International Journal of Radiation Oncology Biology Physics最新文献

{"title":"Dosimetric Outcomes for Stereotactic Radiotherapy in Early-Stage Non-Small Cell Lung Cancer and Interstitial Lung Disease: A Secondary Analysis of the ASPIRE-ILD Trial.","authors":"Alexa Dang, David A Palma, Edward Wang, Pencilla Lang, Andrew Warner, Houda Bahig, Alexander V Louie, Stephen Harrow, Meredith E Giuliani, Brock J Debenham, Christopher J Ryerson, Stewart Gaede","doi":"10.1016/j.ijrobp.2025.09.026","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.09.026","url":null,"abstract":"<p><strong>Purpose: </strong>Stereotactic ablative radiotherapy (SABR) in the setting of interstitial lung disease (ILD) is associated with higher toxicity risks. This dosimetric analysis of the BLINDED-FOR-REVIEW trial evaluates doses delivered to targets and organs at risk (OARs), and correlations between baseline factors and outcomes, to better inform patient selection and treatment planning.</p><p><strong>Methods: </strong>Radiation plans were centrally reviewed, and descriptive statistics were used to assess doses to targets and OARs. Unadjusted Cox proportional hazards and logistic regression were performed to identify predictors of overall survival (OS), local control (LC), and related adverse events. Linear regression was performed to identify significant predictors of the Functional Assessment of Cancer Therapy: Lung (FACT-L).</p><p><strong>Results: </strong>The cohort included 39 patients with early-stage lung cancer and ILD treated with SABR (50 Gy in 5 fractions every other day). The mean internal gross tumor volume (iGTV) and planning target volume (PTV) were 12.0 ± 11.2 cc and 33.9 ± 22.0 cc, respectively. The mean ± SD Dmax was 64.2 ± 6.3 Gy. On unadjusted analyses, LC decreased with increasing tumour size (measured as either iGTV size [p=0.038] or PTV size [p=0.033]). The risk of grade ≥ 2 adverse events increased with higher heart Dmax (p=0.020) and heart D15cc (p=0.025), and with increasing fibrosis surrounding the tumour (measured as the Hounsfield unit density of lung immediately surrounding the PTV [p=0.006]). Worse OS was associated with ILD sub-type, previous or current ILD treatment, home oxygen use, and larger target sizes. Smoking cessation and a diagnosis of idiopathic pulmonary fibrosis (IPF) were associated with improved FACT-L scores at 6 months.</p><p><strong>Conclusion: </strong>Several factors were associated with clinically relevant outcomes after SABR in patients with ILD, including radiation dose to the heart and smoking cessation. SABR delivered to highly fibrotic areas of lung was associated with higher toxicity. Smoking cessation may be important in preserving quality of life after treatment.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206492","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":"Tumor Treating Fields Therapy After Stereotactic Radiosurgery for Brain Metastases From Non-Small Cell Lung Cancer: Final Results of the Phase 3 METIS Study.","authors":"Minesh P Mehta, Vinai Gondi, Manmeet Singh Ahluwalia, David Roberge, Terence Tai Weng Sio, Daniel M Trifiletti, Thierry Muanza, Ana Misir Krpan, Zhengfei Zhu, Naren R Ramakrishna, John B Fiveash, Philippe Metellus, Jinming Yu, Chiachien Jake Wang, Julian Jacob, Christian F Freyschlag, Tibor Csőszi, Andrea Salmaggi, Alisa Taliansky, Ana Lucas, Jürgen Debus, Paul D Brown, Maciej Harat","doi":"10.1016/j.ijrobp.2025.08.066","DOIUrl":"10.1016/j.ijrobp.2025.08.066","url":null,"abstract":"<p><strong>Purpose: </strong>Improved treatments for brain metastases from non-small cell lung cancer (NSCLC BM) are needed to prolong time to intracranial progression (TTIP) without increasing neurotoxicity. Tumor Treating Fields (TTFields), electric fields delivered via skin-based arrays that disrupt cancer cell division, have demonstrated efficacy and safety in glioblastoma, NSCLC, and pancreatic cancer.</p><p><strong>Methods and materials: </strong>In the phase 3 METIS trial (NCT02831959), adults with 1 to 10 newly diagnosed NSCLC BMs suitable for stereotactic radiosurgery (SRS) receiving optimal therapy for extracranial disease were randomized 1:1 to SRS followed by TTFields (150 kHz) or SRS alone. Radiologic progression was assessed by an independent radiology review committee. The primary endpoint was TTIP (Response Assessment in Neuro-Oncology Brain Metastases criteria). Secondary endpoints included overall survival, neurocognitive function, quality of life (QoL), and safety.</p><p><strong>Results: </strong>Patients (N = 298) were followed for a median of 8.6 (0.07-85.2) months. TTFields significantly delayed TTIP (hazard ratio [HR], 0.72 [95% CI, 0.53-0.98]; Fine-Gray P = .044). Intracranial progression rates at months 2, 6, 12, and 24 were 13.6% versus 22.1% (P = .034), 33.7% versus 46.4% (P = .018), 46.9% versus 59.4% (P = .023), and 53.6% versus 65.2% (P = .031; post hoc). Time to distant intracranial progression favored TTFields therapy, although not statistically significantly (HR, 0.76 [95% CI, 0.51-1.12]; log-rank P = .165; post hoc). In patients receiving immune checkpoint inhibitors (n = 118), the delays in both TTIP (HR, 0.63 [95% CI, 0.39-1.0]; Cox P = .049; Fine-Gray P = .055) and time to distant intracranial progression (HR, 0.41 [95% CI, 0.21-0.81]; log-rank P = .0087, post hoc) were more pronounced. Device-related adverse events were mainly grade ≤2 skin events. TTFields did not cause QoL deterioration, and improvements in deterioration-free survival and time to deterioration of the global health status, physical functioning and fatigue domains were observed (post hoc).</p><p><strong>Conclusions: </strong>By significantly prolonging TTIP, without worsening QoL or cognitive function, TTFields after SRS is a new treatment option for patients with NSCLC BMs, including those receiving immune checkpoint inhibitor.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206483","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 Arrhythmia Radiotherapy (STAR) vs Repeat Catheter Ablation for High-Risk Refractory Ventricular Tachycardia: 3-Year Safety and Efficacy Outcomes.","authors":"Shannon J Jiang, Pamela Samson, Phillip Cuculich, Carlos Contreras, Kaitlin Moore, Mitchell N Faddis, Timothy W Smith, Marye J Gleva, Daniel H Cooper, Clifford G Robinson","doi":"10.1016/j.ijrobp.2025.09.006","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.09.006","url":null,"abstract":"<p><strong>Purpose: </strong>Stereotactic Arrhythmia Radiotherapy (STAR) is a noninvasive treatment alternative to repeat catheter ablation (CA) for refractory ventricular tachycardia (VT). However, no studies have directly compared the two modalities. This study reports on 3-year safety and efficacy outcomes for STAR vs CA in refractory VT patients at a high-volume center.</p><p><strong>Methods: </strong>We conducted a retrospective cohort analysis of all patients with recurrent VT who failed medical management with antiarrhythmic medications and failed at least one prior CA (or were deemed medically unfit for CA) who were then treated with either STAR or repeat CA between 2015-2018 at a single institution. Patients treated with STAR who did not receive prior CA were evaluated on a case-by-case basis and deemed by the treating electrophysiologist to be too high risk to undergo repeat CA (\"medically unfit for CA\"). Patients were evaluated for serious adverse events (SAE); freedom from death, shock, or storm (FFDSS); and overall survival (OS). Survival analyses were performed via Kaplan-Meier method and compared by log-rank test.</p><p><strong>Results: </strong>Forty-three patients were included: 22 received STAR and 21 repeat CA. Baseline characteristics were similar, however generally patients treated with STAR were older (median 64.5 vs 59 years), had \"High Risk\" I-VT scores (64% vs 52%), and had higher PAINESD scores (median 18.5 vs 17). Median follow-up was 3 years. More patients treated with CA (N=8, 38%) developed 1-year treatment-related SAEs compared to STAR (N=2, 9%). Median time to any SAE was shorter for patients treated with CA compared to STAR (6 days vs 10.0 months), and most early CA deaths occurred immediately after SAE. Twelve patients died within 3 years of STAR, 75% (N=9) were unrelated to VT and none from treatment-related SAE. There was no statistically significant difference in FFDSS between patients treated by STAR vs CA (6.9 vs 2.9 months, p=0.88). FFDSS for STAR vs CA was 32% vs 27% at 1-year, 27% for both at 2-years, and 18% vs 21% at 3-years. There was no statistically significant difference in OS between patients treated with STAR vs CA (28.2 vs 12.2 months, p=0.91).</p><p><strong>Conclusion: </strong>At 3-year follow-up, STAR offers comparable VT control with fewer SAEs and longer time to toxicity; supporting its possible role as a noninvasive alternative to repeat CA. These findings warrant further prospective study.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206465","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":"Assessing the Implementation of Electronic Patient-Reported Outcomes (ePRO) to Reduce Follow-up Visits for Patients Undergoing Radiation Therapy for Breast Cancer.","authors":"Marco Santos Teles, Kaitlyn Lapen, Jennie Huang, Jun J Mao, Michael B Bernstein, Lior Z Braunstein, Atif J Khan, Bobby Daly, Erin F Gillespie","doi":"10.1016/j.ijrobp.2025.09.027","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.09.027","url":null,"abstract":"<p><strong>Purpose/objectives: </strong>We aimed to evaluate the acceptability, appropriateness, and feasibility of using an ePRO-based strategy to reduce post-radiation therapy (RT) visits in patients with breast cancer who reported minimal symptoms.</p><p><strong>Materials/methods: </strong>An ePRO instrument was administrated weekly for patients undergoing RT for breast cancer at an academic cancer center. The instrument assessed RT toxicities (breast enlargement/tenderness, skin changes, pain, and fatigue) using PRO-CTCAE and anxiety with GAD-2. Patients rated symptom severity on a 5-point Likert scale (None to Very severe). Six weeks after treatment completion, patients with no more than moderate symptoms were offered the option to cancel their routine post-RT follow-up visit. Clinical and demographic data were collected from electronic health records.</p><p><strong>Results: </strong>Among the 46 patients (median age: 60 years) who responded to the appointment cancellation question, 32 (70%) were White, 5 (11%) Black, 5 (11%) Asian, and 2 (4.3%) Hispanic. Regarding acceptability among respondents, we found 36 (78%) chose to keep their appointments, 7 (15%) opted to cancel, and 3 (6.5%) were not sure. In terms of appropriateness, patients who canceled or were unsure were similar in age, race, ethnicity, BMI, and travel distance to the center, but reported fewer symptoms than those who kept their appointments, with significantly lower breast tenderness (10% vs. 50%, respectively, p=0.026), and a trend towards lower pain in the radiated area (30% vs. 61%, p=0.073) and fatigue (30% vs. 56%, p=0.23). As an assessment of feasibility, fewer hospitalizations within 6 months occurred among those cancelling their follow-up visit (0 vs. 2 [5.6%]), while urgent care visits were comparable (8.6% vs. 10%).</p><p><strong>Conclusions: </strong>An ePRO-based strategy to inform post-RT follow-up visits appears feasible and appropriate for patients who completed breast RT with mild to moderate symptoms. Despite low acceptability (20%), the high prevalence of breast cancer suggests this strategy could still reduce the clinical burden of low value visits.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199325","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":"Radiotherapy for Non-Malignant Diseases: An ASTRO-ESTRO-DEGRO-RANZCR White Paper.","authors":"Jarad M Martin, Gopal K Bajaj, Matthias Guckenberger, Tuan Ha, Barbara A Jereczek-Fossa, Jan Kriz, Neha Vapiwala, Sameer Keole","doi":"10.1016/j.ijrobp.2025.09.036","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.09.036","url":null,"abstract":"<p><p>The field of Radiation Medicine has an opportunity to explore emerging indications, including non-malignant disease, where radiotherapy may be beneficial. Since radiotherapy has anti-inflammatory and anti-proliferative effects, there is rationale to deploy it in the management of a range of non-malignant conditions including plantar fasciitis, Dupuytren's Disease and osteoarthritis. Given the prevalence of many potentially relevant pathologies, a body of evidence (albeit commonly lower level) and an often absence of a widely accepted standard treatment for a particular patient cohort, the potential for the field of Radiation Medicine is immense. Although due to the low radiation doses, simple radiotherapy techniques and low burden of acute toxicities the barriers to managing non-malignant conditions are relatively low, there are challenges relating to building a stronger evidence base, constructively engaging with different disciplines and consumer groups, and the possibility that without proactiveness other craft groups with lower expertise in Radiation Medicine will move into these indications. Fortunately, many of the likely solutions have already been tested and validated in the management of cancer. The first pillar is the generation of high quality evidence, the second is education of both trainees and colleagues, and the third aspect is engagement across the spectrum from other medical specialities through to consumers. This Inter-society white paper presents a pathway to help responsibly and efficiently establish the place of radiotherapy in the management of non-malignant disease.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199319","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":"Toxicities and Quality of Life following Observation or Radiation Therapy for Dupuytren's disease: Three year secondary analysis data from the Prevention Group of the International DEPART Randomized Trial.","authors":"Jarad M Martin, Tanya Burgess, Brett McClelland, David Christie, Paul M N Werker, Warren Rozen, Roel J H M Steenbakkers, Anneke de Haan, Sreelakshmi Anoora, Dion Sandoz, Joshua Sappiatzer, Katherine Neville, Sandy Sampaio, David Schlect, Joseph Bucci, David Hunter-Smith, David Dilley","doi":"10.1016/j.ijrobp.2025.09.037","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.09.037","url":null,"abstract":"<p><strong>Purpose: </strong>Low dose radiotherapy (LDRT) has been used for non-malignant conditions including Dupuytren's disease (DD). The DEPART clinical trial randomized hands to either Observation (Obs) or LDRT to assess impact on disease progression (trial registration ACTRN12618000951257). Here we report toxicity and quality of life (QOL) for the first 36 months of follow-up.</p><p><strong>Methods: </strong>Key eligibility criteria included a clinical diagnosis of DD, a patient reported history of disease progression over the last six months and written informed consent. Hands were randomized 1:1 to Obs or LDRT to a dose of 30Gy in 10 fractions. Patients were scheduled to be assessed at baseline, 6, 12, 24, 36, 48, 60, 84 and 108 months post treatment, with specific toxicities graded (CTCAE v4.03). For QOL, QuickDash, URAM and pain were recorded at baseline and subsequently scheduled for 6, 12, 36, 60, 84 and 108 months. HREC approval: 2018-02-134-PVR-1.</p><p><strong>Results: </strong>Between 2018-24, 404 hands (202 Obs, 202 LDRT) were randomized, with this analysis at the current median follow-up of 36 months (IQR 24-48). 162 patients experienced a toxicity (4 obs, 158 LDRT [most commonly dermatitis, reduced sweating and localized oedema]), with 96.6% grade 1 and no grade 3 events. Of the 14 grade 2 (moderate) toxicities recorded, only 1 (reduced sweating) persisted up to 24 months. For QOL lower scores translates to less symptoms. Median baseline scores were equivalent between arms, but improved over time for the LDRT arm. 36 month scores for Obs v LDRT were: QuickDASH (17.8 v 10.9 [p=0.013]), URAM (4.8 v 3.1 [p=0.056]) and Pain (2.1 v 1.0 [p=0.001]).</p><p><strong>Conclusions: </strong>Multicentre randomized controlled trials assessing radiotherapy for non-malignant conditions are feasible, and critical to establish efficacy and risks. LDRT for DD is well-tolerated, with minimal ongoing toxicities. QOL is possibly improved by LDRT. Follow-up is ongoing to assess longer term toxicities, QOL and LDRT's impact on disease control.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199292","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":"Functional avoidance liver 4π-SBRT informed by quantitative Gadoxetic-acid contrast-enhanced MR T1 mapping.","authors":"Joshua Everts, Yang Yang, Qifan Xu, Qihui Lyu, Mary Feng, Jessica Scholey, Michael Ohliger, William C Chen, Alexandra E Hotca, Mekhail Anwar, Junzhou Chen, Zhaoyang Fan, Ke Sheng, Wensha Yang","doi":"10.1016/j.ijrobp.2025.09.051","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.09.051","url":null,"abstract":"<p><strong>Purpose: </strong>Recent studies have identified the T1 reduction rates (k1) from Gadoxetic acid-enhanced magnetic resonance imaging (MR) as a biomarker for liver function. In this study, we validate k1 maps as a functional biomarker and develop 4π noncoplanar treatment plans using k1 maps to guide the optimization for liver functional avoidance stereotactic body radiation therapy (FA-SBRT).</p><p><strong>Methods: </strong>106 patients underwent pre- and post-contrast T1 mapping MR. Mean liverGTV k1 values were correlated with Child-Pugh (CP) and ALBI scores. The highfunction (HF) liver region was identified and masked using a patient-specific threshold from Gaussian decomposition of the k1 histogram. Twenty patients were retrospectively planned with coplanar and non-coplanar 4π-SBRT with and without functional avoidance. Tumor coverage was maintained at a minimum of 90% PTV to receive prescription, and standard OAR constraints were set for all plans. Dose metrics included mean dose to the HF liver and HF liver volume receiving 6 Gy, which was shown to impact patient liver function. A paired, two-tailed t-test was used to determine the statistical significance.</p><p><strong>Results: </strong>k1 values were inversely correlated with CP and ALBI. The 4π FA-SBRT plans reduced the mean dose to the high-function liver volume by 21.8% (from 9.2 Gy to 6.5 Gy) (p<.0001) and the volume of high-function liver receiving > 6 Gy by 39.5% (from 507.5cc to 302.2cc) compared with the 20-beam coplanar geometry (p<.0001). All reductions were statistically significant (p<.01).</p><p><strong>Conclusion: </strong>This study validates k1 derived from free-breathing T1 mapping MR as a liver function biomarker in a cancer patient cohort. Gaussian decomposition can threshold the k1 distribution to create patient-specific HF liver masks. The 4π FA SBRT planning guided by k1 maps significantly reduced the mean dose to the HF liver, as well as the volume of HF receiving >6Gy.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191559","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":"The role of external beam radiation therapy in thyroid cancer management: A Scoping Review.","authors":"Arnaud Beddok, Jean Baptiste Morvan, Laurys Boudin, Antonio Da Silva Ribeiro Mota, Pauline Dutheil, Philippe Guilbert, Laura Rozenblum, Adeline Theresette Guilbert, Mohamad Zalzali, Pierre-Yves Marcy, Juliette Thariat","doi":"10.1016/j.ijrobp.2025.09.050","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.09.050","url":null,"abstract":"<p><strong>Background: </strong>This scoping review aimed to evaluate the role of external beam radiation therapy (EBRT) in the management of thyroid cancers, a heterogeneous disease encompassing multiple histological subtypes, and to clarify its integration with emerging targeted therapies.</p><p><strong>Methods: </strong>Following PRISMA-ScR guidelines, a systematic search of PubMed and BioMed Central from 2012 to 2024 identified 91 studies from an initial pool of 2,309 records. Of these, 36 (39.5%) addressed anaplastic thyroid carcinoma (ATC), 31 (34%) differentiated thyroid carcinoma (DTC), 6 (6.5%) medullary thyroid cancer (MTC), 12 (13.5%) rare subtypes, and 6 (6.5%) focused on metastasis-directed EBRT. EBRT was analyzed as definitive treatment, postoperative EBRT (poRT), or in combination with systemic therapies.</p><p><strong>Results: </strong>Definitive EBRT remains a key option for patients with inoperable, locally advanced ATC, particularly when vital structures such as the trachea or esophagus are involved. Although the studies included in this review did not allow conclusions regarding whether targeted therapies have modified EBRT indications in ATC, recent guidelines increasingly recommend systemic therapies-particularly BRAF/MEK inhibitors-as first-line treatment in unresectable disease, with EBRT considered following re-evaluation. In DTC, poRT combined with radioactive iodine (RAI) reduced the 5-year locoregional recurrence rate by up to 30% in high-risk patients (extrathyroidal extension, incomplete resection, or nodal metastases). While a consistent overall survival (OS) benefit was not observed, improved local control may help reduce recurrence-related morbidity. IMRT improved locoregional failure-free survival (LFFS) compared to 3D-CRT, and proton therapy showed favorable toxicity profiles in small cohorts. In MTC, poRT was associated with reduced locoregional recurrence in patients with extracapsular extension or nodal metastases, but similar to DTC, its impact on OS remains unclear. For primary thyroid lymphoma, EBRT achieved high local control but is generally reserved for refractory or chemotherapy-ineligible patients.</p><p><strong>Conclusion: </strong>EBRT remains an important modality for locoregional control in thyroid cancers, especially in high-risk or inoperable cases. While OS benefit has not been consistently demonstrated across histologies, local control may improve patient outcomes by reducing the burden of recurrence or prolonging survival in selected situations. The integration of EBRT with evolving systemic therapies warrants further prospective investigation.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185927","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":"Tumor Treatment Response Guided Adaptive Dose De-escalation/Escalation Strategy for Concurrent Chemoradiotherapy of Nasopharyngeal Carcinoma.","authors":"Xiaoqiang Chen, Shu Zhang, Xiaofang Gou, Jiaona Dai, Ni Zeng, Baofeng Duan, Konglong Shen, Hui Wang, Renming Zhong, Rong Tian, Nianyong Chen, Di Yan","doi":"10.1016/j.ijrobp.2025.09.049","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.09.049","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;A novel tumor dose response guided adaptive chemo-radiotherapy process for nasopharyngeal carcinoma (NPC) was constructed and evaluated prospectively and retrospectively. In this process, tumor voxel dose response matrices quantified using two-point Fluorodeoxyglucose (FDG) Positron Emission Tomography/Magnetic Resonance (PET/MR) images acquired before and after an induction chemotherapy (IC) were utilized to guide quantitatively the individual patient dose de-escalation/ escalation for NPC patients in the post-IC concurrent chemo-radiotherapy (CCRT).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods and materials: &lt;/strong&gt;Two FDG-PET/MR images were obtained before and after IC for each of 21 patients with stage III and IV NPC who underwent IC + CCRT. The changes of tumor voxel Standardized Uptake Value (SUV&lt;sub&gt;0&lt;/sub&gt;) on the pre-treatment baseline image and the baseline voxel volume were tracked on the post IC image using a deformable image registration tool and utilized to construct the tumor voxel dose response matrix (DRM) as the surrogate of tumor in situ SF&lt;sub&gt;2&lt;/sub&gt; at the voxel level. Equivalent dose in the IC treatment was determined assuming that the IC treatment achieved the same mean DRM to the one achieved using a dose in the CCRT treatment alone. Therefore, the equivalent dose should not be extrapolated with respect to any other clinical endpoints. The tumor voxel SUV&lt;sub&gt;0&lt;/sub&gt; and DRM were used to predict the treatment outcome and create retrospectively the expected treatment dose for the post-IC CCRT treatment. For few patients who were expected for a large dose escalation, new treatment plans targeting the highly resistant tumors were generated to assess clinical feasibility of adaptive dose fractionation painting schema.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The equivalent dose in 2Gy per fraction (EQD&lt;sub&gt;2&lt;/sub&gt;) for 3 cycles IC (Gemcitabine + Cisplatin) was approximately 40Gy. The mean and coefficient variation (CV) of SUV&lt;sub&gt;0&lt;/sub&gt; and DRM for all the primary tumors (Gross Tumor Volume - nasopharynx (GTVnx) group) were 5.98 (62%) and 0.42 (72%) respectively, which were significantly larger than 5.22 (59%) and 0.37 (55%) for the positive nodes (GTVnd group) (p &lt; 0.001). Both GTVnx and GTVnd groups exhibited significantly larger intra-tumoral variations on SUV&lt;sub&gt;0&lt;/sub&gt; compared to the inter-tumoral variations, (55%, 54%) vs (29%, 24%), meanwhile similar intra/inter-tumoral variations on DRM, (47%, 39%) vs (54%, 39%). Individual tumor local control probabilities (TCPs) for the 21 patients calculated using the individual tumor voxel (SUV&lt;sub&gt;0&lt;/sub&gt;, DRM) were from 0.54 to 1.0. To achieve TCP = 0.99, 18/21 patients could have their CCRT treatment dose be de-escalated for one of GTVnx and GTVnd, or both. In addition, 6/21 patients needed the CCRT treatment dose for at least one GTV to be escalated to 78∼126Gy (EQD&lt;sub&gt;2&lt;/sub&gt;); 2 of the 6 needed to escalate the treatment dose for both the primary and positive node GTVs. Ad","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185987","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":"Gender Diversity in the AAPM Annual Meeting: A 2017 Benchmark Analysis of Speakers and Moderators.","authors":"Andrea Roso-Mares, Sara St James, Ashley Cetnar, Julianne Pollard-Larkin, Reshma Jagsi, Suzanne B Evans, Jean M Moran, Laura I Cerviño","doi":"10.1016/j.ijrobp.2025.08.067","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.08.067","url":null,"abstract":"<p><strong>Purpose: </strong>This study assesses gender composition among invitees at the American Association of Physicists in Medicine (AAPM) annual meeting.</p><p><strong>Methods and materials: </strong>A cross-sectional analysis was conducted using data from the 2017 AAPM Annual Meeting. Gender was determined using AAPM member public profiles and data. Statistical analysis of gender representation was performed using the Mann-Whitney-Wilcoxon U test, with a p-value <0.05 considered significant. Speaker and moderator characteristics, including academic impact metrics (h-index, m-index, and publication history), were analyzed. Gender representation for 2012 and 2021 was also calculated to provide a comparative reference.</p><p><strong>Results: </strong>In 2017, women comprised 25% of invited speakers and 19.9% of moderators, while AAPM membership was 23% women. A significant gender difference was observed in h-index values (median: men 18, women 13; p=0.003), but no significant differences were found in presenter evaluation scores. Only 30 states were represented among the invitees, highlighting the need for improved geographic diversity. As a secondary analysis, gender representation among invitees was found to have increased from 17% in 2012 to 25% in 2017 and 39% in 2021.</p><p><strong>Conclusion: </strong>Gender disparities in speaker selection persisted at the 2017 AAPM Annual Meeting, with women underrepresented among both invited speakers and moderators relative to gender parity. While no gender-based differences were observed in presenter evaluations, disparities in academic impact metrics highlight structural challenges in achieving equal representation. These findings provide a baseline for evaluating future initiatives within AAPM, with secondary data suggesting positive trends over time.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185824","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}