Clinical and Translational Radiation Oncology最新文献

{"title":"Personalizing dental screening and prevention protocols in dentulous patients with oropharyngeal cancer undergoing radiotherapy: A retrospective cohort study","authors":"Denzel Chin ,&nbsp;Hetty Mast ,&nbsp;Gerda M. Verduijn ,&nbsp;Michelle Möring ,&nbsp;Steven F. Petit ,&nbsp;Frederik R. Rozema ,&nbsp;Eppo B. Wolvius ,&nbsp;Brend P. Jonker ,&nbsp;Wilma D. Heemsbergen","doi":"10.1016/j.ctro.2024.100759","DOIUrl":"10.1016/j.ctro.2024.100759","url":null,"abstract":"<div><h3>Objectives</h3><p>Patients with head and neck cancer are routinely screened for dental foci prior to radiotherapy (RT) to prevent post- RT tooth extractions associated with an increased risk of osteoradionecrosis. We evaluated the risk factors for post-RT tooth extraction to personalise dental screening and prevention protocols prior to RT.</p></div><div><h3>Materials and methods</h3><p>This retrospective cohort study included dentulous patients diagnosed with oropharyngeal cancer who had undergone radiation therapy at doses 60–70 Gy and achieved a disease-free survival of ≥ 1 year (N = 174). Risk factors were assessed using Cox regression models.</p></div><div><h3>Results</h3><p>The cumulative incidence of post-RT tooth extraction was 30.7 % at 5 years. Main indications for extraction (n = 62) were radiation caries (n = 20) and periodontal disease (n = 27). Risk factors associated (p &lt; 0.05) with radiation caries-related extractions included active smoking, alcohol abuse, poor oral hygiene, parotid gland irradiation, and mandibular irradiation. A high-dose volume in the mandible was associated with periodontal disease events.</p></div><div><h3>Conclusion</h3><p>Post-RT extractions due to radiation caries were influenced by lifestyle factors and RT dose in the mandible and parotid glands. Periodontal disease-related extractions were primarily associated with the mandibular dose. During dental screening these post-RT risk factors should be taken into account to prevent osteoradionecrosis.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824000363/pdfft?md5=2dec21d426286d39026f5cf4f2a781dc&pid=1-s2.0-S2405630824000363-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140083852","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":"MR-guided stereotactic radiation therapy for head and neck cancers","authors":"He Wang ,&nbsp;Jinzhong Yang ,&nbsp;Anna Lee ,&nbsp;Jack Phan ,&nbsp;Tze Yee Lim ,&nbsp;Clifton D. Fuller ,&nbsp;Eun Young Han ,&nbsp;Dong Joo Rhee ,&nbsp;Travis Salzillo ,&nbsp;Yao Zhao ,&nbsp;Nitish Chopra ,&nbsp;Mary Pham ,&nbsp;Pam Castillo ,&nbsp;Angela Sobremonte ,&nbsp;Amy C. Moreno ,&nbsp;Jay P. Reddy ,&nbsp;David Rosenthal ,&nbsp;Adam S. Garden ,&nbsp;Xin Wang","doi":"10.1016/j.ctro.2024.100760","DOIUrl":"https://doi.org/10.1016/j.ctro.2024.100760","url":null,"abstract":"<div><h3>Purpose</h3><p>MR-guided radiotherapy (MRgRT) has the advantage of utilizing high soft tissue contrast imaging to track daily changes in target and critical organs throughout the entire radiation treatment course. Head and neck (HN) stereotactic body radiation therapy (SBRT) has been increasingly used to treat localized lesions within a shorter timeframe. The purpose of this study is to examine the dosimetric difference between the step-and-shot intensity modulated radiation therapy (IMRT) plans on Elekta Unity and our clinical volumetric modulated arc therapy (VMAT) plans on Varian TrueBeam for HN SBRT.</p></div><div><h3>Method</h3><p>Fourteen patients treated on TrueBeam sTx with VMAT treatment plans were re-planned in the Monaco treatment planning system for Elekta Unity MR-Linac (MRL). The plan qualities, including target coverage, conformity, homogeneity, nearby critical organ doses, gradient index and low dose bath volume, were compared between VMAT and Monaco IMRT plans. Additionally, we evaluated the Unity adaptive plans of adapt-to-position (ATP) and adapt-to-shape (ATS) workflows using simulated setup errors for five patients and assessed the outcomes of our treated patients.</p></div><div><h3>Results</h3><p>Monaco IMRT plans achieved comparable results to VMAT plans in terms of target coverage, uniformity and homogeneity, with slightly higher target maximum and mean doses. The critical organ doses in Monaco IMRT plans all met clinical goals; however, the mean doses and low dose bath volumes were higher than in VMAT plans. The adaptive plans demonstrated that the ATP workflow may result in degraded target coverage and OAR doses for HN SBRT, while the ATS workflow can maintain the plan quality.</p></div><div><h3>Conclusion</h3><p>The use of Monaco treatment planning and online adaptation can achieve dosimetric results comparable to VMAT plans, with the additional benefits of real-time tracking of target volume and nearby critical structures. This offers the potential to treat aggressive and variable tumors in HN SBRT and improve local control and treatment toxicity.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824000375/pdfft?md5=940bf7627180ef0eac9d97bb82b0e842&pid=1-s2.0-S2405630824000375-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140113206","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":"Factors influencing local control after MR-guided stereotactic body radiotherapy (MRgSBRT) for adrenal metastases","authors":"Gamze Ugurluer ,&nbsp;Famke L. Schneiders ,&nbsp;Stefanie Corradini ,&nbsp;Luca Boldrini ,&nbsp;Rupesh Kotecha ,&nbsp;Patrick Kelly ,&nbsp;Lorraine Portelance ,&nbsp;Philip Camilleri ,&nbsp;Merav A. Ben-David ,&nbsp;Spencer Poiset ,&nbsp;Sebastian N. Marschner ,&nbsp;Giulia Panza ,&nbsp;Tugce Kutuk ,&nbsp;Miguel A. Palacios ,&nbsp;Alessandra Castelluccia ,&nbsp;Teuta Zoto Mustafayev ,&nbsp;Banu Atalar ,&nbsp;Suresh Senan ,&nbsp;Enis Ozyar","doi":"10.1016/j.ctro.2024.100756","DOIUrl":"https://doi.org/10.1016/j.ctro.2024.100756","url":null,"abstract":"<div><h3>Purpose</h3><p>Stereotactic body radiotherapy (SBRT) is an effective treatment for adrenal gland metastases, but it is technically challenging and there are concerns about toxicity. We performed a multi-institutional pooled retrospective analysis to study clinical outcomes and toxicities after MR-guided SBRT (MRgSBRT) using for adrenal gland metastases.</p></div><div><h3>Methods and Materials</h3><p>Clinical and dosimetric data of patients treated with MRgSBRT on a 0.35 T MR-Linac at 11 institutions between 2016 and 2022 were analyzed. Local control (LC), local progression-free survival (LPFS), distant progression-free survival (DPFS) and overall survival (OS) were estimated using Kaplan-Meier method and log-rank test.</p></div><div><h3>Results</h3><p>A total of 255 patients (269 adrenal metastases) were included. Metastatic pattern was solitary in 25.9 % and oligometastatic in 58.0 % of patients. Median total dose was 45 Gy (range, 16–60 Gy) in a median of 5 fractions, and the median BED10 was 100 Gy (range, 37.5–132.0 Gy). Adaptation was done in 87.4 % of delivered fractions based on the individual clinicians' judgement. The 1- and 2- year LPFS rates were 94.0 % (95 % CI: 90.7–97.3 %) and 88.3 % (95 % CI: 82.4–94.2 %), respectively and only 2 patients (0.8 %) experienced grade 3 + toxicity. No local recurrences were observed after treatment to a total dose of BED10 &gt; 100 Gy, with single fraction or fractional dose of &gt; 10 Gy.</p></div><div><h3>Conclusions</h3><p>This is a large retrospective multi-institutional study to evaluate the treatment outcomes and toxicities with MRgSBRT in over 250 patients, demonstrating the need for frequent adaptation in 87.4 % of delivered fractions to achieve a 1- year LPFS rate of 94 % and less than 1 % rate of grade 3 + toxicity. Outcomes analysis in 269 adrenal lesions revealed improved outcomes with delivery of a BED₁₀ &gt; 100 Gy, use of single fraction SBRT and with fraction doses &gt; 10 Gy, providing benchmarks for future clinical trials.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824000338/pdfft?md5=e17b033d57d6dd65d5f7c7e3e1b3614e&pid=1-s2.0-S2405630824000338-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140015746","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":"Determining risk and predictors of head and neck cancer treatment-related lymphedema: A clinicopathologic and dosimetric data mining approach using interpretable machine learning and ensemble feature selection","authors":"P. Troy Teo ,&nbsp;Kevin Rogacki ,&nbsp;Mahesh Gopalakrishnan ,&nbsp;Indra J Das ,&nbsp;Mohamed E Abazeed ,&nbsp;Bharat B Mittal ,&nbsp;Michelle Gentile","doi":"10.1016/j.ctro.2024.100747","DOIUrl":"https://doi.org/10.1016/j.ctro.2024.100747","url":null,"abstract":"<div><h3>Background and purpose</h3><p>The ability to determine the risk and predictors of lymphedema is vital in improving the quality of life for head and neck (HN) cancer patients. However, selecting robust features is challenging due to the multicollinearity and high dimensionality of radiotherapy (RT) data. This study aims to overcome these challenges using an ensemble feature selection technique with machine learning (ML).</p></div><div><h3>Materials and methods</h3><p>Thirty organs-at-risk, including bilateral cervical lymph node levels, were contoured, and dose-volume data were extracted from 76 HN treatment plans. Clinicopathologic data was collected. Ensemble feature selection was used to reduce the number of features. Using the reduced features as input to ML and competing risk models, internal and external lymphedema prediction capability was evaluated with the ML models, and time to lymphedema event and risk stratification were estimated using the risk models.</p></div><div><h3>Results</h3><p>Two ML models, XGBoost and random forest, exhibited robust prediction performance. They achieved average F1-scores and AUCs of 84 ± 3.3 % and 79 ± 11.9 % (external lymphedema), and 64 ± 12 % and 78 ± 7.9 % (internal lymphedema). Predictive ML and risk models identified common predictors, including bulky node involvement, high dose to various lymph node levels, and lymph nodes removed during surgery. At 180 days, removing 0–25, 26–50, and &gt; 50 lymph nodes increased external lymphedema risk to 72.1 %, 95.6 %, and 57.7 % respectively (p = 0.01).</p></div><div><h3>Conclusion</h3><p>Our approach, involving the reduction of HN RT data dimensionality, resulted in effective ML models for HN lymphedema prediction. Predictive dosimetric features emerged from both predictive and competing risk models. Consistency with clinicopathologic features from other studies supports our methodology.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824000247/pdfft?md5=f866bde6ecd30789bbf2ff097870fa26&pid=1-s2.0-S2405630824000247-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140015747","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":"Individual benefit in heart sparing during DIBH-supported left breast radiotherapy","authors":"Szilvia Gaál ,&nbsp;Zsuzsanna Kahán ,&nbsp;Ferenc Rárosi ,&nbsp;Gergely H. Fodor ,&nbsp;József Tolnai ,&nbsp;Bence Deák ,&nbsp;Katalin Hideghéty ,&nbsp;Zoltán Varga","doi":"10.1016/j.ctro.2024.100746","DOIUrl":"https://doi.org/10.1016/j.ctro.2024.100746","url":null,"abstract":"<div><h3>Introduction</h3><p>Deep-inspirational breath hold (DIBH) is an option for heart protection in breast radiotherapy; we intended to study its individual benefit.</p></div><div><h3>Materials and Methods</h3><p>3DCRT treatment planning was performed in a cohort of 103 patients receiving radiotherapy of the whole breast (WBI)/chest wall (CWI) ± nodal regions (NI) both under DIBH and free breathing (FB) in the supine position, and in the WBI only cases prone (n = 45) position, too. A series of patient-related and heart dosimetry parameters were analyzed.</p></div><div><h3>Results</h3><p>The DIBH technique provided dramatic reduction of all heart dosimetry parameters the individual benefit, however, varied. In the whole population the best predictor of benefit was the ratio of ipsilateral lung volume (ILV)FB and ILVDIBH. In the WBI cohort 9–11 patients and 5–8 patients received less dose to selected heart structures with the DIBH and prone positioning, respectively; based on meeting various dose constraints DIBH was the only solution in 6–13 cases, and prone positioning in 5–6 cases. In addition to other excellent predictors, a small ILVFB or ILVDIBH with outstanding predicting performance (AUC ≥ 0.90) suggested prone positioning. Detailed analysis consistently indicated the outstanding performance of ILVFB and ILVDIBH in predicting the benefit of one over the other technique in lowering the mean heart dose (MHD), left anterior descending coronary artery (LAD) mean dose and left ventricle(LV)-V5Gy. The preference of prone positioning was further confirmed by anatomical parameters measured on a single CT scan at the middle of the heart. Performing spirometry in a cohort of 12 patients, vital capacity showed the strongest correlation with ILVFB and ILVDIBH hence this test could be evaluated as a clinical tool for patient selection.</p></div><div><h3>Discussion</h3><p>Individual lung volume measures estimated by spirometry and anatomical data examined prior to acquiring planning CT may support the preference of DIBH or prone radiotherapy for optimal heart protection.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824000235/pdfft?md5=931bcfa3a3cfa3a515982e025d8825c3&pid=1-s2.0-S2405630824000235-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140181364","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":"Dose-escalated SBRT for borderline and locally advanced pancreatic cancer. Feasibility, safety and preliminary clinical results of a multicenter study","authors":"B. Salas ,&nbsp;L. Ferrera-Alayón ,&nbsp;A. Espinosa-López ,&nbsp;A. Vera-Rosas ,&nbsp;E. Salcedo ,&nbsp;A. Kannemann ,&nbsp;A. Alayon ,&nbsp;R. Chicas-Sett ,&nbsp;M. LLoret ,&nbsp;P.C. Lara","doi":"10.1016/j.ctro.2024.100753","DOIUrl":"https://doi.org/10.1016/j.ctro.2024.100753","url":null,"abstract":"<div><h3>Background</h3><p>Pancreatic Stereotactic Body Radiotherapy (SBRT) allows for the administration of a higher biologically effective doses (BED), that would be essential to achieve durable tumor control. Escalating treatment doses need a very accurate tumor positioning and motion control during radiotherapy.</p><p>The aim of this study to assess the feasibility and safety of a Simultaneous Integrated Boost (SIB) dose-escalated protocol at 45 Gy, 50 Gy and 55 Gy in 5 consecutive daily fractions, in Border Line Resectable Pancreatic Cancer (BRCP) /Locally Advanced Pancreatic Cancer (LAPC) by means of a standard LINAC platform.</p></div><div><h3>Methods</h3><p>Patients diagnosed of BRPC/LAPC, candidates for neoadjuvant chemotherapy and SBRT, in four university hospitals of the province of Las Palmas (Canary Islands, Spain) were included in this prospective study. Radiotherapy was administered using standard technology (LINACS) with advanced positioning (Lipiodol® and metallic stent used as fiducial markers) and tumor motion control (4D, DBH, Calypso®). There were 3 planned dose-escalated SIB groups, 45 Gy/5f (9 patients) 50 Gy/5f (9 + 9 patients) and 55 Gy/5f (9 patients). The defined primary end points of the study were the safety and feasibility of the proposed treatment protocol. Secondary endpoints included radiological tumor response after SBRT, local control and survival.</p></div><div><h3>Results</h3><p>From June 2017 to December 2022, sixty-two patients were initially assessed for eligibility in the study in the four participating centers, and 49 were candidates for chemotherapy (CHT). Forty-one were referred to radiotherapy after CHT and 33 finally were treated by escalated-dose SIB, 45 Gy (9 patients) 50 Gy (16 patients), 55 Gy(8 patients). All patients completed the scheduled treatment and no acute or late severe (≥grade3) gastrointestinal toxicity was observed.</p><p>Local response was analyzed by CT/MRI two months after the end of SBRT. Ten patients (31,25 %) achieved objective response (2/9:45 Gy, 5/15:50 Gy, 3/8:55 Gy). Follow-up was closed as July 2023. Freedom from local progression at 1-2y were 89,3% (95 %CI:83,4–95,2%) and 66 % (95 %CI:54,6–77,4%) respectively. The 1-2y survival rates were 95,7% (95 %CI:91,4–100 % and 48,6% (95 %CI:37,7–59,5%) respectively.</p></div><div><h3>Conclusion</h3><p>These promising results should be confirmed by further studies with larger sample size and extended follow-up period.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824000302/pdfft?md5=db0ce812238195c31d1d3d3d499d4f5a&pid=1-s2.0-S2405630824000302-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139976090","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 oligoprogression with or without switch of systemic therapy","authors":"Jonas Willmann,&nbsp;Eugenia Vlaskou Badra,&nbsp;Selma Adilovic,&nbsp;Maiwand Ahmadsei,&nbsp;Sebastian M. Christ,&nbsp;Stephanie Tanadini-Lang,&nbsp;Michael Mayinger,&nbsp;Matthias Guckenberger,&nbsp;Nicolaus Andratschke","doi":"10.1016/j.ctro.2024.100748","DOIUrl":"https://doi.org/10.1016/j.ctro.2024.100748","url":null,"abstract":"<div><h3>Background</h3><p>Oligoprogression is defined as cancer progression of a limited number of metastases under active systemic therapy. The role of metastasis-directed therapy, using stereotactic body radiotherapy (SBRT), is controversial as is the continuation versus switch of systemic therapy. We report outcomes of oligoprogressive patients after SBRT, and compare those patients that continued or switched their current line of systemic therapy.</p></div><div><h3>Material/Methods.</h3><p>We included patients who developed up to 5 progressive extracranial metastases under systemic therapy for any solid organ malignancy and were treated with SBRT to all lesions at our institution between 01/2014 and 12/2019. Overall survival (OS) and progression-free survival (PFS) were analyzed using the Kaplan-Meier method, and the interval to the next systemic therapy line determined using cumulative incidence functions. Multivariable Cox regression models were used to analyze the influence of baseline and post-progression variables on OS, PFS and survival with the next systemic therapy after SBRT.</p></div><div><h3>Results</h3><p>Among 135 patients with oligoprogressive disease of which the most common primary tumor was lung cancer (n = 46, 34.1 %), 96 continued their current line of systemic therapy after oligoprogression. Among 39 who switched systemic therapy, 28 (71.8 %) paused or discontinued, while 11 (28.2 %) immediately started another systemic treatment. After a median follow-up of 27.2 months, patients that switched and those who continued systemic therapy after oligoprogression had comparable median OS (32.1 vs. 38.2 months, p = 0.47) and PFS (4.3 vs. 3.4 months, p = 0.6). The intervals to the next systemic therapy line were comparable between both cohorts (p = 0.6). An ECOG performance status of 2 and immediately starting a new systemic therapy after oligoprogression were associated with a poorer survival without next systemic therapy, while the de-novo OMD state was associated with better survival without next systemic therapy compared to the induced state.</p></div><div><h3>Conclusion</h3><p>Oncological outcomes of patients that continued or switched systemic therapy after SBRT for oligoprogression were comparable, potentially indicating that further lines of treatment may be safely delayed in selected cases.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824000259/pdfft?md5=6a29f0a3dc0879acec2ced5a24841a9b&pid=1-s2.0-S2405630824000259-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139976089","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":"Response to “Stereotactic body radiotherapy for oligoprogressive lesions in metastatic castration‐resistant prostate cancer patients – A closer inspection will improve your vision”","authors":"D. Baron ,&nbsp;D. Pasquier ,&nbsp;T. Pace-Loscos ,&nbsp;B. Vandendorpe ,&nbsp;R. Schiappa ,&nbsp;C. Ortholan ,&nbsp;J.M. Hannoun-Levi","doi":"10.1016/j.ctro.2024.100755","DOIUrl":"https://doi.org/10.1016/j.ctro.2024.100755","url":null,"abstract":"","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824000326/pdfft?md5=ea945fcb1903aba9d48fc47c78d4389a&pid=1-s2.0-S2405630824000326-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139986085","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":"Stabilised Hyaluronic Acid (sHA) gel as a novel marker for breast cancer tumour bed cavity: Surgical feasibility","authors":"Janice Yeh ,&nbsp;Grace Chew ,&nbsp;Suat Li Ng ,&nbsp;Wei Ming Ooi ,&nbsp;Su-Wen Loh ,&nbsp;Anthony Hyett ,&nbsp;Tristan Leech ,&nbsp;Elaine Bevington ,&nbsp;Jenny Huynh ,&nbsp;Jenny Sim ,&nbsp;Farshad Foroudi ,&nbsp;Sweet Ping Ng ,&nbsp;Michael Chao","doi":"10.1016/j.ctro.2024.100745","DOIUrl":"https://doi.org/10.1016/j.ctro.2024.100745","url":null,"abstract":"<div><h3>Introduction</h3><p>Consistent delineation of the breast conserving surgery (BCS) tumour bed (TB) for breast cancer remains a challenge for radiation oncologists. Accurate delineation allows for better local control and reduces toxicity when planning partial breast or TB boost radiation therapy (RT).</p></div><div><h3>Methods</h3><p>In the operating theatre (OT) breast surgeons inserted stabilised hyaluronic acid (sHA) gel as small drops approximately one cm into the walls surrounding the resection cavity. Surgical feasibility was determined by the rate of successful sHA gel insertion procedure, the ease of insertion as rated by surgeons, the time required for insertion procedure, the quantity used, and any adverse events (AE) relating to sHA gel insertion.</p></div><div><h3>Results</h3><p>Thirty-five patients were enrolled. All patients underwent sHA gel insertion successfully. The procedure added a median of 2.8 min to the OT time and was rated as ‘easy’ in 89 % of patients. There were no immediate AE in OT. Five (14 %) patients experienced a grade 2 or higher AE. Three of the five patients were prescribed oral antibiotics for breast infection. Two of the five patients experienced a grade 3 AE – haematoma which required evacuation in OT day 1 post-BCS, and infected seroma which required drainage and washout in OT 2 months post-BCS. All five patients recovered and underwent the planned adjuvant therapies for their BC. The AE data reflects common risks with standard BCS and are not clearly attributed to sHA gel insertion alone.</p></div><div><h3>Conclusion</h3><p>We show that sHA gel is surgically feasible as a marker to help define the TB cavity for post-BCS adjuvant MRI-based RT planning.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824000223/pdfft?md5=b4f1b69a9d75a2ad2539e3e906f25dee&pid=1-s2.0-S2405630824000223-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139914891","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":"Comparison of conventional and hippocampus-sparing radiotherapy in nasopharyngeal carcinoma: In silico study and systematic review","authors":"Monika Peternel ,&nbsp;Aljaša Jenko ,&nbsp;Primož Peterlin ,&nbsp;Larisa Petrovič ,&nbsp;Primož Strojan ,&nbsp;Gaber Plavc","doi":"10.1016/j.ctro.2024.100751","DOIUrl":"https://doi.org/10.1016/j.ctro.2024.100751","url":null,"abstract":"<div><h3>Background and purpose</h3><p>Radiation-induced damage to the hippocampi can cause cognitive decline. International recommendations for nasopharyngeal cancer (NPC) radiotherapy (RT) lack specific guidelines for protecting the hippocampi. Our study evaluates if hippocampi-sparing (HS) RT in NPC ensures target coverage and meets recommended dose limits for other at-risk organs.</p></div><div><h3>Materials and methods</h3><p>In a systematic literature review, we compared hippocampal D_40% in conventional and HS RT plans. In an in silico dosimetric study, conventional and HS-VMAT plans were created for each patient, following international recommendations for OAR delineation, dose prioritization and acceptance criteria. We assessed the impact on neurocognitive function using a previously published normal tissue complication probability (NTCP) model.</p></div><div><h3>Results</h3><p>In four previous studies (n = 79), researchers reduced D_40% hippocampal radiation doses in HS plans compared to conventional RT on average from 24.9 Gy to 12.6 Gy.</p><p>Among 12 NPC patients included in this in silico study, statistically significant differences between HS and conventional VMAT plans were observed in hippocampal EQD₂ D_max (23.8 vs. 46.4 Gy), D_min (3.8 vs. 4.6 Gy), D_mean (8.1 vs. 15.1 Gy), and D_40% (8.3 vs. 15.8 Gy). PTV coverage and OAR doses were similar, with less homogeneous PTV coverage in HS plans (p = 0.038). This translated to a lower probability of memory decline in HS plans (interquartile range 15.8–29.6 %) compared to conventional plans (33.8–81.1 %) based on the NTCP model (p = 0.002).</p></div><div><h3>Conclusion</h3><p>Sparing the hippocampus in NPC RT is safe and feasible. Given the life expectancy of many NPC patients, their cognitive well-being must be paramount in radiotherapy planning.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824000284/pdfft?md5=3354fbb3ddb777ede106153999009b67&pid=1-s2.0-S2405630824000284-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139937042","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}