Strahlentherapie und Onkologie最新文献

{"title":"Capacitive heating devices for therapeutic hyperthermia: a review of essential physical characteristics and challenges.","authors":"H P Kok, T Ohguri, F Navarro, U S Gaipl, C A Minnaar, J Contreras, P Ghadjar, J Crezee, K Kuroda","doi":"10.1007/s00066-026-02540-1","DOIUrl":"https://doi.org/10.1007/s00066-026-02540-1","url":null,"abstract":"<p><p>Therapeutic hyperthermia is typically applied using radiative or capacitive heating devices. Capacitive heating applies electrode pairs positioned on the patient to increase the tumor temperature and is considered a user-friendly method for relatively easy application of hyperthermia to both superficial and deep-seated tumor sites. However, this heating technique also has some limitations that are mainly inherent to the physics of capacitively induced heating. This review provides an overview of the principles of capacitive heating devices and the factors influencing the power absorption and resulting temperature distribution in the patient. Device parameters that strongly influence the achieved temperature distribution include the electrode sizes, the water bolus temperature for skin cooling, the cooling medium, and the output power. These parameters vary in commercially available devices. Complete characterizations of most of the commercially available capacitive devices are still lacking. Sparse phantom measurements in the literature characterizing capacitive devices indicate that therapeutic heating is at least possible for superficial tumors and tumors at intermediate depth. The dominant E‑field orientation with capacitive heating induces preferential subcutaneous fat heating, which limits deep heating and makes it most effective for slender patients (i.e., fat layer thickness < 1.5-2 cm). Numerical simulations have been helpful in optimizing device design, particularly in terms of bolus cooling, and are increasingly used for patient-specific treatment planning. Based on the physical characteristics and present literature, it can be concluded that appropriate patient selection is important to ensure effective and responsible use of capacitive heating devices.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective study assessing the feasibility of hippocampal-sparing radiotherapy in lung cancer patients requiring cranial irradiation.","authors":"Divya Khosla, Treshita Dey, Gaurav Trivedi, Rakesh Kapoor, Navneet Singh, Vaishali Kataria, Aditya Kumar Singla, Renu Madan, Shikha Goyal, Arun Singh Oinam, Aditya Mehta, Akhilesh Sharma, Kannan Periasamy","doi":"10.1007/s00066-026-02537-w","DOIUrl":"https://doi.org/10.1007/s00066-026-02537-w","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer remains one of the leading causes of cancer-related mortality worldwide, with systemic therapies often limited by poor intracranial penetration, resulting in frequent brain relapses. Whole-brain radiotherapy (WBRT) plays a central role in managing brain metastases and in prophylaxis, although it is frequently associated with significant neurocognitive decline. Hippocampal-sparing WBRT (HSWBRT) represents a strategy to preserve neurocognition and quality of life (QoL) while maintaining disease control. This study evaluated the feasibility and outcomes of HSWBRT in lung cancer patients requiring prophylactic cranial irradiation (PCI) or WBRT.</p><p><strong>Methods: </strong>In this prospective study (2021-2023), 15 patients with histologically confirmed lung cancer with an indication for PCI or WBRT (lesions > 5 mm from hippocampus) were treated with HSWBRT. Target delineation followed Radiation Therapy Oncology Group (RTOG) guidelines, incorporating a 5-mm isotropic margin for hippocampal avoidance. Prescribed doses were 25 Gy in 10 fractions for PCI and 30 Gy in 10 fractions for brain metastases. Neurocognitive function was assessed using the Montreal Cognitive Assessment (MOCA), Trail Making Test parts A and B (Trail A/B), and the Controlled Oral Word Association Test (COWAT). Quality of life was evaluated with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and EORTC Brain Cancer Module (BN20) at baseline and at 2, 4, 6, 9, and 12 months. Outcomes were compared with a retrospective cohort of 15 patients treated with conventional WBRT. The Kaplan-Meier method was used for survival analysis; comparisons employed log-rank and repeated measures analysis of variance tests.</p><p><strong>Results: </strong>Median follow-up was 20 months. Intracranial relapse and overall survival rates did not differ significantly between the HSWBRT and WBRT arms. However, self-reported cognitive decline and QoL deterioration were lower in the HSWBRT arm at 12 months (QoL: 83.33 vs. 66.67, p = 0.07). The MOCA scores remained stable, and Trail A/B performance improved post-treatment in the HSWBRT cohort.</p><p><strong>Conclusion: </strong>Our findings show that HSWBRT appears feasible and effective in preserving neurocognitive function and QoL in lung cancer patients, without compromising intracranial control. Larger randomized studies are needed to validate its role in routine practice.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-invasive prediction of the secondary enucleation risk in uveal melanoma based on pretreatment CT and MRI prior to stereotactic radiotherapy.","authors":"Yagiz Yedekci, Hidetaka Arimura, Yu Jin, Melek Tugce Yilmaz, Takumi Kodama, Gokhan Ozyigit, Gozde Yazici","doi":"10.1007/s00066-025-02449-1","DOIUrl":"10.1007/s00066-025-02449-1","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to develop a radiomic model to non-invasively predict the risk of secondary enucleation (SE) in patients with uveal melanoma (UM) prior to stereotactic radiotherapy using pretreatment computed tomography (CT) and magnetic resonance (MR) images.</p><p><strong>Materials and methods: </strong>This retrospective study encompasses a cohort of 308 patients diagnosed with UM who underwent stereotactic radiosurgery (SRS) or fractionated stereotactic radiotherapy (FSRT) using the CyberKnife system (Accuray, Sunnyvale, CA, USA) between 2007 and 2018. Each patient received comprehensive ophthalmologic evaluations, including assessment of visual acuity, anterior segment examination, fundus examination, and ultrasonography. All patients were followed up for a minimum of 5 years. The cohort was composed of 65 patients who underwent SE (SE+) and 243 who did not (SE-). Radiomic features were extracted from pretreatment CT and MR images. To develop a robust predictive model, four different machine learning algorithms were evaluated using these features.</p><p><strong>Results: </strong>The stacking model utilizing CT + MR radiomic features achieved the highest predictive performance, with an area under the curve (AUC) of 0.90, accuracy of 0.86, sensitivity of 0.81, and specificity of 0.90. The feature of robust mean absolute deviation derived from the Laplacian-of-Gaussian-filtered MR images was identified as the most significant predictor, demonstrating a statistically significant difference between SE+ and SE- cases (p = 0.005).</p><p><strong>Conclusion: </strong>Radiomic analysis of pretreatment CT and MR images can non-invasively predict the risk of SE in UM patients undergoing SRS/FSRT. The combined CT + MR radiomic model may inform more personalized therapeutic decisions, thereby reducing unnecessary radiation exposure and potentially improving patient outcomes.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"476-484"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of primary chemoradiotherapy in the management of advanced stage vulvar cancer : Experience of a large cancer center.","authors":"Lars Wessel, Maria Vinsensia, Thomas Koenigsmann, Juergen Debus, Nathalie Arians","doi":"10.1007/s00066-025-02483-z","DOIUrl":"10.1007/s00066-025-02483-z","url":null,"abstract":"<p><strong>Purpose: </strong>Treatment of advanced vulvar cancer is challenging. The aim of the study was to investigate the potential of primary (chemo)radiotherapy ((C)RT) with regard to clinical outcome and associated prognostic parameters.</p><p><strong>Methods: </strong>A total of 39 patients with squamous cell vulvar cancer receiving primary (C)RT were retrospectively identified through hospital databases. Patient and treatment characteristics as well as outcomes were assessed. Survival statistics were calculated using the Kaplan-Meier method. Univariate analysis was performed using the log-rank test and Spearman's correlation to evaluate associations between patient or treatment characteristics and survival outcomes.</p><p><strong>Results: </strong>Median age at diagnosis was 74 years (range 38-92 years). Patients had advanced stage disease with 28.2%/38.5% presenting with FIGO stage III/IV, respectively. All patients received external beam radiotherapy (EBRT) with a median dose to the primary tumor of 66 Gy EQD2 (range 49.6 Gy-72.6 Gy) and to lymph nodes of 53.1 Gy EQD2 (range 44.1 Gy-67.1 Gy). 69.2% received concurrent chemotherapy, mostly cisplatin weekly or mitomycin/5-fluorouracil. 10.3%/64.1% showed clinical complete remission (cCR)/partial remission (cPR) at first follow-up; 7.7% had disease progression. After a median follow-up of 25.5 months (range 0.5-132.9 months), 3‑year locoregional progression-free survival (LRPFS) and overall survival (OS) were 60.2% and 69.6%, respectively. Age and concurrent chemotherapy were the main prognostic parameters associated with improved oncological outcome.</p><p><strong>Conclusion: </strong>Definitive (C)RT plays an important role in the management of advanced vulvar cancer with high response rates and satisfactory oncological outcomes. However, there is still room for improvement and future trials are needed to further assess the potential of definitive CRT, especially with regard to possible combinations with immunotherapy.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"516-525"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145489011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"29th Annual SASRO Meeting 2025.","authors":"","doi":"10.1007/s00066-025-02496-8","DOIUrl":"10.1007/s00066-025-02496-8","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"547-580"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Prognosis and local treatment methods for Merkel cell carcinoma].","authors":"Tim Winter, Mathias Sonnhoff","doi":"10.1007/s00066-026-02515-2","DOIUrl":"10.1007/s00066-026-02515-2","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"544-546"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147676784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiotherapy in the treatment of malignant fungating wounds: clinical practice, response rates, and outcome from a tertiary cancer center.","authors":"Anna Lena Reinking, Martin Leu, Leif Hendrik Dröge, Benedikt Kieslich, Sandra Donath, Markus Anton Schirmer, Stephanie Bendrich, Laura Anna Fischer, David Alexander Ziegler, Hannes Treiber, Enver Aydilek, Raphael Koch, Stefan Rieken, Manuel Guhlich","doi":"10.1007/s00066-025-02443-7","DOIUrl":"10.1007/s00066-025-02443-7","url":null,"abstract":"<p><strong>Purpose: </strong>Malignant fungating wounds (MFW) are a distressing condition caused by aggressive tumor growth infiltrating the skin. Regularly causing pain, exudation, bleeding, edema and odor, they negatively affect the patients' quality of life (QoL). Radiotherapy (RT) can reduce MFW-associated symptoms and is routinely used in clinical settings, both in curative as well as palliative treatment regimes. However, fundamental data on treatment response, symptom relief and oncological outcomes, as well as potential confounders of treatment response are currently limited.</p><p><strong>Methods: </strong>We performed a retrospective analysis of patients with MFW who received RT between 01/2000 and 06/2022 at our tertiary cancer center. Achievement of treatment goals, including reduction of pain and tumor mass, cessation of bleeding, and improvement of wound condition, were evaluated. The effect of variables on the achievement of treatment goals were assessed by logistic regression. The effect of parameters on overall survival (OS) were assessed using the Kaplan-Meier plot with log-rank test and Cox regression analysis. Statistically significant (p-value < 0.05) confounders were tested in multivariable analyses.</p><p><strong>Results: </strong>101 patients were included. 69.3% of treatments were in palliative intent, 30.7% in curative intent. Main tumor entities were breast cancer, squamous cell carcinoma of the skin and vulvar carcinoma, accounting for 26.7, 22.8 and 9.9% of patients. Main treated locations were head & neck (38.6%), breast/chest wall (29.7%) and genitals (9.9%). Main treated areas were primary tumor (52.5%) and metastasis (22.8%). Concurrent systemic therapy was administered in 32.7%. The predefined therapy goal was achieved in 85% of patients. Median overall survival was 7.8 months. Concurrent systemic therapy was statistically significant associated with achieving the therapy goal [logistic regression; HR 8.45 (95% CI: 1.06-67.37, p = 0.04)]. Concurrent systemic therapy, lower CCI and achieving the therapy related goal were significantly associated with higher overall survival. Overall toxicity was low.</p><p><strong>Conclusion: </strong>RT for MFW is a highly effective treatment option, resulting in very high local tumor regression rates. It therefore reduces the numerous negative QoL-affecting consequences for the patients, which often present in a palliative state. Concurrent systemic therapy can be a prognostically relevant treatment option.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"485-495"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Which is the best timing to assess response after chemoradiation in locally advanced cervical cancer (BRILACC)?","authors":"Rosa Autorino, Gabriella Macchia, Luca Russo, Nicola Dinapoli, Valentina Lancellotta, Nicolò Bizzarri, Maria Gabriella Ferrandina, Maura Campitelli, Viola De Luca, Roberta Giannini, Raffaella Michela Rinaldi, Evis Sala, Benedetta Gui, Maria Antonietta Gambacorta","doi":"10.1007/s00066-025-02463-3","DOIUrl":"10.1007/s00066-025-02463-3","url":null,"abstract":"<p><strong>Purpose: </strong>The goal is to investigate the best time point for assessing radiological complete response after exclusive chemoradiation in locally advanced cervical cancer (LACC). This is a retrospective single-center study.</p><p><strong>Materials and methods: </strong>Seventy-nine patients with LACC, stage IB3-IVA FIGO 2018 treated between January and December 2020 were retrospectively analyzed. All patients received external beam radiotherapy (45 Gy in 25 daily fractions ± simultaneous boost to lymph nodes), and interventional radiotherapy (IRT, 28 Gy/twice/weekly) with concurrent chemotherapy. The radiological complete response evaluation was examined using magnetic resonance imaging (MRI) at three timepoints: (i) before IRT, at the end of external beam radiotherapy, (ii) 3 months following the completion of IRT and (iii) 6 months after IRT. Seventy-nine patients were included.</p><p><strong>Results: </strong>At the three timepoints, the complete response rate increased with 21, 53, and 59 patients reporting a complete response at MRI scan, respectively. Seven patients with partial response at the second assessment had complete response 6 months after treatment completion, overall resulting in 80% clinical complete response.</p><p><strong>Conclusions: </strong>Our findings suggest that 6 months following the end of exclusive treatment for LACC patients is the best time to detect complete radiological response (measured by MRI scan) after chemoradiation. Waiting this period of time before conclusively assessing response would allow for the inclusion of patients who have not yet fully responded at 3 months, while avoiding the performance of salvage therapies too early.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"508-515"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated approaches to sensitizing melanoma to radiotherapy.","authors":"Abdullah A Aseeri, Zahraa AlKhafaje, Uday Abdul-Reda Hussein, Zahraa Adel, Ola Kamal A Alkadir, Ahmed Aldulaimi, Shakir Mahmood Saeed, Waam Mohammed Taher, Mariem Alwan, Aseel Smerat","doi":"10.1007/s00066-025-02501-0","DOIUrl":"10.1007/s00066-025-02501-0","url":null,"abstract":"<p><p>Melanoma presents significant challenges to treatment due to its complex tumor microenvironment (TME) and the development of various resistance mechanisms in cancer cells. Radiotherapy is one of the main treatment modalities for melanoma. It acts by generating reactive oxygen species (ROS) and inducing DNA damage in melanoma cancer cells. However, these malignant cells develop DNA damage responses (DDRs) to resist ionizing radiation (IR). In addition, tumor cells engage in constant dialogue with surrounding stromal cells, immune cells, and extracellular matrix (ECM) components. These interactions shape tumor progression, metastasis, and resistance to different antitumor agents, including radiotherapy. Key players in this cellular orchestra include stromal cells, macrophages, myeloid cells, and different subsets of T cells. In addition, a unique vascular system and subsequent hypoxia in some regions of the tumor can further stimulate resistance to radiotherapy. Emerging research highlights the role of immune checkpoints, hypoxia, growth factors, and growth factor receptors in modulating tumor responses to radiation. Recent studies have uncovered promising molecular targets such as DNA repair inhibitors, immune checkpoint inhibitors (ICIs), tyrosine kinase inhibitors (TKIs), and hypoxia modulators to sensitize melanoma to radiotherapy. This review aims to synthesize current knowledge on melanoma tumor interactions, providing a comprehensive overview of promising targets for improving radiotherapy outcomes in melanoma patients.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"456-475"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current practices in peer review in German radiation oncology: a nationwide survey.","authors":"Andrea Baehr, Maja Guberina, Philipp Ernst, Kilian Koch, Marion Juretko, Ursula Nestle, Maximilian Grohmann","doi":"10.1007/s00066-025-02444-6","DOIUrl":"10.1007/s00066-025-02444-6","url":null,"abstract":"<p><strong>Background: </strong>Clinical peer review (PR) is a structured process in which medical professionals evaluate the quality of their colleagues' work to ensure compliance with healthcare standards. In radiation oncology (RO), intra-institutional PR has become established as a key quality assurance (QA) measure to improve treatment safety and effectiveness. While various guidelines and recommendations exist internationally, no uniform PR framework for radiation treatment decision-making and planning has been defined in Germany.</p><p><strong>Objective: </strong>This study aims to provide an overview of current PR practices in German RO departments, assess the degree of implementation of recommended PR measures, and identify areas for improvement.</p><p><strong>Methods: </strong>A digital survey among RO specialists was conducted from January 7 to February 7, 2025. The survey included structured questions on PR implementation, participation of different professional groups, timing, documentation, and technological infrastructure. Free-text fields allowed for additional insights. The collected data were analyzed descriptively.</p><p><strong>Results: </strong>A total of 51 complete questionnaires-mainly from academic centers-were evaluated. Here, PR was widely implemented, particularly involving physicians and medical physicists, with 86% of departments performing case discussions and 82% PR of plans before the first radiation session. Most participants reported that PR effectively supports treatment planning and safety. However, PR for target delineation and image fusion was only implemented in 41% of cases. The inclusion of RTTs, nurses, and radiologists was rare. Documentation of PR processes, particularly attendance tracking and implementation of recommended changes, was inconsistent. Time constraints, personnel shortages, and high patient volume were the most frequently reported barriers to continuous PR.</p><p><strong>Conclusion: </strong>While PR seems to be an integral part of radiation therapy in Germany, its structure and implementation throughout centers need to be elucidated. While some aspects, such as pre-therapeutic PR, are well established in our cohort, gaps remain in the integration of multidisciplinary teams, structured documentation, and contouring reviews. Further discussions within the German RO community and the development of national recommendations could help to standardize PR processes and improve their efficiency and effectiveness.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"496-507"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}