Practical Radiation Oncology最新文献

{"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, 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":"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":"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":"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":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods and materials: </strong>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).</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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":"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}

{"title":"Near-miss Event in Lung Cancer Radiation Therapy Because of a Random Outlier of Target Volume.","authors":"Savino Cilla, Carmela Romano, Gabriella Macchia, Donato Pezzulla, Marica Ferro, Pietro Viola, Erika Galietta, Costanza M Donati, Alessio G Morganti, Francesco Deodato","doi":"10.1016/j.prro.2025.05.012","DOIUrl":"10.1016/j.prro.2025.05.012","url":null,"abstract":"<p><p>Accurate tumor and organ-at-risk contouring is a critical step in radiation therapy. Contouring procedures, both manual and automated, are prone to errors and to a large degree of interobserver and intraobserver variability. Radiation oncologists and/or medical physicists have to perform independent reviews of all contours for each patient before using them for treatment planning, which is a time-consuming, labor-intensive, and still not error-free process. We presented the tracing of a subtle near-miss event because of the presence of a random outlier in the contours of a lung tumor, very far from the actual gross tumor volume. The treatment plan was performed with an automated treatment engine using the volumetric-modulated arc therapy technique. Despite the implementation and adoption of systematic procedures of quality assurance in our clinical routine, the error crossed the barriers of peer review and was identified subsequently only in the step of pretreatment dosimetric verification. The error was corrected, and the patient was replanned before treatment initiation. In this case study, we showed that the random creation of false-positive target outliers may have a detrimental impact on patient dose when automated planning is performed. This risk is not negligible, and all strategies for improving the robustness of target segmentation should be pursued.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295290","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":"Rosai-Dorfman Disease: The Role of Radiation Therapy","authors":"Elizabeth Thompson MD ,&nbsp;Daniel J. Indelicato MD ,&nbsp;Mark T. Scarborough MD ,&nbsp;Elham Nasri MD ,&nbsp;Joanne Lagmay MD ,&nbsp;David P. Horowitz MD ,&nbsp;Robert J. Amdur MD","doi":"10.1016/j.prro.2025.06.001","DOIUrl":"10.1016/j.prro.2025.06.001","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 5","pages":"Pages 481-484"},"PeriodicalIF":3.5,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287128","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":"Can Online Adaptive Radiation Therapy Eliminate Intrafractional Deformation in Gastric Mucosa-Associated Lymphoid Tissue Lymphoma?","authors":"Yusuke Shibayama, Hidetaka Arimura, Taka-Aki Hirose, Masanori Takaki, Jun-Ichi Fukunaga, Tadamasa Yoshitake, Toyoyuki Kato, Kousei Ishigami","doi":"10.1016/j.prro.2025.05.008","DOIUrl":"10.1016/j.prro.2025.05.008","url":null,"abstract":"<p><strong>Purpose: </strong>We hypothesized that online adaptive radiation therapy (oART) could eliminate errors associated with interfractional deformation in gastric mucosa-associated lymphoid tissue (MALT) lymphoma, but errors in intrafractional deformation remained in 6 directions (anterior, posterior, superior, inferior, left, and right). This study aimed to quantify the anisotropic deformation errors of the clinical target volume (CTV) for MALT lymphoma using oART to determine deformations in the planning target volume (PTV) margins.</p><p><strong>Methods and materials: </strong>Thirty fractional scans from 4 consecutive patients (a total of 120 cone beam computed tomography scans) with gastric MALT lymphoma treated with oART were chosen for this retrospective study. The CTV contours were manually delineated on the pretreatment and posttreatment cone beam computed tomography images. The center-of-mass matching of the CTVs was performed following the bone anatomy matching. Systematic and random errors of intrafractional deformations of the CTV were quantified using displacement vectors between the pretreatment and posttreatment CTV surfaces for each fraction. The PTV margins for oART were anisotropically calculated using the van Herk formula: 2.5Σ + 0.7σ, accounting for intrafractional errors.</p><p><strong>Results: </strong>For intrafractional deformation, the means of standard deviations of systematic errors ranged from 1.2 mm to 2.2 mm, whereas those of random errors ranged from 2.9 mm to 3.6 mm. The PTV margins were up to 13.1 mm in the inferior direction, whereas in other directions, they ranged from 9.7 mm to 12.8 mm. The PTV margin in integer achieved posttreatment CTV coverage for 90% of the fractions, with undercoverage volumes remaining below 0.6 cm³ in all fractions.</p><p><strong>Conclusions: </strong>This study suggests that the impact of intrafractional CTV deformation can not be eliminated even with oART. This highlights the need to set the appropriate anisotropic PTV margins.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276660","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":"Clinician- and Patient-Reported Outcomes of Stereotactic Ablative Radiation Therapy for High-Risk Prostate Cancer.","authors":"Helena B Z Logar, Angel Montero, Ovidio Hernando, Mercedes Lopez, Jeannette Valero, Raquel Ciervide, Beatriz Alvarez, Xin Chen-Zhao, Emilio Sanchez, Mariola Garcia-Aranda, Carmen Saiz, Daniel Zucca, Leyre Alonso, Miguel Sanchez, Rosa Alonso, Pedro Fernandez-Leton, Carmen Rubio","doi":"10.1016/j.prro.2025.05.007","DOIUrl":"10.1016/j.prro.2025.05.007","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated the feasibility and tolerability of SABR in patients with high- and very-high-risk prostate cancer.</p><p><strong>Methods and materials: </strong>A prospective study included patients with high-risk and N1 prostate cancer. SABR was delivered as 40 Gy in 8 Gy fractions, with optional elective nodal irradiation (26 Gy in 5.2 Gy fractions) and a 40 Gy nodal boost for N1 disease. The treatment protocol involved 24 to 36 months of androgen deprivation therapy, premedication with alpha-1 receptor antagonists, and dexamethasone (4 mg on treatment days). Adverse events were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events v5.0, while quality of life was assessed using the EORTC QLQ-C30 and QLQ-PR25 questionnaires at the final check-up.</p><p><strong>Results: </strong>The study included 96 patients (median age 77.2 years) with a median follow-up of 29.8 months. Elective nodal radiation therapy was delivered to 66.7% of patients, and 16.8% received a nodal boost. Acute grade 2 (G2) genitourinary and gastrointestinal (GI) events occurred in 5.2% and 7.3% of patients, respectively, with no grade ≥3 acute events. Late grade ≥2 genitourinary and GI events were observed in 7.8% and 15.7% of patients, respectively, including 1 grade 4 GI event. Common late symptoms included nocturia and rectal bleeding. Most patients (86.5%) reported no or minor difficulties posttreatment, though challenges with sexual activity, nocturia, and incontinence were noted. Physicians underestimated urgency and nocturia and overestimated rectal bleeding.</p><p><strong>Conclusions: </strong>SABR delivering 40 Gy in 5 fractions is feasible and well-tolerated for high-risk prostate cancer, with minimal additional toxicity from elective nodal irradiation and a boost to N1 disease. These findings support SABR as an effective treatment, warranting further long-term studies.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276661","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}