Pub Date : 2025-02-01DOI: 10.1016/j.clon.2024.103728
T.J. Walsh, L.M. Vallodolid, K. Gayford, R. Nayar, K. DeSouza, R. Roylance
{"title":"A comprehensive overview of a single-institutional (University College London Hospital) experience with CDK4/6 inhibitors in ER+/HER2- metastatic breast cancer","authors":"T.J. Walsh, L.M. Vallodolid, K. Gayford, R. Nayar, K. DeSouza, R. Roylance","doi":"10.1016/j.clon.2024.103728","DOIUrl":"10.1016/j.clon.2024.103728","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103728"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429122","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 : 2025-02-01DOI: 10.1016/j.clon.2024.02.001
S.K. Vinod , R. Merie , S. Harden
High-quality decision making in radiation oncology requires the careful consideration of multiple factors. In addition to the evidence-based indications for curative or palliative radiotherapy, this article explores how, in routine clinical practice, we also need to account for many other factors when making high-quality decisions. Foremost are patient-related factors, including preference, and the complex interplay between age, frailty and comorbidities, especially with an ageing cancer population. Whilst clinical practice guidelines inform our decisions, we need to account for their applicability in different patient groups and different resource settings. With particular reference to curative-intent radiotherapy, we explore decisions regarding dose fractionation schedules, use of newer radiotherapy technologies and multimodality treatment considerations that contribute to personalised patient-centred care.
{"title":"Quality of Decision Making in Radiation Oncology","authors":"S.K. Vinod , R. Merie , S. Harden","doi":"10.1016/j.clon.2024.02.001","DOIUrl":"10.1016/j.clon.2024.02.001","url":null,"abstract":"<div><div>High-quality decision making in radiation oncology requires the careful consideration of multiple factors. In addition to the evidence-based indications for curative or palliative radiotherapy, this article explores how, in routine clinical practice, we also need to account for many other factors when making high-quality decisions. Foremost are patient-related factors, including preference, and the complex interplay between age, frailty and comorbidities, especially with an ageing cancer population. Whilst clinical practice guidelines inform our decisions, we need to account for their applicability in different patient groups and different resource settings. With particular reference to curative-intent radiotherapy, we explore decisions regarding dose fractionation schedules, use of newer radiotherapy technologies and multimodality treatment considerations that contribute to personalised patient-centred care.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103523"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139717407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.clon.2024.10.004
H. Zeng, H. Wang, S. Liu, X. Xu
Aims
The efficacy of concurrent chemoradiotherapy (CCRT) for Stage II and T3N0 nasopharyngeal carcinoma (NPC), particularly during the shift from two-dimensional conventional radiotherapy (2DCRT) to intensity-modulated radiotherapy (IMRT) is debated.Therefore this study aims to systematically evaluate and meta-analyze survival benefits of CCRT versus radiotherapy alone for Stage II and T3N0 NPC, stratified by radiotherapy techniques.
Materials and methods
As of April 1, 2024, we conducted an exhaustive literature search across databases such as PubMed, Embase, Cochrane Library, and Web of Science, with the aim of identifying and screening studies that compare the efficacy of CCRT versus radiotherapy alone in the treatment of Stage II and T3N0 NPC.
Results
A total of 10 studies encompassing 5015 patients were included in this comprehensive analysis. The findings indicate that, apart from progression-free survival (PFS), CCRT did not improve survival outcomes, including overall survival (OS), distant metastasis-free survival (DMFS), local recurrence-free survival (LRRFS), and failure-free survival (FFS), with all P values exceeding 0.05. Concurrently, the incidence of grade ≥3 adverse events associated with CCRT was significantly elevated (odds ratio [OR] = 3.77, 95% confidence interval [CI] = 2.75–5.15, P < 0.0001). Subgroup analysis revealed that, compared with RT, the combination of 2DCRT with concurrent chemotherapy significantly improved OS (hazard ratio [HR] = 0.57, 95% CI = 0.46–0.71, P < 0.00001), PFS (HR = 0.65, 95% CI=0.53–0.78, P < 0.00001), DMFS (HR = 0.54, 95% CI = 0.37–0.79, P = 0.002), and LRRFS (HR = 0.63, 95% CI = 0.49–0.82, P = 0.0005). In contrast, the combination of IMRT with concurrent chemotherapy failed to demonstrate improvements in OS, PFS, DMFS, or LRRFS, with all P values exceeding 0.05.
Conclusion
In contrast with RT, CCRT did not enhance survival in stage II and T3N0 NPC patients, yet caused more adverse reactions. 2DCRT combined with concurrent chemotherapy significantly improved OS, PFS, DMFS, and LRRFS, while IMRT with concurrent chemotherapy showed no clinical benefits.
{"title":"Concurrent Chemoradiotherapy versus Radiotherapy Alone in the Treatment of Stage II and T3N0M0 Nasopharyngeal Carcinoma: A Systematic Review and Meta-Analysis","authors":"H. Zeng, H. Wang, S. Liu, X. Xu","doi":"10.1016/j.clon.2024.10.004","DOIUrl":"10.1016/j.clon.2024.10.004","url":null,"abstract":"<div><h3>Aims</h3><div>The efficacy of concurrent chemoradiotherapy (CCRT) for Stage II and T3N0 nasopharyngeal carcinoma (NPC), particularly during the shift from two-dimensional conventional radiotherapy (2DCRT) to intensity-modulated radiotherapy (IMRT) is debated.Therefore this study aims to systematically evaluate and meta-analyze survival benefits of CCRT versus radiotherapy alone for Stage II and T3N0 NPC, stratified by radiotherapy techniques.</div></div><div><h3>Materials and methods</h3><div>As of April 1, 2024, we conducted an exhaustive literature search across databases such as PubMed, Embase, Cochrane Library, and Web of Science, with the aim of identifying and screening studies that compare the efficacy of CCRT versus radiotherapy alone in the treatment of Stage II and T3N0 NPC.</div></div><div><h3>Results</h3><div>A total of 10 studies encompassing 5015 patients were included in this comprehensive analysis. The findings indicate that, apart from progression-free survival (PFS), CCRT did not improve survival outcomes, including overall survival (OS), distant metastasis-free survival (DMFS), local recurrence-free survival (LRRFS), and failure-free survival (FFS), with all <em>P</em> values exceeding 0.05. Concurrently, the incidence of grade ≥3 adverse events associated with CCRT was significantly elevated (odds ratio [OR] = 3.77, 95% confidence interval [CI] = 2.75–5.15, <em>P</em> < 0.0001). Subgroup analysis revealed that, compared with RT, the combination of 2DCRT with concurrent chemotherapy significantly improved OS (hazard ratio [HR] = 0.57, 95% CI = 0.46–0.71, <em>P</em> < 0.00001), PFS (HR = 0.65, 95% CI=0.53–0.78, <em>P</em> < 0.00001), DMFS (HR = 0.54, 95% CI = 0.37–0.79, <em>P</em> = 0.002), and LRRFS (HR = 0.63, 95% CI = 0.49–0.82, <em>P</em> = 0.0005). In contrast, the combination of IMRT with concurrent chemotherapy failed to demonstrate improvements in OS, PFS, DMFS, or LRRFS, with all <em>P</em> values exceeding 0.05.</div></div><div><h3>Conclusion</h3><div>In contrast with RT, CCRT did not enhance survival in stage II and T3N0 NPC patients, yet caused more adverse reactions. 2DCRT combined with concurrent chemotherapy significantly improved OS, PFS, DMFS, and LRRFS, while IMRT with concurrent chemotherapy showed no clinical benefits.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103652"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.clon.2024.103731
J. O'Hara , M.S. Iqbal
{"title":"The Evidence for Low-level Laser Therapy for Oral Mucositis in Head and Neck Cancer Radiotherapy","authors":"J. O'Hara , M.S. Iqbal","doi":"10.1016/j.clon.2024.103731","DOIUrl":"10.1016/j.clon.2024.103731","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103731"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964053","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 : 2025-02-01DOI: 10.1016/j.clon.2024.103730
K. Martell , C. Kirkby
Aims
Prostrate-specific membrane antigen positron emission tomography (PSMA-PET) imaging has led to an increase in identifiable small volume metastatic disease in prostate adenocarcinoma. There is clinical equipoise in how to treat these using radiotherapy regimens. The aim of this study is to determine an adequate dosing regimen for small volume lymphatic metastases in prostate adenocarcinoma.
Materials and methods
The authors first estimated the cell count of small volume metastases in prostate adenocarcinoma and then used a Poisson distribution-based estimation of the tumour control probability distribution, the required doses for 95% and 99% probabilities of tumour sterilisation were calculated using the linear quadratic formula.
Results
Lymph node metastases of 3, 5, and 10 mm diameter were estimated to harbour 1.4, 6.5, and 52.3 million clonogens, respectively. When attempting for a 95% tumour control probability, estimated BEDs of 116.5, 127.0, and 141.1Gy were required. This translated to doses of 26.0, 27.3, and 29.0Gy in 5 fraction regimens. When attempting for a 99% tumour control probability, estimated biological effective doses (BEDs) of 127.6, 138.1, and 152.2 Gy were required. This translated to doses of 27.4, 28.6, and 30.2 Gy in 5 fraction regimens.
Conclusion
In prostate cancers with small-volume metastatic disease, doses can be adjusted according to tumour size without likely to compromise tumour control. This would have positive implications on radiotherapy planning and possibly lead to decreased risks of toxicity in scenarios where planning difficulty is encountered. Clinical evaluation of efficacy and safety for these dose regimens is warranted.
{"title":"Dose Recommendations for Prostrate-specific Membrane Antigen Positron Emission Tomography (PSMA PET) Guided Boost Irradiation to Lymphatic Tissue in Prostate Adenocarcinoma","authors":"K. Martell , C. Kirkby","doi":"10.1016/j.clon.2024.103730","DOIUrl":"10.1016/j.clon.2024.103730","url":null,"abstract":"<div><h3>Aims</h3><div>Prostrate-specific membrane antigen positron emission tomography (PSMA-PET) imaging has led to an increase in identifiable small volume metastatic disease in prostate adenocarcinoma. There is clinical equipoise in how to treat these using radiotherapy regimens. The aim of this study is to determine an adequate dosing regimen for small volume lymphatic metastases in prostate adenocarcinoma.</div></div><div><h3>Materials and methods</h3><div>The authors first estimated the cell count of small volume metastases in prostate adenocarcinoma and then used a Poisson distribution-based estimation of the tumour control probability distribution, the required doses for 95% and 99% probabilities of tumour sterilisation were calculated using the linear quadratic formula.</div></div><div><h3>Results</h3><div>Lymph node metastases of 3, 5, and 10 mm diameter were estimated to harbour 1.4, 6.5, and 52.3 million clonogens, respectively. When attempting for a 95% tumour control probability, estimated BEDs of 116.5, 127.0, and 141.1Gy were required. This translated to doses of 26.0, 27.3, and 29.0Gy in 5 fraction regimens. When attempting for a 99% tumour control probability, estimated biological effective doses (BEDs) of 127.6, 138.1, and 152.2 Gy were required. This translated to doses of 27.4, 28.6, and 30.2 Gy in 5 fraction regimens.</div></div><div><h3>Conclusion</h3><div>In prostate cancers with small-volume metastatic disease, doses can be adjusted according to tumour size without likely to compromise tumour control. This would have positive implications on radiotherapy planning and possibly lead to decreased risks of toxicity in scenarios where planning difficulty is encountered. Clinical evaluation of efficacy and safety for these dose regimens is warranted.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103730"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909389","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 : 2025-02-01DOI: 10.1016/j.clon.2024.10.013
N. Abdul Aziz , S. Ganguli , N.G. Kenrick , P. Rajan , A. Sharma , J. Shamash
{"title":"The prognostic value of LDH in patients with good risk metastatic seminoma treated with single-agent Carboplatin AUC 10","authors":"N. Abdul Aziz , S. Ganguli , N.G. Kenrick , P. Rajan , A. Sharma , J. Shamash","doi":"10.1016/j.clon.2024.10.013","DOIUrl":"10.1016/j.clon.2024.10.013","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Page 4"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143428961","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 : 2025-02-01DOI: 10.1016/j.clon.2024.10.024
A. Singh, Z. Arif, A. Birtle
{"title":"Leading from the front: Real-world treatment of metastatic hormone-sensitive prostate cancer in the Northwest of England","authors":"A. Singh, Z. Arif, A. Birtle","doi":"10.1016/j.clon.2024.10.024","DOIUrl":"10.1016/j.clon.2024.10.024","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Page 8"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143428975","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 : 2025-02-01DOI: 10.1016/j.clon.2024.103720
J. McKeon, E. Daniels, L. Gibbs, C. Comins, J. Jenkins, T. Strawson-Smith, V. Mohan, M.H. Allah, J. Braybrooke, T. Robinson
{"title":"Real-world data (RWD) from patients with triple-negative breast cancer (TNBC) receiving pembrolizumab with neoadjuvant chemotherapy (NACT+P) versus NACT alone","authors":"J. McKeon, E. Daniels, L. Gibbs, C. Comins, J. Jenkins, T. Strawson-Smith, V. Mohan, M.H. Allah, J. Braybrooke, T. Robinson","doi":"10.1016/j.clon.2024.103720","DOIUrl":"10.1016/j.clon.2024.103720","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103720"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429230","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 : 2025-02-01DOI: 10.1016/j.clon.2024.09.003
P.J. Hoskin
Artificial intelligence (AI) is already an essential tool in the handling of large data sets in epidemiology and basic research.
Significant contributions to radiological diagnosis are emerging alongside increasing use of digital pathology. The future lies in integrating this information together with clinical data relevant to each individual patient. Linkage with clinical protocols will enable personalized management options to be presented to the oncologist of the future.
Radiotherapy has the distinction of being the first to have a National Institute for Health and Care Excellence (NICE)-approved AI-based recommendation. There is the opportunity to revolutionize the workflow with many tasks currently undertaken by clinicians taken over by AI-based systems for volume outlining, planning, and quality assurance.
Education and training will be essential to understand the AI processes and inputs. Clinicians will however have to feel confident interrogating the AI-derived information and in communicating AI-derived treatment plans to patients.
{"title":"The Use of Artificial Intelligence Technologies in Cancer Care","authors":"P.J. Hoskin","doi":"10.1016/j.clon.2024.09.003","DOIUrl":"10.1016/j.clon.2024.09.003","url":null,"abstract":"<div><div>Artificial intelligence (AI) is already an essential tool in the handling of large data sets in epidemiology and basic research.</div><div>Significant contributions to radiological diagnosis are emerging alongside increasing use of digital pathology. The future lies in integrating this information together with clinical data relevant to each individual patient. Linkage with clinical protocols will enable personalized management options to be presented to the oncologist of the future.</div><div>Radiotherapy has the distinction of being the first to have a National Institute for Health and Care Excellence (NICE)-approved AI-based recommendation. There is the opportunity to revolutionize the workflow with many tasks currently undertaken by clinicians taken over by AI-based systems for volume outlining, planning, and quality assurance.</div><div>Education and training will be essential to understand the AI processes and inputs. Clinicians will however have to feel confident interrogating the AI-derived information and in communicating AI-derived treatment plans to patients.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"38 ","pages":"Article 103644"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379183","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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