Reports of Practical Oncology and Radiotherapy最新文献

{"title":"Long-term pulmonary function decline after stereotactic body radiation therapy for lung tumors.","authors":"Hidekazu Tanaka, Akane Hironaka, Chika Nakabe, Kazushi Ueda, Taiki Ono, Yuki Manabe, Miki Kajima, Tatsuhiro Sera, Koya Fujimoto, Yuki Yuasa, Takehiro Shiinoki","doi":"10.5603/rpor.111335","DOIUrl":"10.5603/rpor.111335","url":null,"abstract":"<p><strong>Background: </strong>Stereotactic body radiation therapy (SBRT) is widely used for early-stage lung cancer and inoperable cases due to its high local control rate and limited invasiveness. However, its long-term impact on pulmonary function remains controversial.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed patients with lung tumors who underwent SBRT at our institution between November 2009 and May 2024 and had at least one pulmonary function test (PFT) before and after treatment. Patients with prior thoracic radiotherapy or post-treatment events affecting lung function were excluded. PFT changes were assessed at multiple post-treatment intervals. Lung dose parameters and correlations with changes in PFT results were analyzed. Receiver operating characteristic (ROC) analysis was used to determine dose cut-off values predictive of a ≥ 10% decline in pulmonary function.</p><p><strong>Results: </strong>A total of 61 patients were included. Significant declines in vital capacity (VC), forced vital capacity (FVC), and forced expiratory volume in 1 second (FEV₁) were observed only in the very late phase (> 24 months post-SBRT). VC and FVC decline correlated negatively with D33.3%, and FEV₁ decline correlated most strongly with V20. ROC analysis identified D33.3% and V20 thresholds that significantly predicted ≥ 10% decline. Patients above these dose thresholds showed significantly greater reductions in all three parameters.</p><p><strong>Conclusions: </strong>Pulmonary function decline after SBRT becomes evident more than 2 years post-treatment and is associated with specific lung dose parameters. These findings highlight the importance of long-term monitoring and careful dose planning in SBRT for lung tumors.</p>","PeriodicalId":47283,"journal":{"name":"Reports of Practical Oncology and Radiotherapy","volume":"31 3","pages":"367-374"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13364318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438495","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":"Molecularly defined renal cell carcinomas.","authors":"Petr Stránský, Jiří Kolář, Dominika Šiková, Tomáš Pitra, Jan Pernický, Ondřej Fiala, Kristýna Pivovarčíková, Ondrej Ondič, Milan Hora","doi":"10.5603/rpor.111326","DOIUrl":"10.5603/rpor.111326","url":null,"abstract":"<p><p>Current World Health Organization (WHO) Classification of Urinary and Male Genital Tumours (2022) has introduced minor updates in the classification of renal cell carcinomas (RCC). Among the most notable changes is the recognition of a new category: molecularly defined RCC. This group comprises several distinct tumour entities characterized by specific genetic alterations. The inclusion of this category reflects the growing importance of molecular testing in the diagnosis, prognosis and treatment planning of renal malignancies. This review summarizes the basic information, clinical data, and treatment options of these rare RCCs. Due to the low prevalence of molecularly defined RCCs, the clinical management remains challenging, and standardized, evidence-based treatment guidelines are still lacking, particularly for the systemic therapy of advanced RCCs. As part of the review, a clinical case of a female patient with metastatic <i>TFE3</i>-translocated RCC is also presented, illustrating the diagnostic and therapeutic challenges.</p>","PeriodicalId":47283,"journal":{"name":"Reports of Practical Oncology and Radiotherapy","volume":"31 3","pages":"435-449"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13364320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438416","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":"Review of ctDNA in breast cancer - present utility and future perspectives.","authors":"Moushumi Suryavanshi, Shiveta Razdan, Manoj Kumar","doi":"10.5603/rpor.111323","DOIUrl":"10.5603/rpor.111323","url":null,"abstract":"<p><p>Breast cancer is the second most commonly diagnosed cancer worldwide and remains a major cause of cancer-related mortality. Despite advances in treatment, challenges like tumor heterogeneity, recurrence, and drug resistance persist. A critical unmet need in breast cancer management is the lack of validated, real-time biomarkers to monitor disease progression and treatment response. Circulating tumor DNA (ctDNA), a key component of liquid biopsy, offers a promising, non-invasive approach to address this gap. Circulating tumor DNA is released into the bloodstream by tumor cells through apoptosis, necrosis, or active secretion and provides a dynamic snapshot of the tumor's genetic profile. Its short half-life allows real-time monitoring of tumor burden, therapeutic response, and minimal residual disease. Circulating tumor DNA analysis has demonstrated potential in early cancer detection, predicting recurrence, and identifying emerging drug resistance, often surpassing the sensitivity of conventional imaging. Furthermore, its non-invasive nature enables repeated sampling with minimal patient discomfort. As technological advances continue to improve sensitivity and specificity, ctDNA is emerging as a powerful tool in the personalized management of breast cancer. Its integration into clinical practice could transform current paradigms of diagnosis, treatment monitoring, and long-term follow-up, paving the way for truly individualized cancer care.</p>","PeriodicalId":47283,"journal":{"name":"Reports of Practical Oncology and Radiotherapy","volume":"31 3","pages":"418-434"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13364270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438438","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":"Neutrophile-to-lymphocyte ratio predicts survival in patients aged 80 years and older undergoing radiotherapy: a single-center experience.","authors":"Aneta Lebiedzińska, Ewa Wasilewska-Teśluk, Sergiusz Nawrocki","doi":"10.5603/rpor.112209","DOIUrl":"10.5603/rpor.112209","url":null,"abstract":"<p><strong>Background: </strong>The aging population has increased the incidence of cancer among individuals aged ≥ 80 years, highlighting the need to understand treatment feasibility and prognostic factors in this group. This study evaluated the feasibility and safety of radiotherapy in octogenarians with solid tumors and assessed clinical and laboratory predictors of survival.</p><p><strong>Materials and methods: </strong>A single-center retrospective analysis included patients aged ≥ 80 years treated with radiotherapy between 2021 and 2022, with ≥ 12 months of follow-up. Clinical data, laboratory results, and outcomes were collected from medical records. Cut-off values for the neutrophile-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were determined using time-dependent ROC analysis. Their predictive value for mortality was examined, and multivariate logistic regression identified prognostic factors.</p><p><strong>Results: </strong>A total of 352 patients (median age: 84) were included. Radiotherapy was administered with curative intent in 43.2% and palliatively in 56.8%. Median overall survival was 14.4 months, and 30-day mortality was 7.1%. An NLR cut-off of 3.64 strongly predicted 30-day mortality, while PLR showed weaker association. Poor performance status, NLR > 3.64, and living with family were linked to shorter survival. In curative cases, low NLR did not significantly improve survival, whereas in the palliative subgroup it was associated with longer survival. Radiotherapy was well tolerated, with grade ≥ 3 adverse events in 4.8% of patients.</p><p><strong>Conclusions: </strong>Radiotherapy is feasible and generally well tolerated in octogenarians. NLR appears to be a simple, cost-effective biomarker supporting pre-treatment assessment. Prospective validation is needed.</p>","PeriodicalId":47283,"journal":{"name":"Reports of Practical Oncology and Radiotherapy","volume":"31 3","pages":"407-417"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13364371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438490","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":"Accuracy assessment of a hybrid deep learning and image processing approach for lung CT segmentation in external radiotherapy.","authors":"Hamza Sekkat, Abdellah Khallouqi, Yasmina Berrada, Mohammed Talbi, Ahmed Bannan, Oussama El Mouden, Abdellah Halimi, Youssef Madkouri, Omar El Rhazouani","doi":"10.5603/rpor.111328","DOIUrl":"10.5603/rpor.111328","url":null,"abstract":"<p><strong>Background: </strong>Accurate lung segmentation in computed tomography (CT) is a fundamental step for numerous clinical applications, including radiotherapy planning and thoracic disease diagnosis. Manual segmentation, however, remains time-consuming and operator-dependent. This study aims to develop a fully automated segmentation framework combining a well-structured pipeline of image processing techniques with a deep learning model based on a U-Net architecture and a pre-trained VGG16 encoder.</p><p><strong>Materials and methods: </strong>Ninety anonymized thoracic CT scans, including lung and breast cancer patients, were collected, pre-processed and used to generate binary lung masks using a custom Python pipeline. The dataset was split patient-wise into training (70%), validation (15%) and testing (15%) subsets. The model was trained using binary crossentropy loss, the Adam optimizer and data augmentation strategies to improve generalization.</p><p><strong>Results: </strong>High correlations were observed between automatically computed lung volumes and mean Hounsfield units (HU) compared to the treatment planning system (TPS) references (R² = 0.84 for volume, R² = 0.72 for HU, both with p < 1 × 10^-33) and the deep learning model achieved a mean Dice similarity coefficient (DSC) of ~95% and intersection over union (IoU) of ~95% on an independent test set. Mean loss and pixel-wise accuracy were 0.004 and ~95%, respectively.</p><p><strong>Conclusions: </strong>The proposed VGG16-based U-Net model demonstrates high accuracy and robustness in segmenting lungs from thoracic CT scans, achieving ~95% DSC and ~99% pixel-wise accuracy. It effectively replaces manual segmentation with a fully automated, scalable solution. This framework streamlines lung segmentation in clinical radiotherapy workflows, reducing operator variability and time consumption.</p>","PeriodicalId":47283,"journal":{"name":"Reports of Practical Oncology and Radiotherapy","volume":"31 3","pages":"380-388"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13364373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438334","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":"FocaSaBra: a prospective phase II study on focal salvage brachytherapy for prostate cancer recurrence after radiotherapy - trial design.","authors":"Wojciech M Burchardt, Adam Kluska, Adam Chicheł, Grzegorz Zwierzchowski, Ewa Burchardt, Grzegorz Bielęda, Artur J Chyrek","doi":"10.5603/rpor.111330","DOIUrl":"10.5603/rpor.111330","url":null,"abstract":"<p><strong>Background: </strong>Recurrence of prostate cancer (PC) after primary radiotherapy poses a significant therapeutic challenge. While whole-gland salvage treatments carry considerable toxicity risks, focal salvage brachytherapy (FsBT) may preserve quality of life while achieving local control. The FocaSaBra trial is a prospective phase II study designed to evaluate the safety, feasibility, and oncologic efficacy of FsBT.</p><p><strong>Materials and methods: </strong>100 patients with intraprostatic recurrence confirmed by biopsy will be enrolled to the monocentric prospective trial. Depending on the primary radiation modality, patients will receive either high-dose-rate (HDR) FsBT with 26 Gy in 2 fractions using iridium-192 or ultra-low-dose-rate (uLDR) FsBT with iodine-125 seeds delivering 145 Gy. The dominant intraprostatic lesion (DIL) will be targeted with a 5-10 mm margin. The primary endpoint is the incidence of grade ≥ 3 genitourinary (GU) or gastrointestinal (GI) toxicity, assessed using CTCAE v4.0, RTOG scale, IPSS, IIEF, and EORTC QLQ-C30/PR25. Secondary endpoints include biochemical control and progression-free survival.</p><p><strong>Results: </strong>Toxicity and oncological outcomes will be analyzed using descriptive statistics and multivariate modeling. Kaplan-Meier analysis will assess PSA progression-free survival. Subgroup analyses will explore the impact of prior radiation type and treatment volume. The estimated 95% confidence interval for the primary endpoint allows for adequate detection of clinically significant toxicity rates.</p><p><strong>Conclusions: </strong>FocaSaBra is a prospective trial to assess FsBT in radiorecurrent PC. It addresses a critical gap in salvage treatment options by potentially offering effective local control with minimal toxicity. Findings from this study may establish FsBT as a viable alternative to whole-gland salvage approaches.</p>","PeriodicalId":47283,"journal":{"name":"Reports of Practical Oncology and Radiotherapy","volume":"31 3","pages":"341-348"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13364273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438307","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":"Comparative analysis of LDR and HDR intracavitary brachytherapy in cervical cancer: the critical role of overall treatment time - a decade of experience.","authors":"Purnima Thakur, Kaalindi Singh, Vineet Lakhanpal, Manish Gupta, Lalit C Kant, Parul Sharma","doi":"10.5603/rpor.110815","DOIUrl":"10.5603/rpor.110815","url":null,"abstract":"<p><strong>Background: </strong>This study compares low dose rate (LDR) and high dose rate (HDR) intracavitary brachytherapy (ICBT) in the treatment of cervical cancer treated at a tertiary care cancer centre in North India.</p><p><strong>Materials and methods: </strong>A retrospective analysis of 316 cervical cancer patients treated between 2009 and 2019 was conducted. Outcomes of 240 patients receiving external beam radiotherapy (EBRT) followed by HDR were compared with 76 patients treated with a historical group of LDR brachytherapy.</p><p><strong>Results: </strong>The median follow-up was 60 months and 34.4 months for LDR and HDR groups, respectively. Overall treatment time (OTT) was longer in the HDR group and pelvic lymph node positivity was also higher. HDR brachytherapy showed a higher adjusted hazard ratio (HR) for 5-year OS [HR = 2.3, p < 0.001, 95% confidence interval (CI): 1.6-3.3] and local recurrence (HR = 1.5, p = 0.018, 95% CI: 1.07-2.18) compared to LDR. HDR showed higher adjusted HR for 5-year disease-free survival (DFS) (HR = 1.8, p < 0.001, 95% CI: 1.3-2.6). The 5-year OS was 53% in the LDR group and the median survival was not reached, whereas in the HDR group, 5-year OS was 23% with median survival of 34 months. Rectal toxicity was higher in the LDR group.</p><p><strong>Conclusions: </strong>HDR brachytherapy offers clear logistical and patient convenience advantages compared to LDR; however, this benefit comes with the trade-off of higher risks of mortality and relapse when treatment duration is prolonged. Optimizing HDR - through strategies such as reducing OTT and incorporating image guidance - can help mitigate these risks and improve outcomes.</p>","PeriodicalId":47283,"journal":{"name":"Reports of Practical Oncology and Radiotherapy","volume":"31 3","pages":"330-340"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13364224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438314","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":"Many faces of meningeal carcinomatosis - a single-center case series of patients diagnosed in a neurological department setting.","authors":"Marzena Dziedzic, Katarzyna Sawczyńska, Tomasz Homa, Magdalena Spaczyńska-Boczar, Adrian Baran, Joanna Jóźwik, Kaja Zdrojewska, Jeremiasz Jagiełła, Agnieszka Słowik","doi":"10.5603/rpor.111762","DOIUrl":"10.5603/rpor.111762","url":null,"abstract":"<p><strong>Background: </strong>Meningeal carcinomatosis is a rare neurological complication of cancer, but one associated with extremely poor prognosis. The aim of this study was to analyse the incidence, clinical presentations and in-hospital outcomes of patients with meningeal carcinomatosis requiring hospitalization in a neurological department.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed medical files of all patients hospitalized in neurological departments of the University Hospital in Kraków (Poland) from January 2022 to March 2024. To the study we included all patients with meningeal carcinomatosis diagnosed based on neuroimaging results and/or cerebrospinal fluid testing. Their symptoms, underlying malignancy type, auxiliary test results and in-hospital outcomes are presented in the form of a case series. Among 4056 patients hospitalized in neurological departments in the analysed period of time, 200 (4.9%) had active cancer (AC) and 6 (0.15% of all patients and 3% of AC) had a diagnosis of meningeal carcinomatosis (MC).</p><p><strong>Results: </strong>The patients were aged 41-72 with a median age of 57 years. They were all female. The most common underlying malignancy was breast cancer found in 75%. Each patient had a completely different clinical picture.</p><p><strong>Conclusions: </strong>MC is a fatal entity, clinically heterogeneous and rarely diagnosed in a neurological department setting. Nevertheless, in the context of potential treatment options, neurologists should be aware of its symptoms and signs and, being aware of the flaws of auxiliary testing, include it in the differential diagnosis, especially in patients with AC and new-onset neurological symptoms.</p>","PeriodicalId":47283,"journal":{"name":"Reports of Practical Oncology and Radiotherapy","volume":"31 3","pages":"400-406"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13364321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438403","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":"Fistula occurrence after definitive chemoradiotherapy in metastatic or persistent cervical cancer: a retrospective cohort study.","authors":"Munachiso Iheme Ndukwe, Klara Balcarova, Jiri Spacek, Denisa Pohankova, Petra Bretova, Eva Cermakova, Jan Laco, Akaninyene Eseme Ubom, Milan Vosmik, Igor Sirak","doi":"10.5603/rpor.111763","DOIUrl":"10.5603/rpor.111763","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the association between bevacizumab use and fistula occurrence in patients with metastatic or persistent cervical cancer (CC) treated with definitive chemoradiotherapy (CRT).</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 101 patients with FIGO stage IIB-IVB CC treated with curative-intent CRT between 2017 and 2023. The primary outcome was the incidence of fistula formation, with a focus on the impact of bevacizumab exposure.</p><p><strong>Results: </strong>Fistulas occurred in 7 of 101 patients (6.9%). Among the 13 patients treated with bevacizumab, 4 (30.8%) developed fistulas compared with 3 (3.4%) of 88 not receiving bevacizumab. Univariable analysis showed significant associations with bevacizumab use (OR = 12.59, 95% CI: 2.43-65.38, p = 0.003), and FIGO stage IVB (OR = 21.90, p = 0.001). In multivariable analysis, bevacizumab (AOR = 13.5, 95% CI: 1.84-99.5, p = 0.011) and FIGO stage IV (AOR = 26.7, 95% CI: 2.59-274.4, p = 0.006) remained independent predictors. No fistulas occurred after 2021, coinciding with institutional discontinuation of bevacizumab in metastatic or persistent disease after CRT (p = 0.043).</p><p><strong>Conclusions: </strong>Bevacizumab use and FIGO stage IV disease were associated with increased risk of fistula formation after definitive CRT. These findings highlight the need for careful treatment planning when considering bevacizumab in previously irradiated patients, particularly in the current era of multimodal therapy.</p>","PeriodicalId":47283,"journal":{"name":"Reports of Practical Oncology and Radiotherapy","volume":"31 3","pages":"322-329"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13364317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438356","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":"Salvage ultra-low-dose radiotherapy for conjunctival mantle cell lymphoma - a case report and literature review.","authors":"Suyapa Margarita Meléndez Varela, Concepción Victoria Fernández, Sergio Manuel Melgar Rivera, Rodrigo Salcedo Pereda, Luis Cascallar Caneda","doi":"10.5603/rpor.110467","DOIUrl":"10.5603/rpor.110467","url":null,"abstract":"<p><p>Mantle cell lymphoma (MCL) is an aggressive B-cell non-Hodgkin lymphoma with variable responses to frontline chemotherapy. Orbital involvement is rare, and data on radiotherapy, particularly at ultra-low doses, remain limited. The authors report a 64-year-old male with conjunctival MCL refractory to a single cycle of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone). He underwent salvage ultra-low-dose radiotherapy (VLDRT; 4 Gy in 2 fractions) to the left orbit using volumetric modulated arc therapy (VMAT) with 6 MV photons, daily cone beam computed tomography (CBCT) image guidance, thermoplastic mask immobilization, and a 0.5 cm bolus. The patient achieved significant clinical improvement and complete metabolic response within weeks. Ophthalmology evaluation documented preserved visual acuity, normal fundoscopy, and no toxicity. At 24 months, orbital remission is maintained, despite later systemic relapse managed with R-DHAOx regimen (rituximab, dexamethasone, high-dose cytarabine, and oxaliplatin) and ibrutinib, achieving systemic control while maintaining orbital remission. VLDRT can provide durable local control and functional preservation in anatomically critical sites. This case, together with recent literature, highlights the potential role of VLDRT as a salvage strategy in aggressive lymphomas.</p>","PeriodicalId":47283,"journal":{"name":"Reports of Practical Oncology and Radiotherapy","volume":"31 3","pages":"464-468"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13364364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438419","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}