Radiation oncology journal最新文献

{"title":"Radiation therapy volumes after primary systemic therapy in breast cancer patients: an international EUBREAST survey.","authors":"Maria Luisa Gasparri, Orit Kaidar-Person, Oreste Davide Gentilini, Jana de Boniface, Thorsten Kuehn, Philip Poortmans","doi":"10.3857/roj.2024.00248","DOIUrl":"https://doi.org/10.3857/roj.2024.00248","url":null,"abstract":"<p><strong>Purpose: </strong>After primary systemic therapy (PST), agreement on the extent of locoregional therapy is lacking in breast cancer patients who convert from a node-positive to a node-negative status. The aim of this survey was to investigate radiation therapy approaches after PST according to different axillary surgical strategies and disease responses.</p><p><strong>Materials and methods: </strong>The European Breast Cancer Research Association of Surgical Trialists developed a web-based survey containing 39 questions on locoregional management based on clinical scenarios in initially node positive breast cancer patients undergoing PST. Twelve international breast cancer societies distributed the link to breast surgeons and radiation oncologists.</p><p><strong>Results: </strong>Responses from 349 breast specialists were recorded, 72 of whom (20.6%) were radiation oncologists from 17 countries. Nodal status at diagnosis informed the decision for postoperative regional nodal irradiation (RNI) for 44/72 (61.1%) responders. RNI in node positive patients having undergone axillary lymph node dissection (ALND) is delivered in selected cases by 30/72 (41.7%) responders and systemically recommended by 26/72 (36.1%) responders. In case of macrometastases found on ALND, 43/72 (59.7%) responders always deliver RNI. In case of micrometastases in the sentinel lymph node(s) or targeted lymph node(s), 45/72 (62.5%) responders prefer RNI to completion ALND. A majority of responders (59.7%) determine the target volume for RNI according to European Society for Radiotherapy and Oncology guidelines. Significant heterogeneity was observed regarding nodal basins and volumes of interest for dose coverage by RNI.</p><p><strong>Conclusions: </strong>There is significant heterogeneity in radiation-therapy delivered to the axilla after PST. A more standardized approach engaging both radiation oncologists and breast surgeons will help to optimize the harm-benefit equilibrium of axillary surgery and RNI.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 4","pages":"308-318"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924340","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":"Unilateral radiation therapy for well-lateralized tonsillar cancer with multiple ipsilateral neck nodes: should we encourage patients take risks and pursue quality of life or not?","authors":"Sung Ho Moon","doi":"10.3857/roj.2024.00731","DOIUrl":"https://doi.org/10.3857/roj.2024.00731","url":null,"abstract":"","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 4","pages":"245-246"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924272","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":"Lymphopenia is an adverse prognostic factor in rectal adenocarcinoma patients receiving long-course chemoradiotherapy.","authors":"Ioannis M Koukourakis, Ioannis Georgakopoulos, Dimitra Desse, Dina Tiniakos, Vassilios Kouloulias, Anna Zygogianni","doi":"10.3857/roj.2024.00052","DOIUrl":"https://doi.org/10.3857/roj.2024.00052","url":null,"abstract":"<p><strong>Purpose: </strong>Neoadjuvant radiotherapy (RT) or chemoradiotherapy (CRT) is the standard treatment for locally advanced rectal adenocarcinoma. The recent emerging data on preoperative immunotherapy as an effective therapeutic modality for mismatch repair deficient rectal carcinomas suggests that the immune system plays a significant role in tumor eradication. Although RT has been shown to stimulate anti-tumor immunity, it also leads to substantial lymphopenia, hindering the effect of immune response.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 33 rectal adenocarcinoma patients who underwent CRT in our department, aiming to identify the effects of CRT on the peripheral blood lymphocyte counts (LC) and the potential impact of CRT-induced lymphopenia on tumor response and prognosis of patients.</p><p><strong>Results: </strong>A statistically significant decrease in the LC of patients was observed after CRT (median values of 2,184/μL and 517/μL before and after treatment, respectively; p < 0.001). While no correlation between ypT-stage, ypN status, and LC was found, poor tumor regression grade was significantly associated with lower LC (p = 0.036). Moreover, lymphopenia was associated with poorer distant metastasis-free survival (p = 0.003). Distant metastases were documented in 0% of patients with post-CRT LC above 518/μL vs. 44.5% of patients with lower LC values.</p><p><strong>Conclusion: </strong>Although further investigation is demanded, given the limited number of patients analyzed in the study, lymphopenia emerges as a significant adverse event that rectal adenocarcinoma patients face during treatment with neoadjuvant CRT, with subsequent implications on tumor response and prognosis. Protection of the immune system during CRT emerges as an important target for clinical research.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 4","pages":"263-272"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924334","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":"Evidence-based clinical recommendations for hypofractionated radiotherapy: exploring efficacy and safety - Part 4: Liver and locally recurrent rectal cancer.","authors":"Hwa Kyung Byun, Gyu Sang Yoo, Soo-Yoon Sung, Jin-Ho Song, Byoung Hyuck Kim, Yoo-Kang Kwak, Yeon Joo Kim, Yeon-Sil Kim, Kyung Su Kim","doi":"10.3857/roj.2024.00108","DOIUrl":"https://doi.org/10.3857/roj.2024.00108","url":null,"abstract":"<p><p>In this paper, we review the use of hypofractionated radiotherapy for gastrointestinal malignancies, focusing on primary and metastatic liver cancer, and recurrent rectal cancer. Technological advancements in radiotherapy have facilitated the direct delivery of high-dose radiation to tumors, while limiting normal tissue exposure, supporting the use of hypofractionation. Hypofractionated radiotherapy is particularly effective for primary and metastatic liver cancer where high-dose irradiation is crucial to achieve effective local control. For recurrent rectal cancer, the use of stereotactic body radiotherapy offers a promising approach for re-irradiation, balancing efficacy and safety in patients who have been administered previous pelvic radiotherapy and in whom salvage surgery is not applicable. Nevertheless, the potential for radiation-induced liver disease and gastrointestinal complications presents challenges when applying hypofractionation to gastrointestinal organs. Given the lack of universal consensus on hypofractionation regimens and the dose constraints for primary and metastatic liver cancer, as well as for recurrent rectal cancer, this review aims to facilitate clinical decision-making by pointing to potential regimens and dose constraints, underpinned by a comprehensive review of existing clinical studies and guidelines.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 4","pages":"247-256"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924329","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 neoadjuvant chemoradiotherapy in T4 rectal cancer patients: a real-world single institution experience.","authors":"Reza Ghalehtaki, Kasra Kolahdouzan, Guglielmo Niccolò Piozzi, Saeid Rezaei, Zoha Shaka, Nima Mousavi Darzikolaee, Reyhaneh Bayani, Behnam Behboudi, Mahdi Aghili, Felipe Couñago, Azadeh Sharifian, Farzaneh Bagheri, Reza Nazari, Naeim Nabian, Mohammad Babaei, Mohsen Ahmadi Tafti, Mohammadsadegh Fazeli, Farshid Farhan","doi":"10.3857/roj.2024.00136","DOIUrl":"https://doi.org/10.3857/roj.2024.00136","url":null,"abstract":"<p><strong>Purpose: </strong>Treatment outcomes of locally advanced rectal cancer have improved significantly in recent decades. This retrospective study aimed to assess the efficacy of neoadjuvant chemoradiotherapy (nCRT) followed by surgery in patients with T4 rectal cancer and the different outcomes between T4a and T4b patients.</p><p><strong>Materials and methods: </strong>A total of 60 clinically T4 rectal cancer patients who underwent nCRT were included in the analysis. Patient characteristics, treatment regimens, down-staging rates, pathological response, and overall survival (OS) were evaluated.</p><p><strong>Results: </strong>Both T4a and T4b patients experienced down-staging following nCRT (36.6% and 6.2% respectively; p = 0.021). T4a patients exhibited a higher rate of pathological complete response (pCR) than T4b patients (13.3% in T4a vs. 0% in T4b; p = 0.122). After a median follow-up of 36 months, the OS and recurrence-free survival (RFS) of T4a patients were significantly higher compared to T4b patients (hazard ratio [HR] = 2.52, 95% confidence interval [CI] 1.05-6.05, p = 0.038 for OS; HR = 2.32, 95% CI 1.09-4.92, p = 0.025 for RFS).</p><p><strong>Conclusion: </strong>This study provides valuable insights into the effectiveness of nCRT in T4 rectal cancer patients. Although down-staging was observed in both T4a and T4b subgroups, achieving a pCR remains a challenge, particularly in T4b patients. Further research is needed to optimize treatment strategies and enhance pCR rates in T4 rectal cancer patients to improve oncologic outcomes.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 4","pages":"273-280"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The first Korean carbon-ion radiation therapy facility: current status of the Heavy-ion Therapy Center at the Yonsei Cancer Center.","authors":"Min Cheol Han, Seo Hee Choi, Chae-Seon Hong, Yong Bae Kim, Woong Sub Koom, Jin Sung Kim, Jaeho Cho, Chan Woo Wee, Changhwan Kim, Jong Won Park, Soorim Han, Heejeong Lee, Hong In Yoon, Ik Jae Lee, Ki Chang Keum","doi":"10.3857/roj.2024.00206","DOIUrl":"https://doi.org/10.3857/roj.2024.00206","url":null,"abstract":"<p><strong>Purpose: </strong>This report offers a detailed examination of the inception and current state of the Heavy-ion Therapy Center (HITC) at the Yonsei Cancer Center (YCC), setting it apart as the world's first center equipped with a fixed beam and two superconducting gantries for carbon-ion radiation therapy (CIRT).</p><p><strong>Materials and methods: </strong>Preparations for CIRT at YCC began in 2013; accordingly, this center has completed a decade of meticulous planning and culminating since the operational commencement of the HITC in April 2023.</p><p><strong>Results: </strong>This report elaborates on the clinical preparation for adopting CIRT in Korea. It includes an extensive description of HITC's facility layout at YCC, which comprises the accelerator and treatment rooms. Furthermore, this report delineates the clinical workflow, criteria for CIRT application, and the rigorous quality assurance processes implemented at YCC. It highlights YCC's sophisticated radiation therapy infrastructure, collaborative initiatives, and the efficacious treatment of >200 prostate cancer cases utilizing CIRT.</p><p><strong>Conclusion: </strong>This manuscript concludes by discussing the prospective influence of CIRT on the medical domain within Korea, spotlighting YCC's pioneering contribution and forecasting the widespread integration of this groundbreaking technology.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 4","pages":"295-307"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924258","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":"Decoding the influence of external beam radiotherapy to brachytherapy duration and overall treatment on response and early recurrences in cervical cancer patients treated with chemoradiation.","authors":"Abhishek Krishna, Bharat Sai Makkapatti, M S Athiyamaan, Dilson Lobo, Challapalli Srinivas, Johan Sunny, Vaishak Jawahar, Harleen Kaur, Sourjya Banerjee","doi":"10.3857/roj.2023.01025","DOIUrl":"https://doi.org/10.3857/roj.2023.01025","url":null,"abstract":"<p><strong>Purpose: </strong>Cervical cancer is a significant global health issue affecting approximately 600,000 women each year. This study aimed to address the knowledge gaps surrounding the influence of treatment time parameters, including the duration of external beam radiotherapy (EBRT) to brachytherapy and overall treatment duration, on early recurrences.</p><p><strong>Materials and methods: </strong>Details on demographics, tumor characteristics, treatment details, and outcomes in patients undergoing chemoradiation and brachytherapy for cervical cancer were collected from the medical records. Early recurrence was defined as tumor reappearance within 6 months after treatment in patients with an initial complete response. Statistical analyses included descriptive statistics chi-square tests, independent t-tests, and logistic regression.</p><p><strong>Results: </strong>A total of 288 cervical cancer patients were included. Stage IIB was the most common stage and 93% of patients had a complete response, 4.5% partial response, and 3.1% had progressive disease at 3rd month. At 6 months, 8% experienced early. The average interval between EBRT and brachytherapy was 10.4 ± 4.2 days among the no recurrence group and 12.3 ± 4.5 days among early recurrence group. A total of 203 patients had a gap of 10 or fewer days and 123 patients had a gap of more than 10 days between EBRT and brachytherapy. Difference was observed in the overall treatment time between the two groups had significant differences (no recurrence group, 61.6 ± 11.5 days; early recurrence group, 73.8 ± 8.8 days; p < 0.001).</p><p><strong>Conclusion: </strong>The study revealed that longer overall treatment durations were associated with a higher risk of early recurrences, highlighting the need for further investigation and optimized treatment strategies.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 4","pages":"257-262"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924326","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":"Role of memantine to mitigate radiation-induced cognitive dysfunction in brain metastasis patient receiving whole brain radiotherapy: a systematic review.","authors":"Yoga Dwi Oktavianda, Tiara Bunga Mayang Permata","doi":"10.3857/roj.2024.00269","DOIUrl":"https://doi.org/10.3857/roj.2024.00269","url":null,"abstract":"<p><strong>Purpose: </strong>Identifying comprehensively the evidence of neuroprotective effects of memantine for preserving cognitive function in brain metastasis patients receiving whole brain radiotherapy (WBRT).</p><p><strong>Methods: </strong>We searched randomized clinical trials (RCTs) analyzing the effects of memantine to preserve cognitive function in patients with brain metastasis treated with WBRT, performed in some databases, including PubMed, Embase, and Cochrane Library. The protocol was registered at PROSPERO (CRD42023476632). We reported the selection process according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guideline. The studies were appraised by using the revised Cochrane Risk of Bias tool for randomized trials (RoB 2.0).</p><p><strong>Results: </strong>We included three RCTs that met the eligibility criteria. No high risk of bias was found. Two articles compared WBRT + memantine to WBRT + placebo, and the other one compared hippocampal avoidance (HA)-WBRT + memantine to WBRT + memantine. There was no significant difference in characteristics among groups of treatment arms. The differences in cognitive function deterioration between treatment arms began to appear four months after initiated the treatment. The risk of cognitive failure was lower in patients receiving memantine compared to placebo. Moreover, combining HA-WBRT + memantine lowered the cognitive failure compared to standard WBRT + memantine. No article stated significant difference in quality of life (QoL) and survival outcomes in patients receiving memantine.</p><p><strong>Conclusion: </strong>Although the evidence was still limited, memantine was reported to have the potential to mitigate radiation-induced cognitive dysfunction in patients with brain metastasis receiving WBRT. However, there was no evidence revealing the benefit of memantine for enhancing QoL and prolonging survival.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 4","pages":"281-294"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924255","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":"Unilateral radiotherapy for tonsillar cancer with multiple ipsilateral neck lymph nodes.","authors":"Tae Hyun Kim, Hong-Gyun Wu, Soon-Hyun Ahn, Woo-Jin Jeong, Wonjae Cha, Keun-Yong Eom","doi":"10.3857/roj.2024.00164","DOIUrl":"10.3857/roj.2024.00164","url":null,"abstract":"<p><strong>Purpose: </strong>For tonsillar cancer with multiple ipsilateral neck lymph nodes, the safety and efficacy of unilateral radiotherapy (RT) have long been a topic of debate. We performed retrospective analyses of patients having ipsilateral neck lymph nodes treated with unilateral RT in two tertiary referral hospitals.</p><p><strong>Materials and methods: </strong>This study accrued 29 patients who were diagnosed as well-lateralized tonsillar cancer with multiple ipsilateral neck lymph nodes and underwent unilateral RT from March 2000 to March 2020. Patients underwent treatment with one of the following options or a combination of them: induction chemotherapy, surgery, RT, and concurrent chemoradiotherapy. We analyzed the recurrence pattern and survival with special attention to contralateral neck failure. Also, treatment-related toxicities were compared with a 1:1 matched cohort of those who received bilateral RT, using propensity score matching analysis.</p><p><strong>Results: </strong>At a median follow-up of 68 months, no contralateral neck failure was observed. Five-year actuarial locoregional recurrence-free survival, distant metastasis-free survival, and overall survival were 85.6%, 91.8%, and 92.7%, respectively. Both the acute and chronic grade 2 xerostomia occurred in 10.3% of the patients. When the toxicity for unilateral RT was compared to that of bilateral RT using a propensity score-matched cohort, a significantly lower rate of acute xerostomia was observed in unilateral RT group (55.1% vs. 82.7%, p=0.002), primarily at grade 2 level (10.3% vs. 51.7%, respectively).</p><p><strong>Conclusion: </strong>The results of our study suggest that unilateral RT can be safely performed in well-lateralized tonsillar cancer patients with multiple ipsilateral neck lymph nodes.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 3","pages":"192-199"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11467478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362668","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":"Advancing radiation therapy through smartwatch technology to monitor anxiety.","authors":"Byungchul Cho","doi":"10.3857/roj.2024.00577","DOIUrl":"10.3857/roj.2024.00577","url":null,"abstract":"","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 3","pages":"169-170"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11467480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362624","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}