Radiation Oncology最新文献

{"title":"Deformable registration for nasopharyngeal carcinoma using adaptive mask and weight allocation strategy based CycleFCNs model.","authors":"Yi Guo, Jun Chen, Lin Lu, Lingna Qiu, Linzhen Lan, Feibao Guo, Jinsheng Hong","doi":"10.1186/s13014-025-02603-0","DOIUrl":"10.1186/s13014-025-02603-0","url":null,"abstract":"<p><strong>Background: </strong>Deformable registration plays an important role in the accurate delineation of tumors. Most of the existing deep learning methods ignored two issues that can lead to inaccurate registration, including the limited field of view in MR scans and the different scanning angles that can exist between multimodal images. The purpose of this study is to improve the registration accuracy between CT and MR for nasopharyngeal carcinoma cases.</p><p><strong>Methods: </strong>269 cases were enrolled in the study, and 188 cases were designated for training, while a separate set of 81 cases was reserved for testing. Each case had a CT volume and a T1-MR volume. The treatment table was removed from their CT images. The CycleFCNs model was used for deformable registration, and two strategies including adaptive mask registration strategy and weight allocation strategy were adopted for training. Dice similarity coefficient, Hausdorff distance, precision, and recall were calculated for normal tissues of CT-MR image pairs, before and after the registration. Three deformable registration methods including RayStation, Elastix, and VoxelMorph were compared with the proposed method.</p><p><strong>Results: </strong>The registration results of RayStation and Elastix are essentially consistent. Upon employing the VoxelMorph model and the proposed method for registration, a clear trend of increased dice similarity coefficient and decreased hausdorff distance can be observed. It is noteworthy that for the temporomandibular joint, pituitary, optic nerve, and optic chiasma, the proposed method has improved the average dice similarity coefficient from 0.86 to 0.91, 0.87 to 0.93, 0.85 to 0.89, and 0.77 to 0.83, respectively, as compared to RayStation. Additionally, within the same anatomical structures, the average hausdorff distance has been decreased from 2.98 mm to 2.28 mm, 1.83 mm to 1.53 mm, 3.74 mm to 3.56 mm, and 5.94 mm to 5.87 mm. Compared to the original CycleFCNs model, the improved model has significantly enhanced the dice similarity coefficient of the brainstem, pituitary gland, and optic nerve (P < 0.001).</p><p><strong>Conclusions: </strong>The proposed method significantly improved the registration accuracy for multi-modal medical images in NPC cases. These findings have important clinical implications, as increased registration accuracy can lead to more precise tumor segmentation, optimized treatment planning, and ultimately, improved patient outcomes.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"26"},"PeriodicalIF":3.3,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505749","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":"Stereotactic body radiotherapy (SBRT) as a treatment for localized prostate cancer: a retrospective analysis.","authors":"Brecht De Cooman, Tibaut Debacker, Thomas Adams, Guy Lamberts, Bart De Troyer, Marc Claessens, Geert De Kerf, Carole Mercier, Piet Dirix, Piet Ost","doi":"10.1186/s13014-025-02598-8","DOIUrl":"10.1186/s13014-025-02598-8","url":null,"abstract":"<p><strong>Background: </strong>External beam radiotherapy (EBRT) is a standard treatment for localized prostate cancer, with recent advancements favoring a reduced number of treatment sessions. Stereotactic body radiotherapy (SBRT) is a form of radiotherapy that delivers higher doses per fraction, typically in five or fewer sessions. This retrospective study aims to evaluate the implementation of the PACE-SBRT protocol for localized prostate cancer at our center by assessing the incidence and severity of toxicity, as well as biochemical relapse-free survival.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of patients with localized prostate cancer treated with SBRT at the Iridium Network in Antwerp, Belgium, who were treated between January 1, 2020, and December 31, 2022. Data were extracted from electronic medical records and included descriptive information on patient outcomes. Acute and late genitourinary (GU) and gastrointestinal (GI) toxicities were graded according to the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. Acute toxicity was defined as events occurring within 90 days post-SBRT, whereas late toxicity was evaluated at 6 months, 1 year, 2 years, and 3 years post treatment. Biochemical recurrence was defined via the Phoenix criteria, as a rise in PSA levels of 2 ng/mL or more above the post treatment nadir.</p><p><strong>Results: </strong>A total of 267 patients met the eligibility criteria for this study. In total, 9% of patients were low risk, 51% were intermediate risk, and 40% were high risk. The cumulative incidence of Grade 2 or higher GU toxicity was 27%, and for GI toxicity, it was 2%. At 24 months, 11.5% (20/175) of patients experienced CTCAE grade 2 or higher GU toxicity, and 1.7% (3/175) experienced grade 2 or higher GI toxicity. Biochemical relapse occurred in 1.5% (4/267) of patients, leading to a 2-year biochemical relapse-free survival rate of 98.5%.</p><p><strong>Conclusion: </strong>SBRT for localized prostate cancer has favorable oncological outcomes with a low incidence of Grade 2 or higher toxicity. The results of this study are consistent with findings from prospective trials, suggesting that SBRT is an effective treatment modality. Trial registration Retrospectively registered.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"25"},"PeriodicalIF":3.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476928","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":"Therapeutic and prognostic impact of target volume delineation in postoperative radiotherapy for high-grade glioma patients with subventricular zone involvement.","authors":"Fei Sun, Yan Zhu, Guanghui Gan, Yuan Xu, Xiaoting Xu","doi":"10.1186/s13014-025-02601-2","DOIUrl":"10.1186/s13014-025-02601-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to analyze the effect of target volumes for radiotherapy and dose on the prognosis of high-grade glioma (HGG) patients when the tumor involves the subventricular zone (SVZ), and to provide a reference for postoperative target volume delineation in HGG patients with SVZ involvement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The clinical and pathological data were collected from 50 HGG patients with SVZ involvement were collected in the Department of Neurosurgery of the First Affiliated Hospital of Soochow University during the period from January 1, 2017 to December 31, 2020. The average dose (Dmean) of the whole ipsilateral and contralateral SVZs as well as the V45Gy and V60Gy of the whole ipsilateral SVZs of the tumor were derived from the dose-volume histograms (DVH). The Kaplan-Meier analysis was applied to compare the survival differences between groups under different factors. The Cox proportional risk regression model was used to analyze the influencing factors of progression-free survival (PFS) and overall survival (OS). The correlation between the size of the ipsilateral SVZ target area range and the progression pattern was tested by chi-square test.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Univariate analysis revealed that the potential predictors of PFS of HGG patients with tumor involvement in SVZ were as follows: multiple lesions, tumor size &gt; 3.5 cm and total resection; the potential predictors of OS were multiple lesions, surgical approaches to the lateral ventricles and the dose of contralateral SVZ &gt; 37.33 Gy. Multibariate analysis showed that tumor size &gt; 3.5 cm and total resection were the independent prognostic factors of PFS; multiple lesions was the independent prognostic factors of OS. The Kaplan-Meier method showed that the median PFS and OS of HGG patients with V60Gy ≥ 50% was higher than that of patients with V60Gy &lt; 50% but the difference was not statistically significant. Subgroup analysis showed that patients with V60Gy ≥ 50% had significantly higher PFS in the age &lt; 60 years subgroup (P = 0.006), WHO IV grade (P = 0.006), and surgical penetration of the lateral ventricle subgroup (P = 0.034) than in the V60Gy &lt; 50%. Patients with V60Gy ≥ 50% had significantly higher OS in the WHO IV grade subgroup (P = 0.035), surgically penetrated lateral ventricle subgroup (P = 0.008), IDH1 wild-type subgroup (P = 0.012), and MGMT unmethylated subgroup (P = 0.047) than in V60Gy &lt; 50%. A volume of ≥ 50% of the ipsilateral SVZ receiving a 60 Gy irradiation dose improves local control and reduces the risk of local recurrence in patients with SVZ involvement in HGG.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;For SVZ-involved HGG patients, the whole ipsilateral SVZ receiving 60 Gy irradiation dose in ≥ 50% of the volume prolonged PFS in those with age &lt; 60 years, WHO IV grade and surgically penetrating lateral ventricles and prolonged OS in those with WHO IV grade, surgically penetrating lateral ventricles, IDH1 wil","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"24"},"PeriodicalIF":3.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460442","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":"Stereotactic body radiotherapy with carbon ions as local ablative treatment in patients with primary liver cancer.","authors":"Paula Hoffmeister-Wittmann, Philipp Hoegen-Saßmannshausen, Livia Wicklein, Fabian Weykamp, Katharina Seidensaal, Christoph Springfeld, Michael T Dill, Thomas Longerich, Peter Schirmacher, Arianeb Mehrabi, René Michael Mathy, Bruno C Köhler, Jürgen Debus, Klaus Herfarth, Jakob Liermann","doi":"10.1186/s13014-025-02594-y","DOIUrl":"10.1186/s13014-025-02594-y","url":null,"abstract":"<p><strong>Background and aims: </strong>Liver cancer is the third leading cause of cancer related death due to treatment resistance and late onset of symptoms (Rumgay in J Hepatol 77: 1598-1606, 2022). The role of external beam radiotherapy (EBRT) in treatment of unresectable liver cancer needs to be defined. The use of particle therapy such as carbon ion radiation therapy (CIRT) with high linear energy transfer (LET) could increase efficacy of EBRT while limiting the toxic effects of radiation on non-cancerous liver tissue. Promising effects of CIRT have been described in several studies during the past decades, mostly in Japan. To date, no standardized treatment protocol has been established and European data on CIRT for liver cancer is lacking. This retrospective analysis aims to investigate efficacy and safety of hypofractionated CIRT compared to photon-based stereotactic body radiation (SBRT) in primary liver cancer.</p><p><strong>Method: </strong>Thirty-six (n = 36) and twenty (n = 20) patients with primary malignant liver tumors were treated with hypofractionated CIRT (4 fractions) and photon-based SBRT, respectively, between 2011 and 2022 and were retrospectively evaluated for survival, local control, and toxicity.</p><p><strong>Results: </strong>Two-year local control rate after CIRT was 92.3%. Compared to photon- based SBRT, CIRT scores with a significantly longer median distant progression free survival (3.1 versus 0.9 years). In a matched pair comparison of the two treatment regimens, the CIRT cohort demonstrated both longer 2-year overall survival (100% versus 59.6%) and longer 2-year distant PFS (75.7% versus 22.9%). No significant impairment of liver function was observed in either cohort.</p><p><strong>Conclusion: </strong>In this retrospective analysis, patients who received CIRT presented excellent local tumor control and had better oncologic outcomes than patients who received photon-based SBRT. SBRT with carbon ions is a promising local ablative treatment option that needs further investigation in large prospective trials.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"23"},"PeriodicalIF":3.3,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450727","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":"Functional outcome after Brachytherapy with bi-nuclide (Ru-106/Iodine-125) plaques in large uveal melanomas.","authors":"Leyla Jabbarli, Miltiadis Fiorentzis, Philipp Rating, Boerge Schmidt, Eva Biewald, Nika Guberina, Dirk Flühs, Norbert Bornfeld, Wolfgang Sauerwein, Martin Stuschke, Nikolaos E Bechrakis, Maja Guberina","doi":"10.1186/s13014-024-02576-6","DOIUrl":"10.1186/s13014-024-02576-6","url":null,"abstract":"<p><strong>Objective: </strong>Preservation of visual acuity remains a challenging issue after globe sparing therapy of large uveal melanoma. The aim of our study was analyzing the functional outcome after brachytherapy with bi-nuclide plaques (BBNP), maintaining prognostic factors for legal blindness (LB).</p><p><strong>Methods: </strong>We have analyzed all consecutive patients with large uveal melanoma treated with BBNP at our institution between 01/1999 and 12/2020. The post-treatment follow-up data were screened up to 06/2023. Univariate and multivariate Cox regression analysis was performed to identify predictive factors for development of LB following BBNP.</p><p><strong>Results: </strong>Overall, 570 patients with median age of 65.6 years (interquartile range [IQR]: 54.5-74.0) underwent BBNP. During the median post-treatment follow-up of 30.8 months (IQR: 12.9-57.3), LB was diagnosed in 287 (50.4%) patients. Patients' age (> 67 years, adjusted hazard ratio [aHR] = 1.58, 95%-confidence interval [CI] = 1.24-2.00, p < 0.0001), tumor thickness (> 8.5 mm, aHR = 1.43, 95%-CI = 1.12-1.82, p = 0.004), VA (> 0.5 LogMAR, aHR = 1.59, 95%-CI = 1.25-2.02, p < 0.0001), and ciliary body involvement (aHR = 0.77, 95%-CI = 0.60-0.97, p = 0.029) were confirmed as independent predictors of LB in the final multivariable Cox regression analysis.</p><p><strong>Conclusions: </strong>Approximately a half of patients with large uveal melanoma develop LB around 2.5 years after brachytherapy. Further optimization of treatment strategies, including both therapeutic and preventive measures, has the potential to enhance the functional outcome after episcleral plaque therapy for large UMs.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"22"},"PeriodicalIF":3.3,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411234","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":"Phase II clinical trial assessing the addition of hyperthermia to salvage concurrent chemoradiotherapy for unresectable recurrent head and neck cancer in previously irradiated patients.","authors":"Kai-Lin Yang, Mau-Shin Chi, Chung-Yu Hao, Hui-Ling Ko, Yi-Ying Huang, Ren-Hong Wu, Hung-Chih Lai, Ying-Chu Lin, Sheng-Po Hao, Kwan-Hwa Chi","doi":"10.1186/s13014-025-02585-z","DOIUrl":"10.1186/s13014-025-02585-z","url":null,"abstract":"<p><strong>Background: </strong>This single-arm phase II trial aimed to assess the effectiveness and safety of incorporating hyperthermia into salvage concurrent chemoradiotherapy (CCRT) for previously irradiated unresectable recurrent head and neck cancer.</p><p><strong>Methods: </strong>We enrolled patients with non-metastatic recurrent head and neck cancer who had previously undergone radiotherapy (RT) and were unfit for salvage surgery. Eligible patients received hyperthermia during salvage CCRT. RT consisted of an upfront boost with 10 Gy in 2 fractions to gross tumor volume, followed by 40 Gy in 20 fractions to clinical target volume, for a total of 50 Gy in 22 fractions. Weekly hyperthermia for 6 sessions started after RT initiation; each session lasted for 40 min, beginning within 2 h after RT and maintaining a maximum temperature of 42 ± 0.5 °C. Concurrent chemotherapy included weekly cisplatin 20 mg/m² and docetaxel 10-12 mg/m² for 6 weeks. Primary endpoint was overall response rate (ORR). Overall survival (OS), progression-free survival (PFS) and toxicities were evaluated.</p><p><strong>Results: </strong>Among 35 eligible patients, ORR was 82.9%, with complete response in 54.3%, partial response in 28.6%, stable disease in 11.4%, and progressive disease in 5.7%. After a median follow-up of 2.7 years, median OS was 32.8 months (95% confidence interval [CI], 16.7-48.9), and 2-year OS was 57.1% (95% CI, 40.6-73.6). Median PFS was 14.9 months (95% CI, 5.7-24.1), and 2-year PFS was 34.3% (95% CI, 18.6-50.0). Acute mucositis was grade 0-1 in 68.6%, grade 2 in 25.7%, and grade 3 in 5.7%. Acute dermatitis was grade 0-1 in 85.7% and grade 2 in 14.3%. No definite burn injury occurred. Grade 3-4 leucopenia, anemia, thrombocytopenia accounted for 14.3%, 14.3%, and 8.6%, respectively. Osteonecrosis was noted in 12 patients. No grade 5 toxicity was observed.</p><p><strong>Conclusions: </strong>Adding hyperthermia to salvage CCRT greatly enhances tumor response and survival rates compared to historical re-irradiation outcomes for previously irradiated unresectable recurrent head and neck cancer, with manageable toxicities.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (Identifier: NCT02567383 ), Registered October 1 , 201 5 - https://www.</p><p><strong>Clinicaltrials: </strong>gov/study/NCT02567383.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"21"},"PeriodicalIF":3.3,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371348","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":"Development of delayed pulmonary toxicities and transcriptional changes in pre-existing interstitial lung disease mice after partial thoracic irradiation.","authors":"Jiamei Fu, Xinglong Liu, Yuchuan Zhou, Shengnan Zhao, Liang Zeng, Yan Pan, Jianghong Zhang, Kevin M Prise, Chunlin Shao, Yaping Xu","doi":"10.1186/s13014-025-02596-w","DOIUrl":"10.1186/s13014-025-02596-w","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer patients with comorbid interstitial lung disease (LC-ILD) have an increased risk of developing severe or even fatal radiation pneumonitis after thoracic radiotherapy. However, the underlying mechanisms of its pathogenesis are still inconclusive. No approved biomarker or medicine is available to prevent pulmonary toxicities in LC-ILD patients. Appropriate management for them remains a challenge for clinicians due to treatment-related complications.</p><p><strong>Methods: </strong>To elucidate the histopathological characteristics and molecular mechanisms responsible for this severe toxicity in vivo, C57BL/6J mice were used to develop different lung injury models, including radiation-induced lung injury (RILI), bleomycin-induced pulmonary fibrosis (BIPF), and severe radiation-related lung injury (sRRLI) murine model. Biopsy examination was performed on hematoxylin and eosin (H&E), Masson's trichrome, and immunohistochemistry-stained lung tissue sections. Changes in lung function were measured. RNA extracted from mouse lung tissues was sequenced on the Illumina Novaseq platform.</p><p><strong>Results: </strong>A severe lung injury model after irradiation was built based on pre-existing ILD mice induced by BLM administration. Enhanced lung injury was observed in the sRRLI model, including higher mortality and pulmonary function loss within six months compared to the mono-treatment groups. Autopsy revealed that bilateral diffuse alveolar damage (DAD) with an overlap of exudative, proliferative, and fibrosing patterns was usually presented in the sRRLI model. The histological phenotypes manifested exudative predominated DAD phase in the early phase and proliferating DAD pattern in the late phase. Bioinformatic analysis showed signaling pathways relevant to immune cell migration, epithelial cell development, and extracellular structure organization were commonly activated in different models. Furthermore, the involvement of epithelial cells and the infiltration of macrophages and CD4 + lymphocytes were validated during extensive lung remodeling in the sRRLI group.</p><p><strong>Conclusions: </strong>Delayed effects of significantly declined lung function and high mortality were observed in the sRRLI model. DAD with progressive inflammation and fibrosis in bilateral lungs contributed to severe or even fatal complications after partial thoracic irradiation. The hyperactivation of inflammatory responses was clarified during long-term pulmonary toxicities. More studies are needed to investigate potential strategies to prevent and rescue severe lung complications.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"20"},"PeriodicalIF":3.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371344","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":"Local control and recurrence patterns after stereotactic irradiation delivered in more than 4 fractions for hepatocellular carcinomas and liver metastases: a retrospective study.","authors":"Alizée Renan, Marie Bruand, Maria Jolnerovski, Aboubacar Diallo, Nicolas Demogeot","doi":"10.1186/s13014-025-02595-x","DOIUrl":"10.1186/s13014-025-02595-x","url":null,"abstract":"<p><strong>Background: </strong>Stereotactic Body Radiation Therapy (SBRT) is a safe and effective treatment for liver metastases or hepatocellular carcinoma (HCC) with a dose-response relationship for local control (LC). Proximity to organs at risk (OAR) often requires dose de-escalation. This study evaluated LC and recurrence patterns in patients administered hepatic SBRT in more than 4 fractions due to dosimetric constraints.</p><p><strong>Methods: </strong>This retrospective study included 33 patients treated with SBRT (Cyberknife®) in more than 4 fractions for HCC or liver metastases, between January 2011 and December 2019. Patients were ineligible for treatment in 3 or 4 fractions due to OAR proximity. Recurrence patterns were analysed according to the volume shared between recurrence and initial target or treatment isodose volumes.</p><p><strong>Results: </strong>The primary dose ranged from 35 to 50 Gy delivered in 5 to 7 fractions for the treatment of HCC (39%) or liver metastases (61%) mainly secondary to colorectal cancer (40%). LC rate was 64%, with 12 patients showing recurrence volume overlap with the initial target volume or treatment isodose. In-field recurrence occurred in only 12.5% of patients with most relapses being out-of-field. No grade ≥ 3 events were reported.</p><p><strong>Conclusion: </strong>Despite dose reductions to spare OAR, SBRT showed satisfactory LC with low toxicity. Out-of-field recurrence remains the most common pattern identified and likely related to underlying disease. Prospective data are necessary to determine whether preserving dose while reducing planning target volume (PTV) coverage could enhance LC. Trial registration All patients were retrospectively registered, and this study is registered at the Health Data Hub site (number HDH414).</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"19"},"PeriodicalIF":3.3,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366509","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":"Synthetic CT generation from CBCT and MRI using StarGAN in the Pelvic Region.","authors":"Paritt Wongtrakool, Chanon Puttanawarut, Pimolpun Changkaew, Supakiet Piasanthia, Pareena Earwong, Nauljun Stansook, Suphalak Khachonkham","doi":"10.1186/s13014-025-02590-2","DOIUrl":"10.1186/s13014-025-02590-2","url":null,"abstract":"<p><strong>Rationale and objectives: </strong>This study evaluated StarGAN, a deep learning model designed to generate synthetic computed tomography (sCT) images from magnetic resonance imaging (MRI) and cone-beam computed tomography (CBCT) data using a single model. The goal was to provide accurate Hounsfield unit (HU) data for dose calculation to enable MRI simulation and adaptive radiation therapy (ART) using CBCT or MRI. We also compared the performance and benefits of StarGAN to the commonly used CycleGAN.</p><p><strong>Materials and methods: </strong>StarGAN and CycleGAN were employed in this study. The dataset comprised 53 cases of pelvic cancer. Evaluation involved qualitative and quantitative analyses, focusing on synthetic image quality and dose distribution calculation.</p><p><strong>Results: </strong>For sCT generated from CBCT, StarGAN demonstrated superior anatomical preservation based on qualitative evaluation. Quantitatively, CycleGAN exhibited a lower mean absolute error (MAE) for the body (42.8 ± 4.3 HU) and bone (138.2 ± 20.3), whereas StarGAN produced a higher MAE for the body (50.8 ± 5.2 HU) and bone (153.4 ± 27.7 HU). Dosimetric evaluation showed a mean dose difference (DD) within 2% for the planning target volume (PTV) and body, with a gamma passing rate (GPR) > 90% under the 2%/2 mm criteria. For sCT generated from MRI, qualitative evaluation also favored the anatomical preservation provided by StarGAN. CycleGAN recorded a lower MAE (79.8 ± 14 HU for the body and 253.6 ± 30.9 HU for bone) compared with StarGAN (94.7 ± 7.4 HU for the body and 353.6 ± 34.9 HU for bone). Both models achieved a mean DD within 2% in the PTV and body, and GPR > 90%.</p><p><strong>Conclusion: </strong>While CycleGAN exhibited superior quantitative metrics, StarGAN was better in anatomical preservation, highlighting its potential for sCT generation in radiotherapy.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"18"},"PeriodicalIF":3.3,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11796232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191059","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":"Longitudinal assessment of diffusion-weighted imaging during magnetic resonance-guided radiotherapy in head and neck cancer.","authors":"Simon Boeke, Jonas Habrich, Sarah Kübler, Jessica Boldt, Fritz Schick, Konstantin Nikolaou, Jens Kübler, Cihan Gani, Maximilian Niyazi, Daniel Zips, Daniela Thorwarth","doi":"10.1186/s13014-025-02589-9","DOIUrl":"10.1186/s13014-025-02589-9","url":null,"abstract":"<p><strong>Background: </strong>For radiotherapy of head and neck cancer (HNC) magnetic resonance imaging (MRI) plays a pivotal role due to its high soft tissue contrast. Moreover, it offers the potential to acquire functional information through diffusion weighted imaging (DWI) with the potential to personalize treatment. The aim of this study was to acquire repetitive DWI during the course of online adaptive radiotherapy on an 1.5 T MR-linear accelerator (MR-Linac) for HNC patients and to investigate temporal changes of apparent diffusion coefficient (ADC) values of the tumor and subvolume levels.</p><p><strong>Methods: </strong>27 patients treated with curative RT on the 1.5 T MR-Linac with at least weekly DWI in treatment position were included into this prospective analysis and divided in four risk groups (HPV-status and localisation). Tumor and lymph node volumes (GTV-P/GTV-N) were delineated on b = 500 s/mm² images while ADC maps were calculated using b = 150/200 and 500 s/mm² images. Absolute and relative temporal changes of mean ADC values, tumor volumes and a high-risk subvolume (HRS) defined by low ADC tumor voxels (600 < ADC < 900 × 10^-6 mm²/s) were analyzed. Relative changes of mean ADC values, tumor volumes and HRS were statistically tested using Wilcoxon-signed-rank test.</p><p><strong>Results: </strong>Median pretreatment ADC value for all patients resulted in 1167 × 10^-6 mm²/s for GTV-P and 1002 × 10^-6 mm²/s for GTV-N while absolute pretreatment tumor volume yielded 9.1 cm³ for GTV-P and 6.0 cm³ for GTV-N, respectively. Pretreatment HRS volumes were 1.5 cm³ for GTV-P and 1.3 cm³ for GTV-P and GTV-N. Median ADC values increase during 35 fractions of RT was 49% for GTV-P and 24% for GTV-N during RT. Median tumor volume decrease was 68% and 52% for GTV-P and GTV-N with a median HRS decrease of 93% and 87%. Significant differences from 0 for mean ADC were observed starting from week 1, for tumor volumes from week 2 for GTV-P and week 1 for GTV-N and for HRS in week 1 for GTV-P and week 2 for GTV-N.</p><p><strong>Conclusion: </strong>Longitudinal DWI acquisition in HNC is feasible on a MR-Linac during the course of online adaptive MR-guided radiotherapy. Changes in ADC and volumes can be assessed, but future work needs to explore the potential for biologically guided treatment individualization.</p><p><strong>Trial registration: </strong>NCT04172753, actual study start: 09.05.2018.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"15"},"PeriodicalIF":3.3,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069180","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}