Cancer Radiotherapie最新文献

{"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":"2025-09-01","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}

{"title":"Nouveaux éclairages sur la mise en état buccodentaire avant une radiothérapie affectant la cavité buccale","authors":"Fiorenza Dal Cortivo ,&nbsp;Sabah Falek ,&nbsp;Bérengère Phulpin ,&nbsp;Juliette Thariat","doi":"10.1016/j.canrad.2025.104672","DOIUrl":"10.1016/j.canrad.2025.104672","url":null,"abstract":"<div><h3>Purpose</h3><div>Radiotherapy, when it affects the oral cavity, can cause various side-effects and may even lead to more severe complications such as osteoradionecrosis. The development in radiotherapy and dental care techniques, has enabled the optimization of oral management before radiotherapy, enhancing treatment outcomes and reducing side effects. This research focuses on the latest advances in oral health and dental rehabilitation in the context of radiation therapy, comparing them to historical recommendations and discussing their indications.</div></div><div><h3>Material and methods</h3><div>A bibliographic search using the search engine PubMed, between 2009 and 2024, was carried out to evaluate the evolution of oral conditioning and dental rehabilitation in the context of radiotherapy.</div></div><div><h3>Results</h3><div>A total of 215 references were retrieved (first 155 references, then 60 more added secondarily). Recommendations have changed over time, prioritizing a more conservative stance aimed at preserving oral functionality and preventing the nutritional and psychological deficits secondary to edentulism. The development of new materials and strategies in dental care and implantology and the evolution of radiotherapy techniques and software, have made it possible to optimize oral management before radiotherapy and to create, for the first time, a personalized and precise ‘dossier’, which may change the way in which planning before radiotherapy and the patient's quality of life are considered.</div></div><div><h3>Conclusion</h3><div>New practices, techniques and recommendations have emerged in the last decade to reduce radiation morbidity and improve rehabilitation.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 4","pages":"Article 104672"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144634484","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":"Qualitative evaluation of automatic liver segmentation in computed tomography images for clinical use in radiation therapy","authors":"Dorea Maria Khalal ,&nbsp;Souleyman Slimani ,&nbsp;Zine Eddine Bouraoui ,&nbsp;Hacene Azizi","doi":"10.1016/j.canrad.2025.104648","DOIUrl":"10.1016/j.canrad.2025.104648","url":null,"abstract":"<div><h3>Purpose</h3><div>Segmentation of target volumes and organs at risk on computed tomography (CT) images constitutes an important step in the radiotherapy workflow. Artificial intelligence-based methods have significantly improved organ segmentation in medical images. Automatic segmentations are frequently evaluated using geometric metrics. Before a clinical implementation in the radiotherapy workflow, automatic segmentations must also be evaluated by clinicians. The aim of this study was to investigate the correlation between geometric metrics used for segmentation evaluation and the assessment performed by clinicians.</div></div><div><h3>Materials and Methods</h3><div>In this study, we used the U-Net model to segment the liver in CT images from a publicly available dataset. The model's performance was evaluated using two geometric metrics: the Dice similarity coefficient and the Hausdorff distance. Additionally, a qualitative evaluation was performed by clinicians who reviewed the automatic segmentations to rate their clinical acceptability for use in the radiotherapy workflow. The correlation between the geometric metrics and the clinicians’ evaluations was studied.</div></div><div><h3>Results</h3><div>The results showed that while the Dice coefficient and Hausdorff distance are reliable indicators of segmentation accuracy, they do not always align with clinician segmentation. In some cases, segmentations with high Dice scores still required clinician corrections before clinical use in the radiotherapy workflow.</div></div><div><h3>Conclusion</h3><div>This study highlights the need for more comprehensive evaluation metrics beyond geometric measures to assess the clinical acceptability of artificial intelligence-based segmentation. Although the deep learning model provided promising segmentation results, the present study shows that standardized validation methodologies are crucial for ensuring the clinical viability of automatic segmentation systems.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 4","pages":"Article 104648"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144279702","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":"Comparison of static and dynamic intensity-modulated radiotherapy for nasopharyngeal carcinoma: Dosimetric and normal tissue complication probability analysis","authors":"Oumaima Mendessi ,&nbsp;Bilel Daoud ,&nbsp;Omar Nouri ,&nbsp;Wafa Mnejja ,&nbsp;Tarek Sahnoun ,&nbsp;Jamel Daoud ,&nbsp;Leila Farhat","doi":"10.1016/j.canrad.2025.104645","DOIUrl":"10.1016/j.canrad.2025.104645","url":null,"abstract":"<div><h3>Purpose</h3><div>With the advancement of radiotherapy techniques for nasopharyngeal carcinoma, it is essential to evaluate the comparative effectiveness of volumetric-modulated arc therapy and intensity-modulated radiotherapy. This study aimed to evaluate the dosimetric and radiobiological differences between the two techniques for the treatment of nasopharyngeal carcinomas.</div></div><div><h3>Materials and methods</h3><div>This retrospective study involved replanning of 125 cases of nasopharyngeal carcinoma using both intensity-modulated radiotherapy and volumetric-modulated arc therapy techniques. Dosimetric evaluation was performed using dose–volume histogram parameters, while radiobiological analysis was conducted using normal tissue complication probability models. Target coverage (dose delivered to 95 % of the high-risk planning target volume), mean dose, and maximum dose to organs at risk, as well as normal tissue complication probability values, were compared between the two techniques.</div></div><div><h3>Results</h3><div>Both intensity-modulated radiotherapy and volumetric-modulated arc therapy provided comparable dosimetric outcomes. Volumetric-modulated arc therapy showed advantages in certain parameters, with a higher dose delivered to 95 % of the high-risk planning target volume and lower maximum dose for the right and left optic nerves, chiasma, and lenses. Conversely, intensity-modulated radiotherapy provided better sparing of the parotid glands, resulting in lower normal tissue complication probability values. The larynx, pharynx, and thyroid also received lower mean doses with intensity-modulated radiotherapy. The results remained consistent in subgroups of both early and advanced stages of nasopharyngeal carcinoma.</div></div><div><h3>Conclusion</h3><div>Intensity-modulated radiotherapy and volumetric-modulated arc therapy both have distinct advantages in treating nasopharyngeal carcinoma. Organs at risk protected vary between the two techniques. The radiobiological parameters, including normal tissue complication probability models and dosimetric measures, highlight the differential benefits of each technique.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 4","pages":"Article 104645"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365097","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":"Neoadjuvant chemoradiotherapy for oesophageal cancer: Primary tumour/lymph node regression inconsistency and prognostic value analysis","authors":"Zhang Xiaoyuan ,&nbsp;Wang Yong ,&nbsp;Yanbin Wang","doi":"10.1016/j.canrad.2025.104671","DOIUrl":"10.1016/j.canrad.2025.104671","url":null,"abstract":"<div><h3>Purpose</h3><div>Tumour regression grade is an important prognostic indicator for patients undergoing neoadjuvant chemoradiotherapy. However, there is significant controversy regarding the prognostic implications when there is discordance between tumour regression grade in the primary tumour and lymph nodes. This study aims to clarify the impact of tumour regression grade discordance on prognosis for oesophageal cancer and identify potential causes for such discrepancies.</div></div><div><h3>Material and method</h3><div>A total of 112 patients with oesophageal squamous cell carcinoma who received neoadjuvant chemoradiotherapy followed by surgical treatment were included. Cox univariate analysis was performed to evaluate the relationship between primary tumour regression grade, lymph node regression grade, and both recurrence-free survival and overall survival. Logistic univariate analysis was employed to identify factors contributing to primary tumour and lymph node regression grade discordance.</div></div><div><h3>Results</h3><div>Primary tumour and lymph node regression grades, and nodal pathologic classification after preoperative therapy were significant factors influencing both recurrence-free and overall survival of patients with oesophageal cancer. Discordance between primary tumour and lymph node regression grades was observed in 38.4 % of cases. Factors such as radiotherapy modality (involved field or elective nodal irradiation), and the number of lymph nodes dissected were found to significantly affect the consistency between primary tumour and lymph node regression grades. When tumour regression grade discordance occurred, lymph node status had a more significant prognostic impact than the primary tumour.</div></div><div><h3>Conclusion</h3><div>Both primary tumour and lymph node regression grades are critical factors influencing recurrence-free survival. The number of lymph nodes dissected and the radiotherapy modality may contribute to discordance between the two indices. When discordance occurs, lymph node regression grade may hold more prognostic value than that of the primary tumour.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 4","pages":"Article 104671"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631324","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":"Observation of the efficacy and safety of concurrent intensity-modulated radiation with 5-fluorouracil and oxaliplatin for locally advanced nasopharyngeal carcinoma","authors":"Li Yanbing,&nbsp;Cai Lingyu,&nbsp;Zuo Hongbo,&nbsp;Li Zijun","doi":"10.1016/j.canrad.2025.104668","DOIUrl":"10.1016/j.canrad.2025.104668","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study was to investigate the clinical efficacy and safety of concurrent intensity-modulated radiotherapy in combination with 5-fluorouracil and oxaliplatin for patients diagnosed with locally advanced nasopharyngeal carcinoma.</div></div><div><h3>Material and methods</h3><div>A total 66 patients with a newly diagnosed and previously treated locally advanced nasopharyngeal carcinoma were enrolled in this study. The patients were divided into two groups: the control group receiving intensity-modulated radiotherapy with 5-fluorouracil and cisplatin (<em>n</em> <!-->=<!--> <!-->33) and the observation group receiving intensity-modulated radiotherapy with 5-fluorouracil and oxaliplatin (<em>n</em> <!-->=<!--> <!-->33). Short-term efficacy, 6-month survival rate, recurrence rate, and distant metastasis rate of tumours were compared between the two groups. Furthermore, the incidence of treatment-related adverse reactions including nausea and vomiting, thrombocytopenia, hepatorenal syndrome, peripheral neuritis, and oral mucosa reaction was recorded.</div></div><div><h3>Results</h3><div>The overall efficacy rate of short-term treatment in the observation group was 96.97 %, compared to 93.94 % in the control group, indicating no statistically significant difference (<em>p</em> <!-->&gt;<!--> <!-->0.05). There were no significant differences observed between the two groups in terms of 6-month survival rate, recurrence rate, and distant metastasis rate (<em>p</em> <!-->&gt;<!--> <!-->0.05). The incidence of adverse reactions during treatment was 21.21 % in the observation group, which was significantly lower than that of 45.45 % in the control group (<em>p</em> <!-->&lt;<!--> <!-->0.05).</div></div><div><h3>Conclusion</h3><div>Concurrent intensity-modulated radiation therapy with 5-fluorouracil and oxaliplatin may achieve similar short-term outcomes as the standard regimen of 5-fluorouracil and cisplatin in the treatment of locally advanced nasopharyngeal carcinoma, with the added benefit of reduced toxicity.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 4","pages":"Article 104668"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571740","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":"Prise en charge de la gynécomastie à l’ère des inhibiteurs des récepteurs aux androgènes chez les patients atteints de cancer de la prostate","authors":"Nassim Vibert ,&nbsp;Vérane Achard ,&nbsp;Pierre Pouvreau ,&nbsp;Constance Huck ,&nbsp;Jonathan Khalifa ,&nbsp;Paul Sargos","doi":"10.1016/j.canrad.2025.104665","DOIUrl":"10.1016/j.canrad.2025.104665","url":null,"abstract":"<div><div>This review aims to evaluate the incidence, clinical impact, and available therapeutic options for the management of gynecomastia induced by hormonal therapy, particularly in the era of androgen receptor pathway inhibitors, in patients with prostate cancer. We analysed data from clinical trials evaluating the incidence of gynecomastia under androgen receptor pathway inhibitors and the efficacy of both prophylactic and curative strategies, primarily tamoxifen and male breast radiotherapy, in patients receiving bicalutamide. Androgen receptor pathway inhibitors monotherapy is associated with high rates of gynecomastia (34 to 55 %), whereas combining androgen receptor pathway inhibitors with chemical castration significantly reduces this risk. Prophylactic tamoxifen significantly decreases gynecomastia incidence (down to 10 % versus 73 % without treatment) with good overall tolerance; prophylactic breast radiotherapy also shows efficacy. In the curative setting, tamoxifen appears more effective than radiotherapy, while surgery remains an invasive fallback option. However, extrapolating results obtained with bicalutamide to second-generation androgen receptor pathway inhibitors remains uncertain due to pharmacological and clinical differences. Gynecomastia could become a major complication of androgen receptor pathway inhibitors monotherapy. To date, tamoxifen and prophylactic breast radiotherapy are the most validated strategies, with the former appearing more effective. Further studies are needed to confirm their specific efficacy and safety in patients treated with androgen receptor pathway inhibitors.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 4","pages":"Article 104665"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365583","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":"Failure patterns analysis of three-dimensional radiotherapy for stage IV non-small cell lung cancer primary tumours","authors":"Wei Zhang,&nbsp;Xin Yu Wu,&nbsp;Jie Liu,&nbsp;Wen Gang Yang,&nbsp;Xia Xia Chen,&nbsp;Bing Lu","doi":"10.1016/j.canrad.2025.104667","DOIUrl":"10.1016/j.canrad.2025.104667","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study was to investigate the failure patterns of three-dimensional radiotherapy of primary tumours combined with first-line systemic therapy and the influence of radiotherapy-related factors for stage IV non-small cell lung cancer.</div></div><div><h3>Material and methods</h3><div>Seven hundred and forty-eight cases with the initial diagnosis of stage IV non-small cell lung cancer that met the inclusion criteria were selected from 1509 cases registered from March 2003 to July 2021 for univariate analysis and failure patterns test using the chi-square test. Kaplan-Meier survival analysis was performed with the log-rank test and Cox regression model for multifactor prognostic analysis. A value of <em>P</em> below 0.05 indicated a statistically significant difference.</div></div><div><h3>Results</h3><div>The failure incidence of first-line treatment was 72.3 % in 748 cases and 33.6 % within 6<!--> <!-->months, 38.8 % between 6 and 12<!--> <!-->months, 19.4 % between 12 and 24<!--> <!-->months and 8.1 % after 24<!--> <!-->months. A significant difference was observed in the median survival time, which was 7.2, 13.4, 22.2, and 37.6<!--> <!-->months (<em>χ</em>² <!-->=<!--> <!-->324.580, <em>p</em> <!-->&lt;<!--> <!-->0.000), respectively. The incidence of recurrent failure was 20.4 %. A decrease was observed in the recurrence rate with the increasing dose of radiotherapy to the primary tumour, and no significant difference in the incidence of recurrent failure was observed between oligometastatic and non-oligometastatic tumours. The incidence of metastatic failure was 89.4 %, with the order of incidence as follows (from highest to lowest): brain, bone, lung, liver, pleural cavity, distant lymph nodes, adrenal gland, other body parts. The incidence of additional metastases was approximately 50 %, and the progression of synchronous metastases concerned approximately one third of the cases. The metastatic status, time of treatment failure, pathology type, gender, and at least 63<!--> <!-->Gy during the same period of four to six cycles of chemotherapy were independent factors in the prediction of prognosis.</div></div><div><h3>Conclusion</h3><div>The failure patterns of radiotherapy for primary tumours in stage IV non-small cell lung cancer was different from that of first-line systemic therapy alone, with significantly lower local failure, predominant metastatic failure, and the highest incidence of brain metastases. The later treatment failure occurs, the longer will be the oligometastatic status. Oligometastatic cancer, female sex, non-squamous cell carcinoma, the late occurrence of treatment failure, and at least 63<!--> <!-->Gy concurrent four to six cycles of chemotherapy were independent prognostic factors for prolonged survival.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 4","pages":"Article 104667"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365584","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":"Artificial intelligence for radiotherapy dose prediction: A comprehensive review","authors":"Arezoo Kazemzadeh ,&nbsp;Reza Rasti ,&nbsp;Mohammad Bagher Tavakoli","doi":"10.1016/j.canrad.2025.104630","DOIUrl":"10.1016/j.canrad.2025.104630","url":null,"abstract":"<div><div>Patient outcomes are significantly impacted by the effectiveness and quality of radiation treatment planning. Deep learning, a branch of artificial intelligence, is a potent tool for enhancing and automating dose prediction processes. This article provides a comprehensive and critical analysis of deep learning-based dose prediction methods in radiotherapy, with a focus on convolutional neural networks. A comprehensive search throughout Elsevier Scopus®, Medline, and Web of Science™ literature databases was conducted to locate relevant papers published between 2018 and 2024. The use of deep learning methods for dose prediction is thoroughly examined in this paper. Analysis of these dose prediction approaches provides valuable insights into the potential of this technology to improve radiation treatment planning, particularly in the critical area of automating the dose prediction process. The findings aim to guide future research and facilitate the safe and effective integration of artificial intelligence in clinical workflows.</div></div><div><div>Les résultats des traitements pour les patients sont fortement influencés par l’efficacité et la qualité de la planification du traitement par radiothérapie. L’apprentissage profond, une branche de l’intelligence artificielle, est un outil puissant pour améliorer et automatiser les processus de prédiction des doses. Cet article fournit une analyse complète et critique des méthodes de prédiction des doses basées sur l’apprentissage profond dans le cadre de la radiothérapie, en se concentrant sur les réseaux neuronaux convolutifs. Une recherche approfondie dans les bases de données bibliographiques Elsevier Scopus®, Medline et Web of Science™ a été effectuée pour localiser les articles pertinents publiés entre 2018 et 2024. L’utilisation des méthodes d’apprentissage profond pour la prédiction des doses a été examinée en détail dans cet article. L’analyse de ces approches de prédiction des doses offre des perspectives précieuses sur le potentiel de cette technologie pour améliorer la planification des traitements par irradiation, en particulier dans le domaine critique de l’automatisation du processus de prédiction des doses. Les résultats visent à guider les recherches futures et à faciliter l’intégration sûre et efficace de l’intelligence artificielle dans les flux de travail cliniques.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 4","pages":"Article 104630"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144261911","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":"Evaluation of 30-day mortality after palliative radiotherapy of 8 Gy in a single fraction as a quality criteria of patient management in a university hospital","authors":"Kevin Quintin,&nbsp;Jean-Marc Simon,&nbsp;Philippe Maingon,&nbsp;Mickaël Andraud,&nbsp;Alexandra Gabro,&nbsp;Julian Jacob,&nbsp;Cyrus Chargari","doi":"10.1016/j.canrad.2025.104670","DOIUrl":"10.1016/j.canrad.2025.104670","url":null,"abstract":"<div><h3>Purpose</h3><div>Palliative radiotherapy aims to relieve cancer-related complications (pain, bleeding, external compression) and improve patients’ quality of life. The 8<!--> <!-->Gy single-fraction regimen is the most commonly used, as it is effective and convenient to patients. Given that the therapeutic effect of palliative radiotherapy may take several weeks to manifest, a 30-day mortality rate below 16 % is considered a quality criteria, since a higher mortality rate would indicate overtreatment of patients who would not benefit from radiotherapy. Our objective was to determine the 30-day mortality rate following single-fraction 8<!--> <!-->Gy palliative radiotherapy in the radiotherapy department of Pitié-Salpêtrière hospital (Paris, France) during the year 2023.</div></div><div><h3>Material and method</h3><div>We conducted a retrospective study including patients treated between January 2nd and December 31st, 2023, regardless of the primary cancer type or the indication for palliative radiotherapy. Mortality was assessed 30 days after radiotherapy. Factors associated with earlier death were analysed using univariate and multivariate analyses, including the following variables: primary cancer type, gender, 3–4 performance status (according to the World Health Organisation), number of systemic treatment lines received, radiotherapy indication, need for hospitalization, and multiple irradiation sites.</div></div><div><h3>Results</h3><div>A total of 125 patients were included in the study. Among them, 18 patients (14.4 %) received two treatments within the year, leading to a total of 143 radiation treatments delivered. Radiotherapy was primarily intended for pain relief in more than 86 % of cases (94 % for bone metastases, 6 % for epiduritis), while haemostatic and decompressive indications accounted for 3 % of cases each. In this cohort, the 30-day mortality rate was 11 %. However, in the subgroup of 11 patients treated with haemostatic intent, the 30-day mortality rate was significantly higher (46 %). A performance status greater than 2 was significantly associated with a higher 30-day mortality rate (odds ratio: 2.6, <em>P</em> <!-->&lt;<!--> <!-->0.01).</div></div><div><h3>Conclusion</h3><div>Our study estimates the 30-day mortality rate at 11 % following single-fraction 8<!--> <!-->Gy palliative radiotherapy among the 125 patients treated for this indication at Pitié-Salpêtrière Hospital in 2023. This study demonstrates the feasibility of using this simple quality criteria as an indicator for internal or external audit evaluations.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 4","pages":"Article 104670"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549226","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}