Clinical oncology最新文献

{"title":"Establishing a National SABR Service: A Model for Safe and Effective Clinical Implementation","authors":"P. Díez ,&nbsp;R. Patel ,&nbsp;A. Haridass ,&nbsp;M. Kroiss ,&nbsp;C.H. Clark ,&nbsp;M. Hussein ,&nbsp;R. Muirhead ,&nbsp;M.Q. Hatton ,&nbsp;A.C. Tree ,&nbsp;J. Conibear ,&nbsp;G. Radhakrishna ,&nbsp;K. Aitken ,&nbsp;C. Dean ,&nbsp;A. Baker ,&nbsp;J. Lilley ,&nbsp;Y.M. Tsang ,&nbsp;C. Brooks ,&nbsp;N. van As ,&nbsp;S. Mukherjee ,&nbsp;K. Fell ,&nbsp;F. McDonald","doi":"10.1016/j.clon.2025.103990","DOIUrl":"10.1016/j.clon.2025.103990","url":null,"abstract":"<div><h3>Aims</h3><div>Following the successful completion of a registry-based evaluation study of patients with extracranial oligometastatic disease or hepatocellular carcinoma treated with stereotactic ablative body radiotherapy (SABR), National Health Service (NHS) England and NHS Improvement funded an implementation and expansion programme in 2020 to increase SABR provision to 51 radiotherapy centres. This report details the integration of structured mentoring and radiotherapy quality assurance (RT QA) as core components for a safe and effective national SABR implementation programme.</div></div><div><h3>Materials and Methods</h3><div>Six members of the UK SABR Consortium developed a framework for effective mentoring that experienced SABR centres could follow to mentor those with limited or no experience. In parallel, the National Radiotherapy Trials Quality Assurance Group delivered an accreditation programme for completion by those centres comprising a facility questionnaire, contouring and planning benchmarks, end-to-end dosimetry audit and individual case review.</div></div><div><h3>Results</h3><div>Sixteen experienced centres mentored thirty-three new SABR sites, covering a range of techniques and equipment. A large multidisciplinary team of 25 individuals, consisting of clinical oncologists, medical physicists and therapeutic radiographers developed and delivered the RT QA programme. As of April 2025, all centres are accredited for lung, bone and nodes; the programme for the remaining anatomical sites is ongoing. Nearly 24,000 patients have been treated since the NHSE 2020 programme commenced.</div></div><div><h3>Conclusion</h3><div>This is the first nationally funded programme demonstrating how structured mentorship and RT QA have been beneficial in the safe, effective and timely implementation of SABR services in England. The programme, developed through a multi-professional inter-group collaboration of SABR experts, ensured that radiotherapy centres were trained and supported to deliver consistent, high-quality SABR.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"50 ","pages":"Article 103990"},"PeriodicalIF":3.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145780558","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":"Radiotherapy Plan Quality Assurance in the ABC-07 Trial of Stereotactic Body Radiotherapy for Locally Advanced Biliary Tract Cancer","authors":"D.J. Eaton ,&nbsp;D.H. Brand ,&nbsp;N. Hava ,&nbsp;M. Harrison ,&nbsp;A. Lopes ,&nbsp;P. Manoharan ,&nbsp;G. Radhakrishna ,&nbsp;S. Shelly ,&nbsp;M.A. Hawkins","doi":"10.1016/j.clon.2025.103993","DOIUrl":"10.1016/j.clon.2025.103993","url":null,"abstract":"<div><h3>Aims</h3><div>The ABC-07 phase II randomised controlled trial (ISRCTN: 10639376) investigated the addition of stereotactic body radiotherapy (SBRT) to systemic chemotherapy in locally advanced biliary tract cancers (BTCs). We report the radiotherapy quality assurance (RTQA) of SBRT treatment plans in the trial.</div></div><div><h3>Materials and methods</h3><div>RTQA was performed before and during accrual, including benchmark contouring and planning cases, along with prospective independent case review (ICR) of the first three patients from each centre randomised to SBRT. Prescription doses were up to 50 Gy in 5 fractions or up to 67.5 Gy in 15 fractions. Cases were reviewed for segmentation accuracy and plan quality, including target coverage and organ-at-risk (OAR) constraints being met.</div></div><div><h3>Results</h3><div>Benchmark cases: Six of seventeen contouring submissions required revision (35%), and 6/17 planning submissions were revised after feedback on what was achievable by other centres. Prospective ICR: Thirty-one of forty-one cases from all 12 recruiting centres that were randomised to SBRT underwent review in real-time, and the others were reviewed retrospectively. Eight of these prospectively reviewed cases required revisions during the review process (26%, including 7 contouring and 2 planning revisions). Nineteen of forty-one plans overall (46%) had deviations from trial protocol objectives (even after any revisions), mostly unavoidable target coverage compromise (D95% &lt; 90%) because of proximal OARs such as duodenum (17/41) and stomach (6/41).</div></div><div><h3>Conclusion</h3><div>Despite rigorous plan QA, we encountered variability in segmentation and plan coverage. The revision rate was reduced between pre-trial and on-trial cases. Radiotherapy doses in the protocol were achievable in many cases; however, target coverage was frequently compromised to maintain OAR dose constraints. Such compromises should be prespecified in future studies.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"50 ","pages":"Article 103993"},"PeriodicalIF":3.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145908803","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":"Royal College of Radiologists Guidance Statements on the Use of Auto-contouring in Radiotherapy","authors":"K. Mackay ,&nbsp;K. Banfill ,&nbsp;D. Bernstein ,&nbsp;J. Daniel ,&nbsp;P. Diez ,&nbsp;S. Gwynne ,&nbsp;A. Hoole ,&nbsp;R. Jena ,&nbsp;T. Marchant ,&nbsp;M. Nix ,&nbsp;G. Price ,&nbsp;M. Teo ,&nbsp;I. Boon ,&nbsp;S. Hindocha ,&nbsp;J. Wang ,&nbsp;K. Zucker ,&nbsp;A. Taylor","doi":"10.1016/j.clon.2025.104004","DOIUrl":"10.1016/j.clon.2025.104004","url":null,"abstract":"<div><div>Auto-contouring systems are rapidly becoming more widely used for radiotherapy treatment planning. There is an acknowledged need for formal guidance to help healthcare professionals understand how to safely adopt this technology. The Royal College of Radiologists Artificial Intelligence in Clinical Oncology working group established a multi-disciplinary group of national experts in artificial intelligence and radiotherapy quality assurance (QA). This group has produced consensus recommendations for the safe use of the technology. These include model selection, clinical commissioning, day-to-day QA, and post-implementation monitoring. Other factors such as the impact on the multi-disciplinary team, education, and training are also considered.</div><div>The healthcare professional approving auto-contours for use will have overall responsibility, and it is therefore of utmost importance that they have a good understanding of the risks of auto-contouring and how contours should be assessed to mitigate these risks. This guidance aims to enable healthcare professionals acting as operators of a medical device to understand what they need to know about auto-contouring, to facilitate safe adoption of this technology.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"50 ","pages":"Article 104004"},"PeriodicalIF":3.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145923785","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":"Phase II Open-Label Randomised Controlled Trial Comparing Oxaliplatin and Cisplatin Based Concurrent Chemoradiotherapy in Locally Advanced Head and Neck Cancers","authors":"Y. Yanthan ,&nbsp;L. Pandey ,&nbsp;A. Pandey ,&nbsp;R. Pasricha ,&nbsp;D. Joseph ,&nbsp;S. Gupta ,&nbsp;A. Sehrawat ,&nbsp;A. Dhyani ,&nbsp;M. Gupta","doi":"10.1016/j.clon.2025.104005","DOIUrl":"10.1016/j.clon.2025.104005","url":null,"abstract":"<div><h3>Aims</h3><div>Concurrent cisplatin-based chemoradiotherapy (CCRT) is the standard treatment for locally advanced head and neck cancer (LAHNC); however, it also results in substantial treatment-related toxicities. Oxaliplatin has similar radiosensitisation mechanisms to cisplatin and, if found to have equivalent efficacy in LAHNCs, has the potential to replace cisplatin in CCRT protocols.</div></div><div><h3>Materials and methods</h3><div>This prospective trial compared weekly oxaliplatin 50 mg/m2 to weekly cisplatin 40mg/m² in CCRT protocols for the treatment of non-nasopharyngeal LAHNCs. The primary endpoint was to compare the toxicity profile; secondary endpoints were compliance, locoregional control (LRC), disease-free survival (DFS), and overall survival (OS).</div></div><div><h3>Results</h3><div>Between January 2019 and June 2020, we randomly assigned 70 LAHNC patients, 35 in each arm, to receive radical CCRT. At a median follow-up of 18 months (range: 3-72), acute toxicities of grade 3 or higher occurred in 31% of patients in the oxaliplatin arm and 77% of patients in the cisplatin arm (<em>P</em> = 0.007). The estimated 3-year LRC, DFS, and OS in the oxaliplatin and cisplatin arms were 32.3% vs 35.9%, 28.7% vs 35.9% and 35.1% vs 37.3%, respectively, while the 5-year LRC, DFS, and OS were 32.3% vs 32.4%, 28.7% vs 28.8%, and 31.2% vs 30.5%, respectively. The absolute differences observed were not statistically significant.</div></div><div><h3>Conclusion</h3><div>The CCRT with oxaliplatin in non-nasopharyngeal LAHNC exhibits a better toxicity profile and appears comparable to cisplatin in terms of disease control. It may be worthwhile exploring this approach in a larger trial to gather LRC and survival data.</div></div><div><h3>Clinical Trials Registry India</h3><div>CTRI/2019/01/017198.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"50 ","pages":"Article 104005"},"PeriodicalIF":3.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965324","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 AI-Conference_210x280_130126 1","authors":"","doi":"10.1016/S0936-6555(26)00037-3","DOIUrl":"10.1016/S0936-6555(26)00037-3","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"50 ","pages":"Article 104066"},"PeriodicalIF":3.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147397919","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":"Intraocular Sarcomas: A Population-based Study","authors":"P. Loap,&nbsp;Y. Kirova,&nbsp;R. Dendale","doi":"10.1016/j.clon.2025.104006","DOIUrl":"10.1016/j.clon.2025.104006","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"50 ","pages":"Article 104006"},"PeriodicalIF":3.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145923739","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":"When to Hold and When to Fold: The Clinical Approach to Locoregional Recurrence After Curative Treatment of Solid Cancers","authors":"N. Joseph ,&nbsp;P.J. Hoskin","doi":"10.1016/j.clon.2025.103951","DOIUrl":"10.1016/j.clon.2025.103951","url":null,"abstract":"<div><div>Although retreatment of locoregional recurrence offers a critical window of opportunity for curative intervention, it poses a significant clinical challenge due to its complex nature and the scarcity of high-level evidence to guide optimal treatment. This article provides a clinical perspective on approaches to salvage treatment, emphasising the need for personalised strategies. Key considerations include determining the intent of treatment (curative vs palliative), differentiating between true recurrence and <em>de novo</em> primary tumours, and understanding the impact of previous treatments on salvage options. The role of adjuvant and neoadjuvant systemic therapy is also discussed, highlighting the need for further research in this area.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"50 ","pages":"Article 103951"},"PeriodicalIF":3.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343787","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(26)00025-7","DOIUrl":"10.1016/S0936-6555(26)00025-7","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"50 ","pages":"Article 104054"},"PeriodicalIF":3.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147397918","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":"Re-evaluating the 30 Gy Dose for Chest Wall-Abutting Tumours in Single-Fraction Stereotactic Ablative Radiotherapy : Evidence From a Population-Based Study","authors":"Y. Liu ,&nbsp;D. Zhang ,&nbsp;S. Tian","doi":"10.1016/j.clon.2025.104007","DOIUrl":"10.1016/j.clon.2025.104007","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"50 ","pages":"Article 104007"},"PeriodicalIF":3.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145975265","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":"National Reporting of Bowel Cancer Care by the National Bowel Cancer Audit (NBOCA) Supports Hospital Teams to Improve care and Outcomes","authors":"NBOCA Project Team,&nbsp;A. Rashid ,&nbsp;S. Cook ,&nbsp;K. Darley ,&nbsp;A. Kuryba ,&nbsp;L. Watton ,&nbsp;O. Almilaji ,&nbsp;N. Fearnhead ,&nbsp;M. Braun ,&nbsp;J. van der Meulen ,&nbsp;K. Walker","doi":"10.1016/j.clon.2025.104009","DOIUrl":"10.1016/j.clon.2025.104009","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"50 ","pages":"Article 104009"},"PeriodicalIF":3.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145975266","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}