Advances in Radiation Oncology最新文献

{"title":"ASTRO's Advances in Radiation Oncology Outstanding Reviewers for 2023","authors":"Rachel B. Jimenez MD","doi":"10.1016/j.adro.2024.101686","DOIUrl":"10.1016/j.adro.2024.101686","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"9 12","pages":"Article 101686"},"PeriodicalIF":2.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942545","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":"Time to Next Systemic Therapy After Stereotactic Body Radiation Therapy for Oligoprogressive Metastatic Castrate-Resistant Prostate Cancer","authors":"Corbin J. Eule MD ,&nbsp;Nellowe Candelario MD ,&nbsp;Sameer K. Nath MD ,&nbsp;Tyler P. Robin MD, PhD","doi":"10.1016/j.adro.2024.101655","DOIUrl":"10.1016/j.adro.2024.101655","url":null,"abstract":"<div><h3>Purpose</h3><div>Patients with metastatic castrate-resistant prostate cancer (CRPC) with progressive disease generally require a change or escalation in systemic therapy. For patients with limited (1-3) sites of progressive disease (oligoprogression), metastasis-directed therapy with stereotactic body radiation therapy (SBRT) may allow a longer interval before next-line systemic therapy.</div></div><div><h3>Methods and Materials</h3><div>This is a retrospective study of patients with oligoprogressive metastatic CRPC (mCRPC) treated with SBRT at a single center between 2011 and 2022. The primary endpoint was time to next systemic therapy (TTNST) after SBRT stratified by the presence/absence of untreated nonprogressing metastases. Secondary endpoints included TTNST of the overall cohort and median overall survival (OS) after SBRT.</div></div><div><h3>Results</h3><div>Thirty-two patients with oligoprogressive mCRPC received SBRT to 38 metastases. Patients had a median age of 72.5 years (range, 50.6-84.3) and a median PSA of 6.85 ng/mL (range, 0.39-922.0) at the time of SBRT. The most commonly used SBRT regimen was 3000 cGy in 5 fractions (18 metastases, 47.4%). Sixteen patients were treated to all known sites of disease, whereas 16 patients received SBRT to oligoprogressive metastases but had at least 1 untreated nonprogressing metastasis at the time of SBRT. Patients had received a median of 1.0 prior line of androgen receptor signaling inhibitors and were predominantly (26 patients, 81.3%) chemotherapy naïve. Following SBRT, the median TTNST was 10.1 months and the median OS was 41.3 months. For patients with 0 versus ≥1 untreated nonprogressing metastasis, TTNST was 11.3 versus 8.7 months, respectively (HR, 0.67; 95% CI, 0.33-1.36, logrank <em>P</em> = .24). There was no grade ≥3 toxicities because of SBRT.</div></div><div><h3>Conclusions</h3><div>In this cohort, patients with oligoprogressive mCRPC treated with SBRT delayed the next line of systemic therapy for a median of 10.1 months. SBRT in patients with oligoprogressive mCRPC may delay initiation of the next-line systemic therapy in well-selected patients, including those with ≥1 untreated nonprogressing metastasis.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"9 12","pages":"Article 101655"},"PeriodicalIF":2.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765504","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":"Cherenkov Imaged Bio-Morphological Features Verify Patient Positioning With Deformable Tissue Translocation in Breast Radiation Therapy","authors":"Yao Chen BE ,&nbsp;Savannah M. Decker PhD ,&nbsp;Petr Bruza PhD ,&nbsp;David J. Gladstone ScD ,&nbsp;Lesley A. Jarvis MD, PhD ,&nbsp;Brian W. Pogue PhD ,&nbsp;Kimberley S. Samkoe PhD ,&nbsp;Rongxiao Zhang PhD","doi":"10.1016/j.adro.2024.101684","DOIUrl":"10.1016/j.adro.2024.101684","url":null,"abstract":"<div><h3>Purpose</h3><div>Accurate patient positioning is crucial for precise radiation therapy dose delivery, as errors in positioning can profoundly influence treatment outcomes. This study introduces a novel application for loco-regional tissue deformation tracking via Cherenkov image analysis during fractionated breast cancer radiation therapy. The primary objective of this research was to develop and test an algorithmic method for Cherenkov-based position accuracy quantification, particularly for loco-regional deformations, which do not have an ideal method for quantification during radiation therapy.</div></div><div><h3>Methods and Materials</h3><div>Bio-morphological features in the Cherenkov images, such as vessels, were segmented. A rigid/nonrigid combined registration technique was employed to pinpoint both inter- and intrafractional positioning variations. The methodology was tested on an anthropomorphic chest phantom experiment via shifting a treatment couch with known distances and inducing respiratory motion to simulate interfraction setup uncertainties and intrafraction motions, respectively. It was then applied to a data set of fractionated whole breast radiation therapy human imaging (n = 10 patients).</div></div><div><h3>Results</h3><div>The methodology provided quantified positioning variations comprising 2 components: a global shift determined through rigid registration and a 2-dimensional variation map illustrating loco-regional tissue deformation quantified via nonrigid registration. Controlled phantom testing yielded an average accuracy of 0.83 mm for couch translations up to 20 mm in various directions. Analysis of clinical Cherenkov imaging data from 10 breast cancer patients compared with their first imaged fraction revealed an interfraction setup variation of 3.7 ± 2.4 mm in the global shift and loco-regional deformation up to 3.3 ± 1.9 mm (95th percentile of all regional deformation).</div></div><div><h3>Conclusions</h3><div>This study introduces the use of Cherenkov visualized bio-morphological features to quantify the global and local variations in patient positioning based on rigid and nonrigid registrations. This new approach demonstrates the feasibility of providing quantitative guidance for inter/intrafraction positioning, particularly for the loco-regional deformations that have been unappreciated in current practice with conventional imaging techniques.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 4","pages":"Article 101684"},"PeriodicalIF":2.2,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680270","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":"Patient Perceptions of Radiation Therapy Prior to Initial Consultation With a Radiation Oncologist","authors":"Jennifer Novak MD, MS ,&nbsp;Colton Ladbury MD ,&nbsp;Tariq Abuali BS ,&nbsp;Andrew Tam MD ,&nbsp;Jeffrey Brower MD, PhD ,&nbsp;Brett Evans BS ,&nbsp;Virginia Sun PhD, RN ,&nbsp;Matthew J. Loscalzo LCSW ,&nbsp;Arya Amini MD","doi":"10.1016/j.adro.2024.101676","DOIUrl":"10.1016/j.adro.2024.101676","url":null,"abstract":"<div><h3>Purpose</h3><div>There are currently limited data regarding patient perceptions and fears related to radiation therapy (RT). This study sought to identify and quantify patient concerns regarding RT and to determine the potential value of assessing these expectations prior to initial consultation.</div></div><div><h3>Methods and Materials</h3><div>Patients with no prior history of RT were invited to complete an investigator-developed anonymous electronic survey prior to consultation. Patients were queried about their perceptions of RT and potential fears/concerns. The content validity index for survey items were scored with adequate construct validity. Survey items were scored descriptively through summary statistics. Relationships between respondent variables and responses to survey questions were analyzed by univariate and multivariate logistic regression.</div></div><div><h3>Results</h3><div>From September 2020 through June 2022, 214 patients completed the survey and were included in the analysis. Fifty percent of respondents reported a complete lack of knowledge regarding RT. Twenty-seven percent of patients reported that RT is their most worrisome cancer treatment, compared to chemotherapy or surgery. The most common self-reported fears of RT included general side effects, skin burns, not knowing what to expect regarding RT, pain, and organ damage. The most frequently reported concerns of physical side effects of RT included pain (67%), memory loss (62%), nausea/vomiting (60%), and skin reactions (58%). Sixty-two percent of respondents reported being either moderately or very concerned about their ability to perform daily activities. Thirty-six percent of respondents reported at least moderate concern over the financial cost of RT. Twenty-six percent of respondents reported at least moderate concern regarding transportation to RT. Forty-eight percent of respondents reported concern about emitting radiation to others.</div></div><div><h3>Conclusions</h3><div>Patient concerns related to RT toxicities and impact on daily life were common, as were misconceptions of RT. Pre-consultation assessment of patient expectations regarding RT is feasible and may be helpful in addressing patients concerns early and in real-time.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 1","pages":"Article 101676"},"PeriodicalIF":2.2,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748520","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":"Perceptions, Uses, and Information Sources of Medical Cannabis Among Patients With Cancer","authors":"Vera Qu BA ,&nbsp;Caressa Hui MD ,&nbsp;Jennifer Hall BA ,&nbsp;Kekoa Taparra MD, PhD ,&nbsp;Tanaya Kollipara BA ,&nbsp;Sandy Trieu MD ,&nbsp;Beth Beadle MD, PhD ,&nbsp;Scott Soltys MD ,&nbsp;Erqi L. Pollom MD","doi":"10.1016/j.adro.2024.101678","DOIUrl":"10.1016/j.adro.2024.101678","url":null,"abstract":"<div><h3>Purpose</h3><div>Although medical cannabis (MC) has been shown to relieve cancer- and treatment-related symptoms, there is increasing misinformation regarding its antitumor efficacy. We aimed to identify opportunities for oncologists to communicate evidence-based guidance to patients regarding its use.</div></div><div><h3>Methods and Materials</h3><div>Patients with cancer seen in radiation oncology clinic between June 2022 and July 2023 were surveyed with a questionnaire regarding their perceptions and information sources of MC. Associations between survey responses and demographic and disease variables were evaluated. Qualitative thematic analysis was performed on narrative responses in search of common themes.</div></div><div><h3>Results</h3><div>Eighty-four patients (84% completion rate) were included in the analysis. Most (83.3%) strongly agreed or agreed that MC can provide symptom relief, whereas a subset of patients (15.5%) strongly agreed or agreed that MC can cure cancer. This latter subcohort was significantly more likely to identify as Hispanic/Latino (38.5% vs 9.9%, <em>P</em> = .009) and less likely to be up to date on COVID-19 vaccinations (30.8% vs 8.5%, <em>P</em> = 0.044). Identifying as Hispanic/Latino remained significantly associated with strongly agreeing or agreeing that MC can cure cancer on bivariate analysis (odds ratio, 6.528; 95% CI, 1.477-28.715; <em>P</em> = .012). Education level, other sociodemographic characteristics, and sources for information about MC were not significantly different between these patients. Thematic analysis revealed that patients hoped to learn more about MC from their oncologists but perceived them to be unknowledgeable on the subject.</div></div><div><h3>Conclusions</h3><div>Although most patients consider MC to be a valuable addition to conventional therapies for managing refractory symptoms, a subset believed it had potential as an anticancer therapy. Many patients rely on unregulated sources, highlighting the need for providers to address misinformation, bridge knowledge gaps, and clarify its use.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 3","pages":"Article 101678"},"PeriodicalIF":2.2,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143093659","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":"The Impact of Synchrotron Microbeam Radiation Therapy Combined With Broad Beam in a Preclinical Breast Cancer Model","authors":"Elette Engels PhD ,&nbsp;Helen Forrester PhD ,&nbsp;Mitzi Klein VMD ,&nbsp;Caroline Bell BSc ,&nbsp;Indi Balderstone MD ,&nbsp;Kirsty Brunt ,&nbsp;Micah J. Barnes MSc ,&nbsp;Matthew Cameron PhD ,&nbsp;Jeffrey C. Crosbie PhD ,&nbsp;Ryan Middleton PhD ,&nbsp;Cristian Fernandez-Palomo PhD ,&nbsp;Bettina de Breuyn Dietler BSc ,&nbsp;Verdiana Trappetti PhD ,&nbsp;Jennifer M. Fazzari PhD ,&nbsp;Daniel Hausermann PhD ,&nbsp;Robin L. Anderson PhD ,&nbsp;Valentin G. Djonov MD ,&nbsp;Olga A. Martin PhD","doi":"10.1016/j.adro.2024.101680","DOIUrl":"10.1016/j.adro.2024.101680","url":null,"abstract":"<div><h3>Purpose</h3><div>Both local tumor control and distant metastasis are important indicators of the efficacy of radiation therapy treatment. Synchrotron microbeam radiation therapy (MRT), spatially fractionated radiation delivered at ultrahigh dose rates, shows remarkable normal tissue sparing with excellent local control in some models. Some MRT regimens trigger an antitumor immune response that contributes not only to the local but also to systemic treatment efficacy. Despite recent advances in the treatment of primary breast cancer, metastatic disease is still the major cause of treatment failure in the clinic. Here, in an aggressive preclinical triple-negative breast cancer model, we compared local tumor response and metastasis following different MRT treatment programs.</div></div><div><h3>Methods and Materials</h3><div>4T1.2 mouse mammary tumors were treated with 300 Gy peak/7 Gy valley dose MRT and/or 8 Gy broad beam (BB) radiation, all delivered as daily fractionated programs (3 consecutive daily sessions of either MRT or BB or 1 MRT combined with 2 BB sessions, the first or last of the 3 fractions). The mice were euthanized on day 9 post last irradiation, when unirradiated control animals reached an ethical endpoint. Primary tumors were collected to evaluate immune cell prevalence, while lungs, spinal cords, and locoregional lymph nodes were collected to measure metastatic burden. In parallel, local tumor growth and survival were monitored.</div></div><div><h3>Results</h3><div>The combined MRT/BB treatment shifted the balance between pro- and antitumorigenic macrophages toward the accumulation of antitumorigenic macrophages in the tumor. Monitoring of the tumor volume and animal health indicated the benefit of the combined MRT/BB treatment for local control and treatment tolerance, while animal survival was only marginally longer for one combined schedule. The metastatic burden was similar for all 4 treatment schedules.</div></div><div><h3>Conclusions</h3><div>The addition of a single MRT to BB treatment improved the primary tumor response. This provides a basis for future experiments incorporating adjuvant immunotherapy or chemotherapy to improve local and systemic treatment outcomes.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 1","pages":"Article 101680"},"PeriodicalIF":2.2,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757093","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":"A Predictive Nomogram for Development of Lymph Node Metastasis in Muscle-Invasive Bladder Cancer Following Neoadjuvant Therapy","authors":"Garrett K. Harada MD ,&nbsp;Steven N. Seyedin MD ,&nbsp;Olivia Heutlinger BS ,&nbsp;Armon Azizi BS ,&nbsp;Audree Hsu BS ,&nbsp;Arash Rezazadeh MD ,&nbsp;Michael Daneshvar MD, MS ,&nbsp;Greg E. Gin MD ,&nbsp;Edward M. Uchio MD ,&nbsp;Giovanna A. Giannico MD ,&nbsp;Jeremy P. Harris MD ,&nbsp;Aaron B. Simon MD, PhD ,&nbsp;Jeffrey V. Kuo MD ,&nbsp;Nataliya Mar MD","doi":"10.1016/j.adro.2024.101671","DOIUrl":"10.1016/j.adro.2024.101671","url":null,"abstract":"<div><h3>Purpose</h3><div>Pelvic lymph node metastases (ypN+) after multiagent neoadjuvant chemotherapy (NAC) is a poor prognostic sign in nonmetastatic muscle-invasive bladder cancer (nmMIBC). We sought to create a nomogram predicting probability of ypN+ after NAC for cN0 nmMIBC and determine association with overall survival (OS).</div></div><div><h3>Methods and Materials</h3><div>We reviewed the National Cancer Database for patients with cT2-4N0M0 urothelial carcinoma of the bladder receiving multiagent NAC and surgery from 2004 to 2020. Following a data split, univariate logistic regression identified variables associated with ypN+ at <em>P</em> &lt; .05. Eligible variables were used for multivariate logistic regression and nomogram generation. A threshold for 95% sensitivity defined high- and low-risk groups for ypN+. Fine–Gray models assessed ypN+ risk group and OS, accounting for competing risks of surgical mortality.</div></div><div><h3>Results</h3><div>A total of 6194 patients were identified with a median follow-up of 39.5 months (interquartile range [IQR], 20.5-67.2 months). Most patients had high-grade (97.7%) cT2 disease (70.8%) with nonpapillary urothelial histology (67.3%) and initiated NAC at a median of 41.0 days after diagnosis (IQR, 28.0-59.0 days).The nomogram included age in decades (odds ratio [OR], 0.94; 95% confidence interval [CI], 0.87–1.03; <em>P</em> = .172), weeks from diagnosis to NAC (OR, 1.02; 95% CI, 1.01-1.04; <em>P</em> = .004), nonpapillary histology (OR, 1.17; 95% CI, 0.99-1.39; <em>P</em> = .068), and clinical T-stage. Within the testing cohort, ypN+ was found in 392 (22.8%) high-risk and 12 (8.0%) low-risk patients (<em>P</em> &lt; .001), with median OS of 36.1 and 74.0 months, respectively (<em>P</em> &lt; .001). High-risk patients had worse OS despite competing risks of 30-day (subdistribution hazard ratio [SHR], 1.80; 95% CI, 1.49-2.18; <em>P</em> &lt; .001) and 90-day surgical mortality (SHR, 1.68; 95% CI, 1.39-2.04; <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>This is the first study to provide a tool for predicting ypN+ and prognosticate worse OS in primarily high-grade nmMIBC and could select patients for alternative neoadjuvant therapy and facilitate future study.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 1","pages":"Article 101671"},"PeriodicalIF":2.2,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142722500","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":"Benefit of Avasopasem Manganese on Severe Oral Mucositis in Head and Neck Cancer in the ROMAN Trial: Unplanned Secondary Analysis","authors":"Carryn Anderson MD ,&nbsp;Samuel Salvaggio PhD ,&nbsp;Mickaël De Backer PhD ,&nbsp;Jean-Christophe Chiem PhD ,&nbsp;Gary Walker MD, MPH, MS ,&nbsp;Deborah Saunders DMD, BSc ,&nbsp;Christopher M. Lee MD ,&nbsp;Neal Dunlap MD ,&nbsp;Eugene Kennedy MD ,&nbsp;Robert Beardsley PhD ,&nbsp;Benton Schoen BA ,&nbsp;Marc Buyse ScD","doi":"10.1016/j.adro.2024.101674","DOIUrl":"10.1016/j.adro.2024.101674","url":null,"abstract":"<div><h3>Purpose</h3><div>Oral mucositis (OM) is a debilitating side effect of cisplatin and intensity-modulated radiation therapy (IMRT) in patients with head and neck cancer. The phase 3 ROMAN trial showed avasopasem manganese (AVA) significantly decreased individual endpoints of incidence and duration of severe oral mucositis (SOM, World Health Organization [WHO] grade 3-4), with nominal decrease in severity (WHO grade 4) and significant increase in the delay in onset of SOM. We sought to determine the Net Treatment Benefit (NTB) of AVA versus placebo (PBO) using the generalized pairwise comparisons (GPC) method.</div></div><div><h3>Methods and Materials</h3><div>GPC is a statistical method that permits simultaneous analysis of several prioritized outcomes, comparing all possible pairs of a patient in the active (ie, AVA) group and a patient from the control (ie, PBO) group. NTB is the net benefit across all the outcomes for AVA compared to PBO. Key clinically relevant outcomes from ROMAN were prioritized: (1) WHO grade 4 OM incidence; (2) SOM incidence; (3) days of SOM; (4) days to SOM onset, with 7 days difference defined as the clinical relevance threshold for SOM days and SOM onset.</div></div><div><h3>Results</h3><div>GPC analysis of 407 patients (AVA = 241, placebo = 166) stratified by cisplatin schedule and treatment setting resulted in 13,969 pairwise comparisons. AVA showed statistically significant net benefit on all 4 key outcomes with a 53.9% probability that AVA would benefit patients versus a 35.0% probability that PBO would; the difference between these probabilities was a NTB of 18.9% (<em>P</em> = .0012), translating to an AVA number needed to treat of 5.3 patients. All outcomes contributed to NTB, reflecting improvements in SOM incidence, onset and duration, and in grade 4 OM incidence seen in the original ROMAN analysis.</div></div><div><h3>Conclusions</h3><div>This GPC analysis shows compelling evidence from the ROMAN trial of AVA's clinical benefit across key parameters of SOM burden.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 1","pages":"Article 101674"},"PeriodicalIF":2.2,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142722095","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":"Treatment of a Pregnant Patient With a Brain Tumor Using Pencil Beam Scanning Proton Therapy","authors":"Justine M. Dupere PhD,&nbsp;William G. Breen MD,&nbsp;John J. Lucido PhD,&nbsp;Nicholas B. Remmes PhD","doi":"10.1016/j.adro.2024.101673","DOIUrl":"10.1016/j.adro.2024.101673","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 1","pages":"Article 101673"},"PeriodicalIF":2.2,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748518","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":"Delta-Radiomics Approach Using Contrast-Enhanced and Noncontrast-Enhanced Computed Tomography Images for Predicting Distant Metastasis in Patients With Borderline Resectable Pancreatic Carcinoma","authors":"Takanori Adachi PhD ,&nbsp;Mitsuhiro Nakamura PhD ,&nbsp;Takahiro Iwai PhD ,&nbsp;Michio Yoshimura MD, PhD ,&nbsp;Takashi Mizowaki MD, PhD","doi":"10.1016/j.adro.2024.101669","DOIUrl":"10.1016/j.adro.2024.101669","url":null,"abstract":"<div><h3>Purpose</h3><div>To predict distant metastasis (DM) in patients with borderline resectable pancreatic carcinoma using delta-radiomics features calculated from contrast-enhanced computed tomography (CECT) and non-CECT images.</div></div><div><h3>Methods and Materials</h3><div>Among 250 patients who underwent radiation therapy at our institution between February 2013 and December 2021, 67 patients were deemed eligible. A total of 11 clinical features and 3906 radiomics features were incorporated. Radiomics features were extracted from CECT and non-CECT images, and the differences between these features were calculated, resulting in delta-radiomics features. The patients were randomly divided into the training (70%) and test (30%) data sets for model development and validation. Predictive models were developed with clinical features (clinical model), radiomics features (radiomics model), and a combination of the abovementioned features (hybrid model) using Fine-Gray regression (FG) and random survival forest (RSF). Optimal hyperparameters were determined using stratified 5-fold cross-validation. Subsequently, the developed models were applied to the remaining test data sets, and the patients were divided into high- or low-risk groups based on their risk scores. Prognostic power was assessed using the concordance index, with 95% CIs obtained through 2000 bootstrapping iterations. Statistical significance between the above groups was assessed using Gray's test.</div></div><div><h3>Results</h3><div>At a median follow-up period of 23.8 months, 47 (70.1%) patients developed DM. The concordance indices of the FG-based clinical, radiomics, and hybrid models were 0.548, 0.603, and 0.623, respectively, in the test data set, whereas those of the RSF-based models were 0.598, 0.680, and 0.727, respectively. The RSF-based model, including delta-radiomics features, significantly divided the cumulative incidence curves into two risk groups (<em>P</em> &lt; .05). The feature map of the gray-level size-zone matrix showed that the difference in feature values between CECT and non-CECT images correlated with the incidence of DM.</div></div><div><h3>Conclusions</h3><div>Delta-radiomics features obtained from CECT and non-CECT images using RSF successfully predict the incidence of DM in patients with borderline resectable pancreatic carcinoma.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 1","pages":"Article 101669"},"PeriodicalIF":2.2,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748517","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}