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An important challenge is how to combine these treatments to achieve the best control and minimise patients’ neurological impairments, especially because of limited experience with the new target drugs, and the unknown toxicity of the different combinations. Future research should therefore focus on these areas in order to establish the best strategies for the treatment of brain metastases from non-small cell lung cancer.

In this work, we intend to elucidate the best therapeutic options for patients diagnosed with brain metastases of NSCL, which include surgery, WBRT, radiosurgery or systemic treatment, and the most effective combinations and timings of them, and the ones with the lowest associated toxicity.

In this work, we intend to elucidate the best therapeutic options for patients diagnosed with brain metastases of NSCL, which include surgery, WBRT, radiosurgery or systemic treatment, and the most effective combinations and timings of them, and the ones with the lowest associated toxicity.

The aim of this paper is to provide a comprehensive overview of the scenario on radiotherapy (RT) delivered with palliative intent in Italy.

A structured online questionnaire was submitted to Italian radiation oncologists in order to explore the clinical practice in different areas of palliation, namely bone, lung, brain, liver, and emergencies suitable to RT.

209 radiation oncologists took part in the study. Stereotactic body irradiation was found to be the preferred technique in lung and liver metastases, whereas 3D conformal RT was registered as the technique of choice for bone and brain metastases. The majority (98%) of participants stated to treat mainly radiotherapy emergencies with 3D conformal RT at doses ranging from 25 to 50 Gy. Re-irradiation is delivered by the majority of respondents, whereas post-treatment follow-up is done only by 51.4% of them.

This nationwide study highlights some heterogeneity among Italian radiation oncologists regarding treatment and follow-up of metastatic cancer patients.

This nationwide study highlights some heterogeneity among Italian radiation oncologists regarding treatment and follow-up of metastatic cancer patients.

The purpose of this study was to evaluate the incidence of clinical lymphedema following adjuvant proton-based radiotherapy (RT) in breast cancer (BC) patients.

We performed a retrospective review of our institutional database to identify BC patients treated with adjuvant proton-based RT. Patients receiving re-irradiation for a BC recurrence or those with a history of ipsilateral chest wall radiation were excluded. Clinical lymphedema was determined by documentation in the chart at baseline and during follow-up.

We identified 28 patients treated with adjuvant proton-based RT who met the study criteria. Median age at diagnosis was 45 (range, 24-75). Eleven patients (39%) underwent mastectomy, and fourteen (50%) underwent axillary lymph node dissection (ALND). Median number of LNs removed was 6 (range, 1-28). Nineteen patients (68%) received neoadjuvant chemotherapy. Median whole breast/chest wall dose delivered was 50 Gy (range, 44-54.0 Gy). Target volumes included the axillary and supraclavicular lymph nodes in all patients and internal mammary lymph nodes in 27 (96%) patients. Mean dose to the axilla was 49.7 Gy, and mean dose to 95% of the axillary volume (D95) was 46.3 Gy (94% of prescription dose). Mean dose to supraclavicular (SCV) volume was 47.7 Gy, and D95 was 44.1 Gy (91% of prescription dose). Grade 3 dermatitis occurred in 14% of patients. Five patients (18%) had clinical lymphedema, 4 from the ALND subset (n = 14).

The incidence of clinical lymphedema after proton-based RT is comparable to rates reported with photon-based RT with comprehensive nodal coverage.

The incidence of clinical lymphedema after proton-based RT is comparable to rates reported with photon-based RT with comprehensive nodal coverage.

The purpose of this study was to describe the topography, extension (volume), and timing of severe osteoradionecrosis (ORN) that required mandible resection in patients previously treated for head and neck cancer at a high-volume Veterans Affairs Medical Center.

The records from a reference hyperbaric oxygen clinic were retrospectively analyzed (n = 50, 2018-2021). Inclusion criteria were I) severe ORN defined as progressive ORN that required resection; II) pathologic confirmation of ORN; and III) availability of pre-operative CT-imaging. Using a radiotherapy (RT) imaging software, we performed a detailed volumetric (3D) analysis of the bone involvement by ORN. Time intervals from RT to surgery for ORN and from surgery to the last follow-up were calculated.

All patients that met inclusion criteria (n = 10) were male with significant smoking history (median 47.5 pack-years) and a median age of 57 years old at the time of RT. The primary tumors were oropharynx (n = 6), oral cavity (n = 3) and nasopharynx (n = 1). The median time from RT to ORN surgery was 8 years. The most common ORN location was the posterior lateral body (molar) and six patients had associated fractures. The mean ORN volume was 3.6 cc (range 0.6-8.3), corresponding to a mean 6.3% (range 0.7-14) of the total mandibular volume. After a median follow-up of 13.5 months, no recurrence of ORN occurred. check details Three patients died of non-cancer and non-ORN-recurrence related causes (1 y OS 77.1%).

Severe ORN occurred after a median of 8 years from the previous RT and usually affected the posterior lateral body. Surgical resection achieved excellent ORN control.

Severe ORN occurred after a median of 8 years from the previous RT and usually affected the posterior lateral body. Surgical resection achieved excellent ORN control.

In our department, during lung stereotactic body radiation therapy (SBRT), all patients receive an intra-fractional midpoint cone beam computed tomography (CBCT). This study aimed to quantify the benefit of adding a second midpoint CBCT over a course of peripheral lung SBRT.

Six-hundred-sixty-four CBCTs from 166 patients were retrospectively analyzed. Treatments were based on the internal target volume (ITV) approach. An isotropic 0.5 cm margin was used to create the planning target volume (PTV) around the ITV. The prescribed dose was 48 Gy in 4 fractions to the PTV. Patients were divided into two groups patients for whom the 3D-intra-fractional-variation (IFV) was < 0.5 cm (105 patients, low risk group) and patients with at least one 3D-IFV ≥ 0.5 cm (61 patients, high-risk group). Plans simulating the dosimetric impact of the IFV were created as follows the original 2 arcs (ARC ) were copied into a new plan consisting of 4 times ARC 1 and 4 times ARC 2. The delivery of ARC 1 was always assumed to have occurred with the isocenter initially coordinated, whereas the positions of ARC 2 were modified for each arc by the measured the 3D-IFV.

For the PTV, we obtained D99% (Gy) = 45.2

. 48.2 Gy (p < 0.0001); Dmean = 53

. 54 Gy (p < .0001) for the reconstructed

. planned dose values, respectively. For the ITV, the changes are less pronounced D99% (Gy) = 52.2

. 53.6 Gy (p = 0.0007); Dmean = 56

. 56.8 Gy (p = 0.0144). The V48 Gy(%)-ITV coverage did not statistically change between the delivered

. planned dose (p = 0.1803). Regarding the organs at risk for both groups, dose-volume-histograms were near-identical.

We demonstrated that a single CBCT is sufficient and reliable to manage the IFV during peripheral lung SBRT.

We demonstrated that a single CBCT is sufficient and reliable to manage the IFV during peripheral lung SBRT.

The COVID-19 pandemic led to a dramatic decrease in face-to-face teaching. This can particularly impact medical students’ skills development. This prompted development of an in-person surgical skills course as guided by the General Medical Council “Outcomes for Graduates” facilitated by tutors with surgical experience. This study aimed to primarily assess participant confidence in surgical skills following the course.

This was an interventional study assessing both qualitative and quantitative data collected prior to, during, and post course completion. Data were collected from students via online forms, which included a mixture of “Yes/No” responses, self-assessed confidence levels via Likert scales, and free type questions.

The study assessed feedback for a 5-session surgical skills course delivered at the authors’ institution. This is a newly designed course using low-cost materials which was free for all attendees.

Participants were all in the first or second year of medical school. There was capare.

Medical knowledge; practice-based learning and Improvement.

Medical knowledge; practice-based learning and Improvement.We describe a novel computational dictionary for the study of right-wing populist conspiracy discourse (RPC) on the internet, specifically in the context of contemporary German politics. After first presenting our definition of conspiracy discourse and grounding it in antecedent research on mediated rhetoric at the intersection of right-wing populism and conspiracy theory, we proceed by outlining our approach to dictionary construction, relying on a combination of manual and automated methods. We validate our dictionary via parallel manual coding of 2,500 sentences using the categories contained in the dictionary as labels and compare the consensus result with the label assigned to each sentence by the dictionary, achieving satisfactory results. We then test our approach on two different datasets composed of alternative news articles and Facebook comments that spread conspiracy theories. Finally, we summarize our observations both on the methodological premises of the approach and on the object of populist right-wing conspiracy discourse and its dynamics more broadly. We close with an outlook on the potentials and limitations of the dictionary-based approach and future directions in applications of content analysis to the study of conspiracy discourse.

The appropriate implementation of telemedicine in the healthcare system has the potential to overcome global problems such as accessibility and quality healthcare services. Thus assessing the knowledge of health professionals before the actual adoption of telemedicine is considered a prominent solution to the problems.

This study aimed to assess healthcare professionals’ knowledge of telemedicine and its associated factors at private hospitals in low-resource settings.

An institution-based cross-sectional study was conducted among 423 health professionals at private hospitals in low-income settings in Ethiopia, from March to April 2021. Data collection was performed by pretested and self-administered questionnaires. This study employed statistical packages for social sciences software. This study employed multivariable logistic regression to determine dependent and independent variables associated with adjusted odd ratio and 95% CI.

in this study about 65.8% of health professionals have good knowledge on Telemedicine .Computer literacy (AOR = 2.9; 95% CI 1.8, 4.6), computer training (AOR = 2.0; 95% CI 1.2, 3.3), Internet availability at workplace (AOR = 2.1; 95%CI 1.3, 3.4), had private laptop (AOR = 1.7; 95% CI 1.1, 2.9) were significantly associated with knowledge.

In general health professionals had good knowledge of Telemedicine. Inclusive packages of capacity by training among health providers are fundamental for the successful implementation of telemedicine.

In general health professionals had good knowledge of Telemedicine. Inclusive packages of capacity by training among health providers are fundamental for the successful implementation of telemedicine.