Radiotherapy and Oncology最新文献

{"title":"Development and validation of a nomogram to predict overall survival in patients with External auditory canal cancer.","authors":"Shaoqiu Zhang, Li Yan, Ruichen Li, Yang Zhao, Xiaoshen Wang, Ye Zhang, Yi Zhu","doi":"10.1016/j.radonc.2024.110691","DOIUrl":"https://doi.org/10.1016/j.radonc.2024.110691","url":null,"abstract":"<p><strong>Aim: </strong>We aimed to examine the influence of various prognostic factors on the outcome of external auditory canal (EAC) cancer and create a graphical prediction tool, marking a first in this field, premised on these determinants.</p><p><strong>Methods: </strong>We retrospectively analysed 173 patients with EAC cancer, making this the largest patient cohort in the literature. Survival analysis was performed using the Kaplan-Meier method, and the log-rank test was used to assess the differences between established prognostic variables. The risk factors for overall survival (OS) rates were analysed by univariate and multivariable Cox regression analyses.</p><p><strong>Results: </strong>The cohort demonstrated 2-, 5-, and 10-year progression-free survival (PFS) rates of 86.9%, 72.7%, and 60.1%, respectively. The overall survival (OS) rates for the cohort at 2, 5, and 10-years were 93.6%, 80.6%, and 65.8%, respectively. The key predictors of both OS and PFS were squamous cell carcinoma, T stage, margin status, and radiotherapy. The nomogram showed good predictive accuracy and discriminative ability. Post-radiotherapy follow-up data indicated that the incidence rates of allotriogeustia, saprodontia, xerostomia, difficulty in opening the mouth, and facioplegia were 1.3%, 6.5%, 22.7%, 8.4%, and 3.2%, respectively.</p><p><strong>Conclusion: </strong>Our findings highlight the significance of squamous cell carcinoma, T stage, margin status, and radiotherapy as predictors of OS and PFS. Validation analysis confirmed the applicability of the developed nomogram in predicting individual survival probabilities for patients with EAC cancers, signifying a notable progression in the diagnosis and treatment of EAC cancers.</p>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":" ","pages":"110691"},"PeriodicalIF":4.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872757","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":"Modulation of the local angiotensin II: Augmentation of ferroptosis and radiosensitivity in nasopharyngeal carcinoma via the HIF-1α-HILPDA axis.","authors":"Xiuting Huang, Kehai Lin, Weirui Chen, Donghui Zhang, Muhammad Khan, Xiaoxin Ye, Baiyao Wang, Chengcong Chen, Yunhong Tian, Yawei Yuan, Jie Lin","doi":"10.1016/j.radonc.2024.110686","DOIUrl":"https://doi.org/10.1016/j.radonc.2024.110686","url":null,"abstract":"<p><strong>Purpose: </strong>Radiotherapy presents a curative approach for nasopharyngeal carcinoma (NPC); however, the cellular radiosensitivity heterogeneity limits its efficacy. Thus, investigating the specific mechanisms of radioresistance in NPC is crucial for identifying and employing effective radiosensitizing agents to enhance treatment success.</p><p><strong>Methods and materials: </strong>Radioresistant NPC cell lines HONE1-RR and SUNE1-RR were established. Quantitative reverse transcription-PCR (qRT-PCR), western blot, and enzyme-linked immuno sorbent assay (ELISA) were employed to detect the activation of the angiotensinogen (AGT) and local angiotensin II (Ang II). Transmission electron microscopy, ferrous ion detection, and lipid oxidation levels were utilized to detect radiation-induced ferroptosis in NPC. Bioinformatics analysis, along with qRT-PCR, western blotting, co-immunoprecipitation, and dual-luciferase assays were employed to explore downstream mechanisms. Colony formation assay, Cell Counting Kit-8 (CCK-8) assay, and a nude mouse xenograft model were utilized to assess NPC radiosensitivity. The expression of AGT, hypoxia-inducible factor-1 alpha (HIF-1α), hypoxia-inducible lipid droplet-associated protein (HILPDA), and glutathione peroxidase 4 (GPX4) in NPC tissues was detected through immunohistochemistry.</p><p><strong>Results: </strong>Activation of local Ang II was revealed to play a critical role in driving radioresistance in NPC cells modulating ferroptosis. This local Ang II established a positive feedback loop with HIF-1α through two parallel pathways; Ang II stabilizes HIF-1α by activating the MAPK pathway, and AGT directly binds HIF-1α to prevent its degradation. This AGT-HIF-1α loop regulated NPC cell ferroptosis via transcriptional regulation of HILPDA expression. Moreover, the co-administration of Ang II receptor antagonist (ARB) and ferroptosis inducers markedly increased NPC radiosensitivity.Additionally, the expression of AGT, HIF-1α, and HILPDA was closely correlated with the intensity of ferroptosis, radiosensitivity, and prognosis in NPC.</p><p><strong>Conclusions: </strong>Our findings suggest that the AGT-HIF-1α-HILPDA pathway promotes radioresistance in NPC by enhancing lipid droplet accumulation, thereby suppressing ferroptosis. Targeting local Ang II alongside ferroptosis induction offers a promising strategy to improve radiosensitivity in NPC.</p>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":" ","pages":"110686"},"PeriodicalIF":4.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872759","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":"Efficacy of local-regional radiotherapy in de novo metastatic nasopharyngeal carcinoma patients receiving chemo-immunotherapy: A multicenter, propensity score matching study.","authors":"Shui-Qing He, Guo-Ying Liu, Ya-Hui Yu, Lin Wang, Guo-Yi Zhang, Ding-Sheng Peng, Wei-Xin Bei, Chun-Lan Chen, Shu-Hui Lv, Ze-Yu Zhao, Ying Huang, Yan-Qun Xiang","doi":"10.1016/j.radonc.2024.110687","DOIUrl":"10.1016/j.radonc.2024.110687","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the efficacy of local-regional radiotherapy (LRRT) in de novo metastatic nasopharyngeal carcinoma (dm NPC) patients receiving chemo-immunotherapy as first-line treatment and select the beneficiaries from LRRT.</p><p><strong>Methods and materials: </strong>M1-NPC patients receiving platinum-based chemo-immunotherapy with or without LRRT from four centers were included in this study. The propensity score matching (PSM) analysis was employed to balance the baseline characteristics between the LRRT and non-LRRT groups.</p><p><strong>Results: </strong>546 dm NPC patients (140 patients in the non-LRRT group and 406 patients in the LRRT group) were incorporated. Patients receiving LRRT demonstrated significantly improved progression-free survival (3-year PFS rate, 53.2 % vs 31.2 %, p < 0.001). After PSM analysis, there were 244 patients in the LRRT group and 122 patients in the non-LRRT group. Multivariable analysis indicated that LRRT was not an independent prognostic factor in the matched cohort (HR, 1.25, 95 % CI, 0.92-1.69, p = 0.156). Subgroup analysis among the matched cohort showed a significant increase in PFS for patients with oligo metastatic disease (OMD) who received LRRT (3-year PFS rate, 70.6 % vs 49.3 %, p = 0.043). In contrast, no such benefit was observed in patients with poly metastatic disease (PMD, 3-year PFS rate, 35.8 % vs 27.8 %, p = 0.17). Furthermore, LRRT significantly enhanced survival in patients with undetectable EBV DNA_{2-6 cycles} (3-year PFS rate, 57.9 % vs. 43.4 %, p = 0.043), whereas no survival improvement was noted in patients with detectable EBV DNA_{2-6 cycles} (16.2 % vs. 20.3 %, p = 0.21).</p><p><strong>Conclusion: </strong>LRRT could prolong PFS in M1-NPC patients. OMD and undetectable EBV DNA_{2-6 cycles} are potential indicators for selecting beneficiaries from LRRT.</p>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":" ","pages":"110687"},"PeriodicalIF":4.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872758","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":"Routine review of patient-reported outcome data influences radiotherapy care: IMPROVE study results.","authors":"Khinh Ranh Voong, Siyao Li, Chen Hu, Ori Shokek, Russell K Hales, Jeffrey Meyer, Stephen Greco, Todd McNutt, Colin Hill, Kathryn Lowe, James Huang, Jean Wright, Amol Narang, Aditya Halthore, Andrea Brown, Shing Lee, Claire Snyder","doi":"10.1016/j.radonc.2024.110688","DOIUrl":"https://doi.org/10.1016/j.radonc.2024.110688","url":null,"abstract":"<p><strong>Background: </strong>Radiation oncologists closely monitor patients during weekly on-treatment visits (OTVs). This study examines whether routine patient-reported outcome measures (PROMs) during OTVs change physicians' perceptions of treatment-toxicity and inform symptom-management.</p><p><strong>Patient and methods: </strong>IMPROVE is a single-arm prospective multicenter trial, conducted from 2020 to 2023. Patients with locally-advanced or oligometastatic thoracic or gastrointestinal cancers receiving definitive-intent radiation, with or without chemotherapy, and their physicians enrolled. Patients completed a 14-question disease-specific PROM in-clinic prior to OTVs. Physicians rated their patient's global toxicity-burden based on clinical data/assessments, then re-rated their patient's toxicity-burden and reported management-changes after PROM review. At radiotherapy end, physicians completed a Feedback Form. PROMs and outcome-data collection used electronic or paper forms. We report any change in physician-assessed burden-score and symptom-management due to PROMs.</p><p><strong>Results: </strong>The 100 patients enrolled (49 academic, 51 community-based) were 70 years old (median), 51 % female, 81 % Caucasian, 95 % ECOG 0-1, and 94 % received concurrent chemotherapy. The median radiation dose was 60 Gy, delivered over 6 weeks. PROMs were available for review for 607/629 (97 %) OTVs: full 433/629 (69 %), partial 174/629 (28 %). For 75/100 patients (75 %; 95 % CI:65 %-83 %), PROM review resulted in any change in physician-reported burden-score, and for 50/100 patients (50 %; 95 % CI:40 %-60 %) any change in patients' on-treatment management. Rates of burden-score and management-changes were similar between academic and community-based practices (78 % vs. 73 %; 53 % vs. 47 %, respectively). For 78/100 patients with Feedback Forms, physicians agreed/strongly agreed that PROMs improved patients' quality-of-care (91 %).</p><p><strong>Conclusions: </strong>PROM review changes radiation oncologists' on-treatment toxicity assessment in 75 % and care delivery in 50 % of their patients.</p>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":" ","pages":"110688"},"PeriodicalIF":4.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871810","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":"Predictive biomarkers of radiotherapy- related dermatitis, xerostomia, mucositis and dysphagia in head and neck cancer: A systematic review.","authors":"Alexander Koch, Philipp Reinhardt, Olgun Elicin, Daniel M Aebersold, Daniel H Schanne","doi":"10.1016/j.radonc.2024.110689","DOIUrl":"https://doi.org/10.1016/j.radonc.2024.110689","url":null,"abstract":"<p><strong>Background: </strong>Radiotherapy is essential for treating head and neck cancer but often leads to severe toxicity. Traditional predictors include anatomical location, tumor extent, and dosimetric data. Recently, biomarkers have been explored to better predict and understand toxicity. This review aims to summarize the current literature, assess data quality, and guide future research.</p><p><strong>Methods: </strong>Two reviewers independently screened EMBASE and PubMed for studies published between 2010 and 2023. Endpoints were dermatitis, mucositis, sticky saliva/xerostomia, and dysphagia. Statistical analysis was performed using R, and bias assessed via a modified QUIPS questionnaire. Pathway analysis was conducted using gProfiler. The study adhered to PRISMA and COSMOS-E guidelines and was registered in the PROSPERO database (#CRD42023361245).</p><p><strong>Results: </strong>Of 2,550 abstracts, 69 publications met the inclusion criteria. These studies involved a median of 81 patients, primarily male (75 %), with common primary tumors in the nasopharynx (32 %) and oropharynx (27 %). Most patients (84 %) had advanced disease (stage III/IV). The most frequently studied biomarkers were DNA-based single-nucleotide polymorphisms (SNPs, 59 %), salivary proteins (13 %), and bacteria (10 %). Ten statistically-significant biomarkers (all SNPs) in low-bias publications were identified, particularly in DNA repair and cell detoxification pathways. Data quality was often poor and few validation studies were present in the dataset.</p><p><strong>Conclusion: </strong>This review provides an overview of the research landscape, highlights research gaps and provides recommendations for future research directions. We identified several potential biomarkers, particularly in DNA repair pathways, that align with current understanding of radiation-induced cell damage. However, the overall data quality was poor, with key clinical variables often missing. Overall, rigorous standardization of reporting, validation studies and multi-center collaborations to increase study power and sample sizes are necessary to build high-level evidence for clinical application.</p>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":" ","pages":"110689"},"PeriodicalIF":4.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872760","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 radiotherapy with volumetric modulated arc therapy (VMAT) for recurrent prostate cancer after high-intensity focused ultrasound (HIFU): A large French retrospective series and literature review.","authors":"Jérémy Baude, Charles Teyssier, Vincent Barbier, Jack-Charles Tremeaux, Caroline Azélie, Alexis Lépinoy, Pierre-Charles Henry, Vincent Bailly, Nicolas Lescut, Edouard Lagneau, Benjamin Schipman","doi":"10.1016/j.radonc.2024.110665","DOIUrl":"10.1016/j.radonc.2024.110665","url":null,"abstract":"<p><strong>Background and purpose: </strong>Although not validated as a standard treatment, high-intensity focused ultrasound (HIFU) is increasingly used in the management of localised prostate cancer (PCa). In case of recurrence after HIFU, treatment is currently not standardised. Our aim was to evaluate normofractionated (NFRT) and hypofractionated (HFRT) salvage radiotherapy (RT) using volumetric modulated arc therapy (s-VMAT) with doses used in first-line management of localised PCa.</p><p><strong>Material and methods: </strong>We identified all patients with local or locoregional recurrence after HIFU treated with s-VMAT in 3 RT centres between 2014 and 2023. We evaluated acute and late toxicity and oncological outcomes.</p><p><strong>Results: </strong>Fifty-six patients were identified. Median age at recurrence was 75 (70-80) years. Median time between HIFU and s-VMAT was 26.5 months (13.9-47.2). S-VMAT was delivered to the prostate only in 35 (62.5 %) patients and to the prostate and pelvis in 21 (37.5 %) patients. NFRT and HFRT were delivered in 46 (82.1 %) and 10 (17.9 %) patients, respectively. Androgen deprivation therapy (ADT) was given to 27 (48.2 %) patients. Eighteen (32 %) and four (7 %) patients reported an acute grade 2 genitourinary (GU) and gastrointestinal (GI) adverse event (AE), respectively. Two patients presented with a late grade 2 GU AE, and one with a late grade 2 GI AE. No grade 3+ toxicity was reported. With a median follow-up of 19.5 months (12 - 47), no patient had a biochemical, local or distant relapse.</p><p><strong>Conclusions: </strong>This is the largest series of salvage RT after HIFU using VMAT and escalated doses (78-80 Gy/39-40Fr., or 60 Gy/20Fr.). Acute toxicity was acceptable and late AEs were few. Longer follow-up is required to assess efficacy. Overall, available series suggest that salvage RT could represent a valuable option in the treatment of relapses after HIFU.</p>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":" ","pages":"110665"},"PeriodicalIF":4.9,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839085","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":"Is the omission of the external iliac or upper pelvic lymph nodes from elective irradiation safe in selected anal canal squamous cell cancers?","authors":"Karol Paciorek, Anna Zawadzka, Lucyna Pietrzak, Bartłomiej Skrzypiec, Wojciech Michalski, Joanna Socha, Krzysztof Bujko","doi":"10.1016/j.radonc.2024.110682","DOIUrl":"10.1016/j.radonc.2024.110682","url":null,"abstract":"<p><strong>Background: </strong>Guidelines recommend elective irradiation of the external iliac and upper pelvic lymph nodes (LNs) regardless of clinical stage, but the supporting evidence for this recommendation is limited.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 68 consecutive patients with squamous cell carcinoma of the anal canal who underwent volumetric modulated arc therapy chemoradiation, excluding external iliac LNs from elective irradiation. In patients with negative bilateral inguinal LNs, both external iliac regions were omitted, while in those with unilateral positive inguinal LNs, only the ipsilateral external iliac region was included and the contralateral side was omitted. For patients with early-stage tumours, the cranial border of elective irradiation was located in the inferior aspect of the sacroiliac joints.</p><p><strong>Results: </strong>The median follow-up was 4.0 years. Six patients (9 %) experienced recurrence of the primary tumour and three (4 %) developed distant metastases. No isolated nodal recurrences were seen in the LNs that were positive at baseline, or in or outside electively irradiated regions. Notably, no recurrences were seen in any of the 124 external iliac regions omitted from elective irradiation across the 68 patients, or in the upper pelvic region among the subgroup of 33 patients where the cranial irradiation border was at the bottom of the sacroiliac joint. Reducing the elective irradiation volume significantly decreased the dose-volume parameters for organs-at-risk.</p><p><strong>Conclusions: </strong>The present findings suggest that omitting the external iliac and upper pelvic LNs from elective irradiation is safe for selected patients and allows dose reduction in organs-at-risk.</p>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":" ","pages":"110682"},"PeriodicalIF":4.9,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839083","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":"Cost-effectiveness of a nurse-led sexual rehabilitation intervention for women treated with radiotherapy for gynaecological cancer in a randomized trial.","authors":"Isabelle Suvaal, Wilbert B van den Hout, Susanna B Hummel, Jan-Willem M Mens, Charlotte C Tuijnman-Raasveld, Laura A Velema, Henrike Westerveld, Jeltsje S Cnossen, An Snyers, Ina M Jürgenliemk-Schulz, Ludy C H W Lutgens, Jannet C Beukema, Marie A D Haverkort, Marlies E Nowee, Remi A Nout, Cor D de Kroon, Helena C van Doorn, Carien L Creutzberg, Moniek M Ter Kuile","doi":"10.1016/j.radonc.2024.110683","DOIUrl":"10.1016/j.radonc.2024.110683","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the cost-effectiveness of a nurse-led sexual rehabilitation intervention with standard care in women treated with external beam radiotherapy, with or without brachytherapy, for gynaecological cancers.</p><p><strong>Methods: </strong>Eligible women were randomly assigned to the intervention (n = 112) or standard care (n = 117). Primary endpoint was sexual functioning at 12-months post-radiotherapy, assessed by the Female Sexual Function Index (FSFI). Nurses documented frequency and duration of intervention sessions, patients reported sexual healthcare and functioning at 1, 3, 6, and 12-months. Costs were related to quality-adjusted-life-years (QALYs) using the EuroQol-5 Dimensions and visual analogue scale, and to sexual functioning improvement at 12-months. T-tests compared mean QALYs and costs, with multiple imputation for missing data.</p><p><strong>Results: </strong>The nurse-led intervention added €172 per patient, including training costs and 4-5 sessions. Other sexual rehabilitation costs were higher in the standard care group (€107 versus €141, p = 0.02). Total costs were €478 for the intervention group and €357 for standard care (p = 0.03). Valued at €20.000 per QALY, the intervention was 60 %-70 % likely to be cost-effective and less than 50 % likely to be cost-effective in terms of improved sexual functioning.</p><p><strong>Conclusion: </strong>The nurse-led sexual rehabilitation intervention is not more cost-effective than standard care, however with low costs in both groups. Since costs for standard care were slightly lower, it is preferred from a health-economic perspective. It includes detailed patient education and a dedicated sexual rehabilitation session within the first three months post-radiotherapy, which is better provided at lower cost by a trained nurse.</p>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":" ","pages":"110683"},"PeriodicalIF":4.9,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829752","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":"Corrigendum to \"Parallel explorations in LA-NSCLC: Chemoradiation dose-response optimisation considering immunotherapy and cardiac toxicity sparing\" [Radiother. Oncol. 200 (2024) 110477].","authors":"Huei-Tyng Huang","doi":"10.1016/j.radonc.2024.110666","DOIUrl":"https://doi.org/10.1016/j.radonc.2024.110666","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"203 ","pages":"110666"},"PeriodicalIF":4.9,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829756","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":"Incorporating patient-specific prior clinical knowledge to improve clinical target volume auto-segmentation generalisability for online adaptive radiotherapy of rectal cancer: A multicenter validation.","authors":"Nicole Ferreira Silvério, Wouter van den Wollenberg, Anja Betgen, Lisa Wiersema, Corrie A M Marijnen, Femke Peters, Uulke A van der Heide, Rita Simões, Martijn P W Intven, Erik van der Bijl, Tomas Janssen","doi":"10.1016/j.radonc.2024.110667","DOIUrl":"10.1016/j.radonc.2024.110667","url":null,"abstract":"<p><strong>Background & purpose: </strong>Deep learning (DL) based auto-segmentation has shown to be beneficial for online adaptive radiotherapy (OART). However, auto-segmentation of clinical target volumes (CTV) is complex, as clinical interpretations are crucial in their definition. The resulting variation between clinicians and institutes hampers the generalizability of DL networks. In OART the CTV is delineated during treatment preparation which makes the clinician intent explicitly available during treatment. We studied whether multicenter generalisability improves when using this prior clinical knowledge, the pre-treatment delineation, as a patient-specific prior for DL models for online auto-segmentation of the mesorectal CTV.</p><p><strong>Material & methods: </strong>We included intermediate risk or locally advanced rectal cancer patients from three centers. Patient-specific weight maps were created by combining the patient-specific CTV delineation on the pre-treatment scan with population-based variation of likely inter-fraction mesorectal CTV deformations. We trained two models to auto-segment the mesorectal CTV on in-house data, one with (MRI + prior) and one without (MRI-only) priors. Both models were applied to two external datasets. An external baseline model was trained without priors from scratch for one external center. Performance was evaluated on the DSC, surface Dice, 95HD and MSD.</p><p><strong>Results: </strong>For both external centers, the MRI + prior model outperformed the MRI-only model significantly on the segmentation metrics (p-values < 0.01). There was no significant difference between the external baseline model and the MRI + prior model.</p><p><strong>Conclusion: </strong>Adding patient-specific weight maps makes the CTV segmentation model more robust to institutional preferences. Performance was comparable to a model trained locally from scratch. This makes this approach suitable for generalization to multiple centers.</p>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":" ","pages":"110667"},"PeriodicalIF":4.9,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829753","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}