Proton therapy of lung cancer patients - Treatment strategies and clinical experience from a medical physicist's perspective.

Purpose: Proton therapy of moving targets is considered a challenge. At Maastro, we started treating lung cancer patients with proton therapy in October 2019. In this work, we summarise the developed treatment strategies and gained clinical experience from a physics point of view.

Antibody-Drug Conjugates in Non-Small Cell Lung Cancer: State of the Art and Future Perspectives.

Antibody-drug conjugates (ADCs) represent one of the most promising and rapidly emerging anti-cancer therapies because they combine the cytotoxic effect of the conjugate payload and the high selectivity of the monoclonal antibody, which binds a specific membrane antigen expressed by the tumor cells. In non-small cell lung cancer (NSCLC), ADCs are being investigated targeting human epidermal growth factor receptor 2 (), human epidermal growth factor receptor 3 (), trophoblast cell surface antigen 2 (), Mesenchymal-epithelial transition factor (), and carcinoembryonic antigen-related cell adhesion molecule 5 (). To date, Trastuzumab deruxtecan is the only ADC that has been approved by the FDA for the treatment of patients with NSCLC, but several ongoing studies, both using ADCs as monotherapy and combined with other therapies, are investigating the efficacy of new ADCs.

Advanced Imaging and Preoperative MR-Based Cinematic Rendering Reconstructions for Neoplasms in the Oral and Maxillofacial Region.

This case study highlights the use of cinematic rendering (CR) in preoperative planning for the excision of a cyst in the oral and maxillofacial region of a 60-year-old man. The patient presented with a firm, non-tender mass in the right cheek, clinically suspected to be an epidermoid cyst. Conventional imaging, including dental magnetic resonance imaging (MRI) protocols, confirmed the lesion's size, location, and benign nature.

Internet-based cognitive rehabilitation for working cancer survivors: A process evaluation.

Objective: To evaluate the process of an online cognitive rehabilitation program aimed at supporting cancer survivors experiencing cognitive problems at work.

Methods: Cancer survivors (n = 279) were randomized to one of the intervention groups (i.e.

MRI of the Rectum: A Decade into DISTANCE, Moving to DISTANCED.

Over the past decade, advancements in rectal cancer research have reshaped treatment paradigms. Historically, treatment for locally advanced rectal cancer has focused on neoadjuvant long-course chemoradiotherapy, followed by total mesorectal excision. Interest in organ preservation strategies has been strengthened by the introduction of total neoadjuvant therapy with improved rates of complete clinical response.

The Role of ctDNA in the Management of Non-Small-Cell Lung Cancer in the AI and NGS Era.

Liquid biopsy (LB) involves the analysis of circulating tumour-derived DNA (ctDNA), providing a minimally invasive method for gathering both quantitative and qualitative information. Genomic analysis of ctDNA through next-generation sequencing (NGS) enables comprehensive genetic profiling of tumours, including non-driver alterations that offer prognostic insights. LB can be applied in both early-stage disease settings, for the diagnosis and monitoring of minimal residual disease (MRD), and advanced disease settings, for monitoring treatment response and understanding the mechanisms behind disease progression and tumour heterogeneity.

Clinical Introduction of Stem Cell Sparing Radiotherapy to Reduce the Risk of Xerostomia in Patients with Head and Neck Cancer.

Background/objectives: Studies have shown that dose to the parotid gland stem cell rich (SCR) regions should be reduced to lower the risk of xerostomia after radiotherapy (RT). This study aimed to assess whether stem cell sparing (SCS)-RT can be adopted in routine clinical practice.

Methods: Multiple planning studies were performed to compare SCS-RT with standard (ST)-RT using 30 head and neck cancer patients.

The Cost-Effectiveness of Sentinel Lymph Node Mapping in High-Risk Endometrial Cancer.

The aim was to evaluate the cost-effectiveness of sentinel lymph node (SLN) mapping in comparison to routine pelvic lymphadenectomy for lymph node assessment in patients with high-risk endometrial cancer (EC). A decision-analytic model was developed to compare SLN mapping with pelvic lymphadenectomy for guiding adjuvant therapy in patients with high-risk endometrioid and non-endometrioid EC, focusing on costs and health outcomes. The input data were obtained from systematic literature searches and expert consensus.

Bullet characterization using Photon-Counting detector CT: A phantom study with intact bullets.

Objectives: Photon-counting detector CT (PCD-CT) is expected to substantially improve and expand CT-imaging applicability due to its intrinsic spectral capabilities, increased spatial resolution, reduced electronic noise, and improved image contrast. The current study aim is to evaluate PCD-CT efficacy in characterizing bullets based on their dimensions, shape, and material composition.

Materials And Methods: This is an observational phantom study examining 11 unfired, intact bullets of various common calibers, placed in ballistic gelatin.

An international and multidisciplinary EORTC survey on resectability of stage III non-small cell lung cancer.

Introduction: The EORTC-Lung Cancer Group initiated a Delphi consensus process to establish a consensual definition of resectable stage III non-small cell lung cancer (NSCLC) for the use in clinical trials, including a systematic review, survey, and review of clinical cases. Here, the survey results are presented, aimed to identify areas of controversy.

Methods: A survey was distributed among the members of six international organizations related to lung cancer.

Implementation Strategy for Artificial Intelligence in Radiotherapy: Can Implementation Science Help?

Purpose: Artificial intelligence (AI) applications in radiotherapy (RT) are expected to save time and improve quality, but implementation remains limited. Therefore, we used implementation science to develop a format for designing an implementation strategy for AI. This study aimed to (1) apply this format to develop an AI implementation strategy for our center; (2) identify insights gained to enhance AI implementation using this format; and (3) assess the feasibility and acceptability of this format to design a center-specific implementation strategy for departments aiming to implement AI.

[Dental Magnetic Resonance Imaging: Practical insights and evaluation of benefits and drawbacks in dentistry and oral and maxillofacial surgery].

Dental magnetic resonance imaging (MRI) has long been perceived as overly complex, costly, and limited in availability. Despite the numerous advantages of this radiation-free, non-invasive procedure for soft tissue diagnostics in the head and neck region, its imaging capabilities for hard tissue, such as bones and teeth, have thus far remained limited in comparison to conventional X-ray technology. In recent years, however, technological advances have led to a notable enhancement in the image quality and the range of applications of dental MRI.

Colposcopy referrals and CIN3 detection after triage by host cell DNA methylation and/or HPV genotyping in HPV positive women with low-grade cytology from a population-based Dutch primary HPV screening trial.

High-risk HPV (hrHPV)-based screening has led to many unnecessary colposcopy referrals, mainly because of direct referral after low-grade cytology (ASC-US/LSIL). DNA methylation and genotyping tests on ASC-US/LSIL samples have the potential to significantly improve the efficiency of screening. In this study, 12 triage strategies were constructed from FAM19A4/miR124-2 or ASCL1/LHX8 methylation, HPV16/18 or HPV16/18/31/33/45 genotyping and 1-year repeat cytology.

Patient-Representative Cell Line Models in a Heterogeneous Disease: Comparison of Signaling Transduction Pathway Activity Between Ovarian Cancer Cell Lines and Ovarian Cancer.

: Advances in treatment options have barely improved the prognosis of ovarian carcinoma (OC) in recent decades. The inherent heterogeneity of OC underlies challenges in treatment (development) and patient stratification. One hurdle for effective drug development is the lack of patient-representative disease models available for preclinical drug research.

A Bayesian Network Approach to Lung Cancer Screening: Assessing the Impact of Data Quantity, Quality, and the Combination of Data from Danish Electronic Health Records.

: Lung cancer (LC) is the leading cause of cancer mortality, making early diagnosis essential. While LC screening trials are underway globally, optimal prediction models and inclusion criteria are still lacking. This study aimed to develop and evaluate Bayesian Network (BN) models for LC risk prediction using a decade of data from Denmark.

Single-modality endocrine therapy versus radiotherapy after breast-conserving surgery in women aged 70 years and older with luminal A-like early breast cancer (EUROPA): a preplanned interim analysis of a phase 3, non-inferiority, randomised trial.

Background: Optimal therapy following breast-conserving surgery in older adults with low-risk, early-stage breast cancer remains uncertain. The EUROPA trial aims to compare the effects of radiotherapy and endocrine therapy as single-modality treatments on health-related quality of life (HRQOL) and ipsilateral breast tumour recurrence (IBTR) outcomes in this population.

Methods: This non-inferiority, phase 3, randomised study was conducted at 18 academic hospitals across Italy (17 centres) and Slovenia (one centre).

Validation of the generalized stochastic microdosimetric model (GSM2) over a broad range of LET and particle beam type: a unique model for accurate description of (therapy relevant) radiation qualities.

. The present work shows the first extensive validation of the(GSM). This mechanistic and probabilistic model is trained and tested over cell survival experiments conducted with two cell lines (H460 and H1437), three different types of radiation (protons, helium, and carbon ions), spanning a very broad LET range from1 keVμm-1up to more than300 keVμm-1.

Patient preferences for treatment of Bowen's disease.

Background: Discrete choice experiments (DCEs) are increasingly used to understand and quantify patient preferences for a variety of treatments, services or screening in order to analyse the choices patients make when faced with different alternatives. The aim of this DCE was to examine patient preferences for the treatment of Bowen's disease.

Methods: A DCE was conducted alongside a randomised controlled non-inferiority trial comparing the effectiveness of surgical excision, MAL-PDT, and 5-fluorouracil cream as treatments for Bowen's disease.

The DETECTION project part 1: An international Delphi survey about diagnostics and treatment of anterior mediastinal cystic lesions.

Background: Differentiating benign anterior mediastinal cysts from malignancies is challenging in clinical practice. International guidelines on optimal diagnostics and treatment for anterior mediastinal cystic lesions are lacking. The first part of the DETECTION project focuses on possible heterogeneity in diagnostics and treatment of anterior mediastinal cystic lesions among international thoracic medical experts.

Optical assessment of scars after endoscopic mucosal resection of large colorectal polyps in a multicenter, community hospital setting: is routine biopsy still necessary?

Background And Study Aims: Piecemeal EMR of large (≥20mm) non-pedunculated colorectal polyps (LNPCPs) is succeeded by a 6-month surveillance endoscopy to evaluate the post-EMR scar for recurrence. Data from expert centers suggest that routine tattoo placement and scar biopsies can be omitted, but data from community hospitals are lacking.

Patients And Methods: In a post-hoc analysis of the STAR-LNPCP study (NTR7477), containing prospective data on 6-month post-pEMR scar assessments in 30 Dutch community hospitals (October 2019 to May 2022), the agreement between optical assessment and histological confirmation by routine biopsies was evaluated.

Patient perspectives on treatment-related toxicities and therapeutic drug monitoring with tyrosine kinase inhibitors for the treatment of non-small-cell lung cancer.

Background: Tyrosine kinase inhibitors (TKIs) have significantly improved treatment-related outcomes of patients with oncogene-driven non-small-cell lung cancer (NSCLC). TKIs are usually well tolerated and used for a prolonged time, although experienced toxicity varies between patients. It is unclear whether patients report all (low grade) toxicities and how these impact their daily lives.

Preconception carrier screening in couples seeking IVF: exploring the patient perspective.

Research Question: What is the level of understanding, and what are the attitudes and considerations regarding preconception carrier screening (PCS) among couples seeking IVF or intracytoplasmic sperm injection (ICSI)?

Design: A mixed-methods design was used. Nine interviews were conducted with couples or individual partners (n = 16) who had an initial consultation for IVF/ICSI in the 2 years preceding this study. A questionnaire was completed by 115 participants.

Interpretation of intra-operative strain differences in ascending thoracic aortic repair patients.

Local biaxial deformation plays a pivotal role in evaluating the tissue state of the ascending aorta and in driving intramural cell-mediated tissue remodeling. Unfortunately, the absence of anatomical markers on the ascending aorta presents challenges in capturing deformation. Utilizing our established intra-operative biaxial strain measurement method, we delineated local biaxial deformation characteristics in patients undergoing aortic valve replacement and coronary artery bypass graft surgery recipients (n = 20), and Aortic Repair surgery patients (n = 47).