Clinical oncology最新文献

{"title":"Role of Post-operative Thyroglobulin in Predicting Disease-recurrence in Differentiated Thyroid Cancer","authors":"L. Cheng ,&nbsp;M. Gajda ,&nbsp;A. Tran ,&nbsp;N. Jones-Anderson ,&nbsp;S. Iqbal ,&nbsp;J. Wadsley ,&nbsp;K. Newbold","doi":"10.1016/j.clon.2025.104001","DOIUrl":"10.1016/j.clon.2025.104001","url":null,"abstract":"<div><h3>Aims</h3><div>Differentiated thyroid cancer (DTC) patients with intermediate- or high-risk of recurrence are commonly treated with radioactive iodine (RAI). Although the utility of serum thyroglobulin (Tg) levels after surgery and RAI ablation is the standard of care in dynamic risk stratification, its role prior to RAI ablation remains undefined. We evaluated the relationship between post-operative, pre-RAI unstimulated Tg levels and persistent or recurrent structural disease in intermediate- or high-risk patients, postulating that it may help identify patients who may not require RAI.</div></div><div><h3>Materials and methods</h3><div>Patients diagnosed with DTC from three UK cancer centres were retrospectively identified from hospital electronic health records. Data collected included patient characteristics and clinical parameters such as unstimulated, post-operative and pre-RAI Tg levels and follow-up clinical and imaging results. The remaining 301 patients were analysed using univariable and multivariable logistic regression to explore the association between postoperative Tg and structural disease recurrence or persistence.</div></div><div><h3>Results</h3><div>Three hundred and one patients were included in the final analysis. The cohort included 209 (69%) females and 92 (31%) males, with 21 cases of recurrent or persistent disease. Univariable analysis and multivariable logistic regression both showed that unstimulated, post-operative Tg was an independent predictor of structural disease recurrence/persistence. Receiver operator characteristic curve suggested a post-operative unstimulated Tg cutoff of 1.05 ug/L (odds ratio [OR] 1.016, 95% confidence interval [CI] 1.005 to 1.042, p = 0.011). Notably, 17 (81%) of the 21 recurrences had a post-operative Tg levels above this cut-off.</div></div><div><h3>Conclusion</h3><div>Low postoperative unstimulated Tg levels are associated with a low risk of structural recurrence in intermediate- and high-risk DTC patents. Postoperative Tg may enhance current risk stratification in patients who could safely avoid RAI, but prospective trials are needed to validate this.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"50 ","pages":"Article 104001"},"PeriodicalIF":3.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145923736","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! (Feb 2026 Edition)","authors":"D.J. Hughes ,&nbsp;R. Simoes","doi":"10.1016/j.clon.2026.104034","DOIUrl":"10.1016/j.clon.2026.104034","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"50 ","pages":"Article 104034"},"PeriodicalIF":3.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024081","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":"CAR-T in Central Nervous System Tumours: Promising Science, Slow Clinical Progress","authors":"M. Mehfooz,&nbsp;H. Raza,&nbsp;A. Javed,&nbsp;Y. Ejaz","doi":"10.1016/j.clon.2025.103986","DOIUrl":"10.1016/j.clon.2025.103986","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"49 ","pages":"Article 103986"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827034","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":"Stereotactic Body Radiotherapy for Extracranial Oligometastatic Pancreatobiliary Cancer","authors":"A.N. Mian ,&nbsp;S. Myrehaug ,&nbsp;S. Ng ,&nbsp;A. Taggar ,&nbsp;Y. Ung ,&nbsp;S. Ali ,&nbsp;P. Cheung ,&nbsp;A.V. Louie ,&nbsp;I. Poon ,&nbsp;L. Zhang ,&nbsp;H.T. Chung","doi":"10.1016/j.clon.2025.103995","DOIUrl":"10.1016/j.clon.2025.103995","url":null,"abstract":"<div><h3><em>Aims</em></h3><div>In an oligometastatic disease, stereotactic body radiotherapy (SBRT) is being increasingly used in many different histologies to delay progression. However, by virtue of pancreatobiliary cancers not being as common and more aggressive natural history, data on its usage in pancreatobiliary cancers have been limited. Herein, our study aims to evaluate the outcomes of extracranial SBRT for oligometastatic pancreatobiliary cancers.</div></div><div><h3><em>Materials and methods</em></h3><div>A retrospective review was conducted on patients with oligometastatic pancreatobiliary cancer treated with extracranial SBRT between 2014 and 2023 at our institution. The analysis examined cumulative incidence of local failure (LF), progression-free survival (PFS), cumulative incidence of starting or changing systemic therapy (SCST), overall survival (OS) and Radiation Therapy Oncology Group—graded treatment-related toxicities. Kaplan–Meier methodology and Cox proportional hazard models were used for survival analysis.</div></div><div><h3><em>Results</em></h3><div>Among the 62 patients (115 lesions) identified, the median follow-up was 13.4 months. By primary location, 71% had pancreatic cancer, 15% had cholangiocarcinoma, and 15% had ampullary cancer. Synchronous and metachronous oligometastatic disease was 37% and 63%, respectively. Eighty-seven percent of patients had 1-2 lesions treated with SBRT. At 12 months, LF, PFS, SCST, and OS was 21.5%, 28.0%, 33.6% and 61.7%, respectively. On multivariable analysis, the only predictor of worse PFS was higher PTV volume. No grade 3-5 toxicities were reported.</div></div><div><h3><em>Conclusion</em></h3><div>Similar to other cancers, SBRT appears to be a promising option for those with oligometastatic pancreatobiliary cancer. More research in how to optimise integration of SBRT in a multidisciplinary setting for this challenging disease would be of benefit.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"49 ","pages":"Article 103995"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145849046","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":"Geriatric Oncology in Italy. Where we are. A CIPOMO (Italian College of Primary Hospital Medical Oncologists)-Gioger (Italian Group of Geriatric Oncology) Survey","authors":"S. Barni ,&nbsp;A. Luciani ,&nbsp;P. Tralongo ,&nbsp;L. Cavanna ,&nbsp;G. Aprile ,&nbsp;S. Leo ,&nbsp;C. Aschele ,&nbsp;M. Giordano ,&nbsp;R.R. Silva ,&nbsp;C. Ortega ,&nbsp;M.G. Sarobba ,&nbsp;F. Artioli ,&nbsp;A. Scanni ,&nbsp;L. Fioretto","doi":"10.1016/j.clon.2025.103965","DOIUrl":"10.1016/j.clon.2025.103965","url":null,"abstract":"<div><h3><em>Aims</em></h3><div>By the year 2040, the population of adult individuals aged 65 years and older is expected to reach 44%. Understanding the impending global demographic change is important for all stakeholders along the oncology pathway.</div></div><div><h3><em>Materials and</em> <em>methods</em></h3><div>CIPOMO (Italian College of Primary Hospital Medical Oncologists) with Gioger (Italian Group of Geriatric Oncology) conducted a survey by sending a questionnaire to the directors of oncology departments to get a picture of the situation and to be able to devise plans to improve care, fill gaps in research, education, and implementation, in essence to undertake major health care management changes. The questionnaire included eight questions: the presence and type of figures dedicated to geriatric oncology, the presence of a geriatrics department, the use of a geriatric assessment, which one is used and when it is performed, when a patient is geriatric, and whether there are clinical trials reserved for the elderly population.</div></div><div><h3><em>Results</em></h3><div>A total of 159 questionnaires were sent and 144 responses were obtained, with a response rate of 90.5%. The analysis shows that in less than 38.97% of hospitals there are figures dedicated to geriatric oncology; when these figures are present in 80.65% are oncologist, 62.9% geriatrician, and 22.58% nurses. Regarding the minimum age to consider an elderly patient, 44.85% set the limit at 70 years and 47.06% at 75 years. Eighty percent state that a geriatric assessment is performed in their wards, the G8 questionnaire is used by 65.77%, the multidimensional geriatric assessment by 29.73%, and 1.8% use the <strong>erythrocyte sedimentation rate (</strong>ESR-13) or other instruments. Regarding when the geriatric assessment is done, in 40.44% it is done at the first access to oncology, in 16.91% ‘on demand’, in 15.44% in cases of deciding on medical treatment, and in 13.24% at first access and periodically afterwards. The presence in hospital of a geriatrics department is 44.85% and 25.74% the availability of a geriatrician; in 30%, no specific figure is available. When asked about the availability of clinical trials specific to the elderly population, in 87.5% the answer is negative.</div></div><div><h3><em>Conclusion</em></h3><div>The results show the shortage of professionals trained or assigned to geriatric oncology (including oncologists, geriatricians, nurses, or other dedicated staff), a growing but still insufficient specific cultural preparation, and as is known, very few clinical trials dedicated to elderly oncology patients.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"49 ","pages":"Article 103965"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145660216","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":"Quality Assurance in Multi-Modality Oesophago-Gastric Cancer Clinical Trials: Past, Present and Future Perspectives","authors":"J. Helbrow ,&nbsp;M.E. Booth ,&nbsp;B. Vadhwana ,&nbsp;R. Adams ,&nbsp;K.G. Foley ,&nbsp;C.J. Peters ,&nbsp;R.D. Petty ,&nbsp;S. Gwynne","doi":"10.1016/j.clon.2025.103971","DOIUrl":"10.1016/j.clon.2025.103971","url":null,"abstract":"<div><div>Clinical trials must ensure the quality of both standard and interventional treatments to rigorously evaluate potential benefits, avoid adverse outcomes, and maintain the integrity of results. Quality assurance (QA) endeavours to achieve this and is fundamental to all clinical trial elements, though variation exists between specialties. For radiotherapy (RT) in the UK, the NIHR-funded national Radiotherapy Trials Quality Assurance (RTTQA) group has centralised trial RTQA processes across the RT pathway enabling a robust, consistent, efficient and multidisciplinary approach, replacing piecemeal, trial-by-trial application for QA funding. Meanwhile, the surgical community are moving towards standardised QA processes but has yet to achieve this universally. For SACT, though the importance of QA is recognised, under-reporting persists, and the increasing number and diversity of agents used pose challenges. QA in pathology and radiology is also growing as the complexity of clinical trials increases. Internationally, the EORTC has developed QA processes across domains, but uncertainty and challenges in QA implementation remain. Additionally, while the benefits of trial QA are now recognised, the potential negative effects of QA need to be recognised. Using illustrative examples from contemporary oesophago-gastric cancer studies, we further explore the current status of clinical trial QA across these specialties.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"49 ","pages":"Article 103971"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145577366","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":"Boosting the Evidence: Time to Integrate Simultaneous Integrated Boost in Spine Stereotactic Body Radiotherapy?","authors":"C. Udovicich ,&nbsp;S. Siva ,&nbsp;J. Palmer ,&nbsp;M. Guckenberger ,&nbsp;J. Kam ,&nbsp;I. Sher ,&nbsp;T. Tan ,&nbsp;A. Sahgal","doi":"10.1016/j.clon.2025.103961","DOIUrl":"10.1016/j.clon.2025.103961","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"49 ","pages":"Article 103961"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145523063","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":"Liquid Biopsy: A Gentler Window Into Paediatric Brain Tumours","authors":"H. Raza,&nbsp;M. Mehfooz,&nbsp;A. Javed,&nbsp;Y. Ejaz","doi":"10.1016/j.clon.2025.103979","DOIUrl":"10.1016/j.clon.2025.103979","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"49 ","pages":"Article 103979"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145687098","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! (January 2026 Edition)","authors":"S. Parikh ,&nbsp;C. Crockett","doi":"10.1016/j.clon.2025.103988","DOIUrl":"10.1016/j.clon.2025.103988","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"49 ","pages":"Article 103988"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145691023","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 for Oesophageal Cancer in the United Kingdom: Patterns of Practice and Quality Indicators","authors":"C.W. Bleaney ,&nbsp;K. Aitken ,&nbsp;T.D.L. Crosby ,&nbsp;G. Radhakrishna ,&nbsp;R. Roy ,&nbsp;K. Spencer ,&nbsp;C.M. Jones","doi":"10.1016/j.clon.2025.103978","DOIUrl":"10.1016/j.clon.2025.103978","url":null,"abstract":"<div><h3>Aims</h3><div>There is limited guidance relating to the provision of radiotherapy for patients with oesophageal cancer. Given this, we sought to assess variation in patterns of care in the UK and to devise quality improvement metrics to support future treatment standardisation.</div></div><div><h3>Materials and Methods</h3><div>We undertook a cross-sectional survey using a bespoke online survey to explore geographical variation in radiotherapy use for oesophageal cancer across the United Kingdom (UK) National Health Service (NHS). These data were combined with an observational registry analysis using the National Disease Registration Service Radiotherapy Dataset to explore temporal variation in radiotherapy utilization from January 2020 – June 2024.</div></div><div><h3>Results</h3><div>Survey responses were received from 75% (n = 45/60) of UK centres. These demonstrate considerable variation in the interpretation of radiotherapy indications, particularly in the non-curative setting, as well as in radiotherapy technique; with, for instance, one third (n = 15/45) of centres reporting that they do not use motion management strategies for lower third or junctional tumours. Induction chemotherapy use differs between centres and by concurrent regimen, with 93–96% (n = 42–43/45) of centres using induction treatment prior to concurrent platinum/fluoropyrimidine and 56–62% (n = 25–28/45) using it prior to concurrent platinum/taxane. Post-treatment surveillance and follow-up measures also differed with little evidence for more intensive surveillance in patients fit for salvage resection. Most centres reported the use of intensity modulated or volumetric arc therapy (IMRT/VMAT) for radical plans, which was supported by NDRS data demonstrating that the median proportion of patients in each centre treated using IMRT/VMAT increased from 60% (range 14.3–100%) in January-June 2020 to 91.7% (range 16.7–100%) in January-June 2024.</div></div><div><h3>Conclusions</h3><div>There is substantial variation in the radiotherapy-based care of patients with oesophageal cancer in the UK. Formal national guidance is required to build on the quality metrics outlined here.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"49 ","pages":"Article 103978"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145667199","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}