Precision Radiation Oncology最新文献

{"title":"Editorial: 3^rd international workshop on microdosimetry for particle therapy: Bridging physics and biology.","authors":"Sandra Barna, Valeria Conte, Francesco Cordoni, Marta Missiaggia, Fada Guan, Anatoly Rozenfeld, Gustavo Santa Cruz, Tatsuhiko Sato, Giuseppe Schettino, Chiara La Tessa","doi":"10.1002/pro6.70054","DOIUrl":"10.1002/pro6.70054","url":null,"abstract":"","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":"10 1","pages":"4-6"},"PeriodicalIF":3.6,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sodium glycididazole combined with definitive chemoradiotherapy for patients with esophageal squamous cell carcinoma: A multicenter randomized clinical trial.","authors":"Xiaoling Li, Hanxi Zhao, Peng Xie, Wanqi Zhu, Liping Liu, Peipei Wu, Yanxing Sheng, Chuandong Wang, Yipeng Song, Xiangjiao Meng, Jiandong Zhang, Ligang Xing","doi":"10.1002/pro6.70052","DOIUrl":"10.1002/pro6.70052","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy and safety of the radiosensitizer-sodium glycididazole (CMNa) combined with definitive concurrent chemoradiotherapy (CCRT) versus CCRT alone in patients with locally advanced esophageal squamous cell carcinoma (ESCC).</p><p><strong>Methods: </strong>Patients were enrolled and randomly assigned to receive CMNa plus CCRT (CMNa group) or CCRT alone (control group). CMNa (800 mg/m²) was administered three times per week during radiotherapy (1.8-2.0 Gy per fraction, total dose of 59.4-60.0 Gy). The primary endpoint was the objective response rate (ORR) and the secondary endpoint was the incidence of adverse events.</p><p><strong>Results: </strong>Sixty-six patients with ESCC were recruited from six medical centers between 2016 and 2018. The ORRs in the CMNa and control groups were 90.32% and 68.57%, respectively (<i>χ²</i> = 4.925, <i>p</i> = 0.0265). The proportions of patients with a complete response were 8/31 (25.81%) and 8/35 (22.86%) in the CMNa and control groups, respectively. The combination of CMNa and CCRT did not increase the incidence of acute or late adverse effects.</p><p><strong>Conclusion: </strong>CMNa combined with CCRT improved the ORR in patients with ESCC compared with CCRT alone without increasing treatment-related toxicity.</p><p><strong>Trial registration: </strong>The protocol was registered at Clinicaltrials.gov (www.clinicaltrials.gov) (Clinical Trials ID: NCT02721563). Study Registration Date: March 29, 2016.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":"10 1","pages":"19-26"},"PeriodicalIF":3.6,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracic radiotherapy may enhance the survival of patients with low-risk advanced lung adenocarcinoma based on protein biomarkers.","authors":"Chunliu Meng, Fang Wang, Juan Wang, Jia Tian, Xue Li, Haijun Lu, Lujun Zhao, Ping Wang","doi":"10.1002/pro6.70053","DOIUrl":"10.1002/pro6.70053","url":null,"abstract":"<p><strong>Objectives: </strong>Several clinical trials have demonstrated promising outcomes with thoracic radiotherapy (TRT) in patients with advanced lung adenocarcinoma (LUAD). However, a subset of patients derives no significant survival benefit from TRT. This study aimed to develop a risk model integrating biomarkers and clinical factors to identify patients most likely to benefit from TRT.</p><p><strong>Methods: </strong>Prognostic proteins associated with LUAD survival were identified using data from The Cancer Proteome Atlas. Immunohistochemical analysis was performed to evaluate protein expression in patients with advanced LUAD treated at our institution between 2015 and 2019. Univariate and multivariate Cox regression analyses were conducted to determine clinical factors influencing prognosis. A risk model combining biomarkers and clinical variables was constructed to generate individualized risk scores.</p><p><strong>Results: </strong>Four proteins, PAI-1, KU80, FOXO3A_pS318S321, and CKIT, were selected for further analysis. A total of 272 patients were divided into training (<i>n</i> = 181) and validation (<i>n</i> = 91) cohorts. Six prognostic factors including N-stage, presence of sensitive mutations, brain metastasis, adrenal metastasis, leukocyte count, and expression levels of PAI-1 and KU80 were incorporated into the risk model. Patients were stratified into low- and high-risk groups based on calculated risk scores. TRT significantly improved median survival time (69.0 <i>vs</i>. 39.3 months, <i>p</i> = 0.003) and overall survival (67.4 <i>vs</i>. 33.0 months, <i>p</i> = 0.035) in low-risk patients, but not in high-risk patients (median survival time: 19.8 <i>vs</i>. 18.2 months, <i>p</i> = 0.186; overall survival: 19.4 <i>vs</i>. 19.9 months, <i>p</i> = 0.607) for two cohorts.</p><p><strong>Conclusion: </strong>Multiple biomarkers and clinical variables are associated with prognosis in LUAD. The risk model developed herein indicates that TRT confers a survival benefit exclusively in patients classified as low risk.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":"10 1","pages":"27-38"},"PeriodicalIF":3.6,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the research landscape of the correlation between radiotherapy and tumor immune microenvironment: A bibliometric analysis.","authors":"Shangyi Geng, Xia Li, Yongze Dang, Xinran Huang, Lintao Zhang, Xinyu He, Shupei Pan, Hongbing Ma, Xixi Zhao","doi":"10.1002/pro6.70041","DOIUrl":"10.1002/pro6.70041","url":null,"abstract":"<p><strong>Background: </strong>Radiation therapy (RT) is a cornerstone of cancer treatment that not only directly kills tumor cells but also produces synergistic effects with immunotherapy by remodeling the tumor immune microenvironment (TIME). However, systematic bibliometric analyses of RT-TIME interactions remain unexplored.</p><p><strong>Methods: </strong>This study analyzed all the literature related to RT and TIME from the Web of Science (WOS) Core Collection through 2024. It utilized R, VOSviewer, and CiteSpace to visually analyze authors, countries, institutions, keywords, co-cited references, research hotspots, and frontiers.</p><p><strong>Results: </strong>China, the United States, and Germany emerged as the leading contributors, with 1,253, 581, and 162 publications, respectively. Frontiers in Immunology was the most active journal (<i>n</i> = 186). Co-occurrence analysis identified \"radiotherapy\" (<i>n</i> = 898) and \"immunotherapy\" (<i>n</i> = 895) as core themes, with sustained focus on \"CD8(+) T cells\" (citation burst = 8.81) and emerging interest in \"(nature killer) NK cells.\" Temporal evolution revealed three research phases: initial exploration (2007-2015) of RT's immunomodulatory mechanisms of RT, clinical validation of RT combined with Programmed Cell Death Protein 1 (PD-1)/ Cytotoxic T-Lymphocyte-Associated Protein 4 (CTLA-4) inhibitors (2015-2020), and recent diversification (2020-2024) toward technical optimization (e.g., stereotactic RT), tumor type expansion, and safety management.</p><p><strong>Conclusions: </strong>This comprehensive bibliometric analysis highlights future priorities, including exploring optimal synergistic strategies for combination therapies, investigating spatiotemporally resolved immune mechanisms, and developing predictive biomarkers. These areas are currently experiencing rapid growth and require further research.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":"10 1","pages":"48-58"},"PeriodicalIF":3.6,"publicationDate":"2026-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatially fractionated radiotherapy versus conventional radiotherapy in the treatment of soft tissue sarcoma: A multicenter, prospective, phase II, randomized controlled clinical trial protocol.","authors":"Peng Shang, Minghao Li, Xiang Zhang, Dongyuan Zhu, Jinbo Yue","doi":"10.1002/pro6.70046","DOIUrl":"10.1002/pro6.70046","url":null,"abstract":"<p><strong>Objective: </strong>Soft tissue sarcoma (STS) is a rare and highly heterogeneous malignancy. Conventional radiotherapy (CRT) often shows limited efficacy, especially in radioresistant subtypes, such as liposarcoma and fibrosarcoma, with local recurrence rates ranging from 10% to 30%. Spatially fractionated radiotherapy (SFRT), a technique that delivers non-uniform high-dose distributions, has shown promise in improving tumor control and potentially stimulating immune responses in preliminary studies.</p><p><strong>Methods: </strong>This multicenter, prospective, randomized phase II trial aims to enroll 106 patients aged 18-70 years with pathologically confirmed STS and a minimum tumor diameter ≥5 cm. Participants will be randomized 1:1 into SFRT or CRT groups. CRT involves a uniform dose of 3.0 Gy per fraction over 15-20 fractions. SFRT employs a non-uniform dose distribution, supplementing CRT with high-dose spot irradiation of 8-15 Gy per fraction delivered for a total of 3-4 fractions. The primary endpoint was the objective response rate, and the secondary endpoints included local control, progression-free survival, and safety.</p><p><strong>Discussion: </strong>This trial is the first randomized study to directly compare SFRT and CRT for STS. SFRT is expected to enhance tumor control and elicit immunomodulatory effects, particularly in radioresistant tumors. However, the potential acute toxicities and technical complexities warrant further evaluation. Future studies should investigate the synergistic potential of SFRT combined with immunotherapy.</p><p><strong>Trial registration: </strong>The study was registered at ClinicalTrials.gov with the Identifier: NCT06980259 (Registered 12th May 2025).</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":"10 1","pages":"59-64"},"PeriodicalIF":3.6,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel method for generating a fused ventilation-perfusion map using CT-derived ventilation and FDG-PET for lung functional avoidance in radiotherapy: A feasibility study.","authors":"Suyan Bi, Zhitao Dai, Xingru Sun, Wan Fatihah Binti Wan Sohaimi, Ahmad Lutfi Bin Yusoff","doi":"10.1002/pro6.70042","DOIUrl":"10.1002/pro6.70042","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary ventilation-perfusion function plays a crucial role in both radiotherapy planning and prognosis assessment in patients with lung cancer. However, there remains a lack of rapid and cost-effective imaging modalities capable of accurately capturing this functional parameter.</p><p><strong>Purpose: </strong>This study aimed to develop a lung functional image that reflects ventilation-perfusion characteristics by integrating computed tomography (CT) and (positron emission tomography) PET imaging techniques, with the objective of enhancing lung dose evaluation in radiotherapy planning.</p><p><strong>Approach: </strong>A retrospective analysis was performed on twenty lung cancer patients using CT images acquired at two respiratory phases and FDG-PET/CT images. The Elastic Distortion algorithm was applied for deformable image registration, with the end-expiration phase CT serving as the baseline. Values derived from the determinant Jacobian matrices of ventilation CT (V-CT) images and the gray-value matrices of PET images were normalized to a range of 0 to 1. These normalized values were multiplied to generate a ventilation-perfusion matrix. Three types of lung functional images were produced from these matrices: ventilation-imaging (V-imaging), perfusion-imaging (P-imaging), and ventilation-perfusion- imaging (VP-imaging). The Dice Similarity Coefficient (DSC) and Bland-Altman plots were used to assess the correlations and discrepancies among the imaging modalities.</p><p><strong>Results: </strong>The DSC values for the entire lung, regions with low 30% functionality, and regions with high 40% functionality were 0.39 ± 0.05, 0.50 ± 0.03, and 0.20 ± 0.05 for V-P; 0.58 ± 0.03, 0.73 ± 0.03, and 0.32 ± 0.02 for V-VP; and 0.68 ± 0.04, 0.78 ± 0.04, and 0.34 ± 0.04 for P-VP, respectively. Notably, significant concordance was observed between V-VP and P-VP images within the delineated functional lung regions.#x02013;Altman analysis supported the DSC results, revealing high correlation coefficients in the low 30% functional lung region: 0.628 for V-P, 0.857 for V-VP, and 0.779 for P-VP. In contrast, similarity within the high 40% functional regions was markedly lower.</p><p><strong>Conclusion: </strong>This study developed a novel method for generating a fused VP map by integrating CT-derived ventilation and FDG-PET data. The method demonstrated feasibility, and the resulting VP map provided a balanced representation of both ventilation and perfusion signals, particularly in regions with reduced lung function.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":"10 1","pages":"77-87"},"PeriodicalIF":3.6,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engineering dosimetric excellence in total body irradiation: Tomotherapy-driven protocols for precision and reproducibility.","authors":"Sandeep Singh, Dipesh, Supratik Sen, Abhay Kumar Singh, Mahipal, Manindra Bhushan, Jaskaran Singh Sethi, David K Simson, Munish Gairola","doi":"10.1002/pro6.70049","DOIUrl":"10.1002/pro6.70049","url":null,"abstract":"<p><strong>Problem: </strong>The clinical feasibility, dosimetric reproducibility, and in vivo accuracy of a tomotherapy-based total-body irradiation (TBI) protocol in a large cohort of patients undergoing hematopoietic stem cell transplantation (HSCT) is evaluated.</p><p><strong>Methods: </strong>Patients (128 patients with hematological malignancies undergoing TBI with helical tomotherapy) were simulated in dual orientations (head-first and feet-first supine) to accommodate extended anatomical lengths. Plans were generated as separate upper and lower components with structured gradient overlap zones and then composited for delivery. Quality assurance included an ArcCHECK 3D diode array for patient-specific gamma analysis (3%/3 mm criteria), point-dose verification, and in vivo dosimetry. The gamma pass rates, regional dose deviations, and Pearson correlation coefficients were analyzed. Statistical evaluation was performed using the Shapiro-Wilk test, Levene's test, and ANOVA.</p><p><strong>Results: </strong>All treatment plans met the institutional constraints for planning target volume (PTV) coverage and organs at risk sparing. The mean D95% of the PTV consistently exceeded 95% of the prescribed dose, ensuring robust target coverage. This reflects excellent conformity with the planned dose distribution. Region-wise gamma pass rates exceeded 97% in all areas except junctions, where rates were slightly lower owing to dose gradients. The point-dose agreement showed tight clustering within the ±3% range, with the pelvis exhibiting the most significant positive shift. The in vivo optically stimulated luminescence dosimeter dose remained within the clinically acceptable range of 0.8-1.2 Gy. A strong interregional correlation (<i>r</i> > 0.90) was observed, confirming reproducibility. ANOVA identified statistically significant but clinically acceptable regional dose variations (<i>p</i> = 0.030).</p><p><strong>Conclusion: </strong>Tomotherapy-based TBI demonstrated high dosimetric precision, reproducibility, and workflow efficiency. This protocol offers a clinically reliable approach for modern TBI delivery in transplant conditioning.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":"10 1","pages":"88-101"},"PeriodicalIF":3.6,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishment and comparative analysis of radiation-induced liver disease in normal and fibrotic rat models.","authors":"Yanting Jiang, Yuxi Ding, Fang Wang, Danni Chen, Weixiang Zhong, Zhongjie Lu, Yixiang J Wang, Senxiang Yan, Xiaoguang Liu, Feng Zhao","doi":"10.1002/pro6.70050","DOIUrl":"10.1002/pro6.70050","url":null,"abstract":"<p><strong>Purpose: </strong>Hepatocellular carcinoma (HCC) is a lethal malignancy in which stereotactic body radiotherapy (SBRT) is used for inoperable cases. However, radiation-induced liver disease (RILD) remains a major risk, particularly in fibrotic livers. This study established rat models of RILD with and without preexisting fibrosis to evaluate the effects of radiation-fibrosis on liver damage.</p><p><strong>Experimental design: </strong>Male Sprague-Dawley rats were divided into radiation therapy (RT) (<i>n</i> = 41; 25 Gy right liver irradiation) and thioacetamide (TAA)+RT (<i>n</i> = 46; 6-week TAA-induced fibrosis + 20 Gy RT) groups. Pathological assessments (Hematoxylin and Eosin, Masson's Trichrome, Picro-Sirius Red, and TGF-β/α-SMA immunohistochemistry) were performed at 2, 4, 8, and 12 weeks post-RT to quantify fibrosis, collagen, inflammation, and ballooning degeneration. Statistical analyses included independent sample t-tests, Mann-Whitney U tests, and one-way ANOVA, with <i>p</i> < 0.05 considered significant.</p><p><strong>Results: </strong>The RT group exhibited mild edema (2-12 weeks), mild ballooning degeneration (4-12 weeks), and minimal inflammation (2-12 weeks). Collagen deposition and TGF-β expression increased significantly at 8-12 weeks (<i>p</i> < 0.05), whereas α-SMA remained mildly elevated at 4-12 weeks (<i>p</i> > 0.05). The TAA+RT group showed mild/severe ballooning degeneration, moderate inflammation, and markedly higher collagen/fibrosis compared with the RT group (<i>p</i> < 0.05). Both TGF-β and α-SMA increased progressively in the TAA+RT group, peaking at 12 weeks (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Radiation combined with preexisting fibrosis exacerbates hepatic damage and stellate cell activation. This study provides validated RILD models for translational research and highlights the need for cautious radiation dose selection in patients with fibrosis to mitigate the risk of liver injury.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":"10 1","pages":"65-76"},"PeriodicalIF":3.6,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new perspective on cancer treatment: the interaction and application prospect between ICIs and radiotherapy.","authors":"Guiling Song, Lei Wang, Guopeng Zhao, Song Tan, Xin Liu, Xinghua Li","doi":"10.1002/pro6.70047","DOIUrl":"10.1002/pro6.70047","url":null,"abstract":"<p><p>The interaction between immune checkpoint inhibitors (ICIs) and radiotherapy has significantly improved the treatment outcomes for patients with cancer. ICIs activate the immune system by blocking the programmed death-1 (PD-1), programmed cell death-Ligand 1(PD-L1), and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) signaling pathways, thereby killing tumor cells. Radiotherapy activates local and abscopal effects by killing tumor cells, inducing immunogenic death, and releasing antigens and damage-related molecules. The combination of the two methods forms a closed-loop process of \"antigen release-immune activation,\" which significantly improves the therapeutic effect of patients with cancer. Clinical studies have shown that ICIs combined with radiotherapy can significantly improve the objective response rate (ORR) and progression-free survival (PFS) in patients with solid tumors, such as Non-Small Cell Lung Cancer (NSCLC) and melanoma. However, heterogeneous responses, immune-related adverse events (irAEs), and drug resistance are still common clinical problems. Optimizing the fractionation of radiotherapy dose, timing of synchronous intervention, and biomarkers, such as tumor mutation burden, are key to improving tumor treatment efficacy. In the future, precise tumor treatment is expected to improve patient prognosis through the interaction between ICIs and radiotherapy.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":"10 2","pages":"184-191"},"PeriodicalIF":3.6,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13292254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-year follow-up after fractionated ultra-high-dose-rate FLASH radiotherapy in patient with extramammary Paget disease of the scrotum.","authors":"Hui Luo, Chengliang Yang, Ronghu Mao, Leijie Ma, Hongchang Lei, Peng Chen, Yanping Zhang, Meng Xu, Chao Wang, Yiwu Wang, Mingxia Wu, Chanjun Sun, Han Liu, Hui Liu, Hong Ge","doi":"10.1002/pro6.70045","DOIUrl":"10.1002/pro6.70045","url":null,"abstract":"<p><strong>Objective: </strong>Ultrahigh-dose-rate radiotherapy (FLASH-RT) has been shown to reduce radiation-induced normal tissue injury in preclinical studies. Here, we describe the first patient worldwide to receive fractionated FLASH-RT.</p><p><strong>Methods: </strong>An elderly male patient was diagnosed with extramammary Paget disease of the scrotum along with multiple lymph node and bone metastases. After 6 cycles of chemotherapy, the disease progressed in the scrotum. The scrotal lesions were evaluated for FLASH-RT. 9 MeV electron FLASH-RT was performed at a dose rate of 120 Gy/s. The field size was 5 cm × 5 cm, and the prescribed dose was 40 Gy in five fractions. Dosimetric verification was performed daily. Treatment response was evaluated at 3-month post FLASH-RT, and normal tissue toxicity was assessed from the beginning of FLASH-RT to 12-month post-irradiation.</p><p><strong>Results: </strong>A 1-year follow-up was achieved for scrotal lesions treated with electron FLASH-RT in patients with extramammary Paget disease. Electron FLASH-RT was safe, and treatment-related adverse events were mild. Transient skin toxicity occurred 2-5 weeks post FLASH-RT, and exudation and burning pain were significantly alleviated. A complete response was achieved 2-3 months post FLASH-RT, and the tumor lesions were covered by the normal epithelium of the scrotum. At the end of the one-year follow-up, the tumor lesions continued to respond, and one-year survival was achieved without additional injury to the irradiated areas after FLASH-RT.</p><p><strong>Conclusion: </strong>Fractionated electron FLASH-RT is feasible and safe for the treatment of extramammary Paget disease of the scrotum. Our findings support further exploration of electron FLASH-RT in patients with skin tumors.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":"10 2","pages":"120-126"},"PeriodicalIF":3.6,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13292164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}