Evaluation of the effects induced by radiotherapy on dentin during endodontic instrumentation using a novel methodology for assessing wear resistance.

Neoadjuvant radiotherapy for primary retroperitoneal well-differentiated liposarcoma: a Transatlantic Australasian Retroperitoneal Sarcoma Working Group (TARPSWG) propensity score matched analysis.

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

A0759 Cancer-specific mortality outcomes in patients with biochemical recurrence after radical prostatectomy vs. radiation therapy: Report from a single tertiary referral center

A0758 Incidence and prognostic implications of PSA relapse after radical radiotherapy for prostate cancer: A population-based study

Postsurgical immunotherapy for patients with locally advanced head and neck squamous cell carcinoma (HNSCC) remains elusive. This study assesses the value and significance of postoperative immunotherapy in the treatment of locally advanced HNSCC. In total, 212 patients with locally advanced HNSCC who underwent radical surgery were stratified into three treatment groups: adjuvant radiotherapy alone, adjuvant chemoradiotherapy (CRT), and adjuvant chemoradiotherapy plus immunotherapy (PD-1 Ab). A comprehensive analysis was conducted to assess survival outcomes and prognostic factors across diverse patient cohorts. Four patients were lost to follow-up, with a follow-up rate of 98.1% and a median follow-up time of 41 months (IQR 24-68). A total of 64/212 individuals died, with cancer being the cause of 62 cases and noncancer causes accounting for the remaining two deaths; 62/212 (29.2%) patients experienced relapse and/or metastasis. The 3-year OS rates for the radiotherapy group, CRT group, and CRT plus PD-1 Ab group were 54.8%, 75.4%, and 82.2%, respectively. However, no statistically significant difference in OS or PFS was observed between the CRT and CRT + PD-1 Ab groups (pall > 0.05), although both were superior to radiotherapy alone (pall < 0.05). Multivariate analysis indicated that age, smoking history, TNM stage and treatment method were independent prognostic factors for OS (pall < 0.05). Smoking history and treatment methods were independent prognostic factors for PFS and DMFS (pall < 0.05). PD-1 Ab may contribute less to tumors with better treatment outcomes from concurrent chemoradiotherapy.

Objectives Cancer ranks as the second leading cause of death globally, responsible for approximately one in six deaths. Around 70% of these cancer-related deaths occur in low- and middle-income countries. Cancer impacts all aspects of an individual’s life, and a diagnosis can significantly diminish a patient’s quality of life (QoL), often due to the aggressive nature of treatment. The objective of this study is to assess the QoL of cancer patients with radiation and chemotherapy. Material and Methods A quantitative approach using a descriptive cross-sectional study design was conducted among 132 cancer patients aged 20 years and above who underwent either radiation or chemotherapy treatment. Purposive sampling was used for data collection. Patients undergoing radiation or chemotherapy for first and second-stage cancer were included, while those undergoing combined interventions or surgery were excluded from the study. Results The QoL of patients receiving radiation therapy (Group 1) showed that, among the seven domains assessed, psychological well-being had the highest mean score (6.90 ± 1.57), indicating better QoL in this domain. In patients receiving chemotherapy (Group 2), the highest QoL was observed in the domain of general well-being, with a mean score of 6.79 ± 2.98. Conclusion A cancer diagnosis is one of the most serious health challenges, significantly impacting the general well-being of patients throughout the treatment process. The QoL may vary depending on the treatment modality.

Self-management experiences of vaginal toxicities among patients undergoing radical radiotherapy for cervical cancer: a qualitative study.

Cancer-specific mortality (CSM) rates in patients with rare histological prostate cancer subtypes after treatment with radical prostatectomy (RP) versus radiation therapy (RT) are largely unknown. Relying on the Surveillance, Epidemiology, and End Results database (2004-2020), we identified patients with five prostate cancer subtypes treated with RP or RT. Kaplan-Meier analyses and Cox regression models addressed CSM. Of 427,055 patients, 425,692 (99.68%) harbored acinar, 855 (0.20%) ductal, 324 (0.08%) mucinous, 54 (0.01%) signet ring cell adenocarcinoma, and 130 (0.03%) neuroendocrine carcinoma. Of those, 250,910 (59%), 592 (69%), 262 (81%), 34 (63%), and 34 (26%) were treated with RP, respectively. Five-year cancer-specific survival rates after RP versus RT were 99.2 versus 97.1% in acinar; 96.3 versus 87.1% in ductal; 98.7 versus 92.1% in mucinous; 97.0 versus 94.7% in signet ring cell; and 59.4 versus 20.5% in neuroendocrine carcinoma. In univariable Cox regression models, RP was associated with a lower CSM rate in acinar (hazard ratio [HR] 0.28; p < 0.001), ductal (HR 0.25; p < 0.001), and neuroendocrine (HR 0.36; p < 0.001), but not in mucinous (p = 0.052) and signet ring cell carcinoma (p = 0.8). After multivariable adjustment, RP remained an independent predictor of lower CSM in acinar (HR 0.35; p < 0.001), ductal (HR 0.30; p < 0.001), and neuroendocrine carcinoma (HR 0.53; p = 0.042). Higher CSM was recorded after RT in acinar, ductal, and neuroendocrine carcinoma. Conversely, no differences in CSM were identified when RP was compared with RT in mucinous and signet ring cell adenocarcinoma.

Objectives: The aim of the study was to assess the impact of oncological treatment including surgery and radiotherapy on the respiratory function and quality of life of women treated for breast cancer, considering the effects of physiotherapy and additional inspiratory muscle training. Methods: A quantitative, repeated-measures study included 26 women (aged 30-69) with breast cancer who had undergone breast-conserving surgery and radiotherapy, randomly assigned to an IMT group or a sham IMT group. The following tests were performed on each patient: respiratory function, respiratory muscle strength, the WHOQOL-Bref questionnaire. The tests were performed five times as follows: before surgery, after surgery (4-6 days), before the start of radiotherapy (4-5 weeks after surgery), after the end of radiotherapy, and follow-up 4 weeks after the end of radiotherapy. Group I-IMT: patients underwent physiotherapy according to hospital rehabilitation standards and inspiratory muscle strength training at 15-60% PImax. Group II-sham-IMT: patients underwent physiotherapy according to hospital rehabilitation standards and inspiratory muscle strength training at 15% PImax. Results: After the surgery, a reduction in all parameters was observed, which improved gradually and depending on the group after physiotherapy and inspiratory muscle training. The PImax value decreased significantly after the procedure in both groups (p = 0.00), but its significant increase after 4 weeks and radiotherapy (p = 0.00) was noted only in the I-IMT group. The quality of life assessed by women (WHO1) was significantly higher (p = 0.009) only in the group using IMT training with a load of 60% PImax. Conclusions: Radical breast cancer treatment, including surgery and radiotherapy, significantly impairs respiratory function and quality of life in women, with the greatest deterioration observed after surgery. The use of prehabilitation and postoperative physiotherapy reduces the adverse effects of radical treatment, while additional inspiratory muscle training supports the improvement of respiratory function and the subjective assessment of quality of life in patients.

Abstract Background. Trastuzumab deruxtecan (T-DXd) has emerged as the standard treatment for patients with metastatic HER2-positive (HER2+) breast cancer (BC) following disease progression on first-line therapy containing taxanes and trastuzumab. Results from DESTINY-Breast04 have extended the approval of T-DXd to include metastatic BC patients with HER2-low expressing tumours. Radiation therapy (RT) is an integral component of multimodal treatment in the metastatic setting. This retrospective study aims to evaluate the safety of the concurrent use of T-DXd and RT in a consecutive, multicentre international cohort. Material/Methods. A retrospective analysis was conducted on patients with metastatic HER2+ or HER2-low BC treated at six leading European institutions. Ablative RT was defined based on a biological dose threshold of a minimum of 50Gy EQD2(10) delivered in no more than 12 fractions, as per the European Society for Radiotherapy and Oncology (ESTRO) OligoCare study. The primary objective was to assess the association between RT administration and adverse events (AEs) greater than grade 2 (G2). In all cases, RT was administered within one month prior to cycle 1 or during systemic treatment, without any interruption of T-DXd. Results. Data from 147 consecutive patients were evaluated. Sixty-seven patients received RT immediately before or during T-DXd treatment, amounting to 71 concurrent RT treatments, while 80 patients did not receive RT. The median age was 53 years old (range 28-88), and the median follow-up from T-DXd initiation was 15 months (range 1-46). Most patients received T-DXd as fourth or beyond line of systemic therapy (52.4%, N=77/147). The median total RT dose was 44Gy (range 8-48), delivered over a median of 4 fractions (range 1-20). The median EQD2 dose was 82Gy (range 12-104), and the median BED was 98Gy (range 14-125). The central nervous system was the most frequently treated site (58.2%; N=39/67), followed by bone (31.3%; N=21/67). Thirty-six patients (53.7%) received RT with ablative intent, and 31 patients (46.3%) received palliative RT. The relationship between RT and the development of &amp;gt;G2 overall toxicity was not statistically significant (p=0.30), nor when considering acute toxicity &amp;gt;G2 (p=0.31) and late toxicity &amp;gt;G2 (p=0.59) separately. There was no significant association between EQD2 (&amp;lt;50Gy or ≥50Gy) and BED (&amp;lt;50Gy or ≥50Gy) with &amp;gt;G2 and any grade acute and late toxicity. The only factor associated with an increased risk of acute toxicity was age ≥50 years old (p=0.035). Grade 2 interstitial lung disease (ILD) or G2-3 pneumonitis were observed in 7 cases in the RT group (10.5%) and 7 cases in the no-RT group (8.8%). Only one case of radionecrosis was reported among the 39 patients treated with intracranial RT (median follow up of 11 months). Overall, 19 patients permanently discontinued T-DXd due to toxicity, 8 in the RT group (11.9%) and 11 in the no-RT group (13.8%). Conclusion. Our preliminary findings suggest that the combination of T-DXd and concurrent RT does not increase the risk of severe acute and late toxicity. Citation Format: L. Visani, I. Ratosa, R. Bartsch, B. Linderholm, G. Griguolo, C. Becherini, M. Valzano, V. Salvestrini, A. Starzer, P. Kus, M. Lambertini, V. Guarneri, L. Livi, I. Meattini. Safety and efficacy of trastuzumab deruxtecan and concomitant radiation therapy in breast cancer patients: an international retrospective cohort study [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS2-02-02.

Abstract Background: Most individuals diagnosed with ductal carcinoma in situ (DCIS) undergo breast-conserving surgery (BCS) followed by whole-breast radiotherapy (RT). Historically, there have been concerns about increased cardiac risk from breast RT, particularly for left-sided lesions. With the implementation of modern RT techniques and cardiac avoidance protocols, the long-term impact of RT on cardiac outcomes in DCIS remains uncertain. Methods: We conducted a retrospective, population-based cohort study of women diagnosed with pure DCIS in Ontario from 1994 to 2014 who underwent BCS with or without RT. Clinical and pathological characteristics, comorbidity burden (Elixhauser index), socioeconomic status, and treatment variables including laterality and RT receipt were obtained from the Ontario DCIS database and linked administrative datasets. Pre-existing cardiovascular disease and subsequent cardiac events were identified using hospital discharge data. Primary outcomes included acute myocardial infarction (AMI), coronary revascularization (Percutaneous Coronary Intervention (PCI) or Coronary Artery Bypass Grafting (CABG)), death due to ischemic heart disease (IHD), and a composite of these events. Fine-Gray competing risk regression was used to estimate the impact of RT, adjusting for age and baseline cardiac disease. Cumulative incidence functions (CIFs) were compared using Gray’s test. Results: Among 3,009 women with pure DCIS treated with BCS, 1,562 (52%) received RT. Median age at diagnosis was 56 years in the RT group and 62 years in the non-RT group. Median follow-up was 22.4 years for those who received RT and 21.2 years for those who did not. On multivariable analyses adjusting for age and history of heart disease, RT was not associated with a significant increase in the risk of AMI (HR 1.13, 95% CI 0.84-1.53, p=0.43), coronary revascularization (HR 1.33, 95% CI 0.95-1.88, p=0.10), death due to IHD (HR 0.89, 95% CI 0.51-1.55, p=0.68), or the composite outcome (HR 1.09, 95% CI 0.85-1.41, p=0.49). At 20 years, the cumulative incidence of AMI was 5.0% with RT vs 5.9% without RT (p=0.39); coronary revascularization was 4.6% vs 4.0% (p=0.26); and death due to IHD was 1.7% vs 3.7% (p=0.0006). The 20-year cumulative incidence of the composite cardiac outcome was 7.1% with RT vs 7.7% without RT (p=0.04). When stratified by laterality, there were no significant differences in 20-year incidence of AMI (4.6% left vs 5.4% right, p=0.68), IHD death (1.6% vs 1.7%, p=0.85), or the composite event (7.1% vs 7.0%, p=0.95). Conclusions: In this large, population-based cohort of women with pure DCIS treated with BCS, whole-breast RT, including to the left breast, was not associated with increased risk of long-term cardiac events after over two decades of follow-up. These findings support the cardiac safety of contemporary breast RT techniques in the management of DCIS and should be considered when weighing the risks and benefits of adjuvant RT. Citation Format: E. Hahn, R. Sutradhar, F. Johri, D. Rodin, K. J. Jerzak, L. Nguyen, S. Trebinjac, C. Fong, L. Paszat, E. Rakovitch. Impact of Breast Irradiation on Long-Term Risk of Cardiac Events Following Breast-Conserving Surgery for DCIS: A Population-Based Analysis [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PD12-10.

Abstract Background: Li-Fraumeni syndrome (LFS), caused by monoallelic germline pathogenic variant (PV) in TP53 gene, causes an elevated risk of developing certain cancers, mainly early onset breast cancer, sarcoma and brain tumors. While LFS patients are believed to be at an increased risk for radiation-induced sarcomas, only a few retrospective studies have been published studying the impact of radiationtherapy in the treatment of breast cancer among these patients. This study reviews the data concerning LFS patients treated at the Institut Curie with adjuvant radiation therapy for localized breast cancer. Methods: A retrospective study was conducted on female breast cancer patients with confirmed TP53 PV treated at the Institut Curie. Data concerning patients’ characteristics, treatments received, radiotherapy if received, rates of recurrences, rates of radiation induced sarcomas (RIS) and patient outcomes were collected. Results: From 1989 to 2024, we identified 47 female LFS breast cancer patients who met our inclusion criteria. Median age at diagnosis was 31 years (range 18-72). Of them, 76.6% had a family history of cancer suggestive of LFS. 31.9% had tumoral HER2 amplification. 51.1% received a mastectomy and 31.9% received a lumpectomy. 23 patients (48.9%) received radiotherapy as a part of their treatment strategy. The median follow up was 111 months (range 7-413). Among patients who received radiotherapy, 3 (13%) had a known diagnosis of LFS prior to treatment. No case of radiation-induced sarcomas was observed during the follow-up period. In the radiotherapy group, 5 patients (21.7%) later developed a malignancy within the irradiated field. At 10 years post-diagnosis, overall survival did not differ significantly between patients who received radiotherapy and those who did not (58.2% [95%CI: 36.8-91.9] vs. 80.1% [95%CI: 64.2-100]). Similarly, there was no significant difference in loco regional recurrence-free survival (95.2% [95%CI: 86.6-100] vs. 74.0% [95%CI: 54.8-99.9]) or in survival free from subsequent non-breast cancers (59.6% [95%CI: 36.5-97.2] vs. 67.2% [95%CI: 49.8-90.7]). Univariate analysis did not find any correlation between hormonal status, grade, surgical technique, stage, use or non-use of radiotherapy and overall survival, cancer-specific survival, loco regional recurrence-free survival, metastasis-free survival. Conclusion: The incidence of radiation-induced sarcomas and local recurrences in LFS breast cancer patients was lower than anticipated. Further studies with larger cohorts and extended follow-up are required to validate these findings. Citation Format: A. A. Shrebati, P. Loap, E. Mouret-Fourme, K. Cao, M. Belotti, D. Stoppa-Lyonnet, Y. Kirova. Radiation therapy for breast cancer in patients with Li-Fraumeni syndrome (LFS): a single institution cohort study [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS1-03-06.

Abstract Background: Approximately 50% of newly diagnosed invasive breast cancers are stage 1, with the majority being ER/PR-positive, HER2-negative. Genomic assays such as the Oncotype DX® have identified patients (pts) with reduced risk of distant metastasis and without benefit from chemotherapy added to endocrine therapy (ET), freeing them from excess toxicity. Genomic assays are also recognized as prognostic for in-breast recurrence (IBR) after breast-conserving surgery (BCS) and could similarly allow de-escalation of adjuvant radiotherapy (RT). Reducing overtreatment is of interest to pts, providers, and payers. Methods: We hypothesize that BCS alone is non-inferior to BCS plus RT for IBR and breast preservation in women intending ET for stage 1 invasive breast cancer (ER and/or PR-positive, HER2-negative with an Oncotype DX Recurrence Score [RS] of ≤18). Stratification is by age (&amp;lt;60; ≥60), tumor size (≤1 cm; &amp;gt;1-2cm), and RS (≤11, &amp;gt;11-18/MammaPrint Low). Pts are randomized post-BCS to Arm 1 with breast RT using standard methods (moderate or ultra hypo- or conventional-fractionated whole breast RT with/without boost, or APBI) with ≥5 yrs of ET (tamoxifen or AI) or Arm 2 with ≥5 yrs of ET (tamoxifen or AI) alone. The specific regimen of ET in both arms is at the treating physician’s discretion. Eligible pts are stage 1: pT1 (≤2 cm), pN0, age ≥50 to &amp;lt;70 yrs, s/p BCS with negative margins (no ink on tumor), s/p axillary nodal staging (SNB or ALND), ER and/or PR-positive (ASCO/CAP), HER2-negative (ASCO/CAP), and Oncotype DX RS ≤18 (diagnostic core biopsy or resected specimen). A “low risk” MammaPrint is permissible if completed as part of usual care prior to screening. Primary endpoint is IBR (invasive breast cancer or DCIS). Secondary endpoints are breast conservation rate, invasive in-breast recurrence, relapse-free interval, distant disease-free survival, overall survival, patient-reported breast pain, patient-reported worry about recurrence, and adherence to ET. We assume a clinically acceptable difference in IBR of 4% at 10 yrs to judge omission of RT as non-inferior (10-yr event-free survival for RT group is 95.6% v 91.6% for the omission-of-RT group). BR007 is powered to detect non-inferiority with 80% power and a one-sided α=0.025, assuming that there would be a ramp-up in accrual in the first two years (leveling off in Yrs 3-5); 1,670 pts (835 per arm) are required for randomization. Conservative loss to follow-up is 1%/yr. Some T1a pts screened may have Oncotype DX scores &amp;gt;18, making them ineligible for the study. In the accrual process, 1,714 pts will be required to register to ensure that our final randomized cohort is 1,670 pts. As of July 9, 2025, 1,490 pts have been screened and 1,349 randomly assigned. NCT #: NCT04852887 Support: U10 CA180868, -180822, U24 CA196067, UG1 CA189867 Citation Format: J. R. White, R. S. Cecchini, E. E. Harris, E. P. Mamounas, J. G. Bazan, D. G. Stover, P. A. Ganz, R. Jagsi, S. J. Anderson, C. Bergom, V. Théberge, M. B. El-Tamer, R. C. Zellars, D. A. Shumway, G. Chen, T. B. Julian, N. Wolmark. A phase III trial evaluating De-escalation of Breast Radiation (DEBRA) following breast-conserving surgery of stage 1, HR+, HER2-, RS ≤18 breast cancer: NRG-BR007 [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS5-08-20.

Abstract Background: Breast cancer surgery currently focuses on de-escalating treatment without compromising oncological safety. Axillary lymph node dissection (ALND) has been the standard of care in all sentinel lymph node biopsy (SLNB) positive patients. Although axillary lymph node dissection provides excellent regional control, there are additional side effects like lymphoedema, shoulder stiffness, numbness in the arm. Studies show axillary radiotherapy is an alternate and equally effective treatment for SLNB-positive patients with reduced morbidity. However, this is not a standard of practice in all breast centers in UK. Methodology: A retrospective, single center study between June 2015 and June 2022 following the results published from AMAROS (After Mapping of the Axilla: Radiotherapy Or Surgery) trial in 2014. All patients with breast cancer and clinically and radiologically negative axilla underwent SLNB along with either breast conserving surgery or mastectomy as a routine procedure. Patients with positive SLNB were later offered further axillary management (ALND vs Axillary radiotherapy). Patients who opted for axillary radiotherapy were then analyzed in a retrospective study. Patients’ demographics, disease distribution, nodal positivity, adjuvant treatment were studied. The primary end point was axillary recurrence at the end of 5 years (in line with the AMAROS trial i.e. not more than 4% in axillary radiotherapy group). The secondary end point was arm morbidity and overall survival. Results: A total of 186 patients had positive sentinel lymph node biopsy during the study period and out of them 112 patients, opted for axillary radiotherapy as their mainstay of axillary management. 40(35.7%) patients had T1 disease, 57(50.89%) patients had T2, and 15(13.39%) patients had T3 disease. 13.39% had Grade1 disease, 53.57% had Grade2, and 33.92% had Grade 3 disease. The median number of nodes being 1. The mean age was 63 years, and the mean tumor size of 14.33mm. The mean follow-up was 5.58 years. Axillary recurrence was seen in 3 patients (2.67%), and 1 patient (0.89%) developed lymphedema. 9 patients (8.03%) had distant metastasis. Death due to breast cancer was slightly lower in our study as compared to AMAROS trial (7.84% vs 10.3%) and similar overall death rates (19.04% vs 16.4%) Conclusion: Our study shows that the 5-year axillary recurrence rate is comparable with the AMAROS trial (2.76% vs 1.19%) with similar follow up period (5.58years vs 6.1years). Our study has limitations of small numbers but aligns well with the AMAROS trial. Hence, axillary radiotherapy is non-inferior to axillary lymph node dissection in patients with positive SLNB with significantly less morbidity. Citation Format: C. Gavisiddappa, R. Parmeshwar, P. McManus, S. Somasundaram. Retrospective analysis of axillary recurrence in patients with breast cancer receiving radiotherapy to the axillary after positive sentinel lymph node biopsy [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS2-03-03.

To prospectively evaluate functional patient-reported outcomes (PROs) in patients with low-risk prostate cancer (PCa) managed with active surveillance (AS), nerve-sparing radical prostatectomy (NS-RP), non-NS-RP, or radiotherapy (RT). This multicentre prospective cohort study used data from the Prostate Cancer Outcomes (PCO) study in Germany, Austria and Switzerland, including 6265 patients with low-risk PCa enrolled between 2016 and 2023. PROs were assessed at baseline and 12 months after treatment/enrolment using the 26-item Expanded Prostate Cancer Index Composite Short Form (EPIC-26), measuring urinary continence, bowel, sexual, hormonal, and irritative/obstructive symptoms. Mean score changes were compared with minimal important differences (MIDs) to determine clinical significance. In all, 475, 4352, 813, and 625 patients received AS, NS-RP, non-NS-RP, and RT, respectively. At 12 months, AS was associated with stable function across all EPIC-26 domains. In contrast, both RP groups experienced significant declines in urinary continence (NS-RP: -18 points; non-NS-RP: -26 points) and sexual function (NS-RP: -35 points; non-NS-RP: -30 points), exceeding MID thresholds. Urinary continence did not decline after RT but clinically relevant declines occurred in irritative/obstructive urinary (-5 points), bowel (-7 points), hormonal (-5 points), and sexual function (-12 points). Age-stratified analysis showed clinically significant declines in urinary and sexual function after NS-RP across all age groups, with the greatest loss in sexual function among younger patients and the most pronounced continence impairment in the 70-79 years age group. In contrast, functional outcomes under AS remained stable in all age cohorts. Active surveillance is underutilised in the observed cohort. Prospective PCO data demonstrates that AS preserves urinary continence and sexual function compared to active treatment, supporting its role as the first-line strategy for suitable candidates. Despite advancements including NS techniques, RP, and to a lesser extent RT, remain associated with substantial functional impairment even in younger men.

ABSTRACTBackgroundTo analyze survival outcomes and identify prognostic factors in patients with locoregionally recurrent nasopharyngeal carcinoma (NPC) receiving salvage treatment, and to evaluate the safety profile of re‐irradiation.MethodsWe retrospectively analyzed clinical data from 95 patients with recurrent NPC (rM0) who were diagnosed and received salvage treatment at the PLA General Hospital between January 2008 and October 2018. Patients were stratified into two treatment groups: the radiotherapy (RT) group (n = 72) and the non‐RT group (n = 23).ResultsWith a median follow‐up of 37 months (4–100 months), the 3‐year overall survival (OS), progression‐free survival (PFS), and disease‐specific survival (DSS) rates were 58.7%, 46.2%, and 33.3%, respectively. The corresponding 5‐year OS, PFS, and DSS rates were 34.2%, 31.3%, and 11.1%, respectively. Significant differences in survival outcomes were observed between the RT and non‐RT groups: OS (43.4% vs. 0%, p < 0.001), PFS (36.2% vs. 0%, p < 0.001), and DSS (16.2% vs. 0%, p = 0.007). Of the tumor‐related deaths, 19 (31.1%) were attributed to massive hemorrhage and 18 (29.5%) to distant metastasis. The univariate and multivariate analyses identified re‐irradiation as an independent predictor of superior OS and PFS, and salvage surgery as a predictor of OS improvement. Conversely, advanced nodal disease (rN2‐3) independently predicted worse OS and PFS, while local and regional recurrence associated with poorer PFS.ConclusionSalvage re‐irradiation significantly improves survival outcomes in locoregionally recurrent NPC, whereas advanced nodal disease (rN2‐3) independently predicts poor prognosis. Massive hemorrhage and distant metastasis are the most common causes of death.Trial RegistrationClinical Trial Register: ChiCTR2500098189

Because primary ocular adnexal mucosa-associated lymphoid tissue lymphoma (POAML) is rare, key clinical questions, including the best treatment strategy and the validity of watchful waiting (WW), remain unresolved. Although radiotherapy (RT) is the standard treatment for localized POAML, it is commonly associated with acute and late toxicities. Overall, 128 patients with localized POAML diagnosed and managed at our institution between 1998 and 2015 were retrospectively analyzed. Forty-two patients were initially managed with WW, and 86 received immediate RT. During a median follow-up of 7.2years (range 0.1-18.4), no patients died of lymphoma progression. Seven patients in the WW group experienced disease progression at the primary site. In the RT group, almost all patients (97.7%) achieved a complete response after RT; however, 12 patients relapsed. Histological transformation occurred in one patient in each group. The 10-year cumulative incidence of progression was 24.9% (95% CI, 12.6-45.7%) with WW and 13.1% (95% CI, 6.9-23.9%) with RT (p = 0.27). The rate of freedom from systemic therapy at 10years was 89.7 and 94.8%, respectively (p = 0.67). This observational study suggests that WW is an acceptable treatment option for selected patients with localized POAML, with no significant differences in long-term outcomes compared with RT.

This study aimed to assess factors associated with overall survival (OS) in patients with microsatellite stable (MSS) stage IV rectal cancer treated with immunotherapy. In this retrospective review of the NCDB (2015-2021), patients with MSS stage IV rectal adenocarcinoma were divided into immunotherapy and control groups, and propensity-score matched and compared. Multivariable Cox regression analysis was performed to assess the effect of immunotherapy and KRAS genotype on OS. Of 6489 included patients (64.6% males), immunotherapy was given to 47.9%. After matching for age, insurance type, liver metastases, surgery, radiation therapy, and chemotherapy, there were 2422 patients in each group. In the matched cohort, immunotherapy was associated with a similar median OS to the control group [31.8 (95% CI: 27.8-32.2) months vs 29.7 (95% CI: 27.8-32.2) months, P = 0.062]. Immunotherapy was not independently associated with improved OS (HR: 0.88, 95% CI: 0.69-1.14, P = 0.341) but was associated with longer median OS in black patients (25.8 vs 19.1 mo, P = 0.019), patients with bone metastases (22.1 vs 10.7, P < 0.001) and with KRAS mutation (27.4 vs 24.3 mo, P = 0.003). There was no survival benefit from immunotherapy when combined with radical resection, radiation therapy, or chemotherapy. In conclusion, immunotherapy was associated with a modest increase in OS of MSS stage IV rectal cancers, but not independently associated with improved survival. Black patients with bone metastases and KRAS mutations may have survival benefit from immunotherapy. Increased OS with immunotherapy was noted only in patients who did not have surgery, radiation, or chemotherapy. These results seem somewhat disappointing given the enthusiasm for immunotherapy.

Robot-assisted laparoscopic radical prostatectomy (RALRP) and intensity-modulated radiotherapy (IMRT) are the main curative options for localized prostate cancer (PCA). However, both may significantly affect patients' quality of life (QoL). To retrospectively compare post-treatment QoL after at least 24 months of follow-up between bladder-neck- and nerve-sparing RALRP and IMRT in patients with intermediate-risk localized PCA. A total of 164 patients treated between October 2016 and May 2023 were analyzed (104 RALRP; 60 IMRT). QoL was evaluated using the Expanded Prostate Cancer Index Composite (EPIC-2002). Urinary, bowel, sexual, and hormonal domains were compared using appropriate statistical tests . Baseline demographics were similar between groups. The mean age was 68.82 ± 6.72 years in the RALRP group and 68.89 ± 7.81 years in the IMRT group. IMRT patients reported better sexual function (p < 0.05), but this advantage was counteracted by hormonal side effects due to androgen deprivation therapy (ADT). Urinary continence was comparable (p > 0.05), whereas irritative urinary symptoms were more common in IMRT (p < 0.001). Bowel function and overall satisfaction were significantly better in RALRP (both p < 0.001). After ≥ 24 months of follow-up, RALRP provided superior bowel and hormonal outcomes, while IMRT yielded slightly better sexual function scores. Overall satisfaction favored RALRP.