Clinical oncology最新文献

{"title":"Evaluation of Gross Tumour Volume in Head and Neck Cancers on Contrast-Enhanced Computed Tomography vs Magnetic Resonance Imaging and its Implications on Dice Similarity Coefficients and Dose-Volume Parameters","authors":"M. Deshmukh ,&nbsp;B. Mahindrakar Jain ,&nbsp;P. Kalbande ,&nbsp;A. Singh ,&nbsp;C. Dsouza ,&nbsp;A. Tayade ,&nbsp;N.R. Datta","doi":"10.1016/j.clon.2025.103911","DOIUrl":"10.1016/j.clon.2025.103911","url":null,"abstract":"<div><h3>Aims</h3><div>Radiotherapy treatment planning for head and neck cancers (HNCs) is usually based on contrast-enhanced computed tomography (CECT). However, soft-tissue contrast is better evident in magnetic resonance imaging (MRI). The study evaluates the gross tumour volumes (GTVs) delineated on CECT vs MRI along with their Dice similarity coefficients (DSCs) and resultant impact on the dose-volume histogram (DVH) parameters, conformity index (CI), and homogeneity index (HI) during intensity-modulated radiotherapy (IMRT) planning in HNCs.</div></div><div><h3>Material and Methods</h3><div>This prospective study enrolled 50 consecutive HNC patients. Following CECT and MRI simulations, GTV_p (primary) and GTV_n (node) were delineated independently on these co-registered images. Corresponding MRI volumes were then copied onto co-registered CECT images and IMRT plans were generated on the CECT-defined planning target volume (PTV) of primary and nodes (PTV_p+n).</div></div><div><h3>Results</h3><div>The GTV_p, GTV_n, and GTV_p+n observed on MRI were significantly larger than the corresponding GTVs defined on CECT (all <em>P</em> &lt; .001). The DSC of GTV_p, GTV_n, and GTV_p+n was inversely correlated with the corresponding % differences of GTV_p (r = -0.49, <em>P</em> &lt; .001), GTV_n (r = -0.41, <em>P</em> = .021), and GTV_p+n (r = -0.73, <em>P</em> &lt; .001) between CECT and MRI. The mean DSCs of GTV_p, GTV_n, GTV_p+n, and PTV_p+n were 0.78, 0.32, 0.67, and 0.78, respectively. This led to significant differences in CI and HI (both <em>P</em> &lt; .001), as well as other DVH parameters (D₂, D₅₀, D₉₅, D₉₈, V₉₅, and V₁₀₀, all <em>P</em> &lt; .001) between CECT- and MRI-defined PTV_p+n.</div></div><div><h3>Conclusion</h3><div>The GTVs and PTV_p+n defined on MRI were significantly greater than those depicted on CECT, resulting in significant differences in DSC, DVH parameters, CI, and HI. Thus, IMRT planning for HNCs based on CECT-defined PTV appears inappropriate. The study emphasises the importance of accurate delineation to ensure adequate coverage of the target volume and the potential benefit of MRI in this regard.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"46 ","pages":"Article 103911"},"PeriodicalIF":3.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827794","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}

{"title":"Assessing Functional Outcomes and Health-Related Quality of Life After Radiation Therapy in Extremity Soft Tissue Sarcoma","authors":"R.G. Hikmet ,&nbsp;L.B.J. Thorsen ,&nbsp;H.K. Rose ,&nbsp;P. Rossen ,&nbsp;T. Baad-Hansen ,&nbsp;T.B. Nyeng ,&nbsp;B.E. Engelmann ,&nbsp;N. Aggerholm-Pedersen","doi":"10.1016/j.clon.2025.103910","DOIUrl":"10.1016/j.clon.2025.103910","url":null,"abstract":"<div><h3>Aims</h3><div>Extremity soft-tissue sarcomas (ESTS) are rare neoplasms treated with limb-sparing surgery and radiation therapy (RT). While RT improves local control, it can be associated with late functional impairments that may affect health-related quality of life (HR-QOL). As survivorship care gains importance, understanding the relationship between functional outcomes (FO) and HR-QOL is crucial. This study evaluates the relationship between FO, measured by the Toronto Extremity Salvage Score (TESS), and HR-QOL, assessed with the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30).</div></div><div><h3>Materials and method</h3><div>A cohort study including ESTS patients treated with RT (January 2009 to October 2024) was conducted. Eligible patients completed the TESS and QLQ-C30 questionnaires. Correlation analyses, receiver operating characteristic (ROC) curve analysis, and statistical comparisons were performed to assess the association between FO and HR-QOL and to determine a clinically relevant TESS threshold for impairment.</div></div><div><h3>Results</h3><div>Of 255 identified patients, 123 were eligible, and 61 (response rate: 52%) completed the questionnaires. TESS lower-limb scores showed strong correlations with QLQ-C30 physical (r = 0.74), role (r = 0.63), and social functioning (r = 0.62). Notably, ROC analysis identified a clinically meaningful TESS threshold of ≥80, demonstrating high sensitivity (88%) and specificity (100%) for detecting significant functional impairments. Most patients reported good FO and HR-QOL, but a subset experienced severe impairments.</div></div><div><h3>Conclusion</h3><div>ESTS survivors generally maintain good function and HR-QOL, but functional impairments significantly affect some patients. The identified TESS threshold of ≥80 may help clinicians monitor at-risk patients and guide early interventions. Future studies should validate this threshold and explore interventions for patients with severe impairments.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"46 ","pages":"Article 103910"},"PeriodicalIF":3.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827795","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}

{"title":"The Royal College of Radiologists’ Re-Audit of UK Prostate Brachytherapy Delivery","authors":"A. Challapalli ,&nbsp;P. Turner ,&nbsp;K. Drinkwater ,&nbsp;A. Stewart","doi":"10.1016/j.clon.2025.103909","DOIUrl":"10.1016/j.clon.2025.103909","url":null,"abstract":"<div><h3>Aims</h3><div>The Royal College of Radiologists’ (RCR) audit of prostate brachytherapy was initially performed in 2012 and provided the first comprehensive picture of the use of prostate brachytherapy in the UK. A re-audit in 2022 examined the adherence to audit standards based on national and international guidelines.</div></div><div><h3>Materials and methods</h3><div>A web-based data collection tool was developed by The RCR Quality Improvement and Audit Committee and sent to audit leads at all cancer centres in the United Kingdom (UK). Standards were developed based on available guidelines in use at the start of 2021 covering casemix and dosimetry. Audit findings were compared with the 2012 RCR audit and other audits across the world.</div></div><div><h3>Results</h3><div>Fifty-three of 59 cancer centres submitted data. Twenty-five centres reported carrying out prostate brachytherapy and provided data regarding the number of implants, staffing, dosimetry, medication, anaesthesia, and follow-up. There was a decrease in overall prostate brachytherapy numbers with only 79% and 56% of centres treating &gt;25 low-dose rate (LDR) and high-dose rate (HDR) cases per year, respectively. Only 43% (6/14 for LDR) and 31 % (5/16 for HDR) of oncologists performed more than 25 procedures. However, there was an increase in the skill mix of the departments and all centres have been performing post LDR implant dosimetry.</div></div><div><h3>Conclusion</h3><div>This audit provides a comprehensive picture of changes in prostate brachytherapy in the UK over the last 10 years since 2012. The number of prostate brachytherapy implants carried out in the UK has decreased since 2012. Many centres were unable to maintain minimum numbers of cases for compliance to guidelines, risking inadequate experience to maintain competence. The declining trends are similar to practice in the USA and Europe.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"46 ","pages":"Article 103909"},"PeriodicalIF":3.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144892879","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}

{"title":"Testing a 5-fraction Simultaneous Integrated Boost in Radiotherapy for Breast Cancer: The UK FAST-Forward Boost Trial Opens to Recruitment","authors":"A.M. Kirby ,&nbsp;F.H. Cafferty ,&nbsp;K. Poole ,&nbsp;C. Anandadas ,&nbsp;L. Bower ,&nbsp;M.A. Sydenham ,&nbsp;H. Fleming ,&nbsp;N. Somaiah ,&nbsp;V. Grandon ,&nbsp;Z. Nabi ,&nbsp;L. Fox ,&nbsp;S. Cruickshank ,&nbsp;S. Georgopoulou ,&nbsp;C.E. Coles ,&nbsp;A.M. Brunt ,&nbsp;J.M. Bliss","doi":"10.1016/j.clon.2025.103908","DOIUrl":"10.1016/j.clon.2025.103908","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"45 ","pages":"Article 103908"},"PeriodicalIF":3.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144780120","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}

{"title":"Paid MBP advert Journals_AI_Conference_280x210_August_Launch_01","authors":"","doi":"10.1016/S0936-6555(25)00160-8","DOIUrl":"10.1016/S0936-6555(25)00160-8","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"44 ","pages":"Article 103905"},"PeriodicalIF":3.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632423","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}

{"title":"RCR Meetings","authors":"","doi":"10.1016/j.clon.2025.103906","DOIUrl":"10.1016/j.clon.2025.103906","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"44 ","pages":"Article 103906"},"PeriodicalIF":3.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632422","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}

{"title":"Feasibility Study of an Efficient Plan Pool Adaptive Radiotherapy Technology Based on Low-dose Computed Tomography for Cervical Cancer","authors":"F. Sun ,&nbsp;Y. Xu ,&nbsp;X. Xu ,&nbsp;W. Gong ,&nbsp;Z. Mo ,&nbsp;L. Jia ,&nbsp;S. Qin ,&nbsp;G. Gan","doi":"10.1016/j.clon.2025.103903","DOIUrl":"10.1016/j.clon.2025.103903","url":null,"abstract":"<div><h3>Background</h3><div>Online adaptive radiotherapy (oART) involves a complex workflow across multiple departments, requiring significant resources and increasing the workload of radiation oncologists (ROs) and physicists. For cervical cancer, there is a need for a low-dose, image-guided adaptive radiotherapy solution that is both efficient and clinically effective</div></div><div><h3>Aims</h3><div>The aim is to explore the feasibility and performance of a plan-pool adaptive radiotherapy (plan-pool ART) workflow, with a focus on efficiency and dosimetric benefits for both the tumour and organs at risk (OARs).</div></div><div><h3>Materials and Methods</h3><div>A plan-pool ART framework was developed for cervical cancer radiotherapy based on the daily low-dose computed tomography (LDCT). The LDCT images were synthesised into high-quality restorative CT (RCT) images by an image-synthesis model. A total of 257 fractionated fan-beam computed tomography (FBCT) datasets from 17 cervical cancer patients treated with the oART regimen were collected (171 fractions treated with oART and 86 fractions treated with the original plan). A support vector machine (SVM) was used to train (180 cases) and evaluate (77 cases) the oART classification model, which predicts whether the fraction needs to execute oART. The oART classification model selects the daily treatment plan that best aligns with the patient's anatomical positions from the plan pool. Finally, the performance of image-guided radiotherapy (IGRT), plan-pool ART, and triggered oART (trigger-oART) techniques was compared by simulating treatments for 5 cervical cancer cases.</div></div><div><h3>Results</h3><div>The oART classification model achieved high predictive performance, with an under the curve (AUC) of 0.98, accuracy of 0.86, recall of 0.89, and specificity of 0.92. Plan-pool ART reduced the number of oART execution (1.4 vs 3.0 for trigger-oART) while optimising dosimetry. Compared to IGRT, plan-pool ART decreased mean bladder dose (3122cGy vs 3258cGy) and rectum dose (3265cGy vs 3325cGy), along with lower V_4500cGy values for both organs. Target coverage remained comparable across techniques, but IGRT showed greater variability in CTV D_99%, leading to potential underdosing.</div></div><div><h3>Conclusion</h3><div>The simulation results demonstrate that the plan-pool ART technology is feasible, ensuring reliable target dose coverage, reducing the dose to OARs, and lowering the number of oART implementation. This approach offers a promising new technical solution for clinical treatment.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"45 ","pages":"Article 103903"},"PeriodicalIF":3.2,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144696535","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}

{"title":"The Use of Radiotherapy in the Cure of Different Cancers - Further Results From the FORTY (Favourable Outcomes From RadioTherapY) Project","authors":"N.G. Burnet ,&nbsp;T. Mee ,&nbsp;N.F. Kirkby ,&nbsp;K.J. Kirkby","doi":"10.1016/j.clon.2025.103902","DOIUrl":"10.1016/j.clon.2025.103902","url":null,"abstract":"<div><h3>Aims</h3><div>Overall, almost 40% of patients surviving 5 years are estimated to have received radiotherapy (RT). The utilisation of RT for individual tumour types in 5-year survivors was examined.</div></div><div><h3>Materials and methods</h3><div>Patient-level data on RT utilisation in cancer patients in England were analysed. Patient, tumour, and treatment event data were obtained for the 5-year period 2009–2013, together with 5-year individual patient survival (to 2018 ie pre Covid-19 pandemic). All tumour sites (excluding C44) and ages were included. 5-year survivors (n = 537,970) were divided into 22 tumour sites, plus a category of ‘Other’ (5% of patients) where tumour site was unknown, leaving 508,753 with known tumour site diagnosis.</div></div><div><h3>Results</h3><div>Overall cancer-specific 5-year survival was 52%. Of the 5-year survivors with definite tumour site diagnosis, 200,269 (39%) received RT. Breast cancer accounted for 50% of RT patients, prostate 24%. 75% of breast cancer 5-year survivors received RT, 65% of head and neck patients, 49% of rectum, 49% of central nervous system (CNS), and 43% of prostate patients. 25% of lymphoma 5-year survivors received RT. Only 29% of lung cancer 5-year survivors received RT. In 6 tumour sites (pancreas, leukaemia, kidney, colon, ovary, and melanoma), &lt;5% of patients (n = 3981, 2%) received RT. Excluding these, 50% of 5-year survivors received RT.</div></div><div><h3>Conclusions</h3><div>RT contributes significantly to 5-year survival. RT was delivered to 50% of 5-year survivors in tumour sites where RT is utilised for ≥5% of patients. Including the additional tumour sites where RT is used rarely, RT was delivered to almost 40% of patients. We recommend that this exercise is repeated regularly. This 50% figure emphasises the importance of RT. It is critical for service planning and public health messaging. It should be noted for the development of the new cancer plan.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"45 ","pages":"Article 103902"},"PeriodicalIF":3.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144771379","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}

{"title":"Response to ‘Dose Accumulation for Pelvic Stereotactic Ablative Radiotherapy Reirradiation. In Regard to Slevin et al.’","authors":"F. Slevin ,&nbsp;M. Nix ,&nbsp;C. O'Hara ,&nbsp;J. Entwisle ,&nbsp;J. Lilley ,&nbsp;C. Thompson ,&nbsp;M. Tyyger ,&nbsp;A.L. Appelt ,&nbsp;L.J. Murray","doi":"10.1016/j.clon.2025.103901","DOIUrl":"10.1016/j.clon.2025.103901","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"45 ","pages":"Article 103901"},"PeriodicalIF":3.2,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144654995","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}

{"title":"OncoFlash - Research Updates in a Flash!","authors":"J.T. Nicholson ,&nbsp;R. Simões","doi":"10.1016/j.clon.2025.103898","DOIUrl":"10.1016/j.clon.2025.103898","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"44 ","pages":"Article 103898"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144581009","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}