The Impact of COVID-19 on US Radiation Oncology Residents.

The purpose of our study is to assess the impact of COVID-19 on the clinical responsibilities, training, and wellness of US radiation oncology residents. An anonymous cross-sectional survey was sent to all 91 radiation oncology residency programs in the USA. The survey included questions related to demographics, changes in clinical duties and training, job prospects, and wellness indicators. Univariate and multivariate logistic regression analyses were used to evaluate factors associated with residents endorsing high satisfaction with their departments' response to COVID-19. A total of 96 residents completed the survey from 67 US radiation oncology programs. In the multivariate logistic regression model, remote contouring (OR: 3.91 (95% CI: 1.11, 13.80), p = 0.03) and belief that one will be adequately trained to independently practice after completing residency (OR: 4.68 (1.12, 19.47), p = 0.03) were significantly associated with high resident satisfaction with their department's response to COVID-19. Most residents indicated that hypofractionation was encouraged to a greater extent (n = 79, 82.3%), patients were triaged by disease risk (n = 67, 69.8%), and most agreed/strongly agreed that they have been provided with adequate personal protective equipment (PPE) (n = 85, 88.5%). The COVID-19 pandemic has affected the training and wellness of radiation oncology residents. Our analysis suggests that radiation oncology programs might increase resident satisfaction with their department's response to COVID-19 by enabling remote contouring and working with residents to identity and remedy possible concerns regarding their ability to independently practice post residency.

Systematic Review and Meta-Analysis on the Use of Photon-based Stereotactic Radiosurgery Versus Fractionated Stereotactic Radiotherapy for the Treatment of Uveal Melanoma.

PURPOSE: The purpose of this report is to assess the efficacy and adverse event profile of photon-based stereotactic radiosurgery (SRS) compared with fractionated stereotactic radiotherapy (fSRT) for the treatment of uveal melanoma. Primary outcomes include incidence proportions of local control, enucleation, metastatic progression, disease-specific, and overall mortality. Treatment-related toxicities such as incidence proportions of radiation retinopathy, neovascular glaucoma, optic neuropathy, and cataract formation were examined as secondary outcomes. Five-year survival and 5-year local control rates were also assessed. MATERIALS AND METHODS: PubMed, Embase, Web of Science, Scopus, and 2 Cochrane databases were searched up to December 31, 2018. Random effects models were used to calculate pooled incidence proportions of outcome measures. Meta-regression was carried out to explore the potential impact of dose per fraction on local control. RESULTS: Twenty-four articles with a total of 1745 patients were included in the meta-analysis. There were no statistically significant differences between photon-based fSRT and SRS for all primary, secondary and 5-year outcome measures, including local control (P=0.28), enucleation (P=0.51), and neovascular glaucoma (P=0.40). The 5-year local control rate was 90% (95% confidence interval: 76%, 96%) for fSRT and 89% (70%, 97%) for SRS. CONCLUSIONS: Our meta-analysis showed no difference in tumor control, survival and toxicities, as defined in this paper, between SRS and fSRT for uveal melanoma. Confounding biases remain an expected limitation in this study of novel treatment modalities deployed in rare tumors. Further investigation is needed to validate outcomes and compare stereotactic treatment techniques.

IPLaminator: an ImageJ plugin for automated binning and quantification of retinal lamination.

BACKGROUND: Information in the brain is often segregated into spatially organized layers that reflect the function of the embedded circuits. This is perhaps best exemplified in the layering, or lamination, of the retinal inner plexiform layer (IPL). The neurites of the retinal ganglion, amacrine and bipolar cell subtypes that form synapses in the IPL are precisely organized in highly refined strata within the IPL. Studies focused on developmental organization and cell morphology often use this layered stratification to characterize cells and identify the function of genes in development of the retina. A current limitation to such analysis is the lack of standardized tools to quantitatively analyze this complex structure. Most previous work on neuron stratification in the IPL is qualitative and descriptive. RESULTS: In this study we report the development of an intuitive platform to rapidly and reproducibly assay IPL lamination. The novel ImageJ based software plugin we developed: IPLaminator, rapidly analyzes neurite stratification patterns in the retina and other neural tissues. A range of user options allows researchers to bin IPL stratification based on fixed points, such as the neurites of cholinergic amacrine cells, or to define a number of bins into which the IPL will be divided. Options to analyze tissues such as cortex were also added. Statistical analysis of the output then allows a quantitative value to be assigned to differences in laminar patterning observed in different models, genotypes or across developmental time. CONCLUSION: IPLaminator is an easy to use software application that will greatly speed and standardize quantification of neuron organization.