Advances in Radiation Oncology最新文献_第9页

Radiation Dose Overlay Improves Radiologists' Interpretation of Post-therapy Computed Tomography Imaging for Thoracic Malignancies 放射剂量叠加改善放射科医生对胸部恶性肿瘤治疗后计算机断层成像的解释

IF 2.7 Q3 ONCOLOGY

Advances in Radiation Oncology

Pub Date : 2025-09-13 DOI: 10.1016/j.adro.2025.101899

Kira R. Newell BA , Zoe O. Ferguson-Steele BA , David Shin BA , Min Gyu Noh MD , Sudhakar Pipavath MD , Joseph Tsai MD, PhD , Kristi Hendrickson PhD , Tyler Gutschenritter MD , John Kang MD, PhD

Purpose

Radiation therapy dose visualizations created by radiation oncologists are not accessible to diagnostic radiologists; however, access may improve interpretation accuracy and confidence when applied to surveillance imaging of patients with radiation therapy-treated thoracic malignancies.

Methods and Materials

In a prospective analysis of retrospectively acquired data, 32 imaging series of patients treated with radiation therapy for thoracic malignancies (14 men, 18 women; mean age, 71 years ± SD 10.35 years) were interpreted. One cardiothoracic radiology attending and 1 radiology resident interpreted pretreatment, treatment planning, and posttreatment computed tomography (CT) images in anonymized software sessions first without, then—after a 1 month “washout period”—with access to radiation therapy dose overlays. Readers then labeled treated lesion(s) and treatment effect(s) and recorded their confidence using a Likert scale (1-5) and agreement with yes/no statements. Binary data were analyzed with McNemar’s and Fisher’s tests, whereas Likert scale data were analyzed with paired 2-sided t tests.

Results

With the addition of radiation dose visualization, the identification of all treated lesions increased from 61% to 81% of CT series (P < .001). This was most pronounced in CT series with multiple treated lesions (15%-54% of CT series, P = .004). Confidence in identification ability also increased from a rating of 4.1 to 4.8 on a scale of 1 to 5 (P < .001), and the desire to access the chart for additional patient information decreased from 3.63 to 3.28 (P = .005).

Conclusions

Access to radiation dose visualization was associated with increased correct identification rate of irradiated lesions and treatment effects, as well as radiologists' confidence in said identifications.

目的放射肿瘤学家制作的放射治疗剂量可视化对诊断放射科医生来说是不可用的；然而，当应用于放射治疗的胸部恶性肿瘤患者的监测成像时，可提高解释的准确性和信心。方法和材料回顾性分析32例胸部恶性肿瘤放射治疗患者的影像学资料（男性14例，女性18例，平均年龄71岁±SD 10.35岁）。一名心胸放射科主治医师和一名放射科住院医师在匿名软件会议中解释了预处理、治疗计划和治疗后的计算机断层扫描（CT）图像，首先没有，然后经过一个月的“洗脱期”，可以获得放射治疗剂量叠加。然后，读者标记治疗的病变和治疗效果，并使用李克特量表（1-5）记录他们的信心和对是/否陈述的同意度。二元数据采用McNemar 's和Fisher 's检验，李克特量表数据采用配对双侧t检验。结果随着放射剂量显示的增加，所有病灶的CT序列识别率从61%提高到81% （P < .001）。这在多发病灶的CT系列中最为明显（占CT系列的15%-54%，P = 0.004）。在1到5的范围内，对识别能力的信心也从4.1等级增加到4.8等级（P < 0.001），并且访问图表以获取额外患者信息的愿望从3.63下降到3.28 （P = 0.005）。结论放射剂量可视化可提高放射病灶的正确识别率和治疗效果，提高放射科医师对放射病灶识别的信心。

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引用次数: 0

Development and Validation of the Augsburg Nasopharyngeal Applicator: Enhancing Efficacy in Nasal Route Brachytherapy Augsburg鼻咽涂布器的开发和验证：提高鼻路近距离治疗的疗效

IF 2.7 Q3 ONCOLOGY

Advances in Radiation Oncology

Pub Date : 2025-08-30 DOI: 10.1016/j.adro.2025.101896

Jerome Jean-Joseph MSc , Christoph Westerhausen PhD , Johannes Doescher MD , Bruno Maerkl MD , Zoha Roushan MSc , Maria Neu MD , Tilman Janzen PhD , Klaus-Henning Kahl MD , Georg Stueben MD , Nikolaos Balagiannis MD

Purpose

This study evaluates the Augsburg Nasopharyngeal Applicator (ANA), a novel nasal brachytherapy device designed for early-stage nasopharyngeal carcinoma (T1–T2 stages). ANA leverages nasal anatomy to overcome limitations of oral applicators, optimizing tumor targeting while sparing adjacent tissues, such as the soft palate and oral mucosa.

Methods and Materials

ANA was developed using sagittal computed tomography-based anatomic measurements and computer-aided design modeling. Structural integrity was validated through nonlinear finite-element analysis, mechanical stress testing (including Euler buckling tests), and displacement testing (30 min vibration at 5 Hz with 2 cm amplitude). Dosimetry was verified using radiochromic film with 3%/3 mm gamma analysis criteria, following the TG-43 formalism for dose calculation. Insertion feasibility was assessed in a postmortem model under institutional autopsy protocols.

Results

ANA (with nylon 6/6 catheter) withstood displacements up to 30 mm without failure. Simulated motion tests demonstrated positional stability (<1 mm displacement). Dosimetry achieved a 97.5% gamma pass rate (clinical acceptability threshold: 95%), with the 20 mm curvature configuration reducing soft palate doses by >50% compared to standard oral applicators (eg, Rotterdam design). Postmortem insertion was completed in 10 min, with endoscopic confirmation of positioning accuracy within 1 mm.

Conclusions

ANA demonstrates precise positioning, mechanical stability under simulated physiologic motion (<1 mm displacement), and clinically significant dose sparing (>50% reduction to the soft palate with the 20 mm curvature configuration). Its nasal approach and anatomic adaptability position it as a promising alternative to oral applicators. These proof-of-concept findings support the need for phase 1/2 clinical trials to evaluate safety and efficacy in patients.

目的：本研究对早期鼻咽癌（T1-T2期）的新型鼻近距离治疗装置——Augsburg鼻咽插管器（ANA）进行评价。ANA利用鼻腔解剖克服口腔涂抹器的局限性，优化肿瘤靶向，同时保留邻近组织，如软腭和口腔黏膜。方法和材料采用基于矢状位计算机层析成像的解剖测量和计算机辅助设计建模。通过非线性有限元分析、机械应力测试（包括欧拉屈曲测试）和位移测试（5 Hz、2 cm振幅、30 min振动）验证了结构的完整性。使用放射致色膜进行剂量测定，采用3%/ 3mm伽马分析标准，剂量计算遵循TG-43公式。根据机构尸检协议，在死后模型中评估插入可行性。结果ana（尼龙6/6导管）可承受30 mm的位移而无故障。模拟运动测试显示位置稳定性（<；1毫米位移）。剂量学达到了97.5%的伽玛及格率（临床可接受阈值：95%），与标准口腔涂布器（例如鹿特丹设计）相比，20mm曲率配置使软腭剂量减少了50%。死后插入在10分钟内完成，内窥镜确认定位精度在1mm以内。结论sana具有精确的定位，模拟生理运动下的机械稳定性（位移1mm），以及临床上显著的剂量节约（20mm曲率配置下软腭减少50%）。其鼻入路和解剖适应性使其成为口腔应用器的一个有前途的替代品。这些概念验证结果支持需要进行1/2期临床试验来评估患者的安全性和有效性。

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引用次数: 0

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。

{"title":"Preoperative Stereotactic Radiosurgery for Brain Metastases: A Phase 1 Dose Escalation Study Demonstrating Reduced Leptomeningeal Disease","authors":"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","doi":"10.1016/j.adro.2025.101882","DOIUrl":"10.1016/j.adro.2025.101882","url":null,"abstract":"<div><h3>Purpose</h3><div>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.</div></div><div><h3>Methods and Materials</h3><div>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.</div></div><div><h3>Results</h3><div>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%, <em>P</em> = .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, <em>P</em> < .001).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 11","pages":"Article 101882"},"PeriodicalIF":2.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145262945","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

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。

{"title":"Survival Benefit of Combined Chemoimmunotherapy and Radiation Therapy in Patients with Recurrent or Metastatic Esophageal Cancer","authors":"Xueru Wang MD , Danyu Guo MD , Xiaoyang Li PhD , Yuan He PhD , Jieyong Tian MD , Dong Qian PhD , Jingjing Cheng PhD","doi":"10.1016/j.adro.2025.101890","DOIUrl":"10.1016/j.adro.2025.101890","url":null,"abstract":"<div><h3>Purpose</h3><div>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.</div></div><div><h3>Methods and Materials</h3><div>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.</div></div><div><h3>Results</h3><div>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; <em>P</em> = .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; <em>P</em> = .024). Combination of chemoimmunotherapy and RT was safe and tolerable. No treatment-related deaths occurred in either group.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":7390,"journal":{"name":"Advances in Radiation Oncology","volume":"10 11","pages":"Article 101890"},"PeriodicalIF":2.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118951","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

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