Clinical oncology最新文献

{"title":"RCR Meetings","authors":"","doi":"10.1016/S0936-6555(25)00142-6","DOIUrl":"10.1016/S0936-6555(25)00142-6","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"43 ","pages":"Article 103887"},"PeriodicalIF":3.2,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144272487","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":"DICER1 Mutations Exhibit a Distinctive Immune Characteristics With Enhanced Immune Checkpoint Inhibitor Efficacy in Uterine Corpus Endometrial Carcinoma","authors":"X. Tong , Q. Duan , M. Ge , X. Shang , X. Zhang , D. Chen , L. He","doi":"10.1016/j.clon.2025.103883","DOIUrl":"10.1016/j.clon.2025.103883","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"44 ","pages":"Article 103883"},"PeriodicalIF":3.2,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144298360","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":"Quality Indicators and Benchmarks for Radiotherapy in Lung Cancer: A Modified Delphi Approach","authors":"K.-L. Chiew ,&nbsp;C. Donnelly ,&nbsp;S.V. Harden ,&nbsp;G.G. Hanna ,&nbsp;N. Hardcastle ,&nbsp;S. Jolly ,&nbsp;M. Lehman ,&nbsp;M.M. Matuszak ,&nbsp;F. McDonald ,&nbsp;Y.Y. Soon ,&nbsp;Y.M. Tsang ,&nbsp;F. Ynoe Moraes ,&nbsp;S.K. Vinod","doi":"10.1016/j.clon.2025.103886","DOIUrl":"10.1016/j.clon.2025.103886","url":null,"abstract":"<div><h3><em>Aims</em></h3><div>While there are many published quality indicators (QIs) for assessing clinical care in lung cancer, few specifically measure the quality of radiotherapy (RT). To address this gap, we used a structured modified Delphi technique to develop a core set of QIs and benchmarks to evaluate RT processes for lung cancer treatment.</div></div><div><h3><em>Materials and methods</em></h3><div>Candidate QIs identified from the systematic review were evaluated through survey consensus and deliberation by a multidisciplinary reference committee for inclusion in the initial survey and then after each round. A modified Delphi technique was employed across two rounds to reach consensus for QI development. The international expert survey panel consisting of radiation oncologists treating lung cancer rated QI importance, feasibility, and benchmarks, with consensus predefined as at least 70% of respondents reaching a threshold rating on a Likert scale.</div></div><div><h3><em>Results</em></h3><div>There were 70 respondents over two surveys, with 30 of the 47 QIs reaching the threshold for importance in the first Delphi round and 29 after the final Delphi round. Agreement ranged from 71% to 97% with 12 QIs reaching a consensus of 90% or more. Final consensus was reached as all 29 QIs were identified as feasible, and 27 of the suggested benchmarks were deemed acceptable.</div></div><div><h3><em>Conclusion</em></h3><div>This core set of QIs provides a well-defined framework for evaluating RT processes in lung cancer treatment. They have the potential to establish a foundation for standardised quality measurement and benchmarking for guiding quality improvement efforts and improving patient outcomes.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"44 ","pages":"Article 103886"},"PeriodicalIF":3.2,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481809","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 Squamous Cell Carcinoma of Unknown Primary","authors":"I.S. Boon","doi":"10.1016/j.clon.2025.103885","DOIUrl":"10.1016/j.clon.2025.103885","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"44 ","pages":"Article 103885"},"PeriodicalIF":3.2,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470264","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":"Liquid Biopsy Follow-up for Oropharyngeal Squamous Cell Carcinoma After Curative-intent Treatment","authors":"J.S. Lim ,&nbsp;F.X. Y Kua ,&nbsp;T.P.T. Au Yong ,&nbsp;C.S. Boon ,&nbsp;I.S. Boon","doi":"10.1016/j.clon.2025.103884","DOIUrl":"10.1016/j.clon.2025.103884","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"44 ","pages":"Article 103884"},"PeriodicalIF":3.2,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470265","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":"Digital Health in Clinical Oncology","authors":"M. Thor ,&nbsp;A. McWilliam ,&nbsp;S.S. Ahmad","doi":"10.1016/j.clon.2025.103881","DOIUrl":"10.1016/j.clon.2025.103881","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"44 ","pages":"Article 103881"},"PeriodicalIF":3.2,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322634","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":"Dose Accumulation for Pelvic Stereotactic Ablative Body Radiotherapy Reirradiation. In Regard to Slevin et al.","authors":"A. Elmali ,&nbsp;B. Demirhan ,&nbsp;C. Onal","doi":"10.1016/j.clon.2025.103882","DOIUrl":"10.1016/j.clon.2025.103882","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"44 ","pages":"Article 103882"},"PeriodicalIF":3.2,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271314","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":"Effectiveness of Intensity Modulate Proton Therapy in Managing Complex Multiple Meningiomas: A Dosimetric and Radiobiological Comparative Study with Helical Tomotherapy on Neurological Risk","authors":"G. Singh ,&nbsp;D. Sharma ,&nbsp;S. Gayen ,&nbsp;G. Krishnan ,&nbsp;U. Krishna ,&nbsp;G. Aishwarya ,&nbsp;J. Mary Mathew ,&nbsp;R. Jalali","doi":"10.1016/j.clon.2025.103877","DOIUrl":"10.1016/j.clon.2025.103877","url":null,"abstract":"<div><h3>Purpose</h3><div>This study addresses the challenges of sparing neurological organs at risk (OARs) in radiation therapy for multiple meningiomas (MM) by introducing a novel, robust intensity-modulated proton therapy (IMPT) plan and assessing its dosimetric and radiobiological outcomes relative to helical tomotherapy (HT).</div></div><div><h3>Methods</h3><div>CT and MRI datasets from 24 MM patients were used to generate competing IMPT and HT plans. IMPT employed a spot-assignment strategy with five static fields and was robustly optimized for CTV-sum, considering 2–3 mm setup and 2% range uncertainty, while HT was optimized on PTV-sum. The median prescribed dose was 50.2 GyRBE in 28 fractions.</div></div><div><h3>Results</h3><div>The number of isolated CTVs per patient ranged from 2 to 9, with total target volumes of 27.69–1153.61 cc (CTV-sum) and 62.5–1415.25 cc (PTV-sum). The mean±SD dose difference in D_95% between PTV-sum in HT and CTV-sum in the IMPT worst-case scenario (-0.58 ± 0.57 GyRBE, p = 0.03) was clinically acceptable. While D_mean to PTV-sum showed no significant difference (p = 0.06), D2% was significantly higher in IMPT (p = 0.006) than in HT. IMPT significantly reduced both D_max and D_mean for most OARs (p &lt; 0.05) and lowered integral dose to normal brain tissue (p &lt; 0.0001) by a factor of 1.37–6.97 compared to HT. Significant NTCP reductions (p &lt; 0.05) were observed for the lenses, eyes, brainstem, optic nerves, and cochlea.</div></div><div><h3>Conclusions</h3><div>IMPT ensures robust target coverage while significantly lowering D_max, D_mean, and NTCP for several OARs compared to HT. Its reduced integral dose to normal brain tissue may benefit re-irradiation and lower second cancer risk.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"44 ","pages":"Article 103877"},"PeriodicalIF":3.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144270863","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":"Impacts of a Clinical Quality Registry on Lung Cancer Quality Measures: A Retrospective Observational Study of the Victorian Lung Cancer Registry","authors":"R.G. Stirling ,&nbsp;U. Samankula ,&nbsp;M. Lloyd ,&nbsp;M. Brand ,&nbsp;L. Briggs ,&nbsp;J. Lesage ,&nbsp;T. Wood ,&nbsp;C. Underhill ,&nbsp;S. Parakh ,&nbsp;W. Faisal ,&nbsp;R. Blum ,&nbsp;G. Richardson ,&nbsp;P. Parente ,&nbsp;M. Caldecott ,&nbsp;I. Olesen ,&nbsp;J. Torres ,&nbsp;E. Samuel ,&nbsp;B. Jennings ,&nbsp;K. See ,&nbsp;D. Langton ,&nbsp;J. Zalcberg","doi":"10.1016/j.clon.2025.103878","DOIUrl":"10.1016/j.clon.2025.103878","url":null,"abstract":"<div><h3>Aim</h3><div>Clinical quality registries (CQRs) monitor the quality of healthcare by collecting, analysing and reporting benchmarked clinical quality performance outcomes to stakeholder institutions, with the objective of closing the research evidence-practice gap. Little is known of the effects of CQR function on clinical outcomes in lung cancer.</div></div><div><h3><em>Materials and methods</em></h3><div>We studied the attainment of 25 clinical quality indicators (CQIs), in consecutive, newly diagnosed lung cancer patients to assess longitudinal unwarranted clinical variation, quality indicator attainment and consequent survival impacts. This study was an observational cohort study of the Victorian Lung Cancer Registry in Victoria, Australia, between 2016 and 2021.</div></div><div><h3><em>Results</em></h3><div>We studied 12,121 consecutive patients, observing substantial variation in care in institutional indicator attainment for all indicators ranging from very low (2.1%) to high (90%) at study outset. Indicator attainment over time increased (n = 6 indicators), remained stable (n = 17), and decreased (n = 2). The attainment of CQI was associated with a significant reduction in mortality hazard for the majority of indicators (n = 15; HR reduced 10%–67%), and an increase in mortality hazard associated with 3 indicators (HR increased 32%–48%). Population level evaluation of indicators revealed multiple modifiable drivers that may be targeted to enhance indicator attainment. Non-small cell lung cancer (NSCLC) survival analysis identified significant improvement evident for stage II and IV NSCLC in the pre-COVID era and stage I overall.</div></div><div><h3><em>Conclusion</em></h3><div>Clinical quality registries are potentially transformative tools for the definition and engagement of learning health systems in the healthcare quality improvement cycle. This study identified significant variation in hospital lung cancer CQI attainment and unwarranted variation between stakeholder sites. Stakeholder focus on this variation provides context-specific opportunity to identify local improvement opportunities. These process measures impact outcome measures, including survival, and enable the evaluation of the evidence-practice gap for service innovation and iterative quality improvement.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"44 ","pages":"Article 103878"},"PeriodicalIF":3.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281109","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":"Weathering the Storm: The Impact of Weather Events, Lockdowns and Holidays on Oncology and General Emergency Presentations to a United Kingdom Tertiary Centre-A 7.5-year Review","authors":"M.T.K. Cheng ,&nbsp;N. White ,&nbsp;S. Frost ,&nbsp;H. Attia ,&nbsp;D.M. Favara","doi":"10.1016/j.clon.2025.103879","DOIUrl":"10.1016/j.clon.2025.103879","url":null,"abstract":"<div><h3><strong>Aims</strong></h3><div>Weather extremes, public holidays and weekend effects modulate emergency department activity. Their impact on oncology-specific emergency presentations remains poorly defined. The aim of this study was to determine how COVID-19 lockdowns, weather extremes, and calendar factors influence oncology emergency presentations versus all-cause emergency presentations at a United Kingdom tertiary academic centre.</div></div><div><h3><strong>Materials and Methods</strong></h3><div>We conducted a 7.5-year retrospective time-series analysis of daily oncology-specific and all-cause emergency presentations (1/01/2017-9/7/2024). A quasi‑Poisson distributed lag non-linear model quantified same-day and cumulative (0-21 day) effects of COVID-19 lockdowns, weather extremes (≤2.5^th or ≥97.5^th percentile), public holidays, and day of the week, on daily presentation rates.</div></div><div><h3><strong>Results</strong></h3><div>Of 970,884 emergencies, 27,946 (2.9%) were oncology-specific. Lockdowns reduced oncology emergencies by 11% (cumulative relative risk [RR] = 0.89; 95% CI: 0.80-0.99, <em>P</em> = 0.034) and all-cause attendances by 6% (cumulative RR = 0.94; 95% CI: 0.92-0.97, <em>P</em> &lt; 0.0001). Both rebounded after lockdown. Oncology presentations showed no significant association with extreme cold/heat, heavy rainfall or snow, whereas all-cause attendances rose 6% in very-cold weather (cumulative RR= 1.06; 95% CI: 1.03-1.10, <em>P</em> = 0.0009) and fell 7% in heavy rain (cumulative RR = 0.93; 95% CI: 0.89-0.98, <em>P</em> = 0.002). Public holidays halved oncology emergencies (cumulative RR = 0.49; 95% CI: 0.44-0.55, <em>P</em> &lt; 0.001) versus a 9% fall in all-cause emergencies (cumulative RR = 0.91; 95% CI: 0.90-0.93; <em>P</em> &lt; 0.0001). The Boxing Day to New Year period increased oncology emergencies by 21% (same day RR = 1.21; 95% CI: 1.09-1.33, <em>P</em> = 0.0002) and all-cause by 4% (cumulative RR = 1.04; 95% CI: 1.02-1.06, <em>P</em> = 0.001). Weekend volumes for oncology emergencies fell 58% (cumulative RR = 0.42; 95% CI: 0.39-0.45, <em>P</em> &lt; 0.0001), compared with a 15% decrease in all-cause emergencies (same day RR = 0.85; 95% CI: 0.84-0.86, <em>P</em> &lt; 0.0001).</div></div><div><h3><strong>Conclusion</strong></h3><div>Oncology emergency demand was significantly influenced by calendar constraints (public holidays, weekends, lockdowns) but not by weather extremes. All-cause emergencies were influenced by both calendar and weather extremes. Calendar-based rostering of oncology staff around holiday periods and weekends may therefore yield greater benefit than weather-triggered surge plans. Validation in centres with wetter or more extreme climates is warranted.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"44 ","pages":"Article 103879"},"PeriodicalIF":3.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144489556","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}