Clinical and Translational Radiation Oncology最新文献

{"title":"Stereotactic body radiotherapy for lung oligometastatic prostate cancer: An international retrospective multicenter study","authors":"Maximilien Rogé ,&nbsp;Patrick Bowden ,&nbsp;Paul Conway ,&nbsp;Ciro Franzese ,&nbsp;Marta Scorsetti ,&nbsp;Emmanuel Seront ,&nbsp;Pierre Blanchard ,&nbsp;Mario Terlizzi ,&nbsp;Jonathan Khalifa ,&nbsp;Corentin Pasquier ,&nbsp;Ulrike Shick ,&nbsp;Shankar Siva ,&nbsp;Julie Paul ,&nbsp;Stéphane Supiot","doi":"10.1016/j.ctro.2025.100944","DOIUrl":"10.1016/j.ctro.2025.100944","url":null,"abstract":"<div><h3>Background</h3><div>Management of prostate cancer (PCa) patients with lung oligometastases remains unclear in the absence of published data.</div></div><div><h3>Objective</h3><div>The aim of this study was to evaluate the efficacy of Stereotactic Body Radiotherapy (SBRT) in this setting.</div></div><div><h3>Design, setting, and participants</h3><div>We conducted a multicenter retrospective study that included 35 PCa patients treated with SBRT for lung oligometastases in 7 centers across 3 countries.</div></div><div><h3>Outcome measurements and statistical analysis</h3><div>The efficacy was evaluated by the progression free-survival (PFS), defined as pre-SBRT PSA + 25 % or nadir PSA + 25 % and + 2 ng/mL or radiological progression if it occurred before biochemical progression. The local recurrence free-survival (LRFS), distant metastases free-survival (DMFS), Overall Survival (OS) and Androgen Deprivation Therapy free-survival were also assessed. Survival was estimated using the Kaplan Meier method.</div></div><div><h3>Results</h3><div>35 patients were included with lung oligometastases staged with PET-CT for 97 % and histologically biopsy confirmed for 51 %. 77 % had an oligorecurrent metastatic disease. The median pre SBRT PSA was at 1.7 ng/mL [0.8, 3.0] and the median follow-up after SBRT was 28.7 months. The median PFS was 21.6 months [95 %CI: 21.6; NA] and the median DMFS was 32.4 months [95 %CI: 22.2–NA]. No parameters were significantly associated with PFS on the univariate and multivariate models.</div><div>For patients who did not start ADT before or concomitantly with SBRT (n = 18), the 1-year ADT free-survival rate was estimated at 87.2 % [71.9;100].</div></div><div><h3>Conclusions</h3><div>SBRT for PCa lung oligometastases offers good oncological outcomes, comparable to those reported for bone and/or lymph node metastases SBRT. Our results encourage the inclusion of patients with lung oligometastatic disease in clinical trials designed to assess the value of SBRT.</div></div><div><h3>Patient summary</h3><div>SBRT for prostate cancer lung oligometastases shows promising results, similar to treatments for bone or lymph node oligometastases.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100944"},"PeriodicalIF":2.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143601344","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":"Utilization of a stabilized hyaluronic acid spacer in SBRT for retroperitoneal cancers: A case series and dosimetric analysis","authors":"Shing Fung Lee ,&nbsp;Nathanial Harris ,&nbsp;Pui Lam Yip ,&nbsp;Jenna Dean ,&nbsp;Brayden Geary ,&nbsp;George Koufogiannis ,&nbsp;Melanie Bauer ,&nbsp;Daryl Lim Joon ,&nbsp;Farshad Foroudi ,&nbsp;Ee Siang Choong ,&nbsp;Michael Chao","doi":"10.1016/j.ctro.2025.100943","DOIUrl":"10.1016/j.ctro.2025.100943","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the clinical indications, post-operative complications, and dosimetric impact of stabilized hyaluronic acid (sHA) spacer insertion in the retroperitoneum for stereotactic body radiation therapy (SBRT) of retroperitoneal cancers.</div></div><div><h3>Patients and methods</h3><div>This retrospective study analyzed two cases of SBRT for retroperitoneal lesions: a primary left renal cell carcinoma and an oligometastatic renal cell carcinoma (RCC) lesion in the right adrenal gland. In both cases, a sHA spacer was percutaneously inserted between the bowel and the lesion. The spacer was placed under laparoscopic and ultrasound guidance for the renal tumor, and under CT guidance for the adrenal lesion. The prescribed dose was 42 Gy in three fractions for the primary renal lesion and 40 Gy in five fractions for the adrenal lesion. Dosimetric parameters were evaluated in two planning scenarios: (1) without the spacer, adhering to OAR constraints, and (2) with the spacer.</div></div><div><h3>Results</h3><div>Spacer insertion for the primary left renal cancer significantly improved PTV D95% from 67.9 % to 99.5 % of the prescribed dose, a 46.5 % increase. PTV D99% increased from 54.5 % to 86.7 %, reflecting a 59.1 % improvement. The large bowel’s maximum dose was reduced from 28.2 Gy to 24.4 Gy, and the volume receiving 24 Gy was minimal with the spacer (0.06 cc). For the right oligometastatic adrenal lesion, despite a fourfold increase in tumor volume, post-spacer dosimetry showed improved PTV coverage without exceeding OAR constraints. No post-operative complications were observed in either case.</div></div><div><h3>Conclusion</h3><div>This is the first report on sHA spacer use in the retroperitoneum for SBRT. Spacer insertion near the large bowel significantly improves dosimetry, enabling higher doses to targets while keeping OAR doses within safe limits. Further research with a larger patient population is required to assess safety and for optimization of the technique for spacer placement in order to enhance clinical outcomes.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100943"},"PeriodicalIF":2.7,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591730","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":"Prospective planning comparison of magnetic resonance-guided vs. internal target volume-based stereotactic body radiotherapy of hepatic metastases – Which patients do really benefit from an MR-linac?","authors":"Philipp Hoegen-Saßmannshausen ,&nbsp;C. Katharina Renkamp ,&nbsp;Hoi Hin Lau ,&nbsp;David Neugebauer ,&nbsp;Nina Niebuhr ,&nbsp;Carolin Buchele ,&nbsp;Fabian Schlüter ,&nbsp;Elisabetta Sandrini ,&nbsp;Line Hoeltgen ,&nbsp;Fabian Weykamp ,&nbsp;Sebastian Regnery ,&nbsp;Jakob Liermann ,&nbsp;Eva Meixner ,&nbsp;Kevin Zhang ,&nbsp;Oliver Sedlaczek ,&nbsp;Heinz-Peter Schlemmer ,&nbsp;Laila König ,&nbsp;Jürgen Debus ,&nbsp;Sebastian Klüter ,&nbsp;Juliane Hörner-Rieber","doi":"10.1016/j.ctro.2025.100941","DOIUrl":"10.1016/j.ctro.2025.100941","url":null,"abstract":"<div><h3>Purpose/objective</h3><div>To compare online MR-guided SBRT (MRgRT) of liver metastases with state-of-the-art ITV-based SBRT (ITV-SBRT) and assess which patients benefit most from MRgRT.</div></div><div><h3>Materials and methods</h3><div>In a prospective randomized trial (MAESTRO study, NCT05027711), patients were randomized to either gated and online adaptive MRgRT or ITV-SBRT if a biologically effective dose (BED₁₀) of 100 Gy was feasible with ITV-SBRT. Otherwise, patients were treated with MRgRT. In this subgroup analysis of 20 patients, a dosimetric comparison of MRgRT and ITV-SBRT plans was performed. Tumor control and normal tissue complication probabilities were calculated.</div></div><div><h3>Results</h3><div>In 40 % of all patients, MRgRT enabled SBRT with less fractions and/or higher prescription BED₁₀. Almost all target volume metrics were improved with MRgRT. MRgRT PTV D95% was significantly higher in the overall cohort (91.0 ± 22.9 Gy vs. 79.5 ± 27.2 Gy, p = 0.001), in uncritical (111.3 ± 6.2 Gy vs. 104.7 ± 4.1 Gy, p = 0.022) and in critical cases with limited healthy liver volume or nearby gastrointestinal organs at risk (74.1 ± 16.9 Gy vs. 58.5 ± 18.5 Gy, p = 0.041). Target volume V100% was also superior with MRgRT. Calculated 2-year tumor control probability was significantly superior with MRgRT overall (73.0 ± 6.2 % vs. 69.7 ± 7.9 %, p = 0.002), in uncritical cases (78.3 ± 1.4 % vs. 76.8 ± 1.0 %, p = 0.022) and in critical cases (68.5 ± 4.8 % vs. 63.8 ± 5.8 %, p = 0.041), without elevated normal tissue complication probability.</div></div><div><h3>Conclusion</h3><div>Dosimetrically, gated MRgRT was beneficial for virtually all the hepatic metastases analyzed in this study. Patients with metastases located critically near gastrointestinal OAR or with limited healthy liver volume should be allocated to centers providing MRgRT.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100941"},"PeriodicalIF":2.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551981","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":"Correlation between radiation dose to bone marrow subregions and acute hematologic toxicity inendometrial cancer treated with external beam radiotherapy","authors":"R. Autorino ,&nbsp;D. Cusumano ,&nbsp;R.M. Rinaldi ,&nbsp;R. Giannini ,&nbsp;V. De Luca ,&nbsp;M. Campitelli ,&nbsp;V. Lancellotta ,&nbsp;S. Di Franco ,&nbsp;G. Macchia ,&nbsp;G. Ferrandina ,&nbsp;M.A. Gambacorta","doi":"10.1016/j.ctro.2025.100942","DOIUrl":"10.1016/j.ctro.2025.100942","url":null,"abstract":"<div><h3>Aim</h3><div>To identify dosimetric parameters associated with acute hematologic toxicity (HT) in endometrial cancer treated with volumetric modulated arc therapy (VMAT-RT).</div></div><div><h3>Methods</h3><div>Patients with uterine adenocarcinoma treated in our Institution from March 2019 to November 2022 were retrospectively enrolled in this study. All patients underwent adjuvant external beam radiotherapy with Volumetric modulated arc therapy (VMAT) strategy plus a brachytherapy boost on vaginal cuff. When indicated, adjuvant platin-based chemotherapy was administered after surgery in upfront or sandwich setting. Pelvic bone marrow was contoured for each patient and divided into three subsites: lumbosacral spine (LSBM), ilium (IBM) and lower pelvis (LPBM). The volume of each region receiving 10,20,30 and 40 Gy (V10, V20, V30, V40, respectively) and mean dose (Dmean) was collected. Hematological toxicity during radiotherapy treatment was graded according to the CTCAE V 5.0. Linear logistic regression models were used to test associations between dosimetric parameters and HT.</div></div><div><h3>Results</h3><div>Data from 99 patients were retrospectively analyzed. Adjuvant external beam radiotherapy was delivered to the pelvis with Volumetric modulated arc therapy (VAMT) strategy for a total dose of 45  Gy, 1.8  Gy/fraction plus a brachytherapy boost on vaginal cuff for a total dose of 10 Gy in 2 fractions weekly. Thirty-one patients developed during radiotherapy treatment an HT ≥ grade 2.</div><div>With a sensitivity of 83.3 % and specificity of 61.5 %, V20 Gy LSBM &lt; 64 % is associated to a maximum 20 % risk of Grade 2 or worse HT in patients with &lt; 60 years old; for patients older than 70, the risk of toxicity is below 20 % independently by the percentage volume of V20Gy LSBM (95 % CI 0.60–0.87; p = 0.03).</div><div>No association between hematological toxicity and V10-20–30-40 or Dmean of IBM and LPBM were observed.</div><div>Dosimetric parameters involving the lower pelvis had stronger association with hematological toxicity than those involving the ilium, even if not significant.</div></div><div><h3>Conclusions</h3><div>In this experience a dose constraint age-dependent was proposed, to reduce the risk of HT.</div><div>The volume of lombo-sacral pelvis receiving low-dose radiation (V20 LSBM &gt; 64 %) seems to be associated with HT in younger patients; instead in older than 70 patients the percentage of V20Gy LSBM seems not correlate with risk of toxicity. Future investigations should seek to confirm these findings through the inclusion of these parameters in the planning process.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100942"},"PeriodicalIF":2.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551980","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":"Magnetic resonance imaging to detect tumor hypoxia in brain malignant disease: A systematic review of validation studies","authors":"Y. Bai ,&nbsp;E.C. Osmundson ,&nbsp;M.J. Donahue ,&nbsp;J.B. De Vis","doi":"10.1016/j.ctro.2025.100940","DOIUrl":"10.1016/j.ctro.2025.100940","url":null,"abstract":"<div><div>Tumor hypoxia indicates a worse prognosis in brain malignancies; however, current gold-standard methods for assessing tumor hypoxia are invasive and often inaccessible. Magnetic Resonance Imaging (MRI) is widely available, but its validity for identifying tumor hypoxia or hypoxia-related neoangiogenesis is not well characterized. A systematic literature search was performed across PubMed and Embase Databases. The search query identified MRI studies that validated hypoxia-surrogate imaging sequences against gold-standard hypoxia or neoangiogenesis detection methods in patients with brain malignancies. Literature screen identified 23 manuscripts published between 2007 and 2022. Among conventional MRI sequences, peritumoral edema and signal change after contrast administration were associated with gold-standard oxygen-assessment methods. T2*- and T2′-derived measures were associated with gold-standard methods, while reports on quantitative measures of oxygen extraction fraction were conflicting. Fiber density, tissue cellularity, blood volume, vascular transit time, and permeability measurements were associated with gold-standard methods, whereas blood flow measurements yielded conflicting results. MRI measures are promising surrogates for tumor hypoxia or hypoxia-related neoangiogenesis. Additional studies are needed to reconcile disparate findings. Future sensitivity analyses are needed to establish the MRI methods most accurate at identifying tumor hypoxia.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100940"},"PeriodicalIF":2.7,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520619","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":"Letter to the Editor: Reply to Topkan et al","authors":"Claudia Schweizer ,&nbsp;Vratislav Strnad","doi":"10.1016/j.ctro.2025.100938","DOIUrl":"10.1016/j.ctro.2025.100938","url":null,"abstract":"<div><div>We thank the colleagues Topkan and the co-authors for their valuable comments on our study. As they stated correctly, there for sure are more factors influencing the development of necrosis – nicotine and alcohol might also play an important role, for example. Also some hints point at the distance of the catheters being associated with risk of necrosis. Due to the fact that the risk factors influence each other in their effect on the risk of necrosis and usually have an additive effect and due to the generally retrospective data collections in published articles on interventional radiotherapy in the oral cavity, some risk factors for late side effects cannot be perfectly recorded and evaluated. In our understanding, not only the distance to the mandible, but also the bone volume which is affected by radiation dose must be considered. No specific dose constraints exist for the mandible when applying interventional radiotherapy. We are currently analyzing further dose parameters available within CT-based planning workflows and hope for more detailed information on how we can improve the implants. Nevertheless, prospective data is needed to sufficiently address toxicity issues in a larger cohort of patients with long-term follow-up. As far as the disease-free survival is concerned, we indeed estimated this according to the current practice in several other published data without taking the event of death into account. This is obvious when looking at our results. Still, we agree that the different ways of presenting freedom of recurrence throughout the literature makes comparison rather difficult and should be unified. We thank you for your remark and will consider this in our future work.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100938"},"PeriodicalIF":2.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578964","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":"Clinical outcomes and risk factors for local failure and visual impairment in patients treated with Ru-106 brachytherapy for uveal melanoma","authors":"L.J. Pors ,&nbsp;M. Marinkovic ,&nbsp;H.H. Deuzeman ,&nbsp;T.H.K. Vu ,&nbsp;E.M. Kerkhof ,&nbsp;K.M. van Wieringen-Warmenhoven ,&nbsp;C.R.N. Rasch ,&nbsp;J.C. Bleeker ,&nbsp;L.S. Koetsier ,&nbsp;J.W.M. Beenakker ,&nbsp;G.P.M. Luyten ,&nbsp;C.L. Creutzberg ,&nbsp;N. Horeweg","doi":"10.1016/j.ctro.2025.100939","DOIUrl":"10.1016/j.ctro.2025.100939","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Small uveal melanomas are preferably treated with eye-sparing therapies such as brachytherapy or proton beam therapy. Knowledge of clinical outcomes and risk factors is important for personalized patient counselling.</div></div><div><h3>Materials and methods</h3><div>Data of all choroidal melanoma patients treated at the Leiden University Medical Center between 2012–2019 with Ruthenium-106 brachytherapy were collected. Time-to-event analyses were performed with the Kaplan-Meier method, risk factors for local failure and visual acuity (VA) decline were identified using Cox proportional hazards models with predefined covariates.</div></div><div><h3>Results</h3><div>719 patients were included. Median tumour prominence and diameter were 3.8 mm and 11.6 mm, respectively. 52 % of tumours were centrally located, and 19 % were juxtapapillary. Five-year overall survival, eye retention and local failure rates were 83 %, 95 %, and 8 %, respectively. Juxtapapillary location, lower tumour apex doses, and T3-4 tumour stage were significantly associated with local failure. Patients with juxtapapillary tumours had 20 % risk of local failure. Five years posttreatment, 47 % of patients had no functional visual impairment (Snellen VA ≥ 0.5). Lasting functional visual impairment was associated with baseline vision, central tumours, and scleral dose. Patients with central tumours had 75 % risk of mild or worse visual impairment after 5 years.</div></div><div><h3>Conclusion</h3><div>Ruthenium-106 brachytherapy yields good local control and visual outcomes in patients with choroidal melanoma. Juxtapapillary tumours have a high risk of local failure and alternative therapies should be considered in these patients, if available. Patients with central tumours, and those with decreased pre-treatment vision should be counselled on the risk of visual impairment.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100939"},"PeriodicalIF":2.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510605","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 doses to Organs at risk and their Proximity to target volumes are crucial Determinants of brachytherapy toxicity","authors":"Erkan Topkan ,&nbsp;Efsun Somay ,&nbsp;Duriye Ozturk ,&nbsp;Ugur Selek","doi":"10.1016/j.ctro.2025.100937","DOIUrl":"10.1016/j.ctro.2025.100937","url":null,"abstract":"","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100937"},"PeriodicalIF":2.7,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143478925","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":"Recovery of quality of life in 574 patients with inoperable lung cancer undergoing (chemo)radiotherapy","authors":"Marloes Nies ,&nbsp;Robin Wijsman ,&nbsp;Olga Chouvalova ,&nbsp;Fred J.F. Ubbels ,&nbsp;Harriët J. Elzinga ,&nbsp;Ellen Haan-Stijntjes ,&nbsp;Marleen Woltman-van Iersel ,&nbsp;Pieter R.A.J. Deseyne ,&nbsp;Stefanie A. de Boer ,&nbsp;Johannes A. Langendijk ,&nbsp;Joachim Widder ,&nbsp;Anne G.H. Niezink","doi":"10.1016/j.ctro.2025.100935","DOIUrl":"10.1016/j.ctro.2025.100935","url":null,"abstract":"<div><h3>Introduction</h3><div>Quality of life (QoL) of patients with inoperable lung cancer can be negatively affected by both the disease and its treatment, generally consisting of (chemo)radiotherapy. The aim of this study was to prospectively assess QoL in patients with inoperable lung cancer, treated with (chemo)radiotherapy and to assess whether patient- and/or treatment-related characteristics were associated with poorer QoL.</div></div><div><h3>Methods</h3><div>This prospective cohort study evaluated QoL and patient-, tumor-, and treatment characteristics from inoperable lung cancer patients, treated with fractionated (≥40 Gy) (chemo)radiotherapy. Patients were evaluated at baseline, upon finishing radiotherapy, and 3 months, 6 months, 1 year, and yearly thereafter up to 5 years after radiotherapy. The QoL assessment consisted of questionnaires evaluating lung cancer-specific and treatment-related complaints using scale scores.</div></div><div><h3>Results</h3><div>Compliance rates of the 574 analyzed patients ranged from 87 to 97 % during follow-up. Complaints increased after radiotherapy, as the QoL scale scores increased from median 8 (interquartile range, IQR 4–14) to 17 (IQR 4–25) after completing radiotherapy (P &lt; 0.0004), indicating more complaints. From 3 months to 24 months of follow-up, scale scores returned to a median of 13, but were significantly higher compared to baseline (P &lt; 0.0004). However, no clinically relevant differences compared to baseline were observed. Patients with pulmonary comorbidity and WHO scores ≥ 2 generally reported more complaints.</div></div><div><h3>Conclusion</h3><div>Patients experienced a temporary increase in complaints after finishing (chemo)radiotherapy, QoL returned to baseline level and remained stable up to five years of follow-up.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100935"},"PeriodicalIF":2.7,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520621","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":"From pre-clinical studies to human treatment with proton-minibeam radiation therapy: adapted Idea, Development, Exploration, Assessment and Long-term evaluation (IDEAL) framework for innovation in radiotherapy","authors":"Emmanuel Jouglar ,&nbsp;Ludovic de Marzi ,&nbsp;Pierre Verrelle ,&nbsp;Gilles Créhange ,&nbsp;Regis Ferrand ,&nbsp;François Doz ,&nbsp;Yolanda Prezado ,&nbsp;Xavier Paoletti","doi":"10.1016/j.ctro.2025.100932","DOIUrl":"10.1016/j.ctro.2025.100932","url":null,"abstract":"<div><div>The implementation and spread of new radiation therapy (RT) techniques are often rushed through before or without high-quality proof of a clinical benefit. The framework for phase 1, 2 and 3 trials, ideally designed for pharmaceutical evaluation, is not always appropriate for RT interventions. The IDEAL framework is a five-step process initially developed to enable the rapid implementation of surgical innovations while limiting risks for patients. IDEAL was subsequently adapted to RT. Proton-minibeam radiation therapy (pMBRT) is an innovative RT approach, using an array of parallel thin beams resulting in an outstanding increase in the therapeutic ratio. Cumulative preclinical evidence showed pMBRT was superior to standard RT regarding brain tolerance and provided equivalent or better local control in several glioblastoma models. We decided to adapt IDEAL to pMBRT to accelerate the implementation of this promising new technique in clinical care and present here some examples of possible upcoming studies</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100932"},"PeriodicalIF":2.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143561946","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}