Radiotherapy and Oncology最新文献

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Neoadjuvant chemoradiotherapy plus sequential tislelizumab followed by surgery for esophageal carcinoma (CRISEC study): A single-arm, bicentric, phase 2 trial

IF 4.9 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology

Pub Date : 2025-02-18 DOI: 10.1016/j.radonc.2025.110797

Jinsong Yang , Cui Liu , Zhigang Zuo , Fengjun Cao , Zhanjie Zhang , Bian Wu , You Qin , Lu Wen , Jielin Wei , Guangqin Xiao , Shijie Xing , Yue Qu , Lei Huang , Xiaolin Wang , Buhai Wang , Kunyu Yang , Ke Jiang

Background and purpose

To explore the efficacy and safety of neoadjuvant chemoradiotherapy (NCRT) plus sequential tislelizumab followed by surgery for esophageal squamous cell carcinoma (ESCC).

Materials and methods

This single-arm, bicentric, phase 2 trial enrolled patients with resectable or potentially resectable thoracic ESCC to receive neoadjuvant radiotherapy (41.4 Gy in 23 fractions) with concurrent chemotherapy (albumin-bound paclitaxel, 50–100 mg/m², and carboplatin, area under the curve of 2 mg/ml/min, once weekly, five times) plus sequential tislelizumab (200 mg Q3W, three cycles) followed by surgery. The primary endpoint was pathologic complete response (pCR) rate. The secondary endpoints included safety, R0 resection rate, major pathologic response (MPR) rate, disease-free survival (DFS), and overall survival (OS).

Results

Of the 30 patients enrolled from January 2021 to October 2022, 24 (80.0 %) completed planned surgery and gained R0 resection (100 %). Among the 24 patients, nine (37.5 %) achieved pCR and 21 (87.5 %) achieved MPR. Ten patients (35.7 %) developed grade 3–4 toxicities during tislelizumab therapy, including lymphopenia (32.1 %), neutropenia (3.6 %), and thrombocytopenia (3.6 %). Grade 5 hematemesis occurred in two patients and both were attributed to aortic invasion. Three patients (12.5 %) developed grade 3 postoperative complications, including pulmonary infection (8.3 %) and hoarseness (4.2 %). After a median follow-up of 35.4 months, the 2-year OS and DFS rates were 83.3 % and 79.2 %, respectively.

Conclusion

Sequential tislelizumab after NCRT in ESCC is safe and feasible. Further study is warranted to validate the efficacy of this combination mode.

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引用次数: 0

Response to ‘Pioneering BNCT: Refining strategies for complex cutaneous malignancies

IF 4.9 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology

Pub Date : 2025-02-18 DOI: 10.1016/j.radonc.2025.110787

Tairo Kashihara , Satoshi Nakamura , Hiroshi Igaki

引用次数: 0

PACE-B: Where does this position SBRT as an option for localized prostate cancer?

IF 4.9 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology

Pub Date : 2025-02-15 DOI: 10.1016/j.radonc.2025.110793

Juanita Crook , Pierre Blanchard , Jay Ciezki , Gregory Merrick , Jeremy Millar , Mira Keyes , Chad Tang , Richard Stock , Daniel Song , Steven J Frank

引用次数: 0

The fractionation effect on proton RBE in a late normal tissue damage model in vivo

IF 4.9 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology

Pub Date : 2025-02-13 DOI: 10.1016/j.radonc.2025.110792

Cathrine Bang Overgaard , Fardous Reaz , Per Poulsen , Harald Spejlborg , Jens Overgaard , Cai Grau , Niels Bassler , Brita Singers Sørensen

Background and purpose

A constant relative biological effectiveness (RBE) of 1.1 is used in clinical proton therapy (PT) to convert prescribed photon doses into isoeffective proton doses. However, the RBE is not constant; it is a dynamic parameter highly influenced by factors such as linear energy transfer, tissue type, biological endpoint, and dose/fraction. Preclinical in vivo proton RBE studies using fractionated doses and late damage endpoints are almost nonexistent. The aim is to test the hypotheses that the RBE varies between single and fractionated doses and that the late damage development differs between proton and photon irradiation using a 6 MV linac as a reference modality in a murine leg model.

Materials and methods

The right hindlimb of unanesthetized mice was irradiated with single or four fractions of protons or 6 MV photons. Over one year after treatment, the mice were analyzed every fourteenth day using a joint contracture assay to investigate severe radiation-induced late damage.

Results

The results indicated a higher RBE for severe late damage endpoint of 1.25 ± 0.06 (1.13–1.36) for fractionated doses than single doses, exhibiting an RBE of 1.16 ± 0.08 (1.00–1.31). The onset of late damage is earlier for protons than photons for doses higher than 47 Gy and fractionated doses above 50 Gy (12.5 Gy per fraction).

Conclusion

The findings demonstrate that fractionated doses enhance the RBE for a late damage endpoint and lead to an earlier onset of severe late effects than its photon counterpart in vivo.

{"title":"The fractionation effect on proton RBE in a late normal tissue damage model in vivo","authors":"Cathrine Bang Overgaard , Fardous Reaz , Per Poulsen , Harald Spejlborg , Jens Overgaard , Cai Grau , Niels Bassler , Brita Singers Sørensen","doi":"10.1016/j.radonc.2025.110792","DOIUrl":"10.1016/j.radonc.2025.110792","url":null,"abstract":"<div><h3>Background and purpose</h3><div>A constant relative biological effectiveness (RBE) of 1.1 is used in clinical proton therapy (PT) to convert prescribed photon doses into isoeffective proton doses. However, the RBE is not constant; it is a dynamic parameter highly influenced by factors such as linear energy transfer, tissue type, biological endpoint, and dose/fraction. Preclinical <em>in vivo</em> proton RBE studies using fractionated doses and late damage endpoints are almost nonexistent. The aim is to test the hypotheses that the RBE varies between single and fractionated doses and that the late damage development differs between proton and photon irradiation using a 6 MV linac as a reference modality in a murine leg model.</div></div><div><h3>Materials and methods</h3><div> The results indicated a higher RBE for severe late damage endpoint of 1.25 ± 0.06 (1.13–1.36) for fractionated doses than single doses, exhibiting an RBE of 1.16 ± 0.08 (1.00–1.31). The onset of late damage is earlier for protons than photons for doses higher than 47 Gy and fractionated doses above 50 Gy (12.5 Gy per fraction).</div></div><div><h3>Conclusion</h3><div>The findings demonstrate that fractionated doses enhance the RBE for a late damage endpoint and lead to an earlier onset of severe late effects than its photon counterpart <em>in vivo</em>.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110792"},"PeriodicalIF":4.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426068","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}

引用次数: 0

Elective clinical target volume in early squamous cell anal canal cancer: A systematic review and meta-analysis of the risk of recurrence in untreated upper pelvic and external iliac lymph nodes

IF 4.9 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology

Pub Date : 2025-02-13 DOI: 10.1016/j.radonc.2025.110788

Joanna Socha , Karol Paciorek , Krzysztof Bujko

Background

For squamous-cell carcinoma of the anal canal, most delineation guidelines recommend elective irradiation of the external iliac lymph nodes (LNS) and the upper pelvic LNS (located above the inferior aspect of the sacroiliac joints), regardless of clinical stage. However, neither of these regions is the first-echelon nodal station for anal primaries, and there is no conclusive evidence on the risk of microscopic involvement of these LNS in patients with cT1-2N0 disease. The recommendation to include these regions in the elective CTV for early anal canal cancer is based on historical practice, reflecting lymph node regions in earlier AP-PA fields, rather than conclusive evidence.

Patients and methods

A systematic review of the literature and a meta-analysis were performed to determine the rates of regional recurrence in the upper pelvic and external iliac LNS in patients with early anal canal cancer (cT1-2N0) treated with radio(chemo)therapy without elective nodal irradiation (ENI) of these LNS.

Results

One prospective and eight retrospective studies were included in the meta-analysis. The pooled weighted rate of regional recurrence in the upper pelvic LNS was 0.9 % (95 % confidence interval [CI]: 0.1–1.8 %) among 495 cT1-2N0 patients treated with ENI not covering these LNS. None of 233 patients treated with ENI not covering external iliac LNS had a recurrence in this region after radio(chemo)therapy.

Conclusion

Low risk of regional recurrence in the untreated upper pelvic and external iliac LNS suggests they can be confidently excluded from the elective nodal CTV for patients with early squamous cell anal canal cancer.

{"title":"Elective clinical target volume in early squamous cell anal canal cancer: A systematic review and meta-analysis of the risk of recurrence in untreated upper pelvic and external iliac lymph nodes","authors":"Joanna Socha , Karol Paciorek , Krzysztof Bujko","doi":"10.1016/j.radonc.2025.110788","DOIUrl":"10.1016/j.radonc.2025.110788","url":null,"abstract":"<div><h3>Background</h3><div>For squamous-cell carcinoma of the anal canal, most delineation guidelines recommend elective irradiation of the external iliac lymph nodes (LNS) and the upper pelvic LNS (located above the inferior aspect of the sacroiliac joints), regardless of clinical stage. However, neither of these regions is the first-echelon nodal station for anal primaries, and there is no conclusive evidence on the risk of microscopic involvement of these LNS in patients with cT1-2N0 disease. The recommendation to include these regions in the elective CTV for early anal canal cancer is based on historical practice, reflecting lymph node regions in earlier AP-PA fields, rather than conclusive evidence.</div></div><div><h3>Patients and methods</h3><div>A systematic review of the literature and a <em>meta</em>-analysis were performed to determine the rates of regional recurrence in the upper pelvic and external iliac LNS in patients with early anal canal cancer (cT1-2N0) treated with radio(chemo)therapy without elective nodal irradiation (ENI) of these LNS.</div></div><div><h3>Results</h3><div>One prospective and eight retrospective studies were included in the <em>meta</em>-analysis. The pooled weighted rate of regional recurrence in the upper pelvic LNS was 0.9 % (95 % confidence interval [CI]: 0.1–1.8 %) among 495 cT1-2N0 patients treated with ENI not covering these LNS. None of 233 patients treated with ENI not covering external iliac LNS had a recurrence in this region after radio(chemo)therapy.</div></div><div><h3>Conclusion</h3><div>Low risk of regional recurrence in the untreated upper pelvic and external iliac LNS suggests they can be confidently excluded from the elective nodal CTV for patients with early squamous cell anal canal cancer.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110788"},"PeriodicalIF":4.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426067","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}

引用次数: 0

Impact of bra application in breast cancer radiotherapy: A pilot prospective randomized trial 佩戴胸罩对乳腺癌放疗的影响：前瞻性随机试验

IF 4.9 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology

Pub Date : 2025-02-12 DOI: 10.1016/j.radonc.2025.110785

Hwa Kyung Byun , Hojin Kim , Junyoung Son , Yongwan Cho , Yong Jae Kwon , Dong Wook Kim , Ho Lee , Yong Bae Kim

Purpose

This prospective, randomized clinical trial evaluated the effects of bra-wearing during radiotherapy on breast-shape reproducibility, dosimetry, and treatment toxicities in patients with breast cancer.

Methods

Thirty-eight patients with breast cancer who underwent breast-conserving surgery were randomly assigned to bra-wearing or non-wearing groups during radiotherapy. Breast-shape reproducibility was assessed using daily cone-beam computed tomography (CBCT). The primary outcome was breast-shape reproducibility, evaluated by the nipple-to-pectoral muscle distance (ΔNPD) and mean surface distance (MSD), comparing daily CBCT to planning CT. We calculated the mean root-mean-squared error (ε), systematic error (Σ), and random error (σ). Secondary outcomes included dosimetric parameters and acute/subacute toxicities.

Results

ΔNPD ε (1.0 mm vs 3.8 mm, P < 0.001), Σ (0.6 mm vs 3.6 mm, P < 0.001), and σ (0.8 mm vs 2.2 mm, P < 0.001) were significantly smaller in the bra-wearing group. For larger breasts (cup sizes C–D), MSD ε was significantly smaller in the bra-wearing group (1.1 mm vs. 2.1 mm, P = 0.006), but not for smaller breasts. The absolute ΔNPD exceeded 3 mm in 0.4 % of CBCT scans in the bra-wearing group and 48.1 % in the non-wearing group (P < 0.001). Absolute MSD exceeded 3 mm in 2.1 % and 10.0 % of scans in the bra-wearing and non-wearing groups, respectively (P < 0.001). No significant differences were observed in lung and heart dosimetric outcomes between groups. Grade 2 or higher toxicities were minimal in both groups.

Conclusion

The use of a bra during radiotherapy enhances breast-shape reproducibility, particularly in patients with larger breasts, without increasing treatment toxicities.

Trial Registration Number: NCT06178861.

{"title":"Impact of bra application in breast cancer radiotherapy: A pilot prospective randomized trial","authors":"Hwa Kyung Byun , Hojin Kim , Junyoung Son , Yongwan Cho , Yong Jae Kwon , Dong Wook Kim , Ho Lee , Yong Bae Kim","doi":"10.1016/j.radonc.2025.110785","DOIUrl":"10.1016/j.radonc.2025.110785","url":null,"abstract":"<div><h3>Purpose</h3><div>This prospective, randomized clinical trial evaluated the effects of bra-wearing during radiotherapy on breast-shape reproducibility, dosimetry, and treatment toxicities in patients with breast cancer.</div></div><div><h3>Methods</h3><div>Thirty-eight patients with breast cancer who underwent breast-conserving surgery were randomly assigned to bra-wearing or non-wearing groups during radiotherapy. Breast-shape reproducibility was assessed using daily cone-beam computed tomography (CBCT). The primary outcome was breast-shape reproducibility, evaluated by the nipple-to-pectoral muscle distance (ΔNPD) and mean surface distance (MSD), comparing daily CBCT to planning CT. We calculated the mean root-mean-squared error (ε), systematic error (Σ), and random error (σ). Secondary outcomes included dosimetric parameters and acute/subacute toxicities.</div></div><div><h3>Results</h3><div>ΔNPD ε (1.0 mm vs 3.8 mm, P < 0.001), Σ (0.6 mm vs 3.6 mm, P < 0.001), and σ (0.8 mm vs 2.2 mm, P < 0.001) were significantly smaller in the bra-wearing group. For larger breasts (cup sizes C–D), MSD ε was significantly smaller in the bra-wearing group (1.1 mm vs. 2.1 mm, P = 0.006), but not for smaller breasts. The absolute ΔNPD exceeded 3 mm in 0.4 % of CBCT scans in the bra-wearing group and 48.1 % in the non-wearing group (P < 0.001). Absolute MSD exceeded 3 mm in 2.1 % and 10.0 % of scans in the bra-wearing and non-wearing groups, respectively (P < 0.001). No significant differences were observed in lung and heart dosimetric outcomes between groups. Grade 2 or higher toxicities were minimal in both groups.</div></div><div><h3>Conclusion</h3><div>The use of a bra during radiotherapy enhances breast-shape reproducibility, particularly in patients with larger breasts, without increasing treatment toxicities.</div><div>Trial Registration Number: NCT06178861.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110785"},"PeriodicalIF":4.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143418981","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}

引用次数: 0

Clinical experience with free-breathing expiration-gated 10MV FFF VMAT stereotactic lung radiotherapy

IF 4.9 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology

Pub Date : 2025-02-12 DOI: 10.1016/j.radonc.2025.110783

Isabel F. Remmerts de Vries , Max Dahele , Tezontl S. Rosario , Ben J. Slotman , Wilko F.A.R. Verbakel

Background

Free-breathing expiration-gating (EG) is a non-invasive technique used to manage respiratory-induced tumor motion. This study explores the effectiveness of EG stereotactic body radiotherapy (SBRT) for lung tumors using 10MV FFF VMAT.

Methods and Materials

The study included 41 patients (50 targets) treated with EG lung SBRT between September 2019 and February 2023. Patients underwent free-breathing uncoached 10-phase 4DCT for planning, with the choice for EG based on e.g. tumor motion, critical organ dose, expected target visibility on free-breathing CBCT, taking into account suitability of the breathing pattern. The gating window was typically set at phases 30–70 % of the breathing cycle. Treatment planning utilized VMAT with 10MV FFF, and tumor motion was monitored using EG-CBCT ± near real-time markerless kV imaging. Treatment times for the different parts of treatment, tumor stability and clinical outcomes were evaluated. Dosimetric outcomes were compared between EG and free-breathing plans for a subset of 10 patients.

Results

EG SBRT substantially reduced longitudinal tumor motion and internal target volume (ITV) by 77 % and 42 % respectively. There was a mean decrease of 21/24 % in V5/V20Gy for the ipsilateral lung. Motion monitoring during treatment for 20 targets showed that intrafraction tumor motion remained within 2 mm for most patients, ensuring accurate dose delivery. 86 % of fractions were completed within 25 min. No local recurrences were observed during a median follow-up of 13 months.

Conclusion

Free-breathing EG SBRT is a feasible, effective, and practical approach for lung cancer treatment, offering significant reductions in tumor motion and lung doses while maintaining high treatment accuracy and acceptable treatment times.

{"title":"Clinical experience with free-breathing expiration-gated 10MV FFF VMAT stereotactic lung radiotherapy","authors":"Isabel F. Remmerts de Vries , Max Dahele , Tezontl S. Rosario , Ben J. Slotman , Wilko F.A.R. Verbakel","doi":"10.1016/j.radonc.2025.110783","DOIUrl":"10.1016/j.radonc.2025.110783","url":null,"abstract":"<div><h3>Background</h3><div>Free-breathing expiration-gating (EG) is a non-invasive technique used to manage respiratory-induced tumor motion. This study explores the effectiveness of EG stereotactic body radiotherapy (SBRT) for lung tumors using 10MV FFF VMAT.</div></div><div><h3>Methods and Materials</h3><div>The study included 41 patients (50 targets) treated with EG lung SBRT between September 2019 and February 2023. Patients underwent free-breathing uncoached 10-phase 4DCT for planning, with the choice for EG based on e.g. tumor motion, critical organ dose, expected target visibility on free-breathing CBCT, taking into account suitability of the breathing pattern. The gating window was typically set at phases 30–70 % of the breathing cycle. Treatment planning utilized VMAT with 10MV FFF, and tumor motion was monitored using EG-CBCT ± near real-time markerless kV imaging. Treatment times for the different parts of treatment, tumor stability and clinical outcomes were evaluated. Dosimetric outcomes were compared between EG and free-breathing plans for a subset of 10 patients.</div></div><div><h3>Results</h3><div>EG SBRT substantially reduced longitudinal tumor motion and internal target volume (ITV) by 77 % and 42 % respectively. There was a mean decrease of 21/24 % in V5/V20Gy for the ipsilateral lung. Motion monitoring during treatment for 20 targets showed that intrafraction tumor motion remained within 2 mm for most patients, ensuring accurate dose delivery. 86 % of fractions were completed within 25 min. No local recurrences were observed during a median follow-up of 13 months.</div></div><div><h3>Conclusion</h3><div>Free-breathing EG SBRT is a feasible, effective, and practical approach for lung cancer treatment, offering significant reductions in tumor motion and lung doses while maintaining high treatment accuracy and acceptable treatment times.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"205 ","pages":"Article 110783"},"PeriodicalIF":4.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419501","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

Pioneering BNCT: Refining strategies for complex cutaneous malignancies

IF 4.9 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology

Pub Date : 2025-02-12 DOI: 10.1016/j.radonc.2025.110786

Xiaowei Zhang

引用次数: 0

On the significance of peak dose in normal tissue toxicity in spatially fractionated radiotherapy: The case of proton minibeam radiation therapy

IF 4.9 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology

Pub Date : 2025-02-11 DOI: 10.1016/j.radonc.2025.110769

Yolanda Prezado , Charlotte Lamirault , Thibaut Larcher , Cristele Gilbert , Julie Espenon , A. Patriarca , L. de Marzi , Angela Corvino , Ramon Ortiz , Marjorie Juchaux

Purpose

Spatially fractionated radiotherapy is an unconventional radiotherapy approach able to widen the therapeutic window for difficult-to-treat cases today. To unlock its full potential, accurate knowledge of the relationship between the different dosimetry and geometry parameters and the biological response is still needed. When the same beam width is used, the valley dose has been assumed to be the main parameter influencing normal tissue sparing, with peak doses having little relevance. However, a recent retrospective evaluation of preclinical data suggests peak dose plays a major role in the normal tissue sparing of minibeam radiation therapy (MBRT). The goal of this study was to experimentally validate for the first time the significance of the peak dose for normal tissue sparing in proton MBRT.

Materials and methods

We irradiated the brains of naive rats with two different configurations of pMBRT, resulting in the same valley and average doses but different peak doses. Behavioural tests and histopathological evaluations were carried out.

Results

At the same valley dose, a higher peak dose (high peak-to-valley dose ratio (PVDR), larger centre-to-centre (ctc) distance) is more detrimental than a lower peak dose (low PVDR, narrower catch). In the first case, the animals exhibited some hyperactivity in locomotor and exploration activity as well as memory alterations. In addition, the highest peak dose led to a significantly higher cumulative lesion score in the histopathology evaluations than the lowest peak dose.

Conclusions

While our study does not exclude the relevant role of the valley dose in tissue sparing, it does highlight the importance of peak doses, contradicting previous assumptions. Our results agree with the conclusion of a recent retrospective evaluation of preclinical studies in micro and minibeam radiation therapy.

{"title":"On the significance of peak dose in normal tissue toxicity in spatially fractionated radiotherapy: The case of proton minibeam radiation therapy","authors":"Yolanda Prezado , Charlotte Lamirault , Thibaut Larcher , Cristele Gilbert , Julie Espenon , A. Patriarca , L. de Marzi , Angela Corvino , Ramon Ortiz , Marjorie Juchaux","doi":"10.1016/j.radonc.2025.110769","DOIUrl":"10.1016/j.radonc.2025.110769","url":null,"abstract":"<div><h3>Purpose</h3><div>Spatially fractionated radiotherapy is an unconventional radiotherapy approach able to widen the therapeutic window for difficult-to-treat cases today. To unlock its full potential, accurate knowledge of the relationship between the different dosimetry and geometry parameters and the biological response is still needed. When the same beam width is used, the valley dose has been assumed to be the main parameter influencing normal tissue sparing, with peak doses having little relevance. However, a recent retrospective evaluation of preclinical data suggests peak dose plays a major role in the normal tissue sparing of minibeam radiation therapy (MBRT). The goal of this study was to experimentally validate for the first time the significance of the peak dose for normal tissue sparing in proton MBRT.</div></div><div><h3>Materials and methods</h3><div>We irradiated the brains of naive rats with two different configurations of pMBRT, resulting in the same valley and average doses but different peak doses. Behavioural tests and histopathological evaluations were carried out.</div></div><div><h3>Results</h3><div>At the same valley dose, a higher peak dose (high peak-to-valley dose ratio (PVDR), larger centre-to-centre (ctc) distance) is more detrimental than a lower peak dose (low PVDR, narrower catch). In the first case, the animals exhibited some hyperactivity in locomotor and exploration activity as well as memory alterations. In addition, the highest peak dose led to a significantly higher cumulative lesion score in the histopathology evaluations than the lowest peak dose.</div></div><div><h3>Conclusions</h3><div>While our study does not exclude the relevant role of the valley dose in tissue sparing, it does highlight the importance of peak doses, contradicting previous assumptions. Our results agree with the conclusion of a recent retrospective evaluation of preclinical studies in micro and minibeam radiation therapy.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"205 ","pages":"Article 110769"},"PeriodicalIF":4.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143403241","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

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 : 2025-02-09 DOI: 10.1016/j.radonc.2025.110776

Jiao Yu, Xin Chen

引用次数: 0

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