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Objectives: To identify and validate baseline magnetic resonance imaging (b-MRI) radiomic features (RFs) as predictors of disease outcomes in effectively cured head and neck squamous cell carcinoma (HNSCC) patients. Materials and methods: Training set (TS) and validation set (VS) were retrieved from preexisting datasets (HETeCo and BD2Decide trials, respectively). Only patients with both pre- and post-contrast enhancement T1 and T2-weighted b-MRI and at least 2years of follow-up (FUP) were selected. The combination of the best extracted RFs was used to classify low risk (LR) vs. high risk (HR) of disease recurrence. Sensitivity, specificity, and area under the curve (AUC) of the radiomic model were computed on both TS and VS. Overall survival (OS) and 5-year disease-free survival (DFS) Kaplan–Meier (KM) curves were compared for LR vs. HR. The radiomic-based risk class was used in a multivariate Cox model, including well-established clinical prognostic factors (TNM, sub-site, human papillomavirus [HPV]). Results: In total, 57 patients of TS and 137 of VS were included. Three RFs were selected for the signature. Sensitivity of recurrence risk classifier was 0.82 and 0.77, specificity 0.78 and 0.81, AUC 0.83 and 0.78 for TS and VS, respectively. VS KM curves for LR vs. HR groups significantly differed both for 5-year DFS (p

Https://coronavirus.jhu.edu/map.html. Accessed: 8 Sep 2020 Filippi AR, Russi E, Magrini SM et al (2020) Covid-19 outbreak in northern Italy: first practical indications for radiotherapy departments. Int J Radiat Oncol Biol Phys. https://doi.org/10.1016/j.ijrobp.2020.03.007 Article PubMed PubMed Central Google Scholar https://www.corona-data.ch/. Accessed: 8 Sep 2020 Baumann M, Krause M, Overgaard J et al (2016) Radiation oncology in the era of precision medicine. Nat Rev Cancer 16:234–249 CAS Article Google Scholar Meattini I, Franco P, Belgioia L et al (2020) Radiation therapy during the coronavirus disease 2019 (covid-19) pandemic in Italy: a view of the nation’s young oncologists. ESMO Open. https://doi.org/10.1136/esmoopen-2020-000779 Article PubMed PubMed Central Google Scholar Guckenberger M, Belka C, Bezjak A et al (2020) Practice recommendations for lung cancer radiotherapy during the covid-19 pandemic: An ESTRO-ASTRO consensus statement. Radiother Oncol. https://doi.org/10.1016/j.radonc.2020.04.001 Article PubMed PubMed Central Google Scholar Slotman BJ, Ricardi U, Lievens Y (2020) Radiotherapy in a time of crisis, ESTRO Presidents’ statement Google Scholar Sack C, Sack H, Willich N, Popp W (2020) Evaluation of the time required for overhead tasks performed by physicians, medical physicists, and technicians in radiation oncology institutions The DEGRO-QUIRO study. Strahlenther Onkol 191:113–124 Article Google Scholar Achard V, Tsoutsou P, Zilli T (2020) Radiotherapy in the time of the Coronavirus pandemic: when less is better. Int J Radiat Oncol Biol Phys. https://doi.org/10.1016/j.ijrobp.2020.03.008 Article PubMed PubMed Central Google Scholar Thomson D, Palma D, Guckenberger M et al (2020) Practice recommendations for risk-adapted head and neck cancer radiotherapy during the covid-19 pandemic: An ASTRO-ESTRO consensus statement. Int J Radiat Oncol Biol Phys. https://doi.org/10.1016/j.ijrobp.2020.04.016 Article PubMed PubMed Central Google Scholar Download references Radiation Oncology Clinic, Oncology Institute of Southern Switzerland (IOSI), Bellinzona-Lugano, Via Gallino, 6500, Bellinzona, Switzerland Dr. Letizia Deantonio MD, Davide Bosetti MD, Simona Cima MD, Francesco Martucci MD, Giulia Borgonovo MD, Gianluca Di Bella MD, Gianfranco Angelo Pesce MD, Mariacarla Valli MD & Antonella Richetti MD You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar Correspondence to Dr. Letizia Deantonio MD. L. Deantonio, D. Bosetti, S. Cima, F. Martucci, G. Borgonovo, G. Di Bella, G.A. Pesce, M. Valli and A. Richetti declare that they have no known competing interests. Reprints and Permissions Deantonio, L., Bosetti, D., Cima, S. et al. #Stayathome: Smart working for radiation oncologists during the corona pandemic. Strahlenther Onkol (2020). https://doi.org/10.1007/s00066-020-01683-z Download citation Received: 28 May 2020 Accepted: 24 August 2020 Published: 18 September 2020 DOI: https://doi.org/10.1007/s00066-020-01683-z

Objective: To evaluate the performance of low dose cone beam CT (CBCT) acquisition protocols for image-guided radiotherapy of prostate cancer. Methods: CBCT images of patients undergoing prostate cancer radiotherapy were acquired with the settings currently used in our department and two low dose settings at 50% and 63% lower exposure. Four experienced radiation oncologists and two radiation therapy technologists graded the images on five image quality characteristics. The scores were analysed through Visual Grading Regression, using the acquisition settings and the patient size as covariates. Results: The low dose acquisition settings have no impact on the image quality for patients with body profile length at hip level below 100 cm. Conclusions: A reduction of about 60% of the dose is feasible for patients with size below 100 cm. The visibility of low contrast features can be compromised if using the low dose acquisition settings for patients with hip size above 100 cm. Advances in knowledge: Low dose CBCT acquisition protocols for the pelvis, based on subjective evaluation of patient images.

To evaluate acute and late skin/subcutaneous toxicities and radiation-induced lung fibrosis (RILF) in patients treated with adjuvant radiotherapy (RT) for synchronous bilateral breast cancers (SBBC), after conservative surgery. Twenty-five patients were treated with volumetric-modulated arc therapy (VMAT/RapidArc®) on both breasts, and checked clinically for detecting RT toxicities during and after treatment. A high-resolution computed tomography (HRCT) was performed, for detecting RILF during follow-up. We registered acute Grade-1 skin toxicity in 18 patients (72%), while six patients (24%) experienced Grade-2 toxicity. No breath symptoms were reported during and after RT. Late Grade-1 subcutaneous toxicity and late Grade-2 skin toxicity were registered in four patients (16%) and one patient (4%), respectively, at a mean follow-up of 36 months. Grade-1 RILF was detected in six patients (30%). The median volume of fibrosis area was 6.5 cc (range 1.3–21.5 cc). The partial volumes receiving a specified dose (V20, V30, V40, and V50) in patients who developed lung fibrosis were significantly bigger than who did not (p

Objective: To analyze the impact of adjuvant radiotherapy (RT) on ipsilateral breast recurrence (IBR) and overall survival (OS) in patients older than 69 years with early-stage breast cancer. Methods: From January 2007 to June 2015, we analyzed retrospectively 137 women with estrogen receptor–positive T1–2 invasive breast cancer, with negative axillary lymph nodes, dividing them into 2 subgroups: 70 to 79 years and older than 79 years. Results: After a median follow-up of 43.2 months, the 3-year IBR-free survival in patients treated with surgery plus RT was 98.8% and 92.1% in patients treated with surgery alone, with a significant difference ( p = .01). Radiotherapy did not impact overall survival ( p = .10). A higher percentage of patients aged between 70 and 79 years received RT after conservative surgery if compared with the older subgroup ( p < .01). Conclusions: In elderly women, adjuvant RT reduced the IBR, but did not improve OS.

Most developed countries accepted the chronological age of 70 years as the definition of "elderly" and there is a general consensus in clinical practice to consider this age as the threshold in risk assessment. This has a strong impact in the choice of treatment of these lung cancer patients. Indeed, more than 50% of these patients are over 70 and nearly 30% are over 75 years old. Because of the increasing number of elderly patients that are generally fitter than in the past, the treatment options should rather be based on individual fitness, taking into account risks and benefits of the diagnostic and therapeutic procedures. This means considering biological rather than chronological age to make decisions. For these reasons, we developed a simplified short comprehensive geriatric assessment (sCGA), including a standardised evaluation of activity of daily living, depression, cognitive status, comorbidities and geriatric syndromes. This allowed us the classification of these patients into 3 categories: frail, vulnerable and fit. Through the emblematic case of a fit elderly man affected by NSLCC, we present the multidisciplinary assessment and discussions to identify the best treatment options for this patient.