Advances in Radiation Oncology最新文献

{"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":"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":"In Regard to Niazi et al","authors":"Erkan Topkan MD ,&nbsp;Efsun Somay PhD ,&nbsp;Ugur Selek MD","doi":"10.1016/j.adro.2024.101707","DOIUrl":"10.1016/j.adro.2024.101707","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 4","pages":"Article 101707"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834115","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":"Advances in Radiation Oncology Top Downloaded Articles of 2024","authors":"Rachel B. Jimenez MD","doi":"10.1016/j.adro.2025.101749","DOIUrl":"10.1016/j.adro.2025.101749","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 4","pages":"Article 101749"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834114","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":"Association of Circulating Inflammatory Biomarker Levels and Toxicity in Patients Undergoing Pelvic Radiation for Cancer: A Critical Review","authors":"Per Fessé PhD ,&nbsp;Per-Arne Svensson PhD ,&nbsp;Björn Zackrisson PhD ,&nbsp;Alexander Valdman PhD ,&nbsp;Per Fransson PhD ,&nbsp;Kjell Grankvist PhD ,&nbsp;Ingrid Kristensen PhD ,&nbsp;Ulrica Langegård PhD ,&nbsp;Emma Ohlsson-Nevo PhD ,&nbsp;Katarina Sjövall PhD ,&nbsp;Linda Åkeflo PhD ,&nbsp;Karin Ahlberg PhD","doi":"10.1016/j.adro.2025.101766","DOIUrl":"10.1016/j.adro.2025.101766","url":null,"abstract":"<div><h3>Purpose</h3><div>Radiation therapy (RT) causes tissue damage and inflammation. Because cytokines play a key role in such processes, their expression levels can be an indicator of cell and tissue toxicity. This critical review aims to explore whether levels of circulating inflammatory biomarkers in peripheral blood are associated with proton- or photon-based therapy in the pelvic area and how these levels vary over time. Further, we investigated whether these levels can be linked to radiation dose, the incidence of toxicity, and changes in toxicity over time.</div></div><div><h3>Methods and Materials</h3><div>A literature search was conducted in PubMed to find studies involving comparative cohorts of pelvic irradiated patients with cancer. Studies reporting on the association of markers in peripheral blood with inflammatory processes and/or toxicity were included.</div></div><div><h3>Results</h3><div>We found evidence of associations between changes in inflammatory cytokine levels and the total cumulative dose-volume together with RT-induced toxicity in patients with cancer treated with pelvic RT. Common patient-reported outcomes demonstrate an association between radiation toxicity (eg, genitourinary toxicity) and circulating inflammatory biomarker levels.</div></div><div><h3>Conclusions</h3><div>This review highlights that the total cumulative dose and irradiated tissue volume are the primary drivers of RT-induced biomarker expression, influencing both early and late toxicity outcomes. The diversity in RT techniques, total dose, and number of treatment sessions across studies likely contributes to the variation in observed results. Circulating cytokine and biomarker levels in the blood can provide valuable monitoring and predictive insights for patients undergoing proton- or photon-based RT of the pelvis. Biomarker analysis in the context of RT offers clinical value by enabling personalized treatment by helping predict which patients are at higher risk for certain toxicities, guiding clinicians in tailoring treatment, optimizing supportive care, and adjusting RT plans. This approach could improve patient outcomes and quality of life by reducing long-term complications from radiation exposure.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 6","pages":"Article 101766"},"PeriodicalIF":2.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143854518","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":"Re-irradiation With Carbon Ion Beams for Recurrent Adenoid Cystic Carcinoma of the Tongue Base: A Case Report","authors":"Eisuke Horigome MD, PhD ,&nbsp;Atsushi Musha DDS, PhD ,&nbsp;Nobuteru Kubo MD, PhD ,&nbsp;Naoko Okano MD, PhD ,&nbsp;Hidemasa Kawamura MD, PhD ,&nbsp;Tatsuya Ohno MD, PhD","doi":"10.1016/j.adro.2025.101761","DOIUrl":"10.1016/j.adro.2025.101761","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 5","pages":"Article 101761"},"PeriodicalIF":2.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143799444","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":"Targeting Active Microglia Alleviates Distal Edge of Proton Radiation-induced Neural Damage","authors":"Keman Liao PhD ,&nbsp;Dan Ou PhD ,&nbsp;Mei Chen PhD ,&nbsp;Fei Xu MD ,&nbsp;Jianyi Zhao BS ,&nbsp;Li Zhou BS ,&nbsp;Ran Wu PhD ,&nbsp;Yingying Lin PhD ,&nbsp;Yibin Zhang BS ,&nbsp;Lu Cao PhD ,&nbsp;Jiayi Chen PhD","doi":"10.1016/j.adro.2025.101764","DOIUrl":"10.1016/j.adro.2025.101764","url":null,"abstract":"<div><h3>Purpose</h3><div>Proton therapy (PT) has distinct advantages in its ability to precisely target tumors while avoiding adjacent normal tissues. However, the distal edge effects of PT constrain its application. This study investigated the brain tissue response in the distal edge regions of protons and compared it with the effect of photons.</div></div><div><h3>Methods and Materials</h3><div>The occurrence of damage from photons and at the distal edge of protons was investigated in a murine model. Bragg peak treatment plans for murine models were optimized. Hematoxylin and eosin and immunofluorescence staining were performed along the distal margin. In addition, the approximate distance from the Bragg peak to the neuronal damage sites was calculated. Furthermore, a small-molecule inhibitor was studied for its ability to inhibit microglia activation.</div></div><div><h3>Results</h3><div>The distal edge brain injury murine model was successfully established. Reactive gliosis and granulovacuolar neuronal degeneration were observed in the right hemisphere of the brain in the proton irradiation group. Neuronal injuries were observed at multiple locations (the frontal lobe, thalamus, and cerebral cortex) along the distal border, but no injured neurons were detected along vertical photon irradiation exposed areas. Meanwhile, severe neural damage was seen with horizontal photon irradiation. At the distal edge of the Bragg peak (0.4633 ± 0.01856 cm), microglia with abnormal morphology accumulated. IBA1 and CD68 staining revealed activated microglia at the corresponding neuronal damage sites, indicating their involvement in irradiation-induced damage. Activated microglia were not observed with vertical photon irradiation, whereas many activated microglia were observed with horizontal photon irradiation. Moreover, asparagine endopeptidase inhibitors administered via intraperitoneal injection significantly reduced active microglia in the thalamus and cerebral cortex and alleviated brain damage.</div></div><div><h3>Conclusions</h3><div>This study demonstrated that proton radiation induces neuronal damage and accumulation of activated microglia at the distal edge. Targeting activated microglia may play a protective role in distal edge injury from radiation.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 5","pages":"Article 101764"},"PeriodicalIF":2.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816866","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":"The Use of Breast Cup Immobilization in Radiation Therapy and Patient-Reported Outcomes on Cosmesis and Pain","authors":"Daniel Chapman M.D., M.P.H ,&nbsp;Andrea Matsumoto D.N.P. ,&nbsp;Kate Aldridge ,&nbsp;Maggie Yin M.S. ,&nbsp;Kent Griffith M.S. ,&nbsp;Melissa Mietzel M.S. ,&nbsp;Eleanor M. Walker M.D.","doi":"10.1016/j.adro.2025.101759","DOIUrl":"10.1016/j.adro.2025.101759","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;Breast cosmesis and breast pain are among the most reported outcomes in patients undergoing adjuvant breast irradiation. The degree to which such adverse reactions occur can be variable based on different patient-specific characteristics. It has been found that women with a larger body habitus, and larger breasts, tend to have an increased chance of experiencing worse toxicity from treatment. As such, attempts to improve cosmetic and pain outcomes have been a highly explored topic. One such technique, that is studied here, is to explore whether the use of a breast cup during treatment leads to worse breast pain and cosmetic outcomes when compared with those treated without a breast cup. This proves to be an important topic because it is believed that the use of a breast cup would provide a significant dosimetric advantage (ie, breast coverage and organ at risk dosing) during treatment. We now explore this treatment option through the scope of a retrospective analysis of patient-reported outcomes experienced during and after completing postoperative radiation therapy to the breast.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods and Materials&lt;/h3&gt;&lt;div&gt;A total of 645 patients undergoing adjuvant breast irradiation were evaluated from 2011 to 2019. Of the 645 patients, 79 were treated using a breast cup. The mean heart dose was analyzed and compared between the 2 treatment groups. Additionally, patient-reported outcomes among the entire cohort were collected via survey documentation forms during treatment, at 1 month after the completion of treatment, and at 1 year after the completion of treatment. These results were collected using the Michigan Radiation Oncology Quality Consortium database because each patient was consented to enroll in the Michigan Radiation Oncology Quality Consortium prior to starting treatment. The outcomes of skin changes, lymphedema, and breast pain among the 2 treatment groups were then compared for statistically significant differences via a logistic regression analysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of the 79 patients treated with a breast cup, grade 2 pruritus of the treated breast along with grade 1 alteration in skin texture was reported in 49.4%, 35.4%, and 22.8% while on treatment, at 1 month after the completion of treatment, and at 1 year after treatment, respectively; &lt;em&gt;P&lt;/em&gt;-values were nonsignificant at all timepoints when data compared with non-cup-treated patients. With regard to lymphedema, 59.5%, 40.5%, and 10.1% of breast cup patients at the prespecified timepoints reported this sequela; all &lt;em&gt;P&lt;/em&gt;-values were nonsignificant except for the 1-month mark (&lt;em&gt;P&lt;/em&gt;-value .03). Lastly, breast pain was noted in 36.7%, 15.2%, and 11.4% of breast cup-treated patients while on treatment, at 1 month after the completion of treatment, and at 1 year after treatment, respectively; again, &lt;em&gt;P&lt;/em&gt;-values for data analysis at each timepoint were nonsignificant. Other than the patient-reported out","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 5","pages":"Article 101759"},"PeriodicalIF":2.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143825706","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":"Target Contour Consistency During Magnetic Resonance-Guided Online Adaptive Stereotactic Body Radiation Therapy","authors":"Suzanne Kirby BS ,&nbsp;Kiana Rahimi BS ,&nbsp;William Song PhD,&nbsp;Elisabeth Weiss MD","doi":"10.1016/j.adro.2025.101765","DOIUrl":"10.1016/j.adro.2025.101765","url":null,"abstract":"<div><h3>Purpose</h3><div>Adaptive magnetic resonance-guided stereotactic body radiation therapy (MRgSBRT) requires expeditious recontouring of target volumes based on daily anatomy. Contouring of the gross tumor volume (GTV) is frequently performed by covering radiation oncologists who may be less familiar with the case than the primary physician (PP). The objective of this study is to determine consistency in GTV contouring between PP and covering physician (CP) and to analyze the effect of resources to support accurate GTV delineation.</div></div><div><h3>Methods and Materials</h3><div>Between 2021 and 2023, 59 patients underwent 302 fractions of MRgSBRT at our institution. GTVs were analyzed for the effect of 3 different types of contouring support resources: (a) number of slices of the original GTV, (b) external software displaying original GTV contours, and (c) alerting if GTVs differed &gt; 10% from the original. Differences between physicians and contouring support resources were analyzed for different tumor sites and fractions using 2-tailed <em>t</em> test and analysis of variance.</div></div><div><h3>Results</h3><div>One hundred nineteen out of 302 (39.4%) MRgSBRT treatments were supervised by a CP. The difference in the mean absolute percent volume change of GTV compared with original GTV for PPs (11.1%) versus CPs (4.6%) across all treatment fractions was statistically significant (<em>P</em> = .00006). Significant differences were observed for pancreas (12.8% vs 5.0%, <em>P</em> = .03), liver (13.0% vs 4.0%, <em>P</em> = .007), and lymph nodes (12.4% vs 2.1%, <em>P</em> = .004) with larger volume differences for PPs. No significant differences were observed for tumors of the prostate (3.7% vs 3.6%) and adrenal glands (9.7% vs 12.2%). No significant GTV differences between the 3 contouring support techniques were observed.</div></div><div><h3>Conclusions</h3><div>Our results show larger GTV changes by PPs for most tumor sites with little impact from contouring support resources. Observed differences might be related to higher contouring confidence of PPs who are more familiar with the case. Further investigation into enhancing contouring support methods is warranted.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 5","pages":"Article 101765"},"PeriodicalIF":2.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777152","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}