Group 9

Michael S Wheatley

Elizabeth Mcginnis

Thomas Sutherland
DOS - 711

Research Organization Document

Phase I
In the lecture from this week, you learned about the first few essential steps to a successful
research project.
1. Select a philosophical foundation
2. Investigate a topic
a. Develop a research PROBLEM
3. Find a supporting problem/develop a theory base (literature review)
4. Develop scientific question/query and select a research design
This document will help you apply these essential steps to your capstone project.
1. What philosophical foundation are you pursuing? Why?
For this project the group will be pursuing the experimental type of philosophical
design. The nature of the research will involve strictly looking at data, dose to organ
at risk, as our determining factor for outcome of research.

2. What is your topic idea?

The groups topic is the limiting of lumbosacral plexus (LSP) dose in pelvic with
paraaortic treatment planning cases by delineating the LSP as an organ at risk.

a. What is a problem that you can solve? Just because a topic is interesting doesn’t
mean that it is researchable. You MUST have a problem to solve. A good place to
start is to ask your clinical educators what are some problems they have
encountered in their clinics?
i. Is there routinely a dosimetric planning constraint that they can’t meet
necessitating the need to investigate a NEW way to plan that site?
Based on feedback from our clinical mentors, the LSP is not a standard organ
at risk that is routinely contoured and tracked for dose constraints.
ii. Does your clinic routinely have collision issues with the
gantry/couch/patient? Could you come up with a solution?
 iii. Did your clinic recently implement a new technology (FFF capabilities,
Vision RT, bladder scanning etc.)? Is your clinical manager seeking
feedback from staff on how the process is going?
iv. Is there a step of the radiation oncology treatment process
(referralschedulingconsultsimulationtreatment
planningtreatment) that doesn’t transition easily? Or errors occur
frequently? Could you solve this problem?

3. Find a supporting problem/develop a theory base. These concepts are combined

because both concepts support the idea that you need to determine what’s out there
on your particular topic. What knowledge exists on your topic? Conduct a literature
review on your topic. You’ve identified a problem to solve but how do you know
that someone else hasn’t already researched this problem? This is the purpose of a
literature review. You need to find peer-reviewed scholarly articles that support
the need for your proposed research. The pertinent articles that you find will be
used to confirm or refute the results of your study so the research must be current
(5 years old at the most). The only circumstance in which older articles should be
used is in the case of task group reports, QUANTEC or similar monumental articles.
List the articles that you intend to use to support your research in AMA formatting
in this document. Refer to this list often.
In researching this topic, we came across many articles looking at the need for
better dose constraints regarding LSP in pelvic cancer treatments. Most of the
research looked at dose constraints that were established for the V40 and V50
constraints that would fit our patient population.
Here are some of the articles that we used:

References

1. Vinciguerra C, Nardone V, Sicurelli F, Guida C, Cappabianca S. Lumbosacral plexopathy in

pelvic radiotherapy: An association not to be neglected; A systematic review, Arch Neurosci.
2019;6(4):1-6. http://dx.doi.org/10.5812/ans.86686

2. Min M, Roos D, Keating E, et al. External validation of the lumbosacral plexus-contouring

protocol developed by Yi et al. (IJROBP 2012; 84: 376-82) for pelvic malignancies. J Med
Imaging  Radiat Oncol. 2014;58:117-124. http://dx.doi.org/10.111/1754-9485.12106
3. Tunio M, Al Asiri M, Bayoumi Y, et al. Lumbosacral plexus delineation, dose distribution,
and its correlation with radiation-induced lumbosacral plexopathy in cervical cancer
patients. Onco Targets  Ther.  2015;8:21-27. http://dx.doi.org/10.2147/OTT.S71086

4. Delanian S, Lefaix J, Pradat P. Radiation-induced neuropathy in cancer survivors. Radiat

Oncol. 2012;105(3):273-282. http://dx.doi.org/10.1016/j.radonc.2012.10.012

5. Yi S, Mak W, Yang C, et al. Development of a standardized method for contouring the

lumbosacral plexus: a preliminary dosimetric analysis of this organ at risk among 15 patients
treated with intensity-modulated radiotherapy for lower gastrointestinal cancers and the
incidence of radiation-induced lumbosacral plexopathy. Int J Radiat Oncol Biol Phys.
2012;84(2):376-382. http://dx.doi.org/10.1016/j.ijrobp.2011.11.074

6. Bourhafour I, Benoulaid M, El Kacemi H, El Majjaoui S, Kebdani T, Benjaafar N.

Lumbosacral plexopathy: A rare long-term complication of concomitant chemo-radiation for
cervical cancer. Gynecol Oncol Res Pract. 2015;2(12):1-4. http://dx.doi.org/10.1186/s40661-
015-0019-9

4. What are your supporting questions? Develop some key questions that your reader
will know the answer too after reading your research paper that support your
research question. These questions should require elaboration (a simply stated
yes/no answer question is not permitted). For example:
a. Research Question: Where should our next coffee shop location be?
b. Supporting Questions: What customer base are we seeking?

Supporting questions would be:

Can volumetric constraints of V40 and V50 be met for the LSP while still providing an
optimal treatment plan to the target volume?

Will delineation of the LSP as an organ at risk become a standard part of VMAT planning to
prevent unwanted dose to that region?

5. What type of research design are you interested in pursuing with this topic? Some
very basic information on each type (experimental/quantitative or
 naturalistic/qualitative) was provided at the end of this week’s lecture. You will get
more into the research design in the coming weeks but you should determine which
design you are going to pursue now.
For this research it will be done using experimental/quantitative design. Our goal is
to review pelvic with paraaortic cancer cases where the LSP was not previously
identified and to retrospectively contour the LSP to track the volumetric doses.
These patients will then be re planned to see if volumetric recommendations can be
met without jeopardizing the original target volumes. (preventing inadvertent dose
dumping in the region).

Remember that the purpose of this document is to brainstorm ideas. You will post answers to
these questions in the private discussion forum for your group. The instructors and advisors will
then review your posts and give you direction on topics that you are seeking.