Clinical oncology最新文献

{"title":"Immune-related and Common Adverse Events With Programmed Cell Death 1/Programmed Cell Death Ligand 1 inhibitors combined with other Anticancer Therapy for Solid Tumors: A Systematic Review and Meta-analysis","authors":"T. Inoue ,&nbsp;M. Narukawa","doi":"10.1016/j.clon.2024.10.034","DOIUrl":"10.1016/j.clon.2024.10.034","url":null,"abstract":"<div><h3>Aims</h3><div>The combination of programmed cell death 1 (PD-1)/programmed cell death ligand 1 (PD-L1) inhibitors and anticancer therapies has been in the spotlight in recent years. However, the risks associated with these combination therapies are not fully elucidated. The primary objective of this study was to evaluate the relative risk of organ-specific immune-related adverse events (irAEs) and common adverse events (AEs) in patients treated with PD-1/PD-L1 inhibitor–based combination therapies compared to those treated with PD-1/PD-L1 inhibitor monotherapy for solid tumors.</div></div><div><h3>Materials and methods</h3><div>An electronic database search was performed using ClinicalTrials.gov, Medline, and American Society of Clinical Oncology (ASCO)/European Society for Medical Oncology (ESMO) annual meeting libraries. We included randomized controlled trials designed to assess the safety of combination therapies using PD-1/PD-L1 inhibitors and other anticancer drugs. All the selected clinical studies included solid tumors and provided information on the incidence of nonserious and serious AEs. The quality of evidence was assessed using the Cochrane risk-of-bias tool. A meta-analysis was performed using random-effect models to pool the results.</div></div><div><h3>Results</h3><div>The primary analysis included 16 relevant clinical studies comprising 4232 patients, of whom 2071 and 2161 patients received PD-1/PD-L1 inhibitor–-based combination therapy and PD-1/PD-L1 inhibitor monotherapy, respectively. Serious organ-specific irAEs were infrequent, even when PD-1/PD-L1 inhibitors were combined with other anticancer drugs. The incidence of serious colitis was significantly higher in the combination therapy group than in the monotherapy group. Among the common AEs associated with PD-1/PD-L1 inhibitors, the incidence of serious pyrexia/fever, nonserious pyrexia/fever, fatigue, nausea, decreased appetite, vomiting, diarrhea, dyspnea, and rash significantly increased in the combination therapy group. In the subgroup analysis based on the modes of action of concomitant anticancer drugs, the combination of PD-1/PD-L1 inhibitors and DNA synthesis inhibitors significantly increased the risk of serious colitis compared to PD-1/PD-L1 inhibitor monotherapy.</div></div><div><h3>Conclusion</h3><div>Organ-specific irAEs occur infrequently when combinations of PD-1/PD-L1 inhibitors and other anticancer drugs are used. However, the risk of serious colitis and certain AEs is higher than that associated with PD-1/PD-L1 inhibitor monotherapy. Vigilant monitoring of AEs and implementation of appropriate clinical management strategies guided by the mode of action of the combination drugs are essential.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"37 ","pages":"Article 103662"},"PeriodicalIF":3.2,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615147","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":"Clinical Outcomes and Relevance of Composite V12 Gy in Patients With Four or More Brain Metastases Treated With Single Fraction Stereotactic Radiosurgery","authors":"S. Parikh ,&nbsp;U. Alluri ,&nbsp;G. Heyes ,&nbsp;F. Evison ,&nbsp;S. Meade ,&nbsp;H. Benghiat ,&nbsp;A. Hartley ,&nbsp;M. Hickman ,&nbsp;V. Sawlani ,&nbsp;S. Chavda ,&nbsp;V. Wykes ,&nbsp;P. Sanghera","doi":"10.1016/j.clon.2024.10.035","DOIUrl":"10.1016/j.clon.2024.10.035","url":null,"abstract":"<div><h3><em>Aims</em></h3><div>Tissue V12Gy (total brain volume receiving 12Gy including target) can predict for late toxicity in single target benign disease treated with stereotactic radiosurgery (SRS). The value of this metric remains uncertain for multiple brain metastases. This retrospective cohort study reports the outcomes and evaluates the predictors of toxicity in patients with four or more brain metastases treated with single-fraction SRS.</div></div><div><h3><em>Materials and methods</em></h3><div>Two hundred twenty-six patients with 2160 metastases treated from 2014-21 were retrospectively studied. Symptomatic late toxicity (new/progressive neurological symptoms ≥3 months post SRS) with magnetic resonance imaging (MRI) changes suggestive of treatment effect were analysed. Kaplan–Meier and competing risk analysis was used to assess survival and toxicity respectively.</div></div><div><h3><em>Results</em></h3><div>median number of metastases/patient was 6 (range: 4-41) and median composite tissue V12Gy (inclusive of planning target volume (PTV)) was 11.3 cc (IQR: 6.1 cc–17.1 cc). Sixteen out of the 226 patients developed symptomatic late radiation adverse event (R-AE), and the cumulative incidence was 4.9% at 1 year and 6.9% at 2 years. The total target volume was significantly predictive of the risk of late R-AE. Volume of the largest lesion, V12Gy and V15Gy did not predict for late R-AE, but plotted graphs showed suggestions of linear relationships between dosimetric parameters and late R-AE.</div></div><div><h3><em>Conclusion</em></h3><div>Within the limitations of this study, the cumulative incidence of symptomatic toxicity remains acceptable despite routinely accepting a composite tissue V12Gy in excess of 10 cc to treat multiple brain metastases.</div></div><div><h3><em>Advances in knowledge</em></h3><div>V12Gy has limitations as a plan quality metric in multiple brain metastases treated with SRS. There is insufficient evidence to have a defined target limit as &lt;10 cc.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"37 ","pages":"Article 103663"},"PeriodicalIF":3.2,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615238","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":"OSAIRIS: Lessons Learned From the Hospital-Based Implementation and Evaluation of an Open-Source Deep-Learning Model for Radiotherapy Image Segmentation","authors":"A.D. Constantinou ,&nbsp;A. Hoole ,&nbsp;D.C. Wong ,&nbsp;G.S. Sagoo ,&nbsp;J. Alvarez-Valle ,&nbsp;K. Takeda ,&nbsp;T. Griffiths ,&nbsp;A. Edwards ,&nbsp;A. Robinson ,&nbsp;L. Stubbington ,&nbsp;N. Bolger ,&nbsp;Y. Rimmer ,&nbsp;T. Elumalai ,&nbsp;K.T. Jayaprakash ,&nbsp;R. Benson ,&nbsp;I. Gleeson ,&nbsp;R. Sen ,&nbsp;L. Stockton ,&nbsp;T. Wang ,&nbsp;S. Brown ,&nbsp;R. Jena","doi":"10.1016/j.clon.2024.10.032","DOIUrl":"10.1016/j.clon.2024.10.032","url":null,"abstract":"<div><div>Several studies report the benefits and accuracy of using autosegmentation for organ at risk (OAR) outlining in radiotherapy treatment planning. Typically, evaluations focus on accuracy metrics, and other parameters such as perceived utility and safety are routinely ignored. Here, we report our finding from the implementation and clinical evaluation of OSAIRIS, an open-source AI model for radiotherapy image segmentation that was carried out as part of its development into a medical device. The device contours OARs in the head and neck and male pelvis (referred to as the prostate model), and is designed to be used as a time-saving workflow device, alongside a clinician. Unlike standard evaluation processes, which heavily rely on accuracy metrics alone, our evaluation sought to demonstrate the tangible benefits, quantify utility and assess risk within a specific clinical workflow. We evaluated the time-saving benefit this device affords to clinicians, and how this time-saving might be linked to accuracy metrics, as well as the clinicians' assessment of the usability of the OSAIRIS contours in comparison to their colleagues' contours and those from other commercial AI contouring devices. Our safety evaluation focused on whether clinicians can notice and correct any errors should they be included in the output of the device.</div><div>We found that OSAIRIS affords a significant time-saving of 36% (5.4 ± 2.1 minutes) when used for prostate contouring and 67% (30.3 ± 8.7 minutes) for head and neck contouring. Combining editing time data with accuracy metrics, we found the Hausdorff distance best correlated with editing-time, outperforming dice, the industry-standard, with a Spearman correlation coefficient of 0.70, and a Kendall coefficient of 0.52. Our safety and risk-mitigation exercise showed that anchoring bias is present when clinicians edit AI-generated contours, with the effect seemingly more pronounced for some structures over others. Most errors, however, were corrected by clinicians, with 72% of the head and neck errors 81% of the prostate errors removed in the editing step. Notably, our blinded clinician contour rating exercise showed that gold standard clinician contours are not rated more highly than the AI-generated contours.</div><div>We conclude that evaluations of AI in a clinical setting must consider the clinical workflow in which the device will be used, and not rely on accuracy metrics alone, in order to reliably assess the benefits, utility and safety of the device. The effects of human-AI inter-operation must be evaluated to accurately assess the practical usability and potential uptake of the technology, as demonstrated in our blinded clinical utility review. The clinical risks posed by the use of the device must be studied and mitigated as far as possible, and our ‘Mystery Shopping’ experiment provides a template for future such assessments.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"37 ","pages":"Article 103660"},"PeriodicalIF":3.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615420","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":"RCR Meetings","authors":"","doi":"10.1016/S0936-6555(24)00407-2","DOIUrl":"10.1016/S0936-6555(24)00407-2","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"36 11","pages":"Page I"},"PeriodicalIF":3.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142530279","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":"Oncoflash November 2024 Edition","authors":"D. Shor,&nbsp;R. Simões","doi":"10.1016/j.clon.2024.08.013","DOIUrl":"10.1016/j.clon.2024.08.013","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"36 11","pages":"Pages 659-661"},"PeriodicalIF":3.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142529266","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":"Breast Cancer Prognosis in Young BRCA1/BRCA2 Mutation Carriers: A Retrospective Hospital-based Cohort Study","authors":"F. Hego ,&nbsp;M. Barthoulot ,&nbsp;S. Chretien ,&nbsp;C. Pierard ,&nbsp;M. Boulaire ,&nbsp;S. Bécourt ,&nbsp;L. Boulanger ,&nbsp;L. Ceugnart ,&nbsp;A.L. Conoy ,&nbsp;F. Oca ,&nbsp;A. Mailliez","doi":"10.1016/j.clon.2024.10.030","DOIUrl":"10.1016/j.clon.2024.10.030","url":null,"abstract":"<div><h3>Aim</h3><div>Studies evaluating the prognostic impact of germline BRCA1/2 mutations (g<em>BRCA</em>m) in patients with breast cancer report conflicting results. Therefore, we aimed to investigate outcomes of patients with g<em>BRCA</em> mutations and early onset of breast cancer (&lt;30 years) compared with those of noncarriers.</div></div><div><h3>Materials and methods</h3><div>This retrospective study included 149 patients recruited between 2005 and 2019. The outcomes were overall survival (OS) and disease-free survival (DFS), which were defined as the time from the first diagnosis to death from any cause and the first recurrence, second cancer, or death from any cause, respectively. Key patient data, Kaplan–Meier plots, and outcomes were described according to the <em>BRCA</em> mutation status. Hazard ratios (HR) were calculated using the Cox proportional hazards model.</div></div><div><h3>Results</h3><div>Twenty-eight patients (28/149; 18.8 %) were g<em>BRCA</em>m carriers. The OS median follow-up was 8.2 years. OS was 89.3% [70.4–96.4] in carriers vs 99.2% [95% CI: 94.3–99.9] in non-carrier patients at 2 years; 85.2% [65.2–94.2] vs 93.0% [86.5–96.5] at 5 years, and 76.5% [54.7–88.8] vs 85.2% [75.7–91.2] at 10 years. There was no difference in OS between groups in multivariable analysis (HR = 1.90 [0.69–5.23], p = 0.22). The DFS median follow-up was 6.6 years. Similar results were observed for DFS (HR = 1.39 [0.63–3.08], p = 0.42).</div></div><div><h3>Conclusion</h3><div>In this large hospital-based cohort of patients with very early-onset breast cancer, we found no clear evidence that g<em>BRCA</em>1/2m significantly affects OS after adjusting for known prognostic factors.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"37 ","pages":"Article 103658"},"PeriodicalIF":3.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589799","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":"OncoFlash-Research Updates in a Flash!","authors":"S Parikh, K T Jayaprakash","doi":"10.1016/j.clon.2024.10.031","DOIUrl":"https://doi.org/10.1016/j.clon.2024.10.031","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":" ","pages":"103659"},"PeriodicalIF":3.2,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615207","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":"Danish and Swedish National Data Collections for Cancer – Solutions for Radiotherapy","authors":"C.E. Olsson ,&nbsp;S.L. Krogh ,&nbsp;M. Karlsson ,&nbsp;J.G. Eriksen ,&nbsp;T. Björk-Eriksson ,&nbsp;C. Grau ,&nbsp;D. Norman ,&nbsp;B.V. Offersen ,&nbsp;T. Nyholm ,&nbsp;J. Overgaard ,&nbsp;B. Zackrisson ,&nbsp;C.R. Hansen","doi":"10.1016/j.clon.2024.10.009","DOIUrl":"10.1016/j.clon.2024.10.009","url":null,"abstract":"<div><div>Collecting large amounts of radiotherapy (RT) data from clinical systems is known to be a challenging task. Still, data collections outside the original RT systems are needed to follow-up on the quality of cancer care and to improve RT. This paper aims to describe how RT data is collected nationally in Denmark and Sweden for this purpose and gives an overview of the stored information in both countries' national data sources.</div><div>Although both countries have clinical national quality registries with broad coverage and completeness for many cancer diagnoses, some were initiated already in the seventies, and less than one in ten includes quantitative information on RT to a level of detail useful for more than basic descriptive statistics. Detailed RT data can, however, be found in Denmark's DICOM Collaboration (DcmCollab) database, initiated in 2009 and in Sweden's quality registry for RT launched in 2023 (SKvaRT). Denmark has collected raw DICOM data for all patients enrolled in clinical trials, with files being directly and automatically transferred to DcmCollab from the original data sources at each RT centre. Sweden collects aggregated RT data into SKvaRT for all patients undergoing RT in Sweden, with DICOM files being transferred and selected alpha-numeric variables forwarded via a local intermediate storage database (MIQA) at each hospital. In designing their respective solutions, both countries have faced similar challenges regarding which RT variables to collect and how to technically link clinical systems to their data repositories. General lessons about how flexibility currently is balanced with storage requirements and data standards are presented here together with future plans to harvest real-world RT data.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"37 ","pages":"Article 103657"},"PeriodicalIF":3.2,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615143","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":"Real World Outcomes in Patients With Recurrent, Advanced, or Metastatic Endometrial Cancer Treated With Lenvatinib Plus Pembrolizumab","authors":"A. Pawsey ,&nbsp;P. Mahalingam ,&nbsp;N. Senthivel ,&nbsp;A. Ramessur ,&nbsp;E. Turnbull ,&nbsp;S. Usman ,&nbsp;R. Browne ,&nbsp;A. Patel ,&nbsp;A. Stewart ,&nbsp;L. Tookman ,&nbsp;N. Counsell ,&nbsp;R. Miller ,&nbsp;S. Nicum ,&nbsp;G. Eminowicz","doi":"10.1016/j.clon.2024.10.008","DOIUrl":"10.1016/j.clon.2024.10.008","url":null,"abstract":"<div><h3>Aims</h3><div>Patients with endometrial cancer who progress following first line therapy have improved survival outcomes with pembrolizumab and lenvatinib (pem/len) compared with standard of care chemotherapy, as demonstrated in KEYNOTE-775. This was in a group of trial patients with good performance status and excluded those with carcinosarcoma histology. In KEYNOTE-775 pem/len was associated with significant toxicity, leading to dose reductions, treatment cessation, and patient morbidity. We set out to assess the tolerability, toxicity and outcomes following pem/len for patients with recurrent, advanced or metastatic endometrial cancer in a real-world setting.</div></div><div><h3>Materials and methods</h3><div>UK centres treating patients with pem/len for advanced endometrial cancer within the compassionate access programme were approached. Retrospective data were analysed for those treated between May 2022 and June 2023. Data on patient demographics, treatment, toxicity and outcomes were extracted from medical records. Toxicity and tolerability were compared in those over and under the age of 70.</div></div><div><h3>Results</h3><div>Seven centres returned data for 70 patients. Median age of patients was 68.5 years (range 45–85) with a performance status of 0–1 in 77.1% and of 2 in 22.9%. Histological subtypes included serous (34.3%), endometrioid (32.9%), carcinosarcoma (14.3%), clear cell (7.1%), mixed (2.9%) and other (8.6%). Grade ≥3 toxicity was reported in 55.7% with any-grade toxicity observed in 85.7%. In those aged ≥70 years (n = 30) the rate of grade ≥3 toxicity was 60.0%. Rates of dose reduction of lenvatinib were 64.3%, and toxicity-related treatment interruption was 45.7%. The 6-month progression-free and overall survival rates were 54.0% (95%CI: 39.0–66.8) and 70.1% (95%CI:56.5–80.1) respectively.</div></div><div><h3>Conclusion</h3><div>This real-world, observational study of pem/len showed comparable tolerability, toxicity, and outcomes to previously reported clinical trial data. Our cohort included patients with a poorer PS and a broader range of histological subtypes including carcinosarcoma.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"37 ","pages":"Article 103656"},"PeriodicalIF":3.2,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589868","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":"Early Outcomes of Preoperative Short Course Radiotherapy With Simultaneous Integrated Boost and Response-adapted Chemotherapy for Advanced Rectal Cancer","authors":"B. Chan ,&nbsp;N.S.M. Wong ,&nbsp;B.B.W. Wo ,&nbsp;O.L. Chan ,&nbsp;A.S. Lee","doi":"10.1016/j.clon.2024.10.005","DOIUrl":"10.1016/j.clon.2024.10.005","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Limited evidence exists for dose escalation in neoadjuvant short course radiotherapy (SCRT) for rectal cancer. With enhanced imaging and radiotherapy techniques over the past decades along with the valuable endpoint of pathological complete response (pCR), we believe SCRT with simultaneous integrated boost could potentially provide deeper pathological responses and improve local control.</div></div><div><h3>Methods and Materials</h3><div>Between January 2020 and December 2022, locoregional-advanced rectal cancer patients that were treated with neoadjuvant SCRT with simultaneous integrated boost up to 5.5–6Gy per fraction with five daily fractions followed by response-adapted chemotherapy was retrospectively reviewed. The pCR rates, R0 resection rates, tumor downstaging, toxicities, and early pattern of recurrence are reported.</div></div><div><h3>Results</h3><div>Among the 76 patients, 67 (88%) were able to undergo curative intent surgery. R0 resection was achieved in 99% (n = 66) of patients with pCR rates of 28% (n = 19). Forty-six percent (n = 31) of patients had significant pathological downstaging (ypT2N0) and 55% (n = 37) of patients had both T and N downstaging. Most common grade 3 or above radiotherapy-related side-effects were proctitis, rectal pain, and dermatitis found in 5% (n = 4), 3% (n = 2) and 3% (n = 2) of patients, respectively. Grade 3 or above surgical complications were observed in 15% (n = 10) of patients. There were no treatment-related deaths. With a median follow-up of 27 months, only 6% (n = 4) had local recurrence after surgery.</div></div><div><h3>Conclusions</h3><div>Neoadjuvant short course radiotherapy with simultaneous boost for rectal cancer is feasible with no added toxicities. Patients who underwent surgery achieve a high R0 resection and pCR rates. Early data suggest low rates of locoregional recurrence. Further follow-up and research is needed to validate and optimize the dose, method, and schedule of dose escalation.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"37 ","pages":"Article 103653"},"PeriodicalIF":3.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589857","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}