Radiotherapy and Oncology最新文献

{"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}

{"title":"Radiation- versus surgery-based treatment for patients with resectable IIIC1 cervical adenocarcinoma","authors":"Xi-Lin Yang ,&nbsp;Jia-Wei Zhu ,&nbsp;Chen Wang ,&nbsp;Yun-Can Zhou ,&nbsp;Zheng Miao ,&nbsp;Hui Guan ,&nbsp;Zhi-Wei Yang ,&nbsp;Qiu Guan ,&nbsp;Jun-Fang Yan ,&nbsp;Ke Hu ,&nbsp;Fu-Quan Zhang","doi":"10.1016/j.radonc.2026.111370","DOIUrl":"10.1016/j.radonc.2026.111370","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe the utilization trend of radiation-based and surgery-based treatment in patients with resectable IIIC1 cervical adenocarcinoma and explore the optimal treatment strategy for these patients.</div></div><div><h3>Methods</h3><div>Patients with resectable IIIC1 cervical adenocarcinoma in 2005–2022 from Surveillance, Epidemiology, and End Results program (SEER) were analyzed. Trends over time in the utilization of radiation- and surgery-based treatment were plotted and estimated using Mantel-Haenszel test. Logistic regression analysis was performed to identify factors associated with the utilization of treatment. Survival outcomes were assessed and compared using Kaplan-Meire method and log-rank test, respectively. Inverse probability of treatment weighting (IPTW) was performed for adjustment of baseline characteristics. Sensitivity analysis was conducted using a cohort of cervical adenocarcinoma patients from our institution.</div></div><div><h3>Results</h3><div>The utilization of radiation-based treatment has grown steadily from 2005 to 2022 while the trend for surgery-based treatment showed opposite way (<em>P</em> = 0.002). Age, year of diagnosed, tumor size and T stage impacted the utilization of radiation-based treatment (All <em>P</em> &lt; 0.05). Surgery-based treatment demonstrated superior overall survival (HR = 0.55, 95%CI:0.44–0.69; <em>P</em> &lt; 0.001) and cancer specific survival (HR = 0.58, 95%CI:0.45–0.75; <em>P</em> &lt; 0.001) to radiation-based treatment before adjustment of IPTW. However, no significant differences were observed in overall survival (HR = 0.77, 95%CI:0.56–1.05; <em>P</em> = 0.1) and cancer specific survival (HR = 0.86, 95%CI:0.60–1.23; <em>P</em> = 0.4) after baseline characteristics were balanced. Besides, the cohort from our institution further verified that similar survival outcomes were observed between two treatment strategies.</div></div><div><h3>Conclusions</h3><div>The utilization of radiation-based treatment has increased over time and showed non-inferior efficacy for patients with resectable IIIC1 cervical adenocarcinoma when compared to surgery-based treatment.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"216 ","pages":"Article 111370"},"PeriodicalIF":5.3,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948908","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":"Machine learning model for predicting interfraction motion of the seminal vesicles in prostate cancer radiotherapy","authors":"Mitsuaki Terabe ,&nbsp;Takeshi Kamomae ,&nbsp;Yuki Taniguchi ,&nbsp;Takayuki Miyachi ,&nbsp;Hajime Ichikawa ,&nbsp;Risei Miyauchi ,&nbsp;Junji Ito ,&nbsp;Mariko Kawamura ,&nbsp;Shunichi Ishihara ,&nbsp;Shinji Naganawa","doi":"10.1016/j.radonc.2026.111368","DOIUrl":"10.1016/j.radonc.2026.111368","url":null,"abstract":"<div><h3>Background and purpose</h3><div>In external beam radiotherapy for prostate cancer, inclusion of the seminal vesicles (SV) in the clinical target volume (CTV) is often complicated by considerable SV motion and deformation. This study aimed to investigate the feasibility of predicting patient-specific SV motion using anatomical features surrounding the prostate on planning CT (pCT) images.</div></div><div><h3>Materials and methods</h3><div>Interfractional SV motion was quantified using five pretreatment cone-beam CT (CBCT) scans per patient from a cohort of 191 prostate cancer patients. Patients whose SV was not fully covered by a 3-mm margin were assigned to the High SV Motion Group, which served as the target for prediction. A total of 42 anatomical features were extracted from the contours of the prostate, SV, bladder, and rectum on the pCT. Feature selection was performed using Random-Forest Recursive Feature Elimination, and a machine learning model was developed and evaluated using both internal and external patient cohorts.</div></div><div><h3>Results</h3><div>Four anatomical features were selected, including those based on the anatomical relationship between the prostate and the SV. Using these features, the best-performing light gradient boosting machine model achieved an area under the receiver operating characteristic curve of 0.724 in the internal test and 0.632 in the external test for identifying patients in the High SV Motion Group.</div></div><div><h3>Conclusion</h3><div>This study suggests an association between anatomical features derived from pCT and patient-specific SV motion. Although the current predictive performance is moderate, this approach may help support radiotherapy strategies when the SV is included in the CTV.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"216 ","pages":"Article 111368"},"PeriodicalIF":5.3,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927739","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":"Development and validation of A CCTA-based risk prediction model for major adverse cardiovascular events in esophageal cancer patients receiving radiotherapy","authors":"Qian Xu ,&nbsp;Hesong Shen ,&nbsp;Liting Wen ,&nbsp;Chunrong Tu ,&nbsp;Wei Deng ,&nbsp;Renwei Liu ,&nbsp;Fandong Zhang ,&nbsp;Dechun Zheng ,&nbsp;Jiuquan Zhang","doi":"10.1016/j.radonc.2026.111364","DOIUrl":"10.1016/j.radonc.2026.111364","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Major adverse cardiovascular events (MACEs) remain a significant concern in esophageal cancer (EC) patients receiving radiotherapy (RT). This study aimed to develop and validate a CCTA-based model for predicting MACEs in this population.</div></div><div><h3>Materials and methods</h3><div>322 and 216 patients with EC at thoracic middle or lower segment from hospital 1 were randomly divided into the training and internal validation cohorts, while 227 patients from hospital 2 were assigned to the external validation cohort. Pericoronary adipose tissue (PCAT) radiomics features were selected by the least absolute shrinkage and selection operator Cox regression (Lasso-Cox) and Max-Relevance and Min-Redundancy (mRMR). Radiomics model was constructed and compared using seven machine-learning classifiers. A nomogram for predicting MACEs was developed with multivariable Cox regression analysis. Predictive performance of models was evaluated by C-index, and feature importance was interpreted using SHapley Additive exPlanations (SHAP) analysis.</div></div><div><h3>Results</h3><div>The median follow-up was 31 months (IQR, 25–36 months), during which 139 of 765 (18.2 %) patients experienced MACEs. The eXtreme gradient boosting (XGBoost) was used to construct radiomics model. A nomogram incorporating the PCAT radiomics signature, age, mean dose of left circumflex artery (LCX), and fat attenuation index of LCX achieved a moderate to strong predictive capacity across the training, internal, and external validation cohorts (C-index = 0.855, 0.839, and 0.845, respectively). SHAP analysis revealed that the PCAT radiomics signature was the most important predictor of MACEs.</div></div><div><h3>Conclusion</h3><div>A nomogram combining clinical risk factors, CCTA-derived parameters, and PCAT radiomics signature can predict MACEs in patients with EC receiving radiotherapy.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"216 ","pages":"Article 111364"},"PeriodicalIF":5.3,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927821","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}