Clinical oncologyPub Date : 2025-06-18DOI: 10.1016/j.clon.2025.103895
I. Navarro-Domenech , J. Helou , S. Kuruvilla Thomas , L.A. Dawson , A. Hosni , S. Raman , P. Chung , R. Wong , R. Glicksman , P. Lindsay , J. Javor , J. Weiss , A.J. Hope , A.S. Barry
{"title":"Tumour-Specific Growth Rate as a Potential Predictor of Outcomes in Oligoprogressive Disease Treated With Stereotactic Body Radiotherapy","authors":"I. Navarro-Domenech , J. Helou , S. Kuruvilla Thomas , L.A. Dawson , A. Hosni , S. Raman , P. Chung , R. Wong , R. Glicksman , P. Lindsay , J. Javor , J. Weiss , A.J. Hope , A.S. Barry","doi":"10.1016/j.clon.2025.103895","DOIUrl":"10.1016/j.clon.2025.103895","url":null,"abstract":"<div><h3>Aims</h3><div>Growing data suggest a potential progression-free survival advantage with stereotactic body radiotherapy (SBRT) in oligoprogressive disease (OPD). However, optimal candidates remain uncertain. This study aims to investigate tumour-specific growth rate as a potential predictor of outcomes in OPD.</div></div><div><h3>Materials and Methods</h3><div>Patients with ≤5 radiological OPDs were enrolled in a prospective phase II study. SBRT-treated metastases were retrospectively contoured on (1) gross tumour volume (GTV)1—pre-SBRT/baseline computed tomography (CT); (2) GTV2—SBRT planning CT, (3) GTV3—post-SBRT follow-up CT. Specific growth rate for each oligoprogressive lesion (SGR_OP) was calculated according to the literature as (ln(GTVy/GTVx)/t) %/d (t = days). SGR_OP1 was defined as pre-SBRT growth (from SBRT planning CT scan to baseline imaging) and SGR_OP2 as post-SBRT growth (from follow-up CT to planning CT). A high SGR_OP1/2 was defined as one greater than the median SGR_OP1/2 value. The primary endpoint was the impact of SGR1/2 on overall survival (OS) rate, which was estimated using the Kaplan-Meier method and Cox proportional hazards models. Local progression (LP) was progression to the treated lesion, while disease progression (DP) was progression of other nontreated metastases. Cumulative incidence function and Fine-Grey subdistribution hazard models were utilised to estimate progression rates.</div></div><div><h3>Results</h3><div>Thirty-five patients with 55 metastases grouped in gastrointestinal (GI) (40%), genitourinary (GU) (31%), and breast (29%) cancer groups were analysed. The median follow-up was 11.74 months (interquartile range [IQR]: 8.05, 15.65). The median SGR_OP1 and SGR_OP2 value was 0.007 %/d (IQR: 0.004, 0.013) and -0.009 %/d (IQR: -0.014 to 0.002), respectively. Forty-eight percent of patients had high SGR_OP1 (>0.007 %/d). and 50% had high SGR_OP2 (>-0.009 %/d). The 12-month OS rate was 59% (95% confidence interval [CI]: 44.2-78.1), which was significantly lower in the GI group (14% [95% CI: 4-51.5], [<em>P</em> = 0.002]) than in the GU and breast groups. A low SGR_OP1 showed higher rates of OS than high SGR_OP1 (71% vs 47%, <em>P</em> = 0.35).</div></div><div><h3>Conclusion</h3><div>SGR_OP analysis appears to demonstrate a wide range of growth rates within individual cancer group and may allow prediction of patient outcomes independent of histology. Additional validation will be required to confirm if this tool can be used to predict outcomes.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"44 ","pages":"Article 103895"},"PeriodicalIF":3.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549257","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}
Clinical oncologyPub Date : 2025-06-18DOI: 10.1016/j.clon.2025.103890
D.-w. Zhao , H.-y. Jiang , W.-j. Fan , L.-l. Meng , Y.-j. Qu , G.-b. Ren , X.-f. Guo , C.-l. Liu , B.-n. Cai , P.-g. Wang , L. Ma
{"title":"A Comparative Study of Initiated Chemotherapy Versus Initiated Surgery Combined with Primary-Radiotherapy in Locoregionally Advanced Hypopharyngeal Carcinoma","authors":"D.-w. Zhao , H.-y. Jiang , W.-j. Fan , L.-l. Meng , Y.-j. Qu , G.-b. Ren , X.-f. Guo , C.-l. Liu , B.-n. Cai , P.-g. Wang , L. Ma","doi":"10.1016/j.clon.2025.103890","DOIUrl":"10.1016/j.clon.2025.103890","url":null,"abstract":"<div><h3>Background</h3><div>Laryngeal preservation is a pivotal treatment goal in managing locally advanced hypopharyngeal carcinoma (LAHPC). This study compares the outcomes of induction chemotherapy followed by concurrent chemoradiotherapy (IcRT) and surgery followed by radiotherapy or concurrent chemoradiotherapy (SurRT) in patients with LAHPC.</div></div><div><h3>Methods</h3><div>This study included 182 patients with LAHPC treated with either IcRT (n = 137) or SurRT (n = 45). Survival with a functional larynx (SFL), overall survival (OS), progression-free survival (PFS), local failure-free survival (LFFS), locoregional failure-free survival (LRFFS), and distant metastasis-free survival (DMFS) were analyzed. Propensity score matching (PSM) was performed to balance baseline characteristics between the two treatment groups.</div></div><div><h3>Results</h3><div>The IcRT group demonstrated significantly superior 5-yr SFL compared to the SurRT group (50.4% vs. 30.5%, HR 2.38, 95% CI 1.40–4.03, P < 0.001). However, there were no significant differences between the two groups in 5-yr OS (55.2% vs. 56.8%, HR 0.80, P = 0.41), PFS (48.5% vs. 45.7%, HR 0.99, P = 0.99), LFFS (55.1% vs. 57.7%, HR 0.86, P = 0.57), or DMFS (50.2% vs. 42.8%, HR 1.02, P = 0.90), in both pre- and post-PSM analyses. The IcRT group exhibited greater radiation-related toxicities but achieved better local control and distant metastasis rates, while the SurRT group had a lower rate of regional recurrence. T classification and clinical stage were identified as independent prognostic factors for survival outcomes.</div></div><div><h3>Conclusions</h3><div>IcRT may offer enhanced laryngeal preservation compared to SurRT in select patients, albeit with higher acute toxicities. Treatment decisions should prioritize both oncologic outcomes and patient tolerance.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"44 ","pages":"Article 103890"},"PeriodicalIF":3.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549256","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}
Clinical oncologyPub Date : 2025-06-18DOI: 10.1016/j.clon.2025.103892
C. Zhang , H. Zhao , Q. Shi
{"title":"Postoperative Circulating Tumour DNA in Predicting Recurrence of Non-small Cell Lung Cancer: A Systematic Review and Meta-analysis","authors":"C. Zhang , H. Zhao , Q. Shi","doi":"10.1016/j.clon.2025.103892","DOIUrl":"10.1016/j.clon.2025.103892","url":null,"abstract":"<div><h3>Aims</h3><div>Circulating tumour DNA (ctDNA) has become a noninvasive biomarker for dynamic monitoring of tumours. However, available evidence on postoperative ctDNA in patients with non-small cell lung cancer (NSCLC) is limited. This systematic review and meta-analysis aims to appraise the prognostic value of postoperative ctDNA in NSCLC.</div></div><div><h3>Materials and methods</h3><div>PubMed, Cochrane, Web of Science, and Embase were retrieved until May 20, 2024, to identify potentially eligible studies. The primary outcomes were relapse-free survival (RFS) and overall survival (OS) based on the status of postoperative ctDNA. Subgroup analyses were conducted according to baseline characteristics. Data quality were appraised using the Newcastle-Ottawa scale. The meta-analysis was performed using Stata18.</div></div><div><h3>Results</h3><div>Total of 13 studies on predicting NSCLC recurrence based on postoperative ctDNA were included. According to the meta-analysis, postoperative ctDNA-positive patients had markedly shorter RFS (HR = 6.05, 95% CI: 4.48–8.18, <em>P</em> < 0.01) compared to ctDNA-negative patients. Furthermore, ctDNA-positive patients exhibited a shorter OS (HR = 4.53, 95% CI: 2.56–8.02, <em>P</em> < 0.01) than ctDNA-negative patients.</div></div><div><h3>Conclusion</h3><div>Postoperative ctDNA detection can predict tumour recurrence and overall survival in NSCLC patients.</div></div><div><h3>PROSPERO registration number</h3><div>CRD42024577421.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"44 ","pages":"Article 103892"},"PeriodicalIF":3.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144534786","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}
Clinical oncologyPub Date : 2025-05-30DOI: 10.1016/j.clon.2025.103886
K.-L. Chiew , C. Donnelly , S.V. Harden , G.G. Hanna , N. Hardcastle , S. Jolly , M. Lehman , M.M. Matuszak , F. McDonald , Y.Y. Soon , Y.M. Tsang , F. Ynoe Moraes , S.K. Vinod
{"title":"Quality Indicators and Benchmarks for Radiotherapy in Lung Cancer: A Modified Delphi Approach","authors":"K.-L. Chiew , C. Donnelly , S.V. Harden , G.G. Hanna , N. Hardcastle , S. Jolly , M. Lehman , M.M. Matuszak , F. McDonald , Y.Y. Soon , Y.M. Tsang , F. Ynoe Moraes , 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}
Clinical oncologyPub Date : 2025-05-28DOI: 10.1016/j.clon.2025.103882
A. Elmali , B. Demirhan , C. Onal
{"title":"Dose Accumulation for Pelvic Stereotactic Ablative Body Radiotherapy Reirradiation. In Regard to Slevin et al.","authors":"A. Elmali , B. Demirhan , 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}