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Normal tissue outlining guidelines development for soft tissue sarcoma of the extremities 正常组织概述四肢软组织肉瘤的发展指南
IF 2.7 3区 医学
Clinical and Translational Radiation Oncology Pub Date : 2025-07-19 DOI: 10.1016/j.ctro.2025.101020
Rita Simões , Sarah Gulliford , Punita Shah , Eve McAtavey , Elizabeth Richardson , Umme Chowdhury , Laura Fray , Roeum Butt , Yolanda Augustin , Ruqayyah Sarang , Refia Kilinc , Maryam Iqbal , Hakim Moulay-Dehbi , Elizabeth Miles , Peter Hoskin , Shane Zaidi , Kevin J Harrington , Aisha B. Miah
{"title":"Normal tissue outlining guidelines development for soft tissue sarcoma of the extremities","authors":"Rita Simões ,&nbsp;Sarah Gulliford ,&nbsp;Punita Shah ,&nbsp;Eve McAtavey ,&nbsp;Elizabeth Richardson ,&nbsp;Umme Chowdhury ,&nbsp;Laura Fray ,&nbsp;Roeum Butt ,&nbsp;Yolanda Augustin ,&nbsp;Ruqayyah Sarang ,&nbsp;Refia Kilinc ,&nbsp;Maryam Iqbal ,&nbsp;Hakim Moulay-Dehbi ,&nbsp;Elizabeth Miles ,&nbsp;Peter Hoskin ,&nbsp;Shane Zaidi ,&nbsp;Kevin J Harrington ,&nbsp;Aisha B. Miah","doi":"10.1016/j.ctro.2025.101020","DOIUrl":"10.1016/j.ctro.2025.101020","url":null,"abstract":"<div><h3>Introduction</h3><div>Radiotherapy (RT) plans for soft tissue sarcoma of the extremities (STSE) are optimised to achieve maximum target coverage whilst avoiding high doses to weight-bearing bones and intermediate doses to the normal tissue (NT) limb corridor. Within this study, novel lower extremity NT outlining guidelines and atlas were developed based on the hypothesis that using these for RT planning may reduce RT toxicity. Usability and applicability of the guidance were also investigated.</div></div><div><h3>Methods</h3><div>Guidelines for NT outlining were developed. Two STSE cases were selected and a set of reference volumes was outlined on each case by one Therapeutic Radiographer/Radiation Therapist (RTT) and peer-reviewed by a consultant radiation oncologist (RO). NTs were then outlined following the guidelines by 11 (8 RTT and 3 RO) and 12 (9 RTT and 3 RO) additional observers, respectively for cases 1 and 2. Dice coefficient (DICE), Maximum Hausdorff distance (maxHD) and mean surface distance (MSD) were calculated for individual NT volumes against the reference volumes. The Kruskal-Wallis test was performed. Analysis of interobserver variability was then used to inform guidance improvement.</div></div><div><h3>Results</h3><div>Good agreement and reproducibility were observed in DICE, MSD and maxHD for the anterior, posterior, adductor and gluteal muscle compartments, femur and femoral head and neck, knee and hip joints. Moderate agreement was observed for the lateral rotator and iliopsoas muscle compartments, and the femoral and inguinofemoral neurovascular bundle. Poor agreement was observed for the deep thigh neurovascular bundle.</div></div><div><h3>Conclusion</h3><div>Our results identify that the new NT outlining guidance for STSE is reproducible between observers and within a multi-professional environment, with consistent RTT and RO scores. This reproducibility is attributed to the use of guidelines. This study has also identified areas for refinement of the guidelines, particularly for the deep thigh neurovascular bundle.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 101020"},"PeriodicalIF":2.7,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679749","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}
引用次数: 0
Decision regret after reirradiation of the primary site in patients with prostate cancer 前列腺癌患者原发部位再照射后的决定后悔
IF 2.7 3区 医学
Clinical and Translational Radiation Oncology Pub Date : 2025-07-19 DOI: 10.1016/j.ctro.2025.101019
Alexander Fabian , Bilgesu Sahin Öztürk , Lars Haack , Severin Rodler , Christof van der Horst , Christian Schulz , Claudia Schmalz , Stefan Huttenlocher , Olaf Wittenstein , Oliver Blanck , Frank-André Siebert , David Krug
{"title":"Decision regret after reirradiation of the primary site in patients with prostate cancer","authors":"Alexander Fabian ,&nbsp;Bilgesu Sahin Öztürk ,&nbsp;Lars Haack ,&nbsp;Severin Rodler ,&nbsp;Christof van der Horst ,&nbsp;Christian Schulz ,&nbsp;Claudia Schmalz ,&nbsp;Stefan Huttenlocher ,&nbsp;Olaf Wittenstein ,&nbsp;Oliver Blanck ,&nbsp;Frank-André Siebert ,&nbsp;David Krug","doi":"10.1016/j.ctro.2025.101019","DOIUrl":"10.1016/j.ctro.2025.101019","url":null,"abstract":"<div><h3>Purpose</h3><div>A subset of prostate cancer patients develops local relapse at the primary site after radiotherapy. The optimal local salvage strategy is unknown. Therefore, we aimed to explore prevalence and determinants of decision regret among patients after reirradiation of the primary site.</div></div><div><h3>Materials and methods</h3><div>We surveyed 31 patients in a cross-sectional bi-centre exploratory study. Reirradiation was high dose-rate brachytherapy (HDR-BT) in 21 and stereotactic body radiotherapy (SBRT) in 10 patients. Decision regret (DR) was measured using the Decision Regret Scale (DRS) (range: 0–100; higher values higher regret). Further patient-reported outcomes (PRO) included the EPIC-26, EORTC QLQ-C30, PRO-CTCAE, and PSCC questionnaires. Univariable associations of decision regret and potential determinants were assessed by one-way ANOVA or Pearson’s correlation.</div></div><div><h3>Results</h3><div>Median age at reirradiation was 75 years. Median time intervals from initial radiotherapy to reirradiation was 8 years and 4 years from reirradiation to survey. The mean DRS score was 10 (SD: 14). No (0 points), mild (1–25 points), or strong regret (&gt;25 points) was reported by 45 % (14/31), 48 % (15/31), and 7 % (2/31) of the patients, respectively. DR was significantly associated with PRO of urinary symptom burden and toxicity as well as levels of shared-decision making and patient satisfaction. HDR-BT vs. SBRT, further local relapse, and progression-free survival were not associated with DR.</div></div><div><h3>Conclusions</h3><div>DR was mild among prostate cancer patients after reirradiation to the primary site. PRO on symptom burden and shared decision making may be associated with DR. These findings should be validated and may inform treatment decisions on local salvage therapy.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 101019"},"PeriodicalIF":2.7,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144704412","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}
引用次数: 0
CD8-positive lymphocyte infiltration as a marker of anti-tumor immune response in rectal cancer: pre- and post-neoadjuvant radiotherapy comparison cd8阳性淋巴细胞浸润作为直肠癌抗肿瘤免疫反应的标志物:新辅助放疗前后的比较
IF 2.7 3区 医学
Clinical and Translational Radiation Oncology Pub Date : 2025-07-16 DOI: 10.1016/j.ctro.2025.101018
Samaneh Salarvand , Romina Abyaneh , Abdorreza Raee , Mahdieh Yaghooti-Khorasani , Fariba Mohammadjani , Fatemeh Nili , Mahdi Aghili , Reza Ghalehtaki
{"title":"CD8-positive lymphocyte infiltration as a marker of anti-tumor immune response in rectal cancer: pre- and post-neoadjuvant radiotherapy comparison","authors":"Samaneh Salarvand ,&nbsp;Romina Abyaneh ,&nbsp;Abdorreza Raee ,&nbsp;Mahdieh Yaghooti-Khorasani ,&nbsp;Fariba Mohammadjani ,&nbsp;Fatemeh Nili ,&nbsp;Mahdi Aghili ,&nbsp;Reza Ghalehtaki","doi":"10.1016/j.ctro.2025.101018","DOIUrl":"10.1016/j.ctro.2025.101018","url":null,"abstract":"<div><h3>Background</h3><div>Antitumor immunity, exerted by CD8+ cytotoxic T lymphocytes, plays a vital role in tumor control. Therefore, the present study was conducted to compare the amount of CD8+ tumor-infiltrating lymphocytes (TILs) before and after either long- (LCRT) or short-course radiotherapy (SCRT) in rectal cancer.</div></div><div><h3>Methods</h3><div>This study retrospectively assessed rectal cancer patients treated by neoadjuvant radiotherapy between 2019 and 2021. Biopsy and surgical samples were subjected to immunohistochemical staining to count CD8+ TILs. The association between the post-to-pre-treatment CD8+ count ratio and treatment groups, histopathological factors, and response to treatment was assessed.</div></div><div><h3>Results</h3><div>A total of 34 patients were included, with 23 (67.6 %) receiving LCRT and 11 (32.4 %) receiving SCRT. The mean age was 58.56 ± 13.59 years. The number and percentage of CD8+ TILs increased significantly after radiotherapy in all patients (P &lt; 0.001). An increase in CD8+ TILs was observed in both groups, with LCRT showing a median post-to-pre-treatment count ratio of 2.77 and SCRT showing 3.1 (P = 0.127). A generalized linear multivariate model adjusting for mucinous histology, surgical grade, and pathological stages revealed that SCRT was associated with a significantly higher post-to-pre-treatment CD8+ count ratio compared to LCRT (P = 0.03).</div></div><div><h3>Conclusion</h3><div>Our study highlights that both SCRT and LCRT significantly increase CD8+ TIL count and percentage, reflecting robust immune activation after radiotherapy in rectal cancer, with SCRT showing a higher relative increase, though not statistically significant in unadjusted analyses. After adjusting for histopathological variables, SCRT was independently associated with a greater increase in CD8+ T cells.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 101018"},"PeriodicalIF":2.7,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144695174","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}
引用次数: 0
Increasing patient comfort in palliative radiotherapy with a newly developed mattress: a nonrandomized clinical trial 使用新开发的床垫增加姑息性放疗患者舒适度:一项非随机临床试验
IF 2.7 3区 医学
Clinical and Translational Radiation Oncology Pub Date : 2025-07-16 DOI: 10.1016/j.ctro.2025.101017
Nienke Hoffmans-Holtzer, Britt Kunnen, Olijn Tims, Ilse de Pree, Cleo Slagter, Manouk Olofsen-van Acht, Mischa Hoogeman, Steven Petit
{"title":"Increasing patient comfort in palliative radiotherapy with a newly developed mattress: a nonrandomized clinical trial","authors":"Nienke Hoffmans-Holtzer,&nbsp;Britt Kunnen,&nbsp;Olijn Tims,&nbsp;Ilse de Pree,&nbsp;Cleo Slagter,&nbsp;Manouk Olofsen-van Acht,&nbsp;Mischa Hoogeman,&nbsp;Steven Petit","doi":"10.1016/j.ctro.2025.101017","DOIUrl":"10.1016/j.ctro.2025.101017","url":null,"abstract":"<div><h3>Background</h3><div>In palliative radiotherapy, many patients experience discomfort and pain during treatment, particularly while lying on flat, hard treatment couches that are considered essential for accurate treatment delivery. Thin foam matts, often used for palliative treatments, can somewhat reduce discomfort, but they are frequently insufficient.</div></div><div><h3>Aim</h3><div>In this study a mattress was developed and investigated, with the aim to reduce pain during radiotherapy treatments without affecting treatment quality.</div></div><div><h3>Methods</h3><div>A nonrandomized clinical trial compared the newly designed RTComfort mattress with a standard thin foam matt. The primary endpoint was mattress preference, while secondary endpoints included experienced pain, positioning stability, and dosimetric effects. Included patients tested both the mat and mattress for one minute each in the treatment position before planning-CT acquisition, scoring their preference and pain on a Numerical Rating Scale (NRS, 0–10). Subsequently, patients were scanned and treated on their preferred option. Positioning stability during treatment was evaluated using optical surface scanning and dosimetric effects were evaluated through dose calculations with the treatment planning system.</div></div><div><h3>Results</h3><div>Out of 45 patients, 44 (98 %) preferred the RTComfort mattress, with 35 patients showing a strong preference (p &lt; 0.0001). The median pain score on the RTComfort mattress decreased from 4.8 (IQR: 2.0–6.1) to 2.0 (IQR: 0.4 to 4.0 NRS) (p &lt; 0.0001). Both options showed negligible patient sagging, with marginally less on the RTComfort mattress (p &lt; 0.0001). No relevant dosimetric effects were observed.</div></div><div><h3>Conclusions</h3><div>This prospective clinical trial highlights the need for more comfortable radiotherapy treatments. Compared to the standard thin foam matt, 98% of patients preferred the RTComfort mattress. The RTComfort mattress provided clinically significant reduction in pain associated with lying on flat, hard treatment couches. The mattress is safe for clinical use and shows potential beyond palliative radiotherapy settings.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 101017"},"PeriodicalIF":2.7,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665472","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}
引用次数: 0
Reply to comment on Treatment-related toxicity, utility and patient-reported outcomes of head and neck cancer patients treated with proton therapy: A longitudinal study. 质子治疗头颈癌患者的治疗相关毒性、效用和患者报告的结果:一项纵向研究。
IF 2.7 3区 医学
Clinical and Translational Radiation Oncology Pub Date : 2025-07-14 eCollection Date: 2025-09-01 DOI: 10.1016/j.ctro.2025.101013
Yi Hsuan Chen, Michiel Kroesen, Mischa S Hoogeman, Matthijs M Versteegh, Carin A Uyl-de Groot, Hedwig M Blommestein
{"title":"Reply to comment on Treatment-related toxicity, utility and patient-reported outcomes of head and neck cancer patients treated with proton therapy: A longitudinal study.","authors":"Yi Hsuan Chen, Michiel Kroesen, Mischa S Hoogeman, Matthijs M Versteegh, Carin A Uyl-de Groot, Hedwig M Blommestein","doi":"10.1016/j.ctro.2025.101013","DOIUrl":"10.1016/j.ctro.2025.101013","url":null,"abstract":"","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"101013"},"PeriodicalIF":2.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12365528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945217","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}
引用次数: 0
Clarifying gastrointestinal toxicity attribution in WP-SBRT: Commentary on Dinesan et al. and proposal of a bladder-bowel displacement index. 澄清WP-SBRT的胃肠道毒性归属:对Dinesan等人的评论和膀胱-肠移位指数的建议。
IF 2.7 3区 医学
Clinical and Translational Radiation Oncology Pub Date : 2025-07-14 eCollection Date: 2025-09-01 DOI: 10.1016/j.ctro.2025.100995
Gonca Altınışık İnan, Emine Melis Basman, Serenay Demir
{"title":"Clarifying gastrointestinal toxicity attribution in WP-SBRT: Commentary on Dinesan et al. and proposal of a bladder-bowel displacement index.","authors":"Gonca Altınışık İnan, Emine Melis Basman, Serenay Demir","doi":"10.1016/j.ctro.2025.100995","DOIUrl":"10.1016/j.ctro.2025.100995","url":null,"abstract":"","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"100995"},"PeriodicalIF":2.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12365523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945194","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}
引用次数: 0
Immediate 2-Stage breast reconstruction outcomes after proton or photon postmastectomy radiotherapy 乳房切除术后质子或光子放射治疗的即时2期乳房重建结果
IF 2.7 3区 医学
Clinical and Translational Radiation Oncology Pub Date : 2025-07-13 DOI: 10.1016/j.ctro.2025.101015
Robert W. Gao , William S. Harmsen , Na L. Smith , Trey C. Mullikin , Adam C. Amundson , Feven Abraha , Kimberly G. Gergelis , Arslan Afzal , Christin A. Harless , Aparna Vijayasekaran , Minh-Doan T. Nguyen , Judy C. Boughey , Nicholas B. Remmes , Hok S. Wan Chan Tseung , May Elbanna , Allison E. Garda , Mark R. Waddle , Safia K. Ahmed , Sean S. Park , Kimberly S. Corbin , Dean A. Shumway
{"title":"Immediate 2-Stage breast reconstruction outcomes after proton or photon postmastectomy radiotherapy","authors":"Robert W. Gao ,&nbsp;William S. Harmsen ,&nbsp;Na L. Smith ,&nbsp;Trey C. Mullikin ,&nbsp;Adam C. Amundson ,&nbsp;Feven Abraha ,&nbsp;Kimberly G. Gergelis ,&nbsp;Arslan Afzal ,&nbsp;Christin A. Harless ,&nbsp;Aparna Vijayasekaran ,&nbsp;Minh-Doan T. Nguyen ,&nbsp;Judy C. Boughey ,&nbsp;Nicholas B. Remmes ,&nbsp;Hok S. Wan Chan Tseung ,&nbsp;May Elbanna ,&nbsp;Allison E. Garda ,&nbsp;Mark R. Waddle ,&nbsp;Safia K. Ahmed ,&nbsp;Sean S. Park ,&nbsp;Kimberly S. Corbin ,&nbsp;Dean A. Shumway","doi":"10.1016/j.ctro.2025.101015","DOIUrl":"10.1016/j.ctro.2025.101015","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the impact of postmastectomy radiotherapy (PMRT) on immediate breast reconstruction (IBR) outcomes among patients treated with proton or photon radiotherapy.</div></div><div><h3>Material and Methods</h3><div>Patients who had undergone mastectomy, immediate breast reconstruction, and PMRT at our institution were included in a retrospective analysis of risk factors for surgical site infection (SSI), unplanned reoperation, and reconstruction failure. Univariate Cox models were used to examine associations of variables with reconstruction outcomes.</div></div><div><h3>Results</h3><div>Two-hundred thirty-one women were included, of whom 224 (97.0 %) underwent two-stage IBR with placement of a tissue expander and 7 (3 %) had direct-to-implant IBR. One-hundred sixty-five patients (71.4 %) received proton and 65 (28.6 %) received photon therapy. Twenty-nine patients (12.6 %) received hypofractionation. Median follow-up was 1.8 years. Two-year cumulative risk of SSI was 17.83 % (95 % CI 12.27–24.41 %); unplanned reoperation was 16.19 % (95 % CI 10.06–22.10 %); and reconstruction failure was 7.60 % (95 % CI 3.55–12.11). On multivariable analysis, prophylactic use of Mepitel Film reduced the risk of SSI [HR: 0.35 (95 % CI: 0.18–0.69), <em>p</em> = 0.002] and unplanned reoperation [HR: 0.39 (95 % CI: 0.20–0.79), <em>p</em> = 0.008]. The small number of events (n = 16) precluded multivariable analysis of reconstruction failure; on univariate analysis, receipt of a chest wall boost [HR: 4.98 (95 % CI: 1.12–22.10), <em>p</em> = 0.035] and/or lymph node boost [HR: 3.66 (95 % CI: 1.25–10.73), <em>p</em> = 0.018] were associated with reconstruction failure.</div></div><div><h3>Conclusions</h3><div>Although approximately one-fifth of women experienced SSI or unplanned reoperation, the rate of reconstruction failure was low (7.6%) and most women achieved a successful reconstruction outcome with PMRT using photons or protons. The lower rate of SSI and unplanned reoperation with use of Mepitel Film highlights the need for further evaluation.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 101015"},"PeriodicalIF":2.7,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633277","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}
引用次数: 0
Radiotherapy boost to the primary tumour in locally advanced rectal cancer: Systematic review of practices and meta-analysis 放疗对局部晚期直肠癌原发肿瘤的促进作用:实践的系统回顾和荟萃分析
IF 2.7 3区 医学
Clinical and Translational Radiation Oncology Pub Date : 2025-07-13 DOI: 10.1016/j.ctro.2025.101014
Julien Pierrard , Lorraine Donnay , Alix Collard , Geneviève Van Ooteghem
{"title":"Radiotherapy boost to the primary tumour in locally advanced rectal cancer: Systematic review of practices and meta-analysis","authors":"Julien Pierrard ,&nbsp;Lorraine Donnay ,&nbsp;Alix Collard ,&nbsp;Geneviève Van Ooteghem","doi":"10.1016/j.ctro.2025.101014","DOIUrl":"10.1016/j.ctro.2025.101014","url":null,"abstract":"<div><h3>Introduction</h3><div>In locally advanced rectal cancer (LARC), increasing the complete response (CR) rate after total neo-adjuvant treatment may increase the patient eligibility for non-operative management (“watch and wait”, W&amp;W). Although a radiotherapy (RT) boost to the primary tumour may enhance CR rates, clear guidelines are currently lacking. This systematic review and <em>meta</em>-analysis investigate the technical parameters used for rectal boost RT and assess their impact on oncological outcomes.</div></div><div><h3>Methods</h3><div>Following PRISMA guidelines, the terms “rectum,” “radiotherapy,” and “boost” were searched in PubMed and EMBASE (PROSPERO: CRD42023444685). Studies reporting on external beam RT boost to the primary tumour in LARC and meeting quality criteria were included. Descriptive analyses extracted data on RT technique, preparation, boost delineation, dose, chemotherapy, and follow-up. A mixed-effects <em>meta</em>-analysis model evaluated the impact of selected parameters on CR and local recurrence rate (LRR). Studies were analysed separately based on treatment intent: planned surgery or W&amp;W.</div></div><div><h3>Results</h3><div>Out of 3904 references, 83 were included in the descriptive analysis and 78 in the <em>meta</em>-analysis. Substantial variability in RT parameters was observed across studies. Pathologic CR rates were significantly higher with intensity-modulated/volumetric-modulated arc RT (IMRT/VMAT, p = 0.007), simultaneous boost (p = 0.020), dose escalation (Biological equivalent dose &gt; 74 Gy, p = 0.035), and the combination of induction and consolidation chemotherapy (p = 0.023). No significant associations were found for clinical CR or LRR.</div></div><div><h3>Conclusion</h3><div>While rectal RT boost is already part of real-world practices, the wide heterogeneity in techniques highlights the urgent need for standardisation. Our <em>meta</em>-analysis suggests that IMRT/VMAT, simultaneous boost, and dose escalation are associated with higher pathological CR rates and should be considered in future rectal boost guidelines. These findings, however, warrant careful interpretation due to the absence of adjustments for clinical, tumoral, or patient-related parameters that may also influence response rate and oncological outcomes.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 101014"},"PeriodicalIF":2.7,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144654357","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}
引用次数: 0
Overexpression of JAML in colorectal cancer cells predicts higher radiosensitivity by inactivating ATR pathway 结直肠癌细胞中JAML的过表达可通过灭活ATR通路预测更高的放射敏感性
IF 2.7 3区 医学
Clinical and Translational Radiation Oncology Pub Date : 2025-07-11 DOI: 10.1016/j.ctro.2025.101016
Mingyan Zhang , Wenhui Shi , Yanan Liu , Yufeng Wang , Yinying Dong , Chunsheng Yang , Yawen Zheng , Ning Liu , Yan Zheng , Meili Sun
{"title":"Overexpression of JAML in colorectal cancer cells predicts higher radiosensitivity by inactivating ATR pathway","authors":"Mingyan Zhang ,&nbsp;Wenhui Shi ,&nbsp;Yanan Liu ,&nbsp;Yufeng Wang ,&nbsp;Yinying Dong ,&nbsp;Chunsheng Yang ,&nbsp;Yawen Zheng ,&nbsp;Ning Liu ,&nbsp;Yan Zheng ,&nbsp;Meili Sun","doi":"10.1016/j.ctro.2025.101016","DOIUrl":"10.1016/j.ctro.2025.101016","url":null,"abstract":"<div><h3>Background</h3><div>Junctional adhesion molecule–like protein (JAML) is highly expressed in cancer tissues of patients with colorectal cancer (CRC) and promotes cancer proliferation. However, the relationship between JAML expression and radiosensitivity of CRC remains unclear.</div></div><div><h3>Methods</h3><div>Stable CRC cell lines with knocked down or overexpressed JAML were used to evaluate the effects of irradiation on cell viability and cell proliferation using Cell Counting Kit-8 (CCK8) and cell clone formation assay, respectively. Cellular immunofluorescence, flow cytometry, and western blotting were used to determine the mechanism. Tumor-bearing nude mouse models were established to verify the relationships between the expression of JAML and the radiosensitivity of CRC.</div></div><div><h3>Results</h3><div>The results of CCK8 and cell clone formation assay showed that the viability and proliferation of CRC cells with JAML overexpression were significantly inhibited after exposure to irradiation compared with those of CRC cells with low expression of JAML. DNA damage and cell apoptosis were significantly increased in the JAML-overexpression group compared with the JAML-low-expression group after exposure to irradiation. The phosphorylation of the ataxia telangiectasia and Rad3-related protein (ATR)-checkpoint kinase 1 (CHK1)-mediated DNA damage repair pathway was inhibited in the JAML-overexpression group compared with the JAML-low-expression CRC cells after irradiation. Similar results were observed in CRC xenografts <em>in vivo</em>.</div></div><div><h3>Conclusions</h3><div>CRC cells with JAML overexpression are more sensitive to radiotherapy of X-rays because of the decreased phosphorylation of the ATR-CHK1-mediated DNA damage repair pathway. The expression of JAML in CRC cells could be used as a predictive biomarker of radiosensitivity in patients with CRC.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 101016"},"PeriodicalIF":2.7,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631330","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}
引用次数: 0
Palliative expeditiously adaptive quad shot radiotherapy for head and neck cancers (PEAQ-RT) 缓解性快速适应性头颈部肿瘤四针放射治疗(PEAQ-RT)
IF 2.7 3区 医学
Clinical and Translational Radiation Oncology Pub Date : 2025-07-08 DOI: 10.1016/j.ctro.2025.101012
Weiren Liu , Joshua P. Schiff , Comron Hassanzadeh , Karen Miller , Casey Hatscher , Robbie Beckert , Alex Price , Mackenzie Daly , Randall Brenneman , Lauren Henke , Anthony Apicelli , Michael Moravan , Wade Thorstad , Eric Laugeman
{"title":"Palliative expeditiously adaptive quad shot radiotherapy for head and neck cancers (PEAQ-RT)","authors":"Weiren Liu ,&nbsp;Joshua P. Schiff ,&nbsp;Comron Hassanzadeh ,&nbsp;Karen Miller ,&nbsp;Casey Hatscher ,&nbsp;Robbie Beckert ,&nbsp;Alex Price ,&nbsp;Mackenzie Daly ,&nbsp;Randall Brenneman ,&nbsp;Lauren Henke ,&nbsp;Anthony Apicelli ,&nbsp;Michael Moravan ,&nbsp;Wade Thorstad ,&nbsp;Eric Laugeman","doi":"10.1016/j.ctro.2025.101012","DOIUrl":"10.1016/j.ctro.2025.101012","url":null,"abstract":"<div><h3>Purpose/objective</h3><div>Quad shot radiotherapy (QS-RT) is integral to head and neck cancer palliative care, but multiple CT-simulations for QS-RT cycles can be burdensome for patients. We evaluated the ability of an online adaptive radiotherapy (ART) workflow (PEAQ-RT) to eliminate extra CT simulations in QS-RT and reduce treatment related burdens.</div></div><div><h3>Materials/methods</h3><div>Ten patients with head and neck malignancies were enrolled in this prospective study receiving QS-RT for up to three cycles, each comprising four fractions of 350 cGy delivered twice daily, with a total dose of 1400 cGy per cycle. QS-RT could be delivered up to three cycles, spaced three to four weeks apart. Patients underwent standard CT simulation, and the simulation plan served as the treatment plan for the first QS-RT cycle. For subsequent QS-RT cycles, patients proceeded directly to adaptive treatment via institutional online ART protocol. Feasibility was defined as completing this expedited adaptive QS-RT workflow in at least 80 % of attempted adapted fractions.</div></div><div><h3>Results</h3><div>Ten patients aged 56–89 were enrolled. Eight patients received a second cycle of QS-RT and four patients received a third cycle. PEAQ-RT workflow was feasible in 87.5% (7/8) of patients who received at least one adapted cycle and was feasible in 86% (12/14) of attempted adapted fractions. For the second and third cycles, average total workflow time for the adaptive treatments was 28 min (14–38). All constraint violations were resolved with the use of online adaptation. The PEAQ-RT workflow eliminated a median of 2 (range: 0–2) simulation visits with additional QS-RT cycles. This resulted in a median travel distance savings of 50.8 miles (range: 40.6–848 miles) and a median reduction of 3.5 h in travel time per patient.</div></div><div><h3>Conclusion</h3><div>PEAQ-RT enabled QS-RT while eliminating the need for additional CT simulation appointments for subsequent cycles.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 101012"},"PeriodicalIF":2.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144654358","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}
引用次数: 0
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