Purpose: The current review aims to summarize the international experience of the impact of adaptive radiotherapy on dosimetry and clinical and toxicity outcomes. Additionally, it might trigger Radiation Oncologists to use ART and evaluate whether ART improves target volume coverage and/or normal tissue sparing and, consequently, therapeutic results. Materials and methods: We conducted an electronic literature search of PubMed/MEDLINE and ScienceDirect from January 2007 to January 2023. The search adhered to the PRISMA guidelines and employed keywords such as ART, HNC, parotid gland, and target volume. Furthermore, we examined the reference lists for studies pertinent to the present review. This study included both retrospective and prospective studies that were considered for inclusion. Conclusion: ART replanning appears to be a sustainable strategy to minimize toxicity by improving normal tissue sparing. Furthermore, it can enhance target volume coverage by correctly determining the specific dose to be delivered to the tumor. In conclusion, this review confirmed that ART benefits dosimetric, clinical/therapeutic, and toxicity outcomes.

Radiomics has shown great promise in predicting various diseases. Researchers have previously attempted to include radiomics in their automated detection, diagnosis, and segmentation algorithms, taking these steps based on the promising outcomes of radiomics-based studies. As a result of the increased attention given to this topic, numerous institutions have developed their own radiomics software. These packages, on the other hand, have been utilized interchangeably without regard for their fundamental differences. The primary purpose of this study was to explore benefits of predictive model performance for radiation pneumonitis (RP), which is the most frequent side effect of chest radiotherapy, and through this work, we developed a radiomics model based on deep learning that intends to increase RP prediction performance by combining more data points and digging deeper into these data. In order to evaluate the most popular machine learning models, radiographic characteristics were used, and we recorded the most important of them. The high dimensionality of radiomic datasets is a major issue. The method proposed for use in data problems is the synthetic minority oversampling technique, which we used in order to create a balanced dataset by leveraging suitable hardware and open-source software. The present study assessed the efficacy of various machine learning models, including logistic regression (LR), support vector machine (SVM), random forest (RF), and deep neural network (DNN), in predicting radiation pneumonitis by utilizing specific radiomics features. The findings of the study indicate that the four models displayed satisfactory efficacy in forecasting radiation pneumonitis. The DNN model demonstrated the highest area under the receiver operating curve (AUC-ROC) value, which was 0.87, suggesting its superior predictive capacity among the models considered. The AUC-ROC values for the random forest, SVM, and logistic regression models were 0.85, 0.83, and 0.81, respectively.

Radiotherapy (RT) is a major part of cancer treatment. The reported variability in patient response to this modality can interfere with the continuation of best-possible care, promote side effects, and lead to long-term morbidity. Tools to predict a patient’s response to radiation could be highly useful in improving therapeutic outcomes while minimizing unnecessary and toxic exposure to radiation. This study investigates the potential of using molecular biomarkers as predictors of radiosensitivity in clinical practice. We review relative studies researching the positive correlation between various molecular biomarkers and patient radiosensitivity, including DNA damage response and repair proteins, inflammation and apoptosis markers, cell cycle regulators, and other biological markers. The clinical perspectives and applicability of these biomarkers in the prediction of radiosensitivity are also critically discussed. Conclusively, we underline the dynamics of molecular biomarkers to improve the efficacy and safety of radiotherapy in clinical practice and highlight the need for further research in this field. Identification of the most prominent markers is crucial for the personalization of therapies entailing ionizing radiation.

We performed electronic research for articles published in PubMed, MEDLINE, and ScienceDirect databases from January 2004 to January 2023. The systematic review of twenty (20) peer-reviewed articles about dosimetric parameters and eight (8) articles about clinical outcomes confirmed the dosimetric advantages of ART through better target coverage and Organs at Risk (OARs) sparing, with subsequent benefits on decreased toxicity and improved clinical outcome, specifically local control of the disease. ART replanning is a sustainable strategy for minimizing toxicity by improving normal tissue sparing. Furthermore, it enhances target volume coverage by correctly determining the specific amount of dose to be delivered to the tumor. In conclusion, this review confirms that ART benefits dosimetric, clinical/therapeutic, and toxicity outcomes.