Radiotherapy and Oncology最新文献

{"title":"“Cardiovascular toxicities of radiotherapy: From practical issues to new perspectives radiotherapy and Oncology” Marianne C. Aznar, Jutta Bergler-Klein, Giuseppe Boriani, David, J. Cutter, Coen Hurkmans, Mario Levis, Teresa Lopez-Fernandez, Alexander R. Lyon, Maja V. Maraldo. Radiother Oncol. 2024 Aug:197:110336. https://doi.org/10.1016/j.radonc.2024.110336.Epub 2024 may 24","authors":"Henk Struikmans , Anna Petoukhova , Mirjam Mast","doi":"10.1016/j.radonc.2024.110583","DOIUrl":"10.1016/j.radonc.2024.110583","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"202 ","pages":"Article 110583"},"PeriodicalIF":4.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473416","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 “Optimizing palliative radiation: Beyond dose escalation in advanced head and neck squamous cell carcinoma”","authors":"Supriya Mallick","doi":"10.1016/j.radonc.2024.110656","DOIUrl":"10.1016/j.radonc.2024.110656","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"202 ","pages":"Article 110656"},"PeriodicalIF":4.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771898","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 commentary on “Cumulative rib fracture risk after stereotactic body radiotherapy in patients with localized non-small cell lung cancer” by Tugcu et al","authors":"Kristian Kirkelund Bentsen , Carsten Brink , Tine Bjørn Nielsen , Rasmus Bank Lynggaard , Pernille Just Vinholt , Tine Schytte , Olfred Hansen , Stefan Starup Jeppesen","doi":"10.1016/j.radonc.2024.110538","DOIUrl":"10.1016/j.radonc.2024.110538","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"202 ","pages":"Article 110538"},"PeriodicalIF":4.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366373","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 Bentsen et al.’s study of rib fracture risk after stereotactic body radiotherapy","authors":"Ahmet Oguz Tugcu , Galip Dogukan Dogru , Cemal Ugur Dursun","doi":"10.1016/j.radonc.2024.110536","DOIUrl":"10.1016/j.radonc.2024.110536","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"202 ","pages":"Article 110536"},"PeriodicalIF":4.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294141","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":"Comparison of HDR-brachytherapy and tomotherapy for the treatment of non-melanoma skin cancers of the head and neck","authors":"Giacomo Feliciani ,&nbsp;Tiziana Licciardello ,&nbsp;Claretta Guidi ,&nbsp;Massimo Del Duca ,&nbsp;Giorgio Mazzotti ,&nbsp;Salvatore Roberto Bellia ,&nbsp;Giulia Ghigi ,&nbsp;Antonino Romeo ,&nbsp;Anna Sarnelli","doi":"10.1016/j.radonc.2024.110703","DOIUrl":"10.1016/j.radonc.2024.110703","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to investigate and compare High Dose Rate Brachytherapy (HDR-BT) with Helical Tomotherapy (HT) treatment plans. The focus is on small target volumes near radiation-sensitive organs in the ocular region, to evaluate the advantages of these techniques in treating skin cancer.</div></div><div><h3>Methods</h3><div>This retrospective observational analysis included patients who underwent skin cancer HDR-BT Freiburg flap treatment between 2019 and 2023. An expert radiation oncologist contoured the planning target volumes (PTVs) and marked their visible extension with a radio-opaque tin wire. Each patient had two treatment plans: an individually shaped HDR-BT surface mold and an HT calculation used specifically for this study. Quality assurance of treatment plan was performed in both HDR-BT and HT. The plans were then compared using organ at risk (OAR) maximum doses and the conformity index CI. Radiation oncologists assessed their quality using their routine workflow evaluation plan.</div></div><div><h3>Results</h3><div>Twelve patients were selected for the inclusion in this study. HT provided more consistent target coverage than HDR-BT, with a statistically significant difference (p &lt; 0.05) at <em>t</em>-test. HT showed higher CIs and maximum dose for the optic nerve, optic chiasm, and lens in the homolateral part. Radiation oncologists preferred the overall quality of HT treatment due to its superior PTV coverage, especially for convex surfaces, while maintaining effective OAR sparing. HDR-BT is preferred when concave surfaces are present.</div></div><div><h3>Conclusion</h3><div>HT offers more conformal treatment, although some OAR parameters are statistically significantly better with HDR-BT, which may also be superior for complex geometries.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"204 ","pages":"Article 110703"},"PeriodicalIF":4.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903155","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":"Development and external validation of a multi-task feature fusion network for CTV segmentation in cervical cancer radiotherapy","authors":"Zhe Wu ,&nbsp;Liming Lu ,&nbsp;Cheng Xu ,&nbsp;Dong Wang ,&nbsp;Bin Zeng ,&nbsp;Mujun Liu","doi":"10.1016/j.radonc.2024.110699","DOIUrl":"10.1016/j.radonc.2024.110699","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>Accurate segmentation of the clinical target volume (CTV) is essential to deliver an effective radiation dose to tumor tissues in cervical cancer radiotherapy. Also, although automated CTV segmentation can reduce oncologists’ workload, challenges persist due to the microscopic spread of tumor cells undetectable in CT imaging, low-intensity contrast between organs, and inter-observer variability. This study aims to develop and validate a multi-task feature fusion network (MTF-Net) that uses distance-based information to enhance CTV segmentation accuracy.</div></div><div><h3>Materials and Methods</h3><div>We developed a dual-branch, end-to-end MTF-Net designed to address the challenges in cervical cancer CTV segmentation. The MTF-Net architecture consists of a shared encoder and two parallel decoders, one generating a distance location information map (D_img) and the other producing CTV segmentation masks. To enhance segmentation accuracy, we introduced a distance information attention fusion module that integrates features from the Dimg into the CTV segmentation process, thus optimizing target delineation. The datasets for this study were from three centers. Data from two centers were used for model training and internal validation, and that of the third center was used as an independent dataset for external testing. To benchmark performance, we also compared MTF-Net to commercial segmentation software in a clinical setting.</div></div><div><h3>Results</h3><div>MTF-Net achieved an average dice score of 84.67% on internal and 77.51% on external testing datasets. Compared with commercial software, MTF-Net demonstrated superior performance across several metrics, including Dice score, positive predictive value, and 95% Hausdorff distance, with the exception of sensitivity.</div></div><div><h3>Conclusions</h3><div>This study indicates that MTF-Net outperforms existing state-of-the-art segmentation methods and commercial software, demonstrating its potential effectiveness for clinical applications in cervical cancer radiotherapy planning.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"204 ","pages":"Article 110699"},"PeriodicalIF":4.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903158","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":"Clinical validation of a prognostic preclinical magnetic resonance imaging biomarker for radiotherapy outcome in head-and-neck cancer","authors":"René M. Winter ,&nbsp;Simon Boeke ,&nbsp;Sara Leibfarth ,&nbsp;Jonas Habrich ,&nbsp;Kerstin Clasen ,&nbsp;Konstantin Nikolaou ,&nbsp;Daniel Zips ,&nbsp;Daniela Thorwarth","doi":"10.1016/j.radonc.2024.110702","DOIUrl":"10.1016/j.radonc.2024.110702","url":null,"abstract":"<div><h3>Purpose</h3><div>To retrain a model based on a previously identified prognostic imaging biomarker using apparent diffusion coefficient (ADC) values from diffusion-weighted magnetic resonance imaging (DW-MRI) in a preclinical setting and validate the model using clinical DW-MRI data of patients with locally advanced head-and-neck cancer (HNC) acquired before radiochemotherapy.</div></div><div><h3>Material and Methods</h3><div>A total of 31 HNC patients underwent T2-weighted and DW-MRI using 3 T MRI before radiochemotherapy (35 x 2 Gy). Gross tumor volumes (GTV) were delineated based on T2-weighted and b500 images. A preclinical model previously revealed that the size of high-risk subvolumes (HRS) defined by a band of ADC-values was correlated to radiation resistance. To validate this model, different bands of ADC-values were tested using two-sided thresholds on the low-ADC histogram flank to determine HRSs inside the GTV and correlated to treatment outcome after three years. The best model was used to fit a logistic regression model. Stratification potential regarding outcome was internally validated using bootstrap, receiver-operator-characteristic (ROC)-analysis, Kaplan-Meier- and Cox-method, and compared to GTV, <span><math><msub><mrow><mi>ADC</mi></mrow><mrow><mi>mean</mi></mrow></msub></math></span> and clinical factors.</div></div><div><h3>Results</h3><div>The best model was defined by <span><math><mn>800</mn><mo>&lt;</mo><mi>A</mi><mi>D</mi><mi>C</mi><mo>&lt;</mo><mn>1100</mn><mo>·</mo><msup><mn>10</mn><mrow><mo>-</mo><mn>6</mn></mrow></msup><mspace></mspace><msup><mtext>mm</mtext><mtext>2</mtext></msup><mo>/</mo><mtext>s</mtext></math></span> and correlated significantly to treatment outcome (p = 0.003). Optimal HRS cut-off value was found to be 5.8 cm³ according to ROC-analysis. This HRS demonstrated highly significant stratification potential (p &lt; 0.001, bootstrap AUC ≥ 0.84) similar to GTV size (p &lt; 0.001, AUC ≥ 0.79), in contrast to <span><math><msub><mrow><mi>ADC</mi></mrow><mrow><mi>mean</mi></mrow></msub></math></span> (p = 0.361, AUC = 0.53).</div></div><div><h3>Conclusions</h3><div>A preclinical prognostic model defined by an ADC-based HRS was successfully retrained and validated in HNC patients treated with radiochemotherapy. After thorough external validation, such functional HRS based on a band of ADC values may in the future allow interventional response-adaptive MRI-guided radiotherapy in online and offline approaches.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"204 ","pages":"Article 110702"},"PeriodicalIF":4.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903136","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":"A controlled study of use and effectiveness of phosphodiesterase-5 inhibitors in long-term survivors after curative radiotherapy for prostate cancer (PCa)","authors":"Alv A. Dahl ,&nbsp;Tom Børge Johannesen ,&nbsp;Ylva Gjelsvik ,&nbsp;Tor Å. Myklebust ,&nbsp;Sophie D. Fosså","doi":"10.1016/j.radonc.2024.110704","DOIUrl":"10.1016/j.radonc.2024.110704","url":null,"abstract":"<div><h3>Background and purpose</h3><div>We lack population-based data on the use and effectiveness of phosphodiesterase- 5inhibitors (PDE-5Is) in post-radiotherapy long-term prostate cancer survivors (PCaSs). In this cross-sectional survey performed 9 years after curative radiotherapy we explored PDE-5I use and the drugs’effectiveness in 1,092 nine-year PCaSs responding to the sexual items of EPIC-26. The findings from PCaSs were compared to those from 2,847 age-similar men from the general population (Norms).</div></div><div><h3>Results</h3><div>13 % of the PCaSs and 9 % of the Norms were Current Users of PDE-5Ies, High sexual interest and, restricted to PCaSs, age below 70 years significantly increased the use of PDE-Is. In PCaSs and Norms, who used PDE-5Is the levels of the six sexual items of EPIC-26 and of the Sexual Domain Summary Score (DSS) were similar. The corresponding differences were large in Never Users of PDE-5Ies. High sexual interest in PCaSs, and use of PDE-5Is were significantly and positively associated with an acceptable level of the sexual domain in EPIC-26 (Score &gt; 40), whereas the association was negative for age &gt; 70 years, reduced health and obesity,</div></div><div><h3>Conclusion</h3><div>At least 1 of 10 long-term post-radiotherapy PCaSs experience “some help” of their erectile dysfunction by use of PDE-5Is. These patients are identified by high sexual interest, age &lt; 70 years and good health During long-term follow-up of PCaSs clinicians are challenged early to identify these, often relatively young men, based on their high sexual interest.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"204 ","pages":"Article 110704"},"PeriodicalIF":4.9,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142897165","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":"ESTRO/EANO recommendation on reirradiation of glioblastoma","authors":"Nicolaus Andratschke ,&nbsp;Astrid Heusel ,&nbsp;Nathalie L. Albert ,&nbsp;Filippo Alongi ,&nbsp;Brigitta G. Baumert ,&nbsp;Claus Belka ,&nbsp;Antonella Castellano ,&nbsp;Frederic Dhermain ,&nbsp;Sara C. Erridge ,&nbsp;Anca-L. Grosu ,&nbsp;Franciscus Lagerwaard ,&nbsp;Slavka Lukacova ,&nbsp;Per Munck af Rosenschold ,&nbsp;Maximilian Niyazi ,&nbsp;Carsten Nieder ,&nbsp;Matthias Preusser ,&nbsp;Marion Smits ,&nbsp;Damien C. Weber ,&nbsp;Wolfgang A Weber ,&nbsp;Michael Weller ,&nbsp;Giuseppe Minniti","doi":"10.1016/j.radonc.2024.110696","DOIUrl":"10.1016/j.radonc.2024.110696","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>Although reirradiation of glioblastoma has a long history of clinical practice, guidance on how to perform it in the context of recent technological advances, modern imaging modalities or systemic therapy is scarce. This joint ESTRO/EANO guideline aims to collect the existing evidence to produce recommendations for safe reirradiation of glioblastoma.</div></div><div><h3>Methods</h3><div>The basis of this ESTRO/EANO clinical practice guideline are nine key questions (KQ) which were formulated by a consortium of radiation-oncologists, radiologists, medical oncologists, neurooncologists, medical physicists and radiation therapists. A systematic review was conducted and the KQ were addressed based on this evidence and expert opinion to draft recommendations and statements which were then voted on in a modified DELPHI process.</div></div><div><h3>Results</h3><div>The DELPHI consensus process resulted in 18 recommendations and nine statements of which all achieved group consensus. Thirteen (48%) were based on available prospective evidence and 14 (52%) on expert opinion. Level of evidence did not exceed “moderate”, reflecting the scarcity of prospective randomized evidence for most aspects of reirradiation. Consensus recommendations and statements reflected aspects of patient selection, imaging for recurrence assessment, target volume delineation, treatment planning, combined modality treatment, and follow-up.</div></div><div><h3>Conclusions</h3><div>Currently, based on the ESTRO/EANO consensus, reirradiation may be considered in selected patients with glioblastoma. GTV definition is based on T1-weighted MR-sequences, while a GTV to CTV margin is not mandatory. A PTV margin of maximum 3 mm is recommended based on the individual mask system and IGRT procedures. A biological effective dose greater than 36 Gy in 2 Gy fractions is recommended. A careful assessment of prognostic factors on survival such as age, interval from initial radiation, large treatment volumes, poor KPS, and poor neurologic/neurocognitive status is essential for making a clinical recommendation.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"204 ","pages":"Article 110696"},"PeriodicalIF":4.9,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143136441","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":"Analysis of patients with locally advanced rectal cancer given neoadjuvant radiochemotherapy with or without RT dose intensification: A multicenter retrospective study – ATLANTIS part I","authors":"Luca Nicosia ,&nbsp;Marco Lorenzo Bonù ,&nbsp;Ilaria Angelicone ,&nbsp;Gianluigi Lunardi ,&nbsp;Rita Marina Niespolo ,&nbsp;Micol Zannetti ,&nbsp;Linda Agolli ,&nbsp;Giuditta Chiloiro ,&nbsp;Angela Romano ,&nbsp;Fatemeh Jafari ,&nbsp;Mahdi Aghili ,&nbsp;Reza Ghalehtaki ,&nbsp;Giampaolo Montesi ,&nbsp;Francesca De Felice ,&nbsp;Filippo De Renzi ,&nbsp;Alessandro Magli ,&nbsp;Jennifer Le Guevelou ,&nbsp;Marco Lupattelli ,&nbsp;Giuseppe Minniti ,&nbsp;Maria Antonietta Gambacorta ,&nbsp;Mattia Falchetto Osti","doi":"10.1016/j.radonc.2024.110701","DOIUrl":"10.1016/j.radonc.2024.110701","url":null,"abstract":"<div><h3>Introduction</h3><div>Preoperative radiochemotherapy (RCHT) is the standard of care for locally advanced rectal cancer (LARC). While there are several data regarding chemotherapy intensification, actually, no reliable data directly comparing different radiotherapy (RT) dose levels are available. The present study aimed to compare intensified RT versus standard dose in patients with LARC.</div></div><div><h3>Materials and methods</h3><div>Data from 12 centers were collected for the current large retrospective study. The primary end-point evaluated whether RT dose intensification was associated with an increased pathological complete response (pCR). The secondary end-points explored the relation between RT dose and interval to surgery, downstaging, and RT-related toxicity. Subgroup analysis according to primary tumor stage was also performed.</div></div><div><h3>Results</h3><div>1028 patients were analysed. All patients received combined RCHT with (364) or without (664) a RT boost. Patients underwent surgery after a median 10 weeks (IQ range 5–28). The overall pCR rate was 21.5 %. In the boost and no-boost groups, the pCR was 26.6 % (97) and 17 % (114) (p = 0.00), respectively. As a subgroup analysis, the pCR stratified by interval to surgery was 10 %, 23 %, 26.3 %, and 39.3 % (p &lt; 0.000) in the boost group versus 10.6 %, 20.8 %, 19.3 %, and 20.4 % (p = 0.018) in the no-boost group. cT3 patients operated on ≥ week 11 and cT4 patients, regardless of time to surgery, received a significant benefit by the RT boost in terms of pCR rate. Patients in the boost group had a higher rate of grade ≥ 3 acute gastrointestinal toxicities (6 % vs. 1.7 %; p = 0.003).</div></div><div><h3>Conclusion</h3><div>Our results suggest that RT dose intensification (boost) in LARC might significantly increase the pCR rate, although with a small increase in acute toxicity. While pCR seems only partially improved by prolonged time to surgery in the no-boost group, a progressive and significant pCR improvement in patients treated with boost over time was observed. RT boost seems to be beneficial only in more advanced primary tumors.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"204 ","pages":"Article 110701"},"PeriodicalIF":4.9,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143136642","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}