Radiation Oncology最新文献

{"title":"Study protocol: feasibility and safety of conventional external-beam radiotherapy with an integrated stereotactic lite gross-tumour-volume boost for painful bone metastases: the HYBRID study.","authors":"Shing Fung Lee, Ee Siang Choong, John Leung, Tee Lim, Sagar Ramani, Daryl Lim Joon, Craig Macleod, Jonathan Mark Tomaszewski, Jeremy Chee Seong Tey, Farshad Foroudi, Michael Chao","doi":"10.1186/s13014-025-02723-7","DOIUrl":"https://doi.org/10.1186/s13014-025-02723-7","url":null,"abstract":"<p><strong>Background: </strong>Bone metastases cause significant pain and functional limitation. Conventional external beam radiotherapy (EBRT) provides effective symptom relief, but local progression remains frequent. Stereotactic body radiotherapy (SBRT) offers improved local control but is often resource-intensive and associated with higher vertebral compression fracture (VCF) rates. Integrating a simultaneous gross tumour volume (GTV) boost within a conventional EBRT regimen may provide a feasible and safe alternative.</p><p><strong>Methods: </strong>This is a prospective, multicentre, multinational, single-arm study enrolling 100 adults with painful bone metastases from solid tumours. Eligible patients receive 20 Gy in 5 fractions with a 5 Gy \"stereotactic-lite\" GTV boost (total 25 Gy) or 30 Gy in 10 fractions with a 6 Gy boost (total 36 Gy), delivered using intensity modulated radiotherapy or volumetric modulated arc therapy. The primary endpoints are feasibility (commencement of radiotherapy within 10 working days of computed tomography simulation in at least 80% of patients) and safety (incidence of Common Terminology Criteria for Adverse Events version 5.0 grade ≥ 2 acute toxicity within 3 months). Secondary endpoints include pain response, radiation site-specific progression-free survival, rates of VCF and long bone fracture, skeletal-related events, quality of life changes via EORTC QLQ-C30 and BM22, and overall survival.</p><p><strong>Discussion: </strong>This protocol evaluates a hybrid EBRT approach with a simultaneous integrated boost as a practical strategy to enhance local tumour control and symptom relief without delaying palliation. If feasible and safe, this approach may bridge the gap between conventional EBRT and SBRT.</p><p><strong>Trial registration: </strong>Australian and New Zealand Clinical Trial Registry (ACTRN12625000615482).</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"150"},"PeriodicalIF":3.3,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperbaric oxygen therapy for late radiation tissue toxicity injury after head and neck cancer: a systematic review of the literature.","authors":"Soufiane El Hadji, David N Teguh, Milan L Ridderikhof","doi":"10.1186/s13014-025-02680-1","DOIUrl":"10.1186/s13014-025-02680-1","url":null,"abstract":"<p><strong>Background: </strong>Head and neck cancer (HNC), most of which are squamous cell carcinomas, is the seventh most common cancer worldwide. Radiotherapy is a standard treatment for HNC but may lead to late complications and severe complications like osteoradionecrosis (ORN) and impaired wound healing due to tissue hypoxia. Hyperbaric oxygen therapy (HBOT) has shown promise in ameliorating these late radiation effects. The purpose of this review is to summarize the extent of the literature on the effectiveness of HBOT in the treatment of late radiation tissue toxicity injuries (LRTTI) specifically in HNC patients.</p><p><strong>Methods/material and methods: </strong>A systematic literature search was performed using PubMed, Embase, and the Cochrane Library on August 12, 2024, including studies published between 2004 and 2022. Studies that included HNC patients with LRTTI and treated with HBOT were selected. Articles were critically appraised using the Joanna Briggs Institute (JBI) checklists. Data on patient characteristics, HBOT treatment details, and main outcomes were extracted. Primary outcomes assessed included clinical changes, such as the Notani score, while secondary outcomes focused on patient-reported measures such as VAS and OHIP. Descriptive analysis, supported by statistical measures, was used to interpret the results.</p><p><strong>Results: </strong>A total of 17 studies were reviewed, including 640 HNC patients with LRTTI who were treated with HBOT. In this systematic review, HBOT is presented in the included studies as a reliable and safe treatment for the treatment of LRTTI in HNC patients, with positive outcomes observed in 14 out of 17 studies. Specifically, almost all studies investigating ORN and oral health reported beneficial effects, with significant p-values in multiple cases. Overall, significant p-values were found in 11 studies, with a low incidence of adverse effects reported across the studies.</p><p><strong>Conclusion: </strong>This review suggests that HBOT may be effective in the treatment of LRTTI in HNC patients. However, the supporting evidence is mainly derived from low quality studies with a high risk of bias, limited sample sizes, and inconsistent outcome measures. Additional high quality studies are needed to clarify the true clinical benefits and optimal use of HBOT.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"149"},"PeriodicalIF":3.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct-to-unit, single-visit, curative-intent online adaptive stereotactic ablative radiotherapy for early-stage lung adenocarcinoma.","authors":"Farnoush Forghani, Kendall Kiser, Eric Laugeman, Yao Hao, Robbie Beckert, Julie Rolfingsmeier, Clifford Robinson, Thomas Mazur, Pamela Samson","doi":"10.1186/s13014-025-02700-0","DOIUrl":"10.1186/s13014-025-02700-0","url":null,"abstract":"<p><strong>Background: </strong>Advancements in cone beam computed tomography (CBCT)-guided radiotherapy (RT) platforms have created new frontiers in adaptive radiotherapy (ART). This report describes the novel application of single-fraction adaptive stereotactic body radiotherapy (SBRT) for a 66-year-old woman with lung adenocarcinoma for whom a conventional RT workflow was impractical due to advanced Parkinson's disease with uncontrolled tremors.</p><p><strong>Case presentation: </strong>The patient presented with a 2.4 cm spiculated nodule in the left upper lobe (LUL) diagnosed as stage 1A3 lung adenocarcinoma. She declined surgery, and local radiation oncologists deemed SBRT unsafe due to her tremors. Our team proposed a direct-to-unit, single-visit SBRT treatment utilizing anesthesia for immobilization and the Ethos platform for online adaptation to day-of-treatment positioning. An initial treatment plan was generated offline using a diagnostic CT acquired near the patient's home. On the treatment day the patient was anesthetized and a custom foam mold created using a diagnostic CT was used for setup. An internal gross tumor volume (iGTV) was adjusted based on the CBCT of the treatment day. An adaptive plan improved target coverage by 5% without violating organ-at-risk constraints. The entire procedure from initial CBCT to treatment completion took 63 min. Post-treatment recalculations on a CBCT confirmed dosimetric accuracy.</p><p><strong>Conclusions: </strong>This case illustrates the feasibility of direct-to-unit single-fraction CT-guided ART with high-quality CBCT imaging and anesthesia-facilitated immobilization. Our successful completion of this treatment establishes a procedure for future direct-to-unit ART in lung cancer, enhancing accessibility and reducing treatment time for a patient population for whom conventional RT is impractical.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"148"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic resonance imaging-guided radiotherapy for portal vein tumor thrombus in hepatocellular carcinoma: outcomes and prognostic factors.","authors":"So Jung Lee, Myungsoo Kim","doi":"10.1186/s13014-025-02717-5","DOIUrl":"10.1186/s13014-025-02717-5","url":null,"abstract":"<p><strong>Background: </strong>High-dose prescribed radiotherapy has been attempted to improve local control and restore portal vein in patients with hepatocellular carcinoma (HCC) complicated with portal vein tumor thrombus (PVTT). The aim of this study was to evaluate feasibility of real-time tumor-tracking magnetic resonance imaging-guided radiotherapy (rtMRgRT) for PVTT in HCC. In addition, prognostic factors for overall survival (OS) and progression pattern after radiotherapy (RT) were analyzed.</p><p><strong>Methods: </strong>We retrospectively reviewed the data of 34 patients who had unresectable HCC complicated with PVTT and who were treated with rtMRgRT using hypofractionated radiotherapy (HFRT) and stereotactic body radiation therapy (SBRT) between June 2019 and October 2023. HFRT was performed with a total of 50-60 Gy in 10 fractions, and SBRT was performed in a range of 36-50 Gy in 4-5 fractions. The median biologic effective dose with an a/b ratio of 10 was 100 Gy₁₀ (range: 68.4-100 Gy₁₀).</p><p><strong>Results: </strong>Twenty-one patients (61.7%) had an objective response (complete response and partial response) to PVTT; the 1-year estimated local control rate was 77.7%. The median progression-free survival and OS were 5.2 and 10.6 months, respectively. The predominant initial pattern of progressive disease after RT was outfield intrahepatic progression (21/29 cases, 72.4%). RT responder (hazard ratio [HR], 0.33; 95% confidence interval [CI], 0.12-0.88; p = 0.026) and combined transarterial chemoembolization (TACE) within 1-month post-RT (HR, 0.24; 95% CI, 0.08-0.73; p = 0.012) were favorable prognostic factors for OS.</p><p><strong>Conclusions: </strong>The rtMRgRT demonstrated feasibility in treatment of PVTT with favorable overall response and local control. Response to RT and combined TACE within a month post-RT were favorable prognostic factors for OS. Given the predominant patterns of disease progression after RT, timely management of HCC outside RT field may be crucial for enhancing the survival of patients with PVTT undergoing RT. The early combination of TACE within a month post-RT may be beneficial in this regard. Further prospective studies are needed to determine the optimal sequencing and timing for combining RT and other local therapies in patients with PVTT.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"144"},"PeriodicalIF":3.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of different neoadjuvant radiotherapy doses on survival outcomes and toxicity in patients with locally advanced rectal cancer.","authors":"Weiting Huang, Xuming Duan, Hujian Hong, Yan Li, Yongyan Shen, Deyu Sun, Yanli Qu","doi":"10.1186/s13014-025-02726-4","DOIUrl":"10.1186/s13014-025-02726-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and aims: &lt;/strong&gt;To investigate the impact of two neoadjuvant radiotherapy regimens on survival outcomes and adverse reactions in patients with locally advanced low and mid rectal cancer.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was conducted on 247 patients with locally advanced rectal cancer, treated at the Department of Radiation Oncology, Liaoning Cancer Hospital, between January 2015 and December 2020. The patients received two different neoadjuvant radiotherapy regimens: In the experimental group, the prescribed radiation dose for the primary rectal tumor and metastatic lymph nodes (PGTV) was 50.4 Gy/24 fractions, and for the pelvic lymphatic drainage area (PTV) was 45.6 Gy/24 fractions. In the control group, the prescribed radiation dose for the rectal tumor and pelvic lymphatic drainage area (PTV) was 50 Gy/25 fractions. The primary endpoints of the study included comparing the two groups in terms of pathological complete response (pCR), anal sphincter preservation rate, 3-year overall survival (OS), 3-year progression-free survival (PFS), acute adverse reactions, perioperative complications, preventive ileostomy reversal rate after LAR, and late adverse reactions. The secondary endpoints included comparing tumor regression grade (TRG), pT downstaging rate, pN downstaging rate, 3-year disease-free survival (DFS), 3-year metastasis-free survival (MFS), and 3-year local recurrence-free survival (LRFS) between the two groups. Univariate and multivariate analyses were performed to identify clinical factors influencing prognosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;This study included 247 patients with locally advanced rectal cancer, all of whom underwent synchronous chemoradiotherapy and radical total mesorectal excision (TME). The experimental group showed comparable results to the control group in terms of pCR rate, anal sphincter preservation rate, TRG grade, pT and pN downstaging rates, as well as 3-year OS, PFS, DFS, MFS, and LRFS (P &gt; 0.05). The experimental group exhibited a significantly lower incidence of ≥ 3 grade acute adverse reactions compared to the control group and had no severe adverse events leading to perioperative mortality. Additionally, the experimental group showed a significantly lower incidence of perioperative complications and a higher preventive ileostomy reversal rate. There were no significant differences between the groups in the incidence of ≥ 3 grade late adverse reactions. Univariate analysis revealed that gender, TRG grade, postoperative T/N stage, cancer nodules, and baseline CEA and CA199 levels were significant factors influencing OS, PFS, DFS, MFS, and LRFS. Multivariate analysis indicated that postoperative T stage, N stage, and baseline CA199 were significantly correlated with OS, PFS, DFS, and MFS, while postoperative T stage was significantly associated with LRFS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Compared to the control group, the experimental group, which utili","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"143"},"PeriodicalIF":3.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fiducial tracking fidelity in robotic prostate SBRT: a comparison of a 3-fraction boost following pelvic nodal irradiation and definitive 5-fraction treatment.","authors":"Jonathan W Lischalk, Vianca F Santos, Brianna Vizcaino, Andwele Murray, Astrid Sanchez, Christopher Mendez, Todd Carpenter, Joseph Kim, Owen Clancey, Scot Niglio, Aaron Katz, Anthony Corcoran, Anand Mahadevan, Jonathan A Haas","doi":"10.1186/s13014-025-02654-3","DOIUrl":"10.1186/s13014-025-02654-3","url":null,"abstract":"<p><strong>Purpose: </strong>Pelvic nodal irradiation is often used for high-risk prostate adenocarcinoma. A commonly used alternative to low dose rate (LDR) brachytherapy, a 3-fraction SBRT boost with fiducial tracking may allow for better coverage of extracapsular extension and macroscopic seminal vesicle invasion. This study evaluates the practical impact of prior pelvic nodal irradiation on fiducial tracking during a subsequent 3-fraction robotic stereotactic body radiation therapy (SBRT) boost for high-risk prostate cancer and compares these outcomes to a cohort of patients undergoing definitive 5-fraction SBRT.</p><p><strong>Methods: </strong>In this institutional analysis, we prospectively collected fiducial tracking data for patients receiving a 3-fraction boost to the prostate and seminal vesicles after conventional nodal radiation. We also identified patients treated with 5-fraction SBRT with a low risk of nodal involvement. Monte Carlo estimates of the Fisher's Exact Test assessed fiducial tracking loss. Continuous variables within the 5- and 3-fraction cohorts were compared using the Mann-Whitney Test. Changes in fiducial tracking and their association with pre-treatment factors were analyzed through the Kruskal-Wallis test and Monte Carlo for tracking patterns, and Spearman Correlation Coefficient and Mann-Whitney Test for deviations in tracking over 5 fractions.</p><p><strong>Results: </strong>A total of 405 patients were treated from April 2021 to September 2023 with: (1) 5-fraction SBRT (n = 309, 76%), and (2) 3-fraction boost after nodal irradiation (n = 96, 24%). There was no significant fiducial tracking loss over the three-fraction boost treatment regimen that proceeded nodal treatment (p = 0.63). However, there was a significant (p < 0.001) loss of fiducial tracking fidelity as demonstrated by progressive loss of one tracked fiducial over 5-fractions. There was significantly more volatility observed in the 5-fraction versus 3-fraction boost treatment (median volatility 2.4 vs. 0.0, p < 0.001). There were no significant associations between fiducial tracking, independently for 3- or 5-fractions, using either analysis method or volatility for ADT, time from fiducial placement to SBRT, CTV, and QOD vs. daily SBRT.</p><p><strong>Conclusions: </strong>Pelvic nodal treatment does not affect the quantity/quality of fiducial tracking in 3-fraction treatments. However, 5-fraction treatments showed a progressive loss and increased volatility in fiducial tracking over time. No pre-treatment factors significantly influenced fiducial tracking changes in either cohort, though ADT use trended towards increased volatility in the 5-fraction group. With a minimum of 4 fiducials placed for treatment, the loss/volatility of a single fiducial had no clinical impact on the tracking system.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"145"},"PeriodicalIF":3.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of stereotactic body radiotherapy for hepatocellular carcinoma with tumor thrombus in right atrium: a two-center retrospective review.","authors":"Yongjie Shui, Jia Yang, Xianzhi Zhao, Yang Yang, Chunshan Yu, Dongjun Dai, Liang Chen, Haiyan Chen, Di Chen, Xia Li, Lihong Liu, Qiaoying Tian, Yinglu Guo, Huojun Zhang, Qichun Wei","doi":"10.1186/s13014-025-02698-5","DOIUrl":"10.1186/s13014-025-02698-5","url":null,"abstract":"","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"146"},"PeriodicalIF":3.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimization and characterization of acute radiation-induced esophagitis in mice.","authors":"Jianhua Feng, Xiangjun Liu, Lu Xu, Ke Wang, Simin He, Xi Wang, Yujun Huang, Shubin Wang, Xudan Lei, Lingxiao Huang, Zhenni Xu, Jinyi Lang, Dengqun Liu, Jun Yin","doi":"10.1186/s13014-025-02720-w","DOIUrl":"10.1186/s13014-025-02720-w","url":null,"abstract":"<p><strong>Purpose: </strong>To optimize an animal model of acute radiation-induced esophagitis (RIE) in C57BL/6 mice and characterize the histopathological features of RIE at different stages.</p><p><strong>Materials and methods: </strong>C57BL/6 mice were subjected to single thoracic X-ray irradiation at doses ranging from 5 to 30 Gy. Changes in body weight, daily food and water intake, and survival were monitored and compared within 2 weeks after radiation exposure. Epithelial damage to the esophagus, apoptosis, and inflammation at different times after irradiation were examined to characterize the pathological process of RIE.</p><p><strong>Results: </strong>The incidence of acute RIE was strongly correlated with increasing radiation dose across all the experimental groups. No deaths were observed in mice that received 5 or 10 Gy of irradiation, whereas complete mortality was observed within 15 days after exposure to 30 Gy of irradiation. The mice in 20 Gy irradiation group had a low mortality rate. The peak of esophageal tissue damage occurred at Day 7 and was healed by Day 14 after exposure to 20 Gy of thoracic irradiation. The pathology of RIE was induced by radiation-induced DNA damage, apoptosis, reactive oxygen species (ROS), and mitochondrial impairment.</p><p><strong>Conclusions: </strong>In this study, we found that a single 20 Gy thoracic irradiation was the optimal dose to establish acute RIE in C57BL/6 mice. Acute esophageal injury peaked on Day 7 after radiation, and the process of regeneration and repair was complete within 14 days. This work may be a useful reference for experimental research concerning RIE.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"147"},"PeriodicalIF":3.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SSTR PET/CT for skull base low-grade meningioma: a critical tool for accurate gross tumor volume delineation in radiotherapy?","authors":"Frederik Fuchs, Sebastian N Marschner, Jan Hofmaier, Maya Rottler, Indra Hadi, Sebastian H Maier, Tobias Greve, Adrien Holzgreve, Nathalie L Albert, Raphael Bodensohn, Claus Belka, Maximilian Niyazi, Franziska Walter","doi":"10.1186/s13014-025-02718-4","DOIUrl":"10.1186/s13014-025-02718-4","url":null,"abstract":"<p><strong>Background: </strong>Precise delineation of gross tumor volume (GTV) is fundamental for effective radiation therapy in low-grade skull base meningiomas. Magnetic resonance imaging (MRI) serves as the primary imaging tool but may not fully represent tumor extent. This study investigates the additional value of incorporating Somatostatin receptor (SSTR)-directed PET/CT in radiation therapy planning.</p><p><strong>Methods: </strong>A retrospective analysis was conducted with four experienced radiation oncologists contouring GTVs for skull base meningiomas using MRI alone (GTV_MRI), PET/CT alone (GTV_PET/CT), and both modalities combined (GTV_ALL). Consensus ground truth volumes were generated for each modality through a STAPLE algorithm. Agreement between modalities, excluding observer variability, was assessed using statistical metrics including Dice Similarity Coefficient (DSC), Jaccard Index (JCI), Hausdorff distance (HD95), Geographical Miss Index (GMI), sensitivity, and kappa statistics.</p><p><strong>Results: </strong>The study included 25 patients (15 females, 10 males; median age 56 years (range: 23-74 years), with 96% achieving local control post-radiotherapy over a median follow-up of 64 months (range: 28-135 months). Substantial interobserver agreement was observed, with median kappa values of 0.74 for GTV_MRI, 0.68 for GTV_PET/CT, and 0.77 for GTV_ALL. Median consensus volumes were 6.65 cc (MRI_STAPLE), 7.21 cc (PET_STAPLE), and 6.73 cc (ALL_STAPLE). The median GMI for MRI_STAPLE compared to ALL_STAPLE was 0.18 (IQR: 0.11-0.39), and 0.21 (IQR: 0.15-0.28) for PET_STAPLE compared to ALL_STAPLE. The DSC indicated the lowest concordance between MRI_STAPLE and PET_STAPLE with a median of 0.75 (IQR: 0.59-0.82), followed by PET_STAPLE versus ALL_STAPLE with a median DSC of 0.84 (IQR: 0.79-0.89), and MRI_STAPLE versus ALL_STAPLE with a median DSC of 0.89 (IQR: 0.76-0.92). The integration of PET/CT with MRI significantly enhanced concordance metrics.</p><p><strong>Conclusion: </strong>Combining MRI and PET/CT improves GTV delineation in low-grade skull base meningiomas, as PET/CT can reveal regions missed by MRI, which may slightly underestimate tumor size. This multimodal imaging approach enhances consensus and supports its role in radiotherapy planning. Standardized protocols and technical integration remain key future goals.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"142"},"PeriodicalIF":3.3,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Research trends and hot spots in the prevention and management of radiation dermatitis: a bibliometric analysis based on CiteSpace.","authors":"Lu Zhang, Lian Liu, Fang Li, Peijuan Chen, Feng Ye","doi":"10.1186/s13014-025-02728-2","DOIUrl":"10.1186/s13014-025-02728-2","url":null,"abstract":"","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"141"},"PeriodicalIF":3.3,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}