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  1. Article: Activity of sotorasib against brain metastases from NSCLC harboring

    Inno, Alessandro / Marchetti, Fabiana / Valerio, Matteo / Giaj Levra, Niccolò / Alongi, Filippo / Foti, Giovanni / Gori, Stefania

    Drug target insights

    2023  Volume 17, Page(s) 90–91

    Abstract: In the CodeBreaK 100 phase 2 study, sotorasib was active for patients with metastatic non-small cell lung cancer (NSCLC) harboring Kirsten rat sarcoma viral oncogene homologue (KRAS) p.G12C mutation. However, patients with untreated and/or active brain ... ...

    Abstract In the CodeBreaK 100 phase 2 study, sotorasib was active for patients with metastatic non-small cell lung cancer (NSCLC) harboring Kirsten rat sarcoma viral oncogene homologue (KRAS) p.G12C mutation. However, patients with untreated and/or active brain metastases were excluded from the trial, and the activity of sotorasib in the setting of brain metastases should be further investigated. Here we report the case of a KRAS p.G12C mutant NSCLC patient with three brain metastases, of whom one was untreated and the other two had progressed after radiotherapy with symptoms requiring steroids, that responded to sotorasib. Our report suggests that sotorasib may be active against untreated or progressive brain metastases, supporting further evaluation of sotorasib in this setting.
    Language English
    Publishing date 2023-06-20
    Publishing country Italy
    Document type Case Reports
    ZDB-ID 2423820-X
    ISSN 1177-3928
    ISSN 1177-3928
    DOI 10.33393/dti.2023.2593
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Systemic treatment and radiotherapy for patients with non-small cell lung cancer (NSCLC) and HIV infection - A systematic review.

    Brandão, Mariana / Durieux, Valérie / Auprih, Maša / Fozza, Alessandra / Dauby, Nicolas / Cuccia, Francesco / Aspeslagh, Sandrine / Verhaert, Marthe / Giaj-Levra, Niccolò

    Lung cancer (Amsterdam, Netherlands)

    2023  Volume 178, Page(s) 75–86

    Abstract: Lung cancer is the most common non-AIDS defining cancer among people living with HIV (PLWH), but there is a paucity of data regarding the efficacy and toxicity of radiotherapy and systemic regimens, including immunotherapy, in the treatment of these ... ...

    Abstract Lung cancer is the most common non-AIDS defining cancer among people living with HIV (PLWH), but there is a paucity of data regarding the efficacy and toxicity of radiotherapy and systemic regimens, including immunotherapy, in the treatment of these patients. In order to answer this question, we have performed a systematic search of the literature in Ovid Medline until March 17, 2022. We included 21 publications, enrolling 513 PLWH with non-small cell lung cancer (NSCLC), mostly male (75-100%), (ex-)smokers (75-100%) and with stage III-IV at diagnosis (65-100%). The overall response rate (ORR) to chemotherapy (n = 186 patients, mostly receiving platinum-based regimens) was highly variable (17 %-83 %), with a substantial hematological toxicity. ORR varied between 13 % and 50 % with single-agent immunotherapy (n = 68), with median overall survival between 9 and 11 months and a very acceptable toxicity profile, in line with studies in the HIV non-infected population. All five patients receiving tyrosine kinase inhibitors (TKIs; gefitinib or erlotinib) showed a partial response and long overall survival. Yet, combination of TKIs with antiretroviral therapy using pharmacological boosters, such as ritonavir, should be avoided. Radiotherapy was evaluated among 42 patients, showing high ORR (55 %-100 %), but 18 % of patients had a pneumonitis. This systematic review shows that radiotherapy and systemic therapy are effective and safe among PLWH with controlled infection diagnosed with NSCLC. Nonetheless, most reports were small and heterogeneous and larger studies are needed to confirm these encouraging findings. Moreover, clinical trials should not restrict the inclusion of PLWH, as more data is needed regarding the long-term efficacy and safety of treatments among this underserved population, especially of immunotherapy.
    MeSH term(s) Humans ; Male ; Female ; Carcinoma, Non-Small-Cell Lung/radiotherapy ; Carcinoma, Non-Small-Cell Lung/drug therapy ; Lung Neoplasms/radiotherapy ; Lung Neoplasms/drug therapy ; Antineoplastic Agents/therapeutic use ; HIV Infections/complications ; HIV Infections/drug therapy ; Erlotinib Hydrochloride/therapeutic use
    Chemical Substances Antineoplastic Agents ; Erlotinib Hydrochloride (DA87705X9K)
    Language English
    Publishing date 2023-01-21
    Publishing country Ireland
    Document type Systematic Review ; Journal Article ; Review
    ZDB-ID 632771-0
    ISSN 1872-8332 ; 0169-5002
    ISSN (online) 1872-8332
    ISSN 0169-5002
    DOI 10.1016/j.lungcan.2023.01.010
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: ONE SHOT - single shot radiotherapy for localized prostate cancer: 18-month results of a single arm, multicenter phase I/II trial.

    Zilli, Thomas / Franzese, Ciro / Guckenberger, Matthias / Giaj-Levra, Niccolò / Mach, Nicolas / Koutsouvelis, Nikolaos / Achard, Verane / Mcdonald, Andrew / Alongi, Filippo / Scorsetti, Marta / Constantin, Guillaume / Bertaut, Aurelie / Miralbell, Raymond

    Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

    2024  Volume 194, Page(s) 110181

    Abstract: Purpose: To assess in a prospective, multicenter, single-arm phase I/II study the early safety and efficacy profile of single fraction urethra-sparing stereotactic body radiotherapy (SBRT) for men with localized prostate cancer.: Material and methods!# ...

    Abstract Purpose: To assess in a prospective, multicenter, single-arm phase I/II study the early safety and efficacy profile of single fraction urethra-sparing stereotactic body radiotherapy (SBRT) for men with localized prostate cancer.
    Material and methods: Patients with low- and intermediate-risk localized prostate cancer without significant tumor in the transitional zone were recruited. A single-fraction of 19 Gy was delivered to the prostate, with 17 Gy dose-reduction to the urethra. Intrafraction motion was monitored using intraprostatic electromagnetic transponders with intra-fraction correction of displacements exceeding 3 mm. Genitourinary (GU), gastrointestinal (GI), and sexual toxicity during the first 18 months were evaluated using the CTCAE v4.0 grading scale. Quality of life was assessed using the International Prostate Symptom Score, the Expanded Prostate Cancer Index composite 26 score, and the International Index of Erectile Function score.
    Results: Among the 45 patients recruited in 5 centers between 2017 and 2022, 43 received the single fraction without protocol deviations, and 34 had a minimal follow-up of 18 months. The worst GU toxicity was observed at day-5 after SBRT (42.5 % and 20 % with grade 1 and 2, respectively), returning to baseline at week-12 and month-6 (<3% with grade 2), with a 12 % grade 2 flare at month 18. Gl toxicity was mild in the acute phase, with no grade ≥ 2 events (12 % grade 1 at month 6). Grade-3 proctitis was observed in one patient at month 12, with < 3 % grade 2 toxicity at month 18. Mean GU and GI bother scores showed a decline at day 5, a complete recovery at month 6, and a flare between month 12 and 18. Mean PSA dropped from 6.2 ng/ml to 1.2 ng/ml at month 18 and 0.7 ng/ml at month 24. After a median follow-up time of 26 months, 3 biochemical failures (7 %) were observed at month 17, 21 and 30.
    Conclusions: In this multicenter phase I/II trial, we demonstrated that a 19 Gy single-fraction urethra-sparing SBRT is feasible and associated with an acceptable toxicity rate, mostly returning to the baseline at week-12 and with a symptoms flare between months 12 and 18. Longer follow-up is needed to assess the potential long-term adverse effects and the disease control efficacy.
    MeSH term(s) Humans ; Male ; Prostatic Neoplasms/radiotherapy ; Prostatic Neoplasms/pathology ; Prostatic Neoplasms/surgery ; Aged ; Middle Aged ; Prospective Studies ; Radiosurgery/methods ; Radiosurgery/adverse effects ; Aged, 80 and over ; Quality of Life ; Urethra/radiation effects ; Organ Sparing Treatments/methods ; Radiation Injuries/etiology
    Language English
    Publishing date 2024-02-24
    Publishing country Ireland
    Document type Journal Article ; Clinical Trial, Phase II ; Multicenter Study ; Clinical Trial, Phase I ; Research Support, Non-U.S. Gov't
    ZDB-ID 605646-5
    ISSN 1879-0887 ; 0167-8140
    ISSN (online) 1879-0887
    ISSN 0167-8140
    DOI 10.1016/j.radonc.2024.110181
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Epidemiology of oligometastatic non-small cell lung cancer: results from a systematic review and pooled analysis.

    Gobbini, Elisa / Bertolaccini, Luca / Giaj-Levra, Niccolò / Menis, Jessica / Giaj-Levra, Matteo

    Translational lung cancer research

    2021  Volume 10, Issue 7, Page(s) 3339–3350

    Abstract: Background: To describe the incidence and the clinical characteristics of oligometastatic non-small cell lung cancer (NSCLC) patients. Oligometastatic NSCLC is gaining recognition as a clinical condition with a different prognosis compared to multi ... ...

    Abstract Background: To describe the incidence and the clinical characteristics of oligometastatic non-small cell lung cancer (NSCLC) patients. Oligometastatic NSCLC is gaining recognition as a clinical condition with a different prognosis compared to multi metastatic disease. Usually, four different scenarios of oligometastatic disease can be described but not epidemiological data are available. To date, it is difficult to delineate an exhaustive epidemiological scenario because no uniform or shared definition of oligometastatic status exists, even though a recent consensus defined synchronous oligometastatic disease as having a maximum of 5 metastases in 3 different organs.
    Methods: A systematic review and a pooled analysis of literature were performed. Article selection was based on the following characteristics: focus on lung cancers; dealing with oligometastatic settings and providing a definition of oligometastatic disease; number of metastatic lesions with or without the number of organs involved; providing some incidence or clinical characteristics of oligometastatic NSCLC patients. Series focusing on a specific single metastatic organ were excluded. The research was launched in MEDLINE (OvidSP) in March 2020. Full articles were individually and collectively read by the authors according to the previous criteria. Each author inspected the reference list included in the eligible articles. If the selection criteria were recognized, the article was reviewed by all authors and then included. Data on patient clinical features were pooled together from 31 articles selected.
    Results: A total number of 31 articles have been selected for the analysis. The following variables were extracted from the publications: (I) number of metastases, (II) number of organs involved, (III) number of patients, (IV) number and percentage of males and females, (V) number and percentage of squamous and non-squamous histology, (VI) T and N status and/or stage of primary disease for oligometastatic setting. The data collected have been analyzed according to the oligometastatic setting.
    Conclusions: Oligometastatic status is globally identified as a different clinical condition from multi metastatic NSCLC, although the clinical characteristics were consistent in the general metastatic population, even with a lower-than-expected TN status. The brain and bones were the most frequent organs involved. Lacking consensus definition, these results must be interpreted cautiously and a prospective evaluation is urgently needed.
    Language English
    Publishing date 2021-08-06
    Publishing country China
    Document type Journal Article ; Review
    ZDB-ID 2754335-3
    ISSN 2226-4477 ; 2218-6751
    ISSN (online) 2226-4477
    ISSN 2218-6751
    DOI 10.21037/tlcr-20-982
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Immunotherapy in NSCLC Patients With Brain and Leptomeningeal Metastases.

    Pierret, Thomas / Giaj-Levra, Niccolò / Toffart, Anne-Claire / Alongi, Filippo / Moro-Sibilot, Denis / Gobbini, Elisa

    Frontiers in oncology

    2022  Volume 12, Page(s) 787080

    Abstract: Immunotherapy has now been integrated as a treatment strategy for most patients with non-small cell lung cancer (NSCLC). However, the pivotal clinical trials that demonstrated its impressive efficacy often did not include patients with active, untreated ... ...

    Abstract Immunotherapy has now been integrated as a treatment strategy for most patients with non-small cell lung cancer (NSCLC). However, the pivotal clinical trials that demonstrated its impressive efficacy often did not include patients with active, untreated brain metastases or leptomeningeal carcinomatosis. Nevertheless, NSCLC is the most common tumor to metastasize to the brain, and patients develop brain and meningeal involvement in approximately 40 and 10% of cases, respectively. Consequently, the appropriate care of these patients is a recurrent clinical concern. Although there are many aspects that would merit further investigation to explain the mechanism of intracranial response to immune checkpoint inhibitors (ICPs), some data suggest that they are able to cross the blood-brain barrier, resulting in local tumor microenvironment modification. This results in a similar clinical benefit in patients with stable, previously treated brain metastases compared to the general population. Despite important limitations, some real-life studies have described that the ICPs' efficacy was maintained also in less selected patients with untreated or symptomatic brain metastases. In contrast, few data are available about patients with leptomeningeal carcinomatosis. Nevertheless, neurological complications due to ICP treatment in patients with brain metastases have to be evaluated and carefully monitored. Despite the fact that limited data are available in the literature, the purpose of this review is to show that the multimodal treatment of these patients with brain metastases and/or leptomeningeal disease should be discussed during tracing of the history of the disease, participating in the local and possibly systemic control of NSCLC.
    Language English
    Publishing date 2022-04-12
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2649216-7
    ISSN 2234-943X
    ISSN 2234-943X
    DOI 10.3389/fonc.2022.787080
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Stereotactic radiosurgery for the treatment of brainstem metastases: a multicenter retrospective study.

    Nicosia, Luca / Navarria, Piera / Pinzi, Valentina / Giraffa, Martina / Russo, Ivana / Tini, Paolo / Giaj-Levra, Niccolò / Alongi, Filippo / Minniti, Giuseppe

    Radiation oncology (London, England)

    2022  Volume 17, Issue 1, Page(s) 140

    Abstract: Background: Brainstem metastases (BSM) are associated with a poor prognosis and their management represents a therapeutic challenge. BSM are often inoperable and, in absence of randomized trials, the optimal radiation treatment of BSM remains to be ... ...

    Abstract Background: Brainstem metastases (BSM) are associated with a poor prognosis and their management represents a therapeutic challenge. BSM are often inoperable and, in absence of randomized trials, the optimal radiation treatment of BSM remains to be defined. We evaluated the efficacy and toxicity of linear accelerator (linac)-based stereotactic radiosurgery (SRS) and hypofractionated steretotactic radiotherapy (HSRT) in the treatment of BSM in a series of patients treated in different clinical centers.
    Methods: We conducted a multicentric retrospective study of patients affected by 1-2 BSM from different histologies who underwent SRS/HSRT. Freedom from local progression (FLP), cancer-specific survival (CSS), overall survival (OS), and treatment-related toxicity were evaluated. In addition, predictors of treatment response and survivals were evaluated.
    Results: Between 2008 and 2021, 105 consecutive patients with 111 BMS who received SRS or HSRT for 1-2 BSM were evaluated. Median follow-up time was 10 months (range 3-130). One-year FLP rate was 90.4%. At the univariate analysis, tumor volume ≤ 0.4 cc, and concurrent targeted therapy were associated with longer FLP, with combined treatment that remained a significant independent predictor [0.058, HR 0.139 (95% CI 0.0182-1.064]. Median OS and CSS were 11 months and 14.6 months, respectively. At multivariate analysis, concurrent targeted therapy administration was significantly associated with longer OS [HR 0.514 (95%CI 0.302-0.875); p = 0.01]. Neurological death occurred in 30.4% of patients, although this was due to local progression in only 3 (2.8%) patients.
    Conclusion: Linac-based SRS/HSRT offers excellent local control to patients with BSM, with low treatment-related toxicity and no apparent detrimental effects on OS. When treated with ablative intent, BSM are an uncommon cause of neurological death. The present results indicates that patients with BSM should not be excluded a priori from clinical trials.
    MeSH term(s) Brain Neoplasms/radiotherapy ; Brain Neoplasms/secondary ; Brain Neoplasms/surgery ; Brain Stem ; Cranial Irradiation ; Humans ; Radiosurgery/adverse effects ; Radiosurgery/methods ; Retrospective Studies ; Treatment Outcome
    Language English
    Publishing date 2022-08-09
    Publishing country England
    Document type Journal Article ; Multicenter Study
    ZDB-ID 2224965-5
    ISSN 1748-717X ; 1748-717X
    ISSN (online) 1748-717X
    ISSN 1748-717X
    DOI 10.1186/s13014-022-02111-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Stereotactic ablative radiotherapy in patients with refractory ventricular tachyarrhythmia.

    Molon, Giulio / Giaj-Levra, Niccolò / Costa, Alessandro / Bonapace, Stefano / Cuccia, Francesco / Marinelli, Alessio / Trachanas, Konstantinos / Sicignano, Gianluisa / Alongi, Filippo

    European heart journal supplements : journal of the European Society of Cardiology

    2022  Volume 24, Issue Suppl C, Page(s) C248–C253

    Abstract: Stereotactic ablative body radiotherapy (SABR) is an innovative therapeutic approach in patients (pts) with a diagnosis of refractory ventricular tachyarrhythmia (VT) after the use of drugs, radiofrequency catheter ablation, and/or defibrillator (ICD) ... ...

    Abstract Stereotactic ablative body radiotherapy (SABR) is an innovative therapeutic approach in patients (pts) with a diagnosis of refractory ventricular tachyarrhythmia (VT) after the use of drugs, radiofrequency catheter ablation, and/or defibrillator (ICD) implant. The current efficacy data of SABR are limited and several prospective clinical studies are ongoing to support the use of ablative radiation dose to control VT. The aim of the current prospective pilot study is to report the efficacy and tolerability of SABR in ICD implanted pts with refractory VT in our centre. Non-invasive electroanatomical mapping (EAM), cardiac computed tomography (CT), and
    Language English
    Publishing date 2022-05-18
    Publishing country England
    Document type Journal Article
    ZDB-ID 1463769-8
    ISSN 1554-2815 ; 1520-765X
    ISSN (online) 1554-2815
    ISSN 1520-765X
    DOI 10.1093/eurheartj/suac016
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Repeated stereotactic radiosurgery for the treatment of relapsed brain metastases: is it time to give up whole-brain radiotherapy?

    Nicosia, Luca / Figlia, Vanessa / Giaj-Levra, Niccolò / Minniti, Giuseppe / Alongi, Filippo

    Oncoscience

    2020  Volume 7, Issue 3-4, Page(s) 19–20

    Language English
    Publishing date 2020-04-24
    Publishing country United States
    Document type Journal Article
    ISSN 2331-4737
    ISSN 2331-4737
    DOI 10.18632/oncoscience.500
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  9. Article: PSMA-PET/CT-Based Stereotactic Body Radiotherapy (SBRT) in the Treatment of Uncomplicated Non-Spinal Bone Oligometastases from Prostate Cancer.

    Pastorello, Edoardo / Nicosia, Luca / Cuccia, Francesco / Olivari, Laura / Fiorini, Matilde / Giaj Levra, Niccolò / Mazzola, Rosario / Ricchetti, Francesco / Rigo, Michele / Ravelli, Paolo / D'Alessandro, Salvatore / Salgarello, Matteo / Ruggieri, Ruggero / Alongi, Filippo

    Cancers

    2023  Volume 15, Issue 10

    Abstract: Background and purpose: Stereotactic body radiotherapy (SBRT) has a consolidated role in the treatment of bone oligometastases from prostate cancer (PCa). While the evidence for spinal oligometastases SBRT was robust, its role in non-spinal-bone ... ...

    Abstract Background and purpose: Stereotactic body radiotherapy (SBRT) has a consolidated role in the treatment of bone oligometastases from prostate cancer (PCa). While the evidence for spinal oligometastases SBRT was robust, its role in non-spinal-bone metastases (NSBM) is not standardized. In fact, there was no clear consensus about dose and target definition in this setting. The aim of our study was to evaluate efficacy, toxicity, and the pattern of relapse in SBRT delivered to NSBM from PCa.
    Materials and methods: From 2016 to 2021, we treated a series of oligo-NSBM from PCa with
    Results: a total of 150 NSBM in 95 patients were treated with 30-35 Gy in five fractions. With a median follow-up of 26 months, 1- and 3 years LPFS was 96.3% and 89%, respectively. A biologically effective dose (BED) ≥ 198 Gy was correlated with improved LPFS (
    Conclusion: SBRT is a safe and effective tool for NSBM from PCa in the oligometastatic setting. Intraosseous relapse was a relatively rare event. Predictive factors of the improved outcomes were defined.
    Language English
    Publishing date 2023-05-17
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2527080-1
    ISSN 2072-6694
    ISSN 2072-6694
    DOI 10.3390/cancers15102800
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Linac-based versus MR-guided SBRT for localized prostate cancer: a comparative evaluation of acute tolerability.

    Nicosia, Luca / Mazzola, Rosario / Rigo, Michele / Giaj-Levra, Niccolò / Pastorello, Edoardo / Ricchetti, Francesco / Vitale, Claudio / Figlia, Vanessa / Cuccia, Francesco / Ruggieri, Ruggero / Alongi, Filippo

    La Radiologia medica

    2023  Volume 128, Issue 5, Page(s) 612–618

    Abstract: Aim: This study aims to compare acute toxicity of prostate cancer (PCa) stereotactic body radiotherapy (SBRT) delivered by MR-guided radiotherapy (MRgRT) with 1.5-T MR-linac or by volumetric modulated arc (VMAT) with conventional linac.: Methods: ... ...

    Abstract Aim: This study aims to compare acute toxicity of prostate cancer (PCa) stereotactic body radiotherapy (SBRT) delivered by MR-guided radiotherapy (MRgRT) with 1.5-T MR-linac or by volumetric modulated arc (VMAT) with conventional linac.
    Methods: Patients with low-to-favorable intermediate risk class PCa were treated with exclusive SBRT (35 Gy in five fractions). Patients treated with MRgRT were enrolled in an Ethical Committee (EC) approved trial (Prot. n° 23,748), while patients treated with conventional linac were enrolled in an EC approved phase II trial (n° SBRT PROG112CESC). The primary end-point was the acute toxicity. Patients were included in the analysis if they had at least 6 months of follow-up for the primary end-point evaluation. Toxicity assessment was performed according to CTCAE v5.0 scale. International Prostatic Symptoms Score (IPSS) was also performed.
    Results: A total of 135 patients were included in the analysis. Seventy-two (53.3%) were treated with MR-linac and 63 (46.7%) with conventional linac. The median initial PSA before RT was 6.1 ng/ml (range 0.49-19). Globally, acute G1, G2, and G3 toxicity occurred in 39 (28.8%), 20 (14.5%), and 5 (3.7%) patients. At the univariate analysis, acute G1 toxicity did not differ between MR-linac and conventional linac (26.4% versus 31.8%), as well as G2 toxicity (12.5% versus 17.5%; p = 0.52). Acute G2 gastrointestinal (GI) toxicity occurred in 7% and 12.5% of cases in MR-linac and conventional linac group, respectively (p = 0.06), while acute G2 genitourinary toxicity occurred in 11% and 12.8% in MR-linac and conventional linac, respectively (p = 0.82). The median IPSS before and after SBRT was 3 (1-16) and 5 (1-18). Acute G3 toxicity occurred in two cases in the MR-linac and three cases in the conventional linac group (p = n.s.).
    Conclusion: Prostate SBRT with 1.5-T MR-linac is feasible and safe. Compared to conventional linac, MRgRT might to potentially reduce the overall G1 acute toxicity at 6 months, and seems to show a trend toward a lower incidence of grade 2 GI toxicity. A longer follow-up is necessary to assess the late efficacy and toxicity.
    MeSH term(s) Humans ; Male ; Gastrointestinal Diseases/etiology ; Prostatic Neoplasms/radiotherapy ; Prostatic Neoplasms/surgery ; Radiosurgery/adverse effects
    Language English
    Publishing date 2023-04-13
    Publishing country Italy
    Document type Comparative Study ; Evaluation Study ; Journal Article
    ZDB-ID 205751-7
    ISSN 1826-6983 ; 0033-8362
    ISSN (online) 1826-6983
    ISSN 0033-8362
    DOI 10.1007/s11547-023-01624-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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