International Journal of Radiation Oncology Biology Physics最新文献

{"title":"Timescale of FLASH sparing effect determined by varying temporal split of dose delivery in mice.","authors":"Jacob P Sunnerberg, David I Hunter, Austin M Sloop, Armin D Tavakkoli, Petr Bruza, Rongxiao Zhang, Jiang Gui, Lesley A Jarvis, Harold M Swartz, David J Gladstone, P Jack Hoopes, Brian W Pogue","doi":"10.1016/j.ijrobp.2025.09.052","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.09.052","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the timescale for ultra-high dose rate (UHDR) radiation delivery that dictates FLASH normal-tissue sparing and elucidate its relationship to in vivo oxygen dynamics. A split-dose experiment was used to determine the transition time below which the observation of the FLASH sparing effect is preserved.</p><p><strong>Methods and materials: </strong>A 25 Gy dose was split into two deliveries (12.5 Gy), with varied interruption times. Albino B6 mice received flank skin irradiation in eight groups: single-beam UHDR (25 Gy at 415 Gy/s), single-beam conventional dose rate (CDR) (25 Gy at 0.15 Gy/s), or split-beam delivery with two lower-dose UHDR beams (12.5 Gy at 415 Gy/s) separated by 0.1, 1, 5, 15, 25, or 120 seconds. Skin damage was scored daily for 31 days, with mixed-effects analysis comparing damage progression across cohorts. Real-time tissue pO₂ was monitored using the phosphorescence-lifetime probe Oxyphor PdG4. Radiolytic oxygen consumption per unit dose (g_O2) and reoxygenation rates were quantified.</p><p><strong>Results: </strong>Single-beam UHDR significantly spared skin versus CDR. In split-dose groups, this sparing effect showed a transition at longer inter-beam intervals. Damage progression remained significantly lower than CDR and comparable to single-beam UHDR (p>0.16) for interruptions < 15 seconds. Longer intervals progressively lost tissue sparing. Oximetry indicated an average tissue reoxygenation lifetime of 7.7 ± 1.1 s. At the delivery of the second beam, pO₂ remained lower when inter-beam times were shorter than the reoxygenation period but recovered fully for longer interruptions. g_O2 values correlated with baseline tissue pO₂.</p><p><strong>Conclusions: </strong>Observation of the FLASH sparing effect requires delivery within a critical temporal window that is similar timescale to tissue reoxygenation kinetics. The transition time for loss of the FLASH sparing effect in skin roughly corresponds to a diffusion timescale for oxygen, from capillaries to the cells. While not conclusively demonstrating a mechanism, this unique finding supports the likelihood that local oxygen depletion or consumption underlies the FLASH tissue sparing effect observed in vivo, with important implications for clinical implementation and the timescale needed for multi-beam FLASH-RT.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective Trial Evaluating Post-operative Human Papilloma Virus Circulating Tumor DNA Guided Adjuvant Therapy for Human Papilloma Virus-related Oropharyngeal Carcinoma (PATH study): HPV ctDNA Guided Adjuvant therapy in OPC.","authors":"Linda Chen, Marc Cohen, Vaios Hatzglou, Zhigang Zhang, Nadeem Riaz, Achraf A Shamseddine, Luc G T Morris, Sean M McBride, Daphna Y Gelblum, Kaveh Zakeri, Yao Yu, Ian Ganly, Jennifer Cracchiolo, Richard J Wong, Noah S Kalman, Andrew B Tassler, David Kutler, Winston Wong, Anuja Kriplani, Lara Dunn, Alan L Ho, Loren S Michel, James Fetten, David G Pfister, Nora Katabi, Eric J Sherman, Nancy Y Lee","doi":"10.1016/j.ijrobp.2025.09.044","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.09.044","url":null,"abstract":"<p><p>Human papillomavirus circulating tumor DNA (HPV ctDNA) is a biomarker which detects minimal residual disease (MRD) for HPV-associated oropharyngeal carcinoma (HPV+ OPC).</p><p><strong>Purpose: </strong>We conducted the first prospective study using HPV ctDNA as an integral biomarker to select patients for post-operative radiotherapy omission. We tested the hypothesis that undetectable post-operative HPV ctDNA can be used to omit or delay adjuvant radiation until patients develop detectable HPV ctDNA using the NavDx (Naveris, Inc.) tumor-tissue-modified viral (TTMV) HPV DNA score. Eligible HPV+ OPC patients had a preoperative TTMV-HPV DNA Score of ³50 and at least one pathologic risk factor to warrant standard adjuvant radiotherapy.</p><p><strong>Methods and materials: </strong>Post-operatively, eligible patients had no evidence of disease on post-operative MRI and two negative TTMV-HPV DNA test results. Patients with non-HPV-16 genotype, positive margins, and extranodal extension were excluded. Patients were monitored with TTMV-HPV DNA testing, imaging, and physical exams. Delayed adjuvant radiation was initiated if patients developed detectable TTMV-HPV DNA without radiographic recurrence. The primary endpoint was the proportion of patients without gross recurrent disease.</p><p><strong>Results: </strong>Fifty-five HPV+ OPC patients were screened; 12 patients were enrolled. The median follow-up was 26.6 months (Range: 18.3-40.3). One patient (8%) developed detectable HPV ctDNA 6 months after surgery without evidence of recurrence and was treated with delayed adjuvant radiotherapy. Three additional patients (25%) developed radiographic recurrence 6 months after surgery. Radiographic recurrence was not preceded by detectable TTMV-HPV DNA. TTMV-HPV DNA detection was synchronous with radiographically evident disease in 2 of 3 patients. Recurrence was associated with N2b disease pre-treatment (p=0.01). The high gross recurrence rate (3 of 12 patients) led to closure of this cohort due to a pre-specified stopping rule.</p><p><strong>Conclusion: </strong>Deferring adjuvant radiotherapy based on HPV ctDNA using NavDx TTMV-HPV DNA testing resulted in a high rate of disease recurrence.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Ongoing Challenge of Radiation-Immunotherapy Optimization: From Preclinical Insights to Clinical Practice.","authors":"Ryan J Park, Jonathan D Schoenfeld","doi":"10.1016/j.ijrobp.2025.08.044","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.08.044","url":null,"abstract":"","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrifying Results? Tumor Treating Fields Reduce Intracranial Relapse of Non-Small Cell Lung Cancer Brain Metastasis Following Radiosurgery in the METIS Trial.","authors":"Martin C Tom, Kyle Wang, Donna M Edwards, Jiayi Huang","doi":"10.1016/j.ijrobp.2025.09.007","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.09.007","url":null,"abstract":"","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proton therapy may reduce the risk of cancer progression during immune checkpoint inhibitor therapy: a propensity score-matched analysis of intensity-modulated proton versus photon radiotherapy.","authors":"Cong Bo, Zhenhuan Lv, Hong Zhang, Xianmin Hou, Yinxin Wang, Jing Liu, Xue Meng","doi":"10.1016/j.ijrobp.2025.09.042","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.09.042","url":null,"abstract":"<p><strong>Purpose: </strong>Intensity-modulated proton radiotherapy (IMPT) may preserve the immune response more effectively than intensity-modulated photon radiotherapy (IMRT) owing to its dosimetric advantages, making it a potentially superior modality in immunotherapy. This study aimed to evaluate the clinical benefits of IMPT versus IMRT during immune checkpoint inhibitors (ICIs) treatment.</p><p><strong>Methods and materials: </strong>We retrospectively analyzed the data of 466 patients (IMPT group, n=109; IMRT group, n=357) who received radiotherapy (RT) during ICI therapy between July 2022 and September 2024. Propensity score matching (PSM) was applied to balance clinical characteristics. The primary endpoint was the duration of response (DoR). Secondary endpoints included progression-free survival (PFS) and post-RT adverse events. Kaplan-Meier and Cox proportional hazards regression were used to calculate survival curves and identify independent prognostic factors. The threshold used to dichotomize post-RT lymphocyte count was 0.5 × 10⁹/L.</p><p><strong>Results: </strong>Baseline clinical characteristics were balanced after PSM. The IMPT group showed significantly longer median DoR (17.7 vs. 5.7 months, p=0.0001) and PFS (18.8 vs. 6.8 months, p<0.0001) than the IMRT group. Multivariable regression revealed IMPT to be an independent predictor of improved DoR (hazard ratio [HR] 0.34; 95% confidence interval [CI]: 0.21-0.55; p<0.0001) and PFS (HR 0.36; 95% CI: 0.25-0.52; p<0.0001). Subgroup analyses suggested greater benefit of IMPT over IMRT in patients with a Charlson Comorbidity Index ≥4, lung cancer, advanced-stage disease, or those receiving palliative, thoracic, or abdominal/pelvic RT. Higher post-RT lymphocyte counts in the IMPT group showed potential correlation with improved DoR and PFS. Additionally, the IMPT group had fewer grade ≥2 post-RT adverse events (p=0.012).</p><p><strong>Conclusions: </strong>IMPT is linked to enhanced efficacy of ICIs, compared to IMRT, by improving DoR and PFS with tolerable adverse effects. Higher post-RT lymphocyte counts may be associated with improved survival in patients receiving IMPT during ICI therapy. These findings suggest that IMPT may be a preferable option for preserving immune function, thereby optimizing outcomes during immunotherapy.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Stereotactic Arrhythmia Radiotherapy (STAR) a valid alternative to repeated invasive ablation for refractory ventricular tachycardia?","authors":"Francesco Cellini, Judit Boda-Heggemann, Oliver Blanck","doi":"10.1016/j.ijrobp.2025.09.047","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.09.047","url":null,"abstract":"","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dosimetric Outcomes for Stereotactic Radiotherapy in Early-Stage Non-Small Cell Lung Cancer and Interstitial Lung Disease: A Secondary Analysis of the ASPIRE-ILD Trial.","authors":"Alexa Dang, David A Palma, Edward Wang, Pencilla Lang, Andrew Warner, Houda Bahig, Alexander V Louie, Stephen Harrow, Meredith E Giuliani, Brock J Debenham, Christopher J Ryerson, Stewart Gaede","doi":"10.1016/j.ijrobp.2025.09.026","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.09.026","url":null,"abstract":"<p><strong>Purpose: </strong>Stereotactic ablative radiotherapy (SABR) in the setting of interstitial lung disease (ILD) is associated with higher toxicity risks. This dosimetric analysis of the BLINDED-FOR-REVIEW trial evaluates doses delivered to targets and organs at risk (OARs), and correlations between baseline factors and outcomes, to better inform patient selection and treatment planning.</p><p><strong>Methods: </strong>Radiation plans were centrally reviewed, and descriptive statistics were used to assess doses to targets and OARs. Unadjusted Cox proportional hazards and logistic regression were performed to identify predictors of overall survival (OS), local control (LC), and related adverse events. Linear regression was performed to identify significant predictors of the Functional Assessment of Cancer Therapy: Lung (FACT-L).</p><p><strong>Results: </strong>The cohort included 39 patients with early-stage lung cancer and ILD treated with SABR (50 Gy in 5 fractions every other day). The mean internal gross tumor volume (iGTV) and planning target volume (PTV) were 12.0 ± 11.2 cc and 33.9 ± 22.0 cc, respectively. The mean ± SD Dmax was 64.2 ± 6.3 Gy. On unadjusted analyses, LC decreased with increasing tumour size (measured as either iGTV size [p=0.038] or PTV size [p=0.033]). The risk of grade ≥ 2 adverse events increased with higher heart Dmax (p=0.020) and heart D15cc (p=0.025), and with increasing fibrosis surrounding the tumour (measured as the Hounsfield unit density of lung immediately surrounding the PTV [p=0.006]). Worse OS was associated with ILD sub-type, previous or current ILD treatment, home oxygen use, and larger target sizes. Smoking cessation and a diagnosis of idiopathic pulmonary fibrosis (IPF) were associated with improved FACT-L scores at 6 months.</p><p><strong>Conclusion: </strong>Several factors were associated with clinically relevant outcomes after SABR in patients with ILD, including radiation dose to the heart and smoking cessation. SABR delivered to highly fibrotic areas of lung was associated with higher toxicity. Smoking cessation may be important in preserving quality of life after treatment.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor Treating Fields (TTFields) therapy after stereotactic radiosurgery for brain metastases from non-small cell lung cancer: final results of the phase 3 METIS study.","authors":"Minesh P Mehta, Vinai Gondi, Manmeet Singh Ahluwalia, David Roberge, Terence Tai Weng Sio, Daniel M Trifiletti, Thierry Muanza, Ana Misir Krpan, Zhengfei Zhu, Naren R Ramakrishna, John B Fiveash, Philippe Metellus, Jinming Yu, Chiachien Jake Wang, Julian Jacob, Christian F Freyschlag, Tibor Csőszi, Andrea Salmaggi, Alisa Taliansky, Ana Lucas, Jürgen Debus, Paul D Brown, Maciej Harat","doi":"10.1016/j.ijrobp.2025.08.066","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.08.066","url":null,"abstract":"<p><strong>Purpose: </strong>Improved treatments for brain metastases from non-small cell lung cancer (NSCLC BM) are needed to prolong time to intracranial progression without increasing neurotoxicity. TTFields, are electric fields delivered via skin-based arrays that disrupt cancer cell division, have demonstrated efficacy and safety in glioblastoma, NSCLC, and pancreatic cancer.</p><p><strong>Methods and materials: </strong>In the phase 3 METIS trial (NCT02831959) adults with 1-10 newly-diagnosed NSCLC BM suitable for SRS receiving optimal therapy for extracranial disease were randomized 1:1 to SRS followed by TTFields (150 kHz) or SRS alone. Radiologic progression was assessed by an independent radiology review committee. Primary endpoint was time to intracranial progression (TTIP; RANO-BM). Secondary endpoints included overall survival, neurocognitive function, quality of life (QoL), and safety.</p><p><strong>Results: </strong>Patients (N=298) were followed for a median of 8.6 (0.07-85.2) months. TTFields significantly delayed TTIP (HR 0.72 [95% CI 0.53-0.98]; Fine-Gray P=0.044). Intracranial progression rates at months 2, 6, 12, and 24 were 13.6% vs 22.1% (P=0.034), 33.7% vs 46.4% (P=0.018), 46.9% vs 59.4% (P=0.023), and 53.6% vs 65.2% (P=0.031; post hoc). Time to distant intracranial progression (TTDP) favored TTFields therapy, although not statistically significantly (HR 0.76 [0.51-1.12]; log-rank P=0.165; post-hoc). In patients receiving immune checkpoint inhibitors (ICI; n=118), the delays in both TTIP (HR 0.63 [0.39-1.0]; Cox P=0.049; Fine-Gray P=0.055) and TTDP (HR 0.41 [0.21-0.81]; log-rank P=0.0087, post-hoc) were more pronounced. Device-related AEs were mainly grade ≤2 skin events. TTFields did not cause QoL deterioration, and improvements in deterioration-free survival and time to deterioration of the global health status, physical functioning and fatigue domains were observed (post-hoc).</p><p><strong>Conclusions: </strong>By significantly prolonging TTIP, without worsening QoL or cognitive function, TTFields after SRS is a new treatment option for patients with NSCLC BM, including those receiving ICI.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stereotactic Arrhythmia Radiotherapy (STAR) vs Repeat Catheter Ablation for High-Risk Refractory Ventricular Tachycardia: 3-Year Safety and Efficacy Outcomes.","authors":"Shannon J Jiang, Pamela Samson, Phillip Cuculich, Carlos Contreras, Kaitlin Moore, Mitchell N Faddis, Timothy W Smith, Marye J Gleva, Daniel H Cooper, Clifford G Robinson","doi":"10.1016/j.ijrobp.2025.09.006","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.09.006","url":null,"abstract":"<p><strong>Purpose: </strong>Stereotactic Arrhythmia Radiotherapy (STAR) is a noninvasive treatment alternative to repeat catheter ablation (CA) for refractory ventricular tachycardia (VT). However, no studies have directly compared the two modalities. This study reports on 3-year safety and efficacy outcomes for STAR vs CA in refractory VT patients at a high-volume center.</p><p><strong>Methods: </strong>We conducted a retrospective cohort analysis of all patients with recurrent VT who failed medical management with antiarrhythmic medications and failed at least one prior CA (or were deemed medically unfit for CA) who were then treated with either STAR or repeat CA between 2015-2018 at a single institution. Patients treated with STAR who did not receive prior CA were evaluated on a case-by-case basis and deemed by the treating electrophysiologist to be too high risk to undergo repeat CA (\"medically unfit for CA\"). Patients were evaluated for serious adverse events (SAE); freedom from death, shock, or storm (FFDSS); and overall survival (OS). Survival analyses were performed via Kaplan-Meier method and compared by log-rank test.</p><p><strong>Results: </strong>Forty-three patients were included: 22 received STAR and 21 repeat CA. Baseline characteristics were similar, however generally patients treated with STAR were older (median 64.5 vs 59 years), had \"High Risk\" I-VT scores (64% vs 52%), and had higher PAINESD scores (median 18.5 vs 17). Median follow-up was 3 years. More patients treated with CA (N=8, 38%) developed 1-year treatment-related SAEs compared to STAR (N=2, 9%). Median time to any SAE was shorter for patients treated with CA compared to STAR (6 days vs 10.0 months), and most early CA deaths occurred immediately after SAE. Twelve patients died within 3 years of STAR, 75% (N=9) were unrelated to VT and none from treatment-related SAE. There was no statistically significant difference in FFDSS between patients treated by STAR vs CA (6.9 vs 2.9 months, p=0.88). FFDSS for STAR vs CA was 32% vs 27% at 1-year, 27% for both at 2-years, and 18% vs 21% at 3-years. There was no statistically significant difference in OS between patients treated with STAR vs CA (28.2 vs 12.2 months, p=0.91).</p><p><strong>Conclusion: </strong>At 3-year follow-up, STAR offers comparable VT control with fewer SAEs and longer time to toxicity; supporting its possible role as a noninvasive alternative to repeat CA. These findings warrant further prospective study.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Implementation of Electronic Patient-Reported Outcomes (ePRO) to Reduce Follow-up Visits for Patients Undergoing Radiation Therapy for Breast Cancer.","authors":"Marco Santos Teles, Kaitlyn Lapen, Jennie Huang, Jun J Mao, Michael B Bernstein, Lior Z Braunstein, Atif J Khan, Bobby Daly, Erin F Gillespie","doi":"10.1016/j.ijrobp.2025.09.027","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.09.027","url":null,"abstract":"<p><strong>Purpose/objectives: </strong>We aimed to evaluate the acceptability, appropriateness, and feasibility of using an ePRO-based strategy to reduce post-radiation therapy (RT) visits in patients with breast cancer who reported minimal symptoms.</p><p><strong>Materials/methods: </strong>An ePRO instrument was administrated weekly for patients undergoing RT for breast cancer at an academic cancer center. The instrument assessed RT toxicities (breast enlargement/tenderness, skin changes, pain, and fatigue) using PRO-CTCAE and anxiety with GAD-2. Patients rated symptom severity on a 5-point Likert scale (None to Very severe). Six weeks after treatment completion, patients with no more than moderate symptoms were offered the option to cancel their routine post-RT follow-up visit. Clinical and demographic data were collected from electronic health records.</p><p><strong>Results: </strong>Among the 46 patients (median age: 60 years) who responded to the appointment cancellation question, 32 (70%) were White, 5 (11%) Black, 5 (11%) Asian, and 2 (4.3%) Hispanic. Regarding acceptability among respondents, we found 36 (78%) chose to keep their appointments, 7 (15%) opted to cancel, and 3 (6.5%) were not sure. In terms of appropriateness, patients who canceled or were unsure were similar in age, race, ethnicity, BMI, and travel distance to the center, but reported fewer symptoms than those who kept their appointments, with significantly lower breast tenderness (10% vs. 50%, respectively, p=0.026), and a trend towards lower pain in the radiated area (30% vs. 61%, p=0.073) and fatigue (30% vs. 56%, p=0.23). As an assessment of feasibility, fewer hospitalizations within 6 months occurred among those cancelling their follow-up visit (0 vs. 2 [5.6%]), while urgent care visits were comparable (8.6% vs. 10%).</p><p><strong>Conclusions: </strong>An ePRO-based strategy to inform post-RT follow-up visits appears feasible and appropriate for patients who completed breast RT with mild to moderate symptoms. Despite low acceptability (20%), the high prevalence of breast cancer suggests this strategy could still reduce the clinical burden of low value visits.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}