Erratum to:J Huazhong Univ Sci Technol[Med Sci]36(4):548–553,2016 https://doi.org/10.1007/s11596-016-1623-6 In the originally published article(https://doi.org/10.1007/s11596-016-1623-6),the immunofluorescence images...Erratum to:J Huazhong Univ Sci Technol[Med Sci]36(4):548–553,2016 https://doi.org/10.1007/s11596-016-1623-6 In the originally published article(https://doi.org/10.1007/s11596-016-1623-6),the immunofluorescence images in shRNA group in Fig.3 were accidentally used rather than the final,formal experiments.To retain consistency,the entire Fig.3 is replaced here with original images of the experiments.The authors declare that this correction will not affect the conclusion of the study.展开更多
Radiomics and machine learning(ML)are increasingly utilized to predict treatment response by uncovering latent information in medical images.This study systematically reviews radiomics studies on brain metastasis trea...Radiomics and machine learning(ML)are increasingly utilized to predict treatment response by uncovering latent information in medical images.This study systematically reviews radiomics studies on brain metastasis treated with stereotactic radio-surgery(SRS)and quantifies their radiomic quality score(RQS).A systematic search on Scopus,Web of Science,and PubMed was conducted to identify original studies on radiomics for predicting treatment response,adhering to predefined patient,intervention,comparator,and outcome(PICO)criteria.No restrictions were placed on language or publication date.Two in-dependent reviewers assessed eligible studies,and the RQS was calculated based on Lambin’s guidelines.The Preferred Reporting Items for Systematic Review and Meta-Analysis(PRISMA)2020 guidelines were followed.Seventeen studies involving 2744 patients met the inclusion criteria out of 200 identified.All studies were retrospective and utilizing various MRI scanners models with different field strength.The average RQS across studies was low(39.2%),with a maximum score of 19 points(52.7%).Radiomic-based models demonstrated superior predictive accuracy compared to clinical or visual assessment,with AUC values ranging from 0.74 to 0.92.Integration of clinical features such as Karnofsky performance status,dose,and isodose line further improved model performance.Deep learning models achieved the highest predictive accuracy,with AUC of 0.92.Radiomics demonstrate significant potential in predicting treatment outcomes with high accuracy,offering opportunities to advance personalized management for BM.To facilitate clinical adoption,future studies must prioritize adherence to standardized guidelines and robust model validation to ensure reproducibility.展开更多
Lung cancer,particularly non-small cell lung cancer(NSCLC),remains a leading cause of cancer-related death globally,and a significant number of patients develop brain metastasis(BM)as the disease progresses.The presen...Lung cancer,particularly non-small cell lung cancer(NSCLC),remains a leading cause of cancer-related death globally,and a significant number of patients develop brain metastasis(BM)as the disease progresses.The presence of BM,which affects up to 60%of patients with NSCLC,is correlated with an unfavorable prognosis and markedly decreased quality of life.Standard treatment options for BMs,such as whole-brain radiation therapy and surgery,have displayed limited efficacy in controlling disease progression,and they can cause significant neurocognitive side effects.Stereotactic radiotherapy(SRT),including stereotactic radiosurgery,fractionated SRT,and stereotactic body radiotherapy,represents an advanced and precise approach for treating BM that minimizes damage to surrounding healthy tissues.This review highlights recent advances in the application of SRT for treating BM of NSCLC,focusing on its underlying biological principles and mechanisms of action as well as the quality standards necessary for effective SRT implementation.The ability of SRT to deliver substantial radiation doses in a precisely targeted manner has resulted in better local tumor management,fewer side effects,and increased patient survival rates.Future research is crucial to improve SRT procedures and successfully incorporate them into multimodal therapy plans for patients with NSCLC and BM.展开更多
BACKGROUND For patients with unresectable hepatocellular carcinoma(HCC),both stereotactic body radiation therapy(SBRT)and transcatheter arterial chemoembolization(TACE)have demonstrated effectiveness in controlling lo...BACKGROUND For patients with unresectable hepatocellular carcinoma(HCC),both stereotactic body radiation therapy(SBRT)and transcatheter arterial chemoembolization(TACE)have demonstrated effectiveness in controlling local tumor growth.We investigated whether combining these treatments could provide better outcomes than TACE monotherapy.AIM To evaluate whether combining SBRT with TACE provides superior clinical outcomes compared to TACE alone in patients with unresectable HCC.METHODS We conducted a randomized study involving eighty patients diagnosed with unresectable HCC,classified as Barcelona Clinic Liver Cancer stage B and Child-Pugh class A.Participants were divided into two treatment arms:A control group receiving TACE alone(Group A)and an experimental group receiving sequential TACE and SBRT(Group B).The SBRT regimen consisted of 40 Gy administered in five daily fractions over one week.Primary endpoints included local control,progression-free survival(PFS),and overall survival(OS),with secondary endpoints focusing on toxicity profiles.Additional analyses explored the impact of different SBRT dose levels.RESULTS The study enrolled 88 patients from April 2021 to January 2023,with 48 assigned to Group A and 40 to Group B.Over a median follow-up period of 20 months,the combination therapy group demonstrated superior outcomes in both tumor control and disease progression metrics.Complete response rates reached 75%in Group B compared to 54.5%in Group A.The combination therapy extended median PFS to 16 months,significantly longer than the 11 months observed with TACE alone(P=0.003).Neither group had reached median OS by study conclusion.Importantly,both treatment approaches showed comparable safety profiles.CONCLUSION Our findings suggest that supplementing TACE with SBRT offers a well-tolerated and effective treatment strategy for advanced HCC patients.This combination approach achieved better tumor control and delayed disease progression compared to TACE monotherapy,while maintaining an acceptable safety profile.展开更多
A recent study by Zhang et al developed a neural network-based predictive model for estimating doses to the uninvolved liver during stereotactic body radiation therapy(SBRT)in liver cancer.The study reported a signifi...A recent study by Zhang et al developed a neural network-based predictive model for estimating doses to the uninvolved liver during stereotactic body radiation therapy(SBRT)in liver cancer.The study reported a significant advancement in personalized radiotherapy by improving accuracy and reducing treatment-related toxicity.The model demonstrated strong predictive performance with R-values above 0.8,indicating its potential to improve treatment consistency.However,concerns arise from the small sample size and exclusion criteria,which may limit generalizability.Future studies should incorporate larger,more diverse patient cohorts,explore potential confounding factors such as tumor characteristics and delivery technique variability,and address the long-term effects of SBRT.展开更多
Background:Small cell lung cancer(SCLC)is characterized by its aggressive nature and high propensity for brain metastases.This study investigates the clinical efficacy and safety profile of Anlotinib in combination wi...Background:Small cell lung cancer(SCLC)is characterized by its aggressive nature and high propensity for brain metastases.This study investigates the clinical efficacy and safety profile of Anlotinib in combination with Stereotactic Radiotherapy(SRT)for treating brain metastases in patients with small cell lung cancer(SCLC).Methods:This research included 98 SCLC brain metastasis patients treated at Chengde Central Hospital from October 2020 to January 2024.The patients were categorized into a combined treatment group(CTG)(n=45)and a Simple SRT group(SSG)(n=53).The CTG(58 lesions)received Anlotinib with brain SRS,while the SSG(67 lesions)underwent only brain SRS.We compared the rates of intracranial hypertension relief,intracranial lesion treatment efficacy,radiation-induced brain necrosis,intracranial progression-free survival,and overall survival between the groups.Additionally,Anlotinib usage and adverse reactions in the CTG were documented.Results:Intracranial hypertension relief was significantly higher in the CTG at 80.0%(36/45)compared to 11.3%(6/53)in the SSG(p<0.001).Radiation-induced brain necrosis occurred in 3.4%(2/58)of the CTG,markedly less than the 20.9%(14/67)in the SSG,indicating a significant difference(χ^(2)=8.479,p=0.004).Effective intracranial lesion treatment rates were 86.7%(39/45)in the CTG and 62.3%(33/53)in the SSG,with a notable difference(χ^(2)=7.951,p=0.047).The median intracranial progression-free survival was 7.8 months in the CTG vs.4.8 months in the SSG(p<0.0001).Median overall survival times were 11.3 months for the CTG and 7.8 months for the SSG(p=0.3506).The duration of Anlotinib treatment in the CTG was 6(6,18)weeks.Adverse reactions included Grade I hypertension in three patients and Grade I hand-foot skin reactions in two patients,with a drug-related adverse reaction rate of 11.1%(5/45).Conclusion:Anlotinib combined with SRT significantly alleviates brain edema,reduces the incidence of radiation-induced brain necrosis,enhances intracranial progression-free survival,and demonstrates a low adverse reaction rate.展开更多
BACKGROUND About 35%-50%of patients with hepatocellular cancer(HCC)present with portal venous tumor thrombosis(PVTT).Stereotactic body radiation therapy(SBRT)offers a promising approach for locoregional treatment in p...BACKGROUND About 35%-50%of patients with hepatocellular cancer(HCC)present with portal venous tumor thrombosis(PVTT).Stereotactic body radiation therapy(SBRT)offers a promising approach for locoregional treatment in patients with HCC with PVTT.This study aimed to report the clinical characteristics and early outcomes of patients with unresectable HCC and PVTT treated with SBRT.AIM To report the clinical characteristics and early outcomes of patients with unresectable HCC and PVTT treated with SBRT.METHODS This retrospective,single-institution study included adult HCC patients with PVTT treated between March 2020 and December 2023.Eligibility criteria included Child-Pugh A-B liver function,serum bilirubin<3 mg/dL,Eastern Co-operative Oncology Group performance status 0-2,a normal liver volume>700 cc,and a tumor-lumen distance>5 mm.SBRT dose and fractionation were determined based on tumor volume and organ-at-risk constraints.Baseline clinical and dosimetric parameters were recorded.Survival analysis was performed using Kaplan-Meier curves,response was assessed at 3 months post-SBRT using the Revised Response Evaluation Criteria in Solid Tumors 1.1 criteria,and toxicity was graded per Common Terminology Criteria for Adverse Events 4.0.RESULTS Thirty patients(median age:65 years,90%male)were included.Sixteen(53.3%)were Child-Pugh A,and fourteen(46.6%)were Child-Pugh B.Sixty percent had VP4 disease.SBRT doses ranged from 30-50 Gy in 5-6 fractions.The median tumor diameter was 6.1 cm,and the median follow-up was 15 months.The overall response rate was 83.3%,with a median overall survival of 13 months and progression-free survival of 10.2 months.No grade 4 toxicities were observed.CONCLUSION SBRT has the potential to be an effective modality for locoregional control in patients with unresectable HCC with PVTT.展开更多
Objective:To analyze the therapeutic effect and prognosis of frameless stereotactic soft channel intracranial hematoma evacuation for severe basal ganglia hemorrhage.Methods:Clinical data of 411 patients with severe b...Objective:To analyze the therapeutic effect and prognosis of frameless stereotactic soft channel intracranial hematoma evacuation for severe basal ganglia hemorrhage.Methods:Clinical data of 411 patients with severe basal ganglia hemorrhage admitted to the Neurological Intensive Care Unit of Linyi People’s Hospital from January 2020 to December 2021 were collected.According to the modified Rankin Scale(mRS)score at 180 days after onset,the patients were divided into the good prognosis group and the poor prognosis group.The therapeutic effect of frameless stereotactic soft channel intracranial hematoma evacuation on severe basal ganglia hemorrhage was explored,and the influencing factors of prognosis were analyzed.Results:Multivariate Logistic regression analysis showed that the admission Glasgow Coma Scale(GCS)score was an independent protective factor for the prognosis of patients with severe basal ganglia hemorrhage,while age,preoperative hematoma volume,random blood glucose level,and mechanical ventilation were independent risk factors.Conclusion:Frameless stereotactic soft channel intracranial hematoma evacuation has a good therapeutic effect on severe basal ganglia hemorrhage.However,it is necessary to screen the patients’basic information before surgery and provide medical care based on their specific conditions to promote their rapid recovery.展开更多
1文献来源AIZER A A,TANGUTURI S K,SHI D D,et al.Stereotactic radiosurgery in patients with small cell lung cancer and 1-10 brain metastases:a multi-institutional,phaseⅡ,prospective clinical trial[J].J Clin Oncol,2025,...1文献来源AIZER A A,TANGUTURI S K,SHI D D,et al.Stereotactic radiosurgery in patients with small cell lung cancer and 1-10 brain metastases:a multi-institutional,phaseⅡ,prospective clinical trial[J].J Clin Oncol,2025,43(27):2986−2997.doi:10.1200/JCO.25-00056.展开更多
Objective： To investigate the treatment effectiveness and side effects of stereotactic radiotherapy for brain glioma. Methods： From Jun. 1995 to Dec. 1998, 389 cases of brain gliomas were treated by stereotactic rad...Objective： To investigate the treatment effectiveness and side effects of stereotactic radiotherapy for brain glioma. Methods： From Jun. 1995 to Dec. 1998, 389 cases of brain gliomas were treated by stereotactic radiotherapy, among which 151 cases were treated by stereotactic radiosurgery （SRS） and the other 238 cases, by fractionated stereotactic radiotherapy （FSRT）. In the SRS group, the marginal tumor dose was 20 to 30 Gy （median, 2.6 Gy）. One to 6 isocenters （median, 2.48） and 5 to 21 irradiation arcs （median, 8.45） were applied. In the FSRT group, the per-fraction marginal tumor dose was 8 to 12 Gy with 1 to 6 isocenters （median, 2.53）, 6 to 20 irradiation arcs （median, 8.25） and 2-5 fractions delivered everyday or every other day. Results： Three months after treatment, the complete and partial response rates were 13.9% and 45.7% in SRS group respectively. The stable disease rate was 17.2%. The total effective rate was 76.8%. In FSRT group, the complete and partial remission rates were 19.7% and 47.9% respectively. The stable disease rate was 20.6%. The total effective rate was 88.2%. The total effective rate of FSRT group was higher than that in SRS group （X^2=9.874, P=0.020）. The 1-year, 3-year and 5-year survival rate of all patients was 54.3%, 29.3%, 16.5% respectively. The 1-year, 3-year and 5-year survival rate in SRS group and FSRT group was 52.3% vs 26.5%, 11.9% vs 55.5%, and 31.1 vs 19.3% respectively. There was no significant difference between the two groups （X^2=2.16, P=0.1417）. The brain edema caused by the main radiation was more severe in the SRS group than in FSRT group （X^2=4.916, P=0.027）. Conclusion： It is effective for brain glioma to be treated by stereotactic radiotherapy. Compared with SRS, the FSRT has the advantage of good effect and less side response.展开更多
Stereotactic body radiation therapy(SBRT)has a locacontrol rate of 95%at 2 years for non-small cell lungcancer(NSCLC)and should improve the prognosis oinoperable patients,elderly patients,and patients withsignificant ...Stereotactic body radiation therapy(SBRT)has a locacontrol rate of 95%at 2 years for non-small cell lungcancer(NSCLC)and should improve the prognosis oinoperable patients,elderly patients,and patients withsignificant comorbidities who have early-stage NSCLCThe safety of SBRT is being confirmed in internationalmulti-institutional PhaseⅡtrials for peripheral lungcancer in both inoperable and operable patients,bureports so far have found that SBRT is a safe and effective treatment for early-stage NSCLC and early metastatic lung cancer.Radiation pneumonitis(RP)is oneof the most common toxicities of SBRT.Although mospost-treatment RP is Grade 1 or 2 and either asymptomatic or manageable,a few cases are severe,symptomatic,and there is a risk for mortality.The reportedrates of symptomatic RP after SBRT range from 9%to28%.Being able to predict the risk of RP after SBRT isextremely useful in treatment planning.A dose-effecrelationship has been demonstrated,but suggesteddose-volume factors like mean lung dose,lung V20and/or lung V2.5 differed among the reports.We foundthat patients who present with an interstitial pneumo-nitis shadow on computed tomography scan and high levels of serum Krebs von den Lungen-6 and surfactant protein D have a high rate of severe radiation pneumo-nitis after SBRT.At our institution,lung cancer patients with these risk factors have not received SBRT since 2006,and our rate of severe RP after SBRT has de-creased significantly since then.展开更多
Stereotactic body radiation therapy(SBRT) is the treatment of choice for medically inoperable patients with early stage non-small cell lung cancer(NSCLC). A literature search primarily based on PubMed electronic datab...Stereotactic body radiation therapy(SBRT) is the treatment of choice for medically inoperable patients with early stage non-small cell lung cancer(NSCLC). A literature search primarily based on PubMed electronic databases was completed in July 2018. Inclusion and exclusion criteria were determined prior to the search, and only prospective clinical trials were included. Nineteen trials from 2005 to 2018 met the inclusion criteria, reporting the outcomes of 1434 patients with central and peripheral early stage NSCLC. Patient eligibility,prescription dose and delivery, and follow up duration varied widely. Threeyears overall survival ranged from 43% to 95% with loco-regional control of up to 98% at 3 years. Up to 33% of patients failed distantly after SBRT at 3 years. SBRT was generally well tolerated with 10%-30% grade 3-4 toxicities and a few treatment-related deaths. No differences in outcomes were observed between conventionally fractionated radiation therapy and SBRT, central and peripheral lung tumors, or inoperable and operable patients. SBRT remains a reasonable treatment option for medically inoperable and select operable patients with early stage NSCLC. SBRT has shown excellent local and regional control with toxicity rates equivalent to surgery. Decreasing fractionation schedules have been consistently shown to be both safe and effective. Distant failure is common, and chemotherapy may be considered for select patients. However, the survival benefit of additional interventions, such as chemotherapy, for early stage NSCLC treated with SBRT remains unclear.展开更多
BACKGROUND Stereotactic body radiotherapy(SBRT)and programmed cell death 1 inhibitors have shown potential in treating hepatocellular carcinoma(HCC)in retrospective studies.AIM To evaluate the efficacy of combining SB...BACKGROUND Stereotactic body radiotherapy(SBRT)and programmed cell death 1 inhibitors have shown potential in treating hepatocellular carcinoma(HCC)in retrospective studies.AIM To evaluate the efficacy of combining SBRT with sintilimab for patients with recurrent or oligometastatic HCC.METHODS This trial involved patients with recurrent or oligometastatic HCC intravenously treated with SBRT plus sintilimab every 3 wk for 12 mo or until disease progression.The primary endpoint was progression-free survival(PFS).RESULTS Twenty-five patients were enrolled from August 14,2019,to August 23,2021.The median treatment duration was 10.2(range,0.7-14.6)months.SBRT was delivered at a median dose of 54(range,48-60)Gy in 6(range,6-10)fractions.The median follow-up time was 21.9(range,10.3-39.7)mo,and 32 targeted lesions among 25 patients were evaluated for treatment response according to the Response Evaluation Criteria in Solid Tumors version 1.1.The median PFS was 19.7 mo[95%confidence interval(CI):16.9-NA],with PFS rates of 68%(95%CI:52-89)and 45.3%(95%CI:28-73.4)at 12 and 24 mo,respectively.The median overall survival(OS)was not reached,with OS rates of 91.5%(95%CI:80.8-100.0)and 83.2%(95%CI:66.5-100.0)at 12 and 24 mo,respectively.The 1-and 2-year local control rate were 100%and 90.9%(95%CI:75.4%-100.0%),respectively.The confirmed objective response rate and disease control rate was 96%,and 96%,respectively.Most adverse events were graded as 1 or 2,and grade 3 adverse events were observed in three patients.CONCLUSION SBRT plus sintilimab is an effective,well-tolerated treatment regimen for patients with recurrent or oligometastatic HCC.展开更多
The integration of new technologies has raised an interest in liver tumor radiotherapy,with literature evolving to support its efficacy.These advances,particularly stereotactic body radiation therapy(SBRT),have been c...The integration of new technologies has raised an interest in liver tumor radiotherapy,with literature evolving to support its efficacy.These advances,particularly stereotactic body radiation therapy(SBRT),have been critical in improving local control or potential cure in liver lesions not amenable to first-line surgical resection or radiofrequency ablation.Active investigation of SBRT,particularly for hepatocellular carcinoma(HCC),has recently started,yielding promising local control rates.In addition,data suggest a possibility that SBRT can be an alternative option for HCC unfit for other local therapies.However,information on optimal treatment indications,doses,and methods remains limited.In HCC,significant differences in patient characteristics and treatment availability exist by country.In addition,the prognosis of HCC is greatly influenced by underlying liver dysfunction and treatment itself in addition to tumor stage.Since they are closely linked to treatment approach,it is important to understand these differences in interpreting outcomes from various reports.Further studies are required to validate and maximize the efficacy of SBRT by a large,multi-institutional setting.展开更多
Systemic chemotherapy has enabled prolongation of survival in patients with stage IV colorectal cancer. This has subsequently increased the relative significance of local therapy for patients with oligometastases beca...Systemic chemotherapy has enabled prolongation of survival in patients with stage IV colorectal cancer. This has subsequently increased the relative significance of local therapy for patients with oligometastases because they can be cured by removal of oligometastatic lesions. One of the most frequently reported tumor histologies for oligometastases is colorectal cancer. Resection is the standard therapy in most settings of oligometastases. Recently, studies have shown that stereotactic body radiotherapy (SBRT) may become a treatment option that provides high local control with minimal morbidity. Two-year local control rates following SBRT for hepatic and pulmonary oligometastases are almost over 80% and are even higher for patients treated with high-dose regimens. The indications of SBRT for other metastatic sites or conditions include isolated lymph nodes, spinal and adrenal metastasis, and post-surgical pelvic recurrence. Many retrospective studies have indicated that SBRT for various lesions results in good outcomes with low morbidity, both in the curative and palliative setting. However, few reports with a high level of evidence have indicated the efficacy of SBRT compared to standard therapy. Hereafter, the optimal indication of SBRT needs to be prospectively investigated to obtain convincing evidence.展开更多
BACKGROUND Pancreatic cancer is a malignancy with one of the poorest prognoses amongst all cancers.Patients with unresectable tumours either receive palliative care or undergo various chemoradiotherapy regimens.Conven...BACKGROUND Pancreatic cancer is a malignancy with one of the poorest prognoses amongst all cancers.Patients with unresectable tumours either receive palliative care or undergo various chemoradiotherapy regimens.Conventional techniques are often associated with acute gastrointestinal toxicities,as adjacent critical structures such as the duodenum ultimately limits delivered doses.Stereotactic body radiotherapy(SBRT)is an advanced radiation technique that delivers highly ablative radiation split into several fractions,with a steep dose fall-off outside target volumes.AIM To discuss the latest data on SBRT and whether there is a role for magnetic resonance-guided techniques in multimodal management of locally advanced,unresectable pancreatic cancer.METHODS We conducted a search on multiple large databases to collate the latest records on radiotherapy techniques used to treat pancreatic cancer.Out of 1229 total records retrieved from our search,36 studies were included in this review.RESULTS Studies indicate that SBRT is associated with improved clinical efficacy and toxicity profiles compared to conventional radiotherapy techniques.Further dose escalation to the tumour with SBRT is limited by the poor soft-tissue visualisation of computed tomography imaging during radiation planning and treatment delivery.Magnetic resonance-guided techniques have been introduced to improve imaging quality,enabling treatment plan adaptation and re-optimisation before delivering each fraction.CONCLUSION Therefore,SBRT may lead to improved survival outcomes and safer toxicity profiles compared to conventional techniques,and the addition of magnetic resonance-guided techniques potentially allows dose escalation and conversion of unresectable tumours to operable cases.展开更多
BACKGROUND Graft hepatocellular carcinoma(HCC)recurrence after liver transplant is more frequently encountered.Graft hepatectomy is technically challenging and is associated with high morbidity.Stereotactic body radia...BACKGROUND Graft hepatocellular carcinoma(HCC)recurrence after liver transplant is more frequently encountered.Graft hepatectomy is technically challenging and is associated with high morbidity.Stereotactic body radiation therapy(SBRT)has been shown to be safe and effective for the treatment of primary HCC.However,its role in HCC recurrence in a liver graft remains unclear.AIM To evaluate the safety and efficacy of SBRT for the treatment of graft HCC recurrence after liver transplantation.METHODS A retrospective study was conducted.From 2012 to 2018,6 patients with intrahepatic HCC recurrence after liver transplant were treated with SBRT at Queen Mary Hospital,the University of Hong Kong.The primary outcome was time to overall disease progression and secondary outcomes were time to local progression and best local response,as assessed with the Modified response Evaluation Criteria for Solid Tumours criteria.Patients were monitored for treatment related toxicities and graft dysfunction.RESULTS A total of 9 treatment courses were given for 13 tumours.The median tumour size was 2.3 cm(range 0.7-3.6 cm).Two(22%)patients had inferior vena cava tumour thrombus.The best local treatment response was:5(55%)complete response,1(11%)partial response and 3(33%)stable disease.After a median follow up duration of 15.5 mo,no local progression or mortality was yet observed.The median time to overall disease progression was 6.5 mo.There were 6 regional progression in the liver graft(67%)and 2 distant progression in the lung(22%).There was no grade 3 or above toxicity and there was no graft dysfunction after SBRT.CONCLUSION SBRT appears to be safe in this context.Regional progression is the mode of failure.展开更多
文摘Erratum to:J Huazhong Univ Sci Technol[Med Sci]36(4):548–553,2016 https://doi.org/10.1007/s11596-016-1623-6 In the originally published article(https://doi.org/10.1007/s11596-016-1623-6),the immunofluorescence images in shRNA group in Fig.3 were accidentally used rather than the final,formal experiments.To retain consistency,the entire Fig.3 is replaced here with original images of the experiments.The authors declare that this correction will not affect the conclusion of the study.
文摘Radiomics and machine learning(ML)are increasingly utilized to predict treatment response by uncovering latent information in medical images.This study systematically reviews radiomics studies on brain metastasis treated with stereotactic radio-surgery(SRS)and quantifies their radiomic quality score(RQS).A systematic search on Scopus,Web of Science,and PubMed was conducted to identify original studies on radiomics for predicting treatment response,adhering to predefined patient,intervention,comparator,and outcome(PICO)criteria.No restrictions were placed on language or publication date.Two in-dependent reviewers assessed eligible studies,and the RQS was calculated based on Lambin’s guidelines.The Preferred Reporting Items for Systematic Review and Meta-Analysis(PRISMA)2020 guidelines were followed.Seventeen studies involving 2744 patients met the inclusion criteria out of 200 identified.All studies were retrospective and utilizing various MRI scanners models with different field strength.The average RQS across studies was low(39.2%),with a maximum score of 19 points(52.7%).Radiomic-based models demonstrated superior predictive accuracy compared to clinical or visual assessment,with AUC values ranging from 0.74 to 0.92.Integration of clinical features such as Karnofsky performance status,dose,and isodose line further improved model performance.Deep learning models achieved the highest predictive accuracy,with AUC of 0.92.Radiomics demonstrate significant potential in predicting treatment outcomes with high accuracy,offering opportunities to advance personalized management for BM.To facilitate clinical adoption,future studies must prioritize adherence to standardized guidelines and robust model validation to ensure reproducibility.
基金Supported by the National Key Research and Development Program of China,No.2022YFE0110200Project of Science and Technology Department of Jilin Province,No.20240501002GH and No.YDZJ202102CXJD020+3 种基金Jilin University Norman Bethune Medical Department“Medicine+X”Project,No.2022JBGS04Project of Development and Reform Commission of Jilin Province,No.2021C023Department of Human Resources and Social Security Project of Jilin Province20th Batch of Innovation and Entrepreneurship Talent Funding Project of Jilin Province.
文摘Lung cancer,particularly non-small cell lung cancer(NSCLC),remains a leading cause of cancer-related death globally,and a significant number of patients develop brain metastasis(BM)as the disease progresses.The presence of BM,which affects up to 60%of patients with NSCLC,is correlated with an unfavorable prognosis and markedly decreased quality of life.Standard treatment options for BMs,such as whole-brain radiation therapy and surgery,have displayed limited efficacy in controlling disease progression,and they can cause significant neurocognitive side effects.Stereotactic radiotherapy(SRT),including stereotactic radiosurgery,fractionated SRT,and stereotactic body radiotherapy,represents an advanced and precise approach for treating BM that minimizes damage to surrounding healthy tissues.This review highlights recent advances in the application of SRT for treating BM of NSCLC,focusing on its underlying biological principles and mechanisms of action as well as the quality standards necessary for effective SRT implementation.The ability of SRT to deliver substantial radiation doses in a precisely targeted manner has resulted in better local tumor management,fewer side effects,and increased patient survival rates.Future research is crucial to improve SRT procedures and successfully incorporate them into multimodal therapy plans for patients with NSCLC and BM.
文摘BACKGROUND For patients with unresectable hepatocellular carcinoma(HCC),both stereotactic body radiation therapy(SBRT)and transcatheter arterial chemoembolization(TACE)have demonstrated effectiveness in controlling local tumor growth.We investigated whether combining these treatments could provide better outcomes than TACE monotherapy.AIM To evaluate whether combining SBRT with TACE provides superior clinical outcomes compared to TACE alone in patients with unresectable HCC.METHODS We conducted a randomized study involving eighty patients diagnosed with unresectable HCC,classified as Barcelona Clinic Liver Cancer stage B and Child-Pugh class A.Participants were divided into two treatment arms:A control group receiving TACE alone(Group A)and an experimental group receiving sequential TACE and SBRT(Group B).The SBRT regimen consisted of 40 Gy administered in five daily fractions over one week.Primary endpoints included local control,progression-free survival(PFS),and overall survival(OS),with secondary endpoints focusing on toxicity profiles.Additional analyses explored the impact of different SBRT dose levels.RESULTS The study enrolled 88 patients from April 2021 to January 2023,with 48 assigned to Group A and 40 to Group B.Over a median follow-up period of 20 months,the combination therapy group demonstrated superior outcomes in both tumor control and disease progression metrics.Complete response rates reached 75%in Group B compared to 54.5%in Group A.The combination therapy extended median PFS to 16 months,significantly longer than the 11 months observed with TACE alone(P=0.003).Neither group had reached median OS by study conclusion.Importantly,both treatment approaches showed comparable safety profiles.CONCLUSION Our findings suggest that supplementing TACE with SBRT offers a well-tolerated and effective treatment strategy for advanced HCC patients.This combination approach achieved better tumor control and delayed disease progression compared to TACE monotherapy,while maintaining an acceptable safety profile.
文摘A recent study by Zhang et al developed a neural network-based predictive model for estimating doses to the uninvolved liver during stereotactic body radiation therapy(SBRT)in liver cancer.The study reported a significant advancement in personalized radiotherapy by improving accuracy and reducing treatment-related toxicity.The model demonstrated strong predictive performance with R-values above 0.8,indicating its potential to improve treatment consistency.However,concerns arise from the small sample size and exclusion criteria,which may limit generalizability.Future studies should incorporate larger,more diverse patient cohorts,explore potential confounding factors such as tumor characteristics and delivery technique variability,and address the long-term effects of SBRT.
基金supported by the Science and Technology Program of Chengde(Project Number:202301A016).
文摘Background:Small cell lung cancer(SCLC)is characterized by its aggressive nature and high propensity for brain metastases.This study investigates the clinical efficacy and safety profile of Anlotinib in combination with Stereotactic Radiotherapy(SRT)for treating brain metastases in patients with small cell lung cancer(SCLC).Methods:This research included 98 SCLC brain metastasis patients treated at Chengde Central Hospital from October 2020 to January 2024.The patients were categorized into a combined treatment group(CTG)(n=45)and a Simple SRT group(SSG)(n=53).The CTG(58 lesions)received Anlotinib with brain SRS,while the SSG(67 lesions)underwent only brain SRS.We compared the rates of intracranial hypertension relief,intracranial lesion treatment efficacy,radiation-induced brain necrosis,intracranial progression-free survival,and overall survival between the groups.Additionally,Anlotinib usage and adverse reactions in the CTG were documented.Results:Intracranial hypertension relief was significantly higher in the CTG at 80.0%(36/45)compared to 11.3%(6/53)in the SSG(p<0.001).Radiation-induced brain necrosis occurred in 3.4%(2/58)of the CTG,markedly less than the 20.9%(14/67)in the SSG,indicating a significant difference(χ^(2)=8.479,p=0.004).Effective intracranial lesion treatment rates were 86.7%(39/45)in the CTG and 62.3%(33/53)in the SSG,with a notable difference(χ^(2)=7.951,p=0.047).The median intracranial progression-free survival was 7.8 months in the CTG vs.4.8 months in the SSG(p<0.0001).Median overall survival times were 11.3 months for the CTG and 7.8 months for the SSG(p=0.3506).The duration of Anlotinib treatment in the CTG was 6(6,18)weeks.Adverse reactions included Grade I hypertension in three patients and Grade I hand-foot skin reactions in two patients,with a drug-related adverse reaction rate of 11.1%(5/45).Conclusion:Anlotinib combined with SRT significantly alleviates brain edema,reduces the incidence of radiation-induced brain necrosis,enhances intracranial progression-free survival,and demonstrates a low adverse reaction rate.
文摘BACKGROUND About 35%-50%of patients with hepatocellular cancer(HCC)present with portal venous tumor thrombosis(PVTT).Stereotactic body radiation therapy(SBRT)offers a promising approach for locoregional treatment in patients with HCC with PVTT.This study aimed to report the clinical characteristics and early outcomes of patients with unresectable HCC and PVTT treated with SBRT.AIM To report the clinical characteristics and early outcomes of patients with unresectable HCC and PVTT treated with SBRT.METHODS This retrospective,single-institution study included adult HCC patients with PVTT treated between March 2020 and December 2023.Eligibility criteria included Child-Pugh A-B liver function,serum bilirubin<3 mg/dL,Eastern Co-operative Oncology Group performance status 0-2,a normal liver volume>700 cc,and a tumor-lumen distance>5 mm.SBRT dose and fractionation were determined based on tumor volume and organ-at-risk constraints.Baseline clinical and dosimetric parameters were recorded.Survival analysis was performed using Kaplan-Meier curves,response was assessed at 3 months post-SBRT using the Revised Response Evaluation Criteria in Solid Tumors 1.1 criteria,and toxicity was graded per Common Terminology Criteria for Adverse Events 4.0.RESULTS Thirty patients(median age:65 years,90%male)were included.Sixteen(53.3%)were Child-Pugh A,and fourteen(46.6%)were Child-Pugh B.Sixty percent had VP4 disease.SBRT doses ranged from 30-50 Gy in 5-6 fractions.The median tumor diameter was 6.1 cm,and the median follow-up was 15 months.The overall response rate was 83.3%,with a median overall survival of 13 months and progression-free survival of 10.2 months.No grade 4 toxicities were observed.CONCLUSION SBRT has the potential to be an effective modality for locoregional control in patients with unresectable HCC with PVTT.
基金Shandong Provincial Medical and Health Science and Technology Development Program,Clinical Study on Modified Stereotactic Soft Channel Intracranial Hematoma Evacuation for Severe Basal Ganglia Hemorrhage(Project No.:202203071107)。
文摘Objective:To analyze the therapeutic effect and prognosis of frameless stereotactic soft channel intracranial hematoma evacuation for severe basal ganglia hemorrhage.Methods:Clinical data of 411 patients with severe basal ganglia hemorrhage admitted to the Neurological Intensive Care Unit of Linyi People’s Hospital from January 2020 to December 2021 were collected.According to the modified Rankin Scale(mRS)score at 180 days after onset,the patients were divided into the good prognosis group and the poor prognosis group.The therapeutic effect of frameless stereotactic soft channel intracranial hematoma evacuation on severe basal ganglia hemorrhage was explored,and the influencing factors of prognosis were analyzed.Results:Multivariate Logistic regression analysis showed that the admission Glasgow Coma Scale(GCS)score was an independent protective factor for the prognosis of patients with severe basal ganglia hemorrhage,while age,preoperative hematoma volume,random blood glucose level,and mechanical ventilation were independent risk factors.Conclusion:Frameless stereotactic soft channel intracranial hematoma evacuation has a good therapeutic effect on severe basal ganglia hemorrhage.However,it is necessary to screen the patients’basic information before surgery and provide medical care based on their specific conditions to promote their rapid recovery.
文摘1文献来源AIZER A A,TANGUTURI S K,SHI D D,et al.Stereotactic radiosurgery in patients with small cell lung cancer and 1-10 brain metastases:a multi-institutional,phaseⅡ,prospective clinical trial[J].J Clin Oncol,2025,43(27):2986−2997.doi:10.1200/JCO.25-00056.
文摘Objective： To investigate the treatment effectiveness and side effects of stereotactic radiotherapy for brain glioma. Methods： From Jun. 1995 to Dec. 1998, 389 cases of brain gliomas were treated by stereotactic radiotherapy, among which 151 cases were treated by stereotactic radiosurgery （SRS） and the other 238 cases, by fractionated stereotactic radiotherapy （FSRT）. In the SRS group, the marginal tumor dose was 20 to 30 Gy （median, 2.6 Gy）. One to 6 isocenters （median, 2.48） and 5 to 21 irradiation arcs （median, 8.45） were applied. In the FSRT group, the per-fraction marginal tumor dose was 8 to 12 Gy with 1 to 6 isocenters （median, 2.53）, 6 to 20 irradiation arcs （median, 8.25） and 2-5 fractions delivered everyday or every other day. Results： Three months after treatment, the complete and partial response rates were 13.9% and 45.7% in SRS group respectively. The stable disease rate was 17.2%. The total effective rate was 76.8%. In FSRT group, the complete and partial remission rates were 19.7% and 47.9% respectively. The stable disease rate was 20.6%. The total effective rate was 88.2%. The total effective rate of FSRT group was higher than that in SRS group （X^2=9.874, P=0.020）. The 1-year, 3-year and 5-year survival rate of all patients was 54.3%, 29.3%, 16.5% respectively. The 1-year, 3-year and 5-year survival rate in SRS group and FSRT group was 52.3% vs 26.5%, 11.9% vs 55.5%, and 31.1 vs 19.3% respectively. There was no significant difference between the two groups （X^2=2.16, P=0.1417）. The brain edema caused by the main radiation was more severe in the SRS group than in FSRT group （X^2=4.916, P=0.027）. Conclusion： It is effective for brain glioma to be treated by stereotactic radiotherapy. Compared with SRS, the FSRT has the advantage of good effect and less side response.
文摘Stereotactic body radiation therapy(SBRT)has a locacontrol rate of 95%at 2 years for non-small cell lungcancer(NSCLC)and should improve the prognosis oinoperable patients,elderly patients,and patients withsignificant comorbidities who have early-stage NSCLCThe safety of SBRT is being confirmed in internationalmulti-institutional PhaseⅡtrials for peripheral lungcancer in both inoperable and operable patients,bureports so far have found that SBRT is a safe and effective treatment for early-stage NSCLC and early metastatic lung cancer.Radiation pneumonitis(RP)is oneof the most common toxicities of SBRT.Although mospost-treatment RP is Grade 1 or 2 and either asymptomatic or manageable,a few cases are severe,symptomatic,and there is a risk for mortality.The reportedrates of symptomatic RP after SBRT range from 9%to28%.Being able to predict the risk of RP after SBRT isextremely useful in treatment planning.A dose-effecrelationship has been demonstrated,but suggesteddose-volume factors like mean lung dose,lung V20and/or lung V2.5 differed among the reports.We foundthat patients who present with an interstitial pneumo-nitis shadow on computed tomography scan and high levels of serum Krebs von den Lungen-6 and surfactant protein D have a high rate of severe radiation pneumo-nitis after SBRT.At our institution,lung cancer patients with these risk factors have not received SBRT since 2006,and our rate of severe RP after SBRT has de-creased significantly since then.
文摘Stereotactic body radiation therapy(SBRT) is the treatment of choice for medically inoperable patients with early stage non-small cell lung cancer(NSCLC). A literature search primarily based on PubMed electronic databases was completed in July 2018. Inclusion and exclusion criteria were determined prior to the search, and only prospective clinical trials were included. Nineteen trials from 2005 to 2018 met the inclusion criteria, reporting the outcomes of 1434 patients with central and peripheral early stage NSCLC. Patient eligibility,prescription dose and delivery, and follow up duration varied widely. Threeyears overall survival ranged from 43% to 95% with loco-regional control of up to 98% at 3 years. Up to 33% of patients failed distantly after SBRT at 3 years. SBRT was generally well tolerated with 10%-30% grade 3-4 toxicities and a few treatment-related deaths. No differences in outcomes were observed between conventionally fractionated radiation therapy and SBRT, central and peripheral lung tumors, or inoperable and operable patients. SBRT remains a reasonable treatment option for medically inoperable and select operable patients with early stage NSCLC. SBRT has shown excellent local and regional control with toxicity rates equivalent to surgery. Decreasing fractionation schedules have been consistently shown to be both safe and effective. Distant failure is common, and chemotherapy may be considered for select patients. However, the survival benefit of additional interventions, such as chemotherapy, for early stage NSCLC treated with SBRT remains unclear.
基金The Ministry of Science and Technology of The People's Republic of China,No.2022YFC2503700,and No.2022YFC2503704.
文摘BACKGROUND Stereotactic body radiotherapy(SBRT)and programmed cell death 1 inhibitors have shown potential in treating hepatocellular carcinoma(HCC)in retrospective studies.AIM To evaluate the efficacy of combining SBRT with sintilimab for patients with recurrent or oligometastatic HCC.METHODS This trial involved patients with recurrent or oligometastatic HCC intravenously treated with SBRT plus sintilimab every 3 wk for 12 mo or until disease progression.The primary endpoint was progression-free survival(PFS).RESULTS Twenty-five patients were enrolled from August 14,2019,to August 23,2021.The median treatment duration was 10.2(range,0.7-14.6)months.SBRT was delivered at a median dose of 54(range,48-60)Gy in 6(range,6-10)fractions.The median follow-up time was 21.9(range,10.3-39.7)mo,and 32 targeted lesions among 25 patients were evaluated for treatment response according to the Response Evaluation Criteria in Solid Tumors version 1.1.The median PFS was 19.7 mo[95%confidence interval(CI):16.9-NA],with PFS rates of 68%(95%CI:52-89)and 45.3%(95%CI:28-73.4)at 12 and 24 mo,respectively.The median overall survival(OS)was not reached,with OS rates of 91.5%(95%CI:80.8-100.0)and 83.2%(95%CI:66.5-100.0)at 12 and 24 mo,respectively.The 1-and 2-year local control rate were 100%and 90.9%(95%CI:75.4%-100.0%),respectively.The confirmed objective response rate and disease control rate was 96%,and 96%,respectively.Most adverse events were graded as 1 or 2,and grade 3 adverse events were observed in three patients.CONCLUSION SBRT plus sintilimab is an effective,well-tolerated treatment regimen for patients with recurrent or oligometastatic HCC.
文摘The integration of new technologies has raised an interest in liver tumor radiotherapy,with literature evolving to support its efficacy.These advances,particularly stereotactic body radiation therapy(SBRT),have been critical in improving local control or potential cure in liver lesions not amenable to first-line surgical resection or radiofrequency ablation.Active investigation of SBRT,particularly for hepatocellular carcinoma(HCC),has recently started,yielding promising local control rates.In addition,data suggest a possibility that SBRT can be an alternative option for HCC unfit for other local therapies.However,information on optimal treatment indications,doses,and methods remains limited.In HCC,significant differences in patient characteristics and treatment availability exist by country.In addition,the prognosis of HCC is greatly influenced by underlying liver dysfunction and treatment itself in addition to tumor stage.Since they are closely linked to treatment approach,it is important to understand these differences in interpreting outcomes from various reports.Further studies are required to validate and maximize the efficacy of SBRT by a large,multi-institutional setting.
文摘Systemic chemotherapy has enabled prolongation of survival in patients with stage IV colorectal cancer. This has subsequently increased the relative significance of local therapy for patients with oligometastases because they can be cured by removal of oligometastatic lesions. One of the most frequently reported tumor histologies for oligometastases is colorectal cancer. Resection is the standard therapy in most settings of oligometastases. Recently, studies have shown that stereotactic body radiotherapy (SBRT) may become a treatment option that provides high local control with minimal morbidity. Two-year local control rates following SBRT for hepatic and pulmonary oligometastases are almost over 80% and are even higher for patients treated with high-dose regimens. The indications of SBRT for other metastatic sites or conditions include isolated lymph nodes, spinal and adrenal metastasis, and post-surgical pelvic recurrence. Many retrospective studies have indicated that SBRT for various lesions results in good outcomes with low morbidity, both in the curative and palliative setting. However, few reports with a high level of evidence have indicated the efficacy of SBRT compared to standard therapy. Hereafter, the optimal indication of SBRT needs to be prospectively investigated to obtain convincing evidence.
文摘BACKGROUND Pancreatic cancer is a malignancy with one of the poorest prognoses amongst all cancers.Patients with unresectable tumours either receive palliative care or undergo various chemoradiotherapy regimens.Conventional techniques are often associated with acute gastrointestinal toxicities,as adjacent critical structures such as the duodenum ultimately limits delivered doses.Stereotactic body radiotherapy(SBRT)is an advanced radiation technique that delivers highly ablative radiation split into several fractions,with a steep dose fall-off outside target volumes.AIM To discuss the latest data on SBRT and whether there is a role for magnetic resonance-guided techniques in multimodal management of locally advanced,unresectable pancreatic cancer.METHODS We conducted a search on multiple large databases to collate the latest records on radiotherapy techniques used to treat pancreatic cancer.Out of 1229 total records retrieved from our search,36 studies were included in this review.RESULTS Studies indicate that SBRT is associated with improved clinical efficacy and toxicity profiles compared to conventional radiotherapy techniques.Further dose escalation to the tumour with SBRT is limited by the poor soft-tissue visualisation of computed tomography imaging during radiation planning and treatment delivery.Magnetic resonance-guided techniques have been introduced to improve imaging quality,enabling treatment plan adaptation and re-optimisation before delivering each fraction.CONCLUSION Therefore,SBRT may lead to improved survival outcomes and safer toxicity profiles compared to conventional techniques,and the addition of magnetic resonance-guided techniques potentially allows dose escalation and conversion of unresectable tumours to operable cases.
文摘BACKGROUND Graft hepatocellular carcinoma(HCC)recurrence after liver transplant is more frequently encountered.Graft hepatectomy is technically challenging and is associated with high morbidity.Stereotactic body radiation therapy(SBRT)has been shown to be safe and effective for the treatment of primary HCC.However,its role in HCC recurrence in a liver graft remains unclear.AIM To evaluate the safety and efficacy of SBRT for the treatment of graft HCC recurrence after liver transplantation.METHODS A retrospective study was conducted.From 2012 to 2018,6 patients with intrahepatic HCC recurrence after liver transplant were treated with SBRT at Queen Mary Hospital,the University of Hong Kong.The primary outcome was time to overall disease progression and secondary outcomes were time to local progression and best local response,as assessed with the Modified response Evaluation Criteria for Solid Tumours criteria.Patients were monitored for treatment related toxicities and graft dysfunction.RESULTS A total of 9 treatment courses were given for 13 tumours.The median tumour size was 2.3 cm(range 0.7-3.6 cm).Two(22%)patients had inferior vena cava tumour thrombus.The best local treatment response was:5(55%)complete response,1(11%)partial response and 3(33%)stable disease.After a median follow up duration of 15.5 mo,no local progression or mortality was yet observed.The median time to overall disease progression was 6.5 mo.There were 6 regional progression in the liver graft(67%)and 2 distant progression in the lung(22%).There was no grade 3 or above toxicity and there was no graft dysfunction after SBRT.CONCLUSION SBRT appears to be safe in this context.Regional progression is the mode of failure.
