International Journal of Radiation Oncology Biology Physics最新文献

{"title":"Unveiling Cellular Responses and Underlying Immune Effects Induced by Boron Neutron Capture Therapy.","authors":"Hongyuan Mao, Jinyue Li, Chenhan Huang, Zerun Li, Xinyue Ma, Dizhi Jiang, Xinyu Zhang, Tianzi Wang, Bo Cheng, Ruiqing Wang, Jianbo Wang, Yufeng Cheng","doi":"10.1016/j.ijrobp.2025.04.026","DOIUrl":"10.1016/j.ijrobp.2025.04.026","url":null,"abstract":"<p><p>Boron neutron capture therapy (BNCT) is an emerging modality for cancer treatment. Although its concept was proposed in the last century, progress has been relatively slow because limitations in neutron source technology and boron compounds. In recent years, with the increased availability of neutron devices and improvements in boron compounds, the radiobiological effects of BNCT have been investigated more deeply, leading to a surge of research findings in the field. Therefore, a systematic review of the current status of BNCT is particularly warranted. In this review, we integrate the latest studies to provide a comprehensive and detailed description of the direct and indirect mechanisms by which BNCT induces cell killing, as well as the subsequent cellular responses. More importantly, we propose that BNCT exhibits a stronger immunologic foundation and immunogenicity than traditional radiation therapy, indicating significant potential for its combined application with immunotherapy. These results offer a robust theoretical foundation for the future clinical use of BNCT and indicate that continued investigation of BNCT in conjunction with immunotherapy may pave the way for more advanced cancer treatment strategies.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988709","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":"International Patterns of Practice for Stereotactic Ablative Radiotherapy for Early-Stage Non-Small Cell Lung Cancer: Are We All in Sync?: Global patterns of practice for SABR for early-stage NSCLC.","authors":"Salem A Alfaifi, Alexander V Louie, Shankar Siva, Matthias Guckenberger, Gregory M M Videtic, Kristin A Higgins, Faiz Alshafa, Hamza AlGhamdi, Erin F Gillespie, Kevin Stephans, Layth Mula-Hussain, Stephen Harrow, David A Palma","doi":"10.1016/j.ijrobp.2025.04.022","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.04.022","url":null,"abstract":"<p><strong>Purpose: </strong>To generate an understanding of the similarities and variations in international practice patterns for stereotactic ablative radiotherapy (SABR) in early-stage non-small cell lung cancer (NSCLC).</p><p><strong>Methods: </strong>An online survey was conducted from October to December 2023, addressing general clinical and technical considerations for lung SABR, and for 5 specific anatomical NSCLC locations (peripheral, abutting chest wall, near brachial plexus, central, and ultra-central). Invitations to participate were extended through email and were distributed on social media.</p><p><strong>Results: </strong>The survey was completed by 255 radiation oncologists, each representing a single institution across 51 countries. Respondents reported treating a median of 20 cases annually. A total of 38% of participants reported using single-fraction SABR, and 54% applied an upper limit on the maximum dose (Dmax). Among those who applied a Dmax limit, 58% reported a Dmax threshold at ≥130% of the prescription, though this limit varied by region and national economy status. Respondents from low- and middle-income countries were less likely to set a Dmax limit at ≥130% (30% vs. 66%, p < 0.01) and less likely to use single-fraction SABR (14% vs. 44%, p < 0.01). Higher annual SABR patient volumes were associated with higher Dmax adoption (г = 0.23, p < 0.01). Across the 5 clinical scenarios presented; 57 distinct dose regimens were recommended. The most common regimen in each scenario was: 54 Gy in 3 fractions for peripheral tumors, 50 Gy in 5 fractions for apical, central, and abutment of chest wall, and 60 Gy in 8 fractions for ultra-central tumors. Approximately two-thirds of practices recommend a biologically effective dose (BED₁₀) <100 Gy for one or more anatomical sites.</p><p><strong>Conclusion: </strong>The findings reveal considerable variation in global SABR practice. These differences highlight the need for further data to guide prescription practices, and an international experts' consensus may be beneficial to standardize practice.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010303","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":"Reported Early Clinical Outcomes of Forward-Planned Multileaf Collimator-Based 3-Dimensional Conformal Spatially Fractionated Radiation Therapy Technique for Large and Bulky Tumors.","authors":"James A Knight, Nick Trosper, Josh Misa, Mark E Bernard, Denise Fabian, Mahesh Kudrimoti, Weisi Yan, William St Clair, Eddy S Yang, Damodar Pokhrel","doi":"10.1016/j.ijrobp.2025.04.016","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.04.016","url":null,"abstract":"<p><strong>Purpose: </strong>Conventionally fractionated radiation therapy for large, bulky (≥8 cm), unresectable tumors has been hampered by radiation-induced morbidity, but application of spatially fractionated radiation therapy (SFRT) for both palliative and curative intent has been increasingly accepted. We report our clinical use of novel 3-dimensional conformal multileaf collimator (MLC)-based SFRT with same-day computed tomography simulation and forward-planning method, providing a safe, rapidly efficacious reduction in disease burden and pain, with minimal normal-tissue toxicity.</p><p><strong>Methods and materials: </strong>Patients with large, unresectable bulky tumors received 15 Gy in 1 fraction to the gross tumor volume (GTV) within an hour of computed tomography simulation, using a forward-planned MLC-based SFRT technique. All patients subsequently received either 30 Gy in 10 fractions, generally 2 days after SFRT for palliative intent, or site-specific, full-prescription doses starting 2 to 3 days after SFRT for curative intent. Patients underwent follow-up examinations and imaging in 3-month intervals to assess tumor response, pain control, and radiation-associated toxicity.</p><p><strong>Results: </strong>Between November 2019 and January 2024, 24 large tumors in 23 patients were analyzed. Median follow-up was 6 months (range 3-36 months). After SFRT, 16 patients (69.5%) proceeded with palliative-intent radiation therapy, 6 patients (26.0%) underwent curative-intent radiation therapy, and 1 patient (4.3%) declined further radiation therapy. Seven patients (30.4%) reported acute radiation-associated toxicities. A total of 3 acute grade ≥3 toxicities (13.0%) were reported, but no grade 5 toxicities occurred. Complete or partial response was seen in 14 of 24 (58%) tumors; clinical benefit rate was 79.2%. Twenty of 23 patients (86.9%) reported pain relief from tumor burden.</p><p><strong>Conclusions: </strong>Same-day 3-dimensional MLC-based SFRT method provides fast, safe, and effective management of large, bulky, unresectable tumors for both palliative and therapeutic intents across a wide range of tumor sites and histologies, reducing tumor burden and improving patient comfort and compliance. This method could be useful for rapid SFRT including adaptive treatment. We recommend commissioning and validating this method at other institutions, including community cancer centers, to expand the access of efficient, high-quality SFRT treatment to underserved patient cohorts.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008080","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 Comparative Risk Analysis of Cone Beam Computed Tomography-based Daily Adaptive Radiation Therapy and Cone Beam Computed Tomography-based Radiation Therapy Alone.","authors":"Caroline M Colbert, Dustin Melancon, John Kang, Eric C Ford, Wade P Smith","doi":"10.1016/j.ijrobp.2025.04.009","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.04.009","url":null,"abstract":"<p><strong>Purpose: </strong>When adopting a new therapeutic technology, a comparison to a standard of care is needed. We aim to directly compare the specific safety implications of adaptive radiation therapy (ART) to those of traditional image guided radiation therapy (IGRT), as implemented on a ring gantry linear accelerator with kilovoltage cone beam computed tomography-based online ART capability.</p><p><strong>Methods and materials: </strong>An interdisciplinary committee performed a failure modes and effects analysis based on the American Association of Physicists in Medicine (AAPM) Task Group 100 method addressing initial treatment planning, quality assurance, and treatment delivery for both IGRT-alone and IGRT with ART on the Varian Ethos. Failure modes were categorized by process step and associated clinical roles, scored by severity, occurrence, and detectability, and ranked by risk priority number (RPN). Failure modes shared by IGRT and ART were scored and analyzed comparatively.</p><p><strong>Results: </strong>We identified 33 unique system failure modes as part of the IGRT-alone workflow, and 9 additional failure modes specific to ART. Most high-risk IGRT-alone system failure modes were associated with initial treatment planning errors. High-risk ART failure modes also included errors related to adaptive replanning. Reanalysis of 33 IGRT-alone failure modes in the ART setting found an overall decrease in median RPN from 96 (IQR, 56-144) to 72 (IQR, 32-120; P = .035). RPN decreased for 12 failure modes, with the greatest change observed among the highest-ranked failure modes for IGRT-alone.</p><p><strong>Conclusions: </strong>Although online ART introduces new avenues for error in the adaptive replanning process, the enhanced staffing and iterative plan review reduce the risk associated with systematic errors originating in initial treatment planning. The finding that the RPN decreased in the adaptive setting provides a unique motivation for the adoption of ART from a patient safety perspective, beyond the well-documented dosimetric benefit of ART.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997069","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":"Accuracy and Prognosis of Extranodal Extension on Radiologic Imaging in Human Papillomavirus-Mediated Oropharyngeal Cancer: a Head and Neck Cancer International Group (HNCIG) real-world study.","authors":"Hisham Mehanna, Ahmad K Abou-Foul, Christina Henson, Caroline Kristunas, Paul C Nankivell, Lachlan McDowell, C René Leemans, Michiel W M van den Brekel, Christian von Buchwald, Kathrine Kronberg Jakobsen, Christian Grønhøj, Jacob Høygaard Rasmussen, William M Lydiatt, Vishal Gupta, Barton F Branstetter, Jens Peter Klussmann, Barbara Wollenberg, Benedikt Schmidl, Martina A Broglie, Jan-Jaap Hendrickx, Daniel R Awad, Robin Prestwich, Anne-Laure Gaultier, Marc Oliva, Sudhir Nair, Anthony Noor, Suren Krishnan, Zsuzsanna Iyizoba-Ebozue, Mantegh Sethi, Irene H Nauta, Daniel Zhao, Sue S Yom","doi":"10.1016/j.ijrobp.2025.04.003","DOIUrl":"10.1016/j.ijrobp.2025.04.003","url":null,"abstract":"<p><strong>Purpose: </strong>Extranodal extension on radiology (iENE) is reported in single-center studies to be negatively prognostic in human papillomavirus-mediated oropharyngeal cancer (HPV + OPC) and is a major eligibility criterion for surgical treatment. However, studies report widely varying sensitivities, specificities, and interobserver correlation. In this research the prognostic power, sensitivity, and specificity of iENE in HPV + OPC in real-world practice are determined.</p><p><strong>Methods and materials: </strong>A retrospective cohort of 821 consecutive subjects with p16 + OPC, treated with surgery and/or chemoradiation therapy (CRT), from 13 multinational secondary hospitals in 9 countries between January 1, 1999 and December 31, 2020 was analyzed. The main outcomes were sensitivity, specificity, and overall survival (OS). Assessors were blinded to outcomes.</p><p><strong>Results: </strong>Six hundred thirty-eight patients were included in the final analysis. A total of 109 of 394 (27.7%) with no iENE had ENE on histopathology (pENE), and 109 of 192 (56.8%) of patients with pENE were misclassified as having no iENE. iENE sensitivity and specificity were 44.5% (95% CI, 37.8%-51.4%) and 87.6% (95% CI, 84.1%-90.6%), respectively, and varied significantly between centers. Negative predictive value was 75.3% (95% CI, 72.3%-77.5%). Subgroup analyses showed significantly increased sensitivity and specificity if patients had both computed tomography (CT) and magnetic resonance imaging (MRI): 84.6% (95% CI, 65.1%-95.6%, P < .001) and 94.5% (95% CI, 82.3%-99.4%, P = .022), respectively, compared with only CT or MRI alone. Specialist radiologists showed better specificities (89.14%; 95% CI, 85.69%-91.99% vs 46.67%; 95% CI, 21.27%-73.41%, P < .001) and similar sensitivities to nonspecialists. On multivariable analysis, iENE positivity was not a statistically significant independent predictor of OS (adjusted hazards ratio [aHR], 1.50 [95% CI, 0.97-2.32; P = .071]) or disease-free survival (aHR, 1.41; 95% CI, 0.95-2.09; P = .089). Two proposals for amended TNM staging did not yield large improvements.</p><p><strong>Conclusions: </strong>In current real-world practice, iENE showed widely varying and modest accuracy, and was not independently prognostic of outcomes in HPV + OPC. iENE accuracy and prognostic power increased significantly by using combined CT and MRI scanning, experienced head and neck radiologists and more inclusive diagnostic criteria. Validated consensus diagnostic criteria and protocols are urgently needed to enhance the clinical utility of iENE. Until then, clinicians should be cautious about making treatment decisions based on iENE.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966772","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":"Fully Automated Online Adaptive Radiation Therapy Decision-Making for Cervical Cancer Using Artificial Intelligence.","authors":"Shuai Sun, Xinyue Gong, Songyang Cheng, Ran Cao, Shumeng He, Yongguang Liang, Bo Yang, Jie Qiu, Fuquan Zhang, Ke Hu","doi":"10.1016/j.ijrobp.2025.04.012","DOIUrl":"https://doi.org/10.1016/j.ijrobp.2025.04.012","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Interfraction variations during radiation therapy pose a challenge for patients with cervical cancer, highlighting the benefits of online adaptive radiation therapy (oART). However, adaptation decisions rely on subjective image reviews by physicians, leading to high interobserver variability and inefficiency. This study explores the feasibility of using artificial intelligence for decision-making in oART.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods and materials: &lt;/strong&gt;A total of 24 patients with cervical cancer who underwent 671 fractions of daily fan-beam computed tomography (FBCT) guided oART were included in this study, with each fraction consisting of a daily FBCT image series and a pair of scheduled and adaptive plans. Dose deviations of scheduled plans exceeding predefined criteria were labeled as \"trigger,\" otherwise as \"nontrigger.\" A data set comprising 588 fractions from 21 patients was used for model development. For the machine learning model (ML), 101 morphologic, gray-level, and dosimetric features were extracted, with feature selection by the least absolute shrinkage and selection operator (LASSO) and classification by support vector machine (SVM). For deep learning, a Siamese network approach was used: the deep learning model of contour (DL_C) used only imaging data and contours, whereas a deep learning model of contour and dose (DL_D) also incorporated dosimetric data. A 5-fold cross-validation strategy was employed for model training and testing, and model performance was evaluated using the area under the curve (AUC), accuracy, precision, and recall. An independent data set comprising 83 fractions from 3 patients was used for model evaluation, with predictions compared against trigger labels assigned by 3 experienced radiation oncologists.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Based on dosimetric labels, the 671 fractions were classified into 492 trigger and 179 nontrigger cases. The ML model selected 39 key features, primarily reflecting morphologic and gray-level changes in the clinical target volume (CTV) of the uterus (CTV_U), the CTV of the cervix, vagina, and parametrial tissues (CTV_C), and the small intestine. It achieved an AUC of 0.884, with accuracy, precision, and recall of 0.825, 0.824, and 0.827, respectively. The DL_C model demonstrated superior performance with an AUC of 0.917, accuracy of 0.869, precision of 0.860, and recall of 0.881. The DL_D model, which incorporated additional dosimetric data, exhibited a slight decline in performance compared with DL_C. Heatmap analyses indicated that for trigger fractions, the deep learning models focused on regions where the reference CT's CTV_U did not fully encompass the daily FBCT's CTV_U. Evaluation on an independent data set confirmed the robustness of all models. The weighted model's prediction accuracy significantly outperformed the physician consensus (0.855 vs 0.795), with comparable precision (0.917 vs 0.925) but substantially higher recall (0.887 vs 0.","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002106","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":"Stimulator of Interferon Genes Agonist Synergistically Amplifies Programmed Cell Death Protein-1 Blockade and Radiation-Induced Systemic Antitumor Responses via Tumor Microenvironment Enrichment.","authors":"Yue Zheng, Pengfei Zhou, Hui Wang, Shuangsi Liao, Guo Lin, Kai Kang, Ren Luo, Zichong Peng, Shanghai Liu, Linglu Yi, Ruizhan Tong, Jianxin Xue, Zhuoran Yao, You Lu","doi":"10.1016/j.ijrobp.2025.04.011","DOIUrl":"10.1016/j.ijrobp.2025.04.011","url":null,"abstract":"<p><strong>Purpose: </strong>The effectiveness of immune checkpoint inhibitors in solid tumors is limited and heavily dependent on the tumor microenvironment (TME). Radiation therapy (RT) reshapes the TME, promoting T cell infiltration. We explored the combined antitumor effects of the stimulator of interferon genes (STING) agonist with low-dose RT and immunotherapy.</p><p><strong>Methods and materials: </strong>Tumor cell lines (PRM-SCLC, MC38, and LL2) were treated with the STING agonist diABZI (0.001-10 µM) to assess cytotoxicity. The mRNA expression levels of chemokines and cytokines in tumor cells were quantitatively analyzed in conjunction with RT to assess immune activation. Flow cytometry assessed bone marrow-derived dendritic cell and macrophage maturation. Subcutaneous tumor-bearing mouse models (PRM-SCLC, MC38, LL2) were used to monitor tumor volume, body weight, and survival. Tumor samples were collected for flow cytometry, immunofluorescence, immunohistochemistry, and transcriptome sequencing. Bilateral tumor models assessed the abscopal effect, with tumor and tumor-draining lymph node samples collected.</p><p><strong>Results: </strong>The STING agonist diABZI did not directly inhibit tumor cell proliferation at tested concentrations. However, when combined with RT, diABZI significantly upregulated chemokines and IFN-β mRNA levels in tumor cells, while mitigating the RT-induced rise in TGF-β levels. In vitro, bone marrow-derived dendritic cells and macrophages treated with STING agonist + RT showed increased maturation. In tumor-bearing mice, the STING agonist enhanced the efficacy of RT, chemotherapy, and immunotherapy. Adding STING agonist to low-dose RT + αPD-1 activated tumor-infiltrating CD45⁺, CD8⁺, CD4⁺ T cells, natural killer cells, and dendritic cells, and promoted M1 macrophage polarization. Transcriptome analysis showed enhanced antigen presentation and T cell activation. In bilateral tumor models, triple therapy reduced both primary and distant tumor volumes, with increased T cell infiltration and a higher presence of TCF1⁺ PD-1⁺ T_SL cells in tumor-draining lymph nodes.</p><p><strong>Conclusions: </strong>STING agonist boosts immune activation and cell recruitment in the TME, enhancing immunotherapy response. It also amplifies the abscopal effect of RT, promoting systemic antitumor immunity with clinical translational potential.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018221","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":"Experimental Investigation of Hematological Toxicity After Radiation Therapy Combined With Immune Checkpoint Inhibitors.","authors":"Vincent R Timnik, Andreas Zoeschg, Sarah Diederich, Sophie M Nefzger, Ziyi Huang, Nicole A Schmid, Maximilian Giller, Katja Steiger, Stephanie E Combs, Guido Kroemer, Thomas E Schmid, Julius C Fischer","doi":"10.1016/j.ijrobp.2025.04.008","DOIUrl":"10.1016/j.ijrobp.2025.04.008","url":null,"abstract":"<p><strong>Purpose: </strong>Combining immune checkpoint inhibitors (ICIs) with radiation therapy (RT) has led to significant advancements in cancer treatment. However, evidence from clinical and experimental studies suggests that this combination may increase hematopoietic and lymphatic toxicity. This study aims to investigate the effects of the concurrent application of ICIs (anti-PD-1 and anti-CTLA-4) on radiation-induced hematopoietic and lymphatic injuries under standardized and controlled experimental conditions.</p><p><strong>Methods and materials: </strong>We used various experimental models in C57BL/6 and BALB/c mice to evaluate the impact of ICIs combined with RT on the hematopoietic system. These models involved different RT doses, regimens, and target sites in both healthy and tumor-bearing mice.</p><p><strong>Results: </strong>Our findings showed that the concurrent use of ICIs did not meaningfully affect post-RT pancytopenia kinetics or the regeneration of specific blood cell lineages over time. Consistently, combining RT with ICIs did not significantly enhance DNA damage in immune cells within the bloodstream. This outcome was comparable across different RT doses, regimens, and target sites and was reproducible in both tumor-bearing and nontumor-bearing mice. Additionally, there were no significant increases in late side effects, including reductions in bone marrow cell counts or megakaryocyte numbers, after combined radioimmunotherapy.</p><p><strong>Conclusions: </strong>These findings suggest that combining ICIs with RT does not exacerbate hematological toxicity. This information is valuable for interpreting adverse events in clinical trials involving radioimmunotherapy and for predicting potential hematological side effects in cancer patients receiving these treatments.</p>","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Issue Highlights","authors":"","doi":"10.1016/S0360-3016(25)00202-0","DOIUrl":"10.1016/S0360-3016(25)00202-0","url":null,"abstract":"","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"122 1","pages":"Pages A10-A13"},"PeriodicalIF":6.4,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826144","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":"Challenging the Children’s Oncology Group Whole Ventricular Irradiation Atlas: A Call for Standardized Guidelines","authors":"Melek Tugce Yilmaz MD ,&nbsp;Alper Kahvecioglu MD ,&nbsp;Gokcen Coban Cifci MD ,&nbsp;Ahmet Ilkay Isikay MD ,&nbsp;Gozde Yazici MD","doi":"10.1016/j.ijrobp.2024.12.021","DOIUrl":"10.1016/j.ijrobp.2024.12.021","url":null,"abstract":"","PeriodicalId":14215,"journal":{"name":"International Journal of Radiation Oncology Biology Physics","volume":"122 1","pages":"Pages 164-165"},"PeriodicalIF":6.4,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826148","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}