Cancer Radiotherapie最新文献

筛选
英文 中文
Moderate hypofractionated radiotherapy for localised prostate cancer: A new standard of care 中度低分割放疗治疗局限性前列腺癌:一种新的治疗标准
IF 1.4 4区 医学
Cancer Radiotherapie Pub Date : 2025-07-30 DOI: 10.1016/j.canrad.2025.104678
David Dearnaley
{"title":"Moderate hypofractionated radiotherapy for localised prostate cancer: A new standard of care","authors":"David Dearnaley","doi":"10.1016/j.canrad.2025.104678","DOIUrl":"10.1016/j.canrad.2025.104678","url":null,"abstract":"<div><div>Radical radiotherapy is an effective treatment and standard of care for localised prostate cancer. Most conventionally treatment has been given with 1.8 to 2.0<!--> <!-->Gy fractions to a dose of 74 to 79.2<!--> <!-->Gy. Radiobiology insights have encouraged the exploration of hypofractionated schedules. Over 7000 patients have contributed to eight randomised controlled trials comparing conventional fractionation with modest hypofractionation using 2.4 to 3.4<!--> <!-->Gy fractions. These studies have used both non-inferiority statistical designs aiming to define isoeffective and isotoxic moderate hypofractionated radiotherapy schedules as well as dose-escalated hypofractionated schedules intended to show improved disease control whilst maintaining a low level of late side effects. Long-term follow-up of over 10<!--> <!-->years is now available from four of the studies. Patients with low-high risk disease have been studied treating with or without androgen-deprivation. Meta-analysis of individual patient data from seven available trials has been performed with median follow-up of 5 to 7<!--> <!-->years. The studies of isoeffective moderate hypofractionated radiotherapy show that a dose of 60<!--> <!-->Gy in 3<!--> <!-->Gy fractions delivered over 4<!--> <!-->weeks is non-inferior to doses of 74<!--> <!-->Gy to 78<!--> <!-->Gy in 2<!--> <!-->Gy fractions delivered over 7.4 to 7.8<!--> <!-->weeks with similar levels of disease control and survival. Low levels of late side effects were maintained using intensity-modulated radiotherapy techniques. In distinction trials using dose-escalated hypofractionated schedules have not increased effectiveness and have raised levels of late side effects. This may relate to very modest hypofractionation and treatment protraction. There is now adequate evidence for radiotherapy delivering 60<!--> <!-->Gy in 20 fractions over 4<!--> <!-->weeks to be the standard schedule for all patients with localised prostate cancer.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104678"},"PeriodicalIF":1.4,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724196","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}
引用次数: 0
Hypofractionated radiotherapy in the management of bladder cancer 低分割放疗在膀胱癌治疗中的应用
IF 1.4 4区 医学
Cancer Radiotherapie Pub Date : 2025-07-30 DOI: 10.1016/j.canrad.2025.104684
Alice Blache , Constance Huck , Vérane Achard , Alexandre Coutte , Maxime Galienne , Jonathan Khalifa , Paul Sargos
{"title":"Hypofractionated radiotherapy in the management of bladder cancer","authors":"Alice Blache ,&nbsp;Constance Huck ,&nbsp;Vérane Achard ,&nbsp;Alexandre Coutte ,&nbsp;Maxime Galienne ,&nbsp;Jonathan Khalifa ,&nbsp;Paul Sargos","doi":"10.1016/j.canrad.2025.104684","DOIUrl":"10.1016/j.canrad.2025.104684","url":null,"abstract":"<div><h3>Purpose</h3><div>Trimodal therapy, combining transurethral resection of the bladder tumour, radiotherapy, and concurrent radiosensitization, is an established bladder-preserving alternative to radical cystectomy in muscle-invasive bladder cancer. Hypofractionated radiotherapy has gained interest due to radiobiological advantages and logistical convenience, yet its efficacy and safety remain under evaluation.</div></div><div><h3>Methods</h3><div>A review of prospective phase II and III trials published between 2000 and 2025 was conducted in Medline using the search engine PubMed. Studies were included if they assessed hypofractionated radiotherapy (excluding stereotactic body radiotherapy) for non-metastatic muscle-invasive bladder cancer within a curative-intent using a trimodal therapy approach. Key endpoints included progression-free survival, overall survival, and toxicity.</div></div><div><h3>Results</h3><div>Seven prospective trials (five phase II, two phase III) were identified. The largest evidence come from the BC2001 and BCON trials, which demonstrated that a dose of 55<!--> <!-->Gy delivered in 20 fractions was non-inferior to a dose of 64<!--> <!-->Gy delivered in 32 fractions in terms of locoregional control and overall survival, with similar genitourinary and gastrointestinal toxicity rates. Additional studies confirmed comparable efficacy between hypofractionated and conventional fractionated radiotherapy regimens. Various concurrent systemic therapies were used, including cisplatin, 5-fluorouracil with mitomycin C, gemcitabine, and carbogen with nicotinamide, though no regimen showed clear superiority. Elective pelvic nodes irradiation remains controversial; one phase III trial showed no benefit, while recent data suggest a potential survival advantage without increased toxicity, even in hypofractionated protocols.</div></div><div><h3>Conclusion</h3><div>Hypofractionated chemoradiotherapy is a safe and effective bladder-preserving strategy in selected patients with muscle-invasive bladder cancer. It offers comparable oncological outcomes and toxicity to conventional radiotherapy, with improved treatment efficiency. While systemic radiosensitization remains essential, further research is needed to optimize agents and clarify the role of pelvic nodes irradiation in hypofractionated settings.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104684"},"PeriodicalIF":1.4,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144739108","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}
引用次数: 0
Radiotherapy: Beyond cancer… 放疗:超越癌症…
IF 1.4 4区 医学
Cancer Radiotherapie Pub Date : 2025-07-29 DOI: 10.1016/j.canrad.2025.104682
Nicolas Giraud , Cécile Ortholan , Magali Quivrin , Mickaël Andraud , Abel Cordoba , Richard Shaffer , Cyrus Chargari , Thomas Leroy
{"title":"Radiotherapy: Beyond cancer…","authors":"Nicolas Giraud ,&nbsp;Cécile Ortholan ,&nbsp;Magali Quivrin ,&nbsp;Mickaël Andraud ,&nbsp;Abel Cordoba ,&nbsp;Richard Shaffer ,&nbsp;Cyrus Chargari ,&nbsp;Thomas Leroy","doi":"10.1016/j.canrad.2025.104682","DOIUrl":"10.1016/j.canrad.2025.104682","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Radiotherapy, long established as a cornerstone of cancer care, has in recent years broadened its therapeutic reach to include a variety of benign and functional disorders. Advances in imaging, motion management, and highly conformal delivery have made it possible to treat non-malignant conditions with precision and minimal collateral damage. For example, stereotactic arrhythmia radioablation offers a noninvasive, single-session option for refractory ventricular tachycardia, markedly reducing arrhythmic burden and device interventions. In the neuroaxis, stereotactic radiosurgery and hypofractionated regimens achieve durable control of benign intracranial tumours – such as meningiomas, vestibular schwannomas, pituitary adenomas, and craniopharyngiomas – while preserving neurological function. Functional radiosurgery further expands treatment possibilities, targeting lesions to alleviate trigeminal neuralgia and movement disorders without the need for open surgery. Beyond the brain, low-dose radiotherapy leverages anti-inflammatory mechanisms to relieve osteoarticular pain and tendinopathies, orbital irradiation mitigates inflammatory signs in Graves’ orbitopathy, and postoperative protocols significantly decrease keloid recurrence. Emerging results from prospective cohorts and multicentre registries demonstrate consistent symptom relief, favourable safety profiles, and notable quality-of-life improvements across these diverse applications. This review synthesizes current clinical practices, technical considerations, and early research findings, and underscores the urgent need for dedicated trials and consensus guidelines. By charting radiotherapy's expanding role in non-cancer settings, we aim to guide multidisciplinary teams and accelerate the development of evidence-based French recommendations.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;div&gt;La radiothérapie, ancrée de longue date comme pilier du traitement du cancer, a vu ces dernières années son champ d’application s’étendre à diverses pathologies bénignes et fonctionnelles. Les progrès en imagerie, en gestion du mouvement et dans la délivrance du traitement permettent de traiter des affections bénignes en minimisant les effets secondaires. Par exemple, la radiothérapie stéréotaxique des arythmies cardiaques est une nouvelle option non invasive en une seule séance pour le traitement des tachycardies ventriculaires réfractaires. En neurologie, la radiothérapie stéréotaxique et les schémas hypofractionnés assurent un contrôle durable des tumeurs intracrâniennes bénignes – telles que les méningiomes, les schwannomes vestibulaires, les adénomes hypophysaires et les craniopharyngiomes – tout en préservant les fonctions neurologiques. De même, elle permet de soulager la névralgie trigéminale et d’améliorer les troubles du mouvement, évitant ainsi le recours à la chirurgie. La radiothérapie à faible dose trouve également de nouvelles indications par ses mécanismes anti-inflammatoires permettant de soulager les doule","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104682"},"PeriodicalIF":1.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724796","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}
引用次数: 0
Hypofractionated radiotherapy for head and neck squamous cell carcinoma 低分割放疗治疗头颈部鳞状细胞癌
IF 1.4 4区 医学
Cancer Radiotherapie Pub Date : 2025-07-29 DOI: 10.1016/j.canrad.2025.104681
Dylan Bocha , Jennifer Le Guevelou , Cécile Ortholan , Benoît Calderon , Yoann Pointreau
{"title":"Hypofractionated radiotherapy for head and neck squamous cell carcinoma","authors":"Dylan Bocha ,&nbsp;Jennifer Le Guevelou ,&nbsp;Cécile Ortholan ,&nbsp;Benoît Calderon ,&nbsp;Yoann Pointreau","doi":"10.1016/j.canrad.2025.104681","DOIUrl":"10.1016/j.canrad.2025.104681","url":null,"abstract":"<div><div>Head and neck squamous cell carcinoma management involves surgery, radiotherapy, and systemic therapies. While normofractionated radiotherapy with concurrent chemotherapy remains standard, alternative fractionation schedules, such as hypofractionation, hold the potential to shorten treatment duration and therefore limit tumour repopulation, as well as improve patient adherence. Studies have explored hypofractionated radiotherapy in both exclusive and postoperative settings for head and neck squamous cell carcinoma. Recent studies like HYPNO randomized phase III trial (delivering 55<!--> <!-->Gy in 20 fractions) and HYPORT phase I study (delivering 46.5<!--> <!-->Gy in 15 fractions) have shown the feasibility and non-inferiority of hypofractionated radiotherapy compared to standard schedules but these results are insufficient to consider hypofractionated radiotherapy in exclusive and postoperative settings. Hypofractionated radiotherapy has been tested in several clinical situations: for early glottic cancer, in elderly patients, for metastatic disease/in palliative context. For early glottic cancers (T1–T2), moderate hypofractionation is a well-established strategy that showed its non-inferiority in terms of disease control and acceptable toxicity, notably in the JCOG0701 trial (delivery of 60 to 64.8<!--> <!-->Gy in 25 to 27 fractions). Stereotactic body radiotherapy for glottic carcinoma has shown encouraging preliminary results in phase I-II studies, particularly when patient selection criteria are applied but caution remains necessary. In elderly patients, split-course hypofractionated radiotherapy reduced fraction number with favourable tolerance profile. The results of the ELAN-RT randomized phase III study support the possibility to prescribe a hypofractionated radiotherapy in elderly people. In palliative settings, hypofractionated radiotherapy regimens such as Christie and Hypo regimens have demonstrated effective symptom control. Overall, hypofractionated radiotherapy represents a promising strategy in selected clinical contexts for head and neck squamous cell carcinoma, but further prospective randomized studies are needed to define optimal indications and confirm long-term outcomes and safety.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104681"},"PeriodicalIF":1.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724197","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}
引用次数: 0
Hypofractionated radiotherapy of central nervous system tumours: Current thoughts in 2025 中枢神经系统肿瘤的低分割放疗:2025年的现状思考
IF 1.5 4区 医学
Cancer Radiotherapie Pub Date : 2025-07-28 DOI: 10.1016/j.canrad.2025.104680
Agathe Margulies , Anaïs Stefani , Delphine Antoni
{"title":"Hypofractionated radiotherapy of central nervous system tumours: Current thoughts in 2025","authors":"Agathe Margulies ,&nbsp;Anaïs Stefani ,&nbsp;Delphine Antoni","doi":"10.1016/j.canrad.2025.104680","DOIUrl":"10.1016/j.canrad.2025.104680","url":null,"abstract":"<div><div>The use of hypofractionated radiotherapy for central nervous system tumours is expanding, particularly due to the increase in reirradiation situations. This article reports a reflection on its use for neurological tumours through five questions illustrated by non-exhaustive clinical examples. Why? We explored the rationale of hypofractionation and its benefits. For whom? We reviewed the different recommendations on indications including patients and tumours which would benefit more of hypofractionation. How? Treatment planning must be careful and adapted to this specific technique, especially in reirradiation cases, and when systemic therapies are involved. When? Timing is the essence, it can be used exclusively, combined with systemic treatment, prior to or after surgery… Why not? Hypofractionation is not suitable for all central nervous system tumours, it may even be contraindicated in some cases.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104680"},"PeriodicalIF":1.5,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144712977","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}
引用次数: 0
BQUATRO audits in radiotherapy: Crossperspectives between auditors and audited departments 放射治疗中的BQUATRO审核:审核员和被审核部门之间的交叉观点
IF 1.5 4区 医学
Cancer Radiotherapie Pub Date : 2025-07-26 DOI: 10.1016/j.canrad.2025.104679
Aude Vaandering , Séverine Cucchiaro
{"title":"BQUATRO audits in radiotherapy: Crossperspectives between auditors and audited departments","authors":"Aude Vaandering ,&nbsp;Séverine Cucchiaro","doi":"10.1016/j.canrad.2025.104679","DOIUrl":"10.1016/j.canrad.2025.104679","url":null,"abstract":"<div><div>Since 2011, the Belgian College of Physicians for Radiation Oncology has implemented a national program of peer-reviewed clinical audits in radiotherapy departments, aiming to enhance quality practices, safety culture, and promote professional experience sharing. This article summarizes the theoretical and practical aspects of this peer audit process providing cross-perspectives of auditors and audited departments. National audits have been carried out using the BQUATRO methodology and framework whereby radiotherapy departments are audited every 5 to 6 years. The audit is carried out by a multidisciplinary team of clinically active radiotherapy professionals. Peer reviewed clinical audits have been carried out in Belgium since 2010 resulting in all radiotherapy departments having been audited at least twice<em>.</em> Audits have helped reinforce team engagement, highlight often-underestimated strengths, and structure continuous improvement initiatives. Auditors have also developed crossfunctional expertise and a better understanding of organizational challenges. The BQUATRO peer-reviewed clinical audit differs from traditional regulatory approaches by its collaborative and constructive posture. It promotes organizational learning and practice alignment among Belgian radiotherapy departments. The peer-reviewed clinical audit process is a strategic lever for improving quality of care in Belgian radiotherapy. Its sustainability and expansion to other countries represent key improvement opportunities for radiotherapy centres.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104679"},"PeriodicalIF":1.5,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144704151","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}
引用次数: 0
Oligometastatic head and neck cancer: Navigating patient trajectories and broader implications 少转移性头颈癌:引导患者轨迹和更广泛的影响
IF 1.5 4区 医学
Cancer Radiotherapie Pub Date : 2025-07-24 DOI: 10.1016/j.canrad.2025.104675
Juliette Thariat , Jihane Lehyanti , Pierre Boisselier , Anouchka Modesto , Sébastien Thureau , Yoann Pointreau , Xu-Shan Sun
{"title":"Oligometastatic head and neck cancer: Navigating patient trajectories and broader implications","authors":"Juliette Thariat ,&nbsp;Jihane Lehyanti ,&nbsp;Pierre Boisselier ,&nbsp;Anouchka Modesto ,&nbsp;Sébastien Thureau ,&nbsp;Yoann Pointreau ,&nbsp;Xu-Shan Sun","doi":"10.1016/j.canrad.2025.104675","DOIUrl":"10.1016/j.canrad.2025.104675","url":null,"abstract":"<div><div>Oligometastatic head and neck squamous cell carcinoma is a distinct clinical state inadequately addressed in current metastatic disease trials. This narrative review is based on historical literature and recently published data of the Omet trial. The Gortec 2014-04 Omet phase II randomized trial investigated whether genuine metachronous oligometastases in head and neck squamous cell carcinoma, characterized by a limited number (up to three) of lesions not induced by prior systemic therapy, may benefit from a “de-escalation strategy” using curative-intent stereotactic ablative radiotherapy alone rather than strategies relying on systemic treatments upfront. Randomized phase II-III trials are scarce on head and neck squamous cell carcinoma. In the Omet trial, survival at 1 year exceeded 85 % in both arms. Progression-free survival was, as anticipated, slightly longer in the group chemotherapy and stereotactic ablative radiotherapy (10 months versus 7.5 months) but without deleterious impact upon metastatic relapse. Stereotactic ablative radiotherapy alone showed significantly lower grade 3–4 toxicity (8.8 % versus 60 %). Quality of life declined less with stereotactic ablative radiotherapy alone. Poor prognostic factors included male sex and multiple metastases. Major protocol deviations correlated with worse outcomes. Stereotactic ablative radiotherapy offers a viable, less toxic alternative to systemic therapy for genuine oligometastatic head and neck squamous cell carcinoma, warranting refined patient selection and further research. Despite its role as a new standard-of-care, the role of immunotherapy remains uncertain in the oligometastatic setting and requires specific studies in oligometastatic head and neck squamous cell carcinoma to challenge this new option.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104675"},"PeriodicalIF":1.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144696459","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}
引用次数: 0
Intelligence artificielle en oncologie radiothérapie : réinventer la formation et préserver l’esprit critique 放射肿瘤学中的人工智能:重塑训练,保持批判性思维
IF 1.5 4区 医学
Cancer Radiotherapie Pub Date : 2025-07-24 DOI: 10.1016/j.canrad.2025.104673
Lucien Lahmi , Jean-Emmanuel Bibault , Yannis Constantinides , Joseph Azria , Véronique Cheval , Catherine Dejean , Catherine Durdux , Angélique Ducteil , Alexandre Escande , Cédric Gesbert , Thibaud Haaser , Gabriel Kobeissi , Claire Lemanski , Moshe Nataf , Charles Raynaud , Sébastien Thureau , Jean-Léon Lagrange , Florence Huguet , Commission éthique de la Société française de radiothérapie oncologique (SFRO)
{"title":"Intelligence artificielle en oncologie radiothérapie : réinventer la formation et préserver l’esprit critique","authors":"Lucien Lahmi ,&nbsp;Jean-Emmanuel Bibault ,&nbsp;Yannis Constantinides ,&nbsp;Joseph Azria ,&nbsp;Véronique Cheval ,&nbsp;Catherine Dejean ,&nbsp;Catherine Durdux ,&nbsp;Angélique Ducteil ,&nbsp;Alexandre Escande ,&nbsp;Cédric Gesbert ,&nbsp;Thibaud Haaser ,&nbsp;Gabriel Kobeissi ,&nbsp;Claire Lemanski ,&nbsp;Moshe Nataf ,&nbsp;Charles Raynaud ,&nbsp;Sébastien Thureau ,&nbsp;Jean-Léon Lagrange ,&nbsp;Florence Huguet ,&nbsp;Commission éthique de la Société française de radiothérapie oncologique (SFRO)","doi":"10.1016/j.canrad.2025.104673","DOIUrl":"10.1016/j.canrad.2025.104673","url":null,"abstract":"<div><div>The growing integration of artificial intelligence is profoundly transforming radiation oncology, particularly through the automation of tasks such as target volume delineation. While artificial intelligence holds the promise of enhancing treatment efficiency and accuracy, it also raises significant ethical and educational concerns: How can we preserve core clinical skills? How can we transmit expertise that is now less frequently practiced? How can we ensure truly informed patient consent in the face of automated systems? And finally, how should we use the time freed up by automation? To address these challenges, medical training must increasingly incorporate critical thinking and algorithmic literacy. The caregiver–patient relationship must remain central, with medical decisions remaining under human responsibility. Artificial intelligence should thus remain a tool in the hands of physicians, not a substitute for clinical judgment. Ethical reflection must accompany every step of artificial intelligence implementation, ensuring its integration is thoughtful, responsible, and human-centred.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104673"},"PeriodicalIF":1.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144696568","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}
引用次数: 0
Adaptive radiotherapy, promises and pitfalls 适应性放疗,承诺与陷阱
IF 1.5 4区 医学
Cancer Radiotherapie Pub Date : 2025-07-19 DOI: 10.1016/j.canrad.2025.104677
Ariane Lapierre , Pierre Blanchard
{"title":"Adaptive radiotherapy, promises and pitfalls","authors":"Ariane Lapierre ,&nbsp;Pierre Blanchard","doi":"10.1016/j.canrad.2025.104677","DOIUrl":"10.1016/j.canrad.2025.104677","url":null,"abstract":"<div><div>Adaptive radiotherapy is a technique that adapts the radiotherapy to the changes of the patient's anatomy and tumour volume by using repeated images acquired during the treatment course. Adaptive radiotherapy aims to optimize the dose distribution, ensure that the tumour remains in the treatment volume and spare the organs at risk. Adaptive radiotherapy can be applied at three timescales: between fractions (offline), immediately before a fraction (online) or real-time (online, during a fraction). Over the last decade, manufacturers have developed linear accelerators dedicated to online adaptive radiotherapy, based on either computed tomography or magnetic resonance imaging. These systems allow for treatment plan adaptation according to deformable, registration-based segmentation and physicist-driven plan optimization. This has led to a rapid rise of this technique on a larger scale, although robust data on its benefits remains scarce. Adaptive radiotherapy has demonstrated dosimetric benefits, such as improved lesion coverage and sparing of organs at risk, in various tumour sites. However, the clinical benefit, in terms of toxicity reduction or improved tumour control, remains to be demonstrated in many disease sites. Furthermore, the implementation of adaptive radiotherapy requires careful planning, increased time, logistics and security, which represents an extra burden and impacts the cost-efficiency of the approach.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104677"},"PeriodicalIF":1.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144662881","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}
引用次数: 0
Intensification or de-escalation? What is the standard treatment for human papillomavirus-related oropharyngeal cancers in 2025? 升级还是降级?2025年人乳头瘤病毒相关口咽癌的标准治疗方案是什么?
IF 1.5 4区 医学
Cancer Radiotherapie Pub Date : 2025-07-18 DOI: 10.1016/j.canrad.2025.104674
Pierre Blanchard , Anne Aupérin , David Veyer , Hélène Péré , Michaël Chevrot , Laure Monard , Caroline Even , Haitham Mirghani
{"title":"Intensification or de-escalation? What is the standard treatment for human papillomavirus-related oropharyngeal cancers in 2025?","authors":"Pierre Blanchard ,&nbsp;Anne Aupérin ,&nbsp;David Veyer ,&nbsp;Hélène Péré ,&nbsp;Michaël Chevrot ,&nbsp;Laure Monard ,&nbsp;Caroline Even ,&nbsp;Haitham Mirghani","doi":"10.1016/j.canrad.2025.104674","DOIUrl":"10.1016/j.canrad.2025.104674","url":null,"abstract":"<div><div>The incidence of human papillomavirus-related oropharyngeal cancers has been increasing steadily for several decades. They have a better prognosis than alcohol- and tobacco-related oropharyngeal cancers because they are more sensitive to radiotherapy and chemotherapy and patients have fewer comorbidities. However, some tumours have a high risk of recurrence, for which intensified therapy may be considered. On the other hand, for forms with a good prognosis, numerous therapeutic de-escalation strategies have been considered. The aim of this article is to review the standard of care in 2025, the various de-escalation strategies, the potential benefits of immunotherapy, and the impact of human papillomavirus on surveillance and screening of these cancers.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104674"},"PeriodicalIF":1.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144662984","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}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信