Journal of Radiotherapy in Practice (J Radiother Pract)
The Journal of Radiotherapy in Practice is a peer-reviewed journal covering all of the current modalities specific to clinical oncology and radiotherapy. The journal aims to publish research from a wide range of styles and encourage debate and the exchange of information and opinion from within the field of radiotherapy practice and clinical oncology. The journal also aims to encourage technical evaluations and case studies as well as equipment reviews that will be of interest to an international radiotherapy market.
Journal Impact: 0.18*
Journal impact history
|2016 Journal impact||Available summer 2017|
|2015 Journal impact||0.18|
|2014 Journal impact||0.34|
|2013 Journal impact||0.24|
|2012 Journal impact||0.30|
|2011 Journal impact||0.45|
|2010 Journal impact||0.35|
|2009 Journal impact||0.55|
|2008 Journal impact||0.35|
|2007 Journal impact||0.27|
|2005 Journal impact||0.14|
Journal impact over time
|Website||Journal of Radiotherapy in Practice website|
|Other titles||Journal of radiotherapy in practice (Online), Radiotherapy in practice|
|Material type||Document, Periodical, Internet resource|
|Document type||Internet Resource, Computer File, Journal / Magazine / Newspaper|
Publications in this journal
- [Show abstract] [Hide abstract] ABSTRACT: Purpose It is common for head and neck patients to be affected by time trend errors as a result of weight loss during a course of radiation treatment. The objective of this planning study was to investigate the impact of weight loss on volumetric modulated arc therapy (VMAT) as well as intensity modulated radiation therapy (IMRT) for locally advanced head and neck cancer using automatic co-registration of the cone beam computed tomography. Materials and methods A retrospective analysis of previously treated IMRT plans for ten patients with locally advanced head and neck cancer was done. A VMAT plan was also produced for all patients. We calculated the dose–volume histograms (DVH) indices for spinal cord planning at risk volumes (PRVs), the brainstem PRVs (SC+0·5 cm and BS+0·5 cm, respectively) as well as mean dose to the parotid glands. Results The results show that the mean difference in dose to the SC+0·5 cm was 1·03% and 1·27% for the IMRT and VMAT plans, respectively. As for dose to the BS+0·5, the percentage difference was 0·63% for the IMRT plans and 0·61% for the VMAT plans. The analysis of the parotid gland doses shows that the percentage change in mean dose to left parotid was −8·0% whereas that of the right parotid was −6·4% for the IMRT treatment plans. In the VMAT plans, the percentages change for the left and the right parotid glands were −6·6 and −6·7% respectively. Conclusions This study shows a clinically significant impact of weight loss on DVH indices analysed in head and neck organs at risk. It highlights the importance of adaptive radiotherapy in head and neck patients if organ at risk sparing is to be maintained.
- [Show abstract] [Hide abstract] ABSTRACT: Introduction Head and neck cancer patients receiving radiotherapy can experience a number of toxicities, including weight loss and malnutrition, which can impact upon the quality of treatment. The purpose of this retrospective cohort study is to evaluate weight loss and identify predictive factors for this patient group. Materials and methods A total of 40 patients treated with radiotherapy since 2012 at the study centre were selected for analysis. Data were collected from patient records. The association between potential risk factors and weight loss was investigated. Results Mean weight loss was 5 kg (6%). In all, 24 patients lost >5% starting body weight. Age, T-stage, N-stage, chemotherapy and starting body weight were individually associated with significant differences in weight loss. On multiple linear regression analysis age and nodal status were predictive. Conclusion Younger patients and those with nodal disease were most at risk of weight loss. Other studies have identified the same risk factors along with several other variables. The relative significance of each along with a number of other potential factors is yet to be fully understood. Further research is required to help identify patients most at risk of weight loss; and assess interventions aimed at preventing weight loss and malnutrition.
- [Show abstract] [Hide abstract] ABSTRACT: Background There is no consensus on how long the initiation of radiotherapy (RT) can be delayed after surgery without a negative impact on survival. Materials and methods We conducted a retrospective study of 278 patients with stage 0-II breast cancer, all of whom were treated with surgery and RT, with those at stages I-II also receiving chemotherapy. Patients were followed-up for 5 years after diagnosis to assess disease-free and overall survival.The independent variable was the delay in the initiation of RT, assessed by two criteria: time since the last treatment, considered acceptable if ≤6 weeks, and time since surgery, considered acceptable if ≤7 months, these cut-offs being used to categorise patients into two groups according to the length of delay. Results No statistically significant differences were observed in the probability of disease-free survival (p=0·412) or overall survival (p=0·890). The appearance of recurrence was 5-59 months, with an average of 38·50 (14·31). Conclusions Delaying the initiation of RT for more than 6 weeks after last treatment does not seem to have a negative impact on disease-free or overall survival.
- [Show abstract] [Hide abstract] ABSTRACT: Background Monte Carlo (MC) simulations have been used extensively for benchmarking photon dose calculations in modern radiotherapy using linear accelerators (linacs). Moreover, a major barrier to widespread clinical implementation of MC dose calculation is the difficulty in characterising the radiation source using data reported from manufacturers. Purpose This work aims to develop a generalised full MC histogram source model of an Elekta Precise SL-25 linac (electron exit window, target, flattening filter, monitor chambers and collimators) for 6 MV photon beams used in standard therapies. The inclusion of many different probability processes such as scatter, nuclear reactions, decay, capture cross-sections and more led to more realistic dose calculations in treatment planning and quality assurance. Materials and methods Two different codes, MCNPX 2·6 and EGSr-BEAM, were used for the calculation of particle transport, first in the geometry of the internal/external accelerator source, and then followed by tracking the transport and energy deposition in phantom-equivalent tissues. A full phase space file was scored directly above the upper multilayer collimator's jaws to derive the beam characteristics such as planar fluence, angular distribution and energy spectrum. To check the quality of the generated photon beam, its depth dose curves and cross-beam profiles were calculated and compared with measured data. Results In-field dose distributions calculated using the accelerator models were tuned to match measurement data with preliminary calculations performed using the accelerator information provided by the manufacturer. Field sizes of 3×3, 5×5, 10×10, 15×15 and 20×20 cm2 were analysed. Local differences between calculated and measured curve doses beneath 2% were obtained for all the studied field sizes. Higher discrepancies were obtained in the air-water interface, where measurements of dose distributions with the ionisation chamber need to be shifted for the effective point of measurement. Conclusion The agreements between MC-calculated and measured dose distributions were excellent for both codes, showing the strength and stability of the proposed model. Beam reconstruction methods as direct input to dose-calculation codes using the recorded histograms can be implemented for more accurate patient dose estimation.
- [Show abstract] [Hide abstract] ABSTRACT: Aim To explore possible predictors of early vaginal stenosis among patients with locally advanced cervix cancer on pelvic chemoradiation. Patients and methods A total of 232 patients with locally advanced cervix cancer, who received pelvic radiotherapy at our institute from November 2011 to October 2013, were prospectively studied. Possible predictors chosen were age, tumour stage, initial vaginal involvement, concomitant chemotherapy and development of vaginitis of Radio Therapy Oncology Group grade 2 or more during radiotherapy. Multiple logistic regression was carried out to assess predictors and the relative risk of predictors was calculated. Results Initial vaginal involvement and addition of concomitant chemotherapy are predictors of early vaginal stenosis in locally advanced cervix cancer patients on pelvic chemoradiation. Relative risk for early vaginal stenosis with vaginal involvement at presentation was 16·31, whereas that for concomitant chemotherapy was 9·95. Conclusion Among patients with locally advanced cervix cancer receiving pelvic chemoradiation, two factors, namely, initial vaginal involvement and concomitant chemotherapy are predictive of early vaginal stenosis. Patients with these factors should be assessed at regular intervals for early vaginal stenosis during pelvic chemoradiation to assess the optimal timing of intracavitary brachytherapy. This is particularly of importance in the absence of facilities for interstitial brachytherapy to ensure appropriate target coverage.
- [Show abstract] [Hide abstract] ABSTRACT: Introduction Although the notion of advanced practice (AP) has been widely accepted and implemented in some countries, for example, the United Kingdom, in Canada it is has yet to be widely tested as a model of working. Currently it has been implemented and evaluated in Ontario, but this approach is not widespread across the country. To date in British Columbia (BC), there are no advanced practitioners and no research has been conducted regarding the opinions and attitudes of radiation therapists (RTs) in BC towards the implementation of AP. Understanding RTs attitudes and perceptions towards AP may be important when considering the acceptance and implementation of new roles. The research objectives were to explore the attitudes and opinions of RTs and establish what the term AP means to BC RTs, and also to discover what they consider to be benefits, and barriers to implementing AP. Materials and methods A quantitative approach was utilised and an on-line questionnaire was sent to 266 RTs that currently practice in BC. Likert and demographic questions were used to explore the definition of AP and ascertain opinions about the barriers and benefits of implementing AP in BC. Results A total of 183 questionnaires were completed for a response rate of 69%. The majority of respondents agreed with the Canadian Association of Medical Radiation Technologies (CAMRT) and the literature's definition of AP. Cost, time, lack of support and training and issues of medical dominance were cited as barriers. Job satisfaction, autonomy, and increased recruitment and retention of staff were considered benefits. Conclusions Although RTs believe there are obstacles to be overcome regarding the adoption and implementation of AP, these are outweighed by the potential benefits such as enhanced patient care due to increased levels of professional knowledge and development that can lead to increased levels of job satisfaction. These are seen as important drivers for creating the AP role in BC.
- [Show abstract] [Hide abstract] ABSTRACT: Background and purpose To assess the reliability of post-implant CT (PICT) dosimetry for I-125 prostate seed brachytherapy by investigating the variation between centres in performing PICT through a multi-centre audit.Materials and methods Computerised tomography data sets from four I-125 prostate brachytherapy patients were circulated to nine participating centres. Centres followed local protocol for PICT outlining and seed identification, dosimetry for D90, V100 and V150 for the prostate was reported. Outlines were compared to determine the variation in: quality parameters (D90, V100 and V150), dose-volume histograms and approach to PICT dosimetry between the centres.Results There was significant variation in the prostate outlines drawn by the nine centres; for a prostate with mean volume 43 cm3, the range was 39–57 cm3 which led to variations of D90 of 119–154 Gy (mean 140 Gy) and V100 of 80–93% (mean of 88%). Using automatic seedfinder software reduced discrepancies between centres identifying seeds; overall consistency in seed location was good.Conclusions There was a significant uncertainty in the outlining of the prostate volume for PICT dosimetry with an uncertainty value of around ± 20 Gy on D90. PICT is a valuable technique but its accuracy and consistency limitations must be appreciated.
- [Show abstract] [Hide abstract] ABSTRACT: Background and purpose Accurate delineation of the target volume and organs at risk (OARs) are vital to ensure systematic errors are small. The use of contrast agents (CAs) in the bladder and rectum may aid contouring and reduce inter and intra-observer variability. The aim of this study was to evaluate the dosimetric effect of the presence of such contrast on the monitor units (MUs), planning target volume (PTV), rectum and bladder.Materials and methods The prostate, seminal vesicles, rectum and bladder were contoured by a single observer on ten patients with bladder and rectal contrast. To evaluate the dosimetric effect of the presence of contrast, the density of the ten patients with contrast in the bladder and rectum was virtually changed to 1 g/cm3. A four-field 15 MV conformal radiation therapy technique was applied in which dose volume histograms and MUs were compared using computed tomographic (CT) density and the 1 g/cm3 density.Results The presence of contrast resulted in a 0·09% (<1 MU) increase in anterior MUs and decrease of 1% (<1 MU) in the posterior beam MUs. Lateral beams were not affected. The PTV and bladder dose increased slightly without contrast. The rectum showed a maximum change of 0·62% dose among the measured dose values. A maximum dose of 0·3 Gy at the 30% volume was also seen.Conclusions The dosimetric effect of bladder and rectal CAs on MUs, dose to the PTV and OARs in using this technique was very small. This would not be clinically significant, but only if the extreme limits of dose volume constraints were being reached.
- [Show abstract] [Hide abstract] ABSTRACT: Background and purpose To investigate whether inadequate dose to Point-A necessitates treatment plan changes in a time of computed tomography (CT)-image-guided brachytherapy treatment planning for cervix cancer.Materials and methods A total of 125 tandem and ovoid insertions from 25 cervix patients treated were reviewed. CT-image-based treatment planning was carried out for each insertion. Point-A is identified and the dose documented; however, dose optimisation in each plan was based on covering target while limiting critical organ doses (PlanTarget). No attempts were made to equate prescription and Point-A dose. For each insertion, a second hypothetical treatment plan was generated by prescribing dose to Point-A (PlanPoint-A). Plans were inter-compared using dose–volume histogram analyses.Results A total of 250 treatment plans were analysed. For the study population, the median cumulative dose at Point-A was 80 Gy (range 70–95) for PlanTarget compared with 84·25 Gy for PlanPoint-A. Bladder and rectal doses were higher for PlanPoint-A compared with PlanTarget (p < 0·0001). Target D90 did not correlate with Point-A dose (p = 0·60).Conclusions Depending on applicator geometry, tumour size and patient anatomy, Point-A dose may vary in magnitude compared with prescription dose. Treatment plan modifications purely based on inadequate Point-A dose are unnecessary, as these may result in higher organ-at-risk doses and not necessarily improve target coverage.
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