Advances in Radiation Oncology最新文献_第8页

Inflammatory Markers Associated With Radiation-Induced Lung Injury, Metastasis and Mortality After Breast Cancer Treatment 乳腺癌治疗后与放射性肺损伤、转移和死亡率相关的炎症标志物

IF 2.7 Q3 ONCOLOGY

Advances in Radiation Oncology

Pub Date : 2025-08-28 DOI: 10.1016/j.adro.2025.101894

Jarle Karlsen MD , Guro Giskeødegård MSc, PhD , Torgrim Tandstad MD, PhD , Øyvind Salvesen MSc, PhD , Torgeir Wethal MD, PhD , Randi Johansen Reidunsdatter MSc, PhD

Purpose

Breast cancer (BC) radiation therapy (RT) prevents local recurrence and improves survival. However, it can induce acute and late effects on organs at risk, such as the lung. In some patients, radiation activates inflammatory markers, which promote inflammation in the lung leading to radiation pneumonitis and fibrosis (RF). Moreover, inflammatory markers may be associated with metastatic disease and survival. This study examines the relationships between inflammatory markers and clinical radiation pneumonitis and RF and explores their potential to predict BC metastasis or overall survival.

Methods and Materials

Patients prescribed postoperative BC RT were included in this prospective longitudinal cohort study with assessments before RT (baseline) and after 3, 6, and 12 months and at a long-term follow-up 7 to 12 years after RT. Inflammatory markers from each assessment were analyzed. BC metastasis and overall survival were registered up to 16 years after RT.

Results

Monocyte chemoattractant protein 1 at 3 months emerged as a predictor for clinical RF at 12 months. Tumor necrosis factor alpha at baseline and the change in fibroblast growth factor basic, neutrophil lymphocyte ratio, C-reactive protein, and interleukin (IL) 1b (IL-1b) from baseline to 3 months predicted BC metastasis. IL-6 at 3 and 12 months, IL-8 at 12 months, and an increase in fibroblast growth factor basic and IL-6 from baseline to 3 months were associated with all-cause mortality.

Conclusions

We found monocyte chemoattractant protein 1 linked to radiation-induced lung injury. Inflammatory markers before and after RT were associated with BC metastasis and all-cause mortality. Our findings indicate that prolonged inflammation following RT may be linked with BC metastasis and overall survival. However, further research is needed to understand their signaling pathways and their role in predicting BC outcomes.

目的乳腺癌（BC）放射治疗（RT）预防局部复发，提高生存率。然而，它会对有危险的器官（如肺）产生急性和晚期影响。在一些患者中，辐射激活炎症标志物，从而促进肺部炎症，导致放射性肺炎和纤维化（RF）。此外，炎症标志物可能与转移性疾病和生存有关。本研究探讨了炎症标志物与临床放射性肺炎和RF之间的关系，并探讨了它们预测BC转移或总生存的潜力。方法和材料在这项前瞻性纵向队列研究中纳入了接受术后BC RT治疗的患者，在RT前（基线）、3个月、6个月和12个月以及RT后7至12年的长期随访中进行评估。结果3个月时单核细胞趋化蛋白1可以作为12个月时临床RF的预测因子。基线时肿瘤坏死因子α和成纤维细胞生长因子碱性、中性粒细胞淋巴细胞比率、c反应蛋白和白细胞介素（IL） 1b （IL-1b）从基线到3个月的变化预测BC转移。3个月和12个月时的IL-6, 12个月时的IL-8，以及从基线到3个月时成纤维细胞生长因子基础和IL-6的增加与全因死亡率相关。结论单核细胞趋化蛋白1与放射性肺损伤有关。放疗前后的炎症标志物与BC转移和全因死亡率相关。我们的研究结果表明，RT后炎症的延长可能与BC转移和总生存率有关。然而，需要进一步的研究来了解它们的信号通路及其在预测BC预后中的作用。

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引用次数: 0

In Regard to McClure et al 关于麦克卢尔等人

IF 2.7 Q3 ONCOLOGY

Advances in Radiation Oncology

Pub Date : 2025-08-27 DOI: 10.1016/j.adro.2025.101884

Phillip M. Devlin MD, FASTRO , Anna Likhacheva MD , Gerald White MS

引用次数: 0

In Reply to Devlin et al 在回复Devlin等人

IF 2.7 Q3 ONCOLOGY

Advances in Radiation Oncology

Pub Date : 2025-08-27 DOI: 10.1016/j.adro.2025.101885

Erin McClure MD , Mairead Moloney DO , Yuxuan Jin MS , Lio Yu MD

引用次数: 0

Preoperative Stereotactic Radiosurgery for Brain Metastases: A Phase 1 Dose Escalation Study Demonstrating Reduced Leptomeningeal Disease 术前立体定向放射治疗脑转移瘤：1期剂量递增研究显示轻脑膜疾病减轻

IF 2.7 Q3 ONCOLOGY

Advances in Radiation Oncology

Pub Date : 2025-08-22 DOI: 10.1016/j.adro.2025.101882

John M. Hoyle MD , James M. Markert MD , Kristen O. Riley MD , Christopher D. Willey MD, PhD , Samuel R. Marcrom MD , Richard A. Popple PhD , Markus Bredel MD, PhD , John B. Fiveash MD

Purpose

Preoperative stereotactic radiosurgery (SRS) has been proposed as a strategy to reduce nodular leptomeningeal disease (nLMD) after resection of brain metastases by devitalizing tumor cells before surgical manipulation. This study aimed to determine the safety of preoperative SRS via a phase 1 dose escalation trial and compare outcomes—including nLMD, classical LMD, local control, and overall survival (OS)—between preoperative and postoperative treatment cohorts.

Methods and Materials

A phase 1 trial evaluated the safety of single-fraction preoperative SRS at escalating doses (12 and 15 Gy) in patients with tumors 2 to 6 cm. Adverse events were assessed per National Cancer Institute Common Terminology Criteria for Adverse Events v4.0, with dose-limiting toxicity (DLT) defined as high-grade neurologic or wound complications. Retrospective analysis included an expanded preoperative cohort (n = 95) and a historical postoperative cohort (n = 107). Outcomes were analyzed with Kaplan-Meier and Cox proportional hazards models.

Results

Fifteen Gy was well tolerated in the phase 1 cohort, with no DLTs in larger tumors (4-6 cm) and 3 DLTs in smaller tumors, not meeting thresholds for dose de-escalation. In the expanded analysis, preoperative SRS significantly reduced rates of nLMD (7.4% vs 27.1%, P = .002), while rates of classical LMD (4.2% vs 4.5%) and local failure (14.6% vs 18.7%) were similar between groups. OS was also similar (median 12.8 vs 12.3 months). Multivariable analysis confirmed preoperative SRS as protective against nLMD (hazard ratio = 0.18, 95% CI, 0.07-0.43, P < .001).

Conclusions

Preoperative SRS to 15 Gy is safe for tumors 2 to 6 cm and significantly reduces nLMD without compromising local control or OS. These findings support preoperative SRS as a viable treatment strategy and justify further investigation into optimal dosing and patient selection.

目的术前立体定向放射手术（SRS）被认为是一种通过在手术前激活肿瘤细胞来减少脑转移灶切除术后结节性轻脑膜病（nLMD）的策略。本研究旨在通过1期剂量递增试验确定术前SRS的安全性，并比较术前和术后治疗队列的结果，包括nLMD、经典LMD、局部控制和总生存期（OS）。方法和材料一项1期试验评估了肿瘤2 - 6 cm患者术前单组分SRS剂量递增（12 Gy和15 Gy）的安全性。不良事件按照美国国家癌症研究所不良事件通用术语标准v4.0进行评估，剂量限制性毒性（DLT）定义为高级神经或伤口并发症。回顾性分析包括扩大术前队列（n = 95）和术后历史队列（n = 107）。采用Kaplan-Meier和Cox比例风险模型对结果进行分析。结果在1期队列中，15 Gy耐受性良好，较大肿瘤（4-6 cm）中无dlt，较小肿瘤中有3例dlt，未达到剂量递减阈值。在扩展分析中，术前SRS显著降低了nLMD的发生率（7.4% vs 27.1%, P = 0.002），而经典LMD的发生率（4.2% vs 4.5%）和局部失败率（14.6% vs 18.7%）在两组之间相似。OS也相似（中位12.8个月vs 12.3个月）。多变量分析证实术前SRS对nLMD有保护作用（风险比= 0.18,95% CI, 0.07-0.43, P < 0.001）。结论15 Gy的SRS对2 ~ 6 cm的肿瘤是安全的，在不影响局部控制和OS的情况下可显著降低nLMD。这些发现支持术前SRS作为可行的治疗策略，并证明进一步研究最佳剂量和患者选择是合理的。

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引用次数: 0

Survival Benefit of Combined Chemoimmunotherapy and Radiation Therapy in Patients with Recurrent or Metastatic Esophageal Cancer 化疗与放疗联合治疗食管癌复发或转移患者的生存获益

IF 2.7 Q3 ONCOLOGY

Advances in Radiation Oncology

Pub Date : 2025-08-22 DOI: 10.1016/j.adro.2025.101890

Xueru Wang MD , Danyu Guo MD , Xiaoyang Li PhD , Yuan He PhD , Jieyong Tian MD , Dong Qian PhD , Jingjing Cheng PhD

Purpose

Chemotherapy combined with immune checkpoint inhibitors (ICIs) has become the standard first-line treatment for recurrent or metastatic esophageal cancer, but its efficacy remains suboptimal. This study aimed to evaluate whether the addition of radiation therapy (RT) to ICIs can improve patients’ survival.

Methods and Materials

This retrospective cohort study analyzed clinical data from 178 patients with recurrent or metastatic esophageal cancer who were treated at the First Affiliated Hospital of USTC between December 2019 and October 2023. Based on their actual treatment regimens, patients were stratified into 2 groups: the chemoimmunotherapy-alone group (ICIs group) and the chemoimmunotherapy combined with RT group (ICIs + RT group). To minimize selection bias, propensity score matching was used to balance baseline characteristics between the groups before comparative analysis. The primary endpoint was overall survival, and the secondary endpoints were progression-free survival and safety.

Results

After propensity score matching, 128 patients were selected for the final analysis, with 64 patients in the ICIs + RT group and 64 patients in the ICIs group. The median follow-up time was 11.26 months (95% CI, 7.02-15.32). The median overall survival was 23.71 months in the ICIs + RT group and 13.00 months in the ICIs group (hazard ratio, 0.53; 95% CI, 0.31-0.88; P = .013). The median progression-free survival was 10.43 months in the ICIs + RT group and 7.27 months in the ICIs group (hazard ratio, 0.61; 95% CI, 0.39-0.94; P = .024). Combination of chemoimmunotherapy and RT was safe and tolerable. No treatment-related deaths occurred in either group.

Conclusions

Adding RT can significantly improve survival in patients with recurrent or metastatic esophageal cancer who are treated with chemoimmunotherapy, but further prospective trials are needed for validation.

目的：血液疗法联合免疫检查点抑制剂（ICIs）已成为复发或转移性食管癌的标准一线治疗方法，但其疗效仍不理想。本研究旨在评估在ICIs基础上增加放射治疗（RT）是否能提高患者的生存率。方法与材料本回顾性队列研究分析了2019年12月至2023年10月在中国科学技术大学第一附属医院治疗的178例复发或转移性食管癌患者的临床资料。根据患者的实际治疗方案，将患者分为单独化疗免疫治疗组（ICIs组）和化疗免疫治疗联合RT组（ICIs + RT组）。为了尽量减少选择偏差，在比较分析之前，使用倾向评分匹配来平衡各组之间的基线特征。主要终点是总生存期，次要终点是无进展生存期和安全性。结果经倾向评分匹配后，最终选择128例患者进行分析，其中ICIs + RT组64例，ICIs组64例。中位随访时间为11.26个月（95% CI, 7.02-15.32）。ICIs + RT组的中位总生存期为23.71个月，ICIs组的中位总生存期为13.00个月（风险比0.53;95% CI, 0.31-0.88; P = 0.013）。ICIs + RT组的中位无进展生存期为10.43个月，ICIs组的中位无进展生存期为7.27个月（风险比为0.61;95% CI, 0.39-0.94; P = 0.024）。化疗免疫联合放疗安全、耐受。两组均未发生治疗相关死亡。结论放疗可显著提高食管癌复发或转移患者化疗免疫治疗的生存率，但需要进一步的前瞻性试验来验证。

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引用次数: 0

Implementation of Proton Radiation Treatment Exclusion Volume Because of Inconsistent Location of Breast Expander Titanium Port 扩胸器钛口位置不一致导致质子放射治疗排除容积的实现

IF 2.7 Q3 ONCOLOGY

Advances in Radiation Oncology

Pub Date : 2025-08-21 DOI: 10.1016/j.adro.2025.101876

Emily T. Tran BS , Patrick Newbury MD , Mark Newpower PhD , Heather Ortega CMD , Timothy D. Malouff MD , Christina Henson MD

引用次数: 0

Delayed Cutaneous Ecchymosis with Bruton’s Tyrosine Kinase Inhibitors and Breast Radiation: A Case Report 布鲁顿酪氨酸激酶抑制剂和乳房放疗的延迟性皮肤瘀斑：1例报告

IF 2.7 Q3 ONCOLOGY

Advances in Radiation Oncology

Pub Date : 2025-08-20 DOI: 10.1016/j.adro.2025.101878

Jinah Kim MD , Diego Adrianzen Herrera MD , Puyao C. Li MD

引用次数: 0

Physician Body-Site Expertise and Stereotactic Radiosurgery/Stereotactic Body Radiation Therapy Rounds Review 医师身体部位专业知识和立体定向放射外科/立体定向放射治疗查房综述

IF 2.7 Q3 ONCOLOGY

Advances in Radiation Oncology

Pub Date : 2025-08-20 DOI: 10.1016/j.adro.2025.101880

Elizabeth Covington PhD , Krithika Suresh PhD , Aleksandar Dragovic MD , Mary Feng MD , Jason Hearn MD , Reshma Jagsi MD, DPhil , Theodore Lawrence MD, PhD , Dawn Owen , Daniel Spratt MD , Kyle Cuneo MD , Scott W. Hadley PhD

Purpose

Contouring targets for stereotactic body radiation therapy (SBRT) requires expertise for each body site. Likewise, peer reviewers require sufficient expertise to provide an adequate review. In this work, we investigate physician self-reported expertise for performing peer review by body site and how the quality of SBRT peer review is impacted by the expertise of the reviewer.

Methods and Materials

The results of 7 years of SBRT rounds, which included information on body site, attending and reviewing physicians, changes to targets, prescriptions, and planning target volume, were analyzed. We surveyed physicians on their expertise for reviewing each body site and defined them as being an expert by body site if they indicated a moderate or high level of competence. Multivariable logistic regression models were used to assess the association between reviewing physician expertise and planning data changes, and whether this varied by body site or by presenting physician expertise. Models were adjusted for physician and case characteristics, and generalized estimating equations were used to account for the correlation of cases reviewed by the same physician.

Results

The survey response rate was 95% (20/21) with 4103 cases for analysis. Reviewing physician experts were more likely to make any change, gross target volume, and prescription compared with reviewing physicians who were nonexperts. Controlling for physician expertise and case characteristics, brain, liver, spine, and stereotactic radiosurgery cases have an increased odds of any change being made when compared to lung cases, with odds ratios of 2.42 (95% CI, 1.78-3.30), 1.55 (95% CI, 1.19-2.01), 1.7 (95% CI, 1.31-2.20), and 2.18 (95% CI, 1.73-2.77), respectively.

Conclusions

The extent to which changes are made during contour review is associated with both peer reviewer disease-site expertise and disease site. In larger radiation oncology departments relying on a general coverage model, rather than review by disease-site experts, peer review results in variations in the outcome of the preplanning review.

目的：立体定向全身放射治疗（SBRT）的二次巡诊目标需要每个身体部位的专业知识。同样，同行评审人员需要足够的专业知识来提供充分的评审。在这项工作中，我们调查了医生自我报告的同行评议的专业知识，以及评议者的专业知识如何影响SBRT同行评议的质量。方法与材料对7年SBRT轮次的结果进行分析，包括身体部位、就诊和复查医生、目标变更、处方和计划目标量等信息。我们调查了医生的专业知识，以审查每个身体部位，并将他们定义为身体部位的专家，如果他们表示中等或高水平的能力。使用多变量逻辑回归模型来评估回顾医生专业知识和计划数据变化之间的关系，以及这种关系是否因身体部位或医生专业知识而变化。根据医生和病例特征调整模型，并使用广义估计方程来解释由同一医生审查的病例的相关性。结果调查回复率为95%(20/21)，共分析4103例。与非专家医师相比，评估医师专家更有可能做出任何改变、总目标量和处方。在控制医生专业知识和病例特征的情况下，脑、肝、脊柱和立体定向放射手术病例与肺病例相比，发生任何改变的几率更高，比值比分别为2.42 （95% CI, 1.78-3.30）、1.55 （95% CI, 1.19-2.01）、1.7 （95% CI, 1.31-2.20）和2.18 （95% CI, 1.73-2.77）。结论轮廓线审评过程中改变的程度与审稿人疾病现场专业知识和疾病现场有关。在依靠一般覆盖模式的较大的放射肿瘤学部门，而不是由疾病现场专家进行审查，同行审查导致预先计划审查结果的变化。

{"title":"Physician Body-Site Expertise and Stereotactic Radiosurgery/Stereotactic Body Radiation Therapy Rounds Review","authors":"Elizabeth Covington PhD , Krithika Suresh PhD , Aleksandar Dragovic MD , Mary Feng MD , Jason Hearn MD , Reshma Jagsi MD, DPhil , Theodore Lawrence MD, PhD , Dawn Owen , Daniel Spratt MD , Kyle Cuneo MD , Scott W. Hadley PhD","doi":"10.1016/j.adro.2025.101880","DOIUrl":"10.1016/j.adro.2025.101880","url":null,"abstract":"<div><h3>Purpose</h3><div>Contouring targets for stereotactic body radiation therapy (SBRT) requires expertise for each body site. Likewise, peer reviewers require sufficient expertise to provide an adequate review. In this work, we investigate physician self-reported expertise for performing peer review by body site and how the quality of SBRT peer review is impacted by the expertise of the reviewer.</div></div><div><h3>Methods and Materials</h3><div>The results of 7 years of SBRT rounds, which included information on body site, attending and reviewing physicians, changes to targets, prescriptions, and planning target volume, were analyzed. We surveyed physicians on their expertise for reviewing each body site and defined them as being an expert by body site if they indicated a moderate or high level of competence. Multivariable logistic regression models were used to assess the association between reviewing physician expertise and planning data changes, and whether this varied by body site or by presenting physician expertise. Models were adjusted for physician and case characteristics, and generalized estimating equations were used to account for the correlation of cases reviewed by the same physician.</div></div><div><h3>Results</h3><div>The survey response rate was 95% (20/21) with 4103 cases for analysis. Reviewing physician experts were more likely to make any change, gross target volume, and prescription compared with reviewing physicians who were nonexperts. Controlling for physician expertise and case characteristics, brain, liver, spine, and stereotactic radiosurgery cases have an increased odds of any change being made when compared to lung cases, with odds ratios of 2.42 (95% CI, 1.78-3.30), 1.55 (95% CI, 1.19-2.01), 1.7 (95% CI, 1.31-2.20), and 2.18 (95% CI, 1.73-2.77), respectively.</div></div><div><h3>Conclusions</h3><div>The extent to which changes are made during contour review is associated with both peer reviewer disease-site expertise and disease site. In larger radiation oncology departments relying on a general coverage model, rather than review by disease-site experts, peer review results in variations in the outcome of the preplanning review.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 12","pages":"Article 101880"},"PeriodicalIF":2.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145412559","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

Functional Dose-Volume Analysis Based on a Novel Image Biomarker Derived From Dynamic Contrast-Enhanced Magnetic Resonance Imaging for Predicting Poststereotactic Body Radiation Therapy Liver Function Preservation in Patients With Hepatocellular Carcinoma 基于动态增强磁共振成像的新型图像生物标志物的功能剂量-体积分析预测肝癌患者立体定向放射治疗后肝功能保存

IF 2.7 Q3 ONCOLOGY

Advances in Radiation Oncology

Pub Date : 2025-08-19 DOI: 10.1016/j.adro.2025.101883

Yimin Ni MSc , Ho-Fun Victor Lee MD , Chi-leung Chiang MD , Lai-Yin Andy Cheung PhD , Zhengxing Huang PhD , Xinzhi Teng PhD , Jiang Zhang PhD , Ge Ren PhD , Jing Cai PhD , Tian Li PhD

Purpose

The purpose of this study is to identify functional dose-volume parameters based on image biomarker derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for predicting poststereotactic body radiation therapy (SBRT) liver function deterioration (LFD) in patients with hepatocellular carcinoma.

Methods and Materials

Forty-eight patients treated with SBRT were retrospectively included. All patients underwent gadoxetate-enhanced DCE-MRI before treatment. Equivalent uniform dose, absolute dose-volume parameters including Dxcc and VxGy(cc) were calculated in 3 liver volumes: the anatomic volume (AV), the high-functional volumes (HFV) defined based on DCE-MRI derived function map, and the low-functional volume (LFV = AV – HFV). The primary endpoint of this study was the LFD as indicated by ∆albumin-bilirubin ≥ 0.5 at 1-month post-SBRT. Dose-volume parameters in patients with and without LFD were compared. Univariate logistic regression models were built to assess the ability of dose-volume parameters to distinguish between LFD and non-LFD cases.

Results

Of the 48 patients, 12 (25%) had LFD (∆albumin-bilirubin ≥ 0.5). The dose-volume parameters in the AV and LFV were not statistically different in patients with and without LFD (P > .005), while D300cc, D400cc, and V10Gy(cc) of the HFV were significantly higher in patients with LFD than in the non-LFD group (P < .005). For distinguishing LFD and non-LFD cases, the mean area under curves (AUCs) for D300cc of AV, LFV, and HFV are 0.60, 0.50, and 0.78, respectively. The mean AUCs for D400cc of AV, LFV, and HFV are 0.62, 0.50, and 0.78, respectively. The mean AUCs for V10Gy of AV, LFV, and HFV are 0.63, 0.48, and 0.77, respectively.

Conclusions

The dose-volume parameters derived from HFV were linked to the risk of post-SBRT LFD. These functional parameters derived based on DCE-MRI could be useful to guide more personalized SBRT planning to protect liver function.

目的本研究的目的是确定基于动态对比增强磁共振成像（DCE-MRI）获得的图像生物标志物的功能剂量-体积参数，用于预测肝细胞癌患者立体定向放射治疗（SBRT）后肝功能恶化（LFD）。方法与材料回顾性分析48例接受SBRT治疗的患者。所有患者治疗前均行加多赛特增强DCE-MRI检查。计算等效均匀剂量、绝对剂量-体积参数Dxcc、VxGy(cc) 3个肝体积：解剖体积（AV）、基于DCE-MRI衍生功能图定义的高功能体积（HFV）、低功能体积（LFV = AV - HFV）。本研究的主要终点是sbrt后1个月时，以∆白蛋白-胆红素≥0.5表示的LFD。比较LFD患者和非LFD患者的剂量-体积参数。建立单变量逻辑回归模型来评估剂量-体积参数区分LFD和非LFD病例的能力。结果48例患者中，12例（25%）发生LFD（∆白蛋白-胆红素≥0.5）。肝功能不全组与无肝功能不全组间房颤、低房颤的剂量-体积参数差异无统计学意义（P < 0.005），肝功能不全组间房颤D300cc、D400cc、V10Gy（cc）显著高于无肝功能不全组（P < 0.005）。为了区分LFD和非LFD病例，AV、LFV和HFV的D300cc的平均曲线下面积（aus）分别为0.60、0.50和0.78。AV、LFV和HFV D400cc的平均auc分别为0.62、0.50和0.78。AV、LFV和HFV V10Gy的平均auc分别为0.63、0.48和0.77。结论HFV衍生的剂量-体积参数与sbrt后LFD的风险相关。这些基于DCE-MRI的功能参数可用于指导更个性化的SBRT计划以保护肝功能。

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引用次数: 0

Clinical Efficacy of Hydrogen Therapy on Acute Radiation Enteritis and Inflammatory Response in Patients with Cervical Cancer Undergoing Concurrent Chemoradiation Therapy 氢疗法治疗宫颈癌同步放化疗急性放射性肠炎的临床疗效及炎症反应

IF 2.7 Q3 ONCOLOGY

Advances in Radiation Oncology

Pub Date : 2025-08-19 DOI: 10.1016/j.adro.2025.101879

Bo Liu PhD , Yao Bao MD , Jinan Ma PhD , Xiaodong Wang PhD , Yeqian Feng PhD

Purpose

Acute radiation enteritis (ARE) is a common toxic inflammatory reaction in patients with cervical cancer undergoing concurrent chemoradiation therapy (CCRT). Molecular hydrogen, as a novel antioxidant and anti-inflammatory agent, may alleviate treatment-related toxicity. This study aimed to evaluate the efficacy of inhaled hydrogen in preventing ARE and modulating systemic inflammation.

Methods

Eligible patients with cervical cancer undergoing CCRT were prospectively enrolled and randomized into an experimental group (n = 28) or a control group (n = 30). The experimental group received inhalation therapy with a hydrogen-oxygen gas mixture (66.6% hydrogen, 33.3% oxygen; 3 L/min, 2 h/d) on each radiation therapy day. Inflammatory biomarkers—including C-reactive protein, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and interleukin 6—as well as hemogram parameters, fecal occult blood, Late Effects Normal Tissue Task Force—Subjective, Objective, Management, and Analytic scores; Patient-Generated Subjective Global Assessment scores; and Radiation Therapy Oncology Group enteritis grades were monitored during treatment and Response Evaluation Criteria in Solid Tumors scores.

Results

Baseline characteristics (age, tumor stage, pathology, and surgical history) were balanced between groups (P > .05). Compared with the control group, the experimental group showed significantly lower levels of C-reactive protein, neutrophil-to-lymphocyte ratio, interleukin 6, and fecal occult blood positivity rates (P < .05). Clinical assessments also indicated lower Late Effects Normal Tissue Task Force–Subjective, Objective, Management, and Analytic and Patient-Generated Subjective Global Assessment scores and milder Radiation Therapy Oncology Group enteritis grading in the hydrogen group (P < .05). Importantly, no significant difference in tumor response was observed between groups based on the Response Evaluation Criteria in Solid Tumors, suggesting that hydrogen therapy did not interfere with the antitumor efficacy of CCRT. No adverse events related to hydrogen inhalation were reported.

Conclusion

Hydrogen inhalation is a safe and effective adjunctive therapy that significantly alleviates inflammation and mitigates clinical symptoms of ARE in patients with cervical cancer who are undergoing CCRT, without compromising antitumor treatment outcomes.

目的急性放射性肠炎（acute radiation enteritis， ARE）是宫颈癌同步放化疗（CCRT）患者常见的中毒性炎症反应。氢分子作为一种新型抗氧化剂和抗炎剂，可能减轻治疗相关的毒性。本研究旨在评估吸入氢在预防ARE和调节全身炎症中的作用。方法前瞻性选择符合条件的宫颈癌行CCRT患者，随机分为实验组（n = 28）和对照组（n = 30）。实验组患者在每个放疗日采用氢氧混合气体（氢66.6%，氧33.3%,3 L/min, 2 h/d）吸入治疗。炎症生物标志物——包括c反应蛋白、中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值和白细胞介素6——以及血象参数、粪便隐血、后期效应正常组织任务组——主观、客观、管理和分析评分；患者主观整体评估评分；在治疗期间监测肠炎等级和实体瘤反应评价标准评分。结果两组患者的基线特征（年龄、肿瘤分期、病理、手术史）比较平衡（P > 0.05）。与对照组相比，实验组c反应蛋白水平、中性粒细胞与淋巴细胞比值、白细胞介素6水平和粪便隐血阳性率均显著降低（P < 0.05）。临床评估还显示，氢组的后期效应正常组织任务组主观、客观、管理、分析和患者主观整体评估评分较低，放射治疗肿瘤组肠炎评分较轻（P < 0.05）。重要的是，根据实体瘤反应评价标准，两组间肿瘤反应无显著差异，提示氢疗法不干扰CCRT的抗肿瘤疗效。没有与氢气吸入相关的不良事件报告。结论氢吸入是一种安全有效的辅助治疗方法，可显著减轻宫颈癌行CCRT患者急性急性呼吸道感染的炎症和临床症状，且不影响抗肿瘤治疗效果。

{"title":"Clinical Efficacy of Hydrogen Therapy on Acute Radiation Enteritis and Inflammatory Response in Patients with Cervical Cancer Undergoing Concurrent Chemoradiation Therapy","authors":"Bo Liu PhD , Yao Bao MD , Jinan Ma PhD , Xiaodong Wang PhD , Yeqian Feng PhD","doi":"10.1016/j.adro.2025.101879","DOIUrl":"10.1016/j.adro.2025.101879","url":null,"abstract":"<div><h3>Purpose</h3><div>Acute radiation enteritis (ARE) is a common toxic inflammatory reaction in patients with cervical cancer undergoing concurrent chemoradiation therapy (CCRT). Molecular hydrogen, as a novel antioxidant and anti-inflammatory agent, may alleviate treatment-related toxicity. This study aimed to evaluate the efficacy of inhaled hydrogen in preventing ARE and modulating systemic inflammation.</div></div><div><h3>Methods</h3><div>Eligible patients with cervical cancer undergoing CCRT were prospectively enrolled and randomized into an experimental group (n = 28) or a control group (n = 30). The experimental group received inhalation therapy with a hydrogen-oxygen gas mixture (66.6% hydrogen, 33.3% oxygen; 3 L/min, 2 h/d) on each radiation therapy day. Inflammatory biomarkers—including C-reactive protein, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and interleukin 6—as well as hemogram parameters, fecal occult blood, Late Effects Normal Tissue Task Force—Subjective, Objective, Management, and Analytic scores; Patient-Generated Subjective Global Assessment scores; and Radiation Therapy Oncology Group enteritis grades were monitored during treatment and Response Evaluation Criteria in Solid Tumors scores.</div></div><div><h3>Results</h3><div>Baseline characteristics (age, tumor stage, pathology, and surgical history) were balanced between groups (<em>P</em> > .05). Compared with the control group, the experimental group showed significantly lower levels of C-reactive protein, neutrophil-to-lymphocyte ratio, interleukin 6, and fecal occult blood positivity rates (<em>P</em> < .05). Clinical assessments also indicated lower Late Effects Normal Tissue Task Force–Subjective, Objective, Management, and Analytic and Patient-Generated Subjective Global Assessment scores and milder Radiation Therapy Oncology Group enteritis grading in the hydrogen group (<em>P</em> < .05). Importantly, no significant difference in tumor response was observed between groups based on the Response Evaluation Criteria in Solid Tumors, suggesting that hydrogen therapy did not interfere with the antitumor efficacy of CCRT. No adverse events related to hydrogen inhalation were reported.</div></div><div><h3>Conclusion</h3><div>Hydrogen inhalation is a safe and effective adjunctive therapy that significantly alleviates inflammation and mitigates clinical symptoms of ARE in patients with cervical cancer who are undergoing CCRT, without compromising antitumor treatment outcomes.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 11","pages":"Article 101879"},"PeriodicalIF":2.7,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145107380","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