Advances in Radiation Oncology最新文献

{"title":"Taming the Lion: A Report of Pencil Beam Scanning Proton Therapy for Severe Leonine Facies","authors":"Scott C. Lester MD , Emma F. Johnson MD , William G. Breen MD , Arushi Khurana MBBS","doi":"10.1016/j.adro.2024.101559","DOIUrl":"10.1016/j.adro.2024.101559","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"9 9","pages":"Article 101559"},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2452109424001222/pdfft?md5=c48b749ffdbd104509e36d03732e9738&pid=1-s2.0-S2452109424001222-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239286","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":"Positron Emission Tomography and Magnetic Resonance Imaging Findings in the Diagnosis of Stroke-Like Migraine Attacks after Radiation Therapy Syndrome: A Case Report","authors":"Steven D. Pan MD , Joseph R. Osborne MD, PhD , Gloria C. Chiang MD , Rohan Ramakrishna MD , Apostolos J. Tsiouris MD , Howard A. Fine MD , Jana Ivanidze MD, PhD","doi":"10.1016/j.adro.2024.101567","DOIUrl":"10.1016/j.adro.2024.101567","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"9 9","pages":"Article 101567"},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2452109424001301/pdfft?md5=03ff47fddf290720d3cdda47ae1a384c&pid=1-s2.0-S2452109424001301-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141689929","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":"Delayed Radiation Recall in Patients Receiving Cabozantinib: A Case Report and Review of the Literature","authors":"Mihailo Miljanic MD , Dragan Vujovic BS , Tidie Song BS , Chase Adams BS , Aleksandra Tucakovic , Avishek Goswami MBBS , Kiran Kumar MD, MBA","doi":"10.1016/j.adro.2024.101576","DOIUrl":"10.1016/j.adro.2024.101576","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"9 9","pages":"Article 101576"},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2452109424001398/pdfft?md5=c79f4bc9af7810f92a4730fcca843d07&pid=1-s2.0-S2452109424001398-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141853601","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":"Time-Related Outcome Following Palliative Spatially Fractionated Stereotactic Radiation Therapy (Lattice) of Large Tumors – A Case Series","authors":"Gabriela Studer MD,&nbsp;David Jeller,&nbsp;Tino Streller PhD,&nbsp;Dirk Huebner,&nbsp;Christoph Glanzmann MD","doi":"10.1016/j.adro.2024.101566","DOIUrl":"10.1016/j.adro.2024.101566","url":null,"abstract":"<div><h3>Purpose</h3><p>Lattice radiation therapy (LRT), a form of spatially fractionated radiation therapy, holds promise for treating large tumors. Despite its introduction in clinical practice around 2010, there remains limited information on its time-related outcomes despite consistently high response rates and tolerability. We assessed the time-related outcome of our palliative LRT cohort.</p></div><div><h3>Methods and Materials</h3><p>We conducted an analysis of our LRT program, which involved 45 palliative patients with 56 lesions larger than 7 cm, treated between January 2022 and November 2023. Prospectively defined treatment protocols included delivering 20 to 25 Gy/5 fractions to the tumor with a stereotactic simultaneously integrated boost (SIB) of 60 to 65 Gy to lattice vertices (n = 45/56) or, mainly in preirradiated lesions, single fraction stereotaxy with 1 × 15 to 20 Gy to vertices only (n = 11/56). Follow-up (FU) intervals were determined based on clinical considerations, considering the mostly highly palliative situation of included patients. Outcome assessments focused on subjective benefit and objective radiologic FU response.</p></div><div><h3>Results</h3><p>The mean/median FU was 5.5/4.0 months (0.3-21 months). A total of 25/45 (56%) patients died after a mean/median of 3.9/2.0 months (0.3-14 months). Fourteen of 56 lesions (25%) were previously irradiated, with a mean/median of 18/13 months (4-72 months) prior to LRT. The mean/median gross tumor volume (GTV) measured 797/415 cc (54-4027 cc) and 14/13 cm (7-28 cm). Subjective statements at LRT completion were available from 37 symptomatic patients: 32/37 (87%) reported fast symptom relief, and 5/37 felt no change under LRT or at LRT completion. Early tolerance was excellent (G0-1). FU imaging was available from 40/56 lesions (71%): progression in 3/40 at first exam one at 1.5 and 4 months post-LRT, and stable disease (±10%) in 5/40 assessed at 2, 3, 3, and 4 months post-LRT. First measure shrinkage of 48%/30% (10%-100%) was found in 32/40 lesions (80%) after a mean/median of 2.8/3 months (0.3-7 months). Maximum shrinkage over time based on 21 cases with at least 1 FU imaging measured a mean/median of 62%/60% after 6.2/5.5 months. The duration of radiologic response was a mean/median of 7.4/7.0 months (1-21 months).</p></div><div><h3>Conclusions</h3><p>Short-course LRT emerged as an effective and well-tolerated palliative option for very large lesions, whether treatment-naïve or previously irradiated. Nearly 90% of symptomatic patients reported significant subjective benefit, and 80% of assessed lesions demonstrated tumor shrinkage ≥10%, with a mean response duration of &gt;6 months.</p></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"9 9","pages":"Article 101566"},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2452109424001295/pdfft?md5=b573b2ed77b74b99693c0d7fa8815038&pid=1-s2.0-S2452109424001295-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141705705","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":"Two-Stage Stereotactic Body Radiation Therapy for Bulky Extracerebral Metastases: Is It an Opportunity? A Case Report","authors":"María Rodríguez Plá MD,&nbsp;Eduardo Ferrer Albiach PhD","doi":"10.1016/j.adro.2024.101618","DOIUrl":"10.1016/j.adro.2024.101618","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"9 11","pages":"Article 101618"},"PeriodicalIF":2.2,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142327733","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":"Assessing Radiology and Radiation Therapy Needs for Cancer Care in Low-and-Middle-Income Countries: Insight From a Global Survey of Departmental and Institutional Leaders","authors":"Stephanie A. Parker MS ,&nbsp;Joseph Weygand PhD ,&nbsp;Beata Gontova Bernat MS ,&nbsp;Amanda M. Jackson MS ,&nbsp;Osama Mawlawi PhD ,&nbsp;Izabella Barreto PhD ,&nbsp;Yao Hao PhD ,&nbsp;Rao Khan PhD ,&nbsp;Afua A. Yorke PhD ,&nbsp;William Swanson PhD ,&nbsp;Mohammed Saiful Huq PhD ,&nbsp;Eugene Lief PhD ,&nbsp;Cesar Della Biancia PhD ,&nbsp;Christopher F. Njeh PhD ,&nbsp;Ahmad Al-Basheer PhD ,&nbsp;Oi Wai Chau PhD ,&nbsp;Stephen Avery PhD ,&nbsp;Wilfred Ngwa PhD ,&nbsp;Peter A. Sandwall PhD","doi":"10.1016/j.adro.2024.101615","DOIUrl":"10.1016/j.adro.2024.101615","url":null,"abstract":"<div><h3>Purpose</h3><div>The global cancer burden and mortality rates are increasing, with significant disparities in access to care in low- and middle-income countries (LMICs). This study aimed to identify radiology and radiation therapy needs in LMICs from the perspective of departmental and institutional leaders.</div></div><div><h3>Methods and Materials</h3><div>A survey was developed and conducted by the American Association of Physicists in Medicine Global Needs Assessment Committee and the American Association of Physicists in Medicine International Council. The survey, organized into 5 sections (Introduction, Infrastructure Needs, Education Needs, Research Needs, and General Information), was open to respondents from March 1, to August 16, 2022.</div></div><div><h3>Results</h3><div>A total of 175 responses were received from 6 global regions: Africa (31.4%), the Americas (17.7%), the Eastern Mediterranean (14.3%), Europe (9.1%), Southeast Asia (23.4%), and the Western Pacific (4.0%). The greatest reported need was for new or updated equipment, particularly positron emission tomography/computed tomography imaging technology. There was also a high demand for clinical and equipment training. Approximately 25% of institutions reported a lack of radiology-based cancer screening programs because of high health care costs and a shortage of specialized equipment. Many institutions that expressed interest in research face funding and grant challenges.</div></div><div><h3>Conclusions</h3><div>The findings highlight critical areas where organizations can support LMICs in enhancing radiology and radiation therapy services to mitigate the growing cancer burden.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"9 11","pages":"Article 101615"},"PeriodicalIF":2.2,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427440","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":"Magnetic Resonance Imaging Guided Radiation Therapy for Splenomegaly: Clinical Experiences and Technical Tips","authors":"Angela Romano MD ,&nbsp;Lorenzo Placidi PhD ,&nbsp;Luca Boldrini MD, PhD ,&nbsp;Giuditta Chiloiro MD, PhD ,&nbsp;Nicola Dinapoli MD, PhD ,&nbsp;Matteo Galetto MSc ,&nbsp;Ciro Mazzarella MD ,&nbsp;Guenda Meffe MSc ,&nbsp;Matteo Nardini MSc ,&nbsp;Giulia Panza MD ,&nbsp;Sara Ceglie MD ,&nbsp;Patrizia Chiusolo PhD ,&nbsp;Elena Rossi PhD ,&nbsp;Luca Indovina MSc ,&nbsp;Maria Antonietta Gambacorta PhD","doi":"10.1016/j.adro.2024.101616","DOIUrl":"10.1016/j.adro.2024.101616","url":null,"abstract":"<div><h3>Purpose</h3><div>Splenomegaly is a common manifestation in chronic lymphoid and myeloid malignancies. Although splenectomy is the preferred treatment for symptomatic splenomegaly, it carries significant risks. Radiation therapy (RT) has traditionally been considered a palliative option. This study explores the use of magnetic resonance guided radiation therapy(MRgRT) for splenic irradiation (SI) in patients with myelofibrosis (MFI) and myelodysplastic/myeloproliferative neoplasms (MDS/MPN).</div></div><div><h3>Methods</h3><div>This single-center retrospective analysis includes patients with MFI and MDS/MPN who underwent MRgRT SI between 2018 and 2022. Ten 1 Gy fractions were delivered to the planning target volume (spleen + 3/5mm margin). An adaptive online/offline strategy has been used to reduce the dose to healthy organs. Dosimetric data and clinical outcomes, including pain relief, gastrointestinal symptoms, and hematological values, were assessed.</div></div><div><h3>Results</h3><div>Twelve patients completed SI without interruption, with supportive transfusions as needed for cytopenias. Pain and gastrointestinal symptom relief was observed in most cases. The mean percentage reduction in spleen volume was 53.61%, with an average craniocaudal extension reduction of 77.78%. Twenty-nine (24.2%) of 120 fractions were online adapted, and 14 (11.7%) were replanned offline. Nonhematological toxicities were not reported. At a median follow-up of 12.9 months, 6 patients died, whereas 9 patients underwent hematopoietic cell transplantation, with 6 of them surviving.</div></div><div><h3>Conclusion</h3><div>This study demonstrates MRgRT SI feasibility in MFI and MDS/MPN patients, offering symptom relief and significant spleen volume reduction. Real-time setup verification and adaptive planning allowed for tailored treatment with reduced margins, minimizing healthy tissue exposure. Larger prospective studies with longer follow-ups are needed to further validate its efficacy and safety.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"9 11","pages":"Article 101616"},"PeriodicalIF":2.2,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319930","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":"A Qualitative Exploration of Sacred Moments in Radiation Oncology","authors":"Kirin Saint MD ,&nbsp;Rachel Ehrlinger BA ,&nbsp;Jaime Gilliland MA ,&nbsp;Michael F. Barton MD, MPH ,&nbsp;Amy J. Xu MD, PhD ,&nbsp;Patricia Mae G. Santos MD, MS ,&nbsp;Divya Yerramilli MD, MBE","doi":"10.1016/j.adro.2024.101617","DOIUrl":"10.1016/j.adro.2024.101617","url":null,"abstract":"<div><h3>Purpose</h3><div>While there are many benefits to radiation oncology services, there can be emotional burdens in the care of patients with advanced cancer. Burnout is a prevalent problem in oncology. Existing literature suggests refocusing attention on providers’ sense of purpose to protect against burnout. “Sacred moments” are moments of deep interconnection between people with accompanying spiritual emotions such as awe, joy, and gratitude. These moments naturally occur in health care settings, offering potential benefits to both patient and provider. Little is known about the prevalence and impact of sacred moments among health care workers in a radiation oncology setting.</div></div><div><h3>Methods and Materials</h3><div>We conducted an exploratory qualitative study of 13 semi-structured interviews among physicians, registered nurses, and advanced practice providers of a radiation oncology consult service at a large National Cancer Institute-designated cancer center between March and May 2023. Interviews were recorded, transcribed, and analyzed to identify key themes. Data were systematically coded and analyzed in NVivo software and organized into a codebook organized by domains and themes.</div></div><div><h3>Results</h3><div>Of the 13 health care workers interviewed, 12 interviewees reported experiencing at least one sacred moment during their clinical careers. None of the interviewees were initially familiar with the term; however, all understood the concept once explained. Interview findings were organized into four domains: (1) common elements, (2) impact, (3) barriers, and (4) provider reactions. Common elements included a moment of deep interconnection between provider and patient, often involving end-of-life patients. The impact of these moments was most commonly described as an increased sense of purpose in their role. Lack of time with patients was the most common barrier.</div></div><div><h3>Conclusions</h3><div>Sacred moments are commonly experienced by health care workers in a radiation oncology consult service. They helped to humanize the patient, buffer against provider burnout, and increase a sense of purpose and job satisfaction.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"9 11","pages":"Article 101617"},"PeriodicalIF":2.2,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358900","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 and Dosimetric Comparison Between Non-image Guided Radiation Therapy and Fiducial-Based Image Guided Radiation Therapy With or Without Reduced Margin in Intensity Modulated Radiation Therapy for Prostate Cancer","authors":"Itsuko Serizawa PhD ,&nbsp;Takuyo Kozuka PhD ,&nbsp;Takashi Soyano MD ,&nbsp;Kazuma Sasamura MD ,&nbsp;Tatsuya Kamima Bsc ,&nbsp;Hiroaki Kunogi PhD ,&nbsp;Nozomi Kurihara MPh ,&nbsp;Noboru Numao PhD ,&nbsp;Shinya Yamamoto PhD ,&nbsp;Junji Yonese PhD ,&nbsp;Yasuo Yoshioka PhD","doi":"10.1016/j.adro.2024.101612","DOIUrl":"10.1016/j.adro.2024.101612","url":null,"abstract":"<div><h3>Purpose</h3><p>This study aimed to compare the outcomes and toxicities between patients treated with image guided radiation therapy (IGRT) using fiducial markers and non-IGRT in intensity modulated radiation therapy (IMRT) for prostate cancer.</p></div><div><h3>Methods and Materials</h3><p>In total, 518 patients with intermediate- and high-risk prostate cancer received IMRT with 78 Gy in 39 fractions after neoadjuvant androgen deprivation therapy for at least 3 months. Of these patients, 371 were in the non-IGRT group and 147 in the IGRT group, including the IGRT-A group using the same margins as the non-IGRT group and the IGRT-B group using reduced margins. The median follow-up periods for the non-IGRT, IGRT-A, and IGRT-B groups were 99 months, 88 months, and 63 months, respectively.</p></div><div><h3>Results</h3><p>The 5-year biochemical recurrence-free survival rates in the non-IGRT, IGRT-A, and IGRT-B groups were 88%, 95%, and 98% (non-IGRT vs IGRT-A, <em>P</em> = .396; IGRT-A vs IGRT-B, <em>P</em> = .426), respectively. Those for intermediate- and high-risk patients were 94%, 93%, and 96% (non-IGRT vs IGRT-A, <em>P</em> = .916; IGRT-A vs IGRT-B, <em>P</em> = .646), respectively, and 87%, 96%, and 100% (non-IGRT vs IGRT-A, <em>P</em> = .500; IGRT-A vs IGRT-B, <em>P</em> = .483), respectively. For the non-IGRT and IGRT-A groups, the rates of acute grade ≥ 2 gastrointestinal toxicities and late grade ≥ 2 genitourinary toxicities were 17% and 7% (<em>P</em> = .019), respectively, and 28% and 16% (<em>P</em> = .028), respectively. In the IGRT-A and IGRT-B groups, the rates of acute grade ≥ 2 genitourinary toxicities were 45% and 21% (<em>P</em> = .003), respectively. All V60_Gy = the volume at least received 60Gy and V70_Gy = the volume at least received 70Gy values of the bladder and rectal walls in the IGRT-B group were smaller than those in the IGRT-A group.</p></div><div><h3>Conclusions</h3><p>IGRT with fiducial markers results in lower acute and late toxicities compared with non-IGRT in IMRT for intermediate- and high-risk prostate cancer. Moreover, the toxicities are further decreased by reducing the margins in the treatment planning under IGRT. These processes do not decrease the biochemical recurrence-free survival rates.</p></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"9 10","pages":"Article 101612"},"PeriodicalIF":2.2,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2452109424001751/pdfft?md5=21c1fe3a4833e6fc62e3e79a2ce5fd19&pid=1-s2.0-S2452109424001751-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239673","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":"Hippocampal-Sparing Radiation Therapy in Primary Sinonasal and Cutaneous Tumors of the Head and Neck","authors":"Jacob Hall MD ,&nbsp;Michael Dance MS ,&nbsp;Benjamin Huang MD ,&nbsp;Ethan Steele MD ,&nbsp;Lorie Nguyen ,&nbsp;Michael Repka MD ,&nbsp;Xuguang Chen MD, PhD ,&nbsp;Colette Shen MD, PhD","doi":"10.1016/j.adro.2024.101588","DOIUrl":"10.1016/j.adro.2024.101588","url":null,"abstract":"<div><h3>Purpose</h3><p>Patients with primary sinonasal and cutaneous head and neck (H&amp;N) malignancies often receive meaningful radiation dose to their hippocampi, but this not a classic avoidance structure in radiation planning. We aimed to characterize the feasibility and tradeoffs of hippocampal-sparing radiation therapy (HSRT) for patients with primary sinonasal and cutaneous H&amp;N malignancies.</p></div><div><h3>Methods and Materials</h3><p>We retrospectively selected patients who were treated definitively for primary sinonasal or cutaneous malignancies of the H&amp;N at an academic medical center. All received (chemo)radiation alone or adjuvantly and substantial radiation dose to 1 or both hippocampi. We created new HSRT plans for each patient with intensity modulated radiation therapy using the original target and organ-at-risk (OAR) volumes. Hippocampi were contoured based on Radiation Therapy Oncology Group guidelines and reviewed by a neuroradiologist. Absolute and relative differences in radiation dose to the hippocampi, planning target volumes (PTVs), and OARs were recorded and compared.</p></div><div><h3>Results</h3><p>There were 18 sinonasal and 12 cutaneous H&amp;N primary tumors (30 patients in total). Median prescription dose was 6600 cGy (range, 5000-7440 cGy), and 14 of the 30 patients received 120 cGy/fraction twice daily, 13 of the 30 patients received 200 cGy/fraction once daily, whereas others received 180-275 cGy/fraction once daily. The relative decrease in ipsilateral hippocampal D_max and D100% using HSRT was 44% (median, 2009 cGy from 3586 cGy) and 65% (median 434 cGy from 1257 cGy), respectively. There were no statistically significant or clinically meaningful differences in PTV V100%, PTV D1%, or radiation dose to other OARs between HSRT and non-HSRT plans.</p></div><div><h3>Conclusions</h3><p>HSRT is feasible and results in meaningful dose reduction to the hippocampi without reducing PTV coverage or increasing dose to other OARs. We suggest target hippocampal constraints of D_max &lt; 1600 cGy and D100% &lt; 500 cGy when feasible (without compromising PTV coverage or impacting other critical OARs). The clinical significance of HSRT in patients with primary H&amp;N tumors should be investigated prospectively.</p></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"9 10","pages":"Article 101588"},"PeriodicalIF":2.2,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2452109424001519/pdfft?md5=783f46d0790ba5d5231c8c37a73eaf44&pid=1-s2.0-S2452109424001519-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142050028","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}