Radiation-induced bladder injury is a common complication after pelvic radiotherapy. Few studies exist on diagnosing and treating radiation-induced bladder injury, with no established guidelines or consensus in China or internationally. Clinical physicians' diagnosis and treatment of radiation-induced bladder injury are primarily based on their own clinical experience, and there is an urgent need for unified guidelines to standardize clinical diagnosis and treatment. Therefore, the Chinese Radiation Therapy Oncology Group, China Anti-Cancer Association Tumor Support Therapy Committee, and China Anti-Cancer Association Tumor Radiation Protection Committee gathered experts to develop Chinese clinical practice guidelines, guiding diagnosing and treating radiation-induced bladder injury. The development of these guidelines adopted the grading system of evidence quality and recommendation strength (GRADE).
Objective: This study assessed the outcomes of elderly patients with limited-stage small cell lung cancer (LS-SCLC), which may be linked to the timing of thoracic radiotherapy (TRT) following chemotherapy.
Methods: Elderly patients (n = 78) with LS-SCLC were divided into three groups depending on the timing of radiotherapy. The patients in the TRT group were stratified into early (TRT after 1–2 cycles of chemotherapy, n = 29), medium-term (TRT after 3–4 cycles of chemotherapy, n = 33), and late (TRT after 5–6 cycles of chemotherapy, n = 16) TRT groups. The overall survival (OS) and progression-free survival (PFS) were assessed and compared.
Results: The medium-term TRT group demonstrated significantly longer mPFS (20.12 months) and better mOS (35.97 months) than those in the other groups (PFS: P = 0.021;OS: P = 0.035). A pairwise comparison of the three groups revealed that those who received medium-term TRT exhibited significantly improved PFS than the early (mPFS: 20.12 vs. 10.36 mouths, P = 0.018) and late (mPFS: 20.12 vs. 9.17 months, P = 0.016) TRT. The medium-term TRT group demonstrated significantly improved OS than the early TRT (mOS: 35.97 vs. 25.22 months, P = 0.007) but not in comparison with the late TRT (mOS: 35.97 vs. 21.63 months, P = 0.100).
Conclusion: In elderly patients with LS-SCLC, the addition of TRT after 3–4 cycles of chemotherapy appears to be a viable and potentially beneficial treatment approach.
Objective: We retrospectively analyzed breast cancer patients who received adjuvant radiotherapy to determine the incidence of lymphocytopenia and its risk factors.
Methods: We reviewed 812 patients with breast cancer who received postoperative radiotherapy. Patients were divided into two groups based on the use of chemotherapy, and a generalized linear regression model was used to explore predictive factors for grade 2 or higher lymphocytopenia. We also examined the effect of lymphocytopenia on overall survival.
Results: Grade 2 or higher lymphocytopenia was observed in 19.4% of patients who did not receive chemotherapy and 45.1% of patients who received chemotherapy. In multivariate analysis, bilateral disease, regional lymph node irradiation, and baseline lymphocytopenia were associated with lymphocytopenia in patients who did not receive cytotoxic chemotherapy. Regional lymph node irradiation, baseline lymphocytopenia, use of antimetabolites, and use of molecular-targeted agents were associated with lymphocytopenia in patients treated with chemotherapy. In the survival analysis, lymphocytopenia was associated with worse overall survival only in patients treated with cytotoxic chemotherapy (p = 0.039), and not in patients who did not receive chemotherapy (p = 0.77).
Conclusion: The analysis revealed the incidence and risk factors of lymphocytopenia after postoperative radiotherapy in patients with breast cancer.
Introduction: This study evaluated the clinical outcomes of stereotactic body radiotherapy (SBRT) for both pathologically diagnosed (PD) and clinically diagnosed (CD) early-stage non-small cell lung cancer (NSCLC) and explored the significance of accurate expert computed tomography (CT) interpretation.
Methods: We retrospectively analyzed 95 patients with early-stage NSCLC who received SBRT at our institution. Patients were classified into CD and PD groups. Two chest radiologists retrospectively interpreted the pre-SBRT CT images to determine the tumor subtype and probability of malignancy (PM). Clinical findings, CT features, and treatment outcomes were compared between the two groups. The survival rate of the CD group was analyzed separately according to the PM grade.
Results: Median overall survival for the CD and PD groups was 6.0 and 5.4 years (P = 0.57), respectively. Median cause-specific survival was 10.2 years in the CD group and not reached in the PD group (P = 0.76). In the CD group, lung cancer mortality was lower in the low PM group (25% [1 of 4]) than in the high PM group (47.4% [9 of 19]).
Conclusion: It may be desirable to evaluate the PM of the nodule using expert CT interpretation to decide whether SBRT is indicated in CD early-stage NSCLC.
Nasopharyngeal carcinoma(NPC) occurs frequently in Southern China, and radiotherapy is the main treatment method. At present, intensity-modulated radiotherapy is widely used, which has improved efficacy in patients with NPC and reduced toxicity and side effects. Recently, helical tomography radiotherapy, proton radiotherapy, carbon particle radiotherapy, and other radiotherapy techniques have been used for the clinical treatment of NPC. Individualized nasopharyngeal cancer targets have also been explored. This paper reviews the research progress in radiotherapy techniques and target volume for NPC
The superior physical and biological properties of high linear energy transfer (LET), as opposed to traditional low-LET rays, underscore the advantage of proton therapy (PRT) and carbon ion radiotherapy (CIRT) are better than traditional photon radiotherapy (XRT). With the advancements in science, an increasing number of hospitals have introduced new technologies. However, radiotherapy is primarily used for local treatment, which means that if the tumor has metastasized to distant sites, it is often necessary to combine it with systemic therapies such as immunotherapy. In recent years, the combination of high-LET radiotherapy and immunotherapy has emerged as a promising treatment option in oncology and many studies have confirmed its efficacy for both local and distant metastases. In this review, we summarize the effects of PRT and CIRT on the immune system in detail, followed by an introduction to preclinical and clinical studies of PRT and CIRT in combination with immune checkpoint inhibitor (ICIs) therapy. We also briefly introduce some preclinical studies on CIRT in combination with dendritic cells (DCs) and Treg inhibitor therapies.
Stereotactic radiotherapy is a term collectively used to describe the radiation treatment techniques that allow for the delivery of highly precise ionizing radiation. It is usually a high dose per session in single or few fractions. This treatment approach has been in medical use for over six decades and has primarily evolved in the last two decades. Many patients benefit from this unique non-conventional radiotherapy approach. Its indications include various malignant, benign and functional problems in cranial and body sites. This technique is not widespread in developing countries compared to developed countries. This work is an educational narrative review for learners in radiation oncology. We aim to share the knowledge of this practice to improve precision radiation oncology globally. This review summarizes the basics of stereotactic radiotherapy, the technical prerequisites, the clinical considerations, the practical recommendations and the learning points from each site-specific region.