Clinical and Translational Radiation Oncology最新文献

{"title":"Changes in splenic volumes following stereotactic ablative radiotherapy (SABR) to adrenal tumors","authors":"Nicolas Giraud ,&nbsp;Miguel A. Palacios ,&nbsp;John R. van Sornsen de Koste ,&nbsp;Antonio M. Marzo ,&nbsp;Peter S.N. van Rossum ,&nbsp;Famke L. Schneiders ,&nbsp;Suresh Senan","doi":"10.1016/j.ctro.2025.101011","DOIUrl":"10.1016/j.ctro.2025.101011","url":null,"abstract":"<div><h3>Purpose</h3><div>Splenic irradiation can result in life-threatening infections. Updated dose constraints have been recommended for patients undergoing chemoradiotherapy and conventional radiotherapy but splenic constraints were not specified in trials of stereotactic ablative radiotherapy (SABR). We studied splenic doses in patients undergoing SABR for adrenal metastases and late changes in splenic volume (SV).</div></div><div><h3>Material and Methods</h3><div>Patients treated with breath-hold MR-guided SABR for adrenal metastases were identified from an Ethics-approved database. Splenic dose constraints were not routinely used. The spleen was delineated retrospectively on both breath-hold CT and MR-scans. Mean spleen dose (MSD) and relative V_5-10-20-30Gy values were derived from the baseline plan. SV was measured on available follow-up CT scans at 6–12–24 months. Regression analyses were performed to assess SV changes in relation to splenic dose and other parameters.</div></div><div><h3>Results</h3><div>SABR was delivered to 113 adrenal tumors mostly using 5 fractions (64 % of tumors), 3 fractions (19 %) or a single fraction (14 %). Systemic therapy was administered during or within 3 months preceding/after SABR in 51 % of patients. Left-sided tumors comprised 56 % of total, and baseline median MSD and V_10Gy were 9.7 Gy (range 1.5–28.4 Gy) and 46.3 % (range 0–100 %), respectively. Corresponding values for right-sided adrenal plans were 1.5 Gy (0.2–5.9 Gy) and 0 % (0–6.2 %), respectively. In multivariable analysis, a higher MSD was significantly associated with left laterality (p &lt; 0.001), higher prescription dose (p = 0.02), and larger GTV (p &lt; 0.001). An MSD of &gt; 10 Gy was observed in 28 patients (25 %). Among these, a greater than 20 % decrease in SV was found in 46 % of patients with available follow-up at 6 months (n = 59), 40 % at 12 months (n = 47) and 50 % at 24 months (n = 31).</div></div><div><h3>Conclusion</h3><div>Substantial reductions in spleen volume occur in 40–50 % of patients treated with adrenal SABR with an MSD of &gt;10 Gy. The clinical relevance of splenic atrophy merits further study.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 101011"},"PeriodicalIF":2.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571588","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":"Prostate radiotherapy in patients with metastatic hormone-sensitive prostate cancer: A systematic review and meta-analysis of randomised controlled trials","authors":"Navid Roessler ,&nbsp;Marcin Miszczyk ,&nbsp;Alessandro Dematteis ,&nbsp;Fabio Zattoni ,&nbsp;Tamás Fazekas ,&nbsp;Filippo Carletti ,&nbsp;Giuseppe Reitano ,&nbsp;Akihiro Matsukawa ,&nbsp;Ahmed R. Alfarhan ,&nbsp;Angelo Cormio ,&nbsp;Abdulrahman S. Alqahtani ,&nbsp;Timo F.W. Soeterik ,&nbsp;Giulia Marvaso ,&nbsp;Giorgio Gandaglia ,&nbsp;Péter Nyirády ,&nbsp;Paweł Rajwa ,&nbsp;Łukasz Nyk ,&nbsp;Peter Soo Palencia ,&nbsp;Michael S. Leapman ,&nbsp;Barbara A. Jereczek-Fossa ,&nbsp;Shahrokh F. Shariat","doi":"10.1016/j.ctro.2025.101009","DOIUrl":"10.1016/j.ctro.2025.101009","url":null,"abstract":"<div><h3>Introduction</h3><div>The incidence of synchronous metastatic hormone-sensitive prostate cancer (mHSPC) is rising with the increasing use of next-generation imaging. Local radiotherapy (RT) was shown to improve survival in patients with mHSPC; however, new data require a re-assessment of the indication and value of local RT in mHSPC.</div></div><div><h3>Methods</h3><div>In this prospectively registered systematic review and <em>meta</em>-analysis (CRD42025648251), we searched MEDLINE, Scopus, CENTRAL, and Google Scholar in March 2025 for phase 3 RCTs evaluating the addition of RT to systemic therapy to improve OS in mHSPC patients. Hazard ratios (HRs) were pooled using random-effects <em>meta</em>-analysis. Risk of Bias was assessed with Cochrane’s RoB 2 tool.</div></div><div><h3>Results</h3><div>Out of the 10,615 individual records, we identified three RCTs: HORRAD (n = 432), STAMPEDE (n = 2,061), and PEACE-1 (n = 1,173). The systemic treatment included androgen deprivation therapy (ADT) in HORRAD, ADT ± Docetaxel in STAMPEDE, and ADT ± Docetaxel ± Abiraterone in PEACE-1 trial. Local RT was not associated with significantly improved OS in all patients (HR = 0.92; 95 % confidence interval [CI] 0.85–1.00; p = 0.06), or in those with low metastatic burden (HR = 0.74; 95 %CI 0.51–1.06; p = 0.1); however, exploratory analyses showed a significant improvement in androgen deprivation resistance-free survival (HR = 0.76; 95 %CI 0.70–0.82; p &lt; 0.001). Local RT was associated with significant reduction in local prostate cancer related events in the HORRAD (18 % vs. 30 %) and PEACE-1 (12 % vs. 22 %) trials, but not in the STAMPEDE trial (49 % vs. 51 %).</div></div><div><h3>Conclusion</h3><div>Local RT does not improve OS in unselected patients treated with modern systemic therapies for mHSPC. However, it delays ADT resistance and reduces local adverse events, with relatively tolerable toxicity. Future studies should refine selection criteria, ideally using PSMA-PET imaging, dynamic response markers, and/or genomic profiling, to identify mHSPC patients most likely to benefit from local RT.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 101009"},"PeriodicalIF":2.7,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570982","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":"Symptomatic posttreatment edema after stereotactic radiotherapy (SRS/FSRS) for intracranial meningiomas: patterns and predictive factors","authors":"Dorra Aissaoui ,&nbsp;Naoual Oulmoudne ,&nbsp;Houda Bahig ,&nbsp;Giuseppina Laura Masucci ,&nbsp;Robert Moumdjian ,&nbsp;David Roberge ,&nbsp;Cynthia Menard ,&nbsp;Laurent Létourneau-Guillon ,&nbsp;Carole Lambert ,&nbsp;Jean-Paul Bahary","doi":"10.1016/j.ctro.2025.101010","DOIUrl":"10.1016/j.ctro.2025.101010","url":null,"abstract":"<div><h3>Background</h3><div>Symptomatic posttreatment edema (SPTE) is a complication that may develop after radiotherapy for intracranial meningiomas. Our study aims at reviewing rates of SPTE in a large cohort of a single institution and identifying possible predictive factors.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed data of 293 patients with 304 intracranial meningiomas irradiated at our institution between 2005 and 2018. We evaluated rates of SPTE and investigated numerous factors by univariate and multivariate analysis. Kaplan Meier analysis was used for estimation of actuarial local control and overall survival.</div></div><div><h3>Results</h3><div>Median age was 60 years. Meningiomas were treated with fractionated stereotactic radiation therapy (70 %), single fraction stereotactic radiosurgery (24 %) or fractionated stereotactic radiosurgery (6 %). Median imaging follow-up was 60 months, actuarial 10 year local control rate for patients with grade 1 meningiomas who received radiotherapy as definitive treatment was 99 %. Local control at 5 years was 94 % for grade 1 meningioma, 57 % and 53 % for grade 2 and 3 respectively. Sixteen patients (5.5 %) developed SPTE, median time to onset was 3 months (range 1–26 months). the higher rates of SPTE observed were in midline (13 %) and convexity (9 %), compared to skull base tumors (2 %). On univariate analysis, age &gt; 60 years (p &gt; 0.03), pretreatment peritumoral edema (p = 0.014), medline location (p = 0.018), tumor size &gt; 30 mm (p = 0.015) and grade 2 histology (p = 0.03) were predictive of SPTE. On multivariate analysis, only tumor location and size remained statistically significant.</div></div><div><h3>Conclusions</h3><div>Based on our results, patients at high risk of SPTE can be identified based on patient and tumor characteristics. The best treatment technique in high risk patients is yet to be defined.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 101010"},"PeriodicalIF":2.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570981","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":"Changes in prostate volume during prostate SBRT delivered on an MR-Linac and correlation with acute toxicity","authors":"Jason Gurewitz ,&nbsp;Cheongeun Oh ,&nbsp;Sungmin Woo ,&nbsp;Jiyu Kim ,&nbsp;Adam Bruzzese ,&nbsp;Ting Chen ,&nbsp;Hesheng Wang ,&nbsp;David Byun ,&nbsp;Michael J. Zelefsky","doi":"10.1016/j.ctro.2025.101007","DOIUrl":"10.1016/j.ctro.2025.101007","url":null,"abstract":"<div><h3>Purpose</h3><div>We evaluated prostate volume changes during stereotactic body radiation therapy (SBRT) using serial MRI, identifying variables associated with prostatic swelling and their correlation with acute toxicity.</div></div><div><h3>Methods</h3><div>Fifty-two patients with localized prostate cancer, androgen deprivation therapy naive, underwent SBRT to 40 Gy in five fractions on an MRI-Linear Accelerator with dominant intraprostatic lesion boosts to 45 Gy when present. Whole prostate (WP) and transition zone (TZ) measurements were assessed on the pre-treatment T2 MRI obtained for daily adaptation. Volumes were calculated using the ellipsoid formula. Non-transition zone (nonTZ) measures = WP values − TZ values. Transition zone index (TZI) = TZ volume/WP volume. Acute toxicity and International Prostate Symptom Scores (IPSS) were recorded.</div></div><div><h3>Results</h3><div>Prostate volume increased significantly over the first four fractions, peaking at fraction 4 with mean percent and absolute changes of 21 % and 7.8 cc, respectively. Standardized TZ measures were strongly associated with WP volume (β per SD 10.60–12.78; all p &lt; 0.001), whereas the only nonTZ dimension weakly associated was anteroposterior (β per SD 1.78). Each standard deviation increase in baseline TZ parameters doubled to tripled the odds of significant swelling (≥10 cc) (all p ≤ 0.011). The interaction of baseline TZI with later fractions was significantly associated with swelling (fraction 4: β = 12.06, p = 0.020; fraction 5: β = 10.96, p = 0.036), but not baseline TZI alone. Neither Grade 2+ genitourinary toxicity nor IPSS changes were associated with prostate measures or TZI.</div></div><div><h3>Conclusions</h3><div>Prostate volume significantly increases during SBRT, primarily corresponding with TZ volumetric changes. Baseline TZ measurements most strongly predict high-volume swelling. Acute toxicity was not associated with volumetric change.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 101007"},"PeriodicalIF":2.7,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517634","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":"Ten-year survival outcomes of concurrent chemoradiotherapy with or without adjuvant chemotherapy for locoregionally advanced nasopharyngeal carcinoma in the IMRT era: A retrospective cohort study stratified by high- and low-risk profiles","authors":"Wang-Jian Li ,&nbsp;Li-Ting Ling ,&nbsp;Yue Yao ,&nbsp;Kai-Qing Tan ,&nbsp;Bo-Lin Zhu ,&nbsp;Li-Qing Zhou ,&nbsp;Song Qu ,&nbsp;Ling Li ,&nbsp;Ying Guan ,&nbsp;Ling-Hui Pan ,&nbsp;Xiao-Dong Zhu ,&nbsp;Zhong-Guo Liang","doi":"10.1016/j.ctro.2025.101006","DOIUrl":"10.1016/j.ctro.2025.101006","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate 10-year survival outcomes of intensity-modulated radiotherapy (IMRT)-era locoregionally advanced nasopharyngeal carcinoma (NPC) treated with concurrent chemoradiotherapy (CCRT) ± adjuvant chemotherapy (AC), and assess the impact of AC on survival in high-risk and low-risk patients.</div></div><div><h3>Methods</h3><div>This retrospective cohort study analyzed 477 non-metastatic NPC patients (2009–2012) treated with CCRT + AC (n = 315) or CCRT alone (n = 162). Risk stratification into high-/low-risk subgroups utilized a published prognostic model. Kaplan-Meier estimates compared 10-year overall survival (OS), locoregional failure-free survival (LFFS), distant metastasis-free survival (DMFS), and failure-free survival (FFS).</div></div><div><h3>Results</h3><div>The 10-year OS, DMFS, LFFS, and FFS rates for the entire cohort were 71.7 %, 81.4 %, 87.9 %, and 68.1 %, respectively. Compared to CCRT alone, CCRT + AC demonstrated no significant improvement in OS (70.9 % vs. 73.4 %; HR = 1.036, 95 % CI: 0.717–1.497, P = 0.849), LFFS (87.5 % vs. 88.7 %; HR = 1.176, 95 % CI: 0.642–2.154, P = 0.598), DMFS (79.4 % vs. 85.3 %; HR = 1.356, 95 % CI: 0.839–2.191, P = 0.211), or FFS (66.4 % vs. 71.5 %; HR = 1.133, 95 % CI: 0.803–1.599, P = 0.477). In high-risk patients, AC failed to enhance OS (62.7 % vs. 57.5 %; HR = 0.755, 95 % CI: 0.511–1.115, P = 0.156) or other survival endpoints. Notably, AC was associated with reduced OS (84.8 % vs. 94.1 %; HR = 3.319, 95 % CI: 0.966–11.401, P = 0.043) and FFS (77.8 % vs. 92.0 %; HR = 2.596, 95 % CI: 1.064–6.332, P = 0.029) in low-risk patients, while showing no benefit in LFFS or DMFS.</div></div><div><h3>Conclusion</h3><div>The addition of AC to CCRT did not improve 10-year survival outcomes in locoregionally advanced NPC. Moreover, AC may adversely impact survival in low-risk patients, highlighting the need for risk-adapted therapeutic strategies.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 101006"},"PeriodicalIF":2.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510939","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":"Efficacy and safety of the pudendal nerve block as a component of multimodal analgesia for cervical brachytherapy","authors":"Matthew Charles Knox ,&nbsp;Niluja Thiruthaneeswaran ,&nbsp;George Zhong ,&nbsp;Alison Brand ,&nbsp;Unine Herbst ,&nbsp;Emily Flower ,&nbsp;Jennifer Chard ,&nbsp;Alison Salkeld","doi":"10.1016/j.ctro.2025.101001","DOIUrl":"10.1016/j.ctro.2025.101001","url":null,"abstract":"<div><h3>Introduction</h3><div>Whilst an essential component of curative management, cervical brachytherapy is associated with considerable pain and discomfort, with analgesic protocols varying between institutions. We present the first series on adjunctive pudendal nerve block (PNB) in addition to routine anaesthesia.</div></div><div><h3>Methods</h3><div>Retrospective review of patients receiving brachytherapy for cervical malignancies across two time periods, correlating to the institutional introduction of PNB. Technically, bilateral PNB was performed using 1 % ropivacaine under general anaesthesia and intravenous patient-controlled analgesia (PCA) was used post-operatively. Median pain scores (11-point numeric rating scale), acceptability of pain (&lt;20 % of recorded scores ≥ 4), opioid requirement and adverse events are reported. Intracavitary with or without interstitial brachytherapy was performed as per EMBRACE-2 protocol.</div></div><div><h3>Results</h3><div>78 patients receiving 149 brachytherapy episodes were included, of which 95 episodes (64%) utilised PNB. 48% of cases required interstitial needles in both cohorts, with no significant differences in demographics.</div><div>Median pain scores were lower in the PNB cohort (1 vs. 2.5; p = 0.003). PNB was associated with less episodes of unacceptable pain, as defined above (33 % vs. 63 %; p &lt; 0.001). This benefit was sustained on binomial logistic regression, including such factors as number of interstitial needles, baseline opioid use and applicator model choice.</div><div>PNB use was also associated with reduced opioid requirement via PCA (p &lt; 0.001) and there were no differences in the incidence of hypotension, respiratory depression or nausea between cohorts.</div></div><div><h3>Conclusions</h3><div>PNB is an effective and safe adjunct to general anaesthesia and intravenous PCA for cervical brachytherapy, with improved pain and reduced opioid requirements. We advocate for routine use of PNB in addition to multimodal analgesic regimens.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 101001"},"PeriodicalIF":2.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517635","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":"Optimizing predictive accuracy of the two-component repair model for pediatric TBI: Pediatric-specific parameters, toxicity endpoint harmonization, and dose-rate safeguards","authors":"Ruijie Meng","doi":"10.1016/j.ctro.2025.101004","DOIUrl":"10.1016/j.ctro.2025.101004","url":null,"abstract":"<div><div>In response to the innovative two-component repair model for pediatric TBI renal toxicity prediction, this letter proposes three key refinements to enhance clinical translation: adopting pediatric-specific radiobiological parameters (e.g., DNA-PKcs dynamics, α/β ratios) to address systematic overestimation of radiation tolerance; harmonizing toxicity endpoints to CTCAE v5.0 ≥Grade 3 criteria to strengthen doseresponse associations and enable precise risk stratification; and implementing institution-specific minimum dose-rate thresholds to mitigate unmodeled vascular susceptibility during low-dose-rate TBI. Collectively, these optimizations will improve predictive accuracy and support personalized radiotherapy for high-risk pediatric cohorts.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 101004"},"PeriodicalIF":2.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144501201","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":"Decision regret in patients with head-and-neck cancer undergoing radiotherapy","authors":"Anna-Maria Tews ,&nbsp;Andreas Hinz ,&nbsp;Valentin Magnus ,&nbsp;Anna Boide ,&nbsp;Anja Mehnert-Theuerkauf ,&nbsp;Clemens Seidel ,&nbsp;Nils Henrik Nicolay ,&nbsp;Alexander Rühle","doi":"10.1016/j.ctro.2025.101005","DOIUrl":"10.1016/j.ctro.2025.101005","url":null,"abstract":"<div><h3>Purpose</h3><div>Head-and-neck cancer patients often face decisions between treatment options with similar oncological outcomes. In this context, decision regret becomes a central concern, particularly within the framework of shared decision-making. This study aims to assess the prevalence of decision regret and identify associated risk factors among head-and-neck cancer patients.</div></div><div><h3>Methods</h3><div>This cross-sectional observational study included patients who underwent curative radiotherapy for head-and-neck cancer. Decision regret was assessed using the Decision Regret Scale (DRS). Additional patient-reported outcomes included health-related quality of life (HRQoL), psychological distress, anxiety, depression, and fear of cancer progression (FoP).</div></div><div><h3>Results</h3><div>Of 300 eligible patients, 192 participated and filled out the DRS. The median age was 59 years (IQR, 45–65), and the median time between the end of radiotherapy and study participation was 45.5 months (IQR, 24–68.5). No decision regret (0 points) in terms of radiotherapy was reported by 27 %, mild regret (1–25 points) by 34 %, and high regret (&gt;25 points) by 39 %. The mean (SD) DRS score regarding radiotherapy, systemic treatment, and surgery was 23.6 (22.4), 20.8 (19.3), and 20.9 (22.2), respectively. Decision regret was associated with HRQoL (<em>r</em> = -0.34, <em>p</em> &lt; 0.001), distress (<em>r</em> = 0.25, <em>p</em> &lt; 0.001), anxiety (<em>r</em> = 0.20, <em>p</em> &lt; 0.01), depression (<em>r</em> = 0.19, <em>p</em> &lt; 0.01), and FoP (<em>r</em> = 0.29, <em>p</em> &lt; 0.001). In the multiple regression, a poorer ECOG status (β = 0.18, <em>p</em> &lt; 0.01), lower HRQoL (β = -0.22, <em>p</em> &lt; 0.01), and higher FoP (β = 0.19, <em>p</em> &lt; 0.05) were associated with decision regret.</div></div><div><h3>Conclusions</h3><div>More than one-third of head-and-neck cancer patients report high decision regret. These findings highlight the need for enhanced shared decision-making to mitigate decision regret in head-and-neck oncology.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 101005"},"PeriodicalIF":2.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144501200","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":"Cell-specific analysis of microglia following partial brain proton irradiation in mice","authors":"Sindi Nexhipi ,&nbsp;Theresa Suckert ,&nbsp;Johannes Soltwedel ,&nbsp;Elke Beyreuther ,&nbsp;Max Noßol ,&nbsp;Laura Pecht ,&nbsp;Marc Boucsein ,&nbsp;Moritz Schneider ,&nbsp;Felix Horst ,&nbsp;Steffen Löck ,&nbsp;Mechthild Krause ,&nbsp;Armin Lühr ,&nbsp;Antje Dietrich","doi":"10.1016/j.ctro.2025.101003","DOIUrl":"10.1016/j.ctro.2025.101003","url":null,"abstract":"","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 101003"},"PeriodicalIF":2.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570980","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":"Acute toxicity and quality of life in dose-escalated proton reirradiation for locally recurrent rectal cancer: The prospective ReRad II trial","authors":"Truelsen C.G ,&nbsp;Rønde H.S ,&nbsp;Kallehauge J.F ,&nbsp;Szpejewska J.E ,&nbsp;Bahij R ,&nbsp;Diness L.V ,&nbsp;Skriver S.K ,&nbsp;Poulsen L.Ø ,&nbsp;Havelund B.M ,&nbsp;Pedersen B.G ,&nbsp;Iversen L.H ,&nbsp;Spindler K.G ,&nbsp;Kronborg C.S","doi":"10.1016/j.ctro.2025.100999","DOIUrl":"10.1016/j.ctro.2025.100999","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Locally recurrent rectal cancer (LRRC) in pre-irradiated patients remains a clinical challenge. Intensity-Modulated Proton Therapy (IMPT) enables dose escalation with potential for improved tumour control without compromising dose to organs at risk (OAR). However, prospective data on toxicity and patient-reported outcomes (PROs) with quality of life (QoL) are limited.</div></div><div><h3>Materials and Methods</h3><div>This planned interim analysis from the prospective phase II ReRad II trial (NCT04695782) reports acute toxicity and PROs in the first 25 patients treated with dose-escalated IMPT for LRRC. Patients received either 55 Gy (relative biological effectiveness (RBE)) in 44 fractions (neoadjuvant) or 57.5–65 Gy (RBE) in 46–52 fractions (definitive). Acute toxicity was graded using NCI-CTCAE. PROs were assessed using EORTC QLQ-C30 and −CR29 questionnaires at pretreatment, during treatment, and at 3-month follow-up. A linear mixed model evaluated longitudinal PRO trajectories.</div></div><div><h3>Results</h3><div>Among 25 patients, 49 gross tumour volumes resulted in 29 clinical target volumes (median: 84.2 cm³). Median D_mean to bladder, bowel bag, and bowel loops were 7.5, 1.8, and 11.5 Gy(RBE); corresponding D_0.03cc were 58.1, 59.9, and 59.3 Gy(RBE). Grade ≥3 acute toxicity (ileus) occurred in 2 patients with pre-existing ileus episodes. Urinary retention was associated with bladder D_0.03cc(Gy). PROs showed stable global health scores over time, with improvements in emotional and cognitive function.</div></div><div><h3>Conclusion</h3><div>Interim results support the feasibility of dose-escalated IMPT reirradiation for LRRC, with manageable acute toxicity and preserved QoL. Continuance of the trial will inform long-term outcomes and guide future treatment strategies for LRRC management.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 100999"},"PeriodicalIF":2.7,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144491078","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}