Technical Innovations and Patient Support in Radiation Oncology最新文献

{"title":"Improved PTV coverage and OAR sparing with stereotactic MRI-guided online adaptive radiotherapy with elective fields in pancreatic cancer","authors":"Dinah Konnerth ,&nbsp;Hidehiro Hojo ,&nbsp;Frederik Fuchs ,&nbsp;Mohamed A. Shouman ,&nbsp;Diana-Coralia Dehelean ,&nbsp;Aurélie Gaasch ,&nbsp;Franziska Walter ,&nbsp;Chukwuka Eze ,&nbsp;Sebastian N. Marschner ,&nbsp;Sina Mansoorian ,&nbsp;Sebastian H. Maier ,&nbsp;Vanessa da Silva Mendes ,&nbsp;Jan Hofmaier ,&nbsp;Maximilian Niyazi ,&nbsp;Claus Belka ,&nbsp;Stefanie Corradini ,&nbsp;Paul Rogowski","doi":"10.1016/j.tipsro.2025.100354","DOIUrl":"10.1016/j.tipsro.2025.100354","url":null,"abstract":"<div><h3>Purpose</h3><div>Ablative stereotactic radiotherapy for pancreatic ductal adenocarcinoma (PDAC) is limited by adjacent radiosensitive organs at risk (OAR) that exhibit significant daily positional variability. This study aims to investigate the benefit of stereotactic MRI-guided online adaptive radiotherapy (SMART) with elective fields on target coverage and OAR dose sparing in patients with PDAC.</div></div><div><h3>Methods</h3><div>We retrospectively analysed 62 consecutive PDAC patients treated with SMART between 2020–2024, totaling 310 fractions. For each fraction, a non-adapted plan (PLAN_PREDICT) was compared to its online-adapted counterpart (PLAN_REOPTIMIZED). We assessed planning target volume (PTV) coverage and OAR constraints. Plan-adaptation was classified as “useful” when the PLAN_REOPTIMIZED met all objectives or improved PTV coverage or OAR sparing by ≥ 10 %, as “futile” when PLAN_REOPTIMIZED failed to meet or markedly improve objectives, and as “not necessary” when PLAN_PREDICT already met all objectives.</div></div><div><h3>Results</h3><div>Prescribed doses were 40 Gy (71 %) and 33 Gy (29 %) over five fractions. A simultaneous integrated boost approach was used in 47 % of patients. The PLAN_PREDICT met all planning goals in 1 % of fractions, which increased to 72 % with PLAN_REOPTIMIZED. Adaptation yielded significant improvements in PTV coverage (p &lt; 0.001) and reductions in V33Gy for stomach (median 0.26 cc vs. 0.01 cc), duodenum (median 1.08 cc vs. 0.07 cc) and bowel (median 2.04 cc vs. 0.06 cc), all p &lt; 0.001. Adaptation was deemed useful in 305 (98 %), not necessary in 4 (1 %) and futile in 1 fraction (0.3 %).</div></div><div><h3>Conclusion</h3><div>For the vast majority of PDAC patients treated with stereotactic radiotherapy with elective fields daily online adaptation enhances target coverage and OAR sparing.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"36 ","pages":"Article 100354"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145576370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient perspectives on participation in the Danish Breast Cancer Group Proton Trial: A qualitative research study","authors":"Kristine W. Høgsbjerg ,&nbsp;Anne W. Kristensen ,&nbsp;Mette Møller ,&nbsp;Else Maae ,&nbsp;Maja V. Maraldo ,&nbsp;Louise W. Matthiessen ,&nbsp;Sami Al-Rawi ,&nbsp;Mette H. Nielsen ,&nbsp;Cai Grau ,&nbsp;Birgitte V. Offersen","doi":"10.1016/j.tipsro.2025.100344","DOIUrl":"10.1016/j.tipsro.2025.100344","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Participation in clinical trials is essential to advancing oncological treatments, yet equitable trial access remains challenging. Diverse patient inclusion strengthens external validity and enhances the generalisability of trial outcomes. However, barriers to trial participation persist, and the factors influencing patient enrolment are not fully understood. This study investigates the patient perspective on participation in the Danish Breast Cancer Group (DBCG) Proton Trial.</div></div><div><h3>Materials and methods</h3><div>Patients eligible for the DBCG Proton Trial were invited to participate in interviews. Patients were selected to ensure geographical and perspective-based diversity, including randomised and non-randomised patients from eight radiotherapy clinics in Denmark. Semi-structured interviews were conducted via telephone, transcribed, and analysed using an inductive approach to identify the patient perspective on trial participation.</div></div><div><h3>Results</h3><div>A total of fifteen patients were interviewed. The analysis identified five themes encompassing patients’ motivators and barriers to trial participation: distance to the treatment facility, timing of trial information, decisional support, clinical equipoise and patient needs. These factors were reported by both randomised and non-randomised patients.</div></div><div><h3>Interpretation</h3><div>Participation in the DBCG Proton Trial was determined by both logistical and personal factors. Distance to the proton treatment facility was the most important barrier, while the potential for reduced late effects was the main motivator. The decision was difficult for most patients, often guided by one dominant concern rather than a balanced consideration of multiple factors. These findings suggest that improved trial communication, decisional support, and attention to geographical barriers are essential for promoting equitable participation in clinical trials.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"36 ","pages":"Article 100344"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of upright immobilization methods for abdominal and head-and-neck cancer treatments in a carbon ion radiotherapy setting","authors":"Maria Varnava ,&nbsp;Motohiro Kawashima ,&nbsp;Akihiko Matsumura ,&nbsp;Yoshiaki Oohashi ,&nbsp;Makoto Miyazawa ,&nbsp;Junichi Koya ,&nbsp;Naoto Yamaguchi ,&nbsp;Tomoaki Ogano ,&nbsp;Mutsumi Tashiro ,&nbsp;Tatsuya Ohno","doi":"10.1016/j.tipsro.2025.100356","DOIUrl":"10.1016/j.tipsro.2025.100356","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>Upright patient positioning is an emerging approach in radiotherapy that may overcome current limitations in carbon ion radiotherapy (CIRT). This study evaluated upright immobilization techniques for abdominal and head-and-neck (HN) cancers in a CIRT setting.</div></div><div><h3>Materials and Methods</h3><div>Ten volunteers were positioned on the Chair, a demo upright positioning system (Leo Cancer Care, USA). Three setups were evaluated: no immobilization devices, vacuum bags alone (ESFORM; Engineering System Co., Japan), and vacuum bags with a thermoplastic shell (Shellfitter; Kuraray Trading Co., Japan), called the “shell” setup. Interfractional and intrafractional errors were assessed using skin markers drawn on the abdominal and HN areas. Interfractional shifts per direction and Euclidean distances were calculated by comparing reference and repeated images. Intrafractional shifts per direction and Euclidean distances were calculated from images acquired over a 15-min period. Also, volunteers rated their comfort for each setup on a scale of 1–5. Differences in the interfractional and intrafractional motion, and comfort ratings between the three setups were investigated.</div></div><div><h3>Results</h3><div>Significant differences (<em>p</em> &lt; 0.05) in the interfractional Euclidean distances were observed between the three setups in both anatomical areas, while significant differences were observed in more shifts per direction in the abdominal case. The “shell” setup minimized intrafractional distances. No significant differences were observed in the comfort ratings between the setups.</div></div><div><h3>Conclusion</h3><div>Upright positioning in CIRT appears feasible. Further research is needed to refine immobilization techniques to support clinical implementation of upright positioning in CIRT.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"36 ","pages":"Article 100356"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145614331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidental dose to internal mammary nodes in post-operative radiation therapy for breast cancer","authors":"L.Di Lena ,&nbsp;A.W.M. Nielsen ,&nbsp;C.P.L. Fulcheri ,&nbsp;M. Marcantonini ,&nbsp;I. Palumbo ,&nbsp;S. Saldi ,&nbsp;V. Bini ,&nbsp;B.V. Offersen ,&nbsp;C. Aristei","doi":"10.1016/j.tipsro.2025.100346","DOIUrl":"10.1016/j.tipsro.2025.100346","url":null,"abstract":"<div><h3>Aims</h3><div>The incidental dose to the internal mammary nodes (IMN) is understudied in patients treated with newer radiation therapy (RT) techniques. The aim of this study was to quantify the incidental IMN dose in a series of breast cancer (BC) patients receiving post-operative RT to the chest wall/breast and regional nodes (level III-IV).</div></div><div><h3>Methods</h3><div>We retrospectively analyzed data from 95 high-risk BC patients treated between 2015 and 2022. Patients received RT (50 Gy/25fr or 40.05 Gy/15fr) to the breast/chest wall and nodal levels III-IV after mastectomy or breast conserving surgery (BCS). Exclusion criteria were IMN irradiation and pre-operative systemic therapy. One radiation oncologist contoured the CTV_IMN according to ESTRO guidelines and divided it into four sub-regions based on intercostal spaces (ICS): IMNupper, ICS1, ICS2, ICS3. Dosimetric parameters collected were Dmean, V90, V95, D90, and D95. The Dmean was correlated to tumor laterality and location, type of surgery and reconstruction, RT technique (3D-CRT, IMRT, helical RT) and boost.</div></div><div><h3>Results</h3><div>Mean Dmean to IMN was 71.4 % (range 19.6–118.6) of the prescription dose. Among sub-region, ICS2 and ICS3 received significantly higher doses than ICS1 and IMN upper (p = 0.04). V90 of over 90 % was achieved in only 4/95 patients, 3 were treated with helical RT, and the other with IMRT. The mean V95 and V90 were 15.4 % and 26.2 % respectively. Univariate analysis showed that mastectomy (p = 0.002), omission of boost (p = 0.001), and helical RT (p &lt; 0.0001) were associated with significantly higher IMN Dmean. No significant correlation emerged with laterality, tumor location and type of reconstruction.</div></div><div><h3>Conclusions</h3><div>In our series, incidental IMN doses were highest after mastectomy and with helical RT delivery, possibly due to more medial margin in chest wall delineation and the helical dose distribution. Nevertheless, incidental doses to the IMN were below recommended doses, thus highlighting the need for IMN contouring when identified as targets.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"36 ","pages":"Article 100346"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145221916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inter-Observer variability in organs at risk contouring among radiation therapy students and qualified radiation therapists","authors":"Crispen Chamunyonga ,&nbsp;Kerrie Mengersen ,&nbsp;Catriona Hargrave","doi":"10.1016/j.tipsro.2025.100362","DOIUrl":"10.1016/j.tipsro.2025.100362","url":null,"abstract":"<div><h3>Introduction</h3><div>Contouring organ-at-risk structures (OARs) remains an important skill that must be developed through education and training. This study assessed variations in OAR contouring among undergraduate radiation therapy students and qualified radiation therapists (RTs).</div></div><div><h3>Methods</h3><div>Four planning computed tomography datasets (Brain, Lung, Parotid, and Prostate), which included 21 clinician-validated OAR contours, were utilised as references in this contouring study. Participants included 2nd to 4th year students, as well as qualified RTs. A quantitative comparison of contours was performed using the Dice Similarity Coefficient (DICE) and Hausdorff distance (HD) metrics. Statistical analyses assessed variations across structures, tumour sites, experience levels, and contouring methods.</div></div><div><h3>Results</h3><div>A total of 440 OAR contours were analysed. The bladder and lung OARs achieved the highest mean DICE scores (&gt;0.9), while structures such as the brainstem, heart, and parotid gland exhibited mean DICE scores between 0.76 and 0.89. Smaller structures, such as the lens, demonstrated very low HD95 values. A moderate positive correlation (r = 0.591) was observed between OAR volume and DICE scores (&lt;200 cc). Statistical analyses indicated significant differences across tumour sites (P &lt; 0.001 for DICE, HDavg, HD95, and HDmax). The comparison of manual and guided contouring showed statistically significant differences only for DICE (P &lt; 0.001) and HDmax (P = 0.004). There were no significant differences in median scores between students and qualified groups. However, students exhibited higher variance than qualified professionals.</div></div><div><h3>Conclusion</h3><div>This study highlighted OARs that are challenging to contour or edit, suggesting the need for a comprehensive educational framework.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"36 ","pages":"Article 100362"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring lung tumour volume on daily cone beam CT; is it achievable in a real-world setting?","authors":"Sarah Barrett ,&nbsp;Laure Marignol ,&nbsp;Gerard G Hanna ,&nbsp;Conor K McGarry ,&nbsp;Gerard M Walls","doi":"10.1016/j.tipsro.2025.100352","DOIUrl":"10.1016/j.tipsro.2025.100352","url":null,"abstract":"<div><div>Delineating the gross tumour volume (GTV) in non-small cell lung cancer (NSCLC) can be challenging due to anatomical complexities and imaging artefacts. This study evaluates a semi-automated workflow using commercial software for target volume (TV) delineation on cone-beam CT (CBCT) in patients undergoing radical radiotherapy. Seventy-six patients with 553 scans (n = 76 planning CT, n = 477 CBCT) were included. Auto-contours were adjusted by a senior Radiation Therapist and reviewed for accuracy. The majority (59.1 %) required only minor revisions, with median adjustment time of CBCT auto-contours of 83 (range 0–460) seconds. The findings support the feasibility of this approach, offering a pragmatic solution for adaptive radiotherapy workflows in NSCLC.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"36 ","pages":"Article 100352"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145417199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Operational assessment of tattooless breast radiotherapy using AlignRT surface guidance","authors":"Aria Malhotra ,&nbsp;Andrew K.H. Robertson ,&nbsp;Ian Sun ,&nbsp;Samantha A.M. Lloyd","doi":"10.1016/j.tipsro.2025.100349","DOIUrl":"10.1016/j.tipsro.2025.100349","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Surface guided radiation therapy (SGRT) is a new approach for patient setup that can replace tattoo-based positioning. The permanent body markings that come with this long-standing standard of care can have a lasting negative emotional impact on cancer survivors. This study evaluates surface guidance as an alternative positioning modality, comparing speed, accuracy, and cost of the two techniques.</div></div><div><h3>Methods</h3><div>Setup time and positional accuracy prior to radiographic localization for patients receiving radiation therapy for breast cancer were compared between two linear accelerators, one with and one without surface guidance technology. A Wilcoxon rank sum test was used to determine statistically significant differences in setup time and positional shifts. Cost projections per fraction and per patient for both modalities were conducted.</div></div><div><h3>Results</h3><div>SGRT positional accuracy and setup time were equivalent to or better than tattoo-based setup. SGRT setup was faster for all photon treatments by 11 s. Deep inspiration breath hold setup times were equivalent for both positioning modalities, but SGRT was faster by 23 s for free breathing setups. There were no statistically significant differences in the magnitude of positional shifts on pre-treatment imaging. SGRT costs are broken down into item costs and staffing costs, with final estimates dependent on a center’s capacity for treatments per day.</div></div><div><h3>Conclusions</h3><div>Surface guided patient positioning for breast radiotherapy is fiscally feasible and non-inferior to permanent tattoos in terms of set up time and accuracy.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"36 ","pages":"Article 100349"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145362465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating participant experiences and tolerability with MR Linac imaging","authors":"Jayde Nartey ,&nbsp;Helen A. McNair ,&nbsp;Katie Biscombe ,&nbsp;Sophie E. Alexander ,&nbsp;Charlotte Cherry ,&nbsp;Cynthia Eccles ,&nbsp;Trina Herbert ,&nbsp;Shaista Hafeez ,&nbsp;Kelly Jones ,&nbsp;Francesca Mason ,&nbsp;Simeon Nill ,&nbsp;Hosna Mohammad ,&nbsp;Kian Morrison ,&nbsp;Bethany Williams ,&nbsp;Robert Huddart","doi":"10.1016/j.tipsro.2025.100348","DOIUrl":"10.1016/j.tipsro.2025.100348","url":null,"abstract":"<div><h3>Introduction</h3><div>Magnetic Resonance Image Guided Radiotherapy (MRIgRT) integrates MRI with a linear accelerator to enable adaptive treatment delivery. While technical feasibility is well established, patient experience during MR Linac imaging, especially outside treatment sessions, remains underexplored. This study evaluates tolerability, pre-scan anxiety, coping ability, willingness for future scans, and scan-induced symptoms in patients and non-patient volunteers.</div></div><div><h3>Materials and Methods</h3><div>Participants who successfully underwent MR Linac imaging between November 2017 and December 2023 completed a bespoke MR Linac Participant Experience Questionnaire, developed by the PRIMER study team and informed by MRI patient experience literature. The questionnaire assessed pre-scan anxiety, coping, willingness for future scans, and scan-related symptoms using Likert-scale responses. Descriptive analyses summarised responses by participant group and anatomical site.</div></div><div><h3>Results</h3><div>In total, 447 participants (319 patients; 128 non-patient volunteers) completed MR Linac imaging and the questionnaire. Overall tolerability was high, with 65 % strongly disagreeing they felt anxious prior to scanning and most participants reporting good coping ability. Variability was observed across anatomical sites: Participants undergoing head and neck, brain, and oligometastatic bone scans reported higher pre-scan anxiety, with coping difficulties most frequently reported by the head and neck group. Non-patient volunteers reported more physiological symptoms (e.g., sweating, nausea, dizziness) than patients, whereas patients undergoing head and neck and bone oligometastases scans were more reluctant to repeat the procedure. Most patients perceived MR Linac imaging as easier or comparable to diagnostic MRI, though 20 % of brain cancer patients found it more difficult.</div></div><div><h3>Conclusion</h3><div>MR Linac imaging is generally well tolerated, though specific subgroups, particularly those requiring immobilisation, report greater anxiety and discomfort. These findings highlight the need for tailored strategies to improve patient experience, supporting wider implementation of MRIgRT.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"36 ","pages":"Article 100348"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI based sentiment analysis of online discussions related to cervical brachytherapy","authors":"R. Kouzy ,&nbsp;M.K. Rooney ,&nbsp;E.E. Cha ,&nbsp;S. Vinjamuri ,&nbsp;H. Wu ,&nbsp;Z.El Kouzi ,&nbsp;O. Mohamad ,&nbsp;T.T. Sims ,&nbsp;C.R. Weil ,&nbsp;N. Taku ,&nbsp;L.L. Lin ,&nbsp;A. Jhingran ,&nbsp;P. Eifel ,&nbsp;M. Joyner ,&nbsp;L.E. Colbert ,&nbsp;A.H. Klopp","doi":"10.1016/j.tipsro.2025.100340","DOIUrl":"10.1016/j.tipsro.2025.100340","url":null,"abstract":"<div><h3>Purpose/Objective(s)</h3><div>Few studies have documented the experiences of patients receiving cervical brachytherapy. While evidence regarding quality of life issues in this population has emerged, traditional structured questionnaires often fail to capture the full range of patient perspectives. We hypothesized that analyzing unfiltered patient discussions from online forums would reveal unique insights into patient experiences, including previously unidentified emotional responses, concerns, and coping strategies. This study applied an artificial intelligence (AI) workflow to analyze cervical cancer and brachytherapy discussions from an online forum.</div></div><div><h3>Materials/Methods</h3><div>We extracted posts and comments from the subreddit r/cervicalcancer, focusing on discussions about brachytherapy between November 2020 and January 2024. We applied a processing pipeline to prepare the data for analysis. The content was analyzed using RoBERTa, a pre-trained deep learning model, to categorize sentiments as positive, negative, or neutral. We further evaluated posts using pre-defined keyword tagging to identify dominant topics within conversations based on recent literature.</div></div><div><h3>Results</h3><div>The analysis encompassed 898 unique posts and comments from an initial dataset of 1075 entries. Overall sentiments were categorized as 40.4% positive, 29.9% negative, and 29.7% neutral. Discussions related to “Bowel Domain” showed the highest proportion of negative sentiments (51.2%) among all topics. “Urinary Domain” (46.8%), “Pain” (43.4%), “Fatigue” (42.4%), and “Anesthesia” (41.4%) discussions also reflected predominantly negative sentiments. In contrast, “Recovery” and “Survivorship” discussions were predominantly positive. The sentiments on “Sex” and “Mental Health” related topics displayed a more balanced distribution between positive and negative perspectives.</div></div><div><h3>Conclusion</h3><div>Our study demonstrates the value of analyzing unstructured patient narratives from online forums related to cervical brachytherapy. We identified patterns of concerns that can inform clinical practice, particularly regarding patient education about bowel and urinary side effects. These findings can improve informed consent discussions and help clinicians better address patients’ significant concerns. Further work will focus on developing automated systems to bridge the gap between clinicians’ understanding and patients’ lived experiences.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"36 ","pages":"Article 100340"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145047859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-year insights from a proton therapy centre: Evolving strategies in ependymoma treatment planning","authors":"Lieselotte Lauwens ,&nbsp;Anneleen Goedgebeur ,&nbsp;Tom Boterberg ,&nbsp;Tom Depuydt ,&nbsp;Dario Di Perri ,&nbsp;Lorraine Donnay ,&nbsp;Benjamin Ledoux ,&nbsp;Kenneth Poels ,&nbsp;Susana Santos Lopes ,&nbsp;Karen Van Beek ,&nbsp;Robin De Roover ,&nbsp;Maarten Lambrecht","doi":"10.1016/j.tipsro.2025.100347","DOIUrl":"10.1016/j.tipsro.2025.100347","url":null,"abstract":"<div><h3>Background</h3><div>Treatment of posterior fossa ependymoma with proton therapy (PT) is challenging due to the proximity to the brainstem and potential risk of brainstem toxicity.</div></div><div><h3>Materials and methods</h3><div>This retrospective study included patients with intracranial ependymoma treated with PT or a hybrid proton–photon (PT-XT) approach at our centre between July 2020 and December 2023 with a minimum 12 month follow-up. Treatment approach was determined based on tumour relationship to the brainstem. Patient and tumour characteristics and treatment planning approaches were evaluated, and dosimetric data between PT and PT-XT approaches were compared. Outcomes including symptomatic brainstem injury (SBI) and asymptomatic radiographic changes (ARC) were assessed.</div></div><div><h3>Results</h3><div>Fourteen patients were included, of which nine had posterior fossa ependymoma, with five treated using a hybrid PT-XT planning approach and four with PT alone. The hybrid PT-XT approach involved delivering 75 % of the treatment (0–45 Gy(RBE)) with PT and the remaining portion (45–59.4 Gy) with XT, addressing concerns regarding increased relative biological effectiveness of PT in the brainstem. While all plans adhered to the European Particle Therapy Network D_0.03cc brainstem dose constraint, the University of Florida constraints were not always met. Comparison of the hybrid PT-XT and PT-only replans showed a trend towards improved brainstem dose parameters with the hybrid approach. After a median follow-up of 22.2 months, no patients developed symptomatic brainstem injury and three showed asymptomatic radiographic changes.</div></div><div><h3>Conclusion</h3><div>Tailored planning approaches, depending on location and relationship to the brainstem, are essential when treating ependymoma patients. A hybrid PT-XT approach, is feasible in well-selected patients, demonstrating acceptable target coverage, brainstem doses, and to date no occurrence of symptomatic brainstem injury.</div></div>","PeriodicalId":36328,"journal":{"name":"Technical Innovations and Patient Support in Radiation Oncology","volume":"36 ","pages":"Article 100347"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145321263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}