Clinical oncology最新文献

{"title":"Stereotactic Body Radiotherapy for Spinal Oligometastases With or Without Simultaneous Integrated Boost: Results From a Monocentric Retrospective Analysis","authors":"E. Pastorello ,&nbsp;L. Nicosia ,&nbsp;A.G. Allegra ,&nbsp;C. De-Colle ,&nbsp;N. Giaj-Levra ,&nbsp;F. Ricchetti ,&nbsp;M. Rigo ,&nbsp;A. Romei ,&nbsp;C. Orsatti ,&nbsp;R. Ruggieri ,&nbsp;F. Alongi","doi":"10.1016/j.clon.2025.103918","DOIUrl":"10.1016/j.clon.2025.103918","url":null,"abstract":"<div><h3>Aims</h3><div>Radiotherapy has a known role in the treatment of symptomatic spinal bone metastases, but there is a relative paucity of data for ablative treatments. The aim of our study is to evaluate the efficacy and toxicity of stereotactic body radiotherapy (SBRT) in treating spinal oligometastases.</div></div><div><h3>Methods</h3><div>A series of spinal oligometastatic patients was treated between 2018 and 2023. The clinical target volume was defined according to Cox contouring guidelines. When feasible, a simultaneous integrated boost (SIB) was administered to the site of the macroscopic disease. The primary end-point was local progression-free survival (LPFS). Secondary objectives were toxicity, distant progression-free survival (DPFS), and overall survival (OS). The following covariates were evaluated: SIB, biologically effective dose, histology, number of total metastases (including both spinal and extra-spinal), and concurrent systemic therapy.</div></div><div><h3>Results</h3><div>One hundred and fifty-two spinal oligometastases in 120 patients were treated. Median follow-up was 22 months (range 6–72, with an interquartile range (IQR) of 21 months). Median dose was 24 Gy (range 21–30) delivered in 3 (3–5) fractions. The most common fractionation was 24 Gy in 3 fractions (49 metastases, 32.2%) SIB was administered in 33 metastases (21.7%). One-, and 2-year LPFS rates were 92.1% and 90%, respectively. Moreover, SIB resulted in a significantly improved 2-year LPFS (<em>P</em> = 0.037). Fourteen (9.2%) metastases locally relapsed.</div><div>One- and 2-years OS were 94.8% and 90%, respectively. One- and 2-years DPFS were 47.8% and 30.8%, respectively, with a median DPFS of 11 months. Oligometastatic prostate cancer patients showed better polymetastases-free survival (PMFS) (<em>P</em> = 0.03) and DPFS (<em>P</em> = 0.008) than other histologies.</div></div><div><h3>Conclusions</h3><div>Spinal SBRT is effective in treating spinal oligometastases. Dose boost could be safely administered to significantly improve LPFS. Prostate cancer patients showed better outcomes.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"46 ","pages":"Article 103918"},"PeriodicalIF":3.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879827","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":"Letter to the Editor Regarding the Article ‘Feasibility Study of an Efficient Plan Pool Adaptive Radiotherapy Technology Based on Low-dose Computed Tomography for Cervical Cancer’","authors":"A. Natania S","doi":"10.1016/j.clon.2025.103919","DOIUrl":"10.1016/j.clon.2025.103919","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"46 ","pages":"Article 103919"},"PeriodicalIF":3.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865647","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":"Comment on: ‘Effectiveness of Intensity Modulate Proton Therapy in Managing Complex Multiple Meningiomas: A Dosimetric and Radiobiological Comparative Study with Helical Tomotherapy on Neurological Risk’","authors":"P. Aphale,&nbsp;S. Dokania,&nbsp;H. Shekhar","doi":"10.1016/j.clon.2025.103921","DOIUrl":"10.1016/j.clon.2025.103921","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"46 ","pages":"Article 103921"},"PeriodicalIF":3.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865648","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":"Reply to the Letter Regarding “Neuroendocrine Deficits and Weight Development Before and After Proton Therapy in Children With Craniopharyngioma”","authors":"M. Bischoff ,&nbsp;J. Beckhaus ,&nbsp;D. Ahmad Khalil ,&nbsp;F. Sen ,&nbsp;S. Frisch ,&nbsp;B. Koska ,&nbsp;C. Kiewert ,&nbsp;B. Bison ,&nbsp;R.-D. Kortmann ,&nbsp;C. Friedrich ,&nbsp;H.L. Müller ,&nbsp;B. Timmermann","doi":"10.1016/j.clon.2025.103914","DOIUrl":"10.1016/j.clon.2025.103914","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"46 ","pages":"Article 103914"},"PeriodicalIF":3.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890617","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":"Safety of Concurrent Treatment with BRAF Inhibitors and Radiotherapy in Metastatic Melanoma: How Best to Advise Patients?","authors":"N.P. Rowell","doi":"10.1016/j.clon.2025.103915","DOIUrl":"10.1016/j.clon.2025.103915","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"46 ","pages":"Article 103915"},"PeriodicalIF":3.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144858522","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":"Challenges Facing Single-Handed Neuro-Oncologists and Smaller Centres in the UK: An Interview-Based Investigation with Proposed Solutions","authors":"M. Brothwell ,&nbsp;A. Wright ,&nbsp;N. Huskens ,&nbsp;C. McBain","doi":"10.1016/j.clon.2025.103916","DOIUrl":"10.1016/j.clon.2025.103916","url":null,"abstract":"<div><h3>Aims</h3><div>Single-handed oncology practice occurs when only one clinician covers a particular tumour site in a department. There is no quantified evidence about experiences of single-handed practice or its impact in oncology. A team supported by the Tessa Jowell Brain Cancer Mission interviewed 35 neuro-oncologists in the United Kingdom (UK) to better understand the workload, challenges and support networks of single-handed neuro-oncologists compared with those of neuro-oncologists at larger centres.</div></div><div><h3>Methods and Methods</h3><div>Semi-structured virtual interviews were completed: January to May 2024.</div></div><div><h3>Results</h3><div>Thirty-five of 58 neuro-oncologists accepted an invitation to interview. Centres were categorised as those with one neuro-oncologist (single-handed): 7 interviews; two neuro-oncologists (dual-handed): 14 interviews; three or more neuro-oncologists (multihanded): 14 interviews. At the time of the study, there were 129 neuro-oncologists working at 52 centres within 29 multidisciplinary team (MDT) networks. Most neuro-oncologists covered more than one tumour site. Single-handed neuro-oncologists described challenges including access to peer review and cover for leave. Seven of ten neuro-oncologists who had been or currently were single-handed reported a negative impact on wellbeing. Respondents described inequity of access to multidisciplinary services geographically, with neuropsychology and neurology access more difficult in smaller centres. The mean number of clinical trials open at single-handed or dual-handed centres was less than one, compared with five at multi-handed centres. However, excellent collaborative and supportive networks and initiatives at a local, regional, and national level were described.</div></div><div><h3>Conclusion</h3><div>Single-handed neuro-oncology practice may impact wellbeing, recruitment and retention. National research initiatives should consider ways to increase support for, and increase access to research in, single- and dual-handed centres.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"46 ","pages":"Article 103916"},"PeriodicalIF":3.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988531","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! (Sep 2025)","authors":"F. Kazmi ,&nbsp;C. Crockett","doi":"10.1016/j.clon.2025.103917","DOIUrl":"10.1016/j.clon.2025.103917","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"45 ","pages":"Article 103917"},"PeriodicalIF":3.0,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738064","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 POINTER-PC Study-determining Optimal Radiotherapy for Pelvic Nodal Recurrence in Prostate Cancer","authors":"F. Slevin ,&nbsp;S.R. Brown ,&nbsp;P. Ost ,&nbsp;A.M. Henry","doi":"10.1016/j.clon.2025.103912","DOIUrl":"10.1016/j.clon.2025.103912","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"46 ","pages":"Article 103912"},"PeriodicalIF":3.0,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144842271","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":"Construction and Validation of a Nomogram for Postoperative Survival Prognosis in Gastric Cancer Patients Based on miR-139, Nuclear Factor Erythroid2-Related Factor 2, and miR-7","authors":"T. Meng ,&nbsp;X. Fang ,&nbsp;L. Zhang ,&nbsp;D. Hou ,&nbsp;Q. Zhang ,&nbsp;Z. Zuo ,&nbsp;S. Zhu","doi":"10.1016/j.clon.2025.103913","DOIUrl":"10.1016/j.clon.2025.103913","url":null,"abstract":"<div><h3>Aim</h3><div>To explore the relationship among the expression levels of miR-139, nuclear factor erythroid2-related factor 2 (NRF2) and miR-7 and postoperative survival in patients with gastric cancer, and to construct a nomogram prediction model.</div></div><div><h3>Materials and methods</h3><div>The expression levels of miR-139 and miR-7 were detected using real-time fluorescence quantitative polymerase chain reaction (PCR), while NRF2 expression was assessed by immunohistochemistry. The associations between these biomarkers and clinicopathological features as well as postoperative survival were analyzed. Multivariate cox regression analysis was used to identify independent prognostic factors, and a nomogram prediction model was constructed.</div></div><div><h3>Results</h3><div>There were statistically significant differences in tumour diameter, tumour differentiation, infiltration depth, lymph node metastasis, TNM staging, miR-139 level, NRF2 score, and miR-7 level between survival group and death group (<em>P</em> &lt; 0.05). The multivariate Cox regression analysis showed that lymph node metastasis, TNM stage, and miR-139 were independent risk factors, while NRF2 and miR-7 were independent protective factors. The nomogram prediction model achieved an area under the curve (AUC) of 0.959 (95% CI: 0.933-0.985) in predicting postoperative survival factors in gastric cancer patients. The results of calibration chart clearly show that the predicted values of the model are highly consistent with the actual observed values, and its C-index value is 0.959. In addition, the results of decision curve analysis (DCA) further verified the good practicability of the model in clinical application.</div></div><div><h3>Conclusion</h3><div>miR-139, NRF2, and miR-7 are independent influencing factors on postoperative survival of patients with gastric cancer. Based on this, the nomogram prediction model shows good prediction performance in patients with gastric cancer.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"46 ","pages":"Article 103913"},"PeriodicalIF":3.0,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144826598","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":"Evaluation of Gross Tumour Volume in Head and Neck Cancers on Contrast-Enhanced Computed Tomography vs Magnetic Resonance Imaging and its Implications on Dice Similarity Coefficients and Dose-Volume Parameters","authors":"M. Deshmukh ,&nbsp;B. Mahindrakar Jain ,&nbsp;P. Kalbande ,&nbsp;A. Singh ,&nbsp;C. Dsouza ,&nbsp;A. Tayade ,&nbsp;N.R. Datta","doi":"10.1016/j.clon.2025.103911","DOIUrl":"10.1016/j.clon.2025.103911","url":null,"abstract":"<div><h3>Aims</h3><div>Radiotherapy treatment planning for head and neck cancers (HNCs) is usually based on contrast-enhanced computed tomography (CECT). However, soft-tissue contrast is better evident in magnetic resonance imaging (MRI). The study evaluates the gross tumour volumes (GTVs) delineated on CECT vs MRI along with their Dice similarity coefficients (DSCs) and resultant impact on the dose-volume histogram (DVH) parameters, conformity index (CI), and homogeneity index (HI) during intensity-modulated radiotherapy (IMRT) planning in HNCs.</div></div><div><h3>Material and Methods</h3><div>This prospective study enrolled 50 consecutive HNC patients. Following CECT and MRI simulations, GTV_p (primary) and GTV_n (node) were delineated independently on these co-registered images. Corresponding MRI volumes were then copied onto co-registered CECT images and IMRT plans were generated on the CECT-defined planning target volume (PTV) of primary and nodes (PTV_p+n).</div></div><div><h3>Results</h3><div>The GTV_p, GTV_n, and GTV_p+n observed on MRI were significantly larger than the corresponding GTVs defined on CECT (all <em>P</em> &lt; .001). The DSC of GTV_p, GTV_n, and GTV_p+n was inversely correlated with the corresponding % differences of GTV_p (r = -0.49, <em>P</em> &lt; .001), GTV_n (r = -0.41, <em>P</em> = .021), and GTV_p+n (r = -0.73, <em>P</em> &lt; .001) between CECT and MRI. The mean DSCs of GTV_p, GTV_n, GTV_p+n, and PTV_p+n were 0.78, 0.32, 0.67, and 0.78, respectively. This led to significant differences in CI and HI (both <em>P</em> &lt; .001), as well as other DVH parameters (D₂, D₅₀, D₉₅, D₉₈, V₉₅, and V₁₀₀, all <em>P</em> &lt; .001) between CECT- and MRI-defined PTV_p+n.</div></div><div><h3>Conclusion</h3><div>The GTVs and PTV_p+n defined on MRI were significantly greater than those depicted on CECT, resulting in significant differences in DSC, DVH parameters, CI, and HI. Thus, IMRT planning for HNCs based on CECT-defined PTV appears inappropriate. The study emphasises the importance of accurate delineation to ensure adequate coverage of the target volume and the potential benefit of MRI in this regard.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"46 ","pages":"Article 103911"},"PeriodicalIF":3.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827794","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}