Radiotherapy and Oncology最新文献

{"title":"Revisiting hydrogen peroxide as radiosensitizer for solid tumor cells","authors":"F. Geirnaert ,&nbsp;L. Kerkhove ,&nbsp;A. Rifi ,&nbsp;T. Everaert ,&nbsp;J. Sanders ,&nbsp;J. Coppens ,&nbsp;H. Vandenplas ,&nbsp;C. Corbet ,&nbsp;T. Gevaert ,&nbsp;I. Dufait ,&nbsp;M. De Ridder","doi":"10.1016/j.radonc.2024.110692","DOIUrl":"10.1016/j.radonc.2024.110692","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Tumor hypoxia is the principal cause of clinical radioresistance. Despite its established role as radiosensitizer, hydrogen peroxide (H₂O₂) encounters clinical limitations due to stability and toxicity concerns. Recent advancements in drug delivery combine H₂O₂ with sodium hyaluronate (SH), enabling intratumoral administration of H₂O₂. This study investigates the radiomodulatory pathways of Kochi Oxydol-Radiation for Unresectable Carcinomas (KORTUC) (H₂O₂ + SH) under hypoxia.</div></div><div><h3>Materials and methods</h3><div>CT26 and 4T1 tumor cells were exposed to H₂O_2, SH and KORTUC under hypoxic conditions. Toxicity levels were determined using MTT and live-cell analysis. KORTUC’s radiomodulatory properties were evaluated by colony formation assay and in spheroids. Reactive oxygen species (ROS) levels, DNA damage, apoptosis and ferroptosis were analyzed using flow cytometry. Oxygen consumption rate (OCR) and mitochondrial complex activity were assessed by Seahorse Analyzer. Oxygen levels were investigated using fiber-optic sensors. The in vitro findings were validated in CT26-bearing mice.</div></div><div><h3>Results</h3><div>KORTUC demonstrated less cytotoxicity than H₂O₂-alone. KORTUC radiosensitized hypoxic tumor cells in a dose-dependent manner with enhancement ratios of 3.1 (CT26) and 2.7 (4T1). Dose-dependent OCR reduction following KORTUC exposure correlated with complex I and II inhibition, accompanied by mitochondrial ROS elevation. KORTUC injection into a 2D hypoxic tumor model surged O₂ levels. KORTUC radiosensitized CT26-tumors, delaying growth by 14 days.</div></div><div><h3>Conclusions</h3><div>SH in KORTUC mitigates H₂O₂ cytotoxicity. We demonstrate that KORTUC overcomes hypoxia-induced radioresistance through inhibition of OCR, via complex I- and II-blockade, leading to tumor reoxygenation. Understanding KORTUC’s pathways is essential for developing effective cancer combination therapies.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"203 ","pages":"Article 110692"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882736","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 definitive radiotherapy outcomes between younger and older patients with high- or very-high-risk prostate cancer","authors":"Yong-Hyub Kim ,&nbsp;Jae-Uk Jeong ,&nbsp;Jung-Ho Yang ,&nbsp;Taek-Keun Nam ,&nbsp;Ju-Young Song ,&nbsp;Mee Sun Yoon ,&nbsp;Shinhaeng Cho ,&nbsp;Sung-Ja Ahn","doi":"10.1016/j.radonc.2025.110763","DOIUrl":"10.1016/j.radonc.2025.110763","url":null,"abstract":"<div><h3>Background and purpose</h3><div>This study aimed to compare the oncologic outcomes of definitive intensity-modulated radiotherapy (IMRT) between younger and older high- or very-high-risk prostate cancer patients using propensity score matching (PSM) and competing risk analysis (CRA).</div></div><div><h3>Materials and methods</h3><div>A total of 569 patients were included in this analysis: 265 younger than 75 years (Group A) and 304 aged 75 years or above (Group B). All patients received IMRT with a daily fraction of 2.2 Gy, administered over 34 fractions, resulting in a total dose of 74.8 Gy. The primary outcomes included biochemical-failure-free survival (BCFFS), distant-metastasis-free survival (DMFS), clinical-failure-free survival (CFFS), cancer-specific survival (CSS), and overall survival (OS). PSM was used to balance the groups, employing a full matching method, while CRA distinguished between cancer-specific events and non-cancer-specific events.</div></div><div><h3>Results</h3><div>Before PSM, the 7-year BCFFS, DMFS, CFFS, CSS, and OS rates in Groups A and B were 83.0 % vs. 66.7 % (<em>p</em> = 0.011), 84.1 % vs. 68.0 % (<em>p</em> = 0.002), 82.1 % vs. 66.7 % (<em>p</em> = 0.008), 95.6 % vs. 97.3 % (<em>p</em> = 0.704), and 87.4 % vs. 68.6 % (<em>p</em> &lt; 0.001), respectively. After PSM, the 7-year survival rates were comparable between both groups for all outcomes except OS. CRA revealed that cancer-specific events were more frequent in Group A, whereas non-cancer-specific events predominated in Group B.</div></div><div><h3>Conclusions</h3><div>Both PSM and CRA indicated that definitive IMRT can be safely and effectively delivered to older patients with high- or very high-risk prostate cancer, achieving oncologic outcomes comparable to those in younger patients.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"205 ","pages":"Article 110763"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080925","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":"Ninety-day mortality following curative intent radiotherapy for stage I-III lung cancer in the Netherlands","authors":"Krista C.J. van Doorn-Wink ,&nbsp;Pieter E. Postmus ,&nbsp;Dirk de Ruysscher ,&nbsp;Ronald A.M. Damhuis","doi":"10.1016/j.radonc.2024.110661","DOIUrl":"10.1016/j.radonc.2024.110661","url":null,"abstract":"<div><h3>Background and purpose</h3><div>The 90-day mortality following lung cancer treatment is a common performance indicator. The aim of this study was to investigate 90-day mortality following (chemo)radiotherapy for stage I–III lung cancer to evaluate the applicability of this outcome indicator in this patient population.</div></div><div><h3>Materials and methods</h3><div>The Netherlands National Cancer Registry was queried for this retrospective population-based study. Early mortality rates from the start and end of radiotherapy are reported with 95% confidence intervals (CI). The association between clinical characteristics and 90-day mortality was evaluated with multivariable logistic regression analysis.</div></div><div><h3>Results</h3><div>18,355 Patients treated between 2015 and 2020 were included. The 90-day mortality was 2.56% in stages I-II and 4.60% in stage III, was significantly higher in males, elderly patients and patients with a poor performance status and independent of facility volume. In stage I-II, 90-day mortality was lower after stereotactic versus conventional radiotherapy (2.0% versus 5.25%, OR 0.5 (95%CI 0.4–0.7)). In stage III, mortality decreased from 5.26% in 2015–2016 to 3.73% in 2019–2020 (OR 0.7 (95% CI 0.5–0.9)) and was lower after concurrent versus sequential chemoradiotherapy (3.4% versus 5.9%, OR 1.5 (95%CI 1.2–1.9)). Early mortality increased to 3.20% in stages I-II and 6.70% in stage III when calculated from the end of radiotherapy.</div></div><div><h3>Conclusion</h3><div>Short-term mortality rates following curative intent radiotherapy for lung cancer in the Netherlands are low and independent of facility volume. It was demonstrated that 90-day mortality is an arguable indicator to monitor radiotherapy quality and that standardization of definitions and relevant case-mix factors is warranted.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"203 ","pages":"Article 110661"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142795087","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":"Is the omission of the external iliac or upper pelvic lymph nodes from elective irradiation safe in selected anal canal squamous cell cancers?","authors":"Karol Paciorek ,&nbsp;Anna Zawadzka ,&nbsp;Lucyna Pietrzak ,&nbsp;Bartłomiej Skrzypiec ,&nbsp;Wojciech Michalski ,&nbsp;Joanna Socha ,&nbsp;Krzysztof Bujko","doi":"10.1016/j.radonc.2024.110682","DOIUrl":"10.1016/j.radonc.2024.110682","url":null,"abstract":"<div><h3>Background</h3><div>Guidelines recommend elective irradiation of the external iliac and upper pelvic lymph nodes (LNs) regardless of clinical stage, but the supporting evidence for this recommendation is limited.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of 68 consecutive patients with squamous cell carcinoma of the anal canal who underwent volumetric modulated arc therapy chemoradiation, excluding external iliac LNs from elective irradiation. In patients with negative bilateral inguinal LNs, both external iliac regions were omitted, while in those with unilateral positive inguinal LNs, only the ipsilateral external iliac region was included and the contralateral side was omitted. For patients with early-stage tumours, the cranial border of elective irradiation was located in the inferior aspect of the sacroiliac joints.</div></div><div><h3>Results</h3><div>The median follow-up was 4.0 years. Six patients (9 %) experienced recurrence of the primary tumour and three (4 %) developed distant metastases. No isolated nodal recurrences were seen in the LNs that were positive at baseline, or in or outside electively irradiated regions. Notably, no recurrences were seen in any of the 124 external iliac regions omitted from elective irradiation across the 68 patients, or in the upper pelvic region among the subgroup of 33 patients where the cranial irradiation border was at the bottom of the sacroiliac joint. Reducing the elective irradiation volume significantly decreased the dose–volume parameters for organs-at-risk.</div></div><div><h3>Conclusions</h3><div>The present findings suggest that omitting the external iliac and upper pelvic LNs from elective irradiation is safe for selected patients and allows dose reduction in organs-at-risk.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"203 ","pages":"Article 110682"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839083","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":"Interferon signaling is enhanced by ATR inhibition in glioblastoma cells irradiated with X-rays, protons or carbon ions","authors":"Gro Elise Rødland ,&nbsp;Mihaela Temelie ,&nbsp;Adrian Eek Mariampillai ,&nbsp;Ana Maria Serban ,&nbsp;Nina Frederike Jeppesen Edin ,&nbsp;Eirik Malinen ,&nbsp;Lilian Lindbergsengen ,&nbsp;Antoine Gilbert ,&nbsp;François Chevalier ,&nbsp;Diana I. Savu ,&nbsp;Randi G. Syljuåsen","doi":"10.1016/j.radonc.2024.110669","DOIUrl":"10.1016/j.radonc.2024.110669","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Interferon (IFN) signaling plays an important role in antitumor immune responses. Inhibitors of the DNA damage response, such as ATR inhibitors, can increase IFN signaling upon conventional radiotherapy with X-rays. However, it is not known whether such inhibitors also enhance IFN signaling after irradiation with high linear energy transfer (LET) particles.</div></div><div><h3>Materials and methods</h3><div>Human glioblastoma U-251 and T98G cells were irradiated with X-rays, protons (LET: 4.8 and 41.9 keV/µm) and carbon ions (LET: 28 and 73 keV/µm), with and without ATR inhibitor (VE-822) or ATM inhibitor (AZD1390). DNA damage signaling and cell cycle distribution were analyzed by immunoblotting and flow cytometry, and radiosensitivity was assessed by clonogenic survival assay. IFN-β secretion was measured by ELISA, and STAT1 activation was examined by immunoblotting.</div></div><div><h3>Results</h3><div>High-LET protons and carbon ions caused stronger activation of the DNA damage response compared to low-LET protons and X-rays at similar radiation doses. G2 checkpoint arrest was abrogated by the ATR inhibitor and prolonged by the ATM inhibitor after all radiation types. The inhibitors increased radiosensitivity, as measured after X- and carbon ion irradiation. ATR inhibition increased IFN signaling following both low-LET and high-LET irradiation. ATM inhibition also increased IFN signaling, but to a lesser extent. Notably, both cell lines secreted significantly more IFN-β when the inhibitors were combined with high-LET compared to low-LET irradiation.</div></div><div><h3>Conclusion</h3><div>These findings indicate that DNA damage response inhibitors can enhance IFN signaling following X-, proton and carbon ion irradiation, with a strong positive dependency on LET.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"203 ","pages":"Article 110669"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829754","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":"Risk reduction of radiation-induced aspiration by sparing specific aspiration-related-organs at risk; an in silico feasibility study","authors":"Hans Paul van der Laan ,&nbsp;Agata Gawryszuk ,&nbsp;Arjen van der Schaaf,&nbsp;Johannes A. Langendijk","doi":"10.1016/j.radonc.2024.110698","DOIUrl":"10.1016/j.radonc.2024.110698","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the feasibility and benefit of NTCP optimized aspiration-prevention treatment planning by sparing specific aspiration related organs at risk, and to assess the impact of baseline complaints on the planning results.</div></div><div><h3>Materials and Methods</h3><div>This in silico planning study included 30 HNC patients who were previously treated with definitive radiotherapy. New fully automated plans, allowing for sparing specific aspiration related organs at risk, were optimised directly on normal tissue complication probability (NTCP) models for common toxicities: xerostomia and dysphagia. Optimisation was performed with and without aspiration-prevention, i.e., with and without specific sparing of recently identified aspiration-related muscles, and with and without the assumption of existing baseline complaints.</div></div><div><h3>Results</h3><div>All plans complied with the pre-defined treatment planning quality criteria and were successful in limiting the risk of xerostomia and dysphagia. Aspiration-prevention VMAT, optimized using the additional NTCP model for aspiration, significantly reduced the estimated risk of late aspiration (p &lt; 0.001) in all 30 patients when compared to plans without NTCP optimisation for late aspiration. The predicted risk of late aspiration was reduced even further when baseline aspiration was assumed present during optimisation, resulting in an average risk reduction of 13.3 % versus 8.3 % in plans assuming no aspiration at baseline. Aspiration-prevention did not reduce overall plan quality and maintained NTCP values obtained for various other toxicities.</div></div><div><h3>Conclusion</h3><div>Sparing specific aspiration-related organs at risk has the potential to significantly reduce the risk of late RT-induced aspiration, especially in patients who experience aspiration already at baseline.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"203 ","pages":"Article 110698"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882745","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 of the time of day of chemoradiotherapy and durvalumab with tumor control in lung cancer","authors":"Matthew T. McMillan ,&nbsp;Annemarie Shepherd ,&nbsp;Alissa J. Cooper ,&nbsp;Adam J. Schoenfeld ,&nbsp;Abraham J. Wu ,&nbsp;Charles B. Simone II ,&nbsp;Puneeth Iyengar ,&nbsp;Daphna Y. Gelblum ,&nbsp;Jamie E. Chaft ,&nbsp;Daniel R. Gomez ,&nbsp;Narek Shaverdian","doi":"10.1016/j.radonc.2024.110658","DOIUrl":"10.1016/j.radonc.2024.110658","url":null,"abstract":"<div><h3>Background/purpose</h3><div>The circadian clock governs the expression of genes related to immunity and DNA repair. We investigated whether the time of day of radiotherapy and/or systemic therapy infusions (chemotherapy or anti-PD-L1) are associated with disease control and survival in locally advanced non-small cell lung cancer (LA-NSCLC).</div></div><div><h3>Materials/methods</h3><div>178 consecutive patients with inoperable LA-NSCLC who received definitive chemoradiotherapy followed by durvalumab between 5/2017–8/2022 were reviewed. Outcomes evaluated included progression-free survival (PFS), distant metastasis-free survival (DMFS), locoregional control (LRC), and overall survival (OS).</div></div><div><h3>Results</h3><div>At a median follow up of 48.0 mo from durvalumab initiation, median PFS and OS were 26.2 mo and 50.0 mo, respectively. Median LRC and DMFS were not reached and 41.0 mo, respectively. Receiving &gt; 50 % (N = 23) versus ≤ 50 % (N = 155) of radiotherapy treatments within 3 h of sunset was associated with younger age; otherwise, there were no other differences between cohorts. There were no significant differences in characteristics between patients who received &gt; 50 % (N = 23) versus ≤ 50 % (N = 155) of durvalumab infusions within 3 h of sunset. On multivariable analysis, receiving &gt; 50 % of radiotherapy treatments within 3 h of sunset was independently associated with reduced risk for progression (HR 0.39, p = 0.017) and distant metastasis (HR 0.27, p = 0.007); conversely, receiving &gt; 50 % of durvalumab infusions within 3 h of sunset was independently associated with increased risk for distant metastasis (HR 2.13, p = 0.025). The timing of chemotherapy was not associated with disease outcomes.</div></div><div><h3>Conclusion</h3><div>The time of day of radiotherapy and durvalumab infusion may be associated with disease control in LA-NSCLC, and the optimal time of treatment depends on the treatment modality.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"203 ","pages":"Article 110658"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771896","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":"Deglutition preservation after swallowing (SWOARs)-sparing IMRT in head and neck cancers: definitive results of a multicenter prospective study of the Italian Association of Radiotherapy and Clinical Oncology (AIRO)","authors":"Stefano Ursino ,&nbsp;Giulia Malfatti ,&nbsp;Francesca De Felice ,&nbsp;Pierluigi Bonomo ,&nbsp;Isacco Desideri ,&nbsp;Pierfrancesco Franco ,&nbsp;Francesca Arcadipane ,&nbsp;Caterina Colosimo ,&nbsp;Rosario Mazzola ,&nbsp;Marta Maddalo ,&nbsp;Riccardo Morganti ,&nbsp;Giacomo Fiacchini ,&nbsp;Salvatore Coscarelli ,&nbsp;Maurizio Bartolucci ,&nbsp;Marco De Vincentis ,&nbsp;Diletta Angeletti ,&nbsp;Franca De Biase ,&nbsp;Elsa Juliani ,&nbsp;Fabio Di Martino ,&nbsp;Alessia Giuliano ,&nbsp;Fabiola Paiar","doi":"10.1016/j.radonc.2024.110651","DOIUrl":"10.1016/j.radonc.2024.110651","url":null,"abstract":"<div><h3>Background</h3><div>To investigate changes of objective instrumental measures and correlate with patient reported outcomes (PROs) of radiation-induced dysphagia (RID) after swallowing organs at risk (SWOARs)-sparing IMRT.</div></div><div><h3>Methods</h3><div>Patients (pts) underwent Fiberoptic Endoscopic Evaluation of Swallowing (FEES), Videofluoroscopy (VFS) and M.D. Anderson Dysphagia Inventory (MDADI) questionnaire at baseline, 6 and 12 months after treatment. They were categorized in two groups: MDADI-C ≥ 80 and MDADI-C &lt; 80. Pharyngeal residue (PR) and penetration (P) or aspiration (A) were considered as surrogate of RID.</div></div><div><h3>Results</h3><div>Between 2016 and 2022 we enrolled 75 pts, 40 (53 %) MDADI-C ≥ 80 and 35 (47 %) MDADI-C &lt; 80 at baseline.</div><div>Among MDADI-C ≥ 80 the mean baseline PR score at FEES was 0,42 rising to 1,36 at 6 months (p = 0,001) and stabilizing to 1,15 at 12 months (p = 0,21); indeed, the mean baseline PR score at VFS was 0,55 rising to 1 at 6 months (p = 0,069) and slightly dropping to 0,7 at 12 months (p = 0,069). Among MDADI-C &lt; 80 the mean baseline PR score at FEES was 0,56 rising to 1,07 at 6 months (p = 0,012) and stabilizing to 1,07 at 12 months (p = 0,99); indeed the mean baseline PR score at VFS was 0,67 rising to 1,19 at 6 months (p = 0,04) and dropping to 0,78 at 12 months (p = 0,04). No correlation was found between PROs and objective measures.</div></div><div><h3>Conclusion</h3><div>Our results show optimal acceptable deglutition preservation from major complications after SWOARs-sparing IMRT by means of low objective scores in both MDADI-C groups. Lack of correlation between PROs and objective measures suggest that referred RID is likely associated to persistence of SWOARs inflammation rather than to a real impairment of function.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"203 ","pages":"Article 110651"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710917","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":"Randomized trials: When scientific rigor meets field reality","authors":"J.M. Hannoun-Levi ,&nbsp;A. Savignoni ,&nbsp;J. Lemonnier ,&nbsp;Youlia Kirova","doi":"10.1016/j.radonc.2024.110659","DOIUrl":"10.1016/j.radonc.2024.110659","url":null,"abstract":"<div><div>Results from prospective randomized trial results are required to provide practice-changing level-1 evidence. However, if such a trial is not feasible, we should not accept that consequently practice could not change. We discuss hereby a pragmatically approach based on methodological alternatives.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"203 ","pages":"Article 110659"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791775","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":"Routine review of patient-reported outcome data influences radiotherapy care: IMPROVE study results","authors":"Khinh Ranh Voong ,&nbsp;Siyao Li ,&nbsp;Chen Hu ,&nbsp;Ori Shokek ,&nbsp;Russell K. Hales ,&nbsp;Jeffrey Meyer ,&nbsp;Stephen Greco ,&nbsp;Todd McNutt ,&nbsp;Colin Hill ,&nbsp;Kathryn Lowe ,&nbsp;James Huang ,&nbsp;Jean Wright ,&nbsp;Amol Narang ,&nbsp;Aditya Halthore ,&nbsp;Andrea Brown ,&nbsp;Shing Lee ,&nbsp;Claire Snyder","doi":"10.1016/j.radonc.2024.110688","DOIUrl":"10.1016/j.radonc.2024.110688","url":null,"abstract":"<div><h3>Background</h3><div>Radiation oncologists closely monitor patients during weekly on-treatment visits (OTVs). This study examines whether routine patient-reported outcome measures (PROMs) during OTVs change physicians’ perceptions of treatment-toxicity and inform symptom-management.</div></div><div><h3>Patient and methods</h3><div>IMPROVE is a single-arm prospective multicenter trial, conducted from 2020 to 2023. Patients with locally-advanced or oligometastatic thoracic or gastrointestinal cancers receiving definitive-intent radiation, with or without chemotherapy, and their physicians enrolled. Patients completed a 14-question disease-specific PROM in clinic prior to OTVs. Physicians rated their patient’s global toxicity-burden based on clinical data/assessments, then re-rated their patient’s toxicity-burden and reported management-changes after PROM review. At radiotherapy end, physicians completed a Feedback Form. PROMs and outcome-data collection used electronic or paper forms. We report any change in physician-assessed burden-score and symptom-management due to PROMs.</div></div><div><h3>Results</h3><div>The 100 patients enrolled (49 academic, 51 community-based) were 70 years old (median), 51% female, 81% Caucasian, 95% ECOG 0-1, and 94% received concurrent chemotherapy. The median radiation dose was 60 Gy, delivered over 6 weeks. PROMs were available for review for 607/629 (97%) OTVs: full 433/629 (69%), partial 174/629 (28%). For 75/100 patients (75%; 95% CI:65%-83%), PROM review resulted in any change in physician-reported burden-score, and for 50/100 patients (50%; 95% CI:40%-60%) any change in patients’ on-treatment management. Rates of burden-score and management-changes were similar between academic and community-based practices (78% vs. 73%; 53% vs. 47%, respectively). For 78/100 patients with Feedback Forms, physicians agreed/strongly agreed that PROMs improved patients’ quality-of-care (91%).</div></div><div><h3>Conclusions</h3><div>PROM review changes radiation oncologists’ on-treatment toxicity assessment in 75% and care delivery in 50% of their patients.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"203 ","pages":"Article 110688"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871810","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}