Clinical and Translational Radiation Oncology最新文献

{"title":"Prognostic value of pretreatment radiological MRI variables and dynamic contrast-enhanced MRI on radiotherapy treatment outcome in laryngeal and hypopharyngeal tumors","authors":"Hilde J.G. Smits ,&nbsp;Saskia J. Vink ,&nbsp;Mischa de Ridder ,&nbsp;Marielle E.P. Philippens ,&nbsp;Jan W. Dankbaar","doi":"10.1016/j.ctro.2024.100857","DOIUrl":"10.1016/j.ctro.2024.100857","url":null,"abstract":"<div><h3>Background</h3><p>This study aimed to determine the prognostic value of radiological magnetic resonance imaging (MRI) variables and dynamic contrast enhanced (DCE)-MRI for local control (LC), disease control (DC), and overall survival (OS) in laryngeal and hypopharyngeal cancer patients after radiotherapy.</p></div><div><h3>Methods</h3><p>320 patients treated with radiotherapy were retrospectively included. Pretreatment MRIs were evaluated for the following anatomical tumor characteristics: cartilage invasion, extralaryngeal spread, and involvement of the anterior commissure, pre-epiglottic space, and paralaryngeal space.</p><p>Pretreatment DCE-MRI was available in 89 patients. The median and 95th percentile of the 60-second area under the contrast-distribution-curve (AUC60_median and AUC60_p95) were determined in the tumor volume.</p></div><div><h3>Results</h3><p>Univariable log-rank test determined that extralaryngeal spread, tumor volume and T-stage were prognostic for worse LC, DC, and OS. A low AUC60_p95 (&lt;31.7 mmol·s/L) and thyroid cartilage invasion were prognostic for worse OS.</p><p>In multivariable analysis, a Cox proportional hazard model showed that a AUC60_p95 ≥ 31.7 mmol·s/L was prognostic for better OS (HR=0.25, <em>P</em>&lt;.001). Tumor volume was prognostic for DC (HR=3.42, <em>P</em>&lt;.001) and OS (HR=3.27, <em>P</em>&lt;.001). No anatomical MRI variables were significantly prognostic for LC, DC, or OS in multivariable analysis when corrected for confounders.</p></div><div><h3>Conclusion</h3><p>Low pretreatment AUC60_p95 is prognostic for a worse OS, suggesting that poor tumor perfusion leads to worse survival. Large tumor volume is also prognostic for worse DC and OS. Anatomical MRI parameters are not prognostic for any of the evaluated treatment outcomes when corrected for confounders like age, T-stage, N-stage, and tumor volume.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"49 ","pages":"Article 100857"},"PeriodicalIF":2.7,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824001344/pdfft?md5=3576162bf3ca34d1fb03a6dac0e6488b&pid=1-s2.0-S2405630824001344-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142233887","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":"Complications leading to hospitalisation 12 months after brachytherapy or high-intensity focused ultrasound for localized prostate cancer: French national from the PMSI-MCO data, 2019 and 2020","authors":"Timothée Bourgarit ,&nbsp;Clément Larose ,&nbsp;Andrea Dagry ,&nbsp;Nicolas Martz ,&nbsp;Beverley Balkau ,&nbsp;Pascal Eschwège ,&nbsp;Charles Mazeaud","doi":"10.1016/j.ctro.2024.100854","DOIUrl":"10.1016/j.ctro.2024.100854","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Prostate cancer can be treated using either brachytherapy or high-intensity focused ultrasound (HIFU), which are less invasive than surgery. Although both approaches have proved effective, few studies have looked at the specific causes of hospitalisation due to complications, following these treatments. The aim of this study was to compare the causes of hospitalisation.</div></div><div><h3>Methods</h3><div>A retrospective study was carried out examining the records of patients who had undergone brachytherapy or HIFU treatment for localized prostate cancer in 2019 and 2020, using the French national database: Programme de Médicalisation du Système d’Information − Médecine, Chirurgie, Obstétrique (PMSI-MSO). Data on post-treatment hospitalisations were analyzed.</div></div><div><h3>Results</h3><div>3090 patients were included in the study, of whom 1699 underwent brachytherapy and 1391 HIFU procedures. The incidence of hospitalisation was much higher after HIFU than after brachytherapy, notably due to a higher rate of obstructive complications (12.94% vs 2.77%). Large differences were also found for infections (8.20% vs 1.47%) and bleeding (6.76% vs 2.18%) leading to hospitalisation. Most of the complications occurred at the initial hospitalization: 12% for HIFU, and 1.4% for brachytherapy.</div></div><div><h3>Conclusion</h3><div>Complications were more frequent after treatment with HIFU than with brachytherapy in the year following treatment for localized prostate cancer. Further the causes of hospitalisation differed between the two treatments. These differences need to be taken into account in the therapeutic strategy, as well as in post-treatment management.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"49 ","pages":"Article 100854"},"PeriodicalIF":2.7,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824001319/pdfft?md5=426becff83aad519aa6fcdbbde932394&pid=1-s2.0-S2405630824001319-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311226","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":"Temporary halo fixation and radiotherapy as alternative to long-construct spondylodesis in patients with multiple unstable cervical metastases","authors":"E.H. Huele ,&nbsp;J.M. van der Velden ,&nbsp;H.M. Verkooijen ,&nbsp;N. Kasperts ,&nbsp;J.J. Verlaan","doi":"10.1016/j.ctro.2024.100858","DOIUrl":"10.1016/j.ctro.2024.100858","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Currently no minimally invasive surgical treatment exists to provide immediate stability for unstable cervical/cervicothoracic metastases. Long-construct spondylodesis carries a high complication risk and has severe impact on residual range of motion. This study explores temporary halo fixation and radiotherapy as an alternative to long-construct cervical spondylodesis.</div></div><div><h3>Materials and methods</h3><div>This retrospective cohort study included twenty patients with multiple unstable cervical metastases treated between 2013–2023. All patients underwent halo fixation for an intended duration of three months to allow for safe reossification of lytic lesions following radiotherapy, with a dose fractionation scheme best suited to the histological origin of the tumor.</div></div><div><h3>Results</h3><div>Immobilization with halo fixation lasted a median 83 days (range, 41–132 days). Radiotherapy started on average 7 days after halo fixation (range, −35–118 days). The median pain score at baseline was 8, and was 0 at halo removal and at last follow-up. All patients had no or minor neurological deficits at baseline and did not develop new neurological deficits. At halo removal, 17/18 patients showed radiographic evidence of reossification. The majority of patients experienced minor limitations or had full range of motion of the neck at last follow-up.</div></div><div><h3>Conclusion</h3><div>Patients with multiple unstable cervical metastases treated with halo fixation and radiotherapy showed complete pain response or substantial pain reduction, reossification of the vertebrae and a, mostly, preserved range of motion. In selected neurologically intact patients, this treatment might be a patient-friendly alternative to fixation. Prospective evaluation of this treatment combination is needed.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"49 ","pages":"Article 100858"},"PeriodicalIF":2.7,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824001356/pdfft?md5=3c9454ee7e9131e52349a2d5b13d869d&pid=1-s2.0-S2405630824001356-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311164","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":"Durable local control with hypofractionated radiation therapy for unresectable or metastatic melanoma","authors":"Sydney A. Keatts ,&nbsp;Aya F. Salem ,&nbsp;David M. Swanson ,&nbsp;Ahsan S. Farooqi ,&nbsp;Andrew J. Bishop ,&nbsp;Rodabe N. Amaria ,&nbsp;Jennifer L. McQuade ,&nbsp;Isabella C. Glitza Oliva ,&nbsp;Adi Diab ,&nbsp;Roi Weiser ,&nbsp;Sarah B. Fisher ,&nbsp;Ryan P. Goepfert ,&nbsp;Merrick I. Ross ,&nbsp;B. Ashleigh Guadagnolo ,&nbsp;Devarati Mitra","doi":"10.1016/j.ctro.2024.100856","DOIUrl":"10.1016/j.ctro.2024.100856","url":null,"abstract":"<div><h3>Background and purpose</h3><p>As patients with advanced melanoma live longer in the context of systemic therapy advancements, better strategies for durable control of bulky tumors are needed. In this study, we evaluated if dose-escalated hypofractionated radiation therapy (HFRT) can provide durable local control and improve tumor-associated symptoms in patients with unresectable or bulky metastatic melanoma for whom stereotactic ablative radiotherapy (RT) approaches are not feasible due to tumor size or location.</p></div><div><h3>Materials and methods</h3><p>We retrospectively reviewed 49 patients with unresectable or bulky metastatic melanoma who were treated to a total of 53 tumor targets with 12–17 fractions HFRT at our institution between 2015–2022. Clinical scenarios included: unresectable, locoregional only disease (26 %); oligometastatic disease (&lt;3 total sites, 17 %); oligoprogressive disease (&lt;3 sites progressing, 17 %); and aggressive palliation (&gt;5 known sites of disease or with at least 3 sites progressing, 40 %).</p></div><div><h3>Results</h3><p>Of the 53 HFRT targets, 91 % (n = 48) had radiographic evidence of response as defined by either stabilization (6 %, n = 3), decreased size (74 %, n = 39), or decreased FDG avidity (11 %, n = 6). Of the 43 symptomatic patients, 98 % (n = 42) had symptomatic improvement. One −year local control was 79 %, with 2-year progression-free and overall survival of 33 % and 39 % respectively. The most common acute toxicities were radiation dermatitis (16 %, n = 8) or a pain flare (14 %, n = 7). Late toxicities were uncommon and typically grade 1.</p></div><div><h3>Conclusion</h3><p>HFRT provides favorable local control and symptomatic relief with limited toxicity in tumors not amenable to surgical resection or stereotactic ablative RT.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"49 ","pages":"Article 100856"},"PeriodicalIF":2.7,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824001332/pdfft?md5=cf6d774fdeacb5d0ed0a81599e6d8483&pid=1-s2.0-S2405630824001332-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229532","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":"Validation of different automated segmentation models for target volume contouring in postoperative radiotherapy for breast cancer and regional nodal irradiation","authors":"Eva Meixner ,&nbsp;Benjamin Glogauer ,&nbsp;Sebastian Klüter ,&nbsp;Friedrich Wagner ,&nbsp;David Neugebauer ,&nbsp;Line Hoeltgen ,&nbsp;Lisa A. Dinges ,&nbsp;Semi Harrabi ,&nbsp;Jakob Liermann ,&nbsp;Maria Vinsensia ,&nbsp;Fabian Weykamp ,&nbsp;Philipp Hoegen-Saßmannshausen ,&nbsp;Jürgen Debus ,&nbsp;Juliane Hörner-Rieber","doi":"10.1016/j.ctro.2024.100855","DOIUrl":"10.1016/j.ctro.2024.100855","url":null,"abstract":"<div><h3>Introduction</h3><p>Target volume delineation is routinely performed in postoperative radiotherapy (RT) for breast cancer patients, but it is a time-consuming process. The aim of the present study was to validate the quality, clinical usability and institutional-specific implementation of different auto-segmentation tools into clinical routine.</p></div><div><h3>Methods</h3><p>Three different commercially available, artificial intelligence-, ESTRO-guideline-based segmentation models (M1-3) were applied to fifty consecutive reference patients who received postoperative local RT including regional nodal irradiation for breast cancer for the delineation of clinical target volumes: the residual breast, implant or chestwall, axilla levels 1 and 2, the infra- and supraclavicular regions, the interpectoral and internal mammary nodes. Objective evaluation metrics of the created structures were conducted with the Dice similarity index (DICE) and the Hausdorff distance, and a manual evaluation of usability.</p></div><div><h3>Results</h3><p>The resulting geometries of the segmentation models were compared to the reference volumes for each patient and required no or only minor corrections in 72 % (M1), 64 % (M2) and 78 % (M3) of the cases. The median DICE and Hausdorff values for the resulting planning target volumes were 0.87–0.88 and 2.96–3.55, respectively. Clinical usability was significantly correlated with the DICE index, with calculated cut-off values used to define no or minor adjustments of 0.82–0.86. Right or left sided target and breathing method (deep inspiration breath hold vs. free breathing) did not impact the quality of the resulting structures.</p></div><div><h3>Conclusion</h3><p>Artificial intelligence-based auto-segmentation programs showed high-quality accuracy and provided standardization and efficient support for guideline-based target volume contouring as a precondition for fully automated workflows in radiotherapy treatment planning.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"49 ","pages":"Article 100855"},"PeriodicalIF":2.7,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824001320/pdfft?md5=e38267f10cb1b9c6eb12938744ad4ed6&pid=1-s2.0-S2405630824001320-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142171876","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":"Contact X-ray Brachytherapy as a sole treatment in selected patients with early rectal cancer – Multi-centre study","authors":"Ngu Wah Than ,&nbsp;D. Mark Pritchard ,&nbsp;David M. Hughes ,&nbsp;Kai Shing Yu ,&nbsp;Helen S. Minnaar ,&nbsp;Amandeep Dhadda ,&nbsp;Jamie Mills ,&nbsp;Joakim Folkesson ,&nbsp;Calin Radu ,&nbsp;C.A. Duckworth ,&nbsp;Helen Wong ,&nbsp;Muneeb Ul Haq ,&nbsp;Rajaram Sripadam ,&nbsp;Mark D. Halling-Brown ,&nbsp;Alexandra J. Stewart ,&nbsp;Arthur Sun Myint","doi":"10.1016/j.ctro.2024.100851","DOIUrl":"10.1016/j.ctro.2024.100851","url":null,"abstract":"<div><h3>Background and purpose</h3><p>Radical surgery is the standard of care for early rectal cancer. However, alternative organ-preserving approaches are attractive, especially in frail or elderly patients as these avoid surgical complications. We have assessed the efficacy of sole Contact X-ray Brachytherapy (CXB) treatment in stage-1 rectal cancer patients who were unsuitable for or declined surgery.</p></div><div><h3>Materials and methods</h3><p>This retrospective multi-centre study (2009–2021) evaluated 76 patients with T1/2-N0-M0 rectal adenocarcinomas who were treated with CXB alone. Outcomes were assessed for the entire cohort and sub-groups based on the T-stage and the criteria for receiving CXB alone; Group A: patients who were fit enough for surgery but declined, Group B: patients who were high-risk for surgery and Group C: patients who had received prior pelvic radiation for a different cancer.</p></div><div><h3>Results</h3><p>With a median follow-up of 26(IQR:12–49) months, initial clinical Complete Response (cCR) was 82(70–93)% with rates of local regrowth 18(8–29)%, 3-year actuarial local control (LC) 84(75–95)%, distant relapse 3 %, and no nodal relapse. 5-year disease-free survival (DFS) and overall survival (OS) were 66(48–78)% and 58(44–75)%. Lower OS was observed in Groups B [HR:2.54(95 %CI:1.17, 5.59), p = 0.02] and C [HR:2.75(95 %CI:1.15, 6.58), p = 0.03]. Previous pelvic radiation predicted lower cCR and OS. The main toxicity was G1-2 rectal bleeding (26 %) and symptoms of impaired anal sphincter function were not reported in any patients.</p></div><div><h3>Conclusion</h3><p>CXB treatment alone achieved a high cCR rate with satisfactory LC and DFS. Inferior oncological outcomes were observed in patients who had received prior pelvic radiotherapy. CXB alone, with its favourable toxicity profile and avoidance of general anaesthesia and surgery risks, therefore, can be considered for patients who are unsuitable for or refuse surgery.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"49 ","pages":"Article 100851"},"PeriodicalIF":2.7,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824001289/pdfft?md5=cc01f88995e6ee34340069418bb5cf09&pid=1-s2.0-S2405630824001289-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142163931","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":"Understanding the impact of radiation-induced lymphopenia: Preclinical and clinical research perspectives","authors":"E. Prades-Sagarra ,&nbsp;A. Yaromina ,&nbsp;L.J. Dubois","doi":"10.1016/j.ctro.2024.100852","DOIUrl":"10.1016/j.ctro.2024.100852","url":null,"abstract":"<div><p>Immunotherapy has revolutionized the field of cancer treatment, changing the standard of care to the use of immune checkpoint inhibitors. Radiotherapy can boost anti-tumour immune responses by changing the tumour microenvironment, but it also can cause radiotherapy-induced lymphopenia (RIL), a decrease in circulating lymphocyte counts. RIL has been associated with lower survival in patients undergoing radiotherapy, and new studies have suggested that it can also affect immunotherapy outcome. To study RIL’s effects and to explore mitigation treatment strategies, preclinical models closely mimicking the clinical situation are needed. State-of-the-art image-guided small animal irradiators now offer the possibility to target specific organs in small animals to induce RIL, aiding research on its molecular mechanisms and prevention. This review covers the relationship between radiotherapy and RIL, its impact on patient survival, and future directions to generate models to investigate and prevent RIL.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"49 ","pages":"Article 100852"},"PeriodicalIF":2.7,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824001290/pdfft?md5=f211cceb41a3efcaa56cbe746d69fee4&pid=1-s2.0-S2405630824001290-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229531","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":"Prognostic implications of HIF-1α expression in anal squamous cell carcinoma treated with intensity-modulated radiotherapy (IMRT)","authors":"Ahmed Allam Mohamed ,&nbsp;Michael J. Eble ,&nbsp;Edgar Dahl ,&nbsp;Danny Jonigk ,&nbsp;Svetlana Warkentin","doi":"10.1016/j.ctro.2024.100853","DOIUrl":"10.1016/j.ctro.2024.100853","url":null,"abstract":"<div><h3>Background</h3><p>Hypoxia-inducible factor-1α (HIF-1α) is a crucial transcription factor activated under hypoxic conditions, known to regulate genes associated with tumor survival, progression, and response to therapy. This study aimed to evaluate the prognostic significance of HIF-1α expression in patients with anal squamous cell carcinoma (ASCC) undergoing chemoradiation therapy.</p></div><div><h3>Methods</h3><p>We conducted a retrospective analysis of 28 ASCC patients treated with intensity-modulated radiotherapy (IMRT) at our center from 2009 to 2022. HIF-1α expression was assessed via immunohistochemistry on formalin-fixed paraffin-embedded tissue specimens. Quantitative analysis of HIF-1α expression was performed, and its relationship with clinical outcomes, including disease-free survival (DFS), locoregional relapse-free survival (LRRFS), and overall survival (OS), was examined using Cox regression models. Furthermore, ASCC tissue specimens from 17 patients were analyzed for potential <em>PIK3CA</em> mutations using Sanger sequencing.</p></div><div><h3>Results</h3><p>High HIF-1α expression was significantly associated with poorer DFS (p = 0.005), LRRFS (p = 0.012), and OS (p = 0.009). HIF1α expression was marginally significantly higher in males compared to females (p = 0.056) while there was no significant difference found based on tumor stage or p16 status. However, a positive correlation was identified between BMI and HIF-1α levels (Pearson correlation r = 0.5, p = 0.0084), suggesting a link between metabolic status and tumor hypoxia. Only one patient exhibited a PIK3CA mutation, preventing a reliable assessment of its correlation with HIF-1α expression.</p></div><div><h3>Conclusion</h3><p>Our findings underscore the importance of HIF-1α as a potential biomarker for predicting survival outcomes in ASCC patients treated with chemoradiation. The association between higher BMI and increased HIF-1α expression may provide insights into the interplay between metabolic health and tumor biology in ASCC. Further studies with larger cohorts are needed to validate these findings and explore targeted therapies focusing on HIF-1α modulation.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"49 ","pages":"Article 100853"},"PeriodicalIF":2.7,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824001307/pdfft?md5=835571536c0cc3add5d631b48681d90a&pid=1-s2.0-S2405630824001307-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142149987","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":"Comment on “Repeated HyperArc radiosurgery for recurrent intracranial metastases and dosimetric analysis of recurrence pattern to account for diffuse dose effect on microscopical disease”","authors":"Dario Di Perri","doi":"10.1016/j.ctro.2024.100823","DOIUrl":"10.1016/j.ctro.2024.100823","url":null,"abstract":"","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"48 ","pages":"Article 100823"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824001009/pdfft?md5=2e7e1b1ffa95f58421129b9dcbdd9cbf&pid=1-s2.0-S2405630824001009-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141848968","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":"Systemic inflammatory markers and volume of enhancing tissue on post-contrast T1w MRI images in differentiating true tumor progression from pseudoprogression in high-grade glioma","authors":"Camilla Satragno ,&nbsp;Irene Schiavetti ,&nbsp;Eugenia Cella ,&nbsp;Federica Picichè ,&nbsp;Laura Falcitano ,&nbsp;Martina Resaz ,&nbsp;Monica Truffelli ,&nbsp;Stefano Caneva ,&nbsp;Pietro Mattioli ,&nbsp;Daniela Esposito ,&nbsp;Alessio Ginulla ,&nbsp;Claudio Scaffidi ,&nbsp;Pietro Fiaschi ,&nbsp;Alessandro D’Andrea ,&nbsp;Andrea Bianconi ,&nbsp;Gianluigi Zona ,&nbsp;Laura Barletta ,&nbsp;Luca Roccatagliata ,&nbsp;Lucio Castellan ,&nbsp;Silvia Morbelli ,&nbsp;Liliana Belgioia","doi":"10.1016/j.ctro.2024.100849","DOIUrl":"10.1016/j.ctro.2024.100849","url":null,"abstract":"<div><h3>Background</h3><p>High-grade glioma (HGG) patients post-radiotherapy often face challenges distinguishing true tumor progression (TTP) from pseudoprogression (PsP). This study evaluates the effectiveness of systemic inflammatory markers and volume of enhancing tissue on post-contrast T1 weighted (T1WCE) MRI images for this differentiation within the first six months after treatment.</p></div><div><h3>Material and Methods</h3><p>We conducted a retrospective analysis on a cohort of HGG patients from 2015 to 2021, categorized per WHO 2016 and 2021 criteria. We analyzed treatment responses using modified RANO criteria and conducted volumetry on T1WCE and T2W/FLAIR images.</p><p>Blood parameters assessed included neutrophil/lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI). We employed Chi-square, Fisher’s exact test, and Mann-Whitney <em>U</em> test for statistical analyses, using log-transformed predictors due to multicollinearity. A Cox regression analysis assessed the impact of PsP- and TTP-related factors on overall survival (OS).</p></div><div><h3>Results</h3><p>The cohort consisted of 39 patients, where 16 exhibited PsP and 23 showed TTP. Univariate analysis revealed significantly higher NLR and SII in the TTP group [NLR: 4.1 vs 7.3, p = 0.002; SII 546.5 vs 890.5p = 0.009]. T1WCE volume distinctly differentiated PsP from TTP [2.2 vs 11.7, p &lt; 0.001]. In multivariate regression, significant predictors included NLR and T1WCE volume in the “NLR Model,” and T1WCE volume and SII in the “SII Model.” The study also found a significantly lower OS rate in TTP patients compared to those with PsP [HR 3.97, CI 1.59 to 9.93, p = 0.003].</p></div><div><h3>Conclusion</h3><p>Elevated both, SII and NLR, and increased T1WCE volume were effective in differentiating TTP from PsP in HGG patients post-radiotherapy. These results suggest the potential utility of incorporating these markers into clinical practice, though further research is necessary to confirm these findings in larger patient cohorts.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"49 ","pages":"Article 100849"},"PeriodicalIF":2.7,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824001265/pdfft?md5=b176628924c84bf9894ac50ecb13f608&pid=1-s2.0-S2405630824001265-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142122579","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}