Technology in Cancer Research & Treatment最新文献

{"title":"Prognostic Value of G8 Geriatric Screening and Meet-URO Scores in Metastatic Renal Cell Carcinoma Patients Receiving First-Line Ipilimumab-Nivolumab Combination Immunotherapy.","authors":"Ria Nagpal, Marina Campione, Sara Elena Rebuzzi, Lucia Fratino, Pasquale Rescigno, Sergio Bracarda, Davide Bimbatti, Ugo De Giorgi, Matteo Santoni, Fabio Calabrò, Mimma Rizzo, Alessio Signori, Diana Giannarelli, Giuseppe Fornarini, Umberto Basso, Giuseppe Luigi Banna","doi":"10.1177/15330338251316626","DOIUrl":"10.1177/15330338251316626","url":null,"abstract":"<p><strong>Background: </strong>The prognostic value of the Geriatric 8 (G8) screening score in metastatic renal cell carcinoma (mRCC) patients receiving first-line immunotherapy remains unclear. This study aimed to evaluate the prognostic role of G8 within the context of the Meet-URO classification in mRCC patients treated with first-line ipilimumab-nivolumab.</p><p><strong>Methods: </strong>This retrospective multicentre study analysed 106 mRCC patients treated with first-line ipilimumab-nivolumab. G8 and Meet-URO scores were calculated before treatment initiation. Primary endpoint was overall survival (OS), defined as duration from first administration of Nivolumab to death. OS was analysed in relation to age groups, G8 scores, and Meet-URO score categories, with data censored for patients still alive at the last follow-up. The secondary endpoint, progression-free survival (PFS), was measured from initiating Nivolumab to the earliest instance of disease progression or death. OS and PFS were assessed using Kaplan-Meier methods and Cox regression analyses. The reporting of this study conforms to the REMARK guidelines.</p><p><strong>Results: </strong>Patients with G8 > 14 had more favorable IMDC and Meet-URO risk classifications and lower neutrophil-to-lymphocyte ratios. While PFS did not differ significantly between G8 ≤ 14 and >14 groups (1-year 29.3% vs 46.2%, p = 0.2), OS was significantly longer in G8 > 14 group (1-year 76.1% vs 58.6%, p = 0.006). In multivariable analysis, G8 ≤ 14 was independently associated with worse OS (HR 2.36, 95% CI 1.06-5.08, p = 0.03) but not PFS. The Meet-URO score was prognostic for both PFS and OS. In patients ≥70 years, G8 lost its prognostic value, while Meet-URO remained prognostic for OS.</p><p><strong>Conclusions: </strong>The G8 score is an independent prognostic factor for OS but not PFS in mRCC patients receiving first-line ipilimumab-nivolumab. The Meet-URO score shows consistent prognostic ability for PFS and OS across age groups. These findings suggest that while G8 may be useful for individual patient-level OS prediction, the Meet-URO score may be superior for guiding treatment decisions in clinical practice.</p>","PeriodicalId":22203,"journal":{"name":"Technology in Cancer Research & Treatment","volume":"24 ","pages":"15330338251316626"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"β-catenin is a Potential Prognostic Biomarker in Uterine Sarcoma.","authors":"Ying Cai, Yunjia Wang, Ling Yang, Yue Huang, Min-Jun Chen, Chi Zhang, Su-Han Jin, Benjamin Frey, Udo S Gaipl, Hu Ma, Jian-Guo Zhou","doi":"10.1177/15330338251345208","DOIUrl":"10.1177/15330338251345208","url":null,"abstract":"<p><p>IntroductionUterine sarcoma (US) is an extremely rare and aggressive gynecologic malignancy with a poor overall survival (OS). The efficient prognostic biomarker is currently lacking.MethodsUtilizing a Sweden microarray dataset from the Gene Expression Omnibus (GEO) (GSE119043, n = 50) and a clinical cohort (n = 31) retrospectively collected from Suining Central Hospital, we analyzed β-catenin expression profiles and corresponding clinicopathological characteristics. Immunohistochemistry (IHC) was used to assess β-catenin expression level. Survival analysis was used to assess the relationship between β-catenin expression and prognosis. Gene set enrichment analysis (GSEA) was performed to characterize the specific pathways involved in β-catenin expression.ResultsImmunohistochemistry indicated that β-catenin expression was significantly upregulated in US group compared to both the normal uterine smooth muscle (UNSM) and uterine leiomyoma (ULM) groups (<i>P</i> < .01). IHC also exhibited a significant difference in β-catenin expression levels in four pathological subtypes. Leiomyosarcoma (LMS) and high-grade endometrial stromal sarcoma (HG-ESS) suggested higher levels of β-catenin expression compared with adenosarcoma (AS) or low-grade endometrial stromal sarcoma (LG-ESS), but no statistically significant difference was found in box plot (<i>P</i> > .05). GSEA indicated that transcriptional dysregulation in cancer, Wnt, AMPK, MAPK, PI3K, p53, Ras, and TNF signaling pathway were positively enriched in β-catenin high-expression group. Though survival analysis showed that β-catenin expression level was not associated with survival, low-β-catenin expression group showed a longer median OS compared to high expression group (56.17 months VS 9.60 months) in Sweden microarray dataset. Similar results were also observed for progression-free survival (PFS) in clinical cohort (not reached VS 45.97 months in high-expression group). Tumor type, lymphadenectomy, family history of malignancy and tumor recurrence remained significant predictors of OS, while only tumor type, stage and tumor recurrence had prognostic significance for PFS. Age, tumor size, menopausal status, CA125, adjuvant chemotherapy, and adjuvant radiotherapy, were not associated with survival (<i>P</i> > .05).Conclusionβ-catenin was highly expressed in uterine sarcoma and may be promising as a novel potential biomarker for diagnosis and prognosis.</p>","PeriodicalId":22203,"journal":{"name":"Technology in Cancer Research & Treatment","volume":"24 ","pages":"15330338251345208"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Line' Constraints Optimization for Improved Dose Distribution in Locally Recurrent Nasopharyngeal Carcinoma Using Knowledge-Based Planning.","authors":"Xiaoli Yu, Yixuan Wang, Mingli Wang, Huikuan Gu, Xin Yang, Jiang Hu","doi":"10.1177/15330338251351535","DOIUrl":"10.1177/15330338251351535","url":null,"abstract":"<p><p>IntroductionTo investigate the efficacy of a knowledge-based planning (KBP) model in optimizing dose distribution, and identify the inter-institutional variation in radiotherapy of recurrent nasopharyngeal carcinoma (rNPC).MethodsA total of 70 rNPC patients treated with intensity-modulated radiotherapy (IMRT) were recruited to build a KBP model. Following model refinement, 36 patients were retrospectively enrolled for dosimetric comparison between manually optimized and KBP-generated plans. Ten experienced physicists from six different institutions were engaged to independently design manual plan for a representative case, to assess inter-institutional variations, and differences between KBP and manual plans.ResultsThe refined KBP model provided significant reduced dose in brainstem D_1cc (the dose received by the \"hottest\"1 cm³ volume, 41.14 ± 8.51 Gy vs 38.48 ± 8.60 Gy, <i>P</i> < 0.001) and spinal cord D_1cc (17.48 ± 9.38Gy vs 12.23 ± 6.56Gy, <i>P</i> < 0.001). In addition, The mean dose (D_mean) of brainstem, spinal cord, mandible, parotid, temporomandibular joint and inner ear were statistically decreased (<i>P</i> < 0.05). In validation cohort, KBP model eliminated the hotspot (0.57 ± 0.01% vs 0.00 ± 0.00%, <i>P</i> < 0.001), improved target homogeneity (HI: 0.06 ± 0.00 vs 0.08 ± 0.00, <i>P</i> < 0.001), and performed superior to the manual plans in sparing organs. While all institutions achieved comparable target coverage, manual plans exhibited substantial variability in sparing brainstem. KBP implementation reduced inter-institutional dose disparities for brainstem (46.30 ± 10.08 Gy vs 41.80 ± 5.80 Gy, <i>P</i> = 0.041) and spinal cord (26.08 ± 7.06 Gy vs 18.19 ± 1.98 Gy, <i>P</i> = 0.002). Additionally, planning efficiency increased by 48.7% (39 vs 76 min).ConclusionsThis KBP framework optimized rNPC reirradiation from three dimensions: 1) Enhanced OARs' protection; 2) Improved target homogeneity; 3) Improved the multi-institutional consistency and efficiency of planning. These advancements established a clinically actionable paradigm for precision reirradiation.</p>","PeriodicalId":22203,"journal":{"name":"Technology in Cancer Research & Treatment","volume":"24 ","pages":"15330338251351535"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Current Challenges and Pioneering Clinical Applications of Stereotactic Radiotherapy in Cancer Treatment.","authors":"Atsuto Katano","doi":"10.1177/15330338251333658","DOIUrl":"10.1177/15330338251333658","url":null,"abstract":"<p><p>Stereotactic radiotherapy (SRT) has become integral to modern oncology, offering the ability to deliver ablative doses while minimizing damage to surrounding normal tissues. Recent advancements in imaging integration, treatment planning, and dose delivery have expanded their clinical applications across various tumor types. However, challenges such as toxicity in anatomically critical regions, optimal margin determination, and the lack of standardized protocols persist. This review explores key issues in contemporary practice and highlights emerging clinical evidence across lung, liver, prostate, brain, and oligometastatic diseases. Further refinement in patient selection and treatment strategies is essential to maximize therapeutic efficacy and ensure safe implementation in broader clinical settings.</p>","PeriodicalId":22203,"journal":{"name":"Technology in Cancer Research & Treatment","volume":"24 ","pages":"15330338251333658"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Study on Synchronous Bilateral Breast Cancer Radiotherapy Based on an Accelerator Integrated with Optical Surface Monitoring System.","authors":"Zhen Zhou, Tingting Dong, Bei Wang, Zhiqun Wang, Heling Zhu, Wenbo Li, Bo Yang, Jie Qiu","doi":"10.1177/15330338251322075","DOIUrl":"10.1177/15330338251322075","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the optimal radiotherapy regimen for synchronous bilateral breast cancer (SBBC) by utilizing dosimetric and radiobiological indicators, and to assess the impact of applying an optical surface monitoring system(OSMS) on the precision of SBBC radiotherapy treatment.</p><p><strong>Methods: </strong>Nine patients with SBBC who underwent breast-conserving radiotherapy were retrospectively selected. Four treatment plans were designed for each patient using the Versa HD (Elekta, Stockholm) accelerator: single-isocenter intensity-modulated radiotherapy/volumetric modulated arc therapy(IMRT-ISO1/VMAT-ISO1) and dual-isocenter IMRT/VMAT(IMRT-ISO2/VMAT-ISO2), with a prescription dose of 42.4 Gy in 16 fractions. Dosimetric parameters and radiobiological impact were measured for the target and organs at risk(OARs). The monitoring log files of three SBBC patients were analyzed to quantitatively assess real-time delta shifts encompassing six degrees of freedom (DOFs) during intrafraction and interfraction treatment processes.</p><p><strong>Results: </strong>Compared to both the IMRT techniques, the VMAT techniques offered superior target conformity, uniformity, and dose fall-off capability. Among the four treatment plans, VMAT-ISO1 exhibited optimal performance by significantly reducing radiation exposure volume to OARs while maintaining exceptional precision in dose delivery and execution efficiency. The tumor control probability (TCP) was exceeded by 98.5% for all four modalities. According to the OSMS logs, the maximum absolute error in translational motion during the treatment of three SBBC patients was predominantly manifested along the vertical(VRT) axis, with an mean value of 2.2 mm. Additionally, it was observed that the coronal plane (YAW) exhibited the largest error in terms of rotational angle, with an mean deviation of 1.1°.</p><p><strong>Conclusions: </strong>The VMAT-ISO1 technique demonstrates apparent dosimetric and radiobiological advantages in SBBC radiotherapy, ensuring precise dose delivery and shortening treatment durations. The accuracy of SBBC radiotherapy is ensured by OSMS through pre-treatment positioning correction and real-time monitoring throughout the treatment process.</p>","PeriodicalId":22203,"journal":{"name":"Technology in Cancer Research & Treatment","volume":"24 ","pages":"15330338251322075"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attention-based Vision Transformer Enables Early Detection of Radiotherapy-Induced Toxicity in Magnetic Resonance Images of a Preclinical Model.","authors":"Manish Kakar, Bao Ngoc Huynh, Olga Zlygosteva, Inga Solgård Juvkam, Nina Edin, Oliver Tomic, Cecilia Marie Futsaether, Eirik Malinen","doi":"10.1177/15330338251333018","DOIUrl":"10.1177/15330338251333018","url":null,"abstract":"<p><p>IntroductionEarly identification of patients at risk for toxicity induced by radiotherapy (RT) is essential for developing personalized treatments and mitigation plans. Preclinical models with relevant endpoints are critical for systematic evaluation of normal tissue responses. This study aims to determine whether attention-based vision transformers can classify MR images of irradiated and control mice, potentially aiding early identification of individuals at risk of developing toxicity.MethodC57BL/6J mice (n = 14) were subjected to 66 Gy of fractionated RT targeting the oral cavity, swallowing muscles, and salivary glands. A control group (n = 15) received no irradiation but was otherwise treated identically. T2-weighted MR images were obtained 3-5 days post-irradiation. Late toxicity in terms of saliva production in individual mice was assessed at day 105 after treatment. A pre-trained vision transformer model (ViT Base 16) was employed to classify the images into control and irradiated groups.ResultsThe ViT Base 16 model classified the MR images with an accuracy of 69%, with identical overall performance for control and irradiated animals. The ViT's model predictions showed a significant correlation with late toxicity (r = 0.65, p < 0.01). One of the attention maps from the ViT model highlighted the irradiated regions of the animals.ConclusionsAttention-based vision transformers using MRI have the potential to predict individuals at risk of developing early toxicity. This approach may enhance personalized treatment and follow-up strategies in head and neck cancer radiotherapy.</p>","PeriodicalId":22203,"journal":{"name":"Technology in Cancer Research & Treatment","volume":"24 ","pages":"15330338251333018"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Outcome of Brain Metastases from Breast Cancer Following Gamma Knife Radiosurgery: A Retrospective Study in Vietnam.","authors":"Huyen Thi Phung, Yen Thi Le, Tung Van Nguyen, Giang Tien Dang, Quang Hong Nguyen, Duong Thanh Phan, Hoa Thi Nguyen, Long Thanh Nguyen","doi":"10.1177/15330338251328522","DOIUrl":"10.1177/15330338251328522","url":null,"abstract":"<p><p>BackgroundGamma Knife radiosurgery has proven to be highly effective for small brain lesions and those with a limited number of metastases. This study aimed to evaluate the treatment outcome of Gamma Knife radiosurgery in Vietnamese breast cancer patients with brain metastasis.MethodsThis retrospective descriptive study included 75 patients treated between January 2019 and December 2023. Eligible patients had 1 to 5 brain lesions ≤ 3 cm, a Karnofsky Performance Status (KPS) score of ≥ 60, and no prior whole-brain radiotherapy or brain tumor resection. Clinical characteristics were documented, and imaging responses were evaluated using RECIST criteria. Overall survival (OS), brain-specific progression-free survival (BSPFS), and overall response rates were analyzed using Kaplan-Meier survival curves and Cox regression.ResultsSeventy-five patients were included in the study, with a median follow-up time of 15.9 months. The median age was 53.0 years (range: 29-73 years), and 39 patients (52%) were HER2-positive. The median total tumor volume per patient was 3.78 cm³. A total of 152 brain tumors were identified, of which 131 (86.2%) were <2 cm in diameter, 36 patients (48.0%) had a single lesion. The intracranial tumor control rates were 96% at 3 months and 92.5% at 6 months. The median overall survival (OS) was 17.2 months (range: 13.7-20.7 months). Multivariate analysis revealed that the total volume of metastatic lesions ≤7.0 cm³, hormone receptor negativity, ≤ 3 lines of systemic treatment before brain metastasis and controlled extracranial metastases were correlated with both BSPFS and OS.ConclusionGamma Knife radiosurgery is an effective treatment for limited brain metastases, demonstrating a high rate of local control over brain lesions, which contributed to the promising survival outcome in Vietnamese breast cancer patients.</p>","PeriodicalId":22203,"journal":{"name":"Technology in Cancer Research & Treatment","volume":"24 ","pages":"15330338251328522"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dosimetric and Radiobiological Impact of Patient Setup Errors in Intensity-modulated Radiotherapy for Esophageal Cancer.","authors":"Jia-Huan Cai, Xun Peng, Jia-Yang Lu","doi":"10.1177/15330338241311136","DOIUrl":"10.1177/15330338241311136","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the impact of patient setup errors on the dosimetry and radiobiological models of intensity-modulated radiotherapy (IMRT) for esophageal cancer.</p><p><strong>Methods and materials: </strong>This retrospective study with 56 patients in thermoplastic mask (TM) and vacuum bag (VB) groups utilized real setup-error (RSE) data from cone-beam CT scans to generate simulated setup-error (SSE) data following a normal distribution. The SSE data were applied to simulate all treatment fractions per patient by shifting the plan isocenter and recalculating the dose. A simulated plan sum (SPS) was created by accumulating all simulated fraction plans. Comparisons of target dose, improved homogeneity index (iHI), conformity index (CI), tumor control probability (TCP) and normal tissue complication probability (NTCP) were conducted between SPSs and original treatment plans (OTPs). Correlations between RSE and TCP/NTCP were analyzed.</p><p><strong>Results: </strong>Compared to OTPs in the TM group, the planning target volume (PTV) of SPSs showed reductions in D_95%, D_98%, iHI, CI and TCP by 1.2%, 2.2%, 2.3%, 7.3% and 1.2%, while D_2% increased by 0.3%; D_2% of clinical target volume (CTV) increased by 0.2% (<i>P </i>< .05). In the VB group, D_95%, D_98%, iHI, CI and TCP of PTV decreased by 2.5%, 4.5%, 4.2%, 15.6% and 2.0%, with D_2% increasing by 0.5%; D_2% of CTV increased by 0.5% while D_98% decreased by 0.2% (<i>P </i>< .05). The dose of organs at risk (OARs) changed slightly in both groups. The mean and standard deviation of absolute RSE negatively correlated with the TCP of PTV, while the mean RSE positively correlated with the NTCP of lung and spinal cord.</p><p><strong>Conclusions: </strong>Setup errors may reduce dose homogeneity and conformity, potentially reducing TCP of PTV and increasing NTCP, especially when mean RSE shifts the isocenter towards OARs. VB immobilization may result in relatively larger impacts of setup errors, but this needs future validation.</p>","PeriodicalId":22203,"journal":{"name":"Technology in Cancer Research & Treatment","volume":"24 ","pages":"15330338241311136"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Ultrasound-based Machine Learning Model for Predicting Tumor-Infiltrating Lymphocytes in Breast Cancer.","authors":"Boya Liu, Xiangrong Gu, Danling Xie, Bing Zhao, Dong Han, Yuli Zhang, Tao Li, Jingqin Fang","doi":"10.1177/15330338251334453","DOIUrl":"https://doi.org/10.1177/15330338251334453","url":null,"abstract":"<p><p>IntroductionTumor-infiltrating lymphocytes (TILs) are key indicators of immune response and prognosis in breast cancer (BC). Accurate prediction of TIL levels is essential for guiding personalized treatment strategies. This study aimed to develop and evaluate machine learning models using ultrasound-derived radiomics and clinical features to predict TIL levels in BC.MethodsThis retrospective study included 256 BC patients between January 2019 and August 2023, who were randomly divided into training (n = 179) and test (n = 77) cohorts. Radiomics features were extracted from the intratumor and peritumor regions in ultrasound images. Feature selection was performed using the \"Boruta\" package in R to iteratively remove non-significant features. Extra Trees Classifier was used to construct radiomics and clinical models. A combined radiomics-clinical (R-C) model was also developed. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, and decision curve analysis (DCA) to assess clinical utility. A nomogram was created based on the best-performing model.ResultsA total of 1712 radiomics features were extracted from the intratumor and peritumor regions. The Boruta method selected five key features (four from the peritumor and one from the intratumor) for model construction. Clinical features, including immunohistochemistry, tumor size, shape, and echo characteristics, showed significant differences between high (≥10%) and low (<10%) TIL groups. Both the R-C and radiomics models outperformed the clinical model in the test cohort (area under the curve values of 0.869/0.838 vs 0.627, <i>P</i> < .05). Calibration curves and Brier scores demonstrated superior accuracy and calibration for the R-C and radiomics models. DCA revealed the highest net benefit of the R-C model at intermediate threshold probabilities.ConclusionUltrasound-derived radiomics effectively predicts TIL levels in BC, providing valuable insights for personalized treatment and surveillance strategies.</p>","PeriodicalId":22203,"journal":{"name":"Technology in Cancer Research & Treatment","volume":"24 ","pages":"15330338251334453"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective Insights into the Clinicopathological Features and Treatment Outcomes of Thoracic SMARCA4-Deficient Tumors.","authors":"Lijin Chen, Chunyang Su, Jiadi Yao, Xiaofeng Li, Xiaoyan Lin","doi":"10.1177/15330338251345377","DOIUrl":"10.1177/15330338251345377","url":null,"abstract":"<p><p>IntroductionThoracic SMARCA4-deficient tumors, which are rare and aggressive malignancies found in the lung or thoracic cavity, present a challenge in treatment standardization. This challenge arises from their resistance to chemotherapy and the absence of targeted therapy options.MethodsThoracic SMARCA4-deficient tumors were identified retrospectively using pathology databases. The clinicopathological characteristics of these tumors are outlined, and the clinical outcomes of advanced patients treated with immune checkpoint inhibitors (ICIs) in combination with chemotherapy and chemotherapy alone are reviewed.ResultsThirty-nine patients had thoracic SMARCA4-deficient tumors, with a median age of 62 years. The cohort consisted of 92.3% males, and 89.7% had a history of smoking. Within this group, 94.9% had stage III/IV disease at diagnosis. SMARCA4-deficient non-small cell lung cancer (SMARCA4-DNSCLC) and SMARCA4-deficient undifferentiated tumors (SMARCA4-DUT) display distinct histological and immunohistochemical features. Thirty-five patients underwent systemic therapy, achieving an ORR of 51.4%, a DCR of 82.9%, and a median OS of 20.9 months. Patients were categorized into chemotherapy (28.6%) and ICIs plus chemotherapy (71.4%) groups. The ICIs plus chemotherapy group exhibited an ORR of 64.0% and a DCR of 96.0%, while the chemotherapy group had an ORR of 20.0% and 50.0%, respectively (<i>P</i> < .0001 for ORR and DCR). The median OS for ICIs plus chemotherapy and chemotherapy groups were 20.9 months and 6.5 months, and median PFS were 9.6 months and 3.5 months, respectively, all statistically significant (<i>P</i> < .05). Multivariate COX regression analysis indicated that treatment was an independent prognostic factor for OS.ConclusionThoracic SMARCA4-deficient tumors exhibit a lack of SMARCA4 expression, displaying high malignancy and aggressiveness while exhibiting poor response to standard chemotherapy. The combination of ICIs with chemotherapy could potentially serve as an effective treatment approach for thoracic SMARCA4-deficient tumors.</p>","PeriodicalId":22203,"journal":{"name":"Technology in Cancer Research & Treatment","volume":"24 ","pages":"15330338251345377"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}