Clinical and Translational Radiation Oncology最新文献

{"title":"Treatment approaches for non-metastatic small cell bladder cancer: a meta-analysis of reconstructed Kaplan–Meier curves","authors":"Lucas Mose ,&nbsp;Priyamvada Maitre ,&nbsp;Pascal Eberz ,&nbsp;Thomas Zilli ,&nbsp;Osama Mohamad ,&nbsp;Vedang Murthy ,&nbsp;Christian D. Fankhauser ,&nbsp;Bernhard Kiss ,&nbsp;Beat Roth ,&nbsp;Daniel M. Aebersold ,&nbsp;Ursula Vogl ,&nbsp;Mohamed Shelan","doi":"10.1016/j.ctro.2025.101032","DOIUrl":"10.1016/j.ctro.2025.101032","url":null,"abstract":"<div><h3>Introduction</h3><div>Small cell bladder cancer is an aggressive histological subtype and represents one of the most common extra-pulmonary small cell carcinomas. Treatment options include radical cystectomy, chemotherapy, radiotherapy, or combinations of these three. However, the optimal treatment approach remains unknown. This <em>meta</em>-analysis assesses the current literature on non-metastatic SCBC and analyzes different treatment approaches.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted in four electronic databases (PubMed, Scopus, Web of Science, and Cochrane Library) utilizing the search terms “small or neuroendocrine AND cancer OR Carcinoma OR Tumor OR Malignan* OR oncolog* OR metastati* OR neoplasm AND bladder or urothelial or Urologic” from inception until March 2024. Eligible papers reported treatment and overall survival (OS) of non-metastatic SCBC patients. A <em>meta</em>-analysis was conducted comparing treatments with radical cystectomy- and radiotherapy-based approaches in addition to the use of chemotherapy.</div></div><div><h3>Results</h3><div>In total, 12 articles were included in the present systematic review and <em>meta</em>-analysis. Regarding the comparison between radical cystectomy-based treatment and radiotherapy-based treatment, comparable OS was observed between both groups as the reported hazard ratio (HR) was found to be 1.04 (95 % confidence intervals [CI]: 0.90, 1.20, p = 0.6). After including chemotherapy in the analysis, it was observed that using radical cystectomy or radiotherapy with the addition of chemotherapy showed better OS with lower HR (0.53 [95 %CI: 0.39, 0.73], p &lt; 0.0001) compared with radical cystectomy or radiotherapy without chemotherapy. The median OS of radical cystectomy or radiotherapy with chemotherapy was higher than that of radical cystectomy or radiotherapy without chemotherapy, and chemotherapy alone as follows: 30.89 (95 %CI: 23.82, 40.08), 19.67 (95 %CI: 16.26, 23.80), and 19.20 (95 %CI: 16.55, 22.28), respectively.</div></div><div><h3>Conclusion</h3><div>In this systematic review and <em>meta</em>-analysis, no OS difference was observed in patients undergoing radical cystectomy-based or radiotherapy-based treatments. The addition of chemotherapy to local therapy seems to improve OS. However, given the high heterogeneity of the included studies, these results should be interpreted cautiously.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"55 ","pages":"Article 101032"},"PeriodicalIF":2.7,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144842244","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":"Reirradiation clinical practice in gastrointestinal abdominal malignancies: an international reirradiation collaborative group (ReCOG) systematic review","authors":"Nauman H. Malik ,&nbsp;John P. Plastaras ,&nbsp;Stefanie Corradini ,&nbsp;Laura A. Dawson ,&nbsp;Maria A. Hawkins ,&nbsp;Kilian E. Salerno ,&nbsp;Charles S. Mayo ,&nbsp;Emma M. Dunne ,&nbsp;Dorota Gabryś ,&nbsp;Clemens Grassberger ,&nbsp;Theodore S. Lawrence ,&nbsp;Manju Sharma ,&nbsp;Alanah M. Bergman ,&nbsp;Dawn Owen ,&nbsp;Ali Zaila ,&nbsp;Soumon Rudra ,&nbsp;Michael Velec ,&nbsp;Donna H. Murrell","doi":"10.1016/j.ctro.2025.101033","DOIUrl":"10.1016/j.ctro.2025.101033","url":null,"abstract":"<div><h3>Purpose</h3><div>Reirradiation in abdominal malignancies has grown more common with advanced radiotherapy techniques. However, clinical use and implementation varies, and there remains limited consensus on best practices for reirradiation. In this systematic review, a multidisciplinary team treating gastrointestinal and hepatobiliary malignancies within the Reirradiation Collaborative Group (ReCOG) convened to review published literature on reirradiation in the abdomen to offer insights into patient selection, radiotherapy planning, risk management, and assessing knowledge gaps for future development of guidelines.</div></div><div><h3>Methods and Materials</h3><div>A systematic search of Cochrane Central, CINAHL Plus, EMBASE, and PubMed up to August 30, 2024, was conducted as per Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) framework. Data on patient characteristics, radiation doses, dose constraints, treatment outcomes, and toxicities were extracted. Where feasible, pooled weighted analyses were performed.</div></div><div><h3>Results</h3><div>Thirty-three studies involving 1,264 patients met inclusion criteria: 30 were retrospective and 3 prospective. The median number of patients reported per study was 26 (range 2–245). Of the reported tumor sites, 718 patients had liver tumors and 277 pancreas, with smaller numbers of mixed/lymph node targets. Reirradiation doses, fractionation schemes, and dose constraints varied widely; only half of the studies provided explicit organ-at-risk constraints. Three studies included patients treated with palliative intent. Median overall survival ranged from 5.9 to 44 months, with a pooled weighted median OS of 19.6 months across 20 studies that reported it. One-year local control rates ranged from 19 % to 93 %, with severe (grade ≥ 3) toxicities typically reported in 5–15 % of patients, although one study reported 25 % lethal RILD in liver reirradiation.</div></div><div><h3>Conclusion</h3><div>Reirradiation in abdominal malignancies appears to be able to achieve meaningful local control and survival in select patients, though heterogeneity in planning, dosing, and toxicity reporting remains a major challenge for establishing best practices. Standardized reporting of doses, constraints, and dose-volume relationships are needed to guide safe and effective reirradiation in this setting.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"55 ","pages":"Article 101033"},"PeriodicalIF":2.7,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144852277","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":"Comparative analysis of target volume coverage and liver exposure in high-dose-rate interstitial brachytherapy and in silico MR LINAC-based stereotactic body radiotherapy plans for colorectal liver metastases","authors":"Sina Mansoorian ,&nbsp;Svenja Hering ,&nbsp;Jan Hofmaier ,&nbsp;Yuqing Xiong ,&nbsp;Helmut Weingandt ,&nbsp;Maya Rottler ,&nbsp;Franziska Walter ,&nbsp;Paul Rogowski ,&nbsp;Max Seidensticker ,&nbsp;Jens Ricke ,&nbsp;Claus Belka ,&nbsp;Stefanie Corradini ,&nbsp;Chukwuka Eze","doi":"10.1016/j.ctro.2025.101030","DOIUrl":"10.1016/j.ctro.2025.101030","url":null,"abstract":"<div><h3>Background</h3><div>This study compared the plan quality and dosimetric parameters of single-fraction (SF) MR-LINAC (MRL)-based stereotactic body radiotherapy (SBRT) with delivered high-dose-rate interstitial brachytherapy (HDR-iBT) for colorectal liver metastases (CRLM).</div></div><div><h3>Methods</h3><div>Between August 2017 and March 2019, 26 patients with a total of 45 CRLM were treated in 28 sessions using HDR-iBT with 1 × 25 Gy and were retrospectively included in this study. For each patient, an <em>in silico</em> MRL-based SBRT plan was generated using the corresponding iBT CT dataset. In the iBT plans, a single fraction of 25 Gy was prescribed to the periphery of the gross tumor volumes (GTVs), while in the SBRT plans, the same dose was prescribed to the 80% isodose line covering the planning target volumes (PTVs). We compared the dosimetric properties of the delivered HDR-iBT and MRL-based SBRT plans.</div></div><div><h3>Results</h3><div>Median GTV was 3.83 cc (range: 0.13–92.58 cc) and median PTV_SBRT was 15.47 cc (range: 2.68–164.17 cc). Both HDR-iBT and SBRT demonstrated excellent GTV coverage, with no statistically significant differences in GTV D_98% (28.82 ± 2.57 Gy vs. 28.92 ± 0.88 Gy, p = 0.9). HDR-iBT achieved superior GTV D_95% (31.62 ± 3.20 Gy vs. 29.22 ± 0.74 Gy, p &lt; 0.01) and GTV D_50% (64.71 ± 12.78 Gy vs. 30.22 ± 0.52 Gy, p &lt; 0.01). Uninvolved liver dose metrics were higher in the SBRT plans compared to iBT, with a median relative difference in V_5Gy of 5.29% (range: −13.69% to + 17.89%, p &lt; 0.01) and a smaller relative difference in V_10Gy of 1.5% (range: −7.74% to + 11.26%, p &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>Our comparison indicates MRL-based SBRT to liver lesions is feasible, achieving adequate target volume coverage without clinically relevant violations of organ-at-risk (OAR) constraints.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101030"},"PeriodicalIF":2.7,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010898","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":"Comment on “PSMA response evaluation in follow-up PSMA-PET/CT after stereotactic ablative body radiotherapy (SABR) for oligometastases in prostate cancer”","authors":"Parth Aphale,&nbsp;Himanshu Shekhar,&nbsp;Shashank Dokania","doi":"10.1016/j.ctro.2025.101031","DOIUrl":"10.1016/j.ctro.2025.101031","url":null,"abstract":"<div><div>The recently published study by Zang et al. offers valuable insight into PSMA-PET/CTbased response assessment in patients with oligometastatic prostate cancer (PCa) undergoing stereotactic ablative body radiotherapy (SABR), demonstrating an impressive 5-year local control rate of 86 % and progressive reduction in SUVmax values across follow-up intervals [<span><span>1</span></span>]. While the findings reinforce the utility of PSMAPET/CT as a potential biomarker for local tumor control, certain methodological and interpretive issues merit deeper consideration.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"55 ","pages":"Article 101031"},"PeriodicalIF":2.7,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144826473","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":"Defining failure patterns and dynamics in locally advanced pharyngeal and laryngeal SCC following radiotherapy: Real-World Insights in the modern Era!","authors":"Linda Agolli ,&nbsp;Luise Reinhard ,&nbsp;Christine Langer ,&nbsp;Christoph Arens ,&nbsp;Gabriele A. Krombach ,&nbsp;Sebastian Harth ,&nbsp;Andreas Lurtz ,&nbsp;Ann-Katrin Exeli ,&nbsp;Stefan Gattenlöhner ,&nbsp;Daniel Habermehl","doi":"10.1016/j.ctro.2025.101026","DOIUrl":"10.1016/j.ctro.2025.101026","url":null,"abstract":"<div><h3>Introduction</h3><div>We aimed to evaluate the prevalence and patterns of locoregional recurrence (LRR), outcome and prognostic factors in patients with locally advanced squamous cell carcinoma of the oropharynx, hypopharynx, and larynx treated with intensity-modulated or volume-modulated arc therapy definitive radiotherapy (RT) with or without systemic therapy.</div></div><div><h3>Methods</h3><div>Of the 213 reviewed patients treated between 2016 and 2023, 177 met the inclusion criteria. LRR was defined as recurrence in the primary tumor region or regional nodes. Failure patterns were classified based on a recurrence model, including central high-dose (A), peripheral high-dose (B), central elective(C), peripheral elective (D), and out-of-field recurrence (E).</div></div><div><h3>Results</h3><div>LRR was observed in 50/177 (28.2%) patients and 81 recurrent lesions. Most recurrences occurred within the first year after RT (39/177, 22.0%), predominantly in HPV-negative patients. The majority of failures were within the high-dose target volume (65% type A, 14% type C), with marginal recurrences (types B and D) occurring in 22% of cases and type E in 5% of patients. HPV-positive patients had fewer LRR (16.0% vs. 34.4% in HPV-negative patients).</div><div>Multivariate analysis identified HPV status as a significant prognostic factor for OS, PFS and LRR. The occurrence of distant metastases showed a negative impact on OS, PFS and LRR. LRR showed a trend toward worse OS (p = 0.072). Chemotherapy had a significant effect on PFS and LRR.</div></div><div><h3>Conclusion</h3><div>LRR remains a challenge, especially in HPV-negative patients. Most failures occurred centrally, but marginal and extra-field recurrences highlight the need for improved target delineation and adaptive RT strategies. Further research is needed to optimize treatment in high-risk patients.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"55 ","pages":"Article 101026"},"PeriodicalIF":2.7,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144810370","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":"Patient experience and shared decision-making in HPV-positive oropharyngeal cancer: A systematic review of qualitative and quantitative evidence","authors":"Pierluigi Bonomo ,&nbsp;Katherine J. Taylor ,&nbsp;Maria Chiara Bassi ,&nbsp;Valentina Bressan ,&nbsp;Luca Ghirotto","doi":"10.1016/j.ctro.2025.101028","DOIUrl":"10.1016/j.ctro.2025.101028","url":null,"abstract":"<div><h3>Introduction</h3><div>Human papillomavirus (HPV)-related oropharyngeal cancer generally has a good prognosis and can be successfully treated with different modalities (including de-escalation); therefore, shared decision-making regarding treatment has a special role. We aimed to assess how the patients experience this diagnosis in light of optimizing shared decision-making.</div></div><div><h3>Materials and Methods</h3><div>MEDLINE, Embase, CINAHL, PsycINFO, and Scopus were searched in two systematic reviews (CRD42023484134 and CRD42024501211). Studies were included if they described how patients with HPV-positive oropharyngeal cancer experience their illness and what factors they consider when confronted with a treatment decision. A results-based convergent synthesis design was adopted to analyze qualitative and quantitative evidence separately, then integrated through a narrative synthesis approach.</div></div><div><h3>Results</h3><div>Nine of the 1978 articles met the selection criteria, resulting in a total of 392 patients being included. Five factors influencing patient decision-making were identified from the quantitative evidence: priority for cure and survival, and preference for de-intensification, which resulted in top-ranked issues for over 65% and 73% of patients who expressed them, respectively. Three qualitative themes were identified to encapsulate patient experiences, encompassing domains related to receiving and dealing with the diagnosis, decision-making, and perception of the impact of treatments. Based on these findings, a prompting list was created as a suggested communication toolkit for clinical practice.</div></div><div><h3>Conclusions</h3><div>Our systematic review of the literature highlighted the multifaceted and complex experiences of patients facing the diagnosis of a curatively treatable HPV-positive oropharyngeal cancer. Our findings should be considered for optimal shared decision-making in clinical practice.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"55 ","pages":"Article 101028"},"PeriodicalIF":2.7,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144809751","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":"Comment on “Ten-year survival outcomes of concurrent chemoradiotherapy with or without adjuvant chemotherapy for locoregionally advanced nasopharyngeal carcinoma in the IMRT era: A retrospective cohort study stratified by high- and low-risk profiles”","authors":"Erkan Topkan ,&nbsp;Efsun Somay ,&nbsp;Duriye Ozturk ,&nbsp;Ugur Selek","doi":"10.1016/j.ctro.2025.101025","DOIUrl":"10.1016/j.ctro.2025.101025","url":null,"abstract":"","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 101025"},"PeriodicalIF":2.7,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724536","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 radiological and radiation oncology expertise in the delineation of hypopharyngeal tumours: potential effects on treatment volumes and patterns of failure","authors":"Gabriella Alexandersson von Döbeln ,&nbsp;Eva Onjukka ,&nbsp;Halla Sif Ólafsdóttir ,&nbsp;Sara Jonmarker Jaraj ,&nbsp;Mattias Hedman","doi":"10.1016/j.ctro.2025.101022","DOIUrl":"10.1016/j.ctro.2025.101022","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Target definition is one of the greatest uncertainties in the radiotherapy process. We aimed to investigate whether a radiologist specialized in head and neck can improve the target definition of hypopharyngeal cancers.</div></div><div><h3>Materials and methods</h3><div>We retrospectively identified 54 patients with hypopharyngeal cancer who received curative-intent radiotherapy between 2009–2015. New target structures were defined incorporating head and neck radiology expertise and updated delineation guidelines. The new structures were subsequently compared both quantitively and qualitatively to the original delineations. Loco-regional failures were analyzed in relation to radiotherapy dose and target volumes.</div></div><div><h3>Results</h3><div>There was a significant reduction in gross tumour volume (GTV) for the primary tumour, decreasing from 14.4 to 9.2 cm³ (−47 %), and in clinical target volume (CTV), decreasing from 203.7 to 93.8 cm³ (−54 %). Mean quantitative values indicated a large overestimation of the original GTV (Dice Coefficient 0.58 ± 0.2 SD, Jaccard index 0.44 ± 0.19 SD, Positive predictive value 0.53 ± 0.24 SD). Only 39 % of the original primary tumour GTV and 19 % of the original lymph node GTV were assessed as acceptable. Twelve patients (22 %) had a locoregional recurrence. In relation to both the original radiation dose and the updated dose distribution, nine recurrences were classified as in field, two as marginal, and one could not be evaluated. The 3-year and 5-year locoregional progression free survival (PFS) was 75.5 % and 66.6 % respectively.</div></div><div><h3>Conclusion</h3><div>Incorporating radiological expertise in the delineation of hypopharyngeal tumours leads to large changes in tumour volumes and possibly a decrease in radiation volumes which may lead to reduced side effects.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 101022"},"PeriodicalIF":2.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702298","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":"Lattice radiotherapy for extensive liver metastases in synchronous EGFR-mutant lung adenocarcinoma and small cell lung cancer","authors":"Shaïma El Chammah ,&nbsp;Mickael Bendahman ,&nbsp;Sarah Ghandour ,&nbsp;Loris Fuchs ,&nbsp;Rémy Kinj ,&nbsp;Gian Guyer ,&nbsp;Mahmut Ozsahin","doi":"10.1016/j.ctro.2025.101023","DOIUrl":"10.1016/j.ctro.2025.101023","url":null,"abstract":"<div><div>We report the case of exceptional response of massive liver metastases of a patient with synchronous lung adenocarcinoma and small cell lung cancer following lattice radiotherapy (L-RT). After a single irradiation of 16 Gy to 1 % of the metastatic liver burden, the patient reported improved abdominal symptoms within a week. Within two weeks liver volume decreased by 50 %, and liver enzyme levels stabilized or improved. This case highlights L-RT as a novel and effective approach to treat symptomatic liver metastases.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 101023"},"PeriodicalIF":2.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724535","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":"PSMA response evaluation in follow-up PSMA-PET/CT after stereotactic ablative body radiotherapy (SABR) for oligometastases in prostate cancer","authors":"Anna-Lena Zang ,&nbsp;Timo Maier ,&nbsp;Sandra Freitag-Wolf ,&nbsp;Alexander Fabian ,&nbsp;Severin Rodler ,&nbsp;Jürgen Dunst ,&nbsp;David Krug ,&nbsp;Ulf Lützen ,&nbsp;Olaf Wittenstein","doi":"10.1016/j.ctro.2025.101021","DOIUrl":"10.1016/j.ctro.2025.101021","url":null,"abstract":"<div><h3>Purpose</h3><div>PSMA-PET/CT is frequently used for staging patients with de-novo or recurrent prostate cancer (PCa). In patients with oligometastatic PCa PSMA-PET/CT guided stereotactic ablative body radiotherapy (SABR) is a common treatment option. Follow-up is regularly performed via measurement of prostate-specific-antigen (PSA) level. Response assessment based on follow-up PSMA-PET/CTs is poorly studied. Therefore, we report on long-term local tumor response using repeated PSMA-PET/CTs of patients with oligometastatic PCa after PSMA-PET/CT guided SABR.</div></div><div><h3>Methods/Patients</h3><div>Patients with de-novo oligometastatic or oligoprogressive PCa who received PSMA-PET/CT-directed SABR with 5 × 7 Gy of at least one bone or lymph node lesion between 2015 and 2019 and had one or more follow-up PSMA-PET/CT were included in this retrospective single center analysis. PSMA response was evaluated by visual and quantitative assessment of local PSMA uptake pre- and post-SABR.</div></div><div><h3>Results</h3><div>Overall, 48 patients with 97 irradiated lesions and a total of 145 PSMA-PET/CT-scans were analyzed. 26 patients received androgen-deprivation-therapy (ADT) at any time. Median SUV_max per lesion was 10.88 (range 1.59–122.11) before SABR with a median CTV of 4.75 cm³ (Range 0.68–60.4 cm³). In the first follow-up PET/CT after a median of 13 months (range 3–42) after SABR, median SUV_max per lesion declined to 2.2 (range 0.13–26.09). Complete remission (CR) was observed in 49 lesions, partial remission in 32 and stable disease in 12 lesions. Four lesions were non-responders. Over the course of up to five follow-up PSMA-PET/CTs a maximum of 90 % of the lesions showed CR. Median time to SUV_min was 19 months (range 3–50). 5-year local control was 86 %. No short-term or long-term toxicities were reported.</div></div><div><h3>Conclusion</h3><div>PSMA-PET/CT directed SABR provides excellent long-term local tumor control of 90% in bone and lymph node metastasis of oligometastatic PCa and is well tolerated. PSMA activity may further decrease after initial re-imaging with PSMA-PET/CT.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 101021"},"PeriodicalIF":2.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721944","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}