Pub Date : 2026-08-01Epub Date: 2026-10-26DOI: 10.1016/j.canrad.2026.104898
Alizée Camps-Malea, Céline Bourgier, Chloé Buchalet, Malak Chahid, Marie Dworczak, Jean-Michel Hannoun-Lévi, Youlia Kirova, Sofia Rivera
Every year, the Société française de radiothérapie oncologique (SFRO, the French society for radiation oncology) holds its annual conference. This informative event provides an opportunity for everyone to catch up on the latest scientific developments and new advances, whilst engaging in discussion and knowledge sharing. Breast cancer, which is the most common cancer in terms of incidence, is a field in constant evolution with major advances. The aim of this article is to outline the various topics that will be addressed at the 2026 SFRO Congress during the session on breast cancer. This will provide an opportunity to review the latest updates in hypofractionation, lymph node de-escalation following neoadjuvant chemotherapy, chest wall irradiation, tumour bed boost, oligometastatic disease and re-irradiation for a second chance for breast conservation.
{"title":"Update on radiotherapy for breast cancer at the SFRO annual congress 2026","authors":"Alizée Camps-Malea, Céline Bourgier, Chloé Buchalet, Malak Chahid, Marie Dworczak, Jean-Michel Hannoun-Lévi, Youlia Kirova, Sofia Rivera","doi":"10.1016/j.canrad.2026.104898","DOIUrl":"10.1016/j.canrad.2026.104898","url":null,"abstract":"<div><div>Every year, the Société française de radiothérapie oncologique (SFRO, the French society for radiation oncology) holds its annual conference. This informative event provides an opportunity for everyone to catch up on the latest scientific developments and new advances, whilst engaging in discussion and knowledge sharing. Breast cancer, which is the most common cancer in terms of incidence, is a field in constant evolution with major advances. The aim of this article is to outline the various topics that will be addressed at the 2026 SFRO Congress during the session on breast cancer. This will provide an opportunity to review the latest updates in hypofractionation, lymph node de-escalation following neoadjuvant chemotherapy, chest wall irradiation, tumour bed boost, oligometastatic disease and re-irradiation for a second chance for breast conservation.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"30 5","pages":"Article 104898"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149257916","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}
Pub Date : 2026-08-01Epub Date: 2026-10-26DOI: 10.1016/j.canrad.2026.104896
Florence Huguet, Lucien El Mouats, Chloé Cremer, Véronique Vendrely
<div><div>Over the past decade, therapeutic strategies for gastrointestinal cancers have evolved towards greater personalisation, making treatment de-escalation an increasingly relevant option for selected patients. Two main approaches are explored: omitting one component of multimodality treatment or reducing radiotherapy dose or volume. For oesophageal squamous cell carcinoma, active surveillance with salvage surgery after chemoradiotherapy, offers a non-inferior alternative to systematic surgery in patients with complete clinical response, while adenocarcinoma management is shifting towards perioperative chemotherapy with fluorouracil, leucovorin, oxaliplatin, and docetaxel, with durvalumab. In rectal cancer, growing evidence from watch-and-wait strategies or chemotherapy-alone approaches supports selective omission of radiotherapy or surgery in low-risk tumours. Chemoradiotherapy combined with immunotherapy in patients with microsatellite stability increases the response rate while novel node-sparing radiotherapy volumes suggest a paradigm shift, preserving lymph nodes to sustain immune priming for checkpoint inhibitors. For early-stage anal canal carcinoma, the PLATO-ACT4 trial demonstrated that reduced-dose chemoradiotherapy (41.4<!--> <!-->Gy) achieves comparable locoregional control with improved tolerance and quality of life compared to standard-dose treatment. Together, these strategies illustrate a shift towards individualised, response and risk-adapted therapy in digestive oncology. However, most de-escalation approaches still rely on limited follow-up or selected populations, and shared decision-making incorporating patient preferences and quality-of-life trade-offs should increasingly guide these choices. Ongoing trials (NEEDS, GRECCAR 14/16, DECREASE) will help refine patient selection and confirm the long-term safety of these de-escalated strategies.</div></div><div>Over the past decade, therapeutic strategies for gastrointestinal cancers have evolved towards greater personalisation, making treatment de-escalation an increasingly relevant option for selected patients. Two main approaches are explored: omitting one component of multimodality treatment or reducing radiotherapy dose or volume. For oesophageal squamous cell carcinoma, active surveillance with salvage surgery after chemoradiotherapy, offers a non-inferior alternative to systematic surgery in patients with complete clinical response, while adenocarcinoma management is shifting towards perioperative chemotherapy with fluorouracil, leucovorin, oxaliplatin, and docetaxel, with durvalumab. In rectal cancer, growing evidence from watch-and-wait strategies or chemotherapy-alone approaches supports selective omission of radiotherapy or surgery in low-risk tumours. Chemoradiotherapy combined with immunotherapy in patients with microsatellite stability increases the response rate while novel node-sparing radiotherapy volumes suggest a paradigm shift, preserving lymph nodes to su
{"title":"Treatment deintensification: Gastrointestinal cancers","authors":"Florence Huguet, Lucien El Mouats, Chloé Cremer, Véronique Vendrely","doi":"10.1016/j.canrad.2026.104896","DOIUrl":"10.1016/j.canrad.2026.104896","url":null,"abstract":"<div><div>Over the past decade, therapeutic strategies for gastrointestinal cancers have evolved towards greater personalisation, making treatment de-escalation an increasingly relevant option for selected patients. Two main approaches are explored: omitting one component of multimodality treatment or reducing radiotherapy dose or volume. For oesophageal squamous cell carcinoma, active surveillance with salvage surgery after chemoradiotherapy, offers a non-inferior alternative to systematic surgery in patients with complete clinical response, while adenocarcinoma management is shifting towards perioperative chemotherapy with fluorouracil, leucovorin, oxaliplatin, and docetaxel, with durvalumab. In rectal cancer, growing evidence from watch-and-wait strategies or chemotherapy-alone approaches supports selective omission of radiotherapy or surgery in low-risk tumours. Chemoradiotherapy combined with immunotherapy in patients with microsatellite stability increases the response rate while novel node-sparing radiotherapy volumes suggest a paradigm shift, preserving lymph nodes to sustain immune priming for checkpoint inhibitors. For early-stage anal canal carcinoma, the PLATO-ACT4 trial demonstrated that reduced-dose chemoradiotherapy (41.4<!--> <!-->Gy) achieves comparable locoregional control with improved tolerance and quality of life compared to standard-dose treatment. Together, these strategies illustrate a shift towards individualised, response and risk-adapted therapy in digestive oncology. However, most de-escalation approaches still rely on limited follow-up or selected populations, and shared decision-making incorporating patient preferences and quality-of-life trade-offs should increasingly guide these choices. Ongoing trials (NEEDS, GRECCAR 14/16, DECREASE) will help refine patient selection and confirm the long-term safety of these de-escalated strategies.</div></div><div>Over the past decade, therapeutic strategies for gastrointestinal cancers have evolved towards greater personalisation, making treatment de-escalation an increasingly relevant option for selected patients. Two main approaches are explored: omitting one component of multimodality treatment or reducing radiotherapy dose or volume. For oesophageal squamous cell carcinoma, active surveillance with salvage surgery after chemoradiotherapy, offers a non-inferior alternative to systematic surgery in patients with complete clinical response, while adenocarcinoma management is shifting towards perioperative chemotherapy with fluorouracil, leucovorin, oxaliplatin, and docetaxel, with durvalumab. In rectal cancer, growing evidence from watch-and-wait strategies or chemotherapy-alone approaches supports selective omission of radiotherapy or surgery in low-risk tumours. Chemoradiotherapy combined with immunotherapy in patients with microsatellite stability increases the response rate while novel node-sparing radiotherapy volumes suggest a paradigm shift, preserving lymph nodes to su","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"30 5","pages":"Article 104896"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149257909","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}
Pub Date : 2026-08-01Epub Date: 2026-10-26DOI: 10.1016/j.canrad.2026.104887
Julie Leblanc, Mario Terlizzi, Ariane Lapierre, Jennifer Le Guévelou
Adaptive radiotherapy has emerged as a promising strategy to improve the precision of prostate cancer treatment by accounting for daily anatomical variations. Recent technological advances have enabled online treatment adaptation, particularly in the context of magnetic resonance-guided radiotherapy. This review summarizes the current evidence on adaptive radiotherapy for prostate cancer, focusing on dosimetric data and clinical outcomes in the upfront, reirradiation and post-prostatectomy settings. While dosimetric studies support improved target coverage and reduced violations of organ-at-risk dose constraints with adaptive radiotherapy, the clinical translation of these benefits remains unclear. Early clinical data suggest favourable toxicity profiles, especially with magnetic resonance-guided stereotactic body radiotherapy, although most available evidence derives from non-randomized studies with limited follow-up. Further prospective studies are required to establish the true clinical value of adaptive workflows and to define their role in the routine management of prostate cancer.
{"title":"Online adaptive radiotherapy for prostate cancer: Current evidence and clinical perspectives","authors":"Julie Leblanc, Mario Terlizzi, Ariane Lapierre, Jennifer Le Guévelou","doi":"10.1016/j.canrad.2026.104887","DOIUrl":"10.1016/j.canrad.2026.104887","url":null,"abstract":"<div><div>Adaptive radiotherapy has emerged as a promising strategy to improve the precision of prostate cancer treatment by accounting for daily anatomical variations. Recent technological advances have enabled online treatment adaptation, particularly in the context of magnetic resonance-guided radiotherapy. This review summarizes the current evidence on adaptive radiotherapy for prostate cancer, focusing on dosimetric data and clinical outcomes in the upfront, reirradiation and post-prostatectomy settings. While dosimetric studies support improved target coverage and reduced violations of organ-at-risk dose constraints with adaptive radiotherapy, the clinical translation of these benefits remains unclear. Early clinical data suggest favourable toxicity profiles, especially with magnetic resonance-guided stereotactic body radiotherapy, although most available evidence derives from non-randomized studies with limited follow-up. Further prospective studies are required to establish the true clinical value of adaptive workflows and to define their role in the routine management of prostate cancer.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"30 5","pages":"Article 104887"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149257685","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}
Pub Date : 2026-08-01Epub Date: 2026-10-26DOI: 10.1016/j.canrad.2026.104891
Costantino Putzu, Mladen Marinkovic, Milos Grujic, Maria Giulia Vincini, Dario Zerini, Federico Mastroleo, Giovanni Carlo Mazzola, Chiara Lorubbio, Sabrina Clobiaco, Karl Amin, Gennaro Musi, Francesco Alessandro Mistretta, Stefano Luzzago, David Pasquier, Giulia Marvaso, Barbara Alicja Jereczek-Fossa
Local recurrence after curative radiation therapy or postoperative radiotherapy for prostate cancer remains a challenging clinical scenario, requiring careful evaluation to balance disease control with the risk of treatment-related adverse events. Reirradiation has progressively emerged as a clinically meaningful salvage option for appropriately selected patients with localized recurrence. The widespread implementation of multiparametric magnetic resonance imaging and prostate-specific membrane antigen positron emission tomography-computed tomography has transformed clinical decision-making by enabling earlier detection of recurrence, more accurate localization of disease, and improved identification of patients who may benefit from focal salvage approaches. In this setting, multidisciplinary evaluation and careful patient selection are essential. Among available reirradiation techniques, photon-based stereotactic body radiotherapy currently has the largest body of supporting clinical evidence, while brachytherapy remains a valid alternative in experienced centers and protontherapy may offer additional opportunities to improve dose conformity in selected cases. Although oncological outcomes are encouraging, the available evidence remains predominantly retrospective and heterogeneous, highlighting the need for prospective studies and standardized treatment strategies. This commentary synthesizes contemporary evidence on re-irradiation for locally recurrent prostate cancer after both definitive and postoperative radiation therapy, with a particular focus on patient selection, treatment techniques, oncological outcomes, treatment-related adverse events, and emerging future directions.
{"title":"Reirradiation for prostate cancer local recurrence: State of the art and future directions","authors":"Costantino Putzu, Mladen Marinkovic, Milos Grujic, Maria Giulia Vincini, Dario Zerini, Federico Mastroleo, Giovanni Carlo Mazzola, Chiara Lorubbio, Sabrina Clobiaco, Karl Amin, Gennaro Musi, Francesco Alessandro Mistretta, Stefano Luzzago, David Pasquier, Giulia Marvaso, Barbara Alicja Jereczek-Fossa","doi":"10.1016/j.canrad.2026.104891","DOIUrl":"10.1016/j.canrad.2026.104891","url":null,"abstract":"<div><div>Local recurrence after curative radiation therapy or postoperative radiotherapy for prostate cancer remains a challenging clinical scenario, requiring careful evaluation to balance disease control with the risk of treatment-related adverse events. Reirradiation has progressively emerged as a clinically meaningful salvage option for appropriately selected patients with localized recurrence. The widespread implementation of multiparametric magnetic resonance imaging and prostate-specific membrane antigen positron emission tomography-computed tomography has transformed clinical decision-making by enabling earlier detection of recurrence, more accurate localization of disease, and improved identification of patients who may benefit from focal salvage approaches. In this setting, multidisciplinary evaluation and careful patient selection are essential. Among available reirradiation techniques, photon-based stereotactic body radiotherapy currently has the largest body of supporting clinical evidence, while brachytherapy remains a valid alternative in experienced centers and protontherapy may offer additional opportunities to improve dose conformity in selected cases. Although oncological outcomes are encouraging, the available evidence remains predominantly retrospective and heterogeneous, highlighting the need for prospective studies and standardized treatment strategies. This commentary synthesizes contemporary evidence on re-irradiation for locally recurrent prostate cancer after both definitive and postoperative radiation therapy, with a particular focus on patient selection, treatment techniques, oncological outcomes, treatment-related adverse events, and emerging future directions.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"30 5","pages":"Article 104891"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149257695","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}
Pub Date : 2026-08-01Epub Date: 2026-10-26DOI: 10.1016/j.canrad.2026.104897
Brendon Geoffrin-Tanner, Anne-Marie Frelin, François Chevalier, Siamak Haghdoost, Claire Rodriguez-Lafrasse, Sara Marcatili, Marie Vanstalle, Isabelle F. Vanhaezebrouck, Samuel Valable, Guillaume Vogin, Juliette Thariat
Purpose of the research
Particle therapy is rapidly evolving beyond highly conformal dose delivery toward biologically informed, image-guided, and patient-specific treatment strategies.
Materials and methods
Selected preclinical and translational advances presented at the 64th Annual Meeting of the Particle Therapy Co-Operative Group (PTCOG 64) are reported with emphasis on their potential impact and expected timeline for clinical implementation.
Results
Recent developments span accelerator technologies, treatment delivery, dosimetry, imaging, radiobiology, and predictive modeling. Near-term innovations include compact accelerator concepts, software-driven treatment acceleration, photon-counting computed tomography, prompt-gamma range verification, linear energy transfer-aware quality assurance, and uncertainty-aware normal tissue complication probability models for proton therapy selection. Emerging approaches such as optically stimulated luminescence detectors, nanodroplet ultrasound imaging, radioactive and mixed-ion beams, and mechanistic digital twins expand capabilities for biological dosimetry, adaptive imaging, and prediction of late toxicity events. Carbon-ion research is simultaneously progressing toward biologically optimized treatment through advances in immunoradiobiology, flash irradiation, predictive biomarkers, functional imaging, and multi-ion optimization. Quantum technologies represent a longer-term perspective for imaging, dosimetry, and treatment planning.
Conclusion
Particle therapy is transitioning from a dose-centered discipline to an integrated framework combining advanced imaging, radiation quality, biological modeling, and patient-specific decision support. Several technologies are sufficiently mature for near-term clinical translation, with digital twins, biologically optimized multi-ion therapy, and quantum-enabled systems represent innovations likely to shape the next generation of precision particle therapy and guide future priorities within the RadioTransNet network.
{"title":"Preclinical highlights from the 64th Annual Meeting of the Particle Therapy Co-Operative Group (PTCOG 64): Breakthroughs and timelines for potential applications in radiotherapy","authors":"Brendon Geoffrin-Tanner, Anne-Marie Frelin, François Chevalier, Siamak Haghdoost, Claire Rodriguez-Lafrasse, Sara Marcatili, Marie Vanstalle, Isabelle F. Vanhaezebrouck, Samuel Valable, Guillaume Vogin, Juliette Thariat","doi":"10.1016/j.canrad.2026.104897","DOIUrl":"10.1016/j.canrad.2026.104897","url":null,"abstract":"<div><h3>Purpose of the research</h3><div>Particle therapy is rapidly evolving beyond highly conformal dose delivery toward biologically informed, image-guided, and patient-specific treatment strategies.</div></div><div><h3>Materials and methods</h3><div>Selected preclinical and translational advances presented at the 64th Annual Meeting of the Particle Therapy Co-Operative Group (PTCOG 64) are reported with emphasis on their potential impact and expected timeline for clinical implementation.</div></div><div><h3>Results</h3><div>Recent developments span accelerator technologies, treatment delivery, dosimetry, imaging, radiobiology, and predictive modeling. Near-term innovations include compact accelerator concepts, software-driven treatment acceleration, photon-counting computed tomography, prompt-gamma range verification, linear energy transfer-aware quality assurance, and uncertainty-aware normal tissue complication probability models for proton therapy selection. Emerging approaches such as optically stimulated luminescence detectors, nanodroplet ultrasound imaging, radioactive and mixed-ion beams, and mechanistic digital twins expand capabilities for biological dosimetry, adaptive imaging, and prediction of late toxicity events. Carbon-ion research is simultaneously progressing toward biologically optimized treatment through advances in immunoradiobiology, flash irradiation, predictive biomarkers, functional imaging, and multi-ion optimization. Quantum technologies represent a longer-term perspective for imaging, dosimetry, and treatment planning.</div></div><div><h3>Conclusion</h3><div>Particle therapy is transitioning from a dose-centered discipline to an integrated framework combining advanced imaging, radiation quality, biological modeling, and patient-specific decision support. Several technologies are sufficiently mature for near-term clinical translation, with digital twins, biologically optimized multi-ion therapy, and quantum-enabled systems represent innovations likely to shape the next generation of precision particle therapy and guide future priorities within the RadioTransNet network.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"30 5","pages":"Article 104897"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149257917","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}
Pub Date : 2026-07-01Epub Date: 2026-09-23DOI: 10.1016/j.canrad.2026.104876
Alexandre Escande, Yuedan Zhou, Myriam Ayadi, Jonathan Khalifa, Cyrus Chargari, Valentine Guimas, Marie-Pierre Sunyach, Delphine Antoni, Anne Laprie, Yoann Pointreau, Arnaud Beddok, Stéphane Supiot
The process of reirradiation in oncology presents a distinctive set of challenges, wherein clinical decision-making relies on a delicate balance between the efficacy of the treatment and the risk of severe toxicity. Despite the paucity of randomized data, there is an increasing number of data encouraging its consideration for patients with local or metastatic recurrence. While awaiting dedicated guidance from supranational scientific societies, the following publication is based on the “Recommendations Commission” of the Société française de radiothérapie oncologique (the French society for radiation oncology). It addresses key questions related to reirradiation, with a particular focus on brain tumours and head and neck cancers.
{"title":"General technical considerations on reirradiation and focus on brain and head and neck tumours, suggestions from the Recommendations Commission of the Société française de radiothérapie oncologique","authors":"Alexandre Escande, Yuedan Zhou, Myriam Ayadi, Jonathan Khalifa, Cyrus Chargari, Valentine Guimas, Marie-Pierre Sunyach, Delphine Antoni, Anne Laprie, Yoann Pointreau, Arnaud Beddok, Stéphane Supiot","doi":"10.1016/j.canrad.2026.104876","DOIUrl":"10.1016/j.canrad.2026.104876","url":null,"abstract":"<div><div>The process of reirradiation in oncology presents a distinctive set of challenges, wherein clinical decision-making relies on a delicate balance between the efficacy of the treatment and the risk of severe toxicity. Despite the paucity of randomized data, there is an increasing number of data encouraging its consideration for patients with local or metastatic recurrence. While awaiting dedicated guidance from supranational scientific societies, the following publication is based on the “Recommendations Commission” of the Société française de radiothérapie oncologique (the French society for radiation oncology). It addresses key questions related to reirradiation, with a particular focus on brain tumours and head and neck cancers.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"30 4","pages":"Article 104876"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149032195","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}
Stereotactic radiotherapy is a key treatment for brain metastases, alongside surgery and systemic therapies. A substantial proportion of patients develop radiation necrosis after stereotactic radiotherapy. Differentiating radiation necrosis from tumour progression is critical, as they require distinct therapeutic strategies. While magnetic resonance imaging remains the mainstay of surveillance, its limitations emphasize the need for alternative, non-invasive diagnostic modalities. This narrative review aimed to summarize recent imaging techniques for distinguishing radiation necrosis from tumour progression after stereotactic radiotherapy for brain metastases.
Materials and methods
A systematic literature search was conducted in Embase and Medline (using the search engine PubMed) for studies published between January 2012 and February 2025. The terms “radiation necrosis,” “brain metastasis,” and “diagnosis” were combined. Eligible studies included adult patients with brain metastases treated with stereotactic radiation, with differentiation of radiation necrosis from tumour progression assessed by histopathology or imaging follow-up. Studies exclusively on primary brain tumours or without separate brain metastases analysis were excluded. Both prospective and retrospective designs were considered.
Results
Fourty studies met inclusion criteria: magnetic resonance imaging (n = 21), nuclear medicine (n = 13), and radiomics (n = 6). Advanced magnetic resonance imaging (e.g., perfusion, intravoxel incoherent motion, treatment response assessment maps) and aminoacid positron-emission tomography showed the highest diagnostic accuracies. Radiomics, especially multiparametric approaches, improved performance but lacked external validation.
Conclusion
Combined advanced magnetic resonance imaging, aminoacid positron-emission tomography, and radiomics approaches offer the greatest potential. Prospective studies are needed.
{"title":"Differential diagnosis of imaging alterations after stereotactic radiotherapy of brain metastases: A narrative review","authors":"Lara Caglayan, Mathias Sempels, Lieselotte Lauwens, Jean-François Daisne","doi":"10.1016/j.canrad.2026.104859","DOIUrl":"10.1016/j.canrad.2026.104859","url":null,"abstract":"<div><h3>Purpose</h3><div>Stereotactic radiotherapy is a key treatment for brain metastases, alongside surgery and systemic therapies. A substantial proportion of patients develop radiation necrosis after stereotactic radiotherapy. Differentiating radiation necrosis from tumour progression is critical, as they require distinct therapeutic strategies. While magnetic resonance imaging remains the mainstay of surveillance, its limitations emphasize the need for alternative, non-invasive diagnostic modalities. This narrative review aimed to summarize recent imaging techniques for distinguishing radiation necrosis from tumour progression after stereotactic radiotherapy for brain metastases.</div></div><div><h3>Materials and methods</h3><div>A systematic literature search was conducted in Embase and Medline (using the search engine PubMed) for studies published between January 2012 and February 2025. The terms “radiation necrosis,” “brain metastasis,” and “diagnosis” were combined. Eligible studies included adult patients with brain metastases treated with stereotactic radiation, with differentiation of radiation necrosis from tumour progression assessed by histopathology or imaging follow-up. Studies exclusively on primary brain tumours or without separate brain metastases analysis were excluded. Both prospective and retrospective designs were considered.</div></div><div><h3>Results</h3><div>Fourty studies met inclusion criteria: magnetic resonance imaging (<em>n</em> <!-->=<!--> <!-->21), nuclear medicine (<em>n</em> <!-->=<!--> <!-->13), and radiomics (<em>n</em> <!-->=<!--> <!-->6). Advanced magnetic resonance imaging (e.g., perfusion, intravoxel incoherent motion, treatment response assessment maps) and aminoacid positron-emission tomography showed the highest diagnostic accuracies. Radiomics, especially multiparametric approaches, improved performance but lacked external validation.</div></div><div><h3>Conclusion</h3><div>Combined advanced magnetic resonance imaging, aminoacid positron-emission tomography, and radiomics approaches offer the greatest potential. Prospective studies are needed.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"30 4","pages":"Article 104859"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148710136","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}
Pub Date : 2026-07-01Epub Date: 2026-09-23DOI: 10.1016/j.canrad.2026.104863
Sébastien Laroze, Youlia Kirova, Pierre Loap
<div><h3>Introduction</h3><div>Breast adenoid cystic carcinoma is a rare triple-negative breast cancer subtype with a favourable prognosis. While hypofractionated and ultra-hypofractionated radiotherapy are increasingly used for breast cancer, no dedicated data exist for breast adenoid cystic carcinoma. This study reports contemporary oncological outcomes, radiotherapy parameters, and toxicity in a uniformly treated single-institution cohort.</div></div><div>Breast adenoid cystic carcinoma is a rare triple-negative breast cancer subtype with a favourable prognosis. While hypofractionated and ultra-hypofractionated radiotherapy are increasingly used for breast cancer, no dedicated data exist for breast adenoid cystic carcinoma. This study reports contemporary oncological outcomes, radiotherapy parameters, and toxicity in a uniformly treated single-institution cohort.</div><div><h3>Patients and methods</h3><div>We retrospectively reviewed files of all patients with non-metastatic breast adenoid cystic carcinoma treated with surgery and adjuvant radiation between 2006 and 2023. Clinical, pathological, treatment, and follow-up data were analysed. Survival was estimated using Kaplan-Meier methods.</div></div><div>We retrospectively reviewed files of all patients with non-metastatic breast adenoid cystic carcinoma treated with surgery and adjuvant radiation between 2006 and 2023. Clinical, pathological, treatment, and follow-up data were analysed. Survival was estimated using Kaplan-Meier methods.</div><div><h3>Results</h3><div>The data from 13 women (median age 69 years, range 47–79 years) were included; 92.3 % underwent breast-conserving surgery, and all were node-negative. Hypofractionation was used in 69.2 %, including three ultra-hypofractionated regimens (32.5 Gy delivered in five fractions). At a median follow-up of 60 months, there were no regional or distant recurrences and one local recurrence salvaged surgically. Five- and 10-year cancer-specific survival rates were 100 %, overall survival rates were 90.0 % and 67.5 %, respectively, and local recurrence-free survival rate was 90.0 % at both time points. Eight patients developed grade 1 acute radiodermatitis; no other acute or late toxicity events were observed.</div></div><div>The data from 13 women (median age 69 years, range 47–79 years) were included; 92.3 % underwent breast-conserving surgery, and all were node-negative. Hypofractionation was used in 69.2 %, including three ultra-hypofractionated regimens (32.5 Gy delivered in five fractions). At a median follow-up of 60 months, there were no regional or distant recurrences and one local recurrence salvaged surgically. Five- and 10-year cancer-specific survival rates were 100 %, overall survival rates were 90.0 % and 67.5 %, respectively, and local recurrence-free survival rate was 90.0 % at both time points. Eight patients developed grade 1 acute radiodermatitis; no other acute or late toxicity events were observed.</div><div><h3>Conclu
{"title":"Modern adjuvant radiotherapy for breast adenoid cystic carcinoma: Clinical outcomes across normofractionated and hypofractionated schedules","authors":"Sébastien Laroze, Youlia Kirova, Pierre Loap","doi":"10.1016/j.canrad.2026.104863","DOIUrl":"10.1016/j.canrad.2026.104863","url":null,"abstract":"<div><h3>Introduction</h3><div>Breast adenoid cystic carcinoma is a rare triple-negative breast cancer subtype with a favourable prognosis. While hypofractionated and ultra-hypofractionated radiotherapy are increasingly used for breast cancer, no dedicated data exist for breast adenoid cystic carcinoma. This study reports contemporary oncological outcomes, radiotherapy parameters, and toxicity in a uniformly treated single-institution cohort.</div></div><div>Breast adenoid cystic carcinoma is a rare triple-negative breast cancer subtype with a favourable prognosis. While hypofractionated and ultra-hypofractionated radiotherapy are increasingly used for breast cancer, no dedicated data exist for breast adenoid cystic carcinoma. This study reports contemporary oncological outcomes, radiotherapy parameters, and toxicity in a uniformly treated single-institution cohort.</div><div><h3>Patients and methods</h3><div>We retrospectively reviewed files of all patients with non-metastatic breast adenoid cystic carcinoma treated with surgery and adjuvant radiation between 2006 and 2023. Clinical, pathological, treatment, and follow-up data were analysed. Survival was estimated using Kaplan-Meier methods.</div></div><div>We retrospectively reviewed files of all patients with non-metastatic breast adenoid cystic carcinoma treated with surgery and adjuvant radiation between 2006 and 2023. Clinical, pathological, treatment, and follow-up data were analysed. Survival was estimated using Kaplan-Meier methods.</div><div><h3>Results</h3><div>The data from 13 women (median age 69 years, range 47–79 years) were included; 92.3 % underwent breast-conserving surgery, and all were node-negative. Hypofractionation was used in 69.2 %, including three ultra-hypofractionated regimens (32.5 Gy delivered in five fractions). At a median follow-up of 60 months, there were no regional or distant recurrences and one local recurrence salvaged surgically. Five- and 10-year cancer-specific survival rates were 100 %, overall survival rates were 90.0 % and 67.5 %, respectively, and local recurrence-free survival rate was 90.0 % at both time points. Eight patients developed grade 1 acute radiodermatitis; no other acute or late toxicity events were observed.</div></div><div>The data from 13 women (median age 69 years, range 47–79 years) were included; 92.3 % underwent breast-conserving surgery, and all were node-negative. Hypofractionation was used in 69.2 %, including three ultra-hypofractionated regimens (32.5 Gy delivered in five fractions). At a median follow-up of 60 months, there were no regional or distant recurrences and one local recurrence salvaged surgically. Five- and 10-year cancer-specific survival rates were 100 %, overall survival rates were 90.0 % and 67.5 %, respectively, and local recurrence-free survival rate was 90.0 % at both time points. Eight patients developed grade 1 acute radiodermatitis; no other acute or late toxicity events were observed.</div><div><h3>Conclu","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"30 4","pages":"Article 104863"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149032173","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}
Intracranial mesenchymal tumours with in-frame gene fusions of the FET family of RNA-binding proteins to the cyclic AMP response element-binding protein family of transcription factors are exceptionally rare primary central nervous system neoplasms, with morphological similarities to angiomatoid fibrous histiocytoma. Despite their recent inclusion in the 2021 World Health Organisation classification of tumours of the central nervous system, only a limited number of cases have been reported. We describe two cases of intracranial mesenchymal tumours harbouring fusion of the Ewing sarcoma breakpoint region 1 gene with the activating transcription factor 1 gene, both arising from the falx cerebri. Clinical, radiological, pathological, molecular, and therapeutic findings are detailed. A literature review was performed to contextualize our observations. Case 1 involved a 32-year-old man with a parafalcine lesion initially mimicking meningioma, treated with subtotal resection followed by adjuvant radiotherapy. Case 2 concerned a 69-year-old woman with a similar lesion, managed with gross total resection and radiotherapy. Histopathology in both cases revealed epithelioid morphology within myxoid or fibrous stroma, with desmin, epithelial membrane antigen, and CD99 positivity. Molecular analyses confirmed fusion of the Ewing sarcoma breakpoint region 1 gene with the activating transcription factor 1 gene. After 38 and 30 months of follow-up, respectively, both patients remained recurrence-free. These cases reinforce the recognition of intracranial mesenchymal tumours with gene fusions of the FET family of RNA-binding proteins to the cyclic AMP response element-binding protein family of transcription factors as a distinct entity. Accurate diagnosis requires combined histopathological and molecular evaluation. While gross total resection remains the preferred approach, adjuvant radiotherapy may improve disease control. Larger multicentre studies are needed to refine prognostic factors and therapeutic recommendations.
{"title":"Intracranial mesenchymal tumours with FET::CREB fusions: Two case reports and literature review","authors":"Quentin Josset, Josue Biaou, Loic Feuvret, Jihad Aslaoui, Delphine Caron","doi":"10.1016/j.canrad.2026.104860","DOIUrl":"10.1016/j.canrad.2026.104860","url":null,"abstract":"<div><div>Intracranial mesenchymal tumours with in-frame gene fusions of the FET family of RNA-binding proteins to the cyclic AMP response element-binding protein family of transcription factors are exceptionally rare primary central nervous system neoplasms, with morphological similarities to angiomatoid fibrous histiocytoma. Despite their recent inclusion in the 2021 World Health Organisation classification of tumours of the central nervous system, only a limited number of cases have been reported. We describe two cases of intracranial mesenchymal tumours harbouring fusion of the Ewing sarcoma breakpoint region 1 gene with the activating transcription factor 1 gene, both arising from the falx cerebri. Clinical, radiological, pathological, molecular, and therapeutic findings are detailed. A literature review was performed to contextualize our observations. Case 1 involved a 32-year-old man with a parafalcine lesion initially mimicking meningioma, treated with subtotal resection followed by adjuvant radiotherapy. Case 2 concerned a 69-year-old woman with a similar lesion, managed with gross total resection and radiotherapy. Histopathology in both cases revealed epithelioid morphology within myxoid or fibrous stroma, with desmin, epithelial membrane antigen, and CD99 positivity. Molecular analyses confirmed fusion of the Ewing sarcoma breakpoint region 1 gene with the activating transcription factor 1 gene. After 38 and 30 months of follow-up, respectively, both patients remained recurrence-free. These cases reinforce the recognition of intracranial mesenchymal tumours with gene fusions of the FET family of RNA-binding proteins to the cyclic AMP response element-binding protein family of transcription factors as a distinct entity. Accurate diagnosis requires combined histopathological and molecular evaluation. While gross total resection remains the preferred approach, adjuvant radiotherapy may improve disease control. Larger multicentre studies are needed to refine prognostic factors and therapeutic recommendations.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"30 4","pages":"Article 104860"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149032223","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}
Pub Date : 2026-07-01Epub Date: 2026-09-23DOI: 10.1016/j.canrad.2026.104862
Zeina Ayoub, Tarek Al Bitar, Toufic Eid
{"title":"Comment on “Contemporary survival outcomes of patients with isolated nodal recurrences of breast cancer: A population-based study”, Cheptea C, Kirova Y, Fourquet A, Loap P. Cancer Radiother 2026;30:104828","authors":"Zeina Ayoub, Tarek Al Bitar, Toufic Eid","doi":"10.1016/j.canrad.2026.104862","DOIUrl":"10.1016/j.canrad.2026.104862","url":null,"abstract":"","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"30 4","pages":"Article 104862"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149032155","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}
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