Feasibility study of patient-specific four-dimensional in vivo tracking system for high-dose-rate brachytherapy: Experimental evaluation.

Background: High-dose-rate (HDR) brachytherapy using Iridium-192 as a radiation source is widely employed in cancer treatment to deliver concentrated radiation doses while minimizing normal tissue exposure. In this treatment, the precision with which the sealed radioisotope source is delivered significantly impacts clinical outcomes.

Purpose: This study aims to evaluate the feasibility of a new four-dimensional (4D) in vivo source tracking and treatment verification system for HDR brachytherapy using a patient-specific approach.

Status in Brain Gliomas Can Be Predicted by the Spherical Mean MRI Technique.

Background And Purpose: Diffuse gliomas, a heterogeneous group of primary brain tumors, have traditionally been stratified by histology, but recent insights into their molecular features, especially the mutation status, have fundamentally changed their classification and prognosis. Current diagnostic methods, still predominantly relying on invasive biopsy, necessitate the exploration of noninvasive imaging alternatives for glioma characterization.

Materials And Methods: In this prospective study, we investigated the utility of the spherical mean technique (SMT) in predicting the status and histologic grade of adult-type diffuse gliomas.

Proton Beam Therapy for Pancreatic Tumors: A Consensus Statement from the Particle Therapy Cooperative Group Gastrointestinal Subcommittee.

Objectives: Radiotherapy manages pancreatic cancer in various settings; however, the proximity of gastrointestinal (GI) luminal organs-at-risk (OAR) poses challenges to conventional radiotherapy. Proton beam therapy (PBT) may reduce toxicities compared to photon therapy. This consensus statement summarizes PBT's safe and optimal delivery for pancreatic tumors.

Health Utility of Pain Response Versus Nonresponse to Palliative Radiation Therapy for Symptomatic Bone Metastases: Analyses Based on Real-World Data from 26 Centers.

Utility values of responders and nonresponders are essential inputs in cost-effectiveness studies of radiation therapy for painful bone metastases but, to our knowledge, they have not been reported separately. We sought to determine the utility values of responders and nonresponders using data from a prospective observational study on bone metastases. The original prospective observational study was conducted at 26 centers in Japan.

Quantification of beam size impact on intensity-modulated proton therapy with robust optimization in head and neck cancer-comparison with intensity-modulated radiation therapy.

We assessed the effect of beam size on plan robustness for intensity-modulated proton therapy (IMPT) of head and neck cancer (HNC) and compared the plan quality including robustness with that of intensity-modulated radiation therapy (IMRT). IMPT plans were generated for six HNC patients using six beam sizes (air-sigma 3-17 mm at isocenter for a 70-230 MeV) and two optimization methods for planning target volume-based non-robust optimization (NRO) and clinical target volume (CTV)-based robust optimization (RO). Worst-case dosimetric parameters and plan robustness for CTV and organs-at-risk (OARs) were assessed under different scenarios, assuming a ± 1-5 mm setup error and a ± 3% range error.

Role and Effectiveness of Hypofractionated Proton Beam Therapy and Combinations with Systemic Chemotherapy in Inoperable Extrahepatic Cholangiocarcinoma.

Purpose: This study aims to assess the clinical outcomes of hypofractionated proton beam therapy (PBT) for extrahepatic cholangiocarcinoma (EHCC) and to investigate the optimal sequencing for combining PBT with chemotherapy.

Materials And Methods: We retrospectively analyzed fifty-nine consecutive patients with inoperable EHCC treated with PBT. The median prescribed dose of PBT was 50 GyE (range, 45-66 GyE) in 10 fractions.

Concurrent Versus Sequential Adjuvant Capecitabine-Based Chemoradiation in Residual Triple-Negative Breast Cancer After Neoadjuvant-Chemotherapy: A Multicenter Comparative Study.

Purpose: Given the aggressive nature and poor prognosis of triple-negative breast cancer (TNBC), adjuvant capecitabine has been the standard therapy for residual disease after preoperative systemic therapy (PST). However, the optimal sequence of postoperative radiation therapy (RT) and capecitabine remains unclear. This study evaluated the efficacy and safety of concurrent RT and capecitabine (RT+CAP) versus sequential RT followed by capecitabine (RT→CAP) in patients with residual TNBC after PST.

A retrospective bilateral breast proton pencil beam scanning and photon volumetric arc therapy planning comparison.

Background: Advanced bilateral breast cancers with local and regional nodal involvement are rare and challenging to plan due to conflicting demands of conformality, uniformity and sparing of organs at risk such as heart and lungs. Pencil beam scanning (PBS) protons have been shown to provide improved organ at risk (OAR) sparing, conformality and homogeneity compared to photon techniques including three-dimensional conformal radiotherapy, intensity modulated radiation therapy (IMRT), volumetric arc therapy (VMAT), and tomotherapy. We performed a blinded comparison between VMAT and PBS plans and extend this comparison with a case study of a patient win expander during radiotherapy.

The Association of Linear Energy Transfer and Dose With Radiation Necrosis After Pencil Beam Scanning Proton Therapy in Pediatric Posterior Fossa Tumors.

Purpose: Proton therapy is the preferred treatment modality for most pediatric central nervous system tumors. The risk of radiation necrosis may be increased at the distal end of the beam because of an increase in linear energy transfer (LET) and relative biological effectiveness (RBE) dose. We report on the association of LET and dose with radiation necrosis after pencil beam scanning proton therapy in pediatric posterior fossa tumors using a case-control framework.

Impact of Myc-Altered Pathology on Radiation Therapy Efficacy Among Patients With Relapsed/Refractory Large-B Cell Lymphoma: A Collaborative Study by ILROG.

Purpose: The presence of MYC and BCL2 translocations (ie, double-hit lymphoma, DHL) in large B-cell lymphoma (LBCL) is associated with reduced chemosensitivity, but less is known on its impact on radiotherapy (RT) efficacy.

Methods And Materials: Patients with LBCL who received their first course of RT for relapsed/refractory disease between 2008 and 2020 were eligible if there was adequate pathologic evaluation to be categorized as DHL versus non-DHL as per the World Health Organization (fifth edition). Separate analyses were conducted by treatment intent.

Proton FLASH Irradiation Using a Synchrotron Accelerator: Differences by Irradiation Positions.

Purpose: To establish an ultra-high dose-rate (UHDR) radiation system using a synchrotron proton beam accelerator and to compare the effects by irradiation positions on cultured cells and chick embryos.

Methods And Materials: Protons for UHDR were obtained by applying high-frequency power at much higher levels than usual to extract all protons within approximately 50 ms. Subsequently, monitoring with a Faraday cup was performed immediately after synchrotron extraction and the waveform was adjusted accordingly.

Respiratory-gated proton beam therapy for intrahepatic cholangiocarcinoma without fiducial markers.

Background: Intrahepatic cholangiocarcinoma (ICC) is a challenging primary liver cancer with a poor prognosis, especially in unresectable cases. Traditional palliative irradiation is limited in reducing liver doses. This study aimed to evaluate the efficacy and toxicity of respiratory-gated proton beam therapy without fiducial markers for intrahepatic cholangiocarcinoma.

MiRNA Profiling of Areca Nut-Induced Carcinogenesis in Head and Neck Cancer.

Background: While miRNAs are increasingly recognized for their role in tumorigenesis, their involvement in head and neck cancer (HNC) remains insufficiently explored. Additionally, the carcinogenic mechanisms of areca nut, a major habitual carcinogen in Southeast Asia, are not well understood.

Methods And Results: This study adopts a systematic approach to identify miRNA profiles associated with areca nut-induced HNC.

External Beam Radiation Therapy for Liver Metastases.

Stereotactic ablative radiotherapy (SABR) commonly is used for small liver metastases. Modern conformal radiotherapy techniques, including 3-dimensional conformal radiotherapy and intensity-modulated radiation therapy, enable the safe delivery of SABR to small liver volumes. For larger tumors, the safe delivery of SABR can be challenging due to a more limited volume of healthy normal liver parenchyma and the proximity of the tumor to radiosensitive organs, such as the stomach, duodenum, and large intestine.

Hyponatremia unleashes neutrophil extracellular traps elevating life-threatening pulmonary embolism risk.

Neutrophil extracellular traps (NETs), essential for controlling infections, can induce various pathologies when dysregulated. Known triggers for infection-independent NETs release exist, yet a comprehensive understanding of the conditions prompting such responses is lacking. In this study, we identify hyponatremia as an independent inducer of NETs release, a common clinical condition that disrupts sodium/calcium exchange within neutrophils.

Impacts of Employment Status, Partnership, Cancer Type, and Surgical Treatment on Health-Related Quality of Life in Irradiated Head and Neck Cancer Survivors.

: This study aimed to examine the relationship between health-related quality of life (HRQoL) and sociodemographic and clinical variables in survivors of head and neck cancer (HNC) treated with radiotherapy, with or without surgery. : HRQoL was measured using the functional assessment of cancer therapy-head and neck (FACT-H&N) in a cross-sectional survey involving 150 patients. Of these, 60 had nasopharyngeal cancer (NPC), treated exclusively with radiotherapy, while 90 had oral cavity squamous cell cancer (OSCC), undergoing radical surgery followed by adjuvant radiotherapy.

Cardiac Conduction System as an OAR in Radiation Therapy: Doses to SA/AV Nodes and Their Reduction.

Purpose: Despite advancements in radiation techniques, concerns persist regarding the adverse effects of radiation therapy, particularly cardiotoxicity or radiation-induced heart disease. Recently, arrhythmogenic toxicity has come to the forefront-the impact of radiation therapy on the cardiac conduction system. Our objective was to conduct a dosimetric study and subsequently investigate the feasibility of optimizing the sinoatrial (SA) and atrioventricular (AV) nodes as organs at risk (OARs) in proton radiation therapy for non-small cell lung cancer with N3 disease.

First test beam of the DMAPS-based proton tracker at the pMBRT facility at the Curie Institute.

Proton radiotherapy's efficacy relies on an accurate relative stopping power (RSP) map of the patient to optimise the treatment plan and minimize uncertainties. Currently, a conversion of a Hounsfield Units map obtained by a common x-ray computed tomography (CT) is used to compute the RSP. This conversion is one of the main limiting factors for proton radiotherapy.

Treatment Outcomes after Postoperative Radiotherapy in Triple-Negative Breast Cancer: Multi-Institutional Retrospective Study (KROG 17-05).

Background: We designed a multi-institutional retrospective study to investigate the previously unreported failure pattern, survivals, and prognostic factors after postoperative radiotherapy (PORT) in triple negative breast cancer (TNBC) patients in South Korea.

Materials And Methods: We retrospectively reviewed 699 patients with TNBC who underwent PORT at six institutions between 2008 and 2010. The median follow-up period was 94 months (range: 7-192 months).

Clinical Outcomes of Proton Beam Therapy for Unresectable Locally Advanced Pancreatic Cancer: A Single-Center Retrospective Study.

Purpose: We retrospectively researched the treatment outcome of proton beam therapy (PBT) and assessed its efficacy for inoperable locally advanced pancreatic cancer (LAPC) at our institution.

Methods And Materials: Fifty-four patients (28 men and 26 women, median age 67 years ranging from 40-88 years) were diagnosed with unresectable stage III LAPC and administered PBT from April 2009 to March 2020. Patients who could not complete PBT, had new distant metastases during the treatment, or did not have enough follow-up time were excluded from this study.

Proton therapy for adult-type diffuse glioma: A systematic review.

Background: We conducted a systematic review to evaluate outcomes and toxicities associated with proton therapy in the treatment of adult-type diffuse glioma.

Methods: Following PRISMA guidelines, we searched PubMed for both prospective and retrospective studies on proton therapy for adult diffuse gliomas, including IDH-mutated gliomas WHO grade 2-3 and glioblastomas. Survival and toxicity outcomes were reported separately for these glioma types.

Impact of cyclophosphamide on the morphological and histological changes in polyglycolic acid spacers.

In radiotherapy for pediatric abdominal tumors, determining the effect of concurrent chemotherapy on polyglycolic acid (PGA) spacers is crucial; yet this effect has not been validated. Therefore, we aimed to evaluate the impact of cyclophosphamide (CPA) chemotherapy on the PGA spacer using a rat model. Twenty-four rats were implanted with the spacer, and morphological changes in the spacer were assessed on CT for both the CPA-dosed group (40 mg/kg) and the control group.