Frontiers in Oncology最新文献

{"title":"Continuous spatially informed microenvironment programs show cross-cohort concordance and context-dependent spatial organization in diffuse large B-cell lymphoma.","authors":"Junwei Yang, Han Li, Liuxin Jiang, Lishuo Deng, Yuetong Tan, Jianxiong Zhu, Jifan Li, Yao Wang, Gaojie Liu","doi":"10.3389/fonc.2026.1919412","DOIUrl":"10.3389/fonc.2026.1919412","url":null,"abstract":"<p><strong>Background: </strong>Spatial transcriptomics resolves tissue organization in diffuse large B-cell lymphoma (DLBCL), whereas most clinically annotated cohorts remain bulk transcriptomic datasets.</p><p><strong>Methods: </strong>We evaluated six literature-informed curated composite programs across bulk, single-cell and spatial datasets without assuming a discrete ecosystem taxonomy. The programs comprised Macrophage-rich, T cell-inflamed, Antigen-presentation, Stromal/fibrotic, Immune-cold/exclusion and Proliferative/cycling, with 22 memberships per program (132 memberships, 121 unique genes and 11 shared memberships).</p><p><strong>Results: </strong>In 498 GSE31312 tumors, principal components 1 and 2 (PC1 and PC2) explained 48.6% and 20.8% of score variance. No candidate discrete taxonomy demonstrated sufficient stability for retention; k=2 met silhouette and size criteria but failed both bootstrap-stability thresholds. Historical 15-edge concordance was high for GSE10846 (rho=0.936) and GSE181063 (rho=0.982), whereas the most restrictive GSE10846 edge-exclusion sensitivity, removing both shared-gene and proliferation-associated edges, reduced rho to 0.690. Single-cell analysis of 14,368 DLBCL cells from four patients and eight samples provided descriptive lineage context. In Visium V2 areas, the antigen-presentation series was treated as AP-residual (HLA-unmeasured) because only 13/22 program genes were measurable and all nine HLA genes in the defined program were unavailable. Matched-random-gene-set support was broad but not universal (24/30 DLBCL, 18/24 context/background, 42/54 overall; 25/32 primary-plus-exploratory), whereas both depth-adjusted residual endpoints were supported in 30/30 DLBCL area-program combinations.</p><p><strong>Conclusion: </strong>These findings support continuous program-level interpretation while retaining explicit provenance, stability, assay, method and sampling limitations.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"16 ","pages":"1919412"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215830","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":"Methylation profiling reveals epigenetic programs associated with chr18 loss in small intestinal neuroendocrine tumors.","authors":"Fredrik Axling, Samuel Backman, Per Hellman, Olov Norlén, Peter Stålberg","doi":"10.3389/fonc.2026.1885499","DOIUrl":"10.3389/fonc.2026.1885499","url":null,"abstract":"<p><strong>Introduction: </strong>Small intestinal neuroendocrine tumors (SI-NETs) are characterized by a low mutational burden and limited recurrent driver mutations, suggesting that other mechanisms contribute to tumor development. One of the most frequent genomic alterations in SI-NETs is loss of heterozygosity on chromosome 18 (chr18del), which defines a major molecular subtype. However, the epigenetic consequences of this event remain poorly understood.</p><p><strong>Methods: </strong>In this study, we used long-read whole-genome sequencing to characterize genome-wide DNA methylation patterns in twelve primary tumors. Native methylation detection and copy-number profiling enabled stratification of tumors according to chromosome 18 status and direct comparison of epigenetic states between chr18del and non-chr18del (diploid) tumors.</p><p><strong>Results: </strong>Chr18del tumors displayed widespread hypomethylation relative to diploid tumors, while chromosome 18 showed spatially structured regional methylation differences, including localized regions of increased methylation. Cross-platform validation using an independent Illumina EPIC methylation cohort confirmed the direction and distribution of many methylation events. Integration with the corresponding transcriptomic dataset revealed that a subset of methylation changes was associated with differential gene expression consistent with established promoter- and gene-body methylation models. Functional categorization of these methylation states revealed regulatory patterns linked to neuronal signaling, intracellular signaling cascades, and interactions with the extracellular matrix.</p><p><strong>Discussion: </strong>Together, these findings support an association between chromosome 18 status and widespread methylation differences that extend beyond the affected chromosome and are linked to transcriptional programs relevant to neuroendocrine tumor biology.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"16 ","pages":"1885499"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215270","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":"RTK-RAS pathway alterations in hepatocellular carcinoma and cholangiocarcinoma: a multicohort genomic and single-cell transcriptomic study.","authors":"Chongyuan Chen, Rongchun Xing, Yuhong Wen, Meiqi Li, Mingzheng Hu","doi":"10.3389/fonc.2026.1963032","DOIUrl":"10.3389/fonc.2026.1963032","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether heterogeneous genomic alterations detected by clinical tumor panels converge on a reproducible pathway-level difference between hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA), and to examine its transcriptional output, cellular localization, and tumor-stromal coexpression context in public multi-omics cohorts.</p><p><strong>Methods: </strong>The institutional cohort comprised 52 patients who underwent tumor tissue genomic testing, including 28 with HCC and 24 in a CCA working cohort whose intrahepatic location was not uniformly documented. Ten canonical oncogenic pathways were compared using panel-aware evaluable denominators, and the selected pathway was tested in independent Memorial Sloan Kettering (MSK) cohorts. Matched genomic and transcriptomic data from The Cancer Genome Atlas (TCGA) were used to evaluate downstream pathway activity. GSE151530 and GSE189903 were analyzed by patient-level pseudobulk to localize the transcriptional difference, followed by CellChatDB-guided ligand-receptor coexpression analysis.</p><p><strong>Results: </strong>Receptor tyrosine kinase-RAS (RTK-RAS) showed the strongest cancer-type difference in the institutional cohort: alterations were detected in 4/21 evaluable HCC cases and 8/11 evaluable CCA cases (odds ratio [OR] = 9.44; 95% CI, 1.87-47.70; P = 0.00601; Benjamini-Hochberg-adjusted q = 0.0601), with concordant directions across sensitivity analyses. In MSK, integrated RTK-RAS alterations occurred in 240/412 intrahepatic cholangiocarcinoma (iCCA) cases (58.3%) and 107/289 HCC cases (37.0%; OR = 2.37; 95% CI, 1.74-3.22; P = 3.12 × 10^-8). In TCGA, RTK-RAS status was associated with higher mitogen-activated protein kinase (MAPK) activity in the pooled cancer-type-adjusted model (β = 0.240; 95% CI, 0.051-0.428; P = 0.0129), whereas the within-iCCA estimate was positive but imprecise. Patient-level single-cell meta-analysis localized the higher iCCA MAPK activity predominantly to malignant cells (pooled effect = 1.455; 95% CI, 0.658-2.252; P = 3.46 × 10^-4; q = 0.00208). Platelet-derived growth factor (PDGF)-PDGFRA and insulin-like growth factor (IGF)-IGF1R coexpression patterns accompanied this malignant-cell phenotype.</p><p><strong>Conclusion: </strong>Panel-aware integration of clinical genomic testing and public multi-omics data supports a higher burden of heterogeneous RTK-RAS alterations in CCA/iCCA than in HCC and links this difference to a malignant-cell MAPK transcriptional phenotype. The pathway-level framework complements, rather than replaces, established alteration-specific interpretation and generates tumor-stromal coexpression hypotheses for further spatial and functional testing.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"16 ","pages":"1963032"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215633","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":"Risk factors for recurrence after initial transurethral resection of bladder tumor in patients with non-muscle-invasive bladder cancer.","authors":"Fang Yuan, Xiong Li, Jing Zhang, Jian-Yong Gao","doi":"10.3389/fonc.2026.1861461","DOIUrl":"10.3389/fonc.2026.1861461","url":null,"abstract":"<p><strong>Background: </strong>Recurrence remains common after initial transurethral resection of bladder tumor (TURBT) for non-muscle-invasive bladder cancer (NMIBC). This study aimed to identify routinely available clinicopathological, treatment-related, and inflammatory factors associated with recurrence and to characterize recurrence-free survival (RFS).</p><p><strong>Methods: </strong>This retrospective cohort included patients with pathologically confirmed Ta, T1, or primary carcinoma <i>in situ</i> (CIS) who underwent initial TURBT between January 2017 and December 2023. Multivariable logistic regression was used as the primary analysis to evaluate factors associated with documented recurrence during follow-up. Cox proportional hazards regression was performed as a complementary analysis incorporating recurrence timing and censoring. Kaplan-Meier analysis, sensitivity analyses, restricted cubic spline analysis, time-dependent receiver operating characteristic analysis, and bootstrap-corrected model evaluation were also performed.</p><p><strong>Results: </strong>Among 605 patients, 237 (39.2%) experienced recurrence during a median follow-up of 34.0 months. Multiple tumors were associated with higher recurrence odds and hazard (adjusted odds ratio [OR], 1.88; 95% confidence interval [CI], 1.27-2.78; adjusted hazard ratio [HR], 1.62; 95% CI, 1.25-2.10). Higher recurrence odds and hazards were also associated with increasing tumor diameter, T1 or primary CIS, high-grade pathology, concomitant CIS, and higher baseline neutrophil-to-lymphocyte ratio. Maintenance intravesical therapy was inversely associated with recurrence (adjusted OR, 0.49; 95% CI, 0.34-0.72; adjusted HR, 0.62; 95% CI, 0.47-0.81). Estimated RFS rates were 81.5%, 63.8%, and 54.1% at 1, 3, and 5 years, respectively. The bootstrap-corrected area under the curve was 0.769 for the logistic model, and the bootstrap-corrected Harrell's C-index was 0.739 for the Cox model.</p><p><strong>Conclusions: </strong>Recurrence after initial TURBT was associated with greater tumor burden, adverse pathological characteristics, concomitant CIS, and higher baseline neutrophil-to-lymphocyte ratio. Maintenance intravesical therapy showed an inverse observational association with recurrence. These routinely available factors may support postoperative risk stratification and risk-adapted surveillance.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"16 ","pages":"1861461"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215641","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":"Therapeutic outcomes and prognostic determinants of neoadjuvant chemotherapy plus interval debulking surgery compared with primary debulking surgery in advanced-stage epithelial ovarian cancer.","authors":"Yan Ma, Mengli Xu, Qi Zhang, Kamalibek Markya, Li Li","doi":"10.3389/fonc.2026.1893041","DOIUrl":"10.3389/fonc.2026.1893041","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To compare the therapeutic outcomes of neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS) and primary debulking surgery (PDS) in patients with advanced epithelial ovarian cancer (AEOC) and to evaluate factors associated with prognosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective study included 97 patients with AEOC treated between April 2015 and July 2020. According to treatment strategy, 36 patients underwent PDS and 61 underwent NACT-IDS. Overall survival (OS), progression-free survival (PFS), and perioperative outcomes were compared between the two groups. Kaplan-Meier analysis and Cox proportional hazards regression were used to evaluate survival outcomes. Additional adjusted models were used to account for baseline imbalance. Because CA-125 normalization occurred after treatment initiation, it was defined as a serum CA-125 concentration of ≤35 U/mL and analyzed as a time-dependent covariate.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Significant baseline differences were observed between the groups in age, BMI, baseline CA-125 level, and FIGO stage (all P&lt;0.05). During a median follow-up of 43 months [95% CI (39.87, 50.32)], 53 of 97 patients (54.64%) died. Median OS was 41 months in the PDS group and 43 months in the NACT-IDS group, and median PFS was 20 months in both groups. No significant differences were found in unadjusted OS or PFS between the groups (OS: log-rank P = 0.484; PFS: log-rank P = 0.410). After adjustment for age, BMI, log-transformed baseline CA-125 level, and FIGO stage, treatment strategy was not associated with OS [adjusted HR = 0.88, 95% CI (0.49, 1.58), P = 0.667] or PFS [adjusted HR = 1.07, 95% CI (0.64, 1.79), P = 0.798]. Patients who achieved complete cytoreduction (R0) had longer median OS than those with incomplete cytoreduction (R1+R2) [43 vs. 38 months, P = 0.025] and longer median PFS [22 vs. 18 months, P = 0.040]. After adjustment, NACT-IDS remained associated with shorter operation time, lower intraoperative blood loss, earlier initiation of postoperative chemotherapy, and a lower likelihood of drainage-tube placement, whereas its association with postoperative complications was no longer statistically significant. Residual disease was associated with higher mortality [adjusted HR = 2.61, 95% CI 1.10-6.18, P = 0.029]. CA-125 normalization was associated with lower hazards of death [time-dependent adjusted HR = 0.59, 95% CI 0.35-0.99, P = 0.047] and progression or death [time-dependent adjusted HR = 0.63, 95% CI 0.42-0.95, P = 0.026].&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In this exploratory single-center retrospective non-randomized cohort, NACT-IDS was associated with shorter operation time, lower intraoperative blood loss, earlier initiation of postoperative chemotherapy, and less frequent drainage-tube placement than PDS, but not with a significantly lower adjusted postoperative complication rate or with OS or PFS. These findings should not be interpreted a","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"16 ","pages":"1893041"},"PeriodicalIF":3.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180708","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":"Explainable machine-learning model for postoperative lower-extremity deep vein thrombosis after gynecologic cancer surgery.","authors":"Yanhong Zhang, Congcong Shi, Deyan Yang, Xiaona Ji, Yingli Chu","doi":"10.3389/fonc.2026.1813354","DOIUrl":"10.3389/fonc.2026.1813354","url":null,"abstract":"<p><strong>Background: </strong>Postoperative lower-extremity deep vein thrombosis (DVT) is a common and potentially fatal complication after radical surgery for gynecologic malignancies, yet population-specific risk tools remain limited.</p><p><strong>Methods: </strong>We retrospectively analyzed 500 consecutive patients who underwent radical surgery for cervical, endometrial, or ovarian cancer (January 2022-January 2025). The cohort was randomly divided into a training set (n=351, 70%) and a validation set (n=149, 30%) at a 7:3 ratio. Independent predictors were identified using logistic regression, and 10 machine-learning algorithms were trained and compared. Model discrimination, calibration, and clinical utility were evaluated, and the optimal model was interpreted using SHAP.</p><p><strong>Results: </strong>DVT occurred in 116 patients (23.2%). Five variables were independently associated with DVT: age, Caprini score, lymphocyte count, preoperative D-dimer, and neutrophil-to-lymphocyte ratio (NLR).Across candidate models, CatBoost achieved the optimal overall performance on the validation set, yielding an AUC of 0.816 (95% CI: 0.738-0.881), with sensitivity of 0.824 (95% CI: 0.700-1.000) and specificity of 0.730 (95% CI: 0.515-0.876), and SHAP analysis ranked the predictors by mean absolute SHAP value in the following order: lymphocyte count, Caprini score, age, preoperative D-dimer, and neutrophil-to-lymphocyte ratio (NLR).</p><p><strong>Conclusion: </strong>An interpretable CatBoost-based model enables individualized postoperative DVT risk stratification after gynecologic cancer surgery and may support targeted, evidence-based thromboprophylaxis and perioperative nursing management.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"16 ","pages":"1813354"},"PeriodicalIF":3.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180685","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":"Real-world management of ovarian cancer in women living with HIV: treatment exposure, immune monitoring, and care barriers in a five-case series.","authors":"Yang Zhang, Fuxiang Wang, Mingchuan Guo, Jianyu Wan, Huiyan Liao, Ting Mao, Lu Cui, Wenming Cao, Yutao Gao","doi":"10.3389/fonc.2026.1942370","DOIUrl":"10.3389/fonc.2026.1942370","url":null,"abstract":"<p><strong>Background: </strong>With improved survival among people living with HIV (PLWH), non-AIDS-defining cancers have become increasingly prominent. Women living with HIV (WLWH) remain underrepresented in ovarian cancer trials, leaving limited evidence on the tolerability of standard therapies, including chemotherapy, anti-VEGF agents, and PARP inhibitors. These patients also face unique care barriers beyond biological uncertainties.</p><p><strong>Methods: </strong>This retrospective review included five WLWH diagnosed with ovarian cancer (June 2022-March 2024). Three received anticancer treatment; one refused chemotherapy and was lost to follow-up; one had biopsy only. We collected data on demographics, HIV history, tumor characteristics, treatment exposure, adverse events (CTCAE v5.0), CD4⁺/CD8⁺ counts, and HIV RNA, focusing safety and immune analyses on the three treated patients.</p><p><strong>Results: </strong>Median age was 51 years; four had stage III-IV disease. No treatment-related deaths, persistent HIV rebound, or AIDS-defining events occurred. During first-line paclitaxel/carboplatin, one patient developed grade 3 neutropenia managed with G-CSF, but later developed significant thrombocytopenia on niraparib requiring dose reduction and hospitalization. Among two patients receiving bevacizumab, CD4⁺ patterns diverged: one showed a transient decline (387 to 259 cells/μL) with concurrent nedaplatin; another maintained stable counts (150 to 200 cells/μL). One patient had transient, self-limited HIV RNA elevation concurrent with disease progression, which resolved spontaneously.</p><p><strong>Conclusion: </strong>This series provides real-world observations that platinum-based and targeted therapies may be delivered to selected WLWH with close monitoring. The heterogeneous CD4⁺ responses highlight the need for individualized immune surveillance rather than attributing changes to any single agent. Integrated oncologic-HIV care and attention to socioeconomic barriers remain critical for this underrepresented population.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"16 ","pages":"1942370"},"PeriodicalIF":3.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180781","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":"Efficacy and safety of air-flow beds for autologous hematopoietic stem cell transplantation in multiple myeloma: a retrospective cohort study.","authors":"Zhangbiao Long, Dinghui Zhao, Min Ruan, Yutong Jin, Yuxin Li, Zhengfeng Hou, Jian Hong, Jifei Dai, Xinglin Liang, Qingsheng Li, Jian Ge","doi":"10.3389/fonc.2026.1953570","DOIUrl":"10.3389/fonc.2026.1953570","url":null,"abstract":"<p><strong>Background: </strong>Autologous hematopoietic stem cell transplantation (ASCT) is the standard consolidation therapy for multiple myeloma (MM), but its widespread implementation is constrained by the high cost and limited availability of conventional laminar airflow rooms. The air-flow bed, a single-bed unit equipped with high-efficiency particulate air (HEPA) filtration providing class 100 (ISO class 5) air quality, represents a more accessible and cost-effective alternative.</p><p><strong>Methods: </strong>In this retrospective cohort study, we compared the efficacy, safety, and costs of ASCT performed in air-flow beds (Group A, n=91) versus conventional laminar airflow rooms (Group B, n=60) in 151 MM patients treated between 2022 and 2026. Multivariable regression models were adjusted for potential confounders. Sepsis was analyzed descriptively because of the small number of events. Platelet transfusion requirements were analyzed using negative binomial regression.</p><p><strong>Results: </strong>Engraftment outcomes were comparable between groups. Group A showed significantly lower rates of mucositis, diarrhea, and nausea/vomiting, and no sepsis events occurred in Group A compared with four cases (6.7%) in Group B. Pathogen detection rate was lower in Group A than in Group B (5.5% vs. 15.0%, P = 0.050). In negative binomial regression, air-flow bed use was independently associated with a lower number of platelet transfusion units (IRR = 0.50, P<0.001). Higher CD34+ cell dose was also independently associated with fewer platelet transfusions (IRR = 0.94 per 1×10⁶/kg increase, P = 0.003). Sepsis occurred exclusively in Group B (4/60, 6.7% vs. 0/91, 0%). With only four events and complete separation between groups, multivariable logistic regression was not statistically reliable. This finding is therefore reported descriptively and no adjusted effect estimate is presented. Median total costs were significantly lower in Group A (¥121,738 [approximately $16,908] vs. ¥137,506 [approximately $19,098], P = 0.0002). No transplant-related mortality occurred in Group A, whereas one patient (1.7%) in Group B died.</p><p><strong>Conclusion: </strong>These findings suggest that air-flow beds may represent a safe, effective, and economically viable alternative to conventional laminar airflow rooms for ASCT in MM. Because protective environment and transplant era were strongly intertwined, these observational associations should be interpreted with caution and regarded as hypothesis-generating. Prospective validation in randomized controlled trials is warranted to confirm these observations.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"16 ","pages":"1953570"},"PeriodicalIF":3.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180287","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":"Clinical outcomes after reirradiation with dose painting of recurrent or second primary head and neck cancer.","authors":"Einar Dale, Morten E Evensen, Cecilie D Amdal, Torbjørn Furre, Jon M Moan, Liv Cathrine Heggebø, Ayca M Løndalen, Eirik Malinen","doi":"10.3389/fonc.2026.1966123","DOIUrl":"10.3389/fonc.2026.1966123","url":null,"abstract":"<p><strong>Purpose: </strong>Recurrent or second primary head and neck cancer (rsHNC) presents a radiotherapeutic challenge due to limited tolerance of previously irradiated tissues. These patients could benefit from dose painting (DP), which focuses on delivering maximal dose to areas of high tumor burden while respecting dose constraints to organs at risk. In this study, we compare clinical outcomes in one group receiving standard reirradiation with a group receiving 18F-fluorodeoxyglucose (FDG) PET/CT-guided DP.</p><p><strong>Methods: </strong>Our standard reirradiation regimen is hyperfractionated radiotherapy (RT) of 1.5 Gy x 40 (60 Gy total dose). For DP, we defined two FDG-based prescription volumes receiving at least 65 Gy and 70 Gy. Thirteen patients receiving standard RT were compared with 10 DP patients. Toxicity was scored using CTCAE v3.0. Disease-related endpoints were locoregional control (LRC), disease-free survival (DFS) and overall survival (OS).</p><p><strong>Results: </strong>The mean composite toxicity score was maximal at the end of RT, with varying patterns across the CTCAE items. No significant difference in toxicity was found between the groups except for dysphagia at 6 months, where the standard RT group had worse scores (p=0.01). No differences were found in LRC and DFS. Two-year OS was 50% in the DP group versus 15% in the standard group (p=0.04), although this may reflect higher comorbidity in the standard group.</p><p><strong>Conclusion: </strong>DP of rsHNC did not increase toxicity compared with standard reirradiation. No evidence of improved disease control was found. However, DP may benefit selected patients, and future studies should focus on identifying these candidates.</p><p><strong>Clinical trial registration: </strong>https://clinicaltrials.gov, identifier NCT02921581.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"16 ","pages":"1966123"},"PeriodicalIF":3.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180623","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":"Local control after stereotactic radiation for thyroid cancer: a histology risk-stratified analysis.","authors":"Bin Gui, Jayavignesh Sekar, Margaret Locke, Shyamali Saha, Mitchell Tulchinsky, Brianna Jones, Nagashree Seetharamu, Maged Ghaly","doi":"10.3389/fonc.2026.1898567","DOIUrl":"10.3389/fonc.2026.1898567","url":null,"abstract":"<p><strong>Purpose/objectives: </strong>Recurrent and metastatic non-anaplastic thyroid cancer has traditionally been considered relatively radioresistant. We evaluated whether anatomic site or histology risk group better predicts local control (LC) following stereotactic radiation therapy (SBRT/SRS).</p><p><strong>Materials/methods: </strong>We retrospectively reviewed 32 patients with 66 treated lesions (42 skeletal, 24 non-skeletal) treated between 2012 and 2025. Histology was dichotomized into low-risk (papillary, follicular, medullary, Hürthle cell; n=61) and high-risk (poorly differentiated and squamous cell carcinoma; n=5). BED₁₀ was calculated using α/β = 10 Gy. LC was defined per RECIST 1.1. Kaplan-Meier and log-rank tests were used. Intra-patient correlation was addressed via generalized estimating equations (GEE) and Cox shared frailty models. A multivariable GEE model included histology risk, site, BED₁₀, PTV volume, prior surgery, and age.</p><p><strong>Results: </strong>Median follow-up was 15.0 months. Six local failures occurred (crude LC 90.9%); 1- and 2-year LC were 96.5% and 87.1%. Histology risk was the dominant determinant: low-risk histology achieved 95.1% crude LC versus 40.0% for high-risk (log-rank p=0.002). In multivariable GEE analysis, low-risk histology was independently associated with LC (OR 158.0, 95% CI 1.72-14,479.7; p=0.028), whereas skeletal site was not (OR 1.07, 95% CI 0.02-51.8; p=0.974). BED₁₀ was not associated with LC after adjustment (p=0.752). Skeletal and non-skeletal LC were similar after histology stratification (95.0% vs 95.2% among low-risk). Treatment was well tolerated; no Grade ≥3 radiation toxicity, myelopathy, or fractures occurred.</p><p><strong>Conclusion: </strong>In stereotactic radiation for metastatic non-anaplastic thyroid cancer, histology risk grouping-not anatomic site or dose escalation-is the dominant predictor of local control. These findings support histology-based risk stratification for SRT patient selection.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"16 ","pages":"1898567"},"PeriodicalIF":3.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180657","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}