Pub Date : 2025-09-16DOI: 10.1016/j.canrad.2025.104725
Cyrus Chargari , Anne Ducassou , Camille Roukoz , François Lucia , Adeline Petit , Abel Cordoba , Caroline Lafond , Sophie Renard , Alexandre Escande
Primary vaginal cancers are rare tumours, for which external beam radiotherapy and brachytherapy are major treatment tools. Given the complexity of brachytherapy techniques, the treatment should be performed in specialised centres. We present the 2025 update of recommendations of the Société française de radiothérapie oncologique on the indications and techniques for external beam radiotherapy and brachytherapy for primary vaginal cancer.
{"title":"Role of radiotherapy in the treatment of primary vaginal cancer: Recommendations of the Société française de radiothérapie oncologique, 2025 update","authors":"Cyrus Chargari , Anne Ducassou , Camille Roukoz , François Lucia , Adeline Petit , Abel Cordoba , Caroline Lafond , Sophie Renard , Alexandre Escande","doi":"10.1016/j.canrad.2025.104725","DOIUrl":"10.1016/j.canrad.2025.104725","url":null,"abstract":"<div><div>Primary vaginal cancers are rare tumours, for which external beam radiotherapy and brachytherapy are major treatment tools. Given the complexity of brachytherapy techniques, the treatment should be performed in specialised centres. We present the 2025 update of recommendations of the Société française de radiothérapie oncologique on the indications and techniques for external beam radiotherapy and brachytherapy for primary vaginal cancer.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 7","pages":"Article 104725"},"PeriodicalIF":1.4,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082731","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}
Pub Date : 2025-09-16DOI: 10.1016/j.canrad.2025.104726
Cyrus Chargari , Sophie Renard , Marie-Adélaïde Ossedat , Abel Cordoba , François Lucia , Adeline Petit , Sylvain Demontoy , Isabelle Flandin , Caroline Lafond , Anne Ducassou , Alexandre Escande
Primary vulvar carcinomas are rare gynaecological cancers, for which surgery is the mainstay of treatment. There is however a major place for external beam radiotherapy in the situation of inoperable locally advanced tumours and/or as adjuvant therapy, when there are risk factors for locoregional relapse. We present the 2025 update of recommendations from the Société française de radiothérapie oncologique on the indications and techniques for radiotherapy in the treatment of primary vulvar cancer.
{"title":"Role of radiotherapy in the management of vulvar cancer: Recommendations of the Société française de radiothérapie oncologique, 2025 update","authors":"Cyrus Chargari , Sophie Renard , Marie-Adélaïde Ossedat , Abel Cordoba , François Lucia , Adeline Petit , Sylvain Demontoy , Isabelle Flandin , Caroline Lafond , Anne Ducassou , Alexandre Escande","doi":"10.1016/j.canrad.2025.104726","DOIUrl":"10.1016/j.canrad.2025.104726","url":null,"abstract":"<div><div>Primary vulvar carcinomas are rare gynaecological cancers, for which surgery is the mainstay of treatment. There is however a major place for external beam radiotherapy in the situation of inoperable locally advanced tumours and/or as adjuvant therapy, when there are risk factors for locoregional relapse. We present the 2025 update of recommendations from the Société française de radiothérapie oncologique on the indications and techniques for radiotherapy in the treatment of primary vulvar cancer.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 7","pages":"Article 104726"},"PeriodicalIF":1.4,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082065","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}
Cervical lymphadenopathy of unknown primary tumour is a rare entity. In this situation, exhaustive diagnostic procedures are essential, including a comprehensive clinical examination, complete imaging, multiples biopsies and molecular testing. Localized disease cT0N1/N2a or low volumes N2b negative for Epstein-Barr virus can be treated either by surgery alone or unilateral neck radiation. For tumours N2b or above, either bilateral radiotherapy is proposed or chemoradiotherapy with cisplatin. Intensity-modulated radiotherapy is the standard technique of irradiation for the management of cervical lymphadenopathies of unknown primary origin. Dose regimens for postoperative or exclusive radiotherapy are detailed in this article, as well as the selection of prophylactic tumour and lymph node target volumes.
{"title":"Management of cervical lymphadenopathies of unknown primary cancer","authors":"Xavier Musset , Idriss Troussier , Nolwenn Delaby , Pierre Blanchard , Yoann Pointreau , Sébastien Thureau","doi":"10.1016/j.canrad.2025.104721","DOIUrl":"10.1016/j.canrad.2025.104721","url":null,"abstract":"<div><div>Cervical lymphadenopathy of unknown primary tumour is a rare entity. In this situation, exhaustive diagnostic procedures are essential, including a comprehensive clinical examination, complete imaging, multiples biopsies and molecular testing. Localized disease cT0N1/N2a or low volumes N2b negative for Epstein-Barr virus can be treated either by surgery alone or unilateral neck radiation. For tumours N2b or above, either bilateral radiotherapy is proposed or chemoradiotherapy with cisplatin. Intensity-modulated radiotherapy is the standard technique of irradiation for the management of cervical lymphadenopathies of unknown primary origin. Dose regimens for postoperative or exclusive radiotherapy are detailed in this article, as well as the selection of prophylactic tumour and lymph node target volumes.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 7","pages":"Article 104721"},"PeriodicalIF":1.4,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081802","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}
Pub Date : 2025-09-16DOI: 10.1016/j.canrad.2025.104717
Sofiane Allali , Pierre Loap , Adnan Shrebati , Thomas Lacornerie , Youlia Kirova , Frédéric Sebag , Kim-I. Cao
Radiotherapy is a common treatment in the oncological management of patients. Each year, approximately 98,000 patients receive an implanted cardiac device. The integrity and safety of this device must be considered during radiotherapy. Recommendations established by scientific societies have been implemented, particularly to assess the risk of damage to pacemakers or defibrillators based on the dependency on the implanted cardiac device, the energy, and the type of irradiation used. In this article, we review the main recommendations, establish a procedure, and provide guidelines for the management and monitoring of these patients during radiotherapy. The aim is to offer a clear and practical framework for the management of implanted cardiac devices within a radiotherapy department.
{"title":"Radiotherapy for patients with pacemakers and implantable cardioverter defibrillators: A review of the recommendations and practical application","authors":"Sofiane Allali , Pierre Loap , Adnan Shrebati , Thomas Lacornerie , Youlia Kirova , Frédéric Sebag , Kim-I. Cao","doi":"10.1016/j.canrad.2025.104717","DOIUrl":"10.1016/j.canrad.2025.104717","url":null,"abstract":"<div><div>Radiotherapy is a common treatment in the oncological management of patients. Each year, approximately 98,000 patients receive an implanted cardiac device. The integrity and safety of this device must be considered during radiotherapy. Recommendations established by scientific societies have been implemented, particularly to assess the risk of damage to pacemakers or defibrillators based on the dependency on the implanted cardiac device, the energy, and the type of irradiation used. In this article, we review the main recommendations, establish a procedure, and provide guidelines for the management and monitoring of these patients during radiotherapy. The aim is to offer a clear and practical framework for the management of implanted cardiac devices within a radiotherapy department.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 7","pages":"Article 104717"},"PeriodicalIF":1.4,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081829","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}
The personalization of oncology and radiation treatments is becoming increasingly crucial in patient care. Over the past few decades, numerous assays have been developed to predict tumour response and assess the risk of radiation-induced toxicity. These tests have not yet been integrated into routine clinical practice, but recent advances in radiation oncology are paving the way for personalized strategies that consider both tumour recurrence risk and normal tissue reactions. Regarding tumour radiosensitivity prediction, no tests are currently in clinical use, although the radiosensitivity index and Genome-based Model for Adjusting Radiotherapy Dose assays appear to be the most promising, with level II evidence. Development of radiomics has also made it possible to envisage new biomarkers. Prospective studies are ongoing. For normal tissue radiosensitivity prediction, single nucleotide polymorphims in prostate cancer and head and neck cancer patients, and the radiation-induced CD8 T-lymphocyte apoptosis assay for breast and prostate cancers are supported by level I evidence. These tests can be offered prior to the initiation of radiotherapy to tailor treatments based on both tumour and normal tissue radiosensitivity risks.
{"title":"Tumour and normal tissue radiosensitivity: 2025 update","authors":"Ariane Lapierre , Jeanne Monge-Cadet , Muriel Brengues , Igor Bessières , Laurent Quéro , Céline Mirjolet , Olivier Riou","doi":"10.1016/j.canrad.2025.104720","DOIUrl":"10.1016/j.canrad.2025.104720","url":null,"abstract":"<div><div>The personalization of oncology and radiation treatments is becoming increasingly crucial in patient care. Over the past few decades, numerous assays have been developed to predict tumour response and assess the risk of radiation-induced toxicity. These tests have not yet been integrated into routine clinical practice, but recent advances in radiation oncology are paving the way for personalized strategies that consider both tumour recurrence risk and normal tissue reactions. Regarding tumour radiosensitivity prediction, no tests are currently in clinical use, although the radiosensitivity index and Genome-based Model for Adjusting Radiotherapy Dose assays appear to be the most promising, with level II evidence. Development of radiomics has also made it possible to envisage new biomarkers. Prospective studies are ongoing. For normal tissue radiosensitivity prediction, single nucleotide polymorphims in prostate cancer and head and neck cancer patients, and the radiation-induced CD8 T-lymphocyte apoptosis assay for breast and prostate cancers are supported by level I evidence. These tests can be offered prior to the initiation of radiotherapy to tailor treatments based on both tumour and normal tissue radiosensitivity risks.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 7","pages":"Article 104720"},"PeriodicalIF":1.4,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145045189","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}
Pub Date : 2025-09-11DOI: 10.1016/j.canrad.2025.104724
Emmanuelle Le Fur , Matthieu Pallandre , Adeline Pêtre , Pierre Clavère , Laurent Quéro , Emmanuel Rio , Véronique Bodez , Christophe Hennequin
Many histological types of skin cancers may be treated with radiation. In most cases, there are no randomised trials enabling to well define the place of radiotherapy nor the best dose-fractionation schedules. Radiation indications are based at best on large retrospective series and sometimes only on expert opinions. After reviewing the different irradiation techniques available, we will discuss the indications and techniques for irradiation for each skin disease. We will only discuss localised tumours. Considering their wide histological heterogeneity and clinical presentation, a discussion with a multidisciplinary team is absolutely necessary for difficult cases, with at least photographs of the lesion, or even with the presence of the patient who can be examined by the different players in the multidisciplinary team.
{"title":"Radiotherapy of skin cancers","authors":"Emmanuelle Le Fur , Matthieu Pallandre , Adeline Pêtre , Pierre Clavère , Laurent Quéro , Emmanuel Rio , Véronique Bodez , Christophe Hennequin","doi":"10.1016/j.canrad.2025.104724","DOIUrl":"10.1016/j.canrad.2025.104724","url":null,"abstract":"<div><div>Many histological types of skin cancers may be treated with radiation. In most cases, there are no randomised trials enabling to well define the place of radiotherapy nor the best dose-fractionation schedules. Radiation indications are based at best on large retrospective series and sometimes only on expert opinions. After reviewing the different irradiation techniques available, we will discuss the indications and techniques for irradiation for each skin disease. We will only discuss localised tumours. Considering their wide histological heterogeneity and clinical presentation, a discussion with a multidisciplinary team is absolutely necessary for difficult cases, with at least photographs of the lesion, or even with the presence of the patient who can be examined by the different players in the multidisciplinary team.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 7","pages":"Article 104724"},"PeriodicalIF":1.4,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145045188","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}
We present the updated recommendations of the Société française de radiothérapie oncologique (SFRO; the French society of radiation oncology) regarding the radiotherapy management of laryngeal cancers. Clinical examination in a seated position and nasofibroscopy are essential for accurately assessing laryngeal mobility, a crucial parameter in the therapeutic decision-making process for glottic cancer. In early-stage cancers, treatment selection depends on multiple factors and requires thorough consideration and multidisciplinary discussion. Between surgery and radiotherapy, the decision can be personalized to achieve an optimal balance between tumour control and the preservation of laryngeal function. In advanced-stage laryngeal tumours, the therapeutic approach is mainly based on two strategies: concomitant chemoradiotherapy or induction chemotherapy followed by chemoradiotherapy. However, in some cases where these approaches are not feasible, the treatment relies on upfront total laryngectomy, often followed by adjuvant therapy. With the exception of early-stage glottic tumours, where hypofractionation has proven its efficacy, there is no formal indication to modify the standard fractionation regimen. Due to the movements induced by respiration and swallowing, laryngeal mobility must be taken into account. Three-dimensional volumetric imaging is the gold standard for ensuring accurate daily patient positioning and monitoring weight loss. The follow-up of laryngeal cancers is crucial for the early detection of potential recurrences and for adjusting oncological management when necessary. It also plays a key role in patient rehabilitation, ensuring the best possible preservation of vocal and respiratory functions to optimize quality of life.
{"title":"Radiotherapy for laryngeal cancers: 2025 update","authors":"Audrey Maury , Mathieu Bosset , Alexandre Coutte , Michel Lapeyre , Nolwenn Delaby , Pierre Blanchard , Yoann Pointreau , Julian Biau","doi":"10.1016/j.canrad.2025.104727","DOIUrl":"10.1016/j.canrad.2025.104727","url":null,"abstract":"<div><div>We present the updated recommendations of the Société française de radiothérapie oncologique (SFRO; the French society of radiation oncology) regarding the radiotherapy management of laryngeal cancers. Clinical examination in a seated position and nasofibroscopy are essential for accurately assessing laryngeal mobility, a crucial parameter in the therapeutic decision-making process for glottic cancer. In early-stage cancers, treatment selection depends on multiple factors and requires thorough consideration and multidisciplinary discussion. Between surgery and radiotherapy, the decision can be personalized to achieve an optimal balance between tumour control and the preservation of laryngeal function. In advanced-stage laryngeal tumours, the therapeutic approach is mainly based on two strategies: concomitant chemoradiotherapy or induction chemotherapy followed by chemoradiotherapy. However, in some cases where these approaches are not feasible, the treatment relies on upfront total laryngectomy, often followed by adjuvant therapy. With the exception of early-stage glottic tumours, where hypofractionation has proven its efficacy, there is no formal indication to modify the standard fractionation regimen. Due to the movements induced by respiration and swallowing, laryngeal mobility must be taken into account. Three-dimensional volumetric imaging is the gold standard for ensuring accurate daily patient positioning and monitoring weight loss. The follow-up of laryngeal cancers is crucial for the early detection of potential recurrences and for adjusting oncological management when necessary. It also plays a key role in patient rehabilitation, ensuring the best possible preservation of vocal and respiratory functions to optimize quality of life.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 7","pages":"Article 104727"},"PeriodicalIF":1.4,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145045190","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}
Pub Date : 2025-09-10DOI: 10.1016/j.canrad.2025.104713
Nicolas Benziane-Ouaritini , Jennifer Le Guevelou , Stéphane Supiot , Mario Terlizzi , Olivier Chapet , Idir Ouzaid , David Pasquier , Vincent Marchesi , Igor Latorzeff , Paul Sargos
Renal cell carcinoma represents the 14th most frequent tumour worldwide, but its incidence is increasing partly due to incidental diagnoses. As a result, these tumours are diagnosed in patients at an increasingly advanced age, often frail and with comorbidities. Most renal cell carcinoma cases are clear cell carcinoma (80 %), with papillary tumours being the second most frequent histological subtype. The standard of care for localized RCC is surgery, with partial nephrectomy or radical nephrectomy being recommended for T1 and T2 tumours, respectively. Thermoablative strategies have been developed over the past decade for patients who are not amenable to surgery and/or with impaired renal function. Active surveillance remains an alternative in the case of small low-grade renal cell carcinoma. Recent research has evaluated stereotactic ablative body radiotherapy as a well-tolerated and effective treatment for small renal tumours essentially for the management of both T1a and T1b tumours. This article aims to report the recommendations of the Société française de radiothérapie oncologique (SFRO, the French society for radiation oncology) on the role of radiotherapy in the management of localized renal cell carcinoma. These guidelines describe both treatment planning modalities, target volumes, and follow-up procedures. They also focus on the impact of radiotherapy on renal function, and the specific dosimetric constraints to be implemented.
{"title":"Role of radiotherapy in the management of primary renal cell carcinoma: Recommendations from the Société française de radiothérapie oncologique (SFRO, the French society for radiation oncology)","authors":"Nicolas Benziane-Ouaritini , Jennifer Le Guevelou , Stéphane Supiot , Mario Terlizzi , Olivier Chapet , Idir Ouzaid , David Pasquier , Vincent Marchesi , Igor Latorzeff , Paul Sargos","doi":"10.1016/j.canrad.2025.104713","DOIUrl":"10.1016/j.canrad.2025.104713","url":null,"abstract":"<div><div>Renal cell carcinoma represents the 14th most frequent tumour worldwide, but its incidence is increasing partly due to incidental diagnoses. As a result, these tumours are diagnosed in patients at an increasingly advanced age, often frail and with comorbidities. Most renal cell carcinoma cases are clear cell carcinoma (80 %), with papillary tumours being the second most frequent histological subtype. The standard of care for localized RCC is surgery, with partial nephrectomy or radical nephrectomy being recommended for T1 and T2 tumours, respectively. Thermoablative strategies have been developed over the past decade for patients who are not amenable to surgery and/or with impaired renal function. Active surveillance remains an alternative in the case of small low-grade renal cell carcinoma. Recent research has evaluated stereotactic ablative body radiotherapy as a well-tolerated and effective treatment for small renal tumours essentially for the management of both T1a and T1b tumours. This article aims to report the recommendations of the Société française de radiothérapie oncologique (SFRO, the French society for radiation oncology) on the role of radiotherapy in the management of localized renal cell carcinoma. These guidelines describe both treatment planning modalities, target volumes, and follow-up procedures. They also focus on the impact of radiotherapy on renal function, and the specific dosimetric constraints to be implemented.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 7","pages":"Article 104713"},"PeriodicalIF":1.4,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027042","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}
Pub Date : 2025-09-10DOI: 10.1016/j.canrad.2025.104722
Alice Blache , Marina Jolnerowski , Jérome Durand-Labrunie , Nicolas Meillan , Igor Bessières , Benjamin Schipman , Florence Huguet , Véronique Vendrely
We present the updated recommendations of the Société française de radiothérapie oncologique (SFRO, the French society for oncological radiotherapy) for rectal cancer radiotherapy. The standard treatment for locally advanced rectal cancer consists in chemoradiotherapy followed by radical surgery with total mesorectal resection and adjuvant chemotherapy according to nodal status. Although this strategy efficiently reduced local recurrences rates below 5 % in expert centres, functional sequelae could not be avoided resulting in 20 to 30 % morbidity rates. The early introduction of neoadjuvant chemotherapy followed by chemoradiation has proven to be beneficial in recent trials, in terms of recurrence-free and metastasis-free survivals becoming the new standard treatment strategy. Complete pathological responses were obtained in 15 % of tumours treated by chemoradiotherapy, even reaching up to 30 % of tumours when neoadjuvant chemotherapy is associated to chemoradiotherapy. These good results question the relevance of systematic radical surgery in good responders. Personalized therapeutic strategies are now possible by improved imaging modalities with circumferential margin assessed by magnetic resonance imaging, by intensity-modulated radiotherapy and by refining surgical techniques, and contribute to morbidity reduction. Keeping the same objectives, ongoing trials are now evaluating therapeutic de-escalation strategies, in particular rectal preservation for good responders after neoadjuvant treatment or radiotherapy omission in selected cases.
{"title":"Rectal cancer radiotherapy: 2025 update","authors":"Alice Blache , Marina Jolnerowski , Jérome Durand-Labrunie , Nicolas Meillan , Igor Bessières , Benjamin Schipman , Florence Huguet , Véronique Vendrely","doi":"10.1016/j.canrad.2025.104722","DOIUrl":"10.1016/j.canrad.2025.104722","url":null,"abstract":"<div><div>We present the updated recommendations of the Société française de radiothérapie oncologique (SFRO, the French society for oncological radiotherapy) for rectal cancer radiotherapy. The standard treatment for locally advanced rectal cancer consists in chemoradiotherapy followed by radical surgery with total mesorectal resection and adjuvant chemotherapy according to nodal status. Although this strategy efficiently reduced local recurrences rates below 5 % in expert centres, functional sequelae could not be avoided resulting in 20 to 30 % morbidity rates. The early introduction of neoadjuvant chemotherapy followed by chemoradiation has proven to be beneficial in recent trials, in terms of recurrence-free and metastasis-free survivals becoming the new standard treatment strategy. Complete pathological responses were obtained in 15 % of tumours treated by chemoradiotherapy, even reaching up to 30 % of tumours when neoadjuvant chemotherapy is associated to chemoradiotherapy. These good results question the relevance of systematic radical surgery in good responders. Personalized therapeutic strategies are now possible by improved imaging modalities with circumferential margin assessed by magnetic resonance imaging, by intensity-modulated radiotherapy and by refining surgical techniques, and contribute to morbidity reduction. Keeping the same objectives, ongoing trials are now evaluating therapeutic de-escalation strategies, in particular rectal preservation for good responders after neoadjuvant treatment or radiotherapy omission in selected cases.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 7","pages":"Article 104722"},"PeriodicalIF":1.4,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026259","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}
Pub Date : 2025-09-10DOI: 10.1016/j.canrad.2025.104723
Adnan Shrebati , Clara Le Fèvre , Thomas Lacornerie , Georges Noël , Delphine Antoni , Pierre Loap , Youlia Kirova
The number of patients receiving radiotherapy while having metallic implants is steadily increasing. These implants degrade the quality of computed tomography images used throughout the radiotherapy process, including delineation, dosimetry, and dose delivery. This document presents the updated recommendations from the Société française de radiothérapie oncologique (SFRO; i.e., the French society for radiation oncology), outlining the advantages and limitations of various existing and emerging methods designed to reduce the impact of metallic implants on radiotherapy quality and safety.
{"title":"Management of metallic implants in radiotherapy: 2025 update","authors":"Adnan Shrebati , Clara Le Fèvre , Thomas Lacornerie , Georges Noël , Delphine Antoni , Pierre Loap , Youlia Kirova","doi":"10.1016/j.canrad.2025.104723","DOIUrl":"10.1016/j.canrad.2025.104723","url":null,"abstract":"<div><div>The number of patients receiving radiotherapy while having metallic implants is steadily increasing. These implants degrade the quality of computed tomography images used throughout the radiotherapy process, including delineation, dosimetry, and dose delivery. This document presents the updated recommendations from the Société française de radiothérapie oncologique (SFRO; i.e., the French society for radiation oncology), outlining the advantages and limitations of various existing and emerging methods designed to reduce the impact of metallic implants on radiotherapy quality and safety.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 7","pages":"Article 104723"},"PeriodicalIF":1.4,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027039","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}
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