International Journal of Radiation Oncology Biology Physics最新文献

{"title":"Online Adaptive Radiotherapy for Bladder Preservation: Transitioning to Hypofractionation.","authors":"Anuradha Krishnan, Priyamvada Maitre, Sheetal Kashid, Namrata Pansande, Maneesh Singh, Pallavi Singh, Sakshi Dubey, Reena Phurailatpam, Divya Patil, Amit Joshi, Ankit Misra, Amandeep Arora, Mahendra Pal, Gagan Prakash, Vedang Murthy","doi":"10.1016/j.ijrobp.2025.03.018","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.03.018","url":null,"abstract":"<p><strong>Purpose: </strong>To present the clinical experience of bladder preservation with adaptive radiotherapy (ART) in conventionally fractionated RT (ConvRT) and discuss the challenges in transitioning to hypofractionated RT (HypoRT) METHODS AND MATERIALS: Consecutive patients from a prospectively maintained institutional database with histologically proven urothelial carcinoma, staged T1-T4, N0-N3, M0, treated with curative intent chemoradiotherapy from January 2014 to December 2023 were included. Patients from 2014 were treated with a dose of 64Gy/32# to the bladder and 55Gy/32# to the pelvis. From 2021 onwards, most patients received 55Gy/20# to the bladder and 44Gy/20# to the pelvis. Suitable patients received neoadjuvant and concurrent chemotherapy. All patients were treated with the \"plan of the day\" adaptive radiotherapy (POD-ART) technique. Acute (within 3 months of radiotherapy) and late urinary and gastrointestinal toxicity were assessed using the CTCAE criteria. Overall survival (OS), bladder cancer-specific survival (BCSS), disease-free survival (DFS) and local control (LC) were analysed.</p><p><strong>Results: </strong>About 221 patients treated with POD-ART were analysed, 146 with ConvRT and 75 with HypoRT. Most treatment and clinical characteristics were comparable between groups. In HypoRT, the gemcitabine dose was capped at 75 mg/m². Acute GU toxicity rates were similar between ConvRT and Hypo RT cohorts. Acute Grade 2 GI toxicity was higher in the Hypo RT cohort (26.7%) compared to the Conv RT cohort (13.7%, p = 0.02). There were no ≥Grade 3 acute GU or GI toxicity in the Hypo RT cohort. On multivariable analysis, age > 60 years and use of concurrent gemcitabine were statistically significant for acute ≥Grade 2 GI toxicity. Late GU and GI toxicity rates at 15 months were similar in both cohorts. The 2-year OS, BCSS, DFS, and LC rates of patients in the ConvRT cohort were 85.9% (95% CI: 79.6% - 92.1%), 88.2% (95% CI: 82.3% - 94.0%), 83.4% (95% CI: 76.7% - 90.0%) and 89.0% (95% CI: 83.3% - 94.6%) and HypoRT cohort was 85.3% (95% CI: 74.7% - 95.8%), 90.2% (95% CI: 80.7% - 99.6%), 80.4% (95% CI: 69.6% - 91.1%) and 89.6% (95% CI: 81.3% - 97.8%) respectively.</p><p><strong>Conclusion: </strong>POD-ART allows safe treatment transition from ConvRT to HypoRT for bladder preservation. It mitigates some of the treatment-related toxicity during HypoRT, even with concurrent gemcitabine and pelvic radiotherapy.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700445","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":"CT-guided online adaptive SBRT for lymph node oligometastases: impact on dose to target and organs at risk.","authors":"Lucy A van Werkhoven, Maaike T W Milder, Wilco Schillemans, Mischa S Hoogeman, Remi A Nout, Joost J Nuyttens","doi":"10.1016/j.ijrobp.2025.03.020","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.03.020","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigates the radiation dose in abdominal and pelvic lymph node oligometastases (A-P LN) and gastrointestinal organs (GIO) of patients undergoing CT-guided online adaptive stereotactic body radiotherapy (SBRT) in a phase-II study. The study aimed to increase the dose to the target iso-toxically.</p><p><strong>Methods and materials: </strong>Patients with oligometastatic A-P LN received 45 Gy in five fractions on the CyberKnife. Each patient, had three plans created using a pre-treatment planning CT scan: Plan A, Standard of care (SOC) plan based on the planning CT; Plan B, adaptive plan with GIO contours from a diagnostic CT; Plan C, adaptive plan with 45 Gy prescribed to the 80% isodose-line. After a pre-fraction in-room CT scan, the radiotherapy technologist used a decision tree to select the plan with the highest target coverage without exceeding organs at risk constraints. Dose volume histogram parameters were extracted from the original planning CT, the fraction CT with the selected library plan and the fraction CT with the SOC plan.</p><p><strong>Results: </strong>In total, 52 patients were included, and 55 online adaptive treatments were performed. An adaptive plan was chosen in 58% of fractions and in 78% of the patients and resulted in a significant higher D_mean compared to the planned dose (100.6 BED₁₀ vs. 95 BED₁₀, P< 0.001). The GIO D_0.5cc was 2.7 Gy EQD₂³ higher for the SOC plan on the fraction CT compared to the SOC on the original planning CT (P=0.009). There was no significant difference in GIO D_0.5cc between the SOC plan on the fraction CT and the selected plan on the fraction CT.</p><p><strong>Conclusions: </strong>CT-based online adaptive SBRT for A-P LN oligometastases, using a library of plans, led to an adaptive plan selection in the majority of patients. This workflow enabled a mean BED₁₀ 5 Gy iso-toxic dose-escalation to the GTV.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692000","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":"Structural network hubs as potential organs at risk in glioma patients after radiotherapy.","authors":"Laurien De Roeck, Jeroen Blommaert, Patrick Dupont, Stefan Sunaert, Lieselotte Lauwens, Paul M Clement, Steven De Vleeschouwer, Charlotte Sleurs, Maarten Lambrecht","doi":"10.1016/j.ijrobp.2025.03.019","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.03.019","url":null,"abstract":"<p><strong>Background: </strong>Cognitive sequelae are a concern in glioma patients post-radiotherapy. As there is uncertainty regarding which brain regions to spare during radiotherapy to preserve cognition, we explored structural brain network hubs as potential organs at risk.</p><p><strong>Methods: </strong>We conducted a cross-sectional study, involving 39 irradiated adult WHO grade 2 and 3 gliomas along with 50 healthy controls. Cognitive domains (language, memory, attention, motor-, executive functioning) were assessed ≥1-year post-radiotherapy. Using multi-shell diffusion-weighted imaging, weighted structural graphs were constructed, and graph measures calculated to define hubs. The association between mean RTdose in each region and 1) nodal strength and 2) cognitive domains were tested with a linear regression model and Spearman's rho correlations, respectively.</p><p><strong>Results: </strong>Lower nodal strength was significantly associated with increasing RTdose in nine brain regions, significantly (Mc Nemar's test, p<.001) impacting hubs more often than non-hubs (58% vs. 7%). Executive performance (r(37)≥-.474, p_FDR≤.045) and attention (r(37)≥-.471, p_FDR≤.045) were significantly correlated with RTdoses to the left pre- and postcentral gyrus and right posterior cingulate cortex, while poorer language outcomes were observed in patients receiving higher doses to the left insula, superior frontal, and precentral gyrus (r(37)≥-.460, pFDR.≤.045). These correlations were more prevalent in hubs than non-hubs (p=.033), and higher than those between memory and left (r(37)=-.359) and right (r(37)=.059) hippocampal dose.</p><p><strong>Conclusion: </strong>Higher RTdoses to specific brain regions, particularly left-sided hubs, were associated with reduced nodal strength (i.e., lower network centrality) and poorer cognitive performance. While baseline cognitive testing is unavailable and cognitive functioning is influenced by multiple factors, this study highlights the potential value of network- or hub-sparing RT dose planning. Future longitudinal studies are needed to validate these findings before clinical implementation.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692017","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":"Safety and Efficacy of Unresectable Malignant Cardiac Tumors Treated with Concurrent Chemoradiation Therapy Using a 1.5T MR-Linac (GASTO-1078).","authors":"ShiYang Zheng, ShouLiang Ding, QiaoTing Luo, YiXin Xiong, DaQuan Wang, BiaoShui Liu, YueMing Peng, XiaoYan Huang, Bo Qiu, YiShan Lin, Hui Liu, Mai Xiong","doi":"10.1016/j.ijrobp.2025.01.018","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.01.018","url":null,"abstract":"<p><strong>Purpose: </strong>This trial aimed to investigate the safety and efficacy of treating malignant cardiac tumors with hypofractionated radiation therapy and concurrent chemotherapy (hypo-CCRT) using a 1.5T MR-Linac.</p><p><strong>Methods and material: </strong>Patients with both primary and secondary malignant cardiac tumors underwent split-course hypo-CCRT on a 1.5T MR-Linac, receiving 30 Gy/6 fractions initially, followed by a boost course of 20 to 30 Gy/4 to 6 fractions, totaling 50 to 60 Gy. Concurrent chemotherapy (docetaxel and nedaplatin) was administered weekly. The primary endpoint was local recurrence-free survival (LRFS). Secondary endpoints included objective response rate, progression-free survival (PFS), overall survival (OS), toxicity, and quality of life.</p><p><strong>Results: </strong>From October 2021 to October 2023, 7 patients were enrolled in the study and received split-course hypo-CCRT on the 1.5T MR-Linac. The median follow-up was 26 months (range, 8.3-36.3 months). The objective response rate was 85.7% (6/7). The 2-year LRFS rate was 71.4%, with the median LRFS not reached. The 2-year PFS rate was 38.1%, with a median PFS of 20.1 months (95% CI, 8.8-31.5 months). The 2-year OS rate was 71.4%, with the median OS yet to be determined. No patients experienced acute or late toxicity above grade 2. Three months posttreatment, the ejection fraction percentage increased from 63.43% ± 7.21% to 68.57% ± 4.28% (P = .02), and the internal diameter of the right ventricle decreased from 24.43 ± 2.99 to 18.86 ± 3.13 mm (P < .01). The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 scores were significantly improved at 6 months posttreatment (P < .05).</p><p><strong>Conclusions: </strong>Split-course hypo-CCRT on MR-Linac for malignant cardiac tumors was feasible, generally well-tolerated, and showed promising oncologic as well as patient-reported outcomes in this small prospective cohort. Further study is warranted for the long-term effects.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656962","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":"Neurocognitive and resting-state functional MRI changes in patients with diffuse gliomas after chemoradiotherapy.","authors":"Zhihua Liu, Timothy J Mitchell, Chongliang Luo, Ki Yun Park, Joshua S Shimony, Robert Fucetola, Eric C Leuthardt, Stephanie M Perkins, Abraham Z Snyder, Tong Zhu, Jiayi Huang","doi":"10.1016/j.ijrobp.2025.03.017","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.03.017","url":null,"abstract":"<p><strong>Background: </strong>This prospective observational study employed resting-state functional MRI (rs-fMRI) to investigate network-level disturbances associated with neurocognitive function (NCF) changes in patients with gliomas following partial-brain radiation therapy (RT).</p><p><strong>Methods: </strong>Adult post-operative patients with either IDH-wildtype or IDH-mutant gliomas underwent computerized NCF testing and rs-fMRI at baseline and 6 months post-RT. rs-fMRI data were assessed using seed-based functional connectivity (FC). NCF changes were quantified by the percent change in age-normalized composite scores from baseline (ΔNCF_comp). Connectivity-regression analysis assessed the association between network FC changes and NCF changes, using a split-sample approach with a 26-patient training set and a 6-patient validation set, iterated 200 times. Permutation tests evaluated the significance of network selection.</p><p><strong>Results: </strong>Between September 2020 and December 2023, 43 patients were enrolled, with 32 completing both baseline and follow-up evaluations. The mean ΔNCF_comp was 2.9% (SD: 13.7%), with 38% experiencing a decline. Patients with IDH-mutant glioma had similar NCF changes compared to those with IDH-wildtype glioma. Intra-hemispheric FC was similar between ipsilateral and contralateral hemispheres for 91% patients at baseline, and 69% had similar intra-hemispheric FC change post-treatment. FC changes accounted for a moderate fraction of variance in NCF changes (mean R²: 0.301, SD: 0.249), with intra-network FC of the Parietal Memory Network (PMN-PMN, p=0.001) and inter-network FC between the PMN and the Visual Network (PMN-VN, p=0.002) as the most significant factors. Similar findings were obtained by sensitivity analyses using only the FC data from the hemisphere contralateral to the tumor.</p><p><strong>Conclusions: </strong>Post-RT rs-fMRI changes significantly reflected NCF decline, highlighting rs-fMRI as a promising imaging biomarker for neurocognitive decline after RT.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663205","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":"Minibeam radiotherapy valley dose determines tolerance to acute and late effects in the mouse oral cavity.","authors":"Darwin A Garcia, Jennifer M Fazzari, Ruslan Hlushchuk, Oleksiy-Zakhar Khoma, Katrina K Bakken, Danielle M Burgenske, Scott C Lester, Robert W Mutter, Fabrice Lucien, Nicholas B Remmes, Jann N Sarkaria, Sean S Park, Valentin G Djonov, Michael P Grams","doi":"10.1016/j.ijrobp.2025.03.016","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.03.016","url":null,"abstract":"<p><strong>Purpose: </strong>Minibeam radiotherapy (MBRT) is an innovative strategy to improve normal tissue sparing by delivering alternating, submillimeter-wide regions of high \"peak\" and low \"valley\" doses. The purpose of this work is to characterize both acute and late MBRT-induced normal tissue toxicities and determine the dosimetric parameters that dictate toxicity.</p><p><strong>Methods and materials: </strong>Mice were stratified by weight and randomized to receive a single dose of conventional radiotherapy (uniform open field) or MBRT (0.5 mm-wide minibeams spaced 1.1 mm center-to-center) to the oral cavity. The conventional RT groups (n=4 per group) received 16 or 20 Gy, while the MBRT groups (n=5 per group) received peak:valley doses of 48:8, 72:12, 96:8, 96:16 or 152:8 Gy. Acute toxicity (≤3 weeks) was evaluated using changes in weight and mucosal histology. Late effects on bone and dentition were evaluated using microscopic computed tomography (microCT).</p><p><strong>Results: </strong>Animals irradiated with 16 Gy (n=1), 20 Gy (n=4), and 96:16 Gy (n=5) reached acute toxicity endpoint (≥20% weight loss) between 9-11 days post-radiation and exhibited histological changes indicative of mucositis. No animals in the other MBRT groups reached acute toxicity endpoint. While 96:8 Gy induced marked mucosal damage in peak regions, the spared tissue in the valley regions enabled restoration of mucosal integrity within two weeks post-MBRT. MicroCT of surviving mice 12 months post-radiation revealed an alternating pattern of decreased bone volume consistent with the MBRT pattern. The upper incisors of most animals were shortened or completely missing. The mice receiving 16 Gy and 48:8 Gy exhibited the most and least dental damage, respectively.</p><p><strong>Conclusion: </strong>This preliminary work emphasizes that normal tissue sparing by MBRT, as determined by the valley dose, significantly ameliorates dose-limiting toxicities and enables escalation to MBRT peak doses up to an order of magnitude greater than conventional RT doses.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648605","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":"Evaluation of intra-fractional anatomical variations during liver MRgART under abdominal compression using optical flow calculation.","authors":"Takanori Adachi, Nobutaka Mukumoto, Haruo Inokuchi, Nobunari Hamaura, Mutsumi Yamagishi, Mai Sakagami, Naoki Mukumoto, Kenji Hayashi, Ryo Ogino, Mitsuhiro Nakamura, Keiko Shibuya","doi":"10.1016/j.ijrobp.2025.03.014","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.03.014","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the intra-fractional anatomical variations during liver magnetic resonance-guided adaptive radiotherapy (MRgART) under abdominal compression (AC) using optical flow calculations.</p><p><strong>Methods: </strong>This study included 27 consecutive patients who underwent liver MRgART under AC. Overall, 387,566 slices from 145 single-slice cine MR series obtained from 29 different treatment plans were analyzed in the coronal and sagittal planes through tumor centers. After defining the square regions as 12 pixels centered on the isocenter for the tumor and 8 pixels between the inspiratory and expiratory phases, excluding the lung/liver boundary for the diaphragm, the vectors were calculated using Farnebäck optical flow. The intra-fractional superior-inferior (SI) motion range and the root-mean-square error (RMSE) between the position of the tumor and the diaphragm in the coronal (SI_coronal and RMSE_coronal) and sagittal planes (SI_sagittal and RMSE_sagittal) were classified according to the Couinaud-based tumor regions (segment I+IV, II+III, V+VIII, and VI+VII). Statistical significance was determined using the Wilcoxon signed-rank test with Holm-Bonferroni corrections (p < 0.05).</p><p><strong>Results: </strong>The median SI_coronal and SI_sagittal motion ranges of the tumor were 6.1 mm (range, 1.5-18.0 mm) and 8.1 mm (range, 1.0-21.0 mm), respectively (p < 0.05). When classified according to tumor location, segment VI+VII showed the largest difference, with the median SI_coronal and SI_sagittal motion ranges of 6.5 mm (range, 2.3-17.7 mm) and 10.6 mm (range, 4.8-21.0 mm), respectively (p < 0.05). The median RMSE_coronal and RMSE_sagittal values were the largest in segment VI+VII, showing significant differences of 2.6 mm and 2.2 mm, respectively (p < 0.05). These differences were due to the sliding motion of dorsally located tumors.</p><p><strong>Conclusions: </strong>Optical flow analysis underestimated the SI motion range in the coronal plane compared with that in the sagittal plane during liver MRgART under AC. Tumor motion should be monitored in the sagittal plane, considering sliding motion of the liver, with individualized margins according to tumor location.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648588","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":"An International Lymphoma Radiation Oncology Group study of radiotherapy for bilateral indolent orbital adnexal lymphomas.","authors":"Krystel Tran, Dongryul Oh, Richard Tsang, Chang-Ok Suh, Hong-In Yoon, Hwa Kyung Byun, Senzo Taguchi, Jill Gunther, Bouthaina Dabaja, Chelsea Pinnix, John Plastaras, Christopher Wright, Brandon S Imber, Joachim Yahalom, Khaled Elsayad, Hans Eich, Andrea Ng, Rachel Rabinovitch, Michael Binkley, Richard Hoppe, Jessica Brady, George Mikhaeel, Xinyue Wang, Shunan Qi, Mario Levis, Umberto Ricardi, Maggie Harris, Tim Illidge, Michael MacManus, Mathias Bressel, Andrew Wirth","doi":"10.1016/j.ijrobp.2025.03.011","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.03.011","url":null,"abstract":"<p><strong>Purpose/objectives: </strong>Radiotherapy (RT) is curative for the majority of patients with primary indolent orbital adnexal lymphoma (IOAL). Some reports suggest inferior outcomes for bilateral IOAL, leading to uncertainty regarding optimal management for this presentation. This multicentre, retrospective study evaluated long-term outcomes of bilateral IOAL patients treated with radiotherapy alone.</p><p><strong>Materials/methods: </strong>One hundred and eighty-four patients with synchronous (defined as ≤90 days between orbit diagnoses), or metachronous bilateral IOAL, and no prior lymphoma history, received radiotherapy to both orbits. Overall (OS), failure-free survival (FFS), freedom from local (FFLF) and distant (FFDF) failure and toxicity were evaluated. The study met local institutional review board requirements.</p><p><strong>Results: </strong>A total of 184 patients were treated for IOAL from 16 centres. The median age at first orbit diagnosis was 51 years (15-91 years) with 170 (92%) of patients having MZL. Disease location included the conjunctiva in 265 (72%) of orbits. The RT dose (per orbit) was 4 Gy for 40 (11%), 20-26 Gy for 217 (59%), 27-30.6 Gy for 87 (24%), >30.6 Gy for 24 (6.5%). Radiotherapy volume was whole orbit for 162 (44%), conjunctiva only for 177 (48%) and other partial orbit for 29 (8%). The median follow-up was 5.7 years. Ten-year OS and FFS were 99% (95% CI: 95-100) and 72% (95% CI: 62-79), respectively. Ten-year FFLF and FFDF were 87% (95% CI: 80-92) and 81% (95% CI: 72-88), respectively. Ten-year FFS was 85% (95% CI: 75-91) and 50% (95% CI: 32-65) for patients with conjunctival-only disease versus any non-conjunctival disease, respectively. Late toxicities included dry eye in 42% of patients (grade 1 in 86%) and cataract in 27%.</p><p><strong>Conclusions: </strong>In this large, multicentre experience, patients with bilateral IOAL treated with radiotherapy alone had outcomes comparable to historical series of unilateral disease. These results support the treatment of bilateral IOAL as a localised process with curative intent radiotherapy.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639447","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":"In Reply to Saraei and Hosseini","authors":"Daichi Torizuka MD, PhD,&nbsp;Megumi Uto MD, PhD,&nbsp;Katsutsugu Umeda MD, PhD,&nbsp;Tatsuya Kamitori MD,&nbsp;Atsushi Iwai MD,&nbsp;Satoshi Saida MD, PhD,&nbsp;Itaru Kato MD, PhD,&nbsp;Yohei Mineharu MD, PhD,&nbsp;Yoshiki Arakawa MD, PhD,&nbsp;Junko Takita MD, PhD,&nbsp;Takashi Mizowaki MD, PhD","doi":"10.1016/j.ijrobp.2024.12.024","DOIUrl":"10.1016/j.ijrobp.2024.12.024","url":null,"abstract":"","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 5","pages":"Pages 1395-1396"},"PeriodicalIF":6.4,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611494","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":"Oligometastatic Head and Neck Squamous Cell Carcinoma: Is SABR the Solution?","authors":"Sean M McBride MD, MPH","doi":"10.1016/j.ijrobp.2024.11.075","DOIUrl":"10.1016/j.ijrobp.2024.11.075","url":null,"abstract":"","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"121 5","pages":"Pages 1207-1208"},"PeriodicalIF":6.4,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611430","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}