Strahlentherapie und Onkologie最新文献

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Automated contouring for breast cancer radiotherapy in the isocentric lateral decubitus position: a neural network-based solution for enhanced precision and efficiency. 等心侧卧位的乳腺癌放疗自动轮廓:基于神经网络的提高精度和效率的解决方案。
IF 2.7 3区 医学
Strahlentherapie und Onkologie Pub Date : 2025-06-01 Epub Date: 2025-02-03 DOI: 10.1007/s00066-024-02364-x
Pierre Loap, Rémi Monteil, Youlia Kirova, Jérémi Vu-Bezin
{"title":"Automated contouring for breast cancer radiotherapy in the isocentric lateral decubitus position: a neural network-based solution for enhanced precision and efficiency.","authors":"Pierre Loap, Rémi Monteil, Youlia Kirova, Jérémi Vu-Bezin","doi":"10.1007/s00066-024-02364-x","DOIUrl":"10.1007/s00066-024-02364-x","url":null,"abstract":"<p><strong>Background: </strong>Adjuvant radiotherapy is essential for reducing local recurrence and improving survival in breast cancer patients, but it carries a risk of ischemic cardiac toxicity, which increases with heart exposure. The isocentric lateral decubitus position, where the breast rests flat on a support, reduces heart exposure and leads to delivery of a more uniform dose. This position is particularly beneficial for patients with unique anatomies, such as those with pectus excavatum or larger breast sizes. While artificial intelligence (AI) algorithms for autocontouring have shown promise, they have not been tailored to this specific position. This study aimed to develop and evaluate a neural network-based autocontouring algorithm for patients treated in the isocentric lateral decubitus position.</p><p><strong>Materials and methods: </strong>In this single-center study, 1189 breast cancer patients treated after breast-conserving surgery were included. Their simulation CT scans (1209 scans) were used to train and validate a neural network-based autocontouring algorithm (nnU-Net). Of these, 1087 scans were used for training, and 122 scans were reserved for validation. The algorithm's performance was assessed using the Dice similarity coefficient (DSC) to compare the automatically delineated volumes with manual contours. A clinical evaluation of the algorithm was performed on 30 additional patients, with contours rated by two expert radiation oncologists.</p><p><strong>Results: </strong>The neural network-based algorithm achieved a segmentation time of approximately 4 min, compared to 20 min for manual segmentation. The DSC values for the validation cohort were 0.88 for the treated breast, 0.90 for the heart, 0.98 for the right lung, and 0.97 for the left lung. In the clinical evaluation, 90% of the automatically contoured breast volumes were rated as acceptable without corrections, while the remaining 10% required minor adjustments. All lung contours were accepted without corrections, and heart contours were rated as acceptable in 93.3% of cases, with minor corrections needed in 6.6% of cases.</p><p><strong>Conclusion: </strong>This neural network-based autocontouring algorithm offers a practical, time-saving solution for breast cancer radiotherapy planning in the isocentric lateral decubitus position. Its strong geometric performance, clinical acceptability, and significant time efficiency make it a valuable tool for modern radiotherapy practices, particularly in high-volume centers.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"601-605"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123701","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}
引用次数: 0
State-of-the-art application of nanoparticles in radiotherapy: a platform for synergistic effects in cancer treatment. 纳米粒子在放射治疗中的最新应用:癌症治疗的协同效应平台。
IF 2.7 3区 医学
Strahlentherapie und Onkologie Pub Date : 2025-06-01 Epub Date: 2024-10-04 DOI: 10.1007/s00066-024-02301-y
Mehrnaz Mostafavi, Farhood Ghazi, Mahboobeh Mehrabifard, Vahid Alivirdiloo, Mobasher Hajiabbasi, Fatemeh Rahimi, Ahmad Mobed, Gholamreza Taheripak, Marzieh Ramezani Farani, Yun Suk Huh, Salar Bakhtiyari, Iraj Alipourfard
{"title":"State-of-the-art application of nanoparticles in radiotherapy: a platform for synergistic effects in cancer treatment.","authors":"Mehrnaz Mostafavi, Farhood Ghazi, Mahboobeh Mehrabifard, Vahid Alivirdiloo, Mobasher Hajiabbasi, Fatemeh Rahimi, Ahmad Mobed, Gholamreza Taheripak, Marzieh Ramezani Farani, Yun Suk Huh, Salar Bakhtiyari, Iraj Alipourfard","doi":"10.1007/s00066-024-02301-y","DOIUrl":"10.1007/s00066-024-02301-y","url":null,"abstract":"<p><p>Radiotherapy (RT) is a gold standard cancer treatment worldwide. However, RT has limitations and many side effects. Nanoparticles (NPs) have exclusive properties that allow them to be used in cancer therapy. Consequently, the combination of NP and RT opens up a new frontier in cancer treatment. Among NPs, gold nanoparticles (GNPs) are the most extensively studied and are considered ideal radiosensitizers for radiotherapy due to their unique physicochemical properties and high X‑ray absorption. This review analyzes the various roles of NPs as radiosensitizers in radiotherapy of glioblastoma (GBS), prostate cancer, and breast cancer and summarizes recent advances. Furthermore, the underlying mechanisms of NP radiosensitization, including physical, chemical, and biological mechanisms, are discussed, which may provide new directions for next-generation GNP optimization and clinical transformation.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"577-588"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12119707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376047","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}
引用次数: 0
[The EMBARK trial: The use of enzalutamide in biochemically recurrent prostate cancer after primary therapy]. 【EMBARK试验:恩杂鲁胺用于原发性治疗后生化复发的前列腺癌】。
IF 2.7 3区 医学
Strahlentherapie und Onkologie Pub Date : 2025-06-01 Epub Date: 2025-02-21 DOI: 10.1007/s00066-025-02371-6
Mohamed Shelan, Etienne Mathier, Daniel M Aebersold, Thomas Wiegel
{"title":"[The EMBARK trial: The use of enzalutamide in biochemically recurrent prostate cancer after primary therapy].","authors":"Mohamed Shelan, Etienne Mathier, Daniel M Aebersold, Thomas Wiegel","doi":"10.1007/s00066-025-02371-6","DOIUrl":"10.1007/s00066-025-02371-6","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"666-668"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469334","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}
引用次数: 0
Ampelopsis japonica enhances the effect of radiotherapy in non-small cell lung cancer. 参藤增强非小细胞肺癌放疗效果。
IF 2.7 3区 医学
Strahlentherapie und Onkologie Pub Date : 2025-06-01 Epub Date: 2024-12-04 DOI: 10.1007/s00066-024-02322-7
Zhaohua Liu, Peixia Cui, Qian Wu, Xiao Ji
{"title":"Ampelopsis japonica enhances the effect of radiotherapy in non-small cell lung cancer.","authors":"Zhaohua Liu, Peixia Cui, Qian Wu, Xiao Ji","doi":"10.1007/s00066-024-02322-7","DOIUrl":"10.1007/s00066-024-02322-7","url":null,"abstract":"<p><strong>Background: </strong>Radiotherapy is widely used in the clinical treatment of non-small cell lung cancer (NSCLC); however, its effectiveness often proves unsatisfactory. Ampelopsis japonica (AJ) is a traditional Chinese herb with anti-inflammatory and anticancer activities. However, whether AJ could enhance the effect of radiotherapy in NSCLC needs to be further explored.</p><p><strong>Methods: </strong>In vivo, BALB/c nude mice were used for a xenograft tumor model to explore whether AJ could enhance the effect of radiation therapy (RT) in NSCLC. In vitro, human NSCLC cell lines HCC827 and H1299 were used to explore the effect of AJ on the cell proliferation and apoptosis of RT-treated NSCLC. Moreover, bioinformatic analysis was performed to analyze the signaling pathways regulated by AJ.</p><p><strong>Results: </strong>Ampelopsis japonica enhanced the inhibitory effect of RT on NSCLC tumor growth in vivo. Simultaneously, AJ further enhanced the inhibitory effect of RT on NSCLC proliferation and the promoting effect of RT on NSCLC apoptosis. Bioinformatic analysis showed that AJ regulated the PI3K-Akt signaling pathway. We confirmed that AJ decreased the protein levels of the PI3K-Akt signaling pathway. Furthermore, the combination of AJ and RT suppressed activation of the PI3K-Akt signaling pathway.</p><p><strong>Conclusion: </strong>Ampelopsis japonica augmented the inhibitory impact of RT on NSCLC cell proliferation and tumor growth by suppressing the PI3K-Akt signaling pathway.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"627-636"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12119655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772486","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}
引用次数: 0
Change in the serum selenium level of patients with non-metastatic and metastatic non-small cell lung cancer (NSCLC) during radiotherapy as a predictive factor for survival. 非转移性和转移性非小细胞肺癌(NSCLC)患者在放疗期间血清硒水平的变化作为生存期的预测因素。
IF 2.7 3区 医学
Strahlentherapie und Onkologie Pub Date : 2025-06-01 Epub Date: 2024-09-06 DOI: 10.1007/s00066-024-02276-w
Julia Ohlinger, Dirk Vordermark, Christian Ostheimer, Matthias Bache, Therese Tzschoppe, Kamil Demircan, Lutz Schomburg, Daniel Medenwald, Barbara Seliger
{"title":"Change in the serum selenium level of patients with non-metastatic and metastatic non-small cell lung cancer (NSCLC) during radiotherapy as a predictive factor for survival.","authors":"Julia Ohlinger, Dirk Vordermark, Christian Ostheimer, Matthias Bache, Therese Tzschoppe, Kamil Demircan, Lutz Schomburg, Daniel Medenwald, Barbara Seliger","doi":"10.1007/s00066-024-02276-w","DOIUrl":"10.1007/s00066-024-02276-w","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer remains a serious medical problem. The trace element selenium seems to be a promising prognostic marker or therapeutic option for cancer patients.</p><p><strong>Methods: </strong>We enrolled 99 patients with histologically confirmed NSCLC undergoing radiotherapy. The serum selenium level of these patients was determined prior to irradiation (t0), after reaching 20 Gy (t1), and at the end of radiotherapy (t2). Selenium concentrations were measured with total-reflection X‑ray fluorescence (TXRF) spectroscopy. We formed three subgroups according to the change in serum selenium levels across timepoints, and Kaplan-Meier analysis was used to estimate overall survival (OS). Further subgroups were patients with/without metastatic disease. We used adjusted Cox regression models.</p><p><strong>Results: </strong>The change in selenium concentration was especially significant between t0 and t1 for the whole study group (hazard ratio [HR] = 0.5, p = 0.03) as well as in patients with metastasized NSCLC (HR = 0.3, p = 0.04) after adjustment. The baseline selenium value in patients with non-metastasized NSCLC was associated with overall survival (HR = 0.3, p = 0.04). The change in selenium levels between t0 and t2 was significant in patients with metastatic lung cancer (HR = 0.1, p = 0.03). Patients with increased serum selenium levels during radiotherapy between the start of treatment (t0) and t1 had better OS (HR = 0.46, p = 0.05).</p><p><strong>Conclusion: </strong>Especially patients with increasing selenium levels during radiotherapy showed an improved overall survival. Thus, serum selenium might be a predictive factor for OS in NSCLC patients. The value of supplementation of the trace element is subject to future research.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"616-626"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12119749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141104","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}
引用次数: 0
Efficacy and toxicity of stereotactic radiotherapy combined with third-generation EGFR-TKIs and immunotherapy in patients with brain metastases from non-small cell lung cancer. 立体定向放疗联合第三代EGFR-TKIs和免疫治疗对非小细胞肺癌脑转移患者的疗效和毒性
IF 2.7 3区 医学
Strahlentherapie und Onkologie Pub Date : 2025-06-01 Epub Date: 2025-02-26 DOI: 10.1007/s00066-024-02360-1
Xiaoxuan Tao, Qichang Gao, Yiyang Chen, Nannan Cai, Chuncheng Hao
{"title":"Efficacy and toxicity of stereotactic radiotherapy combined with third-generation EGFR-TKIs and immunotherapy in patients with brain metastases from non-small cell lung cancer.","authors":"Xiaoxuan Tao, Qichang Gao, Yiyang Chen, Nannan Cai, Chuncheng Hao","doi":"10.1007/s00066-024-02360-1","DOIUrl":"10.1007/s00066-024-02360-1","url":null,"abstract":"<p><strong>Objective: </strong>Stereotactic radiotherapy (SRT) is fast gaining attention as a preferred treatment alternative for patients with brain metastases (BM) from non-small cell lung cancer (NSCLC). In this study, we examined the efficacy and safety of combining SRT with immunotherapy (IT) and targeted therapy (TT), either separately or concurrently with the aim to formulate an optimal therapeutic regimen for patients with NSCLC BM.</p><p><strong>Methods: </strong>The combination therapy were comprised of IT and TT agents. For the SRT-combined TT agents group, TT was limited to third-generation EGFR-TKIs. The administration of these drugs within 30 days before or after SRT was defined as combination therapy. The primary endpoint was 1-year progression-free survival (PFS), which was evaluated by a blinded independent review committee and categorized into local recurrence at the radiation site and the emergence of new distant intracranial metastases. Secondary endpoints included confirmed intracranial objective response rate (IORR) and intracranial disease control rate in the overall population. Post-treatment grading was performed according to CTCAE, and the levels of radiation necrosis were differentiated.</p><p><strong>Results: </strong>The 266 patients with NSCLC BM were categorized into the following four groups based on their treatment methods: SRT alone, SRT combined with IT, SRT combined with third-generation EGFR-TKIs, and SRT combined with both IT and TT. For the local radiation range, the 1‑year PFS of these four groups were 77.89% (P = 0.239), 88.75% (P = 0.266), 88.01% (P = 0.210), and 91.97% (P = 0.057), respectively. For new intracranial metastases outside of the radiotherapy site, the corresponding values were 63.96% (P = 0.039), 74.17% (P = 0.258), 88.70% (P = 0.024), and 87.81% (P = 0.015), respectively. By the end of the study period, the IORR increased from 32% with SRT alone to 46% in the IT group, 58% in the TT group, and 61% in the SRT combined with both the IT and TT groups. However, the group that received SRT in combination with IT and TT exhibited a higher occurrence rate of grade 3 adverse events, and a statistically significant difference was observed in grade 3 radiation necrosis.</p><p><strong>Conclusion: </strong>For NSCLC BM, IT, TT, or both together with SRT increased the distant intracranial tumor control. Nonetheless, combining SRT with both IT and TT increased the occurrence rate of acute adverse events. Thus, while SRT provided good local control independently, the incidence of symptomatic RN was low.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"645-655"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12119770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504239","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}
引用次数: 0
MR-guided online adaptive stereotactic body radiotherapy (MRgSBRT) of primary lung tumors and lung oligometastases. 磁共振引导的在线自适应立体定向放射治疗(MRgSBRT)原发性肺肿瘤和肺少转移。
IF 2.7 3区 医学
Strahlentherapie und Onkologie Pub Date : 2025-06-01 Epub Date: 2024-12-02 DOI: 10.1007/s00066-024-02328-1
Gamze Ugurluer, Neris Dincer, Teuta Zoto Mustafayev, Gorkem Gungor, Mehmet Ufuk Abacioglu, Meric Sengoz, Enis Ozyar, Banu Atalar
{"title":"MR-guided online adaptive stereotactic body radiotherapy (MRgSBRT) of primary lung tumors and lung oligometastases.","authors":"Gamze Ugurluer, Neris Dincer, Teuta Zoto Mustafayev, Gorkem Gungor, Mehmet Ufuk Abacioglu, Meric Sengoz, Enis Ozyar, Banu Atalar","doi":"10.1007/s00066-024-02328-1","DOIUrl":"10.1007/s00066-024-02328-1","url":null,"abstract":"<p><strong>Purpose: </strong>Stereotactic body radiotherapy is pivotal in the treatment of lung tumors, demonstrating effective local control. However, challenges persist with intra-fractional anatomical changes and organs at risk during delivery. Magnetic resonance-guided online adaptive stereotactic body radiotherapy (MRgSBRT) represents a novel technique promising to achieve safe delivery of ablative doses with improved outcomes for primary lung tumors or lung oligometastases.</p><p><strong>Methods: </strong>In this single-institution retrospective analysis, we evaluated 64 patients (92 lesions) with primary lung cancer or lung oligometastases treated with MRgSBRT. Using Kaplan-Meier method and log-rank test; we estimated local control (LC), local progression-free survival (LPFS), distant progression-free survival (DPFS), and overall survival (OS).</p><p><strong>Results: </strong>A total of 64 patients (92 lesions) treated with MRgSBRT were included comprising 14.1% primary lung cancer lesions and 85.9% lung oligometastases. Median total dose, fraction number, fraction dose and BED<sub>10</sub> were 50 Gy (range, 21-70 Gy), 5 (range, 1-10), 10 Gy (range, 6-34 Gy), 100 Gy (range, 48-180.0 Gy) respectively. Of the 420 fractions administered, 88.6% (n = 372) involved on-table adapted plans. Median LPFS was not reached and the 1‑ and 3‑year LPFS rates were 96.3% (95% CI 92.4-100.0%) and 86.4% (95% CI 76.9-95.9%), respectively. No local recurrences were observed post-treatment with a total dose of > 50 Gy, BED10 > 100 Gy, fractional dose of > 10 Gy or a CCI > 0.96.</p><p><strong>Conclusion: </strong>Our study of MRgSBRT in 92 lung lesions revealed a 1-year and 3‑year LPFS rates of 96.3 and 86.4%, respectively without ≥ grade 3 toxicity. Future prospective studies evaluating lung MRgSBRT are awaited.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"637-644"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772490","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}
引用次数: 0
De-escalation strategies in early breast cancer: implications of sentinel lymph node biopsy omission for adjuvant radiotherapy. 早期乳腺癌的降级策略:前哨淋巴结活检遗漏辅助放疗的意义。
IF 2.7 3区 医学
Strahlentherapie und Onkologie Pub Date : 2025-06-01 Epub Date: 2025-04-16 DOI: 10.1007/s00066-025-02391-2
K J Borm, J Hörner-Rieber, N M Duma, W Budach, M D Piroth, D Krug
{"title":"De-escalation strategies in early breast cancer: implications of sentinel lymph node biopsy omission for adjuvant radiotherapy.","authors":"K J Borm, J Hörner-Rieber, N M Duma, W Budach, M D Piroth, D Krug","doi":"10.1007/s00066-025-02391-2","DOIUrl":"10.1007/s00066-025-02391-2","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"573-576"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12119702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049346","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}
引用次数: 0
Radiotherapy in breast cancer brain metastases: the impact of time interval and disease dynamics when breast cancer seeds to the brain. 乳腺癌脑转移的放疗:乳腺癌播散到大脑时的时间间隔和疾病动态的影响。
IF 2.7 3区 医学
Strahlentherapie und Onkologie Pub Date : 2025-06-01 Epub Date: 2025-03-07 DOI: 10.1007/s00066-025-02378-z
Katharina Hintelmann, Schohla Wahaj, Marvin Henze, Elena Laakmann, Volkmar Müller, David Krug, Tobias Gauer, Cordula Petersen
{"title":"Radiotherapy in breast cancer brain metastases: the impact of time interval and disease dynamics when breast cancer seeds to the brain.","authors":"Katharina Hintelmann, Schohla Wahaj, Marvin Henze, Elena Laakmann, Volkmar Müller, David Krug, Tobias Gauer, Cordula Petersen","doi":"10.1007/s00066-025-02378-z","DOIUrl":"10.1007/s00066-025-02378-z","url":null,"abstract":"<p><strong>Purpose: </strong>The initial brain metastasis velocity (iBMV) is a prognostic metric introduced for patients receiving stereotactic radiosurgery (SRS) for brain metastases (BM), reflecting intracranial disease dynamics. This study aimed to assess the applicability of iBMV in a mixed cohort of breast cancer brain metastases (BCBM) patients treated with SRS/fractionated stereotactic radiotherapy (FSRT) and whole-brain radiotherapy (WBRT). Considering disease dynamics, we analyzed the role of biological subtypes in determining the time interval between initial diagnosis and the occurrence of BM.</p><p><strong>Methods: </strong>We conducted a retrospective, single center cohort study of 126 BCBM patients who received radiotherapy to the brain (SRS/FSRT and WBRT) between 01/2013 and 12/2020. Statistical endpoints included iBMV, time interval between initial diagnosis and the occurrence of BM analyzed per biological subtype, and overall survival (OS).</p><p><strong>Results: </strong>Median iBMV was 0.48 BM/year. The iBMV independently predicted for mortality in the multivariate model after accounting for WBRT (hazard ratio [HR] = 1.21; 95% confidence interval [CI] 1.04-1.41; p = 0.012). The biologic subtype significantly influenced the time interval between initial diagnosis of breast cancer and occurrence of BM. In a multivariate model, the Karnofsky performance status and HER2 status were strongest predictors of overall survival (HR = 2.60; 95% CI 1.60-4.22; p < 0.001 and HR = 2.26; 95% CI 1.34-3.84; p = 0.002, respectively).</p><p><strong>Conclusion: </strong>iBMV correlates with overall survival, regardless of whether WBRT was used as part of local treatment. The biological subtype has a profound impact on prognosis and kinetics of BCBM.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"606-615"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12119732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573979","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}
引用次数: 0
High radiation dose in chemoradiotherapy followed by immunotherapy with durvalumab in patients with stage III non-small cell lung cancer does not increase risk for pneumonitis. 在III期非小细胞肺癌患者中,高剂量放化疗后使用杜伐单抗进行免疫治疗不会增加肺炎的风险。
IF 2.7 3区 医学
Strahlentherapie und Onkologie Pub Date : 2025-06-01 Epub Date: 2025-02-13 DOI: 10.1007/s00066-025-02369-0
Felix Schragel, Melanie Matousek, Christoph Resl, Gudrun Kreye, Nguyen-Son Le, Peter Errhalt, Petra Georg, Klaus Hackner
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