Practical Radiation Oncology最新文献

{"title":"Stereotactic body radiotherapy for locally advanced pancreatic adenocarcinoma: a systematic review and meta-analysis of prospective trials.","authors":"K Liang Zeng, Alexander V Louie, Rupesh Kotecha, Arjun Sahgal, Zhenwei Zhang, Lili Zhou, Thierry Gevaert, Matthias Guckenberger, Mi-Sook Kim, Simon Lo, Marta Scorsetti, Ben Slotman, Alison Tree, Sylvia S W Ng","doi":"10.1016/j.prro.2026.04.015","DOIUrl":"https://doi.org/10.1016/j.prro.2026.04.015","url":null,"abstract":"<p><strong>Purpose: </strong>Modern technology has facilitated dose-escalated stereotactic body radiotherapy (SBRT) through real-time soft tissue delineation and adaptive radiotherapy for locally advanced/unresectable pancreatic cancer (LAPC). The current study examined published prospective trials in SBRT for LAPC to inform clinical decision making with support from the International Stereotactic Radiosurgery Society (ISRS).</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted of all prospective trials in definitive SBRT (up to 6 fractions) for LAPC. Random-effects meta-analysis was performed, and meta-regression was used to assess the effect of covariates on outcomes of interest, including local control (LC), progression-free survival (PFS), overall survival (OS), and toxicities.</p><p><strong>Results: </strong>A total of 23 prospective studies were identified, including 901 patients. Most studies (n=21, 91.3%) used systemic therapy prior to SBRT and delivered a median dose of 40 Gy in 5 fractions (range: 24-50 Gy in 3-6 fractions). The pooled 12- and 24-month LC estimate was 82% and 70%, respectively, 12-month PFS and OS rates were 35% and 63%, respectively, and 24-month PFS and OS rates were 15% and 28%, respectively. On univariable meta-regression, SBRT with ≥5 fractions was associated with improved 12-month LC and OS. Inclusion of an elective clinical target volume (CTV) was associated with improved 24-month PFS and OS. Higher biologically effective dose (BED₁₀) was associated with improved 24-month LC and OS. Surgery was associated with improved 12- and 24-month OS and 12-month PFS. The pooled estimate for risk of any grade 3-4 toxicities was 2%, and that of grade 5 toxicities was 0.2% (7 events), mostly gastrointestinal bleeding. There were no predictors of grade 3-4 or 5 toxicities.</p><p><strong>Conclusions: </strong>Modern radiotherapy techniques allow safe delivery of high radiation doses for LAPC. SBRT provides excellent and durable local control with low rates of treatment-related grades ≥3 toxicities.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857536","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":"Clinical Heterogeneity and Risk Stratification of Carotid Blowout Syndrome After Definitive Radiotherapy for Nasopharyngeal Carcinoma.","authors":"Qiaoyue Tan, Qiang Wang, Yingjie Zhang, Renming Zhong","doi":"10.1016/j.prro.2026.04.013","DOIUrl":"https://doi.org/10.1016/j.prro.2026.04.013","url":null,"abstract":"<p><strong>Purpose: </strong>Carotid blowout syndrome (CBS) is a rare but devastating complication following radiotherapy for nasopharyngeal carcinoma (NPC). This study aimed to identify clinically actionable risk factors for CBS and to explore heterogeneity among anatomically high-risk patients METHODS AND MATERIALS: Patients with NPC treated with a single course of definitive radiotherapy were retrospectively analyzed. Propensity score matching was applied to balance baseline characteristics between patients with and without CBS. Clinical, anatomical, and dosimetric variables were evaluated using logistic regression, with variable selection by least absolute shrinkage and selection operator (LASSO). Model discrimination was assessed using the area under the receiver operating characteristic curve (AUC). Heterogeneity analyses were performed among patients with macroscopic internal carotid artery (ICA) encasement.</p><p><strong>Results: </strong>After matching, 31 patients with CBS and 62 matched controls were analyzed. Macroscopic ICA encasement and hypertension were strongly associated with CBS occurrence. In multivariable analysis, ICA encasement, hypertension, and ICA D0.5cc remained independent predictors of CBS, yielding good discrimination (AUC = 0.83). Among patients with macroscopic ICA encasement, those who developed CBS more frequently had hypertension and tended to receive higher irradiation to the pericarotid soft tissues, although dose differences were not statistically significant. Notably, progression to nasopharyngeal soft tissue necrosis with ICA exposure was observed exclusively in patients who developed CBS, whereas no patient who remained CBS-free demonstrated overt soft tissue necrosis during follow-up.</p><p><strong>Conclusions: </strong>CBS risk after definitive radiotherapy for NPC is primarily driven by anatomical vulnerability and systemic vascular factors. Pericarotid soft tissue injury and impaired post-radiotherapy healing appear to modulate progression from anatomical risk to clinical events. These findings support a risk-adapted surveillance and management strategy for patients with ICA encasement.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857528","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":"Recommendations for radiation treatment in pediatric patients with metastatic rhabdomyosarcoma: Expert consensus from the International Soft Tissue SaRcoma ConsorTium (INSTRuCT).","authors":"Leslie Chang, Alison Cameron, Blair M Murphy, Marc W Muenter, Henriette Magelssen, Suzanne L Wolden, Julia Chisholm, Johannes H M Merks, Carol D Morris, Federica De Corti, Guido Seitz, Martin Ebinger, Monika Sparber-Sauer, Douglas S Hawkins, Stephanie Terezakis","doi":"10.1016/j.prro.2026.04.016","DOIUrl":"https://doi.org/10.1016/j.prro.2026.04.016","url":null,"abstract":"<p><strong>Purpose: </strong>The International Soft Tissue Sarcoma Database Consortium (INSTRuCT) is a collaboration the North American and European pediatric oncology cooperative groups which aims to provide treatment recommendations for pediatric patients' sarcoma diagnoses.</p><p><strong>Methods and materials: </strong>The INSTRuCT radiation oncology committee has developed international consensus guidelines for the use of radiation for local therapy in pediatric patients with metastatic rhabdomyosarcoma (RMS) based on grade and quality of evidence. Specifically, the guidelines address management based on disease burden, disease location, and local therapy options that focus on radiation techniques.</p><p><strong>Results: </strong>Patients who present with metastatic RMS at initial diagnosis should be strongly considered for definitive therapy to the primary site and radiation to involved regional lymph nodes following neoadjuvant chemotherapy. When feasible, local treatment of all sites of disease is recommended. Evaluation of the location, size, and extent of disease and patient prognosis should be used when deciding which radiation dose and modality therapy is most appropriate for metastatic disease.</p><p><strong>Conclusions: </strong>While the evidence is limited, these consensus guidelines highlight consensus positions regarding best practice treatment to give assistance to providers as they navigate treatment decisions for their pediatric patients with metastatic RMS.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857530","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":"Larry and the Contraband Lo Mein.","authors":"John T Butler","doi":"10.1016/j.prro.2026.03.006","DOIUrl":"https://doi.org/10.1016/j.prro.2026.03.006","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846181","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":"Radiation Therapy Documentation Deficiencies in Cancer Survivorship Documents.","authors":"Marielle Fis Loperena, Ramez Kouzy, Rehema Thomas, Elaine E Cha, Gohar Manzar, Arnold C Paulino, Alison K Yoder","doi":"10.1016/j.prro.2026.03.014","DOIUrl":"https://doi.org/10.1016/j.prro.2026.03.014","url":null,"abstract":"<p><strong>Purpose: </strong>Survivorship care plans (SCPs) and treatment summaries (TS) are intended to bridge oncology and primary care, yet it is unclear how well publicly available templates capture radiation therapy (RT) details necessary for safe, coordinated follow-up. We evaluated RT content in U.S. society-sponsored, non-paywalled SCP/TS templates against elements recommended by the American Society for Radiation Oncology (ASTRO).</p><p><strong>Methods and materials: </strong>We identified SCP/TS templates from national medical organizations via targeted web searches. Guided by the ASTRO survivorship template, we abstracted the presence of RT variables including site, technique/modality, total dose, dose per fraction, fractionation, special procedures (e.g., brachytherapy), treatment dates, toxicity, sequencing within multimodality care, concurrent chemotherapy, and radiation oncology contact information. Variables were recorded as present/absent and summarized descriptively.</p><p><strong>Results: </strong>Eighteen templates met inclusion; 11/18 (61.1%) were by the American Society of Clinical Oncology (ASCO) and 14/18 (77.8%) targeted adult populations. RT was mentioned in 17/18 (94.4%), and a radiation oncology contact was listed in 15/18 (83.3%). Key technical details were uncommon: total dose and/or modality 6/18 (33.3%); dose per fraction 4/18 (22.2%); fractionation 5/18 (27.8%); special procedures 3/18 (16.7%); toxicity 2/18 (11.1%). No template captured RT sequencing within multimodality therapy or concurrent chemotherapy. Treatment end dates were more commonly captured than start dates. The Children's Oncology Group (COG) template was the most comprehensive across RT variables.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846217","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":"Hope and Illusion in Medicine: A Clinical and Philosophical Reflection.","authors":"Cellini Francesco","doi":"10.1016/j.prro.2026.04.014","DOIUrl":"https://doi.org/10.1016/j.prro.2026.04.014","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846239","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(26)00078-0","DOIUrl":"10.1016/S1879-8500(26)00078-0","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"16 3","pages":"Page A1"},"PeriodicalIF":3.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826719","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":"Trends in Prostate Brachytherapy Utilization in the United States and Implications for Resident Training","authors":"Evrosina I. Isaac MD ,&nbsp;Mustafa Basree DO, MS ,&nbsp;Peter F. Orio III DO, MS ,&nbsp;Catheryn M. Yashar MD ,&nbsp;Mitchell Kamrava MD","doi":"10.1016/j.prro.2025.10.004","DOIUrl":"10.1016/j.prro.2025.10.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Although there is substantial evidence for prostate brachytherapy as an effective and efficient treatment option as monotherapy or part of multimodality regimens, brachytherapy numbers have decreased over the last decade. The purpose of this analysis is to describe prostate brachytherapy trends from 2013 to 2022 and its relationship with resident brachytherapy training.</div></div><div><h3>Methods and Materials</h3><div>The Medicare Provider and Other Supplier Public Use File database was searched by provider and state for code 55875 (transperineal placement of needles or catheters into prostate for interstitial radio element application, with or without cystoscopy) for years 2013 to 2022. The top 10 states (and providers/organizations) for total contributions to nationwide total of providers and services were determined. Resident brachytherapy case log information was accessed from the Accreditation Council for Graduate Medical Education and included data until 2023/2024.</div></div><div><h3>Results</h3><div>Between 2013 and 2022, there was a 50% decrease in total providers, 30% decrease in patients, and 32% decrease in services. Thirty-eight states had decreases in providers and 32 had decreases in services. There were 15 states in the top 10 for providers and 14 states in the top 10 for services for at least 1 year during this period and had a significant contribution to both providers (62%) and services (66%). Highest volume providers were likely to be in private versus academic practices. Meanwhile, residents had a decrease in median low-dose-rate cases between 2017/2018 and 2023/2024 of 4 to 1 and in high dose rate, an increase from 0 to 1.</div></div><div><h3>Conclusions</h3><div>While there is significant evidence for the use of prostate brachytherapy in many treatment settings, there has been a decrease in the number of practicing providers and the number of patients treated over the last decade. With private practices contributing significantly to services provided, this may be partially responsible to low resident cases being logged. This highlights the need to improve resident training opportunities in academic centers.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"16 3","pages":"Pages e219-e227"},"PeriodicalIF":3.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459965","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":"Immunotherapy in the Upfront Definitive Management of Locally Advanced Cervical Cancer: An Evolving Treatment Paradigm","authors":"Christopher R. Weil MD ,&nbsp;Jeffrey Brower MD, PhD ,&nbsp;William Small Jr. MD ,&nbsp;David K. Gaffney MD, PhD ,&nbsp;Ann H. Klopp MD, PhD","doi":"10.1016/j.prro.2025.09.010","DOIUrl":"10.1016/j.prro.2025.09.010","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"16 3","pages":"Pages 289-293"},"PeriodicalIF":3.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710295","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":"Real-Time Magnetic Resonance Imaging Guidance to Enable Brachytherapy: A Case Series","authors":"John Mohan Mathew MD ,&nbsp;Robert Weersink PhD ,&nbsp;Alejandro Berlin MD ,&nbsp;Enrique Gutierrez Valencia MD ,&nbsp;Alexandra Rink PhD ,&nbsp;Monica Serban PhD ,&nbsp;Carlton Johny MD ,&nbsp;Nauman Malik MD ,&nbsp;Anisha Patel MRT ,&nbsp;Kitty Chan MRT ,&nbsp;Peter W. Chung MB BCh ,&nbsp;Rachel M. Glicksman MD","doi":"10.1016/j.prro.2025.12.009","DOIUrl":"10.1016/j.prro.2025.12.009","url":null,"abstract":"<div><div>Real-time magnetic resonance (MR) guidance during brachytherapy (MRgBT) offers superior soft tissue definition and precise target identification during catheter implantation while minimizing treatment-related complications. This report reviewed the use of MRgBT in a series of complex clinical situations where brachytherapy would have been impossible without MR guidance, and alternate treatment modalities would have involved potentially significant morbidity to the patients. We highlighted the safety and efficacy of MRgBT in controlling targetable disease in a specific group of patients without precluding the ability to go for subsequent treatment options when indicated.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"16 3","pages":"Pages e228-e233"},"PeriodicalIF":3.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901733","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}