Radiotherapy and Oncology最新文献

{"title":"Clinical outcomes of stereotactic MRI-guided adaptive radiotherapy for renal tumors in patients with a solitary kidney","authors":"Claire van Vliet ,&nbsp;Joyce Caro ,&nbsp;Omar Bohoudi ,&nbsp;Axel Bex ,&nbsp;Daphne Damhoff ,&nbsp;Fons J.M. van den Eertwegh ,&nbsp;Niels M. Graafland ,&nbsp;Brunolf W. Lagerveld ,&nbsp;Jeroen R.A. van Moorselaar ,&nbsp;Miguel A. Palacios ,&nbsp;Shyama U. Tetar ,&nbsp;Sonja Verheijen ,&nbsp;Nienke W. Weitkamp ,&nbsp;Antoinet van der Wel ,&nbsp;Patricia J. Zondervan ,&nbsp;Ben J. Slotman ,&nbsp;Anna M.E. Bruynzeel","doi":"10.1016/j.radonc.2026.111389","DOIUrl":"10.1016/j.radonc.2026.111389","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Patients with renal cell carcinoma (RCC) in a solitary kidney have limited treatment options. Stereotactic MRI-guided adaptive radiotherapy (SMART) offers a non-invasive alternative that preserves healthy kidney tissue. This study evaluated the clinical outcomes of SMART in patients with renal tumors in a solitary kidney. Oncological outcomes, renal function preservation, and treatment-related toxicity were assessed.</div></div><div><h3>Materials and methods</h3><div>All consecutive patients with RCC in a solitary kidney treated with SMART between 2018 and 2024 in a single center were analyzed. Local control was defined as any response or stable disease using RECIST criteria. Kaplan-Meier analysis was used for survival outcomes and paired t-tests assessed renal function changes.</div></div><div><h3>Results</h3><div>Thirty-two patients with a median age of 70 years were included. Most patients had WHO status 0–1 (93.8%) and had prior nephrectomy for RCC (78.1%). Median tumor size was 4.2 cm, and median pre-treatment eGFR was 45.8 ml/min. Seven patients were treated for multiple lesions, in simultaneous or separate sessions. Most patients were treated in a single (22.8%) or five (74.3%) fractions. After a median follow-up of 21.3 months, the local control rates at 1 and 2 years were 96.2% and 90.1%, respectively. Mean eGFR change was −6.6 ml/min, none required dialysis. No grade ≥ 3 toxicity was observed. The overall survival rate at 2 years was 80.9%.</div></div><div><h3>Conclusion</h3><div>SMART provides high local control with minimal impact on renal function, offering a non-invasive, kidney-sparing treatment option that also enables repeated treatments within the solitary kidney.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"217 ","pages":"Article 111389"},"PeriodicalIF":5.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146053334","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":"The prospective phase I “Flash-Skin I” trial: ultra-high dose rate radiotherapy implementation and quality assurance at a clinical linear accelerator","authors":"Riccardo Dal Bello ,&nbsp;Serena Psoroulas ,&nbsp;Dominik Flückiger ,&nbsp;Jerome Krayenbühl ,&nbsp;Raphaël Moeckli ,&nbsp;Claude Bailat ,&nbsp;Anna Subiel ,&nbsp;Ileana Silvestre Patallo ,&nbsp;Jens von der Grün ,&nbsp;Panagiotis Balermpas ,&nbsp;Matthias Guckenberger ,&nbsp;Stephanie Tanadini-Lang","doi":"10.1016/j.radonc.2026.111372","DOIUrl":"10.1016/j.radonc.2026.111372","url":null,"abstract":"<div><h3>Background and purpose</h3><div>The combination of reduced normal tissue damage and unaffected tumor control is referred to as Flash-effect. This phenomenon has been observed with ultra-high dose rate (UHDR) radiotherapy in preclinical models. The Flash-Skin I (NCT06549439) treated seven patients with melanoma skin metastasis. The treatment protocol included 2 × 9 Gy UHDR followed by 1 × 9 Gy conventional radiotherapy. Here we report on the implementation of the study at a converted C-arm clinical linear accelerator.</div></div><div><h3>Materials and methods</h3><div>A dedicated preclinical radiation therapy quality assurance (RTQA) program was developed and the linac performance was validated for more than one year. Clinically, fourteen fractions of 9 Gy each were delivered with the 9 MeV UHDR electron linac. In-vivo measurements included: skin dose with radiochromic films, linac output with optically stimulated luminescent dosimeter (OSLD), pulse counting and inter-pulse stability with a scintillator, intra-pulse stability with a diamond detector.</div></div><div><h3>Results</h3><div>The preclinical RTQA identified reduced linac output, which prompted beam tuning and additional quality assurance. This formed the basis for initiation of the clinical trial and successful treatment of all seven patients. All fourteen UHDR fractions showed a dose accuracy within 4.6% or better. The number of delivered pulses consistently matched the planned value, and film measurements confirmed the skin dose. Intra- and inter-pulse stability were within 3.8% and 2.8%, respectively.</div></div><div><h3>Conclusion</h3><div>The clinical implementation of Flash-Skin I at converted C-arm linac was successfully demonstrated and validated. The developed RTQA program may facilitate the development of future UHDR clinical trials.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"216 ","pages":"Article 111372"},"PeriodicalIF":5.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952858","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":"The actual performance of ML/AI models in predicting radiation-induced toxicity in head and neck cancer: a systematic review and meta-analysis","authors":"Gibson C. Ugwu ,&nbsp;Farzad Jalali ,&nbsp;Geoffrey Liu ,&nbsp;Guojun Li ,&nbsp;Johannes Albertus Langendijk ,&nbsp;Behrooz Z. Alizadeh","doi":"10.1016/j.radonc.2025.111350","DOIUrl":"10.1016/j.radonc.2025.111350","url":null,"abstract":"<div><div>An increasing number of Artificial intelligence (AI) and machine learning (ML) models are being developed to predict radiation-induced toxicities (RITs) in patients with head and neck cancer (HNC). But their performance and reliability remain uncertain. This systematic review and <em>meta</em>-analysis evaluated the predictive accuracy and methodological quality of these models. We comprehensively searched PubMed, EMBASE, Web of Science, and the Cochrane Library to identify studies reporting on ML/AI models for predicting RITs in HNC patients. Eligible studies were assessed for bias risk using the PROBAST tool, and key performance metrics, including the area under the receiver operating curve (AUROC), were extracted. A hierarchical multilevel <em>meta</em>-analysis was performed to estimate pooled AUROC values, and subgroup analyses explored the influence of study characteristics on model performance. A total of 67 studies with a total of 568 models were included, showing moderate discriminatory power of ML/AI models, with a pooled AUROC = 0.76; 95 % CI: 0.73–0.78. Nonetheless, substantial heterogeneity was observed across studies. Incorporating imaging biomarkers significantly improved model performance. Prospective and internal validation showed comparable performance; external validation shows true generalizability. The predominance of retrospective designs and variability in predictor selection may have introduced bias, affecting model reliability and generalisability. ML/AI models hold promise for predicting RITs in HNC patients, but methodological constraints limit their applicability. Standardised and transparent reporting of model development and validation processes is vital for improving comparability among studies. Future research should explore hybrid modelling methods and the integration of clinical, dosimetric, radiomic, and genomic data to boost predictive accuracy.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"216 ","pages":"Article 111350"},"PeriodicalIF":5.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800712","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":"In response to Liu et al","authors":"S.P.M. de Vette,&nbsp;J.A. Langendijk,&nbsp;N.M. Sijtsema,&nbsp;L.V. van Dijk","doi":"10.1016/j.radonc.2025.111353","DOIUrl":"10.1016/j.radonc.2025.111353","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"216 ","pages":"Article 111353"},"PeriodicalIF":5.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800707","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":"Chronic radiation-associated dysphagia after curative hypofractionated reirradiation or chemo-reirradiation in head and neck cancer. Does age affect?","authors":"Lucía Gutiérrez Bayard ,&nbsp;Carmen Herrera del Valle ,&nbsp;Beatriz Baños Pérez ,&nbsp;María del Cristo Padrón Hernández ,&nbsp;Tatiana Pérez Calzado ,&nbsp;Isabela Gaztelu ,&nbsp;María Jesúa Macías Lozano ,&nbsp;Nuria Martin Romero ,&nbsp;Lourdes de Ingunza Barón ,&nbsp;Esther González Calvo ,&nbsp;Isabel Villanego Beltrán ,&nbsp;María Lorente Sánchez ,&nbsp;Laura Díaz Gómez ,&nbsp;Verónica Díaz Díaz ,&nbsp;Ricardo Oyarzun Silva ,&nbsp;Javier Jaén Olasolo","doi":"10.1016/S0167-8140(26)00228-8","DOIUrl":"10.1016/S0167-8140(26)00228-8","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"216 ","pages":"Page S69"},"PeriodicalIF":5.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147631356","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":"Title Page","authors":"","doi":"10.1016/S0167-8140(26)00161-1","DOIUrl":"10.1016/S0167-8140(26)00161-1","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"216 ","pages":"Page i"},"PeriodicalIF":5.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147631366","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":"Poor survival outcomes in advanced Head and Neck Cancer with oral tyrosine kinase inhibitors(TKIs) with or without chemotherapy.","authors":"Gunjan Shrivastav ,&nbsp;Megha Sahu ,&nbsp;Nidisha Agrawal ,&nbsp;Abhijeet Chopade ,&nbsp;Viswajit Jalaj ,&nbsp;Braj Raj Shrivastava","doi":"10.1016/S0167-8140(26)00164-7","DOIUrl":"10.1016/S0167-8140(26)00164-7","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"216 ","pages":"Pages S1-S2"},"PeriodicalIF":5.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147631383","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":"Computed tomography assessment of sarcopenia in malnourished head and neck cancer patients: interim results","authors":"María A González Ruiz ,&nbsp;Beatriz Gonzalez Aguilera ,&nbsp;María Galindo Gallardo ,&nbsp;María Laínez López ,&nbsp;Jerónimo Pachón Ibáñez","doi":"10.1016/S0167-8140(26)00239-2","DOIUrl":"10.1016/S0167-8140(26)00239-2","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"216 ","pages":"Page S81"},"PeriodicalIF":5.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147631392","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":"LORIS-like Multimodal Predictive Framework for PFS and response rates to Neoadjuvant therapies: Integrating Imaging, ctDNA in Head and Neck Cancer","authors":"Suresh Attili ,&nbsp;Rakesh Sharrma ,&nbsp;Mallik Singaraju","doi":"10.1016/S0167-8140(26)00199-4","DOIUrl":"10.1016/S0167-8140(26)00199-4","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"216 ","pages":"Page S38"},"PeriodicalIF":5.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147631412","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":"De-escalating neck volumes in adjuvant radiotherapy for squamous cell carcinoma of head and neck.","authors":"Joaquín J Cabrera Rodríguez ,&nbsp;María Medina Cobacho ,&nbsp;Patricia Ruiz Leal ,&nbsp;Maria C Fernández Alcalá ,&nbsp;Almudena Corbacho Campos ,&nbsp;Francisco P Titos Sánchez ,&nbsp;Victoria Vera Barragán","doi":"10.1016/S0167-8140(26)00214-8","DOIUrl":"10.1016/S0167-8140(26)00214-8","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"216 ","pages":"Page S55"},"PeriodicalIF":5.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147631434","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}