International Journal of Radiation Oncology, Biology, Physics

OBJECTIVE: The shift to electronic health records has led to both patient portal messaging and large amounts of digital, real-world data for research. The objective of this study was to examine the association between portal messaging and survival among radiation oncology patients, using real-world data. METHODS: This retrospective cohort study included patients at least 21 years old and seen by radiation oncology providers between January 14, 2014 and April 23, 2023 at XXXX...

PURPOSE: Radiation-induced lymphopenia (RIL) is associated with poor prognosis in patients with locally advanced pancreatic cancers. However, there are no reports comparing the effects of carbon ion radiation therapy (CIRT) and photon beam radiation therapy (RT) on the development of RIL. Differences in RIL after CIRT or photon beam RT and predictive factors for RIL in patients with locally advanced pancreatic cancer were investigated. MATERIALS AND METHODS: This retrospective study cohort included 834 patients who received concurrent chemoradiotherapy (CCRT) in 2 separate institutions: 337 and 497 in the CIRT and photon beam RT groups, respectively...

PURPOSE/OBJECTIVES: Several datasets have demonstrated a correlation between lymph-vascular invasion (LVI) and local-regional recurrence (LRR). Whether the observation of "extensive LVI" is a further and incremental determinant of LRR risk is unknown. We describe clinical outcomes in women with invasive breast cancer stratified by: 1) absence of LVI (neg), 2) LVI focal or suspicious (FS-LVI), 3) usual (non-extensive) LVI (LVI) and 4) extensive LVI (E-LVI). MATERIALS/METHODS: Between 12/2009 and 8/2021, 8837 patients with early-stage breast cancer were treated with curative intent and were evaluable...

PURPOSE: To evaluate the efficacy of recombinant human superoxide dismutase (rhSOD) enemas in radiation-induced acute rectal injury (RARI) in patients with locally advanced cervical cancer. METHODS: In this phase III, randomized, open-label trial (NCT04819685) conducted across 14 medical centers in China from June 2021 to August 2023, all patients received concurrent chemoradiotherapy (CCRT). The experimental group was treated with a rhSOD enema during chemoradiotherapy, and the control group had no enema...

PURPOSE: There is interest in using dual-energy computed tomography (DECT) to evaluate organ function before and after radiotherapy. The purpose of this study (trial identifier: XXXX) is to assess longitudinal changes in lung perfusion using iodine maps derived from DECT in lung cancer patients treated with conventional or stereotactic radiotherapy (RT). METHODS: For 48 prospectively enrolled lung cancer patients, a contrast-enhanced DECT using a dual-source CT simulator was acquired pre-treatment and at 6 and 12 months post-treatment...

PURPOSE: Large, rapid extracellular oxygen transients (ΔpO2 ) have been measured in vivo during Ultra-High Dose Rate (UHDR) radiotherapy; however, it has been unclear if this matches intracellular oxygen levels. Here, the endogenously produced Protoporphyrin IX (PpIX) delayed fluorescence (DF) signal was measured as an intracellular in vivo oxygen sensor to quantify these transients, with direct comparison to extracellular pO2 . Intracellular ΔpO2 is closer to the cellular DNA, the site of major radiobiological damage and therefore should help elucidate radiochemical mechanisms of the FLASH effect and potentially be translated to human tissue measurement...

INTRODUCTION: Osteoradionecrosis of the mandible (ORN) remains a significant complication in the intensity modulated radiotherapy (IMRT) era. Dental dose cannot be predicted from heterogeneous IMRT dose distributions; mandibular dose metrics cannot guide dentist avulsion decisions in high risk ORN situations. Using a mapping tool to report dental root dose, avulsions and ORN sites, we reexamined ORN risk factors in a case-control study. METHODS: From 2008 to 2019, 897 consecutive patients with oral cavity/oropharynx (OC/OR) or unknown primary cancer (CUP) and undergoing IMRT were analyzed to identify ORN cases...

BACKGROUND: Stereotactic ablative body radiotherapy (SABR) is a novel option to treat primary renal cell carcinoma (RCC). However, a high radiation dose may be received by the treated kidney, which may affect its function post-treatment. This study investigates the dose-effect relationship of kidney SABR with posttreatment renal function. METHODS: This was a prespecified secondary endpoint of the multicenter FASTRACK II clinical trial (NCT02613819). Patients received either 26 Gy in a single fraction (SF) for tumors with a maximal diameter of 4 cm or less, or 42 Gy in three fractions (multi-fraction (MF)) for larger tumors...

BACKGROUND: Tumor-infiltrating lymphocytes (TILs) have prognostic significance in several cancers, including breast. Despite interest in combining radiotherapy with immunotherapy, little is known about the effect of radiotherapy itself on the tumor-immune microenvironment, including TILs. Here, we interrogated longitudinal dynamics of tumor-infiltrating and systemic lymphocytes in patient samples taken before, during, and after neoadjuvant radiotherapy (NART), from XXX and XXX breast clinical trials...

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PURPOSE: The role of stereotactic radiosurgery (SRS) in the management of grade 2 and 3 meningiomas is not well elucidated. Unfortunately, local recurrence rates are high, and guidelines for management of recurrent disease are lacking. To address this knowledge gap, we conducted STORM, a multicenter retrospective cohort study of patients treated with primary SRS for recurrent grade 2 and 3 meningiomas. METHODS AND MATERIALS: Data on patients with recurrent grade 2 and 3 meningioma treated with SRS at first recurrence were retrospectively collected from eight academic centers in the United States...

PURPOSE: Regional nodal irradiation (RNI) to the axilla and supraclavicular area presents distinct toxicities, such as lymphedema and shoulder stiffness, compared to whole-breast irradiation. There is insufficient evidence on the safety of dose-escalation in hypofractionated RNI. We aimed to evaluate and compare toxicity rates in patients with breast cancer who received hypofractionated RNI with and without dose-escalation. METHODS: We retrospectively analyzed 381 patients with breast cancer treated with hypofractionated RNI between March 2015 and February 2017...

PURPOSE: Combined modality treatment (CMT) with chemotherapy followed by consolidation radiotherapy (RT), provides excellent outcomes for patients with early-stage Hodgkin lymphoma (HL). The international standard of care for consolidation RT, involved-site/involved-node radiotherapy (ISRT/INRT), has never been evaluated in a randomized phase III trial against the former standard involved-field radiotherapy (IFRT). METHODS AND MATERIALS: In the multicenter phase III AnonymizedStudyGroupXXX AnonymizedStudyYYY trial, patients with early stage unfavorable HL were randomized between the standard CMT group and a positron-emission tomography (PET) -guided group...

PURPOSE: To provide an understanding of current FLI techniques, and their potential to improve dosimetry and outcomes for lung cancer patients receiving radiation therapy (RT). METHODS: EMBASE, PubMed, and Cochrane Library were searched from 1990 until April 2023. Articles were included if they reported on FLI in one of: techniques, incorporation into RT planning for lung cancer, quantification of RT-related outcomes for lung cancer patients. Studies involving all RT modalities, including stereotactic body radiotherapy and particle therapy, were included...

BACKGROUND AND PURPOSE: Previous studies have shown that the mean dose to the parotid gland stem cell rich regions (Dmean,SCR ) is the strongest dosimetric predictor for the risk of patient-reported daytime xerostomia. This study aimed to test whether the relationship between patient-reported xerostomia and Dmean,SCR is explained by a dose-dependent reduction of saliva production. MATERIAL/METHODS: In 570 head and neck cancer patients treated with definitive radiation therapy (RT), flow from the parotid (FLOWPAR ) and submandibular/sublingual glands (FLOWSMSL ) and patient-reported daytime (XERDAY ) and nighttime xerostomia (XERNIGHT ) were prospectively measured before, and at 6 and 12 months after RT...

PURPOSE: The standard treatment schedule for unresectable stage III non-small-cell lung cancer (NSCLC) is chemotherapy with concurrent radiotherapy (60 Gy delivered in 30 fractions), although moderately hypofractionated radiotherapy (Hypo-RT) has also been considered as an alternative strategy. This study aimed to compare the efficacy and toxicity of moderately Hypo-RT with helical TomoTherapy versus conventionally fractionated radiotherapy (Con-RT) in patients with unresectable stage III NSCLC receiving concurrent chemotherapy...

INTRODUCTION: In inflammatory breast cancer (IBC), radiotherapy intensification is considered a standard of care by some teams, although the level of evidence remains low. We sought to analyze the impact of radiotherapy modalities on the risk of loco-regional and distant relapse. METHODS: A retrospective multicenter study included patients with localized IBC treated between 2010 and 2017. Standard post-mastectomy radiotherapy consisted of daily fractions to a total dose of 50 Gy equivalent without a boost or bolus, while intensified radiotherapy referred to the use of a boost or bolus...

PURPOSE/OBJECTIVE(S): We sought to evaluate the toxicity and efficacy of stereotactic body radiotherapy (SBRT) for ultra-central thoracic tumours at our institution. MATERIALS/METHODS: Patients with ultra-central lung tumours or nodes, defined as having the planning target volume (PTV) overlapping or abutting the central bronchial tree and/or esophagus, treated at our institution with SBRT between 2009 and 2019 were retrospectively reviewed. All SBRT plans were generated with the goal of creating homogenous dose distributions...

PURPOSE: Proton Minibeam Radiotherapy (pMBRT) is an innovative radiation therapy approach that highly modulates the spatial dimension of the dose delivery using narrow, parallel, and submillimetric proton beamlets. pMBRT has proven its remarkable healthy tissue preservation in the brain and skin. This study assesses the potential advantages of pMBRT for thoracic irradiations compared to conventional radiotherapy in terms of normal tissue toxicity. The challenge here was the influence of respiratory motion on the typical peak and valley dose patterns of pMBRT and its potential biological impact...

PURPOSE/OBJECTIVE(S): To develop a novel deep ensemble learning model for accurate prediction of brain metastasis(BM) local control outcomes following stereotactic radiosurgery(SRS). MATERIALS/METHODS: A total of 114 BMs from 82 patients were evaluated, including 26 BMs that developed biopsy-confirmed local failure post-SRS. The SRS spatial dose distribution(Dmap ) of each BM was registered to the planning contrast-enhanced T1(T1-CE) MR. Axial slices of the Dmap , T1-CE, and PTV segmentation(PTVseg ) intersecting the BM center were extracted within a fixed field-of-view determined by the V60% in Dmap ...