Tumori最新文献

{"title":"Practices and views about palliative care at the end of life: A survey of oncologists from the Italian region of Liguria.","authors":"Irene Giannubilo, Linda Battistuzzi, Tommaso Ruelle, Francesca Benedetta Poggio, Giulia Buzzatti, Alessia D'Alonzo, Federica Della Rovere, Chiara Molinelli, Maria Grazia Razeti, Simone Nardin, Luca Arecco, Marta Perachino, Diletta Favero, Roberto Borea, Paolo Pronzato, Lucia Del Mastro, Stefania Vecchio, Claudia Bighin","doi":"10.1177/03008916241287616","DOIUrl":"10.1177/03008916241287616","url":null,"abstract":"<p><strong>Introduction: </strong>We conducted an online survey to investigate oncologists' clinical practices and views on palliative care at the end of life in the Italian region of Liguria.</p><p><strong>Methods: </strong>The survey included 29 items divided into three sections: participant characteristics (n=6), hospital resources and practices (n=11), participant practices and views (n=12).</p><p><strong>Results: </strong>Twenty-one of the 41 medical oncologists invited completed the survey (51%). Although almost all reported the presence of palliative medicine physicians at their hospitals (90%), nearly half (48%) stated that palliative medicine physicians were not responsible for managing cancer patients at end of life, and 21% reported routine participation of palliative medicine physicians in multidisciplinary meetings. Thirty-eight percent of the respondents stated they never consulted psychologists regarding end of life patient care, and 43% reported they rarely did. Notably, a substantial proportion of participants stated that they administered active treatments to patients with six months life expectancy. Regarding integration between oncology and palliative medicine, an equal proportion felt it had been fully (48%) or partially achieved (48%) at their hospitals.</p><p><strong>Conclusions: </strong>Participants seemed fairly satisfied with the level of integration between oncology and palliative medicine at their hospitals, which contrasts with other findings regarding, for instance, the scant participation of palliative medicine physicians in multidisciplinary meetings. Exploring the impact of the novel regional clinical healthcare pathway for palliative care on practices at hospitals in Liguria will be crucial to ensure that cancer patients at end of life receive quality care.</p>","PeriodicalId":23349,"journal":{"name":"Tumori","volume":" ","pages":"430-436"},"PeriodicalIF":4.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High throughput sequencing reveals alterations in B cell receptor repertoires associated with the progression of hepatic cirrhosis to hepatocellular carcinoma.","authors":"Yingying Zhao, Fengyan Wang, Xiaofei Lei, Ziqiang Li, Qiwei Cao, Runze Jiang, Changqing Xu, Kun Li","doi":"10.1177/03008916241290638","DOIUrl":"10.1177/03008916241290638","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is developed as a consequence of chronic liver cirrhosis, and both diseases are difficult to diagnose and differentiate. Accurate noninvasive biomarkers for HCC and liver cirrhosis are urgently needed.</p><p><strong>Methods: </strong>Here we used high-throughput sequencing to characterize the B cell receptor (BCR) repertoires from 36 HCC tumor samples and 10 liver cirrhosis (LC) tissue biopsies to understand the immune alterations during hepatic carcinogenesis.</p><p><strong>Results: </strong>The principal components analysis (PCA) showed that the pattern of BCR in HCC was distinct from that in LC. As measured by Clonality and Shannon indexes, the diversity of BCR repertoire was significantly lower in HCC than in LC (P < 0.01).</p><p><strong>Conclusion: </strong>Our results corroborated that the BCR diversity and composition could be closely correlated with hepatic carcinogenesis. And BCR repertoire may be used to predict the progression of HCC and design targeting immunotherapy in the near future.</p>","PeriodicalId":23349,"journal":{"name":"Tumori","volume":" ","pages":"462-469"},"PeriodicalIF":4.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of body mass index on immune checkpoint inhibitor efficacy in patients with advanced cancer.","authors":"Gülin Alkan Şen, Nihan Şentürk Öztaş, Ezgi Değerli, Murad Guliyev, Hande Turna, Mustafa Özgüroğlu","doi":"10.1177/03008916241291989","DOIUrl":"10.1177/03008916241291989","url":null,"abstract":"<p><strong>Background: </strong>The need for predictive factors regarding the response to immune checkpoint inhibitors (ICIs) is increasing. Recent research indicates that an enhanced response to ICIs is associated with a higher body mass index (BMI). This study aims to evaluate the relationship between response to ICIs and BMI in solid tumors.</p><p><strong>Methods: </strong>We retrospectively analyzed patients with advanced cancer treated with ICIs at one academic center. We compared the treatment responses of patients classified as underweight/normal weight (BMI <25) and overweight/obese (BMI ⩾ 25) according to their BMI at the initiation of ICI treatment. After excluding underweight patients, we also compared the progression-free survival (PFS) and overall survival (OS) of normal-weight, overweight, and obese patients.</p><p><strong>Results: </strong>Overall, 113 patients were evaluated. Forty-seven (41.6%) patients had BMI <25 and 66 (58.4%) patients had a BMI ⩾ 25. In underweight/normal patients, median PFS was 7.7 months (95% CI: 4.7-10.6) while it was 8.0 months (95% CI: 4.1-11.9) in overweight/obese patients (HR 1.16, 95% CI: (0.76-1.75), p=0.477). In underweight/normal patients, the median OS was 21.7 months (95% CI: 11.6-31.7) compared to 18.7 months (95% CI: 12.7-24.6) in overweight/obese patients (HR 1.06, 95% CI: (0.69-1.64), p=0.774). The objective response rate (ORR) was 38.3% in underweight/normal patients and 34.8% in overweight/obese patients (p = 0.707). After excluding underweight patients, there were also no significant differences in PFS (p = 0.914), OS (p = 0.642), and ORR (p = 0.909) between patients of normal weight, overweight, and obesity.</p><p><strong>Conclusion: </strong>Our research found no correlation between BMI and response to ICIs. Additional prospective studies are necessary to assess the effect of BMI on the response to ICIs.</p>","PeriodicalId":23349,"journal":{"name":"Tumori","volume":" ","pages":"437-442"},"PeriodicalIF":4.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case series of non-small cell lung cancer patients with <i>EGFR</i> or <i>HER2</i> exon 20 insertion in Li Fraumeni syndrome.","authors":"Valeria Cognigni, Enrica Capelletto, Paola Bordi, Valeria Pavese, Federica Maria Carfì, Francesco Gelsomino, Andrea De Giglio, Rita Chiari, Roberta Minari, Enrico Ambrosini, Antonio Percesepe, Daniela Giachino, Paolo Bironzo, Marcello Tiseo","doi":"10.1177/03008916241255485","DOIUrl":"10.1177/03008916241255485","url":null,"abstract":"<p><strong>Introduction: </strong>Germline pathogenic mutations in <i>TP53</i> gene are associated with a cancer predisposition syndrome known as Li Fraumeni syndrome. Albeit infrequently, non-small cell lung cancer, especially as oncogene-addicted disease, may be diagnosed in young patients with Li Fraumeni syndrome.</p><p><strong>Case description: </strong>We report three cases of patients affected by Li Fraumeni syndrome who developed non-small cell lung cancer with <i>EGFR</i> or <i>HER2</i> exon 20 insertions. The first patient suffered from liposarcoma and, then, brain metastases from <i>HER2</i>-mutated non-small cell lung cancer: after stereotactic radiotherapy, he benefited from enrollment in a clinical trial with a <i>HER2</i>-targeted therapy. The second young patient was a female with personal history of rhabdomyosarcoma, diagnosed with brain metastases from <i>EGFR</i>-mutated non-small cell lung cancer: enrollment in a clinical trial led to a temporary clinical benefit. The last case was a female diagnosed with breast carcinoma, ovarian granulosa cell tumor and advanced <i>EGFR</i>-mutated non-small cell lung cancer at a young age.</p><p><strong>Conclusions: </strong>Young patients affected by oncogene-addicted non-small cell lung cancer and with a positive familial cancer history should be referred for an accurate genetic counselling to look for Li Fraumeni syndrome. The underlying molecular connection between <i>TP53</i> and HER family receptor tyrosine kinases remains unclear, but an extensive molecular characterization of tumors from patients with Li Fraumeni syndrome should always be performed, to offer patients a personalized therapeutic approach.</p>","PeriodicalId":23349,"journal":{"name":"Tumori","volume":" ","pages":"NP5-NP10"},"PeriodicalIF":4.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple targets, germline <i>BRCA1</i> mutation and HRD in a lung cancer patient: Molecular considerations and treatment decision-making.","authors":"Fabiana Perrone, Francesco Facchinetti, Benedetta Pellegrino, Roberta Minari, Letizia Gnetti, Cinzia Azzoni, Lorena Bottarelli, Nicoletta Campanini, Juan Francisco Grau-Bejar, Anna Mingozzi, Valeria Cognigni, Marcello Tiseo","doi":"10.1177/03008916241257754","DOIUrl":"10.1177/03008916241257754","url":null,"abstract":"<p><strong>Introduction: </strong>Several biomarkers are currently available to address targeted treatments in cancer patients, with lung malignancies representing one of the best examples.</p><p><strong>Case description: </strong>We report the case of a patient affected by advanced non-small cell lung cancer with an uncommon histology and a complex biology. The use of a large next-generation sequencing (NGS) NGS panel allowed us to identify an extremely rare <i>BRAF</i> mutation (V600Q), a <i>MET</i> amplification, a high tumor mutational burden, a germline pathogenetic <i>BRCA1</i> mutation and a homologous recombination deficiency through RAD51 assay. The treatment decision was driven by the abundance of molecular information.</p><p><strong>Conclusions: </strong>This case highlights that an attentive and critical evaluation of molecular reports is key for the tailoring of treatment algorithms at the patient-level scale.</p>","PeriodicalId":23349,"journal":{"name":"Tumori","volume":" ","pages":"NP11-NP15"},"PeriodicalIF":4.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hot topics in genitourinary cancers: A multidisciplinary discussion on state-of-the-art and latest developments among international experts and patient advocacy.","authors":"Alessandro Rametta, Paolo Ambrosini, Chiara Cavalli, Eleonora Gusmaroli, Melanie Claps, Patrizia Giannatempo, Valentina Guadalupi, Marco Stellato, Elena Verzoni, Filippo Maria Guglielmo De Braud, Giuseppe Procopio","doi":"10.1177/03008916241270093","DOIUrl":"10.1177/03008916241270093","url":null,"abstract":"<p><p>Genitourinary cancers present significant challenges to oncologists, necessitating innovative approaches for improved patient outcomes. The 'Controversies in Genitourinary Cancers' congress, held in January 2024, convened international experts to address the complexities of prostate, bladder, renal and rare genitourinary cancers. Sessions explored current trends, novel treatments, and unmet needs, emphasizing collaborative efforts to advance knowledge and patient care. Through multidisciplinary engagement and patient advocacy, the congress underscored the imperative of collective action in navigating the complexities of genitourinary cancers, ultimately aiming to transform clinical practice and improve patient outcomes.</p>","PeriodicalId":23349,"journal":{"name":"Tumori","volume":" ","pages":"410-415"},"PeriodicalIF":4.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proton therapy for pediatric malignancies: Indications and challenges focusing on the oncological landscape.","authors":"Sabina Vennarini, Francesca Colombo, Andrea R Filippi, Ester Orlandi","doi":"10.1177/03008916241287016","DOIUrl":"10.1177/03008916241287016","url":null,"abstract":"<p><p>Advances in therapeutic techniques and multimodal approaches have significantly improved the success rates of treatment for pediatric malignancies, with cure rates now close to 80%. This has led to an increase in long-term survival, with 0.10-0.15% of the general population being survivors of childhood cancer. In Italy, cancer registry data suggest that 75% of treated children become long-term survivors. However, these survivors face significant risks of late adverse events, including chronic diseases and severe conditions, highlighting the need for specialized follow-up care.Radiotherapy, a cornerstone of pediatric cancer treatment, contributes to late toxicities due to the susceptibility of growing tissues. Proton therapy offers advantages in reducing treatment-related toxicity, reducing the risk of secondary cancers, and allowing dose escalation for radioresistant tumors. Comparative studies suggest that proton therapy is superior in sparing healthy tissues and reducing long-term toxicities.Despite these benefits, challenges such as the high cost, limited proton therapy centers, and the need for clinical trials hinder the widespread adoption of proton therapy. Efforts to centralize care in high-ranking centers and ensure equitable access to proton therapy are crucial. In Italy, pediatric solid tumors are now eligible for proton therapy under national health policies, ensuring free access for all children.Dedicated proton therapy centers must provide comprehensive care involving multidisciplinary teams and supportive environments for pediatric patients and their families. Addressing current limitations and enhancing care environments are essential for improving outcomes for pediatric oncology patients.</p>","PeriodicalId":23349,"journal":{"name":"Tumori","volume":" ","pages":"416-421"},"PeriodicalIF":4.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced patient journey associated with improved overall survival in colon cancer patients: A study by the Ligurian Oncology Network.","authors":"Andrea Boutros, Nidia Sofia Diaz Gaitan, Giovanni Orengo, Eva Blondeaux, Alessandro Pastorino, Monica Zacconi, Francesca Ferrè, Luca Boni, Barbara Cardinali, Lucia Del Mastro","doi":"10.1177/03008916241286692","DOIUrl":"10.1177/03008916241286692","url":null,"abstract":"<p><strong>Background: </strong>Colon cancer imposes a significant burden on global healthcare systems, necessitating efforts to improve oncology care quality and patient outcomes. We studied the correlation between care quality and survival outcomes among colon cancer patients within the Ligurian Oncology Network (Italy).</p><p><strong>Methods: </strong>We developed an Overall Quality Score (OQS) to evaluate the impact of oncology care quality on survival outcomes within the Ligurian Oncology Network. OQS indicators were selected through expert consensus, covering screening, diagnosis, treatment, and follow-up. A sample of colon cancer patients diagnosed in 2012 was randomly selected from administrative healthcare data. Analyses were performed using two models: a binary model (High and Low OQS) and a stratified model (Low, Medium, and High OQS). Statistical analysis involved survival curves, log-rank tests, and Cox proportional hazards models using SAS 9.4.</p><p><strong>Results: </strong>Of 175 eligible colon cancer patients, 150 were included. Following a median follow-up of 7.6 years, a correlation between High-OQS (⩾ 65%) and prolonged disease-free survival was observed (unadjusted HR 0.57, 95%CI 0.33-0.99, log-rank p=0.041). The five-year disease-free survival rate for High-OQS patients was 70% (95%CI 57-80%), compared to 53% (95%CI 41-64%) for Low-OQS patients. Similarly, the five-year overall survival rate was 78% (95%CI 65-86%) for High-OQS patients, compared to 58% (95%CI 45-68%) for Low-OQS patients (unadjusted HR 0.56, 95%CI 0.31-1.00, log-rank p=0.048).</p><p><strong>Conclusions: </strong>Our findings highlight the potential impact of the patient journey on colon cancer survival outcomes. Optimising care pathways might improve patient outcomes in colon cancer management.</p>","PeriodicalId":23349,"journal":{"name":"Tumori","volume":" ","pages":"422-429"},"PeriodicalIF":4.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fat necrosis after accelerated partial breast irradiation or hypofractionated whole breast irradiation: A case-control study.","authors":"Riccardo Ray Colciago, Eliana La Rocca, Carlotta Giandini, Maria Grazia Carnevale, Giulia Valeria Bianchi, Ilaria Maugeri, Catherine Depretto, Silvia Meroni, Anna Cavallo, Emanuele Pignoli, Laura Lozza, Tiziana Rancati, Maria Carmen De Santis","doi":"10.1177/03008916241291305","DOIUrl":"10.1177/03008916241291305","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare the incidence of fat necrosis after accelerated partial breast irradiation (APBI) vs hypofractionated whole breast irradiation (WBI) in patients with early-stage breast cancer.</p><p><strong>Materials and methods: </strong>Data from early-stage breast cancer patients who underwent breast-conserving surgery and adjuvant radiotherapy between 2009 and 2022 were retrospectively collected. Radiation therapy consisted of APBI of 30 Gy in 5 daily fractions (Fx) (delivered in one week, consecutively) to the tumour bed or WBI (42.4 Gy in 16 Fx). Reports on fat necrosis were extracted from yearly mammograms and breast ultrasound imaging. The primary endpoint was the incidence of radiologically detected fat necrosis.</p><p><strong>Results: </strong>A total of 536 patients were included among the APBI and WBI cohorts, with 268 and 268 patients respectively. The three-year Kaplan-Meier actuarial rate of fat necrosis was 32.8% (95% CI: 30.0% - 35.6%) for APBI and 22.3% (95% CI: 19.7% - 24.9%) for WBI patients. Univariate Kaplan-Meier survival analysis revealed a Hazard Ratio of 1.6 [95% CI: 1.1 - 2.2; p = 0.0055] for the fat necrosis rate within the APBI group compared to WBI. Multivariate Cox proportional hazard regression confirmed significant associations between fat necrosis and APBI (HR = 2.2 95% CI: 1.2 - 4.0; p = 0.01).</p><p><strong>Conclusions: </strong>The occurrence of radiologically diagnosed fat necrosis was higher in the APBI group compared to the WBI. Further investigations aiming to identify a lower-dose schedule with comparable efficacy to 30 Gy in 5 Fx but fewer toxicities, particularly for high-risk patients, are warranted.</p>","PeriodicalId":23349,"journal":{"name":"Tumori","volume":" ","pages":"451-461"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508867","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":"Preoperative chemo-CIRT in Re/BRe pancreatic cancer: Insights from a multicenter prospective phase II clinical study (NCT03822936).","authors":"Amelia Barcellini, Silvia Molinelli, Alessandro Vanoli, Viviana Vitolo, Piero Fossati, Alessandro Vai, Anna Pagani, Frediano Inzani, Mattia Pecorilla, Giovanni Butturini, Catherine Klersy, Lorenzo Preda, Angelica Facoetti, Francesca Valvo, Ester Orlandi","doi":"10.1177/03008916241291341","DOIUrl":"10.1177/03008916241291341","url":null,"abstract":"<p><strong>Purpose: </strong>There is debate about the optimal management of borderline resectable (bRe) and resectable (Re) pancreatic ductal adenocarcinoma (PDAC). Both preclinical and clinical evidence showed that carbon ion radiotherapy (CIRT) produces superior control on radioresistant histologies compared to conventional photon beam radiotherapy (RT). However, so far there is a lack of data concerning the integration of CIRT in a multimodal approach with chemotherapy and surgery for bRe/Re.</p><p><strong>Methods: </strong>We recently presented the first analysis of a multicenter prospective phase II clinical study aimed at assessing the feasibility and effectiveness of a neoadjuvant chemotherapy + short course of CIRT followed by surgery and adjuvant chemotherapy in the management of bRe/Re PDAC. The study was terminated early due to low patient enrollment.Herein, we reported a post-hoc analysis focusing on toxicity, dosimetry and translational assessment.</p><p><strong>Results: </strong>In our experience, CIRT can be integrated into a multimodal treatment strategy for bRe/Re PDAC, alongside chemotherapy and surgery. A case of fatal liver failure occurring three months post-surgery has been documented, likely related to the combination approach. Although the treatment plans were satisfactory according to the Local Effect Model (LEM) model, recalculations using the modified Microdosimetric Kinetic Model (mMKM) revealed suboptimal target coverage. Additionally, we observed an increased expression of PD-L1 following CIRT.</p><p><strong>Conclusions: </strong>This multimodal approach was well tolerated; however, clinicians should carefully monitor for vascular disorders during follow-up and further investigate surgical techniques after CIRT. The increased PD-L1 expression supports the immunogenic effects of particle therapy and lays the groundwork for future studies. To enhance the therapeutic ratio of CIRT treatments, integrating LET-d based objectives into the plan optimization process should be considered.</p><p><strong>Trial registration number: </strong>ClinicalTrials.gov Identifier: NCT03822936.</p>","PeriodicalId":23349,"journal":{"name":"Tumori","volume":" ","pages":"470-474"},"PeriodicalIF":4.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}