Precision Radiation Oncology最新文献_第7页

Thoracic radiotherapy timing and prognostic factors in elderly patients with limited‐stage small cell lung cancer 老年局限期小细胞肺癌患者的胸腔放疗时机和预后因素

Q4 Medicine

Precision Radiation Oncology

Pub Date : 2024-03-14 DOI: 10.1002/pro6.1223

Huan Zhao, Yue Qi, Lanfang Zhang, Meng Xing, Fujun Yang

This study assessed the outcomes of elderly patients with limited‐stage small cell lung cancer (LS‐SCLC), which may be linked to the timing of thoracic radiotherapy (TRT) following chemotherapy.Elderly patients (n = 78) with LS‐SCLC were divided into three groups depending on the timing of radiotherapy. The patients in the TRT group were stratified into early (TRT after 1–2 cycles of chemotherapy, n = 29), medium‐term (TRT after 3–4 cycles of chemotherapy, n = 33), and late (TRT after 5–6 cycles of chemotherapy, n = 16) TRT groups. The overall survival (OS) and progression‐free survival (PFS) were assessed and compared.The medium‐term TRT group demonstrated significantly longer mPFS (20.12 months) and better mOS (35.97 months) than those in the other groups (PFS: P = 0.021;OS: P = 0.035). A pairwise comparison of the three groups revealed that those who received medium‐term TRT exhibited significantly improved PFS than the early (mPFS: 20.12 vs. 10.36 mouths, P = 0.018) and late (mPFS: 20.12 vs. 9.17 months, P = 0.016) TRT. The medium‐term TRT group demonstrated significantly improved OS than the early TRT (mOS: 35.97 vs. 25.22 months, P = 0.007) but not in comparison with the late TRT (mOS: 35.97 vs. 21.63 months, P = 0.100).In elderly patients with LS‐SCLC, the addition of TRT after 3–4 cycles of chemotherapy appears to be a viable and potentially beneficial treatment approach.

本研究评估了局限期小细胞肺癌（LS-SCLC）老年患者的预后，这可能与化疗后胸腔放疗（TRT）的时机有关。根据放疗时机的不同，LS-SCLC老年患者（78人）被分为三组。TRT组患者被分为早期（化疗1-2个周期后TRT，29人）、中期（化疗3-4个周期后TRT，33人）和晚期（化疗5-6个周期后TRT，16人）TRT组。中期 TRT 组的 mPFS（20.12 个月）和 mOS（35.97 个月）明显长于其他组（PFS：P = 0.021；OS：P = 0.035）。对三组患者进行配对比较后发现，与早期（mPFS：20.12 个月 vs. 10.36 个月，P = 0.018）和晚期（mPFS：20.12 个月 vs. 9.17 个月，P = 0.016）TRT 相比，接受中期 TRT 的患者的 PFS 有明显改善。中期TRT组的OS明显优于早期TRT组（mOS：35.97个月 vs. 25.22个月，P = 0.007），但不优于晚期TRT组（mOS：35.97个月 vs. 21.63个月，P = 0.100）。

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引用次数: 0

Stereotactic body radiation therapy for clinically diagnosed early-stage non-small cell lung cancer: Importance of accurate CT interpretation by experts. 立体定向体放射治疗临床诊断的早期非小细胞肺癌：专家准确CT解读的重要性。

Q4 Medicine

Precision Radiation Oncology

Pub Date : 2024-03-10 eCollection Date: 2024-03-01 DOI: 10.1002/pro6.1220

Daisuke Nakamura, Koichi Honda, Takuya Yamazaki, Hideyuki Hayashi, Shin Tsutsui, Aya Fukushima, Sumihisa Honda, Masataka Uetani, Kazuto Ashizawa

Introduction: This study evaluated the clinical outcomes of stereotactic body radiotherapy (SBRT) for both pathologically diagnosed (PD) and clinically diagnosed (CD) early-stage non-small cell lung cancer (NSCLC) and explored the significance of accurate expert computed tomography (CT) interpretation.

Methods: We retrospectively analyzed 95 patients with early-stage NSCLC who received SBRT at our institution. Patients were classified into CD and PD groups. Two chest radiologists retrospectively interpreted the pre-SBRT CT images to determine the tumor subtype and probability of malignancy (PM). Clinical findings, CT features, and treatment outcomes were compared between the two groups. The survival rate of the CD group was analyzed separately according to the PM grade.

Results: Median overall survival for the CD and PD groups was 6.0 and 5.4 years (P = 0.57), respectively. Median cause-specific survival was 10.2 years in the CD group and not reached in the PD group (P = 0.76). In the CD group, lung cancer mortality was lower in the low PM group (25% [1 of 4]) than in the high PM group (47.4% [9 of 19]).

Conclusion: It may be desirable to evaluate the PM of the nodule using expert CT interpretation to decide whether SBRT is indicated in CD early-stage NSCLC.

本研究评估了立体定向体放疗（SBRT）治疗病理诊断（PD）和临床诊断（CD）早期非小细胞肺癌（NSCLC）的临床结果，并探讨了准确的专家计算机断层扫描（CT）解释的意义。方法：我们回顾性分析了95例在我院接受SBRT治疗的早期NSCLC患者。患者分为CD组和PD组。两名胸部放射科医生回顾性分析了sbrt前的CT图像，以确定肿瘤亚型和恶性肿瘤的可能性（PM）。比较两组患者的临床表现、CT表现及治疗效果。根据PM分级，分别分析CD组患者的生存率。结果：CD组和PD组的中位总生存期分别为6.0年和5.4年（P = 0.57）。CD组的中位病因特异性生存期为10.2年，而PD组没有达到（P = 0.76）。在CD组中，低PM组肺癌死亡率（25%[1 / 4]）低于高PM组（47.4%[9 / 19]）。结论：在CD期早期NSCLC中是否需要行SBRT治疗，应通过专家CT解释评估结节的PM。

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引用次数: 0

Lymphocytopenia following adjuvant radiotherapy for breast cancer 乳腺癌辅助放疗后的淋巴细胞减少症

Q4 Medicine

Precision Radiation Oncology

Pub Date : 2024-02-29 DOI: 10.1002/pro6.1221

K. Takeda, R. Umezawa, Takaya Yamamoto, N. Takahashi, Yu Suzuki, K. Kishida, So Omata, K. Jingu

We retrospectively analyzed breast cancer patients who received adjuvant radiotherapy to determine the incidence of lymphocytopenia and its risk factors.We reviewed 812 patients with breast cancer who received postoperative radiotherapy. Patients were divided into two groups based on the use of chemotherapy, and a generalized linear regression model was used to explore predictive factors for grade 2 or higher lymphocytopenia. We also examined the effect of lymphocytopenia on overall survival.Grade 2 or higher lymphocytopenia was observed in 19.4% of patients who did not receive chemotherapy and 45.1% of patients who received chemotherapy. In multivariate analysis, bilateral disease, regional lymph node irradiation, and baseline lymphocytopenia were associated with lymphocytopenia in patients who did not receive cytotoxic chemotherapy. Regional lymph node irradiation, baseline lymphocytopenia, use of antimetabolites, and use of molecular‐targeted agents were associated with lymphocytopenia in patients treated with chemotherapy. In the survival analysis, lymphocytopenia was associated with worse overall survival only in patients treated with cytotoxic chemotherapy (p = 0.039), and not in patients who did not receive chemotherapy (p = 0.77).The analysis revealed the incidence and risk factors of lymphocytopenia after postoperative radiotherapy in patients with breast cancer.

我们对接受辅助放疗的乳腺癌患者进行了回顾性分析，以确定淋巴细胞减少症的发生率及其风险因素。我们对 812 名接受术后放疗的乳腺癌患者进行了研究，根据化疗的使用情况将患者分为两组，并使用广义线性回归模型来探讨 2 级或以上淋巴细胞减少症的预测因素。我们还研究了淋巴细胞减少对总生存期的影响。未接受化疗的患者中有 19.4%出现 2 级或以上淋巴细胞减少，而接受化疗的患者中有 45.1%出现 2 级或以上淋巴细胞减少。在多变量分析中，双侧疾病、区域淋巴结照射和基线淋巴细胞减少与未接受细胞毒化疗患者的淋巴细胞减少有关。在接受化疗的患者中，区域淋巴结照射、基线淋巴细胞减少、使用抗代谢药物和分子靶向药物与淋巴细胞减少有关。在生存率分析中，只有接受细胞毒化疗的患者淋巴细胞减少与总生存率降低有关（p = 0.039），而未接受化疗的患者淋巴细胞减少与总生存率降低无关（p = 0.77）。

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引用次数: 0

Clinical Guidelines for the Prevention and Treatment of Radiation‐induced Bladder Injury 预防和治疗辐射所致膀胱损伤的临床指南

Q4 Medicine

Precision Radiation Oncology

Pub Date : 2024-02-08 DOI: 10.1002/pro6.1215

Weiping Wang, Fuquan Zhang, Shuanghu Yuan

Radiation‐induced bladder injury is a common complication after pelvic radiotherapy. Few studies exist on diagnosing and treating radiation‐induced bladder injury, with no established guidelines or consensus in China or internationally. Clinical physicians' diagnosis and treatment of radiation‐induced bladder injury are primarily based on their own clinical experience, and there is an urgent need for unified guidelines to standardize clinical diagnosis and treatment. Therefore, the Chinese Radiation Therapy Oncology Group, China Anti‐Cancer Association Tumor Support Therapy Committee, and China Anti‐Cancer Association Tumor Radiation Protection Committee gathered experts to develop Chinese clinical practice guidelines, guiding diagnosing and treating radiation‐induced bladder injury. The development of these guidelines adopted the grading system of evidence quality and recommendation strength (GRADE).

放疗引起的膀胱损伤是盆腔放疗后常见的并发症。目前关于放射性膀胱损伤的诊断和治疗研究较少，国内外尚无成熟的指南或共识。临床医生对放射性膀胱损伤的诊断和治疗主要基于自身的临床经验，迫切需要统一的指南来规范临床诊断和治疗。为此，中国放射治疗肿瘤学组、中国抗癌协会肿瘤支持治疗专业委员会、中国抗癌协会肿瘤放射防护专业委员会召集专家制定了中国临床实践指南，指导放射性膀胱损伤的诊断和治疗。指南的制定采用了证据质量和推荐强度分级系统（GRADE）。

引用次数: 0

Clinical Guidelines for the Prevention and Treatment of Radiation‐induced Bladder Injury 预防和治疗辐射所致膀胱损伤的临床指南

Q4 Medicine

Precision Radiation Oncology

Pub Date : 2024-02-08 DOI: 10.1002/pro6.1215

Weiping Wang, Fuquan Zhang, Shuanghu Yuan

Radiation‐induced bladder injury is a common complication after pelvic radiotherapy. Few studies exist on diagnosing and treating radiation‐induced bladder injury, with no established guidelines or consensus in China or internationally. Clinical physicians' diagnosis and treatment of radiation‐induced bladder injury are primarily based on their own clinical experience, and there is an urgent need for unified guidelines to standardize clinical diagnosis and treatment. Therefore, the Chinese Radiation Therapy Oncology Group, China Anti‐Cancer Association Tumor Support Therapy Committee, and China Anti‐Cancer Association Tumor Radiation Protection Committee gathered experts to develop Chinese clinical practice guidelines, guiding diagnosing and treating radiation‐induced bladder injury. The development of these guidelines adopted the grading system of evidence quality and recommendation strength (GRADE).

放疗引起的膀胱损伤是盆腔放疗后常见的并发症。目前关于放射性膀胱损伤的诊断和治疗研究较少，国内外尚无成熟的指南或共识。临床医生对放射性膀胱损伤的诊断和治疗主要基于自身的临床经验，迫切需要统一的指南来规范临床诊断和治疗。为此，中国放射治疗肿瘤学组、中国抗癌协会肿瘤支持治疗专业委员会、中国抗癌协会肿瘤放射防护专业委员会召集专家制定了中国临床实践指南，指导放射性膀胱损伤的诊断和治疗。指南的制定采用了证据质量和推荐强度分级系统（GRADE）。

引用次数: 0

Precision radiotherapy for nasopharyngeal carcinoma 鼻咽癌的精确放射治疗

Q4 Medicine

Precision Radiation Oncology

Pub Date : 2024-01-30 DOI: 10.1002/pro6.1219

Zhenyu Zhang, Xiangzhou Chen, Taize Yuan

Nasopharyngeal carcinoma(NPC) occurs frequently in Southern China, and radiotherapy is the main treatment method. At present, intensity‐modulated radiotherapy is widely used, which has improved efficacy in patients with NPC and reduced toxicity and side effects. Recently, helical tomography radiotherapy, proton radiotherapy, carbon particle radiotherapy, and other radiotherapy techniques have been used for the clinical treatment of NPC. Individualized nasopharyngeal cancer targets have also been explored. This paper reviews the research progress in radiotherapy techniques and target volume for NPC

鼻咽癌在中国南方多发，放疗是主要的治疗方法。目前，调强放疗得到广泛应用，提高了鼻咽癌患者的疗效，减少了毒副作用。近年来，螺旋断层放疗、质子放疗、碳粒子放疗等放疗技术也被用于鼻咽癌的临床治疗。个体化的鼻咽癌靶点也得到了探索。本文回顾了鼻咽癌放疗技术和靶区的研究进展。

引用次数: 0

Editorial: Innovations, advances, and challenges in precision radiation oncology physics 社论：精准放射肿瘤物理学的创新、进步与挑战

Q4 Medicine

Precision Radiation Oncology

Pub Date : 2023-12-06 DOI: 10.1002/pro6.1216

Fada Guan, L. Bronk, Jinbo Yue, R. Mohan, Zhe Chen

引用次数: 0

Is there an optimal time to administer postoperative stereotactic radiosurgery in patients with brain metastases? A systematic review of the literature and meta-analysis. 脑转移患者术后立体定向放射治疗是否有最佳时机？对文献和荟萃分析进行系统回顾。

Q4 Medicine

Precision Radiation Oncology

Pub Date : 2023-12-03 eCollection Date: 2023-12-01 DOI: 10.1002/pro6.1214

Anthony Nwankwo, Danielle D Dang, Kevin Choe, Samir Kanani, Adam L Cohen, Mateo Ziu

Postoperative stereotactic radiosurgery improves local tumor control in patients with metastatic brain cancer. However, the influence of timing on its therapeutic efficacy is unclear. In this study, we performed a meta-analysis and systematic literature review examining publications that reported the timing of postoperative stereotactic radiosurgery (SRS) for patients with intracranial metastases. Our primary outcomes included median overall survival and rates of local and regional failure, while secondary outcomes examined the incidence of treatment-related adverse events. Correlations between median SRS timing and these variables were assessed using linear regression and publication bias was appraised via Egger's test. Our study resulted in 22 articles comprising 1338 patients. The median timing of adjuvant SRS spanned 14.5 to 41 days. There was a significant negative study-level correlation of median time to SRS with regional failure (p = 0.043, R² = 0.32) but not with overall survival (p = 0.54, R² = 0.03) or local failure (p = 0.16, R² = 0.14). Additionally, there was significant heterogeneity within the reports (p<0.0001). In conclusion, our analysis demonstrated that postoperative SRS timing did not influence local failure rates which may in part be due to significant variability between individual study designs and patient demographics. Further research is warranted to elucidate the role of timing for postoperative SRS on oncologic outcomes.

术后立体定向放射手术改善转移性脑癌患者局部肿瘤控制。然而，时间对其治疗效果的影响尚不清楚。在这项研究中，我们进行了荟萃分析和系统的文献综述，研究了报道颅内转移患者术后立体定向放射手术（SRS）时机的出版物。我们的主要结局包括中位总生存率和局部和区域失败率，而次要结局检查治疗相关不良事件的发生率。使用线性回归评估中位SRS时间与这些变量之间的相关性，并通过Egger检验评估发表偏倚。我们的研究纳入了22篇文章，包括1338名患者。SRS辅助治疗的中位时间为14.5 ~ 41天。中位SRS时间与局部失败（p = 0.043, R2 = 0.32）呈显著负相关，但与总生存（p = 0.54, R2 = 0.03）或局部失败（p = 0.16, R2 = 0.14）无显著负相关。此外，报告中存在显著的异质性(p

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引用次数: 0

Red shell‐ high risk normal tissue in stereotactic radiosurgery 红色外壳--立体定向放射手术中的高风险正常组织

Q4 Medicine

Precision Radiation Oncology

Pub Date : 2023-12-01 DOI: 10.1002/pro6.1218

Jun Yang, W. Qi, Lei Wang, Q. Lu, Liangfu Han, Brian Wang, W. Yan

Due to the ablative nature of high prescription in Stereotactic Radiosurgery or stereotactic body radiation therapy (SRS/SBRT), the normal tissue surrounding the CTV receives the dose higher than tissue's dose constraint. A concept of Red Shell is proposed to define and quantify these tissue damaged in SBRT, using biological equivalent dose (BED) concept. The combination of biological factors and physics factors, including serial and parallel organ, dose gradient, dose distribution and fractionations, are further discussed to interpret the clinical meaning of Red Shell. This concept can also help planner to improve the optimization in planning process.

由于立体定向放射手术或立体定向体放射治疗（SRS/SBRT）中高剂量处方的烧蚀性质，CTV 周围的正常组织接收的剂量高于组织的剂量约束。我们提出了 "红壳"（Red Shell）概念，利用生物当量剂量（BED）概念来定义和量化 SBRT 中受损的组织。进一步讨论了生物因素和物理因素的结合，包括串行和并行器官、剂量梯度、剂量分布和分馏，以解释红壳的临床意义。这一概念还能帮助计划者改进计划过程中的优化。

引用次数: 0

Dual‐Energy CT in Breast Cancer: Current Applications and Future Outlooks 双能量 CT 在乳腺癌中的应用：当前应用与未来展望

Q4 Medicine

Precision Radiation Oncology

Pub Date : 2023-12-01 DOI: 10.1002/pro6.1213

Shaolan Guo, Tianye Liu, Guobin Qu, Jian Xu, Qingzeng Liu, Qian Zhao, Zhao Bi, Wanhu Li, Jian Zhu

Breast cancer is the most prevalent cancerous tumor in women, characterized by different subtypes and varying responses to treatment. The continued evolution of breast cancer diagnosis and management has resulted in a transition from a one‐size‐fits‐all approach to a new era of personalized treatment plans. Therefore, it is essential to accurately identify the biological characteristics of breast tissue in order to minimize unnecessary biopsies of benign lesions and improve the overall clinical process, leading to reduced expenses and complications associated with invasive biopsy procedures. Challenges for future research include finding ways to predict the response of breast cancer patients to adjuvant systemic treatment.Dual‐energy CT (DECT) is a new imaging technology integrating functional imaging and molecular imaging. Over the past decade, DECT has gained relevancy, especially in oncological radiology. This article proposed a literature review of the application and research status of DECT in breast cancer treatment strategy determination and prognosis prediction.

乳腺癌是女性中最常见的恶性肿瘤，其特点是不同的亚型和对治疗的不同反应。乳腺癌诊断和管理的不断发展导致了从一刀切的方法到个性化治疗计划的新时代的过渡。因此，准确识别乳腺组织的生物学特征是至关重要的，以尽量减少不必要的良性病变活检，改善整体临床过程，从而减少与侵入性活检手术相关的费用和并发症。未来研究的挑战包括找到预测乳腺癌患者对辅助全身治疗反应的方法。双能CT (Dual - energy CT, DECT)是一种集功能成像和分子成像于一体的新型成像技术。在过去的十年中，DECT已经获得了相关性，特别是在肿瘤放射学中。本文就DECT在乳腺癌治疗策略确定及预后预测中的应用及研究现状进行文献综述。

引用次数: 0