BJR open最新文献

{"title":"The role of artificial intelligence in hastening time to recruitment in clinical trials.","authors":"Abdalah Ismail, Talha Al-Zoubi, Issam El Naqa, Hina Saeed","doi":"10.1259/bjro.20220023","DOIUrl":"10.1259/bjro.20220023","url":null,"abstract":"<p><p>Novel and developing artificial intelligence (AI) systems can be integrated into healthcare settings in numerous ways. For example, in the case of automated image classification and natural language processing, AI systems are beginning to demonstrate near expert level performance in detecting abnormalities such as seizure activity. This paper, however, focuses on AI integration into clinical trials. During the clinical trial recruitment process, considerable labor and time is spent sifting through electronic health record and interviewing patients. With the advancement of deep learning techniques such as natural language processing, intricate electronic health record data can be efficiently processed. This provides utility to workflows such as recruitment for clinical trials. Studies are starting to show promise in shortening the time to recruitment and reducing workload for those involved in clinical trial design. Additionally, numerous guidelines are being constructed to encourage integration of AI into the healthcare setting with meaningful impact. The goal would be to improve the clinical trial process by reducing bias in patient composition, improving retention of participants, and lowering costs and labor.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10636341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43154960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicoradiological outcomes after radical radiotherapy for lung cancer in patients with interstitial lung disease.","authors":"Gerard M Walls,&nbsp;Michael McMahon,&nbsp;Natasha Moore,&nbsp;Patrick Nicol,&nbsp;Gemma Bradley,&nbsp;Glenn Whitten,&nbsp;Linda Young,&nbsp;Jolyne M O'Hare,&nbsp;John Lindsay,&nbsp;Ryan Connolly,&nbsp;Dermot Linden,&nbsp;Peter A Ball,&nbsp;Gerard G Hanna,&nbsp;Jonathan McAleese","doi":"10.1259/bjro.20220049","DOIUrl":"10.1259/bjro.20220049","url":null,"abstract":"<p><strong>Objective: </strong>Interstitial lung disease (ILD) is relatively common in patients with lung cancer with an incidence of 7.5%. Historically pre-existing ILD was a contraindication to radical radiotherapy owing to increased radiation pneumonitis rates, worsened fibrosis and poorer survival compared with non-ILD cohorts. Herein, the clinical and radiological toxicity outcomes of a contemporaneous cohort are described.</p><p><strong>Methods: </strong>Patients with ILD treated with radical radiotherapy for lung cancer at a regional cancer centre were collected prospectively. Radiotherapy planning, tumour characteristics, and pre- and post-treatment functional and radiological parameters were recorded. Cross-sectional images were independently assessed by two Consultant Thoracic Radiologists.</p><p><strong>Results: </strong>Twenty-seven patients with co-existing ILD received radical radiotherapy from February 2009 to April 2019, with predominance of usual interstitial pneumonia subtype (52%). According to ILD-GAP scores, most patients were Stage I. After radiotherapy, localised (41%) or extensive (41%) progressive interstitial changes were noted for most patients yet dyspnoea scores (<i>n</i> = 15 available) and spirometry (<i>n</i> = 10 available) were stable. One-third of patients with ILD went on to receive long-term oxygen therapy, which was significantly more than the non-ILD cohort. Median survival trended towards being worse compared with non-ILD cases (17.8 <i>vs</i> 24.0 months, <i>p</i> = 0.834).</p><p><strong>Conclusion: </strong>Radiological progression of ILD and reduced survival were observed post-radiotherapy in this small cohort receiving lung cancer radiotherapy, although a matched functional decline was frequently absent. Although there is an excess of early deaths, long-term disease control is achievable.</p><p><strong>Advances in knowledge: </strong>For selected patients with ILD, long-term lung cancer control without severely impacting respiratory function may be possible with radical radiotherapy, albeit with a slightly higher risk of death.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10301718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9730153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spectrum of MRI findings of foetal alcohol syndrome disorders-what we know and what we need to know!","authors":"Saad Sharif, Naeha Lakshmanan, Farhana Sharif, Stephanie Ryan","doi":"10.1259/bjro.20210063","DOIUrl":"10.1259/bjro.20210063","url":null,"abstract":"<p><p>The exposure to alcohol <i>in utero</i> has been known to damage the developing foetus. Foetal alcohol spectrum disorders is an umbrella term that highlights a range of adverse effects linked to alcohol exposure <i>in utero</i>. Multiple studies have shown specific brain abnormalities, including a reduction in brain size, specifically in the deep nuclei and cerebellum, and parietal and temporal lobe white matter changes. While studies ascertained that other prenatal risk factors, such as maternal use of illicit drugs or lack of pre-natal care, and post-natal risk factors, such as physical or sexual abuse and low socioeconomic status, may be involved in the pathology of variances in foetal neurological abnormalities, prenatal alcohol exposure remained the strongest factor for effects on brain structure and function. Particularly, the number of days of alcohol consumption per week and drinking during all three trimesters of the pregnancy indicating the strongest relationship with brain abnormalities. Further studies are needed to explain pre-natal risk factors in isolation as well as in combination for neurodevelopmental outcomes. The diverse phenotypic presentations described indicate that the diagnostic criteria of foetal alcohol spectrum disorder must be refined to better represent the range of neurologic anomalies.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10636336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44745116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the implementation of COVID-19 structured reporting templates for chest radiography: a scoping review.","authors":"Peter A O'Reilly,&nbsp;Sarah Lewis,&nbsp;Warren Reed","doi":"10.1259/bjro.20220058","DOIUrl":"10.1259/bjro.20220058","url":null,"abstract":"<p><strong>Objective: </strong>One of the common modalities used in imaging COVID-19 positive patients is chest radiography (CXR), and serves as a valuable imaging method to diagnose and monitor a patients' condition. Structured reporting templates are regularly used for the assessment of COVID-19 CXRs and are supported by international radiological societies. This review has investigated the use of structured templates for reporting COVID-19 CXRs.</p><p><strong>Methods: </strong>A scoping review was conducted on literature published between 2020 and 2022 using Medline, Embase, Scopus, Web of Science, and manual searches. An essential criterion for the inclusion of the articles was the use of reporting methods employing either a structured quantitative or qualitative reporting method. Thematic analyses of both reporting designs were then undertaken to evaluate utility and implementation.</p><p><strong>Results: </strong>Fifty articles were found with the quantitative reporting method used in 47 articles whilst 3 articles were found employing a qualitative design. Two quantitative reporting tools (Brixia and RALE) were used in 33 studies, with other studies using variations of these methods. Brixia and RALE both use a posteroanterior or supine CXR divided into sections, Brixia with six and RALE with four sections. Each section is scaled numerically depending on the level of infection. The qualitative templates relied on selecting the best descriptor of the presence of COVID-19 radiological appearances. Grey literature from 10 international professional radiology societies were also included in this review. The majority of the radiology societies recommend a qualitative template for reporting COVID-19 CXRs.</p><p><strong>Conclusion: </strong>Most studies employed quantitative reporting methods which contrasted with the structured qualitative reporting template advocated by most radiological societies. The reasons for this are not entirely clear. There is also a lack of research literature on both the implementation of the templates or comparing both template types, indicating that the use of structured radiology reporting types may be an underdeveloped clinical strategy and research methodology.</p><p><strong>Advances in knowledge: </strong>This scoping review is unique in that it has undertaken an examination of the utility of the quantitative and qualitative structured reporting templates for COVID-19 CXRs. Moreover, through this review, the material examined has allowed a comparison of both instruments, clearly showing the favoured style of structured reporting by clinicians. At the time of the database interrogation, there were no studies found had undertaken such examinations of both reporting instruments. Moreover, due to the enduring influence of COVID-19 on global health, this scoping review is timely in examining the most innovative structured reporting tools that could be used in the reporting of COVID-19 CXRs. This report could assist cli","PeriodicalId":72419,"journal":{"name":"BJR open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10301714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9736567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging in patients with acute dyspnea when cardiac or pulmonary origin is suspected.","authors":"Ruxandra-Iulia Milos, Carmen Bartha, Sebastian Röhrich, Benedikt H Heidinger, Florian Prayer, Lucian Beer, Christian Wassipaul, Daria Kifjak, Martin L Watzenboeck, Svitlana Pochepnia, Helmut Prosch","doi":"10.1259/bjro.20220026","DOIUrl":"10.1259/bjro.20220026","url":null,"abstract":"<p><p>A wide spectrum of conditions, from life-threatening to non-urgent, can manifest with acute dyspnea, thus presenting major challenges for the treating physician when establishing the diagnosis and severity of the underlying disease. Imaging plays a decisive role in the assessment of acute dyspnea of cardiac and/or pulmonary origin. This article presents an overview of the current imaging modalities used to narrow the differential diagnosis in the assessment of acute dyspnea of cardiac or pulmonary origin. The current indications, findings, accuracy, and limits of each imaging modality are reported. Chest radiography is usually the primary imaging modality applied. There is a low radiation dose associated with this method, and it can assess the presence of fluid in the lung or pleura, consolidations, hyperinflation, pneumothorax, as well as heart enlargement. However, its low sensitivity limits the ability of the chest radiograph to accurately identify the causes of acute dyspnea. CT provides more detailed imaging of the cardiorespiratory system, and therefore, better sensitivity and specificity results, but it is accompanied by higher radiation exposure. Ultrasonography has the advantage of using no radiation, and is fast and feasible as a bedside test and appropriate for the assessment of unstable patients. However, patient-specific factors, such as body habitus, may limit its image quality and interpretability. Advances in knowledge This review provides guidance to the appropriate choice of imaging modalities in the diagnosis of patients with dyspnea of cardiac or pulmonary origin.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10077421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9628472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dosimetric investigation of whole-brain radiotherapy with helical intensity modulated radiation therapy and volumetric modulated arc therapy for scalp sparing.","authors":"Ryosuke Shirata,&nbsp;Tatsuya Inoue,&nbsp;Satoru Sugimoto,&nbsp;Anneyuko I Saito,&nbsp;Motoko Omura,&nbsp;Yumiko Minagawa,&nbsp;Keisuke Sasai","doi":"10.1259/bjro.20220037","DOIUrl":"https://doi.org/10.1259/bjro.20220037","url":null,"abstract":"<p><strong>Objective: </strong>Intensity-modulated radiotherapy (IMRT) is a well-established radiotherapy technique for delivering radiation to cancer with high conformity while sparing the surrounding normal tissue. Two main purposes of this study are: (1) to investigate dose calculation accuracy of helical IMRT (HIMRT) and volumetric-modulated arc therapy (VMAT) on surface region and (2) to evaluate the dosimetric efficacy of HIMRT and VMAT for scalp-sparing in whole brain radiotherapy (WBRT).</p><p><strong>Methods: </strong>First, using a radiochromic film and water-equivalent phantom with three types of boluses (1, 3, 5 mm), calculation/measurement dose agreement at the surface region in the VMAT and HIMRT plans were examined. Then, HIMRT, 6MV-VMAT and 10MV-VMAT with scalp-sparing, and two conventional three-dimensional conformal radiotherapy plans (6MV-3DCRT and 10MV-3DCRT; as reference data) were created for 30 patients with brain metastasis (30 Gy/10 fractions). The mean dose to the scalp and the scalp volume receiving 24 and 30 Gy were compared.</p><p><strong>Results: </strong>The percentage dose differences between the calculation and measurement were within 7%, except for the HIMRT plan at a depth of 1 mm. The averaged mean scalp doses [Gy], V24Gy [%], and V30Gy [%] (1SD) for 6MV-3DCRT, 10MV-3DCRT, HIMRT, 6MV-VMAT, and 10MV-VMAT were [26.6 (1.1), 86.4 (7.3), 13.2 (4.2)], [25.4 (1.0), 77.8 (7.5), 13.2 (4.2)], [23.2 (1.5), 42.8 (19.2), 0.2 (0.5)], [23.6 (1.6), 47.5 (17.9), 1.2 (1.8)], and [22.7 (1.7), 36.4 (17.6), 0.7 (1.1)], respectively.</p><p><strong>Conclusion: </strong>Regarding the dose parameters, HIMRT achieved a lower scalp dose compared with 6MV-VMAT. However, the highest ability to reduce the mean scalp dose was showed in 10MV-VMAT.</p><p><strong>Advances in knowledge: </strong>Scalp-sparing WBRT using HIMRT or VMAT may prevent radiation-induced alopecia in patients with BM.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10077410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9327593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The geometric and dosimetric accuracy of kilovoltage cone beam computed tomography images for adaptive treatment: a systematic review.","authors":"Hussam Jassim,&nbsp;Hassan A Nedaei,&nbsp;Ghazale Geraily,&nbsp;Nooshin Banaee,&nbsp;Ali Kazemian","doi":"10.1259/bjro.20220062","DOIUrl":"https://doi.org/10.1259/bjro.20220062","url":null,"abstract":"<p><strong>Objectives: </strong>To provide an overview and meta-analysis of different techniques adopted to accomplish kVCBCT for dose calculation and automated segmentation.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were performed on eligible studies demonstrating kVCBCT-based dose calculation and automated contouring of different tumor features. Meta-analysis of the performance was accomplished on the reported γ analysis and dice similarity coefficient (DSC) score of both collected results as three subgroups (head and neck, chest, and abdomen).</p><p><strong>Results: </strong>After the literature scrutinization (<i>n</i> = 1008), 52 papers were recognized for the systematic review. Nine studies of dosimtric studies and eleven studies of geometric analysis were suitable for inclusion in meta-analysis. Using kVCBCT for treatment replanning depends on a method used. Deformable Image Registration (DIR) methods yielded small dosimetric error (≤2%), γ pass rate (≥90%) and DSC (≥0.8). Hounsfield Unit (HU) override and calibration curve-based methods also achieved satisfactory yielded small dosimetric error (≤2%) and γ pass rate ((≥90%), but they are prone to error due to their sensitivity to a vendor-specific variation in kVCBCT image quality.</p><p><strong>Conclusions: </strong>Large cohorts of patients ought to be undertaken to validate methods achieving low levels of dosimetric and geometric errors. Quality guidelines should be established when reporting on kVCBCT, which include agreed metrics for reporting on the quality of corrected kVCBCT and defines protocols of new site-specific standardized imaging used when obtaining kVCBCT images for adaptive radiotherapy.</p><p><strong>Advances in knowledge: </strong>This review gives useful knowledge about methods making kVCBCT feasible for kVCBCT-based adaptive radiotherapy, simplifying patient pathway and reducing concomitant imaging dose to the patient.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10301728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9738076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT and MRI of head and neck cutaneous lesions.","authors":"Jason Gan,&nbsp;Romman Nourzaie,&nbsp;Brent J Doolan,&nbsp;Steve Connor","doi":"10.1259/bjro.20230006","DOIUrl":"https://doi.org/10.1259/bjro.20230006","url":null,"abstract":"<p><p>Cutaneous lesions are derived from the epidermis, dermis and cutaneous appendages. Whilst imaging may occasionally be performed to evaluate such lesions, they may be undiagnosed and demonstrated for the first time on head and neck imaging studies. Although usually amenable to clinical examination and biopsy, CT or MRI studies may also demonstrate characteristic imaging features which aid the radiological differential diagnosis. In addition, imaging studies define the extent and staging of malignant lesions, as well as the complications of benign lesions. It is important for the radiologist to understanding the clinical significance and associations of these cutaneous conditions. This pictorial review will describe and depict the imaging appearances of benign, malignant, overgrowth, blistering, appendage and syndromic cutaneous lesions. An increasing awareness of the imaging characteristics of cutaneous lesions and related conditions will help the framing of a clinically relevant report.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10301713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9730151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proton linear energy transfer and variable relative biological effectiveness for adolescent patients with Hodgkin lymphoma.","authors":"Laura Ann Rechner,&nbsp;Maja V Maraldo,&nbsp;Edward Ak Smith,&nbsp;Anni Y Lundgaard,&nbsp;Lisa L Hjalgrim,&nbsp;Ranald I MacKay,&nbsp;Adam H Aitkenhead,&nbsp;Marianne C Aznar","doi":"10.1259/bjro.20230012","DOIUrl":"https://doi.org/10.1259/bjro.20230012","url":null,"abstract":"<p><strong>Objectives: </strong>Proton therapy has a theoretical dosimetric advantage due to the Bragg peak, but the linear energy transfer (LET), and therefore the relative biological effectiveness (RBE), increase at the end of range. For patients with Hodgkin lymphoma, the distal edge of beam is often located within or close to the heart, where elevated RBE would be of potential concern. The purpose of this study was to investigate the impact of RBE and the choice of beam arrangement for adolescent patients with mediastinal Hodgkin lymphoma.</p><p><strong>Methods: </strong>For three previously treated adolescent patients, proton plans with 1-3 fields were created to a prescribed dose of 19.8 Gy (RBE) in 11 fractions (Varian Eclipse v13.7), assuming an RBE of 1.1. Plans were recalculated using Monte-Carlo (Geant4 v10.3.3/Gate v8.1) to calculate dose-averaged LET. Variable RBE-weighted dose was calculated using the McNamara model, assuming an α/β ratio of 2 Gy for organs-at-risk.</p><p><strong>Results: </strong>Although the LET decreased as the number of fields increased, the difference in RBE-weighted dose (Δdose) to organs-at-risk did not consistently decrease. Δdose values varied by patient and organ and were mostly of the order of 0-3 Gy (RBE), with a worst-case of 4.75 Gy (RBE) in near-maximum dose to the left atrium for one plan.</p><p><strong>Conclusions: </strong>RBE-weighted doses to organs-at-risk are sensitive to the choice of RBE model, which is of particular concern for the heart.</p><p><strong>Advances in knowledge: </strong>There is a need to remain cautious when evaluating proton plans for Hodgkin lymphoma, especially when near-maximum doses to organs-at-risk are considered.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10077416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9327590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes following external beam radiotherapy to the prostate and pelvic lymph nodes in addition to androgen deprivation therapy in non-metastatic prostate adenocarcinoma with regional lymph node involvement: a retrospective cohort study.","authors":"Akmal Mohamad Roji,&nbsp;Rahul Sandhu,&nbsp;Anjali Zarkar","doi":"10.1259/bjro.20220030","DOIUrl":"https://doi.org/10.1259/bjro.20220030","url":null,"abstract":"<p><strong>Objective: </strong>There is a paucity of evidence for external beam radiotherapy (EBRT) in patients with non-metastatic prostate adenocarcinoma with regional lymph nodes (cN1) as primary treatment in addition to androgen deprivation therapy (ADT). We present the retrospective outcomes of cN1 patients treated with prostate and pelvic nodal (PPLN) EBRT and ADT.</p><p><strong>Methods: </strong>The clinical records of cN1 patients given PPLN EBRT from January 2012 to January 2020 were retrospectively reviewed. Primary outcomes of overall survival, prostate cancer-specific survival, and failure-free survival were analysed. Secondary outcomes of biochemical relapse-free survival, locoregional recurrence-free survival, and distant metastases-free survival were also reviewed. The prognostic values of clinicopathological parameters were investigated. Treatment toxicity was also reviewed.</p><p><strong>Results: </strong>We identified 121 cN1 patients treated with PPLN EBRT and ADT. Treatment was well tolerated, with only a minority (1.7%) having Grade 3 toxicities. 5-year overall survival and prostate cancer-specific survival were 74.4 and 89.1% respectively. 5-year failure-free survival was 55.4%; with 5-year biochemical relapse-free survival, locoregional recurrence-free survival, and distant metastases-free survival at 56.2%, 85.2%, and 65.4% respectively. The benefits of PPLN EBRT were seen in most patients, with prolonged failure-free period and good loco-regional control.</p><p><strong>Conclusion: </strong>Patients with cN1 disease should be considered for PPLN EBRT, in addition to ADT. Treatment is well tolerated with low toxicity, good locoregional control, and prolonged time to disease progression.</p><p><strong>Advances in knowledge: </strong>We report real-world experience of cN1 patients treated with PPLN EBRT in addition to ADT, with good outcomes following treatment and low toxicity.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10077404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9628471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}