Background: Cisplatin (CDDP) concomitant to radiotherapy (RT) is one of the main treatments for locally advanced head and neck squamocellular carcinoma (LA HNSCC); nevertheless, elderly patients are underrepresented in trials and frequently receive less intensive and suboptimal treatments, which often are unimodal, even if it is well demonstrated how chemoradiotherapy (CRT) with CDDP is superior to RT alone. We aim to analyze clinical feasibility in terms of acute toxicity and treatment adherence in patients receiving concurrent high-dose CDDP and RT with curative or adjuvant intent, comparing elderly (≥65 years) with young (G1 in the elderly versus young population is the null hypothesis. Data were analyzed using MedCal statistical software 14.12. A p < 0.05 was considered statistically significant. Results: A total of 170 patients were included in the study, according to the selection criteria stated. Only 7 elderly (12.3%) patients received a dose < 200 mg/m², whereas 163 patients (87.7%) received ≥ 200 mg/m² and all elderly patients completed RT, indicating a high level of adherence and effective management of treatment protocols, in front of a comparable incidence of acute toxicity to young patients (p-value: 0.84). OS and PFS were not statistically different between elderly and young patients (p = 0.20 and p = 0.72, respectively). Conclusions: Our findings suggest the feasibility of curative oncological treatment for elderly individuals with LA HNSCC, if they are well selected and adequately supported. Future studies should focus on validating and expanding these results to improve patient care and outcomes.

Renal cell carcinoma (RCC) is the most common malignant tumor of the kidney. Stereotactic body radiotherapy (SBRT) has recently emerged as a promising non-invasive treatment option for patients with localized RCC. However, data on SBRT in cases involving multiple renal lesions and pre-existing chronic kidney disease remain limited. We report a case of a 69-year-old male with a history of polycystic kidney disease and prior partial nephrectomy for RCC, who was found to have four new renal lesions during follow-up. At diagnosis of relapse, the patient was treated with SBRT using Cybernife®. All four lesions were treated simultaneously, with a total dose of 30 Gy in five consecutive fractions. No acute toxicity was observed. At the last follow-up, 29 months after SBRT, the MRI confirmed the stable disease observed at the previous controls. Renal function remained stable throughout the follow-up period. This case supports the use of SBRT as a safe and effective alternative to surgery for patients with multiple RCC lesions and compromised renal function. Even with a reduced dose, SBRT achieved long-term disease control and preservation of renal function suggesting its suitability in selected complex cases.

Purpose: This paper aimed to identify dosimetric, clinical, and CT-based densitometric predictors of radiation-induced pulmonary events in breast cancer patients treated with moderately hypofractionated radiotherapy. Materials and Methods: A single-institution cohort of 1172 consecutive patients treated with 3D conformal whole-breast radiotherapy (40 Gy/15 fractions) before 2017 was analyzed. Ipsilateral lung DVHs and CT densitometry metrics were extracted. Clinical variables and cardiac calcification (CAC) scores (Agatston_score, CAC_volume, Max_HU_Heart) were included. Univariable and multivariable logistic regressions were performed; collinearity was assessed via Spearman correlation and VIF. Optimal thresholds were derived using the Youden index. Internal validation used bootstrap resampling. Results: After a median follow-up of 6.5 years, 18 patients developed moderate/severe pulmonary events. The univariable analysis showed associations with lung densitometric features (median/mean HU, 10th percentile, the lung volume with HU < −850 (V850)), V37 Gy, lung volume, and CAC scores. Lower lung HU values and larger lung volumes were linked to higher risk. The best models combined V850 (or lung volume) with a CAC metric. The model including V850 > 175 cc and continuous Max_HU_Heart achieved an optimism-corrected AUC of 0.68, with good fit and calibration (Hosmer–Lemeshow p = 0.33, R² = 0.847). Conclusions: The baseline cardiopulmonary status, captured by lung and heart densitometry, predicts pulmonary toxicity better than dosimetry. V850 > 175 cc was associated with a 4-fold higher risk, consistent with air trapping, known as a marker of emphysema.