Radiation Oncology最新文献

{"title":"The dosimetric value and safety evaluation of 3D printed bolus in adjuvant intensity-modulated radiotherapy after radical mastectomy for breast cancer: a prospective cohort study.","authors":"Yaxue Wang, Hanzong Li, Wendie Hu, Bohan Li, Yujie Du, Fengyan Li","doi":"10.1186/s13014-025-02659-y","DOIUrl":"10.1186/s13014-025-02659-y","url":null,"abstract":"<p><strong>Purpose: </strong>Breast cancer patients may use a bolus to increase the dose to skin in radiotherapy after radical mastectomy. The 3D printed bolus (3DPB) specifically customized based on individual conditions offers better conformity. This study aims to provide clinical insights by evaluating the dosimetric benefits and safety of 3DPB in radiotherapy following radical mastectomy for breast cancer.</p><p><strong>Materials and methods: </strong>The study included breast cancer patients who received post-mastectomy radiotherapy with 3DPB. Researchers retrospectively collected dose data from patients' radiotherapy plans, including with and without 3DPB, and prospectively observed the acute and late side effects in the cohort of patients undergoing mixed plan radiotherapy. To compare the dosimetric differences between radiotherapy plans with and without 3DPB, such as the dose distribution data of CTV, PTV, and organs at risk, matched sample T-test was used for data conforming to normal distribution, and non-parametric test was used for data not conforming to normal distribution. P < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 35 patients were included with a median follow-up time of 16 months. In terms of radiotherapy side-effects, no level 4 acute side-effects occurred. A total of 82.2% of the patients had no obvious side-effects. No late radiotherapy side-effects of level 2 or higher occurred. In terms of dosage, radiotherapy plans with 3DPB showed better conformance (P < 0.001) and dose homogeneity (P < 0.001) than plans without 3DPB. The results indicated that the V95% dose of CTV1, CTV2, P-CTV, P-CTV1, and P-CTV2 was higher in the plans with 3DPB than in those without 3DPB (all P < 0.001).</p><p><strong>Conclusions: </strong>The use of 3DPB in breast cancer radiotherapy is effective, achieving higher and more uniform dose distribution and better target conformity compared to without 3DPB. Additionally, it is associated with a low incidence of acute and late side effects.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"91"},"PeriodicalIF":3.3,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192433","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":"Online adaptive stereotactic body radiotherapy for localized prostate cancer in patients with lower urinary tract symptoms and/or prostate hyperplasia (X-SMILE).","authors":"Tiuri Kroese, Nicolaus Andratschke, Claus Belka, Stefanie Corradini, Sebastian Marschner, Jakob Liermann, Juliane Hörner-Rieber, Christoph Fink, Jürgen Debus, Fabiano Silvia, Stephanie Tanadini-Lang, Bertrand Pouymayou, Alessandro Mencarelli, Debra Fesslmeier, Antonia Schiess, Matthias Guckenberger, Michael Mayinger","doi":"10.1186/s13014-025-02653-4","DOIUrl":"10.1186/s13014-025-02653-4","url":null,"abstract":"<p><strong>Background: </strong>Stereotactic body radiotherapy (SBRT) for localized prostate cancer offers non-inferior oncological outcomes and toxicity profiles compared to conventionally or moderately hypofractioned radiotherapy regimens, with shorter treatment durations. However, SBRT may not be suitable for all patients, particularly those with lower urogenital tract symptoms and/or prostatic hyperplasia.</p><p><strong>Methods: </strong>This study aims to evaluate the safety and efficacy of weekly computed tomography (CT) or magnetic resonance image (MRI)-guided online adaptive SBRT in patients with intermediate to high-risk localized prostate cancer (i.e. ≤ cT3a and Gleason score ≤ 9 and PSA ≤ 20 ng/ml) who present with lower urinary tract symptoms (International Prostate Symptom Score [IPSS] > 12) and/or have prostate hyperplasia (prostate volume > 60 mL). The primary outcome measure is urogenital toxicity grade ≥ 3 within 3 months after completion of SBRT (according to CTCAE V5.0) or treatment-related discontinuation. Our aim is to show an event rate of 3% below a clinically acceptable threshold which is set at 20%. Under the null hypothesis, this design with an alpha of 0.05 and power of 80% results in an expected number of cases of 30.</p><p><strong>Discussion: </strong>In cases of moderate to high IPSS or significant obstructive urodynamics, a pre-emptive transurethral resection of prostate (TURP) may be beneficial. Notably, 10-20% of prostate cancer patients receiving radiotherapy patients have a history of TURP. While TURP can improve obstructive symptoms, its impact on late toxicity, particularly in SBRT, requires further investigation. To mitigate the risk of urogenital toxicity, especially in the case of patients with lower urogenital tract symptoms and/or prostatic hyperplasia, emerging approaches like MR-guided adaptive SBRT and weekly SBRT have shown promise.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov/NCT06834152.</p><p><strong>Protocol version: </strong>Version 6.0.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"90"},"PeriodicalIF":3.3,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175492","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":"Outcomes of gamma knife treated large symptomatic arteriovenous malformations according to guidelines of Taiwan neurosurgical consensus.","authors":"Ming-Hsi Sun, Yuang-Seng Tsuei, Ting-Wei Wang, Szu-Yuan Liu, Ying Ju Chen, Chiung-Chyi Shen, Meng-Yin Yang, Jason Sheehan, Weir-Chiang You, Meei-Ling Sheu, Hung-Chuan Pan","doi":"10.1186/s13014-025-02667-y","DOIUrl":"10.1186/s13014-025-02667-y","url":null,"abstract":"","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"89"},"PeriodicalIF":3.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163546","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":"Craniocaudal spread patterns of retropharyngeal lymph node metastasis in patients with hypopharyngeal carcinoma.","authors":"Satomi Yoshimi, Ryo Toya, Mika Nakatake, Yoshiyuki Fukugawa, Hideki Ishimaru, Reiko Ideguchi, Hirofumi Koike, Yutaro Tasaki, Shinya Shiraishi, Yorihisa Orita, Toshinori Hirai, Natsuo Oya","doi":"10.1186/s13014-025-02651-6","DOIUrl":"10.1186/s13014-025-02651-6","url":null,"abstract":"<p><strong>Background: </strong>The wide adoption of intensity-modulated radiotherapy (RT) renders an extended neck position unnecessary. In this study, the appropriate craniocaudal border of the retropharyngeal lymph node (RPLN) was assessed based on diagnostic and RT images in patients with hypopharyngeal carcinoma (HPC) for recommendation of appropriate target volume for elective nodal irradiation (ENI).</p><p><strong>Methods: </strong>Two board-certified radiation oncologists evaluated the craniocaudal spread of RPLN metastases (RPLNMs) and the position of the hyoid bone using magnetic resonance images (diagnostic position) and RT-planning computed tomography simulator images (RT position with neck extension).</p><p><strong>Results: </strong>Of the 154 patients in whom 308 sides were assessed, 19 (12.3%) were diagnosed with RPLNMs in 24 (7.8%) sides. The cranial border of the RPLNMs was found above the hard palate on 3 (1.0%) and 1 (0.3%) side, between the hard palate and cranial edge of the C1 body on 10 (3.2%) and 13 (4.2%) sides, and at the C1 body on 11 (3.6%) and 10 (3.2%) sides in the diagnostic and RT positions, respectively. The caudal border of the RPLNMs was observed between the hard palate and caudal edge of the C2 body on 22 (7.1%) and 22 (7.1%) sides, at the C2/3 disk level on 1 (0.3%) and 1 (0.3%) side, and at the C3 body level on 1 (0.3%) and 1 (0.3%) side in the diagnostic and RT positions, respectively. In the 19 patients with RPLNMs, the most common level of the caudal edge of the hyoid bone body was at the C4 body in 10 (52.6%) and C3 body in 8 (42.1%) patients in the diagnostic and RT positions, respectively.</p><p><strong>Conclusions: </strong>RPLNMs above the hard palate and below the C2/3 disk level extremely rarely develop in patients with HPC. The cranial edge level of the hyoid bone varied significantly among treatment positions. Regardless of the treatment position, the cranial and caudal borders of the RPLN for ENI should be defined as the hard palate and cranial edge of C3, respectively.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"88"},"PeriodicalIF":3.3,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152494","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 tumour-stroma ratio in nasopharyngeal carcinoma: a two-center retrospective study.","authors":"Wenze Qiu, Wenjing Chen, Jiali Jiang, Ronghui Zheng, Yawei Yuan, Xing Lv, Jiangyu Zhang","doi":"10.1186/s13014-025-02627-6","DOIUrl":"10.1186/s13014-025-02627-6","url":null,"abstract":"<p><strong>Background: </strong>Tumour-stroma ratio (TSR) is the proportion of tumour cells relative to surrounding stroma. This study aimed to investigate the prognostic impact of TSR, and to construct a prognostic nomogram in patients with nasopharyngeal carcinoma (NPC).</p><p><strong>Methods: </strong>Clinico-pathological data of 206 patients treated at Guangzhou Institute of Cancer Research, the Affiliated Cancer Hospital, Guangzhou Medical University for NPC were used as the training cohort. Assessment of TSR was performed on haematoxylin and eosin-stained slides and the correlation of TSR with survival outcomes was examined. A nomogram model comprising TSR was established and the clinical performance was evaluated by concordance index (C-index), calibration curve, time-dependent area under the curve (tAUC), and decision curve analysis (DCA). External validation was performed using cohort from Sun Yat-sen University Cancer Center (n = 343).</p><p><strong>Results: </strong>High stroma ratio was proved to be an adverse prognostic factor for OS. A prognostic model integrating T stage, N stage and TSR for individual prediction of survival was constructed and graphically represented as a nomogram. Calibration curves indicated good agreement between the nomogram and actual observations. Moreover, the nomogram outperformed the commonly used staging systems. In addition, the nomogram could successfully classified patients into three different risk groups. The external validation cohort supported these findings.</p><p><strong>Conclusions: </strong>TSR is a strong and independent prognostic factor for NPC patients. A nomogram that integrated T stage, N stage and TSR could serve as a precise and convenient model of risk stratification in predicting the prognosis of patients with NPC.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"87"},"PeriodicalIF":3.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133193","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":"Carbon ion irradiation mobilizes antitumor immunity: from concept to the clinic.","authors":"Shanghai Liu, Xiangyang He, Siqi Liang, Anqing Wu, Lu Liu, Wentao Hu","doi":"10.1186/s13014-025-02647-2","DOIUrl":"10.1186/s13014-025-02647-2","url":null,"abstract":"<p><p>Carbon ion radiotherapy (CIRT), a type of particle therapy, is at the forefront of clinical oncology treatments due to its superior physical properties and biological performance. Although CIRT has demonstrated outstanding therapeutic outcomes in clinical settings, the biological mechanisms underpinning its effects, particularly its immunogenic potential and the superiority of its induced antitumor immune response compared to photon radiotherapy, remain areas of active investigation. This review summarizes the latest research progress on the mechanisms of antitumor immune responses triggered by CIRT and discusses preclinical and clinical studies related to combined CIRT and immunotherapy (CCIT). Against the backdrop of extensive research and significant clinical efficacy achieved by combining radiotherapy with immunotherapy, this review provides a theoretical foundation for a better understanding of the superior tumor cell-killing effects of CIRT and the underlying immunological mechanisms. Further insights into the factors affecting the efficacy, toxic effects, and developmental limitations of this combination therapy mode will be instrumental in guiding the conduction of CCIT studies.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"85"},"PeriodicalIF":3.3,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129430","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":"Defining occult disease in glioblastoma using spectroscopic MRI: implications for clinical target volume delineation.","authors":"Jonathan B Bell, Sulaiman Sheriff, Mohammed Z Goryawala, Kaylie Cullison, Gregory A Azzam, Jessica Meshman, Matthew C Abramowitz, Michael E Ivan, Macarena I de la Fuente, Eric A Mellon","doi":"10.1186/s13014-025-02666-z","DOIUrl":"10.1186/s13014-025-02666-z","url":null,"abstract":"<p><strong>Background: </strong>Outcomes in glioblastoma are improved by surgical resection and adjuvant radiation (RT). In primary GBM (pGBM), large clinical target volume (CTV) margins typically cover occult invasion. In recurrent GBM (rGBM), RT often uses tiny CTV margins that likely omit occult invasion due to re-RT radiation necrosis concerns. Whole-brain spectroscopic MRI (sMRI) is an emerging technique with similar resolution to PET that may help define the CTV for rGBM.</p><p><strong>Methods: </strong>Patients with pGBM (n = 18) and rGBM (n = 19) underwent sMRI with RT simulation. T1-post contrast (T1PC) and T2/FLAIR MRI volumes were contoured. sMRI generated choline/N-acetylaspartate > 2x (Cho/NAA > 2x) volumes are known to correlate with high-risk invasion. Hausdorff distances were calculated to define the margin necessary to cover Cho/NAA > 2x in pGBM and rGBM. In rGBM, mock CTV expansions from T1PC volumes were created to determine non-selective CTV expansion sizes needed to cover Cho/NAA > 2x volumes.</p><p><strong>Results: </strong>For pGBM, the median T1PC, Cho/NAA > 2x, and T2/FLAIR volumes were 32.3 cc, 45.0 cc, and 74.8 cc respectively. For rGBM, the median T1PC, Cho/NAA > 2x, and T2/FLAIR volumes were 21.7 cc, 58.9 cc, and 118.3 cc, respectively. T2/FLAIR volumes increased more relative to T1PC volumes in rGBM than pGBM (p ≤ 0.001). Meanwhile, the median Hausdorff distance between T1PC and Cho/NAA > 2x was 22.9 mm in pGBM and 25.7 mm in rGBM, suggesting that the high-risk volume does not significantly change. In rGBM, it is common to use no CTV expansion from the T1PC volume which only included 61% of high-risk Cho/NAA > 2x volume. Conversely, T1PC expansions of 10-, 15-, and 20-mm covered 87%, 94%, and 98% of Cho/NAA > 2x volume.</p><p><strong>Conclusions: </strong>sMRI Cho/NAA > 2x delineates high-risk occult disease in glioblastoma and extends beyond T1PC MRI borders. Typical large CTV expansions in pGBM mostly include Cho/NAA > 2x volumes. However, small CTV expansions commonly used in rGBM poorly cover Cho/NAA > 2x, suggesting that larger CTV expansions or Cho/NAA > 2x guidance may be of benefit.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"86"},"PeriodicalIF":3.3,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129432","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":"Improving total bone marrow and lymphoid irradiation: feasibility of intensity-modulated proton therapy (IMPT) and dosimetric comparison with helical tomotherapy (HT).","authors":"Dayananda Shamurailatpam Sharma, Arjunan Manikandan, Gaganpreet Singh, Sanjib Gayen, Sham Sundar, Aishwarya G, Rangasamy S, Mahammood Suhail, Rajesh S, Ganapathy Krishnan, Revathi Raj, Srinivas Chilukuri, Jose Easow, Rakesh Jalali","doi":"10.1186/s13014-024-02572-w","DOIUrl":"10.1186/s13014-024-02572-w","url":null,"abstract":"<p><strong>Background and purpose: </strong>This study aims to develop and validate a novel whole-body intensity-modulated proton therapy (IMPT) approach for total marrow/lymphatic irradiation (TMI/TMLI) and compare its efficacy to helical tomotherapy (HT).</p><p><strong>Materials and methods: </strong>Whole-body IMPT plans were designed using five isocenters and fifteen fields for adult and three isocenters and eight fields for pediatric. Overlapping sub-PTVs were optimized to ensure robust and homogeneous dose distribution across consecutive isocenters and across CT datasets. Dosimetric benefits were compared to HT, safety and accuracy were verified using an in-house algorithm and planar dosage measurement.</p><p><strong>Results: </strong>The average cranio-caudal and lateral whole-body PTV dimensions were 169.24 cm and 46.41 cm for five adults; 95.2 cm and 28.86 cm for one pediatric patient. IMPT plans provided adequate and homogeneous dose to all sub-PTVs, upper and lower body PTVs, with mean D95% ≥ 11.4 GyRBE. In comparison to HT, IMPT plans reduced mean integral dosage to normal tissue by 38%, OARs by a factor of 1.32 to 3.94, and V107% by 520.97 cc for sub-PTVs and 1166 cc for upper-body PTVs. For 38 pairs of planned and measured dosage planes at three depths, the average (± SD) gamma value was 96.77% (± 2.45%). Radiation ON time of 76 and 28 min for the tallest adult and pediatric patient plan was almost double HT plan of 39.9 and 14.1 min.</p><p><strong>Conclusion: </strong>The presented whole-body IMPT approach for TMI/TMLI patients of any physical build-up is dosimetrically superior, safe and feasible to implement. Nevertheless, detailed robustness evaluation and cost-benefit analyses should guide its clinical implementation.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"84"},"PeriodicalIF":3.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121172","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 in pituitary metastases: a systematic review and meta-analysis.","authors":"Bardia Hajikarimloo, Salem M Tos, Mohammadamin Sabbagh Alvani, Alireza Kooshki, Ibrahim Mohammadzadeh, Dorsa Najari, Mohammad Amin Habibi","doi":"10.1186/s13014-025-02640-9","DOIUrl":"10.1186/s13014-025-02640-9","url":null,"abstract":"<p><strong>Background: </strong>The pituitary gland is an infrequent site for metastasis, encompassing approximately 0.4% of all intracranial metastatic lesions. The prognosis of pituitary metastasis (PM) remains dismal despite considerable advances in therapeutic interventions. Stereotactic radiosurgery (SRS) has been increasingly utilized as a minimally invasive therapeutic option for PMs. This study evaluated the efficacy and safety of SRS in patients with PMs.</p><p><strong>Methods: </strong>On November 26, 2024, a systematic search was conducted through PubMed, Embase, Scopus, and Web of Science. Studies that have evaluated the role of SRS in PMs or PMs with cavernous sinus invasion were included. The meta-analysis, sensitivity analysis, publication bias evaluation, and meta-regression were conducted using the R program.</p><p><strong>Results: </strong>Seven studies with 79 individuals with PMs were included. The results showed a pooled local control (LC) rate of 92% (95%CI:83-98%) following intervention. The analysis resulted in a pooled diabetes insipidus (DI) improvement rate of 42% (95%CI:0-100%) and cranial nerve (CN) dysfunction improvement rate of 77% (95%CI:49-98%). In contrast, none of the patients with anterior pituitary dysfunction experienced improvement. The meta-analysis revealed a pooled ARE rate of 2% (95%CI:0-7%) with low heterogeneity (I² = 0%, P = 0.93). The subgroup analysis for single-session SRS revealed a pooled LC rate of 90% (95%CI:80-98%) and a pooled ARE rate of 2% (95%CI:0-8%).</p><p><strong>Conclusion: </strong>SRS is correlated with promising improvement in LC, OS, and CN dysfunction in patients with PM. On the other hand, SRS is accompanied by limited effectiveness in DI and improvement in anterior pituitary dysfunction due to irreversible damage to the pituitary cells by metastatic lesions.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"83"},"PeriodicalIF":3.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121176","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":"Risk factors for severity of breast cancer-related lymphedema.","authors":"Amirhossein Bahanesteh, Hossein Yarmohammadi, Sina Shahshenas, Davood Dalil, Masood Soltanipur, Hamidreza Taheri, Zahra Sheikhi","doi":"10.1186/s13014-025-02663-2","DOIUrl":"10.1186/s13014-025-02663-2","url":null,"abstract":"<p><strong>Introduction: </strong>Breast cancer-related lymphedema (BCRL) is a debilitating condition that affects a significant proportion of breast cancer survivors, profoundly impacting their quality of life. While many studies have investigated the risk factors for BCRL occurrence, the determinants of its severity remain underexplored.</p><p><strong>Methods: </strong>This retrospective observational study evaluated the risk factors associated with BCRL severity among patients treated at the Motamed Cancer Institute, Tehran, Iran. Female patients with unilateral BCRL aged 25-75 years were included. Data were collected over a 10-year period and analyzed for demographic, clinical, and pathological variables. Lymphedema severity was assessed using established clinical staging criteria and categorized into early-stage (stages 1 and 2a) and advanced-stage (stages 2b and 3) groups. Also, presence of fibrosis and non-pitting edema were other indicators of BCRL severity. Statistical analyses included univariate and multivariate logistic regression to identify predictors of advanced-stage BCRL.</p><p><strong>Results: </strong>A total of 500 participants were analyzed, with a mean age of 41.16 ± 10.20 years and BMI of 28.72 ± 4.78 kg/m². Advanced-stage BCRL was significantly associated with older age (p = 0.00), higher number of excised lymph nodes (p = 0.04), and radiotherapy (p = 0.00). Multivariate analysis identified radiotherapy as the strongest independent predictor of advanced-stage BCRL (OR: 2.12, 95% CI: 1.22-3.67, p = 0.007). Other variables, including tumor grade, molecular subtypes, and type of surgery, did not independently predict BCRL severity.</p><p><strong>Conclusion: </strong>Advanced-stage BCRL is influenced by multiple factors, particularly radiotherapy and the extent of lymph node dissection. These findings underscore the importance of strategies to mitigate risk among breast cancer survivors, especially those undergoing radiotherapy. Further research is warranted to explore targeted interventions for reducing BCRL severity.</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"81"},"PeriodicalIF":3.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112467","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}