Practical Radiation Oncology最新文献

{"title":"Radiation Therapy for Heterotopic Ossification: A Systematic Review.","authors":"Christine Bang, Eric Jutkowitz, Eduardo Caputo, Sherry X Yan, Htun Ja Mai, Ghid Kanaan, Tayler Leonard, Taylor Rickard, Thomas Trikalinos, James L Rudolph, Katherine Rieke","doi":"10.1016/j.prro.2024.10.013","DOIUrl":"10.1016/j.prro.2024.10.013","url":null,"abstract":"<p><strong>Purpose: </strong>Heterotopic ossification (HO) is a benign disorder characterized by ectopic bone formation in soft tissues that can lead to functional loss in patients. We conducted a systematic review of the evidence on the use of radiation therapy (RT) for the prevention or treatment of HO.</p><p><strong>Methods and materials: </strong>Literature searches were conducted using Medline (via PubMed), Embase, and ClinicalTrials.gov until April 1_, 2023. Medical subject headings and free text terms relevant to HO and RT were used. In brief, eligible study participants were ≥18 years of age with HO and were treated with low-dose external RT. Two reviewers screened relevant abstracts and extracted full-text data for analysis. The review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines.</p><p><strong>Results: </strong>Ten studies evaluating the effect of RT for either the prevention or treatment of HO met the inclusion for evidence synthesis. Nine randomized controlled trials did not clearly report their methods and had a medium risk of bias. The studies were conducted between 1988 and 2008, with follow-up ranging on average from 3 to 59 months posttreatment. A total of 1530 participants were analyzed, and 566 were treated with RT following fracture fixation, total hip arthroplasty, or total hip replacement. In pooled data from 8 randomized controlled trials, there was a nonsignificant but clinically meaningful reduction in the presence of HO at follow-up for patients who received RT versus comparators (pooled odds ratio, 0.47; 95% CI, 0.19, 1.17). There was minimal evidence of adverse events.</p><p><strong>Conclusions: </strong>This systematic review found a clinically, but not statistically, significant benefit of prophylactic RT for HO at follow-up. These findings are tempered by a moderate risk of bias. While practice patterns vary, RT for HO prophylaxis in high-risk patients may have benefits that outweigh the risks.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632541","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 Graves' Ophthalmopathy: When Is the Optimal Timing of Treatment and Evaluation.","authors":"Ji Hyun Hong, Kyu Hye Choi, Ji Sang Kim, Suk Woo Yang, Yeon-Sil Kim","doi":"10.1016/j.prro.2024.10.012","DOIUrl":"10.1016/j.prro.2024.10.012","url":null,"abstract":"<p><strong>Purpose: </strong>Despite the decades of using radiation therapy (RT) for Graves' ophthalmopathy, the effects and optimal timing remain unclear. We retrospectively analyzed to evaluate the overall efficacy and response, predictive factors, and the effective timing of RT by assessing steroid requirement after RT in patients without prior surgery.</p><p><strong>Methods and materials: </strong>Between 2008 and 2022, we analyzed 74 patients with Graves' ophthalmopathy who received RT to both orbits. Concurrent steroid therapy was administered to 51 patients. Symptoms were evaluated using a modified clinical activity score (CAS), defining responders as those with a ≥2 score improvement in CAS, diplopia, or a significant reduction in exophthalmos asymmetry. Common symptoms included eye swelling (81.1%), and conjunctival edema (81.1%). Diplopia observed in 48 patients (64.9%).</p><p><strong>Results: </strong>Median follow-up was 44.5 months (range, 4.8-169.6). CAS significantly improved in the early-immediate phase, 1 month after RT (P < .001). However, diplopia showed significant improvement at a relatively late phase, 4 months after RT (P = .039). Patients treated with steroids concurrently showed a faster response compared to those without steroids. Initiating RT within 12 months of symptom onset resulted in a shorter duration of steroid use after RT compared with later initiation (65 vs 286 days, P = .011).</p><p><strong>Conclusions: </strong>Our study suggests an evaluation period of at least 4 months after RT regardless of concurrent steroid treatment, recognizing the prolonged improvement timeline for diplopia. Additionally, for reducing steroid use after RT, our study suggests optimal timing of RT within 12 months of symptom onset.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632542","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 Dry Mouth Toxicity Following ¹⁷⁷Lu-PSMA-617 Radioligand Therapy.","authors":"Abigail Pepin, Ana Kiess, J Nicholas Lukens, Philipose Mulugeta, Neil K Taunk","doi":"10.1016/j.prro.2024.10.014","DOIUrl":"10.1016/j.prro.2024.10.014","url":null,"abstract":"<p><p>Treatment options for patients with metastatic castration-resistant prostate cancer include the use of radioligand therapy with ¹⁷⁷Lu-PSMA-617. Although ¹⁷⁷Lu-PSMA-617 can selectively target prostate cancer cells, salivary glands express PSMA on the apical lumen of the acinar epithelium. Xerostomia resulting from the use of radioligand therapy is common. Herein, we report on a case of a Common Terminology Criteria for Adverse Events version 5 grade 2 dry mouth event after administration of ¹⁷⁷Lu-PSMA-617. The patient was managed with oral hygiene and xerostomia mitigation strategies using oral rinses.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632442","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":"Use of Magnetic Resonance Imaging for Postoperative Radiation Therapy Planning in Patients with Carbon Fiber-Reinforced Polyetheretherketone Instrumentation.","authors":"Jacob Ward, Mark Damante, Seth Wilson, Ahmed Nader Elguindy, Dominic Franceschelli, Vicente de Paulo Martins Coelho, Santino Cua, Daniel Kreatsoulas, Wesley Zoller, Sasha Beyer, Dukagjin Blakaj, Joshua Palmer, Raj Singh, Evan Thomas, Vikram Chakravarthy","doi":"10.1016/j.prro.2024.10.011","DOIUrl":"10.1016/j.prro.2024.10.011","url":null,"abstract":"<p><strong>Purpose: </strong>Carbon fiber-reinforced polyetheretherketone (CFR-PEEK) instrumentation is being used more frequently in the spinal oncology landscape. Better visualization with this material allows for more precise postoperative stereotactic body radiation therapy (SBRT) planning using either computed tomography (CT)-myelography or magnetic resonance imaging (MRI) studies. We compared the dosimetric planning equivalencies and outcomes.</p><p><strong>Methods and materials: </strong>Thirty-six consecutively treated patients were reviewed who underwent spinal fusion using CFR-PEEK instrumentation for spine metastases followed by postoperative SBRT between January 1, 2022, and April 3, 2023. Patients were divided into 2 cohorts based on the imaging modality, MRI versus CT-myelogram, used for postoperative SBRT planning. Surgical, demographic, postoperative radiation dosimetry, complication, and survival data were collected. Statistical analysis was performed in SPSS (v29.0.1.0).</p><p><strong>Results: </strong>Eleven patients underwent CT-myelograms, and 25 patients underwent MR-spine imaging for SBRT planning. The median follow-up was 145.5 days (13-530). There were no significant differences between baseline demographic, surgical characteristics, or SBRT dosimetry between the MRI spine and CT-myelogram groups. There was no significant difference between the cohorts for survival (P = .402).</p><p><strong>Conclusions: </strong>MR scans are an effective choice for postoperative SBRT contouring patients using CFR-PEEK instrumentation for oncologic spinal fusions. Avoidance of CT-myelography reduces the need for an invasive procedure and potential risks including cerebrospinal fluid (CSF) leak, nerve root injury, and increased procedural burden.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632543","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":"Appropriateness Criteria for Radiation Therapy in the Setting of Presumed Early-Stage Lung Cancer.","authors":"Laura L Dover, Christopher Abraham, Adam J Kole, Ashley Weiner","doi":"10.1016/j.prro.2024.10.010","DOIUrl":"10.1016/j.prro.2024.10.010","url":null,"abstract":"<p><p>Low-dose chest computed tomography imaging for lung cancer screening is revealing increasing numbers of radiographic early-stage lung cancers. This topic discussion describes when a clinical scenario merits radiation therapy without a histologic diagnosis, with an emphasis on pragmatic algorithms in settings without readily available advanced biopsy techniques.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632520","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":"Simulation of Focal Boosting in Online Adaptive MRI-Guided SBRT for Patients With Locally Advanced Prostate Cancer With Seminal Vesicle Involvement.","authors":"Mathijs G Dassen, Ben Neijndorff, Anja Betgen, Lisa Wiersema, Peter de Ruiter, Joeke van der Linden, Tomas Janssen, Leontien Abbenhuis, Peter van Kollenburg, Casper Reijnen, Floris Pos, Robert J Smeenk, Uulke A van der Heide, Ellen Brunenberg","doi":"10.1016/j.prro.2024.10.009","DOIUrl":"10.1016/j.prro.2024.10.009","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the feasibility and accuracy of focal boosting in online adaptive MRI-guided stereotactic body radiation therapy (SBRT) for patients with prostate cancer (PCa) with seminal vesicle invasion (T3b) by analyzing the impact of intrafraction motion on the dose planned for the gross tumor volume (GTV) and clinical target volume (CTV).</p><p><strong>Methods and materials: </strong>Data from 23 patients with T1-T3a PCa who received focal boosting SBRT on a 1.5T MR-Linac was used. A radiation oncologist replaced clinical GTVs with artificial GTVs representative for T3b tumor(s). For each MRI used for daily adaptation (MRI_adapt), an automated treatment plan was generated (D_f1-5) using the adapted contours. Patients were planned to receive 35 Gy to the CTV, with an isotoxic focal boost to the GTV up to 50 Gy. During each fraction, an additional MRI was acquired to assess intrafraction motion (MRI_during). Dose accumulation of all fractions was performed by deformable registration of MRI_adapt, _f2-5 to MRI_adapt, _f1 (D_{ACC, planned})_. The D_f1-₅ were projected to their corresponding MRI_during, which were used to reconstruct D_{ACC, delivered}, likewise. Our results were compared to patients with tumor(s) without seminal vesicle invasion (T1-T3a).</p><p><strong>Results: </strong>The median (10th-90th percentile) D98%_{ACC, planned} to the GTV, which correlates most strongly with outcome, was 41.1 Gy (40.1-43.0 Gy) in the plans for patients with artificial T3b tumors, compared to 43.0 Gy (40.4-47.2 Gy) in the plans for patients with T1-T3a tumors. The D98%_{ACC, delivered} to the GTV, taking into account intrafraction motion, was 41.0 Gy (39.3-42.6 Gy) and 42.5 Gy (40.0-46.6 Gy) in the plans for the artificial and clinical GTVs, respectively.</p><p><strong>Conclusions: </strong>MRI-guidance can ensure high accuracy of focal boosting in patients with T3b disease. Because of the unfavorable location of the GTV, a lower boost dose was feasible compared to patients with T1-T3a PCa.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607411","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":"Neurostimulators and Radiation Therapy: Is There Any Risk?","authors":"Hanan Rida, Alexander Bennassi, Chahrazed Boukhobza, Fatima Zahra Bellefkih, Kamel Debbi, Yazid Belkacemi","doi":"10.1016/j.prro.2024.09.013","DOIUrl":"10.1016/j.prro.2024.09.013","url":null,"abstract":"<p><p>The use of neurostimulators has increased in recent decades. However, safety guidelines in patients undergoing radiation therapy (RT) are lacking. We report 2 cases of pelvic RT for prostate cancer in patients with spinal cord neurostimulators. The implantable pulse generator was placed close to the irradiated volume in the gluteal region and received a median and maximal dose of 2.8 and 5.68 Gy, respectively for patient 1; and 3.65 and 5.15 Gy, respectively for patient 2. During and after RT, No dysfunction of the device was recorded. Based on the similarity with the cardiac implantable electric devices, we recommend similar safety procedures, this include the following: (i) a cumulative dose <5 Gy, (ii) avoiding neutron-producing RT, (iii) ensuring the implantable pulse generator positioning outside the direct beams, (iv) switching the device to \"off-mode\" during treatment delivery, and (v) in vivo verification in case of implantable pulse generator close to irradiation volume. The final decision should involve neurology specialist.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607410","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":"Erratum to: Shaitelman SF, Anderson BM, Arthur DW, Bazan JG, Bellon JR, Bradfield L, Coles CE, Gerber NK, Kathpal M, Kim L, Laronga C, Meattini I, Nichols EM, Pierce LJ, Poppe MM, Spears PA, Vinayak S, Whelan T, Lyons JA. Partial Breast Irradiation for Patients With Early-Stage Invasive Breast Cancer or Ductal Carcinoma In Situ: An ASTRO Clinical Practice Guideline. Pract Radiat Oncol 2024;14:112-132.","authors":"","doi":"10.1016/j.prro.2024.06.011","DOIUrl":"10.1016/j.prro.2024.06.011","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"14 6","pages":"Page 613"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142551868","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":"Readability and Writing Quality in Radiation Oncology Journal Articles from 2004 to 2024","authors":"Derek A. Mumaw MD,&nbsp;Thomas J. Quinn MD","doi":"10.1016/j.prro.2024.06.013","DOIUrl":"10.1016/j.prro.2024.06.013","url":null,"abstract":"<div><h3>Purpose</h3><div>Scientific literature is a vital tool that we rely on to communicate the findings of our studies; however, we rarely direct our study to the writing itself.</div></div><div><h3>Methods and Materials</h3><div>Here, we make use of modern natural language processing algorithms coupled with the large, open access PubMed Central corpus to analyze trends in writing complexity within the field of radiation oncology from 2004 to 2024. Changes in 1) required grade level to comprehend, 2) lexical complexity, and 3) information content were assessed. Articles were also classified, and then analyzed, by disease subsite.</div></div><div><h3>Results</h3><div>We found significant increases in the 3 domains over the 20-year collection period. Genitourinary literature had the greatest readability, while gastrointestinal literature was the most complex.</div></div><div><h3>Conclusions</h3><div>This analysis reveals broad increases in the complexity of our writing. This study demonstrates metrics to use and benchmark values to refer to when evaluating the complexity of radiation oncology journal articles.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"14 6","pages":"Pages e426-e433"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876721","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 Oligoprogressive Pleural Mesothelioma: Fine-Tuning the Optimal Doses","authors":"","doi":"10.1016/j.prro.2024.05.004","DOIUrl":"10.1016/j.prro.2024.05.004","url":null,"abstract":"<div><div><span><span>There is growing evidence of a role of stereotactic body radiation therapy (SBRT) in the treatment of patients with oligoprogressive </span>pleural mesothelioma (PM). The objective of this study was to investigate the optimal radiation therapy doses and schedules in this setting. The records of patients treated with SBRT (&gt;5 Gy per fraction) for oligoprogression of PM at 2 institutions from June 2014 to September 2022 were reviewed. Patients were divided into 2 groups: “intermediate-dose” SBRT (i-SBRT; total dose, 30-36 Gy in 5-6 fractions) and “high-dose” SBRT (h-SBRT; total dose, 45-50 Gy in 4-8 fractions). The comparison between the 2 groups in terms of local control (LC) and toxicity was the primary endpoint of the study. Overall, 23 patients were treated for 25 pleural lesions. All had received upfront chemotherapy with platinum/pemetrexed. Fifteen patients were treated with i-SBRT and 8 patients with h-SBRT. The median equivalent dose was 40 Gy (range, 40-49.6) in the i-SBRT group and 74.46 Gy (range, 64-88) in the h-SBRT group. Six-month, 1-year, and 2-year LC were 100%, 100%, and 80% in the i-SBRT group and 100%, 100%, and 67% in the h-SBRT group, respectively (</span><em>p</em><span> =.94). Only 2 patients (1 for each dose group) had a recurrence in the radiation therapy field, both after experiencing a distant relapse. No severe acute and late toxicities were observed in the i-SBRT group, whereas in the h-SBRT group, 2 patients experienced G2 acute and late thoracic pain<span> and 1 patient experienced G2 acute and G3 chronic thoracic pain. In our experience, SBRT is a safe and effective option for selected patients with oligoprogressive PM. Use of intermediate total doses keeping the dose per fraction high seems to offer an excellent LC, avoiding the risk of severe toxicity.</span></span></div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"14 6","pages":"Pages e487-e491"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141181226","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}