Advances in Radiation Oncology最新文献

筛选
英文 中文
The Empty Bladder is Preferred in Some Cases of Radiation Therapy for Rectal Cancer 在某些直肠癌的放射治疗中,空膀胱是首选
IF 2.7
Advances in Radiation Oncology Pub Date : 2025-10-03 DOI: 10.1016/j.adro.2025.101872
Inna Ospovat MD, Albert Schlocker MSc, Natan Shtraus MSc, Ravit Geva MD, Shani Hazan BSc, Tatyana Shevchuk MSc, Alexander Barenboim MD, Ido Wolf MD, Orit Gutfeld MD, Viacheslav Soyfer MD
{"title":"The Empty Bladder is Preferred in Some Cases of Radiation Therapy for Rectal Cancer","authors":"Inna Ospovat MD, Albert Schlocker MSc, Natan Shtraus MSc, Ravit Geva MD, Shani Hazan BSc, Tatyana Shevchuk MSc, Alexander Barenboim MD, Ido Wolf MD, Orit Gutfeld MD, Viacheslav Soyfer MD","doi":"10.1016/j.adro.2025.101872","DOIUrl":"10.1016/j.adro.2025.101872","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 11","pages":"Article 101872"},"PeriodicalIF":2.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145217867","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}
引用次数: 0
HyperArc Automated Stereotactic Radiosurgery Planning Enables Accurate a Priori Fractionation Scheme Selection via Adherence to HyTEC Toxicity Thresholds 超弧自动立体定向放射外科计划通过遵守HyTEC毒性阈值,实现准确的先验分选方案
IF 2.7
Advances in Radiation Oncology Pub Date : 2025-09-22 DOI: 10.1016/j.adro.2025.101893
Joel A. Pogue PhD , John Fiveash MD , Rex Cardan PhD , Christopher Willey MD, PhD , Natalie Viscariello PhD , Rodney Sullivan PhD , Samuel Marcrom MD , Luke Moradi MD , Philip Schmalz MD , James Markert MD, MPH , Richard Popple PhD
{"title":"HyperArc Automated Stereotactic Radiosurgery Planning Enables Accurate a Priori Fractionation Scheme Selection via Adherence to HyTEC Toxicity Thresholds","authors":"Joel A. Pogue PhD ,&nbsp;John Fiveash MD ,&nbsp;Rex Cardan PhD ,&nbsp;Christopher Willey MD, PhD ,&nbsp;Natalie Viscariello PhD ,&nbsp;Rodney Sullivan PhD ,&nbsp;Samuel Marcrom MD ,&nbsp;Luke Moradi MD ,&nbsp;Philip Schmalz MD ,&nbsp;James Markert MD, MPH ,&nbsp;Richard Popple PhD","doi":"10.1016/j.adro.2025.101893","DOIUrl":"10.1016/j.adro.2025.101893","url":null,"abstract":"<div><h3>Purpose</h3><div>Radiosurgery plan safety is commonly estimated by volumes receiving specific doses (ie, 12 Gy/1 fraction [fx]), which are evaluated postplan generation. However, automated treatment planning can produce highly consistent and thus predictable plans. Thus, we hypothesized that HyperArc (HA) automated stereotactic radiosurgery (SRS) planning enables clinical decision-making prior to plan generation, such as selecting the appropriate SRS fractionation scheme.</div></div><div><h3>Methods and Materials</h3><div>All previously treated single-isocenter HA plans at our institution were queried, totaling 3361 marginless targets without bridging at the 50% isodose level (1495 plans), making this the largest single-institutional SRS dosimetry study to the authors’ knowledge. Eight isodose volumes (IDVs; 50.00%-97.60%) were calculated for all HA targets, each corresponding to the ratio of a High Dose per Fraction, Hypofractionated Treatment Effects in the Clinic (HyTEC) brain toxicity dose level and a common prescription dose (eg, 50.00% = 12 Gy/24 Gy). Power law relationships of IDV and target volume (<span><math><mrow><mi>I</mi><mi>D</mi><mi>V</mi><mo>=</mo><mi>a</mi><msup><mrow><msub><mi>V</mi><mrow><mi>t</mi><mi>a</mi><mi>r</mi><mi>g</mi><mi>e</mi><mi>t</mi></mrow></msub></mrow><mi>b</mi></msup></mrow></math></span>) were generated from a training data set of 361 targets (10.7%) and validated on the remaining 3000 targets (89.3%), allowing grade 1 to 3 brain toxicity rates to be predicted from target volume.</div></div><div><h3>Results</h3><div>Models resulted in high R² values when applied to the validation cohort (≥0.982), allowing targets to be classified as either above or below the HyTEC thresholds (IDV = 5 cm<sup>3</sup>, 10 cm<sup>3</sup>, and 20 cm<sup>3</sup>) with high accuracy (≥97.6%) and precision (≥99.3%). As an example, the 50.0% IDV model predicted that target volumes/diameters of 1.00 cm<sup>3</sup>/1.24 cm, 2.34 cm<sup>3</sup>/1.65 cm, and 5.51 cm<sup>3</sup>/2.19 cm correlate with 3.6%, 4.8%, and 8.6% grade 1 to 3 brain toxicity rates, respectively, when prescribing 24 Gy/1 fx.</div></div><div><h3>Conclusion</h3><div>The resulting models enabled accurate and precise prediction of target volumes/diameters, resulting in 3.6%, 4.8%, and 8.6% brain grade 1 to 3 toxicity rates, according to HyTEC toxicity estimates. Leveraging relative IDVs rather than prescription doses enabled all 3361 targets to be used for modeling 9 common SRS prescriptions (1 fx: 24 Gy, 20 Gy, 18 Gy, 16 Gy, and 15 Gy; 3 fx: 27 Gy and 24 Gy; 5 fx: 30 Gy and 25 Gy), enabling clinicians to estimate brain toxicity a priori via an open-source calculator.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 11","pages":"Article 101893"},"PeriodicalIF":2.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119616","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}
引用次数: 0
Dosimetric Performance of Orthogonal Dual-Layer Multi-Leaf Collimator System on Locally Advanced Lung Cancer: Cardiac Substructures Sparing Plans 正交双层多叶准直系统在局部晚期肺癌中的剂量学性能:心脏亚结构保留计划
IF 2.7
Advances in Radiation Oncology Pub Date : 2025-09-19 DOI: 10.1016/j.adro.2025.101891
AiHui Feng MS , YanHua Duan MS , ZhangRu Yang MD , Hao Wang PhD , Hua Chen PhD , HengLe Gu MS , Ying Huang MS , ZhenJiong Shen MS , XuFei Wang PhD , ZhiYong Xu PhD
{"title":"Dosimetric Performance of Orthogonal Dual-Layer Multi-Leaf Collimator System on Locally Advanced Lung Cancer: Cardiac Substructures Sparing Plans","authors":"AiHui Feng MS ,&nbsp;YanHua Duan MS ,&nbsp;ZhangRu Yang MD ,&nbsp;Hao Wang PhD ,&nbsp;Hua Chen PhD ,&nbsp;HengLe Gu MS ,&nbsp;Ying Huang MS ,&nbsp;ZhenJiong Shen MS ,&nbsp;XuFei Wang PhD ,&nbsp;ZhiYong Xu PhD","doi":"10.1016/j.adro.2025.101891","DOIUrl":"10.1016/j.adro.2025.101891","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to reduce the risk of cardiovascular incidents and radiation pneumonia (RP) by improving the dose distribution to cardiac substructures through the use of a dual-layer multileaf collimator (MLC) accelerator- VenusX.</div></div><div><h3>Methods and Materials</h3><div>Eighteen patients with advanced-stage lung cancer were selected for this study. The total lung, spinal cord, whole heart, and specific cardiac substructures (including the left ventricle [LV], pulmonary artery, left anterior descending artery, left circumflex artery [LCX], and coronary artery) were delineated as organs at risk and incorporated into the optimization process of the avoidance plan. Single-layer MLC plans optimized for the whole heart, referred to as S-WH plans (where WH denotes whole heart), were developed alongside single-layer MLC plans specifically designed to avoid cardiac substructures, known as S-CS plans (where CS denotes cardiac substructures). Additionally, dual-layer MLC avoidance plans, designated as D-CS plans, were created for each patient. We evaluated the relative risk of coronary artery disease, chronic heart failure, acute cardiac events, and RP, as well as the effective dose to the immune system.</div></div><div><h3>Results</h3><div>D-CS plans significantly reduced the dose metrics of LV, pulmonary artery, left anterior descending artery, LCX, and the coronary, while maintaining target coverage and achieving comparable conformity index to the S-WH plans. Additionally, the D-CS plans significantly decreased the volume receiving 5 Gy (V<sub>5Gy</sub>) for the LV and V<sub>15Gy</sub> of LCX, with other substructures also experiencing a notable degree of dose reduction. Furthermore, the relative risk of coronary artery disease, chronic heart failure, acute cardiac event, and RP is ranked as follows: D-CS &lt; S-CS &lt; S-WH plans. Effective dose to the immune system of the D-CS plans indicated the lowest risk among the 3 plans.</div></div><div><h3>Conclusions</h3><div>The dual-layer MLC system demonstrated superior performance compared to the single-layer MLC system in CS-avoidance plans, providing new opportunities for subsequent immunotherapy in patients with locally advanced lung cancer.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 11","pages":"Article 101891"},"PeriodicalIF":2.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145107381","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}
引用次数: 0
A Precise Reirradiation Supporting Tool Initiative (PRISTIN) for Prescribing Absorbed Dose and Number of Fractions in Reirradiation 精确再照射辅助工具计划(PRISTIN)用于再照射中吸收剂量和分数的处方
IF 2.7
Advances in Radiation Oncology Pub Date : 2025-09-15 DOI: 10.1016/j.adro.2025.101904
Mayu Hagiwara MS , Ryusuke Suzuki PhD , Seishin Takao PhD , Rumiko Kinoshita MD, PhD , Shizusa Yamazaki MS , Keiji Nakazato MS , Hideki Kojima MP , Takayuki Hashimoto MD, PhD , Keiji Kobashi PhD , Yasuhiro Onodera PhD , Hisanori Fukunaga MD, PhD , Hidefumi Aoyama MD, PhD , Michael F Gensheimer MD , Masahiro Mizuta PhD , Hiroki Shirato MD, PhD
{"title":"A Precise Reirradiation Supporting Tool Initiative (PRISTIN) for Prescribing Absorbed Dose and Number of Fractions in Reirradiation","authors":"Mayu Hagiwara MS ,&nbsp;Ryusuke Suzuki PhD ,&nbsp;Seishin Takao PhD ,&nbsp;Rumiko Kinoshita MD, PhD ,&nbsp;Shizusa Yamazaki MS ,&nbsp;Keiji Nakazato MS ,&nbsp;Hideki Kojima MP ,&nbsp;Takayuki Hashimoto MD, PhD ,&nbsp;Keiji Kobashi PhD ,&nbsp;Yasuhiro Onodera PhD ,&nbsp;Hisanori Fukunaga MD, PhD ,&nbsp;Hidefumi Aoyama MD, PhD ,&nbsp;Michael F Gensheimer MD ,&nbsp;Masahiro Mizuta PhD ,&nbsp;Hiroki Shirato MD, PhD","doi":"10.1016/j.adro.2025.101904","DOIUrl":"10.1016/j.adro.2025.101904","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to develop a supporting tool to calculate the most appropriate prescribing absorbed dose and number of fractions for precise reirradiation.</div></div><div><h3>Methods and Materials</h3><div>After deformable image registration of the initial computed tomography to the computed tomography at reirradiation, an initial biological effective dose (BED) taking into account the recovery from the initial irradiation is calculated voxel-by-voxel for each organ at risk (OAR). Using a commercial radiation therapy planning system, the clinical target volume for reirradiation (CTV2) is made. Keeping the BED<sub>tumor’s α/β</sub> to CTV2, cumulative BED<sub>OAR’s α/β</sub>(CBED<sub>OAR’s α/β</sub>) in each voxel of critical OARs is calculated by changing the number of fractions in a stepwise process. The most appropriate prescribing absorbed dose to the target and the number of fractions in reirradiation is determined by using CBED<sub>OAR’s α/β</sub>-volume histogram for critical OARs. The function of the tool was validated in silico using 3 scenarios in 2 patients: a patient with a lung cancer at the peripheral lung parenchyma and at the hilar lymphatic region at different times, and in a patient with a metastatic internal mammary lymph node relapsed after postoperative radiation therapy for breast cancer.</div></div><div><h3>Results</h3><div>In scenario 1, giving 57 Gy in 22 fractions (57 Gy/22 Fr) to the CTV2 at the right hilum, the maximum CBED<sub>α/β=2</sub> was 124.078 Gy, and the mean CBED<sub>α/β=2</sub> of the whole lung parenchyma excluding gross tumor volume was 18.332 Gy. In scenario 2, 44.152 Gy/7 Fr to the target was suggested to be most appropriate. In scenario 3, 71.675 Gy/30 Fr proton therapy to the target was recommended in which the maximum CBED<sub>α/β=2</sub> in the aorta near the recurrence site was 145.796 Gy, and the volume of CBED<sub>α/β=2</sub> ≥ 100 Gy was 0.800 cm<sup>3</sup>, both are within the constraints.</div></div><div><h3>Conclusions</h3><div>The tool was suggested to be useful to find the most appropriate prescribing absorbed dose to the target as well as the number of fractions for precise reirradiation.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 12","pages":"Article 101904"},"PeriodicalIF":2.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145263498","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}
引用次数: 0
Development and Validation of the Augsburg Nasopharyngeal Applicator: Enhancing Efficacy in Nasal Route Brachytherapy Augsburg鼻咽涂布器的开发和验证:提高鼻路近距离治疗的疗效
IF 2.7
Advances in Radiation Oncology Pub Date : 2025-08-30 DOI: 10.1016/j.adro.2025.101896
Jerome Jean-Joseph MSc , Christoph Westerhausen PhD , Johannes Doescher MD , Bruno Maerkl MD , Zoha Roushan MSc , Maria Neu MD , Tilman Janzen PhD , Klaus-Henning Kahl MD , Georg Stueben MD , Nikolaos Balagiannis MD
{"title":"Development and Validation of the Augsburg Nasopharyngeal Applicator: Enhancing Efficacy in Nasal Route Brachytherapy","authors":"Jerome Jean-Joseph MSc ,&nbsp;Christoph Westerhausen PhD ,&nbsp;Johannes Doescher MD ,&nbsp;Bruno Maerkl MD ,&nbsp;Zoha Roushan MSc ,&nbsp;Maria Neu MD ,&nbsp;Tilman Janzen PhD ,&nbsp;Klaus-Henning Kahl MD ,&nbsp;Georg Stueben MD ,&nbsp;Nikolaos Balagiannis MD","doi":"10.1016/j.adro.2025.101896","DOIUrl":"10.1016/j.adro.2025.101896","url":null,"abstract":"<div><h3>Purpose</h3><div>This study evaluates the Augsburg Nasopharyngeal Applicator (ANA), a novel nasal brachytherapy device designed for early-stage nasopharyngeal carcinoma (T1–T2 stages). ANA leverages nasal anatomy to overcome limitations of oral applicators, optimizing tumor targeting while sparing adjacent tissues, such as the soft palate and oral mucosa.</div></div><div><h3>Methods and Materials</h3><div>ANA was developed using sagittal computed tomography-based anatomic measurements and computer-aided design modeling. Structural integrity was validated through nonlinear finite-element analysis, mechanical stress testing (including Euler buckling tests), and displacement testing (30 min vibration at 5 Hz with 2 cm amplitude). Dosimetry was verified using radiochromic film with 3%/3 mm gamma analysis criteria, following the TG-43 formalism for dose calculation. Insertion feasibility was assessed in a postmortem model under institutional autopsy protocols.</div></div><div><h3>Results</h3><div>ANA (with nylon 6/6 catheter) withstood displacements up to 30 mm without failure. Simulated motion tests demonstrated positional stability (&lt;1 mm displacement). Dosimetry achieved a 97.5% gamma pass rate (clinical acceptability threshold: 95%), with the 20 mm curvature configuration reducing soft palate doses by &gt;50% compared to standard oral applicators (eg, Rotterdam design). Postmortem insertion was completed in 10 min, with endoscopic confirmation of positioning accuracy within 1 mm.</div></div><div><h3>Conclusions</h3><div>ANA demonstrates precise positioning, mechanical stability under simulated physiologic motion (&lt;1 mm displacement), and clinically significant dose sparing (&gt;50% reduction to the soft palate with the 20 mm curvature configuration). Its nasal approach and anatomic adaptability position it as a promising alternative to oral applicators. These proof-of-concept findings support the need for phase 1/2 clinical trials to evaluate safety and efficacy in patients.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 11","pages":"Article 101896"},"PeriodicalIF":2.7,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145156160","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}
引用次数: 0
In Regard to McClure et al 关于麦克卢尔等人
IF 2.7
Advances in Radiation Oncology Pub Date : 2025-08-27 DOI: 10.1016/j.adro.2025.101884
Phillip M. Devlin MD, FASTRO , Anna Likhacheva MD , Gerald White MS
{"title":"In Regard to McClure et al","authors":"Phillip M. Devlin MD, FASTRO ,&nbsp;Anna Likhacheva MD ,&nbsp;Gerald White MS","doi":"10.1016/j.adro.2025.101884","DOIUrl":"10.1016/j.adro.2025.101884","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 11","pages":"Article 101884"},"PeriodicalIF":2.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145262943","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}
引用次数: 0
In Reply to Devlin et al 在回复Devlin等人
IF 2.7
Advances in Radiation Oncology Pub Date : 2025-08-27 DOI: 10.1016/j.adro.2025.101885
Erin McClure MD , Mairead Moloney DO , Yuxuan Jin MS , Lio Yu MD
{"title":"In Reply to Devlin et al","authors":"Erin McClure MD ,&nbsp;Mairead Moloney DO ,&nbsp;Yuxuan Jin MS ,&nbsp;Lio Yu MD","doi":"10.1016/j.adro.2025.101885","DOIUrl":"10.1016/j.adro.2025.101885","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 11","pages":"Article 101885"},"PeriodicalIF":2.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145262944","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}
引用次数: 0
Preoperative Stereotactic Radiosurgery for Brain Metastases: A Phase 1 Dose Escalation Study Demonstrating Reduced Leptomeningeal Disease 术前立体定向放射治疗脑转移瘤:1期剂量递增研究显示轻脑膜疾病减轻
IF 2.7
Advances in Radiation Oncology Pub Date : 2025-08-22 DOI: 10.1016/j.adro.2025.101882
John M. Hoyle MD , James M. Markert MD , Kristen O. Riley MD , Christopher D. Willey MD, PhD , Samuel R. Marcrom MD , Richard A. Popple PhD , Markus Bredel MD, PhD , John B. Fiveash MD
{"title":"Preoperative Stereotactic Radiosurgery for Brain Metastases: A Phase 1 Dose Escalation Study Demonstrating Reduced Leptomeningeal Disease","authors":"John M. Hoyle MD ,&nbsp;James M. Markert MD ,&nbsp;Kristen O. Riley MD ,&nbsp;Christopher D. Willey MD, PhD ,&nbsp;Samuel R. Marcrom MD ,&nbsp;Richard A. Popple PhD ,&nbsp;Markus Bredel MD, PhD ,&nbsp;John B. Fiveash MD","doi":"10.1016/j.adro.2025.101882","DOIUrl":"10.1016/j.adro.2025.101882","url":null,"abstract":"<div><h3>Purpose</h3><div>Preoperative stereotactic radiosurgery (SRS) has been proposed as a strategy to reduce nodular leptomeningeal disease (nLMD) after resection of brain metastases by devitalizing tumor cells before surgical manipulation. This study aimed to determine the safety of preoperative SRS via a phase 1 dose escalation trial and compare outcomes—including nLMD, classical LMD, local control, and overall survival (OS)—between preoperative and postoperative treatment cohorts.</div></div><div><h3>Methods and Materials</h3><div>A phase 1 trial evaluated the safety of single-fraction preoperative SRS at escalating doses (12 and 15 Gy) in patients with tumors 2 to 6 cm. Adverse events were assessed per National Cancer Institute Common Terminology Criteria for Adverse Events v4.0, with dose-limiting toxicity (DLT) defined as high-grade neurologic or wound complications. Retrospective analysis included an expanded preoperative cohort (n = 95) and a historical postoperative cohort (n = 107). Outcomes were analyzed with Kaplan-Meier and Cox proportional hazards models.</div></div><div><h3>Results</h3><div>Fifteen Gy was well tolerated in the phase 1 cohort, with no DLTs in larger tumors (4-6 cm) and 3 DLTs in smaller tumors, not meeting thresholds for dose de-escalation. In the expanded analysis, preoperative SRS significantly reduced rates of nLMD (7.4% vs 27.1%, <em>P</em> = .002), while rates of classical LMD (4.2% vs 4.5%) and local failure (14.6% vs 18.7%) were similar between groups. OS was also similar (median 12.8 vs 12.3 months). Multivariable analysis confirmed preoperative SRS as protective against nLMD (hazard ratio = 0.18, 95% CI, 0.07-0.43, <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Preoperative SRS to 15 Gy is safe for tumors 2 to 6 cm and significantly reduces nLMD without compromising local control or OS. These findings support preoperative SRS as a viable treatment strategy and justify further investigation into optimal dosing and patient selection.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 11","pages":"Article 101882"},"PeriodicalIF":2.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145262945","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}
引用次数: 0
Survival Benefit of Combined Chemoimmunotherapy and Radiation Therapy in Patients with Recurrent or Metastatic Esophageal Cancer 化疗与放疗联合治疗食管癌复发或转移患者的生存获益
IF 2.7
Advances in Radiation Oncology Pub Date : 2025-08-22 DOI: 10.1016/j.adro.2025.101890
Xueru Wang MD , Danyu Guo MD , Xiaoyang Li PhD , Yuan He PhD , Jieyong Tian MD , Dong Qian PhD , Jingjing Cheng PhD
{"title":"Survival Benefit of Combined Chemoimmunotherapy and Radiation Therapy in Patients with Recurrent or Metastatic Esophageal Cancer","authors":"Xueru Wang MD ,&nbsp;Danyu Guo MD ,&nbsp;Xiaoyang Li PhD ,&nbsp;Yuan He PhD ,&nbsp;Jieyong Tian MD ,&nbsp;Dong Qian PhD ,&nbsp;Jingjing Cheng PhD","doi":"10.1016/j.adro.2025.101890","DOIUrl":"10.1016/j.adro.2025.101890","url":null,"abstract":"<div><h3>Purpose</h3><div>Chemotherapy combined with immune checkpoint inhibitors (ICIs) has become the standard first-line treatment for recurrent or metastatic esophageal cancer, but its efficacy remains suboptimal. This study aimed to evaluate whether the addition of radiation therapy (RT) to ICIs can improve patients’ survival.</div></div><div><h3>Methods and Materials</h3><div>This retrospective cohort study analyzed clinical data from 178 patients with recurrent or metastatic esophageal cancer who were treated at the First Affiliated Hospital of USTC between December 2019 and October 2023. Based on their actual treatment regimens, patients were stratified into 2 groups: the chemoimmunotherapy-alone group (ICIs group) and the chemoimmunotherapy combined with RT group (ICIs + RT group). To minimize selection bias, propensity score matching was used to balance baseline characteristics between the groups before comparative analysis. The primary endpoint was overall survival, and the secondary endpoints were progression-free survival and safety.</div></div><div><h3>Results</h3><div>After propensity score matching, 128 patients were selected for the final analysis, with 64 patients in the ICIs + RT group and 64 patients in the ICIs group. The median follow-up time was 11.26 months (95% CI, 7.02-15.32). The median overall survival was 23.71 months in the ICIs + RT group and 13.00 months in the ICIs group (hazard ratio, 0.53; 95% CI, 0.31-0.88; <em>P</em> = .013). The median progression-free survival was 10.43 months in the ICIs + RT group and 7.27 months in the ICIs group (hazard ratio, 0.61; 95% CI, 0.39-0.94; <em>P</em> = .024). Combination of chemoimmunotherapy and RT was safe and tolerable. No treatment-related deaths occurred in either group.</div></div><div><h3>Conclusions</h3><div>Adding RT can significantly improve survival in patients with recurrent or metastatic esophageal cancer who are treated with chemoimmunotherapy, but further prospective trials are needed for validation.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 11","pages":"Article 101890"},"PeriodicalIF":2.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118951","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}
引用次数: 0
Implementation of Proton Radiation Treatment Exclusion Volume Because of Inconsistent Location of Breast Expander Titanium Port 扩胸器钛口位置不一致导致质子放射治疗排除容积的实现
IF 2.7
Advances in Radiation Oncology Pub Date : 2025-08-21 DOI: 10.1016/j.adro.2025.101876
Emily T. Tran BS , Patrick Newbury MD , Mark Newpower PhD , Heather Ortega CMD , Timothy D. Malouff MD , Christina Henson MD
{"title":"Implementation of Proton Radiation Treatment Exclusion Volume Because of Inconsistent Location of Breast Expander Titanium Port","authors":"Emily T. Tran BS ,&nbsp;Patrick Newbury MD ,&nbsp;Mark Newpower PhD ,&nbsp;Heather Ortega CMD ,&nbsp;Timothy D. Malouff MD ,&nbsp;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}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信