Clinical and Translational Radiation Oncology最新文献

{"title":"Thoracic reirradiation clinical and technical practices: a survey from the reirradiation Collaborative Group (ReCOG)","authors":"Martha M. Matuszak ,&nbsp;Charles B. Simone II ,&nbsp;Charles K. Matrosic ,&nbsp;Dawn Owen ,&nbsp;Annemarie F Shepherd ,&nbsp;Ane Appelt ,&nbsp;Charles Mayo ,&nbsp;Kelly C. Paradis ,&nbsp;Ellen Yorke ,&nbsp;Nicolaus Andratschke","doi":"10.1016/j.ctro.2025.101042","DOIUrl":"10.1016/j.ctro.2025.101042","url":null,"abstract":"<div><h3>Introduction</h3><div>Thoracic reirradiation is increasingly used globally, but prospective evidence is scarce, leading to practice based primarily on institutional experience. Recognizing the need for guidance, international multi-professional experts convened at the first Reirradiation Collaborative Group (ReCOG) Meeting. This report presents results from a survey on best practices, challenges, and knowledge gaps among experts on thoracic reirradiation.</div></div><div><h3>Methods</h3><div>A comprehensive 50-question survey was developed by experts and discussed within the thoracic focus group at ReCOG. It included questions on participant demographics and clinical experience, patient-related clinical conditions and selection, imaging and targets, treatment planning, and dose accumulation. Participants were asked for perceived challenges as well as gaps in knowledge.</div></div><div><h3>Results</h3><div>The survey was completed by 34/51 invited experts (67 % response rate). Most respondents (79 %) were experienced physicists and radiation oncologists (&gt;10 years) primarily at university hospitals (65 %). The most common tumors treated were locally recurrent lung cancer, mediastinal nodes, or thoracic metastases. Reirradiation goals included prolonging local control and survival, and alleviating/preventing symptoms. Conditions precluding reirradiation were persistent grade 3+ toxicity and progressive disease. Major toxicity concerns were bleeding, airway injury/fistula, and esophageal ulceration/fistula. Technical practices varied with regards to image registration, dose accumulation and recovery factors. Advanced treatment planning techniques and IGRT were consistent amongst respondents. Major challenges included lack of clinical guidelines and lack of software support tools.</div></div><div><h3>Conclusion</h3><div>Thoracic reirradiation is an increasingly prevalent area of interest despite scarcity of prospective data. The major focus currently still is primarily on treatment-related factors and the question of how to combine reirradiation with systemic therapy. However, there is little guidance on whether and how to modify a planned reirradiation dose based on patient comorbidities or recovery from the prior radiation course. This survey identified emerging areas of consensus as well as relevant variations and gaps in practice.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101042"},"PeriodicalIF":2.7,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145156051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of prostate recurrence after focal salvage prostate brachytherapy for radiorecurrent prostate cancer","authors":"Alba Domínguez Domínguez ,&nbsp;Niels den Haan ,&nbsp;Jan Wiersma ,&nbsp;Josephina C.C. Koppes ,&nbsp;Karel A. Hinnen ,&nbsp;Bradley R. Pieters","doi":"10.1016/j.ctro.2025.101043","DOIUrl":"10.1016/j.ctro.2025.101043","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Focal high-dose-rate (HDR) salvage brachytherapy has emerged as a treatment for radiorecurrent prostate cancer. This study aims to evaluate patterns of recurrence after focal salvage brachytherapy and to assess the adequacy of current treatment margins.</div></div><div><h3>Materials and methods</h3><div>Between March 2015 and December 2021, 39 patients with radiorecurrent prostate cancer underwent focal HDR brachytherapy. All patients had biopsy-confirmed local recurrence and were staged using Choline- or PSMA-PET/CT and multiparametric MRI. A 5 mm margin around the GTV was applied to define the CTV. Post-treatment recurrences were analyzed using rigid image registration of PET/CT and MRI to assess spatial relationships among the initial recurrence (Rec1), the recurrence following salvage brachytherapy (Rec2), and the brachytherapy dose distribution. The recurrences were categorized into infield, marginal, and outfield based on overlap of relapse with the treated CTV and based on dose received on the site of the relapse. Additionally, spatial analysis measured minimal distances between Rec1 and Rec2.</div></div><div><h3>Results</h3><div>Nineteen of 39 patients experienced clinical recurrence, with 12 exhibiting 25 local lesions. Based on spatial overlap, 20 % of Rec2 lesions were infield, 28 % marginal, and 52 % outfield. Dose-based classification indicated 52 % infield, 8 % marginal, and 40 % outfield recurrence. The median distance between Rec1 and Rec2 in outfield cases was 11.9–13.4 mm.</div></div><div><h3>Conclusion</h3><div>A substantial proportion of local recurrences after focal salvage brachytherapy occur outside the treated volume. Current 5 mm margins may be insufficient.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101043"},"PeriodicalIF":2.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145047411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combining CAR-T therapy with radiotherapy or not in refractory/relapsed diffuse large B-cell lymphoma: A comparative study","authors":"Yun Yang ,&nbsp;Bichun Xu ,&nbsp;Hong Zhu ,&nbsp;Weikai Sun ,&nbsp;Aibin Liang ,&nbsp;Judong Luo","doi":"10.1016/j.ctro.2025.101041","DOIUrl":"10.1016/j.ctro.2025.101041","url":null,"abstract":"<div><h3>Background</h3><div>Radiotherapy and Chimeric Antigen Receptor(CAR)-T therapy may exhibit a synergistic effect, suggesting that incorporating radiotherapy into CAR-T could improve the prognosis for patients with refractory/relapsed diffuse large B-cell lymphoma (R/R DCBCL). A lack of standardized treatment protocols and relevant guidelines in bridging radiotherapy(BRT) prior to CAR-T therapy still exists. Consequently, we retrospectively analyzed the outcomes of R/R DLBCL patients treated with BRT prior to CAR-T therapy or not, aiming to evaluate the efficacy and satety of BRT as well as the impact of radiotherapy dose on prognosis.</div></div><div><h3>Methods</h3><div>Between December 2017 and January 2025, 80 patients diagnosed with R/R DLBCL were treated with CAR-T. Thirty-five of them received BRT during leukapheresis and lymphodepletion. The primary endpoint of this study was progression free survival(PFS), and secondary endpoints included overall survival(OS), disease-specific survival(DSS), in-field PFS, best objective response rate(ORR), and complete response rate(CRR). PFS and OS of CAR-T were compared between BRT group and no BRT group. In the subgroup of radiotherapy patients, PFS, OS and in-field PFS were compared between the low-Equivalent dose to 2 Gy per fraction(EQD₂) subgroup and the high-EQD₂ subgroup.</div></div><div><h3>Results</h3><div>BRT group showed obviously longer PFS and OS than no BRT group(p = 0.001, p = 0.043). In addition, BRT did not increase the incidence of CAR-T toxicities during follow-up (median:35.27 months). Comprehensive BRT subgroup improved prognosis in PFS(p = 0.015) and OS(p = 0.029) when compared with focal BRT subgroup, no significant effect on DSS was noted(p = 0.109). High-EQD2 subgroup did not significantly improve PFS(p = 0.181) and OS(p = 0.665) except for local control(p = 0.079) especially in patients with high tumor burden(p = 0.005). There is no impact on prognosis between early salvage radiotherapy(SRT) and salvage chemotherapy(SCT) cohorts in patients with PR response to CAR-T therapy.</div></div><div><h3>Conclusions</h3><div>Our analysis demonstrated that BRT is a effective and safe approach for patients with R/R DLBCL preparing for CAR T-cell therapy, which indicated that BRT may enhance the anti-tumor effect of CAR T-cells.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"55 ","pages":"Article 101041"},"PeriodicalIF":2.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous β− particle exposure: A study of DNA damage in ex vivo peripheral blood mononuclear cells irradiation with Radioiodine","authors":"Laura Mazzitelli-Fuentes ,&nbsp;Lara Negrin ,&nbsp;Virginia Venier ,&nbsp;Humberto Romano ,&nbsp;Lucia Pereira ,&nbsp;Jerónimo Leberle ,&nbsp;Maria Soledad Ausas ,&nbsp;Ananya Choudhury ,&nbsp;Luisa V. Biolatti","doi":"10.1016/j.ctro.2025.101040","DOIUrl":"10.1016/j.ctro.2025.101040","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Targeted radionuclide therapy (TRT) is a promising cancer treatment, but insufficient knowledge of the biological dose–response relationships limits its efficacy. The aim of this study was to characterize DNA damage in peripheral blood mononuclear cells (PBMCs) exposed to β-continuous irradiation (¹³¹I), and to assess its relationship with the absorbed dose, using two biomarkers: dicentric chromosomes and γ-H2AX foci.</div></div><div><h3>Materials and methods</h3><div>PBMCs from healthy donors were exposed to ¹³¹I at various activities (0.37–3.7 MBq) and times (1, 4, 24 h). Absorbed doses were calculated using the Medical Internal Radiation Dose formalism. DNA damage was assessed by chromosomal aberration frequency and γ-H2AX foci quantification. Lithium chloride (LiCl) was used to evaluate the rescue of delayed foci formation after 24 h exposure.</div></div><div><h3>Results</h3><div>Continuous β-irradiation induced a linear increase in CAs (α = 0.0643 ± 0.0068), in contrast to the linear-quadratic response observed in acute X-ray exposure (α = 0.0359 ± 0.0093, β = 0.0673 ± 0.0042). The frequency of CAs is lower under radionuclide irradiation compared to X-rays. γ-H2AX increased significantly at 1 and 4 h of continuous exposure but diminished at 24 h, despite continuous irradiation. LiCl treatment partially restored γ-H2AX foci levels at 24 h.</div></div><div><h3>Conclusion</h3><div>Dose-response relationship under continuous β-irradiation, assessed by CAs, follows a linear trend. DNA damage induced foci show a time-dependent dynamic. The decline in foci at 24 h, reversible with LiCl, highlights the limitations of γ-H2AX as a biomarker under prolonged irradiation conditions. These findings emphasize the need for optimized dosimetry methods and identify reliable biomarkers in TRT.</div><div>Abbreviations: TRT, targeted radionuclide therapy; MIRD, Medical Internal Radiation Dose; EBRT, external beam radiotherapy; LQ, linear-quadratic; DCA, dicentric chromosome assay; DSB, double strand break; PBMCs, peripheral blood mononuclear cells; PB, peripheral blood; FBS, fetal bovine serum; PBS, phosphate-buffered saline; CAs, chromosomal aberrations; RT, room temperature.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"55 ","pages":"Article 101040"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in use of magnetic resonance imaging and partial breast irradiation between 2011–2022 in the Netherlands: A population-based study","authors":"Y.A. Civil ,&nbsp;A.H. Eijkelboom ,&nbsp;A.E. Veldink ,&nbsp;M.C. van Maarenc ,&nbsp;J.H. Maduro ,&nbsp;K.M. Duvivier ,&nbsp;S. Siesling ,&nbsp;H.J.G.D. van den Bongard","doi":"10.1016/j.ctro.2025.101039","DOIUrl":"10.1016/j.ctro.2025.101039","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to investigate whether the introduction of partial breast irradiation (PBI) was associated with increased MRI use in the Netherlands from 2011 to 2022, and examined the impact of MRI on treatment and outcomes.</div></div><div><h3>Methods</h3><div>Women aged ≥50 who underwent surgery (without preoperative systemic therapy) for cT1-2N0M0 breast cancer or DCIS between 2011 and 2022 were selected from the Netherlands Cancer Registry. Logistic regression was used to analyze associations between MRI and treatment or surgical radicality, stratified by tumour type. Subgroup analyses were performed in patients meeting ASTRO PBI criteria (unifocal cT1, grade 1/2, ER-positive, pure DCIS ≤ 2,5 cm).</div></div><div><h3>Results</h3><div>Among 119,768 patients, 35,863 (30 %) received MRI, increasing from 24 % (2011) to 37 % (2022). PBI use increased from 3 % (2017) to 21 % (2022). MRI was not associated with the probability of receiving PBI (OR 0.98, 95 % CI:0.90–1.07). In patients with invasive breast cancer, MRI was associated with fewer DCIS-involved margins (OR 0.81, 95 % CI:0.74–0.89), but a higher probability of mastectomy (OR 1.29, 95 % CI:1.24–1.34). In patients with an ASTRO-defined PBI indication, MRI use was associated with a decreased likelihood of receiving PBI in invasive cancer (OR:0.66, 95 % CI:0.60–0.72) and DCIS (OR:0.80, 95 % CI:0.75–0.85).</div></div><div><h3>Conclusion</h3><div>This study shows rising trends in PBI and MRI use in the Netherlands from 2011 to 2022. MRI reduced PBI eligibility and enhanced surgical precision by less involved margins in patients with cT1N0 breast cancer without PST.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"55 ","pages":"Article 101039"},"PeriodicalIF":2.7,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salvage stereotactic MR-Guided adaptive radiotherapy (SMART) re-irradiation for locally recurrent prostate Cancer: Clinical and dosimetric outcomes","authors":"Elena Moreno-Olmedo,&nbsp;Dan Murray,&nbsp;Ben George,&nbsp;Daniel Ford,&nbsp;Nicola Dallas,&nbsp;Prantik Das,&nbsp;Ami Sabharwal,&nbsp;Yoodhvir Nagar,&nbsp;Jamie Mills,&nbsp;Carla Perna,&nbsp;Yae-eun Suh,&nbsp;Alex Martin,&nbsp;Philip Camilleri","doi":"10.1016/j.ctro.2025.101037","DOIUrl":"10.1016/j.ctro.2025.101037","url":null,"abstract":"<div><h3>Introduction</h3><div>Stereotactic ablative radiotherapy (SABR) is a salvage option for locally recurrent prostate cancer (LRPC); however, challenges remain. Stereotactic MRguided Adaptive Radiotherapy (SMART) permits daily adaptation, real-time tracking and automated beam gating, allowing critical organ sparing while potentially improving target coverage. Equivalent Dose in 2 Gy fraction (EQD2) calculation allows accurate organs-at-risk (OAR) dose accumulation in re-irradiation.</div><div>We report safety and efficacy of daily SMART re-irradiation for LRPC, alongside an EQD2-based OAR tolerance calculation method.</div></div><div><h3>Methods</h3><div>Salvage SMART to histologically proven non-metastatic hormone-sensitive LRPC was retrospectively analysed. Inclusion criteria included: ≥18 months post-RT, prostate-specific antigen (PSA) ≤ 30 ng/mL, PSA doubling-time &gt; 6 months, International Prostate Symptom Score (IPSS) ≤ 19, prostate ≤ 80 cc and cT1–T3a/b.Reirradiation regimens were 30–35 Gy/5 fractions. Dose-boost and hormone therapy were allowed. Rectal spacer was recommended.</div><div>Outcomes included toxicity, local control (LC), biochemical relapse-free survival (bRFS), progression free survival (PFS) and overall survival (OS). EQD2-based workflow to estimate OAR cumulative constraints was reported.</div></div><div><h3>Results</h3><div>Between 2019 and 2023, nineteen patients underwent salvage-SMART to whole-gland (n = 12), hemi-gland (n = 5) or seminal vesicle (n = 2) at a median 87 months (range 35–587) from first radiotherapy. All 95 delivered fractions underwent online adaptation, meeting all estimated OAR.</div><div>With 21 months follow-up, acute grade 2 genitourinary (GU) toxicity was 21 % with no acute ≥ grade 3 GU or ≥ grade 2 gastrointestinal (GI) toxicity observed. Late GU grade 3 toxicity occurred in 3 patients (15.7 %).</div><div>OS was 100%; bRFS 73.7%; LC 84.2%; and median-PFS was not reached. One and two-year PFS were 94.7% and 89.4%. One and two-year LC was 100%. Two contralateral intraprostatic failures followed hemi-gland treatment were observed.</div></div><div><h3>Conclusion</h3><div>Daily adaptive SMART re-irradiation is a feasible, non-invasive salvage option for LRPC, combining high LC with low toxicity. Our experience supports integrating MR- guidance with an individualized EQD2-informed planning.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101037"},"PeriodicalIF":2.7,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic factors, patterns of failure and re-irradiation in hypofractionated stereotactic radiotherapy-treated brain metastases from non-small cell lung cancer","authors":"Dayu Xu ,&nbsp;Yechun Pang ,&nbsp;Jinghan Qu ,&nbsp;Jiuang Mao ,&nbsp;Tiantian Guo ,&nbsp;Shanshan Jiang ,&nbsp;Yue Zhou ,&nbsp;Li Chu ,&nbsp;Xi Yang ,&nbsp;Xiao Chu ,&nbsp;Shengping Wang ,&nbsp;Tong Tong ,&nbsp;Zhengfei Zhu ,&nbsp;Jianjiao Ni","doi":"10.1016/j.ctro.2025.101038","DOIUrl":"10.1016/j.ctro.2025.101038","url":null,"abstract":"<div><h3>Background</h3><div>Hypofractionated stereotactic radiotherapy (fSRT) is increasingly used for brain metastases (BMs) from non-small cell lung cancer (NSCLC). However, relevant data concerning treatment outcomes of fSRT and clinical utility of re-irradiation using fSRT (re-fSRT) remain scarce.</div></div><div><h3>Methods</h3><div>Consecutive NSCLC patients with fSRT-treated BMs from May 2018 to May 2022 were included. The cumulative incidence of intracranial local recurrence (iLR), intracranial progressive disease (iPD) and symptomatic radiation necrosis (sRN) were calculated from the initiation of fSRT, choosing death as the competing event. Patients with limited iPD (number ≤5 and size ≤3 cm) and without iLR developed within 12 months, were classified as re-fSRT candidates. The clinical value of re-fSRT and dosimetric predictors of sRN were investigated.</div></div><div><h3>Results</h3><div>With a median follow-up of 22.3 months, the 1-year, 2-year and 3-year cumulative incidence of iLR among the 218 identified patients were 8.1 %, 12.3 %, 17.8 %, respectively. Biological effective dose, total tumor volume and concurrent systemic therapy were associated with the risk of iLR. Notably, 45 (76.3 %) of the 59 patients with iPD were feasible for re-fSRT. Re-fSRT was performed in 19 (42.2 %) of the 45 candidates and associated with improved survival (<em>p</em> = 0.010). The 1-year, 2-year and 3-year cumulative incidence of sRN in the whole population were 4.5 %, 10.3 %, 17.7 %, respectively. Moreover, sRN occurred in 3 (15.8 %) patients receiving re-fSRT and Brain V20Gy was found to be associated with the risk of sRN.</div></div><div><h3>Conclusion</h3><div>fSRT is a promising treatment for limited BMs from NSCLC and some patients may benefit from re-fSRT.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"55 ","pages":"Article 101038"},"PeriodicalIF":2.7,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144902886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re-irradiation of recurrent lung tumours: Associations between dose and 2-year survival","authors":"Robert Rulach ,&nbsp;Stephen Harrow ,&nbsp;Anthony J. Chalmers ,&nbsp;John Fenwick","doi":"10.1016/j.ctro.2025.101036","DOIUrl":"10.1016/j.ctro.2025.101036","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Loco-regional recurrence is seen in up to 50 % of patients with non-small cell lung cancer (NSCLC) by 2 years after curative intent radiotherapy (RT). For these patients, radical re-irradiation (re-RT) is possible, but data is lacking regarding efficacy and radiation dose response, especially about conventionally fractionated re-irradiation. We analysed associations between survival following re-irradiation and RT dose, to guide clinicians regarding target re-RT dose, and predict re-treatment efficacy.</div></div><div><h3>Material and methods</h3><div>We performed a literature search for studies primarily comprised of NSCLC patients that detailed 2-year overall survival (OS_2-yr) rates and delivered doses. These data were collated with intervals between treatments, PTV sizes and use of concurrent chemotherapy where this information was available. Logistic regression analyses of associations between OS_2-yr and treatment and patient factors were carried out. Doses required for 30% and 50% OS_2-yr were calculated.</div></div><div><h3>Results</h3><div>We identified 20 suitable studies (675 patients). In univariable models, OS_2-yr was significantly associated with the initial RT dose, re-RT dose and chemotherapy use but not the interval. The best multivariable OS_2-yr model according to the Akaike Information Criterion included only the re-RT dose (p &lt; 0.05) and described the data well (Hosmer-Lemeshow p-value = 0.385). This model predicted OS_2-yr rates of 30 % and 50 % at re-RT equivalent doses in 2 Gy fractions (EQD2s) of 49.8 Gy₁₀ (95 % CI 36.4, 58.0 Gy₁₀) and 76.5 Gy₁₀ (95 % CI 70.8, 82.7 Gy₁₀) respectively.</div></div><div><h3>Conclusion</h3><div>OS_2-yr following re-RT of recurrent NSCLC is significantly associated with retreatment dose. A reasonable target dose for re-RT is EQD2s &gt; 50 Gy₁₀ with survival rates continuing to increase to 85 Gy₁₀.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"55 ","pages":"Article 101036"},"PeriodicalIF":2.7,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144892913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neoadjuvant prostate artery embolization prior to prostate radiation therapy: A single institution experience on the durability of clinical urinary improvement after radiation","authors":"Vaseem M. Khatri ,&nbsp;G.Daniel Grass ,&nbsp;Ram Thapa ,&nbsp;Laura Maun-Garcia ,&nbsp;Kujtim Latifi ,&nbsp;Arash O. Naghavi ,&nbsp;Aditya Garg ,&nbsp;Daniel Fernandez ,&nbsp;Javier Torres-Roca ,&nbsp;Anupam Rishi ,&nbsp;Omeed Jazayeri-Moghaddas ,&nbsp;Julio Pow-Sang ,&nbsp;Peter A.S. Johnstone ,&nbsp;Kosj Yamoah ,&nbsp;Nainesh Parikh","doi":"10.1016/j.ctro.2025.101035","DOIUrl":"10.1016/j.ctro.2025.101035","url":null,"abstract":"<div><h3>Background</h3><div>Radiation therapy (RT) for prostate cancer has gastrointestinal and genitourinary toxicities, greater with baseline lower urinary tract symptoms (LUTS) and larger prostate volume (PV). Prostate artery embolization (PAE) improves LUTS and PV before RT. This study evaluates the durability of LUTS improvement from neoadjuvant PAE before prostate RT and oncologic outcomes.</div></div><div><h3>Methods</h3><div>We retrospectively identified patients receiving definitive prostate RT following PAE from a prospective database, including International Prostate Symptom Scores (IPSS), pre- and post-PAE MRI PV, and toxicity per CTCAEv5.0. Primary objective was LUTS by IPSS. Secondary objectives included biochemical recurrence-free survival (bRFS), local recurrence, and distant metastasis.</div></div><div><h3>Results</h3><div>From 9/2017–5/2024, 82 patients underwent PAE before RT, with 30.5 % having unfavorable intermediate risk. RT consisted of conventional fractionation (n = 21), moderate hypofractionation (n = 42), SBRT (n = 11), and EBRT/brachytherapy boost (n = 8); a subset of patients received androgen deprivation therapy. Pelvic lymph nodes were treated in 28 (34 %) patients. Median pre-PAE IPSS was 18 (range 2–34), PV 90 cc (14.2–240), and PSA 8.4 ng/mL (0.02–125.5). Post-PAE, mean IPSS reduction was 10.7 points (−13–30). Mean PV reduction was 30.9 cc (−9–136) or 32 %. PAE converted 52 % of patients contraindicated by size/IPSS for brachytherapy/SBRT. Post-RT, mean IPSS changes at 3, 6, 12, 18 and 24 months were −8.7, −8.5, −9.5, −8.9, and −7.6, respectively (<em>p</em> &lt; 0.001). At 24.2-month median follow-up, 1 local recurrence occurred. Two-year bRFS was 92 % for non-metastatic patients.</div></div><div><h3>Conclusion</h3><div>Urinary improvement is durable after RT in men with large prostates and/or high LUTS burden with neoadjuvant PAE, and no increased risk of recurrence at intermediate-term follow-up. Further investigation is warranted.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"55 ","pages":"Article 101035"},"PeriodicalIF":2.7,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biological sex representation and reporting in stereotactic body radiotherapy for kidney cancer: A review of clinical studies","authors":"Sylvia Nwokolo,&nbsp;Laure Marignol","doi":"10.1016/j.ctro.2025.101034","DOIUrl":"10.1016/j.ctro.2025.101034","url":null,"abstract":"<div><h3>Background</h3><div>Stereotactic body radiotherapy (SBRT) is evolving as treatment modality for kidney cancer alongside increased recognition of the importance of sex as a biological variable (SABV) policy in generating deeper insights.</div></div><div><h3>Purpose</h3><div>This review aimed to assess the representation of male and female patients and the reporting of sex-specific outcomes in SBRT clinical studies for primary localised kidney cancer.</div></div><div><h3>Methodology</h3><div>A database search with appropriate search terms was carried out on EMBASE, CINAHL, and Web of Science. Consideration of biological sex was assessed with the male: female ratio, reporting of sex-specific treatment outcomes, and inclusion of sex as a variable in univariate and/or multivariate analysis.</div><div><em><strong>Main findings</strong></em>:</div><div>Twenty-two studies were included. Of 961 patients (with sex stated), 29.24 % were females, with a mean male to female ratio of 2.57 and standard deviation of 1.22 across the studies. There was no relationship between the year, region and study type, and the male to female ratio recorded (Chi-squared test, p = 0.099, 0.29, and 0.719 respectively). Only six studies were sex inclusive, with three reporting sex-based outcomes, and three including sex-specific analysis. Of these, only one study reported significant difference in survival.</div></div><div><h3>Conclusion</h3><div>Supporting the integration of SABV will promote more equitable and biologically informed evidence for the use of SBRT in the management of kidney cancer.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"55 ","pages":"Article 101034"},"PeriodicalIF":2.7,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}