Radiotherapy and Oncology最新文献

{"title":"The prognostic and predictive value of pre-treatment hematologic markers for oropharyngeal carcinoma stratified by HPV status and treated with definitive (chemo) radiation","authors":"A. Hughes ,&nbsp;Ca Johnny ,&nbsp;SH. Huang ,&nbsp;J. Su ,&nbsp;S. Bratman ,&nbsp;J. Cho ,&nbsp;E. Hahn ,&nbsp;A. Hosni ,&nbsp;A. Hope ,&nbsp;J. Kim ,&nbsp;J Tsai ,&nbsp;B. O’Sullivan ,&nbsp;JG. Ringash ,&nbsp;J. Waldron ,&nbsp;A. Spreafico ,&nbsp;L. Eng ,&nbsp;E.Sanz Garcia ,&nbsp;J. DeAlmeida ,&nbsp;L. Tong ,&nbsp;Wei Xu ,&nbsp;A. McPartlin","doi":"10.1016/j.radonc.2025.110851","DOIUrl":"10.1016/j.radonc.2025.110851","url":null,"abstract":"<div><h3>Background and purpose</h3><div>The literature of hematological biomarker performance in oropharynx cancer is conflicted, likely due to heterogeneity of the cohorts studied, limiting clinical application. To resolve this, we analyze the predictive and prognostic power of the pre-treatment hematologic markers total lymphocyte count (TLC), total neutrophil count (TNC), total monocyte count (TMC), and neutrophil–lymphocyte ratio (NLR), for a large oropharynx cohort receiving definitive (chemo)radiotherapy ((C)RT).</div></div><div><h3>Materials and methods</h3><div>All OPC patients treated at a single academic center with definitive (C)RT between 2005–2018 were included. The actuarial rates of locoregional control (LRC) and distant control (DC) were calculated using competing risks methods, while overall survival (OS) was estimated using the Kaplan-Meier method. Multivariable analysis (MVA) was applied to assess the prognostic and predictive value of the TLC, TMC, TNC, and NLR, adjusted for known prognostic factors. A Bonferroni correction was applied with a significance threshold of p &lt; 0.01, due to consideration of multiple markers.</div></div><div><h3>Results</h3><div>A total of 1,515 OPC patients were included (HPV-positive 1,151; HPV-negative 364). The median follow-up was 5.5 years, and 469 deaths were recorded. A significant interaction between the association of TLC and overall survival (OS) and the use of chemotherapy was identified for HPV-positive disease (p &lt; 0.001). Hence, analysis was performed separately to determine the association of TLC with the outcome for the CRT and RT alone cohorts for HPV-positive OPC. On MVA, TLC was only prognostic for HPV-positive OPC when receiving CRT (OS adjusted HR (aHR) 0.51 (0.35–0.74), p &lt; 0.001), with improved outcomes seen with higher TLC. TLC was also predictive for HPV-positive OPC, with a larger benefit to OS from the addition of concurrent cisplatin seen as TLC increased. On MVA, NLR, TNC, and TMC did not show a significant prognostic value in HPV-positive or HPV-negative OPC (p &gt; 0.01 for all markers).</div></div><div><h3>Conclusion</h3><div>In this large and homogenous cohort of OPC patients receiving definitive (C)RT, TLC was found to be a prognostic and predictive biomarker for patients with HPV-positive OPC receiving CRT, but not RT alone nor in HPV-negative disease. No other assessed marker was prognostic. TLC may inform the stratification of patients for investigation of novel treatment strategies in HPV-positive OPC. Prospective validation of this finding is required.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"207 ","pages":"Article 110851"},"PeriodicalIF":4.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674520","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":"PET and CT based DenseNet outperforms advanced deep learning models for outcome prediction of oropharyngeal cancer","authors":"Baoqiang Ma ,&nbsp;Jiapan Guo ,&nbsp;Lisanne V. van Dijk ,&nbsp;Johannes A. Langendijk ,&nbsp;Peter M.A. van Ooijen ,&nbsp;Stefan Both ,&nbsp;Nanna M. Sijtsema","doi":"10.1016/j.radonc.2025.110852","DOIUrl":"10.1016/j.radonc.2025.110852","url":null,"abstract":"<div><h3>Background</h3><div>In the HECKTOR 2022 challenge set [<span><span>1</span></span>], several state-of-the-art (SOTA, achieving best performance) deep learning models were introduced for predicting recurrence-free period (RFP) in head and neck cancer patients using PET and CT images.</div></div><div><h3>Purpose</h3><div>This study investigates whether a conventional DenseNet architecture, with optimized numbers of layers and image-fusion strategies, could achieve comparable performance as SOTA models.</div></div><div><h3>Methods</h3><div>The HECKTOR 2022 dataset comprises 489 oropharyngeal cancer (OPC) patients from seven distinct centers. It was randomly divided into a training set (n = 369) and an independent test set (n = 120). Furthermore, an additional dataset of 400 OPC patients, who underwent chemo(radiotherapy) at our center, was employed for external testing. Each patients’ data included pre-treatment CT- and PET-scans, manually generated GTV (Gross tumour volume) contours for primary tumors and lymph nodes, and RFP information. The present study compared the performance of DenseNet against three SOTA models developed on the HECKTOR 2022 dataset.</div></div><div><h3>Results</h3><div>When inputting CT, PET and GTV using the early fusion (considering them as different channels of input) approach, DenseNet81 (with 81 layers) obtained an internal test C-index of 0.69, a performance metric comparable with SOTA models. Notably, the removal of GTV from the input data yielded the same internal test C-index of 0.69 while improving the external test C-index from 0.59 to 0.63. Furthermore, compared to PET-only models, when utilizing the late fusion (concatenation of extracted features) with CT and PET, DenseNet81 demonstrated superior C-index values of 0.68 and 0.66 in both internal and external test sets, while using early fusion was better in only the internal test set.</div></div><div><h3>Conclusions</h3><div>The basic DenseNet architecture with 81 layers demonstrated a predictive performance on par with SOTA models featuring more intricate architectures in the internal test set, and better performance in the external test. The late fusion of CT and PET imaging data yielded superior performance in the external test.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"207 ","pages":"Article 110852"},"PeriodicalIF":4.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674516","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":"Reply to Ozyurek Y., et al.","authors":"Luca Nicosia,&nbsp;Filippo Alongi,&nbsp;Mattia Falchetto Osti","doi":"10.1016/j.radonc.2025.110842","DOIUrl":"10.1016/j.radonc.2025.110842","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"207 ","pages":"Article 110842"},"PeriodicalIF":4.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674518","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":"Linear energy transfer optimized proton therapy for rectal cancer","authors":"Jiasen Ma ,&nbsp;Sonja Dragojevic ,&nbsp;Nicholas B. Remmes ,&nbsp;Nicole L. Mendelson ,&nbsp;Jake A. Kloeber ,&nbsp;Daniel K. Ebner ,&nbsp;Zheming Wu ,&nbsp;Heather J. Gunn ,&nbsp;Kenneth W. Merrell ,&nbsp;Christopher L. Hallemeier ,&nbsp;Michael G. Haddock ,&nbsp;Krishan R. Jethwa ,&nbsp;Zhenkun Lou ,&nbsp;Robert W. Mutter ,&nbsp;Cameron M. Callaghan","doi":"10.1016/j.radonc.2025.110850","DOIUrl":"10.1016/j.radonc.2025.110850","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the feasibility and utility of an LET-optimized proton treatment planning algorithm in locally advanced rectal cancer and to assess whether the degree of LET-optimization achieved in clinical plans improves efficacy and toxicity in preclinical models.</div></div><div><h3>Materials and Methods</h3><div>A series of five rectal cancer patients treated with standard 25 fraction clinical proton plans were re-planned using an LET-optimization treatment planning algorithm and evaluated for dosimetric endpoints. LET-optimized plans were generated using an algorithm which iteratively increases the weights of higher LET spots in GTV and lower LET in OARs. Murine and <em>in vitro</em> preclinical models of tumor efficacy and normal tissue toxicity were evaluated using comparable LET_d range to that achieved in clinical LET-optimized plans.</div></div><div><h3>Results</h3><div>LET-optimized proton plans increased dose-averaged LET (LET_d) in the GTV and LET-weighted dose in the GTV, and CTV_5625cGy V_100% coverage. At the same time, LET-optimization also decreased mean LET-weighted dose to bladder and small bowel, as well as small bowel V_30Gy(cc) compared to standard proton plans. Optimizing the LET_d to a volume of GTV-3 mm further increased LET_d compared to total GTV. LET-optimization in preclinical models increased tumor efficacy in colorectal cancer cell lines <em>in vitro</em> and decreased small bowel radiation enteropathy in murine models of normal tissue toxicity.</div></div><div><h3>Conclusions</h3><div>LET-optimized proton plans increased LET_d in gross tumor while maintaining or improving target coverage and OAR sparing, with acceptable plan robustness. Preclinical models demonstrated that comparable LET-optimization may increase tumor efficacy and decrease normal tissue toxicity in rectal cancer.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"207 ","pages":"Article 110850"},"PeriodicalIF":4.9,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658414","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":"Early toxicity of moderately hypofractionated radiation therapy in breast cancer patients receiving locoregional irradiation: First results of the UNICANCER HypoG-01 phase III trial","authors":"Thomas Brion ,&nbsp;Robabeh Ghodssighassemabadi ,&nbsp;Guillaume Auzac ,&nbsp;Youlia Kirova ,&nbsp;Séverine Racadot ,&nbsp;Mohamed Benchalal ,&nbsp;Jean-Baptiste Clavier ,&nbsp;Claire Brunaud ,&nbsp;Marie-Eve Fouche-Chand ,&nbsp;Delphine Argo-Leignel ,&nbsp;Karine Peignaux-Casasnovas ,&nbsp;Ahmed Benyoucef ,&nbsp;David Pasquier ,&nbsp;Philippe Guilbert ,&nbsp;Julien Blanchecotte ,&nbsp;Agnès Tallet-Richard ,&nbsp;Assia Lamrani ,&nbsp;Marie Bergeau ,&nbsp;Gabriele Bielynite ,&nbsp;Amandine Ruffier ,&nbsp;Sofia Rivera","doi":"10.1016/j.radonc.2025.110849","DOIUrl":"10.1016/j.radonc.2025.110849","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate early adverse events (AEs) in HypoG-01, a randomised, controlled, multicentre, non-inferiority phase 3 trial comparing toxicity and efficacy of adjuvant loco-regional moderately hypofractionated radiation therapy versus 2 Gy daily radiation therapy.</div></div><div><h3>Methods</h3><div>Women ≥ 18 years with T1-3 N0-3 M0 breast cancer were randomised 1:1 after surgery +/- systemic therapy to receive either 40 Gy/15 fractions (3-week-RT) or 50 Gy/25 fractions (5-week-RT) +/-tumour-bed boost. AEs at baseline, end of treatment, and 6-month follow-up were graded using CTCAEV4.0, LENT/SOMA and Harris 4-point scales. Competing risk analysis for cumulative incidence of AEs, worst grade dermatitis according to risk factors, and cosmetic assessment were performed in the intention-to-treat (ITT) population.</div></div><div><h3>Results</h3><div>From September 2016 to March 2020, 29 sites enrolled 1265 women. The ITT population included 1260 patients (3-week-RT: 631, 5-week-RT: 629). The proportion of patients with maximum grade ≥ 2 AEs were 284 (45 %) in 3-week-RT and 326 (51.8 %) in 5-week-RT. Overall, 88 (7 %) grade 3, one grade 4 and no grade 5 AEs were observed. Reported AEs were mostly dermatitis, fatigue, and pain, numerically lower in 3-week-RT than 5-week-RT. Grade ≥ 2 dermatitis was more frequent in patients receiving a tumour-bed boost or with BMI &gt; 30 but numerically less frequent with 3-week-RT than 5-week-RT even in those subgroups. Of the 552 patients with breast-conserving surgery who completed cosmetic evaluation at M6, 88.4 % had excellent to good cosmetic results with no imbalance between groups.</div></div><div><h3>Conclusion</h3><div>Early AEs were mild and do not raise safety concerns for 3-week-RT in women receiving nodal RT.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"207 ","pages":"Article 110849"},"PeriodicalIF":4.9,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650075","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 the commentary on \"Definitive IMRT in older men with high-risk prostate cancer: additional considerations and future directions\" by Bin Cheng, Yuekun Fang, and Shengyi Chen.","authors":"Taek-Keun Nam, Yong-Hyub Kim, Jae-Uk Jeong","doi":"10.1016/j.radonc.2025.110844","DOIUrl":"10.1016/j.radonc.2025.110844","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":" ","pages":"110844"},"PeriodicalIF":4.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639541","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":"Clinical feasibility of treatment planning on a diagnostic CT scan without or with single fraction plan adaptation in patients with stage II/III rectal cancer","authors":"Claudia S.E.W. Schuurhuizen ,&nbsp;Maaike T.W. Milder,&nbsp;Judith H. Sluijter,&nbsp;Maarten L.P. Dirkx,&nbsp;Joost J.M.E. Nuyttens","doi":"10.1016/j.radonc.2025.110840","DOIUrl":"10.1016/j.radonc.2025.110840","url":null,"abstract":"<div><h3>Background</h3><div>With the ultimate aim of reducing time to start radiotherapy treatment in patients with rectal cancer, this study explores the feasibility of omitting a planning CT scan (pCT), by utilizing the diagnostic CT scan (dCT) for treatment planning, with or without plan adaption using online adaptive radiotherapy.</div></div><div><h3>Methods</h3><div>Fifteen rectal cancer patients, with both dCT and pCT available, were included. Target volumes and organs at risk (OARs) were delineated on both scans, followed by treatment planning based on the dCT contours. Plans were recalculated on the pCT to assess dosimetric differences for target volumes and OARs. Additionally, five patients with HyperSight CBCT scans underwent a similar planning process. An online adaptive treatment workflow was simulated using the Ethos system, where the dCT and its plan served as the reference, and the HyperSight CBCT was used for adaptation.</div></div><div><h3>Results</h3><div>dCT-based plans showed adequate target volume coverage. However, when recalculated on the pCT, median coverage decreased for both CTV and PTV, and OAR doses increased. None of the 15 plans met prescribed constraints without online adaptive radiotherapy. In contrast, for all five patients in the adaptive workflow, the treatment plans met target volume coverage and OAR constraints.</div></div><div><h3>Conclusion</h3><div>Using dCT-based treatment planning is feasible for rectal cancer patients but requires at least one online adaptive session. A prospective trial (MEC 2023-0445) is ongoing in patients with rectal cancer, aiming to reduce time to start treatment, by omitting the pCT and using online adaptive radiotherapy workflow.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110840"},"PeriodicalIF":4.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143629248","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":"Comments on “Analysis of patients with locally advanced rectal cancer given neoadjuvant radiochemotherapy with or without RT dose intensification: A multicenter retrospective study − ATLANTIS part I”","authors":"Yasin Ozyurek,&nbsp;Pervin Hurmuz,&nbsp;Ferah Yildiz","doi":"10.1016/j.radonc.2025.110841","DOIUrl":"10.1016/j.radonc.2025.110841","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"207 ","pages":"Article 110841"},"PeriodicalIF":4.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639502","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":"Optimizing fractionation schedules for de-escalation radiotherapy in head and neck cancers using deep reinforcement learning","authors":"Yongheng Yan ,&nbsp;Xin Sun ,&nbsp;Yuanhua Chen ,&nbsp;Zihan Sun ,&nbsp;SenXiang Yan ,&nbsp;Zhongjie Lu ,&nbsp;Feng Zhao","doi":"10.1016/j.radonc.2025.110833","DOIUrl":"10.1016/j.radonc.2025.110833","url":null,"abstract":"<div><h3>Purpose</h3><div>: Patients with locally-advanced head and neck squamous cell carcinomas (HNSCCs), particularly those related to human papillomavirus (HPV), often achieve good locoregional control (LRC), yet they suffer significant toxicities from standard chemoradiotherapy. This study aims to optimize the daily dose fractionation based on individual responses to radiotherapy (RT), minimizing toxicity while maintaining a low risk of LRC failure.</div></div><div><h3>Method:</h3><div>A virtual environment was developed to simulate tumor dynamics under RT for optimizing dose schedules. Patients predicted to maintain LRC were selected for de-escalation experiments. The proliferation saturation index (PSI) and linear-quadratic model were used to predict responses. A deep reinforcement learning (DRL) agent optimized fractionation schemes by interacting with the simulation environment, aiming to reduce the OAR’s biologically effective dose (BED) while preserving LRC. The impact of model uncertainty was analyzed and a support vector machine (SVM) model was used to segment parameter space and identify patients more robust to noise.</div></div><div><h3>Results:</h3><div>Personalized de-escalation plans were compared to conventional RT in a cohort of 5000 virtual patients. Personalized fractionation reduced the tumor dose and OAR’s BED by 29%, with an average OAR BED reduction of 5.61 ± 2.96 Gy. Prognostic outcomes were nearly identical, with 99.80% of patients in the low-risk LRC failure group. Model uncertainty impacted dosimetric indicators and prognosis, but the high-BED benefit group showed greater robustness to noise. SVM decision boundaries defined parameters range for patient selection.</div></div><div><h3>Conclusion:</h3><div>Optimizing fractionated doses based on patient responses minimizes toxicity while maintaining LRC in HNSCCs. Stratifying patients can mitigate model uncertainty and reduce treatment risks.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"207 ","pages":"Article 110833"},"PeriodicalIF":4.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639517","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":"Longitudinal analysis of cognitive function in patients treated with postoperative radiotherapy for grade 2 and 3 IDH mutant diffuse glioma","authors":"J.P.M. Jaspers ,&nbsp;A. Méndez Romero ,&nbsp;A. El Yaakoubi ,&nbsp;E. van Werkhoven ,&nbsp;R.A. Nout ,&nbsp;M.J. van den Bent ,&nbsp;D. Satoer","doi":"10.1016/j.radonc.2025.110847","DOIUrl":"10.1016/j.radonc.2025.110847","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative radiotherapy and chemotherapy improve survival in <em>IDH</em> mutant diffuse glioma. We investigated whether neurocognitive function declines over time, and whether mean dose to the brain outside of CTV (mean brain dose) is related to neurocognitive function.</div></div><div><h3>Patients and methods</h3><div>Patients that underwent resection and postoperative radiotherapy for grade 2 or 3 <em>IDH</em> mutant diffuse glioma were tested using the Hopkins Verbal Learning Test, Letter Fluency and Trail Making Test before surgery and afterwards up until disease progression. Mixed effects models were fitted for each of three cognitive test scores, using time from surgery, mean brain dose, CTV volume, and tumor grade as fixed effects.</div></div><div><h3>Results</h3><div>Between 1–10-2013 and 31–12-2022, 49 patients underwent longitudinal neurocognitive testing. Average mean dose to brain minus CTV was 17.8 Gy (95 % CI 16.1 – 19.4). At the time of analysis, median follow-up in patients free from disease progression was 5.8 years (range 1.1 – 20.8). Attrition rate during the first five years of follow up was 14.1 %. There was no decline of test performance over time (<em>p</em> ≥ 0.526). However, there was a negative effect of increasing mean brain dose on TMT score A (−0.11, <em>p</em> = 0.008) and TMT score B (−0.13, <em>p</em> = 0.004).</div></div><div><h3>Conclusions</h3><div>In this study, no effect of time after resection on test scores was found. Multivariable modelling indicates an negative relationship between mean brain dose and specific neurocognitive test scores, accounting for effects of tumor grade and CTV volume.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"207 ","pages":"Article 110847"},"PeriodicalIF":4.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639509","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}