Clinical oncology module for the ESTRO core curriculum
The 4th edition of the European Society for Radiotherapy and Oncology Core Curriculum for Radiation Oncology/Radiotherapy (ESTRO Curriculum) describes the minimum competencies necessary to deliver ionising radiation therapy including when this forms part of combined modality treatments with systemic therapies[1]. It identifies that, “Radiotherapy (Radiation Oncology) is the branch of clinical medicine that uses ionising radiation, either alone or in combination with other therapeutic modalities, for the treatment of patients with malignant or benign disease. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 30, 2020 Category: Radiology Authors: Kim Bensteada, Pedro C. Larab, Yannick Ellerc, Lotte Engell-Noerregaardd, Jesper G. Eriksene, Papa Macoumba Gayef, Jana Jaalg, Antonio Juretich, Marju Kasei, Vassilis Koulouliasj, Elvisa Kozmak, Magnus Lagerlundl, Graeme Lumsdenm, Icro Meattinin, Ingvil M Tags: Original Article Source Type: research

Deep learning prediction of proton and photon dose distributions for paediatric abdominal tumours
Neuroblastoma (NBL) and Wilms ’ tumour (WT) belong to the most common types of abdominal cancer in children [1,2]. Radiation therapy (RT) to the primary tumour and regional nodes is currently delivered in patients with high-risk NBL and a subset of patients with medium-risk NBL and WT [3,4]. In children, extra caution is requi red with the delivery of radiation due to the radiosensitive nature of their developing tissue. With more-advanced photon RT techniques, high-doses can be conformably delivered to complex target volumes. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 29, 2020 Category: Radiology Authors: F. Guerreiro, E. Seravalli, G.O. Janssens, J.H. Maduro, A.C. Knopf, J.A. Langendijk, B.W. Raaymakers, C. Kontaxis Tags: Original Article Source Type: research

Multicentre, deep learning, synthetic-CT generation for ano-rectal MR-only radiotherapy treatment planning
The potential benefits of magnetic resonance (MR)-only radiotherapy treatment planning have been well documented, as has the need to generate synthetic-CT (sCT) datasets to allow treatment dose to be calculated [1,2]. Commercial sCT solutions are available however a recent systematic review found that comprehensive dosimetric analysis is required prior to the clinical implementation of pelvic MR-only sites, other than prostate, due to the limited number of site specific synthetic-CT dosimetric assessments in the literature [3]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 29, 2020 Category: Radiology Authors: David Bird, Michael G. Nix, Hazel McCallum, Mark Teo, Alexandra Gilbert, Nathalie Casanova, Rachel Cooper, David L. Buckley, David Sebag-Montefiore, Richard Speight, Bashar Al-Qaisieh, Ann M. Henry Source Type: research

Healthcare resource utilization following unilateral versus bilateral radiation therapy for oropharyngeal carcinoma
Oropharyngeal squamous cell carcinoma (OPC) is rapidly increasing in incidence, due to an association with the human papillomavirus (HPV) infection. [1,2] The standard of care for the majority of OPC is radiation therapy (RT) to the primary tumour and neck lymph nodes with or without concurrent chemotherapy. Due to concern of of contralateral neck nodal involvement, [3] most OPC are treated with bilateral neck RT, while unilateral neck RT is only offered to highly selected OPC patients with low risk of contralateral neck failure. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 29, 2020 Category: Radiology Authors: Ali Hosni, Shao Hui Huang, Wei Xu, Jie Su, Erin Watson, Michael Glogauer, Andrew Bayley, Scott V. Bratman, John Cho, Meredith Giuliani, Andrew Hope, John Kim, Brian O'Sullivan, Jolie Ringash, Anna Spreafico, David P. Goldstein, John Waldron, John R. de Al Tags: Original Article Source Type: research

Dosimetric impact of intrafraction prostate rotation and accuracy of gating, multi-leaf collimator tracking and couch tracking to manage rotation: an end-to-end validation using volumetric film measurements
Stereotactic body radiotherapy (SBRT) is increasingly being used in the treatment of localized prostate cancer (PCa) as ultrahypofractionated treatments have been demonstrated to provide good disease control with minimal toxicity and are more convenient for the patient [1-7]. However, due to the high dose-per-fraction delivered by such ultrahypofractionated treatments, there is a need for steep dose gradients to be employed with tighter than conventional margins as to limit exposure of surrounding organs at risk (OAR) [8,9]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 29, 2020 Category: Radiology Authors: Robin De Roover, Rune Hansen, Wouter Crijns, Casper Gammelmark Muurholm, Kenneth Poels, Simon Skouboe, Karin Haustermans, Per Rugaard Poulsen, Tom Depuydt Tags: Original Article Source Type: research

A graded prognostic model for patients surviving 3 years or more (GPM ≥3Ys) after stereotactic radiosurgery for brain metastasis
Stereotactic radiosurgery (SRS) alone, regardless of whether a gamma knife (GK) or a linac system is used, has been widely applied as a primary treatment for growing numbers of brain metastasis (BM) patients. However, the treatable lesion size limitation is a crucial factor in selecting SRS. Kann et al. recently reported [1], based on their series of 75,953 BM patients included in the National Cancer Data Base during the 2009 through 2014 period, that the overall utilization rate for SRS rose from 9.8% in 2004 to 25.6% in 2014 (P (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 26, 2020 Category: Radiology Authors: Yasunori Sato, Masaaki Yamamoto, Toru Serizawa, Kei-ichiro Yamada, Yoshinori Higuchi, Hidetoshi Kasuya Tags: Original Article Source Type: research

The 70-year-old newly diagnosed glioblastoma patients are older than the 65-year-old? Outcome evaluation of the two categories in a matched case control study with propensity score balancing
The standard of care for newly diagnosed glioblastoma multiforme (GBM) patients consists of surgical resection followed by radiotherapy (RT) with concomitant and adjuvant temozolomide chemotherapy (TMZ-CHT), as defined by the European Organization for Research and Treatment of Cancer –National Cancer Institute of Canada Clinical Trials Group trial [1,2]. This approach affords a median overall survival (OS) time, and a 2-year OS rate of 14.6 months and 26.5%, respectively. Conventional fractionated radiotherapy (CRT) to a total dose of 60 Gy in 30 daily fractions of 2 Gy each i s employed. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 24, 2020 Category: Radiology Authors: Pierina Navarria, Federico Pessina, Ciro Franzese, Mauro Loi, Luisa Bellu, Elena Clerici, Antonio Marco Marzo, Matteo Simonelli, Elena Lorenzi, Letterio Salvatore Politi, Lorenzo Bello, Maurizio Fornari, Zefferino Rossini, Armando Santoro, Marta Scorsetti Tags: Original Article Source Type: research

Pattern of failure in IDH mutated, low grade glioma after radiotherapy – implications for margin reduction
Introduction (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 24, 2020 Category: Radiology Authors: J.P.M. Jaspers, A. M éndez Romero, R. Wiggenraad, I. Compter, D.B.P. Eekers, R.M.D. Nout, M. van den Bent Tags: Original Article Source Type: research

Idiopathic Pulmonary Fibrosis: Current Knowledge, Future Perspectives And Its Importance In Radiation Oncology
Idiopathic pulmonary fibrosis (IPF) is a specific form of chronic, progressive, fibrosing interstitial pneumonia of unknown cause, leading to respiratory failure and ultimately to death. IPF mostly occurs in older individuals (>50 years old) and the incidence of IPF in Europe and North America is 3-9 cases per 100,000 person-years [1]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 24, 2020 Category: Radiology Authors: G örkem Türkkan, Yves Willems, Lizza E.L. Hendriks, Rémy Mostard, Lennart Conemans, Hester A Gietema, Cristina Mitea, Stéphanie Peeters, Dirk De Ruysscher Tags: Review Article Source Type: research

Development and validation of a novel prognostic score for elderly head-and-neck cancer patients undergoing radiotherapy or chemoradiation
Head-and-neck squamous cell carcinoma (HNSCC) is a common malignancy, leading to more than 300000 deaths per year globally, and radiotherapy, either alone or in combination with chemotherapy constitutes a key curative treatment for HNSCC patients [1,2]. Currently, about a quarter of HNSCC patients are 70 years or older, and the proportion of elderly HNSCC patients is estimated to further increase owing to demographic change [3 –5]. There are considerable clinical differences between younger and elderly HNSCC patients, e.g. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 24, 2020 Category: Radiology Authors: Alexander R ühle, Carmen Stromberger, Erik Haehl, Carolin Senger, Hélène David, Raluca Stoian, Constantinos Zamboglou, Andreas Knopf, Volker Budach, Anca-Ligia Grosu, Nils H. Nicolay Tags: Original Article Source Type: research

A case-control study to identify molecular risk factors for local recurrence in young breast cancer patients
Breast conserving therapy (BCT), consisting of breast conserving surgery followed by whole breast irradiation is the standard treatment for early stage breast cancer. In the EORTC boost-no boost trial a boost of 16 Gy to the primary tumor bed reduced the LR rate from 10.2 to 6.2% (p (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 24, 2020 Category: Radiology Authors: Sophie CJ Bosma, Marlous Hoogstraat, Erik van Werkhoven, Michiel de Maaker, Femke van der Leij, Paula HM Elkhuizen, Alain Fourquet, Philip Poortmans, Liesbeth J Boersma, Harry Bartelink, Marc J van de Vijver Tags: Original Article Source Type: research

Significant correlation between gross tumor volume (GTV) D98% and local control in multifraction stereotactic radiotherapy (MF-SRT) for unresected brain metastases
Stereotactic radiosurgery (SRS) and multifraction stereotactic radiotherapy (MF-SRT) have become increasingly common treatment options for suitable patients with brain metastases [1]. Wiggenraad et al. showed in a systematic review that local control (LC) after single fraction SRS was highly dependent upon dose and was high (> 80%) after 21 Gy or more and low ( (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 23, 2020 Category: Radiology Authors: Guillaume Dupic, Lucie Brun, Ioana Molna, Brice Leyrat, Vincent Chassin, Juliette Moreau, V éronique Dedieu, Toufic Khalil, Pierre Verrelle, Michel Lapeyre, Julian Biau Tags: Original Article Source Type: research

Radiotherapy enhances uptake and efficacy of 90Y-Cetuximab: a preclinical trial
Labeling of molecular targeted drugs with toxic effectors is long discussed in the literature as a potential method to treat solid tumors [1]. If radionuclides are used, the approach is referred to as molecular radiotherapy [2,3]. Molecular radiotherapy has the potential to destroy localized tumors and even metastases [4,5]. However, the agents show classical limitations of molecular therapeutics, especially the barriers for drug delivery [6 –8], limiting the therapeutic doses that can be delivered to solid tumors. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 20, 2020 Category: Radiology Authors: Antje Dietrich, Michael Andreeff, Lydia Koi, Ralf Bergman, Maik Schubert, Lena Schreiner, Steffen L öck, Wiebke Sihver, Robert Freudenberg, Sandra Hering, Hans-Jürgen Pietzsch, Jörg Steinbach, Jörg Kotzerke, Michael Baumann, Mechthild Krause Tags: Original Article Source Type: research

Increased Number of Prostate Cancer Patients Selecting High Dose-Rate Interstitial Brachytherapy during the COVID-19 Pandemic
Since the beginning of the outbreak of the novel coronavirus (SARS-CoV-2) disease 2019 (COVID-19) in December 2019 in Wuhan, China [1], the virus rapidly spread around the globe. The virus hardly hit not only European countries, but also the United States, Brazil, and India. Subsequently, the World Health Organization has declared the COVID-19 outbreak a global pandemic on March 12th 2020 and many large cities around the world experienced lock-down. Several organizations or radiotherapy societies published guidelines or suggested solutions for cancer patient ’s management under the global COVID-19 pandemic [2–1...
Source: Radiotherapy and Oncology - November 20, 2020 Category: Radiology Authors: Naoya Murakami, Satoshi Nakamura, Tairo Kashihara, Koji Inaba, Tomoya Kaneda, Kana Takahashi, Kae Okuma, Hiroshi Igaki, Jun Itami Tags: Letter to the Editor Source Type: research

In response to Liu et al
We would like to thank the comments in the letter by Liu and colleagues [1] with regard to our retrospective nationwide multicentre study in carbon ion radiotherapy (CIRT) for sacral chordoma [2]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 19, 2020 Category: Radiology Authors: Yusuke Demizu, Reiko Imai, Hiroki Kiyohara, Akira Matsunobu, Masahiko Okamoto, Tomoaki Okimoto, Hiroshi Tsuji, Tatsuya Ohno, Yoshiyuki Shioyama, Kenji Nemoto, Takashi Nakano, Tadashi Kamada, the Japan Carbon-Ion Radiation Oncology Study Group Tags: Letter to the Editor Source Type: research

Letter to the editor of radiotherapy and oncology regarding the article “Carbon ion radiotherapy for sacral chordoma: a retrospective nationwide multicentre study in Japan” by Demizu el al
Chordoma is a rarely low to intermediate malignant tumor arising from the notochordal remnants. This tumor has a high risk of local recurrence and poorly responds to traditional radiotherapy and chemotherapy. To today, complete or en-bloc resection with widely negative margins is considered to be the standard treatment for chordoma. Despite the improvement of surgical techniques and adjuvant radiotherapy, the clinical outcomes in chordoma is still dismal. Recently, we read with great interest the article by Demizu et al[1]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 19, 2020 Category: Radiology Authors: Fu-Sheng Liu, Fu-Bing Liu, Qian-Shi Zhang, Xiao-Bin Wang, Ming-Xiang Zou, Jing Li Tags: Letter to the Editor Source Type: research

Optimizing Treatment Sequencing of Chemotherapy for Patients with Rectal Cancer: the KIR Randomized Phase II Trial
We conducted a phase 2 randomized, open-label, multicentre trial was in five institutions between 2010 and 2017(NCT01274962). Patients diagnosed with rectal cancer underwent baseline magnetic resonance imaging (MRI) of the pelvis, computed tomography scans of the chest, abdomen and pelvis, baseline serology including carcinogenic embryonic antigen testing. All patients underwent evaluation by a multidisciplinary tumor board including at least one colorectal surgeon, medical oncologist and radiation oncologist; a second radiologist reviewed imaging at tumor board for confirmation of eligibility. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 18, 2020 Category: Radiology Authors: Aurelie Garant, Petr Kavan, Andr é-Guy Martin, Laurent Azoulay, Véronique Vendrely, Caroline Lavoie, Carol-Ann Vasilevsky, Marylise Boutros, Julio Faria, Trung Nghia Nguyen, Emery Ferland, Sylvain Des Groseilliers, Alexis-Simon Cloutier, Hugo Diec, Séb Tags: Original Article Source Type: research

SPARC, a phase-I trial of pre ‐operative, margin intensified, stereotactic body radiation therapy for pancreatic cancer
Surgical resection aims to achieve long-term disease control in pancreatic cancer, but even when adjuvant chemotherapy is prescribed, 50% of patients will suffer local recurrence [1] and improvement in multi ‐modal therapy is therefore required. For patients with positive surgical resection margins, survival outcomes are similar to those for patients who present with unresectable disease [2–4], and despite centralisation of surgery and improved pre-operative investigations, positive margins are repo rted in around 35-60% of UK patients [5,6]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 17, 2020 Category: Radiology Authors: Daniel L.P. Holyoake, Maxwell Robinson, Michael Silva, Derek Grose, David McIntosh, David Sebag-Montefiore, Ganesh Radhakrishna, Somnath Mukherjee, Maria A. Hawkins Tags: Original Article Source Type: research

Pattern of use of palliative radiotherapy fractionation for bone metastases and 30-day mortality
Radiation therapy (RT) can provide successful palliation of painful bone metastases in up to 80% of patients, with approximately 35% of patients achieving complete pain relief [1]. Single-fraction RT (SFRT) is recommended due to its equivalence to multi-fraction (MFRT) in the palliation of uncomplicated bone metastases [2 –9]. However, multiple studies evaluating RT fractionation patterns for palliation of bone metastases have reported wide variations in practice and low uptake of SFRT [10–18]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 17, 2020 Category: Radiology Authors: V. Batumalai, J. Descallar, G.P. Delaney, G. Gabriel, K. Wong, J. Shafiq, S.K. Vinod, M.B. Barton Tags: Original Article Source Type: research

Influence of Tumor Necrosis on Treatment Sensitivity and Long-term Survival in Nasopharyngeal Carcinoma
South China has a high incidence of nasopharyngeal carcinoma (NPC), where its incidence rate in males is>20/105 per year, as compared to (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 17, 2020 Category: Radiology Authors: Shao-Bo Liang, Lu-Si Chen, Xing-Li Yang, Dan-Ming Chen, Dong-Hui Wang, Chun-Yan Cui, Chuan-Bo Xie, Li-Zhi Liu, Xiang-Ying Xu Tags: Original Article Source Type: research

Development and Validation of a Contouring Guideline for the Taste Bud Bearing Tongue Mucosa
Taste impairment is a nearly ubiquitous patient-reported symptom during radiotherapy (RT) for head and neck cancer (HNC) and can affect appetite and subsequent nutritional status and quality of life [1,2]. Whereas over ninety percent of patients reporting moderate or severe problems tasting food in the acute phase [3], this symptom improves with time after RT for the majority of patients. However, many patients fail to recover the same pre-therapy quality of taste [4]. There is a large variation between individuals not only in the impairment of taste during treatment and post-therapy, but also regarding the degree of taste...
Source: Radiotherapy and Oncology - November 17, 2020 Category: Radiology Authors: Sonja Stieb, Abdallah S.R. Mohamed, Renjie He, Lin L. Zhu, Brigid A. McDonald, Kareem Wahid, Lisanne V. van Dijk, Juan Ventura, Sara Ahmed, Lance McCoy, Tanaya S. Deshpande, Stephen Grant, Jay P. Reddy, Jack Phan, Adam S. Garden, David I. Rosenthal, Steve Tags: Original Article Source Type: research

A phase II study of stereotactic radiotherapy after FOLFIRINOX for locally advanced pancreatic cancer (LAPC-1 trial): long-term outcome
Pancreatic cancer is among the most aggressive malignancies. It represents the fourth cause of tumor-related death in the world, and is likely to become even the second cause by 2030 [1]. Despite aggressive multimodality treatment approaches, the prognosis remains poor, with a 5-years life expectancy of 9%. Locally advanced pancreatic cancer (LAPC) is found in 35-40% of patients at time of diagnosis [2]. The involvement of superior mesenteric artery (SMA), celiac artery (CA), common hepatic artery (CHA), portal vein (PV) and superior mesenteric vein (SMV) characterizes the LAPC [3] and defines unresectable disease. (Source...
Source: Radiotherapy and Oncology - November 17, 2020 Category: Radiology Authors: M.A. Teriaca, M. Loi, M. Suker, F.A.L.M. Eskens, C.H.J van Eijck, J.J. Nuyttens Tags: Original Article Source Type: research

Development of Staffing, Workload and Infrastructure in Member Departments of the European Organisation for Research and Treatment of Cancer (EORTC) Radiation Oncology Group
The European Organisation for Research and Treatment of Cancer (EORTC) Radiation Oncology Group (ROG) connects a network of radiation oncology departments in Europe and beyond to conduct clinical trials across different types of cancer. Besides the initiation of radiation therapy-based clinical trials, the EORTC ROG runs an extensive radiation therapy quality assurance (RTQA) program to ensure consistent and reliable delivery of radiation therapy in clinical trials [1 –2]. As part of the RTQA program, the EORTC ROG collects the site-related information of its member departments with a dedicated Facility Questionnaire...
Source: Radiotherapy and Oncology - November 17, 2020 Category: Radiology Authors: Jonas Willmann, Philip Poortmans, Angelo Fillipo Monti, Warren Grant, Enrico Clementel, Coreen Corning, Nick Reynaert, Coen W. Hurkmans, Nicolaus Andratschke Tags: Original Article Source Type: research

Regional Lymph Node Irradiation in Locally Advanced Merkel Cell Carcinoma Reduces Regional and Distant Relapse and Improves Disease-Specific Survival
Merkel cell carcinoma (MCC) is a rare, highly aggressive cutaneous malignancy. MCC has a high propensity for metastasis to regional lymph nodes and distant sites, and 26-32% of patients present with locally advanced disease involving the regional lymph nodes [1]. This includes both clinically detected nodal disease and occult disease detected with a sentinel lymph node biopsy (SNLB). Five-year survival for patients with locally advanced MCC is poor, reported to be 26.8% for those with clinically detected disease and 39.7% for patients with microscopically detected disease [1]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 16, 2020 Category: Radiology Authors: Neal Andruska, Lily Mahapatra, Randall J. Brenneman, Yi Huang, Randal C. Paniello, Sidharth V. Pura, Mena Mansour, Jason T. Rich, Brian C. Baumman, Wade L. Thorstad, Mackenzie D. Daly Tags: Original Article Source Type: research

Proton therapy for selected low grade glioma patients in the Netherlands
Radiotherapy is an important treatment modality in the management of low grade glioma (LGG). The optimal timing of radiation treatment in the disease course is a dilemma in patients with minimal symptoms and favourable prognosis [1]. Early treatment can postpone tumour progression, a process that is otherwise continuously on going. Deferring treatment can postpone side effects, however, inevitably results in larger treatment volumes. Tumour progression and radiotherapy both adversely affect neurocognitive function (NCF). (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 13, 2020 Category: Radiology Authors: Hiska L. van der Weide, Miranda C.A. Kramer, Daniel Scandurra, Dani ëlle B.P. Eekers, Yvonne L.B. Klaver, Ruud G.J. Wiggenraad, Alejandra Méndez Romero, Ida E.M. Coremans, Liesbeth Boersma, Marco van Vulpen, Johannes A. Langendijk, On behalf of the Dutc Tags: Review Article Source Type: research

Beginnings, endings, histories and horizons
This issue of Radiotherapy& Oncology appears at the end of ESTRO ’s 40th anniversary year [1], a year of hugely disruptive still-continuing global Covid pandemic. In different ways these prompt a time of reflection, looking back at how things have developed to where they are now and looking forward to how things might be, might change. Similarly for myself, sin ce this is the last issue to which I will fully contribute as a Physics Editor of Radiotherapy& Oncology. I am stepping down at the beginning of 2021, having been involved in the journal since 1992 when first joining the editorial board. (Source: Radio...
Source: Radiotherapy and Oncology - November 12, 2020 Category: Radiology Authors: David Thwaites Tags: Editorial Source Type: research

Boron neutron capture therapy using cyclotron-based epithermal neutron source and borofalan(10B) for recurrent or locally advanced head and neck cancer (JHN002): An open-label phase II trial
Boron neutron capture therapy (BNCT) is a unique cell-selective cancer treatment technique in which tumor cells are irradiated from the inside with heavy particles produced by a10B(n, α)7Li nuclear transmutation reaction between boron-10 atoms (10B) and thermal neutrons.[1–3] The released α particles and lithium (Li) recoil nuclei produce energy to the surroundings in the range of 9 μm and 5 μm, respectively. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 10, 2020 Category: Radiology Authors: Katsumi Hirose, Akiyoshi Konno, Junichi Hiratsuka, Seiichi Yoshimoto, Takahiro Kato, Koji Ono, Naoki Otsuki, Jun Hatazawa, Hiroki Tanaka, Kanako Takayama, Hitoshi Wada, Motohisa Suzuki, Mariko Sato, Hisashi Yamaguchi, Ichiro Seto, Yuji Ueki, Susumu Iketan Tags: Original Article Source Type: research

Current Delivery Limitations of Proton PBS for FLASH
FLASH radiotherapy with ultra-high dose rate has been demonstrated in a number of in vivo studies[1-6] to better spare normal tissues with equivalent tumor control as compared to traditional external beam radiotherapy at conventional dose rates. In vitro studies using ultra-high dose rate were also carried out to study the cell culture FLASH effects[7-12]. The differential response in terms of normal tissue toxicity and tumor control is very attractive as FLASH may permit reduced organ toxicities and/or safer escalation of the dose to the tumor target than would be feasible with standard dose rates. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 10, 2020 Category: Radiology Authors: Wei Zou, Eric S. Diffenderfer, Keith Cengel, Michele Kim, Steve Avery, Joshua Konzer, Yongliang Cai, Paul Boisseu, Kan Ota, Lingshu Yin, Rodney Wiersma, David J Carlson, Yi Fan, Theresa M Busch, Costas Koumenis, Alexander Lin, James M Metz, BoonKeng K Teo Tags: Original Article Source Type: research

Role of radiotherapy in the management of brain metastases of NSCLC – Decision criteria in clinical routine
Lung cancer is the leading cause of cancer death worldwide. Non-small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancers [1]. 10% of patients with NSCLC have brain metastases at diagnosis, and 25% –40% develop brain metastases during their disease [2]. Approaches in the management of brain metastases include surgery, stereotactic radiosurgery (SRS), fractionated stereotactic radiotherapy, whole brain radiation therapy (WBRT), systemic treatments or best supportive care alone [3]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 10, 2020 Category: Radiology Authors: Markus Glatzer, Corinne Faivre-Finn, Dirk De Ruysscher, Joachim Widder, Paul Van Houtte, Esther G.C. Troost, Ben J. Slotman, Sara Ramella, Christoph P öttgen, Stephanie T.H. Peeters, Ursula Nestle, Fiona McDonald, Cecile Le Pechoux, Rafal Dziadziuszko, J Tags: Original Article Source Type: research

Radiomics analysis of 3D dose distributions to predict toxicity of radiotherapy for lung cancer
(Chemo) –radiotherapy (RT) is the gold standard treatment for patients with locally advanced lung cancer non accessible for surgery. However, current toxicity prediction models rely on clinical and dose volume histograms (DVHs) and remain unsufficient. The goal of this work is to investigate the added pre dictive value of the radiomics approach applied to dose maps regarding acute and late toxicities in both the lungs and esophagus. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 5, 2020 Category: Radiology Authors: V. Bourbonne, R. Da-ano, V. Jaouen, F. Lucia, G. Dissaux, J. Bert, O. Pradier, D. Visvikis, M. Hatt, U. Schick Tags: Original Article Source Type: research

Prediction of Pseudoprogression and Long-term Outcome of Vestibular Schwannoma after Gamma Knife Radiosurgery based on Preradiosurgical MR Radiomics
Vestibular schwannoma (VS) that originates from the Schwann cell sheath of vestibulo-cochlear nerves is the most common type of schwannomas. Although VS is a benign tumor of the nervous system, it causes damage of vestibular function and carry a high risk of deafness and facial palsy by tumor progression or treatment. Recent reports from our and other centers confirmed that Gamma Knife radiosurgery (GKRS) is a safe and effective strategy to treat VSs with an over 90% long-term tumor control rate and a lower risk of treatment-related complications [1 –4]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 5, 2020 Category: Radiology Authors: Huai-Che Yang, Chih-Chun Wu, Cheng-Chia Lee, Huai-En Huang, Wei-Kai Lee, Wen-Yuh Chung, Hsiu-Mei Wu, Wan-Yuo Guo, Yu-Te Wu, Chia-Feng Lu Tags: Original Article Source Type: research

Brachytherapy quality assurance in the PORTEC-4a trial for molecular-integrated risk profile guided adjuvant treatment of endometrial cancer
The primary treatment for women with endometrial cancer (EC) is abdominal or laparoscopic hysterectomy with bilateral salpingo-oophorectomy, followed by adjuvant radiotherapy depending on clinicopathological risk factors. Currently, four risk groups of EC have been defined: low, intermediate, high-intermediate (HIR) and high-risk.[1] (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 4, 2020 Category: Radiology Authors: B.G. Wortman, E. Astreinidou, M.S. Laman, E.M. van der Steen-Banasik, L.C.H.W. Lutgens, H. Westerveld, F. Koppe, A. Slot, H.A. van den Berg, M.E. Nowee, S. Bijmolt, T.C. Stam, A.G. Zwanenburg, J.W.M. Mens, I.M. J ürgenliemk-Schulz, A. Snyers, C.M. Gillha Tags: Original Article Source Type: research

18F-FDG-PET in Guided Dose-Painting with Intensity Modulated Radiotherapy in Oropharyngeal Tumours: A Phase I Study (FiGaRO)
Failure of loco-regional control is the main cause of recurrence in patients with locally advanced head and neck squamous cell carcinoma (HNSCC).[1] Relapses at the primary site are often not amenable to salvage surgery and are associated with significant morbidity and mortality.[2,3] Recurrence of the primary tumour occurs within the high-dose radiotherapy (RT) volume in up to 95.6% of cases,[4,5] suggesting a degree of radio-resistance. It is generally accepted that increasing the radiation dose can improve local control rates (LCR) due to the existence of a dose-response curve.[6] Treatment intensification strategies su...
Source: Radiotherapy and Oncology - November 4, 2020 Category: Radiology Authors: A. Michaelidou, D. Adjogatse, Y. Suh, L. Pike, C. Thomas, O. Woodley, T. Rackely, N. Palaniappan, V. Jayaprakasam, B. Sanchez Nieto, M. Evans, S. Barrington, M. Lei, T Guerrero Urbano Tags: Original Article Source Type: research

Dosimetric Parameters Associated with Radiation-Induced Esophagitis in Breast Cancer Patients Undergoing Regional Nodal Irradiation
In breast cancer patients with axillary node-positive disease, clinical trials and meta-analyses have demonstrated that regional nodal irradiation (RNI) significantly improves breast cancer outcomes [1 –3]. Irradiation of larger volumes with RNI is associated with increased late toxicities including lymphedema, cardiac toxicity, and pulmonary complications [4–7]. However, RNI is also associated with increased acute toxicities. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 3, 2020 Category: Radiology Authors: Alexander Yaney, Ahmet S. Ayan, Xueliang Pan, Sachin Jhawar, Erin Healy, Sasha Beyer, Kylee Lindsey, Karla Kuhn, Kayla Tedrick, Julia R. White, Jose G. Bazan Tags: Original Article Source Type: research

MLC Tracking for Lung SABR is Feasible, Efficient and Delivers High-Precision Target dose and Lower Normal Tissue Dose
Tumor motion in the thorax and abdomen is three dimensional, complex and can vary within and between fractions.[1,2] Motion during treatment may exceed that measured during the 4DCT used for planning.[3 –5] This motion complexity is optimally managed by real-time adaptive radiation therapy, where the radiation beam-target alignment is maintained during treatment obviating the need for an ITV. Real-time adaptation corrects the delivery for motion at treatment, including motion variations and basel ine shifts. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 2, 2020 Category: Radiology Authors: Jeremy Booth, Vincent Caillet, Adam Briggs, Nicholas Hardcastle, Georgios Angelis, Dasantha Jayamanne, Meegan Shepard, Alexander Podreka, Kathryn Szymura, Doan Trang Nguyen, Per Poulsen, Ricky O'Brien, Benjamin Harris, Carol Haddad, Thomas Eade, Paul Keal Tags: Original Article Source Type: research

Editorial Board
(Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 1, 2020 Category: Radiology Source Type: research

Contents
(Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - November 1, 2020 Category: Radiology Source Type: research

Docetaxel and nedaplatin twice a week with concurrent definitive radiotherapy in inoperable esophageal squamous cell carcinoma: a phase I trial (GASTO-1021)
Esophageal cancer is the 9th most common malignancy and the mortality rank 6th globally [1]. In the East Asia, esophageal squamous cell carcinoma (ESCC) is the most frequently reported histologic type [2]. The majority of patients were initially diagnosed with advanced disease and lost the opportunity of curative surgery [3]. On the basis of Radiation Therapy Oncology Group (RTOG) 85-01, the standard therapeutic strategy for inoperable locally advanced disease is concurrent chemoradiotherapy (CCRT). (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - October 31, 2020 Category: Radiology Authors: Nai-Bin Chen, Qi-Wen Li, Su Li, Su-Ping Guo, Yin-Jia Wu, Zhang-Kai Cheng, Ji-Bin Li, Da-Quan Wang, Fang-Jie Liu, Xin-Lei Ai, Nan Hu, Bo Qiu, Hui Liu Tags: Original Article Source Type: research

Management of oligo-metastatic and oligo-recurrent cervical cancer: A pattern of care survey within the EMBRACE research network
Chemo-radiation and image guided brachytherapy for cervix cancer is associated with excellent local control and disease-free survival in women with locally advanced cervix cancer. With advances in image guided brachytherapy and improved ability to dose escalate primary tumour and nodal targets, there is an evolving pattern of failure in aptients with cervix cancer. In the modern series, the predominant site of failure is distant followed by para-aortic nodal, local and pelvic nodal failure [1 –4]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - October 31, 2020 Category: Radiology Authors: Supriya Chopra, Akshay Mangaj, Alisha Sharma, Li Tee Tan, Alina Sturdza, Ina J ürgenliemk-Schulz, Kathy Han, Fleur Huang, Maximilian P. Schmid, Lars Fokdal, Cyrus Chargari, Tamara Diendorfer, Kari Tanderup, Richard Potter, Remi A Nout Tags: Original Article Source Type: research

Non-invasive imaging prediction of tumor hypoxia: a novel developed and externally validated CT and FDG-PET-based radiomic signatures
Since the early 1930s, it has been established that solid tumors contain oxygen-deficient (hypoxic) areas. Cells in such areas may cause tumors to become resistant to radiotherapy and chemotherapy, increase tumor aggressiveness, angiogenesis, and metastatic spread, resulting in a poor prognosis [1 –4]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - October 30, 2020 Category: Radiology Authors: Sebastian Sanduleanu, Arthur Jochems, Taman Upadhaya T, Aniek J.G. Even, Ralph T.H. Leijenaar, Frank J.W.M. Dankers, Remy Klaassen, Henry C. Woodruff, Matthieu Hatt, Hans J.A.M. Kaanders, Olga Hamming-Vrieze, Hanneke W.M. van Laarhoven H, Rathan M. Subram Tags: Original Article Source Type: research

Towards homogenization of total body irradiation practices in pediatric patients across SIOPE affiliated centers a survey by the SIOPE radiation oncology working group
Chemotherapy cures most children with hematologic malignancies. However, some 15% of all children with acute leukemia (acute lymphoblastic leukemia (ALL) or acute myeloid leukemia (AML)) and high risk features or relapse, benefit from donor (allogeneic) hematopoietic stem cell transplantation (HSCT) [1]. HSCT for hematologic malignancies is usually preceded by a conditioning regimen with myeloablative doses of chemotherapy (mostly treosulfan or busulphan-based) or with Total Body Irradiation (TBI), often combined with etoposide or cyclophosphamide [1]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - October 30, 2020 Category: Radiology Authors: Bianca A.W. Hoeben, Montserrat Pazos, Michael H. Albert, Enrica Seravalli, Mirjam E. Bosman, Christoph Losert, Tom Boterberg, Farkhad Manapov, Inna Ospovat, Soraya Mico Milla, Candan Demiroz Abakay, Jacob Engellau, Gregor Kos, St éphane Supiot, Marc Bier Tags: Original Article Source Type: research

The role of the gut microbiome on radiation therapy efficacy and gastrointestinal complications: A systematic review
The gut microbiome represents the collective genomes of a complex and necessary ecosystem, composed of trillions of living microorganisms in the intestine. Recent studies have highlighted how the interplay between the gut microbiota and the immune system is essential for maintaining the health condition [1,2] as a consequence of its impact on several parameters of tissue homeostasis, including angiogenesis [3,4]. Continuing advances in sequencing and metabolomic technologies shed light on specific properties of some individual members of the microbiota that may differentially regulate the immune response. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - October 30, 2020 Category: Radiology Authors: Marion Tonneau, Arielle Elkrief, David Pasquier, Thomas Paz Del Socorro, Mathias Chamaillard, Houda Bahig, Bertrand Routy Tags: Systematic Review Source Type: research

Genistein inhibits radiation-induced invasion and migration of glioblastoma cells by blocking the DNA-PKcs/Akt2/Rac1 signaling pathway
Glioblastoma multiforme (GBM) represents 80% of primary malignant brain tumors [1]. It is characterized by its aggressiveness and high propensity to diffusely infiltrate the adjacent normal brain parenchyma [2,3], which leads to significant obstacles to effective treatment. Its five years survival rate is (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - October 28, 2020 Category: Radiology Authors: Xiongxiong Liu, Qiqi Wang, Bingtao Liu, Xiaogang Zheng, Ping Li, Ting Zhao, Xiaodong Jin, Fei Ye, Pengcheng Zhang, Weiqiang Chen, Qiang Li Tags: Original Article Source Type: research

The impact of stereotactic body radiation therapy on the overall survival of patients diagnosed with early-stage non-small cell lung cancer
Surgical resection is the standard of care treatment in early-stage NSCLC1. However, more than 25% of the early-stage NSCLC patients are not surgical candidates due to existing comorbidities or patient refusal2. These scenarios were traditionally treated with conventional radiotherapy, which resulted in lower 5-year survival rates ranging from 20% to 30%2. Improvements in technology have given rise to Stereotactic Body Radiation Therapy (SBRT) 3-5. SBRT is generally well tolerated and carries a lower risk of adverse events such as pneumonitis, chest wall syndrome, and airway injury6-8. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - October 23, 2020 Category: Radiology Authors: Saber A. Amin, Morshed Alam, Michael J. Baine, Jane Meza, Nathan R. Bennion, Chi Zhang, Ibur Rahman, Chi Lin Tags: Original Article Source Type: research

Immune cell profiling in Gleason 9 prostate cancer patients treated with brachytherapy versus external beam radiotherapy: an exploratory study
This exploratory study evaluates immunological changes in high-risk Gleason 9 prostate cancer patients treated with EBRT+BT compared to EBRT alone. Notably, BT demonstrates the potential to elicit a T cell response which may support further investigation using circulating immune cells as predictive and prognostic biomarkers for radiotherapy response. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - October 23, 2020 Category: Radiology Authors: H Wang, L Mendez, G Morton, A Loblaw, A Mesci, H Chung, S Chan, X Huang, M Downes, D Vesprini, SK Liu Tags: Short Communication Source Type: research

Generation of biological hypotheses by functional imaging links tumor hypoxia to radiation induced tissue inflammation/ glucose uptake in head and neck cancer
Tumor hypoxia is an established negative prognostic marker in almost all solid tumors, including head and neck squamous cell carcinomas (HNSCC) [1]. Methods to assess intra-tumoral hypoxia include the classical gold standard of invasive measurement by Eppendorf electrodes, the use of serological biomarkers, particularly Osteopontin, and various hypoxia gene signatures [2 –5]. For radiotherapy, the use of hypoxia specific positron emission tomography (PET) tracers is especially valuable as this modality delivers information about the spatial distribution of hypoxic sub-volumes that could potentially be boosted by dose...
Source: Radiotherapy and Oncology - October 23, 2020 Category: Radiology Authors: Sebastian Zschaeck, Klaus Z öphel, Annekatrin Seidlitz, Daniel Zips, Jörg Kotzerke, Michael Baumann, Esther G.C. Troost, Steffen Löck, Mechthild Krause Tags: Original Article Source Type: research

Final Results of a Dose Escalation Protocol of Stereotactic Body Radiotherapy for Poor Surgical Candidates with Localized Renal Cell Carcinoma
Worldwide there are approximately 403,000 new cases of kidney cancer annually.[1] Approximately 65% of renal cell carcinomas (RCC) are localized at presentation with 45-50% classified as small renal masses (SRMs) (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - October 23, 2020 Category: Radiology Authors: William R. Grubb, Lee Ponsky, Simon S. Lo, Michael Kharouta, Bryan Traughber, Kate Sandstrom, Gregory T. MacLennan, Eswar Shankar, Sanjay Gupta, Mitchell Machtay, Rodney J. Ellis Tags: Original Article Source Type: research

Dose Prediction with Deep Learning for Prostate Cancer Radiation Therapy: Model adaptation to Different Treatment Planning Practices
Purpose: This work aims to study the generalizability of a pre-developed deep learning (DL) dose prediction model for volumetric modulated arc therapy (VMAT) for prostate cancer and to adapt the model, via transfer learning with minimal input data, to three different internal treatment planning styles and one external institution planning style.Methods: We built the source model with planning data from 108 patients previously treated with VMAT for prostate cancer. For the transfer learning, we selected patient cases planned with three different styles, 14-29 cases per style, in the same institution and 20 cases treated in ...
Source: Radiotherapy and Oncology - October 21, 2020 Category: Radiology Authors: Roya Norouzi Kandalan, Dan Nguyen, Nima Hassan Rezaeian, Ana M. Barrag án-Montero, Sebastiaan Breedveld, Kamesh Namuduri, Steve Jiang, Mu-Han Lin Tags: Original Article Source Type: research

In response to Haas RL et al.
We are grateful to Haas RL and Gronchi A for their interest in our manuscript and the expert-based constructive comments. We propose to incorporate our joint vision into an update of the practice-changing guidelines. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - October 20, 2020 Category: Radiology Authors: F. Roeder, F.A. Calvo, J.M. Asencio, C. Ferrer Albiach, P. Poortmans Tags: Letter to the Editor Source Type: research

In response to Haas RL et al
We are grateful to Haas RL and Gronchi A for their interest in our manuscript and the expert-based constructive comments. We propose to incorporate our joint vision into an update of the practice-changing guidelines. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - October 20, 2020 Category: Radiology Authors: F. Roeder, F.A. Calvo, J.M. Asencio, C. Ferrer, P. Poortmans Tags: Letter to the Editor Source Type: research