Clinical and Translational Radiation Oncology最新文献_第2页

Acute enteritis with pelvic SBRT: Influence of bowel delineation methods

IF 2.7 3区医学 Q3 ONCOLOGY

Clinical and Translational Radiation Oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.ctro.2025.100926

Akshay Dinesan, Maneesh Singh, Prachi Mehta, Priyamvada Maitre, Vedang Murthy

Purpose

One fourth of the patients receiving SBRT to prostate and pelvis develop mild to moderate acute enteritis. In this study, we aim to study bowel dosimetry for different methods of bowel delineation in patients with and without acute bowel toxicity after whole-pelvic SBRT (WP-SBRT).

Methods and materials

In this prospective study, patients with high-risk prostate cancer treated with WP-SBRT were identified. Patients with acute bowel toxicity (CTCAE v5.0) were included as cases while those without were controls. All the patients had previously received 35–36.25 Gy in 5 fractions to the prostate and 25 Gy in 5 fractions to the pelvis. The bowel was contoured on the planning CT scan using seven different methods, namely- bowel bag (BB), small bowel loop (SB), large bowel loop (LB), combined bowel loop (BL) and bowel loops with margins (BL + 0.5 cm, BL + 1 cm and BL + 1.5 cm). The original clinically used plan was applied to all the contouring methods and dose-volume parameters studied.

Results

A total of 102 patients treated with WP-SBRT were screened and only those with properly documented acute toxicity were included for further analysis. While none of the patients had grade 3 bowel toxicity, 23 (22.5 %) patients had grade 1–2 acute enteritis, and 23 patients without were selected as cases and controls respectively. On visual assessment, the composite dose volume histogram (DVH) were similar for cases and controls for all the delineation methods studied. Objectively, the volume of the bowel structures receiving 7 Gy, 14 Gy, and 25 Gy did not show any statistically significant difference between cases and controls. One in five patients treated with WP-SBRT using bowel bag dose constraints of V₇ < 1500 cc, V₁₄ < 500 cc and V₂₅ < 50 cc had acute enteritis.

Conclusion

There was no significant difference in planned bowel doses for different bowel delineation methods in patients with prostate cancer treated with WP-SBRT with or without acute bowel toxicity.

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引用次数: 0

Impact of perineural tumor spread in head and neck adenoid cystic carcinoma for carbon-ion radiotherapy

IF 2.7 3区医学 Q3 ONCOLOGY

Clinical and Translational Radiation Oncology

Pub Date : 2025-01-30 DOI: 10.1016/j.ctro.2025.100928

Atsushi Musha , Nobuteru Kubo , Hidemasa Kawamura , Naoko Okano , Masahiro Onishi , Takeru Ohtaka , Midori Tamura , Osamu Nikkuni , Yuichi Tomidokoro , Satoshi Yokoo , Kazuaki Chikamatsu , Tatsuya Ohno

Background and purpose

Despite recognizing the effectiveness of carbon-ion radiotherapy (C-ion RT) in treating head and neck adenoid cystic carcinoma (HN-ACC), the impact of perineural tumor spread (PNTS) on treatment outcomes and the relationship between PNTS and post-treatment marginal recurrences remain unexplored. Therefore, we analyzed the efficacy of C-ion RT in HN-ACC, focusing on PNTS including details of post-treatment marginal recurrence and indicators for future treatment strategies.

Materials and methods

In this retrospective study, we included 74 patients diagnosed with HN-ACC who underwent C-ion RT between June 2010 and July 2022. Treatment dosages were either 57.6 or 64.0 Gy (relative biological effectiveness) delivered in 16 fractions. Patients undergoing C-ion RT were identified retrospectively from medical records. PNTS was evaluated by magnetic resonance imaging for detecting extratumoral extension to peritumoral nerves.

Results

The median duration of follow-up was 46.4 months. Local recurrence developed in 19 patients. Moreover, most marginal recurrences occurred within the irradiated margins. The 5-year rates for local control (LC), progression-free survival (PFS), and overall survival (OS) were 67.6 %, 47.7 %, and 79.0 %, respectively. LC (p = 0.005) and PFS (p = 0.013) demonstrated significant variances on analysis based on PNTS occurrence; however, OS did not exhibit a similar pattern.

Conclusion

Our findings highlight the importance for considering disease-specific characteristics and the need for developing targeted strategies that address the complex nature of HN-ACC, particularly in cases involving PNTS, to enhance treatment outcomes and potentially reduce recurrence rates.

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引用次数: 0

Effect of FLASH proton therapy on primary bronchial epithelial cell organoids

IF 2.7 3区医学 Q3 ONCOLOGY

Clinical and Translational Radiation Oncology

Pub Date : 2025-01-29 DOI: 10.1016/j.ctro.2025.100927

Merian E. Kuipers , Floriane van Liefferinge , Ernst van der Wal , Marta Rovituso , Annelies M. Slats , Pieter S. Hiemstra , Krista C.J. Van Doorn-Wink

Purpose

The effects of conventional (CONV) and FLASH proton therapy on primary bronchial epithelial cell (PBEC) organoids from individuals with chronic obstructive pulmonary disease (COPD) were investigated. The primary objective was to compare the effect of FLASH and CONV on COPD PBEC organoids with a focus on DNA damage, organoid formation, and gene expression.

Methods

PBECs were obtained from six COPD donors, cultured as three-dimensional (3D) organoids and exposed to 2 and 8 Gy CONV and FLASH proton radiation at the Holland Proton Therapy Center. DNA damage was assessed by γH2AX staining. Organoid formation capacity was assessed by counting the organoids formed after reseeding irradiated cells at 24 h and 7 days. Bulk RNA sequencing (RNAseq) and qPCR analyses were performed to identify pathways and differences in the radiation response.

Results

γH2AX foci analysis showed a significant dose-dependent increase in DNA damage at 1 h for both CONV and FLASH treatments, without differences between the two modalities. Organoid formation assays revealed a dose-dependent decrease in organoid formation capacity at 24 h for both treatments. At 7 days, 2 Gy FLASH-treated samples showed significantly reduced organoid formation compared to 2 Gy CONV (p = 0.008). RNAseq identified CONV and FLASH-induced changes in expression of DNA-damage response and apoptosis pathway genes. A dose-dependent upregulation of MDM2, GDF15, DDB2, BAX, P21, AEN and a decrease in MKi67 expression was confirmed by qPCR analysis.

Conclusion

No significant differences were found in DNA damage or gene expression profiles between CONV and FLASH. The organoid formation assay showed a prolonged detrimental effect in the FLASH-treated organoids, suggesting a more complex interaction of FLASH with lung epithelial cells. The results of this study contribute to the advancement of robust in vitro human lung models for investigating the mechanisms of action of FLASH, potentially facilitating the treatment of NSCLC patients with proton FLASH therapy.

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引用次数: 0

Brachytherapy: Perspectives for combined treatments with immunotherapy

IF 2.7 3区医学 Q3 ONCOLOGY

Clinical and Translational Radiation Oncology

Pub Date : 2025-01-19 DOI: 10.1016/j.ctro.2025.100924

Raphaël Serre , Alexandra Gabro , Mickael Andraud , Jean-Marc Simon , Jean-Philippe Spano , Philippe Maingon , Cyrus Chargari

Combining brachytherapy with immunotherapies, particularly immune checkpoint inhibitors (ICIs), is a promising approach for potentiating both local control of the tumor and fully exploiting the synergies between pharmaceutic immunomodulation and radiotherapy. Compared to other radiotherapy techniques, BT has a potential to better spare lymphatic drainage areas and gut microbiota, thus reducing the immunosuppressive effects of radiation therapy. In addition, it delivers a broad range of doses due to inherent dose inhomogeneity within the implanted volume. This variability increases the probability that immune infiltrates would be activated, particularly since the optimal dose for immune activation is not yet firmly established. Even if preclinical models show that radiotherapy can stimulate immune responses, it can also induce toxic effects on immune effectors and combination trials show conflicting outcomes. There is a need for refining radiation modalities to enhance immune potentiation. The dosimetric specificities of BT may offer various advantages and should be explored further. Scarce clinical data on combining brachytherapy with ICIs in advanced cancer suggest potential benefits, with case reports of complete local responses and abscopal effects. However, validation requires a large number of patients in randomized clinical trials for which ideal design is discussed. In parallel with ongoing clinical developments, there is a need to refine preclinical models in order to better analyze the specific biological effects involved in BT, in light of immunomodulatory systemic treatments.

{"title":"Brachytherapy: Perspectives for combined treatments with immunotherapy","authors":"Raphaël Serre , Alexandra Gabro , Mickael Andraud , Jean-Marc Simon , Jean-Philippe Spano , Philippe Maingon , Cyrus Chargari","doi":"10.1016/j.ctro.2025.100924","DOIUrl":"10.1016/j.ctro.2025.100924","url":null,"abstract":"<div><div>Combining brachytherapy with immunotherapies, particularly immune checkpoint inhibitors (ICIs), is a promising approach for potentiating both local control of the tumor and fully exploiting the synergies between pharmaceutic immunomodulation and radiotherapy. Compared to other radiotherapy techniques, BT has a potential to better spare lymphatic drainage areas and gut microbiota, thus reducing the immunosuppressive effects of radiation therapy. In addition, it delivers a broad range of doses due to inherent dose inhomogeneity within the implanted volume. This variability increases the probability that immune infiltrates would be activated, particularly since the optimal dose for immune activation is not yet firmly established. Even if preclinical models show that radiotherapy can stimulate immune responses, it can also induce toxic effects on immune effectors and combination trials show conflicting outcomes. There is a need for refining radiation modalities to enhance immune potentiation. The dosimetric specificities of BT may offer various advantages and should be explored further. Scarce clinical data on combining brachytherapy with ICIs in advanced cancer suggest potential benefits, with case reports of complete local responses and abscopal effects. However, validation requires a large number of patients in randomized clinical trials for which ideal design is discussed. In parallel with ongoing clinical developments, there is a need to refine preclinical models in order to better analyze the specific biological effects involved in BT, in light of immunomodulatory systemic treatments.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100924"},"PeriodicalIF":2.7,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143171155","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}

引用次数: 0

Fully automatic reconstruction of prostate high-dose-rate brachytherapy interstitial needles using two-phase deep learning-based segmentation and object tracking algorithms

IF 2.7 3区医学 Q3 ONCOLOGY

Clinical and Translational Radiation Oncology

Pub Date : 2025-01-19 DOI: 10.1016/j.ctro.2025.100925

Mohammad Mahdi Moradi , Zahra Siavashpour , Soheib Takhtardeshir , Eman Showkatian , Ramin Jaberi , Reza Ghaderi , Bahram Mofid , Farzad Taghizadeh-Hesary

The critical aspect of successful brachytherapy (BT) is accurate detection of applicator/needle trajectories, which is an ongoing challenge. This study proposes a two-phase deep learning-based method to automate localization of high-dose-rate (HDR) prostate BT catheters through the patient’s CT images. The whole process is divided into two phases using two different deep neural networks. First, BT needles segmentation was accomplished through a pix2pix Generative Adversarial Neural network (pix2pix GAN). Second, a Generic Object Tracking Using Regression Networks (GOTURN) was used to predict the needle trajectories. These models were trained and tested on a clinical prostate BT dataset. Among the total 25 patients, 5 patients that consist of 592 slices was dedicated to testing sets, and the rest were used as train/validation set. The total number of needles in these slices of CT images was 8764, of which the employed pix2pix network was able to segment 98.72 % (8652 of total). Dice Similarity Coefficient (DSC) and IoU (Intersection over Union) between the network output and the ground truth were 0.95 and 0.90, respectively. Moreover, the F1-score, recall, and precision results were 0.95, 0.93, and 0.97, respectively. Regarding the location of the shafts, the proposed model has an error of 0.41 mm. The current study proposed a novel methodology to automatically localize and reconstruct the prostate HDR-BT interstitial needles through the 3D CT images. The presented method can be utilized as a computer-aided module in clinical applications to automatically detect and delineate the multi-catheters, potentially enhancing the treatment quality.

成功近距离放射治疗（BT）的关键在于准确检测涂药器/针头轨迹，这是一项持续的挑战。本研究提出了一种基于深度学习的两阶段方法，通过患者的 CT 图像自动定位高剂量率（HDR）前列腺近距离放射治疗导管。整个过程分为两个阶段，使用两种不同的深度神经网络。首先，通过 pix2pix 生成对抗神经网络（pix2pix GAN）完成 BT 针头分割。其次，使用回归网络（GOTURN）进行通用对象跟踪，以预测针的轨迹。这些模型在临床前列腺 BT 数据集上进行了训练和测试。在总共 25 名患者中，5 名患者的 592 个切片被用作测试集，其余的用作训练/验证集。这些 CT 图像切片中的针头总数为 8764 个，其中使用的 pix2pix 网络能够分割其中的 98.72 %（总数的 8652 个）。网络输出与地面实况之间的骰子相似系数（DSC）和交集大于联合（IoU）分别为 0.95 和 0.90。此外，F1 分数、召回率和精确度结果分别为 0.95、0.93 和 0.97。关于轴的位置，建议模型的误差为 0.41 毫米。本研究提出了一种通过三维 CT 图像自动定位和重建前列腺 HDR-BT 间质针的新方法。该方法可作为临床应用中的计算机辅助模块，自动检测和划分多导管，从而提高治疗质量。

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引用次数: 0

Effectiveness, toxicity and impact on quality of life of high-dose-rate brachytherapy delivered in two fractions as monotherapy in patients with prostate cancer

IF 2.7 3区医学 Q3 ONCOLOGY

Clinical and Translational Radiation Oncology

Pub Date : 2025-01-17 DOI: 10.1016/j.ctro.2025.100923

Johan Staby Olsén , Antonis Valachis , Bengt Johansson

Purpose

The aim of this retrospective, single-center cohort study was to evaluate the effectiveness and safety of two-fraction high-dose-rate brachytherapy (HDR-BT) as monotherapy in a consecutive cohort of prostate cancer patients.

Methods

We included consecutive patients who received 28 Gy HDR-BT in two fractions (14 Gy × 2) as monotherapy during 2005 to 2021 at our institution. Eligible patients were derived from an institutional database consisting of prospectively collected data. Primary endpoint was biochemical recurrence (BCR) and secondary endpoints included toxicity (assessed through both healthcare provider and patient-reported outcomes) and quality-of-life (QoL) assessment.

Results

In total, 175 patients with prostate cancer (94 % classified as low- or intermediate-risk) were treated with HDR-BT during the study period with a median age of 68 years (range: 51–80), and a median follow-up of 60 months (range: 0–174). The estimated five-year cumulative BCR rate was 3.0 % (95 % Confidence Interval (CI): 0 %–13.3 %) for low-risk patients and 9.6 % (95 % CI: 4.7 %–16.7 %) for intermediate-risk patients. PSA exceeding 10 ng/mL at diagnosis was a significant risk factor for BCR (Odds Ratio (OR) = 3.29, 95 % CI: 1.01–10.67) whereas PSA of ≤0.1 ng/ml as nadir was a significant positive prognostic factor, associated with lower risk of BCR (OR = 0.11, 95 % CI: 0.03–0.33). At 12 months, 22 % of the patients had grade 2 and 3 % grade 3 urinary toxicity whereas 2 % of patients had grade 2 and none grade 3 bowel toxicity. At 12 months, 49 % of the patients with at least some erectile function before the treatment, had an impaired function.

Conclusion

We found that two-fraction HDR-BT as monotherapy among patients with mainly low- and intermediate-risk prostate cancer appears to be safe in terms of biochemical recurrence, with a low proportion of severe urinary and bowel toxicity.

{"title":"Effectiveness, toxicity and impact on quality of life of high-dose-rate brachytherapy delivered in two fractions as monotherapy in patients with prostate cancer","authors":"Johan Staby Olsén , Antonis Valachis , Bengt Johansson","doi":"10.1016/j.ctro.2025.100923","DOIUrl":"10.1016/j.ctro.2025.100923","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this retrospective, single-center cohort study was to evaluate the effectiveness and safety of two-fraction high-dose-rate brachytherapy (HDR-BT) as monotherapy in a consecutive cohort of prostate cancer patients.</div></div><div><h3>Methods</h3><div>We included consecutive patients who received 28 Gy HDR-BT in two fractions (14 Gy × 2) as monotherapy during 2005 to 2021 at our institution. Eligible patients were derived from an institutional database consisting of prospectively collected data. Primary endpoint was biochemical recurrence (BCR) and secondary endpoints included toxicity (assessed through both healthcare provider and patient-reported outcomes) and quality-of-life (QoL) assessment.</div></div><div><h3>Results</h3><div>In total, 175 patients with prostate cancer (94 % classified as low- or intermediate-risk) were treated with HDR-BT during the study period with a median age of 68 years (range: 51–80), and a median follow-up of 60 months (range: 0–174). The estimated five-year cumulative BCR rate was 3.0 % (95 % Confidence Interval (CI): 0 %–13.3 %) for low-risk patients and 9.6 % (95 % CI: 4.7 %–16.7 %) for intermediate-risk patients. PSA exceeding 10 ng/mL at diagnosis was a significant risk factor for BCR (Odds Ratio (OR) = 3.29, 95 % CI: 1.01–10.67) whereas PSA of ≤0.1 ng/ml as nadir was a significant positive prognostic factor, associated with lower risk of BCR (OR = 0.11, 95 % CI: 0.03–0.33). At 12 months, 22 % of the patients had grade 2 and 3 % grade 3 urinary toxicity whereas 2 % of patients had grade 2 and none grade 3 bowel toxicity. At 12 months, 49 % of the patients with at least some erectile function before the treatment, had an impaired function.</div></div><div><h3>Conclusion</h3><div>We found that two-fraction HDR-BT as monotherapy among patients with mainly low- and intermediate-risk prostate cancer appears to be safe in terms of biochemical recurrence, with a low proportion of severe urinary and bowel toxicity.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"51 ","pages":"Article 100923"},"PeriodicalIF":2.7,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122572","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}

引用次数: 0

Postoperative brachytherapy alone for 217 patients with early-stage oral cavity squamous cell carcinoma

IF 2.7 3区医学 Q3 ONCOLOGY

Clinical and Translational Radiation Oncology

Pub Date : 2025-01-16 DOI: 10.1016/j.ctro.2025.100922

C. Schweizer , V. Strnad , M. Lotter , S. Kreppner , R. Merten , R. Fietkau , A. Karius

Introduction

Postoperative radiotherapy is generally recommended for pT1/2pN0 squamous cell carcinoma of the oral cavity (OSCC) if risk factors are present. Prospective studies are missing. Interventional radiotherapy offers a precise dose application. In this paper we analyze long-term efficacy and toxicity in a large single-center cohort of patients with early OSCC receiving sole postoperative brachytherapy (BT).

Material and methods

From 1998 to 2023, 217 patients were postoperatively treated with sole BT in our institute. The median follow-up was 110 months (range: 2–316). The primary objective was local control. Secondary outcomes were overall survival, cancer specific survival, and toxicity.

Results

The local recurrence rates for 12, 24, and 60 months were 7.1 %, 9.1 %, and 12.6 %. The disease-free survival was 89.7 %, 86.1 %, and 79.3 %. The overall survival rates at 12, 24, and 60 months were 94.4 %, 89.6 %, and 77.9 %. The cancer-specific survival was 97.1 %, 96.6 %, and 92.9 %, respectively. At two years, the rate of regional recurrence was 8.3 %. Patients without neck dissection had a significantly increased risk for lymph node recurrence (p = 0.025). Side effects ≥ grade 3 were seen in 14 % (30/217). 17 % (37/217) of patients developed a soft tissue necrosis (STN). Osteoradionecrosis (ORN) was seen in 7 % (15/217) of patients. A target volume > 15 cm³ was significantly associated with the occurrence of STN (p = 0.011) and ORN (p = 0.004).

Conclusions

Postoperative interventional radiotherapy for previously not irradiated patients with early-stage OSCC is a safe and efficient treatment. Randomized trials are needed to compare these results to omission of postoperative radiotherapy as well as external beam radiotherapy.

{"title":"Postoperative brachytherapy alone for 217 patients with early-stage oral cavity squamous cell carcinoma","authors":"C. Schweizer , V. Strnad , M. Lotter , S. Kreppner , R. Merten , R. Fietkau , A. Karius","doi":"10.1016/j.ctro.2025.100922","DOIUrl":"10.1016/j.ctro.2025.100922","url":null,"abstract":"<div><h3>Introduction</h3><div>Postoperative radiotherapy is generally recommended for pT1/2pN0 squamous cell carcinoma of the oral cavity (OSCC) if risk factors are present. Prospective studies are missing. Interventional radiotherapy offers a precise dose application. In this paper we analyze long-term efficacy and toxicity in a large single-center cohort of patients with early OSCC receiving sole postoperative brachytherapy (BT).</div></div><div><h3>Material and methods</h3><div>From 1998 to 2023, 217 patients were postoperatively treated with sole BT in our institute. The median follow-up was 110 months (range: 2–316). The primary objective was local control. Secondary outcomes were overall survival, cancer specific survival, and toxicity.</div></div><div><h3>Results</h3><div>The local recurrence rates for 12, 24, and 60 months were 7.1 %, 9.1 %, and 12.6 %. The disease-free survival was 89.7 %, 86.1 %, and 79.3 %. The overall survival rates at 12, 24, and 60 months were 94.4 %, 89.6 %, and 77.9 %. The cancer-specific survival was 97.1 %, 96.6 %, and 92.9 %, respectively. At two years, the rate of regional recurrence was 8.3 %. Patients without neck dissection had a significantly increased risk for lymph node recurrence (p = 0.025). Side effects ≥ grade 3 were seen in 14 % (30/217). 17 % (37/217) of patients developed a soft tissue necrosis (STN). Osteoradionecrosis (ORN) was seen in 7 % (15/217) of patients. A target volume > 15 cm<sup>3</sup> was significantly associated with the occurrence of STN (p = 0.011) and ORN (p = 0.004).</div></div><div><h3>Conclusions</h3><div>Postoperative interventional radiotherapy for previously not irradiated patients with early-stage OSCC is a safe and efficient treatment. Randomized trials are needed to compare these results to omission of postoperative radiotherapy as well as external beam radiotherapy.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"51 ","pages":"Article 100922"},"PeriodicalIF":2.7,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150178","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}

引用次数: 0

Live-cell imaging and analysis of 3D spheroids in hypoxia- and radiotherapy-related research

IF 2.7 3区医学 Q3 ONCOLOGY

Clinical and Translational Radiation Oncology

Pub Date : 2025-01-15 DOI: 10.1016/j.ctro.2025.100920

Claire Beckers, Lazaros Vasilikos, Lorena Moor, Martin Pruschy

3D spheroids are a valuable tool for investigating the interplay between hypoxia and radioresistance. However, standardized methods for visualizing normoxic and hypoxic regions within spheroids and assessing treatment responses are lacking. We developed a straightforward workflow for the analysis of spheroids based on image processing using a novel custom-written script, and flow cytometry.

引用次数: 0

Comparison of lifetime attributable risk of post-irradiation secondary cancer of boron neutron capture therapy, proton beam therapy, and X-ray therapy for pediatric and adolescent and young adult patients

IF 2.7 3区医学 Q3 ONCOLOGY

Clinical and Translational Radiation Oncology

Pub Date : 2025-01-12 DOI: 10.1016/j.ctro.2025.100921

Shunsuke Suzuki , Shintaro Shiba , Hiroki Tanaka , Masashi Yamanaka , Kazuki Matsumoto , Koichi Tokuuye , Motoko Omura

Background and purpose

This study aimed to compare the post-irradiation secondary cancer rates of boron neutron capture therapy (BNCT), proton beam therapy (PBT), and X-ray therapy (XT) in pediatric and Adolescent and Young Adult (AYA) patients with intracranial lesions.

Materials and methods

BNCT, PBT, and XT plans were optimized for nine pediatric and AYA patients with intracranial lesions. The BNCT dose calculation results were biologically effective dose converted. Lifetime attributable risk (LAR) was calculated using a calculation model proposed by Schneider et al. Statistical analysis was performed using log-linear model with mixed effects. Organs included in the radiation field were the brain, bones, and soft tissue. The difference in LAR between the three treatments for each organ and the number needed to treat (NNT), as an indicator of the number of cases required to achieve the effect of suppressing the occurrence of secondary cancers, was calculated and evaluated.

Results

Statistically significant differences between BNCT vs PBT and XT were confirmed for the brain, bone, soft tissue, and cumulative (P < 0.0001). Significant differences were also observed in PBT and XT, with P < 0.0001 for brain and cumulative, P = 0.0002 for bone, and P = 0.0281 for soft tissue. The cumulative NNT for BNCT vs. PBT, BNCT vs. XT, and PBT vs. XT were 162, 78.6, and 153, respectively.

Conclusion

BNCT had a significantly lower LAR compared to PBT and XT. These findings suggest the usefulness of BNCT in pediatric and AYA patients with brain tumors from the perspective of post-irradiation secondary cancer.

{"title":"Comparison of lifetime attributable risk of post-irradiation secondary cancer of boron neutron capture therapy, proton beam therapy, and X-ray therapy for pediatric and adolescent and young adult patients","authors":"Shunsuke Suzuki , Shintaro Shiba , Hiroki Tanaka , Masashi Yamanaka , Kazuki Matsumoto , Koichi Tokuuye , Motoko Omura","doi":"10.1016/j.ctro.2025.100921","DOIUrl":"10.1016/j.ctro.2025.100921","url":null,"abstract":"<div><h3>Background and purpose</h3><div>This study aimed to compare the post-irradiation secondary cancer rates of boron neutron capture therapy (BNCT), proton beam therapy (PBT), and X-ray therapy (XT) in pediatric and Adolescent and Young Adult (AYA) patients with intracranial lesions.</div></div><div><h3>Materials and methods</h3><div>BNCT, PBT, and XT plans were optimized for nine pediatric and AYA patients with intracranial lesions. The BNCT dose calculation results were biologically effective dose converted. Lifetime attributable risk (LAR) was calculated using a calculation model proposed by Schneider <em>et al.</em> Statistical analysis was performed using log-linear model with mixed effects. Organs included in the radiation field were the brain, bones, and soft tissue. The difference in LAR between the three treatments for each organ and the number needed to treat (NNT), as an indicator of the number of cases required to achieve the effect of suppressing the occurrence of secondary cancers, was calculated and evaluated.</div></div><div><h3>Results</h3><div>Statistically significant differences between BNCT vs PBT and XT were confirmed for the brain, bone, soft tissue, and cumulative (P < 0.0001). Significant differences were also observed in PBT and XT, with P < 0.0001 for brain and cumulative, P = 0.0002 for bone, and P = 0.0281 for soft tissue. The cumulative NNT for BNCT vs. PBT, BNCT vs. XT, and PBT vs. XT were 162, 78.6, and 153, respectively.</div></div><div><h3>Conclusion</h3><div>BNCT had a significantly lower LAR compared to PBT and XT. These findings suggest the usefulness of BNCT in pediatric and AYA patients with brain tumors from the perspective of post-irradiation secondary cancer.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"51 ","pages":"Article 100921"},"PeriodicalIF":2.7,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078644","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}

引用次数: 0

Short-term survivors with brain metastases have modest benefits from focal and systemic therapies and remain frequent despite improving treatment landscape

IF 2.7 3区医学 Q3 ONCOLOGY

Clinical and Translational Radiation Oncology

Pub Date : 2025-01-10 DOI: 10.1016/j.ctro.2025.100919

M. Czogalla , J. Stöhr , N. Gleim , K. Papsdorf , S. Klagges , P. Hambsch , T. Kuhnt , F. Nägler , A. Barrantes-Freer , J. Wach , N.H. Nicolay , C. Seidel

Purpose

Therapeutic options for patients with brain metastases (BM) increase. While these lead to considerable survival effects in subgroups, there is limited knowledge about characteristics, prognosticators and treatment effects in patients with BM and short survival.

Methods

Patients with a survival time of ≤ 6 months (short-term survivors, STS), diagnosed with BM between 2009–2021 at a large tertiary cancer center were analysed. Clinical and treatment characteristics, pathological data and causes of death were documented. Descriptive statistics, treatment-specific univariate Kaplan-Meier estimator analyses and multivariate Cox regression were performed.

Results

Among 1248 patients with BM, 480 (38 %) were STS. 256 STS with detailed clinical records were included in this analysis. In univariate and multivariate analysis, Karnofsky Performance Status (KPS) (p < 0.001) and number of BM (p = 0.004) were prognostic. In 75 % of patients, the ds-GPA score predicted short-term survival. Use of resection with focal radiotherapy (p < 0.001) and systemic treatment (p < 0.001) appeared prognostically favourable compared to whole brain radiotherapy (WBRT) alone. However, survival benefits were very modest, with a median gain of 6 weeks following resection and focal radiotherapy compared to whole-brain radiotherapy, and 3 weeks from systemic treatment. Systemic tumor progression was documented as the cause of death in the majority of patients. Over the examined time period, the ratio between STS and other patients remained without significant change.

Conclusion

Within STS, KPS and number of BM are of prognostic relevance. There is benefit from local and systemic therapy to a limited extent. Shared and carefully discussed individual therapy decisions are necessary.

{"title":"Short-term survivors with brain metastases have modest benefits from focal and systemic therapies and remain frequent despite improving treatment landscape","authors":"M. Czogalla , J. Stöhr , N. Gleim , K. Papsdorf , S. Klagges , P. Hambsch , T. Kuhnt , F. Nägler , A. Barrantes-Freer , J. Wach , N.H. Nicolay , C. Seidel","doi":"10.1016/j.ctro.2025.100919","DOIUrl":"10.1016/j.ctro.2025.100919","url":null,"abstract":"<div><h3>Purpose</h3><div>Therapeutic options for patients with brain metastases (BM) increase. While these lead to considerable survival effects in subgroups, there is limited knowledge about characteristics, prognosticators and treatment effects in patients with BM and short survival.</div></div><div><h3>Methods</h3><div>Patients with a survival time of ≤ 6 months (short-term survivors, STS), diagnosed with BM between 2009–2021 at a large tertiary cancer center were analysed. Clinical and treatment characteristics, pathological data and causes of death were documented. Descriptive statistics, treatment-specific univariate Kaplan-Meier estimator analyses and multivariate Cox regression were performed.</div></div><div><h3>Results</h3><div>Among 1248 patients with BM, 480 (38 %) were STS. 256 STS with detailed clinical records were included in this analysis. In univariate and multivariate analysis, Karnofsky Performance Status (KPS) (p < 0.001) and number of BM (p = 0.004) were prognostic. In 75 % of patients, the ds-GPA score predicted short-term survival. Use of resection with focal radiotherapy (p < 0.001) and systemic treatment (p < 0.001) appeared prognostically favourable compared to whole brain radiotherapy (WBRT) alone. However, survival benefits were very modest, with a median gain of 6 weeks following resection and focal radiotherapy compared to whole-brain radiotherapy, and 3 weeks from systemic treatment. Systemic tumor progression was documented as the cause of death in the majority of patients. Over the examined time period, the ratio between STS and other patients remained without significant change.</div></div><div><h3>Conclusion</h3><div>Within STS, KPS and number of BM are of prognostic relevance. There is benefit from local and systemic therapy to a limited extent. Shared and carefully discussed individual therapy decisions are necessary.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"51 ","pages":"Article 100919"},"PeriodicalIF":2.7,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058134","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}

引用次数: 0