Advances in Radiation Oncology最新文献_第10页

Examining Barriers to Practice in Genitourinary and Gynecologic Radiation Oncology: Results from 2 Nationwide Surveys 检查泌尿生殖和妇科放射肿瘤学实践的障碍：来自2个全国性调查的结果

IF 2.2 Q3 ONCOLOGY

Advances in Radiation Oncology

Pub Date : 2025-06-28 DOI: 10.1016/j.adro.2025.101848

Patrick Doyle MS , Neha Vapiwala MD, FACR, FASTRO, FASCO , Mutlay Sayan MD , Miranda Lam MD, MBA , Shalini Moningi MD

Purpose

Gender diversity in academic radiation oncology (RO) has become a topic of interest in recent years, with studies showing that practicing female academic radiation oncologists (AROs) are outnumbered by male colleagues at a rate of approximately 3:1. Gender differences are also observed in subspecialties whose patient populations are overwhelmingly of a single gender, such as genitourinary (GU) and gynecologic (GYN) RO. We aimed to investigate whether challenges exist for academic RO physicians who primarily treat patients of another gender, and, if so, what barriers they face in practice.

Methods and Materials

We conducted 2 national surveys of female GU academic RO physicians and male GYN academic RO physicians working at Accreditation Council for Graduate Medical Education-accredited academic centers. Survey questions focused on career path, challenges faced, and barriers to practicing GU or GYN oncology.

Results

A total of 13/42 (30.2%) GU survey recipients responded as treating GU oncology and 31/77 (40.3%) GYN survey recipients responded as treating GYN oncology. Of these respondents, 9 GU and 3 GYN physicians reported facing challenges as an academic RO faculty member because of their gender identity, and 5 GU and 4 GYN physicians reported that their subspecialty specifically presented challenges. Neither group commonly reported difficulties developing trust and rapport with patients. In the GU academic RO group, reports of challenging relationships with other professional colleagues were common. Difficulties finding or serving as a mentor were also common in both groups.

Conclusions

Female GU AROs and male GYN AROs may face unique challenges. Identifying and understanding these challenges directly from practicing physicians are important steps in improving professional success, career satisfaction, and clinical care quality.

目的：近年来，学术放射肿瘤学（RO）的性别多样性已成为人们关注的话题，研究表明，在职的女性学术放射肿瘤学家（AROs）与男性同事的比例约为3:1。性别差异也被观察到在亚专科，其患者群体绝大多数是单一性别，如泌尿生殖（GU）和妇科（GYN） RO。我们的目的是调查主要治疗其他性别患者的学术RO医生是否存在挑战，如果存在，他们在实践中面临哪些障碍。方法与材料我们对在研究生医学教育认证委员会认可的学术中心工作的女性GU学术RO医师和男性GYN学术RO医师进行了2次全国调查。调查问题集中在职业道路、面临的挑战以及从事妇科肿瘤学的障碍。结果13/42（30.2%）的GU调查受者应答为治疗GU肿瘤，31/77（40.3%）的GYN调查受者应答为治疗GYN肿瘤。在这些受访者中，9名GU医生和3名GYN医生报告说，作为一名学术RO教员，由于他们的性别认同而面临挑战，5名GU医生和4名GYN医生报告说，他们的亚专业特别面临挑战。两组医生都没有普遍报告在与病人建立信任和融洽关系方面存在困难。在GU的学术RO组中，与其他专业同事的关系具有挑战性的报告很常见。在这两个群体中，寻找或担任导师的困难也很常见。结论女性GU AROs和男性GYN AROs可能面临独特的挑战。直接从执业医师那里识别和理解这些挑战是提高专业成功、职业满意度和临床护理质量的重要步骤。

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引用次数: 0

Preservation of Graft Kidney with De Novo Pelvic Urothelial Carcinoma Via Stereotactic Body Radiation Therapy: A Case Report 立体定向放射治疗保存盆腔尿路上皮癌移植肾1例

IF 2.2 Q3 ONCOLOGY

Advances in Radiation Oncology

Pub Date : 2025-06-28 DOI: 10.1016/j.adro.2025.101846

Koyo Kikuchi MD, PhD , Yoshiro Ieko PhD , Ei Shiomi MD, PhD , Ayato Ito MD, PhD , Ryuji Nakamura MD, PhD , Hisanori Ariga MD, PhD

引用次数: 0

Treatment Outcomes and Prognostic Factors for Patients With Medulloblastoma Having Defined Molecular Subtypes 具有明确分子亚型的髓母细胞瘤患者的治疗结果和预后因素

IF 2.7 Q3 ONCOLOGY

Advances in Radiation Oncology

Pub Date : 2025-06-27 DOI: 10.1016/j.adro.2025.101796

Xuejiao Shi MD , Shuang Liu MS , Xiaoyang Sun MD , Yiyuan Li BE , Mawei Jiang MD

Purpose

This study aims to evaluate treatment outcomes and prognostic factors in pediatric patients with medulloblastoma (MB) with defined molecular subtypes to inform subsequent individualized treatment.

Methods and Materials

A retrospective analysis was conducted on 145 patients with MB with defined molecular subtypes who underwent radiation therapy (RT) at our institution from January 2017 to 2021. Patients were subjected to traditional clinical risk stratification, molecular risk stratification, and National Comprehensive Cancer Network (NCCN) risk stratification, respectively. The treatment outcomes and associated prognostic factors were analyzed.

Results

With a median follow‑up of 49 months, the 5-year event-free survival (EFS) and overall survival rates were 68.6% ± 4.0% and 74.7% ± 4.4%, respectively. Multivariate analysis revealed that failure to achieve a complete response after RT (5-year EFS 39.3% ± 9.2% vs 75.7% ± 4.2%; P = .007), the administration of fewer than 6 cycles of chemotherapy (5-year EFS 25.0% ± 11.6% vs 73.9% ± 4.0%; P < .001), and categorization as a member of the NCCN high-risk group (5-year EFS 48.0% ± 6.5% vs 84.5% ± 4.2%; P = .040) were associated with a worse prognosis. Twenty (27.4%) clinical standard-risk patients were reclassified as low risk or high/very high risk according to the NCCN risk stratification with 5-year EFS rates of 100.0% ± 0.0% and 58.3% ± 16.1%, respectively. Further subgroup analysis (N = 103) revealed that patients with 1q gain (5-year EFS 32.7% ± 16.1% vs 67.0% ± 5.2%; P = .035), 10q loss (5-year EFS 25.0% ± 21.7% vs 69.6% ± 4.6%; P = .024), MYCN amplification (5-year EFS 40.0% ± 15.5% vs 70.8% ± 4.1%; P = .010) or TP53 mutation (5-year EFS 33.3% ± 13.6% vs 71.9% ± 4.0%; P = .002) had a worse EFS than those with wild type.

Conclusions

MB is a heterogeneous disease that requires the integration of clinical and molecular features for defined risk stratification to facilitate individualized treatment. In this study, we found that residual disease after RT, fewer than 6 cycles of chemotherapy, and high-risk NCCN risk stratification were independent adverse prognostic factors for patients with MB.

目的本研究旨在评估具有明确分子亚型的髓母细胞瘤（MB）患儿的治疗结果和预后因素，为后续的个体化治疗提供依据。方法与材料回顾性分析2017年1月至2021年在我院接受放射治疗（RT）的145例具有明确分子亚型的MB患者。患者分别进行传统的临床风险分层、分子风险分层和国家综合癌症网络（NCCN）风险分层。分析治疗结果及相关预后因素。结果中位随访49个月，5年无事件生存率（EFS）和总生存率分别为68.6%±4.0%和74.7%±4.4%。多因素分析显示，放疗后未能达到完全缓解(5年EFS为39.3%±9.2% vs 75.7%±4.2%；P = .007)，给予少于6个化疗周期(5年EFS 25.0%±11.6% vs 73.9%±4.0%；P & lt;.001)，并被归类为NCCN高危组成员(5年EFS 48.0%±6.5% vs 84.5%±4.2%；P = 0.040)与较差的预后相关。20例（27.4%）临床标准风险患者根据NCCN风险分层被重新分类为低风险或高/极高风险，5年EFS发生率分别为100.0%±0.0%和58.3%±16.1%。进一步的亚组分析（N = 103）显示，1q增加的患者(5年EFS 32.7%±16.1% vs 67.0%±5.2%；P = 0.035)， 10q损失(5年EFS 25.0%±21.7% vs 69.6%±4.6%；P = 0.024)， MYCN扩增(5年EFS 40.0%±15.5% vs 70.8%±4.1%；P = 0.010)或TP53突变(5年EFS 33.3%±13.6% vs 71.9%±4.0%；P = .002)的EFS较野生型差。结论smb是一种异质性疾病，需要结合临床和分子特征进行明确的风险分层，以促进个体化治疗。在本研究中，我们发现放疗后残留疾病、化疗少于6个周期、高危NCCN风险分层是MB患者独立的不良预后因素。

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引用次数: 0

Phase 2 Trial of Ultrahypofractionated Image-guided Partial Breast Irradiation Following Lumpectomy with Optional Oncoplastic Reconstruction for Early-stage Breast Cancer 超低分割影像引导下部分乳房照射治疗早期乳腺癌的二期临床研究

IF 2.7 Q3 ONCOLOGY

Advances in Radiation Oncology

Pub Date : 2025-06-22 DOI: 10.1016/j.adro.2025.101817

Vani Gupta BS , Andrew T. Wong MD , Rachel Radigan MPH , Michelle Sahagian DO , Sophia L. Fu MD, MS , Austin Barney CMD , Jeffrey Pettit MS , Rishi Shah BS , Shridevi Singh MD , Jana Deitch MD , Johnny Kao MD

Purpose

As accelerated partial breast irradiation is gaining widespread acceptance for low-risk breast cancers treated with breast conservation, its role following oncoplastic surgery remains controversial.

Methods and Materials

We performed a prospective phase 2 trial of women aged 50 and older who were estrogen receptor positive with stage 0 to 1 breast cancer measuring ≤3 cm following successful lumpectomy with optional oncoplastic reconstruction. Patients were treated on the Varian Edge radiosurgery system to a prescribed dose of 30 Gy in 5 fractions, and the primary endpoints were feasibility and safety. Patient-reported cosmesis was assessed using the Breast Cancer Treatment Outcome Scale validated instrument.

Results

From 2018 to 2022, 50 patients with 52 tumors with a median age of 76 were enrolled, including 79% invasive breast cancer with 48% undergoing oncoplastic reconstruction. With a median follow-up of 47 months, long-term patient-reported cosmesis was excellent in 89% of patients and good in 11% of patients. All patients were locally controlled, but there were 2 ipsilateral breast events consisting of an intramammary lymph node failure and second primary triple-negative breast cancer outside the radiation field, both successfully salvaged with further local and systemic therapy.

Conclusions

In carefully selected patients with low-risk early-stage breast cancer, patients treated with a 5-fraction regimen of partial breast irradiation achieve excellent cosmetic and oncological outcomes. Oncoplastic reconstruction was not a contraindication to partial breast irradiation.

目的加速乳房部分照射在低风险乳腺癌保乳治疗中得到广泛接受，但其在肿瘤整形手术后的作用仍存在争议。方法和材料我们进行了一项前瞻性2期试验，患者年龄在50岁及以上，雌激素受体阳性，在成功的乳房肿瘤切除术和选择性的肿瘤整形重建后，0至1期乳腺癌测量≤3cm。患者在Varian Edge放射外科系统上接受5次30 Gy的处方剂量治疗，主要终点是可行性和安全性。使用乳腺癌治疗结果量表验证仪器评估患者报告的美容。结果2018 - 2022年共纳入50例患者，共52例肿瘤，中位年龄76岁，其中侵袭性乳腺癌79%，肿瘤整形重建48%。中位随访时间为47个月，89%的患者报告长期美容效果极佳，11%的患者报告美容效果良好。所有患者均得到局部控制，但有2例同侧乳房事件，包括乳腺内淋巴结衰竭和放射场外的第二次原发性三阴性乳腺癌，均通过进一步的局部和全身治疗成功挽救。结论在精心挑选的低风险早期乳腺癌患者中，采用部分乳房放射治疗方案的患者获得了良好的美容和肿瘤预后。肿瘤成形性重建并不是乳房部分照射的禁忌症。

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引用次数: 0

Functional Imaging of Changes in Lung Function Before and After Radiation Therapy of Lung Cancer 肺癌放射治疗前后肺功能变化的影像学研究

IF 2.2 Q3 ONCOLOGY

Advances in Radiation Oncology

Pub Date : 2025-06-20 DOI: 10.1016/j.adro.2025.101810

Jonathan L. Percy BSc , Marrissa J. McIntosh PhD , Eric Wallat PhD , Keegan R. Staab MSc , Andrew D. Hahn PhD , Katherine J. Carey PhD , Gregory P. Barton PhD , Andrew M. Baschnagel MD , John E. Bayouth MD , Rodrigo M. Bello MD , Scott B. Perlman MD , Sean B. Fain PhD

引用次数: 0

A Modified Failure Mode and Effects Analysis for Linear Accelerator Quality Assurance 线性加速器质量保证的改进失效模式及影响分析

IF 2.7 Q3 ONCOLOGY

Advances in Radiation Oncology

Pub Date : 2025-06-20 DOI: 10.1016/j.adro.2025.101827

Nicole Jessop DClinSci, Jamie Fairfoul MSc

Purpose

Failure mode and effects analysis (FMEA) is a proactive method for evaluating failure modes and the consequences of those failures. In radiation therapy, a risk-based approach such as this can be used to inform and drive the quality assurance (QA) program, help prioritize QA, evaluate the impact of any changes to the QA process, and raise awareness of the potential failure modes. A classical FMEA can result in identical risk priority number (RPN) values for different combinations of occurrence, severity, and detectability. This assumes that these 3 values hold the same significance. In radiation therapy, high-severity failure modes can lead to severe clinical consequences and so should be prioritized.

Methods and Materials

A classical FMEA was carried out for the Varian TrueBeam linear accelerator QA at Peterborough City Hospital. This highlighted the issue of high-severity failure modes appearing relatively low in the FMEA table because of low overall RPN values. Therefore, a modified FMEA using a new clinical severity factor (S²) with hybrid RPN values was proposed and performed.

Results

None of the failure modes resulted in very high RPN values. Some failure modes with high severities, such as gating system beam hold, breathing trace display, and backup timer operation, had relatively low overall RPN scores. The new modified FMEA minimized this effect by moving these failure modes up the FMEA table. For the modified FMEA, the higher scoring failure modes all relate to machine parameters associated with beam delivery and are important for techniques used for most patients. Therefore, the modified FMEA proposed gave clinically relevant results.

Conclusions

A new modified FMEA is proposed for linear accelerator QA in radiation therapy. This method is recommended to prevent high-severity failure modes from appearing low in the FMEA table and thus being given a low overall priority.

失效模式与影响分析（FMEA）是一种评估失效模式及其后果的前瞻性方法。在放射治疗中，这种基于风险的方法可用于通知和推动质量保证（QA）计划，帮助确定质量保证（QA）的优先级，评估质量保证过程中任何变化的影响，并提高对潜在失效模式的认识。经典的FMEA可以为不同的发生、严重性和可检测性组合得出相同的风险优先级数（RPN）值。这里假设这3个值具有相同的重要性。在放射治疗中，高严重性的失效模式可能导致严重的临床后果，因此应优先考虑。方法和材料对彼得伯勒市医院的瓦里安TrueBeam直线加速器进行了经典的FMEA分析。这突出了高严重性失效模式在FMEA表中出现相对较低的问题，因为总体RPN值较低。因此，我们提出并实施了一种使用新的临床严重程度因子（S2）和混合RPN值的改进FMEA。结果没有一种失效模式会导致很高的RPN值。一些严重程度较高的失效模式，如门控系统波束保持、呼吸轨迹显示和备用计时器操作，总体RPN得分相对较低。新修改的FMEA通过将这些失效模式向上移动到FMEA表中来最小化这种影响。对于改进的FMEA，得分较高的失效模式都与与光束传输相关的机器参数有关，对于大多数患者使用的技术很重要。因此，提出的修正FMEA具有临床相关性。结论提出了一种新的修正FMEA，用于放射治疗中直线加速器的质量评价。建议使用这种方法来防止高严重性故障模式在FMEA表中出现较低的位置，从而被赋予较低的总体优先级。

{"title":"A Modified Failure Mode and Effects Analysis for Linear Accelerator Quality Assurance","authors":"Nicole Jessop DClinSci, Jamie Fairfoul MSc","doi":"10.1016/j.adro.2025.101827","DOIUrl":"10.1016/j.adro.2025.101827","url":null,"abstract":"<div><h3>Purpose</h3><div>Failure mode and effects analysis (FMEA) is a proactive method for evaluating failure modes and the consequences of those failures. In radiation therapy, a risk-based approach such as this can be used to inform and drive the quality assurance (QA) program, help prioritize QA, evaluate the impact of any changes to the QA process, and raise awareness of the potential failure modes. A classical FMEA can result in identical risk priority number (RPN) values for different combinations of occurrence, severity, and detectability. This assumes that these 3 values hold the same significance. In radiation therapy, high-severity failure modes can lead to severe clinical consequences and so should be prioritized.</div></div><div><h3>Methods and Materials</h3><div>A classical FMEA was carried out for the Varian TrueBeam linear accelerator QA at Peterborough City Hospital. This highlighted the issue of high-severity failure modes appearing relatively low in the FMEA table because of low overall RPN values. Therefore, a modified FMEA using a new clinical severity factor (S<sup>2</sup>) with hybrid RPN values was proposed and performed.</div></div><div><h3>Results</h3><div>None of the failure modes resulted in very high RPN values. Some failure modes with high severities, such as gating system beam hold, breathing trace display, and backup timer operation, had relatively low overall RPN scores. The new modified FMEA minimized this effect by moving these failure modes up the FMEA table. For the modified FMEA, the higher scoring failure modes all relate to machine parameters associated with beam delivery and are important for techniques used for most patients. Therefore, the modified FMEA proposed gave clinically relevant results.</div></div><div><h3>Conclusions</h3><div>A new modified FMEA is proposed for linear accelerator QA in radiation therapy. This method is recommended to prevent high-severity failure modes from appearing low in the FMEA table and thus being given a low overall priority.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 9","pages":"Article 101827"},"PeriodicalIF":2.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144770631","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}

引用次数: 0

Adaptive Repeat Quad Shot Radiation Therapy for Uncontrolled Symptomatic Fungating or Skin-Infiltrating Primary and Regional Nodes in Patients with Metastatic Breast Cancer: Durable In-Field Tumor Control Without Interrupting Systemic Therapy 适应性重复四次放射治疗对转移性乳腺癌患者未控制的症状真菌感染或皮肤浸润的原发性和局部淋巴结：持久的现场肿瘤控制而不中断全身治疗

IF 2.2 Q3 ONCOLOGY

Advances in Radiation Oncology

Pub Date : 2025-06-19 DOI: 10.1016/j.adro.2025.101842

Whoon Jong Kil MD , Wyatt Smith CMD , Eugene Muchnik MD , Ryan Collins MD , David Cousins MD

引用次数: 0

Clinical Outcomes After Proton Therapy Reirradiation for Recurrent Malignant Glioma: Analysis From the Prospective Proton Collaborative Group Registry 复发性恶性胶质瘤质子治疗再照射后的临床结果：来自前瞻性质子协作组注册的分析

IF 2.2 Q3 ONCOLOGY

Advances in Radiation Oncology

Pub Date : 2025-06-13 DOI: 10.1016/j.adro.2025.101834

Omer Gal MD , Stephen Mihalcik MD , Lia M. Halasz MD , John H. Chang MD , C. Jake Wang MD , J. Isabelle Choi MD , Charles B. Simone II MD , Carlos E. Vargas MD , Henry K. Tsai MD , Rupesh Kotecha MD , Robert H. Press MD

Purpose

Optimal treatment for recurrent glioma after prior radiation therapy (RT) is not well established. Proton therapy (PT) is increasingly used for reirradiation (ReRT); however, treatment outcomes, toxicities, and prognostic factors for PT-ReRT remain poorly defined.

Methods and Materials

The prospective, multi-institutional Proton Collaborative Group registry was queried for patients with malignant glioma who underwent PT-ReRT between July 2011 and December 2023; only patients with at least one follow-up encounter were included. Overall survival (OS) and progression-free survival were assessed using the Kaplan-Meier method, and Cox proportional hazards regression was used for uni- and multivariable analyses (univariable analysis and multivariable analysis).

Results

The study cohort included 143 patients, the median follow-up was 11.2 months, and the median time interval (TI) from prior RT (median 58.5 Gy, IQR, 54-60 Gy) to PT-ReRT (median 44.6 Gy, IQR, 39.4-55.9 Gy) was 42.4 months. Median progression-free survival and OS were 8.1 and 11.2 months, respectively. On univariable analysis, improved OS was associated with oligodendroglioma and astrocytoma histology compared to glioblastoma, TI >60 months, Eastern Cooperative Oncology Group performance status 0, and ReRT dose ≥50 Gy. On multivariable analysis, improved OS remained associated only with oligodendroglioma and TI >60 months. Acute and late grade 3 toxicity occurred in 7% and 4%, respectively. Acute grade 3 toxicity was associated with poor performance status. Incidence of radiographic radiation necrosis was 19%.

Conclusions

In the largest series of glioma PT-ReRT reported to date, retreatment was well tolerated with variable outcomes based on clinical prognostic factors. Toxicity rates were similar compared to photon-based literature despite a high median ReRT prescription dose.

目的既往放射治疗（RT）后复发胶质瘤的最佳治疗方法尚不明确。质子治疗（PT）越来越多地用于再照射（rt）；然而，pt - rt的治疗结果、毒性和预后因素仍然不明确。方法和材料：对2011年7月至2023年12月期间接受pt - rt治疗的恶性胶质瘤患者进行前瞻性、多机构质子协作组注册查询；仅包括至少有一次随访的患者。采用Kaplan-Meier法评估总生存期（OS）和无进展生存期，采用Cox比例风险回归进行单变量和多变量分析（单变量分析和多变量分析）。结果本研究共纳入143例患者，中位随访时间为11.2个月，从先前RT治疗（中位58.5 Gy， IQR, 54-60 Gy）到pt - RT治疗（中位44.6 Gy， IQR, 39.4-55.9 Gy）的中位时间间隔（TI）为42.4个月。中位无进展生存期和OS分别为8.1个月和11.2个月。在单变量分析中，与胶质母细胞瘤相比，改善的OS与少突胶质细胞瘤和星形细胞瘤组织学，TI >；60个月，东部肿瘤合作组表现状态0，rt剂量≥50 Gy相关。在多变量分析中，改善的OS仅与少突胶质细胞瘤和TI相关。急性和晚期3级毒性分别为7%和4%。急性3级毒性与不良的运动状态有关。放射坏死发生率为19%。结论在迄今为止报道的最大的胶质瘤pt - rt系列中，再治疗耐受性良好，基于临床预后因素的结果不同。尽管rrt处方中位剂量较高，但毒性率与基于光子的文献相似。

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引用次数: 0

Stereotactic Radiation Therapy for the Treatment of Glandular Metastases From Renal Cell Carcinoma 立体定向放射治疗肾细胞癌腺体转移

IF 2.7 Q3 ONCOLOGY

Advances in Radiation Oncology

Pub Date : 2025-06-13 DOI: 10.1016/j.adro.2025.101835

Mihailo Miljanic MD , Tidie Song BS , Alana Christie MS , Allen Yen MD , Young Suk Kwon MD, MPH , Aurelie Garant MD , Todd A. Aguilera MD, PhD , Zabihullah Wardak MD , Hans Hammers MD , Kevin Courtney MD, PhD , Suzanne Cole MD , James Brugarolas MD, PhD , Robert Timmerman MD , Raquibul Hannan MD, PhD

Purpose

The optimal management strategies for glandular metastases in patients with metastatic renal cell carcinoma (mRCC) are currently unknown. While local therapy may be effective, there is a paucity of data on Stereotactic Ablative Body Radiation (SABR) particularly considering the risks of duodenal injury and adrenal insufficiency with high-dose radiation in these locations.

Methods and Materials

We conducted an institutional review board-approved, single-institution, retrospective study of patients with RCC metastases to the adrenal and pancreas treated with SABR. Data on patient characteristics, therapies, toxicities, and outcomes were collected and analyzed. Outcome of patient with SABR-treated mRCC was compared between those with and without glandular metastasis.

Results

A total of 46 patients with a median follow-up of 20 months with mRCC were included with 36 adrenal and 19 pancreatic metastases treated with SABR with a median dose of 40 Gray (Gy) delivered in 5 treatments. One-year overall survival was 82.2%, progression-free survival was 48.2%, and local control was 95.9%. Acute grade 2 and 3 toxicity related to SABR was 7.4%. One patient experienced a grade 3 duodenal bleed as a result of pancreatic SABR, whereas 6.1% of patients experienced adrenal insufficiency with a median time to onset of 4 months following adrenal SABR.

Conclusions

SABR for RCC metastases to the pancreas and adrenal gland is feasible, safe, and effective at achieving high rates of local control with a small risk of duodenal injury and adrenal insufficiency, respectively. Oncological outcomes of patients with SABR-treated mRCC with glandular metastasis were comparable to those without glandular metastasis.

目的转移性肾细胞癌（mRCC）患者腺体转移的最佳治疗策略目前尚不清楚。虽然局部治疗可能有效，但缺乏立体定向消融体辐射（SABR）的数据，特别是考虑到在这些部位使用高剂量辐射可能造成十二指肠损伤和肾上腺功能不全的风险。方法和材料我们进行了一项机构审查委员会批准的单机构回顾性研究，研究对象是接受SABR治疗的肾细胞癌转移至肾上腺和胰腺的患者。收集和分析患者特征、治疗方法、毒性和结果的数据。sabr治疗的mRCC患者的预后与有无腺转移的患者进行比较。结果共纳入46例mRCC患者，中位随访时间为20个月，其中36例肾上腺转移灶和19例胰腺转移灶采用SABR治疗，5种治疗方案中位剂量为40 Gy。一年总生存率为82.2%，无进展生存率为48.2%，局部控制率为95.9%。与SABR相关的急性2级和3级毒性为7.4%。1例患者因胰腺SABR发生3级十二指肠出血，而6.1%的患者发生肾上腺功能不全，肾上腺SABR后发病的中位时间为4个月。结论ssabr治疗肾细胞癌转移至胰腺和肾上腺可行、安全、有效，局部控制率高，十二指肠损伤和肾上腺功能不全风险小。sabr治疗伴有腺转移的mRCC患者的肿瘤预后与没有腺转移的患者相当。

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引用次数: 0

Asymptomatic Bladder Stones Exacerbate Acute Genitourinary Adverse Events During Radiation Therapy for Prostate Cancer: Insights From Two Case Reports 无症状膀胱结石加重前列腺癌放射治疗期间急性泌尿生殖系统不良事件：来自两例报告的见解

IF 2.2 Q3 ONCOLOGY

Advances in Radiation Oncology

Pub Date : 2025-06-11 DOI: 10.1016/j.adro.2025.101833

Uchina Hiya MD , Masashi Endo MD , Kohei Okada MD, PhD , Satoru Takahashi MD , Kazunari Ogawa MD , Machi Nakagawa MD , Michiko Nakamura MD , Chiaki Shibayama MD, PhD , Yukiko Fukuda MD , Keiko Akahane MD, PhD , Masahiro Kawahara MD, PhD , Harushi Mori MD, PhD , Katsuyuki Shirai MD, PhD

引用次数: 0