Clinical and Translational Radiation Oncology最新文献

{"title":"Associations of dose to the urethra and long-term patient-reported outcomes after radiotherapy with EBRT and HDR brachytherapy boost for prostate cancer","authors":"Lars Haack ,&nbsp;David Krug ,&nbsp;Justus Domschikowski ,&nbsp;Olaf Wittenstein ,&nbsp;Severin Rodler ,&nbsp;Philipp Nuhn ,&nbsp;Christof van der Horst ,&nbsp;Claudia Schmalz ,&nbsp;Christian Schulz ,&nbsp;Oliver Blanck ,&nbsp;Frank-André Siebert ,&nbsp;Alexander Fabian","doi":"10.1016/j.ctro.2025.100918","DOIUrl":"10.1016/j.ctro.2025.100918","url":null,"abstract":"<div><h3>Purpose</h3><div>Implications of radiation dose exposure to the urethra on urinary morbidity after prostate radiotherapy are poorly understood, especially by long-term patient-reported outcomes (PRO). Therefore, our primary objective was to investigate associations of urethral dose and long-term patient-reported urinary morbidity after external beam radiotherapy and high-dose rate brachytherapy boost for prostate cancer.</div></div><div><h3>Materials and methods</h3><div>We conducted a pre-registered (<span><span>https://doi.org/10.17605/OSF.IO/A6DC3)</span><svg><path></path></svg></span> cross-sectional study at a tertiary academic center including a consecutive sample of patients being at least two years after treatment. Primary outcome measurements included urinary domains of the EPIC-26 questionnaire. Their associations with predefined urethral dose levels were assessed by univariable analyses (Pearson’s correlation) and by predefined multivariable analyses (multiple regression). Sample size calculation was based on a predefined multivariable model. A p-value &lt; 0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>Among 277 screened patients, 113 patients were alive, eligible, consented, and provided PRO. The median time passed since radiotherapy was 4 years. Per univariable analysis, a higher near maximum point dose of the urethra (D_U0.1cc) was associated with worse urinary incontinence (r = -0.32; CI = −0.48 − -0.13; p &lt; 0.001) and worse overall urinary function (r = -0.21; CI = −0.38 − -0.03; p = 0.02) of the respective EPIC-26 domains. Per predefined multivariable analysis, D_U0.1cc and urinary incontinence remained significantly associated (B = −0.005; CI = −0.008 − -0.002; p = 0.003). These associations were only present, when very high D_U0.1 cc above 137 Gy were kept in the analysis.</div></div><div><h3>Conclusions</h3><div>Very high urethral near point doses appear to be associated with worse long-term patient-reported urinary morbidity after radiotherapy for prostate cancer. Urethral dose should be considered in practice and future trials to potentially minimize long-term urinary morbidity.</div></div><div><h3>Trial registration</h3><div>The study protocol was pre-registered prior to patient accrual on the Open Science Framework (<span><span>https://doi.org/10.17605/OSF.IO/A6DC3)</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"51 ","pages":"Article 100918"},"PeriodicalIF":2.7,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11782951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078643","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":"Treatment-related toxicity, utility and patient-reported outcomes of head and neck cancer patients treated with proton therapy: A longitudinal study","authors":"Yi Hsuan Chen ,&nbsp;Michiel Kroesen ,&nbsp;Mischa Hoogeman ,&nbsp;Matthijs Versteegh ,&nbsp;Carin Uyl-de Groot ,&nbsp;Hedwig M. Blommestein","doi":"10.1016/j.ctro.2025.100913","DOIUrl":"10.1016/j.ctro.2025.100913","url":null,"abstract":"<div><h3>Objective</h3><div>In comparison to current standard photon irradiation, proton therapy (PT) significantly reduces dose to the surrounding normal tissue and therefore is expected to reduce toxicity and improve health related quality of life (HRQoL). Despite the high expectations of PT, there is very limited data on patients’ HRQoL after radiotherapy. This study evaluated HRQoL in head and neck cancer (HNC) patients receiving PT and established a robust benchmark for future comparison of PT and the radiotherapy advancements.</div></div><div><h3>Method</h3><div>A questionnaire-based (consisting of EORTC-QLQ-C30, EQ-5D, and EORTC-H&amp;N-35) prospective cohort study was performed in a Dutch proton therapy center. HNC patients who received PT between January 2020 to December 2022 were enrolled in this study. The questionnaires were distributed pre-treatment, and 0, 6, 12, 24 months post-treatment. The generalized estimating equations method was used to analyze the utility change and negative impact of the radiation-related toxicities.</div></div><div><h3>Results</h3><div>119 HNC patients were included in the study. Symptom and function scores showed the deterioration of all reported functions during the period of treatment. Most of the functions recovered within six months and improved beyond baseline. At the end of PT, the patients’ utility decreased significantly (0.12 points) compared to the baseline. The loss in utility was recovered after six months and a further improvement was seen one year after the treatment. This study further provided the estimation of the disutility of each radiation related toxicity.</div></div><div><h3>Conclusion</h3><div>The present study presented the impact of toxicity on patient’s utility over time and further confirmed it with the results of patient-reported symptom and function. This study provided estimation of each radiation-related toxicity, including xerostomia, dysphagia, mucositis, and dermatitis, which could contribute to the value assessment through economic evaluations of PT.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"51 ","pages":"Article 100913"},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078719","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":"Relating proton LETd to biological response of parotid and submandibular glands using PSMA-PET in clinical patients","authors":"Dirk Wagenaar ,&nbsp;Vineet Mohan ,&nbsp;Johannes A. Langendijk ,&nbsp;Roel J.H.M. Steenbakkers ,&nbsp;Wouter V. Vogel ,&nbsp;Stefan Both","doi":"10.1016/j.ctro.2024.100910","DOIUrl":"10.1016/j.ctro.2024.100910","url":null,"abstract":"<div><h3>Background and purpose</h3><div>A recent study investigated the use of PSMA-PET in monitoring loss of secretory cells in salivary glands of head and neck cancer (HNC) patients. Previously, a dose–effect relation has been formulated to the PSMA-PET uptake in salivary glands. The aim of this study was to derive a proton RBE model from the PSMA-PET uptake in salivary glands after proton therapy of HNC patients.</div></div><div><h3>Materials and methods</h3><div>Six patients treated with proton therapy were included. These patients received a PET-CT scan using ⁶⁸Ga (N = 1) or ¹⁸F (N = 5) PSMA before treatment (baseline) and one month after the last fraction (follow-up). Physical dose (D), D·LET_d and the follow-up PSMA-PET scan were deformed to the baseline PET-CT using deformable image registration. Parotid and submandibular gland delineations were adjusted to include voxels which had an uptake of ≥ 5 g/ml in the baseline PSMA-PET scan.</div></div><div><h3>Results</h3><div>The average RBE-LET slope was 0.075 [0.009; 0.125] (keV/μm)^-1 (mean [95 %CI]) for parotid and submandibular glands combined. When analyzing parotid or submandibular glands separately the RBE-LET curve slope varies with two and five patients showing a positive RBE-LET slope when only analyzing parotid or submandibular glands respectively.</div></div><div><h3>Conclusion</h3><div>Our study did not find clear evidence of an increased RBE in parotid and submandibular glands with increasing LET_d. On average an LET_d effect was observed, however our sample size was too small to clearly define an RBE-LET relation. A larger cohort scanned at later time intervals could shed more light on this issue.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"52 ","pages":"Article 100910"},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143170012","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":"Impact of tumor position displacement during end-exhalation breath-hold condition on tumor dose in lung stereotactic body radiation therapy using volumetric modulated arc therapy","authors":"Tatsuya Kamima ,&nbsp;Shunsuke Moriya ,&nbsp;Takeji Sakae ,&nbsp;Hikaru Miyauchi ,&nbsp;Yasushi Ito ,&nbsp;Kenji Tokumasu ,&nbsp;Yasuo Yoshioka","doi":"10.1016/j.ctro.2025.100916","DOIUrl":"10.1016/j.ctro.2025.100916","url":null,"abstract":"<div><h3>Background and purpose</h3><div>In lung stereotactic body radiation therapy (SBRT) using a breath-holding technique, displacement of tumor during breath-holding is rarely considered. This study used four-dimensional (4D) dose calculation with cine computed tomography (CT) to evaluate the impact of unexpected tumor position displacement during breath-holding on the target dose of lung volumetric modulated arc therapy (VMAT)-SBRT.</div></div><div><h3>Materials and methods</h3><div>This study included 20 cases for which tumor position displacement during end-exhalation breath-holding (range: 0.5–12.6 mm) was evaluated on cine CT. VMAT-SBRT plans (3D dose) were generated using treatment planning CT images (reference CT) acquired during end-exhalation breath-hold. For each plan, the 4D dose was calculated using deformable image registration of the cine CT images and was accumulated onto the reference CT. Dose metrics and the mean biologically effective dose at <span><math><mrow><mi>α</mi><mo>/</mo><mi>β</mi></mrow></math></span> = 10 (BED₁₀) for the gross tumor volume (GTV) were compared between 3D and 4D doses.</div></div><div><h3>Results</h3><div>In the 17 cases where the tumor was within the planning target volume (PTV) during breath-holding, the difference between the 3D and 4D doses was within 3 % for each dose metric. However, in 3 cases where the tumor position during breath-holding included displacement outside the PTV, both the D_98% and mean BED₁₀ of the GTV were reduced by 6.9–20.0 % and 2.1–13.8 %, respectively, in 4D doses compared to 3D doses.</div></div><div><h3>Conclusion</h3><div>Our study showed that tumor position displacements during breath-holding may lead to substantial tumor dose reduction.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"51 ","pages":"Article 100916"},"PeriodicalIF":2.7,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058129","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":"Evaluating the radiosensitivity of the oral microbiome to predict radiation-induced mucositis in head and neck cancer patients: A prospective trial","authors":"Andreas R. Thomsen ,&nbsp;Elsa Beatriz Monroy Ordonez ,&nbsp;Michael Henke ,&nbsp;Benedikt Luka ,&nbsp;Jörg Sahlmann ,&nbsp;Henning Schäfer ,&nbsp;Vivek Verma ,&nbsp;Nadine Schlueter ,&nbsp;Anca-Ligia Grosu ,&nbsp;Tanja Sprave","doi":"10.1016/j.ctro.2025.100915","DOIUrl":"10.1016/j.ctro.2025.100915","url":null,"abstract":"<div><h3>Background</h3><div>Predicting the occurrence and/or severity of oral mucositis (OM) before commencing radiotherapy (RT) remains very difficult. The aim of this prospective trial was to investigate whether the <em>ex-vivo</em> radiation sensitivity of oral keratinocytes from head and neck (H&amp;N) cancer patients correlates with severe OM.</div></div><div><h3>Methods</h3><div>Oral microbiopsies of healthy gingival mucosa were collected from 63H&amp;N cancer patients undergoing (chemo)RT, of which 58 samples were useable. Keratinocytes from these microbiopsies underwent <em>ex-vivo</em> proliferation, irradiation, and subsequently the cell spreading assay. Tubes with the cell suspension were placed within the irradiation chamber of a ¹³⁷Cs Gammacell 40 Exactor (Best Theratronics, Canada) and exposed to 0, 2, 4, 6, or 8 Gy at a dose rate of 0.63 Gy min⁻¹. Cell suspension was then immediately pipetted into custom-made polydimethylsiloxane (PDMS) rings.</div><div>The effect of demographic and clinical parameters on the cell spreading assay were also analyzed. Systematic clinical recording of OM was conducted twice a week by a specially trained examiner.</div></div><div><h3>Results</h3><div>Most patients had node-positive disease and cancer of the oropharynx or oral cavity. The vast majority of patients received adjuvant RT and concurrent chemotherapy. Overall, 34 (58.6 %) participants developed grade 3 OM after a median dose of 32 Gy. No patient experienced a grade ≥ 4 event. There was a correlation between the cell spreading assay area and grade 3 OM (p &lt; 0.05), equivalent to approximately 0.5 Gy dose. Demographic and clinical parameters had no significant impact on the cell spreading assay (p &gt; 0.05 for all).</div></div><div><h3>Conclusions</h3><div>It is necessary to establish reliable predictors of severe OM before treatment in H&amp;N cancer to allow early management of treatment-related sequelae. This prospective trial illustrates that the intrinsic <em>ex-vivo</em> radiosensitivity of oral keratinocytes could be correlated with RT-induced OM in patients with H&amp;N cancer. This novel predictor requires validation in larger prospective cohorts.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"51 ","pages":"Article 100915"},"PeriodicalIF":2.7,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078714","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":"Real-world outcomes of prophylactic cranial irradiation utilization and efficacy for patients with extensive-stage small cell lung cancer treated with consolidative thoracic radiotherapy","authors":"Abdul H. Lone ,&nbsp;Rohan Salunkhe ,&nbsp;Vijithan Sugumar ,&nbsp;Luna J. Zhan ,&nbsp;Xiang Y. Ye ,&nbsp;Andrea Bezjak ,&nbsp;John Cho ,&nbsp;Meredith E. Giuliani ,&nbsp;Andrew J. Hope ,&nbsp;Alexander Sun ,&nbsp;Srinivas Raman ,&nbsp;Penelope A. Bradbury ,&nbsp;Lawson Eng ,&nbsp;Natasha B. Leighl ,&nbsp;Frances A. Shepherd ,&nbsp;Adrian Sacher ,&nbsp;Geoffrey Liu ,&nbsp;Benjamin H. Lok","doi":"10.1016/j.ctro.2025.100917","DOIUrl":"10.1016/j.ctro.2025.100917","url":null,"abstract":"<div><h3>Background</h3><div>The role of prophylactic cranial irradiation (PCI) is not well-defined in extensive-stage SCLC (ES-SCLC), with conflicting results from randomized trials and a lack of relevant data for patients who received consolidative thoracic radiotherapy (CTRT). We sought to evaluate the impact of PCI on the outcomes of ES-SCLC patients who were all treated with CTRT.</div></div><div><h3>Methods</h3><div>A retrospective analysis of ES-SCLC patients without brain metastases who were all treated with CTRT between 2013–2021 at our institution was conducted. Overall survival (OS) and incidence of brain failure (BFR) were estimated using Kaplan-Meier estimation and cumulative incidence function. Multivariable Cox or Fine-Gray’s proportional hazard regression analysis (MVA) were performed to determine association between PCI and OS.</div></div><div><h3>Results</h3><div>47 patients met inclusion criteria and were theoretically eligible for PCI, 27 (57.4 %) received PCI and CTRT while 20 (42.6 %) received CTRT alone. Baseline characteristics were similar except for age, where patients receiving PCI were younger (median age 62) compared to patients who did not receive PCI (median age 72). Median OS with PCI was 19.2 months, compared to 10.8 months without PCI (<em>P =</em> 0.0334). This improved OS remained apparent in patients who received post-chemotherapy MRI restaging (<em>P =</em> 0.0245). BFR was reduced with PCI (HR = 0.22 [0.09–0.52], <em>P</em> = 0.0004). On MVA, PCI was significantly and independently associated with improved OS (HR = 0.39 [0.19–0.80], <em>P</em> = 0.01) and reduced BFR (HR = 0.20 [0.09–0.44], <em>P</em> = &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>This real-world study found PCI was independently associated with improved OS and reduced BFR in ES-SCLC patients treated with CTRT compared to patients treated with CTRT not receiving PCI, including after post-chemotherapy brain MRI. The role of PCI with CTRT should be evaluated in prospective studies.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"51 ","pages":"Article 100917"},"PeriodicalIF":2.7,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078717","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":"Large language models for pretreatment education in pediatric radiation oncology: A comparative evaluation study","authors":"Dominik Wawrzuta ,&nbsp;Aleksandra Napieralska ,&nbsp;Katarzyna Ludwikowska ,&nbsp;Laimonas Jaruševičius ,&nbsp;Anastasija Trofimoviča-Krasnorucka ,&nbsp;Gints Rausis ,&nbsp;Agata Szulc ,&nbsp;Katarzyna Pędziwiatr ,&nbsp;Kateřina Poláchová ,&nbsp;Justyna Klejdysz ,&nbsp;Marzanna Chojnacka","doi":"10.1016/j.ctro.2025.100914","DOIUrl":"10.1016/j.ctro.2025.100914","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Pediatric radiotherapy patients and their parents are usually aware of their need for radiotherapy early on, but they meet with a radiation oncologist later in their treatment. Consequently, they search for information online, often encountering unreliable sources. Large language models (LLMs) have the potential to serve as an educational pretreatment tool, providing reliable answers to their questions. We aimed to evaluate the responses provided by generative pre-trained transformers (GPT), the most popular subgroup of LLMs, to questions about pediatric radiation oncology.</div></div><div><h3>Materials and methods</h3><div>We collected pretreatment questions regarding radiotherapy from patients and parents. Responses were generated using GPT-3.5, GPT-4, and fine-tuned GPT-3.5, with fine-tuning based on pediatric radiotherapy guides from various institutions. Additionally, a radiation oncologist prepared answers to these questions. Finally, a multi-institutional group of nine pediatric radiotherapy experts conducted a blind review of responses, assessing reliability, concision, and comprehensibility.</div></div><div><h3>Results</h3><div>The radiation oncologist and GPT-4 provided the highest-quality responses, though GPT-4′s answers were often excessively verbose. While fine-tuned GPT-3.5 generally outperformed basic GPT-3.5, it often provided overly simplistic answers. Inadequate responses were rare, occurring in 4% of GPT-generated responses across all models, primarily due to GPT-3.5 generating excessively long responses.</div></div><div><h3>Conclusions</h3><div>LLMs can be valuable tools for educating patients and their families before treatment in pediatric radiation oncology. Among them, only GPT-4 provides information of a quality comparable to that of a radiation oncologist, although it still occasionally generates poor-quality responses. GPT-3.5 models should be used cautiously, as they are more likely to produce inadequate answers to patient questions.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"51 ","pages":"Article 100914"},"PeriodicalIF":2.7,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11762905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045716","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":"Detection of alteration in carotid artery volumetry using standard-of-care computed tomography surveillance scans following unilateral radiation therapy for early-stage tonsillar squamous cell carcinoma survivors: a cross-sectional internally-matched carotid isodose analysis","authors":"Efstratios Koutroumpakis ,&nbsp;Mohamed A. Naser ,&nbsp;Abdallah Sherif Radwan Mohamed ,&nbsp;Salman A. Eraj ,&nbsp;Andrea Jarre ,&nbsp;Jay C. Shiao ,&nbsp;Mona Kamal ,&nbsp;Subha Perni ,&nbsp;Jack P. Phan ,&nbsp;William H. Morrison ,&nbsp;Steven J. Frank ,&nbsp;G.Brandon Gunn ,&nbsp;Adam S. Garden ,&nbsp;Anita Deswal ,&nbsp;Jun-ichi Abe ,&nbsp;David I. Rosenthal ,&nbsp;Elie Mouhayar ,&nbsp;Clifton D. Fuller","doi":"10.1016/j.ctro.2025.100912","DOIUrl":"10.1016/j.ctro.2025.100912","url":null,"abstract":"<div><h3>Aim</h3><div>This study leveraged standard-of-care CT scans of patients receiving unilateral radiotherapy (RT) for early tonsillar cancer to detect volumetric changes in the carotid arteries, and determine whether there is a dose–response relationship.</div></div><div><h3>Methods</h3><div>Disease-free cancer survivors (&gt;3 months since therapy and age &gt; 18 years) treated with intensity modulated RT for early (T1-2, N0-2b) tonsillar cancer with pre- and post-therapy contrast-enhanced CT scans available were included. Patients treated with definitive surgery, bilateral RT, or additional RT before the post-RT CT scan were excluded. Isodose lines from treatment plans were projected onto both scans, facilitating the delineation of carotid artery subvolumes in 5 Gy increments (i.e. received 50–55 Gy, 55–60 Gy, etc.). The percent-change in sub-volumes across each dose range was examined.</div></div><div><h3>Results</h3><div>Among 46 patients, 72 % received RT alone, 24 % induction chemotherapy followed by RT, and 4 % concurrent chemoradiation. The median interval from RT completion to the latest, post-RT CT scan was 43 months (IQR 32–57). A decrease in the volume of the irradiated carotid artery was observed in 78 % of patients, while there was a statistically significant difference in mean %-change (±SD) between the total irradiated and spared carotid volumes (−7.0 ± 9.0 vs. + 3.5 ± 7.2, respectively, p &lt; 0.0001). Chemotherapy use, in addition to RT, was associated with a significant mean %-decrease in carotid artery volume compared to RT alone. No significant dose–response trend was observed in the carotid artery volume change within 5 Gy ranges.</div></div><div><h3>Conclusions</h3><div>Our data show that standard-of-care oncologic surveillance CT scans can effectively detect reductions in carotid volume following RT for oropharyngeal cancer. Changes were equivalent between studied dose ranges, denoting no further dose–response effect beyond 50 Gy.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"51 ","pages":"Article 100912"},"PeriodicalIF":2.7,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11762641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045703","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 first evaluation of the efficacy of minibeam radiation therapy combined with an immune check point inhibitor in a model of glioma-bearing rats","authors":"Lorea Iturri ,&nbsp;Emmanuel Jouglar ,&nbsp;Cristèle Gilbert ,&nbsp;Julie Espenon ,&nbsp;Marjorie Juchaux ,&nbsp;Yolanda Prezado","doi":"10.1016/j.ctro.2025.100911","DOIUrl":"10.1016/j.ctro.2025.100911","url":null,"abstract":"<div><div>Glioblastoma multiforme (GBM) continues to be a hopeless case today. Its treatment involves the use of multiple modalities. One of them is radiation therapy (RT), that is limited by normal tissue tolerances in GBM patients. GBM is widely recognized to induce local and systemic immunosuppression, which is a hindrance to the use of immune-modulating therapies. One possible strategy is to ally immunotherapy (IT) with novel RT approaches able to revert the immunosuppressive nature of GBM. One example is minibeam radiation therapy (MBRT). Preclinical experiments have shown that MBRT leads to a remarkable widening of the therapeutic window for GBM and elicits an effective immune priming. The main hypothesis of this study is that the activation of the immune system by MBRT would synergize with IT enhancing tumour control and minimizing toxicities. To validate it, <em>in vivo</em> experiments in a glioma rat model were performed. The goal was to assess the gain in survival of animals treated with MBRT, MBRT plus an immune check point inhibitor (ICI) versus conventional RT (CRT) or ICI alone. All treatments (ICI alone, CRT, CRT + ICI, MBRT and MBRT + ICI) increased survival with respect to the non-irradiated controls. However, the high radiation dose (30 Gy) delivered in one fraction in CRT is highly detrimental for normal tissues contrary to MBRT. The combination of CRT plus ICI appeared to be toxic. MBRT + ICI surpassed the survival rate with respect to ICI alone. When ICI was used with high-dose conventional irradiation, tumor eradication was observed in 6 out 8 animals. However, the survival was statistically equivalent to MBRT plus ICI, with a tendency to reduce survival in comparison with CRT alone, suggesting acute toxicity associated with this multimodal treatment.</div><div>In conclusion, our results suggest some advantages for MBRT in combination with ICI. We need to conduct further work to determine the optimal RT-IT combination and schedule for ICI injection and MBRT irradiation.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"51 ","pages":"Article 100911"},"PeriodicalIF":2.7,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078640","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":"Position in proton Bragg curve influences DNA damage complexity and survival in head and neck cancer cells","authors":"Tim Heemskerk ,&nbsp;Celebrity Groenendijk ,&nbsp;Marta Rovituso ,&nbsp;Ernst van der Wal ,&nbsp;Wouter van Burik ,&nbsp;Konstantinos Chatzipapas ,&nbsp;Danny Lathouwers ,&nbsp;Roland Kanaar ,&nbsp;Jeremy M.C. Brown ,&nbsp;Jeroen Essers","doi":"10.1016/j.ctro.2024.100908","DOIUrl":"10.1016/j.ctro.2024.100908","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Understanding the cellular and molecular effect of proton radiation, particularly the increased DNA damage complexity at the distal end of the Bragg curve, is current topic of investigation. This work aims to study <em>in vitro</em> clonogenic survival and DNA damage foci kinetics of a head and neck squamous cell carcinoma cell line at various positions along a double passively scattered Bragg curve. Complementary <em>in silico</em> studies are conducted to gain insights into the link between cell survival variations, experimentally yielded foci and the number and complexity of double strand breaks (DSBs).</div></div><div><h3>Materials and methods</h3><div>Proton irradiations are performed at the HollandPTC R&amp;D proton beamline, using a double passively scattered setup. A custom water phantom setup is employed to accurately position the samples within the Bragg curve. FaDu cells are irradiated at the proximal 36 % point of the Bragg peak, (P36), proximal 80 % point of the Bragg peak (P80) and distal 20 % point of the Bragg peak (D20), with dose-averaged mean lineal energies (<span><math><mover><mrow><msub><mi>y</mi><mi>D</mi></msub></mrow><mrow><mo>¯</mo></mrow></mover></math></span>) of 1.10 keV/μm, 1.80 keV/μm and 7.25 keV/μm, respectively.</div></div><div><h3>Results</h3><div>Clonogenic survival correlates strongly with <span><math><mover><mrow><msub><mi>y</mi><mi>D</mi></msub></mrow><mrow><mo>¯</mo></mrow></mover></math></span>, showing similar survival for P36 (D_37%=3.0 Gy) and P80 (D_37%=2.9 Gy), but decreased survival for D20 (D_37% = 1.6 Gy). D20 irradiated samples exhibit increased 53BP1 foci shortly after irradiation, slower resolution of the foci, and larger residual 53BP1 foci after 24 h, indicating unrepaired complex breaks. These experimental observations are supported by the <em>in silico</em> study which demonstrates that irradiation at D20 leads to a 1.7-fold increase in complex DSBs with respect to the total number of strand breaks compared to P36 and P80.</div></div><div><h3>Conclusions</h3><div>This combined approach provides valuable insights into the cellular and molecular effect of proton radiation, emphasizing the increased DNA damage complexity at the distal end of the Bragg curve, and has the potential to enhance the efficacy of proton therapy.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"51 ","pages":"Article 100908"},"PeriodicalIF":2.7,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058131","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}