ASTCT and USCLC clinical practice recommendations for allogeneic stem cell transplant in mycosis fungoides and Sézary syndrome.

Introduction: Mycosis fungoides (MF) and Sézary syndrome (SS) are the most common subtypes of cutaneous T-cell lymphoma. While MF generally follows an indolent course, a subset of patients will experience progressive and/or treatment-refractory disease. SS is an aggressive cutaneous T-cell lymphoma associated with high morbidity and mortality secondary to immune compromise and opportunistic infection.

ASTCT and USCLC Clinical Practice Recommendations for Allogeneic Stem Cell Transplant in Mycosis Fungoides and Sézary Syndrome.

Mycosis fungoides (MF) and Sézary syndrome (SS) are the most common subtypes of cutaneous T-cell lymphoma (CTCL). While MF generally follows an indolent course, a subset of patients will experience progressive and/or treatment-refractory disease; Sézary syndrome is an aggressive lymphoma associated with high morbidity and mortality. Although allogeneic hematopoietic cell transplant (allo-HCT) is the only currently available potentially curative treatment modality for MF/SS there is no published guidance on referral criteria, transplant timing orallo-HCT approach.

Factors Associated With In-Hospital Mortality in Mycosis Fungoides Patients: A Multivariable Analysis.

Background Mycosis fungoides (MF) is the most common form of cutaneous T-cell lymphoma (CTCL). Although it often has an indolent course, it can progress to more aggressive CTCL forms. There is sparse data in current literature describing specific clinical factors associated with in-hospital mortality in mycosis fungoides patients.

Benefit of Deep Inspiratory Breath Hold for Right Breast Cancer When Regional Lymph Nodes Are Irradiated.

Background: Although deep inspiratory breath-hold (DIBH) is routinely used for left-sided breast cancers, its benefits for right-sided breast cancer (rBC) have yet to be established. We compared free-breathing (FB) and DIBH treatment plans for a cohort of rBC undergoing regional nodal irradiation (RNI) to determine its potential benefits.

Methods And Materials: rBC patients considered for RNI (internal mammary nodal chains, supraclavicular field, with or without axilla) from October 2017 to May 2020 were included in this analysis.

A Blinded, Prospective Study of Error Detection During Physician Chart Rounds in Radiation Oncology.

Purpose: Peer review during physician chart rounds is a major quality assurance and patient safety step in radiation oncology. However, the effectiveness of chart rounds in detecting problematic treatment plans is unknown. We performed a prospective blinded study of error detection at chart rounds to clarify the effectiveness of this quality assurance step.

Outcomes for allogeneic stem cell transplantation in refractory mycosis fungoides and primary cutaneous gamma Delta T cell lymphomas.

We report results on 23 patients with cutaneous T cell lymphoma (7 primary cutaneous γδ T cell lymphoma [PCGDT], 16 mycosis fungoides/Sézary syndrome [MF/SS]) who underwent allogeneic stem cell transplantation. All pts had skin involvement, 14 had total skin electron beam before conditioning. Donors were 10/10 HLA matched related (13), 5/10 haploidentical (4), and matched unrelated (5) or mismatched unrelated (1).

Management of primary skin cancer during a pandemic: Multidisciplinary recommendations.

During the coronavirus disease 2019 (COVID-19) pandemic, providers and patients must engage in shared decision making regarding the pros and cons of early versus delayed interventions for localized skin cancer. Patients at highest risk of COVID-19 complications are older; are immunosuppressed; and have diabetes, cancer, or cardiopulmonary disease, with multiple comorbidities associated with worse outcomes. Physicians must weigh the patient's risk of COVID-19 complications in the event of exposure against the risk of worse oncologic outcomes from delaying cancer therapy.

Socioeconomic Factors Associated With Burnout Among Oncology Trainees.

Purpose: Burnout in the medical workforce leads to early retirement, absenteeism, career changes, financial losses for medical institutions, and adverse outcomes for patients. Recent literature has explored burnout in different specialties of medicine. This article examines burnout among medical oncology trainees and identifies factors associated with burnout and professional dissatisfaction, including socioeconomic factors.

Standard Tangential Radiation Fields Do Not Provide Incidental Coverage to the Internal Mammary Nodes.

Purpose: The purpose of the study was to evaluate the incidental dose delivered to the internal mammary nodes (IMNs) in patients treated with tangential 3-dimensional conformal radiation therapy and to identify potential parameters that may affect the IMN mean dose.

Methods And Materials: The study cohort consisted of 362 consecutively treated patients with breast cancer in our center between January 2015 and July 2017 who had received adjuvant whole-breast radiation therapy or postmastectomy radiation with or without a supraclavicular ± axillary field and without intentional inclusion of the IMN chain. The clinical target volume (CTV) for the IMNs was contoured per the Radiation Therapy Oncology Group 3509/3510 protocol and was then divided into 3 subregions: upper, mid, and lower thirds.

Patient-Reported Outcomes and Cosmesis in a Feasibility Study of 4-Dimensional Simulated Image Guided Accelerated Partial Breast Irradiation.

Purpose: Three-dimensional conformal accelerated partial breast irradiation (APBI) is a treatment option for well selected women with breast cancer, despite reports of adverse cosmetic outcome with this technique. Dose-volume relationships may be responsible for this poor cosmesis. We aimed to determine the feasibility of limiting the exposure of nontarget breast tissue to radiation through smaller planning target volumes achieved through daily image guidance and 4-dimensional computed tomography simulation.

Multi-institutional Investigation: Circulating CD4:CD8 ratio is a prognosticator of response to total skin electron beam radiation in mycosis fungoides.

Background And Purpose: A lower proportion of CD8+ tumor infiltrating lymphocytes in mycosis fungoides (MF) patients is associated with worse survival. However, it is not known whether circulating CD4:CD8 ratio is a prognosticator of response to total skin electron beam therapy (TSEBT).

Methods And Materials: We identified 126 MF patients treated with TSEBT from 2001 to 20014 at two high-volume academic centers.

Is Proton Therapy a "Pro" for Breast Cancer? A Comparison of Proton vs. Non-proton Radiotherapy Using the National Cancer Database.

Limited data exists demonstrating the clinical benefit of proton radiotherapy (PRT) in breast cancer. Using the National Cancer Database, we evaluated predictors associated with PRT use for patients with breast cancer. An exploratory analysis also investigates the impact of PRT on overall survival (OS).

Modern Perspectives on Radiation Oncology Residency Expansion, Fellowship Evolution, and Employment Satisfaction.

Purpose: In an effort to better characterize the extent and impact of residency expansion and job placement, the authors conducted a multilevel survey of radiation oncologists exploring the current state of the radiation oncology employment market.

Methods: A multilevel survey was conducted using the Qualtrics platform in the spring of 2017. Survey participants were categorized into five groups within radiation oncology: (1) chairpersons, (2) program directors, (3) new practitioners (at least 1 year out of residency), (4) new residency graduates (radiation oncology postgraduate year 5 graduates with new jobs), and (5) medical students.

Cutaneous T-Cell Lymphoma: Trends in Radiation Doses and Patterns of Care 2004-2015.

Background And Aim: Radiotherapy is an effective treatment for cutaneous T-cell lymphoma (CTCL). Since 2009, studies have advocated for low-dose radiotherapy (<30 Gy) given it results in similar response rates and less toxicity compared to higher doses (≥30 Gy). We aimed to see if low-dose radiotherapy has been adopted on a national scale in the USA.

Snapshot of a Specialty: Results of the ABR 2016 Radiation Oncology Clinical Practice Analysis.

Purpose: Beginning in 2010, the ABR has administered triennial clinical practice analysis surveys to inform examination development volunteers and staff about the actual state of radiation oncology practice.

Methods And Materials: As reported here, the 2016 survey was designed to provide objective data regarding actual patient volumes of specific disease sites and subjective insight as to the importance and relevance of site-specific therapy to individual practices.

Results: The survey instrument was circulated to 4,075 radiation oncologists listed in the membership database of the American Society for Radiation Oncology, and responses were received from 690 (16.

The Impact of Graduates' Job Preferences on the Current Radiation Oncology Job Market.

Purpose: To examine the role of radiation oncology (RO) graduates' application patterns and personal preferences in current labor concerns.

Methods And Materials: An anonymous, voluntary survey was distributed to 665 domestic RO graduates from 2013 to 2017. Questions assessed graduates' regional (Northeast [NE]; Midwest [MW]; South [SO]; West [WT]) job type and population size preferences.

Meaningful and Accurate Disclosure of Conflict of Interest at the ASTRO National Meeting: A Need for Reassessment of Current Policies.

Purpose:: Conflict of interest (COI) disclosure is essential to research integrity. The average reading comprehension in English is 3.8 words per second (wps).

Resident satisfaction with radiation oncology training.

Purpose: Residency training environments can differ significantly; therefore, resident satisfaction may vary widely among programs. Here, we sought to examine several variables in program satisfaction through a survey of radiation oncology (RO) trainees in the United States.

Methods And Materials: An anonymous, institutional review board-approved, internet-based survey was developed and distributed to U.

Relationship Between Citation-Based Scholarly Activity of United States Radiation Oncology Residents and Subsequent Choice of Academic Versus Private-Practice Career.

Purpose: To assess h-index data and their association with radiation oncology resident choice of academic versus private-practice career, using a recent resident graduating class.

Methods And Materials: A list of 2016 radiation oncology resident graduates (163 residents from 76 Accreditation Council for Graduate Medical Education-certified programs) and their postresidency career choice (academic vs private practice) was compiled. The Scopus bibliometric citation database was then searched to collect h-index data for each resident.

Early Assessment of Lung Cancer Immunotherapy Response via Circulating Tumor DNA.

Decisions to continue or suspend therapy with immune checkpoint inhibitors are commonly guided by tumor dynamics seen on serial imaging. However, immunotherapy responses are uniquely challenging to interpret because tumors often shrink slowly or can appear transiently enlarged due to inflammation. We hypothesized that monitoring tumor cell death in real time by quantifying changes in circulating tumor DNA (ctDNA) levels could enable early assessment of immunotherapy efficacy.