Radiation Oncology最新文献

{"title":"Radiotherapy outcomes and risk factors for young patients with head-and-neck squamous cell carcinomas: a matched-pair analysis.","authors":"Jiadai Zou, Alexander Rühle, Henning Schäfer, Andreas Dietz, Gunnar Wichmann, Thomas Kuhnt, Anca-L Grosu, Nils H Nicolay","doi":"10.1186/s13014-025-02631-w","DOIUrl":"https://doi.org/10.1186/s13014-025-02631-w","url":null,"abstract":"<p><strong>Background: </strong>Head-and-neck squamous cell carcinomas (HNSCC) exhibit significant variations in incidence and outcomes across age groups. There is conflicting data on the oncological outcomes of younger HNSCC patients ≤ 45 years. This study analyzed clinical characteristics, treatment-related toxicities and survival rates of young HNSCC patients treated with (chemo)radiotherapy.</p><p><strong>Methods: </strong>HNSCC patients ≤ 45 years treated with radiotherapy between 2009 and 2021 at two large cancer centers were analyzed and matched to a patient cohort > 45 years based on TNM and tumor localization. Overall (OS), progression-free (PFS) and metastasis-free (DMFS) survival and locoregional control (LRC) were compared and treatment-related toxicities were assessed.</p><p><strong>Results: </strong>99 patients were included in this analysis. Median OS of the young HNSCC cohort was 63 months. Daily alcohol consumption was identified as a key risk factor for reduced OS in the multivariate analysis. OS was similar in the young cohort compared to older patients, although the excess mortality risk compared to the sex- and age-matched general population amounted to 59-fold, while it was only 5.9-fold for patients ≥ 45 years. No significant differences were observed in PFS, LRC, or DMFS between age groups. Higher-grade chronic toxicities were moderate in young HNSCC patients.</p><p><strong>Conclusions: </strong>Young HNSCC patients ≤ 45 years treated with (chemo)radiation have similar rates of oncological survival outcomes compared to older patients. While chronic toxicities from (chemo)radiation are low, further research is needed to explore the long-term quality-of-life.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"62"},"PeriodicalIF":3.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062968","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":"Smart contours: deep learning-driven internal gross tumor volume delineation in non-small cell lung cancer using 4D CT maximum and average intensity projections.","authors":"Yuling Huang, Mingming Luo, Zan Luo, Mingzhi Liu, Junyu Li, Junming Jian, Yun Zhang","doi":"10.1186/s13014-025-02642-7","DOIUrl":"https://doi.org/10.1186/s13014-025-02642-7","url":null,"abstract":"<p><strong>Background: </strong>Delineating the internal gross tumor volume (IGTV) is crucial for the treatment of non-small cell lung cancer (NSCLC). Deep learning (DL) enables the automation of this process; however, current studies focus mainly on multiple phases of four-dimensional (4D) computed tomography (CT), which leads to indirect results. This study proposed a DL-based method for automatic IGTV delineation using maximum and average intensity projections (MIP and AIP, respectively) from 4D CT.</p><p><strong>Methods: </strong>We retrospectively enrolled 124 patients with NSCLC and divided them into training (70%, n = 87) and validation (30%, n = 37) cohorts. Four-dimensional CT images were acquired, and the corresponding MIP and AIP images were generated. The IGTVs were contoured on 4D CT and used as the ground truth (GT). The MIP or AIP images, along with the corresponding IGTVs (IGTV_MIP-manu and IGTV_AIP-manu, respectively), were fed into the DL models for training and validation. We assessed the performance of three segmentation models-U-net, attention U-net, and V-net-using the Dice similarity coefficient (DSC) and the 95th percentile of the Hausdorff distance (HD95) as the primary metrics.</p><p><strong>Results: </strong>The attention U-net model trained on AIP images presented a mean DSC of 0.871 ± 0.048 and mean HD95 of 2.958 ± 2.266 mm, whereas the model trained on MIP images achieved a mean DSC of 0.852 ± 0.053 and mean HD95 of 3.209 ± 2.136 mm. Among the models, attention U-net and U-net achieved similar results, considerably surpassing V-net.</p><p><strong>Conclusions: </strong>DL models can automate IGTV delineation using MIP and AIP images, streamline contouring, and enhance the accuracy and consistency of lung cancer radiotherapy planning to improve patient outcomes.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"59"},"PeriodicalIF":3.3,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024866","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 concurrent programmed cell death protein 1 inhibitor and definitive radiotherapy with immunonutrition support in esophageal squamous cell cancer: a phase II multicenter clinical trial.","authors":"Yupei Yuan, Shihong Luo, Xiaomin Wang, Zhiyong Zheng, Qing Qi, Yunxiao Wang, Meiling Chen, Haihua Yang, Pingjun Gu, Qin Du, Xia Wu, Wenyan Pan, Yuanji Xu, Jianyang Wang","doi":"10.1186/s13014-025-02604-z","DOIUrl":"https://doi.org/10.1186/s13014-025-02604-z","url":null,"abstract":"<p><strong>Background: </strong>Esophageal cancer is one of the most common malignant tumors, with China accounting for 50% of the world's total incidence. Concurrent chemoradiotherapy (cCRT) with platin-based dual-drug regimen is the standard treatment for inoperable, locally advanced esophageal cancer in patients with a good performance status. However, certain patients possess risk factors that heighten toxicity and reduce their tolerance to cCRT, thereby challenging the feasibility of standard treatment. This study evaluates an alternative therapeutic approach combining programmed cell death protein 1 inhibitor (PD-1 inhibitor), definitive radiotherapy, and immunonutrition support for patients with unresectable non-metastatic esophageal cancer expressing PD-L1 who are intolerant to cCRT.</p><p><strong>Methods: </strong>This is a phase II, single-arm, multicenter clinical trial involving patients with histologically confirmed unresectable esophageal squamous cell carcinoma (ESCC), who exhibit positive PD-L1 and are unsuitable for cCRT. Participants will receive a total radiotherapy dose of 50-60 Gy in 25-30 fractions, sintilimab (200 mg every three weeks), alongside, supplemented by enteral nutritional emulsion (600-1600 ml/day). The primary endpoint is the 1-year progression-free survival rate, with secondary endpoints including objective response rate, overall survival and incidence of adverse events.</p><p><strong>Conclusion: </strong>This research has the potential to redefine treatment for inoperable ESCC patients who cannot tolerate conventional therapies. By evaluating a less toxic regimen that combines immunotherapy, radiotherapy, and nutritional support, we aim to determine if this approach can improve both survival rates and quality of life. The synergistic effects of immunonutrition support and PD-1 inhibitor will also be explored.</p><p><strong>Trial registration: </strong>NCT06342167.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"58"},"PeriodicalIF":3.3,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059213","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":"Analysis of intra-fractional surface motion during adaptive radiation therapy and relation of internal vs. external position for prostate cancer.","authors":"Fernanda Macedo-Jiménez, Iris Kalisch, Anna Simeonova-Chergou, Judit Boda-Heggemann, Jens Fleckenstein, Constantin Dreher, Frank A Giordano, Florian Stieler","doi":"10.1186/s13014-025-02638-3","DOIUrl":"https://doi.org/10.1186/s13014-025-02638-3","url":null,"abstract":"<p><strong>Background: </strong>Adaptive radiation therapy (ART) allows real-time treatment plan adjustment based on daily anatomical changes but involves a time-consuming workflow. Surface-guided radiation therapy (SGRT) provides precise patient positioning and intra-fractional motion management. This study retrospectively analyses intra-fractional patient motion using SGRT during long-duration radiotherapy (RT) like ART for prostate cancer and further assesses the relation for internal target position measured by cone-beam CT (CBCT) and surface position measured by SGRT.</p><p><strong>Methods: </strong>Thirty ultra-hypo-fractionated prostate cancer patients (137 fractions) treated with ART on Ethos (version 1.0, Varian Medical Systems, Siemens Healthineers, Palo Alto, CA, USA) using a ring-mounted SGRT system (AlignRT inBore, Vision RT Ltd., UK) were retrospectively analyzed. The mean and standard deviation values of surface positions across three translational axes of up to 60 min of treatment were analyzed. Further, the translational shifts from the second daily CBCT before irradiation and surface position data were compared to evaluate the agreement between internal and surface position. Correlations between CBCT shifts and SGRT data were assessed with the Wilcoxon paired samples test.</p><p><strong>Results: </strong>The maximum mean (± SD) surface motion was - 2.21 ± 1.27 mm (vertical, at 45 min), 0.22 ± 1.55 mm (longitudinal, at 35 min), and 0.16 ± 0.77 mm (lateral, at 20 min). After the second CBCT shift, the mean (± SD) surface position deviations were - 0.63 ± 1.43 mm (vertical), -0.24 ± 1.63 mm (longitudinal), and 0.05 ± 0.87 mm (lateral) with ranges of 8.30 mm, 10.02 mm, and 6.08 mm on the vertical, longitudinal, and lateral axes, respectively. Significant differences (p < 0.05) were found between CBCT and SGRT on the vertical and longitudinal axes.</p><p><strong>Conclusions: </strong>SGRT revealed a consistent vertical shift over the whole course of long-duration RT and not only for the first minutes of the treatment. Further, SGRT exclusively is not an adequate inter-fractional positioning tool for prostate cancer patients, however additional SGRT-based intra-fractional monitoring can add a value for long duration RT.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"57"},"PeriodicalIF":3.3,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040790","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":"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/s13014-025-02628-5","DOIUrl":"10.1186/s13014-025-02628-5","url":null,"abstract":"<p><strong>Objective: </strong>This study sought to examine the current state and explore the key areas and emerging trends in radiation dermatitis prevention and management through bibliometric analysis, with the goal of providing valuable insights for future research endeavors.</p><p><strong>Methods: </strong>This study analyzed all publications on radiation dermatitis prevention and management from the Web of Science (WOS) core database up to 2024. The CiteSpace software was utilized to visualize authors, countries/regions, publishing institutions, keywords, co-cited documents, hot spots, and research frontiers.</p><p><strong>Results: </strong>A total of 459 articles (1995-2024) were identified, with the overall number of publications demonstrating an increasing trend. The United States (125) produced the highest number of publications, followed by China (73) and Canada (45). Key research topics encompass breast cancer, head and neck cancer, acute radiation dermatitis, and radiation recall dermatitis. Double-blind clinical trials constitute the primary research methodology. The main research areas in this field focus on the role of radiotherapy dose fractionation modalities, atmospheric pressure cold plasma, hyperbaric oxygen therapy (HBOT), aloe vera, biomodulation therapy, and biological dressings in the prevention and management of radiation dermatitis.</p><p><strong>Conclusion: </strong>This comprehensive bibliometric analysis reveals that risk prediction, assessment tools, and the efficacy of radiodermatitis are prominent research topics in the field. These areas are currently experiencing rapid growth and warrant further attention from researchers.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"55"},"PeriodicalIF":3.3,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024747","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":"Dosiomic predictors of biochemical failure in patients with localized prostate cancer treated with Iodine-125 low-dose-rate brachytherapy.","authors":"Masahiro Nakano, Shizuo Kaji, Shogo Kawakami, Hideyasu Tsumura, Toshikazu Imae, Yuichi Tanaka, Kyohei Fujii, Takuro Kainuma, Ryosuke Yamazaki, Ayaka Uchida, Hijiri Kaneko, Mako Fujino, Chizu Hata, Yu Murakami, Masatoshi Hashimoto, Hiromichi Ishiyama","doi":"10.1186/s13014-025-02619-6","DOIUrl":"https://doi.org/10.1186/s13014-025-02619-6","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to identify dosiomic features that have a significant impact on biochemical failure (BCF) following low-dose rate (LDR) brachytherapy treatment using Iodine-125 seeds for prostate cancer and to provide insights into LDR brachytherapy treatment efficacy using a dosiomic approach.</p><p><strong>Methods: </strong>Between January 2005 and February 2015, 1,205 patients with localized prostate cancer underwent Iodine-125 seed implantation without combined external irradiation. A total of 96 patients were selected for this study, including 48 with BCF and 48 without BCF. The patients were divided into two cohorts: derivation and validation. Dose distribution images (DDs) were calculated from computed tomography (CT) images taken one month after implantation. A total of 1,130 dosiomic features, including shape-and-size, histogram, and texture features, were extracted from these DDs, their wavelet-transformed images, and Laplacian-of-Gaussian (LoG)-filtered images. The features obtained were categorized into three groups: shape-and-size (S), histogram (H), and texture (T). The Boruta algorithm was used to eliminate less important features. Two analyses were performed: Analysis A performed a multivariate logistic regression analysis using data from the validation cohort to identify significant features. Analysis B generated logistic regression models using derivation cohort data. The accuracy of BCF prediction was assessed using the validation cohort, with performance measured using the area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>After the feature reduction process, two, two, and four features remained in the S, H, and T feature groups, respectively. In analysis A, the multivariate logistic regression identified four dominant features, two from each of the S and T groups. In analysis B, the AUC of the logistic regression prediction models using S, H, and all four features were 0.81, 0.77, and 0.86, respectively.</p><p><strong>Conclusions: </strong>Four significant dosiomic features were identified. Notably, three features-elongation, Maximum2DDiameterRow, and wavelet-HHL_Skewness-strongly distinguished patients with favorable prognoses from others. These findings suggest that dosiomic features from postimplant CT and dose distribution may serve as effective factors for evaluating LDR brachytherapy outcomes in patients with prostate cancer.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"56"},"PeriodicalIF":3.3,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045697","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":"Ultrahypofractionated partial breast irradiation following oncoplastic surgery: secondary analysis of a phase II trial.","authors":"Rachel Radigan, Sophia L Fu, Austin Barney, Jeffrey Pettit, Vani Gupta, Shridevi Singh, Marlene Mancuso, Vikram Soni, Jana Deitch, Andrew T Wong, Johnny Kao","doi":"10.1186/s13014-025-02630-x","DOIUrl":"https://doi.org/10.1186/s13014-025-02630-x","url":null,"abstract":"<p><strong>Purpose: </strong>Although partial breast irradiation (PBI) is accepted as an effective and cosmesis-preserving technique for low-risk early-stage breast cancer following standard lumpectomy, data supporting PBI following oncoplastic surgery are sparse. We report prospective data in efforts to determine whether PBI can be safely utilized after oncoplastic surgery.</p><p><strong>Methods: </strong>Patients with low-risk stage 0-1 breast cancer following successful lumpectomy with optional oncoplastic reconstruction were enrolled on a phase II trial. Patients were treated with a modified Florence regimen to 30 Gy in 5 fractions on the Varian Edge radiosurgery system using IMRT or VMAT. Presurgical MRI, post-operative seroma and surgical clips were used to assist target delineation. The effect of oncoplastic surgery on radiation dosimetry and Breast Cancer Treatment Outcome Scale scores were assessed using student's t-test for continuous variables and chi-square for categorical variables.</p><p><strong>Results: </strong>From 2018 to 2022, 50 patients with 52 tumors were enrolled with 48% undergoing oncoplastic reconstruction. Although median PTV volumes were numerically larger in the oncoplastic group (266 cc vs. 223 cc), there were no statistically significant differences in PTV volumes, ratio of PTV to whole breast or mean heart or lung doses (p > 0.05). Mean baseline BCTOS aesthetic scores were 1.35 for standard lumpectomy vs. 2.52 for oncoplastic (p = 0.003). At long-term follow-up > 2 years, mean BCTOS aesthetic scores were 1.29 for standard lumpectomy vs. 1.35 for oncoplastic (p = 0.71). At a median follow-up of 46 months, there were no local recurrences.</p><p><strong>Conclusions: </strong>When utilizing pre-treatment MRI, surgical clips and a relatively large PTV, PBI after oncoplastic surgery was safe and effective for appropriately selected patients. In combination with oncoplastic surgery, partial breast irradiation achieves excellent long-term cosmesis that improves over time.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"53"},"PeriodicalIF":3.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043216","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":"Bibliometric analysis and visualization of research trends in radiation dermatitis in the past twenty years.","authors":"Xinyi Zhang, Yuai Xiao, Ang Li, Yuchong Wang, Jianguo Xu, Kexin Chen, Haoyuan Zheng, Minliang Wu, Chunyu Xue","doi":"10.1186/s13014-025-02629-4","DOIUrl":"https://doi.org/10.1186/s13014-025-02629-4","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to explore the most influential countries/regions, institutions, journals, authors, keywords, and trends in the study of the mechanism and treatments of radiation dermatitis (RD) from 2003 to 2023 using bibliometric analysis.</p><p><strong>Methods: </strong>The literature associated with RD was retrieved from the Web of Science Core Collection, only articles and reviews in English were included. Individual articles were reviewed to identify the authorship, published journal, journal impact factor, institution and country of origin, and year of publication.</p><p><strong>Results: </strong>A total of 6,453 authors from 1,605 institutions in 64 countries/regions published 1,062 RD-related literature. The United States was the most productive country. The Unicancer in France was the institution that published the majority of articles on RD. Edward Chow was the most productive author and Supportive Care in Cancer contributed the most articles. Advanced head and neck cancer is the most common cause of RD. The mechanism research mainly focused on nitric oxide, oxidative stress, and apoptosis in recent years, and Mepitel film, Mepilex Lite, and PBMT were the main preventive and therapeutic measures for RD.</p><p><strong>Conclusion: </strong>Our bibliometric studies provide a thorough overview of RD and valuable insights and ideas for scholars in this discipline.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"54"},"PeriodicalIF":3.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039489","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":"Dosimetric investigation of multi-parametric 4D-MRI for radiotherapy in liver cancer.","authors":"Sha Li, Xianggao Zhu, Haonan Xiao, Weiwei Liu, Yibao Zhang, Jing Cai, Tian Li, Yanye Lu","doi":"10.1186/s13014-025-02600-3","DOIUrl":"https://doi.org/10.1186/s13014-025-02600-3","url":null,"abstract":"<p><strong>Background: </strong>In radiotherapy, inadequate management of organ motion in liver cancer may lead to inadequate delineation accuracy, resulting in the underdosage of target tissues and overdosage of surrounding normal tissues. To investigate the clinical potential of multi-parametric 4D-MRI in the target delineation and dose accuracy for liver cancer radiotherapy.</p><p><strong>Methods: </strong>Twenty patients receiving radiotherapy for liver cancer were enrolled. Each patient underwent contrast-enhanced planning CT (free-breathing), contrast-enhanced T1-weighted (free-breathing), T2-weighted (gated) 3D-MRI, and low-quality 4D-MRI using the time resolved imaging with interleaved stochastic trajectories volumetric interpolated breath-hold examination (TWIST-VIBE) sequence. A dual-supervised deformation estimation model was used to generate a 4D deformable vector field (4D-DVF) from 4D-MRI data, and the prior images were deformed using this 4D-DVF to generate multi-parametric 4D-MRI. Assisted by 3D-MRI and multi-parametric 4D-MRI, target contours were performed on the planning CT, resulting in the generation of Target_3D and Target_4D. Clinical plans, Plan_3D and Plan_4D, were designed based on these contours respectively. To explore the dosimetric variations resulting from different contours without re-optimization, Plan_3D was directly applied to Target_4D, and Plan_4D was applied to Target_3D to generate Plan_3D' and Plan_4D' respectively. Target volume, contours, dose-volume histograms (DVHs), conformity index (CI), homogeneity index (HI), maximum and mean dose to organ as risks (OARs) were compared and evaluated.</p><p><strong>Results: </strong>Mean volume differences between Target_3D and Target_4D were 2.76 cm³ (standard deviation [SD] 3.42 cm³) in the caudate lobe, 181.54 cm³ (SD 68.50 cm³) in the left hepatic lobe, and 26.08 cm³ (SD 20.52 cm³) in the right hepatic lobe. Mean and SD of CI and HI is 1.02 ± 0.04 and 0.108 ± 0.02 in Plan_3D, 1.02 ± 0.01 and 0.107 ± 0.01 in Plan_4D. There were no statistically significant differences in OAR doses between Plan_3D and Plan_3D', between Plan_4D and Plan_4D'. However, a statistically significant difference in target dose was observed between Plan_3D and Plan_3D' (P = 1.47 × 10⁻⁷) and between Plan_4D and Plan_4D' (P = 0.013). Plan_3D' meets 100% of the prescription dose covering mean 77.89% (SD 10.13%) of the Targeted_4D volume, while Plan_4D' covered mean 94.17% (SD 3.12%) of the Targeted_3D volume.</p><p><strong>Conclusions: </strong>3D image-guided target delineation may be more likely to underestimate target volume and compromise dose coverage, suggesting that using multi-parametric 4D-MRI can provide more precise target contours and enhance target dose coverage.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"51"},"PeriodicalIF":3.3,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056379","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":"Impact of radiation response on survival in pediatric medulloblastoma with residual or disseminated disease.","authors":"Xuejiao Shi, Xiaoyang Sun, Wenqi Fan, Xuan Dai, Mawei Jiang","doi":"10.1186/s13014-025-02632-9","DOIUrl":"https://doi.org/10.1186/s13014-025-02632-9","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine the clinical impact of radiation response on survival in patients with medulloblastoma (MB) and to explore the predictive factor of radiation response.</p><p><strong>Methods: </strong>Data from 170 pediatric patients with MB and residual disease or metastasis before radiotherapy (RT) were analyzed.</p><p><strong>Results: </strong>The median follow-up period was 5.2 years. A total of 74 (43.5%) patients achieved CR, 85 (50.0%) patients achieved PR, 8 (4.7%) patients had SD, and 3 (1.8%) patients developed PD after RT. The five-year post-RT progression-free (prtPFS) and overall survival (prtOS) were superior in patients who achieved CR compared to those who did not (prtPFS: 67% ± 6% vs. 42% ± 6%, P < 0.001; prtOS: 82% ± 5% vs. 44% ± 6%, P < 0.001). Multivariable logistic regression analysis showed that residual disease site was the predictive factor for radiation response, patients who had residual disease in both the brain and spinal cord before RT had higher non-CR rate (OR: 7.312, 95%CI 3.375-15.845, P < 0.001). Multivariate Cox analysis revealed that radiation response and large cell/anaplastic subtype were independent prognostic factors for survival (P < 0.05).</p><p><strong>Conclusions: </strong>Radiation response was an independent prognostic factor for survival in patients with MB. Patients who did not achieve CR after RT should receive intensified adjuvant chemotherapy to improve survival.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"52"},"PeriodicalIF":3.3,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055768","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}