Clinical and Translational Radiation Oncology最新文献

{"title":"Validation of different automated segmentation models for target volume contouring in postoperative radiotherapy for breast cancer and regional nodal irradiation","authors":"Eva Meixner ,&nbsp;Benjamin Glogauer ,&nbsp;Sebastian Klüter ,&nbsp;Friedrich Wagner ,&nbsp;David Neugebauer ,&nbsp;Line Hoeltgen ,&nbsp;Lisa A. Dinges ,&nbsp;Semi Harrabi ,&nbsp;Jakob Liermann ,&nbsp;Maria Vinsensia ,&nbsp;Fabian Weykamp ,&nbsp;Philipp Hoegen-Saßmannshausen ,&nbsp;Jürgen Debus ,&nbsp;Juliane Hörner-Rieber","doi":"10.1016/j.ctro.2024.100855","DOIUrl":"10.1016/j.ctro.2024.100855","url":null,"abstract":"<div><h3>Introduction</h3><p>Target volume delineation is routinely performed in postoperative radiotherapy (RT) for breast cancer patients, but it is a time-consuming process. The aim of the present study was to validate the quality, clinical usability and institutional-specific implementation of different auto-segmentation tools into clinical routine.</p></div><div><h3>Methods</h3><p>Three different commercially available, artificial intelligence-, ESTRO-guideline-based segmentation models (M1-3) were applied to fifty consecutive reference patients who received postoperative local RT including regional nodal irradiation for breast cancer for the delineation of clinical target volumes: the residual breast, implant or chestwall, axilla levels 1 and 2, the infra- and supraclavicular regions, the interpectoral and internal mammary nodes. Objective evaluation metrics of the created structures were conducted with the Dice similarity index (DICE) and the Hausdorff distance, and a manual evaluation of usability.</p></div><div><h3>Results</h3><p>The resulting geometries of the segmentation models were compared to the reference volumes for each patient and required no or only minor corrections in 72 % (M1), 64 % (M2) and 78 % (M3) of the cases. The median DICE and Hausdorff values for the resulting planning target volumes were 0.87–0.88 and 2.96–3.55, respectively. Clinical usability was significantly correlated with the DICE index, with calculated cut-off values used to define no or minor adjustments of 0.82–0.86. Right or left sided target and breathing method (deep inspiration breath hold vs. free breathing) did not impact the quality of the resulting structures.</p></div><div><h3>Conclusion</h3><p>Artificial intelligence-based auto-segmentation programs showed high-quality accuracy and provided standardization and efficient support for guideline-based target volume contouring as a precondition for fully automated workflows in radiotherapy treatment planning.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"49 ","pages":"Article 100855"},"PeriodicalIF":2.7,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824001320/pdfft?md5=e38267f10cb1b9c6eb12938744ad4ed6&pid=1-s2.0-S2405630824001320-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142171876","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":"Contact X-ray Brachytherapy as a sole treatment in selected patients with early rectal cancer – Multi-centre study","authors":"Ngu Wah Than ,&nbsp;D. Mark Pritchard ,&nbsp;David M. Hughes ,&nbsp;Kai Shing Yu ,&nbsp;Helen S. Minnaar ,&nbsp;Amandeep Dhadda ,&nbsp;Jamie Mills ,&nbsp;Joakim Folkesson ,&nbsp;Calin Radu ,&nbsp;C.A. Duckworth ,&nbsp;Helen Wong ,&nbsp;Muneeb Ul Haq ,&nbsp;Rajaram Sripadam ,&nbsp;Mark D. Halling-Brown ,&nbsp;Alexandra J. Stewart ,&nbsp;Arthur Sun Myint","doi":"10.1016/j.ctro.2024.100851","DOIUrl":"10.1016/j.ctro.2024.100851","url":null,"abstract":"<div><h3>Background and purpose</h3><p>Radical surgery is the standard of care for early rectal cancer. However, alternative organ-preserving approaches are attractive, especially in frail or elderly patients as these avoid surgical complications. We have assessed the efficacy of sole Contact X-ray Brachytherapy (CXB) treatment in stage-1 rectal cancer patients who were unsuitable for or declined surgery.</p></div><div><h3>Materials and methods</h3><p>This retrospective multi-centre study (2009–2021) evaluated 76 patients with T1/2-N0-M0 rectal adenocarcinomas who were treated with CXB alone. Outcomes were assessed for the entire cohort and sub-groups based on the T-stage and the criteria for receiving CXB alone; Group A: patients who were fit enough for surgery but declined, Group B: patients who were high-risk for surgery and Group C: patients who had received prior pelvic radiation for a different cancer.</p></div><div><h3>Results</h3><p>With a median follow-up of 26(IQR:12–49) months, initial clinical Complete Response (cCR) was 82(70–93)% with rates of local regrowth 18(8–29)%, 3-year actuarial local control (LC) 84(75–95)%, distant relapse 3 %, and no nodal relapse. 5-year disease-free survival (DFS) and overall survival (OS) were 66(48–78)% and 58(44–75)%. Lower OS was observed in Groups B [HR:2.54(95 %CI:1.17, 5.59), p = 0.02] and C [HR:2.75(95 %CI:1.15, 6.58), p = 0.03]. Previous pelvic radiation predicted lower cCR and OS. The main toxicity was G1-2 rectal bleeding (26 %) and symptoms of impaired anal sphincter function were not reported in any patients.</p></div><div><h3>Conclusion</h3><p>CXB treatment alone achieved a high cCR rate with satisfactory LC and DFS. Inferior oncological outcomes were observed in patients who had received prior pelvic radiotherapy. CXB alone, with its favourable toxicity profile and avoidance of general anaesthesia and surgery risks, therefore, can be considered for patients who are unsuitable for or refuse surgery.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"49 ","pages":"Article 100851"},"PeriodicalIF":2.7,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824001289/pdfft?md5=cc01f88995e6ee34340069418bb5cf09&pid=1-s2.0-S2405630824001289-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142163931","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":"Understanding the impact of radiation-induced lymphopenia: Preclinical and clinical research perspectives","authors":"E. Prades-Sagarra ,&nbsp;A. Yaromina ,&nbsp;L.J. Dubois","doi":"10.1016/j.ctro.2024.100852","DOIUrl":"10.1016/j.ctro.2024.100852","url":null,"abstract":"<div><p>Immunotherapy has revolutionized the field of cancer treatment, changing the standard of care to the use of immune checkpoint inhibitors. Radiotherapy can boost anti-tumour immune responses by changing the tumour microenvironment, but it also can cause radiotherapy-induced lymphopenia (RIL), a decrease in circulating lymphocyte counts. RIL has been associated with lower survival in patients undergoing radiotherapy, and new studies have suggested that it can also affect immunotherapy outcome. To study RIL’s effects and to explore mitigation treatment strategies, preclinical models closely mimicking the clinical situation are needed. State-of-the-art image-guided small animal irradiators now offer the possibility to target specific organs in small animals to induce RIL, aiding research on its molecular mechanisms and prevention. This review covers the relationship between radiotherapy and RIL, its impact on patient survival, and future directions to generate models to investigate and prevent RIL.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"49 ","pages":"Article 100852"},"PeriodicalIF":2.7,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824001290/pdfft?md5=f211cceb41a3efcaa56cbe746d69fee4&pid=1-s2.0-S2405630824001290-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229531","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":"Prognostic implications of HIF-1α expression in anal squamous cell carcinoma treated with intensity-modulated radiotherapy (IMRT)","authors":"Ahmed Allam Mohamed ,&nbsp;Michael J. Eble ,&nbsp;Edgar Dahl ,&nbsp;Danny Jonigk ,&nbsp;Svetlana Warkentin","doi":"10.1016/j.ctro.2024.100853","DOIUrl":"10.1016/j.ctro.2024.100853","url":null,"abstract":"<div><h3>Background</h3><p>Hypoxia-inducible factor-1α (HIF-1α) is a crucial transcription factor activated under hypoxic conditions, known to regulate genes associated with tumor survival, progression, and response to therapy. This study aimed to evaluate the prognostic significance of HIF-1α expression in patients with anal squamous cell carcinoma (ASCC) undergoing chemoradiation therapy.</p></div><div><h3>Methods</h3><p>We conducted a retrospective analysis of 28 ASCC patients treated with intensity-modulated radiotherapy (IMRT) at our center from 2009 to 2022. HIF-1α expression was assessed via immunohistochemistry on formalin-fixed paraffin-embedded tissue specimens. Quantitative analysis of HIF-1α expression was performed, and its relationship with clinical outcomes, including disease-free survival (DFS), locoregional relapse-free survival (LRRFS), and overall survival (OS), was examined using Cox regression models. Furthermore, ASCC tissue specimens from 17 patients were analyzed for potential <em>PIK3CA</em> mutations using Sanger sequencing.</p></div><div><h3>Results</h3><p>High HIF-1α expression was significantly associated with poorer DFS (p = 0.005), LRRFS (p = 0.012), and OS (p = 0.009). HIF1α expression was marginally significantly higher in males compared to females (p = 0.056) while there was no significant difference found based on tumor stage or p16 status. However, a positive correlation was identified between BMI and HIF-1α levels (Pearson correlation r = 0.5, p = 0.0084), suggesting a link between metabolic status and tumor hypoxia. Only one patient exhibited a PIK3CA mutation, preventing a reliable assessment of its correlation with HIF-1α expression.</p></div><div><h3>Conclusion</h3><p>Our findings underscore the importance of HIF-1α as a potential biomarker for predicting survival outcomes in ASCC patients treated with chemoradiation. The association between higher BMI and increased HIF-1α expression may provide insights into the interplay between metabolic health and tumor biology in ASCC. Further studies with larger cohorts are needed to validate these findings and explore targeted therapies focusing on HIF-1α modulation.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"49 ","pages":"Article 100853"},"PeriodicalIF":2.7,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824001307/pdfft?md5=835571536c0cc3add5d631b48681d90a&pid=1-s2.0-S2405630824001307-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142149987","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":"Comment on “Repeated HyperArc radiosurgery for recurrent intracranial metastases and dosimetric analysis of recurrence pattern to account for diffuse dose effect on microscopical disease”","authors":"Dario Di Perri","doi":"10.1016/j.ctro.2024.100823","DOIUrl":"10.1016/j.ctro.2024.100823","url":null,"abstract":"","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"48 ","pages":"Article 100823"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824001009/pdfft?md5=2e7e1b1ffa95f58421129b9dcbdd9cbf&pid=1-s2.0-S2405630824001009-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141848968","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":"Systemic inflammatory markers and volume of enhancing tissue on post-contrast T1w MRI images in differentiating true tumor progression from pseudoprogression in high-grade glioma","authors":"Camilla Satragno ,&nbsp;Irene Schiavetti ,&nbsp;Eugenia Cella ,&nbsp;Federica Picichè ,&nbsp;Laura Falcitano ,&nbsp;Martina Resaz ,&nbsp;Monica Truffelli ,&nbsp;Stefano Caneva ,&nbsp;Pietro Mattioli ,&nbsp;Daniela Esposito ,&nbsp;Alessio Ginulla ,&nbsp;Claudio Scaffidi ,&nbsp;Pietro Fiaschi ,&nbsp;Alessandro D’Andrea ,&nbsp;Andrea Bianconi ,&nbsp;Gianluigi Zona ,&nbsp;Laura Barletta ,&nbsp;Luca Roccatagliata ,&nbsp;Lucio Castellan ,&nbsp;Silvia Morbelli ,&nbsp;Liliana Belgioia","doi":"10.1016/j.ctro.2024.100849","DOIUrl":"10.1016/j.ctro.2024.100849","url":null,"abstract":"<div><h3>Background</h3><p>High-grade glioma (HGG) patients post-radiotherapy often face challenges distinguishing true tumor progression (TTP) from pseudoprogression (PsP). This study evaluates the effectiveness of systemic inflammatory markers and volume of enhancing tissue on post-contrast T1 weighted (T1WCE) MRI images for this differentiation within the first six months after treatment.</p></div><div><h3>Material and Methods</h3><p>We conducted a retrospective analysis on a cohort of HGG patients from 2015 to 2021, categorized per WHO 2016 and 2021 criteria. We analyzed treatment responses using modified RANO criteria and conducted volumetry on T1WCE and T2W/FLAIR images.</p><p>Blood parameters assessed included neutrophil/lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI). We employed Chi-square, Fisher’s exact test, and Mann-Whitney <em>U</em> test for statistical analyses, using log-transformed predictors due to multicollinearity. A Cox regression analysis assessed the impact of PsP- and TTP-related factors on overall survival (OS).</p></div><div><h3>Results</h3><p>The cohort consisted of 39 patients, where 16 exhibited PsP and 23 showed TTP. Univariate analysis revealed significantly higher NLR and SII in the TTP group [NLR: 4.1 vs 7.3, p = 0.002; SII 546.5 vs 890.5p = 0.009]. T1WCE volume distinctly differentiated PsP from TTP [2.2 vs 11.7, p &lt; 0.001]. In multivariate regression, significant predictors included NLR and T1WCE volume in the “NLR Model,” and T1WCE volume and SII in the “SII Model.” The study also found a significantly lower OS rate in TTP patients compared to those with PsP [HR 3.97, CI 1.59 to 9.93, p = 0.003].</p></div><div><h3>Conclusion</h3><p>Elevated both, SII and NLR, and increased T1WCE volume were effective in differentiating TTP from PsP in HGG patients post-radiotherapy. These results suggest the potential utility of incorporating these markers into clinical practice, though further research is necessary to confirm these findings in larger patient cohorts.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"49 ","pages":"Article 100849"},"PeriodicalIF":2.7,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824001265/pdfft?md5=b176628924c84bf9894ac50ecb13f608&pid=1-s2.0-S2405630824001265-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142122579","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":"Half body irradiation (HBI) for bone metastases in the modern radiotherapy technique era – A systematic review","authors":"Mateusz Bilski ,&nbsp;Katarzyna Konat-Bąska ,&nbsp;Federico Mastroleo ,&nbsp;Peter Hoskin ,&nbsp;Barbara Alicja Jereczek-Fossa ,&nbsp;Giulia Marvaso ,&nbsp;Mateusz Korga ,&nbsp;Jakub Klas ,&nbsp;Katarzyna Zych ,&nbsp;Piotr Bijak ,&nbsp;Andrzej Kukiełka ,&nbsp;Jacek Fijuth ,&nbsp;Łukasz Kuncman","doi":"10.1016/j.ctro.2024.100845","DOIUrl":"10.1016/j.ctro.2024.100845","url":null,"abstract":"<div><p>Bone metastases (BMs) are the most common cause of cancer-related pain and radiation therapy plays a key role in treating pain caused by it. The half-body irradiation (HBI) is a modality that can be used to treat patients with multiple painful BMs. In the modern era, concerns about toxicity and the availability of new agents requiring robust bone marrow function have limited the use of HBI in advanced cancer. Concerns about HBI toxicity stem from outdated techniques; modern methods like volumetric modulated arc therapy (VMAT) and helical tomotherapy now allow safer irradiation of complex target volumes. We conducted a systematic review to present updated information about HBI efficacy and potential toxicity. Pain relief usually occurs very quickly 2–3 weeks after HBI. The overall pain response rate was high in all the series, accounting for a median of 84 % (75.6–89 %), with a median of 36 % complete pain response. The toxicity is usually limited to G1/G2, with very rare G3 cases. More than 50 % of patients can reduce analgesic intake after HBI. Additionally, with modern radiotherapy techniques, quality of life is improved in most patients. HBI is a safe and effective method and should once again be reconsidered for more frequent use.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"49 ","pages":"Article 100845"},"PeriodicalIF":2.7,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824001228/pdfft?md5=af18f173a040f7c306df694e2bde909d&pid=1-s2.0-S2405630824001228-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142122475","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":"Evaluation of 68Ga-FAPI PET/CT and 18F-FDG PET/CT for the diagnosis of recurrent colorectal cancers","authors":"Yue Xi ,&nbsp;Yuyun Sun ,&nbsp;Bingxin Gu ,&nbsp;Linjie Bian ,&nbsp;Shaoli Song","doi":"10.1016/j.ctro.2024.100848","DOIUrl":"10.1016/j.ctro.2024.100848","url":null,"abstract":"<div><h3>Objective</h3><p>The present study aimed to compare the diagnostic value of gallium-68-labeled fibroblast activation protein inhibitor positron emission tomography/computed tomography (⁶⁸Ga-FAPI PET/CT) and fluorine-18-labeled fluorodeoxyglucose PET/CT (¹⁸F-FDG PET/CT) for detecting recurrent colorectal cancers (CRCs).</p></div><div><h3>Materials and Methods</h3><p>Fifty-six patients (age: 18–80 years, 31 men and 25 women) with suspected recurrent CRC were enrolled and underwent ¹⁸F-FDG PET/CT and ⁶⁸Ga-FAPI PET/CT sequentially within 1 week. The maximum standard uptake value (SUVmax), tumor-to-background ratio (TBR), and diagnostic accuracy were estimated and compared between the two modalities by using Student’s <em>t</em>-test. The Wilcoxon signed-rank test was used to compare peritoneal carcinoma index (PCI) scores between the two imaging modalities.</p></div><div><h3>Results</h3><p>⁶⁸Ga-FAPI PET/CT showed higher sensitivity for detecting recurrence (93 % vs. 79 %); lymph node metastasis (89 % vs. 78 %), particularly peritoneal lymph node metastasis (92 % vs. 63 %); and metastatic implantation on the intestinal wall (100 % vs. 25 %) compared to ¹⁸F-FDG PET/CT. However, ⁶⁸Ga-FAPI PET/CT showed lower sensitivity for detecting bone metastasis (67 % vs. 100 %). The mean SUVmax values of peritoneal metastases and metastatic implantation on the intestinal wall were 4.28 ± 2.70 and 7.58 ± 1.66 for ¹⁸F-FDG PET/CT and 5.66 ± 1.97 and 6.70 ± 0.25 for ⁶⁸Ga-FAPI PET/CT, respectively. Furthermore, ⁶⁸Ga-FAPI PET/CT showed significantly higher TBR for peritoneal metastatic lesions (4.22 ± 1.47 vs. 1.41 ± 0.89, p &lt; 0.0001) and metastatic implantation on the intestinal wall (5.63 ± 1.24 vs. 2.20 ± 0.5, p = 0.02) compared to ¹⁸F-FDG PET/CT. For the same patient, ⁶⁸Ga-FAPI PET/CT yielded a more accurate PCI score and a greater area under the curve value for the receiver operating characteristic curve (p &lt; 0.01) than ¹⁸F-FDG PET/CT.</p></div><div><h3>Conclusion</h3><p>⁶⁸Ga-FAPI PET/CT was superior to ¹⁸F-FDG PET/CT for detecting recurrence and peritoneal metastases. Hence, we propose the combination of these two modalities for better clinical diagnosis and management of patients with CRC.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"49 ","pages":"Article 100848"},"PeriodicalIF":2.7,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824001253/pdfft?md5=806984fde09a06453b6c04c329cf95f6&pid=1-s2.0-S2405630824001253-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142135874","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":"PTCOG international survey of practice patterns and trends in utilization of proton therapy for breast cancer","authors":"J. Isabelle Choi ,&nbsp;Camille Hardy-Abeloos ,&nbsp;Alicia Lozano ,&nbsp;Alexandra Hanlon ,&nbsp;Carlos Vargas ,&nbsp;John H. Maduro ,&nbsp;Julie Bradley ,&nbsp;Birgitte Offersen ,&nbsp;Bruce Haffty ,&nbsp;Mark Pankuch ,&nbsp;Richard Amos ,&nbsp;Nalee Kim ,&nbsp;Shannon M. MacDonald ,&nbsp;Youlia Kirova ,&nbsp;Robert W. Mutter","doi":"10.1016/j.ctro.2024.100847","DOIUrl":"10.1016/j.ctro.2024.100847","url":null,"abstract":"<div><h3>Purpose/objectives</h3><p>The indications, techniques, and extent to which proton beam therapy (PBT) is employed for breast cancer are unknown. We seek to determine PBT utilization for breast cancer.</p></div><div><h3>Materials/methods</h3><p>The Particle Therapy Co-Operative Group (PTCOG) Breast Subcommittee developed an IRB-approved 29-question survey and sent it to breast cancer radiation oncologists at all active PBT centers worldwide in June 2023. Descriptive statistics were used to summarize responses, and comparisons by continent were performed using Fisher’s exact tests.</p></div><div><h3>Results</h3><p>Of 79 surveys distributed, 28 recipients submitted responses (35 % response rate) representing fifteen U.S., 8 European, and 5 Asian centers (continent response rate 50 %, 38 %, and 18 %, respectively). Overall, 93 % reported treating breast cancer patients with PBT; 13 (50 %) have treated ≥100 breast cancer patients at their center since opening. Most (89 %) have pencil beam scanning technology. Nearly half (46 %) use moderate hypofractionation (15–20 fractions) for regional nodal irradiation and 42 % conventional fractionation (25–30 fractions). More European centers prefer hypofractionation (88 %) vs. Asian (50 %) and U.S. (21 %) centers (p = 0.003). Common patient selection methods were practitioner determination/patient preference (n = 16) and comparative plan evaluation (n = 15). U.S. centers reported the most experience with breast PBT, with 71 % having treated ≥100 breast cancer patients vs. 38 % in Europe and none in Asia (p = 0.001). Of respondent centers, 39 % enrolled ≥75 % of breast PBT patients on a research study.</p></div><div><h3>Conclusion</h3><p>Utilization, patient selection methods, and dose-fractionation approaches for breast cancer PBT vary worldwide. These survey data serve as a benchmark from which successor surveys can provide insight on practice pattern evolution.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"48 ","pages":"Article 100847"},"PeriodicalIF":2.7,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405630824001241/pdfft?md5=34e054a1d1a0907454832f191bca778d&pid=1-s2.0-S2405630824001241-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142084128","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":"Moderately hypofractionated prostate-only versus whole-pelvis radiotherapy for high-risk prostate cancer: A retrospective real-world single-center cohort study","authors":"Jenny Kahlmeter Brandell ,&nbsp;Antonis Valachis ,&nbsp;Henrik Ugge ,&nbsp;Daniel Smith ,&nbsp;Bengt Johansson","doi":"10.1016/j.ctro.2024.100846","DOIUrl":"10.1016/j.ctro.2024.100846","url":null,"abstract":"<div><h3>Background</h3><p>The benefit of prophylactic whole pelvis radiation therapy (WPRT) in prostate cancer has been debated for decades, with evidence based mainly on conventional fractionation targeting pelvic nodes.</p></div><div><h3>Aim</h3><p>This retrospective cohort study aimed to explore the impact of adding moderately hypofractionated pelvic radiotherapy to prostate-only irradiation (PORT) on prognosis, toxicity, and quality of life in real-world settings.</p></div><div><h3>Materials and methods</h3><p>Patients with high-risk and conventionally staged prostate cancer (cT1-3N0M0) treated with moderately hypofractionated WPRT or PORT, using external beam radiotherapy alone or combined with high-dose-rate brachytherapy, at Örebro University Hospital between 2008 and 2021 were identified. Biochemical failure-free survival (BFFS), metastasis-free survival (MFS), prostate cancer-specific survival (PCSS), and overall survival (OS) were compared using Kaplan-Meier method and Cox proportional hazards. Toxicity and quality of life measures were also analysed.</p></div><div><h3>Results</h3><p>Among 516 patients (227 PORT, 289 WPRT), 5-year BFFS rates were 77 % (PORT) and 74 % (WPRT), adjusted HR=1.50 (95 % CI=0.88–2.55). No significant differences were found in MFS, PCSS, or OS in main analyses. WPRT was associated with a higher risk of acute grade ≥ 2 and 3 genitourinary toxicities whereas no differences in late toxicities or quality of life between PORT and WPRT were observed.</p></div><div><h3>Conclusion</h3><p>We found no significant differences in oncological outcomes or quality of life when comparing moderately hypofractionated PORT to WPRT. Some differences in toxicity patterns were observed. Despite caveats related to study design, our findings support the need for further research on WPRT’s impact on treatment-related and patient-reported outcomes.</p></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"48 ","pages":"Article 100846"},"PeriodicalIF":2.7,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S240563082400123X/pdfft?md5=ac075aa12e590c33e0073f55b7bbef0e&pid=1-s2.0-S240563082400123X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142049918","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}