Clinical and Translational Radiation Oncology最新文献

{"title":"Comment on: Concurrent chemoradiotherapy versus radiotherapy alone in postoperative high-risk adenoid cystic carcinoma of the head and neck: A propensity score-matched analysis","authors":"Erkan Topkan , Efsun Somay , Ugur Selek","doi":"10.1016/j.ctro.2025.100982","DOIUrl":"10.1016/j.ctro.2025.100982","url":null,"abstract":"","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100982"},"PeriodicalIF":2.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanically assisted non-invasive ventilation for liver SABR: Improve CBCT, treat more accurately","authors":"Julien Pierrard ,&nbsp;Nicolas Audag ,&nbsp;Christel Abdel Massih ,&nbsp;Maria Alvear Garcia ,&nbsp;Enrique Alvarez Moreno ,&nbsp;Andrea Colot ,&nbsp;Simon Jardinet ,&nbsp;Romain Mony ,&nbsp;Ana Francisca Nevez Marques ,&nbsp;Lola Servaes ,&nbsp;Thaïs Tison ,&nbsp;Valentin Van den Bossche ,&nbsp;Aniko Wale Etume ,&nbsp;Lamyae Zouheir ,&nbsp;Geneviève Van Ooteghem","doi":"10.1016/j.ctro.2025.100983","DOIUrl":"10.1016/j.ctro.2025.100983","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Cone-beam computed tomography (CBCT) for image-guided radiotherapy (IGRT) during liver stereotactic ablative radiotherapy (SABR) is degraded by respiratory motion artefacts, potentially jeopardising treatment accuracy. Mechanically assisted non-invasive ventilation-induced breath-hold (MANIV-BH) can reduce these artefacts. This study compares MANIV-BH and free-breathing CBCTs regarding image quality, IGRT variability, automatic registration accuracy, and deep-learning auto-segmentation performance.</div></div><div><h3>Materials and methods</h3><div>Liver SABR CBCTs were presented blindly to 14 operators: 25 patients with FB and 25 with MANIV-BH. They rated CBCT quality and IGRT ease (rigid registration with planning CT). Interoperator IGRT variability was compared between FB and MANIV-BH. Automatic gross tumour volume (GTV) mapping accuracy was compared using automatic rigid registration and image-guided deformable registration. Deep-learning organ-at-risk (OAR) auto-segmentation was rated by an operator, who recorded the time dedicated for manual correction of these volumes.</div></div><div><h3>Results</h3><div>MANIV-BH significantly improved CBCT image quality (“Excellent”/“Good”: 83.4 % versus 25.4 % with FB, p &lt; 0.001), facilitated IGRT (“Very easy”/“Easy”: 68.0 % versus 38.9 % with FB, p &lt; 0.001), and reduced IGRT variability, particularly for trained operators (overall variability of 3.2 mm versus 4.6 mm with FB, p = 0.010). MANIV-BH improved deep-learning auto-segmentation performance (80.0 % rated “Excellent”/“Good” versus 4.0 % with FB, p &lt; 0.001), and reduced median manual correction time by 54.2 % compared to FB (p &lt; 0.001). However, automatic GTV mapping accuracy was not significantly different between MANIV-BH and FB.</div></div><div><h3>Conclusion</h3><div>In liver SABR, MANIV-BH significantly improves CBCT quality, reduces interoperator IGRT variability, and enhances OAR auto-segmentation. Beyond being safe and effective for respiratory motion mitigation, MANIV increases accuracy during treatment delivery, although its implementation requires resources.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100983"},"PeriodicalIF":2.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting late renal toxicity using a two-component repair model among pediatric patients receiving total body irradiation for stem cell transplant","authors":"Eric D. Ehler,&nbsp;Grace H. Hutchinson,&nbsp;Jianling Yuan,&nbsp;Kathryn E. Dusenbery","doi":"10.1016/j.ctro.2025.100984","DOIUrl":"10.1016/j.ctro.2025.100984","url":null,"abstract":"<div><h3>Purpose/Objectives</h3><div>Late renal toxicity can be impactful for stem cell transplant (SCT) patients with total body irradiation (TBI) as part of the conditioning regimen. This work describes a two component repair model to predict renal toxicity among pediatric patients.</div></div><div><h3>Materials/Methods</h3><div>Systematic literature searches described in two other reports were used to identify articles describing late renal toxicity in children treated with TBI as part of SCT. Six studies were included with a combined sample size of 172 patients. Data pertaining to TBI and renal toxicity endpoints were extracted. Probability of renal toxicity was analyzed in relation to TBI dose, fractionation, and dose rate. A logistic regression model was developed using studies with sufficient TBI and pediatric outcome data. The toxicity was calculated from reported rates from each study and were primarily based on abnormal laboratory values.</div></div><div><h3>Results</h3><div>Physical dose and a traditional method of calculating EQD2 were tested for a significant dose response relationship although none were found. Instead, a statistically significant relationship was found with a two component sublethal repair EQD2 calculation model using logistic regression (p = 0.03). The model predicted the odds ratio for renal toxicity to be 2.9 Gy⁻¹. Predicted probabilities of 5 %, 10 %, and 50 % clinically significant renal toxicities are associated with EQD2 values of 10.4, 11.1, and 13.2 Gy, respectively.</div></div><div><h3>Conclusions</h3><div>A model to predict the risk of renal toxicity was determined. This model indicates that dose rate and the time interval between fractions are important factors in renal toxicity for pediatric patients receiving SCT with TBI as part of the conditioning regimen.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100984"},"PeriodicalIF":2.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A GORTEC survey on low-risk CTV-P2 delineation in head and neck cancers","authors":"Michel Lapeyre ,&nbsp;Yoann Pointreau ,&nbsp;Marc Alfonsi ,&nbsp;Pierre Boisselier ,&nbsp;Julian Biau ,&nbsp;Pierre Blanchard ,&nbsp;Joël Castelli ,&nbsp;Pierre Graff ,&nbsp;Florence Huguet ,&nbsp;Laurent Martin ,&nbsp;Séverine Racadot ,&nbsp;Xu Shan Sun ,&nbsp;Yungan Tao ,&nbsp;Jean Bourhis ,&nbsp;Juliette Thariat","doi":"10.1016/j.ctro.2025.100980","DOIUrl":"10.1016/j.ctro.2025.100980","url":null,"abstract":"<div><h3>Purpose</h3><div>An international consensus was established in 2018 to standardise practice using geometric (5 + 5 mm) expansion around GTV-P for definitive radiotherapy of squamous cell carcinomas of the head and neck (HNC). The GORTEC (French HNC Oncology and Radiotherapy Group) conducted a survey to assess the level of agreement about CTV-P2 delineation using a “formalised consensus method”.</div></div><div><h3>Methods</h3><div>The 32 proposals of the 2018 consensus on CTV-P2 and 6 additional GORTEC proposals were submitted to 13 GORTEC radiation oncologists (RO). Proposals were rated as “suitable” for median scores ≥7, “unsuitable” for scores ≤3.5 or “uncertain.” The degree of agreement was high (≥85 %), moderate (75–84 %) or low (&lt;75 %). Suitable proposals were reviewed by 40 other RO for final recommendations.</div></div><div><h3>Results</h3><div>The 2018 proposals were “uncertain” with low degrees of agreement (41.5–69 %), except for T1 tumors, which had 89 % agreement. Five out of 6 GORTEC proposals were “suitable” and one “uncertain.” The final recommendation was “suitable and to be retained” by 97.5 % of RO, as follows: To obtain CTV-P2, GORTEC recommends applying a “geo-anatomical” approach. Using the geometric concept, 10 mm-isotropic margins are applied to the GTV, for all locations but the hypopharynx (10 mm antero-posterior, laterally and 15 mm craniocaudally). CTV-P2 is further modified using the anatomical concept (anatomical barriers, dissemination routes) and accounting the benefit/risk balance and proximity of organs at risk.</div></div><div><h3>Conclusion</h3><div>The GORTEC survey derived from the 2018 international CTV-Ps delineation consensus suggests a “geo-anatomical” approach for the delineation of CTV-P2 in HNC.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100980"},"PeriodicalIF":2.7,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SBRT in recurrent oligometastatic ovarian cancer: An EORTC Y-ECI GCG systematic review","authors":"Constance Huck ,&nbsp;Melpomeni Kountouri ,&nbsp;Ramon Yarza ,&nbsp;Gloria Marquina ,&nbsp;Manuel Espantaleon ,&nbsp;Judith Kroep ,&nbsp;Fernanda Herrera ,&nbsp;Ainhoa Madariaga ,&nbsp;Noelia Sanmamed","doi":"10.1016/j.ctro.2025.100981","DOIUrl":"10.1016/j.ctro.2025.100981","url":null,"abstract":"<div><div>Managing recurrent oligometastatic ovarian cancer with a limited disease burden is challenging, requiring localized treatments to achieve durable control while reducing systemic therapy exposure. Stereotactic body radiotherapy (SBRT) offers high precision and ablative dosing, minimizing toxicity to adjacent organs. This systematic review analyzed nine studies involving 426 patients and 809 lesions treated with SBRT. Patients had a median age of 61.2 years and underwent a median of three prior systemic treatments. SBRT, delivered at a median dose of 40 Gy, achieved a pooled median progression-free survival (PFS) of 10.32 months (95 % CI: 2.79–38.26) and a 2-year overall survival rate of 78 %. Local outcomes were promising, with a target lesion control rate of 95.9 % and a lesion response rate of 86 %. SBRT delayed systemic therapy initiation, with a median time of 9.45 months, and was well tolerated, with mostly mild toxicities (CTCAE grade ≤ 2). Rare grade 3 and 5 gastrointestinal toxicities were reported. Despite these encouraging results, the studies were limited by moderate to serious risk of bias, heterogeneity in treatment protocols, and variations in SBRT dose and fractionation. These findings highlight SBRT’s potential as an effective treatment for oligometastatic ovarian cancer, but further research is needed to refine strategies, standardize regimens, and identify patient subgroups most likely to benefit. Prospective trials are eagerly awaited to establish SBRT’s role in improving outcomes for this challenging clinical scenario.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100981"},"PeriodicalIF":2.7,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vitro measurement of proton RBE: A multi-centric comparison using a harmonized setup","authors":"Olga Sokol ,&nbsp;Anders Tobias Frederiksen ,&nbsp;Mateusz Sitarz ,&nbsp;Brita Singers Sørensen ,&nbsp;Elham Santina ,&nbsp;Christopher Smith ,&nbsp;John-William Warmenhoven ,&nbsp;Marie Davídková ,&nbsp;Anna Jelínek Michaelidesová ,&nbsp;Irina Danilová ,&nbsp;Oldřich Zahradníček ,&nbsp;Amélia Maia Leite ,&nbsp;Ludovic de Marzi ,&nbsp;Frederic Pouzoulet ,&nbsp;Paweł Olko ,&nbsp;Justyna Miszczyk ,&nbsp;Barbara Orzechowska ,&nbsp;Eleftherios Papalanis ,&nbsp;Mehran Hariri ,&nbsp;Diana Spiegelberg ,&nbsp;Marco Durante","doi":"10.1016/j.ctro.2025.100978","DOIUrl":"10.1016/j.ctro.2025.100978","url":null,"abstract":"<div><h3>Background and purpose</h3><div>This study presents a multi-center comparison of in vitro cell survival measurements and RBE calculations following proton irradiations conducted under harmonized experimental conditions across six European institutions participating in the INSPIRE framework.</div></div><div><h3>Materials and methods</h3><div>V79-4 cells were irradiated using spread-out Bragg peak (SOBP) proton fields of two configurations delivering 6 and 8 Gy with widths of 6 and 4 cm, respectively. Each center adhered to a standardized protocol, utilizing the same phantom design to minimize uncertainties related to sample positioning. X-ray reference irradiations were also performed to assess cell radiosensitivity across the participating centers.</div></div><div><h3>Results</h3><div>Despite the consistent protocol, significant inter-institutional variability was observed in the survival measurements. For both treatment plans, the largest variation was detected in the most distal points of the SOBP (coefficients of variation of 43 % and 60 % for the 6 Gy and 8 Gy plans, respectively). Kruskal-Wallis statistical test confirmed the significant differences between the centers for each of the measured position in the proton field for both SOBP configurations. Discrepancies were observed in calculated RBE data as well, albeit preserving the expected trend for the values to slightly increase towards the distal edge of the SOBP (up to 1.5 and 1.3 for the 6 Gy and 8 Gy plans, respectively).</div></div><div><h3>Conclusion</h3><div>The results of the study highlight the minimal biological variation one could expect performing proton RBE measurements in well-aligned experimental conditions and challenges in conducting large-scale, multi-center radiobiological experiments and inter-comparisons between literature data sets.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100978"},"PeriodicalIF":2.7,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: Reply to Chen et al.","authors":"Wilma D. Heemsbergen,&nbsp;Kim C. de Vries,&nbsp;Luca Incrocci","doi":"10.1016/j.ctro.2025.100979","DOIUrl":"10.1016/j.ctro.2025.100979","url":null,"abstract":"<div><div>We have read the Letter to the Editor of Chen et al. with great interest, and appreciate their pursuit to expand the discussion on how patient-reported outcomes can inform toxicity risk stratification and supportive care strategies in real-world settings. We have added our vision to their raised points in order to contribute to this useful discussion.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100979"},"PeriodicalIF":2.7,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review of the tools and outcomes for the assessment of acute radiation dermatitis severity","authors":"Partha Patel ,&nbsp;Syed Minhaj Rahman ,&nbsp;Tara Behroozian ,&nbsp;Samuel Finkelstein ,&nbsp;Lauren Kanee ,&nbsp;Elwyn Zhang ,&nbsp;Suvam Banerjee ,&nbsp;Michele Aquilano ,&nbsp;Pierluigi Bonomo ,&nbsp;Raymond J. Chan ,&nbsp;Edward Chow ,&nbsp;Adrian Wai Chan ,&nbsp;Jennifer Yin Yee Kwan ,&nbsp;Shing Fung Lee ,&nbsp;Henry Wong ,&nbsp;Corina van den Hurk ,&nbsp;Mark Trombetta ,&nbsp;Julie Ryan Wolf ,&nbsp;on behalf of the Multinational Association of Supportive Care in Cancer MASCC Oncodermatology Study Group Radiation Dermatitis Tools Working Group","doi":"10.1016/j.ctro.2025.100977","DOIUrl":"10.1016/j.ctro.2025.100977","url":null,"abstract":"<div><div>Acute radiation dermatitis (ARD) is a common adverse effect experienced by patients undergoing radiation therapy. Effective assessment tools to accurately measure and manage ARD’s impact on patients’ quality of life and treatment outcomes is needed. The aim of this study was to evaluate the diverse tools and outcome measures used in the assessment of ARD. A systematic review of MEDLINE®, Embase, and Cochrane was conducted for records 1946-March 2024. A total of 423 studies, including 227 randomized controlled trials (RCTs), were included in the analysis. The review identified 58 distinct tools utilized in the assessment of ARD including clinician and patient-reported outcomes, quality-of-life instruments, and biophysical measures. The most frequently employed tools were the Radiation Therapy Oncology Group criteria, Common Terminology Criteria for Adverse Events, Skindex-16, Visual Analogue Scale, Dermatology Life Quality Index, European Organization for Research and Treatment of Cancer Quality of Life C30, Radiation-Induced Skin Reaction Assessment Scale, Skin Toxicity Assessment Tool, photography, reflectance spectrophotometry, and the corneometer. This investigation into ARD assessment tools reveals a broad application of instruments but is limited by a pervasive lack of consensus, preventing the endorsement of a standardized toolset. The variability in tool use necessitates further research, particularly high-quality RCTs, to establish validated and reliable measures. Future publications, including Delphi consensus-based recommendations, are anticipated to address these gaps, aiming to standardize ARD assessment methodologies.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100977"},"PeriodicalIF":2.7,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of dose calculation approaches and clinical dose–response in image-guided head&neck brachytherapy of the oral cavity","authors":"Sabrina Schaller ,&nbsp;Vratislav Strnad ,&nbsp;Claudia Schweizer ,&nbsp;Dorota Lubgan ,&nbsp;Ricarda Merten ,&nbsp;Rainer Fietkau ,&nbsp;Christoph Bert ,&nbsp;Andre Karius","doi":"10.1016/j.ctro.2025.100968","DOIUrl":"10.1016/j.ctro.2025.100968","url":null,"abstract":"<div><h3>Purpose</h3><div>Model-based dose calculation algorithms (MBDCAs) are increasingly applied in brachytherapy, but their considerations in dose–response analyses is still lacking. This study aimed to assess correlations between both TG-43 and MBDCA dosimetry and reports on clinical outcomes for oral cavity brachytherapy.</div></div><div><h3>Methods</h3><div>We considered 158 patients with oral cavity cancer treated in our institution between 2012 and 2021. Survival outcomes and toxicity (soft tissue necrosis, osteoradionecrosis, mucositis, xerostomia) were reported for a median follow-up of 80 months (2–152 months). All clinical, TG-43 based treatment plans were re-calculated using a MBDCA integrated into our planning system. Differences considering several target volume, tissue, and bone dose parameters were evaluated. Parameter correlations with clinical outcomes and thresholds associated with increased toxicity were investigated.</div></div><div><h3>Results</h3><div>Cumulative local recurrence, soft-tissue necrosis, osteoradionecrosis, mucositis, and xerostomia rate were 21 %, 22 %, 28 % and 79 % considering all patients. Substantial differences between MBDCA and TG-43 were observed, especially regarding high-dose areas with changes up to 19 %. A number of dose-toxicity correlations were observed, as for osteoradionecrosis (1.6 % vs. 10.3 % for bone D_2ccm ≥ 59.3 Gy), soft tissue necrosis (16 % vs. 32 % for tissue D_5ccm ≥ 87.7 Gy), and local recurrence (13 % vs. 25 % for dose non-uniformity ratio &lt; 0.29) (using the MBDCA). Target volumes ≥ 10.2–11.8ccm were associated with increased rates of soft tissue necrosis and mucositis. Dosimetric thresholds and correlations differed between TG-43 and MBDCA.</div></div><div><h3>Conclusion</h3><div>For oral cavity brachytherapy, several important dosimetric thresholds associated with increased toxicity were determined. MBDCAs for corresponding dose calculations should be advanced and used in clinical practice.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100968"},"PeriodicalIF":2.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of radiotherapy in the management of metastatic rectal cancer: A narrative review on the opportunities for non-operative management and organ preservation","authors":"Reza Ghalehtaki ,&nbsp;Parmida Sadat Pezeshki ,&nbsp;Amirali Azimi ,&nbsp;Fatemeh-sadat Tabatabaei ,&nbsp;Nina N. Sanford ,&nbsp;Krishan R. Jethwa","doi":"10.1016/j.ctro.2025.100976","DOIUrl":"10.1016/j.ctro.2025.100976","url":null,"abstract":"<div><div>About 20% of patients with rectal cancer present with metastatic rectal cancer (MRC). The 5-year relative survival for patients with MRC is about 15%. With emerging systemic therapies, including more effective chemotherapy regimens, immunotherapy, targeted therapies, and radiotherapy as a local option, more patients with advanced rectal cancer are achieving complete clinical response in the primary tumor. Consequently, non-operative management (NOM) through a “watch and wait approach” is becoming increasingly desired. Additionally, improved biomarkers, such as circulating tumor DNA (ctDNA), can improve accuracy in predicting responses to neoadjuvant chemoradiotherapy and monitoring recurrence after achieving complete clinical response. In this narrative review, we examine the current evidence on the role of radiotherapy in the management of MRC, with a focus on NOM and organ preservation strategies. Notably, although several investigations have evaluated various aspects of the NOM approach, there is still limited data regarding patient satisfaction and quality of life. The improved quality of life may be a key factor driving patient preference for NOM, and we also emphasize the data on the impact of NOM on patient’s quality of life.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100976"},"PeriodicalIF":2.7,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143918201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}