Clinical oncology最新文献

英文中文

Clinical Outcomes and Toxicity Profile of Chemoradiotherapy in Older Versus Younger Patients With Anal Cancer: A Retrospective Cohort Analysis 老年和年轻肛门癌患者放化疗的临床结果和毒性分析：回顾性队列分析。

IF 3 3区医学 Q2 ONCOLOGY

Clinical oncology

Pub Date : 2025-08-23 DOI: 10.1016/j.clon.2025.103929

C. van der Elzen , F. Aires , E.D. Rodrigues , C. Dias , M. Marques , L. Osório

Aims

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.

Materials and methods

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 (<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 P < 0.05.

Results

After a median follow-up of 48 months (range, 6-187), complete response rates were 86.7% and 95.2% in younger and older cohorts, respectively (P = .395). At the 48-month median follow-up, 4-year OS was 72.3% in younger and 68.7% in older patients (P = .845). Four-year LRFS (77.7% vs 88.7%, P = .381), MFS (83.8% vs 93.3%, P = .718), and PFS (77.7% vs 89.3%, P = .656) showed no significant differences between cohorts. Completion of treatment reached 100% and 98% in younger and older groups. A pretreatment haemoglobin <11.7g/dL and an SCC ≥1.3 ng/mL were significant prognostic factors in the younger cohort only (P = .026 and P = .016, respectively).

Conclusion

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.

目的：老年肛门癌（AC）患者接受放化疗（CRT）的最佳管理仍然存在争议，特别是关于治疗耐受性和结果。本研究旨在比较接受标准CRT的老年和年轻患者的治疗结果和毒性特征。材料和方法：我们对2008年至2023年在我院接受CRT治疗的AC患者进行了16年的回顾性分析。共有61例患者被分为老年（≥65岁，n = 25）和年轻(结果：中位随访48个月（范围6-187）后，年轻和老年队列的完全缓解率分别为86.7%和95.2% （P = .395）。在48个月的中位随访中，4年OS在年轻患者中为72.3%，在老年患者中为68.7% （P = .845）。4年LRFS （77.7% vs 88.7%, P = .381）、MFS （83.8% vs 93.3%, P = .718）和PFS （77.7% vs 89.3%, P = .656）在队列间无显著差异。治疗完成率在年轻组和老年组分别为100%和98%。结论：老年AC患者与年轻患者在接受治疗意向CRT时表现出相当的治疗结果。我们的研究结果表明，在不同年龄组之间，完全缓解率、生存结果和较高的治疗完成率相当，精心管理的CRT在老年患者中既可行又有效。

{"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 , F. Aires , E.D. Rodrigues , C. Dias , M. Marques , 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 (<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> < 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 <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}

引用次数: 0

An Institutional Audit on the Usage of the Royal College of Radiologists Consent Forms for Radiotherapy 英国皇家放射科医师学会放射治疗同意表格使用情况的机构审计

IF 3 3区医学 Q2 ONCOLOGY

Clinical oncology

Pub Date : 2025-08-19 DOI: 10.1016/j.clon.2025.103927

M.S. Iqbal, M. Nazir, A. Burns, A. Clark, M. Jackson

引用次数: 0

RCR Meetings 软的会议

IF 3 3区医学 Q2 ONCOLOGY

Clinical oncology

Pub Date : 2025-08-18 DOI: 10.1016/j.clon.2025.103924

引用次数: 0

Paid MBP advert Journals_AI_Conference_280x210_September_SEB_01 付费MBP广告Journals_AI_Conference_280x210_September_SEB_01

IF 3 3区医学 Q2 ONCOLOGY

Clinical oncology

Pub Date : 2025-08-18 DOI: 10.1016/S0936-6555(25)00180-3

引用次数: 0

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 胶质母细胞瘤发生和耐药过程中三维染色质空间组织的改变：分子机制、临床意义和治疗前景的最新进展

IF 3 3区医学 Q2 ONCOLOGY

Clinical oncology

Pub Date : 2025-08-13 DOI: 10.1016/j.clon.2025.103926

A.G. Taki , A. Shareef , L. Baldaniya , R. Oweis , S.R. Jyothi , U. Singh , S. Sahoo , A.S. Chauhan , U. Rakhmatov , H.N. Sameer , A. Yaseen , Z.H. Athab , M. Adil

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.

胶质母细胞瘤（GBM）仍然是最具侵袭性和致死性的脑癌之一，具有深刻的遗传、表观遗传和表型异质性。高分辨率基因组图谱的最新进展揭示了三维（3D）染色质结构——包括染色质环、拓扑相关结构域和增强子-启动子相互作用——在驱动GBM肿瘤发生和治疗耐药性中的关键作用。这篇综述总结了最近关于三维基因组重组在维持致癌转录程序、促进肿瘤内异质性和促进适应性抵抗方面的机制贡献的见解。我们将分子发现与临床和治疗观点结合起来，强调表观遗传药物靶向疾病相关染色质结构的潜力。最后，我们强调了利用染色质构象数据进行GBM精确肿瘤学的未解决问题和未来方向。

{"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 , A. Shareef , L. Baldaniya , R. Oweis , S.R. Jyothi , U. Singh , S. Sahoo , A.S. Chauhan , U. Rakhmatov , H.N. Sameer , A. Yaseen , Z.H. Athab , 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}

引用次数: 0

Early Results of Hypofractionated Chemoradiation in Cervical Cancer with 44 Gy/ 20 F vs 45 Gy/ 25 F: A Phase II, Open-Label, Randomised Controlled Trial (HYPOCx-iRex Trial) 44 Gy/ 20 F与45 Gy/ 25 F低分割放化疗在宫颈癌中的早期结果：一项II期、开放标签、随机对照试验（HYPOCx-iRex试验）

IF 3 3区医学 Q2 ONCOLOGY

Clinical oncology

Pub Date : 2025-08-08 DOI: 10.1016/j.clon.2025.103907

Pittaya Dankulchai , Tissana Prasartseree , Wiwatchai Sittiwong , Kullathorn Thephamongkhol, Pitchayut Nakkrasae

Aims

To compare the safety and efficacy of hypofractionated chemoradiation (HYPO) regimen with a conventional fractionation (CVRT) for locally advanced cervical cancer (LACC).

Materials and methods

A single-centre, open-label, randomised controlled trial enrolled patients with LACC to receive either HYPO (44 Gy/20 fractions) or CVRT (45 Gy/25 fractions) with intensity-modulated radiotherapy, image-guided adaptive brachytherapy, and concurrent weekly cisplatin. The primary outcome was the incidence of acute and late gastrointestinal (GI) and genitourinary (GU) toxicity assessed using the Common Terminology Criteria for Adverse Events version 5.0. Secondary outcomes included health-related quality of life (HRQoL), disease control, and survival.

Results

Forty patients with a median follow-up of 19 months were enrolled (HYPO: n=21; CVRT: n=19). The HYPO achieved a significantly shorter overall treatment time (OTT) compared with CVRT (39 vs 47 days, P < .001). GI and GU toxicities were manageable, with a trend towards higher rates in the HYPO compared with CVRT for both acute (grading [Gr]≥3 CTCAE/patient-reported outcome 43%/29% vs 32%/11%, P=.53/0.24) and actuarial 18-month late GI toxicity (Gr≥2/Gr≥3 26.2%/21.2% vs 20.6%/14.4%, P=.537/0.438), although not statistically significant. No Gr≥3 GU toxicity was observed. HRQoL scores during treatment were lower in the HYPO compared with CVRT; however, recovering within the 3-month post-radiotherapy period. A trend toward superior locoregional control was observed in the HYPO. Notably, para-aortic control at 24 months was significantly higher in the HYPO (100% vs 71.2%, P=.003). No significant differences were observed in local control or overall survival at the time of analysis.

Conclusion

HYPO with modern techniques is feasible for LACC, significantly reducing OTT. A trend towards higher yet tolerable acute and late GI toxicity warrants further investigation. Encouragingly, HYPO showed promising locoregional control.

Registration number

thaiclinicaltrials.org (TCTR20210812003)

目的比较低分割放化疗方案（HYPO）与常规分割放化疗方案（CVRT）治疗局部晚期宫颈癌（LACC）的安全性和有效性。材料和方法一项单中心、开放标签、随机对照试验招募了LACC患者，接受HYPO （44 Gy/20分）或CVRT （45 Gy/25分），同时接受调强放疗、图像引导适应性近距离放疗和每周同步顺铂治疗。主要终点是急性和晚期胃肠道（GI）和泌尿生殖系统（GU）毒性的发生率，使用不良事件通用术语标准5.0版进行评估。次要结局包括健康相关生活质量（HRQoL）、疾病控制和生存。结果40例患者入组，中位随访19个月（HYPO: n=21; CVRT: n=19）。与CVRT相比，HYPO实现了更短的总治疗时间（OTT）（39天和47天，P < 001）。GI和GU毒性是可控的，与CVRT相比，在急性（分级[Gr]≥3 CTCAE/患者报告结果43%/29% vs 32%/11%， P= 0.53 /0.24）和精算18个月晚期GI毒性（Gr≥2/Gr≥3 26.2%/21.2% vs 20.6%/14.4%， P= 0.537 /0.438）中，HYPO的发生率有更高的趋势，尽管没有统计学意义。未见Gr≥3gu毒性。治疗期间，HYPO组HRQoL评分较CVRT组低；然而，在放疗后3个月内恢复。在HYPO中观察到一种向优越的局部区域控制的趋势。值得注意的是，24个月时，HYPO患者的主动脉旁控制率明显更高（100% vs 71.2%， P= 0.003）。在分析时，局部对照或总生存期未观察到显著差异。结论现代hypo技术治疗LACC是可行的，可显著降低OTT。更高但可耐受的急性和晚期胃肠道毒性的趋势值得进一步调查。令人鼓舞的是，HYPO显示出有希望的局部区域控制。注册编号：theicclinicaltrials.org （TCTR20210812003）

{"title":"Early Results of Hypofractionated Chemoradiation in Cervical Cancer with 44 Gy/ 20 F vs 45 Gy/ 25 F: A Phase II, Open-Label, Randomised Controlled Trial (HYPOCx-iRex Trial)","authors":"Pittaya Dankulchai , Tissana Prasartseree , Wiwatchai Sittiwong , Kullathorn Thephamongkhol, Pitchayut Nakkrasae","doi":"10.1016/j.clon.2025.103907","DOIUrl":"10.1016/j.clon.2025.103907","url":null,"abstract":"<div><h3>Aims</h3><div>To compare the safety and efficacy of hypofractionated chemoradiation (HYPO) regimen with a conventional fractionation (CVRT) for locally advanced cervical cancer (LACC).</div></div><div><h3>Materials and methods</h3><div>A single-centre, open-label, randomised controlled trial enrolled patients with LACC to receive either HYPO (44 Gy/20 fractions) or CVRT (45 Gy/25 fractions) with intensity-modulated radiotherapy, image-guided adaptive brachytherapy, and concurrent weekly cisplatin. The primary outcome was the incidence of acute and late gastrointestinal (GI) and genitourinary (GU) toxicity assessed using the Common Terminology Criteria for Adverse Events version 5.0. Secondary outcomes included health-related quality of life (HRQoL), disease control, and survival.</div></div><div><h3>Results</h3><div>Forty patients with a median follow-up of 19 months were enrolled (HYPO: n=21; CVRT: n=19). The HYPO achieved a significantly shorter overall treatment time (OTT) compared with CVRT (39 vs 47 days, <em>P</em> < .001). GI and GU toxicities were manageable, with a trend towards higher rates in the HYPO compared with CVRT for both acute (grading [Gr]≥3 CTCAE/patient-reported outcome 43%/29% vs 32%/11%, <em>P</em>=.53/0.24) and actuarial 18-month late GI toxicity (Gr≥2/Gr≥3 26.2%/21.2% vs 20.6%/14.4%, <em>P</em>=.537/0.438), although not statistically significant. No Gr≥3 GU toxicity was observed. HRQoL scores during treatment were lower in the HYPO compared with CVRT; however, recovering within the 3-month post-radiotherapy period. A trend toward superior locoregional control was observed in the HYPO. Notably, para-aortic control at 24 months was significantly higher in the HYPO (100% vs 71.2%, <em>P</em>=.003). No significant differences were observed in local control or overall survival at the time of analysis.</div></div><div><h3>Conclusion</h3><div>HYPO with modern techniques is feasible for LACC, significantly reducing OTT. A trend towards higher yet tolerable acute and late GI toxicity warrants further investigation. Encouragingly, HYPO showed promising locoregional control.</div></div><div><h3>Registration number</h3><div><span><span>thaiclinicaltrials.org</span><svg><path></path></svg></span> (TCTR20210812003)</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"46 ","pages":"Article 103907"},"PeriodicalIF":3.0,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144926156","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}

引用次数: 0

Response to Letter Regarding ‘Feasibility Study of an Efficient Plan Pool Adaptive Radiotherapy Technology Based on Low-Dose Computed Tomography for Cervical Cancer’ 对“基于低剂量计算机断层扫描的高效计划池自适应宫颈癌放疗技术可行性研究”函件的回应

IF 3 3区医学 Q2 ONCOLOGY

Clinical oncology

Pub Date : 2025-08-08 DOI: 10.1016/j.clon.2025.103922

G. Gan

引用次数: 0

The Power of Precision: Unravelling the Radiobiology of Targeted Radionuclide Therapy 精确的力量：揭示靶向放射性核素治疗的放射生物学。

IF 3 3区医学 Q2 ONCOLOGY

Clinical oncology

Pub Date : 2025-08-08 DOI: 10.1016/j.clon.2025.103923

R. Khanna, P.M.D. Gape, K.C. Grayson, M. Patel, S.Y.A. Terry

Targeted radionuclide therapy (TRT) involves systemic administration of a radionuclide attached to a cancer-targeting moiety. It has been proven to be a promising approach for primary cancer and metastasis treatment with minimal damage to surrounding tissues. TRT integrates the precision of molecular targeting with the therapeutic efficacy of radiation. While the field of TRT is growing, its radiobiological understanding remains incomplete thereby hampering progress and clinical impact. The field is expanding beyond beta particle emitters to include alpha particle and Auger electron emitters, yet most radiobiological principles remain based on external beam X-ray radiotherapy or beta emitter ¹³¹I. This review describes current radiobiological knowledge in TRT, highlights existing gaps, and explores strategies for future advancements. An improved understanding of therapeutic potential, the underlying mechanisms of it, potential synergistic therapy approaches, treatment resistance, and conceivable toxicities, specific to TRT, are still needed.

靶向放射性核素治疗（TRT）是一种全身给药的放射性核素附着在癌症靶向部分。它已被证明是一种很有前途的治疗原发性癌症和转移的方法，对周围组织的损伤最小。TRT将分子靶向的精确性与放射治疗的疗效相结合。虽然TRT领域正在发展，但其放射生物学的理解仍然不完整，从而阻碍了进展和临床影响。该领域正在从β粒子发射器扩展到α粒子和俄歇电子发射器，但大多数放射生物学原理仍然基于外束x射线放疗或β发射器131I。这篇综述描述了目前TRT的放射生物学知识，强调了现有的差距，并探讨了未来发展的策略。仍然需要进一步了解TRT的治疗潜力、潜在机制、潜在的协同治疗方法、治疗耐药性和可能的毒性。

引用次数: 0

Stereotactic Body Radiotherapy for Spinal Oligometastases With or Without Simultaneous Integrated Boost: Results From a Monocentric Retrospective Analysis 立体定向放射治疗脊柱少转移瘤有或没有同步综合增强：来自单中心回顾性分析的结果

IF 3 3区医学 Q2 ONCOLOGY

Clinical oncology

Pub Date : 2025-08-05 DOI: 10.1016/j.clon.2025.103918

E. Pastorello , L. Nicosia , A.G. Allegra , C. De-Colle , N. Giaj-Levra , F. Ricchetti , M. Rigo , A. Romei , C. Orsatti , R. Ruggieri , F. Alongi

Aims

Radiotherapy has a known role in the treatment of symptomatic spinal bone metastases, but there is a relative paucity of data for ablative treatments. The aim of our study is to evaluate the efficacy and toxicity of stereotactic body radiotherapy (SBRT) in treating spinal oligometastases.

Methods

A series of spinal oligometastatic patients was treated between 2018 and 2023. The clinical target volume was defined according to Cox contouring guidelines. When feasible, a simultaneous integrated boost (SIB) was administered to the site of the macroscopic disease. The primary end-point was local progression-free survival (LPFS). Secondary objectives were toxicity, distant progression-free survival (DPFS), and overall survival (OS). The following covariates were evaluated: SIB, biologically effective dose, histology, number of total metastases (including both spinal and extra-spinal), and concurrent systemic therapy.

Results

One hundred and fifty-two spinal oligometastases in 120 patients were treated. Median follow-up was 22 months (range 6–72, with an interquartile range (IQR) of 21 months). Median dose was 24 Gy (range 21–30) delivered in 3 (3–5) fractions. The most common fractionation was 24 Gy in 3 fractions (49 metastases, 32.2%) SIB was administered in 33 metastases (21.7%). One-, and 2-year LPFS rates were 92.1% and 90%, respectively. Moreover, SIB resulted in a significantly improved 2-year LPFS (P = 0.037). Fourteen (9.2%) metastases locally relapsed.

One- and 2-years OS were 94.8% and 90%, respectively. One- and 2-years DPFS were 47.8% and 30.8%, respectively, with a median DPFS of 11 months. Oligometastatic prostate cancer patients showed better polymetastases-free survival (PMFS) (P = 0.03) and DPFS (P = 0.008) than other histologies.

Conclusions

Spinal SBRT is effective in treating spinal oligometastases. Dose boost could be safely administered to significantly improve LPFS. Prostate cancer patients showed better outcomes.

目的放疗在治疗有症状的脊柱骨转移中具有已知的作用，但消融治疗的数据相对缺乏。本研究的目的是评估立体定向放射治疗（SBRT）治疗脊柱少转移瘤的疗效和毒性。方法2018年至2023年，对一系列脊柱少转移患者进行治疗。根据Cox轮廓指南确定临床靶体积。在可行的情况下，同时对宏观疾病部位进行综合增强（SIB）。主要终点是局部无进展生存期（LPFS）。次要目标是毒性、远期无进展生存期（DPFS）和总生存期（OS）。评估了以下协变量：SIB，生物有效剂量，组织学，总转移数（包括脊柱和脊柱外）和并发全身治疗。结果120例脊柱少转移患者共152例得到治疗。中位随访时间为22个月（6-72个月，四分位数间距（IQR）为21个月）。中位剂量为24 Gy（范围21-30），分3（3 - 5）次递送。最常见的是3组24 Gy(49例，32.2%)；33例转移患者给予SIB（21.7%）。1年和2年的LPFS率分别为92.1%和90%。此外，SIB显著改善了2年LPFS （P = 0.037）。14例（9.2%）转移灶局部复发。1年OS为94.8%，2年OS为90%。1年和2年DPFS分别为47.8%和30.8%，中位DPFS为11个月。少转移性前列腺癌患者的无多转移生存期（PMFS）（P = 0.03）和DPFS （P = 0.008）均优于其他组织学。结论脊髓SBRT是治疗脊柱少转移瘤的有效方法。剂量增加可以安全地显著改善LPFS。前列腺癌患者表现出更好的结果。

{"title":"Stereotactic Body Radiotherapy for Spinal Oligometastases With or Without Simultaneous Integrated Boost: Results From a Monocentric Retrospective Analysis","authors":"E. Pastorello , L. Nicosia , A.G. Allegra , C. De-Colle , N. Giaj-Levra , F. Ricchetti , M. Rigo , A. Romei , C. Orsatti , R. Ruggieri , F. Alongi","doi":"10.1016/j.clon.2025.103918","DOIUrl":"10.1016/j.clon.2025.103918","url":null,"abstract":"<div><h3>Aims</h3><div>Radiotherapy has a known role in the treatment of symptomatic spinal bone metastases, but there is a relative paucity of data for ablative treatments. The aim of our study is to evaluate the efficacy and toxicity of stereotactic body radiotherapy (SBRT) in treating spinal oligometastases.</div></div><div><h3>Methods</h3><div>A series of spinal oligometastatic patients was treated between 2018 and 2023. The clinical target volume was defined according to Cox contouring guidelines. When feasible, a simultaneous integrated boost (SIB) was administered to the site of the macroscopic disease. The primary end-point was local progression-free survival (LPFS). Secondary objectives were toxicity, distant progression-free survival (DPFS), and overall survival (OS). The following covariates were evaluated: SIB, biologically effective dose, histology, number of total metastases (including both spinal and extra-spinal), and concurrent systemic therapy.</div></div><div><h3>Results</h3><div>One hundred and fifty-two spinal oligometastases in 120 patients were treated. Median follow-up was 22 months (range 6–72, with an interquartile range (IQR) of 21 months). Median dose was 24 Gy (range 21–30) delivered in 3 (3–5) fractions. The most common fractionation was 24 Gy in 3 fractions (49 metastases, 32.2%) SIB was administered in 33 metastases (21.7%). One-, and 2-year LPFS rates were 92.1% and 90%, respectively. Moreover, SIB resulted in a significantly improved 2-year LPFS (<em>P</em> = 0.037). Fourteen (9.2%) metastases locally relapsed.</div><div>One- and 2-years OS were 94.8% and 90%, respectively. One- and 2-years DPFS were 47.8% and 30.8%, respectively, with a median DPFS of 11 months. Oligometastatic prostate cancer patients showed better polymetastases-free survival (PMFS) (<em>P</em> = 0.03) and DPFS (<em>P</em> = 0.008) than other histologies.</div></div><div><h3>Conclusions</h3><div>Spinal SBRT is effective in treating spinal oligometastases. Dose boost could be safely administered to significantly improve LPFS. Prostate cancer patients showed better outcomes.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"46 ","pages":"Article 103918"},"PeriodicalIF":3.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879827","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}

引用次数: 0

Mesothelioma Immunotherapy: Trends and Directions From Clinical Trials 间皮瘤免疫治疗：临床试验的趋势和方向

IF 3 3区医学 Q2 ONCOLOGY

Clinical oncology

Pub Date : 2025-08-05 DOI: 10.1016/j.clon.2025.103920

J. Ding , Y. Wang , S. Wang, N. Li

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Clinical oncology

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀