Radiation Oncology最新文献

{"title":"Respiratory-gated proton beam therapy for intrahepatic cholangiocarcinoma without fiducial markers.","authors":"Akihito Okubo, Sae Matsumoto, Hiroyasu Tamamura, Yoshitaka Sato, Satoko Asahi, Hitoshi Tatebe, Kazutaka Yamamoto, Keiichiro Matsushita, Makoto Sasaki, Yoshikazu Maeda, Yuji Tameshige, Hajime Sunagozaka, Hiroyuki Aoyagi, Satoshi Shibata, Shigeyuki Takamatsu, Satoshi Kobayashi","doi":"10.1186/s13014-024-02550-2","DOIUrl":"10.1186/s13014-024-02550-2","url":null,"abstract":"<p><strong>Background: </strong>Intrahepatic cholangiocarcinoma (ICC) is a challenging primary liver cancer with a poor prognosis, especially in unresectable cases. Traditional palliative irradiation is limited in reducing liver doses. This study aimed to evaluate the efficacy and toxicity of respiratory-gated proton beam therapy without fiducial markers for intrahepatic cholangiocarcinoma.</p><p><strong>Methods: </strong>Between October 2011 and February 2022, 24 patients (median [range] age, 71 [41-88] years) were evaluated at our institution. Twelve patients were pathologically diagnosed with ICC. All patients underwent respiratory-gated proton beam therapy at a dose of 48-83.6 (relative biological effectiveness) in 20-38 fractions with four-dimensional computed tomography planning. The median follow-up period was 18.5 (range, 2.0-74.0) months. The median tumor size was 41 (range, 10-134) mm. Twenty-one patients were classified as having Child-Pugh class A, and three patients were classified as having Child-Pugh class B. Local progression was defined as any growth of the irradiated tumor.</p><p><strong>Results: </strong>The median survival time was 28 months for all patients. The Kaplan-Meier estimates of the 2-year overall survival, progression-free survival, and local tumor control rates were 51%, 26%, and 73%, respectively. Local tumor control rates were non-inferior to those reported in previous studies using fiducial markers. One patient had grade 4 pleural effusion; however, whether this was an adverse event due to the proton beam therapy was unclear.</p><p><strong>Conclusions: </strong>Respiratory-gated proton beam therapy without fiducial markers is an effective and less invasive treatment option for ICC, showing potential for improved local control and tolerable adverse effects.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"19 1","pages":"160"},"PeriodicalIF":3.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631452","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":"Reproducibility and stability of voluntary deep inspiration breath hold and free breath in breast radiotherapy based on real-time 3-dimensional optical surface imaging system.","authors":"Junxiang Wu, Feng Yang, Jie Li, Xianliang Wang, Ke Yuan, Lipeng Xu, Fan Wu, Bin Tang, Lucia Clara Orlandini","doi":"10.1186/s13014-024-02549-9","DOIUrl":"10.1186/s13014-024-02549-9","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to evaluate the inter-fraction reproducibility and intra-fraction stability of breast radiotherapy using voluntary deep-inspiration breath hold (DIBH) and free breathing (FB) based on an optical surface imaging system (OSIS).</p><p><strong>Methods: </strong>Seventeen patients (510 breath-hold sessions) treated using a field-in-field (FiF) technique and twenty patients (600 breath-free sessions) treated with a volume-modulated arc therapy (VMAT) technique were included in this retrospective study. All the patients were positioned with the guidance of CBCT and OSIS, and also monitored with OSIS throughout the whole treatment session. Eight setup variations in three directions were extracted from the treatment reports of OSIS for all sessions and were subsequently manually introduced to treatment plans, resulting in a total of 296 perturbed plans. All perturbed plans were recalculated, and the dose volume histograms (DVH) for the target and organs at risk (OAR) were analyzed.</p><p><strong>Results: </strong>The OSIS and CBCT for both DIBH and FB treatments showed a good agreement of less than 0.30 cm in each direction. The intra-fraction respiratory motion data during DIBH were -0.06 ± 0.07 cm, 0.12 ± 0.15 cm, and 0.12 ± 0.12 cm in the lateral, longitudinal, and vertical directions, respectively; for FB, the respiratory motion data were -0.02 ± 0.12 cm, 0.08 ± 0.18 cm, and 0.14 ± 0.20 cm, respectively. For the target, DIBH plans were more sensitive to setup errors; the mean deviations in D₉₅ for CTV were 39.78 Gy-40.17 Gy for DIBH and 38.46 Gy-40.52 Gy for FB, respectively. For the OARs, the mean deviations of V₁₀, V₂₀, and D_mean to the heart; V₅, V₂₀, and D_mean to the ipsilateral lung; and D_mean to the breast were lower for the FB plan compared with the DIBH plan.</p><p><strong>Conclusion: </strong>Based on OSIS, our results indicate that both DIBH and FB can provide good reproducibility in the inter-fractions and stability in the intra-fractions. When the patient respiratory motion is large, the FB technology has greater possibility for the undercoverage of the target volume, while DIBH technology is more likely to result in increases in dose to OARs (the lung, heart, and contralateral breast).</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"19 1","pages":"158"},"PeriodicalIF":3.3,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631451","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":"A bibliometrics analysis based on the application of artificial intelligence in the field of radiotherapy from 2003 to 2023.","authors":"Minghe Lv, Yue Feng, Su Zeng, Yang Zhang, Wenhao Shen, Wenhui Guan, Xiangyu E, Hongwei Zeng, Ruping Zhao, Jingping Yu","doi":"10.1186/s13014-024-02551-1","DOIUrl":"10.1186/s13014-024-02551-1","url":null,"abstract":"<p><strong>Background: </strong>Recent research has demonstrated that the use of artificial intelligence (AI) in radiotherapy (RT) has significantly streamlined the process for physicians to treat patients with tumors; however, bibliometric studies examining the correlation between AI and RT are not available. Providing a thorough overview of the knowledge structure and research hotspots between AI and RT was the main goal of the current study.</p><p><strong>Method: </strong>A search was conducted on the Web of Science Core Collection (WoSCC) database for publications pertaining to AI and RT between 2003 and 2023. VOSviewers, CiteSpace, and the R program \"bibliometrix\" were used to do the bibliometric analysis.</p><p><strong>Results: </strong>The analysis comprised 615 publications from 64 countries, with USA and China leading the pack. Since 2017, there have been more and more publications about RT and AI every year. The research center that made the biggest contribution to this topic was Maastricht University. The most articles published journal in this field was Frontiers in Oncology, while Medical Physics received the greatest number of citations. Dekker Andre is the author with the greatest number of published articles, while Philippe Lambin was the most often co-cited author. In the newly identified research hotspots, \"autocontouring algorithm\", \"deep learning\", and \"machine learning\" stand out as the main terms.</p><p><strong>Conclusion: </strong>In fact, our bibliometric analysis offers insightful information on current research directions and advancements pertaining to the use of AI in RT. For academics looking to understand the connection between AI and RT, this study is a great resource because it highlights current research frontiers and hot trends.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"19 1","pages":"157"},"PeriodicalIF":3.3,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631357","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":"Prognostic value of neutrophil to lymphocyte ratio and lymphocyte counts before durvalumab consolidation after radio-chemotherapy in locally advanced non-small cell lung cancer.","authors":"Arnaud Colomb, Benoit Allignet, Mehdi Lamkhioued, Aurelie Swalduz, Lionel Falchero, Aurélie Kienlen, Michaël Duruisseaux, Coralie Moncharmont","doi":"10.1186/s13014-024-02553-z","DOIUrl":"10.1186/s13014-024-02553-z","url":null,"abstract":"<p><strong>Background: </strong>Durvalumab, an anti-PD-L1 immune checkpoint inhibitor, after radio-chemotherapy (RCT) has changed the management of locally advanced non-small cell lung cancer (LA NSCLC). A series of retrospective studies have investigated different cut-off of lymphocyte count (LyC) and neutrophil-to-lymphocyte ratio (NLR) to predict survival in LA NSCLC. None of these studies has validated their threshold in an independent group of patients. We wanted to assess the OS prognostic value of NLR and LyC in patients with LA NSCLC treated by RCT and durvalumab, with threshold determination and their validation in an external cohort.</p><p><strong>Methods: </strong>Patients were enrolled in four institutions between Oct. 2017 and Jan. 2022. Pre durvalumab LyC, neutrophils count (NC) and NLR were collected. To define NLR and LyC cut-off value predicting survival event, time dependent Receiver Operating Characteristics (ROC) curves was performed. Survival outcomes were estimated by the Kaplan-Meier method and differences were compared using univariate and multivariate Cox proportional hazard models.</p><p><strong>Results: </strong>We included 76 patients in the training set and 85 in the test set. The best cut off were 2,94 for NLR and 0,61 G/l for LyC to predict OS in the training set. For patients with NLR > 2,94, univariate analysis showed no significant deterioration in OS in either the training set (p = 0,066) or the test set (p = 0,12). Patients with LyC > 0,61 G/L, in univariate analysis, had longer OS in training set (p = 0,030) and in test set (p = 0,0062). This OS increase was not found in multivariate analysis (p = 0,057) in training set but was confirmed in test set (0,039).</p><p><strong>Conclusion: </strong>LyC > 0,61 G/l is associated with longer OS for LA NSCLC patient's treated with RCT and durvalumab in univariate analysis. In this context, a particular expectation for organs at risk sparing during RT to avoid lymphopenia seems important.</p><p><strong>Trial registration: </strong>Retrospectively registered.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"19 1","pages":"156"},"PeriodicalIF":3.3,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11545521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631448","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":"Growth differentiation factor 15 (GDF15) predicts relapse free and overall survival in unresected locally advanced non-small cell lung cancer treated with chemoradiotherapy.","authors":"Fiorella Di Pastena, Gregory Pond, Evangelia E Tsakiridis, Andre Gouveia, Elham Ahmadi, Olga-Demetra Biziotis, Amr Ali, Anand Swaminath, Gordon Okawara, Peter M Ellis, Bassam Abdulkarim, Naseer Ahmed, Andrew Robinson, Wilson Roa, Mario Valdes, Peter Kavsak, Marcin Wierzbicki, James Wright, Gregory Steinberg, Theodoros Tsakiridis","doi":"10.1186/s13014-024-02546-y","DOIUrl":"10.1186/s13014-024-02546-y","url":null,"abstract":"<p><strong>Introduction: </strong>Growth differentiation factor 15 (GDF15) is a cytokine of the TGFβ family. Here, we analyzed GDF15 levels in patients with locally advanced non-small cell lung cancer (LA-NSCLC) who participated in OCOG-ALMERA (NCT02115464), a phase II randomized clinical trial, that investigated metformin in combination with standard of care concurrent chemoradiotherapy (cCRT). OCOG-ALMERA was not able to demonstrate benefit in the metformin arm. Therefore, biomarker studies are needed to better define stratification parameters for future trials.</p><p><strong>Methods: </strong>Patients were randomized to treatment with platinum-based chemotherapy and concurrent chest radiotherapy (60-66 Gy), with or without metformin (2000 mg/d). The trial collected tumor volume parameters, survival outcomes, and patient blood plasma at baseline, during (weeks 1 and 6) and 6 months after cCRT. Plasma GDF15 levels were assayed with the ELISA method. Statistical analyses explored associations between GDF15, survival outcomes, and radiotherapy tumor volumes.</p><p><strong>Results: </strong>Baseline plasma levels of GDF15 were elevated in study patients, they increased during cCRT (p < 0.001), and the addition of metformin was associated with a further increase (week 6, p = 0.033). Baseline GDF15 levels correlated with the radiotherapy gross target volume (GTV, p < 0.01), while week 1 of radiotherapy levels correlated with radiotherapy planned target volume (PTV, p < 0.006). In multivariate analysis, baseline plasma GDF15 was prognostic for poor relapse-free (RFS) and overall survival (OS) (p = 0.005 and p = 0.002, respectively).</p><p><strong>Conclusions: </strong>GDF15 is a plasma marker that responds to the treatment of unresected LA-NSCLC with cCRT and metformin. GDF15 levels correspond with tumor volume and increased GDF15 levels predict for poor RFS and OS. These results require validation in larger clinical trial datasets.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"19 1","pages":"155"},"PeriodicalIF":3.3,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606790","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 tyrosine kinase inhibitors with thoracic radiotherapy for patients with oncogene-mutated non-small cell lung cancer: a meta-analysis.","authors":"Wenxia Li, Peiye Wu, Zhanpeng Liang, Luzhen Li, Yunqi Chen, Wenjing Zhang, Huatang Zhang, Cantu Fang","doi":"10.1186/s13014-024-02538-y","DOIUrl":"10.1186/s13014-024-02538-y","url":null,"abstract":"<p><strong>Background: </strong>Tyrosine Kinase Inhibitors (TKIs) is an important therapy for patients with oncogene-mutated Non-Small Cell Lung Cancer (NSCLC). However, acquired resistance remains a major challenge. The efficacy of TKIs plus thoracic radiotherapy (RT) in oncogene-mutated NSCLC patients is uncertain. Therefore, we performed a meta-analysis to comprehensively evaluate the efficacy and safety of thoracic RT plus TKIs in oncogene-mutated NSCLC patients.</p><p><strong>Methods: </strong>The following databases were searched for relevant studies: PubMed, EMBASE, and Cochrane Library. Studies comparing the efficacy and safety of TKIs plus RT with TKIs alone in oncogene-mutated NSCLC patients were included in this analysis. Outcomes were median progression-free survival (mPFS), median overall survival (mOS), and incidence of adverse events (AEs). This analysis performed a subgroup analysis of the efficacy of first-line TKIs in combination with RT.</p><p><strong>Results: </strong>This meta-analysis included 12 studies with 2936 patients (n = 823 patients with TKIs plus thoracic RT, n = 2113 patients with TKIs alone). The results showed that patients who received treatment with TKIs plus thoracic RT were associated with superior mPFS and mOS than those who were treated with TKIs alone (hazard ratio [HR]: 0.42, 95% CI 0.30-0.59, p < 0.00001; HR: 0.56, 95% CI 0.41-0.70, p < 0.00001, respectively). Subgroup analyses showed that TKIs plus thoracic RT as first-line treatment was associated with better mPFS and OS (HR: 0.37, 95% CI 0.26-0.52, p < 0.00001; HR: 0.47, 95% CI 0.31-0.70, p = 0.0002, respectively). Although the combination of TKIs with thoracic RT was associated with an increased risk of total AEs (odds ratio [OR]: 1.17, 95% CI 1.06-1.29, P = 0.002), there was no significant difference in serious AEs (grade ≥ 3) (OR: 1.06, 95% CI 0.58-1.92, P = 0.86). The most frequently occurring radiation-related AEs were radiation pneumonitis, radiation esophagitis, and radiation dermatitis, with overall rates of 41.3%, 15.4%, and 11.1%, respectively. The incidence of severe radiation pneumonitis and radiation esophagitis was 4.5% and 6.2%, respectively.</p><p><strong>Conclusions: </strong>In comparison to TKIs alone, TKIs plus thoracic RT are associated with survival benefits, especially as a first-line treatment option. Although TKIs plus thoracic RT may increase the risk of total AEs, it did not increase the risk of severe AEs. Therefore, TKIs plus thoracic RT may be a promising therapeutic regimen for oncogene-mutated NSCLC patients.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"19 1","pages":"154"},"PeriodicalIF":3.3,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589831","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":"Dynamics of cell-free tumor DNA correlate with early MRI response during chemoradiotherapy in rectal cancer.","authors":"Kerstin Clasen, Cihan Gani, Leon Schuetz, Stephan Clasen, Nadja Ballin, Irina Bonzheim, Michael Orth, Stephan Ossowski, Olaf Riess, Maximilian Niyazi, Christopher Schroeder, Olga Kelemen","doi":"10.1186/s13014-024-02540-4","DOIUrl":"10.1186/s13014-024-02540-4","url":null,"abstract":"<p><strong>Background: </strong>In locally advanced rectal cancer, the prediction of tumor response during and after neoadjuvant treatment remains challenging. In terms of organ preservation, adaptive radiotherapy, and intensified (total) neoadjuvant therapies, biomarkers are desirable for patient stratification.</p><p><strong>Methods: </strong>In 16 patients, weekly blood samples (n = 86) to detect cell-free tumor DNA (ctDNA) during long-course neoadjuvant chemoradiotherapy were analyzed. Data were correlated with initial tumor volumes, MRI response in week 2 and 5 of radiotherapy as well as with pathologic tumor response after resection and outcome parameters.</p><p><strong>Results: </strong>Most patients showed decreasing ctDNA during the course of radiochemotherapy. However, we found heterogenous dynamics of ctDNA and could identify three groups: (1) decline (2) no clear decline and/or late shedding (3) persistence of ctDNA. In seven patients we could detect significant amounts of ctDNA in week 5 or week 6 of treatment. In our pilot cohort, we did not find significant correlations of ctDNA dynamics with pathologic response or outcome parameters. However, patients with distinct decline of ctDNA had larger tumor volumes prior to treatment, and MRI imaging in week 2 and 5 revealed bigger absolute decrease of tumor volumes. If significant levels of ctDNA were found in week 5 and / or 6, patients showed less absolute tumor volume decrease in week 2 and 5.</p><p><strong>Conclusions: </strong>Weekly measurement of ctDNA during radiochemotherapy is feasible and might represent a promising biomarker. Bigger initial primary tumors showed different ctDNA shedding profiles compared with smaller primary tumors and correlations of ctDNA dynamics with early imaging response were found.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"19 1","pages":"153"},"PeriodicalIF":3.3,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592166","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":"3D-printed brachytherapy in patients with cervical cancer: improving efficacy and safety outcomes.","authors":"Zenghong Lu, Gangfeng Zhu, Zhengang Qiu, Hailiang Guo, Junyan Li, Liangjian Zheng, Cixiang Chen, Jie Che, Yi Xiang, Yili Wang","doi":"10.1186/s13014-024-02536-0","DOIUrl":"10.1186/s13014-024-02536-0","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the efficacy and safety of 3D printing technology in brachytherapy for cervical cancer, comparing its outcomes with conventional free hand implantation brachytherapy.</p><p><strong>Methods: </strong>A total of 50 cervical cancer patients treated at the First Affiliated Hospital of Gannan Medical College from January 2019 to July 2023 were included in this study. Patients were divided into two groups: 25 patients received intensity-modulated radiotherapy (IMRT) combined with 3D-printed brachytherapy, and 25 patients underwent IMRT combined with free hand brachytherapy implantation. Key indicators analyzed included short-term therapeutic effects, survival outcomes, operation times, the number of CT scans, the number of needles inserted, dosimetric parameters, and complications.</p><p><strong>Results: </strong>The use of 3D-printed brachytherapy significantly improved the safety of radiation therapy operations, especially for large tumors (≥ 30 mm), by providing more precise dose distribution and reducing the radiation doses received by critical organs such as the bladder and rectum. Compared to the artificial implant group (88% prevalence), the 3D-printed brachytherapy group showed a significantly lower incidence of radiation enteritis (29.2% prevalence, p < 0.001). There were no significant differences in other complications between the two groups. For instance, the incidence of radiation cystitis was relatively high in the 3D-printed brachytherapy group (79.2% prevalence) compared to the artificial implant group (64% prevalence, p = 0.240). The median follow-up period in this study was 22.5 months [IQR 18-29]. Among the 49 patients included, 43 had cervical squamous carcinoma and 6 had cervical adenocarcinoma. Short-term therapeutic response rates were comparable, with no significant difference in overall survival observed between the two groups.</p><p><strong>Conclusion: </strong>3D-printed brachytherapy offers a more effective and safer therapeutic option for patients with cervical cancer, particularly for those with large tumors or complex anatomical structures.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"19 1","pages":"152"},"PeriodicalIF":3.3,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565281","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 radiotherapy for patients with bone metastases: a selected group with low rate of radiation treatment during the last month of life?","authors":"Carsten Nieder, Ellinor C Haukland, Luka Stanisavljevic, Bård Mannsåker","doi":"10.1186/s13014-024-02547-x","DOIUrl":"10.1186/s13014-024-02547-x","url":null,"abstract":"<p><strong>Background: </strong>Complex high-precision radiotherapy, such as stereotactic body radiotherapy (SBRT), should only be offered to patients with sufficiently long survival. In the context of bone metastases radiotherapy, low rates of treatment close to the end of life, e.g. last 30 days (RT30), may serve as a quality of care indicator. While traditional, pain-relieving short-course regimens have been studied comprehensively, real-world SBRT results are still limited.</p><p><strong>Methods: </strong>Retrospective analysis (2010-2023, n = 1117 episodes) of patients with bone metastases treated with traditional single-fraction (8 Gy × 1) or multi-fraction regimens (often 4 Gy × 5 or 3 Gy × 10) compared to stereotactic single-fraction (12-16 Gy × 1) or multi-fraction regimens.</p><p><strong>Results: </strong>Except for gender, almost all baseline variables were uneven distributed. Failure to complete fractionated radiotherapy was uncommon in the stereotactic (4%) and non-stereotactic group (3%), p = 1.0. With regard to RT30, relevant differences emerged (19% for 8-Gy single-fraction versus 0% for stereotactic single-fraction, p = 0.01). The corresponding figures were 11% for multi-fraction non-stereotactic and 2% for multi-fraction stereotactic, p = 0.08. Median overall survival was shortest after 8-Gy single-fraction irradiation (4.2 months) and longest after stereotactic multi-fraction treatment (13.9 months). Neither stereotactic radiotherapy nor multi-fraction treatment improved survival in multivariate Cox regression analysis. Factors significantly associated with longer survival included better performance status, lower LabBM score (5 standard blood test results), stable disease outside of irradiated area(s), metachronous distant metastases, longer time interval from metastatic disease to bone irradiation, and outpatient status.</p><p><strong>Conclusion: </strong>The implementation of SBRT for selected patients has resulted in low rates of non-completion and RT30. Optimal selection criteria remain to be determined, but in current clinical practice we exclude patients with poor performance status, unfavorable blood test results (high LabBM score) and progressive disease sites not amenable to SBRT. Established, guideline-endorsed short-course regimens, especially 8-Gy single-fraction treatment, continue to represent an important palliative approach.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"19 1","pages":"151"},"PeriodicalIF":3.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565285","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":"Tissue microarray analyses of the essential DNA repair factors ATM, DNA-PKcs and Ku80 in head and neck squamous cell carcinoma.","authors":"Henrike Barbara Zech, Clara von Bargen, Agnes Oetting, Nikolaus Möckelmann, Christina Möller-Koop, Melanie Witt, Nina Struve, Cordula Petersen, Christian Betz, Kai Rothkamm, Adrian Münscher, Till Sebastian Clauditz, Thorsten Rieckmann","doi":"10.1186/s13014-024-02541-3","DOIUrl":"10.1186/s13014-024-02541-3","url":null,"abstract":"<p><strong>Background: </strong>Head and neck squamous cell carcinoma (HNSCC) negative for Human Papillomavirus (HPV) has remained a difficult to treat entity, whereas tumors positive for HPV are characterized by radiosensitivity and favorable patient outcome. On the cellular level, radiosensitivity is largely governed by the tumor cells` ability to repair radiation-induced DNA double-strand breaks (DSBs), but no biomarker is established that could guide clinical decision making. Therefore, we tested the impact of the expression levels of ATM, the central kinase of the DNA damage response as well as DNA-PKcs and Ku80, two major factors in the main DSB repair pathway non-homologous end joining (NHEJ).</p><p><strong>Methods: </strong>A tissue microarray of a single center HNSCC cohort was stained for ATM, DNA-PKcs and Ku80 and the expression scored based on staining intensity and the percentages of tumor cells stained. Scores were correlated with clinicopathological parameters and survival.</p><p><strong>Results: </strong>Samples from 427 HNSCC patients yielded interpretable stainings and were scored following an established algorithm. The majority of tumors showed strong expression of both NHEJ factors, whereas the expression of ATM varied more. The expression scores of ATM and DNA-PKcs were not associated with patient survival. For HPV-negative HNSCC, the minority of tumors without strong Ku80 expression trended towards superior survival when treatment included radiotherapy. Focusing stronger on staining intensity to define the subgroup with lowest and therefore potentially insufficient expression levels in the HPV-negative subgroup, we observed significantly better overall survival for patients treated with radiotherapy but not with surgery alone.</p><p><strong>Conclusions: </strong>Our data suggest that HPV-negative HNSCC with particularly low Ku80 expression represent a highly radiosensitive subpopulation. Confirmation in independent cohorts is required.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"19 1","pages":"150"},"PeriodicalIF":3.3,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548572","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}