Advances in Radiation Oncology最新文献

{"title":"Impact of a Dedicated Inpatient Radiation Oncology Consult Service on Goal-Concordant Care","authors":"Morgan E. Freret MD, PhD ,&nbsp;Divya Yerramilli MD ,&nbsp;Victoria S. Brennan MBBch, BAO ,&nbsp;Lillian A. Boe PhD ,&nbsp;C. Jillian Tsai MD ,&nbsp;Oren Cahlon MD ,&nbsp;Simon N. Powell MD, PhD, FRCP ,&nbsp;Jonathan T. Yang MD, PhD ,&nbsp;Sean McBride MD, MA ,&nbsp;Puneeth Iyengar MD, PhD ,&nbsp;Daniel R. Gomez MD, MBA ,&nbsp;Amy J. Xu MD, PhD","doi":"10.1016/j.adro.2025.101939","DOIUrl":"10.1016/j.adro.2025.101939","url":null,"abstract":"<div><h3>Purpose</h3><div>Radiation therapy has an increasing role in the management of metastatic cancers. Integrating radiation with surgical and systemic approaches is complex, and inappropriate management can lead to prolonged hospitalizations inconsistent with palliative goals. An inpatient radiation oncology consult (IROC) service was created in January 2020 to provide rapid access to specialized care for hospitalized patients. Here, we report outcomes of the IROC service, focusing on quality-of-care metrics including hospital length of stay (LOS), use of hypofractionated approaches, and treatments for patients discharged to hospice.</div></div><div><h3>Methods and Materials</h3><div>We conducted a pre-post observational study to compare inpatient consults placed before (<em>N</em> = 1507) and after (<em>N</em> = 1509) IROC, from 2019 to 2021. Continuous variables were analyzed using the Mann-Whitney test and categorical variables using Fisher’s exact test.</div></div><div><h3>Results</h3><div>We found that IROC was associated with reductions in hospital LOS (mean difference 1.0 days, <em>P</em> = .045). Under IROC, inpatient treatment courses were shorter (5.8 vs 5.0 days, <em>P</em> = .007), in part driven by increased adoption of palliative hypofractionated radiation therapy approaches (74% vs 82%, <em>P</em> = .001). The reduction in LOS was greatest for patients discharged to hospice (5.1 vs 3.7 days, <em>P</em> = .036).</div></div><div><h3>Conclusions</h3><div>The IROC service was associated with reduced hospital LOS, increased use of hypofractionated approaches, and decreased treatments for patients discharged to hospice. Our findings demonstrate the value of a dedicated program addressing radiation delivery to hospitalized patients to improve goal-concordant treatments. The financial impact of reducing low-value care is an important subject for future investigations.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"11 1","pages":"Article 101939"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145615610","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":"Boron Neutron Capture Therapy in Recurrent High-Grade Gliomas: Safety, Efficacy, and Pharmacokinetics From a Multicenter, Dose-Escalation Phase 1 Trial","authors":"Woohyoung Kim MD, PhD ,&nbsp;Jae-Sung Park MD, PhD ,&nbsp;Jin-Ho Song MD, PhD ,&nbsp;Heon Yoo MD, PhD ,&nbsp;Kawngwoo Park MD, PhD ,&nbsp;Hyun Ju Kim MD ,&nbsp;Dong-Won Shin MD, PhD ,&nbsp;Sung Uk Lee MD, PhD ,&nbsp;Stephen Ahn MD, PhD ,&nbsp;Seunggyun Ha MD, PhD ,&nbsp;JunGyu Yi MS ,&nbsp;Kwan Cho MD ,&nbsp;Hyo Jung Seo MD, PhD ,&nbsp;Hyung-Seok Lim MD, PhD ,&nbsp;Gi-Taek Yee MD, PhD","doi":"10.1016/j.adro.2025.101947","DOIUrl":"10.1016/j.adro.2025.101947","url":null,"abstract":"<div><h3>Purpose</h3><div>Boron neutron capture therapy (BNCT) is an advanced radiation therapy delivering highly selective tumor cell destruction via localized fission reactions. This phase 1 study evaluated the safety and efficacy of BNCT using [B-10]L-4-boronophenylalanine (BPA) in patients with recurrent high-grade gliomas, mostly glioblastomas.</div></div><div><h3>Methods and Materials</h3><div>A 3 + 3 dose-escalation design was used to determine the maximum tolerated dose of BNCT across 3 planned cohorts (D_max: 9, 11, and 13 Gy-Eq), with 3 additional subjects enrolled at any dose level where dose-limiting toxicity (DLT) occurred. DLT was defined as BNCT-related grade 3+ toxicities within 90 days posttreatment, with protocol-defined exclusions. Patients underwent a single session: intravenous BPA administration (500 mg/kg/3 h) and neutron irradiation 1 hour later. The primary endpoint was the recommended phase 2 radiation dose, based on DLT incidence. Secondary endpoint included safety, efficacy, and pharmacokinetics: treatment-emergent adverse events (TEAEs), progression-free survival, objective response rate, and overall survival (OS).</div></div><div><h3>Results</h3><div>Six patients were treated between December 2022 and January 2024: 3 in the 9 Gy-Eq and 3 in the 11 Gy-Eq cohort. No DLTs or grade ≥4 TEAEs occurred. Two patients experienced grade 3 TEAEs (brain edema, seizure). Common adverse events were alopecia, aphasia, brain edema, and seizures. One serious adverse event (grade 3 seizure) was reported. Median follow-up was 9.03 months. Median progression-free survival was 1.87 months by response assessment in neuro-oncology; not reached by modified response assessment in neuro-oncology. Objective response was not observed. All patients survived to study completion; median OS not reached, maximum OS was 16.56 months. BPA pharmacokinetics were within expected ranges. The safety monitoring committee selected 11 Gy-Eq as the recommended phase 2 radiation dose, balancing tumoricidal effects with risks of necrosis and bevacizumab requirements.</div></div><div><h3>Conclusions</h3><div>This study demonstrates the acceptable safety profile of BNCT and suggests potential survival benefits in recurrent high-grade glioma. However, given the limited sample size and follow-up period, extended observation is required to validate long-term efficacy and safety.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"11 1","pages":"Article 101947"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681752","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":"Reduced-Dose Hypofractionated Radiation Therapy (3 Gy × 3 Fractions) for Indolent Non-Hodgkin’s lymphoma (POSEIDON): A Multisite Phase 2 Randomized Trial Protocol","authors":"Omran Saifi ,&nbsp;Scott C. Lester ,&nbsp;William G. Rule ,&nbsp;William Breen ,&nbsp;Randa Tao ,&nbsp;Jason R. Young ,&nbsp;Liuyan Jiang ,&nbsp;Han W. Tun ,&nbsp;Emily Liu ,&nbsp;Lauren E. Haydu ,&nbsp;Allison Rosenthal ,&nbsp;Javier Munoz ,&nbsp;Jose Caetano Villasboas ,&nbsp;Yucai Wang ,&nbsp;Muhamad Alhaj Moustafa ,&nbsp;Madiha Iqbal ,&nbsp;Anna C. Harrell ,&nbsp;Jennifer L. Peterson ,&nbsp;Bradford S. Hoppe MD, MPH","doi":"10.1016/j.adro.2025.101908","DOIUrl":"10.1016/j.adro.2025.101908","url":null,"abstract":"<div><div>Indolent non-Hodgkin’s lymphoma, including follicular and marginal zone lymphoma, is highly radiosensitive, with radiation therapy (RT) serving as an effective treatment. Although standard RT doses (24 Gy in 12 fractions) provide excellent disease control, they are associated with toxicity. Emerging evidence suggests that lower RT doses may maintain efficacy while reducing toxicity; however, prior prospective randomized attempts to reduce the dose to 4 Gy in 2 fractions have demonstrated inferior disease control. This phase 2 randomized trial aims to determine whether reduced-dose hypofractionated RT can achieve comparable disease control while minimizing toxicity and treatment burden. Patients will be randomized 1:1 to receive experimental arm treatment with 8 to 10 Gy in 2 to 5 fractions or standard of care treatment with 24 Gy in 12 fractions. The primary endpoint is acute toxicity (grade ≥ 2). Secondary endpoints include patient-reported quality of life (FACIT-Fatigue scale), response rate at 3 months posttreatment (Lugano criteria), local control, relapse-free survival, and overall survival. Exploratory analyses will evaluate financial toxicity (COST-FACIT questionnaire), health care expenditure, late toxicity, and the prognostic value of preradiation metabolic imaging parameters, including metabolic tumor volume, total lesion glycolysis, and maximum standardized uptake value, as well as molecular biomarkers such as <em>TP53, MYC</em>, and Ki-67.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"11 1","pages":"Article 101908"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145615559","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":"Safety of Combining Radiation Therapy and Antibody Drug Conjugates in Advanced Urothelial and Other Cancers","authors":"Derrick Lock ,&nbsp;Yash S. Soni ,&nbsp;Lindsay Hwang ,&nbsp;Suzanne Cole ,&nbsp;Anishka D’Souza ,&nbsp;Aurelie Garant ,&nbsp;Daniel X. Yang ,&nbsp;Waddah Arafat ,&nbsp;Tian Zhang ,&nbsp;Leslie K. Ballas ,&nbsp;Neil B. Desai","doi":"10.1016/j.adro.2025.101926","DOIUrl":"10.1016/j.adro.2025.101926","url":null,"abstract":"<div><div>Antibody drug conjugates (ADCs) such as enfortumab vedotin and sacituzumab govitecan are novel treatments increasingly used for metastatic urothelial carcinoma. There is limited data evaluating their safety when combined with radiation therapy (RT). A bi-institutional retrospective analysis was performed to characterize toxicity in patients who received RT within 6 months of receipt of ADC. Patients were stratified by intensity of RT (higher vs lower), site of RT, and RT timing relative to ADC. One hundred three patients received 166 courses of RT (66% lower vs 34% higher intensity). In 11% of courses, RT was directed to the pelvis including the bladder. Of 77 (46%) RT courses concurrent with ADC, 7 (12%) patients experienced grade 1-2 toxicity, and 10 (13%) patients experienced grade 3-5 toxicity. All of these were attributed to known ADC toxicities, and only one was possibly influenced by the addition of RT. No patients receiving RT to the bladder experienced high-grade toxicity. This retrospective study thus found no added safety events for patients receiving RT with ADCs, even when administered concurrently. Further data to validate these findings is needed as the use of both ADCs and RT increases in patients with urothelial carcinoma.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"11 1","pages":"Article 101926"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145615562","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":"Lessons Learned From an Epic Transformation of a Radiation Oncology Department in Guatemala: Keys to Success","authors":"Edgar Ruiz MD ,&nbsp;Hiram A. Gay MD ,&nbsp;Milton Ixquiac MS ,&nbsp;Angel Velarde MD ,&nbsp;Baozhou Sun PhD ,&nbsp;Jose García-Ramirez MS ,&nbsp;Eric Laugeman MS ,&nbsp;Benjamin Li MD ,&nbsp;Jeff Michalski MD ,&nbsp;Vicky de Falla MD ,&nbsp;Geoff Hugo PhD ,&nbsp;Jacaranda Van Rheenen PhD","doi":"10.1016/j.adro.2025.101928","DOIUrl":"10.1016/j.adro.2025.101928","url":null,"abstract":"<div><h3>Purpose</h3><div>We describe the radical modernization of a radiation oncology department in a developing country, Guatemala, from 2015 to the beginning of 2024. The Instituto de Cancerología y Hospital Dr. Bernardo del Valle S (INCAN) is the only public radiotherapy clinic serving patient referrals from the Ministry of Public Health and Social Assistance program.</div></div><div><h3>Methods and Materials</h3><div>We describe the state of the radiation oncology department in 2015 versus 2024 while chronicling its gradual transformation. This multifaceted collaboration involved academic centers, government agencies, International Atomic Energy Agency (IAEA), industry, and nonprofits and continues to this day. We analyze the infrastructure, staff, radiotherapy equipment, physics equipment, patient careCo-60 decommissioning, and educational initiatives.</div></div><div><h3>Results</h3><div>We graphically illustrate the impact of these changes in treatment delivery time, consults, follow-up visits, CT simulations, new patients treated in each linear accelerator, new patients treated with 2D, 3D, IMRT/VMAT, and superficial techniques, new patients treated with 2D LDR, 2D HDR, or 3D techniques, causes of linear accelerator downtime, and weekly patients on treatment. We provide a figure of the various sequential and parallel steps to modernize a radiation oncology department. We describe the complexities of radioisotope repatriation and safe disposal. We provide a comprehensive table of wisdom pearls regarding project governance, team, education, finances, culture, and language. We also discuss the impact of artificial intelligence in contouring</div></div><div><h3>Conclusion</h3><div>The transformation of the INCAN radiation oncology department in Guatemala is a testimony to many's hard work, vision, and perseverance for the betterment of Guatemalan patients while facing incredible financial hardship. We hope that what we have learned in the past nine years will help others achieve even greater success in a shorter time</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"11 1","pages":"Article 101928"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733028","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":"Circulating Tumor DNA Predicts Response After Definitive Radiation Therapy for Merkel Cell Carcinoma","authors":"Kyle Murchison BS ,&nbsp;Anthony Camargo BA ,&nbsp;Danielle Margalit MD ,&nbsp;Jonathan D. Schoenfeld MD, MPH ,&nbsp;Roy Tishler MD ,&nbsp;Karam Khaddour MD ,&nbsp;Manisha Thakuria MD ,&nbsp;Ann W. Silk MD","doi":"10.1016/j.adro.2025.101918","DOIUrl":"10.1016/j.adro.2025.101918","url":null,"abstract":"<div><h3>Purpose</h3><div>Merkel cell carcinoma (MCC) is a rare, aggressive skin cancer with a high recurrence rate. Circulating tumor DNA (ctDNA) assays are increasingly used to assess treatment response and detect recurrence. This study evaluated the value of ctDNA levels in MCC patients treated with definitive radiation therapy (dRT).</div></div><div><h3>Methods and Materials</h3><div>We identified 48 patients with MCC treated with dRT from 2021-2024 treated at our institute. The level of ctDNA was measured within 90 days before and 180 days after initiating dRT using a tumor-informed multiplex polymerase chain reaction assay targeting up to 16 patient-specific mutations. Disease status at follow-up was categorized as no evidence of disease (NED) or clinical evidence of disease. ctDNA dynamics were compared across disease outcome groups using the Wilcoxon rank-sum test.</div></div><div><h3>Results</h3><div>At baseline, the value of median ctDNA levels were higher in stage 1 versus stage 1-2. Of 23 patients with detectable ctDNA levels at baseline, 15 achieved undetectable levels following dRT. ctDNA levels declined significantly during (<em>P</em> = .0125) and after dRT (<em>P</em> = .0004). Among patients who became NED, ctDNA levels declined rapidly. In contrast, persistent or rising value of ctDNA levels after dRT was associated with recurrence. Nine of 10 patients with detectable ctDNA levels after dRT experienced recurrence, with a median time to recurrence of 117 days. Among patients with undetectable ctDNA levels during dRT, the negative predictive value for recurrence was 90%.</div></div><div><h3>Conclusions</h3><div>ctDNA levels decline rapidly during and after dRT in patients with MCC, particularly in those who achieve NED. Detectable ctDNA levels after dRT are strongly associated with recurrence, supporting the use of ctDNA level as a noninvasive biomarker to assess treatment response and guide posttreatment surveillance.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"11 1","pages":"Article 101918"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519041","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":"Biologically Effective Dose and Dose Rate in Gamma Knife Radiosurgery for Trigeminal Neuralgia: A Systematic Review and Meta-Analysis","authors":"Jane Jomy MSc ,&nbsp;Ke Xin Lin BMSc ,&nbsp;Radha Sharma BSc ,&nbsp;Rachel Lu BMSc ,&nbsp;Sanchit Kaushal BHSc ,&nbsp;Anna T. Santiago MSc ,&nbsp;Dana Keilty MD, MSc ,&nbsp;David Shultz MD, PhD ,&nbsp;Catherine Coolens PhD ,&nbsp;Michael D. Cusimano MD, PhD ,&nbsp;Gelareh Zadeh MD, PhD ,&nbsp;Mojgan Hodaie MD, PhD ,&nbsp;Suneil K. Kalia MD, PhD ,&nbsp;Farshad Nassiri MD, PhD ,&nbsp;Ying Meng MD ,&nbsp;Derek S. Tsang MD, MSc ,&nbsp;Michael Yan MD, MPH","doi":"10.1016/j.adro.2025.101932","DOIUrl":"10.1016/j.adro.2025.101932","url":null,"abstract":"<div><h3>Purpose</h3><div>Gamma Knife radiosurgery (GKRS) is used in the treatment of trigeminal neuralgia (TN) to deliver precise, focused ionizing radiation to the trigeminal nerve, thereby reducing its ability to transmit pain signals. Understanding the impact of unique radiobiological parameters, such as the biologically effective dose (BED) and dose rate, in GKRS is essential to optimize treatment protocols and ensure predictable therapeutic outcomes. We conducted a systematic review and meta-analysis to evaluate how BED and dose rate impact GKRS effectiveness and toxicity.</div></div><div><h3>Methods and Materials</h3><div>We searched medical and health care databases from inception to May 19, 2024, for publications reporting on the impact of GKRS BED and/or dose rate on TN outcomes. Following 2 rounds of screening conducted in duplicate, we used random-effects meta-analysis and meta-regression to examine the association between dose rate and pain relief.</div></div><div><h3>Results</h3><div>Of 6950 citations identified, 8 publications reported data on BED and dose rate association with GKRS patient outcomes in TN. Eight cohorts reported on 2596 patients in 6 countries. The “beam-on” time ranged from 27 to 171 minutes, and the prescription dose ranged from 62.5 to 95 Gy. The median BED_2.47 was 2105 Gy (range, 1968-2675), the median dose rate was 2.2 Gy/min (range, 2.06-2.81), and the median maximum brainstem dose was 20.7 Gy (range, 14.8-34.7). The meta-analysis suggested that higher dose rates may be associated with higher rates of pain relief (relative risk, 1.36 [95% CI, 1.10-1.67]; <em>P</em> = .005). Meta-regression demonstrated a nonsignificant relationship between dose rate and pain relief, with an estimated 26% increase in the likelihood of pain control for each 1 Gy/min increase in the median dose rate (β, 0.26 [95% CI, −1.09, 1.60]; <em>P</em> = .71).</div></div><div><h3>Conclusions</h3><div>Higher dose rates in GKRS may be associated with better pain relief in TN. Dose rate should be considered in the treatment of TN when using GKRS.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"11 1","pages":"Article 101932"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578204","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":"Feasibility of Very High Cumulative Equivalent Dose in 2 Gy Fraction in Locally Advanced Central/Ultracentral Nonsmall Cell Lung Cancer Treated With Conventional Chemoradiation Therapy and a Stereotactic Boost","authors":"Anna Gueiderikh MD, PhD ,&nbsp;Baptiste Lhomel ,&nbsp;Renaud Schiappa ,&nbsp;Médéric Barret MD ,&nbsp;Victoria Ferrari MD ,&nbsp;Arash O. Naghavi MD, MS ,&nbsp;Bastien Chanoux ,&nbsp;Pierre-Yves Bondiau MD, PhD ,&nbsp;Jérôme Doyen MD, PhD","doi":"10.1016/j.adro.2025.101925","DOIUrl":"10.1016/j.adro.2025.101925","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to evaluate the cumulative equivalent dose in 2 Gy fractions (EQD2) to organs at risk and its potential correlation with toxicities in patients with locally advanced nonsmall cell lung cancer treated with very high mediastinal radiation therapy doses using mixed fractionation.</div></div><div><h3>Methods and Materials</h3><div>Patients from a previously reported phase 1 trial (PMID: 29650404) were included (n = 26). They received a stereotactic boost (3 × 7-12 Gy) following chemoradiation therapy (cisplatin-based chemotherapy and 23 × 2 Gy using three-dimensional conformal radiation therapy). Seventeen treatment plans were available for dosimetric analysis. Doses delivered at each point of the planning computed tomography scan from each treatment phase were converted to EQD2 based on the α:β ratios, which are shown in asterisks following each converted dose. The 3-dimensional conformal radiation therapy and stereotactic body radiation therapy plans were each converted to EQD2, and their summation was used to estimate the total dose delivered to organs at risk.</div></div><div><h3>Results</h3><div>In the entire cohort (n = 26), 77% of tumors were ultracentral, 19% peripheral, and 4% central. We observed 1 grade 3 toxicity (bronchial stenosis/fibrosis), 1 grade 4 toxicity (esophagitis with fistula), and 1 grade 5 toxicity (fatal hemoptysis). Dosimetric evaluation of the proximal bronchovascular (PBV) tree and esophagus revealed no severe late toxicity with PBV tree D1cc &lt; 150 Gy *2* and esophageal D1cc &lt; 100 Gy *10*. Median maximal EQD2 D1cc for organs at risk were as follows: aorta, 84.3 Gy *3* (range, 53.3-190.6); pulmonary arteries, 136.9 Gy *3* (range, 47.2-232.3); superior vena cava, 70.6 Gy *3* (range, 16.2-192.8); pulmonary veins, 69.0 Gy *3* (range, 3.5-231); esophagus, 67.9 Gy *10* (range, 15.7-161); PBV tree, 153.4 Gy *2* (range, 20.3-235.9).</div></div><div><h3>Conclusions</h3><div>The following preliminary dose constraints—PBV tree D1cc &lt; 150 Gy *2* and esophageal D1cc &lt; 100 Gy *10*—may be safe and are currently being prospectively evaluated in an ongoing phase 2 trial (NCT06627738). The correlation between toxicities and the degree of initial tumor infiltration of organs at risk requires further prospective evaluation.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"11 1","pages":"Article 101925"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145615561","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":"A Case of External Beam Radiation Therapy Induced Corneal Damage in the Treatment of Squamoid Eccrine Ductal Carcinoma","authors":"Amelia Momtazzadeh BS ,&nbsp;Ilakiya Raghavendiran ,&nbsp;Christina Henson MD ,&nbsp;Annie Moreau MD ,&nbsp;Elise E. Steinberger MD","doi":"10.1016/j.adro.2025.101935","DOIUrl":"10.1016/j.adro.2025.101935","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"11 1","pages":"Article 101935"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733030","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":"Rural cancer financial toxicity screening","authors":"Yash Deshmukh ,&nbsp;Melanie L. Rose MD ,&nbsp;Renata W. Yen PhD, MPH ,&nbsp;Sybil T. Jones MD ,&nbsp;Nirav S. Kapadia MD, MS","doi":"10.1016/j.adro.2025.101910","DOIUrl":"10.1016/j.adro.2025.101910","url":null,"abstract":"<div><h3>Purpose</h3><div>Cancer treatment expenses can lead to financial toxicity (FT), which reduces treatment compliance and impairs outcomes. Little is known regarding the FT among rural cancer populations, where added barriers impair accrual of survey data. To increase our understanding of FT experienced by these patients, we piloted a validated survey instrument and reported on the feasibility of administration.</div></div><div><h3>Methods and Materials</h3><div>Institutional approval was obtained to prospectively survey rural oncology patients undergoing radiation treatment. Baseline surveys were provided at simulation appointments; weekly surveys were captured during on-treatment visits. Respondents reported on demographics (including self-reported gender, race, education, income, insurance, employment) at baseline and on expenses, the COmprehensive Score for financial Toxicity (range, 0-44, modified such that higher score indicates worse toxicity), perception of providers’ financial empathy, and the minimum financially impactful amount of money at weekly visits. Completion rates and associations between demographic characteristics and FT were assessed with Mann–Whitney <em>U</em> test.</div></div><div><h3>Results</h3><div>Twenty-six participants were enrolled. Patients were elderly (mean 68.3 years old, SD 10.7), male (25 of 26), White (25 of 26). Forty-two percent were low-income (annual income &lt; $48,000) and 50% had high school or less education. Most (n = 19, 73%) were insured through Medicare. Eighty-five percent of surveys were fully complete. The mean COmprehensive Score for financial Toxicity score at baseline was 14.0 (SD, 11.5; range, 0-38). The mean amount of money that would make a meaningful difference was $211 at baseline (interquartile range, $87.50-$350) and rose to $329 toward the end of the survey period (week 7).</div></div><div><h3>Conclusions</h3><div>FT screening of rural radiation oncology populations with a range of education is feasible with high fidelity of data collection. Future steps will identify patterns and predictors of severe FT and develop targeted interventions based on this feasibility study.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 12","pages":"Article 101910"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145576308","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}