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Introduction: Prospective studies on reirradiation are limited, with most available data being retrospective, resulting in challenges in standardising protocols, interpreting outcomes, and facilitating informed patient decisions. Advanced radiotherapy planning and delivery have increased treatment possibilities for complex cases, including reirradiation. However, considerable gaps and variability in reirradiation image-guided radiotherapy (IGRT) and treatment delivery exist. The aim of this work was to identify ways to optimise reirradiation IGRT protocols based on RTT feedback.
Methods: A quantitative and qualitative service improvement approach was selected, using a plan, do, check approach. RTT participants working in a single RT centre participated in focus group/nominal group technique sessions. Sessions were used to generate themes, challenges and solutions, which were then scored using Likert scale scoring criteria by all participants.
Results: Eleven IGRT team members each with > 6 years experience participated in the sessions, (4 senior specialist clinical RTT, 2 team leader specialist RTT, 2 IGRT specialist RTT, 1 consultant RTT and 2 research RTT). Eight themes, 19 challenges and 35 solutions were identified. These included communication challenges and multi-professional team (MPT) involvement, RTT role and development, clinical information and treatment intent, standards and guidelines, individualised approach, technical planning considerations, imaging and verification techniques, and anatomical site-specific considerations.
Conclusion: The themes identified provide valuable insights that will inform future IGRT processes and inform future research collaborations on an international level, working towards improving reirradiation treatment for patients who would benefit. There are many opportunities for the RTT within the MPT, and advanced practice (AP) can provide the framework required to develop this for the benefit of patients.
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http://dx.doi.org/10.1016/j.tipsro.2025.100335 | DOI Listing |
Int Dent J
September 2025
Department of Periodontology, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatolog
Introduction And Aims: Free gingival grafting (FGG) is a common procedure in periodontal and implant therapy to augment keratinized tissue and improve esthetic outcomes. However, the effects of graft dimensions and residual tissue thickness (RTT) on palatal donor site healing remain poorly characterized, lacking standardized 3-dimensional analysis. This study aimed to quantify how these factors influence 3-dimensional tissue recovery over 6 months, with thickness recovery rate as the primary outcome.
View Article and Find Full Text PDFOrphanet J Rare Dis
September 2025
Unit of Child Neuropsychiatry, IRCCS Istituto Giannina Gaslini, Epicare Network for Rare Disease, Genoa, Italy.
Background: Rett Syndrome (RTT) is a rare, and severe neurodevelopmental disorder that primarily affects females and is primarily (> 96%) due to pathogenic loss-of-function genetic variants of methyl-CpG-binding protein 2 (MECP2). Despite the rarity of the syndrome, sporadic twin cases have been reported. The descriptions have often focused on the phenotype, emphasizing differences or similarities.
View Article and Find Full Text PDFBMC Med Res Methodol
September 2025
Department of Statistics, University of Pretoria, Pretoria, South Africa.
Background: Joint modeling is widely used in medical research to properly analyze longitudinal biomarkers and survival outcomes simultaneously and to guide appropriate interventions in public health. However, such models become increasingly complex and computationally intensive when accounting for multiple features of these outcomes. The need for computationally efficient methods in joint modeling of competing risks survival outcomes and longitudinal biomarkers is particularly critical in clinical and epidemiological settings, where prompt decision-making is essential.
View Article and Find Full Text PDFJCEM Case Rep
October 2025
Department of Pediatrics, Rhode Island Hospital/Hasbro Children's, Brown University Health, The Warren Alpert Medical School of Brown University, Providence, RI 02903, USA.
Individuals with Noonan syndrome (NS) are predisposed to hematologic cancers, solid tumors, and low-grade gliomas. We report an 8-year-old girl originally referred at age 14 months for short stature, developmental delay, and failure to thrive who was subsequently found to have pathogenetic variants both in and Family history included a maternal half-sister with NS and a mother carrying the mutation. Familial single-gene testing showed a heterozygous pathogenic variant in (c.
View Article and Find Full Text PDFTech Innov Patient Support Radiat Oncol
September 2025
Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Introduction: Prospective studies on reirradiation are limited, with most available data being retrospective, resulting in challenges in standardising protocols, interpreting outcomes, and facilitating informed patient decisions. Advanced radiotherapy planning and delivery have increased treatment possibilities for complex cases, including reirradiation. However, considerable gaps and variability in reirradiation image-guided radiotherapy (IGRT) and treatment delivery exist.
View Article and Find Full Text PDF