Radiotherapy and Oncology最新文献

{"title":"Children's outcomes in medulloblastoma proton versus photon craniospinal radiotherapy (CURE): meta-analysis.","authors":"Gustavo A Viani, Ana Carolina Hamamura, Caio Viani Arruda, Carlos E Cardoso, Helio A Salmon, Gustavo O Amaral","doi":"10.1016/j.radonc.2026.111367","DOIUrl":"https://doi.org/10.1016/j.radonc.2026.111367","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy and toxicity of craniospinal irradiation (CSI) with proton (PBT) versus photon (PHT) therapy in pediatric patients with medulloblastoma, evaluating overall survival (OS), growth hormone deficiency (GHD), hypothyroidism, neurocognitive decline, and ototoxicity.</p><p><strong>Materials and methods: </strong>A systematic review and meta-analysis followed PRISMA and Cochrane guidelines. Retrospective or prospective cohort studies comparing PBT versus PHT-CSI in children (<21 years) with medulloblastoma were included. Outcomes were OS, GHD, hypothyroidism, neurocognitive decline (full-scale IQ), and ototoxicity (grade ≥ 3). Data from 12 studies were extracted and analyzed using a fixed-effects model, calculating risk ratios (RR) for binary outcomes and standardized mean differences (SMD) for continuous outcomes. Heterogeneity was assessed with Cochran's Q test and I2 statistic.</p><p><strong>Results: </strong>Ten cohort studies were included (no randomized trials), including 1034 patients (PBT = 537 and PHT = 497). No difference in OS was observed (RR: 0.984; 95 % CI: 0.902-1.073; p = 0.7118; I² = 0 %). PBT significantly reduced GHD (RR: 0.379; p < 0.001, NNT = 2), hypothyroidism (RR: 0.256; p < 0.001, NNT = 2), and neurocognitive decline (SMD: 0.708; p = 0.0001, NNT = 5), with no difference in grade ≥ 3 ototoxicity (RR: 0.88; p = 0.5704). Grade ≤ 2 ototoxicity was increased with PHT (RR: 1.15; p = 0.01, NNT = 15).</p><p><strong>Conclusion: </strong>PBT-CSI provides equivalent survival to PHT-CSI while significantly reducing GHD, hypothyroidism, mild ototoxicity, and neurocognitive toxicities in children with medulloblastoma. These findings support the preferential use of PBT to minimize long-term sequelae, though prospective studies are needed to confirm benefits and assess cost-effectiveness.</p>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":" ","pages":"111367"},"PeriodicalIF":5.3,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-based assessment of brain volume decrease after treatment with stereotactic radiosurgery versus whole brain radiotherapy","authors":"Frederic Thiele ,&nbsp;Maria Kawula ,&nbsp;Sophie Katzendobler ,&nbsp;Robert Forbrig ,&nbsp;Christopher Kurz ,&nbsp;Florian Ringel ,&nbsp;Sebastian H. Maier ,&nbsp;Sebastian N. Marschner ,&nbsp;Klaus Belka ,&nbsp;Guillaume Landry ,&nbsp;Maximilian Niyazi ,&nbsp;Raphael Bodensohn ,&nbsp;Jonathan Weller","doi":"10.1016/j.radonc.2026.111377","DOIUrl":"10.1016/j.radonc.2026.111377","url":null,"abstract":"<div><h3>Background</h3><div>Radiotherapy is a cornerstone in the treatment of brain metastases, but its mid- and long-term impact on brain parenchyma remains poorly understood. This study aimed to assess the differential volumetric alterations in the brain following two different modalities of Radiotherapy-Stereotactic Radiosurgery (SRS) and Whole-Brain Radiotherapy (WBRT).</div></div><div><h3>Methods</h3><div>Patients treated with SRS were drawn from the prospective dataset of the STEREOBRAIN study (DRKS00014694) that recruited patients with 4–10 brain metastases from 2017 to 2020. Patients that had received WBRT for the treatment of 4–10 brain metastases from 2012 to 2017 were included retrospectively. Patients with clinical and radiographic signs of hydrocephalus were excluded. Volumetric analysis of CSF space was implemented as a measure of brain volume decrease. Images were registered to MNI305 space and segmented by a pretrained UNesT artificial network.</div></div><div><h3>Results</h3><div>Overall, 59 patients were included. 29 patients received SRS and 30 WBRT respectively. The ventricular system volume increased significantly in both SRS (p-value 0.014) and WBRT (p-value &lt; 0.0001) groups. In the WBRT group, ventricular enlargement was more pronounced, both in absolute and ventricle-brain-ratio terms (p-value &lt; 0.0001). WBRT was associated with significantly larger increases in ventricular volume than SRS, both in absolute (p = 0.0127) and relative (p = 0.0017) terms.</div></div><div><h3>Conclusion</h3><div>Radiotherapy is associated with a decrease in brain volume, which seems be less pronounced in patients treated with SRS as compared to WBRT. The clinical implication of this finding, e.g., the impact of brain volume decrease on overall-survival and neuro-cognitive function, is yet to be determined.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"216 ","pages":"Article 111377"},"PeriodicalIF":5.3,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study on the impact of tumor volume change and radiation dose on 4D-CT-based lung ventilation function at mid-treatment adaptive radiotherapy in stage III non-small cell lung cancer","authors":"Guozhong Deng ,&nbsp;Jiapei Ding ,&nbsp;Jian Zhu ,&nbsp;Lichun Zhou,&nbsp;Xiaomei Wang,&nbsp;Shi Su,&nbsp;Changhui Yu,&nbsp;Haihua Yang","doi":"10.1016/j.radonc.2026.111383","DOIUrl":"10.1016/j.radonc.2026.111383","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to evaluate the impact of tumor volume reduction at mid-treatment on four-dimensional computed tomography (4D-CT) based lung ventilation function for patients with lung cancer undergoing adaptive radiotherapy (ART), and explores the relationship between radiation dose and ventilation loss to inform personalized lung dose optimization in radiotherapy planning.</div></div><div><h3>Materials and methods</h3><div>Forty patients with stage III non-small cell lung cancer (NSCLC) who had undergone ART were enrolled. 4D-CT scans were performed at pre- and mid-treatment. Patients were categorized according to the relative volume changes in primary gross tumor volume (GTV_p) and nodal gross tumor volume (GTV_n). Each metric was used to divide the cohort into three groups, yielding a total of six comparative groups. Pre-treatment lung ventilation maps, divided into high-, medium-, and low-ventilation regions, were intersected with four dose zones that were categorized by the cumulative lung dose. Ventilation changes at mid-treatment ART in these ventilation regions and dose zones were analyzed for each patient group.</div></div><div><h3>Results</h3><div>Negative correlations were observed between relative changes in the overall ventilation and relative volume changes of the two target contours (GTV_p and GTV_n), with Spearman correlation coefficients being –0.625 and –0.452, respectively. Ventilation recovery resulting from tumor shrinkage significantly counteracted radiation-induced functional loss. In contrast, patients with minimal tumor volume reduction showed marked declines in pulmonary ventilation. Nearly all patient groups exhibited ventilation reduction in the high-ventilation region and improvement in the low-ventilation region.<!--> <!-->Ventilation loss showed a clear dose-dependent pattern across all regions, with the high-ventilation region most affected in patients without significant tumor-shrinkage-driven ventilation recovery.</div></div><div><h3>Conclusions</h3><div>Changes in lung ventilation at mid-treatment were strongly influenced by tumor volume reduction. A clear dose-dependent functional loss pattern was confirmed in the high-ventilation region, with high radiation doses inhibiting lung ventilation. These findings underscore the importance of protecting high-ventilation lung in NSCLC radiotherapy and suggest incorporating tumor volume reduction into adaptive re-planning.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"216 ","pages":"Article 111383"},"PeriodicalIF":5.3,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prospective phase I “Flash-Skin I” trial: ultra-high dose rate radiotherapy implementation and quality assurance at a clinical linear accelerator","authors":"Riccardo Dal Bello ,&nbsp;Serena Psoroulas ,&nbsp;Dominik Flückiger ,&nbsp;Jerome Krayenbühl ,&nbsp;Raphaël Moeckli ,&nbsp;Claude Bailat ,&nbsp;Anna Subiel ,&nbsp;Ileana Silvestre Patallo ,&nbsp;Jens von der Grün ,&nbsp;Panagiotis Balermpas ,&nbsp;Matthias Guckenberger ,&nbsp;Stephanie Tanadini-Lang","doi":"10.1016/j.radonc.2026.111372","DOIUrl":"10.1016/j.radonc.2026.111372","url":null,"abstract":"<div><h3>Background and purpose</h3><div>The combination of reduced normal tissue damage and unaffected tumor control is referred to as Flash-effect. This phenomenon has been observed with ultra-high dose rate (UHDR) radiotherapy in preclinical models. The Flash-Skin I (NCT06549439) treated seven patients with melanoma skin metastasis. The treatment protocol included 2 × 9 Gy UHDR followed by 1 × 9 Gy conventional radiotherapy. Here we report on the implementation of the study at a converted C-arm clinical linear accelerator.</div></div><div><h3>Materials and methods</h3><div>A dedicated preclinical radiation therapy quality assurance (RTQA) program was developed and the linac performance was validated for more than one year. Clinically, fourteen fractions of 9 Gy each were delivered with the 9 MeV UHDR electron linac. In-vivo measurements included: skin dose with radiochromic films, linac output with optically stimulated luminescent dosimeter (OSLD), pulse counting and inter-pulse stability with a scintillator, intra-pulse stability with a diamond detector.</div></div><div><h3>Results</h3><div>The preclinical RTQA identified reduced linac output, which prompted beam tuning and additional quality assurance. This formed the basis for initiation of the clinical trial and successful treatment of all seven patients. All fourteen UHDR fractions showed a dose accuracy within 4.6% or better. The number of delivered pulses consistently matched the planned value, and film measurements confirmed the skin dose. Intra- and inter-pulse stability were within 3.8% and 2.8%, respectively.</div></div><div><h3>Conclusion</h3><div>The clinical implementation of Flash-Skin I at converted C-arm linac was successfully demonstrated and validated. The developed RTQA program may facilitate the development of future UHDR clinical trials.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"216 ","pages":"Article 111372"},"PeriodicalIF":5.3,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single vocal cord irradiation (SVCI) vs whole laryngeal radiotherapy in the treatment of T1aN0 glottic cancer A prospective randomized trial","authors":"Mohamed Mortada Elsharief ,&nbsp;Ashraf Hamed Hassouna ,&nbsp;Tarek Shouman ,&nbsp;Abdelrahman Mosallam ,&nbsp;Amr El-Badrawy ,&nbsp;Ashraf Shawky ,&nbsp;Ayman Amin ,&nbsp;Sherweif M. Abdelfatah","doi":"10.1016/j.radonc.2026.111376","DOIUrl":"10.1016/j.radonc.2026.111376","url":null,"abstract":"<div><h3>Introduction</h3><div>Both Transoral laser surgery (TLS) and radiotherapy are used in the treatment of T1aN0 glottic cancer with similar oncological outcomes. Retrospective studies suggest excellent local control with single vocal cord irradiation that targets only the affected vocal cord. So, the aim of this study was to compare the treatment outcome and toxicity of the classic radiotherapy field vs single vocal cord irradiation (SVCI) technique.</div></div><div><h3>Patients and methods</h3><div>This is a prospective phase 2 randomized study (<span><span><u>clinicaltrial.gov</u></span><svg><path></path></svg></span> registration NCT05679856). A total of 57 patients with T1aN0 glottic cancer were randomized. 28 were assigned to standard of care whole larynx radiotherapy that covers the whole larynx with a prescription dose of 63 Gy/28 Fractions (Fs) The remaining 29 patients were randomized to single vocal irradiation with a prescription dose of 58.08 Gy/16Fs. The primary endpoint was to prove superiority of SVCI in terms of voice quality by comparing voice handicap index (VHI) between the 2 study arms. Baseline VHI was recorded before treatment, at end of radiotherapy, then during each follow up visit.</div></div><div><h3>Results</h3><div>Demographic and patients’ characteristics were comparable between the 2 arms. The doses to different organs at risk were statistically lower in the SVCI arm. 2-year local control rate was 100% in SVCI arm and 96% in the whole larynx arm, with no significant difference. No grade 3 or 4 toxicities were reported in both treatment arms. Patients in the SVCI arm demonstrated lower VHI scores at 2 months and 1-year post-treatment, with median scores of 4 and 0, respectively, compared with 22 and 21 in the whole-larynx arm.</div></div><div><h3>Conclusion</h3><div>SVCI is effective and safe treatment for T1aN0 glottic cancer with comparable local control rates and safe toxicity profile. SVCI was associated with superior voice outcome as evidenced by significantly improved VHI scores compared with whole larynx radiotherapy.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"216 ","pages":"Article 111376"},"PeriodicalIF":5.3,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modulating NOS2 of radiotherapy-recruited CCR2+ macrophages enhances radiosensitivity of hepatocellular carcinoma","authors":"Li-Feng Lu ,&nbsp;Yun Chiang ,&nbsp;Yung-Ming Jeng ,&nbsp;Chiao-Ling Tsai ,&nbsp;Feng-Ming Hsu ,&nbsp;Jason Chia-Hsien Cheng","doi":"10.1016/j.radonc.2026.111371","DOIUrl":"10.1016/j.radonc.2026.111371","url":null,"abstract":"<div><h3>Background</h3><div>C–C motif chemokine ligand-2 (CCL2)–C–C motif chemokine receptor-2 (CCR2) axis plays critical roles in hepatocellular carcinoma (HCC) progression and in shaping immune responses following radiotherapy (RT). However, its contribution to radio-resistance and the underlying mechanism remain poorly understood.</div></div><div><h3>Methods</h3><div>CCL2 and CCR2 expressions were analyzed in paired pre-/post-RT HCC tumor samples from patients exhibiting differential responses to RT. In parallel, we assessed CCL2 secretion, infiltration of CCR2-expressing myeloid cells, and tumor-associated macrophage (TAM) subsets, including the subpopulations expressing NOS2, in two murine HCC models: radioresistant BNL and radiosensitive Hepa1-6 allografts.</div></div><div><h3>Results</h3><div>Despite similarly elevated CCL2 levels and comparable induction of immunogenic cell death indicated by calreticulin exposure, CCR2⁺ myeloid cells were recruited in significantly greater abundance in RT-resistant than RT-responsive tumors, both in human tumors and murine allografts. Following RT, there was a significantly greater increase in NOS2-expressing M1-like TAMs in Hepa1-6 than BNL tumors. <em>Ex vivo</em> experiments demonstrated that the TAMs isolated from irradiated Hepa1-6 tumors suppressed tumor proliferation, promoted CD8⁺ T-cell infiltration, and improved tumor control compared to TAMs from non-irradiated tumors. <em>In vitro</em> co-culture assays demonstrated CCR2⁺ myeloid cells attenuated NOS2 expression in M1-like macrophages, suggesting a suppressive effect on their pro-inflammatory phenotype. Furthermore, pharmacologic blockade of CCR2⁺ cells using a CCR2 antagonist restored NOS2 expression, enhanced radiosensitivity, and improved tumor control in radioresistant BNL models.</div></div><div><h3>Conclusions</h3><div>CCR2⁺ myeloid cells suppress NOS2-mediated antitumor responses in HCC following RT. Targeting RT-recruited CCR2⁺ myeloid cells may offer a promising radiosensitizing strategy to overcome therapeutic resistance in HCC.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"216 ","pages":"Article 111371"},"PeriodicalIF":5.3,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum to “Response to “Regarding Dähler K et al.” Evaluation of the prognostic value of the ESTRO/EORTC classification of reirradiation in patients with non-small cell lung cancer” [Radiother. Oncol. 213 (2025) 111214]","authors":"Jonas Willmann,&nbsp;Nicolaus Andratschke","doi":"10.1016/j.radonc.2025.111282","DOIUrl":"10.1016/j.radonc.2025.111282","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"216 ","pages":"Article 111282"},"PeriodicalIF":5.3,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ZIP10 drives radioresistance and malignant progression in lung adenocarcinoma by inhibiting the Hippo pathway via a Zinc-LATS axis","authors":"Lu Yang ,&nbsp;Yaoxiong Xia ,&nbsp;Li Chang ,&nbsp;Hui Yu ,&nbsp;Tao Wei ,&nbsp;Di Zhou ,&nbsp;Chenxi Wang ,&nbsp;Chengshu Gong ,&nbsp;Zhengting Chen ,&nbsp;Wenhui Li","doi":"10.1016/j.radonc.2026.111374","DOIUrl":"10.1016/j.radonc.2026.111374","url":null,"abstract":"<div><h3>Background</h3><div>Lung adenocarcinoma (LUAD) remains a leading cause of cancer-related mortality globally. Although radiotherapy is a cornerstone treatment, its efficacy is severely limited by intrinsic and acquired radioresistance. Zinc transporters, particularly ZIP10, act as critical metabolic regulators in various cancers; however, their specific roles in modulating the radiation response and oncogenic signaling in LUAD remain ill-defined.</div></div><div><h3>Methods</h3><div>Using a subcutaneous Lewis lung carcinoma (LLC) mouse model, we evaluated four hypofractionated radiotherapy regimens, identifying 8 Gy × 3 fractions as the optimal protocol for tumor regression. Transcriptomic profiling of these irradiated tumors identified ZIP10 as the most significantly downregulated gene. We employed functional assays (knockdown/overexpression) to assess the impact of ZIP10 on LUAD cell proliferation, metastasis, and radiosensitivity. Mechanistically, we investigated the zinc-dependent regulation of the Hippo pathway, focusing on the upstream kinase LATS1, using the zinc chelator TPEN and molecular analyses.</div></div><div><h3>Results</h3><div>Clinical analysis revealed that ZIP10 is significantly upregulated in LUAD tissues and correlates with advanced TNM stage and poor prognosis. In vitro, ZIP10 silencing markedly suppressed proliferation, migration, and invasion, while inducing G0/G1 cell cycle arrest and apoptosis. In vivo, ZIP10 depletion synergized with radiotherapy to potently inhibit tumor growth. Mechanistically, we demonstrate that ZIP10-mediated zinc influx directly inhibits the phosphorylation of LATS1, the core kinase of the Hippo pathway. This inactivation of LATS1 prevents the cytoplasmic phosphorylation of YAP/TAZ, thereby promoting their nuclear accumulation and transcriptional activity. Importantly, zinc chelation (TPEN) reversed these effects, confirming a ZIP10–Zinc–LATS1–YAP signaling axis.</div></div><div><h3>Conclusion</h3><div>Our study establishes ZIP10 as a critical metabolic driver of malignant progression and radioresistance in LUAD. By inhibiting LATS1 via intracellular zinc accumulation, ZIP10 locks the Hippo pathway in an inactive state. These findings highlight ZIP10 as a promising therapeutic target for sensitizing LUAD to radiotherapy.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"216 ","pages":"Article 111374"},"PeriodicalIF":5.3,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain irradiation drives remote liver changes via senescence-independent mechanisms","authors":"Yuting Jiang ,&nbsp;Daniëlle C. Voshart ,&nbsp;Alessandro Gustinelli ,&nbsp;Ayla C. Scholma ,&nbsp;Eline Hageman ,&nbsp;Luiza Reali Nazario ,&nbsp;Uilke Brouwer ,&nbsp;Marco Demaria ,&nbsp;Rob P. Coppes ,&nbsp;Lara Barazzuol","doi":"10.1016/j.radonc.2026.111373","DOIUrl":"10.1016/j.radonc.2026.111373","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Although radiotherapy is essential for treating brain tumors, it often damages surrounding healthy brain tissue, causing long-term neurocognitive dysfunction. Cellular senescence, a stable state of cell cycle arrest triggered by various stressors including radiation-induced DNA damage, has been implicated in aging- and neurodegeneration-associated cognitive decline via its pro-inflammatory secretome and has been reported to exert paracrine effects on distant organs. However, whether brain irradiation, particularly through the induction of cellular senescence, can trigger changes in peripheral tissues remains largely unknown.</div></div><div><h3>Materials and methods</h3><div>Adult male rats received 14 Gy X-ray irradiation to the brain. Senescence-associated markers were assessed in the brain at 6 and 12 weeks post-irradiation and in peripheral tissues, including the kidney, small intestine, skeletal muscle, and liver, at 17 weeks post-irradiation. Liver samples were further examined for proliferation and fibrosis markers, as well as for liver enzyme activity. The senolytic ABT263 was administered to eliminate senescent cells.</div></div><div><h3>Results</h3><div>Brain irradiation induced senescence-like features in the brain but did not trigger p21-dependent senescence in the tested peripheral tissues. However, brain-irradiated rats exhibited increased proliferation, elevated GFAP levels, and enhanced ALT and AST activity in the liver. These hepatic changes were likely independent of cellular senescence, as they were not reversed by treatment with ABT263.</div></div><div><h3>Conclusion</h3><div>Brain irradiation induces liver proliferation, increased GFAP levels, and altered ALT and AST activity, via mechanisms likely independent of senescence. Future investigation of blood GFAP levels is needed to determine whether the enhanced hepatic GFAP levels originate from the brain.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"216 ","pages":"Article 111373"},"PeriodicalIF":5.3,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor control probability modeling of pulmonary metastases in oligometastatic head and neck squamous cell carcinoma treated with stereotactic body radiation therapy.","authors":"Felix Ehret, Jimm Grimm, Gopal Subedi, Samuel M Vorbach, Viola Salvestrini, Ilaria Bonaparte, Ahmed Allam Mohamed, Sonja Adebahr, Anne Richter, Alexander Fabian, Thomas Weissmann, Justus Kaufmann, Sophia Drabke, Esmée Lauren Looman, Maria Waltenberger, Kim Melanie Kraus, Maximilian Grohmann, Andrea Baehr, Susanne Rogers, Ahmed Gawish, Jan-Niklas Becker, Rainer J Klement, Richard Partl, Michael J Eble, Anca-Ligia Grosu, Andreas Rimner, Eleni Gkika, Maike Trommer, Oliver Riesterer, Florian Putz, Ute Ganswindt, Christos Moustakis, Nils H Nicolay, Thomas B Brunner, Oliver Blanck, Pierluigi Bonomo, Andrea Wittig-Sauerwein, Panagiotis Balermpas, Franziska Nägler, Alexander Rühle","doi":"10.1016/j.radonc.2026.111375","DOIUrl":"https://doi.org/10.1016/j.radonc.2026.111375","url":null,"abstract":"<p><strong>Background and purpose: </strong>Local control rates for pulmonary metastases from head and neck squamous cell carcinoma (HNSCC) treated with stereotactic body radiation therapy (SBRT) vary substantially in the literature, likely due to differences in the doses applied. This study, therefore, aims to develop tumor control probability (TCP) models.</p><p><strong>Methods: </strong>Dose-time modeling of TCP was performed for three key dose descriptors: 3-fraction equivalent dose (3fxED) prescription dose, 3fxED planning target volume (PTV) D95%, and 3fxED PTV D2%. Each dose descriptor was stratified into 4 dose groups using a k-medians clustering algorithm, and the Kaplan-Meier estimator was computed in each group separately to enable time-dependent dose-response modeling. Logistic regression models were fitted using maximum likelihood estimation with model parameters determined separately for 1-year and 2-year local control.</p><p><strong>Results: </strong>This retrospective multicenter analysis included 318 pulmonary metastases from 215 patients. The median 3fxED prescription dose was 45.0 Gy (IQR, 39.2-46.5), corresponding to a biologically effective dose (α/β = 20 Gy) (BED₂₀) of 78.8  Gy (IQR, 64.8-82.5). After a median radiographic follow-up of 13.3 months (IQR, 6.6-32.0), 21 local failures were observed. All models indicated a dose-dependent effect on the local control probability. A local control rate of 95 % was achieved at 1 and 2 years when 3fxED prescription doses and PTV D95% exceeded about 51 Gy (94 Gy BED₂₀), and when PTV D2% reached 66 Gy (139 Gy BED₂₀).</p><p><strong>Conclusion: </strong>These TCP models suggest a dose-dependent probability of local control in pulmonary HNSCC metastases treated with SBRT and provide a basis for future clinical assessments in this population.</p>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":" ","pages":"111375"},"PeriodicalIF":5.3,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}