Advances in Radiation Oncology最新文献

{"title":"Screening Colonoscopy Association With Gastrointestinal Toxicity and Quality of Life After Prostate Stereotactic Body Radiation Therapy","authors":"Jonathan W. Lischalk MD ,&nbsp;Vianca F. Santos MPH ,&nbsp;Brianna Vizcaino BA ,&nbsp;Astrid Sanchez MS ,&nbsp;Christopher Mendez MA ,&nbsp;Kathleen Maloney-Lutz RN ,&nbsp;Sam Serouya MD ,&nbsp;Seth R. Blacksburg MD, MBA ,&nbsp;Todd Carpenter MD ,&nbsp;Moses Tam MD ,&nbsp;Scott Niglio MD ,&nbsp;William Huang MD ,&nbsp;Samir Taneja MD ,&nbsp;Michael J. Zelefsky MD ,&nbsp;Jonathan A. Haas MD","doi":"10.1016/j.adro.2025.101747","DOIUrl":"10.1016/j.adro.2025.101747","url":null,"abstract":"<div><h3>Purpose</h3><div>Screening colonoscopies (CS) performed before prostate stereotactic body radiation therapy (SBRT) allow for identifying synchronous malignancies and comorbid gastrointestinal (GI) conditions. Performing these procedures prior to radiation precludes the necessity of post-SBRT pelvic instrumentation, which may lead to severe toxicity and fistulization. We review compliance of CSs, incidence of GI pathology, and the impact of pretreatment CS findings on subsequent physician-reported toxicity and patient-reported quality of life (QoL).</div></div><div><h3>Methods and Materials</h3><div>We reviewed an institutional database of patients treated for prostate cancer with SBRT including toxicity and QoL outcomes. A detailed review of pretreatment CS findings was reviewed including identification of diverticulosis, location of polyp resection, and presence of hemorrhoids. Pretreatment CS findings were then correlated with outcomes following SBRT.</div></div><div><h3>Results</h3><div>Identification of comorbid GI conditions was a common event, with the presence of diverticulosis in 49.5% (n = 100), hemorrhoids in 67% (n = 136), and polyps in 48% (n = 98). More than half of patients with polyps removed had at least 1 removed from the rectosigmoid. Pretreatment CS did not introduce a delay in SBRT start date. Grade 1 toxicity was significantly lower in patients who underwent CS closer to the initiation of SBRT. There was no increased risk of physician-graded toxicity in the presence of diverticulosis, hemorrhoids, or polyps. Patient-reported GI QoL pattern in our screening cohort mimicked that seen in the previously published nonscreened population. There was no overt QoL detriment observed in patients who had GI pathology identified before SBRT.</div></div><div><h3>Conclusions</h3><div>GI pathology identified in our elderly patient population was commonly identified on pretreatment CS. Screening CS may optimize bowel health for patients heading into radiation therapy. Toxicity and QoL for patients with GI pathologies identified on pretreatment CS do not preclude the delivery of prostate SBRT. We advocate for pretreatment CS in patients eligible prior to SBRT.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 5","pages":"Article 101747"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum to: Royal-Preyra B, Boucher M, and Marsan I. Urticaria Heralding Breast Cancer: Case Report and Literature Review. Adv Radiat Oncol. 2023;9:101433","authors":"Benjamin Royal-Preyra MD, FRCPC,&nbsp;Melanie Boucher BSc,&nbsp;Isabelle Marsan BSc","doi":"10.1016/j.adro.2025.101735","DOIUrl":"10.1016/j.adro.2025.101735","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 5","pages":"Article 101735"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phase 2 Trial of Stereotactic Body Radiation Therapy with Dose Escalation Using Simultaneous Integrated Boost for Spinal Metastases","authors":"Takamasa Mitsuyoshi MD, PhD ,&nbsp;Peter J. K. Tokuda MD ,&nbsp;Yumi Kokubo MD ,&nbsp;Takahiro Iwai MD ,&nbsp;Hiroyuki Inoo MD ,&nbsp;Ryo Ashida MD, PhD ,&nbsp;Ryosuke Nasada MS ,&nbsp;Mikiko Yamashita PhD ,&nbsp;Hiroaki Tanabe MS ,&nbsp;Shigeki Arizono MD, PhD ,&nbsp;Toshiyuki Imagumbai MD ,&nbsp;Masaki Kokubo MD, PhD","doi":"10.1016/j.adro.2025.101760","DOIUrl":"10.1016/j.adro.2025.101760","url":null,"abstract":"<div><h3>Purpose</h3><div>Stereotactic body radiation therapy (SBRT) is an effective treatment approach for spinal metastases. However, local recurrence may occur. This prospective phase 2 trial evaluated whether SBRT with dose escalation in the gross tumor volume through simultaneous integrated boost (SIB–SBRT) can improve local control (LC) without increasing adverse events (AEs).</div></div><div><h3>Methods and Materials</h3><div>Eligible patients aged ≥ 20 years with spinal metastases and a life expectancy of &gt; 1 year received SIB–SBRT in 5 fractions over 1 week. The prescribed dose was 30 Gy to the planning target volume for evaluation and an escalated dose of 40 to 45 Gy to the gross tumor volume through SIB. Neurologic examinations and magnetic resonance imaging were performed at 3-, 6-, and 12-month follow-up and every 6 months thereafter. The primary endpoint was the 1-year LC rate. The secondary endpoints included overall survival and AEs, such as vertebral compression fractures (VCFs).</div></div><div><h3>Results</h3><div>A total of 25 patients with 28 vertebral segments from September 2020 to March 2023 were enrolled in this study. The median follow-up was 26.2 months, and 24 segments in 21 patients were followed up for &gt;1 year. The 1- and 2-year LC rates were 100.0% and 95.0%, respectively. Local recurrence developed in only 1 patient at 18 months. The 1- and 2-year overall survival rates were 92.0% and 72.8%, respectively. Six patients developed VCFs (3 cases each of grades 1 and 2), with 1- and 2-year cumulative incidence rates of 3.6% and 15.6%, respectively. No radiation myelopathy or other grade ≥ 2 AEs occurred, except for 1 case of grade 2 pain.</div></div><div><h3>Conclusions</h3><div>Dose-escalated SIB–SBRT for spinal metastases demonstrates excellent LC with acceptable toxicity, supporting the need for a larger comparative trial.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 6","pages":"Article 101760"},"PeriodicalIF":2.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National Institutes of Health Funding to Support Radiation Oncology Research: A Comparative Trend Analysis Over a Decade, 2011-2021","authors":"Amir Razavi BSA ,&nbsp;Michael K. Rooney MD, PhD ,&nbsp;Clifton D. Fuller MD, PhD ,&nbsp;James B. Yu MD, MHS ,&nbsp;Neil T. Pfister MD, PhD ,&nbsp;Charles R. Thomas Jr MD ,&nbsp;John M. Buatti MD ,&nbsp;Sophia C. Kamran MD ,&nbsp;Heather M. McGee MD, PhD ,&nbsp;Debra Nana Yeboa MD ,&nbsp;Ana P. Kiess MD, PhD ,&nbsp;Andrew M. Baschnagel MD ,&nbsp;Randall J. Kimple MD, PhD, MBA, FASTRO","doi":"10.1016/j.adro.2025.101767","DOIUrl":"10.1016/j.adro.2025.101767","url":null,"abstract":"<div><h3>Purpose</h3><div>Funding to support radiation oncology discovery and research is essential for advancement in therapeutic strategies to improve outcomes for patients with cancer. We aimed to comprehensively characterize trends in National Institutes of Health (NIH) funding that supports radiation oncology research over time to identify trends, successes, and areas for improvement.</div></div><div><h3>Methods and Materials</h3><div>We queried the NIH Research Portfolio Online Reporting Tools Expenditures and Results database to identify all awarded grants to support radiation oncology research conducted by principal investigators at academic centers, using 3 individual years as representative samples (2011, 2016, and 2021). Abstracts and keywords for resulting grants were manually searched to identify resulting awards topically related to the field of radiation oncology; principal investigators departmental affiliation was also used as a supplemental method serving as a sensitivity analysis to define radiation oncology-related research. Descriptive statistics were used to describe patterns in funding. χ² testing was used to assess differences in proportions of categorical variables.</div></div><div><h3>Results</h3><div>Less than 0.5% of the total NIH budget and &lt; 2% of the total National Cancer Institute budget supported radiation oncology research during the representative study years. There were no significant changes in this allocation pattern over time. A small cohort of institutions held a relatively large proportion of NIH-supported radiation oncology grant funding. Individuals holding PhDs alone received the majority of funding (62%), whereas those with dual-degrees (MD/PhD) held 21% of funding, and those with MD alone were awarded 17% of funding. There was a trend toward an increased proportion of grants awarded to MD/PhDs over time (24% vs 15% in 2021 and 2011, respectively, <em>P</em> = .075).</div></div><div><h3>Conclusions</h3><div>Despite radiation therapy's essential role in multidisciplinary cancer care, NIH, and National Cancer Institute funding to support radiation oncology research has remained disproportionally low over the last decade. These data may be useful to inform future policy aimed at promoting research advancement in radiation oncology both at the micro (individual) as well as macro (institutional and national) level.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 6","pages":"Article 101767"},"PeriodicalIF":2.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Different Patterns of Oral Mucositis and Microbiota Injury After Total Body Irradiation- Versus Chemotherapy-Based Myeloablative Allogeneic Hematopoietic Cell Transplantation","authors":"Maryam Ebadi MD ,&nbsp;Hakan Gem PhD, DDS ,&nbsp;Gale Sebastian DDS ,&nbsp;Rania Abasaeed DDS ,&nbsp;Michele Lloid RDH ,&nbsp;Yolanda D. Tseng MD ,&nbsp;Omar Y. Mian MD, PhD ,&nbsp;Samuel Minot PhD ,&nbsp;David R. Dean DDS ,&nbsp;Armin Rashidi MD, PhD","doi":"10.1016/j.adro.2025.101787","DOIUrl":"10.1016/j.adro.2025.101787","url":null,"abstract":"<div><h3>Purpose</h3><div>Oral mucositis (OM) is a common complication of allogeneic hematopoietic cell transplantation, causing pain, infections, swallowing/speech impairment, and poor quality of life. We hypothesized that patterns (severity and dynamics) of OM and oral microbiota disruptions may be different after high-dose total body irradiation (TBI)- versus chemotherapy-based myeloablative conditioning.</div></div><div><h3>Methods and Materials</h3><div>We conducted an exploratory study including comprehensive, longitudinal mucositis assessment, paired with supragingival plaque and saliva collection. OM was assessed at baseline and days +7, +14, +21, +28, and +84. Total mucositis score at each timepoint was calculated from objective findings in 2 domains and 9 oral sites using a validated scoring system. Plaque and saliva samples (baseline and days +14, +28, and +84) were profiled using shotgun metagenomic sequencing.</div></div><div><h3>Results</h3><div>A total of 249 OM assessments were performed and 342 samples were collected from 47 patients (27 chemotherapy-based, 20 TBI-based). Salivary flow rate remained stable in the chemotherapy-based cohort, but steadily declined in the TBI-based cohort, reaching a significantly lower level in the TBI-based cohort at day +84 both compared to baseline and the chemotherapy-based cohort. OM severity peaked at day +7 in the TBI-based cohort versus day +14 in the chemotherapy-based cohort. Day +14 OM was significantly more severe in the chemotherapy-based cohort; other timepoints were not different. Although the cohorts were similar in plaque microbiota composition at baseline, they became significantly different at all post- hematopoietic cell transplantation timepoints. Salivary microbiota composition was not significantly different between the 2 cohorts. Day +84 plaque microbiota diversity was significantly higher in the TBI-based cohort.</div></div><div><h3>Conclusions</h3><div>We demonstrated different patterns of OM, microbiota injury, and salivary flow rate after TBI- versus chemotherapy-based conditioning. If validated in future studies, our findings could enhance evidence-based pretransplant counseling on oral toxicity and have implications for short- and long-term oral health in transplant survivors.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 6","pages":"Article 101787"},"PeriodicalIF":2.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143931706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantification and Dosimetric Impact of Normal Organ Motion During Adaptive Radiation Therapy Planning Using a 1.5 Tesla Magnetic Resonance–Equipped Linear Accelerator (MR-Linac)","authors":"David Wittmann MD ,&nbsp;Eric S. Paulson PhD ,&nbsp;Anjishnu Banerjee PhD ,&nbsp;Leou Ismael Banla MD, PhD ,&nbsp;Christopher Schultz MD ,&nbsp;Musaddiq Awan MD ,&nbsp;Xinfeng Chen PhD ,&nbsp;Eenas A. Omari PhD ,&nbsp;Michael Straza MD, PhD ,&nbsp;X. Allen Li PhD ,&nbsp;Beth Erickson MD ,&nbsp;William A. Hall MD","doi":"10.1016/j.adro.2025.101758","DOIUrl":"10.1016/j.adro.2025.101758","url":null,"abstract":"<div><h3>Purpose</h3><div>Patients receiving adaptive magnetic resonance guided radiation therapy (MRgRT) undergo contour modification prior to treatment delivery, which takes 15 to over 60 minutes. We hypothesized that during the time required to create an adaptive MRgRT plan, organ movement will result in dosimetric changes to regional organs at risk (OARs). This study quantifies the dosimetric impact of OAR motion during the time required to perform adaptive MRgRT.</div></div><div><h3>Methods and Materials</h3><div>Thirty-one patients with pancreatic adenocarcinoma, prostate adenocarcinoma, hepatocellular carcinoma, and oligo-metastases who received MRgRT using a 1.5 Tesla MR-Linac were prospectively enrolled in an open registry imaging trial (NCT03500081). Two magnetic resonance imaging (MRI) studies were acquired predelivery for each MRgRT treatment fraction: an initial “pretreatment” MRI (input to the adaptive evaluation with or without recontouring and replanning process), and a second “verification MRI” (acquired after the recontouring and adaption process and immediately before treatment delivery or “beam-on”). On the verification MRI, normal organs were recontoured offline. Recontoured normal organs included the colon, duodenum, small bowel, and stomach. Differences in OARs between organ positions represented the normal organ movement during the time required for plan adaption. Maximum dose (Dmax), volumetric (V) 0.5 cubic centimeter dose (D0.5cc), 3000 cGy (V30), and 2000 cGy (V20) were calculated from the recontoured verification MRI.</div></div><div><h3>Results</h3><div>Differences in Dmax, per fraction, for the listed normal organs were as follows: colon/rectum 239.50 cGy (<em>P</em> = .09), duodenum 136.40 cGy (<em>P</em> = .05), small bowel 488.27 cGy (<em>P</em> &lt; .01), and stomach 95.92 (<em>P</em> = .17). Small bowel demonstrated a significant difference in Dmax, D0.5cc, and V30.</div></div><div><h3>Conclusions</h3><div>Statistically significant differences in small bowel doses are demonstrated as a result of motion during the timing required for adaptive MRgRT. These results reflect the importance of verifying MRI acquisition during adaptive MRgRT to confirm the location of OARs. They also identify the necessity of strategies to account for the dynamic nature of regional OARs.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 5","pages":"Article 101758"},"PeriodicalIF":2.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Much Can Optimization of Hypofractionation Help to Reduce Carbon Equivalent Emissions? A Single-Center Modeling Study","authors":"Dimitri Vanmarcke MD ,&nbsp;Olena Holubowska MSc ,&nbsp;Ate Poorthuis MSc, PhD ,&nbsp;Bram Mangelschots MSc ,&nbsp;Jean-François Daisne MD, PhD","doi":"10.1016/j.adro.2025.101781","DOIUrl":"10.1016/j.adro.2025.101781","url":null,"abstract":"<div><h3>Purpose</h3><div>Climate change poses a major threat to public health. The health care sector paradoxically contributes significantly to greenhouse gas emissions. In radiation therapy, increased hypofractionation could reduce both patient transport and linear accelerator (LINAC) use, but the size of the impact remains largely undocumented. We estimated department-wide CO₂ equivalent (CO₂e) emissions of patient transport and LINAC energy consumption both in a real-world scenario and in a hypothetical maximized hypofractionation scenario.</div></div><div><h3>Methods and Materials</h3><div>We performed a retrospective exploratory study of all patients treated with external beam radiation therapy in 2019 (pre-COVID-19 year) at the University Hospitals Leuven (Belgium). CO₂e emissions of patient transport were modeled by considering the kilometers traveled by car between the patient’s home and the hospital as well as the number of visits necessary for the treatment. Second, the hypothetical impact of implementing the most hypofractionated schedules according to the current (December 2024) best scientific evidence was calculated using the model. Finally, energy consumption of our Varian TrueBeam and Halcyon LINAC was measured to calculate the related CO₂e emissions.</div></div><div><h3>Results</h3><div>In 2019, there were 43,433 patient visits over 2625 external beam radiation therapy courses with an estimated total of 2.67 million km traveled, resulting in an estimated 394 t of CO₂e emissions. Implementation of hypothetical maximalized hypofractionation would decrease emissions by 18.3% (95% CI, 17.7%-20.0%) on average. The reduction was much larger for early breast cancer (–32.4%) and prostate cancer (–48.5%) than for all the other pathologies (–7.0%). Comparing a prostate treatment in 16 (<em>n</em> = 2 patients) and 5 (<em>n</em> = 2) fractions on the TrueBeam and 16 (<em>n</em> = 2) fractions on the Halcyon, energy use was, respectively, 47.1, 23.6, and 9.2 kWh over the total course, or 6.17, 3.10, and 1.21 kg of CO₂e emissions.</div></div><div><h3>Conclusions</h3><div>In our hypothetical scenario, maximal optimization of hypofractionation schedules significantly reduces CO₂e emissions by decreasing patient transport and, to a much lesser extent, energy consumption.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 6","pages":"Article 101781"},"PeriodicalIF":2.2,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143937128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Lasting Recovery From Recurrent Brain Radionecrosis Following TRICO Treatment in 2 Head and Neck Cancer Survivors","authors":"Sylvie Delanian MD, PhD ,&nbsp;Florian Chatelet MD ,&nbsp;Philippe Herman MD, PhD","doi":"10.1016/j.adro.2025.101785","DOIUrl":"10.1016/j.adro.2025.101785","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 6","pages":"Article 101785"},"PeriodicalIF":2.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Induction of Cytoplasmic dsDNA and cGAS-STING Immune Signaling After Exposure of Breast Cancer Cells to X-ray or High-Energetic Carbon Ions","authors":"Cristina Totis MSc ,&nbsp;Nicole B. Averbeck PhD ,&nbsp;Burkhard Jakob PhD ,&nbsp;Maik Schork PhD ,&nbsp;Gaia Volpi MSc ,&nbsp;Dennis F. Hintze BSc ,&nbsp;Marco Durante PhD ,&nbsp;Claudia Fournier PhD ,&nbsp;Alexander Helm PhD","doi":"10.1016/j.adro.2025.101783","DOIUrl":"10.1016/j.adro.2025.101783","url":null,"abstract":"<div><h3>Purpose</h3><div>Radiation therapy can trigger activation of the cyclic GMP-AMP synthase (cGAS)- Stimulator of interferon genes (STING) axis via cytoplasmic dsDNA fragment induction. The activation of cGAS-STING initiates innate immune signaling mediated by interferon type I that can contribute to eradicate the malignancy. The effect was shown to depend on the fractionation scheme employed. We hypothesized that the innate immune response can also depend on radiation quality because densely ionizing radiation, such as carbon ions, have different effects on DNA lesion quality.</div></div><div><h3>Methods and Materials</h3><div>We exposed an in vitro 4T1 breast cancer model to either photons or carbon ions and measured the clonogenic survival of cells with the colony-forming assay. The occurrence of cytosolic dsDNA fragments was assessed via immunofluorescence, whereas the expression and release of interferon-β by quantitative reverse transcription polymerase chain reaction and enzyme-linked immunosorbent assay. Bulk RNA sequencing was used to investigate global radiation-induced changes in gene expression.</div></div><div><h3>Results</h3><div>We show here that carbon ions induced a significantly higher yield of cytosolic dsDNA fragments per unit dose as compared to photons. The higher efficiency also translated in expression and release of interferon-β by the tumor cells. The rate of cytoplasmic dsDNA foci as well as interferon-β release increased with doses up to 20 Gy and no differences for a fractionation scheme (3 × 8 Gy) were found as compared to the single high doses (20 or 24 Gy) of photons.</div></div><div><h3>Conclusions</h3><div>In conclusion, we found that the release of interferon-β after radiation increases with the radiation dose up to 20 Gy and that carbon ions have the potential to elicit a strong innate immune signaling.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 6","pages":"Article 101783"},"PeriodicalIF":2.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated With Early Discontinuation of Radiation Therapy: An Analysis of the National Cancer Database","authors":"Jie Yin MD,&nbsp;Muhammad M. Qureshi MBBS, MPH,&nbsp;Daniel Huang MD,&nbsp;Minh T. Truong MD,&nbsp;Kimberley S. Mak MD, MPH,&nbsp;Sherry Yan MD,&nbsp;Ariel E. Hirsch MD","doi":"10.1016/j.adro.2025.101784","DOIUrl":"10.1016/j.adro.2025.101784","url":null,"abstract":"<div><h3>Purpose</h3><div>Radiation therapy (RT) often involves multiple visits over weeks and may be discontinued before planned treatment completion. This analysis aims to identify clinical and socioeconomic factors that could serve as predictors of RT discontinuation.</div></div><div><h3>Methods and Materials</h3><div>Using National Cancer Database data from 2018 to 2019, we identified 749,135 cases treated with RT, chemoradiation (CRT), surgery with RT, or surgery with CRT that had information on radiation discontinuation. All patients were treated with curative intent. The variables assessed include age (18-&lt;50, 50-&lt;70, and ≥70), sex (male and female), race (White, Black, and Other), insurance status (private, Medicare/government, and Medicaid/uninsured), income level (&lt;$46,277, $46,277-$57,856, $57,856-$74,062, and ≥$74,062), facility type (community, comprehensive community, academic/research, and integrated cancer network), Charlson-Deyo Comorbidity Score (0, 1, and ≥2), treatment type (RT, CRT, surgery with RT, and surgery with CRT), and primary tumor site. Reasons for RT discontinuation were evaluated. Univariable and multivariable logistic regression modeling was used to calculate the adjusted odds of RT discontinuation by clinical and socioeconomic factors.</div></div><div><h3>Results</h3><div>Of the 749,135 patients, RT was discontinued in 25,072 (3.3%) patients. The primary tumor sites include breast (36.6%), thorax (18.1%), genitourinary tract (13.2%), head and neck (11.4%), gastrointestinal system (10.9%), gynecologic system (6.0%), central nervous system (3.9%), musculoskeletal system (1.3%), and skin (0.7%). On multivariable analysis, older age, female sex, nonprivate insurance, lower income, treatment at community program facilities, multiple comorbidities, and CRT were independently associated with RT discontinuation. The reasons for RT discontinuation were patient decision (35.5%), contraindication because of patient risk factors (20.0%), toxicity (19.7%), patient expiration (13.8%), and family decision (3.0%).</div></div><div><h3>Conclusions</h3><div>This National Cancer Database analysis showed RT discontinuation rates correlated with clinical factors, including older age, multiple comorbidities, and CRT, and socioeconomic factors, including nonprivate insurance and lower household income.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 6","pages":"Article 101784"},"PeriodicalIF":2.2,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143898712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}