This study aimed to evaluate the usability and benefit of a new generation of auto segmentation, that automatically identifies organs and auto-contours them directly at CT simulator before creating prostate radiotherapy plans. The prostates of 10 patients were automatically contoured using the DirectORGANS auto-segmentation algorithm at the CT simulator. The CT scans were imported into the Eclipse treatment planning system for contouring. On the same CT image sets, the prostate was manually contoured by a group of five experienced physicians. MR-guided prostate contours were delineated using MRI images and used as a reference structure. The volumes of the prostate were measured, and the Overlap index (OI), Dice similarity index (DSC), and Volume difference (Dv) were calculated based on contours. The Kruskal-Wallis H test was performed with SPSS (P<0.05). MR-based contouring was used as a reference, and the OI, DSC, Dv, and contouring time results of users and artificial intelligence were analyzed accordingly. There was a significant difference in OI, DSC, and Dv between the results of users and artificial intelligence. The most significant difference between users, artificial intelligence, and MR-based contouring was contouring time (p <0.001). MR- based contouring was time-consuming. Artificial Intelligence’s automatic contouring of the prostate required minimal modification.

Background and Objectives: Stereotactic radiotherapy enhances local tumor control by delivering high doses directly to the tumor. It is thought to activate the immune system via T-cells, possibly creating a systemic response. This study aims to evaluate stereotactic body radiotherapy’s (SBRT) impact on the immune system by measuring T-cell transcription factors, such as TBX21, GATA-3, FoxP3, and RORɣt. Materials and Methods: Peripheral blood samples were collected from 103 patients before SBRT and from 66 patients two months post-treatment. We measured transcription factors TBX21, GATA-3, FOXP3, and RORγt using ELISA, and performed a complete blood count and C-reactive protein analysis to rule out infections. Statistical analyses included paired t-tests and correlation analyses to assess changes before and after treatment. Results: Post-treatment, significant reductions were observed in TBX21 (Th1), GATA-3 (Th2), and FOXP3 (Treg), while RORɣt (Th17) remained stable but trended higher in lung cancer patients. No correlations were found with demographic factors. However, TBX21 levels were significantly related to the planning target volume (PTV) and biologically effective dose (BED10) in the lung region. Larger PTVs (≥16.5 cc) and higher BED10 doses (≥100 Gy) were linked to smaller reductions in TBX21 (p = 0.008, p = 0.04) and increased RORɣt levels (p = 0.01). Conclusions: Stereotactic radiotherapy reduces immunosuppressive markers like FOXP3 and GATA-3, indicating its potential to boost immune activation by suppressing Treg and Th2 cells. Larger target volumes and higher BED10 values may enhance Th1 responses through TBX21. These findings suggest that SBRT activates the immune system, and its combination with immunotherapy could be promising.

Prognostic Value of Serum Lactate Dehydrogenase (LDH) Levels in Small Cell Lung Cancer Patients Receiving Thoracic Radiotherapy and Prophylactic Cranial Irradiation - Gazi Medical Journal

Congratulations to Cho and colleagues for their study, “Effects of Adjuvant Respiratory Therapy on Secretion Expectoration and Treatment Adherence in Patients with Head and Neck Cancer Receiving Concurrent Chemo-Radiotherapy”