Advances in Radiation Oncology最新文献

{"title":"Setup Accuracy and Efficiency of Real-Time Video Assistance for Surface-Guided Positioning in Radiation Therapy of Right-Sided Locoregional Breast Cancer","authors":"Jørund Graadal Svestad MA ,&nbsp;Stine Gyland Mikalsen PhD ,&nbsp;Mojgan Heydari MA ,&nbsp;Regine Hjort Francke BA ,&nbsp;Maziar Hervani BA ,&nbsp;Taran Paulsen Hellebust PhD","doi":"10.1016/j.adro.2025.101829","DOIUrl":"10.1016/j.adro.2025.101829","url":null,"abstract":"<div><h3>Purpose</h3><div>Real-time video assistance in combination with surface guidance (SG) has been introduced in radiation therapy. In this study, we wanted to investigate the efficiency and accuracy of this new procedure for patients with right-sided locoregional breast cancer with special focus on the arm position.</div></div><div><h3>Methods and Materials</h3><div>Twenty-six patients were included. Each patient was positioned using SG with real-time video assistance for half of the fractions. For the other half of the fractions, patient’s surface was captured (including arm position) and visually compared to the reference surface before adjusting the patient position. This process was repeated until the patient position was acceptable. Pretreatment cone beam computer tomography (CBCT) was acquired at every fraction. Couch shifts after CBCT match were used to calculate systematic and random errors. CBCTs were also used to compare the actual treatment position of the nodal areas to the planned position. To analyze setup efficiency, 6 time points during the whole treatment procedure were recorded and analyzed.</div></div><div><h3>Results</h3><div>Our results showed negligible differences in setup accuracy when comparing couch shifts after CBCT match and the treated position of the nodal area. The group mean of the vertical couch shifts was significantly different between the 2 setup procedures (<em>P</em> = .03). The systematic error and the random error, however, were identical or almost identical. No other metrics regarding setup accuracy were significantly different. Setup efficiency was significantly improved using SG with real-time video assistance. By implementing real-time video assistance, setup time was reduced by an average of 40 seconds</div></div><div><h3>Conclusions</h3><div>By implementing real-time video assistance in the setup of patients with right-sided locoregional breast cancer using SG, setup time can be significantly reduced without compromising setup accuracy.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 9","pages":"Article 101829"},"PeriodicalIF":2.2,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711860","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":"Reporting Clinical Results of EPID-Based Patient-Specific Quality Assurance for Brain Stereotactic Radiosurgery/Radiation Therapy: Demonstrating the Feasibility of Same-Day Stereotactic Radiosurgery via HyperArc Delivery","authors":"Damodar Pokhrel PhD,&nbsp;Josh Misa MS,&nbsp;Shane McCarthy BS,&nbsp;William St. Clair MD, PhD","doi":"10.1016/j.adro.2025.101831","DOIUrl":"10.1016/j.adro.2025.101831","url":null,"abstract":"<div><h3>Purpose</h3><div>Patient-specific quality assurance (PSQA) of complex volumetric modulated arc therapy plans via Electronic portal imaging device (EPID)-based portal dosimetry (PD) is widely adopted by the radiation therapy community. We report our EPID-based PSQA results for brain HyperArc stereotactic radiosurgery/radiation therapy (SRS/SRT) patients, justifying its efficiency for the potential of same-day LINAC-based radiosurgery.</div></div><div><h3>Methods and Materials</h3><div>A total of 130 brain SRS/SRT patients were treated via highly conformal HyperArc delivery for 1, 3, and 5 fractions of 18–24 Gy, 24–27 Gy, and 30–35 Gy to each lesion in either single-isocenter/single-lesion (SISL, 60 plans) or single-isocenter/multilesion (SIML, 70 plans) setting following the Alliance brain SRS/SRT clinical trial criteria. Acuros-based dose engine for 6MV-FFF beam (1400 MU/min) was used. For each HyperArc SRS/SRT plan, EPID-based PD PSQA was performed. Independent dose verification of these brain SRS/SRT plans was done via an in-house Monte Carlo (MC) program. The PSQA results, total quality assurance (QA) time, MC agreement, and MLC modulation (MF) were analyzed.</div></div><div><h3>Results</h3><div>The average gamma passing rates were 99.4% (SISL) and 96.9% (SIML) plans with a 2%/2mm clinical gamma criteria. Compared to SISL plans, SIML plans had a higher average MF by a factor of 1.2, maximum of 1.4. We observed a slight correlation between MF and the number of treated lesions. Although SIML plans had relatively lower PSQA pass rates, all plans met the clinical QA criteria for HyperArc delivery. EPID-based PSQA was completed in ∼15 minutes. Moreover, an independent second physics check via in-house MC dose verification was within ±5% compared to AcurosXB calculation and completed within 15 minutes for both treatment schemes including ARIA documentation.</div></div><div><h3>Conclusions</h3><div>These promising PSQA results for complex clinical HyperArc brain SRS/SRT plans delivered in a timely manner via EPID-based PD and independent MC second check demonstrate EPID-based PD is a fast, safe, and efficient QA method for HyperArc treatments. With proper automation of contouring tool and SRS planning via RapidPlan model, this EPID-based PSQA method can be safely implemented for the same-day HyperArc delivery of high-quality brain SRS/SRT treatments in the near future.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 8","pages":"Article 101831"},"PeriodicalIF":2.2,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144580756","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":"Artificial Intelligence-Assisted Compressed Sensing Technique Accelerates Magnetic Resonance Imaging Simulation for Head and Neck Cancer Radiation Therapy","authors":"Shu-han Zhou MB ,&nbsp;Mao-shen Lin MB ,&nbsp;Yu Luo MB ,&nbsp;Hao-qiang He MB ,&nbsp;Shao-jin Wang MB ,&nbsp;Lin-tao Shang MB ,&nbsp;Tian-you Dong MB ,&nbsp;Wen-jun Fan MD ,&nbsp;Feng Chi MM","doi":"10.1016/j.adro.2025.101819","DOIUrl":"10.1016/j.adro.2025.101819","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the potential of artificial intelligence-assisted compressed sensing (ACS) technique, when compared with that of conventional parallel imaging (PI) technique, in magnetic resonance imaging (MRI) simulation for head and neck cancer radiation therapy.</div></div><div><h3>Methods and Materials</h3><div>Fifty-two patients with pathologically confirmed head and neck cancer underwent MRI simulation using a 3.0-T MRI simulation system. For each patient, axial T1-weighted gradient spin echo, T2-weighted fast spin echo sequence, and postcontrast and postcontrast fat-suppressed T1-weighted gradient spin echo sequence were obtained by ACS and PI. Acquisition time, signal-to-noise ratio, contrast-to-noise ratio, and image quality of both sets of MRI simulation images were compared. Image quality analysis was scored with lesion detection, margin sharpness of lesions, artifacts, and overall image quality using the 5-point Likert scale. Moreover, tumor target volume acquired from fusion images of simulation computed tomography with simulation MRI by ACS and from fusion images by PI were compared. Dice similarity coefficient of gross tumor target between fusion images by ACS and those by PI were also measured.</div></div><div><h3>Results</h3><div>Acquisition time of MRI simulation by ACS was significantly shorter than that by PI, whether for the time of individual sequence or the total acquisition time (<em>P</em> &lt; .05 for all). The mean total acquisition time by PI (694.78 ± 16.85 seconds) was significantly less after using ACS (378.50 ± 10.05 seconds), with a mean reduction ratio 45.52%. Signal-to-noise ratio, contrast-to-noise ratio values and qualitative image scores (lesion detection, margin sharpness, artifacts, and overall image quality) were almost comparable between ACS and PI. Mean tumor target volume of both primary tumors and metastatic lymph nodes acquired from fusion images by ACS were also comparable to those from fusion images by PI (<em>P</em> &gt; .05 for all). Mean Dice similarity coefficient values for primary tumors and metastatic lymph nodes were both close to 1.</div></div><div><h3>Conclusions</h3><div>Compared to PI, ACS can significantly accelerate MRI simulation for head and neck cancer radiation therapy without compromising image quality and degrading the guidance role of tumor target delineation.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 9","pages":"Article 101819"},"PeriodicalIF":2.2,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679652","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":"Excellent Response Following Palliative Radiation for Locally Advanced Epidemic/AIDS-Associated Kaposi Sarcoma of the Lower Extremity: A Case Report","authors":"Anushka S. Mandalapu BS,&nbsp;Alison K. Yoder MD, MPH,&nbsp;Xin Wang PhD,&nbsp;Devarati Mitra MD, PhD,&nbsp;Andrew J. Bishop MD,&nbsp;B. Ashleigh Guadagnolo MD, MPH,&nbsp;Ahsan S. Farooqi MD, PhD","doi":"10.1016/j.adro.2025.101823","DOIUrl":"10.1016/j.adro.2025.101823","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 8","pages":"Article 101823"},"PeriodicalIF":2.2,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549886","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":"Salvage Irradiation for Ocular Adnexal Mucosa Associated Lymphoid Tissue Lymphoma Refractory to Chlamydia psittaci Eradication","authors":"Elena Flospergher MD ,&nbsp;Marianna Sassone MD ,&nbsp;Anna Chiara MD ,&nbsp;Fabrizio Marino MD ,&nbsp;Antonio Giordano Resti MD ,&nbsp;Maurilio Ponzoni MD ,&nbsp;Maria Giulia Cangi MD ,&nbsp;Lucia Bongiovanni MD ,&nbsp;Gilda Magliacane MD ,&nbsp;Giulio Modorati MD ,&nbsp;Elisabetta Miserocchi MD ,&nbsp;Teresa Calimeri MD, PhD ,&nbsp;Piera Angelillo MD ,&nbsp;Federico Erbella MD ,&nbsp;Andrés J.M. Ferreri MD","doi":"10.1016/j.adro.2025.101822","DOIUrl":"10.1016/j.adro.2025.101822","url":null,"abstract":"<div><h3>Purpose</h3><div>Prospective trials show that <em>Chlamydia psittaci (Cp)</em> eradication with doxycycline is followed by lymphoma regression in 2-thirds of patients with ocular adnexal marginal zone lymphoma (OAMZL). Postponing orbit irradiation, a standard treatment for OAMZL, while waiting for the tumor response to antibiotic, could raise concern. Herein, we report the safety and efficacy of salvage radiation therapy in patients with OAMZL relapsed after or refractory to <em>Cp</em> eradication.</div></div><div><h3>Methods and Materials</h3><div>Patients with stage IEA OAMZL diagnosed at our institution between 2005 and 2023 were evaluated for the safety and efficacy of radiation therapy as salvage treatment after doxycycline. Inclusion criteria were as follows: (1) first-line <em>Cp</em>-eradicating therapy with doxycycline; (2) lymphoma relapsed or progressed locally; and (3) orbital irradiation as salvage treatment.</div></div><div><h3>Results</h3><div>A total of 28 patients (median age 66 years; range, 37-92; 16 males) were assessable; all patients but 2 (relapsing after partial response) experienced progressive disease during or after doxycycline (median 9 months; IQR, 4-40). Radiation therapy (30-36 Gy in 15-18 fractions) was well tolerated, with only 3 cases of grade-2 cataract and 3 cases of grade-1 blepharitis; all irradiated patients achieved a lymphoma regression (overall response rate = 100%), with a complete response rate of 89% (95% CI, 80%-97%). At a median follow-up of 60 months (range, 12-166) from radiation therapy, 8 patients experienced relapse, within the irradiated volume only in 2 (7%), with a 4-year progression-free survival of 74% (95% CI, 72%-75%). All patients but one are alive at a median follow-up from initial lymphoma diagnosis of 96 (IQR, 47-128) months; 22 (79%) patients are disease free.</div></div><div><h3>Conclusions</h3><div>The postponing of orbit irradiation until relapse/progression after <em>Cp</em>-eradicating antibiotic therapy is a safe and effective strategy in patients with limited-stage OAMZL. The vast majority of patients with OAMZL can be safely managed without chemotherapeutic agents, and radiation therapy can be delayed until relapse without affecting patients’ survival.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 9","pages":"Article 101822"},"PeriodicalIF":2.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144720773","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":"Using Time-Staged Palliative Conventional Radiation Therapy Followed by Stereotactic Body Radiation Therapy in Malignant Epidural Extension for a Nonsurgical Candidate","authors":"Rohan K. Patel MD, MPH ,&nbsp;Beatriz Guevara MS ,&nbsp;Breanna Peyton MS ,&nbsp;Yiran Zheng PhD ,&nbsp;Jerald Katcher MD ,&nbsp;Allan Hoffer MD ,&nbsp;Angela Y. Jia MD, PhD ,&nbsp;Atallah Baydoun MD, PhD ,&nbsp;Prashant Vempati MD, MS","doi":"10.1016/j.adro.2025.101818","DOIUrl":"10.1016/j.adro.2025.101818","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 9","pages":"Article 101818"},"PeriodicalIF":2.2,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144680558","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":"Electronic Chart Recording for Gamma Knife Stereotactic Radiosurgery","authors":"Sven Ferguson MS ,&nbsp;Gregory Kamal BS ,&nbsp;Nels Knutson PhD ,&nbsp;Timothy Mitchell PhD ,&nbsp;Sreekrishna Murty Goddu PhD ,&nbsp;Eric Filiput BS ,&nbsp;Amanda Schoenberger BS ,&nbsp;Joshua L. Dowling MD ,&nbsp;Jiayi Huang MD ,&nbsp;Yi Huang ScM ,&nbsp;Taeho Kim PhD","doi":"10.1016/j.adro.2025.101777","DOIUrl":"10.1016/j.adro.2025.101777","url":null,"abstract":"<div><h3>Purpose</h3><div>Radiation oncology departments are uniquely susceptible to additional challenges when transitioning from paper to electronic chart recording systems. The Gamma Knife stereotactic radiation therapy system has additional complexities stemming from limited network connectivity to other computer systems used within the department. The goal of this project is to transition from paper charting to completely electronic charting.</div></div><div><h3>Methods</h3><div>To accomplish the digital transformation, our department created a detailed mapping of the paper workflow, converted all documents digitally, implemented a paperless printing solution, and established a digital platform for document processing. Throughout each step, we intended to preserve the integrity of the high-quality treatment workflow in our department by focusing on (1) enhancing the multidisciplinary aspects of the treatment workflow; (2) ensuring protected health information security; and (3) maintaining efficient patient care.</div></div><div><h3>Results</h3><div>Electronic signature software and a digital printer were installed to overcome technical hurdles. All paper documents, such as the written directive, stereotactic radiosurgery-frame measurements, and physics consult, were converted to electronic documents mainly using spreadsheet applications. Based on clinical implementation and practice, all goals were met which enhanced the treatment workflow by allowing less time spent on documentation and more time with the patients.</div></div><div><h3>Conclusions</h3><div>With technical planning and coordination from all team members, we demonstrated that the implementation of electronic chart recording systems can be achieved for Gamma Knife radiosurgery treatments that enhance the treatment workflow, provide flexibility for staff, and allow for greater multidisciplinary communication.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 6","pages":"Article 101777"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263473","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":"Esophageal Circumferential Dose-Length Histogram Parameters to Predict Dysphagia in Patients Receiving Thoracic Radiation Therapy: A Single-Institution Experience","authors":"Andrea Brown MD ,&nbsp;Chen Hu PhD ,&nbsp;Suqi Ke MS ,&nbsp;Peijin Han MS ,&nbsp;Russell Hales MD ,&nbsp;Todd McNutt PhD ,&nbsp;Siyao Li MS ,&nbsp;Claire Snyder PhD ,&nbsp;Shing Lee PhD ,&nbsp;Khinh Ranh Voong MD, MPH","doi":"10.1016/j.adro.2025.101807","DOIUrl":"10.1016/j.adro.2025.101807","url":null,"abstract":"<div><h3>Purpose</h3><div>Chemoradiation for locally advanced non-small cell lung cancer can cause severe esophagitis. Techniques to spare the contralateral esophagus may mitigate toxicity, but traditional dose-volume histograms (DVH) do not capture the degree of circumferential irradiation. We evaluated dose-length histogram (DLH) parameters as predictors of dysphagia compared with DVH metrics.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed patients treated with definitive thoracic radiation therapy from 2019 to 2023. Descriptive statistics described the cohort. Clinician-reported (National Cancer Institute Common Terminology Criteria for Adverse Events [CTCAE] v.4) and patient-reported outcomes (PRO)-CTCAE v.1 dysphagia within 120 days of treatment start were collected prospectively. The McNemar test compared dichotomized scores. The length of esophageal full-circumferential (L_Fdose) and partial-circumferential irradiation (L_Pdose) was defined as the length of the esophagus with ≥90% and ≥50% circumference exposure to threshold radiation doses, respectively. Spearman correlation examined relationships between L_Fdose, L_Pdose, and volumetric (V_dose) parameters. Associations between L_Fdose, L_Pdose, and V_dose, and grade ≥2 dysphagia were evaluated using univariate logistic regression. Likelihood ratio tests assessed model fit.</div></div><div><h3>Results</h3><div>Of 107 patients, 86.9% (93) had non-small cell lung cancer, all received ≥60 Gy (median, 63 Gy; range, 60-70 Gy), and 94.4% (101) received concurrent chemotherapy. Patients and physicians reported rates of grade ≥2 dysphagia differently: 17 (15.9%) and 6 (5.6%), respectively (<em>P</em> = .0015). Each 0.5 cm increase in the length of partial-circumference esophagus receiving ≥55 Gy (L_P55) and 60 Gy (L_P60) resulted in increased odds of PRO-CTCAE dysphagia by 8% and 9%, respectively. Each 0.5 cm increase in full-circumference esophagus receiving ≥60 Gy (L_F60) resulted in 11% increased odds of PRO-CTCAE dysphagia. Esophageal DLH parameters, L_P55 and L_P60, correlated with the esophageal V₆₀ volumetric parameter strongly (ρ = 0.751 and 0.729, respectively). No DVH or DLH parameter predicted grade ≥2 CTCAE dysphagia.</div></div><div><h3>Conclusion</h3><div>Esophageal DLH metrics assessing partial- or full-circumferential esophageal irradiation, specifically L_P55, L_P60, and L_F60, are associated with patient-reported dysphagia and complement traditional DVH parameters.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 8","pages":"Article 101807"},"PeriodicalIF":2.2,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322929","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":"Long-Term Outcomes of Multimodality Accelerated Partial Breast Irradiation for Ductal Carcinoma In Situ","authors":"Silpa Raju-Salicki MD ,&nbsp;Hayley B. Stowe MD, MSCI ,&nbsp;Alden D’Souza MD ,&nbsp;Yi Huang MS ,&nbsp;Mustafaa Mahmood MD ,&nbsp;William R. Kennedy MD ,&nbsp;Randall J. Brenneman MD, PhD ,&nbsp;Julie Margenthaler MD ,&nbsp;Katherine Glover-Collins MD, PhD ,&nbsp;Amy Cyr MD ,&nbsp;Carmen Bergom MD, PhD ,&nbsp;Joanna Yang MD ,&nbsp;Maria A. Thomas MD, PhD ,&nbsp;Jacqueline Zoberi PhD ,&nbsp;Imran Zoberi MD","doi":"10.1016/j.adro.2025.101792","DOIUrl":"10.1016/j.adro.2025.101792","url":null,"abstract":"<div><h3>Purpose</h3><div>To report long-term institutional outcomes for ductal carcinoma in situ treated with accelerated partial breast irradiation (APBI) using multiple modalities as a part of breast-conserving therapy.</div></div><div><h3>Methods and Materials</h3><div>From January 2001 to April 2019, 240 patients with stage 0 breast cancer were treated with breast-conserving surgery (BCS) and adjuvant APBI at our institution. Based on the 2024 American Society for Radiology and Oncology (ASTRO) APBI guidelines, 170 patients were “recommended,” 68 were “conditionally recommended,” and 2 were “not recommended” for APBI. A total of 102 patients were treated with linear accelerator-based external beam radiation therapy, 38 with magnetic resonance image-guided external beam radiation therapy (MRgEBRT), 49 with multicatheter interstitial implant (ISI) brachytherapy, and 51 with intracavitary applicator brachytherapy (strut-adjusted volume implant). Patients treated with external beam radiation therapy received 3850 cGy in 10 fractions twice a day. Patients treated with ISI or strut-adjusted volume implant received 3400 cGy in 10 fractions twice a day. Recurrence and survival were calculated using the Kaplan–Meier method. Cosmesis was scored by the Harvard criteria.</div></div><div><h3>Results</h3><div>At a median follow-up of 11.5 years (range, 1.2-17.8 years), the overall and cause-specific survival rates were 94.8% and 100%, respectively. The 10-year ipsilateral breast tumor recurrence rate was 3.8%. There were 9 observed ipsilateral breast tumor recurrences with 1 concurrent ipsilateral regional lymph node recurrence. No other breast failures, regional recurrences, or distant metastases were noted. Breast cancer–specific survival (BCSS) was 99.6% at the time of analysis. There was no statistically significant difference in overall survival or recurrence rates between the different treatment modalities. Cosmesis was excellent or good in 90% of cases without a statistically significant difference between the treatment method, 2024 American Society for Radiology and Oncology APBI criteria, or the 2022 American Brachytherapy Society (ABS) APBI acceptability categories.</div></div><div><h3>Conclusions</h3><div>APBI as a component of breast-conserving therapy for pure ductal carcinoma in situ is associated with excellent survival rates, local control, and cosmetic outcomes regardless of radiation therapy modality.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 7","pages":"Article 101792"},"PeriodicalIF":2.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Breast Cancer Radiation therapy With Volumetric Modulated Arc Therapy and Skin Flash: A Case Study Using Deep Inspiration Breath Hold and Cherenkov Imaging","authors":"Adi Robinson PhD ,&nbsp;Michael Tallhamer MS ,&nbsp;Amber Orman MD","doi":"10.1016/j.adro.2025.101798","DOIUrl":"10.1016/j.adro.2025.101798","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 7","pages":"Article 101798"},"PeriodicalIF":2.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115132","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}