Advances in Radiation Oncology最新文献

{"title":"Implementation of Proton Radiation Treatment Exclusion Volume Because of Inconsistent Location of Breast Expander Titanium Port","authors":"Emily T. Tran BS , Patrick Newbury MD , Mark Newpower PhD , Heather Ortega CMD , Timothy D. Malouff MD , Christina Henson MD","doi":"10.1016/j.adro.2025.101876","DOIUrl":"10.1016/j.adro.2025.101876","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 12","pages":"Article 101876"},"PeriodicalIF":2.7,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145057443","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":"Delayed Cutaneous Ecchymosis with Bruton’s Tyrosine Kinase Inhibitors and Breast Radiation: A Case Report","authors":"Jinah Kim MD , Diego Adrianzen Herrera MD , Puyao C. Li MD","doi":"10.1016/j.adro.2025.101878","DOIUrl":"10.1016/j.adro.2025.101878","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 11","pages":"Article 101878"},"PeriodicalIF":2.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145045572","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":"Interim Analysis of Pro-Grid: A Phase 1 Proton Spatially Fractionated Radiation Therapy Trial","authors":"Khadija Sheikh PhD ,&nbsp;Anh Tran MSc ,&nbsp;Heng Li PhD ,&nbsp;Anna W. LaVigne MD ,&nbsp;Jean L. Wright MD ,&nbsp;Aditya Halthore MD","doi":"10.1016/j.adro.2025.101857","DOIUrl":"10.1016/j.adro.2025.101857","url":null,"abstract":"<div><h3>Purpose</h3><div>Spatial fractionation (SFRT) is a radiation therapy technique that targets bulky tumors by delivering alternating high and low doses within the tumor. Here, we report an interim analysis of a phase 1 trial examining the feasibility and safety of a novel proton SFRT approach.</div></div><div><h3>Methods and Materials</h3><div>Ten patients with unresectable tumors of varying histopathology measuring at least 7 cm in the palliative setting were enrolled in a prospective phase 1 trial. Robust pencil-beam scanning proton SFRT plans were created using cylindrical (grid) targets within gross tumor treated to a prescription dose of 18 Gy in a single fraction. Quality assurance computed tomography imaging (qCT) was performed before treatment delivery.</div></div><div><h3>Results</h3><div>Four patients had breast primaries, 3 patients had lung primaries, and 3 patients had pelvic primaries. Five patients had prior photon treatment to a different site. Eight patients received additional planned normofractionated radiation therapy totaling an average dose of 30 Gy. Median time from SFRT treatment to last follow-up was 25 weeks (range, 4-60 weeks). Gross tumor volume ranged from 151 cm³ to 1638 cm³. All qCTs maintained robustness, with no re-planning needed. At last follow-up, 40% showed partial response, 20% had stable disease, and 40% experienced disease progression, with half progressing in the treated area. One patient with pelvic treatment developed grade 3 small bowel obstruction, followed by late grade 2 obstructions. No other patients had grade 3 or higher acute or late toxicities attributable to the proton SFRT.</div></div><div><h3>Conclusions</h3><div>Spatial fractionation using a novel pencil-beam scanning SFRT technique was technically feasible to deliver and reliable on robust evaluation of qCT in this small prospective cohort of patients with difficult-to-manage bulky tumors. Proton SFRT appears safe even when additional normofractionated radiation therapy is delivered. Some bulky tumors exhibited significant response to proton SFRT; thus, further work elucidating which patients most benefit from this technique is warranted.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 9","pages":"Article 101857"},"PeriodicalIF":2.7,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144781500","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 ‘Integrating Radiosensitivity Index and Radiation Resistance Related Index Improves Prostate Cancer Outcome Prediction’ [Advances in Radiation Oncology (2025) 10, 101713]","authors":"Qi-Qiao Wu MD ,&nbsp;Zhao-Sheng Yin MD ,&nbsp;Yi Zhang MD ,&nbsp;Yu-Fu Lin MD ,&nbsp;Jun-Rong Jiang BS ,&nbsp;Ruo-Yan Zheng BS ,&nbsp;Tao Jiang MD ,&nbsp;Dong-Xu Lin MD ,&nbsp;Peng Lai MD ,&nbsp;Fan Chao PhD ,&nbsp;Xin-Yue Wang MD ,&nbsp;Bu-Fu Tang PhD ,&nbsp;Shi-Suo Du PhD ,&nbsp;Jing Sun MD ,&nbsp;Ping Yang MD ,&nbsp;Zhao-Chong Zeng PhD","doi":"10.1016/j.adro.2025.101830","DOIUrl":"10.1016/j.adro.2025.101830","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 8","pages":"Article 101830"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831579","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":"Case Volume and Experience in Stereotactic Radiation: Analysis of a Prospective Peer Review Program","authors":"Luke Peng MD ,&nbsp;Kee-Young Shin MS ,&nbsp;Tara Kosak MEd ,&nbsp;Ayal A. Aizer MD ,&nbsp;John G. Phillips MD, MPH ,&nbsp;Itai M. Pashtan MD","doi":"10.1016/j.adro.2025.101875","DOIUrl":"10.1016/j.adro.2025.101875","url":null,"abstract":"<div><h3>Purpose</h3><div>Stereotactic radiation therapy (SRT) is highly effective but carries the risk of significant toxicity. We identified factors associated with SRT plans that require revision in a comprehensive, prospective peer review program conducted across a network of affiliated radiation oncology centers.</div></div><div><h3>Methods and Materials</h3><div>Weekly peer review rounds were conducted to review SRT cases prior to the start of radiation. Revision recommendations were tracked. Univariate and multivariable logistic regression was performed to identify factors associated with case revision.</div></div><div><h3>Results</h3><div>From 2019 to 2024, 1172 SRT cases were reviewed at weekly rounds, including 313 brain stereotactic radiosurgery (SRS), 190 brain multi-fractionated SRS, and 669 stereotactic body radiation therapy. The yearly revision rate ranged from 19% in 2020 to 31% in 2024. There were 16 individual treating physicians with a median of 6 years of experience (range, 1-19 years), measured at the time of each SRT case review. Factors assessed for significance included SRT case volume in the 3 months preceding review (dichotomized as low- or high-volume), physician experience (≤2, 3-9, or ≥10 years), SRT technique (SRS, multi-fractionated SRS, or stereotactic body radiation therapy, and disease site. On multivariable logistic regression, revisions were less likely for high-volume physicians (odds ratio [OR], 0.58; 95% CI, 0.43-0.77), those with 3-9 years of experience (OR, 0.65; 95% CI, 0.44-0.96), and SRS technique (OR, 0.59; 95% CI, 0.41-0.84).</div></div><div><h3>Conclusions</h3><div>These data imply high value to prospective peer review for physicians with low SRT case volume and in their early career. Adequate case volume may be a critical factor for high quality SRT, analogous to the surgical literature. Annual revision rates in the program remained substantial over time, demonstrating the ongoing importance of an effective prospective peer review program for SRT.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 10","pages":"Article 101875"},"PeriodicalIF":2.7,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144921740","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":"Comparative Analysis of Atlas and Neural Network Autosegmentation Methods for Pediatric Craniospinal Irradiation With the Development of a Knowledge-Based Quality Assurance Tool","authors":"Ozgur Ates ,&nbsp;James Man Git Tsui ,&nbsp;Zachary Wooten ,&nbsp;Sydney Hutcheson ,&nbsp;Rico Zhang ,&nbsp;Jared Becksfort ,&nbsp;Thomas E. Merchant ,&nbsp;Chia-ho Hua","doi":"10.1016/j.adro.2025.101847","DOIUrl":"10.1016/j.adro.2025.101847","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to evaluate the performance of Atlas and neural network autosegmentation methods and develop a knowledge-based quality assurance (QA) tool for pediatric craniospinal irradiation (CSI).</div></div><div><h3>Methods and Materials</h3><div>Autosegmentation was performed on 63 CSI patients using 3 methods: Atlas, commercial artificial intelligence (AI), and in-house AI. The performance of these methods was analyzed using 13 quantitative metrics, comprising 6 overlap and 7 distance metrics, across 13 critical organs and a linear mixed-effect model analysis was performed. Additionally, a knowledge-based QA tool was developed by leveraging distinctive computed tomography number distributions from 100 CSI patients for each organ, using the kernel density estimation (KDE) method to ensure robust error detection and validation. The QA tool was tested on 50 CSI cases by comparing baseline KDEs from 100 CSI patients.</div></div><div><h3>Results</h3><div>The linear mixed-effect analysis showed that the in-house AI outperformed both the Atlas and commercial AI methods in overlap and distance metrics. The in-house AI outperformed the commercial AI with a higher average overlap of 0.01 ± 0.01 and surpassed the Atlas method by 0.02 ± 0.01. In terms of distance metrics, the in-house AI matched the commercial AI (–0.31 ± 0.72 mm) and exceeded the Atlas method by 3.10 ± 0.68 mm. Paired t-tests showed the in-house AI was superior to the Atlas in 13.0% of cases, while the Atlas outperformed the in-house method in 8.9% of comparisons. Similarly, the in-house AI was better than the commercial AI in 35.3% of tests, with the commercial AI outperforming in 32.7%. The QA tool results demonstrated that 100% agreement with baseline KDEs occurred in 46.4% of tests for Atlas, 46.5% for the commercial AI, and 60.7% for the in-house AI.</div></div><div><h3>Conclusions</h3><div>The in-house AI excelled over the Atlas and commercial AI methods in autosegmentation accuracy for pediatric CSI patients. Furthermore, a knowledge-based QA tool enables clinicians to detect and correct gross errors in autosegmentation.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 9","pages":"Article 101847"},"PeriodicalIF":2.2,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144712950","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":"Optimizing Workflow for Cone Beam Computed Tomography-Based Online Adaptive Radiation Therapy Toward Reduced Physician Involvement","authors":"Goda Kalinauskaite MD ,&nbsp;Luise A. Künzel PhD ,&nbsp;Anne Kluge PhD ,&nbsp;Kerstin Rubarth PhD ,&nbsp;Jakob Dannehl ,&nbsp;Celina Höhne ,&nbsp;Marcus Beck MD ,&nbsp;Daniel Zips MD ,&nbsp;Carolin Senger MD","doi":"10.1016/j.adro.2025.101874","DOIUrl":"10.1016/j.adro.2025.101874","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the impact of an optimized online adaptive radiation therapy workflow on physician involvement.</div></div><div><h3>Methods and Materials</h3><div>Data from a prospective phase 2 trial involving 34 prostate cancer patients treated with cone beam computed tomography (CBCT)-based online adaptive radiation therapy (62 Gy in 20 fractions) were analyzed. Manual interventions were required for 2 steps in the workflow: radiation therapy technologist review and adjustment of automatically segmented organs, guiding target segmentation, so-called “influencer,” while physicians reviewed and refined the targets. Three different workflows were compared: 2-influencer (rectum and bladder), 3-influencer (+prostate), and 5-influencer (+seminal vesicles and bowel). Time for workflow steps, extent of manual corrections, and target volume changes were compared.</div></div><div><h3>Results</h3><div>A total of 613 fractions were analyzed. The 5-influencer workflow reduced manual target corrections to 11% of fractions compared with 51% for the 3-influencer workflow and 61% for the 2-influencer workflow (<em>P</em> &lt; .001). Median session duration across workflows was 24.0 minutes (IQR, 22.0-28.0). Median target review times were shortest with the 5-influencer workflow at 2.5 minutes compared with 5.0 minutes for the 3-influencer workflow (<em>P</em> &lt; .001) and 5.6 minutes for the 2-influencer workflow (<em>P</em> = .002). Most patients (84%) found the treatment time well tolerable.</div></div><div><h3>Conclusions</h3><div>This study of prostate cancer patients suggests that optimized workflow reduces the need for physician involvement in online CBCT guided adaptive radiation therapy. Optimized workflows may facilitate a more radiation therapy technologist-driven approach similar to standard image guided radiation therapy. Further studies in other cancers, also focusing on clinical endpoints, are needed to further improve CBCT guided online adaptive radiation therapy.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 10","pages":"Article 101874"},"PeriodicalIF":2.7,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912305","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":"Osteoradionecrosis of the Hyoid Bone: A Systematic Review","authors":"Quentin H. Drane BS ,&nbsp;Andrea Ziegler MD ,&nbsp;Eric J. Thorpe MD","doi":"10.1016/j.adro.2025.101873","DOIUrl":"10.1016/j.adro.2025.101873","url":null,"abstract":"<div><h3>Purpose</h3><div>Osteoradionecrosis (ORN) is a serious complication following radiation therapy (RT) for head and neck cancers, commonly affecting the mandible, but is less understood when involving the hyoid bone.</div></div><div><h3>Methods and Materials</h3><div>A literature review through PubMed and Scopus identified 16 relevant articles. Patient characteristics, presentation, imaging findings, management, and outcomes are highlighted.</div></div><div><h3>Results</h3><div>The review found 40 cases of hyoid bone ORN, with an average patient age of 60.0 years. Most patients were male (87.5%) and had oropharyngeal tumors (77.5%). The average RT dose was 66.2 Gy, and ORN typically developed 27.6 months after RT. Patients receiving concurrent radiation and chemotherapy were more likely to need surgery compared with those treated with RT alone (80% vs 30%, <em>P</em> = .0042).</div></div><div><h3>Conclusions</h3><div>While rare, hyoid bone ORN may become more common with increasing rates of oropharyngeal cancers. Clinicians should be aware of presenting symptoms and possible complications and be familiar with a thorough work-up and treatment.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 10","pages":"Article 101873"},"PeriodicalIF":2.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888678","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":"Extracranial Palliative Radiation Therapy for Renal Cell Carcinoma","authors":"Young Suk Kwon MD, MPH ,&nbsp;Eric Hsu MD, PhD ,&nbsp;Maggie Stein BSPH ,&nbsp;Alana Christie MS ,&nbsp;Aurelie Garant MD ,&nbsp;Neil B. Desai MD ,&nbsp;Andrew Wang MD ,&nbsp;Daniel X. Yang MD ,&nbsp;Allen Yen MD ,&nbsp;Mihailo Miljanic MD ,&nbsp;Kevin D. Courtney MD, PhD ,&nbsp;Hans Hammers MD, PhD ,&nbsp;Tian Zhang MD ,&nbsp;Waddah Arafat MD ,&nbsp;Qian Qin MD ,&nbsp;Suzanne Cole MD ,&nbsp;James Brugarolas MD, PhD ,&nbsp;Robert Timmerman MD ,&nbsp;Raquibul Hannan MD, PhD","doi":"10.1016/j.adro.2025.101870","DOIUrl":"10.1016/j.adro.2025.101870","url":null,"abstract":"<div><h3>Purpose</h3><div>Symptom management is an integral component of care for patients with renal cell carcinoma (RCC). We evaluated the efficacy of radiation therapy (RT) and factors influencing symptom in an ethnically diverse patient population.</div></div><div><h3>Methods and Materials</h3><div>An institutional review board-approved retrospective review was conducted of patients with symptomatic extracranial RCC metastases treated with RT between 2011 and 2022 at a tertiary referral center. Symptoms were categorized as pain, neurologic (paresthesia or weakness), respiratory (dyspnea, hemoptysis, or cough) and gastrointestinal/genitourinary (GI/GU) bleeding. Time to symptom alleviation was measured from the start of RT and assessed during-treatment and follow-up visits. Descriptive and survival analyses were performed. Associations between symptom relief and treatment parameters were evaluated by generalized estimating equations</div></div><div><h3>Results</h3><div>We identified 240 symptomatic RCC patients who received RT to 581 metastases including 93.0% for pain, 4.0% for neurologic, 4.1% for respiratory, and 1.6% for GI/GU bleeding. Symptom improvement was observed in 84.0% of patients overall at 6 months (95% confidence interval [CI], 80.4-87.2%). Among symptom categories, pain improved in 84.6% (95% CI, 81.0-87.9%) at 6 months, respiratory symptoms in 69.9% (49.3-88.0%) at 6 months, neurologic symptoms in 88.6% (69.6-98.1%) at 6 months, and GI/GU bleeding in 37.5% (13.9-77.1%) at 1 month. The median times to overall and pain alleviation were 1.6 months (range, 1.4-1.9) and 1.6 months (range, 1.4-1.9), respectively. Although the odds of achieving pain palliation were similar between stereotactic and conventional RT, unexpectedly, symptom relief occurred more quickly with conventional RT (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Stereotactic and conventional RT are effective for symptom palliation for patients with metastatic RCC.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 10","pages":"Article 101870"},"PeriodicalIF":2.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888677","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":"Pancreatic Polypeptide Secretory Paraganglioma Successfully Treated With Radiosurgery Resulting in Elimination of Life-Debilitating Diarrhea","authors":"Astha Rohit BS ,&nbsp;Laurence J. Miller MD ,&nbsp;Brady Laughlin MD ,&nbsp;Michael Hinni MD ,&nbsp;Lisa McGee MD","doi":"10.1016/j.adro.2025.101862","DOIUrl":"10.1016/j.adro.2025.101862","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 10","pages":"Article 101862"},"PeriodicalIF":2.7,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860971","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}