Pittaya Dankulchai

Exposure to radiation oncology is limited for students at medical schools without affiliated radiotherapy centers. To address this barrier, a university-based radiation oncology division delivered a one-day radiation oncology course to medical students from medical schools without radiotherapy facilities. The course included lectures that covered the basic principles of radiotherapy, followed by a department visit to observe external beam radiation therapy and brachytherapy workflows. A self-evaluated questionnaire was distributed upon completion of the course to evaluate the course format and students’ understanding of radiotherapy. During the academic year 2024, thirty-one students from two medical schools participated in the course. The course was well received by the participants. Self-evaluation indicated that most students had limited knowledge and understanding of radiation oncology prior to the course, but this improved following participation. Therefore, a one-day radiation oncology course is a feasible and effective approach to providing accessible radiation oncology education for medical students at institutions lacking radiotherapy facilities.

Khemworapong K, et al. J Gynecol Oncol. 2026 ;37:e77. https://doi.org/10.3802/jgo.2026.37.e77

Recurrent cervical cancer remains a therapeutic challenge despite advances in primary treatment. The emerging paradigm of oligorecurrence and oligometastasis has opened avenues for curative-intent local therapies, including re-irradiation. Modern radiotherapy techniques have enabled high-dose delivery with acceptable toxicity. This study aims to assess clinical outcomes and treatment-related toxicities in patients with oligorecurrent or oligometastatic cervical cancer treated with modern re-irradiation techniques. This retrospective study included 20 cervical cancer patients with oligorecurrence or synchronous/metachronous oligometastases (≤ 5 lesions) who underwent at least one course of re-irradiation. Survival outcomes including locoregional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) were estimated using Kaplan-Meier analysis. Genitourinary (GU), gastrointestinal (GI), and hematologic toxicities were assessed and graded based on CTCAE version 5.0. The median age was 53 years (range: 33–70), with 75% initially diagnosed at FIGO 2018 stage III. The predominant histologies were squamous cell carcinoma (50%) and adenocarcinoma (45%). Recurrences most commonly involved pelvic (30%) and para-aortic (30%) lymph nodes, with 50% occurring in-field. Stereotactic body radiotherapy (SBRT), volumetric modulated arc therapy (VMAT), and MR-guided adaptive brachytherapy (MR-GABT) were the most commonly used re-irradiation modalities, employed in 95% of patients. Median times to first and second recurrence were 11.1 months (IQR: 6.0–17.3) and 13.7 months (IQR: 5.6–21.7), respectively. At a median follow-up of 33.6 months, PFS, LRRFS, DMFS, and OS rates after the first recurrence were were 31.8%, 33.6%, 60.5%, and 84.2% respectively. Grade ≥ 2 genitourinary (GU), gastrointestinal (GI), and hematologic toxicities were observed in 40%, 25%, and 55% of patients, respectively. Grade 3 hematologic toxiciy was 25% and mostly occurred during chemotherapy administration. No grade ≥ 3 GU or GI toxicities were reported. The mean accumulated D0.03 cc after re-irradiation to bladder, rectum, sigmoid and bowel for in-fied/out-of-field were 83.8 ± 6.7/78.5 ± 7.5), 71.2 ± 3.9/69.5 ± 5.2, 68.0 ± 5.5/61.0 ± 5.3, and 62.9 ± 4.6/62.4 ± 7.1 GyEQD2(3), respectively. Re-irradiation with contemporary radiotherapy techniques appears to be a feasible and effective salvage option for selected patients with limited recurrent or metastatic cervical cancer, yielding favorable survival and acceptable toxicity profiles.

Introduction: Rosai-Dorfman disease (RDD) is a rare non-Langerhans cell histiocytosis with no well-established treatment approaches. Surgery is typically indicated for symptomatic patients, but adjuvant treatment to reduce recurrence is infrequently addressed in the literature. Case Presentation: Herein, we describe the case of a 77-year-old woman with a neurological deficit and an infiltrative epidural soft tissue mass at the T3 to T9 levels, as revealed by magnetic resonance imaging (MRI). Following complete tumor resection, pathological examination confirmed spinal RDD. The patient subsequently received postoperative radiotherapy with a dose of 30 Gy in 15 fractions 4 weeks later. At the 18-month postoperative follow-up, the patient was clinically improved and her MRI at 1 year showed no recurrence. Conclusions: Postoperative radiotherapy in spinal RDD remains controversial due to insufficient clinical evidence. Nevertheless, few case reports did not show treatment-related complications.

Radiotherapy employs high-energy X-rays to precisely target tumor tissues while minimizing damage to the surrounding healthy structures. Although its clinical efficacy is well established, the immunomodulatory effects of ionizing radiation remain complex and context-dependent. This study investigated the biological effects of radiotherapeutic doses on immune cells by evaluating lymphocyte viability, phenotypic profiles, and cytokine expression levels. Peripheral blood mononuclear cells (PBMCs) were isolated from six healthy donors and irradiated with 0, 2, or 6 Gy using a 6 MV linear accelerator (LINAC). Dose validation with an ionization chamber demonstrated strong agreement between estimated and measured values (intraclass correlation coefficient = 1, 95% CI). Immune subsets, including T cells (CD3+), helper T cells (CD3+CD4+), cytotoxic T cells (CD3+CD8+), regulatory T cells (CD3+CD4+Foxp3+), and natural killer (CD3-CD56+) cells, along with intracellular cytokines interleukin-12 (IL-12) and interferon-gamma (IFN-γ), were analyzed via flow cytometry at multiple time points. The results showed a significant, dose-dependent decline in overall lymphocyte viability (p < 0.01) compared to control. Cytotoxic T cells were the most radiosensitive, followed by helper and regulatory T cells, while NK cells were the most radioresistant. IL-12 expression initially increased post-irradiation, while IFN-γ levels remained variable. These findings demonstrate that radiation induces distinct alterations in immune phenotypes and cytokine profiles, which may shape the immune response. Immune profiling following irradiation may therefore provide valuable insights for optimizing combination strategies that integrate radiotherapy and immunotherapy in cancer treatment.