Philipp Linde, Biney Pal Singh, Maria Neu, Johannes Gollrad, Martin Bischoff, Gustavo R Sarria, Annett Linge, Nanna E Wielenberg, Anna-Lena Hillebrecht, Laura Höng, Martin Leu, Jörg Andreas Müller, Lukas Fabian Boehme, Anne Caroline Knöchelmann, Jan-Niklas Becker, Klaus Herfarth, Sonia Drozdz, Matthias Mäurer, Ina Patties, Daniel Fleischmann, Daniel Schmottermeyer, Alexander Fabian, Bernd Frerker, Sebastian Heß, Michael Oertel, Hendrik Dapper
{"title":"Correction to: DEGRO consensus framework for undergraduate radiation therapy teaching in Germany: a white paper with integrated guidance on artificial intelligence in medical education.","authors":"Philipp Linde, Biney Pal Singh, Maria Neu, Johannes Gollrad, Martin Bischoff, Gustavo R Sarria, Annett Linge, Nanna E Wielenberg, Anna-Lena Hillebrecht, Laura Höng, Martin Leu, Jörg Andreas Müller, Lukas Fabian Boehme, Anne Caroline Knöchelmann, Jan-Niklas Becker, Klaus Herfarth, Sonia Drozdz, Matthias Mäurer, Ina Patties, Daniel Fleischmann, Daniel Schmottermeyer, Alexander Fabian, Bernd Frerker, Sebastian Heß, Michael Oertel, Hendrik Dapper","doi":"10.1007/s00066-026-02603-3","DOIUrl":"https://doi.org/10.1007/s00066-026-02603-3","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892391","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":"[Evolution of metastases in non-small-cell lung cancer: preliminary results from the TRACERx-PEACE study].","authors":"Jürgen Dunst","doi":"10.1007/s00066-026-02568-3","DOIUrl":"10.1007/s00066-026-02568-3","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"1001-1002"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340333","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}
Paul Jan Warnke, Eirini Moysolgou, Olaf Wittenstein
{"title":"[Pre- versus postoperative stereotactic radiotherapy for brain metastases].","authors":"Paul Jan Warnke, Eirini Moysolgou, Olaf Wittenstein","doi":"10.1007/s00066-026-02566-5","DOIUrl":"10.1007/s00066-026-02566-5","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"995-997"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593238","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}
Yen-Cho Huang, Shih-Ming Huang, Jih-Hsiang Yeh, Shu-Ju Tu
{"title":"Clinical target volume radiomics from planning CT for pretreatment response prediction in rectal cancer undergoing chemoradiotherapy.","authors":"Yen-Cho Huang, Shih-Ming Huang, Jih-Hsiang Yeh, Shu-Ju Tu","doi":"10.1007/s00066-026-02569-2","DOIUrl":"10.1007/s00066-026-02569-2","url":null,"abstract":"<p><strong>Purpose: </strong>Response to neoadjuvant chemoradiotherapy (nCRT) in rectal cancer remains heterogeneous. This exploratory study evaluated whether radiomics features extracted from the clinical target volume (CTV) on pretreatment non-contrast radiotherapy planning CT could provide additional information for pretreatment prediction of poor treatment response.</p><p><strong>Methods: </strong>This retrospective single-center study included 60 patients with rectal cancer treated with nCRT between 2008 and 2024, including 50 good responders and 10 poor responders. A total of 1148 radiomics features were extracted from the original pretreatment treatment-planning CTV and combined with clinical variables, including age, sex, cT stage, cN stage, log-transformed carcinoembryonic antigen, and tumor-to-anal verge distance. Models were internally evaluated using repeated nested cross-validation with fold-wise ComBat harmonization. Performance was assessed from pooled repeated out-of-fold predictions, including discrimination, apparent calibration, exploratory threshold-based operating characteristics, and decision curve analysis.</p><p><strong>Results: </strong>The best-performing combined clinical-radiomics model was Extra Trees, with an area under the receiver operating characteristic curve of 0.754 (95% confidence interval [CI], 0.713-0.789), compared with 0.507 for the clinical-only model. At a post hoc sensitivity-prioritized operating threshold, the combined Extra Trees model achieved sensitivity of 0.94 (95% CI, 0.89-0.98), specificity of 0.47 (95% CI, 0.42-0.51), and negative predictive value of 0.98 in pooled repeated out-of-fold analysis. Decision curve analysis suggested potential net benefit across low-to-moderate threshold probabilities in internal analysis.</p><p><strong>Conclusion: </strong>Clinical target volume-based radiomics from routine pretreatment non-contrast planning CT may provide exploratory information for prediction of poor response to nCRT in rectal cancer. Because treatment-planning CTVs are routinely generated before radiotherapy, this workflow may be practical for radiotherapy-based research. The findings are hypothesis generating and require external validation before clinical use.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"954-967"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148472906","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}
Carsten Nieder, Luka Stanisavljevic, Ellinor C Haukland, Bård Mannsåker, Bence Fajth, Astrid Dalhaug
{"title":"Individualized radiotherapy of bone metastases from prostate cancer: time trends and 5-year survival results.","authors":"Carsten Nieder, Luka Stanisavljevic, Ellinor C Haukland, Bård Mannsåker, Bence Fajth, Astrid Dalhaug","doi":"10.1007/s00066-026-02560-x","DOIUrl":"10.1007/s00066-026-02560-x","url":null,"abstract":"<p><strong>Purpose: </strong>This article describes a regional study performed in patients with bone metastases from prostate cancer hypothesizing that intensified radiotherapy (metastases directed and prostate directed) may result in longer overall survival.</p><p><strong>Methods: </strong>A retrospective study of 246 consecutive male patients who received 347 courses of radiotherapy in the time period 2011-2025 was performed. Patients were stratified into three cohorts spanning 5‑year intervals (2011-2015, 2016-2020, 2021-2025). Survival was analyzed in allcomers and separately in patients without visceral metastases treated within the first year after diagnosis (n = 119).</p><p><strong>Results: </strong>Median overall survival was shortest in the earliest phase of the study (2011-15). The two recent cohorts had similar survival. Outpatients with high performance status irradiated early after diagnosis and to all known sites of disease experienced superior survival. In the subgroup of 119 patients, simultaneous prostate radiotherapy prolonged survival (numerically better than no prostate RT, median 40 vs. 26 months, 5‑year rate 47 vs. 18%, p = 0.11). The impact of bone radiotherapy dose (dichotomized < 3 Gy × 13 or its biological equivalent vs. higher doses) was significant (if synchronous metastases, 5‑year rate 64 vs. 17%, p = 0.026; if metachronous metastases, 5‑year rate 48 vs. 8%, p < 0.001). Bone dose remained significant in multivariate analyses, together with clinical baseline parameters.</p><p><strong>Conclusion: </strong>In our healthcare region, outcomes largely resemble those of prospective trials. Comprehensive radiotherapy to the prostate and bone oligometastases plus guideline-based systemic therapy resulted in favorable 5‑year survival.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"944-953"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319005","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}
A-C Müller, D M Aebersold, C Albrecht, D Boehmer, U Ganswindt, N-S Schmidt-Hegemann, S Höcht, E Hoffmann, T Hölscher, S A Koerber, P Niehoff, J C Peeken, M Pinkawa, B Polat, M Shelan, S K B Spohn, F Wolf, C Zamboglou, D Zips, T Wiegel
{"title":"Ultrahypofractionation of localized prostate cancer-an updated statement of the prostate cancer working group of the German Society of Radiation Oncology (DEGRO).","authors":"A-C Müller, D M Aebersold, C Albrecht, D Boehmer, U Ganswindt, N-S Schmidt-Hegemann, S Höcht, E Hoffmann, T Hölscher, S A Koerber, P Niehoff, J C Peeken, M Pinkawa, B Polat, M Shelan, S K B Spohn, F Wolf, C Zamboglou, D Zips, T Wiegel","doi":"10.1007/s00066-026-02564-7","DOIUrl":"10.1007/s00066-026-02564-7","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer (PCa) is the most frequently diagnosed malignancy among men in Germany. Radiation therapy is a standard treatment for localized PCa. Ultrahypofractionation (UHF) delivers high doses in fewer fractions, thus offering a time-efficient option compared to traditional standard fractionation lasting for 7-8 weeks. The German Society of Radiation Oncology (DEGRO) expert panel statement provides an updated evaluation of randomized trials with at least 5 years of follow-up.</p><p><strong>Methods: </strong>The members of the DEGRO PCa working group performed a literature search for randomized trials of UHF for localized prostate cancer in March 2025. The analysis included phase III randomized trials with at least 5 years of follow-up: HYPO-RT-PC, PACE‑B, and a proton therapy trial.</p><p><strong>Results: </strong>All trials demonstrated noninferiority of UHF radiotherapy in maintaining disease control. The HYPO-RT-PC trial reported a 5‑year failure-free survival rate of 84% in both treatment groups and PACE‑B reported noninferiority with a 95.8% rate in the SBRT group compared to 94.6% in the control group. Acute urinary and bowel toxicities were more pronounced in UHF arms but resolved over time. Late urinary toxicity was significantly higher in SBRT patients (26.9% vs. 18.3%, p < 0.001, PACE-B). Proton SBRT showed slightly increased toxicity measured by sexual and urinary EPIC.</p><p><strong>Conclusion: </strong>Ultrahypofractionation represents an effective alternative to conventional fractionation in low- to intermediate-risk PCa with similar oncologic outcomes. However, physicians should inform their patients-particularly those with suboptimal urinary function-about an increased risk for GU toxicity.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"911-920"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424322","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":"Deep learning-based prediction of interfractional anatomic variations in prostate cancer radiotherapy.","authors":"Javad Derougar, Ahmad Mostaar, Reza Jaferyan","doi":"10.1007/s00066-026-02509-0","DOIUrl":"10.1007/s00066-026-02509-0","url":null,"abstract":"<p><strong>Purpose: </strong>Interfractional prostate displacement challenges the accuracy of the delivered dose during radiotherapy treatment. Variation in bladder volume is a key driver of this movement. A deep learning (DL) model was developed to predict daily megavoltage computed tomography (MVCT) based on bladder volume and treatment fraction, enabling patient-specific anatomic estimation in prostate radiotherapy.</p><p><strong>Methods: </strong>This retrospective study analyzed 700 MVCT scans from prostate cancer patients treated with tomotherapy. The bladder was manually contoured on all MVCT scans, and its volume was calculated. A customized three-dimensional (3D) U‑Net model was trained to generate synthetic MVCT images using the kilovoltage computed tomography (KVCT), bladder volume, and fraction number as inputs. The model's performance was evaluated with data from 84 held-out MVCTs, using image similarity metrics including structural similarity index (SSIM), normalized cross-correlation (NCC), Dice similarity coefficient (Dice), mean absolute error (MAE), and mean squared error (MSE). Additionally, anatomic accuracy was assessed for bladder and prostate contours, applying the Dice similarity and MSD.</p><p><strong>Results: </strong>The model demonstrated accurate MVCT predictions, evidenced by a mean SSIM ranging from 0.76 to 0.80, NCC from 0.84 to 0.89, a Dice of 0.97, and MAE and MSE values between 0.05 and 0.06 and 0.010 and 0.014, respectively. The predicted anatomy enabled bladder contouring with a mean Dice of 0.83 and mean surface distance (MSD) of 1.64 mm and prostate contouring with a mean Dice of 0.92 and MSD of 0.48 mm. Changes in bladder volume showed moderate correlation with bladder Dice, with a correlation coefficient (r = -0.50), and with MSD (r = 0.64), while the prostate contour metrics exhibited weak correlations.</p><p><strong>Conclusion: </strong>The proposed deep learning (DL) framework demonstrated promising capabilities for anatomic prediction and contour generation using noninvasive input features. Within the context of helical radiotherapy delivered on a Radixact X9 system (Accuray Inc., Madison, WI, USA), where daily MVCT acquisition is standard practice, this approach provides a patient-specific method for estimating the anatomic configuration on the day of treatment based on the planning KVCT and bladder volume information.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"930-943"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214310","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}
Anne-Marie Lüchtenborg, Jörg Sahlmann, Kristin Technau-Hafsi, Natalia Volegova-Neher, Beate Rautenberg, Peter Vaupel, Anca-L Grosu, Andreas R Thomsen
{"title":"Management of skin metastases of ovarian cancer: a novel therapeutic approach.","authors":"Anne-Marie Lüchtenborg, Jörg Sahlmann, Kristin Technau-Hafsi, Natalia Volegova-Neher, Beate Rautenberg, Peter Vaupel, Anca-L Grosu, Andreas R Thomsen","doi":"10.1007/s00066-026-02546-9","DOIUrl":"10.1007/s00066-026-02546-9","url":null,"abstract":"<p><strong>Purpose: </strong>Ovarian cancer, one of the most lethal gynecological cancers, metastasizes into skin in 0.9%-5.8% of cases. Cutaneous metastases severely affect the quality of life of ovarian cancer patients. Although cutaneous metastases are rare, a therapeutic option for affected patients is needed. Herein, we present a combination therapy comprising radiation and mild hyperthermia with parallel chemotherapy as a treatment modality.</p><p><strong>Case: </strong>A woman with extensive skin metastases of a high-grade, serous ovarian carcinoma on the thigh was treated with a combination of mild hyperthermia (39-43 °C) immediately followed by low-dose hypofractionated radiotherapy and parallel systemic treatment with carboplatin/gemcitabine. Mild hyperthermia, a strong radiosensitizer, was induced through water-filtered infrared A radiation (wIRA).</p><p><strong>Results: </strong>The patient responded well and remained tumor free in the treatment area for more than 1 year.</p><p><strong>Conclusion: </strong>Radiotherapy combined with mild hyperthermia in addition to systemic treatment allows for tumor control in the treated area, even with a reduced total radiation dose. To the best of our knowledge, this is the first report of a long-term tumor-free situation in the treatment area of skin metastases of ovarian cancer. This novel treatment might also be beneficial for skin metastases from other malignancies.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"986-989"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147933863","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":"Outcomes and PSA kinetics after Magnetic Resonance Image-Guided Stereotactic Body Radiotherapy (MRgSBRT) for prostate cancer.","authors":"Ceren Atahan, Gamze Ugurluer, Gorkem Gungor, Neris Dincer, Edanur Celebi, Alper Gul, Banu Atalar, Meric Sengoz, Ufuk Abacioglu, Ali Riza Kural, Enis Ozyar","doi":"10.1007/s00066-026-02507-2","DOIUrl":"10.1007/s00066-026-02507-2","url":null,"abstract":"<p><strong>Purpose: </strong>Magnetic resonance-guided stereotactic body radiotherapy (MRgSBRT) combines high-precision SBRT with superior soft tissue visualization and daily adaptive planning. While prospective studies suggest reduced toxicity compared to CT-based SBRT, data on oncologic outcomes and PSA kinetics in the MR-guided setting remain limited.</p><p><strong>Methods: </strong>We retrospectively reviewed 150 prostate cancer patients treated with MRgSBRT (ViewRay MRIdian) between September 2018 and April 2024. Patients received 36.25 Gy radiotherapy in 5 fractions with or without androgen deprivation therapy (ADT). Outcomes included biochemical recurrence free survival (bRFS), local progression free survival (LPFS), regional recurrence free survival (RRFS), distant metastases free survival (DMFS), event-free survival (EFS), PSA kinetics, and toxicity (CTCAE v5.0).</p><p><strong>Results: </strong>The median follow-up was 27.2 months (range: 4-73 months). The estimated 5‑year bRFS, LPFS, RRFS, DMFS and EFS rates were 81.8%, 91.4%, 99.2%, 98.3% and 77.3% respectively. All patients were alive at the time of analysis. The estimated EFS was lowest for the very high-risk group (2-year EFS: 55.6%). The median time to nadir PSA (nPSA) was 12 months (range: 3-54 months), with a median value of 0.46 ng/mL, for all cohort. PSA bounce occurred in 15.3% of patients and was associated with numerically higher 5‑year EFS (95% vs. 73.8%). No acute or late grade ≥ 3 GU or GI toxicities were observed.</p><p><strong>Conclusion: </strong>MRgSBRT for localized prostate cancer provides favorable tumor control with minimal toxicity. Although not statistically significant, PSA bounce was associated with improved outcomes, warranting further investigation as a potential prognostic marker.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"921-929"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107246","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}
V Lancellotta, A P Solazzo, B Fionda, G Garganese, S M Fragomeni, A Federico, M C La Milia, P Dragonetti, E Rosa, L Bannoni, M De Angeli, S Russi, S Laurino, A G Morganti, R P De Vincenzo, G Macchia, M A Gambacorta, R Iezzi, L Tagliaferri
{"title":"Image-guided interventional radiotherapy (modern brachytherapy) for treatment of vaginal intraepithelial neoplasia: single-institution experience and systematic literature review and meta-analysis.","authors":"V Lancellotta, A P Solazzo, B Fionda, G Garganese, S M Fragomeni, A Federico, M C La Milia, P Dragonetti, E Rosa, L Bannoni, M De Angeli, S Russi, S Laurino, A G Morganti, R P De Vincenzo, G Macchia, M A Gambacorta, R Iezzi, L Tagliaferri","doi":"10.1007/s00066-026-02549-6","DOIUrl":"10.1007/s00066-026-02549-6","url":null,"abstract":"<p><strong>Purpose: </strong>Vaginal intraepithelial neoplasia (VaIN) is a rare condition that poses diagnostic and management challenges and carries a significant risk of progression to invasive cancer. Image-guided interventional radiotherapy (IG-IRT, modern brachytherapy) has a high overall success rate, but it is usually reserved for poor surgical candidates and those with multifocal disease or failed prior treatments. This study evaluates the efficacy and safety of IG-IRT in high-grade VaIN by combining a retrospective institutional case series with a systematic review of the available literature.</p><p><strong>Methods: </strong>We retrospectively analyzed patients with VaIN3 who received IG-IRT with curative intent between January 2019 and May 2025. The OncentraBrachy treatment planning system and a Flexitron (Elekta, Stockholm, Sweden) afterloading machine with a 192-Ir source were used for IG-IRT. The IG-IRT total dose was 40 Gy over eight high-dose-rate (HDR) fractions to achieve 60 Gy equivalent dose in 2‑Gy fractions (EQD2α/β10) to the clinical target volume (CTV). The exact vaginal target was decided based on the site and the number of lesions. Primary study endpoint was local control (LC); secondary endpoints included the rate and severity of acute and late treatment-related toxicity. A systematic review of the literature was conducted according to the PRISMA guidelines to contextualize institutional outcomes within the existing evidence.</p><p><strong>Results: </strong>A total of 10 patients with high-grade VaIN who were naïve to prior radiotherapy were included in this study. The median follow-up duration was 17 months (7-70 months). The 1‑year actuarial LC and overall survival (OS) rates were 100%. No acute side effects were recorded, while late G2 toxicity (vaginal stenosis 1 and atrophy 4) occurred in four patients. Findings from the systematic review were consistent with the institutional results, supporting high rates of local control and an acceptable toxicity profile with IG-IRT in selected patients.</p><p><strong>Conclusion: </strong>By integrating institutional experience with a systematic review of the literature, this study supports IG-IRT as an effective and safe definitive treatment option for high-grade VaIN, achieving excellent LC with acceptable toxicity. This combined approach provides a more robust framework for clinical decision-making in a rare disease setting.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"976-985"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148035375","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}