Clinical and Translational Radiation Oncology最新文献

{"title":"In vitro determination of patient-specific variation challenges the universal RBE gold standard for proton radiation therapy","authors":"Anna Kirstein , Dan Ionascu , Michael A.S. Lamba , Bianca M. Ruffolo , Katherine J. Crail , Anthony E. Mascia , Mathieu G. Sertorio , Benjamin H. Hinrichs , Chad Zender , Maria A. Lehn , Trisha M. Wise-Draper , John P. Perentesis , Yi Zheng , Susanne I. Wells","doi":"10.1016/j.ctro.2025.101046","DOIUrl":"10.1016/j.ctro.2025.101046","url":null,"abstract":"","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101046"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109636","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":"Pre-PROTO-PRIME: stereotactic body proton therapy to the prostate and pelvic nodes for high-risk and node-positive prostate cancer — feasibility, acute toxicity and dosimetric insights","authors":"Srinivas Chilukuri ,&nbsp;Sham C Sundar ,&nbsp;Vasanthapriya Subramani ,&nbsp;Manikandan Arjunan ,&nbsp;Vysakh Raveendran ,&nbsp;Ramakrishna Kamath ,&nbsp;Lilawati Meena ,&nbsp;Aishwarya Guruvaiah ,&nbsp;Reena Phurailatpam ,&nbsp;Rajesh Selvaraj ,&nbsp;Lalit Narendra Chaudhari ,&nbsp;Vineeth Kumaar ,&nbsp;Nidhi Jain ,&nbsp;Mahima Tiwari ,&nbsp;Priyanka Halsana ,&nbsp;Dayananda Sharma ,&nbsp;Priyamvada Maitre ,&nbsp;Vedang Murthy","doi":"10.1016/j.ctro.2025.101084","DOIUrl":"10.1016/j.ctro.2025.101084","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to assess the clinical feasibility, acute toxicity, and dosimetric advantages of stereotactic body proton therapy (SBPT) to the prostate and pelvic lymph nodes in high-risk and node-positive prostate cancer.</div></div><div><h3>Methods</h3><div>This multicentric analysis included 26 patients treated from February 2024 to February 2025 with SBPT to the prostate and pelvis delivered in five fractions. The doses prescribed were 36.25 CGE to the prostate, 35 CGE to the gross nodes and 25 CGE to the pelvic nodal CTV. Acute genitourinary (GU) and gastrointestinal (GI) toxicities were evaluated up to three months post-treatment using CTCAE v5.0 criteria. Dosimetric parameters of SBPT plans were compared with matched photon-based SBRT plans, generated using identical datasets. Statistical analyses were performed using SPSS (IBM v30) and Python (v3.10).</div></div><div><h3>Results</h3><div>No grade 3 toxicities were observed. Grade 2 GU toxicity occurred in 27 % of patients, predominantly characterized by dysuria and urinary frequency. Grade 2 GI toxicity was observed in 3.8 % of patients. SBPT demonstrated comparable target coverage to SBRT, both for the prostate (median D97%: 98.4 % vs 98.8 %) and the nodal CTV (median D97%: 97.9 % vs 98.9 %), while significantly improving sparing of organs-at-risk (OAR), notably the bowel bag (median V14: 123 cc vs 422 cc; p &lt; 0.001), rectum (median V20: 11 % vs 26 %; p &lt; 0.0001), and bladder (median V20: 16 % vs 21 %; p = 0.004).</div></div><div><h3>Conclusion</h3><div>SBPT to the prostate and pelvic lymph nodes is clinically feasible, with low acute toxicity and superior OAR sparing compared to photon-based SBRT. The dosimetric data from this study were used to propose volumetric dose constraints for SBPT planning of the prostate and pelvis. These preliminary results substantiate the rationale for the prospective PROTO-PRIME trial, which will investigate the clinical benefits of SBPT relative to SBRT in this patient population.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101084"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681365","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":"First-in-human e-Flash radiotherapy using a modified conventional C-arm linear accelerator","authors":"Jens von der Grün ,&nbsp;Riccardo Dal Bello ,&nbsp;Serena Psoroulas ,&nbsp;Jerome Krayenbuehl ,&nbsp;Debra Fesslmeier ,&nbsp;Egle Ramelyte ,&nbsp;Joanna Mangana ,&nbsp;Wendy Smith ,&nbsp;Marta Vilalta ,&nbsp;Lena Tirpak ,&nbsp;Ricky A. Sharma ,&nbsp;Matthias Guckenberger ,&nbsp;Stephanie Tanadini-Lang ,&nbsp;Panagiotis Balermpas","doi":"10.1016/j.ctro.2025.101047","DOIUrl":"10.1016/j.ctro.2025.101047","url":null,"abstract":"<div><h3>Background</h3><div>The FLASH effect is considered being the widening of the therapeutic window at (ultra-)high dose rates due to sparing of normal tissues while preserving tumor response. Our goal was to provide first data on the safety in treating a patient using a conventional linear accelerator converted to deliver 9 MeV UHDR electron beams in the research setting.</div></div><div><h3>Material &amp; methods</h3><div>A conventional Varian TrueBeam linac was converted in the research setting to become capable of delivering 9 MeV UHDR electron beams. A phase I trial protocol was approved by the local authorities (NCT06549439). One patient with ≥ 1 melanoma (sub)-cutaneous lesion(s) was treated with 3x 9 Gy. The first two fractions were applied via e-Flash and the third via conventional electrons.</div></div><div><h3>Results</h3><div>Here we present the experience of the first patient treated with e-Flash in a modified conventional linac. The e-Flash fractions were successfully delivered according to the protocol. The film in-vivo dosimetry confirmed correctness of the delivered dose. A good tumor response without severe or unexpected toxicity was observed up to six weeks after treatment.</div></div><div><h3>Conclusion</h3><div>We demonstrate first-in-human application of e-Flash delivered by a modified conventional linear accelerator. Conversion of conventional linacs into e-Flash systems will accelerate testing Flash radiotherapy in clinical trials.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101047"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145156050","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":"Dosimetric and treatment efficiency comparison of lung SBRT using three different motion management strategies","authors":"Taliah Lansing ,&nbsp;Wendy Harris ,&nbsp;Mitchell Yu ,&nbsp;Zaid Cheema ,&nbsp;Xiuxiu He ,&nbsp;Yabo Fu ,&nbsp;Sang Kyu Lee ,&nbsp;Laura Cervino ,&nbsp;Tianfang Li ,&nbsp;Xiang Li ,&nbsp;Jean Moran ,&nbsp;Boris Mueller ,&nbsp;Daphna Gelblum ,&nbsp;Sean Berry ,&nbsp;Hao Zhang","doi":"10.1016/j.ctro.2025.101044","DOIUrl":"10.1016/j.ctro.2025.101044","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the dosimetry and treatment efficiency of lung stereotactic body radiation therapy (SBRT) using the deep inspiration breath hold (DIBH), free breathing (FB), and respiratory gating (RG) strategies.</div></div><div><h3>Methods and Materials</h3><div>308 lung SBRT patients with middle to lower zone lung tumors were included in this retrospective study. The prescriptions were 1000 cGy x 5 fractions, 1200 cGy x 4 fractions, or 1800 cGy x 3 fractions. They were all treated with a volumetric modulated arc therapy (VMAT) technique and 6 MV flattening filter free (FFF) beam on C-arm linear accelerators, but using different motion management strategies (151 DIBH, 136 FB, 21 RG). The lung dose (mean lung dose (MLD), V5, V20) and treatment time (on table, imaging &amp; verification, delivery) of these patients were retrospectively collected for statistical comparison.</div></div><div><h3>Results</h3><div>The average doses (MLD, V5, V20) to the ipsilateral lung were 408.2 cGy, 20.1 %, 5.7 % for the DIBH cohort, 569.8 cGy, 27.6 %, 8.4 % for the FB cohort, and 519.6 cGy, 23.5 %, 7.5 % for the RG patients. Correspondingly, the average time (on table/imaging &amp; verification/delivery) for the three patient cohorts was 22.3/16.0/6.3 min, 13.6/10.5/3.1 min, and 22.7/14.6/8.1 min, respectively.</div></div><div><h3>Conclusion</h3><div>Quantitative comparison of lung dose and treatment efficiency for three commonly used motion management strategies in lung SBRT is reported. While the relative advantages and disadvantages of these strategies are well recognized, our findings further confirm these differences and provide clinicians with quantitative data to support informed decision-making in clinical practice.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101044"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010899","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 for locally recurrent soft tissue sarcomas: A systematic review","authors":"Konrad Zasadziński ,&nbsp;Aleksandra Bochyńska ,&nbsp;Aneta Borkowska ,&nbsp;Piotr Rutkowski ,&nbsp;Mateusz Spałek","doi":"10.1016/j.ctro.2025.101088","DOIUrl":"10.1016/j.ctro.2025.101088","url":null,"abstract":"<div><div>Locally recurrent soft tissue sarcomas (LRSTS) present a significant clinical challenge.There are major limitations to secondary treatment modalities. Reirradiation in such cases has traditionally been considered contraindicated due to the risk of severe normal tissue toxicity. On the other hand, there is evidence showing that multimodality salvage treatment can improve outcomes in some patients. The objective of this systematic review is to determine the feasibility of reirradiation in LRSTS. This systematic review included clinical studies that presented outcomes of patients who underwent any form of repeated radiation treatment for LRSTS. Authors used PubMed Medline, Embase and Scopus databases. This review follows the PRISMA guidelines. The search and selection identified 20 studies involving reirradiation for LRSTS, encompassing a total of 437 patients. Reirradiation modalities comprised brachytherapy, intraoperative radiotherapy (RT), external-beam RT, carbon ion RT and proton RT, as either definitive or perioperative treatment. Reirradiation doses varied across studies, with cumulative nominal doses exceeding 100 Gy in some cohorts. Local control rates ranged from 15 % to 100 %, with most studies reporting the range of 50–70 %. Overall survival rates were similarly variable. Acute and late toxicities were significant, with grade ≥3 complications reported in up to 50 % of patients. The analysis showed that reirradiation, both definitive or as a part of multimodality treatment, can be used in selected patients with LRSTS. This review is limited by retrospective study designs, and a large heterogeneity in patient populations and treatment regimens. Further quality investigation is needed to clearly determine the indications for reirradiation in LRSTS.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101088"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733144","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":"Quantifying the flash effect and its dependence on average dose rate in vivo for 6 MeV electron and 6 MV photon beams","authors":"Salomé Paillas,&nbsp;Edward R.J.F. Taylor,&nbsp;Nathalie Lövgren,&nbsp;Iain D.C. Tullis,&nbsp;Kristoffer Petersson","doi":"10.1016/j.ctro.2025.101052","DOIUrl":"10.1016/j.ctro.2025.101052","url":null,"abstract":"<div><div>This study shows that an increase in average dose rate delays the onset, and reduces the severity, of radiation induced skin toxicity in mice following hemi-thorax irradiation. The FLASH sparing effect’s magnitude and dependence on dose rate appear similar following irradiations using 6 MV photon and 6 MeV electron beams.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101052"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145156049","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":"Cardiac substructure radiotherapy dose and changes in physical activity and quality of life after chemoradiotherapy for NSCLC: a secondary analysis of the CLARITY prospective study","authors":"Nikhil Yegya-Raman ,&nbsp;Kyunga Ko ,&nbsp;Ivy S. Han ,&nbsp;Joshua D. Mitchell ,&nbsp;Wei Zou ,&nbsp;Nitin Ohri ,&nbsp;Salma K. Jabbour ,&nbsp;Raymond H. Mak ,&nbsp;Clifford Robinson ,&nbsp;William P. Levin ,&nbsp;Leanne Barrett ,&nbsp;Congying Xia ,&nbsp;Eva Berlin ,&nbsp;Paco Bravo ,&nbsp;Marcelo Di Carli ,&nbsp;Roger Cohen ,&nbsp;Sandra Hutton ,&nbsp;Jonathan Keltz ,&nbsp;Jessica Wang ,&nbsp;Omotayo Fasan ,&nbsp;Bonnie Ky","doi":"10.1016/j.ctro.2025.101070","DOIUrl":"10.1016/j.ctro.2025.101070","url":null,"abstract":"<div><h3>Purpose</h3><div>The objective was to assess associations between cardiac substructure dose and changes in patient-reported outcomes (PROs) post-chemoradiotherapy for non-small cell lung cancer (NSCLC).</div></div><div><h3>Methods and Materials</h3><div>The study population was derived from CLARITY (NCT04305613), a multi-institutional longitudinal prospective cohort study. Patients treated with conventionally fractionated radiotherapy (1.8–2 Gy per fraction) with concurrent chemotherapy completed physical activity (Godin) and quality of life (FACIT-Fatigue and Dyspnea) questionnaires at baseline, completion of radiotherapy, 6 and 12 months post-radiotherapy. Thirty cardiac dosimetric parameters were <em>a priori</em> selected from centrally contoured radiotherapy plans: mean dose, maximum dose, volume receiving ≥ 5 Gy (V5Gy), V15Gy, and V30Gy to the whole heart, left ventricle, right ventricle, left atrium, right atrium, and left anterior descending coronary artery, and applied to a LASSO regression model to further define variable importance. Associations between cardiac radiation dose metrics and changes in PROs were assessed using repeated-measures linear regression via generalized estimating equations with correction for multiple testing.</div></div><div><h3>Results</h3><div>In a subcohort of 122 patients, the median age was 67 years, 57% were male, and 41% had prevalent cardiovascular disease. Median whole heart mean dose was 9 Gy, whole heart maximum dose was 64 Gy, and LAD V15Gy was 1%. Godin physical activity (p = 0.0499), FACIT-Fatigue (p &lt; 0.001), and FACIT-Dyspnea scores (p = 0.0037) worsened from baseline to end of radiotherapy, then recovered to baseline levels thereafter. In multivariable analysis and after adjusting for multiple comparisons, no cardiac dose metric was significantly associated with a worsening in patient-reported physical activity, fatigue or dyspnea (p &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>PROs worsened from baseline to the end of thoracic chemoradiotherapy, then recovered to baseline levels. Cardiac radiation dose metrics were not associated with these changes.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101070"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145576154","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":"125I seed brachytherapy synergized with PD-1 inhibitor imparts potent antitumor immune responses in hepatocellular carcinoma","authors":"Peng Zeng ,&nbsp;Yong Wang ,&nbsp;Duo Shen ,&nbsp;Tiancheng Zhao ,&nbsp;Rong Chen ,&nbsp;Jinhe Guo ,&nbsp;Haidong Zhu ,&nbsp;Gao-Jun Teng","doi":"10.1016/j.ctro.2025.101083","DOIUrl":"10.1016/j.ctro.2025.101083","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Hepatocellular carcinoma (HCC) exhibits a complex immunosuppressive network, leading to resistance to immune checkpoint inhibitors (ICIs). To counter this, we introduced a novel method, brachytherapy of ¹²⁵I seed implantation prior to PD-1 inhibitor therapy, aiming to reprogram these inhibitory lymphocyte subsets, which synergized with PD-1 inhibitor to generate robust antitumor immune responses in HCC.</div></div><div><h3>Methods and materials</h3><div>Mouse orthotopic and subcutaneous HCC models were constructed with H22 cells. ¹²⁵I seeds were implanted into the tumors for irradiation, subsequently. Apoptosis of tumor cells and tissues were measured by flow cytometry (FC) and TdT-mediated dUTP nick end labeling (TUNEL). Immunogenic cell death (ICD) molecules and immune checkpoints were detected with flow cytometer (FCM), confocal fluorescence microscopy, ELISA, chemiluminescence assay and immunofluorescence (IF). Changes of lymphocyte subsets were tested by FC and polychromatic immunofluorescence (PIF). Cytokine release was detected by enzyme-linked immunosorbent assay (ELISA).</div></div><div><h3>Results</h3><div>¹²⁵I seed irradiation reversed myeloid cell aggregation, preventing their differentiation into suppressive dendritic cells (DCs), tumor-associated macrophages (TAMs), and myeloid-derived suppressor cells (MDSCs). This reprogramming led to the activation of a T cell-mediated immune response and enhanced susceptibility to anti-PD-1 therapy. The combination of ¹²⁵I seed brachytherapy with anti-PD-1 therapy elicited a robust anti-tumor immune response, stimulated an abscopal effect suppressing unirradiated distant tumors, and generated memory immunity that resisted tumor rechallenge.</div></div><div><h3>Conclusions</h3><div>Our brachy-primed immunotherapy approach offers a promising and effective treatment strategy, which may improve the immunotherapeutic efficacy in HCC.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101083"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145576153","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":"Consolidation ICIs Alter cardiac subregion radiosensitivity in NSCLC patients treated with Chemo-Radiotherapy","authors":"Yejin Kim ,&nbsp;Gowoon Yang ,&nbsp;Jaewon Oh ,&nbsp;Seo-Yeon Gwak ,&nbsp;Kyung Hwan Kim ,&nbsp;Joongyo Lee ,&nbsp;Jin Sung Kim ,&nbsp;Chang Geol Lee ,&nbsp;Jaeho Cho ,&nbsp;Bonnie Ky ,&nbsp;Hong In Yoon ,&nbsp;Clemens Grassberger","doi":"10.1016/j.ctro.2025.101069","DOIUrl":"10.1016/j.ctro.2025.101069","url":null,"abstract":"<div><h3>Purpose</h3><div>he addition of immune checkpoint inhibitor (ICI) as consolidation therapy after chemoradiation (CRT) has improved survival rates in non-small cell lung cancer (NSCLC) patients. However, the cardiotoxicity of CRT combined with ICI remains underexplored. This study assesses if ICI exposure alters the critical cardiac subregion linked to radiation-induced heart disease (RIHD) following CRT.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of 321 locally advanced NSCLC patients treated with definitive CRT from August 2008 to December 2019, including 67 who received consolidation ICI. Cardiac contours include the entire heart, chambers, major coronary arteries, and conduction nodes. The primary endpoint was RIHD, defined as a major adverse cardiac event and atrial fibrillation. We used Fine-Gray analysis to investigate associations between RIHD and mean doses to cardiac subregions.</div></div><div><h3>Results</h3><div>In total, 53 patients (18.4 %) developed RIHD, with no significant difference between CRT and CRT + ICI groups. Doses to cardiac subregions were similar between the groups. In the CRT group, multivariable analysis shows that dose to the base of the heart, especially the sinoatrial node (SAN), correlated with increased RIHD risk (HR = 1.02 per 1 Gy, 95 %CI [1.01–1.03], p &lt; 0.001). In the CRT + IO group, the left ventricle (LV) dose was a significant predictor (1.06 [1.06–1.1], p = 0.006).</div></div><div><h3>Conclusions</h3><div>Doses to the SAN and the base of the heart correlate with RIHD in CRT patients, while doses to LV in CRT + ICI patients. While the 2–6 % increased risk per Gy seems modest, it is clinically significant as the subregions, being small structures, can potentially be completely spared with a carefully optimized plan.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101069"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145576185","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":"Comment on “Examining the role of elective pelvic radiotherapy in patients Diagnosed with high- and very High-Risk Non-Metastatic prostate cancer”","authors":"Yawei Guan ,&nbsp;Yongliang Lu ,&nbsp;Guohui Zhang","doi":"10.1016/j.ctro.2025.101058","DOIUrl":"10.1016/j.ctro.2025.101058","url":null,"abstract":"","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101058"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145358580","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}