Practical Radiation Oncology最新文献

{"title":"Three-Dimensional Radiation Therapy for Early Stage Glottic Cancer Using a 4-Field Technique.","authors":"Jeffrey V Brower, Colin M Harari, John R Matte, Michael J Lawless, Adam R Burr, Tera Kruser, Paul M Harari","doi":"10.1016/j.prro.2025.06.008","DOIUrl":"10.1016/j.prro.2025.06.008","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610327","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":"Modified Recommendations for the Radiation Dose in Patients with Mycosis Fungoides and Localized Lesional Disease Based on a Retrospective Analysis of Treatment Outcomes.","authors":"Juliette M Kersten, Rosanne Ottevanger, Saskia E Rademakers, Maarten H Vermeer, Koen D Quint, Karen J Neelis","doi":"10.1016/j.prro.2025.06.006","DOIUrl":"10.1016/j.prro.2025.06.006","url":null,"abstract":"<p><strong>Purpose: </strong>Primary cutaneous T-cell lymphomas are a rare and heterogeneous group of non-Hodgkin lymphomas predominantly affecting the skin. Treatment strategies are guided by diagnosis and disease stages. In patients with classical mycosis fungoides (MF) or folliculotropic mycosis fungoides, low-dose multiple fraction radiation therapy (RT) is a common approach for localized lesions, but optimal dose regimens are still to be defined. This study aimed to compare the efficacy of single-fraction low-dose RT (1 × 6 Gy) vs the well-accepted 2-fraction regimen (2 × 4 Gy) in patients with localized MF.</p><p><strong>Methods and materials: </strong>A cohort of 54 patients with confirmed diagnoses of classical MF or folliculotropic MF received low-dose RT with either 1 × 6 Gy or 2 × 4 Gy between January 2017 and December 2022. Outcomes assessed included complete response (CR) rates, freedom from treatment failure, and toxicity.</p><p><strong>Results: </strong>The CR rate for 311 treated fields was 86%. There was no significant difference observed in complete response rate between the 88 fields treated with 1 × 6 Gy (88% CR) and the 223 fields treated with 2 × 4 Gy (86% CR) (P = .87). The freedom from treatment failure at 3 years furthermore showed similar outcomes for both regimens (71% for 2 × 4 Gy and 79% for 1 × 6 Gy; P = .18). There were no significant treatment-related toxicities reported.</p><p><strong>Conclusions: </strong>In this study, a single-fraction low-dose RT regimen (1 × 6 Gy) was shown to be comparable to the two-fraction regimen (2 × 4 Gy) in achieving CR for localized disease in patients with MF, offering a more convenient and patient-friendly option without compromising efficacy or safety. These findings support the incorporation of 1 × 6 Gy into clinical guidelines for the palliative management of MF.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568134","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":"Left Ventricular Assist Device, Implantable Cardioverter Defibrillator, and Radiation Therapy: A Technical Report, Review of Literature, and Recommendations.","authors":"Alexander Bennassi, Tony Truong, Nhu Hanh To, Chahrazed Boukhobza, Wassim Ksouri, Lahcène Belaïdi, Fatimah-Zara Bellefkih, Hanan Rida, Kamel Debbi, Yazid Belkacémi","doi":"10.1016/j.prro.2025.05.013","DOIUrl":"https://doi.org/10.1016/j.prro.2025.05.013","url":null,"abstract":"<p><p>Recent advancements in cardiology have significantly improved survival and quality of life for patients with severe heart conditions, including those requiring implantable cardioverter defibrillators (ICDs) and left ventricular assist devices (LVADs). Radiation therapy (RT) using either conventional or advanced techniques, such as stereotactic body RT, remains a cornerstone treatment for cancer. However, managing patients with both ICDs and LVADs during RT presents unique challenges caused by potential device malfunctions and interactions with radiation. In this report, we present a case of a patient with both a triple-chamber ICD and an electronically equipped LVAD undergoing RT. The study explores the dosimetric considerations, device interactions, and adapted simulations required to minimize risks. This work aimed to bridge the knowledge gap and provide recommendations for the safe and effective integration of RT delivery in patients with advanced cardiac devices.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568133","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 of Key Anatomic Structures on Magnetic Resonance Imaging During Prostate Stereotactic Body Radiation Therapy for Dose Avoidance to Reduce Erectile Dysfunction Risk.","authors":"Sungmin Woo, Anton S Becker, Angela Tong, Hebert Alberto Vargas, Peter B Schiff, David J Byun, Michael J Zelefsky","doi":"10.1016/j.prro.2025.06.005","DOIUrl":"10.1016/j.prro.2025.06.005","url":null,"abstract":"<p><p>Postradiation therapy erectile dysfunction can significantly impact the quality of life of patients with prostate cancer (PCa). Critical anatomic structures, such as the neurovascular bundles (NVBs), internal pudendal arteries (IPAs), penile bulb, and corporal tissues track near the prostate, making them susceptible to radiation-related damage. This study aimed to evaluate the anatomic patterns of these structures and their relationship with the prostate and to provide comprehensive illustrative examples on magnetic resonance imaging (MRI) scans. Consecutive patients with PCa who underwent MRI-linear accelerator-based stereotactic body radiation therapy from January 2024 until December 2024 were included. NVB patterns were classified into 3 categories: (1) \"classical\" with discrete NVB elements, (2) \"adherent,\" dispersed and adherent to prostatic capsule, and (3) \"absent.\" The smallest distance between the IPA and the prostate capsule and the membranous urethral length, serving as a surrogate for the distance between corporal tissue and prostatic apex, were also measured. These MRI scan findings were compared between prostate volumes >40 and <40 mL and between MRI scan findings and pathologic features of the dominant intraprostatic lesion. A total of 160 men (median age 70 years, interquartile range [IQR], 64-76) were included. The most common NVB pattern was \"classic\" (80.0%-85.0%), followed by the \"adherent\" NVB pattern (13.8%-18.1%). The median smallest distance between the IPA and prostate was 2.3 cm (IQR, 1.8-2.8 cm), with 3.1% to 3.8% <1.0 cm. The median membranous urethral length was 1.5 cm (IQR, 1.2-1.8 cm), with 2.5% of patients <1.0 cm. No significant association was found between these MRI scan features and prostate volume or other variables (P = .09-.99). In conclusion, most patients with PCa demonstrated favorable anatomy for potential dose sparing of critical structures. Comprehensive MRI scan illustrations are provided to help radiation oncologists recognize the location, trajectory, and relationship of these structures, facilitating their contouring and ultimately aiding in achieving meaningful dose reductions to these erectile function structures.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555735","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":"Computed Tomography Guided Brachytherapy With Hybrid Applicators: An Effective Curative Treatment for Vaginal Cuff Recurrences.","authors":"Evrim Duman, Sinem Karahan, Busra Tavli, Huseyin Sertel, Merdan Fayda","doi":"10.1016/j.prro.2025.06.004","DOIUrl":"10.1016/j.prro.2025.06.004","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated the clinical feasibility of hybrid brachytherapy and the benefits of computed tomography (CT) guidance for optimizing applicator position and needle placement via Utrecht or Venezia applicators in the curative treatment of vaginal cuff recurrence.</p><p><strong>Methods and materials: </strong>Sixteen previously operated patients with gynecological cancer treated with hybrid brachytherapy for vaginal cuff recurrence from 2018 to 2022 were included. The applicators were selected according to vaginal diameter and tumor location. CT scans were conducted before and after needle insertion. The high-risk clinical target volume (CTV-HR), including residual disease and suspicious regions, as well as normal tissues, was contoured. The dosimetry goal was to ensure that the reference isodose (100%) adequately covered the CTV-HR while minimizing overlap with organs at risk. The needle shifts were assessed according to their locations. Outcome measures, including disease-free survival and overall survival, were analyzed.</p><p><strong>Results: </strong>A total of 64 fractions were administered, with Utrecht applicators used for 62.5% (n = 40). The median equivalent doses in 2 Gy fractions (EQD2 D90) for 90% of the CTV-HR and intermediate-risk CTV were 87.64 Gy (57.45-97.78 Gy) and 69 Gy (31.33-76.73 Gy), respectively. Among the 696 possible needle positions, 419 interstitial needles (60%) were successfully inserted. The median number of needles per fraction was 6 (range, 1-12). Needle shifts occurred in 93% of the patients, predominantly in the anteromedial direction, with a mean magnitude of 0.21 ± 0.14 cm. The median follow-up was 14 months, with a 90% local tumor control rate and an 85% overall survival rate over 2 years, without severe side effects.</p><p><strong>Conclusions: </strong>Despite challenges in treating vaginal cuff recurrence in patients with gynecological cancers, hybrid brachytherapy provides an effective and personalized approach. Although needle shifts are common, they do not significantly impact dosimetric outcomes, highlighting the method's adaptability and reliability.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531104","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":"Staged I-125 Eye Plaque Brachytherapy for the Treatment of Large Uveal Melanoma: A Single Institution Experience.","authors":"Kevin Tran, Amy C Schefler, Lindsey N Nguyen, Devin Olek, Hui-Chuan Wang, Ramiro Pino, Edward Brian Butler, Bin S Teh","doi":"10.1016/j.prro.2025.06.003","DOIUrl":"10.1016/j.prro.2025.06.003","url":null,"abstract":"<p><strong>Purpose: </strong>Eye plaque brachytherapy (EPBT) is not routinely performed on large uveal melanomas (UM) as commercially available plaques often cannot ensure adequate coverage of the tumor with high doses of 85 Gy. The purpose of this study is to report our institution's experience with a clinically novel approach of staged EPBT in treating large UM in 2 treatments, 45 Gy in each treatment.</p><p><strong>Methods and materials: </strong>Patients were included if they underwent staged EPBT at our institution between 2020 and 2023.</p><p><strong>Results: </strong>A total of 13 patients with a median age of 65 were included in this study. All patients were treated with Iodine-125 with a first-stage prescription dose of 45 Gy and with a second-stage treatment occurring at median 13 weeks after with prescription dose of 45 Gy. Median follow-up was 42 months, and local control was 100% with no patients requiring an enucleation for a local recurrence or other radiation-related toxicities. At last follow-up, all tumors were decreased in size. Visual acuity worsened in 11 patients, and other radiation-related toxicities included cataract, cystoid macular edema, radiation retinopathy, and neovascular glaucoma. Three patients developed metastases, one of whom died shortly after, while all other patients were alive at last follow-up.</p><p><strong>Conclusions: </strong>Staged EPBT for large UM is a novel and feasible globe-preserving treatment with a high rate of local control. Ocular toxicities are expected but do not require enucleation. Further prospective randomized trials should be performed to validate this treatment approach.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531105","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 for WHO Grade 4 Adult-Type Diffuse Glioma: An ASTRO Clinical Practice Guideline","authors":"Debra Nana Yeboa MD ,&nbsp;Steve E. Braunstein MD, PhD ,&nbsp;Alvin Cabrera MD ,&nbsp;Kevin Crago ,&nbsp;Evanthia Galanis MD ,&nbsp;Eyas M. Hattab MD, MBA ,&nbsp;Dwight E. Heron MD, MBA ,&nbsp;Jiayi Huang MD, MSCI ,&nbsp;Michelle M. Kim MD ,&nbsp;John P. Kirkpatrick MD, PhD ,&nbsp;Jonathan P.S. Knisely MD ,&nbsp;Mary Frances McAleer MD, PhD ,&nbsp;Shearwood McClelland III MD ,&nbsp;Michael T. Milano MD, PhD ,&nbsp;Jennifer Moliterno MD ,&nbsp;Alyx Porter MD ,&nbsp;Kristin J. Redmond MD, MPH ,&nbsp;Daniel M. Trifiletti MD ,&nbsp;Christina Tsien MD ,&nbsp;Bhanu Prasad Venkatesulu MD ,&nbsp;Joseph A. Bovi MD","doi":"10.1016/j.prro.2025.05.014","DOIUrl":"10.1016/j.prro.2025.05.014","url":null,"abstract":"<div><h3>Purpose</h3><div>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 histologic grade 4 glioblastoma.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 5","pages":"Pages 451-471"},"PeriodicalIF":3.5,"publicationDate":"2025-06-25","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}