Cancer Radiotherapie最新文献

{"title":"Four-dimensional computed tomography scan-based evaluation of intrinsic lung tumour motion and hysteresis using tumour centroid: Implication towards high-precision radiotherapy for lung cancer","authors":"Saikat Das ,&nbsp;Suriya Prakash ,&nbsp;Vaibhav Koutu ,&nbsp;Deepak Rawat ,&nbsp;Sunil Chauhan ,&nbsp;Srivathsan Vasudevan ,&nbsp;Rajesh Pasricha ,&nbsp;Manish Gupta ,&nbsp;Vipin Kharade","doi":"10.1016/j.canrad.2025.104624","DOIUrl":"10.1016/j.canrad.2025.104624","url":null,"abstract":"<div><h3>Purpose</h3><div>Predicting the target position accurately based on an external surrogate with quantifiable correlation is important for high-precision radiation in lung cancer. This study aimed to quantify the amount of movement of the lung tumours and understand the pattern of hysteresis based on four-dimensional (4D) computed tomography (CT) imaging compared to the chest wall movement.</div></div><div><h3>Materials and methods</h3><div>From the radiotherapy four-dimensional computed tomography (4DCT) scan images, a total of 43 lung tumours from 21 patients were contoured, and movement in mediolateral (<em>X</em>), anteroposterior (<em>Z</em>), and superoinferior (<em>Y</em>) directions were calculated based on tumour centroid of the smart breath cine mode of the 4DCT scan. The tumour motion in different phases of the breathing cycle was calculated, and the deformation of the shape was illustrated using a 3D slicer. The nonlinear trajectory of the tumour motion resulting in tumour hysteresis was computed.</div></div><div><h3>Result</h3><div>Tumour motion calculated from the 4DCT images in <em>X</em>, <em>Z</em>, and <em>Y</em> directions were 0.21<!--> <!-->±<!--> <!-->0.22 (range: 0.01–1.20), 0.18<!--> <!-->±<!--> <!-->0.15 (range: 0.01–0.49), 0.77<!--> <!-->±<!--> <!-->0.33 (range: 0.24–1.80) respectively. The mean three-dimensional radial motion vector was 0.85<!--> <!-->±<!--> <!-->0.31 (range: 0.21–1.81). No significant correlation between the magnitude of chest wall movement and three-dimensional radial vector was observed. Hysteresis in <em>XZ</em> plane was calculated to be 0.56<!--> <!-->±<!--> <!-->0.61<!--> <!-->cm² (range: 0.01–3.03). A statistically significant difference in hysteresis was observed between central and peripheral tumours (0.19<!--> <!-->±<!--> <!-->0.31<!--> <!-->cm² vs. 0.94<!--> <!-->±<!--> <!-->0.63<!--> <!-->cm², <em>P</em> <!-->&lt;<!--> <!-->0.01).</div></div><div><h3>Conclusion</h3><div>4DCT-based tumour motion estimation is a feasible method, and the predictability of tumour motion by chest wall movement was not optimal. The movement was more for peripheral tumours compared to centrally located lesions. Location relative to midline was the most critical predictor of hysteresis. Considerable shape deformation in different phases of respiration was observed, and peripheral tumours had more than two times the motion during the breathing cycle compared to the central tumours.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 3","pages":"Article 104624"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143947917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive analysis of uveal mucosa-associated lymphoid tissue lymphomas: Epidemiological insights and radiotherapy utilization from the Surveillance, Epidemiology and End Results database","authors":"Pierre Loap ,&nbsp;Rémi Dendale ,&nbsp;Youlia Kirova","doi":"10.1016/j.canrad.2025.104629","DOIUrl":"10.1016/j.canrad.2025.104629","url":null,"abstract":"<div><h3>Purpose</h3><div>Uveal mucosa-associated lymphoid tissue lymphomas are rare, indolent ocular tumours affecting the choroid, ciliary body, or iris. Due to their rarity, demographic and treatment data remain limited.</div></div><div><h3>Materials and methods</h3><div>This retrospective study analysed uveal mucosa-associated lymphoid tissue lymphoma cases diagnosed between 2000 and 2021 from the Surveillance, Epidemiology and End Results (SEER) database across 17 registries.</div></div><div><h3>Results</h3><div>Twenty-seven cases of uveal mucosa-associated lymphoid tissue lymphoma were identified from the SEER database (2000–2021), representing 0.12 % of 22,246 extra-nodal MALT lymphomas, with an age-adjusted incidence of 0.014 per 1,000,000 person-years. Median age was 65–69 years, with a near-equal sex ratio and 74 % of patients being Caucasian. Most cases were stage I (74.1 %) at diagnosis. Radiotherapy alone was the most common treatment (55.6 %). At a median follow-up of 69 months, the 5-year overall survival rate was 78.9 %, with no relapses or lymphoma-related deaths, yielding 100 % cancer-specific and relapse-free survival. Radiotherapy proved highly effective, supporting its role as a primary treatment.</div></div><div><h3>Conclusion</h3><div>This is the largest analysis to date, highlighting the excellent prognosis and suggesting potential for radiotherapy dose reduction to lower long-term toxicity.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 3","pages":"Article 104629"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiotherapy for adenoid cystic carcinoma of the lacrimal gland: Study on twelve patients","authors":"Sezin Yuce Sari ,&nbsp;Gozde Yazici ,&nbsp;Aysenur Elmali ,&nbsp;Pantea Bayatfard ,&nbsp;Irem Koc ,&nbsp;Hayyam Kiratli ,&nbsp;Mustafa Cengiz","doi":"10.1016/j.canrad.2025.104644","DOIUrl":"10.1016/j.canrad.2025.104644","url":null,"abstract":"<div><h3>Purpose</h3><div>Despite its slow growth pattern, adenoid cystic carcinoma of the lacrimal gland poses challenges due to its high recurrence rate. The rarity of this entity hinders the establishment of prospective studies and a consensus on optimal treatment strategies. Herein, we aim to report the results of patients with adenoid cystic carcinoma of the lacrimal gland treated with hypofractionated stereotactic body radiations or conventionally-fractionated radiations.</div></div><div><h3>Materials and methods</h3><div>This study included patients with non-metastatic adenoid cystic carcinoma of the lacrimal gland treated with a curative-intent from 2006 to 2019. Patient data, tumour characteristics, treatment details, and follow-up information were collected. Recurrence patterns, oncologic outcomes, and toxicity were assessed.</div></div><div><h3>Results</h3><div>We evaluated the data of 12 patients with a median 29<!--> <!-->years of age who received stereotactic body radiotherapy (<em>n</em> <!-->=<!--> <!-->5) or conventionally-fractionated radiotherapy (<em>n</em> <!-->=<!--> <!-->7). After a median follow-up of 98<!--> <!-->months, the overall local control rate was 50 %, with recurrences mostly marginal to the radiotherapy field. Although the 10-year overall survival rate was a promising 92 %, the respective rate for local recurrence-free survival was 37 %, which was significantly lower in patients who received stereotactic body radiotherapy (20 %) compared to patients who had with conventionally-fractionated radiotherapy (72 %). Although not statistically significant, patients in the stereotactic body radiotherapy arm encountered a higher rate of severe late toxicity (80 % versus 17 % in the conventionally-fractionated radiotherapy arm, <em>P</em> <!-->=<!--> <!-->0.07). The overall eye preservation rate was 64 %, all eye-losses due to local recurrence.</div></div><div><h3>Conclusion</h3><div>Our findings raise concerns about using stereotactic body radiotherapy for adenoid cystic carcinoma of the lacrimal gland based on increased rates of severe late toxicity and local recurrence. Conventional radiotherapy techniques should be applied to these patients to successfully control the local tumour with less toxicity.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 3","pages":"Article 104644"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144116378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of relapse after postoperative radiotherapy in patients with oral cavity cancer and a flap","authors":"Alice Blache ,&nbsp;Justine Lequesne ,&nbsp;François Christy ,&nbsp;Renaud Preudhomme ,&nbsp;Dylan James ,&nbsp;Mélanie Doré ,&nbsp;Romain Mony ,&nbsp;Laure Hily ,&nbsp;Nazim Khalladi ,&nbsp;Sébastien Guihard ,&nbsp;Alessia Di Rito ,&nbsp;Alexandre Coutte ,&nbsp;Arnaud Beddok ,&nbsp;Juliette Thariat","doi":"10.1016/j.canrad.2025.104642","DOIUrl":"10.1016/j.canrad.2025.104642","url":null,"abstract":"<div><h3>Purpose</h3><div>Reconstructive surgery with a flap is standard practice in advanced oral cavity squamous cell carcinoma to restore essential functions. However, these functions may be compromised by postoperative radiotherapy. This study evaluates relapse patterns and treatment-related toxicity in these patients.</div></div><div><h3>Methods and materials</h3><div>A multicentre 2018–2023 study included 247 patients with oral cavity squamous cell carcinoma. Uni- and multivariate analyses estimated the cumulative incidence of locoregional failures, survival rates, and prognostic factors.</div></div><div><h3>Results</h3><div>Among the patients, 74.0 % had pT3-4 tumours, 78.5 % had free flaps, regional pedicled flaps (12.6 %), or local flaps (8.5 %). Flaps were not delineated on planning CTs. Median follow-up for living patient was 36.8<!--> <!-->months. Fifty-eight patients (23.0 %) had involved soft-tissue margins; no correlation was found between margin involvement, stage, or flap type. Forty patients experienced local relapse within a median of 8.23<!--> <!-->months. Local relapse rates were higher in patients with involved (28.6 %) versus clear margins (9.3 %, <em>P</em> <!-->&lt;<!--> <!-->0.004). Two-year locoregional relapse and survival rates were 17.8 %, and 74.3 %, respectively. Performance status greater than 1, locoregional relapse, and distant relapse were associated with poorer survival. Coregistration of planning-relapse CTs is challenging due to flap changes, limiting relapse pattern analysis. Subgroup analysis of locoregional relapses (14 out of 53) at the main contributing centre revealed that five relapses occurred at the native tissue-flap junction, with minor flap involvement in two cases and no intraflap failure. All other relapses occurred outside the flap.</div></div><div><h3>Conclusions</h3><div>Involved margin rates correlating with increased local relapse risk and were not different according flap type. Further investigation into flap segmentation and planning optimization is needed. The OPTIFLAP trial (<span><span>NCT06798922</span><svg><path></path></svg></span>, PHRC2024) aims to determine whether radiotherapy can be optimized to spare flaps without increasing the risk of locoregional failure.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 3","pages":"Article 104642"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144116377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Specific radiosensitivity of brain structures (areas or regions) and cognitive impairment after focal or whole brain radiotherapy: A review","authors":"Emmanuel Mesny ,&nbsp;Julian Jacob ,&nbsp;Georges Noël ,&nbsp;Marie-Odile Bernier ,&nbsp;Damien Ricard","doi":"10.1016/j.canrad.2025.104625","DOIUrl":"10.1016/j.canrad.2025.104625","url":null,"abstract":"<div><div>Delayed neurocognitive impairment is observed following encephalic radiotherapy, including brain parts (areas), leading to a substantial deterioration of the quality of life. These delayed radiotherapy side effects are variable in terms of intensity of symptoms and time of occurrence, characterized by minor-to-severe cognitive deficits, such as attention or memory disorders and/or dysexecutive syndrome. However, the precise mechanisms leading to these cognitive disorders remain mostly unknown. Various tissue alterations have been reported after brain radiotherapy, in specific brain structures as the hippocampus, the cerebral white matter or the cerebral cortex. Sparing these structures during brain radiotherapy may be a potential approach to limit the development of late cognitive impairment; however, few dose constraints have been published regarding brain areas (regions) involved in cognitive functions. The main purposes of this literature review are to report the pathophysiological process leading to the radiation-induced cognitive impairment, to describe the tolerance and radiological modifications induced by radiation of specific healthy cerebral tissues, to better understand their radiosensitivity and to describe potential improvements.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 3","pages":"Article 104625"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143947915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary extramedullary haematopoiesis managed by radiation therapy: A case report and review of literature","authors":"Alexander Bennassi,&nbsp;Kamel Debbi,&nbsp;Fatima Zahra Bellefkih,&nbsp;Gonzalo De Luna,&nbsp;Gabriele Coraggio,&nbsp;Yazid Belkacémi","doi":"10.1016/j.canrad.2025.104628","DOIUrl":"10.1016/j.canrad.2025.104628","url":null,"abstract":"<div><div>Extramedullary haematopoiesis is a very rare non-oncologic entity, occurring in multiple blood disorders. It refers to haematopoiesis occurring outside the bone marrow. Here we report a patient with an extramedullary haematopoiesis lung mass managed by radiation therapy delivering 20<!--> <!-->Gy in ten fractions. To the best of our knowledge, this is the first case managed with this scheme. A 54-year-old man was referred for acute hypercapnic respiratory failure. A computed tomography scan (CT-scan) had demonstrated 16 years ago bilateral pulmonary masses. The patient was diagnosed with extramedullary haematopoiesis based on concordant haematological history and typical paravertebral masses. The patient had a previous history of clear cell carcinoma of the right kidney, managed by surgery 5 years ago (pT1aN0M0 on histologic examination). The acute hypercapnic respiratory failure was suggested to be secondary to his pulmonary extramedullary haematopoiesis lesions. After multidisciplinary board discussion, radiation therapy was decided to treat the right extramedullary haematopoiesis lung mass, delivering 20<!--> <!-->Gy in ten fractions. At 3 months, the patient experienced excellent tolerance with a significant improvement in respiratory symptoms. Tramadol and non-invasive ventilation could be stopped. CT-imaging at 6 months was consistent with partial response and decrease in arteriovenous circulation within the right mass. At 12-months follow-up, patient presented with no thoracic symptoms. Pulmonary extramedullary haematopoiesis is a very rare entity. Its diagnosis should not be underestimated. Radiation therapy delivering 20<!--> <!-->Gy in ten fractions is a reasonable and safe therapeutic option.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 3","pages":"Article 104628"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143947916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world evidence for preoperative use of (chemo)radiotherapy with intensity modulation for locally advanced rectal cancer by the Colib French group","authors":"Yoann Pointreau ,&nbsp;Nicolas Blanchard ,&nbsp;Jérôme Chamois ,&nbsp;Christophe Debelleix ,&nbsp;Emmanuel Gross ,&nbsp;Charles-Gaëtan Hémery ,&nbsp;Victor Passerat ,&nbsp;Benjamin Schipman","doi":"10.1016/j.canrad.2025.104627","DOIUrl":"10.1016/j.canrad.2025.104627","url":null,"abstract":"<div><h3>Purpose</h3><div>The acute toxicity of chemoradiotherapy can cause treatment interruptions and diminish patient quality of life. Recently, intensity-modulated radiotherapy has been shown to delineate treatment areas more precisely, thereby sparing unnecessary radiation exposure to organs at risk. However, the French national health authority does not currently recommend intensity-modulated radiotherapy for rectal cancer. This study aims to provide real-world data to evaluate the effectiveness of (chemo)radiotherapy with intensity modulation in the preoperative treatment of locally advanced rectal cancer.</div></div><div><h3>Materials and methods</h3><div>This retrospective study was conducted in a private practice setting in France. Patients included had confirmed, locally advanced rectal adenocarcinoma and had received neoadjuvant (chemo)radiotherapy with intensity modulation followed by surgery.</div></div><div><h3>Results</h3><div>A total of 700 patients underwent (chemo)radiotherapy with intensity modulation for a median duration of 6 weeks, most frequently using 45 to 50.4<!--> <!-->Gy. Thirty-seven patients had local disease progression, 98 experienced distant disease relapse, and 39 patients died during the follow-up period. Severe toxicity occurred in 5 % of patients (<em>n</em> <!-->=<!--> <!-->37), which was lower than the toxicity rates reported in previous studies with conformal radiotherapy. Small bowel V40 was identified as a predictive factor. Downstaging T (0.572, 95 % confidence interval [95 % CI]: 0.372–0.880, <em>P</em> <!-->&lt;<!--> <!-->0.0110), downstaging N (0.522, 95 % CI: 0.332–0.820, <em>P</em> <!-->&lt;<!--> <!-->0.0048), pathological complete response rate (0.4432, 95 % CI: 0.218–0.854, <em>P</em> <!-->&lt;<!--> <!-->0.0158), and no abdominal surgery (0.541, 95 % CI: 0.360–0.812, <em>P</em> <!-->&lt;<!--> <!-->0.0077) were found to be predictive for survival.</div></div><div><h3>Conclusions</h3><div>Neoadjuvant (chemo)radiotherapy with intensity modulation was found to reduce the incidence of acute gastrointestinal toxicity events compared to conformal radiotherapy, without compromising efficacy in patients with locally advanced rectal cancer.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 3","pages":"Article 104627"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sole high dose-rate interstitial brachytherapy for early-stage tongue cancer: A systematic review","authors":"Muhammad Kabir Abdulkadir ,&nbsp;Gokula Kumar Appalanaido ,&nbsp;Muhamad Yusri Musa ,&nbsp;Jasmin Bin Jalil ,&nbsp;Ahmad Fakrurrozi Bin Mohamad ,&nbsp;Keerthana Yogabalan ,&nbsp;Mohd Zahri Abdul Aziz","doi":"10.1016/j.canrad.2025.104626","DOIUrl":"10.1016/j.canrad.2025.104626","url":null,"abstract":"<div><h3>Purpose</h3><div>Brachytherapy has the advantage of preserving organs and function, which is of great interest to tongue cancer patients. High dose-rate brachytherapy is a newer form of brachytherapy with the advantage of higher dose conformity than the popular low dose-rate brachytherapy. This article aims to summarize the literature on sole high dose-rate brachytherapy for early-stage tongue cancer, its treatment characteristics, its treatment outcomes, toxicity and reassess its therapeutic benefits.</div></div><div><h3>Materiel and methods</h3><div>A systematic review was done in Medline database using the search engine PubMed. Keywords for the search included interstitial, brachytherapy and tongue cancer. Articles included had to study the outcome of the use of exclusive high dose-rate brachytherapy for early-stage tongue cancer.</div></div><div><h3>Results</h3><div>Eleven articles were eligible comprising 305 patients. The median follow-up ranged from 21 to 53.5 months. The most frequently utilized technique delivered a dose of 60<!--> <!-->Gy in ten fractions (two daily fractions) for one week or five days. Late effects and toxicity were minimal; soft tissue and mandibular bone necrosis occurred in 37 patients (12 %). Local control rates at five years and three years ranged from 65 to 100 % and 71 to 94.7 %, respectively. Cause-specific and overall survival ranged from 57 to 94 % and 46 to 89.4 %, respectively.</div></div><div><h3>Conclusion</h3><div>Sole interstitial high dose-rate brachytherapy is a safe and efficient treatment option for early tongue cancer. The main advantage found is its high local control rate resulting to superior organ function preservation. Sole interstitial high dose-rate brachytherapy is a viable treatment option for early-stage tongue cancer.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 3","pages":"Article 104626"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143947918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dosimetric impact of iodinated contrast agent on planning CT for volumetric-modulated radiotherapy of head and neck cancer","authors":"Brice Leyrat ,&nbsp;Julian Biau ,&nbsp;Lucie Berger ,&nbsp;Corinne Millardet ,&nbsp;Michel Lapeyre","doi":"10.1016/j.canrad.2025.104623","DOIUrl":"10.1016/j.canrad.2025.104623","url":null,"abstract":"<div><h3>Purpose</h3><div>Volumetric-modulated arc therapy for head and neck cancers requires accurate delineation of target volumes and organs at risk. Iodinated contrast agents enhance visualization, but their impact on dose distribution remains a concern. Traditionally, dosimetry is performed on non-contrast CT scans to minimize dose calculation discrepancies. This study evaluates the dosimetric impact of planning directly on contrast-enhanced CT scans.</div></div><div><h3>Material and methods</h3><div>Twelve patients with head and neck cancers (oral cavity, oropharynx, pharyngolarynx, ethmoid, thyroid) treated using volumetric-modulated radiation technique were included. Target and organs at risk delineation and dose calculation were performed on contrast-enhanced CT scans and subsequently transferred to non-contrast CT scans without renormalization. Prescribed doses for high-risk planning target volume were 60 to 70<!--> <!-->Gy, for low-risk planning target volume 54<!--> <!-->Gy, in 30 to 33 fractions. Volumetric-modulated arc therapy planning was performed on Eclipse® (version 15.6), with simultaneous integrated boost, using the AAA dose calculation algorithm. Dosimetric variations in organs at risk and planning target volumes were assessed.</div></div><div><h3>Results</h3><div>Mean variations of mean dose for organs at risk mandible, larynx, parotid glands, and pharyngeal constrictor muscle ranged from 0.02<!--> <!-->Gy (0.10 %) to 0.16<!--> <!-->Gy (0.38 %). Mean D2 % variations for spinal canal, brainstem, brachial plexus, and carotid arteries ranged from 0.05<!--> <!-->Gy (0.17 %) to 0.16<!--> <!-->Gy (0.46 %). None of the variations for organs at risk were found to be statistically or clinically significant. For planning target volumes, variations in coverage by the 95 % isodose of the prescribed dose were always less than 1 %. The maximum variation of maximum dose was a decrease of 0.6<!--> <!-->Gy, representing 0.8 %.</div></div><div><h3>Conclusion</h3><div>Performing volumetric-modulated arc therapy planning directly on contrast-enhanced CT scans leads to minimal dosimetric variations (less than 1 %) compared to non-contrast CT scans. This approach could streamline clinical workflows by eliminating the need for dual CT acquisitions and optimizing treatment preparation.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 3","pages":"Article 104623"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dosimetric comparison of advanced radiotherapy planning techniques for hippocampal sparing whole brain radiotherapy","authors":"Öznur Şenkesen ,&nbsp;Emine Burçin Ispir ,&nbsp;Evren Ozan Göksel ,&nbsp;Yücel Akdeniz","doi":"10.1016/j.canrad.2025.104643","DOIUrl":"10.1016/j.canrad.2025.104643","url":null,"abstract":"<div><h3>Purpose</h3><div>Hippocampal-sparing whole-brain radiotherapy aims to reduce neurocognitive decline in patients receiving cranial irradiation. Advances in radiotherapy planning systems offer improved sparing of organs at risk while maintaining target coverage. This study compared the dosimetric performance of five planning techniques for hippocampal-sparing whole-brain radiotherapy: Radixact with 1<!--> <!-->cm and 2.5<!--> <!-->cm field widths, Ethos, HyperArc, and volumetric modulated arctherapy using advanced optimization algorithms.</div></div><div><h3>Materials and methods</h3><div>Eleven patients who underwent whole brain irradiation were included in this retrospective planning study. The prescribed dose was 30<!--> <!-->Gy in 12 fractions, with hippocampus dose constraints of D98 %<!--> <!-->≤<!--> <!-->9<!--> <!-->Gy and D2 %<!--> <!-->≤<!--> <!-->17<!--> <!-->Gy. Radixact plans were created using the VOLO™ Ultra optimizer with normal tissue objective parameters for dose fall-off control. Ethos plans were generated using an intelligent optimization engine with automated planning. HyperArc employed four non-coplanar arcs with SRS normal tissue objective optimization, while volumetric modulated arctherapy utilized six arcs. Dosimetric parameters, including planning target volume coverage, hippocampal doses, and organs at risk constraints, were analyzed using one-way ANOVA.</div></div><div><h3>Results</h3><div>Radixact with 1<!--> <!-->cm field width achieved the lowest hippocampal doses, whereas HyperArc and volumetric modulated arctherapy provided superior planning target volume coverage. Ethos resulted in the lowest doses to organs at risk, while HyperArc had the shortest treatment duration. Statistically significant differences (<em>P</em> <!-->&lt;<!--> <!-->0.05) were observed across techniques for hippocampal D98 %, D2 %, and sparing of organs at risk.</div></div><div><h3>Conclusion</h3><div>Advanced planning techniques offer distinct dosimetric advantages for hippocampal-sparing whole-brain radiotherapy. Radixact with 1<!--> <!-->cm field width optimally spares the hippocampus, while HyperArc and volumetric modulated arctherapy balance sparing of organs at risk with shorter treatment times. Selection of an optimal planning approach should consider both dosimetric outcomes and clinical workflow efficiency.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 3","pages":"Article 104643"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}