 44.0%, respectively. Median overall survival (OS) time was 38 months, with actuarial 1- and 2-year estimates of 74.2% and 57.2%, respectively. For patients treated with curative intent, median LRRFS was not reached. Actuarial 1- and 2-year LRRFS estimates were 68.2% and 54.5%, respectively. Median OS time after curative intent re-RT was 42 months, with actuarial 1- and 2-year estimates of 75.4% and 63.8%, respectively. One- and 2-year OS estimates based on risk stratification were 68.6% for high risk compared with 80.8% for low risk and 34.3% for high risk compared with 70.7% for low risk, respectively ( P = .223). Three patients (9.4%) developed symptomatic temporal lobe necrosis. There was no reported grade 5 treatment-related toxicity. CONCLUSION Results of the study suggest that re-RT is an effective and safe salvage treatment strategy for rNPC. Re-RT to a maximum equivalent dose in 2-Gy fractions of 60 Gy may yield good LRRFS and translate to prolonged OS.

Background: Telehealth applications may improve health outcomes by engaging patients as active participants, focusing clinic visits on important problems and intensifying symptom management in response to patient reports. Our group developed an internet-based computerized system for patient self-report of symptoms (iComPAsS), and our aim is to evaluate the usability of this mobile application for reporting cancer symptoms among patient and physician end-users. Methods:The literature was surveyed for validated symptom tools available in both English and Filipino.A focused-group discussion (two oncologists, two pain specialists and an international symptom researcher) was conducted to assess face validity and elect an instrument. Application interface and system design was developed collaboratively with information technology consultants over several iterations until beta testing revealed a satisfactory design. Twenty end-users (10 physicians, 10 patients) were invited to assess the app's functionality after a training workshop. App assessment was done using the Mobile Application Rating Scale (MARS).Results: The Edmonton Symptom Assessment System (ESAS) was elected due to its validity, ease of administration and prevalent use in local research and clinical settings. The iComPAsS was shown to be satisfactorily functional on beta testing. It allows patients to report symptom severity, indicate pain location on a body diagram, view prescriptions, and receive notifications from their physicians. On usability testing, engagement, functionality, aesthetics and information scores revealed high and moderate acceptability among physician and patient users, respectively. A clinical trial will be conducted to determine its impact and define maintenance and scale-up issues. Conclusions:The iComPAsS mobile application for patient self-reporting of cancer symptoms is useable and acceptable by both physician and patient end-users.