Acta Oncologica最新文献

筛选
英文 中文
Incidence trends of esophageal squamous cell and adenocarcinoma in Finland in 2000-2021. 2000-2021年芬兰食管鳞状细胞癌和腺癌的发病率趋势
IF 2.7 3区 医学
Acta Oncologica Pub Date : 2025-08-01 DOI: 10.2340/1651-226X.2025.44097
Pietari Junkala, Anssi Auvinen
{"title":"Incidence trends of esophageal squamous cell and adenocarcinoma in Finland in 2000-2021.","authors":"Pietari Junkala, Anssi Auvinen","doi":"10.2340/1651-226X.2025.44097","DOIUrl":"https://doi.org/10.2340/1651-226X.2025.44097","url":null,"abstract":"<p><strong>Background and purpose: </strong>Esophageal cancer (EC) histological subtypes have contrasting incidence trends according to previous studies. In high-income countries, the incidence of esophageal squamous cell carcinoma (SCC) has decreased, while the incidence of esophageal adenocarcinoma (AC) has increased. This descriptive registry-based study evaluates incidence trends by EC subtype in Finland during 2000-2021.</p><p><strong>Material and methods: </strong>Data on all EC cases by histological subtype, sex and 10-year age group diagnosed over the period 2000-2021 was obtained from the Finnish Cancer Registry. In total, 6,482 cases (2,604 AC, 2,979 SCC) were observed. Time trends by histology, sex and age group were evaluated with Poisson regression and joinpoint regression.</p><p><strong>Results: </strong>EC incidence in men increased by an annual percentage change (APC) of 1.3 (95% confidence intervals [CI] 0.8-1.8) while no significant increase was observed in women with APC of -0.1, 95% CI -0.8-0.6). Incidence of AC in men increased with APC of 3.5 (95% CI 2.7-4.2) and by 2.0 (95% CI 0.4-3.6) in women. No consistent trends were observed in SCC incidence although in joinpoint regression, from 2000 to 2006 SCC incidence decreased in men by APC of -6.5 (95% CI -20.3 to -1.1). From 2006 to 2021, rates plateaued with APC of 0.9 (95% CI -0.4 to 7.2). No other joinpoints were identified.</p><p><strong>Interpretation: </strong>EC incidence increased in Finland during 2000-2021 due to an increase in AC. Incidence of AC increased more than threefold in men, with a lesser increase in women. SCC incidence declined until 2006 and plateaued thereafter.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"1014-1020"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144758918","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
Optimal treatment duration in metastatic renal cell carcinoma patients responding to immune checkpoint inhibitors: should we treat beyond two years? 对免疫检查点抑制剂有反应的转移性肾癌患者的最佳治疗时间:我们是否应该治疗超过2年?
IF 2.7 3区 医学
Acta Oncologica Pub Date : 2025-07-30 DOI: 10.2340/1651-226X.2025.43876
Alexander Decruyenaere, Gennigens Christine, Rottey Sylvie, Laenen Annouschka, Emmanuel Seront, Els Everaert, Philip R Debruyne, Heidi Van Den Bulck, Julie Bastin, Verbiest Annelies, Christof Vulsteke, Peter Schatteman, Daisy Luyten, Sandrine Aspeslagh, Nieves Martinez-Chanza, Marlies De Bock, Thomas Meyskens, Jolanda Verheezen, Barbara Brouwers, Benoit Beuselinck
{"title":"Optimal treatment duration in metastatic renal cell carcinoma patients responding to immune checkpoint inhibitors: should we treat beyond two years?","authors":"Alexander Decruyenaere, Gennigens Christine, Rottey Sylvie, Laenen Annouschka, Emmanuel Seront, Els Everaert, Philip R Debruyne, Heidi Van Den Bulck, Julie Bastin, Verbiest Annelies, Christof Vulsteke, Peter Schatteman, Daisy Luyten, Sandrine Aspeslagh, Nieves Martinez-Chanza, Marlies De Bock, Thomas Meyskens, Jolanda Verheezen, Barbara Brouwers, Benoit Beuselinck","doi":"10.2340/1651-226X.2025.43876","DOIUrl":"10.2340/1651-226X.2025.43876","url":null,"abstract":"<p><strong>Background and purpose: </strong>Optimal treatment duration is unknown in metastatic renal cell carcinoma (mRCC) responding to immune checkpoint inhibitors (ICPIs). Prolonged treatment can lead to late toxicity, burden for day clinics and financial impact.</p><p><strong>Patients and methods: </strong>This multicenter retrospective study included mRCC patients responding to ipilimumab/nivolumab in first-line or nivolumab in later lines, who were treated for at least 21 months and did not stop for toxicity. Progression-free survival (PFS), overall survival (OS), and cancer-specific survival (CSS) were modeled non- and semi-parametrically. The effect of elective ICPI discontinuation (i.e. treatment interruption at the clinician's discretion) between 21 and 25 months on PFS was assessed by a causal inference approach using artificial censoring along with inverse probability of censoring weighting.</p><p><strong>Results: </strong>Ninety-five patients were included with a median follow-up of 62.1 (95% confidence interval [CI]: 57.3-67.5) months. Fifty-four received ipilimumab/nivolumab, whereas 41 patients received nivolumab, for a median treatment duration of 33.8 (95% CI: 28.5-39.6) months. Fifty-seven patients discontinued ICPIs electively. Three-year PFS after discontinuation was 57.1% (95% CI: 34.3-95.1), 3-year OS 67.5% (95% CI: 37.0-100.0), and 3-year CSS 90.0% (95% CI: 73.2-100.0). Fifteen (15.8%) patients discontinued ICPIs between 21 and 25 months. Compared to 80 patients who were treated longer, they had more often a metachronous metastatic pattern (p = 0.048) and a complete response (p = 0.045). Elective ICPI stop between 21 and 25 months did not significantly impact the hazard for progression/death (adjusted HR 1.08, 95% CI: 0.64-1.84, p = 0.766).</p><p><strong>Interpretation: </strong>Among mRCC patients responding to ICPI, elective therapy discontinuation approximately 24 months after initiation does not appear to compromise outcomes compared to continuing therapy.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"979-988"},"PeriodicalIF":2.7,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740823","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-reported outcomes after chemoradiotherapy for anal cancer. 患者报告的肛门癌放化疗后的结果。
IF 2.7 3区 医学
Acta Oncologica Pub Date : 2025-07-30 DOI: 10.2340/1651-226X.2025.43636
Kathinka Schmidt Slørdahl, Eva Skovlund, Jan-Åge Olsen, Ragnhild Tvedt, Maria Thomsen, Stein Kaasa, Marianne Grønlie Guren
{"title":"Patient-reported outcomes after chemoradiotherapy for anal cancer.","authors":"Kathinka Schmidt Slørdahl, Eva Skovlund, Jan-Åge Olsen, Ragnhild Tvedt, Maria Thomsen, Stein Kaasa, Marianne Grønlie Guren","doi":"10.2340/1651-226X.2025.43636","DOIUrl":"https://doi.org/10.2340/1651-226X.2025.43636","url":null,"abstract":"<p><strong>Background and purpose: </strong>Chemoradiotherapy (CRT) for squamous cell carcinoma of the anus (SCCA) results in favorable survival. However, treatment intensity must be balanced against late side effects. The aim of this current study was to prospectively investigate patient-reported outcomes (PROs) before CRT and up to 5 years after completed CRT for SCCA. Patient/material and methods: This prospective study included 120 patients with SCCA receiving CRT to total doses of 54-58 Gy with concomitant mitomycin and 5-fluorouracil. Patients completed PRO questionnaires before CRT, and at 3 months, 1-, 3-, and 5 years after completed CRT. The questionnaires were the EORTC QLQ-C30 and QLQ-CR29, St. Marks incontinence score, Fatigue Questionnaire, the Hospital Anxiety and Depression Scale, and a scoring for neuroticism.</p><p><strong>Results: </strong>Patients reported a high burden of symptoms and impaired functional outcomes prior to treatment. Tumor-related symptoms, such as buttock pain, improved (difference 11.1, p = 0.002) at a clinically relevant level 3 months after CRT, consistent with tumor response. Other functional outcomes and symptoms, such as body image (difference 11.5, p < 0.001), worsened. While some outcomes, such as anxiety (difference 10.4, p = 0.001), improved over time, several were persistently impaired, in particular anorectal and sexual function, where symptom burden remained high 5 years after CRT. Chronic fatigue (CF) was reported by 28% of patients at 5-year follow-up.</p><p><strong>Interpretation: </strong>Five years after CRT for SCCA, patients report a persistently high symptom burden regarding anorectal and sexual function, and one-third report CF, demonstrating the long-term impact of treatment.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"1005-1013"},"PeriodicalIF":2.7,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740824","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
Incidence, characteristics, and survival in early- and late-onset colorectal cancer. 早、晚发性结直肠癌的发病率、特征和生存率。
IF 2.7 3区 医学
Acta Oncologica Pub Date : 2025-07-30 DOI: 10.2340/1651-226X.2025.43349
Tanja Hukkinen, Karri Seppä, Nea Malila, Anna Lepistö, Camilla C Böckelman, Laura Koskenvuo
{"title":"Incidence, characteristics, and survival in early- and late-onset colorectal cancer.","authors":"Tanja Hukkinen, Karri Seppä, Nea Malila, Anna Lepistö, Camilla C Böckelman, Laura Koskenvuo","doi":"10.2340/1651-226X.2025.43349","DOIUrl":"https://doi.org/10.2340/1651-226X.2025.43349","url":null,"abstract":"<p><strong>Background and purpose: </strong>To study incidence changes, tumor characteristics, and relative survival (RS) among patients with early- (18-49 years) and late-onset (≥50 years) colorectal cancer (CRC). Patient/material and methods: In this retrospective registry study, all patients diagnosed with CRC in Finland between 1991 and 2015 were included and followed until death or the end of 2022. Data were extracted from the Finnish Cancer Registry. Changes in incidence as an average annual percentage change as well as age- and sex-standardized RS for CRC were estimated for 5-year periods between 1991-1995 and 2011-2015.</p><p><strong>Results: </strong>The annual increase in incidence was higher for early-onset CRC versus late-onset CRC (1.2% vs. 0.44%), primarily due to an increase in left-sided colon cancer (2.0%) and rectal cancer (1.5%). Among 59,631 CRC patients, 3,988 (6.7%) had early-onset CRC, of whom 2,073 (52%) were female. Among 55,643 late-onset CRC patients, 27,796 (50%) were female. Among early-onset CRCs, 44% were right-sided, 19% left-sided, and 34% rectal compared with late-onset CRCs, of which 33% were right-sided, 23% left-sided, and 38% rectal. The 5-year RS for early-onset male patients improved from 64% to 72% and for female patients from 69% to 77%, whereas in late-onset patients, survival improved from 51% to 64% among males and from 52% to 67% among females.</p><p><strong>Interpretation: </strong>The incidence of early-onset CRC is increasing more rapidly than for late-onset CRC. Overall, 5-year RS has improved and is higher in early-onset CRC patients compared with late-onset CRC.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"997-1004"},"PeriodicalIF":2.7,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740821","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
Internal mammary node irradiation in early breast cancer - target coverage and implications on dose to organs at risk. 早期乳腺癌内乳腺淋巴结照射的靶标覆盖范围及其对危险器官剂量的影响。
IF 2.7 3区 医学
Acta Oncologica Pub Date : 2025-07-30 DOI: 10.2340/1651-226X.2025.43716
Lovisa Berg, Jeanette Sporre, Elisabeth Kjellén, Sofie Ceberg, Elinore Wieslander, Sara Alkner
{"title":"Internal mammary node irradiation in early breast cancer - target coverage and implications on dose to organs at risk.","authors":"Lovisa Berg, Jeanette Sporre, Elisabeth Kjellén, Sofie Ceberg, Elinore Wieslander, Sara Alkner","doi":"10.2340/1651-226X.2025.43716","DOIUrl":"https://doi.org/10.2340/1651-226X.2025.43716","url":null,"abstract":"<p><strong>Purpose: </strong>Indications for radiotherapy (RT) of the internal mammary nodes (IMN) in early breast cancer vary between countries. While studies indicate benefits, IMN RT increases the dose to the heart and lungs, and the risk-benefit ratio of this treatment is debated. This study investigates how IMN RT affects dose to organs at risk (OAR) and pneumonitis incidence in a clinical setting.</p><p><strong>Methods: </strong>This retrospective study includes breast cancer patients receiving adjuvant locoregional RT with and without IMN included in the target volume at Skåne University Hospital, Sweden, from 2018 to 2021. Treatment plans followed national dose-volume criteria, prioritizing lung and heart over IMN coverage. A total of 247 treatment plans for locoregional RT with IMN were compared to 397 without. Dose to OAR, IMN coverage and pneumonitis incidence were investigated.</p><p><strong>Results: </strong>The mean ipsilateral lung dose increased by 2.7 Gy with IMN RT (p < 0.001), and the mean heart dose (left-sided treatment) by 0.5 Gy (p < 0.001). Both irradiated and treated volume in relation to planning target volume (PTV) increased with ~20% (p < 0.001). Desired IMN coverage was achieved in 76% of the plans, with lung dose exceeding recommended constraints as the primary reason for decreased target coverage in the remaining plans. Of the 220 patients with follow-up of ≥6 months, 2 (0.9%) were diagnosed with pneumonitis grade 2.</p><p><strong>Interpretation: </strong>Introduction of IMN RT primarily resulted in an increased lung dose. However, rate of symptomatic pneumonitis was low. Most patients achieved desired IMN coverage using 3D-CRT, with lung dose being the limiting factor.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"989-996"},"PeriodicalIF":2.7,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740822","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
Preclinical study of reirradiation with hyperthermia in recurrent murine tumors and normal mouse skin. 复发性小鼠肿瘤和正常小鼠皮肤热疗再照射的临床前研究。
IF 2.7 3区 医学
Acta Oncologica Pub Date : 2025-07-27 DOI: 10.2340/1651-226X.2025.43995
Charlemagne A Folefac, Priyanshu M Sinha, Niels Bassler, Brita S Sørensen, Michael R Horsman
{"title":"Preclinical study of reirradiation with hyperthermia in recurrent murine tumors and normal mouse skin.","authors":"Charlemagne A Folefac, Priyanshu M Sinha, Niels Bassler, Brita S Sørensen, Michael R Horsman","doi":"10.2340/1651-226X.2025.43995","DOIUrl":"10.2340/1651-226X.2025.43995","url":null,"abstract":"<p><strong>Background: </strong>Re-irradiation is an essential treatment option for recurrent tumours but is limited by normal tissue tolerance. Hyperthermia can enhance radiation efficacy by impairing DNA repair and improving tumor oxygenation; however, limited preclinical data are evaluating its combination with re-irradiation in recurrent tumor settings and normal skin.</p><p><strong>Objective: </strong>The study aims to determine optimal priming doses for skin and tumor response and evaluate the radiosensitising effect of hyperthermia when combined with re-irradiation in preclinical models.</p><p><strong>Methods: </strong>The right rear foot of non-tumor-bearing CDF1 mice or a C3H mammary carcinoma implanted in the foot were treated with a single radiation dose or reirradiation + hyperthermia (42.5°C, 1-h). Initial experiments identified a priming dose of 30 Gy that induced moderate but reversible acute skin toxicity and a tumor dose of 40 Gy that resulted in full regression with regrowth in 30-35 days from treatment. Reirradiation dose-response studies were conducted to determine the MDD₅₀ (skin) and TCD₅₀ (tumor) with and without hyperthermia. Thermal Enhancement Ratios (TER) and Therapeutic Gain Factor (TGF) were calculated.</p><p><strong>Results: </strong>The MDD₅₀ for reirradiation-induced skin damage was 25 Gy, reduced to 18 Gy with hyperthermia (TER = 1.4). In tumours, the TCD₅₀ decreased from 49 Gy (reirradiation alone) to 29 Gy with hyperthermia (TER = 1.7). A TGF of 1.2 was observed, indicating selective enhancement of tumor response relative to skin toxicity.</p><p><strong>Conclusion: </strong>Hyperthermia enhances the therapeutic effect of reirradiation by improving tumor control at lower doses, supporting its potential in recurrent cancer treatment strategies.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"972-978"},"PeriodicalIF":2.7,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717165","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
Real-world insights into moderately hypofractionated thoracic radiotherapy in elderly and multimorbid patients with stage II/III NSCLC: a retrospective study. 一项回顾性研究:中度低分割胸部放疗治疗老年和多病II/III期NSCLC患者的现实见解
IF 2.7 3区 医学
Acta Oncologica Pub Date : 2025-07-25 DOI: 10.2340/1651-226X.2025.43496
Helene Kravutske, Sina Mansoorian, Lukas Käsmann, Janina Lehmann, Cedric Richlitzki, Diego Kauffmann-Guerrero, Nina-Sophie Schmidt-Hegemann, Niels Reinmuth, Amanda Tufman, Julien Dinkel, Richard Gaus, Farkhad Manapov, Claus Belka, Chukwuka Eze
{"title":"Real-world insights into moderately hypofractionated thoracic radiotherapy in elderly and multimorbid patients with stage II/III NSCLC: a retrospective study.","authors":"Helene Kravutske, Sina Mansoorian, Lukas Käsmann, Janina Lehmann, Cedric Richlitzki, Diego Kauffmann-Guerrero, Nina-Sophie Schmidt-Hegemann, Niels Reinmuth, Amanda Tufman, Julien Dinkel, Richard Gaus, Farkhad Manapov, Claus Belka, Chukwuka Eze","doi":"10.2340/1651-226X.2025.43496","DOIUrl":"10.2340/1651-226X.2025.43496","url":null,"abstract":"<p><strong>Purpose: </strong>Investigating real-world outcomes of moderately hypofractionated radiotherapy (hypoRT) in elderly and multimorbid stage IIB-IIIC non-small-cell lung cancer (NSCLC) patients ineligible for concurrent chemoradiation.</p><p><strong>Methods: </strong>We retrospectively analysed 70 patients with primary or recurrent stage IIB-IIIC NSCLC (TNM, 8th edition). HypoRT was administered to a total dose of 38-56 Gy in 10-17 fractions (2.5-3.8 Gy/fraction). Patterns of recurrence, survival outcome, and toxicity were assessed.</p><p><strong>Results: </strong>Seventy patients, with a median age of 76.4 years (range: 51.6-88.2 years), who received hypoRT between August 2015 and September 2022, were reviewed. At baseline, the median Charlson Comorbidity Index (CCI) with oncological diagnosis was 8 (range: 3-13). With a median follow-up post-radiotherapy of 63.9 months (95% Confidence Interval [CI]: 34.8-93.1 months), median progression-free survival (PFS) was 7.6 months (95% CI 6.0-11.0 months), and the median overall survival (OS) was 20.7 months (95% CI 16.7-30.7 months). Competing risk analysis revealed 12-month cumulative incidences of locoregional and distant failure in 41% (95% CI 30-53%) and 14% (95% CI 6-23%) of patients, respectively. Following disease progression, 45 patients received subsequent therapy: 25 underwent additional radiotherapy, 22 received systemic treatment (including immunotherapy), and 19 were referred for best supportive care. Treatment was well tolerated; only 3 patients (4%) developed grade 3 pneumonitis. No adverse events of grade > 3 were reported.</p><p><strong>Interpretation: </strong>Moderately hypoRT is a safe, feasible, and effective treatment option for elderly and multimorbid patients with stage IIB-IIIC NSCLC, offering encouraging survival outcomes and low toxicity rates. Future prospective studies are needed to validate these findings and optimise treatment strategies for this high-risk population.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"957-965"},"PeriodicalIF":2.7,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144705968","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}
引用次数: 0
Role of prophylactic cranial irradiation in patients with limited disease small cell lung cancer: A Danish single institution cohort. 预防性颅照射在有限病变小细胞肺癌患者中的作用:丹麦单一机构队列研究
IF 2.7 3区 医学
Acta Oncologica Pub Date : 2025-07-25 DOI: 10.2340/1651-226X.2025.43935
Sara Linde, Marianne Maquard Knap, Lone Hoffmann, Azza Ahmed Kahlil, Christina Maria Lutz, Maria Kandi, Lise Saksø Mortensen, Ditte Sloth Møller, Hjørdis Hjalting Schmidt
{"title":"Role of prophylactic cranial irradiation in patients with limited disease small cell lung cancer: A Danish single institution cohort.","authors":"Sara Linde, Marianne Maquard Knap, Lone Hoffmann, Azza Ahmed Kahlil, Christina Maria Lutz, Maria Kandi, Lise Saksø Mortensen, Ditte Sloth Møller, Hjørdis Hjalting Schmidt","doi":"10.2340/1651-226X.2025.43935","DOIUrl":"10.2340/1651-226X.2025.43935","url":null,"abstract":"<p><strong>Background and purpose: </strong>Prophylactic cranial irradiation (PCI) is part of standard treatment for patients with limited disease small cell lung cancer (LD-SCLC), treated with curative intent. However, doubt has been raised about the efficacy of PCI in a modern clinical setting. Therefore, we examined factors impacting PCI receival, the cumulative incidence of symptomatic brain metastases, and overall survival (OS) with and without PCI. Patient/material and methods: Records of 190 patients with LD-SCLC consecutively treated between 2012 and 2021 at our institution were reviewed. Patients were grouped based on whether they received PCI (PCI, n = 119) or not (no PCI, n = 71). Baseline characteristics, Kaplan-Meier estimates of OS, and cumulative incidence of symptomatic brain metastases were compared for the two groups.</p><p><strong>Results: </strong>PCI no patients were older, had a poorer performance status, were more often treated in 2018-2021 and had more frequently a brain magnetic resonance imaging (MRI) at the time of diagnosis. No PCI median OS was 19 months compared to 24 months for PCI, not significantly different (p = 0.40). During follow-up 54 patients (28.4%) developed symptomatic brain metastases, with no statistically significant difference in the numbers of patients with, and cumulative incidence of, symptomatic brain metastases between the two groups (p = 0.35 and p = 0.21, respectively).</p><p><strong>Interpretation: </strong>Despite patients not receiving PCI being older and in poorer performance status, no statistically significant difference in OS or cumulative incidence of brain metastasis were observed compared to patients who received PCI. This supports uncertainty regarding the role of PCI.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"966-971"},"PeriodicalIF":2.7,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144705969","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}
引用次数: 0
Clinical workflow for reirradiation: national consensus recommendations on imaging, treatment planning, dose accumulation, and treatment delivery. 再照射的临床工作流程:关于成像、治疗计划、剂量积累和治疗递送的国家共识建议。
IF 2.7 3区 医学
Acta Oncologica Pub Date : 2025-07-24 DOI: 10.2340/1651-226X.2025.43567
Laura P Kaplan, Rebecca J Tobin, Ane Appelt, Eliana Vasquez Osorio, Isak Wahlstedt, Rasmus L Christiansen, Martin S Nielsen, Laura A Rechner, Simon N Thomsen, Mikkel D Lund, Kenneth Jensen, Camilla Kronborg, Lone Hoffmann
{"title":"Clinical workflow for reirradiation: national consensus recommendations on imaging, treatment planning, dose accumulation, and treatment delivery.","authors":"Laura P Kaplan, Rebecca J Tobin, Ane Appelt, Eliana Vasquez Osorio, Isak Wahlstedt, Rasmus L Christiansen, Martin S Nielsen, Laura A Rechner, Simon N Thomsen, Mikkel D Lund, Kenneth Jensen, Camilla Kronborg, Lone Hoffmann","doi":"10.2340/1651-226X.2025.43567","DOIUrl":"10.2340/1651-226X.2025.43567","url":null,"abstract":"<p><strong>Background and purpose: </strong>Reirradiation is becoming more frequent in clinical practice. However, workflows and practices vary widely between clinics, as general guidelines are scarce or lacking in practical detail. This paper presents comprehensive national Danish consensus recommendations covering all steps of the reirradiation workflow. The aim is to standardise and improve reirradiation treatment quality and provide guidance for much-needed large-scale clinical trials.</p><p><strong>Methods: </strong>An expert panel was formed comprising physicians, clinical physicists, and clinical researchers from all Danish radiotherapy centres. An in-person 2-day workshop was followed by multiple online meetings. Recommendations were based on expert consensus, supported by review of existing literature, and were reviewed by all Danish Multidisciplinary Cancer Groups before publication.</p><p><strong>Results: </strong>Reirradiation cases should be designated clearly as such at each workflow step. Review of patient cases at multidisciplinary reirradiation conferences is encouraged. Immobilisation, positioning, and motion management should resemble that of previous treatment(s) as closely as possible. Information on previous dose should be used in planning and evaluation. The degree of complexity (e.g. summation of dose maxima, rigid/deformable image registration, 3D dose accumulation) should reflect the clinical situation as well as the extent/quality of available information. Dose should always be converted to an equieffective dose before summation. Daily image-guidance and regular evaluation of delivered dose are recommended. We provide guidance on quality assurance of dose mapping and guidelines for clinical reirradiation trials.</p><p><strong>Interpretation: </strong>We present national consensus guidelines for site-independent reirradiation treatment workflows. The guidelines have been approved by the site-specific Danish Multidisciplinary Cancer Groups.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"946-956"},"PeriodicalIF":2.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697318","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}
引用次数: 0
Heart failure in long-term survivors of childhood cancer - a systematic review and meta-analysis of population-based studies. 儿童癌症长期幸存者的心力衰竭——基于人群研究的系统回顾和荟萃分析。
IF 2.7 3区 医学
Acta Oncologica Pub Date : 2025-07-23 DOI: 10.2340/1651-226X.2025.43654
Tove Berg, Jens Böhmer, Bright Nwaru, Kristjan Karason, Marianne Jarfelt
{"title":"Heart failure in long-term survivors of childhood cancer - a systematic review and meta-analysis of population-based studies.","authors":"Tove Berg, Jens Böhmer, Bright Nwaru, Kristjan Karason, Marianne Jarfelt","doi":"10.2340/1651-226X.2025.43654","DOIUrl":"10.2340/1651-226X.2025.43654","url":null,"abstract":"<p><strong>Background and purpose: </strong>Heart failure is a well-recognised and serious non-malignant late complication among childhood cancer survivors. The primary aim of conducting this systematic review was to identify, critically appraise and synthesise population-based studies reporting on the incidence and/or prevalence of heart failure in 5-year survivors of childhood cancer (age < 18 years).</p><p><strong>Methods: </strong>We conducted this systematic review in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) in April 2021 (registration number: CRD42021247622) and published in June 2022. We searched databases Medline, Embase, Scopus, CINAHL, CAB International, AMED, Global Health, Psycinfo, Web of science and Google Scholar from their inception date until March 14, 2023. Screening, data extraction and quality assessment were conducted independently by two reviewers. The Effective Public Healthcare Practice Project tool was used for quality assessment.</p><p><strong>Results: </strong>Following a comprehensive review of the 3,883 records, only four were found to be eligible for inclusion. The overall quality of the studies was evaluated as strong in two studies and moderate in the remaining two studies. A subsequent meta-analysis of three comparable studies yielded a cumulative incidence of 0.99% (95% confidence interval [CI] 0.57-1.42) over an extended period of 5.0-72.5 years (I-squared = 94.4%, p < 0.001).</p><p><strong>Interpretation: </strong>Existing population-based studies reporting on heart failure in 5-year childhood cancer survivors are few and heterogeneous. Future population-based studies comparing heart failure incidence in childhood cancer survivors with the general population would be of significant value.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"917-926"},"PeriodicalIF":2.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688516","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
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信