Radiotherapy and Oncology最新文献

{"title":"Unilateral vs bilateral neck irradiation in lateralized oropharyngeal carcinoma: Patient selection flaws in propensity matching undermine conclusions.","authors":"Lingling Meng, Yupeng Di","doi":"10.1016/j.radonc.2025.111178","DOIUrl":"10.1016/j.radonc.2025.111178","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":" ","pages":"111178"},"PeriodicalIF":5.3,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239497","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 and toxicity of hypofractionated radiation therapy for patients with hematologic malignancies: A COVID-era ILROG collaborative report","authors":"Jillian R. Gunther ,&nbsp;Joanna C. Yang ,&nbsp;Carla Hajj ,&nbsp;Andrea K. Ng ,&nbsp;Jessica L. Brady ,&nbsp;Shuhui Cheng ,&nbsp;Mario Levis ,&nbsp;Shunan Qi ,&nbsp;N. George Mikhaeel ,&nbsp;Umberto Ricardi ,&nbsp;Timothy M. Illidge ,&nbsp;Anastasia Turin ,&nbsp;Mark Knafl ,&nbsp;Lena Specht ,&nbsp;Bouthaina Shbib Dabaja ,&nbsp;Joachim Yahalom ,&nbsp;International Lymphoma Radiation Oncology Group","doi":"10.1016/j.radonc.2025.111200","DOIUrl":"10.1016/j.radonc.2025.111200","url":null,"abstract":"<div><h3>Background and purpose</h3><div>During the COVID19 pandemic, shorter radiation therapy (RT) courses were needed to minimize patient exposure, ensure staff safety, and conserve healthcare resources. In response, guidelines were published by the International Lymphoma Radiation Oncology Group (ILROG) to guide treatment of hematologic malignancies patients with hypofractionated radiation therapy (hRT) regimens. However, outcomes for these hypofractionated dose/fractionation regimens in terms of efficacy and toxicity are unknown.</div></div><div><h3>Materials and methods</h3><div>In collaboration with ILROG, we performed a retrospective multinational, multicenter study. We included patients treated from 01 January 2020 to 01 September 2020 with hRT given according to the published ILROG guidelines or hRT given at &gt; 3 Gy per fraction. We abstracted patient and treatment data from institutional databases. CTCAE v5.0 was used to grade toxicity.</div></div><div><h3>Results</h3><div>We included 219 patients from 8 different institutions treated with 255 RT courses. Median RT dose was 12 Gy (range 4–39) in a median of 3 fractions (range 1–13). Median follow up was 232 days, with 151 patients (69 %) alive at last follow up. Response within the RT field was assessed in 210 sites, and 127 sites (60 %) had a confirmed complete response. Maximal toxicities (per site) reported were Grade 1 (n = 48), Grade 2 (n = 25), Grade 3 (n = 3) and Grade 4 (n = 1). Grade 3/4 toxicities included dermatitis, pain, and hematologic toxicity.</div></div><div><h3>Conclusions</h3><div>Treatment of hematologic malignancies patients with hRT was generally well tolerated with few unexpected toxicities. These data provide guidance for emergencies, and hRT may be useful and could be considered even in routine settings, especially for certain patient subgroups.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"213 ","pages":"Article 111200"},"PeriodicalIF":5.3,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239333","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":"Conditioned medium from brachytherapy-irradiated hepatocellular carcinoma cells drives SASP-mediated senescence in naïve cellular counterparts.","authors":"Josephine Naruhn, Moritz N Gröper, Elif Öcal, Lukas Salvermoser, Heidrun Hirner-Eppeneder, Jan N Schäfer, Philipp M Kazmierczak, Stephanie Corradini, Justus-Christian Well, Jens Ricke, S Nahum Goldberg, Matthias Stechele, Marianna Alunni-Fabbroni","doi":"10.1016/j.radonc.2025.111068","DOIUrl":"10.1016/j.radonc.2025.111068","url":null,"abstract":"<p><strong>Background and purpose: </strong>Local ablation, including high-dose radiation brachytherapy (HDR-BT), provides a minimally invasive treatment for cancers such as hepatocellular carcinoma (HCC), achieving effective tumor targeting with reduced peri-interventional risk and morbidity. Despite benefits, these treatments face limitations due to tumor recurrence. Cellular senescence might play a key role in therapy resistance by way of tumor cell evasion. This study investigates whether HDR-BT induces cellular senescence in vitro, potentially linking these processes to tumor recurrence in HCC.</p><p><strong>Material and methods: </strong>HCC cell lines (HepG2, Huh7, and Hep3B) were irradiated with 7.5 Gy using an in vitro irradiation device. Culture supernatant was collected and transferred to non-irradiated naïve cells. Cell proliferation and senescence were assessed kinetically using BrdU incorporation, Ki-67 immunostaining, and clonogenic assay. Senescence was confirmed by beta-galactosidase staining. Secretome analysis was conducted using a high-throughput proteomic assay.</p><p><strong>Results: </strong>After irradiation, HCC cells show a transient increase in DNA synthesis, peaking before 72 h without leading to cell division. Exposure of naïve cells to supernatant from irradiated cells replicates these effects, suggesting that the conditioned medium alone can mimic radiation-induced responses. Molecular analysis reveals reduced Ki-67 expression and increased senescence in naïve, incubated cells. Proteomic profiling shows an enrichment of senescence-associated secretory phenotype (SASP) proteins in conditioned medium with exposed naïve cells producing a similar SASP-enriched secretome.</p><p><strong>Conclusion: </strong>In vitro brachytherapy triggers a bystander effect in HCC cells via SASP-associated proteins inducing senescence in neighboring cells. Modulating senescence or its associated secretory phenotype may offer a novel target for therapy in future trials.</p>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":" ","pages":"111068"},"PeriodicalIF":5.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765337","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":"Neoadjuvant immunotherapy and chemoradiotherapy for mismatch repair proficient locally advanced rectal cancer: A systematic review and meta-analysis.","authors":"Yu Wang, Yue Liu, Xu Guan, Xin Liu, Yuan Tang, Wen-Wen Zhang, Chun-Xia Du, Shuang-Mei Zou, Hai-Tao Zhou, Jian-Wei Liang, Jing Jin, Xi-Shan Wang, Shu-Lian Wang, Shu-Nan Qi, Ye-Xiong Li","doi":"10.1016/j.radonc.2025.111073","DOIUrl":"10.1016/j.radonc.2025.111073","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the efficacy and toxicity of combining neoadjuvant immune checkpoint inhibitors (ICIs) with chemoradiotherapy (CRT) for patients with mismatch repair-proficient (pMMR) locally advanced rectal cancer (LARC).</p><p><strong>Methods: </strong>PubMed, Embase, Cochrane Library, and Medline databases were searched. Phase I-III clinical trials reporting pathologic complete response (pCR) or overall CR (pCR + clinical CR) rates for neoadjuvant ICIs plus CRT in pMMR LARC were included. Studies that only enrolled patients with mismatch repair-deficient LARC were excluded. Data were analyzed at trial and arm levels and pooled using random-effects models. Primary outcomes were pCR and overall CR rates. Toxicity occurrence was also measured.</p><p><strong>Results: </strong>In total, 19 trials (n = 1324) were included. At trial level, pooled odds ratios (95 % CIs) of overall CR and pCR rates for neoadjuvant ICIs plus CRT were 1.72 (1.21-2.44) and 1.68 (1.08-2.62), respectively. At arm level, compared with CRT, neoadjuvant ICIs plus CRT significantly improved overall CR (42 % vs 24 %, P < 0.001) and pCR rates (37 % vs 24 %, P = 0.008). Compared with ICIs plus long-course CRT, chemoimmunotherapy plus short-course radiotherapy significantly increased overall CR (51 % vs 36 %) and pCR (48 % vs 30 %) rates (both P < 0.001). Pooled incidence of grade 1-2 and ≥ 3 treatment-related adverse events was 63 % and 28 %, respectively-similar to CRT alone.</p><p><strong>Conclusion: </strong>Neoadjuvant immunotherapy plus CRT is a promising treatment strategy for pMMR LARC, with improved CR rates and manageable toxicity. Chemoimmunotherapy plus short-course radiotherapy exhibits superior efficacy. Further investigation on long-term outcomes and optimal combined regimens is warranted.</p>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":" ","pages":"111073"},"PeriodicalIF":5.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aims+Scope/Editorial Board/ Publication information","authors":"","doi":"10.1016/S0167-8140(25)04653-5","DOIUrl":"10.1016/S0167-8140(25)04653-5","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"211 ","pages":"Article 111149"},"PeriodicalIF":5.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145216659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salvage brachytherapy for locally recurrent prostate cancer after definitive radiotherapy – a multicentric French cohort by the SFRO brachytherapy group","authors":"M. Kissel ,&nbsp;K. Ka ,&nbsp;Y. Meraouna ,&nbsp;M. Terlizzi ,&nbsp;R. Schiappa ,&nbsp;J-M. Hannoun-Levi ,&nbsp;S. Hanaya ,&nbsp;A-A. Serre ,&nbsp;O. Sarr ,&nbsp;C. Verry ,&nbsp;A. Khoukaz ,&nbsp;E. Martin ,&nbsp;J-M. Cosset ,&nbsp;P. Blanchard","doi":"10.1016/j.radonc.2025.111170","DOIUrl":"10.1016/j.radonc.2025.111170","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Salvage brachytherapy (BT) after definitive irradiation for prostate cancer is gaining increasing interest, although many areas of uncertainty remain.</div></div><div><h3>Materials and methods</h3><div>We established a large national retrospective cohort including all patients treated with salvage prostate BT for isolated prostatic local relapse after definitive radiotherapy between 2006 and 2022 in seven French expert centers.</div></div><div><h3>Results</h3><div>A total of 266 patients were included. At initial diagnosis, 42 % of patients presented with high-risk disease. Primary irradiation consisted of external beam radiotherapy (EBRT) in 78 % of cases, most commonly delivered with a 3D conformal technique (51 %), with a median dose of 74 Gy. Median PSA at relapse was 3.7 ng/mL. Salvage BT was performed using low-dose-rate (LDR) permanent iodine seed implantation in 63 % of patients and high-dose-rate (HDR) brachytherapy in 37 %. Seventy percent of patients were treated with whole-gland irradiation, while the remainder received a focal approach. In 34.5 % of cases, androgen deprivation therapy (ADT) was combined with salvage BT. After a median follow-up of 60.1 months, 135 (50.7 %) of patients experienced biochemical relapse. Median biochemical progression-free survival (bPFS) was 40.0 months. On multivariate analysis, initial risk group (high-risk: HR = 1.64, 95 % CI [1.13–2.37], p = 0.008), BT technique (HDR: HR = 2.14, 95 % CI [1.41–3.26], p = 0.0004), and treated volume (focal vs. whole-gland: HR = 2.14, 95 % CI [1.23–3.73], p = 0.007) were significantly associated with bPFS. Late grade 3 gastrointestinal and genitourinary toxicities occurred in 3 % and 14 % of patients, respectively.</div></div><div><h3>Conclusion</h3><div>Salvage BT provides encouraging disease control with an acceptable toxicity profile. Careful patient selection remains essential.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"213 ","pages":"Article 111170"},"PeriodicalIF":5.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjuvant radiotherapy alone, an effective treatment option for early-stage low- risk breast cancer in women over 50: results from a population based cohort study using a Canadian provincial database","authors":"Kurian Joseph ,&nbsp;Ayoola Ademola ,&nbsp;Julia Zebak ,&nbsp;Armaan Singh ,&nbsp;Hanxiao Zuo ,&nbsp;Heather Warkentin ,&nbsp;Aswin Abraham ,&nbsp;Zsolt Gabos ,&nbsp;Keith Tankel ,&nbsp;Susan Chafe ,&nbsp;Karen King","doi":"10.1016/j.radonc.2025.111175","DOIUrl":"10.1016/j.radonc.2025.111175","url":null,"abstract":"<div><h3>Purpose</h3><div>Breast conserving surgery (BCS) is the primary treatment for early-stage breast cancer(EBC). Typically, adjuvant endocrine therapy (ET) and radiation therapy (RT) are standard treatments offered for EBC. However, non-compliance and toxicity remain as issues with HT and many patients choose adjuvant RT alone. The benefit of adjuvant RT alone in women with low-risk EBC remains unclear. It is hypothesized that adjuvant RT-alone can improve outcomes in low-risk EBC patients, similar to ET alone or RT + ET combination.</div></div><div><h3>Methods</h3><div>This population-based study identified women aged 50–80 with T1, N0, Estrogen receptor positive (ER + ve), human epidermal growth receptor-2 negative(Her-2/neu-ve) EBC treated with BCS, followed by adjuvant treatments (RT-alone, ET-alone, or RT + ET combination) from 2010 to 2015. Primary outcomes were recurrence free survival (RFS), overall survival (OS), and breast cancer specific survival (BCSS).</div></div><div><h3>Results</h3><div>2810 patients were identified. Median follow-up was 73 months(Interquartile <span><math><mrow><mfenced><mrow><msub><mi>Q</mi><mn>1</mn></msub><mo>,</mo><mspace></mspace><mspace></mspace><msub><mi>Q</mi><mn>3</mn></msub></mrow></mfenced><mrow><mo>:</mo><mspace></mspace><mn>55.0</mn><mo>,</mo><mspace></mspace><mn>91.6</mn><mo>)</mo></mrow></mrow></math></span>. Adjuvant treatments were: BCS only 216 (8 %), RT alone 803 (29 %), ET alone 274 (10 %), and RT + ET combination 1517 (54 %). 398 patients (22.2 %) completed 5-years of ET. Compared to BCS alone, there was no statistically significant difference between treatment groups for RFS and BCSS. There were significant difference among the treatment groups for OS compared to BCS alone: Hazard ratio (HR) 0.66 (95 % confidence interval (CI): 0.45 – 0.97) for RT alone, 0.55 (95 % CI: 0.35 – 0.87) for ET alone, and 0.48 (95 % CI: 0.33 – 0.70) for RT + ET combination. Determinants of OS were age, tumor grade, comorbidities, and adjuvant therapy.</div></div><div><h3>Conclusions</h3><div>Our population-based cohort study showed that there was no statistically significant difference in RFS and BCSS among various adjuvant treatments versus BCS alone. However, RT alone, ET alone and RT + ET combination resulted in a statistically significant improvement in OS compared to BCS alone. Our findings support RT alone can be a viable alternative to ET + RT combination for women over 50 with low-risk EBC. Ongoing studies like EUROPA, REaCT trial and EPOPE will provide more insight into the role of RT alone as a definite treatment option.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"213 ","pages":"Article 111175"},"PeriodicalIF":5.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Intensity-Modulated radiotherapy with trigeminal nerve pathway delineation for head and neck adenoid cystic carcinoma","authors":"Wen Jiang ,&nbsp;Ying Xiao ,&nbsp;Haisheng Hu ,&nbsp;Jiang Li ,&nbsp;Yining He ,&nbsp;Nannan Han ,&nbsp;Rongrong Li ,&nbsp;Lin Zhang ,&nbsp;Shengjin Dou ,&nbsp;Guopei Zhu","doi":"10.1016/j.radonc.2025.111174","DOIUrl":"10.1016/j.radonc.2025.111174","url":null,"abstract":"<div><h3>Background</h3><div>Head and neck adenoid cystic carcinoma (HN-ACC) is a rare, aggressive malignancy prone to perineural invasion, making treatment challenging. This study evaluates the outcomes of postoperative intensity-modulated radiation therapy (IMRT) for HN-ACC to guide radiation target delineation, optimizing radiation planning and improving patient outcomes.</div></div><div><h3>Patients and Methods</h3><div>A retrospective review of postoperative IMRT outcomes in HN-ACC patients from January 2015 to December 2022 was conducted. Prophylactic coverage of trigeminal nerve branches in the radiation field and cervical nodal irradiation was based on clinical/pathological assessments. The primary endpoint was 5-year locoregional recurrence-free survival (LRRFS), with secondary endpoints including progression-free survival (PFS), distant metastasis-free survival (DMFS), and overall survival (OS).</div></div><div><h3>Results</h3><div>A total of 328 patients were followed for a median of 61.1 months. The 5-year LRRFS, PFS, DMFS, and OS rates were 91.7 %, 63.0 %, 67.1 %, and 91.3 %, respectively. Thirty patients experienced locoregional recurrence, comprising 19 local recurrences, 6 regional recurrences, and 5 combined local and regional recurrences. Eleven patients had recurrence involving trigeminal nerve branches (8 in-field, 3 marginal).</div></div><div><h3>Conclusions</h3><div>Postoperative IMRT for HN-ACC, utilizing our institutional target delineation protocol that prioritizes delineating the target along the trigeminal nerve pathway, suggests favorable locoregional control and survival outcomes. These results suggest evidence-based insights that could inform clinical practice and support radiation oncologists in optimizing IMRT strategies for HN-ACC.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"213 ","pages":"Article 111174"},"PeriodicalIF":5.3,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"18F-FDG PET/CT directed radiotherapy dose escalation in locally advanced esophageal cancer (LAEC), a phase I study","authors":"Ningning Cheng,&nbsp;Zhixiao Chen,&nbsp;Ying Chen,&nbsp;Ye Hu,&nbsp;Zijie Wang,&nbsp;Xuming Chen,&nbsp;Qianqian Liu,&nbsp;Tingfeng Chen","doi":"10.1016/j.radonc.2025.111176","DOIUrl":"10.1016/j.radonc.2025.111176","url":null,"abstract":"<div><h3>Background and purpose</h3><div>To determine the maximum tolerated dose (MTD) of hyperfractionated radiotherapy (HFRT) boost for residual metabolic disease (RMD) as defined by PET/CT following SCRT with concurrent paclitaxel (P) and carboplatin (C) for locally advanced esophageal cancer (LAEC).</div></div><div><h3>Materials and methods</h3><div>Eligible patients received standard chemoradiation therapy(SCRT) with weekly paclitaxel and carboplatin plus preirradiation PET/CT-guided intensity-modulated radiotherapy (IG-IMRT). Patients with RMD received HFRT boost concurrent with the same chemotherapy. Boost doses were escalated using a modified Fibonacci design. Dose limiting toxicity (DLT) was defined as grade ≥4 esophagitis, grade ≥3 non-hematological toxicity (except nausea/vomiting), or grade ≥4 hematological toxicity lasting &gt;7 days. MTD was the highest dose with ≤1 pts experiencing DLT.</div></div><div><h3>Results</h3><div>21pts were assessable. SCRT was well-tolerated. 4 pts achieved complete metabolic response (CMR). DLT occurred at 28.8 and 36 Gy. The MTD wasn’t reached. The most common acute grade ≥ 3 toxicities were esophagitis (17 %), neutropenia (24 %). Late toxicity included grade 1 or 2 esophageal stricture (n = 5). Overall response rate was 88 %. With median follow-up of 9 months, local–regional failure only occurred in 1pt.</div></div><div><h3>Conclusion</h3><div>36 Gy HFRT boost to PET/CT-defined RMD after 50 Gy SCRT using IG-IMRT, resulting in a total composite tumor dose of 86 Gy (BED 100.32 Gy), can be safely delivered concurrent with weekly P/C. MTD remains to be defined.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"213 ","pages":"Article 111176"},"PeriodicalIF":5.3,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From rugged ridges to radiotherapy ROIs: Translating topographical metrics to Surface-Guided Radiation Therapy regions of Interest in radiotherapy","authors":"Ciaran Malone ,&nbsp;Samantha Ryan ,&nbsp;Jill Nicholson ,&nbsp;Sinead Brennan ,&nbsp;Orla McArdle ,&nbsp;Ruth Woods ,&nbsp;Aodh MacGairbhith ,&nbsp;James Waldron ,&nbsp;Clodagh Callagh ,&nbsp;Rachel Harwood ,&nbsp;Brendan McClean ,&nbsp;Frances Duane ,&nbsp;Gerard G. Hanna","doi":"10.1016/j.radonc.2025.111173","DOIUrl":"10.1016/j.radonc.2025.111173","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate whether geography-derived topographical metrics (e.g., slope, aspect, elevation change and ruggedness) provide a quantitative, reproducible description of SGRT ROI surface quality. We pre-specified feasibility criteria: (i) monotonic, directionally consistent changes with controlled smoothing on synthetic surfaces; and (ii) separation of distributions between clinically distinct ROIs (breast size; full- vs limited-face).</div></div><div><h3>Methods</h3><div>Quantitative topographical metrics were identified for investigation including Slope, Aspect, Vector Ruggedness Measure (VRM), Topographic Position Index (TPI) and Terrain Ruggedness Index (TRI). First, synthetic breast-like and face-like surfaces were generated in Python using Perlin noise. Each surface was progressively smoothed and analysed for metric response to surface complexity. Second, three surface captures were exported from the AlignRT SGRT system: a small breast, a large breast and a face, which was cropped to produce a limited‐face and a full‐face surface. Histograms and 3D maps visualized metric distributions for each ROI.</div></div><div><h3>Results</h3><div>Slope, Aspect, TPI, and TRI effectively captured surface variations in both synthetic and patient data, identifying useful topographical features for SGRT. VRM remained low, relative to typical rugged geological terrain, indicating limited value for smooth skin surfaces. For the synthetic surfaces, increased smoothing compressed slope values toward zero, narrowed Aspect spreads, and lowered TRI/TPI variability. For patient/volunteer surfaces, the small-breast ROI showed fewer slope and aspect regions, and the large-breast ROI had broader slope and aspect ranges, and higher TRI/TPI, reflecting more pronounced local folds. Full‐face ROIs exhibited wider slope/TRI/TPI ranges than limited‐face ROIs.</div></div><div><h3>Conclusion</h3><div>Geography-derived metrics quantify ROI surface variation and meet pre-specified feasibility criteria and may help personalise and optimise ROI selection for individual patient anatomy. These results provide a quantitative foundation for ROI design and training; prospective studies are required to link metric thresholds to setup and intrafraction performance.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"213 ","pages":"Article 111173"},"PeriodicalIF":5.3,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}