scholarly journals A Visual Analytics Dashboard to Summarize Serial Anesthesia Records in Pediatric Radiation Treatment

2019 ◽  
Vol 10 (04) ◽  
pp. 563-569
Author(s):  
Olivia Nelson ◽  
Brian Sturgis ◽  
Keri Gilbert ◽  
Elizabeth Henry ◽  
Kelly Clegg ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Radiation Oncology ◽  
Visual Analytics ◽  
Radiation Treatment ◽  
Airway Device ◽  
Vertical Line ◽  
Recovery Score ◽  
Patient Will ◽  
Typical Day ◽  
High Level

Background Young children who undergo radiation therapy may require general anesthesia to remain still during weeks of radiation sessions. On a typical day at our hospital, an anesthesia team will care for 10 patients in the radiation therapy suite, and each patient will have multiple prior anesthetic records. Daily review of prior anesthesia records is important to maintain anesthetic consistency and to identify potential improvement, yet our electronic health record (EHR) made such review time-consuming and cumbersome. Objectives This article aims to design a visual analytics interface that simultaneously displays data from multiple anesthesia encounters to support clinical consistency in medications and airway management. Methods Documentation from the EHR is available in the clinical data warehouse following daily backups. A visual analytics interface was built to aggregate important components of multiple anesthesia encounters in pediatric radiation oncology on a single screen. The application was embedded in the EHR's anesthesia module and updated daily. Results Each anesthesia encounter was represented by a vertical line with the date at the bottom of the screen. Each vertical line was divided into sections corresponding to the medications, type of airway device, type of radiation oncology procedure, days between treatments, and recovery score and time. Information about the medications, airways, and procedures was shown with icon legends. This layout enabled users to quickly see the key components of multiple anesthetics and make inferences between, for example, the medications used and the recovery score. Conclusion The dashboard provides a high-level summary of all radiation therapy anesthesia records for children receiving recurrent treatments. In this clinical scenario, it is desirable to replicate an optimal anesthetic approach for daily or near-daily treatments or adjust the anesthetic based on observed patterns.

Advances in Image-Guided Radiation Therapy

2007 ◽  
Vol 25 (8) ◽  
pp. 938-946 ◽  
Author(s):  
Laura A. Dawson ◽  
David A. Jaffray
Keyword(s):  
Radiation Therapy ◽  
Radiation Oncology ◽  
Planning Process ◽  
Radiation Treatment ◽  
Healthy Tissue ◽  
Tumor Control ◽  
Computer Assisted ◽  
Image Guided Radiation Therapy ◽  
Image Guided ◽  
Radiation Delivery

Imaging is central to radiation oncology practice, with advances in radiation oncology occurring in parallel to advances in imaging. Targets to be irradiated and normal tissues to be spared are delineated on computed tomography (CT) scans in the planning process. Computer-assisted design of the radiation dose distribution ensures that the objectives for target coverage and avoidance of healthy tissue are achieved. The radiation treatment units are now recognized as state-of-the-art robotics capable of three-dimensional soft tissue imaging immediately before, during, or after radiation delivery, improving the localization of the target at the time of radiation delivery, to ensure that radiation therapy is delivered as planned. Frequent imaging in the treatment room during a course of radiation therapy, with decisions made on the basis of imaging, is referred to as image-guided radiation therapy (IGRT). IGRT allows changes in tumor position, size, and shape to be measured during the course of therapy, with adjustments made to maximize the geometric accuracy and precision of radiation delivery, reducing the volume of healthy tissue irradiated and permitting dose escalation to the tumor. These geometric advantages increase the chance of tumor control, reduce the risk of toxicity after radiotherapy, and facilitate the development of shorter radiotherapy schedules. By reducing the variability in delivered doses across a population of patients, IGRT should also improve interpretation of future clinical trials.

scholarly journals Accuracy and Precision of a Veterinary Neuronavigation System for Radiation Oncology Positioning

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Isabelle F. Vanhaezebrouck ◽  
Elizabeth A. Ballegeer ◽  
Stephen Frey ◽  
Rob Sieffert
Keyword(s):  
Radiation Therapy ◽  
Radiation Oncology ◽  
Radiation Treatment ◽  
Patient Positioning ◽  
Cone Beam ◽  
Positioning Accuracy ◽  
Accuracy And Precision ◽  
Neuronavigation System ◽  
Treatment Plans ◽  
Radiation Centers

Conformal radiation treatment plans such as IMRT and other radiosurgery techniques require very precise patient positioning, typically within a millimeter of error for best results. CT cone beam, real-time navigation, and infrared position sensors are potential options for success but rarely present in veterinary radiation centers. A neuronavigation system (Brainsight Vet, Rogue Research) was tested 22 times on a skull for positioning accuracy and precision analysis. The first 6 manipulations allowed the authors to become familiar with the system but were still included in the analyses. Overall, the targeting mean error in 3D was 1.437 mm with SD 1.242 mm. This system could be used for positioning for radiation therapy or radiosurgery.

scholarly journals ILROG emergency guidelines for radiation therapy of hematological malignancies during the COVID-19 pandemic

Blood ◽  
2020 ◽  
Vol 135 (21) ◽  
pp. 1829-1832 ◽  
Author(s):  
Joachim Yahalom ◽  
Bouthaina Shbib Dabaja ◽  
Umberto Ricardi ◽  
Andrea Ng ◽  
N. George Mikhaeel ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Clinical Efficacy ◽  
Radiation Oncology ◽  
Hematological Malignancies ◽  
Radiation Treatment ◽  
Task Force ◽  
Emergency Situation ◽  
Efficacy And Safety ◽  
Oncology Group ◽  
Radiation Oncology Group

Abstract The International Lymphoma Radiation Oncology Group (ILROG) guidelines for using radiation therapy (RT) in hematological malignancies are widely used in many countries. The emergency situation created by the COVID-19 pandemic may result in limitations of treatment resources. Furthermore, in recognition of the need to also reduce the exposure of patients and staff to potential infection with COVID-19, the ILROG task force has made recommendations for alternative radiation treatment schemes. The emphasis is on maintaining clinical efficacy and safety by increasing the dose per fraction while reducing the number of daily treatments. The guidance is informed by adhering to acceptable radiobiological parameters and clinical tolerability. The options for delaying or omitting RT in some hematological categories are also discussed.

scholarly journals RADT-29. EFFECT OF RADIATION THERAPY ON OVERALL SURVIVAL FOLLOWING SUBTOTAL RESECTION OF ADULT PILOCYTIC ASTROCYTOMA

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii187-ii188
Author(s):  
Adham Khalafallah ◽  
Adrian Jimenez ◽  
Henry Brem ◽  
Debraj Mukherjee
Keyword(s):  
Overall Survival ◽  
Radiation Therapy ◽  
Pilocytic Astrocytoma ◽  
Radiation Treatment ◽  
Cox Proportional Hazards Model ◽  
Adult Patients ◽  
Subtotal Resection ◽  
Adjuvant Radiation ◽  
Low Grade ◽  
Risk Of Death

Abstract BACKGROUND Pilocytic astrocytoma (PCA) is a low-grade glioma common in children but also rarely diagnosed in adults. The role of adjuvant radiation therapy (RT) in treating these tumors remains unclear. OBJECTIVE We investigated the effect of RT on overall survival, specifically among adult patients who had undergone subtotal PCA resection. METHODS Information on adult patients (age 18 years old) who had undergone subtotal PCA resection between 2004 and 2016 was collected from the National Cancer Database (NCDB). A multivariate Cox proportional hazards model was utilized to determine factors independently associated with overall survival. RESULTS A total of 451 patients were identified. The mean age of our patient cohort was 36.8 years old, and the majority of patients (83.4%) did not receive radiation treatment following subtotal PCA resection. Overall median survival was 93.8 months. Survival was longer (p < 0.001) in the patients who did not receive post-surgical RT (median: 98.3 months) compared to patients who did (median: 54.8 months). Patients who had older age at diagnosis (hazard ratio [HR]=1.05, 95% confidence interval [CI]=1.03-1.07, p < 0.01), were Black or African American (HR=2.76, CI=1.12-6.46, p=0.019), received radiation during their initial treatment (HR=4.53, CI=2.08-9.89, p < 0.01), or had a Charlson/Deyo score of > 1 (HR=3.68, CI=1.55, p=0.003) had a significantly higher risk of death following subtotal PCA resection. CONCLUSION Postoperative RT is independently associated with a significantly higher risk of death among adults who underwent subtotal PCA resection. Our findings provide a rationale for further investigation into the efficacy and safety of RT within this patient population.

Flap Reconstruction of Sarcoma Defects in the Setting of Neoadjuvant and Adjuvant Radiation

2018 ◽  
Vol 35 (04) ◽  
pp. 287-293 ◽  
Author(s):  
Rohini Kadle ◽  
Catherine Motosko ◽  
George Zakhem ◽  
John Stranix ◽  
Timothy Rapp ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Soft Tissue ◽  
Radiation Treatment ◽  
Soft Tissue Sarcomas ◽  
Adjuvant Radiation ◽  
Complication Rates ◽  
Flap Reconstruction ◽  
Fasciocutaneous Flaps ◽  
Musculoskeletal Tumor Society

Background Limb-sparing treatment of extremity soft tissue sarcomas requires wide resections and radiation therapy. The resulting complex composite defects necessitate reconstructions using either muscle or fasciocutaneous flaps, often in irradiated wound beds. Methods A retrospective chart review was performed of all limb-sparing soft tissue sarcoma resections requiring immediate flap reconstruction from 2012 through 2016. Results Forty-four patients with 51 flaps were identified: 25 fasciocutaneous and 26 muscle-based flaps. Mean defect size, radiation treatment, and follow-up length were similar between groups. More often, muscle-based flaps were performed in younger patients and in the lower extremity. Seventeen flaps were exposed to neoadjuvant radiation, 12 to adjuvant radiation, 5 to both, and 17 to no radiation therapy. Regardless of radiation treatment, complication rates were comparable, with 28% in fasciocutaneous and 31% in muscle-based groups (p < 0.775). Muscle-based flaps performed within 6 weeks of undergoing radiotherapy were less likely to result in complications than those performed after greater than 6 weeks (p < 0.048). At time of follow-up, Musculoskeletal Tumor Society scores for fasciocutaneous and muscle-based reconstructions, with or without radiation, showed no significant differences between groups (mean [SD]: 91% [8%] vs. 89% [13%]). Conclusion The similar complication rates and functional outcomes in this study support the safety and efficacy of both fasciocutaneous flaps and muscle-based flaps in reconstructing limb-sparing sarcoma resection defects, with or without radiotherapy.

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