Clinical oncology最新文献

{"title":"The Use of Artificial Intelligence Technologies in Cancer Care","authors":"P.J. Hoskin","doi":"10.1016/j.clon.2024.09.003","DOIUrl":"10.1016/j.clon.2024.09.003","url":null,"abstract":"<div><div>Artificial intelligence (AI) is already an essential tool in the handling of large data sets in epidemiology and basic research.</div><div>Significant contributions to radiological diagnosis are emerging alongside increasing use of digital pathology. The future lies in integrating this information together with clinical data relevant to each individual patient. Linkage with clinical protocols will enable personalized management options to be presented to the oncologist of the future.</div><div>Radiotherapy has the distinction of being the first to have a National Institute for Health and Care Excellence (NICE)-approved AI-based recommendation. There is the opportunity to revolutionize the workflow with many tasks currently undertaken by clinicians taken over by AI-based systems for volume outlining, planning, and quality assurance.</div><div>Education and training will be essential to understand the AI processes and inputs. Clinicians will however have to feel confident interrogating the AI-derived information and in communicating AI-derived treatment plans to patients.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103644"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379183","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":"Characteristics and Survival Outcomes of Male Breast Cancer in Brazil: A Large Population-Based Study","authors":"R. de Oliveira Frederice ,&nbsp;A.A.L. Pereira ,&nbsp;G.V. Arruda ,&nbsp;A.G. Gouveia ,&nbsp;F.E.M. de Andrade ,&nbsp;L.J. Mori ,&nbsp;R.D.M. Linck ,&nbsp;A.K. Shimada ,&nbsp;S.A. Hanna ,&nbsp;F.Y. de Moraes ,&nbsp;G.N. Marta","doi":"10.1016/j.clon.2024.10.002","DOIUrl":"10.1016/j.clon.2024.10.002","url":null,"abstract":"<div><h3>Aims</h3><div>This study evaluated the clinicopathological characteristics, treatment trends, and overall survival (OS) in male breast cancer (BC) in Sao Paulo State of Brazil.</div></div><div><h3>Materials and methods</h3><div>Men diagnosed with invasive breast cancer between January 2000 and June 2020 were identified from Fundação Oncocentro de Sao Paulo database encompasses data pertinent to 46 million residents of the Sao Paulo State of Brazil. Patients were described according to age, education level, clinical stage, treatment modalities, and medical practice. Categorical variables were described as percentages and frequencies. Demographic, treatment factors, and OS were associated using a Cox proportional hazard regression model while accounting for different lengths of participant follow-up. The Kaplan-Meier curves were used to display survival curves.</div></div><div><h3>Results</h3><div>A total of 907 male BC patients were included. The age distribution at diagnosis was &lt;51 years, 51–70 years, and &gt;70 years in 21.5%, 51.5% and 27.0% of patients, respectively. The proportions of stages I, II, III, and IV were 19.5%, 36.6%, 31.5%, and 12.3%. For each stage I, II, III, and IV, 5- and 10-years OS were 87.9% and 77.8%, 79.9% and 58.9%, 51.6% and 24.5%, 20.0% and 5.6%, respectively. Patients who received postoperative radiotherapy experienced a significant improvement in OS (HR 0.67; 95% CI 0.53–0.84; p &lt; 0.001). In the multivariable analysis adjusted for practice (public or private), education (low or medium/high), age, stage at diagnosis, and treatment modalities, the significant independent predictor for OS was stage at diagnosis.</div></div><div><h3>Conclusion</h3><div>Male BC tends to be diagnosed at a more advanced stage and older age at the time of diagnosis. Age and educational level did not influence survival outcomes. Stage at diagnosis and the use of postoperative radiotherapy were factors associated with improved OS.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103650"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496325","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":"Impact of Multiprofessional Radiotherapy Peer Review on Multidisciplinary Team Meeting Staging in Head and Neck Cancer","authors":"K. Chiu ,&nbsp;A. Gupta ,&nbsp;T. Afxentiou ,&nbsp;A. Ashraf ,&nbsp;R. Kanani ,&nbsp;K. Rajaguru ,&nbsp;N. Bhatt ,&nbsp;P. Hoskin ,&nbsp;S. Ghoshray","doi":"10.1016/j.clon.2024.103696","DOIUrl":"10.1016/j.clon.2024.103696","url":null,"abstract":"<div><h3>Aims</h3><div>Cancer staging is routinely done in a multidisciplinary team meeting (MDM). There is however no established quality assurance (QA) for MDM-recorded cancer staging. Conversely, radiotherapy peer review is a recommended QA process. This study aimed to compare the cancer staging of the multiprofessional radiotherapy peer review (with radiologists) against the referring MDMs.</div></div><div><h3>Materials and methods</h3><div>All head and neck intensity-modulated radiotherapy (IMRT) cases discussed in peer review between May 2023 to April 2024 were prospectively evaluated. Any radiological disease progression (PD) on IMRT-planning scan since the diagnostic scans, and patients' cancer staging, were prospectively recorded. These were compared with the MDM-recorded outcomes data.</div></div><div><h3>Results</h3><div>A total of 235 IMRT cases were peer-reviewed: 166 definitive, 63 post-operative and 6 palliatives. Of the analysable definitive cases, 44/150 (29%) were found to have PD, with a mean interval from diagnostic to IMRT-planning scan of 51 days (Standard Deviation SD = 25), compared to 38 days (SD = 21) in the cohort without PD (p &lt; 0.01). After the exclusion of 28 patients with the most advanced non-metastatic stage, 35 (30%) were upstaged with a mean interval from diagnostic to IMRT-planning of 49 days (SD = 26), compared to 39 days (SD = 23) in the cohort without upstage (p = 0.05). Twenty (57%) upstaged patients had evidence of PD, while the other 15 (43%) were upstaged despite the absence of PD. Two MDM-recorded T3-category larynx cancers were subsequently recommended for a primary laryngectomy due to T4a-category at peer review, and both were proven T4a pathologically. Three upstaged patients were recommended concomitant chemotherapy. The peer review recommended IMRT volume changes to 156 (66%) patients.</div></div><div><h3>Conclusion</h3><div>Discrepancies in MDM staging can occur, and a protracted diagnosis and treatment pathway too can affect final cancer staging. Routine radiologist input in peer review can provide crucial post-MDM outcome assurance and the recommended clinical management.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103696"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784359","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":"Comparing Interfractional Stability of Heart Dose Among Three Breath-Hold Radiotherapy Techniques in Breast Cancer","authors":"A.W. Chan ,&nbsp;A. Hoang ,&nbsp;H. Chen ,&nbsp;M. McGuffin ,&nbsp;A. Sheikh ,&nbsp;D. Vesprini ,&nbsp;L. Zhang ,&nbsp;M. Wronski ,&nbsp;I. Karam","doi":"10.1016/j.clon.2024.103699","DOIUrl":"10.1016/j.clon.2024.103699","url":null,"abstract":"<div><h3>Aims</h3><div>Breath holding can reduce the cardiac dose in radiotherapy for left-sided breast cancer. We evaluated whether any of the existing commonly used breath-hold techniques was superior in maintaining a more reproducible mean heart dose (MHD) during treatment.</div></div><div><h3><em>Materials and Methods</em></h3><div>This was a single-institution, interventional, nonrandomised, three-armed prospective trial, comparing the reproducibility of MHD in breath-hold radiotherapy using voluntary deep inspiration breath hold (vDIBH), active breathing control (ABC), and surface-guided radiotherapy (SGRT). The MHDs were determined based on the anatomy in planning computed tomography (CT) and each weekly cone beam computed tomography (CBCT) during radiotherapy. The reproducibility of MHD was measured by calculating the interfractional variation of MHD (represented by the standard deviation) across the CBCT and the difference between the cumulative MHD at CBCT and at planning CT. These two measures of reproducibility were then compared among vDIBH, ABC, and SGRT.</div></div><div><h3><em>Results</em></h3><div>Of the 55 patients recruited, 19 had ABC, 20 had SGRT, and 16 had vDIBH. SGRT was associated with a slightly greater interfractional variation of the MHD than vDIBH (least squares mean (LSM): 28.8 cGy (SGRT) vs 10.5 cGy (vDIBH), <em>P</em> = 0.0052) and ABC (LSM: 28.8 cGy (SGRT) vs 15.1 cGy (ABC), <em>P</em> = 0.026). In the SGRT group, the cumulative MHD at CBCT was lower than that at planning CT (mean difference: -22.1 cGy, <em>P</em> = 0.013). No such difference existed in vDIBH and ABC. In terms of the reproducibility of cumulative MHD at CBCT as compared to that in planning CT, there was no significant difference between vDIBH (mean: -12.1 cGy), ABC (mean: -4.8 cGy), and SGRT (mean: -22.1 cGy) (<em>P</em> value for pairwise comparison: all &gt;0.1).</div></div><div><h3><em>Conclusions</em></h3><div>SGRT was associated with a slightly greater interfractional variation of MHD than vDIBH and ABC, but the difference may not be clinically significant. All three breath-hold techniques were broadly comparable in their reproducibility of MHD at CBCT relative to the planning CT.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103699"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871595","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":"Effects of Radiotherapy Alone Versus Concomitant Radiotherapy With Temozolomide Chemotherapy on the Outcome of IDH-wildtype Glioblastoma Patients","authors":"M. Kurdi ,&nbsp;A. Alkhotani ,&nbsp;T. Alsinani ,&nbsp;S. Alkhayyat ,&nbsp;Y. Katib ,&nbsp;Z. Jastaniah ,&nbsp;A.J. Sabbagh ,&nbsp;N.S. Butt ,&nbsp;F.A. Toonsi ,&nbsp;M. Alharbi ,&nbsp;S. Baeesa","doi":"10.1016/j.clon.2024.103741","DOIUrl":"10.1016/j.clon.2024.103741","url":null,"abstract":"<div><h3>Background</h3><div>Isocitrate dehydrogenase [<em>IDH</em>]-wildtype glioblastoma is an aggressive brain cancer associated with high recurrence and poor overall survival.</div></div><div><h3>Aim</h3><div>Our study aims to explore the prognostic effects of radiotherapy [RT] alone versus concomitant RT with temozolomide [TMZ].</div></div><div><h3>Methods</h3><div>A multicentre retrospective study included a cohort of 244 patients diagnosed with <em>IDH</em>-wildtype glioblastoma, and it was analysed from 2013 to 2020. All patients underwent complete surgical resection of the tumour followed by standard postsurgical therapies, including RT alone [group A] or concomitant RT with TMZ chemotherapy [group B]. Intra-statistical cohort data analysis was performed.</div></div><div><h3>Results</h3><div>The mean age of the patients was 53.9 years [SD 16.3 years], with 87 [35.7%] females and 157 [64.3%] males. Group “A” patient [n = 67, 27.5%] received RT alone, and group “B” patient [n = 177, 72.5%] received concomitant RT with TMZ chemotherapy. All patients' mean progression-free survival [PFS] was 391.8 days (13.1 months). There was a statistically significant difference in PFS between the two treatment groups [<em>P</em> value&lt;0.0001]. The hazard ratio [HR] for PFS in group “b” compared with group “a” was 0.48 [95% CI: 0.36–0.64, <em>P &lt;</em> 0.001] in the univariable analysis, indicating a significant benefit of the combined treatment. This benefit was maintained in the multivariable analysis with an HR of 0.50 [95% CI: 0.37–0.67, P &lt; 0.001]. Age was found to be a significant factor in PFS, with each additional year of age increasing HR by 2% in the univariable analysis [HR: 1.02, 95% CI: 1.01–1.03, <em>P &lt;</em> 0.001] and the multivariable analysis (HR of 1.01 [95% CI: 1.01–1.02, <em>P &lt;</em> 0.001)].</div></div><div><h3>Conclusions</h3><div>Concomitant RT with TMZ chemotherapy significantly increased PFS beyond that observed from isolated RT in patients with <em>IDH</em>-wildtype glioblastoma.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103741"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Perspectives on the Value of Stereotactic Body Radiotherapy in the Management of Breast Cancer: The PERSPECTIVE Study","authors":"S.K. Nagpal ,&nbsp;G. Ross ,&nbsp;S. Cruickshank ,&nbsp;A.M. Kirby","doi":"10.1016/j.clon.2024.103738","DOIUrl":"10.1016/j.clon.2024.103738","url":null,"abstract":"<div><h3>Aims</h3><div>Oligometastatic disease describes limited metastases amenable to therapy such as stereotactic body radiotherapy (SBRT). This study aims to understand which outcomes are most important to patients when considering SBRT as a treatment option. The insights gained will help inform future patient-directed trial endpoints and provide valuable guidance to clinicians supporting patients through their decision-making process.</div></div><div><h3>Materials and Methods</h3><div>We conducted a qualitative study with focus groups and individual interviews. Participants were recruited using a purposive-sampling matrix accounting for age, presence of metastatic disease, and previous experience with radiotherapy. Each focus group had at least two moderators, and all interviews were digitally recorded and then transcribed. Thematic analysis was performed using NVivo version 12.</div></div><div><h3>Results</h3><div>The study included 18 patients diagnosed with breast cancer, comprising two focus groups and four individual interviews. The median age was 54 years (range 38–74). 15/18 (83%) had prior radiotherapy experience, including 4/18 with previous SBRT experience. Three main themes were identified: 1) Participants' experience with radiotherapy; 2) patients' perceptions and considerations in relation to SBRT (including desired treatment outcomes); and 3) willingness to consider SBRT for its potential local control and durable pain control benefits, even in the absence of survival benefit. Participants prioritised extending their lives as the foremost desired outcome of SBRT, followed by quality of life. Those with prior SBRT experience were keen for repeat treatment, if available, and emphasised SBRT's minimal side effects compared to other interventions.</div></div><div><h3>Conclusion</h3><div>While extension of life was the primary desired treatment outcome of SBRT for oligometastatic breast cancer , all participants were willing to consider SBRT for its minimal side effects and potential benefits in local control and durable pain control, even in the absence of a survival benefit.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103738"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of neoadjuvant EC-PC Pembrolizumab in triple negative breast cancer - Northern Ireland’s experience to date","authors":"C. Carson,&nbsp;E. Johnston,&nbsp;K. Crawford","doi":"10.1016/j.clon.2024.103712","DOIUrl":"10.1016/j.clon.2024.103712","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103712"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429348","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":"Treatment of macroscopic prostate bed recurrences with a focal dose-escalated boost","authors":"K. Palmer,&nbsp;A. Anderson,&nbsp;M. Lovegrove,&nbsp;E. Halliday,&nbsp;E. Cooper,&nbsp;M. Prentice","doi":"10.1016/j.clon.2024.10.022","DOIUrl":"10.1016/j.clon.2024.10.022","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Page 7"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429188","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 of Radiotherapy Workforce Training within the USA","authors":"R. Mulherkar ,&nbsp;D.C. Ling ,&nbsp;R. Tendulkar ,&nbsp;M.R. Kamrava ,&nbsp;S. Beriwal","doi":"10.1016/j.clon.2024.01.019","DOIUrl":"10.1016/j.clon.2024.01.019","url":null,"abstract":"<div><div><span><span>The training, competency requirements and scope of practice of professionals within a </span>radiation oncology<span> department vary across countries. The purpose of this review is to shed light on the current status of radiotherapy training in the USA by discussing current benchmarks for medical residency, physics residency, radiation therapy and dosimetry training programmes. Although there are notable strengths, the US radiotherapy workforce training system also faces several challenges when it comes to standardising education to develop a competent workforce that meets societal needs. Continued efforts are needed at a systemic level to improve training in areas such as brachytherapy and </span></span>proton therapy, promote research involvement and develop trainees who are equipped to form a competent radiation therapy workforce.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103521"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139664419","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":"Longitudinal Image Data for Outcome Modeling","authors":"J.E. van Timmeren,&nbsp;J. Bussink,&nbsp;P. Koopmans,&nbsp;R.J. Smeenk,&nbsp;R. Monshouwer","doi":"10.1016/j.clon.2024.06.053","DOIUrl":"10.1016/j.clon.2024.06.053","url":null,"abstract":"<div><div>In oncology, medical imaging is crucial for diagnosis, treatment planning and therapy execution. Treatment responses can be complex and varied and are known to involve factors of treatment, patient characteristics and tumor microenvironment. Longitudinal image analysis is able to track temporal changes, aiding in disease monitoring, treatment evaluation, and outcome prediction. This allows for the enhancement of personalized medicine. However, analyzing longitudinal 2D and 3D images presents unique challenges, including image registration, reliable segmentation, dealing with variable imaging intervals, and sparse data. This review presents an overview of techniques and methodologies in longitudinal image analysis, with a primary focus on outcome modeling in radiation oncology.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103610"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}