Advances in Radiation Oncology最新文献

{"title":"Internal Target Volume Estimation for Liver Cancer Radiation Therapy Using an Ultra Quality 4-Dimensional Magnetic Resonance Imaging","authors":"Yen-Peng Liao Ph.D. ,&nbsp;Haonan Xiao Ph.D. ,&nbsp;Peilin Wang M.Sc. ,&nbsp;Tian Li Ph.D. ,&nbsp;Todd A. Aguilera M.D., Ph.D. ,&nbsp;Justin D. Visak Ph.D. ,&nbsp;Andrew R. Godley Ph.D. ,&nbsp;You Zhang Ph.D. ,&nbsp;Jing Cai Ph.D. ,&nbsp;Jie Deng Ph.D.","doi":"10.1016/j.adro.2025.101774","DOIUrl":"10.1016/j.adro.2025.101774","url":null,"abstract":"<div><h3>Purpose</h3><div>Accurate internal target volume (ITV) estimation is essential for effective and safe radiation therapy in liver cancer. This study evaluates the clinical value of an ultraquality 4-dimensional magnetic resonance imaging (UQ 4D-MRI) technique for ITV estimation.</div></div><div><h3>Methods and Materials</h3><div>The UQ 4D-MRI technique maps motion information from a low spatial resolution dynamic volumetric MRI onto a high-resolution 3-dimensional MRI used for radiation treatment planning. It was validated using a motion phantom and data from 13 patients with liver cancer. ITV generated from UQ 4D-MRI (ITV_4D) was compared with those obtained through isotropic expansions (ITV_{2 mm} and ITV_{5 mm}) and those measured using conventional 4D-computed tomography (computed tomography-based ITV, ITV_CT) for each patient.</div></div><div><h3>Results</h3><div>Phantom studies showed a displacement measurement difference of &lt;5% between UQ 4D-MRI and single-slice 2-dimensional cine MRI. In patient studies, the maximum superior-inferior displacements of the tumor on UQ 4D-MRI showed no significant difference compared with single-slice 2-dimensional cine imaging (<em>P</em> = .985). Computed tomography-based ITV showed no significant difference (<em>P</em> = .72) with ITV_4D, whereas ITV_{2 mm} and ITV_{5 mm} significantly overestimated the volume by 29.0% (<em>P</em> = .002) and 120.7% (<em>P</em> &lt; .001) compared with ITV_4D, respectively.</div></div><div><h3>Conclusions</h3><div>UQ 4D-MRI enables accurate motion assessment for liver tumors, facilitating precise ITV delineation for radiation treatment planning. Despite uncertainties from artificial intelligence-based delineation and variations in patients’ respiratory patterns, UQ 4D-MRI excels at capturing tumor motion trajectories, potentially improving treatment planning accuracy and reducing margins in liver cancer radiation therapy.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 6","pages":"Article 101774"},"PeriodicalIF":2.2,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890550","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 Silico Assessment of the Radiation Dose Range for Definitive Stereotactic Body Radiation Therapy of Primary Breast Cancer","authors":"I. Frank Ciernik MD ,&nbsp;Shubeen Singh MMed ,&nbsp;Akash K. Singh MS ,&nbsp;Philipp Goldschmidt MS ,&nbsp;Wilfried Budach MD ,&nbsp;Dirk Vordermark MD ,&nbsp;Jérôme Krayenbuehl PhD","doi":"10.1016/j.adro.2025.101775","DOIUrl":"10.1016/j.adro.2025.101775","url":null,"abstract":"<div><h3>Purpose</h3><div>The maximal dose for partial breast irradiation (PBI) with stereotactic body radiation therapy for definitive local therapy of nonmetastatic breast cancer has not been established. Here we evaluate the maximal achievable coverage of the planning target volume suitable for PBI without violating organs-at-risk constraints.</div></div><div><h3>Methods and Materials</h3><div>Planning computed tomography scans of 22 patients with pulmonary or cardiac risk factors and left-sided disease in prone and supine position (sp) were obtained. Plans for PBI in 5 fractions were generated according to the Guidelines of the American Society for Radiation Oncology. Maximum tolerated dose (MTD) was defined when the dose reached any constraint of a neighboring organ based on recommendations of the American Association for Physics in Medicine.</div></div><div><h3>Results</h3><div>Mean MTD was 45.9 ± 3.9 Gy (range, 38.8-53.9) in sp and 46.1 ±3.2 Gy (range, 37.3-53.9) in prone position (pp), respectively. The MTD was ≥44.3 Gy in sp and ≥44.8 Gy in pp in 95% of patients. Fat tissue was the dose limiting structure in 11 of 22 patients in sp and 15 of 22 in pp. D_max to the fat tissue reached 40.0 Gy (±3.3 Gy) in sp and pp. Skin was the dose limiting structure in 7 of 22 patients in sp and in 6 of 22 in pp. D_max to the skin was 30.5 Gy (±7.4 Gy) in sp and 31.0 Gy (±7.0 Gy) in pp (<em>P</em> = .8). Ribs were dose limiting in 4 of 22 patients in sp and in 1 of 22 in pp. D_max to the ribs was 31.4 Gy (±9.5 Gy) in sp and 21.4 Gy (±11.0 Gy) in pp (<em>P</em> &lt; .01). D_max to the intraventricular artery was 3.4 Gy (±3.1 Gy) in sp and 7.5 Gy (±5.7 Gy) in pp (<em>P</em> &lt; .01).</div></div><div><h3>Conclusions</h3><div>For definitive stereotactic body radiation therapy for early-stage breast cancer, we propose a dose escalation starting with 45 Gy in 5 fractions to be tested in a clinical trial. Prone position is advised for tumors close to the thoracic cage.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 6","pages":"Article 101775"},"PeriodicalIF":2.2,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941622","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":"Association of Circulating Inflammatory Biomarker Levels and Toxicity in Patients Undergoing Pelvic Radiation for Cancer: A Critical Review","authors":"Per Fessé PhD ,&nbsp;Per-Arne Svensson PhD ,&nbsp;Björn Zackrisson PhD ,&nbsp;Alexander Valdman PhD ,&nbsp;Per Fransson PhD ,&nbsp;Kjell Grankvist PhD ,&nbsp;Ingrid Kristensen PhD ,&nbsp;Ulrica Langegård PhD ,&nbsp;Emma Ohlsson-Nevo PhD ,&nbsp;Katarina Sjövall PhD ,&nbsp;Linda Åkeflo PhD ,&nbsp;Karin Ahlberg PhD","doi":"10.1016/j.adro.2025.101766","DOIUrl":"10.1016/j.adro.2025.101766","url":null,"abstract":"<div><h3>Purpose</h3><div>Radiation therapy (RT) causes tissue damage and inflammation. Because cytokines play a key role in such processes, their expression levels can be an indicator of cell and tissue toxicity. This critical review aims to explore whether levels of circulating inflammatory biomarkers in peripheral blood are associated with proton- or photon-based therapy in the pelvic area and how these levels vary over time. Further, we investigated whether these levels can be linked to radiation dose, the incidence of toxicity, and changes in toxicity over time.</div></div><div><h3>Methods and Materials</h3><div>A literature search was conducted in PubMed to find studies involving comparative cohorts of pelvic irradiated patients with cancer. Studies reporting on the association of markers in peripheral blood with inflammatory processes and/or toxicity were included.</div></div><div><h3>Results</h3><div>We found evidence of associations between changes in inflammatory cytokine levels and the total cumulative dose-volume together with RT-induced toxicity in patients with cancer treated with pelvic RT. Common patient-reported outcomes demonstrate an association between radiation toxicity (eg, genitourinary toxicity) and circulating inflammatory biomarker levels.</div></div><div><h3>Conclusions</h3><div>This review highlights that the total cumulative dose and irradiated tissue volume are the primary drivers of RT-induced biomarker expression, influencing both early and late toxicity outcomes. The diversity in RT techniques, total dose, and number of treatment sessions across studies likely contributes to the variation in observed results. Circulating cytokine and biomarker levels in the blood can provide valuable monitoring and predictive insights for patients undergoing proton- or photon-based RT of the pelvis. Biomarker analysis in the context of RT offers clinical value by enabling personalized treatment by helping predict which patients are at higher risk for certain toxicities, guiding clinicians in tailoring treatment, optimizing supportive care, and adjusting RT plans. This approach could improve patient outcomes and quality of life by reducing long-term complications from radiation exposure.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 6","pages":"Article 101766"},"PeriodicalIF":2.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143854518","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":"Re-irradiation With Carbon Ion Beams for Recurrent Adenoid Cystic Carcinoma of the Tongue Base: A Case Report","authors":"Eisuke Horigome MD, PhD ,&nbsp;Atsushi Musha DDS, PhD ,&nbsp;Nobuteru Kubo MD, PhD ,&nbsp;Naoko Okano MD, PhD ,&nbsp;Hidemasa Kawamura MD, PhD ,&nbsp;Tatsuya Ohno MD, PhD","doi":"10.1016/j.adro.2025.101761","DOIUrl":"10.1016/j.adro.2025.101761","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 5","pages":"Article 101761"},"PeriodicalIF":2.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143799444","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":"Targeting Active Microglia Alleviates Distal Edge of Proton Radiation-induced Neural Damage","authors":"Keman Liao PhD ,&nbsp;Dan Ou PhD ,&nbsp;Mei Chen PhD ,&nbsp;Fei Xu MD ,&nbsp;Jianyi Zhao BS ,&nbsp;Li Zhou BS ,&nbsp;Ran Wu PhD ,&nbsp;Yingying Lin PhD ,&nbsp;Yibin Zhang BS ,&nbsp;Lu Cao PhD ,&nbsp;Jiayi Chen PhD","doi":"10.1016/j.adro.2025.101764","DOIUrl":"10.1016/j.adro.2025.101764","url":null,"abstract":"<div><h3>Purpose</h3><div>Proton therapy (PT) has distinct advantages in its ability to precisely target tumors while avoiding adjacent normal tissues. However, the distal edge effects of PT constrain its application. This study investigated the brain tissue response in the distal edge regions of protons and compared it with the effect of photons.</div></div><div><h3>Methods and Materials</h3><div>The occurrence of damage from photons and at the distal edge of protons was investigated in a murine model. Bragg peak treatment plans for murine models were optimized. Hematoxylin and eosin and immunofluorescence staining were performed along the distal margin. In addition, the approximate distance from the Bragg peak to the neuronal damage sites was calculated. Furthermore, a small-molecule inhibitor was studied for its ability to inhibit microglia activation.</div></div><div><h3>Results</h3><div>The distal edge brain injury murine model was successfully established. Reactive gliosis and granulovacuolar neuronal degeneration were observed in the right hemisphere of the brain in the proton irradiation group. Neuronal injuries were observed at multiple locations (the frontal lobe, thalamus, and cerebral cortex) along the distal border, but no injured neurons were detected along vertical photon irradiation exposed areas. Meanwhile, severe neural damage was seen with horizontal photon irradiation. At the distal edge of the Bragg peak (0.4633 ± 0.01856 cm), microglia with abnormal morphology accumulated. IBA1 and CD68 staining revealed activated microglia at the corresponding neuronal damage sites, indicating their involvement in irradiation-induced damage. Activated microglia were not observed with vertical photon irradiation, whereas many activated microglia were observed with horizontal photon irradiation. Moreover, asparagine endopeptidase inhibitors administered via intraperitoneal injection significantly reduced active microglia in the thalamus and cerebral cortex and alleviated brain damage.</div></div><div><h3>Conclusions</h3><div>This study demonstrated that proton radiation induces neuronal damage and accumulation of activated microglia at the distal edge. Targeting activated microglia may play a protective role in distal edge injury from radiation.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 5","pages":"Article 101764"},"PeriodicalIF":2.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816866","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 Use of Breast Cup Immobilization in Radiation Therapy and Patient-Reported Outcomes on Cosmesis and Pain","authors":"Daniel Chapman M.D., M.P.H ,&nbsp;Andrea Matsumoto D.N.P. ,&nbsp;Kate Aldridge ,&nbsp;Maggie Yin M.S. ,&nbsp;Kent Griffith M.S. ,&nbsp;Melissa Mietzel M.S. ,&nbsp;Eleanor M. Walker M.D.","doi":"10.1016/j.adro.2025.101759","DOIUrl":"10.1016/j.adro.2025.101759","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;Breast cosmesis and breast pain are among the most reported outcomes in patients undergoing adjuvant breast irradiation. The degree to which such adverse reactions occur can be variable based on different patient-specific characteristics. It has been found that women with a larger body habitus, and larger breasts, tend to have an increased chance of experiencing worse toxicity from treatment. As such, attempts to improve cosmetic and pain outcomes have been a highly explored topic. One such technique, that is studied here, is to explore whether the use of a breast cup during treatment leads to worse breast pain and cosmetic outcomes when compared with those treated without a breast cup. This proves to be an important topic because it is believed that the use of a breast cup would provide a significant dosimetric advantage (ie, breast coverage and organ at risk dosing) during treatment. We now explore this treatment option through the scope of a retrospective analysis of patient-reported outcomes experienced during and after completing postoperative radiation therapy to the breast.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods and Materials&lt;/h3&gt;&lt;div&gt;A total of 645 patients undergoing adjuvant breast irradiation were evaluated from 2011 to 2019. Of the 645 patients, 79 were treated using a breast cup. The mean heart dose was analyzed and compared between the 2 treatment groups. Additionally, patient-reported outcomes among the entire cohort were collected via survey documentation forms during treatment, at 1 month after the completion of treatment, and at 1 year after the completion of treatment. These results were collected using the Michigan Radiation Oncology Quality Consortium database because each patient was consented to enroll in the Michigan Radiation Oncology Quality Consortium prior to starting treatment. The outcomes of skin changes, lymphedema, and breast pain among the 2 treatment groups were then compared for statistically significant differences via a logistic regression analysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of the 79 patients treated with a breast cup, grade 2 pruritus of the treated breast along with grade 1 alteration in skin texture was reported in 49.4%, 35.4%, and 22.8% while on treatment, at 1 month after the completion of treatment, and at 1 year after treatment, respectively; &lt;em&gt;P&lt;/em&gt;-values were nonsignificant at all timepoints when data compared with non-cup-treated patients. With regard to lymphedema, 59.5%, 40.5%, and 10.1% of breast cup patients at the prespecified timepoints reported this sequela; all &lt;em&gt;P&lt;/em&gt;-values were nonsignificant except for the 1-month mark (&lt;em&gt;P&lt;/em&gt;-value .03). Lastly, breast pain was noted in 36.7%, 15.2%, and 11.4% of breast cup-treated patients while on treatment, at 1 month after the completion of treatment, and at 1 year after treatment, respectively; again, &lt;em&gt;P&lt;/em&gt;-values for data analysis at each timepoint were nonsignificant. Other than the patient-reported out","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 5","pages":"Article 101759"},"PeriodicalIF":2.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143825706","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":"Target Contour Consistency During Magnetic Resonance-Guided Online Adaptive Stereotactic Body Radiation Therapy","authors":"Suzanne Kirby BS ,&nbsp;Kiana Rahimi BS ,&nbsp;William Song PhD,&nbsp;Elisabeth Weiss MD","doi":"10.1016/j.adro.2025.101765","DOIUrl":"10.1016/j.adro.2025.101765","url":null,"abstract":"<div><h3>Purpose</h3><div>Adaptive magnetic resonance-guided stereotactic body radiation therapy (MRgSBRT) requires expeditious recontouring of target volumes based on daily anatomy. Contouring of the gross tumor volume (GTV) is frequently performed by covering radiation oncologists who may be less familiar with the case than the primary physician (PP). The objective of this study is to determine consistency in GTV contouring between PP and covering physician (CP) and to analyze the effect of resources to support accurate GTV delineation.</div></div><div><h3>Methods and Materials</h3><div>Between 2021 and 2023, 59 patients underwent 302 fractions of MRgSBRT at our institution. GTVs were analyzed for the effect of 3 different types of contouring support resources: (a) number of slices of the original GTV, (b) external software displaying original GTV contours, and (c) alerting if GTVs differed &gt; 10% from the original. Differences between physicians and contouring support resources were analyzed for different tumor sites and fractions using 2-tailed <em>t</em> test and analysis of variance.</div></div><div><h3>Results</h3><div>One hundred nineteen out of 302 (39.4%) MRgSBRT treatments were supervised by a CP. The difference in the mean absolute percent volume change of GTV compared with original GTV for PPs (11.1%) versus CPs (4.6%) across all treatment fractions was statistically significant (<em>P</em> = .00006). Significant differences were observed for pancreas (12.8% vs 5.0%, <em>P</em> = .03), liver (13.0% vs 4.0%, <em>P</em> = .007), and lymph nodes (12.4% vs 2.1%, <em>P</em> = .004) with larger volume differences for PPs. No significant differences were observed for tumors of the prostate (3.7% vs 3.6%) and adrenal glands (9.7% vs 12.2%). No significant GTV differences between the 3 contouring support techniques were observed.</div></div><div><h3>Conclusions</h3><div>Our results show larger GTV changes by PPs for most tumor sites with little impact from contouring support resources. Observed differences might be related to higher contouring confidence of PPs who are more familiar with the case. Further investigation into enhancing contouring support methods is warranted.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 5","pages":"Article 101765"},"PeriodicalIF":2.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777152","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":"HyperSHArc: Single-Isocenter Stereotactic Radiosurgery of Multiple Brain Metastases Using Proton, Helium, and Carbon Ion Arc Therapy","authors":"Lennart Volz PhD ,&nbsp;Peilin Liu MSc ,&nbsp;Thomas Tessonnier PhD ,&nbsp;Xiaoda Cong MSc ,&nbsp;Marco Durante PhD ,&nbsp;Andrea Mairani PhD ,&nbsp;Wenbo Gu PhD ,&nbsp;Amir Abdollahi MD, PhD ,&nbsp;Xuanfeng Ding PhD ,&nbsp;Christian Graeff PhD ,&nbsp;Taoran Li PhD ,&nbsp;Stewart Mein PhD","doi":"10.1016/j.adro.2025.101763","DOIUrl":"10.1016/j.adro.2025.101763","url":null,"abstract":"<div><h3>Purpose</h3><div>This work presents a proof-of-concept study of HyperSHArc, spot-scanning hadron arc (SHArc) therapy for single-isocenter stereotactic radiosurgery of multiple brain metastases (MBMs). HyperSHArc plans using proton, helium, and carbon ions were compared with state-of-the-art volumetric modulated photon arc therapy.</div></div><div><h3>Methods and Materials</h3><div>Treatment design and optimization procedures were devised using commercial and in-house treatment planning systems. Planning and delivery methods considered dedicated energy, spot, and multiarc selection strategies. Proton, helium, and carbon HyperSHArc plans were generated for patients with MBM exhibiting 3 to 11 intracranial lesions with gross tumor volumes (GTVs) between 0.03 and 19.8 cc, at prescribed doses between 19 and 21Gy in a single-fraction. Planning target volumes (PTVs) considered a 1-mm isotropic margin around the GTV, and robust optimization with 2.5%/1 mm criteria for range and position uncertainty was applied. Photon hyper-arc volumetric modulated arc therapy (HA-VMAT) plans were optimized for the PTVs using the HyperArc® single-isocenter stereotactic radiosurgery platform (Varian, Palo Alto, CA, USA).</div></div><div><h3>Results</h3><div>HyperSHArc plans were comparable between particle species, achieving highly conformal target doses and satisfying clinical coverage criteria. Particle arc plans reduced V_2Gy and V_4Gy in the healthy brain compared with HA-VMAT, while intermediate doses (V_8Gy-V_16Gy) were similar or reduced depending on the number of lesions. Particularly for the case with 11 targets, a considerable reduction in V_12Gy was observed that could be relevant for reducing the risk of treatment-induced radionecrosis. HyperSHArc using carbon ions boosted dose-averaged linear energy transfer inside the target relevant to overcoming radioresistance factors (&gt;100 keV/μm).</div></div><div><h3>Conclusions</h3><div>We present the first particle arc therapy strategies for MBM. Results demonstrate that with HyperSHArc, dose conformity comparable or superior to HA-VMAT is achievable while reducing the low-dose bath and increasing mean dose-averaged linear energy transfer in the GTV. Our findings suggest that HyperSHArc using light and heavy ions could be an effective and efficient means of treating MBM. Further development of HyperSHArc optimization and delivery is justified.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 5","pages":"Article 101763"},"PeriodicalIF":2.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820759","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":"Comparison of Energy Consumption Between Single Energy O-Gantry and Dual Energy C-Arm Linear Accelerator","authors":"Vibhor Gupta MBBS, MBA ,&nbsp;Suresh Chaudhary MSc ,&nbsp;Olajide Fadare PhD ,&nbsp;Shilpa Senapati MSc ,&nbsp;Sushil Beriwal MD, MBA","doi":"10.1016/j.adro.2025.101762","DOIUrl":"10.1016/j.adro.2025.101762","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 5","pages":"Article 101762"},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816867","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":"Longitudinal Analyses and Predictive Factors of Radiation-Induced Lymphopenia After Postmastectomy Hypofractionated Radiation Therapy for Breast Cancer: A Pooled Cohort Study of 2 Prospective Trials","authors":"Xu-Ran Zhao MD ,&nbsp;Hui Fang MD ,&nbsp;Hao Jing MD ,&nbsp;Qiu-Zi Zhong MD ,&nbsp;Hong-Fen Wu MD ,&nbsp;Xiao-Rong Hou MD ,&nbsp;Li-Hua Dong MD ,&nbsp;Ya-Hua Zhong MD ,&nbsp;Jing Jin MD ,&nbsp;Li-Na Zhao MD ,&nbsp;Xiao-Hong Wang MD ,&nbsp;Wei-Fang Yang MD ,&nbsp;Jian Tie MD ,&nbsp;Yu-Fei Lu MD ,&nbsp;Guang-Yi Sun MD ,&nbsp;Dan-Qiong Wang MD ,&nbsp;Yu Tang MD ,&nbsp;Shu-Nan Qi MD ,&nbsp;Yong-Wen Song MD ,&nbsp;Yue-Ping Liu MD ,&nbsp;Shu-Lian Wang MD","doi":"10.1016/j.adro.2025.101750","DOIUrl":"10.1016/j.adro.2025.101750","url":null,"abstract":"<div><h3>Purpose</h3><div>Radiation-induced lymphopenia (RIL) correlates with poor prognoses in solid tumors. This study aimed to investigate the post–radiation therapy (RT) longitudinal lymphocyte changes and the impact of different RT techniques on RIL in breast cancer patients.</div></div><div><h3>Methods and Materials</h3><div>We prospectively assessed 607 breast cancer patients who received hypofractionated postmastectomy RT in 8 hospitals. Radiation therapy techniques included integrated photon-based intensity modulated technique (integrated RT) and a combination of photon irradiation of supraclavicular nodes and electron irradiation of the chest wall and/or the internal mammary node (hybrid RT). Peripheral lymphocyte counts (PLC) were determined before RT, weekly during RT, at 1 and 2 weeks, 3 and 6 months post–RT, and then every 6 months. The primary outcome was the nadir PLC during RT, for which associated factors were analyzed. Univariate, multivariable linear regression and propensity score matching analyses were performed to evaluate the effect of different RT techniques on nadir PLC.</div></div><div><h3>Results</h3><div>During RT, 121 (19.9%) patients had grade ≥3 RIL with a nadir PLC of 0.75 ± 0.33 × 10⁹/L. The PLC started to recover at 1 week and reached pre–RT levels 1 year after RT and higher than pre–RT levels 2 years later. Multivariate analysis identified young age, low body mass index, radiation therapy targets involving multiple regions, integrated RT, and low pre–radiation therapy PLC as independent risk factors for nadir PLC (<em>P</em> &lt; .005). The PLC at each time point during and after radiation therapy was lower in patients receiving integrated RT than in those receiving hybrid RT (<em>P</em> &lt; .05). Before and after propensity score matching, integrated RT was significantly associated with lower nadir PLC after adjusting for radiation therapy targets and age (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Breast cancer patients had prolonged lymphopenia post–RT. Integrated RT increased the risk of RIL and adversely affected recovery. Therefore, an appropriate RT technique should be considered to minimize RIL.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 5","pages":"Article 101750"},"PeriodicalIF":2.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768703","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}