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Personalized Radiation Therapy for Cancers: Current Status and Future Perspectives
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Personalized Radiation Therapy for Cancers: Current Status and Future Perspectives

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Methodology, Drug and Device Discovery".

Deadline for manuscript submissions: 25 September 2026 | Viewed by 4859

Special Issue Editors

Dr. Roberta Carbonara

E-Mail Website
Guest Editor
Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
Interests: radiation oncology; personalized oncology; radiomics; stereotactic radiotherapy; breast cancer; prostate cancer; head and neck cancer
Dr. Alba Fiorentino

E-Mail Website
Guest Editor
1. Department of Radiation Oncology, Miulli General Regional Hospital, 70021 Bari, Italy
2. Department of Medicine and Surgery, LUM University, 70010 Bari, Italy
Interests: radiation oncology; personalized oncology; stereotactic radiotherapy; reirradiation; neuro-oncology; breast cancer; prostate cancer
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In the era of personalized oncology, a significant improvement in patient outcomes has been achieved thanks to a favorable combination of modern knowledge on cancer (i.e., cancer-related genomic and immunological profiles, tumor microenvironment of the primary and metastatic sites, clinicopathological and imaging features predictive of clinical outcomes), technological advances in the diagnostic and radiation oncology fields, as well as recent insights in radiobiology.

Nowadays, a multidisciplinary, integrated approach to cancer patients leads to selecting treatments according to disease-specific proliferating pathways and obtaining synergistic effects between radiotherapy and immunotherapy or targeted therapies.

Furthermore, modern radiation oncology allows higher conformity treatments, adaptive approaches, and salvage/ablative re-irradiation of recurrences, with a significant impact on disease control and patients' quality of life.

This Special Issue will address the current advances and future perspectives in the field of personalized radiation oncology, underscoring the relevance of multidisciplinary evaluations to improve tailored treatments and enhance cancer patients’ outcomes.

Dr. Roberta Carbonara
Dr. Alba Fiorentino
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • personalized radiotherapy
  • personalized oncology
  • adaptive radiotherapy
  • stereotactic radiotherapy
  • re-irradiation
  • immuno-radiotherapy
  • tumor microenvironment and radiotherapy

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Published Papers (4 papers)

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Research

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15 pages, 966 KB  
Article
Omitting Elective Pelvic Nodes Irradiation in High Risk Prostate Cancer: Report on 43 Consecutive Elderly Patients
by Emanuele Chioccola, Mara Caroprese, Christina Amanda Goodyear, Angela Barillaro, Gianluca Valerio, Caterina Oliviero, Mauro Buono, Stefania Clemente, Antonio Farella, Manuel Conson and Roberto Pacelli
J. Pers. Med. 2026, 16(4), 177; https://doi.org/10.3390/jpm16040177 - 24 Mar 2026
Viewed by 381
Abstract
Background: Radiotherapy (RT) combined with androgen deprivation therapy (ADT) is a standard treatment for non-metastatic high-risk (HR) prostate cancer (PC). However, the benefit of elective nodal irradiation (ENI) in clinically node-negative (cN0) patients, although suggested, remains controversial, particularly in the elderly. We [...] Read more.
Background: Radiotherapy (RT) combined with androgen deprivation therapy (ADT) is a standard treatment for non-metastatic high-risk (HR) prostate cancer (PC). However, the benefit of elective nodal irradiation (ENI) in clinically node-negative (cN0) patients, although suggested, remains controversial, particularly in the elderly. We report the outcomes of elderly HR PC patients treated with prostate-only RT (PORT) and ADT in a “real-word” setting. Methods: Between 2016 and 2022, 43 consecutive elderly patients (median age 76 years) with HR- or very HR-PC according to NCCN criteria version 1.2026 (cN0, cT3-cT4 and/or ISUP Grade Group 4–5 and/or PSA serum levels at diagnosis ≥ 20 ng/mL) were treated at our institution. All patients were staged with abdominal MRI or CT and bone scan; nineteen patients (44.2%) also underwent 68Ga-PSMA-11 or 18F-fluorocholine PET/CT. All patients received PORT (predominantly moderate hypofractionation, 67.5–70 Gy in 25–28 fractions) and ADT (median duration 24 months). To ensure consistency, all oncological endpoints—Biochemical Failure-Free Survival (BFFS; Phoenix criteria), Disease-Free Survival (DFS), Metastasis-Free Survival (MFS), Prostate Cancer-Specific Survival (PCSS), and Overall Survival (OS)—were calculated from a unified time-zero (initiation of first oncological treatment). DFS was defined as a composite endpoint including biochemical failure, radiological recurrence, or initiation of salvage therapy. Results: at a median follow-up of 60 months, no patient reached the Phoenix threshold, resulting in a 100% 5- and 7-year BFFS. However, 4 patients (9.3%) experienced radiological recurrence detected via PET/CT before reaching the nadir + 2 threshold, yielding an estimated 5-year and 7-year DFS of 94.7% and 71.8%, respectively. The 5- and 7-year MFS was of 97.6% and 88.7%, respectively. Seven deaths occurred, all non-PC related, resulting in a 5-year OS of 86.7% and a Prostate Cancer-Specific Survival of 100%. Gastrointestinal toxicity was notably low (no acute or late G3-G4 events). Conclusions: Our findings suggest that PORT, when combined with long-term ADT and modern staging, provides excellent disease control and a favorable safety profile in elderly HR PC patients. Given the high rate of competing mortality in this population, treatment de-escalation via PORT appears to be a clinically reasonable strategy. These results are hypothesis-generating and warrant validation in prospective randomized trials. Full article
(This article belongs to the Special Issue Personalized Radiation Therapy for Cancers: Current Status and Future Perspectives)
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15 pages, 1081 KB  
Article
Curative Brachytherapy for Inoperable Early-Stage Oesophageal Cancer: A Case Series and Narrative Review
by Elena Lluzar, Adriana Capdevila, Faegheh Noorian, Antonio Herreros, Cristina Castro, Àngels Gines, Glòria Fernández-Esparrach, Carmen Ares, Yao Qiang and Angeles Rovirosa
J. Pers. Med. 2026, 16(1), 13; https://doi.org/10.3390/jpm16010013 - 31 Dec 2025
Viewed by 623
Abstract
Background: A subset of patients with T1-T2 oesophageal cancer are not candidates for surgery or chemotherapy and have a poor prognosis due to limited treatment options. This study evaluated the combination of external beam radiotherapy (EBRT) and endo-oesophageal brachytherapy (EBT) as a [...] Read more.
Background: A subset of patients with T1-T2 oesophageal cancer are not candidates for surgery or chemotherapy and have a poor prognosis due to limited treatment options. This study evaluated the combination of external beam radiotherapy (EBRT) and endo-oesophageal brachytherapy (EBT) as a curative treatment in these patients, with cause-specific survival (CSS) and local recurrence-free survival (LRFS) as the primary endpoints. Methods: This was a single-centre retrospective analysis of 11 patients with T1-T2 oesophageal cancer treated between 2005 and 2024 with combined EBRT and EBT schedules. Clinical data, treatment schedules, outcomes, and complications were obtained from patient medical records and follow-up documentation. Descriptive statistics and Kaplan–Meier survival analysis were used. Results: The median follow-up was 22 months (2–61 months). CSS rates were 79.5% at 2 years, 66% at 3 years, and 30% at 5 years. LRFS rates were 74.1%, 59%, and 39%, respectively. One severe toxicity (grade ≥ 3) was observed. The most frequent mild toxicities were oesophageal mucositis (18.2%) and ulceration (18.2%). Conclusions: EBT in combination with EBRT seems to be a feasible and well-tolerated treatment with curative intent for inoperable T1-T2 oesophageal cancer patients, offering favourable survival outcomes in a population with limited therapeutic alternatives. Full article
(This article belongs to the Special Issue Personalized Radiation Therapy for Cancers: Current Status and Future Perspectives)
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12 pages, 4050 KB  
Article
Low Radiation Doses to Gross Tumor Volume in Metabolism Guided Lattice Irradiation Based on Lattice-01 Study: Dosimetric Evaluation and Potential Clinical Research Implication
by Giuseppe Iatì, Giacomo Ferrantelli, Stefano Pergolizzi, Gianluca Ferini, Valeria Venuti, Federico Chillari, Miriam Sciacca, Valentina Zagardo, Carmelo Siragusa, Anna Santacaterina, Anna Brogna and Silvana Parisi
J. Pers. Med. 2025, 15(10), 470; https://doi.org/10.3390/jpm15100470 - 2 Oct 2025
Viewed by 1194
Abstract
Purpose: This paper aims to calculate the gross tumor volume (GTV) receiving low radiation doses in patients submitted to “metabolism-guided” lattice radiation therapy and relative possible implications with clinical outcomes. Material and Methods: We reviewed plans for treating voluminous masses via [...] Read more.
Purpose: This paper aims to calculate the gross tumor volume (GTV) receiving low radiation doses in patients submitted to “metabolism-guided” lattice radiation therapy and relative possible implications with clinical outcomes. Material and Methods: We reviewed plans for treating voluminous masses via “metabolism-guided” LATTICE-01 irradiation. The aim was to deliver high-dose radiation to spherical deposits (vertices) within a bulky tumor mass. These were placed at tumor areas with differing PET metabolism. We evaluated the relationships between GTV volumes and dose-volumetric histograms (mean, maximum, minimum, and % GTV received 0.5, 1, 2, 3 Gy). Results: Sixty-two plans of treatment met the inclusion criteria as established. The median GTV volume was 315.9 cc (range = 10.54–2605.9 cc). A median of two Vertices was allocated within the GTVs (range 1–9) and were planned to receive a dose of ≥10 Gy/1 fraction (median 12 Gy, range 10–15 Gy). Median V3Gy percentage was 51.58% (range 2–100%), median V2Gy percentage was 67.80% (range 1.60–100%), median V1Gy percentage was 83.70% (range 0.80–100%), and median V0.5Gy percentage was 88.49% (range 17.60–100%). Conclusions: In the present series, we performed a dosimetric evaluation of the GTV’s volume exposed to low doses during the metabolic guided lattice irradiation process. Combining high- and low-dose radiotherapy based on a spatially fractionated (LATTICE) approach could reactivate the immune system against cancer cells. These observations could be useful for planning prospective studies on immunotherapy combined with the lattice technique. Full article
(This article belongs to the Special Issue Personalized Radiation Therapy for Cancers: Current Status and Future Perspectives)
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Review

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14 pages, 1002 KB  
Review
3D-Printed Devices in Interventional Radiotherapy (Brachytherapy) Applications: A Literature Review
by Enrico Rosa, Sofia Raponi, Bruno Fionda, Maria Vaccaro, Valentina Lancellotta, Antonio Napolitano, Gabriele Ciasca, Leonardo Bannoni, Patrizia Cornacchione, Luca Tagliaferri, Marco De Spirito and Elisa Placidi
J. Pers. Med. 2025, 15(6), 262; https://doi.org/10.3390/jpm15060262 - 19 Jun 2025
Cited by 6 | Viewed by 1891
Abstract
Introduction: Interventional radiotherapy (brachytherapy, IRT, BT) has evolved with technological advancements, improving dose precision while minimizing exposure to healthy tissues. The integration of 3D-printing technology in IRT has enabled the development of patient-specific devices, optimizing treatment personalization and dosimetric accuracy. Methods: [...] Read more.
Introduction: Interventional radiotherapy (brachytherapy, IRT, BT) has evolved with technological advancements, improving dose precision while minimizing exposure to healthy tissues. The integration of 3D-printing technology in IRT has enabled the development of patient-specific devices, optimizing treatment personalization and dosimetric accuracy. Methods: A systematic literature search was conducted in PubMed, Scopus, and Google Scholar to identify studies published between 2020 and 2024 on 3D-printing applications in IRT. The selection process resulted in 74 peer-reviewed articles categorized by radioactive source, brachytherapy technique, endpoint of the 3D-printed product, and study type. Results: The analysis highlights the growing implementation of 3D-printed devices in brachytherapy, particularly in gynecological, prostate, and skin cancers. Most studies focus on technique, including intracavitary, interstitial, and contact applications, with custom applicators and templates emerging as predominant endpoints. The majority of studies involved in vivo clinical applications, followed by in silico computational modeling and in vitro experiments. Conclusions: The upward trend in scientific publications underscores the growing attention on 3D printing for enhancing personalized brachytherapy. The increasing use of 3D-printed templates and applicators highlights their role in optimizing dose delivery and expanding personalized treatment strategies. The current research trend is shifting toward real-world data and in vivo studies to assess clinical applications, ensuring these innovations translate effectively into routine practice. The integration of 3D printing represents a major advancement in radiation oncology, with the potential to enhance treatment efficacy and patient outcomes. Future research should focus on standardizing manufacturing processes and expanding clinical validation to facilitate broader adoption. Full article
(This article belongs to the Special Issue Personalized Radiation Therapy for Cancers: Current Status and Future Perspectives)
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