Clinical and Translational Radiation Oncology最新文献

{"title":"Postoperative chemoradiotherapy for esophageal squamous cell Carcinoma: Results from ESO-Shanghai 17 and joint analyses for phase II clinical trials","authors":"Jingyi Shen ,&nbsp;Dashan Ai ,&nbsp;Yun Chen ,&nbsp;Qi Liu ,&nbsp;Jiaying Deng ,&nbsp;Shengnan Hao ,&nbsp;Xiaofei Zhang ,&nbsp;Junhua Zhang ,&nbsp;Yutong Zhang ,&nbsp;Li Chu ,&nbsp;Yihua Sun ,&nbsp;Yawei Zhang ,&nbsp;Jiaqing Xiang ,&nbsp;Longsheng Miao ,&nbsp;Haiquan Chen ,&nbsp;Hongcheng Zhu ,&nbsp;Kuaile Zhao","doi":"10.1016/j.ctro.2025.101073","DOIUrl":"10.1016/j.ctro.2025.101073","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore efficacy and safety of postoperative chemoradiotherapy in esophageal squamous cell carcinoma.</div></div><div><h3>Materials and methods</h3><div>Two single-arm, phase II trials (ESO-Shanghai 9 and 17) were conducted with the same inclusion criteria: 1) age 18–75, 2) ECOG 0–1, 3) within 3 months after surgery, 4) pathologically confirmed esophageal squamous cell carcinoma(pT3-4orN+,M0), with R0 margins, 5) no preoperative therapy. Both were postoperative concurrent chemoradiotherapy with weekly paclitaxel and carboplatin, and extended-field or small T-shaped field radiotherapy at dose of 45 Gy/25Fx or 50.4 Gy/28Fx in ESO-Shanghai 9 or 17. The primary endpoint was 2-year local control rate, secondary endpoints including overall survival, treatment-related<!--> <!-->toxicities, and failure patterns.</div></div><div><h3>Results</h3><div>ESO-Shanghai 17 enrolled 70 patients from 2020 to 2023. 2-year local control rate was 83.8 %, and 1, 2, 3-year overall survival rates were 95.7 %, 84.0 %, 67.1 %. Local recurrence occurred in 24.3 % and distant metastasis in 21.4 %. There were no significant differences in local recurrence and metastasis. Both studies exhibited similar local recurrence-free survival and overall survival, disease free survival, and distant metastasis-free survival (<em>P</em> = 0.178, 0.224, 0.358, 0.440). No patients experienced grade Ⅳ or higher adverse events (except for leukopenia and neutropenia) in ESO-Shanghai 17. While ESO-Shanghai 9 reported two cases of grade V pneumonia, and grade Ⅲ or higher leukopenia and neutropenia incidences were higher than ESO-Shanghai 17.</div></div><div><h3>Conclusion</h3><div>Postoperative chemoradiotherapy (50.4 Gy/28Fx with small T-shaped field) yielded local control and survival comparable to ESO-Shanghai 9, with no radiation pneumonitis-related deaths in esophageal squamous cell carcinoma.</div><div>(<em>Clinicaltrial:</em> ESO-Shanghai 9, NCT02916511; ESO-Shanghai 17, NCT04764227)</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"57 ","pages":"Article 101073"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145798237","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":"Radiotherapy for Primary Urethral Carcinoma (PUC): An Illustrative and Narrative Review","authors":"Shreya Dhingra ,&nbsp;Arunima Nagar ,&nbsp;Amandeep Arora ,&nbsp;Maneesh Singh ,&nbsp;Priyamvada Maitre ,&nbsp;Ankit Misra ,&nbsp;Mahendra Pal ,&nbsp;Amit Joshi ,&nbsp;Santosh Menon ,&nbsp;Herney Andres Garcia-Perdomo ,&nbsp;Philippe Spiess ,&nbsp;Gagan Prakash ,&nbsp;Vedang Murthy","doi":"10.1016/j.ctro.2025.101074","DOIUrl":"10.1016/j.ctro.2025.101074","url":null,"abstract":"<div><div>Primary urethral carcinoma (PUC) is a rare malignancy with a complex and site-specific management paradigm. While surgery remains the mainstay for many cases, advances in modern radiotherapy have facilitated organ preservation without compromising oncologic outcomes. This narrative review outlines the clinicopathological features, diagnostic evaluation, and evolving role of radiotherapy in the management of PUC. An illustrative case of a young male with high-grade urothelial carcinoma of the bulbar urethra managed successfully with definitive external beam radiotherapy is presented. We explore the rationale, technique, and outcomes associated with radiotherapy, including external beam and brachytherapy modalities, across disease stages. For locally advanced cases, chemoradiotherapy offers an organ-sparing alternative to mutilating surgery, with promising control rates and acceptable toxicity. This article aims to collate current evidence, highlight gaps, and support the integration of personalised, multidisciplinary care in this rare disease context.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101074"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145576155","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":"Prostate- and metastases-directed radiotherapy in de novo low-volume metastatic prostate cancer","authors":"Jan-Hendrik Bolten ,&nbsp;Fabian Weykamp ,&nbsp;Christoph Grott ,&nbsp;David Neugebauer ,&nbsp;Lars Wessel ,&nbsp;Felix H. Englert ,&nbsp;Justus Valentini ,&nbsp;Magdalena Goertz ,&nbsp;Stephanie Zschaebitz ,&nbsp;Johannes Huber ,&nbsp;Erik Winter ,&nbsp;Juergen Debus ,&nbsp;Jakob Liermann","doi":"10.1016/j.ctro.2025.101072","DOIUrl":"10.1016/j.ctro.2025.101072","url":null,"abstract":"<div><h3>Background</h3><div>The role of radiotherapy in de novo low-volume metastatic prostate cancer (LVmPC) is constantly evolving and still offers considerable potential for further optimization. Rising interest in this topic demands further investigations in this specific patient cohort. We report on clinical outcomes and toxicity of combined prostate-directed (PDRT) and metastasis-directed radiotherapy (MDRT) with ablative dose concepts in patients with de novo LVmPC.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 21 patients with LVmPC treated with PDRT plus MDRT between 2018 and 2025 in addition to systemic treatment. Staging was performed with PSMA-PET/CT imaging (n = 19/21). Radiotherapy included high-dose external beam PDRT and MDRT to all detectable bone and nodal metastases. Toxicity was assessed using CTCAE v5.0, IPSS, and EPIC-26 questionnaires. Oncologic outcomes included biochemical recurrence-free survival, PSA response, and time to next-line systemic therapy.</div></div><div><h3>Results</h3><div>Additional radiotherapy of all tumor sites in LVmPC was well tolerated; no grade ≥ III gastrointestinal or genitourinary toxicity occurred. The most common adverse events were associated with hormonal therapy. Quality of life remained stable or improved in urinary and bowel domains. Undetectable PSA was achieved in 67 % of patients after radiotherapy in addition to systemic therapy. 14 % of the patients developed biochemical recurrence within 40 months after radiotherapy completion.</div></div><div><h3>Conclusion</h3><div>Combined PDRT and MDRT in addition to standard of care in patients with de novo LVmPC is feasible, well tolerated, and associated with promising biochemical control. Further prospective studies with larger patient cohorts integrating PSMA-PET/CT and other risk stratification factors are warranted to better define which patient subgroups benefit most from additional radiotherapy.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101072"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145576186","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":"Intensity-modulated radiotherapy with carbon ion boost for high-risk sinonasal squamous cell carcinoma: clinical outcomes and the management of the node-negative neck","authors":"Lukas Bauer ,&nbsp;Katharina Weusthof ,&nbsp;Sebastian Regnery ,&nbsp;Maximilian Deng ,&nbsp;Philipp Schröter ,&nbsp;Florian Stritzke ,&nbsp;Nils Netzer ,&nbsp;Henrik Franke ,&nbsp;Kristin Uzun-Lang ,&nbsp;Julius Moratin ,&nbsp;Oliver Ristow ,&nbsp;Rubens Thoelken ,&nbsp;Semi B. Harrabi ,&nbsp;Klaus Herfarth ,&nbsp;Sebastian Adeberg ,&nbsp;Jürgen Debus ,&nbsp;Thomas Held","doi":"10.1016/j.ctro.2025.101064","DOIUrl":"10.1016/j.ctro.2025.101064","url":null,"abstract":"<div><h3>Background</h3><div>Local control of high-risk sinonasal squamous cell carcinoma (SCC) remains challenging and often involves significant morbidity. Management of the node-negative neck is still debated. This study evaluated treatment outcomes, neck management strategies, and toxicity rates in patients treated with intensity-modulated radiotherapy (IMRT) combined with a carbon ion boost.</div></div><div><h3>Methods</h3><div>We evaluated 43 patients with sinonasal SCC treated with IMRT and carbon ion boost between 2011 and 2019. Follow-up followed head and neck cancer guidelines. Patient and tumor characteristics, treatment outcomes, and toxicity (per CTCAE v5.0) were assessed. Statistical analysis was performed using R version 4.1.0.</div></div><div><h3>Results</h3><div>Median age was 64 years (range 19–83). Most patients had T3–4 tumors (n = 36; 83.7 %) and were clinically node-negative (n = 40; 93.0 %). The predominant regimen was 24 Gy (RBE) carbon ion boost in 8 fractions, followed by 50 Gy IMRT in 25 fractions. Postoperative RT was delivered to 25 patients (58.1 %), while 18 (41.9 %) received definitive RT. Elective or therapeutic neck dissection was performed in 10 patients (23.3 %), none showing lymph node metastases. In total, 22 distinct cervical lymph node treatment strategies were applied. Median follow-up for overall survival (OS) was 25.1 months. Tumor recurrence occurred in 11 patients (25.6 %), primarily due to local failure (n = 7; 63.6 %). OS and local progression-free survival (L-PFS) at 12/24 months were 93.0 %/89.3 % and 88.4 %/79.0 %, respectively. Grade III acute and late toxicity occurred in 9.3 % and 4.7 % of patients, respectively. No grade IV toxicity was reported. Mean numbers of grade I–II toxicities per patient were 4.8 (acute) and 2.4 (late).</div></div><div><h3>Conclusion</h3><div>IMRT with carbon ion boost provides promising OS and local control in high-risk sinonasal SCC. The management of the node-negative-neck was highly individualized. Toxicity was acceptable and may be further reduced by tailoring cervical lymph node treatment in selected patients.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101064"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145462759","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 adrenal metastases using MR-guided adaptive SABR: A feasible and effective approach in a high-risk population","authors":"Miguel A. Palacios ,&nbsp;Anna M.E. Bruynzeel ,&nbsp;Peter S.N. van Rossum ,&nbsp;Omar Bohoudi ,&nbsp;Suresh Senan ,&nbsp;Famke L. Schneiders","doi":"10.1016/j.ctro.2025.101056","DOIUrl":"10.1016/j.ctro.2025.101056","url":null,"abstract":"<div><div>Re-irradiation of adrenal metastases is challenging due to cumulative dose constraints. We present seven patients treated with MR-guided adaptive stereotactic ablative radiotherapy (SABR), leveraging real-time imaging and on-table adaptation for precise dose delivery (5× 10 Gy or 3× 15 Gy). This first report of ablative-dose MR-guided SABR in re-irradiation demonstrates excellent local control and acceptable toxicity, with six patients progression-free at median 8.6 months and no grade ≥3 events (one grade 2 vertebral fracture, one grade 1 nausea). By providing a non-invasive alternative to surgery or palliative radiotherapy, MR-guided adaptive SABR expands therapeutic options for high-risk patients.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101056"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145324844","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":"Evaluation of organ-specific relative biological effectiveness of proton therapy using radiation-induced pneumonitis as an endpoint","authors":"Li Liao ,&nbsp;Ting Xu ,&nbsp;Mei Chen ,&nbsp;Tingshi Su ,&nbsp;Narayan Sahoo ,&nbsp;Xiaorong Zhu ,&nbsp;Steven J. Frank ,&nbsp;Quynh-Nhu Nguyen ,&nbsp;Zhongxing Liao ,&nbsp;Xiaodong Zhang","doi":"10.1016/j.ctro.2025.101089","DOIUrl":"10.1016/j.ctro.2025.101089","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Proton therapy has become widely used for non-small cell lung cancer (NSCLC) due to its ability to spare normal tissue. However, the commonly assumed relative biological effectiveness (RBE) of 1.1 may underestimate the therapy’s true biological effects on lung, potentially leading to a higher than expected incidence of radiation-induced pneumonitis (RP). In this retrospective study, we evaluated the variability of organ-specific RBE of proton therapy using RP grade 2 or higher (RP2+) as an endpoint.</div></div><div><h3>Materials and methods</h3><div>Data from 270 NSCLC patients across two clinical trials were analyzed, with 134 given photon therapy and 136 given proton therapy. The physical dose was obtained for all patients, and the dose-averaged linear energy transfer (LET_d) was computed for proton therapy recipients. The Lyman-Kutcher-Burman (LKB) model was used to predict RP2+ incidence. RBE was determined using 1) the ratio of the photon dose to the proton dose achieved the same RP2+ incidence and 2) an LET-based RBE estimation derived from the LET-enhanced LKB model.</div></div><div><h3>Results</h3><div>The estimated RBE for RP2+ in proton therapy recipients was variable and consistently exceeded 1.1. The RBE estimated from the photon-to-proton dose ratio model between 1.10 and 1.35, with an average of 1.28. While the LET-enhanced LKB model yielded an RBE range of 1.13 to 1.33, with an average of 1.23.</div></div><div><h3>Conclusion</h3><div>This study demonstrated that the RBE of proton therapy for RP2+ is variable and higher than the conventional 1.1 assumption, emphasizing the need to account for variable RBE in treatment planning.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101089"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681362","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":"Geometric evaluation of a deep learning method for segmentation of urinary OARs on magnetic resonance imaging for prostate cancer radiotherapy","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.2025.101091","DOIUrl":"10.1016/j.ctro.2025.101091","url":null,"abstract":"<div><h3>Introduction</h3><div>While urinary organs at risk (OARs) such as the intraprostatic urethra and the bladder trigone are increasingly recognized as associated with severe genitourinary toxicity, their delineation in clinical practice is time consuming and probably associated with a large interobserver variability. The aim of this study was to propose a magnetic resonance (MR) deep learning segmentation of urinary OARs for prostate cancer (PCa) radiotherapy (RT), based on a validated atlas.</div></div><div><h3>Material and methods</h3><div>In this multicentric study, a convolutional neural network (CNN) for image segmentation (nnU-Net) was trained and validated on three image datasets. Two datasets came from MR-linac devices (Unity®, Elekta and MRIdian®, Viewray), and one dataset came from the PROSTATEx database (MAGNETOM® Trio and Skyra, Siemens). Evaluation of the deep learning segmentation was performed using dice score coefficients (DSC), surface distance (SD) and Hausdorff distance.</div></div><div><h3>Results</h3><div>A total of 265 MRI were analyzed. The mean DSC for all urinary structures was 0.88. The automatic segmentation model proved to be effective in the segmentation of the target volume and large OARs such as the bladder (mean DSC ranging of 0.95). Regarding urinary OARs, the mean DSC ranged between 0.50 and 0.68. The Hausdorff distance ranged between 4.0 mm to 10.3 mm for urinary OARs, highlighting local mismatches caused by large anatomical variations between patients. However, the SD ranged between 1.0 mm and 1.3 mm for urinary OARs, highlighting an overall good surface correlation for all organs.</div></div><div><h3>Conclusion</h3><div>This multicentric study is the first to propose a nnU-Net deep learning model for the delineation of urinary OARs, that can be applied to various image dataset. Further work is needed to assess the dosimetric impact of such variations, in various clinical scenarios.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101091"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681363","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 response in head and neck cancer subregions using daily Quantitative MRI from MR-guided radiation therapy","authors":"Ryan Bonate ,&nbsp;Musaddiq Awan ,&nbsp;Heather Himburg ,&nbsp;Stuart Wong ,&nbsp;Monica Shukla ,&nbsp;Joseph Zenga ,&nbsp;Eric S. Paulson","doi":"10.1016/j.ctro.2025.101059","DOIUrl":"10.1016/j.ctro.2025.101059","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>Quantitative MRI (qMRI) is an emerging technique for characterizing tissue microenvironments. Prior work has shown that daily qMRI during MR-guided radiotherapy (MRgRT) detects differential responses to hypofractionated radiotherapy (RT) in head and neck squamous cell carcinoma (HNSCC) within the primary gross tumor volume (GTVp). This exploratory study investigates whether subregions of HNSCC tumors show distinct qMRI responses to hypofractionated RT using contoured GTVp subregions and voxelwise data.</div></div><div><h3>Materials and Methods</h3><div>Eighteen subjects with advanced HNSCC underwent MRgRT with daily qMRI over 15 fractions (total dose 50, 55, or 60 Gy). Daily intravoxel incoherent motion (IVIM) and relaxometry sequences were acquired on a 1.5 T MR-Linac. Median ADC, D, D*, f, T₁, and T₂ were calculated for concentric GTVp subregions and an intra-subject control contour in paraspinal muscle. Mixed effect models were fit for each parameter. Voxelwise analysis included quantile tracking, histograms, and paired tests over the length of RT.</div></div><div><h3>Results</h3><div>Significant changes (p &lt; 0.05) were observed in ADC, D, f, T₂, and T₁ within GTVp subregions. ADC, D, f, and T₂ changes were uniform, while T₁ varied spatially. Spatial patterns were detected in ADC and T₁, with marginal effects in D, f, and T₂. Voxelwise analysis revealed significant changes in all parameters except D* after correction. ADC, D, and f increased consistently; T₁ and T₂ changes were quantile dependent. These trends may reflect biological processes such as declining cellularity, reperfusion, or edema.</div></div><div><h3>Conclusions</h3><div>In this exploratory study, qMRI detected spatial heterogeneity in HNSCC. These findings support its potential role in guiding biologically adaptive RT strategies.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101059"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145358578","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":"Outcomes of pelvic and para-aortic stereotactic reirradiation for gynaecological cancer recurrence","authors":"Benjamin J Thomas ,&nbsp;Kallol Bhadra ,&nbsp;Ian Zing Tan ,&nbsp;Lei Wang ,&nbsp;Susan Lalondrelle","doi":"10.1016/j.ctro.2025.101060","DOIUrl":"10.1016/j.ctro.2025.101060","url":null,"abstract":"<div><h3>Introduction</h3><div>Recurrence of gynaecological cancer in the pelvis is associated with significant morbidity and can be challenging to treat, particularly when arising in a previously irradiated site. For cases of oligometastatic relapse a targeted approach is preferable, avoiding the need for systemic therapy. Type 1 reirradiation using highly conformal techniques such as stereotactic radiotherapy (SBRT) is increasingly used, aiming for disease ablation at the site of relapse. We present an analysis of our institutional experience of using SBRT for gynaecological cancer reirradiation to identify efficacy, toxicity and other factors for appropriate case selection.</div></div><div><h3>Material and methods</h3><div>Patients treated with pelvic or para-aortic SBRT reirradiation at our institution for histologically proven gynaecological malignancies between July 2012 and January 2021 were identified from local records. Indications for treatment included soft tissue and nodal recurrences and cases of positive margin following surgery. Data were collected on survival, failure patterns, demographics, planning and dosimetry.</div></div><div><h3>Results</h3><div>73 patients were identified who had undergone 81 courses of pelvic or para-aortic reirradiation using SBRT. Median prescribed dose was 30 Gy in 5 fractions. Following SBRT reirradiation, median overall survival was 42.9 months (95 % confidence interval, CI 36.0 to 68.9 months), median progression-free survival was 14.0 months (95 % CI 9.2 to 24.3 months). Median time to local failure of the treated lesion following SBRT reirradiation was 35.2 months (95 % CI 24.3 to not reached). SBRT reirradiation was well tolerated with acute grade 3 toxicity reported in two patients. Late grade 3 toxicity was documented in two patients, both occurring over 2 years following treatment.</div></div><div><h3>Conclusion</h3><div>In selected patients with oligometastatic pelvic or para-aortic relapse of gynaecological cancer following previous pelvic radiotherapy, SBRT reirradiation is an effective and safe treatment modality. SBRT reirradiation can provide durable local control and delay time to further treatment by more than 12 months.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101060"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145358579","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":"Comments on “Efficacy of radiotherapy and radiotherapy with hyperthermia to delay change of systemic therapy in patients with metastatic melanoma”","authors":"Himanshu Shekhar,&nbsp;Parth Aphale,&nbsp;Shashank Dokania","doi":"10.1016/j.ctro.2025.101048","DOIUrl":"10.1016/j.ctro.2025.101048","url":null,"abstract":"","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101048"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145217973","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}