Cancer Radiotherapie最新文献

{"title":"Dosimetric comparison of advanced radiotherapy planning techniques for hippocampal sparing whole brain radiotherapy","authors":"Öznur Şenkesen ,&nbsp;Emine Burçin Ispir ,&nbsp;Evren Ozan Göksel ,&nbsp;Yücel Akdeniz","doi":"10.1016/j.canrad.2025.104643","DOIUrl":"10.1016/j.canrad.2025.104643","url":null,"abstract":"<div><h3>Purpose</h3><div>Hippocampal-sparing whole-brain radiotherapy aims to reduce neurocognitive decline in patients receiving cranial irradiation. Advances in radiotherapy planning systems offer improved sparing of organs at risk while maintaining target coverage. This study compared the dosimetric performance of five planning techniques for hippocampal-sparing whole-brain radiotherapy: Radixact with 1<!--> <!-->cm and 2.5<!--> <!-->cm field widths, Ethos, HyperArc, and volumetric modulated arctherapy using advanced optimization algorithms.</div></div><div><h3>Materials and methods</h3><div>Eleven patients who underwent whole brain irradiation were included in this retrospective planning study. The prescribed dose was 30<!--> <!-->Gy in 12 fractions, with hippocampus dose constraints of D98 %<!--> <!-->≤<!--> <!-->9<!--> <!-->Gy and D2 %<!--> <!-->≤<!--> <!-->17<!--> <!-->Gy. Radixact plans were created using the VOLO™ Ultra optimizer with normal tissue objective parameters for dose fall-off control. Ethos plans were generated using an intelligent optimization engine with automated planning. HyperArc employed four non-coplanar arcs with SRS normal tissue objective optimization, while volumetric modulated arctherapy utilized six arcs. Dosimetric parameters, including planning target volume coverage, hippocampal doses, and organs at risk constraints, were analyzed using one-way ANOVA.</div></div><div><h3>Results</h3><div>Radixact with 1<!--> <!-->cm field width achieved the lowest hippocampal doses, whereas HyperArc and volumetric modulated arctherapy provided superior planning target volume coverage. Ethos resulted in the lowest doses to organs at risk, while HyperArc had the shortest treatment duration. Statistically significant differences (<em>P</em> <!-->&lt;<!--> <!-->0.05) were observed across techniques for hippocampal D98 %, D2 %, and sparing of organs at risk.</div></div><div><h3>Conclusion</h3><div>Advanced planning techniques offer distinct dosimetric advantages for hippocampal-sparing whole-brain radiotherapy. Radixact with 1<!--> <!-->cm field width optimally spares the hippocampus, while HyperArc and volumetric modulated arctherapy balance sparing of organs at risk with shorter treatment times. Selection of an optimal planning approach should consider both dosimetric outcomes and clinical workflow efficiency.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 3","pages":"Article 104643"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089401","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":"Evolution of radiation oncology training in France: Over 20 years of the role of the Société Française des Jeunes Radiothérapeutes Oncologues (SFjRO, the French society of young radiation oncologists)","authors":"Audrey Larnaudie ,&nbsp;Youssef Ghannam ,&nbsp;Yasmine El Houat ,&nbsp;Morgan Michalet ,&nbsp;Florence Huguet ,&nbsp;Alizée Camps-Maléa ,&nbsp;Jean-Christophe Faivre ,&nbsp;Yoann Pointreau ,&nbsp;Thomas Leroy ,&nbsp;Alexandre Escande ,&nbsp;Paul Lesueur ,&nbsp;Sebastien Thureau ,&nbsp;Charles Raynaud ,&nbsp;Igor Latorzeff ,&nbsp;Xavier Liem ,&nbsp;Pierre Blanchard ,&nbsp;Sofia Rivera ,&nbsp;Jean-Emmanuel Bibault ,&nbsp;Alain Tolédano ,&nbsp;Guillaume Janoray ,&nbsp;Luc Ollivier","doi":"10.1016/j.canrad.2025.104620","DOIUrl":"10.1016/j.canrad.2025.104620","url":null,"abstract":"<div><div>The Société française des jeunes radiothérapeutes oncologues (SFjRO, French Society of Young Radiation Oncologists) was founded in 2001 with three main objectives: to represent French residents in radiation oncology, to provide training and to promote research. Initially, the board consisted of only three members but has since expanded to over ten. Since its inception, the SFjRO has organized national in-person courses, which have evolved into projects aimed at standardizing training throughout the country. These national courses are now a compulsory part of residency for all radiation oncology residents in France. In terms of representation, the SFjRO has organized cross-sectional studies and meetings to provide up-to-date information on career development, well-being, and academic training, in order to help young radiation oncologists make informed decisions. The SFjRO represents French radiation oncology residents in various societies such as the Société française de radiothérapie oncologique (SFRO, French Society of Radiation Oncologists), the Intersyndicale nationale des internes (ISNI, National Union of French Residents) or the Collège National des Enseignants en Cancérologie (Cnec, National Council of Oncology Teachers). The society's involvement in research has been strengthened through partnerships with national and international organizations, providing numerous opportunities for young residents. This article outlines both the major evolutions over time and the role of the SFjRO in representing residents, training and promoting research for young radiation oncologists.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 2","pages":"Article 104620"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887116","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":"Exposure to the immune system during bridging radiotherapy for Car-T cells","authors":"Pierre Loap ,&nbsp;Justine Decroocq ,&nbsp;Rudy Birsen ,&nbsp;Natacha Johnson ,&nbsp;Didier Bouscary ,&nbsp;Youlia Kirova","doi":"10.1016/j.canrad.2025.104595","DOIUrl":"10.1016/j.canrad.2025.104595","url":null,"abstract":"<div><h3>Purpose</h3><div>The objective of this study was to quantify how much dose from bridging radiotherapy is being delivered to non-lymphoma immune cells.</div></div><div><h3>Material and methods</h3><div>All patients who underwent bridging radiotherapy between January 2023 and April 2024 at the institut Curie (Paris, France) surrounding the infusion of chimeric antigen receptor (Car)-T cells, were identified. The effective dose to the immune cells was calculated for each of them.</div></div><div><h3>Results</h3><div>Nine patients were included, with a mean follow-up time of 6<!--> <!-->months; one patient experienced a recurrence. No grade 2+ toxicity was reported. Median effective dose to the immune cells was 0.56<!--> <!-->Gy (range: 0.039–2.72<!--> <!-->Gy) and varied between patients. The main contribution came from the integral dose (0.43<!--> <!-->Gy, range: 0.039–1.42<!--> <!-->Gy).</div></div><div><h3>Conclusions</h3><div>The doses received by the immune system when undergoing bridging radiotherapy for Car-T cells can vary considerably from one patient to another, and the integral dose represents the primary part of this exposure of the immune system. Prospective solid data is needed in this context to evaluate the role of choice of radiotherapy techniques in bridging radiotherapy.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 2","pages":"Article 104595"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143847333","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":"Analysis of radiological lung changes after stereotactic body radiation therapy","authors":"Victoria Navarro Aznar ,&nbsp;Maria M. Puertas Valiño ,&nbsp;Luis H. Ros Mendoza","doi":"10.1016/j.canrad.2025.104594","DOIUrl":"10.1016/j.canrad.2025.104594","url":null,"abstract":"<div><h3>Purpose</h3><div>Stereotactic body radiation therapy is indicated in cases of early inoperable lung cancer and surgical rejection, and it is also an option for oligometastatic, recurrent, and/or relapsing tumours. The aim of this study was to analyse the incidence of different patterns of radiological changes on CT scans, correlate their occurrence with risk factors, and analyse the usefulness of imaging information to predict treatment outcome in terms of local progression-free survival.</div></div><div><h3>Materials and methods</h3><div>A retrospective review was carried out on the data from 104 patients who received lung stereotactic body radiation therapy between 2014 and 2022. A first check-up visit was carried out a month after treatment. Visits were then performed every 3 to 4<!--> <!-->months during the first year, with imaging tests (CT or PET), and every 4 to 6<!--> <!-->months after the first year. Acute radiological changes were defined as those occurring in the first 6<!--> <!-->months and chronic radiological changes as those occurring starting from 6<!--> <!-->months onwards following treatment.</div></div><div><h3>Results</h3><div>Acute radiological changes were detected in 44.44 % of the patients, with up to 86 % of them appearing chronically. The modified conventional fibrosis pattern was the most prevalent. Having received lung thoracic radiotherapy and irradiation of tumours located in peripheral regions significantly increases the likelihood of chronic radiological changes appearing. Fifteen patients underwent further tests such as a PET scan for suspected local progression after the appearance of chronic changes, of which 11 were positive. No association was identified between the occurrence of either acute or chronic radiological changes with worsened survival or a higher percentage of local progression.</div></div><div><h3>Conclusions</h3><div>Proper knowledge of the different patterns of radiological changes secondary to lung stereotactic body radiation therapy and their dynamics over time is necessary to discern between a benign pathology and progression.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 2","pages":"Article 104594"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143847334","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":"Successful identification and management of a stroke-like migraine attacks after radiation therapy syndrome occurring 36 years after cranial irradiation","authors":"Louisien Lebrun ,&nbsp;Dario Di Perri ,&nbsp;Vincent Marneffe ,&nbsp;Jean-Marc Raymackers","doi":"10.1016/j.canrad.2025.104618","DOIUrl":"10.1016/j.canrad.2025.104618","url":null,"abstract":"<div><div>Stroke-like migraine attacks after radiation therapy syndrome is a rare, late-onset neurological disorder observed in patients with a history of cranial radiation therapy. It presents with stroke-like symptoms, including hemiparesis, hemianopsia, seizures, and migraines, often occurring years or decades post-therapy. We report a case of stroke-like migraine attacks after radiation therapy syndrome in a 51-year-old male, manifesting 36 years after treatment for oligodendroglioma with whole-brain irradiation. The patient developed sudden worsening of left hemiparesis, focal seizures, and bilateral frontotemporal headaches. Brain MRI revealed hyperintensity on T2 fluid-attenuated inversion recovery sequence and gyral enhancement in the right parieto-occipital cortex. The patient responded favourably to a 5-day course of steroid pulse therapy (1000<!--> <!-->mg/day), with significant clinical improvement and resolution of MRI abnormalities. This case highlights one of the longest documented latencies for stroke-like migraine attacks after radiation therapy syndrome and emphasizes the importance of considering this diagnosis in patients after irradiation, even after extended latency periods, to prevent misdiagnosis and inappropriate treatment.</div></div><div><div>Le syndrome « stroke-like migraine attacks after radiation therapy » est un trouble neurologique rare, d’apparition tardive chez les patients ayant un antécédent d’irradiation cérébrale. Il comprend des symptômes de pseudo accident vasculaire cérébral, incluant l’hémiparésie, l’hémianopsie mais aussi des crises d’épilepsie et de migraines, se déclenchant des années voire des décennies après le traitement. Nous présentons un cas de syndrome <em>stroke-like migraine attacks after radiation therap</em>y chez un homme de 51 ans, apparu 36 ans après une irradiation cérébrale pour un oligodendrogliome. Le patient a vu se développer une aggravation subite d’une hémiparésie, des crises focales et des céphalées bilatérales frontotemporales. L’IRM cérébrale a montré une hyperintensité en séquence T2 <em>fluid-attenuated inversion recovery</em> et un rehaussement gyral dans le cortex pariéto-occipital droit. Le syndrome a favorablement répondu à un traitement de 5<!--> <!-->jours de corticoïdes (1000<!--> <!-->mg par jour), avec une amélioration clinique substantielle et la résolution des anomalies de l’IRM. Cela met en avant l’un des cas documentés les plus tardifs de syndrome <em>stroke-like migraine attacks after radiation therapy</em> et insiste sur l’importance de penser à ce diagnostic chez les patients ayant bénéficié d’une radiothérapie, et ce, même après de longues périodes de latence, pour éviter un mauvais diagnostic et un traitement inapproprié.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 2","pages":"Article 104618"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143847335","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":"Long-term outcomes of radiotherapy and impact of nodal disease burden in clinically node-positive prostate cancer","authors":"Tony Felefly ,&nbsp;Alborz Jooya ,&nbsp;Selena Laprade ,&nbsp;Soumyajit Roy ,&nbsp;Shawn Malone ,&nbsp;Scott C. Morgan","doi":"10.1016/j.canrad.2025.104619","DOIUrl":"10.1016/j.canrad.2025.104619","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;The optimal management for pelvic clinical node-positive (cN1) prostate cancer remains controversial and randomized evidence for local therapy is lacking. Recent data suggest that common-iliac nodal metastases might carry a prognosis similar to that of cN1 disease when treated radically. In this context, we retrospectively reviewed the experience at our centre of treating cN1 prostate cancer, with or without common-iliac nodal metastases, focusing on the role of radiotherapy and the effect of nodal disease burden on survival.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and methods&lt;/h3&gt;&lt;div&gt;The study population consisted of men diagnosed with prostate cancer between 2002 and 2018 with cN1 disease and/or common-iliac nodal metastases and treated with androgen deprivation therapy and/or definitive local therapy. Outcomes of interest included overall survival and castration resistance-free survival, which were estimated using the Kaplan-Meier method. Univariable and multivariable Cox regression were used to identify factors associated with overall – and castration resistance-free survival. In the subgroup of patients treated with radiation, the association between a number of variables – including biologically effective dose to the prostate, use of elective pelvic nodal radiotherapy, and escalated dose (radiotherapy boost) to positive nodes–and overall survival was studied.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 87 patients were included, of whom 14 had common-iliac nodal metastases and 68 received radiotherapy. Median follow-up was 110 months. On univariate analysis, radiotherapy was associated with improved overall survival (hazard ratio [HR]: 0.28, 95 % confidence interval [CI]: 0.14–0.55, &lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.0005) and castration resistance-free survival (HR: 0.22, 95 % CI: 0.12–0.41, &lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.0005). Median overall survival in those patients receiving radiotherapy was 134.9 versus 63.1 months in those not receiving radiotherapy. Receipt of radiotherapy remained significantly associated with overall survival on multivariable analysis (HR: 0.13, 95 % CI: 0.05–0.32, &lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.001). Biopsy Gleason score 10 and presence of more than two positive lymph nodes were associated with worse overall survival while presence of common-iliac nodal metastases was not found to have any significant association with overall survival. In patients treated with radiation, increasing the biologically effective dose to the prostate was associated with improved overall survival (HR: 0.73 per 10&lt;!--&gt; &lt;!--&gt;Gy, 95 % CI: 0.54–0.97, &lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.03) while use of elective pelvic nodal radiotherapy and use of a radiotherapy boost to positive nodes had no significant association with overall survival.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;In this cohort, we evaluate the impact of radiotherapy in pelvic clinical node-positive prostate cancer that includes common-iliac nodal metastase","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 2","pages":"Article 104619"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864970","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":"Ultra hypofractionated breast radiotherapy according to the Fast-Forward scheme: Excellent early tolerance or delayed skin reactions? Real life experience","authors":"Jihane Bouziane,&nbsp;Pierre Loap,&nbsp;Sofiane Allali,&nbsp;Kim Cao,&nbsp;Alain Fourquet,&nbsp;Youlia Kirova","doi":"10.1016/j.canrad.2025.104612","DOIUrl":"10.1016/j.canrad.2025.104612","url":null,"abstract":"<div><h3>Purpose</h3><div>Over the past three decades, the fractionation of radiotherapy for breast cancer has evolved, with a trend towards hypofractionated regimens. The Fast-Forward trial evaluated a radiotherapy protocol in five daily fractions, offering a potentially effective and more convenient alternative to conventional regimens. The primary objective of our study was to evaluate acute skin reactions in patients receiving hypofractionated adjuvant radiotherapy for breast cancer according to the Fast-Forward protocol, along with their time to onset.</div></div><div><h3>Materials and methods</h3><div>This retrospective single-centre study was conducted at the institut Curie, including all patients treated for early breast cancer with radiotherapy according to the Fast-Forward regimen (26<!--> <!-->Gy in five daily fractions). Follow-up was performed by clinical examinations and mammography; skin toxicity was assessed according to CTCAE v.5 criteria.</div></div><div><h3>Results</h3><div>Between December 2014 and December 2022, 255 patients were treated according to the Fast-Forward regimen. The median age of patients was 76 years. Of these, 93.7 % had invasive carcinomas, and 93.3 % had tumours staged T1 or T2. Treatments were performed in supine position for 46.3 % of patients and in isocentric lateral decubitus position for 53.7 %. Acute radiodermatitis was observed in 35 patients (13.7 %) mainly grade 1, and 4 patients (1.6 %) had grade 2 radiodermatitis. Acute radiodermatitis occurred after a mean period of 1.6 months. Delayed toxicity events were noted in 24 patients (9.4 %), including oedema, persistent skin pigmentation, and breast fibrosis, 1.2 % of which were grade 2. No acute or delayed toxicity of grade 3 or higher was reported.</div></div><div><h3>Conclusion</h3><div>The efficacy and good tolerance of the adjuvant breast irradiation regimen of 26<!--> <!-->Gy in five fractions has already been proven. Monitoring of this homogeneous group of patients highlighted the possibility of delayed acute skin reactions. Further consultation during treatment seems necessary to diagnose and treat these reactions.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 2","pages":"Article 104612"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143847331","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":"Radiation toxicity and survival in patients with interstitial lung disease and non-small cell lung cancer: A case control study","authors":"Aurélien Justet ,&nbsp;Léonard Jackson ,&nbsp;Matthieu Bardon ,&nbsp;Delphine Lerouge ,&nbsp;Mathieu Césaire ,&nbsp;Cédric Loiseau ,&nbsp;Emmanuel Bergot ,&nbsp;François Christy ,&nbsp;Juliette Thariat","doi":"10.1016/j.canrad.2025.104622","DOIUrl":"10.1016/j.canrad.2025.104622","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;Lung cancers associated with interstitial lung disease are challenging to diagnose and manage. We investigated the prevalence of interstitial lung disease among consecutively irradiated cancer patients, and the tolerance and prognosis of patients with or without interstitial lung disease after thoracic radiotherapy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Material and methods&lt;/h3&gt;&lt;div&gt;This bicentric study was designed as a case-control study of patients with interstitial lung disease prior to radiotherapy (cases) and controls without interstitial lung disease. Patients were irradiated with curative intent for localized, locally advanced or oligometastatic non-small cell lung cancer. Consecutive lung cancer patients undergoing curative radiotherapy between January 2018 and December 2020 had centralized review of their baseline and 6-month CT scans by a multidisciplinary board. Functional evaluation, radiological scores, clinical toxicities, best objective response, progression-free survival and overall survival were assessed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Twelve cases were detected out of 166 patients (7.2 %), including six diagnosed a posteriori by central review (50 %). Initial patient, tumour and lung cancer treatment characteristics were similar between cases and controls except for performance status (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.004), Kazerooni scores of fibrosis and ground glass patterns (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.001). Cases and controls underwent three-dimensional radiotherapy in 0 and 37 (24.2 %), intensity-modulated radiotherapy in eight (66.7 %) and 60 (39.2 %), stereotactic body radiotherapy in four (33.3 %) and 56 (36.6 %), respectively (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.079). Grade&lt;!--&gt; &lt;!--&gt;≥&lt;!--&gt; &lt;!--&gt;2 pneumonitis occurred in 41.7 % of cases versus 11 %, of controls (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.01). Hospitalization rates were 16 % in cases versus 2 % in controls and one case died of lung toxicity. Best objective response was worse for cases (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.046). Median progression-free survival was 9.35 months for cases and 18.56 months for controls. Median overall survival was 17 months for cases and not reached for controls (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.002). Sex, tumour stage, histology, and interstitial pulmonary fibrosis were prognostic factors for overall survival on univariate analysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Interstitial lung disease was present in 7 % of the patients with lung cancer. Patients with interstitial lung disease had higher risks of toxicity events and poorer prognosis, suggesting the lungs should be assessed carefully and that specific management strategies are warranted.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectif de l’étude&lt;/h3&gt;&lt;div&gt;Les cancers pulmonaires associés aux maladies pulmonaires interstitielles sont de diagnostic et prise en charge difficiles. Nous avons étudié la prévalence des cancers pulmonaires associés aux maladies pulmonaires interstitielles parmi les pa","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 2","pages":"Article 104622"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143885959","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":"Artificial intelligence based on imaging data to predict rectal cancer recurrence: A meta-analysis","authors":"Xiaoling Xu ,&nbsp;Weiqun Ao ,&nbsp;Jian Wang","doi":"10.1016/j.canrad.2025.104617","DOIUrl":"10.1016/j.canrad.2025.104617","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study was to evaluate the diagnostic performance of artificial intelligence based on imaging data to predict rectal cancer recurrence using a meta-analysis system.</div></div><div><h3>Materials and methods</h3><div>Medline, Embase, Cochrane Library, Web of Science, and other databases were searched for all articles on artificial intelligence prediction of rectal cancer recurrence based on imaging data published publicly from the establishment of the library to December 31, 2023. The quality of the articles was assessed using Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). Meta-analysis was performed by the software Revman 5.4 and Statistics data (Stata), and sensitivity analysis was used to detect potential sources of heterogeneity and test to assess the presence of publication bias. We evaluated how well imaging-based data can predict recurrence in patients with rectal cancer by analysing the pooled sensitivity, specificity, and area under the curve.</div></div><div><h3>Results</h3><div>Ten studies were included. The pooled sensitivity, specificity, and area under the curve of imaging-based data for recurrence in patients with rectal cancer were respectively 0.84 (95 % confidence interval [CI]: 0.74–0.91), 0.87 (95 % CI: 0.82–0.91) and 0.92 (95 % CI: 0.89–0.94). Based on QUADAS-2, the quality of the article is acceptable. We found the causes of heterogeneity through meta-regression: recurrence time predesign Lasso. Based on Deeks’ funnel plot, no publication bias was detected.</div></div><div><h3>Conclusion</h3><div>Artificial intelligence based on imaging data has a high predictive ability for rectal cancer recurrence.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 2","pages":"Article 104617"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143847330","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":"Prognostic significance of different lymph node staging systems in patients with resectable, node-positive, stage III, non-small cell lung cancer: Identifying the optimal classification for enhanced prognostic stratification","authors":"Yingjun Zhou ,&nbsp;Pan Xiao ,&nbsp;Yunhua Li ,&nbsp;Haibo Liu ,&nbsp;Dengke Jiang ,&nbsp;Zhifeng Shuai","doi":"10.1016/j.canrad.2025.104611","DOIUrl":"10.1016/j.canrad.2025.104611","url":null,"abstract":"<div><h3>Purpose</h3><div>The traditional N staging system fails to adequately stratify the prognostic heterogeneity in patients with resectable node-positive, stage III, non-small cell lung cancer, particularly in those undergoing postoperative radiotherapy. The purpose of this study was to determine the optimal nodal status classification strategy: the traditional N classification, the positive lymph nodes-based classification, or the lymph node ratio-based classification. Furthermore, we aimed to identify the population that would benefit the most from postoperative radiotherapy using the best classification strategy.</div></div><div><h3>Methods</h3><div>We analysed data from 5028 patients with resectable node-positive, stage III, non-small cell lung cancer sourced from the Surveillance, Epidemiology, and End Results (SEER) database. Various lymph node staging systems, including traditional N staging, classification based on the number of positive lymph nodes, and classification based on the lymph node ratio, were incorporated into the prognostic prediction model. Survival outcomes were evaluated using lung cancer-specific survival and Kaplan-Meier analysis.</div></div><div><h3>Results</h3><div>The lymph node ratio classification model demonstrated the highest prognostic prediction performance, with the highest C-index, area under the curve, and the lowest Akaike information criterion, followed by the positive lymph nodes classification model and the traditional N staging model. Prognostic stratification analysis based on different lymph node staging systems indicated that a lymph node ratio greater than 0.28 and more than three positive lymph nodes were associated with a high-risk prognosis. Furthermore, postoperative radiotherapy significantly improved lung cancer-specific survival in overall resectable node-positive, stage III, non-small cell lung cancer (<em>P</em> <!-->&lt;<!--> <!-->0.05). Notably, survival curve analysis revealed the most pronounced differences in lung cancer-specific survival between the groups receiving postoperative radiotherapy or not in the high-risk prognosis group, particularly among those with a lymph node ratio greater than 0.28, and more than three positive lymph nodes, and lastly the traditional N staging model.</div></div><div><h3>Conclusion</h3><div>In patients with resectable node-positive, stage III, non-small cell lung cancer, classification according to the lymph node ratio, followed by the positive lymph nodes, may offer superior prognostic prediction capabilities compared to the traditional N staging in addressing prognostic heterogeneity. Additionally, identifying a high-risk prognosis with a lymph node ratio greater than 0.28 appears to be the most effective criterion for selecting candidates who would benefit from postoperative radiotherapy.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 2","pages":"Article 104611"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143847332","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}