Guidelines for external radiotherapy and brachytherapy procedures: 4th edition.

The purpose of the first three editions of the guidelines for external radiotherapy procedures (RecoRad™, published in 2008, 2016 and 2021 respectively), was to issue recommendations aimed at optimising, harmonising and standardising practices. The purpose of this fourth edition, follow the same plan and takes into account recent technological improvements along with findings from literature. Part one describes the daily use of general principles; part two describes every step of the process treatment for the main types of cancer.

Urinary organs-at-risk for radiotherapy following radical prostatectomy: contouring guidelines on behalf of the Francophone Group of Urological Radiation Therapy (GFRU).

Purpose: Urinary toxicity following radical prostatectomy (RP) and postoperative radiotherapy (RT) includes urinary incontinence and vesicourethral anastomosis (VUA) strictures. With the increasing use of stereotactic body radiotherapy (SBRT), dose-escalation, and reirradiation within the prostate bed (PB), standardization of the definition of urinary organs at risk (OARs) in the post-RP setting is needed. This works aims to provide a comprehensive review of the anatomical and physiopathological changes occurring after RP, as well as to provide a consensus on urinary OARs delineation for prostate cancer (PCa) EBRT in the post-RP setting.

Therapeutic education for patients with prostate cancer: Feasibility, implementation, and preliminary outcomes.

Purpose: Since 2007, therapeutic patient education has been recognized as essential in complementing medical care, particularly for chronic diseases like prostate cancer. To address its underdevelopment in oncology, we have developed a therapeutic patient education programme at our institution specifically for patients with prostate cancer. The aim of this article is to describe the process of developing and implementing this programme and to present a first evaluation at 2 years.

Role of radiotherapy in the management of bladder cancer: Recommendations of the French Society for Radiation Oncology, 2025 update.

We present the recommendations of the Société française de radiothérapie oncologie (SFRO; the French society for radiation oncology) regarding the indications and techniques for external beam radiotherapy for bladder cancer. Together with radical cystectomy, trimodal therapy for well-selected patients is one of the standard-of-care treatments in the management of localized muscle invasive bladder cancer, defined as a maximal trans-urethral resection of the bladder tumour, followed by radiotherapy and concomitant chemotherapy. Adjuvant radiotherapy is an option for patients with pathological high-risk bladder cancer.

Short-term Androgen Deprivation Therapy and High-dose Radiotherapy in Intermediate- and High-risk Localized Prostate Cancer: Results from the GETUG 14 Randomized Phase 3 Trial.

Background And Objective: Few studies have compared short-term androgen deprivation (STADT) combined with high-dose radiotherapy (STADT-RT) versus high-dose radiotherapy (RT) alone in localized prostate cancer.

Methods: The GETUG 14 study randomized 376 patients to RT (n = 191) or STADT-RT (n = 179). The RT dose was 80 Gy in both arms.

Relugolix in prostate cancer therapy: Clinical evidence and practical considerations.

Introduction: Androgen deprivation therapy (ADT) remains a cornerstone of treatment for both localized and metastatic prostate cancer (PC). Relugolix, an oral gonadotrophin-releasing hormone antagonist, provides a new option for achieving rapid testosterone suppression using an oral formulation.

Materials And Methods: A comprehensive literature search was conducted in PubMed by combining the search terms "relugolix", "TAK-385", "MVT-601", "prostate cancer", and "prostatic neoplasms" and focusing on prospective and retrospective studies published in English.

REPAIR_GETUG P16 relapse in previously irradiated prostate bed: a phase I/II study of stereotactic ablative reirradiation potentiated by a metformine study protocol.

Introduction: Salvage prostatic bed radiotherapy (PBRT) is a standard in case of biochemical recurrence following radical prostatectomy (RP) for prostate cancer (PC). The management of isolated prostatic bed recurrence following RP and PBRT is debated. Reirradiation within stereotactic body radiotherapy (SBRT) guided by metabolic imaging could be a relevant option in this case.

oDigital pathology biomarkers for guiding radiotherapy-based treatment concepts in prostate cancer - a systematic review and expert consensus.

Current risk-stratification systems for prostate cancer (PCa) do not sufficiently reflect the disease heterogeneity, and digital pathology (DP) combined with artificial intelligence (AI) tools (DP-AI) may offer a solution to this challenge. The aim of this work is to summarize the role of DP-AI for PCa patients treated with radiotherapy (RT), and to point out future areas of research. We conducted (1) a systematic review on the evidence of DP-AI for patients treated with RT and (2) a survey of experts using a modified Delphi method, addressing the current role of DP-AI in clinical and research practice to identify relevant fields of future development.

Green Perspectives in Radiation Oncology.

The health care sector contributes 4.4% of global greenhouse gas emissions. Many countries are aiming for a carbon net-zero health care system by 2040-2050.

Tailoring prostate cancer external beam radiotherapy for patients with lower urinary tract symptoms.

Background: This narrative review aims to examine the biological mechanisms of toxicity in patients with benign prostatic hyperplasia (BPH) receiving prostate cancer (PCa) external beam radiotherapy (RT), as well as possible strategies to prevent genitourinary (GU) toxicity following PCa RT in men with BPH, through the adaptation of both medical, surgical, and irradiation strategies.

Methods: A broad literature search was performed in November 2024 in the PubMed database with the terms "prostate cancer", "prostate epithelial cells", "prostate stromal cells", "radiation therapy", "lower urinary tract symptoms", "stereotactic body radiotherapy", "transurethral resection of the prostate", "enucleation".

Results: RT affects several pathophysiological contributors to LUTS, such as urothelial dysfunction, prostatic inflammation and bladder fibrosis.

Exploiting the endothelial-immune axis to improve radiotherapy efficacy.

The immune system is essential for controlling tumours and plays a crucial role in how normal and cancer tissues respond to radiotherapy. Lining the inner surface of vessels, the endothelium acts as a barrier that normally prevents the passage of cells from the bloodstream into tissues and promotes the recruitment of immune cells during stressful, injured, or infected conditions. Profound changes in endothelial function occur in response to irradiation, determining the tumour response to radiotherapy and participating in the initiation and development of adverse effects.

Patient-reported Quality of Life in PROFIT, a Phase 3 Randomized Clinical Trial Evaluating Moderately Hypofractionated Radiotherapy for Intermediate-risk Prostate Cancer.

Background And Objective: The PROFIT trial was designed to compare moderately hypofractionated (HF) radiotherapy versus conventional fractionation (CF) for patients with intermediate-risk prostate cancer (IR-PC). Similar efficacy and toxicity outcomes were previously reported. The aim of the current analysis was to evaluate differences in long-term patient-reported outcomes (PROs) between the HF and CF arms in PROFIT.

Perirectal spacers in radiotherapy for prostate cancer - a systematic review and meta-analysis.

Introduction: Perirectal spacers reduce the radiotherapy (RT) dose delivered to the rectum, but their impact on treatment toxicity remains debated. We conducted a systematic review and meta-analysis to synthesise emerging data (PROSPERO: CRD42024506380).

Material And Methods: MEDLINE, Embase, Scopus, and Google Scholar were searched through 2024/08/18 for prospective randomised (RCT) and non-randomised trials evaluating the clinical outcomes of perirectal spacing in prostate cancer (PCa) patients.

Stereotactic body radiotherapy for lung oligometastatic prostate cancer: An international retrospective multicenter study.

Background: Management of prostate cancer (PCa) patients with lung oligometastases remains unclear in the absence of published data.

Objective: The aim of this study was to evaluate the efficacy of Stereotactic Body Radiotherapy (SBRT) in this setting.

Design Setting And Participants: We conducted a multicenter retrospective study that included 35 PCa patients treated with SBRT for lung oligometastases in 7 centers across 3 countries.

Hypofractionated radiotherapy for prostate cancer (HYDRA): an individual patient data meta-analysis of randomised trials in the MARCAP consortium.

Background: Trials comparing moderately hypofractionated radiotherapy (MHFRT) to conventionally-fractionated radiotherapy (CFRT) for prostate cancer have varied considerably in intent (non-inferiority vs superiority) and MHFRT dose. We compare the efficacy and toxicity profiles of isodose MHFRT and dose-escalated MHFRT.

Methods: This was an individual patient data meta-analysis that identified randomised phase 3 trials of CFRT versus MHFRT that had published individual patient-level data on efficacy and late toxicity.

Large Language Models as Decision-Making Tools in Oncology: Comparing Artificial Intelligence Suggestions and Expert Recommendations.

Purpose: To determine the accuracy of large language models (LLMs) in generating appropriate treatment options for patients with early breast cancer on the basis of their medical records.

Materials And Methods: Retrospective study using anonymized medical records of patients with BC presented during multidisciplinary team meetings (MDTs) between January and April 2024. Three generalist artificial intelligence models (Claude3-Opus, GPT4-Turbo, and LLaMa3-70B) were used to generate treatment suggestions, which were compared with experts' decisions.

A comprehensive mechanistic study on the proton FLASH sparing effect in zebrafish embryos: From DNA damage to developmental abnormalities.

Background And Purpose: Ultra-high dose rate (UHDR) irradiation induces less normal tissues toxicities compared to conventional dose rate (CONV) irradiation. We aimed to assess whether UHDR and CONV proton irradiation result in different levels of DNA damage in zebrafish embryos. Moreover, we studied the downstream transcriptional activation and functional changes following both modalities.

Clinical practice in stereotactic radiotherapy delivery at treatment unit: a practitioner survey and consensus-based recommendations for multidisciplinary professional development.

Purpose: Stereotactic radiation therapy (SRT) is on the rise around the world. We aimed to provide recommendations to streamline and assess medical practices in SRT delivery at treatment unit, while complying with legal obligations concerning safety.

Materials And Methods: We conducted an online closed practice survey for heads of radiotherapy departments both nationally in comprehensive cancer centers and university hospitals throughout France, and internationally.

Radiotherapy quality assurance for the PEACE 1 trial: An individual case review analysis.

Purpose: Radiotherapy quality assurance (RTQA) is essential for ensuring adherence to trial protocols. This paper summarizes the individual case review (ICR) results from the PEACE-1 trial, a phase-III study investigates standard of care (androgen deprivation therapy with or without docetaxel) with or without local radiotherapy; and with or without abiraterone acetate plus prednisone in patients with metastatic hormone-sensitive prostate cancer (mHSPC).

Materials And Methods: Participating institutions submitted radiotherapy (RT) plans for central review, assessing protocol compliance in target volume and organs at risk (OARs) delineation, as well as dose specifications.

Results of Stereotactic Body Radiation Therapy for Primary Renal Cell Carcinoma in a Large Multicenter Series.

Background And Objective: For inoperable patients, stereotactic body radiation therapy (SBRT) is a noninvasive treatment approach for primary renal cell carcinoma (RCC). We aimed to evaluate local control (LC) of primary RCC treated with SBRT.

Methods: This multicenter retrospective study involved 16 centers in Australia, France, Italy, and the Netherlands.

Patterns of Relapse Following Radiation Therapy of Intermediate-Risk Prostate Cancer in the PROFIT Randomized Trial.

Purpose: Conventionally fractionated radiation therapy (CFRT) and hypofractionated RT (HFRT) are established treatments for intermediate-risk (IR) prostate cancer (PCa), with differing dose per fraction. However, their comparative patterns of failure remain unclear. This stuy aims to analyze the distinct relapse patterns of HFRT versus CFRT in terms of local progression-free survival (LPFS), pelvic lymph node metastasis-free survival (pnMFS), extrapelvic lymph node MFS (epnMFS), and bone MFS (bMFS).

Urethra-sparing prostate cancer radiotherapy: Current practices and future insights from an international survey.

Purpose: In prostate cancer patients, high radiation doses to the urethra have been associated with an increased risk of severe genitourinary toxicity following dose-escalated radiotherapy. Urethra-sparing techniques have emerged as a promising approach to reduce urinary toxicity. This international survey aims to evaluate current global practices in urethra-sparing and explore future directions for the implementation of this technique in external beam radiotherapy (EBRT) for prostate cancer.

French AFU Cancer Committee Guidelines - Update 2024-2026: Prostate cancer - Management of metastatic disease and castration resistance.

Purpose Of This Document: The Oncology Committee of the French Urology Association is proposing updated recommendations for the management of recurrent and/or metastatic prostate cancer (PCa).

Methods: A systematic review of the literature from 2022 to 2024 was conducted by the CCAFU on the therapeutic management of recurrent PCa following local or metastatic treatment, assessing the references based on their level of evidence.

Results: Molecular imaging is the standard approach for assessing recurrence after local treatment and should not delay early salvage treatment.