The Influence of Imaging in the Modern Practice of Radiation Oncology

Fitzgerald, Thomas J.; Rosen, Mark; Bishop–Jodoin, Maryann

doi:10.1016/j.ijrobp.2018.08.028

Cited by 5 publications

(6 citation statements)

References 4 publications

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“…Our time has become to become leaders in the field of oncology. [36][37][38][39][40][41][42][43][44] Int J Radiat Oncol Biol Phys. 1998;42(1):1-9. doi: 10.1016/s0360-3016(98)00196-5.…”

Section: Complimentary Multidisciplinary Rolesmentioning

confidence: 99%

Radiation Oncology-Future Vision for the Modern Radiation Oncologist

Yancey

Jones

Kopecky

et al. 2023

MRAJ

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Radiation oncology has evolved as a discipline and the physicians who practice radiation oncology are adapting to the changing landscape of oncology management. The skill set for the modern radiation oncologist has matured as the requirements for modern patient care have become increasingly complex both in patient evaluation and treatment execution. Radiation oncology interacts with all medical and surgical subspecialties and advanced radiation therapy treatment plans require nimble use of volumetric anatomic and metabolic image sets and applied pathology to contour targets for successful treatment. Although multidisciplinary care management can serve to confirm and validate a treatment plan among providers, the number of providers involved with an individual patient management plan can also generate confusion and mixed messaging for the patient and their family. Because radiation oncologists work with every discipline and see patients weekly on treatment, often the relationship between the radiation oncologist and the patient can serve as a bridge between disciplines and radiation oncologists can serve to align the disciplines with the patient to re-affirm the care plan, limit confusion, and generate confidence for the patient with the plan and the providers. In this chapter, we will review the changing role of the radiation oncologist as we continually move directly into the mainstream of patient care, in equal partnership to medical oncology with highly advanced tools for modern therapy. Survivorships models of care will mature as radiation oncologists become more integrated into primary and follow up management of each cancer patient.

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“…Our time has become to become leaders in the field of oncology. [36][37][38][39][40][41][42][43][44] Int J Radiat Oncol Biol Phys. 1998;42(1):1-9. doi: 10.1016/s0360-3016(98)00196-5.…”

Section: Complimentary Multidisciplinary Rolesmentioning

confidence: 99%

Radiation Oncology-Future Vision for the Modern Radiation Oncologist

Yancey

Jones

Kopecky

et al. 2023

MRAJ

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“…The more we can streamline our processes, the more quickly we can build robust platforms to support our science. We need to build our departmental infrastructure to support data transfer in uniform formats to be repurposed for use in the next iteration of clinical science (38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50).…”

Section: Next Stepsmentioning

confidence: 99%

Radiation Oncology: Future Vision for Quality Assurance and Data Management in Clinical Trials and Translational Science

et al. 2022

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The future of radiation oncology is exceptionally strong as we are increasingly involved in nearly all oncology disease sites due to extraordinary advances in radiation oncology treatment management platforms and improvements in treatment execution. Due to our technology and consistent accuracy, compressed radiation oncology treatment strategies are becoming more commonplace secondary to our ability to successfully treat tumor targets with increased normal tissue avoidance. In many disease sites including the central nervous system, pulmonary parenchyma, liver, and other areas, our service is redefining the standards of care. Targeting of disease has improved due to advances in tumor imaging and application of integrated imaging datasets into sophisticated planning systems which can optimize volume driven plans created by talented personnel. Treatment times have significantly decreased due to volume driven arc therapy and positioning is secured by real time imaging and optical tracking. Normal tissue exclusion has permitted compressed treatment schedules making treatment more convenient for the patient. These changes require additional study to further optimize care. Because data exchange worldwide have evolved through digital platforms and prisms, images and radiation datasets worldwide can be shared/reviewed on a same day basis using established de-identification and anonymization methods. Data storage post-trial completion can co-exist with digital pathomic and radiomic information in a single database coupled with patient specific outcome information and serve to move our translational science forward with nimble query elements and artificial intelligence to ask better questions of the data we collect and collate. This will be important moving forward to validate our process improvements at an enterprise level and support our science. We have to be thorough and complete in our data acquisition processes, however if we remain disciplined in our data management plan, our field can grow further and become more successful generating new standards of care from validated datasets.

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“…To achieve the goals of this study, primary and response imaging on therapy as well as radiation therapy treatment objects need to be reviewed at QA centers to ensure the correct areas are being treated to the protocol-compliant dose and the dosimetry meets the study defined constraints to normal tissue. The perception that collecting the data adds to cost and is a burden to site investigators, and there are many examples where limiting data acquisition negatively affected trial outcome and interpretation of the data, leads to unrecovered financial loss and generates a false narrative to trial conclusions [1][2][3][4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…Outcome imaging is essential as it becomes the primary vehicle to assess the level of responsibility imposed by therapy on the location of treatment failure including injury imposed by therapy as well. QARC (now the Imaging and Radiation Oncology Core (IROC), Rhode Island) houses outcome images on Children's Oncology Group (COG) trials, which have been essential in distinguishing disease progression from therapy effect in multiple disease groups, including the central nervous system and late effects imposed by therapy on normal tissue [6,7].…”

Section: Introductionmentioning

confidence: 99%

Modern Dosimetry in Radiation Oncology Clinical Trials

Smith,

Ding,

Bishop-Jodoin

et al. 2023

Advances in Dosimetry and New Trends in Radiopharmaceuticals

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Clinical trials in radiation oncology are the best vehicle to optimize our strengths in therapeutic technology, define progress in our field, and improve patient outcome. Trials advance our knowledge in each disease site and provide us information to improve the radiation dose-volume for both tumor control and therapeutic sequelae to normal tissue. An increasing number of systemic and targeted therapies have been developed and are currently in early phase clinical trial design. Ultimately, these new therapies will need to be tested with standard-of-care therapy including radiation oncology. Therefore, during a study, it is essential that radiation therapy is delivered in a uniform and consistent manner for the credibility of the study. If the radiation therapy component of the study does not have a structure or management for maintaining therapeutic compliance, including a real-time data management strategy, it becomes difficult to trust the study outcome and apply the outcome to daily clinical practice. In this chapter, we review the strategy and process involved in the management of dosimetry in radiation oncology clinical trials and how this can impact clinical trial management, primary study endpoints, and the overall success of the study.

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The Influence of Imaging in the Modern Practice of Radiation Oncology

Cited by 5 publications

References 4 publications

Radiation Oncology-Future Vision for the Modern Radiation Oncologist

Radiation Oncology-Future Vision for the Modern Radiation Oncologist

Radiation Oncology: Future Vision for Quality Assurance and Data Management in Clinical Trials and Translational Science

Modern Dosimetry in Radiation Oncology Clinical Trials

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