Clinical and Translational Radiation Oncology最新文献

{"title":"Timeline of cognitive impairments after radiotherapy for head and neck cancer: A review","authors":"K. Wickborn ,&nbsp;C.W.J. van der Weijden ,&nbsp;E.F.J. de Vries ,&nbsp;T.W.H. Meijer ,&nbsp;M.C.A. Kramer ,&nbsp;J.M. Spikman ,&nbsp;A.M. Buunk ,&nbsp;A. van der Hoorn","doi":"10.1016/j.ctro.2024.100890","DOIUrl":"10.1016/j.ctro.2024.100890","url":null,"abstract":"<div><h3>Background</h3><div>With advances in cancer treatments, long-term impairments of survivors have become more apparent. Radiotherapy of tumors in or near the brain can potentially induce cognitive impairments, impacting the quality of life of survivors. Currently, there is a lack of comprehensive information on the timeline of cognitive impairments following radiotherapy for head and neck cancer (HNC). To address this gap, we conducted a literature review on cognitive impairments observed after radiotherapy for HNC.</div></div><div><h3>Methods</h3><div>The literature review was conducted using PubMed, Web of Science, PsycINFO, and Google Scholar. Search terms included the following keywords: head and neck tumors, radiotherapy, treatment responses, cognitive impairments, as well as variants and related subcategories.</div></div><div><h3>Result</h3><div>Our review encompassed 23 studies involving a total of 1059 HNC patients, predominantly nasopharyngeal carcinoma. Overall, studies indicated a decline in cognitive performance post-radiotherapy compared to baseline scores, control groups, or normative data. The literature on acute effects is scarce and studies with complete neuropsychological assessments are missing. Cognitive impairments were prevalent in the majority of patients at six to 12 months post-radiotherapy, with memory deficits being the most prominent. Long-term assessments demonstrated that these cognitive deficits persisted even beyond seven years, suggesting a potentially irreversible decline in cognition following radiotherapy.</div></div><div><h3>Conclusion</h3><div>Cognitive impairments are frequently observed at least six months after radiotherapy. Standardized cognitive assessments are imperative to evaluate impairments in individual patients. Future research in HNC should integrate neuropsychological evaluations to enhance our understanding of domain-specific impairments and the complete timeline of cognitive changes after radiotherapy.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100890"},"PeriodicalIF":2.7,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143171156","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":"Elective pelvic nodal irradiation in elderly men treated with hypofractionated radiotherapy","authors":"Rachel M. Glicksman ,&nbsp;Andrew Loblaw ,&nbsp;Patrick Cheung","doi":"10.1016/j.ctro.2024.100888","DOIUrl":"10.1016/j.ctro.2024.100888","url":null,"abstract":"","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"50 ","pages":"Article 100888"},"PeriodicalIF":2.7,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698210","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":"The prognostic utility of IGF-1 in hepatocellular carcinoma treated with stereotactic body radiotherapy","authors":"Ahmed Allam Mohamed ,&nbsp;Cennet Sahin ,&nbsp;Marie-Luise Berres ,&nbsp;Oliver Beetz ,&nbsp;Martin von Websky ,&nbsp;Thomas Vogel ,&nbsp;Florian W.R. Vondran ,&nbsp;Philipp Bruners ,&nbsp;Matthias Imöhl ,&nbsp;Katharina Frank ,&nbsp;Edith Vogt ,&nbsp;Binney Pal Singh ,&nbsp;Michael J. Eble","doi":"10.1016/j.ctro.2024.100887","DOIUrl":"10.1016/j.ctro.2024.100887","url":null,"abstract":"<div><h3>Background</h3><div>Hepatocellular carcinoma (HCC) poses a significant challenge for patients ineligible for surgical resection or liver transplantation. Local therapies like Stereotactic Body Radiotherapy (SBRT) are crucial for those with liver-limited disease. Insulin-like growth factor-1 (IGF-1) is a potential biomarker for liver function. This study evaluates IGF-1’s prognostic value in predicting survival outcomes in HCC patients undergoing SBRT.</div></div><div><h3>Methods</h3><div>We analyzed 42 HCC patients treated with SBRT between May 2021 and January 2024, with IGF-1 levels measured within four weeks before SBRT. Patient demographics, tumor metrics, and clinical outcomes were examined. The prognostic significance of IGF-1 was assessed using Cox proportional hazards and ROC curve analysis to determine optimal IGF-1 cutoffs for survival prediction. A nomogram predicting 1-year and 2-year survival was constructed using a multivariate Cox model.</div></div><div><h3>Results</h3><div>IGF-1 levels were significantly lower in patients with cirrhosis or sarcopenia. Median overall survival (OS) was 24 months, with a significant survival difference favoring patients with IGF-1 levels above 62.4 ng/ml (Hazard Ratio [HR]: 5.9, P = 0.0025). A multivariable Cox model including Child-Turcotte-Pugh (CTP) score, IGF-1, and tumor volume effectively predicted survival. IGF-1 and tumor volume significantly impacted OS (HR: 6.9 and 1.004, p = 0.014 and 0.0022, respectively). Integrating IGF-1 with CTP score improved predictive accuracy (c-index 0.66 to 0.75, p = 0.052).</div><div>The nomogram, integrating IGF-1 with the CTP and tumour volume, exhibited robust predictive accuracy with an area under the curve (AUC) of 0.84 for 2-year survival.</div></div><div><h3>Conclusion</h3><div>IGF-1 is a reliable biomarker for liver function and survival prediction in HCC patients undergoing SBRT. Higher IGF-1 levels indicate better prognosis. The developed nomogram, incorporating IGF-1, enhances clinical decision-making for SBRT management. Further validation in larger cohorts is needed.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"50 ","pages":"Article 100887"},"PeriodicalIF":2.7,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652596","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":"Normal tissue complication probability modeling for late rectal bleeding after conventional or hypofractionated radiotherapy for prostate cancer","authors":"Christian A.M. Jongen ,&nbsp;Ben J.M. Heijmen ,&nbsp;Wilco Schillemans ,&nbsp;Andras Zolnay ,&nbsp;Marnix G. Witte ,&nbsp;Floris J. Pos ,&nbsp;Ben Vanneste ,&nbsp;Ludwig J. Dubois ,&nbsp;David van Klaveren ,&nbsp;Luca Incrocci ,&nbsp;Wilma D. Heemsbergen","doi":"10.1016/j.ctro.2024.100886","DOIUrl":"10.1016/j.ctro.2024.100886","url":null,"abstract":"<div><h3>Purpose</h3><div>To develop a single NTCP model for grade ≥ 2 late rectal bleeding (G2 LRB) after conventional or hypofractionated radiotherapy for prostate cancer.</div></div><div><h3>Methods and Materials</h3><div>The development dataset consisted of prostate cancer patients (n = 656) previously randomized to conventional (39 x 2 Gy) or hypofractionated (19 x 3.4 Gy) external beam radiotherapy with N = 89 G2 LRB cases. Candidate predictors were obtained from literature. We fitted five separate logistic regression models to the data, each with one of the following dose parameters as candidate predictors in biological effective dose (BED), assuming α/β = 3 Gy: Equivalent uniform dose (EUD) with n = 0.1, EUD with n = 0.2, the relative volume receiving ≥ 111.9 Gy in BED (V111.9, the equivalent of physical V70 for a conventional schedule), minimum BED to the hottest 0.1 cm³ (D_0.1cm3) or 2 cm³ (D_2cm3). Previous abdominal surgery was included in every model and fractionation schedule was tested as predictor in each model. A sensitivity analysis was performed by varying the α/β-ratio, n and dose-volume cutoff.</div></div><div><h3>Results</h3><div>The pre-selected candidate dosimetric predictor and previous abdominal surgery were significantly associated with the outcome in all five models. Fractionation schedule was eliminated by the backward scheme in only the EUD (n = 0.1), D_0.1cm3 and D_2cm3-based models. In internal validation these models showed AUC’s of 0.64, 0.60 &amp; 0.62, respectively. The sensitivity analyses showed that EUD models with n ≥ 0.15 and / or α/β ≥ 4 Gy failed, and EUD models based on α/β = 2 Gy with n = 0.05–0.2 showed good fits as well.</div></div><div><h3>Conclusions</h3><div>Our trial data set with different fractionation schedules offered the unique possibility to generate unbiased BED-based models. EUD (n = 0.1), D_0.1cm3 and D_2cm3 performed overall best in predicting G2 LRB; with α/β = 2 Gy equally good models were obtained. External validation is required to confirm our results.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"50 ","pages":"Article 100886"},"PeriodicalIF":2.7,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698208","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":"Radiobiology and modelling in Brachytherapy: A review inspired by the ESTRO Brachytherapy pre-meeting course","authors":"A.J. Stewart ,&nbsp;C. Chargari ,&nbsp;A. Chyrek ,&nbsp;F. Eckert ,&nbsp;J.L. Guinot ,&nbsp;T.P. Hellebust ,&nbsp;P. Hoskin ,&nbsp;C. Kirisits ,&nbsp;B. Pieters ,&nbsp;F.A. Siebert ,&nbsp;L. Tagliaferri ,&nbsp;K. Tanderup ,&nbsp;D. Todor ,&nbsp;P. Wojcieszek ,&nbsp;J.M. Hannoun-Levi","doi":"10.1016/j.ctro.2024.100885","DOIUrl":"10.1016/j.ctro.2024.100885","url":null,"abstract":"<div><div>Brachytherapy (BT) plays a key role in cancer treatment by delivering a high dose to a small volume over a short time. The use of BT is currently validated in a wide range of cancers such as cervical, prostate and breast cancers while being a favourable choice for organ preservation, such as in penile or rectal cancer, or in the setting of reirradiation. Consideration of the radiobiology of BT is integral to the choices made around dose and fractionation and combination with other techniques such as external beam radiotherapy (EBRT). Much of the radiobiology of brachytherapy is based on historic data, but fortunately there is a drive to integrate translational research including radiobiologic parameters into modern BT research. In a changing therapeutic landscape moving to a high dose rate (HDR) based on high dose per fraction, it is important to ensure that the incorporation of new radiobiology knowledge helps to drive clinical practice.</div><div>This manuscript takes the ESTRO Brachytherapy pre-meeting course (May 3, 2024 - Glasgow ESTRO meeting) as a base and develops the concepts to present an overview of radiobiology in brachytherapy. Presented are 3 different considerations: the fundamentals of BT radiobiology (BT radiobiology history, biology and BT, α/β and re-irradiation), the pre-clinical radiobiology approach (pulsed dose radiotherapy (PDR) vs HDR, BT vs best EBRT techniques, high dose regions and integrated boost) and clinical radiobiology approaches (optimal number of BT fractions, radiobiology in BR for cervical, prostate, breast, skin/H&amp;N and gastro-intestinal cancers). Presented is an analysis of radiobiology and modelling in BT aiding the integration of scientific pre-clinical and clinical data to allow a better understanding of the use of radioactive sources for cancer treatment.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"50 ","pages":"Article 100885"},"PeriodicalIF":2.7,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142722739","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":"Clinical implementation of RTT-only CBCT-guided online adaptive focal radiotherapy for bladder cancer","authors":"K. Goudschaal ,&nbsp;S. Azzarouali ,&nbsp;J. Visser ,&nbsp;M. Admiraal ,&nbsp;J. Wiersma ,&nbsp;N. van Wieringen ,&nbsp;A. de la Fuente ,&nbsp;M. Piet ,&nbsp;L. Daniels ,&nbsp;D. den Boer ,&nbsp;M. Hulshof ,&nbsp;A. Bel","doi":"10.1016/j.ctro.2024.100884","DOIUrl":"10.1016/j.ctro.2024.100884","url":null,"abstract":"<div><h3>Purpose</h3><div>The study assesses the clinical implementation of radiation therapist (RTT)-only Conebeam CT (CBCT)-guided online adaptive focal radiotherapy (oART) for bladder cancer, by describing the training program, analyzing the workflow and monitoring patient experience.</div></div><div><h3>Materials and methods</h3><div>Bladder cancer patients underwent treatment (20 sessions) on a ring-based linac (Ethos, Varian, a Siemens Healthineers Company, USA). Commencing April 2021, 14 patients were treated by RTTs supervised by the Radiation Oncologist (RO) and Medical Physics Expert (MPE) in a multidisciplinary workflow. From March 2022, 14 patients were treated solely by RTTs. RTT training included target delineation lessons and practicing oART in a simulation environment. We analyzed the efficiency of the RTT-only workflow regarding session time, adjustments by RTTs, attendance of the RO and MPE at the linac, and qualitative assessment of gross tumor volume (GTV) delineation. Patient experience was monitored through questionnaires.</div></div><div><h3>Results</h3><div>A training program resulted in a skilled team of RTTs, ROs and MPEs.</div><div>The RTT-only workflow demonstrated shorter session times compared to the multidisciplinary approach. Among 14 patients treated using the RTT-only workflow, RTTs adjusted 99% of bladder volumes and 44% of GTV. 79% of the sessions proceeded without MPEs and ROs. All GTV delineations were RO-approved, thus considered clinically acceptable, and 87% required minor or no adjustments. Patient satisfaction was reported in 18 of 21 cases.</div></div><div><h3>Conclusions</h3><div>The RTT-only oART workflow for bladder cancer, complemented by a training program and on-call support from ROs and MPEs, demonstrated success. Patient experience is positive. It is currently introduced as standard in our clinic.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"50 ","pages":"Article 100884"},"PeriodicalIF":2.7,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578563","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":"The current status of brachytherapy in Europe − A GEC-ESTRO Brachy-HERO survey","authors":"J.G. Johansen ,&nbsp;I.M. Jürgenliemk-Schulz ,&nbsp;H. Haddad ,&nbsp;J.M. Hannoun-Levi ,&nbsp;T.P. Hellebust ,&nbsp;B. Guix ,&nbsp;K. Loessl ,&nbsp;B. Pieters ,&nbsp;C. Rao ,&nbsp;V. Strnad ,&nbsp;A.E. Sturdza ,&nbsp;L. Tagliaferri ,&nbsp;Z. Takacsi-Nagy ,&nbsp;E. Villafranca ,&nbsp;P. Wojcieszek ,&nbsp;A. Rembielak ,&nbsp;P. Niehoff","doi":"10.1016/j.ctro.2024.100883","DOIUrl":"10.1016/j.ctro.2024.100883","url":null,"abstract":"<div><div>A survey regarding utilisation of brachytherapy was distributed to European brachytherapy professionals. Eighty replies from 26 countries were received, two of which were outside Europe. The replies showed that brachytherapy is still widely used. The main indications for brachytherapy are gynaecological and prostate cancer, with &gt;80 % of the responding countries performing brachytherapy for these indications. There is on average one brachytherapy centre per 0.8 million inhabitants, ranging from 0.4 per million to 2.3 per million inhabitants. The organisation of brachytherapy on national levels also varies from country to country, with less than half of the countries having a central brachytherapy registry. All in all, the survey shows that brachytherapy still plays a role on modern radiotherapy, but the field could benefit from a stronger collaboration both nationally and internationally.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"50 ","pages":"Article 100883"},"PeriodicalIF":2.7,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652812","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":"MRI guided online adaptive radiotherapy and the dosimetric impact of inter- and intrafractional motion in patients with cervical cancer","authors":"Shouliang Ding ,&nbsp;Zun Piao ,&nbsp;Meining Chen ,&nbsp;Fanghua Li ,&nbsp;Yongbao Li ,&nbsp;Biaoshui Liu ,&nbsp;Hongdong Liu ,&nbsp;Xiaoyan Huang ,&nbsp;Junyun Li","doi":"10.1016/j.ctro.2024.100881","DOIUrl":"10.1016/j.ctro.2024.100881","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study was to evaluate the inter- and intrafractional organs motions and dosimetric advantages of MRI guided online adaptive radiotherapy for cervical cancer.</div></div><div><h3>Methods</h3><div>A total of 150 fractions treated on the 1.5 T Unity MR-Linac were included in this study. Each fraction, pre-treatment, position validation and post-treatment MRI scans were obtained. Structures including CTV, rectum and bladder were delineated by the same radiation oncologists on each MRI. The inter- and intrafractional changes of contours were assessed by Hausdorff distance (HD), dice similarity coefficient (DSC), relative volume difference (ΔV) and the relative positions of the geometric center. The non-ART plans and online adaptive plans were obtained by recalculating or re-optimizing from reference plans on daily MRI, respectively. CTV coverage and OARs constraints were evaluated between ART and non-ART plans.</div></div><div><h3>Results</h3><div>For each fraction, the interfractional changes of HD, ΔV and DSC for CTV, bladder and rectum were significant. Our study also examined the relationship of bladder and rectum filling on CTV position. For 150 non-ART plans, CTV coverage constraints (D_98% ≥ 45 Gy) were not met by 45 %, while 15 % were not covered by more than 5 % of the prescribed dose. Compared to the non-ART plans, the ART plans had higher CTV coverage and lower dose to the bladder and rectum (P &lt; 0.05). During the treatment, the intrafractional changes of bladder, rectum and CTV may affect actual dose delivery. And we observed an intrafractional time trend in the motion of the CTV. There were 15 % fractions failing the CTV coverage constraints in post-MRI due to intrafractional motion. The adaptive plans optimized with 3 mm margin could cover CTV of post-MRI in 98 % fractions.</div></div><div><h3>Conclusions</h3><div>Considerable inter- and intrafractional CTV and OARs changes were observed in cervical cancer patients treated on MR-Linac. MRI guided online ART has significant dosimetric advantages in cervical cancer and is an ideal approach for achieving individualized and precise radiotherapy.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"50 ","pages":"Article 100881"},"PeriodicalIF":2.7,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571611","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":"Access to brachytherapy treatment for cervical cancer management in Africa","authors":"Emmanuel Fiagbedzi ,&nbsp;Vivian Della Atuwo-Ampoh ,&nbsp;Ishmael Nii Ofori ,&nbsp;Savanna Nyarko ,&nbsp;Asare Adomako ,&nbsp;Francis Hasford ,&nbsp;Jeffrey Gameli Amlalo ,&nbsp;Philip Narteh Gorleku","doi":"10.1016/j.ctro.2024.100880","DOIUrl":"10.1016/j.ctro.2024.100880","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Cervical cancer is an important public health issue with a high incidence and death rate in Africa. It is mostly treated with Brachytherapy as the gold standard but its access is limited. This study set out to investigate the distribution and accessibility of brachytherapy units in Africa for the treatment of cervical cancer, and to provide some recommendations for increasing the quantity and accessibility of such equipment throughout the continent.</div></div><div><h3>Materials and methods</h3><div>The International Atomic Energy Agency’s Division of Human Health’s Directory for radiotherapy Centers (DIRAC) was the principal source of data for this study. The number of brachytherapy equipment in the 54 African countries was obtained from the DIRAC database. The number of cervical cancer cases was obtained from the GLOBOCAN 2022 database, and country’s income was calculated using the Gross Domestic Product (GDP) per capita from the global economics database. All of these searches were conducted in February 2024.</div></div><div><h3>Results</h3><div>Africa exhibited a greater number of cervical cancer cases. A total of one hundred (100) brachytherapy units were present across 84 radiotherapy centres spanning 20 African countries. Egypt and South Africa each possess 23 units, which accounts for 46% of the overall quantity. With just two brachytherapy facilities, Nigeria had the most cervical cancer cases. A significant quantity of brachytherapy unit was situated in countries of northern Africa. The quantity of these units varied among countries, from those without any to those with many, and was not only influenced by GDP per capita.</div></div><div><h3>Conclusion</h3><div>Due to the rising incidence of cervical cancer in Africa, the number of brachytherapy equipment was woefully inadequate. Consequently, Africa requires partnerships and financial support to facilitate the quantity and accessibility of brachytherapy services. This will enable the provision of thorough and holistic care to patients and enhance their quality of life.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"50 ","pages":"Article 100880"},"PeriodicalIF":2.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142561062","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":"Primary site stereotactic ablative body radiotherapy in localized, recurrent, and metastatic renal cell carcinoma","authors":"Daniel Huang ,&nbsp;Connor Lynch ,&nbsp;Lucas M. Serra ,&nbsp;Randy F. Sweis ,&nbsp;Paul J. Chang ,&nbsp;Walter M. Stadler ,&nbsp;Russell Z. Szmulewitz ,&nbsp;Peter H. O’Donnell ,&nbsp;Abhinav Sidana ,&nbsp;Scott E. Eggener ,&nbsp;Arieh L. Shalhav ,&nbsp;Stanley L. Liauw ,&nbsp;Sean P. Pitroda","doi":"10.1016/j.ctro.2024.100879","DOIUrl":"10.1016/j.ctro.2024.100879","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Stereotactic ablative body radiotherapy (SABR) is an effective treatment for localized renal cell carcinoma (RCC). However, the role of primary site SABR for locally recurrent or metastatic RCC is unclear. Here, we report outcomes of primary SABR across a diverse cohort of localized, recurrent, and metastatic RCC patients treated at our institution.</div></div><div><h3>Materials and methods</h3><div>RCC patients treated with SABR to lesions of the kidney or nephrectomy bed at our institution with at least 6 months of follow-up were included for analysis. Local control, overall survival, and freedom from distant failure were estimated using the Kaplan-Meier method. Estimated glomerular filtration rate (eGFR) was assessed at baseline and following SABR.</div></div><div><h3>Results</h3><div>Fifty-three patients received primary site SABR. Thirty-seven (70 %) patients had localized RCC, and 16 (30 %) had metastatic RCC. Seven (13 %) had locally recurrent RCC after prior surgery or ablation. The median tumor size was 4.5 cm (IQR 3.7–6.3). At a median follow-up of 23 months (IQR 12–35), 2-year local control was 100 %, and 3-year local control was 94.4 % (95 % CI 84.4 %–100 %). Among patients with initially localized disease, the 2-year freedom from distant failure was 94.6 % (95 % CI 87.6 %–100 %), and the 2-year overall survival was 66.5 % (95 % CI 51.9 %–85.2 %). Twelve (23 %) patients experienced acute grade 1–2 treatment-related toxicity (nausea, vomiting, or small bowel). There were no acute grade 3–4 toxicities. Two (3.8 %) patients developed late grade 3 gastrointestinal toxicity. The median baseline eGFR was 51 mL/min/1.73 m² (IQR 38–77). At 1-year post-SABR, the median eGFR decline was 5 mL/min/1.73 m² (IQR −3 to 9). One patient required dialysis following SABR.</div></div><div><h3>Conclusion</h3><div>This analysis demonstrates excellent local control rates across patients with localized, recurrent, and metastatic RCC treated with SABR. Treatment was associated with minimal eGFR decline.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"49 ","pages":"Article 100879"},"PeriodicalIF":2.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533330","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}