Clinical oncology最新文献

{"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}

{"title":"Population-Based Outcomes of Single-Fraction Stereotactic Ablative Radiotherapy for Early Stage Non-small Cell Lung Cancer","authors":"J.M. Callueng ,&nbsp;S. Baker ,&nbsp;N. Chng ,&nbsp;J.P. Abrina ,&nbsp;D. Hoegler ,&nbsp;D. Petrik ,&nbsp;E.M. Dunne ,&nbsp;I. Mohamed ,&nbsp;R. Halperin ,&nbsp;S. Atrchian ,&nbsp;A. Lin ,&nbsp;A. Ye ,&nbsp;F. Hsu ,&nbsp;D. Schellenberg ,&nbsp;M. Liu ,&nbsp;B. Mou","doi":"10.1016/j.clon.2025.103997","DOIUrl":"10.1016/j.clon.2025.103997","url":null,"abstract":"<div><h3><em>Aims</em></h3><div>Single-fraction stereotactic ablative radiotherapy (SF-SABR) was introduced in British Columbia (BC), Canada, during the COVID-19 pandemic. It persists as a standard treatment owing to its comparable outcomes with fractionated regimens in two randomised phase II trials and advantages in resource utilisation and patient convenience. This study evaluated the clinical outcomes and toxicities in patients treated with SF-SABR for early stage non-small lung cancer (NSCLC) in BC.</div></div><div><h3><em>Materials and methods</em></h3><div>This multi-institution population-based retrospective study included all patients treated with SF-SABR for early stage NSCLC between March 2020 and August 2023 in BC. All lesions were peripheral T1-T2 tumours, less than 5 cm in diameter. All patients were medically inoperable or declined surgery. Prescription doses were either 30 Gy or 34 Gy in one fraction. Assessed clinical outcomes included 2-year local failure (LF), distant failure (DF), and overall survival (OS). Toxicity endpoints were graded according to Common Terminology Criteria for Adverse Events version 5.0.</div></div><div><h3>RESULTS</h3><div>A total of 179 lesions in 166 patients were included. The median follow-up was 23.0 months. The median age was 75 years. The majority (95%) of tumours were T1. The median tumour diameter was 1.5 cm. Prescription doses of 30 Gy and 34 Gy were delivered to 103 (57.5%) and 76 (42.5%) lesions, respectively. The 2-year LF, DF, and OS rates were 7.1%, 14.1%, and 81.5%, respectively. No grade 4 or 5 toxicities were reported. Crude rates of grade 2 and 3 toxicities were 17.3% and 2.2%, respectively. Grade 2 and 3 chest wall toxicity (CWT) rates were 5.6% and 0.6%, respectively. Chest wall abutment, diabetes, and prior thoracic radiation were significant predictors for CWT on univariate analysis.</div></div><div><h3>CONCLUSIONS</h3><div>This multi-institution population-based study demonstrated that SF-SABR for early stage NSCLC had favourable early clinical outcomes and low toxicity rates comparable to data from other SF-SABR and multi-fraction lung SABR studies. Long-term follow-up of outcomes and toxicity for SF-SABR are warranted.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"50 ","pages":"Article 103997"},"PeriodicalIF":3.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924222","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":"Radiotherapy Plan Quality Assurance in the ABC-07 Trial of Stereotactic Body Radiotherapy for Locally Advanced Biliary Tract Cancer","authors":"D.J. Eaton ,&nbsp;D.H. Brand ,&nbsp;N. Hava ,&nbsp;M. Harrison ,&nbsp;A. Lopes ,&nbsp;P. Manoharan ,&nbsp;G. Radhakrishna ,&nbsp;S. Shelly ,&nbsp;M.A. Hawkins","doi":"10.1016/j.clon.2025.103993","DOIUrl":"10.1016/j.clon.2025.103993","url":null,"abstract":"<div><h3>Aims</h3><div>The ABC-07 phase II randomised controlled trial (ISRCTN: 10639376) investigated the addition of stereotactic body radiotherapy (SBRT) to systemic chemotherapy in locally advanced biliary tract cancers (BTCs). We report the radiotherapy quality assurance (RTQA) of SBRT treatment plans in the trial.</div></div><div><h3>Materials and methods</h3><div>RTQA was performed before and during accrual, including benchmark contouring and planning cases, along with prospective independent case review (ICR) of the first three patients from each centre randomised to SBRT. Prescription doses were up to 50 Gy in 5 fractions or up to 67.5 Gy in 15 fractions. Cases were reviewed for segmentation accuracy and plan quality, including target coverage and organ-at-risk (OAR) constraints being met.</div></div><div><h3>Results</h3><div>Benchmark cases: Six of seventeen contouring submissions required revision (35%), and 6/17 planning submissions were revised after feedback on what was achievable by other centres. Prospective ICR: Thirty-one of forty-one cases from all 12 recruiting centres that were randomised to SBRT underwent review in real-time, and the others were reviewed retrospectively. Eight of these prospectively reviewed cases required revisions during the review process (26%, including 7 contouring and 2 planning revisions). Nineteen of forty-one plans overall (46%) had deviations from trial protocol objectives (even after any revisions), mostly unavoidable target coverage compromise (D95% &lt; 90%) because of proximal OARs such as duodenum (17/41) and stomach (6/41).</div></div><div><h3>Conclusion</h3><div>Despite rigorous plan QA, we encountered variability in segmentation and plan coverage. The revision rate was reduced between pre-trial and on-trial cases. Radiotherapy doses in the protocol were achievable in many cases; however, target coverage was frequently compromised to maintain OAR dose constraints. Such compromises should be prespecified in future studies.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"50 ","pages":"Article 103993"},"PeriodicalIF":3.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145908803","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":"Weathering the Storm: The Impact of Weather Events, Lockdowns and Holidays on Oncology and General Emergency Presentations to a United Kingdom Tertiary Centre: A 7.5-year Review","authors":"D.M. Favara","doi":"10.1016/j.clon.2025.103991","DOIUrl":"10.1016/j.clon.2025.103991","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"49 ","pages":"Article 103991"},"PeriodicalIF":3.0,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145793403","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! (January 2026 Edition)","authors":"S. Parikh ,&nbsp;C. Crockett","doi":"10.1016/j.clon.2025.103988","DOIUrl":"10.1016/j.clon.2025.103988","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"49 ","pages":"Article 103988"},"PeriodicalIF":3.0,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145691023","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":"Enhancing Treatment Resilience in Palliative Oesophagogastric Cancer: Nutritional, Access, and Scoring Considerations","authors":"M. Wajid Siddique ,&nbsp;M.A. Cheema","doi":"10.1016/j.clon.2025.103985","DOIUrl":"10.1016/j.clon.2025.103985","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"49 ","pages":"Article 103985"},"PeriodicalIF":3.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145741228","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":"Reflections on “Radiating Excellence: A Decade of Pioneering Radiotherapy Trials and Collaborative Leadership at Leeds Cancer Research UK Clinical Trials Unit”","authors":"U. Yaseen","doi":"10.1016/j.clon.2025.103987","DOIUrl":"10.1016/j.clon.2025.103987","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"49 ","pages":"Article 103987"},"PeriodicalIF":3.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145793407","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":"CAR-T in Central Nervous System Tumours: Promising Science, Slow Clinical Progress","authors":"M. Mehfooz,&nbsp;H. Raza,&nbsp;A. Javed,&nbsp;Y. Ejaz","doi":"10.1016/j.clon.2025.103986","DOIUrl":"10.1016/j.clon.2025.103986","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"49 ","pages":"Article 103986"},"PeriodicalIF":3.0,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827034","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}