Background: The aim of this retrospective, single-arm study was to present the technique and preliminary efficacy and safety results of a single-fraction SBRT for LAPC using total intravenous anaesthesia and optical surface guidance as motion management. Methods: Fifty-five patients with locally advanced pancreatic cancer were treated with SBRT with a single-fraction receiving a median BED₁₀ = 128.9 Gy. Forty-two patients received systemic treatment. End points were OS, FFLP, PFS, and toxicity. Actuarial survival analysis and univariate analysis were investigated. Results: The median follow-up was 15 months, mean OS was 18 months (95% CI: 16.7 to 19.3), and the one-year FFLP and 1-year OS were 100% and 90.9% (95% CI: ± 1.5%), respectively. Median PFS was 12 months (95% CI: 9.5 to 14.4), and 1-year PFS was 85.5% (95% CI: ± 1.4%). Thirty-five patients (63.6%) were alive at the time of analysis. No acute/late toxicity > G2/G1 was reported. Conclusions: SBRT for LAPC using total intravenous anaesthesia and optical surface guidance presented as an effective and safe treatment with very low toxicity.

Background/Objectives: Metastatic melanoma increasingly includes clinical scenarios in which metastasis-directed treatment may complement systemic immunotherapy, particularly in oligometastatic disease. We evaluated outcomes of stereotactic body radiotherapy (SBRT) combined with immunotherapy in patients with metastatic melanoma, focusing on local control, survival, treatment sequencing, and safety. Methods: In this retrospective single-center study, 63 patients underwent SBRT for 97 extracranial metastatic lesions while receiving immune checkpoint inhibitors. The primary endpoint was local control (LC), while secondary endpoints included progression-free survival (PFS), overall survival (OS), and treatment-related toxicity. Results: LC rates at 12, 24, and 36 months were 95.9%, 89.7%, and 89.7%, respectively, demonstrating durable long-term control of treated lesions. Median OS was 47 months, while median PFS was not reached. A numerical trend toward longer PFS was observed among patients receiving SBRT during immunotherapy, although the differences were not statistically significant. No significant differences in LC were identified across oligometastatic disease subcategories. Combined treatment was well tolerated, with predominantly low-grade toxicity and no signal of increased immune-related adverse events. Conclusions: SBRT combined with immunotherapy appears to be a feasible and effective metastasis-directed treatment strategy in selected patients with metastatic melanoma. Durable local control, encouraging survival outcomes, and favorable tolerability support further prospective studies to optimize treatment sequencing and the integration of local and systemic therapies.

Background: As part of different navigational bronchoscopy (NVB) modalities, radial-probe endobronchial ultrasound (rEBUS) is used to confirm the peribronchial localization of peripheral pulmonary nodules (PPNs) immediately before collecting samples for histopathological analysis. Methods: This retrospective case series study presents the results of en bloc cryobiopsy of PPNs using a flexible 1.1-mm cryoprobe with different NVB modalities. For PPNs classified as adjacent or eccentric lesions by rEBUS (ES-rEBUS), the cryoprobe’s position was adjusted by 90–180° in relation to the ultrasound image of the lesion during the first and second biopsies. Results: All patients with a final histopathologically confirmed diagnosis of PPNs had positive rEBUS findings, regardless of the navigation modality, eccentric (18/42 patients, 43%) and concentric (24/42 patients, 57%) rEBUS view. In 5 out of 6 patients without a histopathological diagnosis, PPNs were not visualized by radial ultrasound. In the (ES-rEBUS) group of patients, 4 out of 18 had fewer than three biopsy samples collected per procedure, which means only an adjusted probe position has been applied, although diagnostic outcomes were achieved. Common Terminology Criteria for Adverse Events (CTCAE) grade 2 complications were reported in 10.4% of the patients, and grade 3 complications in 2% of the patients. Conclusions: Confirming the localization of nodules by rEBUS and properly adjusting the cryoprobe immediately before cryobiopsy of PPNs resulted in a diagnostic yield meeting the literature standards.

Background: The aim of this study was to present the technique and preliminary results of efficacy and safety for single-fraction SBRT for LAPC using Total Intravenous Anaesthesia and Optical Surface Guidance as motion management. Methods: Fifty-five patients were treated with SBRT in a single-fraction receiving median BED₁₀ = 128.9 Gy. Forty-two patients received systemic treatment. End points were OS, FFLP, PFS, and toxicity. Actuarial survival analysis and univariate analysis were investigated. Results: Median follow-up was 15 months. Mean OS was 26.7 months. One-year FFLP and 1-year OS were 100% and 90.9%, respectively. Median PFS was 18 months, and 1-year PFS was 85.5%. Thirty-five patients (63.6%) were alive at the time of analysis. No acute/late toxicity > G2/G1 was reported. Conclusions: SBRT for LAPC using Total Intravenous Anaesthesia and Optical Surface Guidance presented as an effective and safe treatment with very low toxicity.