Artificial intelligence in breast cancer radiotherapy: Insights from the Toolbox Consortium Delphi study.

Artificial intelligence (AI) is being incorporated in several breast cancer care domains, including for radiation therapy (RT). Herein we provide a review about AI for the management and planning of RT for breast cancer, which is part of the Toolbox-3 project's multidisciplinary Delphi study, including a literature review of studies related to the topic raised by the Delphi questionnaire. Our review shows that available evidence mainly consists of small single institutional studies, often at least partly supported by commercial companies.

Study design and rationale of the AZIMUTH trial: a smartphone, app-based, E-health-integrated model of care for heart failure patients.

Aims: Despite advancements in disease-modifying therapies, the rate of hospitalizations in patients with heart failure (HF) remains high, with an increased risk of future adverse events and healthcare costs. In this context, the AZIMUTH study aims to evaluate the large-scale applicability of a smartphone app-based model of care to improve the quality of care and clinical outcomes of HF patients.

Methods And Results: The AZIMUTH trial is a multicentre, prospective, pragmatic, interventional, single-cohort study enrolling HF patients.

Artificial Intelligence and Rectal Cancer: Beyond Images.

The variability of cancers and medical big data can be addressed using artificial intelligence techniques. Artificial intelligence models can accept different input types, including images as well as other formats such as numerical data, predefined categories, and free text. Non-image sources are as important as images in clinical practice and the literature; nevertheless, the secondary literature tends to focus exclusively on image-based inputs.

Simultaneous integrated boost intensity-modulated radiotherapy for treatment of bone metastases: analysis of a breast cancer cohort.

Background: Bone metastases occur in up to 75% of metastatic breast cancer (MBC) cases. Advances in imaging now allow earlier detection, even during the oligometastatic phase. Radiotherapy (RT) is increasingly used in asymptomatic patients with ≤5 bone lesions, however standardised guidelines for dose and target volumes remain lacking.

Radiomic-based models are able to predict the pathologic response to different neoadjuvant chemotherapy regimens in patients with gastric and gastroesophageal cancer: a cohort study.

Background: There is a clinical need to identify early predictors for response to neoadjuvant chemotherapy (NAC) in patients with gastric and gastroesophageal junction cancer (GC and GEJC). Radiomics involves extracting quantitative features from medical images. This study aimed to apply radiomics to build prediction models for the response to NAC.

Temporal trends in guideline-recommended medical therapy after an acute heart failure decompensation event: an observational analysis from Generator Heart Failure DataMart.

Objectives: To evaluate the trend of prescription of the four foundational therapies, and their impact on 30-day urgent re-admissions and all-cause death in patients with heart failure and reduced ejection fraction (HFrEF) following an acute decompensation event.

Design: Retrospective.

Setting: One tertiary referral centre.

The 2024 Assisi think tank on breast cancer: Focus on the use of a tumour bed boost after breast conserving therapy.

At the Fifth Assisi Think Tank Meeting (ATTM) on breast cancer, one key topic was the role of tumor bed boost in invasive breast cancer and ductal carcinoma in situ. The need for a tumor bed boost after whole breast irradiation is controversial. A literature review assessed boost indications, target volume definition, techniques, dose fractionation, and ongoing trials.

Environmental maternal exposures and the risk of premature birth and intrauterine growth restriction: The Generation Gemelli study protocol of newborn exposome.

Background: The study of women exposures and child outcomes occurring in the first 1,000 days of life since conception enhances understanding of the relationships between environmental factors, epigenetic changes, and disease development, extending beyond childhood and spanning the entire lifespan. Generation Gemelli is a recently launched case-control study that enrolls mother-newborns pairs in one of the largest university hospitals in Italy, in order to examine the association between maternal environmental exposures and intrauterine growth restriction (IUGR) and the risk of premature birth. The study will also evaluate the association of maternal exposures and the health and growth of infants and children up to 24 months of age.

Biomarker-Directed Radiotherapy in Breast Cancer: A Narrative Review.

Importance: Integration of molecular biomarker information into systemic therapy has become standard practice in breast cancer care. However, its implementation in guiding radiotherapy (RT) is slower. Although postoperative RT is recommended for most patients after breast-conserving surgery and, depending on risk factors, following mastectomy, emerging evidence has indicated that patients with low scores on gene expression signatures or selected clinical-pathological features may have very low local recurrence rates.

Artificial intelligence applications in personalizing lung cancer management: state of the art and future perspectives.

Lung cancer is still a leading cause of cancer-related deaths worldwide. Vital to ameliorating patient survival rates are early detection, precise evaluation, and personalized treatments. Recent years have witnessed a profound transformation in the field, marked by intricate diagnostic processes and intricate therapeutic protocols that integrate diverse omics domains, heralding a paradigm shift towards personalized and preventive healthcare.

Resilience and spiritual well-being as resources for coping with radiotherapy and surviving in patients with glioblastoma.

Objectives: The primary aims of this multicenter, prospective observational study were to investigate spiritual well-being, resilience, and psychosocial distress in an Italian sample of glioblastoma patients undergoing radiochemotherapy. The secondary aim was to explore the influence of demographic, clinical, and psychological characteristics on survival.

Methods: The assessment was conducted only once, within the first week of radiochemotherapy treatment.

Allies not enemies-creating a more empathetic and uplifting patient experience through technology and art.

Objective: To understand whether art and technology (mainly conversational agents) may help oncology patients to experience a more humanized journey.

Methods: This narrative review encompasses a comprehensive examination of the existing literature in this field by a multicenter, multidisciplinary, and multiprofessional team aiming to analyze the current developments and potential future directions of using art and technology for patient engagement.

Results: We identified three major themes of patient engagement with art and three major themes of patient engagement with technologies.

Outcomes of Radiotherapy in Oligoprogressive Breast Cancer.

Introduction: Radiotherapy (RT) shows potential for improving local control in cases of oligoprogressive metastatic breast cancer (mBC). This retrospective analysis aims to evaluate the advantages of RT in such a clinical scenario.

Methods: We conducted a retrospective analysis including patients with mBC who received radiation therapy (RT) for up to three sites of oligoprogression while continuing systemic therapy.

Artificial intelligence to predict individualized outcome of acute ischemic stroke patients: The SIBILLA project.

Introduction: Formulating reliable prognosis for ischemic stroke patients remains a challenging task. We aimed to develop an artificial intelligence model able to formulate in the first 24 h after stroke an individualized prognosis in terms of NIHSS.

Patients And Methods: Seven hundred ninety four acute ischemic stroke patients were divided into a training (597) and testing (197) cohort.

Post-traumatic growth in oncological patients during the COVID-19 pandemic.

Background: Post-traumatic growth (PTG) is defined as "positive psychological change experienced as a result of the struggle with highly challenging life circumstances". Diagnosis of cancer leads to many psychological challenges. The recent pandemic forced oncological patients to face other multiple stressors.

Radiomics-enhanced early regression index for predicting treatment response in rectal cancer: a multi-institutional 0.35 T MRI-guided radiotherapy study.

Purpose: The accurate prediction of treatment response in locally advanced rectal cancer (LARC) patients undergoing MRI-guided radiotherapy (MRIgRT) is essential for optimising treatment strategies. This multi-institutional study aimed to investigate the potential of radiomics in enhancing the predictive power of a known radiobiological parameter (Early Regression Index, ERI) to evaluate treatment response in LARC patients treated with MRIgRT.

Methods: Patients from three international sites were included and divided into training and validation sets.

Brachyterapy: The radiation oncologist opinion.

The role of the radiation oncologist in the management of patients affected by prostate cancer is increasingly considered thanks to important technological innovations that have marked the radiotherapeutic approach in its three main fields: external beam radiotherapy (EB-RT), brachytherapy (interventional radiotherapy, I-RT), and metabolic radiotherapy (M-RT) through the use of new radiopharmaceuticals. Regarding the modern brachytherapy, the introduction of intensity-modulated techniques (IM-IRT), thanks to the implementation of HDR remote-after loading machines, and image-guided techniques (IG-IRT), has led to advantages in optimizing dose distribution after implantation with the possibility of modulating the dose according to the intraprostatic dominant lesions, limiting the dose to the surrounding tissues with improvement in local control and a significant reduction in side effects. I-RT today represents a safe, scientifically established, effective and well-tolerated treatment for patients affected by prostate cancer.

The Image Biomarker Standardization Initiative: Standardized Convolutional Filters for Reproducible Radiomics and Enhanced Clinical Insights.

Filters are commonly used to enhance specific structures and patterns in images, such as vessels or peritumoral regions, to enable clinical insights beyond the visible image using radiomics. However, their lack of standardization restricts reproducibility and clinical translation of radiomics decision support tools. In this special report, teams of researchers who developed radiomics software participated in a three-phase study (September 2020 to December 2022) to establish a standardized set of filters.

Magnetic resonance imaging for assessment of rectal cancer nodes after chemoradiotherapy: A single center experience.

Background: Accurate nodal restaging is becoming clinically more important in patients with locally advanced rectal cancer (LARC) with the emergence of organ-preserving treatment after a good response to neoadjuvant chemoradiotherapy (nCRT).

Purpose: To evaluate the accuracy of MRI in identifying negative N status (ypN0 patients) in LARC after nCRT.

Material And Methods: 191 patients with LARC underwent MRI before and 6-8 weeks after nCRT and subsequent total mesorectal excision.