Practical Radiation Oncology最新文献

{"title":"PROshot: Intensity Modulated Radiation Therapy for Vulvar Cancer, Completion Axillary Dissection, Ultracentral Lung Radiation, Concurrent Chemotherapy for Endometrial cancer, and Neoadjuvant Therapy for Esophageal Squamous Cell Carcinoma","authors":"Laura Dover , Caleb Dulaney","doi":"10.1016/j.prro.2024.08.001","DOIUrl":"10.1016/j.prro.2024.08.001","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"14 6","pages":"Pages 471-475"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142555620","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":"A Pilot Trial of Proton-Based Cardiac Sparing Accelerated Fractionated Radiation Therapy in Unresectable Non-small Cell Lung Cancer With Extended Durvalumab Therapy (PARTICLE-D)","authors":"Debora S. Bruno MD, MS ,&nbsp;Carley Mitchell MD ,&nbsp;Afshin Dowlati MD ,&nbsp;Stephen Shamp MD ,&nbsp;Pingfu Fu PhD ,&nbsp;John Rindeau BS ,&nbsp;Yiran Zheng PhD ,&nbsp;Mitchell Machtay MD ,&nbsp;Tithi Biswas MD","doi":"10.1016/j.prro.2024.06.007","DOIUrl":"10.1016/j.prro.2024.06.007","url":null,"abstract":"<div><h3>Purpose</h3><div>Concurrent chemoradiation therapy is the current nonsurgical standard of care for locally advanced non-small cell lung cancer. However, this is a difficult regimen to tolerate, especially for those who are elderly, have multiple comorbidities, or have poor performance status. Alternative treatment regimens are needed for this vulnerable population. We report initial results of concurrent durvalumab, an immune checkpoint inhibitor, and hypofractionated, dose-escalating, proton external beam radiation therapy (EBRT).</div></div><div><h3>Methods and Materials</h3><div>This phase 1, pilot dose escalation trial enrolled 7 patients with newly diagnosed stage IIIA to IIIC non-small cell lung cancer and who were unable or unwilling to undergo concurrent chemoradiation therapy. Patients previously treated with immunotherapy were excluded. Five patients in this 3 + 3 study design received a fixed dose of durvalumab on day 1 of each 28-day cycle plus hypofractionated proton EBRT with initial dose of 60 Gy (Arm 1) in 20 fractions while 2 patients received the escalation dose of 69 Gy in 23 fractions (Arm 2). The primary objective was to assess safety and the secondary objective was to assess feasibility and adverse events.</div></div><div><h3>Results</h3><div>All patients experienced treatment-related adverse events, primarily grades 1 and 2. Pneumonitis and anemia were the most common. Only 1 dose-limiting toxicity occurred in arm 1, which was a grade 3 pneumonitis leading to grade 5 pneumonia. Additionally, 2 delayed-onset grade 5 tracheal necrosis events occurred &gt;13 months after treatment initiation.</div></div><div><h3>Conclusions</h3><div>Concurrent durvalumab plus hypofractionated proton EBRT was well tolerated in the short term. However, 3 treatment-related deaths, including 2 delayed-onset grade 5 tracheal necroses negatively impacted overall safety. A dose de-escalation protocol of proton-based radiation therapy plus durvalumab is warranted.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"14 6","pages":"Pages e470-e479"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604503","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 Tam et al.","authors":"Charlotte Rivers MD,&nbsp;Samuel Lewis Cooper MD,&nbsp;Bhishamjit Chera MD, FASTRO","doi":"10.1016/j.prro.2024.04.026","DOIUrl":"10.1016/j.prro.2024.04.026","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"14 6","pages":"Pages e530-e531"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142551864","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":"Bronchiolitis Obliterans Organizing Pneumonia After Breast Radiation Therapy","authors":"Mara Caroprese MD ,&nbsp;Laura Cella MD ,&nbsp;Angela Barillaro MD ,&nbsp;Caterina Oliviero MD ,&nbsp;Stefania Clemente MD ,&nbsp;Pierpaolo Mainenti MD ,&nbsp;Roberto Pacelli MD ,&nbsp;Manuel Conson MD","doi":"10.1016/j.prro.2024.06.008","DOIUrl":"10.1016/j.prro.2024.06.008","url":null,"abstract":"<div><div>Presented here is a case report of a 77-year-old woman affected by rheumatoid arthritis who underwent breast-conserving surgery followed by radiation therapy (RT) for left-breast cancer and developed bronchiolitis obliterans organizing pneumonia (BOOP) after RT and during a COVID-19 vaccination campaign. BOOP incidence is an uncommon morbidity after breast RT (1.2%-2.9%); however, specific predisposing factors can play a role. In this patient, both rheumatoid arthritis and the vaccine may have predisposed her to an increased risk of organizing pneumonia, probably by triggering a proinflammatory cascade. Our report highlights the importance of factors that influence the occurrence of uncommon radiation-induced morbidities, such as BOOP, in specific subsets of patients. Further studies are necessary to evaluate factors increasing radiation sensitivity.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"14 6","pages":"Pages e443-e448"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735654","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 Rivers et al.","authors":"Stephanie Yoon MD, MS,&nbsp;Andrew Tam MD,&nbsp;Yun Rose Li MD, PhD","doi":"10.1016/j.prro.2024.07.011","DOIUrl":"10.1016/j.prro.2024.07.011","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"14 6","pages":"Pages 605-607"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142551865","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 Pneumonitis After Partial Breast Irradiation","authors":"","doi":"10.1016/j.prro.2024.04.024","DOIUrl":"10.1016/j.prro.2024.04.024","url":null,"abstract":"<div><h3>Abstract</h3><div>This case presentation describes development of symptomatic radiation pneumonitis<span> in a healthy woman who underwent partial breast irradiation<span> with deep inspiration breath hold for early stage breast cancer meeting all published dose constraints. Risk factors for, diagnosis and management of radiation pneumonitis are discussed in detail. Radiation pneumonitis is rare, ranging from &lt;1% to 1.5% (when regional nodal irradiation is included). Partial breast irradiation spares breast tissue, but may not spare lung tissue better than whole breast irradiation, depending upon treatment technique such as prone positioning. Dose constraints for normal and target structures from published trials are reviewed, however data specifically relating to pneumonitis in partial breast trials are limited.</span></span></div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"14 6","pages":"Pages 478-483"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201315","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":"Treatment Terminations During Radiation Therapy: A 10-Year Experience","authors":"","doi":"10.1016/j.prro.2024.06.002","DOIUrl":"10.1016/j.prro.2024.06.002","url":null,"abstract":"<div><h3>Purpose</h3><div>Patients undergoing radiation therapy may terminate treatment for any number of reasons. The incidence of treatment termination (TT) during radiation therapy has not been studied. Herein, we present a cohort of TT at a large multicenter radiation oncology department over 10 years.</div></div><div><h3>Methods and Materials</h3><div>TTs between January 2013 and January 2023 were prospectively analyzed as part of an ongoing departmental quality and safety program. TT was defined as any premature discontinuation of therapy after initiating radiation planning. The rate of TT was calculated as a percentage of all patients starting radiation planning. All cases were presented at monthly morbidity and mortality conferences with a root cause reviewed.</div></div><div><h3>Results</h3><div>A total of 1448 TTs were identified out of 31,199 planned courses of care (4.6%). Six hundred eighty-six (47.4%) involved patients treated with curative intent, whereas 753 (52.0%) were treated with palliative intent, and 9 (0.6%) were treated for benign disease<span>. The rate of TT decreased from 8.49% in 2013 to 3.02% in 2022, with rates decreasing yearly. The most common disease sites for TT were central nervous system<span> (21.7%), head and neck (19.3%), thorax (17.5%), and bone (14.2%). The most common causes of TT were hospice and/or patient expiration (35.9%), patient choice unrelated to toxicity (35.2%), and clinician choice unrelated to toxicity (11.5%).</span></span></div></div><div><h3>Conclusions</h3><div>This 10-year prospective review of TTs identified a year-over-year decrease in TTs as a percentage of planned patients. This decrease may be associated with the addition of root cause reviews for TTs and discussions monthly at morbidity and mortality rounds, coupled with departmental upstream quality initiatives implemented over time. Understanding the reasons behind TTs may help decrease preventable TTs. Although some TTs may be unavoidable, open discourse and quality improvement changes effectively reduce TT incidents over time.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"14 6","pages":"Pages e417-e425"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555937","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":"Urinary Organs at Risk for Prostate Cancer External Beam Radiation Therapy: Contouring Guidelines on Behalf of the Francophone Group of Urological Radiation Therapy","authors":"","doi":"10.1016/j.prro.2024.05.009","DOIUrl":"10.1016/j.prro.2024.05.009","url":null,"abstract":"<div><h3>Purpose</h3><div>The occurrence of genitourinary (GU) toxicity is a common adverse event observed after external beam radiation therapy (EBRT) for prostate cancer (PCa). Recent findings suggest that the dose delivered to specific urinary organs at risk (OARs) such as the ureters, bladder trigone, and urethra is involved in the development of GU toxicity.</div></div><div><h3>Methods and Materials</h3><div>A multidisciplinary task force including 3 radiation oncologists, a uroradiologist, and a urologist was created in 2022. First, OARs potentially involved in GU toxicity were identified and discussed. A literature review was performed, addressing several questions relative to urinary OARs: anatomic and radiological definition, radiation-induced injury, and dose-volume parameters. Second, results were presented and discussed with a panel of radiation oncologists and members of the “Francophone Group of Urological Radiation Therapy.” Thereafter, the “Francophone Group of Urological Radiation Therapy” experts were asked to answer a dedicated questionnaire, including 35 questions on the controversial issues related to the delineation of urinary OARs.</div></div><div><h3>Results</h3><div>The following structures were identified as critical for PCa EBRT: ureters, bladder, bladder neck, bladder trigone, urethra (intraprostatic, membranous, and spongious), striated sphincter, and postenucleation or posttransurethral resection of the prostate cavity. A consensus was obtained for 32 out of 35 items.</div></div><div><h3>Conclusions</h3><div>This consensus highlights contemporary urinary structures in both the upper and lower urinary tract to be considered for EBRT treatment planning of PCa. The current recommendations also propose a standardized definition of urinary OARs for both daily practice and future clinical trials.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"14 6","pages":"Pages 541-554"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581509","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":"Being an Oncologist—How I Evolved","authors":"","doi":"10.1016/j.prro.2024.03.002","DOIUrl":"10.1016/j.prro.2024.03.002","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"14 6","pages":"Pages 476-477"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140208236","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":"Empowering Hepatocellular Carcinoma Ablative Therapy: A Renaissance of Collaboration","authors":"Michele Fiore MD,&nbsp;Gabriele D'Ercole MD,&nbsp;Gian Marco Petrianni MD,&nbsp;Pasquale Trecca MD,&nbsp;Sara Ramella MD","doi":"10.1016/j.prro.2024.07.009","DOIUrl":"10.1016/j.prro.2024.07.009","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"14 6","pages":"Pages 603-604"},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142551863","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}