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Editorial Board
doi : 10.1016/S0167-8140(21)06124-7
EDITORIAL BOARD| VOLUME 157, PII, APRIL 01, 2021
Taste dysfunction following radiotherapy to the head and neck: A systematic review
Lucinda Gunn,James Gilbert,Pablo Nenclares,Kee Howe Wong,Kevin Harrington,Chris Nutting
doi : 10.1016/j.radonc.2021.01.021
REVIEW ARTICLE| VOLUME 157, P130-140, APRIL 01, 2021
An intact sense of taste provides pleasure, supports sustenance and alerts the body to toxins. Head and neck cancer (HNC) patients who receive radiotherapy (RT) are high-risk for developing radiation-induced taste dysfunction. Advances in RT offer opportunities for taste-preserving strategies by reducing dose to the gustatory organs-at-risk.
Is radiation-induced arteriopathy in long-term breast cancer survivors an underdiagnosed situation?: Critical and pragmatic review of available literature
S Delanian
doi : 10.1016/j.radonc.2021.01.009
REVIEW ARTICLE| VOLUME 157, P163-174, APRIL 01, 2021
Although considered exceptional, radiation-induced arteriopathy in long-term breast cancer survivors involves three main arterial domains in the irradiated volume, namely axillary-subclavian, coronary, and carotid. Stenosis of medium-large arteries is caused by “accelerated” atherosclerosis, particularly beyond 10 years after long-forgotten radiotherapy. The present review aims at summarizing what is known about arteriopathy, as well as the state of the art in terms of diagnosis and therapeutic management.
State of the art treatment for stage I to III anal squamous cell carcinoma: A systematic review and meta-analysis
Ricardo N. Werner,Matthew Gaskins,Gabriela Avila Valle,Alexander Nast,Robert Siegel,Felix Aigner
doi : 10.1016/j.radonc.2021.01.031
REVIEW ARTICLE| VOLUME 157, P188-196, APRIL 01, 2021
This systematic review summarised and critically appraised evidence on the efficacy and safety of interventions for anal cancer to support the panel of experts developing the national evidence-based anal cancer guideline in Germany.
Risk and impact of radiation related lymphopenia in lung cancer: A systematic review and meta-analysis
Rituraj Upadhyay,Bhanu Prasad Venkatesulu,Prashanth Giridhar,Thiraviyam Elumalai,Supriya Mallick,Matthew Harkenrider
doi : 10.1016/j.radonc.2021.01.034
REVIEW ARTICLE| VOLUME 157, P225-233, APRIL 01, 2021
Despite the modern advances in treatment techniques, the survival of locally advanced lung cancer patients continues to remain poor. Circulating lymphocytes have an important role to play in local immune response to RT as well as immune checkpoint inhibitors, and radiation related lymphopenia has been associated with inferior survival in various tumors.
A multidisciplinary approach for autologous breast reconstruction: A narrative (re)view for better management
Orit Kaidar-Person,Naama Hermann,Philip Poortmans,Wies Maarse,Miri Sklair-Levi,Zolt?n M?trai
doi : 10.1016/j.radonc.2021.01.036
REVIEW ARTICLE| VOLUME 157, P263-271, APRIL 01, 2021
Breast reconstruction and oncoplastic surgery have become an important part of breast cancer care. The use of autologous breast reconstruction (ABR) has evolved significantly with advances in microsurgery, aiming to reduce donor site complications and improve cosmesis. For years, immediate-ABR was considered a contraindication if postmastectomy irradiation (PMRT) was planned. As a result of de-escalation of axillary surgery the indication of PMRT are increasing along-side with observations that PMRT in the setting of ABR is not contraindicated. Surgical techniques may result in different amount and areas of breast residual glandular tissue and patient selection is important to reduce potential residual disease. Meticulus radiation planning is important to potentially reduce complications without compromising oncologic outcomes. Surgical techniques change constantly in aim to improve aesthetic results but should most importantly maintain priority to the oncological indications. By multidisciplinary team work with a comprehensive understanding of each discipline, we can preserve the accomplishments of breast surgery in the setting of PMRT, without compromising disease control.
A Phase 1b trial of prexasertib in combination with chemoradiation in patients with locally advanced head and neck squamous cell carcinoma
Eddy S. Yang,Eric Deutsch,Altan Mehmet,Rodney L. Decker,Aimee K. Bence Lin,William N. William Jr.
doi : 10.1016/j.radonc.2021.01.032
ORIGINAL ARTICLE| VOLUME 157, P203-209, APRIL 01, 2021
This study explored the feasibility of safely combining prexasertib, with cisplatin-radiotherapy (Part A) or cetuximab-radiotherapy (Part B) in patients with previously untreated, locoregionally advanced head and neck squamous cell carcinoma (HNSCC).
Hypofractionated radiotherapy in the real-world setting: An international ESTRO-GIRO survey
Danielle Rodin,Bouchra Tawk,Osama Mohamad,Mei Ling Yap,Eduardo Zubizarreta,Yolande Lievens
doi : 10.1016/j.radonc.2021.01.003
ORIGINAL ARTICLE| VOLUME 157, P32-39, APRIL 01, 2021
Multiple large trials have established the non-inferiority of hypofractionated radiotherapy compared to conventional fractionation. This study will determine real-world hypofractionation adoption across different geographic regions for breast, prostate, cervical cancer, and bone metastases, and identify barriers and facilitators to its use.
Risk of coronary artery disease after adjuvant radiotherapy in 29,662 early breast cancer patients: A population-based Danish Breast Cancer Group study
Marie Louise Holm Milo,Lise Bech Jellesmark Thorsen,S?ren Paaske Johnsen,Jan Brink Valentin,Jan Alsner,Birgitte Vrou Offersen
doi : 10.1016/j.radonc.2021.01.010
ORIGINAL ARTICLE| VOLUME 157, P106-113, APRIL 01, 2021
Radiotherapy (RT) for early breast cancer (BC) reduces the risk of recurrence and improves overall survival. However, thoracic RT may cause some incidental RT dose to the heart with subsequent risk of heart disease. During 2000–2010, CT-based RT planning was gradually introduced. The aim of this study was to investigate the risk of cardiac events in left-sided compared with right-sided BC patients treated during a non-CT-based (1999–2007) vs a CT-based period (2008–2016).
Modelling of late side-effects following cranial proton beam therapy
Almut Dutz,Armin Lühr,Linda Agolli,Beate Timmermann,Helen A. Shih,Steffen L?ck
doi : 10.1016/j.radonc.2021.01.004
ORIGINAL ARTICLE| VOLUME 157, P15-23, APRIL 01, 2021
The limited availability of proton beam therapy (PBT) requires individual treatment selection strategies that can be based on normal tissue complication probability (NTCP) models. We developed and externally validated NTCP models for common late side-effects following PBT in brain tumour patients to optimise patients’ quality of life.
Definitive chemoradiotherapy for clinical T4b esophageal cancer – Treatment outcomes, failure patterns, and prognostic factors
Tzu-Ting Huang,Shau-Hsuan Li,Yen-Hao Chen,Yi-Chun Chiu,Yeh-Pin Chou,Yu-Ming Wang
doi : 10.1016/j.radonc.2021.01.007
ORIGINAL ARTICLE| VOLUME 157, P56-62, APRIL 01, 2021
The management of cT4b thoracic esophageal cancer (EC) is challenging. The optimal treatment remains unclear, and prospective or large-scale retrospective reports on treatment outcomes are lacking. The present study was conducted to investigate the treatment outcomes, failure patterns, treatment responses, and prognostic factors focusing on cT4b thoracic EC treated by definitive concurrent chemoradiotherapy (dCRT).
Neoadjuvant rectal (NAR) score: Value evaluating the efficacy of neoadjuvant therapy and prognostic significance after surgery?
Israa Imam,Klara Hammarstr?m,Tobias Sj?blom,Bengt Glimelius
doi : 10.1016/j.radonc.2021.01.002
ORIGINAL ARTICLE| VOLUME 157, P70-77, APRIL 01, 2021
The Neoadjuvant rectal (NAR) score is a new surrogate endpoint to be used in clinical trials for early determination of treatment response to different preoperative therapies. The aim is to further validate the NAR-score, primarily developed using chemoradiotherapy (CRT) with a delay to surgery 6–8 weeks, and explore its value using other schedules.
Anorectal function and radiation dose to pelvic floor muscles after primary treatment for anal cancer
Camilla J.S. Kronborg,Peter Christensen,Bodil G. Pedersen,Karen-Lise G. Spindler
doi : 10.1016/j.radonc.2021.01.027
ORIGINAL ARTICLE| VOLUME 157, P141-146, APRIL 01, 2021
Chemoradiotherapy is the primary treatment for localized anal cancer (AC). This treatment offers high rates of cure and organ preservation. Radiotherapy can however, result in late persisting anorectal dysfunction, with anal incontinence, urge and clustering. Correlation of radiation doses to pelvic substructures and functional outcome is not well described in AC. We correlated patient reported anorectal function to radiation doses to sphincters and pelvic floor muscles.
Relation between DIR recalculated dose based CBCT and GI and GU toxicity in postoperative prostate cancer patients treated with VMAT
Panyapat Buranaporn,Pittaya Dankulchai,Tanwiwat Jaikuna,Tissana Prasartseree
doi : 10.1016/j.radonc.2020.12.036
ORIGINAL ARTICLE| VOLUME 157, P8-14, APRIL 01, 2021
To investigate the relationship between deformable image registration (DIR) recalculated dose on cone beam computed tomography (CBCT) and gastrointestinal and genitourinary toxicity in postoperative prostate cancer patients treated with volumetric modulated arc therapy and its actual delivered dose.
Dosimetry of local failure with single dose 19 Gy high-dose-rate brachytherapy for prostate cancer
Shreya Armstrong,Yatman Tsang,Gerry Lowe,Peter Ostler,Robert Hughes,Peter Hoskin
doi : 10.1016/j.radonc.2021.01.006
ORIGINAL ARTICLE| VOLUME 157, P93-98, APRIL 01, 2021
Long-term follow up of single dose high-dose rate brachytherapy (HDR BT) for localised prostate cancer has revealed higher than expected rates of biochemical and local failure. This study aimed (i) to investigate the pattern of relapse within the prostate with reference to the initial site of disease in those patients; and (ii) to examine if there were any relationships between the HDR BT dosimetric parameters to these areas of recurrence.
Results of image guided brachytherapy for stage IB cervical cancer in the RetroEMBRACE study
Primoz Petric,Jacob C. Lindegaard,Alina Sturdza,Kari Tanderup,Christian Kirisits,Richard P?tter
doi : 10.1016/j.radonc.2021.01.005
ORIGINAL ARTICLE| VOLUME 157, P24-31, APRIL 01, 2021
Multiple treatment options are used in early local-stage cervical cancer, including combinations of surgery with neoadjuvant/adjuvant radiotherapy and chemotherapy. Our aim was to determine the outcome for definitive chemoradiation with image guided brachytherapy (IGBT).
Development and validation of a contouring guideline for the taste bud bearing tongue mucosa
Sonja Stieb,Abdallah S.R. Mohamed,Renjie He,Steven J. Frank,G. Brandon Gunn,C. David Fuller
doi : 10.1016/j.radonc.2020.11.012
ORIGINAL ARTICLE| VOLUME 157, P63-69, APRIL 01, 2021
To introduce a contouring guideline for the taste bud bearing tongue mucosa for head and neck cancer patients receiving radiotherapy.
Normal tissue complication probability (NTCP) models for predicting temporal lobe injury after intensity-modulated radiotherapy in nasopharyngeal carcinoma: A large registry-based retrospective study from China
Dan-Wan Wen,Li Lin,Yan-Ping Mao,Jun Ma,Ying Sun,Guan-Qun Zhou
doi : 10.1016/j.radonc.2021.01.008
ORIGINAL ARTICLE| VOLUME 157, P99-105, APRIL 01, 2021
To develop predictive models with dosimetric and clinical variables for temporal lobe injury (TLI) in nasopharyngeal carcinoma (NPC) after intensity-modulated radiotherapy (IMRT).
Unambiguous advanced radiologic extranodal extension determined by MRI predicts worse outcomes in nasopharyngeal carcinoma: Potential improvement for future editions of N category systems
Yanping Mao,Shunxin Wang,William Lydiatt,Lizhi Liu,Jian Ren,Jun Ma
doi : 10.1016/j.radonc.2021.01.015
ORIGINAL ARTICLE| VOLUME 157, P114-121, APRIL 01, 2021
To explore the prognostic value of different radiologic extranodal extension (rENE) grades and their potential improvement for the 8th edition N category in nasopharyngeal carcinoma (NPC).
Prevalence and distribution of cervical lymph node metastases in HPV-positive and HPV-negative oropharyngeal squamous cell carcinoma
Laurence Bauwens,Aline Baltres,Danny-Joe Fiani,Bertrand Fleury,Nazim Benzerdjeb,Vincent Grégoire
doi : 10.1016/j.radonc.2021.01.028
ORIGINAL ARTICLE| VOLUME 157, P122-129, APRIL 01, 2021
In oropharyngeal squamous cell carcinoma (OP-SCC), the prevalence and distribution of clinical and pathological lymph node metastasis in the neck have been extensively reported. It served as the basis for consensus recommendations on the selection of the lymph node levels in the neck requiring a treatment. The objective of the study is to compare the prevalence and distribution of neck node metastases in HPV+ and HPV? OP-SCC from a large series of patients with OP-SCC who underwent a cervical lymph-node dissection (LND) as part of their treatment.
Comprehensive toxicity risk profiling in radiation therapy for head and neck cancer: A new concept for individually optimised treatment
Lisa Van den Bosch,Arjen van der Schaaf,Hans Paul van der Laan,Roel J.H.M. Steenbakkers,Ewoud Schuit,Johannes A. Langendijk
doi : 10.1016/j.radonc.2021.01.024
ORIGINAL ARTICLE| VOLUME 157, P147-154, APRIL 01, 2021
A comprehensive individual toxicity risk profile is needed to improve radiation treatment optimisation, minimising toxicity burden, in head and neck cancer (HNC) patients. We aimed to develop and externally validate NTCP models for various toxicities at multiple time points.
Risk of ischaemic cerebrovascular events in head and neck cancer patients is associated with carotid artery radiation dose
Evert S.M. van Aken,Hans Paul van der Laan,Hendrik P. Bijl,Margriet Dieters,Roel J.H.M. Steenbakkers,Johannes A. Langendijk
doi : 10.1016/j.radonc.2021.01.026
ORIGINAL ARTICLE| VOLUME 157, P182-187, APRIL 01, 2021
Radiotherapy in the head and neck area may cause vascular damage to the carotid arteries, increasing the risk of anterior circulation ischaemic cerebrovascular events (ICVEs). However, limited data exists on the relationship between radiation dose to the carotid arteries and risk of ICVE. The purpose of this study was therefore to determine the relationship between radiation dose to the carotid arteries and anterior circulation ICVE risk.
Improved local control in p16 negative oropharyngeal cancers with hypermethylated MGMT
Garrett L. Jensen,Gabriel Axelrud,David Fink,Arundhati Rao,Niloyjyoti Deb,Sameer G. Jhavar
doi : 10.1016/j.radonc.2021.01.035
ORIGINAL ARTICLE| VOLUME 157, P234-240, APRIL 01, 2021
Patients with oropharyngeal cancers that are p16 negative (p16?) have worse outcomes than those who are p16 positive (p16+) and there is an unmet need for prognostic markers in this population. O6-Methylguanine (O6-MG)-DNA-methyltransferase (MGMT) gene methylation has been associated with response to chemoradiotherapy (CRT) in glioblastoma. We sought to find if MGMT promoter methylation was associated with outcomes of locally advanced oropharyngeal and oral cavity squamous cell carcinoma (OOSCC) in patients treated with definitive concurrent CRT.
Diffusion weighted imaging in submandibular gland sparing helical tomotherapy for nasopharyngeal carcinoma
Wen-jun Fan,Feng Teng,Gang Liu,Xin-xin Zhang,Lin Ma,Jian Guan
doi : 10.1016/j.radonc.2021.02.004
ORIGINAL ARTICLE| VOLUME 157, P247-254, APRIL 01, 2021
To verify clinical significance of submandibular gland (SMG)-sparing during helical tomotherapy (HT) for nasopharyngeal carcinoma (NPC) from the perspective of imaging by using diffusion weighted imaging (DWI).
Head and neck imaging surveillance strategy for HPV-positive oropharyngeal carcinoma following definitive (chemo)radiotherapy
Erin T. Wong,Shao Hui Huang,Brian O'Sullivan,Li Tong,Wei Xu,Eugene Yu
doi : 10.1016/j.radonc.2021.02.005
ORIGINAL ARTICLE| VOLUME 157, P255-262, APRIL 01, 2021
To describe the utilization pattern of head and neck (HN) surveillance imaging and explore the optimal strategy for radiologic “residual” lymph node (LN) surveillance following definitive (chemo)radiotherapy (RT/CRT) in human papillomavirus (HPV)+ oropharyngeal carcinoma (OPC).
Local tumour control and radiation side effects for fractionated stereotactic photon beam radiotherapy compared to proton beam radiotherapy in uveal melanoma
Jackelien G.M. van Beek,Wishal D. Ramdas,Martina Angi,Bertil Damato,Heinrich Heimann,Emine Kiliç
doi : 10.1016/j.radonc.2021.01.030
ORIGINAL ARTICLE| VOLUME 157, P219-224, APRIL 01, 2021
To compare the adverse side effects of fractionated stereotactic photon beam radiotherapy (fSRT) with proton beam radiotherapy (PBR) in patients with uveal melanoma (UM).
Incidence, risk factors, and CT characteristics of radiation recall pneumonitis induced by immune checkpoint inhibitor in lung cancer
François Cousin,Colin Desir,Selma Ben Mustapha,Carole Mievis,Philippe Coucke,Roland Hustinx
doi : 10.1016/j.radonc.2021.01.001
ORIGINAL ARTICLE| VOLUME 157, P47-55, APRIL 01, 2021
Radiation recall pneumonitis (RRP) is a delayed radiation-induced lung toxicity triggered by systemic agents, typically anticancer drugs. Immune checkpoint inhibitors (ICIs) have recently been identified as potential causal agents of RRP but its real incidence and potential risk factors remain unknown.
Automatic segmentation of three clinical target volumes in radiotherapy using lifelong learning
Kuo Men,Xinyuan Chen,Bining Yang,Shulian Wang,Yexiong Li,Jianrong Dai
doi : 10.1016/j.radonc.2020.12.034
ORIGINAL ARTICLE| VOLUME 157, P1-7, APRIL 01, 2021
Convolutional neural networks (CNNs) have comparable human level performance in automatic segmentation. An important challenge that CNNs face in segmentation is catastrophic forgetting. They lose performance on tasks that were previously learned when trained on task. In this study, we propose a lifelong learning method to learn multiple segmentation tasks continuously without forgetting previous tasks.
Prospective dual-surrogate validation study of periodic imaging during treatment for accurately monitoring intrafraction motion of prostate cancer patients
Ashley Cetnar,Ahmet S. Ayan,Gavin Graeper,Douglas D. Martin,Dayssy A. Diaz,Nilendu Gupta
doi : 10.1016/j.radonc.2021.01.020
ORIGINAL ARTICLE| VOLUME 157, P40-46, APRIL 01, 2021
The goal of this prospective study is to validate the use of periodic imaging during treatment with a fiducial marker detection algorithm using radiofrequency transponders for prostate cancer patients undergoing treatment for radiation therapy.
Spirometer-guided breath-hold breast VMAT verified with portal images and surface tracking
Laurence Delombaerde,Saskia Petillion,Caroline Weltens,Tom Depuydt
doi : 10.1016/j.radonc.2021.01.016
ORIGINAL ARTICLE| VOLUME 157, P78-84, APRIL 01, 2021
Fast rotating closed-bore gantry linacs are ideally suited for breath-hold treatments due to reduced imaging and delivery times. We evaluated the reproducibility and stability of spirometer-guided breath-hold breast treatments, using intra-bore surface monitoring and portal imaging on Halcyon (Varian Medical Systems).
Robustness of daily dose for each beam angle and accumulated dose for inter-fractional anatomical changes in passive carbon-ion radiotherapy for pancreatic cancer: Bone matching versus tumor matching
Yoshiki Kubota,Masahiko Okamoto,Shintaro Shiba,Kazuhisa Tsuda,Tatsuya Ohno,Takashi Nakano
doi : 10.1016/j.radonc.2021.01.011
ORIGINAL ARTICLE| VOLUME 157, P85-92, APRIL 01, 2021
We aimed to assess the robustness of accumulated dose distributions for inter-fractional changes in passive carbon-ion radiotherapy for pancreatic cancer.
Towards the clinical implementation of intensity-modulated proton therapy for thoracic indications with moderate motion: Robust optimised plan evaluation by means of patient and machine specific information
C?ssia O. Ribeiro,Sabine Visser,Erik W. Korevaar,Christina T. Muijs,Arturs Meijers,Antje Knopf
doi : 10.1016/j.radonc.2021.01.014
ORIGINAL ARTICLE| VOLUME 157, P210-218, APRIL 01, 2021
Compared to volumetric modulated arc therapy (VMAT), clinical benefits are anticipated when treating thoracic tumours with intensity-modulated proton therapy (IMPT). However, the current concern of plan robustness as a result of motion hampers its wide clinical implementation. To define an optimal protocol to treat lung and oesophageal cancers, we present a comprehensive evaluation of IMPT planning strategies, based on patient 4DCTs and machine log files.
Automatic dosimetric verification of online adapted plans on the Unity MR-Linac using 3D EPID dosimetry
Igor Olaciregui-Ruiz,Bego?a Vivas-Maiques,Sandra van der Velden,Marlies E. Nowee,Ben Mijnheer,Anton Mans
doi : 10.1016/j.radonc.2021.01.037
ORIGINAL ARTICLE| VOLUME 157, P241-246, APRIL 01, 2021
The Unity MR-Linac is equipped with an EPID, the images from which contain information about the dose delivered to the patient. The purpose of this study was to introduce a framework for the automatic dosimetric verification of online adapted plans using 3D EPID dosimetry and to present the obtained dosimetric results.
Characterization of cardiovascular injury in mice following partial-heart irradiation with clinically relevant dose and fractionation
Chang-Lung Lee,Jessica W. Lee,Andrea R. Daniel,Dennis Abraham,Cristian T. Badea,David G. Kirsch
doi : 10.1016/j.radonc.2021.01.023
ORIGINAL ARTICLE| VOLUME 157, P155-162, APRIL 01, 2021
Late cardiac toxicity is a major side effect of radiation therapy (RT) for breast cancer. We developed and characterized a mouse model of radiation-induced heart disease that mimics the dose, fractionation, and beam arrangement of left breast and chest wall RT.
X-ray on chip: Quantifying therapeutic synergies between radiotherapy and anticancer drugs using soft tissue sarcoma tumor spheroids
Maeva Bavoux,Yuji Kamio,Emmanuelle Vigneux-Foley,Jean-François Carrier,Thomas Gervais,Philip Wong
doi : 10.1016/j.radonc.2021.01.018
ORIGINAL ARTICLE| VOLUME 157, P175-181, APRIL 01, 2021
Radioresistance, tumor microenvironment, and normal tissue toxicity from radiation limit the efficacy of radiotherapy in treating cancers. These challenges can be tackled by the discovery of new radiosensitizing and radioprotecting agents aimed at increasing the therapeutic efficacy of radiotherapy. The goal of this work was to develop a miniaturized microfluidic platform for the discovery of drugs that could be used in combination with radiotherapy. The microfluidic system will allow the toxicity testing of cancer spheroids to different combinations of radiotherapy and molecular agents.
Dose accumulation for personalized stereotactic MR-guided adaptive radiation therapy in prostate cancer
Omar Bohoudi,Anna M.E. Bruynzeel,Shyama Tetar,Ben J. Slotman,Miguel A. Palacios,Frank J. Lagerwaard
doi : 10.1016/j.radonc.2021.01.022
Adaptive MR-guided radiotherapy (MRgRT) is an innovative approach for delivering stereotactic body radiotherapy (SBRT) in prostate cancer (PC). Despite the increased clinical use of SBRT for PC, there is limited data on the relation between the actual delivered dose and toxicity. We aimed to identify dose parameters based on the total accumulated delivered bladder dose (DOSEACCTX). Furthermore, for future personalization, we studied whether prospective accumulation of the first 3 of 5 fractions (DOSEACC3FR) could be used as a representative of DOSEACCTX.
