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Intensity-modulated radiation therapy for cancer is considered to be effective when dealing with complicated tumour shapes because the dose distribution for each irradiation can be modulated. Fluence map optimization is often formulated as an optimization problem with dose volume constraints (DVCs). A linear programming (LP) method that approximated DVCs was proposed, and it was modified to the successive LP method (SLPM) to find a feasible treatment plan in a wider region. In the present paper, we propose a numerical method called SLPM-R (the SLPM with robustness) that enhances the SLPM using a robust optimization approach. We mathematically prove that the proposed method with extended LP problems has the favourable properties of the SLPM, even taking uncertainty in the influence matrix into consideration. In particular, when the optimal value of the LP problem is non-positive, the proposed SLPM-R guarantees that the output solution can satisfy all DVCs. Through numerical experiments, we observed that the proposed method found a feasible plan that the SLPM could not find. In addition, for a test case that even the SLPM-R failed, the largest deviations of 5.65 Gray in the SLPM was reduced to 3.15 Gray by the SLPM-R. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this paper was to evaluate the level of hope, coping methods, and the factors affecting them in patients aged 60 years and over who were diagnosed with breast and prostate cancer and who were receiving radiotherapy (RT) as part of their treatment. Methods: A total of 66 patients (37 breast cancer and 29 prostate cancer patients) were included in this cross‐sectional study. The RT and treatment information of the patients were collected by using the records in the hospital database. The scale responses, baseline characteristics, and demographic information of the participants were collected through the questionnaire form and scales [HHI (Heart Hope Index), COPE (Coping Attitudes Assessment Scale), and VAS (Visual Analogue Scale)]. Two surveys were administered to the participants before and after radiotherapy treatment. A first survey was administered to the participants 10–15 days before radiotherapy treatment, and the second survey was administered within 2–3 weeks after radiotherapy treatment. The weight and waist circumference of the patients were also measured before and after radiotherapy. Results: The median age of the participants was 65 (interquartile range (IQR): 62.0–70.2) years. There was a decrease in the weight (mean change (MC): −1.5, 95% CI: −2.9 to −0.2, P = 0.029) and waist circumference (MC: −1.8, 95% CI: −3.2 to −0.4, P = 0.014) of the participants after RT. There was no significant change in the HHI (MC: 0.4, 95% CI: −0.7 to 1.5) and COPE (MC: −0.6, 95% CI: −3.2 to 2.0) total scores of the patients before and after RT (P = 0.459 and P = 0.650, respectively). When only patients with prostate cancer were studied, the self‐help sub‐dimension of COPE (MC: −1.5, 95% CI: −2.7 to −0.3, P = 0.013) was found to be lower. Conclusion: Multidimensional evaluations and interventions may be required in terms of hope levels and coping attitudes of cancer patients receiving radiotherapy. There is an increasing need for further studies in larger populations and cohorts related to this topic in the literature. [ABSTRACT FROM AUTHOR]

Background: Approximately 25–50% of patients undergoing radiotherapy (RT) experience psychological distress and anxiety, which can detrimentally affect both their quality of life and treatment outcomes. While previous research has demonstrated that relaxation exercises can enhance the tolerability of RT and alleviate associated stress and anxiety, the specific needs for such therapies in radiation oncology remain under-explored. This study aims to investigate the demand for and preferences toward relaxation exercises among radiotherapy patients, addressing a critical gap in patient-centered care. Methods: A prospective pseudonymized survey study using a one-time paper-based questionnaire was conducted from 2022 to 2023 among patients undergoing curative-intent RT for breast cancer or patients undergoing palliative RT for bone metastases. Patients were asked in a 11-item questionnaire about their anxiety, pre-existing practice of relaxation exercises/interventions, their interest in relaxation exercises, and preferences on the type and format of instruction. Data were analyzed descriptively. Results: 100 patients (74 female and 26 male) responded, of whom 68 received curative-intent adjuvant RT and 32 palliative RT. Median age was 62 years. 78% of patients indicated a desire to be actively involved in their radiotherapy, but only 27% had used relaxation exercises prior to RT. 44.8% of both curatively and palliatively treated patients who wanted to be actively involved in their therapy desired to learn how to best relax. 56.4% of respondents were willing to spend extra time learning offered exercises. Conclusion: The survey indicates that patients undergoing RT, both for curative or palliative intent, desire relaxation exercises to relieve stress and anxiety from RT. It is therefore important to assess the need for relaxation interventions in individual patients and to develop suitable programs or collaborate with other healthcare professionals to meet these needs. [ABSTRACT FROM AUTHOR]

The advent of taxane-based chemotherapy has revolutionized breast cancer care. This advance has helped improve the response to downstaging tumors that might otherwise be inoperable. It has also helped in rendering clinically (cN+) positive lymph nodes (LNs) pathologically negative (ypN0). The standard of care for cN+ patients included post-mastectomy radiotherapy (PMRT), regardless of the response to neoadjuvant chemotherapy. However, PMRT in patients with 1-3 positive LNs still lacks definitive guidelines. Numerous retrospective results have been inconclusive about the benefit of PMRT on survival in patients with 1-3 positive LNs. This pooled analysis attempts to reach a consensus. The PubMed database was searched through October 2023. The search yielded 27 papers, of which 11 satisfied the inclusion criteria. The locoregional recurrence-free survival (LRRFS), disease-free survival (DFS), and overall survival (OS) for each study were tabulated when given, and two groups were created, the PMRT and NO PMRT, respectively. The results were then pooled for analysis. The total number of patients was 8340, 4136 in the PMRT group, and 4204 in the NO PMRT group, respectively. The LRRFS, DFS, and OS were 96.9%, 82.1%, and 87.3% for the PMRT group and 93.2%, 79.6%, and 84.8% for the NO PMRT group, respectively. There was no statistical significance in LRRFS, DFS, or OS between the two groups (p = 0.61, p = 0.61, and p = 0.38, respectively). PMRT does not seem to confer survival benefits in patients with pN1 rendered ypN0 for stages T1-3. This pooled analysis's findings should be confirmed prospectively with a longer period of follow-up. [ABSTRACT FROM AUTHOR]

Background: Palliative radiotherapy plays a crucial role in managing symptomatic gynecological cancers (GCs). This article aims to systematically review literature studies on palliative pelvic radiotherapy in cervical, endometrial, ovarian, vaginal, and vulvar cancers. The primary focus is centered around evaluating symptom relief, quality of life (QOL), and toxicity in order to ascertain optimal radiotherapy regimens. Methodology: For this thorough review, we mainly relied on Medline to gather papers published until November 2023. Selected studies specifically detailed symptomatology and QOL responses in palliative pelvic radiotherapy used for GCs. Results: Thirty-one studies, mostly retrospective studies and those lacking standardized outcome measures, showed varied responses. Encouraging outcomes were noted in managing hemorrhage (55%) and pain control (70%). However, comprehensively assessing overall symptom response rates and toxicity remained challenging. Investigations into 10 Gy fractionation revealed benefits in addressing tumor-related bleeding and pain in female genital tract cancers. Conclusions: Palliative pelvic radiotherapy effectively manages symptomatic GCs. Nonetheless, unresolved dosing and fractionation considerations warrant further investigation. Embracing modern therapies alongside radiotherapy offers improved symptom control, emphasizing the importance of selecting suitable patients for successful GC palliation interventions. [ABSTRACT FROM AUTHOR]