Radiotherapy and Oncology最新文献

{"title":"Pioneering BNCT: Refining strategies for complex cutaneous malignancies","authors":"Xiaowei Zhang","doi":"10.1016/j.radonc.2025.110786","DOIUrl":"10.1016/j.radonc.2025.110786","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"205 ","pages":"Article 110786"},"PeriodicalIF":4.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419500","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":"On the significance of peak dose in normal tissue toxicity in spatially fractionated radiotherapy: The case of proton minibeam radiation therapy","authors":"Yolanda Prezado ,&nbsp;Charlotte Lamirault ,&nbsp;Thibaut Larcher ,&nbsp;Cristele Gilbert ,&nbsp;Julie Espenon ,&nbsp;A. Patriarca ,&nbsp;L. de Marzi ,&nbsp;Angela Corvino ,&nbsp;Ramon Ortiz ,&nbsp;Marjorie Juchaux","doi":"10.1016/j.radonc.2025.110769","DOIUrl":"10.1016/j.radonc.2025.110769","url":null,"abstract":"<div><h3>Purpose</h3><div>Spatially fractionated radiotherapy is an unconventional radiotherapy approach able to widen the therapeutic window for difficult-to-treat cases today. To unlock its full potential, accurate knowledge of the relationship between the different dosimetry and geometry parameters and the biological response is still needed. When the same beam width is used, the valley dose has been assumed to be the main parameter influencing normal tissue sparing, with peak doses having little relevance. However, a recent retrospective evaluation of preclinical data suggests peak dose plays a major role in the normal tissue sparing of minibeam radiation therapy (MBRT). The goal of this study was to experimentally validate for the first time the significance of the peak dose for normal tissue sparing in proton MBRT.</div></div><div><h3>Materials and methods</h3><div>We irradiated the brains of naive rats with two different configurations of pMBRT, resulting in the same valley and average doses but different peak doses. Behavioural tests and histopathological evaluations were carried out.</div></div><div><h3>Results</h3><div>At the same valley dose, a higher peak dose (high peak-to-valley dose ratio (PVDR), larger centre-to-centre (ctc) distance) is more detrimental than a lower peak dose (low PVDR, narrower catch). In the first case, the animals exhibited some hyperactivity in locomotor and exploration activity as well as memory alterations. In addition, the highest peak dose led to a significantly higher cumulative lesion score in the histopathology evaluations than the lowest peak dose.</div></div><div><h3>Conclusions</h3><div>While our study does not exclude the relevant role of the valley dose in tissue sparing, it does highlight the importance of peak doses, contradicting previous assumptions. Our results agree with the conclusion of a recent retrospective evaluation of preclinical studies in micro and minibeam radiation therapy.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"205 ","pages":"Article 110769"},"PeriodicalIF":4.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143403241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel approaches to fiducial-guided SBRT for ultra-central thoracic oligometastases","authors":"Jiao Yu,&nbsp;Xin Chen","doi":"10.1016/j.radonc.2025.110776","DOIUrl":"10.1016/j.radonc.2025.110776","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"205 ","pages":"Article 110776"},"PeriodicalIF":4.9,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386936","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":"Risk-adapted stereotactic body radiation therapy for the treatment of large (>3 cm) primary lung cancer with or without histologic confirmation: A propensity score matched and weighted analysis","authors":"Hong-Yu Zeng ,&nbsp;Yan-Jin Li ,&nbsp;Chao-Zhi Ji ,&nbsp;Huan-Huan Wang ,&nbsp;Xin-Ru Yu ,&nbsp;Yuan He ,&nbsp;Hui Bai ,&nbsp;Bo-Yu Zheng ,&nbsp;Yuan-Yuan Yan ,&nbsp;Ji-Wen Xu ,&nbsp;Nicholas G Zaorsky ,&nbsp;Jin-Ming Shi ,&nbsp;Yang Dong ,&nbsp;Xu-Yao Yu ,&nbsp;Jing-Sheng Wang ,&nbsp;Yong-Chun Song ,&nbsp;Zhi-Yong Yuan ,&nbsp;Ying Chen ,&nbsp;Mao-Bin Meng","doi":"10.1016/j.radonc.2025.110781","DOIUrl":"10.1016/j.radonc.2025.110781","url":null,"abstract":"<div><h3>Purpose</h3><div>Stereotactic body radiation therapy (SBRT) is a promising therapeutic approach for inoperable, small (≤3 cm) primary lung cancer. However, the efficacy and safety of risk-adapted SBRT for treating large (&gt;3 cm) primary lung cancer remains inadequately characterized.</div></div><div><h3>Patients and Methods</h3><div>Patients with large (&gt;3 cm) primary lung cancer, diagnosed either clinically or histologically, were recruited between November 1, 2010 and December 31, 2022. Risk-adapted SBRT was administered in fractions (median, 5) for a total dose of 60 Gy (range, 45–63 Gy). The primary endpoint was overall survival (OS), and secondary endpoints included progression-free survival (PFS), local failure (LF), regional failure (RF), distant metastasis (DM), cancer-specific mortality (CSM), and toxicity. Differences in baseline characteristics were balanced via propensity score matching (PSM) with the logistic regression model, as well as 1:1 ratio matching and inverse probability of treatment weighting (IPTW). The Cox proportional hazards model was used for univariate and multivariate analyses aimed at identifying prognostic factors influencing OS and PFS.</div></div><div><h3>Results</h3><div>The 126 enrolled patients included 61 cases (48.4 %) diagnosed clinically and 65 cases (51.6 %) diagnosed pathologically. Following PSM and IPTW, no differences were found between patients diagnosed clinically versus pathologically in OS, PFS, tumor failure, and CSM. Univariate and multivariate analyses identified a Charlson comorbidity index ≥5 as an adverse prognostic factor for OS and PFS. One patient (0.8 %) in the pathologically diagnosed group developed grade 5 pneumonitis 2 months after undergoing SBRT.</div></div><div><h3>Conclusions</h3><div>Risk-adapted SBRT may be an optimal treatment for appropriately selected patients with a large (&gt;3 cm) primary lung cancer lacking histologic confirmation.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"205 ","pages":"Article 110781"},"PeriodicalIF":4.9,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399840","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 multiple MRI sequences in deep learning-based synthetic CT generation for MR-only radiation therapy of head and neck cancers","authors":"Jacob Antunes ,&nbsp;Tony Young ,&nbsp;Dane Pittock ,&nbsp;Paul Jacobs ,&nbsp;Aaron Nelson ,&nbsp;Jon Piper ,&nbsp;Shrikant Deshpande","doi":"10.1016/j.radonc.2025.110782","DOIUrl":"10.1016/j.radonc.2025.110782","url":null,"abstract":"<div><h3>Purpose</h3><div>This study investigated the effect of multiple magnetic resonance (MR) sequences on the quality of deep-learning-based synthetic computed tomography (sCT) generation in the head and neck region.</div></div><div><h3>Materials and methods</h3><div>12 MR series (T1pre-, T1post-contrast, T2 each with 4 Dixon images) were collected from 26 patients with head and neck cancers. 14 unique deep-learning models using the U-Net framework were trained using multiple MRs as inputs to generate sCTs. Mean absolute error (MAE), Dice Similarity Coefficient (DSC), as well as Gamma pass rates were used to compare sCTs to the actual CT across the different multi-channel MR-sCT models.</div></div><div><h3>Results</h3><div>Using all available MR series yielded sCTs with the lowest pixel-wise error (MAE = 80.5 ± 9.9 HU), but increasing channels also increased artificial tissue which led to poorer auto-contouring and lower dosimetric accuracy. Models with T2 protocols generally resulted in poorer quality sCTs. Pre-contrast T1 with all Dixon images was the best multi-channel MR-sCT model, consistently ranking high for all sCT quality measurements (average DSC across all structures = 80.0 % ± 13.6 %, global Gamma Pass Rate = 97.9 % ± 1.7 % at 2 %/2mm dose criterion and 20 % of max dose threshold).</div></div><div><h3>Conclusions</h3><div>Deep-learning networks using all Dixon images from a pre-contrast T1 sequence as multi-channel inputs produced the most clinically viable sCTs. Our proposed method may enable MR-only radiotherapy planning in a clinical setting for head and neck cancers.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"205 ","pages":"Article 110782"},"PeriodicalIF":4.9,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391637","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":"Current advances in automation in radiotherapy","authors":"Jasper Nijkamp,&nbsp;Barbara Knäusl,&nbsp;Marianne Aznar,&nbsp;Dietmar Georg,&nbsp;Daniela Thorwarth,&nbsp;David Thwaites,&nbsp;Ludvig P. Muren,&nbsp;Uulke A. van der Heide","doi":"10.1016/j.radonc.2025.110779","DOIUrl":"10.1016/j.radonc.2025.110779","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"205 ","pages":"Article 110779"},"PeriodicalIF":4.9,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383223","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 quality assurance for the PEACE 1 trial: An individual case review analysis","authors":"Najlaa Alyamani ,&nbsp;Enrico Clementel ,&nbsp;Paul Sargos ,&nbsp;Pierre Blanchard ,&nbsp;Stephane Supiot ,&nbsp;Philippe Ronchin ,&nbsp;Pascal Pommier ,&nbsp;Thomas Duberge ,&nbsp;Marlon Silva ,&nbsp;Yasser Hammoud ,&nbsp;Ali Hasbini ,&nbsp;Jonathan Khalifa ,&nbsp;Khemara Gnep ,&nbsp;Christopher Scrase ,&nbsp;Jordi Saez ,&nbsp;Laure Vieillevigne ,&nbsp;Melissa Christiaens ,&nbsp;Thomas Zilli ,&nbsp;Hélène Ribault ,&nbsp;Alberto Bossi ,&nbsp;Nicolaus Andratschke","doi":"10.1016/j.radonc.2025.110780","DOIUrl":"10.1016/j.radonc.2025.110780","url":null,"abstract":"<div><h3>Purpose</h3><div>Radiotherapy quality assurance (RTQA) is essential for ensuring adherence to trial protocols. This paper summarizes the individual case review (ICR) results from the PEACE-1 trial, a phase-III study investigates standard of care (androgen deprivation therapy with or without docetaxel) with or without local radiotherapy; and with or without abiraterone acetate plus prednisone in patients with metastatic hormone-sensitive prostate cancer (mHSPC).</div></div><div><h3>Materials and methods</h3><div>Participating institutions submitted radiotherapy (RT) plans for central review, assessing protocol compliance in target volume and organs at risk (OARs) delineation, as well as dose specifications. ICRs were conducted either retrospectively (r-ICRs), after starting RT, or prospectively (p-ICRs), before RT initiation. Case reviews were categorized as acceptable per protocol, acceptable variation, or unacceptable variation based on delineation and dose and plan parameters.</div></div><div><h3>Results</h3><div>Out of 585 patients in the RT arms, 527 (90%) had r-ICRs, primarily using intensity-modulated radiotherapy (IMRT). Delineation review approved 417 (87%) r-ICRs and 44 (92%) p-ICRs. The main reasons for unacceptable delineation were erroneous clinical target volume (CTV) delineation. In dose and plan reviews, 399 (96%) r-ICRs cases and 46 (96%) p-ICRs were approved, with unacceptable cases primarily due to PTV dose distribution issues.</div></div><div><h3>Conclusion</h3><div>RTQA is crucial in prostate cancer trials, primarily for proper target volume delineation. It is recommended to omit r-ICRs due to resource demands and lack of impact on RTQA outcomes, using limited p-ICRs with early feedback for site deviations and reserving full p-ICRs for trails with new techniques or dose regimens.</div><div>ClinicalTrials.gov: NCT01957436.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110780"},"PeriodicalIF":4.9,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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)00048-9","DOIUrl":"10.1016/S0167-8140(25)00048-9","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"204 ","pages":"Article 110753"},"PeriodicalIF":4.9,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143347842","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":"Dose response relation for optic nerve atrophy at low-dose rate brachytherapy of uveal melanoma","authors":"Maja Guberina ,&nbsp;Martin Stuschke ,&nbsp;Dirk Flühs ,&nbsp;Leyla Jabbarli ,&nbsp;Tobias Kiefer ,&nbsp;Eva Biewald ,&nbsp;Philipp Rating ,&nbsp;Henning Manke ,&nbsp;Sami Dalbah ,&nbsp;Christian Hoffmann ,&nbsp;Nika Guberina ,&nbsp;Christoph Pöttgen ,&nbsp;Miltiadis Fiorentzis ,&nbsp;Andreas Foerster ,&nbsp;Tobias Grunewald ,&nbsp;Norbert Bornfeld ,&nbsp;Wolfgang Sauerwein ,&nbsp;Nikolaos Bechrakis ,&nbsp;Ekaterina Sokolenko","doi":"10.1016/j.radonc.2025.110775","DOIUrl":"10.1016/j.radonc.2025.110775","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Dose-response relationships for optic neuropathy and optic nerve atrophy after brachytherapy for posterior uveal melanoma were poorly defined from previous studies. Here, the outcome differences were analyzed in dependence on dosimetric factors, the applicator type, and tumor dependent variables.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;Primary objective was to evaluate the association of applied dose and on-set of optic nerve atrophy after brachytherapy for posterior uveal melanoma in order to allow risk estimation for new patients.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and methods&lt;/h3&gt;&lt;div&gt;This retrospective study was performed at a single high volume centre for ocular oncology. Patients receiving brachytherapy with Ruthenium-106 applicators for posterior uveal melanoma with a maximum distance between optic nerve and the nearest tumor margin of 4 optical disc diameters and follow-up with fundus photographs were included. The dose distribution at the optic nerve was reconstructed from the fundus photographs at latest follow-up and the dose-distribution of the applicator using a dedicated software. A first mask with important structural elements such as optic nerve, macula, tumor and vessels was first superimposed on the fundus photograph and adapted to the real contours. In a second step, an applicator contour mask was adapted to the radiation scar in order to calculate the dose distribution in all structures. Dose-response relations were obtained by weighted logistic regression.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The maximum dose at the optic disc (OD&lt;sub&gt;max&lt;/sub&gt;) in this group of 109 patients ranged from 5.8 Gy – 242.2 Gy, median 48.7 Gy. Optic nerve atrophy was observed in 29&lt;!--&gt; &lt;!--&gt;patients. Median time to radiation induced optic nerve atrophy was 18&lt;!--&gt; &lt;!--&gt;months. Using weighted logistic regression, the dependence of optic nerve atrophy on OD&lt;sub&gt;max&lt;/sub&gt; was significant (&lt;em&gt;p&lt;/em&gt; = 0.0001, chi&lt;sup&gt;2&lt;/sup&gt;-test). There was a considerable interobserver variability in OD&lt;sub&gt;max&lt;/sub&gt; values (&lt;em&gt;p&lt;/em&gt; &lt; 0.02, signed rank test). An additional factor influencing the dose–response was the applicator type (&lt;em&gt;p&lt;/em&gt; = 0.0315, chi&lt;sup&gt;2&lt;/sup&gt;-test). The OD&lt;sub&gt;max&lt;/sub&gt; for a probability of optic nerve atrophy of 50 % (ED50) were 77.6 Gy ± 7.0 Gy for patients treated with notched COB applicators and 53.2 Gy ± 8.2 Gy for patients with other applicators. Including the applicator type, the area under ROC curve reached a value of 0.857 (95 %-CI: 0.793–0.921) for the logistic model with OD&lt;sub&gt;max&lt;/sub&gt;. The ED50 for optic nerve neuropathy, classified as grade ≥ 1 toxicity, was estimated to be 46.9 Gy ± 4.1 Gy for the maximum dose at the optic disc.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Significant dose–response curves were found for optic nerve atrophy at low dose rate brachytherapy. A standard position of COB applicators was identified that allows estimation of the dose–response relation from the scleral dose of","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"205 ","pages":"Article 110775"},"PeriodicalIF":4.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor regarding “The prognostic significance of sarcopenia in patients treated with definitive radiotherapy: A systematic review”","authors":"Erkan Topkan ,&nbsp;Efsun Somay ,&nbsp;Nilufer Kilic Durankus ,&nbsp;Ugur Selek","doi":"10.1016/j.radonc.2025.110778","DOIUrl":"10.1016/j.radonc.2025.110778","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"205 ","pages":"Article 110778"},"PeriodicalIF":4.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374579","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}