International Journal of Radiation Oncology Biology Physics最新文献

{"title":"Hold Your Fire: The Case for Targeted Therapy, Not Radiation, for EGFR-mutant Non-small Cell Lung Cancer Leptomeningeal Disease","authors":"David Rogawski MD, PhD, Seema Nagpal MD","doi":"10.1016/j.ijrobp.2025.01.026","DOIUrl":"10.1016/j.ijrobp.2025.01.026","url":null,"abstract":"","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"122 5","pages":"Page 1084"},"PeriodicalIF":6.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144634045","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":"About the cover image","authors":"","doi":"10.1016/S0360-3016(25)00567-X","DOIUrl":"10.1016/S0360-3016(25)00567-X","url":null,"abstract":"","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"122 5","pages":"Page A8"},"PeriodicalIF":6.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144634050","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 Onal et al","authors":"Martin Langé MD, Jarad Martin MD, PhD, Stéphane Supiot MD, PhD","doi":"10.1016/j.ijrobp.2025.04.024","DOIUrl":"10.1016/j.ijrobp.2025.04.024","url":null,"abstract":"","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"122 5","pages":"Pages 1392-1393"},"PeriodicalIF":6.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144634274","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":"If Medicine were my Spouse","authors":"","doi":"10.1016/j.ijrobp.2025.04.013","DOIUrl":"10.1016/j.ijrobp.2025.04.013","url":null,"abstract":"","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"122 5","pages":"Pages 1088-1089"},"PeriodicalIF":6.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144634048","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":"Radiation therapy utilization for primary cutaneous T-cell lymphoma is lowest amongst patients living in the most geographically accessible areas; an Australian study: Disparate RT-utilization in patients with CTCL.","authors":"Belinda A Campbell, Gabriel Gabriel, Geoff P Delaney, Sandro V Porceddu, Robert Smee, Maichael Barton, H Miles Prince, Karin Thursky","doi":"10.1016/j.ijrobp.2025.07.054","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.07.054","url":null,"abstract":"<p><strong>Aims: </strong>Cutaneous T-cell lymphomas (CTCL) are rare with increasing incidence. Most patients have skin-confined mycosis fungoides (MF): a typically indolent, highly morbid, incurable disease requiring multi-lined treatment. For these patients, radiotherapy (RT) is efficacious, well-tolerated and cost-effective; total skin electron beam therapy (TSEBT) is a specialised technique with proven quality-of-life benefits. Consensus on optimal treatment sequencing is lacking, creating heterogeneity in care. International data suggest declining RT-utilization. Using a state-wide, population-based, Australian cancer registry with linked datasets, we investigated RT-utilization for CTCL, examining for geographically-based disparities. Correlations between dermatologist-availability and linac-density on incidence and RT-utilization rates were also explored.</p><p><strong>Methods: </strong>Retrospective analysis of New South Wales Cancer Registry dataset of all patients diagnosed with CTCL from 2009-2018, with data linkage to the Outpatient Radiation Oncology Database. Actual RT-utilization rates included all treatment lines, calculated per person.</p><p><strong>Results: </strong>553 patients were diagnosed with CTCL; age-standardized incidence was 7.2/million/year. Geographically, 35% resided in regional/rural local health districts (LHD); 13% in under-accessible locations; 16% >50km road-distance from the nearest RT center. RT-utilization and TSEBT-utilization rates were 29.0% and 1.8%, respectively. Variation existed between LHD, with greater RT-utilization in regional/rural over metropolitan LHD (OR 1.7, p=0.01). Patients residing in major cities had lower RT-utilization than those in inner regional areas (OR 2.1, p=0.001). Shortest road-distance to the nearest RT center did not predict for greater RT-utilization. Disparities in access to specialist services existed between LHD. Dermatologist-availability significantly predicted for diagnosis rates (R²=0.336, F(1-11)=5.577, p=0.038). Absence of RT facilities was associated with poor RT-utilization.</p><p><strong>Conclusion: </strong>Over 10 years, only 29% of patients with CTCL received RT across all treatment-lines, with significant geographically-based heterogeneity observed. Contrary to expectation, residence in major cities and proximity to RT facilities were associated with lower RT-utilization. Further advocacy is encouraged to overcome diagnostic and treatment disparities for patients with CTCL.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642546","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":"Feasibility study of functional magnetic resonance imaging-based biologically-guided lattice radiotherapy.","authors":"Ke Yuan, Xinxiang Zhou, Hao Guo, Yi Peng, Peng Xu, Lintao Li, Jie Li, Heng Li, Shun Lu, Mei Feng, Jinyi Lang, Yuanjie Yang, Xianliang Wang","doi":"10.1016/j.ijrobp.2025.06.3901","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.06.3901","url":null,"abstract":"<p><strong>Purpose/objectives: </strong>Lattice radiotherapy (LRT) is a promising approach for treating bulky tumors; however, current methods do not consider patient-specific tumor heterogeneity. Low apparent diffusion coefficient (ADC) regions, identified via diffusion-weighted magnetic resonance imaging (DWI), correspond to areas of high cellular density and radioresistance. Targeted dose escalation in these regions may enhance tumor control. Thus, we propose biologically guided lattice radiotherapy (BG-LRT), which optimizes lattice positioning based on ADC map.</p><p><strong>Methods: </strong>We retrospectively analyzed 20 patients with bulky tumors (>6 cm) who underwent DWI and simulation CT within 3 days. BG-LRT plans were created by aligning high-dose lattice regions with low ADC areas and compared them with hexagonal close-packed lattice radiotherapy (HCP-LRT). Both techniques prescribed 60 Gy in lattice regions and 20 Gy to the gross tumor volume (GTV) over five fractions. The dosimetric evaluation included the peak-valley dose ratio (PVDR) and ablation dose ratio (ADR) within the GTV as well as dose distribution in ADC-defined tumor subregions (R_ADC10-R_ADC50) and organs at risk (OARs).</p><p><strong>Results: </strong>BG-LRT achieved a higher PVDR (2.7 vs. 2.4) and ADR (2.6% vs. 1.7%) than HCP-LRT. ADR values across all ADC-defined tumor subregions (R_ADC10-R_ADC50) were significantly higher for BG-LRT. OAR doses were comparable between methods, with no significant differences in mean dose (D_mean) to the heart, stomach, esophagus, kidneys, liver, and duodenum as well as the maximum doses (D_max) to the lens, eye, optic nerve, brainstem and optic chiasm. Planning time, delivery time, monitor units, and gamma pass rates were similar between techniques.</p><p><strong>Conclusion: </strong>BG-LRT improves PVDR and ADR in the GTV while focusing on dose escalation in biologically relevant tumor regions. This technique maintains low OAR doses and represents a promising step toward personalized LRT treatment planning.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144618072","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 Solution in Search of a Problem: Why the Current Advanced Practice Radiation Therapist Model Doesn't Fit the United States Health Care Landscape.","authors":"Arpit M Chhabra, Bridget F Koontz, Jordan Johnson, Mudit Chowdhary, Casey Chollet-Lipscomb, James E Bates, Michael Weisman, Chirag Shah, Join Y Luh","doi":"10.1016/j.ijrobp.2025.05.080","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.05.080","url":null,"abstract":"","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567364","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":"Global Disparities in Current Clinical Trials in Nasopharyngeal Carcinoma.","authors":"Carl Jay E Jainar, Luisa E Jacomina, Edward Christopher Dee, Anna Lee, Nancy Y Lee, Melvin L K Chua, Michael Benedict A Mejia","doi":"10.1016/j.ijrobp.2025.06.3870","DOIUrl":"10.1016/j.ijrobp.2025.06.3870","url":null,"abstract":"<p><strong>Purpose: </strong>Nasopharyngeal carcinoma (NPC) is characterized by a distinct geographic distribution, with more than 90% of worldwide incidence and mortality occurring in East/Southeast Asia and Northern Africa. Clinical trials that inform evidence-based care must represent the target population of NPC; however, little is known about their geographic distribution and the extent to which they investigate radiation therapy (RT), which plays a central role in NPC management.</p><p><strong>Methods and materials: </strong>Using ClinicalTrials.gov, we characterized phase 2 and 3 clinical trials on adult patients with NPC from 2013 to 2023. Endemic countries were defined as having an age-standardized incidence rate higher than the world age-standardized incidence rate of 1.3 per 100,000 person-years using the Global Cancer Observatory (GLOBOCAN) 2022 database.</p><p><strong>Results: </strong>There were 266 clinical trials eligible for analysis. Trial interventions were immunotherapy/targeted therapy in 133 (50%), chemotherapy in 79 (30%), and RT in 25 (9%). Trials most commonly originated from China (80%), followed by the United States (4.5%) and Singapore (1.5%). Of the 29 NPC-endemic countries, only 5 (17%) are represented in the 11 international trials-China (including Taiwan, Hong Kong, and Macau), Malaysia, Singapore, Thailand, and Tunisia-4 (80%) of which are high- and upper-middle-income countries. In contrast, 18 (75%) out of the 24 underrepresented endemic countries are lower-income. Trials per absolute NPC incidence were significantly fewer in endemic versus nonendemic countries (P < .001) and in lower- versus higher-income countries (P < .001). Similar disparities were observed in the subset of trials that primarily tested RT.</p><p><strong>Conclusions: </strong>The current NPC clinical trial landscape demonstrates significant disparities that do not reflect the global distribution of disease burden and the central role of RT. Lower-income endemic countries are severely underrepresented. Enhanced regional and global collaboration is critical in fostering the inclusion of both patients and researchers from lower-resourced settings in clinical trials and in the global NPC dialogue.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564785","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 Radiation Therapy or Protons for Uveal Melanoma Patients? An Artificial Intelligence (AI)-Based Clinical Treatment Decision-Making Tool Predicting Doses To Radiation Therapy Constraints.","authors":"Emmanuelle Fleury, Jean-Philippe Pignol, Emine Kiliç, Caroline van Rij, Nicole Naus, Serdar Yavuzyigitoglu, Wilhelm den Toom, Andras Zolnay, Kees Spruijt, Marco van Vulpen, Petra Trnková, Mischa Hoogeman","doi":"10.1016/j.ijrobp.2025.06.3867","DOIUrl":"10.1016/j.ijrobp.2025.06.3867","url":null,"abstract":"<p><strong>Purpose: </strong>For ocular melanoma, selecting between stereotactic radiation therapy (SRT) and protons requires a lengthy plan comparison process. The purpose of this brief report is to describe an artificial intelligence (AI) decision-making tool to predict dosimetric and clinical outcomes based on easy-to-access tumor characteristics.</p><p><strong>Methods and materials: </strong>The AI tool was based on a retrospective database of 66 patients with uveal melanoma treated in a single center with robotic SRT. A supervised machine learning model was developed to correlate the risk of toxicity for each radiation modality and clinical features. Clinical toxicity risks were built in various profiles: Profile I for maculopathy, optic-neuropathy, and visual acuity deterioration; Profile II for neovascular glaucoma; Profile III for radiation-induced retinopathy; and Profile IV for dry-eye syndrome.</p><p><strong>Results: </strong>Machine learning-based toxicity prediction accuracy for selecting the correct treatment modality was 81%, 77%, 91%, and 93% for Profiles I, II, III, and IV, respectively.</p><p><strong>Conclusion: </strong>The study shows that a machine learning method based on easy-to-access clinical characteristics can predict which toxicity would be greater with SRT or protons. This AI tool could support patients in making informed treatment decisions in an ophthalmology clinic, without the lengthy wait for computed tomographic simulation results and extensive plan comparisons.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564791","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 Phase 2 Clinical Trial of Carbon Ion Radiation Therapy Combined With Chemotherapy for Locally Advanced Pancreatic Carcinoma.","authors":"Guangyuan Zhang, Xin Cai, Hong Cao, Zhan Yu, Weiwei Wang, Ying Xing, Jingfang Zhao, Qing Zhang, Bo Zhang, Fei Liang, Mansoor M Ahmed, Xiaodong Wu, Chandan Guha, Guo-Liang Jiang, Zheng Wang","doi":"10.1016/j.ijrobp.2025.06.3881","DOIUrl":"10.1016/j.ijrobp.2025.06.3881","url":null,"abstract":"<p><strong>Purpose: </strong>In locally advanced pancreatic carcinoma (LAPC), combining chemotherapy with photon radiation therapy has not demonstrated survival benefits over chemotherapy alone. Conversely, carbon ion radiation therapy (CIRT) has shown encouraging outcomes from Japanese studies. The purpose of this trial was to assess the efficacy and toxicities of CIRT combined with chemotherapy in LAPC through a prospective phase 2 clinical trial.</p><p><strong>Methods and materials: </strong>Patients with histologically or cytologically confirmed pancreatic adenocarcinoma, locally advanced disease without gastrointestinal invasion, no distant metastasis, and who received induction chemotherapy were enrolled. The prescribed relative biological effectiveness-weighted dose of CIRT was 67.5 Gy in 15 fractions over 3 weeks, which was calculated by the local effect model version I. Chemotherapy was administered before and after CIRT. The primary endpoint was the 2-year locoregional progression-free survival rate.</p><p><strong>Results: </strong>From 2018 to 2022, 49 patients (T₄N₀M₀ 39, T₄N_1-2M₀ 10) were enrolled. All patients underwent induction chemotherapy with a median of 6 cycles (range, 1-11 cycles), and 31 patients (63%), post-CIRT chemotherapy. The median overall survival was 24.1 months (95% CI, 19.8-28.0 months) from diagnosis, and 19.6 months (95% CI, 13.6-22.7 months) from CIRT, respectively. In addition, the 1-year and 2-year locoregional control rates were 87.9% (95% CI, 77.9%-97.9%) and 72.9% (95% CI, 56.8%-89.0%), respectively. The 1-year and 2-year locoregional progression-free survival rates were 65.3% (95% CI, 52.0%-78.6%) and 24.5% (95% CI, 12.5%-36.5%), respectively. The 1-year and 2-year distant metastasis-free survival rates were 36.7% (95% CI, 23.2%-50.2%) and 18.4% (95% CI, 7.6%-29.2%), respectively. Thirty-three patients (67%) experienced grade 1-2 acute toxicity, and 2 patients (4%) had grade 2 late toxicity. No acute or late toxicity of ≥grade 3 was observed.</p><p><strong>Conclusions: </strong>Although the primary endpoint was not met, this prospective clinical trial of CIRT with chemotherapy demonstrated promising results with minimal toxicities in patients with LAPC. The findings strongly advocate for prospective randomized trials.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564790","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}