Robert L. Walker MD, Abhrarup Roy MD, Sarini Saksena BS, Nilanjan Haldar MD, Dane Cohen MD, Wenyin Shi MD, Sherry Yang MD, Gregory S. Alexander MD
{"title":"Low-Dose Radiation Therapy in Treatment of Recalcitrant Hidradenitis Suppurativa","authors":"Robert L. Walker MD, Abhrarup Roy MD, Sarini Saksena BS, Nilanjan Haldar MD, Dane Cohen MD, Wenyin Shi MD, Sherry Yang MD, Gregory S. Alexander MD","doi":"10.1016/j.adro.2026.102105","DOIUrl":"10.1016/j.adro.2026.102105","url":null,"abstract":"<div><h3>Purpose</h3><div>Hidradenitis suppurativa (HS) is a benign, chronic inflammatory condition involving painful lesions that can progress to abscesses, skin tunnels, and fibrotic scars. Treatment of recalcitrant disease often involves immunomodulatory agents or surgery, but these often result in modest improvement. This study’s objective was to determine the effectiveness of external beam low-dose radiation therapy (LD-RT) as an adjunct treatment for recalcitrant HS.</div></div><div>Hidradenitis suppurativa (HS) is a benign, chronic inflammatory condition involving painful lesions that can progress to abscesses, skin tunnels, and fibrotic scars. Treatment of recalcitrant disease often involves immunomodulatory agents or surgery, but these often result in modest improvement. This study’s objective was to determine the effectiveness of external beam low-dose radiation therapy (LD-RT) as an adjunct treatment for recalcitrant HS.</div><div><h3>Methods and Materials</h3><div>HS patients receiving LD-RT at a single institution from 2017 to 2024 were retrospectively identified. LD-RT dose included 750 cGy in 3 fractions or 800 cGy in 4 fractions. Patient demographics and comorbidities were recorded. Treatment response was categorized as excellent, partial, or no response, and site-specific symptoms were recorded based on available records.</div></div><div>HS patients receiving LD-RT at a single institution from 2017 to 2024 were retrospectively identified. LD-RT dose included 750 cGy in 3 fractions or 800 cGy in 4 fractions. Patient demographics and comorbidities were recorded. Treatment response was categorized as excellent, partial, or no response, and site-specific symptoms were recorded based on available records.</div><div><h3>Results</h3><div>Thirteen patients with HS underwent LD-RT to 38 sites were identified with a median follow-up period of 1.45 years from completion of LD-RT (range, 0.4-7 years). The majority of sites were Hurley stage III (34/38). At the patient level, all had been previously treated with antibiotics, 9 with prednisone, 12 with biologic agents, and 7 with a surgical procedure. Clinical response per site included 4 of 38 (10.5%) excellent, 26 of 38 (68.4%) partial, and 8 of 38 (21.1%) nonresponders. Four patients reported a reduction in pain score at first radiation oncology follow-up. For those with a response, median time from LD-RT to next rescue intervention was 2.2 months (range, 0.6-23.1 months). Three sites underwent surgery at a median time of 9.3 months from LD-RT completion. Two patients with 5 sites were retreated without response 1 year after LD-RT.</div></div><div>Thirteen patients with HS underwent LD-RT to 38 sites were identified with a median follow-up period of 1.45 years from completion of LD-RT (range, 0.4-7 years). The majority of sites were Hurley stage III (34/38). At the patient level, all had been previously treated with antibiotics, 9 with prednisone, 12 with biologic agents, and 7 with a surgi","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"11 9","pages":"Article 102105"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961340","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}
Ramesh Keerthi Gadam MBBS, Timothy E. Stepp MD, Hongyu Jiang PhD, Adip Bhargav MD, Megan Smith MS, CMD, Rajeev Badkul MS, DRP, DABR, Jeremy Peterson MD, Michael Abraham MD, Ernest Madarang MD, Alan Reeves MD, Ying Cao MS, Koji Ebersole MD, Ronny L. Rotondo MD, Dima Soultan MSc, DABR, Fen Wang MD, PhD
{"title":"Accelerated Volume-Staged Stereotactic Radiosurgery for Large Cerebral Arteriovenous Malformations: A Single Institutional Experience","authors":"Ramesh Keerthi Gadam MBBS, Timothy E. Stepp MD, Hongyu Jiang PhD, Adip Bhargav MD, Megan Smith MS, CMD, Rajeev Badkul MS, DRP, DABR, Jeremy Peterson MD, Michael Abraham MD, Ernest Madarang MD, Alan Reeves MD, Ying Cao MS, Koji Ebersole MD, Ronny L. Rotondo MD, Dima Soultan MSc, DABR, Fen Wang MD, PhD","doi":"10.1016/j.adro.2026.102160","DOIUrl":"10.1016/j.adro.2026.102160","url":null,"abstract":"<div><h3>Purpose</h3><div>Large cerebral arteriovenous malformations (AVMs) pose significant management challenges, particularly in achieving complete nidus obliteration without increasing the risk of symptomatic necrosis. Stereotactic radiosurgery (SRS) is an established, noninvasive treatment for inoperable AVMs. However, for large AVMs, single-stage SRS is complicated by larger volumes of irradiated normal brain and increased radiation-induced toxicity. Here, we describe our institution’s accelerated volume-staged SRS (AVS-SRS) strategy for large cerebral AVMs and report long-term clinical outcomes.</div></div><div>Large cerebral arteriovenous malformations (AVMs) pose significant management challenges, particularly in achieving complete nidus obliteration without increasing the risk of symptomatic necrosis. Stereotactic radiosurgery (SRS) is an established, noninvasive treatment for inoperable AVMs. However, for large AVMs, single-stage SRS is complicated by larger volumes of irradiated normal brain and increased radiation-induced toxicity. Here, we describe our institution’s accelerated volume-staged SRS (AVS-SRS) strategy for large cerebral AVMs and report long-term clinical outcomes.</div><div><h3>Methods and Materials</h3><div>A retrospective analysis was performed on 19 patients with cerebral AVMs (≥6 cm<sup>3</sup>) treated with AVS-SRS at the University of Kansas Medical Center between 2009 and 2024. AVMs were divided into 2 to 3 subtargets, which were treated sequentially using an AVS-SRS approach at 2- to 3-week intervals. The prescription dose to the entire nidus ranged from 16 Gy to 24 Gy. Treatments were delivered on a stereotactic-dedicated linear accelerator platform. Annual follow-up included magnetic resonance imaging/magnetic resonance angiography (MRA) and a confirmatory cerebral arteriogram if MRA showed resolution of the nidus. One patient was excluded from outcome analysis due to a lack of follow-up evaluation. Outcomes included nidus obliteration, symptomatic radiation necrosis, posttreatment hemorrhage, and permanent neurological deficits.</div></div><div>A retrospective analysis was performed on 19 patients with cerebral AVMs (≥6 cm<sup>3</sup>) treated with AVS-SRS at the University of Kansas Medical Center between 2009 and 2024. AVMs were divided into 2 to 3 subtargets, which were treated sequentially using an AVS-SRS approach at 2- to 3-week intervals. The prescription dose to the entire nidus ranged from 16 Gy to 24 Gy. Treatments were delivered on a stereotactic-dedicated linear accelerator platform. Annual follow-up included magnetic resonance imaging/magnetic resonance angiography (MRA) and a confirmatory cerebral arteriogram if MRA showed resolution of the nidus. One patient was excluded from outcome analysis due to a lack of follow-up evaluation. Outcomes included nidus obliteration, symptomatic radiation necrosis, posttreatment hemorrhage, and permanent neurological deficits.</div><div><h3>Results</h3><div>Th","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"11 9","pages":"Article 102160"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961103","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}
Matthew S. Susko MD, MS, Jonathan Massachi MD, Lauren Boreta MD, Jessica Chew MD, Harish Vasudevan MD, PhD, Jean Nakamura MD, Steve E. Braunstein MD, PhD
{"title":"Stereotactic Body Radiation Therapy for Symptomatic Benign Spinal Tumors: A Single-Center Retrospective Experience","authors":"Matthew S. Susko MD, MS, Jonathan Massachi MD, Lauren Boreta MD, Jessica Chew MD, Harish Vasudevan MD, PhD, Jean Nakamura MD, Steve E. Braunstein MD, PhD","doi":"10.1016/j.adro.2026.102127","DOIUrl":"10.1016/j.adro.2026.102127","url":null,"abstract":"<div><h3>Purpose</h3><div>Benign spinal tumors (BSTs) are relatively uncommon, though can yield significant morbidity as related to location and size. Surgical resection is the primary management modality for symptomatic lesions; however, for patients who are nonsurgical candidates or have progressed post-surgery, radiation therapy can be employed for definitive treatment. This institutional series describes the local control and toxicity outcomes of stereotactic body radiation therapy (SBRT) for BST.</div></div><div>Benign spinal tumors (BSTs) are relatively uncommon, though can yield significant morbidity as related to location and size. Surgical resection is the primary management modality for symptomatic lesions; however, for patients who are nonsurgical candidates or have progressed post-surgery, radiation therapy can be employed for definitive treatment. This institutional series describes the local control and toxicity outcomes of stereotactic body radiation therapy (SBRT) for BST.</div><div><h3>Methods and Materials</h3><div>Patients treated with SBRT for BST at a single institution from 2010 to 2021 were retrospectively reviewed and analyzed. Patients were included if they underwent treatment with SBRT with or without prior surgical intervention. Evaluation of posttreatment toxicities, symptomatic improvement, imaging response, and local control were performed.</div></div><div>Patients treated with SBRT for BST at a single institution from 2010 to 2021 were retrospectively reviewed and analyzed. Patients were included if they underwent treatment with SBRT with or without prior surgical intervention. Evaluation of posttreatment toxicities, symptomatic improvement, imaging response, and local control were performed.</div><div><h3>Results</h3><div>During the study period 31 patients were identified with a total of 36 BST. The distribution of the tumors included 16 in the cervical spine (44%), 13 thoracic (n = 36%), and 7 lumbosacral (n = 20%). Histologies included 14 schwannoma (39%), 12 meningioma (33%), and 8 hemangioma (22%), 1 melanocytic tumor (3%), and 1 neurofibroma (3%). Median radiation prescription dose was 25 Gy (range, 18-40 Gy) in 5 fractions (range, 3-5 fractions). Of the treated lesions, 17 (47%) had prior surgical management and 19 (53%) were treated upfront with SBRT. With median imaging follow-up was 49 months (range, 2-171) and the median clinical follow-up was 83 months (range, 10-171) with 86% of assessable patients having stable to improved symptoms in the treated lesion at 12 months. Two patients demonstrated progressive disease on imaging. There were no incidences of National Cancer Institute Common Terminology Criteria for Adverse Events version 4 grade 3 or greater observed toxicities and the most common toxicities were fatigue 6 (17%), and pain flare 5 (14%), both transient. There was no association between treatment course (prior surgery versus definitive radiation) and symptomatic stability or improvement, imagi","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"11 9","pages":"Article 102127"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148958078","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":"Clinical Outcomes of Fractionated Radiation Therapy for Spinal Intramedullary Arteriovenous Malformations: A Single Institutional Retrospective Review","authors":"Ruja Vichitvejpaisal MD, Kentaro Nishioka MD, PhD, Toshiya Osanai MD, PhD, Motoyuki Iwasaki MD, PhD, Takashi Mori MD, PhD, Yusuke Uchinami MD, PhD, Tomohiko Miyazaki MD, Fuki Koizumi MD, Takayuki Hashimoto MD, PhD, Miki Fujimura MD, PhD, Hidefumi Aoyama MD, PhD","doi":"10.1016/j.adro.2025.101778","DOIUrl":"10.1016/j.adro.2025.101778","url":null,"abstract":"<div><h3>Purpose</h3><div>Intramedullary spinal arteriovenous malformations (im-sAVMs) have a bleeding risk of up to 4% to 10% annually. Given the rarity of im-sAVMs and the lack of established evidence regarding the efficacy of radiation therapy, we retrospectively reviewed the treatment outcomes of fractionated radiation therapy (fRT) administered for im-sAVMs at our institution.</div></div><div>Intramedullary spinal arteriovenous malformations (im-sAVMs) have a bleeding risk of up to 4% to 10% annually. Given the rarity of im-sAVMs and the lack of established evidence regarding the efficacy of radiation therapy, we retrospectively reviewed the treatment outcomes of fractionated radiation therapy (fRT) administered for im-sAVMs at our institution.</div><div><h3>Methods and Materials</h3><div>We examined patients of im-sAVMs treated with fRT at Hokkaido University Hospital between January 2003 and December 2023. The incidences of post-fRT bleeding from the AVMs, nidus occlusion/reduction, and late radiation-induced complications were assessed.</div></div><div>We examined patients of im-sAVMs treated with fRT at Hokkaido University Hospital between January 2003 and December 2023. The incidences of post-fRT bleeding from the AVMs, nidus occlusion/reduction, and late radiation-induced complications were assessed.</div><div><h3>Results</h3><div>Of the 25 patients, we analyzed 21 patients, excluding 4 patients with a follow-up period of less than 180 days. Prior to radiation therapy, 10 patients underwent surgical occlusion of feeding vessels because of coexisting arteriovenous fistulas, 2 and 3 patients underwent surgical occlusion and endovascular embolization for arteriovenous malformation, respectively. The radiation dose was 20 Gy in 4 fractions for 19 patients and 24 Gy in 4 fractions for 2 patients. The follow-up period ranged from 12 to 236 months (median, 56.4 months). Complete nidus occlusion was observed in 2 patients (9.5%), whereas 8 patients (38.1%) showed partial reduction with residual nidus, and 10 patients (47.6%) showed no reduction. One patient showed slight nidus enlargement 12 months after fRT, and another patient developed an aneurysm formation in the feeding artery at the margin of the irradiation field 57 months after fRT. No bleeding and late radiation-induced complications were observed during the follow-up.</div></div><div>Of the 25 patients, we analyzed 21 patients, excluding 4 patients with a follow-up period of less than 180 days. Prior to radiation therapy, 10 patients underwent surgical occlusion of feeding vessels because of coexisting arteriovenous fistulas, 2 and 3 patients underwent surgical occlusion and endovascular embolization for arteriovenous malformation, respectively. The radiation dose was 20 Gy in 4 fractions for 19 patients and 24 Gy in 4 fractions for 2 patients. The follow-up period ranged from 12 to 236 months (median, 56.4 months). Complete nidus occlusion was observed in 2 patients (9.5%), whereas ","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"11 9","pages":"Article 101778"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148958801","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}
Kent Wallner MD, Kathleen E. Kearney MD, Joseph M. DeCunha PhD, Edward Y. Kim MD, Lorenzo Azzalini MD, PhD, MSc, Michael R. Folkert MD, PhD, George Sandison PhD, William L. Lombardi MD, Sant Kumar MD, Bishwambhar Sengupta PhD, Creighton Don PhD, MD, Minsun Kim PhD
{"title":"Intravascular Radiation Delays Recurrence of Recalcitrant Coronary In-Stent Restenosis","authors":"Kent Wallner MD, Kathleen E. Kearney MD, Joseph M. DeCunha PhD, Edward Y. Kim MD, Lorenzo Azzalini MD, PhD, MSc, Michael R. Folkert MD, PhD, George Sandison PhD, William L. Lombardi MD, Sant Kumar MD, Bishwambhar Sengupta PhD, Creighton Don PhD, MD, Minsun Kim PhD","doi":"10.1016/j.adro.2026.102111","DOIUrl":"10.1016/j.adro.2026.102111","url":null,"abstract":"<div><h3>Purpose</h3><div>Intravascular brachytherapy (IVBT) has a well-proven activity against coronary restenosis of a native vessel or a single bare metal stent. However, its effectiveness for multiple recurrent same-vessel in-stent restenoses (ISRs) is unproven. The objective of this study was to determine if IVBT prolongs the ISR-free interval in recalcitrant lesions.</div></div><div>Intravascular brachytherapy (IVBT) has a well-proven activity against coronary restenosis of a native vessel or a single bare metal stent. However, its effectiveness for multiple recurrent same-vessel in-stent restenoses (ISRs) is unproven. The objective of this study was to determine if IVBT prolongs the ISR-free interval in recalcitrant lesions.</div><div><h3>Methods and Materials</h3><div>ISR-free intervals before and after IVBT for individual patients were compared. T1 was the ISR-free interval prior to IVBT, and T2 was the ISR-free interval after IVBT. Accrual was sought from patients with a prior ISR-free interval of less than 2 years. Standard radiation techniques were used, with doses of 18, 23, or 34 Gy prescribed at 2 mm from the radiation source. ISR-free intervals before (T1) and after IVBT (T2) were compared.</div></div><div>ISR-free intervals before and after IVBT for individual patients were compared. T1 was the ISR-free interval prior to IVBT, and T2 was the ISR-free interval after IVBT. Accrual was sought from patients with a prior ISR-free interval of less than 2 years. Standard radiation techniques were used, with doses of 18, 23, or 34 Gy prescribed at 2 mm from the radiation source. ISR-free intervals before (T1) and after IVBT (T2) were compared.</div><div><h3>Results</h3><div>Twenty-six vessels in 19 patients were studied. ISR-free intervals prior to IVBT ranged from 25 to 317 days (median, 96 days) compared with ISR-free intervals after IVBT that ranged from 30 to 612 days (median, 350 days; <em>P</em> < .001; log-rank test).</div></div><div>Twenty-six vessels in 19 patients were studied. ISR-free intervals prior to IVBT ranged from 25 to 317 days (median, 96 days) compared with ISR-free intervals after IVBT that ranged from 30 to 612 days (median, 350 days; <em>P</em> < .001; log-rank test).</div><div><h3>Conclusion</h3><div>The results support the use of IVBT to prolong the ISR-free interval in recalcitrant ISRs.</div></div><div>The results support the use of IVBT to prolong the ISR-free interval in recalcitrant ISRs.</div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"11 9","pages":"Article 102111"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961518","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}
Rohini K. Bhatia MD, Suzanne M. Grieb PhD, Chidinma Anakwenze MD, MPH, Katharine A. Rendle PhD, MPH, Wilfred Ngwa PhD, MSc, Surbhi Grover MD, MPH
{"title":"Erratum to: Bhatia RK, Grieb SM, Anakwenze C, Rendle KA, Ngwa W, Grover S. Investigating the Uptake of Hypofractionation for Breast and Prostate Cancer in Sub-Saharan Africa: A Qualitative Study of Physician and Medical Physicist Perspectives. Adv Radiat Oncol. 2024;10:101683","authors":"Rohini K. Bhatia MD, Suzanne M. Grieb PhD, Chidinma Anakwenze MD, MPH, Katharine A. Rendle PhD, MPH, Wilfred Ngwa PhD, MSc, Surbhi Grover MD, MPH","doi":"10.1016/j.adro.2026.102027","DOIUrl":"10.1016/j.adro.2026.102027","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"11 7","pages":"Article 102027"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148443842","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}