Clinical and Translational Radiation Oncology最新文献

{"title":"Dummy run for planning of isotoxic dose-escalated radiation therapy for glioblastoma used in the PRIDE trial (NOA-28; ARO-2024-01; AG-NRO-06)","authors":"Sebastian H. Maier ,&nbsp;Stephan Schönecker ,&nbsp;Vasiliki Anagnostatou ,&nbsp;Sylvia Garny ,&nbsp;Alexander Nitschmann ,&nbsp;Daniel F. Fleischmann ,&nbsp;Marcel Büttner ,&nbsp;David Kaul ,&nbsp;Detlef Imhoff ,&nbsp;Emmanouil Fokas ,&nbsp;Clemens Seidel ,&nbsp;Peter Hau ,&nbsp;Oliver Kölbl ,&nbsp;Ilinca Popp ,&nbsp;Anca-Ligia Grosu ,&nbsp;Jan Haussmann ,&nbsp;Wilfried Budach ,&nbsp;Eren Celik ,&nbsp;Klaus-Henning Kahl ,&nbsp;Elgin Hoffmann ,&nbsp;Raphael Bodensohn","doi":"10.1016/j.ctro.2024.100790","DOIUrl":"https://doi.org/10.1016/j.ctro.2024.100790","url":null,"abstract":"<div><h3>Background</h3><p>The PRIDE trial (NOA-28; ARO-2024-01; AG-NRO-06; NCT05871021) is designed to determine whether a dose escalation with 75.0 Gy in 30 fractions can enhance the median overall survival (OS) in patients with methylguanine methyltransferase (MGMT) promotor unmethylated glioblastoma compared to historical median OS rates, while being isotoxic to historical cohorts through the addition of concurrent bevacizumab (BEV). To ensure protocol-compliant irradiation planning with all study centers, a dummy run was planned and the plan quality was evaluated.</p></div><div><h3>Methods</h3><p>A suitable patient case was selected and the computed tomography (CT), magnetic resonance imaging (MRI) and O-(2-[¹⁸F]fluoroethyl)-L-tyrosine (FET) positron emission tomography (PET) contours were made available. Participants at the various intended study sites performed radiation planning according to the PRIDE clinical trial protocol. The treatment plans and dose grids were uploaded as Digital Imaging and Communications in Medicine (DICOM) files to a cloud-based platform. Plan quality and protocol adherence were analyzed using a standardized checklist, scorecards and indices such as Dice Score (DSC) and Hausdorff Distance (HD).</p></div><div><h3>Results</h3><p>Median DSC was 0.89, 0.90, 0.88 for PTV60, PTV60ex (planning target volume receiving 60.0 Gy for the standard and the experimental plan, respectively) and PTV75 (PTV receiving 75.0 Gy in the experimental plan), respectively. Median HD values were 17.0 mm, 13.9 mm and 12.1 mm, respectively. These differences were also evident in the volumes: The PTV60 had a volume range of 219.1–391.3 cc (median: 261.9 cc) for the standard plans, while the PTV75 volumes for the experimental plans ranged from 71.5–142.7 cc (median: 92.3 cc). The structures with the largest deviations in Dice score were the pituitary gland (median 0.37, range 0.00–0.69) and the right lacrimal gland (median 0.59, range 0.42–0.78).</p></div><div><h3>Conclusions</h3><p>The deviations revealed the necessity of systematic trainings with appropriate feedback before the start of clinical trials in radiation oncology and the constant monitoring of protocol compliance throw-out the study.</p></div><div><h3>Trial registration</h3><p>NCT05871021</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"47 ","pages":"Article 100790"},"PeriodicalIF":3.1,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824000673/pdfft?md5=5f78d707079bfcf7221ac35993812b92&pid=1-s2.0-S2405630824000673-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140894281","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":"Total dose, fraction dose and respiratory motion management impact adrenal SBRT outcome","authors":"Ory Haisraely ,&nbsp;Ilana Weiss ,&nbsp;Marcia Jaffe ,&nbsp;Sarit Appel ,&nbsp;Orit Person-Kaidar ,&nbsp;Zvi Symon ,&nbsp;Maoz Ben-Ayun ,&nbsp;Sergi Dubinski ,&nbsp;Yaacov Lawrence","doi":"10.1016/j.ctro.2024.100788","DOIUrl":"https://doi.org/10.1016/j.ctro.2024.100788","url":null,"abstract":"<div><h3>Purpose/Objective(s)</h3><p>Stereotactic body radiotherapy (SBRT) is an effective treatment for oligometastatic disease in multiple sites. However, the optimal radiation dose for long-term local control of adrenal metastases has yet to be determined. The aim of this study is to evaluate outcomes of adrenal SBRT and to evaluate factors that correlate with local control.</p></div><div><h3>Materials/Methods</h3><p>After IRB approval, a retrospective data review of patients treated with SBRT for adrenal metastases at a medical center in Israel between 2015 and 2021 was conducted. A biological effective dose was calculated using an alpha beta ratio of 10. Kaplan Meier and Cox regression were calculated using SPSS software to describe the hazard ratio for local control and survival.</p></div><div><h3>Results</h3><p>83 cases of adrenal SBRT were identified. The average age was 67 (range 42–92 years old). Non-small cell lung cancer was the primary site in 44 % of patients. A total of 70 % of the patients had oligometastatic disease (less than five lesions), and the rest were polymetastatic, responding to systemic therapy with oligo progression in the adrenal. The average gross tumor volume (GTV) was 42 ml. Respiratory control was applied in 88 % of cases; 49.3 % used 4-D/ITV, and 38.5 % used breath-hold or continuous positive airway pressure (CPAP) with free breathing. On multivariable analysis, Dose above 75 Gy (biological effective Dose) (HR = 0.41, p = 0.031), Dose above 8 Gy per fraction (HR = 0.53p = 0.038), and breath-holds or CPAP (HR = 0.65, p = 0.047) were significant for local control. From multivariable analysis, we computed a predicted nomogram curve using seven clinical parameters to evaluate local control odds.</p></div><div><h3>Conclusion</h3><p>In this single institution series reported to date, we found unilateral adrenal SBRT safe, yet bilateral treatment harbors a risk of adrenal insufficiency. Biological effective Dose &gt; 75 Gy (BED), motion management with breath-hold or CPAP, and Dose per fraction &gt; 8 Gy were the enhanced local controls. We propose a nomogram to help in decision-making regarding total Dose and Dose per fraction when treating adrenal SBRT.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"47 ","pages":"Article 100788"},"PeriodicalIF":3.1,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S240563082400065X/pdfft?md5=1b63256e44f65b1dac8c5416b27c1d9e&pid=1-s2.0-S240563082400065X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140880430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A real-world analysis of stereotactic body radiotherapy combined with immunotherapy in advanced or recurrent non-small cell lung cancer (NSCLC): A single-center experience","authors":"Dan Yao,&nbsp;Xueru Zhu,&nbsp;Jindong Guo,&nbsp;Xiaohuan Dong,&nbsp;Ya Zeng,&nbsp;Xiaolong Fu,&nbsp;Wen Yu","doi":"10.1016/j.ctro.2024.100787","DOIUrl":"https://doi.org/10.1016/j.ctro.2024.100787","url":null,"abstract":"<div><h3>Background</h3><p>We aimed to assess the value of stereotactic body radiotherapy (SBRT) delivered under the situation of controlled or progressed disease during ICI therapy in advanced or recurrent NSCLC.</p></div><div><h3>Methods</h3><p>We retrospectively collected patients with advanced or recurrent NSCLC who received SBRT concurrently with ICI in our institution between January 2017 and December 2021. Patients were divided into two groups, including those for whom SBRT was delivered initially or to the residual tumors during the first- or later-line ICI treatment (Group 1), and those for whom SBRT was given to the progressed tumors irrespective of first- or later-line ICI treatment (Group 2).</p></div><div><h3>Results</h3><p>A total of 144 patients were included. With median follow-up duration of 25.6 (range: 3.6 to 56.2) months, median progression-free survival (PFS) was 13.7 (95 % CI: 10.4 to 17.1) months and median overall survival (OS) was 52.8 [95 % CI: 30.6 to not available (NA)] months. In Group 1 (n = 78), median PFS was 17.9 (95 % CI: 14.5 to 29.8) months while median OS was not reached and 5-year OS rate was 61.2 %. In Group 2 (n = 66), median PFS was 8.0 (95 % CI: 6.0 to 13.1) months and median OS was 30.6 (95 % CI: 21.5 to NA) months.</p></div><div><h3>Conclusions</h3><p>SBRT combined with ICI demonstrated favorable survival for advanced or recurrent NSCLC, delivered in a controlled-disease situation as well as to progressed diseases with salvage-intent. Future prospective studies are warranted to investigate the optimal SBRT dose regimen and appropriate combination strategy to synergize ICI.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"47 ","pages":"Article 100787"},"PeriodicalIF":3.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824000648/pdfft?md5=a0b3c255b1d62a53ea4b3eeffbbc8f12&pid=1-s2.0-S2405630824000648-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140901813","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":"Impact of body composition parameters on radiation therapy compliance in locally advanced rectal cancer: A retrospective observational analysis","authors":"Giuditta Chiloiro ,&nbsp;Marco Cintoni ,&nbsp;Marta Palombaro ,&nbsp;Angela Romano ,&nbsp;Sara Reina ,&nbsp;Gabriele Pulcini ,&nbsp;Barbara Corvari ,&nbsp;Silvia Di Franco ,&nbsp;Elisa Meldolesi ,&nbsp;Gabriele Egidi ,&nbsp;Futura Grassi ,&nbsp;Pauline Raoul ,&nbsp;Emanuele Rinninella ,&nbsp;Antonio Gasbarrini ,&nbsp;Maria Cristina Mele ,&nbsp;Maria Antonietta Gambacorta","doi":"10.1016/j.ctro.2024.100789","DOIUrl":"https://doi.org/10.1016/j.ctro.2024.100789","url":null,"abstract":"<div><h3>Background</h3><p>The impact of body composition and sarcopenia in locally advanced rectal cancer (LARC) is still unclear, even several studies have been published on this issue. Our study aims to analyze the impact of sarcopenia on neoadjuvant chemoradiotherapy (nCRT) tolerance and survival outcomes.</p></div><div><h3>Methods</h3><p>This is a retrospective, monocentric study where LARC patients treated between 2010 and 2020 were enrolled. A single slice, from the pre-therapy simulation computed tomography (CT) scan, was used to perform the body composition analysis with dedicated software. The primary endpoint was the impact of body composition on radiotherapy (RT) interruption secondarily on overall survival (OS), disease-free survival (DFS), and local control (LC).</p></div><div><h3>Results</h3><p>The study included 628 LARC patients (40.9 % female, mean age 63.4 years): 24 % had low skeletal muscle index (SMI), 30 % had low muscle density (MD) and 17 (10.3 % of obese) were sarcopenic obese. Higher BMI (OR 2.38, 95 % CI 1.36–4.01) and lower SMI (0.73, 95 % CI 0.55–0.94) resulted as independent predictors of RT interruption. Sarcopenic obesity (HR 2.83, 95 % CI 1.24–6.45) was related to worse OS, while MD (0.96, 95 % CI 0.93–0.98), and higher SMI (0.97, 95 % CI 0.95–0.99) were related to better OS; a lower MD remained also associated even in adjusted multivariable analysis (0.96, 95 % CI0.93–0.98). Moreover, higher visceral adipose tissue (VAT) resulted associated with worse DFS (1.02, 95 % CI 1.01–1.03), while higher SMI was related to better Local Control (0.96, 95 % CI 0.93–0.99).</p></div><div><h3>Conclusions</h3><p>Body composition analysis, particularly of muscle and fat masses, may be a useful tool for better management of LARC patients undergoing RT. Increased collaboration between radiation oncologists and clinical nutritionists is advisable, to enable early nutritional support of LARC.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"47 ","pages":"Article 100789"},"PeriodicalIF":3.1,"publicationDate":"2024-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824000661/pdfft?md5=52ca76905c62b8377540ee6bbe8d0c24&pid=1-s2.0-S2405630824000661-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140822270","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":"Erectile function preservation after salvage radiation therapy for biochemically recurrent prostate cancer after prostatectomy: Five-year results of the SAKK 09/10 randomized phase 3 trial","authors":"Daniel R. Zwahlen ,&nbsp;Christina Schröder ,&nbsp;Lisa Holer ,&nbsp;Jürg Bernhard ,&nbsp;Tobias Hölscher ,&nbsp;Winfried Arnold ,&nbsp;Bülent Polat ,&nbsp;Guido Hildebrandt ,&nbsp;Arndt-Christian Müller ,&nbsp;Paul Martin Putora ,&nbsp;Alexandros Papachristofilou ,&nbsp;Corinne Schär ,&nbsp;Stefanie Hayoz ,&nbsp;Marcin Sumila ,&nbsp;Kathrin Zaugg ,&nbsp;Matthias Guckenberger ,&nbsp;Piet Ost ,&nbsp;Davide Giovanni Bosetti ,&nbsp;Christiane Reuter ,&nbsp;Silvia Gomez ,&nbsp;Pirus Ghadjar","doi":"10.1016/j.ctro.2024.100786","DOIUrl":"https://doi.org/10.1016/j.ctro.2024.100786","url":null,"abstract":"<div><h3>Objectives</h3><p>To evaluate effects of dose intensified salvage radiotherapy (sRT) on erectile function in biochemically recurrent prostate cancer (PC) after radical prostatectomy (RP).</p></div><div><h3>Materials and methods</h3><p>Eligible patients had evidence of biochemical failure after RP and a PSA at randomization of ≤ 2 ng/ml. Erectile dysfunction (ED) was investigated as secondary endpoint within the multicentre randomized trial (February 2011 to April 2014) in patients receiving either 64 Gy or 70 Gy sRT. ED and quality of life (QoL) were assessed using CTCAE v4.0 and the EORTC QoL questionnaires C30 and PR25 at baseline and up to 5 years after sRT.</p></div><div><h3>Results</h3><p>344 patients were evaluable. After RP 197 (57.3 %) patients had G0-2 ED while G3 ED was recorded in 147 (42.7 %) patients. Subsequently, sexual activity and functioning was impaired. 5 years after sRT, 101 (29.4 %) patients noted G0-2 ED. During follow-up, 44.2 % of patients with baseline G3 ED showed any improvement and 61.4 % of patients with baseline G0-2 ED showed worsening. Shorter time interval between RP and start of sRT (p = 0.007) and older age at randomization (p = 0.005) were significant predictors to more baseline ED and low sexual activity in the long-term. Age (p = 0.010) and RT technique (p = 0.031) had a significant impact on occurrence of long-term ED grade 3 and worse sexual functioning. During follow-up, no differences were found in erectile function, sexual activity, and sexual functioning between the 64 Gy and 70 Gy arm.</p></div><div><h3>Conclusion</h3><p>ED after RP is a known long-term side effect with significant impact on patients’ QoL. ED was further affected by sRT, but dose intensification of sRT showed no significant impact on erectile function recovery or prevalence of de novo ED after sRT. Age, tumor stage, prostatectomy and RT-techniques, nerve-sparing and observation time were associated with long-term erectile function outcome.</p><p><span>ClinicalTrials.gov</span><svg><path></path></svg>. Identifier: NCT01272050.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"47 ","pages":"Article 100786"},"PeriodicalIF":3.1,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824000636/pdfft?md5=99572a5febf51f89c7dd929f0add23fd&pid=1-s2.0-S2405630824000636-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140650326","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":"Fractionated stereotactic radiotherapy of intracranial postoperative cavities after resection of brain metastases – Clinical outcome and prognostic factors","authors":"L. Hahnemann ,&nbsp;A. Krämer ,&nbsp;C. Fink ,&nbsp;C. Jungk ,&nbsp;M. Thomas ,&nbsp;P. Christopoulos ,&nbsp;J.W. Lischalk ,&nbsp;J. Meis ,&nbsp;J. Hörner-Rieber ,&nbsp;T. Eichkorn ,&nbsp;M. Deng ,&nbsp;K. Lang ,&nbsp;A. Paul ,&nbsp;E. Meixner ,&nbsp;F. Weykamp ,&nbsp;J. Debus ,&nbsp;L. König","doi":"10.1016/j.ctro.2024.100782","DOIUrl":"https://doi.org/10.1016/j.ctro.2024.100782","url":null,"abstract":"<div><h3>Background and Purpose</h3><p>After surgical resection of brain metastases (BM), radiotherapy (RT) is indicated. Postoperative stereotactic radiosurgery (SRS) reduces the risk of local progression and neurocognitive decline compared to whole brain radiotherapy (WBRT). Aside from the optimal dose and fractionation, little is known about the combination of systemic therapy and postoperative fractionated stereotactic radiotherapy (fSRT), especially regarding tumour control and toxicity.</p></div><div><h3>Methods</h3><p>In this study, 105 patients receiving postoperative fSRT with 35 Gy in 7 fractions performed with Cyberknife were retrospectively reviewed. Overall survival (OS), local control (LC) and total intracranial brain control (TIBC) were analysed via Kaplan-Meier method. Cox proportional hazards models were used to identify prognostic factors.</p></div><div><h3>Results</h3><p>Median follow-up was 20.8 months. One-year TIBC was 61.6% and one-year LC was 98.6%. Median OS was 28.7 (95%-CI: 16.9–40.5) months. In total, local progression (median time not reached) occurred in 2.0% and in 20.4% radiation-induced contrast enhancements (RICE) of the cavity (after median of 14.3 months) were diagnosed. Absence of extracranial metastases was identified as an independent prognostic factor for superior OS (p = &lt;0.001) in multivariate analyses, while a higher Karnofsky performance score (KPS) was predictive for longer OS in univariate analysis (p = 0.041). Leptomeningeal disease (LMD) developed in 13% of patients.</p></div><div><h3>Conclusion</h3><p>FSRT after surgical resection of BM is an effective and safe treatment approach with excellent local control and acceptable toxicity. Further prospective randomized trials are needed to establish standardized therapeutic guidelines.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"46 ","pages":"Article 100782"},"PeriodicalIF":3.1,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824000594/pdfft?md5=cf4ca1914ae100e3fea5d69d8c8bddf8&pid=1-s2.0-S2405630824000594-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140638187","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":"Stable use of radiotherapy in lymphoma patients over time – A comprehensive national overview of radiotherapy use in Sweden with focus on older patients","authors":"Ingrid Glimelius ,&nbsp;Sara Ekberg ,&nbsp;Karin Ekström Smedby ,&nbsp;Tove Wästerlid","doi":"10.1016/j.ctro.2024.100785","DOIUrl":"https://doi.org/10.1016/j.ctro.2024.100785","url":null,"abstract":"<div><h3>Background and purpose</h3><p>The role of radiotherapy (RT) in lymphoma is constantly refined with the advent of novel treatments. However, RT is still an effective treatment and tolerability is high. Therefore, we aimed to describe the use of RT in primary treatment of lymphoma over calendar time, with a specific focus on older patients (age ≥ 70 years) with non-Hodgkin lymphoma (NHL) subtypes.</p></div><div><h3>Materials &amp; Methods</h3><p>All adult patients diagnosed with lymphoma from 2007 to 2018 in Sweden were included and followed for survival until end of 2020. Patient characteristics and relative survival (RS) were described for patients with NHL by subtype and RT use.</p></div><div><h3>Results</h3><p>In the cohort of lymphoma patients aged ≥ 70 years (n = 12,698) 11 % received RT as part of primary treatment. No decline in use of RT over calendar period was seen. Use of RT as monotherapy was associated with stage I-II disease and older age among patients with stage III-IV disease. Patients with indolent lymphomas aged ≥ 70 years who were selected for treatment with RT as monotherapy with a dose of ≥ 20 Gy had 2-year RS rate of 100 % which remained similar at five years. For patients with DLBCL, RT as monotherapy with a dose of ≥ 20 Gy was mostly administered to patients aged ≥ 85 years with a 2-year RS rate of 68 %.</p></div><div><h3>Conclusion</h3><p>The use of RT in first-line lymphoma treatment was stable over calendar time. RT monotherapy is associated with encouraging outcomes among patients with NHL aged ≥ 70 years who were selected to receive this.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"46 ","pages":"Article 100785"},"PeriodicalIF":3.1,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824000624/pdfft?md5=0e92e96b82fe0bc8157b67a4895c7bfc&pid=1-s2.0-S2405630824000624-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140638173","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":"The first real-world study on the role of carbon ion radiotherapy for oligo-metastatic, persistent, or recurrent (MPR) ovarian/fallopian tube cancer","authors":"Amelia Barcellini ,&nbsp;Kazutoshi Murata ,&nbsp;Giulia Fontana ,&nbsp;Alessandro Vai ,&nbsp;Chiara Cassani ,&nbsp;Fabio Landoni ,&nbsp;Laura Deborah Locati ,&nbsp;Francesco Raspagliesi ,&nbsp;Simona Secondino ,&nbsp;Mattia Pecorilla ,&nbsp;Shigeru Yamada ,&nbsp;Noriyuki Okonogi ,&nbsp;Ester Orlandi","doi":"10.1016/j.ctro.2024.100781","DOIUrl":"10.1016/j.ctro.2024.100781","url":null,"abstract":"<div><h3>Introduction</h3><p>In the multidisciplinary management of oligometastatic, persistent, or recurrent (MPR) ovarian cancer, radiotherapy (RT) is becoming a more and more worthwhile treatment to potentially improve the chronicity of the disease. Particle beam RT has proved to be effective in several gynecological malignancies, but so far no data are available for ovarian cancer.</p></div><div><h3>Material and Methods</h3><p>This is a real-world, retrospective, bi-institutional, single-arm study aimed to assess the effectiveness and the safety of carbon ion RT (CIRT) in this setting. The co-first endpoints are 1-year and 2-year actuarial local control (LC) rates and the objective response rate (ORR) defined on a “per lesion” basis. The secondary endpoint was toxicity. Actuarial outcomes were evaluated using the Kaplan-Meier method while potential predictors were explored using the Log-rank test. Bi-variable logistic regression was employed in the analysis of factors predicting the complete response on a per-lesion basis.</p></div><div><h3>Results</h3><p>26 patients accounting for a total of 36 lesions underwent CIRT with a total median dose of 52.8 Gy[RBE] (range: 39–64 Gy[RBE]). Five patients received CIRT for re-irradiation. No concomitant systemic therapies were administered during CIRT. Within 12 months after the treatment, 17 lesions (47 %) achieved complete response while 18 (50 %) obtained a partial response with an ORR of 97 %. The achievement of a complete response is related to the dose per fraction (&gt;4.2 Gy[RBE], p = 0.04) and total dose (&gt;52,8 Gy[RBE], p = 0.05). The 1-year LC was 92 % and the 2-year LC was 83 %, according to the achievement of a CR (p = 0.007) and GTV ≤ 14 cm3 (p = 0.024). No grade &gt; 3 toxicities were recorded both in naïve and re-irradiated patients. PARP-i and anti-VEGF seemed not to exacerbate the risk of severe toxicities.</p></div><div><h3>Conclusions</h3><p>CIRT was effective and safe in MPR ovarian cancers, even in the case of re-irradiation. Largest cohort studies and longer follow-up are needed to confirm these data.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"47 ","pages":"Article 100781"},"PeriodicalIF":3.1,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824000582/pdfft?md5=a0ca991d0e46b65bc37c94bfaedc8e2c&pid=1-s2.0-S2405630824000582-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140767614","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":"Neuroprotection in radiotherapy of brain metastases: A pattern-of-care analysis in Germany, Austria and Switzerland by the German Society for radiation Oncology − working group Neuro-Radio-Oncology (DEGRO AG-NRO)","authors":"N. Gleim ,&nbsp;A. Rühle ,&nbsp;S. Heider ,&nbsp;F. Nägler ,&nbsp;F.A. Giordano ,&nbsp;S.E. Combs ,&nbsp;J. Becker ,&nbsp;M. Niyazi ,&nbsp;A.L. Grosu ,&nbsp;N.H. Nicolay ,&nbsp;C. Seidel","doi":"10.1016/j.ctro.2024.100783","DOIUrl":"https://doi.org/10.1016/j.ctro.2024.100783","url":null,"abstract":"<div><h3>Background and purpose</h3><p>Many patients with solid tumors develop brain metastases (BM). With more patients surviving long-term, preservation of neurocognitive function gains importance. In recent years, several methods to delay cognitive deterioration have been tested in clinical trials. However, knowledge on the extent to which these neuroprotective strategies have been implemented in clinical practice is missing.</p></div><div><h3>Materials and methods</h3><p>We performed an online survey regarding treatment patterns of BM in German-speaking countries, focused on the use of neuroprotective approaches. The survey was distributed among radiation oncologists (ROs) registered within the database of the German Society for Radiation Oncology (DEGRO).</p></div><div><h3>Results</h3><p>Physicians of 78 centers participated in the survey. Whole brain radiotherapy (WBRT) is still preferred by 70 % of ROs over stereotactic radiotherapy (SRT) in patients with 6–10 BM. For 4–5 BM WBRT is preferred by 23 % of ROs. The fraction of ROs using hippocampal sparing (HS) in WBRT has increased to 89 %, although the technique is used on a regular basis only by a minority (26 %). The drug memantine is not widely prescribed (14% of ROs). A trend was observed for university hospitals to implement neuroprotective approaches more frequently.</p></div><div><h3>Conclusion</h3><p>There is considerable heterogeneity regarding the treatment of BM in German-speaking countries and a general standard of care is lacking. Neuroprotective strategies are not yet standard approaches in daily clinical routine, although usage is increasing. Further clinical trials, as well as improvement of technical opportunities and reimbursement, might further shift the treatment landscape towards neuroprotective radiation treatments in the future.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"47 ","pages":"Article 100783"},"PeriodicalIF":3.1,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824000600/pdfft?md5=c49128b724794be28a5791bfeb12529d&pid=1-s2.0-S2405630824000600-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140643855","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":"Continuous and bilevel positive airway pressure may improve radiotherapy delivery in patients with intra-thoracic tumors","authors":"J. Elshof ,&nbsp;C.M. Steenstra ,&nbsp;A.G.H. Niezink ,&nbsp;P.J. Wijkstra ,&nbsp;R. Wijsman ,&nbsp;M.L. Duiverman","doi":"10.1016/j.ctro.2024.100784","DOIUrl":"https://doi.org/10.1016/j.ctro.2024.100784","url":null,"abstract":"<div><h3>Background</h3><p>Minimizing tumor motion in radiotherapy for intra-thoracic tumors reduces side-effects by limiting radiation exposure to healthy tissue. Continuous or Bilevel Positive Airway Pressure (CPAP/BiPAP) could achieve this, since it could increase lung inflation and decrease tidal volume variability. We aim to identify the better CPAP/BiPAP setting for minimizing tumor motion.</p></div><div><h3>Methods</h3><p>In 10 patients (5 with lung cancer, 5 with other intra-thoracic tumors), CPAP/BiPAP was tested with the following settings for 10 min each: CPAP 5, 10 and 15 cmH₂O and BiPAP 14/10 cmH₂O with a lower (7 breaths/min) and higher back-up respiratory rate (BURR initially 1 breath/min above the spontaneous breathing frequency, with the option to adjust if the patient continued to initiate breaths). Electrical impedance tomography was used to analyse end-expiratory lung impedance (EELI) as an estimate of end-expiratory lung volume and tidal impedance variation (TIV) as an estimate of tidal volume.</p></div><div><h3>Results</h3><p>Nine out of ten patients tolerated all settings; one patient could not sustain CPAP-15. A significant difference in EELI was observed between settings (χ² 22.960, p &lt; 0.001), with most increase during CPAP-15 (median (IQR) 1.03 (1.00 – 1.06), normalized to the EELI during spontaneous breathing). No significant differences in TIV and breathing variability were found between settings.</p></div><div><h3>Conclusions</h3><p>This study shows that the application of different settings of CPAP/BiPAP in patients with intra-thoracic tumors is feasible and tolerable. BiPAP with a higher BURR may offer the greatest potential for mitigating tumor motion among the applied settings, although further research investigating tumor motion should be conducted.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"47 ","pages":"Article 100784"},"PeriodicalIF":3.1,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824000612/pdfft?md5=4c8c2112564cf8b367b58d96a4e37d88&pid=1-s2.0-S2405630824000612-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140644022","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}