Clinical oncology最新文献

{"title":"Optimising the use of tissue-equivalent bolus in post-mastectomy radiotherapy (PMRT) at Rosemere Cancer Centre, Lancashire Teaching Hospitals NHS Foundation Trust","authors":"Sarah Findlay, Keara McDonough, Martin McKeown","doi":"10.1016/j.clon.2025.103811","DOIUrl":"10.1016/j.clon.2025.103811","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"40 ","pages":"Article 103811"},"PeriodicalIF":3.2,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829926","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":"Audit and service evaluation of a new high-dose-rate brachytherapy service for treatment of non-melanoma skin cancer","authors":"Kate Channell, Pauline Humphrey, Amarnath Challapalli","doi":"10.1016/j.clon.2025.103826","DOIUrl":"10.1016/j.clon.2025.103826","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"40 ","pages":"Article 103826"},"PeriodicalIF":3.2,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828404","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":"Audit of changing the hydration protocol for head and neck oncology patients receiving concomitant radiotherapy and weekly cisplatin","authors":"Claire Mortimer, Rowena Cazalet, Ketan Shah, Donna Constantine","doi":"10.1016/j.clon.2025.103822","DOIUrl":"10.1016/j.clon.2025.103822","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"40 ","pages":"Article 103822"},"PeriodicalIF":3.2,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143830038","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":"Improving the experience of returning to clinical oncology training through an educational day for out-of-programme trainees","authors":"Wahyu Wulaningsih , Clare Kane , Rubyyat-A Hakim , Sarah Needleman","doi":"10.1016/j.clon.2025.103814","DOIUrl":"10.1016/j.clon.2025.103814","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"40 ","pages":"Article 103814"},"PeriodicalIF":3.2,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143830045","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":"Improving the palliative radiotherapy training experience of junior clinical oncology trainees","authors":"Alexandra Maling, Jenny Mckeon","doi":"10.1016/j.clon.2025.103819","DOIUrl":"10.1016/j.clon.2025.103819","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"40 ","pages":"Article 103819"},"PeriodicalIF":3.2,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828494","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":"Third Course of Radical Intent Conformal Radiation in Patients with Primary Brain Tumors","authors":"M. Jeeva ,&nbsp;A. Dasgupta ,&nbsp;A. Chatterjee ,&nbsp;A. Sahu ,&nbsp;E. Sridhar ,&nbsp;A. Moiyadi ,&nbsp;G. Chinnaswamy ,&nbsp;T. Gupta","doi":"10.1016/j.clon.2025.103841","DOIUrl":"10.1016/j.clon.2025.103841","url":null,"abstract":"<div><h3>Aims</h3><div>Reirradiation is increasingly considered in patients with recurrent primary brain tumours. However, second course of radical reirradiation (RT2) or third course of radiation (RT3) delivering higher doses is uncommon. The current study was undertaken to report the clinical outcomes after the third course of radical radiation.</div></div><div><h3>Materials and methods</h3><div>The patients undergoing three courses of cranial radiation were obtained from the radiation oncology database. The clinical and treatment details were obtained by reviewing electronic medical records and radiation charts and plans when available. Treatment outcomes, including disease status and radionecrosis, were assessed by reviewing imaging. Analysis was done using descriptive statistics and survival outcomes using Kaplan–Meier survival plots.</div></div><div><h3>Results</h3><div>Eight patients were identified between 2015 and 2023 treated with a third course of radiotherapy (second reirradiation). Histopathology included ependymoma in seven and glioblastoma in one patient. The median age during first radiation was 13.5 years (range: 4–31 years) with interquartile range (IQR) of 7–26 years, and during RT3 was 22 years (range: 9–43 years, IQR: 14–32 years). The median doses at RT1, RT2, and RT3 were 59.4 Gy (IQR: 54.80–60 Gy), 54 Gy (IQR: 51.3–54.0 Gy), and 50.4 Gy (IQR: 50.0–50.4 Gy), respectively. The median interval between RT1 and RT2 was 37 months (IQR: 29–63 months), RT2 and RT3 was 39 months (IQR: 25–67 months). The median cumulative EQD2 from three courses was <span><math><mrow><msub><mrow><mn>153</mn><mspace></mspace><mi>G</mi><mi>y</mi></mrow><mrow><mn>2</mn><mspace></mspace></mrow></msub></mrow></math></span> (IQR: 148.7–159.1 <span><math><mrow><msub><mrow><mi>G</mi><mi>y</mi></mrow><mn>2</mn></msub></mrow></math></span>). After 3rd course, the median follow-up was 25 months (IQR: 15–37 months) with a 2-year overall survival of 85%. One patient had developed symptomatic radionecrosis 14 months after RT3 and was treated with bevacizumab.</div></div><div><h3>Conclusion</h3><div>The third course of radical dose of radiation can be considered a reasonable approach for tumours with local recurrence after a reasonable interval of at least two years between each course, allowing for tissue recovery.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"42 ","pages":"Article 103841"},"PeriodicalIF":3.2,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874397","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":"Oncotype DX Breast DCIS Score® Test: Impact on Radiotherapy Recommendations and Patient Decisional Anxiety","authors":"S. Muktar ,&nbsp;A. Kirby ,&nbsp;I. Locke ,&nbsp;S. Settatree ,&nbsp;G. Kothari ,&nbsp;S. Nimalasena ,&nbsp;A. Ranger ,&nbsp;K. Mohammed ,&nbsp;F. Reid ,&nbsp;G. Ross ,&nbsp;N. Roche","doi":"10.1016/j.clon.2025.103839","DOIUrl":"10.1016/j.clon.2025.103839","url":null,"abstract":"<div><h3>Aims</h3><div>Treatment for Ductal Carcinoma <em>in Situ</em> (DCIS) includes surgery followed by radiotherapy (RT) to reduce local recurrence (LR) risk, though RT may be overtreatment for some patients. The Oncotype DX Breast DCIS Score® test is a genomic test that provides individualised LR risk estimates. This study evaluates the impact of the Oncotype test on RT recommendations, patient anxiety and decisional conflict.</div></div><div><h3>Material and methods</h3><div>Women aged ≥45 years with DCIS up to 25mm treated with breast-conserving surgery were invited to participate. Initial RT recommendations and 10-year LR risk predictions were made before Oncotype testing. Post Oncotype testing, final RT recommendations were recorded. Patients completed decisional conflict and anxiety questionnaires before and after receiving Oncotype results.</div></div><div><h3>Results</h3><div>A total of 71 participants were included with a median age of 59. Ninety percent of DCIS was intermediate/high-grade with a median size of 12mm. Oncologists changed RT recommendations in 28% (20/71) of cases after receiving the Oncotype result; 21% changed from RT to no RT and 7% from no RT to RT. In 79% of cases, the oncologists’ LR estimates were higher than Oncotype predictions. Post Oncotype testing, patient decisional conflict and anxiety decreased.</div></div><div><h3>Conclusion</h3><div>The Oncotype test changed treatment recommendations regarding adjuvant RT in almost a third of patients. Additionally, the assay was associated with reduced treatment-related decisional conflict and anxiety in patients. LR risk predictions by oncologists were higher than the Oncotype predictions highlighting a need for additional tools to aid decision-making.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"42 ","pages":"Article 103839"},"PeriodicalIF":3.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143888124","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":"Is the Juice Worth the Squeeze? Overall Survival Gain per Unit Treatment Time as a Metric of Clinical Benefit of Systemic Treatment","authors":"V. Bamunuarachchi ,&nbsp;V. Peiris ,&nbsp;S. Wijeskera ,&nbsp;D. Rajapakse ,&nbsp;S. Gunasekera ,&nbsp;N. Joseph","doi":"10.1016/j.clon.2025.103840","DOIUrl":"10.1016/j.clon.2025.103840","url":null,"abstract":"<div><h3><em>Aims</em></h3><div>Novel systemic therapeutic options such as enzyme inhibitors and monoclonal antibodies have transformed the practice of medical oncology in the recent past. However, survival gains remain modest in most cases. Quantifying the magnitude of benefit against financial and nonfinancial toxicity of treatment is pivotal in deciding treatment. We describe a novel metric which can be used to assess effectiveness of novel therapeutics for incurable cancers along with other established tools.</div></div><div><h3><em>Materials and methods</em></h3><div>Sixty indications of 30 novel therapeutic agents were selected for analysis. The median overall survival gain was divided by the median duration of treatment to obtain the overall survival gain per treatment time, which was the primary end-point of the study. This parameter was compared with the European Society of Medical Oncology Magnitude of clinical benefit scale (ESMO-MCBS) score. Spearman’s rank correlation coefficient was used to test the association between the novel metric and the ESMO-MCBS scores.</div></div><div><h3><em>Results</em></h3><div>The median overall survival per unit treatment time ranged from 0.68 (range: 0.2–0.51). Only 18/60 indications had a ratio greater than 1, while 13/60 indications had a ratio less than 0.5. The median treatment duration was not mentioned in 12 indications and median progression-free survival was substituted for the analysis. The ESMO-MCBS score was available for 49 of the indications. The Spearman’s rank correlation coefficient was 0.44575 and showed a statistically significant association between survival gain per unit treatment time and the ESMO-MCBS score (<em>P</em> = 0.00133).</div></div><div><h3><em>Conclusion</em></h3><div>Along with other metrics, the ratio of survival gain over treatment duration is a useful parameter to assess effectiveness of novel therapeutics in the palliative setting.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"42 ","pages":"Article 103840"},"PeriodicalIF":3.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143870137","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 ,&nbsp;R. Simoes","doi":"10.1016/j.clon.2025.103838","DOIUrl":"10.1016/j.clon.2025.103838","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"41 ","pages":"Article 103838"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791387","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":"Neuroendocrine Deficits and Weight Development Before and After Proton Therapy in Children With Craniopharyngioma","authors":"M. Bischoff ,&nbsp;J. Beckhaus ,&nbsp;D.A. 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.2025.103837","DOIUrl":"10.1016/j.clon.2025.103837","url":null,"abstract":"<div><h3>Aims</h3><div>Our objective was to analyse tumour- and treatment-related factors influencing endocrine morbidity and obesity pre- and post-proton beam therapy (PBT) in paediatric patients with craniopharyngioma.</div></div><div><h3>Materials and methods</h3><div>A total of 65 patients at the onset of PBT were included in the analysis within our prospective registry study. The data pertaining to endocrine deficits and BMI prior to PBT were retrieved from the medical records on a retrospective basis. Cumulative incidences (CI) of endocrinopathies, age- and sex-adjusted BMI standard deviation scores (BMI-SDS) were calculated.</div></div><div><h3>Results</h3><div>Before PBT, 90.8% had ≥1 neuroendocrine deficit. Diabetes insipidus (DI) was attributed to surgery in 96%. Patients with postoperative DI had a higher 3-year CI of adrenocorticotropic hormone and thyroid-stimulating hormone deficiency rates compared to those without DI (<em>p</em> &lt; .001). At PBT start, 47.7% had already panhypopituitarism compared to 67.7% at the last follow-up (FU). Median FU post-PBT was 3.2 years (range, 1.0–9.6). Post-PBT, 38.2% remained free of additional hormone deficiencies. A trend towards lower endocrine morbidity scores for patients who received PBT during their primary treatment compared to irradiation at progression did not reach statistical significance (<em>p</em> = .068). The BMI-SDS increase from diagnosis to the start of radiotherapy was significantly greater than from the start of PBT to the end of FU (mean BMI-SDS increase: 0.61, ±1.16 vs. 0.13, ±0.84, <em>p</em> = 0.019), with a median time of 10.2 and 38.4 months, respectively. In the multivariate analysis, hypothalamic involvement (<em>p</em> = .042) and the BMI-SDS level at diagnosis (<em>p</em> = .006) were identified as clinical factors indicating severe obesity at FU (BMI-SDS ≥+2).</div></div><div><h3>Conclusions</h3><div>Panhypopituitarism is frequently observed in paediatric patients with craniopharyngioma prior to PBT. The potential benefits of early PBT on endocrine outcomes require further investigation through longer FU periods. The greatest increase in weight occurred before radiotherapy. Endocrine deficiencies and weight gain are multifactorial and require close monitoring.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"42 ","pages":"Article 103837"},"PeriodicalIF":3.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143830326","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}