Advances in Radiation Oncology最新文献

{"title":"Erratum to ‘Integrating Radiosensitivity Index and Radiation Resistance Related Index Improves Prostate Cancer Outcome Prediction’ [Advances in Radiation Oncology (2025) 10, 101713]","authors":"Qi-Qiao Wu MD , Zhao-Sheng Yin MD , Yi Zhang MD , Yu-Fu Lin MD , Jun-Rong Jiang BS , Ruo-Yan Zheng BS , Tao Jiang MD , Dong-Xu Lin MD , Peng Lai MD , Fan Chao PhD , Xin-Yue Wang MD , Bu-Fu Tang PhD , Shi-Suo Du PhD , Jing Sun MD , Ping Yang MD , Zhao-Chong Zeng PhD","doi":"10.1016/j.adro.2025.101830","DOIUrl":"10.1016/j.adro.2025.101830","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 8","pages":"Article 101830"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831579","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":"Case Volume and Experience in Stereotactic Radiation: Analysis of a Prospective Peer Review Program","authors":"Luke Peng MD ,&nbsp;Kee-Young Shin MS ,&nbsp;Tara Kosak MEd ,&nbsp;Ayal A. Aizer MD ,&nbsp;John G. Phillips MD, MPH ,&nbsp;Itai M. Pashtan MD","doi":"10.1016/j.adro.2025.101875","DOIUrl":"10.1016/j.adro.2025.101875","url":null,"abstract":"<div><h3>Purpose</h3><div>Stereotactic radiation therapy (SRT) is highly effective but carries the risk of significant toxicity. We identified factors associated with SRT plans that require revision in a comprehensive, prospective peer review program conducted across a network of affiliated radiation oncology centers.</div></div><div><h3>Methods and Materials</h3><div>Weekly peer review rounds were conducted to review SRT cases prior to the start of radiation. Revision recommendations were tracked. Univariate and multivariable logistic regression was performed to identify factors associated with case revision.</div></div><div><h3>Results</h3><div>From 2019 to 2024, 1172 SRT cases were reviewed at weekly rounds, including 313 brain stereotactic radiosurgery (SRS), 190 brain multi-fractionated SRS, and 669 stereotactic body radiation therapy. The yearly revision rate ranged from 19% in 2020 to 31% in 2024. There were 16 individual treating physicians with a median of 6 years of experience (range, 1-19 years), measured at the time of each SRT case review. Factors assessed for significance included SRT case volume in the 3 months preceding review (dichotomized as low- or high-volume), physician experience (≤2, 3-9, or ≥10 years), SRT technique (SRS, multi-fractionated SRS, or stereotactic body radiation therapy, and disease site. On multivariable logistic regression, revisions were less likely for high-volume physicians (odds ratio [OR], 0.58; 95% CI, 0.43-0.77), those with 3-9 years of experience (OR, 0.65; 95% CI, 0.44-0.96), and SRS technique (OR, 0.59; 95% CI, 0.41-0.84).</div></div><div><h3>Conclusions</h3><div>These data imply high value to prospective peer review for physicians with low SRT case volume and in their early career. Adequate case volume may be a critical factor for high quality SRT, analogous to the surgical literature. Annual revision rates in the program remained substantial over time, demonstrating the ongoing importance of an effective prospective peer review program for SRT.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 10","pages":"Article 101875"},"PeriodicalIF":2.7,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144921740","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":"Comparative Analysis of Atlas and Neural Network Autosegmentation Methods for Pediatric Craniospinal Irradiation With the Development of a Knowledge-Based Quality Assurance Tool","authors":"Ozgur Ates ,&nbsp;James Man Git Tsui ,&nbsp;Zachary Wooten ,&nbsp;Sydney Hutcheson ,&nbsp;Rico Zhang ,&nbsp;Jared Becksfort ,&nbsp;Thomas E. Merchant ,&nbsp;Chia-ho Hua","doi":"10.1016/j.adro.2025.101847","DOIUrl":"10.1016/j.adro.2025.101847","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to evaluate the performance of Atlas and neural network autosegmentation methods and develop a knowledge-based quality assurance (QA) tool for pediatric craniospinal irradiation (CSI).</div></div><div><h3>Methods and Materials</h3><div>Autosegmentation was performed on 63 CSI patients using 3 methods: Atlas, commercial artificial intelligence (AI), and in-house AI. The performance of these methods was analyzed using 13 quantitative metrics, comprising 6 overlap and 7 distance metrics, across 13 critical organs and a linear mixed-effect model analysis was performed. Additionally, a knowledge-based QA tool was developed by leveraging distinctive computed tomography number distributions from 100 CSI patients for each organ, using the kernel density estimation (KDE) method to ensure robust error detection and validation. The QA tool was tested on 50 CSI cases by comparing baseline KDEs from 100 CSI patients.</div></div><div><h3>Results</h3><div>The linear mixed-effect analysis showed that the in-house AI outperformed both the Atlas and commercial AI methods in overlap and distance metrics. The in-house AI outperformed the commercial AI with a higher average overlap of 0.01 ± 0.01 and surpassed the Atlas method by 0.02 ± 0.01. In terms of distance metrics, the in-house AI matched the commercial AI (–0.31 ± 0.72 mm) and exceeded the Atlas method by 3.10 ± 0.68 mm. Paired t-tests showed the in-house AI was superior to the Atlas in 13.0% of cases, while the Atlas outperformed the in-house method in 8.9% of comparisons. Similarly, the in-house AI was better than the commercial AI in 35.3% of tests, with the commercial AI outperforming in 32.7%. The QA tool results demonstrated that 100% agreement with baseline KDEs occurred in 46.4% of tests for Atlas, 46.5% for the commercial AI, and 60.7% for the in-house AI.</div></div><div><h3>Conclusions</h3><div>The in-house AI excelled over the Atlas and commercial AI methods in autosegmentation accuracy for pediatric CSI patients. Furthermore, a knowledge-based QA tool enables clinicians to detect and correct gross errors in autosegmentation.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 9","pages":"Article 101847"},"PeriodicalIF":2.2,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144712950","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":"Optimizing Workflow for Cone Beam Computed Tomography-Based Online Adaptive Radiation Therapy Toward Reduced Physician Involvement","authors":"Goda Kalinauskaite MD ,&nbsp;Luise A. Künzel PhD ,&nbsp;Anne Kluge PhD ,&nbsp;Kerstin Rubarth PhD ,&nbsp;Jakob Dannehl ,&nbsp;Celina Höhne ,&nbsp;Marcus Beck MD ,&nbsp;Daniel Zips MD ,&nbsp;Carolin Senger MD","doi":"10.1016/j.adro.2025.101874","DOIUrl":"10.1016/j.adro.2025.101874","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the impact of an optimized online adaptive radiation therapy workflow on physician involvement.</div></div><div><h3>Methods and Materials</h3><div>Data from a prospective phase 2 trial involving 34 prostate cancer patients treated with cone beam computed tomography (CBCT)-based online adaptive radiation therapy (62 Gy in 20 fractions) were analyzed. Manual interventions were required for 2 steps in the workflow: radiation therapy technologist review and adjustment of automatically segmented organs, guiding target segmentation, so-called “influencer,” while physicians reviewed and refined the targets. Three different workflows were compared: 2-influencer (rectum and bladder), 3-influencer (+prostate), and 5-influencer (+seminal vesicles and bowel). Time for workflow steps, extent of manual corrections, and target volume changes were compared.</div></div><div><h3>Results</h3><div>A total of 613 fractions were analyzed. The 5-influencer workflow reduced manual target corrections to 11% of fractions compared with 51% for the 3-influencer workflow and 61% for the 2-influencer workflow (<em>P</em> &lt; .001). Median session duration across workflows was 24.0 minutes (IQR, 22.0-28.0). Median target review times were shortest with the 5-influencer workflow at 2.5 minutes compared with 5.0 minutes for the 3-influencer workflow (<em>P</em> &lt; .001) and 5.6 minutes for the 2-influencer workflow (<em>P</em> = .002). Most patients (84%) found the treatment time well tolerable.</div></div><div><h3>Conclusions</h3><div>This study of prostate cancer patients suggests that optimized workflow reduces the need for physician involvement in online CBCT guided adaptive radiation therapy. Optimized workflows may facilitate a more radiation therapy technologist-driven approach similar to standard image guided radiation therapy. Further studies in other cancers, also focusing on clinical endpoints, are needed to further improve CBCT guided online adaptive radiation therapy.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 10","pages":"Article 101874"},"PeriodicalIF":2.7,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912305","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":"Osteoradionecrosis of the Hyoid Bone: A Systematic Review","authors":"Quentin H. Drane BS ,&nbsp;Andrea Ziegler MD ,&nbsp;Eric J. Thorpe MD","doi":"10.1016/j.adro.2025.101873","DOIUrl":"10.1016/j.adro.2025.101873","url":null,"abstract":"<div><h3>Purpose</h3><div>Osteoradionecrosis (ORN) is a serious complication following radiation therapy (RT) for head and neck cancers, commonly affecting the mandible, but is less understood when involving the hyoid bone.</div></div><div><h3>Methods and Materials</h3><div>A literature review through PubMed and Scopus identified 16 relevant articles. Patient characteristics, presentation, imaging findings, management, and outcomes are highlighted.</div></div><div><h3>Results</h3><div>The review found 40 cases of hyoid bone ORN, with an average patient age of 60.0 years. Most patients were male (87.5%) and had oropharyngeal tumors (77.5%). The average RT dose was 66.2 Gy, and ORN typically developed 27.6 months after RT. Patients receiving concurrent radiation and chemotherapy were more likely to need surgery compared with those treated with RT alone (80% vs 30%, <em>P</em> = .0042).</div></div><div><h3>Conclusions</h3><div>While rare, hyoid bone ORN may become more common with increasing rates of oropharyngeal cancers. Clinicians should be aware of presenting symptoms and possible complications and be familiar with a thorough work-up and treatment.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 10","pages":"Article 101873"},"PeriodicalIF":2.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888678","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":"Predicting Radionecrosis After Stereotactic Radiation Therapy for Solitary Brain Metastases: External Validation of a Univariable Model and Development of a Multivariable Model","authors":"Elise E.M.W. van Schaik MSc ,&nbsp;Jeroen A. Crouzen MSc ,&nbsp;Mirjam E. Mast PhD ,&nbsp;Marike L.D. Broekman MD, PhD ,&nbsp;Martijn P. Hakstege BSc ,&nbsp;Bart J.A. Mertens PhD ,&nbsp;Mandy Kiderlen PhD ,&nbsp;Noëlle C.M.G. van der Voort van Zyp PhD ,&nbsp;Anna L. Petoukhova PhD ,&nbsp;Jaap D. Zindler PhD","doi":"10.1016/j.adro.2025.101871","DOIUrl":"10.1016/j.adro.2025.101871","url":null,"abstract":"<div><h3>Purpose</h3><div>Stereotactic radiation therapy (SRT) is a frequently used and effective treatment for patients who received diagnosis for brain metastases (BMs). Radionecrosis (RN) is a severe complication of SRT which may cause neurologic symptoms. A normal tissue complication probability (NTCP) model has previously been established to predict the risk of RN based on the volume of healthy brain receiving ≥12 Gy. The aim of this study is to externally validate this prediction model.</div></div><div><h3>Methods and Materials</h3><div>A total of 162 patients treated with SRT for solitary BMs were retrospectively included. The NTCP models for all (asymptomatic and symptomatic) RN and symptomatic RN cases were evaluated using discrimination (C-statistic) and calibration (Brier scores). Overall survival was determined using the Kaplan-Meier method.</div></div><div><h3>Results</h3><div>Median overall survival was 10 months. Asymptomatic or symptomatic RN was found in 44 (27%) of patients. Of these, 26 (16%) RN cases were symptomatic, with actuarial rates of 11% and 22% after 6 and 12 months, respectively. The C-statistics of the “any RN” and the “symptomatic RN” models were identical (0.61). Brier scores were 0.201 and 0.217, respectively. Univariable logistic regression analysis showed a significant correlation between both tumor volume and volume of healthy brain receiving ≥12 Gy with symptomatic RN. These effects did not hold up in the multivariable analysis. A nomogram was established and internally validated.</div></div><div><h3>Conclusions</h3><div>The accuracy of the tested NTCP models in assessing the risk of RN in patients with BM after SRT was insufficient for clinical practice. A novel multifactorial nomogram was developed to predict symptomatic RN. This model needs to be externally validated.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 10","pages":"Article 101871"},"PeriodicalIF":2.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095615","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":"Extracranial Palliative Radiation Therapy for Renal Cell Carcinoma","authors":"Young Suk Kwon MD, MPH ,&nbsp;Eric Hsu MD, PhD ,&nbsp;Maggie Stein BSPH ,&nbsp;Alana Christie MS ,&nbsp;Aurelie Garant MD ,&nbsp;Neil B. Desai MD ,&nbsp;Andrew Wang MD ,&nbsp;Daniel X. Yang MD ,&nbsp;Allen Yen MD ,&nbsp;Mihailo Miljanic MD ,&nbsp;Kevin D. Courtney MD, PhD ,&nbsp;Hans Hammers MD, PhD ,&nbsp;Tian Zhang MD ,&nbsp;Waddah Arafat MD ,&nbsp;Qian Qin MD ,&nbsp;Suzanne Cole MD ,&nbsp;James Brugarolas MD, PhD ,&nbsp;Robert Timmerman MD ,&nbsp;Raquibul Hannan MD, PhD","doi":"10.1016/j.adro.2025.101870","DOIUrl":"10.1016/j.adro.2025.101870","url":null,"abstract":"<div><h3>Purpose</h3><div>Symptom management is an integral component of care for patients with renal cell carcinoma (RCC). We evaluated the efficacy of radiation therapy (RT) and factors influencing symptom in an ethnically diverse patient population.</div></div><div><h3>Methods and Materials</h3><div>An institutional review board-approved retrospective review was conducted of patients with symptomatic extracranial RCC metastases treated with RT between 2011 and 2022 at a tertiary referral center. Symptoms were categorized as pain, neurologic (paresthesia or weakness), respiratory (dyspnea, hemoptysis, or cough) and gastrointestinal/genitourinary (GI/GU) bleeding. Time to symptom alleviation was measured from the start of RT and assessed during-treatment and follow-up visits. Descriptive and survival analyses were performed. Associations between symptom relief and treatment parameters were evaluated by generalized estimating equations</div></div><div><h3>Results</h3><div>We identified 240 symptomatic RCC patients who received RT to 581 metastases including 93.0% for pain, 4.0% for neurologic, 4.1% for respiratory, and 1.6% for GI/GU bleeding. Symptom improvement was observed in 84.0% of patients overall at 6 months (95% confidence interval [CI], 80.4-87.2%). Among symptom categories, pain improved in 84.6% (95% CI, 81.0-87.9%) at 6 months, respiratory symptoms in 69.9% (49.3-88.0%) at 6 months, neurologic symptoms in 88.6% (69.6-98.1%) at 6 months, and GI/GU bleeding in 37.5% (13.9-77.1%) at 1 month. The median times to overall and pain alleviation were 1.6 months (range, 1.4-1.9) and 1.6 months (range, 1.4-1.9), respectively. Although the odds of achieving pain palliation were similar between stereotactic and conventional RT, unexpectedly, symptom relief occurred more quickly with conventional RT (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Stereotactic and conventional RT are effective for symptom palliation for patients with metastatic RCC.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 10","pages":"Article 101870"},"PeriodicalIF":2.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Estimated Difference in Biologically Effective Dose Between Two-Opposing-Fields-Per-Day and One-Alternating-Field-Per-Day Carbon Ion Radiation Therapy for Prostate Cancer","authors":"Chi-Chuan Chiou MD ,&nbsp;Yu-Ming Liu PhD ,&nbsp;Keng-Li Lan PhD ,&nbsp;Yuan-Hung Wu PhD ,&nbsp;Tzu-Yu Lai PhD ,&nbsp;Yu-Mei Kang MD ,&nbsp;Jui-Pin Chen MSc ,&nbsp;Yu-Wen Hu PhD","doi":"10.1016/j.adro.2025.101863","DOIUrl":"10.1016/j.adro.2025.101863","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to determine whether two-opposing-fields-per-day (2-fields-per-day) carbon ion radiation therapy for prostate cancer provides a significant advantage in terms of biologically effective dose (BED) for normal tissue compared to the one-alternating-field-per-day (1-field-per-day) approach.</div></div><div><h3>Methods and Materials</h3><div>The prescribed dose for carbon ion radiation therapy is 54 Gy (relative biological effectiveness [RBE]) in 12 fractions, and 10 patients were randomly selected for analysis. BED was calculated using 3 methods: the linear-quadratic model, modified microdosimetric kinetic model (mMKM) with a fixed clinical RBE of 2.41 (adopted in most treatment planning systems), and the mMKM without rescaling, using domain radius (<span><math><msub><mi>r</mi><mi>d</mi></msub></math></span>) values of 0.28, 0.38, and 0.45 µm with <span><math><mrow><mi>α</mi><mo>/</mo><mi>β</mi></mrow></math></span> ratios of 3, 5, and 10 Gy. Organs at risk (OARs) were contoured following standard guidelines. The dosimetric and dose-volume histogram differences, based on BEDs estimated using various methods, were compared between the 2-fields-per-day and 1-field-per-day approaches. Statistical analyses were performed using the Wilcoxon signed rank test with <em>P</em> &lt; .05 considered statistically significant.</div></div><div><h3>Results</h3><div>The 2-fields-per-day approach resulted in significantly lower BED for noncentrally located OARs, particularly the femoral head, skin, and bone marrow. Among these, the femoral head showed the largest relative mean BED difference, with approximately 17% using the linear-quadratic model (<span><math><mrow><mi>α</mi><mo>/</mo><mi>β</mi></mrow></math></span>= 3 Gy), 7% with the mMKM model using a fixed clinical RBE, and 9% with the mMKM model (<span><math><msub><mi>r</mi><mi>d</mi></msub></math></span> = 0.38 µm, <span><math><mrow><mi>α</mi><mo>/</mo><mi>β</mi><mspace></mspace></mrow></math></span>= 3 Gy), with all <em>P</em> values &lt;.01. In contrast, the differences observed for the obturator muscles and other centrally located OARs, including the urethra, bladder, and rectum, were minimal, with relative BED differences remaining below 3%.</div></div><div><h3>Conclusions</h3><div>Compared to the 1-field-per-day approach, the 2-fields-per-day approach results in lower BED for noncentrally located OARs, though significant variation is observed between the different methods used to estimate BED. The reduction in BED requires further investigation to evaluate its clinical significance and impact on toxicity.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 11","pages":"Article 101863"},"PeriodicalIF":2.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145156161","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":"Pancreatic Polypeptide Secretory Paraganglioma Successfully Treated With Radiosurgery Resulting in Elimination of Life-Debilitating Diarrhea","authors":"Astha Rohit BS ,&nbsp;Laurence J. Miller MD ,&nbsp;Brady Laughlin MD ,&nbsp;Michael Hinni MD ,&nbsp;Lisa McGee MD","doi":"10.1016/j.adro.2025.101862","DOIUrl":"10.1016/j.adro.2025.101862","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 10","pages":"Article 101862"},"PeriodicalIF":2.7,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860971","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":"High-Dose-Rate Brachytherapy Boost for Prostate Cancer: A Retrospective Observational Study in Low- and Middle-Income Countries","authors":"Hamza Samlali MD ,&nbsp;Najlaa Assaid PhD ,&nbsp;Youness Khobbaizi PhD (candidate) ,&nbsp;Omar Hanicha MSc ,&nbsp;Mahdi Abou El Houda MSc ,&nbsp;Sanaa Nabil MSc ,&nbsp;Hassan Jouhadi MD ,&nbsp;Redouane Samlali MD","doi":"10.1016/j.adro.2025.101861","DOIUrl":"10.1016/j.adro.2025.101861","url":null,"abstract":"<div><h3>Purpose</h3><div>Prostate brachytherapy used as an adjunct to external beam radiation therapy is recognized as an effective therapeutic approach in the treatment of intermediate and high-risk prostate cancer. However, data remain limited in African countries, particularly Morocco. The aim of this study was to assess the oncological outcomes and tolerability of boost brachytherapy in a Moroccan cohort.</div></div><div><h3>Methods and Materials</h3><div>A retrospective study was conducted between 2014 and 2022. Among 128 patients treated with prostate brachytherapy, 106 with intermediate- or high-risk prostate cancer who received high-dose-rate brachytherapy as a boost were included. Hormone therapy was administered to 84.91% of patients. Median follow-up was 26 months. Clinical characteristics, dosimetric data, toxicity, and oncological results were analyzed.</div></div><div><h3>Results</h3><div>Of the 106 patients, 59 (55.66%) had intermediate-risk cancer and 47 (44.34%) had high-risk cancer. Locally advanced stage (T3a-T3b) was observed in 43.4% of patients. At 3 years, overall survival, metastasis-free survival (MFS), and biochemical progression-free survival (BPFS) were 87%, 92%, and 78%, respectively. The 3-year BPFS was 75% for intermediate-risk cancers and 70% for high-risk cancers. International Society of Urological Pathology (ISUP)scores 1 to 3 showed better BPFS (85%) and MFS (92%) than ISUP scores 4 to 5 (BPFS: 60%, MFS: 79%). Clinical stage was the only significant factor for MFS (<em>P</em> = .001). No grade 3 acute toxicities (genitourinary or gastrointestinal) were reported. Late grade 3 toxicities were observed in 1.89% (genitourinary) and 0.94% (gastrointestinal) of patients. Grade 2 toxicities remained low (&lt;9%).</div></div><div><h3>Conclusions</h3><div>This single-center study confirms the efficacy and tolerability of the combination of external beam radiation therapy and brachytherapy in the treatment of intermediate- and high-risk prostate cancer. The results are encouraging, even in advanced-stage patients. Clinical stage has been shown to be the main prognostic factor for MFS.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 10","pages":"Article 101861"},"PeriodicalIF":2.7,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007607","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}