International Journal of Radiation Oncology Biology Physics最新文献

{"title":"SBRT: The Most Precise and Least Invasive Tool in the Liver Cancer Toolbox","authors":"Smith Apisarnthanarax, Edward Y. Kim","doi":"10.1016/j.ijrobp.2025.08.023","DOIUrl":"10.1016/j.ijrobp.2025.08.023","url":null,"abstract":"","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"123 4","pages":"Page 919"},"PeriodicalIF":6.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278327","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 Double-Blinded Placebo-Controlled Biomarker Stratified Randomized Trial of Apalutamide (APA) and Radiotherapy for Recurrent Prostate Cancer (NRG GU006, BALANCE trial)","authors":"D.E. Spratt ,&nbsp;T.G. Karrison ,&nbsp;H.M. Sandler ,&nbsp;E. Posadas ,&nbsp;R.C. Chen ,&nbsp;R.E. Wallace ,&nbsp;J.I. Monroe ,&nbsp;L.G. Gomella ,&nbsp;R.T. Dess ,&nbsp;A.D. Vassil ,&nbsp;A. Ebacher ,&nbsp;T. Gunter ,&nbsp;R.J. Lee ,&nbsp;J.W. DiNome ,&nbsp;S.E. Delacroix Jr ,&nbsp;J.M. Michalski ,&nbsp;X. Shen ,&nbsp;T. Johnson ,&nbsp;P.L. Nguyen ,&nbsp;F.Y. Feng","doi":"10.1016/j.ijrobp.2025.08.028","DOIUrl":"10.1016/j.ijrobp.2025.08.028","url":null,"abstract":"<div><h3>Purpose/Objective(s)</h3><div>Currently there are no prospectively validated predictive biomarkers to guide use of hormonal therapy in prostate cancer. NRG GU006, a phase II biomarker stratified randomized trial of patients receiving salvage radiotherapy (SRT) with or without APA, was designed with the hypothesis that transcriptionally defined molecular subtypes would differentially benefit from APA.</div></div><div><h3>Materials/Methods</h3><div>Patients were enrolled between 4/2018-2/2020 and were required to be status post-radical prostatectomy with a PSA 0.1-1.0 ng/mL without evidence of nodal or distant metastasis and randomized to SRT with placebo or APA 240 mg daily for 6 months. Patients were stratified by PAM50 molecular subtype (luminal B vs non-luminal-B). The primary endpoint was biochemical progression-free survival (bPFS), defined as first occurrence of biochemical, local, regional, distant recurrence, or death from any cause. Key secondary endpoints reported are metastasis-free survival (MFS) and adverse events. The design and analysis involved first testing efficacy within the luminal B subtype (hypothesized to show greater benefit), followed by evaluation of the non-luminal-B group. If the lower limit of the 80% confidence interval (CI) for the hazard ratio (HR [APA/placebo]) in the latter group was &gt;0.77, lack of efficacy in this subgroup would be declared.</div></div><div><h3>Results</h3><div>A total of 295 eligible patients were enrolled with a median follow-up of 5.0 years. Arms were well balanced, with a median age of 65 years, 50% with positive surgical margins, 51% with pathologic T3 disease, 86% with entry PSA of &lt;0.5 ng/mL; 19% were grade group 4-5, and 43% were luminal B. In luminal B patients APA significantly improved bPFS (HR 0.45, 80%CI 0.29-0.68, one-sided p=0.0062), with 5-year estimated bPFS of 72.4% vs 53.9% in the APA and placebo arms, respectively. In contrast, non-luminal B patients did not demonstrate improvement in bPFS (HR 0.95, 80%CI 0.65-1.41, p=0.44), with 5-year estimated bPFS of 70.2% vs 71.1%, although the lower CI limit was &lt;0.77. MFS was also improved with APA in luminal B patients, HR 0.27, 95%CI 0.07-0.95, p=0.029; 5-year estimates of 94.7% vs 81.8%, but not in non-luminal B patients, HR 1.06, 95%CI 0.41-2.78, p=0.90; 5-year estimates of 89.9% vs 89.3%. In the APA vs placebo arm (regardless of attribution), grade 3+ gastrointestinal toxicity occurred in 5.7% vs 2.6%, and genitourinary toxicity in 3.5% vs 4.5%, respectively. In the APA arm, grade 3+ rash occurred in 5.0% of patients and breast pain in 0.7%.</div></div><div><h3>Conclusion</h3><div>Patients with transcriptionally defined luminal B tumors derived improvement in clinically meaningful endpoints from the addition of APA to SRT. PAM50 represents the first prospectively validated predictive biomarker for hormone therapy in prostate cancer in a randomized trial.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"123 4","pages":"Pages 1197-1198"},"PeriodicalIF":6.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278057","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":"Efficacy of Hypofractionated Stereotactic Radiotherapy with Different Dose Fractionation Regimens Combined with Concurrent Bevacizumab in Recurrent High-Grade Gliomas: A Randomized Controlled Trial","authors":"F. Liu ,&nbsp;H. Wang ,&nbsp;Y. Li ,&nbsp;X. Chen ,&nbsp;W. Zhu ,&nbsp;Y. Li ,&nbsp;Y. Qiu ,&nbsp;C. Jiang ,&nbsp;C. Fan ,&nbsp;X. Ye ,&nbsp;S. Xiao ,&nbsp;S. Hu ,&nbsp;K. Chen ,&nbsp;X. Wu ,&nbsp;W. Wu ,&nbsp;L. He","doi":"10.1016/j.ijrobp.2025.08.031","DOIUrl":"10.1016/j.ijrobp.2025.08.031","url":null,"abstract":"<div><h3>Purpose/Objective(s)</h3><div>Hypofractionated stereotactic radiotherapy (HSRT) combined with concurrent bevacizumab represents a promising treatment strategy for recurrent high-grade gliomas (HGG). However, the optimal dose fractionation pattern of HSRT remains undefined. This randomized phase 2 trial aimed to compare the efficacy and toxicity profiles of HSRT delivered in different dose fractionation schedules (27 Gy/3 fractions, 30 Gy/5 fractions, and 35 Gy/10 fractions) in combination with concurrent bevacizumab for treating recurrent HGG.</div></div><div><h3>Materials/Methods</h3><div>Eligible patients were those with recurrent HGG (WHO grade 3-4) and an interval of ≥6 months from completion of prior chemoradiation to recurrence. A total of 102 patients were enrolled and received HSRT combined with concurrent bevacizumab. These patients were randomly assigned in a 1:1:1 ratio to three HSRT groups: group A (27 Gy in 3 fractions, 9 Gy/fraction), group B (30 Gy in 5 fractions, 6 Gy/fraction), and group C (35 Gy in 10 fractions, 3.5 Gy/fraction), with 34 patients per group. All patients initiated bevacizumab administration on day 1, concurrent with HSRT, and continued treatment every 14 days until disease progression. The primary end point was objective response rate (ORR), with secondary end points including the 6-month progression-free survival (PFS), overall survival (OS) and treatment-related toxicities.</div></div><div><h3>Results</h3><div>Both group A and group B demonstrated significantly higher ORRs than group C (79.4%, 73.5%, and 50.0%, respectively; p = 0.023). The six-month PFS rates were also notably higher in group A and group B when compared to group C (67.6%, 61.8%, and 47.1%, respectively; p = 0.023). No significant intergroup differences were observed in OS (85.3%, 79.4%, and 76.5%, respectively; p = 0.81). Multivariate analysis identified HSRT dose fractionation (27 Gy/3F or 30 Gy/5F vs 35 Gy/10F), tumor grade (grade 3 vs 4), IDH status (mutation vs wild-type), 1p/19q status (codeletion vs non-codeletion) as significant predictors of PFS. There were no significant intergroup differences in severe (≥ grade 3) treatment-related toxicities. However, group A and group B showed higher incidences of grade 1–2 headache, nausea/vomiting, insomnia, alopecia, loss of appetite, and fatigue compared to group C, with no significant differences observed between group A and group B.</div></div><div><h3>Conclusion</h3><div>In the treatment of recurrent high-grade gliomas with fractionated stereotactic radiotherapy combined with concurrent bevacizumab, HSRT regimens with higher single-fraction doses (27 Gy/3 fractions and 30 Gy/5 fractions) demonstrated improved ORR and PFS compared to the lower single-fraction dose regimen (35 Gy/10 fractions). Although severe adverse events were comparable, these higher single-fraction dose regimens were associated with increased grade 1–2 toxicities.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"123 4","pages":"Page 1199"},"PeriodicalIF":6.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278056","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":"Phase III Randomized Trial of Proton vs. Photon Therapy for Patients with Non-metastatic Breast Cancer Receiving Comprehensive Nodal Radiation: A Radiotherapy Comparative Effectiveness (Radcomp) Consortium Trial: Health-Related Quality of Life Outcomes","authors":"S.M. MacDonald ,&nbsp;S. Pugh ,&nbsp;R. Paulus ,&nbsp;C. Chauhan ,&nbsp;L.Z. Braunstein ,&nbsp;G.M. Freedman ,&nbsp;R.B. Jimenez ,&nbsp;J.N. Kim ,&nbsp;A.D. Thukral Jr ,&nbsp;M.V. Mishra ,&nbsp;R.W. Mutter ,&nbsp;J.L. Wright ,&nbsp;J.J. Urbanic ,&nbsp;N. Ohri ,&nbsp;H. Boggs ,&nbsp;A.K. Chawla ,&nbsp;S. Ellenberg ,&nbsp;A. Lin ,&nbsp;B. Ky ,&nbsp;J.E. Bekelman","doi":"10.1016/j.ijrobp.2025.08.025","DOIUrl":"10.1016/j.ijrobp.2025.08.025","url":null,"abstract":"<div><h3>Purpose/Objective(s)</h3><div>To compare patient-reported body image and function, fatigue, and other measures of health-related quality of life (HRQOL) in a multi-institutional phase III randomized controlled trial of patients with non-metastatic breast cancer undergoing comprehensive nodal irradiation with either proton radiotherapy (PrRT) vs. photon radiotherapy (PhRT).</div></div><div><h3>Materials/Methods</h3><div>The primary HRQOL endpoints were PROMIS Fatigue, Satisfaction with Breast Cosmetic Outcomes, BREAST-Q adverse effects of radiotherapy, and FACT-B. Other domains, including FACIT-TS-G and PRO-CTCAE (severity, interference, frequency of chest pain and shortness of breath), were evaluated as secondary endpoints of HRQOL. HRQOL questionnaires were collected at baseline, at the end of RT, and at 1- and 6-month post-RT follow-ups. Repeated measures linear and generalized linear mixed models were used to compare the impact of treatment on continuous and ordinal/binary HRQOL scores, respectively. The study was powered for the primary endpoint of major cardiovascular events, which provided sufficient power to detect clinically meaningful differences in HRQOL, defined by an effect size of greater than 0.33, in mixed-effects models assuming a correlation of 0.40 or higher.</div></div><div><h3>Results</h3><div>1,239 patients were randomized to PrRT (n = 624) or PhRT (n = 615). The median age was 50 years (range, 21-92). Most patients had a mastectomy (69.7%), 0-2 cardiovascular risk factors (80.6%), and left or bilateral cancer (61.8%). FACT-B completion rate at 6 months was 86.5%. There were no clinically meaningful differences by treatment arm in the PROMIS Fatigue total score, Satisfaction with Breast Cosmetic Outcomes score, BREAST-Q total score, and FACT-B trial outcome index score. PRO-CTCAE severity of shortness of breath, when categorized as 0 vs. 1-4, favored protons (OR=0.74, 95% CI:0.59-0.93, p&lt;0.01); but, when categorized as 0-2 vs 3-4, there was no difference between arms. Other PRO-CTCAEs assessed were similar between arms. FACIT items statistically significant in favor of protons included willingness to recommend treatment (OR=0.13, 95% CI:0.08-0.22, p&lt;0.001) and choose treatment again (OR=0.11, 95% CI:0.07-0.18, p&lt;0.001).</div></div><div><h3>Conclusion</h3><div>In the first randomized study comparing proton to photon radiation for breast cancer, HRQOL through 6 months was excellent and similar between treatment arms. Differences were noted in shortness of breath, willingness to recommend treatment, and to choose treatment again, which should be interpreted with caution in this unblinded study. Loco-regional control and major cardiac events, the primary endpoints of the RadComp trial, will be reported according to the study’s statistical plan in the future.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"123 4","pages":"Page 1195"},"PeriodicalIF":6.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278050","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":"Neoadjuvant and Adjuvant Pembrolizumab (Pembro) Plus Standard of Care (SOC) in Resectable Locally Advanced Head and Neck Squamous Cell Carcinoma (LA HNSCC): Postoperative Risk Subgroup Analysis of KEYNOTE-689","authors":"N.Y. Lee ,&nbsp;D. Adkins ,&nbsp;R.I. Haddad ,&nbsp;Y. Tao ,&nbsp;C. Le Tourneau ,&nbsp;W.H. Westra ,&nbsp;R. Chernock ,&nbsp;M. Tahara ,&nbsp;K. Harrington ,&nbsp;A. Klochikhin ,&nbsp;R. Granado Carrasco ,&nbsp;G.V. Alves ,&nbsp;B.G.M. Hughes ,&nbsp;M. Oliva ,&nbsp;I.P. Figueiredo Lima ,&nbsp;T. Ueda ,&nbsp;C. Manschot ,&nbsp;K. Benjamin ,&nbsp;B. Gumuscu ,&nbsp;R. Uppaluri","doi":"10.1016/j.ijrobp.2025.08.038","DOIUrl":"10.1016/j.ijrobp.2025.08.038","url":null,"abstract":"<div><h3>Purpose/Objective(s)</h3><div>The addition of neoadjuvant and adjuvant (starting concurrently with postoperative radiotherapy [PORT] ± cisplatin) pembro to SOC significantly improved event-free survival (EFS) vs SOC alone for participants (pts) with resectable LA HNSCC in the randomized phase 3 KEYNOTE-689 study (NCT03765918). We present a subgroup analysis by postoperative pathological features.</div></div><div><h3>Materials/Methods</h3><div>Pts had resectable SCC of the oral cavity/larynx/hypopharynx (stage III/IVA) or oropharynx (stage III/IVA p16− or stage III T4 N0-2 p16+) and were randomized 1:1 to pembro 200 mg Q3W (2 cycles neoadjuvant, 3 cycles adjuvant concurrent with PORT, 12 cycles beyond PORT) + SOC vs SOC (surgery + PORT [60 Gy in 30 fractions for low risk or 66 Gy in 33 fractions for high risk] ± 3 cycles cisplatin 100 mg/m² Q3W [high risk only]). Postoperative pathological features by blinded independent pathologist review were based on the presence (high risk) or absence (low risk) of positive margins (&lt;1 mm) or extranodal extension. EFS by blinded independent central review with pembro + SOC vs SOC by risk subgroups was a prespecified exploratory analysis. Formal statistical testing was not planned. As of 25 July 2024, the median follow-up for all pts was 38.3 mo (range, 9.0–66.5).</div></div><div><h3>Results</h3><div>Among 363 pts randomized to pembro + SOC and 351 to SOC: 321 (88.4%) and 308 (87.7%) completed surgery; 118 (32.5%) and 156 (44.4%) had presence of high-risk features, and 196 (54.0%) and 148 (42.2%) did not. 274 pts in the pembro + SOC group and 275 in the SOC group received PORT, of whom 107 and 139 pts also received concurrent cisplatin (median 3 cycles in both groups). Median (range) total PORT dose was 60.0 Gy (2.0–70.0) in the pembro + SOC group and 66.0 Gy (6.0–72.0) in the SOC group. In the high-risk subgroup, median EFS was 41.1 vs 19.5 mo, respectively (HR 0.73, 95% CI 0.52–1.05). The 3-year EFS was 52.0% vs 40.7%. Grade ≥3 TRAEs occurred in 52.1% vs 53.9% of pts. Any-cause AEs led to discontinuation of PORT in 3 pts in the pembro + SOC group and 1 pt in the SOC group. In the low-risk subgroup, median EFS was not reached vs 51.5 mo (HR 0.74, 95% CI 0.51–1.08). The 3-year EFS was 67.7% vs 58.8%. Grade ≥3 TRAEs occurred in 42.9% vs 30.4% of pts. Any-cause AEs led to discontinuation of PORT in 4 pts in the pembro + SOC group and 3 pts in the SOC group.</div></div><div><h3>Conclusion</h3><div>Efficacy results for pts with either presence or absence of high-risk pathological features after surgery demonstrated downgrading of pathological features with the addition of neoadjuvant and adjuvant pembro to SOC, consistent with the primary analysis of KEYNOTE-689. In the pembro + SOC group, fewer pts had high-risk pathological features and more pts received a lower radiation dose and no cisplatin. The safety profile of pembro + PORT ± cisplatin was in line with expectations.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"123 4","pages":"Pages 1203-1204"},"PeriodicalIF":6.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278231","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":"From Supportive Care to Treatment De-Escalation: Sexual Health and Quality of Life Outcomes in Recent Gynecologic Cancer Trials","authors":"Lara Hathout MD, FRCPC ,&nbsp;Eric Leung MD, FRCPC ,&nbsp;Neil K. Taunk MD, MSCTS ,&nbsp;Michelle Ludwig MD, MPH, PhD ,&nbsp;Emma C. Fields MD","doi":"10.1016/j.ijrobp.2025.08.054","DOIUrl":"10.1016/j.ijrobp.2025.08.054","url":null,"abstract":"","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"123 4","pages":"Pages 913-916"},"PeriodicalIF":6.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278330","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":"Strategic Time and Energy Management: Critical Tools for Combating Burnout and Enhancing Impact in Health Care","authors":"Claire Bonilla MSc","doi":"10.1016/j.ijrobp.2025.06.3897","DOIUrl":"10.1016/j.ijrobp.2025.06.3897","url":null,"abstract":"","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"123 4","pages":"Pages 932-936"},"PeriodicalIF":6.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278322","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":"Primary results for the phase III trial of Toxicity Reduction using Proton Beam Therapy for Oropharyngeal Cancer (TORPEdO; CRUK/18/010)","authors":"D. Thomson ,&nbsp;J. Price ,&nbsp;M. Tyler ,&nbsp;M.J. Beasley ,&nbsp;J. Lester ,&nbsp;C.M. Nutting ,&nbsp;N. Palaniappan ,&nbsp;R.J. Prestwich ,&nbsp;R. Shanmugasundaram ,&nbsp;A. Thompson ,&nbsp;H. Bulbeck ,&nbsp;J.A. Langendijk ,&nbsp;M. Lowe ,&nbsp;J. Tyler ,&nbsp;K. Chiu ,&nbsp;J. Christian ,&nbsp;C. Cruickshank ,&nbsp;D. Gardiner ,&nbsp;C.M.L. West ,&nbsp;E. Hall","doi":"10.1016/j.ijrobp.2025.08.026","DOIUrl":"10.1016/j.ijrobp.2025.08.026","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose/Objective(s)&lt;/h3&gt;&lt;div&gt;To investigate differences in clinical outcomes between intensity-modulated proton therapy (IMPT) and intensity-modulated radiation therapy (IMRT) for patients with locally advanced oropharyngeal squamous cell carcinoma (OPSCC).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials/Methods&lt;/h3&gt;&lt;div&gt;In this phase 3, randomised, controlled, multicentre trial participants with OPSCC requiring definitive bilateral chemoradiation were assigned in a 2:1 ratio to IMPT or IMRT (70 Gy (RBE) in 33 once daily fractions over 6.5 weeks), with two cycles of concurrent cisplatin chemotherapy (every 3 weeks, 100mg/m&lt;sup&gt;2&lt;/sup&gt;). Co-primary endpoints at 12 months after radiation were: (i) clinician-reported gastrostomy dependence or CTCAE grade 3 weight loss (20% decrease from baseline) and (ii) patient-reported University of Washington quality of life (UW-QOL) physical composite score of saliva, taste, chewing, swallowing, speech and appearance; each tested at the 2.5% significance level. Analysis accounted for tumour (T) and nodal (N) stage, smoking status, chemotherapy received, baseline body mass index and baseline UW-QOL physical composite score. Secondary endpoints included MD Anderson Dysphagia Inventory (MDADI), freedom from loco-regional recurrence and overall survival.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;205 participants with locally advanced OPSCC (48% T3/4, 21% N2(c), 31% ≥10 pack year history) from 20 UK centres were allocated to IMPT (n=136) or IMRT (n=69) between March 2020 and June 2023. Treatment was delivered over a median of 44 days (IQR: 44, 44) for both IMPT and IMRT. A second cycle of chemotherapy was not given for 5 (3.8%) and 3 (4.5%) patients receiving IMPT and IMRT, respectively. 178/205 (119 IMPT; 59 IMRT) were evaluable for the clinical co-primary endpoint, with data recorded for gastrostomy dependence or weight loss. Both groups had low rates of gastrostomy dependence: IMPT 2/119 (1.7%) vs IMRT 1/59 (1.7%). A higher rate of grade 3 weight loss was seen for IMPT: 20/110 (18.2%) vs IMRT 3/53 (5.7%); taken together, the odds ratio for IMPT was 2.8 (97.5% CI: 0.8, 10.4, p=0.080). 155/205 participants (100 IMPT; 55 IMRT) were evaluable for the patient reported co-primary endpoint. There was no evidence of a difference in mean UW-QOL physical composite score for IMPT vs IMRT (78.3 vs 77.1, difference=1.3 (to 1 decimal place), 97.5% CI: -3.7, 6.2, p=0.563). MDADI mean composite scores at 12 months for IMPT vs IMRT were 79.4 vs 79.5. At a median follow-up of 27 months, 2-year freedom from loco-regional recurrence for IMPT and IMRT was 94.8% (99% CI: 85.8, 98.2) and 96.8% (81.6, 99.5) and for overall survival 94.4% (85.9, 97.9) and 94.9% (79.1, 98.8), respectively.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;For locally advanced OPSCC, IMPT does not reduce long-term gastrostomy dependence or severe weight loss and does not improve long-term patient-reported physical quality of life or swallow function compared with IMRT. There is ","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"123 4","pages":"Pages 1195-1196"},"PeriodicalIF":6.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278058","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":"Clinical Effectiveness of Single Course Low-Dose Radiation Therapy in Knee Osteoarthritis: Short-term Results from the Randomized, Sham-Controlled Trial","authors":"B.H. Kim ,&nbsp;D.H. Ro ,&nbsp;J.H. Wang ,&nbsp;D.H. Lee ,&nbsp;K. Shin ,&nbsp;M.J. Kim ,&nbsp;T.W. Kim ,&nbsp;M.J. Chang ,&nbsp;D.H. Kim ,&nbsp;M. Han ,&nbsp;J.H. Lee ,&nbsp;J.H. Kang ,&nbsp;J.Y. Kim ,&nbsp;E.H. Hong ,&nbsp;S.J. Cho ,&nbsp;H.S. Han ,&nbsp;H.J. Kim ,&nbsp;W. Park","doi":"10.1016/j.ijrobp.2025.08.030","DOIUrl":"10.1016/j.ijrobp.2025.08.030","url":null,"abstract":"<div><h3>Purpose/Objective(s)</h3><div>Low-dose radiation therapy (LDRT) has been historically used as a non-pharmacologic option for osteoarthritis (OA), but solid evidence from randomized trials is still limited.</div></div><div><h3>Materials/Methods</h3><div>In this multicenter, randomized, sham-controlled trial, 114 patients with knee OA were allocated to receive sham irradiation, total 0.3 Gy/6 fractions, or total 3 Gy/6 fractions. The main inclusion criteria are primary knee OA classified as Kellgren-Lawrence grade 2–3 and a baseline walking pain score of 50–90/100. Use of concomitant analgesics, except for rescue drug, was restricted during the first 4 months. Re-irradiation was not allowed. The primary endpoint was the OMERACT-OARSI response rate at 4 months.</div></div><div><h3>Results</h3><div>All participants completed the treatment with perfect adherence. In the full analysis set, the responder rate at 4 months was significantly higher in the 3 Gy group (70.3%) than in the sham group (41.7%, p=0.014), whereas the 0.3 Gy group showed no significant difference compared to sham (58.3%, p=0.157). Similar results were observed in the per-protocol set. Clinically meaningful improvement (≥16) in WOMAC total score at 4 months was observed more frequently in the 3 Gy group (56.8%) compared to sham (30.6%, p=0.024). However, there were no significant differences in the mean changes from baseline in other secondary outcomes, including VAS, PGA, serum inflammatory markers, and the amount of rescue drug use. No treatment-related toxicity was reported.</div></div><div><h3>Conclusion</h3><div>A single course of 3 Gy LDRT led to significant improvement in clinical outcomes for patients with mild-to-moderate knee OA. These findings support its potential as a conservative treatment option. Long-term and imaging-based follow-up is ongoing.</div></div>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"123 4","pages":"Pages 1198-1199"},"PeriodicalIF":6.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278235","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":"Issue Highlights","authors":"","doi":"10.1016/S0360-3016(25)06237-6","DOIUrl":"10.1016/S0360-3016(25)06237-6","url":null,"abstract":"","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"123 4","pages":"Pages A11-A15"},"PeriodicalIF":6.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278329","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}