Gene Expression in Muscle-Invasive and Non-Muscle-Invasive Bladder Cancer Cells Exposed to Hypoxia.

Introduction: Hypoxic cancers are radioresistant, but biomarkers based on expression of multiple genes can identify patients who will benefit from hypoxia modification. Most studies identifying relevant genes exposed cells in culture to 1% oxygen, which activates hypoxia-inducible factor (HIF). However, oxygen concentrations in hypoxic tumours are heterogeneous ranging from <0.

Cell Surface Proteomics Reveals Hypoxia-Regulated Pathways in Cervical and Bladder Cancer.

Unlabelled: Background Plasma membrane proteins (PMPs) play key roles in cell signalling, adhesion, and trafficking, and are attractive therapeutic targets in cancer due to their surface accessibility. However, their typically low abundance limits detection by conventional proteomic approaches.

Methods: To improve PMP detection, we employed a surface proteomics workflow combining cell surface biotinylation and affinity purification prior to LC-MS/MS analysis in cervical (SiHa) and bladder (UMUC3) cancer cell lines cultured under normoxic (21% O) or hypoxic (0.

Radiation-induced extracellular matrix remodelling drives prognosis and predicts radiotherapy response in muscle-invasive bladder cancer.

Muscle-invasive bladder cancer (MIBC) is a prevalent disease that can be treated with radiotherapy, but has a poor prognosis. Radiation-induced extracellular matrix (ECM) remodelling and fibrosis can induce tumour resistance and recurrence, but have not been studied in MIBC. Here, we aimed to characterise the impact of radiation on the ECM composition of MIBC.

Multi-institution longitudinal apparent diffusion coefficient measurements in a diffusion weighted imaging phantom at room temperature.

Background And Purpose: This work contributes to technical validation of apparent diffusion coefficient (ADC) as a biomarker of cancer. The aim was to evaluate ADC accuracy, random error, short-term and long-term repeatability and reproducibility, across multiple institutions using a room temperature phantom.

Materials And Methods: ADC measurements were made in a travelling room temperature diffusion weighted imaging (DWI) phantom on six scanners at four UK institutions over 18 months at six-month intervals.

Normal tissue outlining guidelines development for soft tissue sarcoma of the extremities.

Introduction: Radiotherapy (RT) plans for soft tissue sarcoma of the extremities (STSE) are optimised to achieve maximum target coverage whilst avoiding high doses to weight-bearing bones and intermediate doses to the normal tissue (NT) limb corridor. Within this study, novel lower extremity NT outlining guidelines and atlas were developed based on the hypothesis that using these for RT planning may reduce RT toxicity. Usability and applicability of the guidance were also investigated.

Dose-response mapping of bladder and rectum in prostate cancer patients undergoing radiotherapy with and without baseline toxicity correction.

Background And Purpose: Radiotherapy dose-response maps (DRM) combine dose-surface maps (DSM) and toxicity outcomes to identify high-risk subregions in organ-at-risk. This study assesses the impact of baseline toxicity correction on the identification of high-risk subregions in dose-response modeling for prostate cancer patients undergoing radiotherapy.

Materials And Methods: The analysis included 1808 datasets, with 589 exclusions before toxicity-specific data removal.

Salvage brachytherapy for recurrent prostate cancer after radiotherapy: An expert-endorsed review by uroGEC.

Radiorecurrent prostate cancer remains a challenging clinical scenario. Salvage brachytherapy, either low-dose-rate (LDR) or high-dose-rate (HDR), offers a promising organ-preserving option in carefully selected patients. This narrative review, endorsed by the uroGEC (Urology - Groupe Européen de Curiethérapie), summarizes current evidence, indications, techniques, outcomes, and limitations of SBT in men with local recurrence after primary radiotherapy.

Joint ABS/GEC-ESTRO Consensus Statement on the objectives of training in brachytherapy for physicians.

Brachytherapy is an essential skill in the practice of radiation oncology and is an important component of high-quality, full-service radiation oncology departments. With rapidly changing technology, the role of brachytherapy is constantly evolving, but it remains critically important for optimal patient care in several disease sites. As a procedural aspect of radiation oncology practice, brachytherapy requires a fundamentally different and more focused training approach, with specific training objectives, a unique knowledge base, and specialized training environment.

Combining MRI radiomics, hypoxia gene signature score and clinical variables for prediction of biochemical recurrence-free survival after radiotherapy in prostate cancer.

Purpose: To investigate the value of combining MRI radiomic and hypoxia-associated gene signature information with clinical data for predicting biochemical recurrence-free survival (BCRFS) after radiotherapy for prostate cancer.

Methods: Patients with biopsy-proven prostate cancer, hypoxia-associated gene signature scores and pre-treatment MRI who received radiotherapy between 01/12/2007 and 31/08/2013 at two cancer centres were included in this retrospective cohort analysis. Prostate segmentation was performed on axial T2-weighted sequences using RayStation (v9.

Debate 2: Primary Localized Prostate Cancer: The Case for Whole-Gland Brachytherapy Boost.

Whole gland brachytherapy (BT) boost in combination with external beam radiotherapy (EBRT) improves biochemical relapse free survival (bRFS) for intermediate- and high-risk prostate cancer (PCa). Three randomized control studies (RCT) have demonstrated superiority over EBRT alone, and a meta-analysis alongside updated long-term data demonstrates an ongoing benefit with whole gland BT boost. There are concerns that improved tumor control comes at the expense of late genitourinary (GU) and gastrointestinal (GI) toxicities.

The value of post radiotherapy prostate specific antigen dynamics for prostate cancer risk stratification models.

Background And Purpose: Risk-stratification at diagnosis of prostate cancer does not always predict risk of biochemical recurrence (BCR). Fully utilizing post-radiotherapy follow-up Prostate Specific Antigen (PSA) data could offer earlier and higher prognostic value than pre-treatment risk-stratification.We investigate whether PSA dynamics in the first three-years of follow-up can re-stratify risk of treatment failure after radical radiotherapy, allowing for targeted intervention.

Reirradiation: Standards, challenges, and patient-focused strategies across tumor types.

Reirradiation (reRT), defined as administering a course of radiation therapy to a specific area previously irradiated, is an evolving treatment strategy for locoregionally recurrent cancer that offers significant potential and poses inherent challenges. Advances in such techniques as intensity-modulated and stereotactic body radiation therapy have improved precision, making reRT a viable option for complex scenarios previously deemed high-risk. Nevertheless, reRT remains associated with substantial risks-including life-threatening side effects, functional impairments, and psychosocial effects-which must be carefully balanced against the patient's overall health and the likelihood of achieving cancer control or palliation.

Quantifying the dosimetric impact of online daily adaptation for MR-guided RT in cervical cancer.

Purpose: This study assessed the inter- and intra-fractional dosimetric impact of MR-Linac-based adaptive radiotherapy for cervical cancer (CC).

Methods: A retrospective analysis of five node-negative, locally advanced cervical cancer patients treated under the MOMENTUM study (NCT04075305) using adapt-to-shape (ATS) on an Elekta Unity MR-Linac. Assessing the dosimetric impact of daily online adaptations: (1) comparing dose between daily adapted (MR-adapted) and non-adapted (MR-guided) plans, by quantifying dose differences relative to reference plans (by 2 and 5%) and evaluating adaptation frequency; (2) performing intra-fraction dose evaluations.

Distant Metastasis After Chemoradiation and Image Guided Adaptive Brachytherapy in Locally Advanced Cervical Cancer.

Purpose: This study aimed to assess patterns and risks of distant metastasis (DM) in patients with cervical cancer treated with chemoradiation therapy and MR-image guided adaptive brachytherapy (IGABT) and to explore a potential dose-effect relationship of concomitant cisplatin.

Methods And Materials: Data were derived from EMBRACE I, an international, prospective, and multicenter cohort study conducted at 24 centers across Europe, Asia, and North America from July 30, 2008, to December 29, 2015. The study included 1416 patients with biopsy-confirmed cervical cancer (International Federation of Gynecology and Obstetrics [FIGO] stage IB-IVA or stage IVB limited to paraaortic lymph nodes below the L1/L2 interspace).

Impact of recent clinical trials on meta-analysis of stereotactic body radiation therapy for spine metastases and urgent call for consistent study endpoints.

Pain from spinal metastases can result in significant impact to patients' quality of life. Conventional external beam radiation therapy (cEBRT) has long been shown to be effective in the pain control of patients with spinal metastases. With the advancement in radiation therapy, stereotactic body radiation therapy (SBRT) has been increasingly adopted for the treatment of spinal metastases.

The Promise of Radiotherapy in High-Risk Non-Muscle Invasive Bladder Cancer.

Global shortages, toxicities, and high levels of incomplete treatment with Bacillus Calmette Guerin (BCG) for non-muscle invasive bladder cancer has resulted in increasing interest in alternative treatments. Radiotherapy is not the standard of care for non-muscle invasive bladder cancer (NMIBC), despite being routinely used in muscle invasive bladder cancer. Modern techniques and advances in technology mean that radiotherapy can be delivered with increased precision in reducing normal tissue damage.

Incidental findings in volunteer imaging used to develop radiotherapy MRI workflows.

Introduction/background: Healthy volunteer imaging is integral to optimising sequences for use in a treatment planning pathway to ensure they are fit for purpose. Although initial imaging may not be optimal quality, it may still be possible to identify abnormalities.

Methods: All healthy volunteer participants recruited to approved studies aimed at optimising MRI sequences for use in radiotherapy at our institution were included.

Comparison of standard-dose and reduced-dose treatment of metastatic prostate cancer with enzalutamide, apalutamide or darolutamide: a rapid review.

Objective: To review the efficacy and safety of low-dose versus standard-dose enzalutamide, apalutamide or darolutamide treatment for metastatic prostate cancer.

Methods And Analysis: Keyword searches in MEDLINE and EMBASE up to 1 June 2023, with forward and backward citation searches of potentially relevant studies. Studies were included if primary outcome data were reported for patients with metastatic prostate cancer who had received reduced doses of enzalutamide, apalutamide or darolutamide.

The clinical application of in vivo dosimetry for gynaecological brachytherapy: A scoping review.

Brachytherapy is a key treatment for gynaecological malignancies, delivering high doses to the tumour volume whilst sparing nearby normal tissues due to its steep dose gradient. Accuracy is imperative as small shifts can lead to clinically significant under- or over-dosing of the target volume or organs at risk (OARs), respectively. Independent verification of dose delivered during brachytherapy is not routinely performed but it is important to identify gross errors and define action thresholds to guide inter-fraction treatment decisions.

Development and refinement of patient care recommendations in brachytherapy for locally advanced cervical cancer using nominal group technique workshops.

Purpose: Patient experiences of brachytherapy for locally advanced cervical cancer (LACC) are widely variable, with reports of difficult and traumatic experiences and aspects of care requiring improvement. The aim of this study was to develop patient care recommendations and consult with key stakeholders to review, refine and prioritise recommendations.

Methods: Phase 1: Patient care recommendations were developed from qualitative exploratory study data.

Ongoing prospective studies on reirradiation: A systematic review of a clinical trials database.

Introduction: Reirradiation has gained increasing interest, as advances in systemic therapy increase the survival of patients with cancer, and modern radiation techniques allow more precise treatments. However, high-quality prospective evidence on the safety and efficacy of reirradiation to guide clinical practice remains scarce. This systematic review evaluates ongoing prospective studies on reirradiation to identify research gaps and priorities.

Hypoxia-Associated Gene Signatures Are Not Prognostic in High-Risk Localized Prostate Cancers Undergoing Androgen Deprivation Therapy With Radiation Therapy.

Purpose: Men with high-risk prostate cancer (PCa) are treated with androgen deprivation therapy (ADT) and radiation therapy, but the disease reoccurs in 30% of patients. Biochemical recurrence of PCa after treatment is influenced by tumor hypoxia. Tumors with high levels of hypoxia are aggressive, resistant to treatment, and have increased metastatic capacity.