Pub Date : 2025-08-31DOI: 10.1016/j.ctro.2025.101039
Y.A. Civil , A.H. Eijkelboom , A.E. Veldink , M.C. van Maarenc , J.H. Maduro , K.M. Duvivier , S. Siesling , H.J.G.D. van den Bongard
Purpose
This study aimed to investigate whether the introduction of partial breast irradiation (PBI) was associated with increased MRI use in the Netherlands from 2011 to 2022, and examined the impact of MRI on treatment and outcomes.
Methods
Women aged ≥50 who underwent surgery (without preoperative systemic therapy) for cT1-2N0M0 breast cancer or DCIS between 2011 and 2022 were selected from the Netherlands Cancer Registry. Logistic regression was used to analyze associations between MRI and treatment or surgical radicality, stratified by tumour type. Subgroup analyses were performed in patients meeting ASTRO PBI criteria (unifocal cT1, grade 1/2, ER-positive, pure DCIS ≤ 2,5 cm).
Results
Among 119,768 patients, 35,863 (30 %) received MRI, increasing from 24 % (2011) to 37 % (2022). PBI use increased from 3 % (2017) to 21 % (2022). MRI was not associated with the probability of receiving PBI (OR 0.98, 95 % CI:0.90–1.07). In patients with invasive breast cancer, MRI was associated with fewer DCIS-involved margins (OR 0.81, 95 % CI:0.74–0.89), but a higher probability of mastectomy (OR 1.29, 95 % CI:1.24–1.34). In patients with an ASTRO-defined PBI indication, MRI use was associated with a decreased likelihood of receiving PBI in invasive cancer (OR:0.66, 95 % CI:0.60–0.72) and DCIS (OR:0.80, 95 % CI:0.75–0.85).
Conclusion
This study shows rising trends in PBI and MRI use in the Netherlands from 2011 to 2022. MRI reduced PBI eligibility and enhanced surgical precision by less involved margins in patients with cT1N0 breast cancer without PST.
{"title":"Trends in use of magnetic resonance imaging and partial breast irradiation between 2011–2022 in the Netherlands: A population-based study","authors":"Y.A. Civil , A.H. Eijkelboom , A.E. Veldink , M.C. van Maarenc , J.H. Maduro , K.M. Duvivier , S. Siesling , H.J.G.D. van den Bongard","doi":"10.1016/j.ctro.2025.101039","DOIUrl":"10.1016/j.ctro.2025.101039","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to investigate whether the introduction of partial breast irradiation (PBI) was associated with increased MRI use in the Netherlands from 2011 to 2022, and examined the impact of MRI on treatment and outcomes.</div></div><div><h3>Methods</h3><div>Women aged ≥50 who underwent surgery (without preoperative systemic therapy) for cT1-2N0M0 breast cancer or DCIS between 2011 and 2022 were selected from the Netherlands Cancer Registry. Logistic regression was used to analyze associations between MRI and treatment or surgical radicality, stratified by tumour type. Subgroup analyses were performed in patients meeting ASTRO PBI criteria (unifocal cT1, grade 1/2, ER-positive, pure DCIS ≤ 2,5 cm).</div></div><div><h3>Results</h3><div>Among 119,768 patients, 35,863 (30 %) received MRI, increasing from 24 % (2011) to 37 % (2022). PBI use increased from 3 % (2017) to 21 % (2022). MRI was not associated with the probability of receiving PBI (OR 0.98, 95 % CI:0.90–1.07). In patients with invasive breast cancer, MRI was associated with fewer DCIS-involved margins (OR 0.81, 95 % CI:0.74–0.89), but a higher probability of mastectomy (OR 1.29, 95 % CI:1.24–1.34). In patients with an ASTRO-defined PBI indication, MRI use was associated with a decreased likelihood of receiving PBI in invasive cancer (OR:0.66, 95 % CI:0.60–0.72) and DCIS (OR:0.80, 95 % CI:0.75–0.85).</div></div><div><h3>Conclusion</h3><div>This study shows rising trends in PBI and MRI use in the Netherlands from 2011 to 2022. MRI reduced PBI eligibility and enhanced surgical precision by less involved margins in patients with cT1N0 breast cancer without PST.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"55 ","pages":"Article 101039"},"PeriodicalIF":2.7,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-26DOI: 10.1016/j.ctro.2025.101037
Elena Moreno-Olmedo, Dan Murray, Ben George, Daniel Ford, Nicola Dallas, Prantik Das, Ami Sabharwal, Yoodhvir Nagar, Jamie Mills, Carla Perna, Yae-eun Suh, Alex Martin, Philip Camilleri
Introduction
Stereotactic ablative radiotherapy (SABR) is a salvage option for locally recurrent prostate cancer (LRPC); however, challenges remain. Stereotactic MRguided Adaptive Radiotherapy (SMART) permits daily adaptation, real-time tracking and automated beam gating, allowing critical organ sparing while potentially improving target coverage. Equivalent Dose in 2 Gy fraction (EQD2) calculation allows accurate organs-at-risk (OAR) dose accumulation in re-irradiation.
We report safety and efficacy of daily SMART re-irradiation for LRPC, alongside an EQD2-based OAR tolerance calculation method.
Methods
Salvage SMART to histologically proven non-metastatic hormone-sensitive LRPC was retrospectively analysed. Inclusion criteria included: ≥18 months post-RT, prostate-specific antigen (PSA) ≤ 30 ng/mL, PSA doubling-time > 6 months, International Prostate Symptom Score (IPSS) ≤ 19, prostate ≤ 80 cc and cT1–T3a/b.Reirradiation regimens were 30–35 Gy/5 fractions. Dose-boost and hormone therapy were allowed. Rectal spacer was recommended.
Outcomes included toxicity, local control (LC), biochemical relapse-free survival (bRFS), progression free survival (PFS) and overall survival (OS). EQD2-based workflow to estimate OAR cumulative constraints was reported.
Results
Between 2019 and 2023, nineteen patients underwent salvage-SMART to whole-gland (n = 12), hemi-gland (n = 5) or seminal vesicle (n = 2) at a median 87 months (range 35–587) from first radiotherapy. All 95 delivered fractions underwent online adaptation, meeting all estimated OAR.
With 21 months follow-up, acute grade 2 genitourinary (GU) toxicity was 21 % with no acute ≥ grade 3 GU or ≥ grade 2 gastrointestinal (GI) toxicity observed. Late GU grade 3 toxicity occurred in 3 patients (15.7 %).
OS was 100%; bRFS 73.7%; LC 84.2%; and median-PFS was not reached. One and two-year PFS were 94.7% and 89.4%. One and two-year LC was 100%. Two contralateral intraprostatic failures followed hemi-gland treatment were observed.
Conclusion
Daily adaptive SMART re-irradiation is a feasible, non-invasive salvage option for LRPC, combining high LC with low toxicity. Our experience supports integrating MR- guidance with an individualized EQD2-informed planning.
{"title":"Salvage stereotactic MR-Guided adaptive radiotherapy (SMART) re-irradiation for locally recurrent prostate Cancer: Clinical and dosimetric outcomes","authors":"Elena Moreno-Olmedo, Dan Murray, Ben George, Daniel Ford, Nicola Dallas, Prantik Das, Ami Sabharwal, Yoodhvir Nagar, Jamie Mills, Carla Perna, Yae-eun Suh, Alex Martin, Philip Camilleri","doi":"10.1016/j.ctro.2025.101037","DOIUrl":"10.1016/j.ctro.2025.101037","url":null,"abstract":"<div><h3>Introduction</h3><div>Stereotactic ablative radiotherapy (SABR) is a salvage option for locally recurrent prostate cancer (LRPC); however, challenges remain. Stereotactic MRguided Adaptive Radiotherapy (SMART) permits daily adaptation, real-time tracking and automated beam gating, allowing critical organ sparing while potentially improving target coverage. Equivalent Dose in 2 Gy fraction (EQD2) calculation allows accurate organs-at-risk (OAR) dose accumulation in re-irradiation.</div><div>We report safety and efficacy of daily SMART re-irradiation for LRPC, alongside an EQD2-based OAR tolerance calculation method.</div></div><div><h3>Methods</h3><div>Salvage SMART to histologically proven non-metastatic hormone-sensitive LRPC was retrospectively analysed. Inclusion criteria included: ≥18 months post-RT, prostate-specific antigen (PSA) ≤ 30 ng/mL, PSA doubling-time > 6 months, International Prostate Symptom Score (IPSS) ≤ 19, prostate ≤ 80 cc and cT1–T3a/b.Reirradiation regimens were 30–35 Gy/5 fractions. Dose-boost and hormone therapy were allowed. Rectal spacer was recommended.</div><div>Outcomes included toxicity, local control (LC), biochemical relapse-free survival (bRFS), progression free survival (PFS) and overall survival (OS). EQD2-based workflow to estimate OAR cumulative constraints was reported.</div></div><div><h3>Results</h3><div>Between 2019 and 2023, nineteen patients underwent salvage-SMART to whole-gland (n = 12), hemi-gland (n = 5) or seminal vesicle (n = 2) at a median 87 months (range 35–587) from first radiotherapy. All 95 delivered fractions underwent online adaptation, meeting all estimated OAR.</div><div>With 21 months follow-up, acute grade 2 genitourinary (GU) toxicity was 21 % with no acute ≥ grade 3 GU or ≥ grade 2 gastrointestinal (GI) toxicity observed. Late GU grade 3 toxicity occurred in 3 patients (15.7 %).</div><div>OS was 100%; bRFS 73.7%; LC 84.2%; and median-PFS was not reached. One and two-year PFS were 94.7% and 89.4%. One and two-year LC was 100%. Two contralateral intraprostatic failures followed hemi-gland treatment were observed.</div></div><div><h3>Conclusion</h3><div>Daily adaptive SMART re-irradiation is a feasible, non-invasive salvage option for LRPC, combining high LC with low toxicity. Our experience supports integrating MR- guidance with an individualized EQD2-informed planning.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101037"},"PeriodicalIF":2.7,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-24DOI: 10.1016/j.ctro.2025.101038
Dayu Xu , Yechun Pang , Jinghan Qu , Jiuang Mao , Tiantian Guo , Shanshan Jiang , Yue Zhou , Li Chu , Xi Yang , Xiao Chu , Shengping Wang , Tong Tong , Zhengfei Zhu , Jianjiao Ni
Background
Hypofractionated stereotactic radiotherapy (fSRT) is increasingly used for brain metastases (BMs) from non-small cell lung cancer (NSCLC). However, relevant data concerning treatment outcomes of fSRT and clinical utility of re-irradiation using fSRT (re-fSRT) remain scarce.
Methods
Consecutive NSCLC patients with fSRT-treated BMs from May 2018 to May 2022 were included. The cumulative incidence of intracranial local recurrence (iLR), intracranial progressive disease (iPD) and symptomatic radiation necrosis (sRN) were calculated from the initiation of fSRT, choosing death as the competing event. Patients with limited iPD (number ≤5 and size ≤3 cm) and without iLR developed within 12 months, were classified as re-fSRT candidates. The clinical value of re-fSRT and dosimetric predictors of sRN were investigated.
Results
With a median follow-up of 22.3 months, the 1-year, 2-year and 3-year cumulative incidence of iLR among the 218 identified patients were 8.1 %, 12.3 %, 17.8 %, respectively. Biological effective dose, total tumor volume and concurrent systemic therapy were associated with the risk of iLR. Notably, 45 (76.3 %) of the 59 patients with iPD were feasible for re-fSRT. Re-fSRT was performed in 19 (42.2 %) of the 45 candidates and associated with improved survival (p = 0.010). The 1-year, 2-year and 3-year cumulative incidence of sRN in the whole population were 4.5 %, 10.3 %, 17.7 %, respectively. Moreover, sRN occurred in 3 (15.8 %) patients receiving re-fSRT and Brain V20Gy was found to be associated with the risk of sRN.
Conclusion
fSRT is a promising treatment for limited BMs from NSCLC and some patients may benefit from re-fSRT.
{"title":"Prognostic factors, patterns of failure and re-irradiation in hypofractionated stereotactic radiotherapy-treated brain metastases from non-small cell lung cancer","authors":"Dayu Xu , Yechun Pang , Jinghan Qu , Jiuang Mao , Tiantian Guo , Shanshan Jiang , Yue Zhou , Li Chu , Xi Yang , Xiao Chu , Shengping Wang , Tong Tong , Zhengfei Zhu , Jianjiao Ni","doi":"10.1016/j.ctro.2025.101038","DOIUrl":"10.1016/j.ctro.2025.101038","url":null,"abstract":"<div><h3>Background</h3><div>Hypofractionated stereotactic radiotherapy (fSRT) is increasingly used for brain metastases (BMs) from non-small cell lung cancer (NSCLC). However, relevant data concerning treatment outcomes of fSRT and clinical utility of re-irradiation using fSRT (re-fSRT) remain scarce.</div></div><div><h3>Methods</h3><div>Consecutive NSCLC patients with fSRT-treated BMs from May 2018 to May 2022 were included. The cumulative incidence of intracranial local recurrence (iLR), intracranial progressive disease (iPD) and symptomatic radiation necrosis (sRN) were calculated from the initiation of fSRT, choosing death as the competing event. Patients with limited iPD (number ≤5 and size ≤3 cm) and without iLR developed within 12 months, were classified as re-fSRT candidates. The clinical value of re-fSRT and dosimetric predictors of sRN were investigated.</div></div><div><h3>Results</h3><div>With a median follow-up of 22.3 months, the 1-year, 2-year and 3-year cumulative incidence of iLR among the 218 identified patients were 8.1 %, 12.3 %, 17.8 %, respectively. Biological effective dose, total tumor volume and concurrent systemic therapy were associated with the risk of iLR. Notably, 45 (76.3 %) of the 59 patients with iPD were feasible for re-fSRT. Re-fSRT was performed in 19 (42.2 %) of the 45 candidates and associated with improved survival (<em>p</em> = 0.010). The 1-year, 2-year and 3-year cumulative incidence of sRN in the whole population were 4.5 %, 10.3 %, 17.7 %, respectively. Moreover, sRN occurred in 3 (15.8 %) patients receiving re-fSRT and Brain V20Gy was found to be associated with the risk of sRN.</div></div><div><h3>Conclusion</h3><div>fSRT is a promising treatment for limited BMs from NSCLC and some patients may benefit from re-fSRT.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"55 ","pages":"Article 101038"},"PeriodicalIF":2.7,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144902886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-21DOI: 10.1016/j.ctro.2025.101036
Robert Rulach , Stephen Harrow , Anthony J. Chalmers , John Fenwick
Background and purpose
Loco-regional recurrence is seen in up to 50 % of patients with non-small cell lung cancer (NSCLC) by 2 years after curative intent radiotherapy (RT). For these patients, radical re-irradiation (re-RT) is possible, but data is lacking regarding efficacy and radiation dose response, especially about conventionally fractionated re-irradiation. We analysed associations between survival following re-irradiation and RT dose, to guide clinicians regarding target re-RT dose, and predict re-treatment efficacy.
Material and methods
We performed a literature search for studies primarily comprised of NSCLC patients that detailed 2-year overall survival (OS2-yr) rates and delivered doses. These data were collated with intervals between treatments, PTV sizes and use of concurrent chemotherapy where this information was available. Logistic regression analyses of associations between OS2-yr and treatment and patient factors were carried out. Doses required for 30% and 50% OS2-yr were calculated.
Results
We identified 20 suitable studies (675 patients). In univariable models, OS2-yr was significantly associated with the initial RT dose, re-RT dose and chemotherapy use but not the interval. The best multivariable OS2-yr model according to the Akaike Information Criterion included only the re-RT dose (p < 0.05) and described the data well (Hosmer-Lemeshow p-value = 0.385). This model predicted OS2-yr rates of 30 % and 50 % at re-RT equivalent doses in 2 Gy fractions (EQD2s) of 49.8 Gy10 (95 % CI 36.4, 58.0 Gy10) and 76.5 Gy10 (95 % CI 70.8, 82.7 Gy10) respectively.
Conclusion
OS2-yr following re-RT of recurrent NSCLC is significantly associated with retreatment dose. A reasonable target dose for re-RT is EQD2s > 50 Gy10 with survival rates continuing to increase to 85 Gy10.
{"title":"Re-irradiation of recurrent lung tumours: Associations between dose and 2-year survival","authors":"Robert Rulach , Stephen Harrow , Anthony J. Chalmers , John Fenwick","doi":"10.1016/j.ctro.2025.101036","DOIUrl":"10.1016/j.ctro.2025.101036","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Loco-regional recurrence is seen in up to 50 % of patients with non-small cell lung cancer (NSCLC) by 2 years after curative intent radiotherapy (RT). For these patients, radical re-irradiation (re-RT) is possible, but data is lacking regarding efficacy and radiation dose response, especially about conventionally fractionated re-irradiation. We analysed associations between survival following re-irradiation and RT dose, to guide clinicians regarding target re-RT dose, and predict re-treatment efficacy.</div></div><div><h3>Material and methods</h3><div>We performed a literature search for studies primarily comprised of NSCLC patients that detailed 2-year overall survival (OS<sub>2-yr</sub>) rates and delivered doses. These data were collated with intervals between treatments, PTV sizes and use of concurrent chemotherapy where this information was available. Logistic regression analyses of associations between OS<sub>2-yr</sub> and treatment and patient factors were carried out. Doses required for 30% and 50% OS<sub>2-yr</sub> were calculated.</div></div><div><h3>Results</h3><div>We identified 20 suitable studies (675 patients). In univariable models, OS<sub>2-yr</sub> was significantly associated with the initial RT dose, re-RT dose and chemotherapy use but not the interval. The best multivariable OS<sub>2-yr</sub> model according to the Akaike Information Criterion included only the re-RT dose (p < 0.05) and described the data well (Hosmer-Lemeshow p-value = 0.385). This model predicted OS<sub>2-yr</sub> rates of 30 % and 50 % at re-RT equivalent doses in 2 Gy fractions (EQD2s) of 49.8 Gy<sub>10</sub> (95 % CI 36.4, 58.0 Gy<sub>10</sub>) and 76.5 Gy<sub>10</sub> (95 % CI 70.8, 82.7 Gy<sub>10</sub>) respectively.</div></div><div><h3>Conclusion</h3><div>OS<sub>2-yr</sub> following re-RT of recurrent NSCLC is significantly associated with retreatment dose. A reasonable target dose for re-RT is EQD2s > 50 Gy<sub>10</sub> with survival rates continuing to increase to 85 Gy<sub>10</sub>.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"55 ","pages":"Article 101036"},"PeriodicalIF":2.7,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144892913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-19DOI: 10.1016/j.ctro.2025.101035
Vaseem M. Khatri , G.Daniel Grass , Ram Thapa , Laura Maun-Garcia , Kujtim Latifi , Arash O. Naghavi , Aditya Garg , Daniel Fernandez , Javier Torres-Roca , Anupam Rishi , Omeed Jazayeri-Moghaddas , Julio Pow-Sang , Peter A.S. Johnstone , Kosj Yamoah , Nainesh Parikh
Background
Radiation therapy (RT) for prostate cancer has gastrointestinal and genitourinary toxicities, greater with baseline lower urinary tract symptoms (LUTS) and larger prostate volume (PV). Prostate artery embolization (PAE) improves LUTS and PV before RT. This study evaluates the durability of LUTS improvement from neoadjuvant PAE before prostate RT and oncologic outcomes.
Methods
We retrospectively identified patients receiving definitive prostate RT following PAE from a prospective database, including International Prostate Symptom Scores (IPSS), pre- and post-PAE MRI PV, and toxicity per CTCAEv5.0. Primary objective was LUTS by IPSS. Secondary objectives included biochemical recurrence-free survival (bRFS), local recurrence, and distant metastasis.
Results
From 9/2017–5/2024, 82 patients underwent PAE before RT, with 30.5 % having unfavorable intermediate risk. RT consisted of conventional fractionation (n = 21), moderate hypofractionation (n = 42), SBRT (n = 11), and EBRT/brachytherapy boost (n = 8); a subset of patients received androgen deprivation therapy. Pelvic lymph nodes were treated in 28 (34 %) patients. Median pre-PAE IPSS was 18 (range 2–34), PV 90 cc (14.2–240), and PSA 8.4 ng/mL (0.02–125.5). Post-PAE, mean IPSS reduction was 10.7 points (−13–30). Mean PV reduction was 30.9 cc (−9–136) or 32 %. PAE converted 52 % of patients contraindicated by size/IPSS for brachytherapy/SBRT. Post-RT, mean IPSS changes at 3, 6, 12, 18 and 24 months were −8.7, −8.5, −9.5, −8.9, and −7.6, respectively (p < 0.001). At 24.2-month median follow-up, 1 local recurrence occurred. Two-year bRFS was 92 % for non-metastatic patients.
Conclusion
Urinary improvement is durable after RT in men with large prostates and/or high LUTS burden with neoadjuvant PAE, and no increased risk of recurrence at intermediate-term follow-up. Further investigation is warranted.
{"title":"Neoadjuvant prostate artery embolization prior to prostate radiation therapy: A single institution experience on the durability of clinical urinary improvement after radiation","authors":"Vaseem M. Khatri , G.Daniel Grass , Ram Thapa , Laura Maun-Garcia , Kujtim Latifi , Arash O. Naghavi , Aditya Garg , Daniel Fernandez , Javier Torres-Roca , Anupam Rishi , Omeed Jazayeri-Moghaddas , Julio Pow-Sang , Peter A.S. Johnstone , Kosj Yamoah , Nainesh Parikh","doi":"10.1016/j.ctro.2025.101035","DOIUrl":"10.1016/j.ctro.2025.101035","url":null,"abstract":"<div><h3>Background</h3><div>Radiation therapy (RT) for prostate cancer has gastrointestinal and genitourinary toxicities, greater with baseline lower urinary tract symptoms (LUTS) and larger prostate volume (PV). Prostate artery embolization (PAE) improves LUTS and PV before RT. This study evaluates the durability of LUTS improvement from neoadjuvant PAE before prostate RT and oncologic outcomes.</div></div><div><h3>Methods</h3><div>We retrospectively identified patients receiving definitive prostate RT following PAE from a prospective database, including International Prostate Symptom Scores (IPSS), pre- and post-PAE MRI PV, and toxicity per CTCAEv5.0. Primary objective was LUTS by IPSS. Secondary objectives included biochemical recurrence-free survival (bRFS), local recurrence, and distant metastasis.</div></div><div><h3>Results</h3><div>From 9/2017–5/2024, 82 patients underwent PAE before RT, with 30.5 % having unfavorable intermediate risk. RT consisted of conventional fractionation (n = 21), moderate hypofractionation (n = 42), SBRT (n = 11), and EBRT/brachytherapy boost (n = 8); a subset of patients received androgen deprivation therapy. Pelvic lymph nodes were treated in 28 (34 %) patients. Median pre-PAE IPSS was 18 (range 2–34), PV 90 cc (14.2–240), and PSA 8.4 ng/mL (0.02–125.5). Post-PAE, mean IPSS reduction was 10.7 points (−13–30). Mean PV reduction was 30.9 cc (−9–136) or 32 %. PAE converted 52 % of patients contraindicated by size/IPSS for brachytherapy/SBRT. Post-RT, mean IPSS changes at 3, 6, 12, 18 and 24 months were −8.7, −8.5, −9.5, −8.9, and −7.6, respectively (<em>p</em> < 0.001). At 24.2-month median follow-up, 1 local recurrence occurred. Two-year bRFS was 92 % for non-metastatic patients.</div></div><div><h3>Conclusion</h3><div>Urinary improvement is durable after RT in men with large prostates and/or high LUTS burden with neoadjuvant PAE, and no increased risk of recurrence at intermediate-term follow-up. Further investigation is warranted.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"55 ","pages":"Article 101035"},"PeriodicalIF":2.7,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-18DOI: 10.1016/j.ctro.2025.101034
Sylvia Nwokolo, Laure Marignol
Background
Stereotactic body radiotherapy (SBRT) is evolving as treatment modality for kidney cancer alongside increased recognition of the importance of sex as a biological variable (SABV) policy in generating deeper insights.
Purpose
This review aimed to assess the representation of male and female patients and the reporting of sex-specific outcomes in SBRT clinical studies for primary localised kidney cancer.
Methodology
A database search with appropriate search terms was carried out on EMBASE, CINAHL, and Web of Science. Consideration of biological sex was assessed with the male: female ratio, reporting of sex-specific treatment outcomes, and inclusion of sex as a variable in univariate and/or multivariate analysis.
Main findings:
Twenty-two studies were included. Of 961 patients (with sex stated), 29.24 % were females, with a mean male to female ratio of 2.57 and standard deviation of 1.22 across the studies. There was no relationship between the year, region and study type, and the male to female ratio recorded (Chi-squared test, p = 0.099, 0.29, and 0.719 respectively). Only six studies were sex inclusive, with three reporting sex-based outcomes, and three including sex-specific analysis. Of these, only one study reported significant difference in survival.
Conclusion
Supporting the integration of SABV will promote more equitable and biologically informed evidence for the use of SBRT in the management of kidney cancer.
背景：立体定向放射治疗（SBRT）正在发展成为肾癌的治疗方式，同时人们越来越认识到性别作为生物变量（SABV）政策的重要性，从而产生更深入的见解。目的：本综述旨在评估原发性局部肾癌SBRT临床研究中男性和女性患者的代表性以及性别特异性结果的报告。方法在EMBASE、CINAHL、Web of Science等数据库中选择合适的检索词进行检索。通过男女比例、性别特异性治疗结果的报告以及在单因素和/或多因素分析中将性别作为变量来评估生理性别的考虑。主要发现：纳入22项研究。961例患者（注明性别）中，29.24%为女性，研究中平均男女比例为2.57，标准差为1.22。年份、地区、研究类型与记录的男女比例无关（卡方检验，p分别= 0.099、0.29、0.719）。只有6项研究包含了性别，其中3项报告了基于性别的结果，3项包括了针对性别的分析。在这些研究中，只有一项研究报告了生存率的显著差异。结论支持SABV的整合将为SBRT在肾癌治疗中的应用提供更加公平和生物学知情的证据。
{"title":"Biological sex representation and reporting in stereotactic body radiotherapy for kidney cancer: A review of clinical studies","authors":"Sylvia Nwokolo, Laure Marignol","doi":"10.1016/j.ctro.2025.101034","DOIUrl":"10.1016/j.ctro.2025.101034","url":null,"abstract":"<div><h3>Background</h3><div>Stereotactic body radiotherapy (SBRT) is evolving as treatment modality for kidney cancer alongside increased recognition of the importance of sex as a biological variable (SABV) policy in generating deeper insights.</div></div><div><h3>Purpose</h3><div>This review aimed to assess the representation of male and female patients and the reporting of sex-specific outcomes in SBRT clinical studies for primary localised kidney cancer.</div></div><div><h3>Methodology</h3><div>A database search with appropriate search terms was carried out on EMBASE, CINAHL, and Web of Science. Consideration of biological sex was assessed with the male: female ratio, reporting of sex-specific treatment outcomes, and inclusion of sex as a variable in univariate and/or multivariate analysis.</div><div><em><strong>Main findings</strong></em>:</div><div>Twenty-two studies were included. Of 961 patients (with sex stated), 29.24 % were females, with a mean male to female ratio of 2.57 and standard deviation of 1.22 across the studies. There was no relationship between the year, region and study type, and the male to female ratio recorded (Chi-squared test, p = 0.099, 0.29, and 0.719 respectively). Only six studies were sex inclusive, with three reporting sex-based outcomes, and three including sex-specific analysis. Of these, only one study reported significant difference in survival.</div></div><div><h3>Conclusion</h3><div>Supporting the integration of SABV will promote more equitable and biologically informed evidence for the use of SBRT in the management of kidney cancer.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"55 ","pages":"Article 101034"},"PeriodicalIF":2.7,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-13DOI: 10.1016/j.ctro.2025.101032
Lucas Mose , Priyamvada Maitre , Pascal Eberz , Thomas Zilli , Osama Mohamad , Vedang Murthy , Christian D. Fankhauser , Bernhard Kiss , Beat Roth , Daniel M. Aebersold , Ursula Vogl , Mohamed Shelan
Introduction
Small cell bladder cancer is an aggressive histological subtype and represents one of the most common extra-pulmonary small cell carcinomas. Treatment options include radical cystectomy, chemotherapy, radiotherapy, or combinations of these three. However, the optimal treatment approach remains unknown. This meta-analysis assesses the current literature on non-metastatic SCBC and analyzes different treatment approaches.
Methods
A comprehensive search was conducted in four electronic databases (PubMed, Scopus, Web of Science, and Cochrane Library) utilizing the search terms “small or neuroendocrine AND cancer OR Carcinoma OR Tumor OR Malignan* OR oncolog* OR metastati* OR neoplasm AND bladder or urothelial or Urologic” from inception until March 2024. Eligible papers reported treatment and overall survival (OS) of non-metastatic SCBC patients. A meta-analysis was conducted comparing treatments with radical cystectomy- and radiotherapy-based approaches in addition to the use of chemotherapy.
Results
In total, 12 articles were included in the present systematic review and meta-analysis. Regarding the comparison between radical cystectomy-based treatment and radiotherapy-based treatment, comparable OS was observed between both groups as the reported hazard ratio (HR) was found to be 1.04 (95 % confidence intervals [CI]: 0.90, 1.20, p = 0.6). After including chemotherapy in the analysis, it was observed that using radical cystectomy or radiotherapy with the addition of chemotherapy showed better OS with lower HR (0.53 [95 %CI: 0.39, 0.73], p < 0.0001) compared with radical cystectomy or radiotherapy without chemotherapy. The median OS of radical cystectomy or radiotherapy with chemotherapy was higher than that of radical cystectomy or radiotherapy without chemotherapy, and chemotherapy alone as follows: 30.89 (95 %CI: 23.82, 40.08), 19.67 (95 %CI: 16.26, 23.80), and 19.20 (95 %CI: 16.55, 22.28), respectively.
Conclusion
In this systematic review and meta-analysis, no OS difference was observed in patients undergoing radical cystectomy-based or radiotherapy-based treatments. The addition of chemotherapy to local therapy seems to improve OS. However, given the high heterogeneity of the included studies, these results should be interpreted cautiously.
小细胞膀胱癌是一种侵袭性的组织学亚型，是最常见的肺外小细胞癌之一。治疗方案包括根治性膀胱切除术、化疗、放疗或三者联合。然而，最佳的治疗方法仍然未知。本荟萃分析评估了目前关于非转移性SCBC的文献，并分析了不同的治疗方法。方法采用检索词“small or neuroendocrine and cancer or Carcinoma or Tumor or malignant * or oncolog* or metastati* or neoplasm and膀胱或尿路上皮或泌尿学”，自成立至2024年3月在PubMed、Scopus、Web of Science、Cochrane Library 4个电子数据库中进行综合检索。符合条件的论文报告了非转移性SCBC患者的治疗和总生存期（OS）。进行了一项荟萃分析，比较了根治性膀胱切除术和基于放疗的治疗方法以及化疗的使用。结果本系统综述和meta分析共纳入12篇文献。对于以根治性膀胱切除术为基础的治疗与以放疗为基础的治疗的比较，两组间的OS可比较，报告的危险比（HR）为1.04（95%可信区间[CI]: 0.90, 1.20, p = 0.6）。将化疗纳入分析后，观察到根治性膀胱切除术或放疗加化疗的OS较好，HR较低(0.53 [95% CI: 0.39, 0.73], p <；0.0001)，与根治性膀胱切除术或放疗不加化疗相比。根治性膀胱切除术或放疗加化疗的中位OS高于根治性膀胱切除术或放疗加化疗及单独化疗的中位OS分别为：30.89 （95% CI: 23.82, 40.08）、19.67 （95% CI: 16.26, 23.80）、19.20 （95% CI: 16.55, 22.28）。结论在本系统综述和荟萃分析中，以根治性膀胱切除术为基础的患者和以放疗为基础的患者的OS无差异。在局部治疗的基础上增加化疗似乎可以改善OS。然而，考虑到纳入研究的高度异质性，这些结果应谨慎解释。
{"title":"Treatment approaches for non-metastatic small cell bladder cancer: a meta-analysis of reconstructed Kaplan–Meier curves","authors":"Lucas Mose , Priyamvada Maitre , Pascal Eberz , Thomas Zilli , Osama Mohamad , Vedang Murthy , Christian D. Fankhauser , Bernhard Kiss , Beat Roth , Daniel M. Aebersold , Ursula Vogl , Mohamed Shelan","doi":"10.1016/j.ctro.2025.101032","DOIUrl":"10.1016/j.ctro.2025.101032","url":null,"abstract":"<div><h3>Introduction</h3><div>Small cell bladder cancer is an aggressive histological subtype and represents one of the most common extra-pulmonary small cell carcinomas. Treatment options include radical cystectomy, chemotherapy, radiotherapy, or combinations of these three. However, the optimal treatment approach remains unknown. This <em>meta</em>-analysis assesses the current literature on non-metastatic SCBC and analyzes different treatment approaches.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted in four electronic databases (PubMed, Scopus, Web of Science, and Cochrane Library) utilizing the search terms “small or neuroendocrine AND cancer OR Carcinoma OR Tumor OR Malignan* OR oncolog* OR metastati* OR neoplasm AND bladder or urothelial or Urologic” from inception until March 2024. Eligible papers reported treatment and overall survival (OS) of non-metastatic SCBC patients. A <em>meta</em>-analysis was conducted comparing treatments with radical cystectomy- and radiotherapy-based approaches in addition to the use of chemotherapy.</div></div><div><h3>Results</h3><div>In total, 12 articles were included in the present systematic review and <em>meta</em>-analysis. Regarding the comparison between radical cystectomy-based treatment and radiotherapy-based treatment, comparable OS was observed between both groups as the reported hazard ratio (HR) was found to be 1.04 (95 % confidence intervals [CI]: 0.90, 1.20, p = 0.6). After including chemotherapy in the analysis, it was observed that using radical cystectomy or radiotherapy with the addition of chemotherapy showed better OS with lower HR (0.53 [95 %CI: 0.39, 0.73], p < 0.0001) compared with radical cystectomy or radiotherapy without chemotherapy. The median OS of radical cystectomy or radiotherapy with chemotherapy was higher than that of radical cystectomy or radiotherapy without chemotherapy, and chemotherapy alone as follows: 30.89 (95 %CI: 23.82, 40.08), 19.67 (95 %CI: 16.26, 23.80), and 19.20 (95 %CI: 16.55, 22.28), respectively.</div></div><div><h3>Conclusion</h3><div>In this systematic review and <em>meta</em>-analysis, no OS difference was observed in patients undergoing radical cystectomy-based or radiotherapy-based treatments. The addition of chemotherapy to local therapy seems to improve OS. However, given the high heterogeneity of the included studies, these results should be interpreted cautiously.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"55 ","pages":"Article 101032"},"PeriodicalIF":2.7,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144842244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-13DOI: 10.1016/j.ctro.2025.101033
Nauman H. Malik , John P. Plastaras , Stefanie Corradini , Laura A. Dawson , Maria A. Hawkins , Kilian E. Salerno , Charles S. Mayo , Emma M. Dunne , Dorota Gabryś , Clemens Grassberger , Theodore S. Lawrence , Manju Sharma , Alanah M. Bergman , Dawn Owen , Ali Zaila , Soumon Rudra , Michael Velec , Donna H. Murrell
Purpose
Reirradiation in abdominal malignancies has grown more common with advanced radiotherapy techniques. However, clinical use and implementation varies, and there remains limited consensus on best practices for reirradiation. In this systematic review, a multidisciplinary team treating gastrointestinal and hepatobiliary malignancies within the Reirradiation Collaborative Group (ReCOG) convened to review published literature on reirradiation in the abdomen to offer insights into patient selection, radiotherapy planning, risk management, and assessing knowledge gaps for future development of guidelines.
Methods and Materials
A systematic search of Cochrane Central, CINAHL Plus, EMBASE, and PubMed up to August 30, 2024, was conducted as per Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) framework. Data on patient characteristics, radiation doses, dose constraints, treatment outcomes, and toxicities were extracted. Where feasible, pooled weighted analyses were performed.
Results
Thirty-three studies involving 1,264 patients met inclusion criteria: 30 were retrospective and 3 prospective. The median number of patients reported per study was 26 (range 2–245). Of the reported tumor sites, 718 patients had liver tumors and 277 pancreas, with smaller numbers of mixed/lymph node targets. Reirradiation doses, fractionation schemes, and dose constraints varied widely; only half of the studies provided explicit organ-at-risk constraints. Three studies included patients treated with palliative intent. Median overall survival ranged from 5.9 to 44 months, with a pooled weighted median OS of 19.6 months across 20 studies that reported it. One-year local control rates ranged from 19 % to 93 %, with severe (grade ≥ 3) toxicities typically reported in 5–15 % of patients, although one study reported 25 % lethal RILD in liver reirradiation.
Conclusion
Reirradiation in abdominal malignancies appears to be able to achieve meaningful local control and survival in select patients, though heterogeneity in planning, dosing, and toxicity reporting remains a major challenge for establishing best practices. Standardized reporting of doses, constraints, and dose-volume relationships are needed to guide safe and effective reirradiation in this setting.
{"title":"Reirradiation clinical practice in gastrointestinal abdominal malignancies: an international reirradiation collaborative group (ReCOG) systematic review","authors":"Nauman H. Malik , John P. Plastaras , Stefanie Corradini , Laura A. Dawson , Maria A. Hawkins , Kilian E. Salerno , Charles S. Mayo , Emma M. Dunne , Dorota Gabryś , Clemens Grassberger , Theodore S. Lawrence , Manju Sharma , Alanah M. Bergman , Dawn Owen , Ali Zaila , Soumon Rudra , Michael Velec , Donna H. Murrell","doi":"10.1016/j.ctro.2025.101033","DOIUrl":"10.1016/j.ctro.2025.101033","url":null,"abstract":"<div><h3>Purpose</h3><div>Reirradiation in abdominal malignancies has grown more common with advanced radiotherapy techniques. However, clinical use and implementation varies, and there remains limited consensus on best practices for reirradiation. In this systematic review, a multidisciplinary team treating gastrointestinal and hepatobiliary malignancies within the Reirradiation Collaborative Group (ReCOG) convened to review published literature on reirradiation in the abdomen to offer insights into patient selection, radiotherapy planning, risk management, and assessing knowledge gaps for future development of guidelines.</div></div><div><h3>Methods and Materials</h3><div>A systematic search of Cochrane Central, CINAHL Plus, EMBASE, and PubMed up to August 30, 2024, was conducted as per Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) framework. Data on patient characteristics, radiation doses, dose constraints, treatment outcomes, and toxicities were extracted. Where feasible, pooled weighted analyses were performed.</div></div><div><h3>Results</h3><div>Thirty-three studies involving 1,264 patients met inclusion criteria: 30 were retrospective and 3 prospective. The median number of patients reported per study was 26 (range 2–245). Of the reported tumor sites, 718 patients had liver tumors and 277 pancreas, with smaller numbers of mixed/lymph node targets. Reirradiation doses, fractionation schemes, and dose constraints varied widely; only half of the studies provided explicit organ-at-risk constraints. Three studies included patients treated with palliative intent. Median overall survival ranged from 5.9 to 44 months, with a pooled weighted median OS of 19.6 months across 20 studies that reported it. One-year local control rates ranged from 19 % to 93 %, with severe (grade ≥ 3) toxicities typically reported in 5–15 % of patients, although one study reported 25 % lethal RILD in liver reirradiation.</div></div><div><h3>Conclusion</h3><div>Reirradiation in abdominal malignancies appears to be able to achieve meaningful local control and survival in select patients, though heterogeneity in planning, dosing, and toxicity reporting remains a major challenge for establishing best practices. Standardized reporting of doses, constraints, and dose-volume relationships are needed to guide safe and effective reirradiation in this setting.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"55 ","pages":"Article 101033"},"PeriodicalIF":2.7,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144852277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-11DOI: 10.1016/j.ctro.2025.101030
Sina Mansoorian , Svenja Hering , Jan Hofmaier , Yuqing Xiong , Helmut Weingandt , Maya Rottler , Franziska Walter , Paul Rogowski , Max Seidensticker , Jens Ricke , Claus Belka , Stefanie Corradini , Chukwuka Eze
Background
This study compared the plan quality and dosimetric parameters of single-fraction (SF) MR-LINAC (MRL)-based stereotactic body radiotherapy (SBRT) with delivered high-dose-rate interstitial brachytherapy (HDR-iBT) for colorectal liver metastases (CRLM).
Methods
Between August 2017 and March 2019, 26 patients with a total of 45 CRLM were treated in 28 sessions using HDR-iBT with 1 × 25 Gy and were retrospectively included in this study. For each patient, an in silico MRL-based SBRT plan was generated using the corresponding iBT CT dataset. In the iBT plans, a single fraction of 25 Gy was prescribed to the periphery of the gross tumor volumes (GTVs), while in the SBRT plans, the same dose was prescribed to the 80% isodose line covering the planning target volumes (PTVs). We compared the dosimetric properties of the delivered HDR-iBT and MRL-based SBRT plans.
Results
Median GTV was 3.83 cc (range: 0.13–92.58 cc) and median PTVSBRT was 15.47 cc (range: 2.68–164.17 cc). Both HDR-iBT and SBRT demonstrated excellent GTV coverage, with no statistically significant differences in GTV D98% (28.82 ± 2.57 Gy vs. 28.92 ± 0.88 Gy, p = 0.9). HDR-iBT achieved superior GTV D95% (31.62 ± 3.20 Gy vs. 29.22 ± 0.74 Gy, p < 0.01) and GTV D50% (64.71 ± 12.78 Gy vs. 30.22 ± 0.52 Gy, p < 0.01). Uninvolved liver dose metrics were higher in the SBRT plans compared to iBT, with a median relative difference in V5Gy of 5.29% (range: −13.69% to + 17.89%, p < 0.01) and a smaller relative difference in V10Gy of 1.5% (range: −7.74% to + 11.26%, p < 0.01).
Conclusion
Our comparison indicates MRL-based SBRT to liver lesions is feasible, achieving adequate target volume coverage without clinically relevant violations of organ-at-risk (OAR) constraints.
本研究比较了单组分（SF） MR-LINAC （MRL）立体定向放射治疗（SBRT）与高剂量率间质近距离放射治疗（HDR-iBT）治疗结直肠癌肝转移（CRLM）的计划质量和剂量学参数。方法：在2017年8月至2019年3月期间，26例共45例CRLM患者接受了28次1 × 25 Gy的HDR-iBT治疗，并回顾性纳入本研究。对于每位患者，使用相应的iBT CT数据集生成基于mri的计算机SBRT计划。在iBT计划中，在总肿瘤体积（gtv）的周围给予25 Gy的单一剂量，而在SBRT计划中，在覆盖计划靶体积（ptv）的80%等剂量线上给予相同剂量。我们比较了递送HDR-iBT和基于mrl的SBRT方案的剂量学特性。结果中位GTV为3.83 cc（范围：0.13-92.58 cc），中位PTVSBRT为15.47 cc（范围：2.68-164.17 cc）。HDR-iBT和SBRT均表现出良好的GTV覆盖率，GTV D98%无统计学差异（28.82±2.57 Gy vs 28.92±0.88 Gy, p = 0.9）。HDR-iBT取得优越的制造中心D95%(31.62±3.20 Gy vs 29.22±0.74 Gy, p & lt; 0.01)和制造D50%(64.71±12.78 Gy vs 30.22±0.52 Gy, p & lt; 0.01)。与iBT相比，SBRT计划中未受累的肝脏剂量指标更高，V5Gy的中位相对差异为5.29%（范围：- 13.69%至+ 17.89%,p < 0.01）， V10Gy的相对差异较小，为1.5%（范围：- 7.74%至+ 11.26%,p < 0.01）。结论：我们的比较表明，基于mrl的SBRT治疗肝脏病变是可行的，可以实现足够的靶体积覆盖，而不会违反临床相关的器官危险（OAR）限制。
{"title":"Comparative analysis of target volume coverage and liver exposure in high-dose-rate interstitial brachytherapy and in silico MR LINAC-based stereotactic body radiotherapy plans for colorectal liver metastases","authors":"Sina Mansoorian , Svenja Hering , Jan Hofmaier , Yuqing Xiong , Helmut Weingandt , Maya Rottler , Franziska Walter , Paul Rogowski , Max Seidensticker , Jens Ricke , Claus Belka , Stefanie Corradini , Chukwuka Eze","doi":"10.1016/j.ctro.2025.101030","DOIUrl":"10.1016/j.ctro.2025.101030","url":null,"abstract":"<div><h3>Background</h3><div>This study compared the plan quality and dosimetric parameters of single-fraction (SF) MR-LINAC (MRL)-based stereotactic body radiotherapy (SBRT) with delivered high-dose-rate interstitial brachytherapy (HDR-iBT) for colorectal liver metastases (CRLM).</div></div><div><h3>Methods</h3><div>Between August 2017 and March 2019, 26 patients with a total of 45 CRLM were treated in 28 sessions using HDR-iBT with 1 × 25 Gy and were retrospectively included in this study. For each patient, an <em>in silico</em> MRL-based SBRT plan was generated using the corresponding iBT CT dataset. In the iBT plans, a single fraction of 25 Gy was prescribed to the periphery of the gross tumor volumes (GTVs), while in the SBRT plans, the same dose was prescribed to the 80% isodose line covering the planning target volumes (PTVs). We compared the dosimetric properties of the delivered HDR-iBT and MRL-based SBRT plans.</div></div><div><h3>Results</h3><div>Median GTV was 3.83 cc (range: 0.13–92.58 cc) and median PTV<sub>SBRT</sub> was 15.47 cc (range: 2.68–164.17 cc). Both HDR-iBT and SBRT demonstrated excellent GTV coverage, with no statistically significant differences in GTV D<sub>98%</sub> (28.82 ± 2.57 Gy vs. 28.92 ± 0.88 Gy, p = 0.9). HDR-iBT achieved superior GTV D<sub>95%</sub> (31.62 ± 3.20 Gy vs. 29.22 ± 0.74 Gy, p < 0.01) and GTV D<sub>50%</sub> (64.71 ± 12.78 Gy vs. 30.22 ± 0.52 Gy, p < 0.01). Uninvolved liver dose metrics were higher in the SBRT plans compared to iBT, with a median relative difference in V<sub>5Gy</sub> of 5.29% (range: −13.69% to + 17.89%, p < 0.01) and a smaller relative difference in V<sub>10Gy</sub> of 1.5% (range: −7.74% to + 11.26%, p < 0.01).</div></div><div><h3>Conclusion</h3><div>Our comparison indicates MRL-based SBRT to liver lesions is feasible, achieving adequate target volume coverage without clinically relevant violations of organ-at-risk (OAR) constraints.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"56 ","pages":"Article 101030"},"PeriodicalIF":2.7,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-11DOI: 10.1016/j.ctro.2025.101031
Parth Aphale, Himanshu Shekhar, Shashank Dokania
The recently published study by Zang et al. offers valuable insight into PSMA-PET/CTbased response assessment in patients with oligometastatic prostate cancer (PCa) undergoing stereotactic ablative body radiotherapy (SABR), demonstrating an impressive 5-year local control rate of 86 % and progressive reduction in SUVmax values across follow-up intervals [1]. While the findings reinforce the utility of PSMAPET/CT as a potential biomarker for local tumor control, certain methodological and interpretive issues merit deeper consideration.
{"title":"Comment on “PSMA response evaluation in follow-up PSMA-PET/CT after stereotactic ablative body radiotherapy (SABR) for oligometastases in prostate cancer”","authors":"Parth Aphale, Himanshu Shekhar, Shashank Dokania","doi":"10.1016/j.ctro.2025.101031","DOIUrl":"10.1016/j.ctro.2025.101031","url":null,"abstract":"<div><div>The recently published study by Zang et al. offers valuable insight into PSMA-PET/CTbased response assessment in patients with oligometastatic prostate cancer (PCa) undergoing stereotactic ablative body radiotherapy (SABR), demonstrating an impressive 5-year local control rate of 86 % and progressive reduction in SUVmax values across follow-up intervals [<span><span>1</span></span>]. While the findings reinforce the utility of PSMAPET/CT as a potential biomarker for local tumor control, certain methodological and interpretive issues merit deeper consideration.</div></div>","PeriodicalId":10342,"journal":{"name":"Clinical and Translational Radiation Oncology","volume":"55 ","pages":"Article 101031"},"PeriodicalIF":2.7,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144826473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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