Educational Impact of a National Training Webinar on AI-based Automatic Contouring in Radiation Oncology.

Strategic Medical Student Engagement Enhances Knowledge, Interest, and Recruitment in Radiation Oncology

Management and work-up procedures of patients with head and neck malignancies treated by radiation: 2025 update.

Are Urologists and/or Radiation Oncologists Biased when Reporting of Advantages and Disadvantages of Surgery versus Radiation in Consultations for Early-Stage Prostate Cancer?

How can a radiation oncology society support its members and the community to help reduce the carbon footprint of radiation oncology?

Global Expert Perspectives on Radiation Oncology Education for Managing Older Adults With Cancer: Current Practice and Future Directions.

Review of current best practice in radiation oncology for older adults with cancer: Updates from the International Society of Geriatric Oncology (SIOG) Task Force.

Radiation therapist led treatment of lung stereotactic ablative body radiation therapy patients in the absence of the radiation oncologist - An image matching consistency comparison study.

From BERT to GPT-4: A systematic review of AI-Driven toxicity extraction and grading in radiation oncology.

From evidence to practice: Real-world implementation of ESGO 2023 guidelines for adjuvant radiotherapy in vulvar cancer.

Proton therapy in breast cancer: bridging medical and radiation oncology.

Dogs with intracranial tumours routinely receive radiotherapy, yet species-specific dose-volume constraints for normal brain tissue remain undefined. In human radiation oncology, exceeding certain brain dose-volume thresholds markedly increases the risk of radiation-induced injury (e.g., radionecrosis). Current veterinary practice often extrapolates human guidelines without validation in discrete species, creating a gap in evidence-based planning. This study aimed to identify brain dose-volume thresholds associated with overall survival (OS) in canine brain-tumour patients. We pooled data from two prospective randomised trials (n = 105 dogs) treated with 10 daily fractions of 4 Gy (total 40 Gy) for intracranial tumours at a single institution. Semi-automated scripting extracted multiple dose-volume metrics, including generalised equivalent uniform dose (gEUD), for the whole brain and brain minus gross tumour volume (Brain-GTV). An iterative Kaplan-Meier and Cox proportional hazards approach identified optimal dosimetric cutoffs, which were then adjusted for tumour volume and body weight via a regression residual method. A brain-volume-adjusted gEUD threshold was also derived to account for variation in brain size. Exposure to normal brain to doses around 30-40 Gy emerged as the strongest predictor of OS. Brain-GTV V32 Gy ≤ 13 cm3 was associated with longer OS (covariate-adjusted cutoff 13.4 cm3, HR = 1.74; p = 0.022, unadjusted optimal split 11.5 cm3, HR = 2.08; p = 0.001). Whole-brain gEUD > 30 Gy similarly predicted poorer survival (HR = 1.72; p = 0.034). Implementing a personalised gEUD ceiling increased 2-year sensitivity from 31% to 38% with only a three-point drop in specificity. In a 10 × 4 Gy canine intracranial radiotherapy model, limiting Brain-GTV V32 Gy to ≤ 13 cm3 and whole-brain gEUD to ≤ 30 Gy was associated with longer overall survival. A brain-volume-adjusted gEUD ceiling further refined risk prediction. These evidence-based thresholds provide actionable guidance for veterinary treatment planning, with the potential to improve outcomes in canine brain tumour therapy.

An international modified Delphi study to prioritise levels of evidence and outcomes to appraise radiotherapy innovation in the ESTRO Value-Based Radiation Oncology framework

The evolving role of telehealth in interprofessional radiation oncology service delivery: A narrative review.

Background/Objectives: To compare diagnostic performance and cost-effectiveness of [18F]FDG PET/CT versus MRI for cervical lymph node assessment in nasopharyngeal carcinoma (NPC) and to evaluate their impact on N-staging and upper-neck-only irradiation planning. Materials and Methods: We retrospectively identified treatment-naïve NPC patients who underwent both MRI and FDG PET/CT within 14 days prior to ultrasound-guided biopsy of specific cervical lymph nodes with rigorous one-to-one multimodal matching. Using histopathology as the reference standard (Cohort A, node level), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) were compared between PET/CT and MRI. In a staging cohort (Cohort B, patient level), we compared imaging-based N-staging accuracy and the pathology-concordant classification of treatment recommendations assuming upper-neck-only irradiation for N0 to N1 disease. In discordant cases (Cohort C), three experienced radiation oncologists designed dose prescriptions and neck irradiation volumes, first using MRI alone and then after reviewing PET/CT to quantify decision impact. A decision tree/Markov model (10-year horizon) evaluated cost-effectiveness of MRI- versus PET/CT-initiated strategies. Results: In total, 694 biopsy-verified lymph nodes from 649 patients were analyzed. PET/CT demonstrated higher sensitivity (96.0% vs. 92.6%, p = 0.001) and NPV (80.2% vs. 66.7%, p < 0.001) than MRI, with comparable specificity (64.0% vs. 59.0%, p = 0.317) and PPV (91.4% vs. 90.0%, p = 0.203); AUCs were 0.864 and 0.841, respectively (p = 0.298). In Cohort B (N = 503), PET/CT provided accurate N-staging for a significantly higher proportion of patients compared to MRI (8.0% vs. 4.2%, p = 0.021) and yielded more accurate recommendations for upper-neck-only irradiation when restricted to N0 to N1 disease (93.8% vs. 88.9%, p = 0.003). In discordant cases (Cohort C, N = 62), PET/CT substantially improved accuracy compared with MRI and prompted clinically meaningful plan adjustments, including dose escalation for metastatic nodes (up to 16.7%) and expansion from upper-neck-only to whole-neck irradiation with rates of 6.4%, 8.0%, and 11.3% for the three radiation oncologists, respectively. In the base case economic analysis, PET/CT achieved higher effectiveness (5.329 vs. 5.305 quality-adjusted life years [QALYs]) at higher cost (US$27,228 vs. US$25,596), with an incremental cost–effectiveness ratio (ICER) of approximately US$68,000 per QALY, remaining below a willingness-to-pay threshold of US$100,000 per QALY; probabilistic sensitivity analysis favored PET/CT in 79.6% of iterations. Conclusions: FDG PET/CT provided superior sensitivity and negative predictive value versus MRI for detecting nodal metastases in NPC, improving pathology-adjudicated N-staging and the accuracy of upper-neck-only irradiation recommendations. PET/CT was cost-effective in the modeled setting, although treatment de-escalation for benign nodes remained conservative in clinical decision-making.

Radiodermatitis is a common problem in breast cancer treatment with ionizing radiation. It may result in interruption of radiotherapy, depending on the level of the skin lesion. Therefore, the present study aimed to evaluate the efficacy of Cavilon™ (3M, St. Paul, MN, USA), a novel prophylactic agent, in preventing mammary radiodermatitis compared to conventional sunflower oil. This prospective study involved 19 breast cancer patients receiving radiotherapy. Participants received Cavilon™ on one breast quadrant and sunflower oil on the opposite quadrant. The occurrence and severity of radiodermatitis were assessed twice weekly over 25 treatment sessions. Post-treatment assessments indicated that 16% of the Cavilon™-treated quadrants exhibited no radiodermatitis (stage 0), compared to 11% in the sunflower oil-treated quadrants. The mean degree of radiodermatitis was 0.95 (95% confidence interval [CI]: 0.61-1.29) with Cavilon™ vs. 1.37 (95% CI: 0.97-1.77) with sunflower oil, a statistically significant difference (paired t-test: p=0.016; Wilcoxon signed-rank test: p=0.021). Progression to stage 3 occurred in 5% of Cavilon™-treated quadrants vs. 11% with sunflower oil. The findings suggest that Cavilon™ is more effective than sunflower oil in mitigating the progression of radiodermatitis in breast cancer patients undergoing radiotherapy. Its application is a beneficial addition to the skin management protocol in radiation oncology.

An analysis of a satellite oncological radiotherapy unit in the Canary Islands: a cost-minimisation study.

This study aimed to explore the experiences of dysphagia and rehabilitation care needs of head and neck cancer patients across the pre-, intra-, and post-radiotherapy phases. The findings provide essential evidence for developing individualized rehabilitation care protocols for dysphagia. A qualitative descriptive study was conducted at the Radiation Oncology Department of a cancer hospital in China from December 2024 to March 2025. Purposive sampling was used to select head and neck cancer patients at different radiotherapy phases. Semi-structured interviews were conducted to capture their experiences of dysphagia and rehabilitation care needs. All interviews were audio-recorded, transcribed verbatim, and analyzed qualitatively using a content analysis approach. Four key themes of patients' experiences of dysphagia and rehabilitation care needs were identified: (1) emotional experiences across peri-radiotherapy phases, (2) dynamic swallowing perceptions across peri-radiotherapy phases, (3) radiotherapy phase-specific critical distress points, and (4) evolving rehabilitation care needs in dysphagia management. Situated within the Chinese context, this study explores dysphagia experiences and rehabilitation care needs of head and neck cancer patients across the pre-, intra-, and post-radiotherapy phases. The findings reveal that these experiences and needs are diverse and differentiated. Healthcare providers should develop stage-specific rehabilitation care protocols for dysphagia that are tailored to the experiences and needs of head and neck cancer patients at different phases of radiotherapy.

To summarize recent high-quality trials and provide an update to the original 2022 American College of Radiology Appropriate Use Criteria for Treatment of Locoregional Gastric Adenocarcinoma. This multi-specialty-led committee included gastrointestinal radiation and medical oncology, gastroenterology, radiology, and surgical oncology. Using the population, intervention, comparator, outcome, timing, and study design framework, the evidence was assessed using Cochrane and PRISMA 2020 methodology. Eligible studies included prospective Phase II/II trials and select retrospective studies published between 5/1/2020 and 8/1/2025 in the Embase, Medline, and Pubmed databases. Study type and quality were assessed. Well-established RAND-UCLA consensus methodology (modified Delphi) was used to rate the appropriateness of the treatment options. ARS AUC recommendations include adjuvant FLOT chemotherapy for localized gastric adenocarcinoma after neoadjuvant FLOT and surgery, poCT or perioperative chemoimmunotherapy for localized gastric adenocarcinoma, adjuvant chemotherapy +/- CRT for localized gastric adenocarcinoma that undergoes upfront surgery, and systemic therapy alone for localized gastric adenocarcinoma in a medically inoperable patient. This updated ARS AUC summary provides guidelines for the multimodality treatment of resectable gastric adenocarcinoma.

Intraoperative radiotherapy (IORT) offers single-session treatment during breast-conserving surgery (BCS). Outcomes depend heavily on patient selection and tumor characteristics. To assess local recurrence (LR) and prognosis using the 2024 American Society for Radiation Oncology (ASTRO) risk classification in IORT-treated patients. This multicenter retrospective study analyzed 358 IORT cases (356 patients) treated between 2014 and 2018 using the Zeiss INTRABEAM system. Cases were classified per the 2024 ASTRO partial-breast irradiation guidelines. The primary endpoint was local recurrence-free survival (LRFS); secondary endpoints included overall survival (OS) and mastectomy-free survival (MFS). The median age was 66 years (range 48-80); all tumors were invasive with a median tumor size of 10 mm. At a median follow-up of 7.1 years, LR occurred in 14/358 cases (3.9%) at a median of 5.2 years post-diagnosis. Five- and 8-year LRFS were 98.3% and 94.8%, respectively; 5- and 8-year OS were 99.4% and 97.7%; MFS at 8 years was 98.2%. Cases that were classified as "conditionally recommended" or "conditionally not recommended" had significantly higher LR than the "suitable" group (8.5% vs. 2.7%; HR 3.25, 95% CI 1.05-10.08, p = 0.041). Exploratory analysis showed that cases with ≥2 conditional criteria carried a markedly higher risk than those with 0-1 (21.4% vs. 3.2%; Firth-penalized Cox HR 8.26, 95% CI 2.06-26.06, p = 0.005). In appropriately selected patients, IORT achieves local control consistent with contemporary series. The 2024 ASTRO risk classification effectively identifies high-risk cases, supporting its use for risk-adapted candidate selection.