Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique最新文献

{"title":"[Bronchiolitis obliterans organizing pneumonia after radiotherapy: A systematic review and case report].","authors":"Antoine Ailloud, Mael Morfin, Valérie Grangeon, Laurent Bertoletti, Jean-Philippe Suchaud, Amel Rehailia-Blanchard","doi":"10.1016/j.canrad.2024.05.004","DOIUrl":"https://doi.org/10.1016/j.canrad.2024.05.004","url":null,"abstract":"<p><strong>Purpose: </strong>Bronchiolitis obliterans with pneumonic organization, or organizing pneumonia (OP), is an inflammatory disorder of the lungs, which can be triggered following pulmonary attacks of infectious or non-infectious origin. The non-infectious origins of OP include various entities including connective tissue diseases, exposure to toxic substances, medications, autoimmune diseases, and thoracic radiotherapy. The objective of this article is to summarize the literature on post-radiotherapy organized pneumonia, its etiologies, its clinical and radiological characteristics, as well as its treatment.</p><p><strong>Materials and methods: </strong>A systematic review was performed in Medline database using the search engine PubMed. Keywords for the search included cryptogenic organizing pneumonia, bronchiolitis obliterans organizing pneumonia (BOOP), idiopathic organizing pneumonia and radiation, radiotherapy, breast cancer. The selected articles had to study the link between bronchiolitis obliterans with pneumonic organization and radiotherapy.</p><p><strong>Results: </strong>A total of 96 articles were identified. Of these 96 articles, 49 fulfilled the defined selection criteria. Fourteen epidemiological studies were found in the literature. These epidemiological studies have published incidences of post-radiotherapy organizing pneumonia of less than 2.9% for patients treated for breast cancer. The predictive risk factors for bronchiolitis obliterans with pneumonic organization syndrome were age, smoking and the volume of irradiated lung. In a post-radiation context, bronchiolitis obliterans with pneumonic organization could be diagnosed several months, or even up to a year, after the end of irradiation. Treatment was based on the prescription of long-term corticosteroid therapy. Bronchiolitis obliterans with pneumonic organization should not be confused with post-radiation pulmonary fibrosis, which is inflammatory, dose-dependent, non-immunological, and localized in the irradiation area.</p><p><strong>Conclusion: </strong>Organized pneumonia secondary to radiotherapy is a syndrome affecting approximately 1.4 to 3% of patients treated with radiotherapy for breast cancer. The main risk factors found are age, smoking and the volume of lung irradiated. Post-radiotherapy organized pneumonia needs to be known to all radiotherapists to improve patient care.</p>","PeriodicalId":93921,"journal":{"name":"Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712080","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":"What is the future of uterovaginal brachytherapy in private practice in France?","authors":"Fabien Mignot, Antoine Bruna, Rebecca Msika, Céline Legrand-Hamon, Érik Monpetit, Olivier Bleichner","doi":"10.1016/j.canrad.2024.06.004","DOIUrl":"https://doi.org/10.1016/j.canrad.2024.06.004","url":null,"abstract":"<p><p>Private radiotherapy centres treat almost one in two patients in France. However, very few of these centres perform uterovaginal brachytherapy. In this short communication, we look at the reasons for the underdevelopment of uterovaginal brachytherapy in private practice. In our opinion, there are three factors limiting its development: the lack of doctors trained in brachytherapy, the complex and human resource-heavy organisation, and the inadequate and insufficient reimbursement of uterovaginal brachytherapy. This last point seems to be shared by the entire community of radiation oncologist in France, and it is vital that brachytherapy is given its due value, otherwise it will continue to decline.</p>","PeriodicalId":93921,"journal":{"name":"Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712099","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":"Transformative clinical trials in gynaecologic radiation oncology in 2023-2024: Shaping modern treatment practices.","authors":"Zineb El Ayachi, Alexandra Gabro, Guillaume Camprodon, Supriya Chopra, Philippe Maingon, Cyrus Chargari","doi":"10.1016/j.canrad.2024.10.002","DOIUrl":"https://doi.org/10.1016/j.canrad.2024.10.002","url":null,"abstract":"<p><p>The field of gynaecologic oncology has evolved rapidly in recent years, largely driven by advances in both radiotherapy and systemic therapies. These innovations have reshaped the management of key gynaecologic cancers, including cervical, endometrial, vaginal, and vulvar cancers, leading to more personalized and effective treatment approaches. This review explores pivotal clinical trials conducted between 2023 and 2024 that have potentially modified current practices. Through an extensive analysis of randomized controlled trials and meta-analyses, we examine the evolving role of radiotherapy, the integration and sequencing of immunotherapy, and the refinement of neoadjuvant and adjuvant treatments based on molecular classifications. The combination of immunotherapy with chemoradiotherapy has shown promising outcomes, particularly in patients with locally advanced cervical cancer. For endometrial cancer, molecular profiling has enabled a more precise classification of tumour subtypes, leading to better-targeted adjuvant therapies that reduce unnecessary interventions and increase treatment efficacy. In parallel, radiotherapy has advanced with the increasing use of modern techniques such as intensity-modulated radiotherapy and more recently the developments of adaptive treatments in order to minimize exposure to healthy tissue, thereby reducing toxicity and enhancing patient quality of life. Integration of image-guided brachytherapy and expansion of capabilities with newer generation of brachytherapy applicators have also increased possibilities to achieve efficient local treatments, including in very advanced cases. However, despite progress in common gynaecologic cancers, the management of rare cancers such as vulvar and vaginal cancers continues to face challenges due to limited clinical research and treatment data. This review highlights the transformative potential of these innovations and emphasizes the need for continued research and personalized treatment strategies to optimize patient outcomes in gynaecologic oncology.</p>","PeriodicalId":93921,"journal":{"name":"Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696092","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":"Oncological outcomes of patients with muscle-invasive bladder cancer treated with trimodal strategy: A French multicentric study.","authors":"Carolinne Brassart, Alexandre Coutte, Jennifer Wallet, Emmanuel Meyer, Ahmed Benyoucef, Hajer Mnif, Vincent Kowalski, Maël Barthoulot, David Pasquier","doi":"10.1016/j.canrad.2024.05.005","DOIUrl":"https://doi.org/10.1016/j.canrad.2024.05.005","url":null,"abstract":"<p><strong>Purpose: </strong>Trimodal therapy, an organ-sparing alternative, may be proposed for selected patients with muscle-invasive bladder cancer instead of radical cystectomy. In this multicentre retrospective study, we aimed to assess the oncological outcomes of patients who had trimodal therapy for a muscle-invasive bladder cancer.</p><p><strong>Materials and methods: </strong>Seventy-three patients from four centres treated who had trimodal therapy (maximal transurethral resection of bladder tumour and concomitant chemoradiotherapy) for localized muscle-invasive bladder cancer were included. Patients meeting the optimal trimodal therapy eligibility criteria as per the European Association of Urology guidelines were identified. Overall survival, recurrence-free survival and cancer-specific survival were assessed using the Kaplan-Meier method. The cumulative incidence of recurrence was estimated using the Kalbfleisch-Prentice method.</p><p><strong>Results: </strong>Median overall survival was 27.0 months (95 % confidence interval [CI]: 20.3-58.3 months), 5-years overall-, cancer-specific- and recurrence-free survival rates were 37.5% (95 % CI: 25.5-49.5 %), 60 % (95 % CI: 48.3-72.0 %), and 17.9 % (95 % CI: 9.3-28.8 %), respectively. There was no significant difference in 5-year overall survival and recurrence-free survival between the trimodal therapy-eligible and non-eligible patients (hazard ratio [HR]: 1.38, P=0.30 and HR: 0.96, P=0.90, respectively). The univariate analysis did not reveal any significant prognostic factors associated with recurrence-free or overall survival.</p><p><strong>Conclusion: </strong>Trimodal therapy offers encouraging specific survival, the prognosis remains poor. Our study highlights the low number and high frailty of patients to whom trimodal therapy is offered in clinical practice.</p>","PeriodicalId":93921,"journal":{"name":"Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142694021","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":"Permanent alopecia after radiotherapy of primary brain tumours: The most influential factors.","authors":"Simin Badiei Moghaddam, Afshin Rakhsha, Zahra Siavashpour","doi":"10.1016/j.canrad.2024.05.003","DOIUrl":"https://doi.org/10.1016/j.canrad.2024.05.003","url":null,"abstract":"<p><strong>Purpose: </strong>Alopecia is a distressing side effect of radiotherapy in patients undergoing treatment for primary brain tumours. This study aimed to investigate the most influential clinical, demographic, and dosimetric factors associated with permanent scalp alopecia in patients with brain tumours treated with intensity-modulated radiations.</p><p><strong>Patients and methods: </strong>Eighty patients with brain tumors treated with intensity-modulated radiations were enrolled. Inclusion criteria were having a primary brain tumour and patients with at least 18 months of radiotherapy. Scalp alopecia was evaluated using the Common Terminology Criteria for Adverse Events (CTCAE) v5.0. The scalp location with hair loss was marked and delineated on their follow-up MRI, and the planning dosimetric parameters, including D_0.1cm³ (as maximum dose), mean dose, and various volumetric parameters such as V_16Gy-43Gy (with about 5Gy interval) were recorded. In addition, receiver operating characteristic (ROC) curve analysis was employed to identify predictive parameters for chronic alopecia.</p><p><strong>Results: </strong>The hair loss severity was grade 1 for 70 % of cases, and grade 2 for 30 %. Male gender, history of chemotherapy, and family history of hair loss were significantly associated with increased volume of hair loss follicles. The correlation and ROC analysis revealed that regions receiving doses of 30Gy or higher (i.e., V_30Gy) were associated with a higher risk of developing grade 2 alopecia. The resulting areas under the curve of 0.694 were indicators for moderate correlations between the considered dose-volume histogram parameters and patients' permanent alopecia. Even if these results were not statistically significant, these findings suggest that specific dosimetric parameters, such as V_30Gy to V_43Gy, maybe the strongest predictors of grade 2 chronic radiation-induced alopecia. The cut-off values were also about 13.5 to 8 cm³ for V_30Gy to V_43Gy, respectively, which can be played as an indicator of the dose-volume histogram threshold above which permanent alopecia will be expected after brain intensity-modulated radiotherapy.</p><p><strong>Conclusion: </strong>The incidence of permanent alopecia after intensity-modulated radiotherapy is influenced by demographic, dosimetric, and clinical factors such as gender, history of chemotherapy, and family history, and the skull follicle regions receiving doses of 30Gy or higher.</p>","PeriodicalId":93921,"journal":{"name":"Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142694026","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":"Is hypofractionated radiotherapy used to treat soft tissue sarcomas? Assessment of practices using the NETSARC network.","authors":"Emma Agnoux, Anaïs Stefani, Nassim Sahki, Émilie Meknaci, Maria Jolnerovski","doi":"10.1016/j.canrad.2024.05.007","DOIUrl":"https://doi.org/10.1016/j.canrad.2024.05.007","url":null,"abstract":"<p><strong>Purpose: </strong>Extremity soft-tissue sarcomas are treated by wide surgical resection with normofractionated radiotherapy. Over the past 3years, several phase II trials emerged on perioperative hypofractionated radiotherapy. We aimed to review the current practice in France and Luxembourg of hypofractionated radiotherapy as curative treatment for extremity soft-tissue sarcomas.</p><p><strong>Materials and methods: </strong>We sent an electronic adaptive survey to sarcoma radiation oncologists at 28 centres in France and the Grand Duchy of Luxembourg belonging to the NETSARC network. The questionnaire was distributed via the NETSARC mailing list in December 2021 and January 2022. It consisted of four to nine questions with closed multiple choice, or open-ended (short or long) answers. Some questions assessed agreement with proposals for pre- or postoperative hypofractionated radiotherapy for extremity soft-tissue sarcomas.</p><p><strong>Results: </strong>Of the 28 radiation oncologists surveyed, 11 (39.2 %) from nine centres responded. Of these, 55 % used hypofractionated radiotherapy, mainly for elderly and frail patients. The main reason why hypofractionated radiotherapy was not used was the lack of scientific evidence and therapeutic habits.</p><p><strong>Conclusion: </strong>Hypofractionated radiotherapy for extremity soft-tissue sarcomas remains to be investigated in high-powered studies but could be offered in the future for well-selected patients by a multidisciplinary board in a sarcoma referral centre.</p>","PeriodicalId":93921,"journal":{"name":"Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693992","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":"Management of unilateral neck irradiation in elderly patients with head and neck cancer: Which place for hypofractionation? A single-centre experience of 43 patients.","authors":"Manou Rakotosamimanana, Sophie Renard-Oldrini, Nassim Sahki, Jean-Christophe Faivre","doi":"10.1016/j.canrad.2024.07.018","DOIUrl":"https://doi.org/10.1016/j.canrad.2024.07.018","url":null,"abstract":"<p><strong>Purpose of the study: </strong>The purpose of the study was to evaluate retrospectively the acute toxicity and efficacy in terms of locoregional control of a cervical lymph node irradiation using a hypofractionated regimen in frail elderly patients.</p><p><strong>Material and methods: </strong>Patients receiving unilateral hypofractionated cervical lymph node irradiation at the Institut de cancérologie de Lorraine (France) were retrospectively included. The treatment regimen consisted of delivering 54Gy in 18 fractions to the high-risk tumour or lymph node volume and 45Gy to the prophylactic volume using the technique of simultaneous integrated-boost without concomitant systemic treatment. Toxicity data according to the Common Terminology Criteria for Adverse Events version 4 and survival data were collected.</p><p><strong>Results: </strong>Forty-three patients were treated between January 2013 and July 2021. The median age was 83 years (range: 78-86.5 years), 32 patients (74.4 %) were male and 25.6 % had WHO status ≥ 2. Histological types were cutaneous squamous cell carcinoma (39 patients), salivary gland carcinoma (three patients) and Merkel cell carcinoma (one patient). The mean duration of treatment was 27 days. Seventeen patients (39.5 %) received radiotherapy alone. Acute toxicity events of grade ≥ 2 at the end of radiotherapy in the 43 patients were described as follows: 58.1 % radiodermatitis (25 patients), 24.6 % mucositis (11 patients), and 18.1 % xerostomia (eight patients). Seven patients (16.3 %) experienced grade ≥ 2 odynodysphagia, with four patients (9.3 %) requiring enteral nutrition. No grade 3 toxicity events were reported at 3 months, 6 months or 1 year. After a median follow-up of 9.2 months (range: 6-18.5 months), 11 patients (25.6 %) of those treated by exclusive irradiation had a complete locoregional response as assessed by CT-scan 3 months. At 6 months, two of 20 patients retained grade 2 xerostomia and only four of 20 patients reported residual grade 1 pain.</p><p><strong>Conclusion: </strong>Moderately hypofractionated unilateral cervical lymph node radiotherapy appears to be well tolerated in frail elderly patients with an acceptable locoregional control rate, potentially providing an alternative to palliative strategies.</p>","PeriodicalId":93921,"journal":{"name":"Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142694018","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":"Safety of concurrent trastuzumab-emtansine and radiation therapy for breast cancer: Single-centre experience from a morbidity and mortality review meetings procedure.","authors":"Alexander Bennassi, Mohamed Aziz Chérif, Kamel Debbi, Yazid Belkacémi","doi":"10.1016/j.canrad.2024.07.019","DOIUrl":"https://doi.org/10.1016/j.canrad.2024.07.019","url":null,"abstract":"","PeriodicalId":93921,"journal":{"name":"Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142690088","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":"Interpreting the patterns of local failure following postoperative volumetric-modulated arctherapy in oral cavity and oropharynx cancers: Impact of the different methods of analysis.","authors":"Cécile Mione, Nicolas Saroul, Mélanie Casile, Juliette Moreau, Jessica Miroir, Ioana Molnar, Fanny Martin, Nathalie Pham-Dang, Michel Lapeyre, Julian Biau","doi":"10.1016/j.canrad.2024.05.006","DOIUrl":"https://doi.org/10.1016/j.canrad.2024.05.006","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Intensity-modulated radiation therapy or volumetric-modulated arctherapy is nowadays the recommended radiation technique for the treatment of head and neck cancers. However, by providing a significant dose gradient between target volumes and organs at risk, there is a risk of target missing and thus recurrence in case of inadequate delineation. It is therefore necessary to determine the origin of these recurrences to improve clinical practice. Over the past years, different methods have been described for the analysis of recurrences. Using the patterns of failure of patients with oral cavity and oropharynx carcinoma, treated with postoperative volumetric-modulated arctherapy in our institution, the purpose of this work was to analyse the sites of local recurrences and to evaluate the disparity in the classification of recurrences when different methods were used.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Material and methods: &lt;/strong&gt;Between 2011 and 2019, 167 patients who underwent postoperative volumetric-modulated arctherapy for oral cavity or oropharyngeal cancers were included (60 and 40 % respectively). Two or three dose levels were prescribed (54Gy, 59.4/60Gy±66Gy). Local recurrence occurred in 17 patients (10.2 %). We assessed the patterns of local recurrences according to four methods: 1/ volume-based method using the volume overlap between the recurrence volume and initial target volumes; 2/ volume-based method of overlap between the recurrence volume and the 95 % treatment isodose; 3/ point-based method using the position of the barycentre of the recurrence volume; 4/ combined centroid method classifying recurrences according to both the initial target volumes and dose distribution. Each case was reviewed to make a clinical judgment on these classifications and assessed them as \"appropriate\", \"possible\", or \"inappropriate\".&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;For the volume-based method using overlap between the recurrence volume and the initial clinical target volume, this classification was clinically judged as inappropriate in 11 out of 17 cases (65 %). For the volume-based method using overlap between the recurrence volume and the 95 % prescribed isodose, this classification was clinically judged as appropriate in 15 out of 17 cases (88 %). For the point-based method, this classification was clinically judged as appropriate in 14 out of 17 cases (82 %). Thirteen out of 17 local recurrences had the same classification between this point-based method and the volume-based method of overlap between the recurrence volume and the 95 % prescribed isodose. For the combined centroid method, among 17 local recurrences nine were classified as type A, two as type B, two as type C, three as type D and one as type E. This classification was clinically judged as appropriate in 15 out of 17 cases (88 %). Only five out of 17 of the local recurrences were classified the same way according to the four different methods (29 %).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion:","PeriodicalId":93921,"journal":{"name":"Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634534","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":"Defining the potential for sexual structures-sparing for prostate cancer external beam radiotherapy: A dosimetric study.","authors":"Jennifer Le Guevelou, Ayad Houssayni, Stéphane Key, Axel Largent, Caroline Lafond, Oscar Acosta, Antoine Simon, Renaud de Crevoisier, Anaïs Barateau","doi":"10.1016/j.canrad.2024.05.008","DOIUrl":"https://doi.org/10.1016/j.canrad.2024.05.008","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the study was to evaluate the dosimetric impact of sexual-sparing radiotherapy for prostate cancer, with magnetic resonance-only treatment planning.</p><p><strong>Material and methods: </strong>Fifteen consecutive patients receiving prostate cancer radiotherapy were selected. A synthetic CT was generated with a deep learning method from each T2-weighted MRI performed at the time of treatment planning. For each patient, two plans were performed: standard treatment planning and sexual-structures sparing treatment planning. The treatment plan was designed to deliver a dose of 78Gy to the prostate and 50Gy to the seminal vesicles in 2Gy daily fractions, using volumetric arc therapy. Dose-volume histograms were computed to compare treatment plans.</p><p><strong>Results: </strong>All plans fulfilled dosimetric objectives and were equivalent regarding planning target volume coverage. The doses delivered to both rectum, bladder, and femoral heads were similar between plans (P=0.20). Sexual-sparing plans enabled to decrease all dosimetric parameters on sexual organs-at-risk. The mean penile bulb dose in sexual-sparing plans was significantly reduced (21.1Gy±20.7 versus 13.4Gy±14.0, P<0.01), however with large variability observed between individuals. The mean dose delivered to the corpora cavernosa was also significantly reduced within sexual-sparing plans (13.1Gy±16.7 versus 8.6Gy±10.4, P<0.01). A significant reduction was also observed in the highest doses delivered to internal pudendal arteries (D10%: 48.4Gy±8.3 versus 33.1Gy±4.6, P<0.05; D5%: 52.0Gy±8.7 versus 36.8Gy±5.5, P<0.05).</p><p><strong>Conclusion: </strong>Sparing of sexual structures appears feasible, without compromising neither planning target volume coverage nor doses delivered to non-sexual organs at risk. The clinical significance of this dose-reduction requires prospective evaluation.</p>","PeriodicalId":93921,"journal":{"name":"Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634532","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}