Clinical and Translational Radiation Oncology最新文献

{"title":"Outcomes and predictive factors after second stereotactic radiosurgery for refractory trigeminal neuralgia","authors":"Bailey A. Loving ,&nbsp;Jacob F. Oyeniyi ,&nbsp;Siddharth Ramanathan ,&nbsp;Joseph S. Lee ,&nbsp;Hong Ye ,&nbsp;Yastira Ramdas ,&nbsp;Inga S. Grills ,&nbsp;James F. Fontanesi ,&nbsp;Prakash Chinnaiyan ,&nbsp;Daniel K. Fahim ,&nbsp;Daniel B. Michael ,&nbsp;Peter Y. Chen","doi":"10.1016/j.ctro.2025.100969","DOIUrl":"10.1016/j.ctro.2025.100969","url":null,"abstract":"<div><div>ObjectivesThis study evaluates the safety and efficacy of Gamma Knife Stereotactic Radiosurgery (GKSRS) retreatment (T2) for recurrent or refractory trigeminal neuralgia (TN) following an initial SRS treatment (T1).</div></div><div><h3>Methods</h3><div>We analyzed 53 patients who underwent T2 between 2012 and 2018 using a prospectively maintained single institution database. Baseline characteristics, treatment details, and toxicity data were assessed, with pain responses evaluated via Barrow Neurological Institute (BNI) pain intensity scores. Predictors of pain recurrence and chronic sensory toxicity were identified using univariate and multivariable analyses.</div></div><div><h3>Results</h3><div>The median T2 maximum dose was 70 Gy, primarily targeting the cisternal segment (43 %) and retrogasserian zone (RGZ) (34 %). Following T2, 95 % experienced initial pain relief with a 1-month median time to response, and 1-, 2-, and 3-year freedom from pain recurrence of 51 %, 45 %, and 41 %, respectively. Chronic sensory deficits were observed in 62 % of patients, but motor toxicity remained rare (mastication deficit: 2.5 %; facial motor deficit: 5.1 %). RGZ targeting (HR = 3.84, p = 0.02) and single isocenter treatments (HR = 3.85, p = 0.04) were predictive of pain recurrence when compared to dorsal root entry zone (DREZ) targeting and two isocenters, respectively. Affected trigeminal nerve length &lt;11.5 mm was associated with chronic sensory deficits (OR = 7.14, p = 0.02).</div></div><div><h3>Conclusion</h3><div>GKSRS provides effective pain relief and manageable toxicity in retreatment for refractory/recurrent TN. Optimizing parameters, including DREZ targeting and dual-isocenter strategies, can enhance outcomes, while balancing treatment length to mitigate chronic sensory toxicity. Future research should aim at optimizing treatment parameters to maximize pain relief while minimizing toxicity for these patients.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100969"},"PeriodicalIF":2.7,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943173","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":"Same-Day Magnetic Resonance-Guided Single-Fraction Stereotactic Body Radiation Therapy for Painful Non-Spine Bone Metastases – A Single-Center Study (“BONE SHOT”)","authors":"Sebastian M. Christ ,&nbsp;Eva-Maria Kretschmer ,&nbsp;Michael Mayinger ,&nbsp;Madalyne Day ,&nbsp;Nienke Weitkamp ,&nbsp;Amanda Kristina Moreira ,&nbsp;Stefanie Ehrbar ,&nbsp;Cäcilia S. Reiner ,&nbsp;Marta Bogowicz ,&nbsp;Lotte Wilke ,&nbsp;Stephanie Tanadini-Lang ,&nbsp;Nicolaus Andratschke ,&nbsp;Helena I. Garcia Schüler ,&nbsp;Matthias Guckenberger","doi":"10.1016/j.ctro.2025.100966","DOIUrl":"10.1016/j.ctro.2025.100966","url":null,"abstract":"<div><h3>Introduction and background</h3><div>There is evidence for efficacy of high-dose single-fraction stereotactic body radiotherapy (SF-SBRT) for painful non-spine bone metastases (NSBMs). This study (“BONE SHOT”) assessed feasibility of same-day magnetic resonance-guided (MRg) planning and SF-SBRT delivery, recorded toxicity and assessed efficacy for treating metastatic patients with NSBMs.</div></div><div><h3>Materials and methods</h3><div>Patients with painful (≥3/10 points on a 0–10 numeric rating scale (NRS) for pain) and radiologically confirmed NSBMs from solid organ malignancies were eligible for this prospectively acquired, single-center study. Patients received MRg-SF-SBRT via MR-Linac (ViewRay®) with same-day consultation, consent, planning and treatment. Drop-out rate, procedure times, acute toxicity and pain response were recorded.</div></div><div><h3>Results</h3><div>Between June 2019 and June 2020, 13 patients with 15 NSBMs were treated per protocol. Mean patient age was 64 (range, 30–87) years; most common primary cancer was gastrointestinal malignancies (38.5 %); most commonly treated site was pelvis (53.3 %). All workflows were completed as planned. Median on-table time for contouring, planning and delivery was 65 (range, 57–112) minutes. Treatments were well tolerated; one patient developed “pain flair”; no grade ≥ 3 toxicities were registered. At one week following SBRT, overall and complete pain response rates were 73.3 % and 20.0 %, respectively, which evolved to 66.7 % and 53.3 % at four weeks after SBRT; median pre-treatment pain score was 6 points, which was reduced by a median of 5 points (P = 0.0028) at four weeks.</div></div><div><h3>Conclusion</h3><div>The same-day MRg-SF-SBRT workflow for NSBMs was feasible, safe, and preliminary results indicate promising efficacy, warranting future trials investigating this intervention.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100966"},"PeriodicalIF":2.7,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143899176","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":"Comparison of simultaneous integrated tumor bed boost and sequential boost during hypofractionated whole-breast irradiation after breast-conserving surgery","authors":"Dan-Qiong Wang ,&nbsp;Yu-Chun Song ,&nbsp;Hao Jing ,&nbsp;Hui Fang ,&nbsp;Yong-Wen Song ,&nbsp;Yue-Ping Liu ,&nbsp;Jing Jin ,&nbsp;Shu-Nan Qi ,&nbsp;Yuan Tang ,&nbsp;Ning-Ning Lu ,&nbsp;Bo Chen ,&nbsp;Ning Li ,&nbsp;Yi-Rui Zhai ,&nbsp;Wen-Wen Zhang ,&nbsp;Xin Liu ,&nbsp;Si-Ye Chen ,&nbsp;Zhuan-Bo Yang ,&nbsp;Guang-Yi Sun ,&nbsp;Xu-Ran Zhao ,&nbsp;Zi-Han Qiu ,&nbsp;Shu-Lian Wang","doi":"10.1016/j.ctro.2025.100967","DOIUrl":"10.1016/j.ctro.2025.100967","url":null,"abstract":"<div><h3>Background and purpose</h3><div>This study aimed to compare the safety and efficacy of simultaneous integrated boost (SIB) and sequential boost (SeB) during hypofractionated WBI.</div></div><div><h3>Materials and methods</h3><div>This study analyzed data from two prospective studies, including 1,132 patients with pT1-3 N0-3 M0 breast cancer, of whom 775 received SIB and 357 received SeB. The prescribed dose was 43.5 Gy in 15 fractions to whole breast and/or nodal region, with either 49.5 Gy in 15 fractions (SIB) or 8.7 Gy in 3 fractions (SeB) delivered to tumor bed. Outcomes analyzed included survival outcomes, treatment-related toxicities, and cosmetic outcomes.</div></div><div><h3>Results</h3><div>The 5-year outcomes were local control rates of 97.8 % vs. 98.8 % (<em>p</em> = 0.12), locoregional control rates of 97.7 % vs. 97.1 % (<em>p</em> = 0.72), disease-free survival of 94.1 % vs. 93.1 % (<em>p</em> = 0.71), overall survival of 97.4 % vs. 97.1 % (<em>p</em> = 0.88), and breast-specific survival of 98.2 % vs. 97.5 % (<em>p</em> = 0.43) for SIB versus SeB, respectively. After stabilized inverse probability of treatment weighting, differences between groups remained non-significant. Rates of fair or poor cosmetic outcomes before and after radiotherapy were lower in the SIB group, but there was no difference in cosmetic deterioration (9.8 % vs. 7.6 %, <em>p</em> = 0.22). Grade 2 or higher toxicities, including skin toxicity, pneumonitis, breast swelling, pain, induration, lymphedema, and shoulder mobility issues, were comparable between groups.</div></div><div><h3>Conclusion</h3><div>SIB is a viable alternative to SeB, offering comparable toxicity profiles and survival outcomes while shortening treatment duration. Longer follow-up is warranted to assess long-term outcomes.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100967"},"PeriodicalIF":2.7,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143918200","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":"Microscopic intramural spread in patients with rectal cancer after neoadjuvant chemoradiation","authors":"A.E. Verrijssen ,&nbsp;E.J. Van Limbergen ,&nbsp;M. Bellezzo ,&nbsp;H.I. Grabsch ,&nbsp;R. Houben ,&nbsp;D. Goudkade ,&nbsp;J. Melenhorst ,&nbsp;I. Samarska ,&nbsp;G. Paiva Fonseca ,&nbsp;F. Verhaegen ,&nbsp;M. Berbee","doi":"10.1016/j.ctro.2025.100963","DOIUrl":"10.1016/j.ctro.2025.100963","url":null,"abstract":"<div><h3>Objective</h3><div>This study investigates microscopic intramural spread (MIS) after neoadjuvant (chemo)radiotherapy on Total Mesorectal Excision (TME) specimens of rectal cancer patients and explores the necessity of an additional treatment margin for endorectal radiation boosts (for example through contact brachytherapy (CXB)) or local excisions.</div></div><div><h3>Methods</h3><div>A cohort of patients from Maastricht University Medical Center (MUMC + ) treated between 2016 and 2022 was analyzed. Patients underwent MRI, CT scans, and sigmoidoscopy six weeks after radiotherapy, followed by surgery. Pathological analysis of TME specimens, including whole mount macro-cassettes, was performed to measure residual macroscopic tumor and MIS. Fragmented and continuous MIS were recorded parallel and perpendicular to the bowel wall.</div></div><div><h3>Results</h3><div>Out of 54 patients, 37 (69%) exhibited no MIS. MIS was observed in 4/18 (22%) of patients with ycT1-2 tumors and 13/36 (36%) of patients with ycT3-4 tumors. 4 patients (7%) showed continuous MIS and 15 (28%) showed fragmented MIS. No patients with ypT1-2 had MIS.</div></div><div><h3>Conclusions</h3><div>69% of patients do not retain MIS post-neoadjuvant therapy. Knowledge of tumor thickness seems crucial for patient selection for CXB.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100963"},"PeriodicalIF":2.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869387","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-Treatment and Pre-Brachytherapy MRI first-order Radiomic Features by a Commercial software as survival predictors in radiotherapy for cervical cancer Objectives","authors":"Wiwatchai Sittiwong ,&nbsp;Pittaya Dankulchai ,&nbsp;Pitchayut Wongsuwan ,&nbsp;Tissana Prasartseree ,&nbsp;Wajana Thaweerat ,&nbsp;Nerisa Thornsri ,&nbsp;Pongpop Tuntapakul","doi":"10.1016/j.ctro.2025.100965","DOIUrl":"10.1016/j.ctro.2025.100965","url":null,"abstract":"<div><h3>Materials and Methods</h3><div>The study included 100 patients with LACC who underwent definitive CCRT with IMRT/VMAT technique followed by 3D-IGABT. MRI-based contouring included T2WI and DWI images for primary tumor (GTVp) and lymph nodes (GTVn). The contours were imported to MIM software to extract first-order radiomic features. Radiomic values from pre-treatment (PreRx), pre-brachytherapy (PreBT), differences between PreRx and PreBT (Diff) radiomic and clinical factors were analyzed using univariate and multivariate Cox regression analysis. Predictive models of PFS, LRFS, DMFS, and OS were created along with the optimism index and calibration plot.</div></div><div><h3>Results</h3><div>The median follow-up time was 24.5 months. The 2-year of PFS, LRFS, DMFS, and OS rates were 71, 88.6, 83.1, and 83.5 %, respectively. For all clinical outcomes, CF + RF combined from PreRx and PreBT resulted in the highest Harrell’s C-index compared with the CF or RF alone. Compare with Diff models, models from PreRx and PreBT resulted in higher Harrell’s C-index. The C-indexes from the CF + RF model from PreRx and PreBT for PFS, LRFS, DMFS, and OS were 0.739, 0.873, 0.830 and 0.967 with the optimism indexes of 0.312, 0.381, 0.316, and 0.242, respectively.</div></div><div><h3>Conclusion</h3><div>Radiomic features from the first-order statistics added values to clinical factors to predict the outcomes after CCRT. The highest prediction model performance was for the combined clinical and radiomics from PreRx and PreBT.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100965"},"PeriodicalIF":2.7,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143860156","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":"An offline adaptive planning method based on delivered accumulated dose for brachytherapy in cervical cancer","authors":"Qi Fu ,&nbsp;Yingjie Xu ,&nbsp;Xi Yang ,&nbsp;Jusheng An ,&nbsp;Zhaohan Li ,&nbsp;Manni Huang ,&nbsp;Jianrong Dai","doi":"10.1016/j.ctro.2025.100964","DOIUrl":"10.1016/j.ctro.2025.100964","url":null,"abstract":"<div><h3>Background and purpose</h3><div>In current clinical practice, independent treatment plan optimization for each fraction of brachytherapy might not be able to fully leverage the dosimetric advantage of the cervical cancer radiotherapy combining external beam radiotherapy (EBRT) and brachytherapy (BT). This study proposed an offline adaptive planning method based on accumulated dose for BT, aiming to improve the total dose distribution of the combined radiotherapy.</div></div><div><h3>Methods and materials</h3><div>This study retrospectively reviewed nine cervical cancer patients treated with EBRT followed by high-dose-rate BT. For each BT fraction, we used a multi-metric deformable image registration method to accumulate the dose distributions of previously delivered EBRT and BT. The accumulated dose distribution was then imported into a customized commercial BT treatment planning system as a background in the adaptive dose optimization. Main dosimetric parameters of the target and organs at risk (OARs) were compared between the adaptive BT (ABT) and conventional BT (CBT) planning methods.</div></div><div><h3>Results</h3><div>For approximately 70 % of the BT fractions, the ABT plans have lower D2cc to the bladder or rectum compared with the CBT plans. In terms of total dose evaluation, the ABT planning method resulted in a decrease in mean values of D2cc, V60 and V50 for the bladder (–1.9 ± 2.0 Gy_EDQ2, –1.2 ± 1.2 %, and –0.9 ± 1.1 %) and rectum (–2.1 ± 1.8 Gy_EQD2, –1.2 ± 1.2 %, and –1.4 ± 1.3 %).</div></div><div><h3>Conclusion</h3><div>The offline adaptive planning method could help decrease the doses to OARs and improve the total dose distribution of combined radiotherapy, showing promising prospects for clinical use.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100964"},"PeriodicalIF":2.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143847637","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":"Splenic function post radiation therapy in childhood cancer survivors","authors":"Joy Fulbright ,&nbsp;Kyla Alsman ,&nbsp;Ashley K. Sherman ,&nbsp;Kris Laurence ,&nbsp;Becky Lowry","doi":"10.1016/j.ctro.2025.100961","DOIUrl":"10.1016/j.ctro.2025.100961","url":null,"abstract":"<div><div>Study evaluated splenic function in childhood cancer survivors (CCS) who had received radiation to the spleen utilizing pRBC PIT (vesiculated erythrocytes) count compared to a non-radiated control group. Those exposed to &lt; 20 Gy of radiation had PIT counts not significantly different from the control group. There was trend for higher pRBC PIT count in those exposed to higher doses of radiation.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100961"},"PeriodicalIF":2.7,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869382","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":"Stereotactic body radiotherapy for early glottic cancers: Is this “The Way”?","authors":"Jennifer Le Guévelou ,&nbsp;Audrey Larnaudie ,&nbsp;Pierre Blanchard ,&nbsp;Yoann Pointreau ,&nbsp;Joël Castelli","doi":"10.1016/j.ctro.2025.100962","DOIUrl":"10.1016/j.ctro.2025.100962","url":null,"abstract":"<div><div>In the past decades, several options have been designed in order to preserve vocal function in patients with early glottic cancer, such as transoral laser microsurgery, new surgical strategies such as partial laryngectomy and radiation therapy (RT). With the development of new radiation techniques enabling a more accurate delivery of radiation dose, and the possibility to deliver high dose per fraction while sparing adjacent organs-at-risks (OARs), stereotactic body radiotherapy (SBRT) is being increasingly tested in this disease setting. We aimed to shed light on this appealing strategy, as well as to underline both optimal target population and specific technical considerations.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100962"},"PeriodicalIF":2.7,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843822","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":"ACO/ARO/AIO-22 – External beam radiotherapy combined with endorectal high-dose-rate brachytherapy in elderly and frail patients with rectal cancer: A prospective multicentre trial of the German Rectal Cancer Study Group","authors":"Hendrik Dapper ,&nbsp;Maximilian Fleischmann ,&nbsp;Nikolaos Tselis ,&nbsp;Markus Diefenhardt ,&nbsp;Ralf-Dieter Hofheinz ,&nbsp;Christian Weiß ,&nbsp;Gerhard G. Grabenbauer ,&nbsp;Ricarda Merten ,&nbsp;Anca-Ligia Grosu ,&nbsp;Simon Kirste ,&nbsp;Stefan Rieken ,&nbsp;Johannes Claßen ,&nbsp;Christian Langer ,&nbsp;Thomas Kuhnt ,&nbsp;Heinz Schmidberger ,&nbsp;Michael Ghadimi ,&nbsp;Frank Giordano ,&nbsp;Ursula Nestle ,&nbsp;Stefan A. Koerber ,&nbsp;Felix Bock ,&nbsp;Emmanouil Fokas","doi":"10.1016/j.ctro.2025.100958","DOIUrl":"10.1016/j.ctro.2025.100958","url":null,"abstract":"<div><h3>Purpose</h3><div>Rectal cancer disproportionately affects the elderly population, with more than half of cases diagnosed in individuals aged 70 years or older. Frail patients in this group often face significant challenges tolerating the standard treatment of total mesorectal excision (TME), due to elevated risks of surgical complications and perioperative morbidity. Advances in radiotherapy techniques offer a viable alternative, providing effective tumor control while minimizing treatment-related toxicity. Recent clinical trials, including OPERA and MORPEUS, have demonstrated that dose-escalated radiotherapy, which integrates external beam (chemo)radiotherapy (EBRT) with high-dose-rate endorectal brachytherapy (HDR-BT) or contact X-ray brachytherapy (CXB), can achieve high clinical response rates and facilitate organ preservation in younger, healthier patient cohorts. Building on these findings, the ACO/ARO/AIO-22 study seeks to adapt these innovative approaches to meet the needs of elderly and frail patients with rectal cancer.</div></div><div><h3>Methods/Design</h3><div>The ACO/ARO/AIO-22 trial is a prospective multicentre controlled trial. Elderly (age ≥70 years) and/or frail patients with non-metastatic rectal adenocarcinoma (cT1-3d N0/+ M0, mrCRM − / +) localized 0–16 cm from the ano-cutaneous line, unable to undergo radical surgery can be included. The initial treatment comprises an external beam radiation (EBRT) regime with 13 × 3 Gy (total: 39 Gy) over a period of two and a half weeks. Following initial restaging 6.5 weeks after completion of EBRT, endorectal HDR-BT will be delivered with 3 weekly fractions of 8 Gy to a total dose of 24 Gy (prescribed at the radial margin of the tumor; with a maximum prescription depth of 10 mm); alternatively, with CXB with 90 Gy in 3 weekly fractions. The primary objective is complete or near complete clinical response (cCR or ncCR) and the second primary endpoint is quality of life (QoL) measured with the EORTC QLQ-ELD14, both at 12 months after treatment start.</div></div><div><h3>Discussion</h3><div>The ACO/ARO/AIO-22 prospective multicentre trial will evaluate organ preservation rates and QoL after combining EBRT with endorectal HDR-BT in elderly and/or frail patients with rectal cancer.</div><div><strong>Trial Registration:</strong> <span><span>Clinicialtrials.gov</span><svg><path></path></svg></span> number: NCT06729645.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100958"},"PeriodicalIF":2.7,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833244","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":"Impact of hypoxic versus oxic conditions on local tumor control after proton irradiation in a rat prostate carcinoma","authors":"Michaela Schmitt ,&nbsp;Christin Glowa ,&nbsp;Ina Kurth ,&nbsp;Peter Peschke ,&nbsp;Stephan Brons ,&nbsp;Christian P. Karger","doi":"10.1016/j.ctro.2025.100957","DOIUrl":"10.1016/j.ctro.2025.100957","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Hypoxia in tumors significantly contributes to radiation resistance, often leading to poor treatment outcomes. <em>In vitro</em> studies demonstrated that proton irradiation not only exhibits an increased relative biological effectiveness (RBE), but also a lower oxygen enhancement ratio (OER). This study explored the impact of hypoxic and oxic conditions on local tumor control after proton irradiation in a rat prostate carcinoma.</div></div><div><h3>Material and methods</h3><div>Subcutaneously transplanted Dunning R3327-HI rat prostate carcinomas were irradiated with varying single doses of protons under oxic or hypoxic conditions. Hypoxia was induced by clamping the tumor-supplying vessels. The biological endpoint was local tumor control assessed 300 days after irradiation. Dose-response curves were determined and based on the doses required for 50 % tumor control probability (TCD₅₀), the RBE and OER were calculated.</div></div><div><h3>Results</h3><div>The TCD₅₀ value was significantly higher under hypoxic than under oxic conditions (73.4 ± 1.9 Gy vs. 50.5 ± 1.6 Gy), resulting in an OER of 1.45 ± 0.06 for proton irradiation. Compared to photon irradiation, the RBE for protons was of 1.23 ± 0.07 under oxic and 1.30 ± 0.04 under hypoxic conditions.</div></div><div><h3>Conclusion</h3><div>Proton irradiations showed a 5 % reduction in OER compared to the previously measured photon value of 1.53 ± 0.08, suggesting a slightly higher effectiveness of protons in hypoxic tumors as compared to photons.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"53 ","pages":"Article 100957"},"PeriodicalIF":2.7,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143839629","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}