{"title":"Planning evaluation of stereotactic magnetic resonance-guided online adaptive radiosurgery for kidney tumors close to the organ at risk: is it valuable to wait for good timing to perform stereotactic radiosurgery?","authors":"Takaya Yamamoto, Shohei Tanaka, Noriyoshi Takahashi, Rei Umezawa, Yu Suzuki, Keita Kishida, So Omata, Kazuya Takeda, Hinako Harada, Kiyokazu Sato, Yoshiyuki Katsuta, Noriyuki Kadoya, Keiichi Jingu","doi":"10.3857/roj.2024.00521","DOIUrl":"10.3857/roj.2024.00521","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate changes in target coverage using magnetic resonance-guided online adaptive radiotherapy (MRgoART) for kidney tumors and to evaluate the suitable timing of treatment.</p><p><strong>Materials and methods: </strong>Among patients treated with 3-fraction MRgoART for kidney cancer, 18 tumors located within 1 cm of the gastrointestinal tract were selected. Stereotactic radiosurgery planning with a prescription dose of 26 Gy was performed using pretreatment simulation and three MRgoART timings with an adapt-to-shape method. The best MRgoART plan was defined as the plan achieving the highest percentage of planning target volume (PTV) coverage of 26 Gy. In clinical scenario simulation, MRgoART plans were evaluated in the order of actual treatment. Waiting for the next timing was done when the PTV coverage of 26 Gy did not achieve 95%-99% or did not increase by 5% or more compared to the pretreatment plan.</p><p><strong>Results: </strong>The median percentages of PTV receiving 26 Gy in pretreatment and the first, second, and third MRgoART were 82% (range, 19%), 63% (range, 7% to 99%), 88% (range, 31% to 99%), and 95% (range, 3% to 99%), respectively. Comparing pretreatment simulation plans with the best MRgoART plans showed a significant difference (p = 0.025). In the clinical scenario simulation, 16 of the 18 planning series, including nine plans with 95%-99% PTV coverage of 26 Gy and seven plans with increased PTV coverage by 5% or more, would be irradiated at a good timing.</p><p><strong>Conclusion: </strong>MRgoART revealed dose coverage differences at each MRgoART timing. Waiting for optimal irradiation timing could be an option in case of suboptimal timing.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"43 1","pages":"40-48"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813223","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}
Joo-Hyun Chung, Hak Jae Kim, Hyun-Cheol Kang, Il Han Kim, Joo Ho Lee
{"title":"Long-term outcomes of radiotherapy for inoperable benign soft tissue tumors in the skull base or head.","authors":"Joo-Hyun Chung, Hak Jae Kim, Hyun-Cheol Kang, Il Han Kim, Joo Ho Lee","doi":"10.3857/roj.2024.00493","DOIUrl":"10.3857/roj.2024.00493","url":null,"abstract":"<p><p>This study aimed to evaluate the long-term efficacy and complication of radiotherapy for benign soft tissue tumors. Five cases of benign soft tissue tumors (two plexiform neurofibromas, two juvenile nasopharyngeal angiofibromas, and one cavernous sinus hemangioma) who underwent radiotherapy were enrolled. All patients had at least 10 years of follow-up. The median follow-up duration was 12 years (range, 10 to 27). Three patients underwent incomplete excision prior to radiotherapy. Radiation doses were either 54 Gy in 30 fractions or 50.4 Gy in 28 fractions (1.8 Gy per fraction). Every patient achieved complete remission (CR) or near-CR. The tumor volume decreased significantly within the first 2 years of follow-up and continued to decrease slowly up to 10 years; no distinct further decrease in tumor volume was observed after 10 years. One patient developed left mandibular hypoplasia 8 years after radiotherapy. Significant volume decrease was achievable within a few years after radiotherapy in benign soft tissue tumors. Therefore, radiotherapy is a viable option for unresectable or incompletely resected benign soft tissue tumors with a minimum risk of complication.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"43 1","pages":"49-54"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813271","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}
Erfan Saatchian, Shahrokh Naseri, Sare Hosseini, Hamid Gholamhosseinian
{"title":"Promising application of nano-WO3/epoxy composite in intensity-modulated brachytherapy: a simulation study.","authors":"Erfan Saatchian, Shahrokh Naseri, Sare Hosseini, Hamid Gholamhosseinian","doi":"10.3857/roj.2024.00339","DOIUrl":"10.3857/roj.2024.00339","url":null,"abstract":"<p><strong>Purpose: </strong>Implementing intensity-modulated brachytherapy (IMBT) techniques with high-energy sources like 60Co has always been challenging due to the clinical limitations of the applicator dimensions. This study aims to investigate using tungsten trioxide nanoparticles/epoxy composite as a shielding material to enhance the protective properties of a redesigned applicator.</p><p><strong>Materials and methods: </strong>The Geant4 application to tomographic emission, the Geant4-based Monte Carlo dose calculation engine (version 9.0), was used to simulate the shielding composite and the IMBT technique with a voxelated patient-based phantom. To evaluate the effectiveness of the new shielding material, IMBT plans created with the redesigned applicator were compared with those with a conventional applicator. 60Co and 192Ir were utilized, and in the same high-risk clinical target volumes D90, the D2cc for the bladder and rectum were evaluated in 18 patients with vaginal cancer.</p><p><strong>Results: </strong>For the IMBT plans with the 60Co source, the use of the redesigned applicator decreased the D2cc of the bladder and rectum by 11.1% and 12.8%, respectively, while for those with the 192Ir source, the reduction was 16.6% and 18.7%, respectively. Nevertheless, there was an insignificant alteration in the absorbed dose parameter (D90) for the target using both sources.</p><p><strong>Conclusion: </strong>This study demonstrates that tungsten trioxide nanoparticle/epoxy composite can be advantageous in tackling radiation shielding concerns. Enhancing the shielding properties of this composite, considering the size limitations of applicators, leads to improved protection of organs at risk, such as the bladder and rectum. This substance can be considered a promising shielding material in the construction of applicators.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"43 1","pages":"22-29"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813224","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":"Hounsfield units predict vertebral compression fractures in gastric cancer survivors after adjuvant irradiation.","authors":"Pervin Hurmuz, Yasin Ozyurek, Ecem Yigit, Suayib Yalcin, Fazli Yagiz Yedekci, Faruk Zorlu, Mustafa Cengiz","doi":"10.3857/roj.2024.00409","DOIUrl":"10.3857/roj.2024.00409","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the risk factors and predictive value of vertebral Hounsfield units (HUs) for vertebral compression fracture (VCF) development in gastric cancer (GC) patients who received adjuvant radiotherapy (RT).</p><p><strong>Materials and methods: </strong>We retrospectively analyzed the data of 271 patients with non-metastatic GC who received adjuvant RT between 2010 and 2020. The vertebral bodies from 9th thoracic (T9) to 2nd lumbar (L2) were contoured in computed tomographies used for RT planning, and V30, V35, V40, mean doses, and HUs of vertebrae were documented. We conducted univariate and multivariate analyses to identify the risk factors for VCF development.</p><p><strong>Results: </strong>The median follow-up time was 35.7 months. VCF developed in 23 patients (8.5%) in a median of 30.6 months (range, 3.4 to 117.3) after the end of RT. In total, 37 vertebrae were fractured, with 14 located in T12, nine in L1, seven in T11, four in L2, and three in T10. Older age, female sex, non-smoking status, and lower median vertebrae HUs were significantly associated with VCF in the univariate analysis. In the multivariate analysis, lower median HUs of T12 vertebrae (odds ratio, 0.965; 95% confidence interval, 0.942 to 0.989; p = 0.004) remained significant. The optimal cut-off value for T12 HU was 205.1, with an area under the receiver operating characteristic curve of 0.765, sensitivity of 85.7%, and specificity of 65%.</p><p><strong>Conclusion: </strong>The lower median HU value of T12 vertebrae is a significant and independent risk factor for VCF development in GC patients who received adjuvant RT. HUs values serve as a simple and reliable predictor of VCF development in this population.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"43 1","pages":"30-39"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813270","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":"De-escalation of regional nodal management for breast cancer patients after primary systemic therapy: from radiation oncologist's perspectives.","authors":"Yong Bae Kim","doi":"10.3857/roj.2025.00108","DOIUrl":"10.3857/roj.2025.00108","url":null,"abstract":"","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"43 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813268","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}
Hojin Kim, Sangjoon Park, Jihun Kim, Jin Sung Kim, Dong Wook Kim, Nalee Kim, Jae-Sun Uhm, Daehoon Kim, Hui-Nam Pak, Chae-Seon Hong, Hong In Yoon
{"title":"Reinforcing treatment and evaluation workflow of stereotactic ablative body radiotherapy for refractory ventricular tachycardia.","authors":"Hojin Kim, Sangjoon Park, Jihun Kim, Jin Sung Kim, Dong Wook Kim, Nalee Kim, Jae-Sun Uhm, Daehoon Kim, Hui-Nam Pak, Chae-Seon Hong, Hong In Yoon","doi":"10.3857/roj.2024.00262","DOIUrl":"https://doi.org/10.3857/roj.2024.00262","url":null,"abstract":"<p><strong>Purpose: </strong>Cardiac radioablation is a novel, non-invasive treatment for ventricular tachycardia (VT), involving a single fractional stereotactic ablative body radiotherapy (SABR) session with a prescribed dose of 25 Gy. This complex procedure requires a detailed workflow and stringent dose constraints compared to conventional radiation therapy. This study aims to establish a consistent institutional workflow for single-fraction cardiac VT-SABR, emphasizing robust plan evaluation and quality assurance.</p><p><strong>Materials and methods: </strong>The study developed a consistent institutional workflow for VT-SABR, including computed tomography (CT) simulation, target volume definition, treatment planning, robust plan evaluation, quality assurance, and image-guided strategy. The workflow was implemented for two patients with cardiac arrhythmia. Accurate target volume definition using planning CT images and electronic anatomical mapping was critical. A four-dimensional (4D) cone-beam CT (CBCT) and breath-hold electrocardiographic gated CT images reliably detected target motion.</p><p><strong>Results: </strong>The resulting plans exhibited a conformity index greater than 0.7 and a gradient index around G4.0. Dose constraints for the planning target volume (PTV) aimed for 95% or higher PTV dose coverage, with a maximum dose of 200% or lower. However, one case did not meet the PTV dose coverage due to the proximity of the PTV to gastrointestinal organs. Plans adhered to dose constraints for organs at risk near the heart, but meeting constraints for specific cardiac sub-structures was challenging and dependent on PTV location.</p><p><strong>Conclusion: </strong>The plans demonstrated robustness against respiratory motion and patient positional uncertainty through a robust evaluation function. The 4D and intra-fractional CBCT were effective in verifying target motion and setup stability.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 4","pages":"319-329"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924254","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}
Anna Basu, Natalie Grindrod, A Rashid Dar, Andrew Leung, Matt Cecchini, Michael Lock
{"title":"Left atrial myxoma metastasizing to the brain: a case report and review of literature.","authors":"Anna Basu, Natalie Grindrod, A Rashid Dar, Andrew Leung, Matt Cecchini, Michael Lock","doi":"10.3857/roj.2024.00395","DOIUrl":"https://doi.org/10.3857/roj.2024.00395","url":null,"abstract":"<p><p>Cardiac myxomas, the most common primary cardiac tumors, are believed to originate from multipotent mesenchymal cells. Approximately 75% of myxomas occur within the left atrium, increasing the risk of systemic thromboembolic events. While typically benign, atrial myxomas can rarely metastasize to the brain, with fewer than 60 cases reported. We present a case of a 56-year-old woman with a history of left atrial myxoma who developed headaches, right arm weakness, and blurry vision three months post-cardiac surgery. Imaging showed multiple hemorrhagic brain lesions, and she was treated with whole brain radiotherapy (20 Gy/5 fractions). Four years later, she remains stable with no new lesions and has fully regained function. Currently, there is no standard management for cardiac myxoma metastases. This case highlights the potential role of radiotherapy in managing brain metastases from left atrial myxomas, suggesting a possible treatment strategy based on this case and a review of the literature.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 4","pages":"330-334"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924331","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}
Maria Luisa Gasparri, Orit Kaidar-Person, Oreste Davide Gentilini, Jana de Boniface, Thorsten Kuehn, Philip Poortmans
{"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}