REQUITE aimed to establish a resource for multi-national validation of models and biomarkers that predict risk of late toxicity following radiotherapy. The purpose of this article is to provide summary descriptive data. An international, prospective cohort study recruited cancer patients in 26 hospitals in eight countries between April 2014 and March 2017. Target recruitment was 5300 patients. Eligible patients had breast, prostate or lung cancer and planned potentially curable radiotherapy. Radiotherapy was prescribed according to local regimens, but centres used standardised data collection forms. Pre-treatment blood samples were collected. Patients were followed for a minimum of 12 (lung) or 24 (breast/prostate) months and summary descriptive statistics were generated. The study recruited 2069 breast (99% of target), 1808 prostate (86%) and 561 lung (51%) cancer patients. The centralised, accessible database includes: physician- (47,025 forms) and patient- (54,901) reported outcomes; 11,563 breast photos; 17,107 DICOMs and 12,684 DVHs. Imputed genotype data are available for 4223 patients with European ancestry (1948 breast, 1728 prostate, 547 lung). Radiation-induced lymphocyte apoptosis (RILA) assay data are available for 1319 patients. DNA (n = 4409) and PAXgene tubes (n = 3039) are stored in the centralised biobank. Example prevalences of 2-year (1-year for lung) grade ≥2 CTCAE toxicities are 13% atrophy (breast), 3% rectal bleeding (prostate) and 27% dyspnoea (lung). The comprehensive centralised database and linked biobank is a valuable resource for the radiotherapy community for validating predictive models and biomarkers. Up to half of cancer patients undergo radiation therapy and irradiation of surrounding healthy tissue is unavoidable. Damage to healthy tissue can affect short- and long-term quality-of-life. Not all patients are equally sensitive to radiation "damage" but it is not possible at the moment to identify those who are. REQUITE was established with the aim of trying to understand more about how we could predict radiation sensitivity. The purpose of this paper is to provide an overview and summary of the data and material available. In the REQUITE study 4400 breast, prostate and lung cancer patients filled out questionnaires and donated blood. A large amount of data was collected in the same way. With all these data and samples a database and biobank were created that showed it is possible to collect this kind of information in a standardised way across countries. In the future, our database and linked biobank will be a resource for research and validation of clinical predictors and models of radiation sensitivity. REQUITE will also enable a better understanding of how many people suffer with radiotherapy toxicity.

To analyze the effect of radiotherapy (RT) in patients with metastatic spinal cord compression (MSCC) and poor prognosis in our center. RT is an effective treatment for MSCC. Prospective evaluation on patients with MSCC and limited survival (according to Rades' scale), and treated with single-dose 8 Gy RT (February 2013-August 2014). Pain, ambulatory status and sphincter control were recorded. Pain relief was evaluated following the International Bone Metastases Consensus Working Party Guidelines. Ambulatory status was evaluated with Frankel's scale. Spinal fracture and instability were recorded. Health aspects were evaluated via a short survey and measuring the time spent on RT. 35 patients were included. 51% had unfavorable histologies; 60% bone fracture and 17% spinal instability. Median Karnofsky score was 60; 100% were on high doses of opioids. Median survival was 1.5 months. 49% had a partial pain response at 2 weeks post-radiation, and 47% at one month. Significant reductions in pain intensity were present at 2 weeks (Visual analog scale, VAS score, from 8 ± 1.5 to 5 ± 1.9). Negligible effects were observed on motor and bladder function, along with side effects. KPS score was maintained during follow-up. 80% of patients spent ≤5% of their remaining lifetime on RT. A survey comparison between clinical judgment and the results according to treatment decision consider that these patients merit treatment evaluation. A moderate pain response tailored to life expectancy can be obtained in patients treated with radiation. 8-Gy single-dose is an option for patients with limited survival.

Aim: To find out whether the internal target volume (ITV) vaginal procedure ensures dosimetric coverage during intensity-modulated radiation therapy (IMRT) of post-operative gynaecological tumours without instructions on rectal filling. Background: The ITV vaginal procedure does not necessarily include all movements of the bladder, and does not include changes in the rectal volume. We should know if the vaginal ITV is a useful tool in maintaining CTV coverage during treatment. Materials and methods: A retrospective analysis of 24 patients treated between July 2012 and July 2014 with adjuvant IMRT for gynaecological cancer. All patients underwent empty and full bladder CT on simulation (CT-planning) and three weeks later (CT-control). ITV displacement was measured and the 3D vector was calculated. ITV coverage was then evaluated by comparing the volume covered by the prescription isodose on both CT's. Patients were asked to have full bladder but they did not follow recommendations for the rectum. Results: The mean 3D vector was 0.64 +/- 0.32 cm (0.09-1.30). The mean ITV coverage loss was 5.8 +/- 5.7% (0-20.2). We found a significant positive correlation between the 3D vector and the loss of coverage (Pearson correlation, r = 0.493, 95% CI: 0.111-0.748, p = 0.0144). We did not find any significant correlation between the bladder and rectal parameters with the 3D vector and loss of dosimetric coverage. We found a trend between the maximum rectal diameter in CT-planning and 3D vector (r = 0.400, 95% CI: -0.004 to 0.692, p = 0.0529). Conclusion: ITV vaginal procedure contributed to ensuring a good dose coverage without instructions on rectal filling. (C) 2018 Greater Poland Cancer Centre. Published by Elsevier Sp. z o.o. All rights reserved.

This study assesses the toxicity and clinical outcomes of Hypofractionated 3D radiotherapy (HFRT) for medically inoperable T1-3 N0-1 non-small-cell lung cancer (NSCLC). Thirty-four patients with inoperable early stage NSCLC were treated from August 2008 to April 2013. Prior to enrollment, patients were required to be evaluated by an experienced thoracic surgeon to determine “operability”. All received 57 Gy in 19 fractions followed by escalated doses of 3 Gy fractions, up to a total dose of 66 Gy using a three-dimensional conformal technique. Toxicities were measured using the Common Terminology Criteria for Adverse Effects version 4.0. The median follow-up was 33 months (7-74). Toxicity grades ≥ 3 were not observed. Local control (LC) was 80.4% at 2-year while regional control (RC) was 78%. The overall survival (OS), Time to Progression (TTP) and Time to Distant Metastasis (TTM) at 2-years were 60%, 59% and 80% respectively. For patients with T1-2N0 and a tumour size smaller than 45 mm (n=19), rates of OS and TTP and TTM at 2-years were 71%, 75% and 94% respectively. LC and RC at 2-years were 85% and 94% respectively. HFRT using 3.0 Gy fractions amounting to a total dose of 66 Gy is the recommended dose. A Phase 2 trial is warranted in order to assess the safety and efficacy of this fractionation scheme. HFRT resulting in a favorable outcome in early stage lung cancer without the usual restrictions in tumor size and/or location associated with previous treatment methods. No special equipment is required, therefore permitting its application in any center.

Introduction: To evaluate changes in pulmonary function by spirometry after stereotactic body radiotherapy (SBRT). Methods: A single-center, retrospective study was performed which analyzed lung function after SBRT from January 1, 2015 to January 31, 2020. Eligible patients were ≥18 years of age, with early-stage lung cancer or lung metastases ≤5 cm and Karnofsky performance status (KPS) >70. Patients were excluded if they had a history of non-infectious pneumonitis or interstitial lung disease. Clinical cases were discussed in a multidisciplinary tumor board, and the patients were classified as surgically resectable but medically inoperable. Mixed-effects models were used to evaluate changes in forced expiratory volume in 1 (FEV₁), forced vital capacity (FVC) and diffusing capacity of the lungs for carbon monoxide (DLCO) at 3, 6, 12, and 24 months after SBRT. Results: Fifty-two patients underwent SBRT. Median follow-up spirometry post-SBRT was 12 months (range, 12-24). No significant differences were observed during the first year in both liters and the percentage of predicted FEV₁ evolution. A gain of 5.9% [95% CI, 2.3; 9.6 percent (p=0.0014)] was beheld after 24 months post-SBRT. Although, no significant difference has been viewed when we analyze it in liters with an FEV₁ value 24 months post-SBRT of 1.57 liters [95% CI, 1.56; 1.59 liters (p=0.848)]. There are no differences when we analyze FVC evolution according to liters during the first two years post treatment. Finally, no differences were observed when analyzing DLCO evolution according to percentage or as ml/min/kPa. Conclusions: SBRT in primary lung tumors or pulmonary metastases does not negatively influence pulmonary function assessed by spirometry at least in the first two years after treatment.