Radiation Oncology最新文献

{"title":"Development of heart-sparing VMAT radiotherapy technique incorporating heart substructures for advanced NSCLC patients.","authors":"Linda Agolli, Ann-Katrin Exeli, Uwe Schneider, Sandra Michaela Ihne-Schubert, Andreas Lurtz, Daniel Habermehl","doi":"10.1186/s13014-025-02597-9","DOIUrl":"10.1186/s13014-025-02597-9","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the feasibility of active heart sparing (AHS) planning in patients with locally advanced and centrally located NSCLC receiving standard definitive radiotherapy (RT), while maintaining or improving appropriate lung, esophagus, and spinal cord constraints and planning target volume (PTV) coverage intent.</p><p><strong>Methods and materials: </strong>A total of 27 patients with stage IIIA/B NSCLC treated with curative intent RT were selected for this analysis. All existing radiation plans were revised and 27 further new equivalent plans were calculated using AHS for the same cohort of patients. Primary end-point was feasibility of AHS using constraints for heart substructures. The secondary end point was to calculate the difference in terms of dosimetric parameters of heart substructures and principal OARs as well as PTV-coverage parameters within the current patient group.</p><p><strong>Results: </strong>AHS was feasible in the entire group of patients. An optimal coverage of the target volume was obtained and all mandatory constraints for OARs have been met. The median value of the mean heart dose (MHD) was 8.18 Gy and 6.71 Gy in the standard planning group and AHS-group, respectively (p = 0.000). Other heart parameters such as V_5Gy (40.57% vs. 27.7%; p = 0.000) and V_30Gy (5.39% vs. 3.86%; p = 0.000) were significantly worse in the standard planning group. The following relevant dosimetric parameters regarding heart substructures were found to be significantly worse in the standard planning group compared to the AHS-group: median dose to heart base (16.97 Gy vs. 6.37 Gy, p = 0.000), maximum dose (18.64 Gy vs. 6.05 Gy, p = 0.000) and V_15Gy (11.11% vs. 0% p = 0.000) to LAD; mean dose; V_5Gy (9.55% vs. 0.94%, p = 0.000) and V_23Gy (0.00% vs. 0.00% maximum 45.68% vs. 6.57%, p = 0.002 to the left ventricle.</p><p><strong>Conclusion: </strong>Our analysis showed an improvement of dosimetric parameters of the heart and heart substructures in patients affected by locally advanced and centrally located NSCLC treated with curative RT using AHS optimization. This approach could lead to a possible reduction of heart events and a prolonged survival. New clinical studies regarding RT in advanced NSCLC should include cardiologic evaluations and biomarkers as well as the contouring of cardiac substructures.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"40"},"PeriodicalIF":3.3,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634757","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":"Clinical practice in stereotactic radiotherapy delivery at treatment unit: a practitioner survey and consensus-based recommendations for multidisciplinary professional development.","authors":"Nicolas Martz, Vincent Marchesi, Maximilien Rogé, Camille Verry, Pierre Clavère, Karine Peignaux, Yazid Belkacemi, Alexandre Coutte, Véronique Vendrely, Delphine Antoni, Elise Champeau-Orange, Sébastien Thureau, Khadija Aabibou, Claire Drouin, Amandine Grimon, Christelle Monod, Perrine Farasse, Stéphane Supiot, Jean-Christophe Faivre","doi":"10.1186/s13014-025-02615-w","DOIUrl":"10.1186/s13014-025-02615-w","url":null,"abstract":"<p><strong>Purpose: </strong>Stereotactic radiation therapy (SRT) is on the rise around the world. We aimed to provide recommendations to streamline and assess medical practices in SRT delivery at treatment unit, while complying with legal obligations concerning safety.</p><p><strong>Materials and methods: </strong>We conducted an online closed practice survey for heads of radiotherapy departments both nationally in comprehensive cancer centers and university hospitals throughout France, and internationally. The aim was to obtain a better understanding of how the delivery of SRT at treatment unit was managed across different centers according to experience, and to the machines and repositioning techniques used. Radiation oncologists (ROs) were also asked to assess the difficulties of technical implementation in the department, and whether residents were involved in the validation and delivery of SRT. Differences among countries regarding legislation governing the validation of SRT sessions at treatment unit were also collected. A videoconference was then held to draw up proposals for regulatory changes based on the results obtained. Finally, recommendations were drawn up by the steering committee and approved by heads of radiotherapy departments in comprehensive cancer centers and university hospitals throughout France.</p><p><strong>Results: </strong>Thirty-five French centers and 15 centers from 14 foreign countries responded to the questionnaire. The most common stereotactic machines were Varian Truebeam STX® (45%) and Cyberknife® (39.2%). The departments had been performing SRT for more than 10 years in 60.5% of cases, and for less than 5 years in 10.1% of cases. A RO validated the SRT fractions at each session in 62.9% of French departments, while in countries outside France RO validation concerned the first fraction only for 35.3% or was performed only in the event of an issue for 23.5%. RO patient positioning validation of SRT fractions were considered as: time-consuming / task-interrupting (80%); having no added value with regards its systematic use (41.8%); and leading to a loss of machine time (33.1%). Most heads of departments would like to see an evolution towards systematic RO validation for the first session, then validation by a radiation therapist (RTT) for all subsequent sessions, leaving open the possibility of RO intervention when required in case of difficulty. We drew up a task delegation procedure to meet these requirements.</p><p><strong>Conclusion: </strong>Comparing the French practice to international ones confirmed the need to develop and harmonize recommendations in terms of patient positioning validation at treatment unit. Regulatory changes incorporating a competence transfer to RTTs, particularly after the empowerment process, is key. However, these changes need to be adapted to the experience of each Center and to that of each RTT, as assessed with clearly established criteria and learning curve.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"36"},"PeriodicalIF":3.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626503","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 induction immunochemotherapy followed by radiotherapy for patients with unresectable locally advanced non-small cell lung cancer: A retrospective study.","authors":"Lipin Liu, Cui Gao, Yufan Yang, Min Tang, Ting Zhao, Dazhi Chen, Jingyi Jin, Yonggang Xu, Gaofeng Li, Qiuzi Zhong","doi":"10.1186/s13014-025-02616-9","DOIUrl":"10.1186/s13014-025-02616-9","url":null,"abstract":"<p><strong>Objectives: </strong>Immune checkpoint inhibitor (ICI) has displayed considerable advantages in consolidation therapy of locally advanced non-small cell lung cancer (LA-NSCLC) after concurrent chemoradiotherapy (cCRT). However, many patients are considered unsuitable for cCRT owing to concerns with tolerability. In this study, we aimed to assess the efficacy and toxicity of induction immunochemotherapy followed by radiotherapy for unresectable LA-NSCLC who are not capable of receiving cCRT.</p><p><strong>Methods: </strong>From January 2019 and December 2022, LA-NSCLC patients treated with induction immunochemotherapy followed by radiotherapy as initial treatment at our institution were retrospectively reviewed. The short-term efficacy, overall survival (OS), progression free survival (PFS) and tolerability of induction immunochemotherapy followed by radiotherapy were evaluated in these patients.</p><p><strong>Results: </strong>Overall, 24 patients were enrolled (median age 64 years, 33.3% with ECOG performance status score 2, and 62.5% with stage IIIB-IIIC). Median follow-up from the start of induction immunochemotherapy was 30.5 months. Median number of induction immunochemotherapy was 4 cycles. A median radiotherapy dose of 60 Gy was delivered. After radiotherapy, 16 patients (66.6%) received consolidation immunotherapy. The overall response rate in these patients was 87.5%. The 1-year, 2-year and 3-year OS were 91.7%, 74.8% and 57.0%, respectively. The 1-year, 2-year and 3-year PFS were 87.0%, 54.1% and 37.1%, respectively. The incidence of grade ≥ 2 and grade ≥ 3 pneumonitis were 37.5% and 16.7%, respectively. Radiation pneumonitis of any grade occurred in 8 patients (33.3%), and the incidence of grade ≥ 2 and grade ≥ 3 radiation pneumonitis were 16.7% and 12.5%, respectively.</p><p><strong>Conclusion: </strong>Induction immunochemotherapy followed by radiotherapy and consolidated immunotherapy had encouraging efficacy with acceptable toxicity for LA-NSCLC not capable of receiving cCRT.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"37"},"PeriodicalIF":3.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626504","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":"Postoperative radiotherapy improves disease-free survival of EGFR wild-type pN2 non-squamous-cell non-small-cell lung cancer (Nsq-NSCLC) patients after complete resection: a propensity score matching analysis.","authors":"Yunsong Liu, Yu Men, Xu Yang, Shuang Sun, Yongxing Bao, Zeliang Ma, Yang Wang, Yirui Zhai, Jianyang Wang, Lei Deng, Wenqing Wang, Nan Bi, Luhua Wang, Zhouguang Hui","doi":"10.1186/s13014-025-02592-0","DOIUrl":"10.1186/s13014-025-02592-0","url":null,"abstract":"<p><strong>Background: </strong>The ADAURA study indicated that adjuvant TKI therapy improves survival in postoperative patients with EGFR-mutated (EGFRm) non-small-cell lung cancer (NSCLC), especially in stage III disease. However, the effect of PORT for stage III (N2) NSCLC with different EGFR statuses remains unclear, which we aimed to investigate in the present study.</p><p><strong>Methods: </strong>Between 2006 and 2019, consecutive patients with pN2 non-squamous cell NSCLC (Nsq-NSCLC) after complete resection and adjuvant chemotherapy or EGFR tyrosine kinase inhibitor (TKI) who had detection of EGFR status were retrospectively analyzed. PORT was administered using IMRT at 2 Gy per fraction with a total dose of 50 Gy over 5 weeks. Patients were categorized into 4 groups according to EGFR status and treatment: EGFR wild-type (EGFRwt) PORT group, EGFRwt non-PORT group, EGFRm PORT group, and EGFRm non-PORT group. Propensity score matching (PSM) was used to compensate for differences in baseline characteristics. The Kaplan-Meier method and log-rank test were used to evaluate disease-free survival (DFS), locoregional relapse-free survival (LRFS), and distant metastasis-free survival (DMFS).</p><p><strong>Results: </strong>A total of 566 patients were enrolled: 90 in the EGFRwt PORT group, 154 in the EGFRwt non-PORT group, 111 in the EGFRm PORT group, and 211 in the EGFRm non-PORT group. After PSM, the median DFS in the EGFRwt PORT group versus the EGFRwt non-PORT group were 33.9 versus 17.2 months (HR 0.62, 95%CI 0.417-0.920, P = 0.017). In EGFRwt groups, PORT also improved LRFS (HR 0.58, 95%CI 0.34-0.99, P = 0.042) and DMFS (HR 0.649, 95%CI 0.43-0.98, P = 0.038). In EGFRm groups, PORT only improved LRFS (HR 0.50, 95%CI 0.30-0.85, P = 0.009), with no significant difference in DFS or DMFS between the PORT and non-PORT groups.</p><p><strong>Conclusion: </strong>For patients with completely resected pN2 Nsq-NSCLC receiving adjuvant chemotherapy, PORT may improve DFS in EGFRwt patients but not in EGFRm patients. Randomized clinical trials are needed for validation.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"38"},"PeriodicalIF":3.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626507","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":"Radiation-induced lung injury: from mechanism to prognosis and drug therapy.","authors":"Sheng Wang, Duo Xu, Lingyan Xiao, Bo Liu, Xianglin Yuan","doi":"10.1186/s13014-025-02617-8","DOIUrl":"10.1186/s13014-025-02617-8","url":null,"abstract":"<p><p>Radiation induced lung injury, known as the main complication of thoracic radiation, remains to be a major resistance to tumor treatment. Based on the recent studies on radiation-induced lung injury, this review collated the possible mechanisms at the level of target cells and key pathways, corresponding prognostic models including predictors, patient size, number of centers, radiotherapy technology, construction methods and accuracy, and pharmacotherapy including drugs, targets, therapeutic effects, impact on anti-tumor treatment and research types. The research priorities and limitations are summarized to provide a reference for the research and management of radiation-induced lung injury.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"39"},"PeriodicalIF":3.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626508","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":"Neck muscle training improving the setup of reproducibility in patient with head and neck cancer receiving radiotherapy - a prospective randomized controlled study.","authors":"Fei Bai, Lihua Zhang, Xiaowei Yao, Bo Li, Jie Li, Qiuxia Hu, Yutian Yin, Changhao Liu, Zhaodi Xu, Linlin Xu, Jian Zang, Lina Zhao","doi":"10.1186/s13014-025-02593-z","DOIUrl":"10.1186/s13014-025-02593-z","url":null,"abstract":"<p><strong>Background and purpose: </strong>The aim of this study is to evaluate the effectiveness of a cervical muscle training intervention in decreasing setup errors in patients head and neck cancer (HNC) undergoing radiotherapy (RT).</p><p><strong>Materials and methods: </strong>HNC patients opting for RT at our center. The patients were randomly allocated to either the muscle training group or the control group in a 1:1 ratio. The magnitude of the setup error was measured at the levels of the clivus, C4 and C7 vertebrae respectively. The Van Herk formula was used to determine appropriate planning target volume (PTV) margins. (Trial Registration: ChiCTR2000041009, registration date: 12/16/2020) RESULTS: A total of 221 patients were analyzed, with 109 assigned to the muscle training group and 112 enrolled in the control group. Compared with the control group, the setup errors in the X and Z direction of the clivus and the Z direction of C4 and C7 in the muscle training group were significantly lower (p = 0.031, < 0.001, < 0.001, < 0.001 respectively). The required PTV margins in the Z direction increased from 2.13 mm in the clivus to 3.63 mm in C7 in the muscle training group and from 2.89 mm in the clivus to 4.37 mm in C7 in the control group. Multivariate linear regression analysis demonstrated that the impact of neck muscle training, weight fluctuation, and cervical curvature on the setup error in the Z direction at C7 differed significantly (p = 0.000, 0.001, and 0.008, respectively).</p><p><strong>Conclusion: </strong>Neck muscle training can reduce setup errors and PTV margins in the anterior-posterior direction in patients undergoing RT for HNC.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"35"},"PeriodicalIF":3.3,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617826","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":"Effectiveness of personalized open-face mask combined with styrofoam fixation in radiotherapy treatment of head and neck cancers: a prospective randomized controlled trial.","authors":"Fating Yang, Jingling Li, Bo Li, Lihua Zhang, Jie Li, Xiaowei Yao, Qiuxia Hu, Yutiann Yin, Changhao Liu, Lin Xu, Jian Zang, Lina Zhao, Fei Bai","doi":"10.1186/s13014-025-02609-8","DOIUrl":"10.1186/s13014-025-02609-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The primary aim of this investigation is to assess the effectiveness of implementing an innovative immobilization approach, spec ically the utilization of personalized open-face masks in combination with styrofoam fixation, for head and neck cancers receiving radiotherapy. The study seeks to evaluate the influence of this method on improving patients' precision in positioning and their overall comfort during the treatment process, in addition to exploring its potential capacity to mitigate the occurrence of anxiety and depression in this patient population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A prospective, randomized controlled trial was undertaken to investigate the comparative efficacy of two immobilization approaches for the radiotherapy treatment of head and neck cancers. The experimental group was randomly assigned to receive fixation using personalized open-face masks with nose and mouth apertures, while the control group was immobilized using closed-face masks. Weekly cone-beam computed tomography (CBCT) scans were conducted pre-treatment to assess and record setup errors along three axes. Comparative analysis of setup errors and the planning target volume (PTV) margin between the two groups was performed. Furthermore, the patients' comfort levels and anxiety and depression status were evaluated using the modified Likert questionnaire and the Hospital Anxiety and Depression Scale (HADS).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 106 patients were enrolled in the study and randomly assigned to either the experimental group (n = 53) or the control group (n = 53). There were no statistically significant differences observed between the two groups in terms of age, sex, and disease type indicating comparability. Analysis of the setup errors along different directions showed no significant differences between the experimental and control groups in the X direction (0.90 ± 0.84 mm vs. 0.92 ± 0.85 mm, p = 0.825), Y direction (1.26 ± 0.98 mm vs. 1.37 ± 1.09 mm, p = 0.172), Z direction (1.18 ± 0.84 mm vs. 1.15 ± 0.98 mm, p = 0.651), and Rtn direction (0.65 ± 0.57 vs. 0.62 ± 0.55, p = 0.489). Evaluating the local setup errors in the experimental and control groups, there were no significant differences observed in the X direction (1.13 ± 1.15 mm vs. 1.01 ± 0.89 mm, p = 0.152) and Z direction (1.31 ± 0.88 mm vs. 1.26 ± 1.17 mm, p = 0.549). However, a significant difference was found in the Y direction (1.49 ± 1.19 mm vs. 1.80 ± 1.45 mm, p = 0.003). The Rtn direction also did not show a significant difference (0.90 ± 0.81 vs. 0.84 ± 0.73, p = 0.328). The PTV margin in the X, Y, and Z directions were determined as 2.20 mm, 3.12 mm, and 2.57 mm in the experimental group and 2.35 mm, 3.58 mm, and 2.86 mm in the control group, respectively. The personalized open-face mask patients reported higher levels of comfort compared to the perforated head, neck, and shoulder thermoplastic mask (31.32 ± 1.16 vs. 30.00 ± 1.49, p &lt; 0.001). T","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"34"},"PeriodicalIF":3.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11899069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607041","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 radiosurgery as neuromodulation of refractory angina: an initial case series.","authors":"Jakub Cvek, Otakar Jiravsky, Lukas Knybel, Miroslav Hudec, Radim Spacek, Adrian Reichenbach, Jan Hecko, Radek Neuwirth, Josef Kautzner","doi":"10.1186/s13014-025-02608-9","DOIUrl":"10.1186/s13014-025-02608-9","url":null,"abstract":"<p><strong>Background: </strong>This intervention pilot case series assessed 40-Gy stereotactic radiosurgery (SRS) neuromodulation applied to the bilateral stellate ganglion (SG) as a bailout procedure for patients with refractory angina pectoris (RAP).</p><p><strong>Materials and methods: </strong>The local institutional review board approved this feasibility study. In three patients with RAP, after repeated good response, symptoms were temporarily relieved after anaesthetic blockade of the left SG under ultrasound guidance. Radiosurgical neuromodulation with a dose of 40 Gy in one fraction was used for more permanent pain control. When RAP recurred after the initial SRS, right-sided procedures were considered after a confirmed positive response to right SG anesthetic block.</p><p><strong>Results: </strong>No acute or late radiation-related toxicities were observed. Two patients (67%) responded to bilateral SRS (follow-up: 60 and 48 months, respectively). From baseline to 24 months, their average prescribed nitrate package count decreased from 5.5 to 0 and remained low. Daily emergency nitrates declined from 20 to 30 to 1-2 applications, and walking distance improved from 10 to 20 m to 200-400 m and remained stable. Quality of life as measured with the EQ-5D and all domains of the Seattle Angina Questionnaire improved. The third patient received only unilateral SRS, had a temporary improvement for 6 months before a return to baseline, and died after 42 months of follow-up.</p><p><strong>Conclusions: </strong>Bilateral radiosurgical neuromodulation at 40 Gy appears to be feasible, safe, and effective as a bailout procedure for RAP.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"33"},"PeriodicalIF":3.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598140","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":"Dummy run study for outlining and plan quality of intensity-modulated radiotherapy in elderly patients with newly diagnosed glioblastoma: The Japan clinical oncology group study JCOG1910 (AgedGlio-PIII).","authors":"Tomohiro Ono, Megumi Uto, Yohei Mineharu, Yoshiki Arakawa, Mitsuhiro Nakamura, Teiji Nishio, Hiroshi Igaki, Keiji Nihei, Satoshi Ishikura, Yoshitaka Narita, Takashi Mizowaki","doi":"10.1186/s13014-025-02612-z","DOIUrl":"10.1186/s13014-025-02612-z","url":null,"abstract":"<p><strong>Background: </strong>A dummy run was conducted to ensure the quality of intensity-modulated radiotherapy (IMRT) before registration in a randomized phase III study of elderly patients with newly diagnosed glioblastoma by the Japan Clinical Oncology Group 1910 (JCOG1910).</p><p><strong>Methods: </strong>All 41 institutions enrolled in this study were required to report outlining that included gross tumor volume (GTV), clinical target volume (CTV), planning target volume (PTV), and treatment planning for one benchmark case. First, deviations in outlining were evaluated using the Dice similarity coefficient (DSC) and mean distance agreement (MDA), compared to reference targets delineated by the research secretariat. Second, the participating institutions were required to create treatment plans for arms A (40.05 Gy in 15 fractions) and B (25 Gy in 5 fractions) using IMRT techniques. The quality of the outlining and dose-volume criteria for each target and organs at risk were evaluated.</p><p><strong>Results: </strong>Six institutions failed to adhere to the protocol and required revision due to insufficient GTV outlining, not considering anatomical barriers for CTV, and modifying PTV against protocols. Compared to the reference outlining, the means and standard deviations of DSC and MDA were 0.37 ± 0.19 and 9.41 ± 3.99 mm for GTV; 0.80 ± 0.08 and 4.31 ± 1.85 mm for CTV; and 0.83 ± 0.05 and 4.23 ± 1.45 mm for PTV, respectively. Regarding dose-volume criteria, 40 of the 41 institutions met the per-protocol limits; only one was within the acceptable limits.</p><p><strong>Conclusions: </strong>Several institutions demonstrated deviations in outlining that necessitated revisions. Thus, appropriate feedback and periodic sharing of information with participating institutions is necessary in the upcoming prospective JCOG1910 study.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"32"},"PeriodicalIF":3.3,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587899","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":"Survival analysis of patients with metastatic head and neck squamous cell carcinoma treated with metastasis-directed radiotherapy and immunotherapy.","authors":"Peng Xu, Dongmei Liu, Jie Zhou, Zhengyi Tang, Shuo Wang, Yecai Huang, Mei Feng, Shun Lu, Jinyi Lang, Lucia Clara Orlandini","doi":"10.1186/s13014-025-02610-1","DOIUrl":"10.1186/s13014-025-02610-1","url":null,"abstract":"<p><strong>Objective: </strong>Immunotherapy combined with chemotherapy is currently the first-line treatment for metastatic head and neck squamous cell carcinoma (HNSCC). This study aims to evaluate whether adding metastasis-directed radiotherapy (MDRT) to immunotherapy and chemotherapy could improve the survival rate of patients with metastatic HNSCC.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted on patients with HNSCC who developed distant metastases after curative treatment. Systemic treatment was determined by the multidisciplinary team, with a programmed cell death-1 (PD-1) inhibitor combined with chemotherapy as the primary approach. The feasibility of radiotherapy was evaluated by clinical and imaging examinations. Stereotactic body radiotherapy (SBRT) was used to deliver different doses according to the number and location of metastatic lesions. Kaplan-Meier method was used to estimate survival, and Cox regression analysis was performed to evaluate the association between clinical factors and survival outcomes.</p><p><strong>Results: </strong>From January 2018 to June 2023, a total of 94 patients with 164 metastatic sites were included for the analysis. The most common primary tumor was the nasopharynx (77.7%), with the lung being the most frequent site of metastasis (46.8%), followed by bone (37.2%). Radiotherapy was administered to 276 metastatic lesions, with a median dose of 52.3 Gy (range: 24-60 Gy). The median overall survival (OS) was 43.0 months (range: 20.2-65.8). The OS rates at 2 and 5 years were 70.1% (95% CI, 59.7-80.5%) and 30.1% (95%CI 11.7-48.5%), respectively. Univariate and multivariate analysis showed that the number of metastases and the location of the primary tumor were significantly associated with OS.</p><p><strong>Conclusions: </strong>In patients with metastatic HNSCC, MDRT combined with immunotherapy and chemotherapy can effectively improve local control and OS. These findings warrant further validation through prospective clinical trials.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"31"},"PeriodicalIF":3.3,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574410","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}