Cancer Radiotherapie最新文献

{"title":"Long-term cardiac mortality in patients treated with radiation for gastric mucosa-associated lymphoid tissue lymphoma","authors":"Pierre Loap,&nbsp;Youlia Kirova","doi":"10.1016/j.canrad.2025.104588","DOIUrl":"10.1016/j.canrad.2025.104588","url":null,"abstract":"<div><h3>Purpose</h3><div>Limited-stage gastric mucosa-associated lymphoid tissue (MALT) lymphoma can be treated with radiation alone. Due to the immediate proximity of the stomach to the heart, there is a theoretical risk of radiation-induced cardiac toxicity, the incidence of which has never been precisely studied. The aim of this study was to assess cardiac-specific mortality in patients treated for gastric MALT lymphoma with radiation.</div></div><div><h3>Method</h3><div>This cohort study included all patients treated in the USA between 2000 and 2020 with radiation for gastric MALT lymphoma and whose clinical data were available in the Surveillance, Epidemiology and End Result database (17 registries). The primary endpoint was cardiac-specific survival. Assessed clinical variables were age, sex, race, stage of disease, type of treatment received and cause of death.</div></div><div><h3>Results</h3><div>A total of 1863 patients treated for MALT lymphoma with radiation were analysed. At 10<!--> <!-->years, cardiac-specific survival was 0.924 (95 % confidence interval [CI]: 0.906–0.942) and cancer-specific survival was 0.931 (95 %CI: 0.915–0.947), while non-cardiac/cancer-specific survival was 0.778 (95 %CI: 0.753–0.804). Cardiac-specific mortality was significantly higher in patients aged over 60<!--> <!-->years (hazard ratio [HR]: 9.07; <em>P</em> <!-->=<!--> <!-->0.002) and in cases of additional chemotherapy (HR: 1.83; <em>P</em> <!-->=<!--> <!-->0.017).</div></div><div><h3>Conclusion</h3><div>Cardiac mortality in patients treated with radiation for gastric MALT lymphoma represents a minor contribution compared with other causes of death. As new radiotherapy protocols should further minimize the risk of cardiac toxicity, and given the curability of this type of lymphoma, improving overall survival should also focus on the multidisciplinary management of comorbidities.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 1","pages":"Article 104588"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between radiotherapy and risk of secondary primary malignancies in patients with esophageal cancer: A population-based study utilizing 17 Surveillance, Epidemiology, and End Results cancer registries","authors":"Wenjie Li,&nbsp;Wei Wang","doi":"10.1016/j.canrad.2024.07.020","DOIUrl":"10.1016/j.canrad.2024.07.020","url":null,"abstract":"<div><h3>Purpose</h3><div>Despite the frequent use of radiotherapy as a standard treatment for esophageal cancer, the potential risk of developing second primary malignancies as a result of radiation-related side effects remains underinvestigated.</div></div><div><h3>Methods</h3><div>We conducted a comprehensive analysis using data from the large cohort of 17 cancer registries within the Surveillance, Epidemiology, and End Results (SEER) database. To estimate the incidence of second primary malignancies associated with radiotherapy, we employed Poisson regression and competing risk regression models.</div></div><div><h3>Results</h3><div>A total of 54,844 patients diagnosed with esophageal cancer were identified from the SEER database. Among them, 8351 patients did not receive radiotherapy, while 15,555 patients were treated with radiation. The incidence of second primary malignancies among patients who had radiotherapy was 6.28 % (977 patients) compared to an incidence of 7.09 % (592 patients) for those who had not (<em>P</em> <!-->&lt;<!--> <!-->0.0001). After adjusting for potential confounders, such as age, gender, year of diagnosis, tumor grade, and chemotherapy, the incidence rates of patients who received radiotherapy were significantly higher compared to those who had not (odds ratio [OR] _Poisson _regression <!-->=<!--> <!-->1.18, 95 % confidence interval [CI]: 1.05–1.32, <em>P</em> <!-->=<!--> <!-->0.018; OR _{multivariable} _competing _risk _regression <!-->=<!--> <!-->1.15, 95 %CI: 1.04–1.26, <em>P</em> <!-->=<!--> <!-->0.018). Notably, patients who received radiotherapy were found to be at an increased risk of developing lung cancer, breast cancer, and gastric cancer. Additionally, younger patients with esophageal cancer appeared to be more susceptible, with the highest risk of developing subsequent primary malignancies observed more than 10 years after the esophageal cancer diagnosis.</div></div><div><h3>Conclusion</h3><div>Our findings indicated that radiotherapy for esophageal cancer was associated with an increased risk of developing overall cancer. It is crucial to address and mitigate the risk of second primary malignancies associated with radiotherapy, while also improving the prognosis for patients affected by these secondary malignancies.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 1","pages":"Article 104587"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring treatment complexity in maxillary ameloblastoma: A case study on the efficacy of radiotherapy with transcriptomic and literature insights","authors":"Léa Marxgut ,&nbsp;Philippe Fourneret ,&nbsp;Waisse Waissi","doi":"10.1016/j.canrad.2025.104591","DOIUrl":"10.1016/j.canrad.2025.104591","url":null,"abstract":"<div><div>In this report, we describe the case of a patient initially experiencing symptoms including nasal obstruction and rhinorrhoea, leading to surgeries and a diagnosis of ameloblastoma. Despite complete surgical resections, MRI follow-ups indicated tumour regrowth, prompting a shift to radiotherapy. The treatment plan involved a high-dose (60<!--> <!-->Gy in 30 fractions of 2<!--> <!-->Gy) volumetric modulated arc therapy. During treatment, the patient experienced minimal side effects and showed significant clinical improvement, including tumour size reduction and resolution of facial paralysis. Follow-up MRI confirmed shrinkage of the tumour, with some persistent symptoms like diplopia. To better understand the radiosensitivity of ameloblastomas, transcriptomic analysis highlighted the potential of a radiosensitivity index to predict treatment response, indicating ameloblastomas exhibit higher radiosensitivity compared to odontogenic keratocysts. Finally, literature analysis showed a small number of cases with wide range of radiation dose. In conclusion, the case illustrates the complex diagnostic journey of ameloblastomas and underscores the efficacy of radiotherapy for inoperable cases, and the importance of predictive biomarkers to enhance treatment outcomes.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 1","pages":"Article 104591"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cyberneo trial investigating the efficacy of stereotactic radiotherapy combined to neoadjuvant chemotherapy for locally advanced breast cancer: 14-years follow-up results","authors":"Syrine Ben Dhia ,&nbsp;Renaud Schiappa ,&nbsp;Jocelyn Gal ,&nbsp;Jean-Marc Ferrero ,&nbsp;Philippe Bahadoran ,&nbsp;Claire Chapellier ,&nbsp;Pierre-Yves Bondiau","doi":"10.1016/j.canrad.2025.104592","DOIUrl":"10.1016/j.canrad.2025.104592","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of the phase I trial named “Cyberneo” was to define the efficacy of the stereotactic radiotherapy using CyberKnife® for locally advanced (stage III) breast tumours combined to a neoadjuvant chemotherapy for patients for whom a conservative surgery could not be considered at the onset. Neoadjuvant chemotherapy consisted of six cycles: three cycles of docetaxel and three cycles of the combination of 5-fluorouracil, epirubicin and cyclophosphamide. Stereotactic radiotherapy using CyberKnife® was performed during the second cycle of chemotherapy. Breast surgery was performed 6 to 8 weeks later and conventional breast irradiation without boost, afterwards. The main objective was to define the maximum tolerated dose of hypofractionated radiotherapy concurrent with neoadjuvant chemotherapy. We present an updated survival data for patients included in this trial and we evaluate the late toxicity of this combination.</div></div><div><h3>Patients and methods</h3><div>We updated the survival data of 25 patients treated for a stage III breast cancer between 2007 and 2009 at the Antoine-Lacassagne centre in Nice and included in the Cyberneo trial by recording late toxicity events and aesthetic results.</div></div><div><h3>Results</h3><div>With a median follow-up of 12 years (95 % confidence interval [CI]: 10–14 years), 19 patients were in remission (76 %), one patient had a controlled axillary lymph node relapse (4 %) and five patients (20 %) died due to metastatic progression within a median of 5 years after treatment (range: 1–9 years). Nine patients had a complete histological response (36 %). The highest percentage of complete histological response was in the group of patients treated in the fourth stage (28.5<!--> <!-->Gy in four fractions). Overall survival rate at 14 years was 71 % (95 % CI: [53–94 %]). Two patients developed chronic radiation toxicity during follow-up with a fibrosis (8 %) of which one was in the fourth stage and one in the fifth stage (31.5<!--> <!-->Gy). Three patients (12 %) had a change of prosthesis after treatment, which for one patient was 24 months after the end of support.</div></div><div><h3>Conclusion</h3><div>The updated results of the Cyberneo trial with 14 years of follow-up confirm the satisfactory results in terms of local control with an excellent long-term safety profile.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 1","pages":"Article 104592"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does prior radiotherapy impact the acute cellular liver graft rejection?","authors":"Julien Pierrard ,&nbsp;Maxime Foguenne ,&nbsp;Pamela Baldin ,&nbsp;Eliano Bonaccorsi-Riani ,&nbsp;Laurent Coubeau ,&nbsp;Olga Ciccarelli ,&nbsp;Géraldine Dahlqvist ,&nbsp;Bénédicte Delire ,&nbsp;Geneviève Van Ooteghem","doi":"10.1016/j.canrad.2025.104590","DOIUrl":"10.1016/j.canrad.2025.104590","url":null,"abstract":"<div><h3>Purpose</h3><div>Radiotherapy can be used as a bridge therapy prior to liver transplantation. Radiotherapy generates immune reactions involving T cells, which are the main effectors of acute cellular rejection after transplantation. Here, we investigated the impact of radiotherapy on acute cellular rejection.</div></div><div><h3>Materials and methods</h3><div>We retrospectively reviewed the data of oncological patients who benefited from liver transplantation. Patients who received radiotherapy prior to liver transplantation (“RT cohort”, <em>n</em> <!-->=<!--> <!-->17) were compared to a matched cohort (“NoRT_matched cohort”, <em>n</em> <!-->=<!--> <!-->17) obtained through propensity score-matching analysis of the total non-irradiated cohort (“NoRT_all” cohort, <em>n</em> <!-->=<!--> <!-->136). The acute cellular rejection was evaluated using the Banff score for rejection (mild:<!--> <!-->&lt;<!--> <!-->5, moderate: 5–6, and severe: 7–9) obtained on an early post-transplantation biopsy. Overall and disease-free survival were reported for patients with hepatocellular carcinoma.</div></div><div><h3>Results</h3><div>Median Banff scores was significantly lower for the RT cohort compared to the NoRT_all cohort (2.5 versus 5, respectively, <em>P</em> <!-->=<!--> <!-->0.043) but this statistical difference was eliminated after comparison with the NoRT_matched cohort (median: 4, <em>P</em> <!-->=<!--> <!-->0.62). The 5-year overall and disease-free survival rates were 62 % and 69 %, respectively, for hepatocellular carcinoma patients of the RT cohort (<em>n</em> <!-->=<!--> <!-->14) and did not differ from the 5-year overall (83 %, <em>P</em> <!-->=<!--> <!-->0.15) and disease-free survival rates (90 %, <em>P</em> <!-->=<!--> <!-->0.05) of those of the NoRT_matched cohort (<em>n</em> <!-->=<!--> <!-->16).</div></div><div><h3>Conclusion</h3><div>Radiotherapy given prior to liver transplantation did not impact the rate or severity of acute cellular rejection. Furthermore, overall and disease-free survival rates were not impacted by radiotherapy.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 1","pages":"Article 104590"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dose comparison between hybrid volumetric modulated arc therapy, volumetric modulated arc therapy, and three-dimensional conformal radiotherapy for breast/chest wall irradiation, including regional lymph node irradiation using deep inspiration breath-hold technique","authors":"Zainab Alsaihaty ,&nbsp;Wamied Abdel-Rahman ,&nbsp;Karunakaran Balaji ,&nbsp;Mashaal Alkhaldi ,&nbsp;Abdulraouf Alghufaili ,&nbsp;Shama Alghadban ,&nbsp;Hala El Lathy ,&nbsp;Hanani Abdul Manan ,&nbsp;Akmal Sabarudin ,&nbsp;Noorazrul Yahya","doi":"10.1016/j.canrad.2025.104589","DOIUrl":"10.1016/j.canrad.2025.104589","url":null,"abstract":"<div><h3>Purpose</h3><div>Breast radiation treatment has been linked to complications such as pneumonitis and cardiac toxicity, necessitating dose optimization. This study aims to determine the optimal integration plan of volumetric modulated arc therapy (VMAT) and three-dimensional conformal radiotherapy (3DCRT) in a deep inspiration breath-hold regimen.</div></div><div><h3>Materials and methods</h3><div>CT imaging data from twenty patients with breast or chest wall cancer, either right or left-sided, and with supraclavicular and internal mammary chain lymph nodes were retrieved. The CT data planned with a hybrid VMAT of three different weighting proportions: 30 % using 3DCRT and 70 % using VMAT, 50 % using 3DCRT and 50 % using VMAT, and 70% using 3DCRT and 30 % using VMAT and compared with full 3DCRT and full VMAT plan (classic and five arc design).</div></div><div><h3>Results</h3><div>The homogeneity and conformity indices were better in the hybrid VMAT plans than in plans using VMAT or 3DCRT alone (<em>P</em> <!-->&lt;<!--> <!-->0.005). Results of all hybrid VMAT plans showed a considerable drop of volumes receiving more than 4<!--> <!-->Gy, 8<!--> <!-->Gy or 16<!--> <!-->Gy in the ipsilateral lung compared to the full VMAT plan (<em>P</em> <!-->&lt;<!--> <!-->0.001). There was a noticeable decrease in the mean dose to the heart and the dose in 5% of the contralateral breast in the plan using 70 % 3DCRT and 30 % VMAT compared to full VMAT (<em>P</em> <!-->&lt;<!--> <!-->0.001). The plan using 70 % 3DCRT and 30% VMAT achieved a balance between the target and surrounding areas, compared to using only 3DCRT or VMAT.</div></div><div><h3>Conclusion</h3><div>A hybrid plan using 70 % 3DCRT contribution achieved a balanced outcome for breast or chest wall irradiation, considering both planning target volume and organs at risk. Utilizing our VMAT arc design, incorporating one shortened arc can significantly reduce doses to organs at risk further. It is important to consider the patient's anatomy when making this decision.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 1","pages":"Article 104589"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cone-beam CT radiomics for early response assessment in liver stereotactic body radiation therapy: Results of a pilot study","authors":"Jingjing Shan ,&nbsp;Pengfei Yang ,&nbsp;Eric Yen ,&nbsp;Qinxuan Zhou ,&nbsp;Benxing Gu ,&nbsp;Xuyun Xie ,&nbsp;Jing Wang ,&nbsp;Tianye Niu ,&nbsp;Xiaonan Sun","doi":"10.1016/j.canrad.2024.05.010","DOIUrl":"10.1016/j.canrad.2024.05.010","url":null,"abstract":"<div><h3>Purpose</h3><div>The objective of the study was to assess the correlation between radiomics features extracted from cone-beam CT with the treatment response of liver tumors treated with stereotactic body radiation.</div></div><div><h3>Material and methods</h3><div>The planning CT and cone-beam CT were prospectively collected for 76 patients with liver cancer who received five fractions of stereotactic body radiation therapy. Pearson correlation test was used to identify interchangeable radiomics features between cone-beam- and planning CT from a total of 547 extracted radiomics features. Principal components analysis was used for cone-beam CT delta radiomics to characterize therapy-induced tumor change. The Mann-Whitney U-test was used to identify features with correlation to treatment response: local efficacy versus local non-efficacy; complete versus partial response in both raw and principal components analysis-based cone-beam CT radiomics features. The area under the receiver operating characteristic curve was used for assessing feature performance.</div></div><div><h3>Results</h3><div>A total of 345 cone-beam CT radiomics features were interchangeable with planning CT. The mean value of LHH_GLSZM_LGZE showed an ascending trend in five fractions during the course of treatment. Among these features, PCA3_LHH_Histogram_Energy showed the best performance in predicting local efficacy, with an AUC of 0.879 (0.744–1.00, 95 % CI). For identifying complete response from partial response, CBCT2_LHL_GLSZM_GLV showed the best value, with the highest AUC of 0.884 (0.773–1.00, 95 % CI).</div></div><div><h3>Conclusion</h3><div>Radiomics features extracted from cone-beam CT images have the potential for assessing the response to treatment in advance and can serve as an early biomarker for liver tumor stereotactic body radiation therapy.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 1","pages":"Article 104586"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tolérance à court et moyen terme d’une radiothérapie prostatique hypofractionnée selon la technique du boost intégré","authors":"Laurène Larrivière ,&nbsp;Stephane Supiot ,&nbsp;Astrid Thomin ,&nbsp;Simon Jan ,&nbsp;Sofia Bakkar ,&nbsp;Gilles Calais","doi":"10.1016/j.canrad.2024.04.004","DOIUrl":"10.1016/j.canrad.2024.04.004","url":null,"abstract":"<div><h3>Purpose</h3><div>This retrospective study was conducted to ensure that irradiation of the pelvic lymph node areas associated with simultaneous hypofractionated boost to the prostate according to the protocol implemented at the university hospital of Tours (France) does not result in excess urinary and digestive toxicity in the short and medium term.</div></div><div><h3>Materials and methods</h3><div>The study population included patients with localized unfavourable intermediate or high-risk prostate cancer. The dose delivered was 65<!--> <!-->Gy in 25 fractions of 2.6<!--> <!-->Gy to the prostate and seminal vesicles, and 50<!--> <!-->Gy in 25 fractions of 2<!--> <!-->Gy to the pelvic lymph nodes. Acute toxicit<strong>y</strong> events (between the start of radiotherapy and the first follow-up consultation) and medium-term toxicity events (after the first follow-up consultation) were assessed using the CTCAE version 5.0 classification.</div></div><div><h3>Results</h3><div>Sixty-three patients were treated according to the protocol between January 1st, 2020, and October 31st, 2022. The majority of them had high-risk prostate cancer (79%). The median follow-up was 15 months. Very few patients reported grade 3–4 toxicity acutely (6% urinary and 0% digestive toxicity) or in the medium term (7% urinary and 0% and digestive toxicity).</div></div><div><h3>Conclusion</h3><div>Radiotherapy of pelvic lymph node areas with simultaneous hypofractionated boost to the prostate is feasible, with low rates of severe acute and medium-term toxicit<strong>y</strong>.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"28 8","pages":"Pages 640-649"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oncological outcomes of patients with muscle-invasive bladder cancer treated with trimodal strategy: A French multicentric study","authors":"Carolinne Brassart ,&nbsp;Alexandre Coutte ,&nbsp;Jennifer Wallet ,&nbsp;Emmanuel Meyer ,&nbsp;Ahmed Benyoucef ,&nbsp;Hajer Mnif ,&nbsp;Vincent Kowalski ,&nbsp;Maël Barthoulot ,&nbsp;David Pasquier","doi":"10.1016/j.canrad.2024.05.005","DOIUrl":"10.1016/j.canrad.2024.05.005","url":null,"abstract":"<div><h3>Purpose</h3><div>Trimodal therapy, an organ-sparing alternative, may be proposed for selected patients with muscle-invasive bladder cancer instead of radical cystectomy. In this multicentre retrospective study, we aimed to assess the oncological outcomes of patients who had trimodal therapy for a muscle-invasive bladder cancer.</div></div><div><h3>Materials and methods</h3><div>Seventy-three patients from four centres treated who had trimodal therapy (maximal transurethral resection of bladder tumour and concomitant chemoradiotherapy) for localized muscle-invasive bladder cancer were included. Patients meeting the optimal trimodal therapy eligibility criteria as per the European Association of Urology guidelines were identified. Overall survival, recurrence-free survival and cancer-specific survival were assessed using the Kaplan–Meier method. The cumulative incidence of recurrence was estimated using the Kalbfleisch–Prentice method.</div></div><div><h3>Results</h3><div>Median overall survival was 27.0 months (95 % confidence interval [CI]: 20.3–58.3 months), 5-years overall-, cancer-specific- and recurrence-free survival rates were 37.5% (95 % CI: 25.5–49.5 %), 60 % (95 % CI: 48.3–72.0 %), and 17.9 % (95 % CI: 9.3–28.8 %), respectively. There was no significant difference in 5-year overall survival and recurrence-free survival between the trimodal therapy-eligible and non-eligible patients (hazard ratio [HR]: 1.38, <em>P</em> <!-->=<!--> <!-->0.30 and HR: 0.96, <em>P</em> <!-->=<!--> <!-->0.90, respectively). The univariate analysis did not reveal any significant prognostic factors associated with recurrence-free or overall survival.</div></div><div><h3>Conclusion</h3><div>Trimodal therapy offers encouraging specific survival, the prognosis remains poor. Our study highlights the low number and high frailty of patients to whom trimodal therapy is offered in clinical practice.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"28 8","pages":"Pages 657-666"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142694021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Permanent alopecia after radiotherapy of primary brain tumours: The most influential factors","authors":"Simin Badiei Moghaddam,&nbsp;Afshin Rakhsha,&nbsp;Zahra Siavashpour","doi":"10.1016/j.canrad.2024.05.003","DOIUrl":"10.1016/j.canrad.2024.05.003","url":null,"abstract":"<div><h3>Purpose</h3><div>Alopecia is a distressing side effect of radiotherapy in patients undergoing treatment for primary brain tumours. This study aimed to investigate the most influential clinical, demographic, and dosimetric factors associated with permanent scalp alopecia in patients with brain tumours treated with intensity-modulated radiations.</div></div><div><h3>Patients and methods</h3><div>Eighty patients with brain tumors treated with intensity-modulated radiations were enrolled. Inclusion criteria were having a primary brain tumour and patients with at least 18 months of radiotherapy. Scalp alopecia was evaluated using the Common Terminology Criteria for Adverse Events (CTCAE) v5.0. The scalp location with hair loss was marked and delineated on their follow-up MRI, and the planning dosimetric parameters, including D_0.1cm³ (as maximum dose), mean dose, and various volumetric parameters such as V_16Gy-43Gy (with about 5<!--> <!-->Gy interval) were recorded. In addition, receiver operating characteristic (ROC) curve analysis was employed to identify predictive parameters for chronic alopecia.</div></div><div><h3>Results</h3><div>The hair loss severity was grade 1 for 70 % of cases, and grade 2 for 30 %. Male gender, history of chemotherapy, and family history of hair loss were significantly associated with increased volume of hair loss follicles. The correlation and ROC analysis revealed that regions receiving doses of 30<!--> <!-->Gy or higher (i.e., V_30Gy) were associated with a higher risk of developing grade 2 alopecia. The resulting areas under the curve of 0.694 were indicators for moderate correlations between the considered dose–volume histogram parameters and patients’ permanent alopecia. Even if these results were not statistically significant, these findings suggest that specific dosimetric parameters, such as V_30Gy to V_43Gy, maybe the strongest predictors of grade 2 chronic radiation-induced alopecia. The cut-off values were also about 13.5 to 8 cm³ for V_30Gy to V_43Gy, respectively, which can be played as an indicator of the dose–volume histogram threshold above which permanent alopecia will be expected after brain intensity-modulated radiotherapy.</div></div><div><h3>Conclusion</h3><div>The incidence of permanent alopecia after intensity-modulated radiotherapy is influenced by demographic, dosimetric, and clinical factors such as gender, history of chemotherapy, and family history, and the skull follicle regions receiving doses of 30<!--> <!-->Gy or higher.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"28 8","pages":"Pages 650-656"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142694026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}