Radiotherapy and Oncology最新文献

{"title":"Dosimetric evaluation of variation in Library of plans selection for cervical cancer radiotherapy","authors":"Yvonne J.M. de Hond,&nbsp;Paul M.A. van Haaren,&nbsp;An-Sofie E. Verrijssen,&nbsp;Rob H.N. Tijssen,&nbsp;Coen W. Hurkmans","doi":"10.1016/j.radonc.2025.110835","DOIUrl":"10.1016/j.radonc.2025.110835","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim was to determine whether differences in treatment plan selection methods from a Library-of-Plans (LoP) on cone-beam computed tomography (CBCT) leads to significant discrepancies in total accumulated dose.</div></div><div><h3>Methods</h3><div>Ten cervical cancer patients were retrospectively analyzed on plan selection and dose distribution. Dose accumulation was performed using two different plan selection methods. 1) The clinical plan selections (i.e. plans as selected during actual treatment) and 2) automatic plan selection, which was based on the largest overlap between LoP clinical target volume (CTV) and (auto-)delineated CTV on CBCT. To evaluate the influence of daily plan selection on the treatment dose, the dose of selected plans was calculated on the daily CBCTs for all fractions and accumulated on the CT. The predefined clinical goals were used to determine if there was a relevant dose difference between the clinical LoP-selection, automatic LoP-selection, and selecting solely the default plan (i.e. full bladder plan with similar margins).</div></div><div><h3>Results</h3><div>Different methods of LoP-plan selection did not result in significant dose differences. However, the default non-LoP plan resulted in significant dose differences compared to LoP-selection methods, with a reduced target coverage (99 % vs 100 %) and higher V40Gy to the rectum (55 % vs 44 %) compared to the clinical selection, respectively.</div></div><div><h3>Conclusions</h3><div>LoP is robust to variations in plan selection and LoP outperforms non-LoP approaches in terms of target coverage and organs-at-risk (OAR) sparing. Therefore, LoP is a safe and efficient alternative to online adaptive replanning, particularly for longer fractionation schemes.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110835"},"PeriodicalIF":4.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562120","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":"Severity of internal lymphedema in unilateral or bilateral radiotherapy patients: An exploratory study","authors":"Coralie Arends ,&nbsp;Pieter de Veij Mestdagh ,&nbsp;Abrahim Al-Mamgani ,&nbsp;Martijn Stuiver ,&nbsp;Lisette van der Molen ,&nbsp;Michiel van den Brekel","doi":"10.1016/j.radonc.2025.110834","DOIUrl":"10.1016/j.radonc.2025.110834","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Bilateral elective nodal irradiation (ENI) is part of the standard treatment for most head and neck cancers (HNC) that are treated with primary (chemo)radiotherapy. Recent studies indicate that unilateral radiotherapy can reduce radiation-related toxicities and improve quality of life. This study examines whether there is a difference in the prevalence and severity of internal lymphedema between patients with unilateral or bilateral radiotherapy.</div></div><div><h3>Materials and methods</h3><div>Internal lymphedema was scored on available laryngoscopy videos, using the revised Patterson scale, in patients included in a previous prospective study comparing uni- versus bilateral radiotherapy. Analysis was performed by descriptively comparing the variation in location and severity of internal lymphedema, and by calculating rank biserial correlation coefficients.</div></div><div><h3>Results</h3><div>Out of 100 potentially eligible patients, 41 patients with available good-quality laryngoscopy videos were included. Of these, twenty-three patients were treated with unilateral radiotherapy and 18 with bilateral radiotherapy. The median internal lymphedema score for all patients was 7 (range: 0–24). For the patients with unilateral radiotherapy, the median was 6 (range: 0–19), compared to 9.5 (range: 0–24) for the bilateral group. Nine patients had no internal lymphedema, six in the unilateral group and three in the bilateral group. The rank biserial correlation coefficients showed a negative correlation between lymphedema and unilateral radiotherapy for all regions in the larynx (range −0.19 to −0.63), and for the total lymphedema score −0.92 (95 % CI −0.97 to −0.82).</div></div><div><h3>Conclusion</h3><div>Internal lymphedema prevalent and severity are lower after unilateral radiotherapy for head and neck cancer, compared to the current standard of care bilateral radiotherapy.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110834"},"PeriodicalIF":4.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577287","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":"Predicting 30-day mortality with routine blood tests in patients undergoing palliative radiation therapy: A comparison of logistic regression and gradient boosting models","authors":"Tae Hoon Lee ,&nbsp;Sang Hoon Seo ,&nbsp;Hyunju Shin ,&nbsp;Hee Jung Son ,&nbsp;Kyunga Kim ,&nbsp;Yong Chan Ahn ,&nbsp;Hongryull Pyo ,&nbsp;Do Hoon Lim ,&nbsp;Hee Chul Park ,&nbsp;Won Park ,&nbsp;Dongryul Oh ,&nbsp;Jae Myoung Noh ,&nbsp;Jeong Il Yu ,&nbsp;Won Kyung Cho ,&nbsp;Nalee Kim ,&nbsp;Kyungmi Yang ,&nbsp;Tae Gyu Kim ,&nbsp;Haeyoung Kim","doi":"10.1016/j.radonc.2025.110830","DOIUrl":"10.1016/j.radonc.2025.110830","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to estimate the 30-day mortality (30D_M) and compare models for 30D_M prediction in patients undergoing palliative radiation therapy (RT).</div></div><div><h3>Materials and methods</h3><div>Data from 3,756 patients who underwent palliative RT between 2018 and 2020 at two institutions were retrospectively reviewed. From one institution, 3,315 patients were randomly assigned to the training (N = 2,652) and internal validation (N = 663) cohorts. The remaining 441 patients from the other institution constituted the external validation cohort. Nineteen features, including seven blood test features, were extracted from medical records. For 30D_M prediction, 4 models were constructed: logistic regression comprising all features (LRM-A) and 7 blood test features (LRM-B) and gradient boosting using all features (GBM-A) and 7 blood test features (GBM-B).</div></div><div><h3>Results</h3><div>The 30D_M rates were 10.6 %, 11.2 %, and 17.5 % in the training, internal validation, and external validation cohorts, respectively. GBM-B demonstrated a good value for the area under the receiver operating characteristic curve (AUC) (0.830–0.863). Among the four models, GBM-A exhibited the highest AUC values, although GBM-B still generally outperformed LRM-A and LRM-B. The 30D_M rates significantly differed across the four prognostic groups according to the quantile values of predictive probability of GBM-B: 0–0.8 % (1st quantile), 1.2–3.4 % (2nd quantile), 8.7–12.9 % (3rd quantile), and 31.1–36.6 % (4th quantile), respectively.</div></div><div><h3>Conclusions</h3><div>The 30D_M rates were successfully stratified into distinct prognostic groups by using the GBM-B model. The model could serve as a straightforward and objective tool for predicting mortality in patients undergoing palliative RT.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110830"},"PeriodicalIF":4.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562119","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":"Commentary on feliciani Giacomo et al.’s study of comparison of HDR-brachytherapy and tomotherapy for the treatment of non-melanoma skin cancers of the head and neck","authors":"Elisa Placidi ,&nbsp;Bruno Fionda ,&nbsp;Enrico Rosa ,&nbsp;Luca Tagliaferri ,&nbsp;Marco De Spirito","doi":"10.1016/j.radonc.2025.110826","DOIUrl":"10.1016/j.radonc.2025.110826","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110826"},"PeriodicalIF":4.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543331","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)00106-9","DOIUrl":"10.1016/S0167-8140(25)00106-9","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"205 ","pages":"Article 110811"},"PeriodicalIF":4.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527105","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":"Novel approaches to fiducial-guided SBRT for ultra-central thoracic oligometastases","authors":"Rajesh Thomas,&nbsp;Calvin Sidhu,&nbsp;Colin Tang","doi":"10.1016/j.radonc.2025.110827","DOIUrl":"10.1016/j.radonc.2025.110827","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110827"},"PeriodicalIF":4.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543332","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":"‘iCycle-pBAO’: Automated patient-specific beam-angle selection in proton therapy applied to oropharyngeal cancer","authors":"W. Kong ,&nbsp;M. Huiskes ,&nbsp;S.J.M. Habraken ,&nbsp;E. Astreinidou ,&nbsp;C.R.N. Rasch ,&nbsp;B.J.M. Heijmen ,&nbsp;S. Breedveld","doi":"10.1016/j.radonc.2025.110799","DOIUrl":"10.1016/j.radonc.2025.110799","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to develop a fully-automated patient tailored beam-angle optimisation approach for intensity-modulated proton therapy (IMPT). For oropharynx cancer patients, the dosimetric impact of increasing the number of fields from 4 to 12 was systematically assessed.</div></div><div><h3>Approach</h3><div>A total-beam-space heuristic was developed to simultaneously select optimal patient specific candidate beam directions, according to a cost-function that penalises dose to OARs involved in clinically used NTCPs. The method was dosimetrically validated by comparisons with fixed 4- and 6-field clinical beam-angle templates and equiangular configurations, including 72-field equiangular. The latter served as dosimetric ‘Utopia’ benchmark for the other evaluated beam configurations.</div></div><div><h3>Main result</h3><div>Using 4 optimised patient-specific fields instead of the clinical 4-field beam-angle template resulted in (xerostomia NTCP + dysphagia NTCP)-reductions for all patients, with averages of 3.0 %-point (range: 1.1–5.8) for grade 2 toxicity and 1.2 %-point (range: 0.3–2.8) for grade 3. For 6 fields these reductions were 2.4 %-point (range: 0.0–5.0) and 0.8 %-point (range: −0<em>.</em>1–2.1). Xerostomia NTCPs significantly reduced with increasing numbers of patient-specific fields with a levelling off at 10–12 fields with NTCP values that closely approached those for Utopia 72-field equiangular plans. Beam angle optimisation took 52 min.</div></div><div><h3>Conclusion</h3><div>Automated, patient-tailored beam-angle optimisation could enhance IMPT plans at acceptable optimisation times. Improvements compared to the clinical beam-angle templates were highly patient-specific.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110799"},"PeriodicalIF":4.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537779","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":"Proton FLASH-Arc therapy: Bridging feasibility to clinical Utility","authors":"Jiao Yu,&nbsp;Xin Chen","doi":"10.1016/j.radonc.2025.110807","DOIUrl":"10.1016/j.radonc.2025.110807","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110807"},"PeriodicalIF":4.9,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520380","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 evaluation and tumor shrinkage pattern post-SBRT for renal cell carcinoma","authors":"Lingling Cai ,&nbsp;Kaicong Chen ,&nbsp;Qiwen Pan ,&nbsp;Xinyue Zhang ,&nbsp;Ruiqi Liu ,&nbsp;Yang Liu ,&nbsp;Jianming Gao ,&nbsp;Zhiling Zhang ,&nbsp;Fangjian Zhou ,&nbsp;Pei Dong ,&nbsp;Li Tian ,&nbsp;Liru He","doi":"10.1016/j.radonc.2025.110802","DOIUrl":"10.1016/j.radonc.2025.110802","url":null,"abstract":"<div><h3>Purpose</h3><div>Despite the promising application of stereotactic body radiotherapy (SBRT) in renal cell carcinoma (RCC), the optimal time and method for assessing tumor responses to SBRT remain unclear. We aimed to compare the utility of Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and modified RECIST (mRECIST) in RCC response assessment and clarify the tumor shrinkage pattern post-SBRT.</div></div><div><h3>Materials and methods</h3><div>We retrospectively studied patients with RCC treated with SBRT at our institution between November 2016 and December 2021. Baseline and follow-up images were evaluated using RECIST 1.1 and mRECIST. Landmark analyses were conducted to assess the association between local control and tumor response status evaluated using the above two criteria.</div></div><div><h3>Results</h3><div>Ninety-one RCC patients with 103 primary or metastatic lesions were included. Objective response rates (ORRs) were higher and pseudoprogression was less commonly assessed by mRECIST than by RECIST 1.1 within each time period. The median shrinkage rate of bone lesions was much lower using RECIST 1.1 than that using mRECIST (−0.8 vs −1.7 cm/year). According to both criteria, the ORR tended to be stable on the 9–12 months post-SBRT. Patients with a tumor response at 9–12 months had a lower probability of infield recurrence using mRECIST (P = 0.047), this was not observed using RECIST 1.1 (P = 0.061).</div></div><div><h3>Conclusion</h3><div>mRECIST results in an earlier and more pronounced response evaluation compared to RECIST 1.1 in patients with RCC treated with SBRT. Nine to twelve months post-SBRT may serve as an early landmark for tumor response evaluation by mRECIST.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110802"},"PeriodicalIF":4.9,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493433","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":"Association between dose to cardiac structures and overall survival: A multivariable analysis in a large, multi-institutional database of stage III NSCLC patients with external validation","authors":"Miguel Garrett Fernandes ,&nbsp;Johan Bussink ,&nbsp;Robin Wijsman ,&nbsp;Zeno Gouw ,&nbsp;Albrecht Weiß ,&nbsp;Nanna M. Sijtsema ,&nbsp;Richard Canters ,&nbsp;Andrew Hope ,&nbsp;Dirk De Ruysscher ,&nbsp;Esther G.C. Troost ,&nbsp;Jan-Jakob Sonke ,&nbsp;Barbara Stam ,&nbsp;René Monshouwer","doi":"10.1016/j.radonc.2025.110821","DOIUrl":"10.1016/j.radonc.2025.110821","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>Inconsistencies in identifying dose-limiting cardiovascular substructures for treating stage III non-small cell lung cancer (NSCLC) have hindered the implementation of cardiac sparing treatment planning guidelines. This study aims to address these inconsistencies by performing a multivariable survival analysis with overall survival as the endpoint using a large, multinational database, followed by external validation.</div></div><div><h3>Materials and Methods</h3><div>Clinical and dosimetric parameters from 1587 stage III NSCLC patients treated at five institutes were analyzed. The whole heart, four cardiac chambers, great vessels and their combinations were considered. The dataset was divided into a training set (four institutes) and a test set (one institute). The optimal parameter set was identified through cross-validation, and the resulting multivariable Cox regression model was externally validated using the test set. Adjusted hazard ratios (aHRs) for all cardiovascular parameters were evaluated.</div></div><div><h3>Results</h3><div>The strongest associations were found for low Dx% parameters. However, their incremental contribution to model performance, compared to clinical and lung dosimetric parameters only, was low, with small effect sizes. Specifically, the cardiovascular parameter identified by parameter selection was Left Side D5% (aHR: 1.007 Gy⁻¹, 95 % CI: 1.004 – 1.010 Gy⁻¹, <em>p</em> &lt; 0.0001), which provided a slight improvement in model concordance index of 0.0062 (95 % CI: 0.0000–0.0127) in the training set and 0.0037 (95 % CI: −0.0200–0.0280) in the test set.</div></div><div><h3>Conclusions</h3><div>Although significant associations between cardiovascular parameters and survival were found, their small effect sizes should be considered when prioritizing cardiac sparing in stage III NSCLC treatment.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110821"},"PeriodicalIF":4.9,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493423","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}