Hematological toxicity in patients with solid malignant tumors treated with radiation – temporal analysis, dose response and impact on survival
Mechanisms of hematological toxicity after radiation therapy differ between blood components. Thrombocytopenia and neutropenia are most likely secondary to the myelosuppressive effect of chemotherapy administered before or during radiotherapy,[1] whereas lymphopenia is additionally associated with the direct effect of radiation on circulating lymphocytes and the bone marrow within the irradiated volume.[2] The differential effect of radiotherapy on blood components may be explained by lymphocytes ’ high sensitivity to radiation[3], as well as the conventional way of fractionating radiotherapy in many small doses with...
Source: Radiotherapy and Oncology - February 28, 2021 Category: Radiology Authors: Cynthia Terrones-Campos, Bruno Ledergerber, Ivan Richter Vogelius, Marie Helleberg, Lena Specht, Jens Lundgren Tags: Original Article Source Type: research

End to end intussusception anastomosis decreases the risk of anastomotic leakage after neoadjvant chemoradiation and McKeown oesophagectomy
Oesophageal cancer is one of most threatening and lethal malignant diseases worldwide [1,2], and surgical resection has long been used as a major treatment strategy for the disease. In recent years, neoadjuvant chemoradiation prior to surgical resection has been increasingly used in locally advanced esophageal cancer, leading to tumour resectability and an absolute benefit in long term survival over surgery alone [3 –6]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 28, 2021 Category: Radiology Authors: Yutian Lai, Xiaoxiao Zeng, Kun Zhou, Xiaojuan Zhou, Yongmei Liu, Yang Hu Tags: Original Article Source Type: research

Response to yuce sari et al
We would like to thank Yuce Sari et al. [1] for the opportunity to further explain the reasons behind our article focusing on the importance of the ICRU Bladder Point (ICRU-BP) dose for urinary frequency and incontinence after radio(chemo)therapy and image-guided adaptive brachytherapy in locally advanced cervical cancer [2]. Our analysis was carried out within the international, prospective and multi-institutional EMBRACE I study [3], which collected information on several physician-assessed (CTCAE v.3) and patient-reported (EORTC C30 and CX24) symptoms. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 26, 2021 Category: Radiology Authors: Sofia Spampinato, Lars U. Fokdal, Richard P ötter, Christine Haie-Meder, Jacob C. Lindegaard, Maximilian P. Schmid, Alina Sturdza, Ina M. Jürgenliemk-Schulz, Umesh Mahantshetty, Barbara Segedin, Kjersti Bruheim, Peter Hoskin, Bhavana Rai, Fleur Huang, R Tags: Letter to the Editor Source Type: research

Response to the letter to the editor “Exercise therapy for cancer treatment-induced trismus in patients with head and neck cancer: A systematic review and meta-analysis of randomized controlled trials regards to Chiu et al.”
We read the comments from Chiu and Wang [1] on our work with great interest [2], and we thank the editor for offering us a chance to respond to the comments. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 26, 2021 Category: Radiology Authors: Tsai-Wei Huang, Chia-Hui Shao, Chia-Chun Chiang Tags: Letter to the Editor Source Type: research

Letter to the editor regarding Shao et al., Exercise therapy for cancer treatment-induced trismus in patients with head and neck cancer: A systematic review and meta-analysis of randomized controlled trials
We read with great interest the recent publication from Shao et al [1], aiming to investigate whether exercise is capable of preventing or treating trismus in patients with head and neck cancer. The results revealed the maximal interincisal opening (MIO) significantly increased from 4.48 mm to 14.20 mm after exercise therapy. For the preventive outcome, no significant difference between standard usual care and exercise therapy was concluded. However, we would like to point out the following two methodological concerns. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 26, 2021 Category: Radiology Authors: Yi-Hsiang Chiu, Tyng-Guey Wang Tags: Letter to the Editor Source Type: research

In regard to Spampinato et al
We read the article by Spampinato et al. [1] focusing on the importance of ICRU bladder point (BP) dose on the incidence and persistence of urinary frequency and incontinence with great interest. The authors aimed to determine the patient- and treatment-related risk factors that may be associated with urinary frequency and incontinence by analyzing the patients with locally advanced cervical cancer (LACC) in the EMBRACE-I trial who underwent intracavitary brachytherapy (ICB) following chemoradiotherapy (CRT). (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 26, 2021 Category: Radiology Authors: Sezin Yuce Sar ı, Ecem Yıgıt, Melis Gultekın, Ferah Yıldı Source Type: research

Value of functional in-vivo endpoints in preclinical radiation research
Drug development in cancer research, both for drug treatment alone or in combination with radiotherapy, is suffering from a very high attrition rate after pre-clinical development and during early clinical trials. From first-in-man to clinical approval of a new drug in oncology, the success rate declines down to 5%. After phase II clinical trials ≈70% of all treatments are not further developed [1]. Besides the major impact on cost-efficacy in the healthcare system, this may also be an ethical problem concerning the use of experimental animals and the burden for participants in clinical trials. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 24, 2021 Category: Radiology Authors: Berit Kummer, Steffen L öck, Kristin Gurtner, Nadine Hermann, Ala Yaromina, Wolfgang Eicheler, Michael Baumann, Mechthild Krause, Christina Jentsch Tags: Guidelines Source Type: research

Acute patient-reported intestinal toxicity in whole pelvis IMRT for prostate cancer: bowel dose-volume effect quantification in a multicentric cohort study
Intestinal toxicity is a common radiation induced side-effect in the treatment of pelvic and abdominal tumors [1], representing a limiting factor in the treatment of pelvic lymph-nodal areas with the intent to eradicate micrometastases in the treatment of rectal, gynecological and bladder cancers. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 24, 2021 Category: Radiology Authors: Andrea Bresolin, Adriana Faiella, Elisabetta Garibaldi, Fernando Munoz, Domenico Cante, Vittorio Vavassori, Justina Magdalena Waskiewicz, Giuseppe Girelli, Barbara Avuzzi, Elisa Villa, Alessandro Magli, Barbara Noris Chiorda, Marco Gatti, Letizia Ferella, Tags: Guidelines Source Type: research

Ultra-fractionated radiotherapy for low- and intermediate risk prostate cancer: High-dose-rate brachytherapy vs stereotactic ablative radiotherapy
Background (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 24, 2021 Category: Radiology Authors: Yat Man Tsang, Hannah Tharmalingam, Katherine Belessiotis-Richards, Shreya Armstrong, Peter Ostler, Robert Hughes, Roberto Alonzi, Peter J Hoskin Tags: Guidelines Source Type: research

An evaluation of MR based deep learning auto-contouring for planning head and neck radiotherapy
Accurate volume delineation is required to deliver conformal doses to target structures while maintaining sufficient organ sparing [1]. The large number and complex anatomy of structures in the head and neck makes manual contouring labour intensive and subject to inter and intra-observer variability [2]. Atlas based auto contouring models may reduce time and inter-observer variability, but none have been adopted for widespread use [3]. One reason for the lack of adoption is that the poor imaging quality of computed tomography (CT) limits contour accuracy requiring clinicians to manually edit auto contours before they are c...
Source: Radiotherapy and Oncology - February 23, 2021 Category: Radiology Authors: C. Hague, A. McPartlin, L.W. Lee, C. Hughes, D. Mullan, W. Beasley, A. Green, G. Price, P. Whitehurst, N. Slevin, M. van Herk, C. West, R. Chuter Tags: Guidelines Source Type: research

Determining the incidence of interstitial pneumonitis and chronic kidney disease following full intensity haemopoetic stem cell transplant conditioned using a forward-planned intensity modulated total body irradiation technique
Total body irradiation (TBI) combined with myeloablative chemotherapy has an established role in conditioning for allogeneic haemopoetic stem cell transplant (HSCT) in the treatment of high risk haematological malignancies. TBI is highly immunosuppressant minimising risk of graft rejection, has high anti-tumour efficacy and is effective at penetrating into sanctuary sites meaning it is commonly used in conditioning high risk patients [1,2]. Furthermore, any chemotherapy resistant malignant cells may still be susceptible to radiation. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 23, 2021 Category: Radiology Authors: E. Durie, E. Nicholson, C. Anthias, E.M. Dunne, M. Potter, M. Ethell, C. Messiou, J. Brennan, S. Eagle, J. Talbot, G. Smyth, W. Ingram, F. Saran, H. Mandeville Tags: Guidelines Source Type: research

Intrafraction motion monitoring to determine PTV margins in early stage breast cancer patients receiving neoadjuvant partial breast SABR
The current treatment standard for early-stage breast cancer patients is lumpectomy followed by adjuvant whole breast radiotherapy (RT) over 4-6 weeks [1]. However, this treatment time is prohibitively long for many patients, particularly rural patients, resulting in a lack of patients returning for their radiotherapy [2,3]. As such, early stage breast cancer research is focused on reducing the treatment time to reduce the emotional and physical burden on patients without compromising efficacy of treatment. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 23, 2021 Category: Radiology Authors: Matthew Mouawad, Owen Lailey, Per Poulsen, Melissa O'Neil, Muriel Brackstone, Michael Lock, Brian Yaremko, Olga Shmuilovich, Anat Kornecki, Ilanit Ben Nachum, Giulio Muscedere, Kalan Lynn, Scott Karnas, Frank S. Prato, R. Terry Thompson, Stewart Gaede Tags: Guidelines Source Type: research

What is the role of the subventricular zone in radiotherapy of glioblastoma patients?
Glioblastoma (GBM) is the most common type of malignant brain tumor. GBM is 1.6 times more common in males than in females [1]. The median patient age is 64 years [2]. Despite trimodal therapy including surgery, radiotherapy, and chemotherapy, the prognosis remains poor, with median overall survival times of 15 –18 months in clinical trials [3] and a 5-year survival less than 5% [2]. Current therapies can prolong survival but do not change the unfavorable overall prognosis. GBM tissue contains a subset of cancer stem cells (CSC) with the ability to self-renew and differentiate and which seem to play a ro le in tumor ...
Source: Radiotherapy and Oncology - February 22, 2021 Category: Radiology Authors: Katja Bender, Malte Tr äger, Helena Wahner, Julia Onken, Michael Scheel, Marcus Beck, Felix Ehret, Volker Budach, David Kaul Tags: Guidelines Source Type: research

Adaptive intensity-modulated radiotherapy with simultaneous integrated boost for stage III non-small cell lung cancer: Is a routine adaptation beneficial?
Concurrent chemoradiation is the standard of care prior to consolidative durvalumab for patients with inoperable stage III non-small cell lung cancer (NSCLC).[1,2] Radiation-induced toxicities, especially pneumonitis (RP), are the most important dose-limiting factors hindering dose escalation and further tumor control improvement.[3] Acute toxicities after radiotherapy are also a key factor for patients not eligible to receive consolidation immunotherapy.[4]Fig 1. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 22, 2021 Category: Radiology Authors: Yinnan Meng, Wei Luo, Hailing Xu, Wei Wang, Suna Zhou, Xingni Tang, Zihong Li, Chao Zhou, Haihua Yang Tags: Guidelines Source Type: research

Progressive muscle loss is an independent predictor for survival in locally advanced oral cavity cancer: A longitudinal study
Oral squamous cell carcinoma (OSCC) is the most common head and neck malignancy, with approximately 354,864 new cases and 177,384 deaths worldwide in 2018 [1]. Patients with advanced-stage OSCC often develop severe mouth pain or difficulty swallowing or chewing that can hamper dietary intake; hence, these patients may appear to be malnourished or have cachexia at the time of presentation [2 –5]. Moreover, severe loss of skeletal muscle (i.e., sarcopenia) is a crucial component of cancer cachexia and can affect treatment-related toxicities and survival outcomes [6–17]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 19, 2021 Category: Radiology Authors: Jie Lee, Shih-Hua Liu, John Chun-Hao Chen, Yi-Shing Leu, Chung-Ji Liu, Yu-Jen Chen Tags: Original Article Source Type: research

68Ga-fibroblast activation protein inhibitor PET/CT on gross tumour volume delineation for radiotherapy planning of oesophageal cancer
With approximately 570,000 new diagnoses and 500,000 mortalities in 2018, oesophageal cancer is the 6th leading cause of cancer-associated death worldwide with increased incidence over the past decade [1,2]. Squamous cell carcinoma(SCC) is the major histological type ofoesophageal cancerin the central and south-east Asian region, and adenocarcinoma is the most common form in northern and western Europe, North America and Oceania [3]. More than half of the patients with newly diagnosed oesophageal cancer lose the opportunity to undergo surgery because of the advanced stage [4]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 19, 2021 Category: Radiology Authors: Liang Zhao, Shanyu Chen, Sijia Chen, Yizhen Pang, Yaqing Dai, Shenping Hu, Li'e Lin, Lirong Fu, Long Sun, Hua Wu, Haojun Chen, Qin Lin Tags: Original Article Source Type: research

Two-year toxicity of simultaneous integrated boost in hypofractionated prone breast cancer irradiation: comparison with sequential boost in a randomized trial
In addition to surgery and chemotherapy, radiotherapy (RT) is one of the foundations of breast cancer treatment. With a few exceptions, breast conserving surgery (BCS) is followed by RT[1]. After whole breast irradiation (WBI), an additional boost on the tumour bed has demonstrated to reduce the risk of relapse in the ipsilateral breast. A sequential boost (SEB) typically consists of 4 to 8 extra fractions [2,3] and thus increases the duration of treatment by 1 to 2 weeks. A simultaneous integrated boost (SIB) reduces the burden of breast cancer treatment for the patient by shortening the duration of RT [4]. (Source: Radio...
Source: Radiotherapy and Oncology - February 19, 2021 Category: Radiology Authors: Hans Van Hulle, Eline Desaunois, Vincent Vakaet, Leen Paelinck, Max Schoepen, Giselle Post, Annick Van Greveling, Bruno Speleers, Marc Mareel, Wilfried De Neve, Chris Monten, Pieter Deseyne, Liv Veldeman Tags: Original Article Source Type: research

Local control and postponement of systemic therapy after modest dose radiotherapy in oligometastatic myxoid liposarcomas
Myxoid liposarcoma(MLS) is a rare malignancy with an estimated incidence of 2 per million person years and belongs to the heterogeneous group of Soft Tissue Sarcomas(STS).[1] The standard treatment of primary MLS consists of surgery and RT.[2,3] The 5-year local control rates of 96-98% are to an important extent a result of the well-established exceptional clinical radiosensitivity of MLS.[4 –10] However, notwithstanding the excellent local control, disease specific mortality is predominantly determined by the 14-33% of patients who eventually develop distant metastases.[8–11] As major morbidity can be induced ...
Source: Radiotherapy and Oncology - February 18, 2021 Category: Radiology Authors: Jules Lansu, Winan J. van Houdt, Kirsten van Langevelde, Piet L.A. van den Ende, Winette T.A. van der Graaf, Yvonne Schrage, Hester van Boven, Astrid N. Scholten, Rick L. Haas Tags: Original Article Source Type: research

Relapse pattern and quality of life in patients with localized basal ganglia germinoma receiving focal radiotherapy, whole-brain radiotherapy, or craniospinal irradiation
Germinoma is a rare brain tumour mostly identified in children and young adults. Sellar, pineal gland, and basal ganglia (BG) regions are the most commonly involved areas. Owing to the high sensitivity of germinoma to chemoradiotherapy, the five-year survival rate is over 90%[1,2]. Radiotherapy, which plays an important role in germinoma treatment, has evolved in recent decades. Craniospinal irradiation (CSI) used to be the standard of care, but considering the potential long-term toxicity, many studies have explored reduced-field irradiation and showed that, with chemotherapy support, CSI could be spared in patients with ...
Source: Radiotherapy and Oncology - February 18, 2021 Category: Radiology Authors: Bo Li, Jin Feng, Li Chen, Youqi Li, Jiayi Wang, Wenyi Lv, Yanong Li, Yanwei Liu, Shuai Liu, Shiqi Luo, Xiaoguang Qiu Tags: Original Article Source Type: research

Survival after palliative radiation therapy for cancer: the METSSS model
Around 30% of patients with cancer receive radiation therapy as part of their first course of treatment.[1] Based on the ASTRO evidence-based guideline for palliative radiation therapy, radiation therapy provides excellent palliation for painful metastases.[2] Thus, radiotherapy is a mainstay for improving symptoms due to metastatic disease. Patients receiving palliative radiotherapy for painful metastatic cancer have limited survival.[3] The predictors of survival after palliative radiation therapy are poorly characterized. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 18, 2021 Category: Radiology Authors: Nicholas G. Zaorsky, Menglu Liang, Rutu Patel, Christine Lin, Leila T. Tchelebi, Kristina B. Newport, Edward J. Fox, Ming Wang Tags: Original Article Source Type: research

Vision loss following high-dose proton-based radiotherapy for skull-base chordoma and chondrosarcoma
Chordomas and chondrosarcomas arising in the skull base often present a treatment challenge given their close proximity to critical neurovascular structures. Although primary management involves maximal safe resection, the addition of radiotherapy (RT) demonstrably increases local control [1,2]. Furthermore, dose-escalated and proton-based RT have been associated with both a local control and an overall survival benefit [3 –5]. Therefore, highly conformal RT, such as stereotactic radiosurgery, proton therapy, or intensity-modulated radiotherapy, are the prevailing techniques to deliver sufficient radiation dose to th...
Source: Radiotherapy and Oncology - February 18, 2021 Category: Radiology Authors: Alexandra N. De Leo, Adam L. Holtzman, M.W. Ho, Christopher G. Morris, Michael S. Rutenberg, Ronny L. Rotondo, James E. Bates, Daniel J. Indelicato, Dinesh Rao, Mohammad ASA Hasan, William M. Mendenhall Tags: Original Article Source Type: research

Head and Neck Imaging Surveillance Strategy for HPV-positive Oropharyngeal Carcinoma Following Definitive (Chemo)Radiotherapy
The incidence of human papillomavirus-positive (HPV+) oropharyngeal carcinoma (OPC) has increased in the western world over the past few decades. HPV+ OPC now accounts for over 50% of new OPC diagnoses in North America.1-3 Convincing data has shown that HPV+ OPC has much better locoregional control and survival compared to its HPV-negative (HPV –) counterparts.4,5 The dramatic differences in prognosis between HPV+ and HPV– OPC suggests that a different surveillance strategy may be appropriate for these two diseases. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 15, 2021 Category: Radiology Authors: Erin T. Wong, Shao Hui Huang, Brian O'Sullivan, Vincent Persaud, Jie Su, John Waldron, David P. Goldstein, John de Almeida, Jolie Ringash, John Kim, Andrew Hope, Scott Bratman, John Cho, Meredith Giuliani, Ali Hosni, Anna Spreafico, Aaron Hansen, Li Tong, Tags: Original Article Source Type: research

Prognostic factors of Colorectal Cancer patients with Brain Metastases
The incidence of brain metastases (BM) from colorectal cancer (CRC) ranges from 0.6 to 3.2% of all CRC and is increasing [1 –4]. Improvements in the treatment of metastatic CRC (mCRC) with prolonged survival of more than 30 months probably explain this phenomenon as it corresponds to the mean interval between primary tumor and BM diagnosis [4,5]. Few small series of patients with BM from CRC have identified a specific profile of these patients having predominant primary tumor site in the rectum and sigmoid colon, frequent lung metastases and high rate of KRAS-mutated tumors [2,4,6–8]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 15, 2021 Category: Radiology Authors: Pauline Roussille, Marie Auvray, Damien Vansteene, Thierry Lecomte, Eug énie Rigault, Marianne Maillet, Christophe Locher, Marie Dior, Vincent Hautefeuille, Pascal Artru, May Mabro, Yann Touchefeu, Lysiane Marthey, Valérie Moulin, Samy Louafi, Cédric L Tags: Original Article Source Type: research

The primary site of head and neck squamous cell carcinoma predicts survival benefits of EGFR inhibitors: a systematic review and meta-analysis
In clinical studies, medical oncologists generally group squamous cell carcinomas that originate in the oral cavity, oropharynx, hypopharynx, and larynx as the same disease, head and neck squamous cell carcinoma (HNSCC). The epidermal growth factor receptor (EGFR) is overexpressed in the overwhelming majority of HNSCC, and its overexpression is associated with poor prognosis [1]. Cetuximab, an antibody against EGFR, has been approved in combination with chemotherapy as the first-line treatment for recurrent or metastatic HNSCC [2]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 12, 2021 Category: Radiology Authors: Deheng Nie, Xin Wang, Meiting Sun, Zhenbang Feng, Fengli Pei, Wenhui Liu, Zonghan Wang, Fujun Han Tags: Original Article Source Type: research

Individual patient data meta-analysis of prophylactic cranial irradiation in locally advanced non-small cell lung cancer
Brain metastases (BM) occur in approximately 30% of patients with stage III non-small cell lung cancer (NSCLC) in the first two years after diagnosis and have a devastating impact on survival and quality of life[1]. The 5-year overall survival (OS) of unresectable stage III NSCLC patients who receive concurrent chemoradiotherapy ranges between approximately 24% and 32%[2]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 12, 2021 Category: Radiology Authors: Willem J.A. Witlox, Bram L.T. Ramaekers, Benjamin Lacas, Cecile Le Pechoux, Jean-Pierre Pignon, Alexander Sun, Si-Yu Wang, Chen Hu, Mary Redman, Vincent van der Noort, Ning Li, Matthias Guckenberger, Harm van Tinteren, Harry J.M. Groen, Manuela A. Joore, Tags: Original Article Source Type: research

Electron dose rate and oxygen depletion protect zebrafish embryos from radiation damage
In consequence of a previous study, where no protecting proton Flash effect was found for zebrafish embryos, potential reasons and requirements for inducing a Flash effect should be investigated with higher pulse dose rate and partial oxygen pressure (pO2) as relevant parameters. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 12, 2021 Category: Radiology Authors: J örg Pawelke, Michael Brand, Stefan Hans, Katalin Hideghéty, Leonhard Karsch, Elisabeth Lessmann, Steffen Löck, Michael Schürer, Emília Rita Szabó, Elke Beyreuther Tags: Original Article Source Type: research

Diffusion weighted imaging in submandibular gland sparing helical tomotherapy for nasopharyngeal carcinoma
To verify clinical significance of submandibular gland (SMG)-sparing during helical tomotherapy (HT) for nasopharyngeal carcinoma (NPC) from the perspective of imaging by using diffusion weighted imaging (DWI). (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 12, 2021 Category: Radiology Authors: Wen-jun Fan, Feng Teng, Gang Liu, Da-wei Zhao, Jin-feng Li, Yan-rong Luo, Xin-xin Zhang, Lin Ma, Jian Guan Tags: Original Article Source Type: research

Effectiveness of fractionated carbon ion treatments in three rat prostate tumors differing in growth rate, differentiation and hypoxia
In the last two decades, carbon (12C) ion radiotherapy became increasingly important for the treatment of radioresistant tumors (1-3). Besides high dose conformity resulting from the spread-out Bragg-peak (SOBP), 12C-ions exhibit an increasing linear energy transfer (LET) with depth leading to more direct and more severe cellular damage (4-6). As compared to the same absorbed photon dose, this results in a higher relative biological effectiveness (RBE), which is considered by bio-mathematical models in treatment planning (7-9). (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 12, 2021 Category: Radiology Authors: Christin Glowa, Peter Peschke, Stephan Brons, J ürgen Debus, Christian P. Karger Tags: Original Article Source Type: research

Impact of a fiducial marker based ART strategy on margins in postoperative IMRT of gynecological tumors
Adjuvant pelvic radiotherapy is used after hysterectomy in gynecologic cancers to reduce recurrences and improve progression free survival (1 –4). Currently, Intensity Modulated radiotherapy (IMRT) or Volumetric Modulated Arc Therapy (VMAT) is applied to reduce the dose to normal tissues and subsequently decrease acute and long-term toxicity (5–11). However, to prevent geometrical misses, the use of these highly conformal techniques r equires accurate margins that account for organ motion, set up and delineation errors. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 12, 2021 Category: Radiology Authors: R.T.T. Monica Buijs, Monique C.W.M. Bloemers, Peter Remeijer Tags: Original Article Source Type: research

Evaluation of Interim MRI Changes During Limited-Field Radiation Therapy for Glioblastoma and Implications for Treatment Planning
Glioblastoma (GBM) is the most common primary malignant brain tumor in adults and is treated with a combination of surgery, focal radiation therapy (RT), and temozolomide (TMZ) [1]. RT volume definitions gradually emerged based on surgical series demonstrating that 80-90% of recurrences occurred within 2 cm of the enhancing tumor on CT or MRI and that isolated tumor cells were present at the periphery of T2 abnormalities [2 –5]. A landmark surgical study demonstrated that the T1 contrast-enhancing abnormality contained high-density GBM tumor cells, while the T2 abnormality represented either brain parenchyma with inf...
Source: Radiotherapy and Oncology - February 12, 2021 Category: Radiology Authors: Comron Hassanzadeh, Soumon Rudra, Sirui Ma, Randall Brenneman, Yi Huang, Lauren Henke, Christopher Abraham, Jian Campian, Christina Tsien, Jiayi Huang Tags: Original Article Source Type: research

Predictors for Post-treatment Biopsy Outcomes after Prostate Stereotactic Body Radiotherapy
Stereotactic body radiotherapy (SBRT) is a well-recognized treatment option for low- and intermediate-risk prostate cancer. Five-year prostate-specific antigen (PSA) relapse-free survival rates of approximately 90% have been reported for patients with low-risk and intermediate-risk disease when delivering SBRT prescription dose levels ranging from 34 –50 Gy [1-7]. Recent reports of prospective randomized trials comparing SBRT to moderate hypo-fractionated radiotherapy have demonstrated comparable disease-related outcomes for patients treated for low-risk and intermediate-risk prostate cancer [8,9]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 12, 2021 Category: Radiology Authors: Michael J Zelefsky, Debra A. Goldman, Margaret Hopkins, Attapol Pinitpatcharalert, Sean McBride, Daniel Gorovets, Behfar Ehdaie, Samson W. Fine, Victor E. Reuter, Neelam Tyagi, Laura Happersett, Achiraya Teyateeti, Zhigang Zhang, Marisa A. Kollmeier Tags: Original Article Source Type: research

A multidisciplinary approach for autologous breast reconstruction: A narrative (re)view for better management
Breast reconstruction and oncoplastic surgery have become an important part of breast cancer care. The use of autologous breast reconstruction (ABR) has evolved significantly with advances in microsurgery, aiming to reduce donor site complications and improve cosmesis. For years, immediate-ABR was considered a contraindication if postmastectomy irradiation (PMRT) was planned. As a result of de-escalation of axillary surgery the indication of PMRT are increasing along-side with observations that PMRT in the setting of ABR is not contraindicated. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 11, 2021 Category: Radiology Authors: Orit Kaidar-Person, Naama Hermann, Philip Poortmans, Birgitte V. Offersen, Liesbeth J. Boersma, Dirk de Ruysscher, Trine Tramm, Thorsten K ühn, Tine Engberg Damsgaard, Oreste Gentilini, Wies Maarse, Miri Sklair-Levi, Zoltán Mátrai Tags: Review Article Source Type: research

Automatic dosimetric verification of online adapted plans on the Unity MR-Linac using 3D EPID dosimetry
The Elekta Unity MR-Linac, a combination of a 1.5T MRI scanner and a linear accelerator, is presently one of the systems available for online MR-guided adaptive workflows [1,2],[3]. Patient specific quality assurance (PSQA) programs are typically performed using MR-compatible detector devices [4,5],[6] before treatment starts for the reference plan and, if required, retrospectively for a subset of the online delivered plans. These checks can detect transfer, machine or treatment planning system errors, but they don ’t verify the actual dose delivered to the patient. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 11, 2021 Category: Radiology Authors: Igor Olaciregui-Ruiz, Bego ña Vivas-Maiques, Sandra van der Velden, Marlies E. Nowee, Ben Mijnheer, Anton Mans Tags: Original Article Source Type: research

Mechanisms of radiation-induced endothelium damage: emerging models and technologies
Healthy tissue may be exposed to ionizing radiation (IR) during radiotherapy [1], nuclear accidents, or by weapons of mass destruction (WMD) [2]. IR produces oxidative stress resulting in acute and chronic cellular damage. The vascular endothelium, which plays an important role in organ homeostasis, is a key target of radiation damage. Microvascular endothelial cells (EC), in particular, are sensitive to radiation and radiation-induced alterations in EC structure and function. Damage to the endothelium is an important regulator of radiation damage in both targeted radiotherapy and whole-body irradiation resulting from expo...
Source: Radiotherapy and Oncology - February 10, 2021 Category: Radiology Authors: Harshani Wijerathne, Jordan Langston, Qingliang Yang, Shuang Sun, Curtis Miyamoto, Laurie E. Kilpatrick, Mohammad F. Kiani Tags: Review Article Source Type: research

Alexithymia and professional quality of life in radiation oncology: the moderator effect of the professional profile
Radiation oncology is a medical discipline based on the clinical use of ionizing radiation to treat cancer patients [1,2]. It consists of a multi-professional framework, comprising different occupational profiles such as radiation and/or clinical oncologists (ROs), medical physicists (MPs), radiation therapists (RTTs) and radiobiologists [1]. All professionals are involved, to various extent, in the specific steps of cancer treatment with radiotherapy, including delivery of multimodal personalized cancer treatments, safe utilisation of advanced technologies and optimisation of therapeutic processes [2]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 9, 2021 Category: Radiology Authors: Pierfrancesco Franco, Marialaura Di Tella, Valentina Tesio, Anne Gasnier, Steven Petit, Mateusz Spalek, Jean-Emmanuel Bibault, Jolien Heukelom, Ludwig Dubois, Laura Mullaney, Kathrine R øe Redalen, Cyrus Chargari, Sophie Perryck, Martin-Immanuel Bittner, Tags: Original Article Source Type: research

Risk and impact of radiation related lymphopenia in lung cancer: A systematic review and meta-analysis
Carcinoma of the lung is the most commonly diagnosed cancer worldwide, responsible for 11.6% of total cases and 18.4% of total cancer deaths[1]. The treatment paradigm of lung cancer has seen major strides in the past two decades with evolution of immunotherapy and targeted therapy in the management of metastatic and locally advanced non-small cell lung cancer (NSCLC); minimally invasive surgery and stereotactic body radiotherapy (SBRT) in early stage and oligometastatic as well as oligoprogressive NSCLC; and immunotherapy in small cell lung cancer(SCLC) [2 –4]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 9, 2021 Category: Radiology Authors: Rituraj Upadhyay, Bhanu Prasad Venkatesulu, Prashanth Giridhar, B.K. Kim, Amrish Sharma, Hagar Elghazawy, Bhaswanth Dhanireddy, Thiraviyam Elumalai, Supriya Mallick, Matthew Harkenrider Tags: Review Article Source Type: research

Improved local control in p16 negative oropharyngeal cancers with hypermethylated MGMT
Up to 50% of patients with locally advanced Head and Neck Squamous Cell Carcinomas (HNSCC) have poor treatment response or experience recurrence after concurrent chemoradiotherapy (CRT) [1 –3]. Dramatically improved prognosis of oropharyngeal cancers associated with Human Papilloma Virus (HPV) infection, indicated by its surrogate marker p16, has led to modified staging and investigation into treatment de-escalation in p16 positive (p16+) oropharyngeal cancer patients [4–9]. On th e other hand, oral cavity cancers have a worse prognosis than similarly staged oropharyngeal cancers, and p16 status has not demonst...
Source: Radiotherapy and Oncology - February 9, 2021 Category: Radiology Authors: L. Jensen Garrett, Axelrud Gabriel, Fink David, P. Hammond s Kendall, Walker Kimberly, Volz Marcus, C. Gowan Alan, Rao Arundhati, Deb Niloyjyoti, G. Jhavar Sameer Tags: Original Article Source Type: research

A phase 1b trial of prexasertib in combination with chemoradiation in patients with locally advanced head and neck squamous cell carcinoma
Locoregionally advanced head and neck squamous cell carcinomas (HNSCCs) are commonly treated with radiotherapy (RT) and chemotherapy [1 –3], or cetuximab [4,5]. These combinations improved effectiveness over RT alone in locoregional control, overall survival (OS), and progression-free survival (PFS). It was recently reported that OS and PFS are inferior with cetuximab compared with cisplatin [6,7], making cisplatin-RT the preferre d regimen. Disease recurrence remains a challenge and therapies that potentiate the effects of established treatments, are warranted [8–10]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 8, 2021 Category: Radiology Authors: Eddy S. Yang, Eric Deutsch, Altan Mehmet, Jerome Fayette, Yungan Tao, Lisle Nabell, Sharon A. Spencer, Xuejing A. Wang, Elizabeth A. Spoljoric, Wei Zhang, Scott M. Hynes, Rodney L. Decker, Aimee K. Bence Lin, William N. William Tags: Original Article Source Type: research

The role of combined ion-beam radiotherapy (CIBRT) with protons and carbon ions in a multimodal treatment strategy of inoperable osteosarcoma
Osteosarcoma is the most prevalent malignant bone tumor in children and adolescents and is rarely seen in adults. Most osteosarcomas arise at the distal femur and the proximal tibia, and are treated with a regimen of chemotherapy and surgery. While chemotherapy controls micrometastases, surgery controls the primary tumor. There is a substantial number of patients with axial primary tumors (5-10%), which are non-resectable without unacceptable mutilation and thus have significantly reduced long term survival chances [1-3]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 4, 2021 Category: Radiology Authors: K. Seidensaal, M. Mattke, S. Haufe, H. Rathke, U. Haberkorn, N. Bougatf, A. Kudak, C. Blattmann, S. Oertel, M. Kirchner, C. Buesch, M. Kieser, K. Herfarth, A. Kulozik, J. Debus, M. Uhl, S.B. Harrabi Tags: Original Article Source Type: research

Local tumour control and radiation side effects for fractionated stereotactic photon beam radiotherapy compared to proton beam therapy in uveal melanoma
Introduction (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 4, 2021 Category: Radiology Authors: Jackelien G.M. van Beek, Wishal D. Ramdas, Martina Angi, Caroline M. van Rij, Nicole C. Naus, Andrzej Kacperek, Roger D. Errington, Bertil Damato, Heinrich Heimann, Emine Kili ç Tags: Original Article Source Type: research

State of the art treatment for stage I to III anal squamous cell carcinoma: a systematic review and meta-analysis
Anal cancer is a rare malignancy contributing to fewer than 3% of gastrointestinal malignant tumours [1]. With 1-2 cases per 100,000 population annually [2], its incidence is low but has been rising in recent years [2-5]. In Europe, 5-year survival is approximately 57% [2]. The most important specific cause is an infection with high-risk HPV types (most commonly HPV 16 or 18) [6, 7], and risk factors are increased exposure (number of sex partners [6], receptive anal sex [6, 8], history of HPV-infections at other genital sites [8-11]) and decreased clearance of HPV (immunodeficiency [12-15], smoking [6, 16, 17]). (Source: R...
Source: Radiotherapy and Oncology - February 4, 2021 Category: Radiology Authors: Ricardo N. Werner, Matthew Gaskins, Gabriela Avila Valle, Volker Budach, Stephan Koswig, Franz A. Mosthaf, Hans-Rudolf Raab, Claus R ödel, Alexander Nast, Robert Siegel, Felix Aigner Tags: Review Article Source Type: research

Comments on “Temporal lobe sparing radiotherapy with photons or protons for cognitive function preservation in paediatric craniopharyngioma” by Toussaint, et al.: Prior Similar Field Arrangement Work and a Need for Variable RBE Use
Having recently read the paper by Toussaint, et al, on (Temporal lobe sparing radiotherapy with photons or protons for cognitive function preservation in paediatric craniopharyngioma)1, this prompted consideration of their proposed proton beam arrangements for sparing cognitive structures against other published suggestions2,3, in particular the Indiana University midline beam method used from 2010 and reported in 20154. There is a limited literature on optimizing proton beam arrangements to spare critical cranial structures, and some of these are listed in Table 1. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 3, 2021 Category: Radiology Authors: Jeffrey C. Buchsbaum Tags: Letter to the Editor Source Type: research

Response to: ‘Comments on “Temporal lobe sparing radiotherapy with photons or protons for cognitive function preservation in paediatric craniopharyngioma” by Toussaint, et al.: Prior Similar Field Arrangement Work and a Need for Variable RBE Use’
We would like to thank Dr. Buchsbaum [1] for his interest in our work [2]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 3, 2021 Category: Radiology Authors: Laura Toussaint, Daniel J Indelicato, Ludvig P Muren, Zuofeng Li, Yasmin Lassen-Ramshad, Kevin Kirby, Catia Pedro, Ronni Mikkelsen, Marcos Di Pinto, Morten H øyer, Camilla H Stokkevåg Tags: Letter to the Editor Source Type: research

Towards the clinical implementation of intensity-modulated proton therapy for thoracic indications with moderate motion: robust optimised plan evaluation by means of patient and machine specific information
Conformal and highly precise radiotherapy techniques are required for thoracic indications due to the organs-at-risk (OARs) surrounding the tumour, such as the lungs and the heart. Volumetric modulated arc therapy (VMAT) is capable of reducing the number of monitor units and treatment delivery time, and proved to result at least in similar target coverage and OARs dose sparing for lung and oesophageal cancer patients, compared to conventional photon modalities [1,2]. In terms of treatment related toxicities, even more clinical benefits are anticipated with pencil beam scanned proton therapy (PBS-PT) for these patients. (So...
Source: Radiotherapy and Oncology - February 2, 2021 Category: Radiology Authors: C ássia O. Ribeiro, Sabine Visser, Erik W. Korevaar, Nanna M. Sijtsema, R. Melissa Anakotta, Margriet Dieters, Stefan Both, Johannes A. Langendijk, Robin Wijsman, Christina T. Muijs, Arturs Meijers, Antje Knopf Tags: Original Article Source Type: research

Risk factors and dose-effects for bladder fistula, bleeding and cystitis after radiotherapy with imaged-guided adaptive brachytherapy for cervical cancer: an EMBRACE analysis
Standard of care for locally advanced cervical cancer (LACC) includes external beam radiotherapy (EBRT) with concomitant chemotherapy and image-guided adaptive brachytherapy (IGABT) [1]. The use of IGABT has brought improved disease control and overall survival, as well as decreased morbidity compared to two-dimensional (2D) brachytherapy (BT) [2] –[9]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 2, 2021 Category: Radiology Authors: Sofia Spampinato, Lars U. Fokdal, Richard P ötter, Christine Haie-Meder, Jacob C. Lindegaard, Maximilian P. Schmid, Alina Sturdza, Ina M. Jürgenliemk-Schulz, Umesh Mahantshetty, Barbara Segedin, Kjersti Bruheim, Peter Hoskin, Bhavana Rai, Fleur Huang, R Tags: Original Article Source Type: research

Taste Dysfunction Following Radiotherapy to the Head and Neck: A Systematic Review
Within the United States and across Europe, head and neck cancer (HNC) comprises 3-4% of all cancer incidence (1,2). More than 550,000 cases are diagnosed globally each year and there are approximately 380,000 deaths annually (3). Despite public health efforts to reduce smoking and alcohol consumption, amongst the United Kingdom population, the incidence of HNC continues to rise. Projected incidence between 2014 and 2035, is set to rise by 33% (2), in part reflecting a significant increase in the proportion of HPV-positive squamous cell carcinoma of the oropharynx. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 2, 2021 Category: Radiology Authors: Gunn Lucinda, Gilbert James, Nenclares Pablo, Soliman Heba, Newbold Kate, Bhide Shree, Wong Kee Howe, Harrington Kevin, Nutting Chris Tags: Review Article Source Type: research

Dose accumulation for personalized stereotactic MR-guided adaptive radiation therapy in prostate cancer
Stereotactic body radiation therapy (SBRT) is an increasingly used treatment option for localized prostate cancer (PC), allowing precise delivery of up to five fractions of high biological radiation doses while sparing the surrounding bladder and rectum [1,2]. Several studies have shown an equal efficiency and tolerance for SBRT and conventionally fractionated treatments for PC, particularly for low and intermediate risk PC [3 –5]. Despite the increased clinical use of SBRT for PC, there is limited data on the relation between dosimetric parameters and toxicity or quality of life (QoL). (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 2, 2021 Category: Radiology Authors: Omar Bohoudi, Anna ME Bruynzeel, Shyama Tetar, Ben J Slotman, Miguel A Palacios, Frank J Lagerwaard Tags: Original Article Source Type: research

Characterization of cardiovascular injury in mice following partial-heart irradiation with clinically relevant dose and fractionation
Radiation-induced heart disease (RIHD) is a major late side effect of radiation therapy (RT) for breast cancer and other thoracic cancers. Many women who have been treated with adjuvant RT for left-sided breast cancer received 2 Gy daily fractions to 50 Gy total. While adjuvant RT improves overall survival in patients with invasive breast cancer, survivors who receive RT are at increased risk of late cardiac morbidity and mortality (1-4). A population-based study of 2,168 women receiving RT for breast cancer reported that each 1 Gy increase in mean heart dose conferred a 7.4% increase in the risk of major coronary events, ...
Source: Radiotherapy and Oncology - February 2, 2021 Category: Radiology Authors: Chang-Lung Lee, Jessica Lee, Andrea R. Daniel, Matt Holbrook, Stephanie Hasapis, Ato O. Wright, Jeremy Brownstein, Lorraine Da Silva Campos, Yan Ma, Dennis Abraham, Cristian T. Badea, David G. Kirsch Tags: Original Article Source Type: research

Comprehensive toxicity risk profiling in radiation therapy for head and neck cancer: a new concept for individually optimised treatment
In recent decades, the survival rate of head and neck cancer (HNC) patients has improved significantly due to intensified treatment regimens and an increased incidence of relatively favourable Human Papillomavirus associated oropharyngeal cancer.[1 –5] As patients’ life expectancy is prolonged, the need to prevent treatment related toxicities that affect the quality of life and daily functioning of HNC patients has become increasingly relevant.[6,7] (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 2, 2021 Category: Radiology Authors: Lisa Van den Bosch, Arjen van der Schaaf, Hans Paul van der Laan, Frank J.P. Hoebers, Oda B. Wijers, Johanna G.M. van den Hoek, Karel G.M. Moons, Johannes B. Reitsma, Roel J.H.M. Steenbakkers, Ewoud Schuit, Johannes A. Langendijk Tags: Original Article Source Type: research

Risk of ischaemic cerebrovascular events in head and neck cancer patients is associated with carotid artery radiation dose
Radiotherapy is recommended in around 80% of patients with malignancies in the head and neck area and often combined with surgery or systemic treatment [1,2]. Since survival rates are gradually improving due to more intensified regimens, there is increasing attention to the prevention of long-term side effects caused by (chemo)radiation [3]. In the head and neck region, the salivary glands and the swallowing structures are the most important organs at risk for developing long-term side effects, such as xerostomia, sticky saliva and dysphagia [2,4]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 2, 2021 Category: Radiology Authors: Evert S.M. van Aken, Hans Paul van der Laan, Hendrik P. Bijl, Lisa Van den Bosch, Johanna G.M. van den Hoek, Margriet Dieters, Roel J.H.M. Steenbakkers, Johannes A. Langendijk Tags: Original Article Source Type: research