Practical Radiation Oncology最新文献

{"title":"Effect of Treatment Delivery Schedule for Patients With Early-Stage Non-Small Cell Lung Cancer Treated With Stereotactic Ablative Radiation Therapy: A Population-Based Analysis","authors":"John Paul Abrina MD, MBA ,&nbsp;Sarah Baker MD, PhD, FRCPC ,&nbsp;Ella Mae Cruz-Lim MD ,&nbsp;Nick Chng PhD, FCCPM ,&nbsp;Allison Ye MD, FRCPC ,&nbsp;Shrinivas Rathod MD, FRCPC ,&nbsp;Julianna Caon MD, FRCPC ,&nbsp;Devin Schellenberg MD, FRCPC ,&nbsp;Mitchell Liu MD, FRCPC ,&nbsp;Benjamin Mou MD, FRCPC","doi":"10.1016/j.prro.2024.07.012","DOIUrl":"10.1016/j.prro.2024.07.012","url":null,"abstract":"<div><h3>Purpose</h3><div>The optimal SABR treatment delivery schedule in stage I non-small cell lung cancer (NSCLC) remains unclear. This population-based study investigated grade ≥2 toxicity rates, local failure (LF), and overall survival (OS) in patients treated with 48 Gy in 4 fractions scheduled every other day versus daily with weekends and consecutive daily without weekends.</div></div><div><h3>Methods and Materials</h3><div>Between January 2019 and June 2022, treatment records using 48 Gy in 4 fractions were extracted from a provincial cancer registry and grouped by delivery as every other day, daily with weekends, or consecutive daily without weekends. Toxicity events were recorded using National Cancer Institute Common Terminology Criteria for Adverse Events, version 5.0. The Kaplan-Meier method was used to compute OS and LF was calculated using cumulative incidence methods with death as a competing risk. Cox regression analyses and Fine-Gray modeling was used to assess for variables associated with OS and LF, respectively.</div></div><div><h3>Results</h3><div>Of 404 patients meeting study criteria, 190, 111, and 103 received SABR every other day, daily with weekends, and consecutive daily without weekends, respectively. More patients receiving SABR daily with weekends were medically inoperable and more patients receiving SABR consecutive daily without weekends had tumors abutting the chest wall. Median follow-up time was 29.5 months (IQR, 19.2-38.4 months). Overall toxicity was low, with crude rates of acute and late grade ≥2 toxicity not being statistically different among the groups. No grade 4 or 5 toxicities were recorded. LF rates at 24 months were not different at 7.5% (95% CI, 3.7-11.3), 9.5% (95% CI, 3.9-15.1), and 11.0% (95% CI, 4.9-17.2) for the every other day, daily with weekends, and consecutive daily without weekends groups, respectively (<em>P</em> = .60). Schedules of daily with weekends and consecutive daily without weekends were not associated with LF. Similarly, no significant differences in median OS were found among the every other day, daily with weekends, and consecutive daily without weekends groups at 47.5 months (95% CI, 39.26-55.74), 52.7 months (95% CI, 34.7-70.7), and 49.0 months (95% CI, 31.6-66.4), respectively. Schedules of daily with weekends and consecutive daily without weekends were not associated with OS.</div></div><div><h3>Conclusions</h3><div>This population-based study demonstrated no statistically significant differences in grade ≥2 toxicity rates, LF, and OS for patients with stage I NSCLC treated with lung SABR using 48 Gy in 4 fractions delivered every other day, daily with weekends, and consecutive daily without weekends. Patient convenience and optimization of resources may be considered when choosing a lung SABR treatment delivery schedule.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 2","pages":"Pages e143-e154"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300799","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":"Stereotactic Body Radiation therapy for Liver Metastases: Systematic Review and Meta-Analysis With International Stereotactic Radiosurgery Society (ISRS) Practice Guidelines","authors":"Ciro Franzese MD ,&nbsp;Alexander V. Louie MD, PhD ,&nbsp;Rupesh Kotecha MD ,&nbsp;Zhenwei Zhang PhD ,&nbsp;Matthias Guckenberger MD ,&nbsp;Mi-Sook Kim MD ,&nbsp;Alison C. Tree MD(Res) ,&nbsp;Ben J. Slotman MD, PhD ,&nbsp;Arjun Sahgal MD ,&nbsp;Marta Scorsetti MD","doi":"10.1016/j.prro.2024.09.011","DOIUrl":"10.1016/j.prro.2024.09.011","url":null,"abstract":"<div><h3>Purpose</h3><div>Liver metastases are a significant clinical challenge in cancer management, often representing a stage of disease in which curative treatment is still possible. Stereotactic body radiation therapy (SBRT) has emerged as a promising modality for treating these metastases, offering a noninvasive approach with potential for high efficacy. This systematic review and meta-analysis provides a comprehensive analysis of the efficacy and safety of SBRT in treating liver metastases, and practice recommendations are provided.</div></div><div><h3>Methods and Materials</h3><div>We performed a thorough literature review, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach, and included 33 studies with a total of 3101 patients and 4437 liver metastases.</div></div><div><h3>Results</h3><div>The review revealed pooled local control rates at 1, 2, and 3 years of 85%, 75%, and 68% respectively, while overall survival rates were 79%, 54%, and 37%. Grade 3 and 4 side effects occurred in only 3% of patients. The review of the studies highlighted the importance of factors such as primary tumor histology, lesion characteristics, and radiation dose in predicting treatment outcomes.</div></div><div><h3>Conclusions</h3><div>This review supports the growing body of evidence that SBRT is an efficacious and safe treatment option for liver metastases. It underscores the need for careful patient selection and personalized treatment planning to optimize outcomes.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 2","pages":"Pages e172-e188"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480647","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":"Financial Toxicity and Quality-of-Life Outcomes on a Phase 1 5-fraction Stereotactic Partial Breast Irradiation Protocol for Early-Stage Breast Cancer","authors":"Ambrosia Simmons MD, PhD ,&nbsp;David Sher MD ,&nbsp;Dr. Dong Wook Nathan Kim MD, PhD ,&nbsp;Marilyn Leitch MD ,&nbsp;Rachel Wooldridge MD ,&nbsp;Sally Goudreau MD ,&nbsp;Stephen Seiler MD ,&nbsp;Sarah Neufeld MS ,&nbsp;Maggie Stein BS ,&nbsp;Kevin Albuquerque MD ,&nbsp;Ann Spangler MD ,&nbsp;John Heinzerling MD ,&nbsp;Dan Garwood MD ,&nbsp;Stella Stevenson BSRT(T) ,&nbsp;Chul Ahn PhD ,&nbsp;Chuxiong Ding PhD ,&nbsp;Robert D. Timmerman MD ,&nbsp;Asal Rahimi MD, MS","doi":"10.1016/j.prro.2024.08.012","DOIUrl":"10.1016/j.prro.2024.08.012","url":null,"abstract":"<div><h3>Purpose</h3><div>We report the financial toxicity and quality-of-life outcomes of our prospective phase 1 dose-escalation study of 5-fraction stereotactic partial breast irradiation (S-PBI) for early-stage breast cancer.</div></div><div><h3>Materials and Methods</h3><div>Women with unifocal in situ or invasive epithelial histologies, clinical stages 0, I, or II with tumor size &lt; 3 cm treated with lumpectomy were enrolled in our phase 1 5-fraction S-PBI dose-escalation trial. Our institutionally generated questionnaire on the “Patient Perspective Cost and Convenience of Care” and the EuroQol 5-Dimension 5-level questionnaire were administered to patients treated at follow-up.</div></div><div><h3>Results</h3><div>Between 2010 and 2015, 68 of the 75 patients who enrolled and completed treatment on trial completed at least some component of either the EuroQol 5-Dimension 5-level questionnaire or the “Patient Perspective Cost and Convenience of Care” questionnaire. Nearly all patients reported very high satisfaction with their treatment overall, particularly the shortened length of treatment. Over half of the patients reported some level of financial toxicity (FT) despite a significantly shortened treatment time. Patients who reported any FT were significantly younger than patients with no financial burden of treatment (means 59.2 and 63.7, respectively, <em>P</em> = .03). There was no difference in those who reported any level of FT based on patient race, ethnicity, marital, or employment status. This S-PBI regimen did not significantly affect quality of life over a 4-year follow-up.</div></div><div><h3>Conclusions</h3><div>These patient-reported outcomes suggest that the use of accelerated partial breast irradiation may offer low FT rates in breast cancer care, particularly for disadvantaged patient groups.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 2","pages":"Pages e115-e123"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649685","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":"Impact of Manual Contour Editing on Plan Quality for Online Adaptive Radiation Therapy for Head and Neck Cancer","authors":"Siqiu Wang PhD,&nbsp;Chien-Yi Liao PhD,&nbsp;Byongsu Choi PhD,&nbsp;Sean All MD,&nbsp;Ti Bai PhD,&nbsp;Justin Visak PhD,&nbsp;Dominic Moon MD,&nbsp;Arnold Pompos PhD,&nbsp;Vladmir Avkshtol MD,&nbsp;David Parsons PhD,&nbsp;Andrew Godley PhD,&nbsp;David Sher MD,&nbsp;Mu-Han Lin PhD","doi":"10.1016/j.prro.2024.09.005","DOIUrl":"10.1016/j.prro.2024.09.005","url":null,"abstract":"<div><h3>Purpose</h3><div>Online adaptive radiation therapy (oART) has high resource costs especially for head and neck (H&amp;N) cancer, which requires recontouring complex targets and numerous organs-at-risk (OARs). Adaptive radiation therapy systems provide autocontours to help. We aimed to explore the optimal level of editing automatic contours to maintain plan quality in a cone beam computed tomography-based oART system for H&amp;N cancer. In this system, influencer OAR contours are generated and reviewed first, which then drives the autocontouring of the remaining OARs and targets.</div></div><div><h3>Methods and materials</h3><div>Three-hundred-forty-nine adapted fractions of 44 patients with H&amp;N cancer were retrospectively analyzed, with physician-edited OARs and targets. These contours and associated online-adapted plans served as the gold standard for comparison. We simulated 3 contour editing workflows: (1) no editing of contours; (2) only editing the influencers; and (3) editing the influencers and targets. The geometric difference was quantified using the Dice similarity coefficient (DSC) and Hausdorff distance (HD). The dosimetric differences in target coverage and OAR doses were calculated between the gold standard and these 3 simulated workflows.</div></div><div><h3>Results</h3><div>Workflow 1 resulted in significantly inferior contour quality for all OARs (mean DSC, 0.85 ± 0.17 and HD95, 3.10 ± 5.80mm); hence, dosimetric data was not calculated for workflow 1. In workflow 2, the frequency of physician editing targets and remaining OARs were 80.8% to 95.7% and 2.3% (brachial plexus) to 67.7% (oral cavity), respectively, where the OAR differences were geometrically minor (mean DSC &gt;0.95 with std ≤0.09). However, because of the unedited target contours of workflow 2 (mean DSC, 0.86-0.92 and mean HD95, 2.56-3.30 mm vs the ground-truth targets), plans were inadequate with insufficient coverage. In workflow 3, when both targets and influencers were edited (noninfluencer OARs were unedited), &gt;95.5% of the adapted plans achieved the patient-specific dosimetry goals.</div></div><div><h3>Conclusions</h3><div>The cone beam computed tomography-based H&amp;N oART workflow can be meaningfully accelerated by only editing the influencers and targets while omitting the remaining OARs without compromising the quality of the adaptive plans.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 2","pages":"Pages e211-e219"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395267","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":"Metastatic-Site Radiation Therapy for Ewing Sarcoma and Rhabdomyosarcoma: Consensus Guidelines From the National Pediatric Cancer Foundation","authors":"Dana L. Casey MD ,&nbsp;Erin S. Murphy MD ,&nbsp;Colette J. Shen MD, PhD ,&nbsp;Sarah A. Milgrom MD ,&nbsp;Nicole A. Larrier MD, MS ,&nbsp;Julie A. Bradley ,&nbsp;Matthew M. Ladra MD, MPH ,&nbsp;Daniel J. Indelicato MD ,&nbsp;Christine E. Hill-Kayser MD ,&nbsp;Scott C. Borinstein MD, PhD ,&nbsp;Leo Y. Luo MD","doi":"10.1016/j.prro.2024.10.004","DOIUrl":"10.1016/j.prro.2024.10.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Despite the urgent need for improved outcomes in patients with metastatic Ewing sarcoma (EWS) and rhabdomyosarcoma (RMS), it is unknown how to best approach metastatic-site radiation therapy for these patients and whether such treatment provides a significant oncologic benefit that outweighs the toxicities.</div></div><div><h3>Methods and Materials</h3><div>We gathered a panel of pediatric radiation oncologists from academic hospitals to identify and discuss current controversies regarding the role of radiation in the management of metastatic EWS and RMS. The panel reviewed existing clinical data and ongoing trials to address 5 key questions: (1) the role of whole lung irradiation (WLI) in treating lung metastases; (2) the number of metastatic sites warranting radiation therapy and the radicality of such an approach; (3) radiation techniques, including stereotactic body radiation therapy (SBRT); (4) the timing of metastatic-site radiation therapy; and (5) the utility of metastatic-site radiation therapy for relapsed metastatic disease.</div></div><div><h3>Results</h3><div>After a review of existing data, consensus recommendations were developed to support the decision-making process in metastatic-site irradiation, aiming to improve long-term disease control. Patients with pulmonary metastases should receive WLI. In patients with limited (&lt;8 sites) metastatic disease, a comprehensive approach should be taken to treat all sites of metastatic disease diagnosed at presentation. SBRT should be considered as a preferred treatment technique. The timing of metastatic-site treatment should coincide with the end of systemic therapy. However, if there is a dosimetric advantage or improved compliance, concurrent treatment with the primary site may be preferred.</div></div><div><h3>Conclusions</h3><div>A consensus guideline was established to address several critical questions regarding the role of radiation in the treatment of metastatic EWS and RMS. The study highlights the existing controversies, provides a structured approach, and underscores the need for future studies to further evaluate the therapeutic ratio of metastatic-site directed therapy.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 2","pages":"Pages 180-186"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512853","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":"F18-DCFPyL PSMA-PET/CT Versus MRI: Identifying the Prostate Cancer Region Most at Risk of Radiation Therapy Recurrence for Tumor Dose Escalation","authors":"Colin Belliveau MD ,&nbsp;Mustafa-Karim Benhacene-Boudam PhD ,&nbsp;Daniel Juneau MD ,&nbsp;Nicolas Plouznikoff MD ,&nbsp;Damien Olivié MD ,&nbsp;Stephanie Alley PhD ,&nbsp;Maroie Barkati MD ,&nbsp;Guila Delouya MD ,&nbsp;Daniel Taussky MD ,&nbsp;Carole Lambert MD ,&nbsp;Marie-Claude Beauchemin MD ,&nbsp;Cynthia Ménard MD","doi":"10.1016/j.prro.2024.09.017","DOIUrl":"10.1016/j.prro.2024.09.017","url":null,"abstract":"<div><h3>Purpose</h3><div>Local recurrence of prostate cancer (PCa) after radiation therapy (RT) typically occurs at the site of dominant tumor burden, and recent evidence confirms that magnetic resonance imaging (MRI) guided tumor dose escalation improves outcomes. With the emergence of prostate-specific membrane antigen (PSMA) positron emission tomography (PET), we hypothesize that PSMA-PET and MRI may not equally depict the region most at risk of recurrence after RT.</div></div><div><h3>Methods and Materials</h3><div>Patients with intermediate- to high-risk PCa and MRI plus PSMA-PET performed before RT were identified. The sextant most at risk of recurrence was defined as the pathologically dominant region with peak biopsy percentage core length involvement and any sextant with ≥ 40% percentage core length involvement (pathologic gross tumor volume [pGTV], per prior work). Imaging methods were reviewed independently to compare GTVs with pGTVs most at risk of recurrence. A paired chi-square test was employed for analysis.</div></div><div><h3>Results</h3><div>Eighty-eight patients (n = 88) were identified. Overall, there were no differences in the sensitivity of MRI and PSMA-PET for identifying the pGTV most at risk of recurrence. However, PSMA-PET demonstrated a trend of improved sensitivity for high-risk PCa compared with MRI (n = 46, 96% vs 87%, <em>P</em> = .06), while MRI outperformed PSMA-PET for the intermediate-risk group (n = 42, 93% vs 81%, <em>P</em> = .03). PSMA-PET showed lower specificity, misidentifying GTV in uninvolved pathologic sextants for 12% of intermediate-risk patients, whereas MRI was faultless (12% vs 0%, <em>P</em> = .03). MRI and PSMA-PET each misidentified uninvolved sextants for 9% of patients in the high-risk group.</div></div><div><h3>Conclusions</h3><div>MRI demonstrates superior sensitivity in identifying the region most at risk of RT recurrence for intermediate-risk PCa, whereas PSMA-PET may add value for some high-risk patients. Informed by sextant biopsy information and MRI, clinicians should consider integrating PSMA-PET for patients with high-risk diseases when delineating GTVs.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 2","pages":"Pages 160-168"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Reply to Gregoire et al.","authors":"Danielle N. Margalit MD, MPH ,&nbsp;David J. Sher MD, MPH","doi":"10.1016/j.prro.2024.11.001","DOIUrl":"10.1016/j.prro.2024.11.001","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 2","pages":"Pages 209-210"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705172","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 Dose for Limited-stage Extranodal Marginal Zone Lymphomas of the Mucosa-associated Lymphoid Tissues of the Stomach: A Meta-analysis","authors":"Song Heui Cho MD ,&nbsp;Kyung-Sook Yang PhD ,&nbsp;Ka-Won Kang MD, PhD ,&nbsp;Nam Kwon Lee MD, PhD","doi":"10.1016/j.prro.2024.09.008","DOIUrl":"10.1016/j.prro.2024.09.008","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the outcomes of 2 standard radiation therapy (RT) doses for limited-stage gastric extranodal marginal zone lymphoma (EMZL) of the mucosa-associated lymphoid tissues.</div></div><div><h3>Methods and Materials</h3><div>A database search was performed to identify articles published from database inception to August 31, 2023. Based on the current standard dose of 24.0 to 30.0 Gy, doses of approximately 30.0 Gy were classified as standard dose (SD), while those of approximately 24.0 Gy were classified as low dose (LD). Pooled estimates of the complete remission (CR) and local recurrence (LR) rates were calculated and compared.</div></div><div><h3>Results</h3><div>Data from 1072 patients across 30 included studies were analyzed. SD was used in 28 studies (n = 987), while LD was used in 6 studies (n = 85), and both regimens were used in 4 studies. In all included studies, the CR rate was 0.96 (95% CI, 0.94-0.97), and the LR rate was 0.05 (95% CI, 0.04-0.06), showing no significant between-study heterogeneity (τ² = 0 and <em>I</em>² = 0% for both; <em>P</em> = .8447 and .9998, respectively). SD and LD resulted in no significant differences in the CR rates (0.96 [95% CI, 0.94-0.97] vs 0.96 [95% CI, 0.89-0.99]; <em>P</em> = .9174) or LR rates (0.05 [95% CI, 0.04-0.06] vs 0.03 [95% CI, 0.01-0.10]; <em>P</em> = .5495).</div></div><div><h3>Conclusions</h3><div>Both the SD and LD groups achieved excellent CR and LR rates. These results indicate that the RT dose for limited-stage gastric EMZL may be safely de-escalated without compromising local tumor control.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 2","pages":"Pages e155-e165"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407141","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":"Lorlatinib-Induced Blindness: A Rare Entity","authors":"Neris Dincer MD ,&nbsp;Orcun Can MD ,&nbsp;Gokhan Demir MD ,&nbsp;Enis Ozyar MD","doi":"10.1016/j.prro.2025.01.004","DOIUrl":"10.1016/j.prro.2025.01.004","url":null,"abstract":"<div><div>Lorlatinib is a central nervous system-penetrant third-generation tyrosine kinase inhibitor approved for the first-line management of metastatic non-small cell lung cancer with anaplastic lymphoma kinase rearrangement,<span><span>¹</span></span> which accounts for 3% to 5% of non-small cell lung cancer cases.<span><span>²</span></span> The most commonly reported side effects include hyperlipidemia, edema, peripheral neuropathy, and central nervous system effects.<span><span>²</span></span> Whereas ocular side effects such as photopsia, blurred vision, vitreous floaters, and diplopia have been documented with another anaplastic lymphoma kinase-tyrosine kinase inhibitor, crizotinib, there are few reports of such effects with lorlatinib.<span><span>³</span></span> Herein, we present a case of bilateral optic neuropathy, initially misdiagnosed as optic nerve metastases and treated with palliative radiation therapy.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 2","pages":"Pages 120-123"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043336","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 Dimitroyannis","authors":"Loren Saulsberry PhD,&nbsp;Dezheng Huo MD, PhD","doi":"10.1016/j.prro.2025.01.005","DOIUrl":"10.1016/j.prro.2025.01.005","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 2","pages":"Pages 212-213"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705174","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}