Clinical and Translational Radiation Oncology最新文献

{"title":"Magnetic resonance imaging to detect tumor hypoxia in brain malignant disease: A systematic review of validation studies","authors":"Y. Bai ,&nbsp;E.C. Osmundson ,&nbsp;M.J. Donahue ,&nbsp;J.B. De Vis","doi":"10.1016/j.ctro.2025.100940","DOIUrl":"10.1016/j.ctro.2025.100940","url":null,"abstract":"<div><div>Tumor hypoxia indicates a worse prognosis in brain malignancies; however, current gold-standard methods for assessing tumor hypoxia are invasive and often inaccessible. Magnetic Resonance Imaging (MRI) is widely available, but its validity for identifying tumor hypoxia or hypoxia-related neoangiogenesis is not well characterized. A systematic literature search was performed across PubMed and Embase Databases. The search query identified MRI studies that validated hypoxia-surrogate imaging sequences against gold-standard hypoxia or neoangiogenesis detection methods in patients with brain malignancies. Literature screen identified 23 manuscripts published between 2007 and 2022. Among conventional MRI sequences, peritumoral edema and signal change after contrast administration were associated with gold-standard oxygen-assessment methods. T2*- and T2′-derived measures were associated with gold-standard methods, while reports on quantitative measures of oxygen extraction fraction were conflicting. Fiber density, tissue cellularity, blood volume, vascular transit time, and permeability measurements were associated with gold-standard methods, whereas blood flow measurements yielded conflicting results. MRI measures are promising surrogates for tumor hypoxia or hypoxia-related neoangiogenesis. Additional studies are needed to reconcile disparate findings. Future sensitivity analyses are needed to establish the MRI methods most accurate at identifying tumor hypoxia.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100940"},"PeriodicalIF":2.7,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes and risk factors for local failure and visual impairment in patients treated with Ru-106 brachytherapy for uveal melanoma","authors":"L.J. Pors ,&nbsp;M. Marinkovic ,&nbsp;H.H. Deuzeman ,&nbsp;T.H.K. Vu ,&nbsp;E.M. Kerkhof ,&nbsp;K.M. van Wieringen-Warmenhoven ,&nbsp;C.R.N. Rasch ,&nbsp;J.C. Bleeker ,&nbsp;L.S. Koetsier ,&nbsp;J.W.M. Beenakker ,&nbsp;G.P.M. Luyten ,&nbsp;C.L. Creutzberg ,&nbsp;N. Horeweg","doi":"10.1016/j.ctro.2025.100939","DOIUrl":"10.1016/j.ctro.2025.100939","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Small uveal melanomas are preferably treated with eye-sparing therapies such as brachytherapy or proton beam therapy. Knowledge of clinical outcomes and risk factors is important for personalized patient counselling.</div></div><div><h3>Materials and methods</h3><div>Data of all choroidal melanoma patients treated at the Leiden University Medical Center between 2012–2019 with Ruthenium-106 brachytherapy were collected. Time-to-event analyses were performed with the Kaplan-Meier method, risk factors for local failure and visual acuity (VA) decline were identified using Cox proportional hazards models with predefined covariates.</div></div><div><h3>Results</h3><div>719 patients were included. Median tumour prominence and diameter were 3.8 mm and 11.6 mm, respectively. 52 % of tumours were centrally located, and 19 % were juxtapapillary. Five-year overall survival, eye retention and local failure rates were 83 %, 95 %, and 8 %, respectively. Juxtapapillary location, lower tumour apex doses, and T3-4 tumour stage were significantly associated with local failure. Patients with juxtapapillary tumours had 20 % risk of local failure. Five years posttreatment, 47 % of patients had no functional visual impairment (Snellen VA ≥ 0.5). Lasting functional visual impairment was associated with baseline vision, central tumours, and scleral dose. Patients with central tumours had 75 % risk of mild or worse visual impairment after 5 years.</div></div><div><h3>Conclusion</h3><div>Ruthenium-106 brachytherapy yields good local control and visual outcomes in patients with choroidal melanoma. Juxtapapillary tumours have a high risk of local failure and alternative therapies should be considered in these patients, if available. Patients with central tumours, and those with decreased pre-treatment vision should be counselled on the risk of visual impairment.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100939"},"PeriodicalIF":2.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The doses to Organs at risk and their Proximity to target volumes are crucial Determinants of brachytherapy toxicity","authors":"Erkan Topkan ,&nbsp;Efsun Somay ,&nbsp;Duriye Ozturk ,&nbsp;Ugur Selek","doi":"10.1016/j.ctro.2025.100937","DOIUrl":"10.1016/j.ctro.2025.100937","url":null,"abstract":"","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100937"},"PeriodicalIF":2.7,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143478925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recovery of quality of life in 574 patients with inoperable lung cancer undergoing (chemo)radiotherapy","authors":"Marloes Nies ,&nbsp;Robin Wijsman ,&nbsp;Olga Chouvalova ,&nbsp;Fred J.F. Ubbels ,&nbsp;Harriët J. Elzinga ,&nbsp;Ellen Haan-Stijntjes ,&nbsp;Marleen Woltman-van Iersel ,&nbsp;Pieter R.A.J. Deseyne ,&nbsp;Stefanie A. de Boer ,&nbsp;Johannes A. Langendijk ,&nbsp;Joachim Widder ,&nbsp;Anne G.H. Niezink","doi":"10.1016/j.ctro.2025.100935","DOIUrl":"10.1016/j.ctro.2025.100935","url":null,"abstract":"<div><h3>Introduction</h3><div>Quality of life (QoL) of patients with inoperable lung cancer can be negatively affected by both the disease and its treatment, generally consisting of (chemo)radiotherapy. The aim of this study was to prospectively assess QoL in patients with inoperable lung cancer, treated with (chemo)radiotherapy and to assess whether patient- and/or treatment-related characteristics were associated with poorer QoL.</div></div><div><h3>Methods</h3><div>This prospective cohort study evaluated QoL and patient-, tumor-, and treatment characteristics from inoperable lung cancer patients, treated with fractionated (≥40 Gy) (chemo)radiotherapy. Patients were evaluated at baseline, upon finishing radiotherapy, and 3 months, 6 months, 1 year, and yearly thereafter up to 5 years after radiotherapy. The QoL assessment consisted of questionnaires evaluating lung cancer-specific and treatment-related complaints using scale scores.</div></div><div><h3>Results</h3><div>Compliance rates of the 574 analyzed patients ranged from 87 to 97 % during follow-up. Complaints increased after radiotherapy, as the QoL scale scores increased from median 8 (interquartile range, IQR 4–14) to 17 (IQR 4–25) after completing radiotherapy (P &lt; 0.0004), indicating more complaints. From 3 months to 24 months of follow-up, scale scores returned to a median of 13, but were significantly higher compared to baseline (P &lt; 0.0004). However, no clinically relevant differences compared to baseline were observed. Patients with pulmonary comorbidity and WHO scores ≥ 2 generally reported more complaints.</div></div><div><h3>Conclusion</h3><div>Patients experienced a temporary increase in complaints after finishing (chemo)radiotherapy, QoL returned to baseline level and remained stable up to five years of follow-up.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100935"},"PeriodicalIF":2.7,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mepitel® film versus standard care for the prevention of skin toxicity in breast cancer patients treated with adjuvant radiotherapy: A randomized controlled trial","authors":"Dario Valcarenghi ,&nbsp;Angela Tolotti ,&nbsp;Hansjoerg Vees ,&nbsp;Valter Torri ,&nbsp;Sarah Jayne Liptrott ,&nbsp;Giovanni Presta ,&nbsp;Andrea Puliatti ,&nbsp;Laura Moser ,&nbsp;Davide Sari ,&nbsp;Mariacarla Valli","doi":"10.1016/j.ctro.2025.100936","DOIUrl":"10.1016/j.ctro.2025.100936","url":null,"abstract":"<div><h3>Background &amp; purpose</h3><div>Radiotherapy plays a key role in breast cancer treatment however, radiation-induced dermatitis can impact on treatment delivery and patient quality of life.</div><div>The primary outcome was to compare Mepitel® Film versus standard treatment in preventing radiotherapy skin toxicity onset.</div></div><div><h3>Methods</h3><div>A multicentre randomised controlled phase III study compared standard treatment (aqueous-urea cream − Excipial U hydrolotion applied at the beginning of radiotherapy and antiseptic cream − Flammazine or Ialugen Plus applied at the onset of moist desquamation) versus Mepitel® Film in patients with breast cancer undergoing post-operative radiotherapy. The primary outcome was the proportion of moist desquamation (RTOG score ≥ 2) in the experimental and control groups.</div></div><div><h3>Results</h3><div>During the study (2016–2020), 161 patients were randomized, 154 (95.7 %) were evaluable. Skin toxicity Radiation Therapy Oncology Group (RTOG) score ≥ 2 was observed in 9.5 % and 13.9 % of experimental and control groups respectively (Relative Risk = 0.68, 95 %CI 0.28–1.66; p = 0.393). RTOG scores &gt; 0 were 90.5 % and 94.9 % in experimental and control groups respectively (Relative Risk = 0.95, 95 %CI 0.87–1.04; p = 0.294).</div><div>Multivariable analysis, controlled for age, diabetes, BMI and smoking exposure, showed a risk reduction of RTOG &gt; 0 of 38 % (HR = 0.62 95 %CI 0.49–0.96, p = 0.028), and a risk reduction of RTOG &gt; 1 of 33 % (HR = 0.67 95 %CI 0.26–1.76, p = 0.420) in the experimental group.</div><div>The median time to recovery from RTOG grade &gt; 0 toxicity was 17 and 32 days for experimental and control groups, respectively (p = 0.027). At multivariable analysis, time to recovery was 38 % faster in the experimental group (HR = 1.38 95 %CI (0.99–1.93) p = 0.059).</div></div><div><h3>Conclusions</h3><div>Although the study did not demonstrate a statistically significant reduction in RTOG &gt; 2 skin toxicity, there was evidence of a reduction in the rate of skin toxicity and an improvement in time to recovery. The device was well tolerated by patients.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100936"},"PeriodicalIF":2.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective radiotherapy quality Assurance leads to delineation guideline refinements for recurrent rectal cancer: Experience from the PelvEx II study","authors":"F. Piqeur ,&nbsp;B.J.P. Hupkens ,&nbsp;D.M.J. Creemers ,&nbsp;S. Nordkamp ,&nbsp;M. Berbee ,&nbsp;J. Buijsen ,&nbsp;H.J.T. Rutten ,&nbsp;C.A.M. Marijnen ,&nbsp;J.W.A. Burger ,&nbsp;H.M.U. Peulen","doi":"10.1016/j.ctro.2025.100934","DOIUrl":"10.1016/j.ctro.2025.100934","url":null,"abstract":"<div><h3>Introduction</h3><div>Target volume delineation in locally recurrent rectal cancer (LRRC) is clinically challenging. To ensure the quality of chemoradiotherapy (CRT) within the PelvEx II trial, a delineation guideline was developed and prospective quality assurance (QA) was instated for all patients. Guideline adherence, the impact of QA on target volumes, and subsequent guideline refinements are described in this paper.</div></div><div><h3>Methods and materials</h3><div>All PelvEx II patients, either RT naive patients (50–50.4 Gy) or reirradiation (30 Gy) patients, were eligible for QA prior to CRT. An online meeting with the treating physician and the QA team was planned for each patient prior to treatment, to peer review delineations. Adherence to each of the 7 (reirradiation) or 8 (RT naive) guideline recommendations was scored. Suggested target volume adjustments and any reasons to deviate from protocol were noted. When applicable, target volumes before and after QA were compared. Possible protocol refinements were discussed amongst the trial QA team.</div></div><div><h3>Results</h3><div>Prospective review of 113 cases of LRRC was performed, resulting in a high QA compliance rate of 90 %. All guideline recommendations were followed in 53 % of cases. Changes to the GTV and CTV were advised in 21 and 39 cases respectively. A median increase of GTV (+29 % (p &lt; 0.001)) and CTV (+15 % (p &lt; 0.001)) was seen in reirradiation patients, versus a median CTV increase of + 6 % (p = 0.002) in RT naive patients following QA. Deviations from protocol were accepted in 30 cases (27 %). Thirteen protocol refinements were agreed upon.</div></div><div><h3>Conclusion</h3><div>Peer-review of LRRC target volumes leads to altered target volumes in up to 48% of cases, resulting in an updated delineation guideline.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100934"},"PeriodicalIF":2.7,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of 18F-FET-PET- and MRI-based target definition for re-irradiation treatment of recurrent diffuse glioma","authors":"Albert Everard ,&nbsp;Daniel Versnel ,&nbsp;Veerle Ruijters ,&nbsp;Nelleke Tolboom ,&nbsp;Marielle Philippens ,&nbsp;Tom Snijders ,&nbsp;Joost Verhoeff ,&nbsp;Szabolcs David ,&nbsp;Casper Beijst","doi":"10.1016/j.ctro.2025.100931","DOIUrl":"10.1016/j.ctro.2025.100931","url":null,"abstract":"<div><h3>Background and purpose</h3><div>The target area definition for re-irradiation of recurrent glioma typically relies on T1-weighted gadolinium-enhanced MRI (T1Gd), but T1Gd fails to capture glioma infiltration. While T2 FLAIR and CTV margins can address this limitation, their extend in re-irradiation remains debated to minimize toxicity. In contrast, ¹⁸F-FET-PET imaging can better visualize infiltrative components, improving target definition. This study investigates the role of ¹⁸F-FET-PET in target definition by analyzing shape differences and gray-white matter tissue composition.</div></div><div><h3>Material and methods</h3><div>Retrospective data from 36 patients with recurrent glioma were used. These patients underwent ¹⁸F-FET-PET, on which Biological Tumor Volume (BTV_PET) was delineated, and T1Gd, on which Gross Tumor Volume (GTV_MRI) and Clinical tumor volume (CTV_MRI) were delineated. Lesion volume, shape (Hausdorff distance (HD) and Center of Mass Distance (CoM-D)), tissue composition and re-recurrence volume were compared between the delineations.</div></div><div><h3>Results</h3><div>BTV_PET and the non-overlapping BTV_PET-GTV_MRI volumes were significantly larger than GTV_MRI and non-overlapping GTV_MRI-BTV_PET (P &lt; 0.001), but significantly smaller than the CTV_MRI (P &lt; 0.001). The median HD and CoM-D were 19 mm and 6 mm. A correlation was found between the white matter (WM) ratio in GTV_MRI and WM in non-overlapping BTV_PET (slope = 0.36, R² = 0.36;P &lt; 0.001) and a correlation with gray matter (GM) in non-overlapping BTV_PET (slope = -0.15, R² = 0.11;P &lt; 0.05). Recurrence after reirradiation was significantly higher within BTV_PET than GTV_MRI (P &lt; 0.001). The ratio of the GTV_MRI which recurred was significantly higher than the non-overlapping BTV_PET (P &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Our results suggest that ¹⁸F-FET-PET reveals a more complete extent of glioma’s infiltration, suggesting that the current practice of using isotropic CTV margins around the T1Gd-GTV should be reconsidered in favor of anisotropic CTV based on ¹⁸F-FET-PET.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100931"},"PeriodicalIF":2.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A fully automated machine-learning-based workflow for radiation treatment planning in prostate cancer","authors":"Jan-Hendrik Bolten ,&nbsp;David Neugebauer ,&nbsp;Christoph Grott ,&nbsp;Fabian Weykamp ,&nbsp;Jonas Ristau ,&nbsp;Stephan Mende ,&nbsp;Elisabetta Sandrini ,&nbsp;Eva Meixner ,&nbsp;Victoria Navarro Aznar ,&nbsp;Eric Tonndorf-Martini ,&nbsp;Kai Schubert ,&nbsp;Christiane Steidel ,&nbsp;Lars Wessel ,&nbsp;Jürgen Debus ,&nbsp;Jakob Liermann","doi":"10.1016/j.ctro.2025.100933","DOIUrl":"10.1016/j.ctro.2025.100933","url":null,"abstract":"<div><h3>Introduction</h3><div>The integration of artificial intelligence into radiotherapy planning for prostate cancer has demonstrated promise in enhancing efficiency and consistency. In this study, we assess the clinical feasibility of a fully automated machine learning (ML)-based “one-click” workflow that combines ML-based segmentation and treatment planning. The proposed workflow was designed to create a clinically acceptable radiotherapy plan within the inter-observer variation of conventional plans.</div></div><div><h3>Methods</h3><div>We evaluated the fully-automated workflow on five low-risk prostate cancer patients treated with external beam radiotherapy and compared the results with conventional optimized and inverse planned radiotherapy plans based on the contours of six different experienced radiation oncologists. Both qualitative and quantitative metrics were analyzed. Additionally, we evaluated the dose distribution of the ML-based and conventional radiation treatment plans on the different segmentations (manual vs. manual and manual vs. automation).</div></div><div><h3>Results</h3><div>The automatic deep-learning segmentation of the target volume revealed a close agreement between the deep-learning based and expert contours referring to Dice Similarity- and Hausdorff index. However, the deep-learning based CTVs had a significantly smaller volume than the expert CTVs (47.1 cm3 vs. 62.6 cm³). The fully automated ML-based plans provide clinically acceptable dose coverage within the range of inter-observer variability observed in the manual plans. Due to the smaller segmentation of the CTV the dose coverage of the CTV and PTV (expert contours) were significantly lower than that of the manual plans.</div></div><div><h3>Conclusion</h3><div>Our study indicates that the tested fully automated ML-based workflow is clinically feasible and leads to comparable results to conventional radiation treatment plans. This represents a promising step towards efficient and standardized prostate cancer treatment. Nevertheless, in the evaluated cohort, auto segmentation was associated with smaller target volumes compared to manual contours, highlighting the necessity of improving segmentation models and prospective testing of automation in radiation therapy.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100933"},"PeriodicalIF":2.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the effect of metformin as a radiosensitiser in solid tumours: A systematic review","authors":"Elísabet González del Portillo ,&nbsp;Alejandro Olivares-Hernández ,&nbsp;Luis Corral Gudino ,&nbsp;Laura Corvo Félix ,&nbsp;Lorena Bellido Hernández ,&nbsp;Luis Posado Domínguez ,&nbsp;David León Jiménez ,&nbsp;Rogelio González Sarmiento ,&nbsp;Edel del Barco Morillo ,&nbsp;Emilio Fonseca Sánchez ,&nbsp;José Pablo Miramontes-Gonzáleze","doi":"10.1016/j.ctro.2025.100930","DOIUrl":"10.1016/j.ctro.2025.100930","url":null,"abstract":"<div><h3>Background</h3><div>Metformin is an antidiabetic drug that has shown its benefit in increasing the effect of radiotherapy in the treatment of solid tumors in preclinical studies. The objective of this systematic review is to study the effect of metformin as a radiosensitizer in studies carried out in clinical practice.</div></div><div><h3>Methods</h3><div>Systematic review carried out according to PRISMA criteria of clinical trials, systematic reviews and observational studies focused on the influence of metformin as a radiosensitizer in solid tumors. The studies were published between the years 2010 and 2022. The results of the studies have been analyzed in terms of survival (OS, PFS, DFS, DMFS) and response (ORR) between patients treated with metformin and without it.</div></div><div><h3>Results</h3><div>A total of 16 studies have been found in the literature (the most frequent tumor was prostate cancer, 5 studies). External radiotherapy was administered in all the studies and in two of them to greater brachytherapy. The use of metformin with radiotherapy showed a consistent benefit in terms of survival and response in tumors of prostate, hepatic and gynecological origin. The benefit in the rest of the tumors analyzed (lung, rectal, and head and neck cancer) is doubtful, and the results are contradictory. The greatest benefits were observed in prostate tumors both in OS and SLE.</div></div><div><h3>Conclusions</h3><div>The use of metformin in combination with radiotherapy in solid tumors is one of the most promising treatments under development in oncology. The benefit observed in real-life studies makes it necessary to develop clinical trials that specifically evaluate its use in clinical practice in the future.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100930"},"PeriodicalIF":2.7,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of radiation dose to the brain on early self-reported cognitive function in brain and head-and-neck cancer patients","authors":"Femke Vaassen ,&nbsp;David Hofstede ,&nbsp;Catharina M.L. Zegers ,&nbsp;Jeanette B. Dijkstra ,&nbsp;Ann Hoeben ,&nbsp;Monique H.M.E. Anten ,&nbsp;Ruud M.A. Houben ,&nbsp;Frank Hoebers ,&nbsp;Inge Compter ,&nbsp;Wouter van Elmpt ,&nbsp;Daniëlle B.P. Eekers","doi":"10.1016/j.ctro.2025.100929","DOIUrl":"10.1016/j.ctro.2025.100929","url":null,"abstract":"<div><h3>Purpose</h3><div>Assess cognitive changes after radiotherapy (RT) in brain and head-and-neck (HN) cancer patients using patient-reported outcome measures (PROMs) and evaluate a dose–effect relationship for brain structures.</div></div><div><h3>Materials and methods</h3><div>Primary brain and HN cancer patients treated with RT between 2012–2021 were included. Patient characteristics, clinical parameters, and PROMs at baseline and 1-year follow-up were collected. Cognitive functioning (CF) from the EORTC QLQ-C30, communication deficit (CD) from the QLQ-BN20, and one cognition-related questions from the EQ6D questionnaire were used, the latter two only for brain patients. Missing data were imputed and the four-point scale scores were transformed to a 100-point scale. Change in scores from baseline to 1-year were categorized into improvement/constant or deterioration. Organs-at-risk (OARs) were contoured either clinically or retrospectively using autocontouring and dose to the OARs were calculated.</div></div><div><h3>Results</h3><div>A total of 110 brain and 356 HN cancer patients were included. Median age was 56 (brain) and 67.5 (HN) years. Baseline and 1-year CF was significantly lower for brain patients (p &lt; 0.001). Univariate analysis for ΔCF showed that age at start RT ≤ 65 years, receiving chemotherapy, higher CF Baseline score, brain mean dose &gt; 3 Gy, and multiple dose levels to left and right hippocampus were statistically associated with cognitive deterioration. Multivariate analysis for ΔCF identified age at RT ≤ 65 years, higher CF Baseline score, and brain mean dose &gt; 3 Gy as significant predictors.</div></div><div><h3>Conclusion</h3><div>This study identified risk factors for subjective cognitive decline and suggests that patients’ self-perceived cognitive deterioration may be related to age, CF baseline score and brain radiation dose above 3 Gy.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100929"},"PeriodicalIF":2.7,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}