Clinical oncology最新文献

{"title":"A Nomogram to Estimate Locoregional Recurrence-Free Survival for Women With T1-2 N0 Breast Cancer Managed With or Without Postmastectomy Radiotherapy","authors":"L. Wade ,&nbsp;E.K. Chan ,&nbsp;R. Musoke ,&nbsp;L. Gondara ,&nbsp;C. Speers ,&nbsp;C. Lohrisch ,&nbsp;A.M. Nichol","doi":"10.1016/j.clon.2025.103928","DOIUrl":"10.1016/j.clon.2025.103928","url":null,"abstract":"<div><h3>Aims</h3><div>Postmastectomy radiotherapy (PMRT) in women with T1-2 N0 breast cancer is not routinely recommended by guidelines but is sometimes considered when patients have multiple predictors of locoregional relapse (LRR). This study re-evaluates the role of PMRT in the era of modern systemic therapy.</div></div><div><h3>Materials and methods</h3><div>Patients with pT1-2 pN0 M0 breast cancer treated from 2005 to 2014 with total mastectomy were identified. Patients who had prior or synchronous breast cancer, neoadjuvant chemotherapy, or incomplete radiotherapy courses were excluded. LRR was analysed with a Fine-Gray subdistribution hazard model, and overall survival (OS) was analysed with Cox regression. A nomogram for estimating LRR was devised and validated with propensity score matching.</div></div><div><h3>Results</h3><div>The study cohort included 3752 women with negative margins and a median follow-up of 11.4 years. As systemic therapy, 32.4% had chemotherapy, 70.2% had hormone therapy, and 10.7% had targeted therapy. The 10-year LRR for the study cohort was 3.7%. The 358 PMRT patients had more adverse features than the 3394 no-PMRT patients. LRR was increased by seven predictors: younger age, larger primaries, luminal B or triple-negative subtypes, lymphovascular invasion (LVI), close margins, omission of chemotherapy, and omission of hormone therapy. PMRT receipt was associated with decreased LRR (HR=0.53, <em>P =</em> 0.04) but did not affect OS. Our nomogram only predicted absolute LRR risks &gt;10% without PMRT when combinations of four or more predictors were present. Only 5% of patients had four or more predictors. The nomogram’s predictions for PMRT benefit were within 1% of the predictions based on the higher-risk, propensity-score-matched cohort.</div></div><div><h3>Conclusion</h3><div>For T1-2N0 breast cancers treated in the era of modern systemic therapy, PMRT did not influence OS. However, there is a small subgroup of high-risk patients for whom PMRT offers a meaningful LRR reduction. Our nomogram can help individualise PMRT decision-making for patients with multiple LRR predictors.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"47 ","pages":"Article 103928"},"PeriodicalIF":3.0,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145061247","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 Toxicity Profile of Chemoradiotherapy in Older Versus Younger Patients With Anal Cancer: A Retrospective Cohort Analysis","authors":"C. van der Elzen ,&nbsp;F. Aires ,&nbsp;E.D. Rodrigues ,&nbsp;C. Dias ,&nbsp;M. Marques ,&nbsp;L. Osório","doi":"10.1016/j.clon.2025.103929","DOIUrl":"10.1016/j.clon.2025.103929","url":null,"abstract":"<div><h3>Aims</h3><div>The optimal management of older patients with anal cancer (AC) receiving chemoradiotherapy (CRT) remains controversial, particularly regarding treatment tolerance and outcomes. This study aimed to compare treatment outcomes and toxicity profiles between older and younger patients undergoing standard CRT.</div></div><div><h3>Materials and methods</h3><div>We conducted a 16-year retrospective analysis of AC patients treated with CRT at our institution between 2008 and 2023. A total of 61 patients were stratified into older (≥65 years, n = 25) and younger (&lt;65 years, n = 36) patients. The primary objectives were to compare clinicopathological characteristics, treatment patterns, and outcomes between age groups, as well as to identify prognostic factors in patients with nonmetastatic squamous cell carcinoma of the anus (SCCA). Treatment toxicities were evaluated according to Common Terminology Criteria for Adverse Events (CTCAE). Survival analysis included overall survival (OS), locoregional recurrence-free survival (LRFS), metastasis-free survival (MFS), and progression-free survival (PFS). Analyses of survival curves were performed using the Kaplan-Meier method. Statistical significance was set at <em>P</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>After a median follow-up of 48 months (range, 6-187)<strong>,</strong> complete response rates were 86.7% and 95.2% in younger and older cohorts, respectively (<em>P</em> = .395). At the 48-month median follow-up, 4-year OS was 72.3% in younger and 68.7% in older patients (<em>P</em> = .845). Four-year LRFS (77.7% vs 88.7%, <em>P</em> = .381), MFS (83.8% vs 93.3%, <em>P</em> = .718), and PFS (77.7% vs 89.3%, <em>P</em> = .656) showed no significant differences between cohorts. Completion of treatment reached 100% and 98% in younger and older groups. A pretreatment haemoglobin &lt;11.7g/dL and an SCC ≥1.3 ng/mL were significant prognostic factors in the younger cohort only (<em>P</em> = .026 and <em>P</em> = .016, respectively).</div></div><div><h3>Conclusion</h3><div>Older patients with AC demonstrate comparable treatment outcomes to younger patients when receiving curative-intent CRT. With comparable complete response rates, survival outcomes, and high completion of treatment between age cohorts, our results demonstrate that carefully managed CRT is both feasible and effective in older patients.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"47 ","pages":"Article 103929"},"PeriodicalIF":3.0,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198647","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 Institutional Audit on the Usage of the Royal College of Radiologists Consent Forms for Radiotherapy","authors":"M.S. Iqbal,&nbsp;M. Nazir,&nbsp;A. Burns,&nbsp;A. Clark,&nbsp;M. Jackson","doi":"10.1016/j.clon.2025.103927","DOIUrl":"10.1016/j.clon.2025.103927","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"46 ","pages":"Article 103927"},"PeriodicalIF":3.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996924","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/j.clon.2025.103924","DOIUrl":"10.1016/j.clon.2025.103924","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"45 ","pages":"Article 103924"},"PeriodicalIF":3.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865236","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":"Paid MBP advert Journals_AI_Conference_280x210_September_SEB_01","authors":"","doi":"10.1016/S0936-6555(25)00180-3","DOIUrl":"10.1016/S0936-6555(25)00180-3","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"45 ","pages":"Article 103925"},"PeriodicalIF":3.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865237","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":"Alterations in 3D Chromatin Spatial Organisation in Tumourigenesis and Therapy Resistance of Glioblastoma: The Recent Advances in Understanding Molecular Mechanisms, Clinical Implications, and Therapeutic Perspectives","authors":"A.G. Taki ,&nbsp;A. Shareef ,&nbsp;L. Baldaniya ,&nbsp;R. Oweis ,&nbsp;S.R. Jyothi ,&nbsp;U. Singh ,&nbsp;S. Sahoo ,&nbsp;A.S. Chauhan ,&nbsp;U. Rakhmatov ,&nbsp;H.N. Sameer ,&nbsp;A. Yaseen ,&nbsp;Z.H. Athab ,&nbsp;M. Adil","doi":"10.1016/j.clon.2025.103926","DOIUrl":"10.1016/j.clon.2025.103926","url":null,"abstract":"<div><div>Glioblastoma (GBM) remains one of the most aggressive and lethal forms of brain cancer, characterised by profound genetic, epigenetic, and phenotypic heterogeneity. Recent advancements in high-resolution genome mapping have unveiled the critical role of three-dimensional (3D) chromatin architecture—encompassing chromatin loops, topologically associating domains, and enhancer–promoter interactions—in driving GBM tumourigenesis and therapy resistance. This review summarises recent insights into the mechanistic contribution of 3D genome reorganisation in sustaining oncogenic transcriptional programs, promoting intratumoural heterogeneity, and facilitating adaptive resistance. We integrate molecular discoveries with clinical and therapeutic perspectives, emphasising the potential of epigenetic drugs to target disease-associated chromatin structures. Finally, we highlight unresolved questions and future directions in leveraging chromatin conformation data for precision oncology in GBM.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"46 ","pages":"Article 103926"},"PeriodicalIF":3.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004353","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 Results of Hypofractionated Chemoradiation in Cervical Cancer with 44 Gy/ 20 F vs 45 Gy/ 25 F: A Phase II, Open-Label, Randomised Controlled Trial (HYPOCx-iRex Trial)","authors":"Pittaya Dankulchai ,&nbsp;Tissana Prasartseree ,&nbsp;Wiwatchai Sittiwong ,&nbsp;Kullathorn Thephamongkhol,&nbsp;Pitchayut Nakkrasae","doi":"10.1016/j.clon.2025.103907","DOIUrl":"10.1016/j.clon.2025.103907","url":null,"abstract":"<div><h3>Aims</h3><div>To compare the safety and efficacy of hypofractionated chemoradiation (HYPO) regimen with a conventional fractionation (CVRT) for locally advanced cervical cancer (LACC).</div></div><div><h3>Materials and methods</h3><div>A single-centre, open-label, randomised controlled trial enrolled patients with LACC to receive either HYPO (44 Gy/20 fractions) or CVRT (45 Gy/25 fractions) with intensity-modulated radiotherapy, image-guided adaptive brachytherapy, and concurrent weekly cisplatin. The primary outcome was the incidence of acute and late gastrointestinal (GI) and genitourinary (GU) toxicity assessed using the Common Terminology Criteria for Adverse Events version 5.0. Secondary outcomes included health-related quality of life (HRQoL), disease control, and survival.</div></div><div><h3>Results</h3><div>Forty patients with a median follow-up of 19 months were enrolled (HYPO: n=21; CVRT: n=19). The HYPO achieved a significantly shorter overall treatment time (OTT) compared with CVRT (39 vs 47 days, <em>P</em> &lt; .001). GI and GU toxicities were manageable, with a trend towards higher rates in the HYPO compared with CVRT for both acute (grading [Gr]≥3 CTCAE/patient-reported outcome 43%/29% vs 32%/11%, <em>P</em>=.53/0.24) and actuarial 18-month late GI toxicity (Gr≥2/Gr≥3 26.2%/21.2% vs 20.6%/14.4%, <em>P</em>=.537/0.438), although not statistically significant. No Gr≥3 GU toxicity was observed. HRQoL scores during treatment were lower in the HYPO compared with CVRT; however, recovering within the 3-month post-radiotherapy period. A trend toward superior locoregional control was observed in the HYPO. Notably, para-aortic control at 24 months was significantly higher in the HYPO (100% vs 71.2%, <em>P</em>=.003). No significant differences were observed in local control or overall survival at the time of analysis.</div></div><div><h3>Conclusion</h3><div>HYPO with modern techniques is feasible for LACC, significantly reducing OTT. A trend towards higher yet tolerable acute and late GI toxicity warrants further investigation. Encouragingly, HYPO showed promising locoregional control.</div></div><div><h3>Registration number</h3><div><span><span>thaiclinicaltrials.org</span><svg><path></path></svg></span> (TCTR20210812003)</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"46 ","pages":"Article 103907"},"PeriodicalIF":3.0,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144926156","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":"Response to Letter Regarding ‘Feasibility Study of an Efficient Plan Pool Adaptive Radiotherapy Technology Based on Low-Dose Computed Tomography for Cervical Cancer’","authors":"G. Gan","doi":"10.1016/j.clon.2025.103922","DOIUrl":"10.1016/j.clon.2025.103922","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"46 ","pages":"Article 103922"},"PeriodicalIF":3.0,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932891","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":"The Power of Precision: Unravelling the Radiobiology of Targeted Radionuclide Therapy.","authors":"R Khanna, P M D Gape, K C Grayson, M Patel, S Y A Terry","doi":"10.1016/j.clon.2025.103923","DOIUrl":"https://doi.org/10.1016/j.clon.2025.103923","url":null,"abstract":"<p><p>Targeted radionuclide therapy (TRT) involves systemic administration of a radionuclide attached to a cancer-targeting moiety. It has been proven to be a promising approach for primary cancer and metastasis treatment with minimal damage to surrounding tissues. TRT integrates the precision of molecular targeting with the therapeutic efficacy of radiation. While the field of TRT is growing, its radiobiological understanding remains incomplete thereby hampering progress and clinical impact. The field is expanding beyond beta particle emitters to include alpha particle and Auger electron emitters, yet most radiobiological principles remain based on external beam X-ray radiotherapy or beta emitter ¹³¹I. This review describes current radiobiological knowledge in TRT, highlights existing gaps, and explores strategies for future advancements. An improved understanding of therapeutic potential, the underlying mechanisms of it, potential synergistic therapy approaches, treatment resistance, and conceivable toxicities, specific to TRT, are still needed.</p>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":" ","pages":"103923"},"PeriodicalIF":3.0,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005955","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":"Mesothelioma Immunotherapy: Trends and Directions From Clinical Trials","authors":"J. Ding ,&nbsp;Y. Wang ,&nbsp;S. Wang,&nbsp;N. Li","doi":"10.1016/j.clon.2025.103920","DOIUrl":"10.1016/j.clon.2025.103920","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"46 ","pages":"Article 103920"},"PeriodicalIF":3.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144918930","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}