Seminars In Radiation Oncology[JOURNAL]
Sun
200 papers
A New Lens on Interprofessional Education: Organizational Behavior Theories Explain One Institution's Experience With Authentic Collaboration.
Harnett N, Gillan C
Semin Radiat Oncol · 2026 Apr · PMID 41747356 · Publisher ↗
Interprofessional education (IPE) is based in the belief that increasing specialization of healthcare has led to no single profession being able to encompass all the knowledge and skills to support comprehensive care, th...
Interprofessional education (IPE) is based in the belief that increasing specialization of healthcare has led to no single profession being able to encompass all the knowledge and skills to support comprehensive care, thus requiring the system's reliance on functional healthcare teams. A large academic radiation medicine program built a continuing education program founded in the knowledge that true interprofessional collaboration (IPC) between medical physics, radiation oncology, and radiation therapy is essential for optimal care delivery. The curricular design emphasized the importance of IPC through both concrete instruction on these concepts and through emulation of the collaborative model by course faculty. Participants of the various Program courses reported the value of the interprofessional elements of the course, and the related learnings that influenced their subsequent practice. Little work has examined how the effort required for the delivery of high quality IPE impacts-or may be impacted by-the IPC of faculty who engage in delivering the Program This may include the depth of investment required to truly operate as a functional team, how such investment bred familiarity, and by extension how it reduced the interference of a perceived hierarchy, and improved the ability to collaborate and problem-solve at the front lines. Organizational behavior theories including group cohesion theory, social capital theory, and psychological safety support conceptualization of the value of faculty collaboration, as does the critical framing of the emancipatory role of IPE. This review considers such theories in the context of a successful IPC model, and the value to faculty and the organizations in which they practice, including generation of new ideas, projects and collaborations and took shape in many observable ways.
Application of a Systematic Approach to Curriculum Development Within Oncology Education: The Oncology National Course for Advocacy, Research, and Education.
Dou A, Du J, Zhang J … +2 more , Ladak AM, Ingledew PA
Semin Radiat Oncol · 2026 Apr · PMID 41747355 · Publisher ↗
As with all areas of medical education, thoughtful application of established frameworks is essential during curriculum development. While there are several potential approaches and theoretical models, Kern's model of cu...
As with all areas of medical education, thoughtful application of established frameworks is essential during curriculum development. While there are several potential approaches and theoretical models, Kern's model of curriculum development provides an understandable roadmap with 6 key steps. In this review, a national course for oncology education is used as a practical illustration of a thoughtful application of this curricular framework. This paper highlights the educational theories related to each step with tangible results. This work demonstrates not only the development, implementation and evaluation of a novel educational intervention, but more importantly provides direction and insights applicable to medical educators as they consider implementation of curriculum across the field of radiation oncology.
Radiation Oncology Education Across the Learning Continuum: Current Challenges and Future Directions.
Gribble ML, Gunther JR, Braunstein SE
Semin Radiat Oncol · 2026 Apr · PMID 41719695 · Publisher ↗
Radiation oncology is critical to modern interdisciplinary cancer care, though exposure to radiation oncology remains limited across the medical education continuum. The practice of radiation oncology requires in-depth k...
Radiation oncology is critical to modern interdisciplinary cancer care, though exposure to radiation oncology remains limited across the medical education continuum. The practice of radiation oncology requires in-depth knowledge of evidence-based clinical oncology with highly technical and procedural practice competencies. This review defines the spectrum of teaching in radiation oncology, from effective teaching to scholarly teaching to scholarship of teaching and learning to support learners across the succession of medical education environments, spanning undergraduate, graduate, and continuing education with the goal of examining and defining current best practices in scholarly teaching within radiation oncology.
Recruiting the Next Generation: A Review of Medical Student Interest and Career Decision-Making in Radiation Oncology.
Fedrigo R, Dosani M, Ingledew PA … +1 more , Chai BS
Semin Radiat Oncol · 2026 Apr · PMID 41713103 · Publisher ↗
The rising incidence and complexity of cancer care have increased pressure on the radiation oncology (RO) workforce. Despite growing clinical demand, unfilled residency positions have raised concerns about workforce sust...
The rising incidence and complexity of cancer care have increased pressure on the radiation oncology (RO) workforce. Despite growing clinical demand, unfilled residency positions have raised concerns about workforce sustainability. Modeling studies predict a shortage of radiation oncologists, emphasizing the need to strengthen medical student recruitment in RO. Trainee interest in RO is influenced by both practical and personal factors. Practical components include alignment with career goals, clinical exposure, mentorship, and work-life considerations. Personal experiences, such as one's own or a family member's experience with cancer, also commonly shape interest. Bland-Meurer and Pfarrwaller frameworks contextualize how these factors interact over time to guide specialty choice. Interventions such as the Radiation Oncology Intensive Shadowing Experience and CARO Underrepresented in Radiation Oncology Mentorship Program target key motivating factors, particularly through mentorship. Recruitment challenges for radiation therapy technologists and medical physicists include training bottlenecks, retention concerns, and increasing workload pressures. Sustaining the RO workforce requires early exposure, mentorship, and targeted interventions for trainees, alongside strategies to support allied radiation professionals. Conceptual frameworks can guide development of interventions that align evolving career needs with specialty characteristics. Integrating oncology education into medical curricula and supporting recruitment and retention across the multidisciplinary RO workforce is critical for sustainable cancer care delivery.
Education as a Tool to Navigate Changing Technology in Radiation Oncology.
Gillan C, Low DA, Raman S
Semin Radiat Oncol · 2026 Apr · PMID 41616403 · Publisher ↗
While technological innovation in radiation therapy (RT) continues to accelerate, safe and equitable adoption of emerging tools is reliant on the readiness of the workforce and the robustness of associated educational fr...
While technological innovation in radiation therapy (RT) continues to accelerate, safe and equitable adoption of emerging tools is reliant on the readiness of the workforce and the robustness of associated educational frameworks. Early experience with disruptive technologies such as intensity-modulated RT (IMRT) has taught us that fragmented or insufficient education can create an implementation barrier. The IDEPTH framework (as illustrated here using the translation of IMRT from development to mainstream implementation) describes how development and implementation of new technologies requires coordinated involvement across academia, industry, professional associations, and clinical organizations. Emerging technologies, such as artificial intelligence (AI)-enabled workflows, magnetic resonance (MR)-integrated RT, adaptive radiotherapy and particle therapy will similarly require comprehensive and scalable approaches to education. Despite progress, significant heterogeneity still exists in access to education, integration into professional curricula, and ongoing requirements for competence. Central to this challenge is that the rate at which technology is developed often outpaces the rate at which curricula, accreditation standards, and certification processes are updated. Closing this gap will be most effectively met by increased emphasis on adaptable competencies such as technological literacy, critical evaluation, and effective human-technology interaction rather than mere device-specific skills. Also, the increasing role of automation means RT must also identify legacy skills whose education emphasis is reduced to allow time and attention to the latest technologies and treatment methods. The creation and maintenance of robust, forward-oriented education systems is crucial if future innovations within radiation oncology are to be integrated in ways that are safe and of high quality.
Advancing Equity, Diversity, and Inclusion in Medical Education: Implications For Radiation Oncology.
Khan A, Croke J
Semin Radiat Oncol · 2026 Apr · PMID 41483754 · Publisher ↗
Equity, diversity and inclusion (EDI) have become foundational principles across healthcare organizations and medical education aiming to address historical systemic biases, promote representation and foster inclusive en...
Equity, diversity and inclusion (EDI) have become foundational principles across healthcare organizations and medical education aiming to address historical systemic biases, promote representation and foster inclusive environments. These efforts have patients benefits including improved care and clinical outcomes, especially in minoritized populations. Despite recent advances, women and minority groups remain underrepresented radiation oncology training programs, leadership roles, and academic positions. Embedding EDI early in medical education and training is essential for diversifying the workforce, reducing barriers to entry, and preparing future physicians to deliver equitable care. Organizational and institutional efforts are also important and require strong leadership commitment, accountability and resource allocation. The paper provides an overview of EDI within medical education, with a focus on radiation oncology, and outlines strategies to advance equity, diversity, and inclusion across the specialty.
Radiation Therapy for Benign Diseases and Premalignant Conditions.
Eng TY, Bahig H, Chen TW … +2 more , Meiyappan KP, Roberge D
Semin Radiat Oncol · 2026 Jan · PMID 41391901 · Publisher ↗
Radiation therapy (RT), traditionally reserved for malignant conditions, has emerged as a valuable tool in the management of select benign tumors and proliferative disorders. In clinical scenarios where surgery is not fe...
Radiation therapy (RT), traditionally reserved for malignant conditions, has emerged as a valuable tool in the management of select benign tumors and proliferative disorders. In clinical scenarios where surgery is not feasible, incomplete, or associated with significant morbidity, RT offers a noninvasive and effective alternative, often yielding excellent local control and long-term symptom relief. For instance, although surgery is relatively safe and effective, radiation is the preferred treatment for many patients with acoustic neuroma. Many benign entities have demonstrated favorable responses to radiation [1]. Among these, paragangliomas (PGL)-notably glomus jugulare tumors-have emerged as prime examples where RT plays a critical role. These tumors, while histologically benign, often present with local invasiveness, cranial nerve involvement, and high recurrence rates, making complete surgical resection difficult and frequently associated with significant morbidity. Beyond PGLs, RT has shown promise in a range of other benign conditions, including many benign vascular and lymphoid disorders [2-4]. These entities, although benign, may behave in an infiltrative or recurrent manner, necessitating a multidisciplinary approach to treatment. In particular, localized lymphoid lesions may benefit from RT. This section focuses specifically on the role of RT in the management of PGL, pheochromocytoma (PCC), hemangioma, ameloblastoma, angiofibroma, Castleman disease, cutaneous pseudolymphoma, and adamantinoma. Other benign entities are discussed in a separate section of the current issue.
Radiation Therapy for Non-Malignant Central Nervous System Tumors, Disorders, and Illnesses - Current Applications and Future Directions.
Ehret F, Rogers CL, Fontanesi J … +12 more , Wilson GD, Chitti BS, Starner J, Sidiqi B, Goenka A, Schulder M, Bruynzeel AME, Verhoeff JJC, MacDonagh AC, Park HI, Shih HA, Kleinberg L
Semin Radiat Oncol · 2026 Jan · PMID 41391900 · Publisher ↗
Radiation therapy has a central role in the treatment of various malignant central nervous system tumors, including gliomas, high-grade meningiomas, and brain metastases. This also applies to a plethora of non-malignant...
Radiation therapy has a central role in the treatment of various malignant central nervous system tumors, including gliomas, high-grade meningiomas, and brain metastases. This also applies to a plethora of non-malignant central nervous system lesions, such as vestibular schwannomas and arteriovenous malformations, and, in specific situations, for selected functional and psychiatric disorders. In patients with these conditions, the goal of radiation therapy is generally to preserve and stabilize function. In addition, as these illnesses, with some exceptions such as arteriovenous malformations, are rarely life-threatening, the risks of radiation therapy must be interpreted in a different context than for patients with malignancy. Given the continuous and growing interest in the use of radiation therapy for non-malignant tumors and functional conditions, this review summarizes the current and future directions in central nervous system applications, addressing its use for the management of vestibular schwannomas, arteriovenous malformations, trigeminal neuralgia, tremor, Alzheimer's disease, and other psychiatric conditions, such as obsessive-compulsive disorder, addiction, and eating disorders.
Radioablation for Ventricular Tachycardia: Current Evidence and Future Perspectives.
De Pietro R, Samson P, Ahmadsei M … +7 more , Cuculich P, Hugo GD, Miszczyk M, Nägler F, Saguner AM, Robinson C, Andratschke N
Semin Radiat Oncol · 2026 Jan · PMID 41391899 · Publisher ↗
Stereotactic arrhythmia radioablation (STAR) has emerged as a novel, noninvasive therapeutic option for patients with drug- and ablation-refractory ventricular tachycardia (VT). Derived from stereotactic body radiotherap...
Stereotactic arrhythmia radioablation (STAR) has emerged as a novel, noninvasive therapeutic option for patients with drug- and ablation-refractory ventricular tachycardia (VT). Derived from stereotactic body radiotherapy (SBRT), STAR enables the delivery of a single, high-dose fraction of ionizing radiation to arrhythmogenic myocardial tissue with submillimeter precision while minimizing exposure to surrounding cardiac and extracardiac structures. This review summarizes current evidence regarding mechanisms of action, patient selection, treatment planning, and clinical outcomes of STAR. Preclinical and early clinical studies suggest that STAR exerts rapid antiarrhythmic effects through modulation of cardiac conduction proteins and potential structural remodeling, though long-term efficacy remains under investigation. Clinical trials and prospective registries report substantial reductions in VT burden with acceptable short-term safety, yet recurrence rates and late toxicities require further evaluation. The European STOPSTORM consortium has been established to standardize treatment protocols, harmonize target delineation, and coordinate multicenter clinical validation. As STAR continues to evolve, multidisciplinary collaboration between radiation oncologists, cardiologists, and medical physicists will be essential to define optimal practice standards, ensure patient safety, and assess long-term outcomes. STAR represents a promising paradigm shift in the management of refractory VT, offering a noninvasive alternative when conventional therapies are ineffective or infeasible.
Periarticular Soft Tissue Disorders: Enthesopathies, Tendinopathies, and Bursitis-Pathophysiology and Radiotherapeutic Approaches.
Koneru BN, Barron DA, Muecke R … +8 more , Shaffer R, Thomas TO, Sonnhoff M, Blach RM, Steike DR, Deloch L, Singh PK, Seegenschmiedt H
Semin Radiat Oncol · 2026 Jan · PMID 41391898 · Publisher ↗
Periarticular soft tissue disorders, encompassing enthesopathies, tendinopathies, and bursitis, contribute substantially to musculoskeletal pain and disability, particularly in adult populations. This chapter provides a...
Periarticular soft tissue disorders, encompassing enthesopathies, tendinopathies, and bursitis, contribute substantially to musculoskeletal pain and disability, particularly in adult populations. This chapter provides a comprehensive overview of the pathophysiology, clinical manifestations, and radiotherapeutic management of major periarticular syndromes, including painful shoulder syndrome, lateral epicondylitis, greater trochanteric pain syndrome, and plantar fasciitis. We detail how these conditions often present as a continuum of overlapping pathology at the enthesis, tendon, and peri‑tendinous structures, frequently driven by repetitive microtrauma, mechanical overload, degenerative changes, and low-grade inflammation. Emphasis is placed on the clinical and imaging features distinguishing key entities such as calcific tendinitis, enthesopathies, and bursitis. Special focus is given to the role of low-dose radiotherapy (LDRT) as an effective treatment option for refractory symptoms unresponsive or contraindicated to conservative management. Contemporary practice patterns, including patient selection, target volume delineation based on imaging, and technical variations between linear accelerator and orthovoltage techniques, are discussed. Data from recent prospective and retrospective studies are summarized, demonstrating notable pain reduction rates and functional improvement with LDRT, and outlining response rates, optimal dosage regimens, timing of re-irradiation, and age-based treatment considerations. The chapter concludes with practical recommendations for integrating radiotherapy into multimodal care pathways for periarticular soft tissue disorders, underscoring its utility in symptom control and functional restoration.
Low-Dose Radiotherapy for Osteoarthritis: Current Evidence, Practical Recommendations and Future Perspectives.
Schlamann A, Yu JB, Rühle A
Semin Radiat Oncol · 2026 Jan · PMID 41391897 · Publisher ↗
Osteoarthritis (OA) is a widespread degenerative joint disease with increasing prevalence in aging populations. While conservative management such as physiotherapy, NSAIDs, and intraarticular injections form the mainstay...
Osteoarthritis (OA) is a widespread degenerative joint disease with increasing prevalence in aging populations. While conservative management such as physiotherapy, NSAIDs, and intraarticular injections form the mainstay of treatment, a significant proportion of patients, particularly elderly individuals or those unfit for surgery, remain symptomatic. Low-dose radiotherapy (LDRT) has re-emerged as a potential noninvasive therapeutic option based on its anti-inflammatory effects and favorable safety profile. This narrative review summarizes current clinical evidence, practical recommendations, and future directions for the use of LDRT in OA. Although some randomized controlled trials have reported no additional benefit of LDRT over sham treatment, these studies have been criticized for limited sample size, short follow-up duration, suboptimal patient selection, and deviation from standard LDRT protocols. Nevertheless, other randomized trials as well as large retrospective studies suggest clinically meaningful benefits in selected patients. Standard dosing regimens typically consist of 3.0-6.0 Gy delivered in 0.5-1.0 Gy fractions over 2-3 weeks, with a second course recommended in nonresponders. Practical considerations including patient selection, joint-specific dose planning, and patient education are essential to optimize outcomes. While the absolute risk of radiation-induced malignancy is considered negligible in elderly populations, safety measures such as shielding and cumulative dose monitoring are advised. Further large-scale, placebo-controlled studies are needed to clarify optimal dose, timing, and synergistic effects with pharmacological therapies to strengthen the role of LDRT in OA management.
130 Years of Radiotherapy for Nonmalignant Diseases: A Historical Overview.
Micke O, Oertel M, Muecke R … +2 more , Eich HT, Kriz J
Semin Radiat Oncol · 2026 Jan · PMID 41391896 · Publisher ↗
Radiotherapy has long been associated with the treatment of malignant tumors, yet its application in nonmalignant (benign) diseases predates many contemporary oncologic indications and has played a critical role in shapi...
Radiotherapy has long been associated with the treatment of malignant tumors, yet its application in nonmalignant (benign) diseases predates many contemporary oncologic indications and has played a critical role in shaping the broader field of radiation medicine in early times. As of 2025, roughly 130 years have elapsed since the first experimental clinical applications of X‑rays and radium for non‑malignant conditions, and a review of this period may provide insights both into medical innovation and the trade‑offs inherent in using potentially harmful agents for nonmalignant indications. Such a historical overview can help us understand past missteps, guide present practice, and shape future research, especially in defining indications, optimizing dose/fractionation schedules, and ensuring long‑term monitoring of outcomes and risks. Our review will touch cornerstones and landmarks of the long and widely branched history of radiotherapy and also looks at the biographies of important pioneers of the field, so that we can learn from their thinking, research and experience.
Biological Effects of Low-Dose Radiation Therapy: From Mechanistic Aspects to Translational Approaches and Challenges.
Donaubauer AJ, Mogge L, Schubert P … +4 more , Fietkau R, Ott OJ, Frey B, Gaipl US
Semin Radiat Oncol · 2026 Jan · PMID 41391895 · Publisher ↗
Low dose radiation therapy (LDRT) is commonly applied for its pain and symptom-relieving effects in the treatment of different benign diseases, such as chronic degenerative and inflammatory, or hyperproliferative disorde...
Low dose radiation therapy (LDRT) is commonly applied for its pain and symptom-relieving effects in the treatment of different benign diseases, such as chronic degenerative and inflammatory, or hyperproliferative disorders. Most clinical trials report a beneficial therapeutic effect of LDRT and further, robust preclinical evidence on the biological modes of action of LDRT is existent. In chronic degenerative and inflammatory diseases such as osteoarthritis, LDRT can ameliorate inflammatory processes and impacts positively on the bone metabolism. A key mechanism is the modulation of the endothelium and the phenotype of macrophages. In the bone, the deposition of new bone matrix is supported, while bone degradation is diminished. In hyperproliferative disorders, the main mode of action is the inhibition of the differentiation and proliferation of fibroblasts and myofibroblasts, along with a modulation of inflammatory mediators, such as cytokines. Even though comprehensive preclinical evidence supports the use of LDRT, biological mechanistic insights from randomized clinical trials is mostly missing for LDRT and indicates a significant translational gap. Apart from preclinical data, the evidence for LDRT is based largely on observational clinical trials, with only limited randomized and placebo-controlled trials available. In the future, rigorously designed randomized disease-specific studies with standardized protocols, translational research programs and objectifiable clinical and biological endpoints are needed to establish LDRT as precise and evidence-based therapy.
Genetic and Carcinogenic Risks of Radiotherapy for Nonmalignant Diseases.
Nakamura JL
Semin Radiat Oncol · 2026 Jan · PMID 41391894 · Publisher ↗
Radiotherapy is a valuable treatment option for a variety of nonmalignant diseases. As the indications for low-dose radiotherapy to benign conditions evolve, it is prudent to consider risks and how these might weigh agai...
Radiotherapy is a valuable treatment option for a variety of nonmalignant diseases. As the indications for low-dose radiotherapy to benign conditions evolve, it is prudent to consider risks and how these might weigh against the benefits of therapy. Radiation-induced malignancies are one consideration and are more likely associated with higher doses of radiation and genetic cancer susceptibility. Radiotherapy for nonmalignant diseases typically involves doses much lower than those associated with radiation-induced malignancies. In addition, treatments are employed for conditions that are more common in the older patient population, whereas much of the historical experience with radiation-induced malignancies involves children and young adults. The low doses associated with radiotherapy for nonmalignant diseases and the patient population in whom these treatments are employed makes the estimated risk of radiation-induced carcinogenesis low. Specific factors that increase the concern for radiation-induced malignancies include repeated radiotherapy to the same site, leading to cumulative increasing dosage, radiotherapy in younger individuals, and those with known germline mutations in DNA repair genes.
Radiotherapy for Other Nonmalignant Diseases.
Falke I, Schäfer U, Micke O … +2 more , Mücke R, Kriz J
Semin Radiat Oncol · 2026 Jan · PMID 41391893 · Publisher ↗
Radiotherapy is increasingly used for benign diseases, especially in Germany, where over 50% of radiation treatments address nonmalignant conditions such as osteoarthritis, plantar fasciitis, and Dupuytren's disease. Low...
Radiotherapy is increasingly used for benign diseases, especially in Germany, where over 50% of radiation treatments address nonmalignant conditions such as osteoarthritis, plantar fasciitis, and Dupuytren's disease. Low-dose regimens have shown good efficacy in pain reduction and disease stabilization, with minimal toxicity. For rarer indications like Gorham-Stout disease, pigmented villonodular synovitis, and lymphatic fistulas, evidence is limited to case series and retrospective studies. Randomized trials remain scarce, and further research is needed to evaluate long-term outcomes and patient quality of life. Radiotherapy appears safe when used appropriately, though concerns about late effects require continued monitoring. For rare diseases, collaborative data collection and biological studies may help address current evidence gaps.
Radiotherapy for Nonmalignant Eye Diseases: Graves' Ophthalmopathy - Pseudotumor Orbitae.
Seegenschmiedt MH, Eich HT, Reinartz G
Semin Radiat Oncol · 2026 Jan · PMID 41391892 · Publisher ↗
Orbital radiotherapy (RT) is an effective treatment for moderate-to-severe Graves´ ophthalmopathy (GO), especially when combined with steroids, as it reduces painful eye symptoms associated with retroorbital and eye lid...
Orbital radiotherapy (RT) is an effective treatment for moderate-to-severe Graves´ ophthalmopathy (GO), especially when combined with steroids, as it reduces painful eye symptoms associated with retroorbital and eye lid soft tissue swelling, improves eye movement, and can decrease the need for prolonged steroid therapy. It is generally well-tolerated; common side effects include temporary dryness and conjunctivitis, with rare long-term risks like cataracts and a very small theoretical risk of radiation-induced cancer. RT benefits are rarely immediate and improved symptoms are typically observed several weeks to months after the treatment. GO is treated with the retrobulbar space considered as clinical target volume (CTV). Retrobulbar RT is carried out either with lateral opposing fields or with intensity modulated radiotherapy (IMRT) while protecting the radiosensitive lenses considered as organs at risk (OAR). The dose concept should be adapted to the respective phase of the disease: in the early purely inflammatory phase a single dose 0.3-2.0 Gy applied in 8 daily fractions up to a total dose of 2.4-16 Gy is sufficient and well tolerated; in the more advanced inflammatory to fibrotic phase single doses of 1.8-2.0 Gy applied in 8-10 fractions 5 times weekly up to a total dose of 16-20 Gy are required to gain improvement of symptoms. To avoid severe ophthalmologic symptoms, the efficacy of radiation could also be improved by using a reduced single dose of only 1 Gy and extending the duration of therapy with the radiation applied only once a week. In GO with manifest ocular muscle dysfunction, antiproliferative external beam RT has a Grade B recommendation, supported by Level 2 evidence.
Functional Radiotherapy for Non-Malignant Diseases: The Potential of Ionizing Radiation Beyond Cancer Treatment.
Rühle A, DeLaney TF
Semin Radiat Oncol · 2026 Jan · PMID 41391891 · Publisher ↗
This special issue, "Functional Radiotherapy for Non-Malignant Diseases - The Potential of Ionizing Radiation Beyond Cancer Treatment", addresses one of the oldest yet often overlooked areas of radiation medicine: the th...
This special issue, "Functional Radiotherapy for Non-Malignant Diseases - The Potential of Ionizing Radiation Beyond Cancer Treatment", addresses one of the oldest yet often overlooked areas of radiation medicine: the therapeutic use of ionizing radiation for non-malignant disorders. More than a century after the first medical use of X-rays, functional radiotherapy for non-malignant diseases is experiencing a renaissance, supported by growing clinical and biological evidence. The articles in this issue span the historical evolution, mechanistic underpinnings, and modern clinical applications of radiotherapy across diverse indications. They address topics such as the biological effects and potential carcinogenic risks of low-dose irradiation, radiotherapy for osteoarthritis and periarticular soft-tissue disorders, benign and premalignant tumors, Graves' ophthalmopathy, and hyperproliferative diseases including Dupuytren's and Ledderhose's disease, among others. Emerging applications such as stereotactic arrhythmia radioablation and functional radiotherapy for neurological or psychiatric disorders further extend its scope. Together, these contributions illustrate how radiotherapy for non-malignant diseases has evolved from empirical practice to a scientifically grounded therapy aimed at functional restoration. In the future, the establishment of standardized protocols, international registries, and prospective clinical trials will be essential to validate efficacy and safety, thereby defining the evolving role of radiotherapy beyond cancer treatment.
Driving Precision Medicine in Pancreatic Cancer With Molecular Genetics.
Farooq M, Pishvaian MJ
Semin Radiat Oncol · 2025 Oct · PMID 40935446 · Full text
Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies with dismal 5-year survival rates. Characterized by its complex tumor microenvironment and resistance to conventional therapies, PDAC ha...
Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies with dismal 5-year survival rates. Characterized by its complex tumor microenvironment and resistance to conventional therapies, PDAC has historically been difficult to treat effectively. Recent advances in molecular profiling have revolutionized our understanding of the genetic landscape of pancreatic cancer. This review examines how molecular genetics is driving precision medicine approaches in pancreatic cancer, with particular focus on KRAS-targeted therapies. Understanding these developments is crucial for clinicians seeking to optimize treatment strategies and improve outcomes for patients with pancreatic cancer.
Moving Beyond the Standard Pancreatectomy for Pancreatic Adenocarcinoma.
Hunter MD, Shridhar N, Mlouk K … +4 more , Kaplan B, Sacks GD, Wolfgang CL, Kluger MD
Semin Radiat Oncol · 2025 Oct · PMID 40935445 · Publisher ↗
This manuscript describes the evolution in the operative management of pancreatic cancer. Early attempts at pancreatic resection were met with daunting peri‑operative outcomes but were fine-tuned to yield today's establi...
This manuscript describes the evolution in the operative management of pancreatic cancer. Early attempts at pancreatic resection were met with daunting peri‑operative outcomes but were fine-tuned to yield today's established pancreatic resections. Advances in medical therapy, including neo-adjuvant therapy for borderline resectable pancreatic cancers and refined adjuvant regimens, have improved oncologic outcomes and are allowing surgeons to move beyond current anatomic distinctions of resectability. Venous, hepatic artery and celiac axis resection during pancreatectomy are now common vascular operations at specialty centers which have been associated with favorable oncologic outcomes. Recent efforts are addressing locally advanced pancreatic cancer with superior mesenteric artery and/or multivessel involvement using either arterial divestment or arterial resection and reconstruction. An additional consideration in the treatment of pancreatic cancer is the benefit and risks of neoadjuvant radiation in locally advanced cases which has been avoided thus far given concerns regarding the effect of radiation on the vasculature. Therefore, with these improvements in peri‑operative therapy and robust preoperative planning often with the aid of vascular and microvascular surgeons, several centers have been exploring new frontiers in the operative management of locally advanced pancreatic adenocarcinoma.
Emerging Systemic Therapy Considerations for Pancreatic Cancer.
Liang KL, Guo MZ, Zaidi N
Semin Radiat Oncol · 2025 Oct · PMID 40935444 · Publisher ↗
Pancreatic ductal adenocarcinoma (PDAC) is anticipated to be the second leading cause of cancer-related death in the United States by 2030. For the majority of patients who are diagnosed with de novo metastatic disease,...
Pancreatic ductal adenocarcinoma (PDAC) is anticipated to be the second leading cause of cancer-related death in the United States by 2030. For the majority of patients who are diagnosed with de novo metastatic disease, 5-year overall survival remains dismal at less than 10%. Until recently, PDAC has been considered as a monolithic entity with limited treatment options. With advances in genomic profiling, targeted therapies, and immune-based strategies, a number of emerging biomarker-driven treatment modalities have begun to enter into clinical practice. In this review, we describe the historical perspective of systemic PDAC treatments in the advanced setting, as well as the emerging treatments which leverage genomic heterogeneity and synergistic mechanisms of action.
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