Background: Glioblastoma (GBM) remains the most aggressive primary brain tumor with a dismal prognosis. Radiomics has emerged as a promising approach for survival prediction, although most studies focus on magnetic resonance imaging (MRI). We investigated whether post-operative radiotherapy-planning computed tomography (CT) radiomics can predict survival in GBM patients. Materials and methods: We retrospectively analysed 26 patients with GBM who underwent surgery and completed standard chemoradiotherapy, including radiotherapy (60 Gy in 30 fractions) with temozolomide. Radiomic features (n = 107) were extracted from non-contrast-enhanced post-operative CT scans of the tumor bed. Logistic regression models with elastic-net regularisation were developed to predict survival at 3, 6, and 12 months using leave-one-out cross-validation. A Cox proportional hazards model was built for continuous survival prediction. Results: The 3-month survival model achieved an area under the curve (AUC) of 0.935 [95% confidence interval (CI): 0.81–1.00] with 78.7% sensitivity and 89.6% specificity. The 6-month model showed moderate performance (AUC = 0.712), while the 12-month model had limited discriminative ability (AUC = 0.568). The Cox radiomics model achieved a concordance index of 0.771. Median tumor-bed volume was 64.0 cm 3 [interquartile range (IQR): 25.6–99.5; range 8.5–211.8]. Conclusions: Post-operative CT radiomics demonstrated promising performance for short-term survival prediction in this single-institution cohort. Because of the small sample size, the high AUC of the 3-month model should be interpreted as exploratory and may partly reflect cohort-specific overfitting. External validation in larger cohorts is warranted.
High-risk and locally advanced prostate cancer (PCa) is still a major concern in low- and middle-income countries (LMICs) where the limited availability of human and material resources do not allow implementation of the guidelines developed in high-income countries (HICs). In general, implementation of guidelines must take into account the differences in regional development, the availability of diagnostic tools, cost-effectiveness of treatments and the sociocultural context. In this report, we aim to focus on the applicability of the Western guidelines in LMICs for locally advanced and high-risk PCa and identify “minimal requirements” that should be offered to patients in resource-limited settings and “optimal care” which should be a realistic goal. This expert-based review, developed following the Expert International Oncology Meeting (EXIOME), provides context-adapted recommendations for the management of locally advanced and high-risk PCa in LMICs. This report summarises the EXIOME consensus for minimal requirements and optimal care for diagnosis, locoregional therapy and systemic management of locally advanced and high-risk PCa, oligometastatic and castration sensitive diseases. This consensus aims to support clinicians and policymakers in resource-limited settings by offering practical guidance aligned with global standards while acknowledging local resource and workforce constraints.
BACKGROUND: Breast cancer is most commonly associated with psychological distress, particularly anxiety and depression. While physical activity has been shown to mitigate these symptoms, sedentary behaviour may contribute to their worsening. We aimed to assess changes in symptoms of anxiety/depression over time and to examine their associations with physical activity and sedentary behaviour in women undergoing chemotherapy. MATERIALS AND METHODS: Sixty women aged 40–80 years with histopathologically confirmed breast cancer after surgery were consecutively recruited using purposive sampling. Each participant was assessed twice: before initiation of chemotherapy and six weeks later. Physical activity and sedentary behaviour were measured using the Polish version of the International Physical Activity Questionnaire (IPAQ-L), whereas symptoms of anxiety and depression were assessed with the Hospital Anxiety and Depression Scale (HADS). Statistical analyses included paired tests and correlation analyses (Spearman’s coefficients). RESULTS: Symptoms of anxiety/depression significantly decreased between assessments (p = 0.001 and p = 0.031, respectively). Higher daily walking time was inversely correlated with depression (ρ = −0.399, p = 0.002) and anxiety (ρ = −0.317, p = 0.014). Conversely, sedentary time was positively associated with both depression (ρ = 0.292, p = 0.023) and anxiety (ρ = 0.284, p = 0.028). No significant associations were found between moderate-to-vigorous physical activity and psychological symptoms. Among clinical factors, only age and HER2 status showed notable influence. CONCLUSIONS: In this sample, higher levels of walking were associated with lower anxiety and depression scores, while greater sedentary time was linked with higher symptom levels. These associations suggest that encouraging accessible physical activity and reducing sedentary behaviour may represent useful components of supportive oncological care.
BACKGROUND: Thermoplastic immobilisation masks are widely used in head and neck radiotherapy to ensure patient stability and reproducible positioning during treatment. Because these masks are placed directly in the beam path and consist of perforated polymer materials, they may influence electron dose distributions through additional attenuation and scattering effects, particularly for low-energy electron beams. This study quantifies the dosimetric effects of perforated thermoplastic masks, considering different hole diameters and electron field sizes. MATERIALS AND METHODS: Monte Carlo simulations using GATE modelled 6 MeV electron beams passing through thermoplastic masks with 2 mm and 4 mm hole diameters across 3 × 3 cm², 6 × 6 cm², and 10 × 10 cm² fields. Surface dose (D₀), depth of maximum dose (R₁₀₀), isodose depths (R₉₀, R₅₀), penumbra, flatness and gamma analysis (2%/2 mm and 3%/3 mm) were evaluated. RESULTS: Masks increased D₀ up to +5.9% for 2 mm holes and +4.18% for 4 mm holes. R₁₀₀ showed up to −21.43% reduction for 2 mm masks, with lesser shifts using 4 mm holes. Penumbra widening was also detected, with a maximum relative increase of +4.40% at Zₘₐₓ for the 6 × 6 cm² field using the 2 mm mask. Gamma pass rates were better for 4 mm masks, especially at shallow depths. CONCLUSIONS: Masks with 4 mm perforations consistently outperformed 2 mm variants in dosimetric accuracy while maintaining effective immobilisation. Tailored mask selection based on field size improves clinical outcomes in electron beam radiotherapy.
