Multinational validation of distant metastasis velocity as a post-progression prognostic score in patients with oligometastatic cancer treated with metastasis-directed stereotactic body radiotherapy.

Background: Distant progression is the predominant failure pattern after metastasis-directed stereotactic body radiotherapy (SBRT) for oligometastatic disease, but prognostic tools to guide post-progression management are lacking. We aimed to validate the prognostic value of distant metastasis velocity (DMV) for overall survival (OS) and widespread failure-free survival (WFFS) after distant progression.

Methods: Two independent international cohorts of patients with extracranial oligometastatic disease (≤5 lesions) who developed distant progression after SBRT were analyzed.

Improving risk assessment of local failure in brain metastases patients using vision transformers - A multicentric development and validation study.

Background And Purpose: This study investigates the use of Vision Transformers (ViTs) to predict Freedom from Local Failure (FFLF) in patients with brain metastases using pre-operative MRI scans. The goal is to develop a model that enhances risk stratification and informs personalized treatment strategies.

Materials And Methods: Within the AURORA retrospective trial, patients (n = 352) who received surgical resection followed by post-operative stereotactic radiotherapy (SRT) were collected from seven hospitals.

Evaluation of the prognostic value of the ESTRO/EORTC classification of reirradiation in patients with non-small cell lung cancer.

Background: Retreatment with thoracic radiotherapy for recurrent, metastatic, or new primary non-small cell lung cancer (NSCLC) is increasingly used, yet evidence remains limited. This study evaluated the efficacy and safety of radical thoracic retreatment classified by the ESTRO/EORTC reirradiation definition.

Methods: This retrospective single-center study included patients with NSCLC undergoing retreatment with a second course of radical thoracic radiotherapy (≥40 Gy EQD2) between 2015 and 2023.

Safety in MR-enhanced daily adaptive SBRT Radiotherapy using a conventional C-arm linear accelerator: An FMEA approach.

Background And Purpose: MR-guided adaptive Radiotherapy has the potential to compensate for interfractional changes in patient anatomy. Modern hybrid devices, which combine MR and linear accelerator technologies, have been clinically implemented but their costs may prevent broad adoption. To accelerate the adoption of MR-guided adaptive radiotherapy, we developed a workflow for MR-enhanced daily adaptive Radiotherapy on a C-arm linac using a dedicated MR simulator and a patient transfer shuttle system.

Same-Day Magnetic Resonance-Guided Single-Fraction Stereotactic Body Radiation Therapy for Painful Non-Spine Bone Metastases - A Single-Center Study ("BONE SHOT").

Introduction And Background: There is evidence for efficacy of high-dose single-fraction stereotactic body radiotherapy (SF-SBRT) for painful non-spine bone metastases (NSBMs). This study ("BONE SHOT") assessed feasibility of same-day magnetic resonance-guided (MRg) planning and SF-SBRT delivery, recorded toxicity and assessed efficacy for treating metastatic patients with NSBMs.

Materials And Methods: Patients with painful (≥3/10 points on a 0-10 numeric rating scale (NRS) for pain) and radiologically confirmed NSBMs from solid organ malignancies were eligible for this prospectively acquired, single-center study.

Online adaptive stereotactic body radiotherapy for localized prostate cancer in patients with lower urinary tract symptoms and/or prostate hyperplasia (X-SMILE).

Background: Stereotactic body radiotherapy (SBRT) for localized prostate cancer offers non-inferior oncological outcomes and toxicity profiles compared to conventionally or moderately hypofractioned radiotherapy regimens, with shorter treatment durations. However, SBRT may not be suitable for all patients, particularly those with lower urogenital tract symptoms and/or prostatic hyperplasia.

Methods: This study aims to evaluate the safety and efficacy of weekly computed tomography (CT) or magnetic resonance image (MRI)-guided online adaptive SBRT in patients with intermediate to high-risk localized prostate cancer (i.

Implementation of a comprehensive clinical quality assurance system in radiation oncology.

Objective: The objective of this project was to develop and evaluate a comprehensive clinical quality assurance system for radiation oncology, and assess the system using definitive radiation therapy for prostate cancer as a first use case.

Methods: The Zurich Clinical Quality Assurance System in Radiation Oncology (ZH-CLASSIC) was initiated to allow for continuous quality assurance in radiation oncology with respect to indication for radiation therapy, practice of radiation therapy and patient outcome. Data from the sources of the hospital information system, the Radiation Oncology Record and Verify System and a dedicated follow-up database were automatically retrieved, and combined using a unique patient-ID.

Re-irradiation for recurrent glioblastoma: a pattern of care analysis.

Background: 90% of glioblastomas (GBM) relapse within two years of diagnosis. In contrast to the initial setting, there is no standard management for recurrent disease and options include hypofractionated stereotactic re-irradiation (re-mHSRT). The aims of this study were to investigate re-mHSRT practice in Swiss neuro-oncology centres.

Clinical management of oligometastatic cancer: Applying multidisciplinary tumor board recommendations in practice.

Aims: Multidisciplinary tumor boards (MDTs) are an integral part of ensuring high-quality, evidence-based and personalized cancer care. In this study, we aimed to evaluate the adherence to and implementation of MDT recommendations in patients with oligometastatic disease (OMD).

Methods: We screened all oncologic positron emission tomography (PET) scans conducted at a single comprehensive cancer center in 2020.

Validation of echo planar imaging based diffusion-weighted magnetic resonance imaging on a 0.35 T MR-Linac.

Background And Purpose: The feasibility of acquiring diffusion-weighted imaging (DWI) images on an MR-Linac for quantitative response assessment during radiotherapy was explored. DWI data obtained with a Spin Echo Echo Planar Imaging sequence adapted for a 0.35 T MR-Linac were examined and compared with DWI data from a conventional 3 T scanner.

Stereotactic body radiotherapy for oligoprogression with or without switch of systemic therapy.

Background: Oligoprogression is defined as cancer progression of a limited number of metastases under active systemic therapy. The role of metastasis-directed therapy, using stereotactic body radiotherapy (SBRT), is controversial as is the continuation versus switch of systemic therapy. We report outcomes of oligoprogressive patients after SBRT, and compare those patients that continued or switched their current line of systemic therapy.

Health-related quality of life in men with oligometastatic prostate cancer following metastases-directed stereotactic body radiotherapy: Real-world data from the E-RADIatE OligoCare cohort.

Objective: To evaluate the impact of metastases-directed stereotactic body radiotherapy (SBRT) on health-related quality of life (HRQoL) in men with oligometastatic prostate cancer (PCa) using real-world data from the OligoCare cohort.

Materials And Methods: OligoCare is a pragmatic, observational cohort designed to assess the impact of metastases-directed SBRT on patients with oligometastatic disease (OMD). We report an interim analyses of the secondary endpoint HRQoL, assessed using the EORTC QLQ-C30, within six months of metastases-directed SBRT for oligometastatic disease in men with PCa among the first 1600 registered patients.

Dose escalation for stereotactic arrhythmia radioablation of recurrent ventricular tachyarrhythmia - a phase II clinical trial.

Background: Stereotactic arrhythmia radioablation (STAR) is delivered with a planning target volume (PTV) prescription dose of 25 Gy, mostly to the surrounding 75-85% isodose line. This means that the average and maximum dose received by the target is less than 35 Gy, which is the minimum threshold required to create a homogenous transmural fibrosis. Similar to catheter ablation, the primary objective of STAR should be transmural fibrosis to prevent heterogenous intracardiac conduction velocities and the occurrence of sustained ventricular arrhythmias (sVA) caused by reentry.

Refining critical structure contouring in STereotactic Arrhythmia Radioablation (STAR): Benchmark results and consensus guidelines from the STOPSTORM.eu consortium.

Background And Purpose: In patients with recurrent ventricular tachycardia (VT), STereotactic Arrhythmia Radioablation (STAR) shows promising results. The STOPSTORM.eu consortium was established to investigate and harmonise STAR treatment in Europe.

Dosimetric analysis of 17 cardiac Sub-structures, Toxicity, and survival in ultra central lung tumor patients treated with SBRT.

•Data on cardiac toxicity after SBRT for ultra-central lung tumors remains limited.•We analyzed the dose to 18 cardiac sub-structures and cardiovascular toxicity.•A SBRT regimen of 45 Gy in 8-10 fractions yields good local control and low toxicity.

External validation of three prognostic scores for brain metastasis velocity in patients treated with intracranial stereotactic radiotherapy.

Background And Introduction: Brain metastasis velocity (BMV) has been proposed as a prognostic factor for overall survival (OS) in patients with brain metastases (BMs). In this study, we conducted an external validation and comparative assessment of the performance of all three BMV scores.

Materials And Methods: Patients treated with intracranial stereotactic radiotherapy (SRT) for BM at a single center between 2014 and 2018 were identified.

Identifying core MRI sequences for reliable automatic brain metastasis segmentation.

Background: Many automatic approaches to brain tumor segmentation employ multiple magnetic resonance imaging (MRI) sequences. The goal of this project was to compare different combinations of input sequences to determine which MRI sequences are needed for effective automated brain metastasis (BM) segmentation.

Methods: We analyzed preoperative imaging (T1-weighted sequence ± contrast-enhancement (T1/T1-CE), T2-weighted sequence (T2), and T2 fluid-attenuated inversion recovery (T2-FLAIR) sequence) from 339 patients with BMs from seven centers.

Potential of ChatGPT in facilitating research in radiation oncology?

Purpose: To evaluate the potential of the artificial intelligence (AI) chatbot ChatGPT in supporting young clinical scientists with scientific tasks in radio oncological research.

Materials And Methods: Seven scientific tasks were to be completed in 3 h by 8 radiation oncologists with different scientific experience working at a university hospital: creation of a scientific synopsis, creation of a research question and corresponding clinical trial hypotheses, writing of the first paragraph of a manuscript introduction, clinical trial sample size calculation, and clinical data analyses (multivariate analysis, boxplot and survival curve). No participant had prior experience with an AI chatbot.

Stereotactic Body Radiotherapy for Lung Oligo-metastases: Systematic Review and International Stereotactic Radiosurgery Society Practice Guidelines.

Purpose: A systematic review of treatment characteristics, outcomes, and treatment-related toxicities of stereotactic body radiation therapy (SBRT) for pulmonary oligometastases served as the basis for development of this International Stereotactic Radiosurgery Society (ISRS) practice guideline.

Methods: In accordance with PRISMA guidelines, a systematic review was performed of retrospective series with ≥50 patients/lung metastases, prospective trials with ≥25 patients/lung metastases, analyses of specific high-risk situations, and all randomized trials published between 2012 and July 2022 in the MEDLINE or Embase database using the key words "lung oligometastases", "lung metastases", "pulmonary metastases", "pulmonary oligometastases", "stereotactic body radiation therapy (SBRT)" and "stereotactic ablative body radiotherapy (SBRT)". Weighted random effects models were used to calculate pooled outcomes estimates.