Cancer Radiotherapie最新文献

英文中文

Radiotherapy for skin tumors and soft-tissue sarcomas: Current state of the art and recent advances

IF 1.3 4区医学 Q4 ONCOLOGY

Cancer Radiotherapie

Pub Date : 2026-08-01 Epub Date: 2026-10-26 DOI: 10.1016/j.canrad.2026.104899

Jérôme Doyen, Syrine Ben Dhia

Radiotherapy plays a pivotal role in the management of skin cancers and soft-tissue sarcomas in both curative and adjuvant settings. Over recent years, several clinical trials and international guidelines have refined its indications and identified new strategies that are likely to influence clinical practice. This review provides an updated overview of the role of radiotherapy in basal cell carcinoma, cutaneous squamous cell carcinoma, cutaneous melanoma, Merkel cell carcinoma, cutaneous lymphoma, and soft-tissue sarcoma. Recent evidence highlights the potential benefit of consolidation radiotherapy following hedgehog inhibitors in locally advanced basal cell carcinoma, improved outcomes with the combination of cemiplimab and radiotherapy in cutaneous squamous cell carcinoma, integration of stereotactic radiotherapy with immune checkpoint inhibitors for melanoma brain metastases, the importance of minimizing the interval between surgery and postoperative radiotherapy in Merkel cell carcinoma, the limitations of ultra-low-dose radiotherapy for indolent cutaneous lymphomas, and the emergence of hypofractionated preoperative radiotherapy schedules for soft-tissue sarcoma. By distinguishing established indications from emerging evidence, this review summarizes the developments most likely to influence contemporary radiation oncology practice and highlights areas where further prospective studies are warranted.

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引用次数: 0

Postoperative radiotherapy after radical cystectomy for muscle-invasive bladder cancer: Patient selection, target delineation and contemporary evidence

IF 1.3 4区医学 Q4 ONCOLOGY

Cancer Radiotherapie

Pub Date : 2026-08-01 Epub Date: 2026-10-26 DOI: 10.1016/j.canrad.2026.104900

Constance Huck, Claire Zobouyan, Géraldine Pignot, Gautier Marcq, Mathieu Roumiguie, David Pasquier, Samir Achkar, Jonathan Khalifa, Paul Sargos

Following radical cystectomy, muscle-invasive bladder cancer remains associated with a substantial risk of locoregional recurrence, particularly in patients with pT3–4 disease, nodal involvement, positive surgical margins, or limited pelvic lymph node dissection. Historically, adjuvant radiotherapy reduced pelvic recurrence rates but was largely abandoned because of toxicity concerns associated with older radiation techniques. The development of intensity-modulated radiotherapy, image-guided radiotherapy, contemporary contouring guidelines, and modern dose constraints has renewed interest in adjuvant radiotherapy. Recent randomized trials, including Bladder-ART/GETUG-AFU30 and BART, have demonstrated that modern adjuvant radiotherapy can be safely delivered and significantly improve locoregional control in selected high-risk patients. Current International Bladder Investigator Society recommendations have standardized target volume delineation, including pelvic nodal regions and cystectomy bed. At the same time, the management of muscle-invasive bladder cancer is rapidly evolving with the integration of immune checkpoint inhibitors, antibody–drug conjugates and circulating tumor DNA-guided based treatment strategies. Future research should focus on refining patient selection and integrating adjuvant radiotherapy within a personalized multimodal approach combining clinicopathological risk factors, molecular biomarkers, and contemporary systemic therapies.

{"title":"Postoperative radiotherapy after radical cystectomy for muscle-invasive bladder cancer: Patient selection, target delineation and contemporary evidence","authors":"Constance Huck, Claire Zobouyan, Géraldine Pignot, Gautier Marcq, Mathieu Roumiguie, David Pasquier, Samir Achkar, Jonathan Khalifa, Paul Sargos","doi":"10.1016/j.canrad.2026.104900","DOIUrl":"10.1016/j.canrad.2026.104900","url":null,"abstract":"<div><div>Following radical cystectomy, muscle-invasive bladder cancer remains associated with a substantial risk of locoregional recurrence, particularly in patients with pT3–4 disease, nodal involvement, positive surgical margins, or limited pelvic lymph node dissection. Historically, adjuvant radiotherapy reduced pelvic recurrence rates but was largely abandoned because of toxicity concerns associated with older radiation techniques. The development of intensity-modulated radiotherapy, image-guided radiotherapy, contemporary contouring guidelines, and modern dose constraints has renewed interest in adjuvant radiotherapy. Recent randomized trials, including Bladder-ART/GETUG-AFU30 and BART, have demonstrated that modern adjuvant radiotherapy can be safely delivered and significantly improve locoregional control in selected high-risk patients. Current International Bladder Investigator Society recommendations have standardized target volume delineation, including pelvic nodal regions and cystectomy bed. At the same time, the management of muscle-invasive bladder cancer is rapidly evolving with the integration of immune checkpoint inhibitors, antibody–drug conjugates and circulating tumor DNA-guided based treatment strategies. Future research should focus on refining patient selection and integrating adjuvant radiotherapy within a personalized multimodal approach combining clinicopathological risk factors, molecular biomarkers, and contemporary systemic therapies.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"30 5","pages":"Article 104900"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149257915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

It is a good analysis when…: Quality criteria for a reactive analysis following an adverse event

IF 1.3 4区医学 Q4 ONCOLOGY

Cancer Radiotherapie

Pub Date : 2026-08-01 Epub Date: 2026-10-26 DOI: 10.1016/j.canrad.2026.104893

Gianfranco Brusadin, Margaux Charpentier, Mathieu Herbez, Stéphanie Crombet

Objective

Although radiation oncology relies heavily on adverse event reporting to improve patient safety, the quality of retrospective analyses remains heterogeneous, often leading to ineffective action plans (retraining, simple reminders to remain vigilant). This article aims to propose criteria defining a high-quality reactive analysis based on the human, social, and organizational factors that determine its effectiveness, regardless of the investigation methodology used (ALARM, ORION, etc.).

Discussion

Conducting an effective analysis requires, above all, a non-punitive “just culture” and impartial leadership by an expert trained in cognitive biases. The analysis process is broken down into three key steps: an objective and immediate gathering of facts by a neutral person; a multidisciplinary analysis meeting focused on systemic failures rather than individual blame, dedicating most of its time to developing robust corrective actions; and finally, monitoring the deployment. Furthermore, evaluating the effectiveness of these actions cannot be reduced to the simple absence of recurrence, particularly for rare events, and requires the implementation of proactive approaches such as targeted audits or unannounced “stress tests”.

Conclusion

Ultimately, the value of an analysis depends more on the rigor and fairness with which it is conducted than on the specific tool selected. To sustainably improve safety, it is essential to move beyond technological performance alone and embed collective learning and patient safety within the organization's culture and identity. Direct integration of patients into these analytical processes represents the next challenge in advancing shared systemic resilience.

{"title":"It is a good analysis when…: Quality criteria for a reactive analysis following an adverse event","authors":"Gianfranco Brusadin, Margaux Charpentier, Mathieu Herbez, Stéphanie Crombet","doi":"10.1016/j.canrad.2026.104893","DOIUrl":"10.1016/j.canrad.2026.104893","url":null,"abstract":"<div><h3>Objective</h3><div>Although radiation oncology relies heavily on adverse event reporting to improve patient safety, the quality of retrospective analyses remains heterogeneous, often leading to ineffective action plans (retraining, simple reminders to remain vigilant). This article aims to propose criteria defining a high-quality reactive analysis based on the human, social, and organizational factors that determine its effectiveness, regardless of the investigation methodology used (ALARM, ORION, etc.).</div></div><div><h3>Discussion</h3><div>Conducting an effective analysis requires, above all, a non-punitive “just culture” and impartial leadership by an expert trained in cognitive biases. The analysis process is broken down into three key steps: an objective and immediate gathering of facts by a neutral person; a multidisciplinary analysis meeting focused on systemic failures rather than individual blame, dedicating most of its time to developing robust corrective actions; and finally, monitoring the deployment. Furthermore, evaluating the effectiveness of these actions cannot be reduced to the simple absence of recurrence, particularly for rare events, and requires the implementation of proactive approaches such as targeted audits or unannounced “stress tests”.</div></div><div><h3>Conclusion</h3><div>Ultimately, the value of an analysis depends more on the rigor and fairness with which it is conducted than on the specific tool selected. To sustainably improve safety, it is essential to move beyond technological performance alone and embed collective learning and patient safety within the organization's culture and identity. Direct integration of patients into these analytical processes represents the next challenge in advancing shared systemic resilience.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"30 5","pages":"Article 104893"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149257690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Professional insertion of young French oncologists after post-residency fellowship: A national declarative survey

IF 1.3 4区医学 Q4 ONCOLOGY

Cancer Radiotherapie

Pub Date : 2026-08-01 Epub Date: 2026-10-26 DOI: 10.1016/j.canrad.2026.104890

Adnan Antoine Shrebati, Florence Huguet, Malik Nebbache, Camille Tlemsani, Lucie Houdou, Oliver Chapet, Fabrice Lorchel, Jeanne Duval, Clément Grosnon, Audrey Larnaudie, Emma Ferber, Martin Duval, Charles Raynaud

Purpose

The purpose of this study was to describe the career paths of young French medical oncologists and radiation oncologists after post-residency fellowship and to quantify professional insertion difficulty, its associated factors and reported impact. This was a national cross-sectional declarative survey.

Materials and methods

A self-administered online questionnaire was distributed from 22nd May to 9th June 2026, through professional networks, to oncologists who had completed their residency and/or post-residency fellowship between November 2021 and November 2025. Insertion difficulty was defined a priori by a composite criterion (at least one of: job search of one year or more, constrained locum work, constrained part-time work, constrained change of region, or no oncologist position). The inserted cohort comprised respondents who had completed their post-residency fellowship. Comparisons used Fisher exact, chi-squared and Mann-Whitney tests, with logistic regression for trends.

Results

Among 142 respondents (97radiation oncologists, 45 medical oncologists; 76 women; median age 32.5 years), 98 (69 %) were inserted. Twenty-seven (27.6 %) met the composite criterion, reaching 34.7 % in sensitivity analysis. Difficulty was markedly higher in radiation oncologists than medical oncologists (36.8 versus 6.7 %; odds ratio 8.14, 95 % confidence interval: 1.79–37.10; p = 0.0026) and inversely associated with parenthood (odds ratio: 0.37; p = 0.042). It was accompanied by lower income and overall satisfaction (p = 0.0045 and p = 0.0001) and a threefold more frequent five-year intention to change position (p = 0.0003).

Conclusion

More than one quarter of young French oncologists reported an objectifiable insertion difficulty after post-residency fellowship, predominantly in radiation oncology, warranting prospective monitoring of training-to-job adequacy.

{"title":"Professional insertion of young French oncologists after post-residency fellowship: A national declarative survey","authors":"Adnan Antoine Shrebati, Florence Huguet, Malik Nebbache, Camille Tlemsani, Lucie Houdou, Oliver Chapet, Fabrice Lorchel, Jeanne Duval, Clément Grosnon, Audrey Larnaudie, Emma Ferber, Martin Duval, Charles Raynaud","doi":"10.1016/j.canrad.2026.104890","DOIUrl":"10.1016/j.canrad.2026.104890","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study was to describe the career paths of young French medical oncologists and radiation oncologists after post-residency fellowship and to quantify professional insertion difficulty, its associated factors and reported impact. This was a national cross-sectional declarative survey.</div></div><div><h3>Materials and methods</h3><div>A self-administered online questionnaire was distributed from 22nd May to 9th June 2026, through professional networks, to oncologists who had completed their residency and/or post-residency fellowship between November 2021 and November 2025. Insertion difficulty was defined a priori by a composite criterion (at least one of: job search of one year or more, constrained locum work, constrained part-time work, constrained change of region, or no oncologist position). The inserted cohort comprised respondents who had completed their post-residency fellowship. Comparisons used Fisher exact, chi-squared and Mann-Whitney tests, with logistic regression for trends.</div></div><div><h3>Results</h3><div>Among 142 respondents (97radiation oncologists, 45 medical oncologists; 76 women; median age 32.5 years), 98 (69 %) were inserted. Twenty-seven (27.6 %) met the composite criterion, reaching 34.7 % in sensitivity analysis. Difficulty was markedly higher in radiation oncologists than medical oncologists (36.8 versus 6.7 %; odds ratio 8.14, 95 % confidence interval: 1.79–37.10; <em>p</em>  =0.042). It was accompanied by lower income and overall satisfaction (<em>p</em>  =0.0001) and a threefold more frequent five-year intention to change position (<em>p</em>  <!-->0.0003).</div></div><div><h3>Conclusion</h3><div>More than one quarter of young French oncologists reported an objectifiable insertion difficulty after post-residency fellowship, predominantly in radiation oncology, warranting prospective monitoring of training-to-job adequacy.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"30 5","pages":"Article 104890"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149257691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Quality of life after trimodal treatment for muscle-invasive bladder cancer

IF 1.3 4区医学 Q4 ONCOLOGY

Cancer Radiotherapie

Pub Date : 2026-08-01 Epub Date: 2026-10-26 DOI: 10.1016/j.canrad.2026.104895

Constance Huck, Géraldine Pignot, Alexandra Masson-Lecomte, David Pasquier, Vérane Achard

Muscle-invasive bladder cancer has traditionally been treated with radical cystectomy and pelvic lymph node dissection. However, trimodality treatment, consisting of maximal transurethral resection of the bladder tumour followed by radiotherapy with concurrent radiosensitisation, has emerged as an effective bladder-preserving alternative for selected patients. As oncological outcomes after trimodality treatment appear comparable to those of radical cystectomy in appropriately selected patients, quality of life has become a key consideration in treatment selection. This review summarizes the current evidence regarding quality of life after trimodality treatment and compares these outcomes with those reported after radical cystectomy. We discuss the principal patient-reported outcome measures used in bladder cancer and review data on urinary, bowel, sexual, and global health-related quality of life following both treatment approaches. Available evidence indicates that quality of life after trimodality treatment typically declines during treatment but recovers to baseline within approximately six months in most patients. Long-term survivors generally maintain satisfactory urinary and bowel function and good overall quality of life. Comparative prospective studies suggest similar overall health-related quality of life between trimodality treatment and radical cystectomy, with bladder preservation offering advantages in body image and sexual function. Although current evidence is limited by heterogeneous study designs, quality of life should be considered alongside oncological outcomes when counselling patients with muscle invasive bladder cancer. Future prospective studies using standardized patient-reported outcome measures and longer follow-up are needed to further refine treatment decision-making.

{"title":"Quality of life after trimodal treatment for muscle-invasive bladder cancer","authors":"Constance Huck, Géraldine Pignot, Alexandra Masson-Lecomte, David Pasquier, Vérane Achard","doi":"10.1016/j.canrad.2026.104895","DOIUrl":"10.1016/j.canrad.2026.104895","url":null,"abstract":"<div><div>Muscle-invasive bladder cancer has traditionally been treated with radical cystectomy and pelvic lymph node dissection. However, trimodality treatment, consisting of maximal transurethral resection of the bladder tumour followed by radiotherapy with concurrent radiosensitisation, has emerged as an effective bladder-preserving alternative for selected patients. As oncological outcomes after trimodality treatment appear comparable to those of radical cystectomy in appropriately selected patients, quality of life has become a key consideration in treatment selection. This review summarizes the current evidence regarding quality of life after trimodality treatment and compares these outcomes with those reported after radical cystectomy. We discuss the principal patient-reported outcome measures used in bladder cancer and review data on urinary, bowel, sexual, and global health-related quality of life following both treatment approaches. Available evidence indicates that quality of life after trimodality treatment typically declines during treatment but recovers to baseline within approximately six months in most patients. Long-term survivors generally maintain satisfactory urinary and bowel function and good overall quality of life. Comparative prospective studies suggest similar overall health-related quality of life between trimodality treatment and radical cystectomy, with bladder preservation offering advantages in body image and sexual function. Although current evidence is limited by heterogeneous study designs, quality of life should be considered alongside oncological outcomes when counselling patients with muscle invasive bladder cancer. Future prospective studies using standardized patient-reported outcome measures and longer follow-up are needed to further refine treatment decision-making.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"30 5","pages":"Article 104895"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149257914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dose accumulation in reirradiation: Key practical considerations

IF 1.3 4区医学 Q4 ONCOLOGY

Cancer Radiotherapie

Pub Date : 2026-08-01 Epub Date: 2026-10-26 DOI: 10.1016/j.canrad.2026.104901

Myriam Ayadi, Magali Sandt, Justine Deborne, Marie-Pierre Sunyach, Pauline Dupuis

Reirradiation is a challenge due to both clinical and technical considerations. Dose accumulation corresponds to the summation between previous and current treatment dose distribution and is fundamental to guide clinical decision-making as it helps to estimate cumulative dose to organs of interest and ensure that they comply with institutional or literature-based dose constraints. Performing dose accumulation must rely on a rigorous process, depending on the data available regarding previous irradiation and the tools available in the clinic. In this paper, we present and discuss the different dose accumulation methods, their degree of complexity and potential limitations.

引用次数: 0

Stereotactic body radiotherapy for oligometastatic ovarian cancer: Current evidence, patient selection, and future directions

IF 1.3 4区医学 Q4 ONCOLOGY

Cancer Radiotherapie

Pub Date : 2026-08-01 Epub Date: 2026-10-26 DOI: 10.1016/j.canrad.2026.104889

François Lucia, Laura Deiana, Pierre-François Dupré, Cyrus Chargari

Ovarian cancer recurs in a limited number of sites in a significant proportion of patients, raising interest in metastasis-directed therapy to delay systemic treatment escalation. Stereotactic body radiotherapy is increasingly used in this context. This review synthesises the available evidence on the role of stereotactic body radiotherapy in oligometastatic ovarian cancer, with emphasis on prospective data, patient selection criteria, integration with systemic therapies, and emerging technological approaches. The phase II trial MITO-RT3/RAD, first prospective, multicentre study in this setting reported excellent results in terms of complete response rates and local control at 12 months, with complete response emerging as a strong predictor of local control. The treatment was also very well tolerated, with no grade 3 or worse toxicity and a low rate of grade 1–2 toxicity. Stereotactic body radiotherapy is a safe, effective metastasis-directed therapy option endorsed by current European guidelines. Key unresolved questions include the optimal integration with poly (ADP-ribose) polymerase inhibitors, the surgery versus stereotactic body radiotherapy comparison, and the management of peritoneal oligometastatic disease. The randomised ENGOT-ov74/LoRiO trial will address several of these gaps.

{"title":"Stereotactic body radiotherapy for oligometastatic ovarian cancer: Current evidence, patient selection, and future directions","authors":"François Lucia, Laura Deiana, Pierre-François Dupré, Cyrus Chargari","doi":"10.1016/j.canrad.2026.104889","DOIUrl":"10.1016/j.canrad.2026.104889","url":null,"abstract":"<div><div>Ovarian cancer recurs in a limited number of sites in a significant proportion of patients, raising interest in metastasis-directed therapy to delay systemic treatment escalation. Stereotactic body radiotherapy is increasingly used in this context. This review synthesises the available evidence on the role of stereotactic body radiotherapy in oligometastatic ovarian cancer, with emphasis on prospective data, patient selection criteria, integration with systemic therapies, and emerging technological approaches. The phase II trial MITO-RT3/RAD, first prospective, multicentre study in this setting reported excellent results in terms of complete response rates and local control at 12 months, with complete response emerging as a strong predictor of local control. The treatment was also very well tolerated, with no grade <!-->3 or worse toxicity and a low rate of grade 1–2 toxicity. Stereotactic body radiotherapy is a safe, effective metastasis-directed therapy option endorsed by current European guidelines. Key unresolved questions include the optimal integration with poly (ADP-ribose) polymerase inhibitors, the surgery versus stereotactic body radiotherapy comparison, and the management of peritoneal oligometastatic disease. The randomised ENGOT-ov74/LoRiO trial will address several of these gaps.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"30 5","pages":"Article 104889"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149257684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Survey of the Autorité de sûreté nucléaire et de radioprotection on the quality of significant event reports and significant radiation protection events

IF 1.3 4区医学 Q4 ONCOLOGY

Cancer Radiotherapie

Pub Date : 2026-08-01 Epub Date: 2026-10-26 DOI: 10.1016/j.canrad.2026.104892

Sylvie Thellier

This article presents the Autorité de sûreté nucléaire et de radioprotection's investigation approach to the quality of analyses of significant radiation protection events and significant event reports. Despite the use of methods recognised by the institutions (ORION and ALARM(E)…), the Autorité de sûreté nucléaire et de radioprotection notes inadequacies in the content of these documents for all medical applications using ionising radiation. The first results, based on the responses to the test questionnaire, show that the cultures of individual fault and silence, the lack of availability of participants as well as their initial and continuing training are causes limiting data acquisition, the analysis of significant radiation protection events and their correction and prevention.

引用次数: 0

Prostate cancer: “Less is more”?

IF 1.3 4区医学 Q4 ONCOLOGY

Cancer Radiotherapie

Pub Date : 2026-08-01 Epub Date: 2026-09-22 DOI: 10.1016/j.canrad.2026.104894

Jennifer Le Guévelou

Intensified approaches translated in the past decade into substantial survival gains, especially in patients receiving radiotherapyfor high-risk prostate cancer. It remains that not all of our patients derive benefit from them, underscoring our need to integrate prognostic factors, whether including baseline or treatment response parameters, into our therapeutic decisions. As de-escalated strategies are increasingly applied for patients with prostate cancer, we aimed to review de-escalation approaches for patients with localized disease, either concerning dose, volume, number of fractions or need for systemic therapy.

引用次数: 0

Magnetic resonance imaging and radiotherapy: Precision begins with imaging

IF 1.3 4区医学 Q4 ONCOLOGY

Cancer Radiotherapie

Pub Date : 2026-08-01 Epub Date: 2026-10-26 DOI: 10.1016/j.canrad.2026.104888

Pierrick Gouel, Damien Autret, Aurélie Tournier, Ariane Lapierre, Jérémy Baude, Anaïs Barateau, Stéphane Dufreneix, Isabelle Fitton, Paul Rétif, Vincent Marchesi, Caroline Moreau-Noblet

Magnetic resonance imaging has played an increasingly important role in radiotherapy, both before and during treatment. Before irradiation, its excellent soft-tissue contrast has provided a major advantage over simulation computed tomography by improving the visualization of tumour volumes and organs at risk, and by reducing delineation uncertainties, particularly in high-precision treatments such as stereotactic radiotherapy. Beyond morphological information, magnetic resonance imaging has also provided access to functional and quantitative data, such as diffusion-weighted imaging, apparent diffusion coefficient maps, perfusion and T1/T2 mapping, which may contribute to the biological characterization of tissues and to the early assessment of treatment response. During irradiation, onboard magnetic resonance imaging has helped overcome some of the limitations of cone beam computed tomography, owing to improved soft-tissue visualization, motion monitoring, and adaptation of the treatment plan to inter- or intrafraction anatomical variations. The development of magnetic resonance-only workflows, based on synthetic computed tomography generation, could also reduce dependence on planning computed tomography. However, these benefits have imposed specific requirements: acquisition under treatment-position conditions, geometric distortion control, reproducibility of quantitative acquisitions, accurate computed tomography–magnetic resonance imaging registration, and rigorous validation. Their implementation requires harmonization of practices, strengthened coordination between imaging and radiotherapy, and official recommendations, or even a dedicated regulatory framework.

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引用次数: 0

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