Radiotherapy and Oncology最新文献

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Commentary on feliciani Giacomo et al.'s study of comparison of HDR-brachytherapy and tomotherapy for the treatment of non-melanoma skin cancers of the head and neck.

IF 4.9 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology

Pub Date : 2025-03-01 DOI: 10.1016/j.radonc.2025.110826

Elisa Placidi, Bruno Fionda, Enrico Rosa, Luca Tagliaferri, Marco De Spirito

引用次数: 0

Aims+Scope/Editorial Board/ Publication information

IF 4.9 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology

Pub Date : 2025-03-01 DOI: 10.1016/S0167-8140(25)00106-9

引用次数: 0

Novel approaches to fiducial-guided SBRT for ultra-central thoracic oligometastases.

IF 4.9 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology

Pub Date : 2025-03-01 DOI: 10.1016/j.radonc.2025.110827

Rajesh Thomas, Calvin Sidhu, Colin Tang

引用次数: 0

'iCycle-pBAO': Automated patient-specific beam-angle selection in proton therapy applied to oropharyngeal cancer.

IF 4.9 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology

Pub Date : 2025-02-28 DOI: 10.1016/j.radonc.2025.110799

W Kong, M Huiskes, S J M Habraken, E Astreinidou, C R N Rasch, B J M Heijmen, S Breedveld

Objective: This study aimed to develop a fully-automated patient tailored beam-angle optimisation approach for intensity-modulated proton therapy (IMPT). For oropharynx cancer patients, the dosimetric impact of increasing the number of fields from 4 to 12 was systematically assessed.

Approach: A total-beam-space heuristic was developed to simultaneously select optimal patient specific candidate beam directions, according to a cost-function that penalises dose to OARs involved in clinically used NTCPs. The method was dosimetrically validated by comparisons with fixed 4- and 6-field clinical beam-angle templates and equiangular configurations, including 72-field equiangular. The latter served as dosimetric 'utopia' benchmark for the other evaluated beam configurations.

Main result: Using 4 optimised patient-specific fields instead of the clinical 4-field beam-angle template resulted in (xerostomia NTCP + dysphagia NTCP)-reductions for all patients, with averages of 3.0 %-point (range: 1.1-5.8) for grade 2 toxicity and 1.2 %-point (range: 0.3-2.8) for grade 3. For 6 fields these reductions were 2.4 %-point (range: 0.0-5.0) and 0.8 %-point (range: -0.1-2.1). Xerostomia NTCPs significantly reduced with increasing numbers of patient-specific fields with a levelling off at 10-12 fields with NTCP values that closely approached those for utopia 72-field equiangular plans. Beam angle optimisation took 52 min.

Conclusion: Automated, patient-tailored beam-angle optimisation could enhance IMPT plans at acceptable optimisation times. Improvements compared to the clinical beam-angle templates were highly patient-specific.

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引用次数: 0

Proton FLASH-Arc therapy: Bridging feasibility to clinical Utility

IF 4.9 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology

Pub Date : 2025-02-26 DOI: 10.1016/j.radonc.2025.110807

Jiao Yu, Xin Chen

引用次数: 0

Association between dose to cardiac structures and overall survival: A multivariable analysis in a large, multi-institutional database of stage III NSCLC patients with external validation

IF 4.9 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology

Pub Date : 2025-02-22 DOI: 10.1016/j.radonc.2025.110821

Miguel Garrett Fernandes , Johan Bussink , Robin Wijsman , Zeno Gouw , Albrecht Weiß , Nanna M. Sijtsema , Richard Canters , Andrew Hope , Dirk De Ruysscher , Esther G.C. Troost , Jan-Jakob Sonke , Barbara Stam , René Monshouwer

Background and Purpose

Inconsistencies in identifying dose-limiting cardiovascular substructures for treating stage III non-small cell lung cancer (NSCLC) have hindered the implementation of cardiac sparing treatment planning guidelines. This study aims to address these inconsistencies by performing a multivariable survival analysis with overall survival as the endpoint using a large, multinational database, followed by external validation.

Materials and Methods

Clinical and dosimetric parameters from 1587 stage III NSCLC patients treated at five institutes were analyzed. The whole heart, four cardiac chambers, great vessels and their combinations were considered. The dataset was divided into a training set (four institutes) and a test set (one institute). The optimal parameter set was identified through cross-validation, and the resulting multivariable Cox regression model was externally validated using the test set. Adjusted hazard ratios (aHRs) for all cardiovascular parameters were evaluated.

Results

The strongest associations were found for low Dx% parameters. However, their incremental contribution to model performance, compared to clinical and lung dosimetric parameters only, was low, with small effect sizes. Specifically, the cardiovascular parameter identified by parameter selection was Left Side D5% (aHR: 1.007 Gy⁻¹, 95 % CI: 1.004 – 1.010 Gy⁻¹, p < 0.0001), which provided a slight improvement in model concordance index of 0.0062 (95 % CI: 0.0000–0.0127) in the training set and 0.0037 (95 % CI: −0.0200–0.0280) in the test set.

Conclusions

Although significant associations between cardiovascular parameters and survival were found, their small effect sizes should be considered when prioritizing cardiac sparing in stage III NSCLC treatment.

{"title":"Association between dose to cardiac structures and overall survival: A multivariable analysis in a large, multi-institutional database of stage III NSCLC patients with external validation","authors":"Miguel Garrett Fernandes , Johan Bussink , Robin Wijsman , Zeno Gouw , Albrecht Weiß , Nanna M. Sijtsema , Richard Canters , Andrew Hope , Dirk De Ruysscher , Esther G.C. Troost , Jan-Jakob Sonke , Barbara Stam , René Monshouwer","doi":"10.1016/j.radonc.2025.110821","DOIUrl":"10.1016/j.radonc.2025.110821","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>Inconsistencies in identifying dose-limiting cardiovascular substructures for treating stage III non-small cell lung cancer (NSCLC) have hindered the implementation of cardiac sparing treatment planning guidelines. This study aims to address these inconsistencies by performing a multivariable survival analysis with overall survival as the endpoint using a large, multinational database, followed by external validation.</div></div><div><h3>Materials and Methods</h3><div>Clinical and dosimetric parameters from 1587 stage III NSCLC patients treated at five institutes were analyzed. The whole heart, four cardiac chambers, great vessels and their combinations were considered. The dataset was divided into a training set (four institutes) and a test set (one institute). The optimal parameter set was identified through cross-validation, and the resulting multivariable Cox regression model was externally validated using the test set. Adjusted hazard ratios (aHRs) for all cardiovascular parameters were evaluated.</div></div><div><h3>Results</h3><div>The strongest associations were found for low Dx% parameters. However, their incremental contribution to model performance, compared to clinical and lung dosimetric parameters only, was low, with small effect sizes. Specifically, the cardiovascular parameter identified by parameter selection was Left Side D5% (aHR: 1.007 Gy<sup>−1</sup>, 95 % CI: 1.004 – 1.010 Gy<sup>−1</sup>, <em>p</em> < 0.0001), which provided a slight improvement in model concordance index of 0.0062 (95 % CI: 0.0000–0.0127) in the training set and 0.0037 (95 % CI: −0.0200–0.0280) in the test set.</div></div><div><h3>Conclusions</h3><div>Although significant associations between cardiovascular parameters and survival were found, their small effect sizes should be considered when prioritizing cardiac sparing in stage III NSCLC treatment.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110821"},"PeriodicalIF":4.9,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Response evaluation and tumor shrinkage pattern post-SBRT for renal cell carcinoma SBRT治疗肾细胞癌后的反应评估和肿瘤缩小模式。

IF 4.9 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology

Pub Date : 2025-02-22 DOI: 10.1016/j.radonc.2025.110802

Lingling Cai , Kaicong Chen , Qiwen Pan , Xinyue Zhang , Ruiqi Liu , Yang Liu , Jianming Gao , Zhiling Zhang , Fangjian Zhou , Pei Dong , Li Tian , Liru He

Purpose

Despite the promising application of stereotactic body radiotherapy (SBRT) in renal cell carcinoma (RCC), the optimal time and method for assessing tumor responses to SBRT remain unclear. We aimed to compare the utility of Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and modified RECIST (mRECIST) in RCC response assessment and clarify the tumor shrinkage pattern post-SBRT.

Materials and methods

We retrospectively studied patients with RCC treated with SBRT at our institution between November 2016 and December 2021. Baseline and follow-up images were evaluated using RECIST 1.1 and mRECIST. Landmark analyses were conducted to assess the association between local control and tumor response status evaluated using the above two criteria.

Results

Ninety-one RCC patients with 103 primary or metastatic lesions were included. Objective response rates (ORRs) were higher and pseudoprogression was less commonly assessed by mRECIST than by RECIST 1.1 within each time period. The median shrinkage rate of bone lesions was much lower using RECIST 1.1 than that using mRECIST (−0.8 vs −1.7 cm/year). According to both criteria, the ORR tended to be stable on the 9–12 months post-SBRT. Patients with a tumor response at 9–12 months had a lower probability of infield recurrence using mRECIST (P = 0.047), this was not observed using RECIST 1.1 (P = 0.061).

Conclusion

mRECIST results in an earlier and more pronounced response evaluation compared to RECIST 1.1 in patients with RCC treated with SBRT. Nine to twelve months post-SBRT may serve as an early landmark for tumor response evaluation by mRECIST.

{"title":"Response evaluation and tumor shrinkage pattern post-SBRT for renal cell carcinoma","authors":"Lingling Cai , Kaicong Chen , Qiwen Pan , Xinyue Zhang , Ruiqi Liu , Yang Liu , Jianming Gao , Zhiling Zhang , Fangjian Zhou , Pei Dong , Li Tian , Liru He","doi":"10.1016/j.radonc.2025.110802","DOIUrl":"10.1016/j.radonc.2025.110802","url":null,"abstract":"<div><h3>Purpose</h3><div>Despite the promising application of stereotactic body radiotherapy (SBRT) in renal cell carcinoma (RCC), the optimal time and method for assessing tumor responses to SBRT remain unclear. We aimed to compare the utility of Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and modified RECIST (mRECIST) in RCC response assessment and clarify the tumor shrinkage pattern post-SBRT.</div></div><div><h3>Materials and methods</h3><div>We retrospectively studied patients with RCC treated with SBRT at our institution between November 2016 and December 2021. Baseline and follow-up images were evaluated using RECIST 1.1 and mRECIST. Landmark analyses were conducted to assess the association between local control and tumor response status evaluated using the above two criteria.</div></div><div><h3>Results</h3><div>Ninety-one RCC patients with 103 primary or metastatic lesions were included. Objective response rates (ORRs) were higher and pseudoprogression was less commonly assessed by mRECIST than by RECIST 1.1 within each time period. The median shrinkage rate of bone lesions was much lower using RECIST 1.1 than that using mRECIST (−0.8 vs −1.7 cm/year). According to both criteria, the ORR tended to be stable on the 9–12 months post-SBRT. Patients with a tumor response at 9–12 months had a lower probability of infield recurrence using mRECIST (P = 0.047), this was not observed using RECIST 1.1 (P = 0.061).</div></div><div><h3>Conclusion</h3><div>mRECIST results in an earlier and more pronounced response evaluation compared to RECIST 1.1 in patients with RCC treated with SBRT. Nine to twelve months post-SBRT may serve as an early landmark for tumor response evaluation by mRECIST.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110802"},"PeriodicalIF":4.9,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

In response to Yu and Chen: Proton FLASH-Arc Therapy: Bridging feasibility to clinical utility

IF 4.9 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology

Pub Date : 2025-02-22 DOI: 10.1016/j.radonc.2025.110803

Bethany Rothwell, Alejandro Bertolet, Jan Schuemann

引用次数: 0

Comment on Wu et al’s article on toxicity in patients receiving radiotherapy for ultracentral stage I non-small cell lung cancer

IF 4.9 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology

Pub Date : 2025-02-22 DOI: 10.1016/j.radonc.2025.110805

Andres Huertas , Drew Moghanaki , Shankar Siva

引用次数: 0

Response to: Comment on Wu et al’s article on toxicity in patients receiving radiotherapy for ultracentral stage I non-small cell lung cancer

IF 4.9 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology

Pub Date : 2025-02-22 DOI: 10.1016/j.radonc.2025.110804

Che Hsuan David Wu , Timothy J Whelan , Anand Swaminath

引用次数: 0

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