Advances in Radiation Oncology最新文献

{"title":"Sequential 90Y Selective Internal Radiation Therapy (SIRT) and Stereotactic Body Radiation Therapy (SBRT) using 90Y PET-based Absorbed Dose Maps: Interim Analysis of a Phase 1 Study","authors":"Daniel F. Polan PhD ,&nbsp;Justin K. Mikell PhD ,&nbsp;Kellen Fitzpatrick MS ,&nbsp;Joseph J. Gemmete MD ,&nbsp;Jared A. Christensen MD ,&nbsp;Hassan Anbari MD ,&nbsp;Molly Roseland MD ,&nbsp;Joseph R. Evans MD, PhD ,&nbsp;Daniel T. Chang MD ,&nbsp;Mamadou Sanogo MD ,&nbsp;Baljendra S. Kapoor MD ,&nbsp;Matthew J. Schipper PhD ,&nbsp;Yue Cao PhD ,&nbsp;Madhava P. Aryal ,&nbsp;Theodore S. Lawrence MD, PhD ,&nbsp;Kyle C. Cuneo MD ,&nbsp;Yuni K. Dewaraja PhD","doi":"10.1016/j.adro.2025.101743","DOIUrl":"10.1016/j.adro.2025.101743","url":null,"abstract":"<div><h3>Purpose</h3><div>Selective internal radiation therapy (SIRT) can result in heterogeneous absorbed dose coverage. To address potential underdosing of lesions with SIRT, we designed a phase 1 clinical trial (NCT04518748) to add stereotactic body radiation therapy (SBRT) 6 weeks after ⁹⁰Y SIRT.</div></div><div><h3>Methods and Materials</h3><div>In this ongoing, single-center prospective trial, patients received standard-of-care ⁹⁰Y SIRT with glass microspheres for the treatment of unresectable primary or secondary liver cancer. Post-SIRT dosimetry was performed using ⁹⁰Y positron emission tomography/computed tomography to calculate mean lesion absorbed doses. Lesions were considered eligible for SBRT treatment if the mean absorbed dose was &lt;290 Gy. In the presence of dose heterogeneity, SBRT gross tumor volumes were optionally limited to subvolumes based on a SIRT dose threshold determined from prior modeling. Interim analysis was prespecified after 10 participants received both SIRT and SBRT and completed 6-month follow-up with the primary endpoint of an increase in Child-Pugh score of ≥2.</div></div><div><h3>Results</h3><div>Of the 24 patients who received SIRT as part of the trial, 15 had lesions that were considered dosimetrically eligible for SBRT based on the criteria of 290 Gy mean absorbed dose from ⁹⁰Y. Of those, 10 patients received SBRT with prescription doses between 30 and 50 Gy. Only 1 patient had a Child-Pugh increase of ≥2 at 6 months following SBRT, and only 1 grade 3 nonlaboratory toxicity was reported after SBRT.</div></div><div><h3>Conclusions</h3><div>Interim analysis found that liver toxicity from ⁹⁰Y SIRT followed by SBRT was below the early stopping threshold, and continuation of the study to complete recruitment of 30 evaluable patients was recommended.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 7","pages":"Article 101743"},"PeriodicalIF":2.2,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124069","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":"Outcomes of Primary Mediastinal B-cell Lymphoma Patients with Partial Metabolic Response: A Multicenter Retrospective Analysis","authors":"Nattinee Wattakiyanon MD ,&nbsp;Mahmood Aminilari PhD ,&nbsp;Xiang Y. Ye MSc ,&nbsp;Ur Metser MD ,&nbsp;Anca Prica MD ,&nbsp;Michael Crump MD ,&nbsp;John Kuruvilla MD ,&nbsp;Vishal Kukreti MD ,&nbsp;Robert Kridel MD ,&nbsp;Abi Vijenthira MD ,&nbsp;Sita Bhella MD ,&nbsp;Matthew Cheung MD ,&nbsp;Thayalasuthan Vivekanandan MD ,&nbsp;Danielle Rodin MD ,&nbsp;May Tsao MD ,&nbsp;David Hodgson MD","doi":"10.1016/j.adro.2025.101744","DOIUrl":"10.1016/j.adro.2025.101744","url":null,"abstract":"<div><h3>Purpose</h3><div>Many patients with primary mediastinal B-cell lymphoma (PMBCL) achieve only a partial metabolic response (PMR) after initial systemic therapy. However, limited data exist on their outcomes. This study aimed to characterize outcomes in patients with PMBCL who achieve PMR and identify factors guiding appropriate treatment for these patients.</div></div><div><h3>Methods and Materials</h3><div>We reviewed patients PMBCL patients treated at 2 independent cancer centers from January 2009 through September 2021. Using the modified Lugano criteria (2014), end-of-chemotherapy positron emission tomography (PET) scan results were evaluated to assess response. Progression-free survival (PFS) and overall survival (OS) rates from the end-of-chemotherapy PET scan date were estimated using the Kaplan-Meier method.</div></div><div><h3>Results</h3><div>A total of 151 patients with PMBCL aged between 15 and 65 years were initiated on systemic therapy and underwent a fluorodeoxyglucose PET scan to evaluate response. Of these, 55 (36%) achieved incomplete metabolic response (IMR) (Deauville score [DS] 4 or 5): 13 (8%) progressed on systemic therapy (a DS score of 5), and 42 (27%) achieved a PMR (a DS score of 4). The 4-year PFS and OS rates for all patients (N = 55) with IMR were 73% and 72%, respectively. PMR management included consolidative radiation therapy (RT) in 36 patients (86%), further chemotherapy in 3 patients (7%), and observation in 3 patients (7%). Four-year PFS and OS among all patients with PMR were 83% and 81%, respectively, and 89% and 87% among those receiving RT. Patients with PMR with maximum standard unit value (SUVmax) &gt; 5 had a lower 4-year PFS (74%) compared with those with SUVmax ≤ 5 (95%), although this difference did not achieve statistical significance (<em>P</em> = .07). None of the 3 patients with PMR under observation relapsed.</div></div><div><h3>Conclusions</h3><div>Patients with PMBCL often have an IMR. PMR (a DS score of 4) managed with subsequent RT is associated with excellent outcomes. SUVmax may identify patients who may require more or less intensive treatment.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 5","pages":"Article 101744"},"PeriodicalIF":2.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816865","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 Survival Following Chemoradiation in Locoregional Recurrent Germline ATM Mutated Pancreatic Ductal Adenocarcinoma","authors":"Rachael A. Safyan MD ,&nbsp;Keven Zhang MD ,&nbsp;Smith Apisarnthanarax MD ,&nbsp;Jonathan G. Sham MD ,&nbsp;Venu G. Pillarisetty MD, PhD ,&nbsp;Sita Kugel PhD ,&nbsp;Marianne Dubard-Gault MD, MS ,&nbsp;Colin C. Pritchard MD, PhD ,&nbsp;Eric Q. Konnick MD, MS ,&nbsp;Dushyant Sahani MD ,&nbsp;E. Gabriela Chiorean MD","doi":"10.1016/j.adro.2025.101742","DOIUrl":"10.1016/j.adro.2025.101742","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 4","pages":"Article 101742"},"PeriodicalIF":2.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143601863","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":"Prospective Study of Patients Treated with Palliative Radiation Therapy While on Immunotherapy","authors":"Georgia Harris MBBS, MPH ,&nbsp;Andrew Bang MD ,&nbsp;Rebecca K.S. Wong MB ChB, MSc ,&nbsp;Jolie Ringash MD ,&nbsp;Andrea Bezjak MD ,&nbsp;Bernard Cummings MB ChB ,&nbsp;Barbara-Ann Millar MB ChB ,&nbsp;Zhihui A. Liu PhD ,&nbsp;Laura A. Dawson MD","doi":"10.1016/j.adro.2025.101741","DOIUrl":"10.1016/j.adro.2025.101741","url":null,"abstract":"<div><h3>Purpose</h3><div>To prospectively document the outcomes of patients treated with palliative radiation therapy (RT) who are receiving immunotherapy.</div></div><div><h3>Methods and Materials</h3><div>Patients with advanced cancer receiving or planning to commence immunotherapy within 28 days who were referred for palliative RT at our center between January 2017 and September 2019 were screened for participation in this prospective observational study. Demographic and treatment data, along with patient-reported outcomes (PROs) using the Edmonton Symptom Assessment Scale for cancer, were collected at baseline, after 1 month, and then every 3 months for up to 1 year or until death. RT dose and fractionation were at the discretion of the treating radiation oncologist. Immunotherapy was given as per the standard of care protocol. The primary outcome was 3-month toxicity. Secondary outcomes included response evaluation criteria in solid tumors version 1.1 (RECIST v1.1) response on computed tomography scan performed 1, 3, and 6 months post-RT. The feasibility of enhancing PRO compliance using caregiver-aided PROs and virtual PRO collection was explored.</div></div><div><h3>Results</h3><div>Thirty-nine patients who received 50 courses of palliative RT (most often for pain) and who also received immunotherapy within 28 days of RT were evaluated for toxicity at 3 months post-RT. The most common primary cancer was non-small cell lung cancer (38%), followed by melanoma (36%). The most common RT dose was 20 Gy in 5 fractions (42%). 87% of patients (34/39) received a programmed cell death protein 1 inhibitor alone. An interval of &lt;14 days between RT and immunotherapy. No grade 3 or higher toxicity was attributable to combined treatment. The median survival for the cohort was 11 months. At 3 months, 26 patients had imaging available for RECIST v1.1; 14 of 26 (54%) had an in-field response, and 3 of 26 (12%) had stable disease (with mixed out-of-field response). Compliance with PROs was 79% (31/39) at 1 month and 69% (27/39) at 3 months. Ten of the 31 patients (32%) and 11 of 31 patients (41%) used caregiver-aided PRO collection.</div></div><div><h3>Conclusions</h3><div>Palliative RT appears safe in patients receiving immunotherapy with no apparent increase in toxicity because of the combination. Responses out of irradiated volumes were no better than expected than with immunotherapy alone. Caregiver-aided PROs improved compliance with PRO data collection and were feasible.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 4","pages":"Article 101741"},"PeriodicalIF":2.2,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680383","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 Dosimetric Benefits of Cone Beam Computed Tomography-Guided Online Adaptive Radiation Treatment Frequencies for Lung Cancer","authors":"Jingwei Duan PhD ,&nbsp;Joseph Harms PhD ,&nbsp;Drexell H. Boggs MD ,&nbsp;Adam J. Kole MD, PhD ,&nbsp;Richard A. Popple PhD ,&nbsp;Dennis N. Stanley PhD ,&nbsp;Michael H. Soike MD ,&nbsp;Natalie N. Viscariello PhD ,&nbsp;Rex Cardan PhD ,&nbsp;Carlos E. Cardenas ,&nbsp;Joel A. Pogue PhD","doi":"10.1016/j.adro.2025.101740","DOIUrl":"10.1016/j.adro.2025.101740","url":null,"abstract":"<div><h3>Purpose</h3><div>Online adaptive radiation therapy (oART) has shown the ability to diminish interfraction variations. However, oART is a time- and labor-intensive process, and the optimal adaptation frequency remains to be determined for lung cancer oART. The purpose of this study was to quantify and assess dosimetric benefits associated with various adaptive frequencies in patients with lung cancer receiving oART.</div></div><div><h3>Methods and Materials</h3><div>This study included 8 patients with lung cancer receiving oART treated on the Ethos platform in 30 or 33 fractions (n = 7 /1). For a total of 243 fractions, daily contours on cone-beam computed tomography (CT) and adaptive/nonadaptive plans on synthetic CT scan were used to simulate 4 different adaptation frequencies: none, single, weekly, and daily adaptation, resulting in 972 unique dose distributions. Dose-volume-histograms of targets and organs-at-risk (OARs) were compared between adaptation frequencies. Besides Dose-volume-histogram analysis, 3 radiation oncologists reviewed and scored 185 total plans, evenly sampling plans from the various adaptive frequencies. A comprehensive plan scorecard was fine-tuned to correlate with physician reviews and subsequently used for interplan comparison.</div></div><div><h3>Results</h3><div>Compared with no adaptation, daily adaptation improved the median clinical target volume V100% by 0.2% (IQR, 0.0-1.0) and the planning target volume D98% by 0.5% (IQR, −2.2 to 3.83). It also reduced the planning target volume D0.03cc by 2.1% (IQR, 0.7-3.2), the lungs-internal target volume V20 Gy by 2.5% (IQR, 1.0-4.5), the heart D_mean by 0.9 Gy (IQR, 0.4-2.6), and the esophagus D_mean by 1.6 Gy (IQR, 0.3-4.3). Single and weekly adaptation presented fewer benefits in OAR sparing and led to target undercoverage compared with daily adaptation. The PlanScoreCard effectively quantified plan quality, showing a positive monotonic correlation to physician scores (R = 0.57-0.87). It revealed that daily adaptation significantly improved total plan quality for 7 out of 8 patients, with improvements exceeding 5% of the plan score compared with no adaptation. In contrast, weekly and single adaptations led to improvements in only 2 and 1 patients, respectively.</div></div><div><h3>Conclusions</h3><div>Online kilovoltage cone-beam CT scan-guided daily adaptation may lead to dosimetric benefits in both target coverage and OAR sparing in patients with lung cancer. Other adaptation frequencies are effective for some patients but tend to lead to target undercoverage compared with daily adaptation.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 4","pages":"Article 101740"},"PeriodicalIF":2.2,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680269","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":"Risk Estimation of Late Rectal Toxicity Using a Convolutional Neural Network-based Dose Prediction in Prostate Cancer Radiation Therapy","authors":"Seiya Takano MD, PhD ,&nbsp;Natsuo Tomita MD, PhD ,&nbsp;Taiki Takaoka MD, PhD ,&nbsp;Machiko Ukai MD ,&nbsp;Akane Matsuura MD ,&nbsp;Masanosuke Oguri MD ,&nbsp;Nozomi Kita MD, PhD ,&nbsp;Akira Torii MD, PhD ,&nbsp;Masanari Niwa MD, PhD ,&nbsp;Dai Okazaki MD, PhD ,&nbsp;Takahiro Yasui MD, PhD ,&nbsp;Akio Hiwatashi MD, PhD","doi":"10.1016/j.adro.2025.101739","DOIUrl":"10.1016/j.adro.2025.101739","url":null,"abstract":"<div><h3>Purpose</h3><div>The present study investigated the feasibility of our automatic plan generation model based on a convolutional neural network (CNN) to estimate the baseline risk of grade ≥2 late rectal bleeding (G2-LRB) in volumetric modulated arc therapy for prostate cancer.</div></div><div><h3>Methods and Materials</h3><div>We built the 2-dimensional U-net model to predict dose distributions using the planning computed tomography and organs at risk masks as inputs. Seventy-five volumetric modulated arc therapy plans of prostate cancer, which were delivered at 74.8 Gy in 34 fractions with a uniform planning goal, were included: 60 for training and 5-fold cross-validation, and the remaining 15 for testing. Isodose volume dice similarity coefficient, dose-volume histogram, and normal tissue complication probability (NTCP) metrics between planned and CNN-predicted dose distributions were calculated. The primary endpoint was the goodness-of-fit, expressed as a coefficient of determination (<em>R</em>²) value, in predicting the percentage of G2-LRB-Lyman-Kutcher-Burman-NTCP.</div></div><div><h3>Results</h3><div>In 15 test cases, 2-dimensional U-net predicted dose distributions with a mean isodose volume dice similarity coefficient value of 0.90 within the high-dose region (doses ≥ 50 Gy). Rectum V_50Gy, V_60Gy, and V_70Gy were accurately predicted (<em>R</em>² = 0.73, 0.82, and 0.87, respectively). Strong correlations were observed between planned and predicted G2-LRB-Lyman-Kutcher-Burman-NTCP (<em>R</em>² = 0.80, <em>P</em> &lt; .001), with a small percent mean absolute error (mean ± 1 standard deviation, 1.24% ± 1.42%).</div></div><div><h3>Conclusions</h3><div>A risk estimation of LRB using CNN-based automatic plan generation from anatomic information was feasible. These results will contribute to the development of a decision support system that identifies priority cases for preradiation therapy interventions, such as hydrogel spacer implantation.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 4","pages":"Article 101739"},"PeriodicalIF":2.2,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143592395","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":"Long-Term Toxicity after Non-Myeloablative Conditioning Regimens Using Total Body Irradiation","authors":"Pranalee Patel MD ,&nbsp;Zihan Wan MS ,&nbsp;Mairead Dillon BS ,&nbsp;Donna Niedzwiecki PhD ,&nbsp;Kerri-Anne Crowell MPH ,&nbsp;Mitchell E. Horwitz MD ,&nbsp;Edina Wang MD ,&nbsp;Chris R. Kelsey MD","doi":"10.1016/j.adro.2025.101738","DOIUrl":"10.1016/j.adro.2025.101738","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate long-term health risks after allogeneic hematopoietic stem cell transplantation (HSCT) using non-myeloablative total body irradiation (TBI).</div></div><div><h3>Methods and Materials</h3><div>All adult patients undergoing non-myeloablative allogeneic HSCT using TBI-based conditioning from 1995 to 2020 at our institution were included. Long-term toxicities, defined as events persisting beyond or occurring after 6 months from the date of transplant, were graded per the National Cancer Institute's Common Terminology Criteria for Adverse Events version 5.0. A competing risk analysis was performed to assess the risk of developing long-term toxicities within major organ systems using the Fine-Gray model. Outcomes were compared with a cohort of patients undergoing myeloablative TBI.</div></div><div><h3>Results</h3><div>A total of 174 patients undergoing nonmyeloablative HSCT were assessed along with 378 myeloablative patients. Nonmyeloablative recipients were older (58 vs 43 years, <em>P</em> &lt; .001), less likely to be transplanted for acute leukemia (35% vs 64%, <em>P</em> &lt; .001), more likely to be transplanted for non-malignant conditions (33% vs 11%, <em>P</em> &lt; .001), and were more likely to have used tobacco (33% vs 22%, <em>P</em> = .009). The median follow-up was 7.4 years. The cumulative incidences of long-term toxicities at 5 years for nonmyeloablative and myeloablative patients, taking into account the competing risk of death, were pulmonary (4% vs 4.8%, <em>P</em> &gt; .9), cardiac (6.8% vs 3.3%, <em>P</em> = .11), renal (4.3% vs 4.1%, <em>P</em> = .9), thyroid (3.6% vs 1.5%, <em>P</em> = .2), other endocrine (3.1% vs 8.8%, <em>P</em> = .04), and cataracts (2.5% vs 2.8%, <em>P</em> = .7). The risk of developing a secondary malignancy was 3.5% vs 1.1% (<em>P</em> = .2) between the 2 cohorts. The proportion of all toxicities that were high-grade (3-5) for nonmyeloablative and myeloablative regimens, respectively, were pulmonary (60% and 69%), cardiac (17% and 45%), renal (27% and 21%), and other endocrine (4% and 2%).</div></div><div><h3>Conclusions</h3><div>Recipients of nonmyeloablative conditioning regimens, despite receiving much lower doses of TBI and chemotherapy, are at risk of developing significant, long-term medical conditions comparable with those undergoing myeloablative HSCT.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 4","pages":"Article 101738"},"PeriodicalIF":2.2,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579507","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 Randomized Trial on Accelerated Versus Standard Small-margin Radiation Schedule in Patients With Prostate Cancer Treated With Combined Brachytherapy and External Beam Radiation Therapy: Toxicity Outcomes and Patterns of Prostate Movement","authors":"Johan Staby Olsén MD ,&nbsp;Antonios Valachis PhD ,&nbsp;Bengt Johansson PhD","doi":"10.1016/j.adro.2025.101737","DOIUrl":"10.1016/j.adro.2025.101737","url":null,"abstract":"<div><h3>Purpose</h3><div>Hypofractionated radiation therapy requires high accuracy in dose delivery to enable reduced treatment margins and minimize the dose to organs-at-risk. The purpose of this study was to evaluate whether accelerated (delivered 5 times per week) hypofractionated external beam radiation therapy (EBRT) can be performed without increased acute toxicity using a real-time tracking system. We also aimed to investigate patterns of intrafractional prostate movements.</div></div><div><h3>Methods and Materials</h3><div>Patients with prostate cancer planned for combined high dose rate brachytherapy (14.5 Gy × 1) and EBRT (3 Gy × 14) were included in this randomized trial to receive the EBRT part of the treatment either 3 or 5 times per week. EBRT was delivered using small margins (3 mm) using the Raypilot system for real-time tracking of intrafractional prostate movements. Movements were continuously monitored in 3 dimensions. Primary endpoint was toxicity that was assessed using patient-reported outcome measures through european organisation for research and treatment of cancer (EORTC) quality of life questionnaires QLQ-C30 and QLQ-PR25.</div></div><div><h3>Results</h3><div>During June 2018 to January 2020, 34 patients (median age 70 years) were included in the study of which 17 were randomized to each group. No statistically significant differences in toxicity were found between the study groups. Target displacement was &lt;2 mm during 97.0% of the time and &lt;3 mm during 99.9% of the active treatment time.</div></div><div><h3>Conclusions</h3><div>We found no evidence of increased acute toxicity in patients who received accelerated treatment schedule. Provided that the target is properly delineated, a 3 mm margin seems to be feasible and safe when using a real-time tracking system.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 4","pages":"Article 101737"},"PeriodicalIF":2.2,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143601864","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":"First Application of Boron Neutron Capture Therapy for Recurrent Clival Chordoma With Brainstem Abutment","authors":"Hung-Ruei Liao MD ,&nbsp;Tien-Li Lan MD ,&nbsp;Chun-Fu Lin MD ,&nbsp;Yi-Yen Lee MD, PhD ,&nbsp;Ko-Han Lin MD ,&nbsp;Feng-Chi Chang MD ,&nbsp;Shih-Chieh Lin MD ,&nbsp;Jia-Cheng Lee PhD ,&nbsp;Fong-In Chou PhD ,&nbsp;Jinn-Jer Peir PhD ,&nbsp;Hong-Ming Liu PhD ,&nbsp;Yu-Wei Hu MD ,&nbsp;Yi-Wei Chen MD, PhD","doi":"10.1016/j.adro.2025.101736","DOIUrl":"10.1016/j.adro.2025.101736","url":null,"abstract":"","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 4","pages":"Article 101736"},"PeriodicalIF":2.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521207","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":"Lumbosacral Plexopathy After Carbon-ion Radiation Therapy for Postoperative Pelvic Recurrence of Rectal Cancer: Subanalysis of a Prospective Observational Study (GUNMA 0801)","authors":"Takuya Kumazawa MD, PhD ,&nbsp;Shintaro Shiba MD, PhD ,&nbsp;Yuhei Miyasaka MD, PhD ,&nbsp;Masahiko Okamoto MD, PhD ,&nbsp;Daijiro Kobayashi MD, PhD ,&nbsp;Tatsuya Ohno MD, PhD","doi":"10.1016/j.adro.2024.101711","DOIUrl":"10.1016/j.adro.2024.101711","url":null,"abstract":"<div><h3>Purpose</h3><div>Data are lacking on the risk factors for radiation-induced lumbosacral plexopathy (RILSP) after carbon-ion radiation therapy (CIRT) for pelvic tumors, such as postoperative recurrence of rectal cancer. We investigated the incidence of RILSP and the associated dosimetric parameters using data from a prospective study of CIRT for postoperative pelvic recurrence of rectal cancer (GUNMA 0801).</div></div><div><h3>Methods and Materials</h3><div>The GUNMA 0801 study included 28 patients, of which we analyzed 20 without lumbosacral plexopathy prior to CIRT. The total dose of CIRT was 73.6 Gy (relative biological effectiveness [RBE]) in 16 fractions. The incidence of RILSP and parameters of the dose-volume histogram were evaluated for the lumbosacral plexuses. RILSP was graded according to the Common Terminology Criteria for Adverse Events version 4.0.</div></div><div><h3>Results</h3><div>Median follow-up was 24 months. The incidence of all RILSP (grades 1 and 2) and grade 2 RILSP was 22.5% (9/40) and 10% (4/40) of 40 lumbosacral plexuses in 20 patients, respectively, and no grade ≥ 3 toxicity was observed. Throughout the dose range, the volumes of the irradiated lumbosacral plexuses were significantly higher in patients with RILSP than in patients without RILSP (<em>P</em> &lt; .001 for Dmax, D0.5 cm³ − D2 cm³, V20 Gy(RBE) − V70 Gy(RBE)). D2 cm³ and V50 Gy(RBE) were considered useful for receiver operating characteristic analysis. Cutoff values for RILSP were 73.82 Gy(RBE) and 33.2% for D2 cm³ and V50 Gy(RBE), respectively.</div></div><div><h3>Conclusions</h3><div>We demonstrated the incidence and predictive dosimetric parameters for RILSP after CIRT and showed that D2 cm³ ≥ 73.82 Gy(RBE) and V50 Gy(RBE) = 33.2% are cutoff values for predicting RILSP. These results would improve treatment plans using CIRT for patients with pelvic recurrences of rectal cancer.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 3","pages":"Article 101711"},"PeriodicalIF":2.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143348953","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}