Recommendations for postoperative radiotherapy in head & neck squamous cell carcinoma in the presence of flaps: a GORTEC internationally-reviewed HNCIG-endorsed consensus
For large head and neck tumors, reconstructive surgery is frequently performed using an autologous flap, harvested from the patient donor site and transferred to the tumor bed to compensate for the loss of substance [1 –4]. Increasingly versatile flaps have aimed to achieve high fidelity to the native tissues to improve functional outcomes and quality of life [5]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - May 10, 2021 Category: Radiology Authors: Florent Carsuzaa, Michel Lapeyre, Vincent Gregoire, Philippe Maingon, Arnaud Beddok, Pierre-Yves Marcy, Julia Salleron, Alexandre Coutte, Severine Racadot, Yoann Pointreau, Pierre Graff, Beth Beadle, Karen Benezery, Julian Biau, Valentin Calugaru, Joel Ca Tags: Original Article Source Type: research

Metrics to evaluate the performance of auto-segmentation for radiation treatment planning: a critical review
Contouring target volumes and surrounding organs-at-risk (OARs), also referred to as segmentation or delineation, is a critical step in radiation treatment planning. It is often performed manually by trained radiation oncology professionals (e.g. radiation oncologists/trainees, physicists, dosimetrists, therapists) and is a time-consuming and subjective process. Variation among providers is common and likely driven by numerous underlying factors including experience [1] as well as the availability, quality, and interpretation of diagnostic imaging used to assist in delineation [2]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - May 10, 2021 Category: Radiology Authors: Michael V. Sherer, Diana Lin, Sharif Elguindi, Simon Duke, Li-Tee Tan, Jon Cacicedo, Max Dahele, Erin F. Gillespie Tags: Review Article Source Type: research

Extent of Paranasal Sinus Involvement and its Prognostic Value in Nasopharyngeal Carcinoma: Proposed Modification in the Current UICC/AJCC staging system
Nasopharyngeal carcinoma (NPC) is one of the most prevalent head and neck malignancies in Southeast Asia, and is especially common in Southern China [1]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - May 10, 2021 Category: Radiology Authors: Xiao-Yi Wang, Si-Yu Zhu, Wei-Jie WU, Hao-Jiang Li, Jiao Li, Xiao-Feng Lin, Li Li, Li-Zhi Liu Tags: Original Article Source Type: research

Deciphering the glioblastoma phenotype by Computed Tomography radiomics
In this study we assess the prognostic value of CT radiomics for overall survival in patients with a GBM. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - May 10, 2021 Category: Radiology Authors: Inge Compter, Maikel Verduin, Zhenwei Shi, Henry C. Woodruff, Robert J. Smeenk, Tom Rozema, Ralph T.H. Leijenaar, Ren é Monshouwer, Daniëlle B.P. Eekers, Ann Hoeben, Alida A. Postma, Andre Dekker, Dirk De Ruysscher, Philippe Lambin, Leonard Wee Tags: Original Article Source Type: research

Probing thoracic dose patterns associated to pericardial effusion and mortality in patients treated with photons and protons for locally advanced non-small-cell lung cancer
Radiotherapy (RT) plays a key role in the treatment of non-small cell lung cancer (NSCLC) and the current standard-of-care for locally advanced inoperable NSCLC is concurrent chemotherapy (CHT) and RT [1]. While radiobiological evidence advocated the delivery of higher radiation doses to obtain improved tumor control probability [2], the phase III RTOG 0617 trial [3] failed to demonstrate the overall survival (OS) benefit derived from dose escalation (74 Gy vs. 60 Gy). One of the main concerns is regarding the heart toxicity, which may have offset any potential improvement in OS derived from dose escalation. (Source: Radio...
Source: Radiotherapy and Oncology - May 9, 2021 Category: Radiology Authors: Laura Cella, Serena Monti, Ting Xu, Raffaele Liuzzi, Arnaldo Stanzione, Marco Durante, Radhe Mohan, Zhongxing Liao, Giuseppe Palma Tags: Original Article Source Type: research

First experimental evaluation of multi-target multileaf collimator tracking during volumetric modulated arc therapy for locally advanced prostate cancer
This study experimentally implemented and evaluated a real-time multi-target tracking system for locally advanced prostate cancer. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - May 7, 2021 Category: Radiology Authors: Emily A Hewson, Andrew Dipuglia, John Kipritidis, Yuanyuan Ge, Ricky O'Brien, Stephanie Roderick, Linda Bell, Per R Poulsen, Thomas Eade, Jeremy T Booth, Paul J Keall, Doan T Nguyen Tags: Original Article Source Type: research

Characterizing spatial differences between SPECT-ventilation and SPECT-perfusion in patients with lung cancer undergoing radiotherapy
This study investigates agreement between ventilation and perfusion for lung cancer patients undergoing radiotherapy. Ventilation-perfusion scans of nineteen patients with stage III lung cancer from a prospective protocol were compared using voxel-wise Spearman correlation- coefficients. The presented results show in about 25% of patients, ventilation and perfusion exhibit lower agreement. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - May 5, 2021 Category: Radiology Authors: Farnoush Forghani, Taylor Patton, Jennifer Kwak, David Thomas, Quentin Diot, Chad Rusthoven, Richard Castillo, Edward Castillo, Inga Grills, Thomas Guerrero, Moyed Miften, Yevgeniy Vinogradskiy Tags: Short Communication Source Type: research

Effects of brain radiotherapy on cognitive performance in adult low-grade glioma patients: A Systematic Review
Grade II gliomas (LGG) are primary slow growing brain tumors deriving from glial cells and comprising approximately 15% of all primary brain tumors. They tend to affect younger people, usually before the age of 50 and allow an estimated average survival of 8-15 years [1, 2]. Grade I gliomas affect mainly children and are frequently curable, in case a complete excision has been achieved. Unfortunately, grade II gliomas are known to transform to higher grade tumors [3, 4]. To date, there is still considerable debate regarding the optimal treatment modality strategy. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - May 5, 2021 Category: Radiology Authors: Christos Koutsarnakis, Eleftherios Neromyliotis, Spyridon Komaitis, Nektarios Mazarakis, Dan O Hara, Georgios Stranjalis, Paul Chumas Tags: Systematic Review Source Type: research

Prognostic value of testosterone castration levels following androgen deprivation and high-dose radiotherapy in localized prostate cancer: results from a phase iii trial
Androgen deprivation therapy (ADT) is currently the standard systemic approach for management of localized high-risk prostate cancer (PCa) in combination with high-dose radiotherapy (HRT) (1-4). The regulatory authorities have traditionally set target testosterone level during ADT at (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - May 4, 2021 Category: Radiology Authors: Almudena Zapatero, Ana Álvarez, Araceli Guerrero, Xavier Maldonado, Carmen González San Segundo, María A. Cabeza, Carmen Martín de Vidales, Josep M. Solé, Agustí Pedro Olivé, Francesc Casas, Ana Boladeras, María L. Vázquez de la Torre, Susana Var Tags: Original Article Source Type: research

Dosimetric feasibility of hypofractionation for metastatic bone/bone marrow lesions from paediatric solid tumours
Approximately 20% of the paediatric patients with solid tumours present with distant metastases at diagnosis. Children with metastatic disease generally have a poor prognosis and overall survival rates are on average 35% (range 5-95%), depending on histology and the number of lesions [1 –3]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - May 4, 2021 Category: Radiology Authors: Sophie C. Huijskens, Filipa Guerreiro, Mirjam Bosman, Geert O. Janssens, Bianca A. Hoeben, Raquel D ávila Fajardo, Petra S. Kroon, Enrica Seravalli Tags: Original Article Source Type: research

A deep learning-based auto-segmentation system for organs-at-risk on whole-body computed tomography images for radiation therapy
Cancer (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - May 4, 2021 Category: Radiology Authors: Xuming Chen, Shanlin Sun, Narisu Bai, Hao Tang, Qianqian Liu, Shengyu Yao, Kun Han, Chupeng Zhang, Zhipeng Lu, Qian Huang, Guoqi Zhao, Yi Xu, Tingfeng Chen, Xiaohui Xie, Yong Liu Tags: Original Article Source Type: research

Theranostic AGuIX nanoparticles as radiosensitizer: A phase I, dose-escalation study in patients with multiple brain metastases (NANO-RAD trial)
External radiotherapy is one of the main treatment in neuro oncology due to difficulty of surgery and uncertain distribution of systemic therapy. Despite advances in cancer treatments, however, no curative approaches exist for patients with multiple brain metastases. The use of radiation sensitizers would therefore be of great interest specifically in increasing the effects of RT in tumors while sparing surrounding healthy tissues as RT dose-escalation can significantly improve local tumor control and survival. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - May 4, 2021 Category: Radiology Authors: Camille Verry, Sandrine Dufort, Julie Villa, Marylaure Gavard, Carole Iriart, Sylvie Grand, Julie Charles, Benoit Chovelon, Jean-Luc Cracowski, Jean-Louis Quesada, Christophe Mendoza, Lucie Sancey, Audrey Lehmann, Florence Jover, Jean-Yves Giraud, Fran ç Tags: Original Article Source Type: research

Editorial Board
(Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - May 1, 2021 Category: Radiology Source Type: research

Contents
(Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - May 1, 2021 Category: Radiology Source Type: research

Can 3D pseudo-continuous arterial spin labeling perfusion imaging be applied to predict early response to chemoradiotherapy in patients with advanced nasopharyngeal carcinoma?
Nasopharyngeal carcinoma (NPC) is characterized by distinct geographical distribution worldwide and is particularly prevalent in east and southeast Asia countries such as China [1]. Generally, early-stage NPC (stage ⅠandⅡ) can achieve a cure rate of over 90% by surgery combined with chemoradiotherapy (CRT) [2]. However, because of easily overlooked clinical symptoms, most NPCs are in advanced stage (stage III and IV) with surrounding tissues invaded once the lesions are detected. The opportunity of radical surgery for advanced nasopharyngeal carcinoma (ANPC) is thus unfortunately lost [3]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - May 1, 2021 Category: Radiology Authors: Zongqiong Sun, Shudong Hu, Qian Xue, Linfang Jin, Jianfeng Huang, Weiqiang Dou Tags: Original Article Source Type: research

68Ga-FAPI-PET/CT improves diagnostic staging and radiotherapy planning of Adenoid Cystic Carcinomas – imaging analysis and histological validation
Adenoid cystic carcinoma (ACC) is a rare epithelial tumor mostly situated in the head and neck region (1,2). ACC is characterized by slow, but relentless growth with progressive infiltration of surrounding structures and perineural invasion (2,3). Despite their protracted clinical course, there is a significant risk of late recurrence and distant metastases, resulting in a 10-year overall survival rate of 39-70% (4). (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - April 30, 2021 Category: Radiology Authors: Manuel R öhrich, Mustafa Syed, Dawn P Liew, Frederik L Giesel, Jakob Liermann, Peter L Choyke, Annika K. Wefers, Thomas Ritz, Marina Szymbara, Lisa Schillings, Ulrike Heger, Hendrik Rathke, Clemens Kratochwil, Peter E. Huber, Andreas von Deimling, Jürge Tags: Original Article Source Type: research

NRF2 activation putatively mediates clinical benefits of low-dose radiotherapy in COVID-19 pneumonia and acute respiratory distress syndrome (ards): novel mechanistic considerations
The SARS CoV-2 virus that causes COVID-19 has proven to be problematic to effectively contain, treat, and manage given extant protocols and policies of the international medical and public health communities. The virus ’s sudden occurrence, high infectivity, variant morbidity, lethality, potential mutability, and heretofore lack of safe and effective treatments or vaccines, have all contributed to, and exacerbated public-health challenges throughout the world. Although apparently effective vaccines are now avail able, there is ongoing consideration and concern about their provision and durability, as well as public w...
Source: Radiotherapy and Oncology - April 28, 2021 Category: Radiology Authors: Edward J. Calabrese, Walter J. Kozumbo, Rachna Kapoor, Gaurav Dhawan, Pedro C. Lara Jimenez, James Giordano Tags: Review Article Source Type: research

Outcomes of curative-intent radiotherapy in non-small cell lung cancer (NSCLC) patients with chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD)
Chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) are common comorbidities, affecting 40-70% [1 –4] and 2-11% [5,6] of lung cancer patients, respectively. Previous studies have shown a higher mortality rate and lower quality-of-life post-radiotherapy in lung cancer patients with co-existent COPD [7–9] and ILD [10–15].Oncological treatment of lung cancer in patients with underlying respir atory co-morbiditiesis challenging due to a higher risk of post-radiotherapy side-effects, including atypical infections, exacerbation of COPD/ILD symptoms and fulminant radiation pneumoniti...
Source: Radiotherapy and Oncology - April 23, 2021 Category: Radiology Authors: Celion Tang, Hitesh Mistry, Neil Bayman, Clara Chan, David Cobben, Corinne Faivre-Finn, Margaret Harris, Jason Kennedy, Laura Pemberton, Gareth Price, Hamid Sheikh, David Woolf, Joanna Coote, Ahmed Salem Tags: Short Communication Source Type: research

A Systematic Review on the Usage of Averaged LET in Radiation Biology for Particle Therapy
The linear energy transfer (LET) is commonly used for expressing the radiation quality of ion beams. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - April 20, 2021 Category: Radiology Authors: Fredrik Kalholm, Leszek Grzanka, Erik Traneus, Niels Bassler Tags: Review Article Source Type: research

Higher biologically effective dose is associated with improved survival in patients with squamous cell carcinoma of the lung treated with stereotactic body radiation therapy
Stereotactic body radiation therapy (SBRT) has emerged as the standard of care in the treatment of medically inoperable early-stage non-small cell lung cancer (NSCLC).[1] When compared to conventionally fractionated radiotherapy, SBRT offers improved local control, the convenience of treatment completion in 1-5 fractions, less toxicity, and improved quality of life.[2,3] Historical studies established a dose-response relationship when employing this approach, with a biological equivalent dose (BED10)> 94-105 Gy being associated with improved local control.[4 –6] The Radiation Therapy Oncology Group (RTOG) 0236, a ...
Source: Radiotherapy and Oncology - April 20, 2021 Category: Radiology Authors: Jacob S. Parzen, Muayad F. Almahariq, Thomas J. Quinn, Zaid A. Siddiqui, Andrew B. Thompson, Thomas Guerrero, Kuei Lee, Craig Stevens, Inga S. Grills Tags: Original Article Source Type: research

aImpact of radiation-induced toxicities on quality of life of patients treated for head and neck cancer
In recent years, considerable progress has been made in the development of prediction models for radiation-induced toxicities for head and neck cancer (HNC) [1]. Multivariable prediction models can be used to predict a wide range of normal tissue complication probabilities (NTCP) [2]. These models can provide guidance in treatment plan optimization [3,4], treatment plan comparison and in the selection of patients for new radiation technologies, such as for proton therapy [5,6]. Knowledge on the optimal dose distribution, i.e., the order in which organs at risk (OAR) should be spared to avoid toxicities, is crucial [7]. (So...
Source: Radiotherapy and Oncology - April 20, 2021 Category: Radiology Authors: Hans Paul van der Laan, Lisa Van den Bosch, Ewoud Schuit, Roel J.H.M. Steenbakkers, Arjen van der Schaaf, Johannes A. Langendijk Tags: Original Article Source Type: research

Development of advanced preselection tools to reduce redundant plan comparisons in model-based selection of head and neck cancer patients for proton therapy
In the Netherlands, patients with head and neck cancer (HNC) are selected for proton therapy using a model-based approach. In each patient, a photon vs. proton (Volumetric-Modulated Arc Therapy (VMAT) vs. Intensity-Modulated Proton Therapy (IMPT)) plan comparison is made to determine the expected normal tissue complication probability difference ( ΔNTCP) between the two modalities using normal tissue complication probability (NTCP) models [1–3]. According to the Dutch National Indication Protocol for Proton Therapy (NIPP), three NTCP models (≥ Grade 2 xerostomia [4], ≥ Grade 2 dysphagia [5] and tube feedi...
Source: Radiotherapy and Oncology - April 20, 2021 Category: Radiology Authors: Makbule Tambas, Hans P. van der Laan, Wouter Rutgers, Johanna G.M. van den Hoek, Edwin Oldehinkel, Tineke W.H. Meijer, Arjen van der Schaaf, Daniel Scandurra, Jeffrey Free, Stefan Both, Roel J.H.M. Steenbakkers, Johannes A. Langendijk Tags: Original Article Source Type: research

Verification of field match lines in whole breast radiation therapy using cherenkov imaging
Often in radiation therapy, the treatment of breast cancer includes irradiation of the supraclavicular nodes to discourage further spread. Two irradiation sites are used, including 1) the entire breast (whole-breast/tangent (TAN) fields) and 2) the supraclavicular (SCV) field [1] –[3] where both fields meet at a single isocenter. (Using a dual iscoentric technique is also common, though this study examines the use of one isocenter [4].) In these cases, the fields meet at the isocenter, forming what is known as the field junction, or anterior field match line. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - April 20, 2021 Category: Radiology Authors: R. Hachadorian, C. Farwell, P. Bruza, M. Jermyn, D.J. Gladstone, B.W. Pogue, L.A. Jarvis Tags: Original Article Source Type: research

Identification of patient benefit from proton beam therapy in brain tumour patients based on dosimetric and NTCP analyses
Proton beam therapy (PBT) can achieve high dose conformity with a simultaneous dose reduction in healthy tissues surrounding the tumour compared to conventional photon radiation therapy (XRT). These features, in turn, may result in reduced side-effects and improved quality of life [1 –5]. Although the number of PBT centres continues to increase [6], the broad availability of PBT is limited by the higher costs compared to linac-based therapies with photons [7]. A selection of patients who are most likely to benefit from PBT in terms of a reduction of side-effects is therefore r equired. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - April 16, 2021 Category: Radiology Authors: Almut Dutz, Armin L ühr, Esther G.C. Troost, Linda Agolli, Rebecca Bütof, Chiara Valentini, Michael Baumann, Xavier Vermeren, Dirk Geismar, Beate Timmermann, Mechthild Krause, Steffen Löck Tags: Original Article Source Type: research

Independent external validation using the EORTC HNCG-ROG 1219 DAHANCA trial data of NTCP models for acute oral mucositis
Radiation-induced oral mucositis is a major dose limiting complication in HNC patients, which has marked adverse effects on patient quality of life [1]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - April 16, 2021 Category: Radiology Authors: M. Sharabiani, E. Clementel, N. Andratschke, L. Collette, C. Fortpied, V. Gr égoire, J. Overgaard, J. Willmann, C. Hurkmans Tags: Original Article Source Type: research

The dynamics and prognostic value of FDG PET-metrics in weekly monitoring of (chemo)radiotherapy for NSCLC
Patients with stage II-III non-small lung cancer (NSCLC) often relapse within one year of treatment following radical concurrent chemoradiotherapy (CCRT)[1]. In addition, these patients may experience high toxicity rates (acute grade ≥ 3: 35%)[2]. Hence, an early biomarker may be of use to facilitate treatment adaptations to improve disease control and\or decrease toxicity. While prognostic factors such as stage, performance status and weight loss can aid in determining optimal treatment regimen, they do not provide sufficient accuracy for predicting patient outcome [3]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - April 16, 2021 Category: Radiology Authors: Matthew D. La Fontaine, Natascha M. Bruin, Simon van Kranen, Joost L. Knegjens, Jeroen B. van de Kamer, Wouter V. Vogel, Jan-Jakob Sonke Tags: Original Article Source Type: research

Evolution of the gross tumour volume extent during radiotherapy for glioblastomas
Despite aggressive treatment consisting of maximal surgical debulking followed by radiotherapy (RT), and concomitant and adjuvant temozolomide (TMZ) [1], the prognosis for glioblastoma multiforme (GBM) patients remains poor with 2 years survival rate around 26% [2,3]. Since the late 1970s, RT has been part of standard treatment for patients with GBMs. Initially, whole-brain irradiation was applied, but the morbidity related to this treatment and the documentation of treatment failures primarily being local recurrences introduced regional radiation fields [4]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - April 9, 2021 Category: Radiology Authors: Uffe Bernchou, Trine Skak Tranemose Arnold, Brit Axelsen, Mette Kl üver-Kristensen, Faisal Mahmood, Frederik Severin Gråe Harbo, Jon Thor Asmussen, Olfred Hansen, Anders Smedegaard Bertelsen, Steinbjørn Hansen, Carsten Brink, Rikke Hedegaard Dahlrot Tags: Original Article Source Type: research

Influence of postoperative radiotherapy target volumes in unilateral head and neck carcinoma of unknown primary: a multicentric study using propensity score
In about 3 –5% of patients with malignant epithelial tumours, no primary tumour is found despite extensive investigations, leading to the diagnosis of “Cancer of Unknown Primary” (CUP) (1).The most common histology encountered in Head and Neck (HN) CUP (HNCUP) patients is squamous cell carcinoma (SCC) in 66–77%, followed by undifferentiated carcinoma and adenocarcinoma (2). Lymph node metastases are usually located in the upper two-thirds of the neck (levels II-III according to Robbins) mainly deriving from HNSCC (3). (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - April 9, 2021 Category: Radiology Authors: Brenet Esteban, Philouze Pierre, Schiffler Camille, Pommier Pascal, Crozes Carole, Benzerdjeb Nazim, Monchet Elodie, Boulagnon-Rombi Camille, Ton Van Jean, Podeur Fabien, Servagi-Vernat St éphanie, Liem Xavier, Merol Jean-Claude, Ceruse Philippe, Serre A Tags: Original Article Source Type: research

TNM 8 staging is a better prognosticator than TNM 7 for patients with locally advanced oral cavity squamous cell carcinoma treated with surgery and post-operative radiotherapy
Oral cavity squamous cell carcinoma (OCSCC) is a challenging disease to manage, with recurrence rates higher than for other head and neck cancers (1, 2). Locally advanced OCSCC is conventionally treated by primary surgery and post-operative radiotherapy (PORT) with the addition of concurrent chemotherapy for high risk cases. However, despite this multi-modality approach, the 5 year survival rate is only ∼ 50% (3). Locoregional recurrence is common, (4) with limited salvage treatments available and survival after disease recurrence is extremely poor, (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - April 9, 2021 Category: Radiology Authors: K. Sambasivan, I. Sassoon, S. Thavaraj, R. Kennedy, G. Doss, A. Michaelidou, E. Odell, A. Sandison, G. Hall, P. Morgan, L.H.C. Collins, A. Lyons, L. Cascarini, A. Fry, R. Oakley, R. Simo, J.P. Jeannon, I. Petkar, M. Reis Ferreira, A.Kong, M. Lei, T. Guer Tags: Original Article Source Type: research

The prognostic impact of daytime and seasonality of radiotherapy on head and neck cancer
Head and neck squamous cell carcinoma (HNSCC) is the 6th most common malignancy globally, and most of the patients require radiotherapy (RT) as part of a single- or multimodal treatment plan [1]. Despite advances in surgery, RT and systemic treatment [2 –5], the 5-year cumulative all-cause mortality is about 51% [6]. In treatment of HNSCC, RT is usually delivered in daily fractions over a course of 6 to 7 weeks. As a possible method to reduce RT-associated toxicities and increase tumor control, “chronoradiotherapy” was investigated by several research groups in the past. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - April 9, 2021 Category: Radiology Authors: Olgun Elicin, Eliane Koller Brolese, Beat Bojaxhiu, Burim Sermaxhaj, Daniel Hendrik Schanne, Etienne Mathier, Jana Lippmann, Mohamed Shelan, Yannick Eller, Daniel Matthias Aebersold, Roland Giger, Nikola Cihoric Tags: Original Article Source Type: research

Locoregional control using highly conformal flank target volumes and Volumetric-Modulated Arc Therapy in pediatric renal tumors: results from the Dutch national cohort
Renal tumors account for 5-6% of all pediatric malignancies [1],. Of these tumors, around 90% are considered nephroblastoma ’s or Wilms tumors (WT), while non-WT such as Malignant Rhabdoid Tumors of the Kidney (MRTK), Clear Cell Sarcoma of the Kidney (CCSK), Renal Cell Carcinoma (RCC) and Congenital Mesoblastic Nephroma (CMN) are less common [2],. Annually, 30-35 children in The Netherlands are diagnosed with a renal t umor and treated according to the guidelines of the International Society for Pediatric Oncology - Renal Tumor Study Group (SIOP-RTSG) [3],. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - April 9, 2021 Category: Radiology Authors: J. Mul, M. van Grotel, E. Seravalli, M.E. Bosman, H. van Tinteren, P. Roy, R. D ávila Fajardo, Gam Tytgat, Amc Mavinkurve-Groothuis, C.P. van de Ven, Mhwa Wijnen, R.R. de Krijger, A.S. Littooij, M.M. van den Heuvel-Eibrink, G.O. Janssens Tags: Original Article Source Type: research

Establishment and validation of a prognostic nomogram to predict early metastasis in nasopharyngeal carcinoma patients within six months after radiotherapy and to guide intensive treatment
Nasopharyngeal carcinoma (NPC) is a malignancy with a high incidence (reaching approximately 25 per 100,000) and is endemic in Southeast Asia, North Africa, and South China, especially in the Guangdong province[1,2]. As an aggressive headandneck cancer, NPC is characterized by a high rateoflocal invasionandearly distantmetastasis (DM)[3]. Nearly 70% of NPC patients have been initially diagnosed as having locoregionally advanced cancer[4]. DM is very common inadvanced-stage NPC patients and remains to be the main reason for treatment failure[5]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - April 8, 2021 Category: Radiology Authors: Zi-Jian Lu, Li-Ting Liu, Xue-Song Sun, Shan-Shan Guo, Qi Yang, Sai-Lan Liu, Xiao-Yun Li, Hui-Zhi Qiu, Zhen-Chong Yang, Bei-Bei Xiao, Chao Lin, Dong-Hua Luo, Rui Sun, Huan-Xin Lin, Qiu-Yan Chen, Lin-Quan Tang, Ling Guo, Hai-Qiang Mai Tags: Original Article Source Type: research

Impact of DNA repair and reactive oxygen species levels on radioresistance in pancreatic cancer
Pancreatic cancer is a devastating disease with a 5-year survival rate of less than 5% [1]. It is the 8th leading cause of cancer-related deaths; moreover, it is expected to be the second most common cause by 2030 [2,3]. So far, the only curative treatment option for pancreatic cancer is the complete surgical resection of the tumor; yet, at the time of diagnosis, only 10-20% of patients present a locally resectable disease and are eligible for surgery [4]. Around 50% of the patients present with advanced disease, including distant metastases, and in about one-third of all patients, a locally advanced, but non-metastasized ...
Source: Radiotherapy and Oncology - April 8, 2021 Category: Radiology Authors: Lily Nguyen, Sophie Dobiasch, G ünter Schneider, Roland M. Schmid, Omid Azimzadeh, Kristiyan Kanev, Dominik Buschmann, Michael W. Pfaffl, Stefan Bartzsch, Thomas E. Schmid, Daniela Schilling, Stephanie E. Combs Tags: Original Article Source Type: research

Standard radiotherapy for patients with nasopharyngeal carcinoma results in progressive tract-specific brain white matter alterations: A one-year follow-up via diffusion tensor imaging
Nasopharyngeal carcinoma (NPC) is one of the most common malignant head and neck cancers in Southern China and Southeast Asia [1]. Radiation therapy (RT), with or without adjuvant chemotherapy, is the mainstay treatment modality for patients with NPC due to its radiosensitivity [2]. However, RT also exhibits several caveats, as increasing evidence has shown that RT in NPC patients is correlated with cognitive impairment, which significantly influences the quality of life (QOL) in affected patients [3,4]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - April 8, 2021 Category: Radiology Authors: Yingwei Qiu, Zheng Guo, Xiaoshan Lin, Jing Li, Zhipeng Li, Lujun Han, Yadi Yang, Xiaofei Lv Tags: Original Article Source Type: research

Development and validation of a normal tissue complication probability model for acquired nasal cavity stenosis and atresia after radical radiotherapy for nasopharyngeal carcinoma
Nasopharyngeal carcinoma (NPC) is an endemic malignancy in East and South-East Asia. With the widespread application of intensity-modulated radiotherapy (IMRT) and optimization of chemotherapy regimens, the mortality rate of patients with NPC has been reduced substantially. According to previous studies, the 5-year overall survival rates for patients with stage I-IV NPC were 100%, 91%, 72%, and 44% respectively, meaning NPC has become a highly curable disease [1 –4]. However, the quality of life in survivors is often highly impaired because of toxicity associated with comprehensive radical treatment [5,6]. (Source: R...
Source: Radiotherapy and Oncology - April 8, 2021 Category: Radiology Authors: Jin-Jie Yan, Shan-Shan Guo, Da-Feng Lin, Li-Ting Liu, Sai-Lan Liu, Bei-Bei Xiao, Jin-Hao Yang, Dong-Xiang Wen, Zhen-Chong Yang, Yu-Jing Liang, Qing-Nan Tang, Chao Lin, Xiao-Yun Li, Xue-Song Sun, Ji-Bin Li, Lin-Quan Tang, Qiu-Yan Chen, Hai-Qiang Mai Tags: Original Article Source Type: research

Combining rescanning and gating for a time-efficient treatment of mobile tumors using pencil beam scanning proton therapy
Proton therapy has become a technique that has spread worldwide (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - April 8, 2021 Category: Radiology Authors: Pauline Gut, Miriam Krieger, Tony Lomax, Damien C. Weber, Jan Hrbacek Tags: Original Article Source Type: research

Intensity-modulated proton therapy for oropharyngeal cancer reduces rates of late xerostomia
Radiotherapy is one of the main treatment modalities for oropharyngeal cancer (OPC), especially human papillomavirus-associated OPC [1 –4]. However, radiotherapy can cause severe xerostomia, which can dramatically and irreversibly impair quality of life [5]. Intensity-modulated radiotherapy (IMRT), which markedly reduces the incidence of xerostomia when compared with conventional radiotherapy, is now considered the standard radio therapy technique for head and neck cancer [6,7]. However, IMRT is inherently limited by the physical properties of photon beams and still inevitably results in xerostomia. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - April 8, 2021 Category: Radiology Authors: Jianzhong Cao, Xiaodong Zhang, Bo Jiang, Jiayun Chen, Xiaochun Wang, Li Wang, Narayan Sahoo, X. Ronald Zhu, Rong Ye, Pierre Blanchard, Adam S. Garden, C. David Fuller, G. Brandon Gunn, Steven J. Frank Tags: Original Article Source Type: research

Development of a method for generating SNP interaction-aware polygenic risk scores for radiotherapy toxicity
Recent efforts attempted to include individual patient genetic data in Normal Tissue Complication Probability (NTCP) models [1,2]. As with any predictive model, a clinically useful genetic-based NTCP model requires a sufficient number of common variants, given that each likely has a small effect on risk of complications. Radiogenomic studies are finding an increasing number of common (i.e. seen in>1% of the population) single nucleotide polymorphisms (SNPs) that can be combined to derive a polygenic risk score (PRS). (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - April 7, 2021 Category: Radiology Authors: Nicola Rares Franco, Michela Carlotta Massi, Francesca Ieva, Andrea Manzoni, Anna Maria Paganoni, Paolo Zunino, Liv Veldeman, Piet Ost, Val érie Fonteyne, Christopher J. Talbot, Tim Rattay, Adam Webb, Kerstie Johnson, Maarten Lambrecht, Karin Haustermans Tags: Original Article Source Type: research

Deep learning-based Auto-segmentation of Organs at Risk in High-Dose Rate Brachytherapy of Cervical Cancer
Delineation of organs at risk (OARs), such as the bladder, rectum and sigmoid, plays an important role in the delivery of optimal absorbed dose to the target owing to the steep gradient in high-dose rate brachytherapy (HDR-BT). In this work, we propose a deep convolutional neural network-based approach for fast and reproducible auto-contouring of OARs in HDR-BT. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - April 5, 2021 Category: Radiology Authors: Reza Mohammadi, Iman Shokatian, Mohammad Salehi, Hossein Arabi, Isaac Shiri, Habib Zaidi Tags: Original Article Source Type: research

Editorial Board
(Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - April 1, 2021 Category: Radiology Source Type: research

Contents
(Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - April 1, 2021 Category: Radiology Source Type: research

Long-term follow-up of a phase I/II trial of radiation dose escalation by simultaneous integrated boost for locally advanced esophageal squamous cell carcinoma
Esophageal cancer is one of the most common malignancies with high cancer-related death rate over the world. China possesses the top prevalence and mortality of esophageal squamous cell carcinoma (ESCC). ESCC has a poor prognosis due to high risks of local recurrence and distant metastasis. About one-half of patients present with locally advanced stage at the time of diagnosis. Since (Radiation Therapy Oncology Group) RTOG 85-01, concurrent chemoradiotherapy (CRT) has become the standard treatment of locally advanced esophageal cancer[1,2]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - April 1, 2021 Category: Radiology Authors: Ying Zhang, Wen Feng, Lan-Ting Gao, Xu-Wei Cai, Qi Liu, Zheng-Fei Zhu, Xiao-Long Fu, Wen Yu Tags: Original Article Source Type: research

First experience of autonomous, un-supervised treatment planning integrated in adaptive MR-guided radiotherapy and delivered to a patient with prostate cancer
The process of radiotherapy (RT) treatment planning from simulation using computed tomography (CT) and/or magnetic resonance imaging (MRI) to the application of the first treatment fraction is currently a multi-step routine process requiring human interactions, which is fragmented and time-consuming and thus plan quality can vary significantly [1]. Recently, the potentials of artificial intelligence (AI) in healthcare to automatize, standardize and speed-up processes has been discussed extensively [2 –6]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - April 1, 2021 Category: Radiology Authors: Luise A. K ünzel, Marcel Nachbar, Markus Hagmüller, Cihan Gani, Simon Boeke, Daniel Zips, Daniela Thorwarth Tags: Original Article Source Type: research

Rapid 4D-MRI reconstruction using a deep radial convolutional neural network: Dracula
Magnetic resonance (MR) guided radiotherapy (MRgRT) harnesses the exquisite soft-tissue contrast of magnetic resonance imaging (MRI) to improve the conformity of radiotherapy treatment delivery and subsequently patient outcome [1 –3]. For abdominal and lung cancer patients, four-dimensional (4D) and midposition [4,5] (MidP; time-weighted mean position within respiratory cycle) MRI have many applications on an MR-Linac [6–14]. For instance, 4D/MidP-MRI could be acquired online before treatment delivery (pre-beam) and info rm treatment plan adaptation to better represent the daily patient anatomy and respiratory ...
Source: Radiotherapy and Oncology - April 1, 2021 Category: Radiology Authors: Joshua N. Freedman, Oliver J. Gurney-Champion, Simeon Nill, Anna-Maria Shiarli, Hannah E. Bainbridge, Henry C. Mandeville, Dow-Mu Koh, Fiona McDonald, Marc Kachelrie ß, Uwe Oelfke, Andreas Wetscherek Tags: Original Article Source Type: research

Intrafraction motion during partial breast irradiation depends on treatment time
As the prognosis of early-stage breast cancer patients is excellent, prevention of radiation-induced toxicity has become crucial. Reduction of margins compensating for intrafraction motion reduces non-target dose. We assessed motion of the tumor bed throughout APBI treatment fractions and calculated CTV-PTV margins for breathing and drift. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - March 30, 2021 Category: Radiology Authors: Nienke Hoekstra, Steven Habraken, Annemarie Swaak – Kragten, Mischa Hoogeman, Jean-Philippe Pignol Tags: Original Article Source Type: research

Neoadjuvant Hypofractionated Radiotherapy and Chemotherapy for Extremity Soft Tissue Sarcomas: Safety, Feasibility, and Early Oncologic Outcomes of a Phase 2 Trial
Extremity soft-tissue sarcomas (ESTS) represent a group of diseases which include many different histological subtypes. These subtypes have specific biological and genetic characteristics, as well as distinct clinical behavior and/or sensitivity to both chemotherapy (ChT) and radiation therapy (RT). In more than 90% of cases, ESTS are successfully treated with limb sparing strategies that include wide local excision and RT [1]. RT has also significantly improved local control for patients with high-risk disease [2 –5]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - March 30, 2021 Category: Radiology Authors: Maria Leticia Gobo Silva, Celso Abdon Lopes de Mello, Samuel Aguiar, Felipe D ́Almeida Costa, Paulo Roberto Stevanato Filho, Tiago Santoro Bezerra, Suely Akiko Nakagawa, Antonio Geraldo Nascimento, Isabela Werneck da Cunha, Ranyell Matheus Spencer Sobrei Tags: Original Article Source Type: research

Distance to Isocenter is not associated with an increased risk for Local Failure in LINAC-based Single-Isocenter Stereotactic Radiosurgery (SRS) or Radiotherapy (SRT) for Multiple Brain Metastases
Brain metastases develop in up to 20-40 % of patients with solid cancer and represent a challenging situation for optimal management [1,2]. Intracranial stereotactic irradiation as either radiosurgery (SRS) or stereotactic radiotherapy (SRT) is a widely used treatment modality and has been established as the standard of care for patients with up to 4 brain metastases [3,4]. In patients with multiple brain metastases WBRT is still the treatment of choice but evidence for the use of SRT is growing [5 –7]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - March 29, 2021 Category: Radiology Authors: Johannes Kraft, Janita E. van Timmeren, Michael Mayinger, Simon Frei, Kim Borsky, Luisa Sabrina Stark, Jerome Krayenbuehl, Mariangela Zamburlini, Matthias Guckenberger, Stephanie Tanadini-Lang, Nicolaus Andratschke Tags: Original Article Source Type: research

Is a Higher Estimated Dose of Radiation to Immune Cells Predictive of Survival in Patients with Locally Advanced Non-Small Cell Lung Cancer Treated with Thoracic Radiotherapy?
With the wider application of immunotherapy, the effect of radiation on the immune system has drawn attention as it may affect the efficacy of radiotherapy and immunotherapy. Previous studies have demonstrated the deleterious effect of radiation on the immune system due to killing of immune cells, which may reduce the efficacy of radiotherapy and immunotherapy[1 –6]. However, in other studies, radiation-induced tumor killing was found to activate the immune system by generating tumor-associated antigens, which further improved the efficacy of immunotherapy[7]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - March 29, 2021 Category: Radiology Authors: Xiaoming Yin, Jing Luo, Cai Xu, Chunliu Meng, Jiaqi Zhang, Hao Yu, Ningbo Liu, Zhiyong Yuan, Ping Wang, Yunchuan Sun, Lujun Zhao Tags: Original Article Source Type: research

Thermoacoustic Range Verification During Pencil Beam Delivery of a Clinical Plan to an Abdominal Imaging Phantom
Range uncertainty limits the clinical efficacy and cost effectiveness of proton therapy. Accurate in vivo range verification could increase the number of tumor sites for which proton therapy is appropriate. Increasing patient volumes would help justify the added expense of proton therapy. Although the installation cost has dropped from approximately $200 M for a multi-room center to $30 M for a single room facility[1], proton therapy remains expensive compared to conventional x-ray radiation therapy. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - March 29, 2021 Category: Radiology Authors: S.K. Patch, C Nguyen, D Dominguez-Ramirez, R Labarbe, G Janssens, D Cammarano, J Lister, C Finch, J Lambert, J Pandey, C Bennett, E Porteous, C Chirvase, M Cohilis, K Souris, S Ono, T Lynch Tags: Original Article Source Type: research

Treatment and Outcome of a Patient with Radiation-Induced Organizing Pneumonia in the Context of Coronavirus Disease 2019 (COVID-19)
We report the exceptional case of a RIOP that occurred early after the end of thoracic irradiation and whose diagnosis was particularly challenging in the context of COVID-19, which can also be responsible for diffuse interstitial pneumonitis [3]. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - March 29, 2021 Category: Radiology Authors: Arnaud Beddok, Augusta D'Huy, Alain Livartowski, Vincent Servois, Raffaele Caliandro, Nicolas Girard, Gilles Cr éhange, Sylvie Helfre Tags: Letter to the Editor Source Type: research