scholarly journals Evaluation of practical experiences of German speaking radiation oncologists in combining radiation therapy with checkpoint blockade

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kim M. Kraus ◽  
Julius C. Fischer ◽  
Kai J. Borm ◽  
Marco M. E. Vogel ◽  
Steffi. U. Pigorsch ◽  
...  
Keyword(s):  
Clinical Application ◽  
Radiation Oncology ◽  
Online Survey ◽  
Checkpoint Inhibitors ◽  
Scientific Evidence ◽  
German Society ◽  
Large Variability ◽  
Radiation Oncologists ◽  
German Speaking ◽  
Practical Experiences

AbstractThe results of this survey reveal current clinical practice in the handling of combined radioimmunotherapy with Immune Checkpoint Inhibitors (RT + ICI). We aim to provide a basis to open a discussion for clinical application of RT + ICI by analyzation of experts’ assessment. We conducted a survey with 24 items with a focus on side effects of RT + ICI, common practice of scheduling and handling of adverse events. After pilot testing by radiation oncology experts the link to the online survey was sent to all members of the German Society of Radiation Oncology (DEGRO). In total, 51 radiation oncologists completed the questionnaire. Pulmonary toxicity under RT + ICI with ICIs was reported most frequently. Consensus was observed for bone and soft tissue RT of the limbs in favor for no interruption of ICIs. For cranial RT half of the participants do not suspend ICIs during normofractionated radiotherapy (nfRT) or stereotactic hypofractionated RT (SRT). More participants pause ICIs for central than for peripheral thoracic region. Maintenance therapy with ICIs is mostly not interrupted prior to RT. For management of RT associated pneumonitis under durvalumab the majority of 86.3% suggest corticosteroid therapy and 76.5% would postpone the next cycle of ICI therapy. The here obtained assessment and experiences by radiation oncologists reveal a large variability in practical handling of combined RT + ICI. Until scientific evidence is available a discussion for current clinical application of RT + ICI should be triggered. Interdisciplinary consensus guidelines with practical recommendations are required.

scholarly journals A survey among German-speaking radiation oncologists on PET-based radiotherapy of prostate cancer

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Marco M. E. Vogel ◽  
Sabrina Dewes ◽  
Eva K. Sage ◽  
Michal Devecka ◽  
Jürgen E. Gschwend ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Online Survey ◽  
German Society ◽  
Target Volume ◽  
Radiation Oncologists ◽  
Positron Emission ◽  
Median Total Dose ◽  
Psma Pet ◽  
German Speaking ◽  
The Impact

Abstract Background Positron emission tomography-(PET) has evolved as a powerful tool to guide treatment for prostate cancer (PC). The aim of this survey was to evaluate the acceptance and use of PET—especially with prostate-specific membrane antigen (PSMA) targeting tracers—in clinical routine for radiotherapy (RT) and the impact on target volume definition and dose prescription. Methods We developed an online survey, which we distributed via e-mail to members of the German Society of Radiation Oncology (DEGRO). The survey included questions on patterns of care of RT for PC with/without PET. For evaluation of doses we used the equivalent dose at fractionation of 2 Gy with α/β = 1.5 Gy [EQD2(1.5 Gy)]. Results From 109 participants, 78.9% have the possibility to use PET for RT planning. Most centers use PSMA-targeting tracers (98.8%). In 39.5%, PSMA-PET for biochemical relapse after prior surgery is initiated at PSA ≥ 0.5 ng/mL, while 30.2% will perform PET at ≥ 0.2 ng/mL (≥ 1.0 ng/mL: 16.3%, ≥ 2.0 ng/mL: 2.3%, regardless of PSA: 11.7%). In case of PET-positive local recurrence (LR) and pelvic lymph nodes (LNs), 97.7% and 96.5% of the participants will apply an escalated dose. The median total dose in EQD2(1.5 Gy) was 70.00 Gy (range: 56.89–85.71) for LR and 62.00 Gy (range: 52.61–80.00) for LNs. A total number of ≤ 3 (22.0%) or ≤ 5 (20.2%) distant lesions was most often described as applicable for the definition as oligometastatic PC. Conclusion PSMA-PET is widely used among German radiation oncologists. However, specific implications on treatment planning differ among physicians. Therefore, further trials and guidelines for PET-based RT are warranted.

scholarly journals Management of multiple brain metastases: a patterns of care survey within the German Society for Radiation Oncology

2021 ◽  
Author(s):  
Johannes Kraft ◽  
Michael Mayinger ◽  
Jonas Willmann ◽  
Michelle Brown ◽  
Stephanie Tanadini-Lang ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Radiation Oncology ◽  
Online Survey ◽  
Whole Brain Radiotherapy ◽  
German Society ◽  
Patterns Of Care ◽  
Prognostic Scores ◽  
Mutational Status ◽  
Hippocampal Avoidance ◽  
Current Guidelines

Abstract Purpose The treatment of brain metastases (BM) has changed considerably in recent years and in particular, the management of multiple BM is currently undergoing a paradigm shift and treatment may differ from current guidelines. This survey was designed to analyze the patterns of care in the management of multiple BM. Methods An online survey consisting of 36 questions was distributed to the members of the German Society for Radiation Oncology (DEGRO). Results In total, 193 physicians out of 111 institutions within the German Society for Radiation oncology responded to the survey. Prognostic scores for decision making were not used regularly. Whole brain radiotherapy approaches (WBRT) are the preferred treatment option for patients with multiple BM, although stereotactic radiotherapy treatments are chosen by one third depending on prognostic scores and overall number of BM. Routine hippocampal avoidance (HA) in WBRT is only used by a minority. In multiple BM of driver-mutated non-small cell lung cancer origin up to 30% favor sole TKI therapy as upfront treatment and would defer upfront radiotherapy. Conclusion In multiple BM WBRT without hippocampal avoidance is still the preferred treatment modality of choice regardless of GPA and mutational status, while SRT is only used in patients with good prognosis. Evidence for both, SRS and hippocampal avoidance radiotherapy, is growing albeit the debate over the appropriate treatment in multiple BM is yet not fully clarified. Further prospective assessment of BM management—ideally as randomized trials—is required to align evolving concepts with the proper evidence and to update current guidelines.

scholarly journals Patterns of care for prostate cancer radiotherapy—results from a survey among German-speaking radiation oncologists

2021 ◽  
Author(s):  
Marco M. E. Vogel ◽  
Sabrina Dewes ◽  
Eva K. Sage ◽  
Michal Devecka ◽  
Jürgen E. Gschwend ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Online Survey ◽  
Treatment Options ◽  
Equivalent Dose ◽  
Patterns Of Care ◽  
Treatment Recommendation ◽  
Published Data ◽  
Prostate Bed ◽  
Radiation Oncologists ◽  
German Speaking

Abstract Background Emerging moderately hypofractionated and ultra-hypofractionated schemes for radiotherapy (RT) of prostate cancer (PC) have resulted in various treatment options. The aim of this survey was to evaluate recent patterns of care of German-speaking radiation oncologists for RT of PC. Methods We developed an online survey which we distributed via e‑mail to all registered members of the German Society of Radiation Oncology (DEGRO). The survey was completed by 109 participants between March 3 and April 3, 2020. For evaluation of radiation dose, we used the equivalent dose at fractionation of 2 Gy with α/β = 1.5 Gy, equivalent dose (EQD2 [1.5 Gy]). Results Median EQD2(1.5 Gy) for definitive RT of the prostate is 77.60 Gy (range: 64.49–84.00) with median single doses (SD) of 2.00 Gy (range: 1.80–3.00), while for postoperative RT of the prostate bed, median EQD2(1.5 Gy) is 66.00 Gy (range: 60.00–74.00) with median SD of 2.00 Gy (range: 1.80–2.00). For definitive RT, the pelvic lymph nodes (LNs) are treated in case of suspect findings in imaging (82.6%) and/or according to risk formulas/tables (78.0%). In the postoperative setting, 78.9% use imaging and 78.0% use the postoperative tumor stage for LN irradiation. In the definitive and postoperative situation, LNs are irradiated with a median EQD2(1.5 Gy) of 47.52 Gy with a range of 42.43–66.00 and 41.76–62.79, respectively. Conclusion German-speaking radiation oncologists’ patterns of care for patients with PC are mainly in line with the published data and treatment recommendation guidelines. However, dose prescription is highly heterogenous for RT of the prostate/prostate bed, while the dose to the pelvic LNs is mainly consistent.

scholarly journals What motivated medical students and residents to become radiation oncologists in Japan?—Questionnaire report by the radiotherapy promotion committee of JASTRO

2020 ◽  
Vol 61 (5) ◽  
pp. 727-732
Author(s):  
Yuji Murakami ◽  
Shin-ei Noda ◽  
Yoshiomi Hatayama ◽  
Toshiya Maebayashi ◽  
Keiichi Jingu ◽  
...  
Keyword(s):  
Radiation Oncology ◽  
Clinical Training ◽  
Online Survey ◽  
Radiology Department ◽  
New Members ◽  
Radiation Oncologists ◽  
Significant Difference ◽  
Group A ◽  
To Come ◽  
Group B

Abstract This study aimed to clarify the motivations and timing of the decision to become radiation oncologists. Materials and methods: We conducted an online survey for new members of the Japanese Society for Radiation Oncology (JASTRO). Results: The response rate was 43.3%. Data of the 79 respondents who wanted to obtain a board-certification of JASTRO were analysed. We divided the respondents into two groups: Group A, those who entered a single radiation oncology department, and Group B, those who joined a radiology department in which the radiation oncology department and diagnostic radiology department were integrated. The most common period when respondents were most attracted to radiation oncology was “5th year of university” in Group A and “2nd year of junior residency” and “senior residency” in Group B. Furthermore, 79.5% of Group A and 40% of Group B chose periods before graduation from a university with a significant difference. The most common period when respondents made up their minds to become radiation oncologists was “2nd year of junior residency” in both groups. Internal medicine was the most common department to consider if they did not join the radiation oncology or radiology department. Conclusion: To increase the radiation oncologists, it is crucial to enhance clinical training in the fifth year of university for Group A and to continue an active approach to maintain interest in radiation oncology until the end of junior residency. In Group B facilities, it is desirable to provide undergraduates more opportunities to come in contact with radiation oncology.

scholarly journals Investigation of Radiation Oncologists’ Awareness of Online Reputation Management (Preprint)

2018 ◽  
Author(s):  
Jonathan Fredric Waxer ◽  
Sudesh Srivastav ◽  
Christian Steven DiBiase ◽  
Steven Joseph DiBiase
Keyword(s):  
Patient Satisfaction ◽  
Radiation Oncology ◽  
Online Survey ◽  
Statistical Significance ◽  
Correlation Coefficients ◽  
Online Reviews ◽  
Reputation Management ◽  
Fisher Exact Test ◽  
Radiation Oncologists ◽  
Online Reputation

BACKGROUND Online reputation management (ORM) is an emerging practice strategy that emphasizes the systematic and proactive monitoring of online reviews relating to one’s professional reputation. OBJECTIVE We developed this survey project to assess whether radiation oncologists are aware of ORM and how it is utilized in their practices. We hypothesized that ORM is largely unknown by most practicing radiation oncologists and that little time is spent actively managing their reputations. METHODS An online survey was submitted to 1222 radiation oncologists using the Qualtrics research platform. Physician emails were gathered from the American Society for Radiation Oncology member directory. A total of 85 physicians initiated the survey, whereas 76 physicians completed more than or equal to 94% (15/16) of the survey questions and were subsequently used in our analyses. The survey consisted of 15 questions querying practice demographics, patient satisfaction determination, ORM understanding, and activities to address ORM and 1 question for physicians to opt-in to a US $50 Amazon gift card raffle. The survey data were summarized using a frequency table, and data were analyzed using the Chi-square test, Fisher exact test, and Spearman correlation coefficients. RESULTS We calculated a 7% (85/1222) response rate for our survey, with a completion rate of 89% (76/85). A majority of respondents (97%, 74/76) endorsed being somewhat or strongly concerned about patient satisfaction (P<.001). However, 58% (44/76) of respondents reported spending 0 hours per week reviewing or managing their online reputation and 39% (30/76) reported spending less than 1 hour per week (P<.001). A majority of physicians (58%, 44/76) endorsed no familiarity with ORM (P<.001) and 70% (53/76) did not actively manage their online reputation (P<.001). Although 83% (63/76) of respondents strongly or somewhat believed that patients read online reviews (P<.001), 57% (43/76) of respondents did not check their online reviews (P=.25) and 80% (61/76) endorsed never responding to online reviews (P<.001). Moreover, 58% (44/76) of the respondents strongly or somewhat supported the idea of managing their online reputation going forward (P=.001). In addition, 11 out of the 28 pairs of questions asked in our correlation studies reached statistical significance. Degree of concern for patient satisfaction and the notion of managing one’s ORM going forward were the 2 most frequently correlated topics of statistical significance in our analyses. CONCLUSIONS ORM is presently under-recognized in radiation oncology. Although most practitioners are concerned about patient satisfaction, little effort is directed toward the internet on this matter. ORM offers an area of practice improvement for many practicing radiation oncologists.

Situation of young radiation oncologists, medical physicists and radiation biologists in German-speaking countries

2016 ◽  
Vol 192 (8) ◽  
pp. 507-515 ◽  
Author(s):  
David Krug ◽  
Rene Baumann ◽  
Thorsten Rieckmann ◽  
Emmanouil Fokas ◽  
Tobias Gauer ◽  
...  
Keyword(s):  
Radiation Oncologists ◽  
German Speaking ◽  
Medical Physicists

scholarly journals A survey of clinicians on the use of artificial intelligence in ophthalmology, dermatology, radiology and radiation oncology

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jane Scheetz ◽  
Philip Rothschild ◽  
Myra McGuinness ◽  
Xavier Hadoux ◽  
H. Peter Soyer ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
New Zealand ◽  
Radiation Oncology ◽  
Online Survey ◽  
New Technology ◽  
Medical Liability ◽  
Healthcare Outcomes ◽  
Medical Workforce ◽  
Artificial Intelligence Technology ◽  
Workforce Needs

AbstractArtificial intelligence technology has advanced rapidly in recent years and has the potential to improve healthcare outcomes. However, technology uptake will be largely driven by clinicians, and there is a paucity of data regarding the attitude that clinicians have to this new technology. In June–August 2019 we conducted an online survey of fellows and trainees of three specialty colleges (ophthalmology, radiology/radiation oncology, dermatology) in Australia and New Zealand on artificial intelligence. There were 632 complete responses (n = 305, 230, and 97, respectively), equating to a response rate of 20.4%, 5.1%, and 13.2% for the above colleges, respectively. The majority (n = 449, 71.0%) believed artificial intelligence would improve their field of medicine, and that medical workforce needs would be impacted by the technology within the next decade (n = 542, 85.8%). Improved disease screening and streamlining of monotonous tasks were identified as key benefits of artificial intelligence. The divestment of healthcare to technology companies and medical liability implications were the greatest concerns. Education was identified as a priority to prepare clinicians for the implementation of artificial intelligence in healthcare. This survey highlights parallels between the perceptions of different clinician groups in Australia and New Zealand about artificial intelligence in medicine. Artificial intelligence was recognized as valuable technology that will have wide-ranging impacts on healthcare.

scholarly journals The Application and Development of Deep Learning in Radiotherapy: A Systematic Review

2021 ◽  
Vol 20 ◽  
pp. 153303382110163
Author(s):  
Danju Huang ◽  
Han Bai ◽  
Li Wang ◽  
Yu Hou ◽  
Lan Li ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Systematic Review ◽  
Neural Networks ◽  
Decision Making ◽  
Deep Learning ◽  
Radiation Oncology ◽  
Clinical Work ◽  
Radiation Oncologists ◽  
Basic Concepts ◽  
Further Development

With the massive use of computers, the growth and explosion of data has greatly promoted the development of artificial intelligence (AI). The rise of deep learning (DL) algorithms, such as convolutional neural networks (CNN), has provided radiation oncologists with many promising tools that can simplify the complex radiotherapy process in the clinical work of radiation oncology, improve the accuracy and objectivity of diagnosis, and reduce the workload, thus enabling clinicians to spend more time on advanced decision-making tasks. As the development of DL gets closer to clinical practice, radiation oncologists will need to be more familiar with its principles to properly evaluate and use this powerful tool. In this paper, we explain the development and basic concepts of AI and discuss its application in radiation oncology based on different task categories of DL algorithms. This work clarifies the possibility of further development of DL in radiation oncology.

scholarly journals Statement of the German Roentgen Society, German Society of Neuroradiology, and Society of German-speaking Pediatric Radiologists on Requirements for the Performance and Reporting of MR Imaging Examinations Outside of Radiology

2021 ◽  
Author(s):  
Peter Hunold ◽  
Andreas Michael Bucher ◽  
Jörn Sandstede ◽  
Rolf Janka ◽  
Lars Benjamin Fritz ◽  
...  
Keyword(s):  
Quality Assurance ◽  
Medical Specialty ◽  
German Society ◽  
Position Statement ◽  
Image Evaluation ◽  
Management Quality ◽  
Medical Associations ◽  
Additional Qualification ◽  
German Speaking ◽  
Magnetic Resonance Imaging Mri

Background Magnetic Resonance Imaging (MRI) is a very innovative, but at the same time complex and technically demanding diagnostic method in radiology. It plays an increasing role in high-quality and efficient patient management. Quality assurance in MRI is of utmost importance to avoid patient risks due to errors before and during the examination and when reporting the results. Therefore, MRI requires higher physician qualification and expertise than any other diagnostic imaging technique in medicine. This holds true for indication, performance of the examination itself, and in particular for image evaluation and writing of the report. In Germany, the radiologist is the only specialist who is systematically educated in all aspects of MRI during medical specialty training and who must document a specified, high number of examinations during this training. However, also non-radiologist physicians are increasingly endeavoring to conduct and bill MRI examinations on their own. Method In this position statement, the following aspects of quality assurance for MRI examinations and billing by radiologists and non-radiologist physician specialists are examined scientifically: Requirements for specialist physician training, MRI risks and contraindications, radiation protection in the case of non-ionizing radiation, application of MR contrast agents, requirements regarding image quality, significance of image artifacts and incidental findings, image evaluation and reporting, interdisciplinary communication and multiple-eyes principle, and impact on healthcare system costs. Conclusion The German Roentgen Society, German Society of Neuroradiology, and Society of German-speaking Pediatric Radiologists are critical with regard to MRI performance by non-radiologists in the interest of quality standards, patient welfare, and healthcare payers. The 24-month additional qualification in MRI as defined by the physician specialization regulations (Weiterbildungsordnung) through the German state medical associations (Landesärztekammern) is the only competence-based and quality-assured training program for board-certified specialist physicians outside radiology. This has to be required as the minimum standard for performance and reporting of MRI exams. Exclusively unstructured MRI training outside the physician specialization regulations has to be strictly rejected for reasons of patient safety. The performance and reporting of MRI examinations must be reserved for adequately trained and continuously educated specialist physicians. Key Points: Citation Format

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