Acta Oncologica最新文献

{"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320142/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12319755/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"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}

{"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}

{"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}

{"title":"Regional atrophy, cellular plasticity, and regenerative potential in irradiated murine salivary glands.","authors":"Inga Solgård Juvkam, Olga Zlygosteva, Olaf Joseph Franciscus Schreurs, Nina Jeppesen Edin, Hilde Kanli Galtung, Eirik Malinen, Tine Merete Søland","doi":"10.2340/1651-226X.2025.44012","DOIUrl":"10.2340/1651-226X.2025.44012","url":null,"abstract":"<p><strong>Background and purpose: </strong>Radiotherapy of head and neck cancer may cause detrimental late side effects such as fibrosis and hyposalivation. We investigated mouse salivary glands after fractionated irradiation, with the aim to elucidate cellular plasticity and potential regeneration.</p><p><strong>Methods: </strong>12-week-old female C57BL/6JRj mice were irradiated with X-rays to a total dose of 66 Gy, given in 10 fractions over 5 days. The radiation field covered the oral cavity and major salivary glands. The submandibular (SMG), sublingual (SLG), and parotid glands (PG) were dissected at day 100 after finishing irradiation. Using different histological staining techniques, morphological, cellular, and molecular changes were investigated in irradiated and control SMG, SLG, and PG.</p><p><strong>Results: </strong>Atrophy of acinar cells was observed in irradiated SMG and SLG, but not in PG. Surprisingly, the acinar atrophy was confined to one region of each irradiated gland. These atrophic regions showed distinct cellular and molecular compositions compared to non-atrophic regions and control glands. Increased expression of the ductal cell markers keratin 5 and 19 (K5 and K19), along with increased percentages of proliferating myofibroblasts, fibroblasts, leukocytes, and acinar cells (Nkcc1+) were observed in the atrophic regions compared to controls. In addition, some of the K19+ and K5+ duct-like cells also co-expressed Nkcc1.</p><p><strong>Interpretation: </strong>Through a detailed histological assessment of the cellular and molecular changes in the major salivary glands of irradiated mice, we observed signs of cellular plasticity where ductal cells adopt an acinar cell phenotype upon irradiation. This suggests a regenerative potential of salivary glands after irradiation.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"927-938"},"PeriodicalIF":2.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688519","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322935/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative proton and photon treatment plans in children treated for neuroblastoma.","authors":"Anna Embring, Ingrid Kristensen, Martin P Nilsson, Jacob Engellau, Malin Blomstrand, Charlotta Fröjd, Måns Agrup, Anna Flejmer, Anna-Maja Svärd, Anna Asklid","doi":"10.2340/1651-226X.2025.43865","DOIUrl":"10.2340/1651-226X.2025.43865","url":null,"abstract":"<p><strong>Background and purpose: </strong>Neuroblastoma is the most common extracranial solid tumour in children. Radiotherapy is commonly part of the multimodal treatment for high-risk patients. The aim of this study is to analyse doses to organs at risk (OAR) in comparative proton and photon treatment plans for children treated for neuroblastoma and report side effects. Patient/material and methods: All children in Sweden treated with curative intent radiotherapy for abdominal neuroblastoma in 2017-2024 with comparative proton and photon treatment plans were retrospectively identified through a national registry (RADTOX), where data on side effects were collected. Doses to OAR were compared in each patient's proton and photon treatment plans.</p><p><strong>Results: </strong>A total of 30 children with a median age of 45 months (range 11-150) were included. The low-dose spread was significantly lower in the proton compared to the photon treatment plans measured as Body V5Gy and V10Gy (p < 0.001). Furthermore, the mean doses to the bowel bag, kidneys, liver, pancreas, and spleen were significantly lower in the proton plans. The median follow-up was 14 months (1-61), and the 2-year overall survival was 75.3%. While acute radiotherapy related grade ≥ 2 side effects were experienced by 12 patients (40%), late side effects were experienced by 7 patients (13%). The most common side effects were haematological and from the upper gastrointestinal tract.</p><p><strong>Interpretation: </strong>In selected cases, proton treatment can offer lower doses to OAR and less low-dose exposure compared to photon treatment in children treated for abdominal neuroblastoma. Whether this translates into a clinical benefit is currently unclear and should be evaluated in future studies.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"939-945"},"PeriodicalIF":2.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688588","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":"Outcome of lung cancer surgery and proportion of lung cancer patients eligible for surgery in five Finnish hospitals in 2018, real world study.","authors":"Ville Paappanen, Jenny Tikka, Arja Jukkola, Tuula Klaavuniemi, Liisa Sailas, Maria Tengström, Hanne Kuitunen, Teemu Riekkinen, Satu Tiainen, Outi Kuittinen","doi":"10.2340/1651-226X.2025.43398","DOIUrl":"10.2340/1651-226X.2025.43398","url":null,"abstract":"<p><strong>Background and purpose: </strong>Lung cancer is one of the most common malignancies worldwide and is associated with high mortality. In Finland, overall lung cancer survival is lower than in other Nordic countries. A recent Finnish Cancer Registry publication reported that only 11.8% of patients underwent surgery. We aimed to assess whether operability and surgical outcomes contribute to Finland's inferior lung cancer survival rates.</p><p><strong>Material and methods: </strong>This retrospective study analysed patient data of five Finnish hospital databases. We focused on potentially operable patients, specifically those with non-small cell lung cancer in stage I-IIIA according to computer tomography. A total of 156 patients met the staging criteria, of whom 77 underwent surgery. Among potentially operable patients, 50.6% were deemed ineligible for surgery due to various factors, including poor pulmonary or cardiac function, comorbidities, or localised tumour spread.</p><p><strong>Results: </strong>In our material 156 out of 545 were potentially operable and 77 were operated. 2-year overall survival for operated patients was 79%.</p><p><strong>Interpretation: </strong>We found that patients with lung cancer in Finland present with poorer overall health, a slightly more advanced stage distribution among potentially operable cases, and a lower overall rate of surgical treatment compared to other Nordic countries. Additionally, patients in Finland tend to undergo surgery at more advanced stages. These factors likely contribute to Finland's lower lung cancer survival rates. This study underscores that delayed diagnosis and a lower proportion of patients undergoing surgery may be key contributors to Finland's poorer treatment outcomes.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"909-916"},"PeriodicalIF":2.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688517","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":"Radiation-induced changes of reactive astrocyte distribution in mice as a late response to partial-brain proton irradiation.","authors":"Robin Hegering, Sindi Nexhipi, Theresa Suckert, Johannes Soltwedel, Elke Beyreuther, Mechthild Krause, Antje Dietrich, Armin Lühr","doi":"10.2340/1651-226X.2025.44056","DOIUrl":"10.2340/1651-226X.2025.44056","url":null,"abstract":"<p><strong>Background and purpose: </strong>After proton therapy of brain tumors, several studies have reported late image changes in follow-up magnetic resonance imaging, which result from blood-brain barrier (BBB) disruption. Astrocytes play a central role in the formation and maintenance of the BBB. To study the late response to partial-brain proton irradiation, preclinical mouse data were utilized to investigate the spatial distribution and dose dependence of reactive astrocytes.</p><p><strong>Material and methods: </strong>Previously, C57BL/6JRj mice were irradiated with protons targeting the right hippocampal region with single prescription doses of 45-85 Gy. After six months, mice were sacrificed and the excised brains axially cut into 3 µm thick slices and stained for glial fibrillary acidic protein (GFAP) to target astrocytes. Here, a workflow to segment the GFAP-positive area on slice images was established. The fraction of GFAP-positive area (GFAP+ fraction) was evaluated in the high-dose region in the right hemisphere and in the mirrored region in the left hemisphere. Dose distributions were simulated on pre-irradiation cone-beam computed tomography and co-registered to the histological slices.</p><p><strong>Results: </strong>For all irradiated mice, the GFAP+ fraction in the right hemisphere was significantly increased compared to the left hemisphere and to a sham-irradiated mouse with a highly symmetric GFAP distribution. The GFAP+ fraction in the right hemisphere increased approximately linearly with prescription dose. For comparable doses, the cerebral cortex showed lower GFAP+ fractions than the midbrain.</p><p><strong>Interpretation: </strong>GFAP upregulation correlated with dose level and distribution. In combination with other markers and timepoints, these findings contribute to a comprehensive understanding of cellular response.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"902-908"},"PeriodicalIF":2.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688518","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}