Clinical and Translational Radiation Oncology最新文献

{"title":"Stereotactic Body Radiotherapy vs. Metastasectomy for Soft Tissue and Bone Sarcoma Lung Metastases – A Systematic Review analyzing Safety and Efficacy","authors":"Lena Kretzschmar ,&nbsp;Maksym Fritsak ,&nbsp;Philip Heesen ,&nbsp;Astrid Heusel ,&nbsp;Sylvie Bonvalot ,&nbsp;Matthias Guckenberger ,&nbsp;Aisha Miah ,&nbsp;Falk Röder ,&nbsp;Maria Anna Smolle ,&nbsp;Sebastian M. Christ ,&nbsp;Siyer Roohani","doi":"10.1016/j.ctro.2025.101097","DOIUrl":"10.1016/j.ctro.2025.101097","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary metastases (PM) develop in ∼ 30 % of sarcoma patients after curative therapy and confer poor prognosis. Surgery and stereotactic body radiotherapy (SBRT) are viable local ablative options, but direct comparative data is limited. This systematic review evaluates oncologic outcomes and toxicities of surgery versus SBRT for sarcoma-derived PM.</div></div><div><h3>Materials and methods</h3><div>We systematically reviewed Medline and references for studies of sarcoma-PM treated with surgery or SBRT according to PRISMA, including publications up to 13th May 2025. Outcomes included local control (LC), progression-/disease-free survival (PFS/DFS), overall survival (OS), and toxicities, with OS data harmonized for pooled analysis.</div></div><div><h3>Results</h3><div>Fifty-eight mostly retrospective studies comprising 4,787 patients were included. LC, PFS, and DFS were heterogeneously reported but generally similar. Three-year weighted median LC was 89.6 % (surgery, 2 studies) vs. 87.8 % (SBRT, 15 studies). Reporting on PFS/DFS was limited: Four-year-PFS 21 % (SBRT) vs. 28 % (surgery, 1 study each); 5-year-DFS 12 % (SBRT, 1 study) vs. 19 % (surgery, 9 studies). SBRT toxicities were generally ≤ CTCAE grade 3, while surgery occasionally caused grade 4–5 events. 5-year-OS showed no significant difference: 31.6 % for SBRT [95 %-CI 23.9–41.5 %], 37.8 % for surgery [95 %-CI 30–41.9 %].</div></div><div><h3>Conclusion</h3><div>Evidence indicates SBRT and surgery provide comparable outcomes for sarcoma- PM, with SBRT offering a more favorable toxicity profile. Though heterogeneous indications and incomplete reporting limit comparability, SBRT should not be viewed solely as fallback for surgically ineligible patients. Treatment should be individualized within a multidisciplinary expert team, integrating patient- and modality-specific factors. Well-designed prospective trials are needed to define relative safety and efficacy.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"57 ","pages":"Article 101097"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145880920","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":"Differential regulation of radioadaptation by quercetin between human normal and cancer cells","authors":"Chujie Li ,&nbsp;Xiaojun Li ,&nbsp;Rianne Biemans ,&nbsp;Rui Zhang ,&nbsp;Ming Zhang ,&nbsp;Ludwig J. Dubois","doi":"10.1016/j.ctro.2025.101099","DOIUrl":"10.1016/j.ctro.2025.101099","url":null,"abstract":"<div><h3>Objective</h3><div>Radiotherapy is a primary treatment for many cancers, but its efficacy is often limited by collateral damage to healthy tissues. Radioadaptation, a phenomenon where low-dose radiotherapy (LDRT) enhances a cell’s ability to withstand subsequent high-dose radiation, occurs in normal cells but is generally absent in cancer cells. Quercetin, a natural flavonoid with antioxidant and anticancer properties, has been proposed as a potential radiomodulator. This study aimed to investigate whether quercetin could differentially regulate the radioadaptive response in human normal breast epithelial versus breast cancer cells.</div></div><div><h3>Methods</h3><div>Cell viability, clonogenic survival, oxidative stress, and DNA damage responses were assessed in MCF10A and MCF7 cells following treatment with LDRT (0.1 Gy), quercetin, and high-dose radiation. NQO1 and NRF2 expression levels were measured using RT-qPCR, Western blotting, and immunofluorescence. DNA damage was evaluated by γ-H2AX foci and p-ATM levels.</div></div><div><h3>Results</h3><div>In MCF10A cells, LDRT pre-treatment enhanced resistance to subsequent radiation, which was further potentiated by quercetin, as shown by increased cell viability (p = 0.007), increased surviving fraction (enhancement ratio = 0.85, at 10 % surviving fraction), enhanced adaptation at 4 h on NQO1 mRNA (p &lt; 0.01) and protein expression (p &lt; 0.01), with a modest effect at 24 h on NQO1 mRNA (p = 0.890) and protein (p = 0.453) and reduced ROS level at 24 h (p = 0.021). Quercetin promoted NRF2 delocalization (p = 0.005). In contrast, MCF7 cells showed no radioadaptive response, and quercetin even increased radiosensitivity (enhancement ratio of surviving fraction = 1.12, at 10 surviving fraction) by maintaining ROS levels and DNA damage.</div></div><div><h3>Conclusion</h3><div>Quercetin selectively enhances radioadaptation in normal cells by activating antioxidant pathways and reducing DNA damage, while preserving or amplifying radiosensitivity in cancer cells. These findings support quercetin may serve as a potential radiomodulating agent with favorable safety for increasing the therapeutic window of radiotherapy.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"57 ","pages":"Article 101099"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145798238","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":"Prospective controlled study comparing patient-reported outcomes after daily online adaptive radiotherapy or conventional IGRT in patients with prostate cancer","authors":"Goda Kalinauskaite ,&nbsp;Luise A. Künzel ,&nbsp;Kerstin Rubarth ,&nbsp;Thao Nguyen ,&nbsp;Jakob Dannehl ,&nbsp;Celina Höhne ,&nbsp;Marcus Beck ,&nbsp;Julia Bauer ,&nbsp;Daniel Zips ,&nbsp;Carolin Senger","doi":"10.1016/j.ctro.2025.101092","DOIUrl":"10.1016/j.ctro.2025.101092","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare patient-reported outcome measures (PROMs) in patients treated either with cone-beam CT (CBCT)-based online adaptive radiotherapy (oART) or with CBCT-guided conventional image guided radiotherapy (IGRT).</div></div><div><h3>Materials and methods</h3><div>In this prospective study with convenience allocation, patients with localized prostate cancer received 62 Gy/20 fractions using either daily CBCT-based oART or CBCT-guided conventional IGRT. PROMs (EPIC, QLQ-PR25, IPSS, NCI-PRO-CTCAE) were collected at baseline and at end of therapy. Changes in scores and clinically meaningful deterioration, based on established minimal clinically important differences (MCID), were analyzed.</div></div><div><h3>Results</h3><div>Seventy-four patients were included (oART: 58.1 %; IGRT: 41.9 %). Groups were demographically similar, although the oART group included more patients with high-risk tumors (40.5 % vs. 9.7 %, p = 0.03). Patients after oART tended to experience smaller, although not statistically significant, declines in health-related quality of life (HRQoL) domains compared to IGRT: EPIC urinary summary (−12.15 vs −20.57, p = 0.07), urinary function (−9.53 vs −17.47, p = 0.05), urinary incontinence (−5.47 vs −13.93, p = 0.07) and PR25 urinary symptom (20.0 vs. 27.5, p = 0.06). EPIC bowel function decline was also less pronounced (−12.64 vs. −19.78, p = 0.10). NCI-PRO-CTCAE scores favored oART for reduced urinary urgency (0.95 vs. 1.57, p = 0.02) and fecal incontinence (0.03 vs. 0.71, p = 0.02). Fewer oART patients reached MCID thresholds for urinary (8–21 %) and bowel (20–23 %) deterioration, but these differences were not statistically significant.</div></div><div><h3>Conclusion</h3><div>Our results suggest a small but consistent trend in PROM scores favoring oART over conventional IGRT. In addition, the results may inform the design of controlled randomized trials in the future<strong>.</strong></div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"57 ","pages":"Article 101092"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145798239","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":"Clinical practice, barriers to implementation, and priorities for equitable access of Stereotactic Body Radiation Therapy: An analysis of the global status by the ESTRO SBRT Focus Group","authors":"Ciro Franzese ,&nbsp;Stephanie Tanadini-Lang ,&nbsp;Dirk Verellen ,&nbsp;Lisa Wiersema ,&nbsp;Juliane Hörner-Rieber ,&nbsp;Alejandra Méndez Romero ,&nbsp;David Pasquier ,&nbsp;Anna Bruynzeel ,&nbsp;Judit Boda-Heggemann ,&nbsp;Tom Depuydt ,&nbsp;Patrik Sibolt ,&nbsp;Najma Douir ,&nbsp;Łukasz Kuncman ,&nbsp;Casper Beijst ,&nbsp;Harley Stephens ,&nbsp;Carolina de la Pinta ,&nbsp;Francesco Cuccia ,&nbsp;Maaike Milder ,&nbsp;Luca Nicosia ,&nbsp;Hiroshi Onishi ,&nbsp;Marta Scorsetti","doi":"10.1016/j.ctro.2025.101096","DOIUrl":"10.1016/j.ctro.2025.101096","url":null,"abstract":"<div><h3>Background</h3><div>Stereotactic Body Radiation Therapy (SBRT) has become an established treatment for several primary and metastatic malignancies; however, considerable heterogeneity remains in its definition, clinical indications, and technical delivery.</div></div><div><h3>Methods</h3><div>In May 2025, the SBRT Focus Group of the European Society for Radiotherapy and Oncology (ESTRO), in collaboration with International Stereotactic Radiosurgery Society (ISRS), the Radiosurgery Society (RSS), and the Japanese Society for Radiation Oncology (JASTRO), conducted a global survey. A 44-item questionnaire explored SBRT indications, technical aspects, dose/fractionation, and barriers to implementation. Descriptive statistics summarized the responses.</div></div><div><h3>Results</h3><div>Overall, 289 professionals from 59 countries participated. Routine use of SBRT was reported by 96.6 % of respondents, with lung, bone, liver and prostate as the most frequent indications. Pancreatic tumor (48.4 %), renal cell carcinoma (46.4 %), and ventricular tachycardia (12.4 %) represented emerging indications. C-arm linacs (89.2 %) and in-room Cone beam CT (CBCT) (92.0 %) were the dominant technologies. Motion management relied mainly on 4D-CT internal target volume (ITV) (88.9 %) and deep inspiration breath-hold (DIBH) (57.8 %). Fractionation was consistent for lung and prostate but heterogeneous for liver, and pancreas. Only 3.5 % reported routine use of online adaptive SBRT, while 61.5 % reported artificial intelligence (AI) use, mainly for organs-at-risk delineation. Key barriers included limited clinical trial funding (35.2 %), high equipment costs (34.2 %), insufficient reimbursement (27.7 %), and workforce shortages (33.9 %).</div></div><div><h3>Conclusions</h3><div>This ESTRO international survey provides the first global overview of SBRT practices. It demonstrates broad adoption but also substantial variability, highlighting the need for consensus guidelines, greater trial access, and expanded education to harmonize SBRT delivery and ensure equitable care worldwide.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"57 ","pages":"Article 101096"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145798241","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":"Mini-GRID enhances survival and reduces toxicity in an orthotopic murine model of oral squamous cell carcinoma: A proof-of-concept study","authors":"Loris Roncali ,&nbsp;Maria Isabel Acuña-Perez ,&nbsp;Julie Espenon ,&nbsp;Manuel Sánchez-García ,&nbsp;Victor Luna-Vega ,&nbsp;Eva G. Kölmel ,&nbsp;Cristèle Gilbert ,&nbsp;Mathieu Sertorio ,&nbsp;Marjorie Juchaux ,&nbsp;Yolanda Prezado","doi":"10.1016/j.ctro.2025.101101","DOIUrl":"10.1016/j.ctro.2025.101101","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Oral squamous cell carcinoma (OSCC) remains a major clinical challenge, with limited therapeutic options and poor outcomes. Among the emerging approaches to address this unmet need, spatially fractionated radiotherapy (SFRT) using mini-GRID patterns has emerged as a promising approach, delivering high radiation doses through narrowly collimated beamlets that spare intervening normal tissue and may enhance the therapeutic index. This study evaluated the efficacy and safety of mini-GRID RT in an orthotopic, syngeneic murine model of OSCC.</div></div><div><h3>Materials and methods</h3><div>C57BL/6 mice bearing MOC1 tumors were randomized to receive conventional radiotherapy (conv-RT; 20 Gy), mini-GRID RT (20 Gy average dose), or no treatment. Endpoints included survival, tumor growth, body weight, and histopathological assessment of tumor and surrounding normal tissues.</div></div><div><h3>Results</h3><div>Mini-GRID RT significantly extended median survival (56 days) compared with controls (36 days; <em>p</em> = 0.0456) and conv-RT (35 days; <em>p</em> = 0.0181). Tumor growth was delayed by approximately 20 days in the mini-GRID group, with long-term survivors regaining baseline body weight within 15 days post-irradiation. Fewer animals in the mini-GRID group required early euthanasia due to acute toxicity compared with the conv-RT group. Histological examination revealed no significant increase in normal tissue damage in mini-GRID-treated mice relative to conv-RT.</div></div><div><h3>Conclusion</h3><div>These findings indicate that mini-GRID RT can improve survival while maintaining a favorable toxicity profile in OSCC, supporting its potential as a novel high-dose radiotherapy approach. Further studies are warranted to elucidate underlying mechanisms, including vascular and immune-mediated responses, and to assess its translational relevance in clinical practice.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"57 ","pages":"Article 101101"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145880919","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":"Corrigendum to “Geometric evaluation of a deep learning method for segmentation of urinary OARs on magnetic resonance imaging for prostate cancer radiotherapy”. [Clin. Transl. Radiat. Oncol. 56 (2026) 101091]","authors":"Jennifer Le Guévelou ,&nbsp;Miguel Castro ,&nbsp;Blanche Texier ,&nbsp;Anaïs Barateau ,&nbsp;Romane-Alizé Martin ,&nbsp;Caroline Lafond ,&nbsp;Igor Bessières ,&nbsp;Jean-Claude Nunes ,&nbsp;Renaud De Crevoisier ,&nbsp;Oscar Acosta","doi":"10.1016/j.ctro.2025.101103","DOIUrl":"10.1016/j.ctro.2025.101103","url":null,"abstract":"","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"57 ","pages":"Article 101103"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146141257","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":"Reply to comment on impact of deep learning on CT-based organ-at-risk delineation for flank irradiation in paediatric renal tumours: A SIOP-RTSG radiotherapy committee","authors":"Mianyong Ding ,&nbsp;Matteo Maspero ,&nbsp;Semi Harrabi ,&nbsp;Emmanuel Jouglar ,&nbsp;Sabina Vennarini ,&nbsp;Timothy Spencer ,&nbsp;Britta Weber ,&nbsp;Henriette Magelssen ,&nbsp;Karen Van Beek ,&nbsp;Remus Stoica ,&nbsp;Simonetta Saldi ,&nbsp;Tom Boterberg ,&nbsp;Patrick Melchior ,&nbsp;Marry M. van den Heuvel-Eibrink ,&nbsp;Geert O. Janssens","doi":"10.1016/j.ctro.2025.101087","DOIUrl":"10.1016/j.ctro.2025.101087","url":null,"abstract":"<div><div>We appreciate the commentary from Saad et al., which offers an opportunity to clarify key methodological and clinical aspects of our study assessing the impact of deep learning–based CT auto-contouring for organ-at-risk delineation in paediatric flank irradiation for renal tumours. First, the annotation protocol was provided in the original Supplementary Materials, and additional delineation instructions followed established SIOP-RTSG standards. Second, as already mentioned in the manuscript discussion, we acknowledge the inherent bias associated with STAPLE consensus contours, and we addressed this by including an additional single-expert reference in our evaluation. Third, although dose analysis can provide valuable clinical insights, it is not essential at this stage, as geometric evaluation remains the main benchmark for validating auto-contouring performance. Fourth, while uncertainty quantification is a promising research direction, our study was designed to reflect current clinical practice, where uncertainty-aware segmentation has not yet been integrated into routine auto-segmentation systems. Finally, we recognize that our controlled workshop environment does not fully reflect real-world clinical workflows, a limitation already discussed in our original manuscript. We hope these clarifications foster a balanced understanding of our work and support ongoing efforts toward the safe and effective clinical adoption of AI-assisted contouring in paediatric radiotherapy.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"57 ","pages":"Article 101087"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145749564","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":"Clinical evidence and reporting standards in reirradiation: Insights from 28 studies at ESTRO 2025, endorsed by the ESTRO reirradiation focus group","authors":"Arnaud Beddok ,&nbsp;Ane L. Appelt ,&nbsp;Stefanie Corradini ,&nbsp;Aileen Duffton ,&nbsp;Gian Marco Petrianni ,&nbsp;Bartłomiej Tomasik ,&nbsp;Eliana Vásquez Osorio ,&nbsp;Jonas Willmann ,&nbsp;Nicolaus Andratschke","doi":"10.1016/j.ctro.2025.101090","DOIUrl":"10.1016/j.ctro.2025.101090","url":null,"abstract":"<div><h3>Background</h3><div>Reirradiation (reRT) has become an increasingly relevant treatment option across multiple tumor sites, supported by technological advances that improve precision and safety. At the ESTRO 2025 Annual Meeting, 28 clinical studies on reRT were presented. This work provides a structured synthesis of their clinical outcomes and assesses adherence to the ESTRO–EORTC reporting recommendations.</div></div><div><h3>Materials and methods</h3><div>All abstracts presented at ESTRO 2025 (n = 2,962) were screened to identify reRT studies (n = 51). Only studies reporting at least one clinical outcome were retained (n = 28). ReRT was classified as type 1 (with geometric overlap of irradiated volumes) or type 2 (without overlap but with potential OAR dose concerns). Each study was evaluated using the 10 mandatory ESTRO–EORTC reporting criteria, covering demographics, performance status, organ function, recurrence classification, target volume, technique and dose, interval since RT1, cumulative OAR doses, method for dose summation, and CTCAE toxicity. Reporting scores ranged from 0 to 10.</div></div><div><h3>Results</h3><div>The 28 studies encompassed brain, head and neck, thoracic, pelvic, prostate, metastatic, and pediatric settings. Clinical outcomes were encouraging in selected series, with local control &gt; 85 % in the phase I DESTROY-1 dose-escalation trial, median overall survival &gt; 40 months in lung and prostate cohorts, and grade ≥ 3 toxicity generally below 10 %. Reporting quality was heterogeneous: the median score was 5/10 (IQR 4–7). Demographics, prescribed dose, and technique were consistently reported, whereas organ function, cumulative OAR doses, and methods for dose summation were often omitted. Classification as type 1 or type 2 reRT was explicitly provided in only a minority of abstracts. Items such as baseline organ function were often missing, particularly in CNS studies where standardized tests are rarely applicable.</div></div><div><h3>Conclusion</h3><div>The ESTRO 2025 abstract set illustrates both the clinical potential and methodological variability of modern reRT. While outcomes are promising across several sites, adherence to standardized reporting remains limited, underscoring the need for consistent implementation of ESTRO–EORTC recommendations to enable comparability and harmonization.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"57 ","pages":"Article 101090"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145749565","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":"Iron deficiency in patients undergoing radiotherapy: Prevalence and clinical characteristics","authors":"Sophie Schumacher ,&nbsp;Falk Fabian ,&nbsp;Paula Lehmann ,&nbsp;Daniel Zips ,&nbsp;Felix Mehrhof ,&nbsp;Wolfram Doehner ,&nbsp;Franziska Hausmann","doi":"10.1016/j.ctro.2026.101111","DOIUrl":"10.1016/j.ctro.2026.101111","url":null,"abstract":"<div><h3>Purpose</h3><div>Anemia in patients undergoing radio-chemotherapy (RCTx) is often driven by iron deficiency and can impact quality of life and therapy outcomes. This study aimed to evaluate how RCTx affects iron metabolism and identify additional influencing factors.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study on 156 patients with cancer undergoing RCTx, primarily with head and neck cancer, brain malignancies, or metastatic disease. Anemia was defined as a HB level &lt; 13 mg/L in men and &lt; 12 mg/L in women. Iron deficiency was defined as a transferrin saturation (TSAT) below 20 %. Further blood parameters, including iron, ferritin, and transferrin, were assessed at multiple timepoints before, during, and after RCTx.</div></div><div><h3>Results</h3><div>Prevalence of anemia was 53.8% prior to treatment and increased up to 74.1% at the end of radiotherapy. At baseline, 44.2% of patients were iron deficient. Iron deficiency at baseline was associated with systemic treatment (16.5% of patients with neoadjuvant treatment), while low TSAT at end of treatment was associated with alcohol abuse. During the course of the RCTx patients with divergent changes of TSAT levels were identified (increase, decrease and no change of TSAT). Trajectory of TSAT levels was independent of oral iron substitution as nutritional supplement.</div></div><div><h3>Conclusion</h3><div>Patients undergoing radiotherapy show an exceptionally high prevalence for anemia, with iron deficiency being one of the main causes. Our study suggests that oral iron substitution may not be sufficient to treat iron deficiency in patients undergoing radiotherapy, underlining the need to enhance our understanding of iron balance and how to best target deficiencies in these patients.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"57 ","pages":"Article 101111"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034769","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":"Impact of tumour proximity to organs-at-risk in adaptive MR-guided SBRT for central lung tumours and metastases","authors":"Sina Mansoorian ,&nbsp;Ala Sami Ismail Salameh ,&nbsp;Laura Hamm ,&nbsp;Svenja Hering ,&nbsp;Diego Kauffmann-Guerrero ,&nbsp;Helmut Weingandt ,&nbsp;Vanessa da Silva Mendes ,&nbsp;Jan Hofmaier ,&nbsp;Sebastian Marschner ,&nbsp;Nina-Sophie Schmidt-Hegemann ,&nbsp;Guillaume Landry ,&nbsp;Claus Belka ,&nbsp;Stefanie Corradini ,&nbsp;Chukwuka Eze","doi":"10.1016/j.ctro.2025.101079","DOIUrl":"10.1016/j.ctro.2025.101079","url":null,"abstract":"<div><h3>Background</h3><div>Centrally located lung tumours present challenges for SBRT due to elevated toxicity risk. Online adaptive MR-guided radiotherapy (oMRgRT) offers improved target coverage and Organ at risk (OAR) sparing by accounting for interfractional anatomical changes. This study evaluated the dosimetric impact of oMRgRT, with emphasis on tumour location relative to OARs and the clinical benefit of adaptation.</div></div><div><h3>Methods</h3><div>We retrospectively analysed 36 PTVs across 294 treatment sessions using a 0.35 T MR-Linac. Tumours were categorised by proximity to six critical OARs: proximal bronchial tree (PBT), trachea, heart, great vessels, brachial plexus, and oesophagus. Predicted/reoptimised plans from all fractions were compared to assess improvements in target coverage and OAR sparing. All dosimetric parameters were presented as a percentage of baseline plan metrics. Statistical tests included the Wilcoxon signed-rank test and the Mann-Whitney <em>U</em> test.</div></div><div><h3>Results</h3><div>Adaptive planning significantly improved target volume dosimetry. PTV D_98% increased from 92.8 ± 8.7% to 99.9 ± 1% (p &lt; 0.01); V_{prescription dose (PD)} improved from 92.7 ± 5.4% to 97.7 ± 1.1% (p &lt; 0.01). GTV D_98% rose from 98.5 ± 5.5% to 100.4 ± 4.3% (p &lt; 0.01), with V_PD increasing from 97.7 ± 3.9% to 98.1 ± 3.5% (p &lt; 0.01). Improvements in PTV coverage were observed across all subgroups, with the greatest gains in GTV coverage, most notable in tumours adjacent to the PBT and heart. Tumours near the trachea, great vessels, and brachial plexus showed minimal change. The most significant reductions in OAR doses were also seen in the heart and PBT groups, while proximity to the trachea resulted in minimal benefit<strong>.</strong></div></div><div><h3>Conclusion</h3><div>Daily oMRgRT significantly improves target coverage and OAR sparing in centrally located tumours, especially in anatomically complex regions. The adaptive approach enables clinically meaningful trade-offs between tumour coverage and OAR sparing. Further studies are needed to refine adaptation protocols based on tumour sublocation.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"57 ","pages":"Article 101079"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145798236","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}