Recent Trends in "Manels" and Gender Representation Among Panelists at North American Annual Radiation Oncology Meetings.

PURPOSE: Achieving gender equity in radiation oncology is an important goal, as a smaller proportion of women enter radiation oncology residency compared with those graduating from medical school. As invited speaking opportunities at academic medical conferences are vital for promotion/tenure, we investigated the prevalence of all-men panels ("manels") at American Society for Radiation Oncology (ASTRO) and Canadian Society of Radiation Oncology (CARO) annual meetings. METHODS AND MATERIALS: Using ASTRO and CARO online meeting programs, 2018 to 2021 faculty information was obtained, including gender, panel role (chair vs nonchair), type of session, and topic. Primary outcomes included percentage of manels and proportion of female panelists over time. Representation of women among chairs was also evaluated. RESULTS: Over the 4-year study period across both conferences, a total of 765 panel sessions were held with 2973 faculty members, of whom 1287 (43.3%) were women. Of these sessions, 127 of 765 (16.6%) were manels. ASTRO meetings had 1169 of 2742 (42.6%) female faculty members and held 107 of 680 (15.7%) manels, whereas CARO meetings had 118 of 231 (51.1%) female faculty and held 20 of 85 manels (23.5%). From 2018 to 2021, the proportion of manels decreased at ASTRO and CARO meetings from 25.6% to 8.2% (P < .001) and from 29.6% to 15.0% (P = .130), respectively. The role of chair was majority male in every year from 2018 to 2021 at ASTRO meetings (58.6% overall), but more balanced at CARO meetings (48.0% overall). Among session types, the highest proportion of manels was observed for scientific sessions (19.1%, P = .011) at ASTRO meetings and leadership sessions (29.4%, P = .533) at CARO meetings. The lowest proportion of female panelists was on genitourinary cancer topics at ASTRO meetings (31.9%, P = .018) and physics topics at CARO meetings (40.4%, P = .085). CONCLUSIONS: During the study period, the proportion of female panelists increased with a corresponding decrease in manels. ASTRO and CARO should strive for further involvement of women and the elimination of manels whenever possible.

Reduciendo el impacto de COVID-19 sobre la radioterapia oncológica en países en desarrollo: revisión rápida y consenso de expertos / Reducing the impact of COVID-19 on radiation oncology units of developing countries: a rapid review and expert consensus

OBJETIVO: Establecer recomendaciones para la toma de decisiones de manejo en radioterapia durante la pandemia de COVID-19, adaptadas a un país con recursos de salud limitados. MÉTODOS: A través de una revisión rápida de la literatura se buscaron publicaciones que describieran medidas para reducir el riesgo de infección por COVID-19, así como también pautas de manejo para reducir la carga de trabajo en las unidades de radioterapia. Se incluyeron en el alcance de esta revisión las siguientes patologías: tumores ginecológicos, cáncer de mama, tumores gastrointestinales, tumores genitourinarios, tumores de cabeza y cuello, cáncer de piel, tumores del sistema nervioso central y linfomas. Un grupo de expertos discutió en línea los datos extraídos y redactó las recomendaciones. Mediante un método Delphi modificado, se evaluó el consenso entre 14 radio-oncólogos certificados. Se evaluó la calidad de la evidencia que sustentó las recomendaciones sobre esquemas de tratamiento. RESULTADOS: Se incluyeron un total de 57 documentos. De 25 trabajos se extrajeron las estrategias para reducir el riesgo de infección. De los restantes, se obtuvieron las recomendaciones para cada patología. Las recomendaciones están orientadas a establecer escenarios específicos donde se pueden omitir, diferir, priorizar y acortar los tratamientos. En el ítem de acortar se recomiendan esquemas de tratamiento para cada patología, priorizando los esquemas hipofraccionados cuando fue posible. CONCLUSIÓN: Se plantean estrategias para la gestión de los servicios de radioterapia con el objetivo de garantizar que los tratamientos de alta calidad para pacientes oncológicos sigan entregándose, pese a la crisis sanitaria ocasionada por COVID-19.

OBJECTIVE: To generate recommendations on the management of radiotherapeutic treatments during the pandemic, adapted to a country with limited health resources. METHODS: We did a rapid review of the literature, searching for papers that describe any measures to reduce the risk of COVID-19 infection, as well as management guidelines to reduce the workload, in radiotherapy units. The following conditions were included in the scope of this review: gynecological tumors, breast cancer, gastrointestinal tumors, genitourinary tumors, head and neck tumors, skin cancer, tumors of the central nervous system, and lymphomas. An expert group discussed online the extracted data and drafted the recommendations. Using a modified Delphi method, the consensus was reached among 14 certificated radio-oncologists. The quality of the evidence that supported the recommendations on treatment schedules was assessed. RESULTS: A total of 57 documents were included. Of these, 25 provided strategies to reduce the risk of infection. Recommendations for each condiction were extracted from the remaining documents. The recommendations aim to establish specific parameters where treatments can be omitted, deferred, prioritized, and shortened. Treatment schemes are recommended for each condition, prioritizing hypo-fractionated schemes whenever possible. CONCLUSIONS: We propose strategies for the management of radiotherapy services to guarantee the continuity of high-quality treatments despite the health crisis caused by COVID-19.

Necessidades atuais de radioterapia no SUS e estimativas para o ano de 2030 / Current radiotherapy needs in SUS and estimates for the year 2030 / Las necesidades actuales de radioterapia en el SUS y las estimaciones para el año 2030

Introdução: O câncer se encontra entre as principais doenças crônicas não transmissíveis do mundo e, para 2030, é esperado um aumento na incidência de 54% em relação a 2015. esse incremento requer estratégias e políticas públicas que visem atender às demandas por tratamento, especialmente terapia de radiação, uma vez que envolve equipamentos e recursos humanos específicos. Objetivos: a presentar o cenário atual da radioterapia no Brasil, seus recursos estruturais e humanos, bem como estimar o cenário da radioterapia para o país em 2030. Método: trata-se de um estudo descritivo realizado com base em referencial teórico e conformado a partir de estimativas populacionais, atual e projetada, bancos de dados de sistemas de informação oficiais e sítios de classe profissional, e em legislação e normas emitidas por órgãos que normatizam e licenciam o tema no Brasil. Resultado: o s resultados obtidos demonstram que o déficit em julho de 2015 no Brasil é de 255 serviços de radioterapia e em recursos humanos de 387 radioterapeutas, 546 físico-médicos e 425 supervisores de produção. Para o ano de 2030, o déficit estimado é de 198 serviços de radioterapia e em recursos humanos de 235 físico-médicos e 114 supervisores de produção. Conclusão: o envelhecimento populacional e o consequente aumento das doenças crônicas não transmissíveis como o câncer exigem dos serviços públicos de saúde um planejamento que garanta as demandas por tratamento. o déficit, atual e projetado, de radioterapia no Brasil sinaliza a urgência de estratégias e políticas públicas capazes de atender às necessidades apresentadas.

Introduction: Cancer is amongst the main non-communicable chronic diseases in the world and for 2030 it is expected to increase in the incidence of 54% compared to 2015. This increase requires public strategies and policies to meet the demands for treatment, especially therapy radiation, since it involves specific equipment and manpower. Objectives: to present the current scenario of radiotherapy in Brazil, its structural and human resources, and to evaluate the scene of radiation to the country in 2030. Method: This is a descriptive study based on reference theoretical and in current and projected population estimates, databases of official information systems and professional class, and legislation and regulations issued by agencies that regulate and license the subject in Brazil. Results: The results showed that the deficit in July 2015 in Brazil is 255 radiotherapy services and human resources of 387 radiation therapists, 546 physical-medical and 425 production supervisors. For the year 2030 the estimated deficit is 198 radiotherapy and human resources of 235 physical-medical and 114 production supervisor. Conclusion: The aging population and consequent increase in chronic diseases like cancer demand the public health services to do some planning to ensure the demand for treatment. The deficit, current and projected radiotherapy in Brazil indicates the urgency of strategies and public policies to meet the needs presented.

Introducción: El cáncer es una de las principales enfermedades crónicas más no transmisibles del mundo y para el 2030 se espera un aumento en la incidencia del 54% en comparación con 2015. este aumento requiere de estrategias y políticas públicas para satisfacer las demandas por tratamiento, especialmente la terapia la radiación, ya que se involucra equipos y mano de obra específica. Objetivos: Presentar el escenario actual de la radioterapia en Brasil, sus recursos estructurales y humanos, y para evaluar la escena de la radioterapia para el país en 2030. Método: se trata de un estudio descriptivo con una base referencial teórica y conformado a partir de las estimativas poblacionales, actualizadas y proyectados, bases de datos de los sistemas de información y los sitios oficiales de clase profesional, y en emisiones de leyes y reglamentos de los organismos que regulan y autorizan el tema en Brasil. Resultados: los resultados mostraron que el déficit en julio de 2015 en Brasil es de 255 servicios de radioterapia y recursos humanos de 387 radioterapeutas, 546 supervisores de producción-físicos médicos y 425. Para el año 2030 el déficit estimado es de 198 radioterapia y recursos humanos de los servicios 235 físicos médicos y 114 supervisores de producción. Conclusión: e l envejecimiento de la población y el consiguiente aumento de las enfermedades crónicas como el cáncer exigen que los servicios de salud pública un planeamiento para asegurar las demandas del tratamiento. e l déficit actual, en radioterapia es proyectado en Brasil indica la urgencia de estrategias y políticas públicas capaces de atender las necesidades que se presentan.

Pattern of care in radiotherapy at a University Hospital in Spain: the RENORT project

Purpose RENORT is a novel data mining application developed to extract relevant clinical data from oncology information systems (OIS; ARIA and Mosaiq) used in radiation oncology (RO). Methods/patients We used RENORT to extract demographic and clinical data from the OIS of all patients treated at the RO Department at the General Hospital of Valencia during the year 2019. Results A total of 1158 treatments were performed. The female/male ratio was 39.3%/60.7%, with a mean age of 66 years. The mean waiting time between the treatment decision/proposal to the first visit was 10.1 days. Mean duration of the treatment preparation process was 21 days. Most patients (90.4%) completed treatment within the prescribed time ± 7 days. The most common sites/treatment types were: metastatic/palliative treatments (n = 300; 25.9%), breast (209; 18.0%), genitourinary (195; 16.8%), digestive (116; 10.0%), thoracic (104; 9.0%), head and neck (62; 5.4%), and skin cancer (51; 4.4%). The distribution according to treatment intent was as follows: palliative (n = 266; 23.0%), adjuvant curative (335; 28.9%), radical without adjuvant treatment (229; 19.8%), radical with concomitant treatment (188; 16.2%), curative neoadjuvant (70; 6.0%), salvage radiotherapy (61; 5.3%); and reirradiation (9; 0.8%). The most common treatment techniques were IMRT/VMAT with IGRT (n = 468; 40.4%), 3D-CRT with IGRT (421; 36.4%), SBRT (127; 11.0%), 2DRT (57; 4.9%), and SFRT (56; 4.8%). A mean of 15.9 fractions were administered per treatment. Hypofractionated schemes were used in 100% of radical intent breast and prostate cancer treatments. Conclusions The RENORT application facilitates data retrieval from oncology information systems to allow for a comprehensive determination of the real role of radiotherapy in the treatment of cancer patients. This application is valuable to identify patterns of care and to assess treatment efficacy (AU)

Evaluación de la calidad de un servicio de voluntariado en oncología: un Análisis Importancia-Valoración (IPA) / Quality assessment of a volunteer service in oncology: an importance performance analysis (IPA)

Objetivo: Usando el Análisis de Importancia-Valoración (IPA), este artículo examina la importancia y valoración percibidas por pacientes oncológicos y sus acompañantes de un programa de humanización realizado por voluntarios en un servicio de Radioterapia de un hospital general en España. Método: Los autores identifican una lista de siete ítems que surgen de la revisión de literatura en Marketing Sanitario; cada ítem fue puntuado con una escala Likert de 5 puntos. Resultados: Los resultados se obtuvieron de las respuestas a 148 entrevistas. El gráfico fue corregido con las recomendaciones sugeridas en la literatura y en el caso de los pacientes, muestra tres factores que caen en el cuadrante de "Mantener el buen trabajo", cuatro atributos caen dentro del cuadrante de "Baja Prioridad" y ningún atributo se observa en los cuadrantes de "Posible dilapidación de recursos" y "Concentrarse aquí". Se encuentran diferencias entre medias de la muestra de pacientes (n=68) y de familiares acompañantes (n=80) en los atributos de catering (t=-2,38; g.l.=146; p<0,05), y en el de información (t=2,16; g.l.=146; p<0,05). Conclusiones: Los resultados parecen útiles para identificar áreas de interés para los gestores de los servicios de salud para desarrollar programas de humanización de servicios basados en el trabajo de voluntarios y dirigidos a diferentes tipos de usuarios. Las implicaciones para los gerentes de programas de voluntariado e investigadores son discutidas

Objective: Using an Importance-Performance Analysis (IPA), this paper examined a Radiotherapy and Oncological Patient and Non-patient perceived importance and performance of ten Humanization Volunteer Program selection factors in the General Hospital in Spain. Methods: The authors identified a list of seven items from the Health-marketing literature reviews, and each item was rated using a 5-point Likert scale. Responses were obtained of 148 usable interviews. Results: The importance-performance patient grid was corrected with literature recommendations and, in the patient sample, shows three items fall in the "Keep up the good work" quadrant, four items fall into the "Low priority" quadrant, zero items fall into the "Possible overkill" quadrant, and no items fall in the "Concentrate here" quadrant. Nonpatient (n=80) factors means shows statistical differences with patient (n=68) means in catering (t=-2.38; df.=146; p<0.05), and information (t=2.16; df146; p<0.05). Conclusions: The results are useful in identifying areas for strategic focus to help Health Services managers develop humanization programs with volunteer workers and different program users. Implication to volunteer programs managers and researchers were discussed

Change of the editorial board

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Spanish radiobiological pattern of care in lung cancer: a GOECP/SEOR study

INTRODUCTION: A survey regarding radiobiological questions in the treatment of lung cancer (LC) was done to study the clinical aspects of radiotherapy in Spain, in order to standardise treatment decisions. METHODS AND MATERIALS: From November 2007 to March 2008, a survey was performed among radiation oncologists in Spain specialising in LC treatment via e-mail, which included questions regarding different radiobiological aspects of radiotherapy LC treatment. The extent of the resulting material made it necessary to divide it into two parts; the first is presented in this article. The second, which includes items about alpha/beta-NTCP/TCP values and reirradiation criteria, will be reported elsewhere. RESULTS: Thirty-one radiation therapists from 29 radiation oncology departments answered the survey. 77.4-93.5% of responders used the basic formula from the linear-quadratic model and/or computer software for radiobiological calculations; 100% used lung (mostly V20, median <30%) and spinal cord constraints (mostly a median of physical maximum dose <45.5 Gy); and 90.3% used heart and oesophagus constraints (very heterogeneous parameters in both organs). CONCLUSIONS: Radiobiological considerations are clearly present in the planning process of radiotherapy of LC in Spain, with a high coincidence with the literature regarding lung and spinal cord constraints. The heterogeneity shown for oesophagus and heart results demonstrates the need for continuing investigation into the standardisation of clinical, dosimetric and radiobiologic aspects of the treatment of this cancer (AU)

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Aspectos generales del dolor por cáncer. Experiencia del Grupo Andaluz-Extremeño / General aspects of cancer pain. Experience of the Andalusian-Extremaduran Group

Objetivos: Establecer la incidencia de dolor en los pacientes con cáncer en los Servicios de Oncología Radioterápica, así como su control siguiendo las recomendaciones de la Organización Mundial de la Salud (OMS). Material y métodos: Se analizó la incidencia de dolor y su tratamiento en pacientes sometidos a radioterapia o en revisión, reclutados durante 2 semanas en diferentes Servicios de la Comunidad Autónoma Andaluza y Extremeña. Para evaluar la intensidad del dolor se utilizó la Escala Analógica Visual (EVA). Resultados: De los 544 pacientes sometidos al estudio el dolor estuvo presente, en diferentes intensidades, en el 39,7 por ciento, siendo más frecuente en el grupo sometido a tratamiento que en aquellos en revisiones periódicas, correspondiendo el mayor número a pacientes con EVA < 3 (dolor débil o moderado). Conclusiones: El dolor es un síntoma frecuente en los pacientes con cáncer, afectando al 40 por ciento de los pacientes de nuestro estudio. A pesar de ello un amplio número de pacientes no reciben analgesia (19,4 por ciento) y de los que la reciben, en un alto porcentaje no se hace siguiendo las recomendaciones de la OMS, ya sea por exceso o por defecto. Ello hace necesario la creación de grupos –Alleviare– para extender su conocimiento y tratamiento adecuado (AU)