Radiotherapy and Oncology最新文献

{"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":"Gynaecological reirradiation with image-guided radiotherapy: Tumour Control Probability and Normal Tissue Complication Probability in pre-immunotherapy era.","authors":"Supriya Chopra, Nisarga Vontikoppal Manjunath, Ankita Gupta, Prachi Mittal, Jeevanshu Jain, Prachi Sawant, Mayuri Charnalia, Yogesh Ghadi, Jaya Ghosh, Sushmita Rath, Sudeep Gupta","doi":"10.1016/j.radonc.2025.111064","DOIUrl":"10.1016/j.radonc.2025.111064","url":null,"abstract":"<p><strong>Background and purpose: </strong>Management of recurrent gynaecological cancers after previous pelvic radiation is challenging. This institutional cohort describes clinical outcomes with image-guided radiotherapy techniques.</p><p><strong>Materials and methods: </strong>From 2020 to 2023, patients with recurrent or second primary gynaecological malignancies previously treated with radiotherapy were included. Reirradiation was delivered using image-guided volumetric arc therapy (IG-VMAT), stereotactic body radiotherapy (SBRT), and/or image-guided brachytherapy (IGBT) as clinically appropriate. Infield control, progression-free survival (PFS), and overall survival (OS) were estimated using the Kaplan-Meier method. Prognostic factors for infield control were assessed with uni- and multivariate analyses. Adverse events were reported (CTCAE version 5.0). The dose-response effect for tumour control and late effects were estimated.</p><p><strong>Results: </strong>Seventy patients underwent reirradiation. Of these 62 (88.5 %), 6 (8.5 %), and 2 (2.8 %) had cervical cancer, endometrial cancer, and vulvovaginal cancer, respectively. The majority of patients had squamous cell histology (81.4 %). Fifty-nine patients (84.2 %) were treated for local and/ or nodal recurrence, and 11 patients were treated (15.8 %) for second primary cancer. The median reirradiation dose was 50 Gy (IQR 42.2-64.2 Gy). In this cohort, 34/70 (48.6 %) patients received systemic chemotherapy, and no Bevacizumab or Immunotherapy. With a median follow-up of 37 months, the 3-year infield control, PFS, and OS were 63.5 %, 62.4 %, and 68 %, respectively. Reirradiation dose ≥50 Gy and disease-free interval ≥24 months were independently associated with improved infield control (p = 0.04, 0.004). Grade ≥3 gastrointestinal/genitourinary toxicity occurred in 18.5 % patients. Cumulative EQD2 ≥130 Gy₁₀ predicted for grade ≥3 toxicity (p = 0.008).</p><p><strong>Conclusions: </strong>Image-guided radiotherapy techniques for reirradiation achieve excellent local control with acceptable toxicity in patients with recurrent gynaecological cancers.</p>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":" ","pages":"111064"},"PeriodicalIF":5.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754136","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":"An intelligent postoperative management system for glioblastoma integrating automated segmentation, risk stratification, and recurrence spatial mapping","authors":"Yan Li ,&nbsp;Zekun Jiang ,&nbsp;Jia Tan ,&nbsp;Zhihao Wang ,&nbsp;Yuehao Ma ,&nbsp;Deng Xiong ,&nbsp;Yanhui Liu ,&nbsp;Kang Li ,&nbsp;Su Lui ,&nbsp;Min Wu","doi":"10.1016/j.radonc.2025.111180","DOIUrl":"10.1016/j.radonc.2025.111180","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to develop DeepGBM-Recure, an integrated artificial intelligence (AI) system for optimizing precision radiotherapy and individualized surveillance in glioblastoma (GBM) by automating postoperative risk stratification and spatial targeting of recurrence hotspots.</div></div><div><h3>Methods</h3><div>This DeepGBM-Recure system comprises three synergistic modules: 1) Automated segmentation of <em>peri</em>-cavitary hyperintense regions on postoperative fluid-attenuated inversion recovery (FLAIR) images using a 3D nnU-Net framework; 2) Patient-level early recurrence prediction based on radiomics features and random forest classification; 3) Voxel-wise spatial mapping of high-risk subregions via supervoxel analysis. The system was trained and validated on data from 145 patients across two centers and externally tested on data from 39 patients across another two centers.</div></div><div><h3>Results</h3><div>On the test set, the nnU-Net segmentation model achieved a mean Dice coefficient of 0.85 ± 0.09. The patient-level and voxel-level prediction models achieved area under the ROC curves (AUCs) of 0.76 and 0.80, respectively. Notably, the voxel-level model exhibited strong spatial concordance between predicted high-risk heatmaps and ground-truth recurrence regions. Performance was further supported by calibration curves, decision curve analysis, and clinical application in representative cases, demonstrating favorable predictive accuracy in real-world scenarios.</div></div><div><h3>Conclusion</h3><div>DeepGBM-Recure represents a pioneering integrated solution that combines automated anatomical delineation, individualized risk stratification, and spatial recurrence guidance, offering a clinically applicable tool for precision radiotherapy and individualized surveillance. Prospective multi-center trials with larger cohorts are warranted to validate clinical utility and facilitate integration into real-world decision-making workflows.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"213 ","pages":"Article 111180"},"PeriodicalIF":5.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225498","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":"Response to « Comment on ‘Local control assessment following SABR for lung metastases of colorectal cancer: A multicenter retrospective analysis‘ »","authors":"Robin Morcet-Delattre,&nbsp;Joël Castelli,&nbsp;Loïg Duvergé","doi":"10.1016/j.radonc.2025.111094","DOIUrl":"10.1016/j.radonc.2025.111094","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"211 ","pages":"Article 111094"},"PeriodicalIF":5.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822438","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":"Deep learning NTCP model for late dysphagia after radiotherapy for head and neck cancer patients based on 3D dose, CT and segmentations","authors":"S.P.M. de Vette ,&nbsp;H. Neh ,&nbsp;L. van der Hoek ,&nbsp;D.C. MacRae ,&nbsp;H. Chu ,&nbsp;A. Gawryszuk ,&nbsp;R.J.H.M. Steenbakkers ,&nbsp;P.M.A. van Ooijen ,&nbsp;C.D. Fuller ,&nbsp;K.A. Hutcheson ,&nbsp;J.A. Langendijk ,&nbsp;N.M. Sijtsema ,&nbsp;L.V. van Dijk","doi":"10.1016/j.radonc.2025.111169","DOIUrl":"10.1016/j.radonc.2025.111169","url":null,"abstract":"<div><h3>Background &amp; purpose</h3><div>Late radiation-associated dysphagia after head and neck cancer (HNC) significantly impacts patient’s health and quality of life. Conventional normal tissue complication probability (NTCP) models use discrete dose parameters to predict toxicity risk but fail to fully capture the complexity of this side effect. Deep learning (DL) offers potential improvements by incorporating 3D dose data for all anatomical structures involved in swallowing. This study aims to enhance dysphagia prediction with 3D DL NTCP models compared to conventional NTCP models.</div></div><div><h3>Materials &amp; methods</h3><div>A multi-institutional cohort of 1484 HNC patients was used to train and validate a 3D DL model (Residual Network) incorporating 3D dose distributions, organ-at-risk segmentations, and CT scans, with or without patient- or treatment-related data. Predictions of grade ≥ 2 dysphagia (CTCAEv4) at six months post-treatment were evaluated using area under the curve (AUC) and calibration curves. Results were compared to a conventional NTCP model based on pre-treatment dysphagia, tumour location, and mean dose to swallowing organs. Attention maps highlighting regions of interest for individual patients were assessed.</div></div><div><h3>Results</h3><div>DL models outperformed the conventional NTCP model in both the independent test set (AUC = 0.80–0.84 versus 0.76) and external test set (AUC = 0.73–0.74 versus 0.63) in AUC and calibration. Attention maps showed a focus on the oral cavity and superior pharyngeal constrictor muscle.</div></div><div><h3>Conclusion</h3><div>DL NTCP models performed significantly better than the conventional NTCP model, suggesting the benefit of using 3D-input over the conventional discrete dose parameters. Attention maps highlighted relevant regions linked to dysphagia, supporting the utility of DL for improved predictions.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"213 ","pages":"Article 111169"},"PeriodicalIF":5.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207369","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}