International Journal of Radiation Oncology Biology Physics最新文献

{"title":"Oxygen Consumption In Vivo by Ultra-High Dose Rate Electron Irradiation Depends Upon Baseline Tissue Oxygenation.","authors":"Jacob P Sunnerberg, Armin D Tavakkoli, Arthur F Petusseau, Noah J Daniel, Austin M Sloop, Wilson A Schreiber, Jiang Gui, Rongxiao Zhang, Harold M Swartz, P Jack Hoopes, David J Gladstone, Sergei A Vinogradov, Brian W Pogue","doi":"10.1016/j.ijrobp.2024.10.018","DOIUrl":"10.1016/j.ijrobp.2024.10.018","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess the impact of tissue oxygen levels on transient oxygen consumption induced by ultra-high dose rate (UHDR) electron radiation in murine flank and to examine the effect of dose rate variations on this relationship.</p><p><strong>Methods and materials: </strong>Real-time oximetry using the phosphorescence quenching method and Oxyphor PdG4 molecular probe was employed. Continuous measurements were taken during radiation delivery on a UHDR-capable Mobetron linear accelerator. Oxyphor PdG4 was administered into the subcutaneous tissue of the flank skin 1 hour before irradiation. Skin oxygen tension (pO₂) was manipulated by adjusting oxygen content in the inhaled gas mixture and/or by vasculature compression. A skin surface radiation dose of 19.8 ± 0.3 Gy was verified using a calibrated semiconductor diode dosimeter. Dose rate was varied across the UHDR range by changing linear accelerator cone length and pulse repetition frequency.</p><p><strong>Results: </strong>The decrease in pO₂ per unit dose during radiation delivery, termed oxygen consumption g-value (g_O2, mmHg/Gy), was significantly influenced by tissue oxygen levels in the range 0 to 65 mmHg under UHDR conditions. Within the 0 to 20 mmHg range, g_O2 exhibited a sharp increase with rising baseline pO₂, plateauing at 0.26 mmHg/Gy. Dose rate variations (mean values, 25-1170 Gy/s; per pulse doses of 2.5-9.8 Gy) were explored by varying both cone length and pulse repetition frequency (10-120 Hz) with no significant changes in g_O2. Conventional dose rate irradiation resulted in no discernible changes in pO₂.</p><p><strong>Conclusions: </strong>The results show significant differences in the radiation-chemical effects of UHDR radiation between hypoxic and well-oxygenated tissues. Similar trends between earlier published in vitro and in vivo experiments presented herein suggest the chemical mechanisms driving the dependencies of g_O2 on pO₂ are similar, potentially underpinning the FLASH effect. Importantly, significant variations in baseline pO₂ were observed in animals kept under identical conditions, underscoring the necessity to control and monitor tissue oxygen levels for preclinical investigations and future clinical applications of FLASH radiation therapy.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500469","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":"Accelerated Partial Breast Irradiation for Early-Stage Invasive Lobular Carcinoma.","authors":"Lior Z Braunstein, Lillian Boe, Boris Mueller, Diana Roth Obrien, Isabelle Choi, John Cuaron, Amy Xu, Michael Bernstein, Beryl McCormick, Simon N Powell, Atif J Khan","doi":"10.1016/j.ijrobp.2024.10.024","DOIUrl":"10.1016/j.ijrobp.2024.10.024","url":null,"abstract":"<p><strong>Purpose: </strong>Invasive lobular carcinoma (ILC) represents 10% to 15% of invasive breast cancers with limited representation among trials of accelerated partial breast irradiation (APBI). Contemporary guidelines advise against treating ILC with APBI given a paucity of supportive evidence. Here, we evaluated oncologic outcomes among patients with ILC treated with APBI.</p><p><strong>Methods and materials: </strong>Patients treated from 2010 to 2022 with APBI after breast conserving surgery for ILC (or mixed ILC with other histologies) were ascertained from a prospectively maintained institutional database. All patients received external beam APBI to 40 Gy in 10 daily fractions. Outcomes of interest included local recurrence (LR) and overall survival (OS).</p><p><strong>Results: </strong>Of 1248 patients who underwent APBI at our center, the study cohort comprised 132 (11%) who had ILC, either exclusively or mixed with another histology (median age 63). Median tumor size was 1.1 cm (interquartile range: 0.8-1.5), nearly all had estrogen receptor positive disease (99%) and received hormone therapy (91%), and most underwent sentinel node biopsy (89%) with the remainder having no axillary surgery. At 530 person-years and a median follow-up of 39 months, 2 LRs were observed yielding a 48-month cumulative incidence of LR of 3.0% (95% CI: 0.56%-9.5%). Both events arose in patients with mixed lobular histology (none arose in patients with pure ILC). Two unrelated deaths were also observed yielding a 48-month OS of 98% (95% CI: 95%-100%).</p><p><strong>Conclusion: </strong>Among patients with ILC who received APBI after breast conserving surgery, we observed a 4-year LR rate of 3%. No regional or distant recurrences were observed, and OS was excellent. The safety of APBI for ILC will require confirmation among larger trials with longer follow-up, although the excellent outcomes observed here are consistent with those seen for invasive ductal carcinomas among contemporary trials of APBI.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500375","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":"Patient-Specific Deep Learning Tracking Framework for Real-Time 2D Target Localization in Magnetic Resonance Imaging-Guided Radiation Therapy.","authors":"Elia Lombardo, Laura Velezmoro, Sebastian N Marschner, Moritz Rabe, Claudia Tejero, Christianna I Papadopoulou, Zhuojie Sui, Michael Reiner, Stefanie Corradini, Claus Belka, Christopher Kurz, Marco Riboldi, Guillaume Landry","doi":"10.1016/j.ijrobp.2024.10.021","DOIUrl":"10.1016/j.ijrobp.2024.10.021","url":null,"abstract":"<p><strong>Purpose: </strong>We propose a tumor tracking framework for 2D cine magnetic resonance imaging (MRI) based on a pair of deep learning (DL) models relying on patient-specific (PS) training.</p><p><strong>Methods and materials: </strong>The chosen DL models are: (1) an image registration transformer and (2) an auto-segmentation convolutional neural network (CNN). We collected over 1,400,000 cine MRI frames from 219 patients treated on a 0.35 T MRI-linac plus 7500 frames from additional 35 patients that were manually labeled and subdivided into fine-tuning, validation, and testing sets. The transformer was first trained on the unlabeled data (without segmentations). We then continued training (with segmentations) either on the fine-tuning set or for PS models based on 8 randomly selected frames from the first 5 seconds of each patient's cine MRI. The PS auto-segmentation CNN was trained from scratch with the same 8 frames for each patient, without pre-training. Furthermore, we implemented B-spline image registration as a conventional model, as well as different baselines. Output segmentations of all models were compared on the testing set using the Dice similarity coefficient, the 50% and 95% Hausdorff distance (HD_50%/HD_95%), and the root-mean-square-error of the target centroid in superior-inferior direction.</p><p><strong>Results: </strong>The PS transformer and CNN significantly outperformed all other models, achieving a median (interquartile range) dice similarity coefficient of 0.92 (0.03)/0.90 (0.04), HD_50% of 1.0 (0.1)/1.0 (0.4) mm, HD_95% of 3.1 (1.9)/3.8 (2.0) mm, and root-mean-square-error of the target centroid in superior-inferior direction of 0.7 (0.4)/0.9 (1.0) mm on the testing set. Their inference time was about 36/8 ms per frame and PS fine-tuning required 3 min for labeling and 8/4 min for training. The transformer was better than the CNN in 9/12 patients, the CNN better in 1/12 patients, and the 2 PS models achieved the same performance on the remaining 2/12 testing patients.</p><p><strong>Conclusions: </strong>For targets in the thorax, abdomen, and pelvis, we found 2 PS DL models to provide accurate real-time target localization during MRI-guided radiotherapy.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500470","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":"Hormone Replacement Therapy in Patients with Gynecologic Cancer and Radiation-Induced Premature Ovarian Insufficiency.","authors":"Abigail Pepin, Arina Chesnokova, Allyson Pishko, Stefan Gysler, Caitlin Martin, Emily Smith, Megan Kassick, Neil K Taunk","doi":"10.1016/j.ijrobp.2024.10.023","DOIUrl":"10.1016/j.ijrobp.2024.10.023","url":null,"abstract":"<p><p>Patients with gynecologic, gastrointestinal, or genitourinary malignancy are at elevated risk of developing premature ovarian insufficiency from the multimodality therapies used to treat their cancers. Premature ovarian insufficiency can result in long-term decrements to all-cause mortality, bone density, cardiovascular health, sexual health, cognitive health, and body mass. Hormone replacement therapy has been demonstrated to reverse these long-term sequalae with the goal of restoring estrogen concentrations to physiological levels. Here, we discuss a practical approach for initiation of hormone replacement therapy as well as challenges to consider.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500376","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":"Reduced-dose Radiation Therapy for Stage IE Gastric Mucosa-Associated Lymphoid Tissue Lymphoma: A Multi-Institutional Prospective Study (KROG 16-18).","authors":"Seung Hyuck Jeon, Ji Hyun Chang, Il Han Kim, Hong In Yoon, Keun-Yong Eom","doi":"10.1016/j.ijrobp.2024.10.020","DOIUrl":"10.1016/j.ijrobp.2024.10.020","url":null,"abstract":"<p><strong>Purpose: </strong>Definitive radiation therapy (RT) of 30 Gy or higher is commonly recommended to treat Helicobacter pylori-independent gastric mucosa-associated lymphoid tissue (MALT) lymphoma with an excellent disease control rate. However, the efficacy of reduced-dose RT has not yet been evaluated in a prospective cohort study. This multi-institutional study aimed to determine the role of reduced-dose RT in the treatment of stage IE gastric MALT lymphoma.</p><p><strong>Methods and materials: </strong>Between March 2017 and June 2022, 62 patients with histologically confirmed stage IE gastric MALT lymphoma without evidence of H pylori infection were enrolled. The patients were treated with reduced-dose RT at a total dose of 24 to 25.5 Gy to the entire stomach. The response to therapy was evaluated by endoscopy with a biopsy of suspicious lesions if necessary. The primary endpoints were 6-month complete remission (CR) and local failure-free survival.</p><p><strong>Results: </strong>Among 62 patients, 32 (51.6%) were previously treated for H pylori eradication. Radiation therapy was delivered using 3D-conformal (n = 20, 32.3%) or intensity modulated radiation therapy (n = 42, 67.7%). The median follow-up duration was 34.5 months (range, 9.6-68.8 months). The 6-month CR rate was 96.7%. The 5-year local failure-free survival and progression-free survival rates were 92.0% and 90.4%, respectively. None of the patients experienced grade 3 or worse acute toxicities, and grade 2 acute toxicities were reported in 17 patients (27.4%).</p><p><strong>Conclusions: </strong>Reduced-dose RT exhibited excellent response rates in stage IE gastric MALT lymphoma, comparable to historical controls of standard-dose (≥30 Gy) radiation therapy, with a minimal toxicity profile. Current prospective evidence strongly supports the use of definitive radiation therapy (24-25.5 Gy) for the treatment of H pylori-independent stage IE gastric MALT lymphoma.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500471","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":"A Randomized, Multicenter, Phase 2 Trial of Camrelizumab With or Without Metastasis-directed Stereotactic Body Radiation Therapy in Recurrent or Metastatic Nasopharyngeal Carcinoma.","authors":"Xin Zhang, Jin Yan, Qianqian Lei, Jialing Neo, Sze Huey Tan, Xiaolei Shu, Luo Huang, Bin Long, Yue Xie, Feng Wang, Yuwei Wang, Honglei Tu, Chengchen Wang, Lu Zhang, Jieying Yang, Jianwen Zhang, Huawen Liu, Darren W T Lim, Melvin L K Chua, Jiang Dong Sui, Ying Wang","doi":"10.1016/j.ijrobp.2024.10.019","DOIUrl":"10.1016/j.ijrobp.2024.10.019","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the efficacy of metastasis-directed therapy (MDT) when added to camrelizumab (Cam) in patients with recurrent or metastatic nasopharyngeal carcinoma (R/M-NPC).</p><p><strong>Methods and materials: </strong>We conducted a randomized, controlled, multicenter, phase 2 trial in 3 centers from China (NCT04830267). Patients with R/M-NPC, without prior exposure to immunotherapy, who presented with ≥2 lesions, and at least 1 measurable lesion were randomized 1:1 to either Cam alone or Cam plus MDT (Cam+MDT). Patients randomized to the MDT group must have 1 lesion that is amendable to stereotactic body radiation therapy (SBRT) prescribed to 27 Gy in 3 fractions every other day. The primary endpoint was objective response rate (ORR) of unirradiated lesions using Response Evaluation Criteria in Solid Tumors v1.1.</p><p><strong>Results: </strong>Between April 2021 and August 2023, 39 patients were randomly assigned to receive either Cam (n = 20) or Cam+MDT (n = 19). In total, 17 out of 39 (43.6%) patients had oligometastatic disease (≤3 lesions), 18 out of 39 (46.2%) had liver involvement, and 3 out of 39 (7.7%) had locoregional recurrent disease. ORR of unirradiated lesions did not differ between the treatment groups (26.3% [Cam+MDT] vs 30.0% [Cam], P = 1.0). The disease control rate of unirradiated lesions was 73.7% in the Cam+MDT group compared with 60.0% in the Cam group (P = .571). After a median follow-up of 25.8 months, median progression-free survival was 9.3 (95% CI, 6.2-not reached [NR]) months in the Cam+MDT group and 8.8 (95% CI, 3.3-NR) months in the Cam group (P = .750). Exploratory analyses suggested a longer overall survival (OS) with Cam+MDT for patients with >3 lesions (HR, 0.23; 95% CI, 0.07-0.77; P = .009). G3 and above adverse events were comparable between the treatment groups (15.8% [Cam+MDT] vs 20.0% [Cam]). The overall rate of capillary proliferation was 17.9% (7/39) for the trial.</p><p><strong>Conclusions: </strong>Our study did not meet its primary endpoint of superior ORR of unirradiated lesions with the addition of MDT to Cam in patients with R/M-NPC.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500374","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":"A 5-Year, Multi-Institutional Mentorship Program in Radiation Oncology: The Society for Women in Radiation Oncology Experience.","authors":"Kristin Hsieh, Catherine Yu, Taylor J Corriher, Sara Beltran Ponce, Katarina Nguyen, Winnifred Wong, Jennifer Croke, Lisa A Kachnic, Reshma Jagsi, Crystal Seldon Taswell","doi":"10.1016/j.ijrobp.2024.10.027","DOIUrl":"10.1016/j.ijrobp.2024.10.027","url":null,"abstract":"<p><strong>Purpose: </strong>Mentorship in the field of radiation oncology (RO) promotes career development and satisfaction. Many individuals, however, do not have access to mentorship or are unsatisfied with their mentorship experience, potentially because of insufficient gender-concordant mentorship opportunities. To address this, the Society for Women in Radiation Oncology (SWRO) created the SWRO Mentorship Program for women, gender minorities, and those with intersecting marginalized identities at all stages of training for physicians and medical physicists. We present the 5-year experience of the largest multi-institutional mentorship program, to our knowledge, in RO.</p><p><strong>Methods and materials: </strong>Publicly available information and the SWRO mentorship sign-up forms were used. Descriptive statistics and binomial tests compared with reference points were conducted.</p><p><strong>Results: </strong>Between January 2018 and June 2023, 296 individuals from 19 countries participated in the mentorship program, generating 225 mentee-mentor pairs. The majority were women (89.2%), based in the United States (US; 84.8%), and on the physician track (96.6%). The remainder of the analysis focused on US-based, physician-track participants (n = 244), the majority of whom were women (96.7%) and trainees (58.2%). Among those who have completed RO residency, most accepted a first job in academia (82.1%) and remained in academia at the time of the analysis (76.3%). A significantly higher proportion of SWRO mentorship participants compared with the reference point took a first job in academia (82.1% vs 58.3%; P < .0001). The most common disease sites of focus for the physician-track trainees who finished residency are breast (50.4%), central nervous system (32.7%), and gynecologic malignancies (30.1%), with 54% listing more than 1. The most commonly expressed goals of mentorship are research (35.8%), leadership (24.5%), and building connections within a specific geography or institution (19.2%).</p><p><strong>Conclusions: </strong>The SWRO experience demonstrates the feasibility of a large-scale, multi-institutional mentorship program in RO.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500373","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":"Long Noncoding VIM-AS1: Biomarker of Breast Fibrosis Susceptibility After Radiation Therapy and Promoter of Transforming Growth Factor Beta1-Driven Fibrosis.","authors":"Tatiana Vinasco-Sandoval, Sandra Moratille, Françoise Crechet, Yasmina Mesloub, Juliette Montanari, Frederic Auvré, Jean-François Deleuze, Nicolas Foray, Nicolas O Fortunel, Michele T Martin","doi":"10.1016/j.ijrobp.2024.09.049","DOIUrl":"10.1016/j.ijrobp.2024.09.049","url":null,"abstract":"<p><strong>Purpose: </strong>Fibrosis is a common late complication of radiation therapy. Molecular dysregulations leading to fibrosis have been characterized for the coding part of the genome, notably those involving the TGFB1 gene network. However, because a large part of the human genome encodes RNA transcripts that are not translated into proteins, exploring the involvement of the noncoding part of the genome in fibrosis susceptibility and development was the aim of this work.</p><p><strong>Methods and materials: </strong>Breast cancer patients having or not having developed severe breast fibrosis after radiation therapy were retrospectively selected from the COPERNIC collection. Exome sequencing and RNA-seq transcriptomic profiling were performed on 19 primary dermal fibroblast strains isolated from the patients' nonirradiated skin. Functional experiments were based on fibrogenic induction by transforming growth factor-Beta1 (TGFB1) and gene knockdown in healthy donor fibroblasts.</p><p><strong>Results: </strong>Coding and noncoding transcriptomes discriminated fibrosis from nonfibrosis conditions, and a signature of breast fibrosis susceptibility comprising 15 long noncoding RNAs (lncRNAs) was identified. A hazard ratio validation showed that the lncRNA vimentin antisense long noncoding RNA 1 (VIM-AS1) was the best biomarker associated with fibrosis risk. This lncRNA has not been previously associated with any fibrotic disorder, but we found it upregulated in data sets from cardiac fibrosis and scleroderma, suggesting a general role in tissue fibrosis. Functional experiments demonstrated a profibrotic action of VIM-AS1 because its knockdown reduced myofibroblast activation, collagen matrix production, and dermal organoid contraction. RNA-seq data analysis after VIM-AS1 silencing also pointed out the regulation of replication, cell cycle, and DNA repair. Mechanistically, because VIM-AS1 was found coregulated with the vimentin gene, these data support a profibrotic function of the TGFB1/VIM-AS1/vimentin axis, targeting the dynamics of fibroblast-myofibroblast transition.</p><p><strong>Conclusions: </strong>Noncoding RNA analysis can provide specific biomarkers relevant to the prediction of normal tissue responses after radiation therapy, which opens perspectives of next-generation approaches for treatment, in the frame of the recent developments of RNA-based technologies.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465357","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":"Prognostic and Predictive Value of a Modified Diagnostic Biopsy-Adapted Immunoscore in Patients with Rectal Cancer After Neoadjuvant Treatment: A Translational Study From the STELLAR Trial.","authors":"Qiang Zeng, Yue-Xin Yang, Yuan Tang, Ning Li, Ning-Ning Lu, Shu-Lian Wang, Ye-Xiong Li, Jing Jin, Shuang-Mei Zou, Wen-Yang Liu","doi":"10.1016/j.ijrobp.2024.10.004","DOIUrl":"10.1016/j.ijrobp.2024.10.004","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to assess the prognostic significance of the modified diagnostic biopsy-adapted immunoscore (mIS_b) in determining the outcomes for patients with locally advanced rectal cancer (LARC) in a neoadjuvant setting.</p><p><strong>Methods and materials: </strong>We included 181 patients with LARC from a single subcenter of a prospective study comparing total neoadjuvant therapy (TNT) based on short-course radiation therapy with long-term chemoradiation therapy (CRT). Tumor biopsies at baseline were stained for CD8+ and CD3+ T-cell densities. The mIS_b was developed using mean percentile of CD8+ T-cell density and CD8/CD3 ratio. Patients were classified into low (0%-25%), intermediate (>25%-70%), and high (>70%-100%) in both groups. The relativity among different lymphocytes and their correlation with survival were illustrated. Survival analyses and Cox regression models were used to compare the prognostic values of mIS_b and diagnostic biopsy immunoscore for survival outcomes and to assess the role of mIS_b in TNT and CRT subgroups, respectively.</p><p><strong>Results: </strong>In this study, 151 (83.4%) patients received surgery, and 30 (16.6%) followed a watch and wait strategy. A strong correlation was found between CD8+ and CD3+ T-cell densities (R = 0.86; P < .001), whereas a weak correlation was witnessed between CD8+ and CD8/CD3 ratio (R = 0.45). The 3-year disease-free survival for the entire cohort was 69.9%, with 57.2%, 68.6%, and 85.5% for the low, intermediate, and high mIS_b groups, respectively (P = .01), whereas diagnostic biopsy immunoscore failed to distinguish survival outcomes. Multivariate analysis revealed mIS_b to be an independent prognostic factor for disease-free survival in surgically treated patients (P = .01). Specifically, patients with high mIS_b score showed longer progression-free survival than other subgroups in the TNT cohort (P = .049), but no significant difference was found in the CRT population.</p><p><strong>Conclusions: </strong>In this study, mIS_b demonstrated significant prognostic value in patients with LARC receiving preoperative therapies, especially in the TNT subgroup. These findings may help tailor the intensity of neoadjuvant therapy for patients.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465344","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":"Multimodal Photoacoustic/Elastography Imaging for the Detection of Acute Radiation Dermatitis in Breast Radiation Therapy.","authors":"Keen Yang, Yucong Zhang, Shiyu Li, Liqianqi Chen, Xianming Li, Zihuang Li, Dong Yang, Kun Mao, Rencui Quan, Jinfeng Xu, Gang Xu, Fajin Dong","doi":"10.1016/j.ijrobp.2024.10.006","DOIUrl":"10.1016/j.ijrobp.2024.10.006","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate whether photoacoustic (PA), sound touch elastography (STE), and viscoelasticity (VE) can distinguish between normal and abnormal postradiation therapy breast skin and compare these methods with Radiation Therapy Oncology Group (RTOG) criteria at a 20 Gy threshold.</p><p><strong>Methods and materials: </strong>Patients who met inclusion and exclusion criteria underwent PA, STE, and VE on the same day. Collected data included radiation dose, molecular type, RTOG, Fitzpatrick skin type, pathology, neoadjuvant chemotherapy status, TNM (tumor, node, metastasis) classification, surgical procedures, primary breast cancer location, body mass index, and age. A sample of 41 patients was determined using a 2-sample t test. Statistical tools such as t-tests, variance analysis, rank sum tests, and χ² tests, along with random forest analysis and receiver operating characteristic curves, were used to evaluate the radiation dose effects.</p><p><strong>Results: </strong>Data from 66 patients showed significant differences in parameters such as dermis and subcutaneous tissue oxygen saturation, dermal thickness, and skin elasticity (P values < .05). However, minimum values of oxygen saturation and some photoacoustic measures were not significantly different. Notably, at a 20 Gy radiation threshold, significant variations in oxygen saturation, abnormal dermal thickness, and skin STE and VE were observed, proving more accurate than RTOG grading.</p><p><strong>Conclusions: </strong>Our findings demonstrate that PA and elastography imaging are effective in differentiating between normal and abnormal breast tissue and assessing radiation-induced changes, thereby highlighting the potential of these imaging techniques.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465359","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}