Practical Radiation Oncology最新文献

{"title":"Radiation Therapy for WHO Grade 4 Adult-Type Diffuse Glioma: An ASTRO Clinical Practice Guideline.","authors":"Debra Nana Yeboa, Steve E Braunstein, Alvin Cabrera, Kevin Crago, Evanthia Galanis, Eyas M Hattab, Dwight E Heron, Jiayi Huang, Michelle M Kim, John P Kirkpatrick, Jonathan P S Knisely, Mary Frances McAleer, Shearwood McClelland, Michael T Milano, Jennifer Moliterno, Alyx Porter, Kristin J Redmond, Daniel M Trifiletti, Christina Tsien, Bhanu Prasad Venkatesulu, Yevgeniy Vinogradskiy, Lisa Bradfield, Amanda R Helms, Joseph A Bovi","doi":"10.1016/j.prro.2025.05.014","DOIUrl":"https://doi.org/10.1016/j.prro.2025.05.014","url":null,"abstract":"<p><strong>Purpose: </strong>The central nervous system World Health Organization (WHO) grade 4 adult-type diffuse glioma represents one of the most aggressive and challenging primary brain tumors. This guideline aims to provide evidence-based recommendations for the multidisciplinary management of these tumors, focusing on diagnosis, initial treatment, reirradiation, and health disparities, while acknowledging that present literature primarily represents historical histological grade 4 glioblastoma.</p><p><strong>Methods: </strong>The American Society for Radiation Oncology convened a task force to address 4 key questions focused on indications for radiation therapy (RT) and/or adjunctive therapies (eg, systemic therapy, alternating electric field therapy), appropriate regimens for external beam RT after initial biopsy/resection including variables such as pretreatment characteristics, target volumes, technique, dose, reirradiation indications and techniques, and health disparities. Recommendations are based on a systematic literature review and created using a predefined consensus-building methodology and system for grading evidence quality and recommendation strength.</p><p><strong>Results: </strong>Following maximum safe resection, molecular and pathologic diagnosis, and prognostic stratification of WHO grade 4 adult-type diffuse glioma, concurrent RT with temozolomide followed by adjuvant temozolomide is recommended for eligible patients and incorporation of alternating electric field therapy is conditionally recommended. In elderly patients, hypofractionated RT with concurrent and adjuvant temozolomide is conditionally recommended. In frail patients, supportive and palliative care is conditionally recommended following multidisciplinary, patient-centered discussion. Appropriate reirradiation techniques, with or without additional systemic therapies, can be considered and are conditionally recommended in patients following pathologic or advanced imaging confirmation of WHO grade 4 diffuse glioma recurrence. Health disparities exist in patients with WHO grade 4 adult-type diffuse glioma and attention is necessary to improve outcomes and increase clinical trial enrollment for underserved populations.</p><p><strong>Conclusions: </strong>These evidence-based recommendations and current practice adoption patterns inform best clinical practices on the management of WHO grade 4 adult-type diffuse glioma. Future advancements in personalized medicine, biomarker discovery, and novel therapies are essential to improving outcomes. The integration of multidisciplinary care and participation in future clinical trials, especially in underserved populations, is crucial in addressing the poor outcomes among WHO grade 4 adult-type diffuse glioma.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Masthead/Sub page","authors":"","doi":"10.1016/S1879-8500(25)00124-9","DOIUrl":"10.1016/S1879-8500(25)00124-9","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 4","pages":"Page A1"},"PeriodicalIF":3.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PROshot: Adjuvant Immunotherapy For Nasopharyngeal Carcinoma, Stereotactic Radiosurgery Margins, Surveillance in Esophageal Cancer Complete Responders, and Boswellia Serrata For Radionecrosis","authors":"Caleb Dulaney MD ,&nbsp;Laura Dover MD, MSPH","doi":"10.1016/j.prro.2025.04.002","DOIUrl":"10.1016/j.prro.2025.04.002","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 4","pages":"Pages 311-314"},"PeriodicalIF":3.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PRO's Top 20 Downloads of 2024","authors":"Robert J. Amdur MD ,&nbsp;James B. Yu MD, MHS","doi":"10.1016/j.prro.2025.02.004","DOIUrl":"10.1016/j.prro.2025.02.004","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 4","pages":"Pages 315-317"},"PeriodicalIF":3.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Reply to Hannoun-Levi et al","authors":"Maria Cristina Leonardi MD","doi":"10.1016/j.prro.2025.01.016","DOIUrl":"10.1016/j.prro.2025.01.016","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 4","pages":"Pages 410-411"},"PeriodicalIF":3.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uranium Glass Collection in a Patient With Multiple Cancers","authors":"Laura Freedman MD,&nbsp;Svetlana Denissova MSc","doi":"10.1016/j.prro.2024.09.004","DOIUrl":"10.1016/j.prro.2024.09.004","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 4","pages":"Pages 309-310"},"PeriodicalIF":3.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Regard to Leonardi et al, “Salvage breast conserving surgery and reirradiation with intraoperative electrons for recurrent breast cancer: A multicentric study on behalf of AIRO (Italian Association of Radiotherapy and clinical Oncology)”","authors":"Jean-Michel Hannoun-Levi MD, PhD,&nbsp;Csaba Polgar MD, PhD,&nbsp;Vratislav Strnad MD, PhD,&nbsp;Cristina Gutierrez MD, PhD,&nbsp;BCWG of the GEC-ESTRO","doi":"10.1016/j.prro.2024.08.015","DOIUrl":"10.1016/j.prro.2024.08.015","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 4","pages":"Pages 408-409"},"PeriodicalIF":3.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification and Management of Late toxicities after Radiotherapy for Vulvar Cancer.","authors":"Cristina DeCesaris, Sabrina Bedell, David Gaffney, Gita Suneja, Lindsay Burt, Jeffrey Brower","doi":"10.1016/j.prro.2025.05.010","DOIUrl":"https://doi.org/10.1016/j.prro.2025.05.010","url":null,"abstract":"<p><p>Vulvar cancer is a rare malignancy, with an estimated 6.900 cases diagnosed in 2024, though incidence has been rising in recent years¹. Radiation plays a critical role in definitive and adjuvant management, however late toxicities including pelvic insufficiency fractures (PIFs), anal/fecal incontinence, sexual dysfunction, cutaneous and sub-cutaneous fibrosis, and lymphedema may significantly impact quality of life in long-term survivors. This article will describe the most commonly encountered late radiation-induced toxicities seen in the management of vulvar cancers and provide practical guidance regarding work-up, and evidence-based management.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined Hypofractionated Radiation Therapy and Brachytherapy for Managing Prostate-Specific Membrane Antigen Positron Emission Tomography-Staged Organ-Confined Prostate Cancer: Primary Endpoint Analysis of a Prospective Study.","authors":"Iosif Strouthos, Efstratios Karagiannis, Georgios Antorkas, Yiannis Roussakis, Constantina Cloconi, Antria Savva, Andreas Christoforou, Alexis Vrachimis, Constantinos Zamboglou, Konstantinos Ferentinos","doi":"10.1016/j.prro.2025.03.013","DOIUrl":"10.1016/j.prro.2025.03.013","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;This study aims to evaluate the primary endpoint of a phase 2 prospective trial, which included a patient cohort staged with 18F-prostate-specific membrane antigen positron emission tomography/computed tomography (CT), treated with a combination of prostate high dose-rate brachytherapy and prostate/seminal vesicles external beam radiation therapy for intermediate and high-risk prostate cancer.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods and materials: &lt;/strong&gt;Forty-one patients with unfavorable intermediate, high risk (HR), and very HR prostate cancer were recruited to receive a combination of hypofractionated external beam radiation therapy to the prostate ± seminal vesicles of 36 Gy (12 fractions of 3 Gy each) delivered in consecutive days, followed by single-fraction real-time high-dose-rate brachytherapy of 14 Gy. Patients also received risk-adjusted androgen deprivation therapy (ADT). All patients were primarily conventionally staged with prostate multiparametric magnetic resonance imaging, abdomen/pelvis CT, and bone scintigraphy, receiving an additional prostate-specific membrane antigen positron emission tomography/CT before their study inclusion. Urinary, gastrointestinal symptomatology, sexual potency and acute, as well as early late toxicity, were assessed using various questionnaires (International Prostate Symptom Score, International Index for Erectile Function, Extended Prostate cancer Index Composite for Clinical Practice, Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Forty-one patients (based on National Comprehensive Cancer Network stratification system 48.8% unfavorable intermediate, 43.9% HR, and 7.3% very HR) completed treatment and reached at least 12 months of follow-up at the time of the current analysis. Median follow-up was 20 months (IQR, 13-28). Median age was 71.7 years, median prostate specific antigen before treatment was 8.4 ng/mL (5.0-28.3), and median volume of the prostate was 36.6 cc (14.9-68.2). Short-term ADT was administered to 43.9% of patients, whereas 48.8% received long-term ADT; the rest of the patients did not receive hormonal therapy. No severe (grade ≥3) acute events were recorded. An increase was observed in the prevalence of grade 2 genitourinary toxicity, owed mainly to nocturia (2.4% at 3 months, 4.9% at 6 months, and 26.8% at 12 months), with grade 1 remaining stable over this period. Regarding gastrointestinal toxicity, grade 1 and 2 incidences remained low and almost unchanged over this time interval. A significant decline from baseline compared to 3 months post treatment was observed both in hormonal and sexual domains, with high severity exhibited as a worsening from 12% to 38% and from 0% to 5%, respectively. No other domains exhibited any significant decline (urinary incontinence, irritation/bother, and bowel).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The evaluation of the primary results of the presented pr","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Venous Thrombosis and Pulmonary Embolism During Cervical Brachytherapy.","authors":"Jeffrey V Brower, Andrea L Russo, Kristin A Bradley, Christine M Fisher, Richard Carlson, Lindsay W Brubaker, Patrick A Hagen, Rebecca K Leaf, William Small, Ann H Klopp","doi":"10.1016/j.prro.2025.04.013","DOIUrl":"https://doi.org/10.1016/j.prro.2025.04.013","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}