Advances in Radiation Oncology最新文献

{"title":"Stereotactic Body Radiosurgery Associated With Rectal Displacement using Gelfoam for Sacral Chordomas: Preliminary Report of 3 Cases","authors":"Samir Abdallah Hanna MD, MBA, PhD ,&nbsp;Thiago Dieb Ristum Vieira MD ,&nbsp;Fernanda Hayashida Yoshimoto MD ,&nbsp;Eduardo Samir Cipriano Hanna ,&nbsp;William Gemio Jacobsen Teixeira MD, PhD ,&nbsp;Douglas Kenji Narazaki MD, PhD ,&nbsp;Wellington Furtado Pimenta Neves-Junior BSc ,&nbsp;Rodrigo Ramella Munhoz MD, PhD ,&nbsp;Marcos Vinícius Calfat Maldaun MD, PhD ,&nbsp;João Luis Fernandes da Silva MD ,&nbsp;Gustavo Nader Marta MD, PhD","doi":"10.1016/j.adro.2025.101849","DOIUrl":"10.1016/j.adro.2025.101849","url":null,"abstract":"<div><h3>Purpose</h3><div>The treatment of sacral chordomas remains challenging because of high recurrence rates, postoperative complications, and limited effective radiation therapy options. We report a small case series of sacral chordoma treated exclusively with photon-based stereotactic body radiation therapy (SBRT), incorporating rectal displacement via tomography-guided radiointerventional interposition of a Gelfoam-based solution. This novel combination has not been previously described in the literature.</div></div><div><h3>Methods and Materials</h3><div>Patients with biopsy-confirmed sacral conventional chordomas were included. All patients underwent SBRT with rectal displacement, receiving a single 24-Gy fraction. Treatment parameters and planning details are outlined.</div></div><div><h3>Results</h3><div>Between 2022 and 2024, 3 patients were analyzed. Two were treatment-naïve, whereas 1 had recurrent disease. The median age was 62 years (range, 57-70). After a median follow-up of 21 months (range, 3-32), the local control rate was 100%; there were no treatment-related clinically significant adverse events (including gastrointestinal/rectal toxicities), except for 1 patient who experienced transient pain. The average dose-gradient of 1.4 Gy/mm toward the rectum because of displacement, leading to a potential reduction of the rectal dose by approximately 7 to 14 Gy.</div></div><div><h3>Conclusions</h3><div>This small case series suggests that SBRT with rectal using a Gelfoam-based solution is a feasible and well-tolerated approach for sacral chordoma treatment. Further prospective studies with larger cohorts and extended follow-up are warranted to validate these findings and assess long-term efficacy and safety.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 9","pages":"Article 101849"},"PeriodicalIF":2.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144781499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Radiogenomic Deep Ensemble Learning Model for Identifying Radionecrosis Following Brain Metastases (BM) Stereotactic Radiosurgery in Patients With Non-small Cell Lung Cancer BM","authors":"Jingtong Zhao MS ,&nbsp;Eugene Vaios MD, MBA ,&nbsp;Evan Calabrese MD, PhD ,&nbsp;Zhenyu Yang PhD ,&nbsp;Scott Robertson PhD ,&nbsp;John Ginn PhD ,&nbsp;Ke Lu PhD ,&nbsp;Fang-Fang Yin PhD ,&nbsp;Zachary Reitman MD, PhD ,&nbsp;John Kirkpatrick MD, PhD ,&nbsp;Scott Floyd MD, PhD ,&nbsp;Peter Fecci MD, PhD ,&nbsp;Chunhao Wang PhD","doi":"10.1016/j.adro.2025.101826","DOIUrl":"10.1016/j.adro.2025.101826","url":null,"abstract":"<div><h3>Purpose</h3><div>Stereotactic radiosurgery (SRS) is widely used for brain metastases (BM), but the risk of radionecrosis poses a challenge in post-SRS management. Given the lack of noninvasive imaging methods for distinguishing radionecrosis from recurrence, we aimed to design a deep ensemble learning model that integrates patient clinical features and genomic profiles to identify radionecrosis in patients with BM with post-SRS radiographic progression.</div></div><div><h3>Methods and Materials</h3><div>We studied 90 BMs from 62 patients with non-small cell lung cancer, with 27 biopsy-confirmed post-SRS local recurrences. Clinical features and molecular features were collected. A deep neural network (DNN) was trained for radionecrosis/recurrence prediction using the 3-month post-SRS T1+c magnetic resonance imaging. Preceding the binary prediction output, latent variables were extracted as 1024 deep features. An ensemble learning model was then developed, comprising 2 submodels that fused deep features with clinical (“<em>D+C”</em>) or genomic (“<em>D+G”</em>) features. We employed our positional encoding method to optimally fuse the low-dimensional clinical/genomic features with the high-dimensional image features. The postfusion feature in each submodel yielded a logit result after traversing fully connected layers. The ensemble's final output was the synthesized result of these 2 submodels’ logits via logistic regression. Model training employed an 8:2 train/test split, and 10 model versions were developed for robustness evaluation. Performance metrics were compared against image-only DNN model and “<em>D+C”</em> and “<em>D+G”</em> submodels.</div></div><div><h3>Results</h3><div>The deep ensemble model showed satisfactory performance on the test set, with the area under the receiver operating characteristic curve (ROC_AUC) = 0.91 ± 0.04, sensitivity = 0.87 ± 0.16, specificity = 0.86 ± 0.08, and accuracy = 0.87 ± 0.04. This significantly outperformed the image-only DNN result (ROC_AUC = 0.71 ± 0.05, sensitivity = 0.66 ± 0.32). Higher average performance was also observed compared to the “D+C” result (ROC_AUC = 0.82 ± 0.03, sensitivity = 0.67 ± 0.17) and “D+G” result (ROC_AUC = 0.83 ± 0.02, sensitivity = 0.76 ± 0.22).</div></div><div><h3>Conclusions</h3><div>The deep ensemble model achieved the best performance among the models evaluated in this study for distinguishing BM radionecrosis from recurrence using 3-month post-SRS T1+c MR images, clinical features, and genomic features. This highlights the potential of artificial intelligence in clinical decision-making for BM management, warranting further investigation into its clinical applications.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 8","pages":"Article 101826"},"PeriodicalIF":2.2,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523830","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":"In Regard to Dennstädt et al.","authors":"Ilker Sengul MD ,&nbsp;Demet Sengul MD","doi":"10.1016/j.adro.2025.101799","DOIUrl":"10.1016/j.adro.2025.101799","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 7","pages":"Article 101799"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588424","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":"In Reply to Sengul I and Sengul D","authors":"Fabio Dennstädt MD ,&nbsp;Janna Hastings PhD ,&nbsp;Paul Martin Putora MD, PhD ,&nbsp;Erwin Vu MD ,&nbsp;Galina Fischer MD, PhD ,&nbsp;Krisztian Süveg MD ,&nbsp;Markus Glatzer MD ,&nbsp;Elena Riggenbach MD ,&nbsp;Hông-Linh Hà ,&nbsp;Nikola Cihoric MD","doi":"10.1016/j.adro.2025.101800","DOIUrl":"10.1016/j.adro.2025.101800","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 7","pages":"Article 101800"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588422","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":"Development and Validation of a Computed Tomography-based Radiomics Nomogram for Diagnosing Cervical Lymph Node Metastasis in Oropharyngeal Squamous Cell Carcinomas.","authors":"Ran Zhao, Changdong Ma, Jingmin Zou, Xueli Fang, Qiang Wu, Chao Kong, Changsheng Ma, Kai Liu","doi":"10.1016/j.adro.2025.101844","DOIUrl":"10.1016/j.adro.2025.101844","url":null,"abstract":"<p><strong>Purpose: </strong>To construct and validate a radiomic nomogram based on computed tomography (CT) scan data to diagnose lymph node (LN) metastasis (LNM) in patients with oropharyngeal squamous cell carcinoma (OPSCC) and compare it with a model based on CT scan signs recognized by the naked eye.</p><p><strong>Methods and materials: </strong>Data from patients who visited the authors' hospital between January 2018 and February 2023 were retrospectively reviewed. Eighty-six patients with OPSCC contributed 116 LNs, which were randomly divided into training and test sets. Radiologists derived CT signs characteristic of each LN by visually reviewing CT scan images. The radiomics features of LNs were extracted using \"3Dslicer\" (https://www.slicer.org), and the least absolute shrinkage and selection operator method was used to reduce the dimensions and establish radiomics tags. A CT scan-based radiomic nomogram was constructed and validated. The performance levels of the radiomics nomogram, radiomics signature, and CT-sign model were evaluated according to the area under the receiver operating characteristic curve (AUC) values.</p><p><strong>Results: </strong>CT signs (central necrosis, extensive necrosis, and LN accumulation) exhibited significant differences between the LN-negative and LN-positive groups. For each CT scan, 851 3-dimensional features were extracted from the cervical LN region. Eight of the most pertinent radiomic features were selected using dimensionality reduction to create radiomic tags. The radiomics nomogram incorporating the CT signs and radiomics signature demonstrated favorable predictive value for diagnosing LNM in patients with OPSCC, with the area under the receiver operating characteristic curve values of 0.983 and 0.919 for the training and test sets, respectively.</p><p><strong>Conclusion: </strong>The CT scan-based radiomics nomogram demonstrated good diagnostic utility for LNM in OPSCC and may optimize clinical decision-making. To validate our findings, future studies should consider conducting larger-scale experiments and include external validation sets to confirm the broader applicability of our results.</p>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 9","pages":"101844"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144870847","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":"Spine Stereotactic Body Radiation Therapy for a Patient With a Metallic Implant in Low-Field Magnetic Resonance-Guided Linear Accelerator: A Case Report","authors":"Hiroki Nakayama PhD ,&nbsp;Hiroyuki Okamoto PhD ,&nbsp;Kae Okuma MD, PhD ,&nbsp;Ayaka Nagao MD ,&nbsp;Yuki Tsunoda BSc ,&nbsp;Satoshi Nakamura PhD ,&nbsp;Takahito Chiba MSc ,&nbsp;Tetsu Nakaichi PhD ,&nbsp;Miki Yonemura PhD ,&nbsp;Riki Oshika MSc ,&nbsp;Yuta Kobayashi MSc ,&nbsp;Hironori Kishida MSc ,&nbsp;Shoki Nakamura MSc ,&nbsp;Masato Nishitani MSc ,&nbsp;Shuka Nishina MSc ,&nbsp;Takumi Sakamoto MSc ,&nbsp;Hana Endo BSc ,&nbsp;Junichi Kuwahara MSc ,&nbsp;Yasunori Shuto MSc ,&nbsp;Masataka Ueda MSc ,&nbsp;Hiroshi Igaki MD, PhD","doi":"10.1016/j.adro.2025.101843","DOIUrl":"10.1016/j.adro.2025.101843","url":null,"abstract":"<div><div>The rise in radiation therapy challenges facing the management of pain and neurologic symptoms from vertebral metastasis has paralleled advances in cancer treatment and patient prognosis. Surgical options include decompression to alleviate spinal cord compression symptoms, with consideration for spinal stability through fixation using titanium alloy implants. Previous studies comparing radiation alone with postoperative irradiation following decompression surgery showed superior functional outcomes. Stereotactic body radiation therapy (SBRT), which concentrates radiation on the tumor while sparing surrounding organs, has clinical advantages when combined with surgery. However, the accurate delineation of targets and organs, particularly the spinal cord of a patient with metallic implants, is difficult with computed tomography and magnetic resonance (MR) images because of metal artifacts and registration errors. The low-field MR-guided radiation therapy (the low-field MRgRT) system offers advantages in target delineation with metal artifact suppression because of its associated low-magnetic field and no need for registration between a computed tomography image and an MR image for the delineation of targets and organs because the low-field MRgRT system uses the MR image acquired by itself as the primary image. The advantages make the low-field MRgRT suitable for spine SBRT, especially for patients with metallic implants. Here, we present a case of successful postoperative spine SBRT using the low-field MRgRT, ensuring the identification of the spinal cord, and safe and accurate treatment in a patient with metallic implants. The conclusion highlights the low-field MRgRT as a viable option for postoperative spine SBRT, which is particularly beneficial for patients with metallic implants, ensuring treatment safety and accuracy.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 9","pages":"Article 101843"},"PeriodicalIF":2.2,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144680557","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":"Examining Barriers to Practice in Genitourinary and Gynecologic Radiation Oncology: Results from 2 Nationwide Surveys","authors":"Patrick Doyle MS ,&nbsp;Neha Vapiwala MD, FACR, FASTRO, FASCO ,&nbsp;Mutlay Sayan MD ,&nbsp;Miranda Lam MD, MBA ,&nbsp;Shalini Moningi MD","doi":"10.1016/j.adro.2025.101848","DOIUrl":"10.1016/j.adro.2025.101848","url":null,"abstract":"<div><h3>Purpose</h3><div>Gender diversity in academic radiation oncology (RO) has become a topic of interest in recent years, with studies showing that practicing female academic radiation oncologists (AROs) are outnumbered by male colleagues at a rate of approximately 3:1. Gender differences are also observed in subspecialties whose patient populations are overwhelmingly of a single gender, such as genitourinary (GU) and gynecologic (GYN) RO. We aimed to investigate whether challenges exist for academic RO physicians who primarily treat patients of another gender, and, if so, what barriers they face in practice.</div></div><div><h3>Methods and Materials</h3><div>We conducted 2 national surveys of female GU academic RO physicians and male GYN academic RO physicians working at Accreditation Council for Graduate Medical Education-accredited academic centers. Survey questions focused on career path, challenges faced, and barriers to practicing GU or GYN oncology.</div></div><div><h3>Results</h3><div>A total of 13/42 (30.2%) GU survey recipients responded as treating GU oncology and 31/77 (40.3%) GYN survey recipients responded as treating GYN oncology. Of these respondents, 9 GU and 3 GYN physicians reported facing challenges as an academic RO faculty member because of their gender identity, and 5 GU and 4 GYN physicians reported that their subspecialty specifically presented challenges. Neither group commonly reported difficulties developing trust and rapport with patients. In the GU academic RO group, reports of challenging relationships with other professional colleagues were common. Difficulties finding or serving as a mentor were also common in both groups.</div></div><div><h3>Conclusions</h3><div>Female GU AROs and male GYN AROs may face unique challenges. Identifying and understanding these challenges directly from practicing physicians are important steps in improving professional success, career satisfaction, and clinical care quality.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 9","pages":"Article 101848"},"PeriodicalIF":2.2,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702693","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":"Preservation of Graft Kidney with De Novo Pelvic Urothelial Carcinoma Via Stereotactic Body Radiation Therapy: A Case Report","authors":"Koyo Kikuchi MD, PhD ,&nbsp;Yoshiro Ieko PhD ,&nbsp;Ei Shiomi MD, PhD ,&nbsp;Ayato Ito MD, PhD ,&nbsp;Ryuji Nakamura MD, PhD ,&nbsp;Hisanori Ariga MD, PhD","doi":"10.1016/j.adro.2025.101846","DOIUrl":"10.1016/j.adro.2025.101846","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 9","pages":"Article 101846"},"PeriodicalIF":2.2,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702694","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":"Treatment Outcomes and Prognostic Factors for Patients With Medulloblastoma Having Defined Molecular Subtypes","authors":"Xuejiao Shi MD ,&nbsp;Shuang Liu MS ,&nbsp;Xiaoyang Sun MD ,&nbsp;Yiyuan Li BE ,&nbsp;Mawei Jiang MD","doi":"10.1016/j.adro.2025.101796","DOIUrl":"10.1016/j.adro.2025.101796","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to evaluate treatment outcomes and prognostic factors in pediatric patients with medulloblastoma (MB) with defined molecular subtypes to inform subsequent individualized treatment.</div></div><div><h3>Methods and Materials</h3><div>A retrospective analysis was conducted on 145 patients with MB with defined molecular subtypes who underwent radiation therapy (RT) at our institution from January 2017 to 2021. Patients were subjected to traditional clinical risk stratification, molecular risk stratification, and National Comprehensive Cancer Network (NCCN) risk stratification, respectively. The treatment outcomes and associated prognostic factors were analyzed.</div></div><div><h3>Results</h3><div>With a median follow‑up of 49 months, the 5-year event-free survival (EFS) and overall survival rates were 68.6% ± 4.0% and 74.7% ± 4.4%, respectively. Multivariate analysis revealed that failure to achieve a complete response after RT (5-year EFS 39.3% ± 9.2% vs 75.7% ± 4.2%; <em>P</em> = .007), the administration of fewer than 6 cycles of chemotherapy (5-year EFS 25.0% ± 11.6% vs 73.9% ± 4.0%; <em>P</em> &lt; .001), and categorization as a member of the NCCN high-risk group (5-year EFS 48.0% ± 6.5% vs 84.5% ± 4.2%; <em>P</em> = .040) were associated with a worse prognosis. Twenty (27.4%) clinical standard-risk patients were reclassified as low risk or high/very high risk according to the NCCN risk stratification with 5-year EFS rates of 100.0% ± 0.0% and 58.3% ± 16.1%, respectively. Further subgroup analysis (<em>N</em> = 103) revealed that patients with 1q gain (5-year EFS 32.7% ± 16.1% vs 67.0% ± 5.2%; <em>P</em> = .035), 10q loss (5-year EFS 25.0% ± 21.7% vs 69.6% ± 4.6%; <em>P</em> = .024), <em>MYCN</em> amplification (5-year EFS 40.0% ± 15.5% vs 70.8% ± 4.1%; <em>P</em> = .010) or <em>TP53</em> mutation (5-year EFS 33.3% ± 13.6% vs 71.9% ± 4.0%; <em>P</em> = .002) had a worse EFS than those with wild type.</div></div><div><h3>Conclusions</h3><div>MB is a heterogeneous disease that requires the integration of clinical and molecular features for defined risk stratification to facilitate individualized treatment. In this study, we found that residual disease after RT, fewer than 6 cycles of chemotherapy, and high-risk NCCN risk stratification were independent adverse prognostic factors for patients with MB.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 9","pages":"Article 101796"},"PeriodicalIF":2.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144829606","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":"Phase 2 Trial of Ultrahypofractionated Image-guided Partial Breast Irradiation Following Lumpectomy with Optional Oncoplastic Reconstruction for Early-stage Breast Cancer","authors":"Vani Gupta BS ,&nbsp;Andrew T. Wong MD ,&nbsp;Rachel Radigan MPH ,&nbsp;Michelle Sahagian DO ,&nbsp;Sophia L. Fu MD, MS ,&nbsp;Austin Barney CMD ,&nbsp;Jeffrey Pettit MS ,&nbsp;Rishi Shah BS ,&nbsp;Shridevi Singh MD ,&nbsp;Jana Deitch MD ,&nbsp;Johnny Kao MD","doi":"10.1016/j.adro.2025.101817","DOIUrl":"10.1016/j.adro.2025.101817","url":null,"abstract":"<div><h3>Purpose</h3><div>As accelerated partial breast irradiation is gaining widespread acceptance for low-risk breast cancers treated with breast conservation, its role following oncoplastic surgery remains controversial.</div></div><div><h3>Methods and Materials</h3><div>We performed a prospective phase 2 trial of women aged 50 and older who were estrogen receptor positive with stage 0 to 1 breast cancer measuring ≤3 cm following successful lumpectomy with optional oncoplastic reconstruction. Patients were treated on the Varian Edge radiosurgery system to a prescribed dose of 30 Gy in 5 fractions, and the primary endpoints were feasibility and safety. Patient-reported cosmesis was assessed using the Breast Cancer Treatment Outcome Scale validated instrument.</div></div><div><h3>Results</h3><div>From 2018 to 2022, 50 patients with 52 tumors with a median age of 76 were enrolled, including 79% invasive breast cancer with 48% undergoing oncoplastic reconstruction. With a median follow-up of 47 months, long-term patient-reported cosmesis was excellent in 89% of patients and good in 11% of patients. All patients were locally controlled, but there were 2 ipsilateral breast events consisting of an intramammary lymph node failure and second primary triple-negative breast cancer outside the radiation field, both successfully salvaged with further local and systemic therapy.</div></div><div><h3>Conclusions</h3><div>In carefully selected patients with low-risk early-stage breast cancer, patients treated with a 5-fraction regimen of partial breast irradiation achieve excellent cosmetic and oncological outcomes. Oncoplastic reconstruction was not a contraindication to partial breast irradiation.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 9","pages":"Article 101817"},"PeriodicalIF":2.7,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144770630","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}