Hold fast.

Radiation oncologists love to take their sweet time considering and reconsidering all options. Let’s be honest, the field is virtually the antithesis to trauma surgery. That world order works most of the time, but sometimes quick and steady wins the race. Here’s an interesting report using ExacTrac data to determine the incidence of intrafraction patient movement beyond the tolerated 2 mm during spine stereotactic body radiation (SBRT). Good news is it only happened in 6 out of the more than 1000 cases analyzed. Predictably, though, all 6 cases occurred in the latter half of treatment delivery, echoing commonsense refrains that shorter treatment times are better (we see you FLASH-RT). Speaking of quick, these twin-female co-first authors aren’t wasting any time getting a start on their rad onc residency applications considering they’re both currently high school students. TBL: Dilly-dallying during spine SBRT image review and treatment delivery likely increases the risk of intrafraction patient movement. | Wu & Wu, Pract Radiat Oncol 2019

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