Radiotherapy is a common treatment modality for cancer patients. Unfortunately, the treatment can result in skin reactions that may affect their quality of life and clinical outcomes. PILs can provide guidance on managing early symptoms and reduce unscheduled treatment breaks. Evaluating PILs is not frequently evidence-based, and research into evaluating PILs’ inclusiveness for radiotherapy skin reactions does not exist. This study aims to contribute to the knowledge base to better serve the whole radiotherapy population.

A constructivist methodology was developed to evaluate skin-tone inclusivity in the author’s local PILs, and a literature review was conducted to assess the knowledge base and facilitate providing recommendations for improvement.

Publication, diagnostic, language and educational bias were identified in the literature. The content analysis found the author’s departmental PILs were not inclusive of medium and dark-skinned patients.

Further research into radiotherapy PILs inclusivity is warranted. The creation or amendments to existing radiotherapy skin reaction diagnostic tools are needed to cater for the whole population. Diverse educational resources are needed to contribute to the reduction of health inequalities faced by radiotherapy patients.

Head and neck squamous cell carcinomas (HNSCCs) are aggressive tumours lacking a standardised timeline for treatment initiation post-diagnosis. Delays beyond 60 days are linked to poorer outcomes and higher recurrence risk.

A retrospective review was conducted on patients over 18 with HNSCC treated with (chemo)radiation at a rural tertiary care centre (September 2020–2022). Data on patient demographics, oncologic characteristics, treatment details and delay causes were analysed using SPSS.

Out of 93 patients, 35.5% experienced treatment initiation delays (TTIs) over 60 days. Median TTI was 73 days for delayed cases, compared to 41.5 days otherwise. No significant differences in demographics or cancer characteristics were observed between groups. The primary reasons for the delay were care coordination (69.7%) and patient factors (18.2%). AJCC cancer stage showed a trend towards longer delays in advanced stages.

One-third of patients faced delayed TTI, primarily due to care coordination and lack of social support. These findings highlight the need for improved multidisciplinary communication and patient support mechanisms, suggesting potential areas for quality improvement in HNSCC treatment management.

This study compares tumor control probability (TCP) and normal tissue complication probability (NTCP) across different hypo-fractionated (HypoRT) and conventional breast radiotherapy regimens using radiobiological models.

Computed tomography data from 30 patients with left breast-conserving surgery were used to evaluate three HypoRT regimens (39 Gy and 41·6 Gy in 13 fractions, and 40 Gy in 15 fractions) and a conventional regimen (50 Gy in 25 fractions). Dose-volume histograms (DVHs) were extracted for radiobiological calculations using Equivalent Uniform Dose (EUD) and Poisson models for TCP, and EUD and LKB (Lyman-Kutcher-Burman) models for NTCP.

Conventional treatment achieved significantly higher TCP (95%) than all HypoRT regimens (p < 0·001), with no significant differences between HypoRT regimens (p > 0·05. The 39 Gy/13 fraction regimen showed the lowest lung NTCP (p < 0·05). HypoRT regimens had significantly lower NTCP for the lungs and heart compared to the conventional regimen (p < 0·01). TCP and NTCP values from Poisson and LKB models were higher than those from the EUD model (p < 0·01).

HypoRT regimens reduced NTCP, with the lowest values in the regime of 39 Gy/13 fractions regimen, though the conventional regimen had higher TCP.

Brachytherapy is a widely used cancer treatment technique requiring precise dose delivery for optimal outcomes. This study evaluates the dosimetric properties of the ${{\rm{\;}}^{192}}$Ir Flexisource using Gafchromic EBT3 film, adhering to American Association of Physicists in Medicine guidelines.

The EBT3 film was calibrated with a linear accelerator to establish the relationship between optical density and absorbed dose. Measurements were conducted in a water-equivalent solid phantom to simulate human tissue. The dosimetric properties measured included the dose rate constant, radial dose function and anisotropy function.

The results showed a close alignment with reference data: a maximum deviation of 3·1% for the dose rate constant, 2·3% for the radial dose function and 5·67% for the anisotropy function. These deviations are within acceptable limits, indicating high accuracy.

Gafchromic EBT3 film demonstrates reliable dosimetric measurement in high-dose rate brachytherapy. The film’s accuracy in evaluating the ${{\rm{\;}}^{192}}$Ir Flexisource ensures precise treatment delivery and enhances patient safety, supporting its continued use in clinical practice.

To study the simplified sphericity index (SSI) of planning target volume (PTV) and correlate it with the gradient index (GI) for stereotactic radiosurgery (SRS)/stereotactic radiotherapy (SRT) treatment of brain metastasis.

A collection of fifteen brain metastasis cases previously treated with SRS/SRT by volumetric-modulated arc therapy (VMAT) technique was included in the analysis. All the previous plan data from Monaco 6.2.1.0 TPS were used for re-planning and computation of SSI and GI. Pearson’s correlation analysis was performed by using OriginPro 8.5 software, and the outcomes were tabulated.

The statistical analysis and linear fitting of data show a negative linear correlation between SSI and GI, taking SSI as the independent variable and GI as the dependent variable. Pearson’s correlation coefficient (r) was found to be -0.91563 with a p-value of 0.0000124 showing strong statistical significance.

It is observed that the GI of the PTV improves as the SSI increases, that is, when the target volume approaches a perfect sphere. Calculating the SSI of the target before planning may help in predicting the GI which may guide making crucial decisions regarding PTV dose prescription and acceptance criteria for organs-at-risk dose tolerance.

Lung cancer ranks high among the causes of mortality in cancer patients, as per the most recent World Health Organization report. Proton therapy offers a precise approach to treating lung cancer by delivering protons with high accuracy to the targeted site. However, inaccuracies in proton delivery can lead to increased toxicity in healthy tissues. This study aims to investigate the correlation between proton beam dose profiles in lung tumours and the scattered gamma particles.

The study utilised the Gate simulation software to simulate proton beam radiation and an imaging system for prompt gamma imaging during proton therapy. An anthropomorphic Non-uniform rational B-spline (NURBS) cardiac and torso (NCAT) phantom was employed to replicate lung tumours of various sizes. The imaging system comprised a multi-slit collimation system, CsI(Tl) scintillator arrays and a multichannel data acquisition system. Simulations were conducted to explore the relationship between prompt gamma detection and proton range for different tumour sizes.

Following 60 MeV proton irradiation of the NCAT phantom, the study examined the gamma energy spectrum, identifying peak intensities at energies of 2.31, 3.8, 4.44, 5.27 and 6.13 MeV. Adjustments to the proton beam source tailored to tumour sizes achieved a coverage rate of 98%. Optimal energies ranging from 77 to 91.5 MeV were determined for varying tumour volumes, supported by dose distribution profiles and prompt gamma distribution illustrations.

The study evaluated the viability of utilising 2D gamma imaging with a multi-slit collimator scintillation camera for real-time monitoring of dose delivery during proton therapy for lung cancer. The findings indicated that this method is most suitable for small lung tumours (radius ≤ 12 mm) due to reduced gamma emission from larger tumours.

While the study demonstrates promising results in range estimation using prompt gamma particles, challenges were encountered in accurately estimating large tumours using this method.