Clinical and Translational Radiation Oncology最新文献

{"title":"Regular aerobic exercise ameliorates radiation-induced pulmonary fibrosis: An animal study","authors":"Da Bin Ko ,&nbsp;Seungwoo Cha ,&nbsp;Jae Yong Jeon ,&nbsp;Su SSan Kim ,&nbsp;Won Kim ,&nbsp;Sei Won Lee ,&nbsp;Joongkee Min ,&nbsp;Si Yeol Song ,&nbsp;Seung Hak Lee","doi":"10.1016/j.ctro.2025.100951","DOIUrl":"10.1016/j.ctro.2025.100951","url":null,"abstract":"<div><h3>Background and purpose</h3><div>A definitive treatment for radiation-induced pulmonary fibrosis (RIPF), a common side effect of radiation therapy for thoracic cancer, remains to be established. Pulmonary rehabilitation programs, including regular aerobic exercise, may ameliorate RIPF. However, a scientific basis supporting the protective effect of exercise against RIPF is lacking.</div></div><div><h3>Methods</h3><div>Seven-week-old Sprague-Dawley rats were randomly allocated to the control (CON), training without irradiation (T), irradiation only (IR), and irradiation with training (IR + T) groups. Irradiation of the right lung was commenced at 40 Gy over five consecutive days, followed by regular aerobic exercise training using a treadmill for 7 weeks. The variables were assessed before and after irradiation. Pulmonary fibrosis was assessed using Masson’s trichrome (MT) staining and hydroxyproline (HYP) assay. Behavioral tests were conducted to evaluate functional changes. In addition, potential molecular mechanisms were explored.</div></div><div><h3>Results</h3><div>The body weights of the rats in the IR and IR + T groups were lower than those in the other two groups. The Rota-rod test revealed significantly higher exercise capacity in the IR + T group compared to that in the IR group, which was closer to that in the CON group. MT staining and HYP assay revealed that the amount of fibrosis in the IR + T group was significantly lower than that in the IR group (collagen area (%): IR, 28.00 ± 7.51, n = 7; IR + T, 24.03 ± 6.93, n = 9; HYP concentration (μg/mg): IR, 0.80 ± 0.09, n = 7; IR + T, 0.47 ± 0.14, n = 9; <em>p</em> &lt; 0.05). Superoxide dismutase activity in the IR + T group was higher than that in the IR group (IR, 84.02 ± 12.56, n = 7; IR + T, 100.55 ± 11.18, n = 9; <em>p</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>Regular aerobic exercise ameliorated RIPF in rats, suggesting its potential utility in pulmonary rehabilitation programs for patients undergoing thoracic radiation therapy.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100951"},"PeriodicalIF":2.7,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697533","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":"Concurrent chemoradiotherapy versus radiotherapy alone in postoperative high-risk adenoid cystic carcinoma of the head and neck: A propensity score matched analysis","authors":"Shengjin Dou ,&nbsp;Xin Wang ,&nbsp;Ying Xiao ,&nbsp;Lin Zhang ,&nbsp;Wen Jiang ,&nbsp;Lulu Ye ,&nbsp;Yu Wang ,&nbsp;Yining He ,&nbsp;Shengwen Liu ,&nbsp;Rongrong Li ,&nbsp;Guopei Zhu","doi":"10.1016/j.ctro.2025.100945","DOIUrl":"10.1016/j.ctro.2025.100945","url":null,"abstract":"<div><h3>Background</h3><div>The role of concurrent chemoradiotherapy (CCRT) in postoperative head and neck adenoid cystic carcinoma (ACC) remains controversial due to the limited evidence from randomized trials. This study assessed the effectiveness of CCRT by comparing a prospective CCRT group with a retrospective radiation（RT） alone group using propensity score matching (PSM).</div></div><div><h3>Methods and materials</h3><div>Postoperative head and neck ACC patients with T3-4/N1-3 M0 disease or after R1/R2 resection were enrolled. All patients underwent intensity-modulated radiation therapy (IMRT), and CCRT group received two cycles of concurrent docetaxel and nedaplatin. To ensure comparability, PSM were utilized. Following PSM, survival outcomes were analyzed using Kaplan-Meier curves and compared using the log-rank test.</div></div><div><h3>Results</h3><div>A prospective CCRT group of 55 patients and a retrospective RT alone group of 160 patients were included. The multivariate Cox regression analysis showed no association between CCRT and overall survival (OS) (hazard ratio [HR] = 0.71, 95 %CI: 0.24–2.08, p = 0.537), or other survival outcomes. To mitigate potential confounding factors, a 1: 1 PSM analysis was performed. With a median follow-up of 51 months, post-PSM analysis (including 48 patients in each group) indicated no significant differences in OS (estimated 5-year OS rates: 90.7 % versus 84.3 %, p = 0.331), locoregional recurrence-free survival (LRRFS) (p = 0.261), distant metastasis-free survival (DMFS) (p = 0.425), or disease-free survival (DFS) (p = 0.600) between two groups. The multivariate Cox regression analysis also showed no association between CCRT and OS (HR = 0.29, 95 %CI: 0.06–1.38, p = 0.119), or other survival outcomes.</div></div><div><h3>Conclusion</h3><div>The addition of concurrent chemotherapy to postoperative IMRT did not confer a survival benefit in terms of LRRFS, DMFS, DFS, or OS in patients with head and neck ACC. Upcoming results from randomized studies are anticipated to shed more light on this debated issue. CCRT should be avoided outside of clinical trials.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100945"},"PeriodicalIF":2.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143687836","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":"Predicting radiation-induced hypothyroidism in nasopharyngeal carcinoma patients using a deep learning model","authors":"Yichen Mao ,&nbsp;Mingjun Ding ,&nbsp;Dan Zong ,&nbsp;Zhongde Mu ,&nbsp;Xia He","doi":"10.1016/j.ctro.2025.100946","DOIUrl":"10.1016/j.ctro.2025.100946","url":null,"abstract":"<div><h3>Background</h3><div>Radiation-induced hypothyroidism (RIHT) is a common complication in nasopharyngeal carcinoma patients. Predicting its onset is crucial for effective management and early intervention. This study aims to develop a model based on deep learning survival analysis to predict RIHT in nasopharyngeal carcinoma patients.</div></div><div><h3>Methods</h3><div>This retrospective study included 535 nasopharyngeal carcinoma patients between January 2015 and October 2020. Cox regression, LASSO-Cox analyses and Spearman correlation test were employed to identify significant predictors. Two deep learning and two machine learning algorithms were trained, tuned, and compared against traditional Cox and NTCP models by C-index, Brier score, and decision curve analysis.</div></div><div><h3>Results</h3><div>The study observed a 41.7 % incidence of RIHT, with a median time to onset of 15 months. AJCC N stage, thyroid volume and specific dose-volume parameters were identified as potential predictors. DeepSurv model outperformed traditional ones (C-index: DeepSurv 0.75, traditional models ≤ 0.63). While other models were competitive at early post-treatment intervals, deep learning models demonstrated superior performance over time. Calibration and decision curve analysis corroborated the enhanced predictive capability of DeepSurv. Feature importance analysis highlighted thyroid V30 and V50 as the most significant predictors.</div></div><div><h3>Conclusions</h3><div>DeepSurv demonstrated superior predictive performance for RIHT in nasopharyngeal carcinoma patients compared to traditional models. Deep learning-based predictions offer high accuracy, which may enable personalized patient management and have great potentials in mitigating the risk of RIHT. These findings suggested that incorporating such model into clinical practice could be beneficial for the management of RITH.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100946"},"PeriodicalIF":2.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628667","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":"A dosimetric comparison of different radiotherapy modalities for Non-Resected oligometastatic liver Disease","authors":"Cas Stefaan Dejonckheere ,&nbsp;Mateusz Bilski ,&nbsp;Younèss Nour ,&nbsp;Davide Scafa ,&nbsp;Paweł Cisek ,&nbsp;Katarzyna Korab ,&nbsp;Julia Ponikowska ,&nbsp;Ewa Wojtyna ,&nbsp;Sylwia Sroka ,&nbsp;Fabian Kugel ,&nbsp;Molina Grimmer ,&nbsp;Jasmin Holz ,&nbsp;Stephan Garbe ,&nbsp;Patrick Eich ,&nbsp;Eleni Gkika ,&nbsp;Gustavo Renato Sarria ,&nbsp;Julian Philipp Layer","doi":"10.1016/j.ctro.2025.100947","DOIUrl":"10.1016/j.ctro.2025.100947","url":null,"abstract":"<div><h3>Purpose</h3><div>The role of radiotherapy in the context of limited liver metastases is emerging rapidly with a variety of available technical approaches. Here, we provide a dosimetric comparison of three different radiotherapy modalities for non-resected liver metastases.</div></div><div><h3>Methods</h3><div>This multicentric study included 30 patients previously treated for solitary liver metastases. Interstitial high dose-rate brachytherapy (HDR), stereotactic body radiation therapy (SBRT), and kilovoltage electronic brachytherapy (eBT) with a single dwelling point, as an in this context novel modality, were planned with a 25-Gy single fraction and dosimetrically compared. The primary endpoint was difference in healthy liver tissue exposure. Secondary endpoints included target volume coverage, dose to the surrounding organs at risk (OARs), and radiation treatment time.</div></div><div><h3>Results</h3><div>The median (range) lesion volume was 9.3 (2.5 − 29.7) cm³. Electronic BT yielded a significantly better OAR dose sparing compared to SBRT. Radiation exposure to the healthy liver was significantly lower with eBT (V9.1 Gy 13.8 [3.4–41.6] cm³) and HDR (49.2 [12.7–116.8] cm³) when compared with SBRT (98.8 [54.3–303.7] cm³; <em>p</em> &lt; 0.001 for both). Mean treatment time was shortest for SBRT (6.1 min vs. 7.8 min for HDR [<em>p</em> = 0.003] vs. 16.1 min for eBT [<em>p</em> &lt; 0.001]). Equally, CTV D90% and D95% were superior for SBRT (<em>p</em> &lt; 0.001 vs. HDR and eBT).</div></div><div><h3>Conclusion</h3><div>Minimally invasive single-catheter eBT provides a new potential approach in the context of unresectable liver metastases, with optimal OAR dose sparing, yet suboptimal target volume coverage. Combining the advantages of both modalities, a multi-dwelling eBT approach as in HDR might ease applicability in clinical routine with optimized target coverage while maintaining excellent OAR doses. Future prospective investigations are required to further define its role within well-established liver-directed therapies.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100947"},"PeriodicalIF":2.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628668","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":"Stereotactic body radiotherapy for lung oligometastatic prostate cancer: An international retrospective multicenter study","authors":"Maximilien Rogé ,&nbsp;Patrick Bowden ,&nbsp;Paul Conway ,&nbsp;Ciro Franzese ,&nbsp;Marta Scorsetti ,&nbsp;Emmanuel Seront ,&nbsp;Pierre Blanchard ,&nbsp;Mario Terlizzi ,&nbsp;Jonathan Khalifa ,&nbsp;Corentin Pasquier ,&nbsp;Ulrike Shick ,&nbsp;Shankar Siva ,&nbsp;Julie Paul ,&nbsp;Stéphane Supiot","doi":"10.1016/j.ctro.2025.100944","DOIUrl":"10.1016/j.ctro.2025.100944","url":null,"abstract":"<div><h3>Background</h3><div>Management of prostate cancer (PCa) patients with lung oligometastases remains unclear in the absence of published data.</div></div><div><h3>Objective</h3><div>The aim of this study was to evaluate the efficacy of Stereotactic Body Radiotherapy (SBRT) in this setting.</div></div><div><h3>Design, setting, and participants</h3><div>We conducted a multicenter retrospective study that included 35 PCa patients treated with SBRT for lung oligometastases in 7 centers across 3 countries.</div></div><div><h3>Outcome measurements and statistical analysis</h3><div>The efficacy was evaluated by the progression free-survival (PFS), defined as pre-SBRT PSA + 25 % or nadir PSA + 25 % and + 2 ng/mL or radiological progression if it occurred before biochemical progression. The local recurrence free-survival (LRFS), distant metastases free-survival (DMFS), Overall Survival (OS) and Androgen Deprivation Therapy free-survival were also assessed. Survival was estimated using the Kaplan Meier method.</div></div><div><h3>Results</h3><div>35 patients were included with lung oligometastases staged with PET-CT for 97 % and histologically biopsy confirmed for 51 %. 77 % had an oligorecurrent metastatic disease. The median pre SBRT PSA was at 1.7 ng/mL [0.8, 3.0] and the median follow-up after SBRT was 28.7 months. The median PFS was 21.6 months [95 %CI: 21.6; NA] and the median DMFS was 32.4 months [95 %CI: 22.2–NA]. No parameters were significantly associated with PFS on the univariate and multivariate models.</div><div>For patients who did not start ADT before or concomitantly with SBRT (n = 18), the 1-year ADT free-survival rate was estimated at 87.2 % [71.9;100].</div></div><div><h3>Conclusions</h3><div>SBRT for PCa lung oligometastases offers good oncological outcomes, comparable to those reported for bone and/or lymph node metastases SBRT. Our results encourage the inclusion of patients with lung oligometastatic disease in clinical trials designed to assess the value of SBRT.</div></div><div><h3>Patient summary</h3><div>SBRT for prostate cancer lung oligometastases shows promising results, similar to treatments for bone or lymph node oligometastases.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100944"},"PeriodicalIF":2.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143601344","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":"Utilization of a stabilized hyaluronic acid spacer in SBRT for retroperitoneal cancers: A case series and dosimetric analysis","authors":"Shing Fung Lee ,&nbsp;Nathanial Harris ,&nbsp;Pui Lam Yip ,&nbsp;Jenna Dean ,&nbsp;Brayden Geary ,&nbsp;George Koufogiannis ,&nbsp;Melanie Bauer ,&nbsp;Daryl Lim Joon ,&nbsp;Farshad Foroudi ,&nbsp;Ee Siang Choong ,&nbsp;Michael Chao","doi":"10.1016/j.ctro.2025.100943","DOIUrl":"10.1016/j.ctro.2025.100943","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the clinical indications, post-operative complications, and dosimetric impact of stabilized hyaluronic acid (sHA) spacer insertion in the retroperitoneum for stereotactic body radiation therapy (SBRT) of retroperitoneal cancers.</div></div><div><h3>Patients and methods</h3><div>This retrospective study analyzed two cases of SBRT for retroperitoneal lesions: a primary left renal cell carcinoma and an oligometastatic renal cell carcinoma (RCC) lesion in the right adrenal gland. In both cases, a sHA spacer was percutaneously inserted between the bowel and the lesion. The spacer was placed under laparoscopic and ultrasound guidance for the renal tumor, and under CT guidance for the adrenal lesion. The prescribed dose was 42 Gy in three fractions for the primary renal lesion and 40 Gy in five fractions for the adrenal lesion. Dosimetric parameters were evaluated in two planning scenarios: (1) without the spacer, adhering to OAR constraints, and (2) with the spacer.</div></div><div><h3>Results</h3><div>Spacer insertion for the primary left renal cancer significantly improved PTV D95% from 67.9 % to 99.5 % of the prescribed dose, a 46.5 % increase. PTV D99% increased from 54.5 % to 86.7 %, reflecting a 59.1 % improvement. The large bowel’s maximum dose was reduced from 28.2 Gy to 24.4 Gy, and the volume receiving 24 Gy was minimal with the spacer (0.06 cc). For the right oligometastatic adrenal lesion, despite a fourfold increase in tumor volume, post-spacer dosimetry showed improved PTV coverage without exceeding OAR constraints. No post-operative complications were observed in either case.</div></div><div><h3>Conclusion</h3><div>This is the first report on sHA spacer use in the retroperitoneum for SBRT. Spacer insertion near the large bowel significantly improves dosimetry, enabling higher doses to targets while keeping OAR doses within safe limits. Further research with a larger patient population is required to assess safety and for optimization of the technique for spacer placement in order to enhance clinical outcomes.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100943"},"PeriodicalIF":2.7,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591730","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":"Prospective planning comparison of magnetic resonance-guided vs. internal target volume-based stereotactic body radiotherapy of hepatic metastases – Which patients do really benefit from an MR-linac?","authors":"Philipp Hoegen-Saßmannshausen ,&nbsp;C. Katharina Renkamp ,&nbsp;Hoi Hin Lau ,&nbsp;David Neugebauer ,&nbsp;Nina Niebuhr ,&nbsp;Carolin Buchele ,&nbsp;Fabian Schlüter ,&nbsp;Elisabetta Sandrini ,&nbsp;Line Hoeltgen ,&nbsp;Fabian Weykamp ,&nbsp;Sebastian Regnery ,&nbsp;Jakob Liermann ,&nbsp;Eva Meixner ,&nbsp;Kevin Zhang ,&nbsp;Oliver Sedlaczek ,&nbsp;Heinz-Peter Schlemmer ,&nbsp;Laila König ,&nbsp;Jürgen Debus ,&nbsp;Sebastian Klüter ,&nbsp;Juliane Hörner-Rieber","doi":"10.1016/j.ctro.2025.100941","DOIUrl":"10.1016/j.ctro.2025.100941","url":null,"abstract":"<div><h3>Purpose/objective</h3><div>To compare online MR-guided SBRT (MRgRT) of liver metastases with state-of-the-art ITV-based SBRT (ITV-SBRT) and assess which patients benefit most from MRgRT.</div></div><div><h3>Materials and methods</h3><div>In a prospective randomized trial (MAESTRO study, NCT05027711), patients were randomized to either gated and online adaptive MRgRT or ITV-SBRT if a biologically effective dose (BED₁₀) of 100 Gy was feasible with ITV-SBRT. Otherwise, patients were treated with MRgRT. In this subgroup analysis of 20 patients, a dosimetric comparison of MRgRT and ITV-SBRT plans was performed. Tumor control and normal tissue complication probabilities were calculated.</div></div><div><h3>Results</h3><div>In 40 % of all patients, MRgRT enabled SBRT with less fractions and/or higher prescription BED₁₀. Almost all target volume metrics were improved with MRgRT. MRgRT PTV D95% was significantly higher in the overall cohort (91.0 ± 22.9 Gy vs. 79.5 ± 27.2 Gy, p = 0.001), in uncritical (111.3 ± 6.2 Gy vs. 104.7 ± 4.1 Gy, p = 0.022) and in critical cases with limited healthy liver volume or nearby gastrointestinal organs at risk (74.1 ± 16.9 Gy vs. 58.5 ± 18.5 Gy, p = 0.041). Target volume V100% was also superior with MRgRT. Calculated 2-year tumor control probability was significantly superior with MRgRT overall (73.0 ± 6.2 % vs. 69.7 ± 7.9 %, p = 0.002), in uncritical cases (78.3 ± 1.4 % vs. 76.8 ± 1.0 %, p = 0.022) and in critical cases (68.5 ± 4.8 % vs. 63.8 ± 5.8 %, p = 0.041), without elevated normal tissue complication probability.</div></div><div><h3>Conclusion</h3><div>Dosimetrically, gated MRgRT was beneficial for virtually all the hepatic metastases analyzed in this study. Patients with metastases located critically near gastrointestinal OAR or with limited healthy liver volume should be allocated to centers providing MRgRT.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100941"},"PeriodicalIF":2.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551981","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":"Correlation between radiation dose to bone marrow subregions and acute hematologic toxicity inendometrial cancer treated with external beam radiotherapy","authors":"R. Autorino ,&nbsp;D. Cusumano ,&nbsp;R.M. Rinaldi ,&nbsp;R. Giannini ,&nbsp;V. De Luca ,&nbsp;M. Campitelli ,&nbsp;V. Lancellotta ,&nbsp;S. Di Franco ,&nbsp;G. Macchia ,&nbsp;G. Ferrandina ,&nbsp;M.A. Gambacorta","doi":"10.1016/j.ctro.2025.100942","DOIUrl":"10.1016/j.ctro.2025.100942","url":null,"abstract":"<div><h3>Aim</h3><div>To identify dosimetric parameters associated with acute hematologic toxicity (HT) in endometrial cancer treated with volumetric modulated arc therapy (VMAT-RT).</div></div><div><h3>Methods</h3><div>Patients with uterine adenocarcinoma treated in our Institution from March 2019 to November 2022 were retrospectively enrolled in this study. All patients underwent adjuvant external beam radiotherapy with Volumetric modulated arc therapy (VMAT) strategy plus a brachytherapy boost on vaginal cuff. When indicated, adjuvant platin-based chemotherapy was administered after surgery in upfront or sandwich setting. Pelvic bone marrow was contoured for each patient and divided into three subsites: lumbosacral spine (LSBM), ilium (IBM) and lower pelvis (LPBM). The volume of each region receiving 10,20,30 and 40 Gy (V10, V20, V30, V40, respectively) and mean dose (Dmean) was collected. Hematological toxicity during radiotherapy treatment was graded according to the CTCAE V 5.0. Linear logistic regression models were used to test associations between dosimetric parameters and HT.</div></div><div><h3>Results</h3><div>Data from 99 patients were retrospectively analyzed. Adjuvant external beam radiotherapy was delivered to the pelvis with Volumetric modulated arc therapy (VAMT) strategy for a total dose of 45  Gy, 1.8  Gy/fraction plus a brachytherapy boost on vaginal cuff for a total dose of 10 Gy in 2 fractions weekly. Thirty-one patients developed during radiotherapy treatment an HT ≥ grade 2.</div><div>With a sensitivity of 83.3 % and specificity of 61.5 %, V20 Gy LSBM &lt; 64 % is associated to a maximum 20 % risk of Grade 2 or worse HT in patients with &lt; 60 years old; for patients older than 70, the risk of toxicity is below 20 % independently by the percentage volume of V20Gy LSBM (95 % CI 0.60–0.87; p = 0.03).</div><div>No association between hematological toxicity and V10-20–30-40 or Dmean of IBM and LPBM were observed.</div><div>Dosimetric parameters involving the lower pelvis had stronger association with hematological toxicity than those involving the ilium, even if not significant.</div></div><div><h3>Conclusions</h3><div>In this experience a dose constraint age-dependent was proposed, to reduce the risk of HT.</div><div>The volume of lombo-sacral pelvis receiving low-dose radiation (V20 LSBM &gt; 64 %) seems to be associated with HT in younger patients; instead in older than 70 patients the percentage of V20Gy LSBM seems not correlate with risk of toxicity. Future investigations should seek to confirm these findings through the inclusion of these parameters in the planning process.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100942"},"PeriodicalIF":2.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551980","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":"Magnetic resonance imaging to detect tumor hypoxia in brain malignant disease: A systematic review of validation studies","authors":"Y. Bai ,&nbsp;E.C. Osmundson ,&nbsp;M.J. Donahue ,&nbsp;J.B. De Vis","doi":"10.1016/j.ctro.2025.100940","DOIUrl":"10.1016/j.ctro.2025.100940","url":null,"abstract":"<div><div>Tumor hypoxia indicates a worse prognosis in brain malignancies; however, current gold-standard methods for assessing tumor hypoxia are invasive and often inaccessible. Magnetic Resonance Imaging (MRI) is widely available, but its validity for identifying tumor hypoxia or hypoxia-related neoangiogenesis is not well characterized. A systematic literature search was performed across PubMed and Embase Databases. The search query identified MRI studies that validated hypoxia-surrogate imaging sequences against gold-standard hypoxia or neoangiogenesis detection methods in patients with brain malignancies. Literature screen identified 23 manuscripts published between 2007 and 2022. Among conventional MRI sequences, peritumoral edema and signal change after contrast administration were associated with gold-standard oxygen-assessment methods. T2*- and T2′-derived measures were associated with gold-standard methods, while reports on quantitative measures of oxygen extraction fraction were conflicting. Fiber density, tissue cellularity, blood volume, vascular transit time, and permeability measurements were associated with gold-standard methods, whereas blood flow measurements yielded conflicting results. MRI measures are promising surrogates for tumor hypoxia or hypoxia-related neoangiogenesis. Additional studies are needed to reconcile disparate findings. Future sensitivity analyses are needed to establish the MRI methods most accurate at identifying tumor hypoxia.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100940"},"PeriodicalIF":2.7,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520619","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":"Letter to the Editor: Reply to Topkan et al","authors":"Claudia Schweizer ,&nbsp;Vratislav Strnad","doi":"10.1016/j.ctro.2025.100938","DOIUrl":"10.1016/j.ctro.2025.100938","url":null,"abstract":"<div><div>We thank the colleagues Topkan and the co-authors for their valuable comments on our study. As they stated correctly, there for sure are more factors influencing the development of necrosis – nicotine and alcohol might also play an important role, for example. Also some hints point at the distance of the catheters being associated with risk of necrosis. Due to the fact that the risk factors influence each other in their effect on the risk of necrosis and usually have an additive effect and due to the generally retrospective data collections in published articles on interventional radiotherapy in the oral cavity, some risk factors for late side effects cannot be perfectly recorded and evaluated. In our understanding, not only the distance to the mandible, but also the bone volume which is affected by radiation dose must be considered. No specific dose constraints exist for the mandible when applying interventional radiotherapy. We are currently analyzing further dose parameters available within CT-based planning workflows and hope for more detailed information on how we can improve the implants. Nevertheless, prospective data is needed to sufficiently address toxicity issues in a larger cohort of patients with long-term follow-up. As far as the disease-free survival is concerned, we indeed estimated this according to the current practice in several other published data without taking the event of death into account. This is obvious when looking at our results. Still, we agree that the different ways of presenting freedom of recurrence throughout the literature makes comparison rather difficult and should be unified. We thank you for your remark and will consider this in our future work.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100938"},"PeriodicalIF":2.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578964","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}