Practical Radiation Oncology最新文献

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Detection of Asymptomatic Pneumomediastinum and Subcutaneous Emphysema on Cone Beam Computed Tomography During Head and Neck Radiation Therapy 头颈部放射治疗中无症状纵隔气肿和皮下肺气肿的锥形束ct检测。
IF 3.4 3区 医学
Practical Radiation Oncology Pub Date : 2025-05-01 DOI: 10.1016/j.prro.2024.09.001
Rojine T. Ariani MD, MS, Vishruth Reddy MD, PhD, Ricky R. Savjani MD, PhD
{"title":"Detection of Asymptomatic Pneumomediastinum and Subcutaneous Emphysema on Cone Beam Computed Tomography During Head and Neck Radiation Therapy","authors":"Rojine T. Ariani MD, MS, Vishruth Reddy MD, PhD, Ricky R. Savjani MD, PhD","doi":"10.1016/j.prro.2024.09.001","DOIUrl":"10.1016/j.prro.2024.09.001","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 3","pages":"Pages 217-218"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525138","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}
引用次数: 0
Favorable Rates of Excellent or Good Cosmetic Outcomes in Patients Treated With Carefully Planned Accelerated Partial Breast Irradiation Delivered Twice Daily or Once Every Other Day. 每日两次或隔天一次的精心计划的加速部分乳房照射治疗的患者的优良率或良好的美容结果。
IF 3.4 3区 医学
Practical Radiation Oncology Pub Date : 2025-05-01 DOI: 10.1016/j.prro.2025.04.011
Jose G Bazan, Sachin R Jhawar, Sasha Beyer, Erin Healy, Karla Kuhn, Julia R White
{"title":"Favorable Rates of Excellent or Good Cosmetic Outcomes in Patients Treated With Carefully Planned Accelerated Partial Breast Irradiation Delivered Twice Daily or Once Every Other Day.","authors":"Jose G Bazan, Sachin R Jhawar, Sasha Beyer, Erin Healy, Karla Kuhn, Julia R White","doi":"10.1016/j.prro.2025.04.011","DOIUrl":"10.1016/j.prro.2025.04.011","url":null,"abstract":"<p><strong>Purpose: </strong>Two randomized controlled trials of external beam accelerated partial breast irradiation (EB-APBI) using 38.5 Gy/10 fractions twice daily demonstrated excellent cancer control outcomes in appropriately selected patients, but with conflicting results regarding cosmesis. A recent randomized controlled trial reported high rates of acceptable cosmesis using 30 Gy/5 fractions every other day, calling into question the most appropriate schedule for EB-APBI. Our accelerated partial breast irradiation approach uses strict contouring, dosimetric, and planning guidelines. We report our experience with twice-daily and every-other-day EB-APBI, hypothesizing that our treatment planning approach would result in acceptable acute toxicity and cosmesis.</p><p><strong>Methods and materials: </strong>We identified patients who received EB-APBI from April 2017 to December 2021. Clinical, pathologic, acute toxicity, cosmesis, and dosimetric data for the lumpectomy gross tumor volume, clinical target volume, and planning target volume were collected. Cosmesis was physician-reported using the 4-point Radiation Therapy Oncology Group (RTOG) global cosmetic score: excellent, good, fair (F), and poor (P). We report descriptive statistics to summarize our results.</p><p><strong>Results: </strong>A total of 245 patients were included with a median follow-up of 19 months (IQR, 9-30 months); the median age was 66 years (IQR, 59-71 years), 82% had invasive breast cancer, 100% had invasive tumors that were hormone-receptor positive/human epidermal growth factor receptor 2 negative, and 96% had nodal surgery for invasive disease. Fractionation was twice daily in 55% of patients, and every other day in 45%. Three-dimensional conformal radiation was used in 88%, with a median of 6 fields, and 96% were treated prone. Most patients had no acute toxicity (55% grade 0 dermatitis; 57% grade 0 fatigue; 97% grade 0 pruritis). The rate of excellent/good cosmesis was 97.1% (n = 238), and F/P was 2.9% (n = 7). The ipsilateral breast V100 was marginally associated with increased odds of F/P cosmesis (odds ratio, 1.18; 95% CI, 0.99-1.42; P = .07).</p><p><strong>Conclusions: </strong>With multiple-field 3-dimensional conformal radiation in the prone position, EB-APBI can be delivered with extremely low toxicity and great cosmetic results with twice-daily or every-other-day fractionation. Given the low rate of F/P cosmesis, longer follow-up is needed to confirm the stability of these results and to help identify optimal planning dose-volume parameters to help minimize the rate of F/P cosmesis.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991755","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}
引用次数: 0
Management of de Novo Metastatic Hormone-Sensitive Prostate Cancer (mHSPC) and the Role of Radiation Therapy: A Consensus by the Italian Association of Radiotherapy and Clinical Oncology (AIRO) 新发转移性激素敏感性前列腺癌(mHSPC)的治疗和放疗的作用:意大利放射治疗和临床肿瘤学协会(AIRO)共识》。
IF 3.4 3区 医学
Practical Radiation Oncology Pub Date : 2025-05-01 DOI: 10.1016/j.prro.2024.10.007
Andrea Lancia MD , Anna Rita Alitto MD , Giovanni Pappagallo MD, PhD , Elisa Ciurlia MD , Giulio Francolini MD , Rolando D'Angelillo MD, PhD , Sergio Fersino MD , Niccolò Giaj Levra MD , Barbara Alicja Jereczek-Fossa MD, PhD , Alessandro Magli MD , Francesco Pasqualetti MD, PhD , Alessia Reali MD , Corrado Spatola MD , Luca Triggiani MD, PhD
{"title":"Management of de Novo Metastatic Hormone-Sensitive Prostate Cancer (mHSPC) and the Role of Radiation Therapy: A Consensus by the Italian Association of Radiotherapy and Clinical Oncology (AIRO)","authors":"Andrea Lancia MD ,&nbsp;Anna Rita Alitto MD ,&nbsp;Giovanni Pappagallo MD, PhD ,&nbsp;Elisa Ciurlia MD ,&nbsp;Giulio Francolini MD ,&nbsp;Rolando D'Angelillo MD, PhD ,&nbsp;Sergio Fersino MD ,&nbsp;Niccolò Giaj Levra MD ,&nbsp;Barbara Alicja Jereczek-Fossa MD, PhD ,&nbsp;Alessandro Magli MD ,&nbsp;Francesco Pasqualetti MD, PhD ,&nbsp;Alessia Reali MD ,&nbsp;Corrado Spatola MD ,&nbsp;Luca Triggiani MD, PhD","doi":"10.1016/j.prro.2024.10.007","DOIUrl":"10.1016/j.prro.2024.10.007","url":null,"abstract":"<div><h3>Purpose</h3><div>Prostate cancer treatments paradigms are in continuous evolution, especially in the metastatic setting. In this context, the Genito-Urinary Group of Italian Association of Radiotherapy and Clinical Oncology aimed to create a consensus on radiation therapy indication in de novo metastatic hormone-sensitive prostate cancer both on primary tumor and metastatic sites.</div></div><div><h3>Methods</h3><div>A panel of experts, involved in clinical management of prostate cancer, through the estimate-talk-estimate method, developed a list of items and correspondent statements on the identified topic.</div></div><div><h3>Results</h3><div>Seven conclusive items were identified with 12 statements about the chosen topic, radiation therapy in metastatic hormone-sensitive prostate cancer on primary tumor and metastatic sites.</div></div><div><h3>Conclusions</h3><div>This consensus might help clinicians in prostate cancer managing in daily clinical practice.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 3","pages":"Pages e286-e294"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570220","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}
引用次数: 0
Radiation Therapy for Heterotopic Ossification: A Systematic Review 异位骨化的放射治疗:系统回顾
IF 3.4 3区 医学
Practical Radiation Oncology Pub Date : 2025-05-01 DOI: 10.1016/j.prro.2024.10.013
Christine Bang MD , Eric Jutkowitz PhD , Eduardo Caputo PhD , Sherry X. Yan MD , Htun Ja Mai MBBS, MPH , Ghid Kanaan MD , Tayler Leonard , Taylor Rickard MS , Thomas Trikalinos MD , James L. Rudolph MD , Katherine Rieke PhD
{"title":"Radiation Therapy for Heterotopic Ossification: A Systematic Review","authors":"Christine Bang MD ,&nbsp;Eric Jutkowitz PhD ,&nbsp;Eduardo Caputo PhD ,&nbsp;Sherry X. Yan MD ,&nbsp;Htun Ja Mai MBBS, MPH ,&nbsp;Ghid Kanaan MD ,&nbsp;Tayler Leonard ,&nbsp;Taylor Rickard MS ,&nbsp;Thomas Trikalinos MD ,&nbsp;James L. Rudolph MD ,&nbsp;Katherine Rieke PhD","doi":"10.1016/j.prro.2024.10.013","DOIUrl":"10.1016/j.prro.2024.10.013","url":null,"abstract":"<div><h3>Purpose</h3><div>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.</div></div><div><h3>Methods and Materials</h3><div>Literature searches were conducted using Medline (via PubMed), Embase, and ClinicalTrials.gov until April 1<sub>,</sub> 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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 3","pages":"Pages 228-247"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","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}
引用次数: 0
The Impact of Margin Expansions on Local Control and Radionecrosis Following Stereotactic Radiosurgery for Brain Metastases: A Systematic Review and Meta-Analysis 脑转移瘤立体定向放射手术后切缘扩张对局部控制和放射性坏死的影响:一项系统回顾和荟萃分析。
IF 3.4 3区 医学
Practical Radiation Oncology Pub Date : 2025-05-01 DOI: 10.1016/j.prro.2025.01.012
Raj Singh MD , John G. Roubil MD , Eric J. Lehrer MD, MS , Gael Muanamputu BS , Evan M. Thomas MD, PhD , Sasha J. Beyer MD, PhD , Raju R. Raval MD, DPhil , Rupesh Kotecha MD , Joshua D. Palmer MD
{"title":"The Impact of Margin Expansions on Local Control and Radionecrosis Following Stereotactic Radiosurgery for Brain Metastases: A Systematic Review and Meta-Analysis","authors":"Raj Singh MD ,&nbsp;John G. Roubil MD ,&nbsp;Eric J. Lehrer MD, MS ,&nbsp;Gael Muanamputu BS ,&nbsp;Evan M. Thomas MD, PhD ,&nbsp;Sasha J. Beyer MD, PhD ,&nbsp;Raju R. Raval MD, DPhil ,&nbsp;Rupesh Kotecha MD ,&nbsp;Joshua D. Palmer MD","doi":"10.1016/j.prro.2025.01.012","DOIUrl":"10.1016/j.prro.2025.01.012","url":null,"abstract":"<div><h3>Purpose</h3><div>The implications of margin expansions on local control (LC) and radionecrosis (RN) for treating brain metastases (BMs) with stereotactic radiosurgery (SRS) remain unclear. We performed a systematic review and meta-analysis to compare LC and RN between patients with BMs treated with SRS planned with no margin versus a margin.</div></div><div><h3>Methods and Materials</h3><div>We used the Population, Intervention, Control, Outcomes, Study Design; the Preferred Reporting Items for Systematic Reviews; and Meta-analyses, and the Meta-analysis of Observational Studies in Epidemiology selection inclusion criteria for studies of patients with BMs treated with SRS with no margin or a margin. Primary outcomes were 1-year LC and radiographic and symptomatic RN incidences. Weighted random effects meta-analyses were performed to compare effect sizes.</div></div><div><h3>Results</h3><div>Across 17 studies, we identified 5015 lesions treated with SRS (1360 lesions with no margin and 3684 with a margin). The median total margin was 1.5 (range, 1-3) mm. Single-fraction SRS was most common with a median prescription dose of 21 Gy (range, 15-24 Gy). The estimated 1-year LC rate was similar with a margin (88.4% [95% CI, 83.7%-92.4%]) versus without (83.0% [95% CI, 69.3-93.2%; <em>P</em> = 0.28]). The estimated incidences of radiographic RN after SRS with or without a margin were 9.2% (95% CI, 0.2%-29.6%) and 7.0% (95% CI, 4.1%-10.7%; <em>P</em> = 0.56), respectively. The estimated incidences of symptomatic RN after SRS without or with a margin were 8.6% (95% CI, 5.2%-12.7%) and 4.1% (95% CI, 0.9%-9.3%), respectively (<em>P</em> = .24).</div></div><div><h3>Conclusions</h3><div>We did not note a significant difference in LC or RN between patients treated with or without margin expansions. Prospective evaluations are warranted to further assess this question while controlling for other relevant treatment planning and metastasis considerations.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 3","pages":"Pages e245-e257"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426615","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}
引用次数: 0
Patient Positional Uncertainty and Margin Reduction in Lung Stereotactic Ablative Radiation Therapy Using Pneumatic Abdominal Compression 腹部压迫肺立体定向消融放疗中患者位置不确定。
IF 3.4 3区 医学
Practical Radiation Oncology Pub Date : 2025-05-01 DOI: 10.1016/j.prro.2024.12.001
Yohan A. Walter MS , Chiachien J. Wang MD, PhD , Daniel B. Speir RT , William E. Burrell MSRS, RT , Carlos D. Palomeque CMD , James C. Henry CMD , Megan M. Rodrigues CMD , Troy D. Jacobs MS , Bethany L. Broekhoven MS , Joseph P. Dugas PhD , Anne N. Hubbard MS , Philip F. Durham MS , Hsinshun T. Wu PhD
{"title":"Patient Positional Uncertainty and Margin Reduction in Lung Stereotactic Ablative Radiation Therapy Using Pneumatic Abdominal Compression","authors":"Yohan A. Walter MS ,&nbsp;Chiachien J. Wang MD, PhD ,&nbsp;Daniel B. Speir RT ,&nbsp;William E. Burrell MSRS, RT ,&nbsp;Carlos D. Palomeque CMD ,&nbsp;James C. Henry CMD ,&nbsp;Megan M. Rodrigues CMD ,&nbsp;Troy D. Jacobs MS ,&nbsp;Bethany L. Broekhoven MS ,&nbsp;Joseph P. Dugas PhD ,&nbsp;Anne N. Hubbard MS ,&nbsp;Philip F. Durham MS ,&nbsp;Hsinshun T. Wu PhD","doi":"10.1016/j.prro.2024.12.001","DOIUrl":"10.1016/j.prro.2024.12.001","url":null,"abstract":"<div><h3>Purpose</h3><div>Motion management presents a significant challenge in thoracic stereotactic ablative radiation therapy (SABR). Currently, a 5.0-mm standard planning target volume (PTV) margin is widely used to ensure adequate dose to the tumor. Considering recent advancements in tumor localization and motion management, there is merit to reassessing the necessary PTV margins for modern techniques. This work presents a large-scale analysis of intrafraction repositioning for lung SABR under forced shallow breathing to determine the margin requirements for modern delivery techniques.</div></div><div><h3>Methods and Materials</h3><div>Treatment data for 124 lung SABR patients treated in 607 fractions on a linear accelerator were retrospectively collected for analysis. All patients were treated using pneumatic abdominal compression and intrafraction 4-dimensional (4D) cone beam computed tomography (4D CBCT)-guided repositioning halfway through treatment. Executed repositioning shifts were collected and used to calculate margin requirements using the 2-SD method and an analytical model which accounts for systematic and random errors in treatment.</div></div><div><h3>Results</h3><div>A total of 85.7% of treated fractions had 3-dimensional repositioning shifts under 5.0 mm. Fifty-three fractions (8.7%) had shifts ≥ 5.0 mm in at least 1 direction. Margins in the right-left, inferior-superior, and posterior-anterior directions were 3.62 mm, 4.34 mm, and 3.50 mm, respectively, calculated using the 2-SD method. The analytical approach estimated that 4.01 mm, 4.37 mm, and 3.95 mm margins were appropriate for our workflow. Executing intrafraction repositioning reduced margin requirements by 0.73 ± 0.07 mm.</div></div><div><h3>Conclusions</h3><div>Clinical data suggest that the uniform 5.0-mm margin is conservative for our workflow. Using modern techniques such as 4D CT, 4D CBCT, and effective motion management can significantly reduce required margins, and therefore necessary healthy tissue dose. However, the limitations of margin calculation models must be considered, and margin reduction must be approached with caution. Users should conduct a formal risk assessment prior to adopting new standard PTV margins.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 3","pages":"Pages 253-261"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903455","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}
引用次数: 0
Management of Continuous Glucose Monitors in Radiation Oncology Patients 放射肿瘤患者连续血糖监测仪的管理。
IF 3.4 3区 医学
Practical Radiation Oncology Pub Date : 2025-05-01 DOI: 10.1016/j.prro.2024.06.016
Johnathan Zeng MD , Tara Kosak MEd , Samir Malkani MD , Julie C. Hudson MS , Neil E. Martin MD, MPH , Roy B. Tishler MD, PhD , Itai M. Pashtan MD
{"title":"Management of Continuous Glucose Monitors in Radiation Oncology Patients","authors":"Johnathan Zeng MD ,&nbsp;Tara Kosak MEd ,&nbsp;Samir Malkani MD ,&nbsp;Julie C. Hudson MS ,&nbsp;Neil E. Martin MD, MPH ,&nbsp;Roy B. Tishler MD, PhD ,&nbsp;Itai M. Pashtan MD","doi":"10.1016/j.prro.2024.06.016","DOIUrl":"10.1016/j.prro.2024.06.016","url":null,"abstract":"<div><div>Continuous glucose monitors (CGMs) are an increasingly prevalent electronic medical device used by patients with diabetes, offering several advantages over “finger sticks.” There is a resulting rise in patients with CGMs seen in radiation oncology clinics. Manufacturers specify that CGMs should not be exposed to radiation (both diagnostic and therapeutic) due to the risk of device damage, creating challenges for patients and providers. We present a workflow for the management of CGMs in radiation oncology patients, beginning with systematic screening by providers and staff. We propose options for CGM management together with the device prescriber, including removal of the CGM or keeping it in place with periodic finger sticks to confirm the accuracy and offer guidance to radiation oncology providers and staff.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 3","pages":"Pages e295-e299"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983919","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}
引用次数: 0
Radiation Therapy for Graves’ Ophthalmopathy: When Is the Optimal Timing of Treatment and Evaluation 巴塞杜氏眼病的放射治疗:何时是治疗和评估的最佳时机?
IF 3.4 3区 医学
Practical Radiation Oncology Pub Date : 2025-05-01 DOI: 10.1016/j.prro.2024.10.012
Ji Hyun Hong MD, MPH , Kyu Hye Choi MD, PhD , Ji Sang Kim MD , Suk Woo Yang MD, PhD , Yeon-Sil Kim MD, PhD
{"title":"Radiation Therapy for Graves’ Ophthalmopathy: When Is the Optimal Timing of Treatment and Evaluation","authors":"Ji Hyun Hong MD, MPH ,&nbsp;Kyu Hye Choi MD, PhD ,&nbsp;Ji Sang Kim MD ,&nbsp;Suk Woo Yang MD, PhD ,&nbsp;Yeon-Sil Kim MD, PhD","doi":"10.1016/j.prro.2024.10.012","DOIUrl":"10.1016/j.prro.2024.10.012","url":null,"abstract":"<div><h3>Purpose</h3><div>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.</div></div><div><h3>Methods and Materials</h3><div>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%).</div></div><div><h3>Results</h3><div>Median follow-up was 44.5 months (range, 4.8-169.6). CAS significantly improved in the early-immediate phase, 1 month after RT (<em>P</em> &lt; .001). However, diplopia showed significant improvement at a relatively late phase, 4 months after RT (<em>P</em> = .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, <em>P</em> = .011).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 3","pages":"Pages e221-e229"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","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}
引用次数: 0
Neurostimulators and Radiation Therapy: Is There Any Risk? 神经刺激器和放射治疗:有风险吗?
IF 3.4 3区 医学
Practical Radiation Oncology Pub Date : 2025-05-01 DOI: 10.1016/j.prro.2024.09.013
Hanan Rida MD , Alexander Bennassi MD , Chahrazed Boukhobza MD , Fatima Zahra Bellefkih MD , Kamel Debbi MD , Yazid Belkacemi MD, PhD
{"title":"Neurostimulators and Radiation Therapy: Is There Any Risk?","authors":"Hanan Rida MD ,&nbsp;Alexander Bennassi MD ,&nbsp;Chahrazed Boukhobza MD ,&nbsp;Fatima Zahra Bellefkih MD ,&nbsp;Kamel Debbi MD ,&nbsp;Yazid Belkacemi MD, PhD","doi":"10.1016/j.prro.2024.09.013","DOIUrl":"10.1016/j.prro.2024.09.013","url":null,"abstract":"<div><div>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 &lt;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.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 3","pages":"Pages e300-e303"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","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}
引用次数: 0
The Potential of Diffusion-weighted Magnetic Resonance Imaging for the Definition of Patient-specific Patterns of Tumor Infiltration in Sacral Chordoma 弥散加权磁共振成像在确定骶骨脊索瘤特定患者肿瘤浸润模式方面的潜力
IF 3.4 3区 医学
Practical Radiation Oncology Pub Date : 2025-05-01 DOI: 10.1016/j.prro.2024.09.002
Nadya Shusharina PhD , Evangelia Kaza PhD , Miranda B. Lam MD, MBA
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引用次数: 0
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