Radiotherapy and Oncology最新文献

{"title":"Comparison of stereotactic body radiotherapy and transcatheter arterial chemoembolization for hepatocellular carcinoma: Systematic review and meta‐analysis","authors":"Satoshi Komiyama ,&nbsp;Atsuya Takeda ,&nbsp;Yudai Tateishi ,&nbsp;Yuichiro Tsurugai ,&nbsp;Takahisa Eriguchi ,&nbsp;Nobuyuki Horita","doi":"10.1016/j.radonc.2024.110614","DOIUrl":"10.1016/j.radonc.2024.110614","url":null,"abstract":"<div><div>Stereotactic body radiation therapy (SBRT) is an emerging treatment for hepatocellular carcinoma (HCC), which provides excellent local control (LC) and prolongs overall survival (OS). However, in current guidelines, transcatheter arterial chemoembolization (TACE) has been proposed as a key treatment option for patients with early- and intermediate-stage HCC, whereas SBRT is not. Therefore, we performed a systematic review and <em>meta</em>-analysis of randomized controlled trials and retrospective studies using the propensity score (PS) to compare the outcomes of SBRT and TACE for HCC in a balanced manner. We systematically searched the PubMed, Cochrane, EMBASE, and Web of Science databases to identify randomized controlled trials and studies comparing SBRT and TACE using PS analysis. The hazard ratios (HRs) for OS and LC were pooled. The heterogeneity between the data collected from these studies was also assessed. SBRT led to a comparable OS (HR: 0.83; 95 % confidence interval (CI): 0.52–1.34; p = 0.44) to TACE, and significantly improved LC (HR: 0.25; 95 % CI: 0.09–0.67; p = 0.006). Considerable heterogeneity was observed in the HR of OS and LC. Although there was no significant difference in the rate of grade 3 or higher toxicities between TACE and SBRT, or between studies, liver toxicity was identified as a common adverse event associated with both SBRT and TACE. Compared to TACE, SBRT showed a comparable OS and improved LC without serious toxicity. Therefore, SBRT should be considered an effective treatment option for various stages of HCC, depending on the tumor factors and pretreatment liver function.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"202 ","pages":"Article 110614"},"PeriodicalIF":4.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606183","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":"Validation of an artificial intelligence-based prognostic biomarker in patients with oligometastatic Castration-Sensitive prostate cancer","authors":"Jarey H. Wang ,&nbsp;Matthew P. Deek ,&nbsp;Adrianna A. Mendes ,&nbsp;Yang Song ,&nbsp;Amol Shetty ,&nbsp;Soha Bazyar ,&nbsp;Kim Van der Eecken ,&nbsp;Emmalyn Chen ,&nbsp;Timothy N. Showalter ,&nbsp;Trevor J. Royce ,&nbsp;Tamara Todorovic ,&nbsp;Huei-Chung Huang ,&nbsp;Scott A. Houck ,&nbsp;Rikiya Yamashita ,&nbsp;Ana P. Kiess ,&nbsp;Daniel Y. Song ,&nbsp;Tamara Lotan ,&nbsp;Theodore DeWeese ,&nbsp;Luigi Marchionni ,&nbsp;Lei Ren ,&nbsp;Piet Ost","doi":"10.1016/j.radonc.2024.110618","DOIUrl":"10.1016/j.radonc.2024.110618","url":null,"abstract":"<div><h3>Background</h3><div>There is a need for clinically actionable prognostic and predictive tools to guide the management of oligometastatic castration-sensitive prostate cancer (omCSPC).</div></div><div><h3>Methods</h3><div>This is a multicenter retrospective study to assess the prognostic and predictive performance of a multimodal artificial intelligence biomarker (MMAI; the ArteraAI Prostate Test) in men with omCSPC (n = 222). The cohort also included 51 patients from the STOMP and ORIOLE phase 2 clinical trials which randomized patients to observation versus metastasis-directed therapy (MDT). MMAI scores were computed from digitized histopathology slides and clinical variables. Overall survival (OS) and time to castration-resistant prostate cancer (TTCRPC) were assessed for the entire cohort from time of diagnosis. Metastasis free survival (MFS) was assessed for the trial cohort from time of randomization.</div></div><div><h3>Results</h3><div>In the overall cohort, patients with a high MMAI score had significantly worse OS (HR = 6.46, 95 % CI = 1.44–28.9; p = 0.01) and shorter TTCRPC (HR = 2.07, 95 % CI = 1.15–3.72; p = 0.015). In a multivariable Cox model, MMAI score remained the only variable significantly associated with OS (HR = 6.51, 95 % CI = 1.32–32.2; p = 0.02). In the subset of patients randomized in the STOMP and ORIOLE trials, high MMAI score corresponded to improved MFS with MDT (p = 0.039) compared to patients with a low score, with p_interaction = 0.04.</div></div><div><h3>Conclusion</h3><div>The ArteraAI MMAI biomarker is prognostic for OS and TTCRPC among patients with omCSPC and may predict for response to MDT. Further work is needed to validate the MMAI biomarker in a broader mCSPC cohort.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"202 ","pages":"Article 110618"},"PeriodicalIF":4.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606185","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":"Comment on FET PET-based target volume delineation for the radiotherapy of glioblastoma: A pictorial guide to help overcome methodological pitfalls","authors":"Nicolas Martz ,&nbsp;Mario Levis ,&nbsp;Timothée Zaragori ,&nbsp;Silvia Morbelli ,&nbsp;Antoine Verger","doi":"10.1016/j.radonc.2024.110616","DOIUrl":"10.1016/j.radonc.2024.110616","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"202 ","pages":"Article 110616"},"PeriodicalIF":4.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606184","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":"Long-term trends in the burden of nasopharyngeal carcinoma in China: A comprehensive analysis from 1990 to 2021 and projections to 2030 based on the global burden of disease study 2021","authors":"Bijuan Chen ,&nbsp;Zhouwei Zhan ,&nbsp;Yun Xu ,&nbsp;Sisi Yu ,&nbsp;Jiali Huang ,&nbsp;Yunxiang Fang ,&nbsp;Yifei Liu ,&nbsp;Ruyu Lin ,&nbsp;Jianji Pan ,&nbsp;Shaojun Lin ,&nbsp;Qiaojuan Guo ,&nbsp;Jinsheng Hong","doi":"10.1016/j.radonc.2024.110613","DOIUrl":"10.1016/j.radonc.2024.110613","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>Nasopharyngeal carcinoma (NPC) is a significant public health issue in China, with distinctive epidemiological characteristics and evolving trends. This study aims to analyze long-term trends in NPC burden from 1990 to 2021 and provide projections.</div></div><div><h3>Materials and Methods</h3><div>Data from the Global Burden of Disease (GBD) database (1990–2021) was utilized to evaluate NPC metrics, including incidence, prevalence, mortality, and disability-adjusted life years (DALYs). Joinpoint regression identified significant changes over time. Age-period-cohort (APC) analyses assessed the effects of age, period, and cohort. A decomposition analysis identified factors influencing changes in NPC incidence, prevalence, and DALYs. Projections were made for future trends up to 2030.</div></div><div><h3>Results</h3><div>In 2021, NPC significantly impacted China, with males experiencing higher incidence (5.16 per 100,000) and mortality rates (2.32 per 100,000) than females. NPC prevalence was 342,477 cases, with males accounting for 260,164. DALYs totaled 982,657, predominantly affecting males. From 1990 to 2021, the age-standardized incidence rate (ASIR) in China decreased from 4.64 to 3.42 per 100,000, while globally it declined from 1.74 to 1.38 per 100,000. Between 1990 and 2021, trends showed an initial decline in ASIR and age-standardized prevalence rate (ASPR), followed by a steady increase from 2006 onwards, with males experiencing more significant rises. Mortality rates showed a general downward trend, yet males remained disproportionately affected. Comparative global data indicated that while NPC metrics are declining worldwide, the burden remains higher in China. Decomposition analysis highlighted aging and population growth as major contributors to the NPC burden. Bayesian age-period-cohort (BAPC) projections indicated a continuing rise in age-standardized incidence and prevalence rates for both males and females up to 2030.</div></div><div><h3>Conclusions</h3><div>The burden of NPC in China remains significant, particularly among the male population. Despite declining mortality rates, the increasing prevalence suggests that more people are living with NPC. Targeted public health interventions are urgently needed to address these gender-specific trends and reduce the disease burden.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"202 ","pages":"Article 110613"},"PeriodicalIF":4.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569412","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":"Boron neutron capture therapy for cutaneous angiosarcoma and malignant melanoma: First in-human phase I clinical trial","authors":"Tairo Kashihara ,&nbsp;Satoshi Nakamura ,&nbsp;Naoya Yamazaki ,&nbsp;Akira Takahashi ,&nbsp;Kenjiro Namikawa ,&nbsp;Dai Ogata ,&nbsp;Eiji Nakano ,&nbsp;Kae Okuma ,&nbsp;Tomoya Kaneda ,&nbsp;Taisuke Mori ,&nbsp;Kimiteru Ito ,&nbsp;Jun Itami ,&nbsp;Kazuaki Shimada ,&nbsp;Hitoshi Nakagama ,&nbsp;Hiroshi Igaki","doi":"10.1016/j.radonc.2024.110607","DOIUrl":"10.1016/j.radonc.2024.110607","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Definitive radiotherapy for patients with scalp angiosarcoma has a poor prognosis, often resulting in severe skin adverse events. Additionally, malignant melanoma is known for its radioresistant nature. Boron neutron capture therapy (BNCT) may address these challenges due to the high uptake capacity of boron drugs in these cancer types. We aimed to determine the treatment dose for BNCT and evaluate the incidence of acute adverse events AEs following BNCT in patients with primary or recurrent angiosarcoma/malignant melanoma of the skin.</div></div><div><h3>Materials and methods</h3><div>This was a single-center, non-randomized clinical trial with a three-step dose escalation plan, involving maximum skin doses of 12, 15, and 18 Gy-Eq following a 3 + 3 design. The patients underwent BNCT between November 2019 and April 2022. The primary endpoint was to evaluate the incidence of acute adverse events.</div></div><div><h3>Results</h3><div>Ten patients (scalp angiosarcomanine, forefinger malignant melanoma: one) were included. The median target lesion size was 46.5 (range: 20–145) mm. A transient asymptomatic increase in serum amylase level was the only grade 3 adverse event. The best overall response rate within 180 days was 70 % (median tumor shrinkage rate: 77.5 % [4.9–100 %]).</div></div><div><h3>Conclusions</h3><div>BNCT with a dose of 18 Gy-Eq is a feasible treatment option, demonstrating a favorable safety profile and a high response rate in patients with primary or recurrent angiosarcoma or malignant melanoma of the skin.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"202 ","pages":"Article 110607"},"PeriodicalIF":4.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569393","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":"Patterns of loco-regional progression and patient outcomes after definitive-dose radiation therapy for anaplastic thyroid cancer","authors":"Julianna K. Bronk ,&nbsp;Alexander Augustyn ,&nbsp;Abdallah S.R. Mohamed ,&nbsp;C. David Fuller ,&nbsp;Adam S. Garden ,&nbsp;Amy C. Moreno ,&nbsp;Anna Lee ,&nbsp;William H. Morrison ,&nbsp;Jack Phan ,&nbsp;Jay P. Reddy ,&nbsp;David I. Rosenthal ,&nbsp;Michael T. Spiotto ,&nbsp;Steven J. Frank ,&nbsp;Ramona Dadu ,&nbsp;Naifa Busaidy ,&nbsp;Mark Zafereo ,&nbsp;Jennifer R. Wang ,&nbsp;Anastasios Maniakas ,&nbsp;Renata Ferrarotto ,&nbsp;Priyanka C. Iyer ,&nbsp;G. Brandon Gunn","doi":"10.1016/j.radonc.2024.110602","DOIUrl":"10.1016/j.radonc.2024.110602","url":null,"abstract":"<div><h3>Background</h3><div>The aim of this study is to characterize the patterns of loco-regional progression (LRP) and outcomes after definitive-dose intensity modulated radiation therapy (IMRT) for anaplastic thyroid cancer (ATC) with macroscopic neck disease at the time of IMRT.</div></div><div><h3>Methods</h3><div>Disease/treatment characteristics and outcomes for patients with unresected or incompletely resected ATC who received IMRT (≥45 Gy) were retrospectively reviewed. For those with LRP after IMRT, progressive/recurrent gross tumor volumes (rGTV) were contoured on diagnostic CTs and co-registered with initial planning CTs using deformable image registration. rGTVs were classified based on established spatial/dosimetric criteria.</div></div><div><h3>Results</h3><div>Forty patients treated between 2010–2020 formed the cohort. Median IMRT dose was 66 Gy (45–70 Gy); altered fractionation (AF) was used in 24 (60 %). All received concurrent chemotherapy. In addition to areas of gross disease, target volumes (TVs) commonly included: central compartment/upper mediastinum (levels VI/VII), neck levels II-V in an involved, and levels III-IV in an uninvolved lateral neck. Median overall survival was 7.1 m. Median progression free survival was 7.4 m for patients with locoregional disease and 1.8 m for patients with distant metastasis at the time of IMRT. Twenty-one patients (53 %) developed LRP at median of 10.9 m; freedom from LRP at 3 m and 12 m was 71 % (95 %CI 58–87 %) and 47 % (95 %CI 32–68 %). Forty-one individual rGTVs were identified and most occurred within the high dose (HD) TVs: Type A/central HD (n = 29, 71 %) and B/peripheral HD (n = 3, 7 %).</div></div><div><h3>Conclusions</h3><div>Despite an intensive treatment schedule, including AF and concurrent chemotherapy, classic radio-resistant and rapid Type A failures predominated; isolated extraneous dose failures were rare. While these findings support the IMRT and TV delineation strategies described herein, they highlight the importance of identifying novel strategies to further improve LRC for patients with unresectable disease without targetable mutations for contemporary neo-adjuvant strategies.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"202 ","pages":"Article 110602"},"PeriodicalIF":4.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569418","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":"Auto-contouring of cardiac substructures for Stereotactic arrhythmia radioablation (STAR): A STOPSTORM.eu consortium study","authors":"Luuk H.G. van der Pol ,&nbsp;Oliver Blanck ,&nbsp;Melanie Grehn ,&nbsp;Tomáš Blazek ,&nbsp;Lukáš Knybel ,&nbsp;Brian V. Balgobind ,&nbsp;Joost J.C. Verhoeff ,&nbsp;Marcin Miszczyk ,&nbsp;Slawomir Blamek ,&nbsp;Sabrina Reichl ,&nbsp;Nicolaus Andratschke ,&nbsp;Felix Mehrhof ,&nbsp;Judit Boda-Heggemann ,&nbsp;Bartłomiej Tomasik ,&nbsp;Stefano Mandija ,&nbsp;Martin F. Fast","doi":"10.1016/j.radonc.2024.110610","DOIUrl":"10.1016/j.radonc.2024.110610","url":null,"abstract":"<div><h3>Background/Purpose</h3><div>High doses to healthy cardiac substructures (CS) in stereotactic arrhythmia radioablation (STAR) raise concerns regarding potential treatment-induced cardio-toxicity. However, CS contours are not routinely created, hindering the understanding of the CS dose–effect relationships. To address this issue, the alignment of CS contouring was initiated within the STOPSTORM consortium. In this study, we developed and evaluated auto-contouring models trained to delineate CS and major vessels in ventricular tachycardia (VT) patients.</div></div><div><h3>Methods</h3><div>Eight centres provided standard treatment planning computed tomography (CT) and/or contrast-enhanced CT datasets of 55 VT patients, each including 16 CS. Auto-contouring models were trained to contour either large structures or small structures. Dice Similarity Coefficient (DSC), 95 % Hausdorff distance (HD95) and volume ratio (VR) were used to evaluate model performance versus inter-observer variation (IOV) on seven VT patient test cases. Significant differences were tested using the Mann-Whitney <em>U</em> test.</div></div><div><h3>Results</h3><div>The performance on the four chambers and the major vessels (median DSC: 0.88; HD95: 5.8–19.4 mm; VR: 1.09) was similar to the IOV (median DSC: 0.89; HD95: 4.8–14.0 mm; VR: 1.20).</div><div>For the valves, model performance (median DSC: 0.37; HD95: 11.6 mm; VR: 1.63) was similar to the IOV (median DSC: 0.41; HD95: 12.4 mm; VR: 3.42), but slightly worse for the coronary arteries (median DSC: 0.33 vs 0.42; HD95: 24.4 mm vs 16.9 mm; VR: 1.93 vs 3.30). The IOV for these small structures remains large despite using contouring guidelines.</div></div><div><h3>Conclusion</h3><div>CS auto-contouring models trained on VT patient data perform similarly to IOV. This allows for time-efficient evaluation of CS as possible organs-at-risk.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"202 ","pages":"Article 110610"},"PeriodicalIF":4.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569372","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":"A feasibility study of dose-band prediction in radiation therapy: Predicting a spectrum of plan dose","authors":"Yaoying Liu ,&nbsp;Zhaocai Chen ,&nbsp;Qichao Zhou ,&nbsp;Xuying Shang ,&nbsp;Wei Zhao ,&nbsp;Gaolong Zhang ,&nbsp;Shouping Xu","doi":"10.1016/j.radonc.2024.110593","DOIUrl":"10.1016/j.radonc.2024.110593","url":null,"abstract":"<div><h3>Purpose</h3><div>The current deep learning-based dose prediction methods only predict one dose distribution. If the predicted dose is inaccurate, no additional options can be selected. To overcome this limitation, we propose a novel dose prediction method called “dose-band prediction,” which provides a spectrum of predicted dose distributions for planning and quality assurance (QA) purposes.</div></div><div><h3>Material and methods</h3><div>We utilized Upper/Lower-band losses in 3D neural networks to establish the Upper/Lower-band models (UBM/LBM). The maximum/minimum rational dose predicted in UBM/LBM defined the ideal dose spectrum for each voxel. We enrolled 104 nasopharyngeal carcinoma cases with tomotherapy (dataset 1), 54 cervical carcinoma cases with IMRT (dataset 2), and 37 cervical carcinoma cases with VMAT (dataset 3) in the study. Moreover, a dose band-based auto planning (Auto-plan_dose-band) attempt was carried out in dataset 3, compared with the MSE model (Auto-plan_MSE).</div></div><div><h3>Results</h3><div>The UBM/LBM doses tend to be higher/lower than the clinical dose, forming a predicted dose spectrum. The Middle-line dose represents the average of the Upper/Lower-band, which was consistent with the clinical dose. The mean differences of the planning target volumes (PTVs) and organs at risk (OARs) for the Upper-band, Middle-line, and Lower-band in Dataset 1 were 3.66 %, −0.40 %, and −4.48 % in Dataset 2, they were 2.40 %, −1.62 %, and −5.57 %; in Dataset 3, they were 2.18 %, −0.59 %, and −3.31 %. When PTVs meet prescription, the mean difference between Auto-plan_dose-band and Auto-plan_MSE in OARs was −2.67 %.</div></div><div><h3>Conclusion</h3><div>The dose-band prediction successfully predicted a spectrum of doses, making auto-planning and QA flexible and high quality.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"202 ","pages":"Article 110593"},"PeriodicalIF":4.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569369","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":"Automated segmentation in planning-CT for breast cancer radiotherapy: A review of recent advances","authors":"Zineb Smine ,&nbsp;Sara Poeta ,&nbsp;Alex De Caluwé ,&nbsp;Antoine Desmet ,&nbsp;Cristina Garibaldi ,&nbsp;Kevin Brou Boni ,&nbsp;Hugo Levillain ,&nbsp;Dirk Van Gestel ,&nbsp;Nick Reynaert ,&nbsp;Jennifer Dhont","doi":"10.1016/j.radonc.2024.110615","DOIUrl":"10.1016/j.radonc.2024.110615","url":null,"abstract":"<div><div>Postoperative radiotherapy (RT) has been shown to effectively reduce disease recurrence and mortality in breast cancer (BC) treatment. A critical step in the planning workflow is the accurate delineation of clinical target volumes (CTV) and organs-at-risk (OAR). This literature review evaluates recent advancements in deep-learning (DL) and atlas-based auto-contouring techniques for CTVs and OARs in BC planning-CT images for RT. It examines their performance regarding geometrical and dosimetric accuracy, inter-observer variability, and time efficiency. Our findings indicate that both DL- and atlas-based methods generally show comparable performance across OARs and CTVs, with DL methods slightly outperforming in consistency and accuracy. Auto-segmentation of breast and most OARs achieved robust results in both segmentation quality and dosimetric planning. However, lymph node levels (LNLs) presented the greatest challenge in auto-segmentation with significant impact on dosimetric planning. The translation of these findings into clinical practice is limited by the geometric performance metrics and the lack of dose evaluation studies. Additionally, auto-contouring algorithms showed diverse structure sets, while training datasets varied in size, origin, patient positioning and imaging protocols, affecting model sensitivity. Guideline inconsistencies and varying definitions of ground truth led to substantial variability, suggesting a need for a reliable consensus training dataset. Finally, our review highlights the popularity of the U-Net architecture. In conclusion, while automated contouring has proven efficient for many OARs and the breast-CTV, further improvements are necessary in LNL delineation, dosimetric analysis, and consensus building.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"202 ","pages":"Article 110615"},"PeriodicalIF":4.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569388","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":"EGCG protects intestines of mice and pelvic cancer patients against radiation injury via the gut microbiota/D-tagatose/AMPK axis","authors":"Haiyan Lu ,&nbsp;Liwei Xie ,&nbsp;Liangsheng Guo ,&nbsp;Xuhao Gu ,&nbsp;Ruiqiu Zhu ,&nbsp;Yinyin Yang ,&nbsp;Fengling Tang ,&nbsp;Mingyue Li ,&nbsp;Chengzhi Liu ,&nbsp;Difan Wang ,&nbsp;Ming Li ,&nbsp;Ye Tian ,&nbsp;Shang Cai","doi":"10.1016/j.radonc.2024.110608","DOIUrl":"10.1016/j.radonc.2024.110608","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Radiation-induced intestinal injury (RIII) compromises the clinical utility of pelvic radiotherapy (RT). We aimed to explore the protective effect and underlying mechanism of (−)-epigallocatechin-3-gallate (EGCG) on RIII.</div></div><div><h3>Materials and methods</h3><div>We evaluated the protective effect of EGCG on intestine in RIII mouse model and pelvic cancer patients, while explored the underlying mechanism through (1) 16S rRNA sequencing, (2) metabolomic profiles, (3) fresh sterile fecal filtrate (SFF) transplantation, and (4) transcriptome sequencing.</div></div><div><h3>Results</h3><div>EGCG efficiently prevented RIII in mouse, as reflected by improved survival, alleviated intestinal structure damage, promoted intestinal regeneration, and ameliorated gut microbiota dysbiosis. Prophylactic EGCG intervention reduced the severity of RIII in patients receiving pelvic RT. Mechanistically, the protective effect of EGCG could be transferred to other mice by SFF transplantation. EGCG enriched gut microbiota-derived metabolite D-tagatose, and oral administration of D-tagatose reproduced the radio-protective effect of EGCG via activating AMPK.</div></div><div><h3>Conclusion</h3><div>Oral EGCG may be a promising strategy for preventing RIII clinically, and warrant further investigation in prospective randomized phase III trials.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"202 ","pages":"Article 110608"},"PeriodicalIF":4.9,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564868","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}