Clinical oncology最新文献

{"title":"National Reporting of Bowel Cancer Care by the National Bowel Cancer Audit (NBOCA) Supports Hospital Teams to Improve care and Outcomes","authors":"NBOCA Project Team, A. Rashid , S. Cook , K. Darley , A. Kuryba , L. Watton , O. Almilaji , N. Fearnhead , M. Braun , J. van der Meulen , K. Walker","doi":"10.1016/j.clon.2025.104009","DOIUrl":"10.1016/j.clon.2025.104009","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"50 ","pages":"Article 104009"},"PeriodicalIF":3.0,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145975266","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":"Intraocular Sarcomas: A Population-based Study","authors":"P. Loap, Y. Kirova, R. Dendale","doi":"10.1016/j.clon.2025.104006","DOIUrl":"10.1016/j.clon.2025.104006","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"50 ","pages":"Article 104006"},"PeriodicalIF":3.0,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145923739","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":"Phase II Open-Label Randomised Controlled Trial Comparing Oxaliplatin and Cisplatin Based Concurrent Chemoradiotherapy in Locally Advanced Head and Neck Cancers","authors":"Y. Yanthan ,&nbsp;L. Pandey ,&nbsp;A. Pandey ,&nbsp;R. Pasricha ,&nbsp;D. Joseph ,&nbsp;S. Gupta ,&nbsp;A. Sehrawat ,&nbsp;A. Dhyani ,&nbsp;M. Gupta","doi":"10.1016/j.clon.2025.104005","DOIUrl":"10.1016/j.clon.2025.104005","url":null,"abstract":"<div><h3>Aims</h3><div>Concurrent cisplatin-based chemoradiotherapy (CCRT) is the standard treatment for locally advanced head and neck cancer (LAHNC); however, it also results in substantial treatment-related toxicities. Oxaliplatin has similar radiosensitisation mechanisms to cisplatin and, if found to have equivalent efficacy in LAHNCs, has the potential to replace cisplatin in CCRT protocols.</div></div><div><h3>Materials and methods</h3><div>This prospective trial compared weekly oxaliplatin 50 mg/m2 to weekly cisplatin 40mg/m² in CCRT protocols for the treatment of non-nasopharyngeal LAHNCs. The primary endpoint was to compare the toxicity profile; secondary endpoints were compliance, locoregional control (LRC), disease-free survival (DFS), and overall survival (OS).</div></div><div><h3>Results</h3><div>Between January 2019 and June 2020, we randomly assigned 70 LAHNC patients, 35 in each arm, to receive radical CCRT. At a median follow-up of 18 months (range: 3-72), acute toxicities of grade 3 or higher occurred in 31% of patients in the oxaliplatin arm and 77% of patients in the cisplatin arm (<em>P</em> = 0.007). The estimated 3-year LRC, DFS, and OS in the oxaliplatin and cisplatin arms were 32.3% vs 35.9%, 28.7% vs 35.9% and 35.1% vs 37.3%, respectively, while the 5-year LRC, DFS, and OS were 32.3% vs 32.4%, 28.7% vs 28.8%, and 31.2% vs 30.5%, respectively. The absolute differences observed were not statistically significant.</div></div><div><h3>Conclusion</h3><div>The CCRT with oxaliplatin in non-nasopharyngeal LAHNC exhibits a better toxicity profile and appears comparable to cisplatin in terms of disease control. It may be worthwhile exploring this approach in a larger trial to gather LRC and survival data.</div></div><div><h3>Clinical Trials Registry India</h3><div>CTRI/2019/01/017198.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"50 ","pages":"Article 104005"},"PeriodicalIF":3.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965324","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":"Royal College of Radiologists Guidance Statements on the Use of Auto-contouring in Radiotherapy","authors":"K. Mackay ,&nbsp;K. Banfill ,&nbsp;D. Bernstein ,&nbsp;J. Daniel ,&nbsp;P. Diez ,&nbsp;S. Gwynne ,&nbsp;A. Hoole ,&nbsp;R. Jena ,&nbsp;T. Marchant ,&nbsp;M. Nix ,&nbsp;G. Price ,&nbsp;M. Teo ,&nbsp;I. Boon ,&nbsp;S. Hindocha ,&nbsp;J. Wang ,&nbsp;K. Zucker ,&nbsp;A. Taylor","doi":"10.1016/j.clon.2025.104004","DOIUrl":"10.1016/j.clon.2025.104004","url":null,"abstract":"<div><div>Auto-contouring systems are rapidly becoming more widely used for radiotherapy treatment planning. There is an acknowledged need for formal guidance to help healthcare professionals understand how to safely adopt this technology. The Royal College of Radiologists Artificial Intelligence in Clinical Oncology working group established a multi-disciplinary group of national experts in artificial intelligence and radiotherapy quality assurance (QA). This group has produced consensus recommendations for the safe use of the technology. These include model selection, clinical commissioning, day-to-day QA, and post-implementation monitoring. Other factors such as the impact on the multi-disciplinary team, education, and training are also considered.</div><div>The healthcare professional approving auto-contours for use will have overall responsibility, and it is therefore of utmost importance that they have a good understanding of the risks of auto-contouring and how contours should be assessed to mitigate these risks. This guidance aims to enable healthcare professionals acting as operators of a medical device to understand what they need to know about auto-contouring, to facilitate safe adoption of this technology.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"50 ","pages":"Article 104004"},"PeriodicalIF":3.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145923785","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 Trials in Molecular Radiotherapy: An Overview of the Landscape","authors":"N. Varmenot ,&nbsp;K. Sjögreen Gleisner ,&nbsp;J. Taprogge ,&nbsp;G.D. Flux","doi":"10.1016/j.clon.2025.104003","DOIUrl":"10.1016/j.clon.2025.104003","url":null,"abstract":"<div><div>In recent years the treatment of cancer with radioactive drugs, here termed molecular radiotherapy (MRT), has emerged to take a place alongside other treatment modalities, particularly non-radioactive drugs (NRDs) and external beam radiotherapy (EBRT). A purpose-built tool was developed within the Python programming environment to review the evolution of clinical trials performed in the first quarter of the century as recorded by the ClinicalTrials.gov database. It was found that the number of MRT trials registered on ClinicalTrials.gov increased by 15-fold from 6 trials in 2000 to 89 in 2024. The ratio of MRT clinical trials relative to EBRT has remained constant at approximately 1:5. Although the number of MRT trials has remained comparatively low, their frequency in relation to NRD trials has doubled over the 25-year period. All modalities have been investigated in a similar spread of early and late phase trials, with a slightly higher proportion for early phase trials in MRT. The registration of trials has increased for almost all indications, particularly for prostate, neuroendocrine and liver cancers, although the number of trials for lymphoma has declined. The diversity and number of radionuclides involved in MRT clinical trials have increased, with beta-minus emitting radionuclides accounting in 2024 for approximately 89% of studies compared to 11% for alpha-emitters.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"51 ","pages":"Article 104003"},"PeriodicalIF":3.0,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146036223","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":"From Numbers to Movement: Making the Toronto Extremity Salvage Score a Living Measure in Soft-tissue Sarcoma Survivorship","authors":"S. Haider","doi":"10.1016/j.clon.2025.104002","DOIUrl":"10.1016/j.clon.2025.104002","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"50 ","pages":"Article 104002"},"PeriodicalIF":3.0,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145923738","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":"Access to Stereotactic Radiosurgery Centres Across the United Kingdom—An Investigation of Travel Time","authors":"S.D. Robinson ,&nbsp;S. Kingdon ,&nbsp;M. Williams","doi":"10.1016/j.clon.2025.104000","DOIUrl":"10.1016/j.clon.2025.104000","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"50 ","pages":"Article 104000"},"PeriodicalIF":3.0,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145923735","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":"Role of Post-operative Thyroglobulin in Predicting Disease-recurrence in Differentiated Thyroid Cancer","authors":"L. Cheng ,&nbsp;M. Gajda ,&nbsp;A. Tran ,&nbsp;N. Jones-Anderson ,&nbsp;S. Iqbal ,&nbsp;J. Wadsley ,&nbsp;K. Newbold","doi":"10.1016/j.clon.2025.104001","DOIUrl":"10.1016/j.clon.2025.104001","url":null,"abstract":"<div><h3>Aims</h3><div>Differentiated thyroid cancer (DTC) patients with intermediate- or high-risk of recurrence are commonly treated with radioactive iodine (RAI). Although the utility of serum thyroglobulin (Tg) levels after surgery and RAI ablation is the standard of care in dynamic risk stratification, its role prior to RAI ablation remains undefined. We evaluated the relationship between post-operative, pre-RAI unstimulated Tg levels and persistent or recurrent structural disease in intermediate- or high-risk patients, postulating that it may help identify patients who may not require RAI.</div></div><div><h3>Materials and methods</h3><div>Patients diagnosed with DTC from three UK cancer centres were retrospectively identified from hospital electronic health records. Data collected included patient characteristics and clinical parameters such as unstimulated, post-operative and pre-RAI Tg levels and follow-up clinical and imaging results. The remaining 301 patients were analysed using univariable and multivariable logistic regression to explore the association between postoperative Tg and structural disease recurrence or persistence.</div></div><div><h3>Results</h3><div>Three hundred and one patients were included in the final analysis. The cohort included 209 (69%) females and 92 (31%) males, with 21 cases of recurrent or persistent disease. Univariable analysis and multivariable logistic regression both showed that unstimulated, post-operative Tg was an independent predictor of structural disease recurrence/persistence. Receiver operator characteristic curve suggested a post-operative unstimulated Tg cutoff of 1.05 ug/L (odds ratio [OR] 1.016, 95% confidence interval [CI] 1.005 to 1.042, p = 0.011). Notably, 17 (81%) of the 21 recurrences had a post-operative Tg levels above this cut-off.</div></div><div><h3>Conclusion</h3><div>Low postoperative unstimulated Tg levels are associated with a low risk of structural recurrence in intermediate- and high-risk DTC patents. Postoperative Tg may enhance current risk stratification in patients who could safely avoid RAI, but prospective trials are needed to validate this.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"50 ","pages":"Article 104001"},"PeriodicalIF":3.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145923736","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 Exploring the Effect of Pelvic Radiotherapy on the Intestinal Microbiome and Metabolome to Improve the Detection and Management of Gastrointestinal Toxicity","authors":"C.C. Henson ,&nbsp;K. Green ,&nbsp;R. Slater ,&nbsp;J. McLaughlin ,&nbsp;M. Hann ,&nbsp;L. Barraclough ,&nbsp;S. Burden ,&nbsp;L. Gillespie ,&nbsp;T. Ward ,&nbsp;C. Probert","doi":"10.1016/j.clon.2025.103994","DOIUrl":"10.1016/j.clon.2025.103994","url":null,"abstract":"<div><h3><em>Aims</em></h3><div>Eighty percent patients develop gastrointestinal (GI) symptoms during pelvic radiotherapy. The triggering event is a known enabling identification of pathophysiological changes. The focus of this study was feasibility (identification, recruitment, and retention), however, exploratory microbiome and metabolome analyses were performed.</div></div><div><h3><em>Materials and methods</em></h3><div>Patients undergoing pelvic radiotherapy underwent faecal sampling (baseline, week 4, and 6 months), with assessment of GI toxicity using the Imflammatory Bowel Disease Questionnaire (IBDQ) bowel (IBDQB) subset. Participants were split into 2 groups based on IBDQB at week-4. Exploratory analysis was performed to identify differences in metabolome (gas chromatography-mass spectrometry) and microbiome (16s rRNA sequencing).</div></div><div><h3><em>Results</em></h3><div>Two hundred twenty-seven patients were screened, 69 were approached, and 17 were recruited over 18 months (mean age: 61.6 ± 15.3 years; 14 female; 1 withdrawal).</div><div>Metabolome analysis showed lower heptanal and octanal in baseline samples of patients with higher GI toxicity; lower (methyltrisulfanyl)methane in week-4 samples of patients with higher GI toxicity; and higher butanoic acid and benzaldehyde in month 6 samples in patients with higher GI toxicity.</div><div>Whole-group microbiome analysis showed a trend towards decreased alpha diversity at 4 weeks; no differences in beta diversity; and a trend towards increase in <em>Lachnoclostridium</em> and decrease in Ruminococcaceae <em>Incertae sedis</em> at week 4. Microbiome analysis split by GI toxicity showed lower alpha diversity for the high GI toxicity group (each timepoint); no significant difference in beta diversity between groups; more genera differentially abundant between the GI toxicity groups at 4 weeks, than at other timepoints.</div></div><div><h3><em>Conclusion</em></h3><div>Recruitment was lower than anticipated. Attrition was low. Exploratory analysis suggests heptanal and octanal may have a role as a biomarker for GI toxicity, and lower alpha diversity may predict GI toxicity, with <em>Lachnoclostridium</em> and Ruminococcaceae <em>Incertae sedis</em> as bacteria of interest.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"50 ","pages":"Article 103994"},"PeriodicalIF":3.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145923737","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":"Local Control With Moderately Hypofractionated Definitive Radiotherapy Delivered With a Simultaneous Integrated Boost Technique to Non-extremity Soft Tissue and Bone Sarcomas","authors":"J.D. Towler,&nbsp;C. David,&nbsp;O. Willis,&nbsp;N. Lalli,&nbsp;H. Grimes,&nbsp;F. Le Grange,&nbsp;A. Pilar,&nbsp;B.M. Seddon,&nbsp;M. Ahmed","doi":"10.1016/j.clon.2025.103999","DOIUrl":"10.1016/j.clon.2025.103999","url":null,"abstract":"<div><h3>Aims</h3><div>While surgery is the primary treatment for soft tissue sarcomas (STS) and primary bone sarcomas, a notable proportion of patients with non-extremity tumours do not undergo resection. Outcome data for definitive radiotherapy in this context are limited, as is evidence on the use of hypofractionation at non-extremity sites near sensitive organs at risk. We report our institutional experience delivering moderately hypofractionated definitive radiotherapy (MHDRT) to patients with inoperable non-extremity STS and bone sarcomas including those who were unfit for, or declined, surgery.</div></div><div><h3>Materials and Methods</h3><div>Fifty-nine adult sarcoma patients received MHDRT to non-extremity disease between July 2021 and September 2024 in 60 treatment courses (54 photon, 6 proton). Radiotherapy was delivered over 28 fractions at two dose levels, with 50.4 Gy to the low-dose target volume and a simultaneous integrated boost (SIB) to the high-dose target volume of 63 Gy for STS and 70 Gy for bone sarcomas. Two patients received treatment over 30 fractions to a comparable dose with a SIB of ≥2.2 Gy per fraction.</div></div><div><h3>Results</h3><div>With a median follow-up of 17.7 months, local control at 1 year was 90.8% for STS (n = 37), 100% for chordoma (n = 14) and 55.6% for high-grade primary bone sarcomas (n = 9). Acute and late grade 3 toxicities were observed in 5 (8.3%) and 6 (10%) patients respectively.</div></div><div><h3>Conclusion</h3><div>These data indicate that MHDRT can be delivered to inoperable non-extremity sarcomas with acceptable toxicity and encouraging early local control rates, representing an important radical treatment option in this patient group.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"51 ","pages":"Article 103999"},"PeriodicalIF":3.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146075316","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}