International Journal of Radiation Oncology Biology Physics最新文献

{"title":"The prognostic impact of MLH1 promoter hypermethylation in stage I-II endometrial cancer treated with adjuvant radiotherapy: a multi-institutional retrospective study: MLH1ph status in stage I-II endometrial cancer.","authors":"Zohaib K Sherwani, Shari Damast, Emma C Fields, Sushil Beriwal, Zachary D Horne, Elizabeth A Kidd, Eric W Leung, Neil K Taunk, Junzo Chino, Andrea L Russo, Michael Dyer, Kevin V Albuquerque, Lara Hathout","doi":"10.1016/j.ijrobp.2025.05.004","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.05.004","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the impact of MLH1 promoter hypermethylation (MLH1ph) on prognosis and define the patterns of recurrence in stage I-II endometroid endometrial cancer (EEC) treated with adjuvant radiotherapy.</p><p><strong>Materials and methods: </strong>In a retrospective, IRB-approved, multi-institutional cohort study, 814 patients with stage I-II EEC with known mismatch repair (MMR) status were included. Tumors with MSH2, MSH6, MLH1 or PMS2 mutations were classified as somatic dMMR (sdMMR), while tumors with epigenetic silencing of the MLH1 promoter were classified as MLH1ph. Recurrence-free survival (RFS) was calculated by the Kaplan Meier method. Univariate and multivariate analyses (UVA/MVA) were performed via Cox proportional hazards. Statistical analyses were conducted using SPSS version 27.</p><p><strong>Results: </strong>The median age at diagnosis was 65 (IQR 58-71) and most patients had grade 2-3 disease (59.2%), ≥50% myometrial invasion (56.0%) and absence of lymphovascular space invasion (58%). Vaginal brachytherapy was delivered to 643 (78.1%) patients, while 180 (21.9%) patients received external beam radiation (EBRT) ± VBT. MMR was proficient in 550 (67.6%) patients and deficient in 264 (32.4%) patients. Of the patients with dMMR, most patients harbored MLH1ph (n=171, 66%), while 93 patients (35.2%) had somatic dMMR. Tumor size ≥ 3.8cm (HR 2.2, p=0.003), MMR deficient vs proficient (HR 2.7, p<0.001) and EBRT±VBT vs VBT alone (HR 1.9, p=0.032) were associated with decreased RFS on MVA. On subgroup analysis including patients with dMMR only, patients with MLH1ph had worse RFS compared to patients with sdMMR (HR 1.9 (95% CI1.1-3.6), p=0.025). Distant recurrence was the most common recurrence site, regardless of MMR status. Patients with MLH1ph had significantly higher proportion of vaginal (5% vs 0% vs 2%) and pelvic (5.3% vs 3.2% vs 0.5%) recurrences compared with sdMMR and pMMR, respectively (p=0.038).</p><p><strong>Conclusion: </strong>Patients with MLH1ph had worse RFS, which may be attributed in part to a higher proportion of locoregional recurrences compared to the pMMR and sdMMR patients.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085967","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":"Atezolizumab and Stereotactic Body Radiation in Metastatic, Recurrent, or Persistent Cervical Cancer: Results from a Phase II Multi-Institutional Study.","authors":"Kamran A Ahmed, Allison M Quick, Hye Sook Chon, Jing-Yi Chern, Kristin Bixel, Youngchul Kim, Jiannong Li, Michael E Montejo, Robin A Dowell, Sungjune Kim, Daniel C Fernandez, Cesar A Lam, Ardeshir Hakam, Marilin Rosa, Michael Shafique, Mian M Shahzad, Robert M Wenham","doi":"10.1016/j.ijrobp.2025.05.003","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.05.003","url":null,"abstract":"<p><strong>Background: </strong>Pembrolizumab is approved for PD-L1+ but not PD-L1 negative metastatic, recurrent, or persistent cervical cancer. Response rates to single agent anti-PD-1/PD-L1 therapy have been modest with no responses noted in PD-L1 negative tumors.</p><p><strong>Methods: </strong>The study is designed as a prospective, phase II multi-institutional trial of SBRT followed by atezolizumab (1200 mg intravenously q3 weeks). Key eligibility criteria included patients with metastatic, recurrent, or persistent cervical cancer with at least 2 distinct lesions. The primary objective was objective response rate measured at the unirradiated target lesion.</p><p><strong>Clinical trial information: </strong>NCTXX.</p><p><strong>Results: </strong>A total of 21 patients were enrolled. Median follow-up is 23.6 months. The majority of patients had adenocarcinoma (n=10; 48%) and were PD-L1 negative (n=15; 71%). The best overall response was a partial response in 5 (24%) and stable disease in 12 (57%) patients. The median duration of response was 8.6 months (95% CI: 4.5-13.6 months). An objective response at the unirradiated target lesion was observed in 8 patients (38%), meeting the study defined endpoint. Responses were noted in PD-L1 negative tumors. The most common grade ≥ 2 toxicities at least possibly attributed to study therapy included lymphopenia (n=6; 29%), nausea/vomiting (n=3; 14%), and hyponatremia (n=3; 14%).</p><p><strong>Conclusions: </strong>In this first trial of SBRT and atezolizumab in metastatic cervical cancer unselected for PD-L1, combination therapy was well tolerated. Responses were noted in PD-L1 negative tumors. Combination therapy may allow for improved response rates to immune checkpoint inhibition in metastatic cervical cancer particularly in PD-L1 negative tumors.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085752","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":"Development and Validation of a Computable Radiotherapy Phenotype.","authors":"Cecelia J Madison, Julie A Lynch, Scott L Duvall, Patrick R Alba, Elizabeth Hanchrow, Fatai Y Agiri, Kathryn M Pridgen, Ryan J Burri, Reid F Thompson, Maria Kelly, Evangelia Katsoulakis","doi":"10.1016/j.ijrobp.2025.05.001","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.05.001","url":null,"abstract":"<p><strong>Background: </strong>This study aims to develop a robust methodology using structured and semi-structured health data to identify patients who have undergone radiation therapy, thereby facilitating future research on treatment outcomes.</p><p><strong>Methods: </strong>In this retrospective cohort study, we identified Veterans receiving radiation oncology care through documentation of referrals, encounters, and billing codes from 2014 through 2023. We classified administrative codes based on process of care and type of radiation received, and then analyzed utilization patterns. Unstructured data analysis was performed using keyword search of relevant clinical notes in the metadata fields and categorizing those notes by radiation oncology processes. To validate our algorithm, we compared the cohort we developed using existing data sources to a cohort that was chart reviewed.</p><p><strong>Results: </strong>The final cohort included 589,318 Veterans with radiation oncology care. Among these, 355,276 had codes indicating radiotherapy delivery. The most common treatments were image guided (IGRT), three-dimensional conformal (3DCRT), intensity-modulated (IMRT), and stereotactic radiosurgery/stereotactic body (SRS/SBRT). Anatomy-specific billing codes were underutilized. Clinical note analysis identified 1,341 unique labels for radiation oncology content, with 947,928 notes found for 204,064 patients. Validation against chart-reviewed datasets showed strong concordance and confirmed the accuracy of our algorithm in identifying radiation oncology care.</p><p><strong>Conclusion: </strong>Automated extraction of medical records can be used to identify cohorts of patients who have undergone radiotherapy. Employing this algorithm may facilitate more precise phenotyping of radiotherapy cases and thus significantly enhance our understanding of these cohorts.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077969","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":"Unlocking the Radiosensitizing Potential of MYC Inhibition in Neuroendocrine Malignancies.","authors":"Qianyu Guo, William Yang, Guy Robinson, Keyur Chaludiya, Aisha N Abdulkadir, Falguni Ghosh Roy, Divya Shivakumar, Ayesha N Ahmad, Sarki A Abdulkadir, Austin N Kirschner","doi":"10.1016/j.ijrobp.2025.04.034","DOIUrl":"10.1016/j.ijrobp.2025.04.034","url":null,"abstract":"<p><p>The MYC family of transcription factors-comprising c-MYC, N-MYC, and L-MYC-plays a pivotal role in oncogenesis, driving cancer progression and resistance to therapy. While MYC proteins have long been considered challenging drug targets due to their intricate structures, recent advances have led to the development of promising inhibitors. This review explores the role of MYC overexpression in promoting radiation therapy resistance in aggressive neuroendocrine malignancies through multiple mechanisms, including increased tumor cell invasion, enhanced DNA damage repair and oxidative stress management, prosurvival autophagy, survival of circulating tumor cells, angiogenesis, awakening from dormancy, and modulation of chronic inflammation and host immunity. Paradoxically, MYC overexpression can also enhance radiosensitivity in certain cancer cells by driving proapoptotic pathways, such as reactive oxygen species-induced DNA damage that overwhelms cellular repair mechanisms, ultimately leading to cell death. Additionally, we provide a comprehensive summary of direct MYC inhibitors, detailing their current stage of preclinical and clinical development as novel anticancer therapeutics. This review highlights the role of MYC in cancer metastasis and radiation therapy resistance while examining the potential of MYC inhibitors as radiosensitizers in adult and pediatric neuroendocrine malignancies, including small cell lung cancer, large cell neuroendocrine lung cancer, Merkel cell carcinoma, neuroendocrine-differentiated prostate cancer, neuroblastoma, central nervous system embryonal tumors, and medulloblastoma.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015538","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":"Acute and late radiation-related toxicity after treatment of locally advanced rectal cancer with IMRT compared to 3D-CRT in the RAPIDO trial.","authors":"Max D Tanaka, Bengt Glimelius, Geke A P Hospers, Elma Meershoek-Klein Kranenbarg, Corrie A M Marijnen, Hein Putter, Annet G H Roodvoets, Cornelis J H van de Velde, Boudewijn van Etten, Per J Nilsson, Alice M Couwenberg","doi":"10.1016/j.ijrobp.2025.04.035","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.04.035","url":null,"abstract":"<p><strong>Purpose: </strong>Intensity-modulated radiotherapy (IMRT) aims to lower radiation-related toxicity by delivering more conformal radiotherapy compared to three-dimensional conformal radiotherapy (3D-CRT). This study investigated whether IMRT (including volumetric modulated arc therapy) resulted in less acute and late radiation-related toxicity and better treatment compliance compared to 3D-CRT in the phase III RAPIDO trial.</p><p><strong>Methods and materials: </strong>Patients with locally advanced rectal cancer (LARC), treated with short-course radiotherapy followed by consolidation therapy (TNT arm) or chemoradiotherapy with optional postoperative chemotherapy (CRT arm) were included. IMRT was compared to 3D-CRT, stratified by treatment arm. Acute, late, and persistent toxicity endpoints included radiation-related gastrointestinal, general, genitourinary, hematological, and sexual adverse events (CTCAEv4). Toxicity endpoints were analyzed as binary outcomes (grade ≥ 1 vs. grade 0 and grade ≥ 3 vs. grade 0-2) with univariable and multivariable logistic regression analyses.</p><p><strong>Results: </strong>For acute and late toxicity analyses, 460 and 352 patients were eligible in the TNT arm, respectively, and 441 and 321 patients in the CRT arm. IMRT was delivered in 29% of the patients. After IMRT in the TNT arm, more acute fatigue grade ≥ 1 (OR 2.71 [95%CI 1.60-4.60], p<0.001) and more acute nausea/vomiting grade ≥ 1 (OR 1.79 [95%CI 1.15-2.79], p=0.010) was observed compared to 3D-CRT. After IMRT in the CRT arm, more any late radiation-related toxicity grade ≥ 1 (OR 2.14 [95%CI 1.28-3.57], p=0.004) and more late sexual toxicity grade ≥ 1 (OR 2.31 [95%CI 1.24-4.29], p=0.008) was observed compared to 3D-CRT. No differences were found for other grade ≥ 1 toxicity endpoints, grade ≥ 3 toxicity, or treatment compliance. Persistent toxicity was rare in both groups.</p><p><strong>Conclusions: </strong>IMRT was not associated with less radiation-related toxicity compared to 3D-CRT after TNT or CRT. In contrast, some lower grade toxicities were more frequent after IMRT, in particular fatigue during TNT. Late persistent toxicity was uncommon in both groups.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017249","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":"Distant metastasis after chemoradiation and IGABT in locally advanced cervical cancer.","authors":"Johannes Knoth, Remi A Nout, Richard Pötter, Dr Umesh Mahantshetty, Ina Jürgenliemk-Schulz, Christine Haie-Meder, Israel Fortin, Lars U Fokdal, Alina Sturdza, Peter Hoskin, Barbara Segedin, Kjersti Bruheim, Fleur Huang, Bhavana Rai, Rachel Cooper, Marie A D Haverkort, Erik van Limbergen, Bradley R Pieters, Li Tee Tan, Daniela Boryshchuk, Robin Ristl, Rohini Hawaldar, Sadhana Kannan, Astrid A C de Leeuw, Nicole Eder-Nesvacil, Kari Tanderup, Christian Kirisits, Jacob C Lindegaard, Maximilian P Schmid","doi":"10.1016/j.ijrobp.2025.04.037","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.04.037","url":null,"abstract":"<p><p>Purpose This study aimed to assess patterns and risks of distant metastasis (DM) in cervical cancer patients treated with chemoradiotherapy and MR-image-guided adaptive brachytherapy (IGABT) and to explore a potential dose-effect relationship of concomitant cisplatin. Materials and Methods Data were derived from EMBRACE-I, an international, prospective, multicenter cohort study conducted at 24 centers across Europe, Asia, and North America from July 30, 2008, to December 29, 2015. The study included 1416 patients with biopsy-confirmed cervical cancer (FIGO₂₀₀₉ stage IB-IVA or stage IVB limited to paraaortic lymph nodes). Treatment involved external beam radiotherapy (45-50.4 Gy), weekly cisplatin (40 mg/m², 30 mg/m², or paused), and IGABT. DM was defined as extra-pelvic recurrence excluding paraaortic nodes. Results The analysis included 1318 patients with a median age of 49 years and a median follow-up of 52 months. The 5-year cumulative incidence of DM was 14%, with the lungs (26%), mediastinal lymph nodes (15%), and bones (10%) identified as the most common metastatic sites. Key risk factors for DM included non-squamous histology (HR: 1.89, 95% CI: 1.30-2.75), nodal involvement at diagnosis (pelvic-only nodes: HR: 1.56, 95% CI: 1.07-2.26; paraaortic nodes: HR: 3.15, 95% CI: 1.93-5.16), and large target volume at brachytherapy (HR: 1.93, 95% CI: 1.21-3.08). Patients receiving fewer than 4 cycles of chemotherapy demonstrated a significantly higher risk of DM (HR: 1.52, 95% CI: 1.08-2.13). Conclusion DM is a substantial burden in patients with locally advanced cervical cancer, with the lungs, distant lymph nodes, and bones being the most frequent sites. Risk factors such as non-squamous histology, nodal involvement, and large target volumes at brachytherapy are critical considerations for identifying high-risk patients in future studies. These findings highlight the need for tailored strategies to mitigate DM in this patient population.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987719","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":"Low Dose Radiotherapy for Osteoarthritis: A Retrospective Single Institution Analysis of 69 Patients and 168 Joints.","authors":"Bobby N Koneru, Justin Sick, Hamza Shaikh, Heather Spengler, William Small, Richard Shaffer","doi":"10.1016/j.ijrobp.2025.04.040","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.04.040","url":null,"abstract":"<p><strong>Purpose: </strong>This retrospective study evaluated the analgesic effects of low-dose radiotherapy (LDRT) for painful osteoarthritis.</p><p><strong>Methods: </strong>We analyzed 69 patients who underwent LDRT for osteoarthritis between January and December 2023, treating 168 joints. Pain intensity was measured using a numerical rating scale (NRS) for total score (0-100) and relevant score (0-10). Each phase of treatment was delivered as 3 Gy in 6 fractions (0.5 Gy per fraction) over 2-3 weeks. Assessments were conducted pre-treatment (\"pre-RT\"), at end of treatment (EOT), and at 10-week follow-up (FU). The von Pannewitz score (VPS) measured patient-assessed improvement.</p><p><strong>Results: </strong>The mean pre-RT total pain score was 40.4, with a relevant pain score of 6.3. At EOT, scores decreased significantly to 26.0 and 4.0, respectively (p < 0.05 and p < 0.01). At FU, scores remained significantly lower at 25.8 and 4.0 (p < 0.05 and p < 0.01 compared to pre-RT). 80% of joints showed significant pain improvement (VPS 0-2) at EOT, with 72% maintaining this at FU. 33% of joints received a second LDRT phase, demonstrating further pain reduction. Pain score improvements did not significantly differ across joint types (p = 0.29).</p><p><strong>Conclusion: </strong>This modern American case series demonstrates significant and sustained pain relief with LDRT for osteoarthritis across various joint types. Findings suggest LDRT as a promising non-invasive treatment option, with potential benefits from repeated courses in select patients. Further randomized controlled trials are needed to validate these observations.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035370","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":"PSMA MRI Guided Prostate SABR ARGOS-CLIMBER Phase I/II Trial: A Primary Endpoint Analysis.","authors":"Sherif Ramadan, Andrew Loblaw, Aneesh Dhar, Hatim Fakir, Lucas C Mendez, Andrew Warner, Matt Wronski, John Conyngham, Zahra Kassam, Vibhuti Kalia, Vivian S Tan, Priscila Crivellaro, Aaron D Ward, Jonathan Thiessen, Ting-Yim Lee, David Laidley, Glenn S Bauman","doi":"10.1016/j.ijrobp.2025.04.039","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.04.039","url":null,"abstract":"<p><strong>Purpose: </strong>The XXXXX trial is a multi-institutional phase I/II study utilizing a combined PSMA PET/MRI approach to treat dominant intraprostatic lesions (DILs) and affected lymph nodes in unfavorable intermediate and high-risk prostate cancer using a five fraction SABR and simultaneous in-field boost (SIB) technique. Here we report on the primary endpoint of toxicity within 6 months of treatment.</p><p><strong>Methods and materials: </strong>SIB volumes were defined utilizing a PET/MRI acquired using 18F-PSMA 1007. Five fraction SABR was planned to deliver doses (maximum SIB) to prostate 35 Gy (50 Gy), SV 25 Gy (50 Gy) and lymph nodes 25 Gy (35 Gy) while respecting OAR's. Toxicity and QOL were assessed according to CTCAE 5.0 and EPIC-26 during radiation, at 6 weeks post-treatment and at 6 months post treatment.</p><p><strong>Results: </strong>In total 50 patients were treated, 23 patients had unfavorable intermediate risk disease, 23 were high risk, and 4 were very high-risk prostate cancer. Median prostate SIB of 41.6 Gy (IQR: 39.3-44.8 Gy) was delivered to a median of 1 intra-prostatic lesion. Eighteen patients received nodal treatment. There was a single acute grade 3 GI toxicity of diarrhea and a single late grade 4 GI toxicity of bleeding. With a median follow-up of 12 months, the EPIC-26 scale showed an increase in urinary irritation (p < 0.001) and no differences for urinary incontinence (p=0.12) and GI QOL (p=0.65) and a decrease in hormonal/sexual QOL (p < 0.001 and p < 0.001). Mean ± SD PSA, maximum SUV on PET and maximum MRI PiRADS scores at baseline to 6 months were 15.4 ± 10.3 to 0.18 ± 0.40 ng/mL, 25.5 ± 19.5 to 4.5 ± 7.7, and 4.7 ± 0.6 to 2.9 ± 1.5 respectively.</p><p><strong>Conclusions: </strong>XXXXX demonstrated acceptable toxicity using 5 fraction SABR with PET/MRI directed SIB to prostate and lymph nodes.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019533","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":"Hypofractionated radiosurgery (25 Gy/5 fractions) for optic nerve sheath meningiomas: results from an exploratory phase 2 prospective trial.","authors":"Laura Fariselli, Stefania Bianchi Marzoli, Sara Morlino, Valentina Pinzi, Cristiana Pedone, Elena De Martin, Aurora Romeo, Irene Tramacere, Marcello Marchetti","doi":"10.1016/j.ijrobp.2025.04.038","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.04.038","url":null,"abstract":"<p><strong>Background: </strong>Traditional treatment options for optic nerve sheath meningiomas (ONSMs) include observation, surgery, and radiotherapy; however, none of these has emerged as the definitive treatment of choice to date. Preliminary results on the application of hypofractionated radiosurgery have been quite promising in terms of preserving visual function and achieving local tumor control.</p><p><strong>Objective: </strong>An exploratory trial was conducted to evaluate the safety and effectiveness of hypofractionated radiosurgery (25 Gy in 5 fractions) for ONSMs.</p><p><strong>Methods: </strong>From May 2011 to May 2019, 50 patients with ONSMs were consecutively enrolled and treated with radiosurgery using the frameless CyberKnife system. Patients had median age of 49 years (19-78 years). All patients were treated using hypofractionated radiosurgery, receiving 5 fractions of 5 Gy each, for a total dose of 25 Gy, prescribed at the 75% to 85% isodose line. Patients were evaluated for visual function through visual acuity and visual fields examination, and for local control through volumetric measurement of the tumor.</p><p><strong>Results: </strong>The median follow-up was 6 years (IQR 4.7-9.7 years). All patients tolerated the treatment well, with only 4 (8%) experiencing a reduction in visual acuity. No additional acute or late radiation-induced toxicities were observed. No retinopathy was described. No patients had worsening of visual field function. No patients showed ONSMs progression on MRI follow-up.</p><p><strong>Conclusions: </strong>In this exploratory trial, hypofractionated radiosurgery (25Gy/5 fractions) for ONSMs appears safe and effective in terms of visual function and growth control, which may be validated in future multi-institutional study with longer term follow up.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001623","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":"Second Generation Gd-Bi Ultrasmall Nanoparticles Amplify the Effects of Clinical Radiation Therapy and Provide Clinical MRI Contrast.","authors":"Toby Morris, Zeinaf Muradova, Needa Brown, Léna Carmès, Romy Guthier, Meghna Iyer, Léa Seban, Arianna Liles, Stephanie Bennett, Mileni Isikawa, Michael Lavelle, Guillaume Bort, François Lux, Olivier Tillement, Sandrine Dufort, Geraldine LeDuc, Ross Berbeco","doi":"10.1016/j.ijrobp.2025.04.032","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.04.032","url":null,"abstract":"<p><strong>Purpose: </strong>AGuIX nanoparticles consisting of Gd atoms chelated to a polysiloxane matrix are under clinical evaluation as theranostic agents with radiation therapy. A new generation, AGuIX-Bi, replaces 70% of the Gd atoms in AGuIX with Bi atoms, improving radiation dose amplification while maintaining MRI contrast. The therapeutic efficacy of AGuIX-Bi was investigated under clinical megavoltage and MRI conditions in two of non-small cell lung cancer (NSCLC) models.</p><p><strong>Methods and materials: </strong>Murine (LLC) and human (A549) NSCLC were studied in mice, with animals inoculated and divided into cohorts for control (saline, AGuIX, AGuIX-Bi) and irradiation (saline+RT, AGuIX+RT, AGuIX-Bi+RT). Nanoparticle cohorts were injected 24-hours prior to delivering 10 Gy of irradiation using a 6 MV flattening-filter-free (FFF) beam. Tumors were measured until euthanasia was necessary, taken as time-to-tumor doubling (TTD). Additionally, AGuIX and AGuIX-Bi phantoms were constructed with T1-weighted images and maps taken using a 3T clinical MRI scanner. T1-images of A549 inoculated mice were obtained on the same scanner with injection of AGuIX or AGuIX-Bi 2- and 24-hrs prior to imaging.</p><p><strong>Results: </strong>No toxicity was observed due to nanoparticle injection, anaesthesia, or irradiation. In both LLC and A549 models, AGuIX-Bi+RT significantly outperformed both saline+RT and AGuIX+RT in reducing tumor growth (p<0.05). Median TTD for AGuIX-Bi+RT compared to AGuIX+RT groups was increased by 160% for A549, and by 60% for LLC models (p<0.05). Longitudinal relaxivity constants (r₁) derived from phantom T1-mapping were 6.9 mM^-1 s^-1 for AGuIX and 8.4 mM^-1 s^-1 for AGuIX-Bi. Additionally, T1-weighted mouse tumor imaging showed contrast-to-noise (CNR) of AGuIX-Bi to be roughly half that of AGuIX.</p><p><strong>Conclusions: </strong>AGuIX-Bi nanoparticles proved more effective than AGuIX at delaying tumor growth for both NSCLC models while maintaining sufficient MRI contrast at 3T. Replacing some Gd atoms with bismuth improves the efficacy of AGuIX nanoparticles under clinical megavoltage energies without compromising imaging.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002123","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}