Acta Oncologica最新文献

{"title":"User perceptions of machine learning models as decision support for colorectal cancer multidisciplinary team conferences (AID-SIM-2): a qualitative simulation study.","authors":"Karoline Bendix Bräuner, Birgitte Bruun, Claus Anders Bertelsen, Vegar Johansen Dagenborg, Kristina Safir-Hansen, Rasmus Sanko, Ismail Gögenur, Lars Konge","doi":"10.2340/1651-226X.2026.45754","DOIUrl":"10.2340/1651-226X.2026.45754","url":null,"abstract":"<p><strong>Background: </strong>Multidisciplinary team (MDT) conferences are considered a cornerstone of decision-making in cancer diagnostics and care. However, the current literature has not demonstrated improved patient outcomes based on the decisions of the MDT conferences.</p><p><strong>Aim: </strong>We aimed to evaluate how four different decision-support modalities impacted the decision-making process and the internal discussions in the MDTs in a multicenter simulation study, with a focus on user perceptions.</p><p><strong>Methods: </strong>Four colorectal cancer centers with MDTs participated. We performed four simulations in each center. Each simulation used a different decision-support tool: (1) Current standard, (2) Current standard plus a prediction model, (3) A structured data presentation tool, and (4) A structured data presentation tool plus the prediction model. Clinician- and model-estimated risks were compared, the treatment suggestions from each site were compared, questionnaires about user perceptions were conducted after Simulations 2, 3, and 4 using a Google Form link, and a semi-structured interview was conducted at each site after the last simulation.</p><p><strong>Results: </strong>Similar distributions of risk groups between clinicians and models were found; however, distinct discrepancies in predictions arose, particularly with higher-risk patients, highlighting the need for standardization for more complex clinical cases. The primary perceived benefit of decision support was increased standardization of care, independent of the individual physicians' personal views. However, participants emphasized the necessity of clinician autonomy to overrule tool suggestions when identifying clinical nuances not captured by the model.</p><p><strong>Conclusions: </strong>The colorectal cancer MDTs expressed a positive view regarding the use of prediction models and other forms of decision-support in their workflow. While clinicians and prediction models had similar risk score distributions, they diverged in the assessment of specific individual patients.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"668-678"},"PeriodicalIF":2.7,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629204","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":"The Clinical outcomes following pencil beam scanning proton therapy for skull base chordoma and chondrosarcoma: a single-institution experience.","authors":"Tomasz Skóra, Kamila Rawoj C, Joanna Anioł, Tomasz Banaś, Anna Cepiga, Agnieszka Chrostowska, Adrianna Chudyba, Magdalena Garbacz, Eleonora Góra, Damian Kabat, Emilia Krzywonos, Tomasz Mikołajski, Jadwiga Nowak-Sadzikowska, Anna Patla, Elżbieta Pluta, Antoni Rucinski, Konrad Urbanek, Dominika Wojton-Dziewońska, Mariusz Wszołek, Renata Kopeć, Kamil Kisielewicz","doi":"10.2340/1651-226X.2026.45297","DOIUrl":"10.2340/1651-226X.2026.45297","url":null,"abstract":"<p><strong>Background: </strong>Chordomas and chondrosarcomas of the skull base are rare, locally aggressive tumors that pose significant therapeutic challenges due to their proximity to critical anatomical structures. While maximal safe surgical resection remains the cornerstone of management, the infiltrative nature of these tumors often precludes radical excision, necessitating adjuvant radiotherapy. Given their relative radioresistance, high-dose radiotherapy exceeding 70 Gray Relative Biological Effectiveness (GyRBE) is required to achieve durable local control. This study evaluated long-term outcomes and toxicity following pencil beam scanning (PBS) proton therapy in patients with skull base chordoma and chondrosarcoma.</p><p><strong>Methods: </strong>We retrospectively analyzed 76 patients (50 chordoma, 26 chondrosarcoma) treated with curative-intent PBS between 2016 and 2020. Median prescribed doses were 74.0 GyRBE for chordomas and 70.0 GyRBE for chondrosarcomas. Clinical endpoints included overall survival (OS), local failure-free survival (LFFS), distant metastasis-free survival (DMFS), and toxicity graded according to CTCAE v5.0.</p><p><strong>Results: </strong>At a median follow-up of 70.2 months, 5-year OS, LFFS, and DMFS for the entire cohort were 84.0, 86.9, and 92.7%, respectively. Local control was numerically higher in chondrosarcoma (96.1%) than in chordoma (81.9%; p = 0.116). Tumor contact with the optic apparatus or brainstem was associated with worse OS (p = 0.0034 and p = 0.0151, respectively) and proximity to the optic pathways correlated with poorer local control (p = 0.0182). Grade ≥ 3 late toxicity occurred in 9.2% of patients, predominantly hearing impairment and temporal lobe necrosis.</p><p><strong>Conclusions: </strong>PBS achieves excellent local control and survival with an acceptable safety profile in skull base chordoma and chondrosarcoma. Our findings align with ongoing efforts toward dose intensification, hypofractionation, and particle selection. Moreover, emerging integration of artificial intelligence for contouring, treatment adaptation, and toxicity prediction, along with augmented reality-assisted positioning and patient education, promises to further enhance treatment precision and outcomes. Through long-term follow-up and engagement with international research initiatives, our institution contributes to the global advancement of biologically guided, high-precision radiotherapy for rare skull base malignancies.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"679-688"},"PeriodicalIF":2.7,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629237","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":"Medical physics in the Nordic countries: collaboration and future challenges - report from the Nordic Association for Clinical Physics 2026 Symposium.","authors":"Emelie Adolfsson, Jan Seppälä","doi":"10.2340/1651-226X.2026.46249","DOIUrl":"10.2340/1651-226X.2026.46249","url":null,"abstract":"","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"652-654"},"PeriodicalIF":2.7,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13430637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148617886","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":"Estimated number of children affected by paternal cancer diagnosis and death in Finland during 1970-2022: a population-based registry study.","authors":"Anniina Kyrönlahti, Eetu Mäkinen, Karri Seppä, Tea Lallukka, Janne Pitkäniemi","doi":"10.2340/1651-226X.2026.45653","DOIUrl":"10.2340/1651-226X.2026.45653","url":null,"abstract":"<p><strong>Background and purpose: </strong>Parental cancer effects millions of children worldwide. We estimated the number of children influenced by paternal cancer and paternal orphans, and examined changes in their numbers and annual rates over time, with a focus on time trends and the influence of cancer type.</p><p><strong>Patients and methods: </strong>Male cancer patients aged ≥15 years, diagnosed since 1953, were identified from the Finnish Cancer Registry. Cancer deaths and information on live births were obtained from Statistics Finland. Annual number of new children and prevalent children whose father was diagnosed with cancer and the annual number of new orphans and prevalent orphans due to paternal cancer death for 1970-2022 were estimated indirectly by combining cancer incidence and mortality data with population-level fertility rates.</p><p><strong>Results: </strong>The estimated age-standardized rate of new children with paternal cancer increased from 96/100,000 children in 1970-1974 to 163/100,000 in 2017-2021. The annual rate of new paternal orphans decreased from 56/100,000 in 1970-1974 to 35/100,000 in 2017-2021. The rate of new children increased 1.1% per year while the rate of new orphans decreased 1.1% in 1970-2021.</p><p><strong>Interpretation: </strong>Although the number of paternal orphans is decreasing due to improved cancer survival, the number of children influenced by paternal cancer is rising reflecting the increasing cancer incidence and resulting in more children vulnerable to the harmful effects of paternal cancer.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"661-667"},"PeriodicalIF":2.7,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13430636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148617870","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":"Declining melanoma incidence among younger adults in Sweden: insights from histopathological subtypes and the role of immigration.","authors":"Yodit Girmay, Rasmus Mikiver, Jan Lapins, Karolin Isaksson, Hildur Helgadottir","doi":"10.2340/1651-226X.2026.45887","DOIUrl":"10.2340/1651-226X.2026.45887","url":null,"abstract":"","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"655-660"},"PeriodicalIF":2.7,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13430635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148617918","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":"The impact of pazopanib and extremity radiotherapy on transaminase elevations in soft tissue sarcoma.","authors":"Bauke H G Van Riet, Shermarke Hassan, Thomas R De Wijkerslooth, Tom T P Seijkens, Alwin D R Huitema, Neeltje Steeghs, Rick L Haas","doi":"10.2340/1651-226X.2026.46196","DOIUrl":"10.2340/1651-226X.2026.46196","url":null,"abstract":"<p><strong>Background and purpose: </strong>Unexpected high rates of grade ≥ 3 transaminase elevations were observed in patients receiving pazopanib and extremity radiotherapy. Although alanine transaminase (ALT) and aspartate transaminase (AST) primarily originate from the liver, both are also present in muscle tissue. In extremity soft tissue sarcomas (STS), where large muscle volumes are within the radiation field, radiation-induced muscle damage may contribute to these elevations. This study evaluated the impact of extremity radiotherapy, pazopanib, and their combination on the incidence and degree of ALT/AST elevations in STS patients.</p><p><strong>Patients and methods: </strong>A prospective cohort treated with extremity radiotherapy alone was combined with a retrospective cohort treated with pazopanib alone or in combination. Patient characteristics, treatment details, and laboratory values (liver enzymes and muscle injury biomarkers) were collected. Descriptive analyses and logistic regression were conducted to evaluate the association with grade ≥ 3 ALT/AST elevations.</p><p><strong>Results: </strong>Among 154 patients (10 radiotherapy, 108 pazopanib, 36 radiotherapy plus pazopanib), none of the radiotherapy-only patients experienced grade ≥ 3 elevations. Post-irradiation ALT/AST, creatine kinase and myoglobin elevations were minimal. Grade ≥ 3 elevations occurred in 6% of patients receiving pazopanib and 36% of those receiving both radiotherapy and pazopanib. All elevations typically resolved after pazopanib discontinuation. Grade ≥ 3 elevations were significantly associated with pazopanib, and modestly associated with pazopanib trough levels (odds ratio [OR]: 1.43 per 10 mg/L, 95% confidence interval [CI]: 1.12-1.90), but not with radiotherapy.</p><p><strong>Interpretation: </strong>Adding pazopanib to radiotherapy in localised extremity sarcoma significantly increases the rate of AST/ALT elevations. Extremity radiotherapy alone does not induce clinically relevant transaminase elevations. Grade ≥ 3 elevations were associated with pazopanib treatment. The mechanism underlying the substantially higher incidence of transaminase elevations with combined pazopanib and radiotherapy, compared with pazopanib alone, remains unknown.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"641-651"},"PeriodicalIF":2.7,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13421152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148597565","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":"Changing burden of cancers related to human papillomavirus in Estonia: a population-based registry study.","authors":"Sandra Kase, Mari-Liis Zimmermann, Margit Mägi, Aleksei Baburin, Keiu Paapsi, Reeli Hallik, Piret Veerus, Jana Jaal, Kaire Innos","doi":"10.2340/1651-226X.2026.45671","DOIUrl":"10.2340/1651-226X.2026.45671","url":null,"abstract":"<p><strong>Background and purpose: </strong>Human papillomavirus (HPV) causes multiple cancers. Understanding HPV-related cancer burden may help implement effective strategies for cancer prevention. The aim was to examine incidence and survival trends of eight HPV-related cancer sites in Estonia and estimate the number of cases attributable to HPV. Patient/material and methods: The Estonian Cancer Registry provided data on all cases of eight HPV-related cancer sites diagnosed in Estonia during 1995-2022. Age-standardized incidence trends were analyzed using joinpoint regression, estimating annual percentage change (APC). The number of HPV-attributable cases was estimated using internationally derived site-specific attributable fractions, as tumor HPV status was not available. Five-year relative survival ratios were calculated from national life tables.</p><p><strong>Results: </strong>In all, 11,266 cases of HPV-related cancer sites were diagnosed, of which 6,263 were estimated to be attributable to HPV; over 40% occurred before age 55. In women, estimated average annual number of HPV-attributable cases nearly quadrupled for oropharyngeal cancer (OPC) and tripled for anal cancer. A significant increase in OPC and anal cancer incidence was observed among women (APC 10.0 and 3.8, respectively). Cervical cancer incidence declined after 2012 (APC -5.6). Survival improved for OPC in men (from 13 to 44%) and vaginal cancer in women (from 45 to 73%).</p><p><strong>Interpretation: </strong>HPV-related cancer patterns in Estonia are shifting from cervical to non-cervical cancers. Increasing oropharyngeal and anal cancer incidence highlights the need for prevention strategies beyond cervical screening alone. Strengthening HPV vaccination uptake and sustaining organized cervical screening are critical for reducing future cancer burden.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"632-640"},"PeriodicalIF":2.7,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13421172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590146","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":"Patients' preferences for follow-up after endometrial cancer surgery.","authors":"Linn Renman, Lotta Andréen, Sahruh Turkmen","doi":"10.2340/1651-226X.2026.45981","DOIUrl":"10.2340/1651-226X.2026.45981","url":null,"abstract":"<p><strong>Background and purpose: </strong>To compare follow-up preferences and health-related quality of life between newly operated endometrial cancer patients and those already enrolled in a traditional hospital-based follow-up program, and to explore whether preferences differ depending on follow-up experience. Patient/material and methods: In this prospective cross-sectional study, patients who underwent primary surgery for endometrial cancer in northern Sweden were included. Group 1 consisted of newly operated patients recruited before entering follow-up, and Group 2 included patients already participating in the standard hospital-based follow-up program. Participants completed questionnaires on sociodemographic characteristics, follow-up preferences, and quality of life (EORTC QLQ-C30). Clinical data were obtained from medical records. The primary outcome was follow-up preference; secondary outcomes included quality of life and associations with clinical and demographic variables.</p><p><strong>Results: </strong>Of the 121 invited patients, 92 (76%) responded, and 90 were included in the analysis (48 in Group 1; 42 in Group 2). The groups were comparable in baseline characteristics. Newly operated patients demonstrated more diverse follow-up preferences, with 51.1% preferring physician-led hospital visits compared to 82.9% in Group 2 (p = 0.035). Global quality of life did not differ significantly (p = 0.165), although Group 1 reported lower functional scores, particularly in role and emotional functioning. Appetite loss was the only symptom that differed significantly between groups.</p><p><strong>Interpretation: </strong>Newly operated patients are more open to alternative follow-up models despite similar overall quality of life. Integrating patient preferences into follow-up care may enhance personalization and sustainability.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"624-631"},"PeriodicalIF":2.7,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13421151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590220","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":"Dose calculation errors for volumetric modulated arc therapy plans of various complexity.","authors":"Emmanouil Terzidis, Fredrik Nordström, Magnus Gustafsson, Anna Karlsson, Julia Götstedt, Anna Bäck","doi":"10.2340/1651-226X.2026.45698","DOIUrl":"10.2340/1651-226X.2026.45698","url":null,"abstract":"<p><strong>Background and purpose: </strong>Volumetric modulated arc therapy (VMAT) plans often involve small and irregular beam apertures (i.e. high complexity), which can pose challenges for accurate dose calculations. The aim of this study was to investigate plausible dose calculation errors for VMAT plans of various complexity. Patient/material and methods: Twenty patient cases, each with three VMAT plans of different complexities (i.e. 60 plans in total), were included. All plans were calculated using six different dose calculation methods. It was assumed that greater differences between calculations reflect increased difficulty in accurately estimating dose. Basic performances of the six calculation methods were evaluated based on static fields. Three-dimensional distributions of voxel-wise two standard deviations (2SDs) in percent of local voxel dose were visually evaluated. 2SD volume histograms were analyzed as well as the mean (2SDMean) and maximum 2SD within 2 cm3 (2SD2cc) for different regions of interest.</p><p><strong>Results: </strong>Higher 2SD values were generally found outside the planning target volume (PTV) compared to inside, particularly in low dose and buildup regions. Average (per treatment site) 2SDMean/2SD2cc values were 0.9-1.2%/1.8-5.1% in the PTV and 1.8-3.1/8.4-18.7% for the region 1 cm outside the PTV. For organs of interest, 2SDMean/2SD2cc values were larger than the equivalent values in the PTV, with highest values up to 5/15% observed for the prostate cases.</p><p><strong>Interpretation: </strong>Variations between dose calculation methods were larger in organs of interest than in the PTVs. Differences in 2SD distributions between the patient cases were generally larger than differences between the complexity levels.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"614-623"},"PeriodicalIF":2.7,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13410304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576553","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":"Preliminary feasibility of pre-treatment F-18-PSMA-1007 PET/CT in dose prediction for Lu-177-PSMA-I&T therapy.","authors":"Suvi Kokkonen, Vappu Reijonen, Eero Hippeläinen, Veera Ahtiainen, Jukka Schildt, Outi Sipilä, Sauli Savolainen, Mikko Tenhunen","doi":"10.2340/1651-226X.2026.45700","DOIUrl":"10.2340/1651-226X.2026.45700","url":null,"abstract":"","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"65 ","pages":"609-613"},"PeriodicalIF":2.7,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547464","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}