Clinical and Translational Radiation Oncology最新文献

{"title":"Response to the Comment on “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;Péter Ágoston","doi":"10.1016/j.ctro.2025.101055","DOIUrl":"10.1016/j.ctro.2025.101055","url":null,"abstract":"<div><div>First of all, we would like to sincerely thank the colleagues who authored the commentary on our article. It is encouraging to see that this complex and difficult-to-study field stimulates high-level academic discourse. Precisely for this reason, we are pleased to address the questions they have raised.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101055"},"PeriodicalIF":2.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145217974","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":"Simulation-free palliative radiotherapy using diagnostic CT scans– is less more? A systematic review","authors":"Daniel R. Zwahlen ,&nbsp;Stefan Brodmann ,&nbsp;Robert Förster ,&nbsp;Paul Windisch ,&nbsp;Elena Hofmann ,&nbsp;André Buchali ,&nbsp;Christina Schröder","doi":"10.1016/j.ctro.2025.101053","DOIUrl":"10.1016/j.ctro.2025.101053","url":null,"abstract":"<div><h3>Background</h3><div>Cancer incidence continues to rise globally, with nearly half of patients requiring radiotherapy. Simulation-free radiotherapy (SFRT) using diagnostic CT scans instead of dedicated planning CTs is a streamlined alternative that may reduce patient visits and shorten time to treatment without impacting quality of care. This systematic review evaluates the practical aspects, dosimetric accuracy, and clinical outcomes of SFRT in palliative radiotherapy.</div></div><div><h3>Methods</h3><div>Following PRISMA guidelines, PubMed and Embase were searched for publications on SFRT using multiple search terms. Included studies reported clinical or logistical endpoints such as treatment timing, toxicity, dosimetric errors, and patient-reported outcomes.</div></div><div><h3>Results</h3><div>Eleven studies met inclusion criteria, comprising retrospective and prospective cohorts with patient numbers ranging from 10 to 1000. SFRT was associated with significantly reduced intervals from consultation to treatment start compared to conventional workflows. Dosimetric uncertainties using diagnostic CT scans were generally low, with higher variability observed in thoracic cases. Patient selection typically excluded treatments involving steep dose gradients, reirradiation, or requiring immobilization devices. Limited clinical outcome data showed favourable toxicity profiles and effective symptom relief.</div></div><div><h3>Conclusions</h3><div>SFRT offers a practical, efficient alternative for palliative radiotherapy, enabling faster treatment initiation and optimized resource use without compromising safety or efficacy in selected patients. The overall dosimetric accuracy appears acceptable for most cases, though caution is advised for thoracic lesions and complex treatment plans. Additional prospective studies with robust clinical endpoints are needed to further validate the role of SFRT in palliative radiotherapy.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101053"},"PeriodicalIF":2.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145217972","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":"First-in-human e-Flash radiotherapy using a modified conventional C-arm linear accelerator","authors":"Jens von der Grün ,&nbsp;Riccardo Dal Bello ,&nbsp;Serena Psoroulas ,&nbsp;Jerome Krayenbuehl ,&nbsp;Debra Fesslmeier ,&nbsp;Egle Ramelyte ,&nbsp;Joanna Mangana ,&nbsp;Wendy Smith ,&nbsp;Marta Vilalta ,&nbsp;Lena Tirpak ,&nbsp;Ricky A. Sharma ,&nbsp;Matthias Guckenberger ,&nbsp;Stephanie Tanadini-Lang ,&nbsp;Panagiotis Balermpas","doi":"10.1016/j.ctro.2025.101047","DOIUrl":"10.1016/j.ctro.2025.101047","url":null,"abstract":"<div><h3>Background</h3><div>The FLASH effect is considered being the widening of the therapeutic window at (ultra-)high dose rates due to sparing of normal tissues while preserving tumor response. Our goal was to provide first data on the safety in treating a patient using a conventional linear accelerator converted to deliver 9 MeV UHDR electron beams in the research setting.</div></div><div><h3>Material &amp; methods</h3><div>A conventional Varian TrueBeam linac was converted in the research setting to become capable of delivering 9 MeV UHDR electron beams. A phase I trial protocol was approved by the local authorities (NCT06549439). One patient with ≥ 1 melanoma (sub)-cutaneous lesion(s) was treated with 3x 9 Gy. The first two fractions were applied via e-Flash and the third via conventional electrons.</div></div><div><h3>Results</h3><div>Here we present the experience of the first patient treated with e-Flash in a modified conventional linac. The e-Flash fractions were successfully delivered according to the protocol. The film in-vivo dosimetry confirmed correctness of the delivered dose. A good tumor response without severe or unexpected toxicity was observed up to six weeks after treatment.</div></div><div><h3>Conclusion</h3><div>We demonstrate first-in-human application of e-Flash delivered by a modified conventional linear accelerator. Conversion of conventional linacs into e-Flash systems will accelerate testing Flash radiotherapy in clinical trials.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101047"},"PeriodicalIF":2.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145156050","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":"Quantifying the flash effect and its dependence on average dose rate in vivo for 6 MeV electron and 6 MV photon beams","authors":"Salomé Paillas,&nbsp;Edward R.J.F. Taylor,&nbsp;Nathalie Lövgren,&nbsp;Iain D.C. Tullis,&nbsp;Kristoffer Petersson","doi":"10.1016/j.ctro.2025.101052","DOIUrl":"10.1016/j.ctro.2025.101052","url":null,"abstract":"<div><div>This study shows that an increase in average dose rate delays the onset, and reduces the severity, of radiation induced skin toxicity in mice following hemi-thorax irradiation. The FLASH sparing effect’s magnitude and dependence on dose rate appear similar following irradiations using 6 MV photon and 6 MeV electron beams.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101052"},"PeriodicalIF":2.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145156049","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":"No differences in therapeutic efficacy while sparing healthy tissue for orthotopic glioblastoma patient-derived xenografts in context of proton FLASH","authors":"Taylor L. Schanel ,&nbsp;Manoj Kumar ,&nbsp;Lauren C. Nassour-Caswell ,&nbsp;Sreelakshmi Cherakara ,&nbsp;Rhea Pandit ,&nbsp;Andee M. Beierle ,&nbsp;Joshua C. Anderson ,&nbsp;Patrica H. Hicks ,&nbsp;Rex Cardan ,&nbsp;Anita B. Hjelmeland ,&nbsp;Christopher D. Willey","doi":"10.1016/j.ctro.2025.101050","DOIUrl":"10.1016/j.ctro.2025.101050","url":null,"abstract":"<div><div>Ultra-high dose rate (FLASH-RT) and conventional proton beam radiotherapy to intracranial glioblastoma PDX were compared for tumor control and normal tissue toxicity via DNA and RNA damage response markers. Both conventional and FLASH radiotherapy yielded similar survival benefits; however, conventional radiotherapy resulted in greater normal tissue DNA and RNA damage.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101050"},"PeriodicalIF":2.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099742","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":"Comments on “Efficacy of radiotherapy and radiotherapy with hyperthermia to delay change of systemic therapy in patients with metastatic melanoma”","authors":"Himanshu Shekhar,&nbsp;Parth Aphale,&nbsp;Shashank Dokania","doi":"10.1016/j.ctro.2025.101048","DOIUrl":"10.1016/j.ctro.2025.101048","url":null,"abstract":"","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101048"},"PeriodicalIF":2.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145217973","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 determination of patient-specific variation challenges the universal RBE gold standard for proton radiation therapy","authors":"Anna Kirstein ,&nbsp;Dan Ionascu ,&nbsp;Michael A.S. Lamba ,&nbsp;Bianca M. Ruffolo ,&nbsp;Katherine J. Crail ,&nbsp;Anthony E. Mascia ,&nbsp;Mathieu G. Sertorio ,&nbsp;Benjamin H. Hinrichs ,&nbsp;Chad Zender ,&nbsp;Maria A. Lehn ,&nbsp;Trisha M. Wise-Draper ,&nbsp;John P. Perentesis ,&nbsp;Yi Zheng ,&nbsp;Susanne I. Wells","doi":"10.1016/j.ctro.2025.101046","DOIUrl":"10.1016/j.ctro.2025.101046","url":null,"abstract":"","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101046"},"PeriodicalIF":2.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109636","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":"Spatially fractionated radiotherapy for re-irradiation: feasibility, safety, treatment planning, and outcomes","authors":"Levi Burns ,&nbsp;Jillian Tsai ,&nbsp;Philip Wong ,&nbsp;Amy Parent ,&nbsp;Yat Tsang ,&nbsp;Monica Serban ,&nbsp;Jelena Lukovic","doi":"10.1016/j.ctro.2025.101049","DOIUrl":"10.1016/j.ctro.2025.101049","url":null,"abstract":"<div><div>Spatially fractionated radiotherapy (SFRT) is emerging as an option to deliver high dose radiation to bulky disease sites with an improved therapeutic ratio compared to established radiotherapy techniques. SFRT has not been previously studied for re-irradiation. We describe three patients with previously irradiated bulky oligometastatic disease to different sites (lung, thigh, and adrenal gland) who were re-treated with SFRT, with intention to relieve or prevent worsening of symptoms. Dose prescription was 66.7 Gy in 5 fractions to uniformly spaced lattice vertices in the gross tumour volume (GTV), with the planning target volume (PTV) receiving 20 Gy at the periphery and a mean dose of approximately 27 Gy. Dose summation and image registration techniques, and selection of organs at risk and dose constraints, were defined on a case-by-case basis. GTV volumes ranged from 272 cm³ to 3183 cm³, and mean dose delivered to the PTV ranged from 26.2 to 27.4 Gy. Two treatment plans met all clinical goals, while one plan had marginal excess dose to two structures. All three patients tolerated SFRT at least as well as their initial radiotherapy courses, with no severe radiation-related adverse events. Two patients were symptomatic prior to SFRT and achieved clinically significant symptom improvement following treatment. SFRT offers a feasible and safe re-irradiation option for bulky metastatic disease in the palliative setting.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101049"},"PeriodicalIF":2.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145217970","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 Topkan et al.","authors":"Shengjin Dou ,&nbsp;Guopei Zhu","doi":"10.1016/j.ctro.2025.100990","DOIUrl":"10.1016/j.ctro.2025.100990","url":null,"abstract":"<div><div>We appreciate the insightful letter from Topkan et al., which highlights important considerations regarding postoperative concurrent chemoradiotherapy (CCRT) in highrisk head and neck adenoid cystic carcinoma (ACC) and offers valuable perspectives on future directions. First of all, we agree that the standard use of CCRT cannot be recommended until prospective evidence is available. While chemotherapy may offer some benefit in local control and overall survival in ACC patients, it inevitably increases the risk of treatment-related toxicities. Therefore, the routine use of CCRT in ACC patients cannot be recommended unless sufficient survival benefit is demonstrated in prospective trials. Second, we recognize that one of the limitations of the study was the relatively small sample size, which may have limited its ability to detect statistically significant differences between the CCRT and RT-alone groups. Given the low incidence of ACC, recruiting an adequately large cohort across multiple centers would require substantial collaboration and coordination. This presents a significant challenge, as the rarity of ACC often results in slow patient recruitment, potentially affecting the generalizability of the findings. Nevertheless, with robust multi-institutional collaboration, such studies remain feasible and could yield valuable insights into treatment outcomes for this patient population.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"55 ","pages":"Article 100990"},"PeriodicalIF":2.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043954","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":"Dosimetric and treatment efficiency comparison of lung SBRT using three different motion management strategies","authors":"Taliah Lansing ,&nbsp;Wendy Harris ,&nbsp;Mitchell Yu ,&nbsp;Zaid Cheema ,&nbsp;Xiuxiu He ,&nbsp;Yabo Fu ,&nbsp;Sang Kyu Lee ,&nbsp;Laura Cervino ,&nbsp;Tianfang Li ,&nbsp;Xiang Li ,&nbsp;Jean Moran ,&nbsp;Boris Mueller ,&nbsp;Daphna Gelblum ,&nbsp;Sean Berry ,&nbsp;Hao Zhang","doi":"10.1016/j.ctro.2025.101044","DOIUrl":"10.1016/j.ctro.2025.101044","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the dosimetry and treatment efficiency of lung stereotactic body radiation therapy (SBRT) using the deep inspiration breath hold (DIBH), free breathing (FB), and respiratory gating (RG) strategies.</div></div><div><h3>Methods and Materials</h3><div>308 lung SBRT patients with middle to lower zone lung tumors were included in this retrospective study. The prescriptions were 1000 cGy x 5 fractions, 1200 cGy x 4 fractions, or 1800 cGy x 3 fractions. They were all treated with a volumetric modulated arc therapy (VMAT) technique and 6 MV flattening filter free (FFF) beam on C-arm linear accelerators, but using different motion management strategies (151 DIBH, 136 FB, 21 RG). The lung dose (mean lung dose (MLD), V5, V20) and treatment time (on table, imaging &amp; verification, delivery) of these patients were retrospectively collected for statistical comparison.</div></div><div><h3>Results</h3><div>The average doses (MLD, V5, V20) to the ipsilateral lung were 408.2 cGy, 20.1 %, 5.7 % for the DIBH cohort, 569.8 cGy, 27.6 %, 8.4 % for the FB cohort, and 519.6 cGy, 23.5 %, 7.5 % for the RG patients. Correspondingly, the average time (on table/imaging &amp; verification/delivery) for the three patient cohorts was 22.3/16.0/6.3 min, 13.6/10.5/3.1 min, and 22.7/14.6/8.1 min, respectively.</div></div><div><h3>Conclusion</h3><div>Quantitative comparison of lung dose and treatment efficiency for three commonly used motion management strategies in lung SBRT is reported. While the relative advantages and disadvantages of these strategies are well recognized, our findings further confirm these differences and provide clinicians with quantitative data to support informed decision-making in clinical practice.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101044"},"PeriodicalIF":2.7,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010899","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}