Pediatric Cancer

Article Title:
Local Control of Bladder/Prostate Rhabdomyosarcoma: An Expert Consensus Guideline From the International Soft Tissue Sarcoma Consortium (INSTRuCT). March 2026

Authors:
Daniel J. Indelicato, MD, Amanda F. Buchanan, Cyrus Chargari, Raquel Dávila Fajardo, Joerg Fuchs, Candace F. Granberg, Héléne Martelli, Niccolo M. Passoni, Stephanie M. Perkins, Naima Smeulders, Beate Timmerman, Jonathan C. Routh

Why this is important:Dr. Indelicato led an international group of experts who developed new treatment guidelines for children diagnosed with a rare cancer of rhabdomyosarcoma of the bladder or prostate. Radiation therapy is a key part of treatment for most patients and can often control the cancer while helping preserve the bladder. Newer methods, such as proton therapy and brachytherapy, may reduce radiation exposure to nearby healthy organs. Treatment should be tailored to each child based on the tumor’s size, location, response to chemotherapy and lymph node involvement. Because radiation side effects can appear years later, survivors need long-term follow-up for bladder function, growth, sexual health, fertility and second cancers.

Article Title:
Dose-effect analysis of facial bone morphology following radiation therapy for head and neck rhabdomyosarcoma. January 2026

Authors:
Marinka L F Hol, Michael Suttie, Mark N Gaze, Jan Wiersma, Henry Mandeville, Johannes H M Merks, Bradley R Pieters, Callum Gillies, Nicole Freling, Ludwig E Smeele, Olga Slater, Arjan Bel, Daniel J. Indelicato, MD

Why this is important:
This study examined how radiation affects facial growth in children treated for a rhabdomyosarcoma located in the head and neck. Dr. Indelicato was part of an international group of researchers who compared 3D facial images and radiation plans from 34 survivors who were followed for an average of about nine years. Higher radiation doses to developing facial bones were linked to a greater risk of changes in facial shape, with increased risk beginning around 26–28 Gy for some areas. These findings may help radiation teams better protect facial bones when planning treatment while still giving enough radiation to control the cancer.

Article Title:
DENTALE: a validated Dentofacial EvaluatioN Tool to standardize radiological Assessment of Late dental and maxillofacial adverse Effects following treatment for pediatric rhabdomyosarcoma. May 2026

Authors:
Koen B. Krommenhoek, Reinier C. Hoogeveen, E. Foster-Thomas, Willem M. M. Fennis, Frédérique J. M. San Giorgi, Matthew Krasin, Mark N. Gaze, Olga Slater, Gillian A. Whitfield, Daniel J. Indelicato, MD, Henry C. Mandeville, Shermaine Pan, Marianne C. Aznar, Johannes H. M. Merks, Alfred G. Becking, Marinka L. F. Hol.

Why this is important:
Radiation to the head and neck can affect how a child’s permanent teeth and jawbones develop. Dr. Indelicato and a team of international researchers created DENTALE, a five-minute scoring tool that uses a panoramic dental X-ray to measure these long-term changes. In 83 survivors of rhabdomyosarcoma in the head and neck treated with chemotherapy and radiation, the tool reliably identified children who needed specialized dental care. DENTALE may help dentists find problems earlier and allow researchers to compare dental effects from different radiation treatments. The tool adds to, but does not replace, regular dental examinations and long-term follow-up.

Article Title:
Voxel-wise case-control analysis of dose, linear energy transfer and symptomatic brainstem necrosis in pediatric brain tumors treated with proton therapy. June 2026

Authors:
Andreas H. Handeland, PhD, Daniel J. Indelicato, MD, Grete May Engeseth, PhD, Lars Fredrik Fjæra, PhD, Hardev S. Grewal, PhD, Kristian S. Ytre-Hauge, PhD, Ludvig Paul Muren, PhD, Yasmin Lassen-Ramshad, MD, PhD, Helge Henjum, PhD, Camilla H. Stokkevåg, PhD

Why this is important:
Brainstem damage is a rare but serious possible side effect of radiation therapy for childhood brain tumors. Dr. Indelicato and the team at the University of Florida are considered international experts in studying this phenomenon. In this study, Dr. Indelicato and Dr. Grewal worked with a team in Denmark on a research project that compared 12 children who developed this injury with 36 similar children who did not. The total radiation dose was the strongest factor linked to brainstem damage. In areas receiving high doses, risk may also rise when protons release more energy into the tissue, a feature called linear energy transfer. These findings may help doctors improve proton treatment plans.

Article Title:

Modern Trends in Pediatric Radiotherapy Utilization. June 2026

Authors:
Melisa Pasli, Daniel J. Indelicato, MD, Elizabeth Thompson, Christopher G. Morris, MS, Nancy P. Mendenhall, MD, FACR, FASTRO, Julie A. Bradley, MD, MHCDS

Why this is important:
This research paper was written by Dr. Melisa Pasli, a UF radiation oncology resident under the mentorship of Dr. Indelicato. It examined radiation use among more than 55,000 U.S. children with cancer from 2000 through 2021. Overall, the percentage receiving radiation fell from 25% to 15%, partly because newer medicines can now replace radiation for some cancers. For example, radiation use dropped sharply for leukemia, lymphoma and some low-grade brain tumors. However, it increased for rhabdomyosarcoma, Wilms tumor and high-grade brain tumors, where radiation remains important for controlling disease. These findings show that radiation is being used more selectively based on each cancer’s needs and the risk of long-term side effects.

Prostate Cancer

Article Title:
Particle Therapy Co-Operative Group Consensus Statement on Reirradiation With Proton Therapy for Prostate Cancer. June 2026

Authors:
Shaakir Hasan DO, Xinglei Shen MD, Huan Giap MD, PhD, Sagar A. Patel MD, Christian Hyde MD, Curtiland Deville MD, James Gray MD, Charles B. Simone II MD, Nancy P. Mendenhall MD, FACR, FASTRO, Seungtaek Choi MD, Curtis M. Bryant, MD, MPH

Why this is important:
Our prostate cancer experts are a part of the Particle Therapy Co-Operative Group that provides updated recommendations on radiation treatments based on the latest research. If prostate cancer recurs and is only found within the prostate or surrounding nodes, curative treatment is possible when the recurrence is caught early. A second round of radiation is called re-irradiation. This study focused on determining the patients who may benefit the most with proton therapy during re-irradiation, maintaining high cure rates and lower side effects. Some of the criteria for the most favorable candidates for re-irradiation with proton therapy were: people with a long life expectancy, more than three years since their prior radiation, people who had few long-term side effects on the bladder and rectum from the initial course of radiation and successful use of the rectal spacer placement in the prior radiation treatment. The group also determined that patients were eligible for proton therapy radiation during recurrence if the cancer recurrence was only found in the pelvic nodes or the para-aortic nodes, or within the prostate again (as long as the cancer was also found in the pelvis or para-aortic nodes).

Head and Neck Cancer

Article Title:
Sustained Locoregional Control With Deintensified Chemoradiotherapy for HPV Oropharyngeal Carcinoma. June 2026

Authors:
Ryan T Morse, Ying Cao, Victoria Xu, Jared Weiss, Siddharth Sheth, Shetal Patel, Jeffrey M Blumberg, Wendell G Yarbrough, Catherine Lumley, Trevor Hackman, Samip Patel, Stephen B Huff, Michael C Repka, Roi Dagan, MD, MS, William M. Mendenhall, MD, FACR, Colette J Shen, Xuguang S Chen, Bhishamjit S Chera

Why this is important:
Oropharyngeal cancer is a type of head and neck cancer that can affect the middle of the throat and the area around the tonsils and the back of the tongue. Traditional treatment for these patients includes radiation at a dose of 70 Gy (gray) in addition to chemotherapy treatment. Research is being done to determine if there are some patients who could be treated with lower doses of radiation to reduce the side effects of treatments, with the same positive outcomes. This article reviewed the research for patients who were defined as low-risk. Low-risk means patients who had HPV-positive cancer and who were either non-smokers or former smokers. These patients had positive treatment outcomes when receiving a lower dose of 60 Gy of radiation instead of the standard 70 Gy of radiation. For these low-risk patients, 92.4% of them survived five years after treatment. For the very lowest risk patients, their 5-year survival rate without any recurrences was 93.8%. After five years, only 3.4% of patients had the cancer return in the same location in their mouth, and only 7.3% of the patients had the cancer return outside of the initial area treated. These findings are helping physicians determine the most effective treatments with the least amount of side effects for patients.