Clinical oncology最新文献

{"title":"Radiating Excellence: A Decade of Pioneering Radiotherapy Trials and Collaborative Leadership at Leeds Cancer Research UK Clinical Trials Unit","authors":"F. Slevin ,&nbsp;E.M. Hudson ,&nbsp;A. Hockaday ,&nbsp;J. Kendall ,&nbsp;S. Noutch ,&nbsp;J.B. Oughton ,&nbsp;A. Smith ,&nbsp;J.C. Webster ,&nbsp;D. Sebag-Montefiore ,&nbsp;S.R. Brown","doi":"10.1016/j.clon.2025.103937","DOIUrl":"10.1016/j.clon.2025.103937","url":null,"abstract":"<div><div>Recently, there has been considerable development in radiotherapy technologies and novel drug-radiotherapy combinations, with the potential to develop more effective and less toxic treatments for patients. There is a need to evaluate these approaches through clinical trials, and clinical trials units (CTUs) are ideally positioned to design and deliver these studies. Over the past 10 years, the Leeds Cancer Research UK CTU has developed a flagship portfolio of radiotherapy clinical trials, which encompass novel drug-radiotherapy combinations, radiotherapy technologies and optimising radiotherapy dose. Key to the success of the portfolio has been an emphasis on multidisciplinary collaborations, career development of future leaders in clinical trials, understanding the funding landscape, engagement with discovery and translational scientists, and keeping patients at the heart of our research. Moving forward, the priorities of the CTU are to build on this strong foundation with a pipeline of impactful and scientifically rich clinical trials, which will continue to shape the radiotherapy research landscape.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"47 ","pages":"Article 103937"},"PeriodicalIF":3.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205808","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":"Optimization and Quality Assurance of VMAT-Driven Lattice Radiotherapy in Large Tumors Across Anatomical Sites","authors":"A.K. Singh ,&nbsp;S. Singh ,&nbsp;S. Sen ,&nbsp;A. Vijay ,&nbsp;Dipesh ,&nbsp;M. Bhushan ,&nbsp;Mahipal ,&nbsp;M. Omar","doi":"10.1016/j.clon.2025.103936","DOIUrl":"10.1016/j.clon.2025.103936","url":null,"abstract":"<div><h3>Aims</h3><div>This study investigates the feasibility, dosimetric optimization, and validation of VMAT-based Lattice Radiotherapy (LRT) across head and neck, thoracic, and abdominal tumors using TrueBeam STx(Varian Medical Systems).</div></div><div><h3>Materials and methods</h3><div>60 patients with gross tumor volumes (GTVs) &gt;550 cc and ≥10 lattice vertices were included. Planning CTs were acquired using a Siemens Somatom go.Sim. VMAT plans were generated in Eclipse (v15.1) with 6 MV FFF beams, using HD120 MLCs. Each spherical high-dose vertex received 20 Gy in 5 fractions. Optimization incorporated concentric dose rings (C1–C3) for valley dose control. Dosimetric parameters evaluated included D_95%, Dmean, D_50%, Homogeneity Index (HI), and Peak-to-Valley Dose Ratio (PVDR). Validation was performed using OSLDs in a Rando phantom and ArcCHECK gamma analysis (3%/3 mm).</div></div><div><h3>Results</h3><div>Abdominal tumors showed the highest spatial modulation, with axial VPDR reaching 0.62, compared to 0.47 in head and neck and thoracic sites. Abdominal sphere doses exhibited the lowest standard deviation (Dmean = 2113.8 ± 47.1 cGy). Head and neck cases required higher modulation intensity (MU/deg = 3.8) due to OAR proximity, while abdominal cases required reduced gantry speeds (1.2°/sec) for sharper dose gradients. Gamma pass rates exceeded 96% across all sites, confirming delivery accuracy.</div></div><div><h3>Conclusion</h3><div>VMAT-guided LRT provides robust peak-to-valley dose modulation and reproducible high-dose vertex delivery for large tumors. Anatomical location significantly affects vertex geometry, modulation requirements, and dosimetric outcomes. Abdominal plans demonstrated superior uniformity and spatial separation, whereas head and neck cases demanded more complex optimization. Standardized planning protocols and rigorous QA are essential for safe clinical translation of LRT.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"47 ","pages":"Article 103936"},"PeriodicalIF":3.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145156358","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":"Clinical Evaluation of Stereotactic Ablative Radiotherapy for Oligometastases From Rare Primary Cancers","authors":"R. Talwar ,&nbsp;J. Duong ,&nbsp;P. Nariyangadu ,&nbsp;P. Hoskin ,&nbsp;A. Stewart-Lord ,&nbsp;N. Shah ,&nbsp;P. Ostler ,&nbsp;M. Harrison ,&nbsp;A. Vinayan ,&nbsp;S. Dubash ,&nbsp;Y. Tsang","doi":"10.1016/j.clon.2025.103931","DOIUrl":"10.1016/j.clon.2025.103931","url":null,"abstract":"<div><h3>Aims</h3><div>Stereotactic ablative body radiotherapy (SABR) has emerged as a promising treatment modality for oligometastatic disease from primary breast, prostate, lung, and colorectal cancers. However, there is a paucity of information on clinical outcomes of SABR to oligometastases from rare primary cancers (RPCs). This study aimed to report the treatment outcomes and to investigate what factors are prognostic in terms of overall survival (OS) and progression-free survival (PFS) in patients receiving SABR for oligometastases from RPCs.</div></div><div><h3>Methods and materials</h3><div>All patients with oligometastases from any RPCs were included in this retrospective review of patients treated with SABR at one single institution. This cohort excluded breast, prostate, lung, colon, and rectum primary cancer. OS and PFS were calculated using Kaplan-Meier statistics and post-SABR toxicities were scored following the Common Terminology Criteria for Adverse Events (CTCAE) v. 4.0. An analysis of prognostic factors for OS and PFS was performed based on log-rank tests which were used for the analysis of prognostic factors for OS and PFS based on the site of primary cancer, previous radiotherapy status, previous systemic therapy status, the number of oligometastases, SABR treatment site, biological equivalent dose, total size of gross tumour volume, and planning target volume (PTV).</div></div><div><h3>Results</h3><div>A total of 114 patients with 126 metachronous oligometastatic lesions from RPC receiving SABR were included. The median patient age when they received SABR was 66.7 years (range: 22.3-91.8 years), with the median follow-up of the cohort being 21.7 months (range: 2.8-75.8 months). The estimated median OS was 40.1 months (95% confidence interval [CI]: 27.5-52.6 months), and the estimated median PFS was 14.2 months (95% CI: 11.0-17.5 months). The treatment was well tolerated, with the majority of patients experiencing only grade 1 fatigue as the most common acute toxicity. The previous radiotherapy status (<em>P =</em> 0.04) and cumulative PTV (<em>P</em> = 0.01) were identified as statistically significant independent predictors of OS. For PFS, SABR treatment site (<em>P</em> = 0.03) was the only statistically significant independent predictor.</div></div><div><h3>Conclusion</h3><div>There are limited studies published on the efficacy and post-treatment toxicities of using SABR in the management of oligometastases from RPC. This study confirmed that SABR was a safe, noninvasive treatment option for patients with extracranial oligometastases originated from RPC in terms of the favourable post-treatment toxicities.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"47 ","pages":"Article 103931"},"PeriodicalIF":3.0,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085288","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":"Impact of Treatment Decisions on Survival Outcomes in Elderly Patients With Non–Small Cell Lung Cancer: A Retrospective Real-World Study","authors":"V. Paappanen ,&nbsp;H. Järvenpää ,&nbsp;A. Jukkola ,&nbsp;P. Päkkilä ,&nbsp;S. Sahlström ,&nbsp;T. Klaavuniemi ,&nbsp;L. Sailas ,&nbsp;J. Ahvonen ,&nbsp;H. Kuitunen ,&nbsp;J. Kopra ,&nbsp;O. Kuittinen ,&nbsp;M. Tengström ,&nbsp;S. Tiainen","doi":"10.1016/j.clon.2025.103930","DOIUrl":"10.1016/j.clon.2025.103930","url":null,"abstract":"<div><h3>Aims</h3><div>Lung cancer (LC) is a leading cause of cancer-related mortality, particularly in elderly patients, who often receive less curative treatment and have poorer prognoses than younger individuals. The reasons for these disparities remain unclear. This study aimed to identify clinical factors influencing treatment decisions and survival outcomes in elderly patients with non–small cell lung cancer (NSCLC).</div></div><div><h3>Materials and methods</h3><div>This retrospective study included 395 NSCLC patients diagnosed in 2018 at five Finnish hospitals. Patients were divided into four age cohorts: &lt;61, 61 to 70, 71 to 80, and &gt;80 years. Overall survival (OS) was analysed across age groups, stratified by treatment methods.</div></div><div><h3>Results</h3><div>Stage distribution was similar across age groups; however, older patients had worse performance status and higher Charlson Comorbidity Index (CCI) scores (<em>P ≤</em> 0.008). Elderly patients were less likely to receive surgery, chemoradiotherapy, or chemotherapy and were more frequently offered best supportive care (BSC) (<em>P</em> &lt; 0.013). OS decreased with increasing age (<em>P</em> = 0.006), with 1-year survival rates of 60% and 32% and 2-year survival rates of 41% and 15% in the youngest and oldest cohorts, respectively. LC was the leading cause of death across all age groups.</div></div><div><h3>Conclusion</h3><div>Elderly NSCLC patients had poorer survival outcomes despite similar disease stage at diagnosis, possibly due to lower rates of curative treatment. These findings highlight the need for further investigation into optimising treatment strategies for elderly patients with NSCLC.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"47 ","pages":"Article 103930"},"PeriodicalIF":3.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198607","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":"A Nomogram to Estimate Locoregional Recurrence-Free Survival for Women With T1-2 N0 Breast Cancer Managed With or Without Postmastectomy Radiotherapy","authors":"L. Wade ,&nbsp;E.K. Chan ,&nbsp;R. Musoke ,&nbsp;L. Gondara ,&nbsp;C. Speers ,&nbsp;C. Lohrisch ,&nbsp;A.M. Nichol","doi":"10.1016/j.clon.2025.103928","DOIUrl":"10.1016/j.clon.2025.103928","url":null,"abstract":"<div><h3>Aims</h3><div>Postmastectomy radiotherapy (PMRT) in women with T1-2 N0 breast cancer is not routinely recommended by guidelines but is sometimes considered when patients have multiple predictors of locoregional relapse (LRR). This study re-evaluates the role of PMRT in the era of modern systemic therapy.</div></div><div><h3>Materials and methods</h3><div>Patients with pT1-2 pN0 M0 breast cancer treated from 2005 to 2014 with total mastectomy were identified. Patients who had prior or synchronous breast cancer, neoadjuvant chemotherapy, or incomplete radiotherapy courses were excluded. LRR was analysed with a Fine-Gray subdistribution hazard model, and overall survival (OS) was analysed with Cox regression. A nomogram for estimating LRR was devised and validated with propensity score matching.</div></div><div><h3>Results</h3><div>The study cohort included 3752 women with negative margins and a median follow-up of 11.4 years. As systemic therapy, 32.4% had chemotherapy, 70.2% had hormone therapy, and 10.7% had targeted therapy. The 10-year LRR for the study cohort was 3.7%. The 358 PMRT patients had more adverse features than the 3394 no-PMRT patients. LRR was increased by seven predictors: younger age, larger primaries, luminal B or triple-negative subtypes, lymphovascular invasion (LVI), close margins, omission of chemotherapy, and omission of hormone therapy. PMRT receipt was associated with decreased LRR (HR=0.53, <em>P =</em> 0.04) but did not affect OS. Our nomogram only predicted absolute LRR risks &gt;10% without PMRT when combinations of four or more predictors were present. Only 5% of patients had four or more predictors. The nomogram’s predictions for PMRT benefit were within 1% of the predictions based on the higher-risk, propensity-score-matched cohort.</div></div><div><h3>Conclusion</h3><div>For T1-2N0 breast cancers treated in the era of modern systemic therapy, PMRT did not influence OS. However, there is a small subgroup of high-risk patients for whom PMRT offers a meaningful LRR reduction. Our nomogram can help individualise PMRT decision-making for patients with multiple LRR predictors.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"47 ","pages":"Article 103928"},"PeriodicalIF":3.0,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145061247","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":"Clinical Outcomes and Toxicity Profile of Chemoradiotherapy in Older Versus Younger Patients With Anal Cancer: A Retrospective Cohort Analysis","authors":"C. van der Elzen ,&nbsp;F. Aires ,&nbsp;E.D. Rodrigues ,&nbsp;C. Dias ,&nbsp;M. Marques ,&nbsp;L. Osório","doi":"10.1016/j.clon.2025.103929","DOIUrl":"10.1016/j.clon.2025.103929","url":null,"abstract":"<div><h3>Aims</h3><div>The optimal management of older patients with anal cancer (AC) receiving chemoradiotherapy (CRT) remains controversial, particularly regarding treatment tolerance and outcomes. This study aimed to compare treatment outcomes and toxicity profiles between older and younger patients undergoing standard CRT.</div></div><div><h3>Materials and methods</h3><div>We conducted a 16-year retrospective analysis of AC patients treated with CRT at our institution between 2008 and 2023. A total of 61 patients were stratified into older (≥65 years, n = 25) and younger (&lt;65 years, n = 36) patients. The primary objectives were to compare clinicopathological characteristics, treatment patterns, and outcomes between age groups, as well as to identify prognostic factors in patients with nonmetastatic squamous cell carcinoma of the anus (SCCA). Treatment toxicities were evaluated according to Common Terminology Criteria for Adverse Events (CTCAE). Survival analysis included overall survival (OS), locoregional recurrence-free survival (LRFS), metastasis-free survival (MFS), and progression-free survival (PFS). Analyses of survival curves were performed using the Kaplan-Meier method. Statistical significance was set at <em>P</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>After a median follow-up of 48 months (range, 6-187)<strong>,</strong> complete response rates were 86.7% and 95.2% in younger and older cohorts, respectively (<em>P</em> = .395). At the 48-month median follow-up, 4-year OS was 72.3% in younger and 68.7% in older patients (<em>P</em> = .845). Four-year LRFS (77.7% vs 88.7%, <em>P</em> = .381), MFS (83.8% vs 93.3%, <em>P</em> = .718), and PFS (77.7% vs 89.3%, <em>P</em> = .656) showed no significant differences between cohorts. Completion of treatment reached 100% and 98% in younger and older groups. A pretreatment haemoglobin &lt;11.7g/dL and an SCC ≥1.3 ng/mL were significant prognostic factors in the younger cohort only (<em>P</em> = .026 and <em>P</em> = .016, respectively).</div></div><div><h3>Conclusion</h3><div>Older patients with AC demonstrate comparable treatment outcomes to younger patients when receiving curative-intent CRT. With comparable complete response rates, survival outcomes, and high completion of treatment between age cohorts, our results demonstrate that carefully managed CRT is both feasible and effective in older patients.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"47 ","pages":"Article 103929"},"PeriodicalIF":3.0,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198647","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":"An Institutional Audit on the Usage of the Royal College of Radiologists Consent Forms for Radiotherapy","authors":"M.S. Iqbal,&nbsp;M. Nazir,&nbsp;A. Burns,&nbsp;A. Clark,&nbsp;M. Jackson","doi":"10.1016/j.clon.2025.103927","DOIUrl":"10.1016/j.clon.2025.103927","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"46 ","pages":"Article 103927"},"PeriodicalIF":3.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996924","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.2025.103924","DOIUrl":"10.1016/j.clon.2025.103924","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"45 ","pages":"Article 103924"},"PeriodicalIF":3.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865236","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_September_SEB_01","authors":"","doi":"10.1016/S0936-6555(25)00180-3","DOIUrl":"10.1016/S0936-6555(25)00180-3","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"45 ","pages":"Article 103925"},"PeriodicalIF":3.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865237","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":"Alterations in 3D Chromatin Spatial Organisation in Tumourigenesis and Therapy Resistance of Glioblastoma: The Recent Advances in Understanding Molecular Mechanisms, Clinical Implications, and Therapeutic Perspectives","authors":"A.G. Taki ,&nbsp;A. Shareef ,&nbsp;L. Baldaniya ,&nbsp;R. Oweis ,&nbsp;S.R. Jyothi ,&nbsp;U. Singh ,&nbsp;S. Sahoo ,&nbsp;A.S. Chauhan ,&nbsp;U. Rakhmatov ,&nbsp;H.N. Sameer ,&nbsp;A. Yaseen ,&nbsp;Z.H. Athab ,&nbsp;M. Adil","doi":"10.1016/j.clon.2025.103926","DOIUrl":"10.1016/j.clon.2025.103926","url":null,"abstract":"<div><div>Glioblastoma (GBM) remains one of the most aggressive and lethal forms of brain cancer, characterised by profound genetic, epigenetic, and phenotypic heterogeneity. Recent advancements in high-resolution genome mapping have unveiled the critical role of three-dimensional (3D) chromatin architecture—encompassing chromatin loops, topologically associating domains, and enhancer–promoter interactions—in driving GBM tumourigenesis and therapy resistance. This review summarises recent insights into the mechanistic contribution of 3D genome reorganisation in sustaining oncogenic transcriptional programs, promoting intratumoural heterogeneity, and facilitating adaptive resistance. We integrate molecular discoveries with clinical and therapeutic perspectives, emphasising the potential of epigenetic drugs to target disease-associated chromatin structures. Finally, we highlight unresolved questions and future directions in leveraging chromatin conformation data for precision oncology in GBM.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"46 ","pages":"Article 103926"},"PeriodicalIF":3.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004353","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}