Radiotherapy and Oncology最新文献

{"title":"An intelligent postoperative management system for glioblastoma integrating automated segmentation, risk stratification, and recurrence spatial mapping.","authors":"Yan Li, Zekun Jiang, Jia Tan, Zhihao Wang, Yuehao Ma, Deng Xiong, Yanhui Liu, Kang Li, Su Lui, Min Wu","doi":"10.1016/j.radonc.2025.111180","DOIUrl":"https://doi.org/10.1016/j.radonc.2025.111180","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to develop DeepGBM-Recure, an integrated artificial intelligence (AI) system for optimizing precision radiotherapy and individualized surveillance in glioblastoma (GBM) by automating postoperative risk stratification and spatial targeting of recurrence hotspots.</p><p><strong>Methods: </strong>This DeepGBM-Recure system comprises three synergistic modules: 1) Automated segmentation of peri-cavitary hyperintense regions on postoperative fluid-attenuated inversion recovery (FLAIR) images using a 3D nnU-Net framework; 2) Patient-level early recurrence prediction based on radiomics features and random forest classification; 3) Voxel-wise spatial mapping of high-risk subregions via supervoxel analysis. The system was trained and validated on data from 145 patients across two centers and externally tested on data from 39 patients across another two centers.</p><p><strong>Results: </strong>On the test set, the nnU-Net segmentation model achieved a mean Dice coefficient of 0.85 ± 0.09. The patient-level and voxel-level prediction models achieved area under the ROC curves (AUCs) of 0.76 and 0.80, respectively. Notably, the voxel-level model exhibited strong spatial concordance between predicted high-risk heatmaps and ground-truth recurrence regions. Performance was further supported by calibration curves, decision curve analysis, and clinical application in representative cases, demonstrating favorable predictive accuracy in real-world scenarios.</p><p><strong>Conclusion: </strong>DeepGBM-Recure represents a pioneering integrated solution that combines automated anatomical delineation, individualized risk stratification, and spatial recurrence guidance, offering a clinically applicable tool for precision radiotherapy and individualized surveillance. Prospective multi-center trials with larger cohorts are warranted to validate clinical utility and facilitate integration into real-world decision-making workflows.</p>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":" ","pages":"111180"},"PeriodicalIF":5.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225498","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":"Response to « Comment on ‘Local control assessment following SABR for lung metastases of colorectal cancer: A multicenter retrospective analysis‘ »","authors":"Robin Morcet-Delattre,&nbsp;Joël Castelli,&nbsp;Loïg Duvergé","doi":"10.1016/j.radonc.2025.111094","DOIUrl":"10.1016/j.radonc.2025.111094","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"211 ","pages":"Article 111094"},"PeriodicalIF":5.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822438","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":"Aims+Scope/Editorial Board/ Publication information","authors":"","doi":"10.1016/S0167-8140(25)04653-5","DOIUrl":"10.1016/S0167-8140(25)04653-5","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"211 ","pages":"Article 111149"},"PeriodicalIF":5.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145216659","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":"Salvage brachytherapy for locally recurrent prostate cancer after definitive radiotherapy – a multicentric French cohort by the SFRO brachytherapy group","authors":"M. Kissel ,&nbsp;K. Ka ,&nbsp;Y. Meraouna ,&nbsp;M. Terlizzi ,&nbsp;R. Schiappa ,&nbsp;J-M. Hannoun-Levi ,&nbsp;S. Hanaya ,&nbsp;A-A. Serre ,&nbsp;O. Sarr ,&nbsp;C. Verry ,&nbsp;A. Khoukaz ,&nbsp;E. Martin ,&nbsp;J-M. Cosset ,&nbsp;P. Blanchard","doi":"10.1016/j.radonc.2025.111170","DOIUrl":"10.1016/j.radonc.2025.111170","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Salvage brachytherapy (BT) after definitive irradiation for prostate cancer is gaining increasing interest, although many areas of uncertainty remain.</div></div><div><h3>Materials and methods</h3><div>We established a large national retrospective cohort including all patients treated with salvage prostate BT for isolated prostatic local relapse after definitive radiotherapy between 2006 and 2022 in seven French expert centers.</div></div><div><h3>Results</h3><div>A total of 266 patients were included. At initial diagnosis, 42 % of patients presented with high-risk disease. Primary irradiation consisted of external beam radiotherapy (EBRT) in 78 % of cases, most commonly delivered with a 3D conformal technique (51 %), with a median dose of 74 Gy. Median PSA at relapse was 3.7 ng/mL. Salvage BT was performed using low-dose-rate (LDR) permanent iodine seed implantation in 63 % of patients and high-dose-rate (HDR) brachytherapy in 37 %. Seventy percent of patients were treated with whole-gland irradiation, while the remainder received a focal approach. In 34.5 % of cases, androgen deprivation therapy (ADT) was combined with salvage BT. After a median follow-up of 60.1 months, 135 (50.7 %) of patients experienced biochemical relapse. Median biochemical progression-free survival (bPFS) was 40.0 months. On multivariate analysis, initial risk group (high-risk: HR = 1.64, 95 % CI [1.13–2.37], p = 0.008), BT technique (HDR: HR = 2.14, 95 % CI [1.41–3.26], p = 0.0004), and treated volume (focal vs. whole-gland: HR = 2.14, 95 % CI [1.23–3.73], p = 0.007) were significantly associated with bPFS. Late grade 3 gastrointestinal and genitourinary toxicities occurred in 3 % and 14 % of patients, respectively.</div></div><div><h3>Conclusion</h3><div>Salvage BT provides encouraging disease control with an acceptable toxicity profile. Careful patient selection remains essential.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"213 ","pages":"Article 111170"},"PeriodicalIF":5.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213663","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":"Adjuvant radiotherapy alone, an effective treatment option for early-stage low- risk breast cancer in women over 50: results from a population based cohort study using a Canadian provincial database","authors":"Kurian Joseph ,&nbsp;Ayoola Ademola ,&nbsp;Julia Zebak ,&nbsp;Armaan Singh ,&nbsp;Hanxiao Zuo ,&nbsp;Heather Warkentin ,&nbsp;Aswin Abraham ,&nbsp;Zsolt Gabos ,&nbsp;Keith Tankel ,&nbsp;Susan Chafe ,&nbsp;Karen King","doi":"10.1016/j.radonc.2025.111175","DOIUrl":"10.1016/j.radonc.2025.111175","url":null,"abstract":"<div><h3>Purpose</h3><div>Breast conserving surgery (BCS) is the primary treatment for early-stage breast cancer(EBC). Typically, adjuvant endocrine therapy (ET) and radiation therapy (RT) are standard treatments offered for EBC. However, non-compliance and toxicity remain as issues with HT and many patients choose adjuvant RT alone. The benefit of adjuvant RT alone in women with low-risk EBC remains unclear. It is hypothesized that adjuvant RT-alone can improve outcomes in low-risk EBC patients, similar to ET alone or RT + ET combination.</div></div><div><h3>Methods</h3><div>This population-based study identified women aged 50–80 with T1, N0, Estrogen receptor positive (ER + ve), human epidermal growth receptor-2 negative(Her-2/neu-ve) EBC treated with BCS, followed by adjuvant treatments (RT-alone, ET-alone, or RT + ET combination) from 2010 to 2015. Primary outcomes were recurrence free survival (RFS), overall survival (OS), and breast cancer specific survival (BCSS).</div></div><div><h3>Results</h3><div>2810 patients were identified. Median follow-up was 73 months(Interquartile <span><math><mrow><mfenced><mrow><msub><mi>Q</mi><mn>1</mn></msub><mo>,</mo><mspace></mspace><mspace></mspace><msub><mi>Q</mi><mn>3</mn></msub></mrow></mfenced><mrow><mo>:</mo><mspace></mspace><mn>55.0</mn><mo>,</mo><mspace></mspace><mn>91.6</mn><mo>)</mo></mrow></mrow></math></span>. Adjuvant treatments were: BCS only 216 (8 %), RT alone 803 (29 %), ET alone 274 (10 %), and RT + ET combination 1517 (54 %). 398 patients (22.2 %) completed 5-years of ET. Compared to BCS alone, there was no statistically significant difference between treatment groups for RFS and BCSS. There were significant difference among the treatment groups for OS compared to BCS alone: Hazard ratio (HR) 0.66 (95 % confidence interval (CI): 0.45 – 0.97) for RT alone, 0.55 (95 % CI: 0.35 – 0.87) for ET alone, and 0.48 (95 % CI: 0.33 – 0.70) for RT + ET combination. Determinants of OS were age, tumor grade, comorbidities, and adjuvant therapy.</div></div><div><h3>Conclusions</h3><div>Our population-based cohort study showed that there was no statistically significant difference in RFS and BCSS among various adjuvant treatments versus BCS alone. However, RT alone, ET alone and RT + ET combination resulted in a statistically significant improvement in OS compared to BCS alone. Our findings support RT alone can be a viable alternative to ET + RT combination for women over 50 with low-risk EBC. Ongoing studies like EUROPA, REaCT trial and EPOPE will provide more insight into the role of RT alone as a definite treatment option.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"213 ","pages":"Article 111175"},"PeriodicalIF":5.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207325","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":"Deep learning NTCP model for late dysphagia after radiotherapy for head and neck cancer patients based on 3D dose, CT and segmentations","authors":"S.P.M. de Vette ,&nbsp;H. Neh ,&nbsp;L. van der Hoek ,&nbsp;D.C. MacRae ,&nbsp;H. Chu ,&nbsp;A. Gawryszuk ,&nbsp;R.J.H.M. Steenbakkers ,&nbsp;P.M.A. van Ooijen ,&nbsp;C.D. Fuller ,&nbsp;K.A. Hutcheson ,&nbsp;J.A. Langendijk ,&nbsp;N.M. Sijtsema ,&nbsp;L.V. van Dijk","doi":"10.1016/j.radonc.2025.111169","DOIUrl":"10.1016/j.radonc.2025.111169","url":null,"abstract":"<div><h3>Background &amp; purpose</h3><div>Late radiation-associated dysphagia after head and neck cancer (HNC) significantly impacts patient’s health and quality of life. Conventional normal tissue complication probability (NTCP) models use discrete dose parameters to predict toxicity risk but fail to fully capture the complexity of this side effect. Deep learning (DL) offers potential improvements by incorporating 3D dose data for all anatomical structures involved in swallowing. This study aims to enhance dysphagia prediction with 3D DL NTCP models compared to conventional NTCP models.</div></div><div><h3>Materials &amp; methods</h3><div>A multi-institutional cohort of 1484 HNC patients was used to train and validate a 3D DL model (Residual Network) incorporating 3D dose distributions, organ-at-risk segmentations, and CT scans, with or without patient- or treatment-related data. Predictions of grade ≥ 2 dysphagia (CTCAEv4) at six months post-treatment were evaluated using area under the curve (AUC) and calibration curves. Results were compared to a conventional NTCP model based on pre-treatment dysphagia, tumour location, and mean dose to swallowing organs. Attention maps highlighting regions of interest for individual patients were assessed.</div></div><div><h3>Results</h3><div>DL models outperformed the conventional NTCP model in both the independent test set (AUC = 0.80–0.84 versus 0.76) and external test set (AUC = 0.73–0.74 versus 0.63) in AUC and calibration. Attention maps showed a focus on the oral cavity and superior pharyngeal constrictor muscle.</div></div><div><h3>Conclusion</h3><div>DL NTCP models performed significantly better than the conventional NTCP model, suggesting the benefit of using 3D-input over the conventional discrete dose parameters. Attention maps highlighted relevant regions linked to dysphagia, supporting the utility of DL for improved predictions.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"213 ","pages":"Article 111169"},"PeriodicalIF":5.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207369","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":"Postoperative Intensity-Modulated radiotherapy with trigeminal nerve pathway delineation for head and neck adenoid cystic carcinoma","authors":"Wen Jiang ,&nbsp;Ying Xiao ,&nbsp;Haisheng Hu ,&nbsp;Jiang Li ,&nbsp;Yining He ,&nbsp;Nannan Han ,&nbsp;Rongrong Li ,&nbsp;Lin Zhang ,&nbsp;Shengjin Dou ,&nbsp;Guopei Zhu","doi":"10.1016/j.radonc.2025.111174","DOIUrl":"10.1016/j.radonc.2025.111174","url":null,"abstract":"<div><h3>Background</h3><div>Head and neck adenoid cystic carcinoma (HN-ACC) is a rare, aggressive malignancy prone to perineural invasion, making treatment challenging. This study evaluates the outcomes of postoperative intensity-modulated radiation therapy (IMRT) for HN-ACC to guide radiation target delineation, optimizing radiation planning and improving patient outcomes.</div></div><div><h3>Patients and Methods</h3><div>A retrospective review of postoperative IMRT outcomes in HN-ACC patients from January 2015 to December 2022 was conducted. Prophylactic coverage of trigeminal nerve branches in the radiation field and cervical nodal irradiation was based on clinical/pathological assessments. The primary endpoint was 5-year locoregional recurrence-free survival (LRRFS), with secondary endpoints including progression-free survival (PFS), distant metastasis-free survival (DMFS), and overall survival (OS).</div></div><div><h3>Results</h3><div>A total of 328 patients were followed for a median of 61.1 months. The 5-year LRRFS, PFS, DMFS, and OS rates were 91.7 %, 63.0 %, 67.1 %, and 91.3 %, respectively. Thirty patients experienced locoregional recurrence, comprising 19 local recurrences, 6 regional recurrences, and 5 combined local and regional recurrences. Eleven patients had recurrence involving trigeminal nerve branches (8 in-field, 3 marginal).</div></div><div><h3>Conclusions</h3><div>Postoperative IMRT for HN-ACC, utilizing our institutional target delineation protocol that prioritizes delineating the target along the trigeminal nerve pathway, suggests favorable locoregional control and survival outcomes. These results suggest evidence-based insights that could inform clinical practice and support radiation oncologists in optimizing IMRT strategies for HN-ACC.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"213 ","pages":"Article 111174"},"PeriodicalIF":5.3,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200937","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":"18F-FDG PET/CT directed radiotherapy dose escalation in locally advanced esophageal cancer (LAEC), a phase I study","authors":"Ningning Cheng,&nbsp;Zhixiao Chen,&nbsp;Ying Chen,&nbsp;Ye Hu,&nbsp;Zijie Wang,&nbsp;Xuming Chen,&nbsp;Qianqian Liu,&nbsp;Tingfeng Chen","doi":"10.1016/j.radonc.2025.111176","DOIUrl":"10.1016/j.radonc.2025.111176","url":null,"abstract":"<div><h3>Background and purpose</h3><div>To determine the maximum tolerated dose (MTD) of hyperfractionated radiotherapy (HFRT) boost for residual metabolic disease (RMD) as defined by PET/CT following SCRT with concurrent paclitaxel (P) and carboplatin (C) for locally advanced esophageal cancer (LAEC).</div></div><div><h3>Materials and methods</h3><div>Eligible patients received standard chemoradiation therapy(SCRT) with weekly paclitaxel and carboplatin plus preirradiation PET/CT-guided intensity-modulated radiotherapy (IG-IMRT). Patients with RMD received HFRT boost concurrent with the same chemotherapy. Boost doses were escalated using a modified Fibonacci design. Dose limiting toxicity (DLT) was defined as grade ≥4 esophagitis, grade ≥3 non-hematological toxicity (except nausea/vomiting), or grade ≥4 hematological toxicity lasting &gt;7 days. MTD was the highest dose with ≤1 pts experiencing DLT.</div></div><div><h3>Results</h3><div>21pts were assessable. SCRT was well-tolerated. 4 pts achieved complete metabolic response (CMR). DLT occurred at 28.8 and 36 Gy. The MTD wasn’t reached. The most common acute grade ≥ 3 toxicities were esophagitis (17 %), neutropenia (24 %). Late toxicity included grade 1 or 2 esophageal stricture (n = 5). Overall response rate was 88 %. With median follow-up of 9 months, local–regional failure only occurred in 1pt.</div></div><div><h3>Conclusion</h3><div>36 Gy HFRT boost to PET/CT-defined RMD after 50 Gy SCRT using IG-IMRT, resulting in a total composite tumor dose of 86 Gy (BED 100.32 Gy), can be safely delivered concurrent with weekly P/C. MTD remains to be defined.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"213 ","pages":"Article 111176"},"PeriodicalIF":5.3,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200906","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":"From rugged ridges to radiotherapy ROIs: Translating topographical metrics to Surface-Guided Radiation Therapy regions of Interest in radiotherapy","authors":"Ciaran Malone ,&nbsp;Samantha Ryan ,&nbsp;Jill Nicholson ,&nbsp;Sinead Brennan ,&nbsp;Orla McArdle ,&nbsp;Ruth Woods ,&nbsp;Aodh MacGairbhith ,&nbsp;James Waldron ,&nbsp;Clodagh Callagh ,&nbsp;Rachel Harwood ,&nbsp;Brendan McClean ,&nbsp;Frances Duane ,&nbsp;Gerard G. Hanna","doi":"10.1016/j.radonc.2025.111173","DOIUrl":"10.1016/j.radonc.2025.111173","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate whether geography-derived topographical metrics (e.g., slope, aspect, elevation change and ruggedness) provide a quantitative, reproducible description of SGRT ROI surface quality. We pre-specified feasibility criteria: (i) monotonic, directionally consistent changes with controlled smoothing on synthetic surfaces; and (ii) separation of distributions between clinically distinct ROIs (breast size; full- vs limited-face).</div></div><div><h3>Methods</h3><div>Quantitative topographical metrics were identified for investigation including Slope, Aspect, Vector Ruggedness Measure (VRM), Topographic Position Index (TPI) and Terrain Ruggedness Index (TRI). First, synthetic breast-like and face-like surfaces were generated in Python using Perlin noise. Each surface was progressively smoothed and analysed for metric response to surface complexity. Second, three surface captures were exported from the AlignRT SGRT system: a small breast, a large breast and a face, which was cropped to produce a limited‐face and a full‐face surface. Histograms and 3D maps visualized metric distributions for each ROI.</div></div><div><h3>Results</h3><div>Slope, Aspect, TPI, and TRI effectively captured surface variations in both synthetic and patient data, identifying useful topographical features for SGRT. VRM remained low, relative to typical rugged geological terrain, indicating limited value for smooth skin surfaces. For the synthetic surfaces, increased smoothing compressed slope values toward zero, narrowed Aspect spreads, and lowered TRI/TPI variability. For patient/volunteer surfaces, the small-breast ROI showed fewer slope and aspect regions, and the large-breast ROI had broader slope and aspect ranges, and higher TRI/TPI, reflecting more pronounced local folds. Full‐face ROIs exhibited wider slope/TRI/TPI ranges than limited‐face ROIs.</div></div><div><h3>Conclusion</h3><div>Geography-derived metrics quantify ROI surface variation and meet pre-specified feasibility criteria and may help personalise and optimise ROI selection for individual patient anatomy. These results provide a quantitative foundation for ROI design and training; prospective studies are required to link metric thresholds to setup and intrafraction performance.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"213 ","pages":"Article 111173"},"PeriodicalIF":5.3,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200901","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":"Importance of 3D-TSE imaging for patients with brain metastasis treated with SRS alone.","authors":"Eyub Y Akdemir, Joseph DiStefano, Kevin J Abrams, Charif Sidani, Margaret C Chaneles, Matthew D Hall, Robert H Press, DJay Wieczorek, Ranjini Tolakanahalli, Alonso N Gutierrez, Michael W McDermott, Yazmin Odia, Minesh P Mehta, Rupesh Kotecha","doi":"10.1016/j.radonc.2025.111172","DOIUrl":"https://doi.org/10.1016/j.radonc.2025.111172","url":null,"abstract":"<p><p>This study evaluates the clinical utility of 3D turbo spin echo (3D-TSE) imaging in stereotactic radiosurgery (SRS) planning for brain metastases, examining the value of adding 3D-TSE to MPRAGE. Dual-sequence MRI (MPRAGE + 3D-TSE) significantly prolonged time to distant intracranial failure (DIF) in whole brain radiotherapy (WBRT)-naïve patients (n = 308, 11.4 vs. 6.8 months, p = 0.03), but not in patients previously treated with WBRT and salvaged with SRS (n = 39, 6.5 vs. 5.6 months, p = 0.76). Additional lesion detection attributed to 3D-TSE imaging was greater in WBRT-naïve (19.6 %) than in post-WBRT patients (12.0 %) (p < 0.001). The dual-sequence imaging may improve time to distant failure in the modern era for most patients treated with primary stereotactic radiosurgery and should be integrated into the SRS workflow.</p>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":" ","pages":"111172"},"PeriodicalIF":5.3,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200928","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}