Cancer Radiotherapie最新文献

{"title":"Radiotherapy: Beyond cancer…","authors":"Nicolas Giraud , Cécile Ortholan , Magali Quivrin , Mickaël Andraud , Abel Cordoba , Richard Shaffer , Cyrus Chargari , Thomas Leroy","doi":"10.1016/j.canrad.2025.104682","DOIUrl":"10.1016/j.canrad.2025.104682","url":null,"abstract":"<div><div>Radiotherapy, long established as a cornerstone of cancer care, has in recent years broadened its therapeutic reach to include a variety of benign and functional disorders. Advances in imaging, motion management, and highly conformal delivery have made it possible to treat non-malignant conditions with precision and minimal collateral damage. For example, stereotactic arrhythmia radioablation offers a noninvasive, single-session option for refractory ventricular tachycardia, markedly reducing arrhythmic burden and device interventions. In the neuroaxis, stereotactic radiosurgery and hypofractionated regimens achieve durable control of benign intracranial tumours – such as meningiomas, vestibular schwannomas, pituitary adenomas, and craniopharyngiomas – while preserving neurological function. Functional radiosurgery further expands treatment possibilities, targeting lesions to alleviate trigeminal neuralgia and movement disorders without the need for open surgery. Beyond the brain, low-dose radiotherapy leverages anti-inflammatory mechanisms to relieve osteoarticular pain and tendinopathies, orbital irradiation mitigates inflammatory signs in Graves’ orbitopathy, and postoperative protocols significantly decrease keloid recurrence. Emerging results from prospective cohorts and multicentre registries demonstrate consistent symptom relief, favourable safety profiles, and notable quality-of-life improvements across these diverse applications. This review synthesizes current clinical practices, technical considerations, and early research findings, and underscores the urgent need for dedicated trials and consensus guidelines. By charting radiotherapy's expanding role in non-cancer settings, we aim to guide multidisciplinary teams and accelerate the development of evidence-based French recommendations.</div></div><div><div>La radiothérapie, ancrée de longue date comme pilier du traitement du cancer, a vu ces dernières années son champ d’application s’étendre à diverses pathologies bénignes et fonctionnelles. Les progrès en imagerie, en gestion du mouvement et dans la délivrance du traitement permettent de traiter des affections bénignes en minimisant les effets secondaires. Par exemple, la radiothérapie stéréotaxique des arythmies cardiaques est une nouvelle option non invasive en une seule séance pour le traitement des tachycardies ventriculaires réfractaires. En neurologie, la radiothérapie stéréotaxique et les schémas hypofractionnés assurent un contrôle durable des tumeurs intracrâniennes bénignes – telles que les méningiomes, les schwannomes vestibulaires, les adénomes hypophysaires et les craniopharyngiomes – tout en préservant les fonctions neurologiques. De même, elle permet de soulager la névralgie trigéminale et d’améliorer les troubles du mouvement, évitant ainsi le recours à la chirurgie. La radiothérapie à faible dose trouve également de nouvelles indications par ses mécanismes anti-inflammatoires permettant de soulager les doule","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104682"},"PeriodicalIF":1.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724796","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":"Hypofractionated radiotherapy for head and neck squamous cell carcinoma","authors":"Dylan Bocha ,&nbsp;Jennifer Le Guevelou ,&nbsp;Cécile Ortholan ,&nbsp;Benoît Calderon ,&nbsp;Yoann Pointreau","doi":"10.1016/j.canrad.2025.104681","DOIUrl":"10.1016/j.canrad.2025.104681","url":null,"abstract":"<div><div>Head and neck squamous cell carcinoma management involves surgery, radiotherapy, and systemic therapies. While normofractionated radiotherapy with concurrent chemotherapy remains standard, alternative fractionation schedules, such as hypofractionation, hold the potential to shorten treatment duration and therefore limit tumour repopulation, as well as improve patient adherence. Studies have explored hypofractionated radiotherapy in both exclusive and postoperative settings for head and neck squamous cell carcinoma. Recent studies like HYPNO randomized phase III trial (delivering 55<!--> <!-->Gy in 20 fractions) and HYPORT phase I study (delivering 46.5<!--> <!-->Gy in 15 fractions) have shown the feasibility and non-inferiority of hypofractionated radiotherapy compared to standard schedules but these results are insufficient to consider hypofractionated radiotherapy in exclusive and postoperative settings. Hypofractionated radiotherapy has been tested in several clinical situations: for early glottic cancer, in elderly patients, for metastatic disease/in palliative context. For early glottic cancers (T1–T2), moderate hypofractionation is a well-established strategy that showed its non-inferiority in terms of disease control and acceptable toxicity, notably in the JCOG0701 trial (delivery of 60 to 64.8<!--> <!-->Gy in 25 to 27 fractions). Stereotactic body radiotherapy for glottic carcinoma has shown encouraging preliminary results in phase I-II studies, particularly when patient selection criteria are applied but caution remains necessary. In elderly patients, split-course hypofractionated radiotherapy reduced fraction number with favourable tolerance profile. The results of the ELAN-RT randomized phase III study support the possibility to prescribe a hypofractionated radiotherapy in elderly people. In palliative settings, hypofractionated radiotherapy regimens such as Christie and Hypo regimens have demonstrated effective symptom control. Overall, hypofractionated radiotherapy represents a promising strategy in selected clinical contexts for head and neck squamous cell carcinoma, but further prospective randomized studies are needed to define optimal indications and confirm long-term outcomes and safety.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104681"},"PeriodicalIF":1.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724197","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":"Hypofractionated radiotherapy of central nervous system tumours: Current thoughts in 2025","authors":"Agathe Margulies ,&nbsp;Anaïs Stefani ,&nbsp;Delphine Antoni","doi":"10.1016/j.canrad.2025.104680","DOIUrl":"10.1016/j.canrad.2025.104680","url":null,"abstract":"<div><div>The use of hypofractionated radiotherapy for central nervous system tumours is expanding, particularly due to the increase in reirradiation situations. This article reports a reflection on its use for neurological tumours through five questions illustrated by non-exhaustive clinical examples. Why? We explored the rationale of hypofractionation and its benefits. For whom? We reviewed the different recommendations on indications including patients and tumours which would benefit more of hypofractionation. How? Treatment planning must be careful and adapted to this specific technique, especially in reirradiation cases, and when systemic therapies are involved. When? Timing is the essence, it can be used exclusively, combined with systemic treatment, prior to or after surgery… Why not? Hypofractionation is not suitable for all central nervous system tumours, it may even be contraindicated in some cases.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104680"},"PeriodicalIF":1.5,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144712977","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":"BQUATRO audits in radiotherapy: Crossperspectives between auditors and audited departments","authors":"Aude Vaandering ,&nbsp;Séverine Cucchiaro","doi":"10.1016/j.canrad.2025.104679","DOIUrl":"10.1016/j.canrad.2025.104679","url":null,"abstract":"<div><div>Since 2011, the Belgian College of Physicians for Radiation Oncology has implemented a national program of peer-reviewed clinical audits in radiotherapy departments, aiming to enhance quality practices, safety culture, and promote professional experience sharing. This article summarizes the theoretical and practical aspects of this peer audit process providing cross-perspectives of auditors and audited departments. National audits have been carried out using the BQUATRO methodology and framework whereby radiotherapy departments are audited every 5 to 6 years. The audit is carried out by a multidisciplinary team of clinically active radiotherapy professionals. Peer reviewed clinical audits have been carried out in Belgium since 2010 resulting in all radiotherapy departments having been audited at least twice<em>.</em> Audits have helped reinforce team engagement, highlight often-underestimated strengths, and structure continuous improvement initiatives. Auditors have also developed crossfunctional expertise and a better understanding of organizational challenges. The BQUATRO peer-reviewed clinical audit differs from traditional regulatory approaches by its collaborative and constructive posture. It promotes organizational learning and practice alignment among Belgian radiotherapy departments. The peer-reviewed clinical audit process is a strategic lever for improving quality of care in Belgian radiotherapy. Its sustainability and expansion to other countries represent key improvement opportunities for radiotherapy centres.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104679"},"PeriodicalIF":1.5,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144704151","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":"Oligometastatic head and neck cancer: Navigating patient trajectories and broader implications","authors":"Juliette Thariat ,&nbsp;Jihane Lehyanti ,&nbsp;Pierre Boisselier ,&nbsp;Anouchka Modesto ,&nbsp;Sébastien Thureau ,&nbsp;Yoann Pointreau ,&nbsp;Xu-Shan Sun","doi":"10.1016/j.canrad.2025.104675","DOIUrl":"10.1016/j.canrad.2025.104675","url":null,"abstract":"<div><div>Oligometastatic head and neck squamous cell carcinoma is a distinct clinical state inadequately addressed in current metastatic disease trials. This narrative review is based on historical literature and recently published data of the Omet trial. The Gortec 2014-04 Omet phase II randomized trial investigated whether genuine metachronous oligometastases in head and neck squamous cell carcinoma, characterized by a limited number (up to three) of lesions not induced by prior systemic therapy, may benefit from a “de-escalation strategy” using curative-intent stereotactic ablative radiotherapy alone rather than strategies relying on systemic treatments upfront. Randomized phase II-III trials are scarce on head and neck squamous cell carcinoma. In the Omet trial, survival at 1 year exceeded 85 % in both arms. Progression-free survival was, as anticipated, slightly longer in the group chemotherapy and stereotactic ablative radiotherapy (10 months versus 7.5 months) but without deleterious impact upon metastatic relapse. Stereotactic ablative radiotherapy alone showed significantly lower grade 3–4 toxicity (8.8 % versus 60 %). Quality of life declined less with stereotactic ablative radiotherapy alone. Poor prognostic factors included male sex and multiple metastases. Major protocol deviations correlated with worse outcomes. Stereotactic ablative radiotherapy offers a viable, less toxic alternative to systemic therapy for genuine oligometastatic head and neck squamous cell carcinoma, warranting refined patient selection and further research. Despite its role as a new standard-of-care, the role of immunotherapy remains uncertain in the oligometastatic setting and requires specific studies in oligometastatic head and neck squamous cell carcinoma to challenge this new option.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104675"},"PeriodicalIF":1.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144696459","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":"Intelligence artificielle en oncologie radiothérapie : réinventer la formation et préserver l’esprit critique","authors":"Lucien Lahmi ,&nbsp;Jean-Emmanuel Bibault ,&nbsp;Yannis Constantinides ,&nbsp;Joseph Azria ,&nbsp;Véronique Cheval ,&nbsp;Catherine Dejean ,&nbsp;Catherine Durdux ,&nbsp;Angélique Ducteil ,&nbsp;Alexandre Escande ,&nbsp;Cédric Gesbert ,&nbsp;Thibaud Haaser ,&nbsp;Gabriel Kobeissi ,&nbsp;Claire Lemanski ,&nbsp;Moshe Nataf ,&nbsp;Charles Raynaud ,&nbsp;Sébastien Thureau ,&nbsp;Jean-Léon Lagrange ,&nbsp;Florence Huguet ,&nbsp;Commission éthique de la Société française de radiothérapie oncologique (SFRO)","doi":"10.1016/j.canrad.2025.104673","DOIUrl":"10.1016/j.canrad.2025.104673","url":null,"abstract":"<div><div>The growing integration of artificial intelligence is profoundly transforming radiation oncology, particularly through the automation of tasks such as target volume delineation. While artificial intelligence holds the promise of enhancing treatment efficiency and accuracy, it also raises significant ethical and educational concerns: How can we preserve core clinical skills? How can we transmit expertise that is now less frequently practiced? How can we ensure truly informed patient consent in the face of automated systems? And finally, how should we use the time freed up by automation? To address these challenges, medical training must increasingly incorporate critical thinking and algorithmic literacy. The caregiver–patient relationship must remain central, with medical decisions remaining under human responsibility. Artificial intelligence should thus remain a tool in the hands of physicians, not a substitute for clinical judgment. Ethical reflection must accompany every step of artificial intelligence implementation, ensuring its integration is thoughtful, responsible, and human-centred.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104673"},"PeriodicalIF":1.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144696568","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":"Adaptive radiotherapy, promises and pitfalls","authors":"Ariane Lapierre ,&nbsp;Pierre Blanchard","doi":"10.1016/j.canrad.2025.104677","DOIUrl":"10.1016/j.canrad.2025.104677","url":null,"abstract":"<div><div>Adaptive radiotherapy is a technique that adapts the radiotherapy to the changes of the patient's anatomy and tumour volume by using repeated images acquired during the treatment course. Adaptive radiotherapy aims to optimize the dose distribution, ensure that the tumour remains in the treatment volume and spare the organs at risk. Adaptive radiotherapy can be applied at three timescales: between fractions (offline), immediately before a fraction (online) or real-time (online, during a fraction). Over the last decade, manufacturers have developed linear accelerators dedicated to online adaptive radiotherapy, based on either computed tomography or magnetic resonance imaging. These systems allow for treatment plan adaptation according to deformable, registration-based segmentation and physicist-driven plan optimization. This has led to a rapid rise of this technique on a larger scale, although robust data on its benefits remains scarce. Adaptive radiotherapy has demonstrated dosimetric benefits, such as improved lesion coverage and sparing of organs at risk, in various tumour sites. However, the clinical benefit, in terms of toxicity reduction or improved tumour control, remains to be demonstrated in many disease sites. Furthermore, the implementation of adaptive radiotherapy requires careful planning, increased time, logistics and security, which represents an extra burden and impacts the cost-efficiency of the approach.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104677"},"PeriodicalIF":1.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144662881","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":"Intensification or de-escalation? What is the standard treatment for human papillomavirus-related oropharyngeal cancers in 2025?","authors":"Pierre Blanchard ,&nbsp;Anne Aupérin ,&nbsp;David Veyer ,&nbsp;Hélène Péré ,&nbsp;Michaël Chevrot ,&nbsp;Laure Monard ,&nbsp;Caroline Even ,&nbsp;Haitham Mirghani","doi":"10.1016/j.canrad.2025.104674","DOIUrl":"10.1016/j.canrad.2025.104674","url":null,"abstract":"<div><div>The incidence of human papillomavirus-related oropharyngeal cancers has been increasing steadily for several decades. They have a better prognosis than alcohol- and tobacco-related oropharyngeal cancers because they are more sensitive to radiotherapy and chemotherapy and patients have fewer comorbidities. However, some tumours have a high risk of recurrence, for which intensified therapy may be considered. On the other hand, for forms with a good prognosis, numerous therapeutic de-escalation strategies have been considered. The aim of this article is to review the standard of care in 2025, the various de-escalation strategies, the potential benefits of immunotherapy, and the impact of human papillomavirus on surveillance and screening of these cancers.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104674"},"PeriodicalIF":1.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144662984","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":"Hypofractionated radiotherapy for pancreatic cancer: What role in 2025?","authors":"Pauline Kordalski ,&nbsp;Florence Huguet","doi":"10.1016/j.canrad.2025.104676","DOIUrl":"10.1016/j.canrad.2025.104676","url":null,"abstract":"<div><div>The role of radiation therapy in the treatment of pancreatic cancer has been debated for many years. Recent advances in radiation techniques with the development of stereotactic body radiotherapy and magnetic resonance imaging-guided radiotherapy have opened new therapeutic possibilities, enabling the delivery of ablative doses while minimizing the dose received by surrounding organs at risk. In this context, the potential benefit of radiation therapy should be questioned again.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104676"},"PeriodicalIF":1.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144662985","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":"Nouveaux éclairages sur la mise en état buccodentaire avant une radiothérapie affectant la cavité buccale","authors":"Fiorenza Dal Cortivo ,&nbsp;Sabah Falek ,&nbsp;Bérengère Phulpin ,&nbsp;Juliette Thariat","doi":"10.1016/j.canrad.2025.104672","DOIUrl":"10.1016/j.canrad.2025.104672","url":null,"abstract":"<div><h3>Purpose</h3><div>Radiotherapy, when it affects the oral cavity, can cause various side-effects and may even lead to more severe complications such as osteoradionecrosis. The development in radiotherapy and dental care techniques, has enabled the optimization of oral management before radiotherapy, enhancing treatment outcomes and reducing side effects. This research focuses on the latest advances in oral health and dental rehabilitation in the context of radiation therapy, comparing them to historical recommendations and discussing their indications.</div></div><div><h3>Material and methods</h3><div>A bibliographic search using the search engine PubMed, between 2009 and 2024, was carried out to evaluate the evolution of oral conditioning and dental rehabilitation in the context of radiotherapy.</div></div><div><h3>Results</h3><div>A total of 215 references were retrieved (first 155 references, then 60 more added secondarily). Recommendations have changed over time, prioritizing a more conservative stance aimed at preserving oral functionality and preventing the nutritional and psychological deficits secondary to edentulism. The development of new materials and strategies in dental care and implantology and the evolution of radiotherapy techniques and software, have made it possible to optimize oral management before radiotherapy and to create, for the first time, a personalized and precise ‘dossier’, which may change the way in which planning before radiotherapy and the patient's quality of life are considered.</div></div><div><h3>Conclusion</h3><div>New practices, techniques and recommendations have emerged in the last decade to reduce radiation morbidity and improve rehabilitation.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 4","pages":"Article 104672"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144634484","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}