Practical Radiation Oncology最新文献

{"title":"PROshot: Neoadjuvant Radiation for Pancreatic Cancer, Radiation Alone for Oligometastatic Renal Cell Carcinoma, De-escalated Head and Neck Radiation, and Immunotherapy for Glioblastoma","authors":"Caleb Dulaney MD , Laura Dover MD, MSPH","doi":"10.1016/j.prro.2025.10.001","DOIUrl":"10.1016/j.prro.2025.10.001","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"16 1","pages":"Pages 3-6"},"PeriodicalIF":3.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145897932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Value of 68Ga-DOTATATE Positron Emission Tomography for Skull Base Meningioma Radiation Treatment Planning","authors":"Elizabeth L. McKone MD, William G. Breen MD","doi":"10.1016/j.prro.2025.08.003","DOIUrl":"10.1016/j.prro.2025.08.003","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"16 1","pages":"Pages 22-23"},"PeriodicalIF":3.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145897996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician- and Patient-Reported Outcomes of Stereotactic Ablative Radiation Therapy for High-Risk Prostate Cancer","authors":"Helena B.Z. Logar MD, PhD ,&nbsp;Angel Montero MD, PhD ,&nbsp;Ovidio Hernando MD, PhD ,&nbsp;Mercedes Lopez MD ,&nbsp;Jeannette Valero MD, PhD ,&nbsp;Raquel Ciervide MD, PhD ,&nbsp;Beatriz Alvarez MD ,&nbsp;Xin Chen-Zhao MD, PhD ,&nbsp;Emilio Sanchez MD ,&nbsp;Mariola Garcia-Aranda MD ,&nbsp;Carmen Saiz MD ,&nbsp;Daniel Zucca MSci ,&nbsp;Leyre Alonso MSci ,&nbsp;Miguel Sanchez MD ,&nbsp;Rosa Alonso MD ,&nbsp;Pedro Fernandez-Leton MSci ,&nbsp;Carmen Rubio MD, PhD","doi":"10.1016/j.prro.2025.05.007","DOIUrl":"10.1016/j.prro.2025.05.007","url":null,"abstract":"<div><h3>Purpose</h3><div>This study evaluated the feasibility and tolerability of SABR in patients with high- and very-high-risk prostate cancer.</div></div><div><h3>Methods and Materials</h3><div>A prospective study included patients with high-risk and N1 prostate cancer. SABR was delivered as 40 Gy in 8 Gy fractions, with optional elective nodal irradiation (26 Gy in 5.2 Gy fractions) and a 40 Gy nodal boost for N1 disease. The treatment protocol involved 24 to 36 months of androgen deprivation therapy, premedication with alpha-1 receptor antagonists, and dexamethasone (4 mg on treatment days). Adverse events were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events v5.0, while quality of life was assessed using the EORTC QLQ-C30 and QLQ-PR25 questionnaires at the final check-up.</div></div><div><h3>Results</h3><div>The study included 96 patients (median age 77.2 years) with a median follow-up of 29.8 months. Elective nodal radiation therapy was delivered to 66.7% of patients, and 16.8% received a nodal boost. Acute grade 2 (G2) genitourinary and gastrointestinal (GI) events occurred in 5.2% and 7.3% of patients, respectively, with no grade ≥3 acute events. Late grade ≥2 genitourinary and GI events were observed in 7.8% and 15.7% of patients, respectively, including 1 grade 4 GI event. Common late symptoms included nocturia and rectal bleeding. Most patients (86.5%) reported no or minor difficulties posttreatment, though challenges with sexual activity, nocturia, and incontinence were noted. Physicians underestimated urgency and nocturia and overestimated rectal bleeding.</div></div><div><h3>Conclusions</h3><div>SABR delivering 40 Gy in 5 fractions is feasible and well-tolerated for high-risk prostate cancer, with minimal additional toxicity from elective nodal irradiation and a boost to N1 disease. These findings support SABR as an effective treatment, warranting further long-term studies.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"16 1","pages":"Pages e28-e37"},"PeriodicalIF":3.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shakuntala and the Ring of Recollection: A Lesson in the Theater of Memory and Wisdom","authors":"Varun Kumar Chowdhry MD, MBA","doi":"10.1016/j.prro.2025.08.004","DOIUrl":"10.1016/j.prro.2025.08.004","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"16 1","pages":"Pages 20-21"},"PeriodicalIF":3.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Hydrogel Spacer Intravasation of the Internal Iliac Vein and Associated Thrombus Formation During Preparation for Prostate Cancer External Beam Radiation Therapy","authors":"Jacob Eckstein MD ,&nbsp;Mina S. Makary MD ,&nbsp;Spero R. Cataland MD ,&nbsp;Rebekah Young MD ,&nbsp;Russel Palm MD ,&nbsp;Dayssy A. Diaz Pardo MD ,&nbsp;Therese Andraos MD ,&nbsp;Doug Martin MD ,&nbsp;Shang Jui Wang MD","doi":"10.1016/j.prro.2025.07.001","DOIUrl":"10.1016/j.prro.2025.07.001","url":null,"abstract":"<div><div>Use of rectal spacer gel has been associated with decreased risk of radiation therapy (RT)-related rectal toxicity in clinical trials and has been increasingly adopted. Optimal management of spacer-related toxicities, such as rectal wall and vascular infiltration, remains poorly defined. To address this gap, we present a case of extensive hydrogel intravasation of the periprostatic venous plexus with development of associated bland thrombus extending to the level of the common iliac vein. The patient was evaluated for placement of an inferior vena cava (IVC) filter and anticoagulation by a multidisciplinary team. After undergoing 6 months of anticoagulation without IVC filter placement, both the hydrogel and the associated thrombus resolved asymptomatically. We review the timeline of these events, their associated symptomatology, our rationale in management of this clinical scenario, and propose a treatment paradigm.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"16 1","pages":"Pages 15-19"},"PeriodicalIF":3.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Volumetric Changes and Acute Toxicity With 68Ga Prostate-Specific Membrane Antigen Versus 18F-Fluciclovine Positron Emission Tomography/Computer Tomography Guided Postprostatectomy Radiation: Final Analysis of a Randomized Trial","authors":"Vishal R. Dhere MD ,&nbsp;David M. Schuster MD ,&nbsp;Subir Goyal PhD ,&nbsp;Eduard Schreibmann PhD ,&nbsp;Nikhil T. Sebastian MD ,&nbsp;Sagar A. Patel MD, MSCR ,&nbsp;Sheela Hanasoge MBBS, PhD ,&nbsp;Joseph W. Shelton MD ,&nbsp;Pretesh R. Patel MD ,&nbsp;Bruce W. Hershatter MD ,&nbsp;Olayinka A. Abiodun-Ojo MD, MPH ,&nbsp;Ismaheel O. Lawal MBBS, PhD ,&nbsp;Ashesh B. Jani MD, MSEE","doi":"10.1016/j.prro.2025.07.003","DOIUrl":"10.1016/j.prro.2025.07.003","url":null,"abstract":"<div><h3>Purpose</h3><div>We evaluated changes in radiation therapy target volume and acute toxicity using ⁶⁸Ga-prostate specific membrane antigen (PSMA) versus ¹⁸F-fluciclovine positron emission tomography (PET)/computed tomography in postprostatectomy patients with biochemical recurrence. We hypothesized that both fluciclovine and PSMA-guided radiation therapy would (1) significantly change pre-PET radiation therapy volumes and (2) show similar toxicity.</div></div><div><h3>Methods and Materials</h3><div>We performed an institutional review board-approved, randomized trial comparing fluciclovine (Arm 1) and PSMA (Arm 2)-guided postprostatectomy radiation therapy in patients with detectable prostate-specific antigen after prostatectomy. Treatment volumes were rigidly defined based on PET, and simultaneous integrated boosts to PET uptake in the prostate bed (70.2-76.0 Gy) or pelvis (54.0-56.0 Gy) were allowed. Clinical target volumes (CTVs) included: prostate bed (CTV_PB); pelvic lymph nodes (CTV_PLV); and volumetric constraints for bladder(-CTV) and rectum. Acute genitourinary and gastrointestinal (GI) toxicity (per Common Terminology Criteria for Adverse Events v5.0) was assessed &lt;90 days from treatment.</div></div><div><h3>Results</h3><div>In total, 140 patients were enrolled with 70 randomized to each arm; 11 Arm 1 and 10 Arm 2 patients did not receive radiation on study and were excluded. Fluciclovine and PSMA incorporation increased both CTV_PB and CTV_PLV (<em>P</em> &lt; .01). More fluciclovine patients received prostate bed boosts (45 of 59 patients vs 26 of 60 patients; <em>P</em> &lt; .01), but there was no difference in proportion receiving pelvic nodal boosts (10 of 15 patients vs 9of 16 patients, fluciclovine vs PSMA; <em>P</em> = .97). Dose constraints were met for most patients. Rates of grade 2 genitourinary (17.0% vs 6.7%, fluciclovine vs PSMA; <em>P</em> = .15) and GI (5.1% vs 1.7%, fluciclovine vs PSMA; <em>P</em> = .47) toxicity were low, with no grade 3+ events. Higher rectal and bladder dose metrics correlated with GI toxicity (<em>P</em> &lt; .05), but use of simultaneous integrated boosts was not associated with acute toxicity.</div></div><div><h3>Conclusions</h3><div>Although both PSMA and fluciclovine use modestly increased target volumes, significantly more fluciclovine patients received prostate bed boosts. Planning directives were met for most patients, and acute toxicity was mild in both Arms. Analysis of biochemical control, late toxicity, and patient-reported outcomes are forthcoming.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"16 1","pages":"Pages e38-e46"},"PeriodicalIF":3.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computed Tomography Guided Brachytherapy With Hybrid Applicators: An Effective Curative Treatment for Vaginal Cuff Recurrences","authors":"Evrim Duman MD ,&nbsp;Sinem Karahan MSc ,&nbsp;Busra Tavli MSc ,&nbsp;Huseyin Sertel MSc ,&nbsp;Merdan Fayda MD","doi":"10.1016/j.prro.2025.06.004","DOIUrl":"10.1016/j.prro.2025.06.004","url":null,"abstract":"<div><h3>Purpose</h3><div>This study evaluated the clinical feasibility of hybrid brachytherapy and the benefits of computed tomography (CT) guidance for optimizing applicator position and needle placement via Utrecht or Venezia applicators in the curative treatment of vaginal cuff recurrence.</div></div><div><h3>Methods and Materials</h3><div>Sixteen previously operated patients with gynecological cancer treated with hybrid brachytherapy for vaginal cuff recurrence from 2018 to 2022 were included. The applicators were selected according to vaginal diameter and tumor location. CT scans were conducted before and after needle insertion. The high-risk clinical target volume (CTV-HR), including residual disease and suspicious regions, as well as normal tissues, was contoured. The dosimetry goal was to ensure that the reference isodose (100%) adequately covered the CTV-HR while minimizing overlap with organs at risk. The needle shifts were assessed according to their locations. Outcome measures, including disease-free survival and overall survival, were analyzed.</div></div><div><h3>Results</h3><div>A total of 64 fractions were administered, with Utrecht applicators used for 62.5% (<em>n</em> = 40). The median equivalent doses in 2 Gy fractions (EQD2 D90) for 90% of the CTV-HR and intermediate-risk CTV were 87.64 Gy (57.45-97.78 Gy) and 69 Gy (31.33-76.73 Gy), respectively. Among the 696 possible needle positions, 419 interstitial needles (60%) were successfully inserted. The median number of needles per fraction was 6 (range, 1-12). Needle shifts occurred in 93% of the patients, predominantly in the anteromedial direction, with a mean magnitude of 0.21 ± 0.14 cm. The median follow-up was 14 months, with a 90% local tumor control rate and an 85% overall survival rate over 2 years, without severe side effects.</div></div><div><h3>Conclusions</h3><div>Despite challenges in treating vaginal cuff recurrence in patients with gynecological cancers, hybrid brachytherapy provides an effective and personalized approach. Although needle shifts are common, they do not significantly impact dosimetric outcomes, highlighting the method's adaptability and reliability.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"16 1","pages":"Pages 74-85"},"PeriodicalIF":3.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrahypofractionated Whole Breast Radiation Therapy Using a Novel Boost Regimen for Early-Stage Breast Cancer","authors":"Molly A. Chakraborty BSE ,&nbsp;Atif J. Khan MD ,&nbsp;Audree B. Tadros MD ,&nbsp;Charlie White MS ,&nbsp;Zhigang Zhang PhD ,&nbsp;Minji Kim MD ,&nbsp;Amy J. Xu MD, PhD ,&nbsp;Quincey LaPlant MD, PhD ,&nbsp;Diana Roth O’Brien MD ,&nbsp;John J. Cuaron MD ,&nbsp;Michael B. Bernstein MD ,&nbsp;Lior Z. Braunstein MD ,&nbsp;Simon N. Powell MD, PhD ,&nbsp;Jehee Isabelle Choi MD","doi":"10.1016/j.prro.2025.08.009","DOIUrl":"10.1016/j.prro.2025.08.009","url":null,"abstract":"<div><h3>Purpose</h3><div>The 5-year results of the FAST-Forward trial demonstrated noninferiority of local tumor control using a 26 Gy in 5 fraction regimen compared with 40 Gy in 15 fractions for breast cancer patients receiving adjuvant whole breast radiation therapy (WBRT) with or without a sequential conventionally fractionated tumor bed boost (2 Gy per fraction). Here, we reported our institutional experience using the FAST-Forward regimen with a novel sequential boost regimen of 5.2 Gy in 1 fraction or 10.4 Gy in 2 fractions.</div></div><div><h3>Methods and Materials</h3><div>Patients with nonmetastatic invasive breast cancer or ductal carcinoma in situ treated with adjuvant WBRT of 26 Gy in 5 fractions from January 7, 2019, to January 6, 2022, were identified from an institutional database. Clinical outcomes, including adverse events, disease control, and patient-reported outcomes, were collected. Survival outcomes were estimated using the Kaplan-Meier method. Associations between toxicities and clinicopathologic and treatment characteristics were assessed using logistic regression.</div></div><div><h3>Results</h3><div>A total of 311 consecutive patients were included; the use of a 1- or 2-fraction boost was left to the discretion of the treating physicians (54% 1-fraction, 8.7% 2-fraction, and 38% no boost). Median follow-up was 32 months. Overall survival and local recurrence-free survival probabilities at 36 months were 96% (95% CI, 94-99) and 93% (95% CI, 90-97), respectively. Acute and late toxicities occurred at a higher rate in the 2-fraction versus 1-fraction and no boost groups (37.4%, 10.8%, and 12.2% [acute] and 22.7%, 8.6%, and 7.9% [late], respectively). Boost receipt, greater boost volume, 15× energy, increasing breast V95%, and bolus use were associated with the risk of acute grade ≥ 2 toxicities.</div></div><div><h3>Conclusion</h3><div>A 5-fraction ultrahypofractionated WBRT regimen for early-stage breast cancer with either no boost or a single-fraction boost of 5.2 Gy resulted in excellent disease control and acceptable toxicity. Increased toxicity was observed with a boost of 10.4 Gy in 2 fractions and is no longer used at our institution.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"16 1","pages":"Pages e1-e16"},"PeriodicalIF":3.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Medicare Reimbursement Trends in Medical and Radiation Oncology","authors":"Jacob S. Hogan MD ,&nbsp;John C. Baumann MD ,&nbsp;Neha Vapiwala MD, FASTRO ,&nbsp;Jeff M. Michalski MD, MBA, FASTRO ,&nbsp;Benjamin W. Fischer-Valuck MD, MBA, MS ,&nbsp;Patty Karraker CPC ,&nbsp;Minesh P. Mehta MD, FASTRO ,&nbsp;Jeffrey D. Bradley MD, FASTRO ,&nbsp;Brian C. Baumann MD","doi":"10.1016/j.prro.2025.05.011","DOIUrl":"10.1016/j.prro.2025.05.011","url":null,"abstract":"<div><h3>Purpose</h3><div>Radiation and medical oncology face pressure from payment changes, which aim to increase the value of care and curb rising spending. Multiple models have been proposed or implemented, with mixed results for cost saving and financial stability. Whereas previous studies have quantified changes in Medicare reimbursement for radiation oncology on a per-code basis, this has not been done in medical oncology to our knowledge, and no direct comparisons have been made between oncology subspecialties at this level. Our study aims to quantify and analyze Medicare reimbursement changes for medical and radiation oncology billing codes.</div></div><div><h3>Methods and Materials</h3><div>In this longitudinal study of reimbursement, the publicly available Physician/Supplier Procedure Summary database was used to obtain Medicare reimbursement data for 2010, 2016, and 2020. All reimbursement for providers with primary provider codes 92 (radiation oncology), 83 (hematology oncology), and 90 (medical oncology) were analyzed, combining hematology and medical oncology. Inflation- and utilization-adjusted changes in reimbursement were calculated from 2010 to 2020 and 2016 to 2020 on a per-code basis with results grouped by specialty and billing category.</div></div><div><h3>Results</h3><div>From 2010 to 2020, inflation- and utilization-adjusted Medicare reimbursement decreased by $1.2 billion (−16%) for all codes, $705 million (−29%) for radiation oncology-specific codes, and $541 million (−10%) for medical oncology-specific codes. From 2016 to 2020, inflation- and utilization-adjusted reimbursement decreased by $299 million (−3%) for all codes, $108 million (−5.6%) for radiation oncology-specific codes, and $191 million (−2.2%) for medical oncology-specific codes. Chemotherapy (−40%) and radiation therapy (−33%) saw the largest decreases in inflation- and utilization-adjusted reimbursement from 2010 to 2020, whereas immunotherapy (+21%) saw the largest increase.</div></div><div><h3>Conclusions</h3><div>Our analysis shows continually decreasing Medicare reimbursement for both radiation and medical oncology from 2010 to 2020 and 2016 to 2020. This decade-long continuous decline highlights the need for payment system stabilization—whether through episode-based payment models or another avenue.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"16 1","pages":"Pages 24-31"},"PeriodicalIF":3.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Ventricular Assist Device, Implantable Cardioverter Defibrillator, and Radiation Therapy: A Technical Report, Review of Literature, and Recommendations","authors":"Alexander Bennassi MD ,&nbsp;Tony Truong MD ,&nbsp;Nhu Hanh To MD, PhD ,&nbsp;Chahrazed Boukhobza MD ,&nbsp;Wassim Ksouri PhD ,&nbsp;Lahcène Belaïdi MD ,&nbsp;Fatimah-Zara Bellefkih MD ,&nbsp;Hanan Rida MD ,&nbsp;Kamel Debbi MD ,&nbsp;Yazid Belkacémi MD, PhD","doi":"10.1016/j.prro.2025.05.013","DOIUrl":"10.1016/j.prro.2025.05.013","url":null,"abstract":"<div><div><span><span>Recent advancements in cardiology have significantly improved survival and </span>quality of life<span> for patients with severe heart conditions, including those requiring implantable cardioverter defibrillators<span> (ICDs) and left ventricular assist devices (LVADs). Radiation therapy (RT) using either conventional or advanced techniques, such as </span></span></span>stereotactic body RT, remains a cornerstone treatment for cancer. However, managing patients with both ICDs and LVADs during RT presents unique challenges caused by potential device malfunctions and interactions with radiation. In this report, we present a case of a patient with both a triple-chamber ICD and an electronically equipped LVAD undergoing RT. The study explores the dosimetric considerations, device interactions, and adapted simulations required to minimize risks. This work aimed to bridge the knowledge gap and provide recommendations for the safe and effective integration of RT delivery in patients with advanced cardiac devices.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"16 1","pages":"Pages e60-e69"},"PeriodicalIF":3.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}