Advances in Radiation Oncology最新文献

{"title":"Low-Dose Radiation Therapy (LDRT) for Osteoarthritis: A Retrospective Study of 94 Patients and 136 Joints Treated","authors":"Nayan Shah, Rahul Bhandari MD","doi":"10.1016/j.adro.2026.102050","DOIUrl":"10.1016/j.adro.2026.102050","url":null,"abstract":"<div><h3>Purpose</h3><div>This retrospective study aims to examine the efficacy of low-dose radiation therapy (LDRT) delivered via a linear accelerator in patients with osteoarthritis, measuring pain relief across various joints.</div></div><div>This retrospective study aims to examine the efficacy of low-dose radiation therapy (LDRT) delivered via a linear accelerator in patients with osteoarthritis, measuring pain relief across various joints.</div><div><h3>Methods and Materials</h3><div>A total of 94 patients and a total of 136 affected joints were treated with LDRT between January 2023 and May 2025 at a radiation therapy institute. Each patient received 6 treatments of 0.5 Gy every other day, totaling 3 Gy over the course of 2 weeks. Pain was documented using the numeric rating scale (NRS) before treatment (preradiation therapy) and at follow-up visits approximately 12 weeks posttreatment, with the von Pannewitz score also assessed at follow-up.</div></div><div>A total of 94 patients and a total of 136 affected joints were treated with LDRT between January 2023 and May 2025 at a radiation therapy institute. Each patient received 6 treatments of 0.5 Gy every other day, totaling 3 Gy over the course of 2 weeks. Pain was documented using the numeric rating scale (NRS) before treatment (preradiation therapy) and at follow-up visits approximately 12 weeks posttreatment, with the von Pannewitz score also assessed at follow-up.</div><div><h3>Results</h3><div>The mean age of patients was 74.5 years, with 38% male and 62% female patients. The treated joints included 61 hands (45%), 46 knees (34%), 15 shoulders (11%), 8 hips (6%), and 6 feet (4%). The mean pain score before treatment was 7.30 ± 1.90, while after treatment it dropped to 2.58 ± 3.09 on the NRS scale (<em>P</em> < .0001). Using a minimal clinically important difference threshold of a ≥2-point reduction in NRS, 79% of patients achieved clinically meaningful pain improvement following LDRT. Age (<em>P</em> = .23), sex (<em>P</em> = .20), and joint size (<em>P</em> = .35) were not found to significantly affect treatment outcomes. Most patients received a single course of LDRT treatment, with only 3.7% of patients receiving a second treatment course.</div></div><div>The mean age of patients was 74.5 years, with 38% male and 62% female patients. The treated joints included 61 hands (45%), 46 knees (34%), 15 shoulders (11%), 8 hips (6%), and 6 feet (4%). The mean pain score before treatment was 7.30 ± 1.90, while after treatment it dropped to 2.58 ± 3.09 on the NRS scale (<em>P</em> < .0001). Using a minimal clinically important difference threshold of a ≥2-point reduction in NRS, 79% of patients achieved clinically meaningful pain improvement following LDRT. Age (<em>P</em> = .23), sex (<em>P</em> = .20), and joint size (<em>P</em> = .35) were not found to significantly affect treatment outcomes. Most patients received a single course of LDRT treatment, with only 3.7% of patients receivi","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"11 9","pages":"Article 102050"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961520","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":"Functional Radiation Medicine: Rediscovering the Full Potential of Radiation Therapy","authors":"Jan Kriz MD, PhD, Ralph Mücke MD, PhD, Oliver Micke MD, PhD","doi":"10.1016/j.adro.2026.102163","DOIUrl":"10.1016/j.adro.2026.102163","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"11 9","pages":"Article 102163"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961105","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":"Evaluation of Hemorrhage Risk and Predictors Following Stereotactic Radiosurgery for Cerebral Arteriovenous Malformations: A Retrospective Single-center Study","authors":"Philipp Lishewski MD, Luis Mohr, Kerem Tuna Tas MD, Edgar Smalec MD, Gertrud Schmich MD, Tasneim Abdelrahmen MD, Fatima Frosan Sheikhzadeh MD, Niklas Recknagel MD, André Kemmling MD, Maximilian Schulze MD, Khaled Elsayad MD, Rita Engenhart-Cabillic MD, Hilke Vorwerk MD, Sebastian Adeberg MD, Ahmed Gawish MD","doi":"10.1016/j.adro.2025.101982","DOIUrl":"10.1016/j.adro.2025.101982","url":null,"abstract":"<div><h3>Purpose</h3><div>Radiation therapy is a well-established treatment method for cerebral arteriovenous malformations (AVMs) used in combination with other treatment modalities or alone. This study evaluated the postintervention bleeding risk of cerebral AVMs treated with stereotactic radiosurgery (SRS) using a linear accelerator (LINAC) and identified predictors of posttherapeutic hemorrhage.</div></div><div>Radiation therapy is a well-established treatment method for cerebral arteriovenous malformations (AVMs) used in combination with other treatment modalities or alone. This study evaluated the postintervention bleeding risk of cerebral AVMs treated with stereotactic radiosurgery (SRS) using a linear accelerator (LINAC) and identified predictors of posttherapeutic hemorrhage.</div><div><h3>Methods and Materials</h3><div>A retrospective analysis was conducted on 134 consecutive patients with AVMs treated with LINAC-based SRS between 1983 and 2022 at the department for Radiotherapy and Radiation Oncology at the Marburg University Hospital. Patients were followed for a median of 49 months. Statistical analysis was performed to assess the influence of variables such as AVM grade, prior treatment, SRS dose, and other clinical factors on post-SRS bleeding risk.</div></div><div>A retrospective analysis was conducted on 134 consecutive patients with AVMs treated with LINAC-based SRS between 1983 and 2022 at the department for Radiotherapy and Radiation Oncology at the Marburg University Hospital. Patients were followed for a median of 49 months. Statistical analysis was performed to assess the influence of variables such as AVM grade, prior treatment, SRS dose, and other clinical factors on post-SRS bleeding risk.</div><div><h3>Results</h3><div>Nine post-SRS hemorrhages occurred for a total of 816.6 patient-years, resulting in an overall bleeding rate of 6.7% and an annual rate of 1.1%. No bleeding-related fatalities were recorded. Higher Spetzler-Martin AVM grade (<em>P</em> = .013) and prior treatment, particularly embolization or the combination of surgery and embolization (<em>P</em> = .005), were associated with increased posttherapeutic hemorrhage risk. In contrast, factors such as age, sex, and SRS dose showed no significant influence. Two bleeding events occurred even after presumed angiographic obliteration.</div></div><div>Nine post-SRS hemorrhages occurred for a total of 816.6 patient-years, resulting in an overall bleeding rate of 6.7% and an annual rate of 1.1%. No bleeding-related fatalities were recorded. Higher Spetzler-Martin AVM grade (<em>P</em> = .013) and prior treatment, particularly embolization or the combination of surgery and embolization (<em>P</em> = .005), were associated with increased posttherapeutic hemorrhage risk. In contrast, factors such as age, sex, and SRS dose showed no significant influence. Two bleeding events occurred even after presumed angiographic obliteration.</div><div><h3>Conclusion</h3><div>LINAC-","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"11 9","pages":"Article 101982"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148958800","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":"STAR in a Second: Ultra-High-Dose-Rate Spread-Out Bragg Peak Proton Therapy for Breath-Hold Stereotactic Arrhythmia Radioablation","authors":"Pavitra Ramesh PhD, Marco Schwarz PhD, Caroline Colbert PhD, Xinyuan Claire Chen PhD, Neil Panjwani MD, Stephen R. Bowen PhD, Clemens Grassberger PhD, Chen Wei MD, Uyanga Batnyam MD, Babak Nazer MD, Matthew J. Nyflot PhD","doi":"10.1016/j.adro.2026.102150","DOIUrl":"10.1016/j.adro.2026.102150","url":null,"abstract":"<div><h3>Purpose</h3><div>Stereotactic arrhythmia radioablation (STAR) is a noninvasive treatment option for managing ventricular tachycardia (VT). Combined respiratory and cardiac motion requires management with large target volume margins or motion mitigation techniques. Techniques such as beam gating and breath-holds are limited by low-duty cycles, extending treatment times. We investigate the feasibility of ultra-high-dose-rate (UHDR) proton therapy using a spread-out Bragg peak technique with a conformal energy modulator to achieve respiratory and cardiac motion management within a single breath-hold delivery per beam for cardiac ablation, thereby reducing treatment time without compromising anatomic accuracy.</div></div><div>Stereotactic arrhythmia radioablation (STAR) is a noninvasive treatment option for managing ventricular tachycardia (VT). Combined respiratory and cardiac motion requires management with large target volume margins or motion mitigation techniques. Techniques such as beam gating and breath-holds are limited by low-duty cycles, extending treatment times. We investigate the feasibility of ultra-high-dose-rate (UHDR) proton therapy using a spread-out Bragg peak technique with a conformal energy modulator to achieve respiratory and cardiac motion management within a single breath-hold delivery per beam for cardiac ablation, thereby reducing treatment time without compromising anatomic accuracy.</div><div><h3>Methods and Materials</h3><div>Five ventricular tachycardia cases initially treated on linear accelerators with planning target volumes ranging from 118 to 254 cc were retrospectively planned with UHDR protons on an IBA Proteus Plus system with the ConformalFLASH snout. Plans were contoured on full-inspiration computed tomography phase scans to represent breath-hold anatomy and were planned for 25 Gy in 1 fraction. Plan quality metrics included target coverage (D98%, D2%, V95%) and doses to organs at risk (OARs) such as heart, stomach, and esophagus. An in-house RayStation script was developed to estimate total spot delivery time per beam to assess breath-hold feasibility. Times were validated using logfile-based analysis after delivery on the proton beamline.</div></div><div>Five ventricular tachycardia cases initially treated on linear accelerators with planning target volumes ranging from 118 to 254 cc were retrospectively planned with UHDR protons on an IBA Proteus Plus system with the ConformalFLASH snout. Plans were contoured on full-inspiration computed tomography phase scans to represent breath-hold anatomy and were planned for 25 Gy in 1 fraction. Plan quality metrics included target coverage (D98%, D2%, V95%) and doses to organs at risk (OARs) such as heart, stomach, and esophagus. An in-house RayStation script was developed to estimate total spot delivery time per beam to assess breath-hold feasibility. Times were validated using logfile-based analysis after delivery on the proton beamline.</div><div><h3>Resul","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"11 9","pages":"Article 102150"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961519","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":"Carbon-Ion Radiation Therapy for Unresectable Solitary Fibrous Tumor of the Intermediate Category: A Nationwide Multi-institutional Observational Study by the Japan Carbon-Ion Radiation Oncology Study Group","authors":"Keisuke Tsuchida MD, PhD, Masahiko Okamoto MD, PhD, Akira Matsunobu MD, PhD, Takashi Kaneko MD, PhD, Yusuke Demizu MD, PhD, Tomoaki Okimoto MD, PhD, Masashi Koto MD, PhD, Yoshiyuki Shioyama MD, PhD, Hitoshi Ishikawa MD, PhD, Tatsuya Ohno MD, PhD, Hiroyuki Katoh MD, PhD, Reiko Imai MD, PhD, Japan Carbon-Ion Radiation Oncology Study Group","doi":"10.1016/j.adro.2026.102143","DOIUrl":"10.1016/j.adro.2026.102143","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the efficacy and safety of carbon-ion radiation therapy(C-ion RT) for patients with unresectable intermediate-category solitary fibrous tumor (SFT) in a nationwide multi-institutional observational study.</div></div><div>To evaluate the efficacy and safety of carbon-ion radiation therapy(C-ion RT) for patients with unresectable intermediate-category solitary fibrous tumor (SFT) in a nationwide multi-institutional observational study.</div><div><h3>Methods and Materials</h3><div>This study included patients with unresectable intermediate-category SFT treated with C-ion RT at institutions affiliated with the Japan Carbon-Ion Radiation Oncology Study Group between April 2016 and December 2023. Primary endpoints were local control (LC) and overall survival. Secondary endpoints included progression-free survival, toxicity, and quality of life (QOL). Survival outcomes were analyzed using the Kaplan–Meier method. Toxicities were evaluated using the Common Terminology Criteria for Adverse Events version 5.0. QOL was assessed using the Functional Mobility Scale and EuroQol 5-Dimension 5-Level.</div></div><div>This study included patients with unresectable intermediate-category SFT treated with C-ion RT at institutions affiliated with the Japan Carbon-Ion Radiation Oncology Study Group between April 2016 and December 2023. Primary endpoints were local control (LC) and overall survival. Secondary endpoints included progression-free survival, toxicity, and quality of life (QOL). Survival outcomes were analyzed using the Kaplan–Meier method. Toxicities were evaluated using the Common Terminology Criteria for Adverse Events version 5.0. QOL was assessed using the Functional Mobility Scale and EuroQol 5-Dimension 5-Level.</div><div><h3>Results</h3><div>Ten patients from 3 institutions were enrolled in this study. The prescribed dose was 64.0 to 70.4 Gy in 16 fractions. The median follow-up was 49 months. Four-year overall survival, LC, and progression-free survival rates were 100% (95% CI, not available [NA]-NA), 100% (95% CI, NA-NA), and 67% (95% CI, 20%-90%), respectively. No local recurrences occurred, and 2 patients developed distant metastases. One patient experienced grade 2 late toxicity (peripheral neuropathy), and no grade ≥3 toxicities were observed. QOL scores were preserved throughout treatment. The median baseline EuroQol 5-Dimension 5-Level utility score was 0.85 (IQR, 0.76-0.97), and the median score at the final observation was 0.94 (IQR, 0.88-1.00), with no significant difference observed (<em>P</em> = .225).</div></div><div>Ten patients from 3 institutions were enrolled in this study. The prescribed dose was 64.0 to 70.4 Gy in 16 fractions. The median follow-up was 49 months. Four-year overall survival, LC, and progression-free survival rates were 100% (95% CI, not available [NA]-NA), 100% (95% CI, NA-NA), and 67% (95% CI, 20%-90%), respectively. No local recurrences occurred, and 2 patients developed dist","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"11 9","pages":"Article 102143"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961247","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":"Endobronchial High-Dose-Rate Brachytherapy for Posttransplant-Associated Bronchial Stenosis: Extended Follow-up of Pulmonary Function and Subsequent Procedures","authors":"Dana A. Schaar MD, Abigail Yohannes BS, Abigail Groszkiewicz MD, Uzoma Iheagwara MD, PhD, Bruce A. Johnson MD, Matthew Schuchert MD, Fang Li PhD, Christopher Houser MS, Elangovan Doraisamy MS, Hayeon Kim PhD, Steven A. Burton MD, John A. Vargo MD, MBA","doi":"10.1016/j.adro.2026.102159","DOIUrl":"10.1016/j.adro.2026.102159","url":null,"abstract":"<div><h3>Purpose</h3><div>Bronchial obstruction is a significant complication after lung transplantation. First-line treatments include a variety of bronchoscopic interventions. As an additional option, there is promise in use of endobronchial brachytherapy for treatment-refractory stenotic areas. We hypothesize that high-dose-rate (HDR) brachytherapy is an effective therapy for treatment-refractory bronchial stenosis and present our institutional data on this approach.</div></div><div>Bronchial obstruction is a significant complication after lung transplantation. First-line treatments include a variety of bronchoscopic interventions. As an additional option, there is promise in use of endobronchial brachytherapy for treatment-refractory stenotic areas. We hypothesize that high-dose-rate (HDR) brachytherapy is an effective therapy for treatment-refractory bronchial stenosis and present our institutional data on this approach.</div><div><h3>Methods and Materials</h3><div>This is a retrospective review of double lung transplant patients who underwent endobronchial HDR brachytherapy from February 2005 to July 2025 for symptomatic, treatment-refractory bronchial stenosis. HDR brachytherapy was delivered via flexible bronchoscopy and insertion of a single-lumen brachytherapy catheter. Doses used were 3 or 7 gray (Gy) prescribed to 1 cm depth. Patients were followed with bronchoscopies and pulmonary function testing. Patient, treatment, and outcome data were analyzed descriptively. Percentage predicted forced expiratory volume at 1 second and intervention frequency data were compared with 2-tailed paired <em>t</em> tests.</div></div><div>This is a retrospective review of double lung transplant patients who underwent endobronchial HDR brachytherapy from February 2005 to July 2025 for symptomatic, treatment-refractory bronchial stenosis. HDR brachytherapy was delivered via flexible bronchoscopy and insertion of a single-lumen brachytherapy catheter. Doses used were 3 or 7 gray (Gy) prescribed to 1 cm depth. Patients were followed with bronchoscopies and pulmonary function testing. Patient, treatment, and outcome data were analyzed descriptively. Percentage predicted forced expiratory volume at 1 second and intervention frequency data were compared with 2-tailed paired <em>t</em> tests.</div><div><h3>Results</h3><div>Eight patients were included, comprising 10 brachytherapy treatments, with a median follow-up time of 72.9 months (IQR, 44.8-85.3). Most patients received 1 course of brachytherapy (62.5%), and most treatments were done with 3 Gy in 1 fraction (Fx) (60%). The remainder of patients received 2 brachytherapy treatments (37.5%), and the remainder of treatments were done with 7 Gy in 1 Fx (40%). Median time to next bronchoscopic intervention after brachytherapy was 5.8 months (IQR, 4.3-6.6). After brachytherapy, patients required significantly fewer interventions in the 6 months posttreatment than in the 6 months pretreatment (<em>P</em> = .006, m","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"11 9","pages":"Article 102159"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961338","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":"Quality of Life and Toxicities Following Whole-Palm Versus Involved-Field Radiation Therapy for Dupuytren’s Disease: A Substudy From a Randomized Trial","authors":"Renee Duvenage FRANZCR, Jarad M. Martin DMed (Research), PhD, Tanya Burgess FRACS (Orth), Brett McClelland FRACS (Orth), David Christie FRANZCR, Paul M.N. Werker MD, PhD, Warren Rozen FRACS (Plast), Roel J.H.M. Steenbakkers MD, PhD, Anneke de Haan MSc, Sreelakshmi Anoora MSc, Dion Sandoz BAppSc (OT), Joshua Sappiatzer FRANZCR, Katherine Neville FRANZCR, Sandy Sampaio FRANZCR, David Schlect FRANZCR, Joseph Bucci FRANZCR, David Hunter-Smith FRACS (Plast), David Dilley FRACS (Orth)","doi":"10.1016/j.adro.2026.102083","DOIUrl":"10.1016/j.adro.2026.102083","url":null,"abstract":"<div><h3>Purpose</h3><div>The Dupuytren’s disease Evaluation of Preventative or Adjuvant Radiation Therapy trial compared low-dose radiation therapy (LDRT) with observation for contracture prevention in early Dupuytren’s disease. Guidelines vary regarding field selection due to concerns about toxicity in larger fields. In the LDRT arm of the prevention group, the permitted treatment fields were either whole-palm radiation therapy (WPRT) or involved-field radiation therapy (IFRT). This substudy compares quality-of-life and toxicity outcomes between WPRT and IFRT.</div></div><div>The Dupuytren’s disease Evaluation of Preventative or Adjuvant Radiation Therapy trial compared low-dose radiation therapy (LDRT) with observation for contracture prevention in early Dupuytren’s disease. Guidelines vary regarding field selection due to concerns about toxicity in larger fields. In the LDRT arm of the prevention group, the permitted treatment fields were either whole-palm radiation therapy (WPRT) or involved-field radiation therapy (IFRT). This substudy compares quality-of-life and toxicity outcomes between WPRT and IFRT.</div><div><h3>Methods and Materials</h3><div>This substudy analyzed 202 patients (202 treated hands) treated with LDRT (30 Gy in 10 fractions, split-course) in the Dupuytren’s disease Evaluation of Preventative or Adjuvant Radiation Therapy trial prevention cohort. Quality of life was assessed using the pain intensity visual analog scale, Quick Disabilities of the Arm, Shoulder, and Hand, and Unité Rhumatologique des Affections de la Main at baseline and at 6, 12, and 36 months post-treatment. Toxicities were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.03.</div></div><div>This substudy analyzed 202 patients (202 treated hands) treated with LDRT (30 Gy in 10 fractions, split-course) in the Dupuytren’s disease Evaluation of Preventative or Adjuvant Radiation Therapy trial prevention cohort. Quality of life was assessed using the pain intensity visual analog scale, Quick Disabilities of the Arm, Shoulder, and Hand, and Unité Rhumatologique des Affections de la Main at baseline and at 6, 12, and 36 months post-treatment. Toxicities were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.03.</div><div><h3>Results</h3><div>Of 202 hands treated, 126 (62.4%) received WPRT and 76 (37.6%) received IFRT. Baseline characteristics were balanced between the groups. The pain intensity visual analog scale, Quick Disabilities of the Arm, Shoulder, and Hand, and Unité Rhumatologique des Affections de la Main scores did not differ significantly between the groups at any time point. LDRT was well tolerated with no grade 3 or higher toxicity observed. Acute toxicity was low grade, as expected, and more frequently reported following WPRT than IFRT. Persistent late effects were uncommon, with a <5% incidence of low-grade reduced sweating in ","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"11 9","pages":"Article 102083"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961521","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":"Low-Dose Radiation Therapy for Osteoarthritis: Analysis of Preliminary Outcomes at Scripps Clinic","authors":"Olumide A. Ojo BSc, Abigail Lin BSc, Norbert Kased MD, Shane Mesko MD, Eric Hu PhD, Samantha Bagsic PhD, Thomas A. Buchholz MD, Chien Peter Chen MD, Prabhakar Tripuraneni MD, Anuradha Koka MD, Patrick Linson MD, Ken Shimizu MD, Eva Lean MD, Ray Lin MD","doi":"10.1016/j.adro.2026.102107","DOIUrl":"10.1016/j.adro.2026.102107","url":null,"abstract":"<div><h3>Purpose</h3><div>Osteoarthritis (OA) is a chronic, degenerative joint disease affecting approximately 15% of Americans, resulting in significant pain, functional impairment, and diminished quality of life (QoL). Many patients have symptoms refractory to conventional treatments including lifestyle modification, topical and oral analgesics as well as intra-articular therapy. Low-dose radiation therapy (LDRT) has been used for many decades in Europe to manage OA symptoms, but this treatment remains underutilized in the United States. Since June 2024, LDRT has been routinely used in our clinic to treat OA. This study evaluates early clinical outcomes.</div></div><div>Osteoarthritis (OA) is a chronic, degenerative joint disease affecting approximately 15% of Americans, resulting in significant pain, functional impairment, and diminished quality of life (QoL). Many patients have symptoms refractory to conventional treatments including lifestyle modification, topical and oral analgesics as well as intra-articular therapy. Low-dose radiation therapy (LDRT) has been used for many decades in Europe to manage OA symptoms, but this treatment remains underutilized in the United States. Since June 2024, LDRT has been routinely used in our clinic to treat OA. This study evaluates early clinical outcomes.</div><div><h3>Methods and Materials</h3><div>We retrospectively reviewed patients aged 46 to 96 who received LDRT for OA between June 1, 2024, and May 31, 2025. During this period, departmental policy limited treatment to nonpregnant adults and peripheral joints. Demographics, joint site, imaging, prior therapies, radiation dose, and treatment dates were extracted from the medical record. All patients received 3 Gy in 0.5-Gy fractions over ∼10 days. Standardized forms were completed at baseline and at 2-, 6-, and 12-month follow-up, assessing pain (Visual Analog Scale), analgesic use (days/week), and activities of daily living/QoL impact (1-10 scale). Range of motion and treatment-related side effects were also documented.</div></div><div>We retrospectively reviewed patients aged 46 to 96 who received LDRT for OA between June 1, 2024, and May 31, 2025. During this period, departmental policy limited treatment to nonpregnant adults and peripheral joints. Demographics, joint site, imaging, prior therapies, radiation dose, and treatment dates were extracted from the medical record. All patients received 3 Gy in 0.5-Gy fractions over ∼10 days. Standardized forms were completed at baseline and at 2-, 6-, and 12-month follow-up, assessing pain (Visual Analog Scale), analgesic use (days/week), and activities of daily living/QoL impact (1-10 scale). Range of motion and treatment-related side effects were also documented.</div><div><h3>Results</h3><div>A total of 167 patients and 184 joints were treated with LDRT for OA. Patients with no follow-up were excluded from the study. Patients had statistically significant improvement in pain scores, reduced analgesic ","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"11 9","pages":"Article 102107"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961102","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":"Can Low-Dose Radiation Therapy Aid in Chronic Subdural Hematoma Management? A Historical Review","authors":"Ryan Shah BS, Nilanjan Haldar MD, Debanjan Haldar MD, Keenan Piper MD, Wenyin Shi MD, PhD, Pascal Jabbour MD","doi":"10.1016/j.adro.2026.102157","DOIUrl":"10.1016/j.adro.2026.102157","url":null,"abstract":"<div><h3>Purpose</h3><div>Neurosurgical management of chronic subdural hematoma (cSDH) is complicated by high recurrence rates, which can be especially challenging in the elderly and patients with significant comorbidities. Minimally invasive treatment with middle meningeal artery embolization is increasingly used adjunctively and as a primary treatment for those who are poor surgical candidates, but middle meningeal artery embolization carries its own risks and limitations. Identifying a noninvasive treatment that could similarly be used as an adjunctive or alternative therapy for cSDH may further mitigate morbidity and mortality associated with repeated surgical intervention.</div></div><div>Neurosurgical management of chronic subdural hematoma (cSDH) is complicated by high recurrence rates, which can be especially challenging in the elderly and patients with significant comorbidities. Minimally invasive treatment with middle meningeal artery embolization is increasingly used adjunctively and as a primary treatment for those who are poor surgical candidates, but middle meningeal artery embolization carries its own risks and limitations. Identifying a noninvasive treatment that could similarly be used as an adjunctive or alternative therapy for cSDH may further mitigate morbidity and mortality associated with repeated surgical intervention.</div><div><h3>Methods and Materials</h3><div>This review assesses the potential role of low-dose radiation therapy (LD-RT) in cSDH management by examining the condition’s pathophysiology, current treatment options, and the biological and clinical rationale for LD-RT.</div></div><div>This review assesses the potential role of low-dose radiation therapy (LD-RT) in cSDH management by examining the condition’s pathophysiology, current treatment options, and the biological and clinical rationale for LD-RT.</div><div><h3>Results</h3><div>The anti-inflammatory effects of LD-RT could theoretically modulate the cycle of inflammation, neomembrane vascularization, and microhemorrhage that characterizes the pathophysiology of recurrent cSDH. Historical case series from the mid-20th century reported clinical improvement in cSDH patients treated with low doses of x-ray therapy, but these findings require validation with modern scientific approaches, including preclinical rodent models and prospective pilot clinical trials employing contemporary neuroimaging endpoints to quantify hematoma resolution.</div></div><div>The anti-inflammatory effects of LD-RT could theoretically modulate the cycle of inflammation, neomembrane vascularization, and microhemorrhage that characterizes the pathophysiology of recurrent cSDH. Historical case series from the mid-20th century reported clinical improvement in cSDH patients treated with low doses of x-ray therapy, but these findings require validation with modern scientific approaches, including preclinical rodent models and prospective pilot clinical trials employing contemporary neuroima","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"11 9","pages":"Article 102157"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961248","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":"Necrosis and Neurotoxicity of the Brainstem Following Stereotactic Radiosurgery for Trigeminal Neuralgia: How Much is Too Much?","authors":"Timothy Chen MD, Michael Chaga MS, Wenzheng Feng MS, Tingyu Wang MS, Patrick Pema BS, Akil Anthony BS, Darra Conti MS, Jing Feng MS, Ma Rhudelyn Rodrigo MSN, Elizabeth Luick RN, Joseph Hanley PhD, Shabbar Danish MD","doi":"10.1016/j.adro.2026.102103","DOIUrl":"10.1016/j.adro.2026.102103","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"11 9","pages":"Article 102103"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148958079","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}