Final plans were then optimized using high-priority MD OARs and low-priority AD OARs and compared with reference plans generated using all MD OARs. Multiple different spatial buffers were used to accommodate different potential delineation uncertainties.
 
  Sixty-seven out of 201 total OARs were identified as low-priority using the proposed methodology, which permitted a 33% reduction in structures requiring manual delineation/review. Plans optimized using low-priority AD OARs without review or modification metall planning objectives that were met when all MD OARs were used, indicating clinical equivalence.
 
  Prioritizing OARs using estimated dose distributions allowed a substantial reduction in required MD and review without affecting clinically relevant dosimetry.
 Prioritizing OARs using estimated dose distributions allowed a substantial reduction in required MD and review without affecting clinically relevant dosimetry.The current reproducibility crisis is fundamentally a crisis of knowledge, thus in reality it is an epistemological crisis. The current reigning paradigm of null hypothesis testing using a P value of less then .05 has made the medical literature prone to be filled with spurious correlations rather than true knowledge. This article brings attention to 3 foundational issues to help navigate the current crisis The problem of induction, the concept of epistemological access, and the iatrogenics of information. Scientific reasoning is inductive reasoning and the problem of induction highlights the limitations of such knowledge. The concept of epistemological access is introduced to describe the inability of low-level data to extract true findings. This lack of true knowledge brings with it the iatrogenics of information, where having more data are in fact harmful and can lead to patients receiving ineffective treatments.
  Stereotactic body radiation therapy (SBRT) has emerged as a potential therapeutic option for locally recurrent rectal cancer (LRRC) but contemporaneous clinical data are limited. We aimed to evaluate the local control, toxicity, and survival outcomes in a cohort of patients previously treated with neoadjuvant pelvic radiation therapy for nonmetastatic locally recurrent rectal cancer, now treated with SBRT.
 
  Inoperable rectal cancer patients with ≤3 sites of pelvic recurrence and >6 months since prior pelvic radiation therapy were identified from a prospective registry over 4 years. SBRT dose was 30 Gy in 5 fractions, daily or alternate days, using cumulative organ at risk dose constraints. Primary outcome was local control (LC).  https://www.selleckchem.com/products/ca-170.html  Secondary outcomes were progression free survival, overall survival, toxicity, and patient reported quality of life scores using the EQ visual analog scale (EQ-VAS) tool.
 
  Thirty patients (35 targets) were included. Median gross tumor volume size was 14.3 cm
  . In addition, 27 lapses from rectal cancer, reirradiation with 30 Gy in 5 fractions is well tolerated and achieves an excellent balance between high local control rates with limited toxicity.
  Reirradiation is rarely administered to patients with recurrent craniopharyngioma owing to concerns regarding visual and endocrine side effects. The purpose of this case series was to evaluate our institutional experience of patients with craniopharyngioma treated with 2 courses of fractionated radiation therapy.
 
  A retrospective study was performed of all patients with craniopharyngioma treated with 2 courses of fractionated radiation therapy at a single institution. Electronic medical records and radiation therapy records were reviewed.
 
  We identified 4 eligible patients with recurrent craniopharyngioma. With a median follow-up of 33 months after reirradiation, 3 patients attained disease control; 1 patient developed progressive disease, 27 months after reirradiation. In 3 evaluable patients, vision remained stable or improved after reirradiation; one patient had no light perception before reirradiation. None of the patients experienced additional endocrine toxicities after reirradiation, apart from one patient who had low serum thyroid stimulating hormone before reirradiation and later developed hypothyroidism after treatment.
 
  Reirradiation may represent a safe and effective therapeutic option for selected patients with recurrent, refractory craniopharyngioma and without other salvage treatment options. Larger studies with longer-term follow up are warranted to better understand outcomes in these patients.
 Reirradiation may represent a safe and effective therapeutic option for selected patients with recurrent, refractory craniopharyngioma and without other salvage treatment options. Larger studies with longer-term follow up are warranted to better understand outcomes in these patients.
  We combined clinical practice changes, standardizations, and technology to automate aggregation, integration, and harmonization of comprehensive patient data from the multiple source systems used in clinical practice into a big data analytics resource system (BDARS). We then developed novel artificial intelligence algorithms, coupled with the BDARS, to identify structure dose volume histograms (DVH) metrics associated with dysphagia.
 
  From the BDARS harmonized data of ≥22,000 patients, we identified 132 patients recently treated for head and neck cancer who also demonstrated dysphagia scores that worsened from base line to a maximum grade ≥2. We developed a method that used both physical and biologically corrected (α/β = 2.5) DVH curves to test both absolute and percentage volume based DVH metrics. Combining a statistical categorization algorithm with machine learning (SCA-ML) provided more extensive detailing of response threshold evidence than either approach alone. A sensitivity guided, minimum input, my provides practical demonstration of combining big data with artificial intelligence to increase volume of evidence in clinical learning paradigms.
 This study provides practical demonstration of combining big data with artificial intelligence to increase volume of evidence in clinical learning paradigms.
  This study aimed to investigate radiomic features extracted from magnetic resonance imaging (MRI) scans performed before and after neoadjuvant chemoradiotherapy (nCRT) in predicting response of locally advanced rectal cancer (LARC).
 
  Thirty-nine patients who underwent nCRT for LARC were included, with 294 radiomic features extracted from MRI that was performed before (pre-CRT) and 6 to 8 weeks after completing nCRT (post-CRT). Based on tumor regression grade (TRG), 26 patients were classified as having a histopathologic good response (GR; TRG 0-1) and 13 as non-GR (TRG 2-3). Tumor downstaging (T-downstaging) occurred in 25 patients. Univariate analyses were performed to assess potential radiomic and delta-radiomic predictors for TRG in pathologic complete response (pCR) versus non-pCR, GR versus non-GR, and T-downstaging. The support vector machine-based multivariate model was used to select the best predictors for TRG and T-downstaging.
 
  We identified 13 predictive features for pCR versus non-pCR, 14 for GR versus non-GR, and 16 for T-downstaging.