Equity, Diversity, and Inclusion in Radiation Oncology: A Bibliometric Analysis and Critical Review.

The promotion of equity, diversity, and inclusion (EDI) is being increasingly pursued in health care, both in general and within radiation oncology. Because bibliometrics is a powerful tool to reveal the scientific literature on a specific topic during a certain timespan, a systematic bibliometric analysis of the documents published on EDI in radiation oncology was performed, aiming at exploring common patterns in research and emerging trends, tracking collaborations and networks, and anticipating future directions in clinical research. Standard descriptive statistics and bibliometric techniques were used in the analysis. A collaboration network and thematic map were generated from the data. Four domains were represented: (1) motor themes, including themes well developed and important for the structuring of the research field; (2) niche themes, representing the isolated topics that do not share important external links with other themes; (3) emerging themes, referring to still weakly developed topics; and (4) basic themes, including the essential topics. EDI in the profession of radiation oncology is essential to ensure that the workforce delivering radiation oncology care both draws from the full talent pool of human capital and delivers the highest quality science and clinical care to all patients. The burgeoning literature on EDI in radiation oncology suggests that a large and growing cohort of scholars within radiation oncology are dedicated to addressing these important challenges.

Changes in breast cancer management during the Corona Virus Disease 19 pandemic: An international survey of the European Breast Cancer Research Association of Surgical Trialists (EUBREAST).

BACKGROUND: Corona Virus Disease 19 (COVID-19) had a worldwide negative impact on healthcare systems, which were not used to coping with such pandemic. Adaptation strategies prioritizing COVID-19 patients included triage of patients and reduction or re-allocation of other services. The aim of our survey was to provide a real time international snapshot of modifications of breast cancer management during the COVID-19 pandemic. METHODS: A survey was developed by a multidisciplinary group on behalf of European Breast Cancer Research Association of Surgical Trialists and distributed via breast cancer societies. One reply per breast unit was requested. RESULTS: In ten days, 377 breast centres from 41 countries completed the questionnaire. RT-PCR testing for SARS-CoV-2 prior to treatment was reported by 44.8% of the institutions. The estimated time interval between diagnosis and treatment initiation increased for about 20% of institutions. Indications for primary systemic therapy were modified in 56% (211/377), with upfront surgery increasing from 39.8% to 50.7% (p < 0.002) and from 33.7% to 42.2% (p < 0.016) in T1cN0 triple-negative and ER-negative/HER2-positive cases, respectively. Sixty-seven percent considered that chemotherapy increases risks for developing COVID-19 complications. Fifty-one percent of the responders reported modifications in chemotherapy protocols. Gene-expression profile used to evaluate the need for adjuvant chemotherapy increased in 18.8%. In luminal-A tumours, a large majority (68%) recommended endocrine treatment to postpone surgery. Postoperative radiation therapy was postponed in 20% of the cases. CONCLUSIONS: Breast cancer management was considerably modified during the COVID-19 pandemic. Our data provide a base to investigate whether these changes impact oncologic outcomes.

Physiological (18)F-FDG uptake patterns in female reproductive organs before and after chemotherapy treatments: assessment by PET/CT.

The current study compares FDG uptake in the ovaries and uterus before and after chemotherapy with regard to the menstrual cycle and patient's age. The FDG PET/CT studies of 182 women of reproductive age (12-50 years) referred for the assessment of various malignancies were evaluated. Patterns and degree of FDG uptake in the ovaries or uterus were correlated with patient's age, chemotherapy and with the phase of the menstrual cycle. Physiological FDG uptake in ovaries of women <35 years who did not receive chemotherapy occurred with two peaks: at the beginning of menstrual cycle and at mid-cycle around ovulation. After chemotherapy, women <35 years showed FDG ovarian uptake during various stages of the menstrual cycle. In women >35 years, there was no difference in FDG ovarian uptake before and after chemotherapy. There was a negative relationship between the time elapsed from end of chemotherapy to the incidence of uptake in the ovary (p < 0.001). Bilateral ovarian uptake was significantly more prevalent in women < 35 years after chemotherapy (p < 0.01), with a significant negative dependence to time from the end of chemotherapy (p < 0.05). There was no statistically significant difference in FDG uptake in the uterus before and after chemotherapy in both age groups, as well as in SUVmax measurements in the ovaries and uterus. Chemotherapy may affect physiological FDG uptake in reproductive organs of women of reproductive age.