Research Organization Document

Phase I
The Research Basics lecture identified the following steps in beginning the research
process:
1. Select a philosophical foundation
2. Determine group interest
3. Research your interests and develop a research problem
4. Find a supporting problem/develop a theory base (literature review)
5. Develop scientific question/query and select a research design
In the discussion forum, you should have narrowed down your interests into a single topic.
This document will help you apply these essential steps to your capstone project topic.
1. What philosophical foundation are you pursuing? Why?
 Logical positivism. Our group will be using measurable data and deductive
reasoning to conduct our research. We believe this foundation most closely
aligns with our research methodology due to the use of statistical data and
fact.

2. What is your group interest? (This would be the high-level idea that you
listed/discussed in the discussion forum).
 One commonality with head and neck treatments is a re-simulation due to
weight loss. How can therapists or physicians better predict when this re-
simulation needs happen? Is there a volumetric threshold with the body.
Contour that would indicate a change in dose to the PTV from a body
contour?

3. Find a 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 interest/topic.
 What is the research problem? Your working problem statements below.
 Patient weight loss causes significant changes in dose distribution within
proton therapy. No finite indicator to alert staff that a patient might
need a replan soon or will need to be rescanned and replanned as soon
as possible for optimal treatment.

 What knowledge exists on your interests and the problems you’ve come
up with?
  Conduct a literature review on your topics. If You’ve identified a
potential high-level 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 most pertinent articles that you intend
to use to support your research in AMA formatting in this document.
Refer to this list often. (Note: you will be providing summaries of
these articles in a later assignment so it’s a good idea to hold on to
notes about each article now).
Many articles about the subject we are researching show concern for patient weight loss
and the impact of the treatment plan. None have tried to fully research an exact method to
help catch a patient’s weight loss to signify a replan is needed and alert staff to do so before
it impacts their treatment in a negative way.
1. Mallick I, Gupta SK, Ray R, Sinha T, Sinha S, Achari R, Chatterjee S. Predictors of
weight loss during conformal radiotherapy for head and neck cancers - how
important are planning target volumes? Clin Oncol (R Coll Radiol). 2013
Sep;25(9):557-63. doi: 10.1016/j.clon.2013.04.003. Epub 2013 May 4. PMID:
23651866.
2. Vangelov B, Venchiarutti RL, Smee RI. Critical Weight Loss in Patients With
Oropharynx Cancer During Radiotherapy (± Chemotherapy). Nutr Cancer. 2017
Nov-Dec;69(8):1211-1218. doi: 10.1080/01635581.2017.1367943. Epub 2017 Oct
30. PMID: 29083238.
3. Stauch Z, Zoller W, Tedrick K, Walston S, Christ D, Hunzeker A, Lenards N, Culp L,
Gamez ME, Blakaj D. An evaluation of adaptive planning by assessing the dosimetric
impact of weight loss throughout the course of radiotherapy in bilateral treatment
of head and neck cancer patients. Med Dosim. 2020 Spring;45(1):52-59. doi:
10.1016/j.meddos.2019.05.003. Epub 2019 Jun 17. PMID: 31221447.
4. Martinovic D, Tokic D, Puizina Mladinic E, Usljebrka M, Kadic S, Lesin A, Vilovic M,
Lupi-Ferandin S, Ercegovic S, Kumric M, Bukic J, Bozic J. Nutritional Management of
Patients with Head and Neck Cancer-A Comprehensive Review. Nutrients. 2023 Apr
13;15(8):1864. doi: 10.3390/nu15081864. PMID: 37111081; PMCID:
PMC10144914.
5. Ahn PH, Chen CC, Ahn AI, Hong L, Scripes PG, Shen J, Lee CC, Miller E, Kalnicki S, Garg
MK. Adaptive planning in intensity-modulated radiation therapy for head and neck
cancers: single-institution experience and clinical implications. Int J Radiat Oncol
 Biol Phys. 2011 Jul 1;80(3):677-85. doi: 10.1016/j.ijrobp.2010.03.014. Epub 2010
Jul 9. PMID: 20619553.

4. What is the purpose of your study? This naturally falls in-line with the other
questions as you complete your literature review. What do you hope to find out
after you complete this research? What is the aim? These are all questions you
should ask yourselves.
We would like to determine if there is a better way to deduce when adaptive planning
on a patient undergoing radiation treatments is necessary. Current literature shows that there is
a definite problem with weight loss and tissue changes for patients that are getting radiation to
the head and neck region. Factors like dysphagia, xerostomia, and other side effects from
chemotherapy or radiation are all major factors. It is from these constant tissue and anatomy
changes that there is a push for ways to ensure that dose is being delivered to the proper
locations inside of a patient while sparing as much normal tissue as possible. The most current
method to achieve proper dose distributions seems to be adaptive planning. Adaptive planning
is a major part of modern clinics, and we think that there might be a practical way to determine
when adaptive planning is necessary. With proton therapy, surface tissue changes can greatly
affect the beam delivery due to the nature of the Bragg peak and how a proton beam deposits
dose in tissue. The physics staff at Corewell Health East proton center would like to see the
external tissue falling within 5mm of the planning contours. We think that our proposed
method will help to alert treatment staff when a patient is approaching and has exceeded the
maximum external tissue tolerance and lead to a more consistent method of evaluation for
patient that will eventually need adaptive planning, or a total replan.

5. What are your supporting questions? Develop some key questions that your
reader will know the answer to after reading your research paper that support your
research problem. These questions should require elaboration (a simply stated
yes/no answer question is not permitted). For example:
 Research Question: Where should our next coffee shop location be?
 Supporting Questions: What customer base are we seeking?
- Is there a method to better determine adaptive planning for proton therapy to patients with
head and neck cancer is necessary?
o What are the tolerance limits on external tissue that physicists and physicians
would like to see before adaptive planning is necessary?
o What are the most common causes of tissue changes in patients with head
and neck cancer?
 o Is it necessary to schedule a patient for a new CT simulation when you are
not sure if a new plan will be generated?
o Is our method a viable way of determining when a new plan is necessary to
save extra, and often non necessary, dose to a patient?

6. 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.
 Experimental/quantitative

Submit this document to the appropriate assignment area when instructed.