Clinical and Translational Radiation Oncology最新文献

{"title":"Cell-specific analysis of microglia following partial brain proton irradiation in mice","authors":"Sindi Nexhipi , Theresa Suckert , Johannes Soltwedel , Elke Beyreuther , Max Noßol , Laura Pecht , Marc Boucsein , Moritz Schneider , Felix Horst , Steffen Löck , Mechthild Krause , Armin Lühr , Antje Dietrich","doi":"10.1016/j.ctro.2025.101003","DOIUrl":"10.1016/j.ctro.2025.101003","url":null,"abstract":"","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 101003"},"PeriodicalIF":2.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570980","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":"Acute toxicity and quality of life in dose-escalated proton reirradiation for locally recurrent rectal cancer: The prospective ReRad II trial","authors":"Truelsen C.G ,&nbsp;Rønde H.S ,&nbsp;Kallehauge J.F ,&nbsp;Szpejewska J.E ,&nbsp;Bahij R ,&nbsp;Diness L.V ,&nbsp;Skriver S.K ,&nbsp;Poulsen L.Ø ,&nbsp;Havelund B.M ,&nbsp;Pedersen B.G ,&nbsp;Iversen L.H ,&nbsp;Spindler K.G ,&nbsp;Kronborg C.S","doi":"10.1016/j.ctro.2025.100999","DOIUrl":"10.1016/j.ctro.2025.100999","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Locally recurrent rectal cancer (LRRC) in pre-irradiated patients remains a clinical challenge. Intensity-Modulated Proton Therapy (IMPT) enables dose escalation with potential for improved tumour control without compromising dose to organs at risk (OAR). However, prospective data on toxicity and patient-reported outcomes (PROs) with quality of life (QoL) are limited.</div></div><div><h3>Materials and Methods</h3><div>This planned interim analysis from the prospective phase II ReRad II trial (NCT04695782) reports acute toxicity and PROs in the first 25 patients treated with dose-escalated IMPT for LRRC. Patients received either 55 Gy (relative biological effectiveness (RBE)) in 44 fractions (neoadjuvant) or 57.5–65 Gy (RBE) in 46–52 fractions (definitive). Acute toxicity was graded using NCI-CTCAE. PROs were assessed using EORTC QLQ-C30 and −CR29 questionnaires at pretreatment, during treatment, and at 3-month follow-up. A linear mixed model evaluated longitudinal PRO trajectories.</div></div><div><h3>Results</h3><div>Among 25 patients, 49 gross tumour volumes resulted in 29 clinical target volumes (median: 84.2 cm³). Median D_mean to bladder, bowel bag, and bowel loops were 7.5, 1.8, and 11.5 Gy(RBE); corresponding D_0.03cc were 58.1, 59.9, and 59.3 Gy(RBE). Grade ≥3 acute toxicity (ileus) occurred in 2 patients with pre-existing ileus episodes. Urinary retention was associated with bladder D_0.03cc(Gy). PROs showed stable global health scores over time, with improvements in emotional and cognitive function.</div></div><div><h3>Conclusion</h3><div>Interim results support the feasibility of dose-escalated IMPT reirradiation for LRRC, with manageable acute toxicity and preserved QoL. Continuance of the trial will inform long-term outcomes and guide future treatment strategies for LRRC management.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 100999"},"PeriodicalIF":2.7,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144491078","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":"Volumetric and spatial changes in brain metastases during stereotactic radiosurgery: a case for off-line adaptive planning","authors":"Menekse Turna ,&nbsp;Hale Başak Çağlar","doi":"10.1016/j.ctro.2025.101000","DOIUrl":"10.1016/j.ctro.2025.101000","url":null,"abstract":"<div><div>Stereotactic radiosurgery is a widely used treatment modality for brain metastases, particularly in cases with a limited number and volume of lesions. While adaptive strategies have gained prominence in the stereotactic treatment of extracranial, their application in intracranial SRS remains largely unexplored. This case study presents a 45-year-old female with multiple brain metastases and significant perilesional edema, treated with fractionated stereotactic radiotherapy. Due to tumor displacement during the treatment course, adaptive SRS was implemented after the third fraction, utilizing an updated MRI scan to account for changes in tumor volume and midline shift. The total GTV decreased by 34.2 %, and five lesions were found to be partially outside the prescribed treatment target. Based on this MRI, an offline adaptive SRS plan was generated, and the remaining two fractions were delivered according to the updated plan. This case underscores the potential for significant changes in target volume and spatial displacement during FSRT in patients with brain metastases exhibiting extensive edema and emphasizes the importance of mid-treatment imaging and the potential role of offline adaptive SRS strategies in managing intracranial tumors.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 101000"},"PeriodicalIF":2.7,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144472372","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":"IORT for early-stage, low-risk breast cancer: Outcomes from a prospective, observational study","authors":"Amalia Palacios-Eito ,&nbsp;María del Carmen Moreno-Manzanaro ,&nbsp;María Espinosa-Calvo ,&nbsp;Fátima Ginés-Santiago ,&nbsp;Juan Adrián Camús-Martínez ,&nbsp;Ángel Calvo-Tudela ,&nbsp;Pilar Rioja-Torres ,&nbsp;Sara Romero-Martín ,&nbsp;José Antonio Miñano-Herrero ,&nbsp;Gustavo R. Sarria ,&nbsp;Sonia García-Cabezas","doi":"10.1016/j.ctro.2025.100998","DOIUrl":"10.1016/j.ctro.2025.100998","url":null,"abstract":"<div><h3>Introduction</h3><div>Treatment of early-stage, low-risk breast cancer (BC) has undergone significant de-escalation during the past years. The TARGIT-A trial provided information on intraoperative radiotherapy (IORT) as a convenient, single-fraction modality. Nevertheless, significant discussion regarding different aspects of the trial continues. This study reports on oncological outcomes in a real-world clinical setting and contributes to the understanding of its optimal indication.</div></div><div><h3>Methods</h3><div>Five-hundred patients planned for breast-conserving surgery (BCS) were screened for IORT between June 2017 and December 2023, within this prospective, observational, single-center. The treatment protocol replicated the experimental arm of the TARGIT-A trial, implementing stricter inclusion criteria and maintaining a risk-adapted approach. The primary endpoint was ipsilateral breast recurrence rates (IBR). Secondary endpoints included local recurrence-free survival, progression-free survival, overall survival, and patient-reported cosmesis. The Kaplan-Meier method was used to analyze survival and recurrence risk, and risk factors for IBR were assessed through Cox regression analysis.</div></div><div><h3>Results</h3><div>After screening and recruiting, IORT was performed in 464 patients. The median follow-up was 45.3 (8–89) months. The estimated 5-year IBR risk in the entire cohort was 1.7 % (95 % CI: 0.7 %–2.8 %), decreasing to 1 % (95 % CI: 0.3 %–2.4 %) in the IORT + whole breast irradiation (WBI) cohort. In the IORT-only cohort, the risk was 2.1 % (95 % CI: 0.6 %–3.7 %). No significant differences were observed among the three subgroups. The 5-year overall survival and breast cancer-specific survival rates were 97.6 % (95 % CI: 96.0 %–99.1 %) and 99.5 % (95 % CI: 98.5 %–100 %), respectively. Two independent significant risk factors for IBR were identified: age &lt; 50 years (HR = 0.138, 95 % CI: 0.032–0.597, p = 0.008) and close or affected surgical margins (HR = 5.8, 95 % CI: 1.5–22.5, p = 0.011). No grade 3–4 toxicity events were reported. Patient-reported cosmesis was excellent/good in 84 % of cases.</div></div><div><h3>Conclusions</h3><div>Local recurrence rates were low amongst all groups. Superior control outcomes could be obtained by applying more restrictive criteria than the TARGIT A trial. Longer follow-up is needed to confirm our findings.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 100998"},"PeriodicalIF":2.7,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366491","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":"Unmasking enteritis: reply to commentary titled \"Clarifying Gastrointestinal toxicity attribution in WP-SBRT: A commentary on Dinesan et al. and proposal of a bladder-bowel displacement index\".","authors":"Akshay Dinesan, Maneesh Singh, Vedang Murthy","doi":"10.1016/j.ctro.2025.100996","DOIUrl":"10.1016/j.ctro.2025.100996","url":null,"abstract":"<p><p>We thank the authors for their insightful commentary on our manuscript, \"Acute Enteritis with Pelvic SBRT: Influence of Bowel Delineation Methods.\" In this response, we clarify our methodological decision to focus exclusively on acute enteritis and to exclude proctitis. We highlight the distinct clinical profiles of proctitis and enteritis, emphasizing the importance of careful history taking and clinical evaluation. We believe enteritis is grossly under-reported, despite its clinical relevance, and the dose volume constraints are still being defined for pelvic SBRT. With the increasing adoption of WP-SBRT for high-risk prostate cancer, we felt it was both timely and clinically meaningful to focus exclusively on acute enteritis in this manuscript. We also reflect on the proposed concept of a Bladder-Bowel Displacement Index (BBDI), while intriguing, relative bladder-bowel geometry is only one amongst many patient-related factors that could impact treatment-related toxicity. Developing a geometric predictor for toxicity will warrant careful statistical modelling and prospective validation in large cohorts to be useful in the clinic.</p>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"100996"},"PeriodicalIF":2.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12365525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945231","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 therapeutic radiographer target volume contouring for magnetic resonance image guided online adaptive bladder radiotherapy","authors":"Bethany Williams ,&nbsp;Jonathan Mohajer ,&nbsp;Sophie E. Alexander ,&nbsp;Helen Barnes ,&nbsp;Francis Casey ,&nbsp;Joan Chick ,&nbsp;Alex Dunlop ,&nbsp;Ryan Fullerton ,&nbsp;Trina Herbert ,&nbsp;Robert Huddart ,&nbsp;Sarah A. Mason ,&nbsp;Adam Mitchell ,&nbsp;Jayde Nartey ,&nbsp;Simeon Nill ,&nbsp;Priyanka Patel ,&nbsp;Shaista Hafeez ,&nbsp;Helen A. McNair","doi":"10.1016/j.ctro.2025.100994","DOIUrl":"10.1016/j.ctro.2025.100994","url":null,"abstract":"<div><h3>Background and purpose</h3><div>One barrier to wider clinical implementation of online MRI-guided radiotherapy (MRIgRT) on the MR Linac (MRL) is resource intensity. Specifically, the requirement for a clinical oncologist/radiation oncologist (CO/RO) to perform online contouring each fraction. We report an evaluation of therapeutic radiographer (RTT) online contouring for patients receiving whole bladder MRIgRT.</div></div><div><h3>Materials and methods</h3><div>RTTs undertook a contouring training programme. RTT and CO/RO clinical target volume (CTV) contours from 95 fractions were assessed using dice similarity coefficient (DSC), hausdorff distance (HD), mean distance to agreement (MDA), sensitivity and specificity volume metrics on the Raystation treatment planning system (TPS) (RaySearch Laboratories). Additionally, CTV DSC was evaluated with respect to a simultaneous truth and performance level estimation (STAPLE) generated in ADMIRE (Elekta AB, Stockholm, Sweden). In dosimetric analysis (Monaco, Elekta AB), online adaptive treatment plans, which had been generated using RTT-defined contours, were evaluated using contours delineated offline by CO/ROs.</div></div><div><h3>Results</h3><div>Comparison of RTT versus CO/RO contours found the CTV median (interquartile range) (IQR) for DSC was 0.92 (0.91–0.94), MDA was 0.11 (0.09–0.12) cm, and HD was 0.63 (0.53–0.72) cm, sensitivity and specificity were 0.94 (0.90–0.96) and 0.95 (0.92–0.97) respectively. In dosimetric analysis, 65 % (30/46) plans met optimal PTV coverage of V52.25 Gy &gt; 98 % and all plans met mandatory PTV coverage of V52.25 Gy &gt; 95 %.</div></div><div><h3>Conclusion</h3><div>Following effective training, evaluation results demonstrate RTT whole bladder CTV contours to be comparable to CO/RO contours. Clinical implementation will release CO/ROs from MRL bladder treatments, reducing resource intensity of online workflows.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 100994"},"PeriodicalIF":2.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144314496","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":"Urethral and bladder dosimetry and urinary toxicity in prostate cancer patients undergoing SBRT with and without intra-prostatic boost","authors":"Nisha Bhargava ,&nbsp;Martina Hurwitz ,&nbsp;Josephine Levey ,&nbsp;Lily Bennett ,&nbsp;Joseph A. Aronovitz ,&nbsp;Daniel R. Schmidt ,&nbsp;Jonathan W. Lischalk ,&nbsp;Irving D. Kaplan ,&nbsp;Nima Aghdam","doi":"10.1016/j.ctro.2025.100993","DOIUrl":"10.1016/j.ctro.2025.100993","url":null,"abstract":"<div><h3>Background and purpose</h3><div>To evaluate the dosimetric and toxicity profiles of stereotactic body radiotherapy (SBRT) for prostate cancer, comparing cohorts with and without intraprostatic boost (IPB) to assess feasibility and safety of IPB, with particular attention to urethral and bladder dose and toxicity.</div></div><div><h3>Materials and methods</h3><div>This retrospective cohort study analyzed 349 patients with localized prostate cancer treated between 2018 and 2023. Of these, 266 received SBRT with IPB, and 83 received SBRT without IPB. Patients were treated using a robotic SBRT platform with fiducial tracking. Dosimetric parameters for the urethra, including D0.03cc, D0.3cc, and V40Gy, and for the bladder, including D0.03cc, D5cc, D10cc, and V37Gy, were evaluated. Acute and late toxicities were assessed using CTCAE criteria.</div></div><div><h3>Results</h3><div>For the urethra, median values for D0.03cc, D0.3cc, and V40Gy, and for the bladder, median values D0.03cc, D5cc, D10cc, and V37Gy were compared and no statistically significant differences were observed between the two cohorts. Late urinary toxicity of grade 3 or higher occurred in 2.25 % of patients in the IPB group and 2.47 % in the no IPB group, with no grade 3 acute toxicities reported.</div></div><div><h3>Discussion</h3><div>These findings support the use of SBRT using an IPB as a feasible and safe approach to achieve focal dose escalation to dominant intra-prostatic lesions (DILs) without significantly increasing urethra or bladder dose or toxicity. Future research should focus on standardizing DIL contouring, exploring adaptive planning techniques to increase accuracy, and prospectively studying toxicity and quality of life in patients treated with IPB with SBRT.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 100993"},"PeriodicalIF":2.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144307589","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":"Online CBCT-based adaptive radiation with reduced PTV margins for prostate cancer: Does reference plan comparison tell the whole story?","authors":"Margaret L. Dahn ,&nbsp;R.Lee MacDonald ,&nbsp;Amanda Cherpak ,&nbsp;Stefan Allen ,&nbsp;Hannah M. Dahn","doi":"10.1016/j.ctro.2025.100992","DOIUrl":"10.1016/j.ctro.2025.100992","url":null,"abstract":"<div><h3>Background</h3><div>Online adaptive radiation (ART) is a novel treatment approach that allows for a new daily treatment plan based on cone beam CT (CBCT) imaging. This daily adaptation facilitates precise tumor and organ-at-risk (OAR) localization and minimizes the impact of interfractional motion, allowing for planning target volume (PTV) margin reduction. Isotropic PTV margins for localized non-stereotactic adaptive prostate radiation performed on an ETHOS linear accelerator with HyperSight have been reduced from standard 7 mm to 5 mm. This study assesses the impact of margin reduction by evaluating the dose metrics of patient reference plans, as well as daily treated plans, for 7 mm vs 5 mm PTV margins.</div></div><div><h3>Methods</h3><div>Patients with prostate cancer receiving moderately hypofractionated adaptive radiation were initially treated with a 7 mm PTV margin (n = 10). This retrospective study generated 5 mm PTV margin treatment plans (n = 10) for these patients for comparison. In addition, a full adaptive 20 fraction treatment course was simulated with margin reduction to identify differences not recognized with reference plan comparison alone.</div></div><div><h3>Results</h3><div>Bladder V40.8 and V48.6 but not V60 were significantly reduced in 5 mm treatment plans compared to 7 mm treatment plans. However, when daily treated plan data was examined bladder V60 was lower for the 5 mm PTV case. Similarly, rectum doses V24.6-V57 but not V60 were significantly reduced in 5 mm PTV margin treatment plans. Further differences were identified when looking at the daily treated plan data as opposed to simply comparing reference plans.</div></div><div><h3>Significance</h3><div>In the era of online ART, with significant data available, such as daily treated plan dosimetry, analysis of reference plans alone may not be sufficient. PTV margin reduction, made possible due to the use of online ART, reduced the volume of bladder and rectum receiving &lt;60 Gy, which may reduce toxicity and secondary malignancy risk.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 100992"},"PeriodicalIF":2.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144307590","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":"Head and neck and skin (HNS) GEC-ESTRO and BRAPHYQS working groups joint critical review of the use of Rhenium-188 in dermato-oncology","authors":"Sergio Lozares ,&nbsp;Paula Tur ,&nbsp;Facundo Ballester ,&nbsp;Ralph Alexander Bundschuh ,&nbsp;Víctor González-Pérez ,&nbsp;Ramin Jaberi ,&nbsp;Javier Vijande ,&nbsp;Renate Walter ,&nbsp;Åsa Carlsson Tedgren ,&nbsp;Luca Tagliaferri ,&nbsp;Frank-André Siebert ,&nbsp;Agata Rembielak","doi":"10.1016/j.ctro.2025.100991","DOIUrl":"10.1016/j.ctro.2025.100991","url":null,"abstract":"<div><div>Non-melanoma skin cancers are increasing globally, prompting the need for innovative, non-invasive treatment approaches. Radioactive rhenium (¹⁸⁸Re) paste has emerged as an open-source radiation-based modality in dermato-oncology, offering a novel alternative to conventional radiotherapy and brachytherapy. In this review, a systematic literature search was conducted using PubMed, Scopus, Web of Science, and Google Scholar for studies published over the past 20 years. Data were extracted from case series, pilot studies, and clinical trials, with particular emphasis on response rates, dosimetric parameters, and treatment-associated toxicity. Findings from approximately 240 patients demonstrated complete response rates ranging from 86 % to 100 % after one or two treatment applications, while dosimetric analyses revealed a rapid dose fall-off that effectively confines the therapeutic effect to a tissue depth of 2–3  mm, with most adverse effects being mild and transient. Notably, ¹⁸⁸Re differs from conventional brachytherapy (specifically high-dose-rate modality) due to its open-source application and unique dosimetric profile. The use of ¹⁸⁸Re in clinical practice mandates a highly specialized, multidisciplinary team, including radiation oncologists, nuclear medicine specialists, and experienced medical physicists, and strict quality assurance protocols, thereby limiting its application to carefully selected cases.</div><div>Although ¹⁸⁸Re therapy offers a promising alternative for the treatment of superficial skin cancers, its distinct clinical and dosimetric characteristics warrant further randomized studies with extended follow-up to validate its efficacy and refine patient selection criteria under rigorous multidisciplinary oversight.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100991"},"PeriodicalIF":2.7,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reirradiation with stereotactic radiosurgery for vestibular schwannomas – a systematic review and meta-analysis","authors":"Noel-Adrian Hollosi ,&nbsp;Julie Luise Reimers ,&nbsp;Antonio Santacroce ,&nbsp;Christoph Fürweger ,&nbsp;Markus Kufeld ,&nbsp;Anna M.E. Bruynzeel ,&nbsp;Joost J.C. Verhoeff ,&nbsp;Alexander Muacevic ,&nbsp;Helen A. Shih ,&nbsp;Felix Ehret","doi":"10.1016/j.ctro.2025.100989","DOIUrl":"10.1016/j.ctro.2025.100989","url":null,"abstract":"<div><h3>Introduction</h3><div>Stereotactic radiosurgery (SRS) is a widely used treatment modality for vestibular schwannomas due to its non-invasive nature and high tumor control rates. However, some patients experience tumor progression after treatment. In this setting, reirradiation with SRS represents a potential treatment option. This systematic review and meta-analysis evaluates the evidence for reirradiation of vestibular schwannomas with SRS.</div></div><div><h3>Methods</h3><div>This systematic literature review and meta-analysis investigates the efficacy and safety of reirradiation with SRS for vestibular schwannoma and was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).</div></div><div><h3>Results</h3><div>A total of 806 studies were screened and 35 included, comprising 394 reirradiated patients. The median time from first treatment to reirradiation was 45 months (range: 12 – 65 months). Reirradiation with SRS, applying a median marginal/prescription dose of 12 Gy, achieved an estimated local control of 95% (95% confidence interval (CI): 92 – 97%, I² = 29.62%, p = 0.10). Trigeminal and facial nerve deterioration rates after repeat SRS were 7% (95% CI: 4 – 10%, I² = 0.0%, p = 0.44) and 6% (95% CI: 3 – 8%, I² = 0.0%, p = 0.53), respectively. Serviceable hearing after reirradiation with SRS was rare (5%, 95% CI: 2 – 8%, I² = 0.0%, p = 0.46). Among patients with serviceable hearing before reirradiation, 43% maintained it after treatment (95% CI: 29 – 57%, I² = 65.71%, p = 0.00). The risk of bias across all studies was high.</div></div><div><h3>Conclusion</h3><div>Reirradiation with SRS appears to be a safe and effective salvage treatment for progressive vestibular schwannomas. Prospective studies are warranted to define the optimal dose, timing, and dose constraints for reirradiation.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"54 ","pages":"Article 100989"},"PeriodicalIF":2.7,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144704413","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}