Radiotherapy and Oncology最新文献

{"title":"Corrigendum to “GEC-ESTRO ACROP prostate brachytherapy guidelines” [Radiother Oncol. 2022; 167: 244–251]","authors":"Ann Henry , Bradley R. Pieters , Frank André Siebert , Peter Hoskin , UROGEC group of GEC ESTRO with endorsement by the European Association of Urology","doi":"10.1016/j.radonc.2025.110791","DOIUrl":"10.1016/j.radonc.2025.110791","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110791"},"PeriodicalIF":4.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444585","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":"Consensus for a postoperative atlas of sinonasal substructures from a modified Delphi study to guide radiotherapy in sinonasal malignancies","authors":"Florent Carsuzaa ,&nbsp;Valentin Favier ,&nbsp;Lise Seguin ,&nbsp;Mario Turri-Zanoni ,&nbsp;Anna-Maria Camarda ,&nbsp;Benjamin Verillaud ,&nbsp;Philippe Herman ,&nbsp;Daniele Borsetto ,&nbsp;Alberto Schreiber ,&nbsp;Stefano Taboni ,&nbsp;Vittorio Rampinelli ,&nbsp;Alessandro Vinciguerra ,&nbsp;Alperen Vural ,&nbsp;Xavier Liem ,&nbsp;Fabio Busato ,&nbsp;Sophie Renard ,&nbsp;Charles Dupin ,&nbsp;Mélanie Doré ,&nbsp;Pierre Graff ,&nbsp;Yungan Tao ,&nbsp;Juliette Thariat","doi":"10.1016/j.radonc.2025.110784","DOIUrl":"10.1016/j.radonc.2025.110784","url":null,"abstract":"<div><h3>Background</h3><div>Sinonasal and skull base tumor surgery-related morbidity has been reduced by the use of endoscopic endonasal skull base surgery (EESBS). Postoperative radiation therapy (poRT) requires precise definition of target volumes. To enhance the accuracy of poRT planning, histological and radiological correlations are necessary to locate the tumor attachment on poRT CT scans. An accurate atlas of structures resected or identified during EESBS could serve for the interdisciplinary postoperative management of patients, personalizing poRT by adequate radiation dose delivery. The objective of this study was to achieve a consensual segmentation atlas on CT scan with surgeons practicing EESBS and radiation oncologists.</div></div><div><h3>Methods</h3><div>The sinonasal structures relevant for poRT of sinonasal malignancies were determined by a two-round Delphi process. A rating group of 25 European experts in sinonasal malignancies was set up. Consensual structures emerged and were used to determine the anatomical limits of the retained structures to draft an atlas with expert based relevant structures. The atlas was then critically reviewed, discussed, and edited by another 2 skull base surgeons and 2 radiation oncologists.</div></div><div><h3>Results</h3><div>After the two rating rounds, 46 structures obtained a strong agreement, 7 an agreement, 5 were rejected and 5 did not reach consensus. The atlas integrating all the selected structures is presented attached.</div></div><div><h3>Conclusion</h3><div>Consensual segmentation atlas on CT scan might allow, through careful poRT planning to limit the morbidity of poRT while maintaining good local control. Prospective studies are necessary to validate this potential precision medicine-based approach.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110784"},"PeriodicalIF":4.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477109","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":"Electron vs proton FLASH radiation on murine skin toxicity","authors":"Line Kristensen ,&nbsp;Sky Rohrer ,&nbsp;Lone Hoffmann ,&nbsp;Lars H Præstegaard ,&nbsp;Christina Ankjærgaard ,&nbsp;Claus E Andersen ,&nbsp;Eleni Kanouta ,&nbsp;Jacob Graversen Johansen ,&nbsp;Morten Sahlertz ,&nbsp;Jasper Nijkamp ,&nbsp;Per Rugaard Poulsen ,&nbsp;Brita Singers Sørensen","doi":"10.1016/j.radonc.2025.110796","DOIUrl":"10.1016/j.radonc.2025.110796","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Dose-response modification of FLASH has previously been established for acute skin toxicity in protons. This study used a similar experimental setup to quantify the dose–response modification of electron FLASH irradiation for acute skin- and late fibrotic toxicity in mice. The setup similarity enabled quantitative comparison of the acute skin response for electrons to protons.</div></div><div><h3>Method</h3><div>Female unanaesthetised C3D2F1 mice were restrained with the right hindleg fixated and submerged in a water bath for horizontal electron irradiation at 16 MeV. Mice were randomised in groups of varying single doses (19.4–57.6 Gy) and irradiated with either 0.162 Gy/s conventional (CONV) or 233 Gy/s FLASH dose rate using 8–10 mice per group. Acute skin toxicity was assessed daily from the 8th to the 28th day post-irradiation. The same mice were kept for a fibrotic assay of leg extension assessment done biweekly until 52 weeks post-irradiation. The dose-modifying factor (DMF) of FLASH was quantified from dose-response curves.</div></div><div><h3>Results and discussion</h3><div>Electron FLASH irradiated mice showed a considerable skin-sparing effect with a DMF of 1.45–1.54 and a smaller fibrotic-sparing effect with a DMF of 1.15. The development of acute skin toxicity was similar between CONV and FLASH groups with biological equivalent doses based on the DMF. The acute response of the electron irradiations was similar to previous reports on protons.</div></div><div><h3>Conclusion</h3><div>Despite apparent differences, e.g. average and instantaneous dose rates, the acute skin toxicity of electron beams and previously published proton beams were remarkably similar regarding both biological response and quantified acute skin DMFs.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110796"},"PeriodicalIF":4.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472886","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":"Dosimetric predictors of toxicity for brainstem metastases and AVMs treated with stereotactic radiosurgery: An international, multi-institutional analysis","authors":"Raj Singh ,&nbsp;Samantha Dayawansa ,&nbsp;Duy Pham ,&nbsp;Georgios Mantziaris ,&nbsp;Selcuk Peker ,&nbsp;Yavuz Samanci ,&nbsp;Ali Haluk Duzkalir ,&nbsp;David Mathieu ,&nbsp;Anne-Marie Langlois ,&nbsp;Molly L. Egnot ,&nbsp;Ronald E. Warnick ,&nbsp;Herwin Speckter ,&nbsp;Erwin Lazo ,&nbsp;Laura Mendez ,&nbsp;Angel I. Blanco ,&nbsp;Mark J. Amsbaugh ,&nbsp;Collin Liu ,&nbsp;Andrea Becerril-Gaitan ,&nbsp;Yoshua Esquenazi ,&nbsp;Ching-Jen Chen ,&nbsp;Jason P. Sheehan","doi":"10.1016/j.radonc.2025.110795","DOIUrl":"10.1016/j.radonc.2025.110795","url":null,"abstract":"<div><h3>Background</h3><div>There are limited data on dosimetric predictors of radiation-induced changes (RICs) for brainstem metastases or arteriovenous malformations (AVMs) following single-fraction stereotactic radiosurgery (SRS).</div></div><div><h3>Methods</h3><div>We examined a multi-institutional cohort of patients with brainstem metastases or AVMs treated with SRS. We evaluated predictors of RICs graded per CTCAE(Common Terminology Criteria for Adverse Events), including D5%, D95%, D0.03 cc, and D0.5 cc (brainstem minus lesion). Univariate logistic regressions were initially performed with independent variables trending towards significance included on multivariate logistic regression.</div></div><div><h3>Results</h3><div>A total of 124 brainstem lesions treated with SRS were analyzed (21 AVMs and 103 metastases). The median prescription dose was 16 Gy(range: 13–23 Gy), and the median treatment volume was 0.48 cc(range: 0.002–11.19 cc). The incidence of RICs was 9.7 % (with 3/12 being Grade 3–4 and no Grade 5). All cases occurred in brainstem metastases, with no cases among those of the midbrain-pons transition. Treatment volumes ≥ 1cc were correlated with a higher symptomatic RIC incidence(6/57 vs. 6/65; <em>p</em> = 0.04). Notably, all RIC cases had a D0.5 cc ≥ 15 Gy(12/87 vs. 0/32). Both D5%≥6 Gy(9/55 vs. 3/69; <em>p</em> = 0.04) and D95%≥1 Gy(7/31 vs. 5/93; <em>p</em> = 0.01) were significantly correlated with higher incidence of RICs and D0.03 cc ≥ 22 Gy was correlated with a lower risk(2/61 vs. 9/63; <em>p</em> = 0.03). On MVA, D0.03 cc ≥ 22 Gy remained a significant predictor of a lower incidence of RICs(odds ratio = -1.72 (95 % CI: −3.32 to −0.12; <em>p</em> = 0.04).</div></div><div><h3>Conclusions</h3><div>Incidence of RICs was low following SRS for brainstem metastases and AVMs. We recommend optimizing radiosurgical plans for D0.5 cc &lt; 15 Gy with consideration of D5% and D95%, with less emphasis on D0.03 cc to allow to meet the former metrics as feasible.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110795"},"PeriodicalIF":4.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472884","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":"PIM kinase inhibition counters resistance to radiotherapy and chemotherapy in human prostate cancer","authors":"Anne Rajkumar-Calkins ,&nbsp;Vinay Sagar ,&nbsp;Jian Wang ,&nbsp;Shania Bailey ,&nbsp;Philip Anderson ,&nbsp;Sarki A. Abdulkadir ,&nbsp;Austin N. Kirschner","doi":"10.1016/j.radonc.2025.110794","DOIUrl":"10.1016/j.radonc.2025.110794","url":null,"abstract":"<div><h3>Purpose</h3><div>PIM kinases are associated with treatment resistance and poor prognosis in prostate cancer through roles in DNA damage response, cellular metabolism, proliferation, and survival. We hypothesized PIM inhibition addresses treatment resistance to radiotherapy and docetaxel in prostate cancer.</div></div><div><h3>Methods</h3><div>PIM inhibition in prostate cancer cell lines was examined by phosphorylated H2AX and colony formations assays. In normal and castrated mice with prostate tumor xenografts, tumor growth was monitored with daily oral PIM inhibition +/- fractionated radiotherapy (RT) or docetaxel. Radiotherapy was given 30 Gy in 15 treatments, mimicking clinical conventional daily treatment over 3 weeks in a translational murine model system.</div></div><div><h3>Results</h3><div>PIM inhibition decreased radiotherapy-induced DNA-damage repair and decreased cell proliferation and survival. In mice, PIM inhibition increased the efficacy of both radiation and docetaxel to reduce tumor size in hormone-dependent and −independent xenografts. Xenografts showed altered gene expression changes, including downregulation of ribosomal pathways and upregulation of cardiomyocyte signaling pathways, due to PIM inhibition as analyzed by RNA-Seq. Immunostaining of multiple proteins, including COX-2 and MDM2, was altered by PIM inhibition.</div></div><div><h3>Conclusions</h3><div>PIM inhibition addresses treatment resistance to docetaxel and radiotherapy in multiple prostate cancer models. Our data provide a strong rationale for testing PIM inhibitors in combination with standard therapies for treatment-resistant high-risk localized or metastatic prostate cancer in clinical trials.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110794"},"PeriodicalIF":4.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143463443","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":"Neoadjuvant chemoradiotherapy plus sequential tislelizumab followed by surgery for esophageal carcinoma (CRISEC study): A single-arm, bicentric, phase 2 trial","authors":"Jinsong Yang ,&nbsp;Cui Liu ,&nbsp;Zhigang Zuo ,&nbsp;Fengjun Cao ,&nbsp;Zhanjie Zhang ,&nbsp;Bian Wu ,&nbsp;You Qin ,&nbsp;Lu Wen ,&nbsp;Jielin Wei ,&nbsp;Guangqin Xiao ,&nbsp;Shijie Xing ,&nbsp;Yue Qu ,&nbsp;Lei Huang ,&nbsp;Xiaolin Wang ,&nbsp;Buhai Wang ,&nbsp;Kunyu Yang ,&nbsp;Ke Jiang","doi":"10.1016/j.radonc.2025.110797","DOIUrl":"10.1016/j.radonc.2025.110797","url":null,"abstract":"<div><h3>Background and purpose</h3><div>To explore the efficacy and safety of neoadjuvant chemoradiotherapy (NCRT) plus sequential tislelizumab followed by surgery for esophageal squamous cell carcinoma (ESCC).</div></div><div><h3>Materials and methods</h3><div>This single-arm, bicentric, phase 2 trial enrolled patients with resectable or potentially resectable thoracic ESCC to receive neoadjuvant radiotherapy (41.4 Gy in 23 fractions) with concurrent chemotherapy (albumin-bound paclitaxel, 50–100 mg/m², and carboplatin, area under the curve of 2 mg/ml/min, once weekly, five times) plus sequential tislelizumab (200 mg Q3W, three cycles) followed by surgery. The primary endpoint was pathologic complete response (pCR) rate. The secondary endpoints included safety, R0 resection rate, major pathologic response (MPR) rate, disease-free survival (DFS), and overall survival (OS).</div></div><div><h3>Results</h3><div>Of the 30 patients enrolled from January 2021 to October 2022, 24 (80.0 %) completed planned surgery and gained R0 resection (100 %). Among the 24 patients, nine (37.5 %) achieved pCR and 21 (87.5 %) achieved MPR. Ten patients (35.7 %) developed grade 3–4 toxicities during tislelizumab therapy, including lymphopenia (32.1 %), neutropenia (3.6 %), and thrombocytopenia (3.6 %). Grade 5 hematemesis occurred in two patients and both were attributed to aortic invasion. Three patients (12.5 %) developed grade 3 postoperative complications, including pulmonary infection (8.3 %) and hoarseness (4.2 %). After a median follow-up of 35.4 months, the 2-year OS and DFS rates were 83.3 % and 79.2 %, respectively.</div></div><div><h3>Conclusion</h3><div>Sequential tislelizumab after NCRT in ESCC is safe and feasible. Further study is warranted to validate the efficacy of this combination mode.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110797"},"PeriodicalIF":4.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468956","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 ‘Pioneering BNCT: Refining strategies for complex cutaneous malignancies","authors":"Tairo Kashihara ,&nbsp;Satoshi Nakamura ,&nbsp;Hiroshi Igaki","doi":"10.1016/j.radonc.2025.110787","DOIUrl":"10.1016/j.radonc.2025.110787","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110787"},"PeriodicalIF":4.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468959","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":"PACE-B: Where does this position SBRT as an option for localized prostate cancer?","authors":"Juanita Crook ,&nbsp;Pierre Blanchard ,&nbsp;Jay Ciezki ,&nbsp;Gregory Merrick ,&nbsp;Jeremy Millar ,&nbsp;Mira Keyes ,&nbsp;Chad Tang ,&nbsp;Richard Stock ,&nbsp;Daniel Song ,&nbsp;Steven J Frank","doi":"10.1016/j.radonc.2025.110793","DOIUrl":"10.1016/j.radonc.2025.110793","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110793"},"PeriodicalIF":4.9,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442003","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 fractionation effect on proton RBE in a late normal tissue damage model in vivo","authors":"Cathrine Bang Overgaard ,&nbsp;Fardous Reaz ,&nbsp;Per Poulsen ,&nbsp;Harald Spejlborg ,&nbsp;Jens Overgaard ,&nbsp;Cai Grau ,&nbsp;Niels Bassler ,&nbsp;Brita Singers Sørensen","doi":"10.1016/j.radonc.2025.110792","DOIUrl":"10.1016/j.radonc.2025.110792","url":null,"abstract":"<div><h3>Background and purpose</h3><div>A constant relative biological effectiveness (RBE) of 1.1 is used in clinical proton therapy (PT) to convert prescribed photon doses into isoeffective proton doses. However, the RBE is not constant; it is a dynamic parameter highly influenced by factors such as linear energy transfer, tissue type, biological endpoint, and dose/fraction. Preclinical <em>in vivo</em> proton RBE studies using fractionated doses and late damage endpoints are almost nonexistent. The aim is to test the hypotheses that the RBE varies between single and fractionated doses and that the late damage development differs between proton and photon irradiation using a 6 MV linac as a reference modality in a murine leg model.</div></div><div><h3>Materials and methods</h3><div> <!-->The right hindlimb of unanesthetized mice was irradiated with single or four fractions of protons or 6 MV photons. Over one year after treatment, the mice were analyzed every fourteenth day using a joint contracture assay to investigate severe radiation-induced late damage.</div></div><div><h3>Results</h3><div> <!-->The results indicated a higher RBE for severe late damage endpoint of 1.25 ± 0.06 (1.13–1.36) for fractionated doses than single doses, exhibiting an RBE of 1.16 ± 0.08 (1.00–1.31). The onset of late damage is earlier for protons than photons for doses higher than 47 Gy and fractionated doses above 50 Gy (12.5 Gy per fraction).</div></div><div><h3>Conclusion</h3><div>The findings demonstrate that fractionated doses enhance the RBE for a late damage endpoint and lead to an earlier onset of severe late effects than its photon counterpart <em>in vivo</em>.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110792"},"PeriodicalIF":4.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426068","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":"Elective clinical target volume in early squamous cell anal canal cancer: A systematic review and meta-analysis of the risk of recurrence in untreated upper pelvic and external iliac lymph nodes","authors":"Joanna Socha ,&nbsp;Karol Paciorek ,&nbsp;Krzysztof Bujko","doi":"10.1016/j.radonc.2025.110788","DOIUrl":"10.1016/j.radonc.2025.110788","url":null,"abstract":"<div><h3>Background</h3><div>For squamous-cell carcinoma of the anal canal, most delineation guidelines recommend elective irradiation of the external iliac lymph nodes (LNS) and the upper pelvic LNS (located above the inferior aspect of the sacroiliac joints), regardless of clinical stage. However, neither of these regions is the first-echelon nodal station for anal primaries, and there is no conclusive evidence on the risk of microscopic involvement of these LNS in patients with cT1-2N0 disease. The recommendation to include these regions in the elective CTV for early anal canal cancer is based on historical practice, reflecting lymph node regions in earlier AP-PA fields, rather than conclusive evidence.</div></div><div><h3>Patients and methods</h3><div>A systematic review of the literature and a <em>meta</em>-analysis were performed to determine the rates of regional recurrence in the upper pelvic and external iliac LNS in patients with early anal canal cancer (cT1-2N0) treated with radio(chemo)therapy without elective nodal irradiation (ENI) of these LNS.</div></div><div><h3>Results</h3><div>One prospective and eight retrospective studies were included in the <em>meta</em>-analysis. The pooled weighted rate of regional recurrence in the upper pelvic LNS was 0.9 % (95 % confidence interval [CI]: 0.1–1.8 %) among 495 cT1-2N0 patients treated with ENI not covering these LNS. None of 233 patients treated with ENI not covering external iliac LNS had a recurrence in this region after radio(chemo)therapy.</div></div><div><h3>Conclusion</h3><div>Low risk of regional recurrence in the untreated upper pelvic and external iliac LNS suggests they can be confidently excluded from the elective nodal CTV for patients with early squamous cell anal canal cancer.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110788"},"PeriodicalIF":4.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426067","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}