Rare Case of Squamous Cell Cancer - Mixed Neuroendocrine Neoplasm in the tubular Esophagus (MiNEN) discovered by Endoscopic Submucosal Dissection of the entire Tumor.

Mixed neuroendocrine-non-neuroendocrine neoplasms (MiNENs) are rare in the gastrointestinal tract.We report the case of a patient in whom complete endoscopic resection of a tumorous lesion in the tubular esophagus, initially diagnosed as squamous cell carcinoma (SCC) led to the diagnosis of SCC-MiNEN, which changed the patient´s treatment course.With improvements in endoscopic techniques, we advocate resection of small malignant lesions in the gastrointestinal tract for both curative and diagnostic reasons.

Impact of preoperative radiotherapy on patient-reported outcomes in rectal cancer.

Aim: To prospectively evaluate the effect of preoperative radiotherapy followed by surgery versus surgery alone on patient-reported outcomes (PROs) 1 year after surgery.

Method: Prospective observational cohort study in 127 colorectal cancer centres. Patients with rectal cancer completed European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core (EORTC-QLQ-C30) and Colorectal module (-CR29) questionnaires (thus providing PROs) before initialization of treatment [baseline (T0)] and at 12 months after surgery [follow up (T1)].

Organ preservation after total neoadjuvant therapy for locally advanced rectal cancer (CAO/ARO/AIO-16): an open-label, multicentre, single-arm, phase 2 trial.

Background: Total neoadjuvant therapy has been shown to increase pathological complete response and disease-free survival in patients with locally advanced rectal cancer after total mesorectal excision (TME). We hypothesised that total neoadjuvant therapy could maximise the number of patients attaining a clinical complete response who could then be instead referred to organ preservation with watch and wait.

Methods: This open-label, multicentre, single-arm, phase 2 study (CAO/ARO/AIO-16) was conducted at four centres across Germany.

Comparative analysis of open-source against commercial AI-based segmentation models for online adaptive MR-guided radiotherapy.

Background And Purpose: Online adaptive magnetic resonance-guided radiotherapy (MRgRT) has emerged as a state-of-the-art treatment option for multiple tumour entities, accounting for daily anatomical and tumour volume changes, thus allowing sparing of relevant organs at risk (OARs). However, the annotation of treatment-relevant anatomical structures in context of online plan adaptation remains challenging, often relying on commercial segmentation solutions due to limited availability of clinically validated alternatives. The aim of this study was to investigate whether an open-source artificial intelligence (AI) segmentation network can compete with the annotation accuracy of a commercial solution, both trained on the identical dataset, questioning the need for commercial models in clinical practice.

Rectal stenosis after immunotherapy in a mismatch repair deficient rectal cancer. Case report and review of literature.

We report the case of a 57-year-old male patient who presented with a circumferential cT3 cN1 rectal adenocarcinoma in the mid rectum. The tumor was found to be mismatch repair deficient/microsatellite instable (dMMR/MSI). Instead of multimodality treatment with chemoradiotherapy immunotherapy with Dostarlimab was initiated.

Quality of Life and Toxicity in Patients With Pancreatic Ductal Adenocarcinoma Treated With Online Adaptive Stereotactic Magnetic Resonance Guided Radiation Therapy.

Purpose: Online adaptive magnetic resonance guided radiation therapy (MRgRT) using a hybrid magnetic resonance imaging and linear accelerator enables stereotactic ablative radiation doses to pancreatic tumors. We evaluated patient-reported quality of life (QoL) and clinician-reported toxicity in patients with pancreatic ductal adenocarcinoma after stereotactic MRgRT.

Method: Patients with nonmetastatic pancreatic ductal adenocarcinoma treated with stereotactic MRgRT on a 1.

Development and comprehensive clinical validation of a deep neural network for radiation dose modelling to enhance magnetic resonance imaging guided radiotherapy.

Background And Purpose: Online adaptive magnetic resonance imaging (MRI)-guided radiotherapy requires fast dose calculation algorithms to reduce intra-fraction motion uncertainties and improve workflow efficiency. While Monte-Carlo simulations are precise but computationally intensive, neural networks promise fast and accurate dose modelling in strong magnetic fields. This study aimed to train and evaluate a deep neural network for dose modelling in MRI-guided radiotherapy using a comprehensive clinical dataset.

Longitudinal assessment of diffusion-weighted imaging during magnetic resonance-guided radiotherapy in head and neck cancer.

Background: For radiotherapy of head and neck cancer (HNC) magnetic resonance imaging (MRI) plays a pivotal role due to its high soft tissue contrast. Moreover, it offers the potential to acquire functional information through diffusion weighted imaging (DWI) with the potential to personalize treatment. The aim of this study was to acquire repetitive DWI during the course of online adaptive radiotherapy on an 1.

Simultaneous integrated boost to lateral pelvic lymph nodes during chemoradiotherapy in high-risk rectal cancer.

Background: Preoperative chemoradiotherapy combined with total mesorectal excision (TME) is a standard treatment for locally advanced rectal cancer (LARC). However, lateral pelvic lymph nodes (LPLNs) are often inadequately treated with standard regimens. This study examines the treatment and postoperative outcomes in LARC patients receiving a simultaneous integrated boost (SIB) for LPLNs during long-course chemoradiotherapy.

Tumor sequencing before and after neoadjuvant chemoradiotherapy in locally advanced rectal cancer: Genetic tumor characterization and clinical outcome.

Background And Purpose: Neoadjuvant chemoradiotherapy (NCRT) is a standard treatment option for locally advanced rectal cancer. However, there is still conflicting data about the genetic landscape and potential dynamics during and after NCRT. This study evaluated oncogenic driver mutations before NCRT and investigated corresponding resection samples after treatment.

Simulation-free magnetic resonance-guided radiation therapy of prostate cancer.

Background And Purpose: Despite recent advances of online image-guided high-precision patient positioning and adaptation using magnetic resonance imaging (MRI) or cone-beam computed tomography (CT), standard radiation therapy pathway still involves a dedicated simulation scan. The aim of this study was to evaluate the feasibility and planning quality of integrating a simulation-free treatment planning workflow for adaptive online MRI-guided radiation therapy on a 1.5 T MRI linear accelerator (MRI-Linac) in prostate cancer using diagnostic CT (dCT) scans.

Dynamics of cell-free tumor DNA correlate with early MRI response during chemoradiotherapy in rectal cancer.

Background: In locally advanced rectal cancer, the prediction of tumor response during and after neoadjuvant treatment remains challenging. In terms of organ preservation, adaptive radiotherapy, and intensified (total) neoadjuvant therapies, biomarkers are desirable for patient stratification.

Methods: In 16 patients, weekly blood samples (n = 86) to detect cell-free tumor DNA (ctDNA) during long-course neoadjuvant chemoradiotherapy were analyzed.

Neoadjuvant chemoradiotherapy in combination with deep regional hyperthermia followed by surgery for rectal cancer: a systematic review and meta-analysis.

Background And Purpose: Combining chemoradiotherapy (CRT) with deep regional hyperthermia (HT) shows promise for enhancing clinical outcomes in selected rectal cancer patients. This study aimed to integrate the evidence and evaluate the efficacy of this combined treatment approach.

Materials And Methods: A systematic search of the PubMed, Scopus, and Mendeley databases was performed.

Online Adaptive MR-Guided Ultrahypofractionated Radiotherapy of Prostate Cancer on a 1.5 T MR-Linac: Clinical Experience and Prospective Evaluation.

The use of hypofractionated radiotherapy in prostate cancer has been increasingly evaluated, whereas accumulated evidence demonstrates comparable oncologic outcomes and toxicity rates compared to normofractionated radiotherapy. In this prospective study, we evaluate all patients with intermediate-risk prostate cancer treated with ultrahypofractionated (UHF) MRI-guided radiotherapy on a 1.5 T MR-Linac within our department and report on workflow and feasibility, as well as physician-recorded and patient-reported longitudinal toxicity.

App-based assessment of patient-reported outcomes in the Molecular Tumor Board in the Center for Personalized Medicine-(TRACE).

Background: Biomarker-based therapies are increasingly used in cancer patients outside clinical trials. Systematic assessment of patient-reported outcomes (PRO) is warranted to take patients' perspectives during biomarker-based therapies into consideration. We assessed the feasibility of an electronic PRO assessment via a smartphone application.

European clinical practice guidelines for the definition, diagnosis, and treatment of oligometastatic esophagogastric cancer (OMEC-4).

Introduction: The OligoMetastatic Esophagogastric Cancer (OMEC) project aims to provide clinical practice guidelines for the definition, diagnosis, and treatment of esophagogastric oligometastatic disease (OMD).

Methods: Guidelines were developed according to AGREE II and GRADE principles. Guidelines were based on a systematic review (OMEC-1), clinical case discussions (OMEC-2), and a Delphi consensus study (OMEC-3) by 49 European expert centers for esophagogastric cancer.

Full daily re-optimization improves plan quality during online adaptive radiotherapy.

Background And Purpose: Daily online treatment plan adaptation requires a fast workflow and planning process. Current online planning consists of adaptation of a predefined reference plan, which might be suboptimal in cases of large anatomic changes. The aim of this study was to investigate plan quality differences between the current online re-planning approach and a complete re-optimization.

Ulcerating skin lesions from blastic plasmacytoid dendritic cell neoplasm responding to low-dose radiotherapy-a case report and literature review.

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematologic malignancy that can manifest with skin nodules and erythematous plaques. In most cases BPDCN progresses rapidly, causing multiple skin lesions and also affecting internal organs and bone marrow, warranting initiation of systemic therapies or hematopoietic stem cell transplantation (HCT). Although not curative, radiotherapy for isolated lesions might be indicated in case of (imminent) ulceration and large or symptomatic lesions.