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Ane Appelt
Physicist, cancer & radiotherapy researcher, trialist, data nerd. Unendingly curious. Global traveller. Associate Professor University of Leeds
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Ane Appelt Nov 25
We will get to see the force in action 🔥🔥🔥 ... and it looks like you are all getting ready to treat some truly intergalactic objects ...
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Ane Appelt Nov 24
Replying to @medphys_matt
Not as easy to view on a browser (or on a phone!), sometimes messes up formatting, harder (at least for me) to access from citation / literature managers.
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Ane Appelt Nov 24
Replying to @mschwarz
I'd say that even without autoplanning, IMRT/VMAT is still easier to plan than 3D-CRT (not alway, but often).
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Ane Appelt Nov 23
Replying to @CGlideHurst
But ... you (the author) could just upload them in pdf in the first place? I've never seen a requirement to submit suppl mat as word?
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Ane Appelt Nov 23
Why do people upload supplementary material for papers as word documents and not pdf? It baffles me
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Ane Appelt Nov 23
That's what I'm thinking - you don't even need automated planning (although nice!), just robust class solutions / templates (compared to fiddling with fields and MLCs for 3D-CRT ...). May not be the case for every anatomical site, but e.g. for rectal cancer definitely
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Ane Appelt Nov 22
I have a pet theory that we have seen significant "stage" migration in rectal cancer (⬆️proportion with higher risk features) over the last 5-10 years; not just with introduction of MRI, but with improved MRI quality & reporting
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Ane Appelt Nov 22
Two things I've been pondering: 1) In a modern RT department, are there any *overall* resource implication of switching to IMRT for rectal cancer? We're in a completely different situation than 5-10y ago - today, most departments are set up for IMRT treatment pathway
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Ane Appelt Nov 23
Replying to @Van_den_Begin
And yes, I see the point about low dose bath. At least we are no longer really concerned about increased secondary cancer risk (I think?), given the overall sparing w/ IMRT. The lymphocytes I can see as an issue though - we need better constrains 🙂
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Ane Appelt Nov 23
Replying to @Van_den_Begin
I'm also surprised by centres which choose 3D-CRT or IMRT on a per-patient bases (or who allow doctors to do so ...). It's a mess trying to maintain two pathways, and you end up with a lot of individual QA when IMRT is prescribed only for specific patients
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Ane Appelt Nov 22
Sorry, didn't mean to imply that it would work for all! And appreciate that you have the actual expertise on this 😉 Just ment it as a specific example of the need for practical advice and individual coaching + feedback
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Ane Appelt Nov 22
Did OPERA test lateral pelvic wall lymph node boosts? (That's what I'm commenting on here!)
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Ane Appelt Nov 22
Replying to @brachyexpert
Thanks! Vey much looking forward to the 25Gy/5 plus Papillon publication! I was primarily asking for dedicated publications / studies of elderly or frail cohorts, though, like for HERBERT?
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Ane Appelt Nov 22
Replying to @Isodose_Gym
I should say that the 'too conformal' (do we miss something important that we didn't know to outline??? or a target that moves???) is a genuine comment that I've heard, not my own personal take 😉
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Ane Appelt Nov 22
I've heard a patient explain how the most important advise she ever got wrt dilators was to use it in the shower while washing her hair. Without that specific bit of practical guidance she would've never consistently used it
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Ane Appelt Nov 22
Does anyone know the margins needed for individual lymph nodes, especially with SIB? How much does a co-registered MRI matter for outlining compared to side-by-side? We have a lot to optimise before we look at MR linacs, protons, and more advanced techniques
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Ane Appelt Nov 22
There is a distinct & problematic lack of IGRT studies for rectal cancer. I'm talking the really basic stuff: Does a rectal filling strategy matter? What's the optimal bladder filling approach? Is daily IGRT necessary? Which (surrogate) match structures should we use?
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Ane Appelt retweeted
Manju George MVScPhD, Mask it or CASKET Nov 22
Patients wanted a third option in the poll, where they were told of vaginal stenosis & dilator use with no instructions.(similar to what mentioned) Patient comment attached with permission. Underscores the role patient communities can play
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Ane Appelt Nov 22
Replying to @DrLesterColl
Super interesting, thank you!
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Ane Appelt Nov 22
Replying to @DrLesterColl
Out of interest: Would you say that you do inherently more contouring for an IMRT plan? (Other than the patient-specific complexity which follows from your selection criteria for IMRT, that is.) If so, what are the additional volumes? And how much longer does it take?
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