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Abstract Background The prognostic nutritional index (PNI) is known to be correlated with clinical outcomes in non‐small cell lung cancer (NSCLC) patients. However, its role has not been studied in patients who have undergone postoperative radiotherapy (PORT). This study aimed to investigate the relationship between PNI and survival and recurrence in NSCLC patients with PORT. Methods We reviewed 97 stage I–III NSCLC patients who received PORT between January 2006 and December 2016 at our institution. We obtained PNI values for both pre‐RT (within 1 month before PORT) and post‐RT (within 2 months after PORT) by using serum albumin and lymphocyte count. A cutoff value for PNI was determined by the receiver operating characteristic curve (ROC). The median follow‐up period was 52.8 months. Results The ROC curve of post‐RT PNI exhibited a higher area under the curve (AUC 0.68, cut‐off: 47.1) than that of pre‐RT PNI (AUC 0.55, cutoff: 50.3), so the group was divided into high post‐RT PNI (> 47.1) and low post‐RT PNI (≤ 47.1). The five‐year overall survival rate (OS) was 66.2% in the high post‐RT group, compared with 41.8% in the low post‐RT PNI group (p = 0.018). Those with both low pre‐RT and low post‐RT PNI had the worst five‐year OS of 31.1%. Post‐RT PNI (HR 0.92, p = 0.003) was an independent risk factor for mortality. Conclusions PNI after PORT was significantly associated with survival. This finding suggests that PNI can be used as a prognostic marker.

Background/Aim: The aim was to assess the complexity of breast volumetric-modulated arc therapy (VMAT) plans using various indices and to evaluate their performance through gamma analysis in predicting plan deliverability. Materials and Methods: A total of 285 VMAT plans for 260 patients were created using the VersaHD™ linear accelerator with a Monaco treatment planning system. Corresponding verification plans were generated using the ArcCHECK® detector, and gamma analysis was conducted employing various criteria. Twenty-eight plan complexity metrics were computed, and Pearson's correlation coefficients were determined between the gamma passing rate (GPR) and these metrics. Results: The average GPR values for all plans were 97.7%, 89.9%, and 78.0% for the 2 mm/2%, 1 mm/2%, and 1 mm/1% criteria, respectively. While most complexity metrics exhibited weak correlations with GPRs under the 2 mm/2% criterion, leaf sequence variability (LSV), plan-averaged beam area (PA), converted area metric (CAM), and edge area metric (EAM) demonstrated the most robust performance, with Pearson’s correlation coefficients of 0.57, 0.50, −0.70, and −0.56, respectively. Conclusion: Metrics related to beam aperture size and irregularity, such as LSV, PA, CAM and EAM, proved to be reasonable predictors of plan deliverability in breast VMAT. [ABSTRACT FROM AUTHOR]

Purpose: The target delineation of whole ventricle radiotherapy (WVRT) in germinoma varies among radiation oncologists, especially regarding the inclusion of the prepontine cistern (PC). We evaluated the outcome of PC-sparing WVRT in localized germinoma. Materials and Methods: We identified 87 localized intracranial germinoma patients who received radiotherapy (RT) following chemotherapy between 1999 and 2020. By institutional policy, RT for localized germinoma excluded PC from the target volume. WVRT was delivered to 65 patients (74.7%) and involved field radiotherapy (IFRT) to 22 patients (25.3%). The median dose was 45.0 Gy (range, 23.4 to 55.8 Gy) for the primary tumor and 19.8 Gy (range, 14.4 to 36.0 Gy) for the whole ventricle. We analyzed the dosimetric differences of the organs at risk between the PC-excluding plans and the PC-including ones. Results: The median follow-up duration was 7.8 years (range, 1.0 to 22.5 years). The 10-year recurrence-free survival and overall survival rates were 86.3% and 90.9%, respectively. The recurrences occurred in eight patients (8.7%), including five patients after IFRT and three after WVRT. Five of them showed recurrences at lateral ventricles and only one patient experienced spinal cord relapse. However, no relapse in the PC occurred. Endoscopic third ventriculostomy was not a significant prognostic factor. The dosimetric comparisons showed significantly lower mean doses to the brainstem and the cochleae when the PC was excluded. Conclusion: WVRT for localized germinoma can safely exclude the PC in the target volume, reducing radiation dose to the brain stem. The target protocol needs to reach a consensus regarding the PC in prospective trials. [ABSTRACT FROM AUTHOR]