Clinical and Translational Radiation Oncology最新文献

{"title":"Microscopic intramural spread in patients with rectal cancer after neoadjuvant chemoradiation","authors":"A.E. Verrijssen ,&nbsp;E.J. Van Limbergen ,&nbsp;M. Bellezzo ,&nbsp;H.I. Grabsch ,&nbsp;R. Houben ,&nbsp;D. Goudkade ,&nbsp;J. Melenhorst ,&nbsp;I. Samarska ,&nbsp;G. Paiva Fonseca ,&nbsp;F. Verhaegen ,&nbsp;M. Berbee","doi":"10.1016/j.ctro.2025.100963","DOIUrl":"10.1016/j.ctro.2025.100963","url":null,"abstract":"<div><h3>Objective</h3><div>This study investigates microscopic intramural spread (MIS) after neoadjuvant (chemo)radiotherapy on Total Mesorectal Excision (TME) specimens of rectal cancer patients and explores the necessity of an additional treatment margin for endorectal radiation boosts (for example through contact brachytherapy (CXB)) or local excisions.</div></div><div><h3>Methods</h3><div>A cohort of patients from Maastricht University Medical Center (MUMC + ) treated between 2016 and 2022 was analyzed. Patients underwent MRI, CT scans, and sigmoidoscopy six weeks after radiotherapy, followed by surgery. Pathological analysis of TME specimens, including whole mount macro-cassettes, was performed to measure residual macroscopic tumor and MIS. Fragmented and continuous MIS were recorded parallel and perpendicular to the bowel wall.</div></div><div><h3>Results</h3><div>Out of 54 patients, 37 (69%) exhibited no MIS. MIS was observed in 4/18 (22%) of patients with ycT1-2 tumors and 13/36 (36%) of patients with ycT3-4 tumors. 4 patients (7%) showed continuous MIS and 15 (28%) showed fragmented MIS. No patients with ypT1-2 had MIS.</div></div><div><h3>Conclusions</h3><div>69% of patients do not retain MIS post-neoadjuvant therapy. Knowledge of tumor thickness seems crucial for patient selection for CXB.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100963"},"PeriodicalIF":2.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869387","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":"Pre-Treatment and Pre-Brachytherapy MRI first-order Radiomic Features by a Commercial software as survival predictors in radiotherapy for cervical cancer Objectives","authors":"Wiwatchai Sittiwong ,&nbsp;Pittaya Dankulchai ,&nbsp;Pitchayut Wongsuwan ,&nbsp;Tissana Prasartseree ,&nbsp;Wajana Thaweerat ,&nbsp;Nerisa Thornsri ,&nbsp;Pongpop Tuntapakul","doi":"10.1016/j.ctro.2025.100965","DOIUrl":"10.1016/j.ctro.2025.100965","url":null,"abstract":"<div><h3>Materials and Methods</h3><div>The study included 100 patients with LACC who underwent definitive CCRT with IMRT/VMAT technique followed by 3D-IGABT. MRI-based contouring included T2WI and DWI images for primary tumor (GTVp) and lymph nodes (GTVn). The contours were imported to MIM software to extract first-order radiomic features. Radiomic values from pre-treatment (PreRx), pre-brachytherapy (PreBT), differences between PreRx and PreBT (Diff) radiomic and clinical factors were analyzed using univariate and multivariate Cox regression analysis. Predictive models of PFS, LRFS, DMFS, and OS were created along with the optimism index and calibration plot.</div></div><div><h3>Results</h3><div>The median follow-up time was 24.5 months. The 2-year of PFS, LRFS, DMFS, and OS rates were 71, 88.6, 83.1, and 83.5 %, respectively. For all clinical outcomes, CF + RF combined from PreRx and PreBT resulted in the highest Harrell’s C-index compared with the CF or RF alone. Compare with Diff models, models from PreRx and PreBT resulted in higher Harrell’s C-index. The C-indexes from the CF + RF model from PreRx and PreBT for PFS, LRFS, DMFS, and OS were 0.739, 0.873, 0.830 and 0.967 with the optimism indexes of 0.312, 0.381, 0.316, and 0.242, respectively.</div></div><div><h3>Conclusion</h3><div>Radiomic features from the first-order statistics added values to clinical factors to predict the outcomes after CCRT. The highest prediction model performance was for the combined clinical and radiomics from PreRx and PreBT.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100965"},"PeriodicalIF":2.7,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143860156","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":"An offline adaptive planning method based on delivered accumulated dose for brachytherapy in cervical cancer","authors":"Qi Fu ,&nbsp;Yingjie Xu ,&nbsp;Xi Yang ,&nbsp;Jusheng An ,&nbsp;Zhaohan Li ,&nbsp;Manni Huang ,&nbsp;Jianrong Dai","doi":"10.1016/j.ctro.2025.100964","DOIUrl":"10.1016/j.ctro.2025.100964","url":null,"abstract":"<div><h3>Background and purpose</h3><div>In current clinical practice, independent treatment plan optimization for each fraction of brachytherapy might not be able to fully leverage the dosimetric advantage of the cervical cancer radiotherapy combining external beam radiotherapy (EBRT) and brachytherapy (BT). This study proposed an offline adaptive planning method based on accumulated dose for BT, aiming to improve the total dose distribution of the combined radiotherapy.</div></div><div><h3>Methods and materials</h3><div>This study retrospectively reviewed nine cervical cancer patients treated with EBRT followed by high-dose-rate BT. For each BT fraction, we used a multi-metric deformable image registration method to accumulate the dose distributions of previously delivered EBRT and BT. The accumulated dose distribution was then imported into a customized commercial BT treatment planning system as a background in the adaptive dose optimization. Main dosimetric parameters of the target and organs at risk (OARs) were compared between the adaptive BT (ABT) and conventional BT (CBT) planning methods.</div></div><div><h3>Results</h3><div>For approximately 70 % of the BT fractions, the ABT plans have lower D2cc to the bladder or rectum compared with the CBT plans. In terms of total dose evaluation, the ABT planning method resulted in a decrease in mean values of D2cc, V60 and V50 for the bladder (–1.9 ± 2.0 Gy_EDQ2, –1.2 ± 1.2 %, and –0.9 ± 1.1 %) and rectum (–2.1 ± 1.8 Gy_EQD2, –1.2 ± 1.2 %, and –1.4 ± 1.3 %).</div></div><div><h3>Conclusion</h3><div>The offline adaptive planning method could help decrease the doses to OARs and improve the total dose distribution of combined radiotherapy, showing promising prospects for clinical use.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100964"},"PeriodicalIF":2.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143847637","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":"Splenic function post radiation therapy in childhood cancer survivors","authors":"Joy Fulbright ,&nbsp;Kyla Alsman ,&nbsp;Ashley K. Sherman ,&nbsp;Kris Laurence ,&nbsp;Becky Lowry","doi":"10.1016/j.ctro.2025.100961","DOIUrl":"10.1016/j.ctro.2025.100961","url":null,"abstract":"<div><div>Study evaluated splenic function in childhood cancer survivors (CCS) who had received radiation to the spleen utilizing pRBC PIT (vesiculated erythrocytes) count compared to a non-radiated control group. Those exposed to &lt; 20 Gy of radiation had PIT counts not significantly different from the control group. There was trend for higher pRBC PIT count in those exposed to higher doses of radiation.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100961"},"PeriodicalIF":2.7,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869382","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":"ACO/ARO/AIO-22 – External beam radiotherapy combined with endorectal high-dose-rate brachytherapy in elderly and frail patients with rectal cancer: A prospective multicentre trial of the German Rectal Cancer Study Group","authors":"Hendrik Dapper ,&nbsp;Maximilian Fleischmann ,&nbsp;Nikolaos Tselis ,&nbsp;Markus Diefenhardt ,&nbsp;Ralf-Dieter Hofheinz ,&nbsp;Christian Weiß ,&nbsp;Gerhard G. Grabenbauer ,&nbsp;Ricarda Merten ,&nbsp;Anca-Ligia Grosu ,&nbsp;Simon Kirste ,&nbsp;Stefan Rieken ,&nbsp;Johannes Claßen ,&nbsp;Christian Langer ,&nbsp;Thomas Kuhnt ,&nbsp;Heinz Schmidberger ,&nbsp;Michael Ghadimi ,&nbsp;Frank Giordano ,&nbsp;Ursula Nestle ,&nbsp;Stefan A. Koerber ,&nbsp;Felix Bock ,&nbsp;Emmanouil Fokas","doi":"10.1016/j.ctro.2025.100958","DOIUrl":"10.1016/j.ctro.2025.100958","url":null,"abstract":"<div><h3>Purpose</h3><div>Rectal cancer disproportionately affects the elderly population, with more than half of cases diagnosed in individuals aged 70 years or older. Frail patients in this group often face significant challenges tolerating the standard treatment of total mesorectal excision (TME), due to elevated risks of surgical complications and perioperative morbidity. Advances in radiotherapy techniques offer a viable alternative, providing effective tumor control while minimizing treatment-related toxicity. Recent clinical trials, including OPERA and MORPEUS, have demonstrated that dose-escalated radiotherapy, which integrates external beam (chemo)radiotherapy (EBRT) with high-dose-rate endorectal brachytherapy (HDR-BT) or contact X-ray brachytherapy (CXB), can achieve high clinical response rates and facilitate organ preservation in younger, healthier patient cohorts. Building on these findings, the ACO/ARO/AIO-22 study seeks to adapt these innovative approaches to meet the needs of elderly and frail patients with rectal cancer.</div></div><div><h3>Methods/Design</h3><div>The ACO/ARO/AIO-22 trial is a prospective multicentre controlled trial. Elderly (age ≥70 years) and/or frail patients with non-metastatic rectal adenocarcinoma (cT1-3d N0/+ M0, mrCRM − / +) localized 0–16 cm from the ano-cutaneous line, unable to undergo radical surgery can be included. The initial treatment comprises an external beam radiation (EBRT) regime with 13 × 3 Gy (total: 39 Gy) over a period of two and a half weeks. Following initial restaging 6.5 weeks after completion of EBRT, endorectal HDR-BT will be delivered with 3 weekly fractions of 8 Gy to a total dose of 24 Gy (prescribed at the radial margin of the tumor; with a maximum prescription depth of 10 mm); alternatively, with CXB with 90 Gy in 3 weekly fractions. The primary objective is complete or near complete clinical response (cCR or ncCR) and the second primary endpoint is quality of life (QoL) measured with the EORTC QLQ-ELD14, both at 12 months after treatment start.</div></div><div><h3>Discussion</h3><div>The ACO/ARO/AIO-22 prospective multicentre trial will evaluate organ preservation rates and QoL after combining EBRT with endorectal HDR-BT in elderly and/or frail patients with rectal cancer.</div><div><strong>Trial Registration:</strong> <span><span>Clinicialtrials.gov</span><svg><path></path></svg></span> number: NCT06729645.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100958"},"PeriodicalIF":2.7,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833244","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":"Stereotactic body radiotherapy for early glottic cancers: Is this “The Way”?","authors":"Jennifer Le Guévelou ,&nbsp;Audrey Larnaudie ,&nbsp;Pierre Blanchard ,&nbsp;Yoann Pointreau ,&nbsp;Joël Castelli","doi":"10.1016/j.ctro.2025.100962","DOIUrl":"10.1016/j.ctro.2025.100962","url":null,"abstract":"<div><div>In the past decades, several options have been designed in order to preserve vocal function in patients with early glottic cancer, such as transoral laser microsurgery, new surgical strategies such as partial laryngectomy and radiation therapy (RT). With the development of new radiation techniques enabling a more accurate delivery of radiation dose, and the possibility to deliver high dose per fraction while sparing adjacent organs-at-risks (OARs), stereotactic body radiotherapy (SBRT) is being increasingly tested in this disease setting. We aimed to shed light on this appealing strategy, as well as to underline both optimal target population and specific technical considerations.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100962"},"PeriodicalIF":2.7,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843822","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":"Impact of hypoxic versus oxic conditions on local tumor control after proton irradiation in a rat prostate carcinoma","authors":"Michaela Schmitt ,&nbsp;Christin Glowa ,&nbsp;Ina Kurth ,&nbsp;Peter Peschke ,&nbsp;Stephan Brons ,&nbsp;Christian P. Karger","doi":"10.1016/j.ctro.2025.100957","DOIUrl":"10.1016/j.ctro.2025.100957","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Hypoxia in tumors significantly contributes to radiation resistance, often leading to poor treatment outcomes. <em>In vitro</em> studies demonstrated that proton irradiation not only exhibits an increased relative biological effectiveness (RBE), but also a lower oxygen enhancement ratio (OER). This study explored the impact of hypoxic and oxic conditions on local tumor control after proton irradiation in a rat prostate carcinoma.</div></div><div><h3>Material and methods</h3><div>Subcutaneously transplanted Dunning R3327-HI rat prostate carcinomas were irradiated with varying single doses of protons under oxic or hypoxic conditions. Hypoxia was induced by clamping the tumor-supplying vessels. The biological endpoint was local tumor control assessed 300 days after irradiation. Dose-response curves were determined and based on the doses required for 50 % tumor control probability (TCD₅₀), the RBE and OER were calculated.</div></div><div><h3>Results</h3><div>The TCD₅₀ value was significantly higher under hypoxic than under oxic conditions (73.4 ± 1.9 Gy vs. 50.5 ± 1.6 Gy), resulting in an OER of 1.45 ± 0.06 for proton irradiation. Compared to photon irradiation, the RBE for protons was of 1.23 ± 0.07 under oxic and 1.30 ± 0.04 under hypoxic conditions.</div></div><div><h3>Conclusion</h3><div>Proton irradiations showed a 5 % reduction in OER compared to the previously measured photon value of 1.53 ± 0.08, suggesting a slightly higher effectiveness of protons in hypoxic tumors as compared to photons.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100957"},"PeriodicalIF":2.7,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143839629","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":"Examining the role of elective pelvic radiotherapy in patients Diagnosed with high- and very High-Risk Non-Metastatic prostate cancer","authors":"István Nahaji ,&nbsp;Zsuzsa S. Kocsis ,&nbsp;Andrea Kovács ,&nbsp;Levente Varga ,&nbsp;László Gesztesi ,&nbsp;Kliton Jorgo ,&nbsp;Zoltán Takácsi-Nagy ,&nbsp;Csaba Polgár ,&nbsp;Péter Ágoston","doi":"10.1016/j.ctro.2025.100960","DOIUrl":"10.1016/j.ctro.2025.100960","url":null,"abstract":"<div><h3>Introduction</h3><div>In the treatment of node-negative, non-metastatic high-risk (HR) and very high-risk (VHR) prostate cancer, the necessity of elective pelvic irradiation is controversial. According to our in-house treatment protocol − elective pelvic irradiation is generally omitted for HR and VHR patients over the age of 70 or those in poor general health due to its toxicity.</div></div><div><h3>Objective</h3><div>To retrospectively examine the outcome for HR and VHR prostate cancer patients treated with elective whole pelvic radiotherapy (WPRT) versus prostate-only radiotherapy (PORT).</div></div><div><h3>Materials and Methods</h3><div>The study included 434 patients treated with definitive radiotherapy, 203 patients received PORT (HR: 127, VHR: 76) and 231 WPRT (HR: 113, VHR: 118) with a boost to the prostate. Patients also received 2–3 years of androgen deprivation. Patients’ average age who received PORT vs. WPRT was 73.9 ± 4.3 years vs. 66.4 ± 5.4 years respectively. An inverse propensity score weighting method was utilized to create homogeneous WPRT and PORT treatment groups that are balanced for T stage, PSA, and Gleason score, but not for age. The survival outcomes for HR and VHR subgroups were examined depending on whether they received WPRT or PORT. Biochemical- (BRFS), local- (LRFS) and regional relapse-free survival (RRFS), distant metastasis-free- (DMFS), disease-free- (DFS), failure-free- (FFS), and overall survival (OS) were compared using the Kaplan −Meier method and Cox regression analysis.</div></div><div><h3>Results</h3><div>The median follow-up time was 76 months (3–134 months). In the VHR subgroup five-year outcomes showed a significant advantage for patients receiving WPRT vs. PORT in BRFS (82.2 % vs. 73 %; p = 0.028), in DMFS (87.5 % vs. 73.6 %; p = 0.025), in DFS (86.1 % vs. 70.5 %; p = 0.012), and in FFS (82.3 % vs. 68.9 %; p = 0.005), respectively. The OS (92.8 % vs. 81.8 %; p = 0.056) showed a trend favoring the WPRT group. There was no significant difference between WPRT vs. PORT in LRFS (95.8 % vs. 96.4 %; p = 0.763) and RRFS (95.8 % vs. 89.9 %; p = 0.099). On the contrary, in the HR group, no significant survival differences were observed between WPRT vs. PORT groups: BRFS 93.0 % vs. 93.3 % (p = 0.978), LRFS 99.0 % vs. 100 % (p = 0.120), RRFS 98.2 % vs. 95.1 % (p = 0.813), DMFS 93.5 % vs. 95.5 % (p = 0.793), DFS 91.7 % vs. 92.9 % (p = 0.691), FFS 89.5 % vs. 90.9 % (p = 0.853), OS 91.0 % vs. 87.7 % (p = 0.407).</div></div><div><h3>Conclusion</h3><div>Based on our retrospective data elective pelvic irradiation can be omitted in HR patients, especially over the age of 70. For VHR patients, elective pelvic irradiation should be considered even for the subgroup of elderly patients.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100960"},"PeriodicalIF":2.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826478","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 pattern of local failure after preoperative 5 × 5 Gy in soft tissue sarcomas: A long-term real-world experience","authors":"Konrad Zasadziński ,&nbsp;Aneta Borkowska ,&nbsp;Tadeusz Morysiński ,&nbsp;Hanna Koseła-Paterczyk ,&nbsp;Piotr Rutkowski ,&nbsp;Mateusz Jacek Spałek","doi":"10.1016/j.ctro.2025.100954","DOIUrl":"10.1016/j.ctro.2025.100954","url":null,"abstract":"<div><h3>Introduction</h3><div>Preoperative radiotherapy (RT) is used to improve local control (LC) and facilitate limb-sparing procedures in patients with localized soft tissue sarcomas (STS). While conventional preoperative RT delivers 50–50.4 Gy in 25–28 fractions, alternative hypofractionated regimens are under investigation. A 5x5 Gy regimen has been investigated in STS, but its long-term LC rates appear suboptimal. The aim of this study is to analyze the characteristics of patients with local recurrence (LR) after 5x5 Gy and to identify potential RT-related factors affecting efficacy.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed patients who received 5x5 Gy and underwent surgery for localized extremity and truncal STS in three clinical trials and institutional records. Patient, tumor, and treatment characteristics were evaluated. We assessed the quality of RT plans and recurrence patterns.</div></div><div><h3>Results</h3><div>Among 174 patients who experienced LR after 5x5 Gy, pleomorphic sarcoma (23 %), myxofibrosarcoma (17.8 %), and malignant peripheral nerve sheath tumor (12 %) were the most common pathologic diagnoses. No LR was observed in patients with myxoid liposarcoma. Almost all analyzed plans met the quality criteria. Most patients (86.2 %) had in-volume recurrences, suggesting inadequate tumor cell eradication rather than insufficient margins or poor target coverage. Dose equivalence analysis suggested that 5x5 Gy (EQD2 = 37.5 Gy for STS, assuming alpha/beta ratio of 4 Gy) may be insufficient, especially for radioresistant subtypes.</div></div><div><h3>Conclusions</h3><div>The primary factor contributing to LR after 5x5 Gy appears to be insufficient total dose. Future clinical trials should explore dose escalation beyond 5 Gy per fraction, except in myxoid liposarcoma where 5x5 Gy remains effective.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100954"},"PeriodicalIF":2.7,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rectal stenosis after immunotherapy in a mismatch repair deficient rectal cancer. Case report and review of literature","authors":"Marcel Büttner ,&nbsp;Ulrike Schempf ,&nbsp;Robert Bachmann ,&nbsp;Rüdiger Hoffmann ,&nbsp;Christopher Schroeder ,&nbsp;Sven Mattern ,&nbsp;Stephan Singer ,&nbsp;Marc Steinle ,&nbsp;Maximilian Niyazi ,&nbsp;Michael Bitzer ,&nbsp;Cihan Gani","doi":"10.1016/j.ctro.2025.100953","DOIUrl":"10.1016/j.ctro.2025.100953","url":null,"abstract":"<div><div>We report the case of a 57-year-old male patient who presented with a circumferential cT3 cN1 rectal adenocarcinoma in the mid rectum. The tumor was found to be mismatch repair deficient/microsatellite instable (dMMR/MSI). Instead of multimodality treatment with chemoradiotherapy immunotherapy with Dostarlimab was initiated. Treatment was well-tolerated in general and endoscopy and MRI showed early signs of treatment response. Despite this, the patient developed intestinal obstruction due to scarring that required repeat balloon dilations. In contrast to other oncological treatments, obstructions may worsen during immunotherapy in dMMR rectal cancers. This information has to be considered when patients are consulted regarding the optimal treatment after disease.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100953"},"PeriodicalIF":2.7,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863558","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}